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15 October 2026, Volume 23 Issue 10 Previous Issue   

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Volume 23, Issue 10 Table of Contents 2026, 23(10): 0-0.  Abstract ( 37 )   PDF (534KB) ( 24 )   Related Articles | Metrics

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Research progress in drug therapy for primary central nervous system lymphoma Gao Lei, Zhang Min, Ren Xiaohui, Liu Qian 2026, 23(10): 1081-1085.  DOI: 10.19803/j.1672-8629.20260016 Abstract ( 25 )   PDF (1806KB) ( 22 )   Objective To summarize the current drug therapies for and research progress in treatment strategies for primary central nervous system lymphoma (PCNSL) so as to provide a reference for the safe and rational clinical use of drugs. Methods The mechanism of action, clinical efficacy, and safety of PCNSL therapeutic drugs were analyzed. By focusing on the challenges posed by the blood-brain barrier (BBB) and tumor heterogeneity, this study elaborated the current clinical applications based on the latest literature. Results Chemotherapy regimens that revolved around on high-dose methotrexate (HD-MTX) were the basic approaches to PCNSL. This drug could improve the prognosis of patients by crossing the blood-brain barrier. However, single-drug use had both limitations in efficacy and toxic side effects. Therefore, combined therapy (such as combination with other chemotherapeutic drugs, radiotherapy or targeted therapy) became the mainstream one, which could enhance the tumor-killing effect and prolong the progression-free survival (PFS) of patients. Targeted therapy (e.g., Bruton’s tyrosine kinase inhibitor, BTKi) and immunotherapy opened up new avenues for PCNSL treatment, which were particularly effective for relapsed or refractory PCNSL cases. They could not only increase clinical treatment options, but also mitigate the resistance to traditional chemotherapy. As a breakthrough precision immunotherapy technology, chimeric antigen receptor T-cell (CAR-T) therapy was capable of precise killing of tumor cells by modifying the patient’s autologous immune cells, and showed significant efficacy in some patients with refractory PCNSL. Conclusion Drug therapy for PCNSL is under rapid development. The multimodal treatment strategy combining traditional chemotherapy with emerging targeted therapy and immunotherapy provides a new line of thought for improving the prognosis of PCNSL patients. References | Related Articles | Metrics

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A cell-based study on the efficacy of lenalidomide combined with zanubrutinib against central nervous system lymphoma Liu Dan, Gao Lei, Zhang Min, Ren Xiaohui, Liu Qian 2026, 23(10): 1086-1091.  DOI: 10.19803/j.1672-8629.20260208 Abstract ( 24 )   PDF (2230KB) ( 20 )   Objective To explore the combined effects of lenalidomide and zanubrutinib on the viability, apoptosis, proliferation, and cycle of OCI-Ly10 cells. Methods The CCK-8 method was used to observe the inhibitory effects of 50 μmol·L-1 lenalidomide, 0.312 5 μmol·L-1 zanubrutinib (monotherapy group), 50 μmol·L-1 lenalidomide in combination with 0.312 5 μmol·L-1 zanubrutinib (combination group), and 20、40、80、160、320 μmol·L-1 methotrexate (MTX) on OCI-Ly10 cells. Annexin V-FITC&PI staining was used to detect the effects on the apoptosis of OCI-Ly10 cells in the monotherapy groups and the combination group. 5-ethynyl-2′-deoxyuridine (EdU) staining was adopted to observe the effects on the proliferation of OCI-Ly10 cells in these groups. PI staining was employed to evaluate the effects on the cycle of OCI-Ly10 cells in these groups. Results Lenalidomide (50 μmol·L-1) and zanubrutinib (0.312 5 μmol·L-1) exerted an inhibitory effect on cell viability 24 hours after being administered alone. In contrast, cell viability was significantly suppressed in the combination group (both P<0.01). Notably, no statistically significant difference in cell viability was observed between the combination group and 80 μmol·L-1 MTX. Compared with the control group, apoptosis in OCI-Ly10 cells was significantly aggravated in monotherapy groups (both P<0.001). Moreover, the pro-apoptotic effect was more pronounced in the combination group than in monotherapy groups (both P<0.001). Lenalidomide had no significant effect on OCI-Ly10 cells compared with the control group while zanubrutinib significantly inhibited cell proliferation (P<0.001). The inhibitory effect on cell proliferation was stronger in the combination group than in monotherapy groups (both P<0.001). Cell cycle analysis found that monotherapy significantly increased the proportion of cells in the G0/G1 phase (both P<0.001) but decreased the proportion in the S phase (both P<0.001) compared with the control group. Compared with lenalidomide monotherapy, the combination treatment elevated the proportion of cells in the G0/G1 phase (P<0.01) and reduced the proportion in the S phase (P<0.001). Conversely, compared with zanubrutinib monotherapy, the combination treatment significantly decreased the proportion of cells in the G0/G1 phase (P<0.001) but increased the proportion in the S phase (P<0.01). Conclusion After 24 hours of drug intervention, lenalidomide alone can promote cell apoptosis without affecting cell viability or cell proliferation while zanubrutinib alone can not only induce cell apoptosis but also inhibit cell proliferation by arresting cells in the G0/G1 phase. The combination of both drugs can exert a synergistic effect by significantly reducing cell viability and producing an inhibitory effect comparable to 80 μmol·L-1 MTX so that cell apoptosis is enhanced and cell proliferation is inhibited. References | Related Articles | Metrics

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Toxic effects of a novel chordoma diagnostic agent in mice Liu Yide, Qu Shuang, Zhang Min, Bai Jiwei, Yu Bingran, Liu Qian 2026, 23(10): 1092-1097.  DOI: 10.19803/j.1672-8629.20260237 Abstract ( 18 )   PDF (2488KB) ( 15 )   Objective To assess the in vivo toxicity of a novel chordoma diagnostic agent in animal models in order to provide data for subsequent investigation into novel diagnostic and treatment strategies for chordoma. Methods Forty-eight male and female C57 mice were randomly assigned to four groups: a high-dose (2 mg·kg-1) group, therapeutic-dose (0.4 mg·kg-1) group, and low-dose (0.08 mg·kg-1) group before being administered with a novel diagnostic agent via tail-vein injection or local infusion through a skin incision. These mice were observed daily for 14 consecutive days while their survival, body-weight changes, and abnormal behavior were recorded. At the end of observation, these mice were sacrificed according to approved protocols before their liver, kidney, heart, lung, spleen, and other key organs were harvested for paraffin sections, HE staining and pathological changes. Results During the 14-day experiment, no mortality or abnormal behavior was observed in mice in any group, suggesting that the novel diagnostic agent as used here had no obvious toxic effects on mice. A comparison of body weight between the treatment groups and the control group found no statistically significant differences in the pattern of weight gain curves (P<0.05). Paraffin-embedded tissue sections showed no characteristic pathological changes in any of the groups. Conclusion The novel diagnostic agent induces no pronounced acute manifestations within the dose range and period established in this study. References | Related Articles | Metrics

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Protective effects of Mongolian medicine Xiaohuixiang Sanwei Tang against myocardial ischemia-reperfusion injury in mice and the mechanisms Bai Lulu, Tian Jinman, Lu Jingkun, Zhang Zhongyue, Zhang Xiaoru, Song Xiaoxia, Tang Hao, Yu Lingze, Guo Na, Du Yulu, Wang Minjie 2026, 23(10): 1098-1107.  DOI: 10.19803/j.1672-8629.20260291 Abstract ( 20 )   PDF (3111KB) ( 12 )   Objective To investigate the protective effects of pretreatment with Mongolian medicine Xiaohuixiang Sanwei Tang (XHX) against myocardial ischemia-reperfusion injury (MIRI) in mice. Methods Seventy-two male C57BL/6J mice were evenly and randomly divided into six groups: a sham operation group (Sham), model group (Model), compound Danshen dripping Pill (CDDP, 0.11 g·kg-1) positive control group, and low-dose (XHX-L, 0.65 g·kg-1), medium-dose (XHX-M, 1.3 g·kg-1), and high-dose (XHX-H, 2.6 g·kg-1) XHX groups. An MIRI model was established by 30 minutes of ischemia followed by 24 hours of reperfusion. Cardiac function parameters were recorded, TTC staining was used to detect myocardial infarct size after 24 hours of MIRI, HE staining was performed to observe myocardial tissue structure and cell morphology, and Masson staining was conducted to evaluate myocardial fibrosis. Blood was taken from the heart before the serum was separated to detect the indexes of MIRI oxidative stress in each group. A hypoxia/reoxygenation (H/R) model of H9c2 cardiomyocytes was constructed, and the protective effects of XHX were confirmed at the cellular level by CCK-8 assay. Network pharmacology was used to predict the active components and potential targets of the drug, construct a protein-protein interaction (PPI) network, and perform GO functional annotation and KEGG pathway enrichment analysis on overlapping targets using databases. Myocardial tissue samples from the Sham, Model, and XHX-H groups were collected for transcriptome sequencing to identify and verify potential key targets. Results TTC staining showed that XHX reduced the infarct size in mice 24 hours after MIRI. ELISA and assay kit results suggested that XHX decreased the levels of creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), and malondialdehyde (MDA) while increasing superoxide dismutase (SOD) levels 24 hours after MIRI. HE staining revealed that XHX ameliorated myocardial pathological changes following MIRI. Masson staining indicated that XHX effectively reduced the degree of myocardial fibrosis in mice with MIRI. H9c2 cell experiments confirmed that interventions with the XHX-M group effectively alleviated H/R-induced cardiomyocyte injury and exerted a significant protective effect against cell viability. Transcriptome sequencing combined with network pharmacology analysis revealed that XHX could regulate the progression of myocardial ischemic disease through chemokines. Conclusion XHX pretreatment alleviates MIRI-induced damage, reduces myocardial infarct size and fibrosis, and protects the heart in mice following MIRI. References | Related Articles | Metrics

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Hepatoprotective effects and underlying mechanisms of Ethanolic extract of Mongolian medicinal herb Scabiosa comosa on drug-induced liver injury in rats Chen Xingyu, Zhou Shuhong, Wang Lu, He Jianqi, Tian Jinman, Bao Fushun, Zhang Wenxue, Ma Ao, Bao Lili, Wang Minjie, Yi Letai 2026, 23(10): 1108-1114.  DOI: 10.19803/j.1672-8629.20260257 Abstract ( 15 )   PDF (3185KB) ( 11 )   Objective To explore the pharmacodynamic material basis and potential mechanism of Mongolian medicine Scabiosa comosa Fisch. ex Roem. & Schult. ethanol extract against drug-induced liver injury (DILI). Methods After 8 weeks of preventive administration, an acute drug-induced liver injury model was established in C57BL/6 mice. Serum samples were collected to detect such liver function indicators as alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Liver tissues were subjected to hematoxylin-eosin (HE) pathological staining and transcriptome sequencing analysis. Network pharmacology was applied to screen potential targets of the ethanolic extract of Scabiosa comosa against acute drug-induced liver injury. The mRNA expression levels of candidate targets were verified to identify core targets, which were subjected to molecular docking with blood-absorbed components of the extract to screen core active ingredients. Results Serum liver function tests found that the activities of ALT and AST were significantly reduced in the medium-dose group of Scabiosa comosa ethanolic extract compared with the model group, with statistically significant differences (P<0.05). Pathological staining suggested that hepatic pathological damage was markedly mitigated in both low- and medium-dose extract groups. KEGG pathway enrichment and GO functional enrichment analyses of target gene sets from the transcriptome data revealed significant enrichment in biological processes and signaling pathways related to immune response. RT-qPCR results indicated that the expression levels of vascular cell adhesion molecule 1 (Vcam1), C-C motif chemokine ligand 2 (Ccl2) and androgen receptor (Ar) were significantly different between the model group and the medium-dose extract group (P<0.05). Molecular docking results showed favorable binding affinities between Vcam1 and luteolin, Ccl2 and isochlorogenic acid A, as well as Ar and chlorogenic acid, with binding energies all lower than -6 kcal·mol-1. Conclusion The active components in the ethanolic extract of Scabiosa comosa, including luteolin, isochlorogenic acid A and chlorogenic acid, could alleviate inflammatory response and ameliorate acute drug-induced liver injury by regulating downstream molecules (Vcam1, Ccl2) involved in the TNF signaling pathway. References | Related Articles | Metrics

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Isoorientin from Gentiana dahurica Fisch. Flower regulates COPD-related airway inflammation via MAPK pathway: an in vitro study of mechanisms Song Wenxuan, Zhou Shuhong, Zhang Wenxue, Wang Ning, Guo Qi, Ma Ao, Wang Minjie, Yi Letai 2026, 23(10): 1115-1122.  DOI: 10.19803/j.1672-8629.20260697 Abstract ( 17 )   PDF (2101KB) ( 11 )   Objective To explore the role of ISO, an active component of Gentiana dahurica Fisch. Flower in attenuating airway inflammation related to chronic obstructive pulmonary disease (COPD) and the molecular mechanism. Methods ISO, gentiopicroside and loganic acid in Gentiana dahurica Fisch. Flower were quantified via LC-MS/MS. Lipopolysa-ccharide (LPS, 5 μg·mL-1) was used to establish an in-vitro COPD-related inflammatory model in BEAS-2B human bronchial epithelial cells. CCK-8 assay was performed to screen the safe ISO dosage and evaluate its effect of cytoprotection. RT-qPCR was adopted to detect mRNA levels of inflammatory mediators. Transcriptome sequencing was employed to screen differentially expressed genes and key enriched pathways. RT-qPCR and Western blot were used to measure the expression levels of core MAPK-related genes and proteins. Molecular docking was conducted to predict the binding affinity between isoorientin and target proteins. Results ISO was the leading active component of Gentiana dahurica Fisch. Flower. The safe intervention condition of ISO was 5 μmol•L⁻¹ and 12 hours of intervention. Compared with the control group, LPS markedly reduced cell viability (P<0.001) while 5 μmol·L-1 ISO restored cell viability in the model group (P<0.01). The mRNA levels of IL-6, IL-1β, IL-8, TNF-α, MMP-9 and CXCL5 were significantly elevated in LPS-treated cells (P<0.001), and ISO markedly suppressed these up-regulated transcripts (P<0.01, P<0.001). Transcriptome enrichment identified the MAPK pathway as a major anti-inflammatory target. LPS up-regulated EREG, MAPK8 (JNK1) and FOS at the mRNA level (P<0.01, P<0.001), increased EREG, c-Fos protein abundance and elevated the p-JNK/JNK ratio (P<0.01), but ISO reversed these alterations and restrained excessive MAPK activation (P<0.01, P<0.001). Molecular docking suggested that binding energies between ISO and EREG, JNK1 and c-Fos were all less than -5 kcal·mol-1, suggesting favorable binding potentials. Conclusion ISO derived from Gentiana dahurica Fisch. Flower may inhibit aberrant MAPK signaling, reduce pro-inflammatory mediator release and alleviate LPS-provoked airway inflammatory injury related to COPD by interacting with key MAPK-related proteins. References | Related Articles | Metrics

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Effects of piperlongumine on gut barrier dysfunction in a rat model of carbon tetrachloride-induced liver fibrosis Zhang Ningfang, Zhao Li, Yang Yong, Yang Hongxin 2026, 23(10): 1123-1130.  DOI: 10.19803/j.1672-8629.20260012 Abstract ( 18 )   PDF (3907KB) ( 11 )   Objective To investigate the mechanism of piperlongumine (PPLGM) against carbon tetrachloride (CCl4)-induced liver fibrosis in rats and its protective effect on the intestinal barrier. Methods Fifty SD rats were randomly divided into the control group, model group, and PPLGM low, medium and high-dose groups (2.5, 5, 10 mg·kg-1). Except the control group, all these groups were subcutaneously injected with 50% CCl4-olive oil solution to construct a liver fibrosis model. After modeling, each administration group was given the corresponding dose of PPLGM by gavage for 4 weeks. After the intervention, blood was taken from the abdominal aorta before liver and intestinal tissues were collected. Hematoxylin and Eosin (HE) and Masson staining were used to assess the pathological changes of liver and intestinal tissues and liver collagen deposition. Such liver function indexes as serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected using biochemical methods. Immunohistochemistry, Western blot, and RT-qPCR techniques were adopted to detect expression levels of key molecules in the TLR4-NF-κB signaling pathway, fibrosis markers (α-SMA, CollagenⅠ), and intestinal tight junction protein (Claudin-1) in liver and intestinal tissues. The content of endotoxin (LPS) in serum was detected by ELISA. The binding ability of PPLGM to TLR4, NF-κB and TNF-α was analyzed via molecular docking technology. Results Compared with the control group, α-SMA and collagenⅠ expression levels were upregulated in liver tissues and serum ALT and AST levels were elevated in the model group, accompanied by downregulation of claudin-1 protein expressions in colon tissues and increases in serum endotoxin levels (P<0.05). Immunohistochemistry and Western blot analysis suggested significantly increased expression levels of TLR4, NF-κB, and TNF-α in liver and intestinal tissues (P<0.05). Following treatment with PPLGM, the above abnormalities were significantly reversed in that liver fibrosis was markedly improved pathologically, serum ALT and AST levels were decreased significantly, expression levels of α-SMA, collagen Ⅰ, and the TLR4/NF-κB/TNF-α pathway were downregulated, claudin-1 expression was recovered, and serum LPS levels were decreased (P<0.05). Molecular docking results indicated that the binding affinity of PPLGM to TLR4, NF-κB, and TNF-α was less than -5 kcal·mol-1. Conclusion PPLGM can significantly improve CCl4-induced liver fibrosis and intestinal barrier dysfunction by regulating the gut-liver axis. This compound may block the transmission of intestinal-derived inflammatory signals to the liver by inhibiting the TLR4/NF-κB signaling pathway triggered by intestinal barrier damage, thereby reducing the liver inflammatory microenvironment and fibrosis process. References | Related Articles | Metrics

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Schisandrin B attenuates cardiotoxicity induced by cyclophosphamide and epirubicin Zhi Yating, Yang Bo, Wang Haojie, Mu Taiyang, Feng Yulong, Hu Kaiyong, Zhang Min, Huang Qian, Yang Huaqian 2026, 23(10): 1131-1138.  DOI: 10.19803/j.1672-8629.20260465 Abstract ( 21 )   PDF (2345KB) ( 13 )   Objective To investigate the protective effect of Schisandrin B, an important active component of Schisandra chinensis, against cyclophosphamide- and epirubicin-induced cardiotoxicity and to explore its dose-effect relationship. Methods Mouse models of cardiotoxicity were established using cyclophosphamide and epirubicin, respectively. For each model, male C57BL/6N mice aged 6-8 weeks were randomly divided into five groups (n=10 per group): the control group, model group, model + low-dose Schisandrin B group (10 mg·kg-1·d-1), model + medium-dose Schisandrin B group (30 mg·kg-1·d-1), and model + high-dose Schisandrin B group (100 mg·kg-1·d-1). Schisandrin B was administered by oral gavage once daily for 4 consecutive weeks while cyclophosphamide and epirubicin were injected intraperitoneally once weekly for 4 consecutive weeks, respectively. Left ventricular systolic function was evaluated by echocardiography while left ventricular ejection fraction and fractional shortening were observed. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and aspartate aminotransferase (AST) were measured. Cardiac pathological sections were examined for morphological changes in cardiomyocytes, including vacuolization and other early apoptotic features. Results In both the cyclophosphamide model group and the epirubicin model group, left ventricular ejection fraction and fractional shortening were significantly decreased while serum NT-proBNP and AST levels were markedly elevated. No obvious changes in overall heart size were observed, but significant cardiomyocyte vacuolization was present in both models. Following schisandrin B intervention, all the above parameters—cardiac systolic function, serum cardiac injury biomarkers, and the degree of cardiomyocyte vacuolization—were significantly improved. Moreover, improvements increased with the dose of Schisandrin B, which suggested a dose-effect relationship. Conclusion Schisandrin B can dose-dependently attenuate cyclopho-sphamide- or epirubicin-induced cardiotoxicity, potentially through such mechanisms as anti-oxidative stress and inhibition of apoptosis, suggesting its potential to be used as an adjunctive cardioprotective agent during cancer chemotherapy. References | Related Articles | Metrics

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The origin and modern interpretation of the eighteen incompatibilities in traditional Chinese medicine Yang Yuqin, Lang Yingqi, Wang Minshu, Wu Meiling, Bai Dong 2026, 23(10): 1139-1143.  DOI: 10.19803/j.1672-8629.20260407 Abstract ( 33 )   PDF (1274KB) ( 22 )   Objective To study the connotation of the eighteen incompatible (Shibafan), a core concept of safety of clinical medication in traditional Chinese medicine (TCM), construct a modern framework for theoretical interpretation, and provide data for safe medication and in-depth research on compatibility in TCM. Methods The origin and semantic evolution of the character “fan” (incompatibility) were explored via historical textual research and semantic analysis. By combining empirical analysis and systematic evaluation and integrating modern pharmacopeial standards, clinical trials, and basic experimental research, the toxicity-efficacy transformation mechanism of incompatible medicaments under the syndrome microenvironment was analyzed. Results A multidimensional and clinically-applicable decision tree model was established that involved constitution identification, dosage thresholds, and compatibility with adjuvant herbs. Research indicated that the “eighteen incompatible medicaments” were not absolute compatibility contraindications, but rather an unconventional clinical medication regimen that conformed to the dialectical thinking of TCM. Conclusion Clinical applications of the “eighteen incompatible medicaments” are clearly applicable under specific conditions. In the future, real-world studies (RWS) and N-of-1 randomized crossover trials should be leveraged to provide higher-level evidence-based evidence. References | Related Articles | Metrics

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Evaluation of prescription similarity and safety for the revision of Mongolian medicine standards Lian Chaojie, Ren Jun, Hu Xiaoru, Dai Shengyun, Liu Jie, Wu Dongxue, Xiao Meng, Wu Zhihui, Zheng Jian, Wang Dong 2026, 23(10): 1144-1148.  DOI: 10.19803/j.1672-8629.20260319 Abstract ( 19 )   PDF (1240KB) ( 14 )   Objective To determine the priorities during the revision of the ministerial Mongolian medicine standards by reviewing related literature from the perspectives of prescription similarity and pharmacovigilance. Methods One hundred and forty-four preparations included in the Drug Standards of the Ministry of Public Health of the People’s Republic of China (Mongolian Medicine Fascicle) were selected as the subjects before text analysis was conducted to retrieve and standardize information about these prescriptions. The Jaccard similarity coefficient between preparations was calculated to identify high-frequency and high-proportion medicinal ingredients, as well as highly similar prescription clusters. Meanwhile, the National Center for ADR Monitoring, the National Medical Products Administration website, and the CNKI database were searched for articles on adverse reactions and toxicity related to the relevant medicinal ingredients and preparations. Results The 144 preparations involved a total of 247 medicinal ingredients with a cumulative frequency of 1 446 occurrences. The top 27 ingredients, including Chebulae Fructus (Hezi), Aucklandiae Radix (Muxiang), and Carthami Flos (Honghua), accounted for 51.5% of the total frequency while the top 26 ingredients accounted for 50.58% of the total prescriptions. Notably, Aconiti Kusnezoffii Radix Cocta (Zhi Caowu) ranked only 21st in frequency, yet its proportion of prescriptions reached 1.70%, indicating a high cumulative risk of toxic constituents. Prescription similarity analysis revealed 15 groups of completely identical series varieties (31 preparations) with a Jaccard coefficient of 1, and 22 groups of highly similar prescription clusters (34 preparations) with a coefficient≥0.5, forming multiple “formula clusters” that revolved around core medicinal ingredients. The search for literature on adverse reactions identified multiple reports about hepatotoxicity, nephrotoxicity, cardiotoxicity, and allergic reactions related to high-frequency ingredients such as Moschus (Shexiang), Aconiti Kusnezoffii Radix Cocta (Zhi Caowu), Gardeniae Fructus (Zhizi), and Carthami Flos (Honghua), and to highly similar preparations like Zhenbao pills and Zhenzhu Tongluo pills. Conclusion The ministerial Mongolian medicine prescriptions are strongly characterized by core ingredient clusters and formula cluster derivation. It is recommended that high-frequency and high-proportion medicinal ingredients involved in over 80% of the preparations be designated as the first-batch priority for revision of the standard, with identical series varieties and highly similar prescription clusters as the second-batch priority and packaged together for revision. Additionally, safety-related items indicated by the literature, such as limit tests for toxic constituents and monitoring of allergic reactions, should be incorporated into the efforts to improve the quality standard so as to establish a comprehensive research model that combines drug quality controllability with safety evaluation. References | Related Articles | Metrics

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Safety risks of Gengnian’an preparations Liu Shuo, Ke Xiuqin, Zheng Rui, Xia Dongsheng 2026, 23(10): 1149-1152.  DOI: 10.19803/j.1672-8629.20260516 Abstract ( 32 )   PDF (1265KB) ( 22 )   Objective To analyze the safety risks associated with Gengnian’an preparations and provide a reference for rational clinical use. Methods Data on adverse drug reactions (ADR) caused by Gengnian’an preparations was collected from the National Adverse Drug Reaction Monitoring System database (between January 1, 2004 and April 30, 2025) and from such databases as China National Knowledge Infrastructure (CNKI) and Wanfang Medical Network (from inception to May 1, 2026). Results Between January 1, 2004 and April 30, 2025, a total of 859 ADR cases involving Gengnian’an preparations were reported in the National ADR Monitoring System database, including 13 serious ones (1.51%). These ADRs involved the gastrointestinal system (49.68%), nervous system (16.99%), skin and subcutaneous tissue (12.58%), and general disorders and conditions at administration sites (6.61%). Clinical manifestations included nausea, dizziness, diarrhea, rash, vomiting, abdominal pain, headache, pruritus, abdominal discomfort and dry mouth. Other reported adverse reactions included menstrual disorders, liver injury, hepatocellular injury, abnormal liver function and jaundice. In December 2025, the National Medical Products Administration (NMPA) unified the revision of package inserts for Gengnian’an preparations. Conclusion Clinicians should remain alert to the risks of liver injury, bleeding, and other hazards associated with Gengnian’an preparations, and prescribe this drug based on syndrome differentiation. Marketing authorization holders should fulfill their responsibility and strengthen proactive adverse reaction monitoring and early warning based on real-world data. References | Related Articles | Metrics

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Comparison of adverse events following immunization with diphtheria, tetanus and acellular pertussis combined vaccine in a city before and after adjustment of the immunization schedule Zhang Ping, Jia Feifei 2026, 23(10): 1153-1157.  DOI: 10.19803/j.1672-8629.20260386 Abstract ( 52 )   PDF (1268KB) ( 31 )   Objective To analyze the surveillance data of adverse events following immunization (AEFI) with diphtheria, tetanus and acellular pertussis combined vaccine (DTaP) in Anyang before and after adjustment of the immunization schedule so as to provide references for reducing the incidence of AEFI. Methods Using the Chinese Disease Control and Prevention Information System, the AEFI reports of DTaP in Anyang from January 1, 2024 to December 31, 2025. were collected. Data on DTaP vaccines during the same period was collected via the Henan Provincial Immunization Program Information Management System. The reporting rates and clinical characteristics of AEFI of DTaP vaccines were analyzed and compared. Results Before the adjustment, the reported incidence rate of DTaP AEFI in Anyang was 829.46 per 100 000 doses, and those of common or abnormal reactions were 828.65 per 100 000 doses and 0.81 per 100 000 doses, respectively, compared with 882.78 per 100 000 doses, 882.21 per 100 000 doses and 0.57 per 100 000 doses after the adjustment. There were no significant differences in the reported incidence of AEFI before and after the adjustment(χ2=2.419,P=0.120). Before and after the vaccination program was updated, the reporting rates of fever, local redness and swelling, and local induration rose significantly with the increase in vaccination doses (P<0.001). With the extended time interval between vaccination and onset of adverse events, the proportions of local redness and swelling, and local induration increased. Conclusion Since the immunization schedule was updated, AEFI of DTaP in Anyang is mostly common reactions, and abnormal ones are rare. DTaP vaccines are relatively safe. However, vaccination needs to be standardied and AEFI monitoring enhanced. References | Related Articles | Metrics

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Adverse reactions of traditional Chinese medicine injections based on large language models and multi-dimensional text mining Jiang Gan, He Xiaojun, Li Pengbo, Yu Yanan, Zhi Kai, Dang Haixia 2026, 23(10): 1158-1163.  DOI: 10.19803/j.1672-8629.20260549 Abstract ( 23 )   PDF (2006KB) ( 15 )   Objective To construct a four-step extraction and analysis method for adverse drug reactions (ADR) of traditional Chinese medicine injections based on large language model (LLM)-based few-shot information extraction and multi-dimensional text mining, and to validate the feasibility of this method combination in extracting ADR signals from unstructured narratives in spontaneous reporting systems more fully and accurately. Methods A total of 4 124 spontaneous ADR reports of Danhong injection were collected that were submitted in 2023-2024. The DeepSeek-V3 model was employed with few-shot prompting to retrieve data on underlying diseases, symptoms, and outcomes, which was then concatenated into standardized sentences. Three-dimension text mining was subsequently performed: ① term frequency and TF-IDF analysis to identify high-frequency and highly discriminative symptom terms; ② semantic network analysis to construct symptom association networks based on co-occurrence matrices; and ③ LDA topic modeling to uncover latent topic structures. Results The top five high-frequency symptoms were pruritus (1 111 occurrences), rash (621), dizziness (612), chest tightness (584), and nausea (422). The semantic network identified four symptom clusters that centered on cardiovascular disease, cerebrovascular disease, non-specific systemic symptoms, and skin reactions, respectively. LDA extracted four topics in the following proportions: skin and allergic reactions (22.1%), infusion-related systemic reactions (21.1%), cardiovascular and cerebrovascular comorbidities (21.5%), and non-specific systemic and cardiovascular reactions (35.4%). The results of the two unsupervised methods—semantic network and LDA—were highly consistent and mutually validating. Conclusion The LLM-based few-shot extraction and multi-dimensional text mining method established in this study can effectively extract semantic features and latent topic structures from unstructured ADR narratives. The four-step pipeline—LLM denoising and structuring, TF-IDF for identifying high-frequency and characteristic symptoms, semantic network for revealing symptom co-occurrence associations, and LDA topic modeling for summarizing latent thematic structures—forms a hierarchical analytical framework that progresses from individual terms (“points”) through co-occurrence patterns (“lines”) and to thematic structures (“surfaces”). The feasibility of this pipeline has been validated using Danhong injection as a case study, which has established a method for post-marketing safety evaluation of traditional Chinese medicine injections that makes fuller use of free-text information. References | Related Articles | Metrics

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Adverse events during administration of alteplase for acute ischemic stroke Zhang Jialin, Hu Jia, Xu Yinqiu, Jiang Chenxiao, Li Li 2026, 23(10): 1164-1170.  DOI: 10.19803/j.1672-8629.20260561 Abstract ( 18 )   PDF (2119KB) ( 14 )   Objective To characterize adverse drug events (ADE) during administration of recombinant tissue plasminogen activator (rt-PA) in patients with acute ischemic stroke (AIS) and evaluate the actual rt-PA dose administered in order to contribute to safe medication during thrombolysis. Methods Patients with AIS who received intravenous thrombolysis with rt-PA in 2016-2025 were retrospectively identified and included. Patients were divided into the ADE and non-ADE groups according to the occurrence of ADE during rt-PA administration. The type, severity, and clinical management methods of ADE were described. Baseline characteristics and actual rt-PA doses administered were compared between the two groups. Univariable and multivariable logistic regression analyses were performed to identify contributors to ADE. Results A total of 1 012 patients were included, 373 (36.9%) of whom experienced ADE during rt-PA administration that were mostly mild or moderate non-intracranial bleeding events, but no deaths attributable to ADE were observed. Among these 373 patients, rt-PA administration was discontinued in 206 (55.2%). The actual rt-PA dose administered was significantly lower in the ADE group than in the non-ADE group (P<0.001). Multivariable logistic regression analysis showed that being female (OR=1.383 5, 95%CI: 1.052 3-1.818 8), prior lipid-lowering medications (OR=1.969 4, 95%CI: 1.248 0-3.107 6), prior antihypertensive medications (OR=1.382 0, 95%CI: 1.057 8-1.805 7), and higher D-dimer levels (OR=1.076 1, 95%CI: 1.016 4-1.139 3) could increase the odds of ADE (all P<0.05) while higher platelet counts were associated with lower chance of ADE (OR=0.997 5, 95%CI: 0.995 5-0.999 6; P<0.05). Conclusion ADE during rt-PA administration in patients with AIS might impact the completion of rt-PA administration and the actual dose administered. The incidence is associated with gender, prior medications, and hemostasis-related laboratory parameters. Monitoring during rt-PA administration and appropriate management according to the types and severity of ADE are warranted to ensure safe medication. References | Related Articles | Metrics

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One case of pulmonary hemorrhage caused by nintedanib soft capsules Quan Qiuping, Chen Junshan, Kuang Meidan, Li Jiachun 2026, 23(10): 1171-1174.  DOI: 10.19803/j.1672-8629.20260297 Abstract ( 17 )   PDF (1216KB) ( 16 )   Objective To investigate the clinical characteristics of and risk factors for pulmonary hemorrhage induced by nintedanib soft capsules in the treatment of progressive pulmonary fibrosis so as to provide a reference for clinical safe medication. Methods A case of a 78-year-old patient with progressive pulmonary fibrosis who developed pulmonary hemorrhage after two doses of nintedanib soft capsules was analyzed. Based on literature review, the possible mechanism and risk factors were explored, and ways of prevention and treatment were recommended. Results Nintedanib soft capsules were immediately discontinued upon the clinician’s instruction. Following hemostatic and supportive treatments, the patient’s hemoptysis gradually subsided. Based on the correlation analysis, the causal relationship between nintedanib soft capsules and pulmonary hemorrhage was assessed as “probable”. Conclusion Before prescribing nintedanib soft capsules, clinicians should assess the patient’s local pulmonary vascular status and general condition while staying alert to the hemorrhagic risk associated with nintedanib soft capsules. Dose reduction or delayed administration should be considered when necessary. During treatment, adverse drug reactions should be monitored to prevent pulmonary hemorrhage. References | Related Articles | Metrics

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One case of euglycemic diabetic ketoacidosis caused by dapagliflozin used at a high altitude Wang Huanping, Fang Wei, Zhu Hongxia 2026, 23(10): 1175-1177.  DOI: 10.19803/j.1672-8629.20260364 Abstract ( 18 )   PDF (1876KB) ( 12 )   Objective To investigate the adverse drug reaction of euglycemic diabetic ketoacidosis (euDKA) associated with dapagliflozin used in high-altitude areas in order to provide a reference for safe and rational drug use. Methods A case of euDKA in a 26 year old type 2 diabetes patient with long term high altitude residence and after prolonged use of dapagliflozin was analyzed. The risk factors and strategies for prevention and treatment were studied based on literature review. Results Dapagliflozin was discontinued immediately after admission, and the patient received fluid resuscitation and low dose intravenous insulin. The acidosis was corrected and ketones turned negative. Based on correlation analysis, the causal relationship between dapagliflozin and euDKA was determined as “probable”. Conclusion The use of dapagliflozin in high-altitude hypoxic environments may elevate the risk of euDKA, warranting increased clinical vigilance, prompt identification, and immediate interventions to ensure safe medication. References | Related Articles | Metrics

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One case of drug-induced hypersensitivity syndrome caused by rabeprazole enteric-coated tablets Huang Chunmei, Yu Caixia, Yang Liping 2026, 23(10): 1178-1180.  DOI: 10.19803/j.1672-8629.20260370 Abstract ( 25 )   PDF (1185KB) ( 20 )   Objective To analyze the clinical characteristics, pathosis, and diagnosis and treatment of drug-induced hypersensitivity syndrome (DIHS) caused by rabeprazole enteric-coated tablets in order to provide a reference for safe clinical medications. Methods We reported a case of allergic diathesis in a patient who developed successive high fever, generalized rash and multiple organ injuries (the liver, skeletal muscle, myocardium, lung) after taking oral rabeprazole sodium enteric-coated tablets. The diagnostic and treatment process was summarized and analyzed based on literature. Results After rabeprazole enteric-coated tablets were discontinued, the systemic symptoms of the patient were attenuated, and indicators of organ damage recovered steadily. The patient was discharged after being clinically cured. Given the medication sequence, clinical manifestations and improvement after drug withdrawal, the causality between rabeprazole enteric-coated tablets and DIHS was considered “probable”. Conclusion Rabeprazole enteric-coated tablets can induce rare but life-threatening DIHS, with the risk higher in individuals with allergic constitutions. Clinicians should strengthen drug monitoring while adhering to early discontinuation of the drug, early diagnosis, and standardized hormone therapy to ensure safe medication. References | Related Articles | Metrics

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One case of toxic epidermal necrolysis caused by levofloxacin tablets Cui Yinning, Yang Xueping, Qi Najie, Shi Xiujiang 2026, 23(10): 1181-1184.  DOI: 10.19803/j.1672-8629.20260406 Abstract ( 31 )   PDF (1247KB) ( 21 )   Objective To investigate the potential mechanisms and therapeutic regimens of toxic epidermal necrolysis (TEN) caused by levofloxacin tablets so as to provide references for safe clinical medication. Methods The clinical data of a patient with diarrhea who developed TEN after oral administration of 0.5 g levofloxacin tablets were analyzed. The suspected causative drug was identified, and the potential mechanisms and therapeutic regimens of TEN were summarized. Results TEN occurred approximately 2 hours after levofloxacin tablet administration. Combined with the patient’s history of medication, the causal relationship between TEN and levofloxacin tablets was assessed as “probable”. After discontinuation of levofloxacin tablets and initiation of active therapeutic regimens, the patient’s symptoms gradually improved. Conclusion This case indicates that levofloxacin tablets may trigger TEN in susceptible patients. Despite its low incidence, TEN progresses rapidly and carries potential fatal risks, which requires sufficient clinical vigilance. Once it is diagnosed, prompt and aggressive management should be instituted to ensure a favorable prognosis. References | Related Articles | Metrics

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One case of fulminant type 1 diabetes mellitus complicated with diabetic ketoacidosis and hyperosmolar hyperglycemic state caused by nivolumab Wang Zebin, Jiang Zhiwei, Gong Guanwen 2026, 23(10): 1185-1187.  DOI: 10.19803/j.1672-8629.20260498 Abstract ( 25 )   PDF (1159KB) ( 18 )   Objective To explore the clinical characteristics, underlying pathogenesis, and management strategies related to nivolumab-induced fulminant type 1 diabetes mellitus (FT1DM) complicated by diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) in order to provide crucial pharmacovigilance insights for safe medication. Methods The clinical data of a patient with bladder urothelial carcinoma, who developed FT1DM and severe metabolic derangements following nivolumab therapy, was retrospectively analyzed. Causality was assessed and the mechanism was explored based on literature review. Results The patient experienced an abrupt onset of FT1DM concurrent with DKA and HHS following the administration of nivolumab. The causality between this adverse drug reaction and nivolumab was graded as “probable”. Following aggressive fluid resuscitation and intensive insulin therapy, the metabolic crisis was reversed. However, the patient was discharged with lifelong dependence on exogenous insulin replacement. Conclusion Nivolumab can precipitate FT1DM, a life-threatening condition characterized by rapid progression and irreversible destruction of pancreatic islets. Routine glycemic monitoring should be mandated during clinical administration. Notably, high-dose corticosteroids are contraindicated in suspected cases. Early recognition and a multidisciplinary approach are critical to preventing fatal outcomes. References | Related Articles | Metrics

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Research progress in active components and toxic impurities of ophiopogonin D Huang Ying, Zhang Lijun, Mei Shiqi, Zhang Xianxie, Wang Yuguang 2026, 23(10): 1189-1194.  DOI: 10.19803/j.1672-8629.20260540 Abstract ( 17 )   PDF (1353KB) ( 16 )   Objective To summarize the pharmacology and mechanisms of action of Ophiopogonin D (OPD) against high-altitude heart disease, and review the toxicological profile and current assessment of risks of its isomer, Ophiopogonin D′ (OPD′), in order to provide a reference for safe and rational application of ophiopogonin saponins. Methods Studies on the cardioprotective mechanisms of OPD, animal experiments on high-altitude myocardial injury, the cytotoxicity and hemolytic toxicity of OPD′, and the drug-drug interactions between OPD and OPD′ were reviewed. The findings from these studies were analyzed. Results OPD exerted cardioprotective effects through such mechanisms as the CYP2J3/EETs pathway and anti-inflammatory, anti-apoptotic and antioxidant actions. In an animal model of hypobaric hypoxia that simulated an altitude of 6000 m, OPD significantly reduced myocardial enzyme levels and biomarkers of injury, enhanced SOD activity, and attenuated myocardial histopathological damage. However, OPD′ evoked significant cytotoxicity and hemolytic toxicity, making the control of OPD′ contents in Ophiopogon japonicus-containing formulations critical to quality optimization. Acute toxicity studies found that OPD, when used before OPD′, could effectively reduce the acute toxicity of OPD′. Conclusion So far, progress has been made in research on the pharmacodynamics of OPD against high-altitude myocardial injury, but the toxicological profile of OPD′ and quality control of Ophiopogon japonicus-containing formulations remains to be investigated. Subsequent studies should elucidate the interactions between OPD and OPD′, and establish quality control standards that balance therapeutic efficacy with safety so as to facilitate the application of ophiopogonin saponins in high-altitude heart disease. References | Related Articles | Metrics

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Research progress in the prevention and treatment of diabetic microangiopathy with Mudan granules based on the therapeutic principle of “tonifying qi, activating blood, and unblocking meridians” Wang Siyao, Cai Rushuang, Yi Yan 2026, 23(10): 1195-1200.  DOI: 10.19803/j.1672-8629.20260597 Abstract ( 19 )   PDF (1402KB) ( 21 )   Objective To review the advances in research on the efficacy of Mudan granules in the prevention and treatment of diabetic microangiopathy based on the principle of “tonifying qi, activating blood, and unblocking meridians” in order to provide a reference for their clinical application. Methods Literature on Mudan granules was retrieved from such databases as CNKI and PubMed. The material basis, clinical applications, and mechanisms of action of Mudan granules in the prevention and treatment of diabetic microangiopathy were analyzed. Results Mudan granules contained multiple active compounds, including saponins, flavonoids, alkaloids, and phenolic acids. Through such mechanisms as regulating inflammatory pathways like TLR4/NF-κB and inhibiting fibrotic signals like TGF-β1/Smad, these granules could alleviate inflammation and oxidative stress, delay fibrosis, and improve insulin resistance and microcirculatory disturbances, with the properties of “the same treatment for different diseases” in diabetic microangiopathy. Current clinical studies mostly support the synergistic action of this drug when combined with Western medicine, along with a favorable safety profile. Conclusion Mudan granules have proved to be effective against diabetic microangiopathy. However, current research is facing such problems as insufficient high-quality evidence and poor understanding of the connection between the micro-level mechanisms and the connotation of “unblocking meridians” in TCM. More studies are needed to elucidate the modern biological basis of “tonifying qi, activating blood, and unblocking meridians” in order to popularize this formula in the comprehensive prevention and management of diabetic microangiopathy. References | Related Articles | Metrics

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Falsely elevated digoxin levels with the chemiluminescent microparticle immunoassay test method in patients receiving enzalutamide treatment 2026, 23(10): 1188-1188.  DOI: 10.19803/j.1672-8629.20269910 Abstract ( 21 )   PDF (710KB) ( 12 )   Related Articles | Metrics