She fiercely opposed the coup d'état orchestrated by Cao Pi, repeatedly refusing to hand over the imperial seal.
In March 220, her father died, and her brother Cao Pi succeeded him as the King of Wei.
Later that year, he forced Emperor Xian to abdicate in favour of him, ending the Han dynasty.
Finally under increasing pressure, empress Cao relented, but she angrily threw the seal to the ground and said: "The Heavens will not give you people any blessing!"
It was said that when arriving at Shanyang and witness the poverty and misfortune of the war-torn region, the newly appointed Duke and Duchess decided to use their resources and wealth - including the medicine knowledge learnt in the imperial palace - to support and to cure the local people.
Thanks to the couple's efforts, Shanyang region finally became prosperous, and the local population paid luxurious tributes to the Duke and Duchess as a token of gratitude.
Today, there is still a painting of "Emperor Xian practicing medicine to save the people" (汉献帝行医图).