Basic Medical Research

• Exploration on the mechanism of scutellarin improving bleomycin-in-duced pulmonary fibrosis in mice based on TGF-β1/Smads signaling path-ways

  Qiu Yuanyuan; Qin Huiping; Wang Changming; Ge Run; Hu Xiaowen; Chen Xiaoyi;

  2025,40(11):1361-1364+1389 ,DOI: 10.3969/j.issn.1005-3697.2025.11.001

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  Objective:To explore the improvement effect of scutellarin(SCU)on bleomycin(BLM)-induced pulmonary fi-brosis in mice and to analyze potential action mechanism of SCU based on transforming growth factor-β1(TGF-β1)/Smads sig-naling pathways.Methods:The models of pulmonary fibrosis mice were constructed by intratracheal injection of BLM,and they were divided into blank group,SCU group,BLM group and BLM+SCU group.After 21 d of intervention,growth status,patho-logical changes of lung tissues,levels of inflammatory factors,expressions of pulmonary fibrosis markers proteins and mRNA levels of TGF-β1,Smad2,Smad3 and Smad7 in different groups were observed.Results:Compared with blank group and SCU group,scores of alveolar inflammation and pulmonary fibrosis,levels of interleukin-6(IL-6),IL-1β,tumor necrosis factor-α(TNF-α)and hydroxyproline(HYP),expressions of α-SMA,Collagen I and Fibronectin proteins in lung tissues,mRNA levels of TGF-β1 and Smad2/3/7 were increased in BLM group(P<0.05).The above indexes in BLM+SCU group were all lower than those in BLM group(P<0.05).Conclusion:SCU can improve BLM-induced pulmonary fibrosis and inflammatory response of lung tissues in mice.The improvement mechanism may be related to the down-regulation of TGF-β1/Smads pathways.

• Forensic application research and population structure analysis of 19 X-STRs loci in Sichuan ethnic minority population

  Yang Huiling; Guo Tianqi; Li Yutong; Fan Qingwei; Xu Dongdong; Deng Xiaodong; Du Bing;

  2025,40(11):1365-1370 ,DOI: 10.3969/j.issn.1005-3697.2025.11.002

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  Objective:To investigate the genetic polymorphism of 19 X-STRs loci in the Beichuan Qiang and Xichang Yi ethnic groups in Sichuan Province,evaluate their forensic application value,and analyze their population structure.Methods:Dry blood spot samples were collected from 246 unrelated individuals(188 males and 58 females)of the Beichuan Qiang ethnic group and 281 unrelated individuals(116 males and 165 females)of the Xichang Yi ethnic group.The dry blood spot samples were directly amplified using the MicroreaderTM19X ID System kit,and the PCR products were subjected to capillary electro-phoresis using an ABI3500 genetic analyzer,GeneMapper?ID-X software automatically classifies.Results:A total of 150 alleles were detected in the Beichuan Qiang ethnic group,with a frequency range of 0.003 3～0.828 9.In the Xichang Yi ethnic group,a total of 164 alleles were detected,with a frequency range of 0.002 2～0.800 4.After statistical testing,the gene frequency dis-tribution of the two ethnic minority groups conform to Hardy Weinberg equilibrium law(P>0.05),and after Bonferroni correc-tion,there were no loci with linkage disequilibrium.In the Beichuan Qiang ethnic group,the combined discrimination power for males(PDM)and combined discrimination power for females(PDF)were 0.999 999 999 945 624 and 0.999 999 999 999 999 993 22,re-spectively.The combined mean exclusion chance in duos(MECD)and mean exclusion chance in trios(MECT)were 0.999 999 591 813 975 and 0.999 999 999 465 296,respectively.In the Yi ethnic group of Xichang,the combined discrimination power for males(PDM)and combined discrimination power for females(PDF)were 0.999 999 999 873 529 and 1,respectively.The combined mean exclusion chance in duos(MECD)and mean exclusion chance in trios(MECT)were 0.999 999 284 224 924 and 0.999 999 998 931 424,respec-tively.Conclusion:The MicroreaderTM19X ID fluorescence detection kit has a high overall polymorphism and good discriminatory ability in the Beichuan Qiang and Xichang Yi populations,and can serve as a powerful supplement and verification method for parental relation-ships and individual identification.

• Effect and mechanism of CCL8 promoting the progression of human skin squamous cell carcinoma via JAK1/STAT3 pathway

  Shi Gaofeng; Guo Yun; Yang Minlie;

  2025,40(11):1371-1376 ,DOI: 10.3969/j.issn.1005-3697.2025.11.003

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  Objective:To explore the effect and potential mechanisms of CC chemokine ligand 8(CCL8)in cutaneous squa-mous cell carcinoma(CSCC).Methods:Collecting human skin squamous cell carcinoma tissue and normal skin tissue,and detect the expression of CCL8 through tissue immunofluorescence staining.After overexpression or inhibition of CCL8 in human skin squamous cell carcinoma cell line A431 using construction of myc-CCL8 overexpression plasmid or CCL8 siRNAs,cell viability,migration and invasion ability were detected.The expression levels of cell Epithelial-Mesenchymal Transition(EMT)related proteins(E-cadherin,ZO-1,SNAIL,N-cadherin)and JAK1/STAT3 pathway was detected by Western blot experiment.Re-sults:Compared with barely expressed in normal skin tissue,CCL8 was increased expressed in CSCC tissue(P<0.05).CCL8 could significantly promote the proliferation,migration,and invasion ability of A431 cells(P<0.05).CCL8 could remarkably activate the JAK1/STAT3 pathway in A431 cells,upregulate the expression of SNAIL and N-cadherin proteins,and downregu-late the expression of E-cadherin and ZO-1 proteins(P<0.05).Conclusion:CCL8 is up-regulated expressed in CSCC cells and can promote the EMT process of CSCC cells through the JAK1/STAT3 pathway,thereby facilitating CSCC cell proliferation,migration,and invasion,which provides ideas for clinical treatment of CSCC.

• Correlation study between B3GNT5 expression in gastric cancer tissues and clinicopathological parameters and prognosis

  Jin Lei; Gao Tianyuan; Zhang Minling; Chen Chuanrong;

  2025,40(11):1377-1382 ,DOI: 10.3969/j.issn.1005-3697.2025.11.004

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  Objective:To investigate the expression level of B3GNT5 in gastric cancer(GC)tissues and its correlation with clinicopathological parameters and patient prognosis.Methods:The expression difference of B3GNT5 in GC tissues versus adja-cent non-tumor tissues was analyzed using the GEPIA2 database,Kaplan-Meier Plotter database,and TCGA database.Its corre-lation with patient survival was also explored.Tissue samples and clinical data were collected from 85 GC patients.Immunohis-tochemistry(IHC)was used to detect B3GNT5 expression differences between GC tissues and adjacent non-tumor tissues.The correlation between B3GNT5 expression level and the clinicopathological characteristics of GC was analyzed.Results:Bioinfor-matics analysis showed that B3GNT5 was highly expressed in GC tissues and lowly expressed in adjacent non-tumor tissues,with a statistically significant difference(P<0.05).High expression of B3GNT5 was associated with poorer overall survival(OS)and recurrence-free survival(RFS)in GC patients(P<0.05).Pathological IHC revealed that B3GNT5 expression level was higher in GC tissues compared to adjacent non-tumor tissues.B3GNT5 expression level showed correlations with tumor in-vasion depth,lymph node,and TNM stagemetastasis(P<0.05).Kaplan-Meier survival analysis and Cox regression model a-nalysis indicated that B3GNT5 was an independent risk factor for prognosis assessment in GC(P<0.05).Conclusion:High ex-pression of B3GNT5 in gastric cancer is associated with poor prognosis and may serve as a potential biomarker for prognostic assessment in GC.

Clinical medical research

• Effect of visual function training on ocular accommodative function and refraction related parameters in myopic children and adolescents

  Luo Yue; Tao Jie; Xie Juan; Liao Wenchuan; Cheng Duojia; Hu Yuhuan; Tang Yangyu; Zhang Jiawei; Zou Yunchun;

  2025,40(11):1383-1389 ,DOI: 10.3969/j.issn.1005-3697.2025.11.005

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  Objective:To investigate the effects of combining visual function training with different optical correction mo-dalities on ocular accommodative function and refractive-related parameters in myopic children and adolescents,aiming to evalu-ate their combined efficacy in myopia control and prevention.Methods:This study enrolled 120 patients(240 eyes)meeting in-clusion criteria,they were divided into 6 groups according to different correction methods:single-vision lenses(SVL),defocus incorporated multiple segments(DIMS),orthokeratology(OK),and their respective combinations with vision training(SCVT,DCVT,OCVT),with 20 patients(40 eyes)in each group.Optical correction groups wore lenses only,while combined groups received additional accommodative training.Changes in axial length(AL),anterior chamber depth(ACD),mean keratometry(Km),accommodative amplitude(AMP),accommodative facility(AF),positive relative accommodation(PRA),and negative relative accommodation(NRA)were assessed before intervention and 3 and 6 months after intervention treatment.Results:Af-ter the intervention,in optical correction groups,SVL showed no significant changes,DIMS improved AF(P<0.05),OK im-proved AMP,AF,PRA,and reduced ACD,Km(P<0.05).In combined groups,SCVT improved AMP,AF(P<0.05),DCVT improved AMP,AF,PRA,NRA(P<0.05),OCVT improved AMP,AF,PRA,NRA,and reduced ACD,Km(P<0.05).Com-bined groups showed better AL control and AMP,AF,PRA improvements than in optical correction groups(P<0.05).A-mong combined groups,DCVT and OCVT outperformed SCVT in AMP,AF,PRA improvements(P<0.05),OCVT sur-passed DCVT in AMP improvements(P<0.05).After 6 months of intervention,AL growth was OCVT

• Efficacy of bronchoscopic alveolar lavage as an adjuvant therapy for se-vere Mycoplasma pneumoniae pneumonia in children and the impact on peripheral blood CRP and PCT levels

  Zheng Dandan; Ma Jinhai; Ma Xiaolong; Huang Jie;

  2025,40(11):1390-1393 ,DOI: 10.3969/j.issn.1005-3697.2025.11.006

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  Objective:To investigate the clinical efficacy of bronchoscopic alveolar lavage as an adjuvant therapy for severe Mycoplasma pneumoniae pneumonia(SMPP)in children,and analyze its impact on peripheral blood C-reactive protein(CRP)and procalcitonin(PCT)levels.Methods:A total of 160 children with SMPP were enrolled in the study.Using different treat-ment regimens,they were assigned to the control group and the observation group,80 cases in each group.The groups received conventional treatment and bronchoscopic alveolar lavage assisted conventional treatment,respectively.The duration of clinical symptoms,clinical efficacy,peripheral blood CRP and PCT levels,and complication rate were compared between the two groups.Results:Inter-group comparisons found that the duration of clinical symptoms was shorter in the observation group(P<0.05).The overall clinical effective rate was higher in the observation group(P<0.05).After 2 weeks of treatment,pe-ripheral blood CRP and PCT levels in both groups decreased(P<0.05),and the observation group was lower than the control group(P<0.05).The complication rate in the observation group was lower than that in the control group(3.75%vs.12.50%,P<0.05).Conclusion:Bronchoscopic alveolar lavage as an adjuvant therapy can achieve significant therapeutic effects on SMPP in children.It can shorten the duration of clinical symptoms,lower peripheral blood CRP and PCT levels,and reduce complication risk.

• Analysis of cytokine expression levels in cerebrospinal fluid and their di-agnostic value in neurosyphilis patients

  Chen Wei; Yang Yao; Zou Xiaoxi;

  2025,40(11):1394-1397 ,DOI: 10.3969/j.issn.1005-3697.2025.11.007

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  Objective:To explore the cytokine expression levels in cerebrospinal fluid(CSF)of patients with neurosyphilis(NS)and evaluate their diagnostic value for NS.Methods:A total of 194 syphilis patients were included for this study,inclu-ding 41 patients with NS and 153 patients with non-neurosyphilis(NNS).All participants underwent lumbar puncture.Gener-al information(age,sex)and CSF laboratory test results,including white blood cell count,protein,chloride,Pandy's test,cyto-kines[tumor necrosis factor-alpha(TNF-α),interferon-gamma(IFN-γ),interleukin-2(IL-2),IL-4,IL-6,IL-10,IL-17A]were collected and compared between the two groups.Spearman correlation analysis was performed to examine the correlation be-tween CSF cytokines and white blood cell count and protein levels.Multivariate Logistic regression analysis was used to identi-fy independent predictors,and receiver operating characteristic(ROC)curves were plotted to assess diagnostic performance.Results:NS patients showed higher levels of age,positive Pandy's test,white blood cell count,protein concentration,TNF-α,IFN-γ,IL-2,IL-4,IL-6,IL-10,and IL-17A compared to NNS patients(P<0.05).TNF-α,IFN-γ,IL-2,IL-4,IL-6,IL-10,and IL-17A were positively correlated with both CSF white blood cell count and protein concentration(P<0.05).Multivariate Lo-gistic regression revealed that IL-6,IL-10,and IL-17A(OR=1.112,1.114,1.235)were independent predictors of NS(P<0.05).The areas under the curve(AUC)for IL-6,IL-10,and IL-17A were 0.903,0.893,and 0.844,respectively,and the com-bined AUC for all three indicators was 0.936.Conclusion:The expression levels of multiple cytokines in the CSF of NS pa-tients are elevated and positively correlated with CSF white blood cell count and protein concentration.IL-6,IL-10,and IL-17A can serve as auxiliary diagnostic indicators for NS.

• Effect of oxybuprocaine hydrochloride gel combined with propacetamol on cardiovascular stress,anaesthesia effect and haemodynamics in pa-tients undergoing laparoscopic cholecystobiliary surgery

  Hu Wenju; Ye Miaomiao; Bai Yaolin;

  2025,40(11):1398-1402 ,DOI: 10.3969/j.issn.1005-3697.2025.11.008

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  Objective:To investigate the effects of oxybuprocaine hydrochloride gel combined with propacetamol on cardio-vascular stress,anaesthesia and haemodynamics in patients undergoing laparoscopic cholecystocholedochotomy.Methods:80 pa-tients undergoing elective laparoscopic cholecystocholangiography were selected as study subjects and divided into a control group and a combined group based on different anesthesia protocols used during the operation,with 40 cases in each group.The control group received propacetamol intravenous injection,and the combined group received topical anesthesia with oxybupro-caine hydrochloride gel in addition to the treatment given to the control group.The operation time,anesthesia time,recovery time,extubation time,blood oxygen saturation(SaO2),heart rate(HR),mean arterial pressure(MAP),catecholamines,corti-sol,blood glucose,pain[Visual Analog Scale(VAS)],and the incidence of adverse reactions were recorded and compared be-tween the two groups.Results:There were no significant differences in operation time,anesthesia time,emergence time,and ex-tubation time between the two groups of patients(P>0.05).At 15 and 30 min post-extubation,both HR and MAP were lower in the combination group compared to the control group(P<0.05).On postoperative day 1,catecholamines,cortisol,and blood glucose levels were elevated in both groups,but the levels were lower in the combination group compared to the control group(P<0.05).VAS scores were lower in the combination group compared to the control group immediately after extubation,and at 15 min and 30 min post-extubation(P<0.05).The incidence of adverse reactions was lower in the combination group com-pared to the control group(P<0.05).Conclusion:In laparoscopic cholecystobiliary choledochotomy,compared with propaceta-mol anaesthesia alone,combined with oxybuprocaine hydrochloride gel anaesthesia is more conducive to reducing the degree of postoperative pain and haemodynamic fluctuations of the patient,and can effectively inhibit the patient's level of postoperative cardiovascular stress response,which can help to increase the degree of patient's tolerance to catheterisation.

• The mechanism and treatment of cough variant asthma in children with huanglong zhike granules by regulating macrophage polarization

  Zhang Xiaohong; Li Xin; Zhao Ronghua; Han Ningning;

  2025,40(11):1403-1407+1412 ,DOI: 10.3969/j.issn.1005-3697.2025.11.009

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  Objective:To explore the effect and mechanism of Huanglong Zhike Granules in the treatment of cough variant asthma in children based on macrophage polarization.Methods:160 children with cough variant asthma were divided into a con-trol group and an experimental group,with 80 cases in each group.The control group was given montelukast sodium chewable tablets and Huanglong Zhike Granules placebo,and the experimental group was given montelukast sodium chewable tablets and Huanglong Zhike Granules,both groups received continuous treatment for 4 weeks.After treatment,the clinical efficacy was e-valuated by changes in cough severity score,TCM syndrome score,pulmonary function indicators,and airway anatomical indica-tors.The proportions of M1 and M2 macrophages in peripheral blood and the expression levels of macrophage polarization marker genes before and after treatment were compared between the two groups.The occurrence of complications such as drowsiness and diarrhea during the treatment period was statistically analyzed.Results:After treatment,the cough severity score and TCM syndrome score in the experimental group were lower than those in the control group,and FEV1,FVC,FEV1/FVC,and PEF were higher than those in the control group(P<0.05).After treatment,the airway wall thickness,basement mem-brane thickness,and total airway wall area in the experimental group were smaller than those in the control group(P<0.05).After treatment,the proportion of M1 macrophages in the experimental group was lower than that in the control group,and the proportion of M2 macrophages was higher than that in the control group(P<0.05).After treatment,the mRNA expression levels of Arg-1,iNOS,CD80,and CD163 in the experimental group were lower than those in the control group(P<0.05).Dur-ing the treatment period,1 case of headache occurred in the experimental group,with an incidence of adverse reactions of 1.25%,1 case of drowsiness and 1 case of diarrhea occurred in the control group,with an incidence of adverse reactions of 2.50%.There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Huanglong Zhike Granules can treat cough variant asthma in children by regulating macrophage polarization,and can reduce cough severity and improve lung function and airway function.

• Comparative study on the efficacy and complications of different approa-ches of PVP in the treatment of osteoporotic vertebral compression frac-tures

  Cang Dingwei; Liu Jin; Liu Xingsheng; Ji Biao; Song Changzhi;

  2025,40(11):1408-1412 ,DOI: 10.3969/j.issn.1005-3697.2025.11.010

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  Objective:To compare the efficacy and safety of different approaches of percutaneous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fractures(OVCFs).Methods:A total of 180 patients with OVCFs treated by PVP were collected and divided into two groups according to different surgical approaches.Among them,88 patients under-went unilateral pedicle approach PVP as unilateral approach group,and 92 patients underwent bilateral pedicle approach PVP as bilateral approach group.The visual analogue scale(VAS)pain score and Oswestry disability index(ODI)were evaluated be-fore operation,1 month and 12 months after operation,and the anterior vertebral height and kyphosis Cobb angle were meas-ured.The operation related indexes and complications of the two groups were compared.Results:Compared with the bilateral approach group,the unilateral approach group had shorter operation time(P<0.05),less intraoperative blood loss and fluoros-copy times(P<0.05),and lower bone cement volume(P<0.05).The VAS score and ODI index of the two groups at 1 month and 12 months after operation were lower than those before operation(P<0.05).The height of the anterior edge of the injured vertebra and the Cobb angle of the kyphosis were improved compared with those before operation(P<0.05).There was no significant difference in VAS score,ODI index and above imaging parameters between the two groups before and after operation(P>0.05).The incidence of bone cement leakage in the unilateral approach group was 13.64%,and the incidence of bone cement leakage in the bilateral approach group was 17.39%,there was no significant difference between the two groups(P>0.05).Conclusion:Unilateral pedicle approach PVP can achieve similar efficacy as bilateral pedicle approach PVP.Com-pared with bilateral approach surgery,unilateral approach surgery has the advantages of shorter operation time and less radia-tion damage.

• Clinical effect of esketamine combined with ropivacaine in ultrasound-guided axillary brachial plexus block

  Luo Lin; Chen Yong; Chen Tao; Fu Qiang;

  2025,40(11):1413-1416 ,DOI: 10.3969/j.issn.1005-3697.2025.11.011

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  Objective:To explore the effect of combined use of esketamine and ropivacaine in ultrasound-guided axillary brachial plexus block(BPB).Methods:A retrospective analysis was conducted on the clinical data of 130 patients.They were di-vided into the control group(64 cases receiving general anesthesia)and the observation group(66 cases receiving ultrasound-guided axillary BPB with esketamine and ropivacaine on the basis of general anesthesia)according to different anesthesia meth-ods.The pain,postoperative condition,hemodynamic indices,and adverse reactions were compared between the two groups.Re-sults:The Visual Analog Scale(VAS)scores of both groups reached the highest at 12 h postoperatively and then decreased over time,and the observation group was lower than the control group(P<0.05).Inter-group comparisons found that postoperative extubation time and awakening time of the observation group were shorter.The time of using patient-controlled intravenous an-algesia(PCIA)for the first time was longer,and effective compressions were fewer in the observation group(P<0.05).The incidence of dizziness in the observation group was higher(P=0.033).There was no statistically significant difference in the o-verall incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combined use of esketamine and ropi-vacaine can achieve good analgesic and postoperative effects,without influence on patient hemodynamics or increase in postoper-ative adverse reactions.It can be used for clinical promotion.

• Constructing LASSO regression model for early prediction of fetal growth restriction based on assisted reproductive pregnancy umbilical cord blood flow parameters and placental function indicators

  Wang Wenyang; Ma Qinling;

  2025,40(11):1417-1421+1445 ,DOI: 10.3969/j.issn.1005-3697.2025.11.012

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  Objective:To investigate the early predictive value of combining umbilical cord blood flow dynamics parameters with placental function indicators in the second trimester of pregnancy for fetal growth restriction(FGR)in assisted reproduc-tive technology(ART)pregnancies,and to develop and validate a predictive model.Methods:A total of 317 singleton pregnant women who successfully achieved ART-assisted pregnancies and maintained ongoing pregnancies were enrolled and followed up until delivery.Based on the occurrence of FGR,the participants were categorized into the FGR group(n=41)and the non-FGR group(n=276).At 20～24 weeks of gestation,baseline characteristics,umbilical artery hemodynamic parameters[peak systol-ic velocity(S),end-diastolic velocity(D),S/D ratio,resistance index(RI),pulsatility index(PI),peak systolic velocity(Vs),end-diastolic velocity(Vd)]and placental function indicators[24-hour urinary estriol,serum human placental lactogen(hPL),fetal movement counts within 2 hours]were systematically collected.Independent predictors were screened using LASSO-Lo-gistic regression to construct a combined prediction model.The model's discriminative ability was evaluated using the receiver operating characteristic(ROC)curve.Internal validation assessing stability was performed using the Bootstrap method.Clinical decision curve analysis(DCA)was employed to evaluate clinical utility.Results:Through LASSO-logistic regression analysis,the optimal model was achieved with λ=0.074.The findings indicated that elevated S/D ratios,increased Resistance Index(RI),higher Pulsatility Index(PI),reduced serum hPL levels,low 24-hour urinary estriol levels,and fewer than 6 fetal move-ments within two hours were significant risk factors influencing FGR following successful assisted reproductive pregnancies(P<0.05).The nomogram model was internally validated using the Bootstrap method,with the area under the ROC curve for the LASSO-Logistic prediction model being 0.871.Furthermore,the Hosmer-Lemeshow test demonstrated that the mean abso-lute error between the actual values and the calibration curve was 0.03(χ2=0.162,P=0.872).Conclusion:The LASSO re-gression model,constructed based on mid-trimester umbilical artery hemodynamic parameters(S/D ratio,RI,PI),serum hPL,24-hour urinary estriol,and fetal movement counts<6 within 2 hours,demonstrates good early predictive value for FGR in ART pregnancies.This model exhibits stability and strong clinical utility,providing significant evidence-based support for indi-vidualized fetal surveillance and early intervention in ART pregnancies.

• Predictive value of peripheral blood PLR combined with RTS score for 28-day prognosis of emergency trauma patients

  Li Jianyu; Huang Wenhuan; Feng Wenhao; Zhong Qizhi; Liu Ninggui; Cai Feng;

  2025,40(11):1422-1425 ,DOI: 10.3969/j.issn.1005-3697.2025.11.013

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  Objective:To investigate the predictive value of peripheral blood platelet-to-lymphocyte ratio(PLR)combined with modified trauma score(RTS)for 28-day prognosis in emergency trauma patients.Methods:The clinical data of 108 pa-tients with emergency trauma were retrospectively analyzed.According to the 28-day prognosis,the patients were divided into survival group(n=91)and death group(n=17).The general data and laboratory indexes such as white blood cell count and PLR were compared between the two groups.Logistic regression analysis was used to determine the risk factors of prognosis.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of related indicators for the 28-day prognosis of patients.Results:Compared with the survival group,the proportion of emergency mechanical ventilation in the death group was increased(P<0.05),the RTS score was decreased(P<0.05),and the injury severity score(ISS)was in-creased(P<0.05).Compared with the survival group,the platelet count and PLR in the death group decreased(P<0.05).There was no significant difference in other routine laboratory indexes between the two groups(P>0.05).Logistic regression analysis showed that emergency mechanical ventilation(OR=4.591),RTS score(OR=0.708)and PLR(OR=0.776)were independent factors affecting the 28-day prognosis of patients(P<0.05).ROC curve analysis showed that both PLR and RTS scores had certain predictive ability for 28-day death in emergency trauma patients,with AUC of 0.764 and 0.736,respectively.The AUC of the combination of the two was 0.822,which was higher than that of the single index(P<0.05).Conclusion:Pe-ripheral blood PLR and RTS scores are closely related to the 28-day prognosis of emergency trauma patients,and the combina-tion of the two can better predict the prognosis of patients.

• Correlation between Naples prognostic score and clinicopathological fea-tures and prognosis of patients in newly diagnosed colorectal cancer

  Yan Wanjie; Liu Caixia;

  2025,40(11):1426-1431 ,DOI: 10.3969/j.issn.1005-3697.2025.11.014

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  Objective:To explore the correlation between the naples prognostic score(NPS)and the clinicopathological characteristics and prognosis of patients with newly diagnosed Colorectal Cancer(CRC).Methods:The clinicopathological char-acteristics and prognosis data of 188 diagnosed CRC patients were collected.The cumulative NPS score was calculated based on the pre-treatment serum ALB(<4 g/dL:1 point,≥4 g/dL:0 point),TC(≤180 mg/dL:1 point,>180 mg/dL:0 point),NLR(>2.96:1 point,≤2.96:0 point),and LMR(≤4.44:1 point,>4.44:0 point).The patients were divided into Group A(0 points),Group B(1～2 points),and Group C(3～4 points),and the differences in clinicopathological characteristics and prognosis among the three groups were analyzed.Results:There were statistically significant differences in age,maximum tumor diameter,neurovascular invasion,perivascular invasion,liver metastasis,CA-125,TNM stage,and post-treatment compli-cations among the NPS groups(P<0.05).Univariate Cox analysis showed that NPS was significantly associated with OS(HR=2.477,95%CI:1.468～4.181,P=0.001).After controlling for confounding factors,multivariate analysis showed that NPS remained an independent prognostic factor(HR=2.359,95%CI:1.368～4.067,P=0.002).The K-M curve based on 3-year OS indicated that the prognosis of the high NPS group(Group C)was worse.The ROC curve showed that NPS(AUC=0.691)had better predictive efficacy compared with PNI,SIS,NLR,and LMR,and the NPS+TNM combined model(AUC=0.833)was superior to the single TNM staging(AUC=0.792),It had a good calibration ability.Conclusion:NPS can identify newly diagnosed CRC patients with high inflammatory load and poor nutritional status.It is an independent risk factor for poor prognosis.Its predictive efficacy is higher than that of the classic predictive scores PNI,SIS,NLR,and LMR.When used in combination with TNM,it can further optimize stratified management and provide certain value for clinical diagnosis and treat-ment before treatment.

• Influence of different doses of esomeprazole during bismuth quadruple regimen on Hp eradication rate,serum gastrointestinal hormones and IL-17 levels in patients with peptic ulcer

  Lan Peng; You Jia; Zhu Ye; Pang Lei; Wan Song;

  2025,40(11):1432-1435 ,DOI: 10.3969/j.issn.1005-3697.2025.11.015

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  Objective:To investigate the influence of different doses of esomeprazole during bismuth quadruple regimen on the eradication rate of Helicobacter pylori(Hp)and the levels of serum gastrointestinal hormones and interleukin-17(IL-17)levels in patients with peptic ulcer.Methods:A total of 122 patients with Hp infection and peptic ulcer were enrolled,and they were treated with bismuth quadruple therapy.According to different treatment plans(high and low doses of esomeprazole),pa-tients were divided into a high-dose group and a standard dose group,with 61 cases in each group.The clinical efficacy,Hp erad-ication rate,serum gastrointestinal hormones and inflammatory indexes before and after treatment and adverse drug reactions were compared between the two groups.Results:The clinical efficacy in high-dose group was higher than that in the standard-dose group(P<0.05).PP analysis and ITT analysis showed that the eradication rate of Hp in the high-dose group was higher than that in the standard-dose group(P<0.05).After treatment,serum gastrin,IL-17,IL-6 and CRP levels in the two groups were decreased(P<0.05)while serum motilin level was increased(P<0.05),and the gastrin,IL-17,IL-6 and CRP levels in the high-dose group were lower than those in the standard-dose group(P<0.05)while the motilin level was higher than that in the standard-dose group(P<0.05).There was no statistical difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:The application of high-dose esomeprazole at a dose of 40 mg/time in the bismuth quadrup-le therapy for the treatment of peptic ulcers is more effective than the standard dose of esomeprazole at a dose of 20 mg/time,with higher Hp eradication rate and higher safety,and has clinical application value.

• Efficacy analysis of bilateral cerebellar high-frequency repetitive tran-scranial magnetic stimulation combined with beckman oral-pharyngeal exercises for post-stroke dysphagia

  Ye Ting; Gao Jing; Sun Mingliang; Fang Jing; Meng Zhaoxiang;

  2025,40(11):1436-1441 ,DOI: 10.3969/j.issn.1005-3697.2025.11.016

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  Abstract:

  Objective:To investigate the efficacy of bilateral cerebellar high-frequency repetitive transcranial magnetic stim-ulation(rTMS)combined with Beckman oropharyngeal rehabilitation exercises for dysphagia after stroke.Methods:83 patients with dysphagia following stroke were divided into an observation group(n=42)and a control group(n=41)according to dif-ferent treatment methods.The control group received Beckman oropharyngeal rehabilitation therapy,and the observation group received bilateral cerebellar high-frequency rTMS in addition to Beckman oropharyngeal rehabilitation therapy for the same du-ration,both groups were treated for 4 weeks.The two groups were compared in terms of swallowing function[Kubota Water Swallowing Test,Eating Assessment Tool-10(EAT-10),Standard Swallowing Assessment(SSA)],swallowing time parame-ters,hyoid-laryngeal complex excursion,surface electromyography(sEMG)maximum amplitude and duration,fiberoptic endo-scopic evaluation of swallowing(FEES)findings,and Swallowing Quality of Life(SWAL-QOL)scores.Results:After treat-ment,the Kubota Water Drinking Test scores,EAT-10 scores,and SSA scores of both groups were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).The oral transit time and swal-lowing reaction time of both groups were shorter than those before treatment(P<0.05),and the observation group was shor-ter than the control group(P<0.05).The hyoid-laryngeal complex movement,including the maximum hyoid elevation,maxi-mum hyoid anterior movement,maximum laryngeal elevation,and maximum laryngeal anterior movement,in both groups in-creased compared to before treatment(P<0.05),and the observation group was greater than the control group(P<0.05).The sEMG amplitude of both groups decreased compared to before treatment(P<0.05),and the duration shortened compared to before treatment(P<0.05),with the observation group was lower than the control group(P<0.05).The proportion of vo-cal cord paralysis,nasopharyngeal reflux,saliva stasis,and aspiration in FEES evaluation were all lower in the observation group compared to the control group(P<0.05).The SWAL-QOL scores of both groups increased compared to before treatment(P<0.05),and the observation group was higher than the control group(P<0.05).Conclusion:Bilateral cerebellar high-fre-quency rTMS combined with Beckman oral-pharyngeal rehabilitation significantly improves post-stroke dysphagia,reduces swallowing-related complications,and enhances quality of life through the synergistic effect of neuromodulation and functional training.

• Establishment of reference value range for placental thickness in single-ton pregnancy

  He Ting; Qiu Xia; Ren Tingting; Li Rui;

  2025,40(11):1442-1445 ,DOI: 10.3969/j.issn.1005-3697.2025.11.017

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  Objective:To establish reference ranges for placental thickness in singleton pregnancies based on the 95%bilat-eral percentile confidence intervals.Methods:A total of 483 healthy singleton pregnant women,aged 20～40 years,were enrolled as study participants based on predefined inclusion and exclusion criteria.These women received routine antenatal surveillance and ultimately delivered at the Affiliated Hospital of North Sichuan Medical College.Maternal demographic data and placental thickness measurements were collected at the following gestational intervals:11～13+6 weeks,20～24+6 weeks,28～31+6 weeks,and 37～40+6 weeks.Reference ranges for sonographically measured placental thickness across gestational periods were established by using the 95th percentile method with bilateral confidence intervals[M(P2.5,P97.5)].Results:The sonographic measurements of placental thickness in normal singleton pregnancies were as follows:11～13+6 weeks:14.00(10.00～20.00)mm,20～24+6 weeks:25.00(19.00～36.00)mm,28～31+6 weeks:32.00(24.00～42.00)mm,37～40+6 weeks:36.00(27.00～46.00)mm.Conclusion:The sonographic reference ranges of placental thickness in normal singleton pregnancy provide reference basis for management of high-risk pregnancies.

• Correlation between serum amyloid A protein and growth differentiation factor-15 levels and the severity and prognosis of elderly patients with sep-sis

  Ge Yingxiao; Ru Qianying; Wang Hua; Zhang Danfeng; Li Jinwei;

  2025,40(11):1446-1450 ,DOI: 10.3969/j.issn.1005-3697.2025.11.018

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  Objective:To investigate the correlation between serum amyloid A protein(SAA)and growth differentiation factor-15(GDF-15)levels and the severity and prognosis of elderly patients with sepsis.Methods:80 elderly patients with sepsis were selected as the research subjects.According to the severity of sepsis,they were divided into sepsis group(n=36)and sep-tic shock group(n=44).According to the 28-day survival,the patients were divided into survival group(n=58)and death group(n=22).At the same time,healthy elderly people were selected as the control group(n=60).The serum indicators of SAA,GDF-15,white blood cell count(WBC),and neutrophil count(NEU)levels among different groups of subjects were com-pared,as well as the sequential organ failure score(SOFA)and acute physiology and chronic health status Ⅱ(APACHE Ⅱ)scores for different severity levels of sepsis.Spearman correlation analysis was used to analyze the correlation between serum in-dicators and SOFA and APACHE Ⅱ scores in sepsis patients,multivariate Logistic regression was used to analyze the factors affecting 28 day mortality in elderly sepsis patients,the predictive value of Receiver Operating Characteristic(ROC)curve was used to analyze the 28 day mortality in elderly sepsis patients.Results:Compared with the control group,the levels of SAA,GDF-15,WBC and NEU in septic shock group and sepsis group were increased(P<0.05).Compared with the sepsis group,the SOFA score,APACHE Ⅱ score,SAA,GDF-15,WBC and NEU levels in the septic shock group were increased(P<0.05).Spearman correlation analysis showed that SAA and GDF-15 levels were positively correlated with SOFA score(r=0.784,r=0.816,P<0.05)and APACHE Ⅱ score(r=0.757,r=0.793,P<0.05).Compared with the survival group,the SOFA score,APACHE Ⅱ score,SAA,GDF-15,WBC and NEU levels in the death group were increased(P<0.05).Multivariate Lo-gistic regression analysis showed that SAA(OR=1.551,P=0.003)and GDF-15(OR=1.826,P=0.001)were independent risk factors for 28-day death in elderly patients with sepsis.ROC curve analysis showed that the area under curve(AUC)of SAA for predicting 28-day mortality was 0.774,the AUC of GDF-15 was 0.806,and the AUC of the combined prediction was increased to 0.853.Conclusion:Serum SAA and GDF-15 levels are positively correlated with the severity of sepsis in elderly pa-tients,and the combination of the two has a high predictive value for the 28-day prognosis of patients.

• Clinical study of endoscopic treatment of unilateral thyroid carcinoma by chest-breast and subclavian approach without inflatable

  Li Yangyang; Zhong Kaiqiang; Guo Tao;

  2025,40(11):1451-1455 ,DOI: 10.3969/j.issn.1005-3697.2025.11.019

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  Objective:To compare the clinical effect of chest-breast and subclavian approach endoscopic treatment of unilat-eral thyroid carcinoma.Methods:Clinical data of 105 patients undergoing endoscopic thyroid surgery from March 2022 to Au-gust 2024 were retrospectively analyzed.According to the surgical methods,they were divided into thoracic breast approach en-doscopic thyroid surgery group(n=50)and subclavian approach endoscopic thyroid surgery group(n=55).The general condi-tion,operation related indexes and 3 months follow-up of the two groups were analyzed statistically by χ2 test,t test,Mann-Whitney test and CUSUM learning curve chart.Results:There were no significant differences in tumor size(7.28±4.73)vs.(7.36±4.40)mm,number of lymph nodes cleared(6.12±3.67)vs.(6.76±4.44),number of lymph node metastasis(1.88±2.67)vs.(1.15±1.75),postoperative cosmetic satisfaction between chest-breast and subclavian approach groups(P>0.05).There was significant difference in age(33.82±6.06)vs.(40.24±11.35)years old,time of operation(123±17.04)vs.(100.35±22.08)min and postoperative neck function(P<0.05).Conclusion:Transthoracic and subclavian endoscopic thy-roid surgery are both safe and feasible,with the same aesthetic satisfaction of incision.The operation time is short and the oper-ation is easy to master through the subclavian approach,and the cervical function is better protected through the natural muscle space approach of the side neck.

• Comparison of effect of iroot SP and AH-Plus during root canal therapy

  Wang Chang; Qu Chen;

  2025,40(11):1456-1459 ,DOI: 10.3969/j.issn.1005-3697.2025.11.020

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  Objective:To explore the efficacy of iroot SP and AH-Plus during root canal therapy.Methods:130 patients with pulpitis and periapical periodontitis were divided into iroot SP group(n=66,77 teeth)and AH-Plus group(n=66,75 teeth)by different treatment regimens.All affected teeth were mechanically prepared to F2 using protaper gold under the rub-ber barrier,and performed root canal filling after chemical preparation with 1%sodium hypochlorite solution,and the iroot SP group used iroot SP+hot gutta-percha vertical condensation,and the AH-Plus group adopted AH-Plus+hot gutta-percha verti-cal condensation.All patients were followed up for 3 months after treatment.The clinical efficacy,percussion pain and occlusal pain occurrence,root filling density(number of void area,percentage of void area),and periodontal conditions(gingival sulcus bleeding index score and dental plaque index score)were compared between the two groups.Results:After treatment,the total effective rate revealed no statistical significance between groups(P>0.05).The incidence rates of percussion pain and occlusal pain in iroot SP group were lower than those in AH-Plus group(P<0.05).The scores of gingival sulcus bleeding index and plaque index in the two groups were reduced(P<0.05),and the above scores were lower in iroot SP group than those in AH-Plus group(P<0.05).There was no statistical significance in the number of void area and percentage of void area between iro-ot SP group and AH-Plus group(P>0.05).Conclusion:Both iroot SP and AH-Plus root canal filling show good clinical effica-cy and root filling fitting.Compared with AH-Plus,iroot SP root canal filling therapy can more effectively relieve the percussion pain and occlusal pain of patients with dental pulp disease,and improve the periodontal conditions.

• Influencing factors on the efficacy of one-stage tympanoplasty for chronic otitis media

  Wang Xiao; Zhu Xin; Xie Zhuoliang; Liu Hai;

  2025,40(11):1460-1463 ,DOI: 10.3969/j.issn.1005-3697.2025.11.021

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  Objective:To investigate the factors affecting the efficacy of stage Ⅰ tympanoplasty for chronic otitis media.Methods:A total of 120 patients with chronic otitis media were selected as the research subjects.All patients underwent One-Stage Tympanoplasty.According to the evaluation of air-bone gap(ABG)at 6 months post-operation,postoperative ABG≤20 dB was defined as good hearing recovery,and postoperative ABG>20 dB was defined as poor hearing recovery,patients were divided into two groups based on their hearing recovery status.Single-factor analysis and multivariate Logistic regression analysis were used to further screen for independent factors affecting the effect of hearing recovery.Results:Among the 120 eli-gible patients,there were 85 cases in the good hearing recovery group and 35 cases in the poor hearing recovery group,respec-tively,with a treatment effectiveness rate of 70.8％.There were no significant differences in gender,age,body mass index,le-sion distribution,pathological classification,personal history,and distribution of underlying comorbidities between the two groups of patients(P>0.05).The average postoperative AC and ABG of the group with good recovery were(43.95±7.24)dB and(15.21±3.07)dB,respectively,which were lower than those of the group with poor recovery(P<0.05).The propor-tion of patients with unobstructed Eustachian tube,normal tympanic mucosa,intact stapes structure,and presence of tympanic membrane tension tendon in the well recovered group was higher than that in the poorly recovered group.The proportion of pa-tients with ossicular chain lesions was lower than that in the poorly recovered group(P<0.05).The results of multiple Logistic regression analysis showed that intact stapes structure,presence of tympanic membrane tension tendon,and unobstructed Eustachian tube were independent influencing factors for good hearing recovery(OR>1,P<0.05).Conclusion:One stage tympanoplasty is an effective method for treating chronic otitis media.The intact structure of the stapes,the presence of the tympanic membrane tension tendon,and the patency of the Eustachian tube are independent factors affecting good postoperative hearing recovery.

• Comparative on clinical study of Cu-Ni-Ti versus conventional Ni-Ti archwires during the orthodontic alignment phase

  Liu Weihan; Chen Dinggen; Xi Ke; Li Yuzhi;

  2025,40(11):1464-1467+1480 ,DOI: 10.3969/j.issn.1005-3697.2025.11.022

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  Objective:To compare the clinical efficacy of copper-nickel-titanium(Cu-Ni-Ti)and conventional nickel-titani-um(Ni-Ti)archwires during orthodontic alignment.Methods:72 first-time orthodontic patients were selected as the research subjects and divided into a study group(Cu-Ni-Ti)and a control group(Ni-Ti)according to different treatment materials.In-tercanine/intermolar widths,maxillary Little's Irregularity Index(LII),and VAS pain scores(24 h post-activation)were recor-ded at baseline(T0),3 months(T1),and finishing archwire stage(T2).Treatment duration and unscheduled visits were ana-lyzed.Results:There were no statistically significant differences in treatment duration or improvement in dental arch morpholog-ical parameters between the two groups(P>0.05).Patients in the study group demonstrated lower initial 24-hour VAS pain scores and required fewer clinical appointments compared to the control group(P<0.05).However,intergroup differences in pain scores at both T1 and T2 stages showed no statistical significance(P>0.05).Conclusion:Cu-Ni-Ti have shown advantages in reducing initial pain and fewer clinical appointments,and can be used as one of the options for initial archwires during ortho-dontic alignment.

• Establish and validate a nomogram model to predict the risk of recur-rence one year after radiofrequency ablation in patients with atrial fibril-lation

  Liu Wei; Wang Yubing;

  2025,40(11):1468-1475 ,DOI: 10.3969/j.issn.1005-3697.2025.11.023

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  Objective:To investigate the factors associated with the recurrence of(atrial fibrillation,AF)1 year after(Ra-diofrequency ablation,RFA),and to construct a predictive model and evaluate its clinical performance.Methods:A total of 228 AF patients who were underwent their first cardiac RFA were included as the research subjects.The patients were divided into a development set and a validation set.Univariate and multivariate Logistic regression analyses were employed to identify inde-pendent risk factors for recurrence after RFA using the included variables.A nomogram model for predicting 1-year recurrence after RFA was constructed using R software.Finally,the model was validated and evaluated through concordance statistics,cali-bration plots,and decision curve analysis,respectively.Results:Multivariate Logistic regression analysis revealed that the type of atrial fibrillation(OR=0.107,95%CI:0.034～0.299,P<0.001),hypertension(OR=2.844,95%CI:1.064～8.117,P=0.042),subclinical thyroid dysfunction(OR=12.786,95%CI:2.063～86.374,P=0.007),Left Atrial Diameter(LAD,OR=1.178,95%CI:1.052～1.335,P=0.006),and Lipoprotein(a)[Lp(a),OR=1.002,95%CI:1.001～1.004,P=0.008]were all independent risk factors for AF recurrence 1 year after RFA.The nomogram developed based on these factors demonstrated a concordance index of 0.846(95%CI:0.785～0.905)in the development set for predicting AF recurrence 1 year after RFA,and a concordance index of 0.744(95%CI:0.601～0.890)in the validation set.Internal validation of the model through 1,000 bootstrap resampling showed that the calibration curve indicated a good agreement between the nomogram's predicted out-comes and the observed outcomes.Decision curve analysis suggested that the nomogram exhibited good predictive ability in both the development and validation sets.Conclusion:The nomogram model constructed based on atrial fibrillation type,LAD,hyper-tension,subclinical thyroid dysfunction,and Lp(a)demonstrates good discrimination and accuracy.It has certain predictive val-ue for atrial fibrillation recurrence one year after RFA,and aids clinicians in formulating individualized patient recurrence risk assessments.

中医学研究

• The treatment of functional constipation based on the theory of"Five Stagnation"

  Li Jia; Wang Xingyue; Ren Jiayi; He Decai;

  2025,40(11):1476-1480 ,DOI: 10.3969/j.issn.1005-3697.2025.11.024

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  Functional constipation(FC)is a common gastrointestinal motility disorder,and clinical treatment often focu-ses on promoting bowel movements and obstruction,but there is insufficient exploration of qi stagnation.This article was based on the theory of"Five Stagnation"in the Huangdi Neijing,systematically explored the intrinsic connection between the patho-logical stagnation state of the imbalance of qi,blood,yin and yang in the five internal organs and functional constipation.With the core of the five methods of reaching(Da),releasing(Fa),draining(Duo),discharging(Xie),and breaking(Zhe),it provid-ed a holistic guidance for the diagnosis and treatment of functional constipation in traditional Chinese medicine,proposed the treatment concept of"regulating stagnation before unblocking the bowels and regulated the internal organs when treating the intestines",broadening the diagnosis and treatment ideas of functional constipation.

调查报告

• Analysis of the impact of family support on the quality and efficiency of medical interns from the perspective of multi-level governance

  Li Liang; Li Chunling; Li Xiaodan; Zhang Bo; Deng Hongjie;

  2025,40(11):1481-1486 ,DOI: 10.3969/j.issn.1005-3697.2025.11.025

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  Objective:From the perspective of multi-level governance,understand the influence of family support for medi-cal interns on the quality and efficiency of internships,analyze the key influencing factors therein,and propose countermeasures.Methods:In May 2025,a total of 372 medical Interns from a provincial medical college in Sichuan Province were selected using stratified random sampling.A questionnaire survey was conducted utilizing three instruments:a general information question-naire,the Self-assessment Scale of Internship Quality and Efficiency,and the Family Support Self-rating Scale.The impact of family support on internship quality and efficiency were analyzed.Results:The mean score for internship quality and efficiency a-mong medicine students was 77.91±10.95 points,while the mean score for the Family Support Self-rating Scale was 11.31±2.62 points.Multiple linear regression analysis revealed that satisfaction with the integration of theory and practice,emotional support intensity,consistency between post-graduation destinations and family expectations,economic support intensity,and fre-quency of internship burnout were the main factors affecting the quality and effectiveness of internships(P<0.05).Conclusion:The quality and efficiency of internships for medicine students are at a moderate level.During the internship teaching process,particular attention should be given to interns experiencing low satisfaction with the integration of theory and practice,poor a-lignment between post-graduation destinations and family expectations,high internship burnout frequency,insufficient economic support,and inadequate emotional support.

Short stories and cases

• A case of massive pericardial effusion after thrombolytic therapy for acute cerebral infarction

  Zhang Yuda; Shuai Zhuang; Yang Ying;

  2025,40(11):1487-1488 ,DOI: 10.3969/j.issn.1005-3697.2025.11.026

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  1 case data the patient, female, 83 years old, was admitted to the Department of Cardiology, Affiliated Hospital of North Sichuan Medical College on July 26, 2022 for further diagnosis and treatment because of "dyspnea for 1 D", and a large amount of pericardial effusion was found during chest CT examination in other hospitals, without chest pain, chest tightness and other discomfort during the course of the disease. Past history: the patient was diagnosed as "after intravenous thrombolytic therapy for acute cerebral infarction" in the Department of Neurology on July 11, 2022; History of diabetes mellitus; There was no history of syncope, family sudden death and heart disease; No history of drug allergy.

• Anterior mediastinal B3 thymoma invading the right upper lung + ascending aorta + superior vena cava: a case report

  Lin Yu; Zhong Haihui; Wang Rong; Yang Rihui;

  2025,40(11):1489-1491 ,DOI: 10.3969/j.issn.1005-3697.2025.11.027

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  Thymoma is a relatively common tumor type with unique clinicopathological characteristics among < positive > anterior mediastinal tumors. As a kind of thymic epithelial tumor, B3 thymoma has certain invasiveness, which can cause invasion to important surrounding tissues and organs, resulting in complex disease and increased treatment difficulty [1-2]. When the tumor invades the right upper lung, ascending aorta, superior vena cava and other key structures, not only the difficulty of surgical resection is greatly increased, but also the risk of bleeding is significantly increased. At the same time, it has a serious impact on the patients' cardiopulmonary function and general condition, which brings great challenges to clinical diagnosis and treatment [3].

nursing

• Construction of perioperative nursing quality evaluation index system for patients with Hirschsprung's disease

  Chen Wenqian; Sheng Yu;

  2025,40(11):1492-1496 ,DOI: 10.3969/j.issn.1005-3697.2025.11.028

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  Objective: to construct the evaluation index system of perioperative nursing quality for patients with Hirschsprung's disease, so as to optimize nursing management, meet patients' personalized needs, ensure continuous and efficient nursing services, and promote patients' rehabilitation. Methods: Based on the "structure process result" model, this study constructed the evaluation index system of perioperative nursing quality for patients with Hirschsprung's disease by integrating literature analysis, Delphi expert consultation and analytic hierarchy process, and completed the determination of the weight of each index. Results: the recovery rate of the two questionnaires was 100%, the authority coefficient was 0.908 and 0.917, and the variation coefficient was 0.051 ～ 0.215 and 0.051 ～ 0.229, respectively; The Kendall concordance coefficients were 0.299 and 0.332 (p<0.05), and the consistency coefficients of indicators at all levels were 0.033, 0.034, 0.039, all <0.100. The construction system includes 3 primary indicators, 10 secondary indicators and 55 tertiary indicators. Conclusion: the constructed evaluation index system of perioperative nursing quality for patients with Hirschsprung's disease is scientific and practical, and can objectively evaluate the perioperative nursing quality of patients with Hirschsprung's disease.

Basic Medical Research

• DOK1 recombinant adenovirus enhances insulin sensitivity of BRL-3A cells through DOK1/AKT/SREBP1c signalling pathway

  Cai Xiaoling; Wang Chunlan; Ha Xiaoqin;

  2025,40(6):681-685 ,DOI: 10.3969/j.issn.1005-3697.2025.06.001

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  Objective:To investigate the mechanism of DOK1 recombinant adenovirus(Ad-DOK1)on the regulation of insulin sensitivity in palmitic acid(PA)-induced insulin-resistant hepatocytes(BRL-3A).Methods:The control,solvent and model groups were treated with normal medium,ethanol and palmitic acid to establish a cellular insulin resistance model of BRL-3A cells and to iden-tify the cellular model using cellular glucose uptake assay.The control,null and adenovirus DOK1 overexpression groups were transfect-ed with normal serum,negative virus and Ad-DOK1(51257-1)in insulin-resistant BRL-3A cells,and the transfection efficiency of ade-novirus was detected by flow cytometry,and the Western blot method was used to detect DOK1,IRSI,IRSII,p-PI3K,PI3K,p-AKT,AKT,SREBP1c protein expression levels.Results:Palmitic acid induction for 6 hours resulted in a decrease in intracellular 2-deoxyglu-cose(P＜0.05),down-regulation of DOK1 protein expression level(P＜0.05),no significant change in IRSI and IRSII protein ex-pression level(P>0.05),no change in p-PI3K/PI3K ratio(P>0.05),down-regulation of p-AKT/AKT ratio(P＜0.05),and SREBP1c protein expression expression levels were upregulated(P＜0.05).After transfection of cells with DOK1 recombinant adeno-virus of optimal MOI 60,compared with the normal control group,intracellular 2-deoxyglucose was elevated(P＜0.05),DOK1 protein expression level was up-regulated(P＜0.05),there was no significant change in the expression level of IRSI and IRSII proteins(P>0.05),no significant change in the p-PI3K/PI3K ratio(P>0.05),the p-AKT/AKT ratio was upregulated(P＜0.05),and the ex-pression level of SREBP1c protein expression was downregulated(P＜0.05).Conclusion:Ad-DOK1 may enhance insulin sensitivity of BRL-3A cells by regulating AKT and SREBP1c.

• Development and validation of a malignancy risk prediction model for pul-monary nodules based on multivariable analysis and machine learning

  Hu Xin; Jiang Yongjie; Shilun Guang; Heibieluo; Huang Yuyan; Jiang Li;

  2025,40(6):686-692 712 ,DOI: 10.3969/j.issn.1005-3697.2025.06.002

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  Objective:To develop a robust and widely applicable predictive model to improve the accuracy of diagnosing the ma-lignancy risk of pulmonary nodules.Methods:This study retrospectively collected clinical data from 1,414 patients with pulmonary nod-ules diagnosed and treated at the Affiliated Hospital of North Sichuan Medical College and the Guang'an People's Hospital.Meta-analy-sis and Least Absolute Shrinkage and Selection Operator(LASSO)regression were used to identify predictors related to the malignancy risk of pulmonary nodules.These factors were further optimized by multivariable Logistic regression(LR)to determine key features.Based on these features,8 machine learning models were constructed and evaluated for performance using Receiver Operating Character-istic(ROC)curves,calibration curves,and Decision Curve Analysis(DCA)in the training set and internal validation set.The best-performing model was used to develop a nomogram for risk stratification of patients.Results:Through the combined screening process of Meta-analysis,LASSO regression,and multivariable LR,10 key predictive factors were identified and integrated into eight different ma-chine learning models.Model evaluation demonstrated that the LR model performed best,achieving an Area Under the Curve(AUC)of 0.843 in the internal validation cohort.Additionally,the nomogram derived from this model exhibited strong predictive ability in the ex-ternal validation cohort,with an AUC of 0.770.Risk scores calculated from the nomogram stratified patients into four risk groups,with malignancy rates ranging from 0%in the low-risk group to 100%in the very high-risk group.Conclusion:The prediction model devel-oped in this study effectively assesses the malignancy risk of pulmonary nodules,providing a valuable risk stratification tool for clinical use.

• The causal relationship between sleep disorders and gastric ulcer incidence based on two-sample Mendelian randomization

  Wang Juan; Liu Hao;

  2025,40(6):693-698 ,DOI: 10.3969/j.issn.1005-3697.2025.06.003

  Abstract(16) HTML(0) PDF(1.62 M)( 24)

  Abstract:

  Objective:To investigate whether there was a potential two-way causal relationship between sleep disorder(SD)and the incidence of gastric ulcer(GU)by two sample Mendelian randomization(MR)analysis.Methods:The data sets of exposure and outcome were obtained from IEU database,from which suitable Single Nucleotide Poly Morphisms(SNPs)were selected as instrumental variables(IVs),and then inverse variance weighting(IVW),MR-Egger regression,weighted median(WME),simple model and weigh-ted model were used for two-way MR Analysis.Cochran's Q test and MR-Egger intercept test were used for sensitivity analysis.Results:The IVW method showed that there was a significant unidirectional causal relationship between SD and the incidence of GU.When SD were used as exposure factors,the positive MR Analysis had significant statistical significance(OR=1.009,95%CI:1.004～1.015,P=0.001).When GU used as an exposure factor,reverse MR Analysis was not statistically s-ignificant(OR=1.197,95%CI:0.425～3.371,P=0.734).Further sensitivity analysis showed no significant heterogeneity and horizontal pleiotropy.Conclusion:Mendelian randomization analysis found that there is a potential one-way causal relationship between SD and the risk of GU,and SD are risk factors for GU.

Clinical medical research

• Application value of contrast-enhanced CT histogram parameters in mor-tality risk assessment of severe acute pancreatitis

  Taodi; Zhao Zisheng; Chen Junhui; Zhang Xiaoming;

  2025,40(5):562-568 ,DOI: 10.3969/j.issn.1005-3697.2025.05.004

  Abstract(14) HTML(0) PDF(1.69 M)( 23)

  Abstract:

  Objective:To optimize contrast-enhanced computed tomography(CECT)image quality using Non-Local Means(NLM)denoising technology and construct a mortality risk prediction model for severe acute pancreatitis(SAP)patients based on his-togram parameters.Methods:Retrospective analysis of clinical,laboratory,and CECT data of 74 patients diagnosed with SAP.NLM de-noising was applied to arterial and portal venous phase images at different coefficient levels.Three-dimensional volumes of interest were manually delineated in pancreatic parenchyma on original and denoised images,followed by histogram parameter extraction.After univa-riate Logistic regression feature selection,binary Logistic regression models were built to predict SAP mortality risk and compared with clinical models and conventional CT models.Results:A total of 74 patients with SAP,of whom 27(36.5%)died.After applying NLM-based noise reduction to arterial phase and portal venous phase CECT images,8 histogram prediction models were constructed under dif-ferent noise coefficient levels.There was no significant difference in predictive performance among these histogram models(P＞0.05).Compared to conventional CT models and clinical models,the histogram models demonstrated higher accuracy in predicting mortality risk(P=0.009,P=0.048).The predictive performance of the clinical model and the conventional CT model was similar(P=0.699).Conclusion:CECT histogram parameters show significant clinical value in predicting mortality risk in SAP patients,maintaining stable performance under different noise coefficient levels after NLM denoising.Their noise robustness and quantitative a-nalysis advantages compensate for the limitations of conventional CT.

Basic Medical Research

• Effect and mechanism of miR-139-3p targeting SPP1 on cisplatin resist-ance in A549 lung cancer cells

  Zhang Lingkun; Kang Shirong;

  2025,40(10):1225-1229 1248 ,DOI: 10.3969/j.issn.1005-3697.2025.10.001

  Abstract(23) HTML(0) PDF(4.30 M)( 23)

  Abstract:

  Objective:To explore the effect and mechanism of miR-139-3p targeting secreted phosphoprotein 1(SPP1)on cis-diamminedichloroplatinum(DDP)in A549 lung cancer cells.Methods:A cisplatin(DDP)-resistant A549/DDP cell model was established via gradient concentration induction,validated by resistance index(IR=3.877)and IC50 determination.The re-sistant cells were divided into five groups:blank control,negative control,miR-139-3p mimic,SPP1 overexpression,and SPP1 knockdown.Multi-platform analyses were performed,including qPCR(miR-139-3p and SPP1 expression),Western blot(SPP1,p-AKT,and total AKT protein levels),CCK-8(proliferation and drug sensitivity),flow cytometry(apoptosis),and du-al-luciferase reporter assays(miR-139-3p/SPP1 interaction).Results:The cisplatin-resistant A549/DDP cells exhibited a signifi-cantly higher IC50 value compared to parental A549 cells(P<0.05),with a resistance index(IR)of 3.877.Quantitative PCR(qPCR)analysis revealed that miR-139-3p expression was markedly upregulated in the miR-139-3p mimic group versus the negative control group(P<0.05).Relative to the miR-139-3p mimic group,SPP1 mRNA levels were significantly elevated in the SPP1-overex-pression group and reduced in the SPP1-knockdown group(P<0.05).Western blotting confirmed corresponding changes in SPP1 pro-tein expression across these groups(P<0.05).CCK-8 assays demonstrated that miR-139-3p overexpression enhanced the proliferation inhibition rate and reduced the IC50 value compared to the negative control(P<0.05),whereas SPP1 overexpression reversed these effects,lowering the inhibition rate and increasing IC50(P<0.05).Compared with the miR-139-3p blank control,the luciferase activity of the wild-type SPP13'UTR luciferase reporter plasmid binding to miR-139-3p analog decreased(P<0.05),and the difference in the luciferase activity of the mutant SPP13'UTR luciferase reporter plasmid binding to miR-139-3p analog was not statistically significant(P>0.05).Compared with the negative control group,the protein expression level of p-AKT in miR-139-3p control group was signifi-cantly decreased(P<0.05),compared with the miR-139-3p control group and SPP1 knockdown group,the protein expression level of p-AKT in SPP1 overexpression group was significantly increased(P<0.05).Conclusion:Overexpression of miR-139-3p or knockdown of SPP1 could inhibit the proliferation of A549/DDP cells,enhance their sensitivity to cisplatin,and the mechanism may be related to the AKT signaling pathway.

Clinical medical research

• Correlation between serum brain-derived neurotrophic factor and mono-cyte to HDL-C ratio levels and post-stroke cognitive impairment in pa-tients with acute ischemic stroke

  Shen Yongling; Fang Jianwei; Cheng Fei; Sang Xiaoyi; Meng Jun; Ma Cuihong; Gohong Country;

  2025,40(5):624-627 ,DOI: 10.3969/j.issn.1005-3697.2025.05.018

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  Abstract:

  Objective:To investigate the correlation between serum brain-derived neurotrophic factor(BDNF),monocyte to HDL-C ratio(MHR)and post-stroke cognitive impairment(PSCI)in patients with acute ischemic stroke(AIS).Methods:96 patients with acute AIS were collected and divided into PSCI group(n=39,<26 points)and non-PSCI group(n=57,≥26 points)accord-ing to the Montreal Cognitive Assessment(MoCA)score at 3 months after stroke.The clinical data such as serum BDNF and MHR lev-els at admission were statistically compared between the two groups,and the receiver operating characteristic(ROC)curve of BDNF and MHR levels in predicting PSCI was drawn.Results:Compared with the non-PSCI group,the PSCI group was older,had shorter years of education,had a higher proportion of hypertension,and had lower serum BDNF and higher MHR levels,the differences were signifi-cant(P<0.05).Logistic regression analysis showed that age(OR=1.530),hypertension(OR=1.335),serum BDNF level(OR=0.755)and MHR(OR=1.645)were risk factors for PSCI in AIS patients(P<0.05).ROC curve analysis showed that the AUC of BDNF and MHR levels in predicting PSCI were 0.833 and 0.745,respectively,and the AUC of the combined diagnosis of the two was 0.882,which was greater than that of a single index(P<0.05).Conclusion:Serum BDNF and MHR are closely related to PSCI in AIS patients.Both indicators can predict the occurrence of PSCI,and the combined detection of the two can improve the predictive abili-ty.

• Effects of iTBS and 1 Hz rTMS on depressive symptoms and cognitive function in elderly patients with depression

  Zhou Xueying; Xu Deyi; Shang Fangjie;

  2025,40(6):703-707 ,DOI: 10.3969/j.issn.1005-3697.2025.06.005

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  Abstract:

  Objective:To explore the effects of intermittent theta burst magnetic stimulation(iTBS)and 1 Hz repetitive tran-scranial magnetic stimulation(rTMS)on depressive symptoms and cognitive function in elderly patients with depression.Methods:Eld-erly patients with depression were divided into iTBS group(n=30)and 1 Hz rTMS group(n=43)according to the treatment regi-men.On the basis of antidepressant treatment for both groups,the left dorsolateral prefrontal lobe of the iTBS group was given a stimula-tion frequency of 50 Hz from the internal frequency,5 Hz from the inter-frequency and stimulation strength of 110%RMT,with a stimu-lation time of 2 s,an intermission of 8 s,and a repetition of 20 times,with a total of 600 pulses lasting for 200 s.The 1 Hz rTMS group was given a stimulation frequency of 1.0 Hz and a stimulation intensity of 110%RMT in the dorsolateral right prefrontal lobe,and was treated for 20 min per day,with a total of 1,200 pulses per treatment.Patients in both groups were treated 5 times per week at the same fixed time for 4 weeks for a total of 20 treatments.The Hamilton Depression Scale 24(HAMD-24),Geriatric Depression Scale(GDS),Beck Suicidal Ideation Inventory-Chinese Version(BSI-CV),Wisconsin Card Sorting Test,and Part A of the Connection Test were used for assessment before and after treatment,and adverse reactions during treatment were recorded.Results:With the prolongation of treat-ment time,the HAMD-24 and GDS scores of the two groups gradually decreased(P＜0.05),and the HAMD-24 and GDS scores of the iTBS group were lower than those of the 1 Hz rTMS group,and the difference was statistically significant(P＜0.05).After4 weeks of treatment,the number of correct responses of the patients in the iTBS group was higher than that of the 1 Hz rTMS group,and the num-ber of incorrect responses,BSI-CV score suicidal ideation intensity and suicide risk were lower than those of the 1 Hz rTMS group,and the TMT-A time was shorter than that of the 1 Hz rTMS group,with a statistically significant difference between the groups(P＜0.05).During the treatment period,there was no statistically significant difference in the incidence rate of adverse reactions between the two groups(P>0.05).Conclusion:There are significant advantages of iTBS over1 Hz rTMS in treating elderly patients with depression in terms of improving depressive symptoms,reducing suicidal ideation,and improving cognitive performance,and there was no increased treatment safety risk.

• Effect of esketamine combined with erector spinae plane block on the qual-ity of recovery in patients after thoracoscopic lobectomy under general an-esthesia

  Liu Tongxin; Hou Yongchao; He Peng; Zhang Zhenghui; Zhou Shuzhi;

  2025,40(6):708-712 ,DOI: 10.3969/j.issn.1005-3697.2025.06.006

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  Abstract:

  Objective:To investigate the effect of intravenous esketamine combined with erector spinae plane block(ESPB)on the postoperative recovery quality in patients undergoing thoracoscopic lobectomy with general anesthesia.Methods:A total of 97 pa-tients who underwent thoracoscopic lobectomy were divided into two groups:group K(n=49)and group C(n=48),according to whether or not they were given esketamine.Patients in K group were given slow intravenous injection of 0.2 mg/kg ketamine after anes-thesia induction and 5 minutes before surgical skin incision,and patients in group C received intravenous injection of physiological sa-line equivalent to group K drugs.Comparison of general indicators,quality of recovery at 24 h postoperatively[40-item Quality of Re-covery Rating Scale(QoR-40)score],cellular immune function before and after 24 h of treatment(NK cells,CD4+T cells,and CD8+T cells),hemodynamics at each time point,and the occurrence of postoperative adverse events between the two groups.Results:Intrao-perative remifentanil dosage was lower in group K than in group C(P＜0.05).The overall QoR-40 score,as well as the subscores for pain,emotional state,and physical comfort in group K were higher than those in group C at 24 hours postoperatively(P＜0.05).Addi-tionally,levels of NK cells,CD4+T cells,and CD8+T cells were higher in the group K than those in group C at 24 hours postoperative-ly(P＜0.05).There were no statistically significant differences in hemodynamics and total incidence of adverse effects between the two groups(P>0.05).Conclusion:The intravenous application of esketamine combined with ESPB for thoracoscopic lobectomy under general anesthesia reduces intraoperative remifentanil dosage,improves the quality of postoperative recovery and improves postoperative cellular immune function in patients without increasing adverse effects.

• Analysis of prognostic factors in patients with septic cardiomyopathy and development of prediction model

  Li Pengfei; Lin Jiafu; Yuan Shun; Jiang Zhi;

  2025,40(6):764-769 ,DOI: 10.3969/j.issn.1005-3697.2025.06.018

  Abstract(13) HTML(0) PDF(1.09 M)( 20)

  Abstract:

  Objective:To investigate the predictive factors of prognosis in patients with septic cardiomyopathy and building pre-diction model.Methods:A retrospective study was conducted on 156 patients with purulent pericarditis,and they were divided into a model set and a validation set in a 7∶3 ratio.The patients in the model set were divided into survival and death groups according to dif-ferent outcomes.The influence factors on the prognosis of the model set patients were evaluated by multivariate Cox regression analysis,and a ROC curve and decision curve analysis(DCA)were used to validate the model using R software.Results:Multiple COX regres-sion analysis indicated that lactic acid,D-dimer,interleukin-6,APACHE-Ⅱscore and SOFA score were independent risk factors for 28 deaths in hospital with septic cardiomyopathy.ROC curve analysis results showed that the predictive value curve area(AUC)of the model set was 0.90,and the AUC of the validation set was 0.83,indicated that the model has good value in the prognosis of patients with septic cardiomyopathy.The results of the clinical decision curve(DCA curve)suggested that the clinical benefit of the validation set and the model set in this model was superior to the"assume all patients die"(all)and"assume all patients die"(none)curves.Conclusion:The prediction model has a good fit to the actual and correction curves,approaching the ideal curve,and has certain clini-cal practical value for patients with septic cardiomyopathy.

• Influence of placental morphology and pathological changes on neonatal outcome in patients with premature rupture of membranes

  Gold mineralization; Zhong Hui; Long Luwen; Zhong Wenna;

  2025,40(6):787-790 ,DOI: 10.3969/j.issn.1005-3697.2025.06.023

  Abstract(11) HTML(0) PDF(1.05 M)( 20)

  Abstract:

  Objective:To study the influence of placental morphology and pathological changes on neonatal outcome in patients with premature rupture of membranes(PROM).Methods:100 parturients with PROM were selected as the study group,and 100 nor-mal parturients without PROM during the same period were selected as the control group.HE staining was used to observe the Placental pathological changes and monitor pregnancy outcome.The Placental pathological changes and pregnancy outcome were compared be-tween the two groups.The influencing factors of premature rupture of membranes were analyzed by Single factor and multiple factor Lo-gistic regression analysis.Results:The incidence of placental pathological changes in the study group was higher(P＜0.05).The inci-dence of adverse pregnancy outcome in the study group was higher than that in the control group(23.00%vs.5.00%,P＜0.05).Uni-variate analysis showed that there were no statistically significant difference in the incidence of uterine malformations,cervical dysfunc-tion,polyhydramnios,anemia during pregnancy,placenta previa,and history of induced labor or miscarriage between the two groups(P>0.05).In the study group,gestational diabetes,hypertension,abnormal fetal position,multiple births,reproductive tract infection and unknown causes were all higher(P＜0.05).Logistic regression analysis showed that the abnormal fetal position,multiple births,and reproductive tract infection were all independent risk factors for premature rupture of membranes(P＜0.05).Conclusion:Prema-ture rupture of membranes is affected by abnormal fetal position,multiple pregnancies,and reproductive tract infections,and the placenta of patients with premature rupture of membranes has pathological changes,which will lead to poor neonatal outcome.

Basic Medical Research

• Relevant studies that NETs promote the secretion of inflammatory media-tors by alveolar-type epithelial cells

  Xu Suqing; Tian Jiamei; Lu Hongyan;

  2025,40(5):557-561 ,DOI: 10.3969/j.issn.1005-3697.2025.05.003

  Abstract(25) HTML(0) PDF(1.15 M)( 19)

  Abstract:

  Objective:To explore the role of neutrophil extracellular traps(NETs)in promoting the secretion of inflammatory mediators by alveolar type epithelial cells(AECII).Methods:In 30 7 d born SD rats,blood was drawn from neutrophils(NE)and di-vided into control(control group),LPS and LPS+DNase groups according to different treatment methods.NETs formation was detec-ted by immunofluorescence in vitro.NETs and AECII were co-cultured,and divided into control group(control group),NETs group and NETs+DNase group according to cell suspension incubation method.AECII apoptosis was detected by flow method,the content of free deoxyribonucleic acid(cf-DNA)in coculture supernatants in each group was detected by fluorescence microarray,and the coculture su-pernatants of interleukin 6(IL-6),interleukin 8(IL-8)and tumor necrosis factor(TNF-α)in each group were determined using ELISA kit.And,the correlation between cf-DNA and IL-6,IL-8,and TNF-α was evaluated using Pearson correlation analysis.Results:According to immunofluorescence,mouse citrullinated histone H3(CitH3)and myeloperoxidase(MPO)were found in neutrophil in LPS and LPS+DNase group,CitH3 and MPO levels in LPS and LPS+DNase groups were higher than in the control group(P<0.05),and CitH3 and MPO in LPS+DNase group were lower than those in LPS group(P<0.05).After AECII apoptosis with NE and NETs,there was no significant difference between early and late apoptosis in the three groups(P＞0.05).The levels of cf-DNA,IL-6,IL-8,and TNF-α in NETs group and NETs+DNase group were higher than those of the control group(P<0.05),NETs+DNase group was lower than NETs group(P<0.05).The content of cf-DNA in cell culture supernatant was positively correlated with the levels of IL-6,IL-8,and TNF-α(r=0.432,0.387,0.326,P<0.05).Conclusion:AECII with NETs in the supernatants with NE,NETs could promote the secretion of inflammatory mediators such as IL-6,IL-8,and TNF-α.Moreover,the more NETs are generated,the more inflammatory mediators such as IL-6,IL-8,and TNF-α are secreted.

Clinical medical research

• Effect of evolocumab in patients with early neurological deterioration after noncardiac acute ischemic stroke

  Wang Xiaogan; Fan Ying; Fan Lijuan; Zhou Lifei; Gao Yongchao; Liu Minxiao;

  2025,40(5):593-596 ,DOI: 10.3969/j.issn.1005-3697.2025.05.011

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  Abstract:

  Objective:To examine the impact of the Evolocumab on early neurological deterioration(END)in patients with non-cardioembolic acute ischemic stroke(NCIS).Methods:A total of 110 patients diagnosed with NCIS and END were recruited as re-search subjects.All patients received standardized and systematic treatment protocols.Based on different therapeutic regimens,the pa-tients were categorized into two groups:the conventional group(n=55),which received standard dual antiplatelet therapy,and the ob-servation group(n=55),which received evolocumab in addition to the standard treatment regimen.The clinical efficacy,cerebral blood flow perfusion indicators[resistance index(RI),cerebral blood volume(CBV),and mean blood flow(Qmean)],levels of nerve func-tion reconstruction factors[nerve growth factor(NGF),gamma aminobutyric acid(GABA),and brain-derived neurotrophic factor(BDNF)],lipid metabolism indicators[apolipoprotein B(ApoB),low-density lipoprotein cholesterol(LDL-C)],and incidence of ad-verse reactions were compared between the two groups.Results:The total clinical efficacy rate in the observation group was higher than that in the conventional group(98.18%vs.85.45%,P<0.05).Post-treatment,the RI value in the observation group was lower than that in the conventional group(P<0.05).Additionally,post-treatment serum levels of CBV and Qmean,as well as NGF,GABA,and BDNF,were higher in the observation group compared to the conventional group(P<0.05).Conversely,post-treatment serum levels of Lp(a),ApoB,and LDL-C,and the total incidence of adverse reactions were lower in the observation group compared to the conventional group(P<0.05).Conclusion:Evolocumab enhances cerebral blood perfusion and facilitates neurological function recovery in NCIS patients with early END.Additionally,it regulates lipid metabolism and decreases the incidence of adverse reactions.

• Efficacy of recombinant human interferon α-1b combined with budesonide aerosol inhalation in treating acute bronchitis in children

  Wei Qiong; Rao Rui; Xu Wenyi; Yang Luling; Lu Zhili; Li Zhixin;

  2025,40(6):774-777 ,DOI: 10.3969/j.issn.1005-3697.2025.06.020

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  Abstract:

  Objective:To explore the clinical efficacy of recombinant human interferon α-1b combined with budesonide and sin-gle budesonide aerosol inhalation in the treatment of acute bronchitis in children.Methods:106 children with acute bronchitis were se-lected as study samples,and were divided into control group and study group by adopting different treatment methods,with 53 cases in each group.The children in the control group were treated with budesonide aerosol inhalation inhalation in addition to conventional treatment,while the children in the study group were combined with budesonide and recombinant human interferon α-1b aerosol inhala-tion inhalation on the basis of conventional treatment,both groups were treated for 1 week.The regression times of clinical symptoms,changes in serum inflammatory factors levels[procalcitonin(PCT),serum C-reactive protein(CRP)],blood routine[white blood cell count(WBC),neutrophil percentage(NEU%)]and lung function indexes[maximum expiratory volume in one second(FEV1),FEV1 to forced vital capacity ratio(FEV1/FVC),and maximum expiratory flow(PEF)]before treatment and after 1 week of treatment and adverse reactions during treatment were compared.Results:The regression times of clinical symptoms in study group were shorter than those in control group(P＜0.05).After 1 week of treatment,the levels of serum PCT,CRP,WBC and NEU%were lower in study group than those in control group(P＜0.05).The FEV1/FVC,PEF and FEV1 in study group were higher compared with those in con-trol group(P＜0.05).During treatment,there were no statistical differences in the incidence rates of adverse reactions between both groups(P>0.05).Conclusion:Recombinant human interferon α-1b combined with budesonide aerosol inhalation inhalation for chil-dren with acute bronchitis can quickly relieve the clinical symptoms,and improve the inflammation level,and it has high safety.

• Value of lung ultrasound score combined with peripheral blood procalci-tonin,C-reactive protein and interleukin-6 levels on evaluating the disease severity and prognosis of patients with acute respiratory distress syn-drome

  Wang Xiyu; Liao Rui; Wang Zhong;

  2025,40(10):1244-1248 ,DOI: 10.3969/j.issn.1005-3697.2025.10.005

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  Abstract:

  Objective:To explore the value of lung ultrasound(LUS)score combined with peripheral blood procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)levels on evaluation of disease severity and prognosis of patients with acute respiratory distress syndrome(ARDS).Methods:109 patients with ARDS were selected.The disease severity and progno-sis of patients were grouped according to the Berlin criteria for ARDS.The baseline data were compared among mild group(n=24),moderate group(n=55)and severe group(n=30).According to the prognosis,they were divided into a survival group(n=68)and a death group(n=41).The differences in LUS score,peripheral blood PCT,CRP and IL-6 levels among the three groups and patients with different prognoses were analyzed,and the evaluation value of the above indexes on the disease severity and prognosis was analyzed.Results:There were statistical differences in prognosis and APACHE Ⅱ score among the three groups(P<0.05).The survival rate of patients in severe group was lower than that in moderate group(P<0.05),and the rate in moderate group was lower than that in mild group(P<0.05).The APACHE Ⅱ score of patients in severe group was higher than that in moderate group(P<0.05),and the score in moderate group was higher than that in mild group(P<0.05).The LUS score and peripheral blood PCT,CRP and IL-6 levels revealed statistical differences among ARDS patients with different disease severities(P<0.05).The severe group was higher than the moderate group(P<0.05),and the moder-ate group was higher than the mild group(P<0.05).Spearman analysis showed that LUS score and peripheral blood PCT,CRP and IL-6 in ARDS patients were positively correlated with disease severity(P<0.05).The LUS score,PCT,CRP and IL-6 in death group were higher than those in survival group(P<0.05).After Logistic regression analysis,it was found that A-PACHE Ⅱ score,LUS score,PCT,CRP,IL-6 and disease severity were the influencing factors of prognosis in patients with ARDS(P<0.05).ROC curve results showed that the areas under the ROC curves of LUS score,peripheral blood PCT,CRP and IL-6 and combined detection for predicting the death prognosis in ARDS patients were 0.778,0.781,0.864,0.856 and 0.982,and the sensitivities were 75.61％,78.05％,90.24％,80.49％and 92.68％,respectively.The combined detection value was higher.Conclusion:LUS score and peripheral blood PCT,CRP and IL-6 levels can effectively evaluate the disease severity of ARDS patients,and have reliable predictive value for prognosis of patients.

Basic Medical Research

• Primary study of vortioxetine in inhibiting proliferation and migration of esophageal cancer cells

  Roman; Ma Qiang; Zhong Xiaowu; Liao Zhongbo; Xu Lei; Guo Xiaolan;

  2025,40(5):545-550 ,DOI: 10.3969/j.issn.1005-3697.2025.05.001

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  Abstract:

  Objective:To investigate the effects and mechanisms of vortioxetine on the proliferation and migration of esophageal squamous cell cancer.Methods:CCK-8 assay was used to detect the viability of Eca109 and KYSE150 cells after treated with vortioxe-tine at different concentrations(0,2,4,6,8,10 μmol/L).Moreover,transwell and scratch assays were employed to evaluate the migra-tion of ESCC cells,plate colony formation assay was used to detect the proliferation.The differentially expressed genes were screened by TCGA database,AutoDock software was used to predict the binding of vortioxetine and cyclooxygenase-2(COX-2)protein.Further-more,the expression of COX-2 mRNA and protein were measured by RT-qPCR and Western blot,respectively.Results:The cell viabil-ity of Eca109 and KYSE150 decreased in a concentration-dependent manner after treatment with different concentrations of vortioxetine(P<0.05),and the semi-inhibitory concentrations(IC50)were 5.086 μmol/L and 5.179 μmol/L,respectively.Compared with the control group,the cell proliferation and migration of the vortioxetine group were reduced(P<0.05).In addition,vortioxetine could in-hibit the expression of COX-2 at mRNA and protein level(P<0.05).Conclusion:Vortioxetine inhibits the proliferation and migration of esophageal cancer cells probablly through COX-2 down-regulation.

Clinical medical research

• Curative effect of Zixiandan combined with dipyridamole and its influences on levels of urine immunoglobulin G and β2 microglobulin in children with Henoch-Schonlein purpura

  Zhang Lili; Shang Lili; Cui Heqing;

  2025,40(5):573-576 ,DOI: 10.3969/j.issn.1005-3697.2025.05.006

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  Abstract:

  Objective:To explore the curative effect of Zixiandan combined with dipyridamole and its influences on levels of u-rine immunoglobulin G and β2 microglobulin in children with Henoch-Schonlein purpura.Methods:According to different treatment methods,80 children with Henoch-Schonlein purpura were divided into control group(n=40,routine comprehensive treatment+dipy-ridamole)and observation group(n=40,Zixiandan on basis of control group),the course of treatment was 7～14 days.Clinical cura-tive effect,scores of TCM syndromes,recovery time of symptoms,renal function and adverse reactions were compared between the two groups.Results:The effective rate of treatment was higher in observation group than in control group(95.00%vs.72.50%,P<0.05).After treatment,scores of TCM syndromes were lower in observation group than control group(P<0.05),disappearance time of lbuminuria,remission time of purpura,length of hospital stay,disappearance time of joint symptoms and remission time of ab-dominal pain were shorter in observation group(P<0.05),levels of urine β2-MG and IgG were lower in observation group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion:Zixiandan combined with dipyridamole can improve TCM symptoms,reduce renal injury and promote recovery process in children with Henoch-Schonlein purpura,which has significant curative effect.

• Diagnostic value of multimodal magnetic resonance imaging in grading and Subtype of meningiomas

  Ji Xiaoxiao; Lv Hairong; Jia Rongrong; Zhao Feng;

  2025,40(6):713-718 ,DOI: 10.3969/j.issn.1005-3697.2025.06.007

  Abstract(9) HTML(0) PDF(1.21 M)( 18)

  Abstract:

  Objective:To analyze the diagnostic value of multimodal magnetic resonance imaging(MRI)in grading and Sub-type of meningiomas.Methods:A total of 98 patients with meningiomas were reviewed.They were divided into benign group(n=78)and malignant group(n=20)according to the pathological examination results.All of them underwent conventional MRI scan and mul-timodal MRI examination upon admission.The multimodal MRI parameters[apparent diffusion coefficient(ADC),local cerebral blood flow(rCBF),magnetic sensitive signal intensity(ITSS),N-acetylaspartate(NAA)/choline(Cho),NAA/creatine(Cr),Cho/Cr]of patients with benign and malignant meningiomas,and patients with different subtypes of benign meningiomas were compared.The diag-nostic value of multimodal MRI for meningioma classification and grading were analyzed by receiver operating characteristic(ROC)curves.Results:The ADC,NAA/Cho ratio and NAA/Cr ratio of meningiomas in the malignant group were lower than those in the be-nign group(P＜0.05).The rCBF,ITSS and Cho/Cr ratio were higher than those in the benign group(P＜0.05).The AUC values of three-dimensional arterial spin labeling(3D-ASL),diffusion-weighted imaging(DWI),susceptibility-weighted imaging(SWI)and proton magnetic resonance spectroscopy(1 H-MRS)for grading of meningiomas were 0.723,0.735,0.777 and 0.870.The AUC of com-bined diagnosis was 0.957.There were significant differences in rCBF,ITSS,NAA/Cho ratio,NAA/Cr ratio and Cho/Cr ratio among patients with different subtypes of benign meningiomas(P＜0.05).Conclusion:Multimodal MRI is helpful in clinical grading and Subtype of meningiomas.

• Effects of dapagliflozin combined with enalapril on renal function,urinary podocyte-associated protein and inflammatory factors in patients with dia-betic nephropathy

  Lian Huan; Hu Chun; Deng Xuan; Wu Ting;

  2025,40(6):719-722 ,DOI: 10.3969/j.issn.1005-3697.2025.06.008

  Abstract(15) HTML(0) PDF(722.81 K)( 18)

  Abstract:

  Objective:To investigate the efficacy of dapagliflozin combined with enalapril in the treatment of diabetic nephropa-thy(DN).Methods:A total of 160 patients with DN were divided into control group and observation group according to different treat-ment methods,with 80 cases in each group.The two groups were treated with enalapril and dapagliflozin combined with enalapril respec-tively for 12 weeks.Before and after treatment,the levels of 24 h urinary protein quantification(24 h UAE),urinary albumin to creati-nine ratio(ACR),serum creatinine(Scr),urea nitrogen(BUN)and estimated glomerular filtration rate(eGFR)were detected,and the levels of urine membrane protein(Podocin),podocyte slit diaphragm protein(Nephrin)and serum interleukin 6(IL-6),tumor necrosis factor α(TNF-α)were measured.The efficacy and adverse reactions of the two groups were compared.Results:The total ef-fective rate of the observation group was higher than that of the control group(P＜0.05).After treatment,compared with the control group,the 24 h UAE level,ACR value,Scr and BUN in the observation group decreased(P＜0.05),and the eGFR level increased(P＜0.05).The levels of urinary Podocin,Nephrin,serum IL-6,and TNF-α in the observation group were lower than those in the con-trol group(P＜0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Dapagliflozin combined with enalapril can more effectively reduce proteinuria,improve renal function and im-prove the efficacy of DN.The mechanism may be related to inhibiting inflammation and alleviating podocyte injury.

• Clinical effect of rigid neuroendoscopy and traditional drilling irrigation and drainage in treating chronic subdural hematoma

  Dong Xichao; Wang Fenglu; Zhao Haikang; Rongbo;

  2025,40(6):736-739 ,DOI: 10.3969/j.issn.1005-3697.2025.06.012

  Abstract(23) HTML(0) PDF(739.29 K)( 18)

  Abstract:

  Objective:To explore the clinical effect of rigid neuroendoscopy and traditional drilling irrigation and drainage in the treatment of chronic subdural hematoma(CSDH).Methods:The clinical data of CSDH patients were retrospectively analyzed.Accord-ing to different treatment methods,they were divided into traditional group(treated with traditional drilling irrigation and drainage)and endoscopic group(treated with rigid neuroendoscopy),48 cases in each group.The differences in perioperative indicators,GCS score,Markwalder grading and NIHSS score were compared between groups,and the complications and recurrence rate in the two groups were counted.Results:The intraoperative blood loss,hospitalization time and immediate postoperative hematoma clearance rate in endoscopic group were better than those in traditional group(P＜0.05),and the total surgical time in traditional group was shorter than that in en-doscopic group(P＜0.05).At 7 days after surgery,the GCS score and Markwalder neurological function grading in the two groups were improved(P＜0.05),but there were no obvious differences between the two groups(P>0.05).Different time points after surgery,the NIHSS score in both groups was reduced compared to before surgery(P＜0.05),and the score was lower in endoscopic group than that in traditional group(P＜0.05).The complications showed no significant differences(P>0.05),and the recurrence rate of hematoma was lower than that in traditional group(P＜0.05).Conclusion:Both rigid neuroendoscopy and traditional drilling irrigation and drainage can effectively treat CSDH,but neuroendoscopy has higher hematoma clearance rate,shorter hospitalization time and lower postoperative recurrence rate,which is worthy of clinical promotion.

• Effect of periodontal therapy combined with orthodontics and implant multidisciplinary treatment for patients with dentition defect

  Zhang Chunhui; Guo Jianru; Feng Yan;

  2025,40(6):732-735 ,DOI: 10.3969/j.issn.1005-3697.2025.06.011

  Abstract(15) HTML(0) PDF(3.12 M)( 17)

  Abstract:

  Objective:To investigate the clinical effect of periodontal therapy+orthodontic+implant in the treatment of denti-tion defect.Methods:84 patients with dentition defect were included and divided into two groups according to different treatment meth-ods,with 42 cases in each group.The control group received conventional treatmen,and the observation group was treated with periodon-tal therapy+orthodontic+implant multidisciplinary treatment.The clinical efficacy,lateral skull X-ray measurement results[the dis-tance from the upper dental groove seat point to the maxillary plane(A-PFP),the distance from the lower dental groove seat point to the maxillary plane(B-PFP),the angle between the anterior skull base plane and the mandibular plane(SN-OP),the angle between the orbital ear plane and the mandibular plane(FH-MP),the distance from the upper dental groove edge point to the submental point(ANS Me),the distance from the upper lip protrusion point to the aesthetic line(Ls-E line),and the distance from the lower lip pro-trusion point to the aesthetic line(Li-E line)]and tooth function(self-made dental function score)were compared between the two groups.Results:The total effective rate of observation group was higher than that of control group(P＜0.05).After treatment,there was a statistically significant difference in the changes of A-PFP,SN-OP,FH-MP,ANS-Me and Ls-E lines between the two groups(P＜0.05),and the scores of mastication,pronunciation and swallowing in the observation group were higher than those in the control group(P＜0.05).Conclusion:The combination of periodontal therapy+orthodontic+implant can improve the clinical effect and improve the dental function of patients with dental defects.