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Inhibition of gastric epithelial cell pyroptosis in a rat model of chronic atrophic gastritis by YiQi KangWei Decoction through regulation of the NLRP3/Caspase-1/GSDMD pathway
Mei Fangyu; Yang Yu-ke; Zhang Wen; Zou Ya; Yang Yang; Liu Hao
2026,41(7):769-776+804 ,DOI: 10.3969/j.issn.1005-3697.2026.07.001
Abstract:
Objective: To investigate the ameliorative effect of YiQi KangWei Decoction on gastric mucosal injury in rats with chronic atrophic gastritis (CAG) and to explore its underlying mechanism by which it inhibits pyroptosis of gastric epithelial cells mediated by the NLRP3/Caspase-1/GSDMD signaling pathway. Methods: 39 male SD rats were randomly divided into a control group (n=6) and a model group (n=33), the model group established a CAG model. Among the 30 rats with successful modeling, they were randomly assigned to the CAG model group, the low-dose group of YiQi KangWei decoction, the medium-dose group of YiQi KangWei Decoction, the high-dose group of YiQi KangWei Decoction, and the vitacoenzyme group. Each group consisted of 6 rats. YiQi KangWei Decoction low, medium and high dose groups were intragastric administrated with compound water decoction 5 g/kg/d, 10.15 g/kg/d and 20.3 g/kg/d, respectively, the positive drug group was administered with vitacoenzyme (200 mg/kg/d), the control group and the CAG model group were administered with the same volume of normal saline. The rats were observed for general symptoms during the intervention period, and their body weight was measured weekly. After the intervention, the gastric tissue pathological conditions were observed by HE staining. The levels of serum pepsinogen I (PGI), pepsinogen II (PGII), and the PGI/PGII ratio (PGR) were measured by ELISA, and the levels of interleukin-18 (IL-18) and interleukin-1β (IL-1β) in gastric juice were measured. The expression of nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3), GSDMD-N-terminal fragment (GSDMD-N), and high mobility group box 1 (HMGB1) in gastric tissue was detected by immunohistochemistry. The expression of Caspase-1, cleaved Caspase-1, IL-18, IL-1β, cleaved IL-1β, GSDMD, GSDMD-N, NLRP3, nuclear factor κB (p65), and phosphorylated nuclear factor κB (p-p65) proteins in gastric tissue was measured by Western Blot. Results: Compared with the CAG model group, YiQi KangWei Decoction could improve the mental state and weight gain of rats, improve the histopathological morphology and reduce the pathological scores of gastric tissue, lower the levels of PGI in serum, increase the levels of PGII and PGR, and lower the levels of IL-18 and IL-1β in gastric juice, reduce the expression of NLRP3, GSDMD-N, and HMGB1 in gastric tissue, and lower the expression of cleaved Caspase-1, IL-18, cleaved IL-1β, GSDMD-N, NLRP3, p-p65, and phosphorylated p65 protein. Conclusion: Yi Qi KangWei Decoction may inhibit the occurrence of cell pyroptosis and inflammation in CAG rats by regulating the NLRP3/Caspase-1/GSDMD signaling pathway, thereby alleviating gastric atrophy and gastric tissue damage, providing new theoretical basis and therapeutic ideas for the treatment of CAG.
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The injury mechanism of rectal mucosa induced by neoadjuvant pelvic radiotherapy for rectal cancer based on proteomic approaches
Xue Junze; Wang Kun; Lin Hao; Zhang Yihao; Jiao Xuelong; Tan Xiaojie; Jiang Haitao
2026,41(7):777 ,DOI: 10.3969/j.issn.1005-3697.2026.07.002
Abstract:
Objective: To investigate the molecular mechanisms and pathway information of acute and chronic radiation enteritis following neoadjuvant radiotherapy for rectal cancer by proteomics-based approaches. Methods: Data-Independent Acquisition (DIA) proteomics was used to compare the non-tumor rectal tissues from patients without radiotherapy (group C) with those collected at 60~90 days (group E) and 150~160 days (group P) after radiotherapy. Differentially expressed proteins (DEPs) with |fold change (FC)| > 1.5 and P<0.05 were screened, and enrichment analyses of Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), Eukaryotic Orthologous Groups (KOG) and protein domain were performed on these DEPs. Results: Compared with group C, 94 DEPs were up-regulated and 44 were down-regulated in group E, the up-regulated proteins were mainly enriched in peptide hormone processing, neuroactive ligand-receptor interaction pathway and synaptic protein domains. In the comparison of group P and group C, 46 DEPs were up-regulated and 56 were down-regulated, with the up-regulated proteins primarily enriched in negative regulation of DNA recombination, mitogen-activated protein kinase (MAPK) and Wingless-type (Wnt) signaling pathways, accompanied by changes in domains such as basic leucine zipper. Conclusion: The early phase of radiation-induced rectal injury is characterized by hyperactivity of the enteric neuro-endocrine system, whereas chronic inflammation and matrix deposition in the late phase are likely driven by the activation of MAPK/Wnt pathways. These findings may offer novel insights for the prevention and treatment of radiation enteritis.
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IRF6 as an independent prognostic biomarker and predictor of immunotherapy response in clear cell renal cell carcinoma
Chen Jiali; Li Bo; Tang Xiangyu; He Yujie
2026,41(7):784 ,DOI: 10.3969/j.issn.1005-3697.2026.07.003
Abstract:
Objective: To investigate the expression level and clinical significance of interferon regulatory factor 6 (IRF6) in clear cell renal cell carcinoma (ccRCC), and to analyze its association with the tumor immune microenvironment. Methods: The expression of IRF6 in ccRCC tissues was analyzed using The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Clinical correlation, survival analysis, Cox regression, and nomogram modeling were performed to evaluate its prognostic value. The relationship between IRF6 expression and the tumor immune microenvironment was assessed using the ESTIMATE and CIBERSORT algorithms, followed by correlation analysis with immune checkpoint molecules and tumor mutation burden (TMB). Finally, immunohistochemistry (IHC) was conducted on 30 clinical samples to validate IRF6 protein expression. Results: IRF6 expression was downregulated in ccRCC tissues compared with normal kidney tissues (P<0.001). Low IRF6 expression was associated with higher histologic grade, advanced clinical stage, and metastatic status (P<0.05). Survival analysis demonstrated that patients with low IRF6 expression had shorter overall survival (OS), disease-specific survival (DSS), and progression-free survival (PFS) (P<0.001). Multivariate Cox regression confirmed that IRF6 was an independent protective prognostic factor (P<0.01). The nomogram incorporating IRF6 exhibited good predictive performance. Low IRF6 expression was correlated with higher ImmuneScore and ESTIMATE Score, increased infiltration of macrophages (M0/M1) and activated dendritic cells (P<0.05), and showed a negative correlation with immune checkpoints such as PD-1 and CTLA-4. IRF6 expression was inversely correlated with TMB (P<0.001). IHC results revealed that IRF6 was lowly expressed in tumor tissues (P<0.05). Conclusion: IRF6 is downregulated in ccRCC and serves as an independent protective prognostic biomarker. Its low expression is associated with an immunosuppressive tumor microenvironment and reduced immunotherapy responsiveness. IRF6 may act as a promising biomarker for prognosis evaluation and prediction of immunotherapy response in ccRCC.
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The radiosensitizing effect of targeted nanoparticles loaded with paclitaxel and etanidazole on hypoxic tumor cells
2026,41(7):792 ,DOI: 10.3969/j.issn.1005-3697.2026.07.004
Abstract:
Objective: To design a VEGF monoclonal antibody (mAb)-modified nanoparticles co-loaded with paclitaxel (PTX) and etanidazole (ETA) for radioresistance in hypoxic tumor cells. Methods: Poly(lactic-co-glycolic acid) (PLGA) nanoparticles co-loaded PTX and ETA were prepared using a single emulsion-solvent evaporation method. VEGF monoclonal antibodies were conjugated to the nanoparticles via carbodiimide/N-hydroxysuccinimide (EDC/NHS) coupling. High-performance liquid chromatography (HPLC) was employed to analyze drug encapsulation efficiency, loading capacity, and drug release simulated in vitro. The morphology of nanoparticles was observed by scanning electron microscopy (SEM). Cellular uptake of nanoparticles by human breast cancer MCF-7 cells and cervical cancer HeLa cells was evaluated using fluorescence microscopy. The effect of drug loaded nanoparticles on the clonal formation ability of tumor cells were analysed and detected by cell survival. Results: The targeted nanoparticles exhibited a spherical morphology with an average particle size of approximately 120 nm. The drug loading capacities for PTX and ETA were 4.66% and 1.94%, respectively. In vitro release profiles demonstrated biphasic characteristics: PTX showed sustained release (30% over 5 days), while ETA exhibited rapid release (50% within 3 h and 90% within 24 h). VEGF antibody modification significantly enhanced nanoparticle uptake by both MCF-7 and HeLa cells. Combined with 10 Gy radiation, the targeted nanoparticles significantly reduced the colony formation rate of hypoxic tumor cells compared to non-targeted counterparts. Conclusion: The developed nano-system synergistically enhanced radiotherapeutic efficacy through dual mechanisms of hypoxia targeting and spatiotemporally differential drug release to provide a novel strategy to overcome tumor radioresistance.
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Construction and validation of an nomogram for predicting the prognosis of advanced non-small cell lung cancer treated with immunotherapy based on albumin-related inflammatory composite indicators
Wu Hang; Chen Shirui; Wang Dan; Zhang Guibin; He Fang; Jiang Li
2026,41(7):797 ,DOI: 10.3969/j.issn.1005-3697.2026.07.005
Abstract:
Objective: To investigate the prognostic predictive value of a nomogram constructed based on albumin-related inflammatory composite indicators for patients with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs). Methods: The clinical data of 274 patients with advanced NSCLC were retrospectively analyzed. The overall survival (OS) was set as the primary endpoint. Independent prognostic factors were selected through the Cox proportional hazards model and a nomogram was constructed. The performance of the model was evaluated using C-index, time-dependent ROC curve, calibration curve, and DCA curve, etc. At the same time, the prognostic risk stratification ability of the model was analyzed. Results: Liver metastasis, TNM stage IV, CEA ≥ 2.54 ng/mL, and high-risk group of NPS were independent risk factors for OS. CALLY ≥ 0.6 was an independent protective factor. The AUC of the nomogram for 1-year and 3-year OS was 0.755 and 0.801, respectively, and the C-index was 0.72. The calibration curve and DCA confirmed the good fit of the model and clinical net benefit, and the patients could be stratified into low, medium, and high-risk groups. The stratification ability was significant (P<0.01). Conclusion: The nomogram constructed based on liver metastasis, TNM stage, CEA, NPS, and CALLY can effectively predict the OS of patients, and the prognostic risk stratification ability is good. The model has excellent discrimination and calibration, and has high clinical practical value, which can provide precise references for the formulation of individualized immunotherapy strategies.
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Clinical efficacy and prognosis analysis of intra-aqueous access reconstruction combined with phacoemulsification in the treatment of primary open-angle glaucoma with cataract
2026,41(7):805 ,DOI: 10.3969/j.issn.1005-3697.2026.07.006
Abstract:
Objective: To compare the clinical efficacy and prognosis of intra-aqueous access reconstruction combined with phacoemulsification and glaucoma valve implantation combined with phacoemulsification in the treatment of primary open-angle glaucoma with cataract. Methods: A total of 152 patients with primary open-angle glaucoma and cataract were selected. They were divided into two groups based on the different treatment methods: group A (n=76) received glaucoma valve implantation combined with phacoemulsification, and group B (n=76) received intra-aqueous access reconstruction combined with phacoemulsification. The intraocular pressure, best corrected visual acuity, anterior chamber depth (ACD), thickness of the ganglion cell complex (GCC) in the macular area, central corneal thickness (CCT), corneal endothelial function indicators, and complications were compared between the two groups. Results: Compared with before the operation, 1 month after the operation, both groups showed a reduction in intraocular pressure. However, there was no significant difference in intraocular pressure between the two groups (P>0.05). The best corrected visual acuity of the operated eyes in group B was lower than that in group A (P<0.05), and the ACD was higher in group B (P<0.05). The GCC in group B was higher than that in group A, while the CCT was lower than that in group A (P<0.05). 1 month after the surgery, the density of corneal endothelial cells and the proportion of hexagonal cells in group B were both higher than those in group A (P<0.05). Compared with group A, the coefficient of variation of corneal endothelial cells in group B was smaller (P <0.05). There was no statistically significant difference in the overall incidence of complications between the two groups (P >0.05). Conclusion: Reconstruction of intra-aqueous access reconstruction combined with phacoemulsification for patients with primary open-angle glaucoma and coexisting cataract effectively lowers intraocular pressure, restores visual function, mitigates corneal endothelial cell damage, and does not increase the incidence of postoperative complications.
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The efficacy and safety of low-molecular-weight heparin and rivaroxaban in thromboprophylaxis after total joint arthroplasty
Zhang Yu; Department of Real Estate
2026,41(7):810 ,DOI: 10.3969/j.issn.1005-3697.2026.07.007
Abstract:
Objective: To compare the efficacy and safety of low-molecular-weight heparin and rivaroxaban in the prevention of thrombosis after total joint arthroplasty (TJA) based on a prospective cohort. Methods: A total of 280 adult patients scheduled for elective total hip arthroplasty or total knee arthroplasty were prospectively recruited and divided into two groups based on different intervention methods. The heparin group included 140 patients who were given subcutaneous injections of low-molecular-weight heparin after surgery. The rivaroxaban group included 140 patients who were given oral rivaroxaban after surgery. Both groups were treated for 21 days, and the efficacy and safety of thrombosis prevention were compared between the two groups. Results: The incidence rates of deep vein thrombosis (DVT) in the rivaroxaban group at 7, 14, and 21 days after surgery were lower than those in the heparin group (P<0.05). After treatment, the plasma fibrinogen (Fib) levels, the prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT) were longer than those before treatment (P<0.05), and the rivaroxaban group was longer than the heparin group (P<0.05). The whole blood low shear viscosity, whole blood medium shear viscosity, whole blood high shear viscosity, and endothelin-1 (ET-1) levels were all lower than those before treatment (P<0.05), and those in the rivaroxaban group were lower than those in the heparin group (P<0.05). The nitric oxide (NO) levels were higher than those before treatment, and the rivaroxaban group were higher than the heparin group (P<0.05). The incidence rates of bleeding and subcutaneous ecchymosis in the rivaroxaban group were lower than those in the heparin group (P<0.05), the proportion of the maximum subcutaneous ecchymosis area in the rivaroxaban group was lower than that in the heparin group (P <0.05). Conclusion: Rivaroxaban can better control the hemorheology of patients after TJA, improve vascular endothelial function, and regulate coagulation function indicators, thereby more effectively preventing postoperative thrombosis and is safer than low-molecular-weight heparin.
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Efficacy of different concentrations 5-aminolevulinic acid photodynamic therapy in the treatment of grade I-II CIN combined with HPV infection
Liu Xinyu; Qiu Yafen; Yao Guang
2026,41(7):815 ,DOI: 10.3969/j.issn.1005-3697.2026.07.008
Abstract:
Objective: To observe clinical efficacy of different concentrations 5-aminolevulinic acid photodynamic therapy (5-ALA-PDT) in grade I-II cervical intraepithelial neoplasia (CIN) combined with human papillomavirus (HPV) infection. Methods: A total of 104 patients with grade I-II CIN and HPV infection were enrolled as the research objects. According to different interventions, they were divided into high-concentration group (20% 5-ALA-PDT) and low-concentration group (10% 5-ALA-PDT), 52 cases in each group. Both groups were treated for 6 months. The efficacy, negative conversion rate of HPV, cervical function (cervical canal stenosis, abnormality of cervical mucus secretion, cervical adhesion) and adverse reactions (scar formation, infection, pain, increased vaginal discharge, lower abdominal distension) were compared between the two groups. Results: After 6 months of treatment, there was no significant difference in total response rate between patients with grade I CIN and those with grade II CIN in high-concentration group and low-concentration group (P>0.05), but there were significant differences in total response rate between high-concentration treatment and low-concentration treatment for patients with grade II CIN (P<0.05). In high-concentration group, there was no significant difference in 6-month negative conversion rate of HPV between grade I CIN and grade II CIN (P>0.05). In low-concentration group, 6-month negative conversion rate of HPV in grade I CIN was higher than that in grade II CIN (P<0.05). For patients with grade I CIN, there was no significant difference in negative conversion rate of HPV between high-concentration treatment and low-concentration treatment (P >0.05). For patients with grade II CIN, negative conversion rate of HPV after high-concentration treatment for 6 months was higher than that after low-concentration treatment (P <0.05). After 6 months of treatment, there was no significant difference in the incidence of cervical canal stenosis, abnormal cervical mucus secretion and cervical adhesion between high-concentration group and low-concentration group (P>0.05). The incidence of adverse reactions in high-concentration group was higher than that in low-concentration group (P<0.05). Conclusion: The efficacy of high-concentration 5-ALA-PDT is significant in grade II CIN combined with HPV infection, and negative conversion rate of HPV is considerable. However, the effect of high-concentration 5-ALA-PDT is few in improving efficacy and negative conversion rate of HPV in patients with grade I CIN and HPV infection, and it will instead increase the incidence of adverse reactions.
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Effect and mechanism of enoxaparin sodium combined with modified Xuefu Zhuyu Decoction and acupuncture in DVT
Wang Yulu; Yang Zheng; Han Fang; Chang Chunyang
2026,41(7):819 ,DOI: 10.3969/j.issn.1005-3697.2026.07.009
Abstract:
Objective: To observe the curative effect of enoxaparin sodium combined with modified Xuefu Zhuyu Decoction and acupuncture in deep vein thrombosis (DVT) and explore its action mechanism. Methods: The patients with DVT treated in the hospital were retrospectively enrolled, including 53 cases in control group (anticoagulation therapy with enoxaparin sodium) and 53 cases in observation group (enoxaparin sodium combined with modified Xuefu Zhuyu Decoction + acupuncture). The clinical effect, circumference difference of affected limbs before and after treatment, and level of serum D-dimer (D-D) were compared between the two groups. The changes in hemorheology (hematocrit, red blood cell distribution width, fibrinogen) and serum inflammatory factor [interleukin (IL)-6] before and after treatment were observed. The correlation between hemorheology indexes, serum inflammatory factor and circumference difference of affected limbs was analyzed. Results: Compared with control group after treatment, total response rate was higher in observation group (P<0.05), circumference difference of thigh/shank, levels of serum D-D, hemorheology indexes and IL-6 were lower (P <0.05). The hemorheology indexes and serum IL-6 were positively correlated with circumference difference of thigh/shank (P<0.001). Conclusion: The clinical curative effect of modified Xuefu Zhuyu Decoction combined with acupuncture is more significant in DVT, and the mechanism of action may be related to improving hemorheology state and inhibiting excessive inflammatory response.
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Clinical outcomes of western medicine plus Fuyang cupping therapy for chronic pelvic pain secondary to pelvic inflammatory disease and its impact on serum inflammatory factors and hemorheology
Wang Fangfang; Liu Depei; Liao Yunxia
2026,41(7):823 ,DOI: 10.3969/j.issn.1005-3697.2026.07.010
Abstract:
Objective: To investigate the efficacy of Fuyang cupping therapy combined with western medicine in the treatment of chronic pelvic pain secondary to sequelae of pelvic inflammatory disease (SPID-CPP). Methods: A total of 100 SPID-CPP patients were selected and divided into two groups according to different treatment options, 50 cases in each group. The control group was managed with oral ibuprofen. On this basis, the observation group received supplementary Fuyang cupping sessions. Both groups received treatment for 3 menstrual cycles. The scores of pain score (lower abdominal pain, lumbosacral pain), local sign score, the TCM syndrome scores and quality of life scores were compared between the two groups. Serum inflammatory factors [hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6)] and hemorheology indexes [erythrocyte sedimentation rate (ESR), fibrinogen (Fib), plasma viscosity] were detected in both groups, and the efficacy and incidence of adverse reactions were assessed in each of the two groups. Results: The total effective rate was higher in the observation group than that in the control group (P<0.05). Post-treatment assessments revealed that the observation group had reduced lower abdominal pain, lumbosacral pain, local sign, and TCM syndrome scores relative to the control group (P<0.05), while their quality of life score was elevated (P<0.05). After treatment, the levels of serum hs-CRP, IL-6, ESR, Fib and plasma viscosity in the observation group were lower than those in the control group (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion: Fuyang cupping therapy assisted with western medicine exerts a significant efficacy in the treatment of SPID-CPP. It can more effectively alleviate pain, improve local symptoms, and its underlying mechanism may be related to reducing inflammation and improving hemorheology.
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The correlation between CD56 expression in bone marrow plasma cells, circulating plasma cells and bone marrow infiltration patterns in multiple myeloma
Sun Xuejing; Yan Xiaoyan; Liu Congyan; Sun Wanling; Hui Wuhuan
2026,41(7):827 ,DOI: 10.3969/j.issn.1005-3697.2026.07.011
Abstract:
Objective: To investigate the intrinsic associations between the immunophenotype of bone marrow plasma cells, the status of circulating plasma cells (CPCs), and bone marrow infiltration patterns in patients with multiple myeloma (MM), thereby elucidating the molecular mechanisms underlying CPCs formation. Methods: A total of 83 patients with newly diagnosed MM were enrolled and divided into a CPCs-positive group (n=34) and a CPCs-negative group (n=49) based on peripheral blood flow cytometry results. Flow cytometry was employed to detect the expression of CD56, CD27, CD81, CD45, and CD19 in bone marrow and peripheral blood plasma cells, as well as to assess cytoplasmic light chain restriction. Bone marrow biopsy pathology was performed to determine the bone marrow infiltration patterns (interstitial, nodular, or diffuse). Differences in immunophenotype and infiltration patterns between the two groups were compared. The correlation of CD56, CD27, and CD81 expression in the CPC-positive group was analyzed, and multivariate Logistic regression was used to identify independent influencing factors for CPCs positivity. Results: In the CPCs-positive group, the proportion of Lambda light chain restriction was higher than that in the negative group, while the proportion of Kappa light chain restriction was lower than that in the negative group (P<0.05), and the proportion of diffuse infiltration was also higher than that in the negative group (P<0.05). The positivity rates of CD56 and CD27 in bone marrow plasma cells in the CPCs-positive group were lower than those in the negative group (P<0.05), whereas the positivity rate of CD81 was higher than that in the negative group (P<0.05). CD56 expression was positively correlated with CD27 (P <0.05) and negatively correlated with CD81 (P <0.05). Gradient differences in immunophenotypes were observed among different bone marrow infiltration patterns: within the CPCs-positive group, patients with diffuse infiltration exhibited lower positivity rates of CD56 and CD27 compared to those with nodular and interstitial infiltration (P<0.05), conversely, the positivity rate of CD81 in patients with diffuse infiltration was higher than that in patients with nodular and interstitial infiltration (P <0.05). Multivariate Logistic regression analysis indicated that only the reduced positivity rate of CD56 in bone marrow plasma cells was an independent influencing factor for CPC positivity (P<0.05). Conclusion: The loss of CD56 expression in bone marrow plasma cells is a key driving factor for the emergence of CPCs in MM patients, and this aberrant molecular expression is closely associated with the diffuse bone marrow infiltration pattern. CD56 can serve as a molecular marker to identify high-risk MM patients with “migration-prone” characteristics, providing a novel basis for risk stratification and targeted therapy in multiple myeloma.
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Effect of tegileridine fumarate on postoperative analgesia, early recovery quality, and safety evaluation in patients undergoing laparoscopic gastrointestinal tumour surgery
Liang Jiahao; Qian Chuanmu; Liang Fei
2026,41(7):832 ,DOI: 10.3969/j.issn.1005-3697.2026.07.012
Abstract:
Objective: To investigate the effect of tegileridine fumarate on postoperative analgesia and early recovery quality, as well as its safety, in patients undergoing laparoscopic gastrointestinal tumour surgery. Methods: A retrospective analysis was conducted on 120 patients who underwent laparoscopic gastrointestinal tumour surgery. All patients received postoperative analgesia via patient-controlled intravenous analgesia (PCIA). Based on the different analgesic drugs used, they were divided into an observation group (tegileridine fumarate, n =53) and a control group (sufentanil combined with nalbuphine, n=67). Postoperative pain intensity, serum pain mediator levels, and sleep quality were assessed. Hospital stay duration, hospitalisation costs, and related adverse reactions were also recorded. Results: The VAS scores at 24, 48, and 72 h postoperatively were lower in the observation group than in the control group(P<0.05). At 72 h postoperatively, serum levels of substance P(SP), prostaglandin E2(PGE2), and calcitonin gene-related peptide(CGRP) were lower in the observation group than in the control group(P<0.05). On the day after surgery, the observation group showed better scores than the control group in sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, and total Pittsburgh Sleep Quality Index (PSQI) score(P<0.05). The hospital stay was shorter(P<0.05) and hospitalisation costs were lower(P<0.05) in the observation group compared to the control group. The incidence of postoperative nausea/vomiting and respiratory depression in the observation group was lower than that in the control group (P<0.05). Conclusion: Tegileridine fumarate helps optimise postoperative analgesic effects and early sleep quality in patients undergoing laparoscopic gastrointestinal tumour surgery, shortens hospital stay, reduces hospitalisation costs, and demonstrates a favourable safety profile
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Effects of ezetimibe combined with rosuvastatin on efficacy, blood lipids, limb motor function in elderly patients with intracranial atherosclerosis caused ischemic stroke
Zhang Jie; Zhang Haiyan; Cao Wei; Cao Lin; Meng Yan; Wang Yu
2026,41(7):837 ,DOI: 10.3969/j.issn.1005-3697.2026.07.013
Abstract:
Objective: To explore the effects of ezetimibe combined with rosuvastatin on efficacy, blood lipids, limb motor function in elderly patients with intracranial atherosclerosis (ICA) caused ischemic stroke. Methods: A total of 190 elderly patients with ICA caused ischemic stroke were selected as the research subjects. According to treatment methods, the patients were divided into control group and observation group, with 95 cases in each group. The patients of control group were treated with rosuvastatin, and observation group was treated with ezetimibe on the basis of the control group. The patients of two groups received continuous treatment for 6 months. The efficacy \[modified rankin scale (mRS), national institutes of health stroke scale(NIHSS)\], blood lipids\[total cholesterol(TC), triglycerides(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol (LDL-C), lipoprotein-associated phospholipase A2 (Lp-PLA2)\], limb motor function \[Fugl-Meyer motor assessment(FMA) score, activities of daily living(ADL) score\], and adverse reactions of two groups were compared. Results: After treatment, the mRS and NIHSS scores of observation group were both lower than those of the control group(P<0.05). After treatment, the TG, TC, LDL-C, and Lp-PLA2 of the observation group were decreased compared with control group(P<0.05). After treatment, the FMA upper and lower limb motor scores and ADL scores in the observation group were increased compared with control group (P <0.05). There was no statistically significant difference in the occurrence of adverse reactions between the two groups(P>0.05). Conclusion: The combination of ezetimibe and rosuvastatin improved neurological function and reduced blood lipid levels in elderly patients with ICA caused ischemic stroke. The combination therapy improved the patients’ limb motor function and daily living ability.
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Association of endometriosis with cancer risk: based on the NHANES observational study and mendelian randomization analysis
2026,41(7):841 ,DOI: 10.3969/j.issn.1005-3697.2026.07.014
Abstract:
Objective: To explore the association between endometriosis and cancer risk, and to evaluate the potential causal relationship through Mendelian Randomization (MR) analysis. Methods: Female participants were divided into two groups according to the presence or absence of endometriosis. Multivariate Logistic regression model was used to analyze the relationship between endometriosis and the risk of cancer. The possible confounding factors such as age, body mass index (BMI), race, education level, smoking status, marital status, menarche age, parity, family poverty to income ratio (PIR), diabetes and hypertension were gradually controlled. Subgroup analysis and interaction testing were performed. To test potential causal relationships, single nucleotide polymorphisms (SNPs) associated with endometriosis were selected as instrumental variables on the basis of genome-wide association studies (GWAS), and the causal effects were mainly estimated by inverse variance weighting(IVW). Sensitivity analysis was performed using MR-Egger and Cochrane’s Q test. Results: A total of 3,987 participants were included in NHANES data. Multivariate Logistic regression showed that endometriosis was associated with an increased incidence of malignant tumors \[odds ratio (OR):2.160,95% confidence interval(95%CI):1.429~3.264,P < 0.001\]. The results of subgroup analysis were consistent(all P for interaction>0.05). Two-sample Mendelian randomization analysis showed that endometriosis was associated with an increased risk of ovarian cancer(OR=1.493,95%CI:1.220~1.827,P< 0.001), endometrial cancer(OR=1.125,95%CI:1.037~1.219,P=0.004). There was a causal relationship between the increased risk of cervical cancer(OR=1.186,95%CI:1.063~1.323,P=0.002), and endometriosis was the most closely related to ovarian cancer. Further MR Analysis of the association between endometriosis and different histological subtypes of ovarian cancer revealed that: There was a significant association between endometriosis and high-grade serous ovarian cancer(OR= 1.122,95%CI:1.054~1.195,P<0.001), low-grade serous ovarian cancer(OR= 1.269,95%CI:1.085~1.485,P=0.002), ovarian clear cell carcinoma(OR=1.491,95%CI:1.277~1.741,P<0.001), and endometrioid carcinoma(OR= 1.392,95%CI:1.266~1.530,P<0.001). Although there was an association between endometriosis and low-grade mucinous ovarian cancer (OR = 1.148,95%CI:1.027~1.283,P =0.015), this association was no longer statistically significant after FDR correction. There was no significant association between endometriosis and invasive mucinous ovarian cancer(OR=1.123,95%CI:0.987~1.279,P=0.079). Conclusion: The combined evidence from the NHANES-NDI cohort and MR Analysis suggests an increased risk of ovarian cancer in women with endometriosis, as seen with other gynecologic malignancies, and provides a new epidemiological basis for exploring the potential causal relationship between endometriosis and gynecologic cancers.
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Effects of labetalol combined with low-dose aspirin and vitamin D on miR-210, SIRT3 and placental blood perfusion in patients with gestational hypertension
Luo Dandan; Lan Liubing; Wu Heming; Zhang Hua
2026,41(7):847 ,DOI: 10.3969/j.issn.1005-3697.2026.07.015
Abstract:
Objective: To investigate the effects of labetalol combined with low-dose aspirin and vitamin D on miR-210, SIRT3 and placental blood perfusion in patients with gestational hypertension. Methods: 90 pregnant women with gestational hypertension were selected as the research subjects. Based on therapeutic regimens, they were allocated to either a control group (n=42) receiving labetalol plus low-dose aspirin, or a combination group (n =48) receiving additional vitamin D supplementation. miR-210, silencing information regulatory factor 3 (SIRT3), placental perfusion parameters \[pulsatility index(PI), resistance index (RI), and peak systolic/end diastolic flow velocity (S/D)\], as well as adverse pregnancy outcomes and adverse reactions were compared between the two groups. Results: The combination group exhibited lower miR-210 expression(P<0.05) and higher SIRT3 mRNA levels(P<0.05) in placental tissues relative to controls. Compared with the control group, the PI, RI, and S/D of placental blood perfusion parameters in combination group were lower(P<0.05). There was no statistically significant difference in the incidence of adverse pregnancy outcomes and adverse reactions between the two groups(P>0.05). Conclusion: Labetalol combined with low-dose aspirin and vitamin D can more effectively regulate the expression imbalance of miR-210 and SIRT3 in placental tissue of patients with hypertensive disorder complicating pregnancy, improve placental blood perfusion, and has good safety.
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Risk factors for progression of visual field defects after micropulse laser trabeculoplasty in patients with open-angle glaucoma
Xie Peiling; Li Xiaochun; He Na; Bao Jing
2026,41(7):851 ,DOI: 10.3969/j.issn.1005-3697.2026.07.016
Abstract:
Objective: To analyze the risk factors for progression of visual field defects after micropulse laser trabeculoplasty (MLT) in patients with open-angle glaucoma. Methods: 90 patients (180 eyes) with primary open-angle glaucoma (POAG) who underwent MLT were selected. Based on progression of visual field defects at one year post-surgery, they were assigned to the progression group and the non-progression group. Clinical data of the two groups were collected and compared. Logistic regression was used to analyze the risk factors for progression of visual field defects after MLT. Results: The differences in gender, age, place of residence, body mass index (BMI), education level, drinking history, hypertension, smoking history, family history of glaucoma, history of glaucoma surgery, preoperative highest intraocular pressure, types of preoperative medications, status of cataract surgery, LogMAR visual acuity, central corneal thickness (CCT), and axial length between the two groups were not statistically significant(P>0.05). The proportions of patients with diabetes, preoperative visual field stage 0~3, and severe damage in both superior and inferior retinal nerve fiber layers (RNFL) were higher in the progression group than in the non-progression group(P<0.05). Diabetes, preoperative visual field stage 0~3, and severe damage in both superior and inferior RNFL were risk factors for progression of visual field defects after MLT in patients with POAG (P<0.05). Conclusion: Diabetes, preoperative visual field stage 0~3, and severe damage in both superior and inferior RNFL are main risk factors for progression of visual field defects after MLT in patients with POAG, which deserves close attention in clinical practice
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Efficacy of tumor necrosis factor antagonists and interleukin-17 antagonists in the treatment of ankylosing spondylitis and their effects on patients’ immune function
Guo Jing; Song Dongyun; Cui Can; Ma Rui; Liu Rui; Han Chunchun
2026,41(7):855 ,DOI: 10.3969/j.issn.1005-3697.2026.07.017
Abstract:
Objective: To compare the curative effect of tumor necrosis factor (TNF) antagonist and interleukin 17 (IL-17) in ankylosing spondylitis (AS) and their effects on patients’ immune function. Methods: A retrospective analysis was performed on the data of 244 patients with AS. According to different medication methods, patients were divided into TNF antagonist group (n=196, adalimumab) and IL-17 antagonist group (n=45, secukinumab). The disease activity and function \[AS Disease Activity Score (ASDAS), Bath AS Functional Index (BASFI) and Bath AS Disease Activity Index (BASDAI)\], clinical symptoms \[Visual Analog Scale (VAS) scores for lower back and nighttime pain and duration of morning stiffness\], serological indicators \[C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell count (WBC)\], immune function \[immunoglobulin G (IgG), IgA and IgM\], and incidence of adverse reactions before treatment, after 4 and 24 weeks of treatment were compared between the two groups. Results: After treatment, ASDAS was lower, and BASFI was higher in TNF antagonist group(P<0.05). The changes in pain degree at low back and night, and the duration of morning stiffness were more significant in TNF antagonist group after 4 weeks of treatment, while the above changes were more significant in IL-17 antagonist group after 24 weeks of treatment(P<0.05). After 4 and 24 weeks of treatment, the levels of CRP, ESR, and WBC in both groups decreased(P<0.05), and the levels of CRP and ESR in the TNF antagonist group were lower than those in the IL-17 antagonist group(P<0.05). The IgG level in the TNF antagonist group decreased (P<0.05) and was lower than that in the IL-17 antagonist group(P<0.05). There was no statistically significant difference in the occurrence of adverse reactions between the two groups(P>0.05). Conclusion: Adalimumab has short onset time and better improvement effect on immune function and biochemical indexes, while secukinumab is more beneficial to improve clinical symptoms in patients.
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Application effect of different materials in the restoration of inlay crown for patients with large-area dental defects after root canal therapy
Li Qiong; Chen Xiaoying; Qu Taoran; Yang Ping; Zhou Hanpei; Niu Kaiyu
2026,41(7):860 ,DOI: 10.3969/j.issn.1005-3697.2026.07.018
Abstract:
Objective: To explore the application effect of different materials in the restoration of inlay crown for patients with large-area dental defects after root canal therapy. Methods: A total of 107 patients with large-area dental defects after root canal therapy were enrolled. According to different restoration materials, they were divided into zirconia group (36 cases, 41 teeth), cast porcelain group (35 cases, 40 teeth) and resin group (36 cases, 43 teeth). All were followed up for 24 months to evaluate the restoration effect, functional recovery, exhibition of aesthetics, periodontal health and complications. Results: At 18 and 24 months after restoration, success rate of restoration, bite force, masticatory efficiency and periodontal health indexes in zirconia group were better than those in cast porcelain group and resin group (P<0.05). The comprehensive scores of color matching and aesthetics in cast porcelain group were higher than those in zirconia group and resin group(P<0.05). There was no significant difference in morphological coordination or surface smoothness between zirconia group and cast porcelain group (P>0.05), but which in the two groups were better than those in resin group(P<0.05). There were statistically significant differences in the incidence of complications among the three groups of patients(P<0.05), the incidence of complications was the lowest in zirconia group, while which was the highest in resin group(P<0.05). Conclusion: Zirconia has the best long-term restoration effect, functional recovery and safety, cast porcelain has significant aesthetic advantages, and resin is suitable for short-term transitional restoration. In clinical practice, selection should be made according to one’s needs.
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Analysis of influencing factors of osteoporosis or hip fracture risk assessed in maintenance hemodialysis patients
Zhang Ju; Luo Fuxiu; Tang Wenwu; Li Rong
2026,41(7):865 ,DOI: 10.3969/j.issn.1005-3697.2026.07.019
Abstract:
Objective: To explore the risk factors associated with osteoporosis (OP) and hip fractures in patients undergoing maintenance hemodialysis (MHD). Methods: 179 patients with MHD were selected as the research subjects, and were divided into medium and low-risk groups(n=105) and high-risk groups(n=74) based on the risk assessment results of OP or hip fracture using the FRAX system. The factors influencing the risk of OP or hip fracture in MHD patients was analyzed by univariate and multivariate Logistic regression analysis, the relationship between high risk of OP or hip fracture and indicators related to MHD patients were analyzed by Pearson correlation analysis, the predictive value of related indicators for the high risk of OP or hip fracture in MHD patients was analyzed by ROC curve analysis. Results: Univariate analysis showed that there were statistically significant differences in age, BMI, C-reactive protein(CRP), prealbumin(PAB), serum creatinine(Scr), serum uric acid(UA), and serum sodium between the two groups(P<0.05). Multivariate Logistic regression analysis demonstrated that low levels of PAB, Scr, and UA (OR=0.901,95%CI:0.836~0.965,OR=0.996,95%CI:0.994~0.998, OR=0.994,95% CI:0.989~0.999,respectively), as well as comorbid hypertension(OR=4.507,95% CI:1.478~14.559), were independently associated with a high risk of osteoporotic or hip fractures(P<0.05). The Pearson correlation analysis results showed that the high risk of OP or hip fracture was negatively correlated with serum iron, albumin PAB, Urea nitrogen Scr, UA, Blood phosphorus(P<0.05). ROC curve analysis revealed that a combined model of PAB, Scr, UA, and hypertension yielded an AUC of 0.840 (95% CI:0.783~0.897,P <0.001), with a sensitivity of 67.6% and a specificity of 82.9%. Conclusion: This study indicates that decreased levels of PAB, Scr, and UA, along with hypertension, are significant risk factors for fractures in MHD patients. Close monitoring of these indicators and strict blood pressure management are recommended to reduce fracture risk. These findings provide a valuable reference for individualized risk assessment in clinical practice.
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Curative effect observation of low-dose morphine combined with isoket in the treatment of acute left heart failure
2026,41(7):870 ,DOI: 10.3969/j.issn.1005-3697.2026.07.020
Abstract:
Objective: To investigate the clinical efficacy of low-dose morphine combined with isosorbide dinitrate (Isoket) in the treatment of acute left heart failure (ALHF) on the basis of conventional therapy. Methods: A total of 89 patients with ALHF were selected and divided into treatment group (n=45) and control group (n=44) according to different treatment methods. Both groups received conventional treatments such as cardiotonic, diuretic, antispasmodic and antiasthmatic therapy, and oxygen inhalation. On this basis, the treatment group was treated with low-dose morphine combined with Isoket, while the control group was treated with Isoket alone. Both groups were treated for 24 hours. The clinical efficacy at 30 min, 1 and 24 h after treatment, hemodynamic indexes, blood gas analysis indexes, cardiac function indexes and adverse reactions before and after treatment were compared between the two groups. Results: The total effective rates of the treatment group at 30 min, 1 and 24 h were higher than those of the control group(P<0.05). After 1 and 24 h of treatment, the heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP) and pulmonary artery wedge pressure(PAWP) of both groups decreased compared with before treatment(P<0.05), and those of the treatment group were lower than those of the control group(P<0.05). The PaO2 and SpO2 increased compared with before treatment, and the PaCO2 decreased, with a better improvement range than the control group (P<0.05). After 24 hours of treatment, left ventricular ejection fraction (LVEF) increased in both groups(P<0.05), and the treatment group was higher than the control group(P<0.05), left ventricular end-diastolic diameter(LVEDD) decreased in all groups (P<0.05), and the treatment group was smaller than the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Low-dose morphine combined with Isoket in treatment of acute left heart failure can quickly improve clinical symptoms, hemodynamics and cardiac function of patients with good safety, which has high clinical promotion value.
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Efficacy of ulinastatin combined with norepinephrine bitartrate in the treatment of septic shock and its influence on cardiac function and hemodynamics
Li Yi; Yang Xueli; Lu Chengkang; Xu Yi; Duan Fengmei
2026,41(7):874 ,DOI: 10.3969/j.issn.1005-3697.2026.07.021
Abstract:
Objective: To explore the effect of combining norepinephrine bitartrate with ulinastatin on patients with septic shock and the improvement role on hemodynamics and cardiac function. Methods: According to different treatment methods, 91 patients with septic shock were divided into observation group (ulinastatin combined with norepinephrine bitartrate, n=47) and control group (norepinephrine bitartrate, n=44). Both groups were treated continuously for 7 days and followed up for 28 days. Prognosis indexes, disease severity, coagulation-inflammation indexes, cardiac function parameters, hemodynamic parameters and adverse reactions were compared between the two groups. Results: No obvious differences in 28-day mortality rate and antibiotic use time were found between groups(P>0.05), and the durations of key measures (vasoactive drug and mechanical ventilation) and ICU stay were shorter in observation group compared to control group(P<0.05), and the disease severity scores, coagulation-inflammation indexes, cardiac function and hemodynamic parameters were better(P<0.05). There was no statistically significant difference in adverse reactions between the two groups (P >0.05). Conclusion: Ulinastatin combined with norepinephrine bitartrate for patients with septic shock can help to enhance blood flow status and cardiac function, regulate inflammation and coagulation status, and shorten the treatment time, with good safety
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Emergency cervical cerclage followed by fetoscopic laser coagulation for Quintero stage IV twin-to-twin transfusion syndrome: A case report
Zheng Hui; Qi Xiaorong; Li Junnan
2026,41(7):879 ,DOI: 10.3969/j.issn.1005-3697.2026.07.022
Abstract:
This case report details a case of stage IV Twin-to-twin transfusion syndrome (TTTS) complicated by cervical insufficiency, in which fetoscopic laser coagulation (FLC) following emergency cervical cerclage yielded favorable maternal and neonatal outcomes, thereby providing a practical reference for the management of such rare, acute, and severe conditions
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3 cases of clinical application examples of Chaihu Guizhi Decoction
2026,41(7):884 ,DOI: 10.3969/j.issn.1005-3697.2026.07.023
Abstract:
Objective: To explore the clinical expanded application value and compatibility rationale of the modified Chaihu Guizhi Decoction (Bupleurum and Cinnamon Twig Decoction) in the treatment of coronary heart disease, chronic urinary tract infection, and posterior circulation ischemia. Methods: 3 patients diagnosed respectively with coronary heart disease, chronic urinary tract infection, and posterior circulation ischemia were selected. Based on the core effects of Chaihu Guizhi Decoction—harmonizing Shaoyang, regulating the triple energizers, relieving muscle surfaces, harmonizing nutrient qi and defensive qi, supporting yang to transform qi, and coordinating yin and yang—modifications were made according to the pathophysiological characteristics of each patient. Clinical efficacy was observed, and the compatibility logic between the pathogenesis and formula was analyzed using traditional Chinese medicine theory. Results: After treatment with the modified Chaihu Guizhi Decoction, clinical symptoms significantly improved in all three patients, relevant auxiliary examination indicators recovered or improved, and no significant recurrence was observed during follow-up. Conclusion: Chaihu Guizhi Decoction is not only suitable for treating the combined pattern of Taiyang and Shaoyang disorders but also effective for cardiovascular, urinary, and neurological diseases characterized by liver qi stagnation and qi stagnation, disharmony between nutrient and defensive qi, complicated by phlegm-stasis obstruction and deficiency of healthy qi. Modified application based on pattern differentiation yields good results, reflecting the essence of TCM treatment based on pattern differentiation known as treating different diseases with the same method.
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Construction and effect evaluation of a cancer-related fatigue exercise intervention program for chemotherapy patients with colorectal cancer based on evidence-based concept
Wang Juan; Jiang Yan; Yin Xiaobing; Chen Ran; Han Lijuan; Liang Xiyun; Zhou Yan
2026,41(7):887 ,DOI: 10.3969/j.issn.1005-3697.2026.07.024
Abstract:
Objective: To explore the clinical effectiveness of exercise interventions for cancer-related fatigue in colorectal cancer (CRC) patients undergoing chemotherapy based on evidence-based evidence. Methods: A total of 76 patients with CRC were prospectively selected, and they were divided into two groups according to different intervention methods. 38 patients in the control group received routine intervention, and the remaining 38 patients in the treatment group were given exercise intervention under evidence-based concept. The cancer-related fatigue (CRF) grading, physical activity status, exercise compliance, quality of life \[Quality of Life Questionnaire Core-30 (QLQ-C30)\] scores and occurrence of exercise-related adverse events were compared between the two groups. Results: After intervention, compared with the control group, the CRF grading in the treatment group was lower(P<0.05). The physical activity compliance rate in the treatment group was higher compared with that in the control group(P<0.05). The treatment group had higher exercise compliance degree(P<0.05). Compared with the control group, the QLQ-C30 symptom field score in the treatment group was lower while the scores of overall health field and functional field were higher(P<0.05). There was no statistical difference in the incidence of exercise-related adverse events between both groups(P>0.05). Conclusion: Exercise intervention under evidence-based concept can significantly reduce the CRF grading in patients with CRC chemotherapy, further improve the physical activity and exercise compliance, and enhance the quality of life.
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Preoperative psychological characteristics and targeted psychological nursing analysis of women undergoing superconductive visual painless induced abortion
2026,41(7):892 ,DOI: 10.3969/j.issn.1005-3697.2026.07.025
Abstract:
Objective: To explore the preoperative psychological characteristics of women undergoing painless artificial abortion with superconducting visualization and to evaluate the clinical efficacy of targeted psychological nursing interventions. Methods: A total of 200 women who underwent superconducting visual painless artificial abortion were selected and divided into a control group (n=100, receiving routine nursing care) and a study group (n=100, implementing psychological characteristic analysis and targeted nursing interventions) according to different intervention methods. The Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores before and after nursing care were compared between the two groups. The Numerical Rating Scale (NRS) was used to assess postoperative pain levels. Systolic blood pressure, diastolic blood pressure, and heart rate fluctuations were monitored and recorded. Compliance and nursing satisfaction were also investigated. Results: There was no significant difference in SAS and SDS scores between the two groups before nursing care (P >0.05), after nursing care, the study group was significantly lower than the control group (P < 0.05). The NRS scores and fluctuations in various physiological indicators at anesthesia awakening, 30 minutes, and 60 minutes post-operation in the study group were lower than those in the control group(P<0.05). The compliance and overall satisfaction of the study group were better than those of the control group (P <0.05). Conclusion: By analyzing the preoperative psychological characteristics of women undergoing superconductive visual painless induced abortion and developing targeted psychological nursing interventions, women’s psychological status can be improved, their depression and anxiety levels can be effectively reduced, and the patient’s pain level can be effectively relieved, leading to a significant increase in compliance and satisfaction.
Basic Medical Research
Technology and method
Clinical medical research
Short stories and cases
nursing
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Effectiveness and safety of bupivacaine liposome for bilateral quadratus lumborum block in analgesia of laparoscopic colorectal surgery
Abstract:
目的：探究布比卡因脂质体用于双侧腰方肌阻滞对腹腔镜结直肠手术镇痛的有效性及安全性。方法：纳入行腹腔镜结直肠癌根治术的105名患者进行研究，均采用双侧腰方肌阻滞复合全身麻醉的麻醉方案。使用简单随机法将患者分为布比卡因脂质体组(L组，n=53)和罗哌卡因组(R组，n=52)。对比两组围手术期指标、疼痛情况(VAS)、自理能力(Barthel指数)、不良反应发生率及镇痛满意度。结果：L组术后镇痛泵首次使用时间显著晚于R组(P<0.05)，术后48 h内镇痛泵按压次数、术后48 h补救性镇痛率、下床活动时间、首次肛门排气时间均显著低于或短于R组。术后6~72 h内，两组VAS评分均呈先升后降趋势。术后12 h、24 h、48 h、72 h，L组VAS评分均显著低于R组(P<0.05)。两组术后当天Barthel指数较术前均显著下降(P＜0.05)，术后1 d及出院时逐渐上升。术后当天、术后1 d及出院时，L组Barthel指数均显著高于R组(P＜0.05)。L组术后不良反应总发生率15.09%显著低于R组32.69%(P＜0.05)，镇痛满意度显著高于R组(P＜0.05)。结论：布比卡因脂质体用于腹腔镜结直肠手术双侧腰方肌阻滞，能够改善手术预后，减少术后疼痛，促进患者自理能力恢复的同时降低术后不良反应发生率。
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Clinical outcomes and postoperative intravesical recurrence after laparoscopic radical nephroureterectomy with bladder cuff excision for upper tract urothelial carcinoma
Abstract:
Objective: To summarize the perioperative outcomes, renal function changes, intravesical recurrence (IVR), and extra-vesical progression (EV-PFS) after laparoscopic radical nephroureterectomy (RNU) with bladder cuff excision for upper tract urothelial carcinoma (UTUC). Methods: A retrospective analysis was conducted on 98 patients who underwent laparoscopic RNU with bladder cuff excision between January 2020 and December 2024 at our institution. The primary endpoint was intravesical recurrence-free survival (IVRFS). The exploratory endpoint was extra-vesical progression-free survival (EV-PFS), defined as time to local recurrence, distant metastasis, or cancer-specific death. Survival rates were estimated using the Kaplan-Meier method, and Cox models were used for exploratory association analysis. Results: Among 98 patients (median age 67.0 years), major complications (Clavien-Dindo ≥III) occurred in 6.1%. During a median follow-up of 34.0 months, IVR occurred in 42 patients (42.9%), local recurrence in 25 (25.5%), distant metastasis in 22 (22.4%), and cancer-specific death in 18 (18.4%). The Kaplan-Meier estimated 1-, 2-, and 3-year IVRFS rates were 69.4%, 60.3%, and 52.9%, respectively. The corresponding EV-PFS rates were 78.1%, 62.9%, and 50.3%. Exploratory analysis suggested that non-pelvic tumors were associated with worse IVRFS, while pathological stage ≥pT3 and lymphovascular invasion were significant predictors of worse EV-PFS. Conclusion: Laparoscopic RNU with bladder cuff excision is perioperatively safe for UTUC. Given the high incidence of IVR, intravesical recurrence and extra-vesical progression should be evaluated separately during follow-up.
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Analysis of the relationship between anti-Xa factor activity, serum ET-1, SLC39A11 and the occurrence of lower extremity deep vein thrombosis in patients with gynecological malignant tumors based on DCA curve
Abstract:
Objective: To explore the relationship between anticoagulant Xa factor activity and serum endothelin-1 (ET-1), solute carrier family 39 member 11 (SLC39A11) and the occurrence of deep vein thrombosis (DVT) in the lower extremities of patients with gynecological malignancies Methods: A total of 270 patients with gynecological malignant tumors (malignant group) and 230 patients with gynecological benign tumors (benign group) who underwent surgical treatment in our hospital from October 2023 to October 2025 were selected as the research subjects. Determine the antixa factor activity and the levels of serum ET-1 and SLC39A1 Lasso-Logistic regression was used to analyze the influencing factors of lower extremity deep vein thrombosis (DVT) In addition, the predictive value and clinical significance of anti-Xa factor activity, serum ET- 1, and SLC39A11 levels in the occurrence of lower extremity DVT in patients with gynecological malignant tumors were analyzed. Results: Compared with the benign group, the malignant group had lower anti-factor Xa activity and higher levels of serum ET-1 and SLC39A11(P < 0.05). D-dimer, antithrombin Xa activity, serum ET-1, and SLC39A11 are the influencing factors for the occurrence of lower extremity DVT in patients. (P<0.05).The area under the curve (AUC) of anti-Xa factor activity, serum ET-1, SLC39A11 in predicting lower extremity deep vein thrombosis (DVT) in patients with gynecological malignancies were 0.844, 0.799, 0.771 and 0.931 respectively, all of which had good predictive value Within the risk threshold range of 0.06 to 0.83, the combined prediction of antifactor Xa activity, ET-1, and SLC39A11 for lower extremity DVT in patients with gynecological malignancies has a significantly greater net benefit than that of a single indicator Conclusion: The anti-Xa factor activity, ET-1, SLC39A11 are related to the occurrence of DVT in patients with gynecological malignant tumors. Combined with other factors, they have a good application prospect for predicting postoperative lower extremity DVT.
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The effect of NOL index in general anaesthesia in patients with acute appendicitis and its impact on postoperative recovery
Abstract:
Objective: To explore the impact of nociception level index (nociception level, NOL) guidance on the occurrence of acute postoperative pain (acute postoperative pain, APP) and gastrointestinal function recovery after laparoscopic appendectomy (Laparoscopic appendectomy, LA) in patients with acute purulent appendicitis; to analyze the related factors of APP after LA in patients with acute purulent appendicitis. Methods: A total of 120 patients with acute purulent appendicitis who underwent LA from April 2024 to May 2025 in our hospital were selected and randomly divided into an observation group and a control group (each with 60 cases) using the random number method. Both groups of patients were given combined intravenous and inhalation anesthesia and standard anesthetic nursing, and the observation group used NOL guidance for intraoperative analgesia. The stress response indicators Cor, E, NE, and inflammatory indicators TNF-α, IL-1β, IL-6 levels of the two groups of patients were detected 2 hours before surgery and 60 minutes after surgery; the occurrence of emergence agitation, APP, and intraoperative remifentanil dosage of the two groups of patients were recorded; the gastrointestinal function recovery time of the two groups of patients was observed; all patients were divided into APP group and non-APP group according to whether APP occurred, and the clinical data of the two subgroups were compared, and logistic regression analysis was used to analyze the independent related factors of APP after LA in patients with acute purulent appendicitis. Results: At 60 minutes post-operation, the observation group exhibited significantly lower levels of Cor, E, and NE compared to the control group, along with reduced inflammatory markers TNF-α, IL-1β, and IL-6 (P<0.05). The time to first flatus, first defecation, and first oral intake were shorter in the observation group (P<0.05). The incidence of emergence agitation (EA) and APP was lower in the observation group, accompanied by a reduced remifentanil dosage (P<0.05). No statistically significant difference in adverse reactions was observed between the two groups (P>0.05). Logistic regression analysis identified age (OR=0.908) and NOL guidance (OR=0.281) as independent factors associated with APP occurrence (P<0.05). Conclusion: NOL guidance significantly decreases the incidence of APP in patients undergoing laparoscopic appendectomy while concurrently reducing intraoperative remifentanil consumption.
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Development and Validation of a Simplified Clinical Risk Scoring System for Composite Complications Post-Lung Cancer Thoracoscopic Surgery
Abstract:
Objective: To develop and validate a simple clinical risk scoring system for postoperative complications in patients undergoing thoracoscopic lung cancer surgery. Methods: Data were collected from 165 patients who underwent thoracoscopic lung cancer surgery at our hospital between January 2023 and December 2024, with postoperative composite complications as the primary outcome measure. Single-factor and multivariate logistic regression analyses were performed to identify independent risk factors for postoperative complications. A nomogram model was constructed, and its performance was validated using ROC curves, the Hosmer-Lemeshow (H-L) goodness-of-fit test, and decision curve analysis. Results: The incidence of postoperative composite complications was 25.45% (42/165). Results of multivariate logistic regression analysis showed that concomitant cerebrovascular disease (P=0.003) and increased total intraoperative fluid intake (P=0.005) were independent risk factors; elevated preoperative low-density lipoprotein cholesterol (LDL-C) levels (P<0.001) and elevated preoperative fibrinogen (Fib) levels (P=0.004) were independent protective factors. The model’s AUC was 0.81; the P-value for the H-L test was 0.2766, indicating good model calibration; and the DCA confirmed that the model yields a clinical net benefit. Conclusion: Cerebrovascular disease, total intraoperative fluid intake, and elevated preoperative LDL-C and fibrinogen levels are independent risk factors for postoperative complications. A simple clinical risk scoring system based on these indicators demonstrates good discriminatory power, calibration, and clinical utility.
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Clinical curative effect of extracorporeal shock wave combined with scapular stability training in subacromial impingement syndrome
Abstract:
目的：探究体外冲击波结合肩胛骨稳定性训练对肩峰下撞击综合征(SIS)的临床应用价值。方法：选取160例SIS患者按随机数字表法分为对照组(给予常规治疗，n=80)和观察组(基于对照组给予体外冲击波结合肩胛骨稳定性训练治疗，n=80)。比较两组患者治疗有效率、治疗前后肩关节功能评分[Constant-Murley肩关节功能评定量表]、肩关节活动度(屈曲、外展、内旋、外旋)、生活质量[健康调查简表(SF-36)]。结果：观察组治疗有效率较对照组高(P<0.05)；治疗后，观察组各维度肩关节功能评分、屈曲、外展、内旋、外旋活动度及各维度生活质量评分均高于对照组(P<0.05)。结论：对SIS患者实施体外冲击波结合肩胛骨稳定性训练治疗疗效确切，可改善肩关节功能及活动范围，提升生活质量。
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M2-type Macrophage-derived Exosomes Promote Osteogenic Differentiation of Human Periodontal Ligament Stem Cells by Inhibiting Pyroptosis Mediated by NLRP3 Inflammasome Activation
Abstract:
Bhattarai G, An YH, Shrestha SK, et al. Therapeutic potency and the related mechanism of deinoxanthin in experimental animal and cell models of periodontitis[J]. Sci Rep, 2026, 16(1):5735. Qiu Y, Zhao Y, Jia L, et al. Combination of dasatinib and quercetin promotes osteogenic differentiation and stemness maintenance of hPDLSCs via YAP/TAZ[J]. Anim Cells Syst, 2025, 29(1):19-29.Yang DW, Cui XB, Dong R, et al. Timosaponin B- II Enhances Osteogenic Differentiation of Human Periodontal Ligament Stem Cells via PI3K/AKT/GSK3β Signaling Pathway[J]. Stem Cell Rev Rep, 2025, 21(8):2675-2692.Shen Z, Kuang S, Zhang Y, et al. Chitosan hydrogel incorporated with dental pulp stem cell-derived exosomes alleviates periodontitis in mice via a macrophage-dependent mechanism[J]. Bioact Mater, 2020 , 5(4):1113-1126.Muro P, Jing C, Qiao Y, et al. Advances of exosome regulating?FXR to repair inflammatory bowel disease (Review)[J]. Int J Mol Med, 2025, 56(3):135.Robinson KS, Teo DET, Tan KS, et al. Enteroviral 3C protease activates the human NLRP1 inflammasome in airway epithelia[J]. Science, 2020, 370(6521):eaay2002.Zhang Y, Zhao H, Fu X, et al. The role of hydrogen sulfide regulation of pyroptosis in different pathological processes[J]. Eur J Med Chem, 2024, 268:116254.Zhang L, Wang Q, Su H, Cheng J. Exosomes from adipose derived mesenchymal stem cells alleviate diabetic osteoporosis in rats through suppressing NLRP3 inflammasome activation in osteoclasts[J]. J Biosci Bioeng, 2021, 131(6):671-678.Wang L, Liu T, Zhang W, et al. BMAL1 downregulation drives PANoptosis and the osteogenic differentiation impairment of PDLSCs by ERK/AP-1 signaling pathway[J]. J Periodontol, 2025, 96(8):906-919.Yu H, Wang P, Lu H, et al. Effects of G-CSF on hPDLSC proliferation and osteogenic differentiation in the LPS-induced inflammatory microenvironment[J]. BMC Oral Health,? 2023, 26;23(1):422.Zhao L, Tang S, Chen F, et al. Regulation of macrophage polarization by targeted metabolic reprogramming for the treatment of lupus nephritis[J]. Mol Med, 2024, 30(1):96.Daneshvar A, Nemati P, Azadi A, et al. M2 macrophage-derived exosomes for bone regeneration: A systematic review[J]. Arch Oral Biol, 2024, 166:106034.Zhou YK, Han CS, Zhu ZL, et al. M2 exosomes modified by hydrogen sulfide promoted bone regeneration by moesin mediated endocytosis[J]. Bioact Mater, 2023, 31:192-205.Liao XM, Guan Z, Yang ZJ, et al. Comprehensive analysis of M2 macrophage-derived exosomes facilitating osteogenic differentiation of human periodontal ligament stem cells[J]. BMC Oral Health, 2022, 22(1):647.Zhao Y, Huang Y, Liu H, et al. Macrophages with Different Polarization Phenotypes Influence Cementoblast Mineralization through Exosomes[J]. Stem Cells Int, 2022, 2022:4185972.Gao J, Wu Z. M2 macrophage-derived exosomes enable osteogenic differentiation and inhibit inflammation in human periodontal ligament stem cells through promotion of CXCL12 expression[J]. BMC Oral Health, 2024, 24(1):1070.方俊, 魏伟, 薛亚婷, 等. M2型巨噬细胞衍生外泌体促进小胶质细胞M2型极化[J]. 中国组织工程研究, 2025, 29(25):5320-5327.孙逸梅, 毛诗慧, 李琳, 等. 骨髓间充质干细胞源性外泌体促进小胶质细胞/巨噬细胞M2极化抑制急性期脑缺血大鼠炎症反应[J]. 中国药科大学学报, 2023, 54(05):599-606.Hou C, Zhang Y, Lv Z, et al. Macrophage exosomes modified by miR-365-2-5p promoted osteoblast osteogenic differentiation by targeting OLFML1[J]. Regen Biomater, 2024, 11:rbae018.刘文涛, 冯兴超, 杨毅, 等. M2型巨噬细胞外泌体诱导骨髓间充质干细胞的成骨分化[J]. 中国组织工程研究, 2023, 27(06):840-845.彭巍, 江榕, 李勇, 等. 人诱导多能间充质干细胞来源外泌体对肺泡巨噬细胞焦亡的抑制作用[J]. 中华危重病急救医学, 2021, 33(1):00728.Cheng Y, Zhao P, Zhang N, et al. M2 macrophage-derived extracellular vesicle/polydopamine hydrogel attenuates diabetic periodontitis-induced bone loss via the NEK7/NLRP3/IL-1β pathway[J]. Sci Rep, 2025, 16(1):4080.
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Effects of Roxadustat on Microinflammatory Response, Nutritional Status, and Peritoneal Solute Transport Capacity in Peritoneal Dialysis Patients with Renal Anemia
Abstract:
Objective: To investigate the effects of roxadustat on the microinflammatory response, nutritional status, and peritoneal solute transport capacity in peritoneal dialysis patients with renal anemia. Methods: A total of 90 peritoneal dialysis patients with renal anemia admitted to our hospital were enrolled from June 2022 to June 2025, and they were divided into two groups according to the treatment regimen: the recombinant human erythropoietin (rhEPO) group (treated with rhEPO alone, n=45) and the combined group (treated with rhEPO combined with roxadustat, n=45). After 12 weeks of treatment, anemia?related indicators, microinflammatory factors, nutritional status, and peritoneal solute transport function were compared between the two groups. Results: After treatment, the levels of hemoglobin and hematocrit in both groups were significantly increased compared with baseline (P＜0.05), and the combined group was significantly higher than the rhEPO group (P＜0.05). After treatment, the levels of albumin, prealbumin and transferrin in both groups were significantly higher than those before treatment in the same group (P＜0.05), and the combined group was significantly higher than the rhEPO group (P＜0.05). The serum levels of tumor necrosis factor?α (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP) in both groups were significantly decreased after treatment (P＜0.05), and the combined group showed lower levels than the rhEPO group (P＜0.05). There were no significant changes in the 4-hour dialysate-to-plasma creatinine ratio (4h D/Pcr) before and after treatment in either group, and no significant differences were observed between the two groups (P＞0.05). Conclusion: Roxadustat can further correct the anemic state, improve nutritional status and regulate systemic microinflammation in peritoneal dialysis patients with renal anemia. Meanwhile, it exerts no obvious adverse effect on the rate of peritoneal solute transport, showing favorable overall clinical efficacy and safety.
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Relationship between miR-499 gene polymorphism and genetic susceptibility of hepatocellular carcinoma and its predictive value on prognosis
Abstract:
Objective： To investigate the relationship of microRNA499 (miR-499) gene polymorphism with genetic susceptibility of hepatocellular carcinoma (HCC), and to analyze its predictive value on prognosis. Methods： Eighty patients with HCC admitted to the hospital from January 2023 to August 2024 were selected as experimental group, and thirty patients who were admitted to the hospital for physical examination during the same period were regarded as control group. Venous blood samples were collected to obtain the gene distribution status of miR-499 rs3746444 locus, and the relationship between different genotypes and HCC genetic susceptibility was analyzed. The clinical information and follow-up status of experimental group were combined to explored the influence of miR-499 gene polymorphism on the prognosis of patients with HCC. Results： (1) Carrying miR-499 C/C genotype and allele C could increase the genetic susceptibility of HCC by 2.399 times and 2.282 times (P<0.05). (2) The overall survival rate of patients with miR-499 C/C genotype was lower than that of patients with C/T and T/T genotypes (P<0.05). (3) High alpha-fetoprotein, low degree of differentiation and miR-499 C/C genotype were independent risk factors of poor prognosis in patients with HCC (P<0.05). Conclusion： The C/C genotype of miR-499 gene is a susceptible genotype of HCC and an independent risk factor of poor prognosis.
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Effect of Preoperative Detrusor Pressure at Maximum Flow Rate on Postoperative Outcomes After TULIP for Benign Prostatic Hyperplasia
Abstract:
目的：探讨术前最大尿流率时逼尿肌压力(PdetQmax)对经尿道超声引导激光诱导前列腺切除术(TULIP)治疗良性前列腺增生(BPH)术后疗效的影响。方法：回顾性纳入2022年1月至2024年12月接受TULIP治疗的BPH患者124例，按术前PdetQmax分为A组≤20 cmH?O、B组20＜PdetQmax≤40 cmH?O、C组＞40 cmH?O。比较三组基线资料、围术期指标、术后6个月临床疗效、术前及术后3个月和6个月功能评分、术后3个月排尿功能指标及术后并发症发生情况。结果：三组PdetQmax及BCI比较差异有统计学意义，符合预设分层特征。与A组相比，B、C组术后导尿管留置时间、总住院时间及首次恢复自主排尿时间较短。三组术后6个月国际前列腺症状评分(IPSS)改善值及改善率比较差异有统计学意义，B、C组QoL改善幅度较A组更明显。术后3个月三组PV均较术前下降、Qmax均较术前升高，但A组术后PVR仍相对较高。A组术后急性尿潴留发生率较高。结论：TULIP可改善BPH患者症状和排尿功能，但低PdetQmax患者术后客观排尿恢复相对不足，急性尿潴留发生风险较高，术前PdetQmax可作为疗效预期和围术期管理的参考指标。
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Construction and verification of the prediction of the risk of cardiac injury after anti-tumor treatment in patients with advanced lung cancer
Abstract:
Objective: Cardiotoxicity is an important complication that affects the quality of life of patients with lung cancer after antitumor therapy. This study aimed to develop and validate a nomogram model for predicting the risk of cardiac injury after antitumor therapy in patients with advanced lung cancer. Methods:A total of 404 patients with advanced lung cancer who underwent baseline myocardial enzyme testing at the Affiliated Hospital of North Sichuan Medical College between June 2019 and December 2024 were retrospectively enrolled and randomly assigned to a training cohort and a validation cohort at a ratio of 7:3. Missing data were handled using multiple imputation by chained equations (MICE). In the training cohort, important variables were screened using random forest and extreme gradient boosting (XGBoost) algorithms, and the intersection of the top 12 variables ranked by importance in the two algorithms was selected as candidate predictors. Multivariable logistic regression analysis was then performed, and the results were pooled according to Rubin’s rules to identify independent predictors and construct a nomogram prediction model. The discrimination, calibration, and clinical utility of the model were evaluated using receiver operating characteristic (ROC) curves, calibration curves, the Hosmer–Lemeshow goodness-of-fit test, decision curve analysis (DCA), and clinical impact curves (CICs).Results:XGBoost and random forest algorithms were used to identify the top 12 feature variables ranked by importance, respectively. The intersection of these variables was obtained using a Venn diagram, yielding nine candidate variables. Multivariable logistic regression analysis further identified four independent predictors: age, creatine kinase-MB isoenzyme (CKMB), the neutrophil plus monocyte-to-lymphocyte ratio (NMLR), and serum creatinine (Cr). The nomogram model constructed based on these predictors achieved an area under the receiver operating characteristic curve (AUC) of 0.742 (95% CI: 0.684–0.799) in the training cohort and 0.714 (95% CI: 0.619–0.808) in the validation cohort, indicating good discriminative ability. The calibration curves in both cohorts showed good agreement with the ideal curve, suggesting favorable calibration. Decision curve analysis (DCA) indicated that the model had clinical value for predicting the risk of cardiac injury after antitumor therapy in patients with advanced lung cancer.Conclusion: The prediction model developed in this study can effectively assess the risk of cardiac injury after antitumor therapy in patients with advanced lung cancer. It may provide a useful reference for the early identification of high-risk patients and for developing individualized monitoring and intervention strategies.
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MRI Study on the Relationship Between Thalamic Subregion Volume Changes and Cognitive Impairment in Patients with Cerebral Small Vessel Disease
Abstract:
Objective: To explore the relationship between thalamic subregion volume changes and cognitive function in patients with cerebral small vessel disease (CSVD). Methods: 26 CSVD patients with cognitive impairment (CSVD-CI group), 24 CSVD patients with cognitive normal (CSVD-NC group), and 32 healthy controls (HC group) were included. Collect high-resolution magnetic resonance images of all subjects and perform voxel-based morphometric analysis to obtain the volume of thalamic subregions. Analysis of covariance (ANCOVA) was used to compare thalamic subregion volumes among the three groups, with age, sex, education and total intracranial volume as covariates. Pairwise comparisons were conducted using t-tests with False Discovery Rate (FDR) correction. Partial correlation analysis was further performed to evaluate the correlation between thalamic subregion volume and cognitive performance. Results: There were intergroup differences in the volumes of all subregions among the three groups. The pairwise comparison results showed that all thalamic subregions in CSVD patients exhibited volume atrophy compared to the HC group (all P < 0.05), while there was no significant difference in the volume of thalamic subregions between the CSVD-CI group and the CSVD-NC group (all P > 0.05). Partial correlation analysis showed that the volume of multiple thalamic subregions in CSVD patients was correlated with cognitive performance: executive function (Trail Making Test B) was negatively correlated with the volume of bilateral thalamic subregions (left ventral lateral dorsal nucleus, right anterior nucleus, and right ventral anterior nucleus) (all P < 0.05); The executive function (Stroop test 2) was positively correlated with the volume of the left thalamic subregion (ventral lateral dorsal nucleus, ventral anterior nucleus) (both P < 0.05); Verbal memory (5-minute delayed memory and recognition scores from the auditory language learning test) is positively correlated with the volume of the left thalamic subregion (pulvinar, ventral lateral dorsal nucleus, ventral anterior nucleus, ventral lateral ventral nucleus, etc.) (all P < 0.05). Conclusion: Extended atrophy of thalamic subregion volume is an important structural imaging feature of CSVD, and is associated with multi domain cognitive impairment (mainly including executive and memory). However, a single thalamic subregion volume index cannot effectively distinguish whether CSVD patients have cognitive impairment.
临床医学研究
基础医学研究
临床医学研究
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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
Abstract:
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.
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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
Abstract:
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.
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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
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.
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Effect and mechanism of miR-139-3p targeting SPP1 on cisplatin resist-ance in A549 lung cancer cells
2025,40(10):1225-1229 1248 ,DOI: 10.3969/j.issn.1005-3697.2025.10.001
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.
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Clinical study of Nalbuphine as local anesthetic adjuvant for nerve block analgesia in elderly patients after total hip arthroplasty
Wang Huajuan; Liu Qiyu; Liu Jing; Li Mingming; Song Man; Li Fengjuan; Zheng Xiaozhen;
2025,40(10):1253-1258 ,DOI: 10.3969/j.issn.1005-3697.2025.10.007
Abstract:
Objective:To observe the effect of ultrasound-guided suprainguinal fascia iliaca compartment block(U-SFICB)with ropivacaine combined with different doses of nalbuphine on analgesia in elderly patients after total hip arthroplasty(THA).Methods:101 elderly patients with unilateral THA under general anesthesia were divided into four groups according to different anesthesia regimens:100 mg ropivacaine+normal saline group(R group,n=26),100 mg ropivacaine+10 mg nal-buphine group(LN group,n=25),and 100 mg ropivacaine+15 mg nalbuphine group(MN group,n=25),and 100 mg ropiv-acaine+20mg nalbuphine group(HN group,n=25),all were diluted to 30 mL with 0.9%sodium chloride injection.All four groups underwent U-SFICB in the post-anesthesia care unit(PACU),and sufentanil was used for patient-controlled intravenous analgesia after surgery.Comparison between groups of postoperative 4,8,12,24,and 48 h of resting and motion state of Numer-ical rating scale(NRS).Each group received 12 h preoperatively,12 and 24 h postoperatively,Interleukin 6(IL-6),Tumor nec-rosis factor-α(TNF-α),Interleukin 10(IL-10)concentration,the first start time of postoperative analgesia pump and 48 h of sufentanil use in each group,the early postoperative recovery of each group,and the occurrence of analgesia related adverse reac-tions 48 h after surgery were compared between groups.Results:Compared with R group and LN group,NRS score in MN and HN group was decreased at all time points(P<0.05),IL-6 and TNF-α concentrations were decreased at all time points(P<0.05),IL-10 concentrations were increased at all time points(P<0.05),and the start-up time of postoperative analgesia pump was significantly extended(P<0.05).The amount of sufentanil was significantly decreased 48 hours after operation(P<0.05).Compared with R group,LN group and HN group,the time of first anal exhaust and getting out of bed in MN group were significantly shortened(P<0.05).The incidence of adverse reactions was significantly decreased 48 h after operation(P<0.05).Compared with HN group,the start-up time of postoperative analgesic pump in MN group was significantly short-ened(P<0.05),and the overall incidence of adverse reactions was the lowest at 48 h after surgery(P<0.05).Conclusion:15 mg nalbuphine combined with ropivacaine can significantly prolong the duration of U-SFICB analgesia after THA in elderly pa-tients,and the first postoperative anal exhaust time and the first time of getting out of bed activity are the shortest,and the inci-dence of adverse reactions is the lowest within 48 hours after surgery,which can be clinically promoted and applied.
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The causal relationship between sleep disorders and gastric ulcer incidence based on two-sample Mendelian randomization
2025,40(6):693-698 ,DOI: 10.3969/j.issn.1005-3697.2025.06.003
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.
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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
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.
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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
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.
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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
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.
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Distribution of peripheral blood B cell subsets in patients with systemic lupus erythematosus and their clinical applications
2025,40(10):1285-1290 ,DOI: 10.3969/j.issn.1005-3697.2025.10.014
Abstract:
Objective:To analyze the distribution of peripheral blood B cell subsets in patients with systemic lupus erythe-matosus(SLE)and their clinical applications.Methods:52 SLE patients(SLE group),36 healthy controls(HC group)and 30 rheumatoid arthritis(RA group)patients were included.The percentage of B1,FOB,Breg and ABC cells in total B cells was measured by Flow cytometry.Diagnostic efficacy of individual and combined B cell subsets for SLE was evaluated via ROC curves.Clinical data on SLE activity score(SLEDAI),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),com-plement C3 and C4,immunoglobulin,and various autoantibodies from SLE patients were collected,and the correlations between the subsets percentage and these indicators were analyzed.Results:Compared to HC group,the percentage of B1,Breg,and ABC were higher in SLE group(P<0.05)and the percentage of FOB was lower(P<0.05).The percentage of B1,and Breg in SLE group were obviosly higher than those in RA group(P<0.05)and FOB was lower(P<0.05).There was no statistically sig-nificant difference in the proportion of cells in each subgroup between the RA group and the HC group(P>0.05).ROC curve analysis showed that all B cell subgroups had a certain diagnostic efficacy for SLE,and the combination of multiple subgroups had a higher diagnostic efficacy for SLE.The area under the curve(AUC)of 11 combinations for diagnosing SLE was 0.756～0.892(P<0.05),with(ABC+B1+Breg+FOB)combined was highest.Results of Assay of correlations showed that the per-centage of ABC cells positively correlated with the level of ESR(P<0.05,r=0.403).The percentage of Breg cells negatively correlated with the level of C3(P<0.05,r=-0.421)and positively correlated with the level of anti-dsDNA(P<0.05,r=0.488),anti-M2(P<0.05,r=0.604),SLEDAI(P<0.05,r=0.353).ABC and FOB were negatively correlated in the SLE group(P<0.05,r=-0.571),while there was no correlation between the two in the HC and RA groups(P>0.05).Conclu-sion:There are differences in the distribution of B cell subsets between SLE patients and the normal population.The combina-tion of single or multiple indicators has good diagnostic efficacy for SLE,and the distribution of subsets is correlated with multi-ple clinical and laboratory indicators,suggesting that it may have value in disease diagnosis and disease assessment.
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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:
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.
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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
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.
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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
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.
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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:
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.
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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:
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.
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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
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.
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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:
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.
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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:
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.
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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
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.
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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:
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.
Basic Medical Research
Clinical medical research
Basic Medical Research
Clinical medical research
Basic Medical Research
Clinical medical research
Basic Medical Research
Clinical medical research
Editor in chief：Dai Rongyang
Deputy Editor-in-Chief：Li Zhi
Governed by：The Education Department of Sichuan Province
Sponsored by：North Sichuan Medical College
Phone：0817-2242637
Email：xuebaocby@126.com
ISSN1005-3697
CN51-1254/R
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