Basic Medical Research

• Exploration of the mechanisms of friedelin in the treatment of osteoporosis based on network pharmacology and molecular docking

  Zhou Xuewen; Tang Sheng-an; Zhang Jing; Liu Linfeng; Chen Wei; Yu Xiaoqin; Jiao Li; Liang Qi

  2026,41(8):897-907 ,DOI: 10.3969/j.issn.1005-3697.2026.08.001

  Abstract(47) HTML(0) PDF(9.98 M)( 121)

  Abstract:

  Objective: To investigate the therapeutic effects of friedelin in the treatment of osteoporosis, with a focus on its regulatory role in osteogenic differentiation and bone metabolism. Methods: CCK-8, ALP staining, ARS staining, and RT-qPCR were used to detect the effect of Friedelin on the cell activity and osteogenic differentiation of human mesenchymal stem cells (hMSCs). Network pharmacology, GO/KEGG enrichment analysis, molecular docking, and luciferase reporter assay were employed to explore its molecular mechanism. C57BL/6 mice and ovariectomized (OVX) mouse models were used to evaluate its in vivo biosafety and therapeutic effect. Results: Friedelin had no obvious cytotoxicity on hMSCs, and its efficacy in promoting osteogenic differentiation was superior to that of risedronate sodium (P<0.05). 52 common targets of Friedelin and osteoporosis were screened out, with 6 key targets including INS, EGFR, EGR1, PTGS2, CYP3A4, and CYP19A1, among which CYP19A1 had the most stable binding with Friedelin. Friedelin could activate transcription factors such as RUNX2, and its targets were enriched in prolactin, FoxO and other related pathways. Its intragastric administration had good safety and could improve the bone microstructure of OVX mice, with a therapeutic effect superior to that of risedronate sodium (P<0.05). Conclusion: Friedelin has good in vivo biosafety and significant anti-osteoporotic efficacy. With CYP19A1 as the core target, it regulates osteogenic differentiation and bone metabolism balance through multiple targets and pathways, and is expected to become a new candidate drug for osteoporosis.

• Carnosol influences the inflammatory response in mice suffering from chronic obstructive pulmonary disease through the regulation of TAK1 activity

  Wu Yu; Ougouchun; A Diquegu; Li Xingling; Cai Zhuqing; Wang Shuhong; Huang Yufang; Qiu Rong

  2026,41(8):908-914 ,DOI: 10.3969/j.issn.1005-3697.2026.08.002

  Abstract(28) HTML(0) PDF(4.94 M)( 81)

  Abstract:

  Objective: To investigate the effects of carnosol on pulmonary inflammation and fibrosis in a murine model of chronic obstructive pulmonary disease (COPD) and to elucidate whether these effects are mediated through the regulation of TAK1 activity. Methods: 30 male C57BL/6 mice were randomly allocated into five groups: normal control, COPD model, low-dose carnosol (2.5 mg/kg), high-dose carnosol (5 mg/kg), and dexamethasone positive control (1 mg/kg), with 6 mice in each group. The COPD model was established through intratracheal lipopolysaccharide (LPS) instillation combined with cigarette smoke exposure and intraperitoneal injection of cigarette smoke extract (CSE). Modeling was accompanied by drug intervention, which was administered over a consecutive 7-day period. 24 hours following the final administration, serum, bronchoalveolar lavage fluid (BALF), and lung tissues were collected. Hematoxylin-eosin (HE) staining was performed to evaluate pulmonary histopathological changes, while Masson’s trichrome staining was utilized to assess collagen deposition. Serum and BALF levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) were quantified by enzyme-linked immunosorbent assay (ELISA). Western blot analysis was conducted to determine the protein expression levels of phosphorylated TAK1 (p-TAK1), phosphorylated P38 (p-P38), phosphorylated P65 (p-P65), phosphorylated c-Jun N-terminal kinase (p-JNK), and inhibitor of NF-κBα (IκBα) in lung tissues. Real-time quantitative polymerase chain reaction (RT-qPCR) was employed to measure TAK1 mRNA expression. Results: Compared with the normal control group, the COPD model group exhibited severe pulmonary histopathological damage characterized by massive inflammatory cell infiltration and substantial collagen fiber deposition, and an increase in mean linear intercept (MLI) (P<0.001). Serum and BALF levels of TNF-α and IL-1β were elevated (P<0.001). Furthermore, the protein expression levels of p-TAK1, p-P38, p-P65, and p-JNK, along with the TAK1 mRNA expression in lung tissues, were upregulated (P <0.001). Meanwhile, the IκBα protein expression was down-regulated (P<0.001). Compared with the model group, low-dose carnosol attenuated histopathological injury in lung tissue, suppressed inflammatory cell infiltration, and mitigated collagen deposition (P<0.05), the MLI was reduced (P<0.05). No significant differences were observed in the concentrations of TNF-α and IL-1β in serum or BALF (P>0.05). At the protein level, p-TAK1 and p-P38 was downregulated (P<0.01), whereas IκBα expression was upregulated (P<0.01). In contrast, no statistically significant changes were detected in the p-JNK or p-P65 (P>0.05), the mRNA expression level of TAK1 was down-regulated (P <0.01). In the high-dose carnosol group, histopathological lung injury, inflammatory cell infiltration, and collagen deposition were further attenuated (P<0.001), and MLI was further decreased (P<0.001). TNF-α and IL-1β levels in both serum and BALF were lowered (P<0.05). The levels of p-TAK1, p-JNK, p-P38, and p-P65 were all downregulated (P<0.01), IκBα protein expression was further enhanced (P <0.001), and TAK1 mRNA expression was markedly suppressed (P<0.001). Relative to the low-dose carnosol group, the high-dose group exhibited significantly milder histopathological alterations, less pronounced inflammatory infiltration, and reduced collagen accumulation (P<0.01), along with a shorter MLI (P<0.05). No intergroup differences were observed in serum or BALF TNF-α and IL-1β levels (P>0.05). The levels of p-TAK1, p-P38 and p-P65 were further diminished (P<0.05), there was no difference in the expression levels of p-JNK and total IκBα protein (P >0.05). TAK1 mRNA expression was also lower in the high-dose group (P <0.001). The dexamethasone group demonstrated therapeutic efficacy comparable to that of the high-dose carnosol group across all major endpoints—including attenuation of lung histopathology, suppression of inflammation and fibrosis, reduction of systemic and local pro-inflammatory cytokines, and inhibition of TAK1 activation and downstream NF-κB/MAPK signaling. There was no statistically significant difference in the levels of MLI and TAK1 mRNA between the two groups (P>0.05). Conclusion: Carnosol dose-dependently attenuates pulmonary inflammation and fibrosis in COPD mice by inhibiting TAK1 transcription and phosphorylation, consequently blocking the downstream NF-κB/MAPK signaling cascade and ameliorating pulmonary histopathological damage.

• IL-39 aggravates myocardial injury in septic rats by regulating PHB2/PINK1/Parkin pathway and inhibiting mitophagy

  Luo Jing; Ling Shouyi; Xiao Jiao; Wang Jingjing

  2026,41(8):915-922 ,DOI: 10.3969/j.issn.1005-3697.2026.08.003

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  Abstract:

  Objective: To investigate the effects of interleukin-39 (IL-39) on mitophagy and myocardial injury in septic rats, as well as the regulatory role of Prohibitin2/PTEN induced putative kinase1/Parkin (PHB2/PINK1/Parkin) pathway. Methods: 80 rats were randomly divided into sham group, cecal ligation and puncture (CLP) group, CLP+IL-39 group, CLP+IL-39 inhibitor group, CLP+Ad-NC group, CLP+Ad-PHB2 group, CLP+IL-39+Ad-NC group, CLP+IL-39+Ad-PHB2 group, with 10 rats in each group. A rat sepsis model was established using CLP method. After corresponding intervention, echocardiography was used to detect the cardiac function of rats, ELISA was used to detect serum myocardial injury marker [cardiac troponin I (c-TnI), creatine kinase-myocardial band (CK-MB), lactate dehydrogenase (LDH)] and inflammatory factor [tumor necrosis factor (TNF-α), IL-1β, IL-6] levels. HE staining was used to observe myocardial pathological damage, transmission electron microscopy was used to observe myocardial mitochondrial morphology and mitophagosome formation, Western blotting was used to detect the expression of IL-39, PHB2, PINK1, Parkin, microtubule-associated protein light chain 3 Ⅱ (LC3 Ⅱ), and p62 protein in myocardium. Results: Compared with sham group, left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) values of rats in CLP group decreased, left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) values increased, serum c-TnI, CK-MB, LDH, TNF-α, IL-1β, and IL-6 levels increased. The myocardial cells were disordered with marked inflammatory cell infiltration, myocardial mitochondria were swollen and deformed, with cristae rupture and lysis, and mitophagosome formation was decreased, the expression of IL-39 and p62 in myocardium increased, while the expression of PHB2, PINK1, Parkin, and LC3 Ⅱ decreased (P<0.05). Compared with CLP group, LVEF and LVFS values of rats in CLP+IL-39 group decreased, LVESD and LVEDD values increased, serum c-TnI, CK-MB, LDH, TNF-α, IL-1β, and IL-6 levels increased. The myocardial cells were disordered with marked inflammatory cell infiltration, myocardial mitochondria were swollen and deformed, with cristae rupture and lysis, and mitophagosome formation was decreased, the expression of IL-39 and p62 in myocardium increased, while the expression of PHB2, PINK1, Parkin, and LC3 Ⅱ decreased (P <0.05). LVEF and LVFS values of rats in CLP+IL-39 inhibitor group increased, LVESD and LVEDD values decreased, serum c-TnI, CK-MB, LDH, TNF-α, IL-1β, and IL-6 levels decreased. Myocardial pathological damage was alleviated, mitochondrial structural damage was relieved, and mitophagosome formation was increased, the expression of myocardial IL-39 and p62 decreased, while the expression of PHB2, PINK1, Parkin, and LC3 Ⅱ increased (P <0.05). Compared with CLP+Ad-NC group, LVEF and LVFS values of rats in CLP+Ad-PHB2 group increased, LVESD and LVEDD values decreased, serum c-TnI, CK-MB, LDH, TNF-α, IL-1β, and IL-6 levels decreased. Myocardial pathological damage was alleviated, mitochondrial structural damage was relieved, and mitophagosome formation was increased, the expression of myocardial p62 decreased, while the expression of PHB2, PINK1, Parkin, and LC3 Ⅱ increased(P<0.05). Compared with CLP+IL-39+Ad-NC group, LVEF and LVFS values of rats in CLP+IL-39+Ad-PHB2 group increased, LVESD and LVEDD values decreased, serum c-TnI, CK-MB, LDH, TNF-α, IL-1β, and IL-6 levels decreased. Myocardial pathological damage was alleviated, mitochondrial structural damage was relieved, and mitophagosome formation was increased, the expression of myocardial p62 decreased, while the expression of PHB2, PINK1, Parkin, and LC3Ⅱincreased(P<0.05). Conclusion: IL-39 exacerbates myocardial injury in septic rats by inhibiting PHB2/PINK1/Parkin pathway mediated mitophagy.

Clinical medical research

• The mediating mechanism of T lymphocyte subsets in Helicobacter pylori infection induced refractory peptic ulcers

  Ma Xiaolei; Jia Jing; Geng Qianwen; Yao Juan; Han Liqin

  2026,41(8):923-927 ,DOI: 10.3969/j.issn.1005-3697.2026.08.004

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  Abstract:

  Objective: To investigate the mediating role of peripheral blood T-lymphocyte subsets in Helicobacter pylori (Hp) infection-induced refractory peptic ulcer. Methods: A total of 96 patients with peptic ulcer were enrolled and divided into a non-refractory ulcer group (n=65) and a refractory ulcer group (n=31), with another 30 healthy individuals serving as the control group. The differences in general information and serum T-cell subsets among three groups of patients, specifically T cells (CD3?), helper T cells (CD4?), suppressor T cells (CD8?), CD4?/CD8? ratio, B cells (CD19?), and natural killer cells (CD56?) were explored. Furthermore, the patients with refractory peptic ulcers were classified into the Hp-negative group (n=6) and the Hp-positive group (n=25) according to the Hp test results. The differences in serum T lymphocyte subsets between these two groups were investigated. The mediating role of peripheral blood T-lymphocyte subsets in the relationship between Hp infection and refractory peptic ulcer was examined. Results: Compared with the control group, both the non-refractory and refractory ulcer groups presented decreased serum levels of CD4?, CD4?/CD8? ratio and CD56?, along with elevated CD19? levels. In the refractory ulcer group, CD4? and CD56? levels were further lower than those in the non-refractory group, whereas no significant differences were observed in CD4?/CD8? ratio and CD19? between the two ulcer groups. The refractory ulcer group had markedly lower CD3? levels than both the control group and the non-refractory ulcer group. In terms of CD8? level, it was higher in the non-refractory ulcer group but decreased in the refractory ulcer group when compared with the control group. Compared with Hp-negative patients, Hp-positive patients had elevated serum levels of CD4?, CD8? and CD19? but reduced CD56? levels. Mediation analysis revealed that after adjusting for sex, smoking status and alcohol consumption history, H. pylori infection exerted effects on refractory peptic ulcer by modulating CD3?, CD4? and CD8? levels. Conclusion: Hp infection influences the development of refractory peptic ulcer by modulating peripheral blood T-lymphocyte subsets (CD3?, CD4? and CD8?).

• Diagnostic value of superb microvascular imaging combined with shear wave elastography in preoperative assessment of cervical lymph node metastasis in lung cancer

  Lu Nanyan; Zhan Xiaolin; Huang Lei; Wang Jiajia; Chen Lin; Jiang Fan

  2026,41(8):928-933 ,DOI: 10.3969/j.issn.1005-3697.2026.08.005

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  Abstract:

  Objective: To investigate the diagnostic efficacy of the combined application of Superb Microvascular Imaging (SMI) and Shear Wave Elastography (SWE) in the preoperative evaluation of cervical lymph node metastasis in patients with lung cancer. Methods: A total of 187 patients (with 187 lymph nodes) with suspected lung cancer and cervical lymph node enlargement were selected as the study subjects. All patients underwent conventional ultrasound, superb microvascular imaging (SMI), and shear wave elastography (SWE) before surgery. Using cervical lymph node aspiration/biopsy pathology or pathological staging after radical lung cancer surgery as the gold standard, differences in conventional ultrasound, SMI blood flow parameters, and SWE elastography parameters were compared between the two groups at both the patient level (114 cases in the metastatic positive group and 73 cases in the metastatic negative group) and the lymph node level (114 lymph nodes in the metastatic group and 73 lymph nodes in the non-metastatic group). Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic efficacy of different examination methods and their combined application. Results: At the patient level, the proportion of poor differentiation was higher in the metastatic positive group than in the metastatic negative group (P<0.05). At the lymph node level, metastatic nodes more frequently exhibited features on conventional ultrasound such as a long-axis/short-axis ratio < 2, larger short-axis diameter, indistinct margins, loss of corticomedullary differentiation, heterogeneous internal echogenicity, and microcalcifications (P <0.05). SMI revealed that metastatic nodes predominantly showed peripheral or mixed vascular patterns, while non-metastatic nodes mainly showed hilar vascular patterns (P<0.05). The proportion of nodes with Adler blood flow grade II~III was higher in the metastatic group than that in the non-metastatic group (P<0.05). SWE quantitative parameters showed that the maximum Young’s modulus (Emax), mean Young’s modulus (Emean), minimum Young’s modulus (Emin), and standard deviation (SD) were higher in the metastatic group compared to the non-metastatic group (P<0.05). The sensitivity, specificity, and accuracy of the combined SMI and SWE diagnosis were 95.60%, 90.40%, and 93.60%, respectively, with an AUC of 0.938 (95%CI:0.892~0.973), which were higher than those of any single method (P<0.05). Conclusion: SMI can finely depict the internal vascular architecture of lymph nodes, while SWE can quantitatively assess lymph node stiffness. Both techniques reflect the pathological characteristics of metastatic lymph nodes from different dimensions. Their combined application can improve the diagnostic accuracy for preoperative cervical lymph node metastasis in lung cancer.

• Effects of PENG + LFCN block with bupivacaine liposome on stress and cognitive function in elderly patients after total hip arthroplasty

  Xie Yuhai; Zhang Liliang; Hui Tingqi Yu

  2026,41(8):934-937 ,DOI: 10.3969/j.issn.1005-3697.2026.08.006

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  Abstract:

  Objective: To explore the effects of pericapsular nerve group (PENG) and lateral femoral cutaneous nerve (LFCN) block with bupivacaine liposome (LB) on stress and cognitive function in elderly patients after total hip arthroplasty. Methods: According to different intervention methods, 100 elderly patients undergoing total hip arthroplasty were divided into observation group (n=50, PENG+LFCN block with LB) and control group (n=50, PENG+LFCN block with ropivacaine). The postoperative analgesia, stress response, cognitive function, recovery and adverse reactions were compared between the two groups. Results: At 12, 24 and 48 h after surgery, VAS scores under rest and motion states, and compression frequency of patient controlled intravenous analgesia (PCIA) in observation group were lower than those in control group (P<0.05). At 1 d after surgery, levels of cortisol (COR), adrenaline (E) and norepinephrine (NE) in observation group were lower than those in control group (P<0.05). At 3 and 7 d after surgery, scores of mini-mental state examination (MMSE) in observation group were higher than those in control group (P<0.05). The first leaving bed time and length of hospital stay in observation group were shorter than those in control group (P<0.05). Conclusion: Compared with ropivacaine, PENG+LFCN block with LB has better analgesic effect in elderly patients after total hip arthroplasty, which can alleviate postoperative stress response, protect cognitive function and promote recovery.

• Diagnostic value and hemodynamic characteristics of combined cerebrovascular and cervical ultrasound in differentiating intracranial vertebral artery Occlusion from vertebral artery hypoplasia

  Jiang Hao; Wei Milin; Shi Yingna

  2026,41(8):938-942 ,DOI: 10.3969/j.issn.1005-3697.2026.08.007

  Abstract(16) HTML(0) PDF(3.46 M)( 76)

  Abstract:

  Objective: To investigate the diagnostic value of integrated brain and neck vascular ultrasound in differentiating occlusion of the intracranial segment of the vertebral artery (VA) from vertebral artery hypoplasia, and to analyze the differences in hemodynamic characteristics between the two conditions. Methods: A total of 54 patients with intracranial vertebral artery occlusion (occlusion group) and 48 patients with vertebral artery hypoplasia (hypoplasia group), all of whom underwent integrated carotid ultrasound and transcranial doppler (TCD) examination, were included. Carotid intima-media thickness (IMT) and plaque characteristics were measured. Peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI), and resistance index (RI) were recorded at the intervertebral and intracranial segments of the vertebral artery, the middle cerebral artery, and the basilar artery, along with collateral circulation status. Binary Logistic regression analysis was used to identify independent differentiating factors, and receiver operating characteristic (ROC) curves were employed to evaluate the diagnostic performance of each parameter. Results: In the occlusion group, IMT, plaque detection rate, and the proportion of unstable plaques were all higher than those in the hypoplasia group (P<0.05). On the affected side, PSV and EDV of the vertebral artery at the intervertebral segment decreased, while RI increased. In the intracranial segment, PSV, EDV, and RI on the affected side were all lower, whereas PSV and EDV on the contralateral side were higher. PSV, EDV, and PI of the middle cerebral artery and basilar artery decreased, and the patency rate of the posterior communicating artery increased (P<0.05). Decreased intracranial PSV on the affected side, increased IMT, increased ΔRI on the affected side, and a patent posterior communicating artery were independent predictors of occlusion (P<0.05). The combined model achieved an AUC of 0.958 (95%CI:0.923~0.993), with a sensitivity of 92.59% and a specificity of 89.58%, outperforming any single parameter (P <0.05). Conclusion: Intracranial VA occlusion and VA hypoplasia exhibit distinct hemodynamic profiles. Integrated brain and neck vascular ultrasound enables systematic evaluation of hemodynamic alterations throughout the extracranial and intracranial course of the VA, as well as other cervicocerebral vessels, demonstrating substantial clinical utility in the differential diagnosis of these two entities.

• Relationship between nuclear factor-kappaB, multiple tumor suppressor gene and clinical features of cervical cancer and sensitivity to radiotherapy

  Hou Yue; Gao Yu; Yan Wenming

  2026,41(8):943-947 ,DOI: 10.3969/j.issn.1005-3697.2026.08.008

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  Abstract:

  Objective: To investigate the relationship between nuclear factor-kappaB (NF-κB), multiple tumor suppressor gene (P16) and clinical features of cervical cancer as well as sensitivity to radiotherapy. Methods: Retrospective collection of clinical data from 119 patients with cervical cancer. All patients were tested for the positive expression of NF-κB and P16 in cervical cancer cells. The relationship between their expression and clinical features as well as sensitivity to radiotherapy was analyzed. Results: Among the 119 specimens, 88 (73.95%) were positive for NF-κB and 97 (81.51%) were positive for P16. The positive expression rates of NF-κB and P16 showed significant differences between patients with varying degrees of differentiation and patients with/without lymph node metastasis (P<0.05). Spearman correlation analysis revealed that the positive expression rate of NF-κB was positively correlated with the degree of differentiation and lymph node metastasis (P<0.05), whereas the positive expression rate of P16 was negatively correlated with these clinical features (P<0.05). Univariate and multivariate Logistic regression analyses indicated that lymph node metastasis and NF-κB positivity were independent risk factors for insensitivity to radiotherapy, whereas P16 positivity was an independent protective factor against (P <0.05). Conclusion: NF-κB and P16 are closely related to the degree of differentiation and lymph node metastasis in cervical cancer. The positive expression of NF-κB and the positive expression of P16 are influencing factors for insensitivity to radiotherapy.

• Short-term efficacy and mechanism of colchicine combined with nicorandil in patients with coronary slow flow-type angina

  Ma Honghao; Wang Yanling; Wang Bingcheng; Yang Jing

  2026,41(8):948-952 ,DOI: 10.3969/j.issn.1005-3697.2026.08.009

  Abstract(16) HTML(0) PDF(3.40 M)( 79)

  Abstract:

  Objective: To investigate the short-term efficacy and mechanism of colchicine combined with nicorandil in patients with coronary slow flow (CSF)-type angina. Methods: A total of 120 patients with CSF-type angina were selected and divided into an observation group (colchicine combined with nicorandil) and a control group (nicorandil alone) according to different treatment methods, with 60 cases in each group. After 12 weeks of treatment, the therapeutic effects, angina episodes, corrected Thrombolysis in Myocardial Infarction frame count (CTFC), endothelial function, inflammatory markers, oxidative stress indicators, and adverse reactions were compared between the two groups. Results: After 12 weeks of treatment, the total effective rate in the observation group was higher than that in the control group (P<0.05). After treatment, the frequency and average duration of angina pectoris attacks, the corrected TIMI frame count (CTFC) of the left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA), endothelin-1 (ET-1), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), myeloperoxidase (MPO) and the MPO/paraoxonase (PON) ratio in both groups were lower than those of before treatment (P<0.05), and those in the observation group were lower than those in the control group (P <0.05). The levels of nitric oxide (NO) and flow-mediated dilation (FMD) in both groups were higher than those of before treatment (P<0.05), and those in the observation group were higher than those in the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion: Colchicine combined with nicorandil improves the short-term efficacy in patients with CSF-type angina, and its mechanism may be related to synergistic effects such as improving vascular endothelial function, anti-inflammation, and reducing oxidative stress.

• Application of transient elastography in assessing the degree of liver fibrosis and the efficacy of antiviral treatment in patients with chronic hepatitis B

  Yang Yalan; Liu Jiakai; Zhou Chunmei; He Qian

  2026,41(8):953-956 ,DOI: 10.3969/j.issn.1005-3697.2026.08.010

  Abstract(23) HTML(0) PDF(3.34 M)( 65)

  Abstract:

  Objective: To analyze the value of transient elastography (TE) in assessing the degree of liver fibrosis and the efficacy of antiviral treatment in patients with chronic hepatitis B (CHB). Methods: A total of 186 patients with CHB who underwent TE to obtain liver stiffness measurement (LSM). According to liver biopsy results, patients were divided into the non-significant fibrosis group (F0-1), the significant fibrosis group (F2-3), and the cirrhosis group (F4). Patients with liver fibrosis ≥ F2 were given antiviral treatment and followed up for 12 months. Based on treatment response, they were further grouped. LSM values were compared among patients with different degrees of liver fibrosis and different treatment outcomes. The correlation between LSM and the degree of liver fibrosis, and the predictive efficacy for treatment effect were analyzed. Results: LSM increased with the progression of liver fibrosis (P<0.05). LSM was positively correlated with the degree of liver fibrosis (P<0.05). For the 111 patients who received antiviral treatment, the non-response group had higher LSM than the response group (P<0.05). The area under the curve of LSM in predicting the efficacy was 0.813, with sensitivity of 80.20% and specificity of 73.30%. Conclusion: TE demonstrates good value in assessing the degree of liver fibrosis and the efficacy of antiviral treatment in patients with CHB.

• Effects of laparoscopic total mesorectal excision on perioperative indicators, anal function recovery, and inflammatory response

  Zhang Haoran; He Meiren

  2026,41(8):957-961 ,DOI: 10.3969/j.issn.1005-3697.2026.08.011

  Abstract(25) HTML(0) PDF(3.43 M)( 72)

  Abstract:

  Objective: To investigate the changes in perioperative indicators, recovery of anal function, and levels of systemic inflammatory response in patients with low rectal cancer after undergoing laparoscopic total mesorectal excision. Methods: In a retrospective study, 160 patients with low rectal cancer were divided into a study group and a control group based on different treatment regimens. The study group (n=81) underwent laparoscopic total mesorectal excision, while the control group (n=79) underwent open total mesorectal excision. Perioperative indicators, anal function recovery, inflammatory response, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Colorectal Cancer 29 (EORTC QLQ-CR29) scores, and complication rate were compared between the two groups. Results: Compared with the control group, the study group showed an increase in operation time (P <0.05), reductions in intraoperative blood loss, postoperative recovery time, and complications (P<0.05), and better improvements in anal function, inflammation control and quality of life (P<0.05). Conclusion: Laparoscopic total mesorectal excision is applied in the treatment of low rectal cancer, and it has obvious advantages in optimizing perioperative indicators, accelerating anal function recovery, and reducing inflammatory response.

• Evaluation of the effect of chemo-mechanical caries removal in the treatment of childhood carie in patients with low rectal cancer

  Wang Ke; Shi Tianpeng

  2026,41(8):962-966 ,DOI: 10.3969/j.issn.1005-3697.2026.08.012

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  Abstract:

  Objective: To explore the effects of different methods of caries removal and cavity preparation on children with dental caries and the influence on tooth sensitivity and pulp vitality. Methods: A total of 102 children with dental caries were selected as research subjects and divided into group A (n=51, traditional turbine handset therapy) and group B (n=51, chemo-mechanical therapy) according to the different methods of caries removal and cavity preparation. The perioperative indexes, repair effect after treatment, tooth sensitivity and pulp vitality before and after treatment and occurrence of complications were compared between the two groups of children. Results: In group B, the postoperative pain duration and first normal meal time were shorter than those in group A (P<0.05), and the total time required for caries removal and cavity preparation as well as FBRS score were longer or higher than those in group A (P<0.05). There was no statistically significant difference in the repair effect between group B and group A (P>0.05). At 3 months after surgery, both groups showed decreased Tactile value and Schiff score compared to before surgery (P<0.05), with group B showing lower values than group A (P<0.05). The electric pulp value was increased in both groups compared to before surgery (P<0.05), but the value was lower in group B than that in group A (P<0.05). No statistical differences in the related complications were found between group B and group A (P>0.05). Conclusion: Chemo-mechanical caries removal can more relieve intraoperative pain, stress and postoperative sensitivity compared to traditional turbine handset, with smaller interference to pulp blood flow.

• The clinical efficacy and recurrence rate of minimally invasive surgery for basal cell carcinoma guided by skin imaging

  Deng Xueqin; Ma Jie; You Zhenbo

  2026,41(8):967-970 ,DOI: 10.3969/j.issn.1005-3697.2026.08.013

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  Abstract:

  Objective: To investigate the clinical efficacy and recurrence rate of minimally invasive surgery for basal cell carcinoma (BCC) guided by dermoscopy combined with reflectance confocal microscopy (RCM). Methods: A total of 80 patients with primary BCC were enrolled and assigned to an observation group and a control group according to the different surgical methods, with 40 cases in each group. Prior to surgery, patients in the observation group underwent tumor localization, margin assessment, and depth evaluation using dermoscopy combined with reflectance confocal microscopy (RCM). Based on the imaging findings, individualized minimally invasive surgical plans were formulated. In contrast, patients in the control group received preoperative tumor margin determination via conventional visual inspection and subsequently underwent standard minimally invasive surgical treatment. All patients were followed up for 12 months postoperatively. Surgical-related indicators, incidence of complications, recurrence rates, and cosmetic satisfaction were compared between the two groups. Results: The observation group demonstrated reduced mean operative time, intraoperative blood loss, surgical defect area, and the positive rate of incision margin compared to the control group (P <0.05). The rate of primary wound closure was higher in the observation group (P<0.05). During the 12-month postoperative follow-up, no statistically significant difference in recurrence rates was observed between the two groups (P>0.05). However, the observation group reported higher cosmetic satisfaction at 12 months post-surgery (P<0.05). Conclusion: Minimally invasive surgery for BCC guided by dermoscopy combined with RCM enables precise tumor margin delineation, reduces the rate of positive surgical margins, minimizes surgical trauma, and improves aesthetic outcomes. This approach may also mitigate long-term recurrence risk, serving as a complementary strategy to Mohs micrographic surgery (MMS) and offering a more precise, minimally invasive therapeutic option for BCC patients.

• Application value of multi-phase vascular fusion based on pulmonary CTA in qualitative diagnosis of pulmonary space-occupying lesions

  Yang Dongmei; Chen Dong; Yu Yingming; Lei Xuemei

  2026,41(8):971-974 ,DOI: 10.3969/j.issn.1005-3697.2026.08.014

  Abstract(27) HTML(0) PDF(3.13 M)( 69)

  Abstract:

  Objective: To analyze the value of multi-phase vascular fusion based on computed tomography angiography (CTA) in qualitative diagnosis of pulmonary space-occupying lesions. Methods: A retrospective analysis was performed on the data of 185 patients with pulmonary space-occupying lesions who had pathological results. All patients received conventional contrast-enhanced chest CT followed by chest CTA. Using pathological results as the reference standard, the diagnostic efficacy of the two examination methods was assessed. Results: The sensitivity and specificity of conventional multi-phase contrast-enhanced CT were 87.50% and 84.62% (Kappa value=0.709), and the area under the curve (AUC) was 0.861. The sensitivity and specificity of multi-phase vascular fusion based on CTA were 95.83% and 93.85% (Kappa value=0.893), and the AUC was 0.948. Delong’s test showed that the AUC of multi-phase vascular fusion was greater than that of conventional multi-phase contrast-enhanced CT (P<0.05). Conclusion: Multi-phase vascular fusion based on pulmonary CTA can better display blood supply characteristics of lesions and improve the diagnostic efficacy for benign and malignant lesions.

• Application effect of preoperative use of dexmedetomidine hydrochloride nasal spray on optimizing anesthesia induction and recovery state of preschool children

  He Hongxia; Chen Tingting; Zhao Yanhong; Li Na; Chen Huaxing

  2026,41(8):975-978 ,DOI: 10.3969/j.issn.1005-3697.2026.08.015

  Abstract(22) HTML(0) PDF(2.53 M)( 71)

  Abstract:

  Objective: To explore the effect of preoperative use of dexmedetomidine hydrochloride nasal spray on anesthesia induction and recovery state of preschool children. Methods: 60 preschool children undergoing elective surgery under general anesthesia were divided into group M and group D by different intervention methods, with 30 cases in each group. Children were given intranasal dexmedetomidine hydrochloride nasal spray and 0.9% normal saline at 30 minutes before entering the operating room respectively. The perioperative anxiety status [modified Yale preoperative anxiety scale (m-YPAS) score], anesthesia induction compliance [induction compliance checklist (ICC) score], recovery quality [recovery time, residence time in post-anesthesia care unit (PACU), emergence agitation score] and incidence of adverse reactions were compared between two groups. Results: The m-YPAS scores at the time of separation from parents (T1) and at the time of anesthesia induction (T2), ICC score during anesthesia induction and emergence agitation score in group M were lower than those in group D (P<0.05). The recovery time and PACU stay time were shorter in group M than in group D (P <0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion: Preoperative intranasal administration of dexmedetomidine hydrochloride nasal spray in preschool children can relieve anxiety, enhance anesthesia induction compliance, and improve treatment during recovery.

• Effects of Metformin/Vildagliptin Tablets in the treatment of patients with type 2 diabetes mellitus at high cardiovascular risk and protection of cardiac and renal functions

  Hao Shuangqin; Huang Ming; Liu Zhen; Zheng Hailan

  2026,41(8):979-983 ,DOI: 10.3969/j.issn.1005-3697.2026.08.016

  Abstract(32) HTML(0) PDF(3.29 M)( 70)

  Abstract:

  Objective: To investigate the effects of Metformin/Vildagliptin Tablets in the treatment of patients with Type 2 diabetes mellitus (T2DM) at high cardiovascular risk and protection of cardiac and renal functions. Methods: A total of 94 patients with high cardiovascular risk T2DM were selected as study subjects. According to the different therapeutic drugs, they were divided into the fixed-dose combination (FDC) group (Metformin/Vildagliptin Tablets, n=42) and the metformin group (metformin alone, n=52). Both groups were treated for 6 months. The blood glucose control status [fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), and glycated hemoglobin (HbA1c) levels], pancreatic β-cell function [fasting insulin (FINS) levels, homeostasis model assessment of insulin resistance (HOMA-IR), homeostasis model assessment of β-cell function (HOMA-β)], cardiac function [stroke volume (SV), left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF)], renal function [urinary microalbumin and creatinine levels, urinary albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR)] were compared between the two groups. Results: After treatment, the levels of FBG, 2hPG, and HbA1c, and HOMA-IR, LVEDD, and UACR in the FDC group were lower than those in the metformin group (P<0.05). After treatment, the FINS levels and eGFR in the FDC group were higher than those in the metformin group (P <0.05). Conclusion: For T2DM patients with high cardiovascular risk, the Metformin/Vildagliptin fixed-dose combination is superior to metformin monotherapy in terms of glycemic control, improvement of pancreatic islet function, and cardiac and renal protection.

• Study on sodium thiosulfate ameliorating coronary artery calcification burden and its effects on walking ability and cardiovascular event risk in ESRD dialysis patients

  Zhu Yu; Ju Pingping; Zou Chunbo

  2026,41(8):984-988 ,DOI: 10.3969/j.issn.1005-3697.2026.08.017

  Abstract(15) HTML(0) PDF(3.38 M)( 72)

  Abstract:

  Objective: To investigate the effect of sodium thiosulfate (STS) on improving coronary artery calcification (CAC) burden in patients with end-stage renal disease (ESRD) on maintenance dialysis, and to analyze its impacts on walking ability and the risk of cardiovascular events, so as to provide clinical evidence for the prevention and treatment of cardiovascular complications and the improvement of motor function in ESRD dialysis patients. Methods: A total of 245 ESRD patients with maintenance dialysis complicated with coronary artery calcification were enrolled. All subjects were divided into the sodium thiosulfate group (n=123) and the placebo group (n=122) according to different treatment methods. The placebo group received routine dialysis treatment and basic intervention for cardiovascular risk. On the basis of the regimen of the placebo group, the sodium thiosulfate group was additionally treated with intravenous infusion of sodium thiosulfate. The treatment course lasted for 6 months. CAC burden, walking ability, serum calcification-related indicators and inflammatory factors were compared between the two groups before and after treatment. The incidence of cardiovascular events was recorded during the 6-month follow-up. Results: Before treatment, there were no significant differences in CAC score, 6-minute walk distance (6MWD), serum calcification-related indicators and inflammatory factors between the two groups (P>0.05). After 6 months of treatment, the CAC score in the sodium thiosulfate group was lower, while 6MWD was longer than those in the placebo group (P<0.05). The levels of serum phosphorus, parathyroid hormone, alkaline phosphatase, tumor necrosis factor-α and C-reactive protein in the sodium thiosulfate group were lower than those in the placebo group (P<0.05). The incidence of cardiovascular events in the sodium thiosulfate group was 3.25%, which was lower than 9.84% in the placebo group (P<0.05). Conclusion: Sodium thiosulfate can effectively reduce coronary artery calcification burden, improve walking ability, alleviate inflammatory response, and lower the risk of cardiovascular events in ESRD dialysis patients, which possesses high clinical application value.

• Efficacy and safety of opioid-free general anesthesia combined with regional nerve block versus opioid-based general anesthesia combined with regional nerve block for laparoscopic radical prostatectomy

  Wang Fengfeng; Huang Lanju

  2026,41(8):989-993 ,DOI: 10.3969/j.issn.1005-3697.2026.08.018

  Abstract(17) HTML(0) PDF(3.28 M)( 65)

  Abstract:

  Objective: To compare the clinical efficacy of a simplified opioid-free general anesthesia (OFGA) regimen based on dexmedetomidine and lidocaine combined with quadratus lumborum block (QLB) versus traditional opioid-based general anesthesia with QLB in patients undergoing laparoscopic radical prostatectomy (LRP). Methods: A retrospective cohort study included 120 patients, divided into two groups: the simplified OFGA group (n=56) and the traditional opioid-based anesthesia group (n=64). All patients received ultrasound-guided bilateral QLB. The primary outcomes were total opioid consumption within 48 hours postoperatively (converted to morphine milligram equivalents, MME) and intraoperative opioid rescue rate. Secondary indicators included the postoperative Numerical Rating Scale (NRS) score at rest, recovery quality indicators, and adverse events. Results: The simplified OFGA group exhibited lower total opioid consumption within 48 hours postoperatively but required higher intraoperative opioid rescue rates compared to the traditional opioid-based group (P < 0.001). Generalized estimating equations (GEE) analysis revealed a significant interaction between group and time for NRS pain scores (P<0.05), with post-hoc comparisons showed higher NRS scores in the OFGA group at 12,24, and 48 hours postoperatively (P<0.05). The OFGA group demonstrated higher effective pressing frequency ratio of the patient-controlled analgesia pump, shorter emergence time, earlier first ambulation, and faster first flatus (P <0.001). Regarding safety, the OFGA group had a lower incidence of postoperative nausea and vomiting (P <0.05) but experienced more frequent intraoperative hypotension and bradycardia (P <0.05). Conclusion: In LRP patients receiving QLB, the simplified OFGA regimen combining dexmedetomidine and lidocaine effectively reduces postoperative opioid consumption while accelerating early recovery. However, it may compromise mid-to-late postoperative analgesia and increase intraoperative hemodynamic fluctuations. This approach represents a viable opioid-sparing strategy.

• Analysis of risk factors for postoperative hypoparathyroidism after thyroid cancer surgery

  Chen Guo; Luo Jia; Cao Xiaozhen; Zhao Jingjing; Li Yuemei; Cheng Yifan; Zeng Lingjuan

  2026,41(8):994-998 ,DOI: 10.3969/j.issn.1005-3697.2026.08.019

  Abstract(30) HTML(0) PDF(3.10 M)( 66)

  Abstract:

  Objective: To compare the clinical characteristics of patients with thyroid cancer undergoing open, endoscopic, and robotic surgery, and to explore the related risk factors for postoperative permanent hypoparathyroidism (PPHP) in these patients. Methods: Clinical data of 1,636 thyroid cancer patients were collected. Patients were divided into three groups according to the surgical approach: open surgery group (n=1,154), endoscopic surgery group (n=226), and robotic surgery group (n=256). Patient characteristics were summarized, and differences between patients with and without postoperative PPHP were compared. Univariate and multivariate Logistic regression analyses were performed to identify risk factors for PPHP. Results: Univariate analysis indicated that whether reoperation was performed, surgical approach, surgical procedure, and lymph node surgery procedure were associated with PPHP (P<0.05). Multivariate analysis showed that whether reoperation was performed and the surgical procedure were associated with the occurrence of PPHP after thyroid cancer surgery (P < 0.05). The incidence rates of PPHP in the endoscopic and robotic surgery groups (0% and 0.39%, respectively) were both lower than that in the open surgery group (2.94%) (P<0.05). Conclusion: Clinicians should fully assess surgical risks during thyroid cancer operations, strive to avoid reoperations, and select appropriate surgical procedures to reduce the risk of PPHP.

• The diagnostic value of FPSA/PSAD combined (F/T)/PSAD for elderly patients with prostate cancer

  Nan Lipin; Li Mingmin; Huo Shaojun

  2026,41(8):999-1002+1015 ,DOI: 10.3969/j.issn.1005-3697.2026.08.020

  Abstract(12) HTML(0) PDF(3.32 M)( 67)

  Abstract:

  Objective: To explore the diagnostic value of free prostate-specific antigen/prostate-specific antigen density (FPSA/PSAD) combined free/total prostate-specific antigen ratio [(F/T)]/PSAD for elderly patients with prostate cancer. Methods: Elderly male patients who underwent systematic prostate biopsy were selected as the research subjects, including 312 patients with benign prostatic hyperplasia and 175 patients with prostate cancer. The levels of serum PSA, TPSA and FPSA in each group were detected by chemiluminescence assay. The changes of TPSA, FPSA, F/T, PSAD, FPSA/PSAD and (F/T)/ PSAD between the prostate cancer group and the benign prostatic hyperplasia group were compared. The ROC curve was used to analyze the diagnostic value of each index of TPSA, FPSA, F/T, PSAD, FPSA/PSAD and (F/T)/PSAD for prostate cancer. The ROC curve was used to compare the diagnostic value of FPSA/PSAD and (F/T)/PSAD alone and combined detection of prostate cancer. Results: There were significant differences in TPSA, FPSA, PV, F/T, PSAD, FPSA/PSAD and (F/T)/PSAD between the two groups (P <0.05). The ROC curve results showed that the AUC of FPSA/PSAD and (F/T)/PSAD in detecting prostate cancer was higher than that of F/T, TPSA, FPSA and PSAD (P<0.05). (F/T)/PSAD, FPSA/PSAD, and their combined detection of prostate cancer all had good diagnostic value for prostate cancer (P<0.05). The AUC value of (F/ T)/PSAD combined with FPSA/PSAD for the detection of prostate cancer was greater than that of each index detected separately (P<0.05). Its diagnostic cutoff value was 0.402 ng/ml, the sensitivity was 82.9%, and the specificity was 79.8%. Conclusion: The combined detection of (F/T)/PSAD and FPSA/PSAD can improve the diagnostic efficiency of prostate cancer in the elderly.

Short stories and cases

• Transfusion-related acute lung injury in a patient after artificial liver therapy: a case report

  Lu Jiangtao; Huang Yue; Liu Tianzhao; Peng Hong; Luo Yan

  2026,41(8):1003-1006 ,DOI: 10.3969/j.issn.1005-3697.2026.08.021

  Abstract(43) HTML(0) PDF(2.74 M)( 63)

  Abstract:

  We report a case of transfusion-related acute lung injury (TRALI) occurring during the third session of artificial liver therapy in a patient with hyperbilirubinemia caused by drug-induced liver injury. The patient’s symptoms improved after treatment with non-invasive ventilator-assisted ventilation, methylprednisolone sodium succinate, diuretics, and other interventions. This case reminds clinicians that transfusion-related acute lung injury can also occur rarely during artificial liver therapy. Early diagnosis and timely management are essential to reduce patient mortality.

• A case of stent-assisted embolization for unruptured “butterfly-wing” aneurysm of the basilar artery associated with basilar artery fenestration

  Liu Wei; Sun Xiangrong

  2026,41(8):1007-1009 ,DOI: 10.3969/j.issn.1005-3697.2026.08.022

  Abstract(25) HTML(0) PDF(2.36 M)( 79)

  Abstract:

  Basilar artery fenestration with multiple aneurysms is clinically rare, and treatment strategies remain controversial. This article reports a case of a patient admitted with dizziness and headache, digital subtraction angiography (DSA) revealed a basilar artery fenestration with unruptured “butterfly-wing” aneurysms. After discussion, stent-assisted coil embolization was performed, and postoperative angiography showed patency of the parent artery. On the second postoperative day, the patient developed lethargy, vomiting, and right-sided weakness, which was considered to be related to perioperative ischemia or inflammatory reaction. After adjusting antiplatelet therapy and adding low-dose corticosteroids, her symptoms improved. At discharge, she had right upper limb muscle strength grade 3, right lower limb grade 4, and mild dysarthria. At 2-month follow-up, she continued rehabilitation. This case suggests that the procedure is feasible, but the risk of perioperative complications is high, necessitating individualized decision-making and close monitoring.

nursing

• Impact of predictive nursing based on quality feedback theory on neurological function recovery in patients with acute ischemic stroke undergoing thrombolysis

  Wu Li; Zhang Xiaodong

  2026,41(8):1010-1015 ,DOI: 10.3969/j.issn.1005-3697.2026.08.023

  Abstract(21) HTML(0) PDF(3.70 M)( 64)

  Abstract:

  Objective: To investigate the effect of predictive nursing based on quality feedback theory on neurological function recovery in patients with acute ischemic stroke undergoing thrombolysis. Methods: A total of 100 patients with acute ischemic stroke undergoing intravenous thrombolysis were enrolled as research subjects and randomly assigned to either the experimental group (n=50, receiving quality feedback-based predictive nursing) or the control group (n=50, receiving conventional care) using simple random sampling. Before and 1 month after intervention, the National Institutes of Health Stroke Scale (NIHSS), Mini-Mental State Examination (MMSE) and Barthel Index were used to evaluate the neurological function, cognitive function and activities of daily living of the two groups, and the nursing satisfaction, nursing service quality and occurrence of nursing adverse events were compared between the two groups. Results: After intervention, NIHSS scores in both groups were lower than baseline(P<0.05), while MMSE scores and Barthel Index were higher than baseline(P<0.05). Moreover, NIHSS score in experimental group was lower than that in control group(P<0.05), while MMSE score and Barthel Index in experimental group were higher than those in control group (P<0.05). In addition, nursing service satisfaction and nursing service quality evaluation scores in experimental group were better than those in control group (P <0.05). The incidence of nursing adverse events in experimental group was lower than that in control group, but the difference was not statistically significant(P >0.05). Conclusion: Predictive nursing based on quality feedback theory can effectively promote neurological function recovery, improve cognitive function and activities of daily living, enhance nursing service quality and patient satisfaction, and has certain preventive effect on adverse events in patients with acute ischemic stroke undergoing thrombolysis.

• Application of LK massage programme combined with midwife-led motivational psychological intervention in natural childbirth

  Zhang Huijuan; Guo Xiaoxu; Tang Herui

  2026,41(8):1016-1019 ,DOI: 10.3969/j.issn.1005-3697.2026.08.024

  Abstract(19) HTML(0) PDF(2.68 M)( 60)

  Abstract:

  Objective: To analyze the application effect of LK massage programme combined with midwife-led motivational psychological intervention in natural childbirth. Methods: A total of 92 primiparas who underwent natural childbirth were enrolled. According to the intervention method, they were divided into the control group (n=46) and the observation group (n=46). The control group received routine intervention, while the observation group received LK massage programme combined with midwife-led motivational psychological intervention. The duration of labor, delivery outcomes, neonatal outcomes, and childbirth experience were compared between the two groups. Results: After intervention, the duration of the first, second, and third stages of labor was shorter, the rate of episiotomy was lower, and laceration of perineum was milder in the observation group than in the control group(P<0.05). Moreover, the Labor Agentry Scale (LAS) and the Chinese version of the Childbirth Self-Efficacy Inventory(CBSEI-C32) scores were higher in the observation group(P<0.05). No statistically significant differences were found in the rate of conversion to cesarean section, neonatal birth weight, height, or 1-min and 5-min Apgar scores between the two groups(P>0.05). Conclusion: LK massage programme combined with midwife-led motivational psychological intervention can shorten the duration of labor, reduce the risks of episiotomy and laceration of perineum, and improve parturients’ sense of control and self-efficacy during childbirth, without increasing adverse maternal and neonatal outcomes.

summarize

• Mechanism of hydrogen sulfide alleviating myocardial ischemia-reperfusion injury and related signaling pathways

  Peng Tailan; Xiang Jun; Liu Yong

  2026,41(8):1020-1024 ,DOI: 10.3969/j.issn.1005-3697.2026.08.025

  Abstract(28) HTML(0) PDF(3.09 M)( 78)

  Abstract:

  Ischemia/reperfusion injury is a syndrome characterized by structural and functional changes such as cell swelling and necrosis during rapid blood flow recovery after tissue ischemia, which result in aggravated tissue damage. Ischemia/reperfusion injury is associated with many organs such as heart, liver, brain, kidney. Cardiovascular disease is the most common cause of death in humans, and myocardial ischemia/reperfusion injury is strongly associated with cardiovascular disease. Currently, the research on myocardial ischemia/reperfusion injury has attracted much attention, but the exact mechanism is not fully understood. Hydrogen sulfide is an important gas molecule, it can regulate the equilibrium state of free radicals in the body, combat and alleviate damage caused by free radicals. As a result, hydrogen sulfide plays an important role in the pathophysiological processes of many diseases. In recent years, studies have found that H?S could protect myocardial ischemia/reperfusion injury caused by myocardial infarction, heart failure and other diseases through a variety of molecular mechanisms such as anti-oxidation, anti-apoptosis, anti-inflammation, anti-necrosis, etc., but the specific mechanism was not completely clear, especially the involved signaling pathways. In this paper, the protective mechanism of hydrogen sulfide against myocardial ischemia/reperfusion injury and the involved signaling pathways were reviewed, providing theoretical reference for further research.

临床医学研究

• Application of dietary and exercise prescriptions and behavioral interventions based on the WeChat platform in the health management of MAFLD patients

  童明霞, 王海霞

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  Abstract:

  Objective To explore the application effect of dietary and exercise prescriptions and behavioral interventions based on the WeChat platform in the health management of patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Methods Patients diagnosed with MAFLD by liver ultrasound and transient elastography in the physical examination center of our hospital from Jan, 2024 to Jul, 2025 were selected as the research subjects. All subjects were followed up until January 2026. They were divided into the observation group and the control group by random number table method, with 50 cases in each group. The control group received conventional intervention, while the observation group implemented dietary and exercise prescriptions and behavioral intervention based on the WeChat platform. The albumin (ALB), fasting blood glucose (FBG), liver function indicators [total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST)], and lipid metabolism indicators [total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)] and controlled attenuation parameter (CAP) were compared between the two groups. Results After the intervention, the ALB in both groups was lower than that before treatment, and the ALB in the observation group was lower than that in the control group after the intervention (P<0.05). After the intervention, the levels of TBil, ALT and AST in both groups were lower than those before the intervention, and those in the observation group were lower than those in the control group (P<0.05). After the intervention in both groups, TC, TG and LDL-C were lower than those before the intervention, while HDL-C was higher than that before the intervention. After the intervention, TC, TG and LDL-C in the observation group were lower than those in the control group, and HDL-C was higher than that in the control group (P<0.05). The CAP of both groups after intervention was lower than that before treatment, and the CAP of the observation group after intervention was lower than that of the control group (P<0.05). Conclusion Dietary and exercise prescriptions combined with behavioral interventions delivered via the WeChat platform may help improve liver function, lipid metabolism, and the degree of hepatic steatosis in patients with MAFLD, offering a feasible intervention model for the continuous health management of these patients.

基础研究

• 1. Seventh Department of General Surgery, Handan Central Hospital, Handan 056001, Hebei, China2. First Department of Emergency Surgery, Handan Central Hospital, Handan 056001, Hebei, China

  索龙龙

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  Abstract:

  Objective To investigate the expression and clinical significance of tripartite motif-containing 7 (TRIM7) in hepatocellular carcinoma (HCC), and to explore the molecular mechanism by which TRIM7 regulates mitochondrial function via nuclear factor erythroid 2-related factor 2 (Nrf2) to promote HCC progression. Method The expression and prognostic value of TRIM7 in HCC were analyzed using the TCGA database. Stable Huh7 cell lines were constructed, including the shTRIM7 group, Nrf2 overexpression group, and shTRIM7+Nrf2 rescue group. Mitochondrial function indicators were detected, including mitochondrial complex I activity, ATP content, reactive oxygen species (ROS) level, mitochondrial membrane potential, GSH/GSSG ratio, and NAD+/NADH ratio. Cell proliferation, migration and apoptosis were measured by CCK-8, EdU, Transwell and flow cytometry. The interaction and ubiquitination of TRIM7 and Nrf2 were verified by co-immunoprecipitation (Co-IP) and ubiquitination assays. Protein expression was determined by Western blot. Results TRIM7 expression was significantly higher in HCC tissues than in normal liver tissues (P<0.001), and high TRIM7 expression was associated with shorter overall survival in HCC patients (P<0.05). Genes co-expressed with TRIM7 were significantly enriched in mitochondrial function and oxidative stress pathways. Compared with the Con group,the shTRIM7 group showed significantly decreased complex I activity and ATP content, along with increased ROS levels, elevated mitochondrial membrane potential depolarization ratio, and decreased GSH/GSSG and NAD+/NADH ratios (all P<0.05), along with markedly suppressed proliferation, migration and enhanced apoptosis (all P<0.05). Mechanistic studies confirmed that TRIM7 directly interacted with Nrf2 and mediated Nrf2 ubiquitination to maintain its protein stability. Nrf2 overexpression significantly reversed shTRIM7-induced mitochondrial dysfunction and suppression of malignant phenotypes (all P<0.05). TCGA analysis revealed a significantly positive correlation between TRIM7 and Nrf2 expression (R=0.2, P<0.001), and both were associated with poor prognosis in HCC patients. Conclusion TRIM7 stabilizes Nrf2 expression by mediating its ubiquitination, maintains mitochondrial homeostasis, and thereby promotes proliferation and migration while inhibiting apoptosis in HCC.

综述

• Application value and paradigm evolution of different sources cell for osteoarthritis therapy

  符长红, 焦令, 王闯

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  Abstract:

  Osteoarthritis (OA) is a whole-joint disorder defined by progressive degeneration of articular cartilage, with limited capacity for self-repair. Conventional therapeutic approaches are largely palliative and fail to halt or reverse disease progression. Cell-based therapies, particularly those utilizing mesenchymal stem cells (MSCs), have emerged as a promising regenerative strategy for OA. Despite rapid initial development, the field now confronts significant translational challenges, including variable clinical outcomes, incomplete mechanistic understanding, and a lack of diversity in commercialization pathways. This article systematically evaluates the biological and functional differences among cell sources used in OA therapy, identifies key bottlenecks in clinical translation, and critically examines global and Chinese clinical trial data to reveal an underlying "innovation gap" and the absence of standardized efficacy assessment criteria. To address these issues, we propose a novel "spatiotemporal coordination and multi-axis coupling" mechanistic framework that captures the dynamic interplay between transplanted cells and the pathological joint microenvironment. Finally, we discuss opportunities for deepening scientific insight and fostering innovation in cell therapy for OA, outlining future research directions and advanced application paradigms.

短篇与个案

• Aggressive angiomyxoma recurrence after surgery in pelvis：One Case Report

  陈明, 孙磊

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  Abstract:

  无

基础医学研究

• Investigation of Genes Associated with Mitochondrial Dysfunction in Pulmonary Hypertension by Machine Learning

  徐忆

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  Abstract:

  This study pioneers the systematic identification of core genes associated with mitochondrial dysfunction in pulmonary arterial hypertension (PAH) through multidimensional bioinformatics integration and machine learning algorithms. By elucidating their expression profiles, diagnostic efficacy, and mechanisms of association with immune infiltration, it provides new evidence for molecular mechanism research and clinical translation of PAH. Using GEO database resources, we obtained the training set GSE38267 (13 PAH cases + 28 healthy controls) and validation set GSE15197 (18 PAH samples + 13 normal controls). Through differential expression analysis and mitochondrial gene set intersection screening, we identified differentially expressed genes related to PAH-mitochondrial dysfunction. Subsequent analyses including GO/KEGG enrichment, PPI network construction, Cytoscape core node screening, combined with three machine learning algorithms (LASSO regression, SVM-RFE, and RF), confirmed core genes via validation set. Diagnostic value was assessed using ROC curves, while ssGSEA, Cibersort, and correlation analyses revealed associations between core genes and immune infiltration. Results demonstrated that ISCA1, STOM, NT5M, ACSL6, and ALAS2 are core genes associated with mitochondrial dysfunction in PAH. Their expression abnormalities contribute to disease pathogenesis by regulating mitochondrial energy metabolism, structural homeostasis, and immune cell infiltration. Notably, the area under the ROC curve (AUC) for ISCA1, STOM, and NT5M was significantly higher than 0.9, demonstrating outstanding potential for PAH diagnosis.

临床医学研究

• Association and clinical significance of pseudo-benign sonographic phenotype with pre-treatment high Ki-67 expression in triple-negative breast cancer

  罗玉群

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  Abstract:

  Objective: To examine the association between pseudo-benign sonographic phenotype and pre-treatment high Ki-67 expression in triple-negative breast cancer (TNBC), and to assess its clinical implications. Methods: We retrospectively enrolled 147 patients with pathologically confirmed invasive TNBC who underwent pre-treatment conventional breast ultrasound at the Affiliated Hospital of North Sichuan Medical College from March 2020 to December 2025. A pre-specified threshold of Ki-67 ≥50% was used to define high expression. The pseudo-benign phenotype was defined as a pathologically confirmed TNBC with an overall benign-like sonographic appearance, mainly considering round or oval shape, circumscribed margins, parallel orientation, posterior enhancement, and absence of calcification. Two experienced sonographers independently reviewed the images while blinded to pathological data; disagreements were resolved by consensus or a third senior sonographer. Logistic regression and ROC analysis were performed. Results: Interobserver agreement was good (κ=0.82, 95%CI: 0.71-0.93). The pseudo-benign phenotype was more frequent in the high Ki-67 group than in the low/intermediate group [38.5% (42/109) vs. 5.3% (2/38), P<0.001]. After adjustment for age, tumor size, histological grade III, T3 stage, and lymphovascular invasion, the phenotype remained independently associated with high Ki-67 expression (OR=11.01, 95%CI: 2.30-52.71, P=0.003). The combined model yielded an AUC of 0.752 (95%CI: 0.666-0.833). Conclusion: Pseudo-benign sonographic phenotype is associated with high Ki-67 expression in pre-treatment core needle biopsy specimens of TNBC. A benign-like appearance should not reduce the need for biopsy and further evaluation when malignancy cannot be clinically excluded.

护理

• Current status and influencing factors of knowledge, attitude and practice regarding prosthetic dislocation prevention in patients undergoing total hip arthroplasty

  李燕, 李莉, 冯志尉

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  Abstract:

  Objective: To investigate the current status of knowledge, attitude and practice (KAP) regarding prosthetic dislocation prevention among patients after total hip arthroplasty (THA), and to analyze the correlations among KAP dimensions and their influencing factors, so as to provide evidence for stratified health education and continuous rehabilitation management. Methods: By convenience sampling, 302 postoperative THA patients from the orthopedic outpatient and inpatient departments of two tertiary Grade A hospitals in Nanchong from June to September 2022 were surveyed face to face using a self-developed KAP questionnaire for prosthetic dislocation prevention. Descriptive statistics, t-test, one-way analysis of variance, Pearson correlation analysis and multiple linear regression were used. Results: The scores of knowledge, attitude and practice were 47.78±15.43, 51.37±9.94 and 30.56±7.98, respectively, with scoring rates of 63.70%, 85.62% and 61.13%. Pearson correlation analysis showed positive correlations between knowledge and attitude, knowledge and practice, and attitude and practice (r=0.471, 0.829 and 0.435, all P<0.001). Multiple linear regression showed that age, marital status, educational level, employment status, occupation, primary THA status and rehabilitation complications were influencing factors for knowledge scores; employment status, occupation and rehabilitation complications were influencing factors for attitude scores; age, employment status, occupation, time since primary THA and rehabilitation complications were influencing factors for practice scores (all P<0.05). Conclusion: The overall KAP level regarding prosthetic dislocation prevention among postoperative THA patients needs further improvement. Attitude is relatively positive, whereas knowledge and practice remain insufficient. Clinical nurses should focus on older adults, patients with lower educational levels, unemployed patients, primary THA recipients and patients without complication-related warning experiences, while also assessing patients with limited economic resources. Stratified, continuous and visual health education and follow-up management should be implemented to promote standardized preventive behaviors.

临床医学研究

• Influence of traditional Chinese medicine fumigation combined with glucosamine hydrochloride on serum inflammatory factors in patients with knee osteoarthritis

  涂显琴, 周跃辉

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  Abstract:

  目的：探讨膝骨性关节炎(KOA)患者应用中药熏蒸联合盐酸氨基葡萄糖治疗的临床效果。方法：前瞻性选取110例KOA患者，按照随机数字分组法分为对照组(55例，采取盐酸氨基葡萄糖方案)，观察组(55例，采取中药熏蒸+盐酸氨基葡萄糖方案)，比较治疗后两组血清炎症因子[白细胞介素-6(Interleukin-6，IL-6)、降钙素原(Procalcitonin，PCT)、超敏C反应蛋白(High-sensitivity c-reactive protein，hs-CRP)]、辅助炎症指标[血沉(Erythrocyte sedimentation rate，ESR)、中性粒细胞百分比(Neutrophil percentage，NE%)、白细胞计数(White blood cell，WBC)]、疼痛与关节功能[视觉模拟评分法(Visual analogue scale，VAS)、骨关节炎指数(Western ontario and mcmaster universities osteoarthritis index，WOMAC)]评分、中医证候疗效以及不良反应。结果：治疗后，两组IL-6、PCT、hs-CRP、ESR、NE%、WBC、VAS评分、WOMAC评分均较治疗前降低，且观察组更低(P＜0.05)；与对照组比较，观察组中医证候总有效率更高(P＜0.05)；两组不良反应无显著差异(P＞0.05)。结论：联合中药熏蒸治疗方案可明显缓解寒湿痹阻型KOA患者的炎症反应，并可改善其疼痛与关节功能，疗效显著。

• Impact of Different Anti-VEGF Injection Intervals before Vitrectomy on Vitreoretinal Interface Microstructural Modification and Surgical Outcomes in Proliferative Diabetic Retinopathy

  邵成杰, 朱菊茗, 王珊珊

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  Abstract:

  Objective: To investigate the effect of different anti-VEGF injection intervals before pars plana vitrectomy (PPV) on vitreoretinal interface microstructure modification and surgical outcomes in patients with proliferative diabetic retinopathy (PDR). Methods: A total of 120 PDR patients (120 eyes) scheduled for PPV received preoperative intravitreal injection of conbercept or ranibizumab. Using a representative sampling design, they were divided by the interval from the last injection to surgery: ≤3 days (observation group, 60 eyes) and ≥7 days (control group, 60 eyes). The proportion of the two drugs was balanced between groups. Posterior cortical vitreous detachment (PCD) grading, fibrovascular membrane characteristics, surgical performance indicators, complications, and postoperative best-corrected visual acuity (BCVA) were compared. Subgroup analyses by drug type were performed to verify consistency of effects. Results: The observation group showed significantly better PCD grade distribution: complete PCD (grade III) was 66.67% vs. 31.67% in controls (P<0.05). The proportion of atrophic/regressive fibrovascular membranes was 73.33% vs. 46.67%, while the fibroproliferative rigid type was only 6.67% vs. 31.67% (all P<0.05). Surgical time was shorter, fewer intraocular cautery applications were needed, and the incidence of iatrogenic retinal breaks was significantly lower (5.00% vs. 25.00%) (all P<0.05). Severe intraoperative bleeding rates did not differ significantly (5.00% vs. 13.33%, P>0.05). At 1 and 3 months postoperatively, LogMAR BCVA was significantly better in the observation group (all P<0.05). Stratified by conbercept and ranibizumab, these benefits persisted independently with consistent effect direction in each subgroup; all Breslow-Day interaction tests yielded P>0.05, indicating no drug type–by–interval interaction. Conclusion: Pre-PPV anti-VEGF injection with a short interval (≤3 days) effectively promotes complete PCD, induces benign fibrovascular membrane atrophy, and suppresses pathological fibrosis. This reduces surgical difficulty and iatrogenic injury risk, leading to better early visual recovery. The strategy shows consistent efficacy across conbercept and ranibizumab, representing a universally applicable optimized pretreatment regimen.

基础医学研究

• Yinchenshensha Hewei Powder Inhibits HMGB1/TLRs/NF-κB Signaling Pathway in Neonatal Hyperbilirubinemia-induced Brain Injury

  唐伟东

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  Abstract:

  Abstract: [Objective] To investigate the inhibitory effect of Yinchen Shensha Hewei Powder on hyperbilirubinemia-induced brain injury in neonatal rats and its regulatory mechanism on the HMGB1/TLRs/NF-κB signaling pathway, so as to provide experimental evidence for clinical application. [Methods] Sixty 7-day-old Sprague-Dawley neonatal rats were randomly divided into a model control group, a positive control group, a Yinchen Shensha Hewei Powder group, a Yinchen Shensha Hewei Powder + HMGB1 inhibitor group, a Yinchen Shensha Hewei Powder + TLRs inhibitor group, and a Yinchen Shensha Hewei Powder + NF-κB inhibitor group, with 10 rats in each group. Rat models of hyperbilirubinemia-induced brain injury were established by intraperitoneal injection of bilirubin. After modeling, each experimental group was administered the corresponding intervention for 7 consecutive days. Neurological function was evaluated using the Tarlov score. Serum and brain bilirubin levels were detected by colorimetry. Pathological changes in brain tissue were observed by hematoxylin-eosin staining. The positive expressions of NF-κB, NSE and NF proteins in brain tissue were detected by immunohistochemistry. The mRNA expression levels of HMGB1, TLR4, NF-κB, COX-2 and iNOS in brain tissue were measured by quantitative real-time polymerase chain reaction. Statistical analysis was performed using SPSS 24.0 software with one-way analysis of variance for comparison of quantitative data among multiple groups. A P value < 0.05 indicated a statistically significant difference. This study was approved by the Laboratory Animal Management and Ethics Committee of Wenzhou Medical University (approval No. xms92022-0677). [Results] Compared with the model control group, the positive control group and the Yinchen Shensha Hewei Powder group showed significantly increased Tarlov scores (P<0.05), markedly decreased serum and brain bilirubin levels (P<0.01), obviously alleviated pathological injury in brain tissue, and significantly downregulated expressions of inflammation-related proteins and mRNAs (P<0.01). The combined inhibitor groups exhibited no significant difference or slight improvement in the above indicators compared with the traditional Chinese medicine alone group, showing a synergistic regulatory trend. Yinchen Shensha Hewei Powder significantly attenuated hyperbilirubin-induced brain injury, neuronal apoptosis and inflammatory cell infiltration. Its protective effect was related to the inhibition of excessive activation of the HMGB1/TLRs/NF-κB signaling pathway . [Conclusion] Yinchen Shensha Hewei Powder effectively alleviates hyperbilirubinemia-induced brain injury in neonatal rats. Its mechanism is mainly related to inhibiting abnormal activation of the HMGB1/TLRs/NF-κB inflammatory signaling pathway, downregulating the expression of inflammatory factors and reducing the release of proinflammatory mediators. This study provides experimental evidence for the clinical application of Yinchen Shensha Hewei Powder in the treatment of neonatal hyperbilirubinemia-associated brain injury and lays a foundation for optimizing dosage regimens and developing precise clinical protocols. Large-sample clinical studies can be further conducted to verify its clinical efficacy and safety in humans.

临床医学研究

• Exploration of the application value of amoxicillin and clavulanate potassium combined with azithromycin in children with lobar pneumonia based on changes in serum inflammatory factor levels and symptom improvement

  王培越, 陈荣寿, 刘佳

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  Abstract:

  Objective：To explore the application value of amoxicillin and clavulanate potassium (AMC) combined with azithromycin (AZM) in children with pneumonia based on changes in serum inflammatory factor levels and symptom improvement. Methods：A retrospective analysis was conducted on the clinical data of 100 children with pneumonia who were admitted to Lu’an People’s Hospital from January 2023 to December 2024, whose etiological results were not definite in the early stage of admission, and who received empirical anti-infective therapy. According to clinical medication regimen, they were divided into the control group (50 cases, treated with AMC) and the observation group (50 cases, treated with AMC combined with AZM). Clinical symptoms, inflammatory levels, lung function, and adverse reactions were compared between the two groups. Results：After 3 d of treatment, the proportions of children with normal body temperature, children without cough, and children without lung rales in the observation group (90.00%, 84.00% and 88.00%) were significantly higher than those in the control group (72.00%, 62.00% and 66.00%) (P<0.05). After treatment, serum levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-α (TNF-α) in the observation group [(6.41±1.56) pg/mL, (12.64±2.41) pg/mL and (14.36±2.47) pg/mL] were lower than those in the control group [(8.19±1.68) pg/mL, (15.54±2.65) pg/mL and (16.77±2.89) pg/mL] (P<0.05). For lung function, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) in the observation group [(1.85±0.31) L, (2.08±0.38) L and (3.69±0.61) L/s] were higher than those in the control group [(1.62±0.29) L, (1.73±0.36) L and (3.05±0.58) L/s] (P<0.05). The incidence of adverse reactions was 10% in the observation group and 6% in the control group, showing no statistically significant difference (P>0.05). Conclusion：AMC combined with AZM can effectively improve clinical symptoms, reduce inflammatory factor levels, and enhance lung function in children with pneumonia, with good safety.

临床研究

• Establishment of a Nomogram Model for Early Renal Injury Risk in Patients with Asymptomatic Hyperuricemia Based on High-Frequency Ultrasound and Firefly Imaging Technology

  王钰, 周秀丽, 李建锋

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  Abstract:

  Objective To explore the value of high-frequency ultrasound combined with Firefly imaging technology in assessing early renal injury in patients with asymptomatic hyperuricemia (AHU) and to construct an individualized risk prediction nomogram model. Methods A total of 127 AHU patients admitted to the hospital from January 2020 to December 2020 were selected as the study subjects. They were divided into an injury group (n=29) and a non-injury group (n=98) based on the occurrence of early renal injury. General data, laboratory indicators, high-frequency ultrasound, and Firefly imaging parameters were collected. Univariate and multivariate logistic regression analyses were used to screen for independent risk factors, and a nomogram prediction model was established. Internal validation was performed using the Bootstrap method. The model''s discrimination and calibration were evaluated via the ROC curve and calibration curve. Results Univariate analysis showed that the duration of hyperuricemia, comorbid hypertension, daily water intake, levels of serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), serum uric acid (SUA), serum cystatin C (Cys-C), urinary albumin-to-creatinine ratio (UACR), urinary α1-microglobulin (U-α1-MG), urinary N-acetyl-β-D-glucosaminidase (U-NAG), renal cortical thickness, enhanced renal cortical echogenicity, blurred corticomedullary differentiation, number of microcalcifications on Firefly imaging, interlobar renal artery resistance index, and renal sinus fat thickness were factors associated with early renal injury in AHU patients (all P < 0.05). Logistic regression analysis identified high SUA level, long duration of hyperuricemia, Firefly imaging microcalcifications ≥3, high interlobar renal artery resistance index, and enhanced renal cortical echogenicity as risk factors for early renal injury in AHU patients (all P < 0.05). The nomogram model constructed based on these factors had an AUC of 0.856 for predicting early renal injury in AHU patients. The calibration curve and the Hosmer-Lemeshow test (P > 0.05) confirmed excellent calibration of the model. DCA showed that the model had a clear clinical net benefit within a threshold probability range of 15% to 70%. Conclusion High-frequency ultrasound combined with Firefly imaging technology can sensitively detect early microstructural and microcirculatory abnormalities in the kidneys of AHU patients.

• Clinicalpathological Characteristics of PIK3CA Gene Mutation in Stage III Colorectal Cancer and Preliminary Observation on Its Response to XELOX Chemotherapy

  王怀德, 戴敏, 曹宇, 张德进

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  Abstract:

  Objective: To investigate the clinicopathological characteristics of PIK3CA gene mutation in stage III colorectal cancer and its impact on the response to adjuvant chemotherapy with the XELOX (oxaliplatin + capecitabine) regimen. Methods: A retrospective analysis was performed on the clinical data of 120 patients with stage III colorectal cancer who received adjuvant chemotherapy with the XELOX regimen following radical resection at our hospital between January 2022 and January 2025. Based on the results of PIK3CA gene testing in postoperative tumor tissues, the patients were divided into a mutation group (22 cases) and a wild-type group (98 cases). The baseline clinicopathological characteristics, XELOX chemotherapy-related indicators, and differences in recurrence, metastasis, and mortality rates within one year after surgery were compared between the two groups. Univariate and multivariate Logistic regression analyses were used to identify independent influencing factors for recurrence, metastasis, or death within one year after surgery. Results: The PIK3CA mutation rate was 18.33% (22/120). There were no statistically significant differences between the two groups in terms of age, gender, degree of differentiation, T stage, or N stage (P > 0.05). The proportion of right-sided colon cancer in the mutation group (54.55%) was higher than that in the wild-type group (32.65%), although the difference did not reach statistical significance (P > 0.05). Regarding chemotherapy-related indicators, the number of chemotherapy cycles and relative dose intensity in the mutation group were significantly lower than those in the wild-type group (P < 0.05). There were no statistically significant differences between the two groups in the proportion of planned cycles completed, the proportion of dose reductions/delays, or the incidence of adverse reactions (P > 0.05). The rate of recurrence, metastasis, or death within one year after surgery was 22.73% (5/22) in the mutation group and 12.24% (12/98) in the wild-type group, with no statistically significant difference (P > 0.05). Univariate and multivariate Logistic regression analyses showed that PIK3CA mutation, N2 stage, and right-sided colon location were not independently associated with recurrence, metastasis, or death within one year (P > 0.05). Conclusion: The incidence of PIK3CA mutation in stage III colorectal cancer is 18.33%, showing a certain correlation with right-sided colon cancer. Patients with PIK3CA mutations receiving XELOX adjuvant chemotherapy showed significantly reduced numbers of chemotherapy cycles and relative dose intensity, but no independent statistical association with the risk of recurrence within one year was observed. Future studies with expanded sample sizes and extended follow-up periods are needed for further verification.

临床医学研究

• Long-term efficacy of laparoscopic preservation of left colonic artery (LCA) and root dissection of inferior mesenteric artery (IMA) during anterior resection of rectal cancer

  袁华燕, 王五艺

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  Abstract:

  目的：研究腹腔镜下左结肠动脉(LCA)保留与肠系膜下动脉(IMA)根部离断在直肠癌前切除术中的远期疗效。方法：纳入204例直肠癌患者，随机分为LCA组(保留LCA低位结扎IMA)与无LCA组(根部离断IMA高位结扎)，各102例。比较两组比较手术指标、胃肠功能、排尿及肛门功能、并发症及3年生存率。结果：两组手术时间、出血量、淋巴结清扫总数、切缘距离、造口率、尿潴留及泌尿感染发生率、3年OS与DFS均无显著差异(P>0.05)。LCA组在第253组淋巴结清扫数、膀胱残余尿量及吻合口瘘发生率上更低，首次排气/排便、肠鸣音恢复及住院时间更短，且Qmax、肛管静息压、最大收缩压更高(P<0.05)。结论：保留LCA低位结扎IMA可获得与高位离断相似的远期疗效，且在促进术后胃肠功能恢复、改善肛门及排尿功能、降低吻合口瘘风险方面更具优势。

• Predictive value of PLGF, sFlt-1 combined with uterine artery pulsatility index for preeclampsia in pregnant women with medium to high risk factorsHuang Meihong1, Ni Jingling1, Shi Donghua1, Chen Yiling2, Xu Ronghai3*

  黄美虹

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  Abstract:

  [Abstract] Objective: To analyze the predictive value of placental growth factor (PLGF), soluble fms-like tyrosine kinase-1 (sFlt-1) combined with uterine artery pulsatility index (PI) for preeclampsia in pregnant women with medium to high risk factors. Methods: 536 pregnant women with medium to high risk factors for preeclampsia and regular prenatal check ups who were registered for early pregnancy in our outpatient department from June 2023 to June 2024 were selected as the research subjects, and the PLGF, sFlt-1 and PI of pregnant women were detected and other clinical data were recorded. According to the occurrence of preeclampsia during pregnancy, the pregnant women with medium to high risk factors were divided into preeclampsia group and normal group. The PLGF, sFlt-1, PI and other clinical data between the two groups were compared, and the influencing factors of preeclampsia in pregnant women with medium to high risk factors were analyzed using the stepwise multivariate Cox proportional hazards regression model, and the predictive value of PLGF, sFlt-1 combined with PI for preeclampsia in pregnant women with medium to high risk factors were analyzed using the receiver operating characteristic (ROC) curves. Results: 82 cases developed preeclampsia among 536 pregnant women with medium to high-risk factors, and the incidence rate was 15.30%. The first-trimester PLGFof the preeclampsia group was lower than that in the normal group (P<0.05), while the second-trimester sFlt-1/PLGF, third-trimester sFlt-1/PLGF, first-trimester PI and second-trimester PI were all higher than those in the normal group (P<0.05). The third-trimester sFlt-1/PLGF in two groups were higher than those the second-trimester sFlt-1/PLGF (P<0.05), while the second-trimester PI were lower than those the first-trimester PI (P<0.05). The Cox regression analysis showed that first-trimester PLGF was a protective factor for preeclampsia in pregnant women with medium to high risk factors (P<0.05), while the second-trimester sFlt-1/PLGF, third-trimester sFlt-1/PLGF, first-trimester PI, second-trimester PI, pre pregnancy BMI and high risk factor were risk factors for preeclampsia in pregnant women with medium to high risk factors (P<0.05). The sensitivity, specificity and area under curve (AUC) of the combined prediction of first-trimester PLGF, second-trimester sFlt-1/PLGF, third-trimester sFlt-1/PLGF, first-trimester PI and second-trimester PI for preeclampsia in pregnant women with medium to high risk factors were 95.12%, 81.50% and 0.913 respectively, and the sensitivity and AUC were higher than single indicator predictions, while specificity was similar to single indicator predictions. Conclusion: The first-trimester PLGF, second-trimester sFlt-1/PLGF, third-trimester sFlt-1/PLGF, first-trimester PI and second-trimester PI are all influencing factors factors for preeclampsia in pregnant women with medium to high risk factors, and they have predictive value for preeclampsia, and the combined prediction of the above indicators can further enhance the predictive value.

护理

• Application Effect of Teach-Back Method–Based Health Education in Patients with Epiretinal Membrane

  唐小丽, 张慧, 刘菡萏, 李宗明, 廖萱

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  Abstract:

  【Abstract】Objective: To investigate the effect of health education based on the teach-back method in patients with epiretinal membrane, and to provide evidence for optimizing clinical nursing pathways.Methods: A total of 208 patients (208 eyes) who underwent epiretinal membrane peeling surgery in our hospital from January 2024 to April 2025 were selected and divided into a routine group (n=104) and a study group (n=104) according to the nursing plan. The routine group received conventional health education, while the study group additionally received teach-back-based health education. Both groups underwent a 1-month intervention (twice a week, 20–30 minutes each session). Before and after the intervention, the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Exercise of Self-Care Agency Scale (ESCA), World Health Organization Quality of Life-Brief Version (WHOQOL-BREF), and a nursing satisfaction scale were used to evaluate patients'' anxiety, depression, self-care ability, quality of life, and nursing satisfaction.Results: After the intervention, the HAMA score in the study group was (10.15±1.63) and the HAMD score was (10.86±1.81), both significantly lower than those in the routine group [(11.13±1.92) and (11.78±2.24), respectively, P<0.05]. The scores of all dimensions of ESCA, all domains of WHOQOL-BREF, and all dimensions of the nursing satisfaction scale in the study group were significantly higher than those in the routine group (P<0.05).Conclusion: Implementing teach-back method-based health education in patients with epiretinal membrane can effectively alleviate negative emotions, enhance self-care ability and quality of life, and improve patient satisfaction with health education.

临床医学研究

• Efficacy of ultrasound-guided intercostal nerve block for pain relief in acute herpes zoster and prevention of postherpetic neuralgia

  谭红平, 王先艳

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  Objective: To assess whether ultrasound-guided intercostal nerve block improves analgesia in acute herpes zoster (AHZ) and reduces the risk of postherpetic neuralgia (PHN). Methods: A total of 80 patients with acute herpes zoster were enrolled and randomized into a control group (valacyclovir plus gabapentin, n=40) and an experimental group (the same regimen combined with ultrasound-guided intercostal nerve block, n=40). NRS scores were assessed before treatment and at 1 week, 1 month, and 3 months after treatment; PSQI scores were assessed before treatment and at 1 month and 3 months after treatment. The incidence of PHN at 3 months was compared between the 2 groups. Results: NRS scores at 1 week, 1 month, and 3 months after treatment were lower than baseline in both groups (P<0.05). PSQI scores at 1 month and 3 months after treatment were also lower than baseline in both groups (P<0.05). At the same time points, the experimental group showed lower NRS and PSQI scores than the control group (P<0.05). The incidence of PHN was lower in the experimental group than in the control group during the 3-month follow-up period (P<0.05). Conclusion: Compared with standard antiviral and gabapentin therapy alone, adding ultrasound-guided ICNB provides better pain relief in AHZ, improves sleep quality, and may reduce the risk of PHN within 3 months.

护理

• Effects of Empowerment Theory-Based Nursing Intervention on Functional Exercise Adherence and Physical Symptoms in Patients with Rheumatoid Arthritis

  华海燕

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  Abstract:

  Abstract Objective: To examine the effects of an empowerment theory-based nursing intervention on functional exercise adherence and physical symptoms in patients with rheumatoid arthritis (RA).Methods: A total of 120 RA patients were randomly assigned (using a random number table) into two groups. The control group (n=60) received usual care, while the intervention group (n=60) received the empowerment theory-based nursing intervention in addition to usual care. Both groups were followed for 8 weeks. Outcomes were assessed before and after the intervention, including self-efficacy scores, functional exercise adherence scores, physical symptoms [Disease Activity Score using 28 joints (DAS28), Visual Analog Scale (VAS) for pain, and Health Assessment Questionnaire (HAQ) index], and negative emotions [Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS)].Results: After the intervention, the intervention group showed significantly higher self-efficacy and functional exercise adherence scores compared to the control group (P<0.05). Additionally, the intervention group demonstrated lower DAS28,VAS scores and HAQ score than the control group (P<0.05). Scores for SAS and SDS were also significantly lower in the intervention group post-intervention (P<0.05). Conclusion: The empowerment theory-based nursing intervention can enhance functional exercise adherence, alleviate physical symptoms, and improve negative emotional states in patients with RA.、

临床医学研究

• Development and Validation of a Simplified Clinical Risk Scoring System for Composite Complications Post-Lung Cancer Thoracoscopic Surgery

  李昊晋, 朱云祥, 李晓明

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  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.

• MRI Study on the Relationship Between Thalamic Subregion Volume Changes and Cognitive Impairment in Patients with Cerebral Small Vessel Disease

  贺曦, 王昱心, 吴倩

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  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.

Basic Medical Research

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

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

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

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  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.

• 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(114) HTML(0) PDF(2.46 M)( 341)

  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.

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

  Zhang Lingkun; Kang Shirong;

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

  Abstract(67) HTML(0) PDF(4.30 M)( 340)

  Abstract:

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

Clinical medical research

• 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(66) HTML(0) PDF(3.36 M)( 332)

  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.

• 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(73) HTML(0) PDF(4.01 M)( 330)

  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.

Basic Medical Research

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

  Wang Juan; Liu Hao;

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

  Abstract(93) HTML(0) PDF(1.62 M)( 316)

  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.

• 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(64) HTML(0) PDF(1.75 M)( 310)

  Abstract:

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

Clinical medical research

• 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(90) HTML(0) PDF(812.77 K)( 308)

  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.

Basic Medical Research

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

  Xu Suqing; Tian Jiamei; Lu Hongyan;

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

  Abstract(96) HTML(0) PDF(1.15 M)( 306)

  Abstract:

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

Clinical medical research

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

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

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

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  Abstract:

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

• Distribution of peripheral blood B cell subsets in patients with systemic lupus erythematosus and their clinical applications

  Chen Xiaoyan; Xing Yan;

  2025,40(10):1285-1290 ,DOI: 10.3969/j.issn.1005-3697.2025.10.014

  Abstract(62) HTML(0) PDF(4.75 M)( 304)

  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.

• 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(73) HTML(0) PDF(1.69 M)( 300)

  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.

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

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

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

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  Abstract:

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

• 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(48) HTML(0) PDF(804.74 K)( 298)

  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.

• 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(73) HTML(0) PDF(1.09 M)( 293)

  Abstract:

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

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

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

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

  Abstract(51) HTML(0) PDF(1.05 M)( 292)

  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.

• 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(81) HTML(0) PDF(701.23 K)( 291)

  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.

• 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(60) HTML(0) PDF(880.87 K)( 290)

  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.

• 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(94) HTML(0) PDF(739.29 K)( 285)

  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.

• 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(67) HTML(0) PDF(1.21 M)( 272)

  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.