Table of Content

15 October 2025, Volume 31 Issue 20

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Special Collumn of Neurology

Molecular imaging mechanisms and precise diagnosis and treatment of HRMR-VWI in BA-PACI

Li Shuxia, Wang Aijie, Huang Ranran, Qin Jing, Zhang Shouqiang, Zhang Yafei, Zhang Guowei

2025, 31(20):  3345-3349.  DOI: 10.3760/cma.j.cn441417-20250402-20001

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Basilar artery plaque-related acute cerebral infarction (BA-PACI) is a prevalent ischemic cerebrovascular disease, with high mortality and disability rates. Its diagnosis and treatment endure clinical challenges. High-resolution magnetic resonance vessel wall imaging (HRMR-VWI), leveraging its superior spatial resolution and multi-sequence imaging capabilities, not only delineates fine arterial and branch structures with exceptional clarity, but also precisely characterizes plaque composition, morphological features, and spatial distribution. This technology enables the visualization of the plaque compositions, inflammatory reaction, etc., improves the diagnostic efficacy, and is helpful for individualized diagnosis in early stage, precise treatment, and prognosis evaluation. This review systematically summarize the progress of the molecular imaging mechanisms and precise diagnosis and treatment of HRMR-VWI in BA-PACI, and explores the three-dimension relation of plaque composition-morphology-localization, its value for the evaluation of prognosis and recurrence, and its potentials and challenges in clinical diagnosis and treatment.

Serum levels of MIP-1α, TNF-α, and IL-1β in children with bacterial meningitis of different severities

Wang Xuening, Cao Ruige, Feng Guodong

2025, 31(20):  3350-3354.  DOI: 10.3760/cma.j.cn441417-20250421-20002

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Objective　To investigate the serum levels of macrophage inflammatory protein-1α (MIP-1α), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) in children with bacterial meningitis (BM) of different severities. Methods　A single-center retrospective controlled study was conducted. A total of 104 children with BM admitted to Xi'an Children's Hospital from January 2021 to October 2023 were included. According to the severe standard, they were divided into the general group (63 cases) and the severe group (41 cases). The general group consisted of 31 boys and 32 girls who were (8.08±4.03) years old. The severe group consisted of 22 boys and 19 girls who were (8.48±3.65) years old. The serum levels of MIP-1α, TNF-α, and IL-1β were measured by the enzyme-linked immunosorbent assay (ELISA) at admission and one week after treatment. The Spearman's rank correlation analysis was used to evaluate the associations between the serum levels and disease severity. Receiver operating characteristic curves (ROC) were used to assess the diagnostic performance. Results　The serum levels of MIP-1α, TNF-α, and IL-1β in the severe group were higher than those in the general group [(10.68±2.18) ng/L vs. (8.61 ± 1.72) ng/L, (34.49±6.43) ng/L vs. (27.49±3.78) ng/L, and (65.15±13.62) ng/L vs. (53.57±8.49) ng/L]. After one week's treatment, the levels of MIP-1α, TNF-α, and IL-1β were lower than those before the treatment in both groups (all P<0.05). The Spearman's rank correlation analysis revealed that the levels of MIP-1α, TNF-α, and IL-1β were positively correlated with the disease severity (r= 0.447, 0.553, and 0.492; all P<0.001). The combined detection of the three cytokines showed the highest diagnostic efficacy, with a sensitivity of 90.2%, a specificity of 88.9%,a Youden index of 0.791, and an area under the curve (AUC) of 0.947 (95%CI 0.905-0.989). Conclusion　Serum MIP-1α, TNF-α, and IL-1β may assess BM severity.

Wuxing Sanbu acupuncture method for limb dysfunction in patients with acute cerebral infarction

Gu Baodong, Ma Xianjun, Du Qing, Wang Yingchao, Guo Jialei

2025, 31(20):  3354-3358.  DOI: 10.3760/cma.j.cn441417-20250410-20003

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Objective　To evaluate the clinical efficacy of the Wuxing Sanbu acupuncture method for limb dysfunction in patients with acute cerebral infarction (ACI). Methods　A total of 112 ACI patients with limb dysfunction treated in Lianyungang Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from October 2022 to October 2024 were selected for the randomized controlled trial, and were divided into a study group and a control group by the random number table method, with 56 cases in each group. There were 30 males and 26 females in the control group who were (65.68±12.28) years old. There were 34 males and 22 females in the study group who were (64.21±13.15) years old. The control group took conventional western drugs and rehabilitation therapy; in addition, the study group took Wuxing Sanbu acupuncture. After 2 weeks' treatment, the clinical outcomes were assessed using the modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), and hypersensitive C-reactive protein (hs-CRP). The t test, nonparametric test, and χ² test or Fisher precision probability test were used for the statistical comparisons. Results　After the treatment, the scores of NIHSS and FMA were better than those before the treatment in both groups, and those in the study group were better than those in the control group [2 (1, 3) vs. 3 (2, 5) and 69.07±14.92 vs. 60.34±17.11], with statistical differences (both P<0.05). After the treatment, the score of mRS and the proportion of the patients with favorable neurological recovery in the study group were better than those in the control group [ 1 (1, 2) vs. 2 (1, 3) and 83.93% (47/56) vs. 66.07% (37/56)], with statistical differences (both P<0.05). After the treatment, the levels of hs-CRP in both groups were lower than those before the treatment, and the level in the study group was lower than that in the control group [1.25 (0.47, 2.21) mg/L vs. 1.77 (0.95, 3.21) mg/L], with a statistical difference (P < 0.05). Conclusion　Routine treatment combined with Wuxing Sanbu acupuncture can improve the limb dysfunction of patients with ACI, promote their neurological recovery, reduce systemic inflammation, and improve their prognosis.

Effect of mirror visual feedback training combined with high-frequency repetitive transcranial magnetic stimulation on motor function in patients with early hemiplegia due to cerebral infarction

Wu Peng, Yin Xin, Li Dandong

2025, 31(20):  3359-3363.  DOI: 10.3760/cma.j.cn441417-20250424-20004

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Objective　To explore the effect of mirror visual feedback (MVF) combined with high frequency repetitive transcranial magnetic stimulation (rTMS) on motor function recovery in patients with early hemiplegia due to cerebral infarction. Methods　One hundred and four patients with early hemiplegia due to cerebral infarction treated at Department of Neurology, Honghui Hospital Affiliated to Xi'an Jiaotong University from November 2021 to October 2024 were selected as the study objects by the convenience sampling method, and were divided into a control group and an observation group by the random number table method, with 52 cases in each group. There were 20 women and 32 men in the control group; they were (63.17±8.64) years old; their disease course was (28.39±5.82) d; there 33 cases on the left side and 19 cases on the right side. There were 28 women and 24 men in the observation group; they were (61.89±8.16) years old; their disease course was (26.82±5.08) d; their were 29 cases on the left side and 23 cases on the right side. Both groups received routine rehabilitation treatment. The control group received rTMS, while the observation group received rTMS and MVF. The clinical efficacies, cerebral blood flow velocities [mean velocity (V_m) and peak velocity (V_s)], central motor conduction times (CMCT), middle evoked potential (MEP) latencies, motor function [Fugl Meyer Motor Function Assessment (FMA)], balance function [Berg Balance Scale (BBS)], and daily living ability [Modified Barthel Index (MBI)] were compared between two groups. χ² and t tests were used for the statistical analysis. Results　The total effective rate of the observation group was higher than that of the control group [96.15% (50/52) vs. 82.69% (43/52)], with a statistical difference between the two groups (P<0.05). After the intervention, the V_m and V_s in the observation group were higher than those in the control group [(93.16±16.05) cm/s vs. (86.34±12.71) cm/s and (158.57±19.62) cm/s vs. (134.66±20.34) cm/s]; the CMCT and MEP latency in the observation group were lower than those in the control group [(8.84±1.30) ms vs. (12.02±3.53) ms and (21.68±1.62) ms vs. (24.61±2.09) ms; the scores of FMA, BBS, and MBI in the observation group were higher than those in the control group (61.07±6.32 vs. 53.95±6.18, 30.34±5.31 vs. 22.47±4.26, and 49.84±8.39 vs. 36.42±6.34); there were statistical differences in the above indicators between the two groups (all P<0.05). Conclusion　MVF combined with rTMS for patients with early hemiplegia due to cerebral infarction can improve their cerebral blood flow and cortical excitability, and accelerate their recovery of motor, balance, and daily living abilities.

Effects of transcranial magnetic stimulation combined with walking and balance training on Parkinson's disease

Liu Zhenhuan, Yang Mengli, Zhu Yongxia, Ye Songyan, Zhang Shuang

2025, 31(20):  3364-3368.  DOI: 10.3760/cma.j.cn441417-20250223-20005

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Objective　To investigate the effect of transcranial magnetic stimulation (TMS) combined with walking and balance training on patients with Parkinson's disease (PD). Methods　In the prospective study, 150 PD patients diagnosed and treated in Henan Provincial People's Hospital from January 2023 to October 2024 were selected as the research objects. They were divided into two groups according to the random number table method, 75 cases in each group. There were 38 males and 37 females in the control group , aged (70.35±6.45) years old, and the course of disease was (1.05±0.35) years. There were 42 males and 33 females in the study group, aged (70.82±6.64) years old, and the course of disease was (1.48±0.58) years. Both groups received routine rehabilitation training, and the control group received targeted walking and balance training. The study group was treated with transcranial magnetic stimulation on the basis of the control group. Gait improvement, limb motor function [Fugl-Meyer Motor Function Assessment (FMA)], balance function and fall risk [Berg Balance Scale (BBS), Moese Fall Assessment Scale (MFS)], and cognitive function [ Montreal cognitive assessment scale (MoCA)] were compared before and after intervention. Statistical methods using t test. Result　After intervention, the step length, step width, step speed, FMA total score, BBS score, and MoCA score of the study group were higher than those of the control group [(48.29±4.63) cm vs. (40.55±4.38) cm, (15.66±2.93) cm vs. (14.32±2.61) cm, (1.69±0.34) km/h vs. (1.31 ± 0.22 ) km/h, and 161.74±15.95 vs. 150.62±12.33, 45.09±6.13 vs. 41.35±5.89, 25.06±3.45 vs. 22.87±2.78], and the step frequency, MFS scores were lower [(97.96±12.36) steps/min vs. (105.88±13.19) steps/min, 42.12±5.19 vs. 48.91±6.27], with statistical differences (all P<0.05). Conclusion　TMS combined walking and balance training can improve the gait of patients with Parkinson's disease, improve their balance function, reduce the degree of limb motor dysfunction, reduce the risk of fall, and effectively improve the cognitive function of patients.

Effects of low-frequency transcranial magnetic stimulation combined with cognitive-behavioral nursing on sleep structure and emotion regulation of post-stroke insomnia patients

Zhou Qiuyan, Yang Mengli, Zhang Shuang, Ye Songyan

2025, 31(20):  3368-3373.  DOI: 10.3760/cma.j.cn441417-20250422-20006

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Objective　To explore the effects of low-frequency transcranial magnetic stimulation combined with cognitive behavioral nursing on sleep structure and emotional regulation in patients with insomnia after stroke. Methods　A prospective study was conducted to select 122 stroke patients admitted to Henan Provincial People 's Hospital from June 2023 to October 2024 as the study subjects, and were divided into two groups by random number table method, 61 cases in each group. In the control group, 36 males and 25 females, aged (67.48±10.12) years, with a course of (2.13±0.32) months, were treated with low-frequency transcranial magnetic stimulation. There were 34 males and 27 females in the observation group, aged (67.53±10.13) years old, and the course of disease was (2.07±0.31) months. On the basis of the control group, insomnia cognitive behavioral nursing was combined. Both groups were intervened continuously for 6 weeks. The sleep structure [sleep efficiency (SE), sleep latency (SL), rapid eye movement sleep latency (RL), rapid eye movement sleep time (RT), 1 stage sleep (S1), 2 stage sleep (S2), 3,4 stage sleep (S3, S4), rapid eye movement sleep (R)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], psychological emotion [Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS)], neurological impairment [National Institutes of Health Stroke Scale (NIHSS)], cognitive impairment [Mini-Mental State Examination (MMSE)] and quality of life [36-Item Short Form Health Survey,Short Form 36 (SF-36)] were compared between the two groups before and after intervention. Statistical methods using t test. Results　After intervention, the levels of SE, RT, S3, S4, and R and the scores of MMSE and SF-36 in the observation group were higher than those in the control group [(88.16±13.22)% vs. (72.92±10.94)%, (68.29±10.24) min vs. (52.54±7.88) min, (26.46±3.97)% vs. (21.38±3.21)%, (19.46±2.92)% vs. (16.39±2.46)%, 26.97±4.05 vs. 22.22±3.3, and 88.49±13.27 vs. 74.35±11.15], and the SL, RL, S1, S2 levels and sleep time, sleep quality, sleep time, sleep disorders, sleep efficiency, hypnotic drugs, daytime function, SAS, SDS, NIHSS scores were lower [(11.64±1.75) min vs. (31.35±4.70) min, (118.41±17.76) min vs. (131.36±19.70) min, (12.35±1.85)% vs. (14.44±2.17)%, (41.68±6.25)% vs. (46.47±6.97)%, 0.77±0.12 vs. 0.92±0.14, 1.21±0.18 vs. 1.67±0.25, 0.76±0.11 vs. 1.25±0.19, 0.61±0.09 vs. 0.77±0.12, 0.62±0.09 vs. 0.79±0.12, 0.68±0.10 vs. 0.85±0.13, 1.04±0.16 vs. 1.36±0.20, 44.60±6.69 vs. 51.35±7.70, 43.15±6.47 vs. 50.47±7.57, and 3.88±0.58 vs. 7.74±1.16], with statistical differences (all P<0.05).Conclusions　The application of low-frequency transcranial magnetic stimulation combined with cognitive behavioral intervention for insomnia in stroke patients with insomnia is conducive to improving the sleep structure and quality of patients and alleviating their negative emotions. It can also promote the recovery of neurological function and enhance their quality of life.

Effects of IEES multidimensional supportive care on self-perceived burden and quality of life in patients with myasthenia gravis

Hao Ruihuan, Bao Yuexia, Wu Mingjing

2025, 31(20):  3373-3378.  DOI: 10.3760/cma.j.cn441417-20250226-20007

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Objective　To explore the effects of IEES multidimensional supportive care on self-perceived burden and quality of life of patients with myasthenia gravis (MG). Methods　A prospective study was conducted on 156 MG patients admitted to Henan Provincial People's Hospital from July 2021 to April 2024. They were randomly divided into a routine group and a nursing group by the coin tossing method, with 78 cases in each group. In the routine group, there were 46 males and 32 females, aged (34.18±4.21) years, with a course of (13.58±6.12) months, receiving routine care; in the  nursing group, 49 males and 29 females, aged (35.08±4.67) years, with a course of disease of (14.23±5.93) months, IEES multidimensional support nursing was implemented on the basis of routine nursing. Both groups were continuously intervened for 6 months. The self-perceived burden [Self-Perceived Burden Scale (SPBS)], self-efficacy [Self-efficacy for Managing Chronic Disease 6-Item Scale (CDSS)], social support [Social Support Rating Scale (SSRS)], and quality of life [36-Item Short Form Health Survey,Short Form 36 (SF-36)] were compared between the two groups. Statistical methods using t test. Results　After nursing, the scores of physical factors, emotional factors and economic factors in the nursing group were lower than those in the routine group (13.62±2.48　vs. 16.58±3.14, 12.21±3.05 vs. 14.55±2.10, and 3.15±0.65 vs. 3.89±0.69), and the scores of symptom management self-efficacy, disease common management self-efficacy, objective support, subjective support, support utilization and total score, physiological function, physical function, social function and psychological function were higher (19.65±3.16 vs. 17.08±3.23, 12.08±2.26 vs. 9.43±2.04, 13.53±1.08 vs. 12.26±1.10, 19.89±2.14 vs. 17.58±2.22, 9.45±1.85 vs. 5.86±1.23 and 41.69±4.53 vs. 35.12±4.82, 66.78±5.13 vs. 46.63±3.86, 64.21±3.99 vs. 51.47±2.62, 61.23±5.11 vs. 48.72±4.86, and 62.63±5.17 vs. 49.36±3.64), with statistical differences (all P<0.05). Conclusion　The IIEES multidimensional supportive care model has significant effects in reducing the burden of self-perception, improving self-efficacy, enhancing social support, and improving the quality of life of MG patients.

Basic Research

Glycyrrhizin mitigates puromycin-induced injury to glomerular podocytes stabilizing expression and distribution of nephrin and α-SMA

Tan Junjie, Wen Guohui, Pan Yongxiang, Kong Hua, Jiang Xinxin, Pan Jialong

2025, 31(20):  3379-3384.  DOI: 10.3760/cma.j.cn441417-20250508-20008

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Objective　The mouse models of glomerular podocyte injury induced by puromycin aminonucleoside (PAN) were established. After the intervention with glycyrrhizin, the models were observed for 8, 24, and 48 h. To explore the effects of glycyrrhizin on the expression and distribution of Nephrin and α-SMA and its inhibition of podocyte injury. Methods　The experiment was was from June 2024 to May 2025. The experiment included a control group, a PAN group, and a glycyrrhizin group. The control group was cultured in the RPMI 1640 medium containing 0.02% DMSO. On the basis of the control group, 50 mg/L PAN was added to take effect on the podocytes in the PAN group. On the basis of the control group, 50 mg/L PAN and 500 mg/L glycyrrhizin were added to take effect on the podocytes in the glycyrrhizin group. The podocytes' morphology was observed and photographed by an inverted microscope. The expressions of Nephrin and α-SMA mRNA were detected by the real-time fluorescent quantitative polymerase chain reaction (PCR). The expressions of Nephrin and α-SMA were detected by the Western blot. The distribution of α-SMA was observed by the immunofluorescence. LSD-t test and analysis of variance were used as the statistical methods. Results　⑴ After the intervention, all the groups were observed for 8, 24, and 48 h by a microscope. In the control group, the podocytes were clear in shape, plump in cell body, and tight in intercellular connection. In the PAN group, the foot processes retracted; some even disappeared; the intercellular connections were loose. In the glycyrrhizin group, the morphology and structure of the podocytes gradually became clearer. The intercellular connections were more closely formed compared to the PAN group, and the cell bodies were larger than those in the PAN group. ⑵ The results of real-time fluorescent quantitative PCR showed that: the expressions of Nephrin and α-SMA mRNA in the control group were less. In the PAN group, the expression of Nephrin mRNA gradually decreased with the extension of PAN injury time, and decreased to the lowest level at 48 h (P<0.01); while the expression of α-SMA mRNA gradually increased with the extension of PAN injury time, and reached the highest level at 48 h (P<0.01). The expressions of Nephrin mRNA and α-SMA mRNA in the glycyrrhizin group were significantly higher than those in the PAN group, with statistical differences (both P<0.01). ⑶ The Western blot results showed that: in the control group, the expression levels of Nephrin and α-SMA proteins in the podocytes were less. In the PAN group, the expression of Nephrin gradually decreased and the expression of α-SMA gradually increased with the extension of PAN injury time; the expression of Nephrin was the lowest, and the expression of α-SMA the highest (both P<0.01) at 48 h. After intervention, the expressions of nephrin and α-SMA in the glycyrrhizin group were better than those in the PAN group, with statistical differences (both P<0.05). ⑷ The immunofluorescence results showed that: the distribution of α-SMA protein in cell membrane and cytoplasm increased significantly at 24 and 48 h in the PAN group, and the fluorescence intensity increased. The distribution of α-SMA protein in the glycyrrhizin group was better than that in the PAN group. Conclusions　PAN influences the expression and distribution of podocyte marker proteins (Nephrin and a-SMA), resulting in podocyte damage and subsequently proteinuria. Glycyrrhizin can stabilize the expression of these proteins, prevents podocyte damage, and maintains podocyte structural and functional stability.

Effect of edaravone on oxidative stress factors in kidney tissue of rats with diquat poisoning

Liu Min, Liu Shiwen

2025, 31(20):  3385-3388.  DOI: 10.3760/cma.j.cn441417-20250414-20009

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Objective　To investigate the effect of edaravone on oxidative stress factors in renal tissue of rats with diquat (DQ) poisoning. Methods　Forty-two male SD rats were selected for the study, with a body weight of 250-300 g and an age of 8-10 weeks. During the experiment, 6 rats died, and the other ones were divided into a normal saline group, a DQ group, an edaravone group, and a DQ + edaravone group, with 9 in each group. The models of diquat poisoning were established by intraperitoneal injection of diquat in the rats, and the rats were intervened with edaravone. The expression levels of oxidative stress factors, superoxide dismutase (SOD), malondialdehyde (MDA), and catalase (CAT) in the rats' kidney tissue were detected by the enzyme-linked immunosorbent assay. The infiltration of inflammatory cells in the rats was observed by the HE staining. All the experiments were repeated 3 times. The data were compared by the one-way analysis of variance. Results　In the normal saline group, the structures of glomeruli were normal; parts of the renal tubules were dilated; the renal interstitium was accompanied by a small amount of hemorrhage. In the DQ group, the renal tissue structure was disordered; the glomerulus and renal tubules were swollen and dilated; there was massive bleeding and infiltration of inflammatory cells in the renal interstitium. In the edaravone group, the renal tissue structure was normal; parts of the renal tubules were dilated; there was a small amount of hemorrhage in the glomeruli. In the DQ + edaravone group, the renal tissue structure was normal; parts of the renal tubules were dilated; there was a small amount of hemorrhage in the glomeruli; the infiltration of inflammatory cells was improved after the treatment. After DQ poisoning, the levels of SOD and CAT decreased, and the level of MDA increased [(27.160±1.540) U/mgprot, (3.320±0.052) U/mgprot, and (1.453±0.021) nmol/mgprot]. After the treatment with edaravone, the levels of SOD and CAT increased, and the level of MDA decreased [(35.100±2.241) U/mgprot, (4.112±0.687) U/mgprot, and (0.908±0.167) nmol/mgprot]. Conclusion　Edaravone can increase the expression of SOD and CAT and decrease the expression of MDA in kidney tissue of rats poisoned by diquat, playing a protective role in renal injury.

New Medical Advances

Research progress on mechanism of roles of lncRNA in esophageal cancer

Lin Yuning, Xie Hongyan, Zhao Wenzhen, Zhang Zhongying, Jin Hongwei

2025, 31(20):  3389-3395.  DOI: 10.3760/cma.j.cn441417-20250410-20010

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Esophageal cancer is one of the common and dangerous malignant tumors in the digestive system, particularly in Asia. Its onset is a complex pathological process through multiple stages influenced by multiple factors and genes. Environmental factors, living habits, chronic inflammation, genetic susceptibility, and molecular mechanisms are all involved. In recent years, the roles of long non-coding RNA (lncRNA) as a key regulatory factor in esophageal cancer have attracted much attention. LncRNA is a type of non-coding RNA with a length exceeding 200 nucleotides. It regulates gene expression in various ways, including epigenetic modifications, competitive endogenous RNA networks, RNA protein interactions, and other mechanisms. Researches have found that in esophageal cancer, lncRNAs are involved in regulating many key biological processes of tumor cells, such as proliferation, invasion, metastasis, apoptosis, drug resistance, radiation resistance, stem cell characteristics, epithelial mesenchymal transition (EMT), etc. This review comprehensively summarizes the extensive regulatory roles and potential clinical value of lncRNA in the pathophysiology of esophageal cancer, with a focus on the specific role of the regulatory axis which participates in esophageal cancer, so as to provide directions for the further exploration of the molecular mechanisms and clinical translational applications of lncRNA in the future, as well as new ideas for improving the prognosis of patients with esophageal cancer and exploring therapeutic targets.

From inflammation to carcinogenesis: molecular mechanisms and intervention strategies in progression from ulcerative colitis to colorectal cancer

Feng Zizhao, Jiang Weiwei

2025, 31(20):  3395-3402.  DOI: 10.3760/cma.j.cn441417-20250423-20011

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Ulcerative colitis-related colorectal cancer (UC-CRC) is a typical inflammation-related cancer with a unique and complex carcinogenic mechanism. Identifying its core mechanisms is of significant clinical importance for its early diagnosis and precise prevention. This review systematically summarizes the roles and research progress of chronic inflammation-driven DNA damage, characteristic genetic and epigenetic alterations, tumor microenvironment remodeling, immune evasion mechanisms, and gut microbiota dysbiosis in the carcinogenic process of ulcerative colitis. Studies have shown that UC-CRC exhibits early p53 mutations, a significant increase in microsatellite instability, and relatively delayed KRAS and APC mutations in terms of genetic characteristics. In the tumor microenvironment, its features include the activation of cancer-associated fibroblasts, angiogenesis, and abnormal expansion of cancer stem cells. Moreover, immune evasion mechanisms, such as macrophage polarization, dendritic cell dysfunction, T-cell exhaustion, etc. further promote carcinogenesis. Additionally, the abnormal colonization of pro-carcinogenic gut microbiota exacerbates chronic inflammation and immune imbalance in the host, significantly increasing the risk of malignancy. Future research directions will focus on the early identification of p53 mutations, microsatellite instability, and characteristic microbial populations, precise targeted intervention in key pathways, and the fine-tuned regulation of the gut microbiota as crucial strategies for the early diagnosis and precision treatment of UC-CRC.

Research progress on pathogenesis and clinical treatment of non-alcoholic fatty liver disease

Liu Mengfan, Zhang Lingyun

2025, 31(20):  3402-3406.  DOI: 10.3760/cma.j.cn441417-20250423-20012

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Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease. Its pathogenesis is closely associated with insulin resistance, lipid metabolism imbalance, and cellular stress responses. It is a complex disease linked to systemic metabolic disorders. NAFLD has become the leading cause of chronic liver disease worldwide, without specific therapeutic measures. This article systematically reviews the core pathological mechanisms and clinical treatment advancements of NAFLD, so as to provide a theoretical basis for understanding the pathophysiological processes of NAFLD and the development of new diagnostic and therapeutic strategies.

Treatises

Knockdown of lncRNA LY6E-DT regulates proliferation and migration of thyroid cancer cells affecting expression of miR-148a

Sun Chongpu, Yi Liujun, Tang Yuanhuai, Yang Xiaoqing, Yang Yan

2025, 31(20):  3407-3411.  DOI: 10.3760/cma.j.cn441417-20250209-20013

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Objective　To investigate the role of long noncoding RNA (lncRNA) LY6E-DT in the proliferation and migration of thyroid cancer cells regulating miR-148a expression. Methods　The research was from March 2023 to October 2024. The expression level of LY6E-DT in thyroid cancer tissues was analyzed using the UCSC Xena database. The real-time quantitative polymerase chain reaction (qPCR) was used to detect the expression levels of LY6E-DT in the thyroid cancer cell lines (FTC-133, TPC-1, KTC-1, and 8505C) and thyroid epithelial cells HTori-3. The TPC-1 cells were divided into an si-LY6E-DT group and an si-NC group according to the transfection methods. The clone formation ability of the TPC-1 cells was detected by the clone formation assay. The migration ability of the TPC-1 cells was detected by the Transwell assay. The interaction between LY6E-DT and miR-148a was verified by the dual luciferase reporter assay and qPCR. The expression levels of p-PI3K, p-mTOR, p27, and p-GLUT4 proteins in the PI3K/AKT signaling pathway in the TPC-1 cells were detected by the Western blot. The data were compared between two groups by the t test and between multiple groups by one-way analysis of variance. Results　The expression level of LY6E-DT in the thyroid cancer tissues was significantly higher than that in the adjacent tissues (P<0.01). The expression levels of LY6E-DT in the FTC-133, TPC-1, KTC-1, and 8505C cells were significantly higher than that in the HTori-3 cells (all P<0.01). The expression level of LY6E-DT in the si-LY6E-DT group was lower than that in the si-NC group (1.06±0.59 vs. 7.11±1.53; t=7.37, P<0.01). The numbers of clones formed in the si-LY6E-DT group and the si-NC group were 38.01±9.63 and 113.10±13.33 (t=4.60, P<0.01), and the numbers of cell migration were 45.24±5.99 and 85.65±5.43 (t=4.99, P<0.01). LY6E-DT could target and negatively regulate the expression of miR-148a (P<0.01). Compared with those in the si-NC group, the expression levels of p-PI3K, p-mTOR, p27, and p-GLUT4 proteins in the PI3K/AKT signaling pathway in the TPC-1 cells in the si-LY6E-DT group were lower (all P<0.01). Conclusions　LY6E-DT is over-expressed in thyroid cancer tissues and cell lines. Knockdown of LY6E-DT can inhibit the proliferation and migration of thyroid cancer TPC-1 cells by targeted regulation of miR-148a expression.

Effect of lncRNA POTEM-4 on malignant biological behaviors of thyroid cancer cells by regulating the miR-363-3p/NF-κB axis

Tan Shaocheng, Yu Wanyuan, Sun Chongpu, Yang Xiaoqing, Sun Hui

2025, 31(20):  3412-3417.  DOI: 10.3760/cma.j.cn441417-20250319-20014

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Objective　To investigate the effect of long noncoding RNA (lncRNA) POTEM-4 on the malignant biological behaviors of thyroid cancer cells and its mechanism of action. Methods　The research was from March 2024 to January 2025. The GEO database was used to analyze the expression of POTEM-4 in thyroid cancer tissues. The expression levels of POTEM-4 in thyroid cancer cell lines KTC-1, 8505C, FTC-133, and SW579 were detected by the quantitative real-time polymerase chain reaction (qPCR). POTEM-4 low-expression plasmid and negative control plasmid were transfected into the FTC-133 cells, respectively, and named as an sh-POTEM-4 group and an sh-NC group. The effects of low-expression POTEM-4 on the proliferation and invasion of the FTC-133 cells were detected by the clone formation assay and Transwell assay, respectively. The bioinformatics technology and dual luciferase reporter assay were used to verify the targeting effect of POTEM-4 and miR-363-3p in the FTC-133 cells. The effect of low-expression POTEM-4 on the expression of miR-363-3p was detected by qPCR. The effect of low-expression POTEM-4 on the expression of the NF-κB signaling pathway proteins p65, p50, tumor necrosis factor receptor-associated factor 2 (TRAF2), and tumor necrosis factor receptor-associated factor 6 (TRAF6) was detected by Western blot. The statistical methods used were t test and one-way analysis of variance. Results　POTEM-4 was highly expressed in the thyroid cancer tissues (P<0.01). The expression levels of POTEM-4 in the KTC-1, 8505C, FTC-133, and SW579 cells were significantly higher than that in the thyroid epithelial HTori-3 cells (all P<0.01). POTEM-4 low-expression plasmid could effectively reduce the expression of POTEM-4 in the FTC-133 cells (t=16.320, P<0.01). The numbers of clones formed in the sh-POTEM-4 group and the sh-NC group were 45.52±6.17 and 149.20±12.65, respectively, indicating that the low expression of POTEM-4 inhibited the FTC-133 cells' proliferation ability (t=7.367, P<0.01). The invasion numbers of FTC-133 cells in the sh-POTEM-4 group and the sh-NC group were 38.07±10.84 and 137.30±9.31, respectively, indicating that the low expression of POTEM-4 inhibited the FTC-133 cells' invasion ability (t=6.942, P<0.01). POTEM-4 could target and bind to miR-363-3p (t=7.950, P<0.01). The low expression of POTEM-4 promoted the expression of miR-363-3p in the FTC-133 cells (t=5.840, P<0.01). Compared with those in the sh-NC group, the expression levels of p65, p50, TRAF2, and TRAF6 proteins in the NF-κB signaling pathway in the FTC-133 cells in the sh-POTEM-4 group were lower (all P<0.01). Conclusions　POTEM-4 is highly expressed in thyroid cancer. The downregulation of POTEM-4 inhibits the proliferation and invasion of FTC-133 cells by regulating the miR-363-3p/NF-κB axis.

Euploidy rate of blastocysts at different developmental stages and pregnancy outcomes in patients with chromosomal structural abnormalities

Xu Yanping, Wang Jin, Deng Lanlan, Tian Ye

2025, 31(20):  3417-3421.  DOI: 10.3760/cma.j.cn441417-20250306-20015

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Objective　To explore the differences in euploidy and aneuploidy abnormalities and mosaic abnormalities between day 5 and day 6 embryos submitted for preimplantation genetic testing-structural rearrangements (PGT-SR) in patients with chromosomal structural abnormalities, and to further analyze the pregnancy outcomes after the transfer of euploid embryos in the two groups. Methods　A retrospective cohort study method was used. One hundred and five couples who underwent PGT-SR assisted reproduction treatment at Reproductive Medicine Center, Tianjin Medical University General Hospital from March 2023 to October 2024 were selected for the study. A total of 127 oocyte retrieval cycles were performed, and a total of 633 blastocysts underwent trophectoderm cell biopsy. The women were (32.09±3.48) years old; the men were (32.89±3.63) years old. The number of gonadotropin (Gn) days ranged from 6 to 17 days. The number of retrieved oocytes ranged from 2 to 71. According to the embryo development stage, there were 316 day 5 blastocysts, 298 day 6 blastocysts, and 19 day 7 blastocysts. Due to the small number of day 7 blastocysts and the low euploidy rate, they were not included in the subsequent statistical analysis. The data on the sources and types of chromosomal abnormalities, as well as the baseline data for the formation of blastocysts from D5 and D6, were collected. The formation rates of euploid embryos, aneuploid abnormal embryos, and chimeric abnormal embryos from D5 and D6. Statistical analysis was conducted using t test and χ² test. Results　Among the 633 embryos, there were 220 pieces of female chromosomal balanced translocation, 25 pieces of chromosomal Robertsonian translocation, and 18 pieces of chromosomal inversion and other structural abnormalities; there were 268 pieces of male chromosomal balanced translocation, 59 pieces of chromosomal Robertsonian translocation, and 43 pieces of chromosomal inversion and other structural abnormalities. There were no statistical differences in the baseline data between the patients with day 5 and day 6 blastocysts (all P>0.05). The euploidy rate of the day 5 blastocysts was higher than that of the day 6 blastocysts [37.03% (117/316) vs. 26.17% (78/298)], with a statistical difference (P=0.004). A total of 61 euploid day 5 embryos and 29 euploid day 6 embryos were transplanted in our center. The human chorionic gonadotropin (HCG) positive rate after the transfer of the euploid day 5 blastocysts was 73.8% (45/61), and the clinical pregnant rate was 65.6% (40/61); the HCG positive rate after the transfer of the euploid day 6 blastocysts was 41.4% (12/29), and the clinical pregnancy rate was 27.6% (8/29); there was a statistical difference between the two groups (P<0.05). Conclusion　The euploidy rate after the detection of Day 5 blastocysts is higher, and so is the pregnancy rate after the transfer.

Predictive value analysis of CRP, PCT, and NAR for short-term prognosis in patients with septic shock

Liu Bo, Li Bilin, Zhang Jingyao

2025, 31(20):  3422-3426.  DOI: 10.3760/cma.j.cn441417-20250529-20016

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Objective　To investigate the prognostic value of C-reactive protein (CRP), procalcitonin (PCT), and neutrophil-to-albumin ratio (NAR) in predicting short-term outcomes in patients with septic shock. Methods　A total of 108 patients with septic shock admitted to the Third Hospital of Xi'an and the Third Hospital of Baoji from March 2022 to March 2024 were selected. They were divided into the death group (38 cases) and the survival group (70 cases) based on their 28-day prognosis.The general data, CRP, PCT and NAR levels of the two groups were compared. Logistic analysis was used to identify the influencing factors of 28-day mortality in patients with septic shock and a nomogram was constructed. The receiver operating characteristic curve (ROC) was constructed to analyze the predictive value of CRP, PCT and NAR for 28-day mortality in patients with septic shock.Statistical comparisons were made using the χ² and t tests. Results　There were no statistically significant differences between the death group and the survival group in terms of gender, age, body mass index, history of hypertension, history of diabetes, history of chronic heart failure, infection site, and heart rate (all P > 0.05).There were statistically significant differences in sequential organ failure assessment (SOFA) scores, acute physiology and chronic health evaluation system Ⅱ (APACHE Ⅱ) scores, CRP, PCT, and NAR between the death group and the survival group (all P < 0.05).Logistic regression analysis indicated that SOFA score, APACHE Ⅱ score, CRP, PCT, and NAR were influencing factors for 28-day mortality in patients with septic shock (all P < 0.05).The ROC results indicated that the AUC value of the combined prediction of CRP, PCT and NAR was significantly higher than that of the individual predictions. Conclusion　CRP, PCT and NAR have good predictive value for the short-term prognosis of patients with septic shock.

Determination of the median effective volume of 0.375% ropivacaine for ultrasound-guided serratus anterior plane block in multimodal analgesia following pulmonary lobectomy

Chen Xi, Zheng Jun, Yuan Meng, Wang Chuyan, Zhang Hailiang, Gao Hui

2025, 31(20):  3427-3433.  DOI: 10.3760/cma.j.cn441417-20250422-20017

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Objective　To determine the median effective volume (EV₅₀) of 0.375% ropivacaine for serratus anterior plane block (SAPB) in postoperative analgesia after lobectomy by sequential method, and to provide a reference for clinical application. Methods　A total of 24 adult patients who underwent unilateral thoracoscopic lobectomy from January 2024 to January 2025 were selected. Their ages ranged from 18 to 64 years, body mass index (BMI) was between 18 and 30 kg/m², height was from 155 to 175 cm, and American Society of Anesthesiologists (ASA) classification was grade I to III. For the first patient, 30 ml of 0.375% ropivacaine was selected as the volume of local anesthetic. The volume of the block was adjusted based on the postoperative analgesic effect: if the block effect of the previous patient was complete, the volume of local anesthetic for the next patient was reduced by 2 ml.If the block effect is unsatisfactory, add 2 ml. The inclusion of cases will end after obtaining 7 turning points.Record the block plane at 5, 10, 15, 20 and 30 minutes after the completion of the block. Record the Visual Analogue Scale (VAS) scores of patients at rest and during movement at 2, 6, 12, 24 and 48 hours after surgery. Record the total number of times the patients pressed the patient-controlled intravenous analgesia (PCIA) button from 0 to 12 hours and from 13 to 48 hours after surgery. The Probit regression model was used to determine the EV₅₀ and its 95% confidence interval (CI) of 0.375% ropivacaine serratus anterior plane block for postoperative analgesia in patients undergoing thoracoscopic lobectomy. The occurrence of adverse reactions such as postoperative nausea and vomiting (PONV), skin itching, local anesthetic toxicity, local hematoma, respiratory depression and infection at the puncture site was recorded,Statistical analysis was conducted using t-tests and Fisher's exact probability method. Results　Twenty-four patients successfully underwent serratus anterior plane block and were included in the analysis. Among them, 13 patients (54%) achieved complete analgesia. The EV₅₀ of ultrasound-guided 0.375% ropivacaine SAPB for postoperative analgesia after thoracoscopic lobectomy was 24.97 ml (95%CI 23.81 - 26.10 ml), and the 95% effective capacity(EV₉₅) was 27.10 ml (95%CI 25.99 - 33.51 ml).Three patients experienced postoperative nausea and vomiting (PONV), and one patient had skin itching. None of the patients had any adverse reactions related to the block operation. Conclusion　The EV₅₀ of 0.375% ropivacaine for single-shot paravertebral block under ultrasound guidance in postoperative analgesia after thoracoscopic lobectomy was 24.97 ml (95%CI 23.81 - 26.10 ml).

Clinical Research

Effect of Xiyanping combined with methylprednisolone sodium succinate in the treatment of community-acquired pneumonia in children

Huang Wei, Xie Tian, Ren Qinglong

2025, 31(20):  3434-3437.  DOI: 10.3760/cma.j.cn441417-20250107-20018

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The influence of blood pressure on macular edema secondary to retinal vein obstruction treated with leizumab

Liu Ying, Wang Min, GuoYuanyuan, ZhangXin, Li Guanghui

2025, 31(20):  3437-3441.  DOI: 10.3760/cma.j.cn441417-20241117-20019

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Objective　To investigate the influence of blood pressure factors onintravitreal injection of ranibizumab in the treatment of macular edema secondary to retinalvein occlusion. Methods　Retrospective analysis sixty-four patients (64 eyes) with hypertension combined with retinal vein obstruction secondary macular edema from January 2023 to December 2023 in Jinan Second People's Hospital, including 29 eyes with central retinal vein obstruction, 35 eyes with retinal branch vein obstruction. There were 30 males and 34 females,aged 41-81 years, with a course of 1-9 months. All patients were given intravitreal injection of ranibizumab 0.05 ml (0.5 mg) and medical consultation to intervene hypertension. According to the blood pressure control before operation, on the day of operation and at the time of review, they were divided into a blood pressure controlled group (17 cases), a blood pressure partially controlled group (29 cases), and a blood pressure uncontrolled group (18 cases). The best corrected visual acuity (BCVA) and macular fovea thickness were compared setween the three groups before and 1 day, 1 week, and 1 month after treatment. The numerical variable data were tested by one-way analysis of variance, and the categorical variable data were tested by chi-square test. Results　One month after treatment, the BCVA of the blood pressure controlled group and the blood pressure partially controlled group were 0.27±0.18 and 0.31±0.18, respectively, which were lower than 0.42±0.20 of the blood pressure uncontrolled group, and the difference was statistically significant (P<0.05). One week and one month after treatment, the macular foveal thicknesses in the blood pressure controlled group and the blood pressure partially controlled group [(311.45±40.03) μm, (328.11±43.15) μm, (301.25±40.88) μm, (319.56±43.76) μm] were smaller than those in the blood pressure uncontrolled group [(362.18±50.94) μm, (366.53±49.58) μm], and the differences were statistically significant (all P<0.05). Conclusions　That whether hypertension is controlled has a significant effect on the efficacy of intravitreal injection of ranibizumab in patients with macular edema secondary to retinal vein occlusion. Patients with good blood pressure control can obtain better vision and greater macular edema reduction.

Clinical retrospective analysis of acute drug poisoning in minors

Huang Shuang, Yuan Yuxia, Li Yixi, Jiang Aihua

2025, 31(20):  3442-3445.  DOI: 10.3760/cma.j.cn441417-20250429-20020

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Objective　To deeply analyze the clinical characteristics and causes of drug poisoning in minors, and to put forward targeted prevention and treatment strategies. Methods　From January 2023 to December 2024,171 patients with juvenile drug poisoning admitted to the  Tongde Hospital of Zhejiang Province Affiliated to Zhejiang Chinese Medical University were retrospectively analyzed, including 49 males and 122 females, aged 0-18 years. The patient's age, gender, type of poisoning drug, cause of poisoning, clinical manifestations, mental illness, and time from poisoning to rescue were analyzed in detail. Results　Among the juvenile drug poisoning patients, 12.87% (22/171) were 0-6 years old, 7.02% (12/171) >6-12 , and 80.12% (137/171) >12-18. There were various types of poisoning drugs, mainly psychotropic drugs; of which, sertraline accounted for 26.32% (45/171), followed by quetiapine fumarate tablets [11.70% (20/171)]. The main causes of poisoning included 25 cases of accidental administration (14.62%) and 146 cases of suicide (85.38%). Analysis of suicidal behaviors showed that 91.10% (133/146) of patients had different degrees of psychological problems, such as anxiety, depression, childhood mood disorder, etc. Most poisoned children had different degrees of clinical manifestations, such as in the nervous system: coma, lethargy, dizziness, headache; in the digestive system: nausea, vomiting, abdominal pain, diarrhea; and other symptoms: chest tightness, palpitations, etc. All 171 patients were actively rescued and discharged, with a 100.00% rescue success rate. Conclusions　Drug poisoning in minors cannot be ignored. It is necessary to take comprehensive prevention and control measures, such as strengthening family drug management and paying attention to the mental health of adolescents, according to different age groups and the causes of poisoning to reduce the incidence of poisoning.

Efficacy of cervical vertebra positioning rotational traction manipulation combined with parallel insertion of multiple needles in patients with cervicogenic vertigo

Zhao Tao, Wang Xiangyang, Zhang Shifeng, Li Han

2025, 31(20):  3446-3450.  DOI: 10.3760/cma.j.cn441417-20250416-20021

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Objective　To explore the clinical application value of cervical vertebra positioning rotation manipulation combined with parallel insertion of multiple needles in patients with cervicogenic vertigo. Methods　A total of 124 patients with cervicogenic vertigo admitted to the Department of Orthopedics of Xi'an Hospital of Traditional Chinese Medicine from January 22 to December 2024 were selected and divided into a control group (62 cases) and an observation group (62 cases) by the random number table method. There were 28 males and 34 females in the control group; they were (45.29±3.83) years old; their course was 3(2, 5) years. There were 25 males and 37 females in the observation group; they were (45.32±3.78) years old; their course was 3(2, 5) years. The control group was given routine tuina treatment. The observation group was additionally treated with cervical vertebra positioning rotation manipulation combined with parallel insertion of multiple needles on this basis. The clinical efficacy, symptoms and influences [Modified Neck-related Vertigo Symptom and Function Assessment Scale (ESCV), Dizziness Handicap Inventory (DHI), Neck Disability Index (NDI)], the blood flow velocity of vertebrobasilar artery [blood flow velocity of basilar artery (BA), blood flow velocity of left vertebral artery (LVA), and blood flow velocity of right vertebral artery (RAV)], and neck pain [Visual Analogue Scale (VAS)] of the patients in the two groups were compared. The statistical methods were t test, Mann-Whitney U test and χ² test. Results　The total effective rate of the observation group was 93.55% (58/62), which was higher than 80.65% (50/62) of the control group, and the difference was statistically significant (P<0.05). After treatment, the ESCV scores of the observation group were higher than those of the control group [25.46±2.50 vs. 20.18±2.32, (35.28±3.16) cm/s vs. (32.15±3.10) cm/s, (37.05±3.20) cm/s vs. (34.98±3.22) cm/s, and (35.89±3.09) cm/s vs. (33.15±3.02) cm/s], and the scores of DHI, NDI, natural state and pain during pressing were lower than those of the control group (30.32±5.09 vs. 38.25±5.48, 10.12±1.98 vs. 14.05±2.08, 2.12±0.88 vs. 3.18±0.95, and 3.15±0.90 vs.4.12±0.98), the differences were statistically significant (all P<0.05 ). In the control group, 1 case (1.61%) had mild soreness discomfort, and 2 cases (3.23%) in the observation group had soreness or transient dizziness at the acupuncture site, the difference was not statistically significant (P>0.05). Conclusion　Cervical vertebra positioning rotation manipulation combined with parallel insertion of multiple needles for the treatment of cervicogenic vertigo can more effectively relieve vertigo symptoms, improve cervical vertebra dysfunction, and increase the blood flow velocity of vertebrobasilar artery compared with routine tuina therapy, and it has good value for clinical promotion and application.

Effect of ultrasound-guided suprascapular nerve combined with axillary nerve block in the treatment of patients with adhesive shoulder bursitis

Zhu Min, Liu Pengfei, Hu Xiaoli, Xu Feng, Liu Pei

2025, 31(20):  3451-3455.  DOI: 10.3760/cma.j.cn441417-20250428-20022

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Objective　To investigate the effect of ultrasound-guided suprascapular nerve (SSN) combined with axillary nerve (AN) block in the treatment of patients with adhesive capsulitis.Methods　In the prospective study, 85 patients with adhesive shoulder capsulitis treated in Xuzhou First People's Hospital from January 2022 to February 2025 were selected as the research objects, and they were divided into control group ( 43 cases ) and combined group ( 42 cases ) according to the random number table method. There were 10 males and 33 females in the control group; they were (53.33±8.63) years old; their pain course was (2.48±1.87) month. There were 11 males and 31 females in the combination group; they were (54.50±9.45) years old; their pain course was (2.63±1.55) month. The control group received ultrasound-guided SSN block, and the combined group increased AN block on the basis of the control group, 1 time/week, 2 times as a course of treatment, a total of 1 courses of treatment. The pain degree [Visual Analogue Scale (VAS)], shoulder joint activity (flexion, abduction, extension, internal rotation, external rotation), and adverse reactions were compared between the two groups before and after treatment. Statistical analysis was performed using χ² and t test. Result　At 2 weeks after treatment and 4 weeks after treatment, the VAS scores of the combined group at rest and during activity were lower than those of the control group(1.88±0.60 vs. 2.65±0.83, 0.95±0.31 vs. 1.77±0.54, 4.54±1.14 vs. 5.68±1.22, and 1.86±0.86 vs. 3.72±1.14), and the  flexion, abduction, extension, internal rotation, and external rotation were higher[(157.47±18.67) ° vs. (137.49±21.25) °, (165.28±12.15) ° vs. (153.24±17.97) °, (151.34±13.22) ° vs. (135.15±14.66) °, (168.82±11.04) ° vs. (153.63±14.17) °, (50.88±7.67) ° vs. (43.42±8.83) °, (55.75±5.24) ° vs. (52.14±6.72) °, (47.81±6.03) ° vs. (41.34±6.22) °, (56.26±8.27) ° vs. (51.49±7.09) °, (60.55±7.28) ° vs. (49.31±8.43) °, and (63.25±15.43) ° vs. (55.46±13.98) °], with statistical differences (all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (χ²=0.370, P=0.616). Conclusion　Ultrasound-guided SSN combined with AN block for the treatment of patients with adhesive capsulitis can significantly improve the pain level at rest and in motion, improve the mobility of shoulder joints, and is safe.

The effect of risperidone combined with transcranial magnetic stimulation on clinical symptoms in patients with schizophrenia

Zhang Yibo, Li Mengjie, Huang Hailiang

2025, 31(20):  3455-3459.  DOI: 10.3760/cma.j.cn441417-20250307-20023

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Objective　Analysis of the impact of risperidone combined with transcranial magnetic stimulation on the clinical symptoms of patients with schizophrenia. Methods　A prospective study was adopted. A total of 90 patients with schizophrenia who were admitted to Ankang Central Hospital from June 2021 to December 2023 were selected. They were divided into the conventional group and the research group according to the random number table method, with 45 cases in each group.Control group: 23 males and 22 females, with an age of (40.04±4.93) years and an  disease duration of (4.24±1.12) years.Oral risperidone treatment was adopted (the dose on the first day was 1 mg per time, twice a day; the dose was increased to 3 mg per day on the third day; it was increased to 4 mg per day on the fifth day; after two weeks of adjustment, the dosage was finalized and no further changes were made). Research group: 21 males and 24 females, with an average age of (40.28±4.76) years and an average disease duration of (4.28±1.16) years. In addition to the conventional treatment, transcranial magnetic stimulation at a frequency of 10 Hz was combined.Both groups were intervened for one month.Compare the cognitive functions, clinical symptoms and therapeutic effects of the two groups before and after the intervention.Statistical methods employed were the χ² test and the t test. Results　After the intervention, the score of the Wechsler Memory Scale (WMS) in the study group was higher than that in the control group [(120.49±10.26) points vs. (115.74±10.04) points], and the score of the Positive and Negative Syndrome Scale (PANSS) was lower than that in the control group [(109.29±10.27) points vs. (115.38±10.76) points], and the differences were statistically significant (t=2.220 and 2.747; both P<0.05).After the intervention, the total effective rate of treatment in the study group was higher than that in the control group [91.11% (41/45) vs. 75.56% (34/45)], and the difference was statistically significant (t=3.920, P<0.05). Conclusion　Risperidone combined with transcranial magnetic stimulation is beneficial for promoting the recovery of cognitive function in patients with schizophrenia, alleviating related clinical symptoms, and improving clinical efficacy. It has certain promotional value.

Relation of serum mineral contents and levels of gamma-aminobutyric acid and glutamic acid with core symptoms in children with autism

Li Wen, Liu Yongjuan, Yang Shuhan

2025, 31(20):  3460-3464.  DOI: 10.3760/cma.j.cn441417-20240309-20024

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Objective　To explore the relation of serum minerals, gamma-aminobutyric acid (GABA), and glutamic acid (Glu) with the core symptoms of autistic children. Methods　A total of 102 children with autism admitted to Xi'an Ninth Hospital from January 2021 to July 2023 were selected as an observation group, including 68 boys and 34 girls who were (7.23±2.15) years old. One hundred and two healthy children who underwent physical examination in Xi'an Ninth Hospital during the same period were selected as a control group, including 68 boys and 34 girls who were (7.40±2.08) years old. The serum levels of calcium (Ca), magnesium (Mg), iron (Fe), copper (Cu), and zinc (Zn) in the two groups were measured by the inductively coupled plasma mass spectrometry. The levels of GABA and Glu were determined by the high performance liquid chromatography. The Child Autism Rating Scale (CARS) and Autism Behavior Scale (ABC) were used to evaluate the illness and symptoms of the observation group; the children were divided into a mild to moderate group and a severe group according to the CARS score; the levels of Ca, Mg, Fe, Cu, Zn, GABA, and Glu were compared between the two groups. t and χ² tests were used for the statistical analysis. The relationship between the above indicators and scores of ABC and CARS was analyzed by the Pearson partial correlation analysis. Results　The levels of Mg, Cu, and Zn in the observation group were lower than those in the control group [(18.00±1.00) mg/L vs. (19.96±1.33) mg/L, (1 095.85±10.82) μg/L vs. (1 152.47±13.62) μg/L, and (752.38±12.63) μg/L vs. (770.15±14.63) μg/L; t=11.896, 32.874, and 9.286; all P<0.05], and the levels of GABA and Glu were higher [(108.69±26.27) pmol/L vs. (70.15±18.63) pmol/L and (985.63±158.20) pmol/L vs. (653.77±102.36) pmol/L; t=12.055 and 17.787; both P<0.05]. The levels of Mg, Cu, and Zn in the severe group were lower than those in the mild to moderate group [(15.77±1.02) mg/L vs. (19.56±1.18) mg/L, (1 056.55±8.26) μg/L vs. (1 123.36±11.65) μg/L, and (738.42±8.82) μg/L vs. (762.15±9.45) μg/L; t=16.862, 31.947, and 12.825; all P<0.05], and the levels of GABA and Glu were higher [(120.75±25.69) pmol/L vs. (100.25±23.14) pmol/L and (1 021.92±185.36) pmol/L vs. (960.23±118.36) pmol/L; t=4.207 and 2.051; both P<0.05]. Mg, Cu, and Zn were negatively correlated with autism conditions (r=-0.896, -0.958, and -0.807; all P<0.05). GABA and Glu were positively correlated with autism conditions (r=0.381 and 0.426; both P<0.05). The Mg level was negatively correlated with the score of interaction and total score (r=-0.280 and -0.323; both P<0.05). The Zn level was negatively correlated with the scores of interaction and physical activity and total score (r=-0.275, -0.213, and -0.223; all P<0.05). The GABA level was positively correlated with the scores of sensation and interaction and total score (r=0.495, 0.416, and 0.402; all P<0.05). The Glu level was positively correlated with the scores of communication and language and total score (r=0.382, 0.420, and 0.463; all P<0.05). Conclusions　The levels of Mg, Cu, Zn, and other minerals in children with autism are low, while the levels of GABA and Glu are high. The mineral contents and levels of GABA and Glu are associated with the core symptoms of the disease. Clinical monitoring of the mineral nutrition and levels of GABA and Glu in children with autism should be focused.

Value of multiparametric magnetic resonance imaging, transrectal ultrasound, and serum prostate-specific antigen in diagnosis of prostate cancer

Yan Xiuxiu, Shi Danghui, Zhou Jianhua

2025, 31(20):  3465-3469.  DOI: 10.3760/cma.j.cn441417-20241118-20025

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Objective　To explore the value of multiparametric magnetic resonance imaging (mpMRI), transrectal ultrasound (TRUS), and serum prostate-specific antigen (PSA) in the diagnosis of prostate cancer. Methods　One hundred and thirty patients suspected with prostate cancer and treated at Xi'an Daxing Hospital between August 2020 and August 2023 were selected as the study objects. They were 28-63 (45.02±5.36) years old. The pathological results were set as the gold standard. All the patients underwent mpMRI, TRUS, and the detection of the serum level of PSA. The values of mpMRI, TRUS, and the serum level of PSA in the diagnosis of prostate cancer were assessed by the receiver operating characteristic curves (ROC). χ² and t tests were used for the statistical analysis. Results　The pathological results showed that 75 cases had prostate cancer, and 55 cases benign prostatic hyperplasia. The proportions of the patients with the PI-RADS score of 1-2 and 3 in the prostate cancer group were lower than those in the benign prostatic hyperplasia group [12.00% (9/75) vs. 63.64% (35/55) and 20.00% (15/75) vs. 30.91% (17/55)], and the proportions of the patients with the PI-RADS score of 4 and 5 were higher [50.67% (38/75) vs. 5.45% (3/55) and 7.33% (13/75) vs. 0], with a statistical difference (P<0.05). The serum level of PSA in the prostate cancer group was lower than that in the benign prostatic hyperplasia group [(40.36±5.67) μg/L vs. (16.75±2.17) μg/L], with a statistical difference (t=29.322; P<0.05). Sixty cases were diagnosed with malignancy by mpMRI, 53 by TRUS, 54 by serum PSA, and 68 by their combination. The ROC analysis results showed that the sensitivity and specificity of their combination for prostate cancer were 90.7% and 89.1%, respectively, with an area under the curve of 0.899. Conclusions　mpMRI and TRUS combined with the serum level of PSA demonstrates a high sensitivity and a high specificity in the diagnosis of prostate cancer. Their combination exceeds any one of them, and can increase the diagnostic accuracy for prostate cancer.

Status of perceived discrimination, risk factors, and correlation with quality of life in colorectal cancer patients

Hu Shuai, Liu Zhijin, Wang Xuexing, Tang Jiaming

2025, 31(20):  3469-3473.  DOI: 10.3760/cma.j.cn441417-20250625-20026

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Objective　To explore the current status and risk factors of discrimination perception among patients with colorectal cancer, and to analyze its correlation with health-related quality of life (HRQoL). Methods　From August 2024 to May 2025, a questionnaire survey was conducted among 420 colorectal cancer patients who visited three top-tier hospitals in the central and western regions (Nanchang First Hospital, Anning First People's Hospital, and the High-tech Hospital of the First Affiliated Hospital of Nanchang University) using the Social Data Questionnaire, the Cancer Stigma Perception Scale (CSPDS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Descriptive statistical analysis was used to assess the current status of patients' perception of discrimination. Single-factor ANOVA and multiple-factor linear regression were employed to analyze the risk factors for patients' perception of discrimination, and to explore its correlation with HRQoL. Results　There was a widespread perception of discrimination among 420 patients with colorectal cancer, with a score of 48(40,55).Multivariate linear regression analysis showed that financial hardship, history of intestinal fistula, and introverted personality were all risk factors for patients' perception of discrimination (P<0.05). The patients' perception of discrimination was negatively correlated with HRQoL, five functional domains, overall health, symptom domains, and financial hardship (P<0.05). Conclusions　The widespread perception of discrimination is detrimental to the recovery and improvement of the quality of life of patients with colorectal cancer. Early identification and proactive, effective measures to address this issue are key to reducing the perception of discrimination and can serve as a starting point for further enhancing the health-related quality of life (HRQoL) of these patients in the future.

Objective　To explore the current status and risk factors of discrimination perception among patients with colorectal cancer, and to analyze its correlation with health-related quality of life (HRQoL). Methods　From August 2024 to May 2025, a questionnaire survey was conducted among 420 colorectal cancer patients who visited three top-tier hospitals in the central and western regions (Nanchang First Hospital, Anning First People's Hospital, and the High-tech Hospital of the First Affiliated Hospital of Nanchang University) using the Social Data Questionnaire, the Cancer Stigma Perception Scale (CSPDS), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Descriptive statistical analysis was used to assess the current status of patients' perception of discrimination. Single-factor ANOVA and multiple-factor linear regression were employed to analyze the risk factors for patients' perception of discrimination, and to explore its correlation with HRQoL. Results　There was a widespread perception of discrimination among 420 patients with colorectal cancer, with a score of 48(40,55).Multivariate linear regression analysis showed that financial hardship, history of intestinal fistula, and introverted personality were all risk factors for patients' perception of discrimination (P<0.05). The patients' perception of discrimination was negatively correlated with HRQoL, five functional domains, overall health, symptom domains, and financial hardship (P<0.05). Conclusions　The widespread perception of discrimination is detrimental to the recovery and improvement of the quality of life of patients with colorectal cancer. Early identification and proactive, effective measures to address this issue are key to reducing the perception of discrimination and can serve as a starting point for further enhancing the health-related quality of life (HRQoL) of these patients in the future.

Analysis of the correlation between Multidimensional Fatigue Inventory symptom cluster scores and quality of life in children with glioma

Sun Pei, Jiang Bin, Zhang Luyi

2025, 31(20):  3474-3478.  DOI: 10.3760/cma.j.cn441417-20250109-20027

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Objective　To explore the correlation between the symptom group scores of the Multidimensional Fatigue Scale (MFI-20) in children with glioma and their quality of life. Methods　A total of 90 children with glioma admitted to Xi'an Children's Hospital were selected by  the continuous sampling method. The research period was from March 2019 to February 2024. Among them, there were 42 males and 48 females, with ages ranging from 1 to 16 (5.34±1.12) years old. The fatigue symptoms and quality of life of the children were evaluated through the MFI-20 and the European Organization for Research and Treatment of Cancer's Quality of Life Core Questionnaire (EORTC QLQ-C30), and the correlation between the two was analyzed. Statistical methods employed included t-test, univariate analysis, Pearson linear regression analysis, and multivariate logistic regression analysis. Results　Among the 90 children, 72 showed symptoms of fatigue, with an incidence rate of 80.00%. The total score was (60.46±5.51) points, and the overall quality of life score was (67.23±3.89) points.The single-factor analysis showed that there were statistically significant differences in the total quality of life scores among children of different ages, tumor grades, the number of radiotherapy and chemotherapy sessions, and KPS scores (t=7.470, 7.538, 10.104,and 7.625, all P<0.05).The Pearson correlation analysis revealed that the fatigue symptom scores were associated with each dimension and the total score of quality of life, and all showed a negative correlation (all P<0.05).Logistic regression analysis showed that age [OR=0.705, 95% confidence interval(CI) 0.555-0.895], tumor grade (OR= 0.503, 95%CI 0.338-0.748), the number of radiotherapy and chemotherapy sessions (OR=0.246, 95%CI 0.131-0.462), KPS score (OR=2.361, 95%CI 1.543-3.612), and fatigue symptoms (OR=0.089, 95%CI 0.031-0.257) were all factors influencing the quality of life of children with glioma (all P<0.05). Conclusions　Children with glioma generally suffer from fatigue symptoms, and this symptom is negatively correlated with the quality of life of the children. Age, tumor grade, number of radiotherapy and chemotherapy sessions, KPS score, and fatigue symptoms are all important factors affecting their quality of life.

Effect of tranexamic acid combined with brace uterine suture on blood loss in patients with postpartum hemorrhage due to uterine atony

Wang Xiao, Zhao Haixia, Li Xia

2025, 31(20):  3478-3482.  DOI: 10.3760/cma.j.cn441417-20250302-20028

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Objective　To explore the effect of tranexamic acid combined with uterine belt suture technique on the blood loss of patients with postpartum hemorrhage caused by uterine atony. Methods　A prospective study was conducted, and 102 patients with postpartum hemorrhage due to uterine atony who were admitted to Xi'an International Medical Center Hospital from April 2023 to June 2024 were selected.Using the computer-generated random number table method, the subjects were divided into two groups in a 1:1 ratio, with 51 cases in each group.The control group: age 24-35 (30.82±3.06) years old, gestational weeks 36-42 (39.71±1.34) weeks, underwent uterine belt-style suture surgery.The research group: Age 25-37 (31.02±3.24) years old, gestational weeks 37-42 (39.95±1.87) weeks. In addition to the control group, tranexamic acid was added (1 g of tranexamic acid was dissolved in 100 ml of 5% glucose solution and then administered by intravenous drip). The perioperative indicators of the two groups were compared, as well as the coagulation function, blood indicators and immune function before and after treatment. The statistical method employed was the t-test. Results　The postpartum 24-hour bleeding volume, hemostasis time, operation time, and total hospital stay in the research group were all better than those in the control group (all P<0.05).The thrombin time (TT), activated partial thromboplastin time (APTT), and prothrombin time (PT) of the two groups after treatment were all higher than those before treatment, while fibrinogen (FIB) was lower than before treatment (all P<0.05).After treatment, the TT, APTT, and PT in the research group were shorter than those in the control group [(18.39±1.56) s vs. (21.13±1.93) s, (39.90±2.31) s vs. (43.48±2.54) s, and (14.02±1.17) s vs. (16.37±1.44) s], and the FIB was higher (3.54±0.71) g/L vs. (2.81±0.46) g/L, and the differences were all statistically significant (t=-7.885,-7.447,-9.045,and 6.162, all P<0.05).The hemoglobin (Hb) and platelet count (PLT) in the study group after treatment were both higher than those in the control group [(90.36±5.26) g/L vs. (85.74±5.23) g/L, (190.54±15.27)×10⁹/L vs. (178.24±15.12)×10⁹/L], and the differences were statistically significant (t=4.448 and 4.088; both P<0.05).After treatment, the CD3+ level in the study group was higher than that in the control group, and the CD4+/CD8+ ratio was lower (all P<0.05). Conclusion　The combined use of tranexamic acid and uterine belt-style suture technique can reduce the blood loss in patients with postpartum hemorrhage caused by uterine atony, improve the coagulation function, and enhance the blood indicators and immune function.

Effect of Astragalus tincture+ massage on lipohypertrophy and blood glucose in patients with type 1 diabetes

Li Yanhong, Lu Yacong

2025, 31(20):  3483-3486.  DOI: 10.3760/cma.j.cn441417-20250426-20029

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Objective　To explore the efficacy of Astragalus Tincture combined with massage on lipohypertrophy (LH) and blood glucose in patients with type 1 diabetes (T1DM). Methods　A prospective study was conducted to select T1 DM patients aged 3-16 years with LH at the insulin injection site who were followed up in the endocrinology clinic of Quanzhou Maternal and Child Health Hospital from May 2023 to March 2024. The patients were divided into control group and experimental group by random number method, with 30 cases in each group. A total of 5 cases were lost during the intervention, including 3 cases in the experimental group and 2 cases in the control group. All of them failed to be followed up in time after the intervention, and the improvement of LH could not be judged. In the control group, there were 15 males and 13 females, aged (10.50±2.59) years, and the course of disease was (34.14±19.42) months. There were 13 males and 14 females in the experimental group, aged (9.74±3.65) years old, and the course of disease was (32.67±18.98) months. The control group was treated with 25% magnesium sulfate hot and humid compress, and the experimental group was treated with Huangqi tincture rubbing + massage, 2 times/d, for 14 days.The improvement of LH, blood glucose compliance rate at different time periods [before three meals, 2 h after meals, before bedtime (22:00), early morning (03:00)] and the incidence of hypoglycemia were compared between the two groups after intervention. The statistical methods were t test, χ² test and rank sum test. Results　After the intervention, 23 cases (85.19%) in the experimental group and 16 cases (57.14%) in the control group showed effective improvement in LH, with statistical differences (χ²=5.240, P=0.022). There were statistically significant differences in blood glucose daily compliance between the two groups at different time periods after intervention (all P<0.05). There were 11 cases of hypoglycemia in the two groups, including 2 cases (7.41% ) in the experimental group and 9 cases (32.14%) in the control group, with statistical differences (χ²=4.313, P=0.038). Conclusions　Astragalus tincture combined with massage can effectively improve LH levels in patients with T1DM, which is beneficial for controlling their blood sugar and reducing the occurrence of hypoglycemic events.

Case Report

One case of dorsal soft tissue osteoma of tongue base and literature review

Xu Panpan, Li Hong, Yu Ning, Wang Nana, Qi Jing

2025, 31(20):  3487-3489.  DOI: 10.3760/cma.j.cn441417-20240713-20030

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Primary bone tumor of the tongue is relatively rare. Its pathological morphology is very similar to those of similar tumors occurring in bones, and it is a benign tumor. Surgical removal is the treatment method, and the prognosis is good. This article reports a case of primary bone tumor in the dorsal part of the tongue root and reviews relevant literature. It explores the pathogenesis and morphological characteristics of soft tissue bone tumor, analyzes its clinical and pathological features and diagnosis, as well as the key points of differential diagnosis.

One case of gastric bronchogenic cyst and literature review

Zhao Xiaoman, Li Yanxia, Zhu Mingli, Yu Yongquan

2025, 31(20):  3490-3492.  DOI: 10.3760/cma.j.cn441417-20250509-20031

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Bronchogenic cysts (BCs) are a rare congenital developmental anomaly that can affect multiple sites. Its ectopic occurrence in the gastric wall is rare. Due to the lack of specific clinical symptoms and imaging findings, its preoperative diagnosis is difficult, and clinical misdiagnosis is common. Histopathological examination is the gold standard for the diagnosis of this disease. This article reports a patient with gastrobronchial cysts (GBCs) admitted to Weihai Central Hospital, Qingdao University. The patient was misdiagnosed with gastric duplication malformation before surgery, and was diagnosed with GBCs after surgery. By analyzing the diagnosis and treatment process and reviewing literature, this study aims to improve the clinical understanding of this disease and provide some references for its clinical diagnosis and treatment.

Nursing Research

The effectiveness of biopsychosocial integrated nursing intervention in patients with recurrent vaginitis

Hou Rong, Ma Ying, Li Weize

2025, 31(20):  3493-3497.  DOI: 10.3760/cma.j.cn441417-20250325-20032

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Objective　To explore the application effect of "biological-psychological-social" integrated nursing intervention in patients with recurrent vaginitis. Methods　A total of 56 patients with recurrent vaginitis who were admitted to Xianyang Rainbow Hospital from October 2022 to October 2023 were selected. Using the random number table method, the patients were divided into two groups, with 28 cases in each group. The control group: age ranging from 20 to 50 (34.26±6.73) years old, body mass index (BMI) ranging from 18.5 to 24.0 (22.45±2.46) kg/m²;They received routine care.The observation group: age ranging from 20 to 50 (34.31±6.68) years old, BMI ranging from 18.5 to 24.0 (22.52±2.49) kg/m²;They received "biological-psychological-social" integrated nursing intervention in addition to routine care. Both groups received nursing intervention for 6 months.The vaginal inflammation symptom scores, recurrence rates of vaginal inflammation, self-care ability and psychological states of the two groups before and 6 months after nursing were compared.Statistical methods employed t-test and χ² test. Results　After the intervention, the scores of vaginal burning sensation, vaginal itching, abnormal vaginal discharge, and vaginal pain in the observation group were all lower than those in the control group (t= 6.154, 7.141, 6.321, and 7.719, all P<0.05). After 3 months, and 6 months,  intervention, the recurrence rates of vaginitis in the observation group were lower than that in the control group [3.57% (1/28) vs. 21.43% (6/28), and 0 vs. 14.29% (4/28)], and the differences were statistically significant (χ²=4.082 and 4.308, both P<0.05).The self-care ability scores of the observation group were all higher than those of the control group (all P<0.05).After the intervention, the score of the Depression Self-Evaluation Scale (PHQ-9) in the observation group was lower than that in the control group [(3.94±0.95) points vs. (6.82±1.14) points], and the difference was statistically significant (t=10.270, P<0.05). Conclusion　The "biological-psychological-social" integrated nursing intervention can effectively alleviate the symptoms of patients with recurrent vaginitis, reduce the recurrence rate, improve the patients' self-care ability and mental health level, and provide an effective nursing strategy for patients with recurrent vaginitis.

Intervention effect of regular follow-up on patients with multidrug-resistant tuberculosis

Wu Jin, Zhu Chunlin

2025, 31(20):  3497-3501.  DOI: 10.3760/cma.j.cn441417-20250304-20033

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Objective　To explore the intervention effect of regular follow-up on patients with multidrug-resistant tuberculosis (MDR-TB). Methods　One hundred patients with MDR-TB treated at Jiangxi Chest Hospital from January 2023 to March 2024 were selected for the prospective study, and were divided into a control group and an observation group by the random number table method, with 50 cases in each group. There were 38 males and 12 females in the control group; they were (46.18±12.02) years old. There were 38 males and 12 females in the observation group; they were (42.32±13.22) years old. The control group received routine intervention, while the observation group received regular follow-up after discharge and routine intervention. The medication adherence, follow-up adherence, treatment outcomes, self-care abilities [Exercise of Self-care Agency Scale (ESCA)], and quality of life [Generic Quality of Life Inventory (GQOLI-74)] were compared between the two groups. The measurement data were compared by the t test, the count data by the χ² test, and ranked data by the Mann-Whitney U test. Results　The medication adherence and follow-up adherence in the observation group were better than those in the control group (Z=2.591 and 2.321; P=0.010 and 0.020). The treatment success rate in the observation group was higher than that in the control group [84.00% vs. 66.00%; χ²=4.320; P=0.038]. After the intervention, the scores of self-care responsibility, self-care skills, self-concept, health knowledge, psychological function, social function, material living status, and physical function in the observation group were higher than than those in the control group (20.18±2.08 vs. 18.54±2.96, 36.32±4.51 vs. 32.24±3.62, 25.64±3.22 vs. 20.48±2.65, 53.24±5.81 vs. 45.28±5.08, 85.24±4.21 vs. 72.54±3.52, 84.24±5.22 vs. 78.54±4.65, 88.54±5.88 vs. 82.24±4.66, and 86.64±4.58 vs. 80.64±4.11), with statistical differences (all P<0.05). Conclusion　Regular follow-up intervention for patients with MDR-TB can improve their medication and follow-up adherence, self-care ability, and quality of life, and increase the treatment success rate.

Risk factors of chronic heart failure complicated with frailty in the elderly

Sun Wenwen, Yang Xinying, Wang Lu

2025, 31(20):  3502-3506.  DOI: 10.3760/cma.j.cn441417-20250325-20034

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Objective　To investigate the risk factors of chronic heart failure (CHF) complicated with frailty in the elderly. Methods　This study was a retrospective analysis. One hundred and sixty elderly patients with CHF treated in Henan Provincial People's Hospital from November 2021 to November 2024 were selected as the study objects. One hundred and fifty questionnaires were recovered, including 71 males (47.33%) and 79 females (52.67%) who were (74.29±5.15) years old. The patients' general information and frailty conditions were investigated by questionnaire survey and medical record review. The patients were divided into a frailty group and a non-frailty group according to whether they were complicated with frailty or not; the general information of the two groups was compared. t and χ² tests and binary logistic regression were used to analyze the risk factors of CHF complicated with frailty in the elderly. Results　One hundred and fifty valid questionnaires were recovered, with a questionnaire recovery rate of 93.75%; 52 of the 150 elderly CHF patients were complicated with frailty, with an incidence rate of 34.67%. There were no statistical differences in gender, education level, smoking history, drinking history, and medical payment methods between the two group (all P>0.05); however, the age and the proportions of the patients with BMI > 24.0 kg/m², NYHA grade III-IV, and ≥2 underlying diseases and who lived alone and had malnutrition and sleep disorders in the frailty group were higher than those in the non-frailty group [(75.51±5.36) years vs. (73.65±5.04) years, 15.38% vs. 3.06%, 92.30% vs. 40.82%, 57.69% vs. 29.59%, 55.77% vs. 34.69%, 53.85% vs. 15.31%, and 61.54% vs. 30.61%], with statistical differences (all P<0.05). The results of binary logistic regression analysis showed that BMI > 24.0 kg/m², NYHA grade III-IV, ≥ 2 underlying diseases, malnutrition, and sleep disorders were the risk factors of the elderly CHF patients complicated with frailty. Conclusions　The incidence rate of CHF complicated with frailty in the elderly is high. Its occurrence is closely related to BMI, NYHA grade, underlying diseases, nutritional status, and sleep quality. Clinical intervention strategies should be adopted to reduce the incidence of CHF complicated with frailty in the elderly.

Application of RCA-guided nursing intervention in unplanned extubation of deep venous catheters

Yang Yanli, Pei Xuelei, Li Zongfang

2025, 31(20):  3507-3511.  DOI: 10.3760/cma.j.cn441417-20250317-20035

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Objective　To investigate the value for applying root cause analysis (RCA)-guided nursing intervention in preventing unplanned extubation of deep venous catheters. Methods　One hundred and eighty-six patients requiring deep venous catheterization in Operation Room, Shangluo Hospital of Traditional Chinese Medicine from May 2020 to July 2022 were selected for the prospective study, and were divided into a control group and a study group by the random number table method, with 93 cases in each group. There were 67 males and 26 females in the control group; they were (51.83±6.52) years old. There were 58 males and 35 females in the study group; they were (49.67±6.91) years old. The control group received conventional nursing; in addition, the study group received RCA-guided intervention. The self-efficacy [General Self-Efficacy Scale (GSES)], comfort [General Comfort Questionnaire (GCQ)], unplanned extubation rates, and incidence rates of complications were compared between the two groups by t and χ2 tests. Results　After the intervention, the scores of GSES and GCQ were better than those before the intervention in both groups; the scores of confidence level, coping ability, goal achievement, and persistence of GSES in the study group were higher than those in the control group (29.73±5.86 vs. 21.76±4.11, 28.92±6.94 vs. 21.57±5.35, 29.37±7.08 vs. 22.11±7.27, and 30.15±6.77 vs. 22.43±4.06), with statistical differences between the two groups (all P<0.05); the scores of physical, psychological, environmental and social dimensions of GCQ in the study group were higher than those in the control group (92.47±7.89 vs. 70.56±7.87, 93.72±7.96 vs. 71.64±8.02, 94.23±8.04 vs. 71.49±7.98, and 93.89±7.92 vs. 70.78±7.86), with statistical differences between the two groups (all P<0.05). The unplanned extubation rate due to catheter obstruction, displacement, or detachment in the study group was lower than that in the control group [4.30%(4/93). vs. 12.90%(12/93)], with a statistical difference between the two groups (P<0.05). The incidence rate of complications (infection, thrombosis, and pneumothorax) in the study group was lower than that than in the control group [6.45%(6/93) vs. 16.13%(15/93)], with a statistical difference between the two groups (P<0.05). Conclusion　RCA-guided nursing intervention can effectively decrease the unplanned extubation rate and improve patient comfort and treatment safety.

Summary of nursing cooperation experience for complex lacrimal duct obstruction surgery

Yang Yuanxia, Cai Yue, Xiao Huiming, Liang Xuanwei

2025, 31(20):  3512-3515.  DOI: 10.3760/cma.j.cn441417-20250314-20036

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Objective　To summarize the experience of nursing cooperation in 45 cases of complex lacrimal duct obstruction surgery. Methods　A retrospective analysis was conducted on the clinical data and surgical nursing cooperation of 45 patients (58 eyes) with complex lacrimal duct obstruction treated at Zhongshan Ophthalmic Center, Sun Yat-sen University from January 2023 to January 2024. The key points and experiences of surgical nursing cooperation were summarized. Results　After the surgical treatment for 45 patients with complex lacrimal duct obstruction, a follow-up of 3 months was conducted. Among the 58 eyes, 52 eyes (89.7%) had unobstructed lacrimal ducts, and no epiphora occurred. None of the patients experienced serious complications. Conclusions　Before the operation, conduct a comprehensive assessment of the patient and provide psychological counseling; that the equipment is in good conditions should beensured, and all surgical supplies are prepared adequately. During the operation, precise nursing assistance can effectively improve the quality and efficiency of the surgery, and improve the satisfaction of doctors with the surgical cooperation.

Effects of different humidification modes on respiratory function in children undergoing non-invasive positive pressure ventilation after congenital heart disease surgery

Li Lihua, Liu Dongli, Lin Yawen

2025, 31(20):  3516-3520.  DOI: 10.3760/cma.j.cn441417-20250507-20037

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Objective　To explore the effects of 37 ℃ intubation humidification versus 34 ℃ mask humidification on respiratory function and complications in children undergoing non-invasive positive pressure ventilation (NPPV) after congenital heart disease (CHD) surgery. Methods　One hundred and ten children undergoing NPPV after CHD surgery at Pediatric Intensive Care Unit, Guangdong Provincial People's Hospital, Southern Medical University from January 2023 to January 2025 were selected for the randomized controlled trial, including 57 boys and 53 girls who were 11.00 (4.00, 14.00) months old. They were divided into Group A, taking 37 ℃ intubation humidification, and Group B, taking 34 ℃ mask humidification, by the random number table method, with 55 cases in each group. Both groups used the Fisher & Paykel MR850 humidifier to humidify their air tracts. The general data, complications (sputum viscosity, nasal bleeding, oropharyngeal dryness, etc.), and treatment effects [suction frequency, stuffy nose ventilation time, satisfaction rate with air tract humidification, comfort degree, and partial pressures of oxygen (PaO2), partial pressures of carbon dioxide (PaCO2), and oxygenation indexes (PaO2/FiO2) after 30 minutes' and 12 hours' ventilation] were compared between the two groups.The t test, non-parameter test, and χ2 test were used for the statistical analyses. Results　There were no statistical differences in the general data between the two groups (all P>0.05). The incidence rates of sputum viscosity, nasal bleeding, and oropharyngeal dryness in Group A were lower than those in Group B (all P<0.05). The stuffy nose ventilation time and ICU stay in Group A were shorter than those in Group B [49.0 (30.0, 77.0) h vs. 72.0 (44.0, 112.0) h and 16.0 (12.0, 22.0) d vs. 21.0 (14.0, 26.0) d]; the suction frequency in Group A was lower than that in group B [4 (1, 8) times/d vs. 8 (6, 8) times/d]; the satisfaction rate with air tract humidification and comfort score in Group A were higher than those in Group B [87.3% (48/55) vs. 9.1% (5/55) and 82.0±8.87 vs. 76.0±9.89]; there were statistical differences (all P<0.05). After 30 minutes' ventilation, there were no statistical differences in PaCO2, PaO2, and PaO2/FiO2 between the two groups (all P>0.05). After 12 hours' ventilation, the PaCO2 in Group A was lower than that in Group B [40 (36, 47) mmHg (1 mmHg=0.133 kPa) vs. 49 (45, 55) mmHg, P<0.05]; there were no statistical differences in PaO2 and PaO2/FiO2 between the two groups (both P>0.05). Conclusion　Application of 37 ℃ intubation humidification in children undergoing NPPV after CHD surgery can reduce sputum viscosity and respiratory tract complications, improve their respiratory function, satisfaction with air tract humidification, and comfort, shorten ventilator time and ICU stay, and promote their recovery.