Table of Content

15 April 2025, Volume 31 Issue 8

Previous Issue   

Breast Diseases

Prediction model of effect of interventional ablation for early breast cancer based on ultrasonic elastography and MRI

Luo Ting, Yan Ting, He Rui

2025, 31(8):  1234-1239.  DOI: 10.3760/cma.j.cn441417-20241101-08001

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Objective　To explore the prediction model of the effect of interventional ablation for early breast cancer based on magnetic resonance imaging (MRI) and ultrasonic elastography. Methods　Retrospective analysis was made on 126 female patients with breast cancer admitted to First Affiliated Hospital of Xi'an Medical University from January 2021 to January 2024. They were (49.46±5.17) years old. All the patients were treated with ultrasound guided radiofrequency ablation. Six months after the surgery, the patients were divided into a pathological complete remission (pCR) group and a non-pCR group according to the pathological results. The ultrasonic elastic imaging indicator [shear wave velocity (SWV)] and MRI indicators [T1 weighted (T1WI) signal, T2WI low fat suppression signal, enhanced signal, and apparent diffusion coefficient (ADC)] were compared between the two groups. The influencing factors of the effect of interventional ablation for early breast cancer were analyzed to build a prediction model for evaluating the effect of interventional ablation for early breast cancer. The data were compared between the two groups by t and χ² tests.The influencing factors were analyzed by the logistic regression model. The fitting degree was evaluated by the Hosmer-Lemeshow test. The predictive efficacy was evaluated by the receiver operating characteristic curve (ROC). Results　Among the 126 patients, 114 had pCR, and 12 had non-pCR. The maximum tumor diameter, SWV ratio of diseased side to opposite side (SWVr), T1WI low/equal signal, T2WI fat suppression high signal, and enhanced signal were the risk factors of non-pCR in interventional ablation for early breast cancer, and ADC was the protective factor (all P<0.05). The sensitivity, specificity, and area under the curve of the nomogram model for predicting non-pCR in interventional ablation for early breast cancer were 0.862, 0.874, and 0.879, respectively. Conclusion　Maximum tumor diameter, SWVr, T1WI signal, T2WI low fat suppression signal, enhanced signal, and ADC can evaluate the effect of interventional ablation for early breast cancer, and building a prediction model is helpful to identify the effect of interventional ablation for early breast cancer.

Ultrasonic evaluation of therapeutic effect of Neituo Shengji San for patients with late-stage ulcerative granulomatous mastitis

He Yufan, Zou Suwen, Ma Qiuping, Ouyang Chunyan

2025, 31(8):  1240-1243.  DOI: 10.3760/cma.j.cn441417-20240912-08002

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Objective　To investigate the ultrasonographic characteristics of granulomatous mastitis and to evaluate the efficacy of Neituo Shengji San for patients with late-stage ulcerative granulomatous mastitis. Methods　A retrospective analysis was conducted on the clinical data of 20 patients with late-stage ulcerative granulomatous mastitis treated at Guangdong Provincial Maternal and Child Health Hospital from January 2021 to January 2024. They were 27-40 years old. All the patients were treated with Neituo Shengji San. They were examined by ultrasound before and after the treatment, and the lesion conditions were recorded in detail. The ultrasound characteristics of granulomatous mastitis were analyzed. The clinical efficacy was evaluated by ultrasound. The patients were followed up for 0.5-6.0 months to observe the recurrence or aggravation. Paired t test was used for the statistical comparison. Results　The main ultrasound findings of granulomatous were nodule type, sheet hypoecho type, and diffuse type. After the treatment, 2 were cured; 7 were obviously effective; 8 were improved; 3 were ineffective. The diameter before the treatment was 31.50 (21.50, 42.75) mm; the diameter after the treatment was 10.50 (7.25, 17.50) mm; there was a statistical difference (Z=-2.960; P=0.003). The patients were followed up 2.6 months averagely, and no recurrence or aggravation occurred. Conclusions　In the ulcerative phase, it is crucial to regulate and supplement qi and blood to support detoxification and muscle regeneration. Neituo Shengji San is the main formula for granulomatous mastitis in the ulcerative phase, focusing on the substantial replenishment of qi and blood, and promoting the transformation of decay into muscle, thereby shortening the treatment course for patients with granulomatous mastitis, improving therapeutic efficacy, reducing recurrence. It is a clinically minimally invasive treatment plan that can preserve the appearance and is effective.

Automated breast volume imaging combined with miR-22-3p and PDGF levels in evaluation of relationship between lymph node metastasis and prognosis in patients with breast cancer

Shao Yuan, Wang Zhibin, Kan Binghua

2025, 31(8):  1244-1249.  DOI: 10.3760/cma.j.cn441417-20241031-08003

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Objective　To analyze the relationship between axillary lymph node metastasis (ALN) and prognosis of patients with breast cancer by automated breast volume imaging (ABVS) combined with miR-22-3p and platelet endothelium-derived factor (PDGF). Methods　This was a retrospective study. Ninety-seven patients with breast cancer treated at Hanzhong Central Hospital from January 2021 to September 2023 were selected, including 25 menopausal patients. They were 19-75 years old. The level of PDGF was detected by the enzyme linked immunosorbent assay before the surgery; the ABVS technique was used for the examination. The real-time fluorescence quantitative PCR was used to detect serum miR-22-3p. All the patients were treated with the modified radical operation. According to postoperative pathological results whether they had ALN, the patients were divided into an occurrence group (20 cases) and a non-occurrence group (77 cases). The Pearson correlation was used to analyze the relationship between ABVS technology combined with miR-22-3p and PDGF levels and the occurrence of ALN in the patients. The patients were followed up for 1 year by outpatient recheck or telephone. The recurrence, death, and survival were counted, and the patients were divided into a poor prognosis group (17 cases) and a good prognosis group (cases) according to their prognosis. The basic data were compared between the poor prognosis group and the good prognosis group. The binary logistic stepwise regression model was used to analyze the factors affecting the patients' prognosis. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic efficacy. t and χ² tests were used for the statistical analysis. Results　The level of miR-22-3p in the occurrence group was lower than that in the non-occurrence group (0.81±0.23 vs. 1.14±0.28); the proportions of the patients with lesion size ≥2 cm and distance between lesion and nipple and level of PDGF in the occurrence group was higher than those in the non-occurrence group [60.00% (12/20) vs. 29.87% (23/77), 65.00% (13/20) vs. 32.47% (25/77), and (602.30±52.56) ng/L vs. (543.85±49.74) ng/L]; there were statistical differences (all P<0.05). The results of Pearson correlation analysis showed that miR-22-3p was negatively correlated with the occurrence of ALN in the patients (r=-0.592; P<0.001); the lesion size ≥2 cm, distance between lesion and nipple ≥2 cm, and level of PDGF were positively correlated with the occurrence of ALN in the patients (r=0.612, 0.601, and 0.584; all P<0.001). The level of miR-22-3p in the poor prognosis group was lower than that in the good prognosis group (0.86±0.27 vs. 1.22±0.36); the level of PDGF and the proportions of the patients with TNM stage Ⅲ-Ⅳ, irregular edge, and micro-calcification foci in the poor prognosis group were higher than those in the good prognosis group [(586.32±56.41) ng/L vs. (521.31±54.02) ng/L, 58.82% (10/17) vs. 26.25% (21/80), 64.71% (11/17) vs. 30.00% (24/80), and 70.59% (12/17) vs. 36.25% (29/80)]; there were statistical differences (all P<0.05). The binary logistic regression analysis showed that the levels of miR-22-3p and PDGF, TNM stage Ⅲ-Ⅳ, micro-calcification foci, and irregular edge were the factors affecting the patients' poor prognosis (all P<0.05). The ROC analysis showed that the combination of miR-22-3p, PDGF, TNM stage Ⅲ-Ⅳ, micro-calcification foci, and irregular edge had high value in the prediction of the patients' poor prognosis (area under the curve=0.896). Conclusions　ABVS technology combined with miR-22-3p and PDGF has good efficacy in the evaluation of poor prognosis in patients with breast cancer. The ABVS technology combined with miR-22-3p and PDGF is correlated with the occurrence of ALN in patients with breast cancer.

Ultrasound in diagnosis of primary breast angiosarcoma complicated with ovarian angiosarcoma in 1 case and literature review

He Yuanxun, Zhang Lingyan, Huang Jun

2025, 31(8):  1250-1253.  DOI: 10.3760/cma.j.cn441417-20240507-08004

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Primary breast angiosarcoma (PBA) and ovarian angiosarcoma are rare tumors with high aggressive and metastatic potential, and clinical cases of both tumors at the same time are rare. In order to help clinicians diagnose this disease early, the clinical data and ultrasound manifestations of a patient with PBA confirmed by surgical pathology who was admitted to The First Affiliated Hospital of Jinan University in August 2023 were mainly retrospectively analyzed, and the left ovarian mass was found by transvaginal ultrasound 4 months after surgery. The postoperative pathology showed that the patient had mature cystic teratoma and angiosarcoma. The characteristics of two-dimensional ultrasound images and color Doppler ultrasound images of ovarian angiosarcoma are also mentioned in this article, and summarized in conjunction with the literature.

New Medical Advances

Effects of matrix metalloproteinases and matrix metalloproteinase inhibitors on chronic sinusitis

Miao Senhao, Li Xiuguo

2025, 31(8):  1254-1257.  DOI: 10.3760/cma.j.cn441417-20241205-08005

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Chronic sinusitis (CRS) is a chronic inflammation of nasal cavity and sinus mucosa. According to its clinical manifestations, it can be divided into chronic sinusitis without nasal polyps (CRSsNP) and chronic sinusitis with nasal polyps (CRSwNP). The current conservative treatment effect is not good, and the postoperative recurrence rate is high, which greatly affects the patients' quality of life. The pathogenesis of CRS may be related to the destruction of nasal mucosa epithelium, tissue remodeling, bacterial infection, and other factors. At present, studies show that tissue remodeling plays an important role in the occurrence and development of CRS. Abnormal degradation of extracellular matrix (ECM) is a part of tissue remodeling, in which matrix metalloproteinases (MMPs) and matrix metalloproteinase inhibitors (TIMPs) are the key factors regulating ECM metabolism. Therefore, this paper summarizes the influence of MMPs and TIMPs on CRS.

Research progress of ultrasound-guided radiofrequency ablation in treatment of thyroid micropapillary carcinoma

Li Qiang

2025, 31(8):  1258-1260.  DOI: 10.3760/cma.j.cn441417-20241114-08006

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The incidence rate of papillary thyroid carcinoma (PTC) has been rising annually, with a notable increase in the detection rate of papillary thyroid microcarcinoma (PTMC) due to advancements in medical detection technology. PTMC is characterized by low aggressiveness and a high survival rate, but there is controversy regarding the optimal treatment approach. Traditional thyroidectomy may lead to complications. Radiofrequency ablation (RFA) has garnered significant attention as a novel therapeutic method. RFA utilizes high temperatures to destroy cancerous tissue, with minimal invasion and a low complication rate. Studies have confirmed the efficacy and safety of RFA for treating PTMC, and the long-term follow-up results demonstrated a high rate of complete disappearance and no local tumor progression. Additionally, RFA has some advantages in the treatment of recurrent thyroid cancer. Therefore, RFA has emerged as an effective alternative to traditional surgery for the treatment of PTMC

Research progress of thymidylate synthase gene in tumorigenesis and development

Hong Jinquan, Huang Zhenyu, Huang Huiwen, Huang Haobo

2025, 31(8):  1260-1265.  DOI: 10.3760/cma.j.cn441417-20241118-08007

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Protein encoded by the thymidylate synthase (TYMS) gene is a rate-limiting enzyme necessary for DNA synthesis and is an important enzyme for DNA damage repair, and plays an important role in a variety of physiological and pathological conditions. This article mainly reviews the expression and clinical significance of TYMS gene in various types of tumors, the effect and mechanism of TYMS gene on the malignant biological behaviors and the sensitivity to chemotherapeutic drugs of tumor cells, various factors regulating TYMS gene expression, and the anti-tumor application of TYMS gene targeting.

Research progress on autophagy and ischemic cerebrovascular diseases

Jiang Meng, Zhao Jingru, Liu Hui, Liu Qingxin

2025, 31(8):  1265-1269.  DOI: 10.3760/cma.j.cn441417-20240621-08008

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Ischemic cerebrovascular disease (ICVD) is a disease that seriously endangers human health, and it has the characteristics of acute onset, disability, and high mortality rate. In recent years, the incidence rate has been increasing year by year, and the age of onset is getting younger and younger. Autophagy is a life phenomenon unique to eukaryotes in self-repairing processes, and is a physiological process in which lysosomes in cells degrade phagocytoses. Studies have found that autophagy can be activated after ischemic brain injury, which affects protein expression and internal environment, thereby accelerating or stopping the progression of ICVD. The two-sided nature of autophagy is still unclear, and moderate regulation of autophagy activation may be the key to the protective role of autophagy. This article discusses the related contents of ICVD, autophagy, and the possible protective and damaging effects of autophagy in ICVD, in order to provide new solutions and targets for the diagnosis and treatment of ICVD.

Research progress on neoadjuvant immunotherapy for MSI-H/dMMR subtype patients with locally advanced colorectal cancer

Liu Hanqing, Sun Yinping, Zhao Qiang, Ren Shuai

2025, 31(8):  1270-1274.  DOI: 10.3760/cma.j.cn441417-20240924-08009

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In recent years, neoadjuvant therapy is widely used in the treatment of locally advanced colorectal cancer (LACRC), and has significantly improved the preoperative tumor regression rate and reduced the risk of postoperative local recurrence. Neoadjuvant immunotherapy has achieved favorable clinical effects in the treatment of LACRC. Neoadjuvant immunotherapy with or without neoadjuvant chemoradiotherapy followed by surgery had become a new therapeutic method for LACRC. Based on the expression of mismatch repair proteins, colorectal cancer (CRC) can be divided into two subgroups: microsatellite highly unstable/mismatch repair dysfunction (MSI-H/dMMR) and non-microsatellite highly unstable/ mismatch repair function complete (non-MSI-H/pMMR). MSI-H/dMMR patients obtain limited clinical benefits from chemoradiotherapy, but have favorable clinical effects in immune checkpoint inhibitors (ICIs) treatment due to the abundant immune cell infiltration. This article reviews and discusses the clinical application and advantages of neoadjuvant immunotherapy in MSI-H/dMMR LACRC patients, so as to provide references for the preoperative neoadjuvant treatment for LACRC.

Treatises

Mechanism of total peony glycosides for inhibiting malignant behaviors of thyroid cancer cells

Cao Madi, Wang Ke, Yang Aimin

2025, 31(8):  1275-1282.  DOI: 10.3760/cma.j.cn441417-20241114-08010

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Objective　To investigate the effect and mechanism of total peony glycosides (TPG) on the malignant behaviors of thyroid cancer cells (SW579). Methods　The cancer tissue and their adjacent tissue of 90 patients with thyroid cancer who were diagnosed and received surgical treatment in Xi'an Workers Hospital from June 2016 to December 2019 were collected. The circ_HOMER1 expression level in the thyroid cancer tissue was detected by the real-time fluorescent quantitative reverse transcription PCR (RT-qPCR); the relationship between circ_HOMER1 expression and clinicopathological characteristics of the patients was explored. The SW579 cells were divided into a control (con) group, a TPG 50 mg/L group, a TPG 100 mg/L group, a TPG 200 mg/L group, an si-NC group, an si-circ_HOMER1 group, a TPG + anti-miR-23a-3p group, and a TPG + pcDNA-circ_HOMER1 group. The RT-qPCR was performed to detect the expressions of circ_HOMER1 and miR-23a-3p; the Transwell method was employed to detect the cell migration and invasion; the plate cloning and CCK-8 assays were used to detect the cell proliferation. The targeting relationship between circ_HOMER1 and miR-23a-3p was determined by the dual luciferase reporter assay. The correlation between circ_HOMER1 expression and clinicopathological features was evaluated. χ² test and one-way analysis of variance were used for the statistical analysis. Results　The expression of circ_HOMER1 was up-regulated in the thyroid cancer tissue. The circ_HOMER1 expression was correlated with TNM stage, lymph node metastasis, and envelope infiltration (all P<0.05). The expression levels of circ_HOMER1 in the TPG 50 mg/L group, the TPG 100 mg/L group, and the TPG 200 mg/L group were lower than that in the control group (0.78±0.04, 0.47±0.03, and 0.23±0.02 vs. 1.00±0), while the levels of miR-23a-3p were higher (1.49±0.03, 2.11±0.06, and 2.89±0.09 vs. 1.00±0), with statistical differences (F=1 425.931 and 1 904.071; both P<0.05). The numbers of migration, clone, and invasion in in the TPG 50 mg/L group, the TPG 100 mg/L group, and the TPG 200 mg/L group were lower than those in the control group, while the cell inhibition rates were higher (all P<0.05). The migration, proliferation, and invasion behaviors of the SW579 cells in the si-circ_HOMER1 group were lower than those in the si-NC group (all P<0.05). The proliferation, migration, and invasion behaviors in the TPG+pcDNA-circ_HOMER1 group and the TPG+anti-miR-23a-3p group were higher than those in the TPG group (all P<0.05). MiR-23a-3p was a target gene of circ_HOMER1. Conclusion　TPG may inhibit the malignant proliferation, migration, and invasion of thyroid cancer cells down-regulating the circ_HOMER1/miR-23a-3p axis.

Effect of self-prepared Yinqiao Qingjie Decoction combined with intense pulsed light for patients with rosacea

Chen Lei, Ma Yanmei, Zhang Min

2025, 31(8):  1283-1287.  DOI: 10.3760/cma.j.cn441417-20240311-08011

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Objective　To study the effect of self-prepared Yinqiao Qingjie Decoction combined with intense pulsed light on facial skin microecology of patients with rosacea. Methods　One hundred patients with rosacea treated in Ankang Traditional Chinese Medicine Hospital from June 2022 to August 2023 were selected for the randomized controlled trial, and were divided into a control group and an experimental group by the random number table method, with 50 cases in each group. There were 27 males and 23 females in the control group; they were (40.60±9.75) years old. There were 26 males and 24 females in the experimental group; they were (40.30±9.62) years old. The control group group were treated with intense pulsed light, and the experimental group with intense pulsed light and Yinqiao Qingjie Decoction. Both groups were treated continuously for 3 months. The clinical efficacies, scores of traditional Chinese medicine symptoms, facial skin microecological changes, and serum levels of inflammatory factors [interleukin (IL)-6, tumor necrosis factor-α (TNF-α), IL-17, and IL-23] were compared between the two groups by t and χ². Results　The total effective rate of the experimental group was higher than that of the control group [96.00% (48/50) vs. 82.00% (41/50)], with a statistical difference (χ²=5.005; P=0.025). After 3 months' treatment, the scores of papules and pustules, scalding, erythema, and itch, pH of facial skin, sebum secretion rate, and levels of IL-6, TNF-α, IL-17, and IL-23 in the experimental group were lower than those in the control group [1.60±0.45 vs. 2.50±0.67, 1.22±0.31 vs. 2.08±0.45, 1.20±0.36 vs. 2.12±0.46, 1.16±0.34 vs. 2.04±0.68, 5.12±0.25 vs. 5.34±0.31, (1.40±0.25) μg/(cm²·min) vs. (1.68±0.29) μg/(cm²·min), (19.53±5.23) ng/L vs. (25.71±7.21) ng/L, 30.48±6.82) ng/L vs. (41.20±8.01) ng/L, (34.51±6.21)ng/L vs. (43.97±8.62) ng/L, and (46.28±5.88) ng/L vs. (61.39±9.21) ng/L], with statistical differences (t=7.885, 11.129, 11.137, 8.185, 3.906, 5.171, 4.906, 7.205, 6.296, and 9.778; all P<0.05). Conclusion　Self-prepared Yinqiao Qingjie Decoction combined with intense pulsed light for patients with rosacea is effective and can improve their facial skin microecology and inflammatory response.

Relationship of levels of SIRI, pro-ADM, and MDH1 with pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy

Wang Yatao, Li Feng, Rao Zhouzhou

2025, 31(8):  1287-1291.  DOI: 10.3760/cma.j.cn441417-20241111-08012

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Objective　To investigate the relationship of the levels of systemic inflammatory response index (SIRI), pro-adrenomedullin (pro‐ADM), and lactate dehydrogenase 1 (MDH1) with pregnancy outcomes in patients with intrahepatic cholestasis of pregnancy (ICP). Methods　This is a retrospective study. One hundred and twenty-four patients with ICP treated at Xi'an Third Hospital from July 2021 to June 2024 were selected, and were divided into an adverse outcome group (51 cases), who were (28.94±3.27) years old and (30.55±1.35) weeks pregnant, and a favorable outcome group (73 cases), who were (29.33±2.69) years old and (31.12±1.29) weeks pregnant. The onset weeks of pregnancy, disease severities, and levels of albumin (Alb), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bile acids, pro-ADM, MDH1, and SIRI were compared between the two groups. The logistic regression was used to analyze the factors affecting the patients' pregnancy outcomes. The predictive value of SIRI combined with pro-ADM and MDH1 for adverse pregnancy outcomes was assessed. t and χ² tests were used for the statistical analysis. Results　The adverse group had earlier onset of pregnancy, a higher proportions of severe case, and higher levels of Alb, ALT, AST, total bile acids, pro-ADM, MDH1, and SIRI than the favorable group (t=2.395; χ²=6.529; t=3.001, 2.345, 2.366, 2.628, 6.156, 4.319, and 8.007; all P<0.05). The logistic analysis indicated that the onset weeks of pregnancy, disease severity, and levels of Alb, ALT, AST, total bile acids, pro-ADM, MDH1, and SIRI were significant factors influencing pregnancy outcomes (all P<0.05). The receiver operating characteristic curve showed that the combination of pro-ADM, MDH1, and SIRI had a sensitivity of 82.4% and a specificity of 93.2%. Conclusions　The levels of pro-ADM, MDH1, and SIRI are closely related to pregnancy outcomes in patients with ICP. Enhancing monitoring of these markers can improve clinical management and their prognosis.

Mechanism of treating vulvovaginal candidiasis with Honghe Fujie liquid

Wen Na, Zhang Xuan

2025, 31(8):  1292-1296.  DOI: 10.3760/cma.j.cn441417-20240805-08013

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Objective　To explore the mechanism of Honghe Fujie liquid in treating vulvovaginal candidiasis (VVC). Methods　Sixty SPF-grade SD rats (body weight 180-220 g) were randomly divided into a blank group, a model group, an amphotericin B effervescent tablet group, and low, moderate, and high dosages of Honghe Fujie liquid groups, with 10 rats in each group. Except for the blank group, the VVC rat models were established in the other groups by the subcutaneous injection of 0.2 g of estradiol valerate and intravaginal injection of 20 μl of Candida albicans suspension (5×10⁷ cfu/ml). The rats in the drug groups were administered the corresponding drngs vaginally, while the blank group and the model group were given normal saline, once a day for 7 days. Twenty-four hours after the last administration, the rats were anesthetized, and vaginal tissues were taken for hematoxylin-eosin (HE) staining to observe the pathological changes in the rats' tissues and to analyze the repair of the vaginal mucosa by the Honghe Fujie liquid. The transmission electron microscopy was used to observe the changes in the morphology of Candida albicans after the treatment with the Honghe Fujie liquid. The real-time quantitative PCR (qRT-PCR) was used to detect the expressions of HWP1 and ECE1 genes that enhance the virulence of Candida albicans, the ALS3 gene that promotes adhesion of Candida albicans, and the ECE1, EFG1, ERG1, ERG7 genes that regulate hyphal growth and the integrity of the cell membrane. Data analysis and mapping were performed using GraphPad Prism 8.0; Student's t test was used for comparison between groups. Image data was analyzed using the Image J(NIH) software. Results　Compared with that in the blank group, the model group rats had obvious edema and hyperplasia, epithelial cell shedding, infiltration by a large number of inflammatory cells in the vaginal tissue. Compared with the in the model group, the vaginal tissue lesions of rats in each drug group were improved to varying degrees. The results of transmission electron microscopy suggested that Honghe Fujie liquid could destroy the morphology and structure of bacteria, leading to the leakage of cytoplasmic contents of bacteria, and causing the death of bacteria. The qRT-PCR results showed that Honghe Fujie liquid could downregulate the virulence-enhancing HWP1 and ECE1 genes (P<0.05 or P<0.01), and promote the downregulation of ALS3 gene, which promotes mycelial adhesion, and ECE1, EFG1, ERG1, and ERG7 genes, regulates mycelial growth, and affects the integrity of the fungal plasma membrane. Conclusion　Honghe Fujie liquid has significant antibacterial effect on Candida albicans, which may be related to its ability to regulate the expressions of the genes related to fungal virulence, hyphal adhesion, and the completeness of the fungal cell membrane, as well as its ability to destroy the structure of mature biofilms and promote the entry of drugs into the biofilm to exert a comprehensive bactericidal action.

Different restoration methods for children with 4-5 mm posterior tooth defects

Sun Ying, Lei Yanhua

2025, 31(8):  1297-1301.  DOI: 10.3760/cma.j.cn441417-20240730-08014

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Objective　To evaluate the effects of resin filling, metal prefabricated crowns, and ceramic inlays for children with 4-5 mm posterior tooth defects. Methods　This was a prospective study. From January 2022 to January 2023, 163 children with 4-5 mm posterior tooth defects on 180 teeth treated at Yulin First Hospital were selected as the study objects, and were divided into group A (55 cases with 60 affected teeth), group B (54 cases with 60 affected teeth), and group C (54 cases with 60 affected teeth) by the random number table method. There were 27 boys and 28 girls in group A; they were (6.87±1.52) years old. There were 28 boys and 26 girls in group B; they were (6.92±1.46) years old. There were 27 boys and 27 girls in group C; they were (6.95±1.49) years old. Group A were restored with resin, group B with metal prefabricated crowns, and group C with ceramic inlays. The treatment effects, periodontal health indicators [plaque index (PI), gingival index (GI), and probing depth (PD)], occlusal function, and scores of Child Oral Health Impact Profile (COHIP) and Early Childhood Oral Health Impact Scale (ECOHIS) were compared between the 3 groups. All the 3 groups were followed up one year to assess their tooth conditions, including marginal integrity, proximal contact, wear, and restoration status. The statistical methods included t and χ² tests and analysis of variance. Results　The overall clinical treatment efficacies of groups B [81.7% (49/60)] and C [91.7% (55/60)] were higher than that in group A [63.3% (38/60)], with a statistical difference (χ²=14.878, P<0.001). Three months after the restoration, the scores of PI (0.62±0.07 and 0.57±0.06), GI (0.53±0.06 and 0.50±0.05), and COHIP (15.21±2.17 and 12.47±1.78) in groups B and C were lower than those in group A (0.86±0.09, 0.72±0.08, and 29.27±4.37); the score of ECOHIS in groups B (85.74±12.25) and C (86.89±12.41) were higher than that in group A (78.19±10.98); the PD's in groups B [(2.04±0.21) mm] and C [(2.00±0.20) mm] were smaller than that in group A [(2.36±0.24) mm]; the maximum occlusal forces [(2.21±0.23) kg and (2.05±0.20) kg] and occlusal areas [(72.82±10.40) mm² and (74.14±10.59) mm²] in groups B and C were bigger than those in group A [(1.23±0.17) kg and (61.31±8.75) mm²]; the occlusal contact times in groups B [(1.02±0.19) s] and C [(0.98±0.18) s] were shorter than that in group A [(1.26±0.21) s]; there were statistical differences (F=260.602, 204.960, 542.108, 9.468, 49.457, 408.473, 30.198, and 36.661; all P<0.05). After one year's follow-up, groups B and C had higher success rates in marginal integrity, proximal contact, wear, and restoration conditions than group A, with statistical differences (χ²=8.291, 10.179, 10.015, and 12.975; all P<0.05). Conclusions　Metal prefabricated crowns and ceramic inlays show superior treatment outcomes and shorter treatment times compared to resin fillings for children with 4-5mm posterior tooth defects. They are more effective for improving periodontal health, occlusal function, and oral health-related quality of life, and demonstrate better long-term tooth maintenance.

Tongqiao Ditan Tang combined with acupuncture for patients with acute ischemic stroke

Hou Xi, Ding Qi, Shen Xiaozhi, Yang Dan, Li Xutao

2025, 31(8):  1302-1306.  DOI: 10.3760/cma.j.cn441417-20241112-08015

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Objective　To explore the clinical effect of Tongqiao Ditan Tang combined with acupuncture for patients with acute ischemic stroke. Methods　Ninety-six patients with acute ischemic stroke treated at Luohe Hospital of Traditional Chinese Medicine from February 2021 to February 2024 were selected, and were divided into a control group and an observation group according to the treatment methods, with 48 cases in each group. There were 27 males and 21 females in the control group; they were (74.35±3.28) years old; the onset time was (5.42±1.26) h. There were 25 males and 23 females in the control group; they were (73.84±3.46) years old; the onset time was (5.63±1.18) h. The control group were treated with atorvastatin, for 2 months. The observation group were treated with Tongqiao Ditan Tang for 2 months and acupuncture once per day, 6 times per week, for 2 months. The efficacies, levels of neurofactors [brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE), and nerve growth factor (NGF)], coagulation function [activated partial thromboplastin time (APTT), fibrinogen (FIB), and D-dimer (D-D)], scores of Neurological Impairment Scale (NIHSS), Fugl-Meyer Motor Function Assessment Scale (FMA), Ability to Perform Daily Life Scale (ADL), and Comprehensive Quality of Life Questionnaire (GQOLI74), and incidence rates of adverse reactions were compared between the two groups. The independent sample t and χ² tests were used for the statistical analysis. Results　After two months' treatment, the total effective rate in the observation group was higher than that in the control group [95.83% (46/48) vs. 83.33% (40/48)]; the levels of BDNF, NSE, and NGF in the observation group were better than those in the control group [(35.06±3.12) μg/L vs. (31.87±2.75) μg/L, (48.25±3.17) ng/L vs. (44.16±3.02) ng/L, and (13.72±1.24) μg/L vs. (15.85±1.43) μg/L]; the APTT and levels of FIB and D-D in the observation group were better than those in the control group [(18.95±1.21) s vs. (22.79±1.46) s, (2.65±0.34) g/L vs. (3.48±0.41) g/L, and (0.38±0.07) mg/L vs. (0.49±0.09) mg/L]; the scores of NIHSS, FMA, ADL, and GQOLI74 in the observation group were better than those in the control group (14.92±1.24 vs. 21.87±1.68, 67.52±4.15 vs. 40.26±3.43, 61.56±3.24 vs. 50.48±2.75, and 69.46±3.68 vs. 61.57±3.45); there were statistical differences in the above indicators between the two groups (all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the two groups (P>0.05). Conclusion　Tongqiao Ditan Tang combined with acupuncture for patients with acute ischemic stroke is effective and safe, and can improve their neurological function, limb function, ability of daily life, and quality of life and promote their recovery of cerebral function.

Enteral nutrition support combined with swallowing training for stroke patients with swallowing disorders and psychological anxiety

Ma Yuan, Wu Bingli, Zhang Shike, Li Cancan, Wang Ziliang

2025, 31(8):  1306-1310.  DOI: 10.3760/cma.j.cn441417-20240701-08016

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Objective　To explore the value of enteral nutrition support combined with swallowing training for stroke patients with dysphagia and psychological anxiety. Methods　A retrospective study was conducted to select 130 stroke patients with swallowing disorder combined with anxiety in Henan Provincial People's Hospital from June 2020 to December 2023, and divided them into control group and study group according to different treatment methods, with 65 cases in each group. There were 37 males and 28 females in the control group; they were (62.00±11.05) years old; there were 27 mild cases, 25 moderate cases, and 13 severe cases; there were 38 cases of mild anxiety, 15 cases of moderate anxiety, and 12 cases of severe anxiety. there were 35 males and 30 females in the study group; they were (65.00±11.05) years old; there were 38 mild cases, 25 moderate cases, and 12 severe cases; There were 35 cases of mild anxiety, 18 cases of moderate anxiety, and 12 cases of severe anxiety. The control group did swallowing training; in addition, the study group took enteral nutrition support. The clinical efficacies, nutritional indicators, prognostic effects, immune function indicators, anxiety, and incidence rates of complications were compared between the two groups by t and χ² tests. Results　After the treatment, the total effective rate of the study group was 95.38% (62/65), which was higher than that of the control group [81.54% (53/65)], and the difference was statistically significant (P<0.05). After the treatment, the nutritional indicators [hemoglobin (Hb), albumin (ALB), total protein (TP), and prealbumin (PA)], Brathel score, Fugl Meyer motor function score, and immune function indicators (IgA, IgG, and IgM) in the study group were higher than those in the control group; the scores of NIHSS, SAS, and SDS and incidence rate of complications in the study group were lower than those in the control group (all P<0.05). Conclusion　Enteral nutrition support combined with swallowing training for stroke patients with swallowing disorders and psychological anxiety can improve their nutritional status and alleviate their anxiety, have fewer complications, and is safe.

Value of ultrasound imaging features combined with TgAb and TSH for differentiating benign and malignant thyroid nodules

Yang Jinyan, Ma Zhe, Xu Hua

2025, 31(8):  1311-1315.  DOI: 10.3760/cma.j.cn441417-20240919-08017

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Clinical Research

Effect of Bushen Yangxue Tiaojing Tang for patients with abnormal uterine bleeding

He Jinni, Shang Guotao, Ren Li, Li Fei

2025, 31(8):  1316-1320.  DOI: 10.3760/cma.j.cn441417-20240506-08018

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Objective　To investigate the effect of Bushen Yangxue Tiaojing Tang on endometrial thickness, coagulation function, and serum hormone levels in patients with abnormal uterine bleeding. Methods　This was a prospective study. One hundred patients with abnormal uterine bleeding treated at Yangling Demonstration Zone Hospital from January 2021 to January 2024 were selected as the study objects, and were divided into a control group and an observation group by the random number table method, with 50 cases in each group. There control group were (33.13±7.29) years old; their disease course was (3.79±0.65) years. The observation group were (32.89±7.51) years old; their disease course was (3.83±0.61) years. The control group were conventionally treated with western medicine; in addition, the observation group took Bushen Yangxue Tiaojing Tang. The clinical efficacies, scores of traditional Chinese medicine syndromes, clinically relevant indicators, coagulation function indicators [activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen (FIB)], sex hormone indicators [follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2)], and incidence rates of adverse reactions were compared between the two groups. The statistical methods included t test, χ² test, and rank sum test. Results　The total efficacy in the observation group was higher than that in the control group [98.0% (49/50) vs. 80.0% (40/50)], with a statistical difference (P<0.05). The scores of soreness in the waist and knees, dizziness, hyposexuality, dry mouth and tongue, red tongue with little coating, and deep and thin pulse and the levels of FIB, FSH, LH, and E₂ in the observation group were lower than those in the control group [1.12±0.23 vs. 1.65±0.31, 1.23±0.32 vs. 1.78±0.36, 1.16±0.27 vs. 1.64±0.35, 1.05±0.16 vs. 1.46±0.19, 1.13±0.15 vs. 1.49±0.23, 1.03±0.12 vs. 1.54±0.35, (2.19±0.13) g/L vs. (2.61±0.12) g/L, (14.27±1.45) mIU/L vs. (22.29±2.19) mIU/L, (6.15±1.12) mIU/L vs. (8.28±1.65)mIU/L, (179.23±15.35)ng/L vs. (254.68±20.35)ng/L]; the menstruation period, APTT, and PT in the observation group were shorter than those in the control group [(31.21±3.15) d vs. (44.26±4.19) d, (28.65±3.12) s vs. (30.35±3.26) s, and (14.23±1.35) s vs. (15.68±2.39) s]; the menstruation volume in the observation group was lower than that in the control group [(46.29±10.42) ml vs. (65.15±13.82) ml]; the endometrial thickness in the observation group was smaller than that in the control group [(5.25±0.16) mm vs. (7.05±0.21) mm]; there were statistical differences (all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the two groups (χ²=0.271; P=0.603). Conclusion　Bushen Yangxue Tiaojing Tang for patients with abnormal uterine bleeding can improve their physical signs, coagulation function, and sex hormone levels, and promote the recovery of menstrual flow, menstrual cycle, and endometrial thickness, and is safe.

LncRNA-MEG3 inhibits pancreatic cancer cell migration and invasion through TLR4/NF-κB signaling

Zheng Wei, Guo Dong, Wu Shengli

2025, 31(8):  1321-1326.  DOI: 10.3760/cma.j.cn441417-20241012-08019

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Objective　Based on toll-like receptor 4(TLR4) and nuclear factor-kappa B (NF-κB), to explore the effect of long non-coding RNA (lncRNA) and maternal expression gene 3 (MEG3) on migration and invasion of pancreatic cancer cells. Methods　This study was conducted from January 2022 to January 2023. The human pancreatic cancer cell lines were divided into a blank group (no transfected PANC-1 cells), an idle group (transfected pCDHEF1-copGFP pCDH-Scramble with PANC-1), and an MEG3 group (PANC-1 transfection PCDH-EF1-MEG3-COPGFP pCDH-MEG3). The quantitative real-time polymerase chain reaction (QRT-PCR) was used to detect the expressions of lncRNA-MEG3 and TLR4/NF-κB in the pancreatic cancer cells. The clonal formation rate was detected by the clonal assay. The apoptosis rate of the PANC-1 cells was detected by the flow cytometry. The invasion number and migration distance of the pancreatic cancer cells were detected by the Transwell cell and scratch assay. The expression levels of TLR4, NF-κB, NF-κBp65, and myeloid differentiation factor 88 (MyD88) in the pancreatic cancer cells were detected by the Western blot. t test, one-way analysis of variance, and SNK-q test were used for the statistical analysis. Results　The clonal formation rate, invasion number, and migration distance of the PANC-1 cells in the MEG3 group were lower than those in the blank group and the idle group, and the apoptosis rate of the PANC-1 cells was higher, with statistical difference (F=23.070, 99.390, 23.980, and 265.000; all P<0.05). The protein expressions of TLR4, NF-κB, NF-κBp65, and MyD88 of PANC-1 cells in the MEG3 group and the inhibitor group were lower than those in the blank group and the idle group (all P<0.05). Conclusion　LncRNA-MEG3 can regulate the migration and invasion of PANC-1 cells inhibiting the expression of TLR4/NF-κB gene.

Effect of extended lymph node dissection pancreaticoduodenectomy for patients with pancreatic adenocarcinoma

Li Guangzhou, Wang Honglei, He Yang, Hu Cui, Chen Yanhao

2025, 31(8):  1327-1331.  DOI: 10.3760/cma.j.cn441417-20241113-08020

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Objective　To investigate the effect of extended lymph node dissection pancreaticoduodenectomy  (PD) for patients with pancreatic adenocarcinoma. Methods　Seventy-eight patients with pancreatic adenocarcinoma treated in Nanyang Second People's Hospital from January 2020 to December 2023 were selected for the randomized controlled trial, and were divided into an extended dissection group and a standard dissection group by the random number table method, with 39 cases in each group. There were 22 males and 17 females in the expanded dissection group; they were (59.85±3.26) years old; their body mass index was (22.71±1.08) kg/m²; the maximum tumor diameter was (3.38±1.01) cm. There were 24 males and 15 females in the standard dissection group; they were (60.05±3.34) years old; their body mass index was (22.78±1.12) kg/m²; the maximum tumor diameter was (3.40±0.97) cm. Both groups were treated with PD; the standard dissection group took standard lymph node dissection, and the extended dissection group extended lymph node dissection. The intraoperative indicators (operation time, intraoperative bleeding volume, intraoperative blood transfusion volume, total number of lymph node dissection, and number of positive lymph node dissection), postoperative recovery indicators (time to get out of bed, time for first liquid diet, time to drainage tube extraction, and hospital stay), incidence rates of complications, lymph node metastasis rates, in situ recurrence rates, and survival rates were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The operation time, intraoperative bleeding volume, intraoperative blood transfusion volume, total number of lymph node dissection, and number of positive lymph node dissection in the extended dissection group were (401.36±38.90) min, (293.66±31.68) ml, (145.89±22.17) ml, 24.41±4.33, and 13.69±2.12; those in the standard dissection group were (376.52±33.22) min, (276.85±29.41) ml, (133.34±20.64) ml, 16.98±3.86, and 11.12±2.05; there were statistical differences (all P<0.05). There were no statistical differences in the time to get out of bed, time for first liquid diet, time to drainage tube extraction, hospital stay, total incidence rate of complications, lymph node metastasis rate, in situ recurrence rate, and survival rate between the two groups (all P>0.05). Conclusion　Extended lymph node dissection PD for patients with pancreatic adenocarcinoma can increase the total number of lymph node dissection and the number of positive lymph node dissection, but will increase the surgical trauma and prolong the surgical time, and can not improve the survival rate.

Wengan Tongluo method for patients with compensated hepatitis B cirrhosis

Kong Yanlin, Zhao Xiaoli

2025, 31(8):  1332-1336.  DOI: 10.3760/cma.j.cn441417-20240101-08021

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Objective　To explore the clinical effect of Wengan Tongluo method for patients with compensated hepatitis B cirrhosis. Methods　Seventy-six patients with compensated hepatitis B cirrhosis treated at Tai'an Traditional Chinese Medicine Hospital from August 2022 to July 2024 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 38 cases in each group. The control group was (40.61±4.98) years old; the disease course was (5.61±1.46) years. The observation group was (41.30±5.11) years old; the disease course was (5.85±1.63) years. Both groups were treated with routine liver protection and antiviral therapy; the control group were treated with Wuzhuyu Wengan Decoction, and the observation group with Wuzhuyu Wengan Decoction and umbilical moxibustion. The scores of traditional Chinese medicine syndromes, liver function [aspartate transaminase (AST), alaninetransaminase (ALT), albumin (ALB), and total bilirubin (TBil)], cirrhosis [liver stiffness measurement (LSM)], and hepatic fibrosis indicators [serum laminin (LN), hyaluronicacid (HA), type Ⅳ collagen (Ⅳ-C), and type III precollagen (PCⅢ)] were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　After the treatment, the scores of abdominal distension, fatigue, poor appetite, and pale complexion were lower than those before the treatment in both groups, and the scores in the observation group were lower than those in the control group (all P<0.05); the levels of AST, ALT, ALB, and TBil were better those those before the treatment, and the levels in the observation group were better than those in the control group (all P<0.05); the LSM was lower than that before the treatment in both groups, and the LSM in the observation group was lower than that in the control group (P<0.05); the levels of LN, HA, Ⅳ-C, and PCⅢ were lower than those before the treatment, and the levels in the observation group were lower than those in the control group (all P<0.05). There was no statistical difference in the incidence rate between the control group and the observation group [7.89% (3/38) vs. 2.63% (1/38); correction χ²=0.264; P=0.607]. Conclusion　Wengan Tongluo method for patients with compensated hepatitis B cirrhosis can improve their traditional Chinese symptoms and liver function and reduce their liver stiffness and degree of liver fibrosis, and is safe.

Value of Doppler ultrasound and inflammatory markers in diagnosis of lower limb vascular lesions in patients with type 2 diabetes mellitus

Liu Xueni, Hui Rongrong, Deng Qing

2025, 31(8):  1337-1342.  DOI: 10.3760/cma.j.cn441417-20240829-08022

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Objective　To explore the value of color Doppler ultrasound combined with inflammatory markers in the diagnosis of lower limb vascular lesions in patients with type 2 diabetes mellitus (T2DM). Methods　From January 2019 to January 2024, 185 patients with T2DM and lower limb vascular lesions treated at Yan'an City Traditional Chinese Medicine Hospital were selected as an observation group, and 50 T2DM patients without lower limb vascular lesions a control group. There were 26 males (52.00%) and 24 females (48.00%) in the control group; they were (65.24±3.64) years old; their disease course was (8.53±1.64) years. There were 102 males (55.14%) and 83 females (44.86%) in the observation group; they were (65.57±3.57) years old; their disease course was (8.64±1.35) years. Both groups underwent color Doppler ultrasound examination. The lower limb hemodynamic parameters, the rates of lower limber atherosclerotic plaque formation, plaque locations, and dorsalis pedis arterial stenosis were compared between the two groups. The blood samples from both groups were detected for serum biochemical and inflammatory marker levels. The diagnostic value of Doppler ultrasound parameters and levels of inflammatory markers for lower limb vascular lesions in the patients was assessed using the receiver operating characteristic curve (ROC). χ² and t tests were used for the statistical analysis. Results　The peak flow velocities of the femoral, popliteal, and dorsalis pedis arteries in the observation group were lower than those in the control group [(120.88±0.95) cm/s vs. (135.15±0.88) cm/s, (71.93±0.45) cm/s vs. (79.65±0.31) cm/s, and (33.64±1.11) cm/s vs. (42.42±1.35) cm/s], with statistical differences (t=95.679, 114.122, and 47.300; all P<0.05). The pulsatility indices of the femoral, popliteal, and dorsalis pedis arteries in the observation group were higher than those in the control group (5.56±1.22 vs. 4.59±1.12, 6.31±1.12 vs. 5.54±1.23, and 8.21±1.14 vs. 7.52±1.05), with statistical differences (t=5.073, 4.223, and 3.860; all P<0.05). The stenotic segments of anterior tibial artery, posterior tibial artery, dorsal artery of foot, femoral artery, and femoral artery in the control group was fewer than that in the observation group, and the stenotic degree of dorsal artery of foot was lower, with statistical differences (χ²=44.023 and 165.489; both P<0.05). The levels of low-density lipoprotein cholesterol and glycated hemoglobin in the observation group were higher than those in the control group [(3.55±0.51) mmol/L vs. (2.78±0.47) mmol/L and (8.78±1.12)% vs. (7.57±0.85)%], with statistical differences (t=9.626 and 7.102; both P<0.05). The serum levels of albumin and 25(OH)D in the observation group were lower than those in the control group [(33.21±4.38) g/L vs. (39.34±5.31) g/L and (19.37±3.65) μg/L vs. (25.12±4.38) μg/L], with statistical differences (t=8.377 and 9.456; both P<0.05). The serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNFα), C-reactive protein (CRP), and immunoglobulin (IgA) in the observation group were higher than those in the control group [(140.63±20.14) mg/L vs. (118.65±16.65) mg/L, (25.64±5.11) ng/L vs. (18.32±4.41) ng/L, (9.63±3.65) mg/L vs. (5.97±2.10) mg/L, and (1.12±0.29) g/L vs. (0.55±0.20) g/L], with statistical differences (t=7.087, 9.239, 6.787, and 16.110; all P<0.05). The area under the ROC (AUC) for the diagnosis of lower limb vascular lesions in the patients using color Doppler ultrasound parameters combined with serum levels of low-density lipoprotein cholesterol, albumin, glycated hemoglobin, 25(OH)D, IL-6, (TNFα), (CRP), and IgA was 0.980, with a sensitivity of 99.50%, a specificity of 98.00%, and a Youden index of 0.975. Conclusion　Color Doppler ultrasound combined with inflammatory markers can improve the diagnostic accuracy for lower limb vascular lesions in patients with T2DM, which helps in the early identification and intervention of high-risk patients, improving clinical treatment strategies and their outcomes.

Effect of Qilong Tongluo Decoction combined with acupuncture for patients with diabetic peripheral neuropathy

Liu Yadong, Lei Fang, Qiu Xiaona

2025, 31(8):  1342-1348.  DOI: 10.3760/cma.j.cn441417-20241114-08023

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Objective　To observe the effect of Qilong Tongluo Decoction and acupuncture in the treatment of patients with diabetic peripheral neuropathy (DPN). Methods　A total of 86 patients with DPN treated at Shaanxi Provincial Hospital of Traditional Chinese Medicine from September 2021 to September 2023 were selected for the randomized controlled trial, including 46 males and 40 females. They were 28-75 years old. Their DPN course was 1-10 years. Twenty cases had coronary heart disease, 32 hyperlipidemia, and 8 retinopathy. Their body mass index was 19.68-26.84 kg/m². They were divided into an acupuncture group and an acupuncture-drug group by the random number table method, with 43 cases in each group. Both groups were given symptomatic western medicine treatment. The acupuncture group took acupuncture on the Baliao and Bafeng points. The acupuncture-drug group were given Qilong Tongluo decoction and acupuncture on Baliao and Bafeng points. Both groups were treated for 4 weeks. The numbers of intestinal flora, the relative protein expressions of the kelch-like ECH-associated protein 1 (Keap1)/nuclear factor E2 related factor 2 (Nrf2)/antioxidant response element (ARE) of the mononuclear cell pathway, oxidative stress factors, common carotid artery pressure strain elastic modulus (Ep), nerve conduction, and scores of traditional Chinese medicine symptom were compared between the two groups by t test. Results　After the treatment, the number of the Fusobacterium flora in the acupuncture-drug group was higher than that in the acupuncture group [(10.25±1.20) cfu/g vs. (8.23±1.14) cfu/g; P<0.05], while the number of Bacteroides flora was lower [(7.57±0.61) cfu/g vs. (8.96±0.74) cfu/g; P<0.05]. After the treatment, the relative expressions of Nrf2, ARE, and NAD(P)H:quinone oxidoreductase 1 (NQO1) in the acupuncture-drug group were higher than those in the acupuncture group (1.39±0.31 vs. 1.10±0.28, 0.98±0.14 vs. 0.81±0.11, and 1.73±0.31 vs. 1.42±0.28; all P<0.05); the relative expression of Keap1 in the acupuncture-drug group was lower than that in the acupuncture group (0.43±0.12 vs. 0.59±0.14; P<0.05). After the treatment, the levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) in the acupuncture-drug group were higher than those in the acupuncture group [(85.56±8.65) U/ml vs. (78.41±9.44) U/ml and (278.85±38.96) U/ml vs. (249.56±32.06) U/ml; both P<0.05]; the common carotid artery Ep, score of traditional Chinese medicine symptom, and level of malondialdehyde (MDA) in the acupuncture-drug group were lower than those in the acupuncture group [(115.12±5.98) kPa vs. (124.65±8.75) kPa, 9.44±1.46 vs. 13.25±2.14, and (4.15±0.53) μmol/L vs. (4.82±0.74) μmol/L; all P<0.05]. After the treatment, the sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) of median nerve and common peroneal nerve in the acupuncture-drug group were higher than those in the acupuncture group [(53.47±4.22) m/s vs. (49.58±4.36) m/s, (50.97±3.06) m/s vs. (48.75±3.12) m/s, (52.89±4.26) m/s vs. (50.66±4.01) m/s, and (50.63±3.75) m/s vs. (48.79±3.14) m/s; all P<0.05]. Conclusion　The combination of Qilong Tongluo Decoction and acupuncture for patients with DPN can relieve their symptoms and improve their nerve conduction velocity, which may be related to the regulation of the Keap1/Nrf2/ARE pathway and intestinal flora.

Platelet-derived values in diagnosis and treatment of children with common thrombocytopenia

Fan Chunhui, Yan Bin, Hu Tianxi, Ye Yaping, Tao Linjing, Du Weipeng, Wang Ruijuan

2025, 31(8):  1348-1353.  DOI: 10.3760/cma.j.cn441417-20240407-08024

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Objective　To explore the clinical value of platelet count (PLT), platelet pressure product (PCT), platelet volume distribution width (PDW), platelet mean volume (MPV), and large platelet ratio (P-LCR) in the diagnosis and treatment of common thrombocytopenia in children. Methods　This was a retrospective study. Seventy-six children with immune thrombocytopenia (ITP) treated at Nanyang Central Hospital from December 2021 to January 2024 were selected, including 47 boys and 29 girls; they were 2 (7, 11) years old. Eighty children with leukemia and 75 with aplastic anemia were selected as a case group, including 95 boys and 60 girls; they were 9 (5, 13) years old. In the same period, 182 healthy children with normal physical examination were selected as a control group, including 103 boys and 79 girls; they were 8 (4, 14) years old. The blood routine was detected by the Mindray BC-7500 hematology analyzer. The results of PLT, PCT, PDW, MPV, and P-LCR were collected. The differences in platelet-derived values between the ITP group, the case group, and the control group were analyzed by the t test and Mann-Whitney U test. The Spearman rank correlation was used to analyze the correlation between different platelet-derived values. The diagnostic efficacy of the platelet-derived values for ITP was assessed using the receiver operating characteristic curve (ROC). Results　The PLT and PCT in the ITP group were lower than those in the control group [14.00 (4.25, 41.75)×10⁹/L vs. 308.00 (276.50, 347.25)×10⁹/L and 0.02 (0.01, 0.07)% vs. 0.27(0.24, 0.30)%]; the MPV and P-LCR in the ITP group were higher than those in the control group [11.00 (9.50, 12.70) fl vs. 8.70 (8.20, 9.33) fl and 40.00 (31.00, 50.00)% vs. 16.80 (13.50, 21.50)%]; there were statistical differences (all P<0.001). The PLT, MPV, and PCT in the ITP group were lower than those in the leukemia group or the aplastic anemia group, while the P-LCR was higher (all P<0.001). In the children with ITP, MPV was positively correlated with PCT and P-LCR (r=0.50 and 0.83; both P<0.001), but PCT was not correlated with P-LCR (P>0.05). MPV had high differential diagnostic value for ITP, with an area under the curve of 0.87, a sensitivity of 99.99%, and a specificity of 81.30%; when the maximum of the Jordon index was taken, its cutoff value was 14.05 fl. The combined detection of MPV, PCT, and P-LCR could further improve the differential diagnostic value of ITP (AUC=0.96). After the treatment, the PLT and PCT were higher than those after the treatment [189.00 (118.00, 320.50)×10⁹/L vs. 12.50 (4.00, 34.00)×10⁹/L and 0.20 (0.15, 0.31)% vs. 0.02(0.01, 0.06)%], while the PDW and P-LCR were lower [16.00 (14.65, 16.40) fl vs. 16.50 (15.95, 17.60) fl and 29.85 (22.33, 38.78)% vs. 40.00 (30.85, 50.40)%]; there were statistical differences (all P<0.001). After the treatment, the PDW, MPV, and P-LCR in the ITP group were higher than those in the control group, while the PLT and PCT were lower (all P<0.05). Conclusions　PCT, MPV, and P-LCR differ between children with ITP and bone marrow-associated thrombocytopenia. The combination of the three helps differentially diagnose ITP.

Application of remazolam benzenesulfonate and sufentanil in painless gastroscopy

Tian Dao, Liu Yanxia, Zhang Panshi, Huo Yanlong

2025, 31(8):  1353-1357.  DOI: 10.3760/cma.j.cn441417-20240811-08025

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Objective　To investigate the effect of remazolam benzenesulfonate and sufentanil in painless gastroscopy. Methods　A total of 120 patients who received painless gastroscopy in Shaanxi Honorary Soldiers Rehabilitation Hospital from June to December 2023 were selected, and were divided into an observation group and a control group by the random number table method, with 60 cases in each group. There were 33 males and 27 females in the observation group who were (45.62±14.85) years old. There were 36 males and 24 females in the control group who were (46.15±11.08) years old. The control group were anesthetised with sufentanil and propofol, and the observation group with remazolam benzenesulfonate and sufentanil. The perioperative conditions, the mean arterial pressures (MAP), heart rates (HR), and scores of Mini-mental State Examination (MMSE) at different time points, and the incidence rates of adverse reactions were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　The onset time of anesthesia, recovery time, and time staying in resuscitation room in the observation group were shorter than those in the control group [(1.56±0.41) min vs. (1.99±0.54) min, (4.69±0.85) min vs. (5.77±1.12) min, and (28.77±2.64) min vs. (31.06±3.83) min], with statistical differences (t=4.913, 5.950, and 3.813; all P<0.05). The MAP's and HR's at the beginning and end of the examination in the observation group were higher than those in the control group [(85.94±7.21) mmHg （1 mmHg=0.133kPa） vs. (81.66±6.31) mmHg, (91.25±6.83) mmHg vs. (85.61±6.95) mmHg, (70.11±6.84) times/min vs. (65.47±6.70) times/min, and (78.13±6.18) times/min vs. (74.58±5.69) times/min], with statistical differences (t=3.460, 4.483, 3.754, and 3.273; all P<0.05). The scores of MMSE 10 and 20 min after recovery in the observation group were higher than those in the control group (25.18±2.11 vs. 23.57±1.95 and 27.18±1.63 vs. 26.06±1.77), with statistical differences (t=4.341 and 3.605; both P<0.05). Conclusion　The application of remazolam benzenesulfonate and sufentanil in patients taking painless gastroscopy can maintain the stability of intraoperative hemodynamics and has less effect on postoperative cognitive function.

Clinical characteristics and risk factors of cervical lymph node metastasis in cervical region of papillary thyroid microcarcinoma

Luo Zhenfeng, Zhao Qian, Feng Hui

2025, 31(8):  1358-1363.  DOI: 10.3760/cma.j.cn441417-20241112-08026

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Objective　To analyze the clinical characteristics and risk factors of cervical lymph node metastasis (CLNM) in papillary thyroid microcarcinoma (PTMC). Methods　The clinical data of 237 patients with PTMC treated at Ankang Central Hospital from January 2020 to June 2024 were retrospectively analyzed. There were 34 males and 203 females who were (45.96±6.05) years old. The patients were divided into a CLNM group (83 cases) and a non-CLNM group (154 cases) according to the postoperative pathological results. The clinical characteristics of the two groups were compared, and the risk factors of CLNM in the patients were analyzed by the multivariate logistic regression model. t and χ² tests were used for the statistical analysis. Results　The incidence rate of CLNM in the patients was 35.02% (83/237). The age and proportion of the patients with Hashimoto's thyroiditis in the CLNM group were lower than those in the non-CLNM group [(42.16±5.91) years vs. (47.96±6.13) years and 15.66% (13/83) vs. 27.27% (42/154)]; the proportions of the patients with calcification in tumors, invasion of tumor capsule, and multi-lesions, maximum tumor diameter, tumor aspect ratio, and level of FT4 in the CLNM group were higher than those in the non-CLNM group [34.94% (29/83) vs. 16.23% (25/154), 59.04% (49/83) vs. 25.97% (40/154), 39.76% (33/83) vs. 19.48% (30/154), (7.11±1.72) mm vs. (5.13±1.03) mm, 1.15±0.16 vs. 0.94±0.11, (20.98±2.31) pmol/L vs. (16.67±1.94) pmol/L]; there were statistical differences (all P<0.05). Age, maximum tumor diameter, tumor aspect ratio, multi-lesions, calcification in tumor, invasion of tumor capsule, and level of FT4 were the risk factors of CLNM in the patients (all P<0.05). Conclusions　Patients with PTMC complicated with CLNM have the characteristics of younger age, bigger maximum tumor diameter and aspect ratio, multi-lesions, calcification, invasion of tumor capsule, higher FT4 level, and Hashimoto's thyroiditis. Among them, younger age, bigger maximum tumor diameter and tumor aspect ratio, calcification in tumor, invasion of tumor capsule, multi-lesions, and high FT4 level are the risk factors for PTMC complicated with CLNM.

Value of bone marrow cell morphology combined with hemoglobin/red blood cell distribution width ratio in assessment of failure of CAR-T therapy for diffuse large B-cell lymphoma

Wei Xiaojuan, Li Xinfeng, Guo Tuanmao

2025, 31(8):  1364-1368.  DOI: 10.3760/cma.j.cn441417-20240730-08027

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Objective　To explore the value of bone marrow cell morphology combined with hemoglobin (Hb)/red blood cell distribution width (RDW) ratio in the assessment of treatment failure in patients with diffuse large B-cell lymphoma (DLBCL) undergoing chimeric antigen receptor T-cell (CAR-T) therapy. Methods　Between February 2022 and December 2023, 88 patients with DLBCL treated by CD19 CAR-T cell therapy at Xianyang Central Hospital were selected as the study objects, and were followed up for six months. Based on the follow-up results, the patients were divided into a successful treatment group (39 cases) and a treatment failure group (49 cases). The bone marrow cell morphology and Hb/RDW ratios were compared between the two groups. The receiver operating characteristic curves (ROC) were constructed to evaluate the diagnostic value of bone marrow cell morphology and Hb/RDW ratio for identifying DLBCL CAR-T treatment failure. t and χ² tests were used for the statistical analysis. Results　The proportions of the patients with large cell size (more than twice the normal lymphocyte size), irregular cell morphology, presence of pseudopodia or protrusions, perinuclear pale staining areas in the cytoplasm, irregular cell nuclei, multinucleation, and tumor cell aggregation in the successful treatment group were lower than those in the treatment failure group [35.90% (14/39) vs. 79.59% (39/49), 17.95% (7/39) vs. 75.51% (37/49), 38.46% (15/39) vs. 65.31% (32/49), 5.13% (2/39) vs. 24.49% (12/49), 15.38% (6/39) vs. 81.63% (40/49), 0 vs. 16.33% (8/49), and 0 vs. 24.49% (12/49)], with statistical differences (χ²=17.308, 28.781, 6.289, 6.085, 38.202, 7.004, and 11.059; all P<0.05). The treatment failure group had a lower Hb/RDW ratio than the successful treatment group (0.79±0.18 vs. 1.04±0.21), with a statistical difference (t=6.010; P<0.001). The Kappa values in the assessment of treatment failure in the patients by the bone marrow cell morphology, Hb/RDW ratio, and the combination of both were 0.657, 0.426, and 0.861, respectively. Conclusion　Bone marrow cell morphology combined with Hb/RDW ratio in the assessment of CAR-T treatment failure in patients with DLBCL has potential clinical value. A low Hb/RDW ratio may be an important indicator of CAR-T treatment failure.

Application of serum homocysteine and coagulation function in short-term outcome assessment of patients with acute cerebral infarction

Du Haigang, Cui Han

2025, 31(8):  1369-1372.  DOI: 10.3760/cma.j.cn441417-20240622-08028

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Objective　To evaluate the value of serum homocysteine (Hcy) level and coagulation function indicators in the assessment of short-term outcomes in patients with acute cerebral infarction. Methods　Seventy-eight patients with acute cerebral infarction treated at Laboratory Department, 987th Hospital of Joint Logistics Support Force, People's Liberation Army of China were selected as the study objects. According to the scores of the modified Rankin Scale (mRS) one month after follow-up, the fifty-three patients with mRS scores of ≤2 were including into the good prognosis group, while the 25 patients with mRS scores of >2 the poor prognosis group. The levels of homocysteine (Hcy) and coagulation function [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and plasma fibrinogen (FIB)] were compared between the two groups. The value of serum Hcy level and coagulation function indicators in the short-term outcome assessment of patients with acute cerebral infarction was analyzed using the receiver operating characteristic curve (ROC). Results　There were no statistical differences in gender, age, weight, time from onset to visit, and severity between the good prognosis group and the poor prognosis group (all P>0.05). The Hcy level in the good prognosis group was lower than that in the poor prognosis group [(12.75±1.47) μmol/L vs. (16.96±1.39) μmol/L], with a statistical difference (t=12.009, P<0.001). The PT, APTT, and TT in the good prognosis group were shorter than those in the poor prognosis group [(12.31±1.86) s vs. (10.07±1.71) s, (36.32±4.71) s vs. (28.73±3.09) s, and (18.48±1.95) s vs. (11.27±1.26)s], with statistical differences (t=5.247, 8.483, and 19.605; all P<0.001). The FIB level in the good prognosis group was lower than that in the poor prognosis group [(2.99±0.34) g/L vs. (4.31±0.48) g/L], with a statistical difference (t=12.364; P<0.001). The sensitivity and specificity of serum Hcy and coagulation function in the short-term outcome assessment of acute cerebral infarction were 92.0% and 94.3%, respectively, both higher than any single test. The area under ROC (AUC) was 0.977, higher than the AUC's of Hcy (0.880), PT (0.802), APTT (0.863), TT (0.908), and FIB (0.889). Conclusion　In patients with acute cerebral infarction, the levels of Hcy and coagulation function indicators are closely related to their short-term prognosis and can be used as effective predictive factors. The combined testing shows higher sensitivity and specificity in the assessment of their short-term outcomes.

Experience Exchange

Practice and effectiveness of Huizhou City's Tuberculosis Prevention and Control Mobile Integrated Management System for tuberculosis prevention and control

Tang Huanwen, Wen Wenpei, Liu Zhidong, Chen Hao, Li Xiaofen

2025, 31(8):  1373-1376.  DOI: 10.3760/cma.j.cn441417-20241202-08029

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In order to improve the efficiency of information transmission, service capacity, and work quality of tuberculosis prevention and control, the Huizhou Institute of Tuberculosis Prevention and Treatment independently designed, developed, and promoted the application of the Tuberculosis Prevention and Control Mobile Integrated Management System. After more than 10 years' practical application and improvement, the basic realization of information sharing between tuberculosis prevention and control institutions, comprehensive medical, primary health care institutions, and educational institutions has been achieved, effectively assisting the tuberculosis prevention and control work in Huizhou City. The medical and preventive cooperation has become more close and efficient, providing patients and the public with richer and more effective service models and content.

Nursing Research

Wrist ankle acupuncture combined with moist burn ointment for patients with postoperative pain in hemorrhoids

Xiong Chunyan

2025, 31(8):  1377-1372.  DOI: 10.3760/cma.j.cn441417-20240822-08030

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Objective　To evaluate the clinical effect of wrist ankle acupuncture combined with moist burn ointment in the treatment of patients with postoperative pain in hemorrhoids. Methods　A prospective study was conducted on 60 patients who underwent mixed hemorrhoid surgery in Department of Gastrointestinal, Vascular, and Colorectal Surgery, Jiangxi Integrated Traditional Chinese and Western Medicine Hospital from July 2023 to July 2024. They were divided into a control group and an observation group by the random number table method, with 30 cases in each group. There were 12 males and 18 females in the control group; they were (44.39±3.58) years old; their disease course was (3.14±0.53) years. There were 11 males and 19 females in the observation group; they were (44.45±3.63) years old; their disease course was (3.17±0.59) years. The control group were treated with moist burn ointment, and the observation group with moist burn ointment and wrist ankle acupuncture. The clinical efficacies, pain degrees [Visual Analogue Scale (VAS)], and wound and urination status were compared between the two groups by t and χ² tests. Results　The total effective rate of the observation group was higher than that of the control group [93.33% (28/30) vs. 73.33% (22/30)], with a statistical difference (χ²=4.320; P=0.038). There was no statistical difference in the score of VAS between the two groups on the day after the surgery (P>0.05); 1, 2, 3, 5, and 7 d after the surgery, the scores of VAS in the observation group were lower than those in the control group (3.59±0.46 vs. 4.43±0.58, 3.12±0.42 vs. 3.99±0.55, 2.69±0.38 vs. 3.26±0.42, 2.09±0.31 vs. 2.86±0.39, and 1.57±0.23 vs. 2.42±0.36), with statistical differences (t=6.215, 6.886, 5.512, 8.466, and 10.898; all P<0.05). The wound healing time and recovery time in the observation group were shorter than those in the control group [(15.45±1.24) d vs. (17.86±1.70) d and (6.56±0.72) h vs. (8.33±0.79) h]; the score of wound margin edema and residual urine output in the observation group were lower than those in the control group [1.12±0.20 vs. 1.89±0.23 and (125.42±5.10) ml vs. (141.73±8.77) ml]; the urine output in the observation group was higher than that in the control group [(594.02±19.81) ml vs. (562.49±15.22) ml]; there were statistical differences (t=6.273, 9.070, 13.837, 8.806, and 6.913; all P<0.05). Conclusion　The combination of wrist ankle acupuncture and moist burn ointment is effective in treating patients with mixed hemorrhoids after surgery, and can reduce their pain, promote their wound healing, and improve their urinary function.

Influence of CICARE communication mode combined with structural psychological intervention on patients with acute pancreatitis

Wang Shaoqiu, Huang Yao, Wang Huan

2025, 31(8):  1381-1385.  DOI: 10.3760/cma.j.cn441417-20241109-08031

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Objective　To observe the effects of CICARE communication mode combined with structural psychological intervention on self-efficacy and self-care ability in patients with acute pancreatitis (AP). Methods　Ninety patients with AP treated at Affiliated Hospital of Jiujiang University from February 2023 to 2 February 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 45 cases in each group. There were 27 males and 18 females in the control group; they were (45.37±3.25) years old. There were 25 males and 20 females in the observation group; they were (46.02±3.28) years old. The control group took routine nursing; in addition, the observation group received the CICARE communication mode and structural psychological intervention. The self-efficacies [General Self-Efficacy Scale (GSES)], self-care ability [Self-Care Scale (ESCA], physical health status [Acute Physiology and Chronic Health Score Assessment (APACHEⅡ)], symptom improvement times, and hospital stays were compared between the two groups by t and χ² tests. Results　Before the intervention, there were no statistical differences in self-efficacy, self-care ability, and physical health status between the two groups (all P>0.05). After the intervention, the scores of GSES, ESCA, and APACHEⅡ in the observation group were better than those in the control group (31.25±5.43 vs. 27.62±4.37, 147.48±7.49 vs. 133.62±6.48, and 10.58±1.38 vs. 12.34±2.54); the times for the disappearance of fever and abdominal pain and hospital stay in the observation group were shorter than those in the control group [(2.86±0.64) d vs. (4.25±0.85) d, (4.26±0.74) d vs. (5.15±0.97) d, and (15.42±0.86) d vs. (18.67±1.25) d]; there were statistical differences (t=3.494, 9.388, 4.084, 8.764, 4.894, and 14.369; all P<0.05). Conclusion　CICARE communication mode combined with structural psychological intervention for patients with AP can improve their self-efficacy and self-care ability, and health status of physical disease, promote their recovery, and shorten the disappearance of symptoms and hospitalization time.

Psychological resilience theory intervention in prevention of posttraumatic stress disorder in mothers of preterm infants

Li Xue, Cheng Xianghong

2025, 31(8):  1385-1389.  DOI: 10.3760/cma.j.cn441417-20241011-08032

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Objective　To analyze the effect of psychological resilience theory intervention in the prevention of post-traumatic stress disorder (PTSD) in mothers of preterm infants. Methods　This was a prospective study. One hundred and twenty mothers of preterm infants treated at Henan Provincial People's Hospital from February 2022 to February 2024 were selected as the research objects, and were divided into a control group and an experimental group by the random number table method, with 60 cases in each group. The control group were (28.34±3.52) years old and were (30.12±5.26) weeks pregnant when they delivered. The experimental group were (28.76±3.16) years old and were (30.58±5.02) weeks pregnant when they delivered. The control group took routine nursing, and the experimental group took routine nursing and psychological resilience theoretical intervention. Follow-up was conducted one month later. The psychological resilience Scale (CD-RISC), PTSD Scale (PCL-C), Social Support Rating Scale (SSRS), and Symptom Self-Rating Scale (SCL-90) were used to evaluate their mental resilience, PTSD symptom severity, social support, and mental health. t test was used for the statistical analysis. Results　Seventeen cases (28.3%) had PTSD in the control group, and 16 cases (26.7%) in the experimental group. The total scores of CD-RISC, SSRS, PCL-C, and SCL-90 in the experimental group were better than those in the control group (56.47±6.82 vs. 49.41±6.74, 30.56±2.31 vs. 26.41±2.67, 42.86±5.14 vs. 49.89±5.23, and 14.38±2.68 vs. 16.15±2.74), with statistical differences (t=5.703, 9.105, 7.426, and 3.577; all P<0.05). Conclusion　Psychological resilience theory intervention can effectively improve the psychological resilience of mothers of preterm infants, reduce the risk of postpartum PTSD, and improve their social support and mental health.

Application effect of personalized nursing in patients with acute cerebral infarction treated with butylphenylene peptide

Zhang Yali, Kou Jing, Liu Xue, Cao Hongmei, Pang Haiyan, Zhou Zhen

2025, 31(8):  1390-1394.  DOI: 10.3760/cma.j.cn441417-20241107-08033

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Objective　To analyze the application effect of in patients with acute cerebral infarction treated with butylphenylene peptide. Methods　Nine-six patients with acute cerebral infarction treated at Shangqiu First People's Hospital from June 2022 to May 2023 were selected for the retrospective study. According to the nursing methods, the patients were divided into a reference group and an experimental group, with 48 cases in each group. There were 25 males and 23 females in the reference group; they were (62.58±8.14) years old; the onset time was (4.12±1.21) h. There were 27 males and 21 females in the experimental group; they were (62.51±8.23) years old; the onset time was (4.09±1.23) h. Both groups were treated with butylphenylene peptide. The reference group took routine care. The experimental group took personalized care, including psychological care, rehabilitation care, dietary guidance, medication care, and health education. The drug therapy and nursing intervention lasted for 14 d in both groups. The scores of National Institutes of Health Stroke Scale (NIHSS) and Simple Mental status Checklist (MMSE), intracranial arterial hemodynamics, and quality of life before and after the intervention and nursing satisfaction were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　After the intervention, the scores of NIHSS and MMSE in the experimental group were better than those in the reference group (13.05±1.12 vs. 19.49±1.73 and 26.05±2.32 vs. 20.01±1.92), with statistical differences (both P<0.05). The vascular pulsation index (PI), vascular resistance index (RI) systolic peak blood flow velocity (PSV), and end-diastolic blood flow velocity (EDV) in the experimental group were lower than those in the reference group [(1.35±0.12)% vs. (1.49±0.23)%, (0.95±0.11)% vs. (1.04±0.15)%, (87.72±6.23) cm/s vs. (79.80±5.81) cm/s, and (22.02±2.23) cm/s vs. (19.76±2.61) cm/s, with statistical differences (all P<0.05). The scores of physiological function, physiological function, physical pain, general health, vitality, social function, emotional function, and mental health in the experimental groups were higher than those in the reference group (78.01±4.26 vs. 71.46±4.34, 80.02±4.23 vs. 73.41±4.36, 85.37±4.29 vs. 77.42±4.45, 83.61±4.25 vs. 76.51±4.31, 84.01±4.21 vs. 75.72±4.31, 85.91±4.21 vs. 74.65±4.31, 86.08±4.22 vs. 76.35±4.52, and 88.05±4.52 vs. 77.10±4.41), with statistical differences (all P<0.05). The nursing satisfaction of the experimental group was higher than that of the reference group [95.83% (46/48) vs. 77.08% (37/48)], with a statistical difference (P<0.05). Conclusion　Personalized nursing intervention for patients with acute cerebral infarction treated with butylphenylene peptide can not only improve their neurological function and cognitive function, but also optimize their intracranial arterial hemodynamics and improve their quality of life and satisfaction with nursing services.

Application of rehabilitation nursing combined with mindfulness therapy in patients with cerebral infarction

He Chen, Zhang Yalan, Zhang Ying

2025, 31(8):  1395-1398.  DOI: 10.3760/cma.j.cn441417-20241107-08034

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Objective　To analyze the effect of rehabilitation nursing based on their needs combined with mindfulness therapy for patients with cerebral infarction. Methods　A total of 110 patients with cerebral infarction treated at First People's Hospital of Jiujiang City from February 2022 to March 2024 were included into the prospective study. They were divided into a control group and an observation group by the random number table method, with 55 cases in each group. There were 25 males and 30 females in the control group; they were (61.90±6.05) years old. There were 28 males and 27 females in the control group; they were (61.35±5.17) years old. The control group took routine care. The observation group took rehabilitation nursing based on their needs combined with mindfulness therapy. Both groups were intervened for 1 month. The mental health [Symptom Checklist 90 (SCL-90)], limb function [Fugl-Meyer Scale (FMA)], and life ability [modified Babbitt Index (MBI)] were compared between the two groups before and after the intervention by χ² and t tests. Results　After the intervention, the scores of SCL-90, FMA, and MBI in the observation group were better than those in the control group (97.85±9.36 vs. 157.91±14.96, 75.59±6.94 vs. 68.79±7.15, and 74.44±6.94 vs. 67.37±6.55), with statistical differences (all P<0.05). Conclusion　The application of rehabilitation nursing based on their needs combined with mindfulness therapy in patients with cerebral infarction can improve their mental health, limb function, and movement ability.

Application of an internet-based follow-up system in continuous nursing for patients with acute cerebral infarction

Xie Dongmei, Ke Yang, Wei Xiaoquan, Liang Jinghong, Lyu Yuanyuan, Yu Qingshu

2025, 31(8):  1399-1403.  DOI: 10.3760/cma.j.cn441417-20240912-08035

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Objective　To explore the effect for applying internet-based follow-up system in continuous nursing for patients with acute cerebral infarction. Methods　One hundred and four patients with acute cerebral infarction treated at Department of Neurology, Liuzhou Workers Hospital from July 2020 to October 2021 were selected for the prospective study, and were divided into an observation group and a control group by the random number table method, with 52 cases in each group. There were 36 males and 16 females in the control group; they were (59.56±9.34) years old. There were 37 males and 15 females in the observation group; they were (59.27±9.88) years old. The control group was followed up and recorded based on the discharge information extracted from the hospital information management system (HIS), while the observation group received comprehensive and personalized health follow-up guidance through the internet-based follow-up system for the enrolled individuals. Both groups were intervened for 3 months. The scores of the modified Rankin scale (MRS), satisfaction, lifestyle conditions, return visits, and medication compliance were compared between the two groups. The statistical methods employed included the non-parametric Z test, χ² test, and Fisher's precision probability test. Results　After three months' intervention, the score of MRS in the observation group was lower than that in the control group [1 (0, 1) vs. 1 (1, 2)], with a statistical difference (Z=-1.980; P=0.048). The satisfaction rate, regular exercise rate, medication compliance rate, and outpatient return visit rate in the observation group were higher than those in the control group [92.31% (48/52) vs. 71.15% (37/52), 76.92% (40/52) vs. 46.15% (24/52), 98.08%(51/52) vs. 84.62%(44/52), and 94.23% (49/52) vs. 80.00% (40/52)], with statistical differences (all P<0.05). The smoking rate in the observation group was lower than that in the control group [11.54% (6/52) vs. 26.92% (14/52)], with a statistical difference (χ²=3.962; P=0.047). There were no statistical differences in the alcohol consumption and recurrence rate between the two groups (both P>0.05). Conclusion　The internet-based follow-up system can not only address patients' health needs reducing the smoking rate and promoting regular exercise, but also enhance patient satisfaction with return visits and medication compliance and improve their prognosis.

Effect of FMEA rehabilitation nursing for patients with coronary heart disease and diabetes mellitus during perioperative period of PCI 

Zhang Qiuping, Liu Xinqiong, Ren Qian, Yang Miao

2025, 31(8):  1404-1408.  DOI: 10.3760/cma.j.cn441417-20240919-08036

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Objective　To explore the intervention effect of rehabilitation nursing of failure mode and effect analysis (FMEA) for patients with coronary heart disease and diabetes mellitus during perioperative period of percutaneous coronary intervention (PCI). Methods　This was a retrospective study. One hundred and fifty patients with coronary heart disease and diabetes mellitus during perioperative period of PCI treated at Tongchuan People's Hospital from January 2021 to December 2023 were selected as the study objects. The 75 patients taking routine nursing care from January 2021 to June 2022 were set as a control group, and the 75 patients taking FMEA rehabilitation nursing from July 2022 to December 2023 an observation group. There were 45 males and 30 females in the control group; they were (55.07±3.06) years old; their disease course was (1.36±0.81) years. There were 46 males and 29 females in the observation group; they were (55.12±3.14) years old; their disease course was (1.28±0.75) years. The blood pressures, blood glucose levels, and scores of life quality (physical function, role function, emotion function, and social function) before and 3 months after the intervention and incidence rate of the complications were compared between the two groups by t and χ² tests. Results　Three months after the intervention, the systolic and diastolic blood pressures, fasting blood glucose, and 2 h postprandial blood glucose in the observation group were lower than those in the observation group [(134.12±5.31) mmHg (1 mmHg=0.133 kPa) vs. (136.11±6.31) mmHg, (92.22±4.12) mmHg vs. (94.25±4.22) mmHg, (4.53±0.70) mmol/L vs. (4.89±0.87) mmol/L, and (7.31±1.13) mmol/L vs. (7.89±1.42) mmol/L], with statistical differences (all P<0.05); the scores of physical function, role function, emotion function, and social function in the observation group were higher than those in the control group (17.52±2.05 vs. 16.16±2.83, 17.36±1.91 vs. 16.39±2.27, 16.27±2.50 vs. 14.98±2.28, and 16.81±2.13 vs. 15.74±1.74), with statistical differences (all P<0.05). The incidence rate of complications in the observation group was lower than that in the control group, with a statistical difference [3.99% (3/75) vs. 13.30% (9/75)] (χ²=4.172; P=0.042). Conclusion　FMEA rehabilitation nursing for patients with coronary heart disease and diabetes mellitus during perioperative period of PCI can improve their blood pressures, blood glucose, and life quality and reduce their complications.