Table of Content

15 August 2025, Volume 31 Issue 16

Previous Issue   

Special Collumn of Gynecology and Obstetrics

Investigation of mechanism of Guishen pills in treatment of thin endometrium based on PI3K/AKT signaling pathway

Qiu Chao, Liu Yan, Guan Yongge, Song Yang

2025, 31(16):  2641-2646.  DOI: 10.3760/cma.j.cn441417-20241021-16001

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Objective　To explore the mechanism of aqueous extract of Guishen pills in the treatment of thin endometrium, and its relationship with the phos-phatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway. Methods　The study was from September 2017 to December 2019. The bone marrow mesenchymal stem cells (BMSCs) were taken from 3 weeks old SD rats (3 rats, each weighs approximately 50 grams) to prepare primary cell models. The aqueous extract of Guishen pills was used for in vitro induction. The relative expression levels of phosphatidylinositol 3-kinase (PI3K), protein kinase B (AKT), phosphorylated PI3K (p-PI3K), and phosphorylated AKT (p-AKT) in each group were detected by Western blotting. The expressions of leukocyte inhibition factor (LIF) and vascular endothelial growth factor (VEGF) were detected by the immunofluorescence method. The expression of integrin αvβ3 (ITGαvβ3) in the serum of BMSCs in each group was detected by enzyme linked immunosorbent assay. One-way analysis of variance and rank sum test were used for the statistical analysis. Results　The expressions of PI3K, p-PI3K, AKT, and p-AKT proteins in the aqueous extract intervention group were higher than those in the blank control group and the estrogen group (0.69±0.03 vs. 0.56±0.02 vs. 0.56±0.05, 0.55±0.01 vs. 0.43±0.04 vs. 0.45±0.02, 0.52±0.06 vs. 0.42±0.00 vs. 0.35±0.02, and 0.32±0.05 vs. 0.26±0.02 vs. 0.18±0.01; all P<0.05). No expression of LIF and VEGF proteins was observed in the blank control group. Both the estrogen group and the Guishen pill group showed expression of LIF and VEGF, and the expression levels in the Guishen pill group were higher than those in the estrogen group. There was no statistical difference in the expression level of ITGαvβ3 between the groups (P>0.05). Conclusions　Both Guishen pills and estrogen in the treatment of thin endometrium may be by regulating the PI3K/AKT signaling pathway, promoting angiogenesis factors, and improve the endometrial lining. The induction action of aqueous extract of Guishen pills is better than estrogen.

Value of serum MIP-3α combined with GATA3 in evaluation of premature rupture of membranes complicated with intrauterine infection in pregnant women

Wang Ximei, Jian Tingting, Tong Xiaoling, Luan Lixia

2025, 31(16):  2647-2651.  DOI: 10.3760/cma.j.cn441417-20240913-16002

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Objective　To evaluate the value of serum macrophage inflammatory protein-3α (MIP-3α) combined with GATA binding protein 3 (GATA3) in the evaluation of premature rupture of membranes complicated with intrauterine infection in pregnant women. Methods　One hundred and twenty-two pregnant women with premature rupture of membranes treated at Xi'an International Medical Center Hospital from January 2021 to January 2023 were selected as the study objects. Among them, 35 patients who developed intrauterine infection were set as an observation group, while the rest 86 patients who did not develop intrauterine infection a control group. The clinical data of all the pregnant women were collected. The serum levels of inflammatory factors [C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6)], MIP-3α, and GATA3 in the pregnant women were measured before delivery. The independent-sample t test and χ² test were used for the statistical analysis. The logistic regression analysis was used to explore the risk factors of intrauterine infection in the women. The diagnostic efficacy of combined detection of MIP-3α and GATA3 in the prediction of intrauterine infection was evaluated using receiver operating characteristic curves (ROC). Results　The serum levels of CRP, PCT, IL-6, MIP-3α, and GATA3 before delivery in the observation group were (20.23±3.41) mg/L, (10.15±2.03) μg/L, (8.31±2.76) μg/L, (47.02±6.13) ng/L, and (263.41±28.61) μg/L, and the levels in the control group (11.13±3.12) mg/L, (5.97±1.34) μg/L, (4.89±1.03) μg/L, (25.63±4.20) ng/L, and (301.39±32.28) μg/L, with statistical differences between the two groups (all P<0.05). The multivariate analysis indicated that MIP-3α and GATA-3 were independent influencing factors for the occurrence of intrauterine infection (both P<0.05). The ROC results showed that the combined detection of MIP-3α and GATA-3 had a predictive accuracy of 0.963 for intrauterine infection. Conclusions　Increased levels of serum MIP-3α and GATA3 in pregnant women with premature rupture of membranes may increase the risk of intrauterine infections. The combination of these biomarkers can improve the accuracy for predicting such infections.

Relationship between GPR124 expression in placental tissue and spiral artery recast in preeclampsia patients and clinical study

Yao Tingting, Fan Xiaobin, Cao Yangyang

2025, 31(16):  2652-2657.  DOI: 10.3760/cma.j.cn441417-20240912-16003

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Objective　To investigate the relationship between the expression of G protein-coupled receptor 124 (GPR124) in placental tissue and the level of spiral artery recast in patients with preeclampsia (PE) and its clinical significance. Methods　A total of 96 patients with PE treated at Xi'an Third Hospital from January 2021 to December 2023 were selected as a PE group; they were (33.12±5.07) years old; their body mass index was (27.86±2.34) kg/m²; their gestational week at delivery was (37.85±1.18) weeks; their gestational times was 2.31±0.52; their delivery times was 1.52±0.34. Another 50 healthy full-term pregnant women during the same period were selected as the controls; they were (32.28±2.87) years old; their body mass index was (28.02±2.45) kg/m²; their gestational week at delivery was (38.13±1.12) weeks; their gestational times was 2.28±0.60; their delivery times was 1.46±0.29. The patients were divided into a mild PE group and a severe PE group according to the PE severity. The placental tissues were collected from all the subjects to detect GPR124 mRNA and protein expressions, placental spiral artery wall thickness, lumen area, and levels of angiogenic factors [angiopoietin-2 (Ang2), vascular endothelial growth factor (VEGF), and placental growth factor (PLGF)] and inflammatory cytokines [interleukin (IL) -6, IL-10, IL-1β, and tumor necrosis factor-α (TNF-α)]. Spearman or Pearson were used to analyzed the correlation of GPR124 expression with placental spiral artery recast, angiogenesis factors, inflammatory factors, and clinical features in the patients with PE. The differences between the groups were compared by t test, LSD test and analysis of variance. Results　The relative expression and protein level of GPR124 in the placental tissue in the severe PE group were 0.42±0.07 and 0.26±0.03, those in the mild PE group 0.51±0.11 and 0.34±0.05, and those in the control group 1.02±0.03 and 0.47±0.06, with statistical differences between the 3 groups (both P<0.05). The placental spiral tube wall thicknesses in the mild PE group and the severe PE group were thicker than that in control group, and the lumen area and mRNA expression levels of Ang2, VEGF, and PLGF were lower (all P<0.05). The levels of IL-6, IL-1β, and TNF-α in the mild PE group and the severe PE group were higher than those in the control group, while the level of IL-10 was lower (all P<0.05). With the aggravation of PE, the expression of GPR124, the thickness of placental spiral tube wall, the lumen area, and the levels of angiogenic factors and inflammatory cytokines gradually decreased or increased (all P<0.05). The expression of GPR124 in PE placenta tissue was negatively correlated with the thickness of placental spiral artery wall and the levels of IL-6, IL-1β, and TNF-α (r=-0.631, -0.562, -0.529, and -0.537; all P<0.05), and was positively correlated with the lumen area of spiral artery and the levels of Ang2, VEGF, PLGF, and IL-10 (r=0.705, 0.629, 0.604, 0.597, and 0.548; all P<0.05). The expression of GPR124 was negatively correlated with the severity of disease, 24 h urine protein, and diastolic and systolic blood pressures at admission (r=-0.605, -0.527, -0.554, and -0.512; all P<0.05). Conclusion　The low expression of GPR124 in placental tissue is closely related to the severity of PE, placental spiral artery recast, placental angiogenesis, and inflammatory response, which can provide certain guidance for the diagnosis and disease evaluation of PE.

Risk prediction of early pelvic organ prolapse in primiparas undergoing vaginal delivery

Yuwen Guolin, Wang Ping, Yang Jinjun, Zhao Ruixin, Li Xina

2025, 31(16):  2657-2662.  DOI: 10.3760/cma.j.cn441417-20250221-16004

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Objective　To construct a risk prediction model for early pelvic organ prolapse (POP) in primiparas undergoing vaginal delivery based on pelvic floor ultrasound parameters and clinical data. Methods　The clinical data of 129 primiparas who underwent vaginal delivery in Xianyang First People's Hospital from February 2021 to August 2024 were retrospectively analyzed. They were (28.11±3.77) years old and (38.41±1.82) weeks pregnant when they delivered. All the primiparas underwent three-dimensional ultrasound examination on the pelvic floor. According to the occurrence of early POP, they were divided into a prolapse group (32 cases) and a non-prolapse group (97 cases). The pelvic floor ultrasound parameters and clinical data were compared between the two groups. The influencing factors of early POP in the primiparas were analyzed by the multivariate logistic regression analysis. A nomogram model was drawn by the R3.4.3 software package, and the nomogram model was verified by the Bootstrap method. The calibration curve and receiver operating characteristic curve (ROC) were drawn to evaluate the calibration and prediction efficiency of the nomogram model. The independent sample t and χ² tests were used as the statistical methods. Results　The posterior vesicourethral angle, anteroposterior diameter of levator hiatus, and area of levator hiatus under Valsalva maneuver in the prolapse group were higher than those in the non-prolapse group (all P<0.05). The proportions of the women with gestational age > 37 weeks at delivery, perineal tear, lateral episiotomy, and neonatal birth weight > 4 kg in the prolapse group were higher than those in the non-prolapse group (all P<0.05). The multivariate logistic regression analysis results showed that the high posterior vesicourethral angle, anteroposterior diameter of levator hiatus, and area of levator hiatus, gestational age > 37 weeks at delivery, perineal tear, lateral episiotomy, and neonatal birth weight > 4 kg were all risk factors for early POP in the primiparas undergoing vaginal delivery (all P<0.05). The consistency index (C-index) of the nomogram model constructed based on the above factors verified by the Bootstrap method was 0.860, and the calibration curve was in good agreement with the ideal curve. The ROC results showed that the area under the curve (AUC), sensitivity, and specificity of this model for predicting early POP in the primiparas were 0.890, 90.62%, and 85.57%, respectively. Conclusions　Pelvic floor ultrasound parameters, such as posterior vesicourethral angle, anteroposterior diameter of levator hiatus, and area of levator hiatus, gestational age > 37 weeks at delivery, perineal tear, lateral episiotomy, and neonatal birth weight > 4 kg are all risk factors for early POP in primiparas undergoing vaginal delivery. The risk prediction model constructed based on these factors has good clinical application value.

Influence of aspirin and low molecular weight heparin on uterine artery and umbilical artery blood flow in women with fetal growth restriction

Wang Geli, Li Peiying, Shi Ruijuan, Ren Jianli

2025, 31(16):  2663-2667.  DOI: 10.3760/cma.j.cn441417-20240929-16005

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Objective　To analyze the effects of aspirin and low molecular weight heparin on uterine artery and umbilical artery blood flow and pregnancy outcomes in women with fetal growth restriction (FGR). Methods　This was a prospective study. From May 2021 to May 2023, 104 women diagnosed with FGR at Baoji People's Hospital were selected, and divided into an aspirin combined with low molecular weight heparin group (a combined group) and a low molecular weight heparin alone group (a control group) by the random number table method, with 52 cases in each group. The changes of uterine artery and fetal umbilical artery blood flow [pulsatility index (PI), resistance index (RI), and the ratio of maximum systolic blood flow velocity to end-diastolic blood flow velocity (S/D)] before and after the treatment, the physical health conditions of the newborns at birth (body weight, body length, and respiratory score), and adverse pregnancy outcomes were compared between the two groups by t test and χ² test. Results　After the treatment, the blood flow parameters PI, RI, and S/D of the uterine artery and fetal umbilical artery in the combined group were lower than those before the treatment, and were lower than those in the control group (1.03±0.33 vs. 1.17±0.35, 0.67±0.13 vs. 0.79±0.11, 2.46±0.59 vs. 2.69±0.51, 0.72±0.26 vs. 0.83±0.23, 0.61±0.11 vs. 0.71±0.10, and 2.17±0.43 vs. 2.39±0.37), with statistical differences (all P<0.05). The neonatal weight , length, 1 min Apgar score, and incidence rate of adverse pregnancy outcomes in the combined group were better than those in the control group [(3 182.98±578.94) g vs. (2 836.63±569.13) g, (49.53±2.62) cm vs. (47.25±2.71) cm, 9.28±0.47 vs. 8.71±0.64, 13.46% (7/52) vs. 30.77% (16/52)], with statistical differences (all P<0.05). Conclusion　Aspirin combined with low molecular weight heparin for women with FGR can improve their blood flow parameters and blood circulation, fetal development, and pregnancy outcomes.

Value of three-dimensional ultrasound combined with peripheral blood miR-210 level in diagnosis of early pregnancy fetal growth restriction

Zhang Mengting, Fang Yuan, Wang Li, Wu Yilun

2025, 31(16):  2668-2672.  DOI: 10.3760/cma.j.cn441417-20240812-16006

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Objective　To analyze the value of three-dimensional ultrasound combined with the level of microRNA-210 (miR-210) in maternal peripheral blood in the diagnosis of fetal growth restriction (FGR) in the first trimester of pregnancy. Methods　This was a retrospective study. Fifty-two pregnant women with FGR treated in Xi'an International Medical Center Hospital from January 2021 to December 2023 were selected as an FGR group, and 52 healthy pregnant women during the same period were selected as a control group. Both groups were (31.16±4.66) years old and (12.12±0.74) weeks pregnant. Ultrasound examination was performed on both groups. Their peripheral blood was collected to detect the level of miR-210 by qPCR. The correlations between the indicators and FGR were analyzed. The efficacies of three-dimensional ultrasound, the level of miR-210 in peripheral blood, and the combination were analyzed using the receiver operating characteristic curve (ROC). t χ² tests and Pearson correlation analysis were used for the statistical comparisons. Results　The body length, body weight, head circumference, and body mass index (BMI) of the neonates in the FGR group were lower than those in the control group [(48.17±2.04) cm vs. (50.02±1.85) cm, (2.22±0.35) kg vs. (2.98±0.62) kg, (31.75±1.58) cm vs. (33.95±1.52) cm, and (9.57±1.25) kg/m² vs. (11.91±1.17) kg/m²], with statistical differences (all P<0.05). The resistance index (RI) and miR-210 in of the pregnant women the FGR group were higher than those in the control group (0.71±0.28 vs. 0.56±0.24 and 3.24±1.55 vs. 1.43±0.63), while the placental volume (PV), vascularization index (VI), and flow index (VFI) of the women and crown-rump length (CRL) of the neonates were lower [(0.79±0.38) cm³ vs. (1.03±0.42) cm³, (19.20±9.50)% vs. (26.72±9.69)%, (7.72±2.16)% vs. (9.08±2.35)%, and (60.74±11.28) mm vs. (66.93±12.37) mm], with statistical differences (all P<0.05). The correlation analysis showed that miR-210 was negatively correlated with body length, body weight, head circumference, and BMI (r=-0.320, -0.419, -0.379, and -0.402; all P<0.05), while PV, RI, VI, VFI, and CRL were positively correlated with body length, body weight, head circumference, and BMI weakly (all P>0.05). The ROC analysis showed that the sensitivity of the combined diagnosis was 88.5%; the specificity was 88.5%; the area under the curve (AUC) was 0.943; the Youden index was 0.770. Conclusions　Three-dimensional ultrasound combined with the level of miR-210 in maternal peripheral blood has a high diagnostic value for FGR in the first trimester of pregnancy. It can be used as an effective method for screening FGR in the first trimester of pregnancy, which helps to identify high-risk pregnant women in early stage and provides basis for timely intervention.

A case-control study on influencing factors of fetal outcomes of subclinical hypothyroidism during pregnancy

Wang Bo, Wang Yanxia, Xu Xiaoyan, Zhang Ming, Li Huan

2025, 31(16):  2673-2678.  DOI: 10.3760/cma.j.cn441417-20250115-16007

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Objective　To identify the risk factors of adverse fetal outcomes in pregnant women with subclinical hypothyroidism (SCH) through a case-control approach and to develop a predictive model for risk assessment. Methods　This was a retrospective study. Seventy-one pregnant women with SCH who experienced adverse fetal outcomes during antenatal care and delivery at Northwest Women's and Children's Hospital between September 2021 and September 2024 were selected as a study group. One hundred and forty-two pregnant women with SCH who did not experience adverse fetal outcomes during the same period were selected as a control group. The clinical data were compared between the two groups. The variables with statistical differences were analyzed using the multivariate logistic regression model to identify the independent risk factors of adverse fetal outcomes. χ², t, and Mann-Whitney U tests were used for the statistical comparisons. A predictive model was constructed and evaluated using receiver operating characteristic curves (ROC) for its performance; calibration curves were used to evaluate this model's discrimination. Results　The age, body mass index (BMI) before pregnancy, levels of thyrotropin (TSH) and thyroid peroxidase antibody (TPOAb), and the proportion of the women with gestational anemia in the study group were higher than those in the control group (all P<0.05), and the serum folate level was lower (P<0.05). The multivariate logistic regression model analysis indicated that elder age (OR=2.959, 95%CI 1.491-5.869), high pre-pregnancy BMI (OR=2.142, 95%CI 1.201-3.823), gestational anemia (OR=2.680, 95%CI 1.202-5.976), high TSH (OR=2.811, 95%CI 1.355-5.831), and high TPOAb (OR=3.131, 95%CI 1.554-6.308) were independent risk factors of SCH during pregnancy, while high folate (OR=0.518, 95%CI 0.338-0.792) was a protective factor (all P<0.05). A risk prediction model was constructed. The ROC showed that the area under the curve (AUC) of this model for adverse fetal outcomes of SCH was 0.918 (95%CI 0.873-0.951; Z=19.742; P<0.001), with a sensitivity of 95.77%  and a specificity of 85.92%. The Hosmer-Lemeshow test showed that the predictive probability of adverse fetal outcomes by this model was not statistically different from the actual probability by the calibration curve (χ²=0.715; P=0.398). Conclusions　Elder age, high pre-pregnancy BMI, gestational anemia, high TSH, and high TPOAb are risk factors for adverse fetal outcomes in women with SCH, whereas folate serves as a protective factor. The predictive model constructed by the above factors has good clinical performance, and may provide a quantitative plan for predicting fetal outcomes.

Risk factors of deeply DIE in patients with recurrent ovarian endometriosis

Xiao Lisha, Hu Na, Zhang Aoxue, Lu Meirong

2025, 31(16):  2679-2682.  DOI: 10.3760/cma.j.cn441417-20241112-16008

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Objective　To explore the risk factors of deeply infiltrating endometriosis (DIE) in patients with recurrent ovarian endometriosis (EMT). Methods　A retrospective analysis was conducted on 120 patients with recurrent ovarian EMT treated in Xi'an International Medical Center Hospital from August 2020 to November 2022. The patients were divided into a DIE group (35 cases) and a non-DIE group (85 cases) according to their pathological results. The DIE group were (34.25±4.17) years old, with a disease course of (2.36±0.25) years. The non-DIE group were (33.69±4.55) years old, with a disease course of (2.31±0.27) years. The clinical data were compared between the two groups. Logistic regression was used to analyze the risk factors of DIE in the patients. Results　There were statistical differences in the serum levels of carbohydrate antigen 125 (CA125), serum carbohydrate antigen 199 (CA199), interleukin-8 (IL-8), tumor necrosis factor (TNF-α), and interleukin-6 (IL-6) between the two groups (all P<0.05). The logistic regression analysis showed that severe dysmenorrhea and high serum levels of CA125, CA199, IL-8, TNF-α, and IL-6 were risk factors for recurrent EMT to develop DIE (all P<0.05). Conclusion　It needs to clinically strengthen the detection of severe dysmenorrhea and high serum levels of CA125, CA199, IL-8, TNF-α, and IL-6 in patients with recurrent ovarian EMT, and take timely intervention measures to reduce the risk of DIE.

Expressions of PIVKA-Ⅱ, DKK-4, and lncRNA H19 in ovarian cancer and correlation with ovarian ultrasound blood flow parameters

Zhao Yan, Zhang Tianmei, Jiang Shuyan, Wang Yunqin, Song Xiuqin

2025, 31(16):  2683-2687.  DOI: 10.3760/cma.j.cn441417-20241219-16009

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Objective　To analyze the protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ), Dickkopf-4 (DKK-4), and long-chain noncoding ribonucleic acid H19 (lncRNA H19) in ovarian cancer and their correlation with ovarian ultrasound blood flow parameters. Methods　From April 2019 to January 2024, 95 healthy women who underwent physical examination, 87 patients with benign ovarian tumors, and 80 patients with ovarian cancer were selected from Yantai Yantaishan Hospital as group A, group B, and group C, respectively. Group A were (54.73±6.93) years old; their body mass index was (21.16±0.63) kg/m²; there were 9 cases of hypertension, 7 cases of diabetes, and 7 cases of hyperlipidemia. Group B were (55.49±7.72) years old; their body mass index was (21.09±0.72) kg/m²; there were 7 cases of hypertension, 6 cases of diabetes, and 5 cases of hyperlipidemia. Group C was (54.90 ± 6.84) years old; their body mass index was (20.95±0.68) kg/m²; there were 7 cases of hypertension, 3 cases of diabetes, and 3 cases of hyperlipidemia. The serum levels of PIVKA-Ⅱ, DKK-4, and lncRNA H19 and ovarian ultrasound blood flow parameters were compared between the three groups. The Pearson correlation coefficient was used to analyze the correlation of the serum levels of PIVKA-Ⅱ, DKK-4, and lncRNA H19 with ovarian ultrasound blood flow parameters. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of the three for ovarian cancer. χ² test or rank sum test, one-way analysis of variance, and LSD-t test were used for the statistical analysis. Results　The serum levels of PIVKA-Ⅱ, DKK-4, and lncRNA H19, VM, PSV, and EDV in group C, group B and group A showed a decreasing trend (all P<0.05), while RI and PI showed an increasing trend (both P<0.05). The Pearson correlation coefficient analysis showed that serum PIVKA-Ⅱ, DKK-4, and lncRNA H19 were negatively correlated with ovarian RI and PI (r=-0.649, -0.518, -0.537, -0.519, -0.527, and -0.618; all P<0.05), and positively with VM, PSV, and EDV (r=0.722, 0.509, 0.599, 0.611, 0.694, 0.531, 0.548, 0.704, and 0.605; all P<0.05). The results of ROC analysis showed that the area under the curve of the combination of serum PIVKA-Ⅱ, DKK-4, and lncRNA H19 in the diagnosis of ovarian cancer was higher than that of each one alone (all P<0.05). Conclusions　The occurrence of ovarian cancer can increase the serum levels of PIVKA-Ⅱ, DKK-4, and lncRNA H19, which are correlated with the parameters of ovarian ultrasound blood flow. The combination of the three can effectively improve the diagnostic value of ovarian cancer.

Treatises

Clinical efficacy of Yiqi Zhiqiu Decoction combined with fluticasone propionate nasal spray in treatment of patients with cold-induced allergic rhinitis of lung qi deficiency type

Xue Xiang, Kang Lujiao, Wei Junrong

2025, 31(16):  2688-2692.  DOI: 10.3760/cma.j.cn441417-20241127-16010

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Objective　To investigate the clinical efficacy of Yiqi Zhiqiu Decoction combined with fluticasone propionate nasal spray for patients with cold-induced allergic rhinitis of lung qi deficiency type. Methods　One hundred and fifty-nine patients with cold-induced allergic rhinitis of lung qi deficiency type treated at Shaanxi Provincial Hospital of Traditional Chinese Medicine from April 2022 to April 2024 were selected for the randomized controlled trial, and were divided into a control group (79 cases) and a treatment group (80 cases) by the random number table method. There were 41 males and 38 females in the control group; they were (55.2±6.7) years old; their body mass index (BMI) was (23.5±3.1) kg/m². There were 39 males and 41 females in the treatment group; they were (54.6±6.5) years old; their BMI was (23.8±3.2) kg/m². The control group took fluticasone propionate nasal spray, and the treatment group Yiqi Zhizhou Decoction combined with the nasal spray, for 4 weeks. The main observation indicators included treatment efficacy, traditional Chinese medicine syndrome scores, quality of life, inflammatory factors, immune levels, and adverse reactions. t and χ² tests were taken as the statistical methods. Results　The total effective rate in the treatment group was higher than that in the control group [96.25% (77/80) vs. 78.48% (62/79)], with a statistical difference (P<0.05). After the treatment, the scores of nasal congestion, cough, runny nose, sneezing, sputum, and short breath and fatigue were lower than those before the treatment group in both groups (all P<0.05), and the scores in the treatment group were better than those in the control group (0.58±0.13 vs. 1.31±0.18, 0.47±0.09 vs. 1.46±0.33, 0.62±0.09 vs. 1.76±0.41, 0.48±0.13 vs. 1.99±0.37, 0.53±0.11 vs. 1.27±0.22, and 0.44±0.08 vs. 1.43±0.28; all P<0.05). After the treatment, the scores of nasal, non-nasal, and ocular symptoms and daily activities, the levels of inflammatory factors [interleukin (IL) -6, IL-12, and interferon-γ], and immune levels [immunoglobulin (Ig) A, IgG, and IgE] were lower than those before the treatment in both groups, and those in the treatment group were lower than those in the control group (all P<0.05). Conclusion　Yiqi Zhiqiu Decoction combined with fluticasone propionate nasal spray for patients with cold-induced allergic rhinitis of lung qi deficiency type can improve their clinical symptoms and the treatment efficacy, so it is worth being clinically generalized.

Mechanism of berberine in treating colitis based on network pharmacology

Xue Xuefeng, Liu Wendong, Wang Jiehong

2025, 31(16):  2693-2698.  DOI: 10.3760/cma.j.cn441417-20241125-16011

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Objective　To explore the protective effect and mechanism of berberine on colitis based on network pharmacology and experimental verification. Methods　The data retrieval time for the network pharmacology analysis was June 2023. The databases, such as PharmMapper, SwissTarget Prediction, and Genecards, were used to screen the active ingredients and targets in berberine, and a "disease target compound" network was constructed by the Cytoscape 3.9.1 software. A protein-protein interaction (PPI) network was constructed based on the STRING database to screen the core targets. The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses on common targets were performed using the David database to obtain the potential signaling pathways and to visualize the results. A lipopolysaccharide (LPS) -induced Caco-2 cell model of colon adenocarcinoma cells was established to investigate the efficacy and mechanism of berberine in treating colitis. Results　Through database analysis and sorting, a total of 86 intersecting targets related to drugs and diseases were identified, and the main core targets were JAK3, VEGFR2, ANXA5, and NQO1. The GO and KEGG enrichment analyses results indicated that berberine mainly exerted its therapeutic effect on colitis through the JAK3/STAT1 signaling pathway. Cell experiments have shown that berberine can inhibit the JAK3/STAT1 signaling pathway, suppress the levels of interleukin-1β in Caco-2 cells induced by LPS, and alleviate inflammatory responses. Conclusions　Berberine can reduce LPS-induced inflammatory response in Caco-2 cells inhibiting the JAK3-STAT1 singnaling pathway, enhance intestinal barrier function, and achieve therapeutic effects on colitis.

Changes of AKR1B10 gene level in hepatocellular carcinoma tissue and its clinical significance

Gao Yingfang, Cao Leilei, Pei Tengbo

2025, 31(16):  2698-2702.  DOI: 10.3760/cma.j.cn441417-20240906-16012

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Objective　To investigate the expressions of aldo–keto reductase family 1 member B10 (AKR1B10) mRNA and protein in cancer tissues of patients with hepatocellular carcinoma (HCC) and its clinical significance. Methods　Between June 2021 and June 2023, 102 patients with HCC were selected as the study objects, including 55 males and 47 females. They were (56.9±6.4) years old. Among the 102 patients, there were 44 cases with single lesions and 58 cases with multiple lesions. There were 45 cases of TNM stage Ⅰ, 40 cases of TNM stage Ⅱ, and 17 cases of TNM stage Ⅲ. Forty-one cases had microvascular infiltration (MVI), and the rest 61 cases had no MVI. The expression levels of AKR1B10 mRNA in the HCC and adjacent tissues were compared. According to the pathological features, such as tumor maximum diameter, number of lesions, capsule invasion or not, histological differentiation, MVI status, and lymphatic metastasis, the patients were divided into different subgroups. The expressions of AKR1B10 mRNA and protein were compared between the subgroups. The expressions of AKR1B10 mRNA and protein were compared between the patients with different living conditions. t and χ² tests were used for the statistical analysis. Results　The AKR1B10 mRNA in the HCC tissue was higher than that in adjacent tissue (1.5±0.3 vs. 1.0±0.2; t=5.114; P=0.012). The levels of AKR1B10 mRNA in the patients with tumor maximum diameter ≥ 3 cm, capsule invasion, moderate-low histological differentiation, MVI, and lymphatic metastasis were higher than those in the patients with tumor maximum diameter < 3 cm, no capsule invasion, well differentiation, no MVI, and no lymphatic metastasis, with statistical differences (t=4.551, 4.768, -6.197, 4.183, and 7.844; all P<0.05). Among the 102 patients, 73 cases (71.6%) had high expression of AKR1B10 protein. The positive rates of AKR1B10 protein high expression in the patients with capsule invasion, low and moderate tumor differentiation, MVI, and lymphatic metastasis were higher than those in the patients with no capsule invasion, high differentiation, no MVI, and no lymphatic metastasis, with statistical differences (χ²=5.277, -4.184, 8.882, and 11.998; all P<0.05). The patients were followed up one year; among the 102 patients, 69 cases (67.6%) survived, and 33 cases (32.4%) died. The AKR1B10 mRNA level in the cancer tissue in the survived patients was lower than that in the dead patients (1.3±0.3 vs. 1.7±0.4), with a statistical difference (t=4.568,P=0.032). The positive rates of AKR1B10 protein high-expression in the survived and dead patients were 62.3% (43/69) and 90.9% (30/33), respectively, with a statistical significance (χ²=8.968; P=0.003). Conclusion　The high expression of AKR1B10 mRNA and protein in cancer tissue of HCC patients may be related to the malignant degree of tumor cells, and affect the patients' prognosis.

Role and potential mechanism of RNF31 in regulation of cisplatin resistance in hepatoma cells

Zhai Pengtao, Cheng Yuan, Mu Xudong, Liu Qunyi, Li Mei, Han Pihua

2025, 31(16):  2702-2709.  DOI: 10.3760/cma.j.cn441417-20241114-16013

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Objective　To explore the role and potential mechanism of ringfinger protein 31 (RNF31) in the regulation of cisplatin resistance in hepatoma cells. Methods　The samples of cancer lesion tissues and adjacent normal tissues from 40 patients with liver cancer who underwent surgical treatment in Shaanxi Provincial Cancer Hospital from July 2020 to December 2023, as well as human normal liver cell line IHHA-1, human liver cancer cell line HepG2, and human liver cancer cisplatin-resistant cell line HepG2/DDP, were collected for the study. The expressions of RNF31 in liver cancer tissues, liver cancer cells, and cisplatin-resistant cells were detected by the quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot. The RNF31 over-expressed cell line was constructed. The effects on the proliferation, half maximal inhibitory concentration (IC₅₀), and apoptosis of the HepG2/DDP cells were detected by the cell counting kit-8 (CCK-8) and flow cytometry. The expression levels of E-cadherin, N-cadherin, vimentin, and proteins related to the adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) / mammalian target of rapamycin (mTOR) signaling pathway were detected by the Western blot. t test was used for the statistical analysis. Results　The expression levels of RNF31 mRNA and protein in the liver cancer tissues were lower than those in the adjacent tissues (0.45±0.03 vs. 1.01±0.02 and 0.36±0.03 vs. 1.00±0.02; both P<0.05). The expression levels of RNF31 mRNA and protein in the HepG2 cells (0.49±0.06 and 0.46±0.05) and HepG2/DDP cells (0.30±0.05 and 0.28±0.05) were lower than those in the IHA-1 cells (1.00±0.02 and 1.01±0.02) (all P<0.05). Compared with the control group, the over-expression of RNF31 significantly inhibited the proliferation of the HepG2/DDP cells (1.74±0.23 vs. 1.21±0.15) and the IC₅₀ value (8.01±0.52 vs. 3.53±0.25), and increased the cells' apoptosis rate (5.11±1.34 vs. 23.99±2.06) (all P<0.05). Compared with the control group, the over-expression of RNF31 increased the expression level of E-cadherin protein (1.02±0.03 vs. 2.36±0.18; P<0.05) in the HepG2/DDP cells, and decreased the expression levels of N-cadherin (1.01±0.02 vs. 0.43±0.05; P<0.05) and vimentin (1.01±0.03 vs. 0.32±0.05; P<0.05) proteins. The over-expression of RNF31 significantly reduced the protein expression levels of AMPK (1.02±0.02 vs. 0.42±0.05; P<0.05) and mTOR (1.01±0.02 vs. 0.50±0.06; P<0.05). The over-expression of AMPK significantly reduced the apoptosis rate of the HepG2/DDP cells, and increased the IC₅₀ value, and its regulatory effect could be inhibited by the over-expression of RNF31. Conclusion　RNF31 may reduce cisplatin resistance in hepatoma cells regulating the epithelial-mesenchymal transition mediated by the AMPK-mTOR  singnaling pathway.

Application of cognitive-language dual-task training measures in recovery period of elderly patients with cerebral hemorrhage

Li Fengxia, Zhang Jie, Wang Zhijiang, Li Yaqin, Cheng Shiqing, Cai Li

2025, 31(16):  2709-2714.  DOI: 10.3760/cma.j.cn441417-20250427-16014

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Objective　To explore the effect of cognitive-language dual-task training measures for elderly patients in the recovery period of cerebral hemorrhage. Methods　One hundred and sixty-two elderly patients in the recovery period of cerebral hemorrhage admitted to the Second Affiliated Hospital of Air Force Military Medical University from February 2023 to October 2024 were selected for the randomized controlled trial, and were divided into an observation group (82 cases) and a control group (80 cases) by the random number table method. In the observation group, there were 55 males and 27 females, with an age of (67.29±5.52) years, and a disease duration of (1.54±0.39) months. In the control group, there were 51 males and 29 females, with an age of (66.81±5.35) years, and a disease duration of (1.58±0.25) months. The control group took conventional training, while the observation group adopted the cognitive-language dual-task training program, for 3 months. The scores of Mini-Mental State Assessment Scale (MMSE), Montreal Cognitive Assessment Scale (MoCA), Chinese Standard Aphasia Test (CRRCAE) scale, and Activity of Daily Living Communication Scale (CADL) and levels of nerve growth factor (NGF), neuron-specific enolase (NSE), and brain-derived neurotrophic factor (BDNF) before and 1 and 3 months after the intervention, as well as the patients' satisfaction, were compared between the two groups. The repeated measures equation analysis, χ² test and t test were used for the statistical comparisons. Results　After 1 and 3 months' intervention, the scores of MMSE, MoCA, CRRCAE, and CADL in the observation group were higher than those in the control group (26.32±1.47 vs. 25.57±1.55, 25.51±1.38 vs. 24.74±2.12, 69.21±6.03 vs. 66.67±6.91, 77.53±5.26 vs. 74.87±4.93, 27.74±1.05 vs. 27.15±1.18, 27.39±1.14 vs. 26.89±1.06, 76.84±6.53 vs. 73.69±7.45, and 86.63±5.81 vs. 84.39±5.64), with statistical differences (all P<0.05). After 1 months' intervention, the levels of NGF and BDNF in the observation group were higher than those in the control group [(365.38±25.61) ng/L vs. (355.31±21.04) ng/L and (7.55±1.84) μg/L vs. (6.81±1.60) μg/L], and the level of NSE was lower [(10.54±2.10) μg/L vs. (11.68±2.33)] μg/L; after 3 months' intervention, the levels of NGF and BDNF in the observation group were higher than those in the control group [(472.31±32.64) ng/L vs. (454.04±38.48) ng/L and (8.93±1.65) μg/L vs. (8.22±1.73) μg/L], and the level of NSE was lower [(8.52±1.39) μg/L vs. (9.15±1.61) μg/L]; there were statistical differences (all P<0.05). The total satisfaction of the observation group with the training was higher than that of the control group [91.46% (75/82) vs. 80.00% (64/80)], with a statistical difference (P<0.05). Conclusion　Cognitive-language dual-task training measures for elderly patients in the recovery period of cerebral hemorrhage can promote their recovery of cognitive and language functions and improve their satisfaction.

Value of serum levels of COMP, CTX-Ⅱ, and sVCAM-1 in prediction of prognosis of patients with knee osteoarthritis after joint arthroplasty

Liang Qingfu, Zhang Xiaomin, Bai Jingjing, Jin Zhankui

2025, 31(16):  2714-2719.  DOI: 10.3760/cma.j.cn441417-20250410-16015

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Objective　To investigate the value of serum levels of cartilage oligomeric matrix protein (COMP), C-terminal telopeptide of type Ⅱ collagen (CTX-Ⅱ), and soluble vascular cell adhesion molecule-1 (sVCAM-1) in the prediction of prognosis of patients with knee osteoarthritis (KOA) after joint arthroplasty. Methods　The clinical data of 120 patients with KOA undergoing joint arthroplasty at Xi'an International Medical Center Hospital from January 2023 to August 2024 were retrospectively analyzed. Among them, there were 71 males and 49 females, with an age of (62.55 ± 5.67) years. All the patients were assessed using the Lysholm Knee Score (LKS). Based on the assessment scores 6 months after the surgery, the patients were divided into a good prognosis group (LKS≥70; 92 cases) and a poor prognosis group (LKS <70; 28 cases). The data were collected and compared between the two groups. Receiver operating characteristic (ROC) curves were plotted, and the areas under the curves (AUC) were calculated to evaluate the predictive values of serum COMP, CTX-Ⅱ, and sVCAM-1 levels for postoperative prognosis. Statistical comparisons were conducted using t and χ² tests. Results　There were no statistical differences between the two groups in the terms of gender, age, body mass index, surgical test, American Society of Anesthesiologists (ASA) grade, Association Research Circulation Osseous (ARCO) stage, history of alcohol consumption, history of smoking, diabetes, and hypertension (all P>0.05). The levels of COMP, CTX-Ⅱ, and sVCAM-1 in the good prognosis group were lower than those in the poor prognosis group [(475.81±74.52) ng/L vs. (523.96±74.14) ng/L, (1 005.21±105.99) ng/L vs. (1 070.12±115.67) ng/L, and (43.17±6.59) nmol/L vs. (72.21±6.96) nmol/L], with statistical differences (all P<0.05). The results of logistic regression analysis showed that COMP≥492.51 ng/L, CTX-Ⅱ≥1 040.02 ng/L, and sVCAM-1≥58.41 nmol/L were the independent risk factors affecting the patients' poor prognosis (all P<0.05). The ROC analysis showed that the AUC's of COMP≥492.51 ng/L, CTX-Ⅱ≥1 040.02 ng/L, and sVCAM-1≥58.41 nmol/L in the prediction the patients' prognosis were 0.825, 0.795, and 0.833,  respectively; the AUC of the combination of the three was 0.924, with a sensitivity of 85.84% and a specificity of 86.48%. Conclusions　The serum levels of COMP, CTX-Ⅱ, and sVCAM-1 are valuable for dynamically assessing prognosis of patients with KOA after joint arthroplasty. Their combination may more effectively predict the poor prognosis.

Clinical Research

Efficacy of transfrontal-ethmoidal open endoscopic sinus surgery in treatment of patients with refractory rhinosinusitis

Yang Shuangyuan, Yang Jiangdong, Gao Xudong, Zhong Wei

2025, 31(16):  2720-2724.  DOI: 10.3760/cma.j.cn441417-20250224-16016

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Objective　To compare the postoperative efficacies of functional endoscopic sinus surgery and whole group open endoscopic sinus surgery centered on the frontal and ethmoid regions for patients with refractory sinusitis. Methods　Forty-three patients with refractory sinusitis treated at Gaoxin Branch, the First Affiliated Hospital of Nanchang University from December 2021 to July 2024 were selected as the study objects, including 27 males and 16 females. They were 21-68 years old. There were 23 cases (53.4%) in the experimental group and 20 cases (46.6%) in the control group. The control group took functional endoscopic sinus surgery, and the experimental group whole group open endoscopic sinus surgery centered on the frontal and ethmoid regions. The scores of Sino-nasal Outcome Test-22 (SNOT-22), nasal endoscopic Lund-Kennedy, and Visual Analogue Scale (VAS) before and 2 weeks, 1 month, 3 months, and 6 months after the surgery were compared between the two groups. χ² test, t test, and rank sum test were used for the statistical analysis. Results　The scores of SNOT-22, nasal endoscopic Lund-Kennedy, and VAS were lower after than before the surgery in both groups, with statistical differences (all P<0.05). There were no statistical differences in the scores of SNOT-22, nasal endoscopic Lund-Kennedy, and VAS 2 weeks, 1 month, and 3 months after the surgery between the two groups (all P>0.05). Six months after the surgery, the scores of SNOT-22, nasal endoscopic Lund-Kennedy, and VAS in the experimental group were lower than those in the control group [3.26±4.08 vs. 9.95±8.12, 0 (0, 1.00) vs. 3.00 (2.25, 4.00), and 1.13±2.53 vs. 5.15±4.43], with statistical differences (all P<0.05). Conclusions　Compared with functional endoscopic sinus surgery, whole group open endoscopic sinus surgery centered on the frontal and ethmoid regions for patients with refractory sinusitis is more effective in relieving their sinus inflammation, improving their subjective symptoms, and increasing the postoperative subjective and objective scores.

Relationships of ACA, ARA, and IgG N-glycosylates with diabetic retinopathy

Hu Yahong, Yuan Ye, Li Junqi, Zhang Ning

2025, 31(16):  2725-2728.  DOI: 10.3760/cma.j.cn441417-20240724-16017

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Objective　To explore the relationships of anticardiolipin antibody (ACA), anti-retinal antibody (ARA), and immunoglobulin G (IgG) N-glycosylates with the conditions and development in patients with diabetic retinopathy (DR). Methods　Seventy-five patients with DR treated at the First Affiliated Hospital of Xi'an Jiaotong University from June 2018 to June 2019 were enrolled, including 35 patients with proliferative DR (group Ⅰ) and 40 patients with non-proliferative DR (group Ⅱ). Forty patients with diabetes mellitus and no retinopathy during the same period were selected as a control group (group Ⅲ). Forty healthy subjects taking physical examination at the First Affiliated Hospital of Xi'an Jiaotong University during the same period were selected as a healthy group (group Ⅳ). Analysis of variance and χ² test were used to compare the general data, biochemical parameters, ACA, ARA, and IgG N-glycosylates between the 4 groups. Binary logistic regression models were used to explore the relationship between IgG N-glycosylates (IGPs) and DR progression. Results　There were statistical differences in the systolic blood pressure, HbA1c, fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) between the 4 groups (all P<0.05). The ACA level and ARA positive rate increased with the progress of DR. The logistic regression model found that IGP31 (OR=0.978), IGP35 (OR=0.803), IGP36 (OR=0.784), IGP37 (OR=0.915), and IGP38 (OR=0.987) were negatively associated with the disease progression of DR, and IGP24 (OR=1.039), IGP28 (OR=1.088), IGP29 (OR=1.025), IGP32 (OR=1.038), and IGP34 (OR=1.108) were positively associated with the disease progression of DR. Conclusion　ACA, ARA, and IgG N-glycosylates are closely related to the severity of retinopathy, and can be used as important predictors of DR.

CT findings and qualitative diagnosis of small liver cancer and cirrhotic nodules

Li Mengjie, Gao Xing, Cao Yajun, Shi Zheng, Zheng Xiaona

2025, 31(16):  2729-2733.  DOI: 10.3760/cma.j.cn441417-20241014-16018

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Objective　To explore the differences of CT findings between small liver cancer and cirrhotic nodules and its qualitative diagnostic value. Methods　A total of 164 patients with regenerated nodules of hepatitis B cirrhosis or small liver cancer who received CT examination in Xinyang Central Hospital from March 2021 to March 2024 were selected, and 157 cases were finally included as the study objects after screening according to the inclusion and exclusion criteria. There were 71 patients diagnosed with small liver cancer by surgical resection and histopathological examination (a small liver cancer group), including 38 males and 33 females who were (55.85±4.46) years old. There were 86 cases of cirrhotic reconstituted nodules (a regenerated nodules group), including 45 males and 41 females who were (56.28±4.27) years old. χ² test and independent sample t test were used to compare the genera data, imaging findings (morphology, lesion maximum diameter, density, and CT dynamic enhanced typing) and CT parameters [blood flow (BF), blood volume (BV), mean transit time (MTT), and hepatic arterial fraction (HAF)] of small liver cancer and regenerated nodules of hepatitis B cirrhosis were compared between the two groups. The pathological findings were set as the gold standards. The application values of CT in the diagnosis of regenerated nodules of hepatitis B cirrhosis and small liver cancer were evaluated. The Cohen's Kappa test was used to test the diagnoseis consistency. Results　In the regenerated nodules group, the liver parenchymal morphology was mainly uneven; the lesion maximum diameter was small; the density was mostly isodensity; the dynamic enhanced CT typing was dominated by the low volume and equivalent resistance type and the equivalent volume and equivalent resistance type. On the contrary, the small hepatocellular carcinoma group showed a variety of morphology, such as false envelope, liquefaction, and necrosis; the lesion maximum diameter was larger; the density was mainly low density; the dynamic enhanced CT typing was dominated by the high volume and low resistance type. There were statistical differences in CT imaging findings between the two groups (all P<0.001). The BF, BV, and HAF in the small liver cancer group were higher than those in the regenerated nodules group, while the MTT was lower (all P<0.001). The results of CT examination showed that there were 66 cases of small liver cancer; there were 84 patients with regenerated nodules of hepatitis B cirrhosis; 5 were misdiagnosed; 2 were missedly diagnosed. The accuracy, sensitivity, specificity, and positive and negative prediction rates of CT in the diagnosis of small liver cancer were 95.54% (150/157), 92.96% (66/71), 97.67% (84/86), 97.06% (66/68), and 94.38% (84/89), respectively. The accuracy, sensitivity, specificity, and positive and negative prediction rates of CT in the diagnosis of regenerated nodules of hepatitis B cirrhosis were 95.54% (150/157), 97.67% (84/86), 92.96% (66/71), 94.38% (84/89), and 97.06% (66/68), respectively. The Cohen's Kappa value of CT in the diagnosis of regenerated nodules of hepatitis B cirrhosis and small liver cancer compared with the pathological examination was 0.887, indicating a good consistency. Conclusions　By integrating lesion shape, lesion maximum diameter, density, and hemodynamic parameters, the accuracy of CT in the qualitative diagnosis of small liver cancer and regenerated nodules of hepatitis B cirrhosis  is high and in high agreement with pathological diagnosis.

Risk factors of platelet aggregation in patients undergoing apheresis platelet transfusion

Tang Lin, Chen Yuping, Ju Xiaoying

2025, 31(16):  2734-2738.  DOI: 10.3760/cma.j.cn441417-20241211-16019

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Objective　To analyze the risk factors of platelet aggregation in patients undergoing apheresis platelet (PLT) transfusion based on the reactive scope model. Methods　A retrospective analysis was conducted on the clinical data of 341 patients who underwent apheresis PLT transfusion in Baoji People's Hospital from May 2021 to July 2024, including 180 males and 161 females who were 51 (39, 65) years old. The patients were divided into an occurrence group and a non-occurrence group based on the presence or absence of PLT aggregation. Based on the patients' clinical characteristics, expert consensus, and guidelines, a reactive scope model was designed under expert guidance to study the risk factors of PLT aggregation in the patients. The clinical data of the occurrence group and the non-occurrence group were compared. The influencing factors of PLT aggregation in the patients were analyzed by the logistic regression model. t test, Mann-Whitney U test, and χ² test were used for the statistical analysis. Results　The incidence of PLT aggregation in the 341 patients was 11.14% (38/341). The age, the proportion of single dose PLT inventory time > 3 d, the number of PLT transfusion of the occurrence group were higher than those of the non-occurrence group [58 (40.5, 72.0) years vs. 48.0 (38.0, 60.0) years, 36.84% (14/38) vs. 20.13% (61/303), and (7.03±1.55) times vs. (5.10±1.09) times], and the PLT count before transfusion was lower [10.5 (7.0, 13.0) ×10⁹/L vs. [16.0 (11.0, 20.0) ×10⁹/L], with statistical differences (all P<0.05). The results of logistic regression model analysis showed that older age [odds ratio (OR)=1.183, 95% confidence interval (CI) 1.019-1.373], lower PLT count before transfusion (OR=0.793, 95%CI 0.673-0.935), single dose PLT inventory time > 3 d (OR=2.793, 95%CI 1.079-7.225), and multiple PLT infusions (OR=1.511, 95%CI 1.174-1.946) were all risk factors of PLT aggregation in the patients (all P<0.05). Conclusion　Older age, lower PLT count before transfusion, single dose PLT inventory time > 3 d, and multiple PLT infusions are all risk factors of PLT aggregation in patients undergoing apheresis PLT transfusion.

Value of color Doppler ultrasound combined with ADA and TGF-β1 in diagnosis of tuberculous pleurisy

Zhang Yan, Duan Yan, Huang Yi

2025, 31(16):  2739-2743.  DOI: 10.3760/cma.j.cn441417-20241223-16020

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Objective　To analyze the value of color Doppler ultrasound combined with adenosine deaminase (ADA) and transforming growth factor-β1 (TGF-β1) in the diagnosis of patients with tuberculous pleurisy (TBP). Methods　One hundred and fifty patients with unknown pleural effusion treated at General Medical Xi'an Hospital from May 2021 to September 2023 were selected. Color Doppler ultrasonography was performed on all the patients. The level of TGF-β1 was detected by the enzyme linked immunosorbent assay, and the level of ADA by the rate method. According to whether they were diagnosed with TBP, the patients were divided into a TBP group and a non-TBP group. The basic data of the two groups were compared. The factors affecting the diagnosis of TBP were analyzed the binary logistic stepwise regression model. The receiver operating characteristic curve (ROC) was plotted to evaluate the value of color Doppler ultrasound combined with ADA and TGF-β1 in the diagnosis of TBP. χ² and t tests were used for the statistical analysis. Results　Among the 150 patients, 64 patients had TBP, accounting for 42.67%. The peak systolic velocity (PSV) and levels of ADA and TGF-β1 in the TBP group were higher than those in the non-TBP group, and the resistance index (RI) was lower (all P<0.05). The binary logistic stepwise regression model analysis showed that PSV [OR=1.438 (95%CI 1.198-1.725)], ADA level [OR=1.157 (95%CI 1.077-1.242)], TGF-β1 level [OR=1.124 (95%CI 1.064-1.187)], and RI [OR=0.022 (95%CI 0.004-0.129)] were the influential factors in the diagnosis of TBP (all P<0.05). The ROC analysis showed that the sensitivities of ADA, TGF-β1, PSV, and RI in the diagnosis of TBP were 70.3%, 68.8%, 58.70%, and 62.5%, respectively; the specificities were 64.3%, 66.7%, 67.9%, and 65.5%, respectively. The value of the combination of ADA, TGF-β1, PSV, and RI in the diagnosis of TBP was higher (area under the curve=0.878). Conclusion　Color Doppler ultrasound and ADA and TGF-β1 in pleural effusion have high diagnostic efficacies in the diagnosis of TBP, and the combined diagnosis value is high.

Value of multimodal ultrasound technology alone and in combination for diagnosing thyroid nodules

Ma Rong, Shao Chunhui, Zhao Junzhi, Feng Jianli

2025, 31(16):  2743-2749.  DOI: 10.3760/cma.j.cn441417-20250208-16021

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Objective　To evaluate the values of two dimensional ultrasonography (2D-US), contrast-enhanced ultrasound (CEUS), and microflow imaging (MFI), as well as their combination, in the diagnosis of thyroid nodules. Methods　From January 2024 to January 2025, 120 patients with single thyroid nodules (60 benign nodules and 60 malignant nodules) treated at Baoji People's Hospital were selected selected as the study objects, including 42 males and 78 females. They were 21-72 (45.64±3.19) years old. 2D-US, CEUS, and MFI examinations were performed in both groups. The 2D-US image features, CEUS enhancement patterns, MFI blood flow Alder grading, and blood flow classification of the nodules were analyzed, so as to evaluate the diagnostic values of 2D-US, CEUS, and MFI for benign and malignant thyroid nodules. The pathological results were set as the gold standard. The receiver operating characteristic curves (ROC) of 2D-US, CEUS, MFI, and their combination were drawn, and the diagnostic efficacies were compared by the DeLong test. t and χ² tests were used for the statistical analysis. Results　The age and maximum nodule diameter in the malignant group were smaller than those in the benign group, with statistical differences (t=2.067 and 2.151; both P<0.05). There were statistical differences in the proportions of the patients with solid nodule internal composition, low/very low nodule internal echo, vertical nodule growth pattern, blurred nodule edge, and nodule microcalcification in 2D-US between the two groups (all P<0.05). There were statistical differences in the proportions of the patients with centripetal enhancement, uneven low enhancement, blurred border after enhancement, peripheral no-ring enhancement, and rapid regression of contrast media in CEUS between the two groups (all P<0.05). The Alder blood flow grading of thyroid malignant nodules was mainly grade Ⅲ [66.67% (40/60)], and that of benign nodules grade 0-I [65.00% (39/60)], with a statistical difference (χ²=43.064; P<0.05). The cut-off blood flow type of thyroid malignant nodules was mainly type Ⅳ [68.33% (41/60)], and that of benign nodules type Ⅲ [41.67% (25/60)], with a statistical difference (χ²=25.333; P<0.05). The diagnostic sensitivity of CEUS was higher (85.00%), while the specificity of 2D-US diagnosis was lower (73.33%). The sensitivity (93.33%), specificity (85.00%), positive prediction value (87.50%), negative prediction value (92.73%), and accuracy (89.17%) of the combination were higher those of any method of the three. Based on the pathological results, the ROC's of 2D-US, CEUS, and MFI and their combination were drawn, and the area under the curve (AUC) of the combination was 0.870 (95%CI 0.822-0.941), which was higher than that of any method. Conclusion　The combination of 2D-US, CEUS, and MFI can improve the diagnostic efficacy for thyroid nodules, and provide more valuable information for clinical judgment of nodule nature.

Preoperative sIMRT or dIMRT sequential chemotherapy for patients with stage Ⅱ/Ⅲ middle-low rectal cancer and dosimetry comparison

Jin Ronghui, Jiang Pan

2025, 31(16):  2749-2754.  DOI: 10.3760/cma.j.cn441417-20240722-16022

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Objective　To explore the preoperative static intensity-modulated radiation therapy (sIMRT) or dynamic intensity-modulated radiation therapy (dIMRT) of total neoadjuvant therapy (TNT) for patients with stage Ⅱ/Ⅲ middle-low rectal cancer and dosimetry comparison. Methods　A total of 87 patients with stage Ⅱ/Ⅲ middle-low rectal cancer treated at Shaanxi Provincial People's Hospital from February 2021 to February 2024 were selected as the study objects. According to the preoperative TNT methods, the patients were divided into two groups. Among the 44 patients in the sIMRT group, there were 26 males and 18 females; they were (62.58±6.43) years old; they were given sequential sIMRT chemotherapy. Among the 43 patients in the dIMRT group, there were 23 males and 20 females; they were (60.87±6.41) years old; they were given sequential dIMRT chemotherapy. The clinical efficacies, radiation dosimetry, and safety were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The objective response rate and disease control rate in the sIMRT group were 56.82% (25/44) and 84.09% (37/44), and those in the dIMRT group 67.44% (29/43) and 93.02% (40/43), respectively, with no statistical differences (χ²=1.043 and 1.706; P=0.307 and 0.192). After the treatment, there were no statistical differences in the levels of soluble cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carbohydrate antigen 242 (CA242), and CA72-4 between the sIMRT group and the dIMRT group (all P>0.05). The 2% of the planning target volume dose (D₂)[(2 677.43±3.58) cGy vs. (2 678.54±3.26) cGy], D₉₈ [(2 506.47±5.24) cGy vs. (2 511.43±5.33) cGy], and conformity index (CI) (0.72±0.08 vs. 0.78±0.09) of the sIMRT group were lower than those of the dIMRT group, and the maximum dose (D_max) [(2 763.74±7.41) cGy vs. (2 760.44±7.32) cGy], minimum dose (D_min) [(2 287.41±34.67) cGy vs. (2 264.75±36.42) cGy], and homogeneity index (HI) (0.15±0.04 vs. 0.13±0.03) were higher, with statistical differences (t=2.872, 4.377, 3.288, 2.089, 2.973, and 2.634 ; all P<0.05). The monitor units [(1 314.58±54.77) MU vs. (1 268.73±52.86) MU] and safety [9.30% (4/43) vs. 27.27% (12/44)] in the dIMRT group were better than those in the sIMRT group (t=3.973 and χ²=4.679; both P<0.05). Conclusions　TNT of sIMRT or dIMRT sequential chemotherapy has good efficacy in the clinical treatment of stage Ⅱ/Ⅲ middle-low rectal cancer, and can control tumor progression. Compared with sIMRT sequential chemotherapy, dIMRT sequential chemotherapy can better control the target dose and has higher clinical safety.

Fuyuan Xingnao Decoction combined with edaravone in treatment of patients with T2DM and cerebral infarction

Ke Ting, Xie Ruitao, Xiao Yang

2025, 31(16):  2754-2760.  DOI: 10.3760/cma.j.cn441417-20241206-16023

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Objective　To observe the effect of Fuyuan Xingnao Decoction combined with edaravone for patients with type 2 diabetes mellitus (T2DM) and cerebral infarction. Methods　Ninety-eight patients with T2DM and cerebral infarction treated at Shaanxi Provincial Hospital of Traditional Chinese Medicine from May 2023 to May 2024 were selected for the randomized controlled trial, and were divided into a control group and a study group by the random number table method, with 49 cases in each group. There were 29 males and 20 females in the control group; they were (56.92±9.36) years old; the course of diabetes was (12.39 ± 3.05) years; the course of cerebral infarction was (15.82±4.01) h. There were 27 males and 22 females in the study group; they were (57.88±10.07) years old; the course of diabetes was (13.12 ± 3.03) years; the course of cerebral infarction was (16.98±4.13) h. The control group took conventional treatment and edaravone, while the study group took conventional treatment, edaravone, and Fuyuan Xingnao Decoction, for 2 weeks. The neurological function, daily living ability, glucose metabolism indicators, inflammatory factors, hemorheological indicators, and endothelial function indicators before and after the treatment, clinical efficacies, and medication safety were compared between the two groups. The statistical analysis on the data was performed using t test and χ² test. Results　After the treatment, the score of National Institutes of Health Stroke Scale (NIHSS), fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPBG), glycated hemoglobin (HbA1c), fasting insulin (FINS), homeostasis model assessment-insulin resistance index (HOMA-IR), interleukin-6 (IL-6), soluble intercellular adhesion molecule-1 (sICAM-1), tumor necrosis factor-α (TNF-α), high sensitivity C-reactive protein (hs-CRP), plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, hematocrit, endothelin-1 (ET-1), and homocysteine (Hcy) were lower than those before the treatment in both groups (all P<0.05), and the above indicators in the study group were lower than those in the control group [6.14±2.28 vs. 10.39±3.16, (6.52±0.93) mmol/L vs. (7.18±1.06) mmol/L, (9.41±1.56) mmol/L vs. (10.35±1.62) mmol/L, (6.24±0.86)% vs. (6.85±0.92)%, (10.31±3.02) mU/L vs. (11.64±3.05) mU/L, 2.99±0.62 vs. 3.71±0.75, (6.68±2.13) ng/L vs. (9.31±2.36) ng/L, (250.89±31.65) ng/mL vs. (274.16±30.87) ng/mL, (5.07±1.43) ng/L vs. (7.12±2.24) ng/L, (7.25±2.19) mg/L vs. (9.82±2.76) mg/L, (1.57±0.16) mPa·s vs. (2.16±0.13) mPa·s, (4.27±0.41) mPa·s vs. (5.52±0.49) mPa·s, (8.09±2.07) mPa · s vs. (9.96±2.12) mPa·s, (37.85±2.47)% vs. (41.94±3.52)%, (50.86±7.18) ng/L vs. (63.49±9.22) ng/L, and (12.53±1.08) μmol/L vs. (16.94±1.27) μmol/L] (t=7.635, 3.276, 2.926, 3.391, 2.169, 5.179, 5.791, 3.684, 5.400, 5.106, 20.033, 13.695, 4.418, 6.658, 7.566, and 18.517; all P<0.05). After the treatment, the Barthel index (BI) score and nitric oxide (NO) level were higher than those before the treatment in both groups (all P<0.05), and the above indicators in the study group were higher than those in the control group [79.45±5.76 vs. 70.10±5.93 and (9.16±1.13) μmol/L vs. (7.91±1.05) μmol/L] (t=7.917 and 5.672; both P<0.05). The total clinical effective rate of the study group was higher than that of the control group [95.92% (47/49) vs. 81.63% (40/49); χ²=5.018; P<0.05]. There was no statistical difference in the total incidence rate of adverse reactions between the two groups (P>0.05). Conclusion　Fuyuan Xingnao Decoction combined with edaravone for patients with T2DM and cerebral infarction can significantly regulate their glucose metabolism, reduce the levels of inflammatory factors, improve their hemorheology, neurological function, and daily living ability, and protect their vascular endothelial function.

Predictive value of CT muscle characteristic indicators for chemotherapy sensitivity in patients with rectal cancer

Chen Kun, Liu Yaliang, Qin Shumin, Sheng Jiexin, Yang Lin, Hao Yang

2025, 31(16):  2761-2765.  DOI: 10.3760/cma.j.cn441417-20241223-16024

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Objective　To explore the levels of CT muscle characteristic indicators in patients with colorectal cancer (CRC), and to analyze the predictive value of CT muscle characteristic indicators for the sensitivity of patients with colorectal cancer to chemotherapy. Methods　This was a retrospective study. A total of 120 patients with CRC treated at Hanzhong City Center Hospital from September 2020 to August 2023 were selected as the study objects. Oxaliplatin and capecitabine were administered by all the patients. After the chemotherapy, the patients were divided into a chemotherapy sensitive group (52 cases) and a chemotherapy insensitive group (68 cases) according to the treatment results. The CT muscle characteristic indicators, including skeletal muscle index (SMI), psoas muscle index (PMI), skeletal muscle radiodensity (SMD), and intermuscular adipose tissue (IMAT), were detected before and after the chemotherapy. The data in the two groups were compared by χ² test and t test. The multivariate logistic regression was used to analyze the CT muscle characteristic indicators affecting chemotherapy sensitivity. The predictive value of CT muscle characteristic indicators for chemotherapy sensitivity was analyzed by the receiver operating characteristic curve (ROC). Results　Before the treatment, the SMI, PMI, and SMD in the chemotherapy sensitive group were higher than those of the chemotherapy insensitive group [(49.69±9.55) cm²/m² vs. (44.02±7.95) cm²/m², (4.57±0.89) cm²/m² vs. (4.16±0.84) cm²/m², and (34.31±4.42) HU vs. (31.78±4.73) HU], and the IMAT was lower [(7.04±0.89)% vs. (7.42±0.95)%], with statistical differences (t=3.290, 2.416, 2.818, and 2.105; all P<0.05). After the treatment, the SMI, PMI, and SMD in the chemotherapy sensitive group were higher than those in the chemotherapy insensitive group [(52.16±9.58) cm²/m² vs. (47.51±7.94) cm²/m², (4.93±0.87) cm²/m² vs. (4.23±0.85) cm²/m², and (36.11±4.58) HU vs. (32.40±4.69) HU], and the IMAT was lower [(6.69±0.87)% vs. (7.05±0.82)%], with statistical differences (t=2.695, 4.150, 4.081, and 2.171; all P<0.05). The multifactorial logistic regression analysis showed that SMI (OR=1.090, 95%CI 1.031-1.151), PMI (OR=1.728, 95%CI 1.016-2.937), and SMD (OR=1.140, 95%CI 1.031-1.260) were the independent risk factors for chemotherapy sensitivity of the patients, and IMAT (OR=0.566, 95%CI 0.338-0.946) was an independent protective factor for chemotherapy sensitivity (all P<0.05). The areas under the curves (AUC) of SMI, PMI, SMD, and IMAT were 0.664, 0.662, 0.607, and 0.614, respectively; the AUC of their combination was 0.830 (P<0.05). Conclusion　CT muscle characteristic indicators, PMI, SMI, SMD, and IMAT, have high predictive values for chemotherapy sensitivity in patients with CRC.

Effect of cold snare polypectomy for patients with colorectal polyps

Cao Ya, Cheng Xiangchao, Zhao Jinhua, Liu Yaogang, Tu Chengzhi, Ding Sheng

2025, 31(16):  2766-2769.  DOI: 10.3760/cma.j.cn441417-20241014-16025

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Objective　To explore the effect of cold snare polypectomy for patients with colorectal polyps. Methods　One hundred and forty-eight patients with colorectal polyps treated at the Third People's Hospital of Henan Province from June 2023 to August 2024 were selected as the study objects. The patients were divided into a control group, treated with endoscopic mucosal resection, and a study group, treated with cold snare polypectomy, according to the surgical methods, with 74 cases in each group. In the control group, there were 47 males and 27 females; they were (50.02±5.87) years old; the maximum diameter of the polyp was (6.43±1.25) mm. In the study group, there were 48 males and 26 females; they were (49.87±6.32) years old; the maximum diameter of the polyp was (6.52±1.18) mm. The surgery-related indicators, serum pain factors, stress response indicators, occurrence of complications were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The polyp resection time and hospital stay in the study group were shorter than those in the control group (t=12.893 and 9.473; both P<0.05). There was no statistical difference in the complete polyp resection rate between the two groups (χ²=0.600; P>0.05). One day after the operation, the serum levels of pain factors were higher than those before the operation in both groups, but the levels in the study group were lower than those in the control group (t=10.079 and 12.097; both P<0.05). One day after the operation, the levels of adrenaline, cortisol, and norepinephrine were higher than those before the operation in both groups, but the levels in the study group were lower than those in the control group [(240.03±26.14) pmol/L vs. (269.41±25.56) pmol/L, (134.26±12.78) μg/L vs. (160.05±13.29) μg/L and (2.41±0.32) nmol/L vs. (3.59±0.27) nmol/L] (t=6.913, 12.033, and 24.244; all P<0.05). The total incidence rate of complications in the study group was lower than that in the control group (χ²=12.397; P<0.05). Conclusion　Cold snare polypectomy in the treatment of patients with colorectal polyps can shorten their polyp resection time and hospital stay, and reduce their pain and stress response, with high safety.

Value of chest CT combined with tumor markers for cervical cancer complicated with lung metastasis

Zhang Li, Wang Hai'e, Hu Yunfeng

2025, 31(16):  2770-2774.  DOI: 10.3760/cma.j.cn441417-20240101-16026

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Objective　To explore the diagnostic value of chest CT combined with serum tumor markers [alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), and squamous cell carcinoma antigen (SCC-Ag)] for cervical cancer complicated with lung metastasis. Methods　A total of 280 patients with cervical cancer treated in Yulin Hospital of Traditional Chinese Medicine between January 2020 and December 2024 were selected as the study objects. According to  the presence or absence of lung metastasis, they were divided into a metastasis group [15 cases; (45.73±6.24) years old] and a non-metastasis group [265 cases; (46.31±5.76) years old]. All the patients underwent chest CT examination, and the abnormal signs (lung nodules, lumps, patchy shadow, and pleural effusion) were recorded. The serum levels of AFP, CEA, and SCC-Ag were detected. The diagnostic efficacies of each indicator and the combined detection for cervical cancer complicated with lung metastasis were analyzed by the receiver operating characteristic curve (ROC) and area under the curve (AUC). t test and χ² test were used for the statistical analysis. Results　The proportions of the abnormal chest CT signs (nodules, lumps, patchy shadow, and pleural effusion) and levels of AFP, CEA, and SCC-Ag in the metastasis group were higher than those in the non-metastasis group (all P<0.05). The results of ROC analysis showed that AUC's of SCC-Ag, CEA, AFP, lung nodule, pleural effusion, lung lump, patchy shadow, and their combination in the diagnosis of cervical cancer complicated with lung metastasis were 0.796, 0.781, 0.767, 0.753, 0.681, 0.644, 0.599, and 0.925, respectively. Conclusion　Chest CT combined with serum AFP, CEA, and SCC-Ag can effectively improve the diagnostic accuracy for cervical cancer complicated with lung metastasis, and provide strong support for clinical diagnosis.

Factors of short-term poor prognosis after intracranial aneurysm interventional embolization and construction of a risk prediction model

Zhang Haiping, Li Wei, Jie Liping, Feng Lei

2025, 31(16):  2774-2780.  DOI: 10.3760/cma.j.cn441417-20250115-16027

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Objective　To analyze the influencing factors of short-term poor prognosis of intracranial aneurysm (IA) after interventional embolization, to construct a risk prediction Nomogram model, and to verify its efficacy. Methods　The clinical data of 278 patients with IA treated in Xidian Group Hospital from June 2020 to June 2024 were retrospectively analyzed. There were 107 males and 171 females; they were (57.08±8.94) years old; their body mass index (BMI) was (23.11±3.88) kg/m². They were divided into a poor prognosis group and a good prognosis group according to their prognosis one month after the operation. The clinical data of the two groups were compared by t test and χ² test. The influencing factors of poor prognosis were analyzed by the multivariate logistic regression. A risk prediction Nomogram model was constructed by the R software. The receiver operating characteristic curve (ROC) and calibration curve were drawn to analyze the predictive efficacy and calibration degree of the model for the risk of short-term poor prognosis after IA interventional embolization. Results　The incidence rate of short-term poor prognosis after IA interventional embolization was 23.02% (64/278). Compared with the good prognosis group, the poor prognosis group was older [(63.64±9.52) years vs. (55.12±7.31) years], and had a lower aspect ratio (AR) of aneurysm body (1.63±0.21 vs. 2.48±0.39) and higher proportions of the patients with Hunt-Hess grade 3-5, CT Fisher grade 3-4, operation time >3 d, and postoperative cerebral infarction [71.88% (46/64) vs. 42.52% (91/214), 67.19% (43/64) vs. 43.93% (94/214), 84.38%(54/64) vs. 57.01% (122/214), and 17.19% (11/64) vs. 4.67% (10/214)], with statistical differences (all P<0.05). Older age, preoperative Hunt-Hess grade 3-5, CT Fisher grade 3-4, low AR, operation opportunity >3 d, and postoperative cerebral infarction were the influencing factors of the short-term poor prognosis after IA interventional embolization [ratio ratio (OR)=1.223, 2.784, 2.507, 0.402, 2.683, and 2.134; all P<0.05]. A risk prediction Nomogram model for the short-term poor prognosis after IA interventional embolization was constructed; the area under the curve of this model for predicting the short-term poor prognosis after IA interventional embolization was 0.907 (95%CI 0.846-0.950), and the prediction sensitivity and specificity were 93.75% (60/64) and 80.37% (172/214), respectively. The prediction probability was close to the actual probability, and the Hosmer-Lemeshow goodness-of-fit test showed that it had good fit (χ²=1.905; P=0.309). Conclusions　The influencing factors of short-term poor prognosis after IA interventional embolization are old age, preoperative Hunt-Hess grade 3-5, CT Fisher grade 3-4, operation opportunity >3 d, small AR, and postoperative cerebral infarction. The risk prediction Nomogram model based on the above factors has good predictive value for short-term poor prognosis after IA interventional embolization.

Expression of PTP4A3 in acute myelogenous leukemia and prognosis analysis

Liang Genying, Liang Enyu

2025, 31(16):  2781-2784.  DOI: 10.3760/cma.j.cn441417-20250318-16028

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Objective　To investigate the expression level of PTP4A3 in patients with acute myeloid leukemia (AML) and its correlation with clinical characteristics, relapse, and prognosis. Methods　From January 2019 to December 2020, 79 patients newly diagnosed with AML who took the whole process treatment at Zhongshan People's Hospital were selected as the study objects, including 40 males and 39 females, with a median age of 58. The bone marrow samples were collected before treatment to detect the PTP4A3 expression by quantitative real-time polymerase chain reaction (qRT-PCR). The patients were divided into high- and low-expression groups based on the median PTP4A3 expression level. The relationships of PTP4A3 with the patients' age, gender, ELN risk degree, and prognosis were analyzed. The Kaplan-Meier survival analysis and Cox proportional hazards model were used to analyzed the factors influencing their prognosis. χ² test was used for the statistical analysis. Results　High PTP4A3 expression was associated with age ≥60 years (P=0.017). The relapse rate in the high-expression group was higher than that in the low-expression group [47.50% (19/40) vs. 2.56% (1/39); P<0.001]. The survival analysis revealed a median survival time of 317 d in the high-expression group. The multivariate Cox analysis indicated that age ≥60 years (HR=5.422, P=0.020) and high PTP4A3 expression (HR=4.377, P=0.027) were the independent risk factors for AML relapse. Conclusion　High PTP4A3 expression is closely linked to increased relapse risk and poor prognosis in patients with AML, suggesting its potential as an independent prognostic biomarker and therapeutic target for AML.

Case Report

Breast carcinoma complicated with osteoclast-like giant cells: a case report

Zhou Na, Hou Lingfeng, Liu Ruifa, Wang Sijia, Zhu Yuhong

2025, 31(16):  2785-2788.  DOI: 10.3760/cma.j.cn441417-20241223-16029

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The paper reports one patient with breast carcinoma and osteoclast-like giant cells treated at Binzhou Medical University Hospital. The patient was a 42-year-old woman, and was admitted to the hospital because of left-sided breast carcinoma. She previously underwent rotational excision of a breast mass at Maternal and Child Health Hospital at Hekou District, Dongying. The physical examination revealed postmitotic changes in both breasts, and the breast ultrasound showed bilateral breast hypoechoicity (BI-RADS category 4). The pathological wax blocks were borrowed from Maternal and Child Health Hospital at Hekou District, Dongying, and the pathological examination confirmed breast carcinoma complicated with osteoclast-like giant cells.

Nursing Research

Effect of comprehensive targeted nursing intervention for women with hypertension in pregnancy

Hao Jinhe, Bai Yange, Xiong Dongxin, Ma Pengtao, Cui Xinmiao

2025, 31(16):  2789-2793.  DOI: 10.3760/cma.j.cn441417-20250312-16030

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Objective　To analyze the effect of comprehensive targeted nursing intervention for women with hypertension in pregnancy (HIP). Methods　A total of 105 women with HIP treated at 988 Hospital of Joint Logistic Support Force from November 2022 to October 2024 were selected for the randomized controlled trial, and were divided into a control group (53 cases) and an observation group (52 cases) by the random number table method. The control group were 21-38 (27.60±1.37) years old, and received routine nursing interventions. The observation group were 21-39 (28.09±1.45) years old, and received comprehensive targeted nursing interventions. The adverse pregnancy outcomes, blood pressures, self-care ability [Exercise of Self-care Agency Scale (ESCA)], psychological status [Self‐rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS)], and medication adherence [Morisky Medication Adherence Scale-8 Items (MMAS-8)] were compared between the two groups. Statistical analyses were performed using independent samples t test and χ² test. Results　The incidence rate of adverse pregnancy outcomes in the observation group after the intervention was lower than that in the control group [5.77% (3/52) vs. 18.87% (10/53); χ²=4.151; P<0.05]. After the intervention, the systolic and diastolic blood pressures in the observation group were lower than those in the control group [(119.46±1.48) mmHg (1 mmHg=0.133 kPa) vs. (126.31±2.01) mmHg, (75.16±1.24) mmHg vs. (81.48±1.85) mmHg], and the ESCA scores in various dimensions were higher (25.19±1.49 vs. 18.23±1.32, 20.05±1.38 vs. 14.81±1.02, 38.61±2.21 vs. 29.52±1.91, and 53.18±4.65 vs. 46.27±4.19) (all P<0.05). After the intervention, the SAS and SDS scores in the observation group were lower than those in the control group (40.32±1.15 vs. 47.54±1.72 and 43.15±1.48 vs. 49.27±2.10), while the MMAS-8 score was higher (7.13±0.40 vs. 6.03±0.36) (all P<0.05). Conclusion　Comprehensive targeted nursing intervention for women with HIP can alleviate their adverse psychological status, improve their medication compliance, self-care ability, and pregnancy outcomes and reduce their blood pressures.

Acute-medical rehabilitation-follow-up support stage nursing mode for patients with stroke

Yang Mei , Meng Juanjuan, Yang Kun, Wu Jun, Liu Xianghong

2025, 31(16):  2794-2798.  DOI: 10.3760/cma.j.cn441417-20241128-16031

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Objective　To explore and analyze the impact of the acute-medical rehabilitation-follow-up support stage nursing mode on the cognitive function, motor function, and quality of life of patients with stroke. Methods　This was a prospective study. A total of 136 patients with stroke who were hospitalized in Xi'an International Medical Center Hospital from January 2023 to January 2024 were selected as the research objects. They were divided into a control group and a study group by the random number table method, with 68 cases in each group. In the control group, there were 38 males and 30 females, with an age of (55.20 ± 6.88) years. In the study group, there were 37 males and 31 females, with an age of (55.32 ± 7.03) years. The control group adopted the conventional nursing mode; the study group adopted the acute-medical rehabilitation-follow-up support stage nursing mode. The scores of the Mini-Mental State Examination (MMSE), Fugl-Meyer Assessment (FMA), and EuroQol Five-Dimension Questionnaire (EQ-5D) of the two groups were compared and analyzed. t and χ² tests were used for the statistical analysis. Results　After the intervention, the scores of MMSE and upper and lower limbs of FMA in the study group were higher than those in the control group (24.02±1.90 vs. 22.45±1.88, 63.67±3.60 vs. 59.02±3.55, and  31.44±2.66 vs. 28.85±1.96), with statistical differences (all P<0.05). After the intervention, the scores of mobility (MO), anxiety and depression (AD), usual activities (UA), pain and discomfort (PD), and self-care (SC) of the EQ-5D health description system in the study group were lower than those in the control group (0.79±0.29 vs. 1.16±0.41, 0.78±0.29 vs. 1.30±0.40, 0.84±0.25 vs. 1.32±0.29, 0.85±0.21 vs. 1.41±0.40, and 0.76±0.24 vs. 1.31±0.32), with statistical differences (all P<0.05). Conclusion　Acute-medical rehabilitation-follow-up support stage nursing mode for patients with stroke can improve their cognitive function, motor function, and quality of life.

Application of Omaha system-based continuous nursing care in rehabilitation for patients with hypertensive intracerebral hemorrhage

Ouyang Ling, Lian Pinghong, Peng Hong, Huang Rong, Liu Changhua, Chen Gang, Zhang Shangming

2025, 31(16):  2798-2801.  DOI: 10.3760/cma.j.cn441417-20241106-16032

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Objective　To investigate the efficacy of Omaha system-based continuous nursing care in the rehabilitation for patients with hypertensive intracerebral hemorrhage (HICH). Methods　A total of 76 patients with HICH treated at the 73rd Group Army Hospital of PLA from May 2021 to May 2023 were selected for the randomized controlled trial, and were divided into an observation group and a control group by the random number table method, with 38 cases in each group. The control group included 25 males and 13 females; they were 41-80 (66.08±11.89) years old. The observation group included 22 males and 16 females; they were 39-77 (65.69±11.32) years old. The control group received routine post-discharge rehabilitation guidance; in addition, the observation group took Omaha system-based continuous nursing care. The rehabilitation outcomes were compared between the two groups by t test. Results　The scores of status, behaviors, and cognition in the observation group were 3.55±0.48, 3.02±0.44, and 2.63±0.54, which were higher than those in the control group, with statistical differences (all P<0.05). The scores of Functional Independence Measure (FIM) and Quality of Life Index (QLI) in the observation group were 95.06±20.55 and 7.99±2.01, which were higher than those in the control group, with statistical differences (both P<0.05). Conclusion　Omaha system-based continuous nursing care for patients with HICH can effectively improve their cognitive function, behavioral outcomes, clinical status, self-care ability, and quality of life.

Self-efficacy classification of stress injury management in surgical nurses and potential profile analysis of influencing factors

Dai Hui, Teng Sisi, Li Shiying, Hu Piaopiao

2025, 31(16):  2802-2807.  DOI: 10.3760/cma.j.cn441417-20250219-16033

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Objective　To analyze the self-efficacy classification of stress injury management in surgical nurses by the potential profile analysis, and to explore its influencing factors. Methods　A total of 246 surgical nurses from the Affiliated Children's Hospital of Xiangya School of Medicine, Central South University were selected for this cross-sectional study from March 2024 to October 2024 by the convenience sampling method. Among them, there were 14 males (5.7%) and 232 females (94.3%); there were 95 cases (38.6%) who were 18 to 25 old, 85 cases (34.6%) who were >25 to 36 old, and 66 cases (26.8%) who were ≥36 years old. The General Data Questionnaire and Chinese version of Nurses' Stress Injury Management Self-efficacy Scale were used to investigate them. The statistical methods included potential profile analysis (Mplus 7.0), analysis of variance, χ² test, and logistic regression analysis. P<0.05 was considered statistically significant. Results　The total score of the Nurses' Stress Injury Management Self-efficacy Scale was 31.16±6.18. The results of potential profile analysis showed that the self-efficacy of the surgical nurses in stress injury management was divided into three types: a low self-efficacy group (45.1%, 111/246), a medium self-efficacy group (38.2%, 94/246), and a high self-efficacy group (16.7%, 41/246). The logistic regression analysis showed that professional title (OR=9.122, 95%CI 2.050-40.633, P=0.003), years of work (OR=2.247, 95%CI 1.4813.434, P<0.001), whether they were members of the stress injury group (OR=1.688, 95%CI 1.393-2.044, P<0.001), and the number of stress injury training (OR=4.713, 95%CI 1.874-11.872, P=0.001), and the way of acquiring knowledge about stress injury (OR=4.435, 95%CI 1.673-11.749, P=0.003) were the influential factors for the self-efficacy classification of the nurses' stress injury management. Conclusions　There is heterogeneity in the self-efficacy classification of nurses' stress injury management in operating room. Their professional title, years of working in operating room, whether they are members of a stress injury team, number of stress injury training, and way of acquiring knowledge related to stress injury are the influencing factors. 

Multidisciplinary collaborative management for a patient with sexual dysfunction due to vaginismus-Induced Intercourse failure

Long Lulu, Zhou Yan

2025, 31(16):  2808-2811.  DOI: 10.3760/cma.j.cn441417-20250217-16034

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This article reports a multidisciplinary collaborative management model for a patient with sexual dysfunction due to vaginismus, which led to failed sexual intercourse. The aim is to provide certain ideas for the clinical treatment and management of such patients.

Clinical Teaching

Application of integrated Chinese-western medicine teaching mode in colorectal surgery training

Jiang Tianming, Yi Xiaojiang, Liang Chao, Huang Haipeng, Diao Jingfang

2025, 31(16):  2812-2816.  DOI: 10.3760/cma.j.cn441417-20250609-16035

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Objective　To explore the application effect of an integrated Chinese-western medicine teaching mode in colorectal surgery training. Methods　A total of 100 clinical medicine students undergoing internship in Guangdong Provincial Hospital of Traditional Chinese Medicine from July 2024 to February 2025 were selected for the randomized controlled trial, and divided into a study group and a control group by the random number table method, with 50 cases in each group. There were 33 males and 17 females in the study group; they were 21.00 (20.00, 24.00) years old. There were 32 males and 18 females in the control group; they were 20.00 (19.00, 22.00) years old. The study group were intervened with the integrated Chinese-western medicine teaching mode, while the control group the conventional western medicine teaching mode. Both groups were trained for 2 months. After the training, the cognitive levels of colorectal diseases, teaching acceptance, teaching satisfaction, and command of disease knowledge and skills were compared between the two groups by t test. Results　After the training, the cognitive level of colorectal diseases in the study group was better than that in the control group; the total teaching satisfaction in the study group was higher than that in the control group (4.24±0.39 vs. 3.84±0.51; P<0.05); the scores of disease knowledge command and skill command in the study group were higher than those in the control group (all P<0.05). After the training, the study group thought that they were improved a lot, but pointed out some issues, such as insufficient integration, teachers' lack of guidance by disease-syndrome combination, uneven knowledge levels among the faculty, insufficient systematic teaching materials, and simplistic teaching methods. Conclusions　The integrated Chinese-western medicine teaching mode can effectively improve the clinical training of colorectal surgery and teaching outcomes. The improvements in integrated Chinese-western medicine teaching should focus on integrating clinical thinking with holistic concepts, multidisciplinary case discussions, and real-case learning.