Table of Content

15 June 2025, Volume 31 Issue 12

Previous Issue   

Cerebrovascular Disease

Changes of serum levels of GFAP and HSP47 in patients with hypertensive intracerebral hemorrhage and their relationship with neurological function 

Li Lin, Yang Jie, Zhai Haiyan, Zhu Lifang, Zhang Xiao

2025, 31(12):  1938-1942.  DOI: 10.3760/cma.j.cn441417-20250117-12001

Asbtract ( )  

References | Related Articles | Metrics

Objective　To study and explore the changes of serum levels of glial fibrillary acidic protein (GFAP) and heat shock protein 47 (HSP47) in patients with hypertensive intracerebral hemorrhage and their relationship with neurological function. Methods　One hundred and twenty-four patients with hypertensive intracerebral hemorrhage treated in No. 215 Hospital of Shaanxi Nuclear Industry from June 2023 to June 2024 were selected for the retrospective study.There were 62 male cases and 62 female cases, with an age of ≥18 years old. According to the scores of modified Rankin Scale (mRS) evaluated within one month after the hospitalization treatment, they were divided into a good prognosis group (the score of mRS 0-3, 76 cases) and a poor prognosis group (the score of mRS 4-6, 48 cases). The gender, bleeding site, smoking history, drinking history, diabetes, hyperlipidemia, operation method, blood routine, and other indicators of the two groups were collected. The levels of GFAP, HSP47, interleukin (IL)-6, and neuron-specific enolase (NSE) and bleeding volumes were compared between the two groups. The correlation of prognosis with GFAP and HSP47 was analyzed. The impact of GFAP and HSP47 on their prognosis was analyzed. The sensitivities and specificities of GFAP and HSP47 in predicting their prognosis were explored. The rank sum test and χ² test were used for the statistical comparisons. The correlation of prognosis with GFAP, HSP47, IL-6, NSE, bleeding volume, and score of Glasgow Coma Scale (GCS) were analyzed by the Spearman correlation analysis. The receiver operating characteristic curve was used to analyzed the efficacies of the indicators in the evaluation of the patients' prognosis. Results　The levels of GFAP, HSP47, IL-6, and NSE and bleeding volume in the good prognosis group were lower than those in the poor prognosis group, and the score of GCS was higher, with statistical differences (all P<0.05). The prognosis was positively correlated with GFAP, HSP47, IL-6, NSE, and bleeding volume (r=0.499, 0.388, 0.479, 0.736, and 0.491; all P<0.001), and negatively with the score of GCS (r=-0.775; P<0.001). The areas under the curves of GFAP and HSP47 in the prediction of the prognosis were both greater than 0.7, indicating that both had certain diagnostic efficacy (both P<0.05). GFAP, HSP47, NSE, and bleeding volume were risk factors for prognosis, and the score of GCS a protective factor. Conclusions　The serum levels of GFAP and HSP47 are related to neurological function in patients with hypertensive intracerebral hemorrhage. The higher the levels of GFAP and HSP47, the worse their neurological function. Both are risk factors for evaluating patients with hypertensive intracerebral hemorrhage.

Significance of albumin, miR-134, and mCTA collateral circulation score in patients with cerebral artery occlusion after AIS 

Li Jianjun, Jiang Feng, Liu Xiaoli

2025, 31(12):  1943-1947.  DOI: 10.3760/cma.j.cn441417-20250102-12002

Asbtract ( )  

References | Related Articles | Metrics

Objective　To evaluate the value of serum albumin, microRNA (miR)-134, and multi-temporal computed tomography angiography (mCTA) collateral circulation score for prognosis of patients with cerebral artery occlusion after acute ischemic stroke (AIS). Methods　The medical records of 124 patients with middle artery occlusion after AIS admitted to Yulin Xingyuan Hospital from June 2022 to June 2024 were retrospectively analyzed. The were 42-72 years old. They were divided into a mild to moderate group (59 cases) and a severe group (65 cases) according to the scores of the National Institutes of Health Stroke Scale (NIHSS). According to the scores of the modified Rankin scale (mRS) 90 d after the onset, the patients were divided into a poor prognosis group (mRS score >2; 46 cases) and a good prognosis group (mRS Score ≤2; 78 cases). The serum levels of microRNA-134 and albumin and mCTA collateral circulation scores were compared between the patients with different disease severities and prognoses. t and χ² tests were used for the statistical comparisons. The receiver operating characteristic curve (ROC) was used to analyze the efficacy of each indicator in the prediction of the patients' prognosis. Results　The serum levels of microRNA-134 and albumin and mCTA collateral circulation score in the severe group were (34.13±6.34)g/L, 4.60±0.93, and 3.11±0.58, and those in the the mild to moderate group were (40.29±5.80) g/L, 2.58±0.41, and 3.90±0.35, with statistical differences (all P<0.05). The serum levels of microRNA-134 and albumin and mCTA collateral circulation score in the poor prognosis group were (35.55±5.94) g/L, 4.13±0.75, and 3.28±0.51, and those in the good prognosis group were (39.62±6.33) g/L, 2.81±0.57, and 3.84±0.40, with statistical differences (all P<0.05). The ROC analysis showed that the areas under the curves of serum albumin, miR-134, and mCTA collateral circulation score in predicting the patients' prognosis were 0.708, 0.766, 0.807, and 0.896, respectively. Conclusions　Patients with middle cerebral artery occlusion after AIS who have poor prognosis have higher a serum microRNA-134 level, a lower albumin level, and a lower mCTA collateral circulation score; these indicators have high predictive value for the patients' prognosis.

Effect of oxiracetam combined with aspirin and clopidogrel for patients with TIA and its influence on neurological repair function 

Zheng Chunli, Liu Lei, Yang Weiyi

2025, 31(12):  1948-1952.  DOI: 10.3760/cma.j.cn441417-20241106-12003

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect oxiracetam combined with aspirin and clopidogrel for patients with transient ischemic attack (TIA) and its influence on neurological repair function. Methods　A total of 100 patients with TIA admitted to Department of Neurology, Xi'an Daxing Hospital from March 2021 to March 2024 were selected for the randomized controlled trial. They were divided into a control group and an oxiracetam group by the method of drawing lots from envelopes, with 50 cases in each group. There were 29 males and 21 females in the control group; they were (63.87±5.84) years old; their disease course was (1.57±0.35) d; 18 cases had lesions on the vertebrobasilar artery, and 32 cases on the internal carotid artery. There were 31 males and 19 females on the oxiracetam group; they were (63.74±5.71) years old; their disease course was (1.62±0.42) d; 15 cases had lesions on the vertebrobasilar artery, and 35 cases on the internal carotid artery. The control group took aspirin and clopidogrel, and the oxiracetam group took oxiracetam, aspirin, and clopidogrel. The clinical efficacies and neurological repair function, relevant scores, laboratory indicators, and oxidative stress levels before and after the treatment were compared between the two groups by t and χ² tests. Results　After the treatment, the total effective rate in the oxiracetam group was higher than that in the control group [94.0% (47/50) vs. 80.0% (40/50); P<0.05]. The levels of insulin-like growth factor-1, brain-derived neurotrophic factor, and nerve growth factor in the oxiracetam group were higher than those in the control group [(25.25±2.92) g/L vs. (22.45±2.53) g/L, (39.17±4.47) μg/L vs. (33.77±4.13) μg/L, and (189.37±25.45) ng/L vs. (170.12±22.38) ng/L; all P<0.05]. The levels of monocyte chemoattractant protein-1, tumor necrosis factor-α, and matrix metalloproteinase in the oxiracetam group were lower than those in the control group [(136.64±15.18) μg/L vs. (150.75±18.24) μg/L, (7.36±0.90) μg/L vs. (9.75±1.11) μg/L, (95.78±10.71) ng/L vs. (117.12±13.85) ng/L; all P<0.05]. The levels of superoxide dismutase, nitric oxide , and glutathione peroxidase in the oxiracetam group were higher than those in the control group [(83.53±8.28) U/L vs. (77.52±7.82) U/L, (83.25±3.25) μmol/L vs. (74.67±3.31) μmol/L, and (92.72±6.13) U/L vs. (85.68±5.21) U/L; all P<0.05]. The scores of the Montreal Cognitive Assessment Scale , Mini-Mental State Examination, and Modified Barthel Index in the oxiracetam group were higher than those in the control group (27.10±3.14 vs. 24.76±2.82, 23.45±2.85 vs. 21.13±2.43, and 53.56±7.45 vs. 49.97±6.56), and the score of the National Institutes of Health Stroke Scale was lower (12.69±1.44 vs. 15.78±1.52) (all P<0.05). Conclusion　Oxiracetam combined with aspirin and clopidogrel for patients with TIA is effective and has a significant impact on their neurological repair function.

Factors influencing prognosis of patients with middle cerebral artery stenosis ischemic stroke based on MRI high-resolution vascular wall imaging indicators 

Zhang Xueqin, Cao Wei, Sun Xiangzheng, Wang Nuan, Yang Haoran

2025, 31(12):  1953-1958.  DOI: 10.3760/cma.j.cn441417-20250115-12004

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the prognostic factors influencing the prognosis of patients with middle cerebral artery (MCA) stenosis (CIS) ischemic stroke based on high-resolution vascular wall imaging indicators using magnetic resonance imaging (MRI). Methods　This study was a retrospective study. Eighty patients with poor prognosis of MCA stenosis ischemic stroke admitted to Xuzhou First People's Hospital from January 2020 to May 2024 were selected as a study group (the score of Rankin scale ≤ 2 after discharge for 3 months); there were 49 males and 31 females; they were (58.54±9.54) years old. Another 98 patients with good prognosis of MCA stenosis ischemic stroke admitted during the same period were selected as a control group; there were 61 males and 37 females; they were (60.01±10.67) years old. The clinical data and MRI high-resolution vascular wall imaging indicators were compared between the two groups. The risk factors for the poor prognosis in the patients with MCA stenosis ischemic stroke were analyzed by the multiple logistic regression analysis. The regression equation was constructed, and a receiver operating characteristic curve (ROC) was drawn to analyze the predictive value of the regression equation for the prognosis of the patients with MCA stenosis ischemic stroke. χ² and independent-sample t tests were used for the statistical comparisons. Results　The proportion of the patients with severe stenosis or occlusion of the MCA in the study group was higher than that in the control group [75.00% (60/80) vs. 23.47% (23/98); P<0.05].The score of Glasgow Coma Scale (GCS) in the study group was lower than that in the control group, and the score of National Institutes of Health Stroke Scale (NIHSS) of the United States was higher (both P<0.05). The narrowest lumen area in the study group was smaller than that in the control group (P<0.05); the T1 weighted imaging (T1WI) signal intensity index, T2 weighted imaging (T2WI) signal intensity index, plaque enhancement rate, and wall normalization index (NWI) in the study group were higher than those in the control group (all P<0.05); the total vascular area (TVA) and wall area (WA) in the study group were greater than those in the control group (both P<0.05). The results of multiple logistic regression analysis showed that severe stenosis or occlusion of the MCA (OR=1.966), a high score of NIHSS (OR=2.784), a small lumen area at the narrowest point (OR=2.396), a high T1WI signal intensity index (OR=1.988), a high T2WI signal intensity index (OR=3.047), a high NWI (OR=1.721), a large TVA (OR=2.221), and a large WA (OR=2.998) were independent risk factors for poor prognosis in the patients with MCA stenosis ischemic stroke (all P<0.05). The regression equation was constructed. According to the diagnostic probability logit (P), the ROC was drawn to predict the poor prognosis in the patients. When logit (P)>11.73, the area under the curve (AUC) and χ² value were 0.872 and 13.596, respectively, with a 95%CI of 0.814-0.917. The diagnostic sensitivity and specificity were 85.00% and 79.59%, respectively. Conclusions Severe stenosis or occlusion of the MCA, a small lumen area at the narrowest point, a high score of NIHSS, a high T1WI signal intensity index, a high T2WI signal intensity index, a high NWI, a large TVA, and a large WA are independent risk factors for poor prognosis in patients with MCA stenosis ischemic stroke. The regression equation has high predictive value.

Effect of Fire Dragon Cupping combined with repetitive transcranial magnetic stimulation for patients with post-stroke fatigue 

Liang Miaoting, Cao Wenjun, Wang Ying, Liu Cui, Jin Yuxia

2025, 31(12):  1959-1963.  DOI: 10.3760/cma.j.cn441417-20250107-12005

Asbtract ( )  

References | Related Articles | Metrics

Construction of a personalized Nomogram model for predicting ischemic cerebrovascular disease in patients with Parkinson's disease 

Sun Qian, Shao Li, Zhao Licheng, Shi Jin, Wang Yuanyuan

2025, 31(12):  1963-1967.  DOI: 10.3760/cma.j.cn441417-20241224-12006

Asbtract ( )  

References | Related Articles | Metrics

New Medical Advances

Research progress on regulation mechanisms of synaptic plasticity and its relationship with nervous system diseases 

Wang Linhua, Huo Yingqian, Li Tingting, Liu Yanmin, Xi Yalin, Wang Meiling

2025, 31(12):  1968-1971.  DOI: 10.3760/cma.j.cn441417-20240926-12007

Asbtract ( )  

References | Related Articles | Metrics

The regulatory mechanisms of synaptic plasticity are complex and diverse, and are closely related to many diseases of the nervous system. Impaired synaptic plasticity is found in many neurodegenerative and demyelinating diseases. What is synaptic plasticity? Which factors regulate synaptic plasticity? Can we slow down the progression of the diseases and improve the prognosis regulating synaptic plasticity? In this review, we summarize the regulatory mechanisms of synaptic plasticity and its relationship with nervous system diseases, and explore new therapeutic targets and possible mechanisms for treatment.

Effects of different parathyroid transplantation sites on postoperative hypoparathyroidism 

Li Qiang, Ma Qiusheng, Yang Mengjiao, Chen Fuxi

2025, 31(12):  1972-1975.  DOI: 10.3760/cma.j.cn441417-20250121-12008

Asbtract ( )  

References | Related Articles | Metrics

Autologous parathyroid transplantation is an effective method for the treatment of hypoparathyroidism after thyroid surgery. Different graft sites impact the incidence rate and recovery speed of postoperative hypoparathyroidism. Therefore, choosing an appropriate graft site according to the patient's specific situation can not only improve postoperative recovery, but also reduce the risk of hypoparathyroidism. This paper aims to provide new insights into the protection of parathyroid function by comparing various graft sites, and to help clinicians develop more optimized treatment plans.

Research progress of resting state functional magnetic resonance imaging in treatment of post-stroke aphasia 

Xie Liwen, Liang Zhigang

2025, 31(12):  1975-1979.  DOI: 10.3760/cma.j.cn441417-20241211-12009

Asbtract ( )  

References | Related Articles | Metrics

Post-stroke aphasia (PSA) as one of the common complications in stroke patients, its high disability rate seriously reduces the patients' quality of life and imposes a heavy burden on society. The unclear rehabilitation mechanism makes it difficult to treat patients with PSA accurately. Resting-state functional magnetic resonance imaging (rs-fMRI) can observe changes in the patients' local and overall brain network connections in a task-free state, and is an important tool for exploring the recovery mechanism of PSA and scientifically predicting the prognosis. Starting from the perspective of rs-fMRI, this article reviews the literature on the observation and prediction of brain function changes in patients with PSA, so as to further guide the rehabilitation treatment practice of patients with PSA.

Research progress on application of artificial intelligence in clinical diagnosis and prognosis of patients with hepatocellular carcinoma 

Zhu Peng, Qin Gang, Guo Shimin

2025, 31(12):  1979-1983.  DOI: 10.3760/cma.j.cn441417-20250216-12010

Asbtract ( )  

References | Related Articles | Metrics

Hepatocellular carcinoma (HCC) is a common digestive system malignancy with challenging early diagnosis and poor prognosis. In recent years, the rapid development of artificial intelligence (AI) has demonstrated significant potential in improving HCC diagnosis and treatment. Machine learning (ML) and deep learning (DL)-based AI models can integrate multimodal data, including imaging, serological markers, and gut microbiota, thereby enhancing early risk prediction and lesion detection for HCC. Additionally, AI models provide decision support for interventional and pharmacological therapies through specific algorithms, while improving clinical prognosis assessment to optimize patient survival outcomes. Although AI cannot yet replace clinicians, the emergence of groundbreaking tools such as ChatGPT and DeepSeek suggests that AI will become a powerful adjunct in HCC management. This review summarizes recent advancements in AI-assisted HCC diagnosis, treatment decision-making, and prognosis evaluation, so as to provide insights for broader clinical applications of AI in HCC.

Treatises

Value of procalcitonin, C-reactive protein, and blood routine indicators in diagnosis of children with respiratory tract infections 

Shen Liaoliao, Lei Fang, Song Jingrong

2025, 31(12):  1984-1988.  DOI: 10.3760/cma.j.cn441417-20241104-12011

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the value of procalcitonin (PCT), C-reactive protein (CRP), and blood routine indicators in the diagnosis of children with respiratory tract infections. Methods　A total of 85 hospitalized children treated at Yulin Hospital, The First Affiliated Hospital of Xi'an Jiaotong University from May 2021 to September 2023 were selected for the retrospective study, including 52 boys and 33 girls. They were 3-12 years old. Their body weight was 20-33 kg. They were divided into a respiratory tract infection group (35 cases) and a non-respiratory tract infection group (50 cases) according to whether they had infections. The binary logistic regression model was used to analyze the factors influencing respiratory tract infections in the children. The receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic value of the children with respiratory tract infections. According to the types of pathogens, the children were divided into a bacterial infection group (11 cases), a mycoplasma infection (11 cases), and a viral infection group (13 cases), and the levels of PCT, CRP, and blood routine indicators were compared between the 3 groups. t, χ², and F tests were used as the statistical methods. Results　The PCT, CRP, platelet count (PLT), white blood cell count (WBC), and percentage of neutrophils (NEUT) in the respiratory tract infection group were higher than those in the non-respiratory tract infection group, with statistical differences (t=4.537, 4.472, 4.570, 4.297, and 4.453 ; all P<0.05). The results of the logistic regression model analysis showed that PCT (OR=16.750, 95%CI 3.777-74.283), CRP (OR=1.478, 95%CI 1.193-1.831), PLT (OR=10.071, 95%CI 2.911-34.843), WBC (OR=1.669, 95%CI 1.257-2.216), and NEUT (OR=1.187, 95%CI 1.083-1.301) were influential factors in the diagnosis of respiratory tract infections in the children (all P<0.05). According to ROC analysis, the sensitivities of PCT, CRP, PLT, WBC, and NEUT in the diagnosis of respiratory tract infections in the children were 0.686, 0.743, 0.714, 0.829, and 0.543, respectively; the specificities were 0.620, 0.600, 0.800, 0.780, and 0.820, respectively. The area under the curve of the combination of PCT, CRP, PLT, WBC, and NEUT in the diagnosis of respiratory tract infections in the children was 0.897. Conclusion　PCT and CRP combined with blood routine are of high value in the diagnosis of respiratory tract infections in children, and can provide reliable basis for clinicians to diagnose the pathogen types.

Cytogenetic characteristics and adverse pregnancy outcomes in patients with chromosome Robertsonian translocation 

Shi Xiaohui, Yang Lihui

2025, 31(12):  1989-1992.  DOI: 10.3760/cma.j.cn441417-20241218-12012

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the cytogenetic characteristics of patients with chromosome Robertsonian translocation (RT) and the association with adverse pregnancy outcomes. Methods　The clinical data of 98 patients with RT who were treated in the genetic counseling clinic of Northwest Women's and Children's Hospital from May 2021 to May 2024 were retrospectively analyzed. There were 56 females (57.14%) and 42 males (42.86%). They were (31.22±5.27) years old. The patients' cytogenetic test results and occurrence of adverse pregnancy history (spontaneous abortion, stillbirth, and fetal malformation) were counted. The relationship between RT types and adverse pregnancy history was analyzed. χ² test or Fisher's precision probability test was used for the statistical comparisons. Results　Among the 98 patients, 256 times of pregnancies were recorded, including 158 times (61.72%) of spontaneous abortion [120 times (46.88%) of early abortion (<12 weeks) and 38 times (14.84%) of late abortion (≥ 12 weeks)], 12 times (4.69%) of stillbirth, and 10 times (3.91%) of fetal malformation. The patients' RT types mainly were t(13;14)(q10;q10) and t(14;21)(q10;q10), accounting for 61.22%(60/98) and 20.41%(20/98), respectively; and other types included t(21;21)(q10;q10), t(13;15)(q10;q10), t(13;21)(q10;q10), and t(14;15)(q10;q10), accounting for 6.12% (6/98), 5.10% (5/98), 4.08% (4/98), and 3.06% (3/98), respectively. The fetal malformation rates of the patients with t(14;21)(q10;q10) and t(21;21)(q10;q10) were higher than that of the patients with t(13;14)(q10;q10) (both P<0.05); the stillbirth rate of the patients with t(21;21)(q10;q10) was higher than that of the patients with t(13;14)(q10;q10) (P<0.05). Among the 8 cases of fetal trisomy 21 syndrome, t(14;21) involved in 6 patients, and t(21;21) in 2 patients. t(13;14) were involved in 2 cases of multiple fetal malformations. Conclusion　RT, especially t(14;21)(q10;q10) and t(21;21)(q10;q10) ectopia, is closely related to the higher risk of adverse pregnancy outcomes, such as stillbirth and fetal malformation, especially the occurrence of trisomy 21 syndrome.

Application of ultrasound-guided TAP nerve block in radical gastrectomy for gastric cancer 

Chen Yang, Liu Xiaowei, Gong Jianping

2025, 31(12):  1993-1997.  DOI: 10.3760/cma.j.cn441417-20241119-12013

Asbtract ( )  

References | Related Articles | Metrics

Objective　To evaluate the efficacy of ultrasound-guided transversus abdominis plane (TAP) nerve block in radical gastrectomy for gastric cancer. Methods　A total of 104 patients who underwent radical gastrectomy for gastric cancer at Xidian Group Hospital from January 2021 to October 2023 were selected for the randomized control trial, and were divided into a control group and an experimental group by the randomized controlled trial, with 52 cases in each group. There were 29 males and 23 females in the control group; they were (50.81±5.75) years old; their body weight was (61.05±7.53) kg; their body mass index was (23.82±3.14) kg·m^-2; their operation time was (124.35±10.71) min. There were 27 males and 25 females in the experimental group; they were (50.56±5.49) years old; their body weight was (61.44±7.70) kg; their body mass index was (23.63±3.21) kg·m^-2; their operation time was (124.12±10.35) min. The experimental group took ultrasound-guided TAP nerve block and general anesthesia, and the control group general anesthesia. The intraoperative anesthetic drug consumption, perioperative indicators (postoperative recovery time, time to ambulation, and first postoperative analgesic supplementation time), scores of Visual Analog Scale (VAS) and Bruggrmann Comfort Score (BCS) 1, 4, and 8 h after the operation, levels of inflammatory factors and stress indicators before and 24 h after the operation, and incidences of adverse reactions were compared between the two groups by t and χ² tests. Results　The dosages of propofol, remifentanil, and cisatracurium in the experimental group were lower than those in the control group, with statistical differences (all P<0.05). The times for the first postoperative analgesic supplementation in the experimental group and the control group were (11.39±1.70) h and (4.98±1.12) h, respectively, with a statistical difference (P<0.05). The scores of VAS and the levels of inflammatory markers and stress indicators in the experimental group were lower than those in the control group, and the scores of BCS were higher, with statistical differences (all P<0.05). The incidence rate of adverse reactions in the experimental group was lower than that in the control group [5.77% (3/52) vs. 23.08% (12/52); P<0.05]. Conclusion　The application of ultrasound-guided TAP nerve block in radical gastrectomy for patients with gastric cancer helps reduce their postoperative pain, alleviate stress response and inflammation, and does not increase the incidence of adverse reactions.

Value of transvaginal color Doppler ultrasound in diagnosis of uterine adenomyosis and uterine fibroids 

Li Jing, Wang Xiaohua, Yu Cuiling, Yu Xiaoyong

2025, 31(12):  1997-2001.  DOI: 10.3760/cma.j.cn441417-20250430-12014

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the clinical value of transvaginal color Doppler ultrasound (TVCD) in the diagnosis of uterine adenomyosis and uterine fibroids. Methods　A retrospective study was conducted on 102 patients with suspected uterine adenomyosis or uterine fibroids who visited Department of Gynecology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from March 2023 to March 2025. They were (42.35±6.72) years old. All the patients underwent TVCD examination, and their sonographic features and blood flow signal characteristics were recorded and compared with the surgical pathological results. t and χ² tests and Fisher's precision probability test were used for the statistical comparisons. The sensitivities, specificities, accuracies, positive predictive values, and negative predictive values of TVCD for diagnosing these two diseases were calculated. Results　Among the 102 patients, 45 had uterine adenomyosis, 51 had uterine fibroids, and 6 had both conditions, confirmed by surgical pathology. Six patients with both coexisting conditions were not included in the analyses of sensitivity, specificity, etc. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of TVCD for diagnosing uterine adenomyosis were 93.33% (42/45), 92.16% (47/51), 92.71% (89/96), 91.30% (42/46), and 94.00% (47/50), respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of TVCD for diagnosing uterine fibroids were 94.12% (48/51), 91.11% (41/45), 92.71% (89/96), 92.31% (48/52), and 93.18% (41/44), respectively. Uterine adenomyosis on TVCD mainly manifested as an enlarged uterus, heterogeneous myometrial echoes, cystic areas, and thickened posterior wall; uterine fibroids mainly presented as round hypoechoic or isoechoic masses with clear boundaries and posterior echo enhancement or attenuation. The blood flow of uterine adenomyosis showed a diffuse distribution, with a resistance index (RI) of 0.52±0.07; uterine fibroids showed predominantly peripheral blood flow, with an RI of 0.64±0.06; there was a statistical difference in RI between them (P<0.05). Conclusions　TVCD has high diagnostic value for uterine adenomyosis and uterine fibroids. Its characteristic manifestations and blood flow patterns provide important evidences for clinical differential diagnosis.

Relationship of procalcitonin and cardiac troponin with prognosis of patients with infective endocarditis

Ren Xiaoyan, Wang Xiujun, Fan Yanting

2025, 31(12):  2002-2006.  DOI: 10.3760/cma.j.cn441417-20241120-12015

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the relationship of procalcitonin (PCT) and cardiac troponin (cTn) with the occurrence of complications and prognosis of patients with infective endocarditis (IE). Methods　Two hundred patients with IE treated at Tongchuan People's Hospital between May 2019 and December 2023 were selected as the study objects. All the patients were followed up regularly for six months outside the hospital. According to whether they had complications, the patients were divided into an observation group and a control group. There were 101 males and 49 females in the control group; they were (58.66±4.66) years old; their disease course was (2.98±0.41) years. There were 27 males and 23 females in the observation group; they were (58.44±4.36) years old; their disease course was (3.03±0.48) years. According to whether they recurred or died, the patients were divided into a good prognosis group and a poor prognosis group. The serum levels of PCT and cTn were compared between the observation group and the control group and between the good prognosis group and the poor prognosis group by t test. The independent factors influencing the patients' prognosis were analyzed by the binary logistic regression. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacies of PCT and cTn. Results　Among the 200 patients, 50 cases (25.00%) had complications, and were set as an observation group; the other 150 (75.00%) did not have complications, and were set as a control group. Among the 200 patients, 60 cases (30.00%) recurred or died, and were set as a poor prognosis group; the other 140 cases (70.00%) did not recurred or died, and were set as a good prognosis group. The levels of PCT and cTn in the observation group were higher than those in the control group [(0.35±0.02) μg/L vs. (0.04±0.01) μg/L and (0.29±0.03) μg/L vs. (0.08±0.01) μg/L; both P<0.05]. The levels of PCT and cTn in the good prognosis group were lower than those in the poor prognosis group [(0.32±0.02) μg/L vs. (0.04±0.01) μg/L and (0.30±0.03) μg/L vs. (0.07±0.01) μg/L; both P<0.05]. The Pearson correlation analysis showed that PCT and cTn were positively correlated with the occurrence of complications and poor prognosis in the patients (r=0.731 and 0.628; r=0.718 and 0.669; all P<0.05). PCT (OR=2.356, 95%CI 1.421-4.413), and cTn (OR=2.354, 95%CI 1.204-4.601) were independent risk factors for poor prognosis in the patients (both P<0.05). Conclusion　High PCT and cTn levels are closely related to the occurrence of complications and prognosis of patients with IE and are adverse factors affecting the prognosis of patients with IE.

Effect of tizanidine hydrochloride combined with venlafaxine in treatment of patients with chronic pain 

Gao Jiandong, Sun Fude, Wang Yihao, Yu Yang

2025, 31(12):  2006-2010.  DOI: 10.3760/cma.j.cn441417-20250102-12016

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effect of tizanidine hydrochloride and venlafaxine in the treatment of patients with chronic pain. Methods　One hundred and eight patients with chronic pain treated at Yantai City Yantaishan Hospital from April 2021 to April 2023 were selected for the randomized controlled trial, and were divided into a control group and an observation group by lottery, with 54 cases in each group. There were 32 males and 22 females in the control group; they were (44.64±4.18) years old; their disease course was (1.65±0.57) years; their body mass index was (23.05±1.08) kg/m²; 10 cases had pain on the lumbar, 29 the head, and 15 the limbs. There were 30 males and 24 females in the observation group; they were (44.18±4.03) years old; their disease course was (1.72±0.62) years; their body mass index was (23.15±1.01) kg/m²; 12 cases had pain on the lumbar, 27 the head, and 15 the limbs. The control group took tizanidine hydrochloride, and the observation group tizanidine hydrochloride and venlafaxine. The overall effective rates, scores of pain, depression, anxiety, and sleep quality, quality of life, and adverse reactions were compared between the two groups by χ² and t tests. Results　The total effective rate in the observation group was higher than that in the control group [94.44% (51/54) vs. 79.63% (43/54); χ²=5.252; P<0.05]. The pain scores after 2 weeks', 4 weeks' and 3 months' treatment in the observation group were lower than those in the control group (3.54±0.52 vs. 4.42±1.01, 2.24±0.48 vs. and 3.05±0.84, 1.98±0.36 vs. 3.45±0.79; t=5.692, 6.152, and 12.442; all P<0.05). After the treatment, the scores of depression, anxiety, and sleep quality in the observation group were lower than those in the control group (4.82±1.02 vs. 7.42±1.42, 4.10±0.84 vs. 7.05±1.03, and 5.53±1.06 vs. 8.42±1.84; t=10.927, 16.310, and 10.001; all P<0.05). After the treatment, the scores of somatic function, psychological function, social function, physical life status, and overall quality of life in the observation group were higher than those in the control group (82.52±8.48 vs. 75.45±7.19, 81.19±8.27 vs. 74.49±7.22, 82.82±8.51 vs. 75.62±7.34, 80.05±8.28 vs. 72.52±7.66, and 81.69±8.28 vs. 75.44±7.34; t=4.672, 4.484, 4.707, 4.905, and 4.150; all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the observation group and the control group [9.26% (5/54) vs. 7.41% (4/54); χ²=0.121; P=0.727]. Conclusion　Tizanidine hydrochloride and venlafaxine in the treatment of patients with chronic pain is effective and safe, and can relieve their depression and anxiety and improve their sleep quality and quality of life.

Relationship between vascular endothelial function and ischemic cardiovascular and cerebrovascular diseases in patients with DN

Xie Hui, Zhao Shan, Pang Hui, Feng Meng, Li Na, Zhang Yanli

2025, 31(12):  2011-2016.  DOI: 10.3760/cma.j.cn441417-20250114-12017

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the clinical relationship between vascular endothelial function and ischemic cardiovascular and cerebrovascular diseases in patients with diabetic nephropathy (DN). Methods　Three hundred and thirty-seven patients with DN, 150 patients with type 2 diabetes mellitus, and 150 healthy examinees admitted to Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2020 to January 2023 were set as a DN group, a diabetes group, and a healthy group, respectively. There were 173 males and 164 females in the DN group; they were (60.89±10.78) years old. There were 80 males and 70 females in the diabetes group; they were (60.82±10.63) years old. There are 79 males and 71 females in the healthy group; they were (60.85±10.39) years old. Their vascular endothelial function indicators [endothelin (ET), nitric oxide (NO), endothelium-dependent hyperpolarizing factor (EDHF), von Willebrand factor (vWF), and vascular endothelial growth factor (VEGF)] were detected and compared. The incidence rate of ischemic cardiovascular and cerebrovascular diseases in the patients with DN was calculated. The patients with DN were divided into an occurrence group and a non-occurrence group according to whether they complicated with ischemic cardiovascular and cerebrovascular diseases, and the levels of vascular endothelial function indicators and other clinical data were compared between the two groups. χ² and t tests were used for the statistical analysis. The correlation between vascular endothelial function indicators and ischemic cardiovascular and cerebrovascular diseases in the patients with DN was analyzed by the Pearson correlation analysis. The multivariate logistic regression model was used to analyze the influencing factors of ischemic cardiovascular and cerebrovascular diseases in the patients with DN. Results　The levels of ET, vWF, and VEGF in the DN group were higher than those in the diabetes group and the healthy group [(62.15±7.59) pg/L vs. (51.58±6.88) pg/L and (40.82±5.97) pg/L, (728.35±95.48) U/L vs. (511.58±67.17) U/L and (179.99±22.48) U/L, and (174.96±20.18) ng/L vs. (138.65±18.23) ng/L and (106.78±15.47) ng/L; F=490.30, 2 618.32, and 727.35; all P<0.05], and the levels of NO and EDHF were lower [(51.27±7.02) μmol/L vs. (62.96±8.32) μmol/L and (70.45±9.58) μmol/L and (12.63±2.59) μmol/L vs. (17.56±3.35) μmol/L and (25.14±4.78) μmol/L; F=328.51 and 708.23; both P<0.05]; the levels of ET, vWF, and VEGF in the diabetes group were higher than those in the healthy group (all P<0.05), and the levels of NO and EDHF were lower (both P<0.05). The incidence rate of ischemic cardiovascular and cerebrovascular diseases in the patients with DN was 32.94% (111/337). The age and levels of glycosylated hemoglobin (HbA1c), serum creatinine (SCr), ET, vWF, and VEGF in the occurrence group were higher than those in the non-occurrence group [(70.93±10.05) years vs. (55.96±9.24) years, (12.66±2.67)% vs. (9.03±2.05)%, (120.56±15.98) μmol/L vs. (93.57±13.55) μmol/L, (67.95±8.89) pg/L vs. (59.31±7.45) pg/L, (789.15±80.85) U/L vs. (698.49±77.66) U/L, and (191.36±20.64) ng/L vs. (166.91±19.75) ng/L; t=13.576, 13.783, 16.179, 9.375, 9.936, and 10.523; all P<0.05], the course of DN was longer [(6.34±1.26) years vs. (4.15±1.03) years; t=17.010; P<0.05], and the glomerular filtration rate (GFR) and levels of NO and EDHF were lower [(77.12±10.68) ml/(min·173 m²) vs. 96.22±11.48) ml/(min·173 m²), (44.66±6.82) μmol/L vs. (54.52±6.24) μmol/L, and (9.15±1.78) μmol/L vs. (14.34±1.85) μmol/L; t=14.683, 13.217, and 24.505; all P<0.05]. ET, vWF and VEGF in the patients with DN were positively correlated with the occurrence of ischemic cardiovascular and cerebrovascular diseases (t=5.152, 7.052, and 6.975; all P<0.001), while NO and EDHF were negatively correlated with the occurrence of ischemic cardiovascular and cerebrovascular diseases (t=-5.564 and -6.272; both P<0.001). Age, course of DN, HbA1c, ET, vWF, and VEGF were the risk factors of the DN patients complicated with ischemic cardiovascular and cerebrovascular diseases (all P<0.05), while GFR, NO, and EDHF were the protective factors (all P<0.05). Conclusion　Endothelial function indicators, such as ET, NO, EDHF, vWF, and VEGF, are correlated with ischemic cardiovascular and cerebrovascular diseases in patients with DN, and are all influencing factors of ischemic cardiovascular and cerebrovascular diseases in patients with DN.

Clinical Research

Efficacy of acupoint application in relieving gastrointestinal adverse reactions in patients with tumors and pulmonary tuberculosis 

Zeng Yunyun, Cai Jinglun, Huang Zhihao, Huang Huiyi, Liu Jiaqi, Su Shan

2025, 31(12):  2017-2021.  DOI: 10.3760/cma.j.cn441417-20250324-12018

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the clinical efficacy of traditional Chinese medicine (TCM) acupoint application in treating related gastrointestinal adverse reactions caused by chemotherapy and anti-tuberculosis treatment in patients with tumors and pulmonary tuberculosis. Methods　From January 2022 to October 2024, 44 patients with advanced-stage tumors and active pulmonary tuberculosis undergoing chemotherapy and anti-tuberculosis treatment in Oncology Department, Guangzhou Chest Hospital were selected as the study objects. According to the clinical antiemetic treatment plans, they were divided into a conventional antiemetic treatment group (22 cases) and an acupoint application treatment group (22 cases). In the conventional antiemetic treatment group, there were 21 males and 1 female; they were (62.957±8.014) years old; there were 14 cases of lung cancer and 8 cases of digestive tract tumors. In the acupoint application treatment group, there were 20 males and 2 females; they were (63.900±8.296) years old; there were 12 cases of lung cancer, 7 cases of digestive tract tumors, and 3 of other types of tumors.The acupoint application treatment group took TCM acupoint application therapy and conventional antiemetic treatment. The gastrointestinal adverse reactions, liver function damage, bone marrow suppression, nutritional indicators after chemotherapy, CD4 and CD8 cell counts after chemotherapy, and hospitalization times were compared between the two groups by t and χ² tests. Results　The incidence rate of gastrointestinal adverse reactions in the conventional antiemetic treatment group was higher than that in the acupoint application treatment group (P<0.05). The incidence rate of transaminase elevation, albumin level after chemotherapy [(38.012±4.304) g/L vs. (33.782±4.415) g/L], and upper arm circumference [(34.700±2.203) cm vs. (30.200±1.936) cm] in the acupoint application treatment group were better than those in the conventional antiemetic treatment group (all P<0.05). The hospitalization time in the conventional antiemetic treatment group was longer than that in the acupoint application treatment group [(10.620±0.160) d vs. (9.788±0.331) d], with a statistical difference (P<0.05). Conclusion　The combination of TCM acupoint application with conventional antiemetic treatment for patients with advanced-stage tumors and pulmonary tuberculosis undergoing chemotherapy and anti-tuberculosis treatment can reduce the incidence of gastrointestinal adverse reactions, liver function damage, protein-energy malnutrition caused by chemotherapy and anti-tuberculosis treatment for tumors and tuberculosis, and moderate to severe bone marrow and suppression after chemotherapy, shorten the hospitalization time, and improve their quality of life.

Relationship of VFA and Hcy with SCH in patients with Hashimoto's thyroiditis 

Li Beibei, Lei Ye, Zhang Ying

2025, 31(12):  2022-2027.  DOI: 10.3760/cma.j.cn441417-20250115-12019

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the correlation of visceral fat area (VFA) and serum homocysteine (Hcy) with subclinical hypothyroidism (SCH) in patients with Hashimoto's thyroiditis (HT). Methods　A total of 194 patients with HT admitted to Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from March 2023 to November 2024 were selected for the case control study. According to whether the patients were complicated with SCH, they were divided into a combined group (38 cases) and a non-combined group (156 cases). The VFA and serum Hcy level were measured in all the patients, and the clinical related data were collected. χ² test and t test were used to compare the clinical data. The logistic regression analysis was used to analyze the independent influencing factors. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic value. The Pearson method was used to analyze the correlation. Results　The age [(61.31±4.72) years vs. (57.36±4.78) years], proportion of females [92.11% (35/38) vs. 72.44% (113/156)], levels of thyroid peroxidase antibody (TPOAb) [(55.48±6.16) IU/ml vs. (52.43±5.83) IU/ml] and thyroid stimulating hormone (TSH) [(5.81±1.20) uIU/ml vs. (3.24±1.05) uIU/ml], VFA [(87.36±24.96) cm² vs. (60.44±17.28) cm²], and levels of Hcy [(17.21±4.30) mmol/L vs. (11.54±2.87) mmol/L] and thyroglobulin antibody (TgAb) [(46.32±5.15) IU/ml vs. (43.87±4.87) IU/ml] in the combined group were higher than those in the non-combined group (t=4.579, P<0.001; χ²=6.535, P=0.011; t=2.860, P=0.005; t=13.148, P<0.001; t=7.831, P<0.001; t=9.808, P<0.001; t=2.750, P=0.007). The logistic regression analysis showed that age (OR=2.031, 95%CI 1.178-3.502), gender (OR=3.218, 95%CI 1.229-8.424), TSH level (OR=2.375, 95%CI 1.555-3.626), VFA (OR=6.089, 95%CI 2.197-16.872), and Hcy level (OR=4.642, 95%CI 2.296-9.381) were independent influencing factors for SCH in the patients (all P<0.04). The ROC showed that the sensitivities of VFA, Hcy, and their combination in the diagnosis of SCH in the patients were 71.10%, 73.70%, and 86.80%, respectively; the specificities were73.10%, 75.00%, and 91.70%, respectively;the areas under the curves were 0.781, 0.807, and 0.918, respectively (all P<0.001). VFA and Hcy level were positively correlated with TSH levels in the HT patients with SCH (r=0.632 and 0.577; P=0.001 and 0.003). Conclusions　VFA and Hcy are independent risk factors for SCH in patients with HT; their levels are positively correlated with the serum TSH level in patients with HT combined with SCH, and have certain diagnostic value for the occurrence of SCH in patients with HT.

Effect of warfarin, aspirin, and clopidogrel for patients with atrial fibrillation and its influence on coagulation factors 

Xu Dan, Zhao Ying, Gao Ting

2025, 31(12):  2027-2032.  DOI: 10.3760/cma.j.cn441417-20241216-12020

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the effect of warfarin, aspirin, and clopidogrel for patients with atrial fibrillation (AF) and its influence on coagulation factors. Methods　One hundred and four patients with AF treated at Xianyang Central Hospital from August 2023 to August 2024 were selected as the study objects. Among which, 59 cases were treated with aspirin and clopidogrel, and were set as a control group; the other 45 cases were treated with warfarin, aspirin, and clopidogrel, and were set as an observation group. There were 34 males and 25 females in the control group; they were (64.39±6.48) years old. There were 29 males and 16 females in the observation group; they were (63.82±4.61) years old. The total effective rates and coagulation function and vascular endothelial function before and after the treatment were compared between the two groups. The risk of vascular embolism and bleeding of the patients was assessed by the Congestive Heart Failure, Hypertension, Age≥75 years, Diabetes Mellitus, Stroke (doubled), Vascular Disease, Age 65-74, Sex Category (CHADS2-VASc) and Hypertension and Other Bleeding Risk Factors (HAS-BLED). The major adverse cardiovascular events (MACE) were counted during the treatment in both groups, and the related factors were analyzed using the logistic regression analysis. χ² and t tests were used for the statistical analysis. Results　The total effective rate in the observation group was higher than that in the control group [93.33% (42/45) vs. 79.66% (47/59); P<0.05]. After the treatment, the prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer (D-D) level, and thrombin time (TT) of the observation group were lower than those of the control group (all P<0.05), and the vascular endothelial function was better. The scores of CHADS2-VASc and HAS-BLED were lower after than before the treatment in both groups (all P<0.05), but there were no statistical differences between the two groups (both P>0.05). There was no statistical difference in the incidence rate of MACE between the two groups (P>0.05). The logistic regression analysis showed that age and HAS-BLED score were the independent risk factors for MACE (both P<0.05). Conclusion　Warfarin triple therapy can effectively regulate the coagulation function and vascular endothelial function of patients with AF, and has high safety.

To investigate effect of Jinkui Shenqi pills combined with chlorosartan potassium tablets on renal fibrosis indicators in elderly patients with diabetic nephropathy based on TGF-β1/Smads signal pathway 

Qin Gangxin, Su Yanjin, Zhao Li, Wang Huiling, Yang Jinxin

2025, 31(12):  2033-2038.  DOI: 10.3760/cma.j.cn441417-20241120-12021

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effect of Jinkui Shenqi pills combined with chlorosartan potassium tablets on renal fibrosis indicators in elderly patients with diabetic nephropathy of the yin-yang deficiency type based on the transforming growth factor-β1 (TGF-β1) /Smads signal pathway. Methods　A total of 110 elderly patients with diabetic nephropathy of the yin-yang deficiency type treated at Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from January 2023 to January 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 55 cases in each group. There were 29 males and 26 females in the observation group; they were (68.59±5.48) years old; their disease course was (2.14±0.72) years. There were 32 males and 23 females in the control group; they were (69.25±5.74) years old; their disease course was (2.37±0.68) years. The control group took chlorosartan potassium tablets and conventional treatment; in addition, the observation group took Jinkui Shenqi pills. Both groups were treated continuously for 2 months. The scores of Chinese medicine symptoms, blood glucose levels [fasting blood glucose (FBG) and 2-hour postprandial blood glucose (2hPBG)], levels of renal function indicators [blood urea nitrogen (BUN), serum creatinine (SCr), and 24-hour urinary protein (24hUpro)], levels of renal fibrosis indicators [connective tissue growth factor (CTGF), procollagen type Ⅲ (PCⅢ), laminin (LN), and collagen type Ⅳ (CⅣ)], and protein and mRNA expressions of TGF-β1, Smad2, Smad3, and Smad7 were compared between the two groups before and after the treatment. The clinical efficacies and incidence rates of adverse reactions were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　Before the treatment, there were no statistical differences in the score of traditional Chinese medicine symptoms, levels of FBG, 2hPBG, BUN, SCr, 24hUpro, LN, PCⅢ, CⅣ, and CTGF, and protein and mRNA expressions of TGF-β1, Smad2, Smad3, and Smad7 between the two groups (all P>0.05). After the treatment, the scores of traditional Chinese medicine symptoms, levels of FBG, 2hPBG, BUN, SCr, 24hUpro, LN, PCⅢ, CⅣ, and CTGF, and protein and mRNA expressions of TGF-β1, Smad2, and Smad3 were lower than those before the treatment in both groups, and those in the observation group were lower than those in the control group (all P<0.05). After the treatment, the protein and mRNA expressions of Smad7 were higher than those before the treatment in both groups, and those in the observation group were higher than those in the control group (all P<0.05). The total clinical effective rate of the observation group was higher than that of the control group [92.73% (51/55) vs. 72.73% (40/55); χ²=7.698; P<0.05]. There was no statistical difference in the total incidence rate of adverse reactions between the two groups (χ²=0.440; P>0.05). Conclusion　Jinkui Shenqi pills combined with chlorosartan potassium tablets in the treatment of elderly patients with diabetic nephropathy of the yin-yang deficiency type is effective, which may improve their clinical symptoms and renal function inhibiting the expression of the TGF-β1/Smads signal pathway, and reduce the degree of renal fibrosis.

Significance of serum MFG-E8, FUC-HPT, and visfatin expressions in ulcerative colitis

Liu Xin, Wang Huiping, Lei Lei

2025, 31(12):  2039-2045.  DOI: 10.3760/cma.j.cn441417-20241211-12022

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the relationship of the serum levels of milk fat globule epidermal growth factor 8 (MFG-E8), fucosylated haptoglobin (FUC-HPT), and visfatin with the disease activity index and prognosis in patients with ulcerative colitis (UC). Methods　A total of 170 patients with UC who were admitted to No. 215 Hospital of Shaanxi Nuclear Industry from June 2019 to June 2022 were selected as a disease group, while 170 healthy subjects who underwent physical examinations during the same period were selected as a healthy control group. There were 87 males and 83 females in the disease group; they were (44.03±8.44) years old; their body mass index (BMI) was (23.78±3.01) kg/m². There were 90 males and 80 females in the healthy control group; they were (45.17±7.59) years old; their BMI was (23.31±2.98) kg/m². The serum levels of MFG-E8, FUC-HPT, and visfatin were compared between the control group and the disease group. The disease group were further divided into mild, moderate, and severe activity groups based on their UC activity levels, and the serum levels of MFG-E8, FUC-HPT, and visfatin were compared between the 3 groups. The Pearson correlation analysis was used to examine the relationship of the serum levels of MFG-E8, FUC-HPT, and visfatin with the Mayo score. A two-year follow-up was conducted to record the patients' prognosis, and the disease group were categorized into poor and good prognosis groups based on their outcomes. The general data and serum levels of MFG-E8, FUC-HPT, and visfatin were compared between the poor and good prognosis groups. The multivariate logistic regression model was used to analyze the influencing factors of the patients' prognosis. The Pearson correlation analysis was again employed to investigate the correlation of the serum levels of MFG-E8, FUC-HPT, and visfatin with prognosis (with poor prognosis coded as 0 and good prognosis coded as 1). The independent sample t test, Mann-Whitney U test, analysis of variance, and LSD-t test were used for the statistical analysis. Results　Compared to the healthy control group, the disease group had a lower serum level of MFG-E8 (P<0.05) and higher levels of FUC-HPT and visfatin (both P<0.05). The serum levels of MFG-E8 in the moderate and severe activity groups were lower than that in the mild activity group, while the serum levels of FUC-HPT and visfatin were higher (all P<0.05). The serum level of MFG-E8 in the severe activity group was lower than that in the moderate activity group, while the levels of FUC-HPT and visfatin were higher (all P<0.05). The Pearson correlation analysis revealed that the serum MFG-E8 was negatively correlated with the Mayo score (r=-0.553; P<0.001), while the serum FUC-HPT and visfatin were positively correlated with the Mayo score (r=0.757 and 0.713; both P<0.001). The multivariate logistic regression analysis indicated that the score of Positive and Negative Affect Scale (PANAS), extraintestinal manifestations, increased basal plasmacytes, FUC-HPT, and visfatin were risk factors for poor prognosis in the patients (all P<0.05), whereas MFG-E8 was a protective factor (P<0.05). The Pearson correlation analysis showed that serum MFG-E8 was negatively correlated with poor prognosis (r=-0.345, P<0.001), and serum FUC-HPT and visfatin were positively correlated with poor prognosis (r=0.607 and 0.616; both P<0.001). Conclusion　The serum MFG-E8 level is abnormally reduced, and the serum FUC-HPT and visfatin levels are abnormally increased in patients with UC, which are correlated with the disease activity and are influencing factors for prognosis in patients with UC.

Effect analysis of Jieyu Shugan Decoction in treating polycystic ovary syndrome (liver-stagnation and kidney deficiency syndrome)

Zhang Zhaohong, Liu Yan, Lei Jing, Jiang Lili, Liu Lan, Hu Yaping

2025, 31(12):  2046-2051.  DOI: 10.3760/cma.j.cn441417-20250109-12023

Asbtract ( )  

References | Related Articles | Metrics

Objective To analyze the effect of Jieyu Shugan Decoction on polycystic ovary syndrome (liver-stagnation and kidney deficiency syndrome). Methods A retrospective analysis was conducted. A total of 101 patients with polycystic ovary syndrome (liver-stagnation and kidney deficiency syndrome) admitted to Baoji Maternal and Child Health Hospital during January 2022 to December 2023 were selected and divided into a control group and an observation group based on different treatment methods. The control group received oral cyproterone acetate and ethinyl estradiol tablets, while the observation group received the same tablets plus modified Jieyu Shugan Decoction. The control group consisted of 50 patients with age of (29.67 ± 3.52) years and disease duration of (3.31 ± 0.64) years. The observation group consisted of 51 patients with an average age of (30.43 ± 3.64) years and an average disease duration of (3.48 ± 0.73) years. Both groups were treated continuously for 12 weeks. The clinical efficacy, adverse reactions, and changes in traditional Chinese medicine (TCM) symptom scores, serum hormone levels [follicle stimulating hormone (FSH), estradiol (E2), luteinizing hormone (LH), testosterone (T), anti-mullerian hormone (AMH)], and uterine artery hemodynamics [pulsatility index (PI) and resistance index (RI)] were compared between the two groups. Statistical analysis was performed using t and χ² tests.Results After treatment, the total effective rate of treatment in the observation group was higher than that in the control group [94.12% (48/51) vs. 78.00% (39/50)], and the difference was statistically significant (P<0.05). The TCM syndrome score, serum LH, T, and AMH levels, PI, and RI in the observation group were all lower than those in the control group [(8.61±2.13) points vs. (14.52±3.27) points, (9.05±1.37) IU/L vs. (11.16±1.52) IU/L, (0.92±0.17) pmol/L vs. (1.11±)] 0.23) pmol/L, (7.29±1.14) μg/L vs. (9.46±1.37) μg/L, 2.16±0.26 vs. 2.52±0.39, 0.62±0.11 vs. 0.73±0.10](t=10.783, 12.026, 12.534, 15.904, 5.468, 5.256, all P<0.05), and the levels of serum FSH and E2 were both higher [(5.91±0.61) IU/L vs. (5.64±0.57) IU/L, (204.62±23.57) ng/L vs. (165.38±16.82) ng/L];the differences were all statistically significant (all P<0.05).The total occurrence of adverse reactions in the observation group showed no statistically significant difference compared with that in the control group [7.84% (4/51) vs. 10.00% (5/50), P>0.05].Conclusion Jieyu Shugan Decoction in the treatment of polycystic ovary syndrome (liver-stagnation and kidney deficiency syndrome) can improve the therapeutic effect, alleviate symptoms, regulate serum hormone levels, and improve endometrial blood flow state, without increasing the occurrence of adverse reactions.

Value of contrast-enhanced ultrasound blood flow perfusion parameters in distinguishing pathological differentiation degrees of hepatocellular carcinoma 

Hu Yun, Cui Xiang, Wang Xiaoling, Zhang Jialan

2025, 31(12):  2051-2056.  DOI: 10.3760/cma.j.cn441417-20241014-12024

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the value of contrast-enhanced ultrasound blood flow perfusion parameters in distinguishing the pathological differentiation degrees of hepatocellular carcinoma. Methods　A retrospective analysis was conducted on the clinical data of 134 patients with hepatocellular carcinoma treated in Ankang Traditional Chinese Medicine Hospital from May 2022 to March 2024. There were 96 males and 38 females who were (59.72±10.85) years old. All the patients underwent contrast-enhanced ultrasound examination before the treatment. The blood flow perfusion parameters (initial increase time, peak time, initial retreat time, peak enhancement time, clearance time, initial increase intensity, peak intensity, and average blood flow density) were recorded. The degree of tissue differentiation was determined based on the pathological examination results. The blood flow perfusion parameters of contrast-enhanced ultrasound in the patients with hepatocellular carcinoma of different differentiation degrees were compared, and the value of contrast-enhanced ultrasound blood flow perfusion parameters in distinguishing the pathological differentiation degrees of hepatocellular carcinoma was analyzed using receiver operating characteristic curves (ROC). The statistical methods included nonparametric rank sum test and one-way analysis of variance. Results　Among the 134 patients, 31 were highly differentiated, 59 were moderately differentiated, and 44 were poorly differentiated. There were no statistical differences in initial increase time, initial increase intensity, and peak intensity between the patients with hepatocellular carcinoma of different differentiation degrees (all P>0.05). There were statistical differences in the peak time [(38.29±8.19) s, (28.03±6.69) s, and (23.55±3.61) s], peak enhancement time [21.00 (19.50, 24.50) s, 14.00 (10.00, 18.50) s, and 10.50 (9.00, 12.25) s], initial retreat time [(131.97±37.10) s, (79.44±25.98) s, and (56.11±18.59) s], clearance time [(76.45±23.58) s, (47.90±14.91) s, and (33.05±10.32) s], and average blood flow density (0.36±0.10, 0.57±0.15, and 0.78±0.22) between the patients of high, moderate, and poor differentiation (all P<0.05). The peak time, peak enhancement time, initial retreat time, and clearance time decreased from the patients of high differentiation to the patients of moderate differentiation, and to the patients of poor differentiation, while the average blood flow density increased (P<0.05). The ROC analysis results showed that the areas under the curves for distinguishing the pathological differentiation degrees of hepatocellular carcinoma based on peak time, peak enhancement time, initial retreat time, clearance time, and average blood flow density were 0.767, 0.778, 0.830, 0.824, and 0.828, respectively. The area under the curve of the combined diagnosis of the five factors (0.920) was higher than that of the single diagnosis (all P<0.05). Conclusion　The peak time, peak enhancement time, initial retreat time, clearance time, and average blood flow density in contrast-enhanced ultrasound perfusion parameters can all be used to differentiate the pathological differentiation degrees of hepatocellular carcinoma, and the combined value of these five parameters is higher.

The application of anterograde lobed latissimus dorsi flap in the reconstruction of chest wall after LABC resection 

Ren Jie, Wang Yang, Xi Ruxing

2025, 31(12):  2056-2061.  DOI: 10.3760/cma.j.cn441417-20240827-12025

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the effect of anterograde design of lobular latissimus dorsi flap in immediate reconstruction of chest wall defect after resection of locally advanced breast cancer (LABC). Methods　A retrospective analysis was conducted. Fifty-nine female patients with LABC who underwent radical mastectomy for breast cancer and immediate chest wall repair and reconstruction at Xi 'an International Medical Center Hospital from January 2021 to October 2023 were selected and divided into an observation group and a control group according to different methods of chest wall defect repair and reconstruction. There were 28 cases in the observation group, with an age of (53.1±6.4) years. There were 31 cases in the control group, with an age of (52.6±6.5) years. The observation group used the anterograde method to design lobulated latissimus dorsi flap for defect repair, while the control group used the pedicled rectus abdominis flap for defect repair. The perioperative related indicators (operation duration, intraoperative blood loss, number of lymph node dissections, skin defect area, postoperative drainage time ,and hospital stay), complication rates, appearance satisfaction ,and survival analysis indicators [overall survival rate (OS) and disease-free survival rate (DFS)] of the two groups were compared. Statistical analyses were performed using t-tests, χ² tests, Kaplan-Meier survival analysis methods and Log-Rank tests.. Results　The operation time and postoperative drainage time in the observation group were both shorter than those in the observation group [(231.4±30.7) min vs. (249.3±36.8) min and (4.3±0.4) d vs. (4.5±0.3) d)], and the intraoperative blood loss was lower than that in the control group [(86.9±19.5) ml vs. (98.7±24.4) ml]; the differences were all statistically significant (all P<0.05). The number of lymph node dissections in the observation group was 15.2±1.1, and the postoperative hospital stay was (8.7±0.7) , while those in the control group were 14.8±1.5 and (9.1±1.2) days, respectively; there were no statistically significant differences (both P>0.05). The total incidence of complications in the observation group was lower than that in the control group [10.7% (3/28) vs. 32.3% (10/31)], and the difference was statistically significant (χ²=3.975, P=0.046). After a 6-month follow-up, the proportion of very satisfied individuals in the observation group was significantly higher than that in the control group [(60.7% (17/28) vs. 32.3% (10/31))], and the difference was statistically significant (P<0.05). There was no statistical difference in the overall satisfaction between the two groups (χ²=1.650, P>0.05). The 3-year DFS rate was 71.4%（20/28） in the observation group, and 67.7%（21/31） in the control group. The OS rate was 82.1%（23/28） in the observation group, and 77.5%(24/31) in the control group. The Log-Rank test showed that there were no statistically significant differences in DFS (χ²=0.142, df=1, P=0.706) and OS (χ²=0.171, df=1,P=0.679) between the two groups. Conclusion　The anterior-designed bilateral latissimus dorsi muscle flap for immediate chest wall reconstructions in patients with LABC can significantly optimize the surgical process (reduce operational difficulty, shorten operation time, and reduce intraoperative bleeding), while ensuring reliable blood supply to the flap and reducing complications in the donor area. The clinical efficacy is definite and worthy of promotion and application.

A Study on the Construction and Validation of Prediction Models for Colonoscopy Bowel Preparation Failure in Elderly Patients Using Logistic Regression and Bayesian Methods 

Pan Qiuhua, Cao Puyuan, Chen Aizhen, Xian CaiLian, Liu Zhixiang, Wang He, Li Yongqiang, He Jiali, Li Ping

2025, 31(12):  2062-2068.  DOI: 10.3760/cma.j.cn441417-20241226-12026

Asbtract ( )  

References | Related Articles | Metrics

Objective　To construct and verify the prediction model of intestinal preparation failure for colonoscopy in elderly patients based on logistic regression and Bayes. Methods　From January 2023 to December 2023, 249 patients with failed bowel preparation for colonoscopy were enrolled from Guangzhou First People's Hospital. Using a 1:1.88 ratio, 467 patients without bowel preparation failure during the same period were selected. They were divided into a test group (501 cases) and a validation group (215 cases) according to the different treatment durations. In the test group, there were 174 cases of failed intestinal preparation, including 104 males and 70 females, with an age of (69.49±7.405) years. Intestinal preparation failed in 327 cases, including 139 males and 188 females, with an age of (68.54±5.779) years. In the verification group, there were 75 cases of failed intestinal preparation, including 36 males and 39 females, with an age of (70.32±8.076) years. Intestinal preparation failed in 140 cases, including 70 males and 70 females who were (67.94±6.115) years old.In this study, the data were collected using the General information Questionnaire and the Boston Bowel Readiness Assessment Scale. The differences in categorical variables and continuous variables between different groups were compared respectively through the χ² test and the mean t test. Subsequently, a multivariate Logistic regression model and a Bayesian model were constructed in the test set and verified using the validation set. Finally, the predictive efficacy of the two models was evaluated through the receiver operating characteristic curve(ROC). Results　From January 2023 to December 2023, a total of 716 patients were admitted to Guangzhou First People's Hospital. Among them, 249 patients failed in colonoscopy and intestinal preparation, with an incidence rate of 34.78%. In the test group, the following indicators in the failed bowel preparation group were significantly lower than those in the qualified bowel preparation group: the sequence of this colonoscopy, the grade of hypertension, the history of abdominal surgery, the detection rate of adenoma, the time of the first defecation after taking laxatives, and the compliance with a low-residue diet the day before the examination (all P<0.05). A total of 716 patients were included in this study, among whom 349 were male (48.7%) and 367 were female (51.3%). The age range was 60 to 95 years old, with an average of 69. Through the multivariate logistic regression analysis, it found that the influencing factors of failed bowel preparation included: the number of colonoscopy examinations this time, the grade of hypertension, the history of abdominal surgery, adenoma, the time of the first defecation after taking laxatives, and whether there was a low-residue diet the day before the examination. The comparison of model performance showed that the AUC of the logistic regression model was 0.908 (95%CI: 0.881-0.934), which was significantly higher than 0.767 (95%CI: 0.701-0.833) of the Bayesian model, indicating that the logistic regression model has better classification performance. Conclusions　The logistic regression model can provide parameter details among various variables, offer detailed scores for the prediction of failed bowel preparation, and can be used for clinical promotion. The Bayesian model is faster when the amount of data is large, and can be used as a clinical assistant.

Application of auricular acupoint compression and percutaneous acupoint potential stimulation pretreatment in postoperative patients with breast cancer based on meridian flow theory 

Li Ying, Deng Liuxiang, Xia Lingyi, Zhong Yuting

2025, 31(12):  2069-2072.  DOI: 10.3760/cma.j.cn441417-20250102-12027

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effects of auricular point compression and bean compression combined with percutaneous point potential stimulation pretreatment on sleep quality, emotional state, and quality of life of patients after breast cancer surgery based on the theory of meridian flow. Methods　A total of 120 patients treated in the First Affiliated Hospital of Gannan Medical University from August 2023 to August 2024 underwent radical mastectomy. According to the random number table method, they were divided into a conventional treatment group (Group A), a auricular point bean pressing group (Group B), a percutaneous point potential stimulation group (Group C), and a combined treatment group (Group D, auricular point bean pressing combined with percutaneous point potential stimulation), with 30 cases in each group. The age of group A was (41.35 ± 3.28) years, with 8 cases of Stage Ia, 12 cases of Stage Ib, and 10 cases of Stage Ⅱa breast cancer. The age of group B was (42.05 ± 4.17) years, with 9 cases of stage Ia, 11 cases of stage Ib, and 10 cases of stage Ⅱa breast cancer.The average age of Group C was (42.13 ± 2.73) years, with 10 cases of stage Ia, 11 cases of stage Ib, and 9 cases of stage Ⅱa breast cancer.The age of Group D was (42.42 ± 3.47)years, with 8 cases of stage Ia, 13 cases of stage Ib, and 9 cases of stage Ⅱa breast cancer. Patients in all 4 groups were intervened for one week. The Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and quality of life scores were compared before and after the intervention between the four groups. The clinical indicators, scar scores before and after treatment, serum growth factor levels, and adverse reaction rates were compared. Statistical analysis was performed using t-tests. Results After one week of intervention, PSQI scores in groups B, C and D were significantly decreased compared with group A (P < 0.05). The HAMA and HAMD scores in group D were significantly lower than those in groups A, B and C [(6.13±0.51) points vs. (11.48±1.37), (9.32±1.43), (8.22±1.28) points, (12.84 ± 1.75) points vs. (17.93 ± 1.68), (15.74±1.57), (15.46±1.64) points], with a statistically significant differences (all P < 0.05). The quality of life score of group D was significantly higher than that of group A [(84.39 ± 3.26) points vs. (79.84 ± 4.34) points], with statistically significant differences (P < 0.05). Conclusion Based on the theory of meridian injection, auricular acupoint compression combined with percutaneous acupoint potential stimulation pretreatment can significantly improve the sleep quality, anxiety, depression, and quality of life of patients after breast cancer surgery.

The efficacy of 1565 nm non-ablative fractional laser treatment with different parametexs for hypertrophic scars 

Ma Binx, Wang Yingqua, Ma Yunyu, Zhu Zhenlai

2025, 31(12):  2073-2077.  DOI: 10.3760/cma.j.cn441417-20240805-12028

Asbtract ( )  

References | Related Articles | Metrics

Objective To investigate the efficacy of 1 565 nm non-ablative fractional laser treatment with different parameters on hypertrophic scars and its impact on growth factors. Methods A prospective study was conducted from May 2020 to June 2023 involving 62 patients with hypertrophic scars treated at Yulin Hospital, First Affiliated Hospital of Xi'an Jiaotong University. The patients were divided into two groups using a random number table method. In Group A, there were 15 males and 16 females; the laser parameters were set as follows: energy 30 mJ and density 200 spots/cm²;the age was (25.85±4.54) years old, and the disease duration was (2.98±1.36) years. In Group B, there were 16 males and 15 females;the laser parameters were set as follows: energy 45 mJ and density 200 spots/cm;the age was (26.52±4.18) years old, and the disease duration was (3.02±1.30) years. Both groups were treated once a month for three consecutive months. The clinical indicators, scar scores before and after treatment, serum growth factor levels, and adverse reaction rates were compared between the two groups. Statistical analysis was performed using t-tests and χ² tests. Results After treatment, there were no statistically significant differences in the times for edema and erythema resolution between the two groups [(2.59 ± 0.48) d vs. (2.72 ± 0.43) d and (4.72 ± 1.25) d vs. (5.07 ± 1.29) d], with no statistically significant differences (both P > 0.05). However, the Vancouver Scar Scale (VSS), Observer Scar Assessment Scale (OSAS), and Patient Scar Assessment Scale (PSAS) scores were significantly lower in Group B compared to Group A [(3.42 ± 0.74) points vs. (4.31 ± 0.82) points, (21.46 ± 3.62) points vs. (24.68 ± 3.47) points, and (19.36 ± 3.21) points vs. (21.75 ± 3.13) points, respectively, with t-values of 4.486, 3.575, and 2.968, all P < 0.05]. The post-treatment serum levels of vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and transforming growth factor-β1 (TGF-β1) were lower in Group B than in Group A [(185.43 ± 51.64) ng/L vs. (212.96 ± 52.83) ng/L, (179.35 ± 49.71) ng/L vs. (205.35 ± 50.24) ng/L, and (243.21 ± 48.78) ng/L vs. (275.64 ± 52.46) ng/L], with statistically significant differences (t = 2.075, 2.048, and 2.521, all P < 0.05). There were no statistically significant differences in the incidence rate of adverse reactions such as skin itching, pigmentation, and blisters [96.77% (30/31) vs. 93.55% (29/31), P > 0.05]. Conclusions The 1 565 nm non-ablative fractional laser is highly effective in treating hypertrophic scars. The scar scores (including OSAS and PSAS scores) and serum growth factor (VEGF, EGF, and TGF-β1) levels in the high-energy (45 mJ) treatment group were significantly lower than those in the low-energy (30 mJ) treatment group. Therefore, the high-energy setting of the 1 565 nm non-ablative fractional laser can be an effective choice for treating hypertrophic scars.

Experience Exchange

Study on the influencing factors of the perceived risk of voluntary blood donation among college students in Guangzhou 

Zhang Ting, Chen Jinyan, Tan Yong'en, Huang Jianhua, Wu Lan, He Yanlin, Zheng Xiaoxiao

2025, 31(12):  2078-2082.  DOI: 10.3760/cma.j.cn441417-20241111-12029

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the influencing factors of perceived risks associated with unpaid blood donation among college students in Guangzhou, and provide a scientific basis for optimizing blood donation recruitment strategies for this population. Methods　A semi-structured questionnaire was developed based on literature review and expert consultation. Using a stratified sampling method, an anonymous survey was conducted among students from six universities in Guangzhou via the "Questionnaire Star" platform from September to October 2024. A total of 175 valid questionnaires were collected, including 75 males and 100 females. The respondents were primarily freshmen (26.3%) and masters (24.0%).The questionnaire covered demographic characteristics, blood donation knowledge, and a perceived risk scale. It was designed to examine differences in perceived risks between gender groups, identify key influencing factors, and construct a predictive model for blood donation intention. Statistical analyses were performed using one-way ANOVA, principal component factor analysis, and binary logistic regression analysis. Results　The study revealed that health-related perceived risk (explained variance: 29.378%) was the primary influencing factor, primarily manifested as concerns about physical condition before and after blood donation. This was followed by sense of honor and identity toward blood donation (explained variance: 11.320%),trust-related perceived risk (9.026%), and donation environment and social influence (6.467%).Females' risk perception of health concerns and hygiene concerns about blood collection equipment was significantly higher than men (3.62 vs. 3.06, 3.66 vs. 3.14), and the differences were statistically significant (F=12.458 and 7.578, both P<0.05).Health-related concerns demonstrated a significant negative association with donation willingness (β=-1.029, adjusted OR=0.357,P<0.05).Male gender emerged as a positive predictor (β=1.119, adjusted OR=3.063,P<0.05).Blood donation knowledge level showed a positive correlation (β=0.237, adjusted OR=1.267,P<0.05) Conclusion　Scientific and effective publicity and recruitment strategies should be adopted for the perceived risk factors that affect college students' willingness to donate blood, to improve college students' cognitive level of blood donation and the awareness rate of the destination of blood and the rights and interests of blood donors, to reduce the perceived risks of college students' blood donation, and to further develop the blood donation potential of college students.

Nursing Research

Application of continuous quality improvement in the management of elderly patients with cancer pain 

Ren Chuanwei, Li Huiying, Shen Yanting

2025, 31(12):  2083-2088.  DOI: 10.3760/cma.j.cn441417-20250220-12030

Asbtract ( )  

References | Related Articles | Metrics

Objective Taking the monitoring results of the evaluation indicators of pain care quality as the entry point, organize and carry out the continuous improvement of pain care quality based on the monitoring results to enhance the care quality of elderly cancer pain patients. Methods By using the self-before-and-after control method, 95 elderly patients with cancer pain admitted to Cadre Health Care Center ,Drum Tower Hospital Affiliated to Nanjing University Medical School were selected as the research subjects. According to the nursing intervention methods, they were divided into a control group and an observation group. The control group received conventional nursing, while the observation group implemented a cancer pain nursing plan with continuous quality improvement on the basis of conventional nursing. The number of male and female cases in the control group were 20 and 10, respectively,aged 62~83 (72.45±5.18) years; there were 10 cases with educational attainment of primary school or below, 18 cases of middle school, and 2 cases of college or above. There were 8 cases of stage I cancer, 8 cases of stage Ⅱ cancer, 10 cases of stage Ⅲ cancer and 4 cases of stage Ⅳ cancer. The number of male and female cases in the observation group were 42 and 23 respectively,aged 61~85 (73.58±6.37) years; there were 15 cases with educational attainment of primary school or below, 38 cases of middle school, and 12 cases of college or above. There were 14 cases of stage Ⅰcancer, 19 cases of stage Ⅱ cancer, 22 cases of stage Ⅲ cancer and, 10 cases of stage Ⅳ cancer. Among the 20 female nurses participating in this study, 5 (8.5%) had a junior college degree and 15 (25.4%) had a bachelor's degree. The intervention period was two months. The compliance rates of pain care quality evaluation indicators (including the completion rate of pain assessment frequency, the awareness rate of health education, the standardized medication rate, etc.) of the two groups were compared, as well as the application effects of continuous quality improvement measures. Statistical analysis was performed using t-tests and χ² tests.Results The satisfaction with pain management in the observation group was significantly higher than that in the control group [92.31% (60/65) vs. 77.42% (24/31)] (χ²=4.25, P=0.045). The completion rate of pain assessment frequency, the awareness rate of health education, and the standardized use rate of Doraji patches were all significantly higher than those in the control group, and the differences were statistically significant (all P<0.05). There were no statistically significant differences in the coverage rate of pain assessment at admission and the correct rate of pain assessment tool selection before and after the intervention (all P>0.05).Conclusion Constructing the evaluation indicators of pain care quality and conducting continuous quality improvement of elderly cancer pain care is conducive to improving the quality of elderly cancer pain care and enhancing patients' satisfaction.

Application value of "Three Early" health education combined with nurse-family joint support and postpartum manual massage in primiparous women 

Jia Yimin, Zhang Qian, Wang Qiuming

2025, 31(12):  2088-2092.  DOI: 10.3760/cma.j.cn441417-20241120-12031

Asbtract ( )  

References | Related Articles | Metrics

Objective　To study application value of "Three Early" health education (TEHE) combined with nurse-family joint support(NFS) and postpartum manual massage in primiparous women. Methods　A retrospective analysis was performed on 94 primipara treated in Henan Provincial People's Hospital from January 2021 to December 2023. All subjects were divided into a conventional group (n=47) and a combined group (n=47) according to different nursing methods. The conventional group was 19 to 32 (26.65±2.86) years old; the gestational age was (38.45±0.73) weeks; ; there were 31 cases of natural delivery and 16 cases of cesarean section . The combined group was 19 to 32 (26.75±2.91) years old; the gestational age was (38.52±0.69) weeks;there were 33 cases of natural delivery and 14 cases of cesarean section. The conventional group received routine postpartum care, and the combined group received TEHE and NFS assisted postpartum massage care. The two groups were treated for 7 d. The postpartum milk yield, breast tenderness, anxiety and depression [Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS)], breastfeeding success rate and socres of Breastfeeding Self-confidence Scale (BSES) were compared between the two groups.T test, and χ² test were used for analysis. Results　After treatment,the postpartum milk yield of the combined group was significantly more than that of the conventional group (P=0.003);the incidence rate of breast tenderness of the combined group was lower than that of the conventional group [12.77% (6/47) vs. 36.17% (17/47)](χ²=6.965, P=0.008). The breastfeeding success rate of the intervention group was significantly higher than that of the control group [80.85% (38/47) vs 57.45% (27/47)](χ²=6.034,P=0.014).The BSES scores of the combined group were higher than those of the conventional group at 15 d and 30 d [(84.96±5.63) points vs. (63.54±2.79) points,(128.36±6.78) points vs. (112.05±5.32) points] (all P < 0.05). Conclusion　The application of TEHE with NFS assisted postpartum massage in primipara has significant effects, which can relieve breast tenderness, improve maternal bad mood, increase postpartum milk production, and improve breastfeeding skills and self-confidence.

Effect of multidisciplinary collaboration for Chemotherapy induced peripheral neuropathy in Patients with breast cancer 

Wang Xiao, Deng Zhiping, Zhang Xifan, Li Yang, Zhang Yu

2025, 31(12):  2093-2097.  DOI: 10.3760/cma.j.cn441417-20241029-12032

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the actual effectiveness and feasibility of multidisciplinary collaborative nursing interventions in alleviating symptoms of chemotherapy-induced peripheral neuropathy (CIPN) after breast cancer chemotherapy. Methods　A single-center prospective randomized controlled trial was conducted. The study involved 128 patients with CIPN treated at Shaanxi Provincial Cancer Hospital from February 2022 to January 2024.The patients were randomly divided into a control group and a study group, each consisting of 64 patients. The control group including 1 male and 63 females, aged 31-56 (32.84±2.75) years; the study group including 1 male and 63 females, aged 36-52 (33.27±3.17) years.The control group received routine nursing care, while the study group was administered a multidisciplinary nursing intervention protocol in addition to standard care.Both groups received the allocated interventions for 3 months. Medical Coping Modes Questionnaire (MCMQ), Herth Hope Index (HHI), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Visual Analogue Scale (VAS) for pain, and the Neurotoxicity Quality of Life Scale (FACT/GOG Ntx) score of the American Cancer Treatment Functional Evaluation System were compared between two groups. t test and χ² test were used for statistically analysis. Results　After three months of intervention, the study group showed lower scores in the dimensions of submission and avoidance compared to the control group [(12.57±2.64) points vs. (14.13±3.18) points and (14.62±2.23) points vs. (17.28±2.56) points], while the score of the facing dimension was higher than the control group [(19.13±2.82) points vs. (17.65±2.63) points] (all P<0.05). The study group demonstrated significantly higher HHI scores compared to the control group[(40.81±4.51) points vs. (36.67±4.26) points], but showing lower scores on both SAS and SDS [(55.82±5.24) vs. (60.19±5.73)points and (54.18±6.04) points vs. (59.57±6.38) points], with all differences being statistically significant (all P< 0.05).The study group demonstrated significantly lower neuropathic pain VAS scores than the control group at both 1-month and 3-month post-chemotherapy [(1.83±0.73) points vs. (2.46±0.86)points、(0.58±0.17) points vs. (1.04±0.39)points]. Similarly, FACT/GOG-Ntx scores were significantly reduced in the study group compared to the control group at both 1-month and 3-month post-chemotherapy[(7.23±1.86) points vs. (10.84±2.49)points and (3.56±1.12) points vs. (5.27±1.58) points](t=9.292 and 7.064，both P<0.05). Conclusion　Nursing interventions within a multidisciplinary context effectively improve the psychological state, pain level, and quality of life of patients suffering from CIPN following breast cancer chemotherapy.

Effect of "Internet +" model nursing intervention on psychological resilience of patients with esophageal cancer undergoing chemotherapy 

Guo Wanzhen, Liu Xiangyang, Zhu Jianxin

2025, 31(12):  2098-2103.  DOI: 10.3760/cma.j.cn441417-20241205-12033

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of nursing intervention based on "Internet+" model in patients with esophageal cancer undergoing chemotherapy. Methods　A retrospective analysis was conducted. A total of 86 patients with esophageal cancer admitted to Nanyang Central Hospital from June 2022 to June 2024 were selected, and divided into a control group and an observation group according to different nursing methods. The control group received routine nursing, while the observation group received nursing intervention based on the "Internet +" model. The control group included 43 patients, with 23 males and 20 females, aged 42-76 (59.98 ± 3.27) years. The observation group also included 43 patients, with 23 males and 20 females, aged 42-76 (59.98 ± 3.27) years. The two groups were continuously observed for 3 months. The nutritional status, psychological state, psychological resilience, quality of life, and patient satisfaction with nursing services were compared between the two groups. Statistical analysis was performed using t tests and χ² tests. Results　The levels of hemoglobin (Hb), albumin (ALB), and prealbumin (PA) in the observation group were higher than those in the control group [(135.87 ± 16.01) g/L vs. (111.47 ± 15.65) g/L, (43.76 ± 4.41) g/L vs. (32.78 ± 4.35) g/L, and (253.77 ± 22.75) mg/L vs. (210.15 ± 22.60) mg/L] (t = 7.147, 11.624 and 8.920, all P < 0.05). The stress, depression and anxiety scores of the post-nursing Depression-Anxiety-Stress Scale (DASS) in the observation group were lower than those in the control group [(8.18 ± 1.00) points vs. (12.23 ± 1.01) points, (8.34 ± 1.07) points vs. (12.19 ± 1.13) points, and (8.38 ± 1.03) points vs. (11.89 ± 1.06) points], with statistically significant differences (t = 18.685, 16.223, 15.573, all P < 0.05). The scores of strength, optimism, and fortitude of the post-nursing mental resilience scale (CD-RISC) in the observation group were higher than those in the control group [(25.52 ± 2.10) points vs. (19.49 ± 1.84) points, (12.31 ± 1.13) points vs. (9.62 ± 1.12) points, and (40.53 ± 4.22) points vs. (32.75 ± 4.12) points], with statistically significant differences (t = 14.162, 11.087 and 8.650, all P < 0.05). The scores of physical function, role function, cognitive function, emotional function, and social function in the post-nursing quality of life (QLQ-C30) of the observation group were higher than those of control group [(81.18 ± 4.36) points vs. (75.57 ± 4.27) points, (83.37 ± 4.35) points vs. (76.86 ± 4.21) points, (86.63 ± 4.38) points vs. (79.92 ± 4.14) points, (85.51 ± 4.29) points vs. (77.84 ± 3.92) points, and (86.67 ± 4.77) points vs. (79.29 ± 4.65) points], with statistically significant differences (t = 6.028, 7.052, 7.301, 8.655, and 7.265, all P< 0.05). The scores of demand satisfaction, service attitude, psychological counseling, nursing timeliness, and nursing skills in the nursing satisfaction in the observation group were higher than those in the control group [(85.71 ± 3.94) points vs. (80.53 ± 3.24) points, (86.16 ± 3.62) points vs. (82.28 ± 3.53) points, (85.54 ± 3.91) points vs. (81.97 ± 3.78) points, (86.67 ± 3.61) points vs. (80.49 ± 3.55) points, and (86.86 ± 3.70) points vs. (82.28 ± 3.64) points], with statistically significant differences (t = 6.659, 5.032, 4.305, 8.004, and 5.786, all P < 0.05). Conclusion　Nursing interventions based on the 'Internet +' model can enhance the nutritional status of esophageal cancer patients undergoing chemotherapy, effectively alleviate their negative emotions, strengthen their psychological resilience, improve their overall quality of life, and increase patient satisfaction with nursing care services.

The impact of comfort care combined with mindfulness-based stress reduction therapy on liver function and psychological state in patients with liver cirrhosis 

Liu Ting, Chai Xiaoyun, Huang Na

2025, 31(12):  2103-2108.  DOI: 10.3760/cma.j.cn441417-20241127-12034

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effects of comfortable care combined with mindfulness-based stress reduction therapy on liver function and psychological state in patients with liver cirrhosis. Methods　A retrospective study included 112 patients with liver cirrhosis admitted to Shaanxi Provincial Nuclear Industry 215 Hospital from April 2020 to April 2023 were divided into a control group (55 cases) and an intervention group (57 cases) based on different nursing approaches.There were 28 males and 27 females in the control group; they were (55.21 ± 14.32) years old; the course of disease was (11.21 ± 3.66) years;the body mass index (BMI) was (23.51 ± 3.01) kg/m².There were 29 males and 28 females in the control group; they were (54.27±15.88) years old;the course of disease was (10.47±4.39) years;the BMI was (23.58±3.45) kg/m².The control group received routine nursing interventions, while the intervention group received comfortable care combined with mindfulness-based stress reduction therapy. Both groups received continuous care for 4 weeks. The scores of Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS),the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST),SF-36 quality of life scores, treatment compliance scores, and nursing satisfaction were compared between the two groups. Statistical analysis was performed using t tests and χ² tests. Results　After nursing care, the SAS and SDS scores in the intervention group were significantly lower than those in the control group [(23.12 ± 9.58) ponits vs. (32.58 ± 11.69) ponits and (31.52 ± 12.03) ponits vs. (42.36 ± 10.44) ponits, with statistically significant differences (t=4.167 and 6.871, both P<0.05); the levels of ALT and AST in the intervention group were lower than those in the control group [(32.55 ± 13.88) IU/L vs. (58.31 ± 21.06) IU/L and (35.81 ± 12.03) IU/L vs. (59.22 ± 23.69) IU/L] (t=4.874 and 5.171, both P<0.05); the quality of life score in the intervention group was higher than that in the control group [(78.69 ± 11.33) ponits vs. (67.39 ± 12.36) ponits (t=4.165, P=0.003)]. Treatment adherence was also significantly higher in the intervention group compared to the control group (P<0.05). The overall nursing satisfaction in the intervention group was significantly higher than that in the control group [96.5% (55/57) vs. 81.8% (45/55)], with a statistically significant difference (χ² = 5.314, P = 0.009). Finally, the multiple regression analysis showed that patients receiving comfortable care combined with mindfulness-based stress reduction therapy had a significantly lower ALT level (t =-3.88, P=0.001), a lower SAS score (t =-3.78, P=0.001), higher quality of life score (t = 3.95, P=0.001), and higher nursing satisfaction (t = 3.36, P=0.001). The VIF value was 1.15, indicating no serious multicollinearity issues. Conclusion　Comfortable care combined with mindfulness-based stress reduction therapy has a significant effect in reducing negative emotions, promoting liver function recovery, improving quality of life, enhancing treatment adherence, and increasing nursing satisfaction in patients with liver cirrhosis.

Medical Education

Application of virtual simulation technology in reproductive medicine clinical practice teaching

Lao Kaixue, Li xia, Guo Shuhong, Wang Yanlin

2025, 31(12):  2109-2112.  DOI: 10.3760/cma.j.cn441417-20240726-12035

Asbtract ( )  

References | Related Articles | Metrics

Clinical practice teaching is an important part of the teaching of reproductive medicine. Due to the unique characteristics of patients in reproductive medicine, traditional teaching methods have significant limitations in clinical education, resulting in suboptimal learning outcomes for students. With the advancement of technology and the enrichment of medical education methods, the widespread application of virtual simulation technology has provided new perspectives for reproductive medicine education. This innovation breaks through the limitations of traditional teaching methods, not only stimulating students' learning interest but also significantly improving teaching quality.It is highly recommended for widespread adoption with its broad application prospects.