Table of Content

01 January 2025, Volume 31 Issue 1

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Special Column of Female Fertility

Ethical consideration of fertility preservation in female tumor patients

Huang Meiling, Li Fei

2025, 31(1):  1-4.  DOI: 10.3760/cma.j.cn441417-20240918-01001

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Construction of a prediction model for adverse pregnancy outcomes in placenta accreta spectrum disorders using ultrasound scoring system combined with MRI

Li Xina , Dou Pan , Li Lingmin

2025, 31(1):  5-11.  DOI: 10.3760/cma.j.cn441417-20240729-01002

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To evaluate the efficiency of ultrasound scoring system combined DOI：10.3760/cma.j.cn441417-20240729-01002 收稿日期 2024-07-29 本文编辑 吴相思 引用本文：李西娜, 窦盼, 李令民. 超声评分系统联合MRI对胎盘植入性疾病患者不良妊娠结局的预测模 型构建[J]. 国际医药卫生导报, 2025, 31(1): 5-11. DOI: 10.3760/cma.j.cn441417-20240729-01002. · 5 · 国际医药卫生导报 2025 年1 月第 31 卷第 1 期　IMHGN, January 2025, Vol. 31, No. 1 with magnetic resonance imaging (MRI) in predicting adverse pregnancy outcomes in patients with placenta accreta spectrum disorders. Methods This study was a cross-sectional study. A total of 180 patients with placenta accreta spectrum disorders who underwent cesarean section in Xi'an People's Hospital (Xi'an Fourth Hospital) from January 2021 to January 2024 were selected as the study objects. The patients were assessed using the placenta accreta ultrasound scoring system established by Peking University Third Hospital, and they received MRI before delivery, including 5 MRI signs. The clinical data of all patients were collected, and the adverse pregnancy outcomes were defined as intraoperative uterine rupture, intraoperative bleeding ≥1 500 ml, hysterectomy, or severe postpartum infection. The patients were divided into a normal outcome group (99 cases) and an adverse outcome group (81 cases). Logistic regression analysis was used to analyze the influencing factors of adverse pregnancy outcomes in patients with placenta accreta spectrum disorders, and a nomogram model was constructed. The receiver operating characteristic curve (ROC), calibration curve, and decision curve were used to evaluate the prediction model. Independent sample t test, rank sum test, and χ2 test were used for statistical analysis. Results The normal outcome group was (33.57±3.82) years old, and the adverse outcome group was (34.56± 3.68) years old, without statistically significant difference (P>0.05). The numbers of pregnancies and births in the adverse outcome group were 4 (3, 5) and 1 (1, 2), respectively, which were higher than 3 (2, 4) and 1 (1, 1) in the normal outcome group; the gestational age at delivery in the adverse outcome group was (35.12±2.54) weeks, which was shorter than that in the normal outcome group [(36.68±2.31) weeks]; the ultrasound score in the adverse outcome group was (11.05±1.15) points, which was higher than that in the normal outcome group [(7.00±1.00) points]; the case numbers of placental intravascular growth signs (lakes), T2 dark bands within the placenta, uterine bulging, cervical invasion, and vascular proliferation at the uterine-bladder interface in the adverse outcome group were 64, 67, 62, 18, and 63, respectively, which were more than 37, 36, 32, 4, and 35 in the normal outcome group, with statistically significant differences (all P<0.05). Univariate and multivariate logistic regression analysis showed that gestational week at delivery was an independent protective factor for adverse pregnancy outcomes in patients with placenta accreta spectrum disorders (OR<1, P<0.05); the numbers of pregnancies and births, ultrasound score, placental intravascular growth signs (lakes), T2 dark bands within the placenta, uterine bulging, cervical invasion, and vascular proliferation at the uterine-bladder interface were independent risk factors for adverse pregnancy outcomes (all OR>1, P<0.05). According to the multivariate logistic regression analysis results, a nomogram model was constructed, and ROC analysis was performed on the nomogram model. The sensitivity of the nomogram model was 97.50%, the specificity was 94.90%, the Youden index was 0.924, and the area under the curve (AUC) was 0.980 (0.961-0.999). Conclusions Ultrasound scoring system combined with MRI can effectively predict adverse pregnancy outcomes in patients with placenta accreta spectrum disorders. By using appropriate scoring and imaging standards, physicians can more accurately identify high-risk patients, thereby taking intervention measures to improve pregnancy outcomes. The high sensitivity and specificity of the nomogram model further confirm the clinical application value of this prediction method, providing an important tool for the management of high-risk pregnancies.

Relationships between the expressions of Bcl-2, Bax, LC3, and P62 in chorionic villi and Ureaplasma urealyticum infection in patients with missed abortion 

Yang Jie, Guo Lining, Wang Caili

2025, 31(1):  12-16.  DOI: 10.3760/cma.j.cn441417-20240430-01003

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Objective To study the predictive values of B lymphoblastoma -2 gene (Bcl-2), B lymphocytoma -2 related X protein (Bax), microtubule-associated protein 1 light chain 3 (LC3), and P62 in chorionic villi for Ureaplasma urealyticum infection in patients with missed abortion. Methods It was a cohort study. A total of 156 missed abortion patients admitted to Yulin First Hospital from January 2022 to June 2023 were selected as the missed abortion group, and 170 patients undergoing induced abortion in our hospital during the same period were selected as the induced abortion group. In the induced abortion group, the age, pregnancy times, delivery times, previous abortion times, and pregnancy time were (28.61±5.30) years old, (1.54±0.48) times, (0.97± DOI：10.3760/cma.j.cn441417-20240430-01003 收稿日期 2024-04-30 本文编辑 吴相思 引用本文：杨杰, 郭丽宁, 王彩丽. 绒毛组织Bcl-2、Bax、LC3、P62与稽留流产患者解脲支原体感染的关系 [J]. 国际医药卫生导报, 2025, 31(1): 12-16. DOI: 10.3760/cma.j.cn441417-20240430-01003. · 12 · 国际医药卫生导报 2025 年1 月第 31 卷第 1 期　IMHGN, January 2025, Vol. 31, No. 1 0.24) times, (0.87±0.25) times, and (53.72±4.49) days, and those in the missed abortion group were (29.18±5.57) years old, (1.49±0.43) times, (0.95±0.26) times, (0.91±0.32) times, and (54.55±4.20) days, respectively. The rate of Ureaplasma urealyticum infection and the expressions of Bcl-2, Bax, LC3, and P62 in chorionic villi were compared between the two groups. The patients with missed abortion were divided into a negative group (96 cases) and a positive group (60 cases) according to whether Ureaplasma urealyticum infection occurred, and the expressions of Bcl-2, Bax, LC3, and P62 in chorionic villi were compared between the two groups. The predictive values of Bcl-2, Bax, LC3, and P62 in chorionic villi for Ureaplasma urealyticum infection in patients with missed abortion were analyzed by the receiver operating characteristic curve (ROC). Independent sample t test and χ2 test were used for statistical analysis. Results The positive rate of Ureaplasma urealyticum in the missed abortion group was higher than that in the induced abortion group [38.46% (60/156) vs. 12.94% (22/170)] (P<0.05). The expression levels of Bcl-2 and P62 in chorionic villi of the missed abortion group were lower than those of the induced abortion group, while the expression levels of Bax and LC3 were higher than those of the induced abortion group (all P<0.05). The expression levels of Bcl-2 and P62 in chorionic villi of the positive group were lower than those of the negative group, while the expression levels of Bax and LC3 were higher than those of the negative group (all P<0.05). The area under the curve (AUC) of the combination of Bcl-2, Bax, LC3, and P62 in chorionic villi to predict Ureaplasma urealyticum infection in missed abortion patients was 0.852, which was higher than that of the four alone (all P<0.05). Conclusions Compared with induced abortion patients, the incidence of Ureaplasma urealyticum infection was higher in missed abortion patients, and the expressions of Bcl-2, Bax, LC3, and P62 in chorionic villi were significantly different between the two groups. Ureaplasma urealyticum infection could cause differences in the expressions of Bcl-2, Bax, LC3, and P62 in chorionic villi, and the combination of the four could improve the prediction value for Ureaplasma urealyticum infection in missed abortion patients.

Effects of Bushen Huatan Decoction on ovarian function and sex hormone level in infertile patients with polycystic ovary syndrome 

Wang Ying, Hu Mengdi

2025, 31(1):  16-20.  DOI: 10.3760/cma.j.cn441417-20240702-01004

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Objective　To observe the effects of Bushen Huatan Decoction on ovarian function and sex hormone level in infertile patients with polycystic ovary syndrome (PCOS). Methods　This study was a randomized controlled trial. A total of 114 infertile patients with PCOS admitted to Shaanxi Provincial Hospital of Traditional Chinese Medicine from September 2023 to June 2024 were selected, and were divided into a study group and a control group by the random number table method with 57 cases in each group. The study group was (27.91±3.15) years old, the body mass index (BMI) was (25.47±2.59) kg/m², the infertility time was (3.57±0.62) years, and the age of menarche was (13.86±1.15) years old. The control group was (28.14±3.25) years old, the BMI was (25.88±2.64) kg/m², the infertility time was (3.45±0.71) years, and the age of menarche was (14.03±1.06) years old. The control group took clomiphene orally, 50 mg/time, once a day, starting from the 5th day of the menstrual cycle, and continuously taking for 5 days. The study group received an additional treatment of Bushen Huatan Decoction (200 ml of Chinese medicine juice was taken twice in the morning and evening, one dose daily), continuously taking from the 1st day after the end of menstruation to the next period. Both groups were continuously treated for 3 menstrual cycles. The efficacy of the two groups was evaluated after treatment. Before and after treatment, the traditional Chinese medicine (TCM) syndrome scores, ovarian function [ovarian volume, number of follicles, anti-Müllerian hormone (AMH), and endometrial thickness], and sex hormones [luteinizing hormone (LH), testosterone (T), estradiol (E₂), and follicle-stimulating hormone (FSH)] of the two groups were compared. The occurrence of adverse reactions was counted in the two groups. t test and χ² test were used for statistical analysis. Results　The total effective rate of the study group was higher than that of the control group [91.23% (52/57) vs. 75.44% (43/57)] (P<0.05). After treatment, the scores of TCM syndromes were decreased in both groups, and those in the study group were lower than those in the control group (all P<0.05). After treatment, the ovarian volume, number of follicles, and AMH were decreased in both groups, and those in the study group [(10.53±2.46) cm³, 6.71±0.95, and (7.13±2.08) μg/L] were lower than those in the control group [(13.94±3.02) cm³, 9.03±1.02, and (9.05±4.33) μg/L]; the endometrial thickness was increased in both groups, and that in the study group [(9.83±0.64) mm] was higher than that in the control group [(9.05±0.62) mm] (all P<0.05). After treatment, the levels of LH and T were decreased in both groups, and those in the study group [(6.24±1.79) mIU/ml and (1.42±0.29) nmol/L] were lower than those in the control group [(9.05±2.16) mIU/ml and (1.93±0.34) nmol/L]; the level of E₂ was increased in both groups, and that in the study group [(182.16±15.98) ng/L] was higher than that in the control group [(166.72±14.03) ng/L] (all P<0.05); there was no significant change in the level of FSH in both groups (both P>0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion　Bushen Huatan Decoction has good effect on PCOS infertile patients, which can effectively alleviate the patients' symptoms, improve the ovarian function and sex hormone disorders, and has high safety.

Clinical effect of mifepristone combined with Xiaojia Futong decoction in the treatment of ectopic pregnancy

Shi Juanjuan , Li Nan , Wang Min , Zhang Dan

2025, 31(1):  21-25.  DOI: 10.3760/cma.j.cn441417-20240318-01005

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Objective To investigate the clinical effect of mifepristone combined with Xiaojia Futong decoction in the treatment of ectopic pregnancy. Methods This study was a randomized controlled trial. A total of 80 patients who underwent conservative treatment for ectopic pregnancy in Tengzhou Central People's Hospital from June to December 2023 were simply randomly divided into two groups. The age of the observation group was (30.38±4.52) years old, the duration of menopause was (35.05±17.41) days, the level of human chorionic gonadotropin (HCG) was (771.18±515.59) mIU/ml, and the ectopic pregnancy mass was (2.61±0.93) cm. The age of the control group was (29.90±5.40) years old, the duration of menopause was (40.00±15.59) days, the HCG level was (855.13±680.85) mIU/ml, and the ectopic pregnancy mass was (2.42±0.72) cm. The control group was orally administered mifepristone, 50 mg/time, twice a day, for 3 consecutive days. The observation group was given Xiaojia Futong decoction on the basis of the control group, one dose a day, 400 ml of medicine juice taken twice in the morning and evening, 7 days as 1 course of treatment (if HCG did not decrease by more than 15% on the 7th day, the second course of treatment was carried out). The clinical efficacy and serum indexes of the two groups were compared, and the occurrence of adverse reactions in the two groups were observed. t test and χ2 test were used for statistical analysis. Results In the observation group, 39 cases (97.5%) were successfully treated without operation; in the control group, 37 cases (92.5%) were successfully treated; there was no statistically significant difference in the success rate of drug treatment between the two groups (χ2 = 1.053, P=0.305). The HCG level in the observation group was lower than that in the control group on the 7th day after treatment [(422.01±249.80) mIU/ml vs. (536.56±316.20) mIU/ml], and the time for HCG to fall to normal and the disappearance time of ectopic pregnancy mass were shorter than those in the control group [(13.28±2.91) d vs. (19.03±4.43) d, (23.46±7.38) d vs. (30.38±11.73) d], with statistically significant differences (all P<0.05). Before treatment, there was no statistically significant difference in the level of vascular endothelial growth factor (VEGF), carbohydrate antigen 125 (CA125), or creatine kinase (CK) (all P>0.05); on the 7th day after treatment, the above indexes in the observation group were lower than those in the control group, with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse drug reactions between the two groups (χ2 =0.251, P=0.617). Conclusion Mifepristone combined with Xiaojia Futong decoction can promote the decrease of blood HCG level and the absorption of mass in ectopic pregnancy patients, without increasing adverse drug reactions, and the effect is significant.

Effects of dienogest and GnRH-a on postoperative pain and recurrence rate of ovarian endometriosis cyst 

Zhang Xiuling , Han Zhihong , Dai Xu

2025, 31(1):  26-30.  DOI: 10.3760/cma.j.cn441417-20240311-01006

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Objective　To compare the differences of pain and disease recurrence rates in patients after ovarian endometriosis cyst (OEC) excision treated with dienogest and gonadotropin-releasing hormone agonist (GnRH-a). Methods　This study was a randomized controlled trial. According to the random coin toss method, 113 patients who met the treatment criteria of OEC excision in the Department of Obstetrics and Gynecology of XD Group Hospital from May 2020 to April 2022 were divided into a GnRH-a group (61 cases) and a dienogest group (52 cases). The age of the GnRH-a group was (35.38±4.49) years old, the course of disease was (3.28±1.04) years, the cyst size was 6.00 (5.00, 8.00) cm, and the American Society for Reproductive Medicine (ASRM) staging was stage Ⅰ to Ⅱ in 30 cases and stage Ⅲ to Ⅳ in 31 cases. The age of the dienogest group was (35.52±4.61) years old, the course of disease was (3.52±1.06) years, the cyst size was 6.00 (5.00, 8.00) cm, and the ASRM staging was stage Ⅰ to Ⅱ in 26 cases and stage Ⅲ to Ⅳ in 26 cases. From the first day of the first menstrual period after OEC excision, the GnRH-a group was treated with subcutaneous injection of leuprelin acetate in the anterior abdominal wall, 3.75 mg/time, once every 4 weeks; the dienogest group received oral dienogest tablets, 2 mg/time, once a day. Both groups were treated for 24 weeks. The Visual Analogue Scale (VAS) score, adverse reactions, recurrence rate, and treatment satisfaction were compared between the two groups. Independent sample t test, non-parametric Wilcoxon test, Mann-Whitney U test, and χ² test were used for statistical analysis. Results　After 24 weeks of treatment, the VAS scores of dysmenorrhea, chronic pelvic pain, and sexual pain in the dienogest group were lower than those in the GnRH-a group [0.50 (0, 2.00) points vs. 1.00 (0, 3.00) points, 1.00 (0, 3.00) points vs. 2.00 (1.00, 4.00) points, 0 (0, 2.00) points vs. 1.00 (0, 2.00) points] (Z=2.396, 2.669, and 2.929, all P<0.05). There was no statistically significant difference in the incidence of adverse reactions or the recurrence rate within 12 months after withdrawal between the GnRH-a group and the dienogest group [14.75% (9/61) vs. 5.77% (3/52), 8.20% (5/61) vs. 1.92% (1/52)] (χ²=2.378 and 2.197, both P>0.05). The total satisfaction of the dienogest group was higher than that of the GnRH-a group [94.23% (49/52) vs. 81.97% (50/61)] (χ²=3.889, P<0.05). Conclusion　Compared with GnRH-a, supplement of dienogest after OEC excision can more effectively relieve the patients' pain, prevent the disease recurrence, and obtain higher treatment satisfaction.

Study on the predictive values of autophagy genes for the prognosis of endometrial cancer and their correlations with the efficacy of chemotherapy 

Yang Lili , Wang Cancan , Li Fei , Wang Haijing , Qi Qiaoxia , Lei Liyan , He Fengjie

2025, 31(1):  30-37.  DOI: 10.3760/cma.j.cn441417-20240801-01007

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Objective To explore the potential mechanism of autophagy apoptosis in uterine corpus endometrial carcinoma (UCEC) and analyze the impact of autophagy apoptosis on its survival prognosis. Methods Genomic sequencing data were derived from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) databases. Differentially expressed genes related to UCEC and key autophagy genes related to UCEC survival prognosis were screened. Then, a risk scoring prediction model for survival prognosis in UCEC patients was constructed and validated, and the impact of autophagy apoptosis on UCEC survival prognosis was analyzed. Results A total of 1 964 differentially expressed genes were screened, including 631 (32.13%) upregulated genes and 1 333 (67.87%) downregulated genes, among which there were 21 uterine corpus endometrial carcinoma associated autophagy differentially expressed genes (UCEC-AT-DEGs). Kaplan-Meier survival analysis results showed that the increased expressions of EIF4EBP1, CDKN2A, and VEGFA genes all led to a shorter overall survival period of UCEC (all P<0.05). The decision curve analysis (DCA) curve showed that EIF4EBP1 had a greater clinical application value in influencing the 2-year and 3-year survival rates of UCEC. The LASSO regression results showed that Riskscore = 0.139 5× EIF4EBP1 + 0.182 7×CDKN2A + 0.079 1×ITPR1 + 0.265 8×GRID1 - 0.018 7×TM9SF1 - 0.125 0× RAB24 + 0.071 0×VEGFA (λmin=0.017 2), and this model had reliable predictive performance. The expression level of EIF4EBP1 was negatively correlated with the maximum half inhibitory concentration (IC50) of cisplatin, and the expression level of CDKN2A was negatively correlated with the IC50 of paclitaxel and cisplatin (all P<0.05). Conclusions The expressions of multiple autophagy genes significantly changed in UCEC, and the abnormal high expressions of some key autophagy genes had an adverse impact on the overall survival rate of UCEC patients. EIF4EBP1 had a greater clinical application value in influencing the 2-year and 3-year survival rates of UCEC. The signature model of UCEC survival prognosis established in this study had reliable predictive performance.

Effect of iodine nutritional intervention combined with levothyroxine in patients with subclinical hypothyroidism during pregnancy

Han Beibei, Ge Huixian

2025, 31(1):  38-41.  DOI: 10.3760/cma.j.cn441417-20240701-01008

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Objective　To study the clinical effect of iodine nutritional intervention combined with levothyroxine in patients with subclinical hypothyroidism during pregnancy. Methods　This study was a randomized controlled trial. A total of 116 patients with subclinical hypothyroidism in Zhengzhou Maternal and Child Health Hospital from January to December 2022 were selected and were divided into a control group (58 cases) and an experimental group (58 cases) according to the random number table method. The experimental group was (28.45±2.14) years old, the body mass index (BMI) was (25.15±1.32) kg/m², the gestational age was (9.41±0.92) weeks, the pregnancy times were 2.47±0.56, and there were 16 cases of mild iodine deficiency, 25 cases of moderate iodine deficiency, and 17 cases of severe iodine deficiency. The control group was (28.53±2.08) years old, the BMI was (25.06±1.41) kg/m², the gestational age was (9.38±0.89) weeks, the pregnancy times was 2.56±0.62, and there were 17 cases of mild iodine deficiency, 28 cases of moderate iodine deficiency, and 13 cases of severe iodine deficiency. The control group was given levothyroxine orally, 50 μg/time, once a day. The experimental group was given iodine nutritional intervention on the basis of the control group: the patients with mild and moderate iodine deficiency were additionally given 1 serving of food containing 150 μg of iodine [4 g of nori (dry) or 4 g of porphyra tenera (dry) or 130 g of kelp (wet)], and the patients with severe iodine deficiency were additionally given 2 serving of food containing 150 μg of iodine every day. Both groups were treated continuously for 2 months. The iodine nutrition, thyroid indices [thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4)], and incidence of adverse pregnancy outcomes were compared between the two groups. Independent sample t test, χ² test, and Ridit test were used for statistical analysis. Results　After treatment, the iodine nutrition of the experimental group was better than that of the control group (P<0.05). After treatment, the TSH level of the experimental group was lower than that of the control group, and the FT3 and FT4 levels were higher than those of the control group (all P<0.05). The incidence of fetal growth restriction in the experimental groups was 3.45% (2/58), the incidence of macrosomia was 1.72% (1/58), and the incidence of fetal distress was 1.72% (1/58), which were lower than those in the control group [15.52% (9/58), 13.79% (8/58), and 13.79% (8/58)] (all P<0.05). Conclusion　Iodine nutritional intervention combined with levothyroxine can improve the iodine nutrition and thyroid indices in patients with subclinical hypothyroidism during pregnancy, and reduce the occurrence of adverse pregnancy outcomes.

New Medical Advances

Roles of inflammatory biomarkers in the evaluation of clinical outcomes in chronic heart failure

Jiang Zejun, Tang Shengyu, Yang Hongling

2025, 31(1):  42-46.  DOI: 10.3760/cma.j.cn441417-20240531-01009

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Inflammation participates in the development of chronic heart failure. Traditional inflammatory markers, represented by C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and procalcitonin (PCT), have important value in the prognosis evaluation of chronic heart failure. In recent years, with the continuous deepening of the research, novel composite inflammatory markers such as neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR), monocyte to high-density lipoprotein cholesterol ratio (MHR), systemic immune-inflammatory index (SII) have become research hotspots. Compared to the traditional inflammatory markers, their performances are more stable in chronic heart failure, which are expected to provide a new reference for the clinical diagnosis and treatment of chronic heart failure.

Recent advances of the research between gut microbiota and obstructive sleep apnea syndrome combined with cognitive impairment

Wu Jinglin, Lu Manlu, Li Mingzhen, Liu Lu, Yu Yan, Pan Lei

2025, 31(1):  47-50.  DOI: 10.3760/cma.j.cn441417-20240730-01010

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Obstructive sleep apnea syndrome (OSAS) is a class of diseases characterized by intermittent hypoxia and sleep fragmentation, which seriously affect the patients' sleep quality, and then combine with some cognitive dysfunction, including memory attention and executive function decline. At present, the mechanism of cognitive impairment in OSAS patients is not clear. Studies have shown that the homeostasis of gut microbiota in OSAS patients is disrupted, and the reduction of some flora destroys the internal environment of gut microbiota, leading to cognitive impairment. The present study reviews the research progress of OSAS combined with cognitive dysfunction based on gut microbiota.

Basic Research

Dynamic changes and significance of connexin 43 in gastric smooth muscle tissue of diabetic gastroparesis rats

Song Baihui

2025, 31(1):  51-54.  DOI: 10.3760/cma.j.cn441417-20240812-01011

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Objective　To study the dynamic changes of connexin 43 (Cx43) in gastric smooth muscle tissue of diabetic gastroparesis rats, to elucidate the pathogenesis of diabetic gastroparesis, and to provide experimental basis for drug development and prevention of diabetic gastroparesis and other diabetic smooth muscle lesions. Methods　A total of 40 adult male SD rats, weighing (200±20) g, were selected as the study subjects, in the School of Medicine of Yanbian University from March to July 2023. Ten rats of the normal control group were intraperitoneally injected the same amount of saline. The 0.5% streptozotocin solution was prepared with pH 4.0 citrate buffer (the concentration was 0.1 mol/L), and 65 mg/kg of streptozotocin solution was injected into the abdomen at one time. Seven days after intraperitoneal administration, caudal vein blood was removal, and blood glucose concentration was detected, blood glucose concentration 350 mg/dl as diabetic rats were successfully modeled. They were killed after feeding for 4 w (DM4w group), 6 w (DM6w group), and 8 w (DM8w group), with 10 rats in each group. The expressions of Cx43 protein in the total protein, plasma protein, and membrane protein of gastric smooth muscle tissue of rats in each group were detected by Western blot. t test was used for statistical analysis. Results　The expression of Cx43 in gastric smooth muscle tissue of rats in the normal control group was 1.14±0.15, 1.15±0.14 in the DM4w group, 1.33±0.15 in the DM6w group, and 1.70±0.22 in the DM8w group. The expression of CX43 in the DM8w group was higher than those in the normal control group and DM4w group (t=2.133 and 2.174, both P0.05). At the same time, the membrane expression and plasma expression of Cx43 were detected, and the membrane-to-plasma ratio was calculated. The membrane-to-plasma ratio of Cx43 in the normal control group was 0.50±0.07, 1.18±0.10 in the DM4w group, 3.13±0.40 in the DM6w group, and 2.39±0.21 in the DM8w group. The membrane-to-plasma ratio in the DM4w group was higher than that in the normal control group (t=5.745, P0.01), and those in the DM6w group and DM8w group were higher than that in the DM4w group (t=4.703 and 5.322, both P0.01). Conclusion　Dynamic changes in Cx43 expression and membrane repositioning in gastric smooth muscle tissue of diabetic rats serve as a cause of diabetic gastroparesis.

Treatises

Relationships between levels of serum cytokines and coronary artery lesion in children with Kawasaki disease

Zhao Lanxin, Tian Tian, Gao Xiaoqian

2025, 31(1):  55-60.  DOI: 10.3760/cma.j.cn441417-20240806-01012

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Objective　To analyze the relationships between serum levels of vascular endothelial growth factor receptor 2 (VEGFR2), interleukin-23 (IL-23), and fibroblast growth factor 21 (FGF-21) and coronary artery lesion (CAL) in children with Kawasaki disease (KD). Methods　This was a cross-sectional study. A total of 120 KD children diagnosed and treated in Xi'an Central Hospital from June 2020 to March 2024 were selected as the KD group, including 67 boys and 53 girls, aged (2.88±0.94) years. According to whether the KD children were combined with CAL or not, they were divided into a combined CAL group (CAL subgroup) of 52 cases and a non-combined CAL group (NCAL subgroup) of 68 cases. Another 120 healthy children [69 boys and 51 girls, aged (3.13±1.40) years] were selected as the control group. All children diagnosed with KD received standardized treatment, including high-dose intravenous immunoglobulin (IVIg) and aspirin. The dose of IVIg was 2 g/kg, a single infusion. The initial dose of aspirin was 30 to 50 mg^-1·kg^-1·d^-1, orally. The dose of aspirin was reduced to 3-5 mg^-1·kg^-1·d^-1 after the fever was reduced. Aspirin treatment continued for 8 weeks. The clinical data of each group were collected, the serum levels of VEGFR2, IL-23, and FGF-21 of all subjects were detected, and their relationships with the occurrence of CAL were evaluated by multivariate logistic regression analysis. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic values of VEGFR2, IL-23, and FGF-21 for the occurrence of CAL in KD children. t test , F test and χ² test were used for statistical analysis. Results　Serum levels of VEGFR2, IL-23, and FGF-21 in the control group were (313.43±50.14) µg/L, (1.44±0.24) µg/L, and (4.39±0.58) µg/L, those in the NCAL subgroup were (272.12±49.50) µg/L, (2.23±0.43) µg/L, and (4.87±0.76) µg/L, and those in the CAL subgroup were (230.30±38.94) µg/L, (3.18±0.61) µg/L, and (6.13±1.23) µg/L. There were statistically significant differences in the above indexes between the control group and the NCAL subgroup (t=5.453, 13.967, and 4.516, all P0.05); there were statistically significant differences in the above indexes between the NCAL subgroup and the CAL subgroup (t=5.018, 9.560, and 6.499, all P0.05). The duration of fever before IVIg treatment in the CAL subgroup was longer than that in the NCAL subgroup [(7.42±2.41) d vs. (5.78±1.65) d], with a statistically significant difference (t=4.431, P0.05). The proportion of non-response to IVIg (body temperature remained above 38 ℃ within 36 h after initial treatment with IVIg or increased again within 2 weeks after treatment, with at least one clinical feature of KD) in the CAL subgroup was higher than that in the NCAL subgroup [24.08% (12/52) vs 8.82% (6/68)], with a statistically significant difference (χ²=4.695, P=0.030). Multivariate logistic regression analysis showed that the decrease of serum VEGFR2 level and the increase of IL-23 and FGF-21 levels were independent risk factors for CAL in KD children (all P0.05). ROC analysis showed that the sensitivities of VEGFR2, IL-23, and FGF-21 to predict the occurrence of CAL in KD children were 63.5%, 88.5%, and 86.5%, the specificities were 80.9%, 80.9%, and 66.2%, and the areas under the curves were 0.745, 0.898, and 0.817. The sensitivity and specificity of VEGFR2, IL-23, and FGF-21 combined detection were 92.3% and 95.6%, and the area under the curve was 0.956. Conclusion　The decrease of serum VEGFR2 level and the increase of serum IL-23 and FGF-21 levels are significantly associated with CAL in KD children, and the combination of these markers can serve as effective biomarkers for predicting and diagnosing CAL in KD children.

Analysis of influencing factors and construction of predictive models for coronary artery lesion in children with Kawasaki disease

Liu Juan, Wang Fenglan

2025, 31(1):  60-65.  DOI: 10.3760/cma.j.cn441417-20240910-01013

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Objective　To analyze the influencing factors of coronary artery lesion (CAL) in children with Kawasaki disease (KD) and construct predictive models. Methods  The clinical data of 306 children with KD admitted to Shenmu City Hospital from January 2020 to January 2024 were retrospectively analyzed. According to whether the children had concurrent CAL, they were divided into a CAL group (108 cases) and a non-CAL group (198 cases). In the CAL group, there were 73 boys and 35 girls, 69 cases ≤2 years old and 39 cases 2 years old. In the non-CAL group, there were 117 boys and 81 girls, 105 cases ≤2 years old and 93 cases 2 years old. Multivariate logistic regression analysis was used to analyze the influencing factors of CAL in children with KD. According to the ratio of 7:3, 306 children with KD were randomly divided into a training set (214 cases) and a test set (92 cases). The decision tree model was constructed based on the training set data, and the prediction efficiency of the decision tree model was verified based on the test set data. The receiver operating characteristic curve (ROC) was drawn to evaluate the predictive effect of multivariate logistic regression model and decision tree model. χ² test was used for statistical analysis. Results  The proportions of duration of fever 10 days, platelet count (PLT) 300×10⁹/L, C-reactive protein (CRP)50 mg/L, N-terminal brain natriuretic peptide precursor (NT-proBNP)≥ 300 ng/L, creatine kinase isoenzyme (CK-MB) 18 U/L, erythrocyte sedimentation rate (ESR)40 mm/h, and twice intravenous immunoglobulin (IVIg) treatment in the CAL group [41.67% (45/108), 60.19% (65/108), 49.07% (53/108), 67.59% (73/108), 47.22% (51/108), 34.26% (37/108), and 73.15% (79/108)] were higher than those in the non-CAL group [14.65% (29/198), 45.96% (91/198), 35.86% (71/198), 36.87% (73/198), 32.83% (65/198), 16.67% (33/198), and 52.02% (103/198)] (all P0.05). Multivariate logistic regression analysis showed that the duration of fever 10 days (odds ratio=3.449), PLT 300×10⁹/L (odds ratio=2.088), CRP 50 mg/L (odds ratio=1.883), NT-proBNP ≥300 ng/L (odds ratio=3.267), CK-MB 18 U/L (odds ratio=2.284), ESR 40 mm/h (odds ratio=2.599), and twice IVIg treatment (odds ratio=2.930) were all risk factors for CAL in children with KD (all P0.05). Based on the training set data, a decision tree model of CAL in children with KD was established, including 6 variables of duration of fever, NT-proBNP, IVIg treatment times, ESR, CK-MB, and PLT, and 7 classification rules were extracted, among which duration of fever was the primary influencing factor of the model. The logistic regression model and decision tree model were verified based on the test set data. The results showed that the sensitivity, specificity, and area under curve (AUC) of the decision tree model for predicting CAL in KD children were 81.25%, 86.67%, and 0.818, respectively; the sensitivity, specificity, and AUC of the logistic regression model were 62.50%, 90.00%, and 0.662, respectively. Conclusions  The decision tree model for CAL in children with KD includes 6 variables, namely duration of fever, NT-proBNP, IVIg treatment times, ESR, CK-MB, and PLT. The duration of fever is the primary influencing factor of the model. The model has good predictive performance, which can provide reference for clinical screening of high-risk KD children with CAL.

Analysis of risk factors of pneumonia in premature test tube babies

Zhou Caiying, Li Caihuan, Lu Jiayi, Ye Meiyi, Ruan Wanfen

2025, 31(1):  66-69.  DOI: 10.3760/cma.j.cn441417-20240619-01014

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Objective　To explore the risk factors for pneumonia in premature test-tube babies. Methods　A retrospective analysis was conducted on 312 premature test-tube babies born in Shunde Hospital of Southern Medical University from January 2010 to December 2020. They were divided into a pneumonia group and a control group according to whether early-onset pneumonia occurred. Among the 204 infants with pneumonia, there were 113 boys and 91 girls; there were 32 cases of singleton, 152 cases of both twins (76 pairs), 19 cases of one twin, and 1 case of one triplet; the mothers were (31.63±4.37) years old; all of them were early pneumonia (within 72 h after birth). In the 108 infants of the control group, there were 56 boys and 52 girls; there were 11 cases of singleton, 76 cases of both twins (38 pairs), 19 cases of one twin, 2 cases of one triplet; the mothers were (32.56±4.52) years old. The birth weight, gestational age, and perinatal data were compared between the two groups. χ² test and t test were used for statistical analysis. Results　The birth weight and gestational age of preterm test-tube babies in the pneumonia group were (2 166.05±376.28) g and (34.55±1.24) weeks, and those in the control group were (2 441.63±357.78) g and (35.50±1.02) weeks, with statistically significant differences (t=-6.259 and -6.853, both P<0.001). The rates of gestational diabetes mellitus, group B hemolytic streptococcus (GBS) infection, moderate anemia, central placenta previa, and amniotic fluid turbidity in the pneumonia group were 44.11% (90/204), 8.82% (18/204), 12.25% (25/204), 7.35% (15/204), and 8.33% (17/204), and the above indexes in the control group were 44.4% (48/108), 0.93% (1/108), 0.93% (1/108), 2.78% (3/108), and 0, with statistically significant differences (all P<0.05). Multivariate logistic regression analysis showed that low birth weight [odds ratio (OR) =0.999, 95% confidence interval (CI) 0.998-1.000], younger gestational age (OR =0.543, 95%CI 0.402-0.747), and gestational GBS infection (OR =11.789, 95%CI 1.517-93.758) were independent risk factors for pneumonia in premature test-tube babies (all P<0.05). Conclusion　Low birth weight, younger gestational age, and gestational GBS infection are the independent risk factors for pneumonia in premature test-tube babies.

Quantitative and functional alterations in mucosal-associated invariant T cells in tuberculosis patients with concurrent diabetes mellitus

Liang Jianchang, Wu Yongjian

2025, 31(1):  70-74.  DOI: 10.3760/cma.j.cn441417-20240904-01015

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Objective　To investigate changes in the quantity and function of peripheral blood mucosal-associated invariant T (MAIT) cells in newly diagnosed smear-positive pulmonary tuberculosis (PTB) patients with diabetes mellitus (DM). Methods　This was a cross-sectional study.A total of 61 PTB patients treated in the Fifth Affiliated Hospital of Sun Yat-sen University from October 2022 to October 2023 were selected as the study objects. According to whether the PTB patients were combined with DM, they were divided into a PTB+DM group and a PTB group. Among the 30 patients in the PTB group, there were 25 males and 5 females, aged (33.14±8.76) years. Among the 31 patients in the PTB+DM group, there were 22 males and 9 females, aged (31.57±9.56) years. The proportion of MAIT cells in peripheral blood, the activation marker CD69 and cytokine interferon-γ (IFN-γ) expressions of MAIT cells after infected with Mycobacterium bovis BCG were detected in the two groups. t test was used for statistical analysis. Results　The proportion of MAIT cells in peripheral blood of the PTB+DM group was lower than that of the PTB group [(1.04±0.13)% vs. (1.79±0.25)%], with a statistically significant difference (t=2.727, P=0.008). The proportions of CD4+ and CD8+T cells were (22.91±1.77)% and (7.91±1.05)% in the PTB+DM group, and (27.30±1.34)% and (10.47±1.41)% in the PTB group, without statistically significant difference (t=1.971 and 1.469, both P>0.05). The expression levels of CD69 and IFN-γ in MAIT cells after infection in the PTB+DM group were lower than those in the PTB group [(5.88±0.71)% vs. (9.04±1.08)%, (13.82±1.66)% vs. (26.06±3.77)%], with statistically significant differences (both P<0.05). Conclusions　Peripheral blood MAIT cell numbers are reduced in PTB patients with concurrent DM, and their activation and cytokine secretion capacity are significantly impaired.

Clinical study on Buzhong Yiqi Decoction combined with Xuefu Zhuyu Decoction in the treatment of coronary heart disease complicated with heart failure

Fu Xiaoxing, Zhao Mingjun, Chen Lingli, Hu Jianhong

2025, 31(1):  75-79.  DOI: 10.3760/cma.j.cn441417-20240807-01016

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Objective　To evaluate the efficacy and safety of Buzhong Yiqi Decoction combined with Xuefu Zhuyu Decoction in treating patients with coronary heart disease (CHD) and heart failure (HF). Methods　This was a retrospective study. A total of 140 patients with CHD and HF admitted to the Department of Cardiology, Tongchuan Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were selected and were divided into a control group and a treatment group according to different treatment methods. In the control group of 68 cases, there were 36 males and 32 females, the age was (58.31±8.07) years, and the course of disease was (6.55±3.07) years. In the treatment group of 72 cases, there were 37 males and 35 females, the age was (60.42±7.98) years, and the course of disease was (7.27±2.37) years. The control group received standard cardiology treatment, and the treatment group received Buzhong Yiqi Decoction and Xuefu Zhuyu Decoction on the basis of standard cardiology treatment, 200 ml was taken warmly after breakfast and dinner, 1 dose a day, 7 days as a course of treatment. The efficacy was evaluated in both groups after continuous treatment for 12 weeks. The efficacy evaluation indicators included the New York Heart Association (NYHA) cardiac function grade, left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and 6 min walking distance, heart rate, C-reactive protein, N-terminal pro B-type natriuretic peptide (NT-proBNP), quality of life score, and incidence of adverse reactions. χ² test and t test were used for statistical analysis. Results　After 12 weeks of treatment, the total effective rate was 91.67% (66/72) in the treatment group and 75.00% (51/68) in the control group, with a statistically significant difference (χ²=5.914, P=0.015). In the treatment group, the LVEF, LVESD, and LVEDD were (58.32±9.78)%, (40.67±6.01) mm, and (45.10±6.69) mm, and the above indexes in the control group were (47.67±8.98)%, (48.52±7.47) mm, and (54.31±8.08) mm, with statistically significant differences (t=-6.700, 6.869, and 7.363, all P<0.001). In the treatment group, the 6 min walking distance, heart rate, C-reactive protein, and NT-proBNP were (320.36±28.09) m, (73.31±13.52) beats/min, (4.25±1.21) mg/L, and (301.67±44.45) µg/L, and the above indexes in the control group were (290.58±21.31) m, (82.41±10.44) beats/min, (7.31±3.65) mg/L, and (378.32±36.79) µg/L, with statistically significant differences (t=-7.036, 4.439, 6.734, and 11.080, all P<0.001). The scores of physiological, psychological, environmental, and social relations in the treatment group were higher than those in the control group (all P<0.05). During the treatment period, the incidence of adverse reactions was 12.50% (9/72) in the treatment group and 13.24% (9/68) in the control group, without statistically significant difference (χ²=0.124, P=0.971). Conclusions　Buzhong Yiqi Decoction and Xuefu Zhuyu Decoction have obvious advantages in improving the heart function and quality of life in patients with CHD and HF, with good safety. 

Study of correlation between cardiac dual source CT results and TCM syndrome types of thoracic obstruction

Wang Fangyuan, Zhu Fanghong, Wen Cong, Yang Weining, Ma Jing

2025, 31(1):  80-84.  DOI: 10.3760/cma.j.cn441417-20240815-01017

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Objective　To explore the correlation between the degree of coronary artery stenosis in the dual source CT examination results of thoracic obstruction patients in the real world and the different types of traditional Chinese medicine (TCM) syndrome differentiation. Methods　This study collected general information, examination information, and diagnostic information of 431 patients with thoracic obstruction who underwent cardiac dual-source CT examination at Traditional Chinese Medicine Department, The First Affiliated Hospital of PLA Air Force Military Medical University from July 1, 2011 to December 31, 2021. Circulation software was used to analyze the stenosis site of coronary artery and the degree of intraluminal stenosis. The percentage of each stenosis lesion was recorded and measured. The age and gender of the patients and the distribution of TCM syndrome types were analyzed, and the relationship between thoracic obstruction syndrome types and the degree of coronary artery stenosis was explored. χ² test was used for statistical analysis. Results　A total of 431 patients were included, including 215 males and 216 females. The age range was concentrated between 22 and 81 years old, with an average of 57.28 years old. There were 45 cases <45 years old, 219 cases 45-60 years old, and 167 cases >60 years old. There were 89 cases (20.6%) of heart and blood stasis obstruction, 88 cases (20.4%) of phlegm turbidity obstruction, 65 cases (15.1%) of qi and yin deficiency, 57 cases (13.2%) of heart and kidney yang deficiency, 54 cases (12.5%) of qi stagnation and cardioplegia, 41 cases (9.5%) of heart and kidney yin deficiency, and 37 cases (8.6%) of cold coagulation heart meridian. There were 35 cases (8.1%) of grade 0 coronary artery stenosis, 94 cases (21.8%) of grade 1 stenosis, 111 cases (25.8%) of grade 2 stenosis, 101 cases (23.4%) of grade 3 stenosis, and 90 cases (20.9%) of grade 4 stenosis. Blood stasis obstruction and phlegm turbidity obstruction were more common in grade 3 and grade 4 stenosis of various empirical syndrome types, and were positively correlated with the degree of stenosis. There was no significant difference in the degree of stenosis of the cold coagulation heart meridian, while the qi stagnation heart chest syndrome was more common in grade 1-3 stenosis. The types of deficiency syndromes, including qi yin deficiency, heart kidney yin deficiency, and heart kidney yang deficiency, were mostly distributed in grade 1-2 coronary artery stenosis. The incidence rates of each syndrome type in different degrees of stenosis were statistically different (χ²=111.370, P<0.001). Conclusion　There is a clear correlation between various TCM syndromes and the degree of coronary artery stenosis in patients with thoracic obstruction.

Analysis of the predictive value of multimodal magnetic resonance imaging on the prognosis of neonatal hypoxic-ischemic encephalopathy

Dong Siying, Li Junchao, Yan Song

2025, 31(1):  84-88.  DOI: 10.3760/cma.j.cn441417-20240910-01018

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Objective　To analyze the prognostic value of multimodal magnetic resonance imaging (MRI) in neonatal hypoxic-ischemic encephalopathy (HIE). Methods　Seventy-eight neonates with HIE in Zhumadian Central Hospital from January 2022 to December 2023 were selected as a HIE group, of whom 49 had a good prognosis (Gesell development scale score >75 points) and 29 had a poor prognosis (Gesell development scale score ≤75 points). A total of 78 neonates with asphyxia history but without brain injury during the same period were selected as a non-HIE group, and all of them underwent multimodal MRI. There were 40 boys and 38 girls in the HIE group, aged (4.02±1.38) days; the gestational age was (39.25±0.75) weeks; the head circumference was (32.05±0.71) cm; the delivery methods were natural delivery in 21 cases and cesarean section in 57 cases. There were 42 boys and 36 girls in the non-HIE group, aged (4.06±1.35) days; the gestational age was (39.19±0.72) weeks; the head circumference was (32.01±0.64) cm; the delivery methods were natural delivery in 24 cases and cesarean section in 54 cases. The multimodal MRI parameters of the two groups and the multimodal MRI parameters of HIE neonates with different prognosis were compared, and the correlations between the multimodal MRI parameters and prognosis were analyzed. Independent sample t test, χ² test, and Spearman correlation analysis were used for statistical analysis. Results　In the HIE group, the T₁, apparent diffusion coefficient, and cerebral blood flow were (1 436.85±23.69) ms, (1.18±0.11) ×10^-3 mm²/s, (27.59±2.02) ml/ (100 g·min), and those in the non-HIE group were (1 145.02±15.28) ms, (2.09±0.21) ×10^-3 mm²/s, and (16.03±1.24) ml/ (100 g·min), with statistically significant differences (t=91.428, 33.902, and 43.074, all P<0.001). The levels of T₁ and cerebral blood flow in neonates with poor prognosis were higher than those in neonates with good prognosis [(1 804.35±26.75) ms vs. (1 386.47±20.02) ms, (34.96±2.37) ml/ (100 g·min) vs. (23.02±1.86) ml/ (100 g·min)], and the apparent diffusion coefficient was lower than that in neonates with good prognosis [(0.81±0.07) ×10^-3 mm²/s vs. (1.32±0.15) ×10^-3 mm²/s], with statistically significant differences (t=78.460, 23.708, and 17.201, all P<0.001). Spearman analysis showed that T₁ and cerebral blood flow were positively correlated with poor prognosis of HIE neonates (r=0.837 and 0.840, both P<0.001), and apparent diffusion coefficient was negatively correlated with poor prognosis of HIE neonates (r=-0.837, P<0.001). Conclusion　There are significant differences in the multimodal MRI parameters between HIE neonates and non-HIE neonates, and the multimodal MRI parameters can predict the prognosis of HIE neonates , providing a reference for clinical diagnosis and evaluation of treatment effect.

Analysis of high-risk factors associated with the development of cervical polyps

Zhao Chao, Yu Lu, Liu Ying, Dang Lijuan, Yang Linqing

2025, 31(1):  89-93.  DOI: 10.3760/cma.j.cn441417-20240729-01019

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Objective　To investigate the clinical risk factors associated with the development of cervical polyps and to develop a predictive model to increase population vigilance on this disease. Methods　This was a retrospective study. A total of 239 patients who underwent hysteroscopic surgery in the Department of Gynecology, Affiliated Hospital of Jining Medical College from December 1, 2021 to December 1, 2022 were selected as the study objects, and were divided into two groups according to postoperative pathological data. Among them, 131 patients with cervical polyps ranged in age from 27 to 77 years old, with a median age of 49 years old; 108 patients without cervical polyps ranged in age from 15 to 58 years old, with a median age of 44 years old. Univariate analysis and multivariate binary logistic regression analysis were used to analyze the risk factors of cervical polyps, and the receiver operating characteristic curve (ROC) was used to test the evaluation value of relevant risk factors of cervical polyps. Mann-Whitney U test, χ² test, or Fisher exact probability method were used for statistical analysis.Results　The results of univariate analysis showed that there was statistically significant differences in the incidence of age, body mass index (BMI), obesity (BMI ≥25 kg/m²), gestational time, menopause, hypertension [systolic blood pressure ≥140 mmHg (1 mmHg=0.133 kPa) and/or diastolic blood pressure ≥90 mmHg], uterine fibroids, or endometrial polyps between the cervical polyp group and the non-cervical polyp group (all P<0.05). Multivariate binary logistic regression analysis showed that obesity [odds ratio (OR) =5.080, 95% confidence interval (95%CI) 1.769-14.588, P=0.003], hypertension (OR=6.629, 95%CI 2.456-17.890, P<0.001), uterine fibroids (OR=2.018, 95%CI 1.020-3.993, P=0.044), endometrial polyps (OR=3.623, 95%CI 1.806-7.265, P<0.001), and pregnancy times (OR=1.349, 95%CI 1.037-1.755, P=0.026) were clinical risk factors for cervical polyps. ROC analysis results showed that the combined detection of obesity, hypertension, uterine fibroids, endometrial polyps, and pregnancy times had a medium value in evaluating the occurrence of cervical polyps, with the area under the curve of 0.808 (0.753-0.864). Conclusions　Obesity, hypertension, uterine fibroids, endometrial polyps, and pregnancy times are all high risk factors for the incidence of cervical polyps. The evaluation value of the combined detection of these indicators is higher than that of each single indicator, which is convenient for clinicians to screen high-risk groups early.

Clinical Research

Effect of extracorporeal shock wave combined with sodium hyaluronate on knee osteoarthritis

Li Pengfei, Song Yuxuan, Zhang Jiyang, Jiang Peng, Yang Yanhui

2025, 31(1):  94-98.  DOI: 10.3760/cma.j.cn441417-20240807-01020

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Objective　To explore the application effect of extracorporeal shock wave combined with sodium hyaluronate in patients with knee osteoarthritis (KOA) and its impacts on knee joint function, inflammation level, and bone metabolic activity. Methods　A total of 92 KOA patients admitted to Shaanxi Rehabilitation Hospital from January 2022 to December 2023 were selected as the study objects. The patients were randomly divided into a control group (46 cases) and an observation group (46 cases) by the envelope method. There were 29 males and 17 females in the control group, aged (61.03±5.37) years; the body mass index was (22.43±2.44) kg/m²; the course of disease was (5.72±0.75) years. There were 28 males and 18 females in the observation group, aged (60.98±5.35) years; the body mass index was (22.41±2.42) kg/m²; the course of disease was (5.69±0.73) years. The control group was treated with sodium hyaluronate, and the observation group was combined with extracorporeal shock wave therapy based on the control group. Both groups were treated continuously for 4 weeks. Knee function [Western Ontario and McMaster University Osteoarthritis Index (WOMAC)], inflammation level [interleukin (IL) -17, IL-8, cyclooxygenase-2 (COX-2), tumor necrosis factor-α (TNF-α), and matrix metalloproteinase-9 (MMP-9)], bone metabolic activity [osteocalcin (BGP), osteoprotegerin (OPG), and total type I collagen amino terminal prolongating peptide (TPINP)] before and after treatment, and occurrence of adverse reactions (infection, fever, phlebitis, bleeding, and joint swelling and pain) during treatment were compared between the two groups. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After treatment, the pain, stiffness, and dysfunction scores of the WOMAC in the observation group were lower than those in the control group [(3.53±0.47) points vs. (6.61±0.85) points, (0.67±0.13) points vs. (1.12±0.18) points, (8.51±0.89) points vs. (14.29±1.52) points] (all P<0.05). The levels of IL-8, IL-17, TNF-α, COX-2, and MMP-9 in the observation group were lower than those in the control group [(59.78±5.73) ng/L vs. (109.68±14.31) ng/L, (15.63±2.59) ng/L vs. (23.32±3.97) ng/L, (60.21±6.81) μg/L vs. (89.57±10.25) μg/L, (12.14±1.52) ng/L vs. (18.58±2.69) ng/L, (41.17±5.79) μg/L vs. (69.59±7.84) μg/L] (all P<0.05). The BGP, OPG, and TPINP levels in the observation group were higher than those in the control group [(7.67±0.71) U/L vs. (5.74±0.67) U/L, (6.46±0.59) ng/L vs. (4.86±0.53) ng/L, (34.69±5.63) μg/L vs. (32.12±4.96) μg/L] (all P<0.05). During treatment, there was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusions　The combination of extracorporeal shock wave and sodium hyaluronate can improve knee joint function, reduce inflammatory factor levels, and improve bone metabolism activity in KOA patients. The treatment is safe and worthy of promotion and application.

Correlations between serum cysteine-aspartic protease-3 and soluble vascular endothelial growth factor receptor 1 levels and condition and prognosis in patients with sudden hearing loss

Yang Qimei, Li Weige

2025, 31(1):  99-104.  DOI: 10.3760/cma.j.cn441417-20240705-01021

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Objective　To explore the correlations between serum cysteine-aspartic protease-3 (Caspase-3) and soluble vascular endothelial growth factor receptor 1 (sFIt-1) levels and condition and prognosis in patients with sudden hearing loss. Methods　This study retrospectively analyzed 78 patients with sudden hearing loss treated at Shaanxi Provincial People's Hospital from January 2022 to January 2024 as a research group, including 46 males and 32 females, aged 32-76 (47.92±4.65) years, with a body mass index of 20.37-27.94 (24.57±3.24) kg/m². Additionally, 38 healthy individuals undergoing physical examinations were selected as a reference group, including 21 males and 17 females, aged 34-63 (48.23±4.81) years, with a body mass index of 19.86-22.51 (20.87±2.39) kg/m². Pure tone audiometry (PTA) was used to evaluate the patients with sudden hearing loss, and the patients were divided into 16 cases in the severe group (PTA >60 dBHL), 39 cases in the moderate group (PTA >40-60 dBHL), and 23 cases in the mild group (PTA 20-40 dBHL). All patients received treatments such as steroids and neurotrophic drugs for 10 days as a course of treatment, and the prognosis was evaluated after 10 days. According to the prognosis, the patients with sudden hearing loss after treatment were divided into a good prognosis group (57 cases) and a poor prognosis group (21 cases). Serum Caspase-3 and sFIT-1 levels were detected by enzyme-linked immunosorbent assay (ELISA). General data of the subjects were collected, including gender, age, body mass index, course of disease, clinical symptoms, site of hearing loss, degree of hearing loss, and underlying diseases. Independent sample t test, repeated measure ANOVA, and χ² test were used for statistical analysis. Spearman rank correlation coefficient was used for correlation analysis. Multivariate logistic regression analysis was used to identify factors influencing poor prognosis in patients with sudden hearing loss. The receiver operating characteristic curve (ROC) was plotted to analyze the diagnostic value of serum Caspase-3 and sFIt-1 in predicting the prognosis of sudden hearing loss patients. Results　Serum Caspase-3 and sFIT-1 levels in the study group were higher than those in the reference group [(17.27±3.14) ng/L vs. (6.63±1.67) ng/L, (157.82±13.47) ng/L vs. (81.67±10.63) ng/L] (both P<0.05). Serum Caspase-3 and sFIT-1 levels in the severe and moderate groups were higher than those in the mild group, and the above indexes in the severe group were higher than those in the moderate group (all P<0.05). Spearman correlation analysis showed that serum Caspase-3 and sFIT-1 levels in patients with sudden hearing loss were positively correlated with the severity of the disease (r=0.881 and 0.841, both P<0.05). There were statistically significant differences in the age, severity of hearing loss, and serum Caspase-3 and sFIT-1 levels between the poor prognosis group and the good prognosis group (all P<0.05). Multivariate logistic regression analysis showed that the severity of hearing loss (OR: 0.009, 95%CI: 0.000-0.209), age (OR: 1.165, 95%CI: 1.049-1.293), and serum Caspase-3 (OR: 1.546, 95%CI: 1.183-2.022) and sFIT-1 levels (OR: 1.058, 95%CI: 1.015-1.104) were the prognostic factors in patients with sudden hearing loss (all P<0.05). ROC analysis results showed that the area under the curve (AUC) predicted by serum Caspase-3 combined with sFIt-1 was greater than that predicted by serum Caspase-3 and sFIt-1 alone. The sensitivity of joint prediction was 66.67%, the specificity was 87.72%, and the AUC was 0.819 (0.712-0.925); the sensitivity of Caspase-3 was 52.38%, the specificity was 82.46%, and the AUC was 0.721 (0.593-0.849); the sensitivity of FIT-1 was 52.38%, the specificity was 84.21%, and the AUC was 0.703 (0.573-0.832). Conclusions　Serum levels of Caspase-3 and sFIt-1 are significantly correlated with the degree of hearing loss and prognosis in patients with sudden hearing loss. Combined detection of these biomarkers can effectively predict the severity and prognosis of the disease, serving as biological indicators for evaluating the prognosis of this condition.

Clinical study of Tislelizumab combined with albumin-paclitaxel and cisplatin in elderly patients with advanced non-small cell lung cancer brain metastases

Zhang Juan, Jiang Yibo, Ruan Wenwen

2025, 31(1):  105-110.  DOI: 10.3760/cma.j.cn441417-20240806-01022

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Objective　To explore the efficacy and safety of Tislelizumab combined with albumin-paclitaxel and cisplatin in the treatment of elderly patients with advanced non-small cell lung cancer (NSCLC) brain metastases. Methods　A total of 122 elderly patients with advanced NSCLC brain metastases admitted to Ankang People's Hospital from January 2018 to July 2023 were selected as the study objects. The patients were divided into an observation group (64 cases) and a control group (58 cases) according to the treatment methods. In the observation group, there were 35 males and 29 females, aged 60-85 (70.97±4.91) years, pathological types: 33 cases of squamous cell carcinoma and 31 cases of adenocarcinoma, differentiation degree: 26 poorly differentiated cases, 24 moderately differentiated cases, and 14 highly differentiated cases, pathological stage: 22 cases of stage Ⅲb and 42 cases of stage Ⅳ. In the control group, there were 32 males and 26 females, aged 62-83 (72.71±4.86) years, pathological types: 31 cases of squamous cell carcinoma and 27 cases of adenocarcinoma; differentiation degree: 23 poorly differentiated cases, 25 moderately differentiated cases, and 10 highly differentiated cases, pathological stage: 19 cases of stage Ⅲb and 39 cases of stage Ⅳ. The control group was treated with albumin-paclitaxel combined with cisplatin, and the observation group was treated with Tislelizumab on the basis of the control group. With 21 days was 1 treatment cycle, both groups were treated for 4 consecutive cycles. The clinical efficacy (objective response rate and disease control rate), tumor markers [carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC), and soluble fragment of cytokeratin 19 (CYFRA21-1)] and immune markers (CD3⁺, CD4⁺, and CD4⁺/CD8⁺) before and after treatment, incidence of adverse reactions during treatment, and 12-month follow-up survival prognosis [progression-free survival (PFS) and overall survival (OS)] were compared between the two groups. Independent sample t test, paired t test, χ² test, Fisher exact probability method, and Log-rank test were used for statistical analysis. Results　The objective remission rate and disease control rate of the observation group were higher than those of the control group [56.25% (36/64) vs. 37.93% (22/58), 85.94% (55/64) vs. 70.69% (41/58)] (both P<0.05). After treatment, serum CEA, SCC, and CYFRA21-1 levels in the observation group were lower than those in the control group [(14.92±3.51) μg/L vs. (17.05±4.42) μg/L, (27.64±5.94) μg/L vs. (30.02±6.67) μg/L, (7.51±2.03) μg/L vs. (8.64±2.15) μg/L] (all P<0.05); the serum levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the observation group were higher than those in the control group [(52.09±5.53)% vs. (39.97±5.28)%, (48.71±6.35)% vs. (36.18±5.09)%, 1.84±0.31 vs. 1.12±0.35] (all P<0.05). During treatment, there was no statistically significant difference in the incidences of adverse reactions (fever, hypothyroidism, pruritus, decrease of white blood cell count, and increase of aminotransferase) between the two groups (all P>0.05). At the end of follow-up, 2 cases were lost in the observation group and 1 case in the control group, with an effective follow-up rate of 97.54%(119/122). The median PFS of the observation group and the control group were 9 months and 6 months, respectively. The median OS of the control group was 11 months, and the median OS of the observation group was not reached. After 12 months of follow-up, the overall survival rate of the observation group was higher than that of the control group [69.35% (43/62) vs. 47.37% (27/57)] (P<0.05). There were statistically significant differences in the PFS and OS between the two groups (both P<0.05). Conclusion　Tislelizumab combined with albumin-paclitaxel and cisplatin in the treatment of elderly patients with advanced NSCLC brain metastases can inhibit the expressions of tumor markers, regulate the immune function, improve the efficacy, and have good safety.

Case Report

A case report and literature analysis of herpes zoster involving multiple cranial nerves

Tian Shulei, Yang Mengyu, Wang Yingxuan, Liu Yawen, Chen Yinggang, Wang Xuezhen

2025, 31(1):  111-113.  DOI: 10.3760/cma.j.cn441417-20240624-01023

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Reviewing and summarizing the clinical manifestation, diagnosis, and treatment of a case of herpes zoster involving multiple cranial nerves, deepens our understanding on the diversity of symptoms of herpes zoster infection. The main manifestations of the patient were pain and rash on the right frontal and parietal skin, limitation of movement in multiple directions of the right eye, and loss of direct and indirect reflex to light of the right eye. Laboratory examination showed an increase in the absolute value of monocytes. Typical zoster virus infection can be diagnosed according to clinical manifestations, and atypical herpes zoster virus infection can be diagnosed by detection of herpes zoster virus in vesicular fluid or serum.

Vulvar cancer complicated with systemic lupus erythematosus: a case report and literature review

Han Ze, Chen Jingping, Chen Yizhi, Liu Tianfeng

2025, 31(1):  114-116.  DOI: 10.3760/cma.j.cn441417-20240724-01024

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Malignant tumors of the external genitalia are rare, with squamous cell carcinoma being the main pathological type, which mostly occur in middle-aged and elderly women before and after menopause. In recent years, there has been a trend towards younger age at onset of vulvar cancer in young women, most of which is related to persistent infection with high-risk human papillomavirus (HPV), especially HPV16. Systemic lupus erythematosus (SLE) is a group of autoimmune diseases that are closely related to HPV infection and the development of female genital tract tumors. Due to limited clinical samples and insufficient research evidences, it is difficult to determine the correlation between vulvar cancer and SLE. This article reports a case of vulvar cancer complicated with SLE, describes its clinical diagnosis and treatment process in detail, summarizes experiences, and further explores their correlation based on the latest literature review for discussion and learning among clinical physicians as well as providing reference for diagnosis, treatment, and prevention of vulvar cancer complicated with SLE.

Nursing Research

Effects of preventive nursing on liver function and serum inflammatory factors in patients with severe acute pancreatitis treated by ulinastatin

Li Yixiao, Pang Haiyan, Zhao Jingqin, Cao Fei

2025, 31(1):  117-121.  DOI: 10.3760/cma.j.cn441417-20240707-01025

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Objective　To analyze the effects of preventive nursing on liver function and serum inflammatory factors in patients with severe acute pancreatitis  treated by ulinastatin. Methods　A total of 72 patients with severe acute pancreatitis admitted to Shangqiu First People's Hospital from April 2020 to April 2022 were studied, all of whom were given ulinastatin treatment. The patients were divided into a reference group and an experimental group with 36 cases in each group according to the random number table method. In the control group, there were 20 males and 16 females, aged 21-55 (38.18±1.74) years, and the course of disease was 1-47 (24.26±2.05) h. In the experimental group, there were 22 males and 14 females, aged 20-56 (38.21±1.53) years, and the course of disease was 1-48 (24.19±2.12) h. The reference group received routine nursing, and the experimental group was given preventive nursing measures on this basis for 7 d. The liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBIL)], serum levels of inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), IL-10, and tumor necrosis factor α (TNF-α)], and immune function [immunoglobulin (Ig) G, IgA, and IgM] before and after intervention and improvement time of clinical symptoms (abdominal pain, abdominal distension, bowel sound, and fever) and occurrence of complications (pancreatic encephalopathy syndrome, acute renal failure, upper gastrointestinal bleeding, etc.) during intervention were compared between the two groups. Independent sample t test and χ² test were used for statistical analysis. Results　After intervention, serum ALT, AST, ALP, and TBIL levels in the experimental group were lower than those in the control group [(51.05±3.52) U/L vs. (80.49±5.03) U/L, (53.05±4.32) U/L vs. (84.01±6.92) U/L, (60.72±4.23) U/L vs. (75.80±6.81) U/L, (11.72±1.23) μmol/L vs. (18.80±1.81) μmol/L] (all P<0.05). Serum levels of CRP, IL-6, and TNF-α in the experimental group were lower than those in the control group [(39.05±3.52) mg/L vs. (48.49±4.03) mg/L, (42.05±3.32) μg/L vs. (47.01±3.92) μg/L, (30.76±4.61) ng/L vs. (47.01± 5.26) ng/L], the IL-10 level was higher than that in the control group [(92.72±7.23) ng/L vs. (81.80±6.81) ng/L] (all P<0.05). Serum IgG, IgA, and IgM levels in the experimental group were higher than those in in the control group [(15.05±2.52) g/L vs. (11.49±2.03) g/L, (3.65±0.22) g/L vs. (3.31±0.32) g/L, (1.25±0.13) g/L vs. (1.20±0.11) g/L] (all P<0.05). During the intervention, the improvement time of abdominal pain, abdominal distension, bowel sound, and fever in the experimental group were shorter than those in the control group [(2.58±1.22) d vs. (3.88±1.12) d, (3.05±1.32) d vs. (3.81±1.22) d, (2.45±1.06) d vs. (4.53±1.62) d, (3.72±1.23) d vs. (4.80±1.81) d] (all P<0.05). The total complication rate of the experimental group was lower than that of the control group [8.33% (3/36) vs. 36.11% (13/36)] (P<0.05). Conclusion　After admission of severe acute pancreatitis patients, preventive nursing can not only improve their liver function, reduce the inflammatory response of the body, but also improve their immune function, effectively shorten the time of clinical symptom remission, and reduce the incidence of complications.

Effect of integrated moxibustion therapy with fire dragon pot on patients with cough and asthma of chronic obstructive pulmonary disease

Lyu Haipeng, Chen Yun, Gao Yunji, Zhu Ling, Yi Fei, Deng Hui, Xu Weifang

2025, 31(1):  121-126.  DOI: 10.3760/cma.j.cn441417-20240704-01026

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Objective　To explore the effect of integrated moxibustion therapy with fire dragon pot on patients with cough and asthma of chronic obstructive pulmonary disease (COPD). Methods　This study was a randomized controlled trial. A total of 86 COPD patients with cough and asthma admitted to Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian) from October 2022 to October 2023 were selected as the study objects by the convenience sampling method. The patients were divided into a control group (43 cases) and a treatment group (43 cases) by the random number table method. In the treatment group, 3 patients were admitted to the intensive care unit due to aggravation of the disease and could not continue the study; in the control group, 2 patients could not continue the study because the patient left Shenzhen, and 1 patient failed to follow the doctor's advice to withdraw by themselves. Each 40 patients in the treatment group and control group completed the study. In the control group, there were 28 males and 12 females, aged 43-79 (60.12±5.23) years, and the course of disease ranged from 2 to 13 (10.09±2.23) years. In the treatment group, there were 30 males and 10 females, aged 41-78 (60.56±5.18) years, and the course of disease ranged from 2 to 14 (10.12±2.13) years. The control group was treated with routine nursing and rehabilitation training, and the treatment group was treated with integrated moxibustion therapy with fire dragon pot on the basis of the control group. Both groups were treated continuously for 30 days. The cough and asthma relief rate and pulmonary function indicators [forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁), and FEV₁/FVC], morning symptoms [Chronic Obstructive Pulmonary Disease Morning Symptom Diary (CPLD-MSD)], respiratory function [St.George's Respiratory Questionnaire (SGRQ) and modified Medical Research Council (mMRC)], traditional Chinese medicine (TCM) syndrome score, blood gas analysis indexes [oxygen partial pressure (PaO₂) and carbon dioxide partial pressure (PaCO₂)] before and after treatment were compared between the two groups. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　The total relief rate of cough and asthma in the treatment group was higher than that in the control group [95.00% (38/40) vs. 80.00% (32/40)] (P<0.05). After treatment, the FVC, FEV₁, and FEV₁/FVC in the treatment group were higher than those in the control group [(2.51±0.38) L vs. (2.17±0.35) L, (1.38±0.43) L vs. (1.13±0.37) L, (65.47±5.34)% vs. (62.11±5.17)%] (all P<0.05). The scores of COPD-MSD, SGRQ, and mMRC in the treatment group were lower than those in the control group [(51.78±3.21) points vs. (63.22±3.23) points, (48.19±6.23) points vs. (55.23±6.21) points, (1.48±0.51) points vs. (2.48±0.72) points] (all P<0.05). The main symptom score, secondary symptom score, and total score of TCM syndrome scale in the treatment group were lower than those in the control group [(5.58±1.42) points vs. (8.55±1.71) points, (3.11±0.31) points vs. (5.23±0.44) points, (8.12±0.55) points vs. (13.62±0.72) points] (all P<0.05). The PaO₂ of the treatment group was higher than that of the control group [(76.11±5.12) mmHg (1 mmHg = 0.133 kPa) vs. (65.15±5.11) mmHg], but the PaCO₂ was lower than that of the control group [(48.17±6.32) mmHg vs. (55.23±6.21) mmHg] (both P<0.05). Conclusion　The choice of integrated moxibustion therapy with fire dragon pot for patients with COPD cough and asthma can not only effectively relieve the patients' cough and asthma symptoms, but also enhance their lung function, improve their respiratory function and morning symptoms.

Observation on the effect of staged pulmonary rehabilitation exercise in adult patients with acute respiratory distress syndrome

Li Yahui, Li Caidie, Zhao Xiang

2025, 31(1):  127-131.  DOI: 10.3760/cma.j.cn441417-20240708-01027

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Objective　To investigate the effect of staged pulmonary rehabilitation exercise in adult patients with acute respiratory distress syndrome (ARDS). Methods　A prospective study was conducted on 78 adult ARDS patients admitted to the Second Affiliated Hospital of Zhengzhou University from January 2022 to January 2024, and they were divided into a control group and an observation group by the random number table method. In the control group, there were 20 males and 19 females, aged 26-75 (50.59±3.78) years; the etiology was acute shock in 12 cases, sepsis in 7 cases, trauma in 9 cases, fat embolism in 6 cases, and severe pancreatitis in 5 cases; there were 13 mild cases, 15 moderate cases, and 11 severe cases. In the observation group, there were 21 males and 18 females, aged 25-74 (50.64±3.82) years; the etiology was acute shock in 13 cases, sepsis in 6 cases, trauma in 10 cases, fat embolism in 7 cases, and severe pancreatitis in 3 cases; there were 14 mild cases, 16 moderate cases, and 9 severe cases. The control group received routine nursing intervention, and the observation group received phased pulmonary rehabilitation exercise on the basis of routine nursing. Both groups continued the intervention until the patients were discharged. The nursing satisfaction (self-made nursing satisfaction questionnaire of the Second Affiliated Hospital of Zhengzhou University), blood gas indicators [partial pressure of carbon dioxide (PaCO₂), partial arterial pressure of oxygen (PaO₂), and oxygen saturation (SaO₂)], pulmonary function [forced expiratory volume in the first second (FEV₁), forced vital capacity (FVC), peak expiratory flow (PEF), and maximum volume per minute (MVV)], and quality of life [Health Survey Short Form (SF-36)] before and after intervention, occurrence of complications during intervention (ventilator associated pneumonia, pressure sores, delirium, muscle atrophy, etc.) were compared between the two groups. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After intervention, the PaCO₂ of the observation group was lower than that of the control group [(48.31±2.59) mmHg (1 mmHg= 0.133 kPa) vs. (53.26±2.77) mmHg], and the PaO₂ and SaO₂ were higher than those of the control group [(82.29±4.68) mmHg vs. (73.37±4.54) mmHg, (94.37±1.15)% vs. (86.76±4.05)%] (all P<0.05). The FEV₁, FVC, PEF, and MVV in the observation group were higher than those in the control group [(1.99±0.30) L vs. (1.65±0.28) L, (2.99±0.33) L vs. (2.68±0.27) L, (6.54±0.76) L/s vs. (5.37±0.71) L/s, (47.83±5.45) L/min vs. (44.89±5.31) L/min] (all P<0.05). The physiological function, physical pain, emotional function, vital vitality, mental health, physical function, social function, and overall health scores of the SF-36 in the observation group were higher than those in the control group (all P<0.05). During the intervention period, the total complication rate of the observation group was lower than that of the control group [5.13% (2/39) vs. 23.08% (9/39)] (P<0.05). The scores of service timeliness, working ability, service attitude, health education guidance, and nursing effect in the observation group were higher than those in the control group (all P<0.05). Conclusion　Phased pulmonary rehabilitation exercise can improve the blood gas indexes and lung function in adult ARDS patients, reduce the complications, and improve the patients' quality of life and nursing satisfaction.

Characterisation of cancer-related fatigue in lung cancer survivors and its correlations with anxiety, depression, and stress-related hormones

Duan Kunmei, Shang Xi, Zhang Hongmei

2025, 31(1):  132-135.  DOI: 10.3760/cma.j.cn441417-20240708-01028

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Objective　To explore the characteristics of cancer-related fatigue (CRF) in lung cancer survivors and analyze its correlations with anxiety, depression, and stress-related hormones. Methods　A total of 300 lung cancer survivors admitted to Henan Provincial People's Hospital from July 2023 to May 2024 were selected as the study objects. There were 180 males and 120 females, aged from 28 to 72 (50.13±5.66) years, with pathological stage Ⅰ-Ⅳ of 105, 98, 57, and 40, respectively. The Piper's Fatigue Scale (PFS) was used to evaluate the incidence of CRF in lung cancer survivors. According to the PFS score, lung cancer survivors were divided into a CRF group (≥1 point) and a CRF-free group (0 point), and CRF lung cancer survivors were further subdivided into a mild group (1-3 points), a moderate group (4-6 points), and a severe group (≥7 points). The general data (gender, age, education background, marriage, monthly income, chronic diseases, pathological stage, and post-cure time) of 300 lung cancer survivors were analyzed, and the scores of Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD) and adrenocorticotropic hormone (ACTH) level of CRF lung cancer survivors with different degrees were compared. Pearson correlation coefficient method was used to analyze the correlations between CRF and HAMA and HAMD scores and ACTH level. t test, ANOVA, and χ² test were used for statistical analysis. Results　A total of 300 lung cancer survivors were included in this study, of whom 268 cases (89.33%) developed CRF, including 80 mild cases (29.86%), 143 moderate cases (53.36%), and 45 severe cases (16.78%). There were statistically significant differences in the education background and post-cure time between the CRF group and the CRF-free group (both P<0.05). The HAMA and HAMD scores and ATCH levels in the severe and moderate groups were higher than those in the mild group, and the above indexes in the severe group were higher than those in the moderate group (all P<0.05). Pearson correlation analysis showed that CRF was positively correlated with HAMA and HAMD scores and ACTH level (r=0.458, 0.403, and 0.411, all P<0.001). Conclusion　Lung cancer survivors' CRF was characterized by a higher risk of CRF with lower educational qualifications and shorter post-cure time, and the degree of CRF was positively correlated with patients' anxiety, depression, and stress-related hormones.

Effects of nutritional intervention based on Patient-Generated Subjective Global Assessment score on nutritional intake and quality of life during chemotherapy in colorectal cancer patients

Qiu Huanhuan, Ge Gaoqi, Guo Jin, Liu Jianfang, Lu Yawan

2025, 31(1):  136-140.  DOI: 10.3760/cma.j.cn441417-20240806-01029

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Objective　To investigate the effects of nutritional intervention based on Patient-Generated Subjective Global Assessment (PG-SGA) score on nutritional intake and quality of life during chemotherapy in colorectal cancer patients. Methods　This study was a randomized controlled trial. A total of 102 patients with colorectal cancer who received chemotherapy in Henan Provincial People's Hospital from April 2021 to April 2024 were selected as the study objects. The patients were divided into a control group (51 cases) and an observation group (51 cases) by the random number table method. There were 30 males and 21 females in the control group, aged (59.62±6.00) years; the types of disease were colon cancer in 19 cases and rectal cancer in 31 cases; the clinical stages were stage Ⅰ in 12 cases, stage Ⅱ in 20 cases, and stage Ⅲ in 19 cases. There were 28 males and 23 females in the observation group, aged (59.45±6.18) years; the types of disease were colon cancer in 16 cases and rectal cancer in 35 cases; the clinical stages were stage Ⅰ in 10 cases, stage Ⅱ in 22 cases, stage Ⅲ in 19 cases. The control group received routine nutritional intervention, and the observation group received nutritional intervention based on PG-SGA score. Both groups were intervened until the end of the chemotherapy cycle. Nutritional intake (energy and protein), nutritional status [serum albumin (ALB), hemoglobin (Hb), serum prealbumin (PA), and serum total protein (TP)], and quality of life [Generic Quality of Life Inventory 74 (GQOL-74)] were compared between the two groups before and after intervention. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After intervention, the energy intake and protein intake in the observation group were higher than those in the control group [(1 110.78±256.90) kcal/d vs. (1 001.23±231.78) kcal/d, (57.78±10.04) g/d vs. (43.15±9.26) g/d] (both P<0.05). The levels of ALB, Hb, PA, and TP in the observation group were higher than those in the control group [(42.18±3.01) g/L vs. (39.00±2.89) g/L, (110.89±11.34) g/L vs. (105.28±11.00) g/L, (0.48±0.09) g/L vs. (0.33±0.07) g/L, (59.98±4.63) g/L vs. (55.17±4.38) g/L] (all P<0.05). The scores of physical function, social function, material life, and psychological function of the GQOL-74 in the observation group were higher than those in the control group [(70.12±6.53) points vs. (63.44±6.00) points, (67.19±6.82) points vs. (63.16±6.08) points, (73.22±7.03) points vs. (61.89±6.27) points, (71.26±7.90) points vs. (66.01±6.82) points] (all P<0.05). Conclusion　Nutritional intervention based on PG-SGA score can improve the nutritional intake of colorectal cancer patients during chemotherapy, promote the improvement of quality of life, and is worthy of clinical application.

Analysis of the clinical nursing value of Chinese medicine vapor-mist transdermal therapy for peripheral intravenous catheter phlebitis

Zhao Yu, Liu Lanke, Du Ge

2025, 31(1):  141-145.  DOI: 10.3760/cma.j.cn441417-20240722-01030

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Objective　To analyze the clinical nursing value of Chinese medicine vapor-mist transdermal therapy for peripheral intravenous catheter (PIVC) phlebitis. Methods　A total of 102 patients with PIVC phlebitis treated in Henan Provincial Hospital of Traditional Chinese Medicine from January 2022 to December 2023 were selected as the study objects. The patients were divided into an experimental group (51 cases) and a control group (51 cases) by the random number table method. There were 27 males and 24 females in the experimental group, aged 18-60 (42.16±5.18) years, and the grade of phlebitis was grade Ⅲ in 40 cases and grade Ⅳ in 11 cases. There were 26 males and 25 females in the control group, aged 18-60 (42.03±5.11) years, and the grade of phlebitis was grade Ⅲ in 41 cases and grade Ⅳ in 10 cases. The control group took conventional traditional Chinese medicine topical treatment, and the experimental group took Chinese medicine vapor-mist transdermal therapy for 2 days. The treatment effect, vascular elasticity recovery status, pain degree before treatment and 2, 6, and 24 h after treatment [Numeric Rating Scale (NRS)], and inflammatory indexes before and after treatment [hypersensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6)] were compared between the two groups. Independent sample t test and χ² test were used for statistical analysis. Results　The total effective rate of the experimental group was higher than that of the control group [94.12% (48/51) vs. 80.39% (41/51)] (P<0.05). The normalization rate of vascular elasticity of the experimental group was higher than that of the control group [78.43% (40/51) vs. 47.06% (24/51)] (P<0.05). At 2 h, 6 h, and 24 h after treatment, the NRS scores of the experimental group were lower than those of the control group [(3.58±0.31) points vs. (4.36±0.39) points, (2.77±0.25) points vs. (3.92±0.33) points, (1.95±0.17) points vs. (2.84±0.24) points] (all P<0.05). After treatment, the levels of hs-CRP and IL-6 in the experimental group were lower than those in the control group [(8.73±0.72) mg/L vs. (13.05±1.18) mg/L, (3.93±0.32) μg/L vs. (7.58±0.67) μg/L] (both P<0.05). Conclusion　Chinese medicine vapor-mist transdermal therapy used in the clinical care of PIVC phlebitis can significantly improve the therapeutic effect, accelerate the recovery speed of vascular elasticity, relieve the pain of the body, and reduce the inflammatory response.

Application of PDCA cycle management in improving the qualified rate of volume management in patients with chronic heart failure

Wu Jie, Wang Lu, Cheng Yiran, Guo Xinxin, Xie Henan, Chang Lu,

2025, 31(1):  145-149.  DOI: 10.3760/cma.j.cn441417-20240701-01031

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Objective　To explore the application effect of PDCA cycle management in improving the qualified rate of volume management in patients with chronic heart failure (CHF), and to provide scientific basis for taking effective measures to improve the qualified rate of volume management in patients with CHF. Methods　A total of 52 patients with CHF [23 males and 29 females, aged (61.36±5.16) years] who were admitted to the Department of Geriatrics, Henan Provincial People's Hospital from June 26 to July 23, 2023 were selected as the control group by convenience sampling method. A total of 74 CHF patients [37 males and 37 females, aged (62.75±4.78) years] admitted to the hospital from November 1 to December 15, 2023 after PDCA cycle were included in the observation group. PDCA cycle was used to manage the qualified rate of volume management, and the changes in the qualified rate of volume management were compared before and after management. Results　After PDCA cycle, the qualified rate of volume management in CHF patients increased from 51.28% (100/195) to 87.11% (223/256), which reached the target value. The qualified rate of the volume management knowledge assessment of ward nurses for CHF patients was 95.00% (19/20), and the effective guidance rate of nurses' health education was increased from 85.00% (17/20) to 95.00% (19/20). Conclusion　The application of PDCA cycle can improve the qualified rate of volume management in CHF patients more effectively, ensure the patients' safety in hospital more effectively, and help medical staff solve clinical problems better.

Observation of the therapeutic effect of traditional Chinese medicine hot compress package in pain management for patients with osteoporotic vertebral compression fractures

Wan Yupin, Wan Lei, Luo Xiuyun, Ai Yiming, Wen Jinsheng

2025, 31(1):  150-153.  DOI: 10.3760/cma.j.cn441417-20240407-01032

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Objective　To explore the therapeutic effect of traditional Chinese medicine hot compress package on pain management in patients with osteoporotic vertebral compression fractures (OVCF). Methods　A prospective study was conducted, selecting 80 patients with OVCF admitted to the Second Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2023 to January 2024, and dividing them into two groups using the random number table method, with 40 patients in each group. The age of the control group was 50-78 (60.55±5.68) years old; there were 18 females and 22 males; the causes of fractures included 25 cases of car accident and 15 cases of falling from high altitude. The age of the observation group was 51-79 (60.57±5.71) years old; there were 17 females and 23 males; the causes of fractures included 23 cases of car accident and 17 cases of falling from high altitude. The control group received routine pain care, and the observation group received intervention with traditional Chinese medicine hot compress package on this basis for one week. The intervention effect, pain level [Visual Analogue Scale (VAS)], incidence of complications, and quality of life [Short Form of Health Survey (SF-36)] were compared between the two groups. t test and χ² test were used for statistical analysis. Results　After 1 week of nursing, the total effective rate of the observation group was higher than that of the control group [95.00% (38/40) vs. 77.50% (31/40)], and the total incidence of complications was lower than that of the control group [5.00% (2/40) vs. 20.00% (8/40)], with statistically significant differences (χ²=5.165 and 4.114, both P<0.05). The VAS score of the observation group was lower than that of the control group [(2.28±0.22) points vs. (3.60±0.35) points], and the total SF-36 score was higher than that of the control group [(73.49±7.35) points vs. (62.50±6.26) points], with statistically significant differences (t=20.195 and 7.199, both P<0.05). Conclusion　The application of traditional Chinese medicine hot compress package in pain care for OVCF patients can improve the nursing effectiveness, alleviate the patients' pain, reduce the incidence of complications, and improve their quality of life.

Influences of EENC technique on the initiation of lactation in parturient women and the behavioral status of newborns

Lyu Hairong, Ren Yu, Zhang Qing, Tang Le, Bao Lei

2025, 31(1):  154-158.  DOI: 10.3760/cma.j.cn441417-20240709-01033

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Objective　To study the effects of early essential newborn care (EENC) technique on the initiation of lactation, breastfeeding, and early behavioral status of newborns. Methods　A total of 800 pairs of newborns and primiparas who delivered vaginally in Xi'an People's Hospital from January 2023 to October 2023 were selected as the research objects and were randomly divided into two groups by SPSS 24.0 software, with 400 pairs in each group. In the control group, the maternal age was (27.4±5.1) years old, and the gestational age was (39.1±1.5) weeks; there were 267 boys and 133 girls, with a body weight of (3 268.2±363.7) g and a 1-minute Apgar score of (9.1±0.8) points. In the control group, the maternal age was (26.9±4.8) years old, and the gestational age was (39.0±1.9) weeks; there were 249 boys and 151 girls, with a body weight of (3 287.4±357.2) g and a 1-minute Apgar score of (9.2±0.8) points. The observation group was given EENC technique, and the control group was given traditional neonatal health care. The lactation initiation rate, first breastfeeding success rate, adverse event incidence, lactation initiation time, Bristol Breastfeeding Assessment Tool (BAT) score, arterial oxygen saturation (SaO₂), and Neonatal Behavioral Neurological Assessment (NBNA) score were compared between the two groups. χ² test and t test were used for statistical analysis. Results　The lactation initiation time, the first BAT score, and the duration of first breastfeeding in the observation group were all better than those in the control group [(1.9±0.4) d vs. (2.3±0.5) d, (10.7±1.1) points vs. (10.3±1.0) points, (31.6±6.3) min vs. (25.9±7.7) min], with statistically significant differences (t=-12.494, 5.381, and 11.459, all P<0.05). The lactation initiation rate and the success rate of first breastfeeding in the observation group were higher than those in the control group [95.8% (383/400) vs. 89.8% (359/400), 93.5% (374/400) vs. 89.0% (356/400)], with statistically significant differences (χ²=10.707 and 5.072, both P<0.05). The rates of exclusive breastfeeding at postpartum 24, 48, and 72 h in the observation group were higher than those in the control group (χ²=8.852, 6.199, and 5.126, all P<0.05). The body temperature of newborns in the observation group was higher than that in the control group at 1, 2, and 4 h after birth, and the SaO₂ level was higher than that in the control group at 24, 48, and 72 h after birth, with statistically significant differences (t=13.868, 12.804, 10.243, 32.555, 47.361, and 47.456, all P<0.05). The NBNA scores of newborns in the observation group were higher than those in the control group at 1 month of age (all P<0.05). The neonatal hospitalization time and incidences of hypothermia and hyperbilirubinemia in the observation group were lower than those in the control group [(3.2±0.3) d vs. (3.4±0.5) d, 0.8% (3/400) vs. 2.8% (11/400), 1.0% (4/400) vs. 4.3% (17/400)], with statistically significant differences (t=6.860, χ²=4.653 and 8.265, all P<0.05). Conclusion　EENC technique can accelerate the initiation of lactation in partopregnants, increase the rate of early exclusive breastfeeding, and maintain the levels of body temperature and SaO₂ in a stable state, which has positive effects on neonatal neurobehavioral development and reduce the incidence of adverse events, and is worthy of clinical promotion.

Application of IKAP model guided parent education classroom in prevention and treatment of atopic dermatitis in children

Zhong Xifang, Zeng Cailing, Zhong Qiuming, Chen Hui

2025, 31(1):  159-162.  DOI: 10.3760/cma.j.cn441417-20240715-01034

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Construction of a nursing management plan for gastrointestinal dysfunction in patients receiving mechanical ventilation

Zhang Lijuan, Wang Pu, Guo Shichang, Xue Mengqi, Ma Shihong, Wu Qiaomei

2025, 31(1):  163-168.  DOI: 10.3760/cma.j.cn441417-20240903-01035

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Objective　To construct a nursing management plan for gastrointestinal dysfunction in patients receiving mechanical ventilation. Methods　The relevant literatures on nursing management for gastrointestinal dysfunction in patients receiving mechanical ventilation were systematically searched in major Chinese and English databases from the establishment of the databases to September 2022. The evidences were screened and extracted, and the nursing management plan for gastrointestinal dysfunction in patients receiving mechanical ventilation was initially drawn up. From January to March 2023, the Delphi method was used to conduct two rounds of correspondence with 15 experts, then the experts' opinions were integrated, the contents of the plan were revised, and the final draft of nursing management plan for gastrointestinal dysfunction in patients receiving mechanical ventilation was formed. Results　The positive coefficients of the two rounds of expert correspondence were both 100%, the expert authority coefficients were 0.863 and 0.860, respectively, and the Kendall coordination coefficients were 0.546 and 0.477, respectively (both P<0.001). The final nursing management plan for gastrointestinal dysfunction in patients receiving mechanical ventilation included 3 first-level indicators, 9 second-level indicators, and 25 third-level indicators. Conclusions　The construction of nursing management plan for gastrointestinal dysfunction in patients receiving mechanical ventilation is scientific and reliable, which can provide reference for the clinical management of gastrointestinal dysfunction in patients receiving mechanical ventilation.

Investigation Report

Analysis of quality of life and its influencing factors in rural elderly patients with cancer in Shaanxi Province

Chang Li, Xie Juan, Gao Li, Zhao Jiang, Sun Xiue, He Li, Fan Chunxiu, Yue Qin, Shen Honghong, Wang Yan

2025, 31(1):  169-174.  DOI: 10.3760/cma.j.cn441417-20240807-01036

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Objective　To investigate the quality of life of elderly patients with cancer in rural areas of Shaanxi Province and explore the influencing factors of the quality of life. Methods　This was a cross-sectional study. Using convenience sampling method, 597 rural elderly cancer patients hospitalized in 9 different medical institutions in Shaanxi Province from July to August 2022 were selected as investigation objects. There were 207 males and 390 females, aged (69.56±8.84) years, and the tumor stage included 58 cases of stage I, 222 cases of stage II, 242 cases of stage III, and 75 cases of stage IV. General data questionnaire and Chinese version of Functional Assessment of Cancer Therapy (FACT) were used to investigate. t test, variance analysis, and multiple linear regression analysis were used for statistical analysis. Results　A total of 617 questionnaires were sent out in this study, and 597 valid questionnaires were finally collected, with an effective response rate of 96.76%. The total score of quality of life of rural elderly cancer patients hospitalized in Shaanxi Province was (55.33±8.46) points, which was in the lower middle level. The results of multiple linear regression analysis showed that age, gender, marital status, education level, current place of residence, living style, and whether suffering from chronic diseases were the influencing factors for the quality of life of hospitalized rural elderly cancer patients (β=0.066, 0.070, -0.055, 0.062, -0.066, 0.099, and -0.052, t=2.801, 3.037, -2.347, 2.355, -2.946, 4.212, and -2.253, all P<0.05), together accounting for 12.8% of the variation. Conclusions　The quality of life of rural elderly cancer patients hospitalized in Shaanxi Province is at a lower medium level, and their quality of life is affected by age, gender, marital status, education level, current place of residence, living style, and chronic diseases. More attention should be paid to individual differences and precise intervention measures should be implemented to improve their quality of life.