Table of Content

15 January 2025, Volume 31 Issue 2

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Diabetes

Protective effect of silencing lncRNA Gm9866 on high glucose-induced pancreatic β-cell injury 

Dong Luying , Wang Yueqi , Huang Xiaocheng, Wang Jia

2025, 31(2):  177-182.  DOI: 10.3760/cma.j.cn441417-20240729-02001

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Objective　To observe the protective effect of low expression of Gm9866 on high glucose-induced pancreatic β cell injury. Methods　The study was from January to May 2024. Small interfering RNA (siRNA) was used to silence the expression of long-chain non-coding RNA (lncRNA) Gm9866 in MIN6 of mouse pancreatic β cells. The MIN 6 cells were divided into a control group and a high glucose group. The expression of Gm9866 levelin the MIN6 cells was detected by the real-time quantitative polymerase chain reaction (qRT-PCR). The MIN6 cells cultured in high glucose were divided into an si-NC group and an si-Gm9866 group, infected with si-NC lentivirus and si-Gm9866 lentivirus, respectively. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression level of Gm9866 in the MIN6 cells. The CCK-8 method and flow cytometry were used to detect the activity and apoptosis of the MIN6 cells. The dual luciferase assay was used to detect the targeting relationship between Gm9866 and miR-149-5p. qRT-PCR was used to detect the expression level of miR-149-5p in the MIN6 cells. Western blot was used to detect the expression levels of apoptotic proteins (BID and BIM) and proliferation proteins (Cdk5 and Cyclin D3). t test was used for the statistical analysis. Results　The expression level of Gm9866 in the control group was lower than that in the high glucose group (1.01±0.29 vs. 7.87±1.20; P<0.01). The MIN6 cells' viability in the si-Gm9866 group was higher than that in the si-NC group (P<0.05); the apoptosis rate in the si-Gm9866 group was lower than that in the si-NC group (P<0.01). Gm9866 targeted and bounded miR-149-5p (P<0.01). The expression level of miR-149-5p in the si-Gm9866 group was higher than that in the si-NC group (P<0.01); the expression levels of apoptotic proteins BID and BIM were lower than those in the si-NC group (both P<0.05); the expression levels of proliferation proteins Cdk5 and Cyclin D3 in the si-Gm9866 group were higher than those in the si-NC group (both P<0.05). Conclusion　Silencing Gm9866 increases the activity of islet cells and reduces the apoptosis of islet cells upregulating the expression of miR-149-5p.

Role and regulatory mechanism of mitochondrial dynamics in diabetic nephropathy

Xing Wenhua, Liang Dong, Liu Jie, Li Mengjie, Zhang Xiaomin

2025, 31(2):  183-187.  DOI: 10.3760/cma.j.cn441417-20240722-02002

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Diabetic nephropathy (DN) is a progressive microvascular complication of diabetes. It is the main cause of kidney failure and death in diabetic patients. The balance between mitochondrial division and fusion is essential for maintaining cell homeostasis and mitochondrial health. In DN, the imbalance of mitochondrial dynamics caused by the imbalance of mitochondrial fission and fusion is the core pathological process. In this paper, we review the role and regulatory mechanism of mitochondrial dynamics in DN and the relevant targeted drugs targeting mitochondrial dynamics, so as to provide ideas for the future clinical treatment of DN.

IDegLira combined with heptaphyllum saponin sodium tablets for patients with diabetic retinopathy and macular edema

Zhu Baixue, Dang Jiangbo, Zhou Meijiao

2025, 31(2):  187-192.  DOI: 10.3760/cma.j.cn441417-20240723-02003

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Objective　To investigate the clinical effect of insulin degludec and liraglutide injection (IDegLira) combined with heptaphyllum saponin sodium tablets in the treatment of patients with diabetic retinopathy (DR) and macular edema (DME). Methods　One hundred and twenty patients with DR and DME treated at Yulin Traditional Chinese Medicine Hospital from January 2022 to May 2024 were selected for the randomized controlled trial, and were divided into a study group and a control group by the random number table method, with 60 cases in each group. There were 35 males and 25 females in the study group; they were (58.49±7.84) years old; their disease course was (14.39±2.05) years. There were 32 males and 28 females in the control group; they were (57.88±8.95) years old; their disease course was (14.52±2.10) years. Both groups received conventional treatment; the control group took heptaphyllum saponin sodium tablets; the study group took IDegLira and heptaphyllum saponin sodium tablets. Both groups were treated for 3 months. The blood glucose qualified rates and hypoglycemia incidence rates after the treatment were compared between the two groups. The logarithms of the minimum angle of resolution (logMAR), intraocular pressures, and retinal thicknesses of the macular center medulla (CMT) were compared between the two groups before and after the treatment. The macular penetration was compared between the two groups after the treatment. The levels of interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), monocyte chemotactic protein (MCP-1), nitric oxide synthase (NOS), and soluble intercellular adhesion molecule-1 (sICAM-1) in atrial aqueous humor were compared between the two groups. The treatment efficacies and occurrence of adverse reactions were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The blood glucose qualified rate and the hypoglycemia incidence rate in the study group were better than those in the control group [85.00% (51/60) vs. 48.33% (29/60) and 6.67% (4/60) vs. 36.67% (22/60); both P<0.05]. Before the treatment, there were no statistical differences in logMAR, intraocular pressure, and CMT between the two groups (all P>0.05); after the treatment, the logMAR, intraocular pressure, and CMT in the study group were lower than those in the control group (all P<0.05). The rate of macular leakage regression in the study group was higher than that in the control group after the treatment [95.00% (57/60) vs. 80.00% (48/60); P=0.013]. Before the treatment, there were no statistical differences in the levels of IL-6, VEGF, NOS, MCP-1, and sICAM-1 between the two groups (all P>0.05); after the treatment, the levels of IL-6, VEGF, MCP-1, and sICAM-1 in the study group were lower than those in the control group, while the level of NOS was higher (all P<0.05). The total effective rate in the study group was higher than that in the control group [90.00% (54/60) vs. 71.67% (43/60); P=0.011]. No significant adverse reactions were observed in both groups; there was no statistical difference in the incidence rate of adverse reactions between the study group and the control gorup [3.33% (2/60) vs. 1.67 (1/60); P>0.05]. Conclusion　IDegLira combined with heptaphyllum saponin sodium tablets for patients with DR and DME can significantly improve their glycemic control, visual acuity, and atrial aqueous humor-related indicators and reduce the occurrence of hypoglycemic events and macular leakage, and is clinically effective and safe.

Clinical value of serum Perilipin-2 and urinary Netrin-4 in prediction of diabetic nephropathy in patients with type 2 diabetes mellitus

Yang Wenjuan, Lyu Qianqian, Wang jie, Liu Xiaoning, Qiang Wei, Bian Fang

2025, 31(2):  193-197.  DOI: 10.3760/cma.j.cn441417-20240613-02004

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Objective　To explore the clinical value of serum lipid coated protein 2 (Perilipin-2) and urine axon-guiding factor 4 (Netrin-4) in the prediction of diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM). Methods　This was a cross-sectional study. A total of 208 patients with T2DM treated at Xi'an Daxing Hospital from July 2020 to July 2023 were selected as the study objects. According to their urinary albumin excretion rates (UAER), the patients were divided into a simple T2DM group (UAER<30 mg/24 h) and a DN group (30 mg/24 h≤UAER<300 mg/24 h). There were 74 males and 56 females in the simple T2DM group; they were (56.18±7.38) years old; their body mass index was (22.73 ± 4.37) kg/m². There were 42 males and 36 females in the DN group; they were (57.02±7.13) years old; their body mass index was (23.68±4.29) kg/m². A total of 120 healthy examinees during the same period were selected as a healthy control group. Serum Perilipin-2 and urine Netrin-4 were detected in all the subjects. The contents of serum Perilipin-2 and urine Netrin-4 in all the subjects were detected. t and χ² tests were used for the statistical analysis. The receiver operating characteristic curve (ROC) was used to evaluate the clinical value of serum Perilipin-2 combined with urinary Netrin-4 in the prediction of DN in the patients. Multivariate logistic regression analysis was used to explore the related factors of DN. Results　The serum levels of Perilipin-2 in the simple T2DM group [(12.52±3.37) μg/L] and the DN group [(20.84±3.42) μg/L] were higher than that in the healthy control group [(5.13±2.15) μg/L], and the level in the DN group was higher than that in the simple T2DM group, with a statistical difference between the 3 groups (F=15.14; P<0.05). The urinary Netrin-4 levels in the simple T2DM group [(63.93±8.72) μg/L] and the DN group [(41.32±7.04) μg/L] were lower than that in the healthy control group [(98.64±15.37) μg/L], and the level in the DN group was lower than that in the simple T2DM group, with a statistical difference between the 3 groups (F=37.03; P<0.05). The areas under the curves (AUC) of serum Perilipin-2 and urine Netrin-4 for the occurrence of DN in the patients were 0.739 (95%CI 0.694-0.789) and 0.835 (95%CI 0.791-0.884), respectively; and the AUC of their combination was 0.903 (95%CI 0.858-0.954). The number of the patients with grade 2 or above hypertension in the DN group was higher than that in the simple T2DM group (χ²=11.68; P<0.05). The multivariate logistic regression analysis showed that a history of grade II or above hypertension (OR=3.232, 95%CI 1.499-6.968), serum Perilipin-2 (OR=4.252, 95%CI 1.752-10.267), and urinary Netrin-4 (OR=5.145, 95%CI 1.985-13.337) were the influential factors for the occurrence of DN in the patients (all P<0.05). Conclusion　Serum Perilipin-2 and urine Netrin-4 can be used as biomarkers for predicting the occurrence of DN in patients with T2DM, and their combination can improve the clinical diagnostic value.

Impact of trinity nursing management mode on blood glucose, self-management level, and quality of life in patients with type 2 diabetes mellitus

Wang Rongrong, Zhang Jin

2025, 31(2):  198-202.  DOI: 10.3760/cma.j.cn441417-20240609-02005

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Objective　To explore the impact of the trinity nursing management mode on blood glucose, self-management level, and quality of life in patients with type 2 diabetes mellitus. Methods　Ninety-six patients with type 2 diabetes mellitus treated at Baoji People's Hospital from October 2022 to October 2023 were selected for the randomized controlled trial, and were divided into a control group and a study group by the random number table method, with 48 cases in each group. There were 29 males and 19 females in the control group; they were (48.36±4.17) years old. There were 30 males and 18 females in the study group; they were (48.29±4.33) years old. The control group took routine nursing education. The study group were intervened by the trinity nursing management mode. Both groups were intervened for 3 months. The blood glucose levels (including fasting blood glucose, 2 h postprandial blood glucose, and glycosylated hemoglobin), self-management levels [Diabetes Self-Management Behavior Scale (SDSCA)], and quality of life [Quality of Life Scale for Patients with Type 2 Diabetes Mellitus (DMQLS)] were compared between the two groups before and after the intervention. χ² and t tests were used for the statistical analysis. Results　After the intervention, the levels of fasting blood glucose, 2 h postprandial blood glucose, and glycosylated hemoglobin in the study group were lower than those in the control group [(7.13±2.02) mmol/L vs. (8.37±2.13) mmol/L, (9.51±2.50) mmol/L vs. (10.96±2.61) mmol/L, and (7.81±1.66) mmol/L vs. (8.54±1.76) mmol/L], with statistical differences (t=2.927, 2.780, and 2.090; all P<0.05). After the intervention, the scores of diet management, foot care, blood glucose monitoring, exercise management, and medication management in the study group were higher than those in the control group (23.10±2.11 vs. 21.02±2.30, 12.02±1.45 vs. 10.84±1.66, 11.96±1.85 vs. 10.06±1.77, 12.03±1.17 vs. 10.45±1.36, and 6.02±0.58 vs. 5.13±0.66); the score of smoking in the study group was lower than that in the control group (2.41±0.74 vs. 3.26±0.80); there were statistical differences (t=4.617, 3.709, 5.141, 6.102, 7.018, and 5.404; all P<0.05). After the intervention, the scores of disease, psychology, physiology, society, and satisfaction of DMQLS in the study group were lower than those in the control group (42.31±5.57 vs. 50.06±6.02, 30.26±4.22 vs. 35.31±4.17, 42.37±4.51 vs. 49.26±4.96, 27.56±3.97 vs. 32.38±3.48, and 24.01±2.49 vs. 30.06±2.74), with statistical differences (t=6.547, 5.897, 7.121, 6.325, and 11.321; all P<0.05). Conclusion　Trinity nursing management mode for patients with type 2 diabetes mellitus can effectively improve their blood glucose level, self-management level, and quality of life.

Effect of Yiqi Tongluo Formula on treatment efficacy in patients with type 2 diabetes mellitus

Guo Haonan, Wu Hongqun

2025, 31(2):  203-208.  DOI: 10.3760/cma.j.cn441417-20240309-002006

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Objective　To observe the effects of Yiqi Tongluo Formula on serum levels of apolipoprotein B (apoB), apolipoprotein A-Ⅰ (ApoA-Ⅰ), and glucagon-like peptide 1 (GLP-1) and glucose metabolism in patients with type 2 diabetes mellitus (T2DM). Methods　A total of 98 patients with T2DM treated at Shangluo Central Hospital from August 2020 to August 2023 were selected for the randomized controlled trial. They were divided into a control group and an observation group by the random number table method, with 49 cases in each group. There were 24 males and 25 females in the control group; they were (47.85±6.14) years old; their disease course was (8.34±2.48) years. There were 22 males and 27 females in the observation group; they were (46.59±6.03) years old; their disease course was (8.56±2.25) years. The control group took conventional treatment and mecobalamin tablets, and the observation group conventional treatment, mecobalamin tablets, and Yiqi Tongluo Formula, for 2 months. The clinical efficacies, scores of traditional Chinese medicine syndromes, serum levels of ApoB, ApoA-Ⅰ, and GLP-1, glucose metabolism, lower limb nerve conduction velocities, and adverse reactions were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The total effective rate in the observation group was higher than that in the control group [95.92% (47/49) vs. 79.59% (39/49); χ²=6.078; P<0.05]. The total score of traditional Chinese medicine syndromes in the observation group was lower than that in the control group (3.89±1.03 vs. 4.94±1.21), with a statistical difference (t=4.625; P<0.05). The level of ApoB in the observation group was lower than that in the control group [(0.94±0.17) g/L vs. (1.05±0.25) g/L]; the levels of ApoA-Ⅰ and GLP-1 0 min and 2 h after oral glucose tolerance test (OGTT) in the observation group were higher than those in the control group [(1.18±0.21) g/L vs. (1.06±0.15) g/L, (132.47±15.21) g/L vs. (118.37±16.45) g/L, and (154.23±21.43) mol/L vs. (125.91±23.59) mol/L]; there were statistical differences (t=2.547, 3.255, 5.030, and 8.636; all P<0.05). The levels of fasting blood glucose (FBG), 1-hour postprandial blood glucose (1hPBG), 2-hour postprandial blood glucose (2hPBG), and glycated hemoglobin (HbA1c) in the observation group were lower than those in the control group [(6.51±0.82) mmol/L vs. (7.49±1.18) mmol/L, (8.53±1.19) mmol/L vs. (9.04±1.05) mmol/L, (10.57±1.38) mmol/L vs. (11.26±1.43) mmol/L, and (6.17±0.52)% vs. (6.96±0.68)%], with statistical differences (t=4.774, 2.250, 2.430, and 6.460; all P<0.05). The motor nerve conduction velocities (MNCV) and sensory nerve conduction velocities (SNCV) of median nerve and common peroneal nerve in the observation group were higher than those in the control group [(47.24±2.58) m/s vs. (44.32±3.14) m/s, (47.25±3.73) m/s vs. (45.09±3.26) m/s, (43.58±4.33) m/s vs. (41.04±4.51) m/s, (42.10±3.45) m/s vs. (39.61±3.27) m/s], with statistical differences (t=5.030, 3.052, 2.844, and 3.667; all P<0.05). Conclusion　Yiqi Tongluo Formula combined with mecobalamin tablets can improve clinical therapeutic effects on patients with T2DM, improve their serum factor levels and glucose metabolism, and accelerate their lower limb nerve conduction velocity.

Effect of multidisciplinary collaborative care for elderly patients with diabetic nephropathy and sarcopenia undergoing maintenance hemodialysis

Guo Zhimei, Wang Mingming

2025, 31(2):  208-213.  DOI: 10.3760/cma.j.cn441417-20240809-02007

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Objective　To investigate the effect of multidisciplinary collaborative care on self-care ability and quality of life in elderly patients with diabetic nephropathy and sarcopenia undergoing maintenance hemodialysis. Methods　Seventy elderly patients with diabetic nephropathy and sarcopenia undergoing maintenance hemodialysis at Zhoukou Central Hospital from May 2021 to October 2023 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 35 cases in each group. There were 16 men and 19 women in the control group; they were (65.64±5.76) years old; their disease course was (5.47±1.38) months; their dialysis time was (8.18±1.74) months. There were 17 men and 18 women in the observation group; they were (66.87±5.42) years old; their disease course was (5.64±1.23) months; their dialysis time was (8.96±1.74) months. The control group took routine nursing care, while the observation group multidisciplinary collaborative care. Both groups were intervened for 3 months. The blood glucose and renal function indicators, muscle and exercise ability, quality of life, self-care ability, and scores of Irritability, Depression, and Anxiety Scale (IDA) were compared between the two groups before and after the intervention by t test. Results　After the intervention, the levels of fasting blood glucose, glycosylated hemoglobin, and serum creatinine and urine albumin-to-creatinine ratio in the observation group were better than those in the control group [(8.05±0.62) mmol/L vs. (8.96±0.47) mmol/L, (7.25±0.42)% vs. (8.12±0.64)%, (54.89±13.37) μmol/L vs. (75.06±14.49) μmol/L, and (58.46±3.52) ml/min vs. (55.63±2.64) ml/min], with statistical differences (t=6.920, 6.724, 6.052, and 3.805; all P<0.05). After the intervention, the daily walking speed and hand grip strength in the observation group were better than those in the control group [(1.26±0.33) m/s vs. (1.02±0.27) m/s and (25.34±3.24) kg vs. (22.38±2.76) kg], with statistical differences (t=3.330 and 4.114; both P<0.05). After the intervention, the scores of World Health Organization Quality of Life-Brief and Exercise of Self-Care Agency Scale in the observation group were higher than those in the control group (56.46±6.38 vs. 48.63±5.91 and 135.36±13.54 vs. 126.35±13.45), with statistical differences (t=5.326 and 2.793; both P<0.05). After the intervention, the scores of outward stimulation, inward stimulation, anxiety, and depression and total score of negative emotions in the observation group were lower than those in the control group (4.32±1.44 vs. 5.16±1.33, 4.25±1.52 vs. 5.45±1.46, 7.21±1.56 vs. 8.36±1.37, 6.61±1.35 vs. 8.15±1.32, and 21.56±3.27 vs. 25.62±2.96), with statistical differences (t=2.535, 3.368, 3.277, 4.825, and 5.446; all P<0.05). Conclusion　Multidisciplinary collaborative care for elderly patients with diabetic nephropathy and sarcopenia undergoing maintenance hemodialysis can improve their renal function, blood glucose, quality of life, and clinical self-care ability, promote their physical recovery, and reduce their negative emotions.

Meta Analysis

Meta-analysis on modified uvulopalatopharyngoplasty combined with tongue root radiofrequency ablation for patients with moderate-to-severe obstructive sleep apnea hypopnea syndrome

Chen Qingyong, Sun Dezhong, Wang Dongqing, Lin Liqiang, Chen Zhipeng, Lyu Huaiqing

2025, 31(2):  214-220.  DOI: 10.3760/cma.j.cn441417-20240715-002008

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Objective　To systematically evaluate the safety and efficacy of modified uvulopalatopharyngoplasty (H-UPPP) combined with tongue root radiofrequency ablation in the treatment of patients with moderate-to-severe obstructive sleep apnea hypopnea syndrome (OSAHS). Methods　The literatures related to randomized controlled trials on H-UPPP combined with tongue root radiofrequency ablation in the treatment of patients with moderate-to-severe OSAHS were searched from Pubmed, China Biomedical Abstracts Database (CBM), Embase, Wanfang Database, China Knowledge Network Database (CNKI), and Wipro Database (VIP) from their establishment to January 2024. The experimental group took H-UPPP and tongue root radiofrequency ablation, and the control group H-UPPP. The literature quality of the included randomized controlled trials was evaluated by the Cochrane Risk of Bias Assessment Tool. The data were analyzed using meta-analysis by the RevMan 5.4 software. Results　A total of 2 596 literatures were identified. According to the inclusion and exclusion criteria, 7 studies with 625 patients (321 cases in the experimental group and 304 cases in the control group) were finally included. The results of meta-analysis showed that the overall effective rate (OR=3.26, 95%CI 1.82-5.86, P<0.000 1), apnea-hyponea index (OR=-7.11, 95%CI -11.86--2.35, P=0.003), the lowest oxygen saturation (OR=6.62, 95%CI 1.89-11.35, P=0.006), and score of Epworth Sleepiness Scale (OR=-0.90, 95%CI -1.61--0.20, P=0.01) in the experimental group were better than those in the control group. The incidence rate of temporary complications in the experimental group was higher than that in the control group (OR=2.68, 95%CI 1.34-5.35, P=0.005). Conclusions　For patients with moderate-to-severe OSAHS, H-UPPP combined with tongue root radiofrequency ablation is more effective than H-UPPP alone, with a higher incidence rate of postoperative temporary complications and no statistical difference in long-term complications.

New Medical Advances

Relationship of adverse dietary habits with putrescine and gastritis carcinomatous transformation

Sun Xiao, Liu Chengxia, Wang Na, Hao Jiahui, Chu Linlin, Yu Ruijie

2025, 31(2):  221-223.  DOI: 10.3760/cma.j.cn441417-20240719-02009

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Intestinal type gastric cancer is the most common pathological type of gastric cancer, and its formation process is called gastritis carcinomatous transformation. At present, more and more studies have confirmed that putrescine in gastric juice is involved in and promotes the transformation of gastritis into cancer. Diet is one of the main sources of exogenous putrescine in gastric juice. Long-term and large intake of high-salt food, pickled food, and red meat can affect the concentration of putrescine in gastric juice and destroy the stability of polyamine metabolism. This article reviews the relationship between adverse dietary habits, putrescine, and gastric cancer transformation, so as to explore that adverse dietary habits promote the evolution of gastritis cancer transformation affecting the concentration of putrescine in gastric juice and to reduce the incidence rate of gastric cancer through certain intervention measures.

Treatises

Prediction and APC modeling of burden of neurological diseases in China and the whole world from 1990 to 2019

Zhou Gaoyang, Gao Li, Wei Minghao

2025, 31(2):  224-230.  DOI: 10.3760/cma.j.cn441417-20240515-02010

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Objective　To understand the current situation of neurological disease burden in China, to analyze the changing trend of neurological disease burden in China from 1990 to 2019, and to explore the influence of age, period, and cohort on neurological disease burden. Methods　The burden of neurological diseases in China and the whole world from 1990 to 2019 based on data from the Global Burden of Disease Study 2019 (GBD 2019) was descripted. The changing trends of neurological disease burden were analyzed by the Joinpoint regression model. The endogenous factor estimation method and age-period-cohort (APC) model were used to fit the Chinese and global disability-adjusted life year (DALY) rates of neurological diseases, so as to further analyze the age effect, period effect, and cohort effect. The R language software was used to build ARIMA models to predict the age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALY rate of neurological diseases in China and the whole world from 2020 to 2024. Results　The Joinpoint regression model results showed that the age-standardized DALY rates of neurological diseases in China and the whole world from 1990 to 2019 both showed a decreasing trend, from 1 097.64/100 000 and 1 264.17/100 000 in 1990 to 1 076.59/100 000 and 1 253.56/100 000 in 2019, with a greater decrease in China (1.92%) than the whole world (0.84%); there were statistical differences in the decreasing trends (all P<0.05). The APC model showed that the age effect of neurological disease burden in China and the whole world showed a "J" shaped distribution. The risk of neurological disease burden increased with age after 50; disease burden increased with period effect, but decreased with cohort effect, with the late birth cohort having smaller risk of neurological disease burden than the earlier birth cohort. The ARIMA model results showed that the age-standardized DALY rates for neurological diseases in China and the whole world were roughly on the rise from 2020 to 2024. Conclusions　Strengthening the screening and prevention of neurological diseases, focusing on the elderly, and reducing behavioral risk factors such as smoking and improving irrational dietary habits are priority measures for the prevention and control of neurological diseases.

Value of IgE combined with CRP, IL-6, and IL-13 in diagnosis of complicated acute appendicitis in children

Zhang Ying, Wang Juan, Chen Rui, Cai Wuquan, Zhao Zhuo

2025, 31(2):  231-235.  DOI: 10.3760/cma.j.cn441417-20240905-02011

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Objective　To explore the value of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-13 (IL-13), and immunoglobulin E (IgE) in the diagnosis of complicated acute appendicitis in children. Methods　One hundred and fifty-four children with acute appendicitis treated at Shaanxi Forest Industry Workers' Hospital from February 2022 to February 2024 were selected as the study objects, including 90 males and 64 females. They were (6.73±3.18) years old. According to the pathological classification, they were divided into a simple acute appendicitis group (103 cases) and a complicated acute appendicitis group (51 cases). The clinical data and levels of CRP, IL-6, IL-13, and IgE in peripheral blood were compared between the two groups. The indicators of statistical significance were included into the multivariate logistic regression analysis. The receiver operating characteristic curve (ROC) was drawn to analyze the efficacy of the screening indicators in the diagnosis of complicated acute appendicitis in the children. Results　There were statistical differences in gender and vomiting between the two groups (both P0.05). The age and level of IgE in the complicated acute appendicitis group were lower than those in the simple acute appendicitis group [(5.69±2.85) years vs. (7.27±2.91) years and (76.06±52.34) μg/L vs. (161.64±58.10) μg/L]; the onset time in the complicated acute appendicitis group was shorter than that in the simple acute appendicitis group [(27.04±9.61)h vs. (20.13±6.73)h]; the levels of CRP, IL-6, and IL-13 and the proportion of the children with fever before the surgery in in the complicated acute appendicitis group were higher than those in the simple acute appendicitis group [(78.41±30.19) mg/L vs. (28.31±11.32) mg/L, (16.85±5.26) ng/L vs. (7.88±3.22) ng/L, (19.80±7.70) ng/L vs. (8.00±3.36) ng/L, and 74.51% (38/51) vs. 45.63% (47/103)]; there were statistical differences (t=3.913, 8.883, 5.177, 14.897, 13.073, and 13.244; χ²=11.503; all P0.05). The results of multivariate logistic regression analysis showed that CRP [OR=6.221 (95%CI 1.950-19.852)], IL-6 [OR=18.394 (95%CI 3.972-85.176)], and IL-13 [OR=10.186 (95%CI 4.507-23.020)] were independent risk factors for complicated acute appendicitis, and IgE [OR=0.162 (95%CI 0.062-0.424)] was an independent protective factor (all P0.05). The ROC results showed that the area under the curve (AUC) of the combined model was 0.924 (95%CI 0.881-0.966), and the optimal threshold was  76.84; the AUC of IgE was 0.915 (95%CI 0.867-0.962), and the optimal threshold was  106.0 μg/L. Conclusion　Serum CRP, IL-6, IL-13, and IgE alone and their combination can be used for the differential diagnosis of complicated acute appendicitis in children. Among them, IgE and the combined model have the best effects.

Relationship of quantitative electroencephalogram characteristics with consciousness disturbance degree and outcomes of patients with chronic consciousness disturbance

Liu Zhe, Tang Wenyu, Li Li, Pan Jianping

2025, 31(2):  236-241.  DOI: 10.3760/cma.j.cn441417-20240702-02012

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Objective　To investigate the characteristics of quantitative electroencephalogram (QEEG) in patients with chronic consciousness disturbance, and to analyze its relationship with consciousness disturbance degree and its value in predicting the short-term outcomes of consciousness. Methods　This was a prospective study. A total of 70 patients with chronic consciousness disturbance treated at Xi'an International Medical Center Hospital from June 2021 to January 2024 were selected, and were divided into a vegetative state group (24 cases; 15 males and 9 females; VS group), a microconscious state - group (24 cases; 17 males and 7 females; MCS- group), and a microconscious state + group (22 cases; 14 males and 8 females; MCS+ group) according to the degree of consciousness disorder. All the patients completed 4-week follow-up. The Coma Recovery Scale Revised(CRS-R) scores at admission and 4-week follow-up were compared; the patients were divided into a consciousness improvement group and a no consciousness improvement group according to their improvement. QEEG examination was completed in all the groups. χ² test, t test, and analysis of variance were used for the statistical comparisons. The Pearson correlation analysis software was used to analyze the correlation between QEEG and CRS-R scores in the patients. Univariate and multivariate analyses were performed for the patients' short-term consciousness outcomes. The receiver operating characteristic curve (ROC) was drawn to analyze the predictive efficacy of QEEG for the patients' short-term consciousness outcomes. Results　In the MCS- group, 15 cases were of RAV classification Ⅲ and 6 cases of Ⅳ, and the spectral entropy was 54.43±4.13; in the MCS+ group, 9 cases, 11 cases, and 57.51±4.96; in the VS group, 4 cases, 3 cases, and 51.49±3.35; there were statistical differences between the 3 groups (all P<0.05). The Pearson correlation analysis showed that the CRS-R score was positively correlated with RAV, α relative band energy, and spectral entropy in the patients (r=0.392, 0.349, and 0.486; all P<0.05). The univariate and multivariate results showed that CRS-R, RAV grade, conscious state at admission, α relative band energy, and spectral entropy were independent factors influencing the patients' short-term conscious outcomes (all P<0.05). The ROC results showed that the predictive sensitivity and specificity of the combination of RAV classification, α relative band energy, and spectral entropy for the patients were 89.57% and 85.61%, respectively, which were higher than those of single index (all P<0.05). Conclusion　Chronic consciousness disturbance has typical QEEG characteristics, which can represent the degree of consciousness disturbance and improve the sensitivity and specificity of consciousness prognosis in short term.

Clinical effect of obinutuzumab for patients with rituximab-resistant PLA2R-associated membranous nephropathy

Liu Yuyu, Si Yafang, Wang Yanning

2025, 31(2):  241-246.  DOI: 10.3760/cma.j.cn441417-20240708-02013

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Objective　To investigate the clinical effect of obinutuzumab in the treatment of rituximab-resistant phospholipase A2 receptor (PLA2R) associated membranous nephropathy (MN). Methods　One hundred and forty-nine patients with rituximab-resistant PLA2R-associated MN treated at Yulin Hospital, First Hospital, Xi'an Jiaotong University from January 2021 to August 2022 were selected for the randomized controlled trial, and were divided into a control group (75 cases) and a study group (74 cases) by the random rumber table method. There were 45 males and 30 females in the control group; they were (51.89±8.24) years old; their disease course was (5.89±1.01) years. There were 38 males and 36 females in the study group; they were (53.37±7.96) years old; their disease course was (6.04±1.12) years. The control group took routine drugs and Shenyan Kangfu tablets. The study group took routine drugs, Shenyan Kangfu tablets, and obinutuzumab. The renal function (serum albumin, serum creatinine, and 24 h urinary protein), clinical efficacies, renal injury markers [N-Acetyl-β-D-Glucosaminidase (NAG), retinol-binding protein (RBP), and neutrophil gelatinase-associated lipocalin (NGAL)], immune function (CD4⁺, CD8⁺, and CD4⁺/CD8⁺), PLA2R antibody, inflammatory factors [monocyte chemoattractant protein-1 (MCP-1), platelet alpha-granule membrane protein-140 (GMP-140), and intercellular adhesion molecule-1 (ICAM-1)], and adverse drug reactions were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　Before the treatment, there were no statistical differences in renal function, renal injury markers, immune function, PLA2R antibody, and inflammatory factors between the two groups (all P>0.05). After 6 months' treatment, there were statistical differences in the levels of serum albumin, serum creatinine, 24 urinary protein, NAG, RBP, NGAL, CD4⁺, CD8⁺, CD4⁺/CD8⁺, PLA2R antibody, MCP-1, GMP-140, and ICAM-1 between the study group and the control group [(42.69±6.81) g/L vs. (39.58±5.48) g/L, (66.57±8.28) μmol/L vs. (71.64±10.09) μmol/L, (2.63±0.31) g vs. (2.98±0.41) g, (16.54±2.41) U/L vs. (18.69±2.89) U/L, (1.79±0.21) mg/L vs. (2.04±0.32) mg/L, (52.01±8.23) μg/L vs. (58.64±9.84) μg/L, (43.92±4.81)% vs. (41.54±4.53)%, (21.79±3.72)% vs. (23.84±4.12)%, 1.84±0.35 vs. 1.71±0.32, (41.01±5.39) RU/ml vs. (45.98±6.54) RU/ml, (39.97±5.81) μg/L vs. (43.51±6.21) μg/L, (20.87±3.23) ng/L vs. (23.91±3.51) ng/L, and (59.01±8.21) mg/L vs. (62.84±10.14) mg/L; t=3.073, 3.350, 5.804, 4.928, 5.630, 4.458, 3.110, 3.186, 2.367, 5.058, 3.592, 5.499, and 2.532; all P<0.05]. The total treatment effective rate in the study group was higher that in the control group [91.89% (68/74) vs. 77.33% (58/75)], with a statistical difference (P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the study group and the control group [10.81% (8/74) vs. 8.00% (6/75); P>0.05]. Conclusion　Obinutuzumab for patients with rituximab-resistant PLA2R-associated MN is effective and safe, and can improve their renal function and immune function, alleviate their kidney injury and inflammatory reaction, and decrease their PLA2R antibody level.

OIP5-AS1 regulates ADSCs-Exos secretion and promotes wound healing through VEGF165

Hou Guoling, Gao Dongliang, Qu Wanli, Li Ming, Wang Yakang

2025, 31(2):  247-252.  DOI: 10.3760/cma.j.cn441417-20240904-02014

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Objective To investigate the mechanism of exosomes derived from ADSCs (ADSCs-Exos) knocking down opa-interacting protein 5 antisense RNA 1 (OIP5-AS1) in wound healing. Methods　The adipose-derived stem cells (ADSCs) were isolated from the human normal subcutaneous adipose tissue of 10 patients taking selective liposuction or plastic surgery at Yan'an University Affiliated Hospital from February to June 2024. Subsequently, the exosomes derived from ADSCs supernatant were extracted, and the expressions of exosome marker proteins tumor susceptibility gene 101(TSG101) and CD9 were identified. The expression of OIP5-AS1 was determined using quantitative real-time polymerase chain reaction. The HaCaT cells were treated with H₂O₂ to construct an in vitro skin injury model. MTT assay and flow cytometry were used to detect the cell viability and apoptosis. t test and variance analysis were used for the statistical comparisons. Results　ADSCs-Exos increased the viability and inhibited the apoptosis of the H₂O₂-treated HaCaT cells (t=4.358 and 5.654; both P0.05). OIP5-AS1 expression was significantly upregulated in ADSCs-Exos as compared with ADSCs (t=4.125, P0.01), and the knockdown of OIP5-AS1 inhibited the reparative effect of ADSCs-Exos on wound healing (t=3.367 and 6.674; both P0.05). The knockdown of OIP5-AS1 inhibited the expression of vascular endothelial growth factor 165 (VEGF165) (t=3.105; P0.01), and the overexpression of VEGF165 partially reversed the inhibitory effect of the knockdown of OIP5-AS1 on wound healing (t=3.327 and 5.544; both P0.05). Conclusion　ADSC-Exos with knockdown of OIP5-AS1 affect the wound healing process regulating the expression of VEGF165, providing a new target for the treatment of skin wound healing.

Mechanism of stephania tetrandra-red ginseng in combating colorectal cancer based on network pharmacology

Long Qixiong, Li Jingchun, Feng Feng, Sun Wei

2025, 31(2):  252-259.  DOI: 10.3760/cma.j.cn441417-20240826-02015

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Objective　To explore the effective ingredients and potential molecular mechanism of stephania tetrandra (ST)-red ginseng (RG) in the treatment of patients with colorectal cancer based on network pharmacology analysis methods. Methods　The effective active ingredients and corresponding targets of ST and RG were screened by the Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP), and were intersected with colorectal cancer related targets to obtain potential targets for drug resistance to colorectal cancer. A drug-target network relationship diagram was constructed to screen the key components. The core targets were screened through the protein-protein interaction (PPI) network diagram in the String database, and the expression of core targets in the GEPIA and HPA databases were verified. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on the potential targets using the WebGestalt and Metascape databases. When P0.05, there is a statistical difference. Results　Ten effective ingredients of ST and 19 effective ingredients of RG were screened from the TCMSP. Seventy-one potential targets for drugs against colorectal cancer were obtained by the Wayne diagram. Further calculation and analysis of the drug target network relationship diagram obtained 5 key components of ST-RG against colorectal cancer, including beta-Sitosterol, (+)-Stepharine, Menisperine, Magnoflorine, and Ginsenoside Rh2; 6 core targets were obtained through PPI network screening, including tumor necrosis factor (TNF), heat shock protein 90ɑB1 (HSP90AB1), prostaglandin-endoperoxide synthase (PTGS2), protein kinase A catalytic subunit (PRKACA), dopamine receptor D2 (DRD2), and serotonin transporter (SLC6A4). The GO enrichment analysis showed that ST-RG was mainly involved in biological function processes, such as cell proliferation, metabolic progress, antioxidant activity, etc. (all P0.01). According to the enrichment analysis of KEGG signal pathway, ST-RG involved in colorectal cancer, non-small cell lung cancer, prostate cancer, arterial atherosclerosis, and other disease pathways (all P0.01); the signal pathways were mainly enriched in cAMP, cGMP-PKG, PI3K/AKT (all P0.01), etc. Conclusion　Through network pharmacology analysis, the effective ingredients and potential mechanisms of ST-RG in the treatment of patients with colorectal cancer are elucidated at the molecular level, indicating that ST-RG may synergistically exert anti-cancer effects through multiple components, targets, and pathways.

Bilateral alternating transcranial direct current stimulation combined with swallowing function training in treatment of patients with dysphagia after stroke

Wang Suxin, Wang Lifeng, Zhang Xulong, Zhang Lili

2025, 31(2):  260-264.  DOI: 10.3760/cma.j.cn441417-20240421-02016

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Objective　To observe the rehabilitation effect of swallowing function training combined with bilateral alternating transcranial direct current stimulation (tDCS) in the treatment of patients with dysphagia after stroke. Methods　Sixty patients with dysphagia after stroke treated at Neurorehabilitation Ward, Shaanxi Rehabilitation Hospital from January 2023 to January 2024 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 30 cases in each group. There were 19 males and 11 females in the control group; they were (62.43±5.76) years old; their disease course was (1.46±0.34) months. There were 17 males and 13 females in the observation group; they were (61.37±6.58) years old; their disease course was (1.52±0.65) months. The control group took swallowing function training and received tDCS on their healthy sides. The observation group took swallowing function training and received bilateral alternating tDCS on their healthy and affected sides. The grades of Wada drinking water test (WST), scores of Television Fluoroscopy Swallowing Function Examination (VFSS), Oral Ingestion Function Score (FOIS), and Swallowing Disorder Specific Quality of Life Score (SWAL-QOL), amplitudes of hyoid muscle group checked by surface electromyography, and swallowing times before and 4 weeks after the treatment, clinical efficacies, and incidence rates of complications were compared between the two groups. Independent sample t test, paired t test, and χ² test were used for the statistical analysis. Results　Before the treatment, there were no statistical differences in the scores of WST, VFSS, FOIS, and SWAL-QOL, amplitude of hyoid muscle group, and swallowing time between the two groups (all P>0.05). Four weeks after the treatment, the score of WST in the observation group was lower than that in the control group (2.21±0.31 vs. 3.25±0.16); the scores of VFSS, FOIS, and SWAL-QOL and the amplitude of hyoid muscle group in the observation group were higher than those in the control group [8.79±1.37 vs. 6.34±1.24, 6.56±0.37 vs. 5.38±0.61, 146.89±14.43 vs. 124.87±13.85, and (591.25±23.27) µV vs. (510.81±19.30) µV]; the swallowing time in the observation group was shorter than that in the control group [(1.01±0.21) s vs. (1.25±0.44) s]; there were statistical differences (t=16.326, 7.262, 9.059, 6.030, 14.573, and 2.696; all P<0.05). The total clinical effective rate in the observation group was higher than that in the control group [93.3% (28/30) vs. 70.0% (21/30)], with a statistical difference (χ²=5.455; P=0.020). The incidence rate of complications in the observation group was lower than that in the control group [10.0% (3/30) vs. 33.3% (10/30)], with a statistical difference (χ²=4.812; P=0.028). Conclusion　Bilateral alternating tDCS combined with swallowing function training in the treatment of patients with dysphagia after stroke is effective, and can improve their swallowing function and life quality, and reduce the incidence rate of complications.

Characteristics and disease progression of Haemophilus influenzae infection in children

Li Xiangyu, Zheng Huijuan, Fan Yanting

2025, 31(2):  265-269.  DOI: 10.3760/cma.j.cn441417-20240301-02017

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Objective　To explore the clinical characteristics, drug resistance and related factors affecting disease progression of invasive Haemophilus influenzae infection in children. Methods　This was a retrospective survey. Five hundred children with invasive Haemophilus influenzae infection treated at Tongchuan People's Hospital from January 2021 to December 2023 were selected as the study objects, including 329 boys and 171 girls who were 1 month to 6 years old. Their clinical information, such as gender, age, examination results, and drug sensitivity results  were collected. The clinical characteristics and drug resistance were summarized. According to the condition status, they were divided into a severe group (227 cases) and a non-severe group (273 cases). The related factors affecting the disease progress were analyzed. t and χ² tests, logistic regression analysis, and receiver operating characteristics curve (ROC) were used for the statistical analysis. Results　Among the 500 children, there were 21 newborns, 242 infants, 139 young children, and 98 preschool children. The infection seasons were concentrated from April to June and from December to January. Three hundred and sixty-seven cases had fever, 412 cough, 125 sputum sounds, 147 wheezing sounds, and 289 fever and cough. Two hundred and eleven cases had infections by other pathogens, including 35 cases infected by respiratory syncytial virus, 41 by Mycoplasma pneumoniae, 71 by Moraxella catarrhalis, and 64 by Staphylococcus aureus. The drug sensitivity test results showed that the non-sensitive rates to cotrimoxazole,erythromycin, ampicillin, azithromycin, ciprofloxacin, and cefuroxime were 71.36% (309/433), 62.38% (262/420), 57.67% (282/489), 41.13% (153/372), 1.65% (7/423), and 0.21% (1/479), respectively; it was basically sensitive to third-generation cephalosporins, and most were sensitive to ampicillin/sulbactam. The results of logistic regression analysis showed that age, high incidence seasons, and co-infection might be the independent risk factors for disease progression in the children (OR=13.067, 1.263, and 6.863; all P<0.05). The ROC showed that age, high incidence seasons, and co-infection had high sensitivity to disease progression in the children, with the areas under the curves of 0.701, 0.606, and 0.685, respectively. Conclusions　Invasive Haemophilus influenzae infection often occurs in infants <3 years old. The high incidence seasons are in spring and winter. The clinical symptoms are mainly fever and cough, and they are susceptible to other pathogenic strains. For children with this disease, third generation cephalosporins should be used as the preferred treatment drug. Age, high incidence seasons, and co-infection may be independent risk factors affecting the disease progression of children with invasive Haemophilus influenzae infection.

Clinical Research

Influence of sacubitril valsartan on patients with hypertension undergoing maintenance hemodialysis

Jiang Ping, Yu Zhaobi

2025, 31(2):  270-273.  DOI: 10.3760/cma.j.cn441417-20240723-02018

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Modified Buzhong Yiqi Decoction combined with acupoint application in treatment of patients with overactive bladders 

Du Wei, Liao Tuming, Wu Jiaqiao, Li Xiongcai, Zhu Herong, He Shen, Guan Gangqiang

2025, 31(2):  274-278.  DOI: 10.3760/cma.j.cn441417-20240707-02019

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Objective　To study the effect of Modified Buzhong Yiqi Decoction and acupoint application in the treatment of patients with overactive bladders. Methods　Ninety-one female patients with overactive bladders treated at Department of Urology, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to March 2024 were selected for the randomized controlled trial, and were divided into an experimental group (30 case), a control group 1 (30 cases), and a control group 2 (31 cases) by the random number table method. The experimental group were (46.72±10.13) years old, with a disease course of (3.09±2.49) years. The control group 1 were (46.98±11.29) years old, with a disease course of (3.18±2.63) years. The control group 2 were (47.48±10.11) years old, with a disease course of (3.08±2.44) years. The experimental group were treated by modified Buzhong Yiqi Decoction and acupoint application, the control group 1 with solifenacin succinate, and the control group 2 with modified Buzhong Yiqi Decoction, for 12 weeks. The urination diary (urination times during day time and night, urgency to urinate, and urge incontinence), scores of life quality, and overactive bladder syndrome scores (OABSS) before the treatment and after 12 weeks' treatment, clinical efficacies, and incidence rates of adverse reactions were compared between the 3 groups. t and χ² tests were used for the statistical analysis. Results　The urination times during day time and night and times of urgency to urinate and urge incontinence in 24 h, OABSS, and scores of life quality before the treatment and after 12 weeks' treatment in the experimental group were (14.4±1.57) times, (3.5±0.71) times, (3.5±0.53) times, (2.5±0.53) times, 9.7±1.16, 3.9±0.88, (10.1±1.10) times, (2.1±0.57) times, (1.9±0.57) times, (1.2±0.42) times, 4.4±1.26, and 1.7±0.68; those in the control group 1 were (14.3±2.00) times, (3.5±0.53) times, (3.5±0.85) times, (2.4±0.52) times, 9.9±0.99, 3.9±0.74, (10.3±2.05) times, (2.3±0.48) times, (2.1±0.88) times, (1.2±0.42) times, 4.9±1.29, and 2.1±0.57; those in the control group 2 were (14.1±2.02) times, (3.5±0.97) times, (3.5±1.08) times, (2.6±0.52) times, 10.0±1.76, 3.6±0.84, (11.6±1.83) times, (2.6±0.70) times, (2.3±0.95) times, (1.7±0.48) times, 5.9±1.19, and 2.6±0.84; there were statistical differences in the above indicators between before and after the treatment in the 3 groups (t=20.146, 8.573, 9.798, 8.510, 17.667, 7.571, 26.833, 9.192, 8.571, 9.833, 16.842, 10.554, 11.180, 5.014, 4.649, 7.090, 9.462, and 4.610; all P0.05). The total effective rates of the experimental group, the control group 1, and the control group 2 were 83.3% (25/30), 76.7% (23/30), and 51.6% (16/31), with a statistical difference between the 3 groups (χ²=8.213; P=0.016). No serious adverse reactions occurred in the three groups, with good tolerance. Conclusion　Modified Buzhong Yiqi Decoction combined with acupoint application for patients with overactive bladders is effective and safe and can improve their treatment compliance.

Effect of stereotactic soft channel drainage assisted by Xingnaojing in treatment of patients with hypertensive cerebral hemorrhage

Luo Huiwu, Xu Yaowei, Gu Ruihang, Yang Liu

2025, 31(2):  279-283.  DOI: 10.3760/cma.j.cn441417-20240809-02020

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Objective　To observe the effect of stereotactic soft channel drainage assisted by Xingnaojing injection in the treatment of patients with hypertensive intracerebral hemorrhage. Methods　Eighty-four patients with hypertensive intracerebral hemorrhage treated at Luoyang Hospital, Dongzhimen Hospital, Beijing University of Traditional Chinese Medicine from August 2022 to June 2024 were divided into a conventional group (41 cases) and an observation group (43 cases) according to the treatment methods. The conventional group had 23 males and 18 females; they were (62.85±4.06) years old; their duration of intracerebral hemorrhage was (4.41±1.23) hours; the volume of hemorrhage was (58.85±5.36) ml. The observation group had 22 males and 21 females; they were (63.21±3.27) years old; their duration of intracerebral hemorrhage was (4.68±1.33) hours; the volume of hemorrhage was (59.42±4.76) ml. Both groups underwent stereotactic soft channel drainage; the conventional group took conventional treatment; the observation group took conventional treatment and inravenously dripped Xingnaojing injection. Both groups were treated for 2 weeks. The clinical efficacies, scores of activities of daily living (ADL) and National Institutes of Health Stroke Scale (NIHSS), peak blood flow velocities (Vm), peak systolic blood flow velocities (Vs), blood flow resistance (RI), and levels of neuropeptide Y (NPY), neuron-specific enolase (NSE), glial fibrillary acidic protein (GFAP), and S100 calcium-binding protein B (S100B) before and after the treatment, and safety during the treatment were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　The total effective rate of the observation group was higher than that of the conventional group [93.02% (40/43) vs. 75.61% (31/41); χ²=4.865; P=0.027]. After the treatment, the scores of ADL and NIHSS in the observation group were better than those in the conventional group (82.16±7.52 vs. 68.85±10.26 and 11.28±4.06 vs. 18.74±5.23; both P<0.001). After the treatment, the Vm and Vs were higher than those before the treatment in both group, and the Vm and Vs in the observation group were higher than those in the conventional group (all P<0.001). After the treatment, the RI and levels of NPY, NSE, GFAP, and S100B were lower than those before the treatment, and the those in the observation group were lower than those in the conventional group (all P<0.001). There was no statistical difference in the total incidence rate of adverse reactions between the two groups (P>0.05). Conclusion　Stereotactic soft channel drainage assisted by Xingnaojing injection for patients with hypertensive intracerebral hemorrhage can improve the therapeutic effect, promote their neurological function recovery, enhance their self-care ability, improve their cerebral hemodynamics, and reduce their brain damage, and is safe.

Value of β-endorphin, cyclooxygenase-2, and dopamine receptor D2 in prediction of anxiety conditions in patients with right-to-left shunt migraine 

Zheng Yao, Jia Linnan, Wang Zhihui, Qu Haili, Ding Jian, Wang Baoyue, Wang Ping, Xing Wenjing

2025, 31(2):  284-288.  DOI: 10.3760/cma.j.cn441417-20240820-02021

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Objective　To explore the value of β-endorphin (β-EP), cyclooxygenase-2 (COX-2), and dopamine receptor D2 (DRD2) in the prediction of the anxiety conditions in patients with right-to-left shunt (RLS) migraine. Methods　This was a retrospective study. Three hundred patients with RLS migraine treated at Jilin FAW General Hospital from March 2023 to March 2024 were selected as an RLS group, including 171 males and 129 females who were 23-58 years old and whose disease course was 1-9 years. According to the migraine grade, the patients were classified into minor, moderate, and severe RLS migraine groups (144, 99, and 57 cases, respectively). According to the Hamilton Anxiety Scale (HAMA) scores, the patients were divided into an anxious group (96 cases) and a non-anxious group (204 cases). Fifty healthy examinees in the same period were selected as a control group, including 28 males and 22 females who were 24-54 years old. The levels of β-EP, COX-2, and DRD2 were compared between the groups. The Pearson analysis was used to examine the correlations between these indicators. The receiver operating characteristic curves (ROC) were drawn to analyze the predictive efficacy of anxiety conditions in the patients. The data were statistically analyzed by t test, χ² test, and analysis of variance (ANOVA). Results　There were statistical difference in the levels of β-EP, COX-2, and DRD2 between the RLS group and the control group [(83.30±11.60) ng/L vs. (146.85±23.31) ng/L, (1 639.90±206.18) ng/L vs. (834.91±95.69) ng/L, and (1 375.63±164.57) ng/L vs. (2 911.35±332.23) ng/L; all P<0.05]. There were statistical differences in the levels of β-EP, COX-2, and DRD2 between the minor, moderate, and severe RLS migraine groups [(91.58±10.24) ng/L vs. (79.67±9.14) ng/L vs. (68.68±7.72) ng/L, (1 462.35±155.24) ng/L vs. (1 762.28±181.59) ng/L vs. (1 875.90±193.22) ng/L, and (1 538.40±164.81) ng/L vs. (1 289.59±138.57) ng/L vs. (1 113.85±127.65) ng/L; all P<0.05]. There were statistical differences in the levels of β-EP, DRD2, and COX-2 between the anxious group and the non-anxious group [(63.25±7.56) ng/L vs. (92.73±10.67) ng/L, (1 175.68±131.71) ng/L vs. (1 469.72±163.11) ng/L, and (1 852.52±193.28) ng/L vs. (1 539.84±171.66) ng/L; all P<0.05]. The Pearson analysis showed that the HAMA score was negatively correlated with β-EP and DRD2 (r=-0.696 and -0.534; both P<0.001), and positively with COX-2 (r=0.557; P<0.001) in the patients. The ROC results indicated that the area under the curve (AUC), sensitivity, and specificity of the combination of β-EP, COX-2, and DRD2 were 0.976, 97.9%, and 97.5%, respectively, which were higher than those of β-EP (0.943, 94.8%, and 90.7%), COX-2 (0.852, 68.8%, and 89.2%), and DRD2 (0.897, 81.2%, and 87.3%). Conclusion　β-EP, COX-2, and DRD2 have good predictive value for anxiety conditions in patients with RLS migraine.

Value of diffusion weighted imaging in differential diagnosis of hyperacute cerebral infarction and hemorrhage

Yuan Bo, Yang Xiaoqing, Li Junli, Yan Song

2025, 31(2):  289-293.  DOI: 10.3760/cma.j.cn441417-20240913-02022

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Objective　To investigate the value of diffusion-weighted magnetic resonance imaging (DWI) in the differential diagnosis of hyperacute cerebral infarction and hemorrhage. Methods　This was a prospective study. Thirty-five patients with hyperacute cerebral infarction and 35 patients with hyperacute cerebral hemorrhage treated at Zhumadian Central Hospital from January 2022 to December 2023 were selected. Among the patients with hyperacute cerebral infarction, there were 19 males and 16 females; they were (58.69±5.16) years old; the onset time was (2.45±1.02) h. Among the patients with hyperacute cerebral hemorrhage, there were 21 males and 14 females; they were (58.42±5.05) years; the onset time was (2.39±1.03) h. All the patients were examined by DWI and conventional magnetic resonance imaging (MRI). The detection rates of hyperacute cerebral infarction and hemorrhage and the signal characteristics of the lesion sites were compared between DWI and conventional MRI. The lesion location characteristics of hyperacute cerebral infarction and hemorrhage were analyzed. The statistical software SPSS 26.0 was used to statistically analyze the data. t and χ² tests were used to compare the data between the groups. Results　The detection rate of DWI for hyperacute cerebral infarction was 97.14% (34/35), and that for hyperacute cerebral hemorrhage was 94.29% (33/35); both were higher than those of conventional MRI [62.86% (22/35) and 65.71% (23/35)] (both P<0.05). The signal characteristics of the lesion sites of hyperacute cerebral infarction were mainly high signal in DWI and conventional MRI; the signal characteristics of the lesion sites of hyperacute cerebral hemorrhage were mainly mixed signal and low signal; the sensitivity of DWI to the lesion site signal characteristics of acute cerebral infarction and hemorrhage was higher than that of conventional MRI (both P<0.05). The DWI examination results showed that the detection rates of cerebellar and cerebral cortex lesions in hyperacute cerebral infarction were 54.29% (19/35) and 25.71% (9/35), respectively, which higher than those of hyperacute cerebral hemorrhage [5.71% (2/35) and 2.86% (1/35)]. The detection rates in brain stem and basal ganglia were 2.86% (1/35) and 14.29% (5/35), respectively, which were lower than those in hyperacute intracerebral hemorrhage [22.86% (8/35) and 65.71% (23/35)] (all P<0.05). Conclusion　DWI can improve the detection rates of hyperacute cerebral infarction and hemorrhage, accurately determine the lesion sites, evaluate the lesion signal characteristics, and provide reliable references for clinical differentiation of cerebral infarction and hemorrhage.

Effect of single fiber polyethylene suture combined with rb-bFGF on serum epidermal growth factor and oral function in patients with oral and maxillofacial trauma

Xiang Lin, Ran Bihong, Lyu Chengpeng, Ren Zhanping

2025, 31(2):  293-297.  DOI: 10.3760/cma.j.cn441417-20240813-02023

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Objective　To explore the effect of single fiber polyethylene suture combined with recombinant bovine basic fibroblast growth factor (rb-bFGF) on serum epidermal growth factor (EGF) and oral function in patients with oral and maxillofacial trauma. Methods　This was a retrospective study. One hundred and twenty patients with maxillofacial trauma treated at Xunyang People's Hospital from July 2020 to June 2023 were selected, and were divided into an intervention group (60 cases) and a traditional group (60 cases) according to the treatment methods. There were 39 males and 21 females in the intervention group; they were (35.54±2.61) years old. There were 36 males and 34 females in the traditional group; they were (36.63±2.54) years old. The traditional group were treated with single fiber polyethylene suture, and the intervention group with single fiber polyethylene suture and rb-bFGF. The clinical efficacies, serum EGF levels and oral function (scores of speech intelligibility and masticatory function) before and after the treatment, treatment satisfaction, and safety were compared between the two groups. t test, analysis of variance, and χ² test were used for the statistical comprisons. Results　The total effective rate of the intervention group was higher than that of the traditional group [93.33% (56/60) vs. 73.33% (44/60)], with a statistical difference between the two groups (P<0.05). There was no statistical difference in the serum EGF level between 5 d after the treatment in the traditional group (P>0.05), but was in the intervention group (P<0.05). 5 d after the treatment, the serum EGF levels in the intervention group were higher than those in the control group (both P<0.05). Five days after the treatment, the scores of speech intelligibility and masticatory function in the intervention group were better than those in the traditional group (both P<0.05). The treatment satisfaction in the intervention group was higher than that of the traditional group [90.00% (27/30) vs. 66.67% (20/30)], with a statistical difference between the two groups (P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the traditional group and the intervention group [10.00% (6/60) vs. 13.33% (8/60); P>0.05]. Conclusion　Single fiber polyethylene suture combined with rb-bFGF in the treatment of patients with oral and maxillofacial trauma has positive effect on their serum EGF and oral cavity function, and is safe.

Effect of moxibustion with walnuts on eye movement in patients with acquired paralytic strabismus

Zhou Jiangxia, Gao Mingmei, Wu Tingting

2025, 31(2):  298-302.  DOI: 10.3760/cma.j.cn441417-20240618-02024

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Objective　To study the effect of walnut moxibustion on strabismus degree, eye movement, and oxidative stress in patients with acquired paralytic strabismus. Methods　Ninety patients with acquired paralytic strabismus treated at Department of Ophthalmology of Traditional Chinese Medicine, Jinan Second People's Hospital from January 2021 to December 2022 were selected for the randomized controlled trial, including 52 males and 38 females who were (42.87±3.86) years and whose disease course was (21.73±3.23) d. They were divided into a walnut moxibustion group, an acupuncture group, and a basic treatment group by the random number table method, with 30 cases in each group. All the 3 groups took basic treatment for the primary diseases and were intravenously injected safflower injection and injected mecobalamine through acupoints; in addition, the acupuncture group took acupuncture, and the walnut moxibustion group walnut moxibustion. All the three groups were treated for 4 weeks. The strabismus degrees, eye movement, and levels of oxidative stress indicators [superoxide dismutase (SOD), malonaldehyde (MDA), and glutathione peroxidase (GSH-PX)] before and after 4 weeks' treatment, curative effects after 4 weeks' treatment, and incidence rates of adverse reactions during the treatment were compared between the three groups χ² test, t test, and one-way analysis of variance were used for the statistical analysis. Results　The total effective rate after 4 weeks' treatment in the walnut moxibustion group was higher than those in the basic treatment group and the acupuncture group [93.33% (28/30) vs. 73.33% (22/30) and 63.33% (19/30)], with a statistical difference (χ²=7.826; P=0.020). After 4 weeks' treatment, the strabismatic degree and level of MDA in the walnut moxibustion group were lower than those in the acupuncture group and the basic treatment group [(13.51±3.52)PD vs. (23.64±3.52)PD and (20.18±3.90)PD; (3.96±0.46)nmol/L vs. (4.34±0.48)nmol/L and (4.91±0.45)nmol/L]; the eye movement and levels of SOD and GSH-PX in the walnut moxibustion group were higher than those in the acupuncture group and the basic treatment group [(287.72±21.46)mm² vs. (246.01±24.23)mm² and (231.73±20.81)mm²; (128.82±15.25)U/ml vs. (117.90±14.46)U/ml and (109.02±15.52)U/ml; (138.97±18.26)U/L vs. (123.85±12.32)U/L and (113.14±11.31)U/L]; there were statistical differences (all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the 3 groups (χ²=1.450; P=0.484). Conclusion　Moxibustion with walnut can reduce the strabismus of patients with acquired paralytic strabismus, improve their eye movement, and adjust their level of oxidative stress, and is effective and safe.

Serum miRNA biomarkers in prediction of clinical prognosis of patients with nasopharyngeal carcinoma

Zhang Jun, Gao Wei, Lyu Jinpeng, Zhong Limei

2025, 31(2):  303-307.  DOI: 10.3760/cma.j.cn441417-20240531-02025

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Objective　To explore the value of the levels of miR-29c-3p, miR-143-5p, and miR-205-5p in the prediction of the clinical prognosis of patients with nasopharyngeal carcinoma. Methods　This was a prospective study. One hundred and twenty-six patients with nasopharyngeal carcinoma diagnosised and treated at Second Hospital, Air Force Medical University from January 2019 to April 2022 were selected as an observation group, including 90 males and 36 females who were (47.65 7.97) years old. Fifty healthy examinees during the same period were selected as a control group, including 31 males and 19 females who were (45.38±8.53) years old. The expression levels of miR-29c-3p, miR-143-5p, and miR-205-5p in the biopsy tissues from both groups were measured by reverse transcription polymerase chain reaction (RT-PCR), and their correlation with the patients' clinical prognosis was explored. The survival curve was drawn by the Kaplan-Meier method, the Log-Rank test was used. The measurement data of normal distribution were compared between the groups by t test, and the count data by χ² test. Results　The levels of miR-29c-3p and miR-143-5p in the observation group were lower than those in the control group (2.68±0.64 vs. 5.86±1.95 and 1.83±0.49 vs. 5.04±1.67); the level of miR-205-5p in the observation group was higher than that in the control group (4.81±1.68 vs. 3.89±1.08); there were statistical differences (t=16.284, 19.623, and 4.302; all P<0.05). The levels of miR-29c-3p, miR-143-5p, and miR-205-5p were not correlated with gender, age, T stage, lymph node metastasis, distant metastasis, and clinical stage (all P>0.05). The Kaplan-Meier survival curves showed that the 2-year overall survival rate in the high-expression group of miR-205-5p was lower than that in the low-expression group of miR-205-5p [76.19% (48/63) vs. 90.48% (57/63)], with a statistical difference (χ²=4.629; P<0.05). The 2-year overall survival rates in the high-expression groups of miR-29c-3p and miR-143-5p were higher than those in the low-expression groups of miR-29c-3p and miR-143-5p [93.65% (59/63) vs. 73.02% (46/63) and 95.24% (60/63) vs. 71.43% (45/63)], with statistical differences (χ²=9.657 and 12.857; both P<0.05). Conclusions　The expressions of miR-29c-3p and miR-143-5p are reduced, while the expression of miR-205-5p is increased in patients with nasopharyngeal carcinoma. These expression patterns are significantly correlated with patient survival rates and can serve as prognostic biomarkers.

Cryoprecipitate combined with tranexamic acid for patients with coagulopathy caused by cranial trauma

Yang Juan, Qian Jiaqi

2025, 31(2):  308-312.  DOI: 10.3760/cma.j.cn441417-20240531-02026

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Objective　To explore the effect of cryoprecipitate combined with tranexamic acid for patients with coagulopathy caused by cranial trauma. Methods　From January 2022 to December 2023, 118 patients with coagulopathy caused by cranial trauma treated at Chang'an Hospital were selected for the randomized controlled trial, and were divided into a control group and an experimental group by the random number table method, with 59 cases in each group. There were 29 males and 30 females in the control group; they were (42.35±12.58) years old. There were 31 males and 28 females in the experimental group; they were (43.27±11.94) years old. The control group were treated with cryoprecipitate, and the experimental group with cryoprecipitate and tranexamic acid. The coagulation function [thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fg), and platelet count (PLT)], serum levels of growth factors [transforming growth factor β1 (TGF-β1), vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bF-GF)], levels of inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-8 (IL-8)], levels of fibrinolysis indicators [fibrin degradation products (FDP), and D-dimer (D-D)], and incidence rates of complications were compared between the two groups. t and χ² tests were used for the statistical analysis. Results　Before the treatment, there were no statistical differences in the coagulation function and levels of growth factors, inflammatory factors, and fibrinolysis indicators between the two groups (all P>0.05). After 3 days' treatment, the TT, PT, and APTT in the experimental group were shorter than those in the control group [(14.87±2.46) s vs. (17.01±2.81) s, (14.35±2.68) s vs. (16.99±2.93) s, and (37.01±5.41) s vs. (42.85±5.47) s]; the levels of Fg, PLT, TGF-β1, VEGF, bF-GF, and IL-8 in the experimental group were higher than those in the control group [(1.68±0.29) g/L vs. (1.42±0.24) g/L, (89.77±6.46)×10⁹/L vs. (79.00±6.81)×10⁹/L, (16.65±3.92) ng/L vs. (13.16±3.53) ng/L, (39.77±5.84) μg/L vs. (35.31±5.58) μg/L, (27.74±3.62) μg/L vs. (23.32±3.15) μg/L, and (21.78±4.64) μg/L vs. (18.47±3.90) μg/L]; the levels of TNF-α, IL-6, FDP, and D-D in the experimental group were lower than those in the control group [(2.03±0.27) μg/L vs. (2.84±0.21) μg/L, (2.85±0.73) μg/L, vs. (3.91±0.66) μg/L, (2.75±0.32) mg/dL vs. (5.47±0.82) mg/dL, and (0.97±0.28) mg/L vs. (1.65±0.34) mg/L]; there were statistical differences (t=4.401, 5.107, 5.831, 5.305, 8.813, 5.082, 4.241, 7.075, 4.195, 18.189, 8.273, 23.736, and 11.859; all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the experimental group and the control group [3.39% (2/59) vs. 10.17% (7/59); χ²=2.145; P=0.143]. Conclusion　Cryoprecipitate combined with tranexamic acid for patients with coagulopathy caused by cranial trauma is effective, and can improve their coagulation markers and levels of growth factors, reduces inflammatory responses, and decrease the occurrence of adverse reactions.

Cause analysis and prevention of arytenoid cartilage dislocation in three cases after laparoscopic gastrointestinal surgery under general anaesthesia

Du Shuping, Zhou Yejian, Wang Zhijuan

2025, 31(2):  313-315.  DOI: 10.3760/cma.j.cn441417-20240909-02027

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Arytenoid cartilage dislocation (ACD) is a rare and often overlooked complication of tracheal intubation or blunt laryngeal trauma. Its most common symptom is persistent hoarseness. Procedures, such as pharyngeal intubation, examination, monitoring, and treatment, are potential factors that can lead to ACD. This article reports three cases at Weihai Municipal Hospital, Shandong University; the patients occurred ACD following laparoscopic gastrointestinal surgery under general anesthesia; the patients exhibited symptoms such as hoarseness, choking cough, and dysphonia after surgery; nebulization treatment was ineffective; otolaryngologists were consulted, and the patients were diagnosed as ACD; the patients recovered after manipulative repositioning and voice training by the otolaryngologists. In this paper, the causes and prevention measures of ACD are analyzed.

Case Report

Maintenance hemodialysis for one patient after heart transplantation and literature review

Zhong Mi, Zhou Lifang, Zhao Yina, Li Caixia, Fu Xia

2025, 31(2):  316-318.  DOI: 10.3760/cma.j.cn441417-20240826-02028

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This article summarizes one patient with end-stage renal disease after heart transplantation. The patient underwent maintenance hemodialysis. During the treatment, the patient's blood pressure and blood glucose were kept stable, arrhythmia and other acute complications prevented, individualized nutrition management strengthened, and psychological counseling provided. The patient finished 4 times of hemodialysis.

One case of overlap syndrome complicated with cerebral infarction

Yan Xuantao, Ren Jie

2025, 31(2):  318-322.  DOI: 10.3760/cma.j.cn441417-20240801-02029

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This article reports one patient with newly diagnosed overlap syndrome whose cardiolipin antibodies and lupus anticoagulants were negative. During the patient's oral rivaroxaban anticoagulant treatment, he had cerebral infarction three times (in different parts of the same cerebral blood vessel) within one month. The patient is currently receiving relevant treatment in another hospital. This tells us that when clinicians encounter patients with clinical symptoms that are highly suspected of antiphospholipid antibody syndrome, but their antiphospholipid antibodies and lupus anticoagulants are negative, they should still actively search for non-standard antibodies and screen for hereditary thrombophilia.

Nursing Research

Application of home hospice intervention mode in patients with advanced cancers

Xin Yahui, Chang Li, Song Mingfang, Ma Rongrong, Bai Zhifan, Wang Hengli

2025, 31(2):  323-329.  DOI: 10.3760/cma.j.cn441417-20240705-02030

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Objective　To explore the effect of home hospice intervention mode based on comfort theory for patients with advanced cancers. Methods　One hundred and twenty patients with advanced cancers treated at Hospice, Yulin Hospital, First Affiliated Hospital of Xi'an Jiaotong University from June 1, 2022 to May 31, 2024 were selected by the convenience sampling method for the randomized controlled trial. They were divided into a control group and an intervention group by the random number table method, with 60 cases in each group. There were 32 males and 28 females in the control group; they were 48-79 (67.25±5.87) years old. There were 28 males and 32 females in the intervention group; they were 51-77 (65.52±5.96) years old. The control group received routine home nursing. In the intervention group, the home hospice care model based on comfort theory was implemented on the basis of routine nursing. Both groups were intervened for 2 months. The intervention lasted for 2 months. The patients in both groups were evaluated 1 week before and 2 months after the intervention. t and χ² tests were used for the statistical analysis. Results　After the intervention, the scores of overall comfort, overall health, and function of life quality in the intervention group were higher than those before the intervention, and were higher than those in the control group (4.25±1.07 vs. 2.89±0.95, 57.86±24.13 vs. 36.86±19.42, and 52.25±28.54 vs. 42.37±20.35), with statistical differences (t=7.36, 5.25, and -2.06; all P<0.05). After the intervention, the scores of pain, anxiety, depression, life quality, shortness of breath, insomnia, and appetite loss in the intervention group were lower than those before the intervention, and were lower than those in the control group (3.07±0.79 vs. 4.60±1.29, 47.59±8.09 vs. 53.59±7.65, 49.34±6.72 vs. 56.36±5.70, 38.16±20.23 vs. 55.65±19.26, 30.10±19.52 vs. 45.25±21.35, 28.96±29.65 vs. 49.61±30.19, 32.18±25.12 vs. 51.22±31.37), with statistical differences (t=-6.30, -4.17, -6.17, -4.85, -4.06, -3.78, and -3.67; all P<0.05). Conclusion　The home hospice care intervention mode based on comfort theory for patients with advanced cancers can improve their comfort level, depression, anxiety, and life quality, and relieve their pain.

Effect of oral sensory training combined with graded feeding on patients with dysphagia after stroke

Zhao Rui, Zhu Mingfang, Feng Yingpu, Yang Mengli, Li Yanan

2025, 31(2):  330-334.  DOI: 10.3760/cma.j.cn441417-20240726-02031

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Objective　To explore the effect of oral sensory training combined with graded feeding management on swallowing function and malnutrition risk in patients with dysphagia after stroke. Methods　From February 2022 to April 2024, 118 patients with dysphagia after stroke treated at Department of Neurology, Henan Provincial People's Hospital were selected as the study objects. The 59 patients who received routine swallowing training and nutritional intervention from February 2022 to February 2023 were set as a control group. The 59 patients who received oral sensory training and graded feeding management from March 2023 to April 2024 were set as an experimental group. There were 35 males and 24 females in the control group; they were 57-84 (69.52±3.23) years old; their disease course was 11-45 (23.89±3.27) d. There were 33 males and 26 females in the experimental group; they were 55-85 (69.85±3.42) years old; their disease course was 10-42 (23.52±3.11) d. Both groups were intervened for 30 d. The intervention effects, incidence rates of adverse events, swallowing function [score of Standardized Swallowing Assessment (SSA)], and nutritional status [total protein (TP), albumin, globulin, and serum amino acid ratio] were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The total effective rate, total incidence rate of adverse events, and total score of SSA in the experimental group were better than those in the control group [94.92% (56/59) vs. 83.05% (49/59), 3.38% (2/59) vs. 15.25% (9/59), and 35.46±1.24 vs. 42.66±1.89], with statistical differences (χ²=4.236 and 4.913; t=24.466; all P<0.05). After the intervention, the levels of TP, albumin, and globulin and serum amino acid ratio in the experimental group were better than those in the control group [(61.28±7.28) g/L vs. (57.88±7.41) g/L, (31.18±4.05) g/L vs. (29.23±4.08) g/L, (26.34±3.09) g/L vs. (22.17±2.94) g/L, 1.62±0.41 vs. 2.03±0.55], with statistical differences (t=2.514, 2.605, 7.510, and 4.591; all P<0.05). Conclusion　Oral sensory training and graded feeding management for patients with dysphagia after stroke can improve their swallowing function, regulate their nutritional status, and reduce the risk of adverse events, such as malnutrition, etc.

Impact of hypertension support groups on blood pressure control and treatment compliance in patients with hypertension

Xu Zengyan, Jing Lingling

2025, 31(2):  335-339.  DOI: 10.3760/cma.j.cn441417-20240627-02032

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Objective　To explore the impact of hypertension support groups on blood pressure control and treatment compliance in patients with hypertension. Methods　This prospective clinical controlled trial included 86 patients with hypertension treated at High-tech Branch, Ankang City Traditional Chinese Medicine Hospital from March 2021 to March 2023. The patients were divided into two groups by the random drawing method: the patients with odd numbers were set as a control group (43 cases), and the patients with even numbers an observation group (43 cases). There were 23 males and 20 females in the control group; they were 36-72 (52.89±5.25) years old. There were 24 males and 19 females in the observation group; they were 37-73 (52.97±5.21) years old. The control group were routinely cared, while the observation group were intervened by the hypertension support group care mode. The blood pressures, self-management levels, psychological resilience, and treatment compliance were compared between the two groups before the intervention and after 3 months' intervention. χ² and t tests were used for the statistical analysis. Results　After the intervention, the systolic and diastolic blood pressures in the observation group were lower than those in the control group [(125.34±8.57) mmHg (1 mmHg=0.133 kPa) vs. (139.58±10.31) mmHg and (75.36±6.89) mmHg vs. (85.02±7.13) mmHg], with statistical differences (t=6.965 and 6.389; both P<0.05). The scores in all the dimensions of self-management in the observation group were higher than those in the control group, with statistical differences (all P<0.05). The scores of tenacity, strength, and optimism in the observation group were higher than those in the control group (23.56±3.59 vs. 18.01±3.02, 26.84±4.12 vs. 22.15±3.54, and 33.25±4.89 vs. 28.14±4.12), with statistical differences (t=7.758, 5.662, and 5.240; all P<0.05). The scores of compliance to medication, exercise, and diet and self-monitoring in the observation group were higher than those in the control group (18.12±3.25 vs. 13.36±2.58, 6.22±1.25 vs. 3.89±0.86, 13.06±2.68 vs. 10.69±2.24, and 18.22±3.27 vs. 13.89±2.68), with statistical differences (t=7.552, 10.070, 4.449, and 6.716; all P<0.05). Conclusion　The hypertension support group care mode for patients with hypertension can effectively decrease their blood pressures and improve their self-management ability, psychological resilience, and treatment compliance, including medication, exercise, and dietary compliance and self-monitoring, and has positive impact on their overall management.

Effect of HFMEA in prevention of catheter-related bloodstream infections in artificial liver support system therapy

Ouyang Shan, He Na, Wang Juan, Zheng Lihua, Zheng Zimei, Li Lili

2025, 31(2):  340-344.  DOI: 10.3760/cma.j.cn441417-20240729-02033

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Objective　To analyze the effect of healthcare failure mode and effect analysis (HFMEA) in the prevention of catheter-related bloodstream infections in artificial liver therapy. Methods　The patients taking artificial liver therapy at Third Hospital, Sun Yat-sen University from January 2022 to December 2023 were selected for the non-randomized controlled trial. According to the admission time, the patients were divided into a control group (283 cases), treated from January two December 2022, and an observation group, treated from January to December 2023. There were 283 males and 55 females in the control group; they were (49.35±11.52) years old. There were 323 males and 66 females in the observation group; they were (47.90±12.94) years old. The control group took routine nursing care for artificial liver catheters. The observation group were managed with HFMEA. The risk priority numbers (RPN) of the healthcare failure mode of catheter-related bloodstream infections, incidence rates of catheter-related bloodstream infections, and scores of catheter maintenance theory and operation of the nursing staff were compared between two groups by t test. Results　The RPN of the healthcare failure mode of catheter-related bloodstream infections and incidence rate of catheter-related bloodstream infections in the observation group were lower than those in the control group [1 592 vs. 3 980 and 0.083‰ (1/11 984) vs. 0.418‰ (5/11 952)]. The scores of the nursing staff's theoretical and operational assessments were higher after than before the application of HFMEA (85.28±4.94 vs. 75.56±9.72 and 94.24±2.19 vs. 84.24±2.19 ), with statistical differences (t=6.490 and 23.506; both P<0.05). Conclusion　The application of HFMEA can prospectively foresee the high-risk failure links that are prone to artificial liver catheter-related bloodstream infections, reduce the occurrence of artificial liver catheter-related bloodstream infections, and improve the nursing staff's catheter maintenance ability.

Medical Education

Application of CBL and workshop teaching mode in teaching nutritional management of chronic kidney disease to nursing interns

Zheng Haiying, Chen Xiaoqing, Shao Yixin, Lu Suhong, Sun Wenli, Huang Chunhong

2025, 31(2):  345-349.  DOI: 10.3760/cma.j.cn441417-20240827-02034

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Objective　To explore the effect for applying case-based learning (CBL) and workshop teaching mode in teaching nutritional management of chronic kidney disease (CKD) to nursing interns. Methods　This was a prospective study. Sixty nursing interns who interned in Department of Nephrology, First Affiliated Hospital of Fujian Medical University from August 2022 to November 2023 selected as the study objects. They were divided into s control group (30) and an experimental group (30) according to the internship time. There were 5 males and 25 females in the control group; they were (20.40±2.06) years old. There were 1 male and 31 females in the experimental group; they were (20.44±0.80) years old. The control group were taught by the traditional teaching method, and the experimental group was taught by the CBL combined with workshop mode, for 4 weeks. The scores of theoretical knowledge and operational skill assessment, critical thinking ability, and patients' satisfaction with nutrition management were compared between the two groups. t and Mann-Whitney U tests were used for the statistical analysis. Results　The scores of theoretical assessment, operational assessment, and critical thinking ability in the experimental group were higher than those in the control group [86.84±3.22 vs. 75.83±5.90, 88.00 (83.50, 90.75) vs. 73.50 (70.00, 75.50), and 238.50 (227.25, 249.00) vs. 227.00 (214.25, 251.25)], with statistical differences (t=-9.032; Z=-5.274 and -2.135; all P<0.05). The patients' satisfaction with the nursing interns' nursing in the experimental group was higher than that in the control group [87.50% (28/32) vs. 23.33% (7/30)], with a statistical difference (Z=-5.147; P<0.05). Conclusion　The application of CBL combined with workshop teaching mode in nursing teaching of CKD nutritional management can help improve the students' theoretical knowledge and practical ability, enhance their critical thinking ability, and increase the patients' satisfaction.

Application of multi-cycle teaching mode based on "learning pyramid theory" in medical laboratory practice teaching

Xie Bin, Yin Qiaoli, Huang Fei, Song Wen, Li Qing, Sun Zhuohao

2025, 31(2):  350-352，封三.  DOI: 10.3760/cma.j.cn441417-20240809-02035

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Objective　To explore the application effect of multi-cycle teaching mode based on the "learning pyramid theory" in medical laboratory practice teaching. Method　A total of 96 medical laboratory students practicing at Tengzhou Central People's Hospital from July 2019 to June 2022 were included in this study. According to the time of internship, 48 interns who entered the department from July 2019 to December 2020 were set as a control group, including 14 males and 34 females; they were (22.0±1.4) years old; they were taught routinely. The rest 48 interns who entered the department from January 2021 to June 2022 were set as an observation group, including 12 males and 36 females; they were (22.8±1.5) years old; they were taught by the multi-cycle teaching mode based on the "learning pyramid theory". Both groups interned for 6 months. At the end of the internship, the teacher-student mutual evaluation questionnaire and entrance examination were conducted. t and χ² tests were used for the statistical analysis. Results　The theoretical and practical scores in the observation group were higher than those in the control group (94.50±3.12 vs. 87.96±3.01 and 95.46±2.72 vs. 88.58±2.41; t=7.386 and 9.267; both P<0.01). The total score of teaching effect in the observation group was higher than that in the control group (93.67±1.37 vs. 80.12±1.48; t=32.823; P<0.01). The total score of the evaluation indicators by the teachers in the observation group was higher than that in the control group (94.75±1.68 vs. 81.17±2.41; t=22.690; P<0.01). Conclusion　The application of the multi-cycle teaching mode based on "learning pyramid theory" in medical laboratory practice teaching can improve the theoretical and practical scores, promote knowledge transformation, and improve the satisfaction of teachers and students.