Table of Content

01 July 2025, Volume 31 Issue 13

Previous Issue   

Special Column of Urology and Reproduction

Clinical efficacy observation of early intervention with electrophysiological technology for rapid urinary control after laparoscopic radical prostatectomy 

Pan Bin, Wang Guikang, Xu Jiaxin, Yang Zhihuang, Yang Xi, Gao Ping, Chen Guo, Li Yutong, Zhou E, Chen Jie

2025, 31(13):  2113-2117.  DOI: 10.3760/cma.j.cn441417-20250513-13001

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Objective　To evaluate the clinical efficacy of early intervention with electrophysiological technology in achieving rapid urinary control following laparoscopic radical prostatectomy. Methods　From July 2021 to May 2025, 31 patients who underwent laparoscopic radical prostatectomy in the Department of Urology at the First Affiliated Hospital of Jinan University were included. On postoperative day 1, visual electrodiagnosis was performed using a medical infrared thermography device (TMT9000). Their age was (69.74±7.12) years old, and the prostate-specific antigen (PSA) level was 14.31 (8.30, 44.19) μg/L. Individualized electrical stimulation parameters were selected, and a treatment plan was formulated. Subsequently, percutaneous low-frequency pulsed neuromuscular electrical stimulation therapy was administered. Post-treatment outcomes were assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICI-Q-SF) score, the Incontinence Quality of Life Questionnaire (I-QOL) score, and 24-hour pad usage. Results　All patients successfully completed the surgery, with an operative time of (5.27±1.03) hours, a blood loss of 50 (30, 54) ml, a pelvic drainage tube removal time of (4.96±2.05) days, and a catheter removal time of (12.70±2.51) days. After treatment, the ICI-Q-SF score was (4.90±3.46) points, and the I-QOL score was (94.51±7.86) points. Immediate urinary control after catheter removal was achieved in 77.4% (24/31) of the patients: 18 (58.1%) had no stress urinary incontinence (SUI) and required no pads, while 6 (19.4%) used only 1 pad on the day of catheter removal, with 24-hour pad usage less than 1. The remaining 7 patients (22.6%) experienced SUI, using more than 1 pad per day. After 6 months of follow-up, only 1 patient still had SUI, requiring more than 1 pad daily. Conclusion　Early intervention with electrophysiological technology after laparoscopic radical prostatectomy facilitates rapid urinary control and is safe and effective, which may serve as a sequential treatment to reduce the incidence of SUI following radical prostatectomy.

Comparison of efficacies and safety of TPPB and TRPB in laparoscopic surgery for prostate cancer

Cao Jianwei, Duan Wanli, Cheng Ji, Dong Qingchuan, Fu Guo

2025, 31(13):  2118-2122.  DOI: 10.3760/cma.j.cn441417-20250115-13002

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Objective　To compare the efficacies and safety of transperineal prostate biopsy (TPPB) and transrectal prostate biopsy (TRPB) in laparoscopic surgery for prostate cancer. Methods　Clinical data of 98 patients with prostate cancer admitted to Shaanxi Provincial People's Hospital from January 2023 to October 2024 were retrospectively analyzed, and they were divided into a TPPB group (50 cases) and a TRPB group (48 cases) according to different biopsy methods. In the TPPB group, the age was (60.34±6.87) years old, the prostate volume was (38.54±5.83) ml, and the disease stages were stage Ⅰ in 21 cases and stage Ⅱ in 29 cases. In the TRPB group, the age was (60.93±6.25) years old, the prostate volume was (38.10±5.32) ml, and the disease stages were stage Ⅰ in 23 cases and stage Ⅱ in 25 cases. Both groups underwent laparoscopic surgery 4 weeks after biopsy. The puncture biopsy conditions, laparoscopic surgery conditions, change in serum prostate-specific antigen (PSA), and incidence of complications were compared between the two groups. t-test and χ² test were used for statistical analysis. Results　The puncture time of the TPPB group was (18.94±2.04) min, which was shorter than that of the TRPB group [(23.65±2.71) min] (P<0.05). The operation time and the time for rectal space separation in the TPPB group were (115.83±7.61) min and (18.20±2.54) min, which were both shorter than those in the TRPB group [(134.50±8.57) min and (32.58±2.73) min] (both P<0.05); the intraoperative blood loss in the TPPB group was (203.12±24.83) ml, which was less than that in the TRPB group [(239.61±27.51) ml] (P<0.05). There was no statistically significant difference in the PSA level between the two groups before and after surgery (both P>0.05). The incidences of fever and puncture site bleeding in the TPPB group were 2.00% (1/50) and 4.00% (2/50), which were lower than those in the TRPB group [12.50% (6/48) and 20.83% (10/48)] (both P<0.05). Conclusion　Compared with TRPB, TPPB is more effective in prostate cancer patients, which can reduce the trauma and complications during laparoscopic surgery, with better safety

Analysis of the safety and efficacy of retrograde intrarenal surgery in the lateral position in the treatment of renal lower pole stones: a randomized controlled trial

Zhu Zhenping, Zhong Wen

2025, 31(13):  2122-2126.  DOI: 10.3760/cma.j.cn441417-20241226-13003

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Objective　To compare and analyze the safety and efficacies of retrograde intrarenal surgery (RIRS) in the lateral position and the lithotomy position in the treatment of renal lower pole stones. Methods　This study was a randomized controlled trial. A total of 80 patients with renal lower pole stones admitted to People's Hospital of Leping Town, Sanshui District from January 2023 to November 2024 were included in this study and were divided into two groups according to the random number table method, who underwent RIRS in the traditional lithotomy position and the lateral position, respectively. In the lateral position group, the ratio of male to female was 21:19, with an age of (44.1±10.3) years old and a stone size of (1.49±0.35) cm. In the lithotomy position group, the ratio of male to female was 22:18, with an age of (45.2±12.7) years old and a stone size of (1.56±0.42) cm. The time for placing the position, operation time, surgical outcomes, and complications were compared between the two groups. Statistical analysis was conducted using independent sample t-test, χ² test, and Fisher's exact probability method. Results　The time for placing the position in the lateral position group and the lithotomy position group were (7.1±2.4) min and (4.0±1.2) min, respectively (P<0.001), but the operation time in the lateral position group was shorter than that in the lithotomy position group [(51.5±9.9) min vs. (65.2±7.3) min, P<0.001]. The volume of perfusion fluid used in the lateral position group was more than that in the lithotomy position group [(5 356.4±223.8) ml vs. (3 272.5±457.2) ml, P<0.001]. There was no statistically significant difference in the postoperative fever rate between the two groups [5.0% (2/40) vs. 7.5% (3/40), P=0.644]; there was also no statistically significant difference in the postoperative decrease in hemoglobin level or the length of hospital stay between the two groups [(7.8±2.8) g/L vs. (9.2±3.2) g/L, (0.78±0.29) d vs. (0.82±0.31) d, P=0.823 and 0.947]. On postoperative one month, from the CT scan, the stone free rate (SFR) in the lateral position group was higher than that in the lithotomy position group [95.0% (38/40) vs. 80.0% (32/40), P=0.043]. Conclusion　The lateral position combined with perfusion flushing and active suction clearance effect of suction sheath can significantly improve the lithotripsy efficiency of RIRS in the treatment of renal lower pole stones, shorten the operation time, and improve the postoperative SFR.

Clinical value of tumor abnormal protein combined with fluorescent in situ hybridization detection for diagnosing urothelial carcinoma 

Luo Xuanyi, Li Jing, Yin Yingchun, Cao Zhang

2025, 31(13):  2127-2131.  DOI: 10.3760/cma.j.cn441417-20250107-13004

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Objective　To investigate the clinical value of tumor abnormal protein (TAP) combined with fluorescent in situ hybridization (FISH) detection in the diagnosis of urothelial carcinoma (UC). Methods　Patients who visited the department of urology in Zibo Central Hospital from September 2021 to July 2023 were collected. Data related to TAP were collected from 715 cases (including 593 males, aged 17 to 89 years, with an average age of 69 years old; 122 females, aged 27 to 93 years, with an average age of 58 years old), and data related to FISH were collected from 318 cases (including 227 males, aged 36 to 97 years, with an average age of 67 years old; 91 females, aged 37 to 86 years, with an average age of 69 years old). Among them, 257 cases had pathological diagnoses for TAP and 122 cases had pathological diagnoses for FISH data. The sensitivities and specificities of individual detection and combined detection were compared. The TAP level in the blood samples of the patients was detected, and data from 231 cases with complete clinical information were screened out for analysis. A comprehensive pathological assessment was conducted for the patients, including age, gender, tumor size on imaging, malignant degree of tumor, and whether there was infiltration. The correlations between the TAP expression level and various clinical characteristics were analyzed. Statistical analysis was performed using the independent sample t-test. Results　The TAP level of 246 UC patients was higher than that of 11 non-cancer patients [(213.3±76.95) μm² vs. (104.0±19.81) μm²], with a statistically significant difference (P<0.01). The sensitivities of TAP detection, FISH detection, and combined detection were 92.28% (227/246), 87.23% (82/94), and 98.78% (81/82), respectively. The sensitivity of combined detection was higher than that of individual detection, while the specificity of FISH detection was the highest [92.86% (26/28)]. Among the 231 patients, the high expression of TAP was correlated with advanced age (age ≥40 years old) and the malignant degree of tumor (P=0.006 and 0.003). Conclusions　Serum TAP can be used as a biomarker for UC. TAP combined with FISH detection has a high sensitivity in UC, which can effectively improve the diagnosis. TAP is not significantly correlated with gender, imaging tumor size, or tumor invasion, but is correlated with age and malignant degree of tumor.

Current status of subcutaneous hematoma management following arteriovenous fistula puncture: a cross-sectional survey

Wen Biyi, Song Li, Yin Yan, Wu Guofeng, Zhao Liyan, Cui Dongmei

2025, 31(13):  2132-2135.  DOI: 10.3760/cma.j.cn441417-20250217-13005

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Objective　To conduct a cross-sectional survey on the current management methods for subcutaneous hematoma after arteriovenous fistula (AVF) puncture, providing references for nursing care of hematoma following AVF puncture. Methods　A convenience sampling method was used to conduct a questionnaire survey on 75 dialysis centers across 9 provinces in China in September 2024. The survey aimed to understand the management methods for subcutaneous hematoma or ecchymosis after AVF puncture in maintenance hemodialysis (MHD) patients and the preferred methods recommended by medical staff to patients. Results　A total of 81 questionnaires were collected in this study, with 75 valid questionnaires (excluding 6 questionnaires from the same hospital), resulting in an effective rate of 92.59%. In the participants of the survey, 70.67% (53/75) were from tertiary hospitals, 14.67% (11/75) from secondary hospitals, and 14.67% (11/75) from private hospitals; 66.67% (50/75) were from Guangdong province, and 33.33% (25/75) from other provinces. There were mainly six management methods for subcutaneous hematoma or ecchymosis after AVF puncture in MHD patients: external application of fresh potato slices [88.00% (66/75)], external application of Hirudoid [86.67% (65/75)], hot compress 24 h after hematoma [66.67% (50/75)], wet compress with 50% magnesium sulfate [54.67% (41/75)], papaya wine application [41.33% (31/75)], and application of Ma Yinglong hemorrhoid ointment [4.00% (3/75)]. There were mainly five preferred methods recommended by medical staff to patients with subcutaneous hematoma after AVF puncture: external application of Hirudoid [28.00% (21/75)], wet compress with 50% magnesium sulfate [26.67% (20/75)], external application of fresh potato slices [24.00% (18/75)], hot compress 24 h after hematoma [9.33% (7/75)], and papaya wine application [6.67% (5/75)]. Conclusions　The most commonly used methods for managing subcutaneous hematoma after AVF puncture in MHD patients are external application of fresh potato slices and Hirudoid. The preferred interventions recommended by medical staff are external application of Hirudoid and wet compress with 50% magnesium sulfate.

A cross-sectional study on treatment compliance in patients undergoing peritoneal dialysis in a single center 

Ling Chen, Zeng Hui, Cao Jiaqi, Bi Jingwen, Lei Zihan

2025, 31(13):  2136-2140.  DOI: 10.3760/cma.j.cn441417-20241220-13006

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Objective　To understand the current status of treatment compliance among peritoneal dialysis (PD) patients in a general tertiary hospital. Methods　A quantitative cross-sectional survey method was adopted. The treatment compliance of 226 PD patients in Huadu District People's Hospital of Guangzhou from November 2023 to January 2024 was evaluated using the End Stage Kidney Disease Dialysis Patient Treatment Compliance Scale, Self-rating Depression Scale, and Self-care Ability Score Sheet. Statistical analysis was performed using independent sample t-test and one-way analysis of variance. Results　Among the 226 patients, there were 133 males and 93 females, with an age of (55.77±13.45) years old and a dialysis age of (50.30±43.52) months, and the total score of treatment compliance was (84.94±11.10) points, which was at a moderate level. There was a statistically significant difference in the score of liquid intake compliance score among patients of different ages (P<0.05); there were statistically significant differences in the scores of medication compliance among patients of different ages, educational levels, working situations, and residence situations (all P<0.05); there were statistically significant differences in the scores of dietary compliance among patients of different dialysis ages and PD operators (both P<0.05); there were statistically significant differences in the total scores of treatment compliance among patients with different dialysis ages and working situations (both P<0.05). Conclusions　The medical team for PD should pay attention to the treatment compliance in patients with long dialysis age and young PD patients, and conduct timely reassessment and re-education of PD; utilize information technology to carry out various forms of health education channels; include depression screening in outpatient follow-up to improve the medication adherence among PD patients.

Efficacy and safety of non-steroidal mineralocorticoid receptor antagonists in the treatment of chronic kidney disease: a meta-analysis 

Li Xinmeng, Liu Qianqian, Bian Zuojun, Liu Yunqi

2025, 31(13):  2141-2148.  DOI: 10.3760/cma.j.cn441417-20241220-13007

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Objective　To evaluate the efficacy and safety of non-steroidal mineralocorticoid receptor antagonists (MRAs) in the treatment of chronic kidney disease by meta-analysis, and to provide evidence-based medical evidences for clinical application. Methods　The PubMed, Embase, Web of Science, Scopus, the Cochrane Library, CNKI, Wanfang Data, VIP Database, and China Biology Medicine database were searched for randomized controlled trials on non-steroidal MRAs for the treatment of chronic kidney disease from the establishment of the databases to October 2024. The quality evaluation and data extraction of the included original studies were conducted, and RevMan 5.4 software was used for meta-analysis. Results　A total of 10 articles were included, involving 16 365 patients. The results of the meta-analysis showed that the decrease degree of urinary albumin-to-creatinine ratio (UACR) in the non-steroidal MRA group was greater than that in the placebo group [weighted mean difference (WMD)= -0.35 (-0.41, -0.28), P<0.000 01], and the decrease degree of estimated glomerular filtration rate (eGFR) was greater than that in the placebo group [WMD=-3.26 (-4.86, -1.67), P<0.000 1], the proportions of eGFR decrease ≥30% and end-stage renal disease (ESRD) were lower than those in the placebo group [risk ratio (RR) =0.85 (0.78, 0.93), P=0.000 3; RR=0.80 (0.65, 0.99), P=0.04]. In terms of safety, the incidence of cardiovascular events in the non-steroidal MRA group was lower than that in the placebo group [RR=0.88 (0.81, 0.95), P=0.002]. Although the increase degree of serum potassium concentration in the non-steroidal MRA group was greater than that in the placebo group [WMD=0.17 (0.14, 0.21), P<0.000 01], and the proportion of hyperkalemia was higher than that in the placebo group [RR=2.01 (1.81, 2.23), P<0.000 01]. However, the incidence of adverse events was comparable between the two groups [RR=1.00 (0.98, 1.01), P=0.68]. Conclusions　Non-steroidal MRAs help to reduce the UACR, improve the renal function deterioration in chronic kidney disease patients, and have significant cardiorenal protective effects. Compared with the placebo group, the non-steroidal MRA group has a higher risk of hyperkalemia, but there is no significant difference in overall risk of adverse events.

A randomized controlled trial of aconite cake-separated moxibustion combined with acupoint catgut embedding in treating diminished ovarian reserve of kidney-yang deficiency type 

Zhang Qian, Pan Huiying

2025, 31(13):  2149-2153.  DOI: 10.3760/cma.j.cn441417-20250220-13008

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Objective　To analyze the influence of aconite cake-separated moxibustion combined with acupoint catgut embedding in the treatment of diminished ovarian reserve of kidney-yang deficiency type. Methods　This study was a randomized controlled trial. Totally 120 patients with diminished ovarian reserve of kidney-yang deficiency type in Affiliated Hospital of Shaanxi University of Chinese Medicine were selected from January 2021 to December 2023, and were divided into two groups by simple random grouping method, with 60 cases in each group. The age of the control group was (30.69±2.45) years old, and the disease course was (20.86±3.12) months. The age of the observation group was (30.31±2.58) years old, and the disease course was (21.04±2.93) months. The control group was treated with clomiphene: oral clomiphene was taken since the 5th day of the menstrual cycle at a dose of 50 mg/day for 5 days; if the diameter of the main follicle was ≥18 mm, the dosage should be adjusted specifically. The observation group was given aconite cake-separated moxibustion (once a day, resting for 2 days after 5 days of treatment) combined with acupoint catgut embedding (once a week) on the basis of the control group, for a total of 3 menstrual cycles. The clinical efficacy and traditional Chinese medicine (TCM) syndromes scores, ovarian reserve function related indexes [anti-Mullerian hormone (AMH), inhibin B (InhB), and antral follicle count], estrogen indexes [follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2)], and ovarian blood flow indexes [peak systolic velocity (PSV), blood flow pulsatility index (PI), and resistance index (RI)] before and after treatment were compared between the two groups. Statistical methods used were χ² test and t test. Results　The total effective rate of the observation group was 93.33% (56/60), which was higher than that of the control group [75.00% (45/60)] (χ²=6.253, P=0.012). After treatment, the scores of TCM primary syndrome and secondary syndrome and the levels of FSH and LH in the observation group were (6.57±1.35) points, (3.06±1.04) points, (20.75±3.67) mIU/ml, and (14.36±2.44) mIU/ml, which were lower than those in the control group [(8.78±1.76) points, (4.29±1.21) points, (25.04±4.36) mIU/ml, and (17.89±2.80) mIU/ml] (t=7.718, 5.971, 5.831, and 7.362, all P<0.001); the levels of AMH, InhB, antral follicle count, and E2 in the observation group were (0.99±0.26) μg/L, (38.51±4.14) ng/L, 8.82±1.75, and (52.27±12.46) ng/L, which were higher than those in the control group [(0.80±0.23) μg/L, (34.04±4.72) ng/L, 7.53±1.44, and (46.54±11.08) ng/L] (t=4.240, 5.515, 4.409, and 2.662, all P<0.05); the PSV of the observation group was (7.86±1.82) cm/s, which was higher than that of the control group [(6.92±1.70) cm/s] (t=2.924, P=0.004), and the PI and RI were 1.91±0.37 and 0.82±0.21, which were lower than those of the control group (2.57±0.51 and 0.99±0.26) (t=8.114 and 3.940, both P<0.001). Conclusion　The combination of aconite cake-separated moxibustion and acupoint catgut embedding has a good effect on kidney-yang deficiency type of diminished ovarian reserve, which can effectively alleviate the symptoms, and improve the ovarian reserve function, ovarian stromal blood flow status, and estrogen level.

Meta Analysis

Effect of evidence-based preoperative pulmonary rehabilitation on the prognosis in patients undergoing lung cancer surgery: a meta analysis

Lyu Xiaodong, Gao Chengfei, Yu Dongyi

2025, 31(13):  2154-2160.  DOI: 10.3760/cma.j.cn441417-20241230-13009

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Objective　To systematically evaluate the effects of preoperative pulmonary rehabilitation on postoperative complications, mortality, and hospital stay in patients undergoing lung cancer surgery, providing evidence-based supports for the application of preoperative pulmonary rehabilitation in lung cancer patients. Methods　A comprehensive search was conducted in databases including PubMed, Cochrane, EMBASE, PEDro, CNKI, Wanfang, and VIP to retrieve randomized controlled trials (RCTs) on the effect of preoperative pulmonary rehabilitation on lung cancer patients up to May 2024. Data extraction was performed on studies that met the inclusion criteria, and meta-analysis was performed using STATA software. Results　A total of 16 RCTs involving 1 176 patients were included. Meta-analysis results showed that preoperative pulmonary rehabilitation reduced the incidence of postoperative complications in patients undergoing lung cancer surgery (OR=0.35, 95%CI: 0.26 to 0.46, P<0.001), and shortened the hospital stay (WMD=-2.16, 95%CI: -2.91 to -1.41, P<0.001), but had no significant effect on the postoperative mortality rate (OR=0.37, 95%CI: 0.09 to 1.49, P=0.162). Conclusions　Preoperative pulmonary rehabilitation can significantly reduce the postoperative complications and shorten the hospital stay in lung cancer patients. Future research should explore the optimal preoperative pulmonary rehabilitation regimen and verify its efficacy through large-scale, high-quality RCTs.




Efficacy and safety analysis of ketogenic diet therapy for refractory epilepsy in children: a meta-analysis

Li Bei, He Fangyuan, Jia Shanshan

2025, 31(13):  2160-2166.  DOI: 10.3760/cma.j.cn441417-20250220-13010

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Objective　To systematically evaluate the efficacy and safety of ketogenic diet (KD) therapy for the treatment of refractory epilepsy in children, and to provide an evidence-based basis for the clinical treatment of refractory epilepsy in children. Methods　Literature databases such as PubMed, China National Knowledge Infrastructure, and Wanfang database were searched to collect Chinese and English literatures on KD regimen for refractory epilepsy, and the search time limit was from the establishment of the databases to December 31, 2024, to extract the efficacy and safety related information in the literatures. Quality evaluation was performed using the Cochrane Risk of Bias Assessment Tool, and meta-analysis was performed using RevMan 5.4.1 software. Results　A total of 15 studies with 1 218 children were included. The results of the meta-analysis showed that the total effective rate, Gesell score, quality of life, and electroencephalogram improvement rate of the KD regimen in the observation group for treating refractory epilepsy in children were higher than those of the control group regimen, while the level of β-hydroxybutyric acid was lower than that of the control group regimen (all P<0.05); the level of interleukin (IL)-17A after treatment in children with refractory epilepsy treated by the observation group KD regimen was lower than that before treatment (P<0.05). Conclusions　KD therapy can reduce the frequency of refractory epileptic seizures in children to a certain extent, promote growth and development, and improve the quality of life, with good safety. However, there is no obvious difference in efficacy among different types of KD regimens, and the clinic should choose the appropriate regimen according to the children's specific conditions.

Treatises

Clinical practice exploration of improved cytological rapid on-site evaluation technology 

Tang Jiayue, Hu Xiaoxue, Wang Bixi, Zhang Yaping, Wang Lei, Yan Xuebing

2025, 31(13):  2167-2171.  DOI: 10.3760/cma.j.cn441417-20250102-13011

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The diagnostic value of cardiac ultrasound technology for right heart function in patients with pulmonary arterial hypertension

Duan Jiaqing, Chen Hongliang, Xu Qingyan, Yang Hui, Xie Xinming

2025, 31(13):  2171-2175.  DOI: 10.3760/cma.j.cn441417-20250306-13012

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Objective　To explore the diagnostic value of cardiac ultrasound technology for right heart function in patients with pulmonary arterial hypertension (PAH). Methods　Sixty-five patients with PAH who were admitted to Norinco General Hospital from November 2023 to October 2024 were selected as the study group. There were 31 males and 34 females in the study group, aged (63.83±7.87) years. The study group was divided into three levels based on the pulmonary artery systolic pressure (sPAP) level: 22 cases were classified as mild [35-≤50 mmHg (1 mmHg=0.133 kPa)]; 22 cases as moderate (50-≤70 mmHg); and 21 cases as severe (>70 mmHg). Sixty-five healthy individuals who underwent physical examinations at the same time were selected as the control group. There were 38 males and 27 females in the control group, aged (62.34±7.96) years. The cardiac ultrasound indicators [right ventricular end-systolic volume (ESV), end-diastolic volume (EDV), ratio of peak A velocity to peak E velocity (A/E), stroke volume (SV), ejection fraction (EF)] and pulmonary artery pressure indicators [sPAP, pulmonary artery diastolic pressure (dPAP), mean pulmonary artery pressure (mPAP)] were compared between two groups. The cardiac ultrasound indicators (ESV, EDV, A/E, SV, EF) and pulmonary artery pressure indicators (dPAP, mPAP) were compared among patients with mild, moderate, and severe PAH. Independent sample t test, analysis of variance, paired t test, and χ² test were used for statistical analysis. The diagnostic efficacy of cardiac ultrasound indicators and pulmonary artery pressure indicators for right heart function in patients with PAH was analyzed using the receiver operating characteristic curve (ROC). Results　The ESV, EDV, A/E, SV and EF values of the study group were all lower than those of the control group [(31.58±5.52) ml vs. (41.81±6.34) ml, (65.39±6.86) ml vs. (80.37±7.31) ml, 0.83±0.14 vs. 1.62±0.11, (56.95±6.87) ml vs. (71.42±6.58) ml, (32.69±5.73)% vs. (45.33±5.82)%] (all P<0.05). The sPAP, dPAP and mPAP values of the study group were all higher than those of the control group [(56.43±5.65) mmHg vs. (24.47±3.07) mmHg, (40.75±4.51) mmHg vs. (23.84±3.60) mmHg, (48.83±6.94) mmHg vs. (16.04±3.56) mmHg] (all P<0.05). The ESV, EDV, A/E, SV and EF values of patients with severe PAH were all lower than those of patients with mild and moderate PAH (all P<0.05); the ESV, EDV, A/E, SV and EF values of patients with moderate PAH were all lower than those of patients with mild PAH (all P<0.05). The dPAP and mPAP values of patients with severe PAH were higher than those of patients with mild and moderate PAH (all P<0.05); the dPAP and mPAP values of patients with moderate PAH were also higher than those of patients with mild PAH (both P<0.05). The area under the curve (AUC), sensitivity and specificity of the combined use of cardiac ultrasound indicators and pulmonary artery pressure indicators in diagnosing right heart function in patients with PAH were all higher than those of single diagnosis (all P<0.05). Conclusion　Cardiac ultrasound technology is applied to the diagnosis of right heart function in patients with PAH, which can enhance the diagnostic efficiency and has a relatively high clinical application value.

Risk factors for poor prognosis in children with moderate to severe bronchiolitis 

Gao Ying, Zhang Guocheng, Yang Baoning

2025, 31(13):  2176-2180.  DOI: 10.3760/cma.j.cn441417-20250226-13013

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Objective　To explore the risk factors for poor prognosis in children with moderate to severe bronchiolitis. Methods　A total of 217 children with moderate to severe bronchiolitis who were admitted to the Second Affiliated Hospital of Shaanxi University of Chinese Medicine from January 2022 to October 2023 were selected as the study subjects. There were 126 boys and 91 girls, aged 1-24 (8.77±1.04) months. All children with moderate to severe bronchiolitis were given comprehensive routine inpatient treatment. After the children were discharged from the hospital, they were followed up for one year. Those diagnosed with asthma, recurrence of bronchiolitis, and having more than 3 episodes of wheezing during the follow-up period were included in the poor prognosis group (57 cases), while the remaining children were included in the good prognosis group (153 cases). The clinical data of the patients were collected, including general information (gender, age, premature birth, atopic constitution, feeding method, history of tobacco exposure, history of pet contact, history of eczema, history of asthma), clinical symptoms (pre-admission disease course, severity grading of the condition, infectious pathogens) and laboratory indicators [neutrophil count, white blood cell count (WBC), C-reactive protein (CRP), immunoglobulin E (IgE) levels before treatment]. Independent sample t test and χ² test were used for statistical analysis. Multivariate logistic regression analysis was used to identify the risk factors for poor prognosis in the children; variance inflation factor (VIF) was used to determine whether there was collinearity among the independent variables, and the receiver operating characteristic curve (ROC) was used to analyze the predictive efficacy of the multivariate logistic regression model for poor prognosis in the children. Results　During the follow-up period, 2 patients were transferred to other hospitals and 5 patients were lost to follow-up. Excluding this study, a total of 210 patients were included. Among the 210 children with severe bronchiolitis, the incidence of poor prognosis was 27.14% (57/210). The proportions of premature infants, atopic constitution, severe bronchiolitis, history of eczema, history of asthma in the poor prognosis group, as well as the IgE levels were all higher than those in the good prognosis group, while the proportion of breastfeeding was lower than that in the good prognosis group (all P<0.05). The results of the multivariate logistic regression analysis showed that preterm birth (OR=1.857, 95%CI: 1.197-2.881), atopic constitution (OR=1.586, 95%CI: 1.198-2.099), asthma family history (OR=1.474, 95%CI: 1.094-1.986), and severe bronchiolitis (OR=2.042, 95%CI: 1.446-2.883) were all risk factors for poor prognosis in children with moderate to severe bronchiolitis; breastfeeding (OR=0.590, 95%CI: 0.397-0.877) was a protective factor (all P<0.05). The ROC results showed that the area under the curve (AUC) of the multivariate logistic regression model for predicting poor prognosis in children with moderate to severe bronchiolitis was 0.938 (95%CI: 0.897-0.967), with a sensitivity of 89.47% and a specificity of 88.24%. Conclusion　Premature birth, atopic constitution, family history of asthma, and severe bronchiolitis are all risk factors for poor prognosis in children with moderate to severe bronchiolitis; breastfeeding is a protective factor.

Analysis of the clinical efficacy of recombinant human growth hormone treatment for children with growth hormone deficiency based on the nomogram model 

Zhou Ting, Liu Fei, Zhang Renfang, Fan Tingting

2025, 31(13):  2181-2186.  DOI: 10.3760/cma.j.cn441417-20240708-13014

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Objective　To investigate the clinical efficacy of recombinant human growth hormone in treating children with growth hormone deficiency (GHD), and to predict treatment outcomes using the nomogram model. Methods　A total of 86 children with GHD who were admitted to Shangluo Central Hospital from February 2020 to February 2022 were selected as the study subjects. All the children received recombinant human growth hormone treatment. After the treatment, they were followed up every 3 months for 1 year. Based on the follow-up results, the children were divided into the ineffective group (17 cases) and the effective group (69 cases). The clinical data of the patients were collected, including general information (age, gender, body mass index, bone age index, height standard deviation score, region, guardian's educational level, family economic status, sleep duration) and laboratory indicators [frozen-thawed follicle stimulating hormone (FSH), estradiol (E2), testosterone (T), luteinizing hormone (LH), insulin-like growth factor-1 (IGF-1), fasting blood glucose (FBG), bone alkaline phosphatase (BAP), free triiodothyronine (FT3), free thyroxine (FT4) levels, and FT3/FT4 before treatment]. Independent sample t test and χ² test were used for statistical analysis. Multivariate logistic regression analysis was used to identify the influencing factors for the ineffective treatment of children with GHD; the R3.4.3 software was employed to construct a nomogram model based on the results of the multivariate logistic regression analysis; calibration curves and Hosmer-Lemeshow tests were used to assess the calibration degree of the model; the receiver operating characteristic curve was used to analyze the predictive efficacy of the model for the ineffective treatment of children with GHD, and the area under the curve was calculated. Results　A total of 86 children with GHD were included in this study, and 17 of them (19.77%) were ineffective. The effective group had higher values for bone age index, height standard deviation score, and BAP level than the ineffective group (all P<0.05). The results of the multivariate logistic regression analysis showed that the bone age index (OR=0.114, 95%CI: 0.021-0.620), height standard deviation score (OR=0.019, 95%CI: 0.002-0.185), and BAP level (OR=0.070, 95%CI: 0.009-0.544) were all factors influencing the ineffectiveness of treatment in children with GHD (all P<0.05). Using bone age index, height standard deviation score, and BAP level as predictive variables, a nomogram model was constructed. The calibration and goodness-of-fit of this model were both good. The receiver operating characteristic curve showed that the area under the curve of this model was 0.972 (95%CI: 0.931-1.000), with a sensitivity of 94.1% and a specificity of 97.1%. Conclusion　Bone age index, height standard deviation score, and BAP level are all factors that affect the therapeutic effect of recombinant human growth hormone in children with GHD. The nomogram model can effectively predict the therapeutic effect and is helpful for guiding clinical practice.

Expression levels of miR-9-5p and SOCS5 in peripheral blood of children with bronchial asthma and their relationship with Th1/Th2 balance 

Li Huifang, Han Lingxiang, Li Qinghua

2025, 31(13):  2186-2191.  DOI: 10.3760/cma.j.cn441417-20240517-13015

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Objective　To explore the expression levels of miR-9-5p and SOCS5 in the peripheral blood of children with bronchial asthma and their relationship with the Th1/Th2 balance. Methods　A total of 99 children with bronchial asthma who were admitted to Tongchuan maternal and child health hospital from June 2021 to June 2023 were selected as the study subjects. According to the control status of wheezing, the children were divided into the attack group (42 cases) and the remission group (57 cases). At the same time, 52 children who had no history of lung disease, wheezing, allergies, respiratory tract infections and were age-matched were selected from the pediatric ward as the control group. There were 22 boys and 20 girls in the attack group, aged (8.30±1.42) years. There were 30 boys and 27 girls in the remission group, aged (8.57±1.21) years. There were 32 boys and 20 girls in the control group, aged (8.23±1.36) years. The expression levels of miR-9-5p and SOCS5 were compared between the three groups, as well as the levels of helper T cells (Th) 1 and Th2, Th1/Th2 ratio, C-reactive protein (CRP), white blood cell count (WBC), immunoglobulin E (IgE), and pulmonary function indicators [percentage of forced expiratory volume in the first second as a percentage of predicted value (FEV1%), forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC), and carbon monoxide diffusion capacity (DLCO)]. Analysis of variance, SNK-q test, and χ² test were used for statistical analysis. Using Pearson correlation analysis, the relationships between the expression levels of miR-9-5p and SOCS5 and various indicators were investigated. Multivariate logistic regression analysis was used to investigate the influencing factors of poor asthma control in children. Results　The expression levels of miR-9-5p and SOCS5 in both the remission group and the attack group were higher than those in the control group (all P<0.05); the expression levels of miR-9-5p and SOCS5 in the attack group were higher than those in the remission group (both P<0.05). The levels of Th1 and Th1/Th2 in the remission group and the attack group were both lower than those in the control group, while the levels of Th2 were higher than those in the control group (all P<0.05); the levels of Th1 and Th1/Th2 in the attack group were both lower than those in the remission group, and the level of Th2 was higher than that in the remission group (all P<0.05). The levels of CRP, WBC and IgE in both the remission group and the attack group were higher than those in the control group (all P<0.05); the levels of CRP, WBC and IgE in the attack group were higher than those in the remission group (all P<0.05). The FEV1%, FEV1/FVC and DLCO values in the remission group and the attack group were all lower than those in the control group (all P<0.05); the FEV1%, FEV1/FVC and DLCO values in the attack group were all lower than those in the remission group (all P<0.05). The Pearson correlation analysis showed that the expression levels of miR-9-5p and SOCS5 were positively correlated with the levels of Th2, CRP, IgE, and WBC, and negatively correlated with the levels of Th1, Th1/Th2, FEV1%, FEV1/FVC, and DLCO (all P<0.05). The results of the multivariate logistic regression analysis showed that high expression levels of miR-9-5p (OR=2.203, 95%CI: 1.046-4.640), SOCS5 (OR=2.034, 95%CI: 1.065-3.844), and low Th1/Th2 ratio (OR=4.855, 95%CI: 2.217-10.633) were all independent risk factors for poor asthma control (all P<0.05). Conclusion　The expression levels of miR-9-5p and SOCS5 are high in children with bronchial asthma, and they are related to the Th1/Th2 balance.

The effect of subcutaneous immunotherapy combined with omalizumab on lung function and serum inflammatory markers in children with bronchial asthma 

Chen Yao, Zheng Mao

2025, 31(13):  2192-2196.  DOI: 10.3760/cma.j.cn441417-20240605-13016

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Objective　To evaluate the effect of subcutaneous immunotherapy combined with omalizumab on lung function and serum inflammatory markers in children with bronchial asthma. Methods　This study is a randomized controlled trial. A total of 104 children with bronchial asthma who were admitted to the emergency department of Xi'an Children's Hospital from January 2022 to December 2022 were selected as the study subjects. Using the odd-even numbering method, the children were randomly divided into the control group (52 cases) and the study group (52 cases). There were 31 boys and 21 girls in the control group, aged (10.44±1.26) years, course of the disease (1.92±0.47) years. There were 33 boys and 19 girls in the study group, aged (10.22±1.21) years, course of the disease (1.86±0.56) years. The control group was treated with omalizumab, while the study group received subcutaneous immunotherapy in addition to the treatment of the control group. Both groups were treated continuously for 12 months. The lung function [first-second forced expiratory volume (FEV1), forced vital capacity (FVC), FEV1/FVC], serum inflammatory markers [interleukin-2 (IL-2), IL-4, IL-6, gamma interferon (IFN-γ)], immune indicators [eosinophils (EOS), immunoglobulin E (IgE), immunoglobulin helper type T cell 2 (Th2), immunoglobulin Th17, CD4+, CD8+, CD4+/CD8+] were compared between the two groups before and after treatment, as well as the occurrence of adverse reactions. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After treatment, the FEV1, FVC and FEV1/FVC in the study group were all higher than those in the control group [(1.92±0.70) L vs. (1.68±0.63) L, (2.19±0.63) L vs. (1.81±0.56) L, (79.80±7.31)% vs. (68.83±6.82)%] (all P<0.05); the serum levels of IL-2 and IFN-γ in the study group were higher than those in the control group [(26.43±5.13) ng/L vs. (21.04±4.78) ng/L, (326.81±24.60) ng/L vs. (291.62±20.84) ng/L], while the serum levels of IL-4 and IL-6 were lower than those in the control group [(157.15±29.52) ng/L vs. (279.71±31.77) ng/L, (10.05±2.90) ng/L vs. (16.11±3.51) ng/L] (all P<0.05); the levels of CD4+ and CD4+/CD8+ in the study group were higher than those in the control group, while the levels of EOS, IgE, Th2 and Th17 were lower than those in the control group (all P<0.05). The comparison of the total incidence rates of adverse reactions between the two groups showed no statistically significant difference (P>0.05). Conclusion　Subcutaneous immunotherapy combined with omalizumab can improve the lung function of children with bronchial asthma, enhance the levels of serum inflammatory markers and immune indicators, and has good safety.

The relationship between myocardial function and serum levels of Lp-PLA2, NT-proBNP, PCT and coagulation indicators in children with KD complicated by MP infection 

Xue Zhengfeng, Liu Qing, Zhong Hongping, Li Fang

2025, 31(13):  2197-2201.  DOI: 10.3760/cma.j.cn441417-20250304-13017

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Objective　To investigate the relationship between myocardial function and serum levels of lipoprotein-associated phospholipase A2 (Lp-PLA2), N-terminal pro B-type natriuretic peptide (NT-proBNP), procalcitonin (PCT), and coagulation indicators in children with Kawasaki disease (KD) complicated by mycoplasma pneumoniae (MP) infection. Methods　Eighty children with KD who were admitted to Yan'an University Affiliated Hospital from January 2020 to January 2024 were selected as the study subjects. The MP infection status of the children was detected, and they were grouped accordingly. 31 children with MP infection were included in the infection group, while the remaining 49 children were included in the non-infection group. There were 18 boys and 13 girls in the infection group, aged (3.16±1.22) years. There were 29 boys and 20 girls in the non-infection group, aged (3.72±1.45) years. The clinical data (age, maximum body temperature, duration of fever, conjunctival congestion, dry lips, strawberry tongue, oral mucosa congestion, trunk rashes, limb erythema, limb edema, skin peeling at fingertips, perianal peeling, cervical lymph node enlargement) and laboratory indicators (creatine kinase, creatine kinase isoenzyme, lactate dehydrogenase, α-hydroxybutyrate dehydrogenase, aspartate aminotransferase, NT-proBNP, Lp-PLA2, PCT, prothrombin time, activated partial thromboplastin time, fibrinogen quantification, clotting time, antithrombin Ⅲ, D-dimer) were compared between the two groups. Independent sample t test and χ² test were used for statistical analysis. Pearson correlation analysis was used to investigate the relationship between myocardial function and serum levels of Lp-PLA2, NT-proBNP, PCT, and coagulation indicators. Results　Comparison of the clinical data between the two groups showed no statistically significant differences (all P>0.05). The comparisons of the levels of creatine kinase, lactate dehydrogenase, α-hydroxybutyrate dehydrogenase, and aspartate aminotransferase between the two groups showed no statistically significant differences (all P>0.05); the level of creatine kinase isoenzyme in the infection group was higher than that in the non-infection group [(42.88±5.78) U/L vs. (30.88±7.12) U/L] (P<0.05). There was no statistically significant difference in the levels of serum NT-proBNP between the two groups (P>0.05); the levels of serum Lp-PLA2 and PCT in the infection group were higher than those in the non-infection group [(543.80±121.12) μg/L vs. (466.15±116.15) μg/L, (0.88±0.21) μg/L vs. (0.44±0.15) μg/L] (both P<0.05). There was no statistically significant difference in the comparisons of prothrombin time, activated partial thromboplastin time, fibrinogen quantification, clotting time, and antithrombin Ⅲ level between the two groups (all P>0.05); the D-dimer level in the infection group was higher than that in the non-infection group [(855.12±124.41) μg/L vs. (744.15±110.15) μg/L] (P<0.05). The Pearson correlation analysis showed that the level of creatine kinase isoenzyme was positively correlated with serum levels of Lp-PLA2, PCT, and D-dimer, the level of α-hydroxybutyrate dehydrogenase was positively correlated with the level of serum NT-proBNP, and the level of aspartate aminotransferase was positively correlated with the level of serum PCT (all P<0.05). Conclusion　Children with KD combined with MP infection have more severe impairment of myocardial function, and it also affects the inflammatory response and coagulation function of the children. Specifically, the levels of creatine kinase isoenzyme, serum Lp-PLA2, PCT, and D-dimer increase. There is a positive correlation between myocardial enzymes and inflammatory and coagulation function indicators.

Clinical Research

Quantitative detection of dual phase chest CT in smokers and non-smokers and its correlation analysis with lung structural injury 

Feng Tianbao, Huang Xiaoqi, Chen Zhen

2025, 31(13):  2202-2206.  DOI: 10.3760/cma.j.cn441417-20240812-13018

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Objective　To investigate the quantitative detection of dual phase chest computed tomography (CT) in smokers and non-smokers and its correlation with lung structural injury. Methods　A total of 150 smokers who underwent dual phase chest CT scans and lung function tests at Yan'an University Affiliated Hospital from January 2023 to January 2024 were selected as the study group (112 males and 38 females); the age ranged from 51 to 76 (63.45±9.17) years; the smoking amount (nicotine intake) was 396 to 1 949 (1 387.95±197.38) mg per year. At the same time, subjects with normal lung function and no smoking history were selected as the control group (50 cases), including 38 males and 12 females; the age ranged from 50 to 74 (60.14±10.85) years. The quantitative CT indicators [normal area (Normal%), emphysema area (Emph%), small airway injury area (fSAD%), average lung density during exhalation (MLD-EX), average lung density during inhalation (MLD-IN), percentage of inhalation phase pixels<950 Hu (IN-950%), percentage of exhalation phase pixels<856 Hu (EX-856%)], and lung function [peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), forced vital capacity (FVC), percentage of forced expiratory volume in one second relative to predicted value (FEV1%), FEV1/FVC] were compared between two groups. Independent sample t test was used for statistical analysis. The Pearson correlation analysis was used to investigate the relationship between CT quantitative indicators and lung function. Results　There was no statistically significant difference between the two groups in terms of MLD-IN and IN-950% (both P>0.05). The MLD-EX and Normal% values in the study group were lower than those in the control group, while the fSAD%, Emph%, and EX-856% values were higher than those in the control group (all P<0.05). There was no statistically significant difference in FEV1 and FVC between the two groups (both P>0.05). The PEF, FEV1%, and FEV1/FVC values of the study group were all lower than those of the control group (all P<0.05). The Pearson correlation analysis results showed that Normal% was positively correlated with FEV1/FVC and PEF (r=0.496, 0.365, both P<0.05); MLD-EX was positively correlated with PEF and FEV1/FVC (r=0.478, 0.319, both P<0.05); EX-856% was negatively correlated with FEV1/FVC and PEF (r=0.352, 0.484, both P<0.05); fSAD% was negatively correlated with PEF, FEV1/FVC, and FEV1% (r=-0.457, 0.581, 0.326, all P<0.05); Emph% was negatively correlated with PEF and FEV1/FVC (r=-0.564, -0.429, both P<0.05). Compared with MLD-EX and EX-856%, Normal%, Emph%, and fSAD% have a stronger correlation with lung function. Conclusion　For both smokers and non-smokers, the quantitative detection of fSAD% and Emph% indicators using dual phase chest CT has a high sensitivity in evaluating changes in lung function.

The impact of lower limb rehabilitation robot-assisted gait training based on different weight loss parameters on the rehabilitation outcomes of patients with lower limb fractures

Liu Yan, Li Hongyin

2025, 31(13):  2206-2210.  DOI: 10.3760/cma.j.cn441417-20250120-13019

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Objective　To explore the impact of lower limb rehabilitation robot-assisted gait training based on different weight loss parameters on the rehabilitation outcomes of patients with lower limb fractures. Methods　This study is a prospective cohort study. A total of 98 patients with lower limb fractures who were admitted to the Rehabilitation Medicine Department of the First Hospital of Yulin from January 2021 to December 2023 were selected as the study subjects. Using the random number table method, the patients were divided into the observation group and the control group, with 49 cases in each group. There were 30 males and 19 females in the observation group, aged (65.89±7.33) years, weight (62.54±3.57) kg. There were 26 males and 23 females in the control group, aged (63.64±7.71) years, weight (62.67±3.62) kg. Both groups received the conventional + lower limb rehabilitation robot-assisted gait training program after internal fixation surgery. The initial weight reduction for the observation group was 40%, while that for the control group was 60%. Both groups underwent continuous training for 8 weeks. The hip joint function (Harris hip function score), walking ability (Holden functional walking scale), and 10-meter walking speed (10-meter walking test) were compared between the two groups before training and 4 weeks, and 8 weeks after training. Independent sample t test, χ² test, and rank sum test were used for statistical analysis. Results　After 8 weeks of training, the Harris hip function score of the observation group was higher than that of the control group [(83.89±6.62) points vs. (78.37±8.59) points] (P<0.05); the Holden walking ability grade of the observation group was better than that of the control group (P<0.05); the 10-meter walking speed of the observation group was higher than that of the control group [(0.39±0.08) m/s vs. (0.27±0.05) m/s] (P<0.05). Conclusion　In the initial weight loss plan, patients with lower limb fractures who received internal fixation surgery were advised to start the training with lower weight loss parameters, which is helpful for improving the patients' lower limb movement function, enhancing their walking ability, and promoting recovery.

Effects of sacubitril valsartan sodium tablets combined with folic acid on glucose and lipid metabolism, blood pressure and vascular endothelial function in patients with H-type hypertension 

Liang Yanfen, Chen Ying, Kong Yanliang, Wang Yanli, Feng Junpeng

2025, 31(13):  2210-2215.  DOI: 10.3760/cma.j.cn441417-20241106-13020

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Objective　To observe the effects of sacubitril valsartan sodium tablets combined with folic acid on glucose and lipid metabolism, blood pressure and vascular endothelial function in patients with H-type hypertension. Methods　This study is a randomized controlled trial. Eighty-eight patients with H-type hypertension who were admitted to Tongchuan People's Hospital from April 2022 to April 2024 were selected as the study subjects. Using the random number table method, the patients were divided into the control group and the experimental group, with 44 cases in each group. There were 25 males and 19 females in the control group, aged 45-74 (53.30±7.87) years, body mass index (BMI) 22.87-29.65 (24.85±2.83) kg/m². There were 28 males and 16 females in the experimental group, aged 41-75 (54.68±8.01) years, BMI 22.57-29.41 (24.71±2.43) kg/m². The control group was treated with sacubitril valsartan sodium tablets, while the experimental group was treated with folic acid in addition to the treatment of the control group. Both groups received continuous treatment for 4 months. The glucose and lipid metabolism indicators [fasting blood glucose (FPG), glycosylated hemoglobin (HbAlc), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (ApoA1)], blood pressure and Hcy levels, vascular endothelial function [vascular dilation function (FMD), intercellular adhesion molecule-1 (ICAM-1), endothelin-1 (ET-1)] were compared before and after treatment in the two groups, as well as clinical efficacy and adverse reactions. Independent sample t test, paired t test, Mann-Whitney U test, χ² test, corrected χ² test, and rank sum test were used for statistical analysis. Results　After treatment, the levels of FPG, HbAlc, TC, TG, and LDL-C in the experimental group were all lower than those in the control group [(4.34±0.89) mmol/L vs. (4.77±0.98) mmol/L, (4.11±0.92)% vs. (4.49±0.81)%, (3.98±0.97) mmol/L vs. (4.42±1.03) mmol/L, 1.03 (1.04, 2.18) mmol/L vs. 1.24 (1.06, 2.16) mmol/L, (2.24±0.71) mmol/L vs. (2.54±0.63) mmol/L], while the levels of HDL-C and ApoA1 were higher than those in the control group [(1.39±0.37) mmol/L vs. (1.22±0.35) mmol/L, (154.69±31.15) mmol/L vs. (135.77±38.11) mmol/L] (all P<0.05); the systolic blood pressure, diastolic blood pressure, and Hcy levels in the experimental group were all lower than those in the control group [(142.27±14.14) mmHg (1 mmHg=0.133 kPa) vs. (148.86±13.07) mmHg, (84.05±9.96) mmHg vs. (89.91±9.98) mmHg, (10.95±2.16) μmol/L vs. (12.32±2.99) μmol/L] (all P<0.05); the FMD level in the experimental group was higher than that in the control group [(5.67±0.74)% vs. (5.09±0.87)%], and the levels of ICAM-1 and ET-1 were lower than those in the control group [(114.63±27.74) μg/L vs. (130.01±31.55) μg/L, (2.23±0.64) ng/L vs. (2.61±0.52) ng/L] (all P<0.05). The total effective rate of treatment in the experimental group was higher than that in the control group [88.64% (39/44) vs. 70.45% (31/44)] (P<0.05); the distribution of treatment effect grades in the experimental group was better than that in the control group (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusion　The combination of sacubitril valsartan sodium tablets and folic acid in the treatment of patients with H-type hypertension has a better effect. It can improve glucose and lipid metabolism, vascular endothelial function, lower blood pressure, and has good safety.

Research on Traditional Chinese Medicine

The influence of modified Huiyan Zhuyu decoction on the swallowing function and cerebral blood flow of patients with post-stroke dysphagia

Zheng Qian, Yu Liying, Ruan Jiapeng, Li Wen, Wang Tianrui, Cong Haiming

2025, 31(13):  2216-2220.  DOI: 10.3760/cma.j.cn441417-20250106-13021

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Objective　To explore the influence of modified Huiyan Zhuyu decoction on the swallowing function and cerebral blood flow of patients with post-stroke dysphagia. Methods　A total of 160 patients with post-stroke dysphagia who were admitted to Weihai Central Hospital from January 2020 to December 2023 were selected as the research subjects. According to the treatment methods, the patients were divided into the control group and the observation group, with 80 cases in each group. There were 41 males and 39 females in the control group, aged (51.69±3.31) years, course of the disease (6.33±0.19) days, classification of dysphagia: 53 cases at grades Ⅰ and Ⅱ, 27 cases at grades Ⅲ and Ⅳ. There were 37 males and 43 females in the observation group, aged (50.83±3.10) years, course of the disease (6.50±0.21) days, classification of dysphagia: 51 cases at grades Ⅰ and Ⅱ, 29 cases at grades Ⅲ and Ⅳ. The control group received conventional treatment and swallowing training. The observation group, in addition to the treatment of the control group, was treated with neuromuscular electrical stimulation combined with the modified Huiyan Zhuyu decoction. Both groups received continuous treatment for 6 weeks. The clinical efficacy, the occurrence of complications, and the swallowing disorders (functional swallowing disorder staging assessment form), swallowing-eating function (standard swallowing function evaluation scale), swallowing imaging, cerebral blood flow status (average blood flow velocity of bilateral vertebral arteries and basilar arteries, systolic blood flow velocity and pulsatility index) were compared between the two groups before and after treatment. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　The total effective rate of treatment in the observation group was higher than that in the control group [91.25% (73/80) vs. 65.00% (52/80)] (P<0.05). After treatment, the scores of the functional swallowing disorder staging assessment form and the standard swallowing function evaluation scale in the observation group were lower than those in the control group [(20.30±7.93) points vs. (34.56±8.89) points, (20.13±4.33) points vs. (26.53±5.80) points], and the swallowing imaging score was higher than that of the control group [(9.46±1.25) points vs. (8.65±1.98) points] (all P<0.05); the average blood flow velocity and systolic blood flow velocity of the bilateral vertebral arteries and basilar arteries in the observation group were higher than those in the control group, and the pulsatility index were lower than that of the control group (all P<0.05). The total incidence of complications in the observation group was lower than that in the control group [6.25% (5/80) vs. 21.25% (17/80)] (P<0.05). Conclusion　The neuromuscular electrical stimulation combined with the modified Huiyan Zhuyu decoction has a better therapeutic effect on patients with post-stroke dysphagia. It can improve the swallowing function, the cerebral blood flow status, and reduce complications.

The effect of liver-sparing and brain-benefiting acupuncture method combined with zolmitriptan in the treatment of migraine with hyperactivity of liver-yang syndrome

Wang Bin, Zhang Yan

2025, 31(13):  2221-2225.  DOI: 10.3760/cma.j.cn441417-20241129-13022

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Objective　To observe the effect of liver-sparing and brain-benefiting acupuncture method combined with zolmitriptan in the treatment of migraine with hyperactivity of liver-yang syndrome. Methods　A total of 90 patients with migraine with hyperactivity of liver-yang syndrome who were admitted to Affiliated Hospital of Shaanxi University of Chinese Medicine from May 2021 to October 2022 were selected as the study subjects. Using the envelope method, the patients were divided into the control group (45 cases) and the acupuncture group (45 cases). There were 19 males and 26 females in the control group, aged 19-74 (49.63±7.84) years, course of the disease 1-32 (6.85±1.45) years. There were 16 males and 29 females in the acupuncture group, aged 20-75 (48.78±8.02) years, course of the disease 1-29 (6.79±1.50) years. The control group was treated with zolmitriptan, while the acupuncture group was treated in addition to the control group with liver-sparing and brain-benefiting acupuncture method. Both groups were treated continuously for 2 weeks. Compare the pain levels [visual analogue scale (VAS)] before and after treatment in the two groups at 1 h, 2 h, and 4 h; the levels of vaso-active substance [calcitonin gene-related peptide (CGRP), endothelin-1 (ET-1), β-epinephrine (β-EP), 5-hydroxytryptamine (5-HT)], the levels of inflammatory response-related enzymes [cyclooxygenase-2 (COX-2), nitric oxide synthase (iNOS)], the migraine symptom scores (headache severity, accompanying symptoms, monthly attack frequency and duration per attack), the traditional Chinese medicine syndrome scores (headache and dizziness, irritability and restlessness, insomnia and frequent dreams, tinnitus and vertigo, facial flushing and redness, bitter mouth and dry throat) before and after treatment; and the occurrence of adverse reactions during treatment. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　At 1 h, 2 h, and 4 h after treatment, the VAS scores of the acupuncture group were all lower than those of the control group [(3.28±0.70) points vs. (4.02±1.14) points, (2.67±0.68) points vs. (3.20±0.54) points, (1.87±0.42) points vs. (2.34±0.51) points] (all P<0.05). After treatment, the levels of CGRP and ET-1 in the acupuncture group were lower than those in the control group [(10.14±1.44) ng/L vs. (13.36±1.87) ng/L, (56.74±5.51) ng/L vs. (65.86±5.87) ng/L], while the levels of β-EP and 5-HT were higher than those in the control group [(83.45±9.61) ng/L vs. (71.63±8.47) ng/L, (298.86±30.48) ng/L vs. (272.36±28.94) ng/L] (all P<0.05); the levels of COX-2 and iNOS in the acupuncture group were lower than those in the control group [(1.84±0.51) μg/L vs. (2.21±0.63) μg/L, (1.35±0.48) μg/L vs. (3.08±0.77) μg/L] (both P<0.05); the scores for headache severity, accompanying symptoms, monthly attack frequency and duration per attack in the acupuncture group were lower than those in the control group (all P<0.05); the scores for headache and dizziness, irritability and restlessness, insomnia and frequent dreams, tinnitus and vertigo, facial flushing and redness, bitter mouth and dry throat in the acupuncture group were lower than those in the control group (all P<0.05). During the treatment period, no adverse reactions occurred in either group. Conclusion　Liver-sparing and brain-boosting acupuncture combined with zolmitriptan has a better therapeutic effect on patients with migraine with hyperactivity of liver-yang syndrome. It can relieve pain, alleviate the symptoms of migraine, and regulate the levels of vaso-active substance and inflammatory response-related enzymes.

Effect of Qutan Xuanfei decoction combined with western medicine and the effect on airway inflammation on children with bronchiolitis (Phlegm shuts lung card hotly)

Sun Yuan, Ye Jiaxin, Zhang Guocheng

2025, 31(13):  2226-2231.  DOI: 10.3760/cma.j.cn441417-20250122-13023

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Objective　To explore the efficacy of Qutan Xuanfei decoction combined with Western medicine in treating pediatric bronchiolitis (Phlegm shuts lung card hotly). Methods　A total of 96 children with bronchiolitis, all diagnosed with Phlegm shuts lung card hotly, were selected from the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine between January 2023 and June 2024. The children were randomly divided into two groups, with 48 patients in each group. In the observation group, there were 29 males and 19 females, aged 6 (3, 14) months and the disease duration was (2.85±0.57) d, including 17 mild and 31 moderate cases. In the control group, there were 30 males and 18 females, aged 6 (3, 15) months and the disease duration was (2.81±0.55) d, including 15 mild and 33 moderate cases. The control group received nebulized budesonide + ambroxol hydrochloride + terbutaline + normal saline, administered for 10-15 minutes, twice daily, along with symptomatic treatment. The observation group received Qutan Xuanfei decoction in addition to the treatment given to the control group, with dosages adjusted based on the child's age, administered three times daily. Both groups underwent treatment for 7 days. The study compared traditional Chinese medicine (TCM) syndrome scores, inspiratory/expiratory ratio (Ti/Te), tidal volume per kilogram (VT/kg), respiratory resistance, and airway inflammation indicators [interleukin (IL)-4, IL-8, and tumor necrosis factor-alpha (TNF-α)] before and after treatment, as well as clinical efficacy and adverse reactions between the two groups. Statistical analysis was performed using Fisher's exact probability method, corrected χ² test, χ² test, rank-sum test, and t test. Results　After treatment, the scores for primary symptoms, secondary symptoms, tongue and pulse signs, and total scores in the observation group were (3.09±0.62, 2.28±0.42, 0.72±0.15, 6.09±1.21) points, compared to (4.56±0.91, 2.93±0.55, 1.02±0.18, 8.51±1.35) points in the control group. The Ti/Te and VT/kg values in the observation group were higher than those in the control group [0.85±0.18 vs. 0.72±0.14 and (9.36±1.45) ml/kg vs. (8.35±1.35) ml/kg], while the respiratory resistance was lower in the observation group [(3.26±0.62) kPa/(s·L) vs. (4.47±0.82) kPa/(s·L)]. The levels of IL-4, IL-8, and TNF-α in the observation group were (4.03±0.82, 28.64±5.41, 55.62±10.22) ng/L, compared to (5.10±1.05, 37.94±7.01, 71.52±12.74) ng/L in the control group; all differences were statistically significant (all P<0.05). The overall effective rate in the observation group was 97.83% (45/46), higher than the 82.22% (37/45) in the control group (P=0.015). The total incidence of adverse reactions in both groups was [10.87% (5/46) vs. 6.67% (3/45)], with no statistically significant difference (corrected χ²=0.114, P=0.736). Conclusion　The therapeutic effect of Qutan Xuanfei decoction combined with western medicine in the treatment of children with bronchiolitis (Phlegm shuts lung card hotly) is ideal and it is safety.

Clinical efficacy of Qiju Dihuang decoction combined with methotrexate in treatment of rheumatoid arthritis 

Zhang Min, Zhang Jingkun, Yang Jianwei, Song Xuehong

2025, 31(13):  2231-2236.  DOI: 10.3760/cma.j.cn441417-20240802-13024

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Objective　To analyze the effect of Qiju Dihuang decoction combined with methotrexate in the treatment of liver and kidney deficiency syndrome of rheumatoid arthritis (RA). Methods　A retrospective analysis was conducted on 118 RA patients with liver and kidney deficiency syndrome admitted to Hanzhong Traditional Chinese Medicine Hospital from April 2019 to April 2024. Patients were divided into two groups based on different treatment methods. The control group consisted of 57 patients, including 32 males and 25 females, aged (56.50±4.85) years and a disease duration of (2.45±0.41) years. The observation group included 61 patients, comprising 36 males and 25 females, aged (55.81±4.93) years and a disease duration of (2.64±0.43) years. Both groups received treatment with non-steroidal anti-inflammatory drugs, anti-rheumatic drugs, glucocorticoids, and biological agents. The control group was treated with methotrexate, oral, once a week, 4 tablets/time. On the basis of the control group, the observation group was treated with Qiju Dihuang decoction, 200 ml of medicine juice was taken, and warmed in the morning and evening respectively. Both groups were treated for 4 weeks. The curative effect, Traditional Chinese Medicine (TCM) syndrome scores (main and secondary symptom scores), inflammatory indicators (C-reactive protein, erythrocyte sedimentation rate, rheumatoid factor), disease activity indicators [Disease Activity Score in 28 joints (DAS28), Clinical Disease Activity Index (CDAI)], bone metabolism index [alkaline phosphatase (ALP), type I collagen hydroxyl terminal peptide beta degradation products (β-CTX), osteocalcin], and adverse reactions were compared between the two groups. Statistical analysis was performed using χ² tests and t tests. Results　The total effective rate in the observation group was higher than that in the control group [96.72% (59/61) vs. 80.70% (46/57)], with a statistically significant difference (χ²=7.714, P=0.005). After 4 weeks of treatment, the main symptom scores, secondary symptom scores, DAS28, and CDAI in the observation group were (2.56±0.38, 8.26±1.74, 2.32±0.58, 8.26±1.04) points, all lower than those in the control group (4.08±0.41, 10.25±1.86, 3.74±0.69, 11.74±1.68) points. The levels of C-reactive protein, erythrocyte sedimentation rate, rheumatoid factor, ALP, and β-CTX in the observation group were (18.63±2.84) mg/L, (21.52±3.74) mm/h, (93.52±12.84) U/ml, (70.26±4.26) U/L, and (0.72±0.08) µg/L, respectively, while in the control group they were (32.89±3.01) mg/L, (36.05±4.08) mm/h, (137.45±15.96) U/ml, (79.18±4.24) U/L, and (0.79±0.09) µg/L. The osteocalcin level in the observation group was higher than that in the control group [(39.84±4.85) µg/L vs. (34.05±4.38) µg/L]. Comparisons of the above indicators showed statistically significant differences (all P<0.05). The overall incidence of adverse reactions did not differ significantly between the two groups (P>0.05). Conclusion　Qiju Dihuang decoction combined with methotrexate shows significant efficacy in treating RA patients with liver and kidney deficiency syndrome, improving bone metabolism indicators, reducing the inflammatory state of the body, and lowering disease activity, with acceptable clinical safety.

Clinical efficacy of modified Maxing Shigan decoction combined with anti-allergic decoction plus conventional western medicine in the treatment of children with cough variant asthma

Ni Li, Han Gailin

2025, 31(13):  2237-2241.  DOI: 10.3760/cma.j.cn441417-20250318-13025

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Objective　To investigate the clinical efficacy of modified Maxing Shigan decoction combined with anti-allergic decoction plus conventional Western medicine in the treatment of children with cough variant asthma (CVA). Methods　A prospective study was conducted on 175 children diagnosed with CVA who were admitted to the Department of Pediatrics, Xianyang Central Hospital, from January 2021 to January 2024. Using a random number table method, the children were divided into a treatment group and a control group. The control group (n=86) included 50 males and 36 females, aged (8.31±2.55) years; the treatment group (n=89) included 52 boys and 37 girls, aged (8.26±2.59) years. The control group was given oral Montelukast Sodium chewable tablets: children aged 2-5 years took 4 mg once nightly before bedtime, and children aged 6-15 years took 5 mg once nightly before bedtime. The treatment group received modified Maxing Shigan decoction combined with an anti-allergic decoction additionally, with 200 ml administered twice daily (morning and evening) on top of the control group regimen. Both groups received treatment for 4 weeks. The two groups were compared in terms of clinical efficacy, clinical indicators, traditional Chinese medicine (TCM) syndrome scores, immune function, and incidence of adverse reactions. Statistical analysis was performed using t tests and χ² tests. Results　The total effective rate in the treatment group was higher than that in the control group [89.89% (80/89) vs. 69.77% (60/86)], with a statistically significant difference (χ²=11.066, P=0.001). After 4 weeks of treatment, the durations for sputum resolution, cough resolution, normalization of body temperature, and resolution of wheezing in the treatment group were (4.21±0.89, 7.12±1.05, 5.51±1.02, 4.41±1.24) d, compared to (7.92±0.96, 9.33±1.02, 7.26±1.11, 6.95±1.36) d in the control group, with statistically significant differences (all P<0.001). The scores for dry cough with little sputum, sallow complexion, shortness of breath, sweating, pale red tongue, and thin white or yellow tongue in the treatment group were lower than those in the control group, while levels of IgG, IgA, and IgM were higher in the treatment group compared to the control group (all P<0.05). The overall incidence of adverse reactions did not differ significantly between the two groups (χ²=0.132, P=0.715). Conclusion　Modified Maxing Shigan decoction combined with anti-allergic decoction plus conventional western medicine significantly improves clinical symptoms and immune function in children with CVA, establishing the regimen as a safe and effective treatment method.

Efficacy of Sushen decoction combined with triple therapy on helicobacter pylori-associated gastritis in children: a prospective randomized controlled study 

Chen Yaohua, You Xiying, Zhang Mintao

2025, 31(13):  2242-2247.  DOI: 10.3760/cma.j.cn441417-20241105-13026

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Objective　To explore the efficacy of Sushen decoction combined with triple therapy in the treatment of Helicobacter pylori (HP) -related gastritis. Methods　This study is a prospective, randomized, concurrent control study, 80 children with HP-associated gastritis at Xi'an Traditional Chinese Medicine Hospital from January 2022 to June 2023 were selected as research subjects and randomly divided into a single therapy group and a combined therapy group, with 40 cases in each group. The single therapy group included 23 males and 17 females, aged (10.25±1.55) years and the disease duration was (6.12±1.03) months; they received triple therapy (omeprazole enteric-coated tablets + clarithromycin tablets + amoxicillin capsules), all taken orally 30 minutes after meals for 3 weeks. The combined therapy group included 22 males and 18 females, aged (10.58±1.21) years and the disease duration was (6.27±0.97) months; they received SuShen decoction in addition to the treatment in the single therapy group, at a dose of 1 dose per day, prepared with 100-150 ml of water, taken warm 30 minutes after breakfast and dinner for 3 weeks. The clinical efficacy, improvement of clinical symptoms, traditional Chinese medicine syndrome scores, serum inflammatory factors [C-reactive protein (CRP), interleukin (IL)-6, and soluble interleukin-2 receptor (sIL-2R)] levels, immune function [serum immunoglobulin M (IgM), immunoglobulin G (IgG), and CD4⁺, CD8⁺ levels], HP eradication rates, and recurrence rates of major symptoms were assessed in both groups. Statistical analysis was conducted using χ² test, t test, Fisher's exact probability test, and Mann-Whitney U test. Results　The total effective rate in the combined therapy group was higher than that in the single therapy group [97.2% (39/40) vs. 82.5% (33/40)], with a statistically significant difference (χ²=5.000, P=0.025). After 3 weeks of treatment, the clinical symptoms and traditional Chinese medicine syndrome scores, as well as serum levels of CRP, IL-6, sIL-2R, and CD8⁺ in the combined therapy group were lower than those in the single therapy group (all P<0.05), while levels of IgM, IgG, and CD4⁺ were higher (all P<0.05). During the 3-month follow-up, the HP eradication rate in the combined therapy group was higher than that in the single therapy group [77.5% (31/40) vs. 55.0% (22/40)], and the recurrence rate of major symptoms was lower [5.0% (2/40) vs. 20.0% (8/40)], with both differences being statistically significant (χ²=4.528, 4.331; P=0.033, 0.037). Conclusion　Sushen decoction combined with triple therapy is effective in treating pediatric HP-related gastritis, helping to reduce inflammation, enhance immune function, increase HP negative rate, and lower the risk of recurrence of major symptoms.

Observation on the efficacy of Zhuanggu Chubi pill combined with isokinetic muscle strength training in the treatment of early and mid-stage knee osteoarthritis (cold and dampness obstructive type) 

Yin Xianghui, Chen Rong, Fan Bingyang, Li Xiong

2025, 31(13):  2247-2252.  DOI: 10.3760/cma.j.cn441417-20250312-13027

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Objective　To observe the efficacy of Zhuanggu Chubi pill combined with isokinetic strength training for early-mid knee osteoarthritis (cold-dampness obstructive type). Methods　A total of 120 outpatients with early and mid-stage knee osteoarthritis (cold and dampness obstructive type) were selected from Department of Sports Medicine of Yan'an Traditional Chinese Medicine Hospital from January 2024 to October 2024. Patients were randomly divided into four groups: control group, experimental group A, experimental group B, and experimental group C, with 30 patients in each group. The control group included 15 males and 15 females, aged (55.81±4.96) years; group A included 12 males and 18 females, aged (56.28±5.25) years; group B included 13 males and 17 females, aged (55.70±5.03) years; and group C included 10 males and 20 females, aged (56.15±5.37) years. The control group received celecoxib and functional exercise; group A received celecoxib, functional exercise, and Zhuanggu Chubi pills; group B received celecoxib, functional exercise, and isokinetic strength training; and group C received celecoxib, functional exercise, Zhuanggu Chubi pills, and isokinetic strength training. All groups were treated continuously for 4 weeks and followed up for 12 weeks. Clinical efficacy, traditional Chinese medicine (TCM) symptom grading scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, peak torque (PT) and total work (TW) at a quadriceps flexion/extension speed of 60°/s, and safety evaluations were compared among the four groups. Statistical methods included χ² test, rank-sum test, and analysis of variance. Results　The total effective rate in experimental group C was higher than that in the control group [93.33% (28/30) vs. 70.00% (21/30)], with a statistically significant difference (χ²=5.455, P=0.038). After 4 weeks of treatment and 12 weeks of follow-up, the traditional Chinese medicine symptom grading scores decreased in all four groups. The scores for experimental group A [(13.63±3.17) points, (10.13±2.73) points], group B [(12.57±2.77) points, (10.27±2.63) points], and group C [(10.33±2.80) points, (8.37±2.20) points] were all lower than those in the control group [(15.40±3.07) points, (12.07±2.57) points], with group C having the lowest scores (all P<0.05). WOMAC scores also decreased in all groups, with experimental group A [(22.47±7.67) points, (20.17±5.67) points], group B [(23.53±7.97) points, (20.37±5.77) points], and group C [(16.53±5.47) points, (13.30±4.27) points] being lower than the control group [(29.17±9.73) points, (26.13±7.37) points], and group C having the lowest scores (all P<0.05). Peak torque (PT) and total work (TW) increased in all groups, with experimental group C [(72.56±13.77) N·m, (74.86±12.93) N·m and (79.78±8.63) J, (80.83±8.42) J] being higher than the control group [(65.46±12.95) N·m, (66.71±13.06) N·m and (74.48±10.61) J, (75.01±9.54) J] (all P<0.05). During treatment, all four groups experienced mild adverse reactions that were self-limiting, and no significant abnormalities were observed in any indicators during follow-up. Conclusion　Zhuanggu Chubi Pills combined with isokinetic strength training is effective for early-mid knee osteoarthritis (cold-dampness obstructive type), improving knee function, reducing symptoms and pain, enhancing muscle strength, and maintaining advantages during follow-up.

Case Report

A case report and literature review of the delayed traumatic splenic rupture with hemorrhagic ascites as the first manifestation

Tong Jinyan, Lu Meizhi, Lei Zihan, Cao jiaqi, Li yumin, Yang Shen

2025, 31(13):  2253-2256.  DOI: 10.3760/cma.j.cn441417-20250219-13028

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Patients with end-stage renal failure undergoing peritoneal dialysis often present with multiple confounding factors, resulting in a relatively high incidence of complications and mortality. Delayed splenic rupture, due to its latent period, is often misdiagnosed or overlooked in clinical practice, leading to delays in treatment. The authors conducted a retrospective analysis of a successfully treated case in People's Hospital of Guangzhou Huadu District, where the initial manifestation was hemoperitoneum in peritoneal dialysis fluid, ultimately diagnosed as delayed splenic rupture due to trauma. This analysis includes the cause, treatment process, and follow-up data outside the hospital, aiming to enhance medical professionals'understanding of the complications of delayed splenic rupture in this special population, thereby aiding in early diagnosis and treatment.

A case of relapsed/refractory peripheral T-cell lymphoma treated with EZH2 inhibitors and literature review 

Zhang Ziwei, Yan Jiaxin, Gao Na

2025, 31(13):  2256-2259.  DOI: 10.3760/cma.j.cn441417-20250110-13029

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This article reports a case of relapsed/refractory peripheral T-cell lymphoma treated with an enhancer of zeste homolog 2 (EZH2) inhibitor. Peripheral T-cell lymphoma is a rare and highly heterogeneous and aggressive lymphoproliferative disease originating from post-thymic mature T cells or mature NK cells, characterized by a poor overall prognosis and a high recurrence rate after first-line treatment. There are limited treatment options for relapsed/refractory peripheral T-cell lymphoma. EZH2 is a histone methyltransferase widely expressed in various tumor cells, and its expression is associated with the progression and poor prognosis of peripheral T-cell lymphoma. Therefore, inhibiting EZH2 activity has become a therapeutic target for relapsed/refractory peripheral T-cell lymphoma.

Nursing Research

Application of self-care management guided by the empowerment theory in patients with advanced lung cancer pain 

Guo Yuxia, Wang Yanhui

2025, 31(13):  2260-2264.  DOI: 10.3760/cma.j.cn441417-20241216-13030

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Objective　To explore the effect of self-care management guided by the empowerment theory in patients with advanced lung cancer pain. Methods　A total of 78 patients with advanced lung cancer pain admitted to Zhumadian Central Hospital from May 2022 to May 2024 were selected for a prospective study, and were divided into two groups according to the random number table method, with 39 cases each group. In the control group, there were 25 males and 14 females, aged 53-76 (64.59±3.21) years, with a body mass index of 18.2-25.7 (21.95±1.01) kg/m², 22 cases in stage Ⅲ and 17 cases in stage Ⅳ. In the observation group, there were 26 males and 13 females, aged 54-77 (64.62±3.26) years, with a body mass index of 18.3-25.8 (21.96±1.04) kg/m², 23 cases in stage Ⅲ and 16 cases in stage Ⅳ. The control group received routine care, while the observation group received self-care management guided by the empowerment theory. Both groups were continuously cared and observed for 30 days. The mood states, pain, cancer-related fatigue, and self-management abilities of the two groups were compared. Statistical analysis was performed using independent sample t-test, paired t-test, and χ² test. Results　After nursing, the scores of tension-anxiety, anger-hostility, wearing-lethality, disorient-confusion, and depression-dejection of the Profile of Mood States (PMS-SF) in the observation group were (9.53±1.07) points, (12.82±1.64) points, (7.35±1.04) points, (8.38±1.08) points, and (8.38±1.28) points, which were lower than those in the control group [(14.71±1.19) points, (17.63±1.94) points, (11.89±1.17) points, (12.92±1.14) points, and (12.43±1.67) points]; the scores of energy-vitality and self-related emotions were (18.98±1.94) points and (15.95±1.42) points, which were higher than those in the control group [(13.83±1.81) points and (13.73±1.35) points] (t=20.214, 11.825, 18.112, 18.055, 12.020, 12.122, and 7.076; all P<0.05). After nursing, the scores of Visual Analogue Scale (VAS) and Cancer Fatigue Scale (CFS) in the observation group were (4.03±0.57) points and (29.06±2.12) points, which were lower than those in the control group [(5.49±1.12) points and (35.53±2.18) points] (t=7.255 and 13.287, both P<0.05). After nursing, the scores of self-care skills, self-concept, health knowledge level, and self-responsibility of the Exercise of Self-Care Agency Scale (ESCA) in the observation group were (32.51±2.29) points, (23.71±1.84) points, (48.83±2.81) points, and (16.86±1.47) points, which were higher than those in the control group [(26.43±2.17) points, (19.85±1.73) points, (35.76±2.44) points, and (13.39±1.42) points] (t=12.035, 9.545, 21.933, and 10.603, all P<0.05). Conclusion　Self-care management guided by the empowerment theory can effectively regulate the mood state in patients with advanced lung cancer pain, alleviate the physiological pain, reduce the degree of cancer-related fatigue, and help patients better manage the disease.

Application effect of hierarchical chain nursing combined with vibration sputum elimination in patients with severe pneumonia 

Yin Hongying, Ye Jiawei

2025, 31(13):  2264-2268.  DOI: 10.3760/cma.j.cn441417-20250121-13031

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Objective　To observe the application effect of hierarchical chain nursing combined with vibration sputum elimination in patients with severe pneumonia. Methods　In a prospective study, 86 patients with severe pneumonia admitted to Jiujiang First People's Hospital from August 2022 to August 2024 were selected and divided into two groups of 43 each according to the random number table method. The control group included 25 males and 18 females, aged (64.02±4.67) years and a disease duration of (3.31±0.30) years, receiving routine nursing care and percussion-based sputum clearance. The observation group consisted of 23 males and 20 females, aged (63.85±4.62) years and a disease duration of (3.25±0.34) years, receiving hierarchical chain nursing combined with a vibrating sputum clearance device. Both groups underwent continuous intervention for 5 days. Clinical symptom improvement times, daily sputum volume, pulmonary function indicators [forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), maximum voluntary ventilation (MVV)], and nursing satisfaction were compared. Statistical methods included t tests and χ² tests. Results　In the observation group, the time to fever resolution, disappearance of lung rales, and cough resolution were (2.57±0.38, 8.85±0.54, 6.35±0.48) d, all shorter than those in the control group [(3.64±0.52, 10.76±0.76, 8.52±0.62) d]. The daily sputum volume in the observation group was higher than that in the control group [(34.28±3.79) ml vs. (29.86±2.85) ml], with all differences being statistically significant (all P<0.05). After 5 days of intervention, the FVC, FEV1, and MVV in the observation group were (2.71±0.46, 2.03±0.37, 68.58±6.46) L, compared to (2.48±0.38, 1.72±0.28, 58.62±5.37) L in the control group, with significant differences (all P<0.05). The overall nursing satisfaction rate in the observation group was higher than that in the control group [95.35% (41/43) vs. 79.07% (34/43)], with a statistically significant difference (χ²=5.108, P=0.024). Conclusion　The intervention of cascade nursing combined with vibration sputum elimination is beneficial to promote expectoration, improve lung function and clinical symptoms, and improve nursing satisfaction in patients with severe pneumonia.

Effect of nursing intervention model based on humanistic care concept on negative emotions and self-care ability of patients with hypertension 

Wang Jie, Li Ping, Lyu Haichen

2025, 31(13):  2269-2272.  DOI: 10.3760/cma.j.cn441417-20250211-13032

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Objective　To analyze the effect of nursing intervention model based on the concept of humanistic care on negative emotions and self-care ability of hypertensive patients. Methods　A retrospective analysis was conducted on 90 hypertensive patients admitted to Shaanxi Traditional Chinese Medicine Hospital from December 2023 to November 2024. Patients were randomly assigned to a reference group and an observation group, with 45 patients in each group. In the reference group, there were 26 males and 19 females, aged (55.72±4.31) years and the disease duration was (8.42±1.53) years. In the observation group, there were 24 males and 21 females, aged (54.18±3.95) years and the disease duration was (8.93±1.72) years. The reference group received routine nursing interventions, while the observation group received nursing interventions based on the concept of humanistic care. Both groups underwent continuous intervention for 3 months. Blood pressure indicators [systolic and diastolic blood pressure], negative emotion scores [Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA)], self-care ability scores (Self-Care Ability Scale), and nursing satisfaction were compared before and after the 3-month intervention. Statistical analysis was performed using Fisher's exact probability method and t tests. Results　After 3 months of intervention, the systolic and diastolic blood pressure in the observation group were (116.94±6.82, 82.94±6.26) mmHg (1 mmHg=0.133 kPa), both lower than those in the reference group [(131.52±7.18, 90.13±5.65) mmHg], with statistically significant differences (t=9.877, 5.720, both P<0.001). The HAMD and HAMA scores in the observation group were lower than those in the reference group [(15.39±3.16) points vs. (20.07±3.81) points, (11.68±3.17) points vs. (16.72±3.41) points] (t=6.342, 7.262, both P<0.001). In the observation group , the scores in the self-care ability scale for health knowledge, self-care responsibility, self-concept, and self-care skills were all higher, with statistically significant differences (all P<0.001). The overall nursing satisfaction rate in the observation group was higher than that in the reference group [97.78% (44/45) vs. 82.22% (37/45)], with a statistically significant difference (P=0.030). Conclusion　Implementing nursing interventions based on the concept of humanistic care in hypertensive patients can effectively improve their blood pressure indicators, alleviate negative emotions, enhance self-care abilities, and achieve better nursing satisfaction.

The effect of thrombosis risk assessment combined with cluster nursing on deep venous thrombosis in orthopedic trauma

Wang Yali, Liu Ning, Song Botao

2025, 31(13):  2273-2277.  DOI: 10.3760/cma.j.cn441417-20250213-13033

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Objective　To analyze the effect of thrombosis risk assessment combined with cluster nursing on deep venous thrombosis in patients with orthopedic trauma. Methods　A retrospective analysis was conducted on 106 trauma patients admitted to department of Orthopedics, Shangluo Traditional Chinese Medicine Hospital from December 2023 to November 2024. Patients were divided into a reference group and an intervention group, with 53 cases in each group, using a random number table method. The reference group comprised 29 males and 24 females, aged (46.27±6.13) years; the intervention group had 27 males and 26 females, aged (45.83±5.94) years. The reference group was given routine nursing mode, and the intervention group was given thrombosis risk assessment combined with cluster nursing mode. Both groups were intervened for 1 month. The two groups were compared before and after nursing intervention regarding lower limb blood flow velocity (popliteal vein, total femoral vein, superficial femoral vein), coagulation function indicators [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (FIB)], quality of life (physical function, psychological function, material life, social function), incidence of deep venous thrombosis, and nursing satisfaction. Statistical analysis was performed using χ² test and t test. Results　After 1 month of intervention, the blood flow velocity of popliteal vein, common femoral vein and superficial femoral vein in the intervention group were all higher than those in the reference group [(15.34±1.61) cm/s vs. (13.89±1.83) cm/s, (19.43±1.38) cm/s vs. (17.43±1.52) cm/s, (16.53±1.64) cm/s vs. (15.46±1.15) cm/s], with statistically significant differences (t=4.331, -7.092, -3.889, P<0.05). The levels of PT and APTT in the intervention group were higher than those in the reference group [(20.34±2.64) s vs. (16.79±2.57) s, (14.85±2.74) s vs. (12.04±2.68) s], while FIB was lower in the intervention group [(5.53±0.72) g/L vs. (6.20±1.04) g/L], with all differences being statistically significant (t=-7.015, -5.337, -3.856, all P<0.001). The scores for physical function, psychological function, material life, and social function in the Quality of Life Comprehensive Assessment Questionnaire-74 were higher in the intervention group than in the reference group (all P<0.001). The overall nursing satisfaction rate in the intervention group was higher than that in the reference group [98.11% (52/53) vs. 86.79% (46/53)], and the incidence of deep venous thrombosis was lower in the intervention group [3.77% (2/53) vs. 16.98% (9/53)], with both differences being statistically significant (all P<0.05). Conclusion　The implementation of thrombosis risk assessment combined with cluster nursing in patients with orthopedic trauma can improve the venous blood flow velocity and coagulation function of lower limbs, improve the quality of life, reduce the risk of deep venous thrombosis, and have higher nursing satisfaction.

Investigation Report

Research on the competency requirements for general practitioners

Chen Qingmei, Ding Xin, Xue Gen, Ding Jiao

2025, 31(13):  2278-2285.  DOI: 10.3760/cma.j.cn441417-20250208-13034

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Objective　To investigate the competency requirements for general practitioners, improve training programs, and enhance job competency. Methods　This study selected 100 officially employed general practitioners from various levels of hospitals across more than ten provinces (including Sichuan, Shanghai, Jiangsu, and Guangzhou) from September 2023 to August 2024, and distributed questionnaires to them. A questionnaire survey was conducted, including basic information about the participants and their competency needs. The survey assessed the competencies that general practitioners should possess in five areas: patient-centered care, professional qualities, teamwork, problem-solving, and continuous learning. A total of 100 anonymous questionnaires were distributed, with 93 valid responses collected, resulting in a response rate of 93.00%. Among the 93 general practitioners, there were 44 males and 49 females, with age distribution as follows: 14 cases of 20～≤30 years, 43 cases 30～≤40 years, 28 cases 40～≤50 years, and 8 cases >51 years. Results General practitioners indicated that patient-centered care [76.34% (71/93)], professional qualities [76.34% (71/93)], teamwork [72.04% (67/93)], problem-solving abilities [69.89% (65/93)], and continuous learning capabilities [66.67% (62/93)], were both important. There were deficiencies in patient-centered literacy, which enabled patients and their families to participate in the treatment process [74.19% (69/93)], professional general practitioners with residents ' health management ability [80.65% (75/93)], and teamwork ability to develop diagnosis and treatment programs in a teamwork manner [78.49% (73/93)]; and there was a serious lack of problem-solving abilities among general practitioners [83.87% (78/93)], particularly in emergency handling of sudden medical and health incidents [80.65% (75/93)] and in the systematic analysis of complex events and decision-making abilities [81.72% (76/93)]. Conclusions　Strengthening patient-centered practice capabilities is a current requirement for the competency of general practitioners in China. It is recommended that future training for general practitioners focus on patient needs, encouraging the participation of patients and their families in the treatment process. Regarding professional qualities, training should be enhanced for general practitioners in resident health management. In terms of professional abilities, training should be strengthened in teamwork for developing treatment plans, emergency response capabilities for sudden medical and health incidents, and systematic analysis of complex events and decision-making skills.