Table of Content

01 July 2025, Volume 31 Issue 14

Previous Issue   

Reproductive Medicine

Willingness to undergo re-treatment of patients with no transferable embryos after first IVF/ICSI treatment 

Tian Ye, Xu Yanping

2025, 31(14):  2290-2294.  DOI: 10.3760/cma.j.cn441417-20250414-14001

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the willingness and influencing factors of patients who underwent their first in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment at Reproductive Medical Center, Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital and had no transferable embryos to undergo IVF/ICSI again. Methods　A retrospective analysis was performed on 375 patients who underwent their first IVF/ICSI treatment at Reproductive Medical Center, Department of Obstetrics and Gynecology, Tianjin Medical University General Hospital from January 2016 to October 2024 and had no transferable embryos. As of April 2025, the patients were divided into a return visit group (280 cases) and a non-return visit group (95 cases) according to whether they underwent IVF/ICSI again at our center. The clinical data of the two groups were collected and analyzed through an electronic medical record system, and the factors potentially influencing repeated assisted reproduction were statistically analyzed. Further analysis was performed on the 280 couples who returned, and they were divided into a within-half-a-year return visit group (218 cases) and a beyond-half-a-year return visit group (62 cases) according to whether they underwent IVF/ICSI again within half a year. Independent sample t test and χ² test were used to compare the differential indicators between the two groups. The binary logistic regression was used to observe the influencing factors of the willingness to return within half a year. Results　The proportion of the patients with no transferable embryos who underwent IVF/ICSI again was 74.67% (280/375). Comparing the data characteristics between the return visit group and the non-return visit group, there were statistical differences in male age and female age (both P<0.050), while there were no statistical differences in infertility type, infertility duration, infertility indication, whether having children, residence in Tianjin, and number of oocytes retrieved (all P>0.05). The logistic regression showed that whether to undergo repeated assisted reproduction in the patients with no transferable embryos after the first IVF/ICSI was significantly correlated with the couple's age (P=0.015, OR=1.057, 95%CI 1.011-1.106). In the return visit group, the number of oocytes retrieved in the first IVF/ICSI (P=0.046, OR=1.063, 95%CI 1.001-1.128) and the type of infertility (P=0.002, OR=2.707, 95%CI 1.425-5.139) were associated with whether the patients underwent repeated assisted reproduction within half a year. Conclusions　The couple's age is an important factor affecting the willingness of patients with no embryos after the first IVF/ICSI treatment to undergo repeated assisted reproduction. The total number of oocytes retrieved in the first IVF/ICSI and the type of infertility may predict whether patients will return for repeated assisted reproduction within half a year.

Pregnancy outcome factors of traditional Chinese medicine sequential therapy for patients with repeated embryo implantation failure 

Song Shuxia, Pan Mingwo, He Tiantian, Zhu Ling

2025, 31(14):  2294-2298.  DOI: 10.3760/cma.j.cn441417-20250326-14002

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze pregnancy outcome factors of traditional Chinese medicine sequential therapy for patients with repeated embryo implantation failure (RIF). Methods　A total of 48 patients with RIF who underwent embryo transfer in Guangdong Women and Children Hospital from August 2022 to December 2023 were selected for the retrospective study. All the patients took traditional Chinese medicine sequential therapy before and after embryo transfer. They were divided into a success group (25 cases, live birth) and a failure group (23 cases) according to the pregnancy outcomes. The success group were (33.1±5.3) years old, and had 2-7 times of embryo implantation failure. The failure group were (35.2±5.7) years old, and had 2-8 times of embryo implantation failure. The basic data, high-quality embryo numbers/rates, total gonadotropins (Gn) dosages, and estradiol (E2) levels at Gn initiation were compared between the two groups by t test. The correlations of the high-quality embryo number/rate, total Gn dosage, and E2 level at Gn initiation with pregnancy outcomes were analyzed by Spearman. Results　There were no statistical differences in the basic data between the two groups (all P>0.05). The high-quality embryo number and rates and E2 level at Gn initiation in the success group were higher than those in the failure group [8.9±5.3 vs. 5.9±4.8, 73.0 (58.0,88.0)% vs. 67.0 (33.0,80.0)%, and 38.5 (9.1, 206.1) pmol/L vs. 32.2 (25.9, 54.1) pmol/L], and the total Gn dosage was lower [800 (1 500, 2 550) IU vs. 1 950(1 500, 2 700) IU], with statistical differences between the two groups (all P<0.05).The number/rate of high-quality embryos, the total dosage of Gn, and the E2 level at the time of Gn initiation were correlated with the patients' pregnancy outcomes (r = 0.305, 0.182, -0.117, and 0.287). Conclusion　The number/rate of high-quality embryos, total Gn dosage, and E2 level at Gn initiation are correlated with the pregnancy outcomes of patients with RIF.

Genetic factors and prediction model establishment of chromosome microarray analysis technique in embryo damage

Yan Hongwei, Qu Ping, Jia Qingge, Yin Ting

2025, 31(14):  2299-2304.  DOI: 10.3760/cma.j.cn441417-20250217-14003

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the application value of chromosome microarray analysis (CMA) in the analysis of genetic factors of embryo damage, to identify the risk factors of embryo damage, and to establish a clinical prediction model. Methods　One hundred and twenty patients with embryo damage who underwent uterine ablation at Xi'an High-tech Hospital from July 2023 to December 2024 selected; they were (33.5±1.9) years old; their body mass index was (23.8±2.2) kg/m²; 84 cases had 1-2 pregnancies, and 36 cases ≥3 pregnancies; 25 cases had no induced abortion, 79 cases 1-2 times of induced abortion, and 16 cases ≥3 times. One hundred women with normal pregnancy who voluntarily requested artificial termination of pregnancy during the same period were taken as the controls; they were (30.4±2.6) years old; their body mass index was (24.3±2.5) kg/m²; 85 cases had 1-2 pregnancies, and 15 cases ≥3 pregnancies; 60 cases had no induced abortion, 33 cases 1-2 times of induced abortion, and 7 cases ≥3 times. The chromosomal abnormalities and their distribution were observed in both groups by CMA detection of fluidproduct villi tissue. χ² and t tests were used for the statistical comparisons. The logistic regression was used to analyze the related independent risk factors affecting embryo damage, and the risk model of embryo damage was established. Hosmer-lemeshow was used to evaluate the fit degree of the prediction model, and the receiver operating characteristic curve (ROC) was used to verify the diagnostic value of the model. Results　In the observation group, 82 cases (68.3%) of chromosome abnormalities were detected by CMA, including 75 cases of abnormal chromosome number, 5 cases of abnormal structure, and 2 cases of other abnormalities. Three cases (3.0%) of abnormal chromosome number were detected by CMA in the control group. The chromosome abnormality rate in the observation group was significantly higher than that in the control group (χ²=98.202; P<0.001). The most common abnormal number of chromosomes in the embryos was autosomal trisomy (52.4%, 43/82), such as 16-trisomy (8 cases, 9.8%), 22-trisomy (6 cases, 7.3%), 21-trisomy (5 cases, 6.1%), and 15-trisomy (4 cases, 4.9%); X sex chromosome abnormality was the second (22 cases, 26.8%). Age, number of induced abortion, bad living habits, previous history of embryo damage, blood β-HCG level, and chromosome abnormality were the independent risk factors for embryo damage in early pregnancy (all P<0.05). According to the binary logistic regression, the prediction model of embryo damage was constructed. The Hosmer-lemeshow test model had good fit. The area under the curve of the predictive model verified by ROC was 0.935 (0.902-0.978), with a sensitivity of 94.2%, a specificity of 80.8%, and high predictive value. Conclusions　Abnormal chromosome number is an important cause of embryo damage. The application of CMA in genetic diagnosis of embryo damage can provide guidance for the evaluation of reproductive risk of patients. The risk model of embryo damage constructed in this study has good predictive value.

Exploration on mechanism of embryo damage based on TGF-β1, E-Cad, and related signaling pathways 

Wang Dongliang, Liu Yuling

2025, 31(14):  2305-2309.  DOI: 10.3760/cma.j.cn441417-20250123-14004

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the mechanism of embryo damage based on transforming growth factor β1 (TGF-β1), E-cadherin (E-Cad), and related signaling pathways. Methods　The group design study was performed between February and November 2024. The rats with embryo damage during suitable pregnancy were selected to isolate placental trophocytes. The trophocytes with TGF-β1 overexpresssion were constructed. TGF-β1, E-Cad, Smad-dependent signaling pathways (Smad2, Smad3, Smad4), and non-Smad-dependent signaling pathway [phosphatidylinositol 3-kinase (PI3K)] in the cells were detected by the fluorescence quantitative polymerase chain reaction. The effects of Smad signal activator (SRI-011381) and PI3K activator (740Y-P) on E-Cad were observed. One-way analysis of variance and independent sample t test were used for the statistical analysis. Results　The levels of TGF-β1, Smad2, Smad3, Smad4, and PI3K mRNA in the pcDNA3.1-TGF-β1 group were all higher than those in the normal group (3.15±0.21 vs. 1.00±0.15, 2.12±0.19 vs. 1.00±0.13, 1.94±0.22 vs. 1.00±0.09, 1.73±0.20 vs. 1.00±0.14, and 1.98±0.24 vs. 1.00±0.11), while the level of E-Cad mRNA was lower (0.51±0.08 vs 1.00±0.12). The levels of Smad2, Smad3, and Smad4 mRNA in the SRI-011381 group were higher than those in the normal group (2.58±0.22 vs. 1.00±0.13, 2.27±0.24 vs. 1.00±0.15, and 2.04±0.19 vs. 1.00±0.11), while the level of E-Cad mRNA was lower (0.47±0.07 vs. 1.00±0.09). The level of PI3K mRNA in the 740Y-P group was higher than that in the normal group (2.36±0.20 vs. 1.00±0.12), while the level of E-Cad mRNA was lower (0.55±0.09 vs. 1.00±0.08). There were statistical differences in the above indicators between the groups (all P<0.05). Conclusion　TGF-β1 may inhibit the expression of E-Cad activating Smad and PI3K signaling pathways, and inhibit embryo damage.

New Medical Advances

Research progress on function and mechanism of PAI-1 in bladder cancer 

Liu Shuaimei, Hou Yanqiang

2025, 31(14):  2310-2313.  DOI: 10.3760/cma.j.cn441417-20241113-14005

Asbtract ( )  

References | Related Articles | Metrics

Plasminogen activator inhibitor-1 (PAI-1), a member of the serine protease inhibitor superfamily, is a pleiotropic factor that plays a variety of cellular effects, many of which are potentially related to the occurrence and development of tumors, including cell migration, invasion, adhesion, and angiogenesis, laying the foundation for potential therapeutics and the development of new drugs. PAI-1 over-expression in many types of cancers has been found to be an indicator of poor prognosis. Studies suggest that PAI-1 can be used as a potential predictive biomarker and therapeutic target in the clinical treatment of bladder cancer. In this paper, the function and mechanism of PAI-1 in bladder cancer are discussed.

Application of injection therapy in androgenic alopecia 

Cao Yinghan, Gao Yu

2025, 31(14):  2313-2316.  DOI: 10.3760/cma.j.cn441417-20241213-14006

Asbtract ( )  

References | Related Articles | Metrics

Injection therapy is a significant treatment method for androgenic alopecia (AGA). Currently, local injections of platelet concentrates, botulinum toxin type A (BoNT/A), stem cells, and stromal vascular fraction (SVF) have been used in clinical practice. This article offers a comprehensive review of these injection therapy methods in AGA.

Meta Analysis

Bifidobacterium preparations combined with enteral nutrition for severe acute pancreatitis: a meta-analysis

Li Yang, Zhou Ze, Liu Jinxiang, Shi Ying, Ma Xiaobing, Jing Zhiqiang

2025, 31(14):  2317-2323.  DOI: 10.3760/cma.j.cn441417-20241125-14007

Asbtract ( )  

References | Related Articles | Metrics

Objective　To evaluate the efficacy and safety of bifidobacterium preparations and enteral nutrition for severe acute pancreatitis. Methods　China National Knowledge Infrastructure (CNKI), VIP, Wanfang Data, PubMed, and Embase were searched for the clinical trials published from their establishment to June 2024. The RevMan 5.3 software was used for the meta-analysis of the included researches. The Cochrane handbook5.3 was used to evaluate the literature quality. Results　Nineteen randomized controlled trials were included. The meta analysis results showed that there were statistical differences in the levels of C-reactive protein (CRP) (SMD=-3.72, 95%CI -4.67--2.78, Z=7.74, P<0.01), interleukin (IL)-6 (SMD=-2.44, 95%CI -3.38--1.48, Z=5.07, P<0.01), IL-8 (SMD=-2.66, 95%CI -3.68--1.64, Z=5.13, P<0.01), tumor necrosis factor (TNF)-α (SMD=-3.15, 95%CI -3.98--2.33, Z=7.51, P<0.01), white blood cell count (WBC) (SMD=-1.26, 95%CI -1.83--0.69, Z=4.30, P<0.01), amylase (AMY) (SMD=-0.98, 95%CI -1.30--0.66, Z=5.97, P<0.01), diamine oxidase (DAO) (SMD=-3.55, 95%CI -4.61--2.49, Z=6.54, P<0.01), lactic acid (Lac) (SMD=-2.93, 95%CI -3.76--2.10, Z=6.93, P<0.01, and endotoxin (SMD=-2.26, 95%CI -2.83--1.68, Z=7.63, P<0.01) between the two groups. Conclusions　Bifidobacterium preparations combined with enteral nutrition can effectively inhibit the inflammatory response of patients with severe acute pancreatitis, reduce the level of AMY, and promote their recovery.

Treatises

Levels and differences of vitamin D and fasting blood glucose in patients with polycystic ovary syndrome 

Xu Yanping, Sun Yue, Wang Jin, Tian Ye

2025, 31(14):  2324-2328.  DOI: 10.3760/cma.j.cn441417-20250208-14008

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the differences in the expression levels of serum vitamin D and fasting blood glucose in patients with polycystic ovary syndrome (PCOS). Methods　A retrospective study was conducted. Eighty-eight 20-40 years old patients with PCOS of childbearing age treated at Tianjin Medical University General Hospital from January 2022 to December 2024 were enrolled as a PCOS group. At the same time, 87 non-PCOS women who were 20-40 years old were included as a control group. The baseline data and expression levels of vitamin D and fasting blood glucose were compared between the PCOS group and the control group. The independent sample t test was used for the statistical comparisons. The receiver operating characteristic curve (ROC) was used to analyze the efficacy of vitamin D and fasting blood glucose for PCOS. The correlations between vitamin D and fasting blood glucose in the PCOS group and the control group were analyzed by Pearson test. Results　The body weight, body mass index (BMI), and serum fasting blood glucose level in the PCOS group were higher than those in the control group [(65.330±12.031) kg vs. (59.989±8.438) kg, (24.708±4.256) kg/m² vs. (22.737±3.169) kg/m², and (4.953±0.495) mmol/L vs. (4.790±0.377) mmol/L], while the serum vitamin D level was lower [(42.804±23.084) nmol/L vs. (53.083±18.366) nmol/L], with statistical differences (all P<0.05). The results of the ROC analysis showed that when the indicators were applied individually for prediction, the sensitivity and specificity of body weight were 0.545 and 0.701; the sensitivity and specificity of BMI were 0.489 and 0.759; the sensitivity and specificity of fasting blood glucose were 0.545 and 0.724; the sensitivity and specificity of vitamin D were 0.511 and 0.874. When the four indicators were combined for prediction, the sensitivity and specificity were 0.545 and 0.828. However, regardless of whether in the PCOS group or the control group, the correlation between vitamin D and fasting blood glucose was not strong (r=-0.093, -0.017, both P>0.05). Conclusions　The sensitivity and specificity of the combined prediction of high risk of PCOS using the four indicators are superior to any single indicator. However, the performance of the curve model is average. It can be appropriately used to assist in the prediction of high risk of PCOS in clinical practice.

Mechanism of N6 methyladenosine mediated FAM83H-AS1/miR-485-5p/PAK1 axis in regulating malignant progression of endometrial cancer 

Song Xiaoxia, Xi Wei, Liu He, Zhang Jinlei

2025, 31(14):  2328-2334.  DOI: 10.3760/cma.j.cn441417-20241106-14009

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effect of lncRNA FAM83H-AS1 modified by N6 methyladenosine (m6A) on the proliferation and invasion of endometrial cancer cells regulating the miR-485-5p/PAK1 axis. Methods　The endometrial cancer tissues and paired adjacent tissues from 76 patients who underwent surgical treatment in Department of Gynecology, Zhengzhou People's Hospital from February 2022 to September 2023 were collected. The expressions of lncRNA FAM83H-AS1 in the endometrial cancer tissues, adjacent normal tissues, endometrial cancer cells (HEP-1A, JEC, Ishikawa), and human normal endometrial cells (EEC) were detected by reverse transcription polymerase chain reaction (RT-PCR), respectively. The effect of m6A on lncRNA FAM83H-AS1 expression was detected by RT-PCR. The regulatory relationship of lncRNA FAM83H-AS1/miR-485-5p/PAK1 was analyzed by bioinformatics and dual luciferase assay. The cells were transfected to regulate the expression of lncRNA FAM83H-AS1 and miR-485-5p, and the cell proliferation and invasion were detected by CCK8 and Transwell. The one-way analysis of variance combined with post-Tukey event test and independent-sample t test were used for the statistical analysis. Results　The expression of lncRNA FAM83H-AS1 in the endometrial cancer tissues was higher than that in the adjacent tissues (4.8±1.3 vs.1.0±0.2, P=0.002 7). Compared with that in EEC, lncRNA FAM83H-AS1 was up-regulated in the endometrial cancer cells (HEP-1A, JEC, Ishikawa): Ishikawa (6.4±0.8, P<0.001), HEC-1A (3.2±0.5, P=0.017), and JEC (2.7±0.3, P=0.032); lncRNA FAM83H-AS1 was regulated by m6A modification. Compared with those in the sh-NC group, the cell proliferation and invasion in the sh-lncRNA FAM83H-AS1 group decreased (P<0.05). Overexpression of lncRNA FAM83H-AS1 promoted the proliferation and invasion of endometrial cells, and miR-485-5p could reverse this promotion effect. PAK1 gene was the target gene of miR-485-5p and positively correlated with lncRNA FAM83H-AS1 (r=0.73). Conclusions　LncRNA FAM83H-AS1 modified by m6A, as crRNA, competitively absorbs miR-485-5p, inhibits its expression, and up-regulates PAK1, promoting the proliferation and invasion of endometrial cancer cells probably.

Value of decision tree and logistic regression model in prediction of postpartum pelvic floor dysfunction in patients with gestational diabetes mellitus

Xing Yanni, Xiao Jinghua, Zhou Manhong, Zhang Wanwan, Wang Yanxia, Hao Lijun

2025, 31(14):  2335.  DOI: 10.3760/cma.j.cn441417-20250114-14010

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the value of decision tree and logistic regression model in the prediction of postpartum pelvic floor dysfunction in patients with gestational diabetes mellitus. Methods　Two hundred and four patients with gestational diabetes who gave birth and underwent pelvic floor function screening 42 d after delivery in Northwest Women's and Children's Hospital from September 2022 to September 2024 were selected as the study objects. The clinical data, such as age, pre-pregnancy body mass index (BMI), etc. were collected. According to whether they had postpartum pelvic floor dysfunction, the patients were divided into a pelvic floor dysfunction group and a non-pelvic floor dysfunction group. The clinical data were compared between the two groups. The decision tree model and multivariate logistic regression analysis model were constructed to analyze the risk factors of postpartum pelvic floor dysfunction in the patients with gestational diabetes mellitus. The data were compared between the two groups by independent sample t test and χ² test. A receiver operating characteristic curve (ROC) was drawn to analyze the risk prediction effects of the decision tree model and multivariate logistic regression model. Results　There were statistical differences in age, parity, neonatal weight, second stage of labor, history of pelvic operation, and pelvic floor function rehabilitation exercise between the two groups(all P<0.05). The multivariate logistic regression analysis showed that ≥35 years old (OR=3.702), parity ≥2 times (OR=2.054), neonatal weight > 4 000 g (OR=2.516), second stage of labor > 1 h (OR=7.744), history of pelvic surgery (OR=9.052), and no postpartum pelvic floor rehabilitation exercise (OR=18.504) were considered as the risk factors of postpartum pelvic floor dysfunction in the women with gestational diabetes mellitus (all P<0.05). The decision tree model showed that postpartum pelvic floor function rehabilitation exercise had the strongest correlation with postpartum pelvic floor dysfunction in the patients (χ²=27.886; P<0.001). The ROC analysis showed that the area under the curve (AUC) of the decision tree model for predicting postpartum pelvic floor dysfunction in the patients was 0.939, which was higher than the AUC of the multivariate logistic regression model (0.807). Conclusion　Both the decision tree and logistic regression model have certain predictive value for postpartum pelvic floor dysfunction in patients with gestational diabetes mellitus, and the decision tree model has a higher sensitivity.

Individualized prediction of fetal growth restriction in patients with ICP based on clinical features

Wang Xiaoli, Li Jie, Wang Bufei, Luo Limei

2025, 31(14):  2341-2346.  DOI: 10.3760/cma.j.cn441417-20241209-14011

Asbtract ( )  

References | Related Articles | Metrics

Objective　To construct a Nomogram model to predict fetal growth restriction in patients with intrahepatic cholestasis of pregnancy (ICP) based on the clinical features, and to verify its efficacy. Methods　The clinical data of 344 patients with ICP treated at Jinan Maternal and Child Health Hospital Affiliated to Shandong First Medical University from January 2018 to January 2024 were retrospectively analyzed. They were followed up until delivery. They were divided into an occurrence group and a non-occurrence group according to whether they had fetal growth restriction, and the clinical data were compared between the two groups by independent-sample t test and χ² test. The influencing factors of ICP complicated with fetal growth restriction were analyzed by the multivariate logistic regression analysis. The individualized prediction Nomogram model was constructed using the R software, and receiver operating characteristic curves (ROC) and calibration curves were drawn to verify the prediction efficacy of the model. Results　Among the 344 patients, 51 had fetal growth restriction, with an incidence rate of 14.83%. The proportions of the patients with pregnancy-induced hypertension syndrome and gestational diabetes mellitus and the level of total bile acid in the occurrence group were higher than those in the non-occurrence group(all P<0.05), and the amniotic fluid index and folic acid level were lower (both P<0.05). Pregnancy-induced hypertension syndrome (OR=2.675, 95%CI 1.382-5.179), gestational diabetes mellitus (OR=2.921, 95%CI 1.494-5.711), total bile acid (OR=1.956, 95%CI 1.089-3.515), amniotic fluid index (OR=0.471, 95%CI 0.285-0.780), and folic acid (OR=0.525, 95%CI 0.322-0.856) were the influencing factors of fetal growth restriction in the patients (all P<0.05). Taking the influencing factors as risk predictors, an individualized prediction Nomogram model for fetal growth restriction in the patients was constructed. The ROC showed that the area under the curve, sensitivity, and specificity for predicting fetal growth restriction in the patients with ICP were 0.932 (95%CI 0.869-0.970), 94.12%, and 85.67%, respectively; the calibration curve showed that the prediction probability of the model was close to the actual probability; the Hosmer-Lemeshow goodness-of-fit test showed that the fitting was good (χ²=1.905, P=0.312). Conclusions　Pregnancy-induced hypertension syndrome, gestational diabetes mellitus, total bile acid, amniotic fluid index, and folic acid are the influencing factors of fetal growth restriction in patients with ICP. The individualized prediction Nomogram model based on the above clinical features has good prediction efficacy for ICP complicated with fetal growth restriction and good clinical application value.

Clinical effect of cerebellar cTBS combined with peripheral rTMS in treatment of patients with post-stroke upper limb spasticity 

Jin Yanchun, Zhang Xulong, Guan Jie

2025, 31(14):  2347-2352.  DOI: 10.3760/cma.j.cn441417-20241210-14012

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effect of cerebellar continuous theta burst stimulation (cTBS) combined with peripheral low-frequency repetitive transcranial magnetic stimulation (rTMS) for patients with post-stroke upper limb spasticity and its impact on ApoB and BDNF levels. Methods　One hundred and twenty patients with post-stroke upper limb spasticity who underwent rehabilitation treatment at Shaanxi Rehabilitation Hospital between June 2023 and March 2024 were selected as the study objects. The patients were divided into three groups according to the treatment methods, with 40 cases in each group. There were 25 males and 15 females in the conventional group; they were (67.38±6.17) years old; their disease course was (4.28±1.10) years. There were 24 males and 16 females in the central stimulation group; they were (66.94±6.25) years old; their disease course was (4.54±1.21) years. There were 26 males and 14 females in the combined group; they were (67.15±6.36) years old; their disease course was (4.46±1.35) years. The conventional group took conventional rehabilitation training. The central stimulation group took bilateral cTBS and conventional rehabilitation training. The combined group took peripheral upper limb low-frequency rTMS, bilateral cTBS, and conventional rehabilitation training. All the three groups underwent treatment once per day, five times per week, for 8 weeks. The treatment effects were evaluated by the Modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA), Stroke-Specific Quality of Life Scale (SS-QOL), and National Institutes of Health Stroke Scale (NIHSS). The levels of apolipoprotein B (ApoB) and brain-derived neurotrophic factor (BDNF) and root mean squares (RMS) of upper limb surface electromyography (sEMG) were measured before and after the treatment. t, F, and χ² tests were used for the statistical analysis. Results　After the treatment, the scores of MAS, FMA, SS-QOL, and NIHSS in the combined group were 1.35±0.54, 28.60±2.25, 113.53±13.74, and 8.32±1.49; the scores in the conventional group were 2.52±0.78, 20.31±2.67, 91.39±9.67, and 10.42±2.86; the scores in the central stimulation group were 2.06±0.63, 23.08±2.86, 100.82±10.21, and 9.15±1.78. Under stretching conditions, the RMS's of the biceps brachii and triceps brachii in the combined group, the conventional group, and the central stimulation group were (13.35±3.21) μV/s and (13.15±2.06) μV/s, (21.67±4.68) μV/s and (21.35±3.59) μV/s, and (17.64±4.35) μV/s and (16.79±3.27) μV/s. Under resting conditions, the RMS's of the biceps brachii and triceps brachii in the combined group, the conventional group, and the central stimulation group were (10.25±1.66) μV/s and (12.80±1.79) μV/s, (16.85±2.18) μV/s and (17.14±2.32) μV/s, and (14.06±1.89) μV/s and (15.48±1.95) μV/s. The levels of ApoB and BDNF in the combined group, the conventional group, and the central stimulation group were (0.86±0.15) g/L and (20.65±3.08) μg/L, (1.42±0.37) g/L and (15.89±3.17) μg/L, and (1.05±0.24) g/L and (17.98±2.73) μg/L. There were statistical differences (all P<0.05). Conclusion　cTBS combined with peripheral low-frequency rTMS for patients with post-stroke upper limb spasticity can effectively improve their spasticity, motor function, levels of ApoB and BDNF, demonstrating superior efficacy compared to single central stimulation or conventional rehabilitation therapy.

Value of video electronystagmogram in diagnosis of postcirculation ischemic vertigo 

Zhang Le, Mu Pengying, Chen Weiqiang, Wang Chengjie, Liu Xiaohe

2025, 31(14):  2352-2355.  DOI: 10.3760/cma.j.cn441417-20240827-14013

Asbtract ( )  

References | Related Articles | Metrics

Objective　To study the value of video electronystagmogram in the diagnosis of postcirculation ischemic vertigo (PCIV). Methods　A total of 240 patients with PCIV treated at Yulin Xingyuan Hospital from August 2020 to August 2023 were selected as a PCIV group, including 132 males and 108 females who were (61.37±10.36) years old. Another 80 healthy volunteers during the same period were selected as a healthy group, including 47 males and 33 females who were (61.45±10.49) years old. Both groups were examined by video electronystagmus. The incidences of the abnormalities of spontaneous nystagmus, saccade test, follow-up test, visual motor test, and position test were compared between the two groups by χ² test. Results　The incidence rate of spontaneous nystagmus in the PCIV group was lower than that in the healthy group [8.75% (21/240) vs. 3.75% (3/80)], with a statistical difference between the two groups (P>0.05). In the saccade test, the incidence rates of low peak velocity, long latency, low precision, undershoot, and overshoot in the PCIV group were higher than those in the control group [12.50% (30/240) vs. 1.25% (1/80), 33.75% (81/240) vs. 3.75% (3/80), 26.25% (63/240) vs. 5.00% (4/80), 36.25% (87/240) vs. 6.25% (5/80), and 13.75% (33/240) vs. 2.50% (2/80)], with statistical differences between the two groups (all P<0.05). The abnormal rates of follow-up test, visual motor test, and position test in the PCIV group were higher than those in the healthy group [48.75% (117/240) vs. 3.75% (3/80), 68.75% (165/240) vs. 17.50% (14/80), and 73.75% (177/240) vs. 27.50% (22/80)], with statistical differences between the two groups (all P<0.05). Conclusion　Video electronystagmogram plays an auxiliary role in the diagnosis of PCIV.

Study of relationship between blood selenium level and stroke based on results of NHANES database 

Sun Lingling, You Xuemei, Zhao Rongjian, Meng Junpeng, Liu Lijuan, Han Bin

2025, 31(14):  2356-2360.  DOI: 10.3760/cma.j.cn441417-20240722-14014

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the relationship between blood selenium level and stroke. Methods　The data for the cross-sectional study were obtained from the National Health and Nutrition Examination Survey (NHANES) database of the United States from 2015 to 2020. After screening, 7 677 participants were included in this study. We examined the association between blood selenium and stroke using the multiple regression model. Interaction tests were used to assess the relationship between blood selenium and stroke in different subgroups. t and χ² tests were used for the statistical comparisons. Results　Among the 7 677 participants, there were 3 954 males (51.50%) and 3 723 females (48.50%). There were 369 cases (4.81%) of stroke and 7 308 (95.19%) cases of non-strokes. After adjusting all the variables, blood selenium was negatively correlated with stroke (OR=0.47, 95%CI 0.27-0.80, P=0.005 3). The dose-response correlation was analyzed using the smoothed curve fitting, and it revealed a linear negative correlation between blood selenium and stroke(P=0.011 3). The subgroup analyses showed that the negative correlation between blood selenium and stroke was stable between the subgroups. Conclusions　Blood selenium is negatively associated with the incidence of stroke in ≥20 years old Americans.

Effect of "bow tie sign" iliofascial multipoint block combined with sciatic nerve block in upper popliteal fossa during operation for elderly patients with diabetic feet 

Wu Wenbin, Wang Qin, Zeng Zisan

2025, 31(14):  2360-2365.  DOI: 10.3760/cma.j.cn441417-20241119-14015

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the anesthetic effects of "bow tie sign" iliofascial multipoint block and single point block combined with upper popliteal sciatic nerve block in upper popliteal fossa during operation for elderly patients with diabetic feet. Methods　Ninety-five elderly patients undergoing DF operation in Tongchuan People's Hospital from April 2021 to February 2024 were divided into a control group (46 cases) and an observation group (49 cases) according to the anesthesia methods. In the control group, there were 29 males and 17 females; they were (70.15±3.96) years old; the duration of DM was (13.02±2.98) years; the duration of DF was (2.43±0.34) years; there were 23 cases of American Society of Anesthesiologists (ASA) grade Ⅰ and 23 cases of grade Ⅱ. In the observation group, there were 25 males and 24 females; they were (69.52±3.45) years old; the duration of DM was (12.42±2.74) years; the duration of DF was (2.30±0.31) years; there were 26 cases of ASA grade Ⅰ and 23 cases of grade Ⅱ. The control group took "bow tie sign" iliofascial single point block and sciatic nerve block in upper popliteal fossa. The observation group took "bow tie sign" iliofascial multipoint block and sciatic nerve block in upper popliteal fossa. The hemodynamic indicators and stress indicators before anesthesia (T₀), 10 min after anesthesia (T₁), and 20 min after operation (T₂), sensation and motor nerve block onset and maintenance times, pain degrees, comfort degrees, and incidence rates of adverse reactions were compared between the two groups. χ² test, t test, and analysis of variance were used for the statistical analysis. Results　At T₁ and T₂, the mean arterial pressures (MAP) [(84.25±3.69) mmHg (1 mmHg=0.133 kPa) vs. (75.41±2.69) mmHg and (85.26±3.89) mmHg vs. (79.41±3.08) mmHg, heart rates (HR) [(70.23±3.26) beats/min vs. (68.17±3.67) beats /min and (71.05±3.54) beats/min vs. (72.36±3.78) beats/min], and blood oxygen saturation (SpO₂) [(87.62±4.05)% vs. (84.19±4.59)% and (89.47±4.87)% vs. (82.05±4.99)%] in the observation group were better than those in the control group (all P<0.05). At T₁ and T₂, the levels of cortisol (Cor) [(280.36±26.74) μg/L vs. (295.16±25.74) μg/L and (272.20±24.96) μg/L vs. (286.78±25.11) μg/L], endothelin (ET) [(77.56±8.24) ng/L vs. (83.47±9.74) ng/L and (71.29±7.15) ng/L vs. (76.96±8.14) ng/L], and malondialdehyde (MDA) [(67.52±3.54) μmol/L vs. (72.96±4.05) μmol/L and (61.47±3.28) μmol/L vs. (64.89±3.84) μmol/L] in the observation group were better than those in the control group (all P<0.05). The motor and sensory nerve block maintenance times in the observation group were longer than those in the control group [(356.24±19.57) min vs. (286.95±17.25) min and (382.41±23.62) min vs. (327.18±21.05) min; both P<0.05]. Twelve hours after surgery, the pain score and score of Bruggman Comfort Scale (BCS) in the observation group were lower than those in the control group (2.63±0.41 vs. 3.89±0.64 and 1.85±0.32 vs. 2.63±0.38; both P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the two groups (P>0.05). Conclusion　"Bow tie sign" iliofascial multipoint block combined with sciatic nerve block in upper popliteal fossa can effectively stabilize hemodynamics, reduce stress response, relieve postoperative pain, and do not increase adverse reactions in DF patients.

Survival cycle and prediction model of patients with nasopharyngeal carcinoma based on SEER 

Li Yaqiong, Wang Yan, Yuan Haozhan, Wang Yanting

2025, 31(14):  2366-2372.  DOI: 10.3760/cma.j.cn441417-20240814101-14016

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the survival cycle and prediction model of patients with nasopharyngeal carcinoma based on the Surveillance Epidemiology and End Results (SEER). Methods　A total of 1 000 patients diagnosed with nasopharyngeal carcinoma from 2014 to 2022 were collected through the SEER, and the patients' data were retrospectively analyzed. The extracted data were analyzed using the R 3.6.3 software; the patients were divided into a training set and a verification set according to the ratio of 7∶3. A model was built with the training set, and the Cox regression analysis was performed. On this basis, a nomogram survival prediction model was established. The C-index was used to evaluate the differentiation between the training set and the verification set, and the calibration curve was used to detect the nomogram fit. Results　Among the 1 000 patients, 74.1% (741/1 000) were male, and 25.9% (259/1 000) female; the patients with Keratinized squamous cell carcinoma accounted for 6.0% (60/1 000), the patients with non-keratinized squamous cell carcinoma 66.1% (661/1 000), the patients with basal-like squamous cell carcinoma 5.8% (58/1 000), and the patients with other pathological types 22.1% (221/1 000); 32.4% (324/1000) were undifferentiated, 33.0% (330/1 000) poorly differentiated, 24.4% (244/1 000) moderately differentiated, and 10.2% (102/1 000) highly differentiated. The overall survival rate was 33.9% (339/1 000), and the mortality rate was 66.1 (661/1 000). To ensure the stability of the subsequent model, χ² test was used to confirm that there were no statistical differences in baseline characteristics between the training set and the verification set (all P>0.05). Age, gender, pathological type, tumor grade, TNM stage, number of metastatic organs, surgical treatment, radiotherapy, and chemotherapy all affected the patients' overall survival (all P<0.05), while marital status, education level, and differentiation degree had no effect on the patients' overall survival (all P>0.05). Multivariate Cox regression analysis was performed on the factors with P < 0.05 in the results of univariate analysis. The results showed that age, gender, pathological type, tumor grade, TNM stage, number of metastatic organs, surgical treatment, radiotherapy, and chemotherapy were all independent risk factors for the patients' overall survival. The patients aged > 50 years old, female patients, the patients with non-keratinized squamous cell carcinoma, high tumor grade, late local stage, and more organ metastases, and the patients who did not take surgery, radiotherapy, and chemotherapy had poor prognosis. In order to be more convenient and intuitive for clinical application, a nomogram of the patients was constructed based on the results of multi-factor Cox regression analysis to predict the 3-year survival level. In the training set, the C index of the nomogram prediction model to judge the prognosis was 0.828 (95%CI 0.791-0.863); in the verification set, the C index of the nomogram prediction model to judge the prognosis was 0.826 (95%CI 0.77-0.862); the RFS prediction effect of the nomogram was good. Conclusions　Age, gender, chemotherapy, TNM stage, pathological type, and number of metastatic organs are the risk factors affecting the survival cycle of patients with nasopharyngeal carcinoma. The model is successfully constructed, and the model has good differentiation and fit.

Relationship of AR and EGR1 with clinicopathological features and prognosis of patients with triple-negative breast cancer 

Huang Yingnan, Ding Caixia, Kang Bo

2025, 31(14):  2373-2377.  DOI: 10.3760/cma.j.cn441417-20240814-14017

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the expressions of androgen receptor (AR) and early growth response gene-1 (EGR1) in triple-negative breast cancer, and to explore their relationship with the clinical features and prognosis. Methods　One hundred patients with triple-negative breast cancer treated at Shaanxi Provincial Cancer Hospital from March 2022 to March 2024 were selected as a study group; they were (48.21±7.52) years old; their disease course was (16.12±3.21) months. One hundred patients with non-triple-negative breast cancer during the same period were selected as a reference group; they were (47.54±5.68) years old; their disease course was (16.32±3.24) months. Immunohistochemistry was used to detect the AR and EGR1 expressions. The positive expression rates of AR and EGR1 in the reference group, carcinoma tissue, and adjacent tissue were compared. The correlation of AR and EGR1 expressions in the cancer tissue with the pathological characteristics was also analyzed. The patients with triple-negative breast cancer were divided into a survival group and a death group according to their prognosis, and the AR and EGR1 expressions were compared between the two groups. The statistical methods included the independent sample t test, χ² test, and multiple linear regression analysis. Results　The positive expression rate of AR and the high expression rate of EGR1 in the cancer tissue were 22.00% (22/100) and 21.00% (21/100), which were lower than those in the reference group [52.00% (52/100) and 45.00% (45/100)] and those in the adjacent tissue [78.00% (78/100) and 78.00% (78/100)], with statistical differences (χ²=62.838 and 52.415; both P<0.05). The AR positive expression rates of the triple-negative breast cancer patients with invasive ductal carcinoma, grade Ⅰ-Ⅱ, and Ki-67 index <14% were 29.17% (21/72), 27.94% (19/68), and 45.95% (17/37), respectively; there were statistical differences between the groups (χ²=7.696, 4.371, and 19.625; all P<0.05). The high expression rates of EGR1 in the patients with tumor diameter <3 cm, grade Ⅰ-Ⅱ, stage Ⅰ-Ⅱ, no lymph node metastasis, and Ki-67 index <14% were 42.22% (19/45), 27.94% (19/68), 27.69% (18/65), 40.74% (11/27), and 48.65% (18/37), respectively; there were statistical differences between the groups (χ²=22.212, 6.171, 5.014, 6.573, and 27.062; all P<0.05). The positive expression rate of AR and the high expression rate of EGR1 in the survival group were 43.18% (19/44) and 45.45% (20/44), which were higher than those in the death group (χ²=20.543 and 28.323; both P<0.05). Conclusion　The abnormal expressions of AR and ERG1 in patients with triple-negative breast cancer are closely related to the pathological stage and pathological features such as Ki-67, and have significant impact on their prognosis.

Clinical Research

Efficacy of balloon dilation eustachian tuboplasty combined with nasal nebulization in treatment of adults with secretory otitis media

Li Shidong, Yang Qimei, Yun Yonggang

2025, 31(14):  2378-2382.  DOI: 10.3760/cma.j.cn441417-20250121-14018

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the clinical efficacy of balloon dilation eustachian tuboplasty combined with nasal nebulization in the treatment of adults with secretory otitis media. Methods　A prospective study was conducted on 102 adult patients with secretory otitis media treated at Shaanxi Provincial People's Hospital from January 2020 to January 2023. They were divided into a reference group, treated with balloon dilation eustachian tuboplasty, and a combined group, treated with balloon dilation eustachian tuboplasty and pressurized nasal nebulization, by the random number table method, with 51 cases in each group. The combined group consisted of 29 males and 22 females; they were (38.26±5.16) years old; their disease duration was (4.36±0.47) years; affected sides: 21 left and 30 right. The reference group consisted of 27 males and 24 females; they were (39.87±4.97) years old; their disease duration was (4.42±0.51) years; affected sides: 23 left and 28 right. The clinical efficacies, hearing function, Eustachian tube function [Eustachian Tube Score-5 (ETS-5) and Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7)], quality of life [Chinese version of the Chronic Ear Survey (CCES)], adverse events, and recurrence rates were compared between the two groups. Statistical analyses were performed using t tests and χ² tests. Results　The overall efficacy rate in the combined group was higher than that in the reference group [96.08% (49/51) vs. 82.35% (42/51)], with a statistical difference (P<0.05). After the treatment, the air conduction threshold, bone conduction threshold, and air-bone gap in the combined group were lower than those in the reference group (all P<0.05); The scores of ETS-5 and CCES in the combined group were higher than those in the reference group, while the score of ETDQ-7 was lower (all P<0.05). There was no statistical difference in the incidence rate of adverse events between the two groups (P>0.05). The recurrence rate of combined group was lower than that of the reference group [1.96% (1/51) vs. 15.69% (8/51)], with a statistical difference (P<0.05). Conclusion　Balloon dilation eustachian tuboplasty combined with nasal nebulization in the treatment of adults with secretory otitis media is effective and safe.

Effects of dietary fiber intervention on risk factors in high-risk population of cerebral infarction in Guangzhou communities 

Deng Xingdong, Zhao Qiuge, Huang Haibin, Yang Qindan, Wei Yonggang, Xu Pingyi, Tian Zuojun

2025, 31(14):  2383-2388.  DOI: 10.3760/cma.j.cn441417-20241206-14019

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the interventional effects of dietary fiber (DF) on risk factors in high-risk population of cerebral infarction in Guangzhou communities. Methods　From May 2018 to July 2023, 203 cases of local high-risk cerebral infarction taking less than 25 g of DF per day were prospectively collected from Department of Neurology, the First Affiliated Hospital of Guangzhou Medical University from Guangzhou communities. There were 121 males and 82 females. They were (69.26±9.50) years old. The patients were randomly divided into a DF additional group (92 cases) and a control group (111 cases). The DF additional group drank extra Konjac powder by adding it to warm water on the basis of regular diet, so that their daily DF intake reached 25-30 g per day. The control group kept the usual daily diet unchanged. The systolic pressures (SBP), diastolic pressures (DBP), Crouse score, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), and glycosylated hemoglobin (HBA1C) before and 3 months after DF intervention were compared between the two groups (△ values). Then, the patients were further divided into a hypertension group and a non-hypertension group, as well as a diabetes group and a non-diabetes group for hierarchical analyses. t test, Mann-Whitney U test, or Wilcoxon sign rank test , and χ² test were used for the statistical analysis. Results　After 3 months' DF intervention, the △DBP of the intervention group was significantly lower than that of the control group (Z=-2.412; P=0.016). Among them, the improvement of △DBP in the non-hypertensive subgroup was better than that in the control subgroup (Z=-2.802; P=0.005); the △DBP (Z=-2.196; P=0.028) and △HBA1C (Z=-2.216; P=0.027) in the non-diabetic subgroup was better than that in the control group. The △HDL in the diabetic subgroup was better than that in the control subgroup (Z=-2.545; P=0.011). Conclusions　DF intervention can significantly reduce DBP in non-diabetic and non-hypertensive populations, up-regulate HDL in diabetic patients, and down-regulate HBA1C in non-diabetic population.

Effect of foscarnet sodium and sodium chloride combined with female Kangdu Jieyin compound for patients with cervical high-risk HPV infection

Ma Yaofang, Zhu Jing, Li Haixiang

2025, 31(14):  2388-2392.  DOI: 10.3760/cma.j.cn441417-20240729-14020

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the effect of foscarnet sodium and sodium chloride combined with female Kangdu Jieyin compound for patients with cervical high-risk human papillomavirus (HPV) infection. Methods　Eighty-nine patients with cervical high-risk HPV infection treated at Yulin Hospital, the First Affiliated Hospital of Xi'an Jiaotong University from March 2022 to January 2024 were selected as the study objects. According to the treatment methods, they were divided into a control group (43 cases) and an observation group (46 cases). The control group were (40.45±6.97) years old, while the observation group 41.52±6.38. The control group took foscarnet sodium and sodium chloride; in addition, the observation group took female Kangdu Jieyin compound adjuvant treatment. The clinical efficacies, immune function, inflammatory response, vaginal cleanliness, cytokines, and adverse reactions were compared between the two groups. t test and χ² test were used as the statistical methods. Results　The total effective rate of the observation group was higher than that of the control group [93.48% (43/46) vs. 72.42% (32/43); P<0.05]. After the treatment, the levels of CD3+ and CD4+ in the observation group were higher than those in the control group [(65.41±6.85)% vs. (60.57±5.74)% and (44.22±6.94)% vs. (36.38±5.67)%], and the level of CD8+ was lower [(20.06±3.24)% vs. (24.11±4.30)%] (all P<0.05). After the treatment, the serum levels of interleukin-4 (IL-4) and transforming growth factor β1 (TGF-β1) in the observation group were lower than those in the control group [(6.05±1.32) ng/L vs. (12.73±2.48) ng/L and (15.13±3.10) ng/L vs. (22.48±4.36) ng/L], and the serum level of interferon gamma (IFN-γ) was higher [(197.42±22.58) ng/L vs. (181.36±19.45) ng/L] (all P<0.05). After the treatment, the Nugent score, cleanliness of vaginal secretions, and level of helper T cell 2 (Th2) in the observation group were lower than those in the control group [(2.18±0.42 vs. 2.67±0.64, 1.12±0.21 vs. 1.68±0.26, and (4.79±0.65)% vs. (6.20±0.74)%], and the level of Th1 was higher [(14.85±2.94)% vs. (11.53±2.40)%] (all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the two groups (P>0.05). Conclusion　Foscarnet sodium and sodium chloride combined with female Kangdu Jieyin compound for patients with cervical high-risk HPV infection is effective, safe, and reliable, and can reduce their inflammation, improve their immune function and vaginal cleanliness, and regulate cytokines.

Effect of edaravone and dexbomeol combined with rosuvastatin calcium for patients with acute posterior circulation cerebral infarction 

Lin Chong, Li Deshuai, Chen Xiaoru

2025, 31(14):  2393-2398.  DOI: 10.3760/cma.j.cn441417-20241202-14021

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of edaravone and dexbomeol combined with rosuvastatin calcium for patients with acute posterior circulation cerebral infarction. Methods　A prospective, randomized, single-blind, single-center clinical trial was designed. One hundred and fourteen patients with acute posterior circulation cerebral infarction treated at Affiliated Hospital of Xi'an Medical College from January 2021 to January 2024 were selected as the study objects, and were divided into a control group and an observation group by the random number table method, with 57 cases in each group. In the control group, there were 31 males and 26 females who were (67.19±7.26) years old. In the observation group, there were 29 males and 28 females who were (66.84±7.18) years old. The control group took routine treatment and rosuvastatin calcium; in addition, the observation group took edaravone and dexbomeol. Both groups were treated for 14 d. The clinical efficacies, neurological function (NIHSS score and mRS score), cognitive function (MoCA score), cerebral blood flow perfusion indicators [peak flow velocity (Vp), mean flow velocity (Vm), resistance index (RI), and pulsatility index (PI)], oxidative stress markers [malondialdehyde (MDA) and superoxide dismutase (SOD)], and neurotrophic factors before and after the treatment, and adverse drug reactions were compared between the two groups. t and χ² tests were used for the statistical comparisons. Results　The overall effective rate of the observation group was higher than that of the control group [91.23% (52/57) vs. 71.93% (41/57)], with a statistical difference between the two groups (P<0.05). After the treatment, the scores of NIHSS, mRS, and MoCA in the observation group were better than those in the control group (5.19±1.01 vs. 7.06±1.15, 1.81±0.37 vs. 2.30±0.49, and 24.10±3.02 vs. 20.04±2.93), with statistical differences between the two groups (all P<0.05). After the treatment, the RI, PI, and MDA in the observation group were lower than those in the control group, and the levels of VM, VP, SOD, and neurotrophic factors were higher, with statistical differences (all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the two groups (P>0.05). Conclusion Edaravone and dexbomeol combined with rosuvastatin calcium for patients with acute posterior circulation cerebral infarction is effective.

Shear wave elastography imaging combined with Bishop score in prediction of outcomes in pregnant women

Fu Lina, Yang Bin, Gou Yongxian, Zhang Baojuan

2025, 31(14):  2398-2402.  DOI: 10.3760/cma.j.cn441417-20241125-14022

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the value of shear wave elastography imaging quantitative parameters combined with the Bishop score in the prediction of the outcomes of preterm birth in singleton pregnant women. Methods　A total of 116 pregnant women at risk of preterm delivery treated at Baoji Maternal and Child Health Hospital from September 2021 to January 2023 were retrospectively analyzed, and were divided into a preterm delivery group (15 cases) and a term delivery group (101 cases) according to their delivery outcomes. The age of full-term mothers was (30.24 ± 3.67) years, while the age of premature mothers was (30.78 ± 4.01) years. Shear wave elastography was used to measure their cervical parameters (cervical length, mean Young's modulus, and maximum Young' s modulus), and the Bishop score on the cervix was evaluated before labor. Independent sample t test and χ² test were used to compare the differences in cervical length, mean Young's modulus (Emean) (at A, B, C, and D points), maximum Young' s modulus (Emax) (at A, B, C, and D points), and Bishop score between the two group. Receiver operating characteristic curves (ROC) were used to analyze the predictive value of each parameter of cervical shear wave elastography and Bishop score alone and their combination for preterm birth outcomes. Results　The rate of normal cervical length, Emean values (at A, B, C, and D points), and Emax values (at A, B, C, and D points) in the delivery term group were higher than those in the preterm delivery group (all P<0.05). The Bishop score in the delivery term group was higher than that in the preterm delivery group (P<0.05). The areas under the curves (AUC) of cervical length, Bishop score, Emean values (at A, B, C, and D points), Emax values (at A, B, C, and D points), and their combination for predicting the preterm birth outcomes in the singleton pregnant women were 0.688, 0.674, 0.777, 0.717, 0.771, 0.754, 0.812, 0.672, 0.742, 0.727, and 0.924, respectively. Conclusion　The combination of shear wave elastography imaging quantitative parameters and the Bishop score can improve the predictive value for the outcomes of preterm birth in singleton pregnant women.

Treatises

Application of MALDI-TOF MS in homology analysis of carbapenem-resistant Klebsiella pneumoniae

Gao Fanglin, Ruan Haitao, Zhan Wenfang

2025, 31(14):  2402-2407.  DOI: 10.3760/cma.j.cn441417-20240101-14023

Asbtract ( )  

References | Related Articles | Metrics

Objective　To Explore the value of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) in the homology analysis of carbapenem-resistant Klebsiella pneumoniae (CRKP). Methods　Three strains of CRKP isolated from the sputum, urine, and blood of the same patient in ICU, People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine from May to June 2024 were collected. Homology analysis of the three strains of CRKP was performed using MALDI-TOF MS and detection of single nucleotide polymorphisms (SNP) variation sites. Results　The homology analysis results of MALDI-TOF MS showed that CRKP1 isolated from the sputum had a higher homology with CRKP3 isolated from the blood, indicating that the CRKP3 detected in the patient's blood might originate from the respiratory tract. This result was consistent with the homology analysis results based on SNP variation detection. Conclusions　MALDI-TOF MS is capable of performing homology analysis on strains from different sources in the same patient, enabling strain tracing. It is of significant importance for achieving rapid diagnosis in clinical settings.

Clinical Research

Construction of a preoperative prediction model for microvascular infiltration in hepatocellular carcinoma based on multimodal ultrasound 

Ji Li, Zhang Jiao, Li Jing, Zhu Limin

2025, 31(14):  2408-2413.  DOI: 10.3760/cma.j.cn441417-20241209-14024

Asbtract ( )  

References | Related Articles | Metrics

Objective　To construct a preoperative prediction model of microvascular invasion (MVI) in hepatocellular carcinoma (HCC) by multimodal ultrasound. Methods　A total of 121 patients with HCC treated at Shaanxi Nuclear Industry 215 Hospital from June 2022 to September 2024 were selected as the study objects, and were divided into an MVI occurrence group and a non-occurrence group according to the preoperative pathological examination results. All the patients completed multimodal ultrasound examinations, such as two-dimensional ultrasound and contrast-enhanced ultrasound, and the relevant parameters were recorded. Both groups' medical records were reviewed to analyze the possible influencing factors of MVI in HCC. The nomogram was drawn, and a preoperative prediction model of MVI in the patients was constructed; the predictive efficacy was analyzed and verified. t and χ² tests were used for the statistical analysis. Results　Among the 121 patients, 35 (28.93%) had MVI. The univariate and multivariate analyses results showed that lesion size and signals during the arterial phase (AP), portal phase (PP), and posterior vascular phase (PVP) were the independent risk factors for MVI in the patients (all P<0.05). The established model formula was as below: Logit (P)=12.151+4.280×lesion size-AP×10.089-PP×6.231-PVP×4.710, which was used to predict the occurrence of MVI in the patients before surgery. The receiver operating characteristic curve results showed that the area under the curve (AUC) of the occurrence group was 0.971 (95%CI 0.934-1.000), and that of the non-occurrence group 0.886 (95%CI 0.751-1.000). The results of decision curve showed that when the threshold probability of the occurrence group was 0-0.4 and the threshold probability of the non-occurrence group was 0.1-1.0, the model had a higher positive net profit. The clinical impact curve results showed that the prediction accuracy of the model was high when the threshold probability of the occurrence group was 0-0.4 and the threshold probability of the non-occurrence group was 0-0.7. Conclusions　The occurrence of MVI in patients with HCC is often affected by lesion size and signals during AP, PP, and PVP. The prediction model of MVI in patients with HCC based on multimodal ultrasound parameters has high predictive efficacy.

Investigation on use of antibacterial drugs and distribution of pathogenic bacteria in patients with diabetes feet 

Ma Hui, Guo Lubo, Yin Yanhui, Zhang Xiang, Wang Qian

2025, 31(14):  2414-2418.  DOI: 10.3760/cma.j.cn441417-20241115-14025

Asbtract ( )  

References | Related Articles | Metrics

Objective　Through investigating and analyzing the use of antibacterial drugs and the distribution of pathogenic bacteria in patients with diabetes feet, to guide the clinical rational drug use and improve the management of antibacterial drugs in hospitals. Methods　A total of 2 990 inpatients with diabetes feet hospitalized in Jinan Central Hospital from January 2017 to December 2022 were retrospectively collected as the research objects, including 1 876 males and 1 114 females. There were 2 396 cases ≥65 years old and 594 cases <65. The use of antibacterial drugs and the distribution of pathogenic bacteria were analyzed. The antibacterial drug usage rates, proportions of use of various categories and dosage forms, antibacterial drug combination, and microbial submission rate were counted and analyzed. The Excel was used for data analysis and presentation. Results　Cephalosporins were the main antibacterial drugs used by the patients, accounting for 50.72% (843/1 662), and the most frequently used drug was ceftizoxime. The use frequency of restricted class antibacterial drugs was the highest, accounting for 56.56% (940/1 662). The intravenous administration was the main method for using antibacterial drugs, accounting for 84.09% (2 473/2 941). The microbial submission rate reached 43.14% (717/1 662). Staphylococcus aureus was the most common pathogenic bacteria, with a detection rate of 35.84% (257/717). Conclusions　There are many kinds of antibacterial drugs used by hospitalized patients with diabetes feet. The use frequencies of restricted and special class antibacterial drugs are high. The microbial submission rates in the patients who use the restricted and special class antibacterial drugs do not meet the national regulations. There are unreasonable phenomena in the use of antibacterial drugs in Jinan Central Hospital. Therefore, it's necessary to strengthen the training of relevant regulations and management of antibacterial drug usage, in order to reduce the occurrence of clinical unreasonable drug usage.

Value of ultrasound combined with ALB in evaluation of gastroesophageal variceal bleeding in patients with liver cirrhosis 

Ren Weihua, Wang Yu, Zhao Weiwu, Li Qing

2025, 31(14):  2418-2423.  DOI: 10.3760/cma.j.cn441417-20240906-14026

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the value of ultrasound parameters combined with plasma albumin (ALB) in the evaluation of esophagogastric variceal bleeding in patients with liver cirrhosis. Methods　A total of 126 patients with liver cirrhosis and esophagogastric varices treated at Xi'an International Medical Center Hospital from March 2021 to March 2024 were included in the study. The patients were divided into a bleeding group (54 cases) and a non-bleeding group (72 cases) based on whether they had variceal bleeding. The bleeding group included 29 males and 25 females, with an age of (61.12±6.21) years. The non-bleeding group included 41 males and 31 females, with an age of (59.77±6.15) years. The general clinical data were compared between the two groups. All the patients underwent ultrasound examination to measure the ultrasound parameters. The logistic regression analysis was used to identify the influencing factors of esophagogastric variceal bleeding in the patients and construct a nomogram. The receiver operating characteristic curves (ROC) were constructed to analyze the value of ultrasound parameters combined with ALB in the evaluation of esophagogastric variceal bleeding in the patients. t and χ² tests were used for the statistical analysis. Results　The bleeding group had higher Child-Pugh liver function grade and degree of esophagogastric varices, longer prothrombin time, and lower platelet count (PLT) and ALB than the non-bleeding group (all P<0.05). The hepatic vein diameter and splenic vein flow velocity in the bleeding group were lower than those in the non-bleeding group [(5.65±0.85) mm vs. (6.07±0.92) mm and (11.55±1.66) cm/s vs. (18.15±2.21) cm/s], and the splenic vein diameter, spleen area, and mean spleen elasticity value were higher [(11.28±1.67) mm vs. (8.47±1.25) mm, (53.74±2.84) cm² vs. (51.32±2.08) cm², and (16.46±1.30) kPa vs. (12.24±1.15) kPa] (t=2.649, 19.143, 10.376, 5.288, and 18.936; all P<0.001). The logistic regression analysis revealed that the degree of esophagogastric varices, PLT, PT, ALB, splenic vein diameter, and mean spleen elasticity value were influencing factors for esophagogastric variceal bleeding (all P<0.05). The ROC results showed that the combination of ALB, splenic vein diameter, and mean spleen elasticity value had an area under the curve (AUC) of 0.977, a sensitivity of 94.4%, and a specificity of 93.1%, which were significantly higher than those of ALB (AUC=0.748, sensitivity=57.4%, and specificity=79.2%), splenic vein diameter (AUC=0.892, sensitivity=81.5%, and specificity=88.9%), and mean spleen elasticity value (AUC=0.936, sensitivity=92.6%, and specificity=93.1%). Conclusion　The combination of ultrasound parameters and ALB is valuable for predicting esophagogastric variceal bleeding in patients with liver cirrhosis.

Diagnostic value of DSC-PWI quantitative parameters combined with serum α-HBDH and MMP-9 for lung cancer brain metastasis 

Tian Juan, Yan Teng, Xi Junfeng, Wang Huifang

2025, 31(14):  2424-2428.  DOI: 10.3760/cma.j.cn441417-20240805-14027

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the diagnostic value of dynamic magnetic sensitive contrast-enhanced perfusion weighted imaging (DSC-PWI) quantitative parameters combined with serum α-hydroxybutyrate dehydrogenase (α-HBDH) and matrix metalloproteinase-9 (MMP-9) for lung cancer brain metastasis. Methods　One hundred and sixteen patients with advanced lung cancer and suspected brain metastases treated at Yulin First Hospital from June 2019 to June 2023 were selected as the study objects, including 72 males and 44 females. They were (61.93±9.21) years old. With pathological examination as the gold standard for diagnosing brain metastasis, the patients were divided into a brain metastasis group and a lung cancer group. All the patients underwent DSC-PWI examination to obtain cerebral blood volume (CBV) and cerebral blood flow (CBF), and the perfusion parameters of the abnormal perfusion area and contralateral mirror area within the tumor were standardized to obtain mean local cerebral blood volume (rCBV) and mean local cerebral blood flow (rCBF). The DSC-PWI quantitative parameters and levels of α-HBDH and MMP-9 were compared between the two groups. The risk factors for lung cancer brain metastasis was analyzed. The diagnostic values of DSC-PWI quantitative parameters, α - HBDH, and MMP-9 for lung cancer brain metastasis were evaluated. t and χ² tests were used for the statistical analysis. Results　According to pathological diagnosis, 84 out of the 116 patients were diagnosed with brain metastases. The rCBV, rCBF, serum α-HBDH, and serum MMP-9 in the brain metastasis group and the lung cancer group were 2.54±0.72 and 0.97±0.31, 2.31±0.75 and 1.16 ± 0.41, (176.31±38.54) U/L and (141.09±35.16) U/L, and (114.35±26.98) ng/L and (98.51±17.04) ng/L, respectively, with statistical differences between the two groups (all P<0.05). rCBV (OR=3.691, 95%CI 1.630-8.357), rCBF (OR=3.647, 95%CI 1.611-8.258), α-HBDH (OR=4.104, 95%CI 1.812-9.292), and MMP-9 (OR=3.955, 95%CI 1.747-8.954) were the risk factors for brain metastasis in the patients (all P<0.05). The sensitivities of rCBV, rCBF, α-HBDH, and MMP-9 in the diagnosis of lung cancer brain metastasis were 0.82, 0.73, 0.71, 0.80, and 0.89, respectively; the specificities were 0.78, 0.77, 0.69, 0.59, and 0.91; the areas under the curves were 0.781, 0.725, 0.731, 0.739, and 0.885, respectively. Conclusion　rCBV, rCBF, α-HBDH, and MMP-9 are associated with lung cancer brain metastasis and can be used as auxiliary diagnostic tools for lung cancer brain metastasis, with good diagnostic efficacy.

Effects of dezocine and sufentanil on serum levels of VEGF and MMP-9 in early period after surgery for patients with colorectal cancer 

Wu Hao, Wen Xianjie, Luo Bing, Yang Kai, Ling Chen, Liu Xingqing, Hu Xudong

2025, 31(14):  2429-2434.  DOI: 10.3760/cma.j.cn441417-20240624-14028

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the effects of sufentanil and dezocine on the serum levels of vascular growth factor (VEGF) and matrix metalloproteinase 9 (MMP-9) in early period after surgery for patients with colorectal cancer. Methods　Forty-eight patients undergoing elective laparoscopic radical surgery for colorectal cancer in Foshan Second People's Hospital from January to May 2024 were selected for the randomized controlled trial, and were divided into an SF group and a DE group by the random number table method, with 24 cases in each group. The SF group were (65.42±11.44) years old; their body mass index (BMI) was (21.81±4.23) kg/m²; they were of American Society of Anesthesiologists (ASA) grade Ⅱ-Ⅲ. The DE group were (66.38±12.04) years old; their BMI was (22.52±3.47) kg/m²; they were of ASA grade Ⅱ-Ⅲ. The SF group received patient-controlled intravenous analgesia with 4 μg/kg of sufentanil, and the DE group with 1.5 mg/kg of dezocine. The pain degree was assessed 2, 12, 24, and 48 h after the operation using the Visual Analogue Scale (VAS). The numbers of cases of nausea and vomiting, dizziness and headache, itchy skin, urinary retention, and respiratory depression were recorded in both groups. The serum levels of metallomatrix proteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) were compared between the two groups. The t test and multivariate repeated measure analysis of variance were used for the statistical analysis. Results　There were no statistical differences in the scores of VAS 2, 12, 24, and 48 h after the operation between the two groups (all P>0.05). There were no statistical differences in the incidence rates of nausea and vomiting, dizziness and headache, itchy skin, urinary retention, and respiratory depression between the two groups (all P>0.05). The serum levels of VEGF 2, 24, and 48 h after the operation in the DE group were lower than those in the SF group [(235.48±19.57) ng/L vs. (243.21±23.65) ng/L, (220.98±26.49) ng/L vs. (233.57±32.48) ng/L, and (213.72±20.89) ng/L vs. (229.65±28.36) ng/L], with statistical differences (all P<0.05). There was no statistical differences in the serum level of MMP-9 2 h after the operation between the two groups (P>0.05); the serum levels of MMP-9 24 and 48 h after the operation in the DE group were lower than those in the SF group [(426.84±39.84) ng/L vs. (453.65±43.65) ng/L and (419.35±43.08) ng/L vs. (447.36±39.87) ng/L], with statistical differences (both P<0.05). Conclusion　Dezocine can better inhibit serum VEGF and MMP-9 expression in patients in early period after colorectal cancer surgery than sufentanil.

Research on Traditional Chinese Medicine

Effect of acupressure at Hegu point in treatment of dizziness and nausea in patients with benign paroxysmal positional vertigo after successful reduction 

Lu Shigang, Zhang Teng

2025, 31(14):  2435-2438.  DOI: 10.3760/cma.j.cn441417-20241227-14029

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the therapeutic effect of acupressure at Hegu point in the treatment of dizziness and nausea in patients with benign paroxysmal positional vertigo after successful reduction. Methods　One hundred and four patients with dizziness and nausea after reduction for benign paroxysmal positional vertigo in Shanxian Central Hospital from June 2022 to May 2024 were selected for the randomized controlled trial, including 25 males and 79 females; they were 30 to 82 years old, with a disease course ranging from 3 h to 2 weeks. They were divided into an observation group and a control group by the random number table method, with 52 cases in each group. The observation group had 13 males and 39 females, with an average age of 63.6 years. The control group had 12 males and 40 females, with an average age of 63.8 years. The observation group took acupressure at Hegu point for 3 minutes immediately after manual reduction, and then the patients sat quietly for rest. The control group only sat quietly for rest after routine manual reduction. The numbers of the patients who could see objects and the scores of the Dizziness Handicap Inventory (DHI) and the Vestibular Symptom Index (VSI) immediately after reduction and 30 min after the reduction were compared between the two groups by χ² and t tests. Results　Thirty min after the reduction, the number of the patients who could see objects in the observation group was 37 cases (accounting for 71.15%), and that in the control group was 23 cases (accounting for 44.23%), with a statistical difference (P<0.05). The scores of DHI and VSI in the observation group were 30.49±6.40 and 29.32±4.70, and the scores in the control group were 37.76±6.29 and 34.78±4.94, respectively, with statistical differences (both P<0.05). Conclusion　Acupressure at Hegu point has good clinical effect in relieving the symptoms of dizziness and nausea in patients with benign paroxysmal positional vertigo after successful reduction.

Effect of postauricular acupoint injection of methylprednisolone sodium succinate combined with modified Longdan Xiegan decoction in treatment of sensorineural hearing loss

Gao Yanbin, Han Ning, Li Guohui

2025, 31(14):  2439-2443.  DOI: 10.3760/cma.j.cn441417-20250221-14030

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of postauricular acupoint injection of methylprednisolone sodium succinate combined with modified Longdan Xiegan decoction in the treatment of patients with sensorineural hearing loss (SNHL). Methods　Sixty patients with SNHL treated in Department of Vertigo Diseases, Yinchuan Hospital of Traditional Chinese Medicine, Ningxia Medical University from January to September 2024 were selected for the randomized controlled trial, and were divided into a treatment group (30 cases) and a control group (30 cases) by the random number table method. In the treatment group, there 15 males and 15 females; they were (49.53±10.38) years old; their disease duration was (6.43±2.33) months. In the control group, there were 16 males and 14 females; they were (49.63±10.11) years old; their disease duration was (6.30±2.35) months. The treatment group took the postauricular acupoint injection of methylprednisolone sodium succinate and Longdan Xiegan decoction, and the control group methylcobalamin tablets, for 4 weeks. The pure tone hearing threshold measurement, scores of Tinnitus Assessment Scale, and auditory brainstem response I-wave latency before and after the treatment, clinical efficacies, and adverse reactions were compared between the two groups by t, U, rank sum, and χ² tests. Results　Before and after the treatment, the values of pure tone hearing threshold determination [low-frequency (0.5 kHz), middle-frequency (1.0 kHz), and high-frequency (2.0 kHz)], score of Tinnitus Assessment Scale, and auditory brainstem response I-wave latency in the treatment group were (57.33±13.16) dB, (31.83±6.94) dB, 52.50 (45.00, 65.00) dB, 34.50 (27.00, 37.00) dB, (53.73±10.99) dB, (24.73±4.78) dB, 53.07±13.18, 29.20±6.99, 0 (0, 0.50) s, and 0 (0, 0.20) s, respectively; and the above indicators in the control group were (56.10±12.27) dB, (33.77±7.68) dB, 53.00 (44.00, 65.00) dB, 34.00 (27.75, 41.25) dB, (53.83±1.49) dB, (31.96±1.68) dB, 52.60 (26.30, 78.90), 35.50 (28.50, 42.25), 0.15 (0, 0.50) s, and 0.10 (0, 0.40)s, respectively; there were statistical differences in the above indicators between before and after the treatment in both groups (all P<0.05). The total effective rate in the treatment group was higher than that in the control group [96.67% (29/30) vs. 90.00% (27/30)], with a statistical difference (χ²=4.250; P<0.05). The overall tolerability in both groups during the treatment was good, and no serious adverse reactions occurred. Conclusion　Postauricular acupoint injection of methylprednisolone sodium succinate combined with modified Longdan Xiegan decoction in the treatment of patients with SNHL is effective and safe, and can improve their clinical symptoms and hearing status.

Tiaoren Tongdu acupuncture combined with Shugan Jieyu decoction for patients with insomnia and anxiety disorder

Liang Dan, Chen Jing, Li Min, Gao Menghui, Zhang Yaping, Zhang Mingyue, Chen Jingping

2025, 31(14):  2443-2449.  DOI: 10.3760/cma.j.cn441417-20241106-14031

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of Tiaoren Tongdu acupuncture combined with Shugan Jieyu decoction for patients with insomnia and anxiety disorder. Methods　A total of 168 patients with insomnia and anxiety disorder (heart kidney disharmony) treated at Hanzhong Hospital of Traditional Chinese Medicine from January 2021 to June 2024 were selected for the randomized controlled trial, and were divided into groups A, B, C, and D by the random number table method, with 42 cases in each group. In group A, there were 18 males and 24 females; they were (55.12±9.63) years old; the duration of anxiety disorder was 22 (14, 31) months; the duration of insomnia was 34 (20, 48) months. In group B, there were 16 males and 26 females; they were (56.55±10.98) years old; the duration of anxiety disorder was 25 (14, 33) months; the duration of insomnia was 36 (21, 50) months. In group C, there were 15 males and 27 females; they were (54.64±9.27) years old; the duration of anxiety disorder was 24 (12, 32) months; the duration of insomnia was 34 (21, 51) months. In group D, there were 16 males and 26 females; they were (54.83±10.02) years old; the duration of anxiety disorder was 23 (15, 30) months; the duration of insomnia was 32 (20, 47) months. Group A were treated with conventional western medicine, group B with conventional western medicine and Shugan Jieyu decoction, group C with conventional western medicine and Tiaoren Tongdu acupuncture, and group D with conventional western medicine, Tiaoren Tongdu acupuncture, and Shugan Jieyu decoction. The scores of traditional Chinese medicine symptoms, Hamilton Anxiety Scale (HAMA), and Pittsburgh Sleep Quality Index (PSQI) and serum levels of 5-hydroxytryptamine (5-HT), norepinephrine (NE), and dopamine (DA) before and after the treatment, clinical efficacies, and occurrence of adverse reactions were compared between the two groups. Statistical analyses were performed using the χ² test, rank sum test, t test, one-way analysis of variance, SNK-q test, Kruskal-Wallis H test, and Mann-Whitney U test. Results　Six cases were excluded, and 162 were included, including 39 in group A, 41 in group B, 40 in group C, and 42 in group D. After the treatment, the scores of traditional Chinese medicine main symptoms, secondary symptoms, and tongue and pulse, total score of traditional Chinese medicine symptoms, scores of HAMA and PSQI, and serum levels of 5-HT, NE, and DA in group A were 7.92±1.25, 7.38±1.17 points, 2 (0, 2), 16.36±3.36, 9.62±1.42, 8.33±1.54, (133.06±18.74) g/L, (25.31±4.82) μg/L, and (394.49±72.32) mmol/L; those in group B were 7.02±1.06, 6.80±1.06, 1 (0, 2), 14.80±2.81, 8.76±1.31, 7.37±1.41, (145.11±20.36) g/L, (19.99±3.96) μg/L, and (343.19±59.63) mmol/L; those in group C were 6.95±1.03, 6.70±1.01, 1(0, 2), 14.60±2.75, 8.53±1.27, 7.45±1.36, (148.13±20.17) g/L, (20.05±4.03) μg/L, and (340.13±58.49) mmol/L; those in group D were 5.83±0.98, 5.74±0.96, 0(0, 1), 12.38±2.44, 7.02±1.12, 6.79±1.24, (162.74±22.55) g/L, (15.98±3.36) μg/L, and (318.53±50.17) mmol/L; after the treatment, the traditional Chinese medicine main symptom score, secondary symptom score, tongue and pulse score, total score, HAMA score, PSQI score, and serum levels of NE and DA were lower than those before the treatment in all the groups; those in groups B,C, and D were higher than those in group A (all P<0.05); those in group D were higher than those in groups B and C (all P<0.05). The total effective rates of groups A, B, C, and D were 76.92% (30/39), 85.37% (35/41), 87.50% (35/40), and 97.62% (41/42), respectively, and the total effective rate of group D was higher than that of group A (P<0.05). There was no statistical difference in the total incidence rate of adverse reactions between the 4 groups (P>0.05). Conclusion　On the basis of conventional western medicine, the effect and safety of applying Tiaoren Tongdu acupuncture and Shugan Jieyu decoction in the treatment of patients with insomnia and anxiety disorder (heart kidney disharmony) can relieve their symptoms and anxiety, improve their sleep quality, and regulate the serum levels of neurotransmitters.

Effect of Simiao pills combined with conventional western medicine for patients with multiple sclerosis 

Li Ling, Chen Xiao, Nie Wei

2025, 31(14):  2450-2455.  DOI: 10.3760/cma.j.cn441417-20241119-14032

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the effect of Simiao pills combined with conventional western medicine for patients with multiple sclerosis. Methods　Eighty-six patients with multiple sclerosis treated at Xi'an Traditional Chinese Medicine Brain Disease Hospital from April 2022 to June 2024 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 43 cases in each group. There were 16 males and 27 females in the control group; they were (37.65±9.13) years old; their body mass index was (23.72±2.78) kg/m²; their disease course was (4.28±1.07) years; the attack frequency was 2.53±0.63; 18 cases had lesions in the cerebral hemisphere, 9 in the cerebellum, 13 in the brainstem, and 3 in the spinal cord. There were 14 males and 29 females in the observation group; they were (38.86±9.51) years old; their body mass index was (23.47±2.45) kg/m²; their disease course was (4.16±1.04) years; the attack frequency was 2.65±0.67; 17 cases had lesions in the cerebral hemisphere, 10 in the cerebellum, 12 in the brainstem, and 4 in the spinal cord. The control group took conventional western medicine, and the observation group Simiao pills and conventional western medicine, for 4 weeks. The clinical treatment efficacies, incidence rates of adverse reactions, and neurological function, traditional Chinese medicine symptom scores, levels of immune function indicators [helper T cell 17 (Th17), regulatory T cell (Treg), and Th17/Treg], and levels of inflammatory indicators [interleukin (IL) -17, IL-23, and tumor necrosis factor-α (TNF-α)] before and after the treatment were compared between the two groups by t test, χ² test, rank sum test, calibration χ² test, and Fisher's precision probability test. Results　After the treatment, the score of the Expanded Disability Status Scale, traditional Chinese medicine syndrome score, and the levels of Th17, Th17/Treg, IL-17, IL-23, TNF-α, and Treg in the observation group were better than those in the control group [3.79±0.76 vs. 4.51±0.92, 9.45±1.59 vs. 11.27±1.88, (1.58±0.39)% vs. (1.82±0.46)%, 0.79±0.21 vs. 1.05±0.26, (51.36±12.84) ng/L vs. (62.23±15.55) ng/L, (436.71±109.67) ng/L vs. (512.58±128.65) ng/L, (17.78±4.49) ng/L vs. (23.26±5.85) ng/L, and (2.01±0.51)% vs. (1.73±0.43)%; t=3.891, 4.766, 2.566, 5.018, 3.476, 2.894, 4.794, and 2.701; all P<0.05]. The total effective rate of the observation group was higher than that of the control group [95.24% (40/42) vs. 78.05% (32/41); χ²=4.822; P=0.028]. There was no statistical difference in the incidence rate of adverse reactions between the observation group and the control group [14.29% (6/42) vs. 7.32% (3/41); calibration χ²=0.771; P=0.380]. Conclusion　Simiao pills combined with conventional western medicine in the treatment of patients with multiple sclerosis is effective, and can effectively improve their neurological function and clinical symptoms, regulate Th17/Treg cell balance, and alleviate inflammatory reactions.

Visual analysis of traditional Chinese medicine research hotspots and trends in functional dyspepsia 

Dong Ning, Yu Tao

2025, 31(14):  2455-2459.  DOI: 10.3760/cma.j.cn441417-20250121-14033

Asbtract ( )  

References | Related Articles | Metrics

Objective　To conduct a bibliometric and visual analysis of the development status in the field of traditional Chinese medicine in the treatment of functional dyspepsia in the past 10 years based on CiteSpace, to summarize the research hotspots and development trends, and to provide references for scholars in this field. Methods　The relevant literature in China National Knowledge Infrastructure database, Wanfang database, and VIP database from January 1,2014 to December 31, 2024 was searched, and the authors, research institutions, and key words in this field were analyzed through the CiteSpace knowledge graph, and their occurrence frequencies were calculated. Results From the perspective of the number of publications, the overall trend was upward in the early years, but it has been declining in recent years. From the perspectives of the authors and institutions, the top 3 authors are Professor Tang Xudong, Professor Xu Paide, and Professor Zhang Shengsheng, and the top 3 institutions are Hubei University of Chinese Medicine, Hunan University of Traditional Chinese Medicine, and Guangxi University of Traditional Chinese Medicine. From the perspectives of key word co-occurrence and cluster analysis, the research hotspots mainly focus on acupuncture and moxibustion, electroacupuncture, motilin, gastrin, gastrointestinal hormones, brain-gut axis, and other mechanisms, as well as mosapride and domperidone. Conclusion The study of the pathogenesis and action mechanism,the syndrome of spleen and stomach weakness, and the excavation of classic prescriptions and the experience of famous doctors are the research hotspots and trends of functional dyspepsia in China.

Nursing Research

Nursing effect of Robocare whole-process nursing mode for patients with tumors 

Ma Nan, Han Mengmeng, Zhou Jing, Wang Pei, Zhang Jing

2025, 31(14):  2460-2464.  DOI: 10.3760/cma.j.cn441417-20241118-14034

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the nursing effect of Robocare whole-process nursing mode for patients with tumors. Methods　Ninety-eight patients with malignant tumors of digestive tract and urinary system treated at Shaanxi Cancer Hospital from January to December 2023 were selected for the randomized controlled trial. There were 55 males and 43 females; they were 39-76 years old; there were 60 cases of digestive tract tumors and 38 cases of urinary system tumors. The patients were divided into an experimental group and a control group by the random number table method, with 49 cases in each group. The observation group established a Robocare nursing team, and implemented the whole-process nursing from admission to discharge according to the Robocare whole-process nursing mode. The life quality 1 week after the operation, postoperative pain degrees, hospitalization times, incidence rates of complications, and nursing satisfaction degrees were compared between the two groups by χ², ｔ, F, and non-parameter rank sum tests. Results　One week after the operation, the scores of life quality in the experimental group were better than those in the control group (all P<0.05). The pain scores 1, 3, and 7 d after the operation in the experimental group were lower than those in the control group (all P<0.05). The hospitalization time in the control group was 11.0 (10.5, 13.0) d, and that in the experimental group 8.0 (6.5, 9.5) d, with a statistical difference (Z=7.338; P<0.001). The incidence rates of complications in the experimental group was lower than that in the control group (P<0.05). The nursing satisfaction degree in the control group was 87.74±3.46, and that in the experimental group 95.56±3.55, with a statistical difference (t=6.507; P<0.001). Conclusion　Robocare whole-process nursing mode for patients with tumors can improve their life quality, relieve their pain, reduce the incidence of complications and hospitalization time, and increase the nursing satisfaction degree.