Table of Content

15 September 2025, Volume 31 Issue 18

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Cerebrovascular Disease

Progress in assessment of post-stroke hand dysfunction

Guan Menghan, Wu Mingrui, Zhang Jingsha, Liu Xixian

2025, 31(18):  2993-2998.  DOI: 10.3760/cma.j.cn441417-20250402-18001

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Stroke is a common disease caused by cerebrovascular disorders. Its high-risk factors include hypertension, diabetes mellitus, aging, etc. Post-stroke hand dysfunction, one of the common sequelae, manifests as reduced muscle strength, impaired coordination, and loss of fine motor skills, and directly affects patients' daily living activities (e.g., grasping, eating, dressing, and so on), occupational development, and learning abilities, while potentially triggering psychological issues such as depression and anxiety. Consequently, disease assessment is critical in its subsequent treatment. In recent years, artificial intelligence technologies have provided new pathways for dynamic monitoring and evaluation alongside traditional methods. This article reviews and analyzes clinically used assessment approaches and emerging technologies for evaluating post-stroke hand dysfunction.

Research progress of ASL in assessment of cerebral blood flow perfusion in patients with sensorineural hearing loss

Yi Yongjie, Huang Ranran, Wang Aijie, Huang Qiaolu, Li Chaohui, Jiang Xingyue, Zhang Guowei

2025, 31(18):  2999-3003.  DOI: 10.3760/cma.j.cn441417-20250310-18002

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Sensorineural hearing loss (SNHL) is a type of hearing impairment caused by metabolic abnormalities of the sensory hair cells in the inner ear, insufficient blood supply, inflammatory reactions, and other factors. It severely affects the patients' physical and mental health, as well as their work and daily life. Arterial spin labeling (ASL), as a contrast-free magnetic resonance imaging technique, can objectively reflect cerebral blood flow perfusion and cerebral blood flow reserve without radiation or contrast agents. It holds significant value in the assessment of cerebral blood flow perfusion in patients with SNHL. ASL can not only precisely locate the blood flow perfusion in brain regions related to SNHL, but also dynamically monitor changes in cerebral blood flow perfusion before and after treatment. It is gradually becoming an important tool for studying the pathophysiological mechanisms of cerebral blood flow in SNHL. Based on this, this article summarizes the latest progress of ASL in the assessment of cerebral blood flow perfusion in patients with SNHL, and explores the mechanisms underlying the changes in cerebral blood flow in these patients, so as to provide some references for clinical diagnosis and treatment as well as laboratory research.

Whole-brain CT perfusion parameters combined with clinical characteristics in prediction of ischemic stroke secondary to transient ischemic attack

Wang Minru, Yang Wei, Li Dandong, Zhou Xin

2025, 31(18):  3004-3010.  DOI: 10.3760/cma.j.cn441417-20250311-18003

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Objective　To develop a risk prediction model combining whole-brain CT perfusion parameters and clinical characteristics for transient ischemic attack (TIA)-related ischemic stroke, and to evaluate its predictive performance and clinical applicability. Methods　This retrospective study collected the data of 304 patients with TIA treated at No.215 Hospital of Shaanxi Nuclear Industry between January 2019 and January 2024. There were 172 males and 132 females. They were (55.26±11.96) years old. According to whether they had cerebral infarction, the patients were divided into an infarction group (51 cases) and a non-infarction group (253 cases). The whole-brain CT perfusion parameters [cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time to peak (TTP)] were obtained using the Philips Brilliance iCT (256-slice) system. The multivariate logistic regression analysis was performed to construct a Nomogram prediction model based on the CT perfusion parameters and clinical characteristics (ABCD2 score, history of hypertension and hyperlipidemia, etc.). Statistical comparisons were conducted using t-test, rank sum tests, χ² test, and Spearman correlation analysis. The predictive performance of the model was evaluated using the receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA). Results　The multivariate logistic regression analysis showed that frequency of ischemic episodes, ABCD2 score, CBF, CBV, MTT, history of hypertension and hyperlipidemia, atrial fibrillation, and carotid artery stenosis were the independent risk factors (all P<0.05). The area under the curve of the Nomogram model was 0.962 (95%CI 0.941-0.984); the C-index was 0.900 (95%CI 0.854-0.945). The calibration curve demonstrated good agreement between the predicted and actual outcomes, and the DCA showed clinical benefit across a risk threshold range of (0-97)%, with a maximum net benefit of 83.22%. Conclusion　The Nomogram model, combining whole-brain CT perfusion parameters and clinical characteristics, can accurately predict the risk of ischemic stroke secondary to TIA, has high predictive performance and clinical utility, and can provide scientific references for early intervention strategies.

Value of D-dimer in prediction of improvement of lesion area after edaravone dexcamphol for progressive cerebral infarction

Yang Juanjuan, Li Xiaotong, Dai Suya

2025, 31(18):  3011-3016.  DOI: 10.3760/cma.j.cn441417-20250208-18004

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Objective　To explore the value of D-dimer level in the prediction of the improvement of lesion area after edaravone dexcamphol for progressive cerebral infarction. Methods　The clinical data of 102 patients with progressive cerebral infarction treated at Zhengzhou Central Hospital, Zhengzhou University from January 2023 to April 2024 were selected as the study objects. According to their prognosis, the patients were divided into a good prognosis group (74 cases) and a poor prognosis group (28 cases). The general data and serum indicators of the two groups were compared. The influence of time on the relationship between the D-dimer level and lesion area was analyzed by the hierarchical interaction test using the EmpowerStats software. The correlation between D-dimer level and adverse prognosis risk was analyzed by the multivariate Cox regression analysis. Results　There were statistical differences in the systolic blood pressure, diabetes, hypertension, atrial fibrillation, hyperlipidemia, D-dimer, uric acid (UA), and score of National Institute of Health Stroke Scale (NIHSS) before the treatment between the good prognosis group and the poor prognosis group (all P<0.05). The levels of D-dimer [(219.43±21.67) g/L vs. (172.88±22.11) g/L, (207.67±22.43) g/L vs. (153.79±22.12) g/L, (184.49±22.08) g/L vs. (122.95±22.11) g/L, and (163.59±22.45) g/L vs. (101.69±22.47) g/L] and the Alberta Stroke Program Early CT Scores (ASPECTS) (1.45±0.46 vs. 2.22±0.45, 2.84±0.44 vs. 4.62±0.43, 3.72±0.47 vs. 5.95±0.51, and 5.02±0.58 vs. 7.52±0.45) on the day when the treatment was finished and 1, 2, and 4 weeks after the treatment in the poor prognosis group were worse than those in the good prognosis group, with statistical differences (all P<0.05). There was a correlation between the level of D-dimer and the change of lesion area at each time point (all P<0.05). According to the D-dimer level triplet, the patients were divided into a low-level group (D-dimer<188.27 g/L; 25 cases), a middle-level group (D-dimer 188.27-241.21 g/L; 54 cases), and a high-level group (D-dimer>241.21 g/L; 23 cases); the high-level group had higher adverse prognosis risk than the other two groups (P<0.05). Conclusion　The level of D-dimer has certain predictive value for the improvement of lesion area after edaravone dexcamphol for progressive cerebral infarction, and can be used as an indicator for clinically monitoring the effect of edaravone dexcamphol for progressive cerebral infarction.

Quantitative analysis of white matter DTI and resting state fMRI in patients with relapsing-remitting multiple sclerosis

Yin Baoyuan, Sun Qing, Liu Tao, Li Yunbo, Shang Wenbo

2025, 31(18):  3016-3021.  DOI: 10.3760/cma.j.cn441417-20250410-18005

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Objective　To analyze the clinical features of white matter diffusion tensor imaging (DTI) and resting state functional magnetic resonance imaging (rs-fMRI) in patients with relapse-remitting multiple sclerosis (RRMS). Methods　One hundred and two patients with RRMS treated at Xi'an Qinhuang Hospital from March 2023 to March 2025 were selected as the research objects and set as an observation group, including 37 males and 65 females who were (38.25±18.36) years old. One hundred healthy individuals who underwent physical examination during the same period were selected as a control group, including 46 males and 54 females who were (37.45±17.78) years old. Both groups underwent DTI and rs-fMRI examinations. The parameters of DTI and rs-fMRI were analyzed, including the mean diffusivity (MD), fractional anisotropy (FA), and fMRI regional homogeneity (ReHo) of protein resting-state of the cingulum bundle (CCG), anterior limb of internal capsule (ALIC), posterior limb of internal capsule (PLIC), external capsule EC), superior longitudinal fasciculus (SLF), superior fronto-occipital fasciculus (SFOF), inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), uncinate fasciculus (UF), genu of corpus callosum (gCC), splenium of corpus callosum (sCC), etc.; the Expanded Disability Status Scale (EDSS) was used to quantify the degree of neurological impairment; the subjects' conditions were evaluated by the paced auditory serial addition test (PASAT) and the Modified Fatigue Impact Scale (MFIS). The Kolmogorov-Smirnov test was used to judge the data distribution. t test was used for the data of normal distribution. The independent-sample permutation test (5 000 permutations) was used to statistically analyze the data of brain function imaging. Results　The score of PASAT in the observation group was lower than that in the control group (87.44±12.37 vs. 100.43±8.54), with a statistical difference (P<0.05). The scores of EDSS and MFIS in the observation group were 87.44±12.37 and 100.43±8.54, and the scores in the control group 0 and 0, indicating that the observation group had obvious neurological function disorder and fatigue, while the control group were normal. The FA values of bilateral CCG, bilateral ALIC, bilateral PLIC, bilateral EC, bilateral SLF, bilateral SFOF, bilateral IFOF, bilateral ILF,  bilateral UF, gCC and sCC in the observation group were all lower than those in the control group; while the MD values of bilateral CCG, bilateral ALIC, bilateral PLIC, bilateral EC, bilateral SLF, bilateral SFOF, bilateral IFOF, bilateral ILF, bilateral UF, gCC and sCC in the observation group were all higher than those in the control group (all P < 0.05). The regional homogeneities (ReHo) of corpus callosum, internal capsule, radiative crown, pontine cross tract, and cingulate tract in the observation group were lower than those in the control group (all P<0.05). The global white matter network in the observation group showed compensatory increase in functional connection density. The nodal efficiency of specific fiber bundles (gCC and right upper longitudinal tract Ⅲ segment) in the observation group was lower than that in the control group (P<0.05). Conclusion　The combination of DTI and rs-fMRI can evaluate the structure and function of the white matter in patients with RRMS, and provide evidences for the early diagnosis and treatment of the disease.

Clinical effect of interventional therapy for patients with dysarthria after anterior circulatory acute cerebral infarction

Deng Xingdong, Zhang Ting, Xu Pingyi, Tian Zuojun

2025, 31(18):  3022-3027.  DOI: 10.3760/cma.j.cn441417-20250417-18006

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Objective　To explore the effect of interventional therapy for patients with dysarthria after acute anterior circulatory cerebral infarction. Methods　From January 2020 to December 2024, 174 patients with dysarthria after anterior circulatiory acute cerebral infarction from Guangzhou communities treated at the First Affiliated Hospital of Guangzhou Medical University were selected for the prospective study. There were 119 males and 55 females. They were (66.71±11.54) years old. The patients were divided into an interventional group (85 cases) and a conservative group (89 cases). In the interventional group, stent implantation was performed in the narrow carotid arteies or middle cerebral arteries on the basis of conventional conservative treatment. The conservative group only received conventional conservative treatment. The differences of the scores of the Frenchay, modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS) (△Frenchay, △mRS, and △NIHSS) were evaluated at admission and 10 days after the treatment. The scores of Frenchay, NIHSS, and mRS and frequency of mRS≤2 10 and 90 d after the treatment were evaluated. For data analysis, t test, χ² test, or Mann-Whitney U test were used for the inter-group comparisons, and Wilcoxon signed rank test was used for the intra-group comparisons. The correlation was analyzed using Spearman correlation analysis. Results　Ten days after the treatment, the scores of Frenchay, NIHSS, and mRS were all significantly lower than those before the treatment in both groups (all P<0.01); ninety days after the treatment, the above three indicators were further improved compared with those ten days after the treatment (all P<0.01). The △Frenchay, △mRS, and △NIHSS in the interventional group were higher than those in the conservative group (all P<0.05). Ten and ninety days after the treatment, the scores of Frenchay, mRS, and NIHSS in the interventional group were significantly lower than those in the conservative group (all P<0.05), while the frequencies of mRS≤2 were significantly higher (P<0.01). Ten days after the treatment, the △Frenchay was positively correlated with △NIHSS and △mRS in both groups (r=0.446, 0.409, 0.486, and 0.269; all P<0.05). Conclusions　Interventional therapy for patients with dysarthria after acute anterior circulatory cerebral infarction can improve the therapeutic effect. The improvement of dysarthria parallels the recovery of neurological function.

Carbamazepine combined with Tongqiao Huoxue Decoction in treatment of secondary epilepsy after ischemic stroke

Yang Rui, Chen Xiao, Li Changqing

2025, 31(18):  3027-3031.  DOI: 10.3760/cma.j.cn441417-20240926-18007

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Objective　To investigate the clinical efficacy of carbamazepine combined with Tongqiao Huoxue Decoction in the treatment of secondary epilepsy (SE) after cerebral ischemic stroke (CIS). Methods　One hundred and eighty patients with SE after CIS treated at Xi'an Traditional Chinese Medicine Brain Disease Hospital from June 2021 to June 2023 were selected for the prospective study, and were divided into a western medicine group and a study group by the random number table method, with 90 cases in each group. In the western medicine group, there were 67 males and 23 females; they were (52.56±6.22) years old; the course of the latest seizure was (3.23±0.66) d; 32 cases had mild seizures, 45 cases moderate, and 13 cases severe; they were treated with carbamazepine. In the study group, there were 65 males and 25 females; they were (52.74±6.44) years old; the course of the latest seizure was (3.11±0.56) d; 28 cases had mild seizures, 47 cases moderate, and 15 cases severe; they were treated with Tongqiao Huoxue Decoction and carbamazepine. Both groups were treated for 16 weeks. After the treatment, all the patients were followed up for 3 months by recheck, telephone, etc. The clinical efficacies, epileptic seizures and electroencephalogram indicators before and 3 months after the treatment, cognitive function and neurological function before and after the treatment, and incidence rates of adverse reactions were compared between the two groups by χ² test, t test, and rank sum test. Results　Among the 180 patients, 2 cases were excluded from the study because of poor compliance, and 1 case was excluded because of being out of follow-up; 177 cases were included,including 89 cases in the study group and 88 cases in the western medicine group. The total effective rate of the study group was higher than that of the western medicine group [89.89% (80/89) vs. 69.32% (61/88)], with a statistical difference (P<0.05). The number of epileptic seizures, duration of seizures, number of affected leads, and epileptic discharge 3 months after the treatment and the score of National Institutes of Health Stroke Scale (NIHSS) after the treatment were lower than those before the treatment in both groups (all P<0.05), while the scores of Montreal Cognitive Assessment Scale (MoCA) after the treatment were higher (both P<0.05). After the treatment, the number of epileptic seizures, duration of seizures, number of affected leads, epileptic discharge, and score of NIHSS in the study group were lower than those in the western medicine group [(1.76±0.24) times/d vs. (2.45±0.44) times/d, (1.13±0.32) min/time vs. (1.63±0.51) min/time, (3.67±1.20) 180 s vs. (4.89±1.57) 180 s, (7.22±2.11) t/180 s vs. (10.72±3.36) t/180 s, and 7.44±1.23 vs. 9.63±1.48], but the score of MoCA was higher (24.45±4.37 vs. 18.33±4.44), with statistical differences (all P<0.05). There was no statistical difference in the incidence rate of adverse reactions between the study group and the western medicine group (P<0.05). Conclusion　Carbamazepine combined with Tongqiao Huoxue Decoction for patients with SE after CIS is effective and safe, and can control their epileptic seizures, reduce epileptic discharge and involvement range, and improve their cognitive and neurological functions.

Treatises

Low-frequency electrical stimulation combined with moxibustion for parturient women

Shen Lihong, Ye Dongmei, Xu Nannan

2025, 31(18):  3032-3036.  DOI: 10.3760/cma.j.cn441417-20250215-18008

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Objective　To observe the effects of low-frequency electrical stimulation combined with moxibustion on lactation, breastfeeding, and quality of life of parturient women. Methods　One hundred parturient women who gave birth in Department of Obstetrics and Gynecology, Fuzhou Hospital of Traditional Chinese Medicine from June 2022 to November 2024 were selected for the randomized controlled trial. They were divided into a control group and an observation group by the random number table method, with 50 cases in each group. The control group were (27.62±3.25) years old; their body weight was (69.78±8.11) kg; they were (37.27±1.34) weeks pregnant when they delivered; the neonates' body weight was (3 214.18±249.37) g. The observation group were (28.73±3.34) years old; their body weight was (68.32±8.48) kg; they were (38.51±1.29) weeks pregnant when they delivered; the neonates' body weight was (3 197.01±250.57) g. Twenty-four hours after delivery, the control group took moxibustion, while the observation group took low-frequency electrical stimulation and moxibustion. After 3 days' intervention, the psychological status, postpartum milk production, breastfeeding situation, quality of life, and incidence rates of adverse reactions were compared between the two groups by t and χ² tests. Results　After the intervention, the scores of Edinburgh Postnatal Depression Scale and Breast Feeding Self-Efficacy Scale, postpartum exclusive breastfeeding rate, score of Short Form 36 Health Survey, onset time of postpartum lactation, and the incidence rates of breast swelling and pain and mastitis in the observation group were better than those in the control group [6.98±0.82 vs. 8.01±0.62, 130.96±3.49 vs. 118.54±3.19, 100% (50/50) vs. 75% (35/50), 87.78±3.30 vs. 77.90±2.79, (30.02±2.99) h vs. (41.80±2.46) h, 2% (1/50) vs. 14% (7/50), and 0 vs. 12% (6/50); t=9.223, P<0.001; t=18.567, P<0.001; χ²=17.647, P<0.001; t=16.166, P<0.001; t=21.537, P<0.001; χ²=4.891 and 6.383, P=0.027 and 0.012]. Conclusion　Low-frequency electrical stimulation combined with moxibustion for parturient women can alleviate their adverse emotions, promote lactation, and improve their breastfeeding and quality of life.

Changes of digestive tract microecology and serum levels of Hcy and Apo-A and their correlation with heart failure in patients with acute myocardial infarction

Shi Yingpeng, Cui Jie, Li Chaojie, Wang Dan, Chang Jia, He Hongmei, Tian Lin

2025, 31(18):  3036-3040.  DOI: 10.3760/cma.j.cn441417-20250410-18009

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Objective　To study the changes of digestive tract microecology and serum levels of homocysteine (Hcy) and apolipoprotein A (Apo-A) in patients with acute myocardial infarction (AMI) and their correlation with heart failure (HF). Methods　A retrospective analysis was conducted on the medical records of 120 patients with AMI treated at the First Affiliated Hospital of Xi'an Medical University from October 2022 to October 2024. They were divided into an HF group (56 cases) and a non-HF group (64 cases) according to whether they were complicated with HF. There were 30 males and 26 females in the HF group, with an age of (55.17±5.26) years, and a disease course of (2.51±0.45) h. There were 35 males and 29 females in the non-HF group, with an age of (55.26±5.32) years and a course of disease of (2.45±0.39) h.The changes of digestive microecology (Bacteroidetes, Bifidobacterium, Enterobacteriaceae, and Enterococcus) and serum levels of Hcy and Apo-A were compared between the two groups, and the correlations of digestive microecology and serum levels of Hcy and Apo-A with HF in the patients were analyzed by the Spearman rank correlation analysis. t test was used as the statistical method. Results　The levels of Bacteroidetes and Bifidobacterium in the HF group were lower than those in the non-HF group [(3.52±0.75) lgCFU/g vs. (6.89±1.32) lgCFU/g and (4.01±0.55) lgCFU/g vs. (7.45±1.46) lgCFU/g], and the levels of Enterobacteriaceae, Enterococcus, Hcy, and Apo-A were higher [(22.36±3.65) lgCFU/g vs. (18.72±3.14) lgCFU/g, (20.92±2.54) lgCFU/g vs. (17.48±2.26) lgCFU/g, (19.22±3.80) μmol/L vs. (16.51±2.45) μmol/L, and (0.62±0.15) g/L vs. (0.40±0.10) g/L], with statistical differences (t=21.870, 16.623, 5.873, 7.851, 4.699, and 9.557; all P<0.05). The Spearman rank correlation analysis showed that the levels of Bacteroidetes and Bifidobacteria were negatively correlated with HF in the patients (r=-0896 and -0.837; both P<0.001), and the levels of Enterobacteriaceae, Enterococcus, Hcy, and Apo-A were positively correlated with HF (r=0.476, 0.586, 0.394, and 0718; all P<0.001). Conclusion　Patients with AMI have gastrointestinal microbiota imbalance and abnormal levels of serum Hcy and Apo-A, which are closely related to the occurrence and development of HF.

Application of flash glucose monitoring in blood glucose fluctuation of patients with diabetic retinopathy

Zhang Xuelian, Meng Wei, Zhang Min, Shen Jie, Wang Chunhong, Li Shanshan, Chang Bing

2025, 31(18):  3041-3044.  DOI: 10.3760/cma.j.cn441417-20250312-18010

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Objective　To study the effect of flash glucose monitoring (FGM) for patients with diabetic retinopathy (DR) and its influence on blood glucose fluctuation. Methods　Sixty patients with DR treated at Xuzhou First People's Hospital from October 2023 to March 2024 were selected for the prospective study, and were divided into a control group and an observation group according to the intervention methods, with 30 cases in each group. There were 23 males and 7 females in the control group; they were (53.74±12.96) years old; their diabetic course was (5.60±1.48) years. There were 19 males and 11 females in the observation group; they were (52.18±10.09) years old; their diabetic course was (5.43±1.51) years. The control group received routine intervention. The observation group received FGM and personalized intervention management. The blood glucose [fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2 hPG), glycosylated hemoglobin (HbA1c), and time in range (TIR)], best corrected visual acuity (BCVA), and self-management ability levels before and after the intervention were compared between the two groups by t test. Results　After the intervention, the FPG, 2 hPG, and HbA1c in the observation group were lower than those in the control group [(5.92±1.28) mmol/L vs. (6.58±1.10) mmol/L, (7.47±1.72) mmol/L vs. (8.53±1.84) mmol/L, and (5.10±0.69)% vs. (5.67±0.82)%], and the TIR, BCVA, and total score of Summary of Diabetes Self-care Activities (SDSCA) were higher [(72.30±7.26)% vs. (65.97±8.74)%, (0.53±0.18) logMAR vs. (0.42±0.17) logMAR, and 47.68±9.30 vs. 40.21±7.62], with statistical differences (t=2.142, 2.305, 2.913, 3.051, 2.433, and 3.403; all P<0.05). Conclusion　Application of FGM in patients with DR is effective, and can improve their blood glucose levels and self-management ability and reduce blood glucose fluctuation.

Mechanism of Danggui Buxue Decoction in treatment of iron deficiency anemia based on network pharmacology and molecular docking

Chen Chao, Li Yanling, Mai Dongmei, Cai Donghao

2025, 31(18):  3045-3052.  DOI: 10.3760/cma.j.cn441417-20240101-18011

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Objective　To explore the mechanism of Danggui Buxue Decoction in the treatment of iron deficiency anemia based on network pharmacology and molecular docking technology. Methods　The active components and targets of Astragalus and Angelica sinensis were screened by the Traditional Chinese Medicine Systems Pharmacology (TCMSP) and reading literature, and the effective targets were screened by the Swiss Target Prediction database. The targets of iron deficiency anemia were obtained from the GeneCards database. Through the intersection of drug targets and disease targets, the key targets were obtained. Gene ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed using the David database. According to the enrichment results of the pathways, the "drug-component-target-pathway" map was drawn, and the key active ingredients and their core targets were obtained. The MOE software was used to verify the molecular docking of the key components and core targets. Results　A total of 30 active ingredients and their corresponding 661 targets and 939 disease targets were included in this study, and 110 key targets were obtained by the intersection of the two. Quercetin, kaempferol, 3, 9-di-o-methylnissolin, and cis-ferulic acid were the key active ingredients of Danggui Buxue Decoction in the treatment of iron deficiency anemia. Fifteen targets, including phosphoinositol 3-kinase regulatory subunit 1 (PIK3R1), RAC-alpha serine/threonine-protein kinase (AKT1), transcription factor p65 (RELA), mitogen-activated protein kinase 1 (MAPK1), MAPK14, etc., were the corresponding core action targets. It might play a role through several signaling pathways, such as the advanced glycation endproducts (AGE)-receptor for advanced glycation endproducts (RAGE) signaling pathway and HIF-1 signaling pathway. The molecular docking showed that the key active ingredients and the corresponding core target had good binding activity. Conclusion　Danggui Buxue Decoction is an effective traditional Chinese medicine for iron-deficiency anemia, and exert its effects through multiple targets and various signaling pathways.

Jianpi Huoxue formula combined with acupuncture and moxibustion for patients with precancerous lesions of chronic atrophic gastritis

Jia Lele, Song Yuanyuan, He Minmin, Huang Yahui

2025, 31(18):  3053-3058.  DOI: 10.3760/cma.j.cn441417-20250326-18012

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Objective　To investigate the efficacy of Jianpi Huoxue formula combined with acupuncture and moxibustion for patients with precancerous lesions of chronic atrophic gastritis. Methods　Eighty patients with precancerous lesions of chronic atrophic gastritis treated at Xi'an Hospital of Traditional Chinese Medicine from December 2023 to December 2024 were selected for the randomized controlled trial. These patients were divided into a control group, treated with western medicine, and an observation group, treated with Jianpi Huoxue formula, acupuncture, and moxibustion, by the random number table method, with 40 cases in each group. There were 22 males and 18 females in the control group; they were (54.63±6.58) years old; their disease course was (5.63±2.54) years. There were 21 males and 19 females in the observation group; they were (55.10±7.52) years old; their disease course was (5.60±2.65) years. The scores of traditional Chinese medicine symptoms, gastric mucosal function, TLR4 inflammatory pathway, and serum tumor markers were compared between the two groups. ｔ and χ² tests were used for the statistical analysis. Results　After the treatment, the scores of major and minor symptoms and total score in the observation group were 4.01±0.12, 3.10±0.21, and 7.11±1.23, which were lower than those in the control group (5.10±0.66, 4.00±0.52, and 9.10±2.01) (t=10.276, 10.149, and 5.340; all P<0.05). The scores of gastric mucosal inflammation, glandular atrophy, intestinal metaplasia, and dysplasia in the observation group were 0.98±0.13, 0.35±0.03, 0.48±0.12, and 0.35±0.06, which were lower than those in the control group (1.91±0.31, 1.55±0.23, 1.34±0.24, and 1.23±0.17) (t=17.497, 32.720, 20.270, and 30.872; all P<0.05). The levels of Toll-like receptor 4 (TLR4), nuclear factor kappa B (NF-κB), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) in the observation group were (10.70±0.06)%, (620.90±10.44) ng/L, (30.78±3.90) ng/L, and (25.11±2.52) ng/L, which were lower than those in the control group [(15.98±0.31)%, (730.00±10.15) ng/L, (44.31±5.48) ng/L, and (35.97±3.31) ng/L] (t=105.758, 47.388, 12.722, and 16.510; all P<0.05). The levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 72-4 (CA72-4), and carbohydrate antigen 125 (CA125) in the observation group were (9.10±1.23) mg/L, (30.02±3.10) U/ml, (4.37±1.30) U/ml, and (17.58±2.37) U/ml, which were lower than those in the control group [(13.11±2.14) mg/L, (42.01±4.17) U/ml, (6.38±2.34) U/ml, and (25.35±3.41) U/ml] (t=10.274, 14.594, 4.748, and 11.833; all P<0.05). The overall incidence rate of adverse reactions in the observation group was lower than that in the control group (χ²=5.164; P<0.05). Conclusion　Jianpi Huoxue formula combined with acupuncture and moxibustion in the treatment of patients with precancerous lesions of chronic atrophic gastritis can effectively improve their gastric mucosal function, optimize the TLR4 inflammatory pathway, and reduce the risk of adverse reactions.

SIRT3 regulates the sensitivity of esophageal squamous cell carcinoma to cisplatin through the AKT signaling pathway

Yuan Mingliang, Lu Yu, Ye Xin, Yang Xi, Yu Xuechun

2025, 31(18):  3058-3064.  DOI: 10.3760/cma.j.cn441417-20250327-18013

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Objective To investigate the effect of silent information regulator 3 (SIRT3) on the sensitivity of esophageal squamous cell carcinoma to cisplatin through protein kinase B (AKT) signaling pathway and a the possible molecular mechanism. Methods The implementation period of this experiment was from May to December 2023. By knocking down SIRT3 expression in ECA109 and KYSE30 cells, the two cell lines were divided into a negative control group with SIRT3 knockdown (shNC group) and a control group with SIRT3 knockdown (shSIRT3 group). The protein expression levels of SIRT3, AKT, Phosphor-protein kinase B (p-AKT) and hexokinase 2 (HK2) in each group of cells were detected by Western blot; the effect of cisplatin on the viability of cells in each group was detected by Cell Counting Kit-8 (CCK-8), and the half inhibitory concentration (IC50) of cisplatin was calculated; the effect of each group of cells on cisplatin was evaluated by plate cloning assay. Statistical analysis was conducted using the independent sample t-test. Results The IC50 value of the shSIRT3 group in ECA109 cells was lower than that of the shNC group [(6.65 ± 0.45) μmol/L vs. (11.16 ± 0.75) μmol/L, P < 0.001]. In KYSE30 cells, the IC50 value of the shSIRT3 group was also lower than that of the shNC group [(9.81 ± 0.19) μmol/L vs. (15.53 ± 1.11) μmol/L, P < 0.001]. In ECA109 cells, under the same concentration of cisplatin, The relative clone formation rate of cells in the shSIRT3 group was compared with that in the shNC group (0.69±0.04 vs. 0.84±0.01, 0.40±0.02 vs. 0.59±0.02, 0.24±0.01 vs. 0.37±0.01, 0.08±0.01 vs. 0.17±0.01) (all P < 0.05). In KYSE30 cells, at low concentrations of cisplatin (0.1 μmol/L and 0.2 μmol/L), the relative clone formation rate in the shSIRT3 group was compared with that in the shNC group (all P > 0.05); Under the action of high-concentration cisplatin (0.3 μmol/L and 0.4 μmol/L), the relative clone formation rate of cells in the shSIRT3 group was compared with that in the shNC group (0.41±0.01 vs. 0.66±0.06 and 0.14±0.01 vs. 0.50±0.02) (both P < 0.05). In ECA109 cells and KYSE30 cells, the expressions of HK2 and p-AKT proteins in the shSIRT3 group were lower than those in the shNC group (all P<0.01) Conciusion Silencing SIRT3 expression may down-regulate HK2 expression through the AKT signaling pathway, thereby enhancing the sensitivity of esophageal squamous cell carcinoma to cisplatin.

Current status and changing trends of disease burden of hepatocellular carcinoma associated with hepatitis B virus infection in China

Wang Ruiping, Zhang Jie, Li Qianrong, Kou Xiaoni, Zhang Rongqiang, Zhang Xilu

2025, 31(18):  3065-3070.  DOI: 10.3760/cma.j.cn441417-20250322-18014

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Objective　To analyze the current status and changing trends of the disease burden of hepatocellular carcinoma (HCC) associated with hepatitis B virus (HBV) infection in China. Methods　The global disease burden data from 1990 to 2021 were analyzed, so as to reveal the changing trends and influencing factors of the disease burden of HBV-related HCC. The estimated annual percentage change (EAPC) was used to assess the trends of the incidence rates globally and in China. The Bayesian Age-Period-Cohort (BAPC) model was used to separate the effects of age, period, and birth cohort on the disease burden. According to the GBD guidance in 2019, the global standard population was used to standardize the incidence rate, morbidity rate, disability adjusted life year (DALY) rate, and YLDs in age. The changing rate of each indicator from 1990 to 2021 was calculated. The disease burden of HBV-related HCC of different age groups was analyzed. The statistical analyses were performed by the SPSS 23.0 and R language software. Results　The standardized mortality rate, standardized DALYs, standardized morbidity rate, and standardized incidence rate of HBV-related HCC showed a significant downward trend globally and in China. In China, the number of male patients with HBV-related HCC was higher than that of females, with the peak incidence occurring in >50-70 years old males. The Joinpoint regression model showed that from 1990 to 1997, the standardized mortality rate of HBV-related HCC decreased significantly, increased obviously from 1997 to 2014, and decreased again from 2014 to 2024. From 1990 to 1995, the standardized morbidity rate of HBV-related HCC declined slowly, increased rapidly from 1995 to 2003, rose slowly from 2003 to 2011, and showed a significant downward trend from 2011 to 2021. From 1990 to 1995, the standardized incidence rate of HBV-related HCC declined slowly, increased rapidly from 1995 to 2013, and decreased sharply from 2013 to 2021. From 1990 to 1997, the standardized DALYs of HBV-related HCC declined slowly, increased rapidly from 1997 to 2012, and decreased sharply again from 2012 to 2021. Conclusions　The disease burden of HBV-related HCC has shown a decreasing trend globally and in China. The study reveals the impact of sociodemographic indices, age, period, and birth cohort on the disease. These findings provide some scientific evidences for formulating targeted prevention and control strategies.

Clinical Research

Application of dynamic contrast-enhanced MRI combined with DWI in the differential diagnosis of BI-RADS type 4 breast lesions

Wu Peng, Zhang Hongxia, Bai Zhengrong, Chen Haihai

2025, 31(18):  3071-3076.  DOI: 10.3760/cma.j.cn441417-20250331-18015

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Objective　To explore the application of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with diffusion-weighted imaging (DWI) in the differential diagnosis of Breast Imaging Reporting and Data System (BI-RADS) type 4 breast lesions. Methods　By conducting a retrospective analysis, the clinical data of 90 patients with BI-RADS type 4 breast lesions indicated by breast ultrasound who were admitted to Yan'an People's Hospital from January to December 2024 were collected. All were female, with an average age of (46.52 ± 5.77) years; 49 cases were on the left side of the chest and 41 cases on the right; the maximum long diameter of the nodules was (2.95 ± 0.82) cm.The consistency between DCE-MRI combined with DWI and pathological examination of BI-RADS type 4 breast lesions was analyzed. The differences in DCE-MRI parameters [volume transfer constant (K^trans), reverse reflux rate constant (K_ep), maximum slope of increase (MSI)] and DWI parameter [apparent diffusion coefficient (ADC)] were compared between malignant group and benign group. The statistical method employed was Student's t-test. Receiver operating characteristic (ROC) curve was used to analyze the efficiency of DCE-MRI parameters and DWI parameter in distinguishing benign and malignant lesions. Results　Pathological results showed that 52 patients were malignant lesions and 38 patients were benign lesions. The consistency Kappa values of DCE-MRI, DWI, DCE-MRI combined with DWI in the diagnosis of benign and malignant BI-RADS type 4 breast lesions were 0.683, 0.703 and 0.840 respectively. The values of K^trans, K_ep and MSI in the malignant group were higher than those in the benign group, while the ADC value was lower than that in the benign group. The differences were all statistically significant (all P< 0.05). According to ROC curve analysis, the AUCs of K^trans, K_ep, MSI, ADC value and combination for benign and malignant BI-RADS type 4 breast lesions were 0.774, 0.847, 0.822, 0.766 and 0.977, and the sensitivities were 0.48, 0.75, 0.83, 0.67 and 0.89, and the specificities were 0.95, 0.87, 0.82, 0.79 and 1.00 respectively. Conclusion　DCE-MRI combined with DWI has great potential for the diagnosis of benign and malignant nature of BI-RADS type 4 breast lesions.

One case of Noonan syndrome type 3 caused by KRAS gene mutation and analysis of clinical phenotypic spectrum

Li Xin, Wang Zhenjing, Qi Caihui, Liu Xin, Yang Wentao, Wang Shuping

2025, 31(18):  3076-3080.  DOI: 10.3760/cma.j.cn441417-20250408-18016

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Objective　To explore the clinical features and genetic variants in a case of KRAS gene mutation-induced Noonan syndrome type 3, and to provide some references for its diagnosis. Methods　We selected a case of a 15-year-and-2-month-old male patient with Noonan syndrome type 3 who visited Dongying People's Hospital in August 2024. The patient's clinical data were retrospectively collected. Whole-exome sequencing was performed on the peripheral blood samples from the patient and his parents. The candidate variants were validated by Sanger sequencing, and analyzed by the bioinformatics tools. The pathogenicity of the identified variant was classified according to the standards and guidelines for the interpretation of sequence variants established by the American College of Medical Genetics and Genomics (ACMG). Results　The patient's clinical features included short stature, growth and developmental delay, facial dysmorphism, and electrocardiographic abnormalities. The whole-exome sequencing revealed a de novo pathogenic point mutation in the KRAS gene: NM_004985.4: c.40G>A (p.Val14Ile). According to the ACMG guidelines, the variant was classified as pathogenic (PS2_VeryStrong+PS3+PS4+PM1+PP2+PM2_Supporting). Conclusions　The de novo variant in the KRAS gene is considered the genetic etiology of Noonan syndrome type 3 in this patient. For children with short stature, growth and developmental delay, facial dysmorphism, or electrocardiographic abnormalities, clinical suspicion for Noonan syndrome type 3 should be raised, and early genetic testing is recommended to confirm the diagnosis. The findings of this study also expand the known variant spectrum of the KRAS gene.

Value of serum levels of IL-6, TNF-α, and LDH in prediction of prognosis of children with RMPP

Liu Tiaoxia, Wu Beilei, Li Xiaohua

2025, 31(18):  3081-3085.  DOI: 10.3760/cma.j.cn441417-20250504-18017

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Objective　To explore the value of serum levels of interleukin-6 (IL-6), tumor necrosis factor-α, (TNF-α), and lactate dehydrogenase (LDH) in the prediction of children with refractory Mycoplasma pneumonia (RMPP). Methods　Sixty children with RMPP treated at Tongchuan Maternal and Child Health Hospital from October 2023 to October 2024 were selected as an observation group, and sixty children with common mycoplasma pneumonia (MPP) during the same period were selected as a control group. In the observation group, there were 35 boys and 25 girls; they were (8.32±1.60) years old. In the control group, there were 32 boys and 28 girls; they were (8.21±1.54) years old. The serum levels of IL-6, TNF-α, and LDH were compared between the two groups. The serum levels of IL-6, TNF-α, and LDH were compared between the children with different prognoses in the observation group. The risk factors associated with the prognosis of the children with RMPP were analyzed. The predictive value of serum levels of IL-6, TNF-α and LDH for the prognosis of the children with RMPP was analyzed. The statistical methods employed included t test, χ² test, multivariate logistic regression analysis, and receiver operating characteristic curve (ROC) analysis. Results　The serum levels of IL-6, TNF-α, and LDH in the observation group were higher than those in the control group [(28.18±4.28) ng/L vs. (22.85±2.23) ng/L, (38.52±4.32) ng/L vs. (30.20±2.96) ng/L, (377.70±38.63) U/L vs. (257.67±16.49) U/L], with statistical differences (all P<0.05). Among the children in the observation group, 17 cases were classified into the poor prognosis group, while the rest 43 cases the good prognosis group; the serum levels of IL-6, TNF-α, and LDH in the poor prognosis group were higher than the those in good prognosis group [(32.42±3.25) ng/L vs. (26.51±3.39) ng/L, (43.15±3.71) ng/L vs. (36.69±2.99) ng/L, and (377.23±26.15) U/L vs. (322.08±30.88) U/L], with statistical differences (all P<0.05). The multivariate logistic regression analysis showed that the serum levels of IL-6, TNF-α, and LDH were risk factors for the prognosis of the children RMPP (all P<0.05). The area under the receiver operating characteristic curve (AUC) of the combined detection of serum IL-6, TNF-α, and LDH for predicting the prognosis of the children with RMPP was 0.992 (95%CI 0.977-0.997), with a sensitivity of 97.20% and a specificity of 93.00%. Conclusion　The combination of IL-6, TNF-α, and LDH in the prediction of the prognosis of children with RMPP has high sensitivity and specificity, indicating good predictive value.

Xiao'ai Shunqi Decoction combined with FAP regimen in treatment of patients with advanced liver cancer

Jiang Jing, Li Xiling, Yu Zhiping, Cong Haibo

2025, 31(18):  3086-3091.  DOI: 10.3760/cma.j.cn441417-20250410-18018

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Objective　To investigate the short-term efficacy of adjuvant therapy with Xiao'ai Shunqi Decoction combined with the FAP regimen (combination of fluorouracil, doxorubicin, and cisplatin injection) for patients with advanced liver cancer, as well as its impact on the serum level of alpha-fetoprotein (AFP) and their quality of life. Methods　A total of 104 patients with advanced liver cancer who were treated in Weihai Central Hospital from February 2021 to January 2024 were selected for the randomized controlled trial, and were divided into a treatment group and a control group by the random number table method, with 52 patients in each group. The treatment group consisted of 32 males and 20 females, with an age of (56.56±7.34) years. The control group consisted of 34 males and 18 females, with an age of (55.88±8.24) years. The treatment group were treated with Xiao'ai Shunqi Decoction and the FAP regimen, while the control group with the FAP regimen. Both groups were treated for 3 months. The objective response rates (ORR) and disease control rates (DCR) after the treatment, liver function indicators [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), and albumin (Alb)], serum levels of AFP and carcino-embryonic antigen (CEA), and quality of life [the score of the Karnofsky Performance Status (KPS)] before and after the treatment, and the incidences of adverse reactions were compared between the two groups. χ² and t tests were used for the statistical analysis. Results　The ORR and DCR in the treatement group were higher than those in the control group [40.38% (21/52) vs. 21.15% (11/52) and 82.69% (43/52) vs. 55.77% (29/52); both P<0.05]. After the treatment, the serum levels of ALT, AST, and TBIL in the treatment group were lower than those in the control group [(46.17±9.84) U/L vs. (51.11±11.77) U/L, (41.51±7.66) U/L vs. (48.40±8.59) U/L, and (26.25±6.79) μmol/L vs. (30.17±7.73) μmol/L], and the serum level of Alb was higher [(40.82±3.35) g/L vs. (36.75±3.22) g/L] (all P<0.05). After the treatment, the serum levels of AFP and CEA in the treatment group were lower than those in the control group [(24.09±3.15) μg/L vs. (47.31±3.80) μg/L and (13.25±1.68) μg/L vs. (18.35±2.19) μg/L; both P<0.05]. After the treatment, the score of KPS in the treatment group was higher than that in the control group (81.15±4.17 vs. 74.44±4.91; P<0.05). The incidence rate of adverse reactions in the treatment group was lower than that in the control group (P<0.05). Conclusion　Adjuvant therapy with Xiao'ai Shunqi Decoction combined with the FAP regimen in the treatment of patients with advanced liver cancer can improve the short-term efficacy and their liver function and quality of life and reduce the serum level of AFP and the occurrence of adverse reactions.

Case Report

One case of misdiagnosis of eosinophilic hepatic infiltration

Zhao Xiaoman, Zhu Mingli, Han Zhihao, Liu Chunguang

2025, 31(18):  3092-3094.  DOI: 10.3760/cma.j.cn441417-20240101-18019

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Eosinophilic hepatic infiltration (EHI) is a rare and easily misdiagnosed liver disease characterized by sustained excessive proliferation of eosinophils infiltrating local liver tissue. This article reports a patient with EHI admitted to Weihai Central Hospital, Qingdao University. Preoperative misdiagnosis was hepatic inflammatory myofibroblastic tumor (HIMT), and postoperative histopathological examination confirmed EHI. The diagnosis and treatment process and misdiagnosis reasons were retrospectively analyzed, so as to provide some references for the clinical diagnosis and treatment of this disease.

One case of gastric metastasis from lung cancer with upper digestive tract bleeding as the first symptom

Chen Lanxin, Xu Lan, Liu Lin, Ye Gang

2025, 31(18):  3095-3097.  DOI: 10.3760/cma.j.cn441417-20250430-18020

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Gastric metastasis from primary lung cancer is very rare, and the patients may present with common gastrointestinal symptoms but lack of specificity, leading to missed diagnosis and misdiagnosis. In this article, we share one case of severe anemia due to upper gastrointestinal bleeding who was admitted to the First Affiliated Hospital of Jinan University. The patient was diagnosed as gastric metastasis from lung cancer after gastroscopic examination and biopsy of pathological tissue.

Nursing Research

Impact of environmental intervention combined with partner participatory care on primiparas' breastfeeding self-efficacy

Meng Qiufang, Guo Na, Huang Rong

2025, 31(18):  3098-3102.  DOI: 10.3760/cma.j.cn441417-20241126-18021

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Objective　To explore the effect of environmental intervention combined with partner participatory care on primiparas' breastfeeding self-efficacy. Methods　Eighty primiparas admitted to Tongchuan People's Hospital from January 2023 to March 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 40 cases in each group. The control group were (27.40±1.06) years old, and the observation group 27.50±1.52. The control group were routinely cared. The observation group took environmental intervention and partner participatory care. The maternal emotional status, breastfeeding success rates, and self-efficacy levels were compared between the two groups. t test, repeated measurement analysis of variance, and χ² test were used for the statistical analysis. Results　After 3 and 7 days' intervention, the scores of Symptom Check-list-90 (SCL-90) in the observation group were lower than those in the control group (215.68±11.31 vs. 224.90±9.88 and 97.58±8.23 vs. 122.43±7.38; t=3.883 and 14.218; both P<0.05). After 7 days' intervention, the breastfeeding success rate in the observation group was higher than that in the control group [90.00% (36/40) vs. 70.00% (28/40)], and the artificial feeding rate was lower [5.00% (2/40) vs. 20.00% (8/40)] (χ²=5.000 and 4.114; both P<0.05). After 7 days' intervention, the scores of overall confidence in feeding, breastfeeding skills, and feeding adjustment coping of the Breastfeeding Self-Efficacy Scale Short Form (BSES-SF) in the observation group were higher than those in the control group (10.00±1.50 vs. 8.13±2.71, 15.95±1.30 vs. 14.85±2.50, and 9.13±2.14 vs. 6.78±2.12; t=3.818, 2.469, and 4.934; all P<0.05). Conclusion　Environmental intervention combined with partner participatory care for primiparas can significantly improve their emotional status and self-efficacy and the breastfeeding success rate.

Effect of self-care theory combined with predictive nursing for patients with postpartum urinary retention

Wang Meixia, Zhang Yu, Wang Saiying

2025, 31(18):  3102-3106.  DOI: 10.3760/cma.j.cn441417-20241206-18022

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Objective　To explore the effect of self-care theory combined with predictive nursing for patients with postpartum urinary retention, and to improve postpartum women's rehabilitation and quality of life. Methods　One hundred and twenty postpartum women who delivered in Shenmu City Hospital from January 2022 to December 2023 were selected for the randomized controlled trial, and were divided into a control group and an observation group by the random number table method, with 60 cases in each group. The control group took routine nursing care, and the observation group received self-care theory combined with predictive nursing. The observation indicators included the incidence rate of postpartum urinary retention, bladder function, psychological status [Edinburgh Postnatal Depression Scale (EPDS) and Self-Perceived Burden Scale (SPBS)], and incidence rate of complications. t and χ² tests were used for the statistical analysis. Results　After the intervention, the total incidence rate of postpartum urinary retention in the observation group was lower than that in the control group [10.00% (6/60) vs. 23.33% (14/60); χ²=4.286; P<0.05]. The first urination time, single urination volume, residual urine volume, and maximum urine flow rate in the observation group were better than those in the control group [(4.62±0.78) h vs. (5.65±0.89) h, (168.38±20.54) ml vs. (136.95±17.32) ml, (111.74±10.85) ml vs. (137.69±14.01) ml, and (15.47±3.15) ml/s vs. (12.63±2.89) ml/s; t=6.742, 9.061, 11.343, and 5.146; all P<0.05]. After the intervention, the scores of EPDS and SPBS in the observation group were lower than those in the control group (12.05±1.87 vs. 15.26±1.32 and 21.59±2.86 vs. 27.33±2.91; t=10.863 and 10.897; both P<0.05). The total incidence rate of complications in the observation group was lower than that in the control group [10.00% (6/60) vs. 30.00% (18/60); χ²=7.500; P<0.05]. Conclusion　Self-care theory combined with predictive nursing for women with postpartum urinary retention can effectively reduce the incidence of postpartum urinary retention, improve their bladder function and psychological health, and decrease the incidence rate of complications.

Study on the influencing factors of termination of pregnancy upon diagnosis of early onset preeclampsia

Wang Li, Guo Zhenzhen, Sun Hongyue

2025, 31(18):  3107-3111.  DOI: 10.3760/cma.j.cn441417-20241014-18023

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Objective To analyze the influencing factors for pregnancy termination decisions in patients diagnosed with early-onset preeclampsia (EOPE). Methods A retrospective analysis was conducted using colored pens to collect clinical data of 103 patients with severe EOPE diagnosed at Women & Infants Hospital of Zhengzhou from March 2021 to March 2024. The patients were divided into a termination group (31 cases) and a pregnancy group (72 cases) based on whether they chose to terminate their pregnancy at the time of diagnosis. The termination group had an age of (30.42±3.06) years, while the pregnancy group had an age of (29.67±3.04) years. Statistical comparison was conducted using t test and χ² test, and univariate and multivariate logistic regression analyses were conducted to identify the relevant factors for selecting pregnancy termination in patients with severe EOPE upon diagnosis. Receiver Operating Characteristic curves (ROC) and calibration curves were plotted to evaluate the value of the model. Results Multiple logistic regression analysis showed that the presence of severe complications (OR=3.363), progressive thrombocytopenia (OR=6.535), high levels of D-dimer (OR=9.296), high levels of cystatin C (OR=13.205), and low cerebral placental ratio (OR=0.005) were the relevant factors for choosing to terminate pregnancy in patients with severe EOPE upon diagnosis (all P<0.05). The risk prediction model constructed based on the above factors showed that the area under the curve of the model was 0.873, and the model calibration was good. Conclusions The combination of severe complications, progressive thrombocytopenia, high levels of D-dimer, high levels of cystatin C, and low brain placental ratio are relevant factors for the selection of pregnancy termination in patients with severe EOPE diagnosis. The risk prediction model constructed has good predictive value.

The effect of multidisciplinary collaborative nursing model on blood pressure level and delivery outcome of patients with pregnancy-induced hypertension

Yuan Guoxiang, Tang Le, Li Xiaohong, Liu Rong, Gao Yingxia

2025, 31(18):  3112-3117.  DOI: 10.3760/cma.j.cn441417-20240923-18024

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Objective　To investigate the clinical efficacy of multidisciplinary collaborative care models in patients with gestational hypertension. Methodology　A randomized controlled trial was conducted, in which 200 patients diagnosed with gestational hypertension and preeclampsia through comprehensive clinical examinations at Xi'an People's Hospital (Xi'an Fourth Hospital) between April 2023 and May 2024 were selected and randomly assigned to either the control group (100 cases) or the experimental group (100 cases) using a random number table method. The control group comprised patients with a mean age of (29.28±3.67) years and gestational age of (26.18±1.28) weeks, who received standard care protocols.The experimental group comprised patients with a mean age of (29.53±3.46) years and gestational age of (25.97±1.43) weeks, who received multidisciplinary collaborative nursing intervention.Compare the blood pressure (diastolic blood pressure, systolic blood pressure, mean arterial pressure), vascular endothelial function [endothelin-1 (ET-1), nitric oxide (NO)] levels, and maternal-neonatal outcomes between the two groups of patients before and after the intervention.Statistical analysis was conducted using t-tests and χ² tests. Results　After the intervention, the experimental group exhibited the following parameters: diastolic blood pressure (81.23±7.69 mmHg; 1 mmHg=0.133 kPa), systolic blood pressure (116.25±13.54) mmHg, mean arterial pressure (75.68±5.52) mmHg, ET-1 level (23.49±3.36 μmol/L), and NO level (56.39±8.72) ng/L. The control group showed corresponding values of 87.37±7.37 mmHg, (126.48±16.48 mmHg, (79.37±5.76) mmHg, (20.43±3.23) μmol/L, and (70.56±9.38) ng/L, respectively. All intergroup differences were statistically significant (all P<0.05).The incidence of adverse pregnancy outcomes in the experimental group [16.00% (16/100)] and neonatal adverse outcomes [3.00% (3/100)] were significantly lower than those in the control group [36.00% (36/100) and 13.00% (13/100), respectively], with statistically significant differences between the two groups (all P<0.05). Conclusion　The multidisciplinary collaborative care model demonstrates efficacy in reducing blood pressure levels among pregnant women with hypertension, promoting the amelioration of vascular endothelial function, and mitigating the incidence of adverse pregnancy outcomes as well as neonatal complications.

Application of eating posture guidance combined with swallowing training in patients with dysphagia after cerebral infarction

Zhong Hui, Liu Dan, Zhou Jia, Li Xia

2025, 31(18):  3117-3121.  DOI: 10.3760/cma.j.cn441417-20250219-18025

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Objective　To explore the intervention effect of implementing eating position guidance combined with swallowing training for patients with dysphagia after cerebral infarction. Methods　A prospective study was conducted on 98 patients with post-cerebral infarction dysphagia who were admitted to Zhongshan Central Hospital in Dezhou from October 2022 to October 2024. They were randomly divided into a control group and an observation group, with 49 cases in each group using the random number table method.Control group: 26 males and 23 females, aged 51 to 72(61.59±3.36) years. Received routine intervention. Observation group: 27 males and 22 females, aged 52 to 71(61.68±3.40) years. In addition to the routine intervention, they received guidance on eating postures combined with swallowing training.Both groups underwent continuous training intervention for 30 days. The recovery of swallowing function, incidence of choking and aspiration, eating situation, nutritional status, and quality of life were compared between the two groups before and after the intervention.Statistical analysis was conducted using t-test and χ² test. Results　After the intervention, the clinical examination, water intake test and normal eating score of the observation group were all lower than those of the control group (t=19.287, 16.470, and 27.787; all P<0.05). The incidences of choking cough and aspiration were both lower in the experimental group compared to the control group [20.41% (10/49) vs. 38.78% (19/49) and 8.16% (4/49) vs. 24.49%(12/49)], and the differences were statistically significant (χ²=3.967 and 4.781; both P<0.05). The time for the observation group to achieve self-feeding was shorter than that of the control group, and the actual proportion of self-feeding was higher than that of the control group (t=10.560 and 7.291; both P<0.05). After the intervention, the levels of hemoglobin (Hb), albumin (ALB), and prealbumin (PA) in the observation group were all higher than those in the control group [(118.78±12.96) g/L vs. (106.67±12.73) g/L, (44.70±4.38) g/L vs. (40.78±4.32) g/L, and (245.77±25.96) mg/L vs. (211.15±22.59) mg/L], and the differences were statistically significant (t=4.666,4.460, and 7.042; all P<0.05).After the intervention, the scores in each item of the Specific Quality of Life Scale for Dysphagia (SWAL-QOL) in the observation group were all higher than those in the control group (all P<0.05). Conclusion　Guidance on eating postures combined with swallowing training can improve the swallowing function of patients with post-stroke dysphagia, reduce the occurrence of choking and aspiration and other accidents, facilitate better eating for patients, enhance their nutritional status, and improve their quality of life.

Effects of enhanced recovery after surgery on patients undergoing surgery for esophageal cancer based on multidisciplinary participation

Jia Bo, Tang Keli, Hou Lingling

2025, 31(18):  3122-3126.  DOI: 10.3760/cma.j.cn441417-20250110-18026

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Objective　The analysis focuses on the impact of rapid recovery surgery (ERAS) involving multiple disciplines on the negative emotions and postoperative pain of patients undergoing combined thoracoscopic and laparoscopic surgery for esophageal cancer (EC). Methods　A prospective study was adopted. A total of 86 patients who underwent combined EC thoracoscopic and laparoscopic surgery at Nanyang Central Hospital from May 2021 to April 2023 were selected as the research subjects. All the included subjects were divided into the conventional group (43 cases) and the ERAS group (43 cases) according to different nursing methods.Control group: 23 males and 20 females, aged 42 to 72 (57.89±7.05) years. They received routine care. ERAS group: 25 males and 18 females, aged 42 to 73 (58.05±6.96) years. They received ERAS care based on multidisciplinary participation.Both groups were intervened for 3 months.Compare the clinical indicators, negative emotions [Anxiety Self-Rating Scale (SAS), Depression Self-Rating Scale (SDS)], Visual Analogue Scale (VAS) scores, and the incidence of complications before and after the intervention in the two groups.Statistical methods employed were the χ² test and the t test. Results　The time for getting out of bed, the time for rectal gas release, and the length of hospital stay in the ERAS group were all shorter than those in the conventional group [(52.25±5.36) hours vs.(78.16±7.29) hours,(47.52±4.23) hours vs.(72.36±6.58) hours, and (8.25±0.56) days vs.(9.76±0.68) days], and the differences were statistically significant (t=18.777,20.823,and 11.240; all P<0.05).After the intervention in the ERAS group, the scores of SAS, SDS and VAS were all lower than those in the conventional group [(18.95±1.68) points vs.(26.74±2.35) points, (17.32±1.62) points vs.(25.46±2.41) points, and (2.03±0.25) points vs.(3.87±0.42) points], and the differences were statistically significant (t=17.683, 18.382, and 24.686; all P<0.05).The incidence of complications in the ERAS group was lower than that in the conventional group [4.65% (2/43) vs. 18.60% (8/43)], and the difference was statistically significant (χ²=4.074, P<0.05). Conclusion　The ERAS nursing care model based on multi-disciplinary participation, when applied to patients undergoing combined thoracoscopic and laparoscopic surgeries for EC, can alleviate pain in the body, improve the negative emotions of patients, shorten the time for getting out of bed and the length of hospital stay, promote postoperative recovery of patients, and reduce the occurrence of complications.

Effect of yang-entering-yin breath guidance massage combined with ear acupressure on improving symptoms of patients with insomnia

Wang Jing, Wang Xiaoling, Wang Xuanmei

2025, 31(18):  3126-3131.  DOI: 10.3760/cma.j.cn441417-20241107-18027

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Objective　To analyze the effect and improvement of symptoms in patients with insomnia by yang-entering-yin breath guidance massage and ear acupressure. Methods　A total of 120 patients with insomnia diagnosed and treated in Department of Brain Diseases, Ankang Traditional Chinese Medicine Hospital from January to September 2024 were randomly divided into a control group, an observation group 1, an observation group 2, and an observation group 3, with 30 cases in each group. There were 13 males and 17 females in the control group; they were (45.07±5.47) years old; their disease course was (2.37±0.42) years. There were 12 males and 18 females in the observation group 1; they were (44.17±6.52) years old; their disease course was (2.40±0.49) years. There were 11 males and 18 females in the observation group 2; they were (45.79±5.73) years old; their disease course was (2.28±0.36) years; 1 case could not stick to the treatment scheme, and were excluded from the study. There were 11 males and 17 females in the observation group 3; they were (44.86±6.28) years old; their disease course was (2.46±0.41) years; 1 case quit during the treatment, and 1 case was not treated according to the treatment scheme, so they were excluded from the study. The control group orally took eszopiclone tablets; the observation group 1 took yang-entering-yin breath guidance massage; the observation group 2 took ear acupressure therapy; the observation group 3 took yang-entering-yin breath guidance massage and ear acupressure; all the 4 groups were treated continuously for 4 weeks. The scores of traditional Chinese medicine symptoms, sleep status, anxiety, and depression before the treatment and after 2 and 4 weeks' treatment were compared between the 4 groups. The clinical efficacies and safety were evaluated. The repeated measurement analysis of variance, LSD-t test, one-way analysis of variance, SNK-q test, χ² test, and Fisher's precision probability test were used for the statistical analysis. Results　Before the treatment, after 2 weeks' treatment, and 2 weeks after discharge, the scores of traditional Chinese medicine symptoms, Insomnia Severity Index, Pittsburgh Sleep Quality Index, Anxiety Self-evaluation Scale, and Depression Self-evaluation Scale in the four groups decreased successively (all P<0.05); the scores of the observation group 1, the observation group 2, and the observation group 3 were lower than those of the control group after 2 and 4 weeks' treatment (all P<0.05); the scores of the observation group 3 were lower than those of the observation group 1 and the observation group 2 after 2 and 4 weeks' treatment (all P<0.05). The total effective rates of the control group, the observation group 1, the observation group 2, and the observation group 3 were 63.33% (19/30), 80.00% (24/30), 75.86% (22/29), and 96.43% (27/28), respectively, with a statistical difference between the 4 groups (P<0.05); the total effective rate of the observation group 3 was higher than that of the control group (P<0.05). During the treatment, 1 patient in the control group experienced fatigue, and 1 patient dizziness; the other three groups did not have any adverse reactions; there was no statistical difference (P>0.05). Conclusion　The combination of yang-entering-yin breath guidance massage and ear acupressure therapy for insomnia can not only improve the efficacy and safety, but also is more effective in improving insomnia, depression, and anxiety.

Potential profile analysis and influencing factors of occupational protection awareness and behaviors in intern nurses

Quan Yi, Xie Jiang, Quan Li, Long Yingzi

2025, 31(18):  3132-3137.  DOI: 10.3760/cma.j.cn441417-20250310-18028

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Objective　To explore the potential profile of occupational protection awareness and behaviors in intern nurses, and to analyze the influencing factors of different categories. Methods　The convenient sampling method was used to select 266 intern nurses from three hospitals in Hunan Province from August to December 2024, including 230 females and 36 males who were (21.13±1.09) years old. The General Information Questionnaire, Occupational Protection Knowledge and Behavior Questionnaire, and Nurse Professional Self-concept Scale were used for the questionnaire survey. The potential profile analysis was used to explore the potential categories of the intern nurses' occupational protection awareness and behaviors. The multiple logistic regression analysis was used to evaluate the influence of various factors on different subtypes. Results　The intern nurses' occupational protection awareness and behaviors were divided into three potential categories: 96 cases (36.09%) in the high-level occupational protection group, 72 cases (27.07%) in the medium-level occupational protection and high knowledge level group, and 98 cases (36.84%) in the low-level occupational protection and poor behavior level group. The multiple logistic regression analysis showed that the intern nurses with a bachelor's degree and high professional self-concept level were more likely to enter the medium level occupational protection and high knowledge level group (OR=0.685 and 0.831; both P<0.05), while the male intern nurses and the intern nurses who did not like nursing were more likely to enter the low-level occupational protection and poor behavior level group (OR=3.521 and 10.509; both P<0.05). Conclusions　There are three potential categories of occupational protection awareness and behaviors in intern nurses, with significant heterogeneity. It is recommended that nursing managers should provide individualized interventions based on the characteristics of different categories of intern nurses to enhance their occupational protection awareness and behavior levels.

Experience Exchange

Effect of digital operating room information management system on work efficiency and operation safety of neurosurgery related personnel

Gao Hui, Chang Hui, Ma Xiaoyuan, Ma Liujia, He Xiuli

2025, 31(18):  3138-3142.  DOI: 10.3760/cma.j.cn441417-20250415-18029

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Objective　To explore the effect of digital operating room information management system on the work efficiency and surgical safety of neurosurgical related personnel. Methods　The data of neurological surgery in the operating room of the Cardia-cerebrovascular Disease Hospital, Yan'an University Affiliated Hospital from January to December 2024 were retrospectively analyzed, including operation type, anesthesia method, and operation time. From January to June 2024, it was before the application of digital operating room information management system, and from July to December 2024, it was after the application. Before and after the application, 104 and 112 operation sets were selected respectively, and 23 medical staff were included, including 12 surgeons, 4 anesthesiologists, and 7 operating room nurses. There were 9 males and 14 females (32.67±5.98) years old. The work efficiencies safety verification execution rates and operating room errors of medical staff during surgical treatment before and after application were compared, and the satisfaction of medical staff in the operating room with the system [post-test system usability questionnaire (PSSUQ) score ] was evaluated. The statistical methods were t test and χ² test. Results　After the application, the preparation time of the items, the opening time of the patients' venous fluid access, the completion time of the anesthesia, and the turnaround time were shorter than those before the application [(21.26±6.02) min vs. (30.25±7.25) min, (6.14±1.29) min vs. (9.26±2.33) min, (15.28±5.29) min vs. (21.25±6.38) min, and (24.37±5.61) min vs. (32.69±5.45) min], with statistical differences (all P<0.05). After the application, the safety verification execution rates of medical staff before anesthesia, before operation, and before leaving the room were higher than those before application [97.32% (109/112) vs. 89.42% (93/104), 98.21% (110/112) vs. 91.35% (95/104), 98.21% (110/112) vs. 90.38% (94/104)], and the incidence rate of operating room errors was lower than that before the application [3.57% (4/112) vs. 11.54% (12/112)], with statistical differences (all P<0.05). After the application, the system satisfaction survey was conducted on the medical staff included in the study in the operating room. The results showed that the total score of the satisfaction evaluation of the system by the medical staff in the operating room was 97.44±11.08, and the average score of each item was 6.08±0.68. Conclusions　The digital operating room information management system effectively improves the work efficiency of neurosurgical related personnel by optimizing the management process of neurosurgical operating room and improving the accuracy and real-time of information. At the same time, it reduces surgical errors and improves the safety and quality of surgery.

Medical Education

Application of "4C" teaching method and teaching for understanding mode in clinical internship teaching in urology

Hu Jun, Fu Zhenyu, Zhang Ge, Zhang Yan, Jiang Ling, Jiang Yingying

2025, 31(18):  3143-3147.  DOI: 10.3760/cma.j.cn441417-20250309-18030

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Objective　To explore the application effect of the "4C" teaching method combined with the teaching for understanding (TfU) mode in clinical internship teaching in urology. Methods　A total of 65 undergraduate interns undergoing clinical internship in Department of Urology, Changshu Second People's Hospital from July 2022 to April 2024 were selected as the study objects by the convenient sampling method. The 31 interns taking the internship from July 2022 to April 2023 were set as a control group; the 34 interns taking the internship from July 2023 to April 2024 were set as an experimental group. There were 24 males and 7 females in the control group; they were (23.06±2.52) years old. There were 30 males and 4 females in the experimental group; they were (22.76±1.63) years old. The control group used the traditional teaching method for clinical training. The experimental group used the "4C" teaching method and the TfU mode. The theoretical and practical skill scores, critical thinking abilities, doctor-patient communication skills, and satisfaction with teaching quality were compared between the two groups.The statistical methods were t test and χ² test. Results　The theoretical score and scores of practical skills, doctor-patient communication skills, truth-seeking, analytical ability, systematic ability, self-confidence, curiosity, and critical thinking ability in the experimental group were higher than those in the control group (86.85±6.01 vs. 76.26±8.11, 83.79±4.51 vs. 72.16±5.89, 18.09±2.88 vs. 14.03±3.51, 18.03±2.62 vs. 13.03±3.78, 12.62±2.39 vs. 9.23±2.14, 15.26±3.39 vs. 12.90±3.22, 31.79±5.90 vs. 23.16±6.56, 21.06±4.79 vs. 17.06±4.69, 126.32±10.57 vs. 100.74±11.90), with statistical differences (all P<0.05). The satisfaction with teaching quality in the experimental group was higher than that in the control group [91.2% (31/34) vs. 67.7% (21/31)], with a statistical difference (P<0.05). Conclusion　The "4C" teaching method combined with the TfU mode can improve the theoretical and practical skills of urology clinical interns, enhance their critical thinking abilities, doctor-patient communication skills, and teaching satisfaction.

Application of group-based case teaching method in nursing ethic courses

Chen Si, Liu Xiangyu, Zhang Hao, Ji Manfeng, Cao Jin, Fang Peihong, Xiong Haiyan

2025, 31(18):  3148-3152.  DOI: 10.3760/cma.j.cn441417-20250220-18031

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Objective　To explore the effect for applying the group-based case teaching method in nursing ethic course teaching. Methods　Sixty-eight students of the nursing class of Guangdong Medical University 2+2 Longhua District People's Hospital from January 2020 to December 2021 were selected as the study objects. The 35 students of grade 2020 were set as a control group, and the 33 students of grade 2021 a study group. There were 3 males and 32 females in the control group; they were (21.22±1.02) years old. There were 2 males and 31 females in the study group; they were (21.25±1.01) years old. The control group used the traditional teaching method. The study group used the group-based case teaching method. The course assessment results (theoretical score and nursing practice score), the satisfaction with the teaching methods, and the improvement of learning ability were compared between the two groups by t test. Results　The theoretical score, nursing practice score, and scores of group cooperation ability, case analysis, memory and attention, linguistic expression, and satisfaction with the teaching methods in the study group were higher than those in the control group (80.18±5.23 vs. 76.40±8.89, 94.64±1.15 vs. 90.05±1.11, 93.24±3.04 vs. 90.15±2.78, 92.68±2.78 vs. 89.24±2.48, 93.04±2.15 vs. 90.35±2.27, 94.24±1.35 vs. 91.04±1.27, and 95.65±1.15 vs. 88.24±0.84), with statistical differences (t=2.120, 16.747, 4.378, 5.391, 5.010, 10.188, and 30.467; all P<0.05). Conclusion　The application of the group-based case teaching method in nursing ethic course teaching has a significant effect, and can improve students' academic performance and learning ability, with high student satisfaction.

Construction of a homogeneous training program for comprehensive geriatric assessment under CDIO concept

Li Jing, Zeng Shumei, Huang Weihong, Cao Ziwei, Huang Jia, Chong Jing, Wen Tingting, Liu Shuo, Yue Liqing, Hu Jianzhong, Peng Hua

2025, 31(18):  3152-3158. 

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Objective　To construct a homogeneous training program for comprehensive geriatric assessment (CGA) based on the CDIO (conceive-design-implement-operate) mode, and to explore its application effect. Methods　One hundred and eight nursing staff were selected from Hunan medical institutes from April to May 2024 as the study objects by the convenient sampling method, including 11 males and 97 females who were (38.41±5.33) years old. The self-designed Knowledge-Attitude-Practice Questionnaire of CGA and Training Satisfaction Survey Questionnaire were used to evaluated the training effects. SPSS 26.0 was used to perform paired t test and one-way analysis of variance. Results　The standard scores of knowledge, attitude, and behavior after the training were 81.91±8.89, 71.02±11.76, and 56.88±13.44, and the scores before the training 77.16±9.35, 79.58±12.31, and 51.79±15.27 (all P<0.05). The univariate analysis found that the standard score of attitude of the nurses with undergraduate degree or above and the associate chief nurses or chief nurses were higher than those of the nurses with junior college education or below and the nurses-in-charge (80.42±12.24 vs. 72.92±11.17 and 56.11±16.51 vs. 49.63±14.24; P=0.046 and 0.037). After the training, there were no statistical differences in the standard scores of knowledge-attitude-practice of CGA between the nurses of different ages, professional titles, education levels, and work times (all P>0.05). The students' satisfaction rate with training duration was 84.69% (94/111), and the satisfaction rates with the other items were >98.0%. Conclusions　The construction and application of the homogeneous training program for CGA based on the CDIO mode can improve the nursing staff's comprehensive geriatric assessment ability. Nursing staff of all educational levels can participate in the training and implementation of CGA.

Correlation between nurse-patient relationship and professional identity in post-2000s generation nursing students

Wang Yuan, Hu Guangqian, Li Huafen

2025, 31(18):  3159-3164.  DOI: 10.3760/cma.j.cn441417-20250107-18033

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Objective　To understand the current status of nurse-patient relationships and professional identity in post-2000s generation nursing students, and to explore the correlation between these two factors. Methods　Three hundred and ninety-five post-2000s generation nursing interns were selected from 3 grade A tertiary hospitals in Guangzhou and 1 grade A tertiary hospital in Foshan as the study objects by the convenient sampling method, including 53 males and 342 females who were (19.54±2.39) years old. The General Information Questionnaire, Nurse-Patient Relationship Self-Assessment Scale, and Nurses' Professional Identity Scale were used to investigate the interns. The general data, nurse-patient relationship, and scores of professional identity were analyzed by the descriptive statistical analysis. The correlation between nurse-patient relationship and professional identity was analyzed by the Spearman correlation analysis. The influence of nurse-patient relationship on the interns' professional identity was analyzed by the hierarchical multiple regression. Results　The interns' total scores of professional identity and nurse-patient relationship were 118.37±20.65 and 37.33±5.55, respectively. There was a positive correlation between nurse-patient relationship and professional identity (r=0.789; P<0.001). The hierarchical multiple regression analysis results showed that nurse-patient relationship was included into the professional identity influencing factor model (F=63.158; P<0.001), and positively influenced professional identity. Conclusions　Post-2000s generation nursing students' nurse-patient relationship can influence their professional identity. Clinical nursing educators should develop clinical teaching and practice plans to improve their nurse-patient relationship and professional identity.

Application of BOPPPS teaching mode in clinical teaching of nursing students in department of neurology and effect analysis

Lin Yi, Fan Yuzhen, Ding Yueming, Deng Lili

2025, 31(18):  3164-3167.  DOI: 10.3760/cma.j.cn441417-20241220-18034

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Objective　To explore the effect for applying the BOPPPS teaching mode in clinical teaching of nursing students in department of neurology. Methods　From July 2023 to April 2024, 40 nursing students in Department of Neurosurgery, Fangcun Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine were selected for the prospective study. The patients were divided into s control group and an experimental group by the random number table method, with 20 cases in each group. There were 4 males and 16 females in the control group; they were (20.65±1.35) years old. There were 4 males and 16 females in the experimental group; they were (21.35±1.06) years old. The control group adopted the traditional teaching mode, and the experimental group the BOPPPS teaching mode. The theoretical knowledge, operation skills, and teaching satisfaction were compared between the two groups by t and χ² tests. Results　The theoretical and operation scores in the experimental group were higher than those in the control group(83.21±3.37 vs. 74.16±2.15 and 85.16±2.52 vs. 80.53±1.83), with statistical differences (t=10.125 and 6.649; both P<0.05). The teaching satisfaction of the experimental group was higher than that of the control group [95.00% (19/20) vs. 70.00% (14/20)], with a statistical difference (χ²=4.329; P=0.037). Conclusion　The application of the BOPPPS teaching mode can improve the theoretical achievement, operation level, and teaching satisfaction of nursing students.