Table of Content

01 October 2025, Volume 31 Issue 19

Previous Issue   

Special Column of Cardiovascular Diseases

Relationships between serum Gas6 and NETs levels and the prognosis in elderly patients with coronary heart disease after interventional therapy

Zhang Along, Ma Jingying, Mi Baibing

2025, 31(19):  3174-3180.  DOI: 10.3760/cma.j.cn441417-20250512-19002

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the influences of serum levels of growth arrest-specific gene 6 (Gas6) and neutrophil extracellular traps (NETs) on the prognosis of elderly patients with coronary heart disease after interventional therapy. Methods　This study was a retrospective study. The clinical data of 242 elderly patients with coronary heart disease who underwent percutaneous coronary intervention (PCI) at Yan'an University Xianyang Hospital from April 2022 to September 2023 were collected. Based on whether the major adverse cardiovascular events (MACE) occurred during the follow-up period, the patients were divided into a MACE group [40 cases, including 28 males and 12 females, with an age of (73.28±6.59) years old] and a non-MACE group [202 cases, including 130 males and 72 females, with an age of (72.10±5.47) years old]. Univariate analysis (χ² test and t test) and multivariate logistic regression analysis were used to evaluate the independent factors for the occurrence of MACE after PCI. The receiver operating characteristic curve (ROC) analysis was used to determine the predictive power of Gas6 and NETs for MACE. The Kaplan-Meier survival curve was used to assess the predictive value of Gas6 and NETs levels for MACE incidence. Results　The rate of number of stents ≥2 in the MACE group was higher than that in the non-MACE group [62.50% (25/40) vs. 37.62% (76/202)], with a statistically significant difference (χ²=8.497, P<0.05). The Global Registry of Acute Coronary Events (GRACE) score, apolipoprotein B/apolipoprotein A (ApoB/ApoA), low-density lipoprotein cholesterol (LDL-C), lipoprotein(a) [Lp(a)], Gas6, and NETs levels in the MACE group were all higher than those in the non-MACE group [(120.28±15.40) points vs. (85.58±12.27) points, (0.81±0.22) vs. (0.73±0.17), (2.53±0.38) mmol/L vs. (2.38±0.31) mmol/L, (443.30±168.83) mg/L vs. (297.40±124.59) mg/L, (24.60±5.76) μg/L vs. (16.69±4.90) μg/L, (30.47±9.08) μg/L vs. (20.28±6.10) μg/L], with statistically significant differences (t=13.432, 2.175, 2.688, 5.193, 9.051, and 6.800, all P<0.05). Multivariate logistic regression analysis revealed that the GRACE score and serum Gas6 and NETs levels were independent risk factors for the occurrence of MACE after PCI (all P<0.05). ROC analysis showed that the sensitivities of Gas6 and NETs in predicting the occurrence of MACE in elderly patients with coronary heart disease after interventional therapy were 80.0% and 67.5%, respectively, the specificities were 80.2% and 85.6%, respectively, and the areas under the curve (AUCs) were 0.862 and 0.817, respectively; when Gas6 and NETs were combined for prediction, the sensitivity and specificity were 85.0% and 86.6%, respectively, and the AUC value reached 0.937. The probability of MACE after PCI in patients with high level of Gas6 or NETs was higher than that in patients with low level of Gas6 or NETs (both P<0.05). Conclusion　Elevated serum levels of Gas6 and NETs are closely associated with an increased incidence of MACE in elderly patients with coronary heart disease after PCI, and Gas6 and NETs can serve as potential biomarkers for predicting poor prognosis in these patients following interventional therapy.

Study on the correlations between serum NT-proBNP and CysC levels and left ventricular remodeling in patients with type 2 diabetes and myocardial hypertrophy

Yuan Bo, Wang Xin, Ji Zhaohong, Ma Hong'en

2025, 31(19):  3181-3186.  DOI: 10.3760/cma.j.cn441417-20250605-19003

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the correlations between the levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cystatin C (CysC) and left ventricular remodeling in patients with type 2 diabetes and myocardial hypertrophy. Methods　From December 2022 to December 2024, 120 patients with type 2 diabetes and myocardial hypertrophy who were admitted to Xi'an Ninth Hospital were selected as the observation group. Meanwhile, 100 patients with simple type 2 diabetes and 100 healthy individuals were selected as the simple diabetes group and the healthy control group, respectively. In the observation group, there were 58 males and 62 females, with an age of (55.02±5.74) years old; in the simple diabetes group, there were 47 males and 53 females, with an age of (55.19±6.01) years old; in the healthy control group, there were 50 males and 50 females, with an age of (54.67±6.39) years old. The general conditions, interventricular septal thickness (IVST), left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), early diastolic mitral inflow velocity (E)/ late diastolic mitral inflow velocity (A), E/ early diastolic mitral annular tissue velocity (e'), and serum NT-proBNP and CysC levels of the three groups were compared. Pearson correlation analysis was used to analyze the correlations between serum NT-proBNP and CysC levels and left ventricular remodeling indicators. Statistical analysis was performed using the variance analysis and χ² test. Results　The levels of IVST, LVMI, and E/e' in the observation group were all higher than those in the simple diabetes group and the healthy control group, while the LVEF and E/A were lower than those in the simple diabetes group and the healthy control group (all P<0.05); there were no statistically significant differences in the left ventricular remodeling function indexes between the simple diabetes group and the healthy control group (all P>0.05). The levels of serum NT-proBNP and CysC in the observation group were higher than those in the simple diabetes group and the healthy control group [(528.96±39.19) ng/L vs. (177.69±23.28) ng/L and (175.29±27.60) ng/L; (1.27±0.27) mg/L vs. (0.94±0.20) mg/L and (0.84±0.22) mg/L], and the serum CysC level in the simple diabetes group was higher than that in the healthy control group (all P<0.05). Pearson correlation analysis showed that the levels of serum NT-proBNP and CysC were positively correlated with IVST, LVMI, and E/e' (all P<0.05), and negatively correlated with LVEF and E/A (all P<0.05). Conclusion　The levels of serum NT-proBNP and CysC are correlated with the left ventricular remodeling function in patients with type 2 diabetes and myocardial hypertrophy, and close attention should be paid to clinically.

Clinical efficacy of ivabradine combined with furosemide in elderly patients with hypertension and heart failure

Li Chao, Kou Yinyan, Pan Shuo

2025, 31(19):  3186-3190.  DOI: 10.3760/cma.j.cn441417-20250331-19004

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the clinical efficacy of ivabradine combined with furosemide in elderly patients with hypertension and heart failure. Methods　A total of 102 elderly patients with hypertension and heart failure who were admitted to Department of Cardiovascular and Critical Care Medicine, Xi'an Daxing Hospital from January to December 2024 were selected. They were divided into a control group and a combined group according to the random number table method, with 51 cases in each group. In the control group, there were 32 males and 19 females, with an age of (68.49±5.28) years old; in the combined group, there were 29 males and 22 females, with an age of (67.97±5.81) years old. The control group was intervened with ivabradine: for the first two weeks, the dosage was 5.0 mg per time, twice a day; since the third week, the dosage was 7.5 mg per time, twice a day. The combined group was intervened with furosemide on the basis of the control group, 60 mg per time, twice a day. Both groups were continuously intervened for 3 months. The clinical efficacies of the two groups were compared, as well as the blood pressure levels (systolic and diastolic blood pressure), cardiac function indicators [left ventricular end-diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF)], and renal function indicators [24-hour urine protein quantification (24 h UP) and urine microalbumin (mAlb)] before and after intervention and safety. Statistical analysis was conducted using t-test and χ² test. Results　The total effective rate of the combined group was 98.04% (50/51), which was higher than that of the control group [84.31% (43/51)], with a statistically significant difference (P<0.05). After intervention, the systolic blood pressure [(122.07±8.05) mmHg (1 mmHg = 0.133 kPa)], diastolic blood pressure [(77.94±7.31) mmHg], and LVEDD [(49.53±4.35) mm] in the combined group were all lower than those in the control group [(132.69±8.20) mmHg, (84.54±7.62) mmHg, and (53.64±4.26) mm], and the LVEF was higher than that in the control group [(52.65±4.36)% vs. (44.86±4.72)%], with statistically significant differences (all P<0.05). After intervention, the 24 h UP [(128.45±6.29) mg] and mAlb [(15.52±1.02) mg/L] in the combined group were lower than those in the control group [(142.62±6.51) mg and (18.63±1.06) mg/L], with statistically significant differences (both P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the combined group and the control group [13.73% (7/51) vs. 7.84% (4/51)] (P>0.05). Conclusion　The combination of ivabradine and furosemide in the treatment of hypertensive patients with heart failure can effectively reduce the blood pressure, improve the heart function, and alleviate the renal function damage, with high safety.

Efficacy of Yiqi Fumai injection in treating patients with chronic heart failure and its impact on cardiac function and hemorheology

Zang Keliang, Ban Fang, Zhang Qiumei, Zhang Hengliang

2025, 31(19):  3191-3195.  DOI: 10.3760/cma.j.cn441417-20250331-19005

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effects of injectable Yiqi Fumai on patients with chronic heart failure (CHF) and its impact on cardiac function and blood rheology. Methods　A retrospective study was conducted on 94 CHF patients treated at Shangqiu Municipal Hospital from June 2021 to May 2024. The patients were divided into a control group and an observation group based on different treatment methods, with 47 cases in each group. The control group included 21 males and 26 females, with an average age of (63.29±4.17) years and a disease duration of (8.12±3.51) months. The observation group included 20 males and 27 females, with an average age of (62.02±4.52) years and a disease duration of (9.15±3.24) months. The control group received spironolactone capsules on the basis of conventional treatment, the observation group received injectable Yiqi Fumai in addition to the treatment in the control group. Both groups continued the medication for 2 weeks. The efficacy of treatment, Traditional Chinese Medicine (TCM) syndrome scores before and after 2 weeks of treatment, blood rheology parameters, serological indicators [serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), vascular endothelial growth factor (VEGF)], cardiac function indicators [left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF)], and adverse reactions were compared. Statistical analysis was performed using χ² and t tests. Results　The overall effective rate in the observation group was higher than that in the control group [97.87% (46/47) vs. 85.11% (40/47)], with a statistically significant difference (χ²=4.919, P=0.027). After 2 weeks of treatment, the primary symptoms, secondary symptoms, and total scores of TCM syndromes in the observation group were lower than those in the control group [(3.26±0.97, 2.43±0.85, and 5.69±1.36) points vs. (6.43±1.24, 4.25±0.76, and 10.68±2.07) points]. The levels of whole blood viscosity (high shear, low shear), plasma viscosity, NT-proBNP, hematocrit, LVESD, fibrinogen, and LVEDD in the observation group were lower than those in the control group, while VEGF and LVEF levels were higher in the observation group, with all differences being statistically significant (all P<0.05). No significant adverse reactions were observed in either group. Conclusion　Yiqi Fumai injection is effective in the treatment of CHF, which can significantly relieve clinical symptoms, improve hemorheology and serological indexes, and promote the recovery of cardiac function.

Study on the relationship between PDE9A gene polymorphism and the lipid-regulating efficacy of atorvastatin in patients with coronary heart disease

Wang Fen, He Keqiang, Zhang Shuyuan, Feng Xuyang

2025, 31(19):  3196-3201.  DOI: 10.3760/cma.j.cn441417-20250428-19006

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the influence of the gene polymorphism and expression level of recombinant phosphodiesterase 9A (PDE9A) on the lipid-regulating efficacy of atorvastatin in patients with coronary heart disease (CHD). Methods　It was a retrospective cohort study. A total of 186 patients with CHD who were admitted to Xianyang First People's Hospital and Yan'an University Xianyang Hospital from May 2022 to May 2023 were selected. Among them, there were 115 males and 71 females, with an age of (47.85±6.42) years old and a body mass index (BMI) of (22.27±2.53) kg/m². All the patients received 3-month atorvastatin treatment (oral administration, starting dose of 10 mg per time, once a day, and the lipid levels were rechecked every 4 weeks for individualized adjustment, with the maximum dose of 80 mg per time). Another 100 healthy individuals who underwent physical examinations during the same period were selected as the control group. Among them, there were 52 males and 48 females, with an age of (47.62±6.34) years old and a BMI of (22.15±2.60) kg/m². The expression level of PDE9A was compared between the control group and the CHD group. Based on the PDE9A genotype distribution of the CHD patients, they were divided into 3 groups: CC type (58 cases), CT type (86 cases), and TT type (42 cases). The frequency distribution of PDE9A alleles and genotypes were determined in the 186 CHD patients. The levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in the CHD patients with different genotypes were measured before and after treatment, and their change rates were calculated [lipid change rate = (lipid level before treatment - lipid level after treatment) / lipid level before treatment × 100%]. Statistical analysis was conducted using the independent sample t-test, one-way analysis of variance, LSD test, Kruskal-Wallis H test, and χ² test. Results　The expression level of PDE9A in the CHD patients was significantly upregulated compared with that in the control group [(1.06±0.08) vs. (0.87±0.13)], with a statistically significant difference (t=15.276, P<0.001). There were no statistically significant differences in the levels of gender, age, BMI, fasting blood glucose, systolic blood pressure, diastolic blood pressure, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and serum creatinine (Scr) among the three genotypes of the CHD patients (all P>0.05). The distribution of each genotype at the rs2250870 locus of the PDE9A gene in 186 CHD patients conformed to the Hardy-Weinberg genetic equilibrium law (χ²=0.870, P>0.05). Before treatment, there was no statistically significant difference in the blood lipid levels among the three groups of CHD patients (all P>0.05); compared with those before treatment, the levels of TC, TG, and LDL-C in the three groups decreased after treatment, while the level of HDL-C increased (all P<0.05); after treatment, there was no statistically significant difference in the TG level among the three groups (P>0.05), but the levels of TC and LDL-C of CC type were lower than those of CT and TT types, the level of HDL-C was higher than those of CT and TT types, and the level of LDL-C of CT type was lower than that of TT type (all P<0.05). The change rates of TC, LDL-C, and HDL-C levels of CC type were higher than those of CT and TT types, with statistically significant differences (H=3.568, 16.984, and 11.718, all P<0.05); there was no statistically significant difference in the change rate of TG level among the three groups (P>0.05). Conclusions　The polymorphism of the PDE9A gene is correlated with the lipid-regulating efficacy of atorvastatin. Different genotypes at the rs2250870 locus have differential effects on the efficacy of atorvastatin. The reductions in TC and LDL-C and the increase in HDL-C in patients with the CC genotype after treatment are greater than those in patients with the CT and TT genotypes. This locus may affect the drug response through the dominant inheritance pattern.

Application of right heart acoustic cardiography combined with transesophageal echocardiography in the diagnosis of occult patent foramen ovale classification

Yin Xiaoling, Wang Jing, Li Yanting, Kong Yanliang

2025, 31(19):  3202-3207.  DOI: 10.3760/cma.j.cn441417-20250520-19007

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the application value of right heart acoustic cardiography (RHAC) combined with transesophageal echocardiography (TEE) in the diagnosis of the classification of occult patent foramen ovale (PFO). Methods　A retrospective study was conducted on 98 suspected PFO patients at Tongchuan People's Hospital from June 2021 to June 2024, who presented with unexplained stroke, migraine, transient ischemic attack, or unexplained syncope and underwent RHAC and TEE examinations. Among them, there were 42 males and 56 females, with an age range of 21 to 68 (43.7±12.5) years old. RHAC used the modified Valsalva maneuver to enhance the visualization of right to left shunt, while TEE confirmed the anatomical structure and shunt characteristics of PFO. PFO was classified into three types based on the degree of shunt and anatomical features: type I (minimal shunt), type II (moderate shunt), and type III (significant shunt). The gold standard was clinical follow-up combined with surgical verification. The study analyzed the differences in the detection rate and classification accuracy between the two methods and the advantages of their combined use. Statistical analysis was conducted using the χ² test, McNemar test, Pearson correlation analysis, enter method multiple linear regression analysis, and receiver operating characteristic curve (ROC). Results　Of the 98 suspected PFO patients, 73 (74.49%) were ultimately diagnosed with PFO. RHAC detected 67 cases of PFO with a sensitivity of 91.78% and a specificity of 100.00%. TEE detected 59 cases of PFO with a sensitivity of 80.82% and a specificity of 100.00%. Combined diagnosis (positive in either method) detected 73 cases, with a sensitivity of 100.00% and a specificity of 100.00%. In the classification diagnosis, the combined determination achieved a accuracy rate of 100.00% for the diagnosis of type I, type II, and type III PFO. Among the patients with occult PFO, there were 25 cases with atrial septal aneurysm and 16 cases with Chiari's network. The detection rates of atrial septal aneurysm by RHAC and TEE were 80.00% (20/25) and 100.00% (25/25), respectively, and the detection rates of Chiari's network were 56.25% (9/16) and 100.00% (16/16), respectively; there were statistically significant differences in the detection rates of atrial septal aneurysm and Chiari's network between the two examination methods (χ²=5.56, P=0.018; χ²=9.14, P=0.003). The number of RHAC microbubbles was positively correlated with the size of the PFO opening measured by TEE (r=0.785, P<0.001). The predictive model established by combining the two parameters of microbubble quantity and opening size had a macro-average AUC (area under the curve) of 0.899 (95%CI: 0.848 - 0.951) for PFO classification. Conclusion　RHAC combined with TEE examination provides a more comprehensive evaluation method for the classification diagnosis of occult PFO, improving diagnostic accuracy and providing important evidences for clinical intervention decisions.

Survey of patients' perceived recurrence risk scores and associated factors after PCI

Liu Weiping

2025, 31(19):  3207-3211.  DOI: 10.3760/cma.j.cn441417-20241202-19008

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the perceived recurrence risk score and related factors in patients after performing percutaneous coronary intervention (PCI). Methods　This study is a retrospective cohort study. A total of 120 patients with coronary heart disease (CHD) who were admitted to Fuwai Central China Cardiovascular Hospital from January 2023 to June 2024 were selected as the study subjects. There were 67 male patients and 53 female patients, with ages ranging from 45 to 75 years old. All patients underwent PCI treatment. Three months after the operation, based on the score of the recurrence risk perception assessment scale, the patients were divided into the high-risk-perception group (32 cases) and the low-risk-perception group (88 cases). General patient information was collected through the hospital medical record management system, including gender, age, body mass index, marital status, monthly family income, educational level, disease awareness level (survey questionnaire on health education knowledge), alcohol consumption, smoking, nutritional status, coexisting underlying diseases, cardiac function classification, systolic blood pressure, diastolic blood pressure, number of stents implanted, operation time, and Hamilton Anxiety Scale (HAMA) score. A multivariate logistic regression analysis was conducted to identify the influencing factors of the perceived risk of recurrence in patients with CHD. Independent sample t test, and χ² test were used for statistical analysis. Results　The age of the low-risk-perception group was lower than that of the high-risk-perception group (P<0.05). The proportions of those with low disease awareness level, having <3 underlying diseases, and having a HAMA score of <7 were all higher in the low-risk-perception group than in the high-risk-perception group (all P<0.05). The results of the multivariate logistic regression analysis showed that age (OR=0.599, 95%CI=0.482-0.744), disease awareness level (OR=4.714, 95%CI=1.972-11.272), presence of underlying diseases (OR=3.947, 95%CI=1.598-9.753), and HAMA score (OR=4.472, 95%CI=1.847-10.832) were all influencing factors of the perceived risk of recurrence (all P<0.05). Conclusions　Age, disease awareness level, coexisting underlying diseases, and HAMA score are all factors influencing the perception score of recurrence risk in CHD patients after PCI. Clinicians should attach great importance to this and take effective management measures as soon as possible to accelerate the recovery process of the patients' conditions.

Network pharmacology, bioinformatics, and molecular docking revealing the therapeutic mechanisms of Simiao Yong'an decoction against atherosclerosis

Liu Zenghui, Zhao Jiaxing, Zhou Xiaohui, Li Shuaiyi, Yin Huayu, Kuang Lu, Sun Mingshuang, Liu Xuehui, Liu Shuyan, Liu Dabin, Wu Shaoguo, Wu Limei

2025, 31(19):  3212-3217.  DOI: 10.3760/cma.j.cn441417-20250208-19009

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the mechanism of Simiao Yong'an decoction (SMYAD) in treating atherosclerosis (AS) using network pharmacology, bioinformatics, and molecular docking. Methods　The active components and target information of SMYAD were collected from the Traditional Chinese Medicine System Pharmacology Database and Analysis Platform (TCMSP) and SwissTargetPrediction. AS-related targets were retrieved from disease databases including GeneCards and Therapeutic Target Database (TTD). The GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) enrichment analysis were performed using R4.4.1. The protein-protein interaction (PPI) network and topological network model were constructed using Cytoscape 3.9.1. Molecular docking was conducted using AutoDock Vina. The Gene Expression Omnibus (GEO) datasets GSE100927 and GSE28829 were analyzed to identify the potential core therapeutic targets. Results　A total of 108 active components were obtained, with 218 overlapping targets and 42 core PPI targets. GO and KEGG revealed 2 947 functional terms and 182 signaling pathways. Molecular docking results demonstrated that there was a strong binding energy between the active components and the core targets. Seven hub genes were identified from drug targets and GEO datasets. Conclusion　SMYAD may delay AS progression by regulating key biological processes through the synergistic effects of multiple active components and signaling pathways.

New Medical Advances

Spatial proteomics: technological methodological advances and clinical application translation

He Donghao, Yin Lianghong

2025, 31(19):  3218-3222.  DOI: 10.3760/cma.j.cn441417-20250402-19010

Asbtract ( )  

References | Related Articles | Metrics

The spatiotemporal dynamic distribution and functional regulation of proteins represent core features of life activities. Traditional proteomics faces bottlenecks due to its difficulty in resolving subcellular localization heterogeneity and dynamic translocation events. By integrating high-precision mass spectrometry, super-resolution imaging, and artificial intelligence algorithms, spatial proteomics constructs a multidimensional analytical framework, enabling a comprehensive understanding of the mechanisms underlying the occurrence and development of diseases such as cancer and neurodegenerative disorders. This paper briefly reviews the technological advancements and clinical translational applications of spatial proteomics.

Research progress on the effects of opioid drugs on sleep during the perioperative period

Zhou Yejian, Wang Anqi, Guan Yingchao, Du Shuping, Fa Zhiqiang

2025, 31(19):  3223-3227.  DOI: 10.3760/cma.j.cn441417-20241230-19011

Asbtract ( )  

References | Related Articles | Metrics

Opioid drugs, as commonly used analgesics during the perioperative period, act on the central nervous system. By mimicking the effects of endogenous opioid peptides, they effectively alleviate the pain caused by surgery, playing a crucial role in reducing patients' pain, enhancing their comfort, and facilitating a rapid recovery. However, opioid drugs may disrupt the sleep structure, resulting in a decline in sleep quality. This not only reduces the quality of life of patients but also may delay the recovery process and increase the risk of postoperative complications. This article reviews the effects of opioid drugs on perioperative sleep and the underlying mechanisms, providing a reference for the rational use of opioid drugs in clinical practice. It also explores corresponding prevention and treatment measures, helping medical staff ensure effective pain relief while reducing the negative impact on the sleep quality during the perioperative period, thereby improving the rehabilitation effect and quality of life of patients.

Research on the clinical experience of chief physician Li Ruichun in treating gouty arthritis

Kang Zijian, Li Ruichun

2025, 31(19):  3228-3230.  DOI: 10.3760/cma.j.cn441417-20250523-19012

Asbtract ( )  

References | Related Articles | Metrics

Gouty arthritis (GA), as a common and complex type of arthritis, has a high incidence rate and an increasing prevalence trend worldwide. It is a public health issue that seriously affects human health and quality of life. Traditional Chinese medicine, as a precious treasure of our traditional medicine, classifies GA under categories such as "arthritis", "gout", and "joint deformity". Its occurrence is closely related to external pathogenic factors such as wind, cold, dampness, and heat, as well as internal factors such as improper diet, fatigue, and emotional disturbances. The pathogenesis mainly involves the accumulation of dampness and heat, the intermingling of phlegm and blood stasis, and the deficiency of the spleen and kidney. Treatment emphasizes syndrome differentiation and treatment based on individual conditions, and places great emphasis on the holistic concept and individualized therapy. Dr. Li Ruichun, a practicing traditional Chinese medicine physician for over three decades, has accumulated rich and unique clinical experience in GA treatment. He adheres to traditional Chinese medical theories and combines modern medical research results to develop a systematic and effective GA diagnosis and treatment plan. This article reviews the clinical experience of Dr. Li Ruichun, a traditional Chinese medicine specialist, in treating GA. It covers the understanding of the causes and pathogenesis of GA, as well as the staged treatment in the acute and remission phases. The aim is to provide reference for traditional Chinese medicine practitioners and promote the application of traditional Chinese medicine in the prevention and treatment of GA.

Basic Research

The study on the mechanism of LncRNA MALAT1 on osteoblast differentiation

Zhang Liangliang, Feng Yangyang, Zhao Chengjin, Zhou Yuhu, Li Nannan, Cao Qiang

2025, 31(19):  3231-3235.  DOI: 10.3760/cma.j.cn441417-20241211-19013

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the mechanism by which LncRNA MALAT1 affects the differentiation of osteoblast. Methods　This experiment was conducted at the Biological Experiment Center of Yan'an University Medical College from January to June 2024.The osteogenic precursor cells derived from mouse skull, MC3T3-E1, were induced to differentiate into osteoblasts. The cells were divided into the control group (untreated cells), the LPS group (1 mg/L LPS treatment of cells), and the LPS+siMALAT1 group (cells treated with LPS after siMALAT1 transfection). The viability of MC3T3-E1 cells was determined using the MTT assay. The effects of siMALAT1 on the mitochondrial function of MC3T3-E1 cells were evaluated by measuring the mitochondrial adenosine triphosphate (ATP) level, membrane potential (MMP), and superoxide. The expression levels of osteoblast differentiation-related markers, including alkaline phosphatase (ALP), osteocalcin (OCN), osteopontin (OPN), and RUNT-related transcription factor 2 (RUNX2), were detected by enzyme-linked immunosorbent assay (ELISA) and real-time fluorescence quantitative PCR (RT-qPCR). The expression levels of silent information regulator-1 (Sirt1) and peroxisome proliferator-activated receptor gamma coactivator-1α (PCG-1α) were determined by Western blot. LSD test and one-way analysis of variance were used for statistical analysis. Results　LPS can dose-dependently reduce the mitochondrial ATP level and MMP in MC3T3-E1 cells, and promote the production of superoxide (all P<0.05). siMALAT1 can improve the functional disorders of LPS-treated MC3T3-E1 cells, including the viability of MC3T3-E1 cells, mitochondrial ATP levels, MMP and the production of superoxide(all P<0.05). siMALAT1 can improve the inhibitory effect of LPS on the osteogenic differentiation of MC3T3-E1 cells (ALP, OCN, OPN, and RUNX2) (all P<0.05). siMALAT1 can increase the expression levels of Sirt1 and PCG-1α in LPS-treated MC3T3-E1 cells (0.62±0.06 vs. 0.30±0.03, 0.75±0.07 vs. 0.42±0.04) (both P<0.05). Conclusion　siMALAT1 can alleviate the osteogenic differentiation inhibition of LPS-suppressed MC3T3-E1 cells, and reduce the damage caused by LPS to MC3T3-E1 cells, especially the mitochondrial dysfunction.

Treatises

The effect of local injection of autologous platelet rich plasma via bronchoscopy in the treatment of tracheobronchial fistula

Ou Siyi, Wu Shangjun, Luo Dongling, Chen Xueping

2025, 31(19):  3236-3240.  DOI: 10.3760/cma.j.cn441417-20250213-19014

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the efficacy of local injection of autologous platelet rich plasma via bronchoscopy in the treatment of tracheobronchial fistula. Methods　Thirty patients with tracheobronchial fistula who were admitted to the First People's Hospital of Qinzhou from January 2023 to January 2025 were selected as the study subjects. According to the different treatment methods, the patients were divided into the control group (20 cases) and the study group (10 cases). There were 15 males and 5 females in the control group, aged 20-70 (50.92±8.01) years, diameter of the fistula opening 1.20-5.00 (4.10±0.50) mm. There were 8 males and 2 females in the study group, aged 20-70 (50.85±8.96) years, diameter of the fistula opening 1.10-4.90 (4.05±0.45) mm. The control group received conservative treatments such as anti-infection and nutritional support, while the study group was treated with local injection of autologous platelet rich plasma via bronchoscopy. Both groups were treated continuously for 3 weeks. The healing conditions of the fistulas were compared between the two groups, and measure the dyspnea score and the Karnofsky Performance Status Scale (KPS) score before and after treatment. Independent sample t test, and Fisher's exact probability method were used for statistical analysis. Results　Among the 20 patients with tracheobronchial fistulas in the control group (with a total of 22 fistula openings), the complete healing rate was 54.55% (12/22), and the incomplete healing rate was 45.45% (10/22). Among the 10 patients with tracheobronchial fistulas in the study group (with a total of 10 fistula openings), the complete healing rate was 90.00% (9/10), and the incomplete healing rate was 10.00% (1/10). There was a statistically significant difference between the two groups (P<0.05). After treatment, the dyspnea score of the study group was lower than that of the control group, and the KPS score was higher than that of the control group [(1.60±0.40) points vs. (2.10±0.10) points, (85.10±10.20) points vs. (75.30±8.00) points] (both P<0.05). Conclusion　Local injection of autologous platelet rich plasma via bronchoscopy has a better therapeutic effect on tracheobronchial fistula and can improve the quality of life of patients.

The effect of CO₂ laser combined with Kegel exercises in the treatment of stress urinary incontinence in women of different ages

Yang Dongqing, Bao Liyan, Yin Liying, Chen Jianguo

2025, 31(19):  3240-3245.  DOI: 10.3760/cma.j.cn441417-20250509-19015

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the clinical efficacy of CO₂ laser combined with Kegel exercises in treating patients with stress urinary incontinence of different age groups and its impact on quality of life. Methods　A total of 100 female patients with stress urinary incontinence who visited the obstetrics and gynecology department of Zhuhai Doumen District Maternal and Child Health Hospital from February 2023 to October 2024 were selected as the study subjects. The patients were divided by age into the reproductive age group (<45 years old) and the perimenopausal group (≥45 years old), with 50 cases in each group. After stratification, they were randomly divided into the control group and the study group, with 25 cases in each group. Reproductive age patients: in the control group, the age was (35.72±4.82) years, the body mass index was (22.06±0.87) kg/m², and there were 8 cases of mild stress urinary incontinence and 17 cases of moderate stress urinary incontinence; in the study group, the age was (36.60±4.20) years, the body mass index was (21.72±1.04) kg/m², and there were 14 cases of mild stress urinary incontinence and 11 cases of moderate stress urinary incontinence. Perimenopausal patients: in the control group, the age was (54.88±6.19) years, the body mass index was (21.85±0.75) kg/m², and there were 9 cases of mild stress urinary incontinence and 16 cases of moderate stress urinary incontinence; in the study group, the age was (53.44±8.80) years, the body mass index was (22.09±0.73) kg/m², and there were 8 cases of mild stress urinary incontinence and 17 cases of moderate stress urinary incontinence. The control group received Kegel exercise therapy, while the study group received CO₂ laser therapy combined with Kegel exercise. All groups received a continuous treatment course (3 months). The 1-hour urine leakage volume (1-hour urine pad test) were compared before and after treatment in each group of reproductive-aged and post-menopausal patients, as well as the symptoms score of stress urinary incontinence [International Consultation on Incontinence Questionnaire - Short Form (ICI-Q-SF)], quality of life [World Health Organization Quality of Life - Brief Version (WHOQOL-BREF)], and anxiety level [Self-Rating Anxiety Scale (SAS)]. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After treatment, the 1-hour urine leakage volume and ICI-Q-SF score of the reproductive age and perimenopausal patients in the study group were lower than those in the control group [(0.56±0.27) g vs. (1.26±1.24) g, (4.52±3.06) points vs. (6.40±2.94) points; (0.68±0.26) g vs. (5.46±1.02) g, (7.52±3.95) points vs. (11.24±4.53) points] (all P<0.05); the WHOQOL-BREF scores of the reproductive age and perimenopausal patients in the study group were higher than those in the control group [(86.44±4.39) points vs. (77.76±4.44) points; (86.12±5.06) points vs. (60.80±4.92) points] (both P<0.05). There was no statistically significant difference in the SAS scores between the two groups of patients of reproductive age and those in the perimenopausal (both P>0.05). Conclusions　Simple Kegel exercises are highly effective for patients in the reproductive age group, but have less effect on those in the perimenopausal. Moreover, in both the reproductive age group and the perimenopausal group, the combined treatment of CO₂ laser and Kegel exercises for stress urinary incontinence is highly effective, which can improve the quality of life of patients and alleviate their anxiety.

Clinical application of the IQQA three-dimensional reconstruction system in thoracoscopic combined subsegmental pulmonary resection

Xie Xin, Zhu Jimin, Wei Wei

2025, 31(19):  3246-3250.  DOI: 10.3760/cma.j.cn441417-20250325-19016

Asbtract ( )  

References | Related Articles | Metrics

Objective　By analyzing and comparing the effect of the application and non-application of IQQA three-dimensional reconstruction system assisted thoracoscopic subsegmental pulmonary resection, the effectiveness and safety of the subsegmental pulmonary resection were discussed. Methods　Forty patients with pulmonary nodules who underwent thoracoscopic combined subsegmental resection in Zhuhai People's Hospital from July 2023 to December 2024 were selected as the study subjects. According to the principle of patient's voluntary consent, whether to perform the three-dimensional IQQA reconstruction before the operation was divided into the reconstruction group (28 cases) and the control group (12 cases). The reconstruction group included 10 males and 18 females; the average age was (55.56±12.34) years; the body mass index was (23.10±1.55) kg/m²; the size of the nodules was (0.89±0.21) cm. The control group included 5 males and 7 females; the average age was (57.58±16.47) years; the body mass index was (22.86±1.29) kg/m²; the size of the nodules was (0.85±0.18) cm. Both groups underwent bilateral thoracoscopic combined subsegmental pulmonary resection. The intraoperative observation indicators were compared between the two groups (operation time, intraoperative blood loss, number of lymph node dissections, rate of intraoperative surgical modification, and rate of conversion to open surgery) and the postoperative observation indicators [duration of chest drainage tube placement, thoracic drainage volume (average drainage volume), postoperative complications (pulmonary infection, prolonged air leakage, pulmonary embolism, and chylothorax), length of hospital stay, and hospitalization expenses]. Independent sample t test, and Fisher's exact probability method were used for statistical analysis. Results　There was no statistically significant difference in the rate of conversion to open surgery between the two groups (P>0.05). The operation time of the reconstruction group was shorter than that of the control group [(94.15±10.71) min vs. (125.59±7.17) min], and the intraoperative blood loss, the number of lymph node dissections, and the rate of intraoperative surgical modification were all lower in the reconstruction group [(40.57±10.35) ml vs. (74.33±12.18) ml, (4.89±1.26) vs. (8.75±1.22), 0 vs. 25.00% (3/12)] (all P<0.05). There was no statistically significant difference in the postoperative complications and hospitalization expenses between the two groups (both P>0.05). The duration of chest drainage tube placement, the thoracic drainage volume, and the length of hospital stay in the reconstruction group were all lower than those in the control group [(3.13±0.82) d vs. (4.71±1.30) d, (189.92±93.81) ml vs. (387.83±175.04) ml, (5.27±0.94) d vs. (6.29±1.39) d] (all P<0.05). Conclusions　By combining the IQQA three-dimensional reconstruction system with thoracoscopic surgery, precise resection of pulmonary nodules was achieved, with satisfactory therapeutic effects. Therefore, it has considerable clinical application value.

A comparative study on the clinical outcomes of different doses of gonadotropin in the antagonist protocol for the low prognosis population of Poseidon

Jing Xiao, Kou Xiaoping, Jia Qingge

2025, 31(19):  3251-3255.  DOI: 10.3760/cma.j.cn441417-20250314-19017

Asbtract ( )  

References | Related Articles | Metrics

Objective　To compare the effects of different doses of gonadotropin (Gn) on the clinical outcomes of the Poseidon population with low prognosis when used in an antagonist protocol, and to provide a basis for individualized medication. Methods　This study was a retrospective cohort study. A total of 195 patients who underwent assisted reproductive technology (ART) assisted pregnancy treatment in the reproductive medicine department of Xi'an Gaoxin Hospital from February 2023 to February 2024 were selected. Among them, 221 oocyte retrieval cycles of patients with low prognosis according to the Poseidon criteria and using the antagonist protocol for ovulation induction were identified. The included patients were followed up for at least one year. According to the different total doses of Gn used in the antagonist protocol, the patients were divided into the low-dose group (≤3 000 U) with 124 oocyte retrieval cycles and the high-dose group (>3 000 U) with 97 oocyte retrieval cycles. The age of the low-dose group was (36.52±2.55) years; the body mass index was (22.56±4.51) kg/m²; the duration of infertility was (3.11±1.04) years. The age of the high-dose group was (36.83±3.11) years; the body mass index was (23.60±4.25) kg/m²; the duration of infertility was (2.87±1.44) years. The baseline data were compared between the two groups [age, body mass index, duration of infertility, basal follicle-stimulating hormone (bFSH), basal estradiol (bE₂), basal progesterone (bP), basal luteinizing hormone (bLH), basal testosterone (bT), basal prolactin (bPRL), and anti-Müllerian hormone (AMH)], the outcome of ovulation induction (initial dose of Gn, number of days used by Gn, total dose of Gn, number of retrieved oocytes, number of mature oocytes, fertilization rate, and quality embryo rate), and clinical outcomes [clinical pregnancy rate, live birth rate, and incidence of ovarian hyperstimulation syndrome (OHSS)]. Independent sample t test, non-parametric test, χ² test, and Fisher's exact probability method were used for statistical analysis. Results　Comparison of baseline data between the two groups showed no statistically significant differences (all P>0.05). There was no statistically significant difference in the initial dose of Gn, fertilization rate, and quality embryo rate between the two groups (all P>0.05). The number of days used by Gn, total dose of Gn, number of retrieved oocytes, and number of mature oocytes in the high-dose group were all higher than those in the low-dose group [(11.24±2.68) d vs. (10.44±3.01) d, (3 344.13±525.74) U vs. (2 431.57±642.63) U, 3.00 (2.00, 6.00) vs. 2.00 (2.00, 5.00), 3.00 (2.00, 5.00) vs. 2.00 (2.00, 4.00)] (all P<0.05). In the low-dose group, a total of 17 oocyte retrieval cycles were not carried out for embryo transfer due to the occurrence of OHSS or poor endometrial conditions. In the high-dose group, 9 oocyte retrieval cycles were not performed for embryo transfer. There was no statistically significant difference in the clinical pregnancy rate, live birth rate, and the incidence of OHSS between the two groups (all P>0.05). Conclusions　The use of high-dose Gn can increase the number of oocytes retrieved by patients, but it has no significant effect on the clinical pregnancy rate, live birth rate, or the incidence of OHSS. Although not statistically significant, it was observed that the incidence of OHSS in the high-dose Gn group was higher, suggesting that clinicians still need to be vigilant when applying it.

The effect of the Andian Huayu formula combined with western medicine on the balance of coagulation-fibrinolysis in patients with recurrent spontaneous abortion positive for anticardiolipin antibody

He Tiantian, Huang Simin, Li Meifen, Song Shuxia, Chen Fengmei, Zheng Xiaohong

2025, 31(19):  3256-3261.  DOI: 10.3760/cma.j.cn441417-20250603-19018

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of the Andian Huayu formula combined with western medicine on the balance of coagulation-fibrinolysis in patients with recurrent spontaneous abortion positive for anticardiolipin antibody. Methods　Sixty patients with positive anticardiolipin antibody and recurrent spontaneous abortion who visited Guangdong Women and Children Hospital from January 2021 to December 2023 were selected as the research subjects. Using the random number table method, the patients were divided into the western medicine group (30 cases) and the treatment group (30 cases). The age of the western medicine group was (30.90±3.43) years; the number of spontaneous abortions was (2.82±0.94) times. The age of the treatment group was (31.10±3.19) years, and the number of spontaneous abortions was (2.73±0.82) times. At the same time, 20 non-pregnant women of childbearing age without a history of spontaneous abortion were selected as the normal control group, with an average age of (30.37±4.24) years. The western medicine group was treated with oral western medicine. The treatment group was treated in addition with the Anding Huayu formula. Both the treatment group and the western medicine group started the treatment at least 3 months before pregnancy. After 3 months, they were instructed to have sexual intercourse for conception preparation. The treatment with both traditional Chinese medicine and western medicine was stopped when the pregnancy reached 12 weeks. The antibody clearance rate, the rate of threatened miscarriage and the pregnancy success rate were compared between the western medicine group and the treatment group. The coagulation and fibrinolysis system indicators before and after treatment in the three groups were compared [activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), antithrombin Ⅲ (AT-Ⅲ), D-dimer (D-D), fibrinogen (Fbg)]. The normal control group only compared the data before treatment. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　There was no statistically significant difference in the antibody clearance rate between the western medicine group and the treatment group (P>0.05). The rate of threatened miscarriage in the treatment group was lower than that in the western medicine group, and the pregnancy success rate was higher in the treatment group than in the western medicine group [16.67% (5/30) vs. 40.00% (12/30); 63.33% (19/30) vs. 36.67% (11/30)] (both P<0.05). Before treatment, the levels of D-D and Fbg in both the western medicine group and the treatment group were higher than those in the normal control group [(0.35±0.15) mg/L, (0.37±0.16) mg/L vs. (0.20±0.09) mg/L; (3.23±0.84) g/L, (3.08±0.68) g/L vs. (2.38±0.50) g/L] (all P<0.05); there were no statistically significant differences in the levels of APTT, PT, TT, and AT-Ⅲ among the western medicine group, the treatment group, and the normal control group (all P>0.05); there were no statistically significant differences in the levels of APTT, PT, TT, AT-Ⅲ, D-D, and Fbg between the western medicine group and the treatment group (all P>0.05). In the western medicine group, there were 12 patients whose pregnancies lasted until 12 weeks. In the treatment group, there were 19 patients whose pregnancies lasted until 12 weeks. After treatment, the levels of D-D and Fbg in the treatment group were lower than those in the western medicine group [(0.18±0.11) mg/L vs. (0.27±0.11) mg/L; (2.50±0.65) g/L vs. (2.98±0.55) g/L] (both P<0.05); there were no statistically significant differences in APTT, PT, TT, and AT-Ⅲ levels between the western medicine group and the treatment group (all P>0.05). Conclusions　The combined use of traditional Chinese medicine and western medicine can more effectively maintain the coagulation-fibrinolysis balance in patients with recurrent spontaneous abortion, improve the pre-thrombotic state, thereby increasing the pregnancy rate and improving the pregnancy outcome. It is worthy of clinical promotion.

Effect of roxadustat capsules on peritoneal dialysis patients with renal anemia

Hou Lixia, Xu Yapei, Wang Xifeng

2025, 31(19):  3261-3266.  DOI: 10.3760/cma.j.cn441417-20250506-19019

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effects of Roxadustat capsules on anemia indicators, cardiac function, and lipid metabolism levels in patients with peritoneal dialysis and renal anemia. Methods　A total of 113 patients with peritoneal dialysis and renal anemia who were treated at Zhengzhou Third People's Hospital from October 2021 to December 2023 were prospectively selected. They were randomly divided into a control group (56 cases) and an observation group (57 cases) using a random number table. The control group included 30 males and 26 females, with an average age of (45.18±12.47) years and a dialysis duration of (23.51±6.16) months. The observation group consisted of 34 males and 23 females, with an average age of (46.97±12.08) years and a dialysis duration of (22.89±6.07) months. The control group received subcutaneous injections of recombinant human erythropoietin, while the observation group was treated with oral Roxadustat capsules. Both groups were treated continuously for 3 months. Anemia status, cardiac function, lipid metabolism levels, and adverse reaction rates were compared between the two groups. Statistical analysis was performed using χ² and t tests. Results　After 3 months of treatment, the observation group had higher levels of hemoglobin, hematocrit, and red blood cell count than the control group [(116.29±21.02) g/L vs. (105.14±22.21) g/L; (33.21±5.02)% vs. (29.18±4.81)%; (1.58±0.31)×10¹²/L vs. (1.39±0.28)×10¹²/L], with statistically significant differences (all P<0.05). The left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and left ventricular posterior wall thickness in the observation group were (47.56±2.34) mm, (37.59±1.13) mm, and (9.67±0.19) mm, respectively, all lower than those in the control group [(48.62±2.32) mm, (38.68±1.12) mm, (9.75±0.22) mm], with significant differences (all P<0.05). The observation group had lower levels of total cholesterol and low-density lipoprotein, while high-density lipoprotein levels were higher than in the control group (all P<0.05). The overall incidence of adverse reactions in the observation group was 10.53% (6/57), lower than the 25.00% (14/56) in the control group (χ²=4.062, P=0.044). Conclusion　Roxadustat capsule can significantly correct the anemia index of peritoneal dialysis patients with renal anemia, effectively improve the cardiac function and lipid metabolism level of patients, and help to reduce the incidence of adverse reactions.

【Key words】  Peritoneal dialysis;  Renal anemia;  Roxadustat;  Cardiac function

The impact of finerenone combined with SGLT2 inhibitor on cardiorenal outcomes in patients with diabetes mellitus complicated by CKD

Song Shuxian, Liu Limin, Guo Yaju, Cui Xiang, Lin Yuan, Gao Haiyan

2025, 31(19):  3266-3270.  DOI: 10.3760/cma.j.cn441417-20250319-19020

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of fineridone combined with sodium-dependent glucose transporters 2 (SGLT2) inhibitor on cardiorenal outcomes in diabetes mellitus complicated with chronic kidney disease (CKD) patients. Methods　This study was a prospective study. A total of 82 patients with diabetes and CKD who were treated at the Second Affiliated Hospital of Xi'an Medical University from March 2022 to March 2024 were selected for this study. They were randomly divided into a control group and a study group, with 41 cases in each group, using the envelope method. The control group consisted of 24 males and 17 females, with an average age of (58.22±6.55) years. The study group included 22 males and 19 females, with an average age of (59.02±6.44) years. The control group received SGLT2 inhibitor (dapagliflozin) plus placebo (starch tablets simulating Finerenone), while the study group received SGLT2 inhibitor (dapagliflozin) combined with Finerenone. Both groups were treated continuously for 3 months. Clinical efficacy, laboratory indicators of cardiovascular and renal function before and after treatment, and cardiovascular and renal outcomes were compared. Statistical analysis was performed using t tests, χ² tests, and Fisher's exact probability method. Results　The overall clinical effective rate in the study group was higher than that in the control group [95.12% (39/41) vs. 80.49% (33/41)], with a statistically significant difference (χ²=4.100, P=0.043). After treatment, levels of brain natriuretic peptide, urinary albumin excretion rate, and blood urea nitrogen in the study group were lower than those in the control group [(142.63±28.74) ng/L vs. (210.26±38.78) ng/L; (98.52±18.63) mg/24 h vs. (130.85±25.63) mg/24 h; (7.22±2.01) mmol/L vs. (9.18±2.37) mmol/L], with all differences being statistically significant (t=8.971, 6.533, 4.039; all P<0.001). The incidence of the primary endpoint in the study group was lower than that in the control group [9.76% (4/41) vs. 26.83% (11/41)] (χ²=3.998, P=0.046), with 2 cardiovascular events and 2 renal events in the study group, compared to 7 cardiovascular events and 4 renal events in the control group. The incidence of newly developed proteinuria in the study group was lower than that in the control group [4.88% (2/41) vs. 19.51% (8/41)] (χ²=4.100, P=0.043). There were no statistically significant differences in all-cause mortality, hyperkalemia incidence, and drug safety between the two groups (all P>0.05). Conclusion　The combination of finerenone and SGLT2 inhibitor in patients with diabetes and CKD can enhance clinical efficacy, improve cardiac and renal functions, and optimize cardiac and renal outcomes, making it worthy of promotion and application.

Clinical effect of Huaiqihuang granules on children with anaphylactoid purpura nephritis

Xu Ximei, Zhu Huimin, Wu Tingbai, Li Qiaoru, Zhang Yunfan

2025, 31(19):  3271-3276.  DOI: 10.3760/cma.j.cn441417-20250228-19021

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the clinical efficacy and immune regulation effect of Huaiqihuang granules on children with hypersensitive purpura nephritis (HSPN). Methods　This study is a single-center, non-randomized, controlled clinical trial. A total of 30 children diagnosed with HSPN who were admitted to the pediatrics department of Zhongshan People's Hospital from January 2022 to December 2023 were selected for the HSPN group. Based on the family's willingness to use Huaiqihuang granules for treatment, the patients were divided into a conventional group and a Huaiqihuang group, with 15 cases in each group. The conventional group included 6 males and 9 females, with an average age of (8.07±2.17) years. The Huaiqihuang group included 10 males and 5 females, with an average age of (7.13±2.43) years. A healthy control group consisted of 30 healthy children who underwent health check-ups at the same hospital, matched for gender and age with the HSPN group. The healthy control group included 18 males and 12 females, with an average age of (6.95±2.08) years. The conventional group received standard treatment, while the Huaiqihuang group received oral Huaiqihuang granules as an adjunctive therapy. Both groups were treated for 1 month. The differences of clinical symptoms, laboratory indexes and immunological indexes were compared among the groups. Statistical analysis was performed using t test, Mann-Whitney U test, and Fisher's exact probability method. Results　In the HSPN group, levels of Th1-type cytokines IL-2 and interferon-gamma (IFN-γ) were lower than those in the healthy control group [(2.24±0.90) ng/L vs. (3.80±1.20) ng/L; 2.52 (1.04, 3.87) ng/L vs. 5.26 (3.39, 5.87) ng/L] (both P<0.05). Th2-type cytokines IL-4 and IL-6 were higher in the HSPN group than in the healthy control group [5.04 (3.75, 5.98) ng/L vs. 4.08 (3.73, 4.44) ng/L; 15.38 (8.85,26.31) ng/L vs. 3.65 (2.36, 5.21) ng/L], while IL-10 was lower in the HSPN group [(1.19±0.74) ng/L vs. (5.02±1.82) ng/L], with all differences being statistically significant (all P<0.05). After treatment, levels of IL-2, IL-10, and IFN-γ in the Huaiqihuang group were higher than those in the conventional group [(3.66±1.27) ng/L vs. (2.73±1.00) ng/L; 3.26 (2.50, 3.95) ng/L vs. 2.63 (2.39, 3.48) ng/L; (4.84±1.32) ng/L vs. (3.63±1.16) ng/L], while IL-4, IL-6 levels were lower in the Huaiqihuang group [(3.43±1.76) ng/L vs. (4.85±1.69) ng/L; 3.00 (2.42, 3.52) ng/L vs. 3.02 (2.51, 4.74) ng/L]. The levels of CD3⁺, absolute CD3⁺, CD4⁺, CD4⁺/CD8⁺, and NK cells were higher in the Huaiqihuang group, while CD8⁺, NKT, IgE, IgA, and C3 levels were lower compared to the conventional group, with all differences being statistically significant (all P<0.05). The urinary protein clearance time in Huaiqihuang group was shorter than that in routine group [(14.67±6.25) days vs. (20.67±8.02) days], and the total incidence of secondary infection was lower than that in routine group [13.3% (2/15) vs. 60.0% (9/15)], with statistically significant differences (all P<0.05). Conclusion　Huaiqihuang granules can significantly improve the clinical symptoms of children with HSPN by regulating immune disorders, reduce the occurrence of secondary infections, and have good clinical efficacy.

Clinical Research

Application of ultrasound-guided dexamethasone combined with ropivacaine in fascia iliaca compartment block at anterior superior iliac spine level in children with congenital dislocation of hip joint

Tang Jie, Zhang Bo, Xue Yuting, Chen Yan, Yu Xiaorong, Lyu Haigang

2025, 31(19):  3277-3282.  DOI: 10.3760/cma.j.cn441417-20250114-19022

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effects of general anesthesia (GA) combined with ultrasound-guided dexamethasone and ropivacaine in fascia iliaca compartment block at the level of the anterior superior iliac spine during surgery for congenital dislocation of the hip (CDH) in children. Methods　This study is a randomized controlled trial. A prospective study was conducted involving 100 children undergoing CDH surgery at Xi'an People's Hospital (Fourth Hospital of Xi'an) from March 2023 to September 2024. The children were randomly divided into a control group and an observation group, with 50 cases in each. In the control group, there were 14 males and 36 females, with an average age of (4.20±1.03) years; American Society of Anesthesiologists (ASA) classification: 33 cases of grade I and 17 cases of grade II. In the observation group, there were 11 males and 39 females, with an average age of (4.36±1.12) years; ASA classification: 31 cases of grade I and 19 cases of grade II. Both groups received ultrasound-guided fascia iliaca compartment block at the level of the anterior superior iliac spine combined with general anesthesia, with the control group using ropivacaine and the observation group using a combination of dexamethasone and ropivacaine. Heart rate and mean arterial pressure (MAP) were compared between the two groups at five time points: before induction of general anesthesia (T₀), at tracheal intubation (T₁), at skin incision (T₂), 1 hour intraoperatively (T₃), and at extubation (T₄). Anesthesia recovery and maintenance parameters were assessed (recovery room stay duration, extubation time, and dosages of remifentanil and propofol). Serum inflammatory markers [interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α)] were measured before induction and 6 hours postoperatively. The Face Pain Scale (FPS) scores were recorded preoperatively and at 6, 12, and 24 hours postoperatively, along with the incidence of adverse reactions. Statistical analysis was performed using repeated measures ANOVA, t tests, and χ² tests. Results　At time points T₁, T₂, T₃, and T₄, the MAP and heart rate in the observation group were significantly lower than those in the control group (all P<0.05). The recovery room stay duration and extubation time in the observation group were shorter than those in the control group [(18.65±5.42) min vs. (22.14±7.32) min; (9.25±2.81) min vs. (11.13±3.16) min], with statistically significant differences (t=2.709, 3.144, 2.827, 2.761; all P<0.05). The dosages of remifentanil and propofol in the observation group were lower than those in the control group [(186.49±42.21) µg vs. (211.36±45.69) µg; (192.71±44.51) mg vs. (218.36±48.32) mg], with all differences being statistically significant. Six hours postoperatively, serum levels of IL-6 and TNF-α in the observation group were lower than those in the control group [(16.76±3.73) ng/L vs. (19.42±4.38) ng/L; (37.28±8.34) ng/L vs. (42.79±8.93) ng/L]. The FPS scores at 6, 12, and 24 hours postoperatively were also lower in the observation group compared to the control group [(7.05±2.25, 5.16±1.62, 3.38±0.92) points vs. (8.34±2.62, 6.08±1.87, 4.04±1.11) points], with all differences being statistically significant (all P<0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (χ²=1.333, P=0.248). Conclusion　Ultrasound-guided fascia iliaca compartment block at the level of anterior superior iliac spine with dexamethasone and ropivacaine combined with general anesthesia can effectively relieve pain, stabilize intraoperative hemodynamics, reduce anesthetic dosage, shorten recovery time, reduce inflammatory reactions, and has good safety in CDH surgery.

The expression of NLRP3 in peripheral blood mononuclear cells of patients with diabetic retinopathy and its correlation with visual impairment

Fan Qiang, Xue Tao, Xu Tianyu, Hou Lihua

2025, 31(19):  3282-3287.  DOI: 10.3760/cma.j.cn441417-20250306-19023

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the expression of NLRP3 in peripheral blood monocytes in patients with diabetic retinopathy (DR) and its correlation with visual impairment. Methods　A retrospective analysis was conducted on 152 patients with type 2 diabetes who were treated at Xianyang First People's Hospital from January 2022 to March 2024. Among them, 94 were male (61.84%) and 58 were female (38.16%), with an average age of (55.02±5.36) years and a diabetes duration of (14.06±3.78) years. Based on the severity of DR, patients were divided into no DR (NDR) group (36 cases), non-proliferative DR (NPDR) group (68 cases), and proliferative DR (PDR) group (48 cases). The expression of NLRP3 mRNA in peripheral blood mononuclear cells was detected using reverse transcription polymerase chain reaction (RT-PCR), and serum levels of interleukin (IL)-1β and IL-18 were measured using enzyme-linked immunosorbent assay (ELISA). Visual impairment was assessed using the CV-5000S autorefractor and Humphrey visual field analyzer. Corneal and retinal nerve fiber metrics were evaluated using the Spectralis OCT and HRT3-RCM laser confocal microscopy. The severity of visual impairment, corneal nerve fiber metrics [nerve fiber length (NFL), corneal nerve fiber density (NFD), corneal nerve fiber branching density (NFB)], and retinal nerve fiber metrics [retinal nerve fiber layer (RNFL) thickness, foveal avascular zone (FAZ) area, superficial capillary layer (SCL) blood flow density, and deep capillary layer (DCL) blood flow density] were compared among the groups. Statistical comparisons were made using χ², t tests, SNK-q tests, and one-way analysis of variance. Results　The NLRP3 mRNA, IL-1β, IL-18 levels, and the proportion of severe visual impairment in the NDR group were 0.90±0.14, (20.03±4.01) ng/L, (76.96±22.85) ng/L, and 5.56% (2/36), respectively. In the NPDR group, these values were 1.19±0.13, (27.15±3.69) ng/L, (112.05±20.76) ng/L, and 25.00% (17/68). In the PDR group, they were 1.59±0.23, (36.02±3.71) ng/L, (136.20±18.95) ng/L, and 54.17% (26/48), all showing a gradual increase (all P<0.05). NFL, NFD, NFB, RNFL thickness, SCL, and DCL metrics gradually declined in the NDR, NPDR, and PDR groups, while FAZ values [(0.34±0.07, 0.40±0.09, 0.46±0.08) mm²] gradually increased, with all differences being statistically significant (all P<0.05). Spearman correlation analysis showed that NLRP3 was positively correlated with the severity of visual impairment (r=0.493, P<0.001). Conclusion　The expression level of NLRP3 in peripheral blood monocytes increased with the severity of DR and it was positively correlated with the severity of visual impairment in DR patients.

Effect of sodium aesculin on limb swelling degree and callus growth in patients with limb fracture after operation

Fan Xiaohong, Liang Tuo, Li Liyuan, Wu Guiyue, Li Guanghui

2025, 31(19):  3288-3292.  DOI: 10.3760/cma.j.cn441417-20250226-19024

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effects of sodium aesculin on limb swelling and callus growth in patients with limb fracture after operation. Methods　This study is a prospective analysis. A total of 102 patients who underwent surgical treatment for limb fractures at Henan Provincial Hospital from January 2021 to January 2024 were selected and randomly divided into a control group and an observation group, with 51 cases in each group. The control group consisted of 33 males and 18 females, with an average age of (54.50±11.00) years and a time from fracture to treatment of (4.25±0.48) hours. The observation group included 30 males and 21 females, with an average age of (53.00±11.23) years and a time from fracture to treatment of (4.25±0.45) hours. The control group received intravenous infusion of mannitol at 250 ml per dose, once daily. The observation group received intravenous infusion of sodium aesculin 20 mg + 500 ml sodium chloride solution, once daily. Both groups were treated continuously for one week. Limb swelling, visual analog scale (VAS) scores, callus formation scores, inflammatory factors, bone metabolism indicators, and treatment safety were compared before and after one week of treatment. Statistical analysis was performed using χ² and t tests. Results　After one week of treatment, limb swelling and VAS scores in the observation group were (0.75±0.13, 1.68±0.31) points, while in the control group they were (0.96±0.16, 2.45±0.41) points, with statistically significant differences (t=7.275, 10.698; both P<0.001). The callus volume, callus density, and callus margin scores in the observation group were (3.50±0.34, 3.30±0.21, 3.29±0.18) points, all higher than those in the control group [(2.86±0.30, 2.71±0.18, 2.75±0.15) points], with statistically significant differences (t=10.080, 15.234, 16.459; all P<0.001). Levels of tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) in the observation group were lower than those in the control group, while alkaline phosphatase (ALP), bone gamma-carboxyglutamic acid-containing protein (BGP), osteoprotegerin (OPG), and carboxy terminal peptide of type Ⅰ procollagen(PⅠCP) levels were higher in the observation group than in the control group (all P<0.05). There was no statistically significant difference in the overall incidence of adverse reactions between the two groups (χ²=0.297, P=0.586). Conclusion　Sodium aesculin is safe in alleviating limb swelling, promoting callus growth, regulating inflammatory factors and bone metabolism in patients with limb fracture.

Effect of pediatric spleen-strengthening, turbidity-resolving and fat-reducing formula combined with vitamin D in the treatment of obesity-related metabolic-associated fatty liver disease in children

Wu Jing, Hua Peng, Cui Xiang, Wang Fujun, Pi Yuxiang

2025, 31(19):  3293-3298.  DOI: 10.3760/cma.j.cn441417-20250306-19025

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the efficacy of pediatric spleen-strengthening, turbidity-resolving and fat-reducing formula combined with vitamin D in the treatment of children with obesity-related metabolic fatty liver disease of spleen deficiency and impaired transportation type. Methods　This study is a prospective, single-center, controlled study. A total of 118 children diagnosed with obesity-related metabolic fatty liver disease of spleen deficiency and impaired transportation type were selected from Ankang Traditional Chinese Medicine Hospital between January and October 2024. They were randomly divided into a control group and an observation group, with 59 cases in each group. There were 31 males and 28 females in the control group, aged (11.41±2.21) years. There were 34 males and 25 females in the observation group, aged (11.67±2.58) years old. Both groups received a comprehensive intervention focused on a reasonable dietary structure and oral silymarin capsules. The control group also received oral vitamin D drops, while the observation group received the pediatric spleen-strengthening, turbidity-resolving and fat-reducing formula in addition to the treatment in the control group. Both groups were treated continuously for 12 weeks. Clinical efficacy, blood lipids [total cholesterol (TC) and triglycerides (TG)], liver function [aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin (ALB)], body mass index (BMI), liver/spleen CT ratio, and traditional Chinese medicine syndrome scores were compared, along with the recording of adverse reactions. Statistical analysis was performed using χ² and t tests. Results　The overall effective rate in the observation group was 94.92% (56/59), compared to 79.66% (47/59) in the control group, with a statistically significant difference (χ²=6.186, P=0.013). After treatment, the observation group's TC, TG, and BMI were (3.72±0.29) mmol/L, (1.48±0.19) mmol/L, and (24.86±2.02) kg/m², respectively, while the control group's values were (4.18±0.34) mmol/L, (1.69±0.21) mmol/L, and (27.18±2.19) kg/m². The ALB levels and liver/spleen CT ratio in the observation group were higher than those in the control group, while AST, ALT, and traditional Chinese medicine syndrome scores were lower in the observation group, with all differences being statistically significant (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=0.902, P=0.342). Conclusion　pediatric spleen-strengthening, turbidity-resolving and fat-reducing formula combined with vitamin D can improve clinical efficacy, effectively reduce blood lipid levels and improve liver function in the treatment of metabolic-related fatty liver disease in obese children with spleen deficiency and loss of transportation.

Application of low frequency repetitive transcranial magnetic stimulation combined with behavior analysis therapy in children with autism spectrum disorders

Wen Yanan, Chen Xiaoyan, Wan Kai

2025, 31(19):  3298-3302.  DOI: 10.3760/cma.j.cn441417-20250307-19026

Asbtract ( )  

References | Related Articles | Metrics

Objective　Investigating the application and observation of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with behavioral analysis therapy (ABA) in children with autism spectrum disorder (ASD). Methods　A total of 68 children with ASD who were admitted to Anyang No.7 People's Hospital from June 2022 to June 2024 were selected for a prospective study. They were randomly divided into two groups according to the random number table method, with 34 cases in each group.In the control group, there were 19 males and 15 females, with an average age of (9.94±0.65) years and a disease duration of (2.56±0.33) years. They received conventional intervention.In the observation group, there were 18 males and 16 females, with an average age of (9.98±0.68) years and a disease duration of (2.59±0.31) years. They received low-frequency rTMS combined with ABA treatment.Both groups were continuously observed and intervened for 12 weeks.The autism behaviors, cognitive functions and quality of life of the two groups of children were compared [using the Autism Treatment Evaluation Checklist (ATEC)], [using the Montreal Cognitive Assessment Scale (MoCA)], and [using the Pediatric Quality of Life Inventory 4.0 (PedsQL4.0)].The statistical method employed was the t-test. Results　Before the intervention, there was no statistically significant difference in the ATEC, MoCA and PedsQL4.0 scores between the two groups of children (all P>0.05).After the intervention, the scores of social ability [(27.35±1.09) points], perception/cognitive ability [(22.38±1.07) points], health/physiological behavior [(31.18±1.29) points], and expression/language communication [(17.77±1.10) points] in the observation group were all lower than those in the control group [(30.74±1.22) points, (26.76±1.11) points, (35.53±1.74) points, (20.92±1.13) points],The MoCA score [(19.92±1.78) points], as well as the scores for physiological function [(23.36±1.81) points], emotional function [(14.74±1.53) points], social function [(15.65±1.62) points], and role function [(15.75±1.40) points] were all higher than those of the control group [(15.74±1.63) points, (18.97±1.44) points, (11.94±1.65) points, (11.09±1.54) points, (11.54±1.35) points].The differences were all statistically significant (t=12.083、16.565、11.710、11.647、10.099、11.067、7.256、11.896, and 12.622，all P<0.05). Conclusion　Low-frequency rTMS combined with ABA can accelerate the recovery of symptoms in children with ASD, improve their cognitive function levels, help them return to family and society earlier, and contribute to enhancing their quality of life.

Study on the effect of transcutaneous electrical nerve stimulation combined with closed-chain functional training on patients with knee osteoarthritis

Wu Xiaogang, He Haiyan, Yang Chunqin, Jing Qi, Yuan Jinghe

2025, 31(19):  3303-3308.  DOI: 10.3760/cma.j.cn441417-20250311-19027

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect of transcutaneous electrical nerve stimulation (TENS) combined with closed-chain functional training on pain relief and functional recovery in patients with knee osteoarthritis. Methods　A prospective, single-center, single-blind trial was conducted. The research subjects were 96 patients with knee osteoarthritis who received treatment at the Affiliated Hospital of Yan'an University from January 2022 to January 2024. They were randomly divided into two groups, with 48 cases in each group.Control group: 21 males and 27 females, with an average age of (65.11±7.63) years and a disease duration of (7.73±1.28) months.Conventional rehabilitation training and TENS therapy were adopted.Observation group: 19 males and 29 females, with an average age of (64.72±7.51) years and a disease duration of (7.81±1.32) months.Combined with closed-chain functional training on the basis of the control group.Both groups were treated for 4 weeks.Compare the levels of inflammatory factors in the knee joint fluid, the circumference of the knee joint, the thickness of the effusion, the isokinetic muscle strength of the knee flexion and extension muscle groups, the three-dimensional gait parameters, as well as the pain condition and knee joint function of the two groups of patients before and after treatment.Statistical methods employed t-test and χ² test. Results　After treatment, the knee joint circumference and the thickness of the effusion in the observation group were smaller than those in the control group [(37.15±1.05) cm vs. (38.01±1.21) cm, (37.46±4.52) mm vs. (41.68±5.84) mm], and the differences were statistically significant (t=3.719 and 3.959; both P<0.05). The levels of inflammatory factors in the knee joint fluid were all lower than those in the control group, and the average peak torque of the knee flexion and extension muscle groups, as well as the three-dimensional gait parameters, were all higher than those in the control group (all P<0.05).After treatment, the visual analogue scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores of the observation group were lower than those of the control group [(2.60±0.71) points vs. (3.81±1.06) points, (29.94±3.69) points vs. (40.01±5.41) points], and the Lysholm knee joint score of the observation group was higher than that of the control group [(71.01±7.82) points vs. (60.24±6.31) points], and all the differences were statistically significant (t=6.571, 10.654,and 7.426, all P<0.05). Conclusion　The combination of TENS (Transcutaneous Electrical Nerve Stimulation) and closed-chain functional training is beneficial in alleviating the pain of patients with knee osteoarthritis and promoting the recovery of joint function.

The application value of the joint management model of trauma orthopedics and internal medicine in the perioperative period of elderly patients with hip fractures

Wu Dalong, Zhang Shikui, Yue Long, Li Zhihao, Zhang Shao'an

2025, 31(19):  3309-3314.  DOI: 10.3760/cma.j.cn441417-20250528-19028

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the application value of the co-management model of orthopedics and internal medicine in the perioperative management of elderly patients with hip fractures. Methods　Sixty elderly patients with hip fractures who underwent surgery at the Second Affiliated Hospital of Luohe Medical College from January 2023 to December 2023 were selected.The subjects were randomly divided into the study group and the control group by the random number table method, with 30 cases in each group.Research group: 14 males and 16 females, with an average age of (73.39±5.16) years and a body mass index (BMI) of (25.18±6.16) kg/m².Fracture types: 12 cases of femoral neck fractures, 14 cases of intertrochanteric fractures of the femur, and 4 cases of subtrochanteric fractures of the femur.Adopt a co-management model of trauma orthopedics and internal medicine.Control group: 12 male and 18 females, with an average age of (73.16±5.87) years and a BMI of (26.12±5.44) kg/m².The fracture types included 15 cases of femoral neck fractures, 10 cases of intertrochanteric femoral fractures, and 5 cases of subtrochanteric femoral fractures. Adopt the routine diagnosis and treatment procedures of orthopedics. The time of first getting out of bed after surgery, length of hospital stay, hospitalization cost, time from admission to surgery, health belief in deep vein thrombosis of the lower extremities, degree of swelling of the affected limb, quality of life (SF-36 score) and incidence of postoperative complications were compared between the two groups of patients.Statistical methods included t-test and χ² test. Results　The time to get out of bed for the first postoperative activity and the length of hospital stay in the study group were both shorter than those in the control group [(39.16±7.15)h vs. (59.77±6.87)h, (10.02±1.66)d, vs. (12.11±1.31)d], and the differences were statistically significant (t=11.385 and 5.413; both P<0.05).There was no statistically significant difference in hospitalization expenses and the time from admission to operation between the two groups (all P>0.05).At discharge, the health belief score and SF-36 score of deep vein thrombosis of the lower extremities in the study group were higher than those in the control group, and the degree of swelling of the affected limb at 1 day, 3 days and 7 days after the operation was lower than that in the control group (all P<0.05).The incidence of postoperative complications in the study group was lower than that in the control group [16.67% (5/30) vs. 40.00% (12/30)], and the difference was statistically significant (χ²=4.022, P<0.05). Conclusion　The co-management model of trauma orthopedics and internal medicine can effectively optimize the perioperative management of elderly patients with hip fractures, shorten the recovery time, improve health beliefs and quality of life, and reduce the incidence of postoperative complications. It has high clinical application value.

Nursing Research

Study on the improvement effect of group cognitive behavioral nursing on the mental state in children undergoing chemotherapy for leukemia

Wang Ke, Zhu Lijun, Kang Yingjie

2025, 31(19):  3315-3319.  DOI: 10.3760/cma.j.cn441417-20250307-19029

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the intervention effect of group cognitive behavioral nursing in children undergoing chemotherapy for leukemia. Methods　A total of 86 children undergoing chemotherapy for leukemia in Zhumadian Central Hospital from August 2022 to August 2024 were selected for a prospective study. They were divided into a control group (43 cases) and an observation group (43 cases) by the random number table method. In the control group, there were 23 boys and 20 girls; the age ranged from 7 to 14 years old [with an average of (10.56±1.13) years old]; the disease duration was from 1 to 3 years [with an average of (2.19±0.33) years]. In the observation group, there were 22 boys and 21 girls; the age ranged from 7 to 14 years old [with an average of (10.59±1.14) years old]; the disease duration was from 1 to 3 years [with an average of (2.16±0.35) years]. The control group received routine nursing, while the observation group received group cognitive behavioral nursing. Both groups received continuous nursing for 6 weeks. The mental state, coping style, quality of life, and family satisfaction were compared between the two groups. Statistical analysis was conducted using the t test and χ² test. Results　After nursing, the scores of separation anxiety, generalized anxiety, social phobia, school phobia, and somatization/panic of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in the observation group were (5.54±1.01) points, (7.37±1.04) points, (4.39±1.05) points, (2.18±0.34) points, and (11.87±1.26) points, which were all lower than those in the control group [(8.76±1.07) points, (10.19±1.12) points, (6.08±1.10) points, (4.27±0.50) points, and (15.35±1.64) points] (t=14.350, 12.099, 7.288, 22.666, and 11.034, all P<0.001). After nursing, the score of facing situations of the Medical Coping Modes Questionnaire (MCMQ) in the observation group was (17.96±1.94) points, which was higher than that in the control group [(14.79±1.78) points]; the scores of avoidance and submission in the observation group were (10.01±1.05) points and (8.71±1.04) points, which were lower than those in the control group [(12.39±1.08) points and (11.53±1.07) points] (t=7.895 10.361, and 12.393, all P<0.001). After nursing, the scores of emotional function, social function, role function, and physical function of the Pediatric Quality of Life Inventory Version 4.0 (PedsQL4.0) in the observation group were (79.19±4.16) points, (82.29±4.70) points, (84.49±5.31) points, and (85.15±4.53) points, which were all higher than those in the control group [(72.28±4.04) points, (75.53±4.61) points, (76.06±5.23) points, and (77.19±4.26) points] (t=7.814, 6.733, 7.417, and 8.394, all P<0.001). The satisfaction rate of family members towards the nursing services in the observation group was 95.35% (41/43), which was higher than that in the control group [81.40% (35/43)] (χ²=4.074, P=0.044). Conclusion　Group cognitive behavioral nursing can alleviate the negative psychological state in children undergoing chemotherapy for leukemia, improve their coping style, improve their quality of life, and enhance the satisfaction of family members with nursing services.

Study on the application of focused solution mode combined with incentive psychological intervention in patients with aortic dissection after operation

Zou Xiangyun, Zhang Chao

2025, 31(19):  3320-3324.  DOI: 10.3760/cma.j.cn441417-20250402-19030

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the application effect of focused solution mode combined with incentive psychological intervention on postoperative patients with aortic dissection ( AD ). Methods　Adopt a prospective research method.A total of 89 AD patients admitted to the Second Affiliated Hospital of Nanchang University from February 2022 to January 2024 were selected and divided into the control group (45 cases) and the intervention group (44 cases) according to the random number table method.Control group: 27 males and 18 females, with an average age of (42.68±2.30) years. They received routine intervention.Intervention group: 28 males and 16 females, with an average age of (42.81±2.44) years. They received the combined intervention of focused problem-solving model and motivational psychological therapy.Both groups were intervened for one month.Compare the psychological states, psychological resilience and coping styles of the two groups before and after the intervention.Statistical methods employed t-test and χ² test. Results　After the intervention, the scores of the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS) in the intervention group were lower than those in the control group [(44.54±3.21) points vs. (47.54±3.66) points, (45.25±3.64) points vs. (49.58±3.71) points], and the score of psychological resilience was higher than that in the control group [(84.54±5.66) points vs. (78.96±5.17) points], and the differences were all statistically significant (t=4.108, 5.557,and 4.853, all P<0.05).The scores of avoidance and submission in the MCMQ of the intervention group were lower than those of the control group [(10.25±1.42) points vs. (14.50±1.85) points, (8.54±1.16) points vs. (11.58±1.32) points], while the score of confrontation was higher than that of the control group [(25.65±3.50) points vs. (19.58±3.14) points], and the differences were all statistically significant (t=12.138, 11.531,and 8.616, all P<0.05). Conclusion　For patients with AD, adopting the focused problem-solving model combined with the motivational psychological intervention can improve their postoperative psychological state, enhance psychological resilience, and regulate coping styles.

Effect of rehabilitation nursing based on myofascial chain theory on pain and functional rehabilitation of patients with cervical spondylosis

Wu Linlin, Shang Kaibei, Niu Qingsong, Jia Xueqin, Kong Deyu

2025, 31(19):  3324-3329.  DOI: 10.3760/cma.j.cn441417-20250301-19031

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the application effect of rehabilitation nursing based on myofascial chain theory in patients with cervical spondylosis. Methods　A prospective study was conducted, enrolling 72 patients with cervical spondylosis who were treated at the Dushan Campus of Nanyang Traditional Chinese Medicine Hospital from July 2023 to July 2024. They were randomly divided into two groups using a random number table, with 36 cases in each group.Control group: 20 males and 16 females, disease duration 1 to 5 (2.28±0.40) years, age 18 to 64 (40.34±8.75) years;Apply acupoint massage with medication sticks combined with instrument-assisted soft tissue release technique (IASTM).Observation group: 19 males and 17 females, with a disease duration ranging from 1 to 5 years (2.34±0.38) years, and an age range of 20 to 65 years (40.50±8.69) years.Based on the myofascial chain theory, the method of using a drug rod for acupoint massage combined with IASTM is applied.Both groups were subjected to continuous intervention for 2 weeks.The pain severity, cervical function and cervical range of motion of the two groups were evaluated.The statistical method employed was the t-test. Results　After the intervention, the pain grading index (PRI), current pain intensity (PPI), and visual analogue scale score (VAS) of the observation group were all lower than those of the control group [(7.85±1.37) points vs. (10.01±1.70) points, (1.16±0.22) points vs. (1.55±0.31) points, (1.57±0.32) points vs. (2.70±0.54) points], and the differences were statistically significant (t=5.936, 6.156 and 10.801, all P<0.05).After the intervention, the NDI scores of the observation group were lower than those of the control group, and the cervical spine mobility and SF-36 scores were higher than those of the control group. The differences were statistically significant (all P<0.05). Conclusion　Rehabilitation nursing based on the myofascial chain theory can alleviate the pain of patients with cervical spondylosis, promote the recovery of cervical function, and enhance the quality of life. It has high clinical application value and is worthy of further promotion in clinical practice.

Application of personalized nursing for pediatric autoimmune diseases based on the concept of precision medicine

Qiu Yujing, Cao Ruiming, Yang Bo, Wang Yanli

2025, 31(19):  3330-3333.  DOI: 10.3760/cma.j.cn441417-20241111-19032

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the application effect of personalized care plans for children's autoimmune diseases (AD) based on the concept of precision medicine. Methods　From March 2022 to March 2024, 120 children with AD who visited Henan Provincial People's Hospital were selected for a randomized controlled trial. They were divided into the study group and the control group using a random number table, with 60 cases in each group.In the control group, there were 31 males and 29 females, with an average age of (9.04±1.39) years. They received routine care.The research group consisted of 35 males and 25 females, with an average age of (9.36±1.87) years. On the basis of the control group, personalized care based on the concept of precision medicine was implemented.Both groups received 1 month of nursing care and were followed up for 6 months.Compare the levels of medical fear, treatment compliance, self-management ability, as well as the satisfaction of family members with the care provided and the recurrence frequency after discharge of the two groups of children before and after the nursing process.Statistical methods employed t-test and χ² test. Results　After the nursing intervention, the medical fear score of the children in the study group was lower than that of the control group [(4.67±0.81) points vs. (5.99±0.95) points], and the difference was statistically significant (t=8.190, P<0.05).The scores of treatment compliance, self-management ability, and family satisfaction with care of the children in the study group were significantly higher than those in the control group [(90.85±7.02) points vs. (87.59±5.92) points, (78.85±4.05) points vs. (76.74±4.16) points, 91.67%(55/60) vs. 71.67%(43/60)], and the differences were statistically significant (t=2.75 and 2.815, χ²=8.015, all P<0.05).The recurrence frequency of the study group's children within 3 months and 6 months after discharge was lower than that of the control group [(4.00±0.67) times vs. (4.59±1.40) times, (2.86 0.56) times vs. (3.25±0.63) times], and the differences were statistically significant (t=2.945 and 3.584; both P<0.05). Conclusion　The personalized care plan based on the concept of precision medicine can reduce the medical fear and recurrence frequency of children with AD, improve treatment compliance and self-management ability, and result in higher satisfaction among family members. It has clinical promotion value.

A qualitative study on the impact of patient expert program intervention on self-efficacy and quality of life in patients with pulmonary hypertension

Xu Yanni, Pan Yanfen, Cheng Xiaoling, Guo Jinling, Zeng Qiuxuan

2025, 31(19):  3334-3339.  DOI: 10.3760/cma.j.cn441417-20250211-19033

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the actual nursing experience of patients with pulmonary hypertension who participated in the patient-expert project intervention, and to provide innovative nursing methods for nursing staff. Methods　Thirty patients with pulmonary hypertension who received the patient expert program intervention at the First Affiliated Hospital of Guangzhou Medical University from December 2020 to March 2022 were interviewed using a semi-structured approach.Through the qualitative research phenomenological analysis method, the data were sorted and analyzed, and three themes and 14 sub-themes were extracted: negative physical and psychological discomfort of patients with pulmonary arterial hypertension, lack of disease-related knowledge, and the patient expert project enhancing self-efficacy and quality of life. Results　The themes that the respondents mentioned regarding negative physical and psychological discomfort were: limited mobility, other physical discomfort, psychological stress caused by burdening the family, and passive reduction in social interaction.The topics lacking in knowledge related to the disease are: the causes of pulmonary arterial hypertension, the latest treatment progress, home care guidance such as daily diet and health care, issues related to pregnancy for female patients, and methods for maintaining emotional stability, etc.The theme of the "Patient Expert Project" on enhancing self-efficacy and quality of life are: willingness to participate in the program, convenient communication, time-saving, strong professionalism, enhancing self-efficacy, and effectively improving quality of life. Conclusion　The intervention of the patient expert program has a positive effect on the self-efficacy and quality of life of patients with pulmonary hypertension.By implementing the patient expert project intervention and formulating a nursing plan for patients with pulmonary hypertension, the medical quality of pulmonary hypertension treatment can be effectively improved.

Medical Education

Application of the "internet+" combined with PBL/CBL teaching mode in teaching innovation of biochemistry

Zhong Liangying, Feng Pinning, Yao Shaoyu, Dong Lejian

2025, 31(19):  3340-3344.  DOI: 10.3760/cma.j.cn441417-20250408-19034

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effect for applying the "internet+" combined with problem-based learning (PBL)/case-based learning (CBL) teaching mode in the teaching innovation of clinical biochemistry. Methods　Forty-eight senior students who practiced in the laboratory medicine, The first affiliated Hospital of Sun Yat-sen University from June 2022 to June 2023 were selected as the research objects. They were divided into a control group and an experimental group by the random number table method, with 24 cases in each group. There were 7 males and 17 females in the control group who were (20.60±2.60) years old. There were 6 males and 18 females in the experimental group who were (20.50±2.80) years old. Both group were taught by the same teacher. The control group used the CBL and traditional teaching methods. The experimental group used the "technology media type" +PBL/CBL teaching method, such as WeChat, Massive Open Online Courses, etc. The teaching effects were compared between the two groups. The enumeration data were compared by the χ² test, and the measurement data by the t test. When P<0.05, there is a statistical difference. Results　The score of theoretical examination in the experimental group was lower than that in the control group (44.02±1.04 vs. 43.26±0.98), with a statistical difference (P<0.05). The scores of skill operation and case analysis questions in the experimental group were higher than those in the control group (44.54±2.75 vs. 34.26±2.42 and 87.80±2.25 vs. 78.28±3.03), with statistical differences (both P<0.05). The scores of summary ability, literature retrieval ability, improving the ability to combine theory with practice, and effectively using various teaching media in the experimental group were higher than those in the control group, with statistical differences (all P<0.05). Conclusion　Application of the "internet+" combined with PBL/CBL teaching mode in teaching innovation of biochemistry is of high value.