Table of Content

01 November 2025, Volume 31 Issue 21

Previous Issue   

Special Topic on Prostate

Research progress of RNA editing enzyme ADAR1 in tumor immunity of prostate cancer

Li Xiezhao, Cai Zhiduan, Yuan Yaoji, Zhu Rui, Zhou Zewen, Xu Guibin, Zhao Haibo

2025, 31(21):  3522-3525.  DOI: 10.3760/cma.j.cn441417-20250318-21001

Asbtract ( )  

References | Related Articles | Metrics

Adenosine deaminase acting on RNA 1 (ADAR1) has attracted much attention in the field of cancer, including prostate cancer. As the first identified A-to-I RNA editing enzyme (converting adenosine to inosine), ADAR1 is increasingly being studied in the context of tumor immune evasion. Therefore, this article reviews the mechanisms of action of ADAR1 and its role in tumor immunity in prostate cancer, providing a valuable summary for exploring ADAR1 as a potential therapeutic target in the diagnosis and treatment of prostate cancer.

The application value of radiomics in the diagnosis of prostate PI-RADS category 3 lesions

Fang Fen, Wu Yi, Fang Yu, Lin Daiying

2025, 31(21):  3525-3530.  DOI: 10.3760/cma.j.cn441417-20250512-21002

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the application value of radiomics in the differential diagnosis of benign and malignant lesions classified as PI-RADS 3 in prostate imaging reports, providing an objective basis for clinical decision-making. Methods　A retrospective study included 96 patients who underwent prostate biopsy or surgery at Shantou Central Hospital from January 2018 to December 2024, all with preoperative magnetic resonance imaging (MRI) reports classified as PI-RADS 3 and confirmed by pathology, with an average age of (70.60±7.41) years. All patients underwent multiparametric MRI. Using 3D-Slicer software, regions of interest (ROIs) of the lesions were manually delineated on axial T2-weighted images (T2WI), and 1 127 radiomic features were extracted using open-source software FAE. In the training group (67 cases), recursive feature elimination (RFE) was employed to select key features, and a radiomic score (Radscore) model was constructed based on the coefficients of these features. The model's performance was evaluated in the validation group (29 cases) and compared with traditional indicators such as prostate-specific antigen (PSA) and apparent diffusion coefficient (ADC). Independent samples t tests, Mann-Whitney U tests, and χ² tests were used for intergroup comparisons, logistic regression analysis was conducted to build the model, and receiver operating characteristic (ROC) curves were plotted to assess diagnostic performance. Results　Six key features were selected from the 1 127 features to construct the Radscore model. In the training group, the area under the curve (AUC) of the Radscore model for distinguishing benign from malignant lesions was 0.974 [95% confidence interval (CI) 0.942-1.000], with a sensitivity of 92.9% and specificity of 100.0%. In the validation group, the AUC was 0.933 (95% CI 0.813-1.000), with a sensitivity of 95.8% and specificity of 80.0%. The diagnostic performance (AUC) of the Radscore model was significantly higher than that of the PSA and ADC value models in both the training and validation groups. Multivariable logistic regression analysis indicated that Radscore was an independent factor for predicting prostate cancer (OR=1.80, P=0.003). Conclusion　The T2WI-based radiomics model significantly improves diagnostic accuracy for PI-RADS 3 lesions by quantifying tumor heterogeneity, surpassing traditional indicators (PSA/ADC). This model provides an objective basis for clinical decision-making, helping to optimize biopsy strategies and reduce unnecessary invasive procedures.

Research progress of imaging omics based on deep learning in the precise diagnosis and treatment of prostate cancer

Qin Jing, Wang Aijie, Zhang Yafei, Huang Ranran, Wang Longjiang, Li Zhongwei, Zhang Guowei

2025, 31(21):  3531-3535.  DOI: 10.3760/cma.j.cn441417-20250414-21003

Asbtract ( )  

References | Related Articles | Metrics

Prostate cancer (PCa) is one of the most common malignant tumors in men, and the precise diagnosis and treatment of PCa urgently need to address the challenges of tumor heterogeneity and prognostic variability. Radiomics, by extracting high-throughput features from medical imaging and integrating artificial intelligence technologies, provides new tools for lesion detection, Gleason score prediction, and treatment response monitoring. This article systematically reviews the latest advancements in the technical processes, diagnostic efficacy, prognostic assessment, and treatment monitoring of radiomics in PCa. It highlights breakthrough achievements in non-invasive grading, metastatic risk prediction, and personalized radiotherapy planning, with a focus on integrating multimodal imaging technologies and deep learning methods. Addressing current technical limitations, it proposes future development directions, including the establishment of multicenter collaborative databases, multimodal omics, integrative omics, and the development of standardized validation models. Through a balanced approach of technological innovation and clinical practice, radiomics is expected to drive the transition of PCa diagnosis and treatment towards a paradigm of dynamic precision medicine, ultimately enhancing patient survival benefits.

New Medical Advances

Progress in minimally invasive treatment of cervical spondylotic radiculopathy

Xu Zengmao, Feng Bo, Zhang Jijiang, Hu Peng, Dai Guohua

2025, 31(21):  3536-3540.  DOI: 10.3760/cma.j.cn441417-20250619-21004

Asbtract ( )  

References | Related Articles | Metrics

This article reviews the application and progress of minimally invasive techniques in the treatment of cervical spondylotic radiculopathy. Through a systematic review of relevant literature, it compares and analyzes the processes, operations, advantages, and disadvantages of various minimally invasive techniques, including unilateral dual-channel endoscopy, foraminoscopy, microendoscopy, radiofrequency, and collagenase. Currently, conservative treatment remains the primary approach for clinical management of cervical spondylotic radiculopathy; however, minimally invasive surgery has become an important option due to its advantages. Among these, the Key-hole technique performed under unilateral dual-channel endoscopy shows promising clinical prospects due to its gentle learning curve, short operative time, lower costs, and the ability to utilize existing instruments.

Current status and progress in diagnosis and treatment of ureteral stent knotting

Chen Yang, Chen Yide, Pan Bin

2025, 31(21):  3540-3544.  DOI: 10.3760/cma.j.cn441417-20250527-21005

Asbtract ( )  

References | Related Articles | Metrics

Ureteral stents are widely used in upper urinary tract surgeries in urology. Ureteral stent knotting is a rare complication. At present, some foreign literatures have reported cases and treatment methods of ureteral stent knotting. This article summarizes the relevant literature. To provide evidence-based treatment strategies for similar complications that occur in clinical practice.

Basic Research

Study on the inhibitory effect of ethanol extract of Livistona chinensis on the proliferation of Huh-7 cells by regulating glycolysis related genes and proteins

Li Yuexuan, Zhang Xiaoyuan, Chen Shuyou, Sun Ruihan, Chen Xuzheng, Lin Wei

2025, 31(21):  3545-3550.  DOI: 10.3760/cma.j.cn441417-20250430-21006

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate whether the inhibitory effect of ethanol extracts from Livistona chinensis seeds (EELC) on the proliferation of Huh-7 hepatocellular carcinoma cells is related to its regulation of the glycolytic process. Methods　This experiment was conducted from January 2022 to December 2023 at the Key Laboratory of Geriatric Diseases of Integrated Traditional Chinese and Western Medicine, Fujian Province. The MTT assay was used to evaluate the effects of different concentrations of EELC on Huh-7 cell viability after 24 hours of treatment. The Seahorse XFe 96 Analyzer was employed for real-time dynamic monitoring of mitochondrial ATP production rates and glycolytic ATP production rates, while simultaneously measuring instantaneous changes in oxygen consumption rate, extracellular acidification rate, and proton efflux rate. Real-time PCR and Western blotting were utilized to detect the mRNA and protein expression levels of hypoxia-inducible factor 1-alpha (HIF-1α), hexokinase (HK), and glucose transporters (Glut1, Glut3). One-way analysis of variance was used for comparison among multiple groups, and one-way repeated measurement analysis of variance was used for repeated measurement data. Results　EELC exerted a concentration-dependent inhibitory effect on Huh-7 cell proliferation. Cell energy metabolism analysis showed that EELC could increase mitochondrial ATP production rate and reduce glycolysis ATP production rate. The real-time oxygen consumption rate of the EELC treatment group was significantly increased, and the extracellular acidification rate and proton outflow rate were significantly decreased (all P<0.0001). Molecular level assessments indicated that EELC downregulated the mRNA and protein expression of HIF-1α and reduced Glut1 protein expression (all P<0.01). Conclusions　EELC effectively inhibits the proliferation and growth of Huh-7 cells by regulating cellular energy metabolism, downregulating HIF-1α mRNA levels, and reducing the expression of glycolysis-related proteins HIF-1α and Glut1. This results in decreased glycolytic capacity and enhanced mitochondrial function to improve cellular aerobic respiration.

Study on the protective effect of calycosin on nerve injury and cognitive dysfunction induced by propofol in rats by regulating the Nrf2/HO-1 pathway

Huo Yan, Chen Xi, Li Ge, Zhao Pin, Liu Chen, Bai Jie

2025, 31(21):  3551-3557.  DOI: 10.3760/cma.j.cn441417-20250123-21007

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effects and mechanisms of calycosin on nerve injury and cognitive dysfunction induced by propofol in rats. Methods　This research was conducted from June 2023 to January 2024 at the Animal Laboratory of Shaanxi Provincial Hospital of Traditional Chinese Medicine. Fifty male SD rats were randomly divided into 5 groups: a control group, a propofol group, a low-dose calycosin group, a high-dose calycosin group, and a ML385 group. The last 4 groups were intraperitoneally injected with 100 mg/kg of propofol, while the control group was injected with the same amount of normal saline. The low and high dose groups of calycosin were orally administered 50 mg/kg and 100 mg/kg of calycosin respectively after intraperitoneal injection of propofol, once a day for 7 days. The ML385 group was intraperitoneally injected with 30 mg/kg of nuclear factor-E2 related factor-2 (Nrf2) inhibitor ML385 30 minutes after oral administration of 100 mg/kg of calycosin. The learning and memory abilities of the rats were evaluated through the Morris water maze test. After the behavioral experiments, the rats in each group were sacrificed, and the bilateral hippocampal tissues were isolated and the hippocampal neuron cells were extracted. The apoptosis rate was detected by flow cytometry; the expression levels of cysteinyl aspartate specific proteinase (caspase-3), B-cell lymphoma-2 (Bcl-2), Bcl-2-related X protein (Bax), and Nrf2/heme oxygenase 1 (HO-1) pathway-related proteins in hippocampal neurons were detected by Western blot; the levels of inflammatory factors [interleukin (IL)-6 and IL-1β] and antioxidant indicators [superoxide dismutase (SOD) and catalase (CAT)] in the rat hippocampal neurons were detected by enzyme-linked immunosorbent assay (ELISA). Statistical analysis was conducted using one-way analysis of variance and the LSD method. Results　The results of the Morris water maze experiment showed that calycosin could alleviate the nerve injury and cognitive dysfunction induced by propofol in rats (all P<0.05). Calycosin could inhibit the expressions of the neuroapoptotic proteins caspase-3 and Bax induced by propofol in rats, and increase the expression of Bcl-2 protein in a dose-dependent manner (all P<0.05). Calycosin could inhibit the levels of IL-6 and IL-1β in rat hippocampal neurons induced by propofol, and increase the levels of antioxidant enzymes (SOD and CAT) (all P<0.05). Calycosin could enhance the protein expressions of Nrf2 and HO-1 in rat hippocampal neurons induced by propofol, and activate the Nrf2/HO-1 signaling pathway (all P<0.05). The ML385 treatment could reverse the inhibitory effects of high-dose calycosin on neuron cell apoptosis and inflammatory responses, and it could also inhibit the expressions of Nrf2 and HO-1 proteins (all P<0.05). Conclusion　Calycosin can improve propofol-induced nerve injury and cognitive dysfunction in rats by activating the Nrf2/HO-1 pathway in hippocampal neurons.

Study on the protective effect of Coptis chinensis extract on colonic ulcerative mucosal injury in rats by regulating JAK2/STAT3 signaling pathway

Gan Huiping, Wu Chengcheng, Gao Lei

2025, 31(21):  3557-3557.  DOI: 10.3760/cma.j.cn441417-20241120-21008

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the effects of Coptis chinensis extract  (CE) on colonic ulcerative mucosal injury in rats and explore the underlying mechanisms. Methods　The formal experiment was conducted on March 5, 2024, in the animal laboratory of the Jiangxi University of Traditional Chinese Medicine. 70 rats were divided into blank group, UC model group, CE (low, medium, and high) dose group (given 0.4, 0.6, and 0.8 g/kg CE by gavage), mesalazine group (given 0.36 g/kg mesalazine by gavage), and CE+JAK2 activator group (given 0.8 g/kg CE+1 mg/kg coumermycin A1 by gavage), with 10 rats in each group. A 3% dextran sulfate sodium (DSS) solution was provided for free drinking for 7 days to construct the UC rat model. All rats were given intragastric administration once a day for 7 days. During the experiment, the health status of the rats was observed, and the disease activity index (DAI) score was calculated; the length of the colon tissue was measured; HE staining was used to observe pathological changes in the colon tissue; RT-qPCR was employed to detect the expression of pro-inflammatory cytokines interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α) mRNA in the colon; ELISA was used to measure the levels of inflammatory factors in the colon tissue; and Western blot analysis was performed to detect the expression of proteins related to the JAK2/STAT3 signaling pathway [Janus kinase 2 (JAK2), pJAK2, signal transducer and activator of transcription 3 (STAT3), and p-STAT3]. Statistical analysis was conducted using t test and F test. Result　Compared to the blank group, the model group exhibited significant pathological damage in the colon tissue, poor mental state, and a marked reduction in colon length (P<0.05). Body weight and levels of IL-4 and IL-10 decreased significantly (all P<0.05), while the disease activity index (DAI) score, histopathological score, and expression of IL-1β, IL-6, and TNF-α mRNA in the colon, along with the expression of proteins related to the JAK2/STAT3 signaling pathway, increased significantly (all P<0.05).In comparison to the model group, the CE gradient dose groups and the mesalazine group showed improvements in mental state and pathological damage in the colon tissue. Body weight and levels of IL-4 and IL-10 in the colon tissue significantly increased (all P<0.05), while DAI scores, histopathological scores, levels of IL-1β, IL-6, TNF-α, and the expression of JAK2, phosphorylated JAK2 (p-JAK2), STAT3, and phosphorylated STAT3 (p-STAT3) proteins decreased significantly (all P<0.05). The colon length also increased significantly (P<0.05) and was positively correlated with the dosage. Furthermore, the JAK2 activator was found to activate the JAK2/STAT3 signaling pathway, diminishing the therapeutic effect of CE on intestinal mucosal injury in the UC rats. Conclusion　CE can improve intestinal damage to ulcerative colitis in rats, and its mechanism of action may be to inhibit the activation of JAK2/STAT3 signaling pathway, reduce the release of pro-inflammatory factors, and enhance the barrier function of colon mucosa.

Treatises

Application effect of 3D printing technology in assisting intubation for patients with difficult airway

Lu Huamei, Yu Guojun, Guo Yongjuan, Yang Fulin, Zhao Liyan

2025, 31(21):  3565-3569.  DOI: 10.3760/cma.j.cn441417-20250619-21009

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the application effect of 3D printing technology in assisting intubation for patients with difficult airway. Methods　Sixty patients who required orthopedic surgery under general anesthesia and had difficult airway at Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital) from January 2020 to June 2023 were selected, and were divided into a 3D group (30 cases) and a control group (30 cases) according to the random number table method. In the 3D group, there were 27 males and 3 females, with an age of (36.28±10.42) years old and a body mass index of (22.90±1.27) kg/m², and the American Society of Anesthesiologists (ASA) classification was grade II in 18 cases and grade III in 12 cases. In the control group, there were 26 males and 4 females, with an age of (35.89±11.06) years old and a body mass index of (22.84±1.52) kg/m², and the ASA classification was grade II in 15 cases and grade III in 15 cases. The 3D group used 3D printing technology to create a model of difficult airway before surgery and simulated tracheal intubation on the model; the control group used a video laryngoscope or bronchoscope for tracheal intubation based on the assessment results of common surface difficult airway indicators. The intubation time and the number of successful first intubation cases were recorded, and the hemodynamic indexes, stress responses, and intubation-related complications during intubation were evaluated. Statistical analysis was conducted using t test, non-parametric test, and χ² test. Results　Both groups had successful extubation after surgery. The intubation time, the number of times of intubations, and the proportions of changing intubation tools and post-extubation pharyngeal discomfort in the 3D group were all lower than those in the control group, with statistically significant differences (all P<0.05). Compared with those before induction, both groups showed a decrease in the systolic blood pressure (SBP) and diastolic blood pressure (DBP) after induction, with statistically significant differences (all P<0.05); compared with those after induction, the SBP and DBP of both groups increased 5 minutes and 30 minutes after intubation, with statistically significant differences (all P<0.05). Compared with those before induction, the blood glucose and cortisol levels in both groups increased 5 minutes after intubation, with statistically significant differences (all P<0.05); the blood glucose and cortisol levels in the 3D group were lower than those in the control group 5 minutes after intubation, with statistically significant differences (both P<0.05). During the intubation process of both groups, no tooth damage occurred, but a small amount of blood was found on the laryngoscope blades of a few patients. The incidences of hypoxia during intubation, postoperative 24-hour sore throat, and transient hoarseness in the 3D group were lower than those in the control group [3.33% (1/30) vs. 20.00% (6/30), 13.33% (4/30) vs. 40.00% (12/30), 3.33% (1/30) vs. 20.00% (6/30)], with statistically significant differences (all P<0.05). Conclusion　The application of 3D printing technology in difficult airway can shorten the intubation time, improve the success rate, and reduce the intubation injury.

Accuracy verification and clinical adaptability research of 3D printed dentures

Ma Hongbin, Zhang Wenyi, Jin Yanjiao, Wu Wei

2025, 31(21):  3570-3575.  DOI: 10.3760/cma.j.cn441417-20250626-21010

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the clinical adaptability and accuracy of 3D-printed denture frameworks and validate the application value of 3D printing technology in oral rehabilitation. Methods　A prospective randomized controlled design was adopted. A total of 114 patients with complete dentition loss at Tianjin Medical University General Hospital from January 2022 to June 2024 were included, and were randomly divided into an observation group and a control group, with 57 cases in each group. In the observation group, there were 28 males and 29 females, with an age of (58.21±7.62) years old and a number of missing teeth of (4.30±1.17); in the control group, there were 29 males and 28 females, with an age of (57.84±8.08) years old and a number of missing teeth of (4.21±1.09). The observation group used 3D printing technology [digital design + selective laser melting (SLM) printing] to manufacture the dentures, while the control group used the traditional casting process. The edge fit, abutment contact, occlusal relationship, wearing stability, and patients' satisfaction of the two groups were evaluated. Statistical analysis was conducted using the independent sample t test and χ² test; multivariate logistic regression analysis was used to analyze the influencing factors of patients' satisfaction one month after surgery; the mediating effect of framework fit between the production method and satisfaction was tested by the Bootstrap method (5 000 sampling); a linear mixed-effect model was used to analyze the repeated measurement data. Results　One month after surgery, the good rate of edge fit in the observation group was higher than that in the control group [87.72% (50/57) vs. 71.93% (41/57)], the excellent rate of abutment tooth contact was higher than that in the control group [78.95% (45/57) vs. 61.40% (35/57)], the rate of good occlusion [85.96% (49/57)] and the rate of reaching stability standards [84.21% (48/57)] were both higher than those in the control group [70.18% (40/57) and 68.42% (39/57)], and the patients' satisfaction was also higher than that in the control group (all P<0.05). Three months after surgery, the indicators of the observation group were still superior to those of the control group (all P<0.05), but the differences narrowed at 6 months (all P>0.05). Logistic regression analysis revealed that the 3D printing process was the key factor in enhancing the patients' satisfaction (OR=3.467, P=0.004). The framework fit served as a complete mediator between the 3D printing process and satisfaction (P<0.05). Conclusion　3D-printed denture frameworks exhibit significantly better early clinical adaptability and accuracy than traditional casting, achieve through digital closed-loop control and biomechanical optimization, thereby providing a basis for the transition of oral restoration toward data-driven approaches.

Clinical analysis of glomerular disease children with Pneumocystis pneumonia

Li Zhijuan, Bao Ying, Zhang Min, Wang Ying, Suo Lei, Liang Nan

2025, 31(21):  3576-3580.  DOI: 10.3760/cma.j.cn441417-20250619-21011

Asbtract ( )  

References | Related Articles | Metrics

Objective　To understand the clinical characteristics and prognosis of glomerular disease children with Pneumocystis pneumonia (PCP). Method　A retrospective analysis was conducted on the clinical features, laboratory examinations, treatment, and prognosis of 12 children diagnosed with glomerular disease complicated with PCP in Xi'an Children's Hospital from June 2019 to August 2024. Results　Among the 12 children, there were 7 boys and 5 girls, with an age of (10.19±3.29) years old. The basic diseases were mainly lupus nephritis and IgA nephropathy. Shortness of breath was common in the clinical manifestations, but the pulmonary signs were not obvious. Only 3 cases had moist rales heard in both lungs. The lymphocyte count and CD4+ lymphocyte count in the blood of 12 children were both decreased to varying degrees. Among them, the CD4+ lymphocyte count of 10 children was less than 200/ul. The lactate dehydrogenase (LDH) levels of all cases were increased to varying degrees, with a median value of 586.5 (422.0, 1 084.5) U/L. The 1-3β-glucan level of 12 children was (165.27±103.26) ng/L, and 9 of them showed an increase. The other common specific pathogen was cytomegalovirus (5 cases, accounting for 41.67%). All 12 children were treated with sulfamethoxazole-trimethoprim, and 5 of them were also given micafungin. The mortality rate was 33.33% (4/12). Conclusions　For children with glomerulonephritis, if they have fever, cough, and shortness of breath but no obvious lung signs, especially if their CD4+ lymphocyte count is decreased, it is necessary to be vigilant of concurrent PCP. Early diagnosis and treatment should be carried out to reduce the mortality rate.

Genotypic and clinical phenotypic analysis of hypophosphatasia-induced epilepsy in children and literature review

He Yunyuan, Xie Bing, Zhang Junli, Cai Shufang

2025, 31(21):  3581-3586.  DOI: 10.3760/cma.j.cn441417-20250713-21012

Asbtract ( )  

References | Related Articles | Metrics

The boy, whose age of onset was 3 years and 9 months old, presented with recurrent seizures as the primary clinical manifestation, along with decreased blood alkaline phosphatase (ALP). Brain MRI revealed no structural abnormalities or calcifications. The electroencephalogram (EEG) showed normal background activity with slow wave bursts in the anterior head region, predominantly in the bilateral frontal areas during wakefulness and persisting into the sleep period, accompanied by electrical persistence during sleep. Second-generation sequencing identified a heterozygous mutation in the alkaline phosphatase liver/bone/kidney (ALPL) gene at the c.100C>T site, resulting in premature protein translation termination and following an autosomal dominant inheritance pattern. The boy was diagnosed with childhood hypophosphatasia (HPP) related to the ALPL gene mutation and was treated with a combination of vitamin B6 and levetiracetam, resulting in manageable clinical seizures but persistent abnormal EEG discharges. Long-term regular follow-up was currently ongoing. A literature search using keywords "ALPL gene" "hypophosphatasia" "epilepsy" was conducted in the CNKI, Wanfang Database Knowledge Service Platform, and China Medical Journal Full-text Database from January 2015 to March 2025 to summarize the genotypic characteristics of HPP in Chinese pediatric patients.

Clinical observation of phlegm-heat-clearing capsules in the adjuvant treatment of influenza with heat-toxin attacking lung syndrome

Chen Shuowen, Xie Linna, Li Jiayao, Cheng Yaokang, Li Qiao

2025, 31(21):  3587-3591.  DOI: 10.3760/cma.j.cn441417-20250731-21013

Asbtract ( )  

References | Related Articles | Metrics

Objective　To observe the clinical efficacy of phlegm-heat-clearing capsules in the adjuvant treatment of influenza with heat-toxin attacking lung syndrome. Methods　From September 2023 to September 2024, 72 patients with influenza of heat-toxin attacking lung syndrome in the Department of Respiratory and Critical Care Medicine, Jieshou Hospital of Traditional Chinese Medicine were selected, and were divided into a control group (36 cases) and an experimental group (36 cases) using the random number table method. In the experimental group, there were 19 males and 17 females, with a median age of 53.50 (42.50, 58.75) years old; in the control group, there were 20 males and 16 females, with a median age of 50.00 (35.00, 55.75) years old. The control group was given oral oseltamivir phosphate capsules, 75 mg each time, twice a day; the experimental group was additionally treated with phlegm-heat-clearing capsules, 0.8 g each time, three times a day. The treatment course was 5 days, with follow-up until complete recovery. The complete fever reduction time, total score of traditional Chinese medicine symptoms, clinical efficacy, C-reactive protein (CRP) level, abnormal rate of white blood cell count, abnormal rate of neutrophil percentage, and adverse reactions were observed. Statistical analysis was conducted using paired sample t test, independent sample t test, Welch-corrected t test, Mann-Whitney U test, χ² test, corrected χ² test, and Fisher's exact probability method. Results　The complete fever reduction time of the experimental group was (34.06±12.25) hours, which was shorter than that of the control group [(40.72±13.77) hours], with a statistically significant difference (t=-2.170, P=0.033). On the 4th day after treatment, the total score of traditional Chinese medicine symptoms of the experimental group was lower than that of the control group [(3.06±1.84) points vs. (5.75±2.75) points], with a statistically significant difference (t=-4.889, P<0.001); the total recovery rate of the experimental group was higher than that of the control group [80.56% (29/36) vs. 50.00% (18/36)], with a statistically significant difference (χ²=7.414, P=0.006); the CRP level, abnormal rate of white blood cell count, and abnormal rate of neutrophil percentage in the experimental group were all lower than those in the control group [(7.44±2.24) mg/L vs. (10.05±3.16) mg/L, 2.78% (1/36) vs. 22.22% (8/36), 11.11% (4/36) vs. 30.56% (11/36)] (all P<0.05). During the treatment process, one adverse reaction occurred in the experimental group (mild diarrhea), while there were no such cases in the control group. The incidences of adverse reactions in the two groups were compared using the Fisher's exact probability method, and the difference was not statistically significant (P=1.000). Conclusion　The combination of phlegm-heat-clearing capsules and oseltamivir phosphate capsules in the treatment of influenza with heat-toxin attacking lung syndrome outperforms the use of oseltamivir phosphate capsules alone in terms of fever reduction time, symptom relief, and improvement of inflammation.

Study on the prediction scheme for poor prognosis of epithelial ovarian cancer-related immune-related LncRNAs based on TCGA and ImmPort

Yan Xue, Liu Yuanyuan, Zhao Gang

2025, 31(21):  3592-3596.  DOI: 10.3760/cma.j.cn441417-20250324-21014

Asbtract ( )  

References | Related Articles | Metrics

Objective　To construct a prediction scheme for poor prognosis of epithelial ovarian cancer-related immune-related long non-coding ribonucleic acids (LncRNAs) based on the Cancer Genome Atlas (TCGA) database and the Immunology Database and Analysis Portal (ImmPort). Methods　LncRNAs data of epithelial ovarian cancer and adjacent normal tissues, as well as patients' clinical data, were downloaded from the TCGA database; differentially expressed immune-related LncRNAs were screened by combining immune related LncRNA data downloaded from ImmPort (as of May 31, 2024). Immune related LncRNAs independently associated with poor prognosis of epithelial ovarian cancer were screened using univariate and multivariate Cox regression analysis, and a risk scoring model was constructed. The predictive value of the risk scoring model was analyzed using the Kaplan-Meier survival analysis curve and receiver operating characteristic curve (ROC). Results　A total of 208 cases of epithelial ovarian cancer tissues and 104 cases of normal tissues adjacent to the cancer were downloaded from the TCGA database, and 128 differentially expressed immune-related LncRNAs were screened out. Univariate Cox regression analysis identified 11 immune-related LncRNAs that were associated with the prognosis of epithelial ovarian cancer (all P<0.05). Multivariate Cox regression analysis revealed 5 immune-related LncRNAs (MALAT1, LINC00958, AC011445.1, PRKAR1B-AS2, and SNHG17) that independently affected the prognosis of epithelial ovarian cancer (all P<0.05). Based on the results of multivariate Cox regression analysis, an immune-related LncRNA prognostic risk scoring model for epithelial ovarian cancer was constructed: the risk score = 0.592 × MALAT1 + 0.491 × LINC00958 + 0.413 × AC011445.1 + 0.641 × PRKAR1B-AS2 + 0.309 × SNHG17. The Kaplan-Meier survival analysis curve showed that the survival rate of the high-risk group (risk score ≥ median) was lower than that of the low-risk group (risk score < median) (Log-rank test: χ²=13.784, P<0.001). The ROC analysis showed that the area under the curve for predicting poor prognosis at 1 year, 3 years, and 5 years by the risk scoring model was 0.815 (95%CI: 0.754 - 0.867), 0.735 (95%CI: 0.667 - 0.796), and 0.691 (95%CI: 0.621 - 0.755), respectively. Conclusion　A risk scoring model based on above-mentioned 5 immune-related LncRNAs related to the prognosis of epithelial ovarian cancer can predict the prognosis and provide potential immunotherapy targets for epithelial ovarian cancer.

Clinical Research

Evaluation of the effect of distributed intelligent interactive acupoint electrical awakening system on awakening in patients with disorders of consciousness by magnetic resonance spectroscopy

Cao Yanjie, Wan Zhaoxin

2025, 31(21):  3597-3602.  DOI: 10.3760/cma.j.cn441417-20250604-21015

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the magnetic resonance spectroscopy to evaluate the efficacy of the distributed intelligent interactive electro-stimulating awakening system in promoting awakening in patients with consciousness disorders. Methods　A total of 124 patients with consciousness disorders who were admitted to Shaanxi Provincial Hospital of Traditional Chinese Medicine from June 2022 to December 2024 were selected. They were randomly divided into the control group and the study group, with 62 cases in each group. Control group: 35 males and 27 females, with an age of (45.00±21.60) years. The research group consisted of 33 males and 29 females, with an average age of (45.50±20.40) years. The control group received conventional treatment, while the research group received treatment with the distributed intelligent interactive electro-stimulatory arousal system in addition to the treatment received by the control group. Compare the brain metabolic indicators, cerebral blood flow perfusion conditions, latencies of each wave of brainstem auditory evoked potential (BAEP), latency of SEP N20 wave, electroencephalogram (EEG), Glasgow Coma Scale (GCS), Modified International Coma Recovery Scale (CRS-R) score, and clinical efficacy before and after treatment in the two groups. Statistical methods employed t-test and χ² test. Results　The total effective rate of the research group was higher than that of the control group [96.77% (60/62) vs. 88.70% (52/62)], and the difference was statistically significant (χ²= 5.904, P<0.05). After treatment, compared with the control group, the study group showed higher levels of N-acetylaspartate (NAA) / creatinine (Cr), cerebral blood volume (CBV), and cerebral blood flow (CBF), while choline (Cho) / Cr and mean transit time (MTT) were lower. All these differences were statistically significant (all P<0.05). The wave I, wave Ⅲ and wave V of the research group were all lower than those of the control group, and the differences were statistically significant (t= 8.384, 14.990,and 20.540, all P<0.05). After treatment, the N20 wave in the study group was lower than that in the control group [(15.51±0.60) ms vs. (18.43±0.86) ms], and the difference was statistically significant (t= 21.930, P<0.05). The scores of EEG, GCS and CRS-R in the research group were all higher than those in the control group [(1.89±0.58) points vs. (1.37±0.35) points, (12.54±1.86) points vs. (8.46±1.57) points, (9.84±1.75) points vs. (7.49±1.46) points], and the differences were statistically significant (t=6.044, 13.200,and 8.119, all P<0.05). Conclusion　The distributed intelligent interactive electro-stimulating awakening system can improve the brain metabolism, cerebral blood flow perfusion, neuroelectrophysiological functions and clinical scores of patients with consciousness disorders, thereby enhancing the awakening effect of these patients.

The influence of FOLFOX chemotherapy regimen combined with Jianpi Shengbai formula on patients with advanced colorectal cancer of liver depression and spleen deficiency type

Zhang Xilu, Xiao Gang, Wei Hailiang, Si Mingming, Guo Hui, Li Chen

2025, 31(21):  3602-3607.  DOI: 10.3760/cma.j.cn441417-20250610-21016

Asbtract ( )  

References | Related Articles | Metrics

Objective　To study the effect of the chemotherapy regimen of calcium folinate + fluorouracil + oxaliplatin (FOLFOX) combined with Jianpi Shengbai formula on patients with liver depression and spleen deficiency type advanced colorectal cancer (CRC). Methods　A prospective randomized controlled design was adopted. 108 patients with advanced liver depression and spleen deficiency type CRC who were admitted to the Affiliated Hospital of Shaanxi University of Chinese Medicine from February 2022 to February 2025 were selected. They were divided into two groups using the random number table method, with 54 cases in each group. There was no statistically significant difference in general data such as age, gender, and tumor stage between the two groups of patients (all P>0.05). The control group received the FOLFOX chemotherapy regimen, while the combined group was treated with the Jianpi Shengbai formula in addition to the regimen of the control group. Compare the TCM syndrome scores, Karnofsky Performance Status (KPS) score, immune function indicators [total T cell percentage in lymphocytes (CD3⁺), helper/inducer T cell percentage (CD4⁺), suppressor/cytotoxic T cell percentage (CD8⁺), CD4⁺/CD8⁺ ratio], hematological monitoring indicators [white blood cells (WBC), neutrophils (NEU), hemoglobin (Hb), platelets (PLT)], efficacy of solid tumors [disease control rate (DCR)], and the total incidence of adverse reactions between the two groups. The statistical methods employed were t-test, χ² test and rank sum test. Results　After treatment, the total symptom score of the combined group was lower than that of the control group [(11.1±2.3) points vs. (17.9±2.8) points], and the KPS score was higher than that of the control group [(92.6±2.2) points vs. (87.7±2.7) points], and the differences were statistically significant (t=13.790 and 10.339; both P<0.05). The immune function indicators of the combined group (CD3⁺, CD4⁺, CD4⁺/CD8⁺), WBC count, NEU count, Hb, and PLT count were all higher than those of the control group (all P<0.05). The DCR of the combined group was higher than that of the control group [83.33% (45/54) vs. 62.96% (34/54)], and the total incidence of adverse reactions was lower than that of the control group [35.19% (19/54) vs. 61.11% (33/54)], and the differences were statistically significant (χ²=5.704 and 7.269; both P<0.05). Conclusion　The FOLFOX chemotherapy regimen combined with the Jianpi Shengbai formula can increase the DCR of patients with liver depression and spleen deficiency type advanced colorectal cancer. It also has advantages in alleviating bone marrow suppression, enhancing immune function, and improving chemotherapy tolerance. It can be used as an adjuvant treatment for such patients receiving FOLFOX chemotherapy.

The application effect of ultrasound-guided stellate ganglion block combined with auricular acupressure in patients with anxiety and sleep disorders

Chen Ming'an, Li Shuxiao, Zhang Wei, Lei Bao

2025, 31(21):  3608-3612.  DOI: 10.3760/cma.j.cn441417-20250713-21017

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the application effect of ultrasound-guided stellate ganglion block (SGB) combined with auricular acupressure in patients with anxiety and sleep disorders. Methods　A prospective, randomized, controlled trial design was adopted. A total of 74 patients with anxiety and sleep disorders who were admitted to Yan'an Hospital of Traditional Chinese Medicine from January 2023 to October 2023 were selected as the research subjects. They were randomly divided into the control group and the observation group, with 37 cases in each group. Control group: 13 males and 24 females; age range 22 to 73 (49.31±9.32) years; duration of anxiety disorder 3 to 20 (14.35±2.52) months, duration of sleep disorder 1 to 15 (8.93±2.17) months; received conventional treatment. Observation group: 12 males and 25 females; age range 23 to 75 (49.26±9.37) years; duration of anxiety disorder 3 to 21 (14.38±2.59) months, duration of sleep disorder 1 to 14 (8.97±2.15) months; based on the conventional treatment of the control group, ultrasound-guided SGB combined with auricular acupressure was used for treatment. Both groups were treated for 20 consecutive days. The total effective rate, the scores of Athens Insomnia Scale (AIS), Pittsburgh Sleep Quality Index (PSQI), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) after 10 days and 20 days of treatment, as well as the incidence of adverse reactions during the treatment were compared between the two groups. Statistical methods employed were the χ² test and the t test. Results　The total effective rate of treatment in the observation group was higher than that in the control group [91.89% (34/37) vs. 72.97% (27/37)], and the difference was statistically significant (χ²=4.573, P<0.05). After 10 days and 20 days of treatment, the scores of AIS, PSQI, SAS and SDS in the observation group were all lower than those in the control group, and the differences were statistically significant (all P<0.05). The comparison of the incidence rates of adverse reactions between the two groups [10.81% (4/37) vs. 13.51% (5/37)] showed no statistically significant difference (χ²=0.127, P>0.05). Conclusion　Based on conventional treatment, the combined application of ultrasound-guided SGB and auricular acupressure has a significant effect in patients with anxiety and sleep disorders, which can effectively improve sleep quality and alleviate anxiety and depression.

The effect of thymic peptide combined with meropenem on patients with multidrug-resistant Klebsiella pneumoniae infection

Xiao Huifang, Li Mingwei, Yuan Pujun, Feng Yulong, Lyu Xiliang, Wang Xiaobao

2025, 31(21):  3613-3617.  DOI: 10.3760/cma.j.cn441417-20250122-21018

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the effects of thymic peptide combined with meropenem on inflammatory cytokines and lymphocyte subpopulations in patients with multidrug-resistant Klebsiella pneumoniae infection. Methods　A retrospective analysis was conducted on 140 patients with multidrug-resistant Klebsiella pneumoniae infection who visited Henan Provincial Workers' Hospital from January 2023 to December 2024. Patients were randomly divided into a control group and an experimental group, with 70 cases in each group. The control group included 42 males and 28 females, with an average age of (55.99±7.51) years. The experimental group included 45 males and 25 females, with an average age of (57.02±6.96) years. The control group was given intravenous infusion of meropenem. The experimental group was treated with thymosin orally on the basis of the control group. Both groups received treatment for 7 days. Changes in inflammatory cytokines, lymphocyte subpopulations, clinical efficacy, and bacterial clearance rates were observed. Statistical analysis was conducted using χ² and t tests. Results　After treatment, the levels of interleukin (IL)-4, IL-6, tumor necrosis factor-alpha, IL-17A, and interferon-gamma in the experimental group were (9.12±1.81, 26.93±3.97, 12.96±1.38, 16.85±1.94, 17.82±2.66) ng/L, while in the control group they were (10.07±2.62, 30.72±5.36, 15.09±2.28, 19.82±2.19, 20.16±3.64) ng/L, with statistically significant differences (all P<0.05). The CD4⁺/CD8⁺ T lymphocyte ratio in the experimental group was higher than that in the control group (2.40±0.12 vs. 1.89±0.11, t=-26.210, P<0.001). The bacterial clearance rate and overall treatment efficacy in the experimental group were higher than those in the control group [78.57% (55/70) vs. 55.71% (39/70); 70.00% (49/70) vs. 48.57% (34/70)], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=0.282, P=0.595). Conclusion　The combination of thymic peptide and meropenem in the treatment of multidrug-resistant Klebsiella pneumoniae can reduce levels of inflammatory cytokines, increase CD4⁺/CD8⁺ T lymphocyte subpopulations, and improve bacterial clearance rates and clinical efficacy, providing important guidance for the clinical treatment of multidrug-resistant Klebsiella pneumoniae.

Efficacy of secukinumab combined with Xijiao Dihuang decoction  in the treatment of patients with plaque psoriasis

Zhang Yuanyuan, Wang Xiaomei, Zhao Tuoli

2025, 31(21):  3618-3622.  DOI: 10.3760/cma.j.cn441417-20250611-21019

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the efficacy of secukinumab combined with Xijiao Dihuang decoction in the treatment of patients with plaque psoriasis, as well as its effects on immune function and inflammatory factors. Methods　A randomized, double-blind, superiority trial design was adopted. A total of 82 patients with plaque psoriasis who were admitted to Hanzhong Traditional Chinese Medicine Hospital from December 2023 to December 2024 were selected as the research subjects. They were randomly divided into the observation group and the control group using the simple ranking randomization method, with 41 cases in each group. Observation group: 24 males and 17 females, aged 24 to 58 (43.24±4.67) years, with a disease duration of (10.75±2.45) years; Administer the combination of secukinumab and Xijiao Dihuang decoction. Control group: 26 males and 15 females, aged 22 to 59 (43.29±4.65) years, with a disease duration of (10.69±2.43) years. Administer stibocizumab treatment. Both groups were treated for one month. Compare the clinical efficacy, immune function, inflammatory factors [interleukin (IL)-6, IL-8, tumor necrosis factor α (TNF-α)], traditional Chinese medicine symptom scores (scaly dryness, itching, dry mouth, desquamation), time of clinical symptom improvement, psoriasis area and severity index (PASI) score, and incidence of adverse reactions between the two groups after treatment. Statistical methods employed t-test and χ² test. Results　The total effective rate of the observation group was higher than that of the control group [92.68% (38/41) vs. 75.61% (31/41)], and the difference was statistically significant (χ²=4.479, P<0.05). After treatment, the levels of CD4⁺ and CD8⁺ in the observation group were higher than those in the control group [(36.28±5.14)% vs. (33.19±5.23)%, (35.98±5.25)% vs. (33.66±5.24)%], while the levels of IL-6, IL-8, and TNF-α were lower than those in the control group [(95.54±25.33) ng/L vs. (109.57±25.26) ng/L, (4.92±1.74) ng/L vs. (6.14±1.88) ng/L, (12.15±3.42) ng/L vs. (14.25±3.37) ng/L], and the differences were statistically significant (t=2.698, 2.003, 2.511, 3.049, and 2.801, all P<0.05). After the treatment, the scores of traditional Chinese medicine symptoms, the time for clinical symptom improvement, and the PASI score in the observation group were all lower than those in the control group (all P<0.05). The comparison of the incidence rates of adverse reactions between the two groups [17.07% (7/41) vs. 14.63% (6/41)] showed no statistically significant difference (χ²=0.091, P>0.05). Conclusion　The combination of secukinumab and Xijiao Dihuang decoction in the treatment of patients with plaque psoriasis can improve immune function and inflammatory factor levels, and the clinical efficacy is quite good.

Effects of floating needle therapy on rheumatoid arthritis and its impact on the balance of peripheral blood Th17/Tregs

Zhao Min, Zhang Qian, Wei Changzheng, Cao Yujia, Lyu Yanyan, Zhao Huani

2025, 31(21):  3623-3627.  DOI: 10.3760/cma.j.cn441417-20240930-21020

Asbtract ( )  

References | Related Articles | Metrics

Objective　The efficacy of floating needle therapy in treating patients with rheumatoid arthritis (RA) and its impact on the balance of Th17/Tregs in peripheral blood. Methods　A prospective study was conducted. The research subjects were 104 RA patients who received treatment at Xi'an Fifth Hospital from July 2022 to September 2023. They were divided into two groups using the random number table method, with 52 patients in each group. Control group: 13 males and 39 females, aged 40 to 70 (58.64 ± 3.90) years; received conventional anti-rheumatic drug treatment. Experimental group: 14 males and 38 females, aged 40 to 70 (58.76 ± 3.49) years. They were treated with floating needle therapy on the basis of the control group. Both groups were treated for one month. Compare the changes in TCM syndrome scores (joint swelling and pain, limb coldness and numbness, limited joint movement), 28-joint disease activity score (DAS-28), as well as the levels of peripheral blood Th17/Tregs and laboratory indicators [rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP)]. Statistical methods employed t-test and χ² test. Results　After treatment, the total effective rate of the experimental group was higher than that of the control group [92.31% (48/52) vs. 76.92% (40/52)], and the difference was statistically significant (χ²=4.727, P=0.030). The scores of TCM syndromes related to joint swelling and pain, limb coldness and numbness, and limited joint movement in the experimental group, as well as the levels of serum CRP and ESR, were all lower than those in the control group, and the differences were statistically significant (all P<0.05). After the treatment, the DAS-28 score of the experimental group was lower than that of the control group [(3.05±0.78) points vs. (4.10±0.96) points], and the difference was statistically significant (t=6.121, P<0.05). There was no statistically significant difference in the ratio of Th17/Tregs between the two groups of peripheral blood (t=1.357, P>0.05). Conclusion　Floating needle therapy can enhance the clinical treatment effect of RA patients, reduce the TCM syndrome score, lower the levels of serum ESR, CRP and DAS-28 score, but it cannot regulate the balance of Th17/Tregs. When applying floating needle therapy for rheumatoid arthritis in clinical practice, it is necessary to combine with systemic anti-rheumatic treatment.

The effect of zoledronic acid combined with Wenjing decoction on postmenopausal osteoporosis patients with kidney deficiency and blood stasis type

Xin Jie, Wang Xiulin, Li Zhi

2025, 31(21):  3627-3632.  DOI: 10.3760/cma.j.cn441417-20250418-21021

Asbtract ( )  

References | Related Articles | Metrics

Objective　Analysis of the effect of zoledronic acid combined with Wenjing decoction on patients with postmenopausal osteoporosis of the kidney deficiency and blood stasis type. Methods　A retrospective analysis was conducted on 87 patients with postmenopausal osteoporosis of the kidney deficiency and blood stasis type who were admitted to Baoji High-tech Hospital from July 2022 to August 2023. These patients were divided into the control group (42 cases) and the observation group (45 cases) according to the treatment methods. Control group: Age (56.21±7.43) years, Menopause (4.51±0.85) years, Duration of disease (9.34±1.70) weeks; Received treatment with zoledronic acid. Observation group: Age (57.10±7.89) years, menopause (4.79±0.72) years, disease duration (9.61±1.52) weeks; Treated with Wenjing decoction on the basis of the control group. Compare the traditional Chinese medicine symptom scores, sex hormones, oxidative stress responses, bone metabolism, as well as clinical efficacy and adverse reactions before treatment and 3 months after treatment between the two groups. Statistical methods employed were the χ² test and the t test. Results　After treatment, the total score of TCM syndromes in the observation group was lower than that in the control group [(3.16±0.73) points vs. (5.82±1.59) points], and the difference was statistically significant (t=10.139, P<0.05). The levels of luteinizing hormone (LH), progesterone (P), and estradiol (E2) in the observation group were all higher than those in the control group (all P<0.05). The levels of monoamine oxidase A (MAOA), advanced oxidation protein products (AOPP), type I collagen cross-linked carboxy-terminal peptide (β-CTX), and bone alkaline phosphatase (BALP) in the observation group were all lower than those in the control group, while the total antioxidant capacity (T-AOC) and type I procollagen amino-terminal propeptide (PINP) were all higher than those in the control group (all P<0.05). The total effective rate of the observation group was higher than that of the control group [91.11% (41/45) vs. 73.81% (31/42)], and the difference was statistically significant (χ²=4.558, P<0.05). The comparison of the total incidence of adverse reactions between the two groups [8.89% (5/45) vs. 7.14% (3/42)] showed no statistically significant difference (χ²=0.090, P>0.05). Conclusion　Zoledronic acid combined with Wenjing decoction is highly effective in treating postmenopausal osteoporosis of the kidney-yin and blood-stasis type. It can increase sex hormone levels, reduce oxidative stress responses, improve bone metabolism, and is safe and reliable.

The anesthetic effect of dexmedetomidine combined with ropivacaine for erector spinae plane block in the surgery of lumbar disc herniation

Lyu Juntao, Xu Shuai, Yuan Bin, Fan Yingying

2025, 31(21):  3632-3636.  DOI: 10.3760/cma.j.cn441417-20250102-21022

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the anesthetic effect of dexmedetomidine combined with ropivacaine for erector spinae plane block (ESPB) in the surgery for lumbar disc herniation. Methods　A total of 100 patients with lumbar disc herniation who were admitted to Xi'an Daxing Hospital from January 2023 to May 2024 were selected as the study subjects. Using the odd-even random number table method, the patients were divided into the control group (50 cases) and the study group (50 cases). In the control group, there were 28 males and 22 females; age (47.25±5.63) years. In the study group, there were 31 males and 19 females; age (47.94±5.81) years. All patients underwent posterior lumbar bone graft fusion and internal fixation surgery. The control group received ropivacaine ESPB, while the study group received dexmedetomidine combined with ropivacaine ESPB. The stress indicators [cortisol (Cor), aldosterone (ALD)] were compared between the two groups before entering the operating room (T1), during incision (T2), at the end of the surgery (T3), and at extubation (T4); the number and dosage of intravenous analgesics used were compared between the two groups during the surgery and within 7 d after the surgery; the Visual Analogue Scale (VAS) scores of movement and rest status were compared between the two groups at 4 h, 8 h, 16 h, and 24 h after the surgery; the occurrence of adverse reactions (nausea and vomiting, dizziness/headache, hematoma at the puncture site, and nerve injury) were compared between the two groups within 72 h after the surgery. Independent sample t test, repeated measures analysis of variance, χ² test, and Fisher's exact probability method were used for statistical analysis. Results　At T1,There was no statistically significant difference in the levels of Cor and ALD between the two groups (both P>0.05). At T2, T3 and T4,the levels of Cor and ALD in the study group were all lower than those in the control group (all P<0.05). During the surgery and within 7 d after the surgery, the number and dosage of intravenous analgesics used in the study group were all lower than those in the control group [(10.62±1.69) times vs. (15.04±2.07) times, (542.25±65.26) mg vs. (783.29±94.45) mg; (11.63±1.37) times vs. (18.26±2.07) times, (584.27±72.57) mg vs. (904.48±105.38) mg] (all P<0.05). At 4 h, 8 h, 16 h and 24 h after the surgery, the VAS scores of the study group during both exercise and rest were lower than those of the control group [(2.05±0.64) points vs. (5.34±1.06) points, (1.93±0.54) points vs. (4.58±0.95) points, (1.63±0.42) points vs. (5.11±0.87) points, (3.13±0.49) points vs. (3.54±0.84) points; (1.40±0.58) points vs. (3.67±0.66) points, (1.53±0.47) points vs. (2.84±0.72) points, (1.03±0.27) points vs. (2.63±0.62) points, (1.60±0.43) points vs. (2.76±0.58) points] (all P<0.05). Within 72 h after the surgery, there was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Conclusions　Dexmedetomidine combined with ropivacaine ESPB has a good anesthetic effect in lumbar disc herniation surgery, and the postoperative analgesic effect is significant. It can also improve the stress response and is worthy of promotion and application.

Case Report

Fenestration decompression combined with cyst enucleation for jaw cyst in a mixed dentition child: a case report

Shi Yu, Xia Xin, Zheng Ting, Fan Jiayi, Zhuang Peilin

2025, 31(21):  3637-3641.  DOI: 10.3760/cma.j.cn441417-20250522-21023

Asbtract ( )  

References | Related Articles | Metrics

Jaw cysts are one of the common lesions in oral and maxillofacial surgery. When the lesion area is extensive, it can damage the adjacent anatomical structures. Especially for jaw cysts in children during the mixed dentition period, more attention should be paid to protecting the adjacent anatomical tissues and the growth and development of the children. This article reports a case of a 9-year-old girl with a jaw cyst. The cyst was large and involved the body of the mandible, the permanent tooth germs (33, 43), and the young permanent teeth (32-42). To remove the cyst, protect jaw and teeth development, a two-stage treatment was adopted: the first stage (decompression stage) involved fenestration decompression, which effectively protected the undeveloped permanent teeth and permanent dental germ (the pulp survival rate was 100% after 1-year follow-up), and reduced the risk of intraoperative fractures (the volume reduction rate of the cyst was 54.41% 6 months after the operation); the second stage (radical treatment stage) was to perform the cyst enucleation after the shrinkage rate of the cyst cavity stopped, and 6 months after the second surgery, cone-beam computed tomography (CBCT) showed that it reached the anatomical healing standard. This case adopted a treatment plan centered on protecting the children's jaw function and growth development, providing a reference for the treatment of children's jaw cysts.

Single-port laparoscopic treatment for a 1 case of greater omentum teratoma in a perimenopausal woman

Liu Weilong, Han Wenfei, Shi Hongtang, Liu Zhiqiang

2025, 31(21):  3642-3644.  DOI: 10.3760/cma.j.cn441417-20240801-21024

Asbtract ( )  

References | Related Articles | Metrics

Teratoma is one of the common reproductive cell tumors in gynecology. Due to the specific ultrasound manifestations and clinical symptoms, it can often be diagnosed before surgery. However, gonad-extrinsic teratomas occurring on the greater omentum are extremely rare, and preoperative diagnosis is difficult. Therefore, this article reports a case of a perimenopausal female who underwent complete resection of the tumor through a single-port laparoscopy and was diagnosed with greater omentum teratoma after surgery. This serves as a warning for clinicians to make adequate preoperative preparations.

Nursing Research

Correlation analysis of care ability and care burden of caregivers of children with type 1 diabetes

Lu Yacong, Li Yanhong, Zhang Xiaohong, Shi Yanxi

2025, 31(21):  3645-3649.  DOI: 10.3760/cma.j.cn441417-20250416-21025

Asbtract ( )  

References | Related Articles | Metrics

Objective　To investigate the current status of the care ability and care burden of caregivers of children with type 1 diabetes, and to explore the correlation between the two, in order to provide a reference for the construction of a precise care support system. Methods　A total of 101 caregivers of children with type 1 diabetes from the Endocrinology Department of Quanzhou Women's and Children's Hospital from July 2023 to December 2024 were selected as the survey subjects. A questionnaire survey was conducted using the general information questionnaire, the care ability scale, and the care burden scale. Independent sample t test, and analysis of variance were used for statistical analysis. The Pearson correlation analysis was used to examine the correlation between the caregivers' care ability and the care burden. Taking the care ability as the dependent variable, the variables that showed statistically significant differences in the single-factor analysis and Pearson correlation analysis were selected as independent variables, and a multiple linear stepwise regression analysis was conducted. Results　A total of 101 questionnaires were collected, and 101 valid questionnaires were returned, with an effective recovery rate of 100%. The score of the care ability scale was (106.23±18.15) points, and the score of the care burden scale was (60.03±5.62) points. There was a negative correlation between the two (r=-0.876, P<0.001). The results of the multiple linear stepwise regression analysis showed that the glycosylated hemoglobin level of the children, the educational level and the care burden of the caregivers were all the main influencing factors of the care ability (all P<0.05). Conclusions　There is a significant negative correlation between the care ability of caregivers of children with type 1 diabetes and the care burden. Moreover, the children's glycosylated hemoglobin levels, the caregivers' educational attainment and the care burden are all key factors influencing the care ability.

Construction and application of a hospitalized patient fall risk prediction model based on data mining

Cai Danyan, Liu Zhixiang, Ma Wei, Rao Hongying, Yang Jin, Wu Yan

2025, 31(21):  3650-3656.  DOI: 10.3760/cma.j.cn441417-20250707-21026

Asbtract ( )  

References | Related Articles | Metrics

Objective　The decision tree algorithm in data mining was applied to build a fall risk prediction model. The influencing factors of fall risk for hospitalized patients were analyzed, and the model was integrated into the hospital information system for clinical application, providing a reference for the comprehensive management of preventing falls for patients. Methods　The patients who suffered falls while hospitalized at Guangzhou First People's Hospital from January 2013 to December 2020 were selected as the study subjects. The clinical data of the patients (including past medical history, nursing classification and activity ability status, etc.) were collected. Independent sample t test, and χ² test were used for statistical analysis. A single-factor logistic regression analysis was conducted to identify the influencing factors of falls. A decision tree model was constructed using the R programming language and the rpart package. The model was optimized by adjusting the decision tree parameters, and the performance of the prediction model was evaluated by drawing the receiver operating characteristic curve and calculating the area under the curve. Based on the characteristics of the constructed decision tree model, improve the fall risk monitoring indicators and the functions of the hospital nursing information system, formulate comprehensive fall prevention management strategies and implement them (from January 2023 to December 2024), and continuously track patients to compare the implementation effect of the model. Results　This study included a total of 2 040 hospitalized patients. Among them, 414 patients experienced falls, while 1 626 patients did not. There were 1 083 male patients and 957 female patients. The age of the fallers was (76.88±9.07) years, and the age of the non-fallers was (62.49±9.89) years. The results of the single-factor logistic regression analysis showed that age (OR=1.125), gait during exercise (OR=594.435), history of falls (OR=1 807.398), sleep condition (OR=16.772), vision condition (OR=6.710), hearing condition (OR=42.385), defecation ability (OR=34.771), Mini-Mental State Examination (MMSE) score (OR=1.575), nutritional score (OR=1.347), nursing classification (OR=1.493), and Activities of Daily Living (ADL) (OR=0.981) were all factors influencing the occurrence of falls (all P<0.05). The decision tree model was verified using the test set, and the evaluation indicators of the training set and test set were obtained. The accuracy of the training set was 0.983 9, the recall rate was 0.958 6, and the F1 value was 0.960 2; the accuracy of the test set was 0.978 7, the recall rate was 0.935 5, and the F1 value was 0.946 9. The analysis of feature importance in the decision tree model shows that gait during exercise, MMSE score, history of falls, and age are all important features for predicting the risk of falls in hospitalized patients. Through practical application, the decision tree model constructed in this study has increased the assessment rate for patients at high risk of falls and reduced the incidence of falls. Conclusions　Gait during exercise, MMSE score, history of falls, and age are four important factors for predicting the risk of falls in hospitalized patients. They are conducive to the rapid screening of high-risk patients with falls and the comprehensive management of fall prevention in clinical settings.

Evaluation of the effect of the multidisciplinary co-management model in the perioperative treatment of elderly patients with intertrochanteric femoral fractures

Dai Xinghua, Du Hongyang, Song Yuanzheng, Liu Zhidong, Yang Lili

2025, 31(21):  3657-3661.  DOI: 10.3760/cma.j.cn441417-20241223-21027

Asbtract ( )  

References | Related Articles | Metrics

Objective　Evaluate the effectiveness of the multidisciplinary co-management model in the perioperative treatment of elderly patients with intertrochanteric femoral fractures. Methods　This study was a randomized controlled trial. 100 patients with intertrochanteric femoral fractures who were admitted to Tengzhou Central People's Hospital from January 2022 to December 2022 were selected as the study subjects. Using simple random sampling method, the patients were divided into the observation group (50 cases) and the control group (50 cases). In the observation group, there were 13 males and 37 females; age (83.76±7.38) years. In the control group, there were 17 males and 33 females; age (84.98±5.91) years. The control group received conventional perioperative management intervention, while the observation group was intervened with a multidisciplinary co-management model. Both groups were intervened until the 5 days after surgery. The incidence of delirium, the delay time of surgery, the length of hospital stay, and the satisfaction during hospitalization were compared between the two groups; the scores of the Visual Analogue Scale (VAS), the Basel Index (BI), and the Richards-Campbell Sleep Questionnaire (RCSQ) were compared between the two groups (at admission, 1 day after surgery, and 5 days after surgery). Independent sample t test, χ² test, Mauchly sphericity test, and repeated measures analysis of variance were used for statistical analysis. Results　The incidence of delirium in the observation group was lower than that in the control group; the delay time of surgery and the length of hospital stay were shorter in the observation group than in the control group; the satisfaction during hospitalization was also higher in the observation group than in the control group [10.00% (5/50) vs. 30.00% (15/50), (1.84±0.37) days vs. (4.12±0.69) days, (12.68±3.50) days vs. (17.06±2.60) days, (95.68±2.55) points vs. (83.92±4.25) points] (all P<0.05). At 1 day and 5 days after surgery, the VAS scores of the observation group were lower than those of the control group, while the BI and RCSQ scores of the observation group were higher than those of the control group (all P<0.05). Conclusion　The multidisciplinary co-management model can effectively reduce the incidence of delirium in elderly patients with intertrochanteric femoral fractures, alleviate pain, improve sleep quality, shorten the delay time of surgery and length of hospital stay, and enhance postoperative functional recovery and satisfaction during hospitalization.

Analysis of hemodialysis knowledge level in maintenance hemodialysis patients

Shen Xiaobo, Zhang Ke, Zhao Songwei, Li Tingru, Duan Changwei, Zhang Zhu

2025, 31(21):  3662-3665.  DOI: 10.3760/cma.j.cn441417-20241022-21028

Asbtract ( )  

References | Related Articles | Metrics

维持性血液透析；知识水平；线性回归分析

Latent class analysis of health behavior patterns after PCI for acute myocardial infarction and its relationship with prognosis

Song Ge, Zhang Caili

2025, 31(21):  3666-3671.  DOI: 10.3760/cma.j.cn441417-20250228-21029

Asbtract ( )  

References | Related Articles | Metrics

Objective　To analyze the latent classes of health behavior patterns in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI), and to explore their relationship with prognosis. Methods　A prospective cohort study was conducted on 173 patients with AMI who underwent PCI at Department of Cardiovascular Medicine, The First Affiliated Hospital of Nanyang Medical College from January 2023 to May 2024, including 116 males and 57 females who were (59.82 ± 8.04) years old. Among them, 134 cases were classified as Killip heart function grades Ⅰ-Ⅱ, and 39 cases grade Ⅲ. A questionnaire survey was conducted to investigate their general information and health behaviors. The latent classes of health behavior patterns in the patients were analyzed using the latent class model, and the clinical data of the patients with different latent classes of health behavior patterns were compared. The factors affecting the prognosis after PCI were analyzed. χ² test, logistic regression analysis, and latent class analysis were used for the statistical analysis. Results　The effective recovery rate of the questionnaires was 97.69% (169/173). The fitting effect of the model on the health behavior patterns of the patients was optimal in two latent classes (the classification accuracy index = 0.80; the Rommel and Ruben corrected likelihood ratio test P=0.003; the Bootstrap likelihood ratio test P<0.001), which were named as a poorly controlled group and a well controlled group, respectively. The proportions of the patients with a junior high school education level or below, rural family residence, and Killip heart function grade Ⅲ in the poorly controlled group were higher than those in the well controlled group (χ²=6.018, 4.431, and 7.814; all P<0.05). The logistic regression analysis confirmed that age ≥ 60 years [odds ratio (OR) =2.472, 95% confidence interval (95%CI) 1.252-4.879], Killip heart function grading Ⅲ (OR=2.670, 95%CI 1.440-4.950), and poor control of health behavior patterns (OR=2.113, 95%CI 1.185-0.376) were all risk factors for poor prognosis in the patients (all P<0.05). Conclusion　The health behavior patterns of patients with AMI after PCI have two latent classes, namely poorly controlled and well controlled, which may be related to the patient's education level, family residence, and heart function, and these are the factors affecting poor prognosis.

The impact of nursing strategies based on health ecology theory on the health of pregnant women with gestational hypertension

Li Ting, Zheng Li

2025, 31(21):  3672-3676.  DOI: 10.3760/cma.j.cn441417-20250228-21030

Asbtract ( )  

References | Related Articles | Metrics

Objective　Explore the impact of nursing strategies based on health ecology theory on the health of pregnant women with gestational hypertension. Methods　A total of 104 pregnant women with gestational hypertension who were admitted to Women&Infants Hospital of Zhengzhou from August 2022 to August 2024 were selected as the research subjects. Using the random number table method, the patients were divided into the observation group (52 cases) and the control group (52 cases). In the observation group, there were 33 primiparas and 19 multiparas; age (28.20±3.42) years; gestational age (24.85±1.96) weeks. In the control group, there were 30 primiparas and 22 multiparas; age (27.96±3.33) years; gestational age (24.13±1.79) weeks. The control group received conventional nursing intervention, while the observation group was given nursing strategies based on the health ecology theory. Both groups were intervened until the delivery was completed. The health knowledge levels (disease knowledge, blood pressure monitoring knowledge, complication knowledge, and healthy lifestyle knowledge) and mental health conditions [Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS)] as well as blood pressure levels were compared between the two groups before and after the intervention. Independent sample t test, paired t test, and χ² test were used for statistical analysis. Results　After the intervention, the scores of disease knowledge, blood pressure monitoring knowledge, complication knowledge and healthy lifestyle knowledge in the observation group were all higher than those in the control group [(8.36±1.05) points vs. (6.67±1.23) points, (7.84±1.32) points vs. (6.43±1.24) points, (7.53±1.04) points vs. (6.29±1.12) points, (8.24±1.30) points vs. (6.65±1.11) points] (all P<0.05); the SAS and SDS scores of the observation group were lower than those of the control group [(42.56±5.57) points vs. (48.62±4.67) points, (42.97±5.33) points vs. (48.67±5.72) points] (both P<0.05); the diastolic and systolic blood pressures in the observation group were both lower than those in the control group [(78.39±8.93) mmHg (1 mmHg=0.133 kPa) vs. (90.97±10.69) mmHg, (122.49±9.99) mmHg vs. (138.72±10.66) mmHg] (both P<0.05). Conclusion　For pregnant women with gestational hypertension, implementing a nursing intervention strategy based on the health ecology theory can effectively enhance their health knowledge, alleviate negative psychological emotions, and stabilize blood pressure levels.

Summary of best evidences for enteral nutrition management in patients with anastomotic leakage after esophageal neoplasms surgery

Yu Jing, Sun Zhongwen, Lin Feiyun, Huang Wenting

2025, 31(21):  3676-3681.  DOI: 10.3760/cma.j.cn441417-20250625-21031

Asbtract ( )  

References | Related Articles | Metrics

Objective　To identify and synthesize the best available evidences on enteral nutrition management for patients with anastomotic leakage after esophageal cancer surgery, and to provide some references for clinical nursing practice. Methods　A systematic search was conducted across multiple databases and evidence sources, including Up To Date, BMJ Best Practice, NICE, GIN, RNAO, SIGN, YIMAITONG, CINAHL, PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, and VIP, for clinical guidelines, systematic reviews, and other studies related to enteral nutrition management in these patients. The search covered the records from the databases' establishment to June 1st, 2024. Two researchers independently evaluated the quality of the retrieved literature, and extracted relevant evidences. Results　Twelve articles were included: 5 guidelines, 2 expert consensus statements, 1 meta-analysis, and 4 quasi-experimental studies. Fifteen key pieces of best evidences were synthesized, and were categorized into 10 domains: nutritional assessment, nutrient intake, formula selection, patient positioning, initiation timing, infusion rate and temperature, prevention of gastrointestinal intolerance, tube care, and dynamic monitoring and evaluation. Conclusion　This study synthesizes evidence-based best practices for managing enteral nutrition in patients experiencing anastomotic leakage after esophageal cancer surgery, and these findings may improve patient nutritional status and clinical outcomes.

Application of collaborative comfort care model based on IKAP theory and incorporating a modified A-DIVA scale in blood collection for voluntary blood donation

Su Wei, Deng Yawen, He Ying, Liang Hanwen, Cai Jiaying, Xie Xiaoping, Liu Xing, Huang Xiaobin, Qi Yanping

2025, 31(21):  3682-3687.  DOI: 10.3760/cma.j.cn441417-20250507-21032

Asbtract ( )  

References | Related Articles | Metrics

Objective　To verify the application effect and nursing strategy applicability of the collaborative comfort care model based on the IKAP theory and incorporating a modified A-DIVA (adult-difficult intravenous access) scale in the voluntary blood donation. Methods　A total of 1 074 donors who donated whole blood at Guangzhou Blood Center from June to October 2024 were selected by the random sampling method for the randomized controlled trial, and were divided into a control group (534 cases) and an experimental group (540 cases) by the participants were divided  method. In the control group, there were 372 males (69.66%) and 162 females (30.34%), with an age of (31.35±5.16) years. In the experimental group, there were 361 males (66.85%) and 179 females (33.15%), with an age of (31.19±5.33) years. The control group received routine care, while the experimental group implemented hierarchical precision nursing intervention based on the IKAP theory and comfortable nursing mode, with the improved A-DIVA scale as the risk assessment tool for the blood donors. t and χ² tests were used as the statistical methods. Results　The first puncture success rate of the experimental group was higher than that of the control group [96.67% (522/540) vs. 92.32% (493/534); χ²=10.235; P<0.05]. The score of venous puncture pain in the experimental group was lower than that in the control group (0.41±0.07 vs. 0.78±0.14; t=54.869; P<0.05). The incidence rate of DRVR in the the experimental group was lower than that in the control group [2.59% (14/540) vs. 5.99% (32/534);χ²=8.421; P<0.05]. The score of A-DIVA in the experimental group was higher than that in the control group, and the blood collection time and the number of punctures were both shorter (all P<0.05). Conclusion　The collaborative comfort care model based on the IKAP theory and incorporating a modified A-DIVA scale can effectively identify blood donors who are at risk of having difficulties with venous access. It also enhances the success rate of the first venous puncture, alleviates the puncture pain, and reduces the incidence of adverse reactions, primarily DRVR.

Management status of negative pressure sinus displacement technique in 44 hospitals in Guangdong province: a cross-sectional study

Wu Jieli, Xie Ruiling, Wang Fengli, Yu Qin, Zhang Lei, Wen Yihui, Hu Lijing

2025, 31(21):  3687-3691.  DOI: 10.3760/cma.j.cn441417-20250604-21033

Asbtract ( )  

References | Related Articles | Metrics

Objective　To explore the current management status of negative pressure sinus irrigation technology in Guangdong Province and provide a basis for formulating and promoting relevant technical standards. Methods　A cross-sectional survey was conducted from February to March 2024 using convenience sampling.Participants included 44 head nurses or nursing backbone from 44 hospitals in 21 prefecture-level cities in Guangdong Province were selected as the study subjects,all of whom were female,with a weighted average age of 39.95 years. Among them, 40 were from tertiary hospitals, 3 from secondary hospitals, and 1 from a specialized hospital; 10 were nurse practitioners, 28 were nurse supervisor, 5 were associate chief nurses, and 1 was a chief nurse practitioner; working years: 12 had 5≤ years <10, 23 had 10≤ years <20, and 9 had years ≥20. Data were collected via a self-designed questionnaire assessing negative pressure sinus displacement technique practices. Results　44 questionnaires were returned. (1) Related knowledge mastery : 28 (63.64%) mastered the operation indications of sinus negative pressure replacement technology, 10 (22.73%) mastered the contraindications, and 13 (29.55%) mastered the operation complications. (2) Procedure management:26 hospitals (59.09%) used mucosal contraction agents, 29 hospitals (65.91%) used syringe drip diluent, and 40 hospitals (90.91%) used normal saline as drip solution. 31 hospitals (70.45%) used negative pressure below 0.024 Mpa for suction, and 42 hospitals (95.45%) used pillow-supported supine position.(3) Procedural training management:All 44 hospitals (100%) had qualified access requirements for negative pressure sinus displacement technique , and 42 hospitals (95.45%) had strict operation training programs. Conclusion　Nurses in Guangdong Province's otorhinolaryngology departments demonstrated suboptimal knowledge regarding negative pressure sinus displacement technique ,procedural management requires standardization.It is recommended that professional associations establish evidence-based practice guidelines for negative pressure sinus displacement technique ,individual hospitals should enhance operator training and management.

A qualitative study on the user experience of elderly users of the "Internet + Nursing Services" platform

Tang Li, Jiang Ting, Yu Lingna, Huang Xia, Luo Fengjun, Li Anting, Tong Yun, Tang Yaping, Gao Zihang

2025, 31(21):  3692-3696.  DOI: 10.3760/cma.j.cn441417-20250804-21034

Asbtract ( )  

References | Related Articles | Metrics

Objective　To establish a user experience indicator system for the "Internet + Nursing Services" platform, this study conducts empirical investigations focusing on the demand characteristics of elderly users. Methods　Utilizing purposive sampling, semi-structured interviews were conducted with 30 elderly individuals who had previously used the "Internet + Nursing Services" platform across five typical settings in Haizhu District, Guangzhou, from January to February 2025. These settings included university residential compounds, high-/low-income neighborhoods, community parks, tertiary hospitals, and senior activity centers. The cohort comprised 19 males and 11 females, with a mean age of (68.9±11.9) years. Data analysis was performed using Colaizzi's phenomenological methodology. Results　The needs of elderly users encompass five core dimensions: interface accessibility, functional adaptability, operational convenience, trust-building mechanisms, and safety assurance. Specifically, interface design should prioritize simplicity and practicality (e.g., high-contrast color schemes, adjustable fonts); functional development must integrate voice assistants, online appointment systems, and family support services; operational processes require streamlined steps with enhanced privacy protection; trust establishment relies on hospital reputation, peer recommendations, and service evaluations; safety safeguards should incorporate emergency call functions, health monitoring capabilities, and informational alerts. Conclusion　The needs of elderly users exhibit multi-layered and context-specific characteristics. Future platform optimization should center on users' cognitive habits, enhancing their experience through age-friendly interface redesign, precise functional adaptation, and trust mechanism design. This study provides a theoretical framework and practical foundation for evaluating the age-appropriateness of digital health services.