Email
RSSCurrent Issue
2026 Vol. 47, No. 7
2026, 47(7): 1-10.
doi: 10.12259/j.issn.2095-610X.S20260701
Abstract:
Major Depressive Disorder （MDD） is a highly prevalent psychiatric disorder worldwide. Its pathogenesis is complex and not yet fully understood, and current clinical management is limited by delayed therapeutic onset and treatment resistance in a subset of patients. Non-human primates share a high degree of similarity with humans in neural development, emotional regulation, stress response and other aspects, making them more translationally valuable animal models for the research on MDD mechanisms and drug development. This paper systematically consolidates classical NHP models of MDD established both domestically and internationally, elaborating in detail on the modeling principles, construction methodologies, as well as behavioral and physiological phenotypes of each model. This synthesis aims to provide novel insights for deepening our understanding of MDD pathophysiology and for developing innovative therapeutic strategies and drug screening paradigms.
Major Depressive Disorder （MDD） is a highly prevalent psychiatric disorder worldwide. Its pathogenesis is complex and not yet fully understood, and current clinical management is limited by delayed therapeutic onset and treatment resistance in a subset of patients. Non-human primates share a high degree of similarity with humans in neural development, emotional regulation, stress response and other aspects, making them more translationally valuable animal models for the research on MDD mechanisms and drug development. This paper systematically consolidates classical NHP models of MDD established both domestically and internationally, elaborating in detail on the modeling principles, construction methodologies, as well as behavioral and physiological phenotypes of each model. This synthesis aims to provide novel insights for deepening our understanding of MDD pathophysiology and for developing innovative therapeutic strategies and drug screening paradigms.
2026, 47(7): 11-19.
doi: 10.12259/j.issn.2095-610X.S20260702
Abstract:
Objective To investigate the neuroprotective effect of cytochrome c oxidase subunit 5A （COX5A） overexpression in mice with traumatic brain injury （TBI） and its association with mitochondrial function. Methods C57BL/6J wild-type （WT） mice aged 4–6 weeks and age-matched COX5A-overexpressing （COX5A-UP） transgenic mice were randomly divided into WT+sham operation group, WT+TBI group, COX5A-UP+sham operation group, and COX5A-UP+TBI group （n = 12 per group, male∶female = 1∶1）. The TBI model was established using the controlled cortical impact method. At 14 days after surgery, neurological and behavioral performance, brain water content, oxygen consumption rate of hippocampal synaptosomal mitochondrial , ATP levels, reactive oxygen species, malondialdehyde, mitochondrial membrane potential and mitochondrial ultrastructure were examined. Results Compared with the WT+sham group, WT+TBI group showed impaired neurological and behavioral performance, increased brain water content, reduced mitochondrial energy metabolism, enhanced oxidative stress and mitochondrial morphological damage （P < 0.05）. Compared with the WT+TBI group, the COX5A-UP+TBI group showed improvements in these neurological, behavioral, edema-related and mitochondrial abnormalities （P < 0.05）. Conclusion COX5A overexpression alleviates TBI-induced neurological impairment, and this effect may be associated with amelioration of synaptosomal mitochondrial dysfunction and preservation of mitochondrial structural homeostasis.
2026, 47(7): 20-27.
doi: 10.12259/j.issn.2095-610X.S20260703
Abstract:
Objective To investigate the effects of Decursin （DEC） on myocardial fibrosis after myocardial infarction in mice and its regulatory mechanism underlying the activation of cardiac fibroblasts （CFs）. Methods C57BL/6J mice were subjected to ligation of the left anterior descending coronary artery to establish a mouse myocardial infarction model. The mice were randomly divided into three groups （n = 5 per group）: sham operation group （Sham）, myocardial infarction model group （MI）, and decursin treatment group （DEC）. DEC was administered by intragastric gavage. For 28 days post-surgery, cardiac function was evaluated by echocardiography; histopathological changes and the degree of myocardial fibrosis were assessed by immunohistochemistry. The migratory capacity of cardiac fibroblasts was determined by wound-healing assay; the proliferation of cardiac fibroblasts was detected by EdU assay. The expression levels of key proteins related to myocardial fibrosis signaling pathways were measured by Western blot （WB）. Results Echocardiographic assessment revealed that compared with the MI group, the DEC treatment group exhibited significantly increased left ventricular ejection fraction （LVEF, increased by 25%, P < 0.001）, left ventricular fractional shortening （LVFS, increased by 16%, P < 0.001）, and mitral valve E/A ratio （MV E/A, P < 0.001）. Immunohistochemical results showed that the MI group presented increased myocardial interstitial collagen deposition and enlarged fibrotic area （P < 0.001）, whereas DEC intervention markedly attenuated the fibrotic process （P < 0.01）. In vitro experiments demonstrated that DEC significantly inhibited the proliferation （P < 0.01） and migration （P < 0.05） of cardiac fibroblasts, downregulated the expression of fibronectin （P < 0.05）, α-SMA, collagen I and other proteins （P < 0.01）, and suppressed the activation of cardiac fibroblasts. Conclusion Decursin can improve cardiac function and attenuate myocardial fibrosis after myocardial infarction, and its mechanism may be associated with the PI3K/AKT signaling pathway.
2026, 47(7): 28-36.
doi: 10.12259/j.issn.2095-610X.S20260704
Abstract:
Objective To investigate the expression of the endoplasmic reticulum stress protein kinase R-like endoplasmic reticulum kinase （PERK）/eukaryotic initiation factor 2α （eIF-2α） signaling pathway in cervical intraepithelial neoplasia （CIN） and cervical carcinoma （CC）, and its impact on tumor progression. Methods A total of 58 cervical biopsy specimens from patients diagnosed with cervical cancer (CC) treated at Nanjing Mingji Hospital from January 2022 to April 2023 were collected as the cervical cancer group. Concurrently, 52 cases of cervical intraepithelial neoplasia (CIN II and CIN III) were selected as the control group, and 34 cases of healthy uterine tissues from the same period were chosen as the normal group. Western blot was used to detect the expression of endoplasmic reticulum-mediated related proteins; immunohistochemistry was employed to assess the staining status of PERK/eIF-2α in CC tissues. HeLa cells were divided into the following groups: control group, pcDNA3.1-NC group, overexpressed PERK group, sh-NC group, and PERK interference group. Cell proliferation activity was detected using the CCK-8 assay, and the expression of epithelial cadherin （E-cadherin） was observed by immunofluorescence staining. Apoptosis and cell cycle distribution were analyzed by flow cytometry, and cell migration and invasion ability were evaluated by Transwell assay. Results With increasing CIN grade, the expression of PERK/eIF-2α increased （P < 0.05）, and its expression in CC tissues was significantly higher than that in CIN tissues （P < 0.05）. Compared with the pcDNA3.1-NC group, cells in the PERK overexpression group enhanced proliferation activity, markedly reduced intracellular E-cadherin fluorescence expression （P < 0.05）, and downregulated E-cadherin protein expression （P < 0.05）, accompanied by promotion of cell proliferation, migration, and invasion, as well as inhibition of apoptosis （P < 0.05）. In contrast, compared with the sh-NC group, cells in the PERK interference group showed decreased proliferation activity, significantly increased intracellular E-cadherin fluorescence expression （P < 0.05）, upregulated E-cadherin protein expression （P < 0.05）, along with inhibition of cell proliferation, migration, invasion, and promotion of apoptosis （P < 0.05）. Conclusion The expression of the endoplasmic reticulum stress-related PERK/eIF-2α pathway is upregulated in uterine intraepithelial neoplasia and CC tissues. Inhibition of its expression can reduce the tumor cell proliferation in CC, thereby slowing tumor progression.
2026, 47(7): 37-45.
doi: 10.12259/j.issn.2095-610X.S20260705
Abstract:
Objective To investigate the mechanism by which Glutathione Peroxidase 4 （GPX4） expression promotes ferroptosis and participates in the malignant behavior of Endometrial Carcinoma （EC）. Methods The expression of GPX4 in EC tissues was determined by quantitative real-time PCR （qPCR）, Western blot, and immunohistochemistry （IHC）. KLE cells were cultured and divided into an shNC group （n = 6） and an shGPX4 group （n = 6）. The effects of GPX4 on EC cell proliferation, migration, and apoptosis were investigated using Transwell assay, colony formation assay, and flow cytometry. Intracellular Fe2+, reactive oxygen species （ROS）, and malondialdehyde （MDA） levels were detected. Mitochondrial membrane potential （MMP） was measured by JC-1 staining. GPX4 enzyme activity was assessed with a commercial kit. The content of lipid peroxide 4-hydroxynonenal （4-HNE） was determined by ELISA; and the expression of key ferroptosis-related proteins, Acyl-CoA Synthetase Long Chain Family Member 4 （ACSL4） and Solute Carrier Family 7 Member 11 （SLC7A11）, was analyzed by Western blot. An EC xenograft tumor model in nude mice was established and divided into an shNC group （n = 6） and an shGPX4 group （n = 6）. The in vivo effect of GPX4 knockdown was evaluated by measuring tumor volume, weight, and levels of Fe2+ and MDA. Results GPX4 was highly expressed in EC tissues and cell lines （GPX4 mRNA in EC tissues: 118.1±6.92 vs. 62.72±5.20 in adjacent normal tissues, t = 15.68, P < 0.001, Cohen's d=8.62）.Compared with the shNC group, the shGPX4 group showed significantly decreased KLE cell proliferation （colony number: 0.37±0.05 vs. 0.89±0.07, t = 14.94, P < 0.001） and migration capacity, along with an increased apoptosis rate （61.64±7.03% vs. 12.60±2.48%, t = 16.12, P < 0.001）. Additionally, in the shGPX4 group, intracellular levels of Fe2+, lipid ROS, MDA, and 4-HNE were increased; GSH level and GPX4 enzyme activity were decreased; MMP was impaired; and the expression of ACSL4 was up-regulated while that of SLC7A11 was down-regulated （all P < 0.001）.In the nude mouse model, the shGPX4 group showed significantly reduced tumor volume （0.36±0.07 vs. 0.87±0.12 cm3, t = 9.07, P < 0.001） and weight, along with increased iron content and MDA levels in tumor tissues （both P < 0.001）. Conclusion The study demonstrates that GPX4 silencing can significantly induce ferroptosis, thereby reducing the proliferation and invasion of endometrial cancer cells.
2026, 47(7): 46-54.
doi: 10.12259/j.issn.2095-610X.S20260706
Abstract:
Objective To investigate the expression pattern and mechanism of Chromobox homolog 2 （CBX2） in cervical cancer. Methods Clinical tissue specimens from 60 patients with cervical cancer were collected from the Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Bengbu Medical College between January 2022 and December 2024. CBX2 expression in cervical cancer was detected using immunohistochemistry, RT-PCR, and Western blotting. Through transfection techniques, cells were divided into four experimental groups: si-NC （negative control）, si-CBX2, oe-NC , and oe-CBX2. Colony formation assays and Western blotting were used to assess the effect of CBX2 on cervical cancer cell proliferation. Transwell chamber assays and wound healing assays were conducted to evaluate the effect of CBX2 on cell invasion and migration. Finally, Western blot experiments were used to investigate the effect and mechanism of CBX2 on cervical cancer. Results Immunohistochemistry, RT-PCR, and Western blot analyses of clinical samples revealed that CBX2 was highly expressed in cervical cancer tissues （P < 0.05）. The experimental results show that compared with the control group, knockdown of CBX2 can inhibit the proliferation, metastasis and glycolysis process of cervical cancer cells (P < 0.05). On the contrary, compared with the control group, overexpression of CBX2 will promote the proliferation, metastasis and glycolysis process of cervical cancer cells (P < 0.05). The results of Western blotting suggest that compared with the control group, overexpression of CBX2 can regulate the biological behavior of cervical cancer cells by activating the JAK2/STAT3 signaling pathway （P < 0.05）. Conclusion CBX2 promotes proliferation, metastasis, and glycolysis in cervical cancer cells by regulating the JAK2/STAT3 signaling pathway.
2026, 47(7): 55-61.
doi: 10.12259/j.issn.2095-610X.S20260707
Abstract:
Objective To explore the effects of childhood left-behind experiences and the depression-related risk gene rs12678428 polymorphism on brain structure and function in adulthood. Methods Healthy adults from southern China, with or without left-behind experiences, were recruited between September 2022 and August 2025. Demographic data, venous blood samples and MRI data were collected. Participants were divided into two genotype groups according to the presence of the T allele of rs12678428: TT+TC and CC. Gray matter volume （GMV）, amplitude of low-frequency fluctuation （ALFF）, fractional ALFF （fALFF）, regional homogeneity （ReHo）, and degree centrality （DC） were compared between different genotypes in the non-left-behind and left-behind groups. The functions of differential brain regions were analyzed, and the relationships among left-behind experience, rs12678428 polymorphism, and brain structure and function were further explored. Results No significant differences in gender, age, or education level were found between the TT+TC and CC groups （P > 0.05）. In the non-left-behind group, significant differences in GMV, ALFF, ReHo, and DC were observed between TT+TC and CC genotypes （P < 0.05）, mainly in the bilateral insula, temporal lobe, postcentral gyrus and fusiform gyrus. In the left-behind group, significant differences in GMV, ALFF, fALFF, and ReHo were found between TT+TC and CC genotypes （P < 0.05）, predominantly in the bilateral pericalcarine cortex, lingual gyrus, precentral gyrus, postcentral gyrus and caudate nucleus. Conclusion The rs12678428 gene polymorphism is closely associated with alterations in brain structure and function, and left-behind experiences may modulate its pattern of effects.
2026, 47(7): 62-70.
doi: 10.12259/j.issn.2095-610X.S20260708
Abstract:
Objective To develop a risk association model for dyslipidemia, providing a scientific tool to support early screening and precision interventions. Methods Based on a cross-sectional survey of the Yunnan Provincial Chronic Disease and Risk Factor Surveillance Project conducted in Shilin Yi Autonomous County from November 2022 to April 2023, a total of 1577 eligible participants were enrolled. Data were collected through questionnaires, physical examinations, and laboratory tests. After preprocessing, 46 variables were included, and the dataset was randomly split into training and test sets at a ratio of 7∶3. Univariate analysis was first performed on the training set to identify statistically significant variables. Subsequently, four machine learning algorithms—Lasso, Boruta, SWSFS, and XGBoost—were employed for feature selection. Variables commonly identified by all four algorithms were retained as key variables to construct a multivariable logistic regression model, which was visualized as a nomogram. Model performance was systematically assessed using the test set via the confusion matrix, area under the ROC curve （AUC）, decision curve analysis （DCA）, and calibration curves. Results The prevalence of dyslipidemia in this study was 43.37%. Six important variables were ultimately identified in the model: BMI, waist circumference, glycated hemoglobin, heart rate, serum uric acid, and walking or cycling. Among them, glycated hemoglobin exhibited a significant nonlinear association （P for nonlinearity=0.003）, whereas BMI （P = 0.002） and serum uric acid （P < 0.001） showed linear positive correlations; establishing them as key risk factors for dyslipidemia. Walking or cycling was a significant protective factor （P < 0.001）. The associations of waist circumference （P = 0.384） and heart rate （P = 0.078） with dyslipidemia did not reach statistical significance. The model achieved an AUC of 0.663 in the testing set; with a sensitivity of 67.1% and specificity of 63.2%. DCA showed a significant clinical net clinical benefit within the threshold probability range of 0.25～0.65, and the calibration curve indicated good model fit. Conclusion The proposed dyslipidemia risk association model demonstrates moderate discriminatory performance and clinical utility, offering a reference for early identification of high-risk individuals with dyslipidemia and targeted interventions.
2026, 47(7): 71-78.
doi: 10.12259/j.issn.2095-610X.S20260709
Abstract:
Objective To explore the predictive value of lipoprotein-associated phospholipase A2 （Lp-PLA2）, small dense low-density lipoprotein cholesterol （sdLDL-C）, and 25-hydroxyvitamin D （25-OH-VD） on the degree of neurological impairment and prognosis in patients with ischemic stroke after intravenous thrombolysis. Methods A retrospective analysis was conducted on the medical data of 108 patients with ischemic stroke who received intravenous thrombolysis at Harrison International Peace Hospital from January 2021 to June 2023. Based on the National Institute of Health Stroke Scale （NIHSS） score at admission, patients were divided into mild group （NIHSS < 5, n = 49）, moderate group （NIHSS 5–15, n = 35）, and severe group （NIHSS > 15, n = 24）. Serum levels of Lp-PLA2, sdLDL-C and 25-OH-VD were detected using enzyme-linked immunosorbent assay. Differences in Lp-PLA2, sdLDL-C and 25-OH-VD levels among groups were compared. Spearman correlation analysis was used to explore the relationship between Lp-PLA2, sdLDL-C, 25-OH-VD and the degree of neurological impairment. Receiver operating characteristic （ROC） curves were constructed to evaluate the value of Lp-PLA2, sdLDL-C and 25-OH-VD in assessing disease severity and predicting prognosis. Results The levels of Lp-PLA2, sdLDL-C, NIHSS score and infarct lesion diameter gradually increased, while 25-OH-VD level gradually decreased in the mild, moderate and severe groups （P < 0.05）. Lp-PLA2 and sdLDL-C were positively correlated with disease severity of neurological injury, whereas 25-OH-VD was negatively correlated （P < 0.05）. The combined detection of the three indicators showed the optimal ROC efficacy in assessing stroke severity and predicting poor prognosis. Conclusion Levels of Lp-PLA2, sdLDL-C and 25-OH-VD are closely associated with the degree of neurological impairment in patients with ischemic stroke after intravenous thrombolysis. The combined detection of the three indicators shows high predictive efficacy for disease severity and prognosis.
2026, 47(7): 79-88.
doi: 10.12259/j.issn.2095-610X.S20260710
Abstract:
Objective To investigate the correlation between myeloid-derived suppressor cells （MDSCs）, B7 Homolog 2 （B7-H2）, and regulatory T cell （Treg）/T helper 17 cell （Th17） immune imbalance in patients with primary immune thrombocytopenia （ITP）, and to analyze their predictive value for therapeutic efficacy. Methods A total of 191 ITP patients （ITP group, modeling set） admitted to Zhuzhou Central Hospital from January 2020 to January 2025 were selected for prospective study, and another 191 healthy subjects in the same period were selected in a 1:1 ratio as the control group. MDSCs, B7-H2, Treg/Th17, bone marrow megakaryocyte morphology and platelet-associated antibodies [platelet-associated Immunoglobulin G （PAIgG）, platelet-associated Immunoglobulin A （PAIgA）, platelet-associated Immunoglobulin M （PAIgM）] were compared between the two groups. The effects of MDSCs, B7-H2 and Treg/Th17 on ITP treatment efficacy and their predictive value were analyzed. In addition, another 52 ITP patients from January 2025 to December 2025 were selected as independent external validation set to validate the combined predictive value of MDSCs, B7-H2, and Treg/Th17. Results The ITP group showed lower MDSCs, Treg, and Treg/Th17 ratio, and higher B7-H2 and Th17 levels compared to the control group （P < 0.05）. After treatment, the effective subgroup had higher MDSCs and Treg/Th17 ratio, and lower B7-H2 than the ineffective subgroup （P < 0.05）. Before treatment, MDSCs, B7-H2, and Treg/Th17 ratio were all related factors affecting the efficacy of ITP treatment （P < 0.05）. Before treatment, MDSCs and Treg/Th17 showed a positive correlation with efficacy （Ptrend <0.05, Pnonlinea>0.05）, while B7-H2 showed a negative correlation with efficacy （Ptrend < 0.05, Pnonlinea>0.05）. The combined AUC value （0.898） was significantly greater than that of MDSCs alone （0.764）, B7-H2 alone （0.739）, and Treg/Th17 alone （0.761）. In the validation set, the AUC of the combined prediction model was similar to that in the training set. Pearson correlation analysis showed that granular megakaryocytes were negatively correlated with MDSCs and Treg/Th17, and positively correlated with B7-H2 （P < 0.001）. Plate-forming megakaryocytes were positively correlated with MDSCs and Treg/Th17, and negatively correlated with B7-H2 （P < 0.001）. PAIgG, PAIgA and PAIgM were negatively correlated with MDSCs and Treg/Th17, and positively correlated with B7-H2 （P < 0.001）. Conclusion MDSCs and b7-h2 in ITP patients are closely related to Treg/Th17. The detection of these indicators has predictive value for curative effect, and combined analysis can improve the predictive efficiency.
2026, 47(7): 89-96.
doi: 10.12259/j.issn.2095-610X.S20260711
Abstract:
Objective To investigate the relationship between peripheral blood miR-409-3p, miR-6861-5p and the prognosis of patients with Hepatocellular carcinoma （HCC） after Transcatheter arterial chemoembolization （TACE）. Methods Two hundred HCC patients admitted to the Sichuan Provincial Armed Police Corps Hospital from January 2019 to April 2022 were selected as the HCC group and treated with TACE. Another 200 healthy subjects were selected in the same period as the control group. The expression levels of miR-409-3p and miR-6861-5p in peripheral blood were compared between the two groups and among HCC patients with different clinical characteristics. The expression levels of peripheral blood miR-409-3p and miR-6861-5p were compared between the two groups and patients were followed for 3 years to assess TACE treatment outcomes. Expression levels and changes of peripheral blood miR-409-3p and miR-6861-5p were compared among patients with different prognoses and treatment responses. COX regression was used to analyze the prognostic factors. Receiver operating characteristic （ROC） curves were plotted to analyze the efficacy of miR-409-3p and miR-6861-5p in predicting the prognosis of TACE treatment in HCC patients. Kaplan-Meier survival curves were used to analyze the relationship between miR-409-3p, miR-6861-5p and the prognosis of TACE in HCC patients. Results Compared with the control group, the expression level of miR-409-3p in peripheral blood in the HCC group was lower, while the expression level of miR-6861-5p was higher （P < 0.05）. Of the 200 patients followed for 3 years, 9 patients were lost to follow up. Among the remaining patients, 101 （52.88%） died from HCC. The results of multivariate COX regression analysis showed that the number of tumors, portal vein tumor thrombus, initial TACE response, subsequent systemic treatment, and the expression levels of miR-409-3p and miR-6861-5p in peripheral blood were independent prognostic factors for HCC patients （P < 0.05）. After adjusting for the number of tumors, portal vein tumor thrombus, initial TACE response, and subsequent systemic treatment, the expression of ΔmiR-409-3p and ΔmiR-6861-5p was still independently associated with the prognosis of HCC patients （P < 0.05）. ROC curve showed that the Area under the curve （AUC） of ΔmiR-409-3p and ΔmiR-6861-5p alone in predicting the prognosis of TACE was 0.766 and 0.750, respectively. The area under the curve of the combined prediction of the two markers yielded an AUC of 0.863, which was significantly larger than that of either index alone （P < 0.05）. Conclusion Peripheral blood miR-409-3p and miR-6861-5p are important potential regulatory molecules for HCC, and their dynamic changes (Δ values) before and after treatment are closely related to TACE efficacy and patient survival. The prediction model based on the Δ values of the two is expected to be used for screening high-risk patients with TACE and dynamic evaluation of efficacy.
2026, 47(7): 97-104.
doi: 10.12259/j.issn.2095-610X.S20260712
Abstract:
Objective To evaluate the predictive value of neutrophil extracellular traps （NETs）–related indicators combined with neutrophil functional indices for thrombotic complications in patients receiving extracorporeal membrane oxygenation （ECMO） support. Methods The single-center prospective cohort study consecutively enrolled 100 patients receiving ECMO-assisted therapy at the Inner Mongolia Autonomous Region People's Hospital from January 2023 to December 2024. Patients were classified into the non-thrombotic complication group and the thrombotic complication group based on the presence or absence of thrombotic complications. The total study population was further divided into the MACE group and the non-MACE group according to the incidence of MACE events. Laboratory assessments included routine blood tests, coagulation function, NETs markers [myeloperoxidase-DNA complexes （MPO-DNA） and citrullinated histone H3 （CitH3）], and neutrophil functional indices [surface markers （CD11b, CD62L） and reactive oxygen species （ROS） production]were measured. Thrombotic complications were identified through imaging examinations and clinical evaluation. The predictive value of each indicator was assessed using t-test, chi-square test, correlation analysis, and receiver operating characteristic （ROC） curve analysis. Results Among the 100 patients, 30 （30.0%） developed thrombotic complications. MPO levels were significantly higher in the thrombosis group than in the non-thrombosis group （P < 0.05）. During follow-up, 23 patients experienced MACE. Levels of MPO and ceruloplasmin （CER） were significantly higher in the MACE group （P < 0.05）. CER levels were correlated with MPO levels （r = 0.333, P < 0.001）. ROC analysis showed that MPO had better predictive performance for MACE than CER （AUC: 0.867 vs 0.856, P < 0.05）, whereas CER demonstrated better performance in predicting thrombotic complications than MPO（AUC: 0.865 vs 0.825, P < 0.05）. Conclusion NETs-related indicators combined with neutrophil functional indices have potential predictive value for thrombotic complications in ECMO-supported patients and may aid in clinical risk assessment.
2026, 47(7): 105-113.
doi: 10.12259/j.issn.2095-610X.S20260713
Abstract:
Objective To explore and construct a combined prediction model integrating clinical, CT features and radiomics for preoperative prediction of Ki-67 expression levels in stage IA lung adenocarcinoma, and to assess its diagnostic efficacy; Methods A total of 193 patients with surgically and pathologically confirmed stage IA lung adenocarcinoma from Jining First People's Hospital （January 2016 to January 2024） were retrospectively selected as the training set, and 73 patients from Yantai Yeda Hospital （May 2019 to February 2024） served as the validation set. Based on the Ki-67 index, patients were divided into high expression （Ki-67 ≥ 15%） and low expression （Ki-67<15%） groups. Tumor region of interest （ROI） were delineated with the ITK-SNAP; Radiomics features were extracted with Python 3.7.3 and R Studio 4.1.2; Univariate and multivariate logistic regression were used to analyze the clinical and CT features in both sets. Variance threshold method and LASSO regression were used to screen the radiomics features, and the predictive models were constructed through logistic regression. The risk factors of clinical and CT features are combined with radiomics features to construct a joint model and generate a nomogram. Model predictive performance was evaluated by the receiver operating characteristic curve （ROC）, calibration curve and decision curve analysis. Result The patient's gender, age, lesion characteristics, lobulation sign, and mean lesion diameter were identified as independent risk factors for elevated Ki-67 expression （P < 0.05）. The area under the curve （AUC） for the clinical model is 0.775 in the training set and 0.703 in the validation set. The AUC for the CT feature model is 0.762 in the training set and 0.747 in the validation set. The AUC for the radiomics model was 0.835 in the training set and 0.811 in the validation set, indicating a relatively high predictive efficacy. The combined model, which integrated clinical and CT feature risk factors with radiomics, achieved AUCs of 0.892 and 0.866 in the training and validation sets, respectively, surpassing the performance of the radiomics model alone.The Delong test also demonstrated statistical significance （P < 0.05）. Conclusion A model based on clinical, CT features, and radiomics allows for the preoperative prediction of Ki-67 expression levels in stage IA lung adenocarcinoma, and the combined model can enhance predictive accuracy.
2026, 47(7): 114-123.
doi: 10.12259/j.issn.2095-610X.S20260714
Abstract:
Objective To investigate the effects of metoprolol combined with experiential, multi-level interventions and exercise rehabilitation training on the short-term prognosis in patients with coronary heart disease. Methods A retrospective cohort study design was used. The study included 90 patients with coronary heart disease admitted to our hospital between January 2023 and December 2024. The patients were divided into a control group of 45 patients (receiving conventional intervention) and a study group of 45 patients (receiving metoprolol combined with an experiential, multi-level intervention model and exercise rehabilitation training). We compared echocardiographic and cardiopulmonary function parameters, ventricular remodeling, quality of life, clinical efficacy, and the incidence of adverse reactions between the two groups. Results Compared with the control group, the study group demonstrated reductions in NT-proBNP, CK-MB, cTnI, LVESV, LVEDV, LVPWT, LVMI, MLHFQ scores, total incidence of adverse reactions, and MACE incidence during and after intervention （P < 0.05）, while cardiac function, FVC, FEV1, VCmax, AT, METs, Peak VO2, WR, SF-36 scores, and overall response rate increased significantly （P < 0.05）. Conclusion The combination of metoprolol with the experiential multi-level intervention model and exercise rehabilitation training demonstrates significant therapeutic efficacy, enhancing patients' cardiopulmonary function and ventricular remodeling, reducing adverse reactions, and improving short-term prognosis in CHD patients.
2026, 47(7): 124-132.
doi: 10.12259/j.issn.2095-610X.S20260715
Abstract:
Objective To investigate the correlation of serum neutrophil extracellular traps （NETs）, forkhead box protein M1 （FOXM1）, and interleukin-17 A （IL-17A） with the progression of mycoplasma pneumoniae pneumonia （MPP） to necrotizing pneumonia in children. Methods A total of 203 pediatric patients with MPP admitted to the First Hospital of Qinhuangdao from January 2023 to December 2024 were selected as the modeling set, and they were divided into a necrotizing group （n = 39） and a non-necrosis group （n = 164） based on the presence or absence of pulmonary necrosis. Another 30 children with MPP from January 2025 to March 2025 were selected as an external validation set. Baseline data, serum levels of NETs, FOXM1, and IL-17A were compared between the two groups. Pearson correlation analysis was used to assess correlations among serum NETs, FOXM1 and IL-17A. Logistic regression analysis was used to investigate the relevant influencing factors of MPP necrotic pneumonia. Receiver Operating Characteristic （ROC） curve analysis was conducted to evaluate the predictive value of conventional indicators （duration of fever, pulmonary consolidation, white blood cell count, and their combination） and serum NETs, FOXM1, IL-17A, and their combination in predicting necrotizing pneumonia in MPP. The consistency between the predictions made by the combination of NETs, FOXM1 , and IL-17A and clinical outcomes was analyzed using the Kappa analysis. Results The necrotizing group had a longer duration of fever, a higher proportion of lung consolidation, and higher white blood cell counts than the non-necrosis group （P < 0.05）. Serum levels of NETs, FOXM1, and IL-17A were significantly higher in the necrotizing group than in the non-necrotizing group （P < 0.05）. Pearson correlation analysis showed that NETs were positively correlated with FOXM1 and IL-17 A （r = 0.194, 0.216, P = 0.006, 0.002）, and FOXM1 was positively correlated with IL-17 A （r = 0.203, P = 0.004）. Logistic regression analysis showed that after adjusting for duration of fever, lung consolidation, and white blood cell counts, serum NETs, FOXM1, and IL-17A remained independent factors associated with necrotizing pneumonia in MPP （P < 0.05）. For conventional indicators, the AUC values for duration of fever, lung consolidation, white blood cell counts, and their combination in predicting necrotizing pneumonia ranged from 0.648 to 0.854 （P < 0.05）. For serum indicators, the AUC values for NETs, FOXM1, IL-17A） and their combination ranged from 0.749 to 0.941 （P < 0.05）. The AUC of the combination of conventional indicators was significantly higher than that of fever duration, lung consolidation, and white blood cell counts alone （P < 0.05）. The AUC for the combination of NETs, FOXM1, and IL-17A was significantly higher than that for any single serum indicator （P < 0.05）, and significantly higher than that for the combination of conventional indicators （P < 0.05）. Conclusion Serum NETs, FOXM1, and IL-17A are associated with the progression of MPP to necrotizing pneumonia in children. The combined detection of these three biomarkers can improve the predictive efficacy for necrotizing pneumonia.
2026, 47(7): 133-141.
doi: 10.12259/j.issn.2095-610X.S20260716
Abstract:
Recurrent spontaneous abortion （RSA） is a common reproductive disorder affecting approximately 2%～5% of women of childbearing age. Recent studies have indicated that abnormalities in homocysteine （Hcy） metabolism, particularly hyperhomocysteinemia （HHcy）, may play an important role in the onset and progression of RSA. By systematically reviewing relevant studies from both domestic and international sources, this article summarizes the metabolic regulation of Hcy and its dynamic changes during pregnancy, with a focus on recent advances in understanding the involvement of HHcy in the pathogenesis of RSA through multiple pathways, including vascular endothelial dysfunction, oxidative stress, immunothrombotic dysregulation, trophoblast dysfunction, and epigenetic modifications. In addition, the roles of Hcy metabolism-related genetic polymorphisms （such as MTHFR, MTRR, and CBS）, as well as nutritional and lifestyle factors, in the development of HHcy are analyzed. The potential significance of folic acid and vitamin B12 supplementation in lowering Hcy levels and improving pregnancy outcomes is also discussed. In conclusion, HHcy may represent an important but often overlooked metabolic risk factor for RSA. In summary, early screening and individualized nutritional interventions in high-risk populations may help improve pregnancy outcomes.
Recurrent spontaneous abortion （RSA） is a common reproductive disorder affecting approximately 2%～5% of women of childbearing age. Recent studies have indicated that abnormalities in homocysteine （Hcy） metabolism, particularly hyperhomocysteinemia （HHcy）, may play an important role in the onset and progression of RSA. By systematically reviewing relevant studies from both domestic and international sources, this article summarizes the metabolic regulation of Hcy and its dynamic changes during pregnancy, with a focus on recent advances in understanding the involvement of HHcy in the pathogenesis of RSA through multiple pathways, including vascular endothelial dysfunction, oxidative stress, immunothrombotic dysregulation, trophoblast dysfunction, and epigenetic modifications. In addition, the roles of Hcy metabolism-related genetic polymorphisms （such as MTHFR, MTRR, and CBS）, as well as nutritional and lifestyle factors, in the development of HHcy are analyzed. The potential significance of folic acid and vitamin B12 supplementation in lowering Hcy levels and improving pregnancy outcomes is also discussed. In conclusion, HHcy may represent an important but often overlooked metabolic risk factor for RSA. In summary, early screening and individualized nutritional interventions in high-risk populations may help improve pregnancy outcomes.
2026, 47(7): 142-152.
doi: 10.12259/j.issn.2095-610X.S20260717
Abstract:
Bisphenol A （BPA） is an estrogen-like compound widely present in daily life and is one of the compounds extensively studied for its harmful effects on human health. In recent years, increasing attention has been paid to the negative impact of BPA on female reproductive health. Accumulating evidence indicates that BPA impairs endometrial receptivity, ovarian function, and oocyte quality through multiple mechanisms, such as interfering with hormone signaling, inducing oxidative stress and inflammation, and disrupting epigenetic regulation. Furthermore, BPA has been shown to exert transgenerational effects. This article summarizes the sources and metabolism of BPA, its effects on endometrial receptivity, its damage to the ovaries and oocytes, and its transgenerational effects. Provide novel insights into the effects of BPA on female reproductive health.
Bisphenol A （BPA） is an estrogen-like compound widely present in daily life and is one of the compounds extensively studied for its harmful effects on human health. In recent years, increasing attention has been paid to the negative impact of BPA on female reproductive health. Accumulating evidence indicates that BPA impairs endometrial receptivity, ovarian function, and oocyte quality through multiple mechanisms, such as interfering with hormone signaling, inducing oxidative stress and inflammation, and disrupting epigenetic regulation. Furthermore, BPA has been shown to exert transgenerational effects. This article summarizes the sources and metabolism of BPA, its effects on endometrial receptivity, its damage to the ovaries and oocytes, and its transgenerational effects. Provide novel insights into the effects of BPA on female reproductive health.
2026, 47(7): 153-163.
doi: 10.12259/j.issn.2095-610X.S20260718
Abstract:
Objective To investigate nurses' mastery of the group standards for Feeding Care for Patients with Post-Stroke Dysphagia and to identify the relevant influencing factors. Method A stratified random sampling method was employed to enroll registered nurses in the neurology, neurosurgery, rehabilitation, geriatrics, and cerebrovascular disease departments of 32 tertiary hospitals across 16 prefectures and cities in Yunnan Province between August and October 2025. A self-designed questionnaire was designed based on the group standards for Feeding Nursing for Patients with Post-Stroke Dysphagia and used to conduct the investigation. Multiple linear regression analysis was performed to explore the factors influencing nurses’ mastery of knowledge and skills related to feeding nursing for patients with post-stroke dysphagia. Result A total of 1, 671 valid questionnaires were recovered. Among them, only 49.79% of nurses were aware of the release date of the group standards, and 35.85% had received systematic training on this standard.The mean scores of knowledge and skills were 162.55 ± 28.96 and 45.47 ± 8.10, respectively. Multiple linear regression analysis revealed that nurses’ level of knowledge mastery was mainly associated with gender, age, department, professional title, and whether the department implemented nursing practice in accordance with the group standard （P < 0.05）. The level of skill mastery was associated with multiple factors, including professional title, whether the nurse was a specialized nurse, whether they had direct experience in caring for relevant patients, whether they had studied the group standard or knew its release date, and learning approaches （P < 0.05）. Conclusion Nurses achieved a moderate level of cognition of the group standards for Feeding Nursing of Stroke Patients with Dysphagia, and their practical skills were rated as moderately above average. Knowledge level was correlated with gender, age, department, professional title and departmental implementation of the standard. Practical skills were affected by professional title, specialist nurse identity, direct patient care experience, familiarity with and learning of the standard, as well as learning approaches.
2026, 47(7): 164-173.
doi: 10.12259/j.issn.2095-610X.S20260719
Abstract:
Objective To evaluate the current clinical application of evidence for preventing nasal mucosal pressure injury in patients with nasal catheterization in the intensive care unit, develop audit criteria, analyze obstacles and facilitating factors, and formulate corresponding improvement strategies. Methods According to the JBI evidence-based healthcare model, best nursing strategies for the prevention of nasal mucosal pressure injury in patients with nasal tube placement were developed. Corresponding audit criteria were formulated, and a clinical audit was conducted from March to June 2025, involving 60 ICU patients with nasal tube placement and 27 nurses from the Department of Critical Care Medicine in a tertiary hospital in Kunming. According to the i-PARIHS conceptual framework, obstacles and facilitators during the implementation phase were analyzed from three aspects: "innovation, recipients and context", and the corresponding implementation strategies were constructed. Results A total of 20 pieces of best evidences were ultimately included, based on which 30 audit criteria were developed. Only 8 criteria achieved 100% clinical compliance, 9 criteria had compliance rate below 60%, and another 11 criteria had a clinical compliance rate of zero. Major obstacles included the lack of corresponding evaluation and nursing process, insufficient attention to nasal care among nursing staff, and immature training and assessment mechanisms. Facilitators included positive attitude of nurses, good cooperation between medical and nursing care, strong support from change leaders, and a solid scientific research foundation. After implementing the targeted strategies, 27 of the 30 audit criteria reached 100% compliance. Conclusion There is a significant gap between the evidence for the prevention of nasal mucosal pressure injury and its clinical application. Accurately identifying facilitators and obstacles in the implementation process and implementing targeted interventions can effectively promote the integration of evidence-based practices into clinical care.
2026, 47(7): 174-182.
doi: 10.12259/j.issn.2095-610X.S20260720
Abstract:
Objective To explore the current status of fear of falling in elderly patients with debilitating diseases and analyze its influencing factors. Methods An explanatory mixed-methods design was adopted. Through convenience sampling, a total of 335 elderly debilitated patients hospitalized in the department of geriatrics a tertiary hospital in Yunnan Province from January 2025 to October 2025 were enrolled as participants. Data were collected using a general Information Questionnaire, the Morse Balance Scale, the Self-Rating Anxiety Scale, the Self-Rating Depression Scale and the Modified Fear of Falling Questionnaire. Multiple linear regression analysis was used to identify the influencing factors of Fear of Falling in elderly debilitated patients. Semi-structured interviews were conducted with 16 elderly debilitated patients by purposive sampling and the interview data were analyzed qualitatively. Results The mean score of fear of falling in frail elderly patients was 42.88 ± 3. 65. The mean scores of anxiety and depression were 41.17 ± 10. 83 and 44.21 ± 8. 92 respectively. Multiple linear regression showed that gender, monthly income, age, emotional status, weekly exercise frequency, number of disease types, Morse score and daily sleep duration were the main influencing factors of fear of falling in elderly debilitated patients （P < 0.05）. The qualitative study refined four themes: the dual challenges of physical frailty and disease onset, self-suggestion caused by the fall experience; lack of a safe and comfortable external environment; and incomplete understanding of information. The integrated results show that the quantitative and qualitative findings mutually validated and supplemented each other. Conclusion The level of fear of falling in elderly debilitated patients is moderately high, influenced by both individual and environmental factors. Healthcare providers should implement targeted nursing interventions for this population.
