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2026, Volume 47, Issue 9
2026,
47(9):
1-18.
doi: 10.12259/j.issn.2095-610X.S20260901
Abstract:
Quality of life （QoL） among ethnic minority residents in Yunnan Province is shaped by multiple factors, including disease status, functional status, regional development, access to health services, social support, and cultural context. This review aimed to systematically synthesize evidence on assessment instruments, major QoL characteristics, associated factors, and interventions. A systematic search of the China National Knowledge Infrastructure （CNKI）, Wanfang Data, the Chinese Biomedical Literature Service System （SinoMed）, PubMed, and the Web of Science Core Collection was conducted, and 56 eligible reports representing 50 independent studies were included. The included studies focused primarily on older adults and patients with chronic diseases, with relatively limited attention to children and adolescents, ethnic groups with relatively small populations, and other special populations. The 36-item short form health survey （SF-36）, the World Health Organization quality of life brief version （WHOQOL-BREF）, and the EuroQol five-dimensional questionnaire （EQ-5D） were commonly used assessment instruments. However, most studies directly applied existing Chinese-language versions. QoL varied substantially across ethnic groups, regions, and populations. Some ethnic groups showed relative strengths in social relationships, community support, and psychological adaptation, but relative weaknesses in physical functioning, general health, pain or discomfort, environmental conditions, and access to health services. Chronic diseases, age-related functional decline, psychological distress, and lower levels of education and income were repeatedly reported as factors associated with poorer QoL across ethnic groups, whereas family support, mutual assistance within communities, and cultural identity may be associated with better QoL. Existing studies were predominantly single-region cross-sectional surveys, and evidence on interventions was limited and derived mainly from populations with specific diseases. Future research should expand ethnic and regional coverage, conduct more longitudinal studies, strengthen evaluations of the cultural applicability of assessment instruments, and further investigate factors associated with QoL and relevant intervention strategies among ethnic minority residents, thereby providing evidence to inform efforts to improve their QoL.
Quality of life （QoL） among ethnic minority residents in Yunnan Province is shaped by multiple factors, including disease status, functional status, regional development, access to health services, social support, and cultural context. This review aimed to systematically synthesize evidence on assessment instruments, major QoL characteristics, associated factors, and interventions. A systematic search of the China National Knowledge Infrastructure （CNKI）, Wanfang Data, the Chinese Biomedical Literature Service System （SinoMed）, PubMed, and the Web of Science Core Collection was conducted, and 56 eligible reports representing 50 independent studies were included. The included studies focused primarily on older adults and patients with chronic diseases, with relatively limited attention to children and adolescents, ethnic groups with relatively small populations, and other special populations. The 36-item short form health survey （SF-36）, the World Health Organization quality of life brief version （WHOQOL-BREF）, and the EuroQol five-dimensional questionnaire （EQ-5D） were commonly used assessment instruments. However, most studies directly applied existing Chinese-language versions. QoL varied substantially across ethnic groups, regions, and populations. Some ethnic groups showed relative strengths in social relationships, community support, and psychological adaptation, but relative weaknesses in physical functioning, general health, pain or discomfort, environmental conditions, and access to health services. Chronic diseases, age-related functional decline, psychological distress, and lower levels of education and income were repeatedly reported as factors associated with poorer QoL across ethnic groups, whereas family support, mutual assistance within communities, and cultural identity may be associated with better QoL. Existing studies were predominantly single-region cross-sectional surveys, and evidence on interventions was limited and derived mainly from populations with specific diseases. Future research should expand ethnic and regional coverage, conduct more longitudinal studies, strengthen evaluations of the cultural applicability of assessment instruments, and further investigate factors associated with QoL and relevant intervention strategies among ethnic minority residents, thereby providing evidence to inform efforts to improve their QoL.
2026,
47(9):
19-32.
doi: 10.12259/j.issn.2095-610X.S20260902
Abstract:
Heterogeneous vancomycin-intermediate Staphylococcus aureus （hVISA） harbors minor resistant subpopulations that routinely evade detection by conventional susceptibility testing and represent a principal driver of clinical failure in vancomycin-based therapy. This organism develops intermediate resistance through a multilayered regulatory network: crosstalk between the WalKR and GraSR two-component systems hyperactivates peptidoglycan biosynthesis, leading to pronounced cell wall thickening that serves as a physical barrier to antibiotic penetration. Under antimicrobial stress, the strain initiates metabolic reprogramming of amino acid and purine pathways; in parallel, the mgrA-agr regulatory axis, acting in concert with biofilm formation, synergistically enhances both resistance and virulence. Sustained vancomycin selection drives convergent evolution, generating stably transmissible resistant clones that simultaneously exhibit cross-resistance to lipoglycopeptides and collateral sensitivity to β-lactams. The population analysis profile-area under the curve （PAP-AUC） remains the reference standard for detection; however, its labor-intensive procedure limits rapid screening applications. Emerging techniques, particularly single-cell sequencing and CRISPR-Cas9-based genome-wide screening, offer new opportunities for dissecting the mechanisms of hVISA heteroresistance. On the basis of available evidence, this review proposes two conceptual models—the "cell wall stress-threshold response" model and the "metabolic burden-collateral sensitivity trade-off" model—to explain the emergence of resistant subpopulations and the collateral sensitivity phenotype, respectively. An integrative systems-biology approach to deciphering multilayer regulatory networks is expected to provide a theoretical framework for optimizing rapid diagnostic algorithms, identifying novel anti-staphylococcal targets, and formulating evidence-based infection control strategies.
Heterogeneous vancomycin-intermediate Staphylococcus aureus （hVISA） harbors minor resistant subpopulations that routinely evade detection by conventional susceptibility testing and represent a principal driver of clinical failure in vancomycin-based therapy. This organism develops intermediate resistance through a multilayered regulatory network: crosstalk between the WalKR and GraSR two-component systems hyperactivates peptidoglycan biosynthesis, leading to pronounced cell wall thickening that serves as a physical barrier to antibiotic penetration. Under antimicrobial stress, the strain initiates metabolic reprogramming of amino acid and purine pathways; in parallel, the mgrA-agr regulatory axis, acting in concert with biofilm formation, synergistically enhances both resistance and virulence. Sustained vancomycin selection drives convergent evolution, generating stably transmissible resistant clones that simultaneously exhibit cross-resistance to lipoglycopeptides and collateral sensitivity to β-lactams. The population analysis profile-area under the curve （PAP-AUC） remains the reference standard for detection; however, its labor-intensive procedure limits rapid screening applications. Emerging techniques, particularly single-cell sequencing and CRISPR-Cas9-based genome-wide screening, offer new opportunities for dissecting the mechanisms of hVISA heteroresistance. On the basis of available evidence, this review proposes two conceptual models—the "cell wall stress-threshold response" model and the "metabolic burden-collateral sensitivity trade-off" model—to explain the emergence of resistant subpopulations and the collateral sensitivity phenotype, respectively. An integrative systems-biology approach to deciphering multilayer regulatory networks is expected to provide a theoretical framework for optimizing rapid diagnostic algorithms, identifying novel anti-staphylococcal targets, and formulating evidence-based infection control strategies.
2026,
47(9):
33-45.
doi: 10.12259/j.issn.2095-610X.S20260903
Abstract:
Postoperative meningitis in neurosurgery poses significant challenges in diagnosis and treatment owing to its complex pathogenesis, nonspecific clinical manifestations, a diverse pathogen spectrum, and marked antimicrobial resistance. This review centers on the core pathophysiological mechanisms, including disruption of anatomical barriers and cerebrospinal fluid leakage, implant-associated biofilm formation, host susceptibility, and nosocomial infections. It systematically delineates the evolving etiological characteristics, with particular emphasis on recent advances in rapid pathogen detection technologies—such as metagenomic next-generation sequencing （mNGS） and multiplex PCR—as well as the clinical application of empirical antimicrobial therapy, pathogen-targeted therapy, and intraventricular drug administration. Furthermore, the review highlights the pivotal role of surgical source control （e.g., removal of infected materials, management of external ventricular drains, and repair of cerebrospinal fluid leaks） and multidisciplinary collaboration in refractory cases. Finally, it discusses the development of preventive systems and future directions, including artificial intelligence and nano-based drug delivery, and proposes a clinical pathway transitioning from empirical management to precision individualized therapy, thereby providing a reference for the comprehensive management of postoperative meningitis in neurosurgery.
Postoperative meningitis in neurosurgery poses significant challenges in diagnosis and treatment owing to its complex pathogenesis, nonspecific clinical manifestations, a diverse pathogen spectrum, and marked antimicrobial resistance. This review centers on the core pathophysiological mechanisms, including disruption of anatomical barriers and cerebrospinal fluid leakage, implant-associated biofilm formation, host susceptibility, and nosocomial infections. It systematically delineates the evolving etiological characteristics, with particular emphasis on recent advances in rapid pathogen detection technologies—such as metagenomic next-generation sequencing （mNGS） and multiplex PCR—as well as the clinical application of empirical antimicrobial therapy, pathogen-targeted therapy, and intraventricular drug administration. Furthermore, the review highlights the pivotal role of surgical source control （e.g., removal of infected materials, management of external ventricular drains, and repair of cerebrospinal fluid leaks） and multidisciplinary collaboration in refractory cases. Finally, it discusses the development of preventive systems and future directions, including artificial intelligence and nano-based drug delivery, and proposes a clinical pathway transitioning from empirical management to precision individualized therapy, thereby providing a reference for the comprehensive management of postoperative meningitis in neurosurgery.
2026,
47(9):
46-53.
doi: 10.12259/j.issn.2095-610X.S20260904
Abstract:
Objective This study aims to explore the interplay between autophagy and apoptosis in heart failure （HF） induced by pressure overload. Methods SD rats aged 6 weeks were used, and the EP model was established by pilocarpine induction. They were randomly divided into Sham group, EP model group and lv-ATF4 group （n = 10）. qRT-PCR was used to detect the expression levels of activating transcription factor 4 （ATF4） and tribble homologue 3 （TRIB3） in EP rats. Morris water maze and Racine score were used to evaluate the severity of epilepsy in rats. Nissl and HE staining were performed to observe the morphological structure of hippocampal tissue. TUNEL assay was used to detect the apoptosis of hippocampal neurons. Western blot was applied to detect the expression of mitochondrial unfolded protein response （mtUPR）-related proteins. The mitochondrial function indexes in hippocampal tissue were determined by assay kits. Results The expression of ATF4 and TRIB3 was decreased in the brain tissue of EP rats, and overexpression of ATF4 significantly promoted the expression of TRIB3.The Racine score and escape latency in the EP group were higher than those in the Sham group （P < 0.05）, while the number of crossings of the original platform was lower than that in the Sham group （P < 0.05）. The Racine score and escape latency in the lv-ATF4 group were lower than those in the EP group （P < 0.05）, and the number of crossings of the original platform was higher than that in the Sham group （P < 0.05）.In addition, overexpression of ATF4 reversed the pathological damage and hippocampal neuronal apoptosis in the hippocampal CA1 region of EP rats.The expression of mtUPR-related proteins and mitochondrial function indexes in the hippocampal tissue of the lv-ATF4 group were increased compared with the EP group （P < 0.05）. Conclusion The ATF4/TRIB3 pathway was involved in the damage of hippocampal neurons and the protein response of mtUPR.
2026,
47(9):
54-66.
doi: 10.12259/j.issn.2095-610X.S20260905
Abstract:
Objective To establish an in vitro co-culture model of Jurkat cells and lung cancer cells, and to evaluate the in vitro anti-tumor activity of PD-1/PD-L1 inhibitors combined with cisplatin. Methods Activated Jurkat cells were co-cultured with HCC95 and A549 cells at different ratios, respectively. The experiment was divided into a cisplatin monotherapy group and combination therapy groups （cisplatin combined with camrelizumab, tislelizumab, or toripalimab）. After 24 hours of intervention, cell viability, apoptosis rate, and the expression/secretion levels of PD-1, PD-L1, IL-2, and IFN-γ were detected using CCK-8 assay, flow cytometry, Western blot, and ELISA. Results The in vitro co-culture models of Jurkat/A549 （ratio 5∶1） and Jurkat/HCC95 （ratio 3∶1） were successfully established. After drug administration, compared with the cisplatin monotherapy group, the viability and PD-L1 expression of lung cancer cells in the combination therapy groups were significantly decreased （P < 0.05）, and the apoptosis rates were significantly increased （P < 0.01）. Furthermore, in the camrelizumab and tislelizumab combination groups, the viability of Jurkat cells, as well as the PD-1 expression and IFN-γ secretion levels, were significantly increased （P < 0.05）. Conclusion PD-1/PD-L1 inhibitors combined with cisplatin exhibit a significant synergistic anti-tumor effect in the in vitro lung cancer model.
2026,
47(9):
67-77.
doi: 10.12259/j.issn.2095-610X.S20260906
Abstract:
Objective To explore the effect of propofol on pain relief in rats with knee osteoarthritis （KOA） and its regulatory mechanism on the microRNA-142-3p （miR-142-3p）/Ras-related C3 botulinum toxin substrate 1 （RAC1）/nuclear factor-κB （NF-κB） axis. Methods A rat knee osteoarthritis model was established by surgically transecting the anterior cruciate ligament, medial collateral ligament, and medial meniscus, with intervention by miR-142-3p antagomir or propofol. Following the conclusion of the intervention, the mechanical pain withdrawal threshold in rats was assessed. Enzyme-linked immunosorbent assay （ELISA） was employed to detect levels of substance P （SP）, calcitonin gene-related peptide （CGRP）, tumour necrosis factor-α （TNF-α）, interleukin （IL）-1β, IL-4 and IL-10 levels in rat serum. Modified Lequesne MG score for assessing knee joint function. Immunofluorescence detection of ionized calcium-binding adaptor molecule 1 （IBA-1） , an activational marker of microglia, in spinal cord tissue. Quantitative real-time reverse transcription polymerase chain reaction （qRT-PCR） was employed to determine the relative expression levels of inducible nitric oxide synthase （iNOS）, arginase 1 （Arg-1）, and miR-142-3p in spinal cord tissue. Western blot analysis of RAC1, p-NF-κB p65 and NF-κB p65 protein expression levels in spinal cord tissue. Results Compared with the KOA group, rats in the miR-142-3p antagomir group exhibited a reduced mechanical pain threshold （P < 0.05）, increased Lequesne MG scores and serum levels of SP, CGRP, TNF-α, and IL-1β （P < 0.05）, serum IL-4 and IL-10 levels, and spinal cord tissue Arg-1 and miR-142-3p expression levels decreased （P < 0.05）. Spinal cord tissue IBA-1 fluorescence intensity, iNOS mRNA expression levels, and RAC1 and p-NF-κB p65 protein expression levels increased （P < 0.05）. The propofol group exhibited increased mechanical pain thresholds in rats （P < 0.05）, reduced Lequesne MG scores and serum levels of SP, CGRP, TNF-α, and IL-1β （P < 0.05）, serum IL-4 and IL-10 levels, and spinal cord tissue Arg-1 and miR-142-3p expression levels increased （P < 0.05）. Spinal cord tissue IBA-1 fluorescence intensity, iNOS mRNA expression levels, and RAC1 and p-NF-κB p65 protein expression levels decreased （P < 0.05）. Compared with the miR-142-3p antagomir group, the propofol group and the propofol+miR-142-3p antagomir group demonstrated significant improvement in the aforementioned indicators in rats （P < 0.05）. The miR-142-3p antagomir partially reversed the ameliorative effects of propofol in KOA rats （P < 0.05）. Conclusion Propofol may inhibit the M1 polarization of microglia, promote the M2 polarization, exert anti-inflammatory effect and inhibit the pain response of KOA rats by regulating the miR-142-3p/RAC1/NF-κB axis.
2026,
47(9):
78-88.
doi: 10.12259/j.issn.2095-610X.S20260907
Abstract:
Objective To investigate the effects of dexmedetomidine （DEX） combined with sufentanil （SUF） on pain sensitization and spinal inflammatory responses in rats with incisional pain. Methods Incisional pain models were established in rats. The mechanical paw withdrawal threshold （PWT） and cumulative pain score （CPS） of rats in each group, as well as the levels of inflammatory cytokines in spinal cord tissues, were measured. Immunofluorescence was used to detect the level of Iba-1-positive cells. RT-PCR was employed to assess the mRNA expression levels of SIRPα and CD47. Western blotting was conducted to examine the polarization of microglia and the protein expression levels related to the SIRPα/CD47 pathway. Results PWT measurement and CPS assessment demonstrated that dexmedetomidine combined with sufentanil significantly increased the PWT values and decreased the CPS values in rats （P < 0.05）. Enzyme-linked immunosorbent assay （ELISA） results revealed that dexmedetomidine combined with sufentanil significantly elevated the levels of interleukin （IL）-10 and reduced the levels of IL-1β and IL-6 in rats （P < 0.05）. Immunofluorescence results showed that dexmedetomidine combined with sufentanil significantly decreased the number of Iba-1-positive cells （P < 0.05）. RT-PCR results indicated that dexmedetomidine combined with sufentanil significantly promoted the mRNA expression levels of SIRPα and CD47 in rats （P < 0.05）. Western blot results demonstrated that dexmedetomidine combined with sufentanil significantly enhanced the protein expression levels of arginase-1 （Arg1） and scavenger receptor cluster of differentiation 163 （CD163）, while reducing the protein expression levels of Fcγ receptor II （cluster of differentiation 32, CD32） and Fcγ receptor III （cluster of differentiation 16, CD16） in rats （P < 0.05）. Conclusion Dexmedetomidine combined with sufentanil alleviates pain sensitization and reduces spinal inflammatory cytokines in rats with incisional pain by activating the SIRPα/CD47 pathway and inhibiting the M1 polarization of microglia.
2026,
47(9):
89-96.
doi: 10.12259/j.issn.2095-610X.S20260908
Abstract:
Objective To establish a nomogram model for predicting abnormal bone mass in diabetic patients. Methods A total of 944 diabetic patients who underwent health checkups at the Affiliated Hospital of Southwest Jiaotong University （Chengdu Third People's Hospital） from January 2024 to January 2025, were selected. The patients were divided into a training set （n = 661） and a validation set （n = 283） in a 7∶3 ratio. The training group was further categorized into normal and abnormal bone mass groups based on T-scores/Z-scores. Various indicators were compared between the two groups, and potential factors were screened using LASSO regression. Logistic regression was then performed to establish a nomogram, which was subsequently validated. Results Among the 661 patients in the training set, 323 （48.87%） exhibited abnormal bone mass. Logistic regression analysis based on LASSO regression results showed that male sex, age, glycated hemoglobin, uric acid, and type I procollagen N-terminal propeptide （PINP） were the independent risk factors for abnormal bone mass in diabetic patients, while BMI served as a protective factor （P < 0.05）. The AUC for predicting abnormal bone mass in diabetic patients was 0.804 （95%CI: 0.771～0.837） in the training set, with a sensitivity of 73.1% and a specificity of 74.9%. In the validation set, the AUC was 0.774 （95%CI: 0.739～0.810）, with a sensitivity of 75.9% and a specificity of 65.1%. The prediction curve closely matched the standard curve, and the decision curve analysis indicated that the patient benefit rate was highest when the model-predicted probability ranged from 0.15 to 0.95. Conclusion Abnormal bone mass in diabetic patients is primarily influenced by factors such as sex, age, and BMI. The nomogram model established based on these factors can effectively predict the risk of abnormal bone mass in diabetic patients.
2026,
47(9):
97-105.
doi: 10.12259/j.issn.2095-610X.S20260909
Abstract:
Objective To understand the core knowledge of cancer prevention and control and its influencing factors of residents living in Yunnan-Province ethnic minority area , for putting forward targeted countermeasures and recommendations. Methods A cross-sectional study was conducted in eight ethnic minority areas in Yunnan Province from September to December 2022, multi-stage probability sampling was used to recruit participants, and their demographic characteristics were collected, the five core areas of cancer prevention and control knowledge: basic knowledge, prevention, early-stage diagnosis and treatment, health management and rehabilitation was included. A binary logistics regression model with the stepwise conditional method was employed to identify the influencing factors asscoiated with the core knowledge of cancer prevention and control. Results A total of 3507 participants were included in this study, and the overall rate of awareness was 52.07%（95%CI: 50.42%～53.72%）. The ethnicity, city/prefecture of residence, education level, occupation, family history of cancer, self-assessment of health status, and whether participated in cancer screening were significantly associated with the awareness rate of cancer prevention knowledge. Conclusions The overall awareness rate of cancer prevention and control is low among eight ethnic minority regions of Yunnan Province. In addition, ethnicity, city/prefecture of residence, education level, occupation, family history of cancer, self-assessment of health status, and whether participated in cancer screening were found to influence residents' core knowledge of cancer prevention and control.
2026,
47(9):
106-121.
doi: 10.12259/j.issn.2095-610X.S20260910
Abstract:
Objective To investigate the distribution characteristics of the Coronal Plane Alignment of the Knee （CPAK） classification in patients with knee osteoarthritis （KOA） and healthy individuals in Yunnan, China. Methods A total of 243 KOA patients (263 knees) enrolled in Yunnan from January 2021 to July 2025 were assigned to the KOA group, and 69 healthy young adults (138 knees) enrolled from September 2023 to February 2025 served as the healthy group. Based on parameters including the hip-knee-ankle angle （HKA）, lateral distal femoral angle （LDFA）, and medial proximal tibial angle （MPTA）, the arithmetic hip-knee-ankle angle （aHKA） and joint line obliquity （JLO） were calculated to determine the CPAK classification. Differences in classification distribution among subgroups were compared. Results The healthy group was predominantly composed of CPAK type 2 （37.7%）, type 1 （23.9%）, and type 3 （17.4%）, with no cases of types 7, 8, or 9. The KOA group was mainly composed of CPAK type 1 （53.2%） and type 4 （22.1%）, with no cases of type 8 and only one case of type 9. After adjusting for age, BMI, and gender, no statistically significant differences were found in any CPAK type between the two groups （P > 0.05）. In the healthy group, there were no significant differences in CPAK distribution between genders （P > 0.05）, and bilateral consistency of CPAK classification was only 39.1%. In the KOA group, no significant differences in CPAK types were observed among subgroups stratified by gender, age （<65 years vs. ≥65 years）, or BMI （<25 kg/m2 vs. ≥25 kg/m2） （P > 0.05）, with type 1 and type 4 being predominant in all subgroups. The proportion of constitutional varus in the KOA group （77.6%） was significantly higher than that in the healthy group （32.6%）. Compared with the healthy group, the KOA group had lower MPTA, higher LDFA, and higher aHKA （P < 0.001）. Conclusions The most common distributions in Yunnan healthy and osteoarthritic populations were types 2 and 1, respectively. Gender, BMI, and age do not affect the distribution of CPAK types. The contralateral limb should not be used as a reliable reference for coronal alignment planning in total knee arthroplasty.
2026,
47(9):
122-130.
doi: 10.12259/j.issn.2095-610X.S20260911
Abstract:
Objective To explore the risk factors for recurrence in patients after endoscopic gastrointestinal polypectomy, and to evaluate the intervention effect of the informatized hierarchical management model on patients with recurrence based on these risk factors. Methods A retrospective selection was made of 234 patients who underwent endoscopic gastrointestinal polyp removal at the First Affiliated Hospital of Air Force Military Medical University from June 2022 to May 2024 as the research subjects. The ratio of patients with postoperative recurrence to those without recurrence was approximately 1:1.3 (100 cases with recurrence and 134 cases without recurrence). Based on the postoperative recurrence situation, in order to reduce the baseline difference between the groups, To enhance the statistical efficiency of the research, 100 patients without recurrence were selected at a ratio of 1:1 as the non-recurrence group. Collect general information of patients [gender, age, body mass index (BMI), history of smoking and drinking, hypertension, diabetes, cardiovascular diseases, helicobacter pylori] [Hp)], clinical data (polyp location, type, number, diameter, shape) and laboratory indicators [gastrin (GAS), motilin (MTL), pepsinogen Ⅰ (PGⅠ), pepsinogen Ⅱ (pepsinogen Ⅱ) [PGⅡ), growth hormone-releasing peptide (Ghrelin)]. Logistic regression analysis was used to determine the independent risk factors. Meanwhile, 100 patients in the recurrence group were randomly divided into the observation group and the control group, with 50 cases in each group. The control group received conventional management, while the observation group adopted the information-based hierarchical management model. The differences in complications, management quality, self-care ability and negative emotions between the two groups were compared. Results Multivariate logistic regression analysis showed that villous tubular adenoma, number of polyps, age, BMI, GAS, MTL, PG I, PG II, and ghrelin were independent risk factors for recurrence after endoscopic gastrointestinal polypectomy （P < 0.05）. The total incidence of adverse reactions and the scores of negative emotions in the observation group were lower than those in the control group, while the scores of management quality and self-care ability in the observation group were higher than those in the control group, with statistically significant differences （P < 0.05）. Conclusion Villous tubular adenoma, number of polyps, age, BMI, GAS, MTL, PG I, PG II, and ghrelin are independent risk factors for recurrence after endoscopic gastrointestinal polypectomy. The information-based hierarchical management model can reduce adverse reactions and improve management quality and patients’ self-care ability.
2026,
47(9):
131-139.
doi: 10.12259/j.issn.2095-610X.S20260912
Abstract:
Objective To investigate the correlation between serum microRNA-125b-5p （miR-125b-5p）, cardiac function indexes and myocardial injury in patients with heart failure with preserved ejection fraction （HFpEF）, and their predictive value for major adverse cardiovascular events （MACEs）. Methods A total of 225 patients with HFpEF treated in Hengshui People’ s Hospital from December 2023 to April 2025 were selected. According to New York Heart Association （NYHA） cardiac function classification, they were divided into class Ⅱ group （67 cases）, class Ⅲ group （98 cases） and class Ⅳ group （60 cases）. Serum miR-125b-5p, cardiac troponin I （cTnI）, N-terminal pro-B-type natriuretic peptide （NT-proBNP）, left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVEDD）, left ventricular mass index （LVMI）, T1 mapping and extracellular volume fraction （ECV） were detected in each group. All patients were followed up for 12 months, and the occurrence of MACEs was recorded. The patients were divided into MACEs group （67 cases） and non-MACEs group （158 cases）. Collect clinical data from patients in each group and compare levels of serum miR-125b-5p, cardiac function, and markers of myocardial injury; Pearson correlation analysis of the relationship between miR-125b-5p, cardiac function-related indicators, and myocardial injury; Multivariate logistic regression analysis was performed to identify risk factors for MACE in patients with HFpEF; receiver operating characteristic （ROC） curves were used to evaluate the predictive value of miR-125b-5p and cardiac function indices for cardiovascular adverse events in patients with HFpEF. Results Compared with the Class II group, the Class III and IV groups showed decreased LVEF and miR-125b-5p levels, as well as elevated levels of cardiac troponin I （cTnI）, N-terminal pro-B-type natriuretic peptide （N-terminal pro-B-type natriuretic peptide, NT-proBNP）, left ventricular end-diastolic diameter （LVEDD）, and left ventricular mass index （LVMI）, while T1 mapping and extracellular volume fraction （ECV） values were all elevated; Compared with the Grade III group, the Grade IV group showed decreased levels of miR-125b-5p and left ventricular ejection fraction （LVEF）, as well as increased levels of cTnI, NT-proBNP, LVEDD, and LVMI, along with elevated T1 mapping and ECV values （P < 0.05）. Logistic regression analysis revealed that, after adjusting for confounding factors, LVEF, HDL-C, hematocrit, cTnI, NT-proBNP, and miR-125b-5p were all risk factors for the occurrence of MACE in patients with HFpEF; Pearson correlation analysis revealed that cTnI, NT-proBNP, T1 mapping, and ECV were negatively correlated with LVEF and miR-125b-5p, and positively correlated with LVMI and LVEDD （P < 0.05）. The ROC curve showed that the combined assessment of LVEF, LVMI, LVEDD, and miR-125b-5p had higher AUC values, sensitivity, and accuracy for predicting the occurrence of MACEs than any single parameter （P < 0.05）. Conclusion Patients with HFpEF have reduced serum miR-125b-5p levels and abnormal cardiac function parameters, which are associated with myocardial injury; combined testing of miR-125b-5p and cardiac function parameters has high predictive value for the occurrence of MACE in these patients.
2026,
47(9):
140-150.
doi: 10.12259/j.issn.2095-610X.S20260913
Abstract:
Objective To observe the accelerated rehabilitation effects of myofascial trigger point （MTrPs） manual massage combined with periodic phased rehabilitation training following total knee arthroplasty （TKA）. Methods A total of 116 patients who underwent TKA at Foshan Hospital of Traditional Chinese Medicine from January 2020 to January 2025 were selected and randomly divided into a control group （periodic phased rehabilitation training） and an experimental group （periodic phased rehabilitation training combined with MTrPs manual massage）, with 58 cases in each group. The intention-to-treat （ITT） principle and per-protocol （PP） analysis were applied for the primary and secondary analyses, respectively. The rehabilitation process, pain status, range of motion, motor function, knee joint function, and adverse reactions were compared between the two groups. Results The results of the ITT and PP analyses were consistent: the time to achieve 90° of flexion, independent walking time, and independent stair-climbing time in the experimental group were all shorter than those in the control group （P < 0.05）. At 2, 6, and 12 weeks after the intervention, the Visual Analogue Scale （VAS） scores in the experimental group were lower than those in the control group （P < 0.05）, and the VAS scores in both groups decreased over time （P < 0.05）. At 2, 6, and 12 weeks after the intervention, the maximum active range of motion （AROM） of the knee joint in the experimental group was greater than that in the control group （P < 0.05）, the six-minute walk test （6MWT） distance was longer than that in the control group （P < 0.05）, and the Western Ontario and McMaster Universities Osteoarthritis Index （WOMAC） scores were lower than those in the control group （P < 0.05）. Over time, the AROM in both groups showed an increasing trend （P < 0.05）, the 6MWT distance showed a lengthening trend （P < 0.05）, and the WOMAC scores showed a decreasing trend （P < 0.05）. Conclusion MTrPs manual massage combined with periodic phased rehabilitation training can effectively shorten the postoperative rehabilitation process, alleviate pain, and improve knee joint function and motor function in patients following TKA.
2026,
47(9):
151-158.
doi: 10.12259/j.issn.2095-610X.S20260914
Abstract:
Objective To identify the pathogenic gene variants in ten polycystic kidney disease （PKD）pedigrees, to clarify the molecular diagnosis of the probands and other family members. Methods Clinical data of 10 PKD pedigrees was collected, genomic DNA was extracted from peripheral blood samples of the probands and family members, and sequenced by next generation sequencing （NGS）, candidate variants wereanalyzed by bioinformatics and confirmed by Sanger sequencing. Results A total of 8 PKD1 variants and 3 PKD2 variants and 2 PKHD1 variants were found in the 10 pedigrees. Among these, PKD1: c.3416_3417delTG, c.10264_10265insTCGG, c.10762T>C and PKD2: c.602delG, c.1548G>C variants have not been reported in HGMD database, ClinVar database or previous literature.According to the American College of Medical Genetics and Genomics （ACMG） standards and guidelines for the interpretation of sequence variants, PKD1: c.3416_3417delTG, c.10264_10265insTCGG and PKD2: c.602delG were classified as likely pathogenic （LP）, PKD1: c.10762T>C and PKD2: c.1548 G>C were classified as variantsof uncertain significance （VUS）. Conclusion In this study, the cause of PKD in 10 pedigrees was identified by molecular diagnosis, and three novel PKD1gene variants and two novel PKD2 gene variants were reported for the first time, which expanded the mutation spectrum of PKD.
2026,
47(9):
159-167.
doi: 10.12259/j.issn.2095-610X.S20260915
Abstract:
Objective To investigate the correlation between serum chemokines, stromal cell-derived factor 1α （SDF-1α） and micro ribonucleic acid-21 （miR-21） and adjacent vertebral re-fracture after thoracolumbar fracture surgery in the elderly, and to explore the predictive value of the three. Methods A total of 285 elderly patients with thoracolumbar fractures in Jincheng People's Hospital from September 2021 to September 2024 were selected as the study subjects. All patients underwent percutaneous vertebroplasty （PVP） or percutaneous kyphoplasty （PKP）, and they were followed up for 12 months. According to the occurrence of adjacent vertebral re-fracture, they were divided into re-fracture group and non-re-fracture group. The clinical data, serum chemerins, SDF-1α and miR-21 levels were compared between the two groups, and the predictive value of serum chemerins, SDF-1α and miR-21 for postoperative adjacent vertebral re-fracture was evaluated. Results In this study, 281 elderly patients with thoracolumbar fractures were followed up for 12 months, and 4 patients were lost to follow-up. The incidence of adjacent vertebral re-fracture was 26.69 % （75/281）. The levels of serum chemokine and SDF-1α in the re-fracture group were higher than those in the non-re-fracture group, and the level of miR-21 was lower than that in the non-re-fracture group （P < 0.05）. According to Lasso-Logistic regression analysis, bone mineral density, bone cement extravasation, postoperative vertebral height recovery rate, postoperative Cobb angle, serum chemokine, SDF-1α and miR-21 were independent influencing factors of adjacent vertebral refracture after thoracolumbar fracture in the elderly （P < 0.05）. Receiver operating characteristic （ROC） curve analysis showed that the area under the curve （AUC） of serum chemerin, SDF-1α and miR-21 in predicting adjacent vertebral re-fracture was 0.761 （95%CI: 0.706-0.809）, 0.736 （95%CI: 0.681-0.787） and 0.773 （95%CI: 0.719-0.820）. The AUC of serum chemerin, SDF-1α, miR-21 combined with clinical indicators in predicting adjacent vertebral re-fracture was 0.934 （95%CI: 0.898-0.960）. The 10-fold cross-validation showed that the average AUC was 0.926 （95%CI: 0.892-0.955）, and the AUC range of each fold was 0.911-0.942. The calibration curve showed that the calibration of the prediction model was good （Hosmer-Lemeshow test P > 0.05）. Conclusion Serum chemerin, SDF-1α and miR-21 are independently associated with adjacent vertebral re-fracture after thoracolumbar fracture surgery in the elderly. Combined detection can effectively predict the risk of adjacent vertebral re-fracture.
2026,
47(9):
168-176.
doi: 10.12259/j.issn.2095-610X.S20260916
Abstract:
Objective To explore the application effect of the integrated teaching model combining the BOPPPS （Bridge-In, Outcomes, Pre-assessment, Participatory Learning, Post-assessment, Summary） framework with TBL （Team-Based Learning） in the emergency nursing module of surgical nursing courses for undergraduate nursing students. Methods A mixed-methods design integrating quasi-experimental and descriptive qualitative research was adopted. The sample size was calculated via G*Power 3.1 software with an effect size of 0.5, α value of 0.05, and β value of 0.20, and a minimum of 50 participants was required for each group. A total of 110 sophomore undergraduate nursing students from two parallel classes were enrolled through convenience sampling. The intervention group （n = 55） received 16-week teaching intervention based on the integrated BOPPPS-TBL model, while the control group （n = 55） received conventional traditional teaching. Quantitative outcome indicators included final examination scores, self-directed learning ability （assessed by self-study hours and the Self-Directed Learning Readiness Scale, SDLRS）, critical thinking ability （measured by the Critical Thinking Disposition Inventory-Chinese Version, CTDI-CV）, and team effectiveness （evaluated by the Team Strategies and Tools to Enhance Performance and Patient Safety （TeamSTEPPS） scale）. Qualitative data were collected via semi-structured interviews to summarize students’ learning experience and feedback. Results Compared with the control group, the intervention group obtained significantly better scores in the total critical thinking score （285.53 ± 33.752 vs. 269.63 ± 25.957, P < 0.05, Cohen’ s d = 0.528）, self-directed learning ability （SDLRS score: 145.6 ± 18.3 vs. 126.4 ± 16.8, P < 0.01）, and final examinations （85.6 ± 7.2 vs. 78.3 ± 8.1, P < 0.05）. Analysis of covariance （ANCOVA） further indicated that the integrated teaching model exerted a significant net promoting effect on students’ critical thinking ability after controlling for baseline levels （F = 6.92, P = 0.01）. Five core themes were extracted from student interview feedback: improved learning self-efficacy, enhanced teamwork outcomes, transferable critical thinking competence, effective critical thinking training, and existing problems in teaching methods as well as overall learning satisfaction. Conclusion The integrated BOPPPS and TBL teaching model can effectively improve undergraduate nursing students’ critical thinking ability, self-directed learning capacity and teamwork competency, which is worthy of clinical nursing teaching promotion.
