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2025, Volume 46, Issue 8
2025,
46(8):
1-9.
doi: 10.12259/j.issn.2095-610X.S20250801
Abstract:
This article aims to explore the mechanism of protein lactate modification （Kla） in sepsis and multiple organ dysfunction syndrome （MODS）. By regulating gene transcription and inflammatory factor expression, Kla participates in sepsis organ function damage, and can also destroy the cell structure and metabolic homeostasis, aggravating sepsis induced lung, kidney, heart, brain, liver organ damage. By conducting in-depth study on its mechanism, it will help to explore new therapeutic targets and provide innovative ideas for clinical treatment of sepsis.
This article aims to explore the mechanism of protein lactate modification （Kla） in sepsis and multiple organ dysfunction syndrome （MODS）. By regulating gene transcription and inflammatory factor expression, Kla participates in sepsis organ function damage, and can also destroy the cell structure and metabolic homeostasis, aggravating sepsis induced lung, kidney, heart, brain, liver organ damage. By conducting in-depth study on its mechanism, it will help to explore new therapeutic targets and provide innovative ideas for clinical treatment of sepsis.
2025,
46(8):
10-19.
doi: 10.12259/j.issn.2095-610X.S20250802
Abstract:
Objective To analyze the effects of the histone deacetylase inhibitor suberoylanilide hydroxamic acid （SAHA） on the secondary metabolites of the entomopathogenic fungus Samsoniella hepiali CDB9-31 using thin-layer chromatography （TLC） and high-performance liquid chromatography （HPLC）. Methods The fermentation products of Samsoniella hepiali CDB9-31 treated with epigenetic modifiers were separated and purified using methods such as silica gel column chromatography, Sephadex column chromatography and reversed-phase column chromatography. The structures of the compounds were elucidated using modern spectroscopic analysis methods. The antimicrobial activity of the obtained monomeric compounds was determined using the filter paper disc diffusion method. Results The TLC and HPLC analyses of its fermentation extracts revealed that SAHA could induce the strain to produce more diverse array of secondary metabolites, and 11 monomeric compounds were isolated and identified as follows: N'-phenyloctanediamide （1）, 5-Phenylcarbamoyl-pentanoic （2）, ergosterol （3）, 5, 8-Epidioxy-5α, 8α-ergosta-6, 22E-diene-3β-ol （4）, 1-monolinolein （5）, （4E, 8E）-2-N-（2-Hydroxypalmitoyl）-1-O-（β-D-glucopyranosyl）-9-methyl-4, 8-sphingadienine （6）, Ergosterol peroxide 3-O-β-D-glucopyranoside （7）, （22E, 24R）-7, 22-diene-3β, 5α, 6β-ergostatriol （8）, （2S, 2'R, 3R, 4E, 8E）-N-2'-Hydroxyhexadecanoyl-2-amion-9-methyl-4, 8-octadecadiene-1, 3-diol （9）, Adenosine （10）, D-Glulopyranose （11）. Compounds 1 and 2 were derivatives of SAHA, and it was speculated that the special metabolic environment of CDB9-31 caused the biotransformation of SAHA. Except for compound 3, all other compounds were isolated from this genus for the first time. The antibacterial activity results showed that six of these compounds exhibited varying degrees of inhibitory effects against at least one pathogenic bacterium. Conclusion This study has enriched the chemical diversity of secondary metabolites from the entomopathogenic fungus Samsoniella hepiali.
2025,
46(8):
20-26.
doi: 10.12259/j.issn.2095-610X.S20250803
Abstract:
Objective To investigate the effect of calorie restriction on glucose metabolism in pregnant rats with Gestational diabetes mellitus （GDM） and the mechanism of impaired lipid metabolism in their offspring. Methods 45 healthy SD rats were randomly divided into the healthy group, the GDM model group, and the treatment group respectively with 15 in each group, and the rats in the GDM model were subjected to the calorie restriction intervention. The indicators of glucose metabolism and oxidative stress were detected by enzyme-linked immunosorbent assay and the blood lipid levels were detected by the fully automatic biochemical analyzer. Hematoxylin-eosin staining was used to observe the histopathological changes of pancreatic tissue in rats. Meanwhile, 45 offspring mice were collected and divided into the healthy offspring group, the model offspring group and the treatment offspring group respectively, with 15 in each group. The blood lipid levels were detected by an automatic biochemical analyzer. Western blotting was used to detect the protein expression in pancreatic tissue. Results Compared with the healthy group, the model group showed the increases in the Homeostatic Model Assessment of Insulin Resistance （HOMA-IR）, fasting blood glucose, fasting insulin, total cholesterol （TC）, triacylglycerol （TG）, low density lipoprotein cholesterol Elevated LDL-C, nuclear factor erythroid-2 related factor 2 （Nrf2） hemeoxygenase-1 （HO-1） levels, and a decrease in high density lipoprotein cholesterol （HDL-C） level （P < 0.05）; After the calorie intervention, the treatment group showed the decreases in HOMA-IR, fasting blood glucose, fasting insulin, TC, TG, LDL-C, Nrf2 and HO-1 levels, and an increase in HDL-C level （P < 0.05）. Compared with the healthy group, the model group showed the decreases in the Superoxide dismutase （SOD） and Glutathione peroxidase （GSH-Px） levels, and an increase in Malondialdehyde （MDA） level. Compared with the model group, SOD and GSH-Px in the treatment group increased, while MDA decreased （P < 0.05）. Compared with the offspring of the healthy group, the offspring mice in the model group showed the increases in the TC, TG and LDL-C levels in, and a decrease in the HDL-C level （P < 0.05）. Compared with the offspring of the model group, the offspring mice in the treatment group showed the decrease in the TC, TG and LDL-C of levels, and an increase in the HDL-C （P < 0.05）. Conclusion Calorie restriction can improve the levels of glucose metabolism and lipid metabolism in GDM rats and reduce the pathological damage of pancreatic tissue. The mechanism of action may be related to the activation of the Nrf2/HO-1 signaling pathway.
2025,
46(8):
27-32.
doi: 10.12259/j.issn.2095-610X.S20250804
Abstract:
Objective To analyze the epidemiological characteristics of influenza-like illness outbreaks in Yunnan Province from 2017 to 2023, and to provide the evidence for the prevention and control of influenza in Yunnan Province. Methods The data of influenza-like illness outbreaks and outbreak specimens were collected in Yunnan Province from 2017 to 2023. Descriptive epidemiological methods were used to describe and analyze the epidemic time, population, region and pathogen distribution. Results A total of 340 influenza-like illness outbreaks were reported in Yunnan Province from 2017 to 2023, with 12586 reported cases and a cumulative incidence of 2.34%. The outbreaks were mainly concentrated in November to January and March of the following year, with a high incidence in winter and spring. Schools were the most important place of outbreak, with primary and secondary school students being the main affected group. The cumulative number of reported cases in Dali Prefecture, Dehong Prefecture, Yuxi City and Kunming City ranked among the top in the province, accounting for 79.71% of the total number of outbreaks in the province. The pathogen types alternated and were mainly prevalent in H1N1 （119 cases）, H3N2 （81 cases）, and Victoria （83 cases）. Conclusion The outbreak of influenza-like illness in Yunnan Province shows the obvious seasonality, and primary and secondary schools are the main outbreak sites. The outbreak surveillance in schools should be strengthened continuously to control the occurrence and development of the epidemic.
2025,
46(8):
33-42.
doi: 10.12259/j.issn.2095-610X.S20250805
Abstract:
Objective To evaluate the relationship between nutritional parameters and the risk of venous thromboembolicism （VTE） in patients with tuberculosis so as to identify the risk factors and predictors of thrombosis and assist in the early identification of high-risk factors for VTE in patients with the pulmonary tuberculosis. Methods A total of 323 patients diagnosed with the pulmonary tuberculosis and hospitalized in Kunming Third People’s Hospital from August 2021 to August 2023 were collected. According to the VTE risk assessment of non-operative patients, they were divided into the high-risk group and the low-risk group respectively with 116 and 207 in each group. The nutritional indicators with statistically significant differences between the two groups were screened by Lasso regression. Multivariate Logistic regression was used to screen the independent risk factors for high VTE risk in pulmonary tuberculosis patients, and a nomogram prediction model was constructed. The prediction model was evaluated by receiver operating characteristic curve （ROC）, calibration curve, decision curve, and influence curve. Results Patients in the high-risk group were significantly older than those in the low-risk group （59 vs.41, P < 0.001）, hypertension, gender, and Type 2 diabetes did not differ significantly （P values were 0.084, 0.724 and 0.488, respectively）. 9 variables were selected from the inter-group comparison and Lasso regression, including ALB, HCT, NRS2002 scores, HBDH, RDW-SD, RDW-CV, TG, CONUT scores, and NEFA. Multivariate Logistic regression analysis showed that ALB, NRS2002 scores, RDW-SD, and CONUT scores were independent influencing factors for the high risk of VTE scores in patients with tuberculosis （P < 0.005）. Area under the ROC curve showed that the AUC （0.892） for high-risk VTE scores in patients with the pulmonary tuberculosis was greater than that of ALB （0.803）, NRS2002 score （0.735）, RDW-SD （0.685）, and CONUT score （0.774）. Fitting prediction model: Logit （P）: Y=0.433×NRS-0.136×ALB+0.411×CONUT score+0.072×RDW-SD-1.770, P = 1/（1+e-Y） （Y: prediction index, P: prediction probability）. Calibration curve showed that the model prediction tended to be consistent with the actual results （U: > 0.05）, and the decision curve and influence curve showed that the model can bring clinical benefits. Conclusion ALB, NRS2002 scores, RDW-SD, and CONUT scores are independent influencing factors for the high risk of VTE scores in patients with tuberculosis. They can guide the clinical practice, improve these indicators as soon as possible, reduce VTE scores, and reduce the thrombosis risk. At the same time, the prediction model performs well in the verification cohort, with its discrimination ability, calibration accuracy and clinical utility （decision curve analysis） all reaching a satisfactory level.
2025,
46(8):
43-50.
doi: 10.12259/j.issn.2095-610X.S20250806
Abstract:
Objective To explore the expression of pepsinogen I/II （PG Ⅰ/PG Ⅱ）, nucleosome assembly protein 1 like protein 1 （NAP1L1）, and SERPINB5 in the serum of gastric cancer patients and their correlation with prognosis. Methods From February 2019 to February 2022, 200 gastric cancer patients admitted to Zhuozhou Hospital were served as the gastric cancer group and another 100 patients with benign gastric lesions who received the treatment at Zhuozhou Hospital during the same period were served as the benign group, with 200 healthy adults as the control group. Chemiluminescence and ELISA methods were used to detect the serum PG Ⅰ/PG Ⅱ, NAP1L1, and SERPINB5. ROC curve was used to explore the diagnostic value. Kaplan-Meier method was used to explore the survival curve. Moreover, multivariate Cox method was used to analyze the factors that affected the prognosis. Results Compared with the control group, the benign group and gastric cancer group had the lower serum PG Ⅰ/PG Ⅱ and higher serum NAP1L1 and SERPINB5, and the difference was statistically significant （P < 0.05）. Compared with the benign group, the gastric cancer group had the lower serum PG Ⅰ/PG Ⅱ and higher serum NAP1L1 and SERPINB5, and the difference was statistically significant （P < 0.05）. PG I/PG II, NAP1L1, and SERPINB5 were all influential factors in gastric carcinogenesis （P < 0.05）. The AUC values of serum PG Ⅰ/PG Ⅱ, NAP1L1, and SERPINB5 alone in the diagnosis of gastric cancer were 0.821, 0.808, and 0.833, respectively. The AUC of the combination of the three was 0.916, indicating that their combined diagnostic value was superior （Z = 3.142, 3.896, 3.114, P < 0.05）. During the 3-year follow-up period of gastric cancer patients, 57 cases died, accounting for 28.50% （57/200）, and 143 cases survived. Patients with the high expression of PG Ⅰ/PG Ⅱ had a higher 3-year overall survival rate after the surgery compared to those with low expression, and the difference was statistically significant （χ2 = 7.830, P < 0.05）; and patients with the low expression of NAP1L1 and SERPINB5 had a higher 3-year overall survival rate after the surgery compared to those with high expression, and the difference was statistically significant （χ2 = 8.612, 13.321, P < 0.05）. The serum PG Ⅰ/PG Ⅱ levels in the death group were lower than those in the survival group, and the serum NAP1L1, SERPINB5 levels were higher in patients with preoperative lymph node metastasis and TNM stage III-IV than those in the survival group, and the difference was statistically significant （P < 0.05）. Elevated level of PG Ⅰ/PG Ⅱ was a protective factor for the prognosis of gastric cancer patients, while preoperative lymph node metastasis, elevated levels of NAP1L1 and SERPINB5 were risk factors affecting the prognosis of gastric cancer patients （P < 0.05）. Conclusion Serum PG I /PG II levels are decreased and NAP1L1 and SERPINB5 levels are increased in gastric cancer patients, and NAP1L1 and SERPINB5 are risk factors affecting the prognosis of gastric cancer patients, while PG I /PG II is a protective factor.
2025,
46(8):
51-57.
doi: 10.12259/j.issn.2095-610X.S20250807
Abstract:
Objective To construct a predictive model for clinical pregnancy outcomes in frozen-thawed embryo transfer （FET） cycles in women with advanced maternal age （age ≥ 35 years） and to analyze its influencing factors. Methods A retrospective analysis was conducted on the clinical data of 2717 older patients who underwent FET treatment at the First Affiliated Hospital of Kunming Medical University from January 2018 to December 2023. These Patients were divided into a clinical pregnancy group （n = 851） and a non-clinical pregnancy group （n = 1866） based on whether the clinical pregnancy had occurred. The general characteristics and transplantation details of the two groups were compared, and a logistic regression analysis model was constructed. Results The clinical pregnancy rate （CPR） was 31.32%. The CPR for women aged 35-40 years （40.06%） was higher than that for women aged ≥ 40 years （19.35%）, with a statistically significant difference （χ2 = 133.371, P < 0.05）. The model results showed that the higher anti-Mullerian hormone （AMH） levels （OR = 1.053, 95%CI: 1.012–1.095）, the more high-quality blastocysts were transferred （OR = 1.704, 95%CI: 1.143–2.542; OR = 2.861, 95%CI: 1.921–4.262）; the more high-quality blastocysts were transferred （OR = 2.033, 95%CI: 1.077–3.836; OR = 3.886, 95%CI: 2.035–7.420）, the thicker the endometrial lining on the day of transfer （OR = 1.150, 95%CI: 1.092–1.212） and it could increase the probability of clinical pregnancy. However, for women over 40 years of age （OR = 0.551, 95%CI: 0.437–0.694） and secondary infertility （OR = 0.704, 95%CI: 0.552–0.896）, the probability of clinical pregnancy would be reduced; ROC curve analysis results showed that the AUC for predicting clinical pregnancy occurrence in the training set and validation set of the predictive model were 0.723 （95%CI: 0.699–0.748） and 0.726 （95%CI: 0.689–0.764）, respectively, with cutoff values of 0.262 and 0.260 and the model fit was good （P > 0.05）. Conclusion Female age, AMH level, type of infertility, number of high-quality embryos （cleavage embryos, blastocysts） transferred, and endometrial thickness on the day of transfer are important factors affecting FET cycles in advanced maternal age women. The constructed prediction model based on these factors has a certain predictive ability for clinical pregnancy.
2025,
46(8):
58-64.
doi: 10.12259/j.issn.2095-610X.S20250808
Abstract:
Objective To investigate the differences in BMD, T-scores, lumbar HU values, and modified VBQ scores in patients with thoracolumbar fractures, analyze their correlations, and evaluate their predictive efficacy for thoracolumbar fractures. Methods Patients with thoracolumbar fragility fractures and hospitalized in the Department of Orthopedics at the Second Affiliated Hospital of Kunming Medical University from January 2022 to March 2025 were retrospectively enrolled. Among them, 132 eligible patients were divided into the fracture group （n = 63） and the non-fracture group （n = 69）. BMD and T-scores of L1～L4 vertebrae were measured via DEXA, lumbar HU values were obtained from CT scans, and modified VBQ scores were calculated using lumbar MRI. Intergroup comparisons were performed using independent samples t-tests. Pearson's correlation analysis was used to assess the relationships among BMD, T-scores, HU values, and modified VBQ scores. Receiver operating characteristic （ROC） curve analysis was conducted to evaluate their predictive performance for thoracolumbar fractures. Results The fracture group exhibited significantly lower mean BMD, T-scores, and HU values in L1～L4 compared to the non-fracture group, while modified VBQ scores were significantly higher （P < 0.001）. Correlation analysis revealed a significant positive correlation between BMD, T-scores, and HU values in L1～L4, whereas all three parameters showed a significant negative correlation with modified VBQ scores （P < 0.001）. The AUC values for predicting thoracolumbar fractures were 0.826 （T-score）, 0.836 （BMD）, 0.759 （HU value）, and 0.875 （modified VBQ score）, with optimal cutoff thresholds of -1.65 （T-score）, 0.836 g/cm2 （BMD）, 68.4 （HU value）, and 3.01 （modified VBQ score）, respectively. Conclusion BMD, T-scores, HU values, and modified VBQ scores in L1～L4 vertebrae are significantly correlated and can serve as the predictive indicators for thoracolumbar fractures. Among them, the modified VBQ score demonstrates the best predictive performance, making it a valuable auxiliary tool for assessing the vertebral bone quality.
2025,
46(8):
65-71.
doi: 10.12259/j.issn.2095-610X.S20250809
Abstract:
Objective To assess the prevalence and clinical features of nonalcoholic fatty liver disease （NAFLD） and its risk factors in patients with CHF, so as to provide the reference for early identification of NAFLD. Methods The data from 1120 CHF patients aged 14～89 was collected, including the general demographic information （age, gender, smoking status, height, weight, BMI, etc.）, clinical diagnosis and treatment data （blood pressure, NYHA heart function classification, blood biochemical indicators, etc.）, and medication use status. SPSS 27.0 was applied to analyze the clinical characteristics of CHF combined with NAFLD, and binary multivariate logistic regression was used to analyze the independent risk factors of CHF combined with NAFLD. Results Among the 1120 patients, 634 （56.6%） were male and 486 （43.4%） were female. The prevalence of CHF patients with NAFLD was 25.0%. The results of univariate analysis showed that the weight of NAFLD patients BMI, systolic blood pressure, diastolic blood pressure, FPG, UA, left room expansion ratio, ALT, CHO, TG, obesity rate, hyperuricemia rate and β-blocker usage rate were all higher than those of non NAFLD patients. The age, BNP, HDL and ACEI/ARB/ARNI usage rate of NAFLD patients were lower than those of non NAFLD patients （all P < 0.05）. Logistic regression analysis showed that age （OR = 0.988）, FPG （OR = 1.099）, overweight （OR = 3.497） and obesity （OR = 9.193） were independent risk factors for CHF patients with NAFLD. Conclusion NAFLD may be a common complication in CHF patients, especially those who are young, have high FPG, overweight and obese. In the clinical practice, NAFLD screening, evaluation and management should be focused on CHF patients who are young, have high fasting blood sugar, overweight, and obese.
2025,
46(8):
72-77.
doi: 10.12259/j.issn.2095-610X.S20250810
Abstract:
Objective To explore the factors affecting the success rate of operation in patients with end-stage renal disease by analyzing and comparing the differences of patients’ basic conditions and clinical laboratory data. Methods A total of 107 patients who underwent forearm autogenous arteriovenous fistula surgery in Nujiang Lisu Autonomous Prefecture People’ s Hospital from January 2021 to August 2024 were selected and divided into AVF failure group and AVF success group according to whether internal fistula occluded during the operation or within 1 week after the operation. The basic data and clinical laboratory data of enrolled patients were collected. Correlation statistical methods were used to compare whether there were differences between the two indexes. Results Univariate analysis showed that there were statistically significant differences between the two groups in smoking history, diabetes history, nephritic syndrome history, gender, preoperative blood pressure, hemoglobin, low density lipoprotein and total cholesterol （P < 0.05）. However, There was no significant difference between the two in history, age, white blood cell count, neutrophil count, lymphocyte count, monocyte count, platelet, creatinine, urea nitrogen, triglyceride, blood calcium, blood phosphorus, calcium-phosphorus product, fibrinogen, D-dimer and albumin （P > 0.05）. Binary Logistic regression analysis showed that gender, diabetes history, nephritic syndrome history, preoperative blood pressure, hemoglobin and low- density lipoprotein were independent risk factors for AVF initiation failure （P < 0.05）. Conclusion Female patients, history of diabetes mellitus, history of nephrotic syndrome, low hemoglobin, elevated low-density lipoprotein, and poor blood pressure control are independent factors affecting the failure of AVF initiation.
2025,
46(8):
78-85.
doi: 10.12259/j.issn.2095-610X.S20250811
Abstract:
Objective To explore the risk factors of cardiomyopathy in patients with diabetes and their correlations with the levels of serum fork head box protein O1 （FOXO1）, growth differentiation factor 11 （GDF11）, and matrix metalloproteinase-3 （MMP3）. Methods 200 patients with diabetes complicated with cardiomyopathy and 200 patients with simple diabetes admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from September 2023 to April 2025 were selected to detect serum FOXO1, GDF11 and MMP3 levels, analyze their correlation with cardiac function parameters, screen risk factors through multifactor logistic regression, construct a nomogram model and a receiver operating characteristic （ROC） curve, and evaluate the diagnostic value. Results The duration of diabetes cardiomyopathy group ≥ 10 years, the expression rate of reactive oxygen species （ROS） ≥ 90%, the insulin resistance index and the levels of FOXO1 and MMP3 were significantly higher than those in the simple diabetes group （P < 0.05）, and the level of GDF11 was lower than that in the simple diabetes group （P < 0.05）. FOXO1 and MMP3 were positively correlated with E/e 'and negatively correlated with LVEF and E/A; GDF11 was negatively correlated with E/e 'and positively correlated with LVEF and E/A （P < 0.05）. The nomogram model showed that the weights of the influencing factors were GDF11, FOXO1, insulin resistance index, MMP3, ROS expression rate, and the course of diabetes. The model calibration was good （χ2=7.336, P = 0.719）. The combined diagnostic AUC of FOXO1, GDF11, and MMP3 was 0.950, which was better than that of a single indicator （P < 0.05）. Conclusion GDF11, FOXO1, Insulin resistance index, MMP3, ROS expression rate and the course of diabetes are risk factors for diabetes cardiomyopathy, and the combination of the three is of high diagnostic value.
2025,
46(8):
86-92.
doi: 10.12259/j.issn.2095-610X.S20250812
Abstract:
Objective To discuss the risk factors and genotype distribution of high-risk human papillomavirus （HR-HPV） infection in women aged 18～60 in Liaoning region. Methods A total of 12688 women aged 18~60 from Liaoning Province from June to December 2024 were selected as the research subjects. Logistic regression analysis was used to screen risk factors for HR-HPV infection in women aged 18～60 in the Liaoning region, and the distribution of gene types was statistically analyzed. Results Among 12688 women aged 18～60 in Liaoning region, 2992 （23.58%） were infected with HR-HPV. Among the 2992 with HR-HPV infection, 2804 were infected with single infection and 188 with mixed infection. Among the 2804 single infected individuals, the main genetic types were HPV 16, HPV 52, and HPV 58 respectively. The results of logistic regression analysis showed that divorce or widowhood （OR = 3.005, P = 0.001）, age of first sexual intercourse younger than 18 years old （OR = 2.111, P = 0.002）, number of abortions more than 2 times （OR = 1.703, P = 0.000）, lack of previous HPV vaccination （OR = 4.852, P = 0.000）, smoking history （OR = 3.169, P = 0.000）, cervical and vaginal inflammation （OR = 4.741, P = 0.002）, and syphilis infection （OR = 3.726, P = 0.000） were independent risk factors for HR-HPV infection in women aged 18～60 in Liaoning region. Conclusion The main genotypes of HR-HPV infection among women aged 18-60 in Liaoning region were HPV 16, HPV 52, and HPV 58. HR-HPV infection was associated with divorce or widowhood, age of first sexual intercourse “< 18 years old”, number of abortions “≥ 2 times”, lack of previous HPV vaccination, smoking history, cervical and vaginal inflammation, syphilis infection. It is recommended that prevention and control measures for HR-HPV infection among women aged 18-60 years in Liaoning region be formulated and optimized targeting the aforementioned independent risk factors, so as to reduce the HR-HPV infection rate in this population.
2025,
46(8):
93-99.
doi: 10.12259/j.issn.2095-610X.S20250813
Abstract:
Objective To evaluate the high-risk factors for venous thromboembolism （venous thromboembolism, VTE） during the perioperative period in gynecology and analyze the rationality of anticoagulant drug use. Methods Clinical data of 183 gynecological surgical patients treated at Kunming Maternal and Child Health Hospital from January 2023 to December 2024 were collected. Among them, 29 diagnosed with postoperative VTE were classified as the VTE group and 154 diagnosed with no postoperative VTE during the same period were classified as the non-thrombosis group. Independent sample t-test, Mann–Whitney U test, or χ2 test were used to analyze high-risk factors for VTE during the perioperative period. Logistic regression analysis was employed to identify risk factors for VTE after the gynecological surgery and a predictive regression model was established. The ROC curve was plotted to evaluate the model’ s validity. Results Elevated D-dimer levels, open abdominal surgery, and history of thrombosis were independent risk factors for VTE in postoperative gynecological patients （OR >1, P < 0.05）. The AUC of the regression-based predictive model was higher than that of the Caprini and G-Caprini scores, indicating that this model had the good discriminatory ability its resolution was better than G-Caprini and Caprini risk assessment tools. The identified issues in VTE prophylaxis at the hospital included the insufficient mechanical prevention time limit and delayed initiation of anticoagulant therapy in patients at moderate risk of bleeding. Conclusion This predictive model has certain clinical value for broader application. For issues related to drug therapy such as delayed use of anticoagulant drugs, clinical pharmacists should collaborate with physicians to assess patients’ bleeding and thrombosis risks, jointly develop precise anticoagulation regimens.
2025,
46(8):
100-107.
doi: 10.12259/j.issn.2095-610X.S20250814
Abstract:
Objective To analyze the evaluation value of regulatory T cells （Treg）, helper T cells （Th17） and Treg / Th17 changes on the morbidity and severity of viral myocarditis （VMC） patients, and further analyze the influencing factors of morbidity and severity of VMC patients. Methods Press 1∶1 The research objects were screened according to the matching principle. 140 VMC patients admitted to Dingzhou People’ s Hospital from January 2022 to January 2024 were selected as the observation group, and the severity of the disease was determined according to the left ventricular ejection fraction （LVEF） and serum troponin （cTnI） levels. According to the severity of the disease, the observation group was divided into a mild group （n = 79） and a moderately severe group （n = 61）. In addition, 140 healthy people in the same period were selected as the control group. All patients were followed up for one year. According to the Treg / Th17 cutoff value in the receiver operating characteristic （ROC） curve, the patients were grouped based on the expression levels of the indicators into the Treg / Th17 high-expression group （107 patients） and the Treg / Th17 low-expression group （30 patients）. The levels of Treg, Th17, Treg / Th17 and baseline data were compared between the control group and the observation group. The levels of Treg, Th17, Treg / Th17 and baseline data were compared between the mild group and the moderate-severe group. The diagnostic value of the combined detection of Treg, Th17, Treg / Th17 alone and in a parallel mode for the onset and severity of the disease in patients with VMC was analyzed using the ROC curve. Multivariate Logistic regression was used to analyze the influencing factors of the onset and severity of VMC. Results During the study period, 4 cases were shed in the observation group, including the study period, 4 cases dropped out and 136 cases were included in the observation group, and 3 cases dropped out and 137 cases were included in the control group. Compared with the control group, Treg and Treg / Th17 in the observation group were significantly lower, and Th17 was significantly higher （P < 0.05）. Th17 was the risk factor affecting the incidence of VMC patients （OR = 2.547, 2.698）, Treg and Treg / Th17 were the protective factors affecting the incidence of VMC patients （OR = 0.507, 0.519）. The area under the curve （AUC）, sensitivity and specificity of Treg, Th17 and Treg / Th17 combination in the diagnosis of VMC were higher than those of single detection. Delong’ s test confirmed that the AUC of the combined detection （0.893） was significantly greater than that of the individual detections of Treg （0.664, Z = 7.042）, Th17 （0.696, Z = 6.033）, and Treg / Th17 （0.721, Z = 5.691） （P < 0.05）. Compared with the mild group, Treg and Treg / Th17 in the moderate and severe group were significantly lower, and Th17 was significantly higher （P < 0.05）. Treg and Treg / Th17 were the independent protective factors affecting the severity of VMC patients （OR = 0.547, 0.419）, and Th17 was the independent risk factor affecting the severity of VMC patients （OR = 2.554） （P < 0.05）. The AUC, sensitivity and specificity of Treg, Th17 and Treg / Th17 combination in detecting the severity of VMC patients were higher than those of single detection （P < 0.05）. During the 1-year follow-up, a total of 36 patients with VMC died. The 1-year survival rate and OS of patients with high expression of Treg / Th17 were higher than those of patients with low expression of Treg / Th17 （P < 0.05）. Conclusion During the onset and progression of VMC, there is an imbalance in Treg / Th17 cytokines. Treg / Th17 can serve as an important indicator for detecting the deterioration of the condition in VMC patients at an early stage. Clinically, the combined detection scheme of Treg, Th17, and Treg / Th17 can be used as a reference for clinical assessment of the onset diagnosis and disease progression of VMC patients.
2025,
46(8):
108-114.
doi: 10.12259/j.issn.2095-610X.S20250815
Abstract:
Objective To study the risk factors of myelosuppression after the chemotherapy in patients with malignant tumors, and to construct a Logistic regression prediction model based on the risk factors. Methods Clinical information of 80 chemotherapy patients from the First Affiliated Hospital of Kunming Medical University during 2021.01-2022.12 was anonymously collected, and the obtained clinical data were used for Logistic regression univariate analysis with the use of SPSS19.0 software to identify the risk factors related to chemotherapy induced myelosuppression. The risk factors were tested in Logistic multi-factor regression analysis and the Logistic regression analysis prediction models were constructed. In addition, clinical information of 40 patients was collected to test the prediction model, then the ROC curve, AUC value and Youden index were obtained. Results Univariate Logistic regression analysis showed that age, bone metastases, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, serum creatinine clearance （CCr）, serum creatinine （Cr）, concurrent radiotherapy （CRT）, concurrent immunotherapy （IO）, and the recent surgery were associated with the bone marrow suppression after the chemotherapy （P < 0.05）. The AUC values of the ROC curves of the corresponding models were 0.745, 0.755 and 0.791, respectively, indicating that the risk of bone marrow suppression was higher when the predictive model p-value was greater than the above values. The Youden indices of the corresponding models were 0.677, 0.713 and 0.769, respectively, indicating that the prediction performance of the model was better. Conclusion Age, serum creatinine clearance, liver function, the recent surgery, bone metastasis, concurrent radiotherapy/immunotherapy, and serum creatinine clearance are related to the incidence of chemotherapy induced myelosuppression. When p≥0.745 （leukocytes）, p≥0.755 （platelets）, and p≥0.791 （anemia） through the predictive model calculations, the risk of leukocyte, platelets, and the anemia-related myelosuppression are significantly increased （≥95%）, and appropriate preventive measures are recommended.
2025,
46(8):
115-126.
doi: 10.12259/j.issn.2095-610X.S20250816
Abstract:
Knee osteoarthritis （KOA） is a common chronic degenerative bone and joint disease characterized by degeneration and wear of knee cartilage. It is commonly found in middle-aged and elderly people and seriously impacts on their lower limb activity and quality of life. At present, the treatment of early and middle stage KOA mainly relies on the conservative methods such as oral medication, joint injection, topical patches and traditional Chinese medicine. Platelet rich plasma （PRP）, as an autologous platelet concentrate, is rich in various growth factors and has no risk of immune rejection. In recent years, it has been widely used in the repair of bone, joint, and soft tissue injuries. However, the short biological half-life of growth factors in PRP and the fluidity of injection sites can result in insufficient binding force, short action time, poor target therapy efficacy, and the need for repeated injections in the joint cavity, which will increase the risk of iatrogenic infections. Hydrogels are cross-linked polymer networks containing water, and their high histocompatibility and drug release have attracted much attention. The slow and continuous release of drug is achieved by loading PRP onto hydrogel. Its unique adhesion reduces the flow of drug in the joint, thus extending the local action time of PRP and reducing the need for repeated injection. This article reviews the biological characteristics of PRP and hydrogel, the mechanism of action and clinical application of PRP loaded hydrogel in the treatment of KOA, and analyzes the existing problems and challenges, aiming to provide more effective treatment options for KOA patients through the in-depth discussion of this new treatment method.
Knee osteoarthritis （KOA） is a common chronic degenerative bone and joint disease characterized by degeneration and wear of knee cartilage. It is commonly found in middle-aged and elderly people and seriously impacts on their lower limb activity and quality of life. At present, the treatment of early and middle stage KOA mainly relies on the conservative methods such as oral medication, joint injection, topical patches and traditional Chinese medicine. Platelet rich plasma （PRP）, as an autologous platelet concentrate, is rich in various growth factors and has no risk of immune rejection. In recent years, it has been widely used in the repair of bone, joint, and soft tissue injuries. However, the short biological half-life of growth factors in PRP and the fluidity of injection sites can result in insufficient binding force, short action time, poor target therapy efficacy, and the need for repeated injections in the joint cavity, which will increase the risk of iatrogenic infections. Hydrogels are cross-linked polymer networks containing water, and their high histocompatibility and drug release have attracted much attention. The slow and continuous release of drug is achieved by loading PRP onto hydrogel. Its unique adhesion reduces the flow of drug in the joint, thus extending the local action time of PRP and reducing the need for repeated injection. This article reviews the biological characteristics of PRP and hydrogel, the mechanism of action and clinical application of PRP loaded hydrogel in the treatment of KOA, and analyzes the existing problems and challenges, aiming to provide more effective treatment options for KOA patients through the in-depth discussion of this new treatment method.
2025,
46(8):
127-135.
doi: 10.12259/j.issn.2095-610X.S20250817
Abstract:
Cardiovascular disease remains a significant factor leading to patient mortality and influencing outcomes during the perioperative period. Dexmedetomidine is an α2-adrenergic receptor agonist with functions such as analgesia, sedation, and anti-anxiety. This review summarizes various types of findings regarding dexmedetomidine in myocardial ischemia/reperfusion injury and conducts in-depth discussions on the corresponding mechanisms of the results, aiming to further clarify the potential cardioprotective effects of dexmedetomidine in patients with heart diseases.
Cardiovascular disease remains a significant factor leading to patient mortality and influencing outcomes during the perioperative period. Dexmedetomidine is an α2-adrenergic receptor agonist with functions such as analgesia, sedation, and anti-anxiety. This review summarizes various types of findings regarding dexmedetomidine in myocardial ischemia/reperfusion injury and conducts in-depth discussions on the corresponding mechanisms of the results, aiming to further clarify the potential cardioprotective effects of dexmedetomidine in patients with heart diseases.
2025,
46(8):
136-146.
doi: 10.12259/j.issn.2095-610X.S20250818
Abstract:
Objective To investigate the effectiveness of the curriculum design and teaching mode reform in Health Statistics through the assessment by postgraduate students so as to enhance the teaching performance of the course. Methods A questionnaire survey was conducted among the postgraduate students of grade 2023 at a certain medical university. The survey covered such aspects as students' mastery and application of the course learning content, their evaluation and satisfaction with the course, etc. Descriptive approaches were employed to analyze and summarize the data. Results Students achieved a good command of theoretical knowledge and its application. They highly evaluated the teacher, the course content and its practicality, demonstrated a strong interest in learning, expressed a high level of satisfaction with the course, and manifested a strong willingness to continue studying the course. The learning of the course met the expectations of the students. The final exam scores in the later stage of curriculum reform （78.60 ± 10.58） was higher than that before the reform （75.78 ± 7.97, P < 0.05）; the excellent rate after the reform was 53.6%, which was higher than the 33.5% before the reform （P < 0.05）. Conclusion The construction of a course system that integrates knowledge, skills the mixed teaching mode of case-based teaching and the combination of theory and statistical software package operation are beneficial for enhancing postgraduate students' learning and application of the course in health statistics. It also strengthens the design and training of course application aspects for students in clinical medicine and dental medicine disciplines.
2025,
46(8):
147-155.
doi: 10.12259/j.issn.2095-610X.S20250819
Abstract:
Objective To investigate the effectiveness of an evidence-based continuity of care intervention program for patients with dental implant restorations. Methods Dental implant restoration patients attending the implantology department of a tertiary dental specialty hospital in Yunnan Province from May 2024 to December 2024 were selected, and 64 eligible subjects were randomly assigned to the experimental group and the control group using the convenience sampling method, with 32 patients in each group. The control group received a routine care program for oral implant restorations, while the experimental group received an evidence-based continuity of care intervention program. The self-efficacy, medical compliance, and periodontal condition of dental implant restoration patients within 6 months after wearing dentures were compared between the two groups. Results After 6 months of intervention, the oral health self-efficacy, medical compliance, and periodontal condition （including Modified Sulcus Bleeding Index （mSBI）, Modified Plaque Index （mPLI）, and Probing Depth （PD）） of the patients in the experimental group were superior to those in the control group, and the differences were statistically significant （P < 0.05）. Conclusion An evidence-based continuity of care intervention program for patients with dental implant restorations can effectively improve their oral health care self-efficacy level and medical compliance, reduce the periodontal bleeding, decrease the plaque buildup, and improve the periodontal status.
2025,
46(8):
156-170.
doi: 10.12259/j.issn.2095-610X.S20250820
Abstract:
Chronic coronary syndrome (CCS) is one of the most prevalent cardiovascular disease (CVD) in clinical practice. With the accelerating aging of the population and the increasing prevalence of cardiovascular risk factors, CVD has become the leading cause of death among Chinese residents. To optimize diagnosis and treatment strategies through integrated traditional Chinese and Western medicine approaches, and to further improve the clinical management of CCS, the expert group reviewed recent domestic and international guidelines on CCS diagnosis and treatment. Incorporating advances in traditional Chinese medicine (TCM) and leveraging the unique characteristics of Yunnan’ s local herbal medicine (Yunyao), this consensus document was developed. It aims to guide clinical practice and enhance the overall management of CCS patients in the province.
Chronic coronary syndrome (CCS) is one of the most prevalent cardiovascular disease (CVD) in clinical practice. With the accelerating aging of the population and the increasing prevalence of cardiovascular risk factors, CVD has become the leading cause of death among Chinese residents. To optimize diagnosis and treatment strategies through integrated traditional Chinese and Western medicine approaches, and to further improve the clinical management of CCS, the expert group reviewed recent domestic and international guidelines on CCS diagnosis and treatment. Incorporating advances in traditional Chinese medicine (TCM) and leveraging the unique characteristics of Yunnan’ s local herbal medicine (Yunyao), this consensus document was developed. It aims to guide clinical practice and enhance the overall management of CCS patients in the province.
