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2026, Volume 47, Issue 5
2026,
47(5):
1-12.
doi: 10.12259/j.issn.2095-610X.S20260501
Abstract:
Percutaneous coronary intervention （PCI） is currently the most widely used myocardial reperfusion therapy worldwide and is effective in increasing survival rates and improving quality of life in patients with coronary artery disease and myocardial infarction. However, the progressive thickening of neo-atherosclerotic （NA） plaques after PCI can lead to in-stent restenosis （ISR）, which can even rupture and progress to acute adverse cardiovascular events, seriously affecting patient prognosis. Progressive angina due to in-stent restenosis and acute cardiovascular events due to in-stent thrombosis are the main pathological manifestations of ISR after PCI. This article provides an in-depth discussion of the pathogenesis of ISR and its clinical implications by reviewing imaging in the interventional field, endothelial cell injury and thrombus formation, vascular smooth muscle cell （VSMCs） proliferation and migration, inflammatory response, and neointimal atherosclerosis.
Percutaneous coronary intervention （PCI） is currently the most widely used myocardial reperfusion therapy worldwide and is effective in increasing survival rates and improving quality of life in patients with coronary artery disease and myocardial infarction. However, the progressive thickening of neo-atherosclerotic （NA） plaques after PCI can lead to in-stent restenosis （ISR）, which can even rupture and progress to acute adverse cardiovascular events, seriously affecting patient prognosis. Progressive angina due to in-stent restenosis and acute cardiovascular events due to in-stent thrombosis are the main pathological manifestations of ISR after PCI. This article provides an in-depth discussion of the pathogenesis of ISR and its clinical implications by reviewing imaging in the interventional field, endothelial cell injury and thrombus formation, vascular smooth muscle cell （VSMCs） proliferation and migration, inflammatory response, and neointimal atherosclerosis.
2026,
47(5):
13-23.
doi: 10.12259/j.issn.2095-610X.S20260502
Abstract:
Objective To perform whole-genome analysis of recombinant Coxsackievirus B2 （CVB2） strains isolated in Yunnan Province. Methods Primers spanning the complete CVB2 genomic sequence were designed. Viral genomic fragments were amplified using a segmented PCR strategy, followed by sequencing via primer walking and subsequent sequence assembly. Comprehensive genomic analyses were conducted using DNAStar 7.1, MEGA 7.0, Simplot 3.5.1, and RDP4 software. Results Phylogenetic analysis of the VP1 region confirmed both CVB2 isolates belonged to genotype C. Evolutionary assessment of P1-P3 regions revealed clustering of CVB2 strains with diverse EVB strains in P2 and P3 regions. Simplot and Bootscan analyses identified potential multiple recombination events within non-structural coding regions of isolate 135V3/YN/CHN/2022. Furthermore, RDP4 analysis demonstrated that isolate 135V3/YN/CHN/2022 underwent recombination events involving strains E31/USA/13H4/2016 and CVB5/Swab/HB. HS/CHN/2019. Conclusion The two CVB2 strains, isolated in Kunming Yunnan in 2022 belonged to genotype C and exhibited recombination events, highlighting the need for continuous monitoring of their genomic changes.
2026,
47(5):
24-36.
doi: 10.12259/j.issn.2095-610X.S20260503
Abstract:
To investigate the positive expression of syndecan-2 （SDC2） in esophageal squamous cell carcinoma （ESCC）, analyze its correlation with clinical prognosis and pathological parameters of ESCC patients, and explore the effects of SDC2 on the proliferation, migration, invasion and epithelial-mesenchymal transition （EMT） of ESCC cells. To clarify its relationship with STAT3 signaling pathway. Methods:Immunohistochemistry was used to detect the expression of SDC2 in 120 ESCC tissues and 80 paired adjacent tissues. Chi-square test was used to analyze the correlation between SDC2 positive expression and clinicopathological parameters of patients. Kaplan-Meier method was used to evaluate its effect on prognosis. The ESCC cell model with stable knockdown and overexpression of SDC2 was constructed by lentivirus transfection. The effects of SDC2 on the malignant biological behavior and STAT3 pathway of ESCC cells were detected by CCK-8, clone formation, scratch test, Transwell test and Western blot. Results:The expression level of SDC2 in ESCC tissues was significantly higher than that in adjacent tissues （P < 0.05）. The expression of SDC2 was significantly correlated with the pathological stage of patients （P < 0.05）, and the overall survival of patients with high expression was shorter （P < 0.05）. Knockdown of SDC2 inhibited the proliferation, migration and invasion of KYSE-150 cells, down-regulated the expression of Vimentin, Snail and p-STAT3Tyr705, and up-regulated the expression of E-cadherin （P < 0.05）. Overexpression of SDC2 promoted the proliferation, migration and invasion of Eca-109 cells, up-regulated the expression of Vimentin, Snail and p-STAT3Tyr705, and down-regulated the expression of E-cadherin（P < 0.05）. The application of STAT3 inhibitor Stattic in Eca-109 cells overexpressing SDC2 could significantly inhibit the phosphorylation level of STAT3（P < 0.05）. Conclusion:SDC2 is highly expressed in ESCC, which is closely related to the clinicopathological stage and poor prognosis of patients. As a key downstream effector molecule, STAT3 drives cell proliferation, migration, invasion and EMT processes by activating the STAT3 signaling pathway.
To investigate the positive expression of syndecan-2 （SDC2） in esophageal squamous cell carcinoma （ESCC）, analyze its correlation with clinical prognosis and pathological parameters of ESCC patients, and explore the effects of SDC2 on the proliferation, migration, invasion and epithelial-mesenchymal transition （EMT） of ESCC cells. To clarify its relationship with STAT3 signaling pathway. Methods:Immunohistochemistry was used to detect the expression of SDC2 in 120 ESCC tissues and 80 paired adjacent tissues. Chi-square test was used to analyze the correlation between SDC2 positive expression and clinicopathological parameters of patients. Kaplan-Meier method was used to evaluate its effect on prognosis. The ESCC cell model with stable knockdown and overexpression of SDC2 was constructed by lentivirus transfection. The effects of SDC2 on the malignant biological behavior and STAT3 pathway of ESCC cells were detected by CCK-8, clone formation, scratch test, Transwell test and Western blot. Results:The expression level of SDC2 in ESCC tissues was significantly higher than that in adjacent tissues （P < 0.05）. The expression of SDC2 was significantly correlated with the pathological stage of patients （P < 0.05）, and the overall survival of patients with high expression was shorter （P < 0.05）. Knockdown of SDC2 inhibited the proliferation, migration and invasion of KYSE-150 cells, down-regulated the expression of Vimentin, Snail and p-STAT3Tyr705, and up-regulated the expression of E-cadherin （P < 0.05）. Overexpression of SDC2 promoted the proliferation, migration and invasion of Eca-109 cells, up-regulated the expression of Vimentin, Snail and p-STAT3Tyr705, and down-regulated the expression of E-cadherin（P < 0.05）. The application of STAT3 inhibitor Stattic in Eca-109 cells overexpressing SDC2 could significantly inhibit the phosphorylation level of STAT3（P < 0.05）. Conclusion:SDC2 is highly expressed in ESCC, which is closely related to the clinicopathological stage and poor prognosis of patients. As a key downstream effector molecule, STAT3 drives cell proliferation, migration, invasion and EMT processes by activating the STAT3 signaling pathway.
2026,
47(5):
37-47.
doi: 10.12259/j.issn.2095-610X.S20260504
Abstract:
Objective To investigate the specific molecular mechanisms by which the hypoxia-inducible factor 2alpha （HIF-2α）/C-X-C chemokine receptor 4 （CXCR4） pathway regulates the progression of osteoarthritis （OA）. Method A cartilage degeneration cell model was established using primary chondrocytes from male C57BL/6 mice. Co-transfected cells with pcDNA, pcDNA-HIF-2α, si-NC, si-HIF-2α, and si-CXCR4 plasmids. Detected expression levels of HIF-2α, CXCR4, MMP-3, Collagen II, and aggrecan via RT-qPCR, Western blot, and immunofluorescence. Flow cytometry assessed apoptosis, while ELISA measured levels of inflammatory mediators PGE2, IL-6, IL-1β, and TNF-α. EMSA, ChIP, and dual luciferase assays validated the interaction between HIF-2α and CXCR4. Results HIF-2α promoted chondrocyte apoptosis under hypoxic conditions by upregulating MMP-3 expression and secretion of inflammatory mediators PGE2, IL-6, IL-1β, and TNF-α （P < 0.05） while downregulating Collagen II and aggrecan expression （P < 0.001）. HIF-2α binds to the CXCR4 promoter to regulate its transcriptional expression. HIF-2α promotes OA progression under hypoxia by activating CXCR4. Knockdown of CXCR4 inhibited HIF-2α's promotion of chondrocyte inflammation, degradation, and apoptosis, thereby alleviating OA progression. Conclusion The HIF-2α/CXCR4 axis effectively mediates chondrocyte inflammation, matrix degradation, and apoptosis.
2026,
47(5):
48-58.
doi: 10.12259/j.issn.2095-610X.S20260505
Abstract:
Objective To investigate the role of Sirtuin 3 （SIRT3） in 5-fluorouracil （5-FU） resistance of colorectal cancer （CRC） cells and to elucidate whether it enhances tumor cell sensitivity to 5-FU by regulating Forkhead box O3a （FoxO3a）/BCL2 interacting protein 3 （BNIP3）-mediated mitophagy. Methods A 5-FU-resistant CRC cell line was established, and a SIRT3 stably overexpressing cell line was constructed via lentiviral transfection. The half-maximal inhibitory concentration （IC50） was measured by CCK-8 assay, and apoptosis was detected by flow cytometry. Western blot was used to detect the expression of SIRT3, FoxO3a, BNIP3, and mitophagy-associated proteins including microtubule-associated protein 1 light chain 3 （LC3）, sequestosome 1 （p62）, PTEN-induced putative kinase 1 （PINK1）, and Parkin RBR E3 ubiquitin-protein ligase （Parkin）. Co-localization of mitochondria and autophagosomes was observed by immunofluorescence staining. Western blot was used to detect the expression of SIRT3, FoxO3a, BNIP3, and mitophagy-associated proteins including microtubule-associated protein 1 light chain 3 (LC3), sequestosome 1 (p62), PTEN-induced putative kinase 1 (PINK1), Parkin RBR E3 ubiquitin-protein ligase (Parkin) and FoxO3a acetylation level. A subcutaneous xenograft tumor model in nude mice was established to evaluate the anti-tumor effect of SIRT3 overexpression in vivo. Results The protein expression of SIRT3, FoxO3a, and BNIP3 was significantly downregulated in 5-FU-resistant CRC cells compared with parental cells （P < 0.05）, accompanied by decreased co-localization of mitochondria and autophagosomes. Overexpression of SIRT3 markedly reduced the IC50 value of 5-FU-resistant cells, increased the apoptosis rate （P < 0.01）, elevated the LC3-II/I ratio, decreased p62 expression, and upregulated PINK1 and Parkin expression （P < 0.05）. Furthermore, SIRT3 overexpression decreased FoxO3a acetylation and increased BNIP3 expression. The combination of SIRT3 overexpression and 5-FU significantly inhibited tumor growth in vivo （P < 0.01）, and the changes in autophagy-associated protein expression in tumor tissues were consistent with the in vitro results, with an increase in autophagosomes. Conclusion SIRT3 reverses 5-FU resistance in CRC cells by deacetylating and activating the FoxO3a/BNIP3 pathway to induce mitophagy, and combination therapy exerts a synergistic anti-tumor effect.
2026,
47(5):
59-66.
doi: 10.12259/j.issn.2095-610X.S20260506
Abstract:
Objective To investigate the effects of TMAO inhibitor on mitochondrial damage, skeletal muscle function, and microvascular senescence in rats with diabetic sarcopenia. Methods An animal model of diabetic sarcopenia was established in specific pathogen-free experimental animal （SPF） grade male rats, and intervention was carried out with 3, 3-dimethyl-1-butanol （DMB）. The fasting blood glucose, insulin and insulin resistance index of rats in each group were detected. Rope grasping test, gastrocnemius muscle weight, body weight detection; Pathological morphology of the gastrocnemius muscle detection of mitochondrial membrane potential and ultrastructure expression of microvascular aging-related proteins MMP-2, MCP-1 and TGFβ1. Results Compared with the healthy control group, the model group showed significant decreases in insulin level, wire-hanging time, body weight, gastrocnemius muscle weight, gastrocnemius-to-body weight ratio, and mitochondrial membrane potential （P < 0.05）, along with significant increases in FBG, HOMA-IR （P < 0.05）, and the expression levels of MMP-2, MCP-1, and TGF-β1 （P < 0.05）. Compared with the model group, the 0.1% DMB group exhibited significant increases in insulin level, wire-hanging time, body weight, gastrocnemius muscle weight, gastrocnemius-to-body weight ratio, and mitochondrial membrane potential, as well as significant decreases in FBG, HOMA-IR, and the expression levels of MMP-2, MCP-1, and TGF-β1 （P < 0.05）. Conclusion TMAO inhibitor can reduce FBG and insulin resistance, alleviate mitochondrial damage, and thereby improve skeletal muscle function in rats with diabetic sarcopenia. This effect is presumably achieved by inhibiting the expression of MMP-2, MCP-1, and TGF-β1 to reduce microvascular senescence.
2026,
47(5):
67-79.
doi: 10.12259/j.issn.2095-610X.S20260507
Abstract:
Objective To preliminarily investigate the molecular mechanisms of interleukin-15 （IL-15） in T-cell acute lymphoblastic leukemia （T-ALL）. Methods Open-access T-ALL datasets syn54032669 （n = 1335 ） and GSE33315 （n = 38） were used to analyze the correlation between IL-15 levels and clinical features including survival and minimal residual disease （MRD）; DESeq2 package in R was used to identify differentially expressed genes between IL-15-high and IL-15-low groups; packages including clusterProfiler were utilized to perform enrichment analyses; Annexin V/7-AAD staining and cell growth curves were performed to analyze the effects of IL-15 on the apoptosis and growth of T-ALL cells; real-time quantitative PCR and Western blot were performed to validate the effects of IL-15 on PI3K/AKT pathway and transcription of downstream genes. Results T-ALL patients with high IL-15 levels had longer overall survival （P < 0.05） and event-free survival （P = 0.074） but lower MRD levels （P < 0.0001 ）; IL-15 increased the proportion of early apoptotic cells but failed to inhibit the growth of T-ALL cells; IL-15 remarkably inhibited the transcription of neurotrophic receptor tyrosine kinase 1 （NTRK1） （P < 0.01） and fibroblast growth factor 9 （FGF9） （P < 0.05）, and also NTRK1-mediated activation of PI3K/AKT pathway; T-ALL patients with high NTRK1 and FGF9 levels had worse prognosis （P < 0.05）. Conclusion IL-15 exerts tumor suppressor-like functions by repressing the transcription of NTRK1 and FGF9, as well as inhibiting PI3K-AKT pathway activated by NTRK1 in T-ALL.
2026,
47(5):
80-87.
doi: 10.12259/j.issn.2095-610X.S20260508
Abstract:
Objective To investigate the application value of diaphragmatic ultrasound, reflex cough peak flow （RCPF） and Glasgow Coma Scale （GCS） in extubation evaluation of patients with brain injury after tracheotomy. Methods A retrospective analysis was performed on 39 patients with brain injury after tracheotomy admitted to the Rehabilitation Medicine Center of The Second Affiliated Hospital of Kunming Medical University from August 2024 to October 2025. The patients were divided into successful extubation group （19 cases） and a failed extubation group （20 cases） according to extubation outcomes during hospitalization. General clinical data, diaphragm ultrasound parameters, RCPF, GCS and interleukin-6 （IL-6） were collected and all examinations were completed within 24 hours before extubation. Exploratory statistical analyses were conducted using univariate analysis, stepwise binary Logistic regression, and receiver operating characteristic （ROC） curve. Results The diaphragm thickening fraction （DTF）, diaphragm excursion （DE）, RCPF, and GCS in the successful extubation group were significantly higher than those in the failed extubation group （P < 0.05）. There were no significant differences in diaphragm thickness at end inspiration （DTei） or IL-6 between the two groups （P > 0.05）. Logistic regression showed that RCPF and GCS were correlated with extubation outcomes （P < 0.05）. The area under the ROC curve （AUC） of combined evaluation of the two indicators was 0.911, with a sensitivity of 89.50% and a specificity of 75.00%, indicating satisfactory model fitting and validation performance. Conclusion This study demonstrates that DTF, DE, RCPF, and GCS score are all associated with extubation outcomes, among which the combined evaluation of RCPF and GCS score presents favorable predictive efficacy.
2026,
47(5):
88-96.
doi: 10.12259/j.issn.2095-610X.S20260509
Abstract:
Objective To analyze, based on cardiac magnetic resonance imaging （CMR）, the factors influencing the occurrence of left ventricular reverse remodeling （LVRR） in patients with heart failure with reduced ejection fraction （HFrEF） following treatment with an angiotensin receptor-neprilysin inhibitor （ARNI） combined with standard anti-heart failure medications. Methods This study enrolled 65 patients with HFrEF who were treated at the First Affiliated Hospital of Kunming Medical University. All of whom received treatment with ARNI combined with standard anti-heart failure medications. Clinical data, medication history, and CMR and echocardiographic parameters were collected. Patients were divided into an LVRR group and a non-LVRR group based on echocardiographic follow-up results, and statistical analysis was performed to identify predictors of LVRR. Results The median follow-up duration was 10 （5, 20） months. The LVRR group comprised 31 patients （48%）, and the non-LVRR group comprised 34 patients （52%）. Compared with the non-LVRR group, the LVRR group had a higher initial ARNI dose, a lower incidence of atrial fibrillation, and higher values for interventricular septal thickness, left ventricular lateral wall thickness, myocardial mass, and myocardial mass index. Additionally, the LVRR group had a smaller left atrial anterior-posterior diameter （LAAPD） and a lower percentage of late gadolinium enhancement （LGE） myocardium relative to total left ventricular myocardial mass （LGE%）. All these differences were statistically significant （P < 0.05）. Regression analysis of these variables with LVRR as the endpoint identified three predictors of LVRR: ARNI starting dose （OR: 3.253, 95%CI: 1.277～8.285, P = 0.013）, LGE% （OR: 0.789, 95%CI: 0.647～0.963, P = 0.020）, LAAPD （OR: 0.883, 95%CI: 0.804～0.969, P = 0.009）. Conclusion ARNI starting dose, LGE%, and LAAPD are predictors of LVRR in patients with HFrEF treated with ARNI combined with standard heart failure medications. CMR can provide prognostic indicators for ARNI therapy in heart failure.
2026,
47(5):
97-106.
doi: 10.12259/j.issn.2095-610X.S20260510
Abstract:
Objective To systematically analyze the burden of ischemic heart disease （IHD） attributable to low physical activity （LPA） globally and in China from 1990 to 2021, and to predict its trends up to 2030, thereby providing evidence for formulating relevant healthcare policies. Methods Based on the global burden of disease （GBD） 2021 data, a comprehensive analysis and projection were conducted using Joinpoint regression, age-period-cohort （APC） modeling, decomposition analysis, and Bayesian age-period-cohort （BAPC） modeling. Results In 2021, the global age-standardized mortality rates （ASMR） and age-standardized DALYs rates （ASDR） for IHD attributable to LPA were 2.88 per 100,000 and 46.63 per 100,000, respectively. In China, the corresponding figures were 3.52 per 100,000 and 46.05 per 100,000. Joinpoint regression analysis revealed a declining trend in global ASMR and ASDR, whereas in China, these rates showed an M-shaped fluctuating rise with significant gender disparities. Similarly, the APC model also indicates a downward trend in the global burden of disease, while China shows a pattern of initial deceleration, followed by an increase, and then a renewed moderation. Moreover, the burden of disease among Chinese males has grown more markedly compared to that among females. Decomposition analysis highlighted population growth and aging as the primary drivers of the disease burden. BAPC model projections suggested that by 2030, China’ s disease burden was expected to grow faster than the global average, with the trend being more pronounced among younger male populations. Conclusion The global burden of IHD attributable to LPA is declining. However, in China, due to population growth and aging, the disease burden continues to rise, characterized by a heavier absolute burden among females and a particularly pronounced increasing trend among young males.
2026,
47(5):
107-114.
doi: 10.12259/j.issn.2095-610X.S20260511
Abstract:
Objective To investigate the efficacy of combining serum fibronectin 3 （FCN3） with insulin-like growth factor 1 （IGF-1） in evaluating recurrent respiratory tract infections （RRTIs） in children and its correlation with immune function. Methods A total of 142 children with RRTIs （RRTIs group） and 142 children with acute occasional respiratory tract infection （infection group） admitted to Zigong Maternal and Child Health Hospital from September 2022 to August 2024 were selected. Additionally, 50 healthy children during the same period were selected as the control group. Another 50 children with respiratory tract infection from September 2024 to January 2025 were selected as the validation set for prospective cohort validation. The baseline data and serum levels of FCN3 and IGF-1 were compared among the three groups. The evaluation value of FCN3 and IGF-1 for the risk of RRTIs was analyzed. The immune functions （CD3+ T lymphocytes, CD4+ T lymphocytes, CD4+/CD8+） were compared among the three groups, and their correlation with serum level of FCN3 and IGF-1 was analyzed. Results The levels of serum FCN3 and IGF-1 in the RRTIs group were lower than those in the infection group and the control group （P < 0.05）, the level of serum FCN3 in the infection group was lower than that in the control group, However, there was no significant difference in the levels of serum IGF-1 between the infection group and the control group （P > 0.05）. Elevated FCN3 and IGF-1 were independently associated protective factors for RRTIs （P < 0.05）. The AUC value of the combined evaluation of RRTIs using serum FCN3 and IGF-1 is greater than that of serum FCN3 and IGF-1 （P < 0.05）. The levels of CD3+ T lymphocytes, CD4+ T lymphocytes, and CD4+/CD8+ in the RRTIs group were lower than those in the infection group and the control group, with the infection group having lower levels than the control group （P < 0.05）. The levels of serum FCN3 and IGF-1 were positively correlated with CD3+ T lymphocytes, CD4+ T lymphocytes, and CD4+/CD8+ （all P < 0.05）. The Kappa value consistency analysis showed that the coincidence rate of the ROC results of FCN3 and IGF-1 combined with clinical practice in the validation set was 90.00 %, and the Kappa value was 0.799 （95%CI: 0.524～0.912） （P < 0.001）. Conclusion The levels of serum FCN3 and IGF-1 in children with RRTIs are closely related to immune function, and the combined detection of their levels has certain evaluation value for the risk of RRTIs.
2026,
47(5):
115-125.
doi: 10.12259/j.issn.2095-610X.S20260512
Abstract:
Objective To explore the value of uterine artery blood flow Doppler ultrasound combined with serum suppressor of cytokine signaling 3 （SOCS-3） and Fibulin-3 in predicting the pregnancy outcome of preeclampsia pregnant women in the second trimester. Method A retrospective analysis method was adopted. The clinical baseline data of 123 pregnant women with preeclampsia in the second trimester who were received by the Medical Ultrasound Center of Northwest Women's and Children's Hospital from January 2022 to December 2024 were collected as the case group. Another 105 pregnant women in the second trimester who underwent routine health examinations were selected as the normal group. The uterine artery blood flow parameters were detected by color Doppler ultrasound. Including the pulsatility index （PI） and the resistance index RI and the ratio of systolic peak velocity to end-diastolic velocity （S/D）; The levels of serum SOCS-3 and Fibulin-3 were detected by enzyme-linked immunosorbent assay （ELISA）. the predictive efficacy of individual and combined detection of each index for the pregnancy outcome of preeclampsia was evaluated through statistical analysis, and the area under the curve （AUC）, sensitivity and specificity were calculated. Result The PI, RI, S/D values of uterine artery blood flow and the level of Fibulin-3 in the case group of pregnant women were all higher than those in the normal group （P < 0.05）, while the level of serum SOCS-3 was significantly lower than that in the normal group （P < 0.05）. Among pregnant women with preeclampsia in the second trimester of pregnancy, there were 3 cases of premature birth, 5 cases of fetal growth restriction, 10 cases of placental abruption, 7 cases of eclampsia, 10 cases of postpartum hemorrhage, and a total of 35 cases of adverse pregnancy outcomes. Univariate analysis showed that PI, RI, S/D values and serum levels of SOCS-3 and Fibulin-3 were all influencing factors of adverse pregnancy outcomes （P < 0.05）; Logistic regression analysis confirmed that Fibulin-3, RI, S/D value, decreased SOCS-3, and elevated PI were independent risk factors for adverse pregnancy outcomes （P < 0.05）. Construct a joint prediction model （regression equation:） （Fibulin-3×4.767+RI×1.735+S/D value ×2.286-SOCS-3×10.402+PI×1.044）, the area under the ROC curve （AUC） was 0.998, the specificity was 96.59%, and the sensitivity was 100.00% It was significantly superior to each individual indicator （Fibulin-3 AUC 0.996, RI AUC 0.977, S/D value AUC 0.877, SOCS-3 AUC 0.914, PI AUC 0.794, P < 0.05）. Conclusion The combination of uterine artery blood flow parameters and the levels of SOCS-3 and Fibulin-3 in serum has a predictive value that significantly exceeds the limitations of a single indicator, greatly improving the accuracy of predicting adverse pregnancy outcomes in pregnant women with preeclampsia. It provides a new evaluation method for the early prediction of pregnancy outcomes in pregnant women with preeclampsia in the second trimester.
2026,
47(5):
126-134.
doi: 10.12259/j.issn.2095-610X.S20260513
Abstract:
Objective To explore the relationship between neurological involvement in patients with antineutrophil cytoplasmic antibody （ANCA）-associated vasculitis and the difference of serum levels of perinuclear anti-neutrophil cytoplasmic antibody （p-ANCA）, erythrocyte sedimentation rate （ESR）, myeloperoxidase immunoglobulin G antibodies （MPO-IgG） and C-reactive protein （CRP）, as well as their predictive value for the prognosis. Methods A total of 106 patients with ANCA-associated vasculitis admitted to the First Affiliated Hospital of Zhejiang University School of Medicine from January 2020 to November 2024 were selected and divided into good prognosis group and poor prognosis group according to the prognosis. Propensity score matching （PSM） was used to reduce baseline differences. The positive rate of p-ANCA and the levels of ESR, MPO-IgG antibody and CRP in patients with different prognosis and neurological involvement were compared. Multivariate Logistic regression was used to analyze the relationship between the above indicators and the prognosis of patients, and ROC curve was used to analyze the predictive efficacy of each indicator and combined detection on prognosis. Results The positive rate of p-ANCA and the levels of ESR, MPO-IgG antibody and CRP in the poor prognosis group were significantly higher than those in the good prognosis group （P < 0.05）. The above indexes in patients with neurological involvement were also significantly higher than those in patients without involvement （P < 0.05）. Multivariate logistic regression analysis showed that p-ANCA positive, ESR, MPO-IgG antibody and CRP were independent predictors of prognosis, especially in patients with neurological involvement （greater OR value, P < 0.05）. ROC curve analysis showed that AUC of each single index in predicting prognosis was between 0.675 and 0.780, and AUC of combined prediction was as high as 0.922, which was significantly better than that of single index （P < 0.05）. The combined AUC values were significantly greater than p-ANCA, ESR, MPO-IgG, and CRP alone （Z = 4.813, 3.414, 2.508, 2.291, P < 0.001, P = 0.001, P = 0.012, P = 0.022）. Conclusion The positive rate of p-ANCA and the levels of ESR, MPO-IgG antibody and CRP are closely related to the neurological involvement and poor prognosis in patients with ANCA-associated vasculitis.
2026,
47(5):
135-140.
doi: 10.12259/j.issn.2095-610X.S20260514
Abstract:
Objective To analyze the achievement rate of steady-state trough concentrations （hereinafter referred to as trough concentrations） and the occurrence of nephrotoxicity in elderly patients receiving vancomycin, and to explore the appropriateness of initial dosing regimens based on the Chinese Guidelines for Therapeutic Drug Monitoring of Vancomycin （2020 Update）. Methods Clinical data of 307 elderly patients treated with vancomycin were retrospectively collected. According to creatinine clearance (Ccr), the patients were divided into six groups: Ccr < 30 mL/min (n = 25), Ccr 30～39.99 mL/min (n = 32), Ccr 40～54.99 mL/min (n = 70), Ccr 55～74.99 mL/min (n = 94), Ccr 75～89.99 mL/min (n = 48), and Ccr ≥ 90 mL/min (n = 38). The trough concentration attainment rate and the incidence of nephrotoxicity of vancomycin were analyzed for different dosing regimens within each group. Results Only 39.8% of the initial dosing regimens in elderly patients were consistent with the guideline recommendations, and 41.6% of patients had daily doses exceeding the recommended range. The overall achievement rate of vancomycin trough concentrations was 41.7%, with statistically significant differences among different Ccr groups（χ2 = 24.652, P = 0.006）. In the Ccr 30～39.99 mL/min group, the achievement rates of the 1 g/d and 0.5 g/12 h regimens were higher than that of the 0.5 g/d regimen （P = 0.007）; in the Ccr 40～54.99 mL/min group, the achievement rate of the 0.5 g/8 h regimen was higher than those of the 1 g/d and 0.5 g/12 h regimens （P = 0.006）. The overall incidence of nephrotoxicity was 16.9%. Multivariate analysis identified age, ICU admission, and vancomycin trough concentration as independent risk factors for nephrotoxicity in elderly patients. Conclusion For elderly patients with Ccr 30～54.99 mL/min, optimizing the dosing regimen based on guideline recommendations （1 g/d or 0.5 g/12 h for Ccr 30～39.99 mL/min; 0.5 g/8 h for Ccr 40～54.99 mL/min） could improve the achievement rate of trough concentrations without significantly increasing the risk of nephrotoxicity.
Application of miR-132，BDNF and NRG-1 in the Diagnosis and Prognosis of AI-related Vascular Dementia
2026,
47(5):
141-148.
doi: 10.12259/j.issn.2095-610X.S20260515
Abstract:
Objective To discuss the application of serum microRNA-132 （miR-132） jointed with brain-derived neurotrophic factor （BDNF） and neuregulin-1 （NRG-1） in the diagnosis and prognosis evaluation of acute ischemic stroke （AIS）-related vascular dementia （VD）. Methods A total of 183 patients with AIS and complicated VD admitted to Xi'an Gaoxin Hospital from August 2022 to January 2025 were included as the VD group. They were followed up for 6 months and separated into adverse group （n = 54） and good group （n = 129） based on their prognosis. Another 175 AIS patients who did not have complicated VD during the same period were included as the non VD group. In addition, the influencing factors of poor prognosis in patients with AIS and complicated VD and the predictive efficacy of serum miR-132, BDNF, and NRG-1 levels for poor prognosis in patients with AIS and complicated VD were discussed. Results The levels of serum miR-132, BDNF and NRG-1 in the VD group were all lower than those in the non-VD group （P < 0.05）. Serum miR-132, BDNF and NRG-1 were the influencing factors of AIS complicated with VD （P < 0.05）. The AUC （0.860） of the jointed diagnosis for AIS complicated with VD was higher than that of the individual diagnosis （0.796, 0.758, 0.713） （P < 0.05）. Compared with the good group, the poor group had a higher proportion of admission MMSE scores ≤ 20, and lower levels of serum miR-132, BDNF, and NRG-1 （P < 0.05）. Serum miR-132, BDNF, and NRG-1 were prognostic factors in patients with AIS and complicated VD （P < 0.05）. The AUC of the jointed prediction （0.920） for the prognosis of patients with AIS and complicated VD was obviously higher than that of the individual predictions of each indicator （0.806, 0.788, 0.850）. Conclusion Serum miR-132, BDNF, and NRG-1 are all reduced in patients with AIS and complicated VD. The combined detection of these three markers may have certain application value in the diagnosis and prognosis evaluation of AIS-related vascular disease.
2026,
47(5):
149-157.
doi: 10.12259/j.issn.2095-610X.S20260516
Abstract:
Objective To investigate the clinical significance of receptor tyrosine kinase-like orphan receptor 1 （ROR1）, epidermal growth factor receptor （EGFR）, and cell proliferation nuclear antigen （Ki-67） expression in invasive pulmonary adenocarcinoma （IPA） of different histological grades, and to explore their value in assisting the pathological grading of IPA. Methods A total of 290 patients with pathologically confirmed IPA admitted to the First Affiliated Hospital of Kunming Medical University from June 2019 to June 2021 were enrolled. Cancer tissue specimens were collected and stained with hematoxylin and eosin （HE）. Histological grading was performed according to the International Association for the Study of Lung Cancer （IASLC） criteria. The expression levels of ROR1, EGFR and Ki-67 were determined by immunohistochemical staining using a semi-quantitative scoring method. Statistical analyses were conducted to evaluate the association of high expression of ROR1, EGFR and Ki-67 with different clinicopathological features and the correlations among these three markers. Results High expression levels of ROR1, EGFR and Ki-67 were observed in poorly differentiated IPA, and significant differences in expression were found among well-differentiated, moderately differentiated, and poorly differentiated groups （P < 0.05）. The expression levels of these markers were not associated with patient sex, age, or smoking history （P > 0.05）, but were significantly correlated with aggressive biological behaviors including tumor diameter, histological morphology, lymph node metastasis, nerve invasion, vascular invasion, and pleural invasion （P < 0.05）. Positive correlations were found between ROR1 and EGFR expression （C = 0.342, P < 0.001） and between ROR1 and Ki-67 expression （C = 0.287, P < 0.001）. Conclusion ROR1 in combination with EGFR and Ki-67 may help determine the differentiation degree and biological characteristics of IPA, providing reference evidence for prognosis assessment and treatment decision-making in patients with pulmonary adenocarcinoma.
2026,
47(5):
158-166.
doi: 10.12259/j.issn.2095-610X.S20260517
Abstract:
Citrate is an essential component of bone and a key metabolic intermediate in the tricarboxylic acid cycle.In recent years, it has become a focal point in biomaterials research due to its excellent biocompatibility, biodegradability, and multifunctional chemical structure. Citrate-based biomaterials not only offer tunable mechanical properties and favorable processability but also actively promote bone tissue regeneration through various mechanisms, including cellular metabolic regulation, immunomodulation, vascular-bone coupling, and neuro-bone integration.To date, several citrate-based orthopedic fixation devices have been approved by the U.S. Food and Drug Administration.This article systematically reviews the development history, current application status, and osteogenic mechanisms of citrate-based materials in orthopedics, and analyzes the progress and challenges of their clinical translation.
Citrate is an essential component of bone and a key metabolic intermediate in the tricarboxylic acid cycle.In recent years, it has become a focal point in biomaterials research due to its excellent biocompatibility, biodegradability, and multifunctional chemical structure. Citrate-based biomaterials not only offer tunable mechanical properties and favorable processability but also actively promote bone tissue regeneration through various mechanisms, including cellular metabolic regulation, immunomodulation, vascular-bone coupling, and neuro-bone integration.To date, several citrate-based orthopedic fixation devices have been approved by the U.S. Food and Drug Administration.This article systematically reviews the development history, current application status, and osteogenic mechanisms of citrate-based materials in orthopedics, and analyzes the progress and challenges of their clinical translation.
2026,
47(5):
167-176.
doi: 10.12259/j.issn.2095-610X.S20260518
Abstract:
Bladder cancer （BCa） is a common malignancy of the urinary system, and early precise diagnosis and treatment are essential for improving prognosis. Near-infrared fluorescence imaging （NIR）, with low background interference, high signal-to-noise ratio, and real-time imaging capability, has shown promising potential in bladder cancer management. This review summarizes recent advances in NIR imaging for bladder cancer, focusing on the design of targeted fluorescent probes and their applications in tumor detection, margin delineation, and lymph node localization, as well as their value in transurethral surgery and related procedures. Current challenges, including limited tissue penetration, inconsistency in signal quantification, and insufficient clinical standardization, are also discussed. In addition, future directions involving photothermal/photodynamic therapy, multimodal imaging, and artificial intelligence are highlighted. This review may provide a reference for further research and clinical translation of NIR imaging in bladder cancer.
Bladder cancer （BCa） is a common malignancy of the urinary system, and early precise diagnosis and treatment are essential for improving prognosis. Near-infrared fluorescence imaging （NIR）, with low background interference, high signal-to-noise ratio, and real-time imaging capability, has shown promising potential in bladder cancer management. This review summarizes recent advances in NIR imaging for bladder cancer, focusing on the design of targeted fluorescent probes and their applications in tumor detection, margin delineation, and lymph node localization, as well as their value in transurethral surgery and related procedures. Current challenges, including limited tissue penetration, inconsistency in signal quantification, and insufficient clinical standardization, are also discussed. In addition, future directions involving photothermal/photodynamic therapy, multimodal imaging, and artificial intelligence are highlighted. This review may provide a reference for further research and clinical translation of NIR imaging in bladder cancer.
