Tianjin Medical Journal

Tianjin expert consensus on the prevention and treatment of refractory chemotherapy-related nausea and vomiting (2025 edition)

Tianjin Anti-Cancer Association Committee of Rehabilitation and Palliative Care, Tianjin Medical Doctor Association Committee of Tumor Multidisciplinary Diagnosis and Treatment

2025, 53 (1): 1-8. doi: 10.11958/20240783

Abstract ( 161 )

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Nausea and vomiting are the most common adverse reactions of chemotherapy. In recent years, with the progression of palliative and supportive care, the prevention and control rate of chemotherapy induced nausea and vomiting (CINV) have been effectively improved. However, a small number of CINV still cannot be controlled satisfactorily or recurrence after receiving CINV prevention and treatments, which gradually develops into refractory CINV. Refractory CINV is a very difficult problem in the field of supportive care, which seriously affects the quality of life of patients, chemotherapy progress and prognosis. Therefore, Tianjin Anti-Cancer Association Committee of Rehabilitation and Palliative Care and Tianjin Medical Doctor Association Committee of Tumor Multidisciplinary Diagnosis and Treatment (MDT) organized experts to formulate a Tianjin expert consensus on the prevention and treatment of refractory CINV. The concept of refractory CINV, prevention and treatment strategies, specific medication guidance, traditional Chinese medical treatments, nursing and MDT management are summarized. Meanwhile, the corresponding recommendations are also given in order to provide more reference for improving the prevention and treatment of refractory CINV. This consensus only provides academic guidance for refractory CINV, the specific implementation plans need to be determined based on actual clinical conditions.

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Effect of protein tyrosine phosphatase receptor R-type on malignant biological behavior of glioma cells

GAO Rui, ZHOU Guanen, HONG Yan, YAN Yan

2025, 53 (1): 9-13. doi: 10.11958/20240831

Abstract ( 144 )

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Objective To explore effects of protein tyrosine phosphatase receptor type R (PTPRR) on malignant biological behavior of glioma cells.Methods UALCAN website was used to analyze the expression of PTPRR in glioma samples from the Cancer Genome Atlas (TCGA) database. The fresh brain glioma tissue samples of 20 patients with glioma and normal brain tissue samples of 20 patients with traumatic cerebral hemorrhage removed during operation were obtained. Human glioma cell line and human astrocyte cell line were cultured. U87 cells were respectively transfected with PTPRR over-expression plasmid pcDNA3.1/PTPRR (pcDNA3.1/PTPRR group) and blank control plasmid pcDNA3.1 (pcDNA3.1 group). The expression of PTPRR mRNA in different glioma cell lines and glioma tissue samples were detected by quantitative real-time PCR. Cell activity was detected by CCK-8 assay. Cell proliferation capacity was detected by colony formation assay. Cell migration and invasion ability were detected by transwell assay. Meanwhile, the cell apoptosis experiment was performed.Results The result of UALCAN database analysis indicated that the expression of PTPRR in glioma was lower than that in normal brain tissue, and the expression of PTPRR was lower in high grade gliomas than that of low grade gliomas. The survival time of glioma patients with low/medium PTPRR expression was shorter than that of patients with high PTPRR expression. The result quantitative real-time PCR showed that the expression levels of PTPRR mRNA in different glioma cell lines and glioma tissue were decreased. CCK-8 assay showed that the cell viability at 24 h and 48 h after over-expression of PTPRR was decreased respectively compared with the pcDNA3.1 group. Results of colony formation assay, Transwell migration and invasion assays showed that the number of colony formation, migration and invasion ability of glioma cells after over-expression of PTPRR were lower than the pcDNA3.1 group. The result of apoptosis experiment showed that the apoptosis rate of glioma cells after over-expression of PTPRR was increased compared with that of the pcDNA3.1 group.Conclusion The expression of PTPRR in glioma is lower. PTPRR acted as a tumor suppressor gene inhibits the activity, proliferation, migration and invasion of glioma cells, and promotes glioma cell apoptosis.

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The mechanism of excessive mechanical stress modulates Piezo1-mediated ferroptosis in chondrocytes

WU Bin, LIU Zhaoxiang, ZHANG Yuehong, WANG Changyao

2025, 53 (1): 14-18. doi: 10.11958/20241259

Abstract ( 147 )

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Objective To explore the mechanism of excessive mechanical stress regulated ferroptosis induced by Piezo1 channel in mouse chondrocytes.Methods The experiment was performed on mouse ATDC5 chondrocytes. siRNA-Piezo1 interference plasmid and Piezo1 overexpression plasmid were used to transfect chondrocytes, and mechanical stress stimulation was given. The control group, the mechanical stress stimulation group (MS group), the MS+siRNA-Piezo1 group (MS+sh group) and the MS+Piezo1 overexpression group (MS+OV group) were constructed, respectively. The cell viability, Fe²⁺, ROS levels, the expression of ferroptosis-related proteins SLC7A11 and GPX4, and the expression of Collagen Ⅱ, MMP-13, Aggrecan and p53 proteins were detected in each group.Results Compared with the control group, the cell viability was decreased in the MS group (P<0.05). Levels of Fe²⁺, reactive oxygen species (ROS) and malondialdehyde (MDA) were increased (P<0.05). Levels of reduced glutathione (GSH) and superoxide dismutase (SOD) were decreased (P<0.05), and the mitochondrial ridge was decreased detected by transmission electron microscopy. Protein levels of SLC7A11, GPX4, Collagen Ⅱ and Aggrecan were decreased (P<0.05), while protein levels of p53 and MMP-13 were increased (P<0.05). Compared with the MS group, Fe²⁺, ROS and MDA levels were decreased in the MS+sh group (P<0.05), GSH and SOD levels were increased (P<0.05), and protein levels of SLC7A11, Collagen Ⅱ, GPX4 and Aggrecan were increased (P<0.05). The protein levels of MMP-13 and p53 were decreased (P<0.05). Compared with the MS group, cell viability was decreased (P<0.05), Fe²⁺, ROS and MDA levels were increased (P<0.05), GSH and SOD levels were decreased (P<0.05), and protein levels of SLC7A11, Collagen Ⅱ, GPX4 and Aggrecan were decreased in the MS+OV group (P<0.05). Levels of MMP-13 and p53 protein were increased (P<0.05).Conclusion Excessive mechanical stress can induce chondrocyte ferroptosis and promote extracellular matrix degradation via Piezo1 channel protein.

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Magu Xujin capsule promotes hip fracture healing in aged rats through SDF-1/CXCR4 signaling pathway

HOU Xiuxiu, XING Baorui, FENG Yuanchao, ZHANG Yadi

2025, 53 (1): 19-23. doi: 10.11958/20241261

Abstract ( 179 )

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Objective To explore the effects of Magu Xujin capsule on hip fracture healing and stromal cell-derived factor-1/CXC chemokine receptor 4 (SDF-1/CXCR4) signaling pathway in elderly hip fracture rats. Methods The hip fracture model of aged rats was established, and successfully modeled rats were randomly separated into the model group, the low-dose Magu Xujin capsule group, the high-dose Magu Xujin capsule group, the high-dose Magu Xujin capsule+pathway inhibitor group (the high-dose Magu Xujin capsule and AMD3100 group), with 12 rats in each group. An additional 12 healthy rats were selected as the control group. X-ray was used to observe the healing of hip fractures in rats, and Garrett score was performed. Enzyme-linked immunosorbent assay (ELISA) was applied to detect serum levels of inflammatory factors related to fracture healing, such as tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10). CT scanning analysis was used to determine bone volume fraction (BV/TV) and bone surface area/volume ratio (BS/BV). Immunohistochemistry was applied to detect the expression of fracture healing factor insulin-like growth factor-1 (IGF-1) and bone morphogenetic protein-2 (BMP-2). Western blot assay was applied to detect the expression of SDF-1/CXCR4 signaling pathway related proteins. Results Garrett score, IL-10 level, BV/TV, BS/BV, the IGF-1, BMP-2, SDF-1 and CXCR4 expression were lower in the model group than those in the control group, while TNF-α level was higher (P<0.05). Garrett score, IL-10 level, BV/TV, BS/BV, IGF-1, BMP-2, SDF-1 and CXCR4 expression were higher in the low-dose and high-dose Magu Xujin capsule groups than those in the model group, while TNF-α level was lower (P<0.05). Garrett score, IL-10 level, BV/TV, BS/BV, IGF-1, BMP-2, SDF-1 and CXCR4 expression were lower in the high-dose Magu Xujin capsule+AMD3100 group than those in the high-dose Magu Xujin capsule group, while TNF-α level was higher (P<0.05). Conclusion Magu Xujin capsule can promote hip fracture healing in aged rats, and its mechanism may be related to the activation of SDF-1/CXCR4 signaling pathway.

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Study on the mechanism of Fu Fang Ku Shen Zhu She Ye alleviating adverse reactions of 5-fluorouracil chemotherapy in rats with liver cancer

WANG Ruoyu, ZHANG Yu, WANG Jiahui, ZHANG Zhanxia

2025, 53 (1): 24-28. doi: 10.11958/20241277

Abstract ( 116 )

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Objective To explore effects and action mechanism of Fu Fang Ku Shen Zhu She Ye on adverse reactions of 5-fluorouracil (5-FU) chemotherapy in rats with liver cancer.Methods The rat model of liver cancer was constructed by diethylnitrosamine (DEN). Model rats were divided into the liver cancer group, the chemotherapy group and the chemotherapy +Fu Fang-L/M/H groups. At 24 h after modeling, the chemotherapy group and the chemotherapy + Fu Fang groups were given intraperitoneally injection of 5-FU (100 mg/kg, once/week), and the chemotherapy + Fu Fang-L/M/H groups were given intraperitoneally injection of Fu Fang Ku Shen Zhu She Ye [0.7, 1.4 and 2.8 mL/kg, once/d] for 8 weeks. The cardiac function, myocardial injury markers and pathological changes of myocardial tissue were compared between different groups. Serum levels of brain natriuretic peptide (BNP), cardiac troponin I (cTnI) and creatine kinase MB (CK-MB) were detected by enzyme-linked immunosorbent assay. The expression levels of glucose-regulating protein 78 (GRP78), activating transcription factor 6 (ATF6) and endoplasmic reticulum stress-related protein (CHOP) in myocardial tissue were detected by Western blot assay. Changes of immune function indexes were compared between different groups.Results Compared with the liver cancer group, left ventricular ejection fraction (LVEF) and left ventricular anterior wall thickness in systole (LVAWs) were decreased in the chemotherapy group (P<0.05), left ventricular end diameter in systole (LVEDs), levels of BNP, cTnI and CK-MB were increased (P<0.05), levels of tumor necrosis factor α (TNF-α), interleukin (IL)-1β and IL-6 in myocardial tissue, expression levels of GRP78, ATF6 and CHOP were increased (P<0.05). Levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺, IgG, IgM and IgA were decreased in the chemotherapy group (P<0.05). The myocardial tissue was disordered, vacuolated and infiltrated by inflammatory cells. Compared with the chemotherapy group, the above indexes and pathological changes of myocardial tissue were significantly improved in the chemotherapy + Fu Fang-L/M/H groups, and the improvement was more significant in the chemotherapy + Fu Fang-H group.Conclusion Fu Fang Ku Shen Zhu She Ye injection can alleviate cardiotoxic injury induced by 5-FU in rats with liver cancer, which may be related to alleviating endoplasmic reticulum stress. It can also alleviate immunosuppression.

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T-ALL derived bone marrow stromal stem cells promote T-ALL proliferation through the FGF2-FGFR2 pathway

YANG Jian, LI Min, LI Yueyang, TIAN Chen

2025, 53 (1): 29-34. doi: 10.11958/20240355

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Objective To elucidate the mechanistic role of bone marrow mesenchymal stromal cells (BM-MSCs) in T-cell acute lymphoblastic leukemia (T-ALL), and to find effective therapeutic strategies targeting BM-MSCs.Methods A T-ALL mouse model induced by Notch-1 overexpression was constructed. An in vitro co-culture system was established to investigate the proliferative capacity of T-ALL cells upon co-culturing with leukemia-derived MSCs. RNA sequencing was performed to identify key differentially expressed genes, which were further validated by PCR. BGJ398 was injected into mice to detect tumor growth.Results Co-culturing with T-ALL-derived MSCs resulted in a significant increase in T-ALL cell proliferation. RNA sequencing results revealed that the secretion of fibroblast growth factor 2 (FGF2) from T-ALL-derived MSCs was increased, which binds to fibroblast growth factor 2 receptor (FGFR2) on T-ALL cells, activating the PI3K/AKT/mTOR signaling pathway. Blocking the interaction between FGF2 and FGFR2 using BGJ398 inhibited the growth of T-ALL tumors in mice.Conclusion BM-MSCs can promote T-ALL tumor growth through FGF2/FGFR2 pathway, and blocking FGF2/FGFR2 pathway is an effective strategy to overcome BM-MSCS-mediated T-ALL progression.

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Mechanism of nodakenin in relieving neuropathic pain

LIU Hongyan, LI Yachen, SHENG Gege, ZHU Haili, WU Jiliang

2025, 53 (1): 35-41. doi: 10.11958/20240971

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Objective To investigate the effect and mechanism of nodakenin (Nod) in neuropathic pain (NP).Methods Differential expression genes in the primary somatsensory cortex (S1) of NP data and overlapping genes between the dataset and mitochondrial data were screened and analyzed. Overlapping gene interaction networks were overlapped and core genes were screened. A total of 27 mice were randomly divided into the sham operation group, the model group and the drug administration group (9 mice/group). The chronic compression injury model of sciatic nerve was constructed in the model group and the drug administration group. Nod 10 mg/kg was intraperitoneally injected into the drug administration group for 1 week. Changes of pain behavior and motor ability in mice were detected. HE staining and Nissl staining were used to detect effects of nerve injury and inflammation on brain tissue of S1 region of mice. The expression levels of interleukin-1β, early gene (c-Fos), panthenol-cytochrome c reductase complex III subunit (Uqcrq) and ubiquinone oxidoreductase subunit (Nduf) b5 in S1 brain region were analyzed by Western blot assay. Molecular docking was used to study the target of Nod. PC12 cells were divided into the control group, the IL-1β group (1 μmol/L IL-1β treatment) and the IL-1β+Nod group (1 μmol/L IL-1β+1 μmol/L Nod treatment), and mitochondrial membrane potential was detected in each group.Results In the NP dataset GSE180627, S1 brain region contained 293 differentially expressed genes, and the mitochondrial data contained 1 082 genes. There were 34 overlapping genes, and genes related to oxidative phosphorylation and electron transport chain were enriched. The protein interaction network showed that core genes included electron transport chain related proteins Ndufb5, Uqcrq, Ndufs8, Ndufa7, Ndufa3, Cox6b1 and Mrps33. Compared with the model group, the mechanical foot shrinkage threshold, thermal foot shrinkage reflex latency and rod rotation residence time of mice were increased in the drug administration group, the number of inflammatory infiltrating cells in S1 tissue and the number of Nislet bodies in neurons, expression levels of c-Fos and IL-1β in neurons were decreased, and expression levels of Uqcrq and Ndufb5 were increased (P<0.05). Molecular docking showed that Nod could bind Uqcrq and Ndufb5. Compared with the IL-1β group, the fluorescence signal of mitochondrial membrane potential was enhanced in the IL-1β+Nod group (P<0.05).Conclusion Nodakenin can improve pain behavior in mice, and its mechanism involves ameliorating mitochondrial damage in S1.

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Constructing a risk prediction model for hepatocellular carcinoma in patients with chronic liver disease based on aMAP score combined with RAR and PIV

JIANG Xiaohan, CAO Jie, LIU Dandan, XUE Dan, GUO Zhiguo

2025, 53 (1): 42-46. doi: 10.11958/20241112

Abstract ( 165 )

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Objective To construt and validate a risk prediction model for hepatocellular carcinoma (HCC) in patients with chronic liver disease based on age-male -ALBI-platelets (aMAP) score combined with RAR and PIV.Methods A total of 143 patients with chronic liver disease were divided into the HCC group (32 cases) and the non-HCC group (111 cases) according to whether HCC occurred. General clinical data, aMAP score and peripheral blood indicator level were compared between two groups. Multivariate Logistic regression was used to analyze influencing factors of HCC in inpatients with chronic liver disease. A nomogram risk prediction model was constructed and validated.Results Compared with the non-HCC group, there were higher age, higher proportion of males, higher levels of total bilirubin (TBIL), red blood cell distribution width (RDW), neutrophil count (NEU) and monocyte count (MON), lower levels of albumin (ALB) and lymphocyte count (LYM), higher levels of aMAP score, RDW to ALB (RAR) and pan-immune inflammation value (PIV) in the HCC group (P<0.05). Multivariate Logistic regression showed that higher levels of aMAP score, RAR and PIV were independent risk factors for HCC in inpatients with chronic liver disease (P<0.05). The area under receiver operator characteristic (ROC) curve (AUC) of the nomogram risk prediction model constructed based on above factors was 0.823 (95%CI: 0.747-0.899). The calibration curve showed that the predicted value was basically consistent with the actual observed value, and the Brier score was 0.125. The decision curve showed that the model had a clear positive net benefit. The AUC of internal validation of the prediction model by Bootstrap method was 0.823 (95%CI: 0.820-0.825), indicating that the model had a good degree of differentiation.Conclusion The nomogram risk prediction model based on aMAP score, RAR and PIV showed a good predictive performance of HCC in patients with chronic liver disease, which could benefits the individualized treatment and follow-up.

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Correlation between ferroptosis and post operative cognitive dysfunction in elderly patients with fractures

ZHANG Xungong, YANG Guanghui, DU Zengli, XUE Pei, MA Zikun

2025, 53 (1): 47-51. doi: 10.11958/20241526

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Objective To analyze the correlation between ferroptosis and post operative cognitive dysfunction (POCD) in elderly patients with fractures.Methods A total of 120 elderly patients with fracture were divided into the control group and the POCD group according to whether POCD occurred, with 60 cases in each group. Basic data of the two groups were collected. The levels of nerve injury indicators [brain myelin basic protein (MBP), glial fibrillary acidic protein (GFAP)], and fractures markers [glutathione peroxidase 4 (GPX4), cyclooxygenase 2 (COX2), long-chain acyl-CoA synthase 4 (ACSL4)] were detected by enzyme-linked immunosorbent assay at 6 h after surgery. Logistic regression was used to analyze risk factors of POCD in elderly patients with fracture. The correlations between MBP, GFAP and GPX4, COX2 and ACSL4 were analyzed by Pearson correlation analysis. Receiver operating characteristic (ROC) curves were used to analyze predictive values of MBP, GFAP, GPX4, COX2 and ACSL4 levels to POCD.Results The age, proportion of general anesthesia, anesthesia time, intraoperative blood loss and MBP, GFAP, COX2, ACSL4 levels were higher in the POCD group than those in the control group (P<0.05), while GPX4 was lower than that in the control group (P<0.05). The levels of MBP and GFAP were negatively correlated with levels of GPX4 in elderly patients with fractures, and positively correlated with levels of COX2 and ACSL4 (P<0.05). Advanced age, general anesthesia, long duration of anesthesia, increased levels of MBP, GFAP, COX2 and ACSL4, and decreased level of GPX4 were independent risk factors for POCD in elderly fracture patients (P<0.05). The critical values of GPX4, COX2 and ACSL4 for predicting POCD in elderly patients with fractures were GPX4≤23.05 μg/L, COX2≥20.35 μg/L and ACSL4≥237.85 μg/L, and the AUC were 0.869, 0.736 and 0.841. The sensitivity was 76.67%, 68.33% and 88.33%, and the specificity was 86.67%, 78.33% and 75.00%, respectively. The diagnostic efficacy of GFAP, COX2 and ACSL4 was higher than that of MBP and GFAP.Conclusion The incidence of POCD in elderly patients with fracture is associated with ferroptosis, and levels of GPX4, COX2 and ACSL4 have certain predictive value for the incidence of POCD after surgery in elderly patients with fracture.

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Comparison of therapeutic effects between AcoStream and AngioJet in acute iliofemoral vein thrombosis

WANG Guohua, CHEN Baoxing, LI Huipeng, GUO Pengwei, ZHANG Hua

2025, 53 (1): 52-56. doi: 10.11958/20240740

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Objective To investigate the clinical efficacy and safety of two thrombus thrombectomy devices, AcoStream and AngioJet, in the treatment of acute iliofemoral vein thrombosis (AIFVT).Methods A total of 97 AIFVT patients were treated with different thrombus clearing devices according to their states of illness, and patients were divided into the AcoStream group (41 cases) and the AngioJet group (56 cases). The thrombus clearing status, degree of swelling reduction in affected limb, surgical time and intraoperative blood loss were compared between the two groups, and the need for assisted catheter contact thrombolysis (CDT) treatment, urokinase dosage, iliac vein stent placement, incidence of complications, length of hospital stay and hospitalization costs were also compared between the two groups. Regular follow-up was conducted to record for recurrence of thrombosis, the patency of the stent, deep vein thrombosis syndrome (PTS) and PTS degree were evaluated in lower limbs.Results There were no significant differences in age, gender, affected limb, time of illness, site of illness and causes of illness between the two groups (P>0.05). The operation was successful in both groups and the thrombus removal effect was satisfactory. There were no significant differences in terms of thrombus clearance rate, the degree of swelling reduction in the limb 48 hours after surgery and assisted CDT rate between the two groups (P>0.05). Compared with the AcoStream group, the AngioJet group had a longer surgical time, reduced intraoperative blood loss, increased hospitalization costs and higher rates of complications (P<0.05). There was no significant difference in the recurrence rate of thrombosis between the two groups (P>0.05), and there was no occurrence of iliac vein stent occlusion or PTS in either patients.Conclusion Two mechanical thrombus clearing devices of AcoStream and AngioJet are safe and effective for treating AIFVT.

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Observation on the therapeutic effect of stellate ganglion block combined with nicergoline on dysphagia after stroke

YAO Yuting, ZHAO Peng, LI Yan, YAO Yuxin, LIU Minxiao

2025, 53 (1): 57-60. doi: 10.11958/20241237

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Objective To investigate the clinical efficacy of stellate ganglion block (SGB) combined with nicergoline in patients with dysphagia after stroke.Methods A total of 104 patients with dysphagia after stroke were randomly divided into the observation group and the control group. The observation group was treated with niergoline and SGB, while the control group received functional electrical stimulation. The total effective rate, swallowing condition, inflammatory factor level and adverse events were compared between the two groups.Results After treatment, the total effective rate was significantly higher in the observation group (92.31%) than that of the control group (73.08%, P<0.05). The level of interleukin-6 (IL-6), the standardized swallowing assessment (SSA) score and the level of tumor necrosis factor alpha (TNF-α) were significantly lower in the observation group than those in the control group (P<0.05). The Mann swallowing ability assessment scale (MASA) score was significantly higher in the observation group than that of the control group (P<0.05). There were no significant differences in adverse reactions such as glottis closure and laryngeal spasm between the two groups (P>0.05).Conclusion The combined treatment of SGB and nicergoline can effectively improve swallowing function in patients with dysphagia after stroke, with good safety, ideal results and high clinical application value.

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Predictive value of serum APOC1 and Klotho expression for prognosis in patients undergoing laparoscopic partial nephrectomy for renal cancer

WU Yameng, LI Liangliang, WANG Yangang, XING Defu

2025, 53 (1): 61-64. doi: 10.11958/20240969

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Objective To explore the clinical value of apolipoprotein C1 (APOC1) and Klotho expression levels in predicting the prognosis of patients with renal cancer after laparoscopic partial nephrectomy.Methods Eighty patients diagnosed as renal cell carcinoma and underwent laparoscopic partial nephrectomy were collected as the study subjects. According to the prognosis, patients were separated into the good prognosis group (61 cases) and the poor prognosis group (19 cases). Seventy-eight healthy individuals underwent physical examination were collected as the control group. The general clinical data of the subjects were collected, and serum levels of APOC1 and Klotho were tested and analyzed in three groups. Pearson method was applied to analyze the correlation between serum APOC1 and Klotho levels in patients. Cox regression was applied to analyze factors affecting the prognosis of patients. Receiver operating characteristic (ROC) curve was applied to analyze the predictive efficacy of APOC1 and Klotho levels on the prognosis of patients.Results There were significant differences in clinical stage and pathological grade between the poor prognosis group and the good prognosis group (P<0.05). Compared with the control group, the serum APOC1 levels were significantly increased in the good prognosis group and the poor prognosis group (P<0.05), while the Klotho expression levels were obviously reduced (P<0.05). And the serum APOC1 level in the control group, the poor prognosis group and the good prognosis group was increased successively (P<0.05), while the serum Klotho level was obviously decreased successively (P<0.05). The serum APOC1 expression level of patients was negatively correlated with Klotho level (r=-0.577, P<0.001). The Cox regression results showed that decreased expression level of Klotho and elevated expression level of APOC1, pathologic grading 2 and clinical staging stage Ⅱ were all independent risk factors for poor prognosis (P<0.05). The area under the curve (AUC) of serum APOC1 and Klotho levels, and their combined application in predicting poor postoperative prognosis in renal cancer patients was 0.863, 0.850 and 0.953, respectively, and the clinical value of combination of the two in predicting the prognosis of patients was superior to that of APOC1 and Klotho alone.Conclusion Patients with poor prognosis after retroperitoneal laparoscopic partial nephrectomy have a obvious increase in serum levels of APOC1 and a obvious decrease in serum level of Klotho. The combination of the two has high clinical significance in predicting the prognosis of patients with retroperitoneal laparoscopic partial nephrectomy.

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The value of combined detection of PCT, IL-6 and CysC for the diagnosis and prognosis assessment of septic acute kidney injury

SONG Hu, ZHU Jian, FU Yongmei, ZHANG Yongbiao, ZHENG Changlong

2025, 53 (1): 65-70. doi: 10.11958/20240835

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Objective To explore the diagnostic and prognostic values of procalcitonin (PCT), interleukin 6 (IL-6) and cystatin C (CysC) combined detection in sepsis acute kidney injury (AKI).Methods A total of 100 patients with sepsis were divided into the AKI group (n=56) and the non AKI group (n=44) according to the occurrence of AKI. The prognosis of AKI patients was followed up, and patients were divided into the survival group (n=32) and the death group (n=24) according to the presence or absence of death. Enzyme-linked immunosorbent assay (ELISA) was used to detect PCT, IL-6 and CysC in different groups of patients. The Acute Physiological Function and Chronic Health Status Score (APACHEⅡ) was used to assess the condition of illness. ROC curve was used to analyze the predictive values of PCT, IL-6 and CysC in the diagnosis and death of sepsis combined with AKI.Results The male ratio, age, hypertension with diabetes ratio, APACHE Ⅱ score, serum creatinine (Scr), PCT, IL-6 and CysC levels were higher in the AKI group than those in the non AKI group, and the ratio of complications and onset time were lower in the AKI group than those in the non AKI group (P<0.05). The ROC curve results showed that the area under the curve (AUC) of PCT, IL-6, and CysC combined for the diagnosis of sepsis complicated with AKI was 0.859, with a sensitivity of 91.07% and a specificity of 90.91%. The combined diagnostic efficacy was better than that of a single indicator. The APACHE Ⅱ score, PCT, IL-6 and CysC levels were higher in the death group than those in the survival group (P<0.05). The ROC curve results showed that the AUC, sensitivity and specificity of PCT, IL-6 and CysC combined in predicting mortality in sepsis patients with AKI were 0.847, 91.67% and 87.50%, respectively. The combined predictive efficacy was better than that of single indicator.Conclusion The combination of PCT, CysC and IL-6 indicators is more valuable in diagnosing and predicting prognosis of sepsis with AKI.

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A single-center study of the relationship between QRS duration of first medical contact and clinical endpoint in acute ST-segment elevation myocardial infarction

LIU Huan, ZHANG Qi, YAN Qikun, CAO Lu

2025, 53 (1): 71-74. doi: 10.11958/20241504

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Objective To evaluate the relationship between the QRS duration (QRSd) of the first medical contact (FMC) and the 30-day clinical endpoint of acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 547 STEMI patients were selected and divided into the QRSd < 100 ms group (306 cases) and the QRSd≥100 ms group (241 cases). Clinical data of the patients were collected, and electrocardiography (ECG) and cardiac ultrasound were evaluated according to the FMC examination results of patients. The starting point of the study was the postoperative day. Outpatient or telephone follow-up was performed after discharge until 30 days or death, the primary endpoint was major adverse cardiovascular events (MACE), which was defined as the composite endpoint of all-cause mortality, acute heart failure (AHF) and revascularization again, and the secondary endpoint was AHF. Kaplan-Meier curves were drawn to evaluate the incidence rates of MACE and AHF. QRSd was included in Cox regression with continuous variables and categorical variables to analyze influence factors of 30-day MACE and AHF in STEMI patients. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of QRSd in predicting 30 d MACE occurrence in STEMI patients.Results Compared with the QRSd < 100 ms group, HR was faster and the proportion of smoking history was lower in the QRSd≥100 ms group (P<0.05). MACE occurred in 44 patients, including 11 in the QRSd < 100 ms group and 33 in the QRSd≥100 ms group. AHF occurred in 17 patients, including 2 patients in the QRSd < 100 ms group and 15 patients in the QRSd≥100 ms group. Kaplan-Meier survival analysis showed that the incidence of MACE and AHF were higher in the QRSd≥100 ms group than those in the QRSd < 100 ms group (P<0.01). Multivariate Cox regression analysis showed that prolonged QRSd and QRSd≥100 ms were risk factors for MACE and AHF (P<0.05). ROC curve results showed that the best cutoff value of QRSd for predicting MACE was 111 ms, the area under the curve (AUC) was 0.796 (95%CI: 0.710-0.881), the sensitivity was 0.75, and the specificity was 0.84.Conclusion Compared with QRSd <100 ms, QRSd ≥100 ms of the FMC can increase the risk of 30-day MACE and heart failure in patients with STEMI, and this risk increases with prolonged QRSd.

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The expression of plasma lncRNA CEBPA-AS1 and miR-139-5p in patients with acute cerebral infarction and their correlation with cognitive dysfunction

LI Peiyuan, WANG Gang, SHI Junfeng

2025, 53 (1): 75-79. doi: 10.11958/20241422

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Objective To detect levels of plasma long non coding RNA (lncRNA) CCAAT enhancer binding protein alpha antisense 1 (CEBPA-AS1) and microRNA-139-5p (miR-139-5p) in patients with acute cerebral infarction (ACI), and to explore their relationship with cognitive dysfunction in ACI patients.Methods A total of 132 ACI patients treated in our hospital were included for the study. The Montreal Cognitive Assessment Scale (MoCA) was used to evaluate the cognitive function of ACI patients, and they were diveded into the cognitive dysfunction group (n=63) and the normal cognitive function group (n=69). The general data of the two groups were compared. The qRT-PCR method was applied to measure plasma levels of lncRNA CEBPA-AS1 and miR-139-5p in ACI patients. Pearson method was applied to analyze the correlation between plasma lncRNA CEBPA-AS1 and miR-139-5p in ACI patients. Multivariate Logistic regression was applied to analyze factors influencing cognitive dysfunction in ACI patients. Receiver operating characteristic (ROC) curve was applied to evaluate the diagnostic value of plasma lncRNA CEBPA-AS1 and miR-139-5p for cognitive dysfunction in ACI patients.Results Compared with the normal cognitive function group, the plasma lncRNA CEBPA-AS1 was higher and the miR-139-5p was lower in the cognitive dysfunction group (P<0.05). Correlation analysis showed that there was a negative correlation between lncRNA CEBPA-AS1 and miR-139-5p (r=-0.462, P<0.01). Multivariate analysis showed that high school education or below, decreased plasma miR-139-5p, and increased lncRNA CEBPA-AS1 were risk factors for cognitive dysfunction in ACI patients (P<0.05). The area under the curve (AUC) of lncRNA CEBPA-AS1 and miR-139-5p in the diagnosis of cognitive dysfunction in ACI patients was 0.865 and 0.798, respectively. The combined diagnostic efficacy of the two (AUC=0.912) was better than single index.Conclusion The plasma lncRNA CEBPA-AS1 is increased and the plasma miR-139-5p is decreased in patients with ACI combined with cognitive dysfunction, and both are influencing factors for cognitive dysfunction in ACI patients, and the combined diagnostic efficacy is high.

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Clinical significance of expression levels of serum Spexin and Pannexin 1 in elderly patients with diabetic cataract

ZHANG Xinqiao, LI Xing, ZHANG Huiqin, CHEN Haiting, LIU Mingyuan

2025, 53 (1): 80-84. doi: 10.11958/20240821

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Objective To study the correlation between expression levels of serum Spexin and Pannexin 1 protein, glucose and lipid metabolism and insulin resistance in elderly patients with diabetic cataract.Methods A total of 118 elderly diabetic cataract patients were selected as the case group, and 103 elderly diabetic non-cataract patients were selected as the control group who were treated in the same hospital during the same period. Serum levels of Spexin and Pannexin1 were detected by enzyme-linked immunosorbent assay (ELISA). Fasting blood glucose (FPG) and glycosylated hemoglobin (HbA1c) were measured. Lipid metabolism related indicators including triacylglycerol (TG), high density lipoprotein cholesterol (HDL-C), total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were detected in two groups of patients. Insulin resistance related indexes: fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance index (HOMA-IR) and islet beta cell function index (HOMA-β) were also detected. The correlation between serum Spexin and Pannexin1 levels, glucolipid metabolism and ISI was detected by Pearson method. Receiver operating characteristic (ROC) curves were used to assess the predictive value of serum Spexin and Pannexin1 levels and their combination in the development of cataract in elderly diabetic patients.Results The level of Spexin was lower in the observation group than that in the control group, and the level of Pannexin1 was higher than that in the control group (P<0.01). Levels of TG, TC, LDL-C, FPG, HbA1c, FINS and HOMA-IR of the observation group increased compared with the control group, while HDL-C, ISI and HOMA-β levels decreased compared with the control group (P<0.01). Pearson correlation analysis showed that serum Spexin level was positively correlated with ISI and HOMA-β, and negatively correlated with TG, TC, LDL-C, FPG, HbA1c, FINS and HOMA-IR in elderly patients with diabetic cataract (P<0.05). Serum Pannexin1 was negatively correlated with ISI and HOMA-β, and positively correlated with TG, TC, LDL-C, FPG, HbA1c, FINS and HOMA-IR (P<0.05). There was no correlation between the above indexes and HDL-C (P>0.05). The combination of both serum Spexin and Pannexin1 predicted the development of cataracts in elderly diabetic patients was better than serum Spexin and Pannexin1 assessed individually (Z _{both combination-Spexin}=3.220, P=0.001, Z _{both combination-Pannexin1}=4.838, P<0.001).Conclusion In elderly patients with diabetic cataract, the expression of serum Spexin decreases and the expression of Pannexin1 increases, and they have a certain correlation with glucose and lipid metabolism and insulin resistance

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Effects of internal trabeculectomy on postoperative intraocular pressure and visual acuity in patients with primary open-angle glaucoma

ZHANG Yang, DUAN Ying, CUI Mingxia, SHU Lingbo

2025, 53 (1): 85-87. doi: 10.11958/20241389

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Objective To investigate the effect of internal trabeculectomy on postoperative intraocular pressure and visual acuity in patients with primary open angle glaucoma (POAG).Methods A total of 126 POAG patients underwent internal trabeculectomy were included in this study. Intraocular pressure, types of drug used, visual acuity and complications were compared before and after operation.Results Intraocular pressure was significantly decreased, types of drug used were significantly reduced and visual acuity was significantly improved at 1 week, 1 month and 3 months after surgery (P < 0.05). The incidence of postoperative intraocular pressure rebound complication was the highest in postoperative patients (27.78%), followed by hyphema (14.29%), corneal edema (10.32%) and ciliary detachment (7.14%).Conclusion Internal trabeculectomy for POAG patients can effectively control the decrease of intraocular pressure in patients, help to restore vision, reduce types of drug used, and the effect is ideal, and the clinical application value is high.

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Correlation between systemic inflammation markers and bone mineral density in male patients with type 2 diabetes

WEI Sicheng, YU Sui, YU Ying, LI Huafeng, ZHANG Qi, TANG Yuxiao, WANG Qiuling, YU Xiao

2025, 53 (1): 88-92. doi: 10.11958/20241148

Abstract ( 195 )

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Objective To evaluate the relationship between systemic inflammation makers and bone mineral density (BMD) in male patients with type 2 diabetes (T2DM).Methods A total of 261 male patients with T2DM were selected and divided into three groups based on diagnostic criteria: the normal bone mass group (96 cases), the reduced bone mass group (111 cases) and the osteoporosis group (54 cases). Differences in systemic inflammation markers and bone metabolic markers were compared between the three groups. Multivariate ordered Logistic regression analysis was used to investigate factors influencing the progression from normal bone mass to osteoporosis in male patients with T2DM. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of inflammatory markers for osteoporosis in male patients with T2DM. Correlation analysis was conducted to investigate the correlation between inflammatory markers and BMD and bone turnover markers (BTM) in male patients with T2DM.Results Platelet count (PLT), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII) and neutrophil-to-lymphocyte ratio (NLR) were significantly higher in the osteoporosis group than those in the normal bone mass group (P<0.05). Multivariate ordered Logistic regression analysis showed that PLR and SII were risk factors for the progression from normal bone mass to osteoporosis in male patients with T2DM (P<0.05). The area under the ROC curve of PLR was 0.590, and the cut-off value was 96.67. The area under the curve of SII was 0.613, with a cut-off value of 307.9, and the area under the combined curve of the above two indicators was 0.612. In patients with osteoporosis and osteopenia, SII, PLR and PLT were negatively correlated with L_1-4 BMD and left hip BMD (P<0.05). SII was also negatively correlated with left femoral neck BMD (P<0.05).Conclusion Inflammatory markers PLR and SII have predictive values for the progression from normal bone mass to bone loss and osteoporosis in male patients with T2DM.

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The relationship between triglyceride glucose body mass index, high density lipoprotein cholesterol to apolipoprotein A ratio, glycemic risk index and diabetic retinopathy

SUI Yuan, JIANG Bingbing, GOU Xiaomei, SUN Jingwen, ZHANG Chengsen

2025, 53 (1): 93-97. doi: 10.11958/20241485

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Objective To investigate the relationship between triglyceride glucose body mass index (TyG-BMI), high density lipoprotein cholesterol to Apolipoprotein A ratio (HAR), glycemic risk index (GRI) and diabetic retinopathy (DR).Methods A total of 159 patients with type 2 diabetes mellitus (T2DM) complicated with DR (the DR group) were divided into the non-proliferative retinopathy group (NPDR group, 66 cases) and the proliferative retinopathy group (PDR group, 93 cases) according to DR international clinical grading criteria, and 159 T2DM patients without DR were selected as the control group. Clinical information and baseline laboratory test results were recorded, and TyG-BMI, HAR and GRI were calculated. Multivariate Logistic regression analysis was conducted to analyze the related factors of the incidence of DR, and receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of TyG-BMI, HAR and GRI for DR.Results The duration of T2DM, the proportion of hypertension, diabetic nephropathy and diabetic foot, levels of HbA1c, homeostasis model insulin resistance index (HOMA-IR), total cholesterol (TC), C-reactive protein (CRP), TyG-BMI, HAR and GRI were higher in the DR group than those in the control group (P < 0.05). TyG-BMI, HAR and GRI were higher in the PDR group than those in the NPDR group (P < 0.05). Multivariate Logistic regression analysis showed that the longer course of T2DM disease [OR (95%CI) : 2.781 (1.398-5.534)], high TyG-BMI [2.036 (1.169-3.546)], high HAR [1.890 (1.090-3.280)] and high GRI [1.836 (1.065-3.167)] were risk factors for DR (P < 0.05). ROC curve analysis results showed that, the area under the curve (AUC) of combined TyG-BMI, HAR and GRI diagnosis of DR was higher than that of single diagnosis [0.940 (0.908-0.964), 0.864 (0.821-0.900), 0.796 (0.747-0.839) and 0.836 (0.790-0.875), all P < 0.05].Conclusion The increased TyG-BMI, HAR and GRI in T2DM patients is associated with the onset and severity of DR, and which can be used to assess the risk of DR.

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Clinical study of levosimendan combined with enalapril in treating acute anterior wall myocardial infarction complicated with cardiac dysfunction after emergency PCI

ZHANG Jie, LIU Xianglong, ZHANG Jing

2025, 53 (1): 98-102. doi: 10.11958/20241218

Abstract ( 134 )

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Objective To investigate the efficacy of levosimendan combined with enalapril on acute anterior wall myocardial infarction complicated with cardiac dysfunction after emergency percutaneous coronary intervention (PCI).Methods Ninety-eight patients with acute anterior wall myocardial infarction who underwent emergency PCI surgery and developed heart failure were prospectively selected, and randomly divided into the single group and the combined group, 49 patients in each group. The single group received enalapril at a dose of 5 mg/(times · day). The combined group received levosimendan on the basis of the single group, with an initial dose of 6 μg/kg within 10 minutes after the start of intravenous injection, and the adjusted dose was 0.1 μg/(kg·min) after 10 minutes. The infusion lasted for 24 hours. The effects, improvement in Killip heart function classification, cardiac remodeling indicators [left atrial diameter (LAD), left ventricular ejection fraction (LVEF), interventricular septal thickness (IVST) and left ventricular end-diastolic diameter (LVEDD)], serological indicators [creatine kinase isoenzyme (CK-MB), cystatin C (Cys C) and cardiac troponin I (cTnI)], 6-minute walk distance and incidence of adverse reactions were compared between the two groups.Results The overall effective rate was higher in the combined group than that of the single group (P<0.05). After treatment, the cardiac function was better in the combined group than that of the single group.Data of LAD, IVST, LVEDD, CK-MB, Cys C and cTnI were lower in the combined group than those of the single group, and LVEF was higher in the combined group than those of the single group (P<0.05). The distance of the 6MWT was longer in the combined group than that in the single group (P<0.05). There was no significant difference in the total incidence of adverse reactions between the two groups.Conclusion Levosimendan in combination with enalapril is effective in treating patients with acute anterior wall myocardial infarction complicated with cardiac insufficiency after emergency PCI, which can effectively reduce myocardial injury, improve cardiac and renal functions, and has high safety.

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Research progress on the correlation between sagittal spinopelvic parameters and the prognosis of lumbar fusion surgery

JIANG Zehua, CUI Haojun, ZHANG Boyu, REN Zhishuai, MA Junfeng, ZHANG Hongjie, ZHU Rusen

2025, 53 (1): 103-107. doi: 10.11958/20241580

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lumbar fusion surgery is one of the commonly used surgical interventions and treatments for lumbar degenerative diseases. A small proportion of patients still experience complications such as low back pain after lumbar fusion surgery. Spinal-pelvic parameters are closely related to the occurrence of complications in patients after lumbar fusion surgery. This article reviews the commonly used lumbar fixation and fusion surgical techniques and mainstream sagittal spinal-pelvic parameters. Additionally, it summarizes the research progress and current status regarding the relationship between sagittal spinal-pelvic parameters and various postoperative complications, including low back pain.

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A review of the research progress on tumor-associated macrophages

HAO Chengfei, CHEN Guoshan, ZHANG Xibo, QI Feng

2025, 53 (1): 108-112. doi: 10.11958/20241415

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In the tumor microenvironment, tumor-associated macrophages construct complex interaction networks through highly plasticity, promoting the dynamic evolution of the cancer ecosystem. With the innovation of single-cell sequencing technology, the heterogeneity, functional diversity, and interaction mechanisms of tumor-associated macrophages with tumor microenvironment have been revealed. This suggests that tumor-associated macrophages may become a new target for tumor targeted therapy, driving the development of precision anti-cancer strategies. This review summarizes the relevant research progress, explores the interaction mechanisms, describes the classification and clinical therapeutic potential, aiming to provide new perspectives and guidance for tumor research and clinical practice.

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