Tianjin Medical Journal

Effects of nobiletin on proliferation and apoptosis of laryngeal squamous cell carcinoma cells by regulating the FAK/AKT signaling pathway

HAN Jiancun, ZHOU Yi

2025, 53 (6): 561-565. doi: 10.11958/20250433

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Objective To investigate the effect of nobiletin on the proliferation and apoptosis of laryngeal squamous cell carcinoma (LSCC) cells and its mechanism related to the focal adhesion kinase (FAK)/protein kinase B (AKT) signaling pathway. Methods TU177 cells of LSCC were randomly assigned into the control group, the L-nobiletin group (10 mg/L) group, the M-nobiletin group (20 mg/L), the H-nobiletin group (40 mg/L) and the H-nobiletin+FAK activator ZINC40099027 group (40 mg/L nobiletin+2.5 g/L ZINC40099027). CCK-8 method was used to detect cell viability. Flow cytometry was used to detect cell apoptosis. Scratch experiment was used to detect cell migration. Transwell method was used to detect cell invasion. Western blot assay was used to detect apoptosis and FAK/AKT pathway related proteins. Results Compared with the control group, the cell viability, scratch healing rate, number of invasive cells, the protein expressions of Bcl-2, p-FAK/FAK and p-AKT/AKT were decreased in a dose-dependent manner in the L-nobiletin group, the M-nobiletin group and the H-nobiletin group, while the cell apoptosis rate and protein expressions of Bax and caspase-3 were increased in a dose-dependent manner (P<0.05). The OD value, scratch healing rate, number of invasive cells, Bcl-2, p-FAK/FAK and p-AKT/AKT protein expression levels were higher in the H-nobiletin+ZINC40099027 group than those of the H-nobiletin group, and cell apoptosis rate, Bax and caspase-3 protein expression were lower compared to the H-nobiletin group (P<0.05). Conclusion Nobiletin may inhibit the proliferation and promote the apoptosis of LSCC cells by suppressing the FAK/AKT signaling pathway.

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Study on the characteristics of bone remodeling in ovariectomized mice

LI Linsen, FENG Yumei

2025, 53 (6): 566-570. doi: 10.11958/20250846

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Objective To explore the effect of estrogen deficiency on bone remodeling characteristics in an ovariectomized mouse model. Methods Ten 12-week-old female C57BL/6J mice were randomly divided into the sham operation group and the ovariectomy (OVX) group, with 5 mice in each group. The uteri of mice were isolated at 16 weeks postoperatively. The morphology was observed, and uterine weights were counted. CT scans were performed to analyze the distal femur of the mice, and anti-tartrate acid phosphatase (TRAP) staining was performed to assess the number of osteoclasts in paraffin sections of femoral tissue. Bone marrow-derived mesenchymal stem cells (BM-MSCs) and bone marrow-derived macrophages (BMMs) were sorted from femoral bone marrow of mice using CD11b magnetic beads. Alkaline phosphatase (ALP) staining was performed to assess the osteogenic differentiation potential of BM-MSCs. Reverse transcription-quantitative PCR (RT-qPCR) was performed to detect the expression levels of genes related to osteogenic differentiation of BM-MSCs (Runx2, Sp7, and Spp1) and osteoclast differentiation of BMMs (Ctsk, Acp5, and Cd40). Results Compared with the sham group, the uterus of the OVX group showed significant atrophy and weight loss, and bone mineral density (BMD), bone volume fraction (BV/TV), bone surface area tissue volume ratio (BS/TV), number of trabeculae (Tb.N), trabecular thickness (Tb.Th), cortical bone mineral density (Ct.BMD) and cortical bone thickness (Ct.Th) were significantly reduced, and bone trabecular separation (Tb.Sp) was significantly increased (P<0.01). The mRNA expression levels of Runx2, Sp7 and Spp1 were reduced in BM-MSCs of the OVX group compared with the sham group (P<0.01). The osteogenic differentiation was also diminished after induction. The mRNA expression levels of Ctsk, Acp5 and Cd40 were elevated in the BMMs of the OVX group, and the number of osteoclasts in bone marrow of the distal femur was greater in the OVX group than that in the sham group (P<0.01). Conclusion OVX-induced estrogen deficiency can enhance osteoclast differentiation and attenuate osteogenic differentiation capacity, ultimately causing dysregulation of bone homeostasis and resulting in osteoporosis.

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Effect of miRNA-381-3p/MuRF1 axis on cardiopulmonary injury in mice with hypoxic pulmonary hypertension

WU Bin, YANG Zigeng, JIN Ling, ZHANG Jing, WEI Hongmei, CAI Bingbing, WEI Yuying

2025, 53 (6): 571-577. doi: 10.11958/20251127

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Objective To explore the effect of microRNA-381-3p (miR-381-3p) /MuRF1 axis on cardiopulmonary injury in hypoxia-induced pulmonary hypertension (HPH) mice and its potential mechanisms. Methods Sixty mice were randomly assigned to four groups: the normal control group (NC), the hypobaric hypoxia-induced pulmonary hypertension (HPH) group, the HPH + agomir control group and the HPH + miR-381-3p agomir analog group (HPH + miR-381-3p agomir), with 15 mice in each group. The HPH mouse model was established using a low-pressure and hypoxic artificial chamber. Three weeks prior to the establishment of the HPH model, miR-381-3p agomir and its corresponding control agomir were prepared by dissolving them in RNA-free phosphate-buffered saline (PBS) according to the experimental requirements. These solutions were administered via tail vein injection at a dose of 10 mg/kg, twice weekly for three consecutive weeks. Right heart function was assessed using echocardiography. Right ventricular systolic pressure (RVSP) was measured via cardiac catheterization. Pulmonary vascular remodeling was evaluated through hematoxylin and eosin (HE) staining. Levels of inflammatory cytokines in bronchoalveolar lavage fluid were quantified using enzyme-linked immunosorbent assay (ELISA). Real-time quantitative fluorescent PCR (RT-qPCR) was employed to analyze the mRNA expression levels of miR-381-3p and MuRF1. Potential targets of miR-381-3p were predicted, and pathway enrichment analysis was conducted. A dual-luciferase reporter gene assay was performed to confirm the direct regulatory effect of miR-381-3p on MuRF1. Results Compared with the NC group, the mRNA expression of miR-381-3p was significantly decreased in both the HPH group and the HPH+agomir control group, whereas the mRNA expression of MuRF1 was significantly increased (P<0.05). In contrast, compared with the HPH group and the HPH+agomir control group, the mRNA expression of miR-381-3p was significantly increased in the HPH+miR-381-3p agomir group, while the mRNA expression of MuRF1 was significantly decreased (P<0.05). Additionally, compared with the NC group, RVSP, right ventricular anterior wall thickness (RVAW), right ventricular hypertrophy index (RVHI), right ventricular collagen volume fraction (CVF), distal pulmonary artery wall thickness ratio (WT), pulmonary artery wall area ratio (WA), as well as IL-1β, IL-6 and TNF-α levels in alveolar lavage fluid were significantly increased in the HPH group and the HPH+agomir control group, whereas the right ventricular diameter (RVID) was significantly decreased (P<0.05). Conversely, compared with the HPH group and the HPH+agomir control group, RVSP, RVAW, RVHI, right ventricular CVF, WT, Wa and RVID were decreased in the HPH+miR-381-3p agomir group, and IL-1β, IL-6, and TNF-α levels of alveolar lavage fluid were significantly decreased (P<0.05). Furthermore, the downstream target genes of miR-381-3p were predicted in the database, and MuRF1 was a potential target, and the Cytoskeleton in muscle cells ranked first in the significant enrichment of target genes. Compared with WT-MuRF1+mimic control group, the luciferase activity was decreased in the WT-MuRF1+miR-381-3p mimic group (P<0.05). There was no significant difference in the luciferase activity between the Mut-MuRF1+mimic control group and the Mut-MuRF1+miR-381-3p mimic group. Conclusion Overexpression of miR-381-3p can improve cardiopulmonary injury in HPH mice, and the mechanism may be related to the targeted inhibition of MuRF1 by miR-381-3p.

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Expression of Decorin and Mimecan in cervical cancer and their impact on prognostic assessment

LIU Xingchen, WANG Fang, SHEN Yong

2025, 53 (6): 578-583. doi: 10.11958/20250268

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Objective To explore the expression of core proteoglycans (Decorin) and osteoglycine (Mimecan) in cervical cancer and their relationship with the characteristics of clinical pathological traits and the prognosis of patients. Methods A total of 148 patients with cervical cancer who underwent surgical treatment in our hospital were selected. The expression levels of Decorin and Mimecan were determined by immunohistochemistry (IHC). The positive expression rates of Decorin and Mimecan in patients with different clinicopathological features were compared, and the correlation between the two was analyzed. Cox regression model was used to assess risk factors for death in patients with cervical cancer. Kaplan-Meier survival curve was used to compare the survival rates of patients with positive and negative Decorin and Mimecan expression. Results The positive expression levels of Decorin and Mimecan were both lower in cervical cancer tissue than those in adjacent tissue of cancer (20.0% vs. 75.0%, 28.3% vs. 63.3%, all P<0.05). The positive expression rates of Decorin and Mimecan were lower in patients with a tumor diameter ≥ 2 cm, FIGO stage Ⅲ-Ⅳ, lymph node metastasis and low tumor differentiation degree compared to those with a tumor diameter<2 cm, FIGO stage Ⅰ-Ⅱ, no lymph node metastasis and moderately to well tumor differentiation degree (P<0.05). There was a positive correlation of Decorin and Mimecan in cervical cancer tissue (r = 0.686, P<0.01). Multivariate Cox regression analysis confirmed that negative expression of Decorin (HR = 2.365, 95%CI: 1.236-4.525) and Mimecan (HR = 2.191, 95%CI: 1.322-3.631), FIGO stage Ⅲ-Ⅳ (HR = 1.747, 95%CI: 1.147-2.660) and low tumor differentiation degree (HR = 1.577, 95%CI: 1.035-2.404) were independent risk factors for mortality in cervical cancer patients (P<0.05). The 5-year survival rate of patients with positive Decorin and Mimecan expression was higher than those with negative expression (79.3% vs. 51.3%,73.8% vs. 50.0%), and the median survival time was prolonged (75 months vs. 60 months, 74 months vs. 60 months). Conclusion The positive expression rates of Decorin and Mimecan are reduced in cervical cancer tissue and may serve as potential biomarkers for prognostic evaluation of cervical cancer.

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Study on influencing factors and predictive model construction of cardiopulmonary complication after thoracoscopic surgery in stage I-II non-small cell lung cancer

LI Jianlin, SUN Sijin, WANG Dali

2025, 53 (6): 583-588. doi: 10.11958/20250702

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Objective To construct a multivariable prediction model for assessing the risk of cardiopulmonary complication after thoracoscopic lobectomy in patients with stage Ⅰ-Ⅱ non-small cell lung cancer (NSCLC). Methods Clinical data of 600 patients with stage Ⅰ-Ⅱ NSCLC who underwent thoracoscopic lobectomy were retrospectively analyzed. Patients were divided into the complication group (84 cases) and the non-complication group (516 cases) based on the occurrence of postoperative complication within 7 days, including atelectasis, pulmonary embolism, respiratory failure, chylothorax, massive pleural effusion, hypoxemia and atrial fibrillation. Demographic characteristics, preoperative pulmonary function assessment, pathological features and perioperative indicators were collected. Multivariate Logistic regression analysis was used to identify independent risk factors influencing postoperative cardiopulmonary complication in patients and construct a predictive model. Internal validation was performed using the Bootstrap resampling method (1 000 iterations) to evaluate the discrimination, calibration and clinical decision-making value of the model. Results Multivariate Logistic regression analysis identified the following independent risk factors of postoperative cardiopulmonary complication, including age (OR=1.832, 95%CI: 1.537-2.183), history of chronic obstructive pulmonary disease (COPD) (OR=6.782, 95%CI: 2.685-17.130), Karnofsky performance status (KPS) score (OR=0.926, 95%CI: 0.888-0.965), the percentage of forced expiratory volume in the first second to the predictive value (FEV1%pred) (OR=0.906, 95%CI: 0.845-0.972), the percentage of diffusing capacity for carbon monoxide to the expected value (DLCO%pred) (OR=0.901, 95%CI: 0.832-0.975), intraoperative blood loss (OR=1.025, 95%CI: 1.014-1.036) and one-lung ventilation time (OR=1.057, 95%CI: 1.034-1.080). The area under the curve (AUC) of the combined diagnosis was 0.977 (95%CI: 0.965-0.989), with 96.4% sensitivity and 87.6% specificity. The Hosmer-Lemeshow test indicated excellent calibration (χ2=1.285, P=0.994). Decision curve analysis demonstrated significant clinical net benefit when the risk threshold probability ranged between 20% and 98%. Conclusion The multivariable prediction model for cardiopulmonary complication after thoracoscopic lobectomy in stage Ⅰ-Ⅱ NSCLC patients exhibits strong predictive performance.

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Predictive value of plasma von Willebrand factor antigen levels for long-term prognosis of elderly patients with acute myocardial infarction

CHEN Zhenjin, JIN Xiaoqing, QI Anning, HAN Chongxu

2025, 53 (6): 589-593. doi: 10.11958/20250518

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Objective To investigate the predictive value of plasma von Willebrand factor (VWF) antigen levels for the long-term prognosis of patients with acute myocardial infarction (AMI). Methods A total of 150 elderly patients diagnosed with AMI were selected and treated with percutaneous coronary intervention (PCI) at admission. The plasma VWF antigen level of the patients was detected within 24 hours after PCI. Patients were followed up for 12 months and were divided into the major adverse cardiac events (MACE) group and the non-MACE group according to the occurrence of MACE. The risk factors for MACE in AMI patients within 12 months were analyzed. The prognostic value of VWF antigen level in AMI patients were evaluated. The optimal cut-off value of plasma VWF antigen level was determined by receiver operating characteristic (ROC) curve. Patients were groups according to the optimal cut-off value. Kaplan-Meier curve was drawn to compare the occurrence of MACE in patients with different plasma VWF antigen levels. Results Among the 150 observed patients, 7 patients were lost to follow-up, and eventually 143 patients were included. In 143 patients there were 53 patients (37.1%) in the MACE group and 90 cases (63.9%) in the non-MACE group. The age, B-type natriuretic peptide (BNP), D-dimer and VWF antigen levels were significantly higher in the MACE group than those in the non-MACE group. The results of the Cox proportional hazards model showed that age increase (HR=1.085, 95%CI：1.014-1.160), increased plasma VWF antigen level (HR=1.030, 95%CI: 1.017-1.045) and increased BNP (HR=1.016, 95%CI: 1.004-1.027) were risk factors for elderly patients in the MACE group one year after surgery. The maximum approximately Youden index of plasma VWF antigen level for predicting MACE was 0.616, the optimal cut-off value was 162.5 μg/L, the sensitivity was 84.9% and the specificity was 76.7%. The results of survival analysis showed that the average time to MACE in the group with plasma VWF antigen ≥162.5 μg/L was shorter than that in the group with plasma VWF antigen < 162.5 μg/L (7.7 months vs. 11.6 months, Log-rank χ²=63.060, P<0.001). Conclusion The increased plasma VWF antigen is an independent risk factor for AMI and can be used as a predictor of long-term prognosis in patients with AMI.

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The relationship between plasma IGFBP2, SMOC2 levels and cardiac function and prognosis in patients with chronic heart failure

DONG Yuting, GONG Xuelian, QU Chao

2025, 53 (6): 593-598. doi: 10.11958/20250289

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Objective To explore the relationship between plasma insulin-like growth factor-binding protein 2 (IGFBP2), secreted modular calcium-binding protein 2 (SMOC2) levels and cardiac function and prognosis in patients with chronic heart failure (CHF). Methods A total of 120 CHF patients (the CHF group) and 60 healthy volunteers undergoing physical examination during the same period (the control group) were enrolled. CHF patients were classified according to the New York Heart Association (NYHA) functional classification into the class Ⅱ (46 cases) group, the class Ⅲ group (42 cases) and the class Ⅳ group (32 cases). Based on the 6-month prognosis, patients were further divided into the poor prognosis group (42 cases) and the good prognosis group (78 cases). Plasma IGFBP2 and SMOC2 levels were measured using enzyme-linked immunosorbent assay. The correlation between plasma IGFBP2 and SMOC2 levels with NYHA functional classification was analyzed using Spearman rank correlation. Multivariate unconditional Logistic regression was used to analyze the relationship between plasma IGFBP2 and SMOC2 levels and poor prognosis in CHF patients. The predictive efficacy of plasma IGFBP2 and SMOC2 levels for CHF prognosis was evaluated using receiver operating characteristic (ROC) curve analysis. Results Compared with the control group, plasma IGFBP2 and SMOC2 levels were significantly higher in the CHF group (P<0.05). Plasma IGFBP2 and SMOC2 levels increased progressively in the class Ⅱ group, the class Ⅲ group and the class Ⅳ group (P<0.05). Plasma IGFBP2 and SMOC2 levels were positively correlated with NYHA classification of CHF patients (P<0.05). The 6-month poor prognosis rate for the 120 CHF patients was 35.00% (42/120). Compared with the good prognosis group, the plasma IGFBP2 and SMOC2 levels were significantly higher in the poor prognosis group (P<0.05). After adjusting for confounding factors, high levels of IGFBP2 and SMOC2 were independent risk factors for poor prognosis in CHF patients (P<0.05). The area under the curve (AUC) for the combined prediction of poor prognosis in CHF patients by plasma IGFBP2 and SMOC2 levels was 0.899, which was higher than that of plasma IGFBP2 (0.800) and SMOC2 (0.782) alone (P<0.05). Conclusion The plasma levels of IGFBP2 and SMOC2 in CHF patients are increased, which is related to the decrease of cardiac function and poor prognosis. The combination of plasma IGFBP2 and SMOC2 levels has a high predictive efficiency for the prognosis of CHF patients.

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The predictive value of serum CysC and CD147 levels for restenosis after intracranial artery stenting in patients with acute ischemic stroke

ZHANG Zaihang, WANG Ning, ZHANG Qi, ZHOU Jing, GUO Yuanzhan, PEI Shuang, GUO Shiqian, SUN Jun

2025, 53 (6): 599-603. doi: 10.11958/20250634

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Objective To explore the application value of serum cystatin C (CysC) and cluster of differentiation 147 (CD147) in predicting restenosis after intracranial artery stenosis stenting (ICASS) in patients with acute ischemic stroke (AIS). Methods A total of 151 AIS patients who received ICASS were selected as the study group, and 112 healthy individuals who underwent physical examinations during the same period were chosen as the control group. The study group was further divided into the restenosis group (30 cases) and the non-stenosis group (121 cases) based on the restenosis status within 6 months after ICASS. The serum CysC levels of the subjects were detected by immunoturbidimetry, and the serum CD147 levels were measured by enzyme-linked immunosorbent assay. Multivariate Logistic regression analysis was conducted to identify factors influencing restenosis after ICASS in AIS patients. The receiver operating characteristic (ROC) curve was used to evaluate the application efficacy of serum CysC and CD147 levels in predicting restenosis after ICASS in AIS patients. Results Serum levels of CysC and CD147 were higher in the study group than those in the control group (P<0.01). The proportion of patients with stenosis degree > 75% and serum levels of CysC and CD147 were higher in the restenosis group than those in the non-stenosis group (P<0.01). The degree of stenosis > 75% and the increased serum levels of CysC and CD147 were risk factors for restenosis after ICASS in AIS patients (P<0.01). ROC curve analysis showed that serum CysC and CD147 levels independently predicted the AUC of AIS patients with restenosis after ICASS were 0.845 and 0.850, respectively, and the combined predicted AUC was 0.942. The combined prediction efficiency was significantly better than that of single indicator prediction (P<0.05). Conclusion The increased levels of serum CysC and CD147 in AIS patients are risk factors for restenosis after ICASS, and the combination of the two is more effective in predicting intracranial artery restenosis after ICASS in AIS patients.

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The correlation between C1q, MBL, C5a and the progression of type 2 diabetes nephropathy and tubular injury

LIU Li, HOU Jian, ZHANG Qiaoling, YANG Hongxiu, YUAN Baojun

2025, 53 (6): 603-609. doi: 10.11958/20250671

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Objective To explore the clinical value of complement 1q (C1q), mannose-binding lectin (MBL) and complement 5a (C5a) in the early diagnosis and disease monitoring of diabetic kidney disease (DKD), as well as their relationship with renal tubular injury. Methods A total of 232 patients with type 2 diabetes mellitus admitted to the Endocrinology Department of Kailuan General Hospital from December 2020 to December 2021 were selected in this study. Patients were divided into the simple diabetes mellitus (SDM) group (n=50) and the DKD group (n=182) based on urinary albumin/creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR). The DKD group was further divided into the low-risk diabetic nephropathy (LDKD) group (n=90), the moderate-risk diabetic nephropathy (MDKD) group (n=55) and the high-risk diabetic nephropathy (HDKD) group (n=37) according to the risk of chronic kidney disease progression. Forty healthy individuals who underwent physical examinations in our hospital during the same period were selected as the healthy control group (NC group). The DKD group was divided into the Q1-Q4 groups based on the quartile levels of NAG/Ucr according to the severity of renal tubular injury from mild to severe. General biochemical indicators, as well as the levels of C1q, MBL and C5a in each group were detected. Spearman correlation analysis was used to analyze the correlation between C1q, MBL, C5a and glomerular and tubular injury indexes. Multivariate ordinal Logistic regression analysis was used to analyze the influencing factors of the progression risk of DKD and the degree of renal tubular injury. Results The levels of systolic blood pressure, diastolic blood pressure, triglycerides (TG), serum creatinine (Scr), uric acid (UA), UACR, NAG/Ucr, C1q, MBL and C5a were higher in the DKD group than those in the SDM group and the NC group. The levels of TC, LDL-C, ApoB and HbA1c were higher than those in the NC group, while the level of HDL-C was lower than that in the NC group. The levels of TC, LDL-C, HbA1c and NAG/Ucr were higher in the SDM group than those in the NC group, while the level of HDL-C was lower than that in the NC group (P<0.05). Among different progression risk groups of DKD, the levels of C1q were higher in the HDKD group than those in the SDM group and the LDKD group. The levels of MBL and C5a were higher in the MDKD group than those in the SDM group and the LDKD group, and the level of MBL was higher in the LDKD group than that in the SDM group (P<0.05). After grouping according to the quartile levels of NAG/Ucr, the levels of TC, ApoB, HbA1c, Scr, UACR, C1q and C5a were significantly higher in the Q4 group than those in the Q1 group. The levels of TC, ApoB, Scr, UACR, C1q and C5a were significantly higher than those in the Q2 group, and the levels of UACR and C5a were significantly higher than those in the Q3 group. The levels of HbA1c, Scr, UACR, C1q and C5a were significantly higher in the Q3 group than those in the Q1 group. The level of UACR was higher in the Q2 group than that in the Q1 group (all P<0.05). The Spearman correlation analysis showed that C1q, MBL and C5a were positively correlated with UACR and NAG/Ucr, and negatively correlated with eGFR (all P<0.05). The ordinal Logistic regression analysis showed that elevated levels of MBL, C5a, NAG/Ucr, Scr and systolic blood pressure were independent influencing factors of progression risk in DKD patients. Elevated levels of C5a, HbA1c and UACR were independent influencing factors of renal tubular injury in DKD patients. Conclusion C1q and C5a can be used to monitor middle and late DKD and tubular injury, and C5a is an independent risk factor for DKD progression and tubular injury. MBL can be used to screen for early DKD and is also an independent risk factor for its progression.

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Relationship between serum Spexin, FoxO1 and insulin resistance as well as prognosis in patients with gestational diabetes mellitus

YANG Jingjing, YAN Kanglu, MENG Jie, YANG Chunli

2025, 53 (6): 610-614. doi: 10.11958/20250653

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Objective To investigate the correlation of serum levels of Spexin, FoxO1 and insulin resistance (IR) with prognosis in patients with gestational diabetes mellitus (GDM). Methods A total of 198 patients with GDM were prospectively selected as the GDM group, and 195 healthy pregnant women who underwent physical examinations during the same period were selected as the control group. The age at enrollment, gestational age, triglyceride (TG), pre-pregnancy body weight, fasting insulin (FINS), parity, fasting blood glucose (FBG), total cholesterol (TC) and homeostasis model assessment of insulin resistance index (HOMA-IR) of the subjects were collected. The serum levels of Spexin and FoxO1 in subjects were detected by enzyme-linked immunosorbent assay (ELISA). According to the pregnancy outcome, the GDM patients were divided into the adverse pregnancy outcome group (96 cases) and the good pregnancy outcome group (102 cases). The correlations between serum Spexin, FoxO1, and HOMA-IR in GDM patients were analyzed by Pearson's method. Logistic regression was used to analyze risk factors affecting the pregnancy outcome of GDM patients. The predictive value of serum Spexin and FoxO1 levels for the pregnancy outcome of GDM patients was analyzed by receiver operating characteristic (ROC) curve. Results The serum levels of FINS, TG, FBG, Spexin, FoxO1 and HOMA-IR were higher in the GDM group than those in the control group (P<0.01). Pearson correlation analysis showed that serum levels of Spexin and FoxO1 in GDM patients were positively correlated with HOMA-IR, and serum level of Spexin was positively correlated with FoxO1 (P<0.05). The incidences of gestational hypertension, cesarean section, macrosomia, neonatal malformations, low birth weight infants and neonatal asphyxia were higher in the GDM group than those in the control group (P<0.05). Serum levels of Spexin and FoxO1 and FINS, FBG and HOMA-IR were significantly higher in the adverse pregnancy group than those in the good pregnancy group (P<0.01). Multivariate Logistic regression analysis showed that the increased Spexin and FoxO1 were the risk factor for adverse pregnancy outcomes in GDM patients (P<0.01). The ROC curve analysis showed that the area under the curve (AUC) of serum Spexin and FoxO1 levels for predicting pregnancy outcomes in GDM patients was 0.887 and 0.883, respectively, and the AUC of combined prediction was 0.942. Conclusion Serum levels of Spexin and FoxO1 are elevated in GDM patients, and both are related to IR. The combination of the two can assist in judging the pregnancy outcome of GDM patients.

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Predictive value of SUVmax and SUVmean parameters in ¹⁸F-PSMA-1007 PET/CT for the diagnosis and disease progression of prostate cancer

WANG Haicheng, ZHAO Yihan, XIE Meiyi, ZHAO Yuming

2025, 53 (6): 614-618. doi: 10.11958/20250665

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Objective To explore the predictive value of maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean) parameters in ¹⁸F-prostate specific membrane antigen-1007 positron emission tomography/computed tomography (¹⁸F-PSMA-1007 PET/CT) for the diagnosis and disease progression of prostate cancer (PCa). Methods Eighty patients with suspected PCa who underwent ¹⁸F-PSMA-1007 PET/CT examination in the hospital were selected and divided into the PCa group (49 cases) and the non-PCa group (31 cases) according to the biopsy pathological results. The ¹⁸F-PSMA-1007 PET/CT parameters were collected in the two groups of patients at admission, including SUVmax and SUVmean. The prostate specific antigen (PSA) and prostate cancer histological grade (GLEASON) score were also collected in patients of the PCa group at admission and 3 months after admission. The diagnostic efficiency of ¹⁸F-PSMA-1007 PET/CT parameters on PCa was analyzed by receiver operating characteristic (ROC) curve. The correlation between ¹⁸F-PSMA-1007 PET/CT parameters of patients in the PCa group at admission and PSA, GLEASON score was analyzed by Pearson method. Results The SUVmax and SUVmean in the PCa group were higher than those in the non-PCa group (P<0.05). ROC curve analysis showed that the areas under the curves (AUCs) of SUVmax and SUVmean were 0.887 and 0.843 respectively, the sensitivities were 80.65% and 83.87%, and the specificities were 87.76% and 73.47% respectively. The PSA and GLEASON score were lower 3 months after admission than those at admission in the PCa group (P<0.05). Pearson correlation analysis showed that the SUVmax and SUVmean of patients in the PCa group at admission were positively correlated with PSA and GLEASON score at admission and 3 months after admission (P<0.05). Conclusion SUVmax and SUVmean parameters of ¹⁸F-PSMA-1007 PET/CT have high predictive value for the diagnosis and disease progression of PCa.

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The clinical value of the combination of routine pleural effusion and serum assay in distinguishing tuberculous pleural effusion from malignant pleural effusion

DU Yunze, TANG Qiong

2025, 53 (6): 619-624. doi: 10.11958/20241860

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Objective To evaluate the clinical value of the combination of routine pleural effusion and serum assay in differentiating tuberculous pleural effusion from malignant pleural effusion. Methods A total of 160 patients with tuberculous pleural effusion and 267 patients with malignant pleural effusion were selected as the study group. Pleural effusion and serum levels of lactate dehydrogenase (LDH), adenosine deaminase (ADA) and carcinoembryonic antigen (CEA) were collected. Receiver operating characteristic (ROC) curve was used to determine the diagnostic value of pleural effusion ADA, serum LDH/ pleural effusion ADA and pleural effusion CEA/ serum CEA in tuberculous pleural effusion, and to determine the optimal cut-off value. The initial diagnosis procedure was designed as follows: the group 1 was defined as meeting the three conditions of pleural effusion ADA≥29.700 U/L, serum LDH/ pleural effusion ADA < 8.523 and pleural effusion CEA/ serum CEA < 1.096 (considering tuberculous pleural effusion), patients meeting the three conditions of pleural effusion ADA < 29.700 U/L, serum LDH/ pleural effusion ADA≥8.523 and pleural effusion CEA/ serum CEA≥1.096 were defined as the group 2 (malignant pleural effusion considered), and the remaining ones that did not meet all of the above conditions were defined as the group 3. For patients in the group 3, if multinucleated cells ≥ 50% in cell classification of pleural effusion, malignant pleural effusion was considered. For patients with monocytes > 50% in cell classification of pleural effusion, the optimal critical value of ADA in pleural effusion was determined as 34.450 U/L by ROC curve. If ADA≥34.450 U/L, tuberculous effusion was considered. If ADA < 34.450 U/L, malignant pleural effusion was considered. According to the initial diagnosis process, 151 patients with exudative pleural effusion were selected as the verification group. Results Through the initial diagnosis process, 5 patients in the study group did not meet the final diagnostic criteria, including 3 patients with tuberculous pleural effusion (the pleural effusion disappeared after standard anti-tuberculosis treatment), 1 patient was found to have lung cancer 3 years later, 1 patient was found to have colon cancer 2 years later, and 1 patient was complicated with ulcerative colitis. There were 2 patients with malignant pleural effusion, among whom 1 was pleural mesothelioma and the other was lung adenocarcinoma. The sensitivity and specificity of the study group diagnosed by this initial diagnostic procedure for tuberculous pleural effusion were 98.13% and 99.25%, respectively, which were higher than those using ADA alone for pleural effusion. After excluding 49 patients who did not meet the criteria of this study, 102 patients were finally included in the verification group, including 20 cases of tuberculous pleural effusion and 82 cases of malignant pleural effusion. Through the initial diagnosis process, only 2 patients with tuberculous pleural effusion were preliminarily diagnosed and did not meet the final diagnostic criteria, including 1 case of leukemia and 1 case of lymphoma. Conclusion The initial diagnosis process designed by combining conventional pleural effusion and serum tests has improved the accuracy of differentiating tuberculous and malignant pleural effusion.

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Effects of transcranial direct current stimulation combined with cognitive-motor dual task training on memory and executive function in patients with post-stroke cognitive impairment

RAN Longfei, GUO Junhui, LUAN Lingqin, NIE Zhiqiang, WANG Tongyu

2025, 53 (6): 624-628. doi: 10.11958/20250535

Abstract ( 25 )

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Objective To explore the influences of transcranial direct current stimulation (tDCS) in combination with cognitive-motor dual task training (CMDT) on memory and executive function in patients suffering from post-stroke cognitive impairment. Methods A total of 75 stroke patients were randomly divided into the tDCS group, the CMDT group and the combined group, each consisting of 25 cases. All patients in the three groups received routine rehabilitation treatment. The tDCS group underwent tDCS stimulation of dorsolateral prefrontal lobe (DLPFC）of the region, the CMDT group received CMDT and the combined group received CMDT on the basis of tDCS treatment. The fourth edition of the Wechsler Memory Scale (WMS-IV), Wisconsin Card Test (WCST), Montreal Cognitive Assessment (MoCA) and Modified Barthel Index (MBI) were used to evaluate the overall cognitive function, memory, executive function, and daily living ability of the patients before and 4 weeks after treatment, respectively. Results Before treatment, there were no significant differences in the evaluation indices between the three groups (P>0.05). After 4 weeks of treatment, the scores of WCST, WMS-IV, MoCA and MBI in the three groups were improved compared with those before the treatment (P<0.05), and the combined group was significantly superior to the tDCS group and the CMDT group (P<0.05). Conclusion The combination of tDCS and CMDT can improve the cognitive function after stroke, and at the same time exert a synergistic effect on memory and executive function.

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The evaluation value of CTP and CTA combined with serum NSE in collateral circulation status and prognosis of patients with post-stroke hemiplegia

LIU Xin, MA Yu, LU Kai, ZHANG Guicheng, WU Yue, HU Fangmei, CUI Youxiang, SUN Yunchuan

2025, 53 (6): 629-633. doi: 10.11958/20250127

Abstract ( 28 )

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Objective To investigate the value of CT perfusion imaging (CTP) and CT angiography (CTA) combined with serum neuron-specific enolase (NSE) in assessing the status and prognosis of collateral circulation (CC) in hemiplegic patients with stroke. Methods A total of 106 patients with stroke hemiplegia were selected in this study. All patients underwent CTA and CTP, and patients were classified into the good CC group (n=67) and the poor CC group (n=39) based on CTA images. Patients were also classified into the good prognostic group (n=56) and the poor prognostic group (n=50) based on modified Rankin Scale (mRS) scores after 3 months of treatment. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum NSE levels. Pearson correlation analysis was used to analyse the correlation between CC scores and CTP parameters and serum NSE levels. The receiver operating characteristic (ROC) curve was used to analyze the evaluation value of serum NSE for the prognosis of hemiplegic patients after stroke. Kappa test was used to analyse the consistency of the prognosis and follow-up results of hemiplegic stroke patients assessed by CTP and CTA alone and in combination with serum NSE. Results The CTP parameters rCBF and rCBV were lower in the poor CC group than those in the good CC group (P<0.05), and levels of rTTP, rMTT and serum NSE were higher than those in the good CC group (P<0.01). CC score was positively correlated with rCBF and rCBV, and negatively correlated with rTTP, rMTT and serum NSE levels (P<0.05). The rCBF and rCBV were lower in the poor prognosis group than those in the good prognosis group, and the proportion of poor CC, rTTP, rMTT, serum NSE level and mRS score were higher than those in the good prognosis group (P<0.01). The area under the curve of serum NSE alone for predicting poor prognosis in hemiplegic patients with stroke was 0.878 (95%CI: 0.800-0.934), with a sensitivity of 74.00% and a specificity of 91.07%, which was in good agreement with the results of the follow-up (Kappa value=0.654, P<0.001). Conclusion CTP, CTA combined with serum NSE have a relatively high evaluation value for the assessment of the CC status and prognosis of stroke patients with hemiplegia.

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The predictive value of Naples prognostic score and prognostic nutritional index for postoperative recurrence and survival in endometrial cancer patients

SHA Yajuan, ZHAO Yingyan, LI Haiyan

2025, 53 (6): 634-639. doi: 10.11958/20242339

Abstract ( 27 )

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Objective To investigate the impact of Naples prognostic score (NPS) and prognostic nutritional index (PNI) on postoperative recurrence and survival in patients with endometrial cancer (EC). Methods A total of 258 EC patients were selected for surgical treatment. Clinical data such as the patients' age at admission, pathological grade, depth of myometrial invasion, lymphovascular space invasion (LVSI), lymph node metastasis and clinical stage of the International Society of Gynecological Oncology (FIGO) were collected. One week before the operation, the laboratory indicators were detected in patients, and NPS and PNI were calculated. The patients were followed up and divided into the recurrence group (n=72) and the non-recurrence group (n=186) according to whether there was recurrence after the operation. The recurrence curves were plotted using Kaplan-Meier method, and the Log-rank test was used to compare the differences in recurrence curves between patients with different NPS and PNI. The Cox proportional hazards regression model was used to analyze the influencing factors of postoperative recurrence in patients with EC. The receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of PNI and NPS scores for postoperative recurrence in patients with EC. Results The proportion of patients with high-risk NPS scores was significantly higher in the recurrence group than that in the non-recurrence group (41.7% vs. 19.4%, P<0.05). The PNI was significantly lower in the recurrence group than that in the non-recurrence group (42.1±7.6 vs. 47.2±8.9, P<0.01). Multivariate Cox regression analysis showed that advanced age, elevated serum carbohydrate antigen 125 (CA125), pathological grades G2 and G3, myometrial invasion depth >1/2, positive LVSI, FIGO stage Ⅲ-Ⅳ and medium-high risk patients with NPS score were independent risk factors for recurrence. Postoperative radiotherapy and chemotherapy and elevated PNI were independent protective factors for recurrence in patients. ROC curve analysis showed that the combined predictive value of NPS score and PNI for postoperative recurrence in patients with EC was superior to that of individual predictions. Conclusion Both NPS and PNI can be used as potential indicators to predict the prognosis of patients with endometrial cancer.

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The effect of continuous positive airway pressure ventilation on mean airway pressure and neurological function in stroke patients with obstructive sleep apnea syndrome

JIA Jianbo, SUN Gen, GU Yuanyuan

2025, 53 (6): 639-643. doi: 10.11958/20250596

Abstract ( 28 )

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Objective To investigate the effects of continuous positive airway pressure (CPAP) on mean airway pressure and neurological function in cerebral infarction patients with obstructive sleep apnea-hypopnea syndrome (OSAS). Methods A total of 245 patients with cerebral infarction complicated with OSAS (who received treatment in our hospital from February 2020 to October 2023) were collected and studied by prospective study. Among them, 152 patients received basic intervention measures such as conventional drugs and rehabilitation therapy, and 93 patients received CPAP therapy on the basis of basic intervention measures. Matching according to 1∶1 propensity score matching method, 48 cases were divided into the control group and 48 cases were used as the observation group. The treatment period of the two groups was 14 days. Before treatment and after 14 days of treatment, the oxygen desaturation index (ODI), lowest oxygen saturation (LS_aO₂), respiratory mechanics indexes [airway resistance (Raw), mean airway pressure (MPaw) and peak inspiratory pressure (PIP)], neurological function scores [National Institutes of Health Stroke Scale (NIHSS) score, modified Rankina scale (mRS) score after 3 months] and Barthel index (BI) score were compared between the two groups, and the efficacy and the occurrence of adverse reactions were evaluated. Results After 14 days of treatment, the ODI, respiratory mechanics indexes Raw, MPaw, PIP, NIHSS score and mRS score were greatly reduced in the two groups, however, LS_aO₂ and BI score was increased (P<0.05). The ODI, Raw, MPaw, PIP, NIHSS score and mRS score were lower in the observation group than those of the control group, while LS_aO₂ and BI score were higher in the observation group than those of the control group (P<0.05). The total effective rate of the observation group was higher than that of the control group (87.5% vs. 68.8%, P=0.026). There was no significant difference in the incidence of adverse reactions between the two groups (P=0.673). Conclusion CPAP is beneficial for reducing MPaw, improving oxygen saturation and neurological function, and increasing total effective rate in patients with cerebral infarction combined with OSAS. It can be widely applied in clinical practice.

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The effect of core muscle group stability training combined with biofeedback electrical stimulation on postpartum pelvic floor function in women underwent selective episiotomy

WANG Jie, XIAO Maocui, WANG Aiwen, CUI Haiping, WANG Ruiping

2025, 53 (6): 644-648. doi: 10.11958/20250386

Abstract ( 24 )

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Objective To explore the effect of core muscle stability training combined with biofeedback electrical stimulation on pelvic floor muscle function in postpartum women underwent episiotomy. Methods Clinical data of 98 parturients who underwent selective episiotomy during natural childbirth were retrospectively analyzed. According to different intervention methods, the included parturients were divided into the control group and the combination group, with 49 cases in each group. The control group was treated only with biofeedback electrical stimulation therapy, while the combination group was treated with core muscle stability training combined with biofeedback electrical stimulation therapy. The general information and pelvic floor muscle strength, pelvic floor electromyography values, pelvic floor dysfunction questionnaire (PFDI-20) scores and female sexual function score scale (FSFI) scores were compared between the two groups of parturients before and after intervention. Results There were no significant differences in age, gestational age, body mass index and pelvic floor muscle strength grading between the two groups (P>0.05). Compared with before intervention, pelvic floor muscle strength, pelvic floor electromyography values and FSFI scores increased in both groups after intervention, while PFDI-20 scores decreased (all P<0.05). After intervention, compared with the control group, the combination group showed more significant improvement in pelvic floor muscle strength, with an increase in class Ⅰ and class Ⅱ fiber electromyography values, a decrease in PFDI-20 score, and an increase in FSFI scores (all P<0.05). The incidence of pelvic floor dysfunction in the two groups was statistically significant (22.45% vs.6.12%, P<0.05). Conclusion Core muscle stability training combined with biofeedback electrical stimulation can effectively promote the recovery of pelvic floor muscle function and improve sexual function in postpartum women underwent episiotomy.

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Analysis of influencing factors of acute cardiovascular and cerebrovascular accidents after surgery in elderly patients with lower extremity fracture

LI Wanting, LIU Hongyang, SANG Jing, RUAN Yufeng, XU Li, LI Dongmei

2025, 53 (6): 648-653. doi: 10.11958/20250587

Abstract ( 32 )

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Objective To analyze risk factors of acute cardio-cerebrovascular accidents in elderly patients with lower extremity fracture, and to construct a risk prediction diagram model. Methods A retrospective analysis was conducted on the clinical data of 510 elderly patients with lower extremity fractures, and the patients were divided into the occurrence group and the non-occurrence group based on the occurrence of acute cardiovascular and cerebrovascular accidents during the postoperative hospitalization. Univariate and multivariate Logistic regression analysis was used to analyze risk factors affecting acute cardiovascular and cerebrovascular accidents in elderly patients with lower extremity fracture, and the risk prediction model was constructed and verified. Results A total of 52 cases of acute cardio-cerebrovascular accidents occurred during hospitalization in 510 patients (10.20%). Age, ASA grade Ⅲ ratio, preoperative concurrent cerebrovascular disease, postoperative pneumonia ratio and postoperative bed time ≥ 5 days ratio were higher in the occurrence group than those in the non-occurrence group (P<0.05). Multivariate Logistic regression analysis showed that age, ASA grade Ⅲ, preoperative concurrent cardiovascular and cerebrovascular disease, and postoperative pneumonia were risk factors for acute cardio-cerebrovascular accidents in elderly patients with lower limb fracture (P<0.05). Multivariate Logistic regression analysis was used to screen risk factors as predictive variables to build a risk early warning histogram model for acute cardio-cerebrovascular accidents. The total score ranged from 103 to 168 points, corresponding to a risk range of 0.1 to 0.9 points. Receiver operating characteristic curve (ROC) curve results showed that the area under the curve (AUC) of this model for predicting acute cardiovascular and cerebrovascular accidents was 0.980 (95%CI: 0.964-1.000), and discrete choice approach (DCA) showed that when the risk threshold was 0.2-0.6, the prediction model of this column graph had a good clinical advantage. Conclusion The risk diagram model constructed based on risk factors has good predictive value for the occurrence of acute cardio-cerebrovascular accidents after lower extremity fracture in elderly patients.

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Application of energy spectrum CT quantitative analysis in the diagnosis of malignant thyroid nodules and evaluation of cervical lymph node metastasis

WANG Mingyang, LI Li, LI Lingling, WU Yue

2025, 53 (6): 654-658. doi: 10.11958/20250052

Abstract ( 35 )

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Objective To explore the application value of energy spectrum CT quantitative analysis in the diagnosis of malignant thyroid nodules and evaluation of cervical lymph node metastasis. Methods A total of 100 patients with thyroid nodules screened by ultrasound were selected as the study subjects. They were divided into the benign group (n=42) and the malignant group (n=58) according to pathological results. Patients in the malignant group were sub-divided into the metastasis group (n=26) and the non-metastasis group (n=32) according to the presence or absence of cervical lymph node metastasis. All patients received energy spectrum CT examination. The iodine concentration (IC), normalized iodine concentration (NIC) and the slope of the spectral Hounsfield unit curve (λHU) were measured. The receiver operating characteristic (ROC) curve was used to analyze the application value of energy spectrum CT quantitation in diagnosing malignant thyroid nodules and evaluating cervical lymph node metastasis. Results There were statistically significant differences in CT features (shape, edge, cystic changes and surrounding tissue invasion) between benign and malignant thyroid nodules (P<0.05). However, there were no statistically significant differences in the maximum diameter, number, enhancement degree and calcification (P>0.05). IC_lesion, NIC and λHU were lower in the benign group than those of the malignant group. IC_lesion, NIC and λHU of the metastasis group were lower than those of the non-metastasis group (P<0.05). ROC curve analysis results showed that the AUCs, specificity, sensitivity and Youden index of the combination of IC_lesion, NIC and λHU for diagnosing malignant thyroid nodules and evaluating cervical lymph node metastasis were higher than those of each parameter (P<0.05). Conclusion Energy spectrum CT quantitative analysis is of high value in the diagnosis of malignant thyroid nodules and evaluation of cervical lymph node metastasis.

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Diagnostic value of masseter muscle thickness fraction measured by ultrasound for dysphagia in patients with Parkinson's disease

MAI Xiangxiang, LI Ningxiao, YOU Yong

2025, 53 (6): 659-664. doi: 10.11958/20250931

Abstract ( 26 )

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Objective To investigate the diagnostic value of masseter muscle thickness fraction (MMTF) measured by ultrasound for the occurrence of dysphagia in patients with Parkinson's disease (PD). Methods A total of 100 patients were selected as the study group, and another 50 healthy individuals who received medical checkups with matched age, gender and body mass index (BMI) in our hospital during the same period were selected as the control group. The demographic data and disease characteristics of PD patients were recorded, and patients were divided into the dysphagia group (n=34) and the non-dysphagia group (n=66) according to the occurrence of dysphagia. The demographic data, and disease characteristics such as Hoehn-Yahr (H&Y) stage, Unified Parkinson's Disease Rating Scale (UPDRS) Ⅲ score, levodopa equivalent daily dose (LEDD) and MMT-related parameters measured by ultrasound were compared between the two groups. The indicators with P<0.05 in univariate analysis were used as independent variables, and the influencing factors of dysphagia in patients with PD were investigated by binary Logistic regression analysis. The diagnostic efficacy of each index for dysphagia in patients with PD was evaluated by constructing receiver operating characteristic (ROC) curves, and the area under the curve (AUC) was calculated. Results The MMT during forceful biting and MMTF were lower in the study group than those in the control group (all P<0.05). Compared with the non-dysphagia group, the dysphagia group was older and had higher H&Y stage and UPDRS III scores (all P<0.05). The MMT during forceful biting and MMTF in the dysphagia group were lower than those in the non-dysphagia group (all P<0.05). Multivariate Logistic regression analysis showed that increased UPDRS Ⅲ score was the risk factor for dysphagia in patients with PD, and increased MMT during forceful biting and MMTF were protective factors. The ROC curve analysis indicated that the AUC (95%CI) of UPDRS Ⅲ score, MMT during forceful biting and MMTF for diagnosing dysphagia in patients with PD were 0.714 (0.615-0.800), 0.744 (0.647-0.826) and 0.888 (0.809-0.942), respectively. The AUC of MMTF for diagnosing dysphagia in patients with PD was higher than those of UPDRS Ⅲ scores and MMT during forceful biting (Z values were 2.611 and 2.208, respectively, P<0.05). Conclusion MMTF is an independent influencing factor for dysphagia in patients with PD and can be used as a screening indicator for dysphagic patients.

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Efficacy of lenalidomide combined with bortezomib and dexamethasone in the treatment of multiple myeloma

XIANG Lili, WANG Qian, MENG Yanna, FU Jie, ZHANG Pu

2025, 53 (6): 665-669. doi: 10.11958/20250356

Abstract ( 39 )

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Objective To investigate the efficacy of lenalidomide combined with bortezomib and dexamethasone in the treatment of multiple myeloma (MM) and their effects on heat shock protein 90 (HSP90) mRNA, miR-28-5p, anti-tartrate acid phosphatase 5b (TRACP-5b) and high mobility group protein B1 (HMGB1). Methods Eighty patients with newly diagnosed MM were selected and divided into the two-combination group (40 patients treated with bortezomib and dexamethasone) and the three-combination group (40 patients treated with bortezomib and dexamethasone combined with lenalidomide) according to the treatment modalities. Real-time fluorescence quantitative polymerase chain reaction was used to detect HSP90 mRNA and miR-28-5p levels. Enzyme-linked immunosorbent assay was used to detect TRACP-5b and HMGB1 levels. The clinical efficacy of the 2 groups was compared. Levels of HSP90 mRNA, miR-28-5p, TRACP-5b, HMGB1, the immune cell function, renal function indexes and the incidence of adverse reactions were compared before and after treatment. Results The total effective rate of the three-combination group was higher than that of the two-combination groups (92.50% vs. 75.00%, P<0.05). Compared with the pretreatment, the levels of HSP90 mRNA, TRACP-5b, blood creatinine (SCr), and urea nitrogen (BUN) decreased in the 2 groups after treatment, and which was lower in the three-combination group than that in the two-combination groups. The levels of miR-28-5p, HMGB1, CD4⁺, CD3⁺ and CD4⁺/CD8⁺ were elevated in the 2 groups, and the levels were higher in the three-combination group than those in the two-combination group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Lenalidomide combined with bortezomib and dexamethasone is clinically effective, safe and reliable in the treatment of MM.

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Risk analysis of allergy to ketoconazole shampoo and selenium sulfide shampoo in patients with androgenetic alopecia

WANG Ying, YANG Dingquan

2025, 53 (6): 670-672. doi: 10.11958/20250019

Abstract ( 32 )

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Objective To analyze the incidence of contact allergic reactions to ketoconazole shampoo and selenium sulfide shampoo in patients with androgenetic alopecia (AGA). Methods A retrospective analysis was conducted on 683 AGA patients. Based on medical records, dermoscopy findings, fungal examinations and patch test results, the number of patients with seborrheic dermatitis, Malassezia-positive cases and contact allergy to ketoconazole and selenium sulfide shampoos were recorded. Results The incidence of seborrheic dermatitis in AGA patients was 65.59%, and the Malassezia-positive rate was 42.02%. The allergy rate to ketoconazole shampoo in AGA patients was 34.70%, which was significantly higher than the 25.62% allergy rate to selenium sulfide shampoo (P<0.01). In AGA patients with concomitant seborrheic dermatitis and Malassezia positivity, the allergy rate to ketoconazole lotion was higher than that to selenium sulfide lotion (P<0.05). The positivity rate of Malassezia was 45.98% in seborrheic dermatitis patients, which was higher than that of the 34.47% in non-seborrheic dermatitis patients (P<0.01). Conclusion In patients with AGA, ketoconazole shampoo carries a higher allergy risk compared to selenium sulfide shampoo. Long-term use of antifungal shampoos should be avoided in patients with AGA and conduct patch tests for drug detection when necessary.

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