Tianjin Medical Journal

Research on emodin improving high glucose-induced mitophagy impairment in hippocampal neurons

HE Yu, SUN Yu, ZHANG Yiqiong, XU Yongjie, WANG Shuang, PAN Wei, REN Zhijing

2026, 54 (5): 449-454. doi: 10.11958/20252781

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Objective To investigate the protective effect of emodin, an active component of polygonum multiflorum, against mitochondrial autophagy dysfunction in hippocampal neurons under high-glucose conditions by inhibiting histone acetyltransferase 2A (KAT2A), and its potential molecular mechanism. Methods An in vitro model was established by inducing hippocampal neurons with high glucose. Following intervention with emodin, cell viability, lactate dehydrogenase (LDH) content, histone acetyltransferase (HAT) content and reactive oxygen species (ROS) levels were measured, and mitochondrial membrane potential changes were also detected. Western blot assay and RT-qPCR were employed to assess the expression of mitochondrial autophagy-related proteins, including microtubule-associated protein 1 light chain 3-Ⅱ(LC3-Ⅱ), P62, PTEN-induced prokinase 1 (PINK1), KAT2A and their corresponding mRNAs. Molecular docking analysis was conducted to evaluate the binding affinity between emodin and KAT2A. Results Emodin treatment significantly enhanced neuronal viability under high-glucose conditions, while reducing LDH leakage, HAT and intracellular ROS levels, and effectively mitigated mitochondrial membrane potential decline. Additionally, Western blot assay and RT-qPCR results demonstrated that after emodin intervention, the expression levels of KAT2A, P62 and PINK1 proteins and mRNA were significantly downregulated, while LC3-Ⅱ protein and mRNA expression were upregulated. Molecular docking results further revealed that emodin exhibited good binding activity with KAT2A, with a binding energy of -32.6 kJ/mol. Conclusion This study demonstrates that emodin can effectively alleviate high glucose-induced mitophagy dysfunction in hippocampal neurons and reduce the generation of ROS and LDH. The underlying mechanism may be associated with the inhibition of KAT2A activity.

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Mechanism study of IgE high-affinity receptor binding to NPC2 on regulating DNP-BSA-induced mast cell degranulation and histamine release

LIU Shenhong, MA Yuanyuan, ZHANG Limei

2026, 54 (5): 455-461. doi: 10.11958/20252449

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Objective To detect the expression of the high-affinity IgE receptor (FcεRⅠ) and Niemann-Pick disease type C2 protein (NPC2) in mast cells treated with 2,4-dinitrophenyl-conjugated bovine serum albumin (DNP-BSA), and to investigate the regulatory mechanism, by which NPC2 protein binding to FcεRⅠ modulating DNP-BSA-induced mast cell degranulation and histamine release. Methods From June to December 2023, five patients with allergic asthma diagnosed in the Department of Respiratory Medicine at Urumqi Friendship Hospital (asthma group) and five healthy controls (control group) were enrolled. Four- to six-week-old male wild-type C57BL/6 mice (n=5) and NPC2 gene knockout mice (n=3) were selected in this study. For in vitro experiments, bone marrow-derived mast cells (BMMCs) were isolated from two randomly selected wild-type mice. NPC2 knockdown was established via siRNA transfection (siNPC2 group), with corresponding negative control group (NC group) and wild-type (WT group) group. For in vivo experiments, an ovalbumin (OVA)-induced allergic asthma mouse model was established (grouping as above). Quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) was used to detect NPC2 and FcεRⅠ messenger RNA (mRNA) expression in peripheral blood from the asthma and control groups. Flow cytometry was used to detect the expression of cluster of differentiation 117 (CD117), FcεRⅠ and lysosome-associated membrane protein 1 (CD107a). Enzyme-linked immunosorbent assay (ELISA) was used to measure levels of inflammatory cytokines, chemokines, colony-stimulating factors and histamine release. Co-immunoprecipitation (Co-IP) was performed to verify the interaction between NPC2 and FcεRⅠ in mast cells. Hematoxylin and eosin (HE) staining was used to examine pathological changes in mouse ear tissue and lung tissue. Results The expression of NPC2 and FcεRⅠ mRNA in peripheral blood was significantly higher in the asthma group compared to the control group (P < 0.05). In vitro flow cytometry confirmed that the purity of the cultured BMMCs reached 93.4%. Compared to the WT group, NPC2 knockdown (siNPC2 group) significantly inhibited DNP-BSA-induced release of inflammatory cytokines [interleukin (IL)-4, IL-5, IL-9, IL-13, tumor necrosis factor-α (TNF-α)], chemokine CCL2 and granulocyte-macrophage colony-stimulating factor (GM-CSF) (P < 0.05), and reduced the histamine release rate and CD107a expression level. Co-IP experiments confirmed a direct interaction between NPC2 and FcεRⅠ in mast cells. In vivo experiments showed that NPC2 knockdown/knockout (siNPC2 group) mice exhibited significantly alleviated lung inflammatory injury compared to wild-type (WT group) mice. Conclusion NPC2 promotes mast cell activation and degranulation by binding to FcεRⅠ, and knockout of NPC2 significantly suppresses allergic response.

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MiR-421 targeting the MPP7/EGFR/AKT axis to regulate macrophage M2 polarization and alleviating airway inflammation in asthmatic mice

LU Hongxia, GUO Yanjun, HUANG Han, ZHANG Ting

2026, 54 (5): 462-468. doi: 10.11958/20253182

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Objective To investigate the mechanism by which miR-421 affects macrophage M2 polarization of macrophages and improves airway inflammation in asthmatic mice. Methods BALB/c mice were randomly divided into the control group, the asthma group, the mimic NC group, the miR-421 mimic group, the miR-421 mimic + OE-NC group and the miR-421 mimic + OE-Membrane-associated Guanylate Kinase p55 Scaffold Protein 7 (MPP7) group, with 12 mice in each group. Except for the control group, all other groups were subjected to establish asthma model. After successful modeling, each intervention was administered once, and indicators were assessed after 7 days. The expression levels of serum-free miR-421 and MPP7 mRNA were detected by qRT-PCR. Airway resistance and lung compliance were measured using a dedicated system. Serum levels of immunoglobulin E (IgE), interleukin (IL)-4 and IL-13 were determined by enzyme-linked immunosorbent assay (ELISA). Lung tissue morphology was assessed by HE staining. The proportion of M2-type macrophages in lung tissue was analyzed by flow cytometry. Western blot assay was used to detect the protein levels of Arginase-1 (Arg-1), MPP7, epidermal growth factor receptor (EGFR) and p-protein kinase B (AKT)/AKT in lung tissue. The targeting relationship between miR-421 and MPP7 was verified by dual-luciferase reporter assay. Results Compared with the control group, mice of the asthma group exhibited significant pathological changes: thickened tracheal walls, fused adjacent alveoli forming cystic cavities and obvious inflammatory cell infiltration. Furthermore, the asthma group showed decreased expression of serum miR-421 and lung dynamic compliance, while serum MPP7 mRNA, inspiratory resistance, expiratory resistance, IgE, IL-4, IL-13, the proportion of M2-type macrophages in lung tissue, and the protein expression of Arg-1, MPP7, EGFR and p-AKT/AKT were significantly increased (P<0.05). Compared with the asthma group and the mimic NC group, changes in the aforementioned indicators showed the opposite trends in the miR-421 mimic group (P<0.05). OE-MPP7 reversed the improvement effect of overexpression of miR-421 on airway inflammation in asthmatic mice. Conclusion Overexpression of miR-421 may inhibit macrophage M2 polarization by suppressing the MPP7/EGFR/AKT axis, thereby alleviating airway inflammation in asthmatic mice.

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Expression and clinical significance of serum arginase-2 in cardiac surgery associated acute kidney injury

LIU Bingqian, JIN Xin, QIAN Xiaoli

2026, 54 (5): 469-472. doi: 10.11958/20252825

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Objective To investigate the expression of serum arginase 2 (Arg-2) in patients with cardiac surgery-related acute kidney injury (CAS-AKI) and its relationship with clinical prognosis. Methods A total of 112 patients who underwent cardiac surgery were selected and divided into the acute kidney injury (AKI) group (35 cases) and the non-AKI group (77 cases) based on whether AKI occurred within 7 days after surgery. The differences in serum Arg-2 levels between the two groups were compared. The correlation between serum Arg-2 levels and renal function indicators was analyzed. The receiver operating characteristic (ROC) curve was used to analyze the auxiliary diagnostic value of serum Arg-2 for CAS-AKI. Logistic regression analysis was used to analyze the influence of Arg-2 on the occurrence of CAS-AKI. Results The serum Arg-2 level was higher in the AKI group than that in the non-AKI group. The expression level of serum Arg-2 was positively correlated with serum creatinine (Scr), neutrophil gelatinase-associated lipocalin (NGAL) and urinary kidney injury molecule-1 (Kim-1). The elevated expression of serum Arg-2 was an independent risk factor for the occurrence of CAS-AKI (OR=1.045，95%CI：1.009-1.082). Serum Arg-2 alone had a high sensitivity and specificity for predicting CAS-AKI, which were 74.30% and 66.20%, respectively. And the area under the curve (AUC) was 0.738 (95%CI: 0.636 - 0.840). Combining with Kim-1 and NGAL could improve the sensitivity and specificity of diagnosing CAS-AKI (85.70% and 81.80%), respectively, with an AUC increase to 0.886 (95%CI: 0.823 - 0.950). Conclusion The expression level of serum Arg-2 in patients with CAS-AKI is elevated, and it can be used as an early auxiliary diagnostic marker for CAS-AKI.

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Comparison of the clinical efficacy between limited craniotomy and standard decompressive craniectomy in the treatment of middle-aged and elderly patients with spontaneous cerebral hemorrhage

WANG Xueyan, SHANG Gechu, WANG Guan, WANG Huile, ZHANG Qiyang

2026, 54 (5): 473-477. doi: 10.11958/20253058

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Objective To explore the differences of perioperative indicators, inflammatory response and neurological prognosis between small bone window craniotomy and traditional large bone flap craniotomy in middle-aged and elderly patients with spontaneous intracerebral hemorrhage (SICH). Methods A total of 133 middle-aged and elderly SICH patients were selected and 94 were included after propensity score matching. Patients were divided into the small bone window group (47 cases) and the large bone flap group (47 cases) according to the surgical methods. The baseline data (gender, age, smoking history, drinking history, history of hypertension, diabetes, cerebrovascular disease and coronary heart disease), surgical related indicators (operation time, hospital stay and postoperative fever days), C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC) on postoperative 1, 3 and 7 days, preoperative and postoperative hematoma volume and hematoma clearance rate, Glasgow Coma Scale (GCS), 90-day mortality and modified Rankin Scale (mRS) were compared on admission and postoperative 1, 3, 7 and 14 days between the two groups. Results There were no statistically significant differences in age, gender, smoking history, drinking history, history of hypertension, diabetes, cerebrovascular disease and coronary heart disease, hospital stay, postoperative fever days, WBC, preoperative and postoperative hematoma volume and hematoma clearance rate, GCS score, 90-day mRS score distribution and 90-day cumulative survival rate between the two groups. The operation time of the small bone window group was shorter than that of the large bone flap group, and the CRP and PCT levels on postoperative 3 days were lower than those of the large bone flap group (P<0.01). Conclusion Small bone window craniotomy for middle-aged and elderly patients with SICH can achieve a comparable long-term prognosis compared to that of large bone flap decompression, and it has the advantages of shorter operation time and milder postoperative inflammatory response.

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Construction and validation of a prediction model for minor amputation in patients with diabetic foot ulcers during hospitalization

HUANG Fei, WANG Lihang, SUN Guanwen, BAO Huhe, YANG Pengbo, ZHANG Yaxing

2026, 54 (5): 478-483. doi: 10.11958/20252907

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Objective To explore the independent risk factors for minor amputation during hospitalization in patients with diabetic foot ulcer (DFU), and to construct and validate an individualized risk prediction model. Methods A retrospective analysis was conducted on the clinical data of 154 patients with DFU. Patients were categorized into the minor amputation group (48) and the non-amputation group (106) based on whether they underwent minor amputation during hospitalization. Multivariate Logistic regression analysis was employed to identify risk factors and construct a prediction model. Additionally, clinical data from 71 DFU patients were collected as an external validation cohort. In both the modeling and validation cohorts, the discrimination, calibration and clinical utility of the model were evaluated using receiver operating characteristic (ROC) curves, calibration curves and decision curve analysis (DCA). Results Compared with the non-amputation group, higher proportion of male patients, longer ulcer duration, higher rates of deep ulcers and lower extremity arterial occlusion, elevated levels of fasting plasma glucose (FPG), creatine kinase (CK), serum creatinine (Scr), triglycerides (TG) and D-Dimer were found in the minor amputation group (all P < 0.05), while the proportion of pre-hospital treatment was significantly lower in the minor amputation group (P < 0.05). Multivariate Logistic regression analysis showed that male sex, prolonged duration of ulcer, deep ulcer, lower extremity arterial occlusion, elevated levels of Scr and D-Dimer, and lower extremity vascular occlusion were independent risk factors for minor amputation in patients with DFU (P<0.05). Receiving prehospital treatment was a protective factor. The area under the curve (AUC) for predicting minor amputation in the modeling group was 0.898 (95%CI: 0.842-0.953), with a sensitivity of 87.5% and a specificity of 82.1%. The AUC of the validation group was 0.887 (95%CI: 0.808-0.966), with a sensitivity of 92.3% and a specificity of 77.8%. The calibration curve and DCA showed that the model had good calibration accuracy and clinical utility. Conclusion The nomogram model constructed in this study can effectively predict the risk of minor amputation during hospitalization in patients with DFU. Among them, "pre-hospital treatment" as an interventional factor provides a practical tool for the early identification of high-risk patients and the implementation of precise intervention.

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Influencing factors and risk prediction model of enteral nutrition intolerance in postoperative colorectal cancer patients

PENG Jing, YU Xiaoqian

2026, 54 (5): 484-488. doi: 10.11958/20252863

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Objective To analyze the influencing factors of enteral nutrition feeding intolerance (EFI) in patients after colorectal cancer surgery and construct a predictive model. Methods A total of 392 patients who underwent colorectal cancer surgery were selected and divided into the modeling group (274 cases) and the validation group (118 cases) at a ratio of 7∶3. The modeling group was further divided into the EFI group (88 cases) and the normal group (186 cases) based on whether EFI occurred after surgery. Basic patient information, drug use, nutritional status and the first postoperative laboratory indicators (serum albumin, hemoglobin and white blood cell count) were collected. Logistic regression was used to analyze the influencing factors of EFI in patients after colorectal cancer surgery, and a risk prediction scoring model was established. The discrimination of the model was evaluated by the receiver operating characteristic (ROC) curve, and the calibration of the model was evaluated by the calibration curve. Results The age, comorbidity index, white blood cell count, use of analgesic drugs, malnutrition and the proportion of patients with serum albumin < 35 g/L in the EFI group were all higher than those in the normal group. Moreover, there were statistically significant differences in tumor type and tumor stage between the two groups (P<0.01). Multivariate Logistic regression analysis revealed that age≥70 years, Charlson comorbidity index ≥2, ulcerative/infiltrative tumor type, tumor stage Ⅲ-Ⅳ, use of analgesic drugs, malnutrition, serum albumin <35 g/L and white blood cell count > 10×10⁹/L were risk factors for EFI after colorectal cancer surgery. The area under the ROC curve of the validation group was 0.834 (95%CI: 0.756 - 0.920), with a sensitivity of 92.2% and a specificity of 76.4%. The calibration curve of the validation group was close to the reference curve, suggesting that this model has a very good predictive effect. Conclusion The constructed EFI warning model for patients after colorectal cancer surgery can help identify high-risk patients for feeding intolerance in clinical practice and provide a reference for the timely implementation of preventive strategies and reduction of the risk of nutritional intolerance.

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Prediction value of APD combined with RCT grading for fetal renal pelvis dilatation and neonatal renal function

PANG Jing, JIAO Yan, ZHU Haili, GAO Fang, LI Junjie, LI Xuefeng

2026, 54 (5): 489-493. doi: 10.11958/20253139

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Objective To investingate the predictive value of a grading system based on the anteroposterior diameter of the renal pelvis (APD) combined with renal cortex thickness (RCT) for fetal renal pelvis dilation and neonatal renal function. Methods A retrospective study was conducted on 186 fetuses diagnosed with renal pelvis dilation by prenatal ultrasound at Qinhuangdao Maternal and Child Health Hospital. Based on postpartum follow-up, they were divided into the normal renal function group (n=146) and the abnormal renal function group (n=40). Logistic regression was used to analyze risk factors, and a combined APD-RCT grading standard was established. The predictive efficacy and consistency were evaluated using ROC curves and Kappa test. Results There were significantly higher APD, higher proportion of renal parenchyma echo enhancement, bladder wall thickening and oligohydramnios, while RCT was significantly lower in the abnormal renal function group (P<0.05). Multivariate Logistic regression analysis showed that increased APD, decreased RCT, renal parenchyma echo enhancement, bladder wall thickening and oligohydramnios were independent risk factors for abnormal renal function [OR(95%CI): 2.369 (1.753-3.204), 0.734 (0.557-0.968), 3.394 (1.696-6.793), 2.089 (1.344-3.247), 2.774 (1.938-3.971), respectively]. With the increase of APD-RCT grade (from I to IV), the rate of renal dysfunction increased progressively (2.6%, 10.5%, 40.0%, 92.9%, P<0.01). ROC analysis showed that the APD-RCT grading system predicted abnormal renal function with an AUC of 0.922. The weighted Kappa value was 0.86, indicating high consistency. Conclusion The combined APD-RCT grading system can effectively predict neonatal renal function abnormality in fetuses with renal pelvis dilation and demonstrate good clinical application value.

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The predictive value of serum HDAC3 and LOXL2 for recurrence of atrial fibrillation in patients with persistent atrial fibrillation after radiofrequency ablation

YANG Yingtao, DING Yameng, GUO Huijun

2026, 54 (5): 493-497. doi: 10.11958/20253150

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Objective To analyze the predictive value of serum histone deacetylase 3 (HDAC3) and lysyl oxidase like protein 2 (LOXL2) levels in patients with persistent atrial fibrillation for artial fibrillation recurrence one year after radiofrequency ablation. Methods A total of 200 patients with persistent atrial fibrillation treated in our hospital were served as the disease group, and 132 healthy individuals of the same age during the same period were selected as the healthy group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum HDAC3 and LOXL2 before and after surgery in the two groups, and other relevant clinical indicators were collected. Patients were assigned into the non recurrence group (125 cases) and the recurrence group (75 cases) based on their recurrence status within one year. Multivariate Logistic regression model was used to analyze factors influencing the recurrence within one year in patients of the disease group. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum HDAC3 and LOXL2 levels for recurrence of atrial fibrillation in patients within one year. Results The postoperative serum HDAC3 and LOXL2 levels were prominently lower in the disease group than those before surgery (P<0.05). The serum levels of HDAC3 and LOXL2 were higher in the recurrence group than those in the non-recurrence group (P<0.05). The high levels of HDAC3 and LOXL2 were risk factors affecting the recurrence of atrial fibrillation in patients (P<0.05). The area under the curve (AUC) values of serum HDAC3 and LOXL2 alone and their combination for predicting recurrence of atrial fibrillation in patients in the disease group were 0.833 (95%CI: 0.774-0.882), 0.829 (95%CI: 0.770-0.879) and 0.907 (95%CI: 0.858-0.943), respectively. The combined prediction was superior to the individual predictions (Z_{combination-HDAC3}=3.384, Z_{combination-LOXL2}=3.438, P<0.05). Conclusion The elevated serum levels of HDAC3 and LOXL2 are factors influencing the recurrence of atrial fibrillation in patients, and both are predictive factors that affect recurrence of atrial fibrillation in patients one year after radiofrequency ablation.

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The predictive value of systemic inflammation response index combined with atrial cardiomyopathy markers for new-onset atrial fibrillation after acute myocardial infarction

ZHENG Jianfa, YANG Yang, ZHANG Xiaohong

2026, 54 (5): 498-503. doi: 10.11958/20253715

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Objective To explore the predictive value of the systemic inflammatory response index (SIRI) combined with atrial cardiomyopathy markers, left atrial diameter (LAD) and N-terminal pro-brain natriuretic peptide (NT-proBNP) for new-onset atrial fibrillation (AF) after acute myocardial infarction (AMI). Methods A total of 356 AMI patients were selected and divided into the AF group (62 cases) and the non-AF group (294 cases) based on whether new-onset AF occurred after percutaneous coronary intervention (PCI) during hospitalization. Baseline data, laboratory indicators and echocardiographic parameters of the two groups were collected and compared. Logistic regression analysis was used to evaluate the risk factors for new-onset AF. Restricted cubic spline plots were applied to verify the dose-response relationship between SIRI, LAD, NT-proBNP and new-onset AF, and receiver operating characteristic (ROC) curves were drawn to evaluate the predictive efficacy of SIRI, LAD, NT-proBNP and their combined indicators. Results Compared with the non-AF group, patients in the AF group exhibited higher age, heart rate, CHA₂DS₂-VASc score, neutrophil count, monocyte count, neutrophil-to-lymphocyte ratio (NLR), SIRI, serum creatinine, NT-proBNP, anterior-posterior diameter of left atrium (LAD), left ventricular end-diastolic diameter, left ventricular end-diastolic volume index and left atrial volume index, and diastolic blood pressure, triglycerides, estimated glomerular filtration rate and left ventricular ejection fraction were lower (P<0.01). Multivariate Logistic regression analysis showed that advanced age, increased LAD, logNT-proBNP and SIRI were independent risk factors for new-onset AF after AMI. Restricted cubic spline analysis showed that SIRI, LAD and logNT-proBNP had a linear dose-response relationship with new-onset AF after AMI (P nonlinearity>0.05), and were positively correlated with AF risk (P overall<0.01). ROC curve analysis showed that the AUC of the combined prediction model of SIRI, LAD and NT-proBNP was 0.863 (95% CI: 0.800 - 0.926), with a sensitivity of 87.5% and a specificity of 74.1%. Conclusion SIRI, LAD and NT-proBNP are independent predictors of new-onset AF after AMI. The combination of the three can significantly improve the predictive performance, providing a practical tool for the early identification of high-risk patients.

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The predictive value of the TyG index for restenosis after interventional treatment in patients with lower extremity arteriosclerotic occlusive disease

LI Fei, WU Chengwen, WANG Fengyun, KANG Haihan

2026, 54 (5): 503-507. doi: 10.11958/20252830

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Objective To explore the predictive value of the triglyceride-glucose (TyG) index for restenosis in patients with lower extremity arteriosclerotic occlusive disease after interventional therapy. Methods A retrospective analysis was conducted on the clinical data of 210 patients with lower extremity arteriosclerotic occlusive disease who received interventional treatment. The patients were divided into the low TyG group (TyG<7.70, n=75), the medium TyG group (7.70≤TyG≤8.50, n=80) and the high TyG group (TyG>8.50, n=55) based on the TyG index. The clinical characteristics of the three groups were compared. Univariate analysis was used to screen the factors related to restenosis, and Cox proportional hazards regression analysis was used to determine the independent influencing factors. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive efficacy of the TyG index for restenosis, and the Kaplan-Meier method was used to compare the occurrence of restenosis in patients with different TyG levels. Results The patient age, body mass index (BMI), prevalence of diabetes, lesion length and stent implantation rate were higher in the high TyG group compared with those of the low TyG group and the medium TyG group (P<0.05). After 6 to 24 months of postoperative follow-up, with an average of (15.36±4.25) months, the restenosis rate of the entire group was 34.76% (73/210), including 26 cases (35.62%) of mild restenosis, 24 cases (32.88%) of moderate restenosis and 23 cases (31.50%) of severe restenosis. The restenosis rates of the low, medium and high TyG groups increased successively (21.33% vs. 35.00% vs. 52.73%). Cox proportional hazards regression analysis showed that an elevated TyG index (HR=3.245, 95%CI: 1.987-5.316, P<0.001) was an independent risk factor for restenosis. Kaplan-Meier analysis revealed that the restenosis rate of the high TyG group was higher than that of the low TyG group and the medium TyG group (Log-rank χ²=13.951, P<0.01). Conclusion The TyG index can serve as an effective predictor for restenosis in patients with lower extremity arteriosclerotic occlusive disease after interventional treatment. The higher the TyG index, the higher the risk of restenosis after the operation.

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A clinical study on type A botulinum toxin combined with red and blue light therapy in improving facial post-traumatic pigmentation

REN Zhixin, LIU Yingqi, MA Bing

2026, 54 (5): 508-512. doi: 10.11958/20253270

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Objective To explore the clinical effect of botulinum toxin type A combined with red and blue light in improving post-traumatic facial pigmentation. Methods A total of 120 patients with post-traumatic facial pigmentation were selected as the research subjects and randomly divided into the red and blue light group (60 cases) and the combined treatment group (60 cases) according to the random number table method. The red and blue light group was treated with a red and blue light therapy device for 6 weeks, and the combined treatment group was given botulinum toxin type A injection on the basis of the red and blue light group. The therapeutic effects, skin property scores before and after treatment, facial image scores, changes in serum oxidative stress indicators such as malondialdehyde (MDA), lipid peroxides (LPO) and superoxide dismutase (SOD), as well as the occurrence of adverse reactions were compared between the two groups. Results The total effective rate was significantly higher in the combined treatment group than that of the red and blue light group (78.33% vs. 60.00%, P<0.05). After treatment, the skin moisture, elasticity scores, pigmentation scores and serum SOD levels were increased in both groups, and those in the combined treatment group were higher than those in the red and blue light group (P<0.05). After treatment, the serum MDA, LPO levels and pigmentation area scores were decreased in both groups, and those in the combined treatment group were lower than those in the red and blue light group (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the red and blue light group and the combined treatment group (20.00% vs. 16.67%, P > 0.05). Conclusion Botulinum toxin type A combined with red and blue light therapy has a good clinical efficacy and high safety in the treatment of post-traumatic facial pigmentation.

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Feasibility analysis of reimplantation after unplanned removal of totally implantable venous access ports

WANG Xinyi, MU Ning, LI Feng’e, LIU Mei, XU Yue, WU Shengnan, MA Chunhua

2026, 54 (5): 513-516. doi: 10.11958/20253701

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Objective To evaluate the feasibility, safety and appropriate patient selection for re-implantation of totally implantable venous access ports (TIVAPs) after unplanned port removal. Methods Clinical data from 10 patients who required unplanned port removal due to TIVAP dysfunction were retrospectively collected to evaluate the technical success rate, postoperative complications and follow-up outcomes of TIVAP reimplantation. Results Ten patients underwent TIVAP re-implantation under digital subtraction angiography (DSA) guidance following unplanned port removal, with a technical success rate of 100%. By the end of follow-up on 30 November 2025, the median follow-up duration was 271 days. Eight patients experienced no further TIVAP-related complications and successfully completed their planned treatments, while two patients required premature port removal due to recurrent pocket rupture with port exposure and persistent wound non-healing, respectively. There were no infection, drug extravasation or other serious adverse events in the intire group. Conclusion TIVAP reimplantation may serve as an effective remedial strategy for selected cases of unplanned port removal, with acceptable safety and economic value.

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Predictive value of combined serum DKK1, SETDB1 and SMURF1 tests for postoperative delayed healing in patients with tibial shaft fractures

LIU Yuxin, YU Liang, LU Tan, LI Qi, SHEN Zhizhong, ZHAO Yilei

2026, 54 (5): 517-521. doi: 10.11958/20253266

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Objective To investigate the predictive value of serum levels of Dickkopf-related protein 1 (DKK1), SET domain bifurcated 1 (SETDB1) and SMAD specific E3 ubiquitin protein ligase 1 (SMURF1) on delayed healing in tibial shaft fracture patients. Methods A total of 210 patients who underwent surgical treatment for tibial shaft fractures were enrolled as study subjects, and patients were categorized into the normal healing group (n = 142) and the delayed healing group (n = 68) based on the presence or absence of postoperative delayed fracture union. Serum levels of DKK1, SETDB1 and SMURF1 were measured at 1 day, 1 week, 4 weeks and 8 weeks postoperatively using enzyme-linked immunosorbent assay (ELISA). Clinical data were collected from both groups, and multivariate Logistic regression analysis was performed to identify factors influencing postoperative delayed healing. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive value of serum DKK1, SETDB1 and SMURF1 levels individually and in combination for delayed healing following surgery in patients with tibial shaft fractures. Results The proportions of cardiovascular disease, hypertension and osteoporosis were higher in the delayed group than those in the normal group (P<0.05). At all measured time points, serum levels of DKK1 and SETDB1 were significantly lower in the delayed healing group than those in the normal healing group, whereas SMURF1 level was significantly higher (P<0.05). Multivariate Logistic regression analysis revealed that decreased serum levels of DKK1 and SETDB1, along with elevated SMURF1 levels, were independent risk factors for postoperative delayed healing (P<0.05). ROC curve analysis demonstrated that the combined detection of DKK1, SETDB1 and SMURF1 had high predictive accuracy for delayed healing, with an area under the curve (AUC) of 0.931 (95%CI:0.897-0.966，P<0.05). Conclusion The combined detection of serum DKK1, SETDB1 and SMURF1 can effectively predict the risk of postoperative delayed healing in patients with tibial shaft fracture, thereby facilitating early clinical identification of high-risk individuals and guiding the development of targeted intervention strategies.

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Analysis of risk factors for delayed bleeding in patients with gastrointestinal mucosal tumors after EMR

YU Bo, PU Xiaolin, LIU Naiting, LI Yabin, WU Zhiru

2026, 54 (5): 522-527. doi: 10.11958/20252631

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Objective To explore the risk factors of delayed bleeding in patients with gastrointestinal mucosal tumors after endoscopic mucosal resection (EMR), and to construct the nomogram prediction model. Methods A retrospective analysis was performed on clinical data of patients with gastrointestinal mucosal tumors who underwent EMR in Harbin Second Hospital between May 2020 and September 2023. Among all patients, 160 cases with delayed bleeding within 30 d after surgery were enrolled as the bleeding group, while 320 cases from patients without bleeding during the same period were enrolled as the non-bleeding group according to 1∶2 simple and random sampling method. The clinical data were compared between the two groups. The risk factors of delayed bleeding after EMR were analyzed by multivariate Logistic regression analysis. The nomogram model for postoperative delayed bleeding was constructed. Its predictive efficiency was analyzed by receiver operating characteristic (ROC) curves, calibration degree of the model was evaluated by calibration curves, and the net benefit of the model was evaluated by clinical decision curve analysis (DCA). Results Compared with the non-bleeding group, patient age, proportion of hypertension, tumor diameter, resection area, intraoperative blood loss and postoperative usage rate of anticoagulant agents were higher, and preoperative prothrombin time (PT), withdrawal time of anticoagulant drugs and postoperative duration of anticoagulant drugs were longer, and frequency of preoperative biopsy was higher in the bleeding group (P<0.05). Results of Logistic regression analysis showed that increased age and frequency of preoperative biopsy and intraoperative bleeding were risk factors of delayed bleeding within 30 d after surgery (P<0.05). The area under ROC curve (AUC) of the nomogram model constructed based on the above factors was 0.906 (95%CI: 0.804-0.951), showing high predictive and discriminative efficiency. The calibration curve showed that the consistency between the model and actual condition for predicting bleeding rate was good. Hosmer-Lemeshow test with P=0.352 confirmed the stability of model calibration. DCA revealed that the model achieved clinical net benefit across a wide range of threshold probabilities. Conclusion The nomogram prediction model constructed based on independent risk factors has high predictive efficiency and discriminative ability, which can provide reference for preoperative risk stratification and perioperative individualized management in clinical practice.

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Observation on the therapeutic efficacy of ketogenic diet combined with perampanel in children with epileptic encephalopathy accompanied by sharp-slow wave activation during sleep period

CHEN Man, ZHENG Nuo, ZHANG Dongli, CHEN Jiao, LIU Xiaoming

2026, 54 (5): 528-532. doi: 10.11958/20253253

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Objective To evaluate the therapeutic effects of ketogenic diet (KD) combined with perampanel (PER) on sleep-related spike-and-wave activity index (SWI), serum levels of central nervous system-specific protein S-100β and intellectual development in children diagnosed with epileptic encephalopathy with sleep-related spike-and-wave activation (EE-SWAS). Methods A prospective randomized controlled trial was conducted involving 99 children with EE-SWAS, and they were randomly assigned to the control group (n = 49, receiving PER monotherapy) and the experimental group (n = 50, receiving KD combined with PER). After six months of treatment, clinical efficacy, SWI, serum biomarkers including S-100β, neuron-specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) were assessed and compared between groups. Cognitive function was evaluated using the Wechsler Intelligence Scale for Children—Fifth Edition (WISC-V). Adverse events were systematically monitored throughout the study period. Results After treatment, SWI, S-100β and NSE levels were significant reduced in both groups, and BDNF level and WISC-V scores were higher compared to those of the control group (P<0.05). SWI, S-100β and NSE levels were lower in the experimental group than those of the control group, and BDNF level and WISC-V scores were higher in the control group (P<0.05). After treatment, the total effective rate was hiter in the experimental group (96.00%) than that in the control group (79.59%, P<0.05). There was no significant difference in the incidence of adverse events during the treatment period between the two groups (12.00% vs. 16.32%，P>0.05). Conclusion The combination of KD and PER demonstrates superior therapeutic efficacy in children with EE-SWAS, effectively reducing abnormal electroencephalographic activity, modulating key neurochemical markers, supporting cognitive development and exhibiting a favorable safety.

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Observation on the therapeutic effect of modified Bu Pi Yi Xin decoction combined with dibenzoyl phenylalanine soft capsules in the treatment of vascular dementia after cerebral infarction

FAN Xin, ZHOU Xiaoying, XU Shuxiao

2026, 54 (5): 533-538. doi: 10.11958/20253541

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Objective To explore the efficacy of modified Bu Pi Yi Xin decoction combined with N-butylphthalide (NBP) soft capsules in treating vascular dementia (VD) after cerebral infarction, and its influences on cognitive function, serum histone deacetylase 6 (HDAC6) and neuregulin 1 (NRG1) levels. Methods One hundred patients with VD after cerebral infarction were included and randomly divided into the NBP group and the combined group according to the random number table method, with 50 cases in each group. In the NBP group, NBP soft capsules were used for treatment, while in the combined group, on the basis of the NBP group, modified Bu Pi Yi Xin decoction was given. The differences in the total scores of traditional Chinese medicine (TCM) syndromes, cognitive function [Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores], degree of dementia [Clinical Dementia Rating (CDR) score and modified Hasegawa Dementia Scale (HDS-R) score], hemorheology [high/low shear whole blood viscosity and plasma viscosity] and serum-related factors [HDAC6, NRG1 and brain-derived neurotrophic factor (BDNF)] were compared before and after treatment between the two groups. Results After treatment, the total effective rate was higher in the combined group than that of the NBP group (P<0.05). After treatment, the total score of TCM syndromes and CDR score were lower in the combined group than those in the NBP group (P<0.05), and MMSE score, MoCA score and HDS-R score were higher in the combined group than those in the NBP group (P<0.05). After treatment, the high/low shear viscosity of whole blood, plasma viscosity and serum levesl of HDAC6 were lower in the combined group than those in the NBP group (P<0.05), while serum levels of BDNF and NRG1 were higher in the combined group than those in the NBP group (P<0.05). Conclusion The modified Bu Pi Yi Xin decoction combined with NBP soft capsules have a significant therapeutic effect on VD patients after cerebral infarction, and it can alleviate the severity of dementia, improve cognitive function, reduce blood viscosity and increase serum levels of HDAC6 and NRG1.

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The therapeutic effect of guanxinning tablets combined with indapamide on patients with hypertension and coronary heart disease

LI Yingjie, HOU Ruirui, GUO Lin, JI Yujie, GUO Fang

2026, 54 (5): 538-543. doi: 10.11958/20253569

Abstract ( 43 )

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Objective To observe the effect of guanxinning tablets combined with indapamide in the treatment of hypertension with coronary heart disease, as well as its influences on the number of plasma circulating endothelial cells (CEC) and the serum level of energy balance protein Adropin in patients. Methods Totally 150 patients with hypertension and coronary heart disease were randomly assigned into the single-use group (indapamide sustained-release tablets) and the combined group (indapamide sustained-release tablets + guanxinning tablets) by random number table method, with 75 cases per group. The therapeutic effect, blood pressure, cardiac function indicators, endothelium-related indicators, hemorheology, lipid indicators, inflammatory indicators and changes in Adropin were observed and compared between the two groups. Results The total effective rate of the combined group was higher than that of the single-use group (P<0.05). After medication, the systolic blood pressure (SBP), diastolic blood pressure (DBP), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), endothelin-1 (ET-1), CEC, hematocrit (HCT), plasma viscosity (PV), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and high-sensitivity C-reactive protein (hs-CRP) were lower than those before medication in both groups, and the combined group was lower than the single-use group (P<0.05). After medication, the left ventricular ejection fraction (LVEF), nitric oxide (NO) and Adropin increased compared with those before medication in both groups, and the combined group was higher than the single-use group (P<0.05). There was no manifest difference in untoward reactions between the single-use group and the combined group during treatment (P>0.05). Conclusion Guanxinning tablets combined with indapamide have an ideal therapeutic effect on hypertension with coronary heart disease, and which can conspicuously improve the levels of CEC and Adropin in patients.

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Multidisciplinary diagnosis and treatment analysis of one case of ventricular electrical storm secondary to septic cardiomyopathy

LI Shixin, WANG Jiajia, HE Qijin, LIU Siqi, JIANG Xiaosi, FAN Xikai, SONG Shumei, ZHAI Jianhua

2026, 54 (5): 544-549. doi: 10.11958/20253200

Abstract ( 46 )

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Ventricular electrical storm (ES) is a critical medical state defined by severe cardiac electrical instability, manifesting as repeated episodes of sustained ventricular arrhythmias within a short duration. As the cardiac expression of a sympathetic storm, ES significantly elevates the risk of sudden cardiac death. It predominantly occurs in patients with pre-existing structural heart disease or inherited arrhythmia syndromes. Precipitating factors frequently include heart failure, volume overload, electrolyte imbalance and drug-induced proarrhythmic effects. Sepsis can trigger exaggerated sympathetic tone, myocardial impairment and hemodynamic compromise. Clinical management of sepsis is frequently complicated by volume overload and may require the administration of medications with proarrhythmic potential. These elements collectively establish a pathophysiological environment that facilitates the emergence of ES. This article presents a case study of a patient with septic cardiomyopathy who developed ES. Through a multidisciplinary approach involving geriatrics, cardiology, pharmacy and critical care medicine, the study analyzes the pathophysiology of ES, its relationship between sepsis and ES, potential triggers, antiarrhythmic strategy adjustments, selection of electrophysiological interventions and planning of circulatory support. The findings aim to assist clinicians in accurately identifying the causes of ES, implementing appropriate treatment strategies and improving patient outcomes.

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Research progress on Toll-like receptor agonists and their application in tumor vaccines

XU Tong, YANG Xingwang, LIU Yonghui

2026, 54 (5): 550-555. doi: 10.11958/20253005

Abstract ( 68 )

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Toll-like receptor (TLR) agonists, when used as adjuvants in tumor vaccines, can effectively activate the innate immune response and enhance antitumor immune responses. By specifically recognizing pathogen-associated molecular patterns, they activate downstream signaling pathways, promote the maturation and antigen presentation of dendritic cells, and thereby induce strong cellular immunity. Various TLR agonists have shown potential in tumor vaccines to enhance immunogenicity, reverse immune suppression and synergize with immune checkpoint inhibitors. This article reviews the classification, mechanism of action and research progress of TLR agonists in tumor vaccines, aiming to provide a reference for tumor immunotherapy.

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Research progress on the mechanism of SIRT1 in regulating podocyte injury-induced proteinuria

HE Jia, DOU Yitian

2026, 54 (5): 556-560. doi: 10.11958/20253032

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Proteinuria is an important clinical indicator for the early diagnosis of kidney disease and disease progression, and its occurrence is related to podocyte injury. Sirtuin 1 ( SIRT1 ) is a highly conserved multifunctional protein that acts as a nicotinamide adenine dinucleotide-dependent deacetylase and affects a variety of biological processes by regulating the deacetylation process of transcription factors. It can also participate in signal transduction by virtue of its non-enzymatic activity mechanism, which together constitute the molecular basis for its regulation of podocyte homeostasis. Relevant studies have shown that SIRT1 is closely related to podocyte injury. It regulates macrophage function, autophagy process, lipid metabolism, oxidative stress and epithelial-mesenchymal transition (EMT) process, and maintains mitochondrial homeostasis, thereby protecting podocytes, reducing proteinuria and delaying the progression of renal injury. Here is to make a preliminary review of the research on the related mechanisms in recent years, in order to provide reference for the related clinical and basic research. This article reviews the mechanism of SIRT1 regulating podocyte injury-induced proteinuria, in order to provide reference for further mechanism research and wider clinical application.

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