Tianjin Medical Journal

Research on the role of ACE2 in drug resistance of colorectal cancer and its predictive vaule

DONG Qian, CHEN Shuhua, ZHANG Fei

2026, 54 (6): 561-569. doi: 10.11958/20260224

Abstract ( 169 )

HTML ( 15 )

PDF (1404KB) ( 96 )

Objective To investigate the role of angiotensin-converting enzyme 2 (ACE2) in chemoresistance in colorectal cancer (CRC) and evaluate its potential as a predictive biomarker. Methods Serum samples were collected from patients with colorectal cancer and healthy controls, and ACE2 protein levels were measured by enzyme-linked immunosorbent assay (ELISA). Baseline and drug-induced (cisplatin, 5-fluorouracil and paclitaxel) ACE2 expression in CRC cell lines were detected by Western blot assay and quantitative reverse transcription-polymerase chain reaction (qRT-PCR). Small interfering RNAs (siRNAs) and lentiviral systems were employed to construct ACE2 knockdown and stable overexpression cell models. The effect of ACE2 expression on chemoresistance was evaluated by calculating the half-maximal inhibitory concentration (IC₅₀) for cisplatin, 5-fluorouracil and paclitaxel. Cell proliferation and migration abilities were assessed using the Cell Counting Kit-8 (CCK-8) assay, colony formation assay and Transwell assay, respectively. The association between ACE2 expression and treatment response or prognosis in CRC patients was analyzed using clinical specimen and public database. Results Clinical data revealed that serum ACE2 levels were higher in the healthy controls than those in colorectal cancer patients (P<0.05). Serum ACE2 levels were higher in the chemotherapy-resistant group than those in the chemotherapy-sensitive group（P<0.05). Exposure to chemotherapeutic agents (cisplatin, 5-fluorouracil, and paclitaxel) upregulated ACE2 expression in colorectal cancer cells（P<0.05). Knockdown of ACE2 reduced the IC₅₀ value of these drugs, and significantly inhibited cell proliferation and migration（P<0.05). Bioinformatics analysis showed that ACE2 expression was correlated with multiple drug resistance-related genes. Moreover, among colorectal cancer patients with low KRAS expression, high ACE2 expression was associated with poorer prognosis（P<0.05). Conclusion ACE2 expression is positively correlated with malignant phenotypes (proliferation and migration) and chemoresistance in CRC cells. Elevated ACE2 levels in patients after chemotherapy can serve as a potential biomarker for predicting chemoresistance.

Figures and Tables | References | Related Articles | Metrics

Auranofin inhibits glucose uptake and induces ferroptosis in anaplastic thyroid cancer

DENG Xinyi, YANG Chen, CAO Jianlin, YANG Lei, TAN Jian, JIA Qiang, MENG Zhaowei

2026, 54 (6): 570-576. doi: 10.11958/20251716

Abstract ( 130 )

HTML ( 7 )

PDF (1610KB) ( 122 )

Objective To investigate the effect and molecular mechanism of auranofin (AUF) in inhibiting glucose uptake and inducing ferroptosis in anaplastic thyroid carcinoma (ATC) cells. Methods CAL-62 cells were routinely cultured and treated with AUF at various concentrations (0, 0.2, 0.4, 0.6, 0.8, 1.0 and 1.2 μmol/L). Cells were also treated with 0.6 μmol/L AUF (AUF group), BAY (BAY group), the combination of 0.6 μmol/L AUF and BAY (AUF+BAY group), Erastin (Erastin group) and the combination of 0.6 μmol/L AUF and Erastin (AUF+Erastin group). Untreated cells were served as the control group. Cell viability of CAL-62 cells was detected by CCK-8 assay, and cell apoptosis was determined by flow cytometry. Glucose uptake was measured using a glucose detection kit, and intracellular iron content and glutathione (GSH) levels were determined using ferroptosis-related assay kits. The mRNA expressions of glucose transporter 1 (GLUT1), long-chain acyl-CoA synthetase 4 (ACSL4) and glutathione peroxidase 4 (GPX4) in ATC tissue were detected by quantitative real-time polymerase chain reaction (qRT-PCR). A subcutaneous xenograft tumor model was established in nude mice to evaluate the antitumor effect of AUF on ATC in vivo. The protein expression levels of ACSL4, GPX4 and thioredoxin reductase 1 (TXNRD1) were detected by Western blot assay. Results Compared with the control group, AUF inhibited the viability of CAL-62 cells in a dose-dependent manner (P<0.01). Both AUF alone and its combined treatment with BAY or Erastin increased the apoptosis rate (P<0.05). Compared with the control group, the residual glucose content in the cell culture supernatant and intracellular iron content were increased, while the GSH content was decreased in the 0.8 and 1.0 μmol/L AUF groups (P<0.05). Compared with the control group, the mRNA expression levels of GLUT1 and GPX4 were decreased in the 0.6, 0.8 and 1.0 μmol/L AUF groups (P<0.05), and the mRNA expression level of ACSL4 was increased in the 0.8 and 1.0 μmol/L AUF groups (P<0.05). In animal experiments, the tumor volume was significantly smaller in the AUF+Erastin group than that in the control group only on day 14 (P<0.05), while there was no statistically significant difference in tumor volume between the AUF group and the control group (P>0.05). There was no statistically significant difference in body weight between each group and the control group (P>0.05). Compared with the control group, the protein expression levels of TXNRD1 and GPX4 were decreased and the protein expression level of ACSL4 was increased in the AUF group (P<0.05). The protein expression level of GPX4 was decreased and the protein expression level of ACSL4 was increased in the AUF+Erastin group (P<0.05). Conclusion AUF promotes ferroptosis and suppresses glucose uptake in ATC cells, thereby inhibiting their proliferation.

Figures and Tables | References | Related Articles | Metrics

Protective effect and mechanism of miR-194-5p inhibitor on myocardial injury in mice with type 2 diabetic cardiomyopathy

ZHANG Jing, ZHANG Ming, WEI Wei, NING Haihong, WEI Hongmei, LI Haiyan, WU Bin

2026, 54 (6): 577-584. doi: 10.11958/20260039

Abstract ( 99 )

HTML ( 3 )

PDF (1562KB) ( 92 )

Objective To investigate the protective effect and its potential mechanism of miR-194-5p inhibitor (miR-194-5p antagomir) on myocardial injury in mice with type 2 diabetic cardiomyopathy (DCM). Methods Sixty C57BL/6 mice were randomly divided into the normal control (NC) group, the DCM group, the DCM+antagomir control group and the DCM+miR-194-5p antagomir group (n=15). The DCM model was established by high-fat diet combined with intraperitoneal injection of streptozotocin. After successful model establishment, mice in the DCM+miR-194-5p antagomir group were injected via the tail vein with miR-194-5p antagomir dissolved in PBS at a dose of 10 mg/kg, while mice in the control group were injected with the same dose of antagomir control dissolved in PBS, twice a week for 4 weeks. Twelve weeks after the intervention, cardiac function was evaluated by echocardiography. Myocardial cell cross-sectional area was detected by wheat germ agglutinin (WGA) staining. Inflammatory cytokines interleukin (IL)-6 and tumor necrosis factor (TNF)-α in myocardial tissue were determined by enzyme-linked immunosorbent assay (ELISA). The expression levels of miR-194-5p and dual-specificity phosphatase 9 (DUSP9) mRNA were detected by real-time fluorescence quantitative PCR (RT-qPCR). Myocardial mitochondrial ultrastructure was observed by transmission electron microscopy. The target of miR-194-5p was predicted by bioinformatics methods, and pathway enrichment analysis was performed. The dual-luciferase reporter gene assay was used to verify the targeted regulation of DUSP9 by miR-194-5p. The expression levels of DUSP9 protein and mitogen-activated protein kinase (MAPK) pathway-related molecules were detected by Western blot assay. Results Compared with the NC group, left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were decreased in the DCM group and the DCM+antagomir control group, and myocardial cell cross-sectional area, apoptosis rate, levels of inflammatory factors IL-6 and TNF-α, phosphorylated ERK (p-ERK) and phosphorylated p38 (p-p38) increased (P<0.05). The expression of miR-194-5p mRNA was up-regulated, while the mRNA and protein expression of DUSP9 were down-regulated (P<0.05), and the myocardial mitochondrial ultrastructure was severely damaged. Compared with the DCM group and the DCM+antagomir control group, LVEF and LVFS were increased, and myocardial cell cross-sectional area, apoptosis rate, inflammatory factor levels, p-ERK and p-p38 were decreased in the DCM+miR-194-5p antagomir group (P<0.05). The expression of miR-194-5p mRNA was down-regulated, while the mRNA and protein expression of DUSP9 were up-regulated (P<0.05), and the myocardial mitochondrial ultrastructural injury was alleviated. Bioinformatics prediction indicated that DUSP9 was a potential target of miR-194-5p, and the MAPK signaling pathway was the most significantly enriched pathway among the target genes. The dual-luciferase reporter assay confirmed that miR-194-5p could directly target the 3'-UTR region of DUSP9. Conclusion Inhibition of miR-194-5p attenuates myocardial injury in DCM mice, likely by targeting DUSP9 for upregulation, thereby suppressing the MAPK signaling pathway.

Figures and Tables | References | Related Articles | Metrics

Study on mechanism of Yunpi Tiaozhi formula in improving lipid metabolism and hepatic steatosis in hyperlipidemic rats

LIU Jun, LIANG Dongli, YAN Qiongzhi, ZHU Yidong, HAN Tianxiong, YAN Qianlin

2026, 54 (6): 585-590. doi: 10.11958/20253761

Abstract ( 84 )

HTML ( 3 )

PDF (1171KB) ( 86 )

Objective To investigate the effects of the Yunpitiaozhi formula on the lipid levels, liver lipid deposition, liver and kidney functions and blood glucose (Glu) through the adenylate activated protein kinase (AMPK)?peroxisome proliferator-activated receptor (PPAR) α -sterol regulatory element binding protein (SREBP) axis and related targets in hyperlipidemic rats, and to evaluate its efficacy and safety. Methods Sixty SPF-grade SD rats were randomly divided into the blank group, the model group, the low, medium and high-dose groups of the Yunpitiaozhi formula (0.4, 0.8 and 1.6 g/kg), and the atorvastatin group. Each group consisted of 10 rats. Except for the blank group, all groups were induced with high-fat diet combined with intraperitoneal injection of vitamin D₃ for 6 weeks. Then, each group was given the corresponding drug by gavage for 6 weeks. Serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen (BUN), serum creatinine (Scr), uric acid (UA) and Glu were detected before and after the intervention. Liver tissue pathological observation was conducted for each group, and the non-alcoholic fatty liver disease (NAFLD) activity score (NAS) was evaluated. Western blot assay was used to detect key proteins of lipid metabolism in liver tissue. Results Before treatment, compared with the blank group, the TC, TG, HDL-C and LDL-C levels were increased in the model group and all intervention groups (P<0.01). After treatment, compared with the model group, the expression levels of TC, LDL-C, ALT, Scr and SREBP-1c decreased in each dose group of the Yunpitiaozhi formula, and the p-AMPK/AMPK ratio and PPARα expression level increased (P<0.05). There were no statistically significant differences in AST, UA and blood glucose between the groups. In the high-dose group, TG, steatosis score, ballooning score, lobular inflammation score, NAS total score and BUN decreased, and the Glu level increased in the atorvastatin group (P < 0.05). The ALT, BUN, Scr and UA levels were within the normal range in each group. Conclusion Yunpitiaozhi formula can improve lipid metabolism in hyperlipidemic rats by regulating the AMPK-PPARα-SREBP axis, alleviate liver steatosis, and has no adverse effects on liver and kidney functions and blood glucose.

Figures and Tables | References | Related Articles | Metrics

The protective effect of exosomes derived from bolbostemma paniculatum on sepsis-induced acute lung injury

CUI Zhigang, YING Ce, ZHANG Cen, LI Dihua, ZHUO Yuzhen, YANG Lei

2026, 54 (6): 591-597. doi: 10.11958/20260566

Abstract ( 78 )

HTML ( 2 )

PDF (1225KB) ( 75 )

Objective To investigate the protective effect and the related mechanisms of bolbostemma paniculatum-derived nanoparticles (BDNPs) on acute lung injury (ALI) induced by sepsis in mice. Methods BDNPs were extracted by ultracentrifugation, and their characteristics were detected by transmission electron microscopy and nanoparticle tracking analysis. A mouse model of ALI induced by cecal ligation and puncture (CLP) was established. Thirty mice were randomly divided into the sham operation group (Sham group), the model group (CLP group) and the BDNPs treatment group (BDNPs group), with 10 mice in each group. After 24 hours of modeling, lung tissue samples were collected for HE staining to detect pathological changes. q-PCR was used to detect the expression changes of inflammatory factors (TNF-α, IL-1β and IL-18 mRNA) in lung tissue. Transcriptome high-throughput sequencing was used to detect changes in signaling pathways in lung tissue. Western blot assay was used to detect the expression changes of pyroptosis-related proteins (NLRP3, GSDMD and Caspase-1) in lung tissue. 16S rDNA high-throughput sequencing was used to detect changes of intestinal flora. Results BDNP were successfully prepared by ultracentrifugation. Compared with the CLP group, BDNPs treatment could significantly improve the pathological damage of lung tissue and reduce the expression of TNF-α, IL-1β and IL-18 mRNA in lung tissue as well as the expression of NLRP3, GSDMD and Caspase-1 proteins in lung tissue (P<0.05). Compared with the Sham group, KEGG analysis indicated that the IL-17 signaling pathway and TNF-α signaling pathway and other inflammatory signaling pathway were enriched in the CLP group. Compared with the CLP group, BDNPs treatment could significantly reduce the related signaling pathways (P<0.05). BDNPs treatment could significantly improve the composition of intestinal flora, reduce the relative abundance of Acinetobacter and Shigella species, and significantly increase the relative abundance of Clostridium species (P<0.05). Conclusion BDNPs have a significant protective effect on CLP-induced ALI, and the mechanism may be related to improving the intestinal flora, inhibiting pyroptosis and reducing inflammatory responses.

Figures and Tables | References | Related Articles | Metrics

The diagnostic value of serum NFL and NGB in elderly patients with sepsis associated encephalopathy

WU Yuanhui, YAN Li, LI Linfang

2026, 54 (6): 598-602. doi: 10.11958/20253056

Abstract ( 106 )

HTML ( 4 )

PDF (928KB) ( 80 )

Objective To investigate the dynamic changes of serum neurofilament light chain (NFL) and neuroglobin (NGB) in elderly patients with sepsis-associated encephalopathy (SAE) and their diagnostic value. Methods A total of 128 elderly sepsis patients were divided into the SAE group (53 cases) and the non-SAE group (75 cases) based on the occurrence of SAE. Clinical data were collected. Serum NFL and NGB levels were measured using enzyme-linked immunosorbent assay at different time points (0-6 h, 24 h and 48 h after diagnosis). Multivariate Logistic regression was used to analyze the relationship between serum NFL and NGB levels at 0-6 h and SAE, and a probability risk model was constructed accordingly. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the auxiliary diagnostic value of NFL, NGB levels, sequential organ failure assessment (SOFA) score and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score for SAE. Results Serum NFL and NGB levels at 0-6 h, 24 h and 48 h were higher in the SAE group compared to those of the non-SAE group (P<0.05). Multivariate Logistic regression analysis showed that elevated serum NFL and NGB levels at 0-6 h, as well as higher SOFA and APACHE Ⅱ scores, were independent risk factors for SAE (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for diagnosing SAE was 0.723 (95%CI: 0.695-0.854) for serum NFL at 0-6 h, 0.769 (95%CI: 0.607-0.836) for NGB at 0-6 h, 0.677 (95%CI: 0.568-0.774) for SOFA score, 0.700 (95%CI: 0.588-0.787) for APACHE Ⅱ score, and 0.894 (95%CI: 0.805-0.952) for the combination of all four factors. The combined application of the four factors was superior to their individual diagnostic values (P<0.05). Conclusion The combination of serum NFL and NGB and related scores within 0 to 6 hours has relatively high diagnostic value for SAE in elderly sepsis patients.

Figures and Tables | References | Related Articles | Metrics

Clinical value of the combined CTI and CALLY index in assisting the diagnosis of heart failure in elderly patients with acute exacerbation of chronic obstructive pulmonary disease

YANG Dan, LIU Cuicui, ZHAO Dongfang, LIU Zheng, ZHU Yafang

2026, 54 (6): 603-607. doi: 10.11958/20253236

Abstract ( 91 )

HTML ( 2 )

PDF (906KB) ( 85 )

Objective To investigate the clinical value of C-reactive protein-triglyceride-glucose index (CTI) combined with the C-reactive protein-albumin-lymphocyte (CALLY) index in the auxiliary diagnosis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with heart failure (HF) in elderly patients. Methods Clinical data of 260 elderly patients with AECOPD were retrospectively analyzed. The CTI and CALLY index were calculated. Patients were divided into the AECOPD+HF group (n=117) and the AECOPD without HF group (n=143) based on the presence or absence of HF. Multivariate Logistic regression analysis was used to identify factors influencing HF in elderly patients with AECOPD. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP), CTI and CALLY index for HF. Results Compared with the AECOPD without HF group, in the AECOPD with HF group, the age, the proportion of diabetes and hypertension increased, the course of COPD was prolonged, the CALLY index decreased, and the serum creatinine, NT-proBNP and CTI increased (P<0.05). Multivariate Logistic regression showed that elevated CTI was an independent risk factor for HF in elderly patients with AECOPD (OR = 1.253, 95%CI: 1.164-1.349, P<0.001), while the elevated CALLY index was an independent protective factor (OR = 0.786, 95%CI: 0.693-0.892, P<0.001). The area under the curve (AUC) for CTI alone, CALLY index alone and their combination in diagnosing HF in elderly patients with AECOPD was 0.791 (95%CI: 0.736-0.839), 0.781 (95%CI: 0.726-0.830) and 0.877 (95%CI: 0.830-0.914), respectively. The diagnostic value of the combined detection was superior to that of CTI or CALLY index alone (P<0.05). Conclusion The combination of CTI and CALLY index has high value in the auxiliary diagnosis of HF in elderly patients with AECOPD.

Figures and Tables | References | Related Articles | Metrics

Application of gene copy number variation combined with cytokine detection in the etiological diagnosis of early abortion

LIU Junxiu, SONG Yanmin, ZHAO Mingyang, ZHUAN Jia, HAN Zhe, ZHAO Yuanyuan, MA Hua, YANG Xiumei

2026, 54 (6): 608-611. doi: 10.11958/20252918

Abstract ( 63 )

HTML ( 2 )

PDF (825KB) ( 75 )

Objective To explore the application value of gene copy number variation (CNV) combined with cytokine detection in the diagnosis of early abortion in pregnant women, and its relationship with maternal-fetal immune imbalance. Methods This study enrolled 80 early miscarriage patients as the study group, with 80 healthy pregnant women undergoing routine prenatal examination serving as the control group during the same period. Both groups of patients underwent chromosomal non-viability (CNV) testing and cytokine analysis (IL-2, TNF-α, IL-4 and IL-10). The research aimed to investigate the correlation between chromosomal abnormalities and Th1/Th2 immune imbalance, evaluate their impact on early miscarriage risk, and analyze the multifactorial mechanism contributing to this condition. The diagnostic efficacy of single testing versus combined testing for the early miscarriage was analyzed using receiver operating characteristic (ROC) curve, and the clinical application value of combined testing was clarified. Results The serum levels of IL-2 and TNF-α, as well as the Th1/Th2 ratio were higher in the study group than those in the control group, while the levels of IL-4 and IL-10 were lower (P<0.05). The detection rate of CNV abnormalities was 32.50% (26/80) in the study group, which was significantly higher than 2.50% in the control group (2/80, P<0.05). Among the CNV-abnormal subjects in the study group, the Th1/Th2 imbalance rate was 84.62% (22/26), which was significantly higher than that in CNV-normal subjects [51.85% (28/54), P<0.05]. Multivariate Logistic regression analysis revealed that CNV abnormalities (OR=4.586, 95%CI: 3.582-5.590) and Th1/Th2 imbalance (OR=4.721, 95%CI: 3.577-5.865) were independent risk factors for early miscarriage. The diagnostic efficacy of CNV detection combined with Th1/Th2 imbalance detection was the highest for early miscarriage, with an area under the curve (AUC) of 0.894, which was significantly higher than that of single CNV detection (AUC=0.743) or single Th1/Th2 imbalance detection (AUC=0.733). Conclusion The combination of CNV testing and cytokine analysis enhances the accuracy of early miscarriage diagnosis. Both CNV abnormality and Th1/Th2 imbalance are independent risk factors for early miscarriage, providing valuable insights for etiological diagnosis and clinical intervention.

Figures and Tables | References | Related Articles | Metrics

Impact and prediction model construction of spontaneous portosystemic shunts on the prognosis of patients with hepatitis B virus-related decompensated cirrhosis

JIAO Yubing, LEI Xiaojuan, GUO Wuhua

2026, 54 (6): 612-617. doi: 10.11958/20253576

Abstract ( 82 )

HTML ( 2 )

PDF (1189KB) ( 79 )

Objective To analyze the impact of spontaneous portosystemic shunts (SPSS) on the prognosis of patients with hepatitis B virus-related decompensated cirrhosis (HBV-DC), and to develop and validate a prognostic nomogram model based on the total cross-sectional SPSS area (TSA). Methods A total of 641 patients with HBV-DC were divided into three groups according to TSA measured by abdominal computed tomography: the non-SPSS group (n=169), the small-SPSS group (TSA<83 mm², n=343) and the large-SPSS group (TSA≥83 mm², n=129). General data, cirrhosis-related complications and prognosis were compared between the three groups. The Cox proportional hazards model was applied to identify independent risk factors for death in patients with HBV-DC, and a prognostic nomogram model was constructed and validated. The predictive performance of this model was compared with that of traditional prognostic models by calculating the area under the receiver operating characteristic curve (AUC). Results Compared with the non-SPSS group, there were lower levels of hemoglobin (Hb) and platelet counts (PLT), higher levels of international normalized ratio (INR), serum creatinine, higher incidence of portal vein thrombosis and esophagogastric variceal bleeding (EGVB) in the small-SPSS group and the large-SPSS group (P<0.05). Compared with the small-SPSS group, there were lower levels of PLT and incidence of moderate-to-massive ascites, and higher levels of INR and model for end-stage liver disease (MELD) score, higher incidence of portal vein thrombosis and hepatic encephalopathy in the large-SPSS group (P<0.05). The cumulative overall survival rates decreased gradually in the non-SPSS group, the small-SPSS group and the large-SPSS groups (P<0.05). Multivariate Cox regression analysis showed that advanced age, decreased hemoglobin, increased total bilirubin (TBil), INR and TSA, presence of massive ascites and hepatic encephalopathy were independent risk factors for death in patients (P<0.05). The nomogram model constructed based on aforementioned factors had a C-index of 0.711 (95%CI：0.639-0.783). The calibration curve showed that the model had a relatively high degree of calibration, and decision curve analysis indicated that the model had a clear positive net benefit. ROC curve analysis at 6, 12 and 24 months showed that the predictive value of the nomogram model was significantly superior to the Child-Turcotte-Pugh (CTP) score, MELD score and albumin-bilirubin (ALBI) score (P<0.05). Conclusion Increased TSA is an independent risk factor for death in patients with HBV-DC, and the established predictive model has a high value in evaluating the prognosis of patients.

Figures and Tables | References | Related Articles | Metrics

Predictive value of total load of cerebral small vessel disease combined with serum 8-OHDG and Ficolin-3 for prognosis in elderly patients with branch atheromatous disease

CAO Yang, DUAN Pengcang, LI Mengyu, SHI Fangkun, HU Chen, XING Fangyuan, LI Hualian

2026, 54 (6): 618-622. doi: 10.11958/20252920

Abstract ( 78 )

HTML ( 5 )

PDF (808KB) ( 76 )

Objective To investigate the predictive value of total cerebral small vessel disease (CSVD) burden combined with serum 8-hydroxydeoxyguanosine (8-OHDG) and Ficolin-3 for the prognosis of elderly patients with branch atheromatous disease (BAD). Methods A retrospective selection of 85 BAD patients treated at our hospital from April 2022 to October 2024 was conducted. Patients were divided into the good prognosis group (n=52) and the poor prognosis group (n=33) using the modified Rankin scale (mRS). Spearman's method was used to analyze the correlation between NIHSS scores and the total CSVD burden, as well as serum 8-OHDG and Ficolin-3 levels in BAD patients. Receiver operating characteristic (ROC) analysis was used to evaluate the predictive performance of the total CSVD burden combined with serum 8-OHDG and Ficolin-3 levels for poor prognosis in BAD patients. Logistic regression was used to analyze the factors associated with poor prognosis in BAD patients. Results The proportion of patients with a total CSVD burden score of 3- 4 was higher in the poor prognosis group than that in the good prognosis group. Compared with the good prognosis group, there were higher NIHSS scores and 8-OHDG levels, and lower Ficolin-3 level in the poor prognosis group (P<0.05). In BAD patients, NIHSS scores at admission were positively correlated with total CSVD burden and 8-OHDG levels, and negatively correlated with Ficolin-3 levels (P<0.05). The areas under the curve (AUC) for total CSVD burden, serum 8-OHDG, Ficolin-3 levels, and the combination of these three in predicting poor prognosis in BAD patients were 0.793（95%CI: 0.694-0.892), 0.713（95%CI: 0.602-0.823), 0.735（95%CI: 0.626-0.844) and 0.875（95%CI: 0.798-0.951), respectively, with the combined prediction showing higher accuracy than individual indicators (Z_{CSVD total burden-combined prediction} = 2.231, Z_{8-OHDG-combined prediction} = 2.627, Z_{Ficolin-3-combined prediction} = 2.304, all P<0.05). A total CSVD burden of 3-4 points, higher serum levels of 8-OHDG and low levels of Ficolin-3 were risk factors for poor prognosis in BAD patients 90 days after admission (P<0.05). Conclusion The combined assessment of total CSVD burden with serum 8-OHDG and Ficolin-3 levels can effectively evaluate the prognosis of BAD patients.

Figures and Tables | References | Related Articles | Metrics

The relationship between serum TM4SF1, KLF5 and SOX3 levels with prognosis in patients with esophageal cancer

ZHANG Fuyun, JIANG Longchao, YANG Xueyan

2026, 54 (6): 623-626. doi: 10.11958/20253552

Abstract ( 63 )

HTML ( 2 )

PDF (819KB) ( 70 )

Objective To investigate the relationship between serum levels of transmembrane 4 L six family member 1 (TM4SF1), Kruppel-like factor 5 (KLF5), SRY-box transcription factor 3 (SOX3) and prognosis in patients with esophageal cancer (EC). Methods A total of 120 patients with EC were enrolled as the observation group, and they were divided into the early group (73 cases) and the middle group (47 cases) according to the degree of disease. Patients were also divided into the good prognosis group (77 cases) and the poor prognosis group (43 cases) according to the prognosis of 1 year after operation. Another 120 healthy subjects who underwent physical examination in the same period were selected as the control group. Serum levels of TM4SF1, KLF5 and SOX3 were detected by ELISA. The prognostic factors and the evaluation value of receiver operating characteristic (ROC) curve were analyzed. Results Serum levels of the three indicators were significantly higher in the observation group than those in the control group (P<0.05). The levels in the middle-stage group were higher than those in the early-stage group (P<0.05). The proportion of lymph node metastasis and serum levels of the three indicators were significantly higher in the poor prognosis group than those in the favorable prognosis group (all P<0.05). The three indicators and lymph node metastasis were independent prognostic factors for EC (P<0.05). The AUC of the combined detection of the three indicators for predicting the prognosis of EC was 0.963 (95%CI：0.912-0.989), which was superior to that of single detection (Z _{combination-TM4SF1}=3.229, Z_{combination-KLF5}=3.122, Z _{combination-SOX3}=2.696, all P<0.01). Conclusion Serum levels of TM4SF1, KLF5 and SOX3 are elevated in EC patients, which are associated with poor prognosis. Combined detection of the three indicators can improve the efficacy of prognostic evaluation in EC patients.

Figures and Tables | References | Related Articles | Metrics

The differences in bone mineral density and proximal femoral geometry between middle-aged and young adult patients with different types of hip fractures

ZHAO Likun, CUI Shuangshuang, YU Jingbo, SUN Xiaolei, ZHANG Wenhai, MA Xinlong

2026, 54 (6): 627-631. doi: 10.11958/20260225

Abstract ( 76 )

HTML ( 2 )

PDF (784KB) ( 78 )

Objective To compare the differences of bone mineral density (BMD) and proximal femoral geometry between the different types of hip fractures. Methods A total of 132 patients with hip fractures aged 18 to 50 years were selected and divided into the intertrochanteric fracture (ITF) group (n=55) and the femoral neck fracture (FNF) group (n=77) according to different fracture sites. Age and gender were matched in the two groups using propensity score matching (PSM). The basic patient information, BMD and proximal femoral geometry were compared between the two groups. Results There was no significant difference in patient age between the two groups of patients before PSM (P>0.05). Both groups were dominated by male patients, but the proportion of males was higher in the ITF group (P<0.01). Low-energy trauma was the predominant injury mechanism in both groups of patients, and the proportion of low-energy injury was higher in the FNF group (P<0.05). There were no significant differences in BMD of the cervical area, Wards triangle area, greater trochanter area and total hip area between the two groups, and no significant in incidence of overall low bone mass between the two groups (P>0.05). There were no significant differences in hip axial length (HAL), neck-shaft angle (NSA) and buckling ratio (BR) between the two groups. However, the cross-sectional area (CSA), cross-sectional moment of inertia (CSMI) and section modulus (SM) of the ITF group were greater than those of the FNF group (P<0.05). Conclusion In young and middle-aged hip fracture patients, there is no significant difference in BMD between ITF patients and FNF patients. However, the bones of ITF patients have stronger compressive and bending resistance.

Figures and Tables | References | Related Articles | Metrics

Comparison of GMA-Tulip laryngeal mask and tracheal intubation in robotic-assisted laparoscopic proctectomy

HU Xiaotong, WANG Lei, YANG Tao

2026, 54 (6): 632-636. doi: 10.11958/20253402

Abstract ( 67 )

HTML ( 2 )

PDF (791KB) ( 74 )

Objective To compare the differences in airway management between GMA-Tulip laryngeal mask and tracheal intubation in robot-assisted laparoscopic rectal resection surgery. Methods Data were collected from 60 patients who underwent robot-assisted laparoscopic rectal resection under general anesthesia in Tianjin Union Medical Center, and patients were randomly divided into the GMA-Tulip laryngeal mask group and the endotracheal intubation group using a random number table, with 30 cases in each group. The peak airway pressure (Ppeak) in the trendelenburg position and oropharyngeal leak pressure (OLP) were observed in the GMA-Tulip laryngeal mask group. The number and duration of insertion, heart rate (HR) and mean arterial pressure (MAP) before insertion (T1), immediately after insertion (T2), before extubation and removal of the laryngeal mask (T3), immediately after extubation (T4), the arterial partial pressure of oxygen [p（O₂）]after entering the operating room (T0), at the 1st and 2nd hours, the occurrence of restlessness, choking, sore throat and hoarseness during the anesthetic emergence and the occurrence of postoperative pulmonary complications (PPCs) whinin 7 days were compared between the two groups. Results The Ppeak of the trendelenburg position was lower than that of the OLP in the GMA-Tulip laryngeal mask group. The insertion time of the GMA-Tulip laryngeal mask group was shorter than that of intubation group. There was no statistically significant difference in the number of insertion between the two groups (P > 0.05). The HR and MAP at T2 and T4 were respectively higher than those at T1 and T3 within the same group (P < 0.05), and there were no statistically significant differences in HR and MAP at T1 and T3 between the two groups (P > 0.05). The HR and MAP of T2 and T4 were lower in the GMA-Tulip laryngeal mask group than those of the tracheal intubation group (P < 0.05). There was no statistically significant difference in p（O₂）at T0, 1st and 2nd hours intraoperatively between the two groups (P > 0.05). There were no statistically significant differences in the incidence of sore throat and hoarseness during the anesthetic emergence, as well as the incidence of PPCs within 7 days between the two groups (P > 0.05). The total incidence of complications during emergence and the total incidence of PPCs within 7 days were lower in the GMA-Tulip laryngeal mask group than those in the endotracheal intubation group (P < 0.05). Conclusion The application of the GMA-Tulip laryngeal mask for airway management during robot-assisted laparoscopic rectal resection under general anesthesia offers advantages over endotracheal intubation in maintaining hemodynamic stability and reducing postoperative complications.

Figures and Tables | References | Related Articles | Metrics

Development of a preoperative assessment model for the malignant potential in gastrointestinal stromal tumor based on endoscopic ultrasound and contrast-enhanced computed tomography

KANG Xiaona, LIU Yaping, FENG Yun, LUO Yumei, JIA Ai

2026, 54 (6): 637-642. doi: 10.11958/20253436

Abstract ( 76 )

HTML ( 2 )

PDF (828KB) ( 77 )

Objective To explore the preoperative evaluation value of endoscopic ultrasonography (EUS) and enhanced CT for the malignant potential of gastrointestinal stromal tumor (GIST), and to construct a preoperative evaluation model of the malignant potential of GIST based on EUS and CT and verify the model efficacy. Methods Clinical, imaging and histopathological data were retrospectively collected from 191 consecutive patients with pathologically confirmed GIST. Preoperative EUS and CECT image features-including tumor size, boundary definition and enhancement pattern were systematically assessed. Patients were stratified according to the classfication system of the National Institutes of Health (NIH) of the United States. Those classified as "extremely low-risk" or "low-risk" (n = 145) constituted the low-malignant-potential group, those classified as "intermediate-risk" or "high-risk" (n = 46) formed the high-malignant-potential group. The clinical data, EUS and enhanced CT imaging features of the two groups were compared. Multivariable Logistic regression was employed to identify independent predictors of high malignant potential, and a predictive model was constructed based on statistically significant variables. Model performance was evaluated using receiver operating characteristic (ROC) curve analysis and calibration assessment. Results Compared with the low-malignant-potential group, the high-malignant-potential group exhibited significantly longer tumor diameters measured by EUS, a higher prevalence of ill-defined tumor margins on EUS and a greater frequency of irregular and heterogeneous enhancement patterns on CECT（P<0.05). Multivariable Logistic regression identified EUS tumor diameter， ill-defined EUS tumor boundaries and irregular/heterogeneous CECT enhancement as independent predictors of high malignant potential (P<0.05). The result of predictive model achieved an AUC of 0.880 (95%CI: 0.826-0.923), with sensitivity of 82.6% and specificity of 90.3%. Calibration analysis demonstrated excellent agreement between predicted and observed probabilities (Hosmer-Lemeshow χ²=0.396, P=0.508). Conclusion The preoperative assessment model based on EUS and enhanced CT has a high assessment efficacy for the high malignant potential of GIST patients.

Figures and Tables | References | Related Articles | Metrics

Ultrasound-guided infiltration anesthesia with the femoral sheath during endovascular aneurysm repair surgery

LYU Lu, ZHU Jiechang, WANG Zheng, BI Jiaxue

2026, 54 (6): 643-646. doi: 10.11958/20260228

Abstract ( 70 )

HTML ( 1 )

PDF (830KB) ( 73 )

Objective To compare the analgesic efficacy and safety of the ultrasound-guided infiltration anesthesia with the femoral sheath (IAFS) and local infiltration anesthesia (LIA) for femoral arterial access gain during endovascular aneurysm repair (EVAR) surgery. Methods A total of 256 patients who underwent EVAR via common femoral artery (CFA) under local anesthesia from January 2017 to December 2020 were retrospectively analyzed and divided into the IAFS group and the LIA group. The LIA group included 232 CFA punctures and sheath placement in 116 patients, and the IAFS group included 276 CFA punctures and sheath placement in 140 patients. The analgesic effect of IAFS and LIA in EVAR was analyzed. The technical success rate, anesthesia duration, volume of anesthetics, pain visual-analogue scale (VAS score 0-10) during operation and conversion to general anesthesia were compared between the two groups. Results There were no significant differences in technical success (100.0% vs. 99.3%) and the anesthesia time [(17.88±1.49) s vs. (18.14±1.82) s] between the LIA group and the IAFS group (P>0.05). The volume of anesthetic solution used in the IAFS group was significantly less compared to the LIA group [(17.71±1.16) mL vs. (22.72±2.38) mL, P<0.01]. The pain scores during the advancement of the delivery system or a larger profile sheath were significantly lower in the IAFS group compared to the LIA group (1.23±0.90 vs. 2.38±1.30, P<0.01). There was no significant difference in conversion to general anesthesia between the two groups (6.9% vs. 2.9%, P>0.05). Conclusion Both LIA and IAFS are safe during EVAR, but IAFS can significantly reduce patients' pain more than LIA.

Figures and Tables | References | Related Articles | Metrics

Clinical efficacy of DEX-I combined with ranibizumab for macular edema secondary to retinal vascular diseases

XU Zhengjie, LI Tian, CHANG Libin

2026, 54 (6): 647-652. doi: 10.11958/20260079

Abstract ( 80 )

HTML ( 2 )

PDF (793KB) ( 160 )

Objective To explore the clinical efficacy of dexamethasone intravitreal implant (DEX-I) combined with ranibizumab in the treatment of macular edema (ME) secondary to retinal vascular diseases. Methods The data of 116 patients with ME secondary to diabetic retinopathy (DR) or retinal vein occlusion (RVO) were retrospectively analyzed. Based on different treatment methods, patients were assigned to the DEX-I group (n=39, 0.7 mg of DEX-I was injected into the vitreous cavity, with subsequent dosing as needed after a single treatment), the ranibizumab group (n=37, 0.05 mL of ranibizumab was injected into the vitreous cavity, once a month for 3 consecutive months, followed by dosing as needed), and the combined group (n=40, 0.05 mL of ranibizumab was injected into the vitreous cavity, followed by 0.7 mg of DEX-I injected into the vitreous cavity 1 week later, with subsequent dosing as needed after a single treatment). The central macular thickness (CMT), best corrected visual acuity (BCVA), intraocular pressure (IOP), and the levels of miR-146a, miR-377-3p and vascular endothelial growth factor (VEGF) in aqueous humor were compared between the three groups. Adverse events and the number of injections were recorded. Results After 1, 2, 3 and 6 months of treatment, CMT was lower in the combined group than that in the DEX-I group and the ranibizumab groups (P<0.05)，and CMT of the DEX-I group was smaller than that of the ranibizumab group after 1 and 2 months of treatment (P<0.05). After 1, 2, 3 and 6 months of treatment, the BCVA was lower in the combined group than that of the DEX-I group and the ranibizumab group (P<0.05), and there was no significant difference in IOP between the three groups (P>0.05). After 6 months of treatment, the combined group exhibited higher levels of miR-146a and miR-377-3p and lower VEGF level in aqueous humor compared to those of the DEX-I group and the ranibizumab group (P<0.05). There was no significant difference in incidence of adverse events between the three groups (P>0.05). The number of injections was higher in the combined group and the ranibizumab group than that in the DEX-I group (P<0.05). Conclusion DEX-I combined with ranibizumab can reduce CMT in patients with ME secondary to retinal vascular diseases, improve visual acuity and levels of miR-146a and miR-377-3p in the aqueous humor, inhibit VEGF levels, and the safety is controllable.

Figures and Tables | References | Related Articles | Metrics

Epidemiological survey on the diagnosis and treatment status of cough patients in Tianjin

LIU Li, HU Xiaotian, QIAN Xuejiao, JIANG Ping

2026, 54 (6): 653-657. doi: 10.11958/20252735

Abstract ( 79 )

HTML ( 3 )

PDF (784KB) ( 98 )

Objective To investigate the prevalence of cough patients in the Tianjin region and to evaluate the etiological composition and current status of diagnosis and treatment for acute, subacute and chronic cough. Methods This observational study employed a cross-sectional design with short-term follow-up. Using stratified cluster sampling, patients were recruited from the respiratory outpatient departments of nine tertiary hospitals in Tianjin between November 1, 2022, and October 31, 2023. Eligible participants included those with cough as the sole or primary symptom, no severe comorbidities, and residence in Tianjin for at least one year. A unified epidemiological questionnaire was administered, covering general information, cough characteristics, diagnostic details and empirical treatment plans. Follow-up was conducted one month (±7 days) after treatment to assess therapeutic outcomes. Results A total of 2 247 patients were enrolled, including 998 males and 1 249 females, with a mean age of (46.05 ± 15.44) years. Among them, 1 051 cases (46.77%) were classified as chronic cough, 589 (26.21%) as subacute cough and 607 (27.01%) as acute cough. The main causes of chronic cough were corticosteroid-responsive cough (CRC, 58.61%), upper airway cough syndrome (UACS, 32.83%) and gastroesophageal reflux-related cough (GERC, 5.33%), collectively accounting for 96.77%. Acute cough was primarily attributed to acute tracheobronchitis (46.46%) and the common cold (43.99%), together representing 90.45%. The predominant cause of subacute cough was post-infectious cough (PIC, 66.72%). Symptomatic antitussive therapy was the mainly used for acute and subacute cough. For chronic cough, CRC patients primarily received corticosteroid therapy (inhaled or oral), while non-CRC patients received etiology-targeted treatment. Follow-up one-month after treatment, there were no significant differences in the overall treatment effectiveness rate between the three groups (98.66% vs. 98.58% vs. 98.46%, P>0.05). Conclusion This study preliminarily reveals the epidemiological characteristics and etiological distribution of cough patients in the Tianjin region. The findings validate the feasibility of empirical treatment in cough management and provide a reference for optimizing local diagnostic and therapeutic strategies.

Figures and Tables | References | Related Articles | Metrics

Ankylosing spondylitis complicated with chronic myeloid leukemia: a case report

JU Danna, ZHU Yongcun, LI Yi, XIA Wen, WANG Xiaoyi, WEI Wei

2026, 54 (6): 658-662. doi: 10.11958/20253670

Abstract ( 96 )

HTML ( 5 )

PDF (1184KB) ( 101 )

The co-occurrence of ankylosing spondylitis (AS) with hematological malignancies is relatively rare. This article presents a case of AS complicated by chronic myeloid leukemia (CML). The patient responded effectively to the treatment with nilotinib combined with non?steroidal anti?inflammatory drugs. By reviewing clinical data and conducting a literature review, we aim to enhance clinicians’ awareness of AS with concurrent CML, provide reference for the diagnosis and treatment of similar cases, and avoid misdiagnosis and missed diagnosis.

Figures and Tables | References | Related Articles | Metrics

Research progress on the risk management of frailty-oriented pneumonia after neurointervention in the elderly

SHANG Gechu, WANG Guan

2026, 54 (6): 663-667. doi: 10.11958/20253188

Abstract ( 95 )

HTML ( 7 )

PDF (768KB) ( 88 )

The management of pneumonia risk in elderly patients after neurointerventional treatment has become the focus of clinical attention. Frailty, as a clinical syndrome characterized by the exhaustion of multi-system physiological reserves, is an independent predictor of adverse events after surgery. This article systematically reviews the key role of frailty and the clinical response strategies in the management of pneumonia risk after neurointerventional surgery in the elderly, analyzes the multi-dimensional concept of frailty, and reviews the application characteristics and selection logic of different frailty assessment scales in the neurointerventional setting. On this basis, a multidisciplinary collaborative care pathway, risk prevention and control system oriented by frailty assessment are constructed. Through the systematic integration of frailty management concepts, it provides theoretical basis and practical framework for improving the perioperative safety of elderly patients undergoing neurointerventional treatment.

Figures and Tables | References | Related Articles | Metrics

Advances in the application of artificial intelligence-assisted colonoscopy for the diagnosis of early colorectal cancer and precancerous lesions

HUANG Xiuqiang, LIU Qian, LIU Lurong, LI Muran, LIU Yandi

2026, 54 (6): 668-672. doi: 10.11958/20253275

Abstract ( 84 )

HTML ( 3 )

PDF (770KB) ( 105 )

Colonoscopy is the gold standard for the detecton and diagnosis of early colorectal cancer and precancerous lesions. However, its efficacy is affected by the characteristics of lesions and operator’s experience, and there is a certain rate of missed diagnoses. The rapid development of artificial intelligence (AI) technology has provided a new solution for improving objectivity, accuracy and uniformity of colonoscopy diagnosis. This article systematically reviews the application progress of AI in colonoscopy, focusing on the latest research achievements and clinical value in real-time detection and classification of colorectal polyps, identification of adenomas and serrated lesions, prediction of early cancer invasion depth, and quality control of the entire operation process. The aim is to provide a reference for the deep research and clinical standardized application of AI-assisted colonoscopy technology.

References | Related Articles | Metrics

Table of Content