Table of Content

15 August 2026, Volume 54 Issue 8 Previous Issue   
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Cell and Molecular Biology
Experimental Research
Clinical Research
Drug Clinical Evaluations
Multidisciplinary Diagnosis and Treatment
Review


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Cell and Molecular Biology

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The mechanism of miR-451 on regulating differentiation of 3T3-L1 preadipocytes through AMPK signaling pathway CAO Can, XIE Kun, ZENG Weili 2026, 54 (8):  785-789.  doi: 10.11958/20253387 Abstract ( 74 )   HTML ( 8 )   PDF (1227KB) ( 58 )   Objective To investigate the role and mechanism of miR-451 in regulating the differentiation of 3T3-L1 preadipocytes through the adenosine monophosphate-activated protein kinase (AMPK) signaling pathway. Methods 3T3-L1 cells were randomly divided into the control group, the NC group, the miR-451 mimics group and the miR-451 inhibitor group. The expression of miR-451 was detected by quantitative real-time polymerase chain reaction (qRT-PCR). Lipid droplet formation was observed by Oil Red O staining. The targeting relationship between miR-451 and calcium-binding protein 39 (CAB39) was verified by dual-luciferase reporter gene assay. The protein expressions of AMPK and mammalian target of rapamycin (mTOR) were detected by Western blot assay. 3T3-L1 cells with AMPK knockdown were constructed and divided into the NC-N.A group, the miR-451 mimics-N.A group and the miR-451 inhibitor-N.A group. Triglyceride (TG) levels were measured. Results After 7 days of induced differentiation of 3T3-L1 cells into mature adipocytes, the expression of miR-451 was significantly increased (P<0.05). Compared with the control group volume and the NC group, the miR-451 mimics group showed significantly increased miR-451 expression, larger lipid droplets volume and deeper Oil Red O staining (P<0.05). In contrast, the miR-451 inhibitor group exhibited the opposite changes (P<0.05). The dual-luciferase reporter assay confirmed that CAB39 was a direct target gene of miR-451. Western blot results showed that, compared with the control group and the NC group, p-AMPK expression decreased, and p-mTOR expression increased in the miR-451 mimics group (P<0.05), while p-AMPK expression increased and p-mTOR expression decreased in the miR-451 inhibitor group (P<0.05). In AMPK-knockdown 3T3-L1 cells, neither overexpression nor inhibition of miR-451 affected TG production. Conclusion miR-451 can promote the differentiation of 3T3-L1 preadipocytes, and this process is associated with the inhibition of the AMPK signaling pathway by miR-451. Figures and Tables | References | Related Articles | Metrics

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The effects of daphnetin regulating the Src/FAK pathway on the proliferation, migration and epithelial-mesenchymal transition of nasopharyngeal carcinoma cells MA Yuexiang, FENG Zhanwang, WANG Qianyu, PENG Jinwen, WANG Wenying, ZHU Zhenhua, BIN Ji 2026, 54 (8):  790-795.  doi: 10.11958/20260416 Abstract ( 55 )   HTML ( 2 )   PDF (1198KB) ( 56 )   Objective To investigate the effects of daphnetin regulating the steroid receptor coactivator (Src)/focal adhesion kinase (FAK) pathway on the proliferation, migration and epithelial-mesenchymal transition of nasopharyngeal carcinoma cells. Methods Human nasopharyngeal carcinoma cells 5-8F were assigned into the control group, the L-daphnetin (4 mg/L) group, the M-daphnetin (8 mg/L) group, the H-daphnetin (12 mg/L) group and the H-daphnetin+activator (3 μmol/L Src-family activator) group. Cell proliferation was detected by cell counting kit 8 (CCK-8) and colony formation assay. Apoptosis was detected by flow cytometry. The cell migration ability was detected using the scratch healing test. Western blot assay was used to detect the expressions of epithelial-mesenchymal transition-related proteins (E-cadherin, N-cadherin, vimentin), Src and FAK proteins. Results Compared with the control group, the OD450 values of 5-8F cells in the L-daphnetin group, the M-daphnetin group and the H-daphnetin group were lower, the number of colony formation was less, the apoptosis rate was higher, the scratch healing rate was lower, the expression of E-cadherin protein was higher, the expressions of N-cadherin and vimentin proteins were lower, and the protein expressions of p-Src and p-FAK were lower (P<0.05), and there were obvious differences between different concentrations (P<0.05). Compared with the H-daphnetin group, the OD450 value of 5-8F cells in the H-daphnetin+activator group was higher, the number of colony formation was more, the apoptosis rate was lower, the scratch healing rate was higher, the expression of E-cadherin protein was lower, the expressions of N-cadherin and vimentin proteins were higher, and the protein expressions of p-Src and p-FAK were higher (P<0.05). Conclusion Daphnetin can inhibit the proliferation, migration and epithelial-mesenchymal transition of nasopharyngeal carcinoma cells by suppressing the Src/FAK pathway. Figures and Tables | References | Related Articles | Metrics

Experimental Research

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Wentong Huoxue Cream alleviating diabetic peripheral neuropathy by inhibiting the mTOR/4E-BP1 pathway AMANGULI Sulitang, TIE Ling, MA Jing, MA Li 2026, 54 (8):  796-801.  doi: 10.11958/20253618 Abstract ( 63 )   HTML ( 3 )   PDF (1469KB) ( 56 )   Objective To investigate whether the Wentong Huoxue Cream affected Schwann cells (SC) by regulating the mammalian target of rapamycin (mTOR)/eukaryotic translation initiation factor 4E binding protein 1 (4E-BP1) signaling pathway, thereby alleviating sciatic nerve injury in diabetic peripheral neuropathy (DPN) model rats. Methods Sixty 8-week-old male SD rats were randomly divided into the normal group (10 rats) and the model group (50 rats). The model group was established by intraperitoneal injection of streptozotocin (STZ) combined with high-sugar and high-fat diet. The rats in the model group were randomly divided into 5 groups: the model group, the high-dose Wentong Huoxue Cream group, the low-dose Wentong Huoxue Cream group, the matrix group (blank cream) and the metformin group (positive control). After 4 weeks of continuous intervention, the latency of hot tail flicking of rats was detected. The pathological morphology of the sciatic nerve was observed by HE staining. The ultrastructure of myelin sheath and autophagosomes of Schwann cells were observed by transmission electron microscopy. The protein expression levels of mTOR, phosphorylated mTOR (p-mTOR), 4E-BP1, phosphorylated 4E-BP1 (p-4E-BP1) and microtubule-associated protein 1 light chain 3 (LC3-Ⅱ) in sciatic nerve were detected by Western blot assay. The mRNA expressions of mTOR, 4E-BP1 and LC3-Ⅱwere detected by real-time fluorescence quantitative PCR. Results Compared with the model group, the latency of tail flicking was significantly shortened in the Wentong Huoxue Cream groups (P<0.05), the nerve pathological damage and ultrastructural destruction were significantly alleviated and the number of autophagosomes in Schwann cells decreased. Western blot assay and PCR results showed that the protein or mRNA expression levels of p-mTOR, mTOR, p-4E-BP1, 4E-BP1 and LC3-Ⅱwere lower in the Wentong Huoxue Cream groups than those in the model group (P<0.05), and the improvement effect was more significant in the high-dose Wentong Huoxue Cream group than that of the low-dose Wentong Huoxue Cream group. Conclusion Wentong Huoxue Cream can significantly improve neuropathic hyperalgesia and myelin pathological damage in DPN rats. The mechanism may be related to the inhibition of excessive activation of the mTOR/4E-BP1 signaling pathway and the down-regulation of autophagy-related protein LC3-Ⅱ level. Figures and Tables | References | Related Articles | Metrics

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Effect of hydrogen-rich normal saline on wound repair in rats with stage 3 pressure injury LIU Bingyan, HUANG Dongxue, ZHANG Yue, LIU Haiying, XIE Keliang, ZHUANG Shumei, SHEN Yuehao 2026, 54 (8):  802-807.  doi: 10.11958/20260964 Abstract ( 63 )   HTML ( 1 )   PDF (3113KB) ( 53 )   Objective To observe the effect of topical application of hydrogen-rich normal saline on wound repair in rats with stage 3 pressure injury. Methods Thirty-six SPF-grade male SD rats were selected to establish a stage 3 pressure injury model (among which 4 rats were used to evaluate successful modeling). Rats were then randomly divided into the control group and the intervention group, with 16 rats in each group. The control group received debridement with normal saline, while the intervention group received debridement with hydrogen-rich normal saline (with hydrogen content ≥ 2 mg/L), both twice daily. Wound healing rate was observed on the 0th, 3th, 7th, 10 and 14 days of intervention. On the day 3, serum levels of tumor necrosis factor-α (TNF-α)，interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) were measured. On days 7 and 14, wound tissue samples were collected for HE staining. Masson staining and Ki-67 immunohistochemistry were used to evaluate tissue pathology, collagen deposition and cell proliferation. Results Compared with the control group, the wound healing rate was significantly higher on days 3, 7, 10 and 14 in the intervention group (P<0.05). On days 3 of intervention, serum levels of TNF-α and IL-6 were decreased, while VEGF level was increased (P<0.05) in the intervention group. HE and Masson staining showed the wound healing quality was better in the intervention group, and the collagen volume fraction was higher on days 7 and 14 than those in the control group (P<0.05). Immunohistochemistry showed that the percentage of Ki-67 positive cells on days 7 was significantly increased in the intervention group than that of the control group (P<0.05). Conclusion Topical application of hydrogen-rich normal saline can promote wound healing in stage 3 pressure injury, and the mechanism may be associated with alleviating oxidative stress and inflammatory responses, as well as promoting collagen synthesis and cell proliferation. Figures and Tables | References | Related Articles | Metrics

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Effects of ziyuglycoside I on inflammatory injury in lung tissue of juvenile mice with mycoplasma pneumoniae via regulating the RhoA/ROCK signaling pathway LIANG Dongge, CAO Huan, ZHANG Ting, HE Qianqian, HUANG Han, TONG Ruifang 2026, 54 (8):  808-814.  doi: 10.11958/20260535 Abstract ( 49 )   HTML ( 1 )   PDF (1283KB) ( 57 )   Objective To investigate the effects of ziyuglycoside Ⅰ on inflammatory injury in lung tissue of juvenile mice with mycoplasma pneumoniae (MP) through regulation of the Ras homolog gene family member A (RhoA)/Rho-associated coiled-coil forming protein kinase (ROCK) pathway. Methods Seventy-two mice were randomly divided into the control group, the MP group, the low-dose ziyuglycoside Ⅰ group, the high-dose ziyuglycoside Ⅰgroup, the azithromycin group and the high-dose ziyuglycoside Ⅰ+ RhoA activator (lysophosphatidic acid) group, with 12 mice in each group. Except for the control group, all other groups were modeled by daily intranasal instillation of MP suspension for three consecutive days. After successful modeling, drug treatments were administered once daily for 7 days. Cough latency, cough frequency, partial pressure of carbon dioxide, arterial partial pressure of oxygen and lung index were detected. Pathology of lung tissue was assessed by HE staining. Levels of C-X-C motif chemokine ligand 1 (CXCL1), interleukin (IL)-1β, tumor necrosis factor-α (TNF-α) and IL-10 in lung tissue were measured by ELISA. Apoptosis in lung tissue was detected by TUNEL staining. Protein expression levels of cleaved caspase-3, P53, RhoA, ROCK1 and ROCK2 were determined by Western blot assay. Results Compared with the control group, the alveolar septa in lung tissue of the MP group were significantly widened, a large number of inflammatory cells were diffuse infiltration, the cough latency was shortened, cough frequency was increased, partial pressure of carbon dioxide was increased, and lung index, CXCL1, IL-1β, TNF-α, apoptosis rate, and protein expression of cleaved caspase-3, P53, RhoA, ROCK1 and ROCK2 were increased, while arterial partial pressure of oxygen and IL-10 levels in lung tissue were decreased (P<0.05). Compared with the MP group, the changing trends of the above indicators were opposite in the low-dose ziyuglycoside Ⅰ group, the high-dose ziyuglycoside Ⅰgroup and the azithromycin group. Moreover, the changes of each indicator were more significant in the high-dose ziyuglycoside Ⅰ group than those in the low-dose ziyuglycoside Ⅰgroup (P <0.05). There was no significant difference between the high-dose ziyuglycoside Ⅰ group and the azithromycin group (P > 0.05). Lysophosphatidic acid reversed the ameliorative effect of high-dose ziyuglycoside Ⅰon pulmonary inflammatory injury in MP-infected juvenile mice. Conclusion Ziyuglycoside I can effectively ameliorate inflammatory lung injury in MP of juvenile mice, and its mechanism may be related to the inhibition of RhoA/ROCK pathway activation. Figures and Tables | References | Related Articles | Metrics

Clinical Research

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The predictive value of sublingual microcirculation combined with ROX-HR index for the prognosis of patients with septic shock LI Rong, CHEN Yan 2026, 54 (8):  815-820.  doi: 10.11958/20253353 Abstract ( 72 )   HTML ( 1 )   PDF (857KB) ( 68 )   Objective To investigate the predictive value of combining dynamic monitoring of the change rate of sublingual microcirculation perfusion vessel proportion (ΔPPV) and the respiratory rate-oxygenation-heart rate (ROX-HR) index for 28-day prognosis in patients with septic shock during early fluid resuscitation. Methods A retrospective analysis was conducted on clinical data from 150 patients with septic shock who received early fluid resuscitation in our hospital from August 2020 to September 2024. According to the 28-day outcome after treatment, patients were divided into the survival group (n=103) and the death group (n=47). Baseline data, ΔPPV at 6 h, 24 h and 72 h, and the lowest ROX-HR index within 2 h after admission were compared between the two groups. Logistic regression model was used to identify the independent predictive factors influencing 28-day mortality of sepsis. The receiver operating characteristic (ROC) curves were used to evaluate the predictive value of ΔPPV and the ROX-HR index for the 28-day prognosis of patients with sepsis. Results Acute physiology and chronic health (APACHE) Ⅱ score, sequential organ failure assessment (SOFA) score, lactate, IL-6 and IL-10 were significantly higher in the death group than those in the survival group (P<0.05), whereas Glasgow coma scale (GCS), ROX-HR index, 6 hΔPPV, 24 hΔPPV and 72 hΔPPV were significantly lower (P<0.05). The maximum dose of norepinephrine in the first 72 h was higher, the duration of usage time was longer and the proportion of fungal infection was also higher in the death group than those in the survival group (P<0.05). Multivariate Logistic regression analysis showed that increased SOFA score and lactate, decreased ROX-HR index and ΔPPV at 72 h were risk factors for poor prognosis in patients with septic shock after 28 days of treatment (P<0.05). Area under the curves (AUCs) of SOFA score, lactate, ROX-HR index and 72 hΔPPV for predicting prognosis were 0.806 (95%CI: 0.734-0.866), 0.757 (95%CI: 0.681-0.823), 0.885 (95%CI: 0.823-0.932) and 0.890 (95%CI: 0.828-0.935), with sensitivities of 97.87%, 87.23%, 95.74% and 85.11%, and specificities of 59.22%, 55.34%, 76.70% and 80.58%, respectively. The combined model (SOFA score+lactate+ROX-HR index+72 hΔPPV) achieved an AUC of 0.989 (95%CI: 0.956-0.999), with a sensitivity of 91.49% and a specificity of 98.06%. Conclusion Dynamic monitoring of ΔPPV, ROX-HR index combined with SOFA score and lactate shows superior predictive value for the early prognosis in septic shock. Figures and Tables | References | Related Articles | Metrics

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Predictive value of MRI-based paraspinal muscle parameters for postoperative recurrence in patients undergoing single-level percutaneous endoscopic lumbar discectomy ZHANG Weihao, FENG Jiangtao, ZHANG Kaihui, ZHANG Zepei 2026, 54 (8):  821-826.  doi: 10.11958/20253241 Abstract ( 61 )   HTML ( 2 )   PDF (1247KB) ( 52 )   Objective To investigate the independent impact of paraspinal muscle parameters on postoperative recurrence after percutaneous transforaminal endoscopic discectomy (PTED) in patients with lumbar disc herniation (LDH) and to evaluate their predictive value for postoperative recurrence. Methods A total of 186 patients with single-segment LDH who underwent PTED were selected. Patients were followed up for more than 6 months and were divided into the recurrence group (24 cases) and the non-recurrence group (162 cases) based on the follow-up results. Baseline data were collected in the two groups, and the standardized cross-sectional area (SCSA) and fat infiltration rate (FIR) of the multifidus and erector spinae muscles were measured and calculated. The fat infiltration grade was evaluated. Multivariate Logistic regression was used to analyze the influence of paraspinal muscle parameters on postoperative recurrence, and the predictive efficacy was evaluated by the receiver operating characteristic (ROC) curve. Results The body mass index (BMI), proportion of diabetes history, pain visual analogue scale (VAS) score, Oswestry disability index (ODI), proportion of Pfirrmann grade Ⅳ/Ⅴ, FIR of multifidus muscle, FIR of erector spinae muscle, proportion of patients with severe infiltration (Grade 2) of multifidus muscle and erector spinae muscle in the recurrence group were higher than those in the non-recurrence group, while the SCSA of the multifidus and erector spinae muscles were smaller (P<0.05). The difference in fat infiltration degree was statistically significant. The Firth bias-corrected Logistic regression analysis showed that decreased SCSA of the multifidus and erector spinae muscles, increased FIR were all risk factors for postoperative recurrence in LDH patients after PTED. ROC curve analysis indicated that the area under the ROC curve (AUC) of the combined prediction of paraspinal muscle parameters for postoperative recurrence was 0.898 (95%CI: 0.845-0.937), with a sensitivity of 83.3% and a specificity of 88.3%. Conclusion MRI-based measurements of paraspinal muscle parameters demonstrate good predictive value for postoperative recurrence and can serve as useful indicators for preoperative risk assessment, identification of high-risk patients, and guiding individualized intervention strategies. Figures and Tables | References | Related Articles | Metrics

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Latent profile analysis of postoperative pain and fear kinesiophobia on the quality of life in patients after lumbar spinal stenosis surgery LU Qing, ZHU Rusen, ZHANG Boyu, YU Hao, WEI Yue 2026, 54 (8):  827-833.  doi: 10.11958/20253285 Abstract ( 65 )   HTML ( 1 )   PDF (875KB) ( 59 )   Objective To explore the latent class characteristics of pain catastrophizing, kinesiophobia and quality of life (QOL) in patients after lumbar spinal stenosis (LSS) surgery, and to analyze the factors influencing class membership. Methods A convenience sampling method was used to recruit patients who underwent LSS surgery in the Department of Spinal Surgery, Tianjin Union Medical Center, from March 2023 to March 2024. Data were collected using a general information questionnaire, the Pain Catastrophizing Scale (PCS), the Tampa Scale for Kinesiophobia (TSK-17) and the 12-Item Short-Form Health Survey (SF-12). Latent profile analysis (LPA) was performed to identify heterogeneous subgroups. Univariate analysis and multinomial Logistic regression analysis were used to explore the factors influencing class membership. Results A total of 184 patients were included, consisting of 95 males (51.63%) and 89 females (48.37%). Three latent classes of psychobehavioral responses were identified: the high QOL class (96 cases, 52.17%), the high pain catastrophizing-high kinesiophobia class (30 cases, 16.30%) and the low QOL class (58 cases, 31.52%). Univariate analysis showed that there were significant differences in gender, age, educational level, marital status, living arrangement, monthly income and level of disease-related knowledge between patients with different potential categories (all P < 0.05). Multinomial Logistic regression analysis revealed that male gender, middle educational level (senior high school or technical secondary school), a higher level of disease-related knowledge and a monthly income of 5 001-8 000 yuan were independent protective factors for belonging to the high QOL class. Female gender was an independent risk factor for belonging to the high pain catastrophizing-high kinesiophobia class. Conclusion There is significant heterogeneity in pain catastrophizing, kinesiophobia and quality of life in patients after lumbar spinal stenosis surgery. These findings may inform precise assessment and stratified intervention in clinical practice to improve patient outcomes. Figures and Tables | References | Related Articles | Metrics

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Analysis of oral salivation microbiome characteristics in patients with depression complicated with periodontal disease ZHANG Guoshuang, PAIHEIERDING Kaisaier, WANG Conghui 2026, 54 (8):  834-841.  doi: 10.11958/20253429 Abstract ( 54 )   HTML ( 2 )   PDF (1790KB) ( 66 )   Objective To investigate the compositional characteristics and potential functional alterations of the oral microbiome in patients with periodontitis comorbid with depression. Methods A total of 32 patients with periodontitis and comorbid depression were selected as the depression-associated periodontal disease group, while 33 patients without depression but with periodontal disease were selected as the non-depression periodontal disease group. Unstimulated saliva samples were collected from participants and subjected to 16S rRNA sequencing on the Illumina NovaSeq 6000 platform. Alpha and beta diversity and differences in microbial abundance were analyzed. Indicator species analysis (ISA), linear discriminant analysis effect size (LEfSe) for differential taxa screening, and BugBase functional prediction were used to identify depression-associated characteristic genera and their phenotypic features. Results A total of 1 617 399 high-quality sequences and 3 451 non-redundant amplicon sequence variants (ASVs) were obtained from 32 samples in the depression-associated periodontal disease group. In the non-depression periodontal disease group, 33 samples obtained 1 568 119 high-quality sequences and 3 729 ASVs. The total number of ASVs in the two groups was 1 587. The alpha diversity indices of saliva microbiota in the depression-combined-with-periodontitis group, namely Shannon, Simpson, Chao1 and Faith's PD, were higher than those in the non-depression-periodontitis group (P<0.05). The beta diversity analysis revealed that there were significant differences in the community structure of oral bacteria between the two groups (P<0.05). ISA analysis identified three characteristic genera of the non-depressed periodontitis group: Atopobium, Prevotella_7 and Megamonas. LEfSe analysis indicated that genera enriched in the periodontitis-with-depression group included Neisseria, Haemophilus, Lautropia, Capnocytophaga and Actinobacillus. The genera enriched in the non-depressed periodontitis group mainly included Atopobium, Megamonas, Prevotella_7, Veillonella, Prevotella, Actinomyces, Gemella, and the Eubacterium nodatum group. BugBase predictions indicated that compared with the non-depression periodontitis group, the depression with periodontitis group had higher relative abundances in phenotypes such as aerobic bacteria, bacteria containing mobile genetic elements, biofilm formation, Gram-positive bacteria, potential pathogenicity and stress tolerance (P<0.05), while its relative abundance was lower in anaerobic bacteria and Gram-negative bacteria（P<0.05). Conclusion Depressive state may be related to the imbalance of oral microbiome in the occurrence and development of periodontitis patients with depression through a “psychological-microbial-inflammatory” pathway. Figures and Tables | References | Related Articles | Metrics

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The clinical value of right bundle branch block combined with serum high-mobility group box 1 for monitoring of cor pulmonale in patients with chronic obstructive pulmonary disease ZHANG Jing, GUI Xiaoling, LI Jinpeng, CHEN Xin 2026, 54 (8):  842-847.  doi: 10.11958/20253397 Abstract ( 53 )   HTML ( 1 )   PDF (1004KB) ( 49 )   Objective To investigate the clinical value of electrocardiographic right bundle branch block (RBBB) combined with serum high-mobility group box 1 (HMGB1) in monitoring the development of cor pulmonale in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 138 COPD patients were enrolled and followed up for 12 months. Patients were divided into the cor pulmonale group (n=42) and the non-cor pulmonale group (n=96) based on whether cor pulmonale occurred during follow-up. Baseline characteristics, RBBB positivity rates and serum HMGB1 levels were compared between the two groups. Multivariate Cox regression was used to assess the association between RBBB, HMGB1 and cor pulmonale development. Receiver operating characteristic (ROC) curves were constructed to evaluate the predictive performance of each indicator, and the Kaplan-Meier method was applied to analyze the progression of cor pulmonale in COPD patients. Results The positive rate of RBBB (59.5% vs. 22.9%) and serum HMGB1 levels [(8.92±2.61) μg/L vs. (5.38±1.77) μg/L)] were significantly higher in the cor pulmonale group than those in the non-cor pulmonale group ( P<0.01). The area under the curve (AUC) for RBBB combined with HMGB1 in predicting cor pulmonale was 0.915 (95%CI: 0.856-0.962), which was superior to either marker alone. Multivariate Cox regression analysis demonstrated that after adjusting for multiple confounding factors, RBBB positivity (HR=2.002, 95%CI: 1.289-3.107, P<0.001) and elevated HMGB1 (HR=1.177, 95%CI: 1.063-1.303, P=0.002) remained independent risk factors for cor pulmonale in COPD patients. Kaplan-Meier analysis revealed that the 1-year incidence of cor pulmonale was 63.64% in the high-risk group (RBBB-positive and HMGB1 ≥6.85 μg/L), which was significantly higher than that in the low-risk group (RBBB-negative and HMGB1<6.85 μg/L) (8.82%, Log-rank χ2=50.465, P<0.001). Conclusion The combination of RBBB and serum HMGB1 provides valuable clinical utility in assessing the risk of cor pulmonale in COPD patients and enables effective identification of high-risk individuals. Figures and Tables | References | Related Articles | Metrics

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Analysis of risk factors for group B streptococcus colonization and perinatal outcome in patients with gestational diabetes mellitus XIAO Fan, HUANG Huiping, ZHANG Dongmei, LI Li, YANG Yuxia 2026, 54 (8):  848-853.  doi: 10.11958/20252731 Abstract ( 63 )   HTML ( 1 )   PDF (807KB) ( 60 )   Objective To retrospectively analyze the colonization of group B streptococcus (GBS) in patients with gestational diabetes mellitus (GDM), and to explore the risk factors for GBS colonization in GDM patients and their impact on pregnancy outcome. Methods A total of 2 777 GDM patients were enrolled and divided into the GBS-negative group (2 672 cases, including 1 275 vaginal deliveries and 1 397 cesarean sections) and the GBS-positive group (105 cases, including 61 vaginal deliveries and 44 cesarean sections) according to GBS colonization status. General datas and pregnancy outcome were compared between the two groups. Binary Logistic regression analysis was used to identify risk factors for GBS colonization in late pregnancy GDM patients. Results There were no statistically significant differences in maternal age, gravidity, parity, history of abortion, body mass index at delivery, gestational weight gain, prenatal care in our hospital, fasting blood glucose, blood glucose at each time point of oral glucose tolerance test, gestational week at delivery and the incidence of complicated bacterial vaginosis, premature rupture of membranes, scarred uteru and pregnancy complications between the two groups (all P>0.05). The proportion of complicated vulvovaginal candidiasis (VVC) was higher in the GBS-positive group than that in the GBS-negative group (P<0.05). Among women with vaginal delivery, the incidence of meconium-stained amniotic fluid was significantly higher in the GBS-positive group than that in the GBS-negative group (P<0.05).There were no significant differences in intrapartum fever, preterm birth, acute chorioamnionitis, postpartum hemorrhage, the incidence of fetal distress between the two groups (P<0.05). Among pregnant women who delivered by cesarean section, the incidence of acute chorioamnionitis was higher in the GBS positive group than that in the negative group (P<0.05), while there were no significant differences in the incidence of fecal contamination of amniotic fluid, preterm birth, postpartum hemorrhage and fetal distress between the two groups. Among neonates delivered vaginally or by cesarean section, the proportion of admission to the neonatal intensive care unit was higher in the GBS-positive group than that in the negative group (P<0.05). There were no significant differences in neonatal birth weight, the incidence of small for gestational age infants, macrosomia infants and neonatal respiratory distress syndrome between the two groups (P>0.05), and there was no case of neonatal GBS infection in either group. There was significant difference in the overall distribution of causes of cesarean section between the two groups (P<0.05), and the proportion of cesarean section performed due to fetal distress and acute chorioamnionitis was higher in the GBS-positive group than that in the GBS-negative group. Logistic regression analysis showed that complicated VVC was an independent risk factor for GBS colonization in late pregnancy in GDM women (P<0.05). Conclusion Pregnancy complicated with VVC can increase the risk of GBS colonization in pregnant women with GDM. Standardized management of GDM pregnant women, completed screening for GBS colonization during pregnancy, and targeted intrapartum antibiotic intervention are of great significance for improving maternal and neonatal outcomes. Figures and Tables | References | Related Articles | Metrics

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The predictive value of TyG index combined with Naples prognostic score for the severity and prognosis of acute pancreatitis WEI Changqin, WANG Lin, CAI Wenjun, YU Yong, XU Lili 2026, 54 (8):  854-857.  doi: 10.11958/20253396 Abstract ( 55 )   HTML ( 1 )   PDF (857KB) ( 51 )   Objective To investigate the predictive value of the triglyceride-glucose (TyG) index combination with the Naples prognostic score (NPS) for the severity and prognosis of acute pancreatitis (AP). Methods A retrospective study was conducted involving 227 patients with acute pancreatitis (AP). Patients were categorised according to disease severity into the mild acute pancreatitis (MAP) group (137 patients) and the severe acute pancreatitis (SAP) group (90 patients). Additionally, patients were classified into the favourable prognosis group (169 patients) and the unfavourable prognosis group (58 patients) based on clinical outcome during hospitalisation. Clinical data were compared between groups. Spearman correlation analysis was used to assess the correlation between these factors and disease severity. Multivariate Logistic regression model was employed to analyse their impact on prognosis. The predictive value was evaluated using receiver operating characteristic (ROC) curves. Results Compared with the MAP group, the age, TyG index, proportion of patients with NPS ≥ 2, neutrophil count (NEU), neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), amylase (AMY), lipase (LPS), serum creatinine (Scr), blood urea nitrogen (BUN) and total cholesterol (TC) were significantly higher (P<0.05), whilst lymphocyte count (LYM), lymphocyte-to-monocyte ratio (LMR) and albumin (ALB) were significantly lower in the SAP group (P<0.05). TyG index and NPS were positively correlated with the severity of AP (both P<0.001). Multivariate Logistic regression analysis showed that, after adjusting for confounding factors, elevated TyG index (OR = 1.200, 95%CI: 1.036-1.390, P = 0.015) and NPS (OR = 1.418, 95%CI: 1.118-1.797, P = 0.004) were independent factors for poor prognosis. Both TyG index and NPS had predictive value for patients with different severities of AP and for prognosis. Furthermore, their combined predictive value was even higher. Conclusion The combination of the TyG index and NPS has high predictive value for the severity and prognosis of AP, and can serve as a reference for clinical management. Figures and Tables | References | Related Articles | Metrics

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Evaluation of the rotational stability of the Toric intraocular lens after cataract capsular tension ring implantation based on the equivalent diameter of the lens measured by CASIA 2 XU Yanhui, MENG Keqing, LIU Xiaojing, ZHANG Xin, ZHAI Xinran, ZHEN Yuhan, CHEN Zhimin 2026, 54 (8):  858-864.  doi: 10.11958/20253708 Abstract ( 48 )   HTML ( 1 )   PDF (1153KB) ( 50 )   Objective To measure the lens equivalent diameter (LE-Dia) using the anterior segment swept-source optical coherence tomography CASIA 2 and investigate its relationship with the rotational stability of toric intraocular lens (IOL) after capsular tension ring (CTR) implantation in highly myopic cataract patients. Methods This prospective randomized controlled study enrolled 40 bilateral highly myopic cataract patients (80 eyes) who visited Hebei Eye Hospital from January 2023 to March 2024. Using a paired design, both eyes of each patient were randomly assigned to the CTR group and the control group, with 40 eyes in each group. Piecewise linear regression was used to determine the threshold of LE-Dia affecting rotational stability. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), the attachment rate of the posterior lens capsule to the posterior surface of the IOL and IOL rotation were compared between the two groups before operation and at 1 week, 1 month, 3 months and 6 months postoperatively. The correlation between LE-Dia and IOL rotation at 6 months postoperatively was also analyzed. Results At 6 months after operation, UCVA and BCVA were significantly improved in both groups compared with preoperative values (all P<0.05). There was no significant difference in the proportion of IOL rotation <5° between the CTR group and the control group (100% vs. 87.5%, P>0.05). The attachment rate of the posterior lens capsule to the posterior surface of the IOL in the CTR group was superior to that in the control group (97.2% vs. 77.8%， P<0.05). The correlation analysis and piecewise regression analysis showed a threshold effect in the correlation between LE-Dia and IOL rotation: when LE-Dia ≤11.0 mm, no significant correlation was observed (r=0.073, P=0.682, β=1.103, R2=0.005); when LE-Dia was 11.1-11.34 mm, a moderate positive correlation was found (r=0.579, P=0.030, β=15.041, R2=0.335); when LE-Dia >11.34 mm, a strong positive correlation was observed (r=0.712, P<0.001, β=8.903, R2=0.507). Conclusion In highly myopic cataractous eyes, LE-Dia is a critical factor affecting toric IOL rotational stability. Conventional CTR is effective when LE-Dia ≤11.0 mm, but has limited efficacy when LE-Dia >11.34 mm, suggesting that individualized capsular support strategies should be selected based on LE-Dia measurements. Figures and Tables | References | Related Articles | Metrics

Drug Clinical Evaluations

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Effects of two preoperative sedative regimens on intraoperative qCON and qNOX and maintenance anesthetic requirements in pediatric total intravenous anesthesia ZHENG Hongru, WANG Zhifen, LI Mingshan, WANG Haoqi, YUAN Xinying, DU Linna, LIU Jinzhu 2026, 54 (8):  865-869.  doi: 10.11958/20260438 Abstract ( 52 )   HTML ( 1 )   PDF (804KB) ( 54 )   Objective To evaluate the effects of preoperative intranasal dexmedetomidine and intravenous midazolam on anesthesia depth and maintenance drug requirements during pediatric total intravenous anesthesia (TIVA), as monitored by the consciousness index (qCON) and nociceptive index (qNOX). Methods This prospective, randomized, double-blind controlled trial enrolled 79 children (aged 3-6 years, weighing 10-25 kg) scheduled for radiofrequency ablation of tonsils and adenoids. Patients were randomly divided into three groups: group A (no premedication, n=27), group B (intranasal dexmedetomidine 2.0-2.5 μg/kg, n=26), and group C (intravenous midazolam 0.05 mg/kg, n=26). Anesthesia was induced with sufentanil, etomidate, propofol, and cisatracurium, followed by continuous intravenous infusion of propofol and remifentanil. Infusion rates were adjusted intraoperatively to maintain qCON between 40 and 60, and qNOX between 30 and 80. Hemodynamic parameters, qCON and qNOX values, intraoperative infusion doses of remifentanil and propofol, and postoperative recovery profiles were recorded at four time points: before anesthesia induction (T0), before tracheal intubation (T1), 5 minutes after surgery commencement (T2), and before discontinuation of anesthetics (T3). Results During T2-T3, qCON and qNOX values in the group B and C were significantly lower than those in the group A (P<0.05). The maintenance doses of both remifentanil and propofol decreased sequentially across groups A, B, and C. The extubation time in the group C was significantly longer than that in the group A and B (P<0.05), and the richmond agitation-sedation scale (RASS) score during the recovery period was significantly lower in the group C than in the group A and B (P<0.05). Conclusion In pediatric TIVA with propofol and remifentanil, preoperative intranasal dexmedetomidine and intravenous midazolam both deepen anesthesia, reduce qCON and qNOX values, and decrease the required dose of remifentanil. Midazolam can significantly reduce propofol consumption synergistically, but may mildly prolong postoperative extubation time. Figures and Tables | References | Related Articles | Metrics

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Efficacy of faricimab for polypoidal choroidal vasculopathy in the loading stage MENG Bin, CUI Min, LIU Xin, GUO Yin, JI Ang 2026, 54 (8):  870-873.  doi: 10.11958/20260828 Abstract ( 72 )   HTML ( 2 )   PDF (768KB) ( 53 )   Objective To evaluate the efficacy of faricimab for polypoidal choroidal vasculopathy (PCV) in the loading stage. Methods A total of 23 patients (23 eyes) who were diagnosed with PCV in the ophthalmology department of our hospital from August 2024 to December 2025 and treated with faricimab were included in this study. The average age was (74.2±6.5) years, including 13 newly treated eyes and 10 treated eyes. All patients underwent faricimab therapy once a month for 3 consecutive months. The best-corrected visual acuity (BCVA), central retinal thickness (CRT) and central choroidal thickness (CCT) were evaluated at baseline and after each therapy. Subsequent to the completion of the loading stage, the regression rates of polypoidal lesions (PL) and serous pigment epithelial detachment (PED), along with the proportion of patients with dry macula, were assessed. Results After the treatment, both the visual function and anatomic outcome of patients were improved significantly. The BCVA increased from the baseline of 0.68±0.27 to 0.50±0.29, 0.46±0.29 and 0.38±0.25 after three injections respectively (P<0.01), and the improvement persisted throughout the loading stage. CRT decreased from the baseline of (422.0±110.4) μm to (291.2±49.0) μm, (272.2±44.7) μm and (260.8±44.9) μm (P<0.01) ，and CCT decreased from (256.3±131.5) μm at baseline to (249.1±131.2) μm, (245.2±127.6) μm and (239.3±127.0) μm after three injections, respectively (P<0.01). After the loading stage, the regression rate of PL was 47.8% (11/23), the regression rate of serous PED was 73.3% (11/15) and the proportion of dry macula was 78.3% (18/23). There were no adverse drug events in this study. Conclusion After faricimab loading phase treatment, the anatomical and vision functions of PCV patients improve significantly, especially in the regression of PL. Figures and Tables | References | Related Articles | Metrics

Multidisciplinary Diagnosis and Treatment

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Multidisciplinary diagnosis and treatment analysis of pulmonary tuberculosis latent infection activation in a lung cancer patient after immune checkpoint inhibitor therapy YANG Liheng, LI Yi, LIU Shuang, KONG Nan, ZHANG Dongrui, JIA Wei 2026, 54 (8):  874-880.  doi: 10.11958/20260542 Abstract ( 65 )   HTML ( 2 )   PDF (1242KB) ( 64 )   Immune checkpoint inhibitors (ICIs) have been widely used in the treatment of lung cancer. While ICIs can improve overall survival period of patients, it can also lead to a range of immune-related adverse events. This article details the diagnosis and treatment course of a patient with stage ⅢA lung squamous cell carcinoma who developed active pulmonary tuberculosis shortly after initiation of PD-1 inhibitor tislelizumab combined with TP chemotherapy. From a multidisciplinary perspective, we systematically analyze the collaboration and contributions of various specialties throughout the diagnostic process, therapeutic decision-making and overall management of the case. The report aims to elucidate the critical role of the multidisciplinary treatment in identifying tuberculosis risk associated with ICIs, achieving accurate differential diagnosis, formulating sequential treatment strategies and improving patient prognosis, thereby providing a reference for clinical practice. Figures and Tables | References | Related Articles | Metrics

Review

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The pharmacological properties and research status of liposomal bupivacaine LU Futai, YANG Tao, WANG Ting, WANG Lei 2026, 54 (8):  881-885.  doi: 10.11958/20260369 Abstract ( 59 )   HTML ( 4 )   PDF (781KB) ( 59 )   Local anesthetics play a significant role in clinical anesthesia and pain management. However, the duration of action of traditional local anesthetics is limited, which restricts their application in the field of postoperative analgesia. Liposomal bupivacaine, as a novel long-acting local anesthetic, significantly prolongs the duration of drug action through its unique DepoFoam technology, offering a new solution for pain management. Since the U.S. Food and Drug Administration (FDA) first approved bupivacaine liposome for wound infiltration to control postoperative pain in 2011, it has gradually attracted global attention, and related studies have emerged continuously. This article will elaborate the pharmacological properties of liposomal bupivacaine including pharmacokinetics and pharmacodynamics, and comprehensively review its clinical research progress in local infiltration anesthesia, nerve block anesthesia and application in special populations, so as to provide evidence-based references for the rational and standardized clinical application of liposomal bupivacaine and the optimization of perioperative analgesia regimens. References | Related Articles | Metrics

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Research advances of the effects of neoadjuvant chemotherapy on postoperative cognitive function in cancer patients HU Nan, WANG Jiefu 2026, 54 (8):  886-890.  doi: 10.11958/20253033 Abstract ( 70 )   HTML ( 4 )   PDF (837KB) ( 60 )   Neoadjuvant chemotherapy plays a significant role in tumor treatment, but it can lead to postoperative cognitive dysfunction. Studies have shown that the neurotoxicity of different chemotherapy drugs varies significantly and is dose-dependent, especially for high-risk groups such as the elderly and those with underlying diseases.The mechanisms of postoperative cognitive impairment involve multiple factors such as neuroinflammation, oxidative stress, blood-brain barrier disruption and inhibition of hippocampal neurogenesis. To address this issue, multi-dimensional intervention strategies should be adopted, including optimizing chemotherapy regimens and applying neuroprotective agents. Future research should focus on long-term follow-up, mechanism exploration and precise intervention to balance the anti-tumor efficacy and cognitive function protection, and further improve the quality of life of patients. Figures and Tables | References | Related Articles | Metrics

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Research progress of hidden blood loss in spinal diseases treated by spinal endoscopy LIU Yang, DING Zihua, LIU Jichen, WANG Zhen 2026, 54 (8):  891-896.  doi: 10.11958/20260447 Abstract ( 58 )   HTML ( 7 )   PDF (803KB) ( 52 )   Hidden blood loss (HBL) refers to blood seeping into tissue spaces or blood loss that cannot be directly observed due to causes such as haemolysis. It is common during percutaneous endoscopic lumbar discectomy (PELD) and unilateral bi-lateral endoscopic discectomy (UBE) procedures and can have a significant negative impact on postoperative recovery of patients. The occurrence of HBL is primarily associated with blood seeping into tissue spaces and haemolysis mediated by oxygen-free radicals. The anatomical characteristics of the Batson paravertebral venous plexus in the spinal region, the rich blood supply of the vertebral cancellous bone, the spaces within loose connective tissue and continuous intraoperative perfusion fluid constitute the specific basis for its occurrence. Key influencing factors include advanced age, increased thickness of the paraspinal muscles, high body mass index (BMI), diabetes, hypertension, osteoporosis, as well as fusion procedures, multi-segment operations and prolonged operative time. Whereas the use of tranexamic acid is a key protective factor. The prevention and control of HBL should run through the entire perioperative period, including the preoperative identification and management of modifiable risk factors.The intraoperative measures such as controlled hypotension, maintenance of normal body temperature and the appropriate use of tranexamic acid should be adopted. After the operation, haematological parameters need to be dynamically monitored. Blood transfusion or iron supplementation treatment should be given if necessary. References | Related Articles | Metrics