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Spine Professional Committee, Shanghai Community Health Association
2025,46(6):785-794 ,DOI: 10.12289/j.issn.2097-4345.25573
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Mattresses, pillows, and desks/chairs—key elements of daily human-environment interaction—play a crucial role in biomechanical spinal alignment. However, most commercial furniture products are designed based on average anthropometric data, neglecting individual differences such as height, body shape, and posture preferences, which may result in poor posture and increased risk of musculoskeletal disorders. To address this issue, a multidisciplinary expert panel in orthopedics, rehabilitation, and ergonomics developed this expert consensus. Drawing upon evidence-based research, national and international standards, and local anthropometric datasets, the consensus proposes 13 detailed recommendations, including mattress zoning and firmness customization, pillow height and contour design, ergonomic dimensions of desks and chairs, backrest tilt and support configuration, population-specific fitting strategies, and functional adjustability. Emphasizing the principle of “personalized adjustment,” this consensus aims to guide tailored mattress and furniture configurations for various age groups and spinal health needs, thereby preventing spinal strain and postural disorders, while enhancing comfort and quality of life.
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GU Nannan, LI Chunbo, QIAN Jie
2025,46(6):795-803 ,DOI: 10.12289/j.issn.2097-4345.25593
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Insomnia is the most prevalent sleep disorder. The Chinese Sleep Research Society comprehensively updated the 2017 edition of “Chinese Guidelines for the diagnosis and treatment of insomnia” in collaboration with experts in sleep medicine in September, 2025. The new edition of the guideline was developed following a standardized process and offers comprehensive content that covering the definition, epidemiology, pathophysiology, assessment, diagnosis, and treatment of insomnia. Separate sections addressed the unique characteristics of special populations, including children and adolescents, adult women, and older adults. This article provides a point-by-point interpretation of the guideline(2025 edition) contents and key updates to serve as a clinical reference for practitioners.
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ZHU Fangzhou, YANG Yiheng, ZHANG Siyu, JIA Xinming
2025,46(6):804-810 ,DOI: 10.12289/j.issn.2097-4345.25088
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ObjectiveTo investigate the role and mechanism of mannan derived from flo8-deficient Candida albicans(flo8Δ-M) in regulating ulcerative colitis(UC) in a mouse model. MethodsMannan from C. albicans was extracted using a hot alkali method. The UC models were established in both wild-type(WT) and Clec4n knockout mice(Clec4n-/-). The mice were administered mannan via gavage at specified time points, and the weight changes, colon length and disease activity index(DAI) were monitored. The colonic levels of interleukin(IL)-6 and IL-10 were measured by enzyme-linked immunosorbent assay(ELISA). The bone marrow-derived dendritic cells(BMDCs) in the mice were stimulated with flo8Δ-M, and the IL-10 levels in the supernatant were quantified by ELISA. The phosphorylation of spleen tyrosine kinase(Syk) in BMDCs was assessed by Western blotting, and the IL-10 mRNA expression was determined by quantitative real-time polymerase chain reaction(qPCR). ResultsIn vivo experiments demonstrated that flo8Δ-M gavage significantly increased the body weight, colon length, and IL-10 levels, while reduced the DAI and IL-6 levels in UC mice(all P<0.05). In vitro experiments indicated that the flo8Δ-M significantly induced IL-10 secretion in BMDCs via the Dectin-2-Syk signaling pathway(P<0.05). The critical regulatory role of Dectin-2 was further validated in Clec4n knockout UC mice. ConclusionMannan derived from flo8-deficient C. albicans exerts protective effects in UC mouse model by promoting anti-inflammatory cytokine IL-10 production through the Dectin-2-Syk signaling pathway.
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GAO Yijie, MENG Lulu, FENG Xiaowan, WANG Zinuo, RU Ping, LIU Yun, WANG Ling, NI Xiaotian, LIU Ming
2025,46(6):811-818 ,DOI: 10.12289/j.issn.2097-4345.25395
Abstract:
ObjectiveThis study aims to observe the preventive effect and safety of stellate ganglion block(SGB) on paroxysmal sympathetic hyperactivity(PSH) in patients with traumatic brain injuries(TBI). MethodsA retrospective cohort study was carried out in patients with TBI admitted to High Dependency Unit(HDU) from 1st September 2023 to 28th September 2024 at Shanghai Yangzhi Rehabilitation Hospital. The eligible patients were divided into an SGB group and a control group depending on whether they received ultrasound-guided SGB during hospital stay. The primary outcome measured was the incidence of PSH during hospitalization, defined by a PSH-AM score≥8 points. The secondary outcomes included Glasgow coma score(GCS) score at discharge, blood pressure and heart rate before and after SGB, and the occurrence of adverse events including but not limited to nerve injury, neck hematoma, or hoarseness, etc. Multivariate regression models were employed to adjust for confounding factors, and subgroup analyses were performed to confirm the robustness of the findings. ResultsThe study included a total of 234 patients, 101 of whom had sustained TBI, 48 of them underwent ultrasound-guided SGB treatment. The multivariate regression analysis revealed that patients undergoing SGB experienced a significantly lower incidence of PSH than those who did not receive SGB treatment during hospitalization(P<0.05). Additionally, systolic blood pressure and heart rate significantly decreased following SGB treatment, while diastolic blood pressure remained unchanged. No adverse events, including nerve injury, neck hematoma, or hoarseness, were reported during the treatment. ConclusionIt indicated that ultrasound-guided SGB significantly reduces the incidence of PSH after TBI, has the preventive effect and improves the patients neurological function score . These findings underscore the potential therapeutic benefits of SGB; however, additional prospective randomized controlled trials are needed to confirm its efficacy.
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LI Yuanyuan, ZHAO Chen, ZHU Pingyi, CHEN Xin, CHEN Jialu, HE Yuan
2025,46(6):819-827 ,DOI: 10.12289/j.issn.2097-4345.25172
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ObjectiveTo investigater the therapeutic effects of mouse adipose-derived mesenchymal stem cells(mADSCs) on chemotherapy-induced oral mucositis(CIOM), along with their potential mechanisms. MethodsA mouse CIOM model was established by intraperitoneally injecting 5-fluorouracil(5-FU) and chemically damaging the tongue mucosa with 70% acetic acid, followed by the injection of mADSCs into the ulcerated area. Hematoxylin and eosin(H-E) staining was performed to observe histological changes, while qRT-PCR was used to measure the expression of inflammatory cytokines and oxidative stress-related factors. Immunohistochemical staining assessed the expression of oxidative stress-related proteins. ResultsAfter local injection of mADSCs, the ulcer area in the experimental group was reduced compared to the control group on the ninth day of the experiment., along with restoration of the epithelial structure, decreased inflammatory cell infiltration, and lowered expression of interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α), indicating therapeutic effects on CIOM. Additionally, treatment with mADSCs resulted in elevated expression of oxidative stress-related factors heme oxygenase 1(HO-1), superoxide dismutase 1(SOD-1), and Nuclear factor(erythroid-derived 2) -like 2(NFE2L2)(Nrf2) in the lesions, while Kelch-like ECH-associated protein 1(Keap1) expression decreased, indicating that these therapies may alleviate oxidative stress through the Nrf2/Keap1 signaling pathway in the treatment of CIOM. ConclusionThis study provides preliminary insights into the roles and mechanisms of mADSCs in treating chemotherapy-induced oral mucositis, offering a theoretical foundation for new treatment strategies for CIOM.
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AILIYAER Ainiwaer, SUN Shuwen, AYINUER Bohetiyaer, ZHANG Jingcheng, JIANG Yufeng, YAN Yang
2025,46(6):828-839 ,DOI: 10.12289/j.issn.2097-4345.25115
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ObjectiveTo investigate the protective mechanism of salidroside(SAL) in cisplatin nephrotoxicity. MethodsThe protective effect of SAL against cisplatin-induced acute kidney injury was determined by in vitro and in vivo model, and the expression of renal injury markers and apoptosis-related proteins were detected by Western blotting assay and serum examination. Flow cytometry was used to detect apoptosis and reactive oxygen species(ROS), and transmission electron microscopy was used to observe mitochondrial damage. Transcriptome sequencing was used to analyze differentially expressed genes, and relevant pathways were screened by combining GO/KEGG enrichment; the siRNA was used to knock down the target gene to verify the protective role of SAL by upregulating EFNA1. In addition, the phosphorylation levels of phosphoinositide 3-kinase(PI3K) and protein kinase B(AKT) and the nuclear localization of Nrf2 were detected, and changes in the activities of antioxidant enzymes [superoxide dismutase(SOD), glutathione peroxidase(GSH-px), catalase(CAT)] were assessed. ResultsSAL reduced the levels of renal injury markers, promoted the levels of antioxidant enzymes and inhibited ROS, reduced mitochondrial damage and apoptosis in cisplatin-treated HK2 cells and mice. Transcriptome sequencing combined with WB results showed that SAL promoted the phosphorylation of PI3K and AKT through up-regulation of EFNA1, mediated the nuclear translocation of the downstream protein Nrf2, and ultimately elevated the levels of antioxidant enzymes, such as SOD, CAT, and GSH-px, and inhibited apoptosis to alleviate cisplatin-induced acute kidney injury. ConclusionSAL inhibits oxidative stress and attenuates cisplatin-induced acute kidney injury by up-regulating EFNA1 to activate the PI3K/AKT/Nrf2 pathway.
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WU Jieman, CAI Mengyi, CHEN Liwen, LIANG Jingjing, ZHONG Runtao, ZOU Mengchen
2025,46(6):840-847 ,DOI: 10.12289/j.issn.2097-4345.25182
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ObjectiveTo investigate the relationship between thyroid-stimulating hormone(TSH) levels and thyroid nodules(TN) in euthyroid populations. MethodsA total of 3 416 healthy adults with complete baseline data from a hospital health management center in Guangdong Province from September 2022 to September 2023 were considered as the study subjects. The logistic regression models were applied to investigate the correlations between TSH levels and their tertiles with TNs. Subgroup analyses were performed based on different stratifications. ResultsCompared to the non-TN group, TNs were more common in women, the age group over 41 years, and the free triiodothyronine/free thyroxine ratio(FT3/FT4) abnormal group. The levels of FT3, TSH, triglyceride(TG), uric acid(UA), and albumin(ALB) were even lower in TN group; additionally, the high density lipoprotein(HDL-C) level and systolic blood pressure(SBP) were much higher(all P<0.05). After adjusting for confounding factors, individuals with low TSH levels had a significantly increased risk of TN detection(P<0.001). In the TSH tertile groups, the low TSH group had a 1.980-fold higher risk of TN detection compared to the high TSH group(P<0.001). No significant interaction of TSH with other baseline characteristics was found in the subgroup analysis of TSH and TN detected risk associations(interaction P>0.05). ConclusionIn euthyroid individuals, low serum TSH levels are associated with an increased risk of TN detection, suggesting that greater attention should be paid to thyroid health in individuals over 40 years old with low TSH levels during health examinations.
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WANG Lei, CAO Jie, LIU Zhibin, CHENG Liping, WU Xiaocui, SUN Qin, SHA Wei
2025,46(6):848-856 ,DOI: 10.12289/j.issn.2097-4345.25390
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ObjectiveBased on lymphocyte subset count indicators, diagnostic models were constructed using different machine learning methods to distinguish non-tuberculous mycobacterial pulmonary disease(NTM-PD), pulmonary tuberculosis(PTB), and other common confounding pulmonary diseases, to provide a scientific basis for the early identification of infectious pulmonary diseases. MethodsThe patients diagnosed with active tuberculosis(ATB), NTM-PD, or other pulmonary diseases(including inflammatory and neoplastic conditions) admitted to the Department of Tuberculosis at Shanghai Pulmonary Hospital from January to December in 2023 were included in this study. Lymphocyte subset counts were measured using flow cytometry. Four machine learning algorithms—multinomial logistic regression, naive Bayes, random forest, and XGBoost—were employed for model development. Hyperparameter tuning was performed using Bayesian optimization and cross-validation. The variables with P<0.1 from univariate analysis were selected and further refined via correlation analysis and LASSO for final model input. The models were evaluated using area under the receiver operating characteristic curve(AU-ROC), average precision-precision recall curve(AP-PR), and decision curve analysis(DCA) curves on the test set. ResultsA total of 1 383 patients were included, with 836 cases in the ATB group, 254 in the NTM group, and 293 in the OTHER group. Using selected demographic data, comorbidities, and lymphocyte subset indices as input variables and disease category as the outcome variable, four machine learning models were successfully constructed. Among them, the random forest model demonstrated the best predictive performance; the top contributing variables in the models were body mass index(BMI), CD3+T cells, CD16+56+NK cells, CD8+T cells(cytotoxic T cells), age, %CD3+T cells, CD19+B cells, CD4+T cells(helper T cells), gender, anemia, diabetes, leukopenia, hypoproteinemia, and autoimmune disease; and BMI, CD3+T cells, CD16+56+NK cells, and CD+T cells(cytotoxic T cells) contributed most significantly. ConclusionThe machine learning models developed in this study successfully differentiated ATB, NTM-PD, and other pulmonary diseases by integrating lymphocyte subset profiles with clinical features. These models provide novel approaches for the early diagnosis and personalized management of pulmonary diseases.
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YAN Jiayu, SHI Jiaying, CHEN Siyi, ZHAO Ruowen, WU Junhua, WU Junhua
2025,46(6):857-864 ,DOI: 10.12289/j.issn.2097-4345.25078
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ObjectiveTo explore the impact of nutritional status on the risk of readmission among hospitalized children with pneumonia after discharge and to propose countermeasures and recommendations. MethodsA total of 8 817 children aged 6-18 years who were first hospitalized for community-acquired pneumonia from 2017 to 2024 at Shanghai Childrens Hospital were enrolled according to the inclusion and exclusion criteria in this study. Data on pneumonia hospitalizations, height, weight, and readmission status after discharge were retrieved from the hospitals electronic medical record system. Nutritional status was classified based on body mass index(BMI) using the WS/T 456 and WS/T 586 nutritional screening templates compiled in Excel. The SPSS was used to describe and stratify the distribution of nutritional screening results. A multivariate COX regression model was employed to analyze the association and strength between nutritional status and cumulative readmission rates within one year or 30 days after discharge for both mild and severe pneumonia, controlling for confounding factors such as gender, age, and region. ResultsThe average age of children first hospitalized for pneumonia was (8.47±2.02) years. The nutritional status distribution was as follows: 61.4% normal, 16.7% wasted, and 21.9% overweight or obese. Mild pneumonia accounted for 83.6% of cases, while severe pneumonia accounted for 16.4%. Among children hospitalized for severe pneumonia for the first time, the one-year readmission rates was 9.6% and 10.1% in the wasting and overweight/obesity groups respectively, significantly higher than the 5.4% in the normal nutrition group. The 30-day readmission rate in the overweight/obesity group(5.1%) was also notably higher than the 2.6% observed in the normal nutrition group. After controlled for gender, age and residential area, the COX regression analysis revealed that the adjusted risk ratios(RR) for one-year readmission were 1.777 for wasting and 1.966 for overweight/obesity children when compared to that in the normal nutrition group. The RR for 30-day readmission in the overweight/obesity group was 2.052. All these differences demonstrated statistical significance(all P<0.05). ConclusionCompared to children with normal nutrition, wasting and overweight/obesity are associated with an increased readmission rate after pneumonia discharge. It is recommended to strengthen nutritional screening for children, promote nutritional screening for hospitalized pneumonia children, enhance nutritional interventions, encourage influenza vaccination, and focus on improving dietary patterns and lifestyle behaviors, particularly for wasted and overweight/obese children.
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FANG Xiuming, LI Bingxin, LIU Jingnan, YUAN Lingdan, SONG Lige, JIN Wei
2025,46(6):865-874 ,DOI: 10.12289/j.issn.2097-4345.25029
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ObjectiveTo investigate the effects of urinary ketone level on perinatal complications in pregnant women and fetuses in mid-and late pregnancy. MethodsThe clinical data of a total of 771 pregnant women who delivered in the Obstetrics Department of Tongji Hospital from January 2022 to January 2023 were retrospectively analyzed. The pregnant women were divided into normoglycemic group and gestational diabetes mellitus(GDM) group according to oral glucose tolerance test results. The participants were further divided into three groups according to the urine ketone body test results: urine ketone-negative group: -/+-; moderate urinary ketones group: +/++; severe urinary ketones group: +++/++++. The differences in general characteristics, blood indices, and maternal-neonatal clinical outcomes were compared among normoglycemic pregnant women and GDM pregnant women with varying levels of urinary ketone bodies. Multivariate logistic was used to analyze the influencing factors of pregnancy outcomes of mothers and infants, and the influencing factors of urine ketone levels were analyzed by ordered multivariate logistic analysis. ResultsThere were 666(86.38%) pregnant women with normal blood glucose and 105(13.62%) with GDM in the study population. Among the normoglycemic pregnant women, the proportions of the urine ketone-negative(Ket-N) group, the moderate urinary ketones(Ket-M) group and the severe urinary ketones(Ket-S) group was 53.60%, 36.04% and 10.36% respectively; and it was 31.43%, 33.33% and 35.24% in the pregnant women with GDM, respectively. Among the normoglycemic pregnant women, the proportions of the Ket-S group, the Ket-M group and the Ket-S group was 82.73%、13.21% and 4.05%, respectively, in the second trimester of pregnancy; and it was 61.71%, 31.23% and 7.06%, respectively, in the third trimester. Among the pregnant women with GDM, the proportions of the Ket-N group, the Ket-M group and the Ket-S group was 65.71%, 22.86% and 11.43%, respectively, in the second trimester of pregnancy; and it was 37.14%, 27.62% and 35.24% respectively, in the third trimester. Among the normoglycemic pregnant women, the incidences of pre-eclampsia and primary caesarean section in the urine ketone positive group were both higher than those in the urine ketone negative group(both P<0.05). The incidence of neonatal asphyxia in the Ket-S group was higher than that in the Ket-N group(P<0.05). In the GDM group, the Ket-S group was transferred to the neonatal ward at a higher rate than the Ket-N group and the Ket-M group(P<0.05). The results of multivariate Logistic regression analysis of clinic outcomes in pregnant women showed that the initial birth and the elevating alanine aminotransferase(ALT) were risk factors for adverse clinic outcomes(OR=11.912，1.025, both P<0.05). The results of ordered multivariate Logistic regression analysis of urine ketone levels showed that age, family history of diabetes, GDM, and insulin therapy during pregnancy were risk factors for high levels of ketonuria in pregnant women(OR=1.042, 2.244, 1.759, 7.729, all P<0.05). Age was a risk factor for high levels of ketonuria in normoglycemic pregnant women(OR=1.048, P<0.05). Pre-pregnancy body mass index(BMI) and family history of diabetes were risk factors for high levels of ketonuria in pregnant women with GDM(OR=1.249, 12.557, both P<0.05). ConclusionPregnant women are prone to develop ketonuria in the second and third trimesters. The presence of ketonuria in normoglycemic pregnant women increases the risk of preeclampsia, primary cesarean delivery and neonatal asphyxia. GDM women with ketonuria in the second and third trimesters have an increased risk of neonates being admitted to the neonatal ward. In conclusion, the presence of different levels of ketonuria in the second and third trimesters of pregnancy may increase the risk of adverse perinatal pregnancy outcomes for both pregnant women and fetuses.
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ATAWULA Aili, LI Haonan, LI Ruiyuan, LI Moran, ZHANG Yi, XU Yawei
2025,46(6):875-884 ,DOI: 10.12289/j.issn.2097-4345.25070
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ObjectiveTo compare the predictive ability of estimated glomerular filtration rate(eGFR) calculated with five different equations on cardiovascular events in elderly hypertensive patients. MethodsThis study presents a post hoc analysis of 1 714 elderly hypertensive patients who were prospectively recruited from communities in the northern Shanghai. The eGFR was calculated with the Modification of Diet in Renal Disease(MDRD), Chinese-abbreviated MDRD(c-aMDRD), Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI), Asian-modified CKD-EPI(aCKD-EPI), and Chinese-modified CKD-EPI(cCKD-EPI) equations. The primary endpoint was major adverse cardiovascular events(MACE), and secondary endpoints included cardiovascular death and all-cause mortality. ResultsThe prevalence of eGFR<60 mL/(min·1.73 m2) ranged from 7.9%(c-aMDRD) to 20.7%(cCKD-EPI) across the five equations. Patients with eGFR<60 mL/(min·1.73 m2) had significantly higher incidence and risk of MACE(P<0.05). The CKD-EPI, aCKD-EPI, and cCKD-EPI equations demonstrated significantly better predictive ability for MACE, cardiovascular death, and all-cause mortality when compared to the MDRD and c-aMDRD equations(all P <0.05). Notably, the cCKD-EPI equation outperformed the other four equations in predicting MACE(P<0.05). ConclusionAmong elderly hypertensive patients residing in northern Shanghai communities, the cCKD-EPI equation has superior performance than the CKD-EPI, aCKD-EPI, MDRD, and c-aMDRD equations in predicting MACE. Based on these findings, it is recommended that elderly hypertensive patients in China prioritize the use of the cCKD-EPI equation for renal function assessment.
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HUANG Yarong, LI Peng, WANG Xiaobo, JIANG Liren, WU Rong, LI Xin
2025,46(6):885-890 ,DOI: 10.12289/j.issn.2097-4345.25077
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ObjectiveTo investigate the correlation between ultrasound combined with serum sex hormones and microdissection testicular sperm extraction in patients with non-obstructive azoospermia with Logistic regression analysis, and construct a regression model to predict the results of microdissection testicular sperm extraction. MethodsA total of 102 patients with non-obstructive azoospermia(204 testes) who underwent microdissection testicular sperm extraction were selected. Preoperative ultrasound was used to measure testicular volume, rete testis thickness, thickness of various parts of the epididymis, and serum sex hormones were tested. According to whether sperm was obtained by microdissection testicular sperm extraction, the patients were divided into two groups. Analysis of variance was used to compare the differences in various indicators between the two groups. The indicators with significant differences were introduced into the Logistic regression model, and receiver operating characteristic(ROC) curves were drawn to evaluate the predictive value of ultrasound combined with serum sex hormones for microdissection testicular sperm extraction results. ResultsThe binary Logistic regression model selected four variables with statistical significance for predicting sperm retrieval results: testicular volume(X1), rete testis thickness(X2), luteinizing hormone(X3), and testosterone(X4). The Logistic regression equation was: Logit(P)=-0.100-0.170X1+0.950X2-0.066X3-0.279X4, the sensitivity and specificity of this model for predicting microdissection testicular sperm extraction results was 81.6%, 60.8%, respectively; and the area under the ROC curve was 0.764. ConclusionThe Logistic regression model established by ultrasound measurement of rete testis thickness, testicular volume combined with luteinizing hormone and testosterone has good predictive value for preoperative non-invasive prediction of microdissection testicular sperm extraction in NOA patients.
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DONG Shihong, GONG Weiwei, ZENG Yanyu, HU Guojiong, XU Gang
2025,46(6):891-897 ,DOI: 10.12289/j.issn.2097-4345.25104
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ObjectiveTo dynamically evaluate the functional status of thermal-sensitive sensory nerve fibers in healthy individuals with quantitative thermal testing(QTT) and specific transient receptor potential(TRP) channel agonists. MethodsSeventy-two healthy volunteers(42 males, aged 20-35 years) were recruited. The QTT was used to measure warm detection threshold(WDT), cold detection threshold(CDT), and heat pain threshold(HPT) at the chest(T5) and abdomen(T10). The TRPM8 agonist menthol and transient receptor potential vanilloid 1(TRPV1) agonist capsaicin were topically applied to the T5 area, followed by repeated QTT measurements. The non-parametric tests were used to compare the changes in thermal thresholds before and after TRP channel agonist interventions. ResultsAt the T5 site, female participants showed significantly lower CDT than males [1.08(0.80, 1.46) ℃ vs 1.49(1.05, 2.10) ℃, P < 0.05]. At the T10 site, CDT and HPT in females were both significantly lower than those in males [0.97(0.83, 1.42) ℃ vs 1.26(1.17, 1.95) ℃, 38.88(38.12, 41.42) ℃ vs 40.19(38.45, 42.80) ℃, both P<0.05]. After menthol application, the cold detection increased: in males, CDT decreased from 1.49(1.05, 2.10) ℃ to 0.96(0.70, 1.25) ℃(P < 0.05); in females, it decreased from 1.08(0.80, 1.46) ℃ to 0.77(0.59, 1.25) ℃(P < 0.05). After capsaicin application, the heat pain detection increased: in males, HPT decreased from 39.97(38.62, 41.71) ℃ to 38.67(37.49, 40.29) ℃(P<0.05); in females, it decreased from 39.34(38.36, 40.93) ℃ to 38.66(37.47, 40.12) ℃(P < 0.05). ConclusionQTT combined with TRPV1 and TRPM8 agonists is a useful approach for dynamically evaluating the functional status of thermal-sensitive sensory nerve fibers in healthy individuals.
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LI Chunguang, YU Tao, XU Xiangyang
2025,46(6):898-903 ,DOI: 10.12289/j.issn.2097-4345.25137
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ObjectiveTo compare the efficacy of extensor digitorum brevis transfer and fat graft interposition following surgical resection of calcaneonavicular coalition. MethodsA retrospective analysis was conducted on 28 patients with calcaneonavicular coalition who underwent surgical treatment in the Department of Orthopaedics at Rui Jin Hospital between July 2008 and August 2018. There were 15 males and 13 females with an average age of(33.5±4.8)(range: 13-65 years). There were 13 congenital calcaneonavicular coalitions and 15 acquired calcaneonavicular coalitions. Visual analogue scores of pain(VAS) was(5.5±0.5) points(range: 4-8 points). The mean America Orthopedic Foot and Ankle Society(AOFAS) midfoot score was(62.6±1.2) points(range: 44-76 points). The patients were divided into two groups based on the surgical procedure they received: one group(n=14) underwent surgical resection of the coalition combined with extensor digitorum brevis transfer, while the other group(n=14) received coalition resection with fat graft interposition. The perioperative parameters, imaging findings, VAS(visual analog scale) and AOFAS(American Orthopaedic Foot & Ankle Society) scores, and recurrence rates were evaluated in the two groups. ResultsAll the 28 patients were followed-up for a mean duration of(65±7.3) months(range: 48-97 months), with all surgical wounds healing primarily. At the final follow-up: the extensor digitorum brevis transfer group demonstrated longer operative time and hospital stay, and shorter wound healing time, the VAS scores ranged from 0 to 5 points [mean: (1.6±0.3) points], the AOFAS hindfoot scores ranged from 78 to 100 points [mean: (88.6±1.4) points]. The VAS scores in fat graft interposition group ranged from 0 to 4 points [mean: (1.9±0.2) points], the AOFAS hindfoot scores ranged from 74 to 96 points [mean: (87.2±2.3) points]. No coalition recurrence or joint degeneration were observed in all patients. Notably, the fat graft interposition group exhibited significantly lower VAS scores at 1-month post operation when compared to that in the tendon transfer group(P<0.05). ConclusionSurgical resection of calcaneonavicular coalition combined with soft tissue interposition yields satisfactory clinical outcomes. The efficacy of extensor digitorum brevis transfer and fat graft interposition is comparable in these patients.
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AIKEBAIER·Aisikaer, JIN Chen, RAO Zhitao, CHENG Liming
2025,46(6):904-910 ,DOI: 10.12289/j.issn.2097-4345.25223
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ObjectiveTo explore the biomechanical characteristics related to structural differences in joint cartilage between shoulder and knee. MethodsSix joint cartilage samples from human cadavers(shoulder and knee) were selected. The arrangement of chondrocytes, cartilage thickness, distribution of proteoglycans and collagen fibers were observed with histological staining methods such as hematoxylin and eosin(H-E), toluidine blue, and safranin O-fast green-staining. The biomechanical parameters(stress-strain relationship, elastic modulus, peak force, equilibrium force, and maximum stress reduction) were measured via static indentation and dynamic fatigue testing. ResultsSignificant differences in cell morphology, matrix composition, and chondrocyte arrangement were observed between shoulder and knee cartilage. Knee cartilage was thicker than shoulder cartilage, with distinct stratification, higher cell density, and more pronounced heterogeneous staining. Knee cartilage demonstrated higher proteoglycan content, and exhibited a denser collagen fiber network. In contrast, shoulder cartilage was thinner, lacked distinct stratification, exhibited sparse cell distribution, weaker staining intensity, lower proteoglycan content, and evenly distributed but low-density collagen fibers. Pre-fatigue, shoulder cartilage showed higher peak force [(2.428±0.759) N vs (1.853±0.871) N, P=0.004] and equilibrium force [(0.923±0.247) N vs (0.646±0.330) N, P<0.001] when compared to knee cartilage. No significant differences was found in elastic modulus [median 14.469(10.637，16.592) Pa vs 11.459(8.543，15.001) Pa, P=0.086]. Post-fatigue, the shoulder cartilage retained higher peak force [(2.081±0.624) N vs (1.540±0.685) N, P<0.001] and equilibrium force [(0.870±0.223) N vs (0.596±0.292) N, P<0.001]. There was no significant differences in elastic modulus between the shoulder and knee cartilage [(15.451±4.517) Pa vs (13.363±6.350) Pa, P=0.117]. ConclusionKnee cartilage exhibits higher cell density and matrix complexity, shoulder cartilage demonstrates superior load-bearing capacity with higher stress values. Within the elastic range, the elevation of elastic modulus in shoulder cartilage is lower than knee, and fatigue loading elevates the elastic modulus of both tissues. These differences may be closely related to the distinct functional and loading requirements of the two types of joints.
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YANG Linshan, SHENG Shuyue, LIU Xiaobin, FAN Guoliang, MA Shaolin, ZHU Feng
2025,46(6):911-921 ,DOI: 10.12289/j.issn.2097-4345.25044
Abstract:
ObjectiveTo investigate the impact of total bilirubin levels on the risk of sepsis-associated acute kidney injury(SA-AKI) in patients with sepsis and analyze its association with short-term prognosis. MethodsIt was a retrospective cohort study and the data were obtained from the Medical Information Mart for Intensive Care-Ⅳ(MIMIC-Ⅳ-2.2) database. The primary outcomes were the incidence of new-onset AKI within 7 days and 28-day all-cause mortality in sepsis patients admitted to the intensive care unit(ICU), and the exposure was the initial measurement of total bilirubin levels within 24 hours of admission to the ICU in patients with sepsis. Multivariate logistic regression model and restricted cubic spline regression(RCS) analysis were used to evaluate the association between total bilirubin and the risk of SA-AKI, and stratified analysis based on different subgroups was performed. The 28-day survival rate was analyzed using Kaplan-Meier survival curve. ResultsA total of 9 834 patients were included in the study, and 7 159 patients developed SA-AKI. Multivariate logistic regression model with adjustment for correlation confounders showed that: when total bilirubin was used as a continuous type variable, the risk of SA-AKI increased by 10.2% for every 10 mg/L increase in total bilirubin in model 1(OR=1.102, 95%CI: 1.074-1.131, P<0.001); the risk of SA-AKI increased by 10.8% for every 10 mg/L increase in total bilirubin in model 2(OR=1.108, 95%CI: 1.079-1.138, P<0.001); the risk of SA-AKI increased by 5.4% for every 10 mg/L increase in total bilirubin in model 3(OR=1.054, 95%CI: 1.021-1.087, P=0.001). Similarly, when total bilirubin was categorized by tertiles, the risk of SA-AKI continued to increase with the increase of the tertiles of total bilirubin in each model. The RCS curve analysis showed a linear relationship between total bilirubin level and the risk of SA-AKI. In addition, Kaplan-Meier survival curve analysis showed that the 28-day survival rate was significantly reduced with the increase of total bilirubin levels in patients with sepsis. ConclusionTotal bilirubin levels exhibit a linear relationship with the risk of SA-AKI and are significantly associated with poor short-term prognosis. Larger prospective studies are required to confirm these findings.
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ZHANG Huijuan, QI Ansi, ZHOU Hongying, LI Chuoran, WANG Lanlan, CHENG Wenhong
2025,46(6):922-927 ,DOI: 10.12289/j.issn.2097-4345.25034
Abstract:
ObjectiveTo describe the personality traits of patients with anxiety disorders and evaluate their relation to psychosocial status. MethodsThis retrospective study included 6 814 adult patients with anxiety disorders who had their first outpatient visit at the Department of Psychological Medicine at Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, from February 2009 to March 2023. A total of healthy people were set as controls. The demographic and psychometric information from the two groups were gathered. The Eysenck Personality Questionnaire(EPQ) and the Symptom Checklist 90(SCL-90) were applied to assess their personality characteristics and clinical symptoms separately. The t-test and Analysis of Covariance(ANCOVA) was used to compare the results of patients with control group. After controlling for demographic factors, partial correlation analysis was applied to explore the relationship between SCL-90 and EPQ results. Meanwhile, the analysis of variance, t-test and Pearson correlation analysis were applied to investigate the relationship between demographic data and the SCL-90 and EPQ results. ResultsPatients with anxiety disorders scored higher on “neuroticism” [(13.63±5.88) vs (13.03±6.42) points] and lower on “extraversion” [(8.54±4.68) vs (9.04±4.85) points] when compared with those in control group(both P<0.05). The patients scored higher on SCL-90 subscale than the controls, such as “somatization” “anxiety” and phobia, while lower on “interpersonal sensitivity” “hostility” “paranoid” and “psychotic symptom”. Besides, it indicated that neuroticism scores were significantly positively correlated with all SCL-90 subscales(r ranged from 0.43 to 0.62, all P<0.01), while extraversion scores showed slight negative correlations with these SCL-90 subscales(r ranged from -0.20 to -0.07, all P<0.01). Higher SCL-90 scores were associated with certain demographic characteristics: being younger, having a higher level of education, and being unmarried. ConclusionPatients with anxiety disorders exhibited higher levels of neuroticism and low extraversion personality traits, which are related to more severe clinical symptoms on a variety of dimensions. More attention should be paid to the young, single, more educated population.
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SHI Xin, ZHOU Dongdong, ZHAO Hua, PAN Xinyu, LI Lijuan
2025,46(6):928-935 ,DOI: 10.12289/j.issn.2097-4345.25079
Abstract:
ObjectiveTo analyze the association between the risk of chronic diseases and nutrition-related indicators in the rural elderly population receiving physical examination in Shanghai Lingang area, and to explore the necessity of multidimensional interventions for the rural elderly chronic disease population. MethodsThe physical examination data of the rural elderly physical examination population in Shanghai Lingang area were collected for three consecutive years, including demographic data, major chronic diseases(hypertension, diabetes mellitus, dyslipidemia and renal function abnormality) and nutrition-related indicators. Trends in the prevalence of major chronic diseases over the three consecutive years were assessed using the trend chi-square test; logistic regression was used to explore the factors affecting the prevalence of chronic diseases. ResultsThe prevalence of diabetes mellitus, hypertension, dyslipidemia and co-morbidities in the rural elderly population in Lingang area showed an increasing trend, while the prevalence of chronic kidney disease showed a decreasing trend. The prevalences of diabetes mellitus, hypertension and co-morbidities in men were all lower than those in women, and the prevalence of dyslipidemia in men was higher than that in women; the prevalence of chronic diseases was affected by nutrition and health-related indicators in varying degrees. ConclusionThe elderly population in rural areas should be encouraged to actively participate in health management, especially for those who already suffer from chronic diseases, and more precise and targeted health education and interventions should be provided to improve their health status and reduce the burden of chronic diseases. At the same time, the problem of malnutrition should be focused on, the monitoring and assessment of lifestyle and nutritional status should be strengthened, and scientific dietary guidance and nutritional intervention strategies should be promoted to help the elderly population improve their nutritional level, thereby further improving the overall quality of health in those population.
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2025,46(6):936-941 ,DOI: 10.12289/j.issn.2097-4345.24439
Abstract:
With the continuous development of medical imaging technology, its application in the evaluation of intestinal structure and transit function in patients with constipation has gradually attracted attention. This article will review the recent research progress in the use of clinical and imaging technologies, such as X-ray, magnetic resonance imaging(MRI), computed tomography(CT), to assess intestinal structural abnormalities and transit dysfunction in patients with constipation. These imaging technologies can not only non-invasively observe the anatomical structure of the intestine, but also evaluate the motor function of the intestine, providing an important basis for the diagnosis and treatment of constipation. By combing through the existing literature, we found that the application of imaging technology in the field of constipation has broad prospects and potential, but further research is needed to optimize evaluation methods and improve diagnostic accuracy.
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NI Zihan, MEI Xinchun, SHEN Yuan
2025,46(6):942-948 ,DOI: 10.12289/j.issn.2097-4345.25002
Abstract:
Postoperative neurocognitive disorders are common complications in elderly patients. However, the exact causes of these disorders are still not fully understood, and current methods for prevention and treatment remain limited. More and more studies are focusing on the potential role of olfactory function in this area. As an important sensory system, impaired olfactory function has been shown to be closely related to cognitive decline and neurodegenerative diseases. This review summarizes current olfactory interventions for postoperative neurocognitive disorders and explores how olfactory dysfunction may contribute to the development of these disorders through mechanisms such as neuroinflammation, central nervous system degeneration, and emotional regulation. This review also examines the clinical potential of olfactory function in postoperative neurocognitive disorders, including the use of olfactory assessments to identify patients at risk and perioperative olfactory interventions to reduce these disorders. This review summarizes existing research and explores potential research directions regarding the pathological mechanisms of perioperative neurocognitive disorders and their early identification and intervention.
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ZHU Yuyao, XIAO Yao, ZHAO Xi, YU Bin
2025,46(6):949-956 ,DOI: 10.12289/j.issn.2097-4345.25018
Abstract:
Transcranial direct current stimulation(tDCS), as a non-invasive neuromodulation technique, has demonstrated potential for cognitive and functional recovery in patients with chronic disorders of consciousness(pDOC), including coma, unresponsive wakefulness syndrome, and minimally conscious state. Current clinical applications have validated its safety and efficacy, particularly in enhancing clinical recovery indicators in patients with minimally conscious state. This paper reviews the application and mechanisms of transcranial direct current stimulation in the treatment of chronic disorders of consciousness and discusses the limitations of current research as well as the development trends of future therapeutic strategies.
Volume 46,2025 Issue 6
Expert Consensus
Expert Forum
Basic Research
Clinical Research
Investigation Research
综 述
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GOU Hongquan, BIAN Zhixuan, SUN Fenyong
2022,43(5):603-610 ,DOI: 10.12289/j.issn.1008-0392.22060
Abstract:
Stress granules(SGs) are untranslated messenger ribonucleoprotein（mRNP） condensates that formed in eukaryotic cells with an inhibition of translation initiation in response to stressors. SGs dynamically isolate translationally stalled mRNAs and proteins from surrounding cytoplasm into cellular compartments. Meanwhile, SGs regulates cell survival through the recruitment of essential components in some signaling pathways by the interaction between proteins. However, the assembly and disassembly of the cellular compartments rely on intercellular phase separation. This article reviews SGs, phase separation, the roles of phase separation in the assembly and pathological mechanism of SGs and their research methods to provide information for the relationship between SGs Stress granules(SGs) are untranslated messenger ribonucleoprotein（mRNP） condensates that formed in eukaryotic cells with an inhibition of translation initiation in response to stressors. SGs dynamically isolate translationally stalled mRNAs and proteins from surrounding cytoplasm into cellular compartments. Meanwhile, SGs regulates cell survival through the recruitment of essential components in some signaling pathways by the interaction between proteins. However, the assembly and disassembly of the cellular compartments rely on intercellular phase separation. This article reviews SGs, phase separation, the roles of phase separation in the assembly and pathological mechanism of SGs and their research methods to provide information for the relationship between SGs and phase separation.
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2020,41(2):259-263 ,DOI: 10.16118/j.1008-0392.2020.02.021
Abstract:
Cyclin-dependent kinases(CDKs) play a pivotal role in cell cycle regulation, which makes them a distinct therapeutic target to interfere with cell division and proliferation in cancer patients. Palbociclib is the first and specific inhibitor of CDK4/6 with excellent clinical efficacy and limited toxicity. It has been approved in combination with letrozole for the treatment of postmenopausal women with ER+ and HER2- advanced metastatic breast cancer as initial endocrine-based therapy. Extensive studies have also shown that this inhibitor may be used as a potential targeting drug for treatment of other cancers. This review describes the action and mechanism of palbociclib in breast cancer treatment and preclinical studies in other cancers, as well as prospects in the development of palbociclib.
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LIU Jian-hui, HU Jia-yong, DU Xue
2020,41(1):9-18 ,DOI: 10.16118/j.1008-0392.2020.01.003
Abstract:
Perioperative neurocognitive disorders(PND） is an important complication of surgical anesthesia, characterized by impairment of memory, attention, language comprehension and social ability, which can lead to decreased quality of life, prolonged hospital stay, and increased mortality. Due to high incidence, it has a great impact on postoperative recovery and quality of life of patients; it also can cause heavy economic burden to the society and families, and become an important public health problem. Advanced age is a major risk factor for PND, so the study of PND has become one of the research hotspots of senile diseases. The occurrence of PND may be related to multiple factors such as anesthesia, surgery and patients themselves, but its pathogenesis is still unclear. There is lack of a clear definition and effective diagnostic test, the clinical study of PND seems to be more complex. Preoperative evaluation of neurocognitive function and risk factor identification is important to determine the true extent of PND and to look for any causal relationship associated with anesthesia and surgery, but to date, no single anesthesia technique, drug, or monitoring pattern has been shown to reduce the incidence of PND. This article summarizes studies on PND in recent years and provides relevant prevention recommendations for patients at high risk of PND.
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LIU Li, ZHANG Guangyuan, ZHANG Fangfei, WANG Yifan, YIN Jianyong, WANG Niansong, WANG Feng
2023,44(6):805-812 ,DOI: 10.12289/j.issn.1008-0392.23065
Abstract:
Objective To prepare and identify monoclonal antibodies against human IL-17C. Methods The monoclonal antibodies against human IL-17C(mAbs) with hybridoma technique using six-week-old female BALB/c mice. The titers, cross-reactivity, specificity and subclass of the mAbs were determined. The applicability of the mAb was verified by immunoassay, and the mAb 7F10 was used as primary antibody for immunofluorescence and immunohistochemistry analysis. Results Nine hybridoma clones stably secreting mAb against human IL-17C were successfully screened out and named as 1F11, 3A3, 7F10, 9B3, 10C6, 10A7, 10B10, 12F1 and 12F7, which all possessed significant receptor-blocking activity. Further studies showed that clone 7F10 and 10A7 could cause a cross-reaction between human and mouse IL-17C; and no cross-reactivity between mAb 7F10 or 10A7 and other members of the IL-17 family was observed. Both 7F10 and 10A7 were the IgG1 subclass antibodies, and the light chain was kappa type. The mAb 7F10 as primary antibody was successfully applied in immunofluorescence and immunohistochemistry assays. Conclusion The monoclonal antibodies against human IL-17C have been successfully prepared, among which 7F10 can be successfully applied in immunofluorescence and immunohistochemical detection, indicating that 7F10 may be used for diagnosis and treatment of IL-17C-associated diseases clinically.
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YU Shanshan, LI Jing, XU Zhen, CHENG Yu, ZONG Ming, FAN Lieying
2023,44(6):785-791 ,DOI: 10.12289/j.issn.1008-0392.23239
Abstract:
Objective To investigate the role of exosomes derived from fibroblast-like synoviocytes from patients with rheumatoid arthritis(RA-FLS) in macrophage(M) polarization. Methods Synovial fluid and tissue from osteoarthritis(OA） patients(n=6） and rheumatoid arthritis(RA) patients（n=6）were collected, and the cytokines in joint fluid were detected using flow cytometry bead array(CBA) method. The expression of extracellular marker CD9 in the synovium was detected with immunohi-stochemical method. Primary synovial RA-FLS and OA-FLS were isolated, and the exosomes from cell-culture supernatant were identified by Western blotting and nanoparticle tracking analysis(NTA). The effects of OA-FLS and RA-FLS exosomes on the M1 and M2 phenotype genes were determined with real time fluorescence quantitative PCR(qRT-PCR）and CBA. Results The expressions of M1 type markers（IL-1β, IL-6, IL-8）, and M2 type marker（IL-10） in RA joint fluid were significantly higher than those in the OA group. High expression of CD9 was detected in RA synovium. RA-FLS was found to secrete more exosomes than OA-FLS. Elevated gene and protein expression levels of M1 markers were found in M treated with RA-FLS derived exosomes. Conclusion RA-FLS derived exosomes can induce M1 polarization in vitro.
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LI Ping-ping, MA Tao, ZHANG Xin, WU Han-rong, SUN Yan-rong
2019,40(4):397-401 ,DOI: 10.16118/j.1008-0392.2019.04.001
Abstract:
The neuroscience research is known as the “ultimate territory” of understanding the nature and human beings. In recent years, many countries around the world have started brain projects. And the establishment of an international brain initiative is on the way. This article summarizes the latest progresses, future perspectives, and layout strategies of the brain projects of major countries in the world. Characteristics of brain project development of these countries are analyzed, and the opportunities and problems in technology development of brain science that China is facing are also discussed.
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2023,44(6):777-784 ,DOI: 10.12289/j.issn.1008-0392.23330
Abstract:
Guidelines for the diagnosis and treatment of primary osteoporosis(2022) developed by the Chinese Society of Osteoporosis and Bone Mineral Research have been recently released. On the basis of the 2017 version, the current version of guidelines have incorporated the latest developments in the epidemiology, pathogenesis, disease diagnosis and treatment options for primary osteoporosis from both domestic and international sources over the past five years to provide guidance for clinical practice. This article interprets the main updates of the new guidelines.
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LI Huai-fang, SONG Si-rui, CHU Lei
2018,39(6):5-7,29 ,DOI: 10.16118/j.10080392.2018.06.002
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Stress urinary incontinence(SUI) is a common problem suffered from by many women, and surgery is an effective therapeutic method for severe SUI. The American Urological Association(AUA) and Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction(SUFU) collected and sorted the latest clinical research evidences, jointly updated the guideline for surgical treatment of SUI in 2017. This article interprets this latest guideline and its application in the treatment of SUI.
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LIN Hao, YUAN Deqiang, CHEN Fei, LIU Xuebo
2023,44(6):925-932 ,DOI: 10.12289/j.issn.1008-0392.23034
Abstract:
Sodium-dependent glucose transporter 2 inhibitors(SGLT2i) have been widely used for glucose-lowering therapy andalso recommended as a class Ⅰ medication for treating heart failure. However, the exact effects and mechanisms of SGLT2i in coronary heart disease(CHD) are still not fully understood. This review summarizes the pharmacological effects and relevant mechanisms of SGLT2i in CHD, particularly for improving vascular endothelial function; and also discusses limitations of related studies and future research directions.
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ZHANG Li-li, WANG Qiang-xiong, SHEN Liang-liang, JI Yan-fen, DENG Shu-wen, ZHAO Jing-jun
2018,39(1):70-75 ,DOI: 10.16118/j.1008-0392.2018.01.014
Abstract:
Objective To investigate the molecular identification and susceptibility to antifungal agents of clinical isolates of Aspergillus species. Methods Fifty-three clinical isolates of Aspergillus were identified to species level based on Internal Transcribed Spacer(ITS) and β-tubulin gene sequencing. The in vitro susceptibility to anidulafungin, caspofungin, micafungin, posaconazole, voriconazole, itraconazole and amphotericin B was tested by CLSI M38-A2. Results Among 53 isolates, there were 21 strains of Aspergillus fumigatus, 16 of Aspergillus tubingensis, 5 of Aspergillus niger, 4 of Aspergillus flavus, 4 of Aspergillus terreus, 2 of A. welwitschiae and 1 of A. lentulus. The MIC90 of micafungin,anidulafungin, caspofungin, posaconazole, voriconazole, itraconazole, amphotericin B were 0.031, 0.031, 0.25, 0.5, 0.5,1 and 2μg/mL.One Aspergillus fumigatus strain showed resistance to itraconazole and voriconazole. Aspergillus lentulus strain was resistant to Amphotericin B. Other strains were sensitive to 7 antifungal angents.The susceptibility of 4 species complexes to different antifungal drugs was statistically significant differences（P＜0.05）. Conclusion Echinocandins drugs have best antifungal activity against 5 Aspergillus species, followed by asoles and amphotericin B. Different species of Aspergillus show different patterns of antifungal susceptibility.
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WEN Yu-hua, LIU Pei-pei, SONG Li-ge
2021,42(2):266-270 ,DOI: 10.12289/j.issn.1008-0392.20380
Abstract:
Peroxisome-proliferator-activated receptor γ coactivator-1α（PGC-1α) is a master regulator of oxidative metabolism and mitochondrial oxidative stress in various organs. In bone metabolism, PGC-1α promotes the differentiation, proliferation and mineralization of osteoblasts and inhibits the differentiation of osteoclasts. At the same time, it is important for maintaining the expression of specific genes in osteocytes. This article reviews the effects of PGC-1α on osteoblasts, osteocytes and osteoclasts to provide insight for the mechanism, diagnosis and treatment of bone metabolism-related diseases.
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2022,43(6):867-874 ,DOI: 10.12289/j.issn.1008-0392.22119
Abstract:
The hypothalamus is an important organ for controlling food intake and energy balance, which is critical for the obesity development. Hypothalamic inflammation can result in hypothalamic leptin and insulin resistance, as well as impair signaling pathways that regulate energy homeostasis, which may be the initiator of energy regulation imbalance and obesity. Foxo1 is a nuclear transcription factor expressed abundantly in AgRP and POMC neurons in the hypothalamic arcuate nucleus and has a critical role in hypothalamic inflammation and central insulin resistance；however, its molecular mechanism is still unknown. It is suggested that Foxo1 might be a key regulator of energy balance in the hypothalamus and it would be a novel therapeutic target for obesity. This review summarizes the relationship between Foxo1 and hypothalamic inflammation, as well as its role in the occurrence and progression of obesity.
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2012,33(6):126-130 ,DOI: 10. 3969/j.issn1008 -0392.2012.06.030
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Notch pathway is highly conservative and exists extensively in a variety of animals. It plays a crucial role in the biological activities of cells, including meditated cell-to-cell communication and reaction in relevant signaling pathway, regulation of proliferation, differentiation and apoptosis. Recent research of Notch has revealed that there is a close connection between Notch signaling and cancers. Notch signal not only plays a role in the promotion of some cancers such as breast cancer, small cell lung carcinoma and melanoma, but also in suppression of other cancers like non-small cell lung carcinoma and skin cancer. This article reviews the characterization of Notch signal, specially in its promotion and suppression effect on individual cancers.
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HUANG Zi-ling, YU Xiao-ting, YI Xiang-hua
2018,39(3):123-127 ,DOI: 10.16118/j.1008-0392.2018.03.024
Abstract:
The detection of circulating tumor cells is a new type of "liquid biopsy" technique. It has the advantages of non-invasiveness, convenience, real-time, integrity, precision and repeatability. The technique provides a clinical analysis platform from cellular to molecular levels, and makes up the deficiency of the existing methods of cancer diagnosis, to facilitate more accurate medical treatment for cancer patients. This article reviews the latest progress on the clinical application and common methods of circulating tumor cell detection.
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2018,39(2):73-78 ,DOI: 10.16118/j.1008-0392.2018.02.014
Abstract:
ObjectiveTo assess the diagnostic value of miR-146b-3p in peripheral blood for early non-small cell lung cancer (NSCLC). MethodsPeripheral blood samples were collected from 118 patients with early NSCLC, 42 patients with benign pulmonary nodules and 48 healthy subjects. Circulating miR-15b-5p, miR-17-5p, miR-19a-3p, miR-20a-5p, miR-92a-3p and miR-146b-3p were detected by real-time fluorescent quantitative PCR (RT-qPCR) and compared among different groups. ResultsThe expression of miR-146b-3p was significantly higher in NSCLC patients than that in patients with benign lung nodules and healthy controls. The area under the ROC curve (AUC) of miR-146b-3p in differential diagnosis between NSCLC and benign lung nodules was 0.77; with the cut-off value of 0.01, the sensitivity and specificity was 75% and 71%, respectively. The AUC of miR-146b-3p in differentiating early NSCLC patients from healthy subjects was 0.93; with the cut-off value of 0.72, the sensitivity and the specificity was 89% and 84%, respectively. Logistic regression model indicated that age and miR-146b-3p were independent risk factors for early NSCLC compared to benign lung nodules, and the AUC was 0.81, with the cut-off value of 0.85, the sensitivity and the specificity was 65% and 89%. MiR-19a-3p and miR-146b-3p were independent risk factors for early NSCLC compared to healthy controls, and the AUC was 0.98, with the cut-off value of 0.90, the sensitivity and specificity was 94% and 95%, respectively. ConclusionMiR-146b-3p can differentiate early NSCLC from benign lung nodules and healthy control, indicating that it might be used as a new biomarker for early diagnosis of non-small cell lung cancer.
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LIU Xiao-yu, YANG Yong, XIA Yun1
2012,33(5):119-124 ,DOI: 10.3969/j.issn1008 -0392.2012.05.028
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Cardiovascular disease is the primary cause of morbidity and mortality in modern society all over the world. The present article reviewed the recent research on the correlation between NF-kB and the onset, progression and treatment of cardiovascular disease. It can be expected that NF-kB signaling pathway will provide an important therapeutic pathway and target for cardiovascular disease.
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WANG Ya-ru, JI Hong-wei, ZHANG Yi, XU Ya-wei
2018,39(4):1-5 ,DOI: 10.16118/j.1008-0392.2018.04.001
Abstract:
In June 2018, the European Society of Cardiology and the European Society of Hypertension (ESC/ESH) jointly published the “2018 ESC/ESH Arterial Hypertension Guidelines” at the ESH Annual Meeting in Barcelona, Spain. This article explains the definition, measurement and screening of hypertension. The article further explains the overall risk stratification, initial blood pressure level, office blood pressure in hypertension treatment and lifestyle intervention, drug therapy, instrument therapy for hypertension. It also brings many thoughts and inspirations for the revision of the hypertension guidelines for our country in the future.
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CONG Rui-jun, ZHANG Li-yun, WANG Miao, SONG Yu, TAO Kun
2018,39(5):77-82 ,DOI: 10.16118/j.1008-0392.2018.05.015
Abstract:
Objective To compare the posterolateral minimally invasive approach with conventional posterior-lateral approach for bipolar artificial hip replacement in elderly patients. Methods Thirty two patients aged 60-80 years scheduled to undergo bipolar artificial hip replacement were divided into two groups randomly. The posterolateral minimally invasive approach was applied in 15 patients(study group) and the conventional posterior-lateral approach was used in 17 patients(control group). The volume of intraoperative blood loss, surgery time, length of incision, SF-36 score, Harris score, VAS score, amount of analgesic, infection of incision, infection around the prosthesis, deep vein thrombosis, pulmonary embolism, prosthetic cacothesis, dislocation, aseptic loosening were recorded and compared between two groups. Results The length of incision, surgery time, the volume of intraoperative blood loss in study group were significantly lower than those in control group(P<0.05). The Harris score and SF-36 score on the second week after the operation in study group were significantly higher than those in control group(P<0.05). No severe complications were found in both groups. Conclusion Compared to conventional posterior-lateral approach, the posterolateral minimally invasive approach in hip arthroplasty has advantage of less invasiveness during surgery, quicker rehabilitation after operation, the less use of the analgesics. But more data and longer follow-up are needed for evaluation of this approach.
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JIANG Shuo, MAO Yanjun, LU Min, CHENG Jie, CHEN Danping, LI Jinling, DING Junrong, SUN Jinglin, MO Xinxia, HUANG Yaohua
2023,44(5):735-739 ,DOI: 10.12289/j.issn.1008-0392.23214
Abstract:
Objective To analyze the risk factors of falls in hospitalized elderly patient and related countermeasures. Methods A questionnaire survey was conducted among aged ≥60 years in Shanghai Pulmonary Hospital Tongji University. The questionnaire contained the basic information and health status of patients, the experience of falling and related factors. The causes and characteristics of falling and its distribution were analyzed. Results A total of 6 162 valid questionnaires were collected with a recovery rate of 100.0%. There were 23 patients with the experience of falls during hospitalization with a prevalence of 0.37%. The logistic regression showed that taking antiarrhythmic drugs(OR=3.872, 95%CI: 1.702-8.808), mobility impairment(OR=3.872，95%CI: 1.702-8.808), frequent urination and frequent nocturia(OR=3.64, 95%CI: 1.149-11.534) were independent risk factors of falls in elderly patients during hospitalization. Conclusion According to the risk factors appropriate countermeasures should be taken to prevent falls in elderly patients during hospitalization.
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2023,44(5):631-633 ,DOI: 10.12289/j.issn.1008-0392.23286
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With the modification of 2018 edition, the Guideline for the Diagnosis and Treatment of Psoriasis in China(2023 edition) has been developed by an expert group under the Psoriasis Committee of the Chinese Society of Dermatology. The new guideline updates the criteria for severity grading and diagnostic typing of psoriasis, and improves the concept of psoriasis comorbidities. In terms of auxiliary investigation, the new guideline recommends the application of non-invasive imaging examination; in terms of treatment, the new guideline optimizes the recommendation of traditional drugs, refines and supplements the application guidance for biological agents and small-molecule targeted agents. This article interprets the main contents of the new guideline.
