中华全科医学

Research on the development pathway of general practice specialty: based on provincial clinical key specialty construction practices and national strategies

HE Jia, MU Qiong, HE Qian

2026, 24(3): 357-361. doi: 10.16766/j.cnki.issn.1674-4152.004397

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Objective Drawing on provincial key clinical specialty construction practices and national strategic priorities, this study explores effective pathways and outcomes for developing key clinical specialties in general practice. It aims to provide practical references for deepening healthcare reform and advancing the implementation of hierarchical diagnosis and treatment. Methods Taking the 2023 provincial-level clinical key specialty construction project at the Affiliated Hospital of Guizhou Medical University as a platform, a series of interventions were implemented, including the development of a structured talent echelon, innovation in diagnosis and treatment systems, and the integration of research and teaching. Based on key data collected from 2020 to the first half of 2025, changes in indicators such as medical service efficiency and hierarchical diagnosis and treatment capacity were analyzed to evaluate the effectiveness of implementation. Additionally, differences in medical models between eastern and western regions were compared. Results Following the implementation of the project, healthcare service efficiency significantly improved. In the first half of 2025, the number of general practice inpatients reached 805, representing a 27.6% year-on-year increase compared to the same period in 2024. The average length of hospital stay decreased from 9.7 days to 8.2 days, while the bed turnover rate improved from 90% to 95%. The hierarchical diagnosis and treatment system achieved notable outcomes: referrals from primary to tertiary hospitals and from tertiary to primary care institutions increased by 75.8% and 108.6%, respectively. The standardized management rate for chronic diseases improved from 65% to 91%, and community satisfaction increased from 92% to 98%. The pass rate for resident physicians in the national licensing examination rose from 55.8% (24/43) to 95.0% (38/40). Over the past three years, the total output of teaching and research achievements grew by 188%. Significant differences were observed between eastern and western regions in terms of technical support, human resource allocation, and applicable conditions. Conclusion Through the "three-dimensional integration" approach encompassing talent, technology, and management, primary care service capacity was effectively enhanced, the implementation of hierarchical diagnosis and treatment was promoted, and comprehensive improvements were achieved in service efficiency, chronic disease management, and talent cultivation capabilities. In the future, policy coordination and digital empowerment should be strengthened to advance the transformation of general practice toward quality-driven development. This study offers a replicable and cost-effective practical model for the development of general practice specialties in underdeveloped western regions.

Expert consensus on the diagnosis, treatment, and management of abnormal creatine kinase (2025)

General Practice Branch of Cross-Straits Medicine Exchange Association, General Practice Branch of Zhejiang Medical Association, Medically Unspecified Disease Professional Committee of Zhejiang Society for Mathematical Medicine, the Expert Collaboration Group on, Medically Unspecified Disease in General Practice, Chinese Geriatrics Society

2026, 24(3): 362-374. doi: 10.16766/j.cnki.issn.1674-4152.004398

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Abnormal creatine kinase (CK) levels represent a prevalent clinical problem with diverse and complex etiologies, for which systematic clinical research evidence remains limited. This condition not only adversely affects patients' physical and mental health but also imposes a substantial economic burden on society. This consensus statement was collaboratively drafted by multidisciplinary panel of experts in general practice, cardiovascular disease, and laboratory medicine. It provides a comprehensive overview of the definition, classification, epidemiology, etiology, and pathophysiological mechanisms underlying CK abnormalities. Furthermore, it elaborates on standardized diagnostic strategies, encompassing patient history-taking, physical examinations, and appropriate auxiliary assessments. Additionally, individualized treatment principles and specific therapeutic measures for CK abnormalities are systematically outlined. The consensus also underscores the importance of comprehensive community-based management strategies for CK abnormalities, including screening, risk assessment, follow-up care, tiered referral systems, and health education. Moreover, it proposes future directions for the diagnosis, treatment, and management of CK abnormalities, drawing on the applications of artificial intelligence and precision medicine in CK diagnostics and therapeutics. The ultimate goal is to offer guidance for the standardized diagnosis, treatment, and holistic management of CK abnormalities in clinical practice.

Relationship blood routine and coagulation related indicators with short term prognosis of acute perforator atherosclerotic cerebral infarction

YUN Jing, LIU Bin, LI Haibo, ZUO Junqin, ZHENG Jiao, MAO Wenjing, DENG Chunying

2026, 24(3): 375-378. doi: 10.16766/j.cnki.issn.1674-4152.004399

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Objective To explore the correlation of blood routine-related indexes and coagulation index-related markers with the short-term prognosis of acute perforator atherosclerotic cerebral infarction, in order to provide a reference for early clinical intervention. Methods A total of 303 patients admitted to our department of neurology from October 2021 to September 2023 were consecutively recruited, and according to their short-term prognosis, they were divided into a good prognosis group (189 cases) and a poor prognosis group (114 cases). The two groups were compared with blood routine-related indexes [mean platelet volume (MPV), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR)] and coagulation index-related markers [prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB)]. Multivariate logistic regression analysis was applied to identify the relationship of the above indicators with the prognosis of acute perforator atherosclerotic cerebral infarction. ROC curve was plotted to analyze the predictive value of the indicators for disease prognosis in these patients. Results Compared with the good prognosis group, the MPV, NLR, PLR, and FIB in the poor prognosis group were significantly increased (P < 0.05), and the PT and APTT were significantly decreased (P < 0.05). Multivariate regression analysis showed that MPV, NLR, PLR, PT, APTT, and FIB were independent influencing factors for poor prognosis (P < 0.05). The results of ROC curve analysis showed that MPV, NLR, and PLR had certain predictive efficacy on the poor prognosis of patients. Among them, the area under the curve of NLR and PLR for predicting poor prognosis was 0.814 (95% CI: 0.763-0.865) and 0.753 (95% CI: 0.695-0.811), respectively. Compared with PLR, NLR had a significantly higher predictive value for prognosis (P=0.038). PT, APTT, and FIB all had certain predictive power for patients with poor prognosis in the near future, but there was no significant difference in the predictive value of the three. Conclusion MPV, NLR, PLR, PT, APTT, and FIB are associated with the short-term prognosis of acute perforator atherosclerotic cerebral infarction. Early monitoring and intervention can improve the prognosis.

The influence of improved nutritional support programs on the nutritional status and prognosis of patients in the recovery period of cerebral infarction

GUO Xiang, ZHAO Jianjun, SU Xingxing, ZHAO Cunxi

2026, 24(3): 379-381. doi: 10.16766/j.cnki.issn.1674-4152.004400

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Objective To explore the effects of different nutritional treatment regimens on the nutritional status, activities of daily living, neurological deficits, length of hospital stay, and hospitalization costs of patients in the recovery period of cerebral infarction. Methods A total of 103 patients with cerebral infarction in the recovery stage admitted to Hefei Baihui Hospital from November 2023 to October 2024 were divided into three groups by the envelope method. Group A was a sequential nutrition group (n=24), group B was a conventional nutrition group (n=24), and group C was a modified nutrition group (n=55). The changes in indicators before and after 3 weeks of intervention were collected, and the intervention effects of the three nutritional treatment regimens were compared. Results After treatment, the nutritional risk screening 2002 (NRS2002) of group C (2.69±0.86) was significantly lower than that of group A (3.54±0.88) and group B (3.12±0.99, F=8.842, P < 0.001). The prognostic nutritional index (PNI), ALB, and HB of group C were significantly higher than those of group A and group B (all P < 0.05). The CRP of group C was significantly lower than that of group A and group B (P < 0.05). Before and after treatment, the NRS2002 score of group A was significantly reduced, and the PNI, total protein (TP), ALB, prealbumin (PA), lymphocytes (LYM), and Barthel index (BI) were significantly increased (P < 0.05). The NRS2002 score, CRP, and National Institutes of Health Stroke Scale (NIHSS) score of group B were significantly reduced, and the PNI score, TP, ALB, PA, LYM, and BI were significantly increased (P < 0.05). The NRS2002, CRP, and NIHSS scores of group C were significantly reduced, and the PNI score, TP, ALB, PA, HB, LYM, and BI were significantly increased (P < 0.05). The hospitalization cost of group C was the lowest, and the difference was statistically significant (P < 0.05). Conclusion All three nutritional regimens can improve the nutritional status and prognosis of patients, and the modified nutritional regimen is more beneficial to patients.

Curative effect of quadruple therapy on hypertension complicated with cerebral infarction and its effect on serum PI3K/Akt signaling pathway

ZHANG Xiujuan, ZHOU Wan, ZHANG Qunwei, ZHU Jie

2026, 24(3): 382-385. doi: 10.16766/j.cnki.issn.1674-4152.004401

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Objective To observe the clinical efficacy of quadruple therapy in the treatment of hypertension complicated with cerebral infarction, detect the expression changes of the serum phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) pathway before and after treatment, and explore its potential mechanism of action. Methods A total of 158 patients with hypertension and cerebral infarction were selected from the 901st Hospital of the Joint Service Support Force of the Chinese People's Liberation Army from January 2021 to October 2024 as the study samples. The patients were divided into the control group and the observation group, with 79 patients each by random number table. The control group received triple therapy with aspirin enteric coated tablets, clopidogrel hydrogen sulfate tablets, and atorvastatin calcium tablets, while the observation group received quadruple therapy with amlodipine besylate tablets. The clinical efficacy of the two groups was compared, including systolic blood pressure (SBP), diastolic blood pressure (DBP), National Institutes of Health stroke scale (NIHSS) score, stroke specific quality of life scale (SS-QOL) score, serum PI3K and AKT protein expression levels, and incidence of adverse reactions after treatment. Results The total clinical effective rate of the observation group was 91.14% (72/79), which was significantly higher than that of the control group (70.89%, 56/79, χ²=15.003, P=0.001). After 1, 2, and 3 months of treatment, SBP, DBP, and NIHSS scores decreased in both groups, while SS-QOL scores increased, and serum levels of PI3K and AKT proteins decreased (P < 0.05), with more pronounced improvements observed in the observation group. Both time and group factors had significant effects on the outcomes (P < 0.05). The total incidence of adverse reactions in the observation group was 7.59% (6/79), while in the control group it was 13.92% (11/79), with no statistically significant difference (χ²=2.377, P=0.677). Conclusion Quadruple therapy is effective in the treatment of hypertension complicated with cerebral infarction. It can not only effectively control blood pressure, improve neurological function and quality of life, but also play a therapeutic role by regulating serum PI3K/Akt signaling pathway, without increasing the incidence of adverse reactions.

Regulatory role of lysosomal potassium channel TMEM175 mediated by rs13063138 in Parkinson's disease

WANG Zihao, XIA Huan, YAO Yani, YONG Yuxuan, LI Peishan, SHANG Shuying, YANG Xinling

2026, 24(3): 386-389. doi: 10.16766/j.cnki.issn.1674-4152.004402

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Objective To explore the potential association between TMEM175 gene expression levels, its genetic loci, and the risk of Parkinson's disease (PD). Methods This study was conducted from June 2023 to September 2024 at the Second Affiliated Hospital of Xinjiang Medical University. A total of 215 participants (105 patients with PD and 110 healthy controls) were included in the study. Serum TMEM175 expression levels were measured using enzyme-linked immunosorbent assay (ELISA). Genomic studies, including a genome-wide association study (GWAS) and colocalization analysis, were conducted. Single-cell RNA sequencing and chromatin accessibility analyses were employed to explore the expression characteristics of TMEM175 in brain cells. Results The expression level of TMEM175 in the PD patient group [(183.27±11.97) ng/mL] was significantly lower than that in the healthy control group [(187.28±10.24) ng/mL], with a statistically significant difference (t=2.647, P=0.009). Logistic regression analysis showed that increased TMEM175 levels significantly reduced the risk of PD, particularly in the higher concentration Q3 (185.32-＜192.92 ng/mL) and Q4 (> 192.92 ng/mL) groups, which showed statistical significance (P < 0.05). Genomic analysis indicated that TMEM175 has a protective effect on PD (OR=0.75, 95% CI: 0.55-1.01, P=0.048), and the key co-localized locus rs13063138 may influence PD risk by regulating TMEM175. Single-cell RNA sequencing data showed that TMEM175 is highly expressed in astrocytes and oligodendrocytes, suggesting its important role in glial cell function. Conclusion This study reveals the role of TMEM175 in PD from three perspectives: serum levels, genetic background, and cellular function. It provides evidence supporting TMEM175 as a potential therapeutic target for PD.

Identification of HTR1D as a therapeutic target and prognostic indicator for colorectal cancer

HU Yiyang, YAO Liuxu, LI Weiwei, HE Liu, LI Yuhong

2026, 24(3): 390-394. doi: 10.16766/j.cnki.issn.1674-4152.004403

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Objective To screen and identify differential genes in colorectal cancer by bioinformatics, and to explore the role and value of 5-hydroxytryptamine receptor 1D (5-HTR1D) in colorectal cancer. Methods The differentially expressed genes (DEGs) between colorectal cancer and adjacent normal tissues were identified in this study by using GEO data set. Subsequently, a protein-protein interaction network and key genes related to colorectal cancer were established. Tissue samples from colorectal cancer and adjacent tissues were collected for immunohistochemistry, and different colorectal cancer cell lines were subjected to Western blotting to verify the differences of HTR1D. The potential mechanism of HTR1D was discussed by GO and KEGG enrichment analysis. Kaplan-Meier survival analysis and multivariate Cox regression analysis were used to verify the correlation between HTR1D expression and the clinicopathological features and prognosis of patients with colorectal cancer. A mouse xenotransplantation model was established, and the effectiveness of HTR1D as a target for CRC treatment was verified by in vivo experiments. Results The results of the present study demonstrated that the expression of HTR1D was considerably upregulated in CRC tissue, and was principally expressed in the cytoplasm of tumor cells. Western blotting assay was performed to detect HTR1D expression in CRC cell lines: HTR1D was highly expressed in poorly differentiated cell lines. From clinical aspects, HTR1D expression was significantly correlated with tumor size (P=0.044)and hypertension(P=0.039) in CRC. Kaplan-Meier survival analysis [(18.9±2.5) mouths vs. (26.7±1.9) mouths, P=0.033] and multivariate Cox regression analysis indicated that the expression of HTR1D was closely associated with the prognosis of patients (P=0.019, HR=1.159, 95% CI: 1.024-1.312). In vivo experiments demonstrate that the inhibition of HTR1D expression results in a reduction of expression level in a reduction in the mass and volume of tumors. Conclusion HTR1D has been identified as both a viable therapeutic target and a prognostic indicator in colorectal cancer cases.

The role of TRIM62 in regulating autophagy in aortic smooth muscle cells through the mTOR pathway

CAI Fengjiao, WU Jinhong, WANG Lili, MA Yichao, LU Yan

2026, 24(3): 395-398. doi: 10.16766/j.cnki.issn.1674-4152.004404

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Objective To explore the role of TRIM62 in regulating autophagy in aortic smooth muscle cells (ASMCs) and its potential mechanisms, and to evaluate its impact on vascular calcification. Methods Aortic smooth muscle cells were isolated and cultured from Sprague-Dawley rats. Stable cell lines were constructed for overexpression of TRIM62 (OE-TRIM62), empty vector control (Vector), knockout of TRIM62 (KO-TRIM62), and negative control (NC) groups with 12 samples in each group. Vascular calcification was induced using sodium β-glycerophosphate. Autophagy levels were assessed by monodansylcadaverine (MDC) fluorescent flow cytometry, observation of autophagosomes by transmission electron microscopy, LC3 fluorescent imaging, and adenosine triphosphate (ATP) activity assay. The expression of autophagy-related proteins (P62, ATG3, LC3) and mammalian target of rapamycin(mTOR) signaling pathway proteins (mTOR, p-mTOR) was detected by Western blot (WB). Results Compared with the Vector group, the median fluorescence intensity of MDC in OE-TRIM62 group was significantly increased (156.7±12.4 vs. 108.6±9.1, P < 0.05), and transmission electron microscopy showed that the number of autophagosomes increased. The ratio of p-mTOR/mTOR significantly increased (1.12±0.09 vs. 0.86±0.07, P < 0.05), and the relative expression levels of P62, ATG3, and LC3-Ⅱ proteins significantly decreased (P < 0.05). The rate of LC3 positive cells was significantly increased (24.3%±2.7% vs. 13.1%±1.8%, P < 0.05), and ATP activity was significantly decreased (P < 0.05). The p-mTOR/mTOR ratio was significantly decreased (P < 0.05), and the relative expressions of P62, ATG3 and LC3-Ⅱ proteins were significantly increased (P < 0.05). Compared with NC group, the median fluorescence intensity of MDC in KO-TRIM62 group was significantly decreased (78.4±6.2 vs. 105.3±8.7, P < 0.05). Transmission electron microscopy showed that the number of autophagosomes and the rate of LC3 positive cells were significantly decreased (6.8%±0.9% vs. 12.5%±1.6%, P < 0.05), the p-mTOR/mTOR ratio was significantly increased (P < 0.05), and the relative expressions of P62, ATG3 and LC3-Ⅱ proteins were significantly decreased (P < 0.05). Conclusion TRIM62 may promote the autophagy process in ASMCs by inhibiting the p-mTOR-dependent autophagy pathway, thereby relieving the suppression of autophagy by the mTOR pathway. This, in turn, may be involved in regulating the process of vascular calcification.

Associations of FCGR3A gene polymorphisms with the risk of ulcerative colitis

LIN Limiao, YUAN Zihui, WANG Weizhong, SHAO Xiaoxiao, XU Yuan, CAO Shuguang, JIANG Yi

2026, 24(3): 399-402. doi: 10.16766/j.cnki.issn.1674-4152.004405

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Objective To investigate the association between FCGR3A gene polymorphisms and the risk of ulcerative colitis (UC), disease location, and clinicopathological features related to disease activity. Methods From January 2012 to January 2021, 545 UC patients and 545 age- and gender-matched healthy controls were recruited from the Department of Gastroenterology, the Second Affiliated Hospital of Wenzhou Medical University. The modified Mayo score was employed to assess the disease activity of UC. The FCGR3A polymorphisms (rs396991 and rs4656317) were genotyped using MALDI-TOF mass spectrometry. Haplotype analysis and linkage disequilibrium assessment were performed with Haploview 4.2 software. Results Genotype analysis revealed that the frequency of the C allele at rs396991 was significantly higher in UC patients than in healthy controls (P=0.025), and the frequencies of the C allele and its carriers at rs4656317 were also markedly elevated (both P < 0.001). The frequencies of the variant allele and genotype of rs396991 in patients with moderate-to-severe active UC were both higher than those in patients with mild active UC (P=0.012 and P=0.032, respectively). The rs4656317 and rs396991 loci of theFCGR3A gene exhibited strong linkage disequilibrium (D'=0.920, r²=0.667). Haplotype analysis demonstrated that the frequencies of AG (P=0.003) and CG (P=0.006) haplotypes were decreased, while those of CC (P=0.002) and AC (P=0.005) haplotypes were increased in the UC group; furthermore, the AG haplotype was downregulated and the CC haplotype was upregulated in moderate-to-severe active UC patients (P=0.032 and 0.003, respectively). Conclusion FCGR3A (rs396991, rs4656317) gene variations may be risk factors for UC. In addition, FCGR3A (rs396991) gene variation may also be related to the increased disease activity in UC patients.

Correlation between the characteristics of right ventricular remodeling and therapeutic response in patients with pulmonary hypertension

Alidan · Aierken, LI Mingyuan, Wangminawaer · Hujiaaihemaiti

2026, 24(3): 403-406. doi: 10.16766/j.cnki.issn.1674-4152.004406

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Objective Exploring the relationship between right ventricular remodeling characteristics and treatment responsiveness in patients with pulmonary arterial hypertension(PAH), providing insights for a more accurate assessment of patient prognosis. Methods A total of 102 PAH patients who visited the First Affiliated Hospital of Xinjiang Medical University from April 2020 to April 2024 were enrolled in this study. According to their treatment responsiveness, they were divided into a responsive group (n=79) and a non-responsive group (n=23). The differences in general clinical data, right-heart catheterization parameters before treatment, echocardiogram parameters, and cardiopulmonary function between the two groups were compared. Spearman analysis and logistic regression analysis were performed to screen out the risk factors for non-responsiveness to treatment in PAH patients. Results The proportion of patients with hypertension, mean pulmonary artery systolic pressure (PASP), pulmonary vascular resistance (PVR), transpulmonary gradient (TPG), the ratio of right-ventricular anterior-posterior diameter to left-ventricular anterior-posterior diameter at end-systole (RVADs/LVADs), the ratio of right-ventricular transverse diameter to left-ventricular transverse diameter at end-diastole (RVTDd/LVTDd), the ratio of right-ventricular transverse diameter to left-ventricular transverse diameter at end-systole (RVTDs/LVTDs), right-ventricular end-diastolic volume (3DRVEDV), and the Brog dyspnea score in the non-responsive group were significantly higher than those in the responsive group (P < 0.05). Spearman correlation analysis and logistic regression analysis showed that PVR, TPG, RVADs/LVADs, and 3DRVEDV were all important risk factors for non-responsiveness to treatment in PAH patients (OR=4.716, 2.083, 6.379, 1.721, all P < 0.05). Conclusion There is a significant correlation between the severity of right ventricular remodeling and non-responsiveness to treatment in PAH patients. Timely right-heart catheterization and echocardiogram have great clinical significance for evaluating the treatment prognosis of PAH patients.

Effects and mechanism of exosomes derived from menstrual blood-derived stromal cells in restoring ovarian function in a rat model of premature ovarian failure

XU Liya, CHENG Li, CHENG Xianying, WU Yanqin, LIU Minjie, YAN Guanghan, ZHANG Ting, XU Zhenyu

2026, 24(3): 407-410. doi: 10.16766/j.cnki.issn.1674-4152.004407

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Objective The purpose of this study was to explore the reparative effects and mechanisms of exosomes derived from menstrual blood-derived stromal cells (MenSCs-Exos) in restoring ovarian function of premature ovarian failure (POF) rats. Methods After the POF model was successfully established, it was divided into the transplantation treatment group and the placebo group (each 8 rats) using the random number table method. Both groups received tail vein injections of MenSCs-Exos and PBS. Control group (8 rats) was also set up. The physical conditions, body weight, and estrus cycle of the SD rats were monitored. Plasma was harvested to measure the levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), anti-Mullerian hormone (AMH), and estradiol (E2) by ELISA. The ovarian pathology and follicle counts were examined by HE. The protein concentration of B-cell lymphoma-2 (Bcl-2) and Bcl-2 associated X protein (Bax) in ovarian tissue were examined by ELISA. Results Rats in the transplantation group restored physical condition and the motility cycle after treatment. On day 14 after intervention, the weight of rats in the transplantation group was lower [(289.56±10.80) g] than that of the control group [(313.38±8.94) g] and higher than that of the placebo group [(280.82±4.40) g, P < 0.05]. The levels of LH and FSH in the transplantation group were significantly lower than those in the placebo group and higher than those in the control group, while the levels of AMH and E2 were significantly higher than those in the placebo group and lower than those in the control group (P < 0.05). The pathological morphology of the ovaries in the transplantation group was improved, with follicle numbers at all developmental stages lower than those of the control group and higher than those of the placebo group (P < 0.05). In addition, the concentration of Bcl-2 protein was lower than that of the control group and higher than that of the placebo group, while the concentration of Bax protein was higher than that of the control group and lower than that of the placebo group (P < 0.05). Conclusion MenSCs-Exos transplantation effectively restores ovarian function and ameliorates ovarian damage, potentially through regulation of apoptosis-related protein expression.

Construction and validation of a predictive model for the efficacy of neoadjuvant chemotherapy in patients with non-small cell lung cancer based on serum PI3K, AKT, and mTOR levels

PAN Kunlei, ZHENG Qingxiu, HUANG Yuenuo, LIU Gang

2026, 24(3): 411-414. doi: 10.16766/j.cnki.issn.1674-4152.004408

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Objective There are individual differences in the efficacy of neoadjuvant therapy for non-small cell lung cancer (NSCLC). Phosphatidylinositol-3-kinase (PI3K)/serine-threonine kinase (Akt)/mammalian target of rapamycin (mTOR) pathway is a key regulatory pathway for the occurrence and development of NSCLC. The aim of this study is to explore the efficacy of the prediction model based on the above serum indicators to guide clinical treatment decisions. Methods A total of 200 patients with NSCLC were selected from those admitted to Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from January 2024 to April 2025. They were randomly divided into a training set (n=141) and a validation set (n= 59) in a 7∶3 ratio. Biochemical tests were conducted before chemotherapy. LASSO regression was employed to screen for characteristic variables associated with the efficacy of neoadjuvant therapy in NSCLC patients. A predictive model was then constructed based on the random forest algorithm. The predictive performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analysis (DCA), and was externally validated on the independent validation set. Results The variables related to the efficacy of neoadjuvant chemotherapy in NSCLC patients included the maximum diameter of the tumor, degree of differentiation, PI3K mRNA, AKT mRNA, mTOR mRNA, and carcinoembryonic antigen(CEA). A random forest model was constructed based on the variables related to the non-response of neoadjuvant chemotherapy in NSCLC patients screened out by LASSO regression, and the AUC values in the training set and the validation set were 0.889 and 0.801, respectively. The Brier scores in the training set and validation set random forest models were 0.091 and 0.110 respectively. The DCA curve revealed that, in the training set, the curve was above the "None" line within the threshold probability range of 0.10 to 0.76, while in the validation set, it remained above the "None" line from 0.10 to 0.58. The performance of the training set was superior to that of the validation set, adhering to the golden rule of model validation. Conclusion The random forest model established based on serum levels of PI3K, AKT, and mTOR demonstrates high predictive efficacy for the response to neoadjuvant chemotherapy in patients with NSCLC, thereby facilitating clinical decision-making.

A predictive model for cervical lymph node metastasis in differentiated thyroid carcinoma based on PLT, NLR, PLR, and thyroid function parameters

WANG Chunyan, ZHOU Lanzhu

2026, 24(3): 415-419. doi: 10.16766/j.cnki.issn.1674-4152.004409

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Objective To analyze the relationship between platelet count (PLT), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), thyroid function related indicators, and cervical lymph node metastasis in differentiated thyroid cancer (DTC), and to provide a reference for optimizing the diagnosis and treatment strategy of DTC patients. Methods A total of 221 DTC patients admitted to the First Affiliated Hospital of Bengbu Medical University between January 2020 and January 2024 were enrolled. According to the presence or absence of cervical lymph node metastasis (LNM), the patients were divided into a metastasis group (n = 78) and a non-metastasis group (n = 143). Differences in PLT, NLR, PLR, and thyroid function-related indicators were compared between the two groups. Multivariate logistic regression analysis was used to analyze the influencing factors for DTC with cervical lymph node metastasis. ROC curves were plotted to evaluate the predictive performance of each independent risk factor individually and in combination for DTC with cervical lymph node metastasis. Results The proportion of patients in clinical stage Ⅱ, as well as the levels of PLT, NLR, PLR, thyroid-stimulating hormone (TSH), and thyroglobulin (Tg), were higher in the metastasis group than in the non-metastasis group (P < 0.05). Binary logistic regression analysis showed that clinical stage, PLT, NLR, PLR, TSH, and Tg were independent risk factors for DTC with cervical lymph node metastasis (P < 0.05). A nomogram risk prediction model for DTC with cervical lymph node metastasis was established. ROC analysis showed that the areas under the curve (AUC) for clinical stage, PLT, NLR, PLR, TSH, Tg, and the nomogram prediction model were 0.573, 0.720, 0.613, 0.738, 0.751, 0.718, and 0.898, respectively. Conclusion Clinical stage Ⅱ and elevated PLT, NLR, PLR, TSH, and Tg are independent risk factors for DTC with cervical lymph node metastasis. The nomogram prediction model constructed based on these factors demonstrates high predictive performance and clinical utility.

Analysis of the current status of Helicobacter pylori infection, antibiotic resistance, and associated factors in patients at a Grade B tertiary hospital

HU Kunmiao, ZHOU Limin, YU Zhenhua

2026, 24(3): 420-423. doi: 10.16766/j.cnki.issn.1674-4152.004410

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Objective To investigate the current status of Helicobacter pylori infection and its antibiotic resistance profile in a specific patient population at our hospital, and to analyze the association between the resistance patterns and factors such as sex and age. The findings aim to provide evidence to support individualized H. pylori eradication therapy in this region. Methods A total of 214 patients who underwent gastroscopy at the Chun'an Branch of Zhejiang Provincial People's Hospital between January 2022 and February 2023 were enrolled. Gastric mucosal specimens were collected from them for Hp culture and drug susceptibility testing to assess the prevalence of Hp infection and antibiotic resistance patterns. Results Among the 214 patients, 81 were tested positive for Hp infection, yielding an Hp infection rate of 37.85%. Among the 81 isolated Hp strains, resistance to six antibiotics were evaluated. The highest resistance rate was observed for metronidazole (76.54%), followed by amoxicillin (41.98%), and clarithromycin (20.99%). The difference in resistance rates among the six antibiotics was statistically significant (P < 0.001). Regarding resistance patterns, 39.51% of strains exhibited single-drug resistance, 32.10% showed dual resistance, 17.28% demonstrated triple resistance, and 3.70% exhibited multiple (over 3 types) resistance. Among patients with metronidazole monoresistance, those aged 50-64 years had the highest resistance rate (90.00%), whereas patients aged 18-29 years had the lowest resistance rate (46.15%). Conclusion The prevalence of Helicobacter pylori infection rate among patients in our hospital is lower than that reported in national epidemiological surveys, while the overall antibiotic resistance rate remains relatively high. The resistance rates to metronidazole, amoxicillin, and clarithromycin show an increasing trend, and age-related differences are observed in metronidazole monoresistance. Regional hospitals should perform susceptibility testing and implement targeted H. pylori eradication strategies based on resistance profiles.

Effect of multi-mode perception control and motion interactive rehabilitation on cancer related fatigue level of breast cancer patients undergoing chemotherapy

HUANG Yaqiong, ZHOU Fang, ZHU Weihong, ZOU Jing, CHEN Tiexia

2026, 24(3): 424-428. doi: 10.16766/j.cnki.issn.1674-4152.004411

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Objective This study aims to explore the intervention effect of exercise interactive rehabilitation system (MPCI-R) based on multimodal perceptual control technology on cancer-related fatigue (CRF) in breast cancer patients undergoing chemotherapy, and evaluate its effect on cellular immune function, in order to provide a more interactive and individualized rehabilitation program for clinical practice. Methods Seventy patients undergoing postoperative chemotherapy for breast cancer at Hangzhou First People's Hospital between January and December 2023 were randomly assigned to a control group (n=34) and an intervention group (n=35) using the random number table. The control group received conventional exercise rehabilitation and comprehensive CRF management. The intervention group also received an 8-week MPCI-R (≥5 sessions per week, ≥150 minutes cumulatively, aerobic and resistance training combined with wearable sensors and virtual reality feedback). The primary outcome was the piper fatigue scale-Chinese (RPFS-C) score at baseline, 4 weeks, and 8 weeks. Secondary outcomes were the percentages of CD3⁺, CD4⁺, CD8⁺ T cells, and natural killer (NK) cells in peripheral blood (baseline and 8 weeks). Results Baseline RPFS-C did not differ between groups (P>0.05). At 4 and 8 weeks after intervention, the RPFS-C of the intervention group was lower than that of the control group [(4.23±1.52) vs. (5.59±1.40), t=3.873, P < 0.001; (3.43±1.34) vs. (5.06±1.35), t=5.049, P < 0.001]. Repeated-measures ANOVA indicated significant main effects of group and time and a group×time interaction (P < 0.001). At week 8, the intervention group had higher CD3⁺ T cells, CD4⁺ T cells, and NK cell proportions and lower CD8⁺ T cells proportion than controls (P < 0.05). Conclusion Adding MPCI-R to usual care significantly reduces CRF and favorably modulates immune cell profiles during chemotherapy for breast cancer, supporting its feasibility and potential for broader implementation.

Progressive resistance training combined with neuromuscular exercise for the treatment of knee osteoarthritis and its impact on inflammatory factors

YANG Jun, CHU Ruzai, CHEN Zhengbin, CHEN Ying, CHEN Congping

2026, 24(3): 429-432. doi: 10.16766/j.cnki.issn.1674-4152.004412

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Objective In recent years, non-pharmacological treatments (such as exercise therapy) have become increasingly prominent in the management of knee osteoarthritis (KOA), but traditional single-mode rehabilitation interventions have therapeutic limitations. This study aims to explore the clinical efficacy of progressive resistance training (PRT) combined with neuromuscular exercise therapy (NEMEX) in patients with knee osteoarthritis (KOA) and its impact on inflammatory factors in knee synovial fluid. Methods A total of 110 patients with KOA admitted to the Department of Orthopedics, People's Hospital of Tiantai County from July 1, 2024 to July 1, 2025 were selected as the research subjects. The patients were randomly grouped, with 55 cases in each group. The control group was treated with NEMEX, while the observation group was treated with NEMEX+PRT for a total of eight weeks. The system collected the clinical data of the two groups of patients before treatment and eight weeks after treatment, mainly including the assessment of the degree of pain by the visual analogue scale (VAS) for pain. The knee osteoarthritis score scale (KOOS) and the knee joint function score (Lysholm) were used to assess the severity of the patient's condition. Knee joint range of motion (AROM) and 10-meter walk test (10MWT) were used to assess the patients' mobility. The levels of IL-17, IL-1β, and PGE2 in knee joint synovial fluid. The quality of life of patients was evaluated by using the Quality of Life Scale (QOL) and the Activity of Daily Living Scale (ADL). Results After treatment, the VAS score and 10MWT of the patients in the observation group were significantly lower than those in the control group [(2.52±0.71) points vs. (3.18±0.86) points; (10.37±1.27) s vs.(11.21±1.36) s, P < 0.05]. The scores of KOOS, Lysholm, AROM, QOL, and ADL in the observation group were higher than those in the control group (P < 0.05). After treatment, the levels of IL-17, IL-1β, and PGE2 in both groups decreased, and those in the observation group were lower than those in the control group during the same period (P < 0.05). Conclusion Progressive resistance training combined with neuromuscular exercise therapy has a good clinical application effect in patients with knee osteoarthritis. It can improve pain conditions, enhance the motor capacity of the knee joint, reduce the levels of inflammatory factors in the knee joint, and improve the living ability and quality of life of patients.

Study on the curative effect of added Banxia Baizhu Tianma Decoction combined with Meridian craping in the treatment of phlegm-dampness obstructing hypertension

LU Yonghong, SUN Yanqin, YANG Honglei, CAO Yanyan, LIU Yanping

2026, 24(3): 433-436. doi: 10.16766/j.cnki.issn.1674-4152.004413

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Abstract:
Objective To investigate the clinical efficacy of supplemented Banxia Baizhu Tianma Decoction combined with Meridian craping in treating hypertension with phlegm-dampness obstructing and its influence on blood viscosity, and to provide a reliable integrated plan for the clinical treatment of hypertension. Methods A total of 104 hypertensive patients were admitted to the First Affiliated Hospital of Henan University of Chinese Medicine from January 2024 to May 2024. These patients were divided into a control group and a study group, with 52 patients assigned according to the random number table. The control group received amlodipine treatment, while the study group received a combination of supplemented Banxia Baizhu Tianma Decoction and Meridian scraping. Following a period of six weeks, a comparison was made of the therapeutic effect, blood pressure change, TCM syndrome score, blood viscosity and the occurrence of adverse reactions. Results The total effective rate of the study group was 90.38% (47/52), which was higher than that in the control group [73.08% (38/52), χ²=4.300, P=0.038]. After treatment, SBP and DBP in two groups were lower (P < 0.05), and the study group were lower than control group [(126.31±6.28) mmHg vs. (130.48±7.20) mmHg, (75.54±7.12) mmHg vs. (79.85±6.30) mmHg, P < 0.05, 1 mmHg=0.133 kPa]. After treatment, a reduction in TCM syndrome score, red blood cell aggregation index and plasma viscosity was observed in both groups (P < 0.05), and the study group were lower than control group (P < 0.05). Conclusion Supplemented Banxia Baizhu Tianma Decoction combined with Meridian scraping has a good effect on treating hypertension, which can further reduce blood pressure, improve TCM syndromes, regulate blood viscosity and have good safety.

Investigation into the use of an intelligent follow-up management system for enhancing self-management skills in patients with chronic kidney disease

YING Jiapei, HUANG Dandan, CHEN Lingling, YAO Yao, GAN Rong, DAI Lili

2026, 24(3): 437-441. doi: 10.16766/j.cnki.issn.1674-4152.004414

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Abstract:
Objective The intelligent follow-up management system was applied in patients with CKD to evaluate its effects on self-management ability. Methods From April 2022 to March 2023, 207 patients with CKD recruited from a tertiary hospital in Zhejiang Province were randomly allocated into an intervention group (n=103) and a control group (n=104). The control group was followed up regularly, while the intervention group adopted intelligent follow-up management. Self-management ability, physiological indicators, standardized follow-up rate, and unplanned hospitalization rate were compared between the two groups before the intervention, 6 months post-intervention, and 12 months post-intervention. Results At 6 months and 12 months post-intervention, the intervention group's total self-management ability scores were (82.49±6.58) points and (89.07±5.29) points, respectively, which were significantly higher than those of the control group (77.25±10.56) points and (78.41±9.24)points, with statistically significant differences (P < 0.001); health indicators of the intervention group, including the estimated glomerular filtration rate difference (ΔeGFR), BMI compliance rate, diastolic blood pressure and systolic blood pressure were superior to those of the control group, with statistically significant differences (P < 0.05). After the intervention, the intervention group achieved a significantly higher standardized follow-up rate [86.80% (80.00%, 100.00%)] compared to the control group [71.15% (50.00%, 100.00%), Z=5.241, P < 0.001]; clinically meaningful reductions in unplanned hospitalization rate were achieved in the intervention group 15.5% (15/97), substantially below control levels 28.0% (28/100), with statistical confirmation (χ²=4.535, P=0.033). Conclusion The intelligent follow-up management system can significantly enhance self-management proficiency in patients with CKD, improve health indicators.

Observation of the clinical effect of cardiac rehabilitation in patients with chronic heart failure

CHANG Yan, MA Weitao, WANG Lin, SHI Zenggang

2026, 24(3): 442-446. doi: 10.16766/j.cnki.issn.1674-4152.004415

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Abstract:
Objective Exploring the impact of cardiac rehabilitation on cardiopulmonary function, self-management ability, and quality of life in patients with chronic heart failure. Methods 99 patients with chronic heart failure admitted to Bengbu Third People's Hospital from March 2022 to March 2024 were randomly divided into two groups. The control group (50 cases) received routine nursing care, while the study group (49 cases) received cardiac rehabilitation nursing care. Observe the cardiopulmonary function indicators, self-care ability, and quality of life before and after intervention in two groups, as well as the 3-month recurrence rate of heart failure and adverse cardiac events. Results After intervention, both groups showed significant improvement in cardiac and pulmonary function indicators, and the study group had a 6-minute walking distance, VO_2max, oxygen pulse, and maximum exercise time improvement, all of which were higher than the control group (P < 0.05); The self-care score of the research group was (189.93±19.97) points, which was higher than that of the control group [(155.72±22.05) points, P < 0.05]; The quality of life score of the research group was (41.38±5.79) points, lower than that of the control group [(49.17±5.95)points, P < 0.05]; After 3 months of discharge, the recurrence rate of chronic heart failure and the incidence of adverse cardiac events (MACE) in the study group, respectively, which were lower than those in the control group(P < 0.05). The interval between episodes of chronic heart failure was longer than that in the control group (t=27.675, P < 0.001). Conclusion The implementation of cardiac rehabilitation nursing mode for patients with chronic heart failure can significantly improve their cardiopulmonary function, enhance their self-care ability and quality of life, improve prognosis, and has important clinical application value.

Etiological characteristics of recurrent urinary tract infection in children and construction of risk factors model for recurrence

SONG Han, GAO Yanli, LI Jinling, CHENG Mengmeng, WANG Hongyang, YANG Ying

2026, 24(3): 447-450. doi: 10.16766/j.cnki.issn.1674-4152.004416

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Abstract:
Objective To explore the etiological characteristics of recurrent urinary tract infection in children, aiming to provide a reference for the early clinical identification of high-risk children and the formulation of individualized intervention strategies. Methods A total of 160 children with urinary tract infection in the Children's Hospital Affiliated to Capital Institute of Pediatrics were selected from July 2021 to December 2024. The general data and clinical symptoms of children were collected. The patients were followed up for half a year and divided into non-recurrence group (103 cases) and recurrence group (57 cases) based on the recurrence status of urinary tract infection. The two groups were compared in terms of differences in clinical characteristics of urinary tract infection. Logistic regression analysis was performed to screen the predictive variables, and a prediction model was established. Results A total of 175 strains of pathogenic bacteria were cultured in 160 children with first infection, with Escherichia coli being the predominant pathogen. The rate of Escherichia coli infection in the recurrent children was higher than that in the non-recurrent children, and the rate of complex infection was also higher (P < 0.05). The recurrence group exhibited higher proportions of children with anemia, urinary system malformation, indwelling catheterization time of 5-10 d and reduced IgA than the non-recurrence group (P < 0.05). Multivariate analysis suggested that complex infection, urinary system malformation, and non-standard use of antibiotics were independent risk factors of recurrence of urinary tract infection in children (P < 0.05). The results of model validation showed that AUC was 0.773 (95% CI: 0.684-0.862), indicating that the model had a good discrimination degree. The calibration curve was close to the ideal curve (Hosmer-Lemeshow P=0.152), indicating that the model had good predictive efficiency. Decision curve revealed that when the prediction probability threshold was in the range of 0.10-0.97, the model of this study had a higher predicted net benefit value. Conclusion The main pathogen of recurrent urinary tract infection in children is Escherichia coli, and complex infection is predominant. Complex urinary tract infection, urinary system malformation and non-standard use of antibiotics are independent risk factors of recurrence. Early identification and intervention can help to improve the prognosis.

Investigation and analysis of trauma perception and influencing factors in postpartum women undergoing vaginal delivery

LI Fangfang, FAN Shuli, LIN Feng, TAN Xiaoxue, XIA Huihua, ZENG Haixia

2026, 24(3): 451-454. doi: 10.16766/j.cnki.issn.1674-4152.004417

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Abstract:
Objective To investigate the current status of postpartum trauma perception in women undergoing vaginal delivery and analyze its influencing factors. Methods Convenience sampling was used to select postpartum women who underwent vaginal delivery in our hospital from February 2022 to January 2023 as the research subjects. We conducted a survey on postpartum women using a general information questionnaire, the Postnatal Trauma Perception Scale for Vaginal Delivery, the Family Care Index (APGAR), and the Childbirth Attitude Scale (CAQ). Pearson correlation analysis was conducted to investigate the relationship between postpartum trauma perception, family care, and childbirth fear among women who had vaginal delivery. Multiple linear regression analysis was used to investigate the influencing factors of postpartum trauma perception in women undergoing vaginal delivery. Results The total score of trauma perception during vaginal delivery was (81.05±21.41) points, which was above average. The total score of family care was (8.27±1.06) points, and the total score of childbirth fear was (38.71±8.49) points; Pearson correlation analysis showed that there was a negative correlation (r=-0.286, P < 0.05) between the total score of the delivery trauma awareness scale and the total score of the APGAR scale for women undergoing vaginal delivery, and a positive correlation (r=0.397, P < 0.01) with the total score of the CAQ scale. Multiple linear regression analysis showed that parity, frequency of prenatal check ups, family care, frequency of pregnancy education, fear of childbirth, and understanding of the vaginal delivery process were factors affecting the perception of delivery trauma in women undergoing vaginal delivery (P < 0.05), which could explain 32.5% of the variance variation in the perception of delivery trauma in women undergoing vaginal delivery. Conclusion The perception of childbirth trauma among women undergoing vaginal delivery is at a moderate to high level. Factors influencing the perception of childbirth trauma among women undergoing vaginal delivery include parity, frequency of prenatal check-ups, family care, frequency of pregnancy education, fear of childbirth, and understanding of the vaginal delivery process. Medical staff should pay attention to the emotional changes of postpartum women, carry out diversified and effective prenatal health education activities, stimulate their positive psychological state, and thereby reduce their perception of childbirth trauma.

Rethinking the professional spirit of family doctors in integrated medical and elderly care services in mountainous areas under the digital intelligence era

PEI Ruotong, WANG Haili, WANG Runying, ZHANG Yiyao, PENG Yingchun

2026, 24(3): 455-459. doi: 10.16766/j.cnki.issn.1674-4152.004418

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Abstract:
Objective To investigate integrated elderly care services in mountainous regions and the professional challenges faced by family doctors in the digital intelligence era, with a view to proposing improvement strategies. Methods A study was conducted in five townships in the northern Huairou Districtof Beijing, with the implementation of the "Comprehensive Remote Diagnosis and Treatment Model". Surveys were administered to 217 elderly residents and five community health centers, combined with interviews and case analysis of Liulimiao Community Health Center ' s remote services. Results The majority of elderly residents expressed a preference for home-based care (178 cases, 82.03% of whom resided with their spouses), with a 63.59% prevalence of chronic diseases (138 cases) and a higher level of trust in rural doctors (116 cases, 53.46%). While family doctors demonstrated proficiency in digital technologies, they encountered challenges such as inadequate transportation and communication infrastructure, which they anticipated would have a detrimental effect on professional activities. The majority of family doctors and their team members believe that digital and intelligent technologies have a positive impact on their work efficiency (60 cases, 76.92%) and quality (59 cases, 75.64%). Conclusion Family doctors in mountainous areas encounter difficulties including low efficiency, expanded service scope, heightened risks associated with home visits, and communication barriers. The recommendations set out in the report include adopting smart medical technologies, improving elderly-adapted environments, refining primary care policies, and enhancing doctor-patient communication.

Prevalence and clinical characteristics of chronic constipation in elderly patients with type 2 diabetes mellitus under family doctor contract management

ZHU Xuemei, TAO Jie, TAN Juan

2026, 24(3): 460-463. doi: 10.16766/j.cnki.issn.1674-4152.004419

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Abstract:
Objective To investigate the prevalence of chronic constipation among community-dwelling elderly patients with type 2 diabetes mellitus (T2DM) and to analyze their clinical characteristics regarding metabolic profiles, lifestyle factors, and psychological status, aiming to provide scientific evidence for comprehensive interventions in this population. Methods A cross-sectional survey was conducted from June 2022 to June 2024 involving 293 elderly T2DM patients under contract management in Huaihai Community, Huaian City. Demographic characteristics, lifestyle, constipation symptoms, psychological scores, and biochemical indicators were collected and compared between the constipation and non-constipation groups. Results The prevalence of chronic constipation was 37.5% (110/293). Compared with the non-constipation group, the constipation group was older [(74.26±7.69) years vs. (70.66±6.25) years, P < 0.001] and had a longer diabetes duration [15.00(5.00, 20.00)years vs. 10.00(5.00, 18.50)years, P=0.016]. The rates of adequate coarse grain intake (47.71% vs. 61.67%, P=0.020), daily water intake (72.22% vs. 84.83%, P=0.010), sleep duration (38.89% vs. 52.51%, P=0.025), and physical activity (72.48% vs. 83.71%, P=0.022) were significantly lower in the constipation group. Additionally, the constipation group exhibited higher HbA1c levels [(7.82±1.70)% vs. (7.24±1.08)%, P=0.019] and anxiety/depression scores (P < 0.001), while estimated glomerular filtration rate was significantly lower [(79.97±21.81) mL/(min·1.73 m²) vs. (86.69±24.99) mL/(min·1.73 m²), P=0.023]. Conclusion Community-dwelling elderly T2DM patients with chronic constipation are characterized by advanced age, longer diabetes duration, poor glycemic control, reduced renal function, significant anxiety and depression, and unhealthy lifestyle habits.

Efficacy of repetitive transcranial magnetic stimulation combined with cognitive behavior therapy on post-stroke depression

HE Ting, CHEN Xiaohong, ZHONG Genlong, LAN Likang, LIU Minfen, WU Yu, LIU Huifen

2026, 24(3): 464-467. doi: 10.16766/j.cnki.issn.1674-4152.004420

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Abstract:
Objective To investigate the repetitive transcranial magnetic stimulation (rTMS) combined with cognitive behavior therapy (CBT) on post-stroke depression (PSD). Methods Eighty patients diagnosed with post-stroke depression in our hospital from September 2022 to August 2023 were selected. They were divided into a control group and an observation group according to the random number table, with 40 cases in each group. During the research process, 5 cases dropped out. In the end, there were 37 cases in the observation group and 38 cases in the control group. The control group received conventional treatment, while the observation group was additionally treated with low-frequency repetitive transcranial magnetic stimulation (rTMS) and cognitive-behavioral therapy, and the treatment lasted for 8 weeks. Before treatment, at 4 weeks of treatment, and at 8 weeks of treatment, the self-rating depression scale (SDS), self-rating anxiety scale (SAS), mini-mental state examination (MMSE), Pittsburgh sleep quality index (PSQI), and National Institutes of Health stroke scale (NIHSS) were used to assess the emotional state, mental state, sleep condition, and neurological function rehabilitation of the two groups of patients. Results At 4 weeks and after 8 weeks of treatment, SDS, SAS, MMSE, PSQI, and NIHSS scores of patients in both groups were significantly improved (P < 0.001), and the observation group was better than the control group. After 4 weeks of treatment, MMSE and NIHSS in the observation group improved significantly compared with the control group [(24.67±1.33) points vs. (21.55±1.48) points, F=9.608, P < 0.001; (8.43±1.01) points vs. (9.15±0.97) points, F=3.147, P=0.002]. After 8 weeks of treatment, the SDS, SAS, MMSE, PSQI, and NIHSS in the observation group improved significantly compared with the control group (P < 0.001). Conclusion Repetitive transcranial magnetic stimulation combined with cognitive behavior therapy can effectively improve sleep quality, relieve depression in patients with post-stroke depression, and enhance cognitive behavior.

Clinical study of sodium valproate sustained release tablets combined with risperidone in the treatment of mental and behavioral symptoms of Alzheimer ' s disease

FAN Dekang, LING Yingchun, LYU Pingping, WANG Haiyan

2026, 24(3): 468-471. doi: 10.16766/j.cnki.issn.1674-4152.004421

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Abstract:
Objective To investigate the efficacy and safety of sodium valproate sustained-release tablets combined with risperidone in the treatment of Alzheimer ' s disease (AD) with psychobehavioral symptoms (BPSD), providing evidence for clinical treatment strategies. Methods A total of 186 patients with AD with BPSD admitted to Yongkang Third People ' s Hospital from May 2023 to April 2025 were randomly divided into group A and group B. 93 cases in group A were treated with risperidone, and 93 cases in group B were treated with sodium valproate sustained-release tablets combined with risperidone. The cognitive function, mental and behavioral symptoms, activities of daily living, clinical efficacy, and adverse reactions of the two groups were observed. Results The Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) scores of the two groups were improved after treatment (P < 0.05), and the MoCA and MMSE scores of group B were higher than those of group A (P < 0.05). After treatment, the behavioral pathology in the Alzheimer ' s disease rating scale (BEHAVE-AD) and neuropsychiatric inventory (NPI) scores in the two groups were decreased (P < 0.05), and the BEHAVE-AD and NPI scores in group B were lower than those in group A (P < 0.05). After treatment, the ADL scores of the two groups were improved (P < 0.05), and the ADL scores of group B were higher than those of group A (P < 0.05). The total effective rate of group B was 86.02% (80/93), which was higher than 74.19% (69/93) of group A (χ²=4.082, P=0.043). The incidence of adverse reactions was 12.90% (12/93) in group A and 10.75% (10/93) in group B, and there was no significant difference between the two groups (P>0.05). Conclusion Sodium valproate sustained-release tablets combined with risperidone in the treatment of AD with BPSD can improve the cognitive function, mental behavior-related symptoms, and the ability of daily life of patients, improve the clinical efficacy, and perform well in terms of safety, which is worthy of promotion.

Exploratory study on 3D-CPA for differential diagnosis and efficacy evaluation of AUB-O in perimenopause

BIAN Huanjie, QIAN Lyuli, ZHANG Linyan

2026, 24(3): 472-475. doi: 10.16766/j.cnki.issn.1674-4152.004422

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Abstract:
Objective To explore the clinical value of three dimensional energy Doppler ultrasound (3D-CPA) in the diagnosis, evaluation, and efficacy monitoring of perimenopausal ovulation disorders associated with abnormal uterine bleeding (AUB-O). Methods A total of 160 patients with perimenopausal AUB and 160 healthy subjects admitted to Zhuji Maternal and Child Health Hospital were selected as the study subjects from September 2020 to March 2024. All study subjects underwent a uterine 3D-CPA examination to explore the differences in 3D-CPA parameters between perimenopausal AUB-O patients and other types of AUB patients, as well as healthy women. Results The 3D-CPA indicators of endometrial volume (EV), vascularity index (VI), flow index (FI), and vascular flow index (VFI) in perimenopausal AUB-O patients were higher than those in other types of AUB patients and healthy subjects (P < 0.001). Although the endometrial thickness of AUB-O patients and other types of AUB patients was higher than that of healthy subjects (P < 0.001), the difference between AUB-O patients and other types of AUB patients was not statistically significant (P>0.05). After 2 weeks of mifepristone treatment, the serum follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels in perimenopausal AUB-O patients significantly decreased compared to before treatment [(13.96±2.07) IU/L vs. (22.96±3.14) IU/L; (12.06±1.58) IU/L vs. (19.78±2.49) IU/L; (52.63±6.12) ng/L vs. (96.54±10.49) ng/L, P < 0.001]. The EV, VI, FI, and VFI values of AUB-O patients who were effectively treated with mifepristone were significantly lower than those of patients who were ineffective in treatment (P < 0.001). The changes in EV, VI, FI, and VFI before and after mifepristone treatment in perimenopausal AUB-O patients were positively correlated with changes in sex hormone levels (P < 0.05). Conclusion 3D-CPA examination can effectively identify the differences in uterine blood flow supply and endometrial proliferation activity between AUB-O patients and healthy subjects, as well as between AUB-O patients with different therapeutic levels. Therefore, it has potential application value in AUB-O diagnosis, therapeutic evaluation, disease monitoring, and prognosis evaluation.

The double effect of autophagy on stroke and the progress of acupuncture intervention

LUO Baochun, LIU Sifan, ZHENG Jia, ZHENG Lei, ZHANG Baiwen, SHANG Tong, SHANG Yaxin, ZOU Wei

2026, 24(3): 476-480. doi: 10.16766/j.cnki.issn.1674-4152.004423

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Abstract:
Stroke is defined as a severe malignant cerebrovascular event that poses a significant threat to human health. It is distinguished by a high incidence, high disability rate and high mortality rate. The exploration of the pathogenesis and effective treatment methods of stroke is a key and challenging focus of both traditional Chinese medicine and Western medicine research. Autophagy, a pivotal degradation and metabolic mechanism in eukaryotic cells, plays a crucial role in maintaining cellular homeostasis, responding to oxidative stress and regulating energy metabolism. Researchers have demonstrated that autophagy exhibits a bidirectional regulatory function in the context of stroke: moderate autophagy is beneficial for clearing damaged organelles and proteins, maintaining energy homeostasis, and exerting protective effects; however, excessive or insufficient autophagy may promote inflammatory responses and cell death. Furthermore, the role of autophagy exhibits dynamic variation across the various pathological stages of stroke. Acupuncture, a fundamental element of traditional Chinese medicine, has been demonstrated to play a substantial role in promoting recovery from central nervous system diseases. Among its advantages are high safety and proven therapeutic efficacy in the treatment of stroke. Mechanistic studies have demonstrated that acupuncture can regulate key autophagy proteins and affect multiple signaling pathways, thus promoting normal autophagy activation to aid cellular self-repair, while also inhibiting excessive autophagy to reduce cell death, achieving neuroprotection and functional recovery. The therapeutic effect of acupuncture on stroke is closely related to its dynamic regulation of autophagy levels. This regulatory process is not simply activation or suppression, but is tailored according to disease stages and pathological types. This review methodically summarizes the mechanisms of autophagy in stroke, and the potential role of acupuncture in regulating autophagy for stroke treatment, with the objective of providing more comprehensive theoretical support for acupuncture therapy in stroke.

The mechanism of LncRNA regulating ubiquitination and its research progression in cancer

LIU Hanyan, LIU Ke, ZHANG Fen, LIU Junjiang, HUANG Ge, LI Na

2026, 24(3): 481-485. doi: 10.16766/j.cnki.issn.1674-4152.004424

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Abstract:
Long non-coding RNAs (LncRNAs) are a class of RNA molecules that surpass 200 nucleotides in length, distinguished by the absence of an open reading frame and primarily transcribed by RNA polymerase Ⅱ. LncRNAs have been demonstrated to play pivotal roles in epigenetic regulation, gene expression modulation, and protein post-translational modifications. Ubiquitination, a critical post-translational modification mechanism, regulates protein stability, activity and degradation by changing intracellular target proteins. A plethora of biological activities, encompassing cell signaling pathways, metabolic reprogramming, immunological evasion and oncogenesis, are intricately linked to the ubiquitination process. Research has demonstrated that LncRNAs influence the process by modulating ubiquitinases and engaging with substrate proteins or deubiquitinases. For instance, LncRNAs have been shown to function as molecular scaffolding to help ubiquitinated complexes form or directly interact with ubiquitinases to modulate their catalytic activity, stabilizing and inhibiting target protein ubiquitination. By activating signaling pathways or repressing tumor suppressors such as p53, LncRNAs can help or hinder cancer cells proliferation. Furthermore, certain LncRNAs have been found to regulate the ubiquitination of immune-related molecules or metabolic enzymes inside the tumor microenvironment, thus facilitating cancer ' s evasion of immune surveillance or modifying energy metabolism to enhance the survival and dissemination of cancer cells. The present review aims to elucidate how LncRNAs influence protein ubiquitination and their roles in cancer, thereby providing new insights into searching mechanisms of cancer development and screening the therapeutic targets.

Effect of ear acupoint "three sequence" therapy combined with fire dragon jar in improving insomnia of cancer patients

DONG Huaqian, XIE Wei, CHEN Xiaoqiong, WEI Wei, TIAN Tian, REN Xiuya

2026, 24(3): 486-490. doi: 10.16766/j.cnki.issn.1674-4152.004425

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Abstract:
Objective To observe the effects of the ear acupoint "three sequence" therapy combined with the fire dragon jar comprehensive moxibustion technique on the sleep, mood, and physical condition of cancer patients. Methods A total of 108 cases of tumor insomnia treated at the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from January 2023 to December 2023 were selected.The patients were randomly divided into ear acupoint group, fire dragon jar group, and combination group using a random number table method, with 36 patients in each group.A total of 98 cases were finally included in the study, with 33 cases in the ear acupoint group, 31 cases in the fire dragon jar group, and 34 cases in the combination group.All three groups received routine care.The ear acupoint group provided patients with the ear acupoints "three sequence" therapy, the fire dragon jar group provided patients with fire dragon jar comprehensive moxibustion treatment, and the combination group provided patients with ear acupoints and fire dragon jars.The three groups received the same treatment frequency, with an intervention duration of 1 month.Before and after intervention, Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), and Karnofsky performance status (KPS) were used to evaluate the sleep, anxiety, and physical condition of the subjects. Results The ear acupoint group showed a significant efficacy rate of 72.7%(24/33), the effective rate of the fire dragon jar group was 64.5%(20/31), and the combination group showed a significant efficacy rate of 94.1%(32/34).After intervention, there was statistically significant difference in the PSQI total score between the three groups (P < 0.05), and the PSQI total score of the combined group was lower than that of the fire dragon jar group (P < 0.05).There was statistically significant difference in SAS standard score between the three groups (P < 0.05), and the SAS standard score in the ear acupoint group and the combination group was lower than that in the fire dragon jar group (P < 0.05).There was a significant difference in KPS scores among the three groups (P < 0.05), and the KPS score in the combination group was higher than that in the ear acupoint group (P < 0.05). Conclusion The combination of the ear acupoint "three sequence" therapy combined with the fire dragon jar comprehensive moxibustion can effectively improve the sleep quality of cancer insomnia patients, alleviate anxiety and negative emotions, improve their physical state to a certain extent.

The clinical efficacy of Huatan Tongluo Decoction+Acupuncture on nuchal region for dysphagia disorder after stroke with wind-phlegm-blocked collateral syndrome

YUAN Qiangqiang, SUN Lulu, ZHENG Qi, KONG Lingzhong, ZHANG Kun

2026, 24(3): 491-494. doi: 10.16766/j.cnki.issn.1674-4152.004426

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Abstract:
Objective To verify the clinical effect of Huatan Tongluo Decoction combined with acupuncture,clarify its role in improving patients'swallowing function and alleviating clinical symptoms,and provide a reference for diagnosis and treatment. Methods A total of 94 patients with dysphagia disorder after stroke with wind-phlegm-blocked collateral syndrome treated in Bozhou People's Hospital from March 2024 to August 2025 were chosen and separated into the control group (n=47,conventional treatment+rehabilitation training) and the observation group (n=47,Huatan Tongluo Decoction+acupuncture on the nuchal region on the basis of the control group) by random number table method.The clinical efficacy,TCM syndrome score,swallowing function,inflammatory factor level,and adverse reactions were compared. Results After 4 weeks of treatment,the total effective rate of the observation group was 95.74%(45/47),which was higher than that of the control group (80.85%,38/47,χ²=5.045,P=0.025);after 4 weeks of treatment,the TCM syndrome score of the observation group was lower (P<0.05);after 4 weeks of treatment,the proportion of grade Ⅰ swallowing function in the observation group was 29.79%,which was higher than that of the control group (12.77%,P<0.05);after 4 weeks of treatment,the levels of inflammatory factors in the observation group were lower than those in the control group (P<0.05);the incidence of adverse reactions in the two groups was 6.38%(3/47) and 12.77%(6/47) respectively,and there was no significant difference (χ²=0.490,P=0.483). Conclusion Huatan Tongluo Decoction combined with acupuncture on the nuchal region has a good effect on dysphagia disorder after stroke,which can significantly improve the symptoms of dysphagia,improve the swallowing function,reduce inflammation,and have high safety.

Therapeutic effect of holographic ear copper needle scraping combined with ear acupressure on adolescent depression and its impact on non-suicidal self-injury behavior

LUO Ping, TANG Zhixian, YAN Rong, JIN Mingmin, WANG Yuanyuan, WEI Jianhong

2026, 24(3): 495-498. doi: 10.16766/j.cnki.issn.1674-4152.004427

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Abstract:
Objective To investigate the therapeutic effect of holographic ear copper needle scraping combined with ear acupressure on adolescent depression and its impact on non-suicidal self-injury (NSSI) behavior, aiming to provide reference for clinical treatment. Methods A total of 160 outpatient and inpatient adolescent depression patients from Shaoxing Seventh People's Hospital from January to December 2024 were randomly divided into a control group (group A), an ear acupressure group (group B), a holographic ear copper needle scraping group (group C), and a holographic ear copper needle scraping combined with ear acupressure group (group D), with 40 cases in each group.Intervention for 8 weeks, the depressive symptoms[17-item Hamilton depression rating scale (HAMD-17) score], NSSI behavior occurrence[Ottawa self-injury inventory (OSI) score], depression TCM syndrome score, and clinical efficacy were observed. Results The HAMD-17 scores of groups B, C, and D decreased after treatment (P < 0.05), and the HAMD-17 score of group D was lower than that of group A, B, and C after treatment (P < 0.05).The OSI scores of groups B, C, and D decreased after treatment (P < 0.05), and the OSI score of group D was lower than that of group A, B, and C after treatment (P < 0.05).The TCM syndrome scores of depression in groups B, C, and D decreased after treatment (P < 0.05), while the TCM syndrome scores of depression in group D were lower than those in groups A, B, and C after treatment (P < 0.05).The total effective rates of groups A, B, C, and D were 20.00%(8/40), 80.00%(32/40), 77.50%(31/40) and 95.00%(38/40), the overall efficacy rates of Group B, Group C, and Group D were all higher than that of Group A (P < 0.008), with no statistically significant difference observed between Group D and Groups B and C (P>0.008). Conclusion The combination of holographic ear copper needle scraping and ear acupressure has a good therapeutic effect on adolescent depression, which can alleviate patients'depressive symptoms and improve NSSI behavior.

Evaluation of the effect of Kirkpatrick's evaluation model on the standardized training of order oriented medical students in Yunnan Province

WANG Xing, HUANG Qiaoyun, LIU Yingyurui, LEI Anye, CHEN Yuechao, LI Weiming

2026, 24(3): 499-503. doi: 10.16766/j.cnki.issn.1674-4152.004428

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Abstract:
Objective To evaluate the current status and effectiveness of standardized residency training for order-directed medical students in Yunnan Province based on the Kirkpatrick four-level evaluation model, and to provide reference suggestions for residency training bases. Methods From June to August 2022, a cross-sectional survey was conducted using stratified cluster sampling and questionnaires among 608 order-directed medical students from 8 general practice training bases in Yunnan Province.Simultaneously, interviews were conducted with some trainees, teaching staff, and administrators. Results Among the 608 order-directed medical students, 547(90.0%) were aware of the standardized training policy, and 555(91.3%) expressed support for the policy.Trainees indicated that practical operation opportunities and teaching quality at different bases were critical factors affecting the pass rate of the final assessment.In their self-assessment of core competencies, the top three factors ranked were professional ethics[(3.79±0.74) points], communication and collaboration[(3.70±0.76) points], and patient management[(3.61±0.74) points].However, some trainees showed low learning initiative, with salary satisfaction being the lowest[(2.65±1.01) points].Only 160 trainees (26.3%) chose to remain in primary care after completing their service, and their willingness to work[(3.79±0.74) points]was also a concern. Conclusion The implementation of standardized residency training for order-directed medical students in Yunnan Province has achieved positive outcomes.While these students demonstrate a basic understanding of the program's policies, they express a desire for improved salary and benefits.Although homogenization in training quality is evident, disparities persist.Post-training, their professional competencies have improved, yet their willingness to continue serving in primary healthcare after completing the residency remains low.

Application of formative assessment in teaching ward rounds of standardized training for general practice residents

NIU Xiaolu, SONG Zhixiu, ZHU Yingjie, GUAN Xinlei, SHI Zhuolin, WAN Yonggan

2026, 24(3): 504-506. doi: 10.16766/j.cnki.issn.1674-4152.004429

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Abstract:
Objective Standardized training for general practice residents (hereafter referred to as "resident training") is an important method of cultivating excellent general practitioners.Standardized teaching rounds have been shown to improve the teaching quality and learning outcomes.Formative evaluation is an effective teaching evaluation method that can help teachers to understand the learning status of students in a timely manner, and promote the improvement of teaching quality.The purpose of this study is to explore the application value of formative evaluation in the teaching rounds of general practice residential training. Methods The present study selected general practice resident trainees who rotated in the Department of General Medicine at the First Affiliated Hospital of Xinxiang Medical College from January 2022 to June 2023 as the research subjects, conducting formative evaluation using the Questionnaire Stars platform, and collecting their satisfaction with teaching rounds before and after the formative evaluation.Simultaneously, collect the supervision and evaluation of the teaching staff by the hospital's residential training center.A comparative analysis of the application value of formative assessment in teaching rounds is presented herein. Results A total of 573 resident trainees and 3 supervising teachers participated in this study.The mean satisfaction rating of students after completing the formative assessment was 4.49±0.61, significantly higher than before the formative assessment (4.09±0.79, t=5.082, P < 0.001).An analysis of the detailed rules set out in the supervision score sheets of the three teachers showed that the scores were on the rise, particularly in the chronic disease management, two-way referral, curriculum ideology and politics, professional English application and other aspects of general practice, which had improved the teaching ability of teachers in the overall quality of our hospital as a whole. Conclusion Formative evaluation has outstanding advantages in general residential training, which can not only improve the satisfaction of the participants in the residential training, promote the improvement of self-learning ability, and stimulate the interest in learning, but also improve the quality of teachers'teaching.In addition, this method of formative evaluation, utilizing Questionnaire Stars as the medium, offers a swift and efficient approach to the application process.This evaluation method has certain advantages and feasibility in the teaching rounds of general practice residential training.

Visual analysis of the research hotspots and the development trends at home and abroad related to patient-centered health care in general practice

GAO Xiaotong, ZHANG Qiang, YU Kai, CHEN Xinyue, HE Yini, HE Xiaoqing, YU Xiaosong, WANG Shuang

2026, 24(3): 507-511. doi: 10.16766/j.cnki.issn.1674-4152.004430

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Abstract:
Objective To conduct a dynamic and longitudinal bibliometric analysis of patient-centered care (PCC) in general practice (GP) in order to examine the research hotspots and domestic and international development trends related to PCC in general practice. Methods Relevant literature and reviews regarding "PCC in GP" were retrieved from the Web of Science Core Collection (WoSCC) database for the period 2013-2023.Visualization bibliometric analysis software Excel, VOSviewer, and CiteSpace were used for analysis. Results A total of 2 126 studies published in 733 journals from 102 countries were included in this search.Based on analysis by country and region, European and American countries, along with China, were the main contributors to this research field.Based on journal and keyword analysis, over the past decade, the focus of research in this field has been on health issues in primary health care, with close connections and extensive intersections with cardiovascular diseases and diabetes, public health and mental health, geriatrics and chronic diseases, as well as oncology.Research themes on "PCC in GP" include PCC and quality evaluation in primary health care, doctor-patient communication and shared decision-making, cancer care and quality of life, as well as disease prevalence, disease management, and disease outcomes.In the context of the new era, "PCC in GP" was closely related to the formulation and reform of national health policies; the concept and specific implementation methods of "PCC in GP" were continuously being improved and promoted. Conclusion This analysis provides a comprehensive overview of PCC-related research in the field of general practice over the past decade, offering practical guidance for clinicians and providing evidence-based insights and scientific references for researchers and health care policymakers in this field.In the future, we encourage the healthcare system to construct a diversified and universal model of PCC in general practice, tailored to the challenges and changes of national conditions, to better serve the healthcare system and improve the health of the population.

Analysis on the awareness rate and satisfaction of basic public health services in Henan province under the background of medical preventive integration

LIU Yahui, WEI Shufan, WANG Wenjuan, WANG Rui, ZENG Hongji, TIAN Qingfeng

2026, 24(3): 512-516. doi: 10.16766/j.cnki.issn.1674-4152.004431

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Abstract:
Objective To explore the awareness rate and satisfaction of basic public health services of residents in Henan Province in the background of medical preventive integration. Methods General residents aged 19-64 years and key groups were randomly selected for telephone interviews in December 2023, and the awareness rate and satisfaction of basic public health services of residents were analyzed by univariate and multivariate analysis. Results The overall awareness rate (awareness scoring rate) of general residents aged 19-64 years was 89.0% (4 455/5 006). The awareness rate of women was higher than that of men, and the overall awareness rate of S1 was the highest (P < 0.05). Multiple linear regression analysis showed that gender and region were the influencing factors of the overall awareness rate of residents (P < 0.001). The overall satisfaction of the project service in the key groups was 92.8% (5 365/5 784). The satisfaction of males was higher than that of females, and the overall satisfaction of people over 65 years old and the S3 area was the highest (P < 0.05). The results of multiple linear regression analysis showed that age and types of key groups were the influencing factors of residents' overall satisfaction with the project services (P < 0.001). Conclusion The overall awareness rate and satisfaction rate of the national basic public health services among the residents in Henan Province are at a high level. We should give full play to the maximum efficiency of the utilization of basic public health services from the perspective of medical prevention integration, and promote the continuous development of basic public health services.

Meta-analysis of the intervention effect of meaning-oriented therapy on depressive mood

JIA Tingrui, WANG Shiqi, LIU Quzhi

2026, 24(3): 517-520. doi: 10.16766/j.cnki.issn.1674-4152.004432

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Abstract:
Objective To systematically evaluate the overall effectiveness of meaning-oriented therapy in alleviating depressive moods through a meta-analysis, and to further explore potential moderators influencing the intervention outcomes, thereby providing evidence-based support for psychological intervention practices. Methods A comprehensive search was conducted in China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine, Web of Science, PubMed, Cochrane Library, and Embase for RCTs involving meaning-oriented therapy for depressive mood. The search covered all publications up to May 2024. The CMA V3.3 software was used to calculate pooled effect sizes and conduct moderator analyses. Results A total of 26 RCTs were included, with a combined sample size of 2, 105 participants and the age range of 11.00 to 67.75 years. The meta-analysis showed a significant overall effect size (SMD=-0.869, 95% CI: -1.017 to -0.722, P < 0.05). Moderator analyses indicated that, in the meta-regression, the intervention effects were significantly influenced by the proportion of female participants and dropout rate (P < 0.05). Subgroup analyses further revealed that therapy type, study quality, and geographic region had significant moderating effects on the intervention outcomes (P < 0.05), whereas the moderating effect of the depression assessment tool was not significant. Conclusion Meaning-oriented therapy has a significant effect in reducing depressive mood. Future research should focus on developing more localized and systematic meaning-oriented therapy protocols within the Chinese context and further examining their practical application and efficacy.

A two-sample Mendelian randomized study of type 2 diabetes versus ankle fracture risk

MENG Siyu, CHEN Xiumin

2026, 24(3): 521-524. doi: 10.16766/j.cnki.issn.1674-4152.004433

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Abstract:
Objective It has been proven that diabetes mellitus plays an important role in the occurrence and development of joint fractures. In this study, a two-sample Mendelian randomization analysis was conducted to investigate the causal relationship between diabetes and ankle fractures. Methods Data from published genome-wide association studies (GWAS) were collected, and 116 single-nucleotide polymorphisms (SNPs) were selected as instrumental variable (IVs) by removing linkage disequilibrium and confounding factors, setting correlation thresholds. The association between diabetes mellitus and the risk of ankle fracture was evaluated by inverse variance-weighted (IVW), MR-Egger, weighted median (WME), simple multivariate analysis (SM), and weighted multivariate analysis (WM). The sensitivity analysis was carried out by using the leave-one-out method, and the robustness of the results was evaluated by sensitivity analysis. The reliability and robustness of the MR analysis results were further evaluated by visual means. Cochran's Q test was used to detect heterogeneity between instrument variables. Results Statistical analysis showed that there was a significant causal relationship between diabetes mellitus and ankle fracture (IVW: OR=1.001, 95% CI: 1.001-1.002, P=0.035). The results of MR analysis showed that MR Egger (P=0.007), weighted median method (P=0.006), the results of the weighted model method (P=0.002) further verified this finding, the causal relationship obtained by the above methods was in the same direction, and the analysis of the leave-one-out method did not find a single SNP that significantly affected the overall results, and the heterogeneity test and pleiotropic experimental results supported the reliability and robustness of the MR conclusions. Conclusion There is a positive causal relationship between diabetes and ankle fractures, and diabetes is associated with an increased risk of ankle fractures.

A study on the impact of retirement expectations on the life satisfaction of older adults in Sichuan Province

ZHANG Xiaofang, XIA Xiaohong, WANG Chunping, DONG Aiping, SUN Wenxue, TANG Yunfeng

2026, 24(3): 525-529. doi: 10.16766/j.cnki.issn.1674-4152.004434

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Abstract:
Objective To explore the relationship between life satisfaction and life expectancy of the elderly, and to provide theoretical support and empirical evidence for improving life satisfaction of the elderly and promoting social harmony. Methods A stratified sampling method was used to select 1856 elderly people in Sichuan Province as the research objects, who then completed face-to-face questionnaire surveys. Through descriptive analysis, the gap between pension expectation and reality was compared, and logistic regression evaluated the correlation between pension expectation and life satisfaction of the elderly. Results At present, the elderly in Sichuan province felt satisfied, generally satisfied, and dissatisfied with their lives accounted for 43.43%, 42.56% and 14.01%, respectively. The expected financial support (3.09±0.99) was lower than the actual financial support (3.45±0.89). The proportion of expected family pension (60.29%) was the largest and lower than that of actual family pension (67.62%, P < 0.05). The analysis of influencing factors showed elderly individuals living in urban areas (OR=1.383, 95% CI: 1.127-1.697), with a high school or technical secondary education (OR=3.136, 95% CI: 1.687-5.824), and experiencing a mismatch in preferred versus actual retirement location (OR=1.504, 95% CI: 1.184-1.910) tended to have higher life satisfaction. Conversely, larger gaps between economic expectations and reality (OR=0.702, 95% CI: 0.630-0.781), greater disparities between expected and actual healthcare experiences (OR=0.773, 95% CI: 0.700-0.852), and having suffered from illness in the past two weeks (OR=0.787, 95% CI: 0.630-0.983) were associated with lower life satisfaction among the elderly. Conclusion The narrowing of the expectation gap is closely related to improvements in the elderly's life satisfaction. On this basis, it is suggested that the government should formulate policies that are closer to the needs of the elderly, the community should provide diversified services for the elderly according to the actual needs of the elderly, and the children should earnestly fulfill their maintenance obligations and give the elderly adequate material and spiritual support.

To explore the effects of family integrated nursing based on pre-rehabilitation strategy on postoperative physical function and psychological state of patients with colorectal cancer

ZHOU Weiwei, ZHU Yaoyao, CHEN Hongyan, CHEN Yujun, CHEN Wenjing, ZHOU Qingqing

2026, 24(3): 530-534. doi: 10.16766/j.cnki.issn.1674-4152.004435

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Abstract:
Objective To evaluate the effect of family-involved care based on prehabilitation strategy during the perioperative period in patients with colorectal cancer on postoperative physical function and psychological status. Methods A convenience sampling method was used to select 112 patients with colorectal cancer admitted to Wenzhou Traditional Chinese Medicine Hospital from January 2024 to March 2025 as the study subjects. According to the random number table method, they were divided into a control group and an observation group, each consisting of 56 cases. The control group received conventional preoperative nursing, while the observation group received home-based participatory nursing based on a prehabilitation strategy in addition to the control group's treatment. The postoperative rehabilitation indicators, motor ability, nutritional status, psychological state, and complication rates were compared between the two groups. Results After the intervention, the observation group's first time to stand up, flatus passage, and defecation were (1.70±0.34) days, (2.01±0.46) days, and (7.13±1.19) days, respectively, all shorter than those of the control group (2.28±0.60) days, (3.00±0.55) days, and (8.94±1.23) days (P < 0.05). The 6-minute walk test (6MWT) in the observation group was higher than that in the control group, while the nutrition risk screening 2002 (NRS2002) score was lower (P < 0.05). The Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), and fear of progression of disease questionnaire-short form (FoP-Q-SF) scores in the observation group were all lower than those in the control group (P < 0.05). There was no significant difference in postoperative complication rates between the two groups (χ²=2.624, P=0.105). Conclusion Preoperative home-based participatory nursing care based on a prehabilitation strategy for colorectal cancer patients facilitates postoperative physical function recovery, improves nutritional status and exercise capacity, and alleviates negative emotions.

Rehabilitative effects of a stage-based nursing intervention program based on Hogan's theory in postoperative breast cancer patients

ZHANG Huan, HONG Jia, JIANG Chunyun, SHAO Su

2026, 24(3): 535-538. doi: 10.16766/j.cnki.issn.1674-4152.004436

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Abstract:
Objective Modified radical mastectomy (MRM) is the preferred surgical procedure for the treatment of breast cancer, but it is associated with a high risk of postoperative complications. Rehabilitation training can reduce the incidence of complications; however, the effects of conventional nursing interventions are often suboptimal. Therefore, this study applied Hogan's theory to the field of postoperative rehabilitation in breast cancer patients and explored its rehabilitative effects. Methods A total of 62 breast cancer patients scheduled for MRM at the Chun'an Branch of Zhejiang Provincial People's Hospital from October 2023 to October 2024 were enrolled. Patients were grouped according to queueing sequences generated by computerized random numbers: odd numbers were assigned to the observation group (n=31), and even numbers to the control group (n=31). The control group received conventional nursing care, while the observation group received conventional nursing combined with a stage-based nursing intervention program based on Hogan's theory. After intervention, intergroup comparisons were conducted for pain intensity, upper limb dysfunction, functional exercise compliance, complications, and quality of life. Results At 2 weeks, 1 month, and 4 months postoperatively, the observation group showed lower scores on the Numerical Rating Scale (NRS) for pain and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire for upper limb dysfunction compared to the control group (P < 0.05). The observation group also had higher compliance scale scores than the control group (P < 0.05). The complication rate in the observation group was 6.45% (2/31), which was lower than in the control group 29.03% (9/31), P < 0.05. After the intervention, the Functional Assessment of Cancer Therapy-Breast (FACT-B) score for quality of life was higher in the observation group than in the control group (P < 0.05). Conclusion The stage-based nursing intervention program based on Hogan's theory can effectively alleviate the postoperative pain degree in breast cancer patients, reduce upper limb dysfunction, improve the compliance of functional exercise, decrease the incidence of postoperative complications, and enhance the quality of life.

About Journal

Current Issue
2026, Volume 24, Issue 3

Submission System

About Journal

Current Issue 2026, Volume 24, Issue 3

Submission System

Current Issue
2026, Volume 24, Issue 3