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2026, Volume 24,  Issue 4

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General Practice Forum
Development status and application challenges of patient versions of guidelines from a general practice perspective
ZHANG Eryao, LAN Yanfen, SUN Junsheng, REN Jingjing
2026, 24(4): 539-543. doi: 10.16766/j.cnki.issn.1674-4152.004437
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  Objective  Patient version guidelines (PVGs) are evidence-based knowledge translation tools under the principles of evidence-based medicine and "patient-centered care", aiming to convert professional guidelines into decision-making information that patients can understand. This article aims to review the current status of PVGs from a general practice perspective and analyze the core challenges in their application.  Methods  A literature review was conducted to systematically search Chinese and English databases such as China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, PubMed, and Web of Science, with a search period from January 2020 to January 2026. Keywords included "patient guide", "patient version guidelines", "patient and public guide", "doctor-patient collaborative decision-making", and their corresponding Chinese terms. Relevant studies, papers, and reports were included, and evidence on the concept, development, formulation methods, reporting standards, and implementation effects of PVGs was summarized and comprehensively analyzed.  Results  PVGs are primarily formulated through two models: "direct translation" and "reformulation". Domestic practices differ in methodological standardization and reporting transparency. Their application value has gained preliminary recognition in general practice settings, particularly in standardized patient education. However, the application challenges are significant and multidimensional, including inconsistent methodological quality, lack of consensus on localization, insufficient patient engagement, limited communication channels and low patient accessibility, low awareness and utilization rates among general practitioners, conflicts between universal guideline recommendations and the principles of personalized medicine.  Conclusion  PVGs are important potential tools for achieving high-quality, patient-centered services in general practice. Future efforts should focus on building localized methodological systems, innovating communication and training models, deepening patient engagement mechanisms, and conducting efficacy studies based on general practice scenarios to fully leverage their role in improving primary care quality and patient health outcomes.
Guidelines and Consensus
Expert consensus on the diagnosis, treatment, and management of hyperhidrosis (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(4): 544-558. doi: 10.16766/j.cnki.issn.1674-4152.004438
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Hyperhidrosis is a common clinical manifestation that may occur independently or as a concomitant symptom of systemic diseases, significantly impacting an individual's daily life, work, social interactions, and psychological well-being. Currently, China lacks large-scale epidemiological data on hyperhidrosis, and there is no unified diagnostic criteria or severity grading system, leading to inconsistent clinical judgments for the same condition. This consensus, oriented towards the diagnosis, treatment, and management of hyperhidrosis, systematically elaborates on its definition, epidemiological characteristics, etiology, and pathogenesis. It reviews diagnostic methods, including detailed history taking, physical examination, assessment tools, and diagnostic procedures, and provides a detailed exposition of treatment principles, protocols, and interventions. Furthermore, this consensus proposes recommendations for the comprehensive management of hyperhidrosis, covering community management, follow-up, bidirectional referral, health education, and future research directions. The aim is to provide standardized and normalized guidance for general practitioners and relevant medical professionals, thereby improving the accuracy of etiological diagnosis, optimizing treatment outcomes, and enhancing patients'quality of life.
Special Topic/ Pulmonary Neoplasm
Study on the expression characteristics, prognostic value, and potential mechanisms of TMEM63C in lung adenocarcinoma
WANG Hanlin, HONG Yuan, TANG Jiaxin, ZHANG Renquan
2026, 24(4): 559-563. doi: 10.16766/j.cnki.issn.1674-4152.004439
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  Objective  To analyze the expression of transmembrane protein 63C (TMEM63C) in lung adenocarcinoma (LUAD), its relationship with patient prognosis, and its effects on the proliferation, migration, and invasion of LUAD cells, as well as the underlying molecular mechanisms.  Methods  TMEM63C expression in LUAD cells was detected by RT qPCR and Western Blotting. Its expression and prognostic value in LUAD tissues were analyzed using the GEPIA, MetaIntegrator, Kaplan Meier plotter databases, and Cox regression. Immune infiltration and enrichment analyses were performed with the TIMER, LinkedOmics, and Metascape databases. Following siRNA interference, CCK-8, colony formation, wound healing, Transwell, and Western Blotting assays were used to assess changes in cell proliferation, migration, invasion, and PI3K/AKT protein expression.  Results  TMEM63C was highly expressed in LUAD, and elevated expression was significantly associated with improved overall survival (P < 0.05). Multivariate Cox regression analysis showed that high expression of TMEM63C was an independent protective factor for overall survival in LUAD patients [HR (95% CI): 0.798 (0.686~0.928), P=0.003]. TMEM63C expression was positively correlated with infiltration of NK cells (r=0.275) and dendritic cells (r=0.188), and negatively correlated with neutrophil infiltration (r=-0.106, P < 0.05). Knockdown of TMEM63C significantly promoted LUAD cell proliferation, migration, and invasion, accompanied by increased expression of PI3K and AKT proteins (P < 0.05).  Conclusion  TMEM63C is highly expressed in LUAD and is associated with a favorable patient prognosis. Its tumor-suppressive effects may be mediated through modulating of the tumor microenvironment and inhibiting of the PI3K/AKT signaling pathway.
Predictive value of iSEND immunity scoring system and LIPI on the efficacy of immuno-combination chemotherapy for extensive stage small cell lung cancer treatment
LU Gang, LIU Liming, LYU Yunxiang
2026, 24(4): 564-568. doi: 10.16766/j.cnki.issn.1674-4152.004440
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  Objective  To analyze the predictive value of iSEND immune score and lung immune prognostic index (LIPI) in the prognosis and efficacy of immunotherapy combined with chemotherapy in patients with extensive-stage small cell lung cancer, and to explore novel indicators guided clinical treatment.  Methods  A retrospective analysis was performed on the clinical data of 127 patients with extensive-stage small cell lung cancer (ES-SCLC) treated with immunotherapy combined with chemotherapy (CIT) admitted to the First Affiliated Hospital of Bengbu Medical University from June 2022 to December 2024. Patients were stratified according to the iSEND immune score and LIPI, respectively, and receiver operating characteristic (ROC) curves were constructed to compare the predictive efficacy of the two scoring systems for treatment response and prognosis. Kaplan-Meier method, univariate and multivariate Cox regression analyses were applied to explore the association between various prognosis-related factors and progression-free survival (PFS).  Results  The median PFS was 3.50 months, 8.50 months, and 13.17 months in the poor, intermediate, and favorable subgroups of the iSEND immune score, respectively; while the median PFS was 3.67 months, 8.20 months, and 10.83 months in the corresponding subgroups of the LIPI, with statistically significant differences (P < 0.001). The area under the curve (AUC) values of LIPI for predicting disease control rate (DCR), objective response rate (ORR), and PFS were 0.731, 0.725, and 0.751, respectively, whereas those of the iSEND immune score were 0.708, 0.649, and 0.677, which were significantly lower than those of LIPI (P < 0.01). Cox regression analysis revealed that lactate dehydrogenase (LDH) and derived neutrophil-to-lymphocyte ratio (dNLR) were independent prognostic factors for PFS in both the entire cohort and all subgroups.  Conclusion  Both scoring systems exhibit favorable predictive value for the prognosis and efficacy of CIT in patients with ES-SCLC, with LIPI demonstrating superior predictive ability. LDH and dNLR, as LIPI components, are independent predictors of PFS across overall and subgroup analyses, likely attributed to LIPI's enhanced predictive capacity over the iSEND model.
Evidence Summary for management of symptom clusters of gastrointestinal adverse reactions caused by radiotherapy and chemotherapy for lung cancer
YANG Xinyao, CUI Lei, LIU Xue, ZHANG Like, HOU Lili
2026, 24(4): 569-573. doi: 10.16766/j.cnki.issn.1674-4152.004441
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  Objective  To search and summarize the best evidence for assessing and managing gastrointestinal adverse reactions caused by radiotherapy and chemotherapy for lung cancer, and support evidence-based practice.  Methods  Systematically searched each database and guideline networks for management evidence of gastrointestinal adverse reactions caused by radio- and chemotherapy for lung cancer. The search timeline was from database establishment to August 2024. Two trained researchers performed literature screening, quality evaluation, evidence extraction, and integration independently.  Results  Twenty-eight articles were included, including 5 meta-analyses, 2 systematic reviews, 4 evidence summaries, 8 expert consensuses, 5 guidelines, and 4 clinical decisions. One hundred and six recommendations in three dimensions of assessment, prevention, treatment, and intervention were summarized, involving seven themes of oral mucositis, radiation esophagitis, anorexia, nausea and vomiting, chemo- and radiotherapy-associated diarrhea/constipation, and malnutrition.  Conclusion  Tumor teams should fully consider the individual differences of patients and provide appropriate evidence-based interventions.
General Practice Research
Clinical analysis of NETs biomarkers and their relationship with leukocytes and neutrophils in empyema-associated pleural effusion
SHI Lilu, HUANG Zaizhong, WEIMO Luyu, QING Cao, HUANG Wenhui, WANG Ke
2026, 24(4): 574-576. doi: 10.16766/j.cnki.issn.1674-4152.004442
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  Objective  To investigate the correlation between neutrophil extracellular traps (NETs) in pleural fluid and leukocytes, neutrophils, and the inflammatory marker C-reactive protein (CRP) in patients with empyema, in order to provide references for clinical diagnosis and treatment.  Methods  Clinical data were collected from patients with pyothorax admitted to the Third Ward of the Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Guangxi Medical University, from June 2017 to June 2021. Pleural effusion samples were collected under sterile conditions, and 38 eligible samples along with corresponding clinical data were included after rigorous screening. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of NETs markers in pleural effusion, and all data were summarized and statistically analyzed.  Results  The data showed a trend of elevated leukocytes, neutrophils, and NETs biomarkers were observed in 38 pleural fluid samples. The concentration of citrullinated histone H3 (citH3) was 14.63(0.99, 21.45) ng/mL, and extracellular DNA (eDNA) 14.09(3.22, 21.93) ng/μL. The leukocytes count was (15.08±8.15)×109/L, the count of neutrophils was [12.04(7.57, 17.99)]×109/L, and CRP level was 100.50(44.63, 187.00) mg/L. In the group with positive pleural fluid microbial cultures, the concentrations were as follows: citH3 at 19.12(0.37, 21.23)ng/mL, eDNA at 13.15(4.48, 19.62)ng/μL, white blood cell count at (15.58±5.23)×109/L, neutrophil count at [14.92(12.21, 16.73)]×109/L, and C-reactive protein level at 147.00(103.50, 189.75) mg/L. Spearman correlation analysis revealed that, in the microbial culture-positive pleural fluid group, citH3 levels were highly correlated with both leukocytes count and neutrophil count (r=0.833, 0.867, P < 0.05). No other significant correlations were observed among the remaining indicators across the groups.  Conclusion  NET biomarkers, particularly eDNA and citH3, are associated with white blood cells, neutrophils, and C-reactive protein, and may serve as potential indicators for assessing inflammatory severity and disease progression in empyema.
The preventive effect of combining different concentrations of sodium bicarbonate with nystatin on oral and pulmonary infections in SLE patients
FAN Yumiao, ZHENG Zhaohui, FENG Duoduo, LUO Heng, WANG Qing
2026, 24(4): 577-580. doi: 10.16766/j.cnki.issn.1674-4152.004443
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  Objective  To investigate the preventive efficacy of sodium bicarbonate mouthwash at various concentrations combined with nystatin against oral and pulmonary infections in patients with systemic lupus erythematosus(SLE), and to provide evidence for clinical prevention and treatment.  Methods  A total of 97 SLE patients admitted to the First Affiliated Hospital of the Military Medical University of the Chinese People's Liberation Army Air Force from April 2023 to May 2024 were randomly assigned to three groups: Group A (n=32), Group B (n=32) and Group C (n=33). Group A received nystatin mouthwash alone. Group B received nystatin plus 2% sodium bicarbonate mouthwash. Group C received nystatin plus 4% sodium bicarbonate mouthwash. We compared oral and pulmonary fungal infection rates, time to infection onset and resolution, oral pH levels and pain intensity among the groups.  Results  Group C had lower rates of oral fungal infection[9.09% (3/33) vs.37.50% (12/32) vs.31.25% (10/32)] and pulmonary fungal infection [6.06% (2/33) vs.31.25% (10/32) vs.25.00% (8/32)] compared to Groups A and B(P < 0.05). The onset of both oral and pulmonary fungal infections occurred earliest in Group A and latest in Group C, while cure times were longest in Group A and shortest in Group C (P < 0.05). Oral infection severity was higher in Groups A and B than in Group C(P < 0.05). After mouth rinsing on days 1, 5, and 10, oral pH and VAS scores were lowest in Group A and highest in Group C (Pintergroup < 0.05). These differences decreased over time(Pinteraction < 0.05).  Conclusion  Combining 4% sodium bicarbonate mouthwash with nystatin increases oral pH in SLE patients, reduces the risk of oral and pulmonary fungal infections, shortens treatment time and provides effective prophylaxis.
The relationship between lipoprotein lipase-related angiopoietin-like proteins and trimethyl-5-aminopentanoic acid with the severity of coronary artery stenosis
SUN Xing, FAN Baohan, CAI Yue, SHEN Tongtong
2026, 24(4): 581-584. doi: 10.16766/j.cnki.issn.1674-4152.004444
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  Objective  To investigate the correlation between angiopoietin-like proteins (ANGPTLs) related to lipoprotein lipase (LPL) and trimethyl-5-aminovaleric acid (TMAVA) with the severity of coronary artery stenosis, thereby providing a novel theoretical basis for the prediction, diagnosis, and treatment of coronary heart disease.  Methods  A total of 270 patients who underwent coronary angiography at the Affiliated Chuzhou Hospital of Anhui Medical University from June 2024 to June 2025 were consecutively enrolled. Gensini scores were calculated, and patients were divided into a high-score group (GS score > 15.6, 110 cases) and a non-high-score group (GS score ≤ 15.6, 160 cases). Subsequently, the non-high-score group was further categorized into a low-score group (0 < GS score ≤ 15.6, 49 cases) and a normal group (GS score = 0, 111 cases). Baseline data of the high-score, low-score, and normal groups were compared. Spearman correlation analysis was employed to explore the correlation between ANGPTLs (angiopoietin-like proteins) and TMAVA (trimethyl-5-aminovaleric acid) with the GS (Gensini) score. Logistic regression analysis was conducted to identify independent influencing factors for the occurrence of coronary heart disease.  Results  There were statistically significant differences in the history of diabetes, age, fasting plasma glucose (FPG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and non-high-density lipoprotein cholesterol (Non-HDL-C) among the high-score, low-score, and normal groups (all P < 0.05). Spearman correlation analysis revealed that ANGPTL3, ANGPTL4, ANGPTL8, and TMAVA were all positively correlated with the GS (Gensini) score (rs=0.754, 0.348, 0.749, 0.762, all P < 0.001). Logistic regression analysis indicated that elevated concentrations of ANGPTL3, ANGPTL4, ANGPTL8, and TMAVA were all independent risk factors for coronary heart disease [OR(95% CI)=1.614(1.435-1.864), 1.375(1.261-1.512), 14.488(6.643-36.374), 1.114(1.079-1.148), all P < 0.001].  Conclusion  LPL-associated ANGPTLs and TMAVA can serve not only as indicators for evaluating the severity of coronary artery lesions but also as potential markers for early identification of patients with coronary heart disease.
Effects of Tiaoshen Xingnao acupuncture on oxidative stress, miR-34a and SIRT1 in patients with cognitive impairment after stroke
GAO Jun, BIAN Zhe, ZHANG Saixue
2026, 24(4): 596-600. doi: 10.16766/j.cnki.issn.1674-4152.004448
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  Objective  This study investigated the effects of Tiaoshen Xingnao acupuncture on patients with post-stroke cognitive impairment by observing and comparing the changes in inflammatory response, stress response, cognitive function, and the expression levels of miR-34a and SIRT1, with the aim of providing new ideas and approaches for clinical treatment.  Methods  Ninety patients with post-stroke cognitive impairment treated in the Affiliated Hospital of North China University of Science and Technology from March 2023 to September 2023 were enrolled. Using a block randomization method, they were randomly assigned at a 2:1 ratio to an observation group (60 cases, Tiaoshen Xingnao acupuncture + cognitive function training) and a control group (30 cases, cognitive function training) according to the treatment modalities. The inflammatory response indicators (IL-6, CRP), oxidative stress response (SOD, MDA), cognitive effects (MESSS), and effects on miR-34a, SIRT1 were compared between the two groups.  Results  After 4 weeks of treatment, MDA [(5.68±0.86) μmol/mL vs. (8.37±1.68) μmol/mL] and MESSS [(14.00±3.00) points vs. (18.00±4.00) points] in the observation group were lower than those in the control group, and the differences were statistically significant (P < 0.05), whereas SOD [(126.35±12.37) U/mL vs. (82.38±10.49) U/mL] was higher than that in the control group, with a statistically significant difference (P < 0.05). After 4 weeks of treatment, IL-6 [(148.59±29.67) pg/L vs. (209.59±26.37) pg/L] and CRP [(6.19±1.86) mg/L vs. (10.68±3.67) mg/L] in the observation group were lower than those in the control group, and the difference was statistically significant (P < 0.05). After 4 weeks of treatment, miR-34a [(1.16±0.19)] was lower than that in the control group [(1.46±0.16)], while SIRT1 [(1.16±0.22) vs. (0.93±0.18)] was higher than that in the control group, and the difference was statistically significant (P < 0.05).  Conclusion  Tiaoshen Xingnao acupuncture can improve oxidative stress responses, reduce inflammatory reactions, decrease the expression of miR-34a and SIRT1, and promote the recovery of cognitive function in patients with cognitive impairment after stroke.
General Practice Researc
Construction and validation of a catheter-related infection prediction model for patients undergoing continuous renal replacement therapy
WANG Tianqi, Dai Weiying, Xia Liuqin, Yu Mengsha
2026, 24(4): 585-588. doi: 10.16766/j.cnki.issn.1674-4152.004445
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  Objective  To investigate the risk factors for catheter-related infection (CRI) in patients undergoing continuous renal replacement therapy (CRRT), to construct a prediction model, and to evaluate its clinical application value.  Methods  The clinical data of 208 patients who underwent CRRT in Hangzhou First People ' s Hospital from January to December 2023 were collected. Univariate and multiple logistic regression analyses were used to screen the risk factors for CRI in CRRT patients, and a prediction model was constructed. Receiver operating characteristic (ROC) curve, calibration curve (CC), decision curve analysis (DCA), and clinical impact curve (CIC) were used to evaluate the discrimination, calibration, and clinical utility of the model.  Results  The incidence of CRI in CRRT patients was 16.8%. Multiple logistic regression analysis showed that age, acute physiology and chronic health evaluation Ⅱ, diabetes mellitus, catheterization site, CD4+/CD8+, albumin level, and operator hand hygiene (OR=3.494, 3.270, 4.004, 2.328, 0.385, 0.916, and 0.390, respectively; all P < 0.05) were associated with CRI in CRRT patients. A prediction model was constructed based on these seven risk factors. The area under the ROC curve (AUC) was 0.854 (95% CI: 0.784-0.923). The results of the CC showed that the predicted calibration curve of the model closely matched the ideal curve, indicating good agreement. The results of the DCA showed that using this model to guide clinical decisions provided higher net benefits for patients than the extreme strategies of no intervention or full intervention when the threshold probability was greater than 15%. The results of the CIC showed that the population identified as high risk for CRI by the model matched well with the actual population when the threshold probability was greater than 30%.  Conclusion  The risk prediction model constructed in this study demonstrates high predictive efficacy and clinical utility, which could help identify patients at high risk of CRI during CRRT at an early stage and enable timely intervention, thereby improving prognosis.
A model study of biomarkers combined with lung function to predict the risk of acute exacerbations of COPD
GUO Lijuan, MA Fangxu, BAO Jie, WANG Shuang, LI Yi
2026, 24(4): 589-592. doi: 10.16766/j.cnki.issn.1674-4152.004446
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  Objective  To investigate the value of a combined lung function index model constructed from soluble cancer suppressor factor 2 (sST2), chitinase protein 40 (YKL-40), interleukin-10 (IL-10), and pulmonary surfactant D (SP-D) in early risk assessment of chronic obstructive pulmonary disease (COPD) acute exacerbations.  Methods  A total of 120 COPD patients admitted at Hebei Provincial Chest Hospital between January 2023 and December 2024 were selected as subjects, and divided into stable phase group (60 cases) and acute exacerbation phase group (60 cases) based on whether they experienced acute exacerbations. All patients ' serum levels of sST2, YKL-40, IL-10, and SP-D were measured, along with pulmonary function tests. Multivariate logistic regression was used to identify independent risk factors for COPD acute exacerbations, and a combined prediction model was established. The predictive efficacy of each indicator and the combined model was evaluated using receiver-operating characteristic (ROC) curves.  Results  Patients in the acute exacerbation group showed significantly higher serum levels of sST2, YKL-40, and SP-D compared to the stable phase group (P < 0.05), while IL-10 and FEV1%pred were markedly lower (P < 0.05). Multivariate logistic regression analysis demonstrated that all four biomarkers-sST2, YKL-40, IL-10, SP-D, and FEV1% pred-were independent predictors of COPD acute exacerbations (P < 0.05). The combined predictive model achieved an area under the curve (AUC) of 0.923 (95% CI: 0.881-0.965), with a sensitivity of 86.7% and specificity of 88.3%, demonstrating superior predictive performance compared to single biomarkers.  Conclusion  The integrated pulmonary function biomarker model combining sST2, YKL-40, IL-10, SP-D provides reliable prediction for COPD acute exacerbations, offering valuable insights for early risk assessment and clinical intervention guidance.
Analysis of factors influencing oral frailty in elderly stroke patients
LIU Weilong, WANG Xiaoyan, YANG Sijia, ZHANG Xiping
2026, 24(4): 593-595. doi: 10.16766/j.cnki.issn.1674-4152.004447
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  Objective  To identify the risk factors for oral frailty (OF) in elderly stroke patients and to develop a risk prediction model, thereby providing a reference for OF prevention and management.  Methods  The study subjects were elderly stroke patients (n=286) admitted to the First People ' s Hospital of Hangzhou Affiliated to Westlake University from January to October 2025. A general information questionnaire, oral frailty screening scale, micronutrient assessment scale, frailty scale, and the simplified version of the geriatric depression rating scale (GDRS) were used for data collection. Multivariate logistic regression analysis was conducted to identify the risk factors for osteoporosis in elderly stroke patients, followed by the construction of a predictive model. The model ' s goodness of fit and predictive performance were validated using the Homser-Lemeshow test and ROC curve analysis.  Results  Among 286 patients, 179 (62.59%) developed OF. Logistic regression analysis: age (OR=1.607), female sex(OR=1.283), smoking history (OR=1.519), comorbid diabetes (OR=4.022), physical frailty (OR=3.108), malnutrition (OR=4.674), and depression (OR=2.860) were factors influencing OF in elderly stroke patients (P < 0.05). A risk prediction model of OF was constructed, with an area under the ROC curve of 0.916 (95% CI: 0.891-0.943), sensitivity of 0.890, specificity of 0.822. The Homser-Lemeshow goodness-of-fit test indicated good model fit (χ2=5.031, P=0.722).  Conclusion  The incidence of OF in elderly stroke patients is high and is mainly related to factors such as advanced age, smoking history, diabetes, physical weakness, malnutrition, and depression. It is recommended to develop individualized oral management plans to prevent or delay the occurrence of OF.
General Clinical Research
The regulatory effects of Bacillus subtilis combined with mesalazine on intestinal microecology and inflammatory factors in patients with ulcerative colitis
PANG Xiaojun, SUN Wei, WANG Junwei
2026, 24(4): 601-604. doi: 10.16766/j.cnki.issn.1674-4152.004449
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  Objective  To investigate the effects of Bacillus subtilis combined with mesalazine on the gut microbiota and inflammatory factors in patients with ulcerative colitis (UC), and to provide references to support the development of optimized clinical treatment plan formulation.  Methods  A total of 210 UC patients admitted to the Department of Gastroenterology, Tianta County People ' s Hospital of Zhejiang Province from May 2020 to May 2025 were randomly divided into Group A (n=105) and Group B (n=105). Group A was treated with mesalazine, while Group B was treated with mesalazine combined with Bacillus Licheniformis live bacteria capsules. The clinical efficacy, number of intestinal flora colonies, intestinal mucosal permeability, inflammatory factors, and adverse reactions were compared between the two groups.  Results  The total effective rate in the Group B [90.48% (95/105)] was higher than that in the Group A [79.05% (83/105), χ2=5.309, P=0.021]. After treatment, the counts of Lactobacillus and Bifidobacterium in the Group B were higher than those in the Group A (P < 0.05), whereas the count of Escherichia coli in the Group B was lower than that in the Group A (P < 0.05). The levels of diamine oxidase (DAO) and endotoxin (ETX) in the Group B after treatment were lower than those in the Group A (P < 0.05). The levels of C-reactive protein (CRP) and interleukin-8 (IL-8) in the Group B after treatment were lower than those in the Group A (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).  Conclusion  The combination of Bacillus licheniformis live bacteria capsules and mesalazine in the treatment of UC can enhance efficacy by modulating the structure of intestinal microbiota, enhancing the integrity of intestinal mucosal barrier, and reducing the expression of inflammatory factors, while maintaining a favorable safety profile.
Analysis of the effectiveness of the "1+1+1" management model for chronic disease management at the primary level in Hainan Province
WANG Hui, GU Shenghong, ZHANG Yunbo, SONG Yanling, JI Xinbo, HU Shiling
2026, 24(4): 605-609. doi: 10.16766/j.cnki.issn.1674-4152.004450
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  Objective  By comparing the management effects of different management models on patients with chronic disease in primary healthcare institutions in Hainan Province, this study aimed to optimize the management model for chronic disease patients.  Methods  From January 2017 to January 2021, 915 patients with chronic diseases were randomly selected from 19 primary healthcare institutions in Hainan Province. They were divided into a control group (n=463) and an intervention group (n=452) using a random number table method. The control group received routine management, while the intervention group received chronic disease "1+1+1" management model. Basic information, management control indicators, lifestyle and exercise indicators, and patient satisfaction data were collected and compared after 2 years.  Results  After 2 years of intervention, the fasting and 2-hour post-meal blood glucose, glycosylated hemoglobin, triglycerides, alcohol consumption and hospitalization rates in the intervention group were (6.99±1.58) mmol/L, (10.15±2.15) mmol/L, (6.25±0.83)%, 1.66(1.26, 2.40) mmol/L, 22.8% (103 cases) and 17.0% (77 cases), respectively, which were lower than those in the control group [(6.40±2.19) mmol/L, (8.70±2.86) mmol/L, (5.69±1.04)%, 1.06(0. 60, 1. 80) mmol/L, 44.1% (204 cases) and 31.5% (146 cases)], and the differences were statistically significant (P < 0.05); the complete medication compliance, management rate, physical exercise and satisfaction rates in the intervention group were 412 cases (91.2%), 412 cases (91.2%), 333 cases (73.7%), respectively, which were higher than those in the control group [377 cases (81.4%), 354 cases (76.5%), 186 cases (40.2%)], and the differences were statistically significant (P < 0.05).  Conclusion  The application of the chronic disease "1+1+1" management model in primary healthcare institutions is more effective than conventional management in managing chronic disease patients.
The effect of GLP-1RA semaglutide on cognitive function and serum Aβ1-42 levels in patients with type 2 diabetes
WU Wei, HAO Shuli, MEI Yanjie, SHI Fangfang, LI Xinjie
2026, 24(4): 610-612. doi: 10.16766/j.cnki.issn.1674-4152.004451
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  Objective  This study explores the effects of the glucagon-like peptide-1 receptor agonist semaglutide on the MoCA cognitive score and serum β-amyloid protein 1-42 (Aβ1-42) levels in patients with type 2 diabetes, aiming to provide a new therapeutic approach for improving the cognitive function of patients with type 2 diabetes.  Methods  Sixty patients with type 2 diabetes mellitus admitted to the Endocrinology Department of Bozhou People ' s Hospital from December 2022 to December 2023 were selected as the research subjects and randomly divided into two groups by random number method, with 30 cases in each group. The conventional group was treated with oral hypoglycemic drugs and/or insulin, while the semaglutide group was treated with semaglutide combined with oral hypoglycemic drugs and/or insulin. The treatment period was 6 months. The MoCA cognitive function scores and serum Aβ1-42 levels of the two groups after treatment were compared.  Results  There were no statistically significant differences in fasting blood glucose (FBG), glycosylated hemoglobin ratio (HbA1c%), triglycerides (TG), total cholesterol (TC), and insulin resistance index (HOMA-IR) between the two groups after treatment (P>0.05). The MoCA cognitive score of the semaglutide group [28.00 (26.00, 29.00) points] was higher than that of the control group [24.50 (23.00, 26.00) points, P < 0.001], and the serum Aβ1-42 level [(100.67±23.34) pg/mL] was lower than that of the control group [(119.03±34.43) pg/mL, P < 0.001].  Conclusion  Semaglutide can reduce the serum Aβ1-42 level in patients with type 2 diabetes, increase the MoCA cognitive score, and improve cognitive function.
Clinical study on prone position ventilation regulation of oxygenation and circulatory function in children with hypoxemia after congenital heart disease surgery
WANG Ning, GUO Ying, WANG Xuejing, ZHU Hongmin
2026, 24(4): 613-617. doi: 10.16766/j.cnki.issn.1674-4152.004452
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  Objective  This study explores the effects of prone positioning ventilation on oxygenation function, circulatory function regulation, and clinical safety in children with postoperative hypoxemia following congenital heart disease surgery, aiming to provide a basis for selecting respiratory intervention strategies in clinical practice.  Methods  A retrospective analysis was conducted on the clinical data of 160 children with postoperative hypoxemia due to congenital heart disease admitted to Beijing Children's Hospital Capital Medical University from November 2022 to November 2025. Eighty children who received alternating supine and lateral position ventilation interventions were included in the control group, and 80 children who received intermittent prone position ventilation interventions were included in the observation group. The oxygenation function, circulatory function indicators, and incidence of complications were compared between the two groups before ventilation and at 4, 8, and 12 hours of ventilation.  Results  The arterial partial pressure of carbon dioxide (PaCO2) levels in the observation group at 4, 8, and 12 h of ventilation were (50.35 ± 5.02) mmHg (1 mmHg=0.133 kPa), (46.15 ± 4.61) mmHg, and (41.38 ± 3.97) mmHg, respectively, all of which were lower than those in the control group[(53.55 ± 4.92) mmHg, (50.19 ± 4.25) mmHg, and (47.71 ± 4.31) mmHg]. Moreover, the differences in arterial partial pressure of oxygen (PaO2)/fraction of inspiration O2 (FiO2) and percutaneous arterial oxygen saturation (SpO2) levels between the two groups were statistically significant (P < 0.05).The total incidence of complications in the observation group was 6.25% (5/80), which was lower than 23.75% (19/80) in the control group, and the difference was statistically significant (P < 0.05).  Conclusion  Along with prolonged ventilation time, prone position ventilation can improve oxygenation function in children with hypoxemia after congenital heart disease surgery, maintain stable circulatory function, and have fewer complications, making it safe and effective.
Research on the effect of seasonal and regional variations on neonatal TSH and the adjustment of TSH Cut-off
GE Lisha, PAN Xiaoli, PAN Shuqing, PAN Yun, LI Haibo, ZHUANG Danyan
2026, 24(4): 618-620. doi: 10.16766/j.cnki.issn.1674-4152.004453
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  Objective  Analyzing the influence of geographical and seasonal variations on neonatal thyroid-stimulating hormone (TSH) levels to establish a regionally appropriate TSH cut-off for neonatal congenital hypothyroidism (CH) screening in Ningbo, thereby guiding local CH screening practices.  Methods  The TSH of 310 791 newborns born in Ningbo from January 2019 to December 2023 were retrospectively analyzed. According to the coastline length of the 10 counties in Ningbo city, they were divided into coastal and inland groups, and then further divided into four groups according to the birth season: spring, summer, autumn, and winter. Percentile method and ROC curve analysis were used to calculate the cut-off and establish the TSH cut-off conforming to the local CH screening.  Results  Among 310 791 newborns screened, 11 359 cases were initially positive. 328 cases were confirmed as CH, and 492 cases were diagnosed with hyperthyrotropinemia. The positive rate of TSH screening and the incidence of CH in the coastal group were higher than those in the inland group, and the difference was statistically significant (P < 0.05). The positive rate of TSH and the incidence of CH in winter were higher than those in the other three seasons, and the difference was statistically significant (P < 0.05). The TSH cutoff values determined by the percentile method for the four seasons were 9.0, 8.5, 8.8, and 10.4 mIU/L, which would result in 52, 57, 59, and 100 additional missed cases, respectively, compared with the original cutoff. In contrast, the cutoff values derived from the ROC curve method were 6.4, 7.0, 6.9, and 6.4 mIU/L for the four seasons. Except for the spring season, where four additional cases were detected compared to the original cutoff, the number of cases identified in the other seasons remained consistent with that of the original cutoff.  Conclusion  The incidence of CH in newborns was 0.11%, which was higher than that in other parts of China. The TSH values in the Ningbo area were affected by region and season, and were higher in the coastal area and winter. The cut-off was determined to be 7.0 mIU/L based on the laboratory screening efficiency and the actual operability.
Study on depression status and influencing factors of working population in functional community of Shanghai
LU Ting, TANG Xiuxiang, QIN Li, ZHANG Hanzhi
2026, 24(4): 621-624. doi: 10.16766/j.cnki.issn.1674-4152.004454
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  Objective  To understand the current situation of depression among the working population in functional communities in Shanghai and analyze its influencing factors, in order to provide a basis for improving mental health services in functional communities.  Methods  The typical sampling method was used to select functional communities in 12 districts and counties of Shanghai, and the cluster random sampling method was used to select 580 working people in the selected functional communities from September to November in 2024. The self-developed questionnaires of socio demographic and economic characteristics, health and life behavior, and work conditions, patient health questionnaire, ten-item personality inventory Chinese version, general self-efficacy scale, perceived social support scale, and overall job satisfaction were used to conduct an online questionnaire survey to understand the depression status of working people in functional communities, and the influencing factors of depressive symptoms were explored by multivariate logistic regression analysis.  Results  A total of 580 questionnaires were distributed, and 570 questionnaires were returned, with a recovery rate of 98.28%. Among the working population in functional communities in Shanghai, 53.33% (304/570) had depressive symptoms. Multivariate logistic regression analysis showed that age (OR=0.429, 95% CI: 0.207-0.888), nationality (OR=3.046, 95% CI: 1.285-7.219), prevalence of chronic diseases (OR=0.506, 95% CI: 0.275-0.933), weekend rest (OR=3.554, 95% CI: 1.098-11.500), self-rated working environment (OR=0.064, 95% CI: 0.005-0.760; OR=0.011, 95% CI: 0.001-0.166), conscientious personality (OR=0.767, 95% CI: 0.667-0.882), emotional stability personality (OR=0.766, 95% CI: 0.668-0.878) were the main factors affecting the depressive symptoms of the working population in functional communities (P < 0.05).  Conclusion  The detection rate of depressive symptoms among the in-service population in functional communities in Shanghai is high. Conscientiousness and emotional stability personality have a significant negative impact on depressive symptoms. Community medical workers should pay more attention to the mental health of the in-service population in functional communities, and formulate corresponding psychological intervention programs according to their personality traits, and improve the mental health level of the in-service population in functional communities.
Effects of loneliness on sleep quality of middle-aged and older adults and the suppressive effect of depression
LIU Yue, SUI Linpeng, LI Dan, ZHANG Lei, WANG Wenhua, ZHANG Donglin, XUE Mei, HAO Jianfen, WANG Minjuan
2026, 24(4): 625-629. doi: 10.16766/j.cnki.issn.1674-4152.004455
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  Objective  To explore the impact of loneliness on sleep quality and analyze the mediating role of depression, and to provide targeted interventions to improve the sleep quality of middle-aged and older adults.  Methods  During July-August 2023, the residents ≥45 years old in Ankang City, Shaanxi Province, were selected by a whole cluster random sampling method. Their loneliness level, depressive symptoms, and sleep quality were assessed by the Loneliness scale (ULS-8), the Centre for Epidemiological Studies depression scale (CESD-10), and the Pittsburgh sleep quality index scale (PSQI). The SPSS 25.0 statistical software was used for statistical descriptions, correlation analyses, univariate and multivariate analyses, and mediation tests using the SPSS Process program.  Results  (1) A total of 1 018 participants were enrolled, including 341 males (33.5%) and 677 females (66.5%), with a median age of 60 years. Participants who reported sleep disturbance, loneliness, and depressive symptoms accounted for 34.1% (347/1 018), 23.5% (239/1 018), and 20.8% (212/1 018) of the total, respectively. (2) Among participants who self-reported sleep disturbance, 94.2% presented with sleep latency disturbance. (3) The loneliness score was positively correlated with the sleep quality score (r=0.140, P < 0.01). The depression score was positively correlated with the sleep quality and loneliness scores (r=0.486, 0.449; both P < 0.01). (4) There was a suppressive effect of depression between loneliness and sleep quality (ab=0.275, c ' =-0.113).  Conclusion  The effect of loneliness on the sleep quality of middle-aged and older adults was suppressed by depressed mood. Detecting and intervening in loneliness and depression in time can help to improve the sleep quality of middle-aged and older adults and reduce the incidence of sleep disorders.
Correlation between serum hs-CRP, five thyroid function parameters, and the severity of depression
WANG Linping, SHI Yongcun, ZHANG Hengfang, LI Na, LI Lijuan
2026, 24(4): 630-632. doi: 10.16766/j.cnki.issn.1674-4152.004456
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  Objective  To explore the distribution differences of serum hypersensitive C-reactive protein (hs-CRP) and five thyroid function parameters in depression patients with different severity, in order to provide potential indicators for evaluating the condition of the disease.  Methods  A total of 114 patients with depression admitted to the Third People ' s Hospital of Heze City, the First Hospital of Hebei Medical University from January 2021 to December 2023 were enrolled and categorized into the mild group (48 cases), the moderate group (40 cases) and the severe group (26 cases) according to Hamilton depression scale (HAMD) score. The levels of serum hs-CRP, five thyroid function parameters and the relationship of each index with HAMD score were compared.  Results  Serum hs-CRP, TSH levels and HAMD scores in the mild group [(3.65±0.71) mg/L, (1.35±0.16) μIU/mL, (12.41±3.08) points] were lower than those in the moderate group [(7.63±1.59) mg/L, (1.81±0.30) μIU/mL, (20.55±2.31) points] and the severe group [(9.84±2.15) mg / L, (2.74±0. 58) μIU / mL, (28.39±2.02) points], meanwhile the moderate group was lower than the severe group (P < 0.05). Serum FT3 and FT4 levels in the mild group were higher than those in other two groups, and the moderate group was higher than the severe group (P < 0.05). Pearson correlation analysis showed that serum hs-CRP, TSH and HAMD scores were positively correlated, while serum FT3, FT4 and HAMD scores were negatively correlated (r=0.652, 0.560, -0.431, -0.464, P < 0.05).  Conclusion  Serum hs-CRP, TSH, FT3 and FT4 are closely related to the severity of depression, and may be an important auxiliary indicator for the assessment of the condition of patients with depression.
Visual analysis of research progress of artificial intelligence in carotid plaque ultrasound examination
LIU Wenli, ZHANG Shuhua, WANG Yihua, LIU Yang, ZHANG Xue, YAN Huishan, LIN Hongzhao, YIN Tong, LI Ning
2026, 24(4): 633-637. doi: 10.16766/j.cnki.issn.1674-4152.004457
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  Objective  To provide a reference direction for the research on the application of artificial intelligence (AI) in the recognition and analysis of carotid plaque ultrasound images by analyzing the research status and progress of AI in carotid plaque ultrasound at home and abroad.  Methods  Using the China National Knowledge Infrastructure (CNKI), Wanfang Data, Web of Science, PubMed, and IEEE as databases, relevant research literatures on the application of AI in carotid plaque ultrasound from the establishment of the databases to December 2024 were retrieved as the research objects, and CiteSpace was used for visual analysis.  Results  After retrieval and screening, a total of 14 Chinese-language references and 88 foreign-language references were ultimately included. The number of literatures published at home and abroad on the application of AI in carotid plaque ultrasound is relatively small, and the publishing trends are both tending to be flat. There is cooperation among relevant researchers and institutions, but the degree of close cooperation is low. Keywords with high frequencies of occurrence include deep learning, machine learning, plaque segmentation, stroke, convolutional neural network, carotid plaque characterization, etc.  Conclusion  The research hotspots of AI in carotid plaque ultrasound at home and abroad mainly focus on the application of deep learning in identifying carotid plaques in ultrasound images, AI - based plaque segmentation technology, and the relationship between AI - analyzed ultrasound characteristics of carotid plaques and the occurrence of stroke and cardiovascular diseases. Computer-aided diagnosis and classification algorithms will become the research trend of AI in carotid plaque ultrasound. Meanwhile, due to the limited research on the application of AI in carotid plaque ultrasound examination at present, its application value in clinical practice remains to be verified and improved. In the future, more researchers are needed to engage in research on the application of AI in carotid plaque ultrasound examination.
Diagnostic value of pelvic floor ultrasound and diastasis recti assessment in the evaluating pelvic floor function and postpartum stress urinary incontinence
FANG Jing, WANG Mengjuan, CHEN Guo
2026, 24(4): 638-640. doi: 10.16766/j.cnki.issn.1674-4152.004458
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  Objective  To explore the relationship between pelvic floor ultrasound parameters and the degree of rectus abdominis diastasis in postpartum women, and to analyze their diagnostic value for stress urinary incontinence (SUI).  Methods  A retrospective analysis was performed on 307 postpartum women who had undergone vaginal delivery and attended the Maternal and Child Health Center, Anhui Medical University from February 2022 to October 2024. The bladder neck mobility (BND), urethral rotation angle (URA), latissimus dorsi muscle cleavage area (LHA), and bladder posterior angle (BA), as well as rectus abdominis muscle spacing measured during maximal Valsalva maneuver (at the umbilical level, 3 cm above the umbilicus, and 3 cm below the umbilicus), were collected. According to the outpatient medical records, participants were divided into 61 cases of SUI group and 246 cases of non-SUI group. Differences between the two groups were compared, and the independent and combined diagnostic values of the indexes were evaluated by multivariate logistic regression and ROC curve analyses.  Results  The BND, URA, and LHA were significantly higher in the SUI group than in the non-SUI group (P < 0.001). The rectus abdominis muscle spacing at the umbilical level was also higher in the SUI group than in the non-SUI group (P < 0.001). No statistically significant differences were observed in BA, 3 cm above the umbilicus, or 3 cm below the umbilicus (P> 0.05). After multifactorial logistic regression analysis identified BND, URA, LHA, and rectus abdominis muscle spacing at the umbilical level as independent influencing factors for postnatal SUI (P < 0.05). ROC curves showed that the areas under the curve for BND, URA, LHA, and rectus abdominis muscle spacing at the umbilical level were 0.794, 0.814, 0.782, and 0.716, respectively (P < 0.001), while the combined area under the curve could reached 0.886.  Conclusion  Maternal pelvic floor ultrasound indexes and abdominis muscle spacing at the umbilical level demonstrate clinical diagnostic value for the diagnosis of SUI.
Immunomodulatory mechanisms of acupuncture in the treatment of immune thrombocytopenia
REN Xiaoyun, GAO Mingjie, CHEN Tao, LI Zheyuan, LI Heran, WANG Jinhuan
2026, 24(4): 641-645. doi: 10.16766/j.cnki.issn.1674-4152.004459
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Immune thrombocytopenia (ITP) is an acquired autoimmune disorder characterized by immune-mediated platelet destruction, resulting in thrombocytopenia and an increased risk of bleeding. First-line therapies, such as corticosteroids and intravenous immunoglobulin, can achieve short-term disease control but are limited by adverse effects, high relapse rate, and inadequate responses in a subset of patients. As a key non-pharmacological therapy in traditional Chinese medicine, acupuncture exerts holistic regulation and multi-target intervention. By modulating the neuro-endocrine-immune network and restoring immune homeostasis, acupuncture has emerged as a promising adjunctive treatment for ITP. At the innate immunity level, acupuncture regulates the activity of antigen-presenting cells, attenuates excessive activation, and suppresses pro-inflammatory responses, thereby mitigating aberrant autoantigen presentation. Within adaptive immunity, acupuncture contributes to immune balance by suppressing pathogenic antibody production in B cells and rebalancing T-cell subset homeostasis, characterized by suppression of effector T-cell hyperactivation and enhancement of regulatory T-cell function. This review summarizes recent evidence on acupuncture-mediated immunomodulation and ITP pathogenesis, delineating the cellular and molecular mechanisms through which acupuncture may restore immune homeostasis. By integrating fragmented findings, we aim to clarify the multi-cellular and multi-pathway synergistic effects underlying its therapeutic actions, thereby providing a mechanistic rationale for acupuncture as a complementary strategy and supporting the optimization of clinical management for ITP.
Department of Endocrinology, the Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570311, China
CHEN Mingfei, CHEN Zongcun
2026, 24(4): 646-649. doi: 10.16766/j.cnki.issn.1674-4152.004460
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Diabetic peripheral neuropathy (DPN) is one of the most common chronic complications of diabetes, often leading to pain, sensory abnormalities, and loss of function, which seriously affects the quality of life of patients. With the continuous increase in the global prevalence of diabetes, the prevention and control situation of DPN is severe, and research on its mechanism has attracted much attention. In recent years, novel adipokines such as Apelin, adiponectin, lipocalin-2, omentin-1, and Nesfatin-1, as bioactive molecules secreted by adipose tissue and potential biomarkers, have been extensively explored for their roles in metabolic diseases. Studies have shown that changes in the expression levels of these novel adipokines and their signaling pathways are closely related to the occurrence and development of DPN, and they may participate in the process of DPN through multiple mechanisms such as metabolic abnormalities, inflammatory responses, and nerve damage. However, current research on the specific mechanisms and clinical applications of novel adipokines in DPN is still insufficient. This article aims to summarize the mechanisms of action, influencing factors, and the latest research progress of these adipokines in DPN, explore the value of novel adipokines in the early diagnosis and intervention of DPN, and provide a theoretical basis and clinical reference for future research.
Application of modified volumetric viscosity test combined with laryngoscopic swallowing function assessment in feeding training of stroke patients with dysphagia
LUO Yanqun, CHEN Ailian, LI Meixi, HU Tingting, ZHENG Yaxing
2026, 24(4): 650-653. doi: 10.16766/j.cnki.issn.1674-4152.004461
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  Objective  To observe the effect of the modified volume-viscosity awallowing test-Chinese version (VVST-CV) combined with flexible endoscopic evaluation of swallowing (FEES) in the feeding training of patients with post-stroke dysphagia (PSD), aiming to provide a more precise assessment method and intervention strategy for clinical practice.  Methods  A total of 60 patients with PSD admitted to the Department of Rehabilitation Medicine, Hunan Provincial People ' s Hospital between May 2023 and May 2024 were enrolled. They were divided into an experimental group and a control group (30 cases each) using the odd-even number method. The control group was assessed using VVST-CV alone, while the experimental group underwent assessment with VVST-CV combined with FEES. The effects of feeding training were compared between the two groups.  Results  Before treatment, no statistically significant differences were found in the baseline characteristics between the two groups regarding kubota water swallowing test (KWST) grade, functional oral intake scale (FOIS) grade, or standardized swallowing assessment (SSA) scores (P>0.05). After treatment, the experimental group showed a significantly lower KWST grade (P < 0.05) and a significantly higher FOIS grade (P < 0.05) compared to the control group. The SSA score in the experimental group (22.93±1.89) was significantly lower than that in the control group (24.87±2.05, F=14.562, P < 0.001). Furthermore, the overall clinical efficacy grade was superior in the experimental group (P < 0.05).  Conclusion  The combined application of the modified volumetric viscosity test and laryngoscopic swallowing function assessment can significantly enhance oral feeding ability and improve swallowing function in stroke patients with dysphagia.
A qualitative study on the use of pre-exposure prophylaxis for men who have sex with men
SUN Yongbing, SONG Bing, JIANG Tianjun
2026, 24(4): 654-657. doi: 10.16766/j.cnki.issn.1674-4152.004462
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  Objective  The prevention and control of human immunodeficiency virus (HIV) in China still faces significant challenges. Currently, men who have sex with men (MSM) have become one of the key populations in efforts to reduce HIV transmission. To control HIV transmission among MSM, pre-exposure prophylaxis (PrEP) serves as a crucial preventive measure. However, the uptake of PrEP among MSM in China remains low. This study aimed to explore the barriers to PrEP use among MSM through qualitative interviews.  Methods  Following the principle of information saturation, 10 MSM were recruited from an HIV-focused non-governmental organization in Beijing between April and August 2023 for in-depth interviews. A qualitative research approach using 7-step thematic analysis was employed to summarize and extract key themes from the interview data.  Results  A total of 10 MSM participated in the study, with ages ranging from 21 to 53 years. Six participants had received higher education, and six reported a monthly income of 5 000-10 000 RMB. Through data analysis, 10 subthemes were identified: awareness level, publicity, prevention of other infectious diseases, passion, behavioral disinhibition, drug side effects, dosing regimen, drug accessibility, cost, and benefits. These subthemes were further consolidated into three overarching themes: cognitive factors, sex and drug-related factors, and economic factors.  Conclusion  The comprehensive implementation of PrEP in China still encounters considerable challenges. Chinese MSM exhibit insufficient knowledge of PrEP, concerns regarding its limited scope of disease prevention, memory lapses in medication compliance, fear of side effects, and high costs. It is recommended to promote PrEP through multiple channels, enrich educational content, and strengthen peer-led initiatives. Additionally, the role of MSM-focused NGOs should be leveraged to enhance awareness of infectious disease prevention and mental health support within this population. Harnessing the influence of these organizations may accelerate the dissemination and adoption of PrEP strategies.
Effects of Bianshi heat therapy on abdominal bloating, diarrhea, and constipation during the pretreatment phase of hematopoietic stem cell transplantation patients
MAO Xiaopei, YAO Binlian, PENG Min, ZHU Rui, SHEN Wangfang, QIU Yanfei
2026, 24(4): 658-663. doi: 10.16766/j.cnki.issn.1674-4152.004463
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  Objective  To explore the effect of Bianshi heat therapy on abdominal bloating diarrhea, and constipation during the pretreatment phase of hematopoietic stem cell transplantation (HSCT) patients, providing a new approach to improve patient quality of life.  Methods  A total of 66 HSCT patients admitted to the Department of Hematology, the First Affiliated Hospital of Zhejiang Chinese Medical University from October 2023 to April 2024 were selected and divided into an intervention group (Bianshi heat therapy + routine nursing) and a control group (routine nursing) according random number table, with 33 patients in each group. The intervention was administered for 7 days over 2 consecutive treatment courses. The incidence and severity of abdominal bloating, diarrhea, and constipation were recorded and evaluated over a 14-day observation period.  Results  The incidence of abdominal bloating and diarrhea in the intervention group was lower than that in the control group within 14 days (P < 0.05), while no significant difference was observed in the incidence of constipation between the two groups (P>0.05). The severity of abdominal bloating was lower in the intervention group compared to the control group (Waldχ2=17.568, P < 0.001) and showed a progressive improvement over time (Waldχ2=71.992, P < 0.001). The severity of diarrhea was also lower in the intervention group than in the control group (Waldχ2=16.149, P < 0.001), with a significant time-dependent improvement over time (Waldχ2=21.409, P < 0.001). For constipation severity, no significant difference was observed between the two groups (Waldχ2=0.464, P=0.496), however, a significant interaction effect was found (Waldχinteraction2=715.967, Pinteraction < 0.001).  Conclusion  Bianshi heat therapy significantly reduces the incidence and severity of bloating and diarrhea during the pretreatment phase of HSCT patients, contributing to improved quality of life. Its effect on constipation appears to be limited.
Exploration and Practice of Blended Teaching Model for the Formulaology Based on OBE Concept
GAO Changyu, YUAN Fu, CHEN Baozhong, FU Qiang, ZHAO Xueying, BI Junhui, MENG Tuo
2026, 24(4): 664-667. doi: 10.16766/j.cnki.issn.1674-4152.004464
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  Objective  To implement a small private online course (SPOC)-based online-offline blended teaching model in the Formulaology course, explore and summarize the features and advantages of this teaching model, and provide insights for the reform of Formulaology pedagogy.  Methods  Guided by the concept of outcome-based education (OBE), a SPOC aligned with the teaching objectives of the Formulaology course was developed. The online-offline blended teaching model was restructured and innovated, then implemented and practiced in the Formulaology course.  Results  The SPOC-based blended teaching model centered on students ' needs and interests, aiming to enhance their autonomous learning and practical application abilities, thereby truly prioritizing student-centered education. A comprehensive before-class, in-class, and after-class teaching evaluation system was established throughout the course. A multi-dimensional assessment approach evaluated the entire learning process, complemented by questionnaires assessing teaching effectiveness, forming a closed-loop evaluation system for both teaching and learning. This provided a foundation for teachers and students to understand current teaching and learning dynamics and to drive future improvements. The components of the OBE concept, student-centered, outcome-oriented focus, and continuous improvement, were integrated into the entire teaching process.  Conclusion  The SPOC-based blended teaching model for the Formulaology course, grounded in the OBE concept, scientifically designs the teaching process to align with course objectives. This model fosters harmonious, efficient, and engaging teacher-student interactions, stimulating students ' enthusiasm and initiative in learning Formulaology. Rich and targeted course resources fully meet students ' needs for autonomous and in-depth learning. The multi-dimensional evaluation system shifts students ' mindset from exam-oriented or perfunctory learning, fully embodying the "student-centered" philosophy. This model warrants further promotion and application.
The application of mixed teaching mode based on OBE concept in clinical teaching of integrated traditional Chinese and western medicine in thoracic surgery
XU Zhaojun, ZHANG Shengkang, WANG Zhaoli, ZHU Wei, LU Jing, SONG Lan
2026, 24(4): 668-672. doi: 10.16766/j.cnki.issn.1674-4152.004465
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  Objective  Under the background of the innovative service model integrating traditional Chinese and Western medicine in diagnosis and treatment, traditional clinical teaching has difficulty achieving the goal of cultivating outstanding physicians in integrated traditional Chinese and Western medicine. Guided by the concept of "competence in the diagnosis and treatment of integrated traditional Chinese and Western medicine in thoracic surgery", this study aimed to construct and implement a blended teaching model for thoracic surgery integrating traditional Chinese and Western medicine, in order to improve teaching effectiveness and facilitate the cultivate of outstanding integrated Chinese and Western medicine physicians.  Methods  A total of 114 interns from the Department of Thoracic Surgery, First Affiliated Hospital of Hunan University of Traditional Chinese Medicine, from January to December 2022 were selected and randomly divided into a control group and an experimental group, with 57 participants in each group, using a random number table method. The experimental group adopted a blended learning model based on the OBE concept, and theoretical assessment, operational skills assessment, and Mini-CEX evaluation model were used for evaluation. A questionnaire survey was conducted to evaluate the teaching effectivenes. The control group adopted the traditional teaching mode and used the same assessment methods as the experimental group.  Results  At the end of the internship, the theoretical assessment scores of the experimental group and the control group were 84.6±3.2 and 73.8±4.0, respectively (P < 0.05), and the operational skills assessment scores were 84.2±4.6 and 76.1±5.4, respectively (P < 0.05). Prior to the internship, no significant differences were observed between the groups in mini-CEX scores for clinical reception, physical examination, clinical diagnosis, humanistic care, communication skills, organizational effectiveness, and overall performance. After the internship, the scores were higher than those before the internship; however, the scores of the experimental group were higher than those of the control group (P < 0.05). The results of the questionnaire survey showed that teaching satisfaction and satisfaction with teaching methods in the experimental group were higher than those in the control group (P < 0.05).  Conclusion  The blended teaching mode in thoracic surgery clinical teaching based on the OBE concept can improve the clinical teaching effectiveness of integrated traditional Chinese and Western medicine in thoracic surgery.
The application of mini clinical practice assessment based on Gibbs reflective cycle model in the nursing training of ICU disuse syndrome
FAN Qiaoling, GU Jiahuan
2026, 24(4): 673-677. doi: 10.16766/j.cnki.issn.1674-4152.004466
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  Objective  To construct a mini-clinical exercise assessment nursing training program based on the Gibbs reflective cycle model, aiming to improve the quality of care for patients with disuse syndrome in the ICU.  Methods  Fifty-two ICU nurses from Shaoxing People ' s Hospital from October 2022 to May 2025 were selected and divided into two groups according to the random number table method. Group A, 26 nurses, received nursing training for ICU disuse syndrome using the traditional teaching method, while Group B, 26 nurses, received nursing training for ICU disuse syndrome using the mini clinical exercise assessment teaching method based on the Gibbs reflection cycle model. It lasted for four weeks. After the training, 120 patients with ICU disuse syndrome during the same period were selected and grouped according to the random number table method. Sixty cases in Group A were cared for by nurses in Group A. Sixty cases in Group B were cared for by nurses in Group B for 4 weeks. The scores of the Self-Directed Learning Assessment Scale (SRSSDL), the mastery of theoretical knowledge and practical skills of Group A and Group B before and after the training were compared. The scores of the manual muscle strength Test (MMT) scale, activities of daily living, and psychological states [Self-Rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores] of Group A and Group B before and after nursing.  Results  After training, the SRSSDL score of group B was higher than that of group A (P < 0.05), and the examination scores of theoretical knowledge[(90.12±6.26) vs.(79.23±8.45) points] and practical skills [(90.45±8.37) vs.(80.05±9.24) points] were higher than those of Group A (P < 0.05). After nursing, the MMT score [(3.67±0.66) vs.(3.10±0.51) points] and the modified Barthel index [(65.89±7.11) vs.(58.78±6.05) points] in group B were higher than those in group A (P < 0.05), while the SAS and SDS scores were lower than those in group A (F=20.871, 18.973; P < 0.001, < 0.001).  Conclusion  The mini clinical practice assessment based on the Gibbs reflective cycle model can not only enhance the self-directed learning and professional ability of ICU nurses, but also improve the muscle strength and daily living ability of patients with ICU disuse syndrome, and alleviate their anxiety and depression.
Home life experience in patients with temporary ileostomy for rectal cancer: A qualitative study
ZHOU Qiang, ZHANG Xiaoshuang, SUN Lin, GUO Kun, WANG Xi, SHEN Minjing, WANG Jiacheng, YUAN Li, FANG Haonan
2026, 24(4): 678-681. doi: 10.16766/j.cnki.issn.1674-4152.004467
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  Objective  To explore the home-living experiences of patients with rectal cancer with a temporary ileostomy, and to provide a reference for clinical healthcare professionals in developing home-care plans for such patients.  Methods  Purposive sampling was used to recruit patients with rectal cancer who retained a temporary ileostomy and were treated at the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital) between December 2023 and October 2024, and semi-structured interviews were conducted with 15 patients. The interview guide was developed on the basis of a literature review, project-group discussions, and pilot interviews with two patients, interviews were audio-recorded, and within 24 h after each interview two researchers transcribed the recordings into text and analyzed the interview content using Colizzi ' s seven-step method to synthesize themes.  Results  The home-living experiences of patients with rectal cancer and a temporary ileostomy were distilled into four themes: (1) changes in living behaviors (reduced sleep quality, dietary changes, and insufficient physical activity); (2) complex emotions (reluctant acceptance of the illness, positive psychological adjustment, and courageous confrontation of the illness); (3) difficulties in home life (stoma-related complications, lack of self-care ability, and heavy financial burden); (4) needs in home life (need for continuity of care services and hope for stoma reversal).  Conclusion  The home-living experiences of patients with rectal cancer with a temporary ileostomy are rich, patients have positive experiences of courageously facing the illness, but also negative experiences such as problems with sleep and diet, stoma-related complications, a heavy financial burden, and needs for continuity of care. Healthcare professionals should attend to these negative experiences in home-dwelling patients. By collaborating with families, local government, and society resources, they can provide multidimensional support to improve the quality of patients ' home life.
Bidirectional two-sample Mendelian randomization investigation of the causal association between liver function indicators and autoimmune liver diseases
LIANG Xiyao, ZENG Xin, DAI Yan, CHEN Jiaxing, FENG Yitian, LIU Yuan
2026, 24(4): 682-686. doi: 10.16766/j.cnki.issn.1674-4152.004468
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  Objective  To investigate the causal associations between liver function indices and autoimmune liver diseases (AILD) using a bidirectional two-sample Mendelian randomization (MR) approach.  Methods  Genome-wide association study (GWAS) data for liver function indices and AILD were obtained from the open GWAS database. Forward MR analysis was performed with 9 liver function indices including alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT): as exposures, while 3 types of AILD autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC) were considered as outcomes. Reverse MR analysis was subsequently conducted to validate potential causal effects in the opposite direction. The inverse variance weighted (IVW) method was used as the primary analytical approach. Sensitivity analyses, including weighted median, MR-Egger, MR-PRESSO, horizontal pleiotropy test, and heterogeneity test were conducted to verify result robustness.  Results  Forward MR analysis showed that ALT (OR=1.719, 95% CI: 1.276-2.316, P < 0.001), AST (OR=1.358, 95% CI: 1.012-1.824, P=0.041), and GGT (OR=1.535, 95% CI: 1.255-1.877, P < 0.001) were positively associated with AIH. ALP and GGT exhibited positive causal relationships with PBC (ALP: OR=1.309, P < 0.001; GGT: OR=1.168, P=0.007) and PSC (ALP: OR=1.208, P=0.037; GGT: OR=1.155, P=0.046). Reverse MR analysis revealed causal associations between AIH and GGT (OR=1.004, P=0.021), PBC/PSC and ALP (PBC: OR=1.007, P=0.018; PSC: OR=1.008, P=0.039), as well as PBC/PSC and GGT (PBC: OR=1.014, P=0.003; PSC: OR=1.010, P < 0.001).  Conclusion  At the genetically predicted level, elevated ALT, AST, and GGT are associated with an increased risk of AIH, and AIH may, in turn, influence GGT levels. Bidirectional causal relationships were identified between ALP/GGT and PBC/PSC. These findings provide novel insights into the non-invasive diagnosis and potential therapeutic strategies for AILD.
Influence of quality intervention based on causal analysis on disinfection effect of disinfection supply room
ZHU Ying, BAO Lei, SHI Hui, TANG Liyuan, WANG Zuming
2026, 24(4): 687-691. doi: 10.16766/j.cnki.issn.1674-4152.004469
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  Objective  The disinfection effect of medical devices in the central sterile supply department directly influences medical quality, patient safety, and the efficacy of hospital infection prevention and control. To improve sterilization quality in the central sterile supply department, this study applied quality intervention based on causal analysis to the central sterile supply department and explored its clinical value.  Methods  From June 2022 to December 2022, 1 326 surgical instruments disinfected in the Central Sterile Supply Department of Eastern Theater General Hospital, Chinese People's Liberation Army, which did not receive quality intervention based on causal analysis, were set as the control group. From January 2023 to June 2023, 1 389 surgical instruments receiving quality intervention based on causal analysis were selected as the observation group. The control group received conventional quality intervention, while the observation group was given quality intervention based on causal analysis in addition to conventional intervention. The disinfection effects between the two groups were compared.  Results  The scores for the knowledge level of infection management among the disinfection supply staff, supervisors, and medical device engineers in the observation group were (94.63±3.32) points, (93.80±2.21) points, and (86.68±2.89) points respectively, which were all higher than those of the control group (90.27±4.36) points, (87.62±2.03) points, and (81.92±1.45) points (P < 0.05). The proportion of standardized operations in the recovery, cleaning and disinfection, packaging sterilization, aseptic testing, and equipment distribution of the observation group was higher than that of the control group (P < 0.05). The incidence of unqualified events in the cleaning and sterilization of medical devices in the control group was 2.04% (27/1 326), which was higher than that in the observation group [0.94% (13/1 389), χ2=5.658, P=0.017].  Conclusion  Quality intervention based on causal analysis can improve the knowledge level of infection management in the disinfection supply room, improve the quality of disinfection and sterilization.
Efficacy analysis of acupuncture combined with medicine in the adjuvant treatment of lumbar spinal stenosis: a meta-analysis
YANG Linlin, WANG Yan, YUAN Haiguang, YU Boqiang, HE Yingtao
2026, 24(4): 692-697. doi: 10.16766/j.cnki.issn.1674-4152.004470
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  Objective  The reports on the use of acupuncture combined with medicine for the treatment of lumbar spinal stenosis have been increasing. However, no relevant systematic evaluation is currently available. Based on the meta-analytic methods of evidence-based medicine, this study evaluates the efficacy and safety of acupuncture combined with medicine in the treatment of lumbar spinal stenosis.  Methods  A computerized search for randomized controlled trials on acupuncture combined with medicine for lumbar spinal stenosis was conducted in CNKI, Wanfang Data, VIP, SinoMed, Cochrane Library, PubMed, Embase, and Web of Science from inception to September 2023. Two researchers independently collected the literature, and meta-analysis was performed using RevMan 5.4 software following initial and subsequent screening.  Results  A total of 14 papers involving 990 patients were included. The results of the meta-analysis showed that, compared with the control group, the observation group demonstrated significantly better outcomes in pain score (SMD=-1.63, 95% CI: -2.16 to -1.09), the lumbar function score (SMD=1.58, 95% CI: 0.81 to 2.35), the serum inflammatory factor IL-1ɑ content (MD=-2.70, 95% CI: -3.68 to -1.73), the serum inflammatory factor TNF-α content (MD=-5.27, 95% CI: -7.62 to -2.93), and overall effective rate (OR=3.47, 95% CI: 1.86 to 6.48).  Conclusion  The combination of acupuncture and medicine can improve the clinical efficacy of lumbar spinal stenosis, with fewer adverse events and better safety.
Meta-analysis of vitamin D supplementation combined with insulin therapy on blood glucose, HbA1c and insulin resistance in gestational diabetes mellitus
JIANG Xiaofeng, XIA Guoxiang, JIN Mengxia, SUN Jiaqing, YUAN Lin, LOU Luyao
2026, 24(4): 698-702. doi: 10.16766/j.cnki.issn.1674-4152.004471
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  Objective  To evaluate the efficacy of Vitamin D combined with insulin in the treatment of gestational diabetes mellitus, and to provide evidence-based support for clinical application.  Methods  A comprehensive search was conducted in the Cochrane Library, Embase, PubMed, Web of Science, Wanfang, VIP, CNKI and CBM Database using keywords including geostationary diabetes mellitus, GDM, Vitamin D, insulin, gestational diabetes, Vitamin D and insulin. Two researchers independently screened the studies and performed a quality assessment. The analysis of the data conducted were analyzed using RevMan 5.4.  Results  A total of 26 RCTs involving 2 392 participants were included in the analysis. A meta-analysis was conducted to ascertain the efficacy of the intervention group (Vitamin D + insulin) achieved significantly lower levels than control (insulin alone) in fasting plasma glucose (FPG, MD=-0.96, 95% CI: -1.26 to -0.65), fasting blood glucose (FBG, MD=-0.62, 95% CI: -0.96 to -0.29), 2-hour postprandial blood glucose (2hPG, MD=-1.27, 95% CI: -1.56 to -0.98), 2-hour postprandial plasma glucose (2hBG, MD=-1.61, 95% CI: -2.61 to -0.61), glycated hemoglobin (HbA1c, MD=-1.21, 95% CI: -1.53 to -0.72), homeostatic model assessment of insulin resistance (HOMA-IR, MD=-0.59, 95% CI: -0.87 to -0.31). A sensitivity analysis was conducted, which revealed a significant change in the combined effect of 2hBG, indicating unstable results. Funnel plot asymmetry was observed for HbA1c, suggesting potential publication bias.  Conclusion  The combination of vitamin D and insulin has been demonstrated to assist patients diagnosed with GDM in the maintenance of optimal blood glucose levels, in addition to the enhancement of HOMA-IR.
Application of HACCP system in the whole process management of arm infusion port for patients with lung cancer chemotherapy
XU Yan, WU Linke, ZHANG Qiwan, ZHANG Kai, HUANG Baoli
2026, 24(4): 703-706. doi: 10.16766/j.cnki.issn.1674-4152.004472
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  Objective  To observe the application effect of hazard analysis and critical control point (HACCP) system in the whole process management of arm infusion port for patients undergoing lung cancer chemotherapy.  Methods  A total of 106 patients with lung cancer chemotherapy who received arm infusion port implantation were selected from Department of Respiratory Medicine of Nanjing Hospital Affiliated with Nanjing Medical University from May 2022 to May 2024, and were grouped according to admission time. In HACCP group, 53 patients were placed from May 2023 to May 2024 and implemented HACCP whole process management. In control group, 53 patients were placed from May 2022 to April 2023 and carried out routine infusion port management. The incidence rates of infusion port-related complications, process execution and operation quality indicators, medical data consumption indicators, and patient self-management ability were compared between the two groups.  Results  The total incidence rate of bag infection, tube plugging, thrombosis and catheter displacement in the HACCP group (7.55%, 4 patients) was lower than that in the control group (35.85%, 19 patients, χ2=12.494, P < 0.001). The compliance rate of timely replacement rate of dressing, qualified rate of flushing technique and qualified rate of dressing fixation in the HACCP group with 90.57% (48 cases), 92.45% (49 cases) and 96.23% (51 cases) were higher than 60.38% (32 cases), 64.15% (34 cases) and 64.15% (34 cases) in the control group (χ2=13.046, 12.494, 17.162, P < 0.001). The number of unplanned hospital returns was less in the HACCP group than that in the control group (P < 0.05), and the scores of infection prevention knowledge, daily maintenance skills, complication identification ability and medical order compliance and total score in the HACCP group were higher than those in the control group (P < 0.05).  Conclusion  HACCP system can significantly reduce the incidence rates of arm infusion port-related complications in patients with lung cancer chemotherapy, and enhance the quality of process execution and self-management ability, and it does not increase the consumption of medical resources.
Application of H2H standardized nasal irrigation management model in radiotherapy patients with nasopharyngeal carcinoma
LI Yanqing, HUANG Xiaoyan, JIANG Qingyu, LIU Cuirong, WENG Jingjin
2026, 24(4): 707-711. doi: 10.16766/j.cnki.issn.1674-4152.004473
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  Objective  To explore the effect of H2H standardized nasal irrigation management mode on the nasal condition of patients with nasopharyngeal carcinoma after radiotherapy, and to provide a reference for nasal care after radiotherapy.  Methods  A total of 128 patients with nasopharyngeal carcinoma who received radiotherapy in the Department of Otolaryngology and Head and Neck of Guangxi Zhuang Autonomous Region People's Hospital from January 2021 to December 2022 were selected as the study subjects, and were divided into a control group and an observation group according to a random number method, with 64 cases in each group. Both groups were given conventional nasal irrigation care during treatment. On this basis, the observation group was given H2H standardized nasal irrigation management mode from the first nasal irrigation to 6 months after discharge, and continuous individualized care was provided for patients from hospital to home. The compliance of nasal irrigation, the consistency of nasal secretions, the site of radioactive sinusitis, and the quality of life (SONT-20 scale) were compared between the two groups at different stages.  Results  Follow-up to 6 months after discharge, nasal irrigation compliance and quality of life between the two groups were statistically significant (P < 0.05);The viscosity (severe) of nasal secretions in the observation group was 40.63% (26/64), lower than that in the control group (62.5%, 40/64, P < 0.05); Site of radiation sinusitis (≥3) in the observation group was 28.13% (18/64), lower than that in the control group (40.63%, 26/64, P=0.062).  Conclusion  H2H standardized nasal irrigation management mode can effectively improve the compliance of nasal irrigation in nasopharyngeal carcinoma patients, improve the nasal condition of patients after radiotherapy, reduce the severity of radioactive sinusitis in patients, and improve the quality of life.
Two cases of spondyloarthritis with dual HLA-B*27 subtype positivity and literature review
HUANG Yue, QIAN Luxin, XU Congying, YAO Lin, LI Yasong
2026, 24(4): 712-715. doi: 10.16766/j.cnki.issn.1674-4152.004474
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HLA-B*27 dual positivity is a rare genetic phenotype in spondyloarthritis and may be associated with specific clinical manifestations and disease severity. This paper reports two cases of spondyloarthritis with dual positivity for HLA-B*2704 and HLA-B*2705, as well as for HLA-B*2704 and HLA-B*2702. Combined with a literature review, the following characteristics of spondyloarthritis with dual HLA-B*27 subtype positivity are summarized: (1) Dual positivity of HLA-B*27 subtypes is based on HLA-B*2704, most commonly presenting as simultaneous positivity for HLA-B*2704 and HLA-B*2705; the protective subtype HLA-B*2706 does not appear to exert a protective effects. (2) Most patients are male, with axial spondyloarthritis as the predominant clinical phenotype. (3) The patients show a poor response to nonsteroidal anti-inflammatory drugs demonstrate a favorable response to TNF-α inhibitors.
An experience in the diagnosis and treatment of difficult-to-treat complicated urinary tract infection
TIAN Xiaotong, LIU Zhengyin, LI Taisheng, ZHANG Li
2026, 24(4): 716-720. doi: 10.16766/j.cnki.issn.1674-4152.004475
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A 29-year-old female presented with recurrent fever, lumbar pain, pyuria, and renal masses. Imaging revealed structural abnormalities of the right kidney, demonstrating the classical "Bear's Paw sign", with angular or linear calculi. Renal hemodynamic scintigraphy suggested that the right kidney was non-functional. Despite adequate anti-infective treatment, the patient continued to exhibit persistent pyuria with mildly increased inflammatory markers. Reviewing the literature and consulting multidisciplinary specialists, a therapeutic regimen centered on radical right nephrectomy was ultimately determined. Histopathology identified xanthogranulomatous pyelonephritis (XGP), establishing the final diagnosis. The prognosis of XGP was improved over a 6-month follow-up period. This study summarizes the key points of XGP diagnosis to improve the general physicians' awareness, facilitating earlier diagnosis, treatment, and rehabilitation.

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