1.Physical exercise improves physical function in burn patients:a systematic review and meta-analysis
Qiang CHEN ; Wenjuan WU ; Shuhua JIANG ; Da HUANG
Chinese Journal of Tissue Engineering Research 2026;30(5):1269-1281
OBJECTIVE:Some studies have shown that physical exercise can effectively improve knee extensor strength and cardiorespiratory function in burn patients;some studies have also shown that physical exercise is not effective in improving respiratory function in burn patients.Improvement effects of physical exercise on physical functions(muscle function,walking function,cardiopulmonary function,and lean body mass)of burn patients were evaluated by a systematic evaluation and meta-analysis.METHODS:Based on databases including Web of Science,PubMed,Embase,Cochrane Library,CNKI,WanFang,and the Chinese Biomedical Database,literature on the improvement of physical function in burn patients through physical exercise was searched using subject headings and free terms.With muscle function,walking ability,cardiopulmonary function,and lean body mass as the primary outcome measures,a meta-analysis was conducted to compare the efficacy of physical exercise with traditional physical therapy or conventional care methods.RESULTS:A total of 38 papers were included,of which 26 papers were included in the meta-analysis,involving 1 658 patients.Meta-analysis results showed that:(1)Physical exercise significantly enhances the knee extensor strength of the dominant leg in burn patients(mean difference[MD]=8.34,95%confidence interval[CI]:6.95-9.72,P<0.000 01),increases quadriceps strength,peak oxygen uptake,forced vital capacity and maximum ventilation volume in 1 second,and resting heart rate(standardized mean difference[SMD]=4.41,95%CI:2.52-6.30,P<0.000 01;MD=4.91,95%CI:3.52-6.29,P<0.000 01;MD=5.86,95%CI:0.09-11.63,P=0.05;MD=6.90,95%CI:2.93-10.87,P=0.000 7;MD=5.03,95%CI:1.45-8.61,P=0.006),and improves the 6-minute walking distance,gait parameters,and total lean body mass(MD=45.29,95%CI:24.7-65.89,P<0.0001;SMD=7.84,95%CI:6.05-9.63,P<0.000 01;MD=2.47,95%CI:2.01-2.93,P<0.000 01).(2)The subgroup analysis results indicated that the improvement in knee extensor strength of the dominant leg may be better in children than in adults and better in the extra-heavy group than in the heavy group.Improvement in the 6-minute walking distance is better in children than in adults,and higher degree of burn indicates better improvement effects,with no difference from the control group for<12 weeks.Peak oxygen uptake may be better in adults and severe burn groups than in children and moderate burn groups,resistance combined with aerobic exercise modalities may be better than aerobic exercise alone,and exercise duration>60 minutes may be better than<60 minutes.CONCLUSION:Physical activity is effective in improving physical function in burn patients,as evidenced by improvements in muscle strength,walking ability,cardiorespiratory fitness,and lean body mass.The quality of evidence recommended for all indicator results is moderate or below,with imprecision and inconsistency being the main factors for downgrading.Therefore,more high-quality randomized controlled trials are needed in the future to verify the reliability of the results.
2.Increased risk of osteoporotic pathological fractures associated with sterol esters:evidence from IEU-GWAS and FinnGen databases
Zengjie GAO ; Xiang PU ; Lailai LI ; Yihui CHAI ; Hua HUANG ; Yu QIN
Chinese Journal of Tissue Engineering Research 2026;30(5):1302-1310
BACKGROUND:Although previous studies have reported associations between lipids and the risk of osteoporotic pathological fractures,the specific causal relationships between lipid level and osteoporotic pathological fractures remain unclear.OBJECTIVE:To elucidate the causal relationship between lipids and osteoporotic pathological fractures using a two-sample bidirectional Mendelian randomization analysis.METHODS:The data for 178 lipid metabolites were obtained from the IEU-GWAS database(developed by the MRC Integrative Epidemiology Unit at the University of Bristol,UK,which provides extensive summary data from genome-wide association studies),while osteoporotic pathological fracture data(from 173 619 European participants)were acquired from the FinnGen database(constructed by the Finnish national gene research program,focusing on investigating relationships between genomics and health/disease in the Finnish population).Osteoporotic pathological fracture data were used as the outcome variable,with lipids serving as exposures,for the bidirectional Mendelian randomization study to evaluate the causal effects of different lipids on osteoporotic pathological fractures.The UK Biobank database was employed as a validation set by switching the outcome variable to verify the findings horizontally.RESULTS AND CONCLUSION:(1)The inverse variance weighted analysis indicated that each unit increase in sterol ester(27∶1/20∶2)levels was associated with a 25.55%increase in the risk of osteoporotic pathological fractures(odds ratio=1.256,95%confidence interval:1.001-1.575,P=0.049),suggesting a significant positive correlation between elevated sterol ester levels and increased fracture risk.Reverse Mendelian randomization analysis revealed a significant negative association between osteoporotic pathological fractures and three types of phosphatidylcholine.Horizontal validation yielded consistent results,confirming sterol ester as a risk factor for osteoporotic pathological fractures.(2)The results indicate that sterol ester is a risk factor for osteoporotic pathological fractures,while phosphatidylcholine serves as a protective factor.These findings strengthen the evidence supporting the effect of lipids on the risk of osteoporotic pathological fractures.Although the GWAS data used in this study were derived from European populations,given the broad commonality of human genetics,the results provide valuable reference significance for improving osteoporosis in Chinese populations through lipid regulation.
3.Relationship between plasma proteins and pulmonary arterial hypertension and potential therapeutic targets
Cuicui ZHANG ; Huanyu CHEN ; Qiao YU ; Yuxuan HUANG ; Gengzhen YAO ; Xu ZOU
Chinese Journal of Tissue Engineering Research 2026;30(5):1331-1340
BACKGROUND:Pulmonary arterial hypertension is a destructive cardiopulmonary disease for which there is no cure.An association between plasma proteins and pulmonary arterial hypertension has been suggested,but the causal relationship has not been specifically elucidated.OBJECTIVE:To elucidate the causal relationship between plasma proteome and pulmonary arterial hypertension using a two-sample Mendelian randomization method,thereby searching for potential therapeutic targets for pulmonary arterial hypertension.METHODS:Plasma Protein Gene-Wide Association Analysis Statistics for 4 907 Aptamer Measurements in 35 559 Icelanders from the Icelandic Database;Genome-wide association analysis statistics for pulmonary arterial hypertension were obtained from the Finn Gen database,version R9,including 234 cases and 265 626 controls.Analyses were performed using Mendelian randomization and Bayesian co-localization analysis,the findings were examined using sensitivity analyses,and protein-protein interaction network maps were constructed to explore the causal relationship between plasma proteins and pulmonary arterial hypertension.RESULTS AND CONCLUSION:(1)The results of inverse variance weighting,maximum likelihood and Wald ratio methods showed 19 proteins causally associated with pulmonary arterial hypertension(P<0.05).Among them,10 plasma proteins,including Beta-1,3-N-acetylglucosaminyltransferase manic fringe(odds ratio[OR]=0.12,95%confidence interval[CI]0.02-0.61,P=0.01)and interferon alpha/beta receptor 1(OR=0.45,95%CI 0.24-0.84,P=0.012),might be associated with a reduced risk of pulmonary arterial hypertension.In contrast,nine plasma proteins,such as glucoside xylosyltransferase 1(OR=3.48,95%CI 1.51-8.00,P=0.003)and plasminogen(OR=42.78,95%CI 2.49-734.31,P=0.01),might be associated with an increased risk of pulmonary arterial hypertension.After the false discovery rate was corrected,19 proteins remained significantly associated with pulmonary arterial hypertension.(2)Multiple sensitivity analyses such as the MR-Egger intercept test and leave-one-out method showed no horizontal multiplicity or heterogeneity in the results of the study,indicating the stability of the study's results.(3)Bayesian co-localization analysis showed that six plasma proteins,including plasminogen(PPH4=1.0)and glucoside xylosyltransferase 1(PPH4=0.94),had PPH4>0.8,suggesting that plasma proteins and the genome-wide association study of pulmonary arterial hypertension had similar causal variance in terms of genetic association.(4)By constructing a protein-protein interaction network map,plasminogen,Annexin A1,fibrinogen gamma chain and matrix metalloproteinase 7 were found to be core proteins.(5)The article used Mendelian randomization analysis to reveal a potential causal association between 4 907 plasma proteins and pulmonary arterial hypertension,suggesting that plasma proteins may be potential therapeutic targets for pulmonary arterial hypertension.The core proteins identified in the study also provide a theoretical basis for further in-depth study of the pathophysiological mechanisms of pulmonary arterial hypertension.Secondly,analyses using the large-scale international databases of Iceland and FinnGen provide new research directions and treatment ideas for pulmonary arterial hypertension in specific populations and environments,as well as ideas and methods that can be used to prevent and treat pulmonary arterial hypertension in China.
4.Analyses of the epidemiological characteristics of multiple pathogens in people aged 14 years and above with acute respiratory infection in Huangpu District of Shanghai from 2015 to 2024
Yun ZHANG ; Yinzi CHEN ; Zhenzi ZUO ; Yu WANG ; Fujie SHEN ; Yuliang HUANG ; Qiang GAO ; Chenyan JIANG ; Yijun WANG
Shanghai Journal of Preventive Medicine 2026;38(2):116-121
ObjectiveTo analyze the epidemiological characteristics of 8 major respiratory pathogens in influenza-like illness (ILI) cases with acute respiratory infections at fever clinics in Huangpu District, Shanghai from 2015 to 2024, and to provide a scientific basis for the prevention and treatment of respiratory diseases. MethodsA retrospective study was conducted in Huangpu District. Individuals meeting the case definition of ILI from 2015 to 2024 was registered. Their nasopharyngeal swabs were collected for pathogen detection. A total of 8 respiratory viruses were tested, including Influenza A virus (Flu A), Influenza B virus (Flu B), adenovirus (ADV), enterovirus/human rhinovirus (EV/HRV), human parainfluenza virus (HPIV), human coronavirus (HCoV), respiratory syncytial virus (RSV), and human metapneumovirus (HMPV). ResultsFrom 2015 to 2019, a total of 344 ILI cases were tested, of which 192 out of 344 cases (55.81%) were tested positive for single respiratory pathogen. From 2023 to 2024, 1 557 ILI cases were tested, with 572 out of 1 557 cases (36.74%) being positive for single pathogen. From 2023 to 2024, the positive rate of single pathogen in ILI cases was significantly lower than that in 2015‒2019 (χ2=42.66, P<0.001). Specifically, the positive rate of Flu A (χ2=74.43, P<0.001) decreased, while that of HPIV (χ2=8.66, P=0.003) increased, both with statistically significant differences. According to the seasonal pattern, the epidemic intensity of Flu A decreased in summer, while that of HPIV increased in summer and autumn. Demographic results showed statistically significant differences in the positive rates of EV/HRV between genders (χ2=22.38, P<0.001), with males exhibiting a higher positive rate than females. No statistically significant differences were identified in the positive rates of single pathogen among different age groups (χ2=4.42, P=0.110). Nevertheless, statistically significant differences were noted when comparing the positive rates of EV/HRV, Flu A, Flu B and HPIV across different age groups (P<0.05). EV/HRV was more commonly detected in the 15‒<25 age group (10.93%), while Flu A and HPIV had the highest positive rates in the ≥60 age group (21.24% and 4.77%). Flu B had the highest positive rate in the 25‒<60 age group (11.26%). 52.63% of cases with co-infections occurred during winter, with the primary pathogens involved being EV/HRV (9 cases) and HCoV (6 cases). The most prevalent combination of co-infection was Flu A with EV/HRV. ConclusionThe prevalence of respiratory pathogens among ILI cases from 2023 to 2024 exhibited notable fluctuations compared to that from 2015 to 2019. Therefore, influenza surveillance should be strengthened, and attention should also be paid to the prevalence of respiratory pathogens such as HPIV. These findings have profound implications for future research, surveillance, vaccine planning, and public health policy making.
5.Safety of endoscopic variceal ligation and endoscopic cyanoacrylate injection in treatment of esophagogastric varices in patients with liver cirrhosis and influencing factors for postoperative bleeding
Luyao JIA ; Baoying CAO ; Chunming HUANG ; Biao XIE ; Hongbo GAO ; Chuo LI ; Qinghua HUANG
Journal of Clinical Hepatology 2026;42(2):356-361
ObjectiveTo investigate the risk factors for bleeding within 5 days and 2 weeks after endoscopic variceal ligation (EVL) or endoscopic cyanoacrylate injection (ECI) for the treatment of esophagogastric varices in patients with liver cirrhosis, as well as the safety of EVL/ECI in patients with thrombocytopenia. MethodsA total of 489 patients with liver cirrhosis and esophagogastric varices who underwent EVL/ECI in Guangzhou Eighth People’s Hospital, Guangzhou Medical University, from January 2018 to December 2023 were enrolled as subjects, and according to the presence or absence of bleeding after surgery, they were divided into bleeding group and non-bleeding group. The risk factors for bleeding within 5 days and 2 weeks after surgery were analyzed. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between groups, and the chi-square test or the continuity-corrected chi-square test was used for comparison of categorical data between groups; the receiver operating characteristic (ROC) curve was plotted to determine the cut-off value of MELD score; a multivariate logistic regression analysis was used to identify the independent risk factors for postoperative bleeding. ResultsThere were no significant differences in the bleeding rates within 5 days and 2 weeks after EVL/ECI between the 386 patients with a platelet count of ≥50×109/L and the 103 patients with a platelet count of (25 — 49)×109/L (5 days: 1.94% vs 2.85%, P=0.870; 2 weeks: 2.91% vs 4.92%, P=0.544). The overall bleeding rate was 2.66% (13/489) and 4.50% (22/489), respectively, within 5 days and 2 weeks after EVL/ECI. The multivariate logistic regression analysis showed that MELD score was an independent risk factor for bleeding within 5 days (odds ratio [OR]=3.726, 95% confidence interval [CI]: 1.214 — 11.429, P=0.021) and 2 weeks (OR=5.760, 95%CI: 1.779 — 18.651, P=0.003) after EVL/ECI, while hemoglobin (Hb) was a protective factor against bleeding within 5 days (OR=0.972, 95%CI: 0.948 — 0.996, P=0.025) and 2 weeks (OR=0.976, 95%CI: 0.957 — 0.995, P=0.016) after surgery; portal vein tumor thrombus (OR=2.667, 95%CI: 1.000 — 7.117, P=0.050) was an independent risk factor for bleeding within 2 weeks after surgery, while platelet count [(25 — 49)×10⁹/L] was not a risk factor for postoperative bleeding (P>0.05). ConclusionBoth EVL and ECI have good safety in patients with liver diseases and grade 3 thrombocytopenia. MELD score is an independent risk factor for bleeding within 5 days and 2 weeks after EVL/ECI, while Hb is a protective factor; portal vein tumor thrombus is an independent risk factor for bleeding within 2 weeks after surgery.
6.Influencing factors for calcium salt deposition in patients with alveolar echinococcosis
Zitong XIONG ; Zhiyi LIN ; Yanxin HUANG ; Fuzhong FANG ; Zhengzhan WU ; Zirui XIN ; Chunxia HU ; Jiayu ZHOU ; Yuan YAO ; Hongwei ZHANG
Journal of Clinical Hepatology 2026;42(2):372-379
ObjectiveTo investigate the imaging features of calcium salt deposition and serological markers in patients with alveolar echinococcosis through a retrospective analysis, as well as independent risk factors for the degree of calcium salt deposition in lesions, and to provide a basis for assessing disease process. MethodsA retrospective analysis was performed for the imaging and clinical data of 107 patients with alveolar echinococcosis who were admitted to The First Affiliated Hospital of Shihezi University from December 2023 to June 2025, and according to the volume of calcium salt deposition, they were divided into non-deposition group with 16 patients, mild deposition group with 52 patients, moderate deposition group with 16 patients, and severe deposition group with 23 patients. A one-way analysis of variance or the Kruskal-Wallis H test was used for comparison of continuous data between groups, and the χ2 test or Fisher’s exact test was used for comparison of categorical data between groups. The four groups were further combined into the low deposition group (no/mild deposition) and the high deposition group (moderate/severe deposition). A binary logistic regression analysis was used to investigate the independent influencing factors for calcium salt deposition, and a predictive model was established. The receiver operating characteristic (ROC) curve was used to assess the predictive performance of the model, and the Bootstrap method was used for internal validation. ResultsThere were significant differences between the four groups in sex distribution, involvement of other sites, white blood cell count, lymphocyte percentage, fibrinogen, uric acid, sodium ion, chloride ion, and calcium ion (all P<0.05). The univariate analysis showed that there were significant differences between the four groups in sex, involvement of other sites, white blood cell count, lymphocyte percentage, fibrinogen, alanine aminotransferase, albumin, creatinine, uric acid, sodium ion, chloride ion, and calcium ion (all P<0.1). The multi-collinearity diagnosis showed that the VIF values for all continuous variables ranged from 1.104 to 1.760, suggesting that collinearity did not affect modeling. An ordinal logistic regression model was established based on sex, involvement of other sites, calcium ion, lymphocyte percentage, and uric acid. The multivariate analysis showed that lymphocyte percentage (odds ratio [OR]=1.106, 95% confidence interval [CI]: 1.041 — 1.174, P=0.001) and blood calcium level (OR=0.005, 95%CI: 0.000 —0.230, P=0.007) were independent influencing factors for the degree of calcium salt deposition. The regression equation was established as Logit(P)=8.231 + 0.100 × lymphocyte percentage -5.344 × calcium ion. The ROC curve analysis showed that the model had an area under the ROC curve of 0.716, with a Youden index of 0.353, a sensitivity of 1.000, and a specificity of 0.353. The Hosmer-Lemeshow test showed that the model had poor calibration (χ2=20.688, P=0.008). The Bootstrap method with 1000 repeated samples showed that the estimated values of lymphocyte percentage (OR=1.106, 95%CI: 1.049 — 1.186, P=0.002) and calcium ion (OR=0.005, 95%CI: 0.000 — 0.214, P=0.010) were consistent with the original model, and the confidence intervals did not include 1, which further supported the reliability of the model. ConclusionBoth lymphocyte percentage and blood calcium level are independent influencing factors for calcium salt deposition in alveolar echinococcosis, and the degree of calcium salt deposition in alveolar echinococcosis lesions increases with the reduction in blood calcium level and the increase in lymphocyte percentage.
7.Hepatitis B cirrhosis comorbid with Staphylococcus lugdunensis bloodstream infection: A case report
Shuyun HUANG ; Bukun ZHU ; Wei ZHANG ; Liqiong WANG
Journal of Clinical Hepatology 2026;42(2):409-413
As a coagulase-negative staphylococcus, Staphylococcus lugdunensis has stronger virulence and pathogenicity than other Staphylococcus bacteria and is comparable to Staphylococcus aureus. In recent years, there has been a gradual increase in the number of related case reports, A patient with hepatitis B cirrhosis and Staphylococcus lugdunensis bloodstream infection was admitted to our department and was followed up for more than 2 years, and the patient was analyzed in terms of clinical features, pathogenicity, invasion, and the application of related antibiotics.
8.Interventional effect and mechanism of Bifidobacterium in chronic liver disease
Liyi PAN ; Yueqiao CHEN ; Yu CHEN ; Yuyun HUANG ; Hao PEI ; Fenglan WU ; Lyuping YE ; Na WANG
Journal of Clinical Hepatology 2026;42(2):464-471
Compared with traditional therapies for chronic liver disease (CLD), Bifidobacterium has the characteristics of multi-target intervention, high biosafety, and good host compatibility and provides new strategies for intervention of CLD progression in terms of microecological regulation. Various studies have shown that Bifidobacterium regulates liver homeostasis and exerts a therapeutic effect on CLD by regulating intestinal flora, maintaining antioxidation, promoting energy consumption, alleviating inflammation, improving glycolipid metabolism, and exerting an antitumor effect. This article systematically reviews the studies on Bifidobacterium in the treatment of CLD in China and globally, explores their different mechanisms, and elaborates on the interaction between related signaling pathways (such as the nuclear factor erythroid 2-related factor 2 signaling pathway and the adenosine monophosphate-activated protein kinase signaling pathway) and the liver, in order to provide a basis for probiotic intervention in liver pathology, as well as new ideas for the comprehensive treatment of CLD.
9.Effects of galangin on rheumatoid arthritis in rats by regulating the JAK3/STAT3 pathway
Yan HUANG ; Weiming WANG ; Haiying LIU ; Yi ZHAN ; Xi CHEN ; Dehong YU
China Pharmacy 2026;37(6):764-769
OBJECTIVE To investigate the effects of galangin on rheumatoid arthritis (RA) in rats by regulating the Janus kinase 3 (JAK3)/signal transducer and activator of transcription 3 (STAT3) pathway. METHODS Fifty male SD rats were taken, and an emulsion composed of bovine type Ⅱ collagen and Freund’s complete adjuvant was injected subcutaneously to establish an induced arthritis model. The rats that were successfully modeled were randomly divided into model group, low, medium and high dose groups of galangin (1, 5, 15 mg/kg), and methotrexate group (positive control, 2 mg/kg), with 10 rats in each group. Another 10 normal rats were taken as the normal group. Starting from the 15th day of modeling, each group of rats was gavaged with the corresponding drug solution or normal saline containing 0.5% Tween 80 once a day for 28 consecutive days. The arthritis index (AI) scores and paw volume of rats were compared before and after gavage administration. Twenty-four hours after the last administration, the serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), IL-4 and IL-10 were determined, the pathological changes in ankle joint synovial tissue were observed, and the protein expressions of UNC-51 like kinase 1 (ULK1), Beclin-1, microtubule-associated protein 1 light chain 3 (LC3), B cell lymphoma 2 (Bcl-2), Bcl-2-associated X protein (Bax), caspase-3, JAK3, phosphorylated JAK3 (p-JAK3), STAT3 and phosphorylated STAT3 (p-STAT3) in the synovial tissue of the ankle joint were detected, as well as the fluorescence intensity of LC3-positive areas. RESULTS Compared with the model group, the pathological changes such as cellular proliferation of ankle joint synovial tissue and infiltration of inflammatory cells in rats of each administration group showed improvement. Moreover, their AI scores and paw pad volumes (on day 28 after gavage), the levels of IL-6 and TNF-α, the protein expression of Bcl-2, and the phosphorylation levels of JAK3 and STAT3 were all significantly reduced ( P <0.05). The levels of IL-4 and IL-10, the protein expressions of ULK1, Beclin-1, Bax, caspase-3 and LC3, as well as the fluorescence intensity of LC3-positive areas, were all significantly increased ( P <0.05). Moreover, the effect of galangin was in a dose-dependent manner ( P <0.05). CONCLUSIONS Galangin can induce sustained autophagy in synovial tissue cells of RA rats, promote cell apoptosis, inhibit synovial cell proliferation, and alleviate persistent inflammatory responses. The above anti-RA effects may be related to the inhibition of the JAK3/STAT3 pathway.
10.Brain-computer interface technology in treatment for spinal cord injury: a bibliometric analysis
Kui SUN ; Hailun HUANG ; Yongai LIU ; Heng GAO
Chinese Journal of Rehabilitation Theory and Practice 2026;32(3):317-328
ObjectiveTo analyze the research hotspots and development trends of brain-computer interface (BCI) in the treatment for spinal cord injury (SCI). MethodsRelevant literatures on BCI applied in SCI treatment, published from the inception of the Web of Science Core Collection to July, 2025, were retrieved. Visualization analysis was performed using CiteSpace, VOSviewer and Tableau Desktop. ResultsA total of 437 literatures were included, and the annual number of publications showed an overall increasing trend. The United States ranked first in the number of publications; Graz University of Technology was the institution with the highest number of publication; Gernot R Mueller-Putz was the most productive author, while Jonathan R Wolpaw was the most cited author. Brain-computer interface and artificial intelligence were identified as the high-frequency and bursting keywords in this field. The researches were characterized by the cross-integration of five core disciplines: neuroscience and rehabilitation medicine, biomedical engineering, computer science and artificial intelligence, neurophysiology, and materials science. ConclusionResearches on BCI in SCI treatment are accelerating continuously, and technological integration is becoming the core trend.

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