1.Influencing factors for recompensation and its impact on the prognosis in patients with decompensated liver cirrhosis
Danqing XU ; Haiwen LI ; Huan MU ; Yingyuan ZHANG ; Caifen SA ; Li LIU ; Yongrui YANG
Journal of Clinical Hepatology 2026;42(1):90-100
ObjectiveTo investigate the influencing factors for recompensation in patients with decompensated liver cirrhosis, as well as the impact of recompensation on the prognosis of such patients, and to provide a basis for early identification of high-risk patients in clinical practice. MethodsA retrospective analysis was performed for the clinical data of patients who attended The Third People’s Hospital of Kunming from January 2016 to December 2022 and were diagnosed with decompensated liver cirrhosis due to hepatitis B, hepatitis C, alcoholic hepatitis, and autoimmune hepatitis, and they were divided into recompensation group and persistent decompensation group. To control for confounding factors, whether recompensation occurred was used as the rouping variable,and BMI, alcohol consumption history, HIV infection history, TG, CHOL, LDL, and HDL were used as covariates. The propensity score was calculated, and 1:1 nearest neighbor matching was performed with a caliper value of 0.1. After propensity score matching, the recompensation group and the persistent decompensation group with relatively balanced covariates were obtained. Univariate and multivariate Cox proportional-hazards regression model analyses were used to investigate the influencing factors for recompensation; the “rms” package was used to establish a nomogram; the receiver operating characteristic (ROC) curve was plotted to calculate the area under the ROC curve (AUC); the Hosmer-Lemeshow test was used to assess the goodness of fit of the model; the “Calibration Curves” package was used to plot calibration curves for model assessment. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was used for comparison of survival curves. ResultsAmong the 863 patients with decompensated liver cirrhosis, 305 experienced recompensation, resulting in an incidence rate of 35.3%. After PSM, 610 cases were successfully matched, with 305 cases in each group. The univariate and multivariate Cox regression analyses showed that etiology (hepatitis C: hazard ratio[HR]=0.288, P=0.002); male(HR=0.701, P=0.016), age(HR=0.988, P=0.047), hemoglobin (HGB)(HR=1.006, P=0.017), and CD4 T cell(HR=1.001,P=0.047), TIPS procedure (HR=1.808,P=0.042) were independent influencing factors for recompensation in patients with decompensated liver cirrhosis. During follow-up, 116 patients died of liver disease-related causes, with 27 patients (8.85%) in the recompensation group and 89 (15.95%) in the persistent decompensation group; 109 patients developed HCC, with 23 patients (7.54%) in the recompensation group and 86 (15.41%) in the persistent decompensation group. The Kaplan-Meier survival curves showed significant separation between the patients with different states of compensation in terms of liver disease-related mortality rate and the incidence rate of HCC, and the Log-rank test showed that there were significant differences between the two groups in liver disease-related mortality rate (χ2=9.023, P=0.003) and the incidence rate of HCC (χ2=10.526, P=0.001). ConclusionEtiology,sex,age,TIPS,HGB,and CD4 T cell are independent influencing factors for recompensation in patients with decompensated liver cirrhosis. There is a significant difference in the incidence rate of recompensation between decompensated liver cirrhosis patients with different etiologies, and female patients and patients with a younger age,a history of TIPS, a higher HGB level, and a higher CD4 lymphocyte count are more likely to experience recompensation. Recompensation is the key to improving the long-term prognosis of patients and can significantly reduce long-term liver disease-related mortality rate and the incidence rate of HCC.
2.Association between albumin and recompensation in patients with hepatitis B/C virus-related decompensated liver cirrhosis
Danqing XU ; Yingyuan ZHANG ; Jingru SHANG ; Caifen SA ; Wenyan LI ; Li LIU ; Zhijian DONG
Journal of Clinical Hepatology 2025;41(11):2323-2328
ObjectiveTo investigate the association between albumin (Alb) and recompensation by comparing recompensation rate between hepatitis B/C virus-related decompensated liver cirrhosis patients with different Alb levels, and to provide guidance for the identification and management of high-risk patients in clinical practice. MethodsRelated clinical data were collected from 734 patients with hepatitis B/C virus-related decompensated liver cirrhosis who attended The Third People’s Hospital of Kunming from January 1, 2016 to December 31, 2022, and they were divided into three groups based on the level of Alb. The linear regression analysis and chi-square test were used for trend tests. The Kaplan-Meier curve was plotted for the cumulative incidence rate of recompensation in the three groups, and the log-rank test was used for comparison between groups. A Cox proportional-hazards regression model analysis was used to investigate the association between Alb and recompensation in patients with hepatitis B/C virus-related decompensated liver cirrhosis. ResultsAmong the 734 patients with hepatitis B/C virus-related decompensated liver cirrhosis, 270 achieved recompensation, with a recompensation rate of 36.8%. All patients had a median Alb level of 29.90 (25.90 — 34.80) g/L on admission, and according to the level of Alb, they were divided into <25.9 g/L group with 177 patients, 25.9 — 34.8 g/L group with 377 patients, and >34.8 g/L group with 180 patients; 36 patients (20.3%) in the <25.9 g/L group, 138 (36.6%) in the 25.9 — 34.8 g/L group, and 96 (53.3%) in the >34.8 g/L group achieved recompensation, and the recompensation rate increased with the increase in Alb level (χ2=41.730, P<0.001). After adjustment for all confounding factors, compared with the <25.9 g/L group, there was a significant increase in the incidence rate of recompensation in the 25.9 — 34.8 g/L group (hazard ratio [HR]=1.842, 95% confidence interval [CI]: 1.274 — 2.663) and the >34.8 g/L group (HR=2.336, 95% CI: 1.575 — 3.463). The Kaplan-Meier survival analysis showed that there was a significant difference in the cumulative incidence rate of recompensation between the three groups (χ2=41.632, P<0.001). ConclusionAlb level is an influencing factor for recompensation in patients with hepatitis B/C virus-related decompensated liver cirrhosis, and the recompensation rate increases with the increase in Alb level.
3.Influencing factors for recompensation in patients with decompensated hepatitis B cirrhosis
Danqing XU ; Yingyuan ZHANG ; Huan MU ; Caifen SA ; Chunyan MOU ; Yuanzhen WANG ; Weikun LI ; Li LIU
Journal of Clinical Hepatology 2025;41(7):1364-1370
Objective To investigate the influencing factors for recompensation in patients with decompensated hepatitis B cirrhosis,and to establish a predictive model.Methods A total of 517 patients who attended The Third People's Hospital of Kunming and were diagnosed with decompensated hepatitis B cirrhosis from January 1,2016 to December 31,2022 were enrolled.The clinical data of the patients were reviewed,and the 207 patients with no portal hypertension-related complications within at least 1 year were enrolled as recompensation group,while the 310 patients without recompensation were enrolled as persistent decompensation group.Related clinical data were collected,and the univariate and multivariate Cox regression analyses were performed for the factors that might affect the occurrence of recompensation.The independent-samples t test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups;the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups.The"rms"package was used to establish a nomogram;the receiver operating characteristic(ROC)curve was plotted,and the area under the ROC curve(AUC)was calculated;the Hosmer-Lemeshow test was used to evaluate the degree of fitting of the model;the"Calibration Curves"package was used to plot the calibration curve for model assessment.Results Among the patients with decompensated hepatitis B cirrhosis,207(40.03%)had recompensation.The univariate Cox regression analysis showed that there were significant differences between the recompensation group and the persistent decompensation group in TIPS history,genotyping,portal vein thrombosis,complicated infection,Child-Pugh class,age,hemoglobin(Hb),platelet count,total protein,albumin(Alb),alanine aminotransferase,triglyceride,cholesterol,creatinine,Na,interleukin-6,high-sensitivity C-reactive protein,portal vein width,and portal vein velocity(all P<0.05).The multivariate regression analysis showed that TIPS history(hazard ratio[HR]=2.491,95%confidence interval[CI]:1.325-4.681,P=0.005),portal vein thrombosis(HR=0.345,95%CI:0.152-0.783,P=0.001),Hb(HR=1.007,95%CI:1.000-1.013,P=0.028),Alb(HR=1.048,95%CI:1.017-1.080,P=0.002),and portal vein width(HR=0.899,95%CI:0.835-0.967,P=0.004)were independent influencing factors for recompensation in patients with decompensated hepatitis B cirrhosis.A nomogram model was established based on the above five influencing factors,and the Hosmers-Lemeshow test showed that this model had a good degree of fitting(χ2=3.202,P=0.921).The nomogram model had an AUC of 0.728,a sensitivity of 50.3%,and a specificity of 85.0%,and the calibration curve showed good consistency between the actual value of this model in predicting the occurrence of recompensation and the predicted value in patients with decompensated hepatitis B cirrhosis.Conclusion Patients with decompensated hepatitis B cirrhosis who have a history of TIPS and high levels of Alb and Hb are more likely to have recompensation,and it is relatively difficult for patients with portal vein thrombosis and an increase in portal vein width to achieve recompensation.
4.Association of urinary serine protease Corin with clinical staging in early diabetic kidney disease
Wenqian TIAN ; Jingyi LU ; Danyang CHEN ; Sa LI ; Shiyu LIU ; Xiaoying ZHANG ; Wanjun PANG ; Yahui HU
Chinese Journal of Endocrinology and Metabolism 2025;41(2):120-128
Objective:To investigate the level of urinary serine protease(Corin) in early diabetic kidney disease(DKD) and its correlation with clinical stage.Methods:One hundred and seventy-three patients with type 2 diabetes mellitus(DM) from two tertiary A hospitals in Henan, diagnosed between April 2023 and December 2023 were selected as the research group, and 120 healthy subjects were selected as the control group. Basic clinical information and laboratory data were collected, and urinary Corin level was detected. DM patients were classified into G1-G5 stages based on estimated glomerular filtration rate(eGFR), and those in the early DKD stages(G1-G3) were further divided into A1-A3 subgroups based on urinary albumin/creatinine ratio(ACR). Spearman correlation analysis was performed to assess relationships between urinary Corin and other indicators, linear regression analysis identified factors influencing urinary Corin in early DKD patients, logistic regression analysis evaluated the risk factors for early DKD, and receiver operating characteristic(ROC) curve analysis determined the diagnostic value of urinary Corin in early DKD. Results:Urinary Corin levels were significantly higher in early DKD patients compared to healthy controls, with levels increasing as ACR rose( P<0.05). Urinary Corin was positively associated with serum creatinine( r=0.570), urea( r=0.458), cystatin C( r=0.693), ACR( r=0.616), urinary transferrin( r=0.448), urinary α1 microglobulin( r=0.507), urinary n-acetyl-β-D-glucosaminase( r=0.388) and A subgroup( r=0.692) while was negatively correlated with eGFR( r=-0.647), albumin( r=-0.312)(all P<0.05). eGFR was the only independent factor affecting urinary Corin. After adjusting for confounding factors in logistic regression analysis, urinary Corin was still an independent influencing factor for early DKD. ROC curve analysis indicated that urinary Corin had a diagnostic AUC of 0.842(95% CI 0.791-0.892, P<0.001), with a cut-off value of 2 226.04 pg/mL, sensitivity of 0.712, and specificity of 0.858 for early DKD diagnosis. Conclusions:Urinary Corin was elevated in early DKD patients and correlated with clinical stage. Urinary Corin is an independent factor of early DKD, and a reliable predictor of early DKD diagnosis.
5.Clinical effect of non-transecting anastomotic lingual mucosal augmentation urethroplasty in the treatment of traumatic urethral stricture
Wenxiong SONG ; Jiemin SI ; Xuxiao YE ; Zuowei LI ; Jianwen HUANG ; Yinglong SA ; Yuemin XU
Chinese Journal of Urology 2025;46(2):119-124
Objective:To investigate the clinical effect of lingual mucosal augmentation urethroplasty with non-transecting urethral cavernous anastomosis in the treatment of traumatic urethral stricture.Methods:The clinical data of 39 patients with traumatic urethral stricture admitted to our clinical center from March 2023 to December 2023 were retrospectively analyzed. Their mean age was (49.7±2.0)years. The cause of urethral injury was pelvic fracture in 32 cases, riding injury in 5 cases, and iatrogenic injury in 2 cases. Suprapubic vesicostomy tube was indwelled before operation in 39 cases. There was 1 case with hypospadias and 1 case with urethral false passage. 9 patients had urethral dilatation before surgery, 5 had internal urethrotomy operation, 5 had urethroplasty, and 22 had no history of urethral surgery. The International Erectile Function Index (IIEF-5)score of 39 cases last 1 month before surgery was collected and classified.In which, the IIEF-5 score of 19 cases with no or mild erectile dysfunction was median 20 (18, 23)points, the MSHQ-Ejd score was median 16 (11, 19)points, and the number of effective erections was median 4(3, 5)times on the NPT. And in which, the IIEF-5 score of 20 cases with moderate to severe erectile dysfunction was median 10 (3, 14)points, the MSHQ-Ejd score was median 3(1, 7)points, and the number of effective erections was median 1(0, 2)times on the NPT. All 39 cases underwent non-transecting anastomotic lingual mucosal augmentation urethroplasty. The central tendon of the perineum and the ventral side of the bulbar urethra were preserved through perineal approach. The dorsal side of the urethra was mobilized and through the dorsal side of the urethra, the scar of the urethra was enucleated along the mucosa of the urethra. Then the ventral mucosa of the urethra was anastomosed end to end and the dorsal urethra was repaired by lingual mucosa transplantation. The Clavien-Dindo complication grading system was performed. The catheter was removed 4 weeks after operation, and urine flow rate was recorded 1 month after extubation. IIEF-5 score, MSHQ-Ejd score and NPT were recorded 6 months after operation.Results:The mean operation time of 39 cases was (118.0±18.3)min. 39 cases were followed up for median 8.0(6.0, 10.0)months. The Q max ≥15 ml/s in 24 cases. The Q max <15ml/s in 13 cases, of which, the Q max ≥15 ml/s after 1 internal urethrotomy operation in 10 cases and Q max≥15 ml/s after 2 internal urethrotomy operations in 3 cases. 2 cases were still failed to urinate and Q max≥15 ml/s after end-to-end urethral anastomosis. All 39 cases’ Clavien-Dindo complications were graded Ⅰ.Of the 19 cases with no or mild erectile dysfunction, the IIEF-5 score was median 20(17, 23)points, the MSHQ-Ejd score was median 16(11, 19)points, and the number of effective erections was median 4(3, 4)times on the NPT postoperatively, all were not significantly different from those before operation ( P> 0.05). Of the 20 cases with moderate and severe erectile dysfunction, the IIEF-5 score was median 9(4, 13)points, the MSHQ-Ejd score was median 4(2, 7)points, and the number of effective erections was median 1(0, 2)times on the NPT postoperatively, and all were not significantly different from those before operation ( P>0.05). Conclusions:Non-transecting anastomotic lingual mucosal augmentation urethroplasty is a reliable surgical method with few complications for traumatic urethral stricture. Moreover, the operation has little effect on the sexual function of patients.
6.Management strategies for vesicovaginal fistula following cervical cancer radiotherapy in women
Jiemin SI ; Weidong ZHU ; Ranxing YANG ; Lujie SONG ; Chongrui JIN ; Jianwen HUANG ; Xuxiao YE ; Zuowei LI ; Wenxiong SONG ; Qiang FU ; Yinglong SA
Chinese Journal of Urology 2025;46(8):587-592
Objective:To investigate the treatment strategies for vesicovaginal fistula(VVF)in women following cervical cancer radiotherapy.Methods:A retrospective analysis was performed on the clinical data of 33 female patients with post-radiotherapy VVF after cervical cancer treatment at Shanghai Sixth People’s Hospital between January 2020 and June 2024. The patients were categorized into three groups based on surgical approaches:Group A(11 patients):Underwent prone-position VVF repair. Mean age:(50.0±9.6)years;mean radiotherapy sessions:(22.6±2.2). All had simple VVF without concurrent intestinal or surrounding soft-tissue fistulas. Among them,1 patient previously received laparoscopic VVF repair,1 transvaginal VVF repair,and 2 gracilis muscle flap packing for VVF repair. One month prior to surgery,the average daily usage of urine pads was 16.7(12.8,25.7)pieces,and the quality of life(QOL)score stood at 4.0(4.0,5.0)points. Preoperative cystoscopy revealed that 8 cases had fistulas located in the trigonal region of the bladder,while 3 cases had fistulas on the posterior bladder wall. The diameter of the fistula openings,measured under a microscope,was 1.2(0.8,1.6)cm. Based on the Goh classification criteria for vesicovaginal fistulas,this group included 3 cases of type 1,4 cases of type 2,2 cases of type 3,and 2 cases of type 4;7 cases of type A and 4 cases of type B;as well as 3 cases of typeⅠ,7 cases of type Ⅱ,and 1 case of type Ⅲ.Group B(20 patients):Underwent gracilis muscle flap packing for VVF repair. Mean age:(58.6±8.8)years;mean radiotherapy sessions:(29.8±3.9). Three patients had concurrent rectovaginal fistulas and received colostomy for fecal diversion. History of previous interventions:3 had laparoscopic VVF repair,4 transvaginal VVF repair,and 1 both transvaginal and laparoscopic VVF repair. One month prior to surgery,the average daily usage of urine pads was 19.7(15.8,27.7)pieces,and the QOL score stood at 5.0(5.0,6.0)points. Preoperative cystoscopy revealed that 13 cases had fistulas located in the trigonal region of the bladder,while 7 cases had fistulas on the posterior bladder wall. The diameter of the fistula openings,measured under a microscope,was 1.8(1.0,3.2)cm. Based on the Goh classification criteria for vesicovaginal fistulas,this group included 4 cases of type 1,9 cases of type 2,3 cases of type 3,and 4 cases of type 4;6 cases of type A,11 cases of type B and 3 cases of type C;as well as 1 cases of type Ⅱ,and 19 case of type Ⅲ. Group C(2 patients):Underwent ureterocutaneous diversion. Ages:67 and 73 years;radiotherapy sessions:51 and 60,respectively. Both had concurrent rectovaginal fistulas and bladder soft-tissue fistulas. The patient presented with recurrent thigh abscesses accompanied by fever. One month prior to surgery,the daily usage of urine pads was 29 and 23 pieces,respectively,and the QOL score was 6 points. Cystoscopic examination revealed that the vesicovaginal fistulas were located in the trigone of the bladder,with diameters of 3 cm and 4 cm,respectively. Additionally,partial defects were noted in the ventral wall of the urethra,while no bladder soft tissue fistulas were detected. According to the Goh classification for vesicovaginal fistulas,both cases were categorized as type 4,type C,and type Ⅲ. For Groups A and B,urinary catheters were indwelled for 3 weeks postoperatively,then removed to assess spontaneous urination and incontinence. QOL was evaluated,with a minimum 6-month follow-up. For confirmed postoperative VVF recurrence,re-repair was performed 3?6 months later based on patient preference. For Group C,double-J stents were placed in the ureters,and stoma bags were applied 3 days postoperatively. Stents were replaced every 1?2 months,with QOL assessment. Successful fistula repair in Groups A and B was defined as the absence of vaginal leakage confirmed by cystoscopy after six months of the procedure with no vaginal leakage. For Group C,surgical success was determined by the resolution of perineal urinary leakage and improvement in QOL.Results:All 33 patients completed surgery successfully. Group A:Follow-up duration:16.3(9.6,24.6)months. Surgical repair succeeded in 7 patients,with unobstructed spontaneous urination and no vaginal incontinence. Four patients had VVF recurrence:2 refused further treatment,and 2 underwent repeat gracilis muscle flap packing. One was successfully repaired,while one recurrence case refused further treatment. Group B:Follow-up duration:17.0(9.5,24.8)months(8?32 months). Thirteen patients restored spontaneous urination without recurrence. Seven had recurrence:5 refused further surgery,and 2 underwent re-repair. One repair succeeded without incontinence,while one recurrence case refused treatment. Group C:Follow-up durations were 6 and 22 months. Perineum remained dry without incontinence(no urine pads needed),and no recurrence of thigh soft-tissue redness/infection occurred. QOL scores were 2 and 3,respectively.Conclusions:Post-radiotherapy VVF in women after cervical cancer presents complex and variable conditions. The primary goal of treatment should be to improve patients’ quality of life. Treatment approaches should be selected based on the complexity of urinary fistulas and local tissue conditions. In general,patients who are younger,have received lower doses of radiation therapy,present with smaller fistula diameters,have well-vascularized and elastic perifistular tissues,and have no concurrent tissue fistulas are candidates for prone-position VVF repair. Patients who do not meet the criteria for transvaginal repair,have a history of at least two previous repair attempts,or have concurrent vaginorectal fistulas require gracilis muscle flap packing for VVF repair. Patients with three or more types of concurrent tissue fistulas,extensive pale and inelastic perifistular tissues,and who are not amenable to repair surgery undergo ureterocutaneous diversion.
7.Analysis of Screening Results of Cervical Cancer and Precancerous Lesions Among Women in Shihezi City of Xinjiang from 2021 to 2023
Yanqiu LI ; Xiaoju LI ; Yaling DU ; Bingyi ZHANG ; Xin SHI ; Sa LI ; Xiujuan JIN
China Cancer 2025;34(4):311-318
[Purpose]To analyze the results of cervical cancer screening among married women of 25~64 years old in Shihezi City from 2021 to 2023,and to explore the risk factors of cervical le-sions.[Methods]The results of cervical cancer screening among married women aged 25~64 years old in Shihezi City from 2021 to 2023 were retrospectively analyzed.The detection rates of common gynecological diseases,cervical cancer and precancerous lesions and human papillo-mavirus(HPV)infection by cervical cytology,colposcopy and cervical biopsy were analyzed.[Re-sults]The HPV infection(mainly single infection)rate was 10.74%.The common gynecological diseases were vaginitis,cervicitis and uterine leiomyoma.The detection rate of cervical cancer was 19.59/105,and the detection rate of cervical precancerous lesions was 308.52/105.Rural resi-dents,HPV 16/18 infection,genital warts were the risk factors for cervical lesions.[Conclusion]Female cervical lesions are significantly correlated with HPV 16/18 infection,genital condyloma acuminatum,particularly for rural residents,and preventive care,early screening and interven-tion should be strengthened for these populations.
8.STUDY ON THE POPULATION STRUCTURE OF MOSQUITOES AND THE APPLICATION OF MOSQUITO-REPELLENT SILICONE-BASED OIL FILM IN THE DRAINAGE SYSTEM OF MINHANG DISTRICT,SHANGHAI
Min-Hui ZHU ; Li-Jun LIU ; Lu ZHANG ; Xiao-Sa WEN ; Zhi-Yin XU ; Zhao-Wen ZHANG ; Yi-Bin ZHOU
Acta Parasitologica et Medica Entomologica Sinica 2025;32(2):105-111
Objective Understanding the population structure of mosquitoes in the drainage system of Minhang District,Shanghai,and exploring the physical prevention and control technology of mosquito traps with a Vazor mosquito repellent film in the drainage system.Methods A 500 mL water spoon was used to assist in visual inspection to investigate the breeding status of mosquito larvae in the drainage system.A carbon dioxide mosquito trap method was used to monitor adult mosquitoes around the ground drainage system,and the artificial hour method was used to monitor adult mosquitoes around the underground drainage system.Mosquito-repellent film was applied at a rate of 1 mL/m2 to the drainage system where mosquito larvae or pupae are found,and the breeding situation was observed and recorded.Results The positivity rate of mosquitoes breeding in the ground drainage system was 50%.The mosquito larvae in the drainage channels were primarily Aedes albopictus,whereas Ae.albopictus were primarily noted in the sewage wells.The proportions of Ae.albopictus and Culex pipiens pallens in the rainwater wells were similar,and the dominant mosquito species around the surface drainage system was Ae.Albopictus.The positive rate of mosquito breeding in the underground drainage system was 47%,with the dominant mosquito species being Cx.pipiens pallens(58.39%)followed by Ae.albopictus(41.6%).The dominant adult mosquito species around the drainage system were Cx.pipiens pallens(83%)followed by Ae.albopictus(11%).In terms of the effectiveness of mosquito-repellent water film,the mosquito breeding rates of the ground and underground drainage systems using mosquito-repellent water film decreased to 2.78%and 5%after 1 week of use,respectively,and then rebounded after the 3rd week.After a supplementary dose during the 5th week,the breeding rates returned to normal.No statistically significant differences were observed in the effect compared with the standard control group using 1%bisulfite granules;however,a statistically significant difference was noted compared with the blank control group without special treatment.Conclusions In the drainage system of Minhang District,Shanghai,mosquito breeding is severe,and variations exist in the dominant mosquito species in different environmental drainage facilities.The simultaneous use of mosquito-repellent films can effectively control mosquito breeding in drainage systems.
9.Exploring the protective mechanism of electroacupuncture at Neiguan points on acute high-altitude hypoxic brain injury based on PI3K/AKT signaling pathway
Yongping LI ; Xiuping CHEN ; Yuping SA ; Li TONG ; Yanming REN ; Yi GUO
Space Medicine & Medical Engineering 2025;36(4):362-366
Objective To explore the preventive effect and protective mechanism of electroacupuncture at Neiguan points on acute high altitude hypoxic brain injury by detecting the expression of EPO,p-PI3K,p-AKT and Bcl-2 proteins.Methods 48 male SD rats of SPF grade were randomly divided into control group,model group,western medicine group and Neiguan group.The acute high altitude hypoxic brain injury model was established using a hypobaric hypoxia chamber.The Western medication group received Citicoline Sodium via gastric gavage administration,while the Neiguan acupoint group was administered bilateral electroacupuncture stimulation at the Neiguan acupoints.The morphological changes of hippocampal tissues were observed by HE method,serum biochemical indexes were determined by ELISA method,neuronal apoptosis of rat hippocampal tissues was observed by TUNEL method and the positive rate was calculated,and the expression levels of EPO,p-PI3K,p-AKT and Bcl-2 proteins were detected in rat hippocampal tissues by Western-blot method.Results Compared with the control group,the model group exhibited extensive necrotic pyramidal cells with pyknotic and deeply stained nuclei,significantly elevated serum levels of GFAP,S100B,and UCH-L1(P<0.01),markedly increased hippocampal neuronal apoptosis(P<0.01),and upregulated protein levels of EPO,p-PI3K,p-AKT,and Bcl-2 in hippocampal tissue(P<0.01).Compared with the model group,both the western medication group and the electroacupuncture at Neiguan group exhibited a significant reduction in necrotic pyramidal cells in brain tissue,with occasional pyknotic and deeply stained nuclei.Serum levels of GFAP,S100B,and UCH-L1 were markedly decreased(P<0.01),hippocampal neuronal apoptosis was significantly reduced(P<0.01),and protein expression of EPO,p-PI3K,p-AKT,and Bcl-2 in hippocampal tissue was upregulated(P<0.01).No statistically significant differences were observed between the western medication group and the Neiguan electroacupuncture group(P>0.05).Conclusion Electroacupuncture at Neiguan may ameliorate acute high-altitude hypoxic brain injury,potentially through modulating EPO protein expression to activate the PI3K/AKT signaling pathway,thereby inhibiting hippocampal neuronal apoptosis.
10.Construction of a regional collaborative cloud-based treatment model for patients with severe traffic injuries and evaluation of the timeliness of care
Shuaishuai ZHOU ; Sa WANG ; Danping YAN ; Shurong XU ; Yajie LIU ; Meiling WANG ; Yulin LI ; Yuwei WANG
Chinese Journal of Nursing 2025;60(2):170-176
Objective To construct a regional collaborative cloud-based treatment model treatment model for patients with severe road traffic injuries,and to preliminarily evaluate the differences in nursing timeliness indicators and outcomes.Methods The regional collaborative cloud-based treatment platform includes 4 ports,including public security traffic police,pre-hospital emergency center,regional trauma center triage,and regional trauma center resuscitation unit.This forms a standardized real-time interactive treatment process between regional medical services and police for patients with severe road traffic injuries.Using a concurrent control study design,241 patients with severe road traffic injuries admitted to the emergency department of a regional trauma center in Zhejiang Province from May 2022 to May 2024 were selected as the study subjects.Among them,120 patients treated with the regional real-time collaborative cloud-based treatment model were designated as an experimental group,while 121 patients treated with the original trauma care process were designated as a control group.The differences in timeliness indicators and outcomes between the 2 groups were compared.Results The study included 241 patients with severe trauma.After the application of the regional collaborative cloud-based treatment model,the time from the scene of the accident to the hospital,the proportion of information early waming,completion time of pre-examination and triage,waiting time of the trauma team,the time of the first CT,the length of multidisciplinary consultation,and the time for completing hospitalization procedures in the experimental group were shorter than those in the control group(P<0.05),the proportion of information early waming in the experimental group was 100%(120/120),and the proportion of information early waming in the control group was 52.1%(63/121).The difference between the two groups was statistically significant(P<0.001).The survival rate of the experimental group was 90.8%(109/120),and that of the control group was 86.0%(104/121).There was no significant difference between the two groups(x2=1.399,P=0.237).Conclusion The regional collaborative cloud-based treatment model improves the timeliness and standardization of the treatment of patients with severe road traffic injury,which has certain reference significance and promotion value.

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