1.Construction of a prediction model for early hormone remission after prolactinoma surgery based on machine learning
Yanxia DENG ; Jiahui LIU ; Jing XU ; Weijie WANG ; Kun SUN ; Lianshu DING ; Jian JIANG
Chinese Journal of Clinical Medicine 2026;33(3):406-413
Objective To explore factors associated with early postoperative hormonal remission in patients with prolactinoma and to develop prediction models based on clinical and radiological features. Methods Data from 107 patients with prolactinoma who underwent transsphenoidal surgery at The First People’s Hospital of Huai’an, Nanjing Medical University between January 2020 and December 2024 was collected, included general clinical characteristics, preoperative laboratory indicators, and imaging features. Based on whether early postoperative prolactin (PRL) levels normalized, patients were divided into a remission group (n=76) and a non-remission group (n=31). Univariate logistic regression was used for preliminary evaluation of candidate variables, followed by LASSO regression for feature selection. Multiple machine learning models were constructed, including logistic regression, random forest, support vector machine, K-nearest neighbors, naive Bayes, decision tree, neural network, and gradient boosting decision tree (GBDT). All models were trained and evaluated using ten-fold cross-validation, with comprehensive assessment of model performance based on the area under the ROC curve (AUC), accuracy, sensitivity, specificity, precision, and F1 score. Results The maximum diameter of tumors in the non remission group was larger than that in the remission group (P=0.019), and the incidence of tumor stroke and preoperative PRL levels were significantly higher than those in the remission group (P<0.001). Univariate analysis showed that sex, maximum tumor diameter, tumor stroke, and preoperative PRL levels were influencing factors for early postoperative hormone response in patients with prolactinoma (P<0.05). The comparison results of machine learning models show that the neural network model performs the best (AUC=0.921) and has good clinical application value, followed by the GBDT model (AUC=0.893) and the support vector machine model (AUC=0.884). Other models also show certain predictive ability. Conclusions Sex, preoperative PRL levels, maximum tumor diameter, Hounsfield unit value, and tumor stroke are important factors affecting early hormone response after prolactinoma surgery. The machine learning model constructed based on the above variables has good predictive performance, and performs the best and has good clinical application value.
2.Relationship between sleep disorders and physical activity in patients with Alzheimer's disease, and the effectiveness of light therapy intervention
Yanxia LIU ; Xiaojiao WANG ; Xin JIA
Journal of Public Health and Preventive Medicine 2026;37(4):110-113
Objective To investigate the current status of sleep disorders in patients with Alzheimer’s disease (AD) and its relationship with physical activity, and analyze the intervention effect of light therapy. Methods A total of 345 patients with AD admitted to the First Affiliated Hospital of Air Force Medical University from June 2020 to June 2025 were included. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep disorders, and the Physical Activity Scale for the Elderly (PASE) was applied to evaluate the physical activity. Pearson correlation analysis model was adopted to analyze the correlation between PSQI and PASE in patients with AD. 345 patients with AD were treated with light therapy intervention for 4 weeks. The changes of PSQI and PASE scores were compared before and after intervention. Results Among the 345 patients with AD, 251 cases had sleep disorders, accounting for 72.75% (251/345), and the PSQI score was (9.87±2.95) points. The scores of leisure activity, housework and occupation-related activity of PASE were (25.81±6.12) points, (78.15±12.93) points, and (45.31±8.74) points, respectively. Pearson correlation analysis model revealed that the leisure activity score of PASE was negatively correlated with the PSQI score (P<0.05), and the scores of housework and occupation-related activity were not significantly correlated with the PSQI score (P>0.05). After 4 weeks of light therapy intervention, the score of leisure activity of patients was increased significantly (P<0.05), while the scores of housework and occupation-related activity did not change significantly (P>0.05), and the PSQI scores were decreased significantly (P<0.05). Conclusion There is a correlation between sleep disorders and leisure time and physical activity in patients with Alzheimer's disease. The implementation of light therapy intervention can effectively improve sleep disorders in AD patients.
3.Analysis of acupoint selection rules for acupuncture treatment of functional constipation based on data mining
Yitong LIU ; Qi QIN ; Dong CHEN ; Yanxia GENG ; Yanyun MU
Journal of Clinical Medicine in Practice 2025;29(2):75-79
Objective To analyze the characteristics of acupoint selection in treatment for func-tional constipation.Methods Clinical literature on acupuncture and electroacupuncture therapy for functional constipation from January 1,2013,to December 31,2023,was retrieved from CNKI.The acupuncture prescriptions were collected and organized,and data mining techniques were employed to analyze the patterns of acupoint selection.Results A total of 182 articles were included,yielding 123 acupuncture prescriptions involving 92 acupoints with usage frequency of 967 times.The top 10 acu-points in frequency were Tianshu(158 times),Shangjuxu(138 times),Dachangshu(61 times),Zu-sanli(60 times),Zhigou(57 times),Fujie(57 times),Guanyuan(35 times),Zhongwan(34 times),Qihai(34 times),and Quchi(28 times).The meridians of the selected acupoints for acu-puncture treatment of functional constipation were mainly involved in stomach,bladder,Ren,and spleen meridians.Association rule analysis revealed that the combination of Tianshu-Shangjuxu had the highest occurrence probability(75.82%),followed by Tianshu-Dachangshu(33.52%)and Tianshu-Zusanli(32.97%).Cluster analysis of acupoints showed that the main acupoints selected for acu-puncture treatment of functional constipation could be divided into 10 clusters,including primary acu-points,acupoints for various syndrome types,acupoints for regulating spirit,and acupoints for regula-ting sympathetic nerves.Conclusion Acupuncture treatment for functional constipation should follow the principles of holistic treatment and syndrome differentiation,combined with the methods of selecting acupoints based on their upper-lower,proximal-distal,and anterior-posterior relationships.The acu-point selection patterns identified in this study can provide important references for clinical treatment of functional constipation,offer guidance for practitioners in acupoint selection,facilitate precise treatment,and promote early patient recovery.
4.Application of the Yang-Reinforcing Method in the Syndrome Differentiation and Treatment of Pulmonary Sarcoidosis
Yanxia LIANG ; Bing WANG ; Guangsen LI ; Wenwen SU ; Fenggu LIU ; Jiaoqiang ZHANG ; Hongfei XING ; Maorong FAN
Journal of Traditional Chinese Medicine 2025;66(11):1182-1185
Pulmonary sarcoidosis is an immune system disease with an unclear etiology. Guided by the yang-reinforcing method, it is believed that the fundamental pathogenesis of pulmonary sarcoidosis lies in the disharmony between water and fire and the reckless movement of the ministerial fire. The failure of the spleen and stomach to maintain warmth, leading to the production of phlegm and blood stasis, is an important pathogenesis. The invasion of external pathogenic toxins, deeply penetrating into the interior, is considered a triggering factor for the disease. The treatment focuses on supplementing the yang, consolidating the kidney, drawing fire back to its source, warming the yang, benefiting the kidney, and nourishing the spleen to generate metal. It also emphasizes unblocking the yang, transforming turbidity, and eliminating phlegm and blood stasis.
5.Survey and drug resistance analysis on pathogens in the intestines of healthy humans in Guangzhou from 2018 to 2023
Shuang MA ; Yun XIAO ; Bixia KE ; Fangzhu OUYANG ; Keng LIN ; Yanxia LIU ; Xiang MA ; Bosheng LI ; Dongmei HE
International Journal of Laboratory Medicine 2025;46(10):1221-1226,1233
Objective To investigate the carrying status and drug resistance analysis of pathogenic bacteria in the gut of healthy population in Huadu District,Guangzhou,and provide reference for epidemiological re-search.Methods A total of 337 459 anal swabs were directly isolated and cultured from healthy individuals who underwent physical examinations from 2018 to 2023.600 anal swabs from 2022 were randomly selected for multi pathogen nucleic acid testing,direct isolation and culture,and enrichment culture.Identification of bacteria was conducted by using VITEK 2 Compact and VITEK MS,serological testing was used for determi-nation of type,and drug susceptibility testing of pathogenic bacteria was conducted.Results A total of 128 pathogenic bacteria were isolated from rectal swabs,including 52 strains of Salmonella,71 strains of Aero-monas,3 strains of Vibrio parahaemolyticus,and 2 strains of Shigella flexneri,with a total detection rate of 3.79/10 000.The detection rate of Salmonella in direct isolation and culture of 600 rectal swabs was 0.50%,the detection rate of enrichment culture was 1.00%,and the detection rate of multi-pathogen nucleic acid de-tection was 1.17%.52 strains of Salmonella were divided into 27 serotypes,and Salmonella Ⅰ 4,5,12:i:—was the dominant serotype.Aeromonas sobria was the dominant serotype in Aeromonas.The sensitivity of Salmonella to piperacillin/tazobactam,imipenem,cefepime,levofloxacin,and aztreonam was up to 92.00%or more,however,the phenomenon of multidrug resistance was severe,with a multidrug resistance rate as high as 40.38%.The resistance rate of Aeromonas to ampicillin and ampicillin/sulbactam was up to 85.00%or more,while Aeromonas was relatively sensitive to other antibiotics.Conclusion There are many species and types of intestinal pathogenic bacteria carried by healthy individuals in Huadu District,Guangzhou,with Aero-monas and Salmonella ranking first and second,and levofloxacin treatment could be preferred.The use of bac-terial culture and multi pathogen nucleic acid testing methods could improve the detection rate of intestinal pathogenic bacteria,and attention should be paid to the monitoring of intestinal pathogenic bacteria among rel-evant practitioners.
6.Research progress in moxibustion for treating gastrointestinal dysfunction after laparoscopic cholecystectomy
Shuo LI ; Dongdong LU ; Qiuhui LIANG ; Quanxin LIU ; Weiwei JIAO ; Ying ZHEN ; Min DENG ; Lingyun WEN ; Jinbao WANG ; Yanxia CAO
International Journal of Traditional Chinese Medicine 2025;47(9):1327-1331
TCM believes that the main pathogenesis of gastrointestinal dysfunction (GD) after laparoscopic cholecystectomy (LC) is spleen and stomach weakness, liver and stomach disharmony, liver depression and spleen deficiency, and intestinal depression. Moxibustion in the treatment of GD after LC can avoid the aggravation of gastrointestinal burden caused by oral drugs. The intervention methods mainly include suspension moxibustion, umbilical moxibustion, heat sensitive moxibustion, thunder fire moxibustion, warm acupuncture, partition moxibustion, etc. Moxibustion is often performed on the acupoints in liver meridian, spleen meridian, stomach meridian, small intestine meridian, large intestine meridian and Conception Vessel, such as Taichong (LR3), Ganshu (BL18), Yinlingquan (SP9), Zusanli (ST36), Tianshu (ST25), Wangu (SI4), Hegu (LI4), Zhongwan (CV12), Shenque (CV8) and Qihai (CV6). At present, most studies combined with moxibustion on the basis of conventional Western medicine treatment can significantly improve the efficacy, and have certain advantages in improving gastrointestinal motility decline, intestinal flora imbalance, first exhaust time, gastrointestinal hormone level disorder and intestinal mucosal barrier dysfunction. However, there are still some problems in the existing research: small sample size of clinical research, not perfect scoring scale, not unified treatment plan and operation standard, relatively scarce basic research, relatively simple acupoint research, lack of biochemical evaluation indicators, and the research of national moxibustion needs to be explored and improved in the future.
7.Xu Youjia's Experience in Treating Allergic Comorbidity in Children from the Deficiency-Cold Pathogenesis
Yanxia ZHENG ; Lanlin YOU ; Yanzhu HUO ; Zhuoxun LIU ; Youjia XU
Journal of Guangzhou University of Traditional Chinese Medicine 2025;42(5):1255-1259
Allergic comorbidity is a common allergic-related disease in the department of pediatrics,which is called atopic triad in modern medicine.Professor Xu Youjia believes that the children with allergic comorbidity have a more distinctive constitution of insufficiency of immature yang.Children with allergic comorbidity initially have the spleen-qi deficiency pathogenesis,and then the kidney yang will be further involved if the children fail in timely regulation and supplementation,which will result in kidney yang deficiency.In the view of spleen-kidney deficiency-cold pathogenesis of children with allergic comorbidity,Professor Xu Youjia suggested that,during the treatment,attention should be paid to the protection of the spleen(earth)of the middle energizer,thus to ensure the postnatal fire warm congenital kidney yang,and then the efficacy of raising qi and reinforcing yang can be achieved.The core medicines used for the treatment of deficiency-cold snineling nose include seven herbs,and they were Glycyrrhizae Radix et Rhizoma,Atractylodis Macrocephalae Rhizoma,Angelicae Dahuricae Radix,Saposhnikoviae Radix,Xanthii Fructus,Magnoliae Flos,and Schisandrae Chinensis Fructus.For children with severe deficiency-cold,the treatment needs to start from supplementing kidney-qi and protecting the root of yang,and the medicinals such as Psoraleae Fructus,Cimicifugae Rhizoma,Eucommiae Cortex,and Cinnamomi Cortex can be used.Professor Xu stressed the importance of adjusting the children's dietary structure and habits for protecting the spleen and stomach.The application of therapy of mediating the middle earth,raising qi and strengthening yang should accord with the growth and development of children,and the therapy is suitable for guiding the clinical treatment of diseases related to deficiency-cold syndrome.The selection of prescriptions should be based on the identification of the pathogenesis of deficiency-cold and its severity.
8.Differention and Treatment of Brain Metastasis from Lung Cancer Based on Theory of "Yang Qi Depletion and Latent Pathogens Transmitting to the Brain"
Huiying ZHAO ; Yanxia LIANG ; Guangsen LI ; Wenwen WANG ; Wenwen SU ; Fenggu LIU ; Hongfei XING ; Maorong FAN
Journal of Traditional Chinese Medicine 2025;66(9):968-972
9.Practice and evaluation of pharmacists’participation in long-term MTM models for stroke patients based on family doctor system
Lu SHI ; Chun LIU ; Lian TANG ; Jingjing LI ; Sudong XUE ; Yanxia YU ; Wenwen LI ; Keren YU ; Jianhui XUE ; Wen MA ; Hongzhi XUE
China Pharmacy 2025;36(9):1129-1134
OBJECTIVE To investigate the clinical efficacy of integrating pharmacists into family health teams (FHTs) for long-term medication therapeutical management (MTM) in stroke patients, and empirically evaluate the service model. METHODS A pharmacist team, jointly established by clinical and community pharmacists from the Affiliated Suzhou Hospital of Nanjing Medical University (hereinafter referred to as “our hospital”), developed a pharmacist-supported MTM model integrated into FHTs. Using a prospective randomized controlled design, 170 stroke patients discharged from our hospital (July 2022-December 2023) and enrolled in FHTs at Suzhou Runda Community Hospital were randomly divided into trial group (88 cases) and control group (82 cases) according to random number table. The control group received routine FHTs care (without pharmacist involvement in the team collaboration), while the trial group xhz8405@126.com received 12-month MTM services supported by pharmacists via an information platform. These services specifically included innovative interventions such as personalized medication regimen optimization based on the MTM framework, dynamic medication adherence management, medication safety monitoring, a home medication assessment system, and distinctive service offerings. Outcomes of the 2 grousp were compared before and after intervention, involving medication adherence (adherence rate, adherence score), compliance rates for stroke recurrence risk factors [blood pressure, low-density lipoprotein cholesterol (LDL-C)], and incidence of adverse drug reactions (ADR). RESULTS After 12 months, the trial group exhibited significantly higher medication adherence rates, improved adherence scores, higher compliance rates for blood pressure and LDL-C targets compared to the control group (P<0.05). The incidence of ADR in the trial group (4.55%) was significantly lower than that in the control group (8.11%), though the difference was not statistically significant (P> 0.05). CONCLUSIONS Pharmacist involvement in FHTs to deliver MTM services significantly enhances medication adherence and optimizes risk factor for stroke recurrence, offering practical evidence for advancing pharmaceutical care in chronic disease management under the family doctor system.
10.Effect of Ziyu Ointment on TGF-β/Smad signal pathway in granulation tissue of wound healing rats
Xia WANG ; Zhiqing LIU ; Zhijuan QIN ; Yanxia JIN ; Zijuan JIA ; Sun GUO ; Yuanyuan GAO ; Ling LI
Chinese Journal of Immunology 2025;41(2):387-392
Objective:To explore the effects of Ziyu Ointment on granulation tissue,TGF-β and downstream Smad protein in the process of wound healing in rats by constructing a rat model of back trauma.Methods:A rat model of back trauma was constructed,and 100 SD male rats were separated into healthy group,back trauma group,Ziyu Ointment treatment group,petrolatum treatment group,Ziyu Ointment+TGF-β1 activation group,with 20 per group.Wound formation surgery was performed,and wound healing of rats in each group was recorded at 5th,10th,and 15th day after operation;the levels of IL-6,IL-1β and TNF-α in the serum of rats in each group were detected;the granulation tissue formed by wound healing at 15th day was selected for HE and Masson staining,the proportion of blood vessel area and collagen area of granulation tissue of rats in each group were analyzed and calculated;the mRNA expression levels of TGF-β1 and Smad3 in granulation tissues of rats in each group were detected by fluorescence quantitative PCR;the expression levels of TGF-β1,Smad3 and p-Smad3 in granulation tissues of rats in each group were detected by Western blot.Results:The healthy group rats had complete epidermal tissue;the levels of serum IL-6,IL-1β,TNF-α,the expression of TGF-β1 mRNA and protein in the wound granulation tissue,and the phosphorylation of Smad3 in the back trauma group were obviously higher than the healthy group(P<0.05);compared with back trauma group,the wound healing rate,proportion of collagen area,and propor-tion of blood vessel area in Ziyu Ointment treatment group and petrolatum treatment group were obviously increased,the serum IL-6,IL-1β,TNF-α contents,TGF-β1 mRNA and protein expression,and Smad3 phosphorylation were obviously decreased(P<0.05);compared with Ziyu Ointment treatment group,the petrolatum treatment group,Ziyu Ointment+TGF-β1 activation group had obviously lower wound healing rate,collagen area percentage,and blood vessel area percentage,and obviously lower serum IL-6,IL-1β,TNF-α contents,TGF-β1 mRNA and protein expression and Smad3 phosphorylation(P<0.05).Conclusion:Ziyu Ointment can inhibit the expression of related genes and proteins by regulating the TGF-β/Smad signal pathway,thereby alleviating inflammation and promoting wound healing.


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