1.The effect of combining case-based teaching method with micro teaching method in the teaching of re-habilitation nurses
Jingjing QI ; Xinxin ZHU ; Zhifang LIU ; Nanbing ZHANG ; Xi SHAN
Modern Hospital 2025;25(3):480-482
Objective To explore the effect of combining case-based teaching method with micro teaching method in the teaching of rehabilitation nurses.Methods A total of 60 students from the rehabilitation department of a hospital were selected from January 2021 to December 2022 and divided into control group and observation group by drawing lots,with 30 cases in each group.The control group adopted the traditional teaching and case teaching mode,and the observation group adopted the Semi-nar-case teaching mode and microteaching mode.The results of operation examination,basic theory and independent learning a-bility were compared between the two groups.Results After two months of study,the observation group had higher scores in the operation exam and basic theory than the control group(P<0.05);The observation group scored higher in self-directed learning ability than the control group(P<0.05).Conclusion The combination of case teaching method and microteaching method in the teaching process of rehabilitation nurses is conducive to the students'learning of clinical theoretical knowledge and practical operation,and improving their self-learning ability in the learning process.
2.Predictive value of reverse shock index multiplied by Glasgow coma scale score for mortality of trauma patients: a Meta analysis
Bing LIU ; Guohong JIA ; Xiaopei BU ; Chuangye SONG ; Jianghua ZHANG ; Zhifang JIA ; Xiaowu LI ; Jianjun MIAO
Chinese Journal of Trauma 2025;41(11):1094-1102
Objective:To systematically evaluate the predictive value of the reverse shock index multiplied by the Glasgow coma scale score (rSIG) for mortality of trauma patients.Methods:A comprehensive literature search was conducted to identify studies on the predictive value of rSIG for mortality of trauma patients in the following databases from inception to April 2025, including CNKI, Wanfang Data, SinoMed, PubMed, Cochrane Library, Web of Science, and Embase. Two investigators independently screened the literature, extracted data, and assessed study quality according to predefined inclusion and exclusion criteria. The Quality assessment of diagnostic accuracy studies-2 (QUADAS-2) tool was used to evaluate the risk of bias in the included studies. Meta analysis was performed using Stata 17.0 software with a bivariate mixed-effects model. The following metrics were used to assess the predictive value of rSIG for mortality in trauma patients, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic (SROC) curve (AUC). The influence of various factors on the predictive performance of rSIG was examined, including injury type, study design, region, sample size, cut-off value, rSIG measurement time, and outcome measures. Additionally, sensitivity analysis, Fagan′s nomogram, and Deeks′ funnel plot were employed to assess the robustness of the findings, clinical applicability, and publication bias.Results:A total of 15 studies involving 710 612 trauma patients were included, 26 105 of whom were deceased. Meta analysis results showed that rSIG had a pooled sensitivity of 0.78(95% CI 0.71, 0.84), a pooled specificity of 0.78(95% CI 0.68, 0.86), a pooled PLR of 3.60(95% CI 2.46, 5.27), a pooled NLR of 0.28(95% CI 0.22, 0.36), a pooled DOR of 12.70(95% CI 8.10, 19.91), and an AUC of 0.85(95% CI 0.81, 0.87) for predicting mortality of trauma patients. Subgroup analysis identified injury type as one of the major sources of heterogeneity, and the predictive specificity of rSIG was significantly higher in patients with multiple trauma (0.82) than in those with isolated traumatic brain injury (0.65) ( P<0.05). Sensitivity analysis indicated that the findings were robust and stable. Fagan′s nomogram showed that when the pre-test probability was 7%, the post-test probability of death increased to 21% in patients with low rSIG and decreased to 2% in those with high rSIG. Deeks′ funnel plots suggested no significant publication bias among the included studies ( P>0.05). Conclusion:Low rSIG has good predictive performance for mortality of trauma patients and can serve as an effective tool for early and rapid prognosis assessment with superior predictive performance in patients with multiple trauma compared to those with traumatic brain injury.
3.MicroPET/CT-based exploration of the effects of acute sleep deprivation on glucose metabolism and neuroinflammation in rat brain
Mengya DAI ; Zhenyu XIANG ; Yan ZHANG ; Chaofeng LIU ; Jie GAO ; Zhixing QIN ; Hongliang WANG ; Zhifang WU ; Jianguo LI ; Sijin LI
Chinese Journal of Nuclear Medicine and Molecular Imaging 2025;45(9):555-559
Objective:To investigate the effects of acute sleep deprivation (ASD) on hippocampal glucose metabolism and neuroinflammation in rat models.Methods:Twenty SD rats (10 males and 10 females) were divided into four groups (five in each group) by random sampling method: female ASD group, male ASD group, female control group, and male control group. Among them, the ASD group constructed the ASD model. After 72h sleep deprivation, all rats underwent 18F-FDG and N, N-diethyl-2-(2-(4-(2- 18F-fluoroethoxy)phenyl)-5, 7-dimethylpyrazolo[1, 5-a]pyrimidin-3-yl)acetamide ( 18F-DPA-714) microPET/CT brain imaging in 2d to compare the changes of 18F-FDG and 18F-DPA-714 SUV mean in the hippocampus of rats. Brain histopathology, immunohistochemistry and immunofluorescence staining were detected in rats. Independent-sample t test was used to analyze the data. Results:18F-FDG imaging showed the hippocampal SUV mean between ASD group and control group (female: 4.11±0.35 vs 1.89±0.28; male: 3.43±0.47 vs 2.02±0.54) were statistically significant ( t values: 9.65, 3.92, P values: <0.001, 0.002). 18F-DPA-714 imaging showed the hippocampal SUV mean between ASD group and control group (females: 0.28±0.01 vs 0.28±0.02; male: 0.26±0.02 vs 0.31±0.04) were not statistically significant ( t values: -0.18, -2.24, P values: 0.859, 0.056). The 18×10 3 translocator protein (TSPO) immunohistochemistry showed the expression in the hippocampal region of the brain between ASD group and control group (female: 0.19±0.02 vs 0.19±0.01; male: 0.21±0.01 vs 0.20±0.01) were not statistically different ( t values: -0.48, -1.67, P values: 0.651, 0.139). Immunofluorescence staining showed that microglial cytosol in the hippocampal region of the brain decreased after 72h of ASD, and the protrusion points and surrounding branches were significantly reduced. Conclusion:Increased hippocampal glucose metabolism in rats is observed after 72 h of ASD without significant neuroinflammation.
4.Progress in role and expression regulation of asprosin in metabolic syndrome
Jie REN ; Zhifang REN ; Rui LIU ; Jie QIN
Chinese Journal of Pathophysiology 2025;41(5):1024-1029
Metabolic syndrome is a group of clinical syndromes of metabolic disorders characterized by the in-dividual clustering of various disease states such as central obesity,hypertension,dyslipidemia,abnormal glucose metabo-lism,and hyperuricemia.This syndrome not only causes an increased hospitalization rate,complication rate,and mortali-ty but also is a metabolic disorder syndrome that can affect the prognosis of other diseases.It often leads to an increased risk of cardiovascular and cerebrovascular accidents in patients.Asprosin is a novel adipokine discovered in recent years that plays a crucial role in appetite regulation,adipose tissue remodeling,inflammatory response,and oxidative stress.More and more studies have found that asprosin is involved in the development of obesity and related metabolic syndrome,as well as its role in metabolic disorders such as diabetes and its chronic complications,insulin resistance,nonalcoholic fatty liver disease,and polycystic ovary syndrome.In this paper,we review the regulatory effect and mechanism of aspro-sin in obesity and related metabolic syndrome.We further elaborate on its regulatory mechanism and research status on metabolic disorders,providing new targets and ideas for improving obesity and other related metabolic diseases.
5.Effect of MOTS-c on hepatocyte injury induced by glycochenodeoxycholic acid by regulating transporter MRP2 expression
Yu AO ; Xuyang ZHANG ; Dan TANG ; Gongwei LIU ; Dan HUANG ; Zhifang CAI
Organ Transplantation 2025;16(3):425-434
Objective To investigate the effects and related mechanisms of mitochondrial-derived peptide MOTS-c on glycochenodeoxycholic acid (GCDCA)-induced injury in human hepatocytes (THLE-3 cells). Methods THLE-3 cells were cultured in vitro and treated with different concentrations of GCDCA and MOTS-c. The optimal concentrations of GCDCA and MOTS-c were determined by cell counting kit (CCK)-8 method. Subsequently, THLE-3 cells were treated or pre-treated with GCDCA (200 µmol/L), MOTS-c (15, 30, 60 µmol/L), the multidrug resistance protein 2 (MRP2) inhibitor Probenecid (500 µmol/L), and the nuclear factor erythroid 2-related factor 2 (Nrf2) inhibitor ML385 (10 µmol/L). Cell proliferation was assessed by CCK-8 method. Lactate dehydrogenase (LDH) levels in the culture medium were measured by biochemical method. Cell apoptosis rates were determined by flow cytometry. MRP2 messenger RNA (mRNA) levels were detected by real-time quantitative polymerase chain reaction (RT-qPCR). MRP2 and Nrf2 protein expression levels were analyzed by Western blotting. Results As the concentration of GCDCA increased, the proliferation activity of THLE-3 cells gradually decreased, while LDH activity in the culture medium and apoptosis levels increased, and the expression levels of MRP2 in the cells decreased (all P<0.05). Treatment with 30 and 60 µmol/L MOTS-c significantly enhanced the proliferation activity of THLE-3 cells exposed to GCDCA, upregulated the expression of MRP2 and Nrf2, and reduced LDH activity and apoptosis levels (all P<0.05). Co-treatment with Probenecid partially reversed the protective effects of MOTS-c on GCDCA-induced THLE-3 cells injury, while co-treatment with ML385 partially inhibited the induction of MRP2 expression by MOTS-c in THLE-3 cells exposed to GCDCA. Conclusions MOTS-c may alleviate GCDCA-induced injury in human hepatocytes (THLE-3 cells), and its mechanism may be related to the upregulation of MRP2 expression mediated by Nrf2.
6.Electroacupuncture at neuro-arterial stimulation points for post-stroke shoulder-hand syndrome: a randomized controlled trial.
Man ZHANG ; Zhifang XU ; Meidan ZHAO ; Xiumei YIN ; Jiazhu WU ; Zhixin LIU ; Yuanhao DU
Chinese Acupuncture & Moxibustion 2025;45(9):1241-1247
OBJECTIVE:
To compare the clinical efficacy of electroacupuncture (EA) at neuro-arterial stimulation points with topical western medication in treating post-stroke shoulder-hand syndrome (SHS).
METHODS:
A total of 72 patients with post-stroke SHS were randomly assigned to an observation group (n=36, 2 cases dropped out) and a control group (n=36, 3 cases dropped out). Both groups received standard neurological treatment, comprehensive rehabilitation, and physical therapy. The observation group received EA at neuro-arterial stimulation points, including the ipsilateral stellate ganglion point, vagus nerve trunk and auricular branch (left side), and stimulation points of the radial and ulnar arteries, radial nerve, ulnar nerve, and median nerve, once daily for 4 weeks. The control group was treated with topical diclofenac diethylamine emulgel, and mucopolysaccharide polysulfate cream was added for patients with pronounced early-stage edema, twice a day for 4 weeks. The VAS pain score and hand edema volume were recorded before treatment, at 2 and 4 weeks during treatment, and 2 weeks after treatment completion (follow-up). Musculoskeletal ultrasound was used to measure the thickness of the dorsal hand and middle finger skin on the affected side before and after 4 weeks of treatment.
RESULTS:
Compared before treatment, the VAS pain scores and edema volume of the affected hand in both groups were decreased at week 2, week 4, and follow-up (P<0.05). At week 4, both groups showed lower VAS pain scores and edema volume than those at week 2 (P<0.05); during follow-up, both VAS pain scores and edema volume were further reduced compared to those at week 4 (P<0.05). At week 2, week 4, and follow-up, the VAS scores and edema volume of the affected hand in the observation group were lower than those in the control group (P<0.05). Compared before treatment, the dorsal hand skin thickness and middle finger skin thickness on the affected side were decreased in both groups after 4 weeks of treatment (P<0.05). Compared with the control group, the observation group showed thinner dorsal hand and middle finger skin thickness after 4 weeks of treatment (P<0.05).
CONCLUSION
EA at neuro-arterial stimulation points effectively alleviates pain and edema in patients with post-stroke SHS, and demonstrates superior efficacy compared to topical western medication.
Humans
;
Male
;
Female
;
Middle Aged
;
Electroacupuncture
;
Aged
;
Stroke/complications*
;
Acupuncture Points
;
Adult
;
Reflex Sympathetic Dystrophy/physiopathology*
;
Treatment Outcome
;
Hand
7.The role of PGC-1α mediated mitochondrial biosynthesis in the protection of AMPK agonist against hepatic ischemia-reperfusion injury
Yu Ao ; Xuyang Zhang ; Dan Tang ; Gongwei Liu ; Dan Huang ; Zhifang Cai
Acta Universitatis Medicinalis Anhui 2025;60(7):1194-1203
Objective:
To investigate the role and mechanism of PGC-1 α-mediated mitochondrial biosynthesis in AMP-activated protein kinase (AMPK) agonist anti-hepatic ischemia-reperfusion injury (HIRI) .
Methods :
SD rats were randomly divided into Control group,HIRI group,HIRI + AICAR group,HIRI + SR-18292 group and HIRI + AICAR + SR-18292 group,with 8 rats in each group.The rats were intraperitoneally injected with AICAR (500 mg / kg) or SR-18292 (32 mg / kg) before operation,and then the HIRI model was established by non-invasive vascular clamp clamping method.The samples were taken 24 hours after reperfusion.The contents of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum and the levels of malondialdehyde (MDA) ,superoxide dis- mutase (SOD) and adenosine triphosphate (ATP) in liver tissue were detected.HE staining was used to observe the pathological changes of liver tissue.The level of reactive oxygen species (ROS) and the changes of mitochondri- al membrane potential in liver tissue were detected by fluorescence probe.The copy number of mitochondrial DNA (mtDNA) and the mitochondrial biosynthesis-related genes PGC-1 α, NRF1,TFAM,UQCRC2 and other mRNA ex- pression levels were detected by qRT-PCR. Western blot was used to detect the protein expression levels of AMPKα, p-AMPKα , mTOR , p-mTOR , PGC-1α and TFAM in liver tissue.
Results :
Compared with the control group,the levels of ALT and AST in serum and MDA and ROS in liver tissue of rats in HIRI group increased,while the levels of SOD and ATP decreased ( all P <0. 05) .At the same time,the mtDNA copy number,mitochondrial membrane potential and the mRNA expression levels of PGC-1α , NRF1,TFAM,and UQCRC2 in liver tissues de- creased,and the protein ratio of p-AMPKα/AMPKα and the protein expression levels of PGC-1α and TFAM de- creased.The ratio of p-mTOR/ mTOR protein increased (both P<0. 05) .Compared with HIRI group,the levels of ALT and AST in serum and MDA and ROS in liver tissue of rats in HIRI + AICAR group decreased,while the levels of SOD and ATP increased ( all P <0. 05) .At the same time,the mtDNA copy number,mitochondrial membrane potential and the mRNA expression levels of PGC-1α , NRF1,TFAM,and UQCRC2 in liver tissue increased,and the protein ratio of p-AMPKα/AMPKα and the protein expression levels of PGC-1α and TFAM increased.The ratio of p-mTOR/ mTOR protein decreased (both P<0. 05) .However,combined with SR-18292 intervention,the protective effect of AICAR on liver tissue of HIRI rats was significantly reversed.
Conclusion
PGC-1α mediated mitochondri- al biosynthesis is involved in the regulation of AMPK agonist-mediated protective effect of HIRI,and its mechanism may be related to the activation of AMPK/ mTOR signaling pathway.
8.Genetic analysis of a Chinese pedigree affected with Epidermolysis bullosa simplex due to a novel variant of KRT5 gene.
Shaoguang LYU ; Fang LIU ; Zhifang DU ; Kun WANG ; Mengdi YANG
Chinese Journal of Medical Genetics 2025;42(10):1226-1231
OBJECTIVE:
To investigate the clinical characteristics and genetic etiology of eight members from a pedigree affected with epidermolysis bullosa (EB).
METHODS:
A girl presented with recurrent, unexplained blisters on the palmar and plantar skin for 8 years and sought medical care in October 2024 was enrolled as the study subject. A retrospective study was conducted to collect the child's clinical data, and a detailed medical history was taken for her family members. Peripheral venous blood samples were collected from the child and her parents for genomic DNA extraction. Whole-exome sequencing (WES) was performed. Candidate variant was validated by Sanger sequencing. The pathogenicity of the candidate variants was classified in accordance with the Standards and Guidelines for the Interpretation of Sequence Variants issued by the American College of Medical Genetics and Genomics (ACMG, hereinafter referred to as the "ACMG Guidelines"). This study was approved by the Medical Ethics Committee of the 980th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army (Ethics No.: 2019-KY-01).
RESULTS:
The proband was an 8-year-and-4-month-old female. Four months after birth, she had developed recurrent blisters on the palmar and plantar skin without obvious triggers, accompanied by significant pain. Symptoms were more severe in summer and slightly relieved in winter. Although symptomatic treatment could alleviate the symptoms, she was unable to participate in physical activities. A detailed family history revealed that her great-grandfather, grandfather, father, half-brother, great-aunt, great-aunt's son and two grandsons, as well as her aunt and aunt's son, had similar clinical manifestations. WES revealed that she has harbored a heterozygous c.556-16(IVS1)C>G (NM_000424.4) variant in the KRT5 gene, which was identified as a splice site mutation. Reverse transcription sequencing confirmed that this variant can disrupt normal splicing, resulting in retention of a 15 bp sequence in the first intron. Sanger sequencing demonstrated that the variant was inherited from the father, and the 6 aforementioned relatives with similar phenotypes have all carried the same variant (the great-grandfather, grandfather, and great-aunt had declined genetic testing due to advanced age). Based on the ACMG guidelines, this variant was classified as pathogenic (PS3+PM2_Supporting+PP3+PP1_strong).
CONCLUSION
Patients with epidermolysis bullosa simplex may exhibit clinical features including blistering on the skin or mucous membranes of friction-prone sites (e.g. hands, feet, elbows, and knees) following minor trauma or friction, as well as increased skin fragility. The c.556-16(IVS1)C>G (rs376462752) variant of the KRT5 gene probably underlay the pathogenesis of EB in this child. Above findings have enriched the mutational spectrum of the KRT5 gene.
Child
;
Female
;
Humans
;
Infant
;
Male
;
China
;
Epidermolysis Bullosa Simplex/genetics*
;
Exome Sequencing
;
Keratin-5/genetics*
;
Mutation
;
Pedigree
;
Retrospective Studies
;
East Asian People/genetics*
9.Biological dose estimation in a patient with radiation dermatitis
Zhifang LIU ; Yingyi PENG ; Xiaolian LIU ; Qiying NONG ; Qiuying LIU ; Na ZHAO ; Xiaoyong LIU ; Weixu HUANG
China Occupational Medicine 2025;52(4):410-415
Objective To estimate the biological dose in a patient who developed radiation dermatitis after a local X-ray exposure incident. Methods Peripheral blood samples, which were used to performed lymphocyte chromosome aberration analysis, were collected from the patient at 54 and 102 days after the last exposure. Biological dose in the patient was estimated using four published X-ray dose-effect calibration curves for chromosomal aberrations. The absorbed dose in the patient was reconstructed using Dolphin′s model and time correction factors. Results The abnormal rates of chromosome aberration at 54 and 102 days after exposure were 1.00% and 0.40%, respectively. Based on the four calibration curves, the estimated local exposure dose at 54 day ranged from 3.59 to 10.51 Gy, and the time-corrected whole-body equivalent dose ranged from 0.27 to 0.87 Gy. The local dose estimated at 102 days ranged from 2.24 to 6.64 Gy, with a time-corrected whole-body equivalent dose of 0.12 to 0.60 Gy, which differed from the day-54 estimates. The biological doses estimated by both methods were lower than the physical dose (29.43 Gy). Conclusion The estimation of local biological dose of patient various in four dose-effect curves selected in this study. Delayed blood sampling will lead to underestimate biological dose. Early blood collection after radiation incidents is critical to ensure accuracy and reliability. Moreover, biological dose reconstruction methods for complex exposure scenarios require further research to improve the accracy of emergency response in radiation accidents.
10.Relationship between work-family conflict, depressive mood, and eating behavior of occupational populations aged 18-60 years
Haixia ZHAO ; Zhifang LIU ; Chunlan FU ; Meng ZHANG ; Wei LUO
Journal of Environmental and Occupational Medicine 2025;42(12):1456-1464
Background Psychological disturbances such as work-family conflict and depressive mood are prevalent among occupational groups and are closely related to eating behavior. Therefore, investigating the influencing factors of eating behavior is of great significance for promoting the health behaviors of occupational populations. Objective To clarify the current situation of eating behavior among the occupational populations aged 18 to 60 years in China, and to explore the relationship between work-family conflict, depressive mood, and eating behavior, and to test the mediating role of depressive mood in the relationship. Methods The study used a data set containing occupational populations aged 18 to 60 years extracted from the 2021 Psychology and Behavior Investigation of Chinese Residents. The Work-Family Conflict Scale, the Chinese version of the Sakata Eating Behavior Scale Short Form, and the Patient Health Questionnaire-Depression Scale were used. Potential influencing factors of eating behavior of the occupational populations were evaluated by multiple linear regression. Structural equation modeling was used to analyze the relationships between work-family conflict, depressive mood, and eating behavior, and the Bootstrap method was used to test the mediating effect of depressive mood on the relationship of work-family conflict and eating behavior. Results Among the occupational populations, the proportion of reporting high work-family conflict was 48.4%, and the proportion of reporting mild depression and above was 48.7%. The total score of eating behavior was (16.16±4.64), and the proportion of high abnormal eating behavior tendency was 39.1%. There were significant differences in eating behavior score among different age, educational level, marital status, number of offspring, occupation, smoking, and drinking groups (P<0.05). The partial correlation analysis showed that work-family conflict and depressive mood were positively correlated with abnormal eating behavior (r=0.367, 0.386, P<0.001); work-family conflict was positively correlated with depressive mood (r=0.466, P<0.001). The results of the multiple linear regression showed that depressive mood, work-family conflict, age, smoking, drinking, and education level were associated with eating behavior (P<0.05). The structural equation modeling indicated that work-family conflict positively associated with depressive mood (b=0.529, P<0.001), depressive mood positively associated with abnormal eating behavior (b=0.292, P<0.001), and work-family conflict positively associated with abnormal eating behavior (b=0.270, P<0.001). Depressive mood played a partial mediating role in the relationship between work-family conflict and eating behavior, and the effect value was 0.154 (95%CI: 0.132, 0.179) that accounted for 36.32% of the total effect. Conclusion Work-family conflict could directly affect the eating behavior among occupational populations, and also indirectly affect eating behavior through a mediating effect of depressive mood. Therefore, optimizing the allocation of tasks between work and family, providing psychological support in need, alleviating work-family conflict and depressive mood may improve the eating behavior and mental health of working populations.


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