1.A systematic review on the integrated application of evidence-based narrative education and undergraduate nursing teaching
Nannan BAI ; Meng LI ; Qian LIANG ; Chou YAO ; Yan WANG ; Ju HAN ; Chenyang HOU ; Nana XING
Chinese Medical Ethics 2026;39(2):229-237
ObjectiveTo systematically evaluate the application of narrative education in undergraduate nursing teaching, to understand the current application status of narrative education, and to provide a theoretical basis for the subsequent establishment of a sound narrative education system. MethodsA systematic search was conducted for studies published in Chinese and English databases on applying narrative education to undergraduate nursing teaching, with the search period ranging from database inception to February 23, 2025. Literature was screened, and relevant information was extracted. A rigorous quality evaluation was conducted on the included studies, and a descriptive analysis was performed on their content. ResultsA total of 20 papers were included, involving 3,180 research subjects, all of whom were undergraduate nursing students. The results of descriptive analysis showed that the teaching model of narrative education primarily encompassed reading narrative works, watching films and videos, performing narrative scenarios, and writing reflective journals. The course setting and content covered pre-teaching preparation and in-teaching implementation. The evaluation of teaching effectiveness included the evaluation of teachers’ teaching methods (student evaluation/self-evaluation) and the evaluation of students’ learning effectiveness (course grade evaluation/humanistic care scale/empathy scale assessment, and others). ConclusionNarrative education combines abstract concepts with concrete clinical situations, which not only enriches students’ learning experiences but also enhances their humanistic literacy. Meanwhile, it provides teachers with opportunities to develop their narrative teaching skills, which requires them to possess profound professional knowledge and employ narrative techniques to guide students in reflection and critical thinking, thereby improving teaching quality and learning outcomes. Future efforts should consistently deepen the connotation research of narrative education and build a systematic nursing education system.
2.The Regulatory Effects and Mechanisms of Piezo1 Channel on Chondrocytes and Bone Metabolic Dysregulation in Osteoarthritis
Yan LI ; Tao LIU ; Yu-Biao GU ; Hui-Qing TIAN ; Lei ZHANG ; Bi-Hui BAI ; Zhi-Jun HE ; Wen CHEN ; Jin-Peng LI ; Fei LI
Progress in Biochemistry and Biophysics 2026;53(3):564-576
Osteoarthritis (OA), a highly prevalent degenerative joint disease worldwide, is defined by articular cartilage degradation, abnormal bone remodeling, and persistent chronic inflammation. It severely compromises patients’ quality of life, and currently, there is no radical cure. Abnormal mechanical stress is widely regarded as a core driver of OA pathogenesis, and the exploration of mechanical signal perception and transduction mechanisms has become crucial for deciphering OA’s pathophysiological processes. Piezo1, a key mechanosensitive cation channel belonging to the Piezo protein family, has recently gained significant attention due to its pivotal role in mediating cellular responses to mechanical stimuli in joint tissues. This review systematically examines Piezo1’s expression patterns, regulatory mechanisms, and pathological functions in OA, with a particular focus on its dual roles in modulating chondrocyte homeostasis and bone metabolism disorders, while also delving into the underlying molecular signaling pathways and potential therapeutic implications. Piezo1, consisting of approximately 2 500 amino acids and forming a unique trimeric propeller-like structure, is widely expressed in chondrocytes, osteocytes, mesenchymal stem cells, and synovial cells. It exhibits permeability to cations such as Ca2+, K+, and Na+, and directly responds to membrane tension changes induced by mechanical stimuli like fluid shear stress and mechanical overload. In OA patients and animal models, Piezo1 expression is significantly upregulated, especially in cartilage regions subjected to abnormal mechanical stress (e.g., human temporomandibular joint cartilage). This overexpression is closely associated with aggravated cartilage degeneration, increased chondrocyte apoptosis, accelerated cellular senescence, and intensified inflammatory responses. Mechanical overload and pro-inflammatory cytokines (e.g., IL-1β) are key inducers of Piezo1 upregulation: IL-1β activates the PI3K/AKT/mTOR signaling pathway to enhance Piezo1 expression, forming a pathogenic positive feedback loop that inhibits chondrocyte autophagy, promotes apoptosis, and further accelerates joint degeneration. Mechanistically, Piezo1 mediates OA progression through multiple interconnected pathways. When activated by mechanical stress, Piezo1 triggers excessive Ca2+ influx, leading to endoplasmic reticulum stress (ERS) and mitochondrial dysfunction, which directly induce chondrocyte apoptosis. This process involves the activation of downstream signaling cascades such as cGAS-STING and YAP-MMP13/ADAMTS5. YAP, a transcriptional regulator, upregulates the expression of matrix metalloproteinase 13 (MMP13) and aggrecanase (ADAMTS5), thereby accelerating cartilage matrix degradation. Additionally, Piezo1-driven Ca2+ overload promotes the accumulation of reactive oxygen species (ROS) and upregulates senescence markers (p16 and p21), accelerating chondrocyte senescence via the p38MAPK and NF-κB pathways. Senescent chondrocytes secrete senescence-associated secretory phenotype (SASP) factors (e.g., IL-6, IL-1β), further amplifying joint inflammation. In terms of bone metabolism, Piezo1 maintains joint homeostasis by promoting the differentiation of fibrocartilage stem cells into chondrocytes and balancing bone formation and resorption through regulating the FoxC1/YAP axis and RANKL/OPG ratio. Therapeutically, targeting Piezo1 shows promising potential. Preclinical studies have demonstrated that Piezo1 inhibitors (e.g., GsMTx4) can reduce joint damage and alleviate pain in OA mice. Simultaneously, siRNA-mediated co-silencing of Piezo1 and TRPV4 (another mechanosensitive channel) decreases intracellular Ca2+ concentration, inhibits chondrocyte apoptosis, and promotes cartilage repair. Conditional knockout of Piezo1 using Gdf5-Cre transgenic mice alleviates cartilage degeneration in post-traumatic OA models by downregulating MMP13 and ADAMTS5 expression. Despite existing challenges, such as off-target effects of inhibitors, inefficient local drug delivery, and interindividual genetic variability, strategies like developing selective Piezo1 antagonists, optimizing targeted nanocarriers, and combining Piezo1-targeted therapy with physical therapy provide viable avenues for clinical translation. The authors propose that Piezo1 serves as a critical therapeutic target for OA, and future research should focus on deciphering its context-dependent regulatory networks, developing tissue-specific intervention strategies, and validating their efficacy and safety in clinical trials to address the unmet medical needs of OA patients.
3.THBS4 in Disease: Mechanisms, Biomarkers, and Therapeutic Opportunities
De-Ying HUANG ; Yan-Hong LI ; Xiu-Feng BAI ; Yi LIU
Progress in Biochemistry and Biophysics 2025;52(9):2217-2232
Thrombospondin 4 (THBS4; TSP4), a crucial component of the extracellular matrix (ECM), serves as an important regulator of tissue homeostasis and various pathophysiological processes. As a member of the evolutionarily conserved thrombospondin family, THBS4 is a multidomain adhesive glycoprotein characterized by six distinct structural domains that mediate its diverse biological functions. Through dynamic interactions with various ECM components, THBS4 plays pivotal roles in cell adhesion, proliferation, inflammation regulation, and tissue remodeling, establishing it as a key modulator of microenvironmental organization. The transcription and translation of THBS4 gene, as well as the activity of the THBS4 protein, are tightly regulated by multiple signaling pathways and extracellular cues. Positive regulators of THBS4 include transforming growth factor-β (TGF-β), interferon-γ (IFNγ), granulocyte-macrophage colony-stimulating factor (GM-CSF), bone morphogenetic proteins (BMP12/13), and other regulatory factors (such as B4GALNT1, ITGA2/ITGB1, PDGFRβ, etc.), which upregulate THBS4 at the mRNA and/or protein level. Conversely, oxidized low-density lipoprotein (OXLDL) acts as a potent negative regulator of THBS4. This intricate regulatory network ensures precise spatial and temporal control of THBS4 expression in response to diverse physiological and pathological stimuli. Functionally, THBS4 acts as a critical signaling hub, influencing multiple downstream pathways essential for cellular behavior and tissue homeostasis. The best-characterized pathways include: (1) the PI3K/AKT/mTOR axis, which THBS4 modulates through both direct and indirect interactions with integrins and growth factor receptors; (2) Wnt/β-catenin signaling, where THBS4 functions as either an activator or inhibitor depending on the cellular context; (3) the suppression of DBET/TRIM69, contributing to its diverse regulatory roles. These signaling connections position THBS4 as a master regulator of cellular responses to microenvironmental changes. Substantial evidence links aberrant THBS4 expression to a range of pathological conditions, including neoplastic diseases, cardiovascular disorders, fibrotic conditions, neurodegenerative diseases, musculoskeletal disorders, and atopic dermatitis. In cancer biology, THBS4 exhibits context-dependent roles, functioning either as a tumor suppressor or promoter depending on the tumor type and microenvironment. In the cardiovascular system, THBS4 contributes to both adaptive remodeling and maladaptive fibrotic responses. Its involvement in fibrotic diseases arises from its ability to regulate ECM deposition and turnover. The diagnostic and therapeutic potential of THBS4 is particularly promising in oncology and cardiovascular medicine. As a biomarker, THBS4 expression patterns correlate significantly with disease progression and patient outcomes. Therapeutically, targeting THBS4-mediated pathways offers novel opportunities for precision medicine approaches, including anti-fibrotic therapies, modulation of the tumor microenvironment, and enhancement of tissue repair. This comprehensive review systematically explores three key aspects of THBS4 research(1) the fundamental biological functions of THBS4 in ECM organization; (2) its mechanistic involvement in various disease pathologies; (3) its emerging potential as both a diagnostic biomarker and therapeutic target. By integrating recent insights from molecular studies, animal models, and clinical investigations, this review provides a framework for understanding the multifaceted roles of THBS4 in health and disease. The synthesis of current knowledge highlights critical research gaps and future directions for exploring THBS4-targeted interventions across multiple disease contexts. Given its unique position at the intersection of ECM biology and cellular signaling, THBS4 represents a promising frontier for the development of novel diagnostic tools and therapeutic strategies in precision medicine.
4.Multivariate quantitative combined with chemometrics for evaluating the quality of Sophora flavescens from different producing areas
Jiahui CHEN ; Qiong LUO ; Junli ZHAO ; Yan HAI ; Chengdong LIU ; Tuya BAI ; Jun LI ; Yuewu WANG
China Pharmacy 2025;36(19):2404-2408
OBJECTIVE To establish a content determination method for multiple components in Sophora flavescens from different origins and to evaluate its quality by combining with chemometrics. METHODS Thirteen batches (No. K1-K13) of S. flavescens from different origins were selected as test samples. A high-performance liquid chromatography-tandem triple quadrupole mass spectrometry (HPLC-MS/MS) method was established to determine the contents of 12 components, including matrine, oxymatrine, betaine, cytisine, N-methylcytisine, sophoridine, genistein, sophoricoside, sophorone, formononetin, sophorolone Ⅰ and norkurarinone in S. flavescens. Chromatographic separation was performed on a Shim-pack GIST-HP C18 column with a mobile phase consisting of methanol (A) and water containing 0.1% formic acid (B), using gradient elution at a flow rate of 0.25 mL/min, column temperature of 35 ℃, and an injection volume of 3 μL. Mass spectrometry was conducted using an electrospray ionization source with positive and negative ion scanning. Data were collected in segments using the multiple reaction monitoring mode. Technique for order preference by similarity to ideal solution (TOPSIS) and grey relational analysis (GRA)methods were employed to compare and comprehensively evaluate the 13 batches of S. flavescens from different origins. RESULTS The methodological validation for the content determination met the relevant regulatory requirements. The contents of the 12 components were 490.66-1 231.00, 11 088.10- 18 021.50, 7.91-25.38, 903.97-1 713.64, 336.08-1 485.54,1 065.33-2 075.50, 27.52-71.80, 109.36-517.83, 6 034.55-10 632.73, 21.26-145.35, 814.84-1 911.32, 1 040.87-3 446.37 μg/g), respectively. TOPSIS results showed that the top 7 samples in Euclidean distance ranking were K6, K12, K11, K3, K5, K10, K13. The GRA results showed that the top 7 samples in the relative correlation ranking were K12, K11, K10, K6, K13, K5, K3. CONCLUSIONS The established HPLC-MS/MS method is rapid, accurate, highly sensitive, stable and reliable. Combined with chemometrics methods, it can be used for the quality control and evaluation of S. flavescens. The comprehensive quality of samples K3, K5, K6( from Hebei), K10( from Sichuan), K11-K13( from Shanxi), etc. is relatively superior.
5.Influencing factors for anxiety symptoms among human papilloma virus-infected women
BAI Maochao ; LI Fen ; Dilinuer Tuerxun ; Remila Rezhake ; WANG Yan
Journal of Preventive Medicine 2025;37(6):573-577,582
Objective:
To investigate the influencing factors for anxiety symptoms among human papilloma virus (HPV)-infected women, so as to provide the evidence to improve the mental health of HPV-infected women.
Methods:
HPV-infected women visiting the gynecology department of a tertiary hospital in Urumqi from September to December 2024 were selected using a convenience sampling method. Basic information of HPV-infected women and information related to HPV infection were collected through a self-designed questionnaire. Anxiety symptoms was assessed by using the Generalized Anxiety Disorder-7 (GAD-7), with a GAD-7 score of ≥5 determined to be the presence of anxiety symptoms. Factors affecting anxiety symptoms in HPV-infected women were analyzed using a multivariable logistic regression model.
Results:
A total of 436 HPV-infected women were investigated. Among them, 361 (82.80%) were aged 30-<60 years old, 286 (65.60%) had a high school/technical secondary school or above, 361 (82.80%) had a spouse, 389 (89.22%) had given birth, and 234 (53.67%) had a family monthly income of less than 5 000 yuan. There were 90 HPV-infected women with multiple HPV infections, accounting for 20.64%. The sexual life of 155 people was affected, accounting for 35.55%. A total of 165 HPV-infected women with anxiety symptoms were detected, with a detection rate of 37.84%. Multivariable logistic regression analysis showed that multiple HPV infections (OR=1.776, 95%CI: 1.068-2.954), HPV infection time <3 months (OR=1.858, 95%CI: 1.132-3.050), lack of HPV-related knowledge (OR=1.742, 95%CI: 1.045-2.905), sexual life was affected (OR=3.480, 95%CI: 2.146-5.642), and monthly family income was less than 5 000 yuan (OR=1.815, 95%CI: 1.119-2.946) had a higher risk of anxiety symptoms
Conclusions
The detection rate of anxiety symptoms in HPV-infected women is high. The type of HPV infection, the duration of HPV infection, the understanding of HPV-related knowledge, the impact on sexual life, and the monthly family income are influencing factors of anxiety symptoms among HPV-infected women.
6.Investigation on the current nursing practice status of prone position ventilation in patients with moderate to severe acute respiratory distress syndrome among intensive care unit nurses in Shandong province
Lixia CHANG ; Jicheng ZHANG ; Min DING ; Fengzhi CHEN ; Yan CHEN ; Beibei LIU ; Li CHEN ; Xue BAI
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care 2025;32(1):67-72
Objective To understand the nursing practice of prone position ventilation for patients with moderate to severe acute respiratory distress syndrome(ARDS)in intensive care unit(ICU)in Shandong province,so as to provide basis for standardizing the nursing practice process of prone position ventilation and carrying out training for hospitals.Methods A self-made questionnaire was used,and convenience sampling was adopted.From September 15th to November 5th,2023,ICU nurses were selected from various hospital levels in Shandong province to investigate the obstructive factors of prone ventilation implementation,the weak links in nursing practice and status,and the occurrence of complications.Results A total of 1 188 questionnaires were collected,of which 991 were valid.92.8%(920/991)of nurses had performed prone position ventilation.The biggest obstacle to the implementation of prone position ventilation was the complexity of patient treatments and multiple devices involved[74.6%(686/920)].Regarding the status of training,90.5%(897/991)of nurses had received training on prone position ventilation and 77.0%(763/991)of nurses felt that training was needed.As for pre-operation assessment,more than 80.0%of nurses evaluated patients'vital signs,airway and secretions and so on,among which the evaluation awareness of analgesia was the worst[81.6%(751/920)].As for the main points of implementation,only 14.0%(129/920)of nurses chose the opposite side of the most important pipeline as the turning direction;48.6%(447/920)of nurses chose the anti-Trendelenburg position;36.3%(334/920)of nurses chose to ventilate≥12 hours.Facial edema[81.7%(752/920)],skin pressure injury[78.9%(726/920)]and eye complication[75.8%(697/920)]were the top 3 most frequent complications.Conclusions ICU nurses'prone position ventilation practices were generally line with the nursing team standard for prone position of adult mechanically ventilated patients and the best evidence recommendation,and needs to be further standardized in aspects of turning direction,position management,ventilation duration,and enteral nutrition management.It is recommended that nursing managers at all levels of hospitals further improve the quality of nursing practice of prone position ventilation according to relevant evidence-based evidence and the actual situation of hospitals.
7.Comparison of left ventricular reverse remodeling and prognosis after transcatheter aortic valve replacement in aortic stenosis and mixed aortic valve disease
Meng SUN ; Lu-lin CHEN ; Jing-yun BAI ; Li-jie YAN ; Jing-jing LIU ; Xian-wei FAN ; Xue-jie LI ; Juan HU ; Jin-tao WU ; Hai-tao YANG
Chinese Journal of Interventional Cardiology 2025;33(2):71-78
Objective To evaluate the effects of transcatheter aortic valve replacement(TAVR)on left ventricular reverse remodeling(LVRR)and outcomes in patients with mixed aortic valve disease(MAVD)and predominant aortic stenosis(AS).Methods Patients undergoing TAVR at our center between January 2020 and December 2022 were enrolled consecutively.Propensity score matching(PSM)(1∶1 ratio)was used to reduce selection bias.Transthoracic echocardiography(TTE)was used to monitor left ventricular ejection fraction(LVEF)and other structural parameters over time.The study outcome was a composite of cardiovascular death and rehospitalization due to cardiovascular causes.Linear mixed-effects models and logistic regression were utilized for comparing echocardiographic changes across groups and identifying independent risk factors for no-LVRR,respectively.Results After PSM,126 patients were included.MAVD group exhibited larger structural parameters(left ventricular end-systolic/end-diastolic diameter and volume,left ventricular mass index)and a lower left ventricular ejection fraction(LVEF)(all P<0.05).However,more pronounced improvements in left ventricular structure and hemodynamics were observed during follow-up.Multivariate logistic regression analysis indicated that the left ventricular mass index(LVMI)was an independent predictor of left ventricular reverse remodeling(LVRR)after TAVR,whereas persistent moderate or greater mitral regurgitation(MR)and paravalvular leak(PVL)significantly reduced the incidence of LVRR.During a median follow-up period of 23 months,a total of 31 endpoint events occurred,and there was no statistically significant difference in long-term prognosis between the two groups(Log-rank P=0.330).Conclusions Compared to patients in the AS group,those in the MAVD group exhibited more severe left ventricular remodeling before TAVR.However,more significant LVRR was observed during postoperative follow-up.Additionally,the long-term prognosis was comparable between the two groups.
8.Antimicrobial resistance surveillance in the bacterial strains isolated from pediatric intensive care units in China:results from 2020 to 2022
Jing LIU ; Huiyuan YAN ; Gangfeng YAN ; Guoping LU ; Pan FU ; Chuanqing WANG ; Danqun JIN ; Wenjia TONG ; Chenyu ZHANG ; Jianli CHEN ; Yi LIN ; Jia LEI ; Yibing CHENG ; Qunqun ZHANG ; Kaijie GAO ; Yuanyuan CHEN ; Shufang XIAO ; Juan HE ; Li JIANG ; Huimin XU ; Yuxia LI ; Hanghai DING ; Hehe CHEN ; Yao ZHENG ; Qunying CHEN ; Ying WANG ; Hong REN ; Chenmei ZHANG ; Zhenjie CHEN ; Mingming ZHOU ; Yucai ZHANG ; Yiping ZHOU ; Zhenjiang BAI ; Saihu HUANG ; Lili HUANG ; Weiguo YANG ; Weike MA ; Qing MENG ; Pengwei ZHU ; Yong LI ; Yan XU ; Yi WANG ; Yanqiang DU ; Huijun CAI ; Bizhen ZHU ; Huixuan SHI ; Shaoxian HONG ; Yukun HUANG ; Meilian HUANG
Chinese Journal of Infection and Chemotherapy 2025;25(3):303-311
Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2%)and gram-negative organisms(60.8%).The top three organisms were S.aureus(13.6%,1 453/10 688),A.baumannii(10.0%,1 067/10 688),and coagulase-negative Staphylococcus(9.9%,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1%,19.4%,8.8%,30.9%,67.4%,and 28.8%,respectively.Overall,more than 50%of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25%of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80%of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3%in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.
9.Measurement of intervertebral disc height and analysis of strength after induced resorption of herniated nucleus pulpous
Liang BAI ; Su FU ; Xu YAN ; Chunlin ZHANG ; Ying LI
Chinese Journal of Tissue Engineering Research 2025;29(27):5785-5794
BACKGROUND:Induced resorption of herniated nucleus pulpous is a minimally invasive,non-invasive and innovative method for the treatment of cervical/lumbar intervertebral disc herniation.After induced resorption of herniated nucleus pulpous,the research about whether cervical/lumbar intervertebral disc can maintain the original biomechanical strength has not been reported.OBJECTIVE:To measure the height of adjacent vertebral centroid of cervical/lumbar intervertebral disc before and after induced resorption of herniated nucleus pulpous operation to analyze the changes of the biomechanical strength of the intervertebral disc after reclining and to provide a new basis for induced resorption of herniated nucleus pulpous treatment of cervical and lumbar intervertebral disc herniation.METHODS:A retrospective analysis was performed on 140 patients with cervical/lumbar intervertebral disc herniation who received induced resorption of herniated nucleus pulpous surgery in the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2023.Related software was used to measure the height of adjacent vertebral centroid of cervical/lumbar intervertebral disc of patients at each follow-up time point before and after induced resorption of herniated nucleus pulpous surgery in Magnetic Resonance Imaging image data under Artificial Intelligence-assisted calibration.Unoperated T1/T2 and T12/L1 segments were taken respectively as controls.Those with preoperative height of adjacent vertebral centroid less than 8%of the corresponding T1/T2 or T12/L1 control segment were in the"height reduction group"(hereafter referred to as group A)and the rest were in the"height unchanged group"(hereafter referred to as group B).The difference of height of adjacent vertebral centroid before and after operation between the group A and the group B was statistically analyzed.Simultaneously,the correlation between the volume of cervical and lumbar herniated discs and the changes of height of adjacent vertebral centroid was analyzed according to the result measured by artificial intelligence.RESULTS AND CONCLUSION:(1)The study maintained a total of 140 patients,including 60 cases of cervical disc herniation and 80 cases of lumbar disc herniation.The postoperative follow-up period was 7 days to 12 months.(2)A total of 281 discs were measured in the cervical vertebra group,including 60 intervertebral discs in the control group.The mean value of height of adjacent vertebral centroid before and at the last postoperative follow-up was about 20.46 mm and 20.17 mm,respectively,with no statistical difference(P>0.05).There were 162 cervical discs in group A.The average height of adjacent vertebral centroid before and after operation was 16.65 mm and 15.92 mm,respectively,with no statistically significant difference(P>0.05).The mean cervical disc herniation volume before and after surgery was 510.28 mm3 and 364.76 mm3,respectively,which was not significantly correlated with height of adjacent vertebral centroid change(P>0.05).There were 64 discs in the group B,with average of 20.15 mm before operation and 19.09 mm at the last follow-up,and there was no significant difference(P>0.05).The mean volume of cervical disc herniation before and after surgery was 515.32 mm3 and 361.98 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid(P>0.05).(3)A total of 258 discs were measured in the lumbar spine group,of which 80 intervertebral discs in the control group,the average height of adjacent vertebral centroid was 33.03 mm before operation and 32.40 mm at the last follow-up,and there was no significant difference.There were 59 discs in the group A,and the average height of adjacent vertebral centroid before and after operation was 30.08 mm and 31.67 mm,respectively,with no statistically significant difference.The mean volume of lumbar disc herniation before and after operation was 690.51 mm3 and 496.58 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid(P>0.05).There were 119 discs in the group B,with an average height of adjacent vertebral centroid of 35.91 mm before surgery and 34.12 mm at the last follow-up.The mean volume of lumbar disc herniation before and after operation was 698.70 mm3 and 535.99 mm3,respectively,and there was no significant correlation with the change of height of adjacent vertebral centroid.(4)It is concluded that patients with cervical/lumbar intervertebral disc herniation can maintain the same intervertebral height level after induced resorption of herniated nucleus pulpous regardless of whether the intervertebral height has decreased before operation.It can be inferred that the resorption of the herniated disc does not affect its biomechanical strength.It suggests that induced resorption of herniated nucleus pulpous surgery should be performed before the intervertebral height of the degenerate segment has decreased.The induced resorption of herniated nucleus pulpous is more valuable to maintain the biomechanical strength of the resorptive disc.
10.Efficacy and safety of a facilitated percutaneous coronary intervention with half-dose recombinant staphylokinase in ST-segment elevation myocardial infarction
Tian-yu WU ; Wen-hao ZHANG ; Peng-sheng CHEN ; Chen LI ; Tian WU ; Zhan LÜ ; Tong WANG ; Kun LIU ; Zhi-wen TAO ; Xiao-xuan GONG ; Liang YUAN ; Yong LI ; Bo CHEN ; Xin CHEN ; Zeng-guang CHEN ; Nai-quan YANG ; Yuan-yuan SANG ; Xiao-yan WANG ; Bai-hong LI ; Li ZHU ; Guo-yu WANG ; Xin ZHAO ; Chuan LU ; Jun JIANG ; Rui-na HAO ; Chun-jian LI
Chinese Journal of Interventional Cardiology 2025;33(8):431-438
Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P<0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P>0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.


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