1.Exploring Mechanism of Anti-atherosclerosis Effect of Huangqi Chifengtang Based on AMPK/PPARα Signaling Pathway and NLRP3 Inflammasome
Yuqin LIANG ; Jie LIU ; Chi ZHANG ; Pingping CHEN ; Fang LU ; Shumin LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):131-139
ObjectiveTo explore the improving effect of Huangqi Chifengtang(HCT) on atherosclerosis(AS), and elucidate its mechanism in relation to adenosine monophosphate-activated protein kinase(AMPK)/peroxisome proliferator-activated receptor α(PPARα) signaling pathway and nucleotide-binding oligomerization domain(NOD)-like receptor thermal protein domain associated protein 3(NLRP3) inflammasome. MethodsEight C57BL/6J mice were set as the normal group, and 32 ApoE-/- mice were randomly divided into the model group, the positive drug group(atorvastatin, 5 mg·kg-1·d-1), HCT low- and high-dose groups(1.95, 3.90 g·kg-1·d-1). ApoE-/- mice were fed with high-fat and high-cholesterol feed to establish an AS mouse model. After modeling, they were orally administered corresponding dose of drugs for 28 days, while the normal and model groups received an equal volume of physiological saline via oral gavage. Hematoxylin-eosin(HE) staining was used to observe the pathological status of the aorta and liver in mice, Biochemical testing and enzyme-linked immunosorbent assay(ELISA) were used to detect the levels of total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), alanine aminotransferase(ALT), aspartate aminotransferase(AST), C-reactive protein(CRP), interleukin(IL)-1β, IL-18 in the serum, as well as superoxide dismutase(SOD), malondialdehyde(MDA), and reduced glutathione(GSH) in the liver. Real-time fluorescence quantitative polymerase chain reaction(Real-time PCR) was used to measure the mRNA expression levels of NLRP3, apoptosis-associated speck-like protein(ASC), cysteinyl aspartate specific proteinase-1(Caspase-1), Toll-like receptor 4(TLR4) in the aorta, and fatty acid synthase(FAS), stearoyl-CoA desaturase 1(SCD1), PPARα, and carnitine palmitoyltransferase 1A(CPT1A) in the liver. Immunohistochemistry was used to determine the protein expressions of NLRP3, Caspase-1, and ASC in the aorta, and Western blot was used to measure the protein expressions of AMPK, p-AMPK, sterol regulatory element binding protein-1c(SREBP-1c), CPT1A, and FAS in the liver. ResultsCompared with the normal group, the model group showed a significant increase in lipid plaque deposition in the aorta and lipid accumulation in the liver, the levels of TC, TG, LDL-C, AST, ALT, IL-1β, IL-18 and CRP in the serum were significantly increased(P<0.01), and the mRNA and protein expressions of aortic TLR4, NLRP3, Caspase-1 and ASC were significantly upregulated(P<0.01). The levels of SOD and GSH in the liver were significantly reduced, while the level of MDA was significantly increased(P<0.01). The mRNA expressions of FAS and SCD1 in the liver were significantly downregulated, while the mRNA expressions of PPARα and CPT1A were significantly upregulated. The protein expressions of p-AMPK/AMPK and CPT1A in the liver were significantly reduced, while the expressions of SREBP-1c and FAS proteins were significantly increased(P<0.01). Compared with the model group, the low- and high-dose HCT groups showed significant improvements in aortic plaques and hepatic lipid deposition. The levels of TC, LDL-C, AST, IL-1β and IL-18 in the serum of the low-dose HCT group, as well as TC, TG, LDL-C, AST, ALT, IL-1β, IL-18 and CRP in the serum of the high-dose HCT group, were significantly reduced(P<0.01). The mRNA expressions of TLR4, NLRP3 and Caspase-1 in the aorta of the low-dose HCT group, as well as TLR4, NLRP3, Caspase-1 and ASC in the aorta of the high-dose HCT group, were significantly downregulated(P<0.01). The protein expressions of Caspase-1 and ASC in the aorta of the low-dose HCT group, as well as NLRP3, Caspase-1 and ASC in the high-dose HCT group, were significantly downregulated(P<0.01). The levels of SOD and GSH in the liver of the low- and high-dose HCT groups were significantly increased, while the level of MDA in the high-dose HCT group was significantly decreased(P<0.05, P<0.01). In the HCT-treated group, the mRNA expressions of FAS and SCD1 in the liver were significantly upregulated, while the mRNA expressions of PPARα and CPT1A were significantly downregulated, the protein expressions of p-AMPK/AMPK and CPT1A in the liver were significantly increased, while the protein expressions of SREBP-1c and FAS were significantly decreased(P<0.05, P<0.01). ConclusionHCT can improve lipid metabolism by activating the AMPK/PPARα pathway and inhibit NLRP3 inflammasome-mediated inflammatory responses, thereby reducing hepatic lipid deposition and AS plaque formation.
2.Effect of standardized rehabilitation unit on traumatic brain injury
Qianqian CHI ; Xiaonian ZHANG ; Xiaomin ZHU ; Wanyue SUN ; Xin ZHANG ; Jin ZHOU ; Hongwei BU ; Lei ZHAI ; Xin ZHANG ; Zirui LING ; Hongyu CHEN
Chinese Journal of Rehabilitation Theory and Practice 2026;32(9):1033-1040
ObjectiveTo establish three standardized rehabilitation unit models covering acute, critical and comprehensive recovery stages for traumatic brain injury (TBI) that fit the whole-course characteristics, clarify their multidisciplinary collaborative framework, standardized procedures, and information management system, and verify the clinical effectiveness of this staged rehabilitation unit on long-term functional prognosis and in-hospital complications of TBI patients. MethodsThis study was conducted at two stages: model construction and efficacy verification. At the first stage, TBI rehabilitation units for acute, critical and recovery stages were established in the Department of Neurosurgery, Intensive Care Unit and Department of Rehabilitation Medicine, respectively, with unified multidisciplinary team configuration, standardized assessment and treatment protocols, collaborative workflows, and a dedicated information management system. At the second stage, 324 TBI patients admitted to the newly built rehabilitation units from July, 2023 to July, 2025 were enrolled as the observation group, and 167 TBI patients receiving traditional management from January, 2018 to December, 2022 were retrospectively selected as the control group. The primary outcomes were 1-year post-injury Glasgow Outcome Scale (GOS) and Disability Rating Scale (DRS) scores. Secondary outcomes included the incidence of in-hospital complications and the mean indwelling time of tracheal intubation, gastric tube and urinary catheter. ResultsThe 1-year GOS score was significantly higher (t = -7.836, P < 0.001), and the DRS score was significantly lower (t = -6.742, P < 0.001) in the observation group than in the control group. The overall incidence of complications was significantly lower in the observation group than in the control group (χ2 = 18.762, P < 0.001). The incidences of pulmonary infection, urinary tract infection, pressure ulcer, lower extremity venous thrombosis and joint contracture deformity were all significantly reduced (χ2 > 4.328, P < 0.05). The indwelling time of tracheal intubation, gastric tube and urinary catheter was significantly shorter in the observation group than in the control group (t > 10.276, P < 0.001). ConclusionThe acute-critical-comprehensive three-stage standardized TBI rehabilitation unit could significantly improve the long-term functional outcomes of TBI patients, reduce the incidence of complications, and shorten the indwelling time of invasive tubes through multidisciplinary collaboration, whole-course standardized management and information-based quality control. This model conforms to the pathological and functional laws of TBI, realizes seamless whole-course connection from acute treatment to recovery rehabilitation, and has good clinical feasibility and promotion value. It can provide evidence-based evidence and practical reference for the homogenized and standardized development of TBI rehabilitation in China.
3.A multicenter clinical study on intramedullary vancomycin injection for preventing periprosthetic joint infection in total knee arthroplasty
Te LIU ; Jun FU ; Shiguang LAI ; Zhuo ZHANG ; Chi XU ; Lei GENG ; Yang LUO ; Peng REN ; Xin ZHI ; Quanbo JI ; Heng ZHANG ; Runkai ZHAO ; Haichao REN ; Ye TAO ; Qingyuan ZHENG ; Zeyu FENG ; Jianfeng YANG ; Yiming WANG ; Pengcheng LI ; Shuai LIU ; Wei CHAI ; Xiang LI ; Huiwu LI ; Xiaogang ZHANG ; Baochao JI ; Xianzhe LIU ; Xinzhan MAO ; Jianbing MA ; Xiangxiang SUN ; Jiying CHEN ; Yonggang ZHOU ; Jinliang WANG ; Weijun WANG ; Guoqiang ZHANG ; Ming NI
Chinese Journal of Orthopaedics 2025;45(12):803-811
Objective:To explore the safety and efficacy of intraosseous regional administration (IORA) of vancomycin for preventing infection in primary total knee arthroplasty (TKA).Methods:A total of 124 patients with knee osteoarthritis undergoing TKA between February 2024 and May 2024 at nine hospitals were enrolled. Preoperative infection prophylaxis involved either IORA (0.5 g vancomycin administered via intraosseous regional infusion before incision) or intravenous infusion (1 g vancomycin via peripheral vein). The IORA group included 15 males and 47 females with a median age of 66.5 years (range, 60.0-70.0 years), while the intravenous group included 14 males and 48 females with a median age of 66.0 years (range, 61.8-70.3 years) years. Intraoperative samples were collected including fat and synovium tissues after incision, before prosthesis placement, and after tourniquet release; distal femoral cancellous bone during femoral osteotomy; proximal tibial cancellous bone during tibial osteotomy; proximal intercondylar cancellous bone before prosthesis placement; and peripheral blood from non-infused arms at surgery initiation and after tourniquet release. Vancomycin concentrations were measured using liquid chromatography-tandem mass spectrometry. Vital sign changes were recorded from admission to 5~10 minutes post-IORA (IORA group) or post-incision (intravenous group). Follow-ups were conducted on postoperative day 1 and 3, and at 1 and 3 months, to document complications including IORA-related adverse events, periprosthetic joint infections, surgical site infections, red man syndrome, acute kidney injury, deep vein thrombosis and so on.Results:Vancomycin concentrations in bone, fat, and synovial tissue samples were significantly higher in the IORA group than in the intravenous group ( P<0.05), while vancomycin concentrations in blood samples were significantly lower in the IORA group than in the intravenous group ( P<0.05). Only 7.3%(41/558) of tissue samples in the IORA group had vancomycin concentrations below 2.0 μg/g (the minimum inhibitory concentration of vancomycin against coagulase-negative staphylococcus), compared to 59.3%(331/558) in the intravenous group (χ 2=11.285, P<0.001). In the intravenous group, 16.9%(21/124) of blood samples had vancomycin concentrations exceeding 15.0 mg/L (the threshold associated with a significantly increased risk of nephrotoxicity), while all concentrations in the IORA group were below this threshold, the difference was statistically significant (χ 2=22.943, P<0.001). There were no statistically significant difference ( P>0.05) in vital signs changes before and after vancomycin administration between the two groups. Two patients in the intravenous group experienced incision exudate, while no other related complications occurred in either group. Conclusions:Compared to the traditional intravenous infusion of 1 g vancomycin, intraosseous injection of a low dose (0.5 g) of vancomycin achieves higher local tissue concentrations in the knee joint with a lower incidence of adverse reactions and is safe for infection prophylaxis. Despite guidelines not recommending the routine use of vancomycin for preventing infection after primary TKA, intraosseous injection of 0.5 g vancomycin may be considered intraoperatively for primary TKA in the following scenarios: patients in medical institutions with a high prevalence of methicillin-resistant staphylococcus aureus (MRSA) infections, patients with potential preoperative MRSA colonization, or patients with cephalosporin allergy.
4.Clinical analysis of anti-GT1a antibody-positive Guillain-Barré syndrome in 25 children
Dan CHEN ; Chi HOU ; Haixia ZHU ; Jie YU ; Yani ZHANG ; Kelu ZHENG ; Yuanyuan GAO ; Xiaojing LI
Chinese Journal of Pediatrics 2025;63(10):1092-1096
Objective:To summarize the clinical characteristics, treatment, and prognosis of children with anti-GT1a antibody-positive Guillain-Barré syndrome (GBS).Methods:A case series study was conducted, including 25 children diagnosed with serum anti-GT1a antibody-positive GBS at Guangzhou Women and Children′s Medical Center from March 2019 to December 2024. Clinical data, treatment protocols, and follow-up outcomes were analyzed. Mann Whitney U test was used to compare the changes in Hughes functional grading scale (HFGS). Results:A total of 25 children included 12 boys and 13 girls, and the age at first onset was (71±8) months. There were 16 children (64%) had preceding infections, and of which 13 children had predominantly respiratory tract infections. At disease peak, neurological manifestations included limb weakness (21 cases (84%)), bulbar palsy (13 cases (52%)), drowsiness (7 cases (28%)), limb pain (9 cases (36%)), ataxia (6 cases (24%)), respiratory muscle paralysis (5 cases (20%)), ophthalmoplegia (5 cases (20%)), and unilateral facial nerve palsy (4 cases (16%)). Cerebrospinal fluid analysis in 23 children revealed albuminocytological dissociation in 18 children. All 25 children underwent whole-spine magnetic resonance imaging (MRI), demonstrated spinal nerve root enhancement in 18 children, with leptomeningeal enhancement combined with spinal nerve root enhancement in 1 child. Electromyography in 16 children showed 15 children abnormality, of which demyelinating lesions in 8 children, mixed demyelinating-axonal changes in 4 children, and pure axonal involvement in 3 children. Intravenous immunoglobulin (IVIG) was administered to 21 cases (84%), of which 3 children required mechanical ventilation and blood purification (plasma exchange in 2 children and immunoadsorption in 1 child) due to disease progression. Four children (16%) received intravenous methylprednisolone (IVMP) instead of IVIG, with 1 child requiring ventilatory support due to respiratory muscle paralysis, and the tracheal tube was removed after continued sequential IVMP treatment. The hospitalization duration of 25 children was (23±3) d. At discharge, HFGS was 1.6 (0.6, 2.7) score. At a follow-up of 12 (4, 18) months, HFGS was 0.1 (0.0, 0.5) score, and higher than that at discharge ( Z=4.38, P<0.05). Two children relapsed but achieved remission after IVIG retreatment with no recurrence during 1-year follow-up. Conclusions:Anti-GT1a antibody-positive GBS in children predominantly presents with limb weakness and bulbar palsy, occasionally complicated by respiratory failure in the acute phase. Demyelinating neuropathy and spinal nerve root enhancement on MRI are characteristic. IVIG therapy yields favorable outcomes, with low residual disability. Relapses are rare but manageable with re-treatment.
5.Anti-osteoporotic mechanisms of kaempferol based on gut microbiota and comprehensive targeted metabolomics
Zhou LIANG ; Chi ZHANG ; Chengzhen PAN ; Bo YANG ; Zhanglin PU ; Hua LIU ; Jinhui PENG ; Lichun WEN ; Guanhan LING ; Feng CHEN
Chinese Journal of Tissue Engineering Research 2025;29(20):4190-4204
BACKGROUND:Kaempferol has anti-osteoporotic effects,but the mechanisms by which kaempferol regulates gut microbiota and metabolites to prevent and treat osteoporosis remain unclear.OBJECTIVE:To exploring the potential mechanisms by which kaempferol inhibit osteoporosis based on gut microbiota and comprehensive targeted metabolomics.METHODS:Eighteen female Sprague-Dawley rats were randomly divided into three groups:sham operation group,model group,and kaempferol group,with 6 rats in each group.Animal models of osteoporosis were made in the latter two groups through removal of bilateral ovaries.Eight weeks after modeling,the sham operation and model groups were gavaged with distilled water,and the kaempferol group was gavaged with 40 mg/kg kaempferol.Continuous administration in each group was carried out for 12 weeks.Rat fecal samples were collected for 16S rDNA amplicon sequencing to observe changes in the gut microbiota structure.Serum samples were subjected to comprehensive targeted metabolomics analysis using ultra-high performance liquid chromatography-tandem mass spectrometry technology,along with a proprietary database and multivariate statistical analysis.RESULTS AND CONCLUSION:After 12 weeks of continuous intervention,the results of 16S rDNA amplicon sequencing showed that compared with the sham operation group,the abundance of gut microbiota increased in the model group.Compared with the model group,kaempferol group exhibited a statistically significant increase in the abundance of the genus Latilactobacillus(P=0.021),while the abundances of Pantoea(P=0.034),Enterorhabdus(P=0.000),Monoglobus(P=0.024),Butyricimonas(P=0.034),Rothia(P=0.043),and Clostridia(P=0.004)were significantly downregulated.After 12 weeks of continuous intervention,the results of the serum samples analyzed by broad-targeted metabolomics revealed that 120 and 79 metabolites were identified between the sham operation and model groups and between the model and kaempferol groups,respectively.Among the three groups,there were 17 overlapping differentially expressed metabolites,including Cis-aconitic acid,barbituric acid,L-homocitrulline,3,4,5-trimethoxycinnamic acid,L-3-phenyllactic acid,cyclo(pro-pro),L-phenylalanine-L-serine,proline-isoleucine,L-donoraminoacetic acid-L-phenylalanineacetic acid,and phenylalanine-aspartic acid.Most of them belong to amino acids and their metabolites,glycerophospholipids and fatty acyls.The Kyoto Encyclopedia of Genes and Genomes pathways involved in the differential metabolites were mainly enriched in D-amino acid metabolism,histidine metabolism,propionate metabolism,lysine degradation,fatty acid metabolism and sphingolipid metabolism.After 12 weeks of continuous intervention,combined analysis revealed that genera such as Enterorhabdus,Latilactobacillus,Rothia,and Ruminococcus were closely associated with differential serum metabolites.To conclude,kaempferol may exert its anti-osteoporotic effects by modulating the abundance,diversity,and structure of gut microbiota,thereby regulating the metabolism of amino acids,their metabolites,and fatty acids.
6.Optimization of low frequency function of vertical semicircular canal in rotating test and analysis of three-dimensional parameters of induced nystagmus
Yueling CHEN ; Chi WANG ; Yutang LIU ; Yuanling LI ; Xiaofei LI ; Yafeng LYU ; Yongdong SONG ; Daogong ZHANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2025;60(6):630-637
Objective:To study the feasibility of detecting vertical semicircular canal function and to analyze the three-dimensional(3D)characteristics and normal reference value in healthy young people.Methods:This was a cross-sectional study conducted from January to June 2024. A three-axis rotating chair was used to perform vertical sinusoidal rotation on 52 healthy young adults (26 males and 26 females, aged 18-40 years) in the left anterior-right posterior (LARP) and right anterior-left posterior (RALP) semicircular canal planes. For each plane, nystagmus was induced with six combinations of different angles and velocity front and back rotation angles of ±30°,±60°,±90°, and velocities of 40°/s and 80°/s, the slow phase velocity (SPV) and their symmetry of 3D nystagmus were analyzed. SPSS 20.0 was used to compare the statistical differences in these two parameters across different stimulation protocols.Results:There were no spontaneous nystagmus in the 52 subjects, and all tests were finished. Except the combinations of (±30°-40°/s), three components of nystagmus were induced stably in the rest of the stimulations. The SPVs of vertical components were no statistically insignificant ( P>0.05), and some horizontal or torsion components were statistically significant ( P<0.05). The 95% reference range of the symmetry was≤25% in the vertical and≤30% in the torsional component of the nystagmus except for (±30°-80°/s), the symmetry was 32.2% and 49.2% respectively. The trend changes of the three components were consistent, among which the vertical and torsional components induced by (±60°-80°/s) and (±90°-80°/s) were the best, the SPV value of the vertical components was higher in the latter group than the former apart from the front RALP, while no significant difference was found in the torsional components ( P>0.05). Conclusion:The (±90°-80°/s) combination is the optimal method to detect the function of vertical semicircular canal in 3D chair test. When observing torsional component, the combining scheme of (±60°-80°/s) and (±90°-80°/s) is better. Considering tolerance, the (±60°-80°/s) combination is recommended.
7.TCMKD:From ancient wisdom to modern insights-A comprehensive platform for traditional Chinese medicine knowledge discovery
Wenke XIAO ; Mengqing ZHANG ; Danni ZHAO ; Fanbo MENG ; Qiang TANG ; Lianjiang HU ; Hongguo CHEN ; Yixi XU ; Qianqian TIAN ; Mingrui LI ; Guiyang ZHANG ; Liang LENG ; Shilin CHEN ; Chi SONG ; Wei CHEN
Journal of Pharmaceutical Analysis 2025;15(6):1390-1402
Traditional Chinese medicine(TCM)serves as a treasure trove of ancient knowledge,holding a crucial position in the medical field.However,the exploration of TCM's extensive information has been hindered by challenges related to data standardization,completeness,and accuracy,primarily due to the decen-tralized distribution of TCM resources.To address these issues,we developed a platform for TCM knowledge discovery(TCMKD,https://cbcb.cdutcm.edu.cn/TCMKD/).Seven types of data,including syndromes,formulas,Chinese patent drugs(CPDs),Chinese medicinal materials(CMMs),ingredients,targets,and diseases,were manually proofread and consolidated within TCMKD.To strengthen the integration of TCM with modern medicine,TCMKD employs analytical methods such as TCM data mining,enrichment analysis,and network localization and separation.These tools help elucidate the molecular-level commonalities between TCM and contemporary scientific insights.In addition to its analytical capabilities,a quick question and answer(Q&A)system is also embedded within TCMKD to query the database efficiently,thereby improving the interactivity of the platform.The platform also provides a TCM text annotation tool,offering a simple and efficient method for TCM text mining.Overall,TCMKD not only has the potential to become a pivotal repository for TCM,delving into the pharmaco-logical foundations of TCM treatments,but its flexible embedded tools and algorithms can also be applied to the study of other traditional medical systems,extending beyond just TCM.
8.Impact of ultrasound guided interscalene versus axillary brachial plexus block on patency rate of arteriove-nous fistula
Chi ZHANG ; Xiao LI ; Xiang WEI ; Gangyi CHEN ; Hongmei LI ; Kejia WANG ; Junyi ZHENG
The Journal of Practical Medicine 2025;41(9):1293-1298
Objective To compare the safety and efficacy of various brachial plexus block techniques using local anesthesia(LA)in patients undergoing their first radiocephalic arteriovenous fistula(RCAVF)surgery.Methods Patients were randomly allocated into three groups:LA,interscalene brachial plexus block(ISBPB),and axillary brachial plexus block(ABPB).Ultrasound was utilized to evaluate the pre-and post-anesthesia changes in vessel diameter and blood flow.Postoperative follow-up assessments were performed at three days and three months to determine fistula patency.Results Immediate patency rates were 92.52%(LA),96.26%(ISBPB),and 95.33%(ABPB),with no statistically significant differences among the groups(χ2=1.615,P=0.446).However,at three months,primary patency rates differed significantly among the groups(χ2=22.691,P<0.001).Specifically,the ISBPB group(83.18%)exhibited significantly higher patency compared to the LA group(57.01%)(χ2=17.477,P<0.001).Similarly,the ABPB group(80.37%)demonstrated better patency than the LA group(χ2=13.580,P<0.001).Regarding respiratory complications,they were more prevalent in the ISBPB group(15.89%)compared to the LA group(2.80%)(χ2=9.761,P=0.002)and the ABPB group(0.93%)(χ2=14.377,P<0.001).No significant difference was observed between the LA and ABPB groups in terms of respiratory complications(χ2=1.019,P=0.313).Conclusions Both ISBPB and ABPB demonstrated superior primary patency compared to LA.Nevertheless,ABPB exerted a lesser impact on respiratory function and provided a more comfortable surgical experience for ESRD patients.
9.Value of different noninvasive diagnostic models in the diagnosis of esophageal and gastric varices with significant portal hypertension in compensated hepatitis B cirrhosis
Cheng LIU ; Jiayi ZENG ; Mengbing FANG ; Zhiheng CHEN ; Bei GUI ; Fengming ZHAO ; Jingkai YUAN ; Chaozhen ZHANG ; Meijie SHI ; Yubao XIE ; Xiaoling CHI ; Huanming XIAO
Journal of Clinical Hepatology 2025;41(2):263-268
ObjectiveTo investigate the value of different noninvasive diagnostic models in the diagnosis of esophageal and gastric varices since there is a high risk of esophageal and gastric varices in patients with compensated hepatitis B cirrhosis and significant portal hypertension, and to provide a basis for the early diagnosis of esophageal and gastric varices. MethodsA total of 108 patients with significant portal hypertension due to compensated hepatitis B cirrhosis who attended Guangdong Provincial Hospital of Traditional Chinese Medicine from November 2017 to November 2023 were enrolled, and according to the presence or absence of esophageal and gastric varices under gastroscopy, they were divided into esophageal and gastric varices group (GOV group) and non-esophageal and gastric varices group (NGOV group). Related data were collected, including age, sex, imaging findings, and laboratory markers. The chi-square test was used for comparison of categorical data between groups; the least significant difference t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of five scoring models, i.e., fibrosis-4 (FIB-4), LOK index, LPRI, aspartate aminotransferase-to-platelet ratio index (APRI), and aspartate aminotransferase/alanine aminotransferase ratio (AAR). The binary logistic regression method was used to establish a combined model, and the area under the ROC curve (AUC) was compared between the combined model and each scoring model used alone. The Delong test was used to compare the AUC value between any two noninvasive diagnostic models. ResultsThere were 55 patients in the GOV group and 53 patients in the NGOV group. Compared with the NGOV group, the GOV group had a significantly higher age (52.64±1.44 years vs 47.96±1.68 years, t=0.453, P<0.05) and significantly lower levels of alanine aminotransferase [42.00 (24.00 — 17.00) U/L vs 82.00 (46.00 — 271.00) U/L, Z=-3.065, P<0.05], aspartate aminotransferase [44.00 (32.00 — 96.00) U/L vs 62.00 (42.50 — 154.50) U/L,Z=-2.351, P<0.05], and platelet count [100.00 (69.00 — 120.00)×109/L vs 119.00 (108.50 — 140.50)×109/L, Z=-3.667, P<0.05]. The ROC curve analysis showed that FIB-4, LOK index, LPRI, and AAR used alone had an accuracy of 0.667, 0.681, 0.730, and 0.639, respectively, in the diagnosis of esophageal and gastric varices (all P<0.05), and the positive diagnostic rates of GOV were 69.97%, 65.28%, 67.33%, and 58.86%, respectively, with no significant differences in AUC values (all P>0.05), while APRI used alone had no diagnostic value (P>0.05). A combined model (LAF) was established based on the binary logistic regression analysis and had an AUC of 0.805 and a positive diagnostic rate of GOV of 75.80%, with a significantly higher AUC than FIB-4, LOK index, LPRI, and AAR used alone (Z=-2.773,-2.479,-2.206, and-2.672, all P<0.05). ConclusionFIB-4, LOK index, LPRI, and AAR have a similar diagnostic value for esophageal and gastric varices in patients with compensated hepatitis B cirrhosis and significant portal hypertension, and APRI alone has no diagnostic value. The combined model LAF had the best diagnostic efficacy, which provides a certain reference for clinical promotion and application.
10.The effect of transcutaneous acupoint electrical stimulation on nausea and vomiting after painless gastroscopy and colonoscopy
Yujie CHEN ; Yongliang CHI ; Weiliang ZHANG
Chongqing Medicine 2025;54(10):2258-2262
Objective Through a non-inferiority trial design,to verify whether the efficacy of transcuta-neous electrical acupoint stimulation(TEAS)in intervening with nausea and vomiting after painless gastros-copy and colonoscopy was not inferior to that of ondansetron,and evaluate its effect on patient recovery.Meth-ods A total of 112 patients who experienced nausea and vomiting after painless gastroscopy and colonoscopy in the gastroscopy and colonoscopy center of the hospital from March 2022 to March 2023 were selected as the research subjects,and divided into the TEAS group(n=56)and the control group(n=56)according to the random number table method.The TEAS group received TEAS intervention,while the control group received ondansetron hydrochloride injection intervention.The non-inferiority margin was set at 10.0%.The interven-tion effective rate of nausea and vomiting after examination,as well as heart rate,blood pressure,length of stay,satisfaction,and visual analogue score(VAS)were compared between the two groups.Results The in-tervention effective rate of the TEAS group was close to that of the control group[82.4%(46/56)vs.80.4%(45/56)],risk difference(RD)=2.0%(95%CI:-9.8%to 13.8%),the lower limit of 95%CI(-9.8%)was higher than the preset cut-off value(-10.0%),and non-inferiority was established(P=0.032).Com-pared with before the examination,the heart rates of the two groups were slower,and the levels of systolic blood pressure(SEP)and diastolic blood pressure(DBP)were lower during the examination,and the differ-ences were statistically significant(P<0.05).There was no statistically significant difference in the two groups of heart rate,SBP,DBP,length of stay[(69.9±14.2)min vs.(75.3±22.8)min],satisfaction score(9.8±0.6 vs.9.2±2.0),VAS(1.5±0.5 vs.2.1±0.5,P>0.05).Conclusion The efficacy of TEAS in in-tervening with nausea and vomiting after painless gastroscopy and colonoscopy is not inferior to that of ondan-setron.

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