1.Diagnostic value of serum lncRNA H19 and miR-22-3p in patients with acute myocardial infarction
Sheng ZHAO ; Dinghong LIU ; Mengyu ZHU ; Li RONG ; Wei CHENG ; Yanlin GAO
Acta Universitatis Medicinalis Anhui 2026;61(5):855-860
ObjectiveTo explore the expression levels of long non-coding RNA (lncRNA) H19 and microRNA-22-3p (miR-22-3p) in the serum of patients with acute myocardial infarction (AMI) and their diagnostic value for AMI. MethodsA total of 176 AMI patients were selected as the experimental group and were divided into ST-segment elevation myocardial infarction (STEMI) group (n=95) and non-ST-segment elevation myocardial infarction (NSTEMI) group (n=81) based on their medical history and electrocardiogram. Meanwhile, 156 patients with negative angiography during the same period were selected as the control group (CON group). The relative expression levels of lncRNA H19 and miR-22-3p in the serum of the two groups were detected by real-time fluorescence quantitative polymerase chain reaction. The diagnostic value of miR-22-3p and lncRNA H19 in AMI was evaluated by receiver operating characteristic curve (ROC) analysis. The levels of serum cardiac troponin I (cTnI), creatine kinase (CK), creatine kinase MB isoenzyme (CK-MB), and high-sensitivity C-reactive protein (CRP) were detected in all study subjects. Spearman correlation analyses were used to evaluate the correlations between lncRNA H19 and miR-22-3p and cTnI, CK, CK-MB and CRP. ResultsCompared with the control group, the expression level of lncRNA H19 was upregulated and the expression level of miR-22-3p was downregulated in the AMI group (all P<0.01); compared with the NSTEMI group, the expression level of lncRNA H19 was upregulated and the expression level of miR-22-3p was downregulated in the STEMI group (P<0.01). The areas under the ROC curves (AUC) for the diagnosis of AMI by miR-22-3p, lncRNA H19 and their combination were 0.555, 0.977, and 0.983, respectively. lncRNA H19 was positively correlated with cTnI, CK, CK-MB and CRP (P<0.05), and negatively correlated with left ventricular ejection fraction (LVEF) (P<0.001); miR-22-3p was negatively correlated with cTnI, CK and CRP, and positively correlated with LVEF (P<0.05). ConclusionThe expression level of lncRNA H19 is elevated and the expression level of miR-22-3p decreased in AMI patients, and their levels may have potential value as an auxiliary biomarker for AMI diagnosis and cardiac function assessment.
2.Integrated bioinformatics analysis and experimental validation of angiogenesis-related genes in diabetic retinopathy
Peng LI ; Kun LIANG ; Feng WU ; Jia LI ; Lun LIU ; Yulin TAO
Acta Universitatis Medicinalis Anhui 2026;61(5):861-871
ObjectiveTo investigate the molecular mechanisms related to angiogenesis during the development and progression of diabetic retinopathy (DR). MethodsAngiogenesis-related genes were obtained from the Gencard website and intersected with differentially expressed genes from DR datasets (GSE60436 and GSE94019). Functional enrichment and protein-protein interaction (PPI) networks were then used to screen candidate genes and evaluate their diagnostic value. Gene set enrichment analysis (GSEA) was used to explore potential pathways underlying candidate genes, and immune infiltration analysis revealed associations between candidate genes and immune cells. Cellular experiments were conducted to validate the role of fibronectin 1 (FN1) in human retinal microvascular endothelial cells (HRMECs) under high glucose (HG) conditions. ResultsA total of 237 differentially expressed genes related to angiogenesis were identified, enriched in pathways such as phosphoinositide 3-kinase/protein kinase B signaling pathway (PI3K-Akt), tumor suppressor protein 53 (P53), tumor necrosis factor (TNF), and Janus kinase (JAK)/signal transducer and activator of transcription signaling pathway (STAT). Among them, collagen type I alpha 1 chain (COL1A1), COL1A2, FN1, TNF, and tumor protein p53 (TP53) were key genes with high diagnostic value. GSEA indicated that these genes were involved in multiple signaling pathways, including P53. CIBERSORTx analysis revealed significant associations with the infiltration of multiple immune cells. HG treatment led to the upregulation of FN1. In HG-induced HRMECs, compared with the si-NC control group, si-FN1 significantly reduced cell proliferation, migration, and tube formation, while P53 protein expression was increased. ConclusionThis study reveals the important role of FN1 in angiogenesis in DR and suggests that it may be a potential diagnostic and therapeutic target.
3.Comparative study on the efficacy of superior rectal artery preservation versus high ligation of the inferior mesenteric artery in laparoscopic radical resection of sigmoid colon cancer
Mingye ZHENG ; Bo YANG ; Yongxiang LI
Acta Universitatis Medicinalis Anhui 2026;61(5):880-887
ObjectiveTo investigate the short-term clinical outcomes and long-term prognostic value of preserving the superior rectal artery (SRA) versus high ligation of the inferior mesenteric artery (IMA) in laparoscopic sigmoid colon cancer resection (LSCER) for sigmoid colon cancer (SCC). MethodsA retrospective comparative analysis was performed of 316 SCC patients who underwent LSCER. Patients were divided into the SRA preservation group (Group A,132 cases) and IMA high ligation group (Group B,184 cases) according to the vascular management strategy. Short-term clinical indicators and long-term follow-up outcomes were compared between the two groups. ResultsThere were no significant differences in baseline data between the two groups. The mean operation time of Group A was (190.0 ± 61.9) min, which was significantly longer than that of Group B [(165.0 ± 49.1) min, P<0.001]. However, Group A demonstrated significantly shorter time to drain removal, time to first flatus, and postoperative hospital stay (P<0.001). No significant differences were observed in intraoperative blood loss, number of lymph nodes dissected, or incidence of anastomotic leakage (AL) between the two groups. Long-term follow-up results showed that there were no significant differences in 3-year overall survival rate and 3-year disease-free survival rate between the two groups. ConclusionLaparoscopic sigmoid colon cancer resection with SRA preservation is safe and feasible for the treatment of SCC. Although the operation time is slightly prolonged, it can effectively promote short-term postoperative recovery without affecting the curative effect of tumor resection or long-term prognosis.
4.Risk factors and altered functional connectivity of brain networks in end-stage renal disease complicated with frailty
Zhaohua SUN ; Dashan LI ; Nan FENG ; Zilian CHEN ; Pei ZHANG ; Yonggui WU
Acta Universitatis Medicinalis Anhui 2026;61(5):894-900
ObjectiveTo explore the risk factors and alterations in functional connectivity of brain networks in end-stage renal disease (ESRD) patients complicated by frailty. MethodsA total of 84 patients with ESRD were enrolled and divided into the frailty group (31 cases) and non-frailty group (53 cases) according to the Chinese version of the Tilburg Frailty Indicator (TFI). Cranial magnetic resonance imaging (MRI) data, neuropsychological test results and clinical data were collected for all subjects. Logistic regression analysis was used to explore risk factors for frailty in ESRD patients, and image preprocessing and independent component analysis were performed to compare differences in brain network functional connectivity between the two groups. ResultsLogistic regression analysis showed that high blood urea nitrogen level, depression, malnutrition, and sleep disturbance were risk factors for frailty in patients with ESRD (P<0.05), while a higher level of education served as a protective factor (P<0.05). Compared with the non-frailty group, the frailty group exhibited significantly weakened functional connectivity between the sensorimotor network and the visual network (P<0.05). ConclusionHigh levels of blood urea nitrogen, depression, malnutrition, and sleep disorders can increase the risk of frailty in patients with end-stage renal disease (ESRD), while a higher educational level may reduce this risk. Patients with ESRD complicated by frailty exhibit a significant decrease in functional connectivity between the sensorimotor network (SMN) and visual network (VN), which provides novel imaging evidence for exploring the central neural mechanisms underlying the development of frailty in ESRD patients.
5.Effects of VEGFA genetic polymorphisms on chemotherapy toxicities and clinical prognosis in children with brain tumors
Zhengyue LIU ; Lingjia MENG ; An YAN ; Miao LI ; Shumei WANG
Acta Universitatis Medicinalis Anhui 2026;61(5):901-907
ObjectiveTo explore the effects of vascular endothelial growth factor A (VEGFA) rs2010963 and rs3025039 polymorphisms on chemotherapy toxicities and clinical prognosis in children with brain tumors. MethodsA total of 104 pediatric patients with brain tumors receiving standardized chemotherapy were enrolled. Matrix-assisted laser desorption/ionization time of flight mass spectrometry was used for VEGFA rs2010963 and rs3025039 genotyping. The χ² test was applied to analyze the association between genotypes and chemotherapy‑related toxicities. Cox regression was used to evaluate the correlations of clinicopathological characteristics and genotypes with the progression‑free survival (PFS). In addition, bioinformatic analyses were conducted to investigate the regulatory factors potentially affected by the two SNP loci. ResultsThe VEGFA expression in brain tumors (5.17±1.81) was significantly higher than that in normal tissues (4.33±1.56, P<0.001). Patients with high VEGFA expression had significantly worse overall survival than patients with low VEGFA expression (P<0.001). Among the 104 children with brain tumors included, the rs2010963 CC, CG, and GG genotypes accounted for 14.42%, 55.77%, and 29.81%, respectively. The frequencies of C and G alleles were 42.31% and 57.69%, respectively. The rs3025039 CC, CT, and TT genotypes accounted for 70.19%, 25.96%, and 3.85%, respectively. The frequencies of C and T alleles were 83.17% and 16.83%, respectively. The children with the rs3025039 CC genotype had significantly higher incidences of thrombocytopenia (46.58%) and gastrointestinal toxicity (56.16%) than CT genotype carriers (22.22% and 33.33%, respectively, P<0.05), and significantly lower incidences of coagulation disorders (4.11%) than TT genotype carriers (50.00%, P<0.05).The incidence of hyperlipidemia (2.74%) was significantly lower than that in the CT genotype carriers (14.82%, P<0.05). The tumor type and the rs2010963 genotype were significantly associated with PFS (P<0.05) in univariable and multivariable Cox regression analysis. Bioinformatic analysis indicated that the rs2010963 and rs3025039 polymorphisms regulated VEGFA expression by affecting the binding of transcription factors and miRNAs to their target gene sequences, respectively. ConclusionThe VEGFA rs3025039 CC genotype is a risk factor for thrombocytopenia and gastrointestinal toxicity, and a protective factor for coagulation disorders and hyperlipidemia. The rs2010963 CG genotype is a protective factor for brain tumor progression.
6.Expert consensus on the application of artificial intelligence in lung cancer screening, diagnosis, and treatment (2026 edition)
Wenzhao ZHONG ; Haibo WANG ; Yi HU ; Hao ZHANG ; Jigang DAI ; Junqiang FAN ; Guibin QIAO ; Fan YANG ; Jian HU ; Fengwei TAN ; Xuening YANG ; Qiang PU ; Zihao CHEN ; Hongxia TIAN ; Lunxu LIU ; Hecheng LI ; Xiaolong YAN ; Zongyang YU ; Zhenbin QIU ; Yihua SUN ; Jing HU ; Yuhang SHI ; Zhifei GUO ; Peng ZHANG ; Kezhong CHEN ; Shugeng GAO ; Yilong WU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):848-856
With the continuous deepening of the concept of precision diagnosis and treatment for lung cancer, how to achieve higher efficiency and accuracy in the screening, diagnosis, and treatment pathways in clinical practice has become an important issue that urgently needs to be overcome. The current clinical difficulty lies in the fact that despite continuous advancements in imaging and molecular diagnostic technologies, there are still limitations in manual efficiency and subjective experience when it comes to massive data analysis and multi-scale feature extraction. Artificial intelligence (AI), especially algorithm systems based on deep learning, is an innovative technology capable of deeply empowering medical big data. This method utilizes algorithms such as convolutional neural networks, combined with radiomics, pathomics, and multi-modal data fusion analysis, demonstrating immense potential in early precise detection and benign-malignant differentiation of pulmonary nodules, digital pathological subtype recognition and non-invasive prediction of driver genes, precise 3D surgical planning and automatic delineation of radiotherapy target volumes, as well as dynamic risk warning during follow-up. This innovative technology provides a brand-new solution for realizing intelligent and individualized lung cancer diagnosis and treatment models. This consensus, based on the latest evidence from evidence-based medicine and combined with the development trends in the AI field and real-world clinical needs, was ultimately formed by gathering the consensus opinions of multidisciplinary experts in radiology, pathology, thoracic surgery, and other fields. The main content covers the application specifications of AI in the three core scenarios of lung cancer screening, diagnosis, and treatment, the technical standards for data collection and algorithm validation, as well as the ethical and regulatory challenges faced at the current stage. It aims to clarify the applicable boundaries of AI as a clinical auxiliary decision support tool, providing scientific guidance and standardized exploration directions for peers currently engaged in or planning to carry out AI-assisted clinical diagnosis, treatment, and translation of lung cancer.
7.Expert consensus on the clinical application of domestic ultra-high-definition medical endoscopes in cardiovascular surgery (2026 edition)
Junfei ZHAO ; Biaochuan HE ; Yun TENG ; Xiaohua LI ; Zerui CHEN ; Chungeng LIU ; Yijiu REN ; Chang CHEN ; Nianguo DONG ; Jimei CHEN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):857-865
This consensus focuses on the clinical application of domestic ultra-high-definition (UHD) medical endoscopes in cardiovascular surgery, addressing their clinical value, key technical aspects, and strategies for broader implementation. It traces the evolution of domestic endoscopic platforms from high-resolution imaging toward integrated advanced functionalities such as fluorescence imaging, three-dimensional visualization, and intelligent assistance. The document outlines standardized procedural steps and perioperative management pathways for minimally invasive endoscopic cardiovascular surgery and summarizes specific application scenarios and technical considerations in congenital heart disease, valvular disorders, coronary artery disease, arrhythmias, and cardiac tumors. Furthermore, recommendations are provided regarding professional training, multicenter collaboration, the establishment of clinical evaluation systems, and coordinated policy-industry support to promote standardized adoption and high-quality dissemination of domestic medical devices. Based on available evidence and expert agreement, 16 consensus statements are presented, aiming to offer authoritative and actionable guidance for clinical practice.
8.Evaluation system for standardized surgery in elderly patients with lung cancer
Xingqi MI ; Nan CHEN ; Jiandong MEI ; Hecheng LI ; Shuguang ZHANG ; Huanwen CHEN ; Peng JIAO ; Jun WANG ; Chunfang ZHANG ; Guangjian ZHANG ; Xin LI ; Qiang PU ; Peng LIN ; Lunxu LIU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):866-873
To address the growing challenge of an increasing number of elderly lung cancer patients amidst China's aging population and to fill the gap in quality control standards for surgical treatment in this special population, this study aimed to develop a standardized surgical evaluation system for elderly lung cancer patients tailored to China's national conditions. The system was established through a literature review, integrated the pathophysiological characteristics of elderly patients, and was constructed following review, feedback, and revision by experts from multiple thoracic surgery centers. Employing a 100-point scoring system, it comprises three primary domains: physical infrastructure and geriatric adaptability foundational conditions (10 points); management level and perioperative care models (20 points); and technical proficiency and clinical outcomes (70 points). The system places a strong emphasis on geriatric adaptability, proposing specific, quantifiable indicators for age-friendly facility modifications, control of elderly-specific complications, multidisciplinary collaboration, and standardized perioperative management. It provides a convenient and measurable assessment tool for quality control in the surgical treatment of elderly lung cancer in China, which is expected to promote the standardization and homogenization of diagnosis and treatment.
9.Effect evaluation of short video based health education on e-cigarette awareness improvement among junior high school students
LI Da,WANG Xiaodan,LI Lei,LIU Na,ZHAO Lei
Chinese Journal of School Health 2026;47(6):799-803
Objective:
To evaluate the efficacy of a short video based health education model in enhancing e-cigarette awareness among junior high school students, so as to provide empirical evidence for optimizing school based health education in the digital era.
Methods:
In December 2024, a cluster sampling method was applied to recruit 465 eighth grade students from a middle school in Kunming for a survey. The intervention was implemented through playing short videos produced by the research team in the classroom, and a self designed adolescent e-cigarette questionnaire was used to conduct assessments before and after intervention, along with qualitative interviews with 60 teachers and students by purposive sampling. Pre and post intervention outcomes were compared by using paired t-test and Chi-square test. Qualitative data underwent a three stage coding process of "open, axial, and selective coding" to construct an explanatory framework.
Results:
Quantitative analysis showed significant post intervention increases in both baseline awareness scores(92.1±6.6)and deep awareness scores (70.0±17.6) compared with pre intervention( 78.2± 14.0,46.1±20.5)( t =23.54,26.72,both P <0.05), both meeting the criteria for large effect sizes (Cohen s d =1.09, 1.24). The improvement in deep awareness was particularly pronounced, specifically regarding addictive ingredients, illicit additives(tiletamine,metomidate,etomidate), and misconceptions about smoking cessation efficacy ( χ 2=150.54,113.27,117.40,112.92, 69.93 , all P <0.01). Qualitative insights revealed that narrative transportation and visual enhancement were the core mechanisms of efficacy: 87.3% of students preferred contextualized narratives, 85.5% of students decoded cognitive bottlenecks more effectively because of visual enhancement, and 72.7% relied on short videos for micro learning.
Conclusion
Short video based health education can effectively enhance e-cigarette awareness among junior high school students, offering a pragmatically viable digital pathway for school based health education.
10.Correlation between parental behaviors and autistic traits in children with autism spectrum disorder
Chinese Journal of School Health 2026;47(6):818-821
Objective:
To understand the correlation between autistic traits in children with autism spectrum disorder(ASD) and their parental behaviors, so as to provide evidence for improving social behavior in children with ASD.
Methods:
A total of 62 children aged 4-7 years diagnosed with ASD at Guangdong Provincial Work Injury Rehabilitation Hospital and Guangzhou Yuexiu District Children s Hospital from October 2021 to May 2025 were selected as the ASD group. A random number table method was used to select 62 healthy children of the same age from 3 ordinary kindergartens in Guangzhou as the control (typically developing,TD) group. The Parental Behavior Inventory and Social Responsiveness Scale were used to evaluate parental behaviors and autistic traits in both groups. The t-test and multiple linear regression were used to analyze the relationship between autistic traits in children with ASD and parental behaviors.
Results:
Compared with the TD group, the ASD group had significantly higher scores in social awareness, social cognition, social communication, social motivation, autistic behavior patterns, and the total score of social responsiveness, with statistically significant differences ( t =35.83, 46.17, 64.36, 41.45, 49.46,101.15, all P <0.01). The score of parental support/participation in the ASD group (24.61±4.30) was lower than that in the TD group (31.27±4.58), while the score of parental hostility/coercion in the ASD group (25.51±2.72) was higher than that in the TD group (12.75±2.72), with statistically significant differences ( t = -8.34, 26.14, both P <0.01). The total score of the Social Responsiveness Scale was negatively correlated with the dimension score of parental support/participation behaviors, and positively correlated with the dimension score of parental hostility/coercion behaviors ( r =-0.60, 0.91,both P <0.05). After adjusting for covariates such as children s age, gender, and primary caregiver, ASD children with exclusive breastfeeding ( β =-8.79) and parental support/participation behaviors ( β = -0.79 ) had a lower risk of autistic traits, while children with parental hostility/coercion behaviors ( β =4.62) had a higher risk of autistic traits (all P <0.05).
Conclusion
Autistic traits in children with ASD may be related to their parental behaviors and early feeding mode.


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