1.Tanyu Tongzhi Youhua Prescription Regulates cGAS/STING Signaling Pathway to Inhibit Inflammation and Ameliorate No-reflow Phenomenon in Myocardial Ischemia/Reperfusion Injury
Sijia WU ; Yingying LI ; Haonan WU ; Xiang LI ; Lingfeng ZHOU ; Huamin ZHANG ; Danli TANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):99-107
ObjectiveThis paper aims to investigate the protective effects of the Tanyu Tongzhi Youhua prescription(TYTZP) against myocardial ischemia/reperfusion injury in rats via regulation of the cyclic GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) signaling pathway. MethodsFifty-six 8-week-old male Sprague-Dawley (SD) rats were randomly divided into sham group, model group, ticagrelor group (32.4 mg·kg-1), RU320521 (RU.521cGAS inhibitors) group (5 mL·kg-1), groups of TYTZP with low dose (3.6 g·kg-1), medium dose (7.2 g·kg-1), and high dose (14.4 g·kg-1), with eight rats per group. The ticagrelor group and groups of TYTZP with different doses received pre-treatment for seven days according to their respective protocols. The RU.521 group received an intraperitoneal injection one hour before modeling. A rat model of the no-reflow phenomenon in myocardial ischemia/reperfusion injury was established by ligating the left anterior descending coronary artery in situ. Myocardial no-reflow area was determined by thioflavin staining. Histopathological morphology of myocardial tissue was observed via hematoxylin and eosin (HE) staining. Cardiac function was detected by echocardiography. Myocardial microcirculation function change was observed by using real-time myocardial contrast echocardiography. The myocardial enzyme levels in the serum were measured by serum biochemical analysis. The double-stranded DNA (dsDNA) levels were detected by using PicoGreen. The protein expression of cGAS, STING, and nuclear factor-κB (NF-κB) p65 in myocardial tissue was detected by Western blot. The levels of cardiac troponin Ⅰ (cTNⅠ), cardiac troponin T (cTNT), interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA). ResultsCompared with the sham group, the model group showed a significantly increased myocardial no-reflow area (P<0.01). Myocardial fiber rupture and disarray and inflammatory cell infiltration were observed by HE staining. The ultrasound results indicated that left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) (P<0.01) were significantly decreased. Real-time myocardial contrast echocardiography showed that the peak time of myocardial blood perfusion was significantly prolonged (P<0.01), and the levels of creatine kinase (CK), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), cTNⅠ, cTNT, and dsDNA were significantly elevated (P<0.01). Western blot results showed that the myocardial protein expressions of cGAS, STING, and NF-κB p65 were upregulated (P<0.01). ELISA results showed that the inflammatory factors in the serum such as IL-6, IL-1β, and TNF-α were increased (P<0.01). Compared with the model group, the group of the TYTZP significantly reduced the levels of myocardial enzyme, troponins, and dsDNA (P<0.01, P<0.05), improved cardiac function and myocardial microcirculation, alleviated histopathological morphology and inflammatory infiltration, inhibited activation of the cGAS/STING pathway, reduced the expression of NF-κB p65 (P<0.01, P<0.05), and inhibited inflammatory response. ConclusionThe TYTZP mitigates the no-reflow phenomenon in myocardial ischemia/reperfusion injury, and its mechanism is associated with inhibiting the activation of the cGAS/STING pathway and attenuating inflammatory responses.
2.Tanyu Tongzhi Youhua Prescription Regulates cGAS/STING Signaling Pathway to Inhibit Inflammation and Ameliorate No-reflow Phenomenon in Myocardial Ischemia/Reperfusion Injury
Sijia WU ; Yingying LI ; Haonan WU ; Xiang LI ; Lingfeng ZHOU ; Huamin ZHANG ; Danli TANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):99-107
ObjectiveThis paper aims to investigate the protective effects of the Tanyu Tongzhi Youhua prescription(TYTZP) against myocardial ischemia/reperfusion injury in rats via regulation of the cyclic GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) signaling pathway. MethodsFifty-six 8-week-old male Sprague-Dawley (SD) rats were randomly divided into sham group, model group, ticagrelor group (32.4 mg·kg-1), RU320521 (RU.521cGAS inhibitors) group (5 mL·kg-1), groups of TYTZP with low dose (3.6 g·kg-1), medium dose (7.2 g·kg-1), and high dose (14.4 g·kg-1), with eight rats per group. The ticagrelor group and groups of TYTZP with different doses received pre-treatment for seven days according to their respective protocols. The RU.521 group received an intraperitoneal injection one hour before modeling. A rat model of the no-reflow phenomenon in myocardial ischemia/reperfusion injury was established by ligating the left anterior descending coronary artery in situ. Myocardial no-reflow area was determined by thioflavin staining. Histopathological morphology of myocardial tissue was observed via hematoxylin and eosin (HE) staining. Cardiac function was detected by echocardiography. Myocardial microcirculation function change was observed by using real-time myocardial contrast echocardiography. The myocardial enzyme levels in the serum were measured by serum biochemical analysis. The double-stranded DNA (dsDNA) levels were detected by using PicoGreen. The protein expression of cGAS, STING, and nuclear factor-κB (NF-κB) p65 in myocardial tissue was detected by Western blot. The levels of cardiac troponin Ⅰ (cTNⅠ), cardiac troponin T (cTNT), interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the peripheral blood were measured by enzyme-linked immunosorbent assay (ELISA). ResultsCompared with the sham group, the model group showed a significantly increased myocardial no-reflow area (P<0.01). Myocardial fiber rupture and disarray and inflammatory cell infiltration were observed by HE staining. The ultrasound results indicated that left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) (P<0.01) were significantly decreased. Real-time myocardial contrast echocardiography showed that the peak time of myocardial blood perfusion was significantly prolonged (P<0.01), and the levels of creatine kinase (CK), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), cTNⅠ, cTNT, and dsDNA were significantly elevated (P<0.01). Western blot results showed that the myocardial protein expressions of cGAS, STING, and NF-κB p65 were upregulated (P<0.01). ELISA results showed that the inflammatory factors in the serum such as IL-6, IL-1β, and TNF-α were increased (P<0.01). Compared with the model group, the group of the TYTZP significantly reduced the levels of myocardial enzyme, troponins, and dsDNA (P<0.01, P<0.05), improved cardiac function and myocardial microcirculation, alleviated histopathological morphology and inflammatory infiltration, inhibited activation of the cGAS/STING pathway, reduced the expression of NF-κB p65 (P<0.01, P<0.05), and inhibited inflammatory response. ConclusionThe TYTZP mitigates the no-reflow phenomenon in myocardial ischemia/reperfusion injury, and its mechanism is associated with inhibiting the activation of the cGAS/STING pathway and attenuating inflammatory responses.
3.Metronidazole-related Stevens-Johnson syndrome: a case report and literature review
SHI Haibo ; LIU Changyang ; NA Sijia ; LI Xingqiang
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(7):688-695
Objective:
To analyze the clinical characteristics and management strategies of metronidazole-associated Stevens-Johnson syndrome (SJS), and to provide a clinical basis for medication safety during the oral perioperative period.
Methods:
The study adhered to the tenets of the Declaration of Helsinki and was approved by the Ethics Committee of Stomatological Hospital of Xi'an Jiaotong University. A retrospective analysis was conducted on a case of SJS following mandibular impacted tooth extraction, for which the patient had taken metronidazole. Additionally, a literature review was performed by searching databases including China National Knowledge Infrastructure, Wanfang, PubMed, and Web of Science to identify reported cases of metronidazole-associated SJS. Demographic features, medication regimens, latency periods, clinical signs, interventions, and prognosis were analyzed.
Results:
The patient presented with lip swelling, extensive erosion and ulceration of the oral mucosa, and severe odynophagia. Scattered erythematous macules and bullae were observed on the trunk and extremities, with a positive Nikolsky sign. Additionally, there was erosion of the perineal skin and glans penis mucosa, along with skin desquamation of the scrotum. The patient with SJS was managed in the hospital by discontinuing metronidazole and administering sequential treatments, including glucocorticoids, immunomodulators, intravenous immunoglobulin, and plasma exchange. The condition gradually improved; after a 14-month follow-up, only mild dry eye remained, with no significant scarring of the skin or mucosa. However, delayed recognition of early warning signs resulted in delayed drug withdrawal and intervention. The literature review identified 6 additional cases (3 males, 3 females) with a median age of 45.5 years (range 31-61). Indications for metronidazole included postoperative sepsis prophylaxis after duodenal ulcer perforation repair, digestive system infections, mucosal diseases, pelvic inflammatory disease, septic cellulitis with pneumonia, and gingivitis. Administration routes comprised oral (n = 2), intravenous (n = 3), and topical (n = 1). The latency period from drug administration to onset ranged from 0.25 to 7 days (median 4 days). All of the cases presented with oral mucosal erosion, and a positive Nikolsky’s sign was noted for five patients. Discontinuation of the causative drug was the cornerstone of treatment, supplemented by immunomodulatory therapy, symptomatic support, and multidisciplinary collaboration. Prognoses varied significantly: among the four patients treated with “drug withdrawal + glucocorticoids + supportive care,” three recovered fully and one improved; among the two patients receiving “drug withdrawal + simple supportive care,” one recovered and one died
Conclusion
Although metronidazole-associated SJS is rare, it progresses rapidly and frequently involves oral mucosal damage, typically occurring within one week of administering the medication. Early drug withdrawal and prompt initiation of glucocorticoid therapy can improve prognosis. During the oral perioperative period, strict adherence to metronidazole indications, enhanced monitoring for early warning symptoms, and the establishment of a multidisciplinary collaborative diagnosis and treatment model are essential to minimize the risk of severe adverse drug reactions.
4.Effect of rehabilitation robot training on abdominal muscle thickness and balance ability in children with hemiplegia
Yanhua LIANG ; Tong ZHANG ; Qi ZHANG ; Tiantian ZHOU ; Yanqing ZHANG ; Qing YUE ; Sijia LI
Chinese Journal of Rehabilitation Theory and Practice 2026;32(8):927-937
ObjectiveTo observe the effect of rehabilitation robot training on abdominal muscles thickness and balance ability in children with hemiplegia. MethodsFrom October, 2024 to December, 2025, 58 children with hemiplegia were admitted to Beijing Bo'ai Hospital and randomly divided into control group (n = 29) and experimental group (n = 29). Both groups received conventional rehabilitation treatment, and the experimental group received rehabilitation robot training in addition, for four weeks. The thickness of bilateral external oblique, internal oblique and transversus abdominis, Berg Balance Scale (BBS) score, the time of Timed Up and Go Test (TUGT), the center of pressure (COP) ellipse area, and self-selected walking speed (SWS) and maximum walking speed (MWS) of 10-meter walk test were compared before and after training. ResultsThree cases dropped out in each group. After training, the thickness of the external oblique, internal oblique and transverse abdominis on the hemiplegic side increased significantly in the experimental group (|t| > 7.280, P < 0.001, Cohen's d = 1.43~2.01), and was better in the experimental group than in the control group (|t| > 2.895, P < 0.01, Cohen's d = 0.80~1.60); the BBS score increased in both groups (|t| > 6.667, P < 0.001, Cohen's d = 1.30~4.06), and was better in the experimental group than in the control group (t = -2.721, P < 0.01, Cohen's d = 0.75). The time of TUGT decreased in both groups (t > 5.790, P < 0.001, Cohen's d = 1.14~2.68), and was better in the experimental group than in the control group (t = 2.290, P < 0.05, Cohen's d = 0.63). The SWS and MWS increased in both groups (|Z| > 2.910, P < 0.01, r = 0.40~0.68), and were better in the experimental group than in the control group (|Z| > 2.912, P < 0.05, r = 0.40~0.45), and the differences remained significant after correction. ConclusionRehabilitation robot training can improve the thickness of external oblique, the internal oblique and transversus abdominis muscles on the hemiplegic side in children with hemiplegia, and improve their balance and walking functions.
5.Current application and prospects of new ultrasound technologies in the diagnosis and treatment of hepatocellular carcinoma
Sijia LIN ; Lingling LI ; Jianhua ZHOU
Journal of Clinical Hepatology 2026;42(7):1507-1512
As a common type of primary liver cancer, hepatocellular carcinoma (HCC) is a major health threat in China. Ultrasound is a crucial imaging modality in the clinical diagnosis and treatment of HCC, and the development and application of new ultrasound technologies have high clinical value. Currently, ultrasound and contrast-enhanced ultrasound combined with artificial intelligence have shown promising potential in the detection of focal liver lesions, image-based HCC diagnosis, outcome assessment, and prognostic prediction; furthermore, ultrasound fusion imaging technology has shown certain clinical value in guidance and efficacy evaluation of percutaneous thermal ablation; three-dimensional ultrasound has certain advantages in assisting ablation and assessing ablation margins; endoscopic ultrasonography can be used as a supplementary method for HCC cases that are difficult to scan or guide via percutaneous ultrasound.
6.Buzhong Yiqitang Combined with Cisplatin Inhibits Lung Adenocarcinoma Cell Proliferation by Suppressing PDK1/Akt Signaling Pathway and Regulating Glycolysis
He LI ; Sijia BAI ; Wenjun LIU ; Jianguang WANG ; Jialu LYU ; Chun WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):1-12
ObjectiveTo investigate the impact of Buzhong Yiqitang combined with cisplatin on the proliferation of human lung adenocarcinoma (A549) cells through regulation of the pyruvate dehydrogenase kinase 1 (PDK1)/protein kinase B (Akt) signaling pathway and influence on glycolysis. MethodsTranscriptome sequencing (RNA-seq) was employed to compare the expression of glycolysis-related genes between A549 cells and cisplatin-resistant human lung adenocarcinoma cells (A549/DDP). Small interfering RNA (siRNA) was employed to knock down PDK1, and the knockdown efficiency was verified by Western blot and Read-time PCR. The cell counting kit-8 (CCK-8) assay was used to assess the survival and viability of A549 cells under the following conditions: siRNA negative control+cisplatin (128, 64, 32, 16, 8, 4, 0 μmol·L-1), siPDK1+cisplatin (128, 64, 32, 16, 8, 4, 0 μmol·L-1), and siPDK1+cisplatin (128, 64, 32, 16, 8, 4, 0 μmol·L-1)+Buzhong Yiqitang (10%)-containing serum. The 20% inhibitory concentration (IC20) of the siRNA negative control+cisplatin group (7.832 μmol·L-1) was calculated and used as the subsequent cisplatin concentration. Colony formation assay was performed to evaluate the proliferation of A549 cells. Lactate and adenosine triphosphate (ATP) assay kits were used to measure lactate and ATP production. The mitochondrial membrane potential was detected with the fluorescent probe JC-1. Western blotting was conducted to examine the expression levels of PDK1, phosphorylated (p)-Akt, Akt, pyruvate kinase M2 (PKM2), glucose transporter 1 (GLUT1), pyruvate dehydrogenase (PDH), and lactate dehydrogenase A (LDHA). Confocal immunofluorescence was employed to detect PDK1 and p-Akt. ResultsRNA-seq results identified PDK1 as a highly expressed differential gene in glycolysis metabolism between A549 cells and A549/DDP cells, and it was highly expressed in tumor cells. Gene Set Enrichment Analysis (GSEA) revealed upregulated and downregulated genes in glycolysis and gluconeogenesis pathways. Western blot and RT-qPCR confirmed that PDK1-si-2 had the highest transfection efficiency, with a PDK1 knockdown rate exceeding 60%. CCK-8 assay determined the half-maximal inhibitory concentration (IC50) values for each group as (30.698±5.348), (16.372±3.562), (13.237±1.573) μmol·L-1, while the IC20 of cisplatin in siRNA negative control-transfected A549 cells was (7.832±0.672) μmol·L-1. Compared with the siRNA negative control group, the siRNA negative control+cisplatin group showed decreased colony formation rate, reduced lactate production, lowered mitochondrial membrane potential, downregulated protein levels of p-Akt, GLUT1, PDK1, PDH, and LDHA, and reduced PDK1 fluorescence intensity (P<0.05). The siPDK1 group exhibited decreased colony formation rate, reduced lactate production, increased ATP production, lowered mitochondrial membrane potential, downregulated protein levels of p-Akt, PKM2, GLUT1, PDK1, PDH, and LDHA, and reduced PDK1 and p-Akt fluorescence intensity (P<0.05). Compared with the siPDK1 group, the siPDK1+Buzhong Yiqitang group showed decreased colony formation rate, reduced lactate production, downregulated protein levels of PKM2, GLUT1, and PDK1, and reduced PDK1 fluorescence intensity (P<0.05). The siPDK1+cisplatin group exhibited decreased colony formation rate, reduced lactate production, increased ATP production, lowered mitochondrial membrane potential, downregulated protein levels of PKM2, GLUT1, PDK1, and PDH, and reduced PDK1 and p-Akt fluorescence intensity (P<0.05). The siPDK1+cisplatin+Buzhong Yiqitang group demonstrated decreased colony formation rate, reduced lactate production, increased ATP production, lowered mitochondrial membrane potential, downregulated protein levels of p-Akt, PKM2, GLUT1, PDK1, PDH, and LDHA, and reduced PDK1 and p-Akt fluorescence intensity (P<0.05). Compared with the siPDK1+Buzhong Yiqitang group, the siPDK1+cisplatin group showed decreased colony formation rate, downregulated protein levels of p-Akt and PDH, and reduced PDK1 and p-Akt fluorescence intensity (P<0.05). The siPDK1+cisplatin+Buzhong Yiqitang group exhibited decreased colony formation rate, reduced lactate production, increased ATP production, lowered mitochondrial membrane potential, downregulated protein levels of p-Akt, GLUT1, PDH, and LDHA, and reduced PDK1 and p-Akt fluorescence intensity (P<0.05). Compared with the siPDK1+cisplatin group, the siPDK1+cisplatin+Buzhong Yiqitang group showed decreased colony formation rate, increased ATP production, and downregulated protein levels of p-Akt, PKM2, and LDHA (P<0.05). ConclusionBuzhong Yiqitang combined with cisplatin can suppress lung adenocarcinoma cell proliferation by modulating glycolysis through the PDK1/Akt signaling pathway.
7.Mechanism of Yantiao Prescription in Treating Lipopolysaccharide-induced Acute Lung Injury Based on Arachidonic Acid Metabolic Pathways
Pengcheng LI ; Tianyang CHEN ; Rong FANG ; Anna ZHANG ; Sijia WU ; Wei LIU ; Qian WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):101-110
ObjectiveTo clarify the anti-inflammatory and lung-protective effects of Yantiao prescription on lipopolysaccharide (LPS)-induced acute lung injury (ALI), and to explore the impact of Yantiao prescription on the metabolic pathways of arachidonic acid (AA) in vivo. MethodsThirty male C57BL/6J mice were randomly divided into the following groups based on body weight: normal group, model group, dexamethasone group (2 mg·kg-1), low-dose Yantiao prescription group (18 g·kg-1), and high-dose Yantiao prescription group (36 g·kg-1), with 6 mice in each group. The ALI mouse model was established by intraperitoneal injection of LPS. The treatment groups received oral gavage once a day for 7 consecutive days, and serum and lung tissue were collected at the end of the experiment. The content of pro-inflammatory cytokines tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) in serum was detected by enzyme-linked immunosorbent assay (ELISA). Hematoxylin-eosin (HE) staining was used to assess lung tissue pathology. The wet/dry weight ratio (W/D) and myeloperoxidase (MPO) activity in lung tissue were measured. The content of AA metabolites in serum and lung tissue was measured by liquid chromatography triple quadrupole-mass spectrometry (LC-MS/MS). ResultsCompared with the conditions in the normal group, the content of serum pro-inflammatory cytokines TNF-α, IL-1β, and IL-6 in the model group was significantly increased (P<0.01). The alveolar structure in mice was severely damaged, with markedly thickened alveolar walls and extensive inflammatory cell infiltration. The W/D ratio and MPO activity in lung tissue were significantly increased (P<0.01). The content of AA metabolites, including prostaglandin D2 (PGD2), prostaglandin E2 (PGE2), 11(S)-hydroxy-eicosatetraenoic acid [11(S)-HETE], and 5-hydroxy-eicosatetraenoic acid (5-HETE) in serum and lung tissue was significantly increased (P<0.05), while the content of 11,12-epoxyeicosatrienoic acid (11,12-EET) and 14,15-epoxyeicosatrienoic acid (14,15-EET) in serum was significantly decreased (P<0.01). Compared with the results in the model group, the content of serum pro-inflammatory cytokines TNF-α, IL-1β, and IL-6 in the dexamethasone group, low-dose Yantiao prescription group, and high-dose Yantiao prescription group was significantly reduced (P<0.05). Mild thickening of alveolar walls, scattered inflammatory cell infiltration, and relatively intact tissue structure with improved alveolar architecture were observed. The W/D ratio and MPO activity in lung tissue were significantly reduced (P<0.01). The content of AA metabolites PGD2, PGE2, 11(S)-HETE, and 5-HETE in serum from the dexamethasone group was significantly decreased (P<0.05), while the content of 14,15-EET in serum significantly increased (P<0.01), and the content of 5-HETE in lung tissue significantly decreased (P<0.01). In the low-dose and high-dose Yantiao prescription groups, the content of AA metabolites PGD2, PGE2, 11(S)-HETE, and 5-HETE in serum and lung tissue was significantly decreased (P<0.05), while the content of 11,12-EET in both serum and lung tissue was significantly increased (P<0.05). ConclusionYantiao prescription has significant protective effects against LPS-induced ALI, which are related to its regulation of AA metabolic pathways in vivo.
8.Efficacy and safety of ketogenic diet on metabolic and reproductive outcomes in overweight/obese patients with polycystic ovary syndrome:a meta-analysis of randomized controlled trials
Lu TANG ; Sijia WENG ; Liping HU ; Qingjiao LI ; Hua CAI ; Bo JIANG
Journal of Clinical Medicine in Practice 2025;29(20):109-118
Objective The ketogenic diet(KD)is a dietary intervention with potential therapeu-tic effects on polycystic ovary syndrome(PCOS),yet the existing evidence remains controversial.Fur-thermore,there is a lack of evidence-based medicine data for a comprehensive assessment of the safety of KD in the treatment of PCOS.This study aims to systematically evaluate,through a meta-analysis,the effects of KD on body composition,metabolic indicators,and reproductive hormone levels in over-weight/obese patients with PCOS,and to explore its safety and clinical applicability.Methods This study systematically searched PubMed,Web of Science,Embase,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Database,and VIP Database.Randomized controlled trials(RCT)on KD for the treatment of PCOS were included,with the search time frame spanning from the establishment of each database to May 31,2025.Two researchers independently screened and extracted data according to inclusion and exclusion criteria,and assessed the quality of the in-cluded literature using the Cochrane Handbook.The Q-test and inconsistency index(I2)were used to evaluate the heterogeneity of the results.Based on the level of heterogeneity,a fixed-effects model or a random-effects model was selected for data pooling.Sensitivity analysis was employed to explore the robustness of the results.Results A total of 7 RCT studies involving 495 overweight/obese subjects were included in this study.Body composition analysis revealed that,compared with the control group,KD significantly reduced body mass index,body weight,waist circumference,waist-to-hip ra-tio,total fat mass,and visceral fat area in overweight/obese patients with PCOS(P<0.05),but had no significant effect on fat-free mass.Analysis of glucose and lipid metabolism indicated that KD sig-nificantly decreased fasting blood glucose,fasting insulin,insulin resistance index,and triglycerides(P<0.05),but had no significant impacts on total cholesterol,low-density lipoprotein cholesterol,or high-density lipoprotein cholesterol.Reproductive hormone analysis showed that KD significantly reduced luteinizing hormone,the ratio of luteinizing hormone to follicle-stimulating hormone,and total testosterone levels,while significantly increased sex hormone-binding globulin levels(P<0.05),but had no significant effect on follicle-stimulating hormone.Sensitivity analysis suggested that the results were relatively robust.In terms of safety,no serious adverse reactions were observed during the KD intervention;however,further verification through high-quality RCTs with larger sample sizes and long-term interventions is still required.Conclusion KD can effectively improve body composition,glucose metabolism,lipid metabolism indicators,and reproductive hormone levels in overweight/obese patients with PCOS.This study confirms that KD significantly increase sex hormone-binding globulin level and reduce visceral fat area.It is found that KD has a more pronounced effect on impro-ving triglycerides compared to its effects on low-density lipoprotein cholesterol and high-density lipo-protein cholesterol.The current evidence does not indicate significant safety risks associated with KD,but relevant conclusions still require further confirmation with more high-quality evidence.
9.Analysis of the anticoagulant effect and influencing factors of warfarin in patients after left ventricular assist device implantation guided by gene test
Ying WANG ; Jin LI ; Sijia ZHAO ; Tao CHEN ; Chengbin TANG ; Jia LIU
China Pharmacy 2025;36(17):2160-2164
OBJECTIVE To evaluate the effectiveness and safety of warfarin anticoagulation therapy guided by gene test in patients undergoing left ventricular assist device (LVAD) implantation, and to analyze the influencing factors of warfarin anticoagulation efficacy. METHODS Patients who underwent LVAD implantation at the Heart and Vascular Center of Northern Jiangsu People’s Hospital from January 2023 to October 2024 and required warfarin anticoagulant therapy were selected as the study subjects. They were divided into genetic testing group (n=51) and empirical treatment group (n=17) based on whether they underwent CYP2C9 and VKORC1 gene test. The gene test group was given warfarin based on the predicted dose calculated by gene test, while the empirical treatment group was given warfarin by clinical doctors based on international normalized ratio (INR) experience, all patients were given warfarin once a day. Follow-up observation was conducted for 6 months to compare the effectiveness [time in therapeutic range(TTR), the time required to reach INR for the first time, the incidence of embolic events, the incidence of INR<1.5 events] and safety (the incidence of major and minor bleeding events,the incidence of INR>3.5 events) of warfarin treatment between two groups of patients. According to whether the patient’s TTR was ≥60%, they were divided into TTR≥60% group (n=20) and TTR<60% group (n=48). Univariate and multivariate binary Logistic regression analysis were used to determine the factors affecting the anticoagulant effect of warfarin in patients. RESULTS The TTR of patients in the gene test group was significantly higher than that in the empirical treatment group (P<0.05). The incidence of INR<1.5 events in the gene test group was significantly lower than in the empirical treatment group (P<0.05). The incidence of minor bleeding events and INR>3.5 events in the gene test group were lower than in the empirical treatment group, but the difference was not statistically significant (P>0.05). The results of multivariate binary Logistic regression analysis showed that gene test was an independent protective factor for warfarin anticoagulant therapy [odds ratio (OR)=10.842, 95% confidence interval (CI): 1.211-27.037, P=0.033], and the combination of statins was an independent risk factor for warfarin anticoagulant therapy [OR=0.196, 95%CI: 0.045-0.861, P=0.031]. CONCLUSIONS Under the guidance of gene test, warfarin anticoagulation therapy for LVAD patients after implantation can improve TTR, shorten the anticoagulation target time, and has good safety; meanwhile, it should be noted that the combination of statins may enhance the anticoagulant effect of warfarin, thereby increasing the risk of bleeding in patients.
10.Characteristics of injury cases among the elderly in Ningbo City from 2014 to 2023
SUN Qiang ; HUANG Ying ; LI Xiaoyong ; YANG Chenying ; WANG Sijia
Journal of Preventive Medicine 2025;37(8):822-826,831
Objective:
To analyze the characteristics of injury surveillance cases among the elderly in Ningbo City, Zhejiang Province from 2014 to 2023, so as to provide the basis for formulating targeted injury intervention measures.
Methods:
Injury surveillance cases aged ≥60 years were collected from seven injury sentinel hospitals in Ningbo City through the Zhejiang Provincial Chronic Disease Surveillance Information Management System from 2014 to 2023. Population distribution, temporal distribution, injury circumstances, and clinical characteristics were described.
Results:
A total of 67 259 injury surveillance cases among the elderly were reported in Ningbo City from 2014 to 2023, including 32 159 males (47.81%) and 35 100 females (52.19%). The median age was 68.00 (interquartile range, 14.00) years. The three months with a higher number of cases were December (6 271 cases, 9.32%), August (6 226 cases, 9.26%) and October (6 221 cases, 9.25%). The primary causes of injury were falls (25 276 cases, 37.58%), stabs (12 250 cases, 18.21%), and sprains (11 815 cases, 17.57%). The injury occurred mainly in homes (44 975 cases, 66.87%) and streets/urban areas (16 174 cases, 24.05%). The predominant activities at the time of injury were leisure activities (28 801 cases, 42.82%) and household chores (23 647 cases, 35.16%). The proportions of falls as the cause of injury and injuries occurring at home among females and people aged 80 years and above were relatively high. The predominant sites of injury were upper limbs (23 354 cases, 34.72%) and lower limbs (20 343 cases, 30.25%). The predominant nature of injury were soft tissue injuries (43 345 cases, 64.44%) and bone and joint injuries (22 042 cases, 32.77%). Injuries were primarily mild and moderate in severity, with 46 391 cases (68.97%) and 20 205 cases (30.04%), respectively. The proportion of bone and joint injuries, moderate in injuries among females and people aged 80 years and above was relatively high.
Conclusions
The main causes of injury surveillance cases among the elderly in Ningbo City from 2014 to 2023 were falls and stabs, and the injuries occurred mainly in homes and streets/urban areas. Female and elderly people have a higher risk of injury.


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