1.Research on The Genealogical Inference Efficiency of High-density SNPs
Jing LI ; Yi-Jie SUN ; Wen-Ting ZHAO ; Zi-Chen TANG ; Jing LIU ; Cai-Xia LI
Progress in Biochemistry and Biophysics 2026;53(3):740-753
ObjectiveThis study aims to explore the potential of different orders of magnitude single-nucleotide polymorphism (SNP) locus combinations for predicting distant kinship relationships. A high-density SNP locus set was constructed, and a comprehensive assessment of its inference capability was conducted. MethodsFirstly, we selected three commercial chip panels, CGA (Chinese genotyping array, Illumina), GSA (Global screening array, Illumina), Affy (23MF_V2 high-density SNP array, Affymetrix) and merged them after quality control, forming a high-density SNP locus panel(1 180 k). Secondly, we selected 161 samples and collected their peripheral blood samples by using whole-genome sequencing technology. Within this sample population, the levels of kinship relationships fully covered the range from level 1 to level 9, and the number of kinship pairs at each level was consistently maintained at over 50 pairs. From 161 samples data of whole-genome sequencing, the 1 180 k locus set was extracted, which is referred to as the high-density SNP locus set in the following text. The kinship inference was conducted using the identity-by-descent (IBD) algorithm with the selected optimal parameters. To comprehensively evaluate the performance of the high-density SNP locus set in kinship inference, we compared it with the three commercial chip panels, the intersection of these three chip loci, and the control sets constructed by randomly reducing the number of the high-density SNP locus set. Based on the changes in the IBD lengths, as well as the dynamic trends in prediction accuracy, we conducted a scientific assessment of the kinship inference capability of the high-density SNP locus set. ResultsAfter screening, a set of 1 184 334 autosomal SNPs was obtained. During the process of screening the optimal IBD length threshold, the result revealed that 0 cM, 1 cM, and 2 cM all demonstrated good applicability. However, to avoid the issue of a large amount of redundant information caused by setting a too low IBD length threshold, this study ultimately selected 2 cM as the optimal threshold. Compared with the average results of three chip panels, the high-density SNP locus set increased the total IBD length and the average IBD length across levels 1-9; the accuracy of the confidence interval for level 8 was 70.97%, which represented a 3.50% improvement; the average confidence interval accuracy for levels 1-8 was 91.39%, representing a 1.00% increase; and the false negative rates at levels 8 and 9 were reduced by 2.42% and 6.76%, respectively. The system efficacy of the high-density SNP locus set for kinship inference of first to eighth degree relationships reached 98.91%. Through random reduction of the high-density SNP locus set results, it is found that increasing the number of SNPs with the panel, the detection efficiency of IBD length showed a significant upward trend. At the same time, the overall trend in the accuracy of kinship relationship prediction as well as the confidence interval accuracy also indicated that both metrics steadily increased with the addition of more loci. ConclusionThe results show that the high-density SNPs panel significantly enhances the efficacy of distant kinship inference, accurately covering kinship degrees, with the average confidence interval accuracy for first to eighth degree relationships stably above 90%. The study finds that increasing the number of SNPs panel can improve the ability to predict distant kinship.
2.Retrospective analysis of a tuberculosis outbreak among junior high school students in Chongqing
LI Jianqiong, ZHANG Ting, CHEN Aihua, WANG Qingya, ZHANG Ya, CHEN Jian, TANG Jie, LI Liang
Chinese Journal of School Health 2026;47(5):741-746
Objective:
To analyze changes in tuberculosis infection among junior high school students before and after tuberculosis exposure, so as to provide a reference for improving school tuberculosis prevention and control measures and policy formulation.
Methods:
Retrospectively collect data on a tuberculosis outbreak that occurred in a grade of a junior high school in Chongqing in 2025, including tuberculosis screening records of students in this grade upon their enrollment in 2022 (1 156 students) and after two tuberculosis outbreaks in 2023 (206 students) and 2025 (171 students). The Wilcoxon signed rank test for paired design was used to compare the induration diameters of the subjects, and the Chi square test was adopted to analyze the rate of tuberculosis infection among students.
Results:
In the tuberculosis outbreak in 2023, the rate of tuberculosis infection among close contacts ( 11.84 %) and the rate of tuberculosis infection among freshrman at school enrollment (12.89%) showed no statistically significant difference ( χ 2=0.25, P >0.05). The rate of tuberculosis infection of close contacts in the 2025 tuberculosis outbreak (55.56%) was higher than that in the 2023 outbreak (11.84%) ( χ 2=30.42, P <0.01). Among the 106 students included in the cohort analysis, the median induration diameter was 3.50 (1.50, 7.50) mm in 2023 and 8.75 (4.25, 11.50) mm in 2025, with a statistically significant difference ( Z=-5.76, P <0.01). There was no statistically significant difference between the infection rate in 2022 (16.98%) and that in 2023 (10.38%) ( χ 2=1.96, P =0.16). The infection rate in 2025 (43.40%) was higher than those in 2022 and 2023 ( χ 2=17.55, 29.39, both P <0.017). The seroconversion rate of students in the same class in 2025 ( 58.00 %) was higher than that of students in different classes (16.07%), with a statistically significant difference ( χ 2=20.19, P <0.01). All 72 individuals with latent tuberculosis infections identified during the pandemic in 2023 and 2025 refused to undergo prophylactic treatment.
Conclusions
The lack of preventive treatment may be the underlying cause of the successive outbreaks during the epidemic. Early detection of infection sources and standardized outbreak management are crucial to controlling the spread of the epidemic.
3.Current Status,Challenges,and Strategies of Basic Research on the Brain-Gut Interaction Theory for Spleen and Stomach Diseases in Traditional Chinese Medicine
Ting CHEN ; Jinxia ZHU ; Xiaohua HOU ; Xiaoli ZHANG ; Lifei ZHENG ; Lei ZHANG ; Xinxin WANG ; Xuan LI ; Xudong TANG
Journal of Traditional Chinese Medicine 2026;67(5):517-522
The brain-gut interaction theory is a multidimensional integrative concept based on the brain-gut axis, involving neural, endocrine, and immune regulatory networks as well as the gut microbiota. Zang-fu organs (脏腑) theory in traditional Chinese medicine (TCM) shows a high degree of consistency with the brain-gut interaction theory, and the core functions such as the spleen and stomach governing the ascending of the clear and descending of the turbid, the liver governing the free flow of qi, and the heart governing mental and emotional activities are closely associated with the multi-level regulatory mechanisms of the brain-gut axis. TCM therapy can modulate brain-gut interactions through multiple pathways in the treatment of spleen and stomach diseases, including the regulation of gastrointestinal hormone secretion, neurotransmitter levels, the hypothalamic-pituitary-adrenal (HPA) axis, immune homeostasis and inflammatory responses, as well as the gut microecology. However, current basic research on the brain-gut interaction theory in TCM for spleen and stomach diseases still faces several challenges, such as difficulties in integrating TCM spleen-stomach theory with modern pathophysiology, lack of innovation in research concepts, and limitations in research methodologies. It is therefore proposed that multidisciplinary collaboration, multi-omics technologies, and targeted research approaches should be adopted to provide more comprehensive methods for basic research on TCM spleen and stomach diseases, thereby promoting the in-depth development of brain-gut interaction theory.
4.Mechanisms of Tongmai Yangxin Pills and Tongxinluo Capsules in Treating Myocardial No-reflow Based on Treating Same Disease with Different Methods
Siqi LIU ; Wenqing YANG ; Ting CHEN ; Yan TANG ; Ju WANG ; Yaxuan PENG ; Haoxue QIN ; Lanyue DENG ; Jialu GONG ; Ning XU ; Shuying ZHANG ; Wei ZHANG ; Ting CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(17):125-133
ObjectiveTo investigate the mechanisms of Tongmai Yangxin pills (TMYX) and Tongxinluo capsules (TXL) in treating no-reflow (NR) after myocardial ischemia and reperfusion following the concept of treating the same disease with different methods, based on integrative pharmacology and experimental validation. MethodsEighty 8-week-old SPF-grade SD rats were randomly assigned into four groups (n=20): sham operation, NR, TMYX (4 g·kg-1), and TXL (2 mg·kg-1). A rat model of myocardial ischemia-reperfusion no-reflow was established by in-situ ligation of the left anterior descending coronary artery. Gastric gavage was first performed 4 h after the operation, and samples were collected on day 7. Thioflavin S staining was used to observe the NR area in rat myocardium. Echocardiography was performed to examine the cardiac function. Hematoxylin-eosin (HE) staining was conducted to observe the pathological changes of the myocardial tissue. An automatic biochemical analyzer was adopted to measure myocardial enzyme activity. Then, integrated pharmacology was applied for Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Finally, Western blot was employed to quantify the protein levels of key targets in the myocardial tissue, including soluble guanylyl cyclase (sGC), cyclic guanosine monophosphate (cGMP)/dependent protein kinase (PKG), phosphorylated phosphatidylinositol 3-kinase (p-PI3K), phosphorylated protein kinase B (p-Akt), and hypoxia-inducible factor-1α (HIF-1α). ResultsCompared with the sham operation group, the NR group showed increased NR area of myocardium, decreased left ventricular ejection fraction (EF), left ventricular fractional shortening (FS), left ventricular outflow tract peak velocity (LVOT Peak), and left ventricular stroke volume (LVSV) (P<0.01), fractured and disordered myocardial fibers as well as inflammatory cell infiltration in the myocardial tissue, enhanced activities of creatine kinase (CK), creatine kinase isoenzyme (CK-MB), and lactate dehydrogenase (LDH) in the myocardial tissue (P<0.01), and downregulated protein levels of sGC, PKG, phosphorylated (p)-PI3K (Tyr458), and p-Akt (Tyr315) in the myocardial tissue (P<0.05, P<0.01). The expression level of HIF-1α protein showed a downward trend. Compared with the NR group, the TMYX group and TXL group exhibited a decreasing trend in myocardial NR area, EF, FS, and LVOT Peak significantly increased (P<0.05, P<0.01), LVSV showed an upward trend, ameliorated myocardial pathological morphology and inflammatory infiltration, reductions in CK, CK-MB, and LDH activities (P<0.05, P<0.01), and upregulated protein levels of sGC, PKG, p-PI3K (Tyr458) in myocardial tissue (P<0.05, P<0.01), the protein expressions of p-Akt (Tyr315) and HIF-1α showed an upward trend. A comparison of the therapeutic effects between the two compound prescriptions showed that TMYX tended to exert a better effect in restoring cardiac function and protecting cardiac structure in NR rats, whereas TXL was more effective in reducing myocardial NR area and lowering myocardial enzyme activities in NR rats. Integrative pharmacology analysis combined with experimental verification demonstrated that both TMYX and TXL could alleviate NR through the following mechanisms: activating the cyclic cGMP/PKG signaling pathway to regulate vascular tone, activating the PI3K/Akt signaling pathway to dilate blood vessels, and activating the HIF-1 signaling pathway to inhibit oxidative stress. However, TMYX had an advantage in activating the cGMP/PKG pathway, while TXL was superior in activating the PI3K/Akt pathway. The two compound prescriptions exerted comparable effects on the HIF-1 signaling pathway, which might serve as their common therapeutic pathway. ConclusionBoth TMYX and TXL could alleviate NR damage. TMYX exerts its protective effect against NR mainly by activating the cGMP/PKG signaling pathway, while TXL exerts its effect mainly through the PI3K/Akt pathway. The HIF-1α signaling pathway may be a common pathway for the two compound prescriptions to exert their protective effects against NR. This study reveals the similarities and differences between TMYX and TXL in the treatment effect and mechanism for NR, providing an experimental basis and a theoretical basis for better clinical application of the two compound prescriptions.
5.Prediction and verification of the mechanism of action of Jiawei qifang weitong granule in ameliorating precancerous lesions of gastric cancer
Wenlong CHEN ; Meiwen TANG ; Yeping YU ; Xinyuan CHEN ; Long PANG ; Changzhou XIONG ; Yingye LIANG ; Ting WANG
China Pharmacy 2026;37(15):1948-1953
OBJECTIVE To predict and verify the mechanism of Jiawei qifang weitong granule in ameliorating precancerous lesions of gastric cancer (PLGC). METHODS Transcriptomic data of PLGC-related were obtained from the GEO database to screen differentially expressed genes and conduct functional enrichment analysis. Targets related to gastric mucosal injury repair were screened via the GeneCards database. The active ingredient targets of Jiawei qifang weitong granule were predicted using the TCMSP and other databases. The intersection of differentially expressed genes, gastric mucosal repair targets and active ingredient targets was extracted. A protein-protein interaction network was constructed based on the STRING database, and the top 6 hub target genes with the highest connectivity were screened. A PLGC rat model was established by combining 1-methyl-3-nitro-1-nitrosoguanidine with alternating fasting and full feeding. Model rats were divided into model group, weifuchun group (positive control, 0.40 g/kg), low-, medium- and high-dose Jiawei qifang weitong granule groups (9.73, 19.44, 38.90 g/kg), with 10 rats in each group. Another 10 unmodeled rats were set as control group. Rats in each group were intragastrically administered corresponding liquid medicine or normal saline once a day for 30 consecutive days. After the last administration, pathological morphological changes of rat gastric tissues were observed, and the mRNA expression levels of hub target genes as well as partial protein expression levels in gastric tissues were detected. RESULTS Transcriptomics and network pharmacology analyses revealed that the top 6 hub target genes ranked by connectivity included MMP9 (matrix metalloproteinase 9), BCL2(B-cell lymphoma 2), IL10(interleukin 10),ICAM1(intercellular adhesion molecule 1), PTGS2 (prostaglandin-endoperoxide synthase 2), and HIF1A (hypoxia-inducible factor 1α subunit). Animal experiments showed that compared with the model group, gastric mucosal pathological injury was significantly alleviated in medium- and high-dose Jiawei qifang weitong granule groups and weifuchun group. The pathological injury score of gastric mucosa, the mRNA expression levels of MMP9, PTGS2, ICAM1, BCL2 and HIF1A, as well as the protein expression levels of PTGS2 and BCL2 in gastric tissues were significantly decreased (P<0.05), while the mRNA expression level of IL10 was significantly increased (P<0.05). CONCLUSIONS Jiawei qifang weitong granule may ameliorate PLGC by targeted down-regulating the mRNA expression of MMP9, PTGS2, ICAM1, BCL2 and HIF1A, up-regulating IL10 mRNA expression, and regulating the imbalance between gastric mucosal inflammatory response and injury repair.
6.Expert consensus on basic public services for vision health management of primary and secondary school students
YANG Lihua , WU Xi, TAO Shuman, YAO Jun, WU Fengbo, LIU Fangli, MA Yinghua, FENG Zhanchun, SUN Renbiao, LIU Dongru, CHEN Qiusheng, CHEN Jie, YU Yizhen, ZHANG Mingchang, WU Xiaoyan, DU Yukai, LI Xiaoqing, LI Li, WU Xixi, JIN Xiaoqin, XU Ting, WU Mengjia, TANG Jia, Society of Student Vision Health Management of Chinese Health Association, Vision Health Branch of Chinese Association for Student Nutrition & ; Health Promotion
Chinese Journal of School Health 2026;47(8):1069-1074
Abstract
To clarify the service targets, service contents, and safeguard mechanisms of the basic public service program for student vision health management, the study grounded in the current status of child and adolescent myopia prevention and control in China and integrated with the practical experience and innovative practices of Wuhan National Demonstration Area for Student Vision Health Management, takes education as the main thread and schools as the base, consolidating resources from multiple stakeholders including education administrative departments, schools, families, and professional technical service institutions. Centering on four core components—vision health education, monitoring and record keeping, risk prevention and control, and dynamic management, the study constructs a multi tiered basic public service system for vision health management of primary and secondary school students. It further proposes the use of an intelligent management platform and a "three tier color coded early warning" mechanism (red, yellow, blue) to prevent and control student myopia at the source, providing schools with replicable and operable implementation pathways to enhance the level of student vision health management.
7.Mechanism of Modified Danggui Shaoyaosan in Improving Inflammation and Apoptosis in Acne via Regulating JNK/p38 MAPK Pathway
Gongzhen CHEN ; Yuqi YANG ; Xin LIU ; Ting TANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):31-40
ObjectiveTo explore the therapeutic effects and mechanisms of modified Danggui Shaoyaosan on acne based on the c-Jun N-terminal kinase (JNK)/p38 mitogen-activated protein kinase (p38 MAPK) pathway. MethodsA rat ear acne model was established in SD rats, and the rats were divided into a blank group, a model group, and low-, medium-, and high-dose groups of modified Danggui Shaoyaosan (7.15, 14.30, 28.60 g·kg·d-1), with six rats in each group. After the administration for 14 consecutive days, morphological changes in the rats' auricles were observed, and hematoxylin-eosin (HE) staining was used to examine the pathological changes in the acne-affected ear tissue. Enzyme-linked immunosorbent assay (ELISA) was employed to measure the levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the ear tissue. Quantitative reverse transcription polymerase chain reaction (Real-time PCR) was performed to detect the mRNA expression levels of Caspase-3, B cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), JNK, and p38 MAPK in the ear tissue. Additionally, Western blot analysis was conducted to assess the protein levels of Caspase-3, Bcl-2, Bax, JNK, and p38 MAPK in the ear tissue. The active components and key targets of modified Danggui Shaoyaosan in the treatment of acne were identified through network pharmacology analysis. Molecular docking was then employed to evaluate the interactions between the main active components and the key targets. ResultsThe results of the animal experiment demonstrated that compared with those in the blank group, rats in the model group exhibited redness, swelling, thickening, hardening, dryness, and roughness of the auricle. The surface showed sebaceous scales and desquamation, accompanied by acne-like lesions such as papule-like elevations or cysts. Histopathological changes included keratinization, epidermal thickening, dermal collagen fiber degeneration and necrosis, subcutaneous muscle degeneration and necrosis, inflammatory cell infiltration, and fibrous tissue proliferation. The mRNA and protein expression levels of IL-1β, TNF-α, Caspase-3, Bax, JNK, and p38 MAPK were significantly increased (P<0.01), while those of Bcl-2 were significantly decreased (P<0.01). In comparison to the model group, the modified Danggui Shaoyaosan groups showed marked improvement in acne-like lesions of the auricle, with varying degrees of histopathological damage reduction. Additionally, the mRNA and protein expression levels of IL-1β, TNF-α, Caspase-3, Bax, JNK, and p38 MAPK in the tissue were significantly decreased (P<0.05, P<0.01), while those of Bcl-2 were significantly increased (P<0.05, P<0.01). Network pharmacology analysis indicated that the key compounds in modified Danggui Shaoyaosan responsible for its effects in treating acne may include acacetin, kaempferol, luteolin, quercetin, wogonin, and baicalein. These compounds exerted their effects by modulating core targets such as TNF, IL-1β, Caspase-3, and Bcl-2, thereby alleviating inflammation and apoptosis and ultimately improving acne symptoms. ConclusionModified Danggui Shaoyaosan may exert its therapeutic effects on acne by inhibiting the activation of the JNK/p38 MAPK pathway, thereby alleviating inflammation and apoptosis.
8.Mitochondrial Transcription Factor B1(TFB1M)Is Highly Expressed in Colon Cancer and Promotes Cell Growth Based on Bioinformatics Database
Zhi-Gao OU ; Hui-Ying CHEN ; Ting TANG ; Jian-Jun ZHU
Chinese Journal of Biochemistry and Molecular Biology 2025;41(1):125-135
Mitochondrial transcription factor B1(TFB1M)is mainly involved in mitochondrial DNA transcription and related to the development of hepatocellular carcinoma and breast cancer.However,its role in colon cancer is unclear.In this study,the expression level of TFB1M in colon cancer and its prognosis were analyzed based on TCGA and other databases and IHC assays.Differentially expressed genes(DEGs)were screened and subjected to the analysis of functional enrichment,mutation analysis,immune cell infiltration,and drug sensitivity analysis.CCK-8 and flow cytometry were used to detect the effects of overexpression of TFB1M on the viability,apoptosis and cell cycle distribution of colon cancer cells.Our results showed that the expression level of TFB1M was significantly up-regulated in colon canc-er,and its expression level was correlated with the N stage and TNM stage(P<0.05).The prognosis of colorectal cancer patients in the high TFB1M expression group was worse.Functional enrichment results showed that TFB1M was related to leukocyte-mediated immunity,immunoglobulin production and other signaling pathways.Mutation results showed that high-frequency mutated genes,such as ZFHX4,RYR2,PIK3CA and FAT4,had significantly higher mutation frequencies in the TFB1M high-expression group(all P<0.05).In addition,the expression level of TFB1M was significantly higher in the PIK3CA and FAT4 mutation groups(all P<0.05).Immune infiltration results showed that the percentage of CD4+memory activated T cells was increased in the TFB1M high expression group,while the percentage of Treg cells was reduced.The drug sensitivity results showed that patients in the TFB1M high expression group might be more sensitive to Tozasertib,cytarabine,vincristine,etc.,while patients in the TFB1M low expression group might be more sensitive to Dasatinib,JQ1,ERK_2440,etc.The results of cellular experiments showed that over-expression of TFB1M enhanced viability,reduced apoptosis and increased the percentage of S-phase and G2/M-phase cells in colon cancer cells.Altogether,the results indicated that TFB1M might play a key role in the growth of colon cancer cells by regulating immune cell infiltration and function.
9.Analysis on current status and outcomes of comprehensive control of cardiovascular disease risk factors based on community population cohort
Caixia SU ; Xiaofei LIU ; Peng SHEN ; Yexiang SUN ; Tianjing ZHOU ; Ting WANG ; Qi CHEN ; Hongbo LIN ; Xun TANG ; Pei GAO
Chinese Journal of Epidemiology 2025;46(5):768-775
Objectives:To describe the use of antihypertensive, antidiabetic and lipid-lowering drugs, and evaluate the effects on blood pressure, blood glucose and blood lipids controls required by Chinese Guideline on the Primary Prevention of Cardiovascular Diseases (the guideline) in a community-based cohort of individuals at high risk for cardiovascular disease. To analyze the association of the uses of antihypertensive, antidiabetic and lipid-lowering drugs, and the comprehensive control of blood pressure, blood glucose and blood lipids with cardiovascular disease. Methods:From the CHinese Electronic health Records Research in Yinzhou (CHERRY), those who were at high risk for cardiovascular disease and aged 40-75 years as of January 1, 2013 in in Yinzhou District of Ningbo, Zhejiang Province were selected as study subjects. The information about their antihypertensive, antidiabetic, and lipid-lowering drug uses between 2013 and 2015 was collected, and blood pressure, blood glucose, and blood lipid measurements were conducted during the follow-up. The study constructed two kinds of comprehensive scores: the comprehensive medication score based on the guideline requirement for the treatment of hypertension, diabetes and hyperlipidemia, dividing the study participants into the compliancy group and non-compliancy group; and the comprehensive control score based on the guideline requirement for blood pressure, blood glucose, and blood lipids control, dividing the study participants into better control group, moderate control group, and poor control group. Cox proportional hazards regression model was used to analyze the association of the comprehensive medication score and comprehensive control score with cardiovascular disease. The incidence data of cardiovascular disease were collected from January 1, 2015 (baseline time) to August 31, 2020 (follow up end time).Results:A total of 79 734 participants at high risk for cardiovascular disease were included in the study, in whom 68.4%, 27.4%, and 4.2% had 1, 2, or 3 cardiometabolic conditions (hypertension, diabetes, or hyperlipidemia), respectively. In the participants with hypertension, diabetes, and hyperlipidemia from 2013 to 2015, the proportions of those who had two years of medication compliancy records were 66.0%, 67.4%, and 13.9%, respectively. In the hypertension patients, 59.2% had better blood pressure control, in the diabetes patients, 28.7% had better blood glucose control, and in the patients with hyperlipidemia, 27.4% had better blood lipid control. After a median follow-up of 5.66 years, 4 088 cardiovascular disease cases or deaths occurred. After multivariate adjustment, compared with the non-compliancy group, the compliancy group had lower risk for cardiovascular disease ( HR=0.91, 95% CI: 0.85-0.96). Compared with the better control group, the poor control group had an increased risk for cardiovascular disease ( HR=1.67, 95% CI: 1.53-1.81). In the moderate control group, the risk increased significantly in the diabetes patients ( HR=1.29, 95% CI: 1.07-1.56), while no additional risk for cardiovascular disease was observed in non-diabetes patients ( HR=1.06, 95% CI: 0.97-1.16). Conclusions:Compliancy to the medication required by the guideline is associated with lower risk for cardiovascular disease. However, it is still necessary to improve the medication compliancy in people at high risk in primary prevention, especially in the patients with hyperlipidemia, due to their low taking rate of lipid-lowering drugs. Additionally, as the requirement of the guideline becomes more stringent, the management of disease has met more challenges. Notably, diabetes patients who have not met the guideline requirement are at high risk for cardiovascular disease, to whom the disease management should be strengthened.
10.Finite element analysis of treatment for Sanders type IIB intra-articular calcaneal fracture by percutaneous screws
Yixuan CHEN ; Jiachen WU ; Chang LIU ; Tianyi WU ; Shang GUO ; Jiangyu CAI ; Ting WANG ; Mingjie TANG ; Zhongmin SHI ; Xin MA
Chinese Journal of Orthopaedics 2025;45(19):1241-1250
Objective:To evaluate the stability of percutaneous screw fixation for minimally invasive treatment of intra-articular calcaneal fractures using three-dimensional finite element analysis.Methods:CT scan was performed on the calcaneus of a normal adult for three-dimensional reconstruction. The DICOM data were imported into Mimics software to establish a model of a Sanders type IIB intra-articular calcaneal fracture. Based on the Essex-Lopresti classification of posterior facet morphology, the model was subdivided into two subtypes: tongue-type and depression-type. The calcaneus was divided into four fragments: sustentaculum tali, posterior tuberosity, anterior process (three points), and posterior articular surface (one surface). Two types of fixation methods, classical lateral anatomical plates and combinations of percutaneous screws, were simulated and performed. A three-dimensional finite element analysis was conducted by applying a stress combination of 420 N on the posterior subtalar articular surface, 200 N on the middle subtalar articular surface, and 300 N at the Achilles tendon insertion point. The maximum displacement and von Mises stress values of each bone fragment and implant were recorded to evaluate the biomechanical stability. For clinical validation, 34 patients with Sanders type IIB calcaneal fractures from Orthopedics Department of the Sixth Affiliated People's Hospital of Shanghai Jiao Tong University were treated with percutaneous reduction and screw fixation using the following configurations.Results:Under simulated stress, the A4 group with medial support screws in the tongue-type fracture subgroup demonstrated minimal overall calcaneal displacement (0.22 mm) and internal fixation displacement (0.14 mm). For the depression-type, the B2 group with medial support screws showed lower maximum stress in the calcaneus and internal fixation, at 22.04 MPa and 41.14 MPa, respectively, along with the lowest overall displacement (0.14 mm). The peak stress of all groups of implants remained below the material yield strength. The A4 and B2 protocols were applied to 15 cases of tongue-type calcaneal fractures and 19 cases of collapse-type calcaneal fractures. At the final follow-up The American Orthopaedic Foot & Ankle Society ankle-hindfoot score scale was 86.1±5.82 and 87.2±5.18, respectively, while the visual analog scale for pain was 1.60±1.24 and 1.58±1.02, respectively.Conclusions:Percutaneous screw fixation provided reliable stability for Sanders type IIB calcaneal fractures. The fixation configuration incorporating a medial support screw offers superior biomechanical performance in both tongue-type and depression-type fractures, representing an optimized minimally invasive technique with strong clinical applicability.


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