1.Minimally invasive management of spontaneous renal vascular rupture:a report of two cases
Jizong LYU ; Fei LIU ; Feng LI ; Guangli FAN ; Baoming YANG ; Siwei GONG ; Yuanlong ZHANG ; Yao ZHAI ; Ke WANG
Journal of Modern Urology 2026;31(2):157-159
Objective To investigate the diagnosis and treatment of 2 cases with spontaneous renal vascular rupture, and discuss the possible causes and treatment methods of this disease. Methods The clinical data and treatment methods of the 2 patients with spontaneous renal vascular rupture treated with renal artery embolization in Universal Global Xi'an Beihuan Hospital were analyzed. Relevant literature was reviewed to summarize the possible causes of this condition. Results The patients had no obvious history of trauma and no obvious abnormal coagulation function, and sought treatment due to sudden lumbar and abdominal pain. Laboratory tests revealed significantly decreased hemoglobin level, and elevated blood glucose (27.8, 27.6mmol/L). Abdominal computed tomography (CT) indicated perirenal hematoma and active bleeding. The bleeding arteries were located at the terminal branches of the anterior renal artery. Precise embolization was performed using CT angiography and selective renal artery angiography plus embolization, achieving an immediate hemostasis success rate of 100%. Postoperative hemoglobin level stabilized, and follow-up CT scans showed significant absorption of the perirenal hematoma without significant deterioration of renal function. Based on literature review and case analysis, the possible cause of spontaneous renal vascular rupture in these two patients was renal vascular sclerosis due to long-term diabetes. Other common etiologies of this condition included renal tumor, vascular malformation, and hypertension. Conclusion Spontaneous renal vascular rupture is rare. Renal artery embolization, as aminimally invasive treatment, can effectively control bleeding and protect renal function. The specific pathogenesis of this condition still requires further investigation. Long-term diabetes mellitus with poor blood glucose control may be associated factors, but more evidence is needed.
2.Xiao Chaihutang Combined with Erchen Tang Ameliorates Metabolic-associated Fatty Liver Disease in Mice by Regulating SIRT1/PGC-1α/PPARα Signaling Pathway
Kai LIU ; Chenfang ZHANG ; Chaowen FAN ; Qiuyue YAO ; Zunli KE
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(18):69-76
ObjectiveTo investigate the ameliorating effect of Xiao Chaihutang combined with Erchen Tang (XAE) on metabolic-associated fatty liver disease (MAFLD) in mice and the influence of this therapy on the silent information regulator 1 (SIRT1)/peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α)/peroxisome proliferator-activated receptor α (PPARα) signaling pathway. MethodsForty-eight C57BL/6 mice were randomized into six groups: normal (CHOW), atorvastatin (ATO, 0.05 g·kg-1), high-fat diet (HFD), low-dose XAE (XAE-L, 10 g·kg-1), medium-dose XAE (XAE-M, 20 g·kg-1), and high-dose XAE (XAE-H, 40 g·kg-1). Each group contained 8 mice. Except the CHOW group, the other groups of mice were fed a HFD for the modeling of MAFLD. The experiment lasted for 20 weeks. Starting from the 13th week, mice were administered corresponding agents daily by gavage, and the mice in both the CHOW and HFD groups received equal volumes of purified water. At the end of the experiment, cardiac blood, liver, and adipose tissue samples were collected. Pathological staining was performed on the liver and adipose tissue separately. The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC) in the serum, as well as TG and TC in the liver, were determined. Additionally, the mRNA levels of fatty acid synthetase (FASN), stearoyl-CoA desaturase 1 (SCD1), sterol regulatory element-binding protein 1c (SREBP-1c), SIRT1, PPARα, PGC-1α, interleukin 6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α) in the liver were measured by real-time PCR. The protein levels of SIRT1, PGC-1α, PPARα, and CPT1α in the mouse liver tissue were determined by Western blot. ResultsCompared with the CHOW group, the HFD group exhibited increased body weight, liver weight, and white adipose tissue weight (P<0.01). After XAE intervention, these parameters were reduced compared with those in the HFD group (P<0.01). Pathological section results showed that the morphology of hepatocytes and epididymal white adipocytes in the model mice was significantly improved after XAE intervention, with decreases in both the number and volume of lipid droplets. Furthermore, the XAE groups had lower levels of AST, ALT, HDL-C, LDL-C, TG, and TC in the serum and TG and TC in the liver than the HFD group (P<0.05,P<0.01). Moreover, XAE administration downregulated the mRNA levels of lipid synthesis-related genes (FASN and SCD1) (P<0.05) and upregulated the mRNA levels of lipid oxidation-related genes (SIRT1, PPARα, and PGC-1α) (P<0.05,P<0.01). Additionally, the protein levels of SIRT1, PGC-1α, PPARα, and CPT1α in the liver were upregulated after XAE treatment compared with those in the HFD group (P<0.05,P<0.01). ConclusionXAE exerts a therapeutic effect on MAFLD by activating the SIRT1/PGC-1α/PPARα signaling pathway.
3.Convergent modulation of default mode network effective connectivity by modified Suanzaoren Decoction and estazolam in patients with chronic insomnia disorder
Ke WANG ; Yiding HAN ; Haohao YAN ; Xingyan GUO ; Wuhong LIN ; Ping YAO ; Min LIU ; Min CHEN ; Longbiao CUI ; Wenbin GUO ; Dongsheng LYU
Sichuan Mental Health 2026;39(4):356-366
BackgroundBoth modified Suanzaoren Decoction and estazolam serve as effective treatments for chronic insomnia disorder (CID). Default mode network (DMN) dysfunction is recognized as the primary pathophysiological mechanism underlying CID. However, it remains unclear whether the two treatments exert their therapeutic effects via convergent modulation of DMN functional connectivity. ObjectiveTo investigate the convergent remodeling characteristics of bidirectional effective connectivity (EC) of core DMN nodes with both the intra-network and the remaining whole-brain regions in CID patients with Yin-deficiency and fire-hyperactivity syndrome following the treatment with modified Suanzaoren Decoction or estazolam, so as to provide neuroimaging evidence for the convergent neural mechanisms underlying the therapeutic effects of both therapies in treating CID. MethodsEighty-two patients diagnosed with CID according to the International Classification of Sleep Disorder, third edition (ICSD-3) were consecutively recruited from the outpatient clinic of the Inner Mongolia Autonomous Region Mental Health Center from October 2020 to September 2023. Based on treatment preference, patients were assigned to receive a 6-week intervention in either the modified Suanzaoren Decoction group (n=52) or the estazolam group (n=30). Ultimately, 66 patients completed follow-up assessments (modified Suanzaoren Decoction group, n=41; estazolam group, n=25). All CID patients underwent resting-state functional magnetic resonance imaging scanning before and after treatment. Core DMN nodes including medial prefrontal cortex (mPFC), bilateral inferior parietal lobule (IPL), and precuneus (PCUN) were selected as seed regions. Granger causality analysis (GCA) was employed to assess bidirectional EC between the seed regions and both the other intra-DMN nodes and the remaining whole-brain regions. Hepatic and renal function indices were detected pre- and post-treatment to evaluate the safety profiles of both treatments. ResultsAt baseline, significant between-group differences were identified in EC from the left IPL to the left middle fronto-orbital gyrus/gyrus rectus (t=5.24, Z=4.84, voxel-level P<0.001, cluster-level P<0.05, GRF-corrected), with the modified Suanzaoren Decoction group exhibiting stronger EC than the estazolam group. No significant between-group differences were observed in EC between other core DMN nodes and remaining whole-brain regions (P>0.05). Within-group pre- to post-treatment comparisons demonstrated consistent connectivity alterations in both groups. Specifically, EC from the left IPL to the supplementary motor area (SMA) decreased after treatment (modified Suanzaoren Decoction group: t=-6.28, Z=5.208; estazolam group: t=-5.58, Z=4.425). Conversely, EC from the SMA to the left IPL increased (modified Suanzaoren Decoction group: t=5.89, Z=4.968; estazolam group: t=6.15, Z=4.720). Furthermore, both groups demonstrated reduced EC from the PCUN to the left IPL (modified Suanzaoren Decoction group: t=-5.85, Z=4.94; estazolam group: t=-5.75, Z=4.515), and elevated EC from the left IPL to the PCUN (modified Suanzaoren Decoction group: t=5.29, Z=4.579; estazolam group: t=4.55, Z=3.826) (voxel-level P<0.001, cluster-level P<0.05, GRF-corrected). No significant pre- to post-treatment differences were observed in hepatic or renal function indices in either group (P>0.05). ConclusionIn CID patients with Yin-deficiency and fire-hyperactivity syndrome, both modified Suanzaoren Decoction and estazolam induce convergent bidirectional remodeling of EC between the left IPL and the SMA and the PCUN. [Funded by Natural Science Fund Project of Inner Mongolia Autonomous Region (number, 2019MS08099); ClinicalTrials.gov number, NCT06452953]
4.Preparation and hydrolytic activity analysis of dual-catalytic-triad PETase
Qiudong SU ; Xining YAO ; Feng QIU ; Feng WANG ; Shuang ZHANG ; Ke XU ; Shengli BI ; Yanhai WANG
Acta Universitatis Medicinalis Anhui 2026;61(3):546-551
ObjectiveTo prepare a recombinant PETase with a dual-catalytic-triad and to evaluate its efficiency in the biodegradation of polyethylene terephthalate (PET). MethodsBased on the crystal structure of wild-type PETase, point mutations (T88H/L117D) were introduced via site-directed mutagenesis. The recombinant protein was prepared using prokaryotic expression and chromatography purification techniques. The enzymatic hydrolysis of the mutant PETase was assessed by relatively quantifying the products mono (2-hydroxyethyl) terephthalate (MHET) and terephthalic acid (TPA). ResultsBoth wild-type and mutant PETases accumulated as inclusion bodies, accounting for approximately 20% of the total bacterial protein. After solubilization in urea, the proteins were eluted at 300 mmol/L imidazole during affinity chromatography purification, with concentrations of 1.824 and 1.833 mg/mL and purities of 83.11% and 84.32%, respectively. Subsequent anion-exchange chromatography yielded highly pure enzymes in the 200 mmol/L NaCl fraction: 2.776 mg/mL (96.86% purity) for the wild type and 1.967 mg/mL (95.13% purity) for the mutant. Following refolding, the final concentrations were 0.484 mg/mL for the wild type and 0.991 mg/mL for the mutant. Hydrolysis assays revealed that the mutant released MHET and TPA at (237.67±17.00)% and (197.33±12.01)% of the wild-type levels, respectively. ConclusionThe T88H/L117D dual-catalytic-triad PETase is successfully prepared and it significantly enhanced PET-degrading activity, thus, it′s a promising biocatalyst for PET bioremediation.
5.Based on Experimental Verification, Mechanism of Euphorbia humifusa in Treatment of Acute Kidney Injury was Explored
Lijuan ZHANG ; Xuehai JIA ; Yaping GUO ; Shunying LI ; Lu YANG ; Dahong YAO ; Ke ZHANG ; Hangyu WANG ; Jinhui WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(13):166-176
ObjectiveTo explore the efficacy and mechanism of Euphorbia humifusa on acute kidney injury (AKI) based on network pharmacology, molecular docking and experimental verification. MethodsThe active components and targets of E. humifusa were retrieved from TCMSP and SwissTargetPrediction database, and the AKI targets were screened by GeneCards and Online Mendelian Inheritance in Man(OMIM) databases. The drug targets and disease targets were intersected to construct a protein-protein interaction network, and the intersection targets were subjected to gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis. Discover Studio software was used to verify the molecular docking of key components and core targets. Gentamicin (GM) was used to induce AKI rat model. Control group, model group, verapamil (16 mg·kg-1) group, E. humifusa extract (18, 54, 162 mg·kg-1·d-1) group and E. humifusa 70% ethanol extract (423 mg·kg-1) group were continuously administered for 14 days. Urine volume was detected 24 h after modeling and administration. Serum creatinine (SCr), Blood urea nitrogen (BUN), 24-hour urine protein (24 hUTP) and uric acid (UA) content; the contents of malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), carbon monoxide synthase (NOS) and lactate dehydrogenase (LDH) in kidney were measured. The levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α in serum were detected by enzyme linked immunosorbent assay(ELISA) kit. The pathological changes of renal tissue were detected by hematoxylin-eosin (HE) and Masson staining. Western blot was used to detect the expression of PI3K/protein kinase B(Akt)/NF-κB signaling pathway-related proteins. ResultsIn this study, 13 active components such as kaempferol, luteolin, apigenin, gallic acid and quercetin were screened and identified from E. humifusa. Through bioinformatics analysis, these components and AKI have a total of 289 targets, of which 62 are core targets, including Akt1, TNF, tumor protein p53(TP53) and IL-1β. These targets are mainly involved in the regulation of biological processes such as NF-κB signaling pathway, HIF-1 signaling pathway, TNF signaling pathway, PI3K/Akt signaling pathway and mitogen-activated protein kinase(MAPK) signaling pathway. In animal experiments, we successfully constructed a GM-induced AKI model in rats. Compared with the model group, E. humifusa extract could significantly reduce the levels of 24 hUTP, BUN and SCr in rats (P<0.01), indicating its improvement effect on renal function. In addition, the extract of E. humifusa also significantly reduced LDH activity and MDA content in rat kidney tissue (P<0.05, P<0.01), and significantly increased SOD, NOS activity and GSH content (P<0.05), indicating that the extract of E. humifusa has the potential of anti-oxidation and protection of renal function. Further analysis of inflammatory factors showed that the levels of IL-6 and TNF-α in serum of rats treated with E. humifusa extract were significantly decreased (P<0.01), indicating that E. humifusa extract had anti-inflammatory effects. In addition, the extract of E. humifusa can also regulate the protein expression of PI3K/Akt/NF-κB signaling pathway, which further confirmed its mechanism of reducing GM-induced AKI. ConclusionThe extract of E. humifusa has a significant therapeutic effect on acute kidney injury through its multi-component and multi-target mechanism. Its effect is reflected in improving renal function, anti-oxidation, anti-inflammation and regulating immune response. These findings provide a scientific basis for the application of E. humifusa in the treatment of acute kidney injury, and point out the direction for future drug development and clinical research.
6.Changes in Astronaut Brain Function and Behavior Associated With Habitation on Low-Earth-orbit Space Stations
Hong-Ting JIANG ; You-Fu LUO ; Zheng-Jiang YANG ; Yuan YAO ; De-Zhong YAO ; Ke CHEN
Progress in Biochemistry and Biophysics 2026;53(10):2786-2796
During habitation on low-Earth-orbit (LEO) space stations, astronauts are exposed to a combination of orbital microgravity, space radiation, an enclosed and artificially controlled cabin environment, altered sleep-wake rhythms, and sustained operational and psychosocial demands. These factors can modify sensorimotor inputs, body-fluid distribution, arousal state, and task-related neural processing, thereby affecting brain function and behavior. Because evidence from real spaceflight remains limited by small samples, heterogeneous mission durations, and different measurement time points, this review integrates findings from real human spaceflight with relevant ground-based analog studies while treating real orbital studies as the primary source of evidence. We focus on electroencephalography (EEG) and event-related potentials (ERPs), structural and functional neuroimaging, and sensorimotor and cognitive outcomes, with particular attention to the direction, anatomical distribution, temporal course, and possible physiological significance of the reported changes. EEG studies indicate that long-duration spaceflight is associated with increased resting-state beta activity, particularly in sensorimotor and frontotemporal regions, together with state-dependent alterations in beta-band functional connectivity. In contrast, alpha source power and functional connectivity associated with the default mode network are reduced during long-duration missions, and some of these effects may persist into the early postflight period. Task-related electrophysiological findings further suggest that sustained mental workload can weaken frontocentral theta-temporoparietal gamma phase-amplitude coupling, whereas in-flight decision-making is accompanied by reduced P300 amplitude and reorganization of feedback-related potentials. Short-duration missions, however, have shown relative preservation of posterior dominant rhythms and some ERP measures, indicating that mission duration, recording state, and task demands substantially influence the observed electrophysiological phenotype. Neuroimaging provides complementary evidence at structural and network levels. Long-duration spaceflight has been associated with upward brain displacement, ventricular and cerebrospinal fluid expansion, regional gray- and white-matter remodeling, and alterations in white-matter structural connectivity. Functional magnetic resonance imaging (fMRI) studies further indicate reorganization of vestibular-sensorimotor, visual, and default mode networks. Some network changes recover after return to Earth, whereas others may remain detectable for months. Importantly, most MRI measurements are obtained after landing rather than in orbit; therefore, postflight findings may reflect a mixture of in-flight adaptation, the rapid transition back to 1 g, and subsequent readaptation rather than a single spaceflight effect. Behavioral evidence is most consistent for sensorimotor function. Early after return, astronauts frequently show impaired postural control, gait, spatial orientation, and coordination, consistent with reweighting among vestibular, visual, and proprioceptive information. By comparison, simple cognition and some critical operational tasks are often preserved. More subtle or high-load processes-including sustained attention, feedback evaluation, temporal processing, error monitoring, and metacognitive calibration may be more sensitive than global cognitive performance. This dissociation between neural change and preserved behavior suggests that altered brain activity should not automatically be interpreted as functional deterioration. Integrating the available modalities, we propose that LEO space-station habitation is better characterized by system-specific and stage-dependent neural adaptation than by a generalized increase or decline in brain function. The most coherent cross-modal pattern involves sensorimotor reorganization: reduced gravitational reference and weight-bearing feedback under microgravity may drive reweighting of vestibular, visual, and proprioceptive inputs, accompanied by changes in beta activity and vestibular-sensorimotor networks and followed by transient postflight sensorimotor deficits. A second major process involves fluid-related structural remodeling, in which cephalad fluid shifts and altered hydrostatic gradients may contribute to changes in cerebrospinal fluid spaces, ventricular volume, and brain tissue configuration. Resting-state and cognitive electrophysiological changes likely represent additional adjustments in network regulation and resource allocation, but their functional interpretation remains more dependent on sleep, workload, recording conditions, and individual differences. Future studies should move beyond isolated pre-post comparisons and group averages toward standardized longitudinal designs spanning preflight, multiple in-flight time points, and postflight recovery. Synchronized assessment of brain function, behavior, sleep, and key environmental parameters should be used to characterize individual adaptation trajectories and determine which neural changes reflect successful compensation, which predict delayed recovery, and which have genuine value for brain-health risk prediction and individualized countermeasures.
7.A multicenter study of allogeneic hematopoietic stem cell transplantation for stage 4/M neuroblastoma
Liping QUE ; Yao XUE ; Honggui XU ; Fenying ZHAO ; Wenguang JIA ; Shihao HUANG ; Xiaojun YUAN ; Yunyan HE ; Xiaojun XU ; Jianpei FANG ; Yongjun FANG ; Yang LI ; Ke HUANG
Chinese Journal of Pediatrics 2025;63(5):511-517
Objective:To evaluate the effectiveness and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with stage 4/M neuroblastoma (NB).Methods:This study was a prospective, single-arm, multicenter clinical trial conducted by Sun Yat-sen Memorial Hospital, Children′s Hospital of Nanjing Medical University, Children′s Hospital, Zhejiang University School of Medicine, the First Affiliated Hospital of Guangxi Medical University, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. From March, 2019 to August, 2023, 25 children with confirmed with stage 4/M NB and received allo-HSCT were enrolled. The patients received either unrelated cord blood transplantation (UCBT) or peripheral blood stem cell transplantation (PBSCT). Conditioning regimens for UCBT was fludarabine+busulfan+cyclophosphamide+topotecan, and for PBSCT was fludarabine+busulfan+melphalan+thiotepa+antithymocyte globulin, respectively. Until the last follow-up date of September, 2023, the overall survival (OS) rate and event free survival (EFS) rate were analyzed to evaluate efficacy. The engraftment rate and transplant-related complications were statistically assessed to evaluate safety. Survival analysis was performed using the Kaplan-Meier method.Results:Of the 25 patients, there were 15 males and 10 females. The age at transplantation was 5.7 (3.8, 7.3) years. The engraft rate was 100%, with recovery time of neutrophil as 15.7 (12.5, 17.0) d, and the recovery time of platelets as 33.5 (18.0, 48.0) d. Seventeen of the 25 children (68%) developed acute graft versus host disease (aGVHD), occurred at 18.0 (13.0, 22.5) d after transplantation, including 13 of grade Ⅲ-Ⅳ cases. The main sites of aGVHD were skin and intestinal tract. After treatment, 13 cases improved, 4 patients developed chronic graft-versus-host disease (cGVHD). After allo-HSCT, 14 children received maintenance therapy. Twenty of the 25 patients survived, the 2-year cumulative OS rate was (80±9)%, and 2-year EFS rate was (56±11)%. Nine cases (36%) relapsed, the time from allo-HSCT to disease relapse was 10.9 (5.5, 16.0) months. Five cases (20%) died. The hematopoietic stem cell transplantation associated mortality rate was 4% (1/25).The 2-year OS rate of patients who had partial remission prior to allo-HSCT was significant lower than those who had complete remission prior to allo-HSCT ((33±25)% vs. 100%, P=0.037). Conclusion:allo-HSCT is an effective treatment for patients with stage 4/M NB.
8.Research on the prevalence of overweight and obesity among children
Xinyi LIANG ; Jingnan CHEN ; Xuelian ZHOU ; Ruimin CHEN ; Jingsi LUO ; Rongxiu ZHENG ; Chunxiu GONG ; Chunlin WANG ; Zhe SU ; Mireguli MAIMAITI ; Yan LIANG ; Hui YAO ; Haiyan WEI ; Hongwei DU ; Shaoke CHEN ; Yu YANG ; Feihong LUO ; Pin LI ; Min ZHU ; Wei WU ; Ke HUANG ; Guanping DONG ; Junfen FU
Chinese Journal of Pediatrics 2025;63(6):612-619
Objective:To investigate the prevalence and risk factors of overweight and obesity among Chinese children aged 3-18 years from 11 provinces, antonomous regions, or municipalities.Methods:This national cross-sectional community health survey utilized a multistage stratified cluster-random sampling method to recruit 193 997 nationally representative participants from 11 provinces, autonomous regions, or municipalities between January 2017 and December 2019. All participants underwent physical examinations, and their caregivers completed questionnaires assessing participants′ dietary, lifestyle, familial, and perinatal information. Multilevel multinomial logistic regression models were employed to identify the potential risk factors.Results:The cohort comprised 193 997 children (102 178 boys, 91 819 girls),aged (10±4) years. Overall prevalence rates were 30 574(15.8%)overweight children and 17 217(8.9%) obesity children. Boys exhibited higher overweight and obesity rates than girls (17.0% (17 368/102 178) vs. 14.4% (13 206/102 178), 11.3% (11 553/91 819) vs. 6.2% (5 664/91 819), χ2=249.12,1 578.69,both P<0.001). The detection rates of obesity in Tanner stage 2 and 3 were the highest in boys and girls, with 13.4%(2 231/16 665) and 8.6%(880/10 221) respectively. Risk factors for obesity included parental overweight (paternal OR=2.34 and maternal OR=2.29), annual household income of 100 000-200 000 yuan (compared with<100 000 yuan, OR=1.04), higher paternal education (compared with below high school,high school and a college education OR=1.09,1.14), birth weight >4.0 kg (≤5 and>5 years old OR=1.74, 1.44,respectively), and western food consumption≥1 time/month (compared with<1, 1-2, 3-4,>4 times/month OR=1.36, 1.30, 1.67(≤5 years), 1.19, 1.16, 1.15 (>5 years), respectively) (all P<0.05). Conversely, coarse grain intake≥1 times/week (compared with<1 times/week, every day, 3-4, 1-2 times/week OR=0.74, 0.80, 0.71 (≤5 years), 0.75, 0.87, 0.90(>5 years), respectively, all P<0.05) was associated with reduced obesity risk. Conclusions:Obesity epidemiology in children demonstrates significant heterogeneity across age, gender, geographic regions, and pubertal stages. It is necessary to establish a personalized prevention and control strategy.
9.Health economic evaluation of minimally invasive surgery in treatment of digestive tract cancers: a Meta-analysis
Xiaoyue YIN ; Ning ZHOU ; Xueli YANG ; Zhuoyu SUN ; Yinghui BAO ; Shengshu WANG ; Ke HAN ; Jing LONG ; Min ZHAO ; Haowei LI ; Rongrong LI ; Shimin CHEN ; Junhan YANG ; Huaihao LI ; Yueting SHI ; Guoning ZHU ; Jianhua WANG ; Shanshan YANG ; Boyan LI ; Wenchang WANG ; Shengyan DU ; Yao HE ; Enqiang LING-HU ; Huikai LI ; Miao LIU ; Juan XIE
Chinese Journal of Epidemiology 2025;46(1):154-165
Objective:To compare minimally invasive surgery with traditional open surgery, analyze the current application status of health economic evaluations in the treatment of digestive tract cancers, such as esophageal cancer, gastric cancer, and colorectal cancer by minimally invasive surgery and provide evidence for the rational selection of clinical treatment, alleviation of disease-related economic burdens, and rational allocation of healthcare resources.Methods:By using five databases, i.e. China National Knowledge Infrastructure, Wanfang data, Chinese Biomedical Literature Database, PubMed, and Embase, a database was established to retrieve all the papers about health economic studies of minimally invasive surgery for esophageal cancer, gastric cancer, and colorectal cancer published until December 31, 2023. Literature was analyzed by using software NoteExpress 3.8, and data were processed using Excel 2021. The quality of included papers was evaluated using the CHEERS 2022 checklist, and Meta-analysis was conducted by using software Stata 17.0.Results:A total of 10 919 relevant papers were retrieved, and 59 studies were included. Only 14 studies (23.7%) used standard health economic evaluation methods. Meta-analysis results revealed no significant differences in direct medical expenditure and total expenditure between minimally invasive surgery and open surgery. However, the expenditure for minimally invasive surgery exhibited a significant increase [mean difference ( MD)=5 973.12 yuan, P<0.001], while hospital stay and indirect expenditure significantly decreased ( MD: -4.85 days and -733.79 yuan, P<0.001). In China, for gastric cancer, the direct medical expenditure of endoscopic surgery was lower than that of open surgery ( MD=-33 000.00 yuan) with no significant difference ( P<0.001). In colorectal cancer cases, the direct medical and surgical expenditures for laparoscopic surgery were higher than those for open surgery ( MD: 4 277.94 yuan and 4 267.80 yuan, P<0.001), while the indirect and total medical expenditures decreased ( MD: -768.34 yuan and -159.10 yuan). Hospital stays in patients who had minimally invasive surgery for all three types of cancer were shorter than those who had open surgery ( P<0.001). Conclusions:In the treatment of gastrointestinal cancer, compared with open surgery, minimally invasive surgery shows higher expenditure, but has advantages, such as shorter hospital stay and lower indirect expenditure, and there were no significant differences in direct medical and total expenditures between the two approaches. When conducting health economic evaluation, factors such as postoperative complications, hospital stay, and patient's economic status should be considered for their impact on total medical expenditure. It is necessary to pay attention to the application of health economic evaluations in healthcare decision-making.
10.Current status and latent profile analysis of elderly stroke patients' medication literacy
Ying YAO ; Yuan SONG ; Haixu ZHAO ; Yunjing XING ; Hongbing LIU ; Ce ZONG ; Ke ZHANG ; Yuanli GUO ; Yuan GAO
China Modern Doctor 2025;63(11):45-49
Objective To explore current status and potential subtypes of elderly stroke patients' medication literacy among,and to analyze related influencing factors of different subtypes.Methods A total of 285 elderly stroke patients admitted in the First Affiliated Hospital of Zhengzhou University from November 2023 to June 2024 were selected as subjects.General Information questionnaire,medication literacy scale for elderly patients with chronic diseases,and perceived social support scale were conducted.Latent profile analysis(LPA)of elderly stroke patients' medication literacy was conducted,and Logistic regression analysis was used to explore influencing factors of different profiles.Results Score of medication literacy scale for elderly stroke patients was(48.26±12.51)points.Medication literacy among elderly stroke patients can be divided into 3 profiles,namely proactive-high literacy type(51.9%),balanced-medium literacy type(34.0%),and dependent-low literacy type(14.1%).Logistic regression analysis showed that recent medication types,current place of residence,educational level,diabetes,and social support were the influencing factors of elderly stroke patients' medication literacy(P<0.05).Conclusion The level of medication literacy among elderly stroke patients is medium,which is characterized by 3 categories.Medical staffs targeted intervention should be adopted according to different category characteristics,so as to accurately meet their nursing needs,finally improve the level of elderly stroke patients' medication literacy.

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