1.Application of perioperative enhanced recovery after surgery clinical pathway for percutaneous vertebro plasty
Xuehu XIE ; Zhiwu ZHANG ; Jisheng LIN ; Hai MENG ; Tianyu BAI ; Zihan FAN ; Nan SU ; Jiashen SHAO ; Jinjun LI ; Guoyu NI ; Feng JIN ; Yong YANG ; Qi FEI
International Journal of Surgery 2025;52(6):415-422
Objective:To evaluate the perioperative application effect of enhanced recovery after surgery (ERAS) clinical pathway in percutaneous vertebro plasty (PVP).Methods:The clinical data of 274 patients who underwent PVP treatment for osteoporotic vertebral compression fracture (OVCF) in Beijing Friendship Hospital, Capital Medical University from May 2023 to August 2024 were retrospectively analyzed. The patients were divided into two groups according to the different numbers of surgical segments: the single-segment group ( n=211) and the multisegment group ( n=63). Patients in the single-segment group underwent single-segment surgery, while patients in the multisegment group underwent surgery on ≥2 segments. The core points of the ERAS clinical pathway adopted in this study include perioperative education, pain management, early mobilization, application of "outfast", and joint guidance from the departments of nutrition and rehabilitation. Comparison was made between the two groups of patients in terms of visual analog scale (VAS) scores for low back pain at preoperative, 2 h, 6 h, 24 h postoperatively, and on the day of discharge; Oswestry disability index (ODI) scores preoperatively and on the day of discharge; time to first ambulation postoperatively, total length of hospital stay, postoperative length of stay, perioperative complications, and perioperative application of Opioid consumption. Measurement data were expressed as mean±standard deviation ( ± s), and the independent sample t-test was used for comparison between groups; count data were expressed as cases and percentage, and the Chi-square test was used for comparison between groups. The VAS pain scores at each stage of the perioperative period were evaluated using repeated measures analysis of variance or generalized estimating equations. Results:Compared with that before the operation [(6.17±0.93) points, (6.29±0.83) points], the VAS scores of low back pain of patients in the single-segment group and the multisegment group at 2 hours after surgery [(3.09±0.82) points, (3.27±0.65) points], 6 hours after surgery [(2.60±0.79) points, (2.62±0.55) points], and 24 hours after surgery [(1.89±0.77) points, (1.97±0.72) points] and on the day of discharge [(1.72±0.71) points, (1.81±0.64) points] were significantly decreased, and the differences were statistically significant ( P<0.05). At the same stage, the VAS scores of low back pain in both groups were not statistically significant ( P>0.05). The ODI scores of patients in the single-segment group and the multisegment group on the day of discharge [(24.21±2.35) points, (24.63±3.31) points] were significantly lower than those before the operation [(64.50±4.81) points, (65.52±4.08) points], and the differences were statistically significant ( P<0.05). There were no statistically significant differences in perioperative complications and the proportion of Opioid drug application between the two groups of patients ( P>0.05). Conclusion:For patients with single-segment or multisegment OVCF, PVP surgical treatment under ERAS clinical pathway management can achieve immediate pain relief, early ambulation exercise, and satisfactory perioperative efficacy.
2.Investigation on the preoperative nutritional status and analysis of risk factors of patients with osteoporotic vertebral compression fracture based on the MNA-SF scoring tool
Tianyu BAI ; Guoyu NI ; Feng JIN ; Hai MENG ; Jisheng LIN ; Zihan FAN ; Qi FEI
International Journal of Surgery 2025;52(7):456-460
Objective:To evaluate preoperative malnutrition risk in patients with osteoporotic vertebral compression fracture (OVCF) based on mini nutritional assessment short form (MNA-SF) and analyze the related clinical risk factors.Methods:A cross-sectional study was conducted using clinical data from 129 OVCF patients who underwent percutaneous vertebroplasty at Beijing Friendship Hospital, Capital Medical University, between May 2023 and December 2023. The cohort included 26 males and 103 females, aged (74.71±9.13) years(ranging from 48-98 years). According to MNA-SF scoring method, they were divided into three groups, the malnutrition group ( n=6), the nutritional risk group ( n=40), and the good nutrition group ( n=83). Nutritional risk and malnutrition rates were evaluated using the MNA-SF score. Measurement data with normal distribution were expressed as mean±standard deviation ( ± s) and compared using one-way ANOVA. The comparison between groups of count data was conducted using chi-square test. Univariate analysis and multivariate logistic regression were performed to identify independent risk factors for malnutrition and nutritional risk. Results:According to the MNA-SF score, among 129 patients, the malnutrition rate was 4.7%, the nutritional risk rate was 31.0%, and 64.3% exhibited adequate nutrition based on MNA-SF scores. The results of one-way ANOVA showed that gender ( P=0.023) and BMI ( P<0.001) were significantly correlated with malnutrition and nutritional risk; Logistic regression analysis suggested that the influencing factors of nutritional risk included gender ( P=0.002) and BMI ( P<0.001), while the only dangerous factor of malnutrition was BMI ( P<0.001). Conclusions:Bsed on MNA-SF, OVCF patients undergoing percutaneous vertebroplasty have a higher incidence of malnutrition and nutritional risk. The risk factors for nutritional risk in patients are gender and BMI, while the risk factor for malnutrition is only BMI.
3.Association between inflammation-related dietary patterns and cognitive impairment in older adults aged 65 years and above in longevity areas of China: a reduced rank regression analysis
Yang LI ; Zihan LU ; Yangyang XIONG ; Wenjing CHEN ; Jun WANG ; Zenghang ZHANG ; Chen CHEN ; Wenhui SHI ; Xi MENG ; Zhenwei ZHANG ; Zinan XU ; Yuan XIA ; Yiqi LI ; Honglin LAI ; Yujie LI ; Cuipeng ZHANG ; Yuming ZHAO ; Yuebin LYU ; Xiaoming SHI
Chinese Journal of Epidemiology 2025;46(5):737-745
Objective:To analyze the association between inflammation-related dietary patterns and the risk for cognitive impairment in older adults aged ≥65 years in longevity areas in China by using reduced rank regression (RRR) analysis.Methods:This study used cross-sectional data from the 2021 Healthy Aging and Biomarkers Cohort Study, including the information about study participants' demographic characteristics, lifestyles, daily life activities, and disease histories. Dietary intake was obtained by using a simplified food frequency questionnaire. Cognitive impairment was evaluated based on the Mini-Mental State Examination Scale combined with years of education. Fasting venous blood samples were collected to detect inflammatory markers, especially high-sensitivity C-reactive protein (hs-CRP) and the platelet-to-lymphocyte ratio (PLR). RRR analysis was used to obtain inflammation-related dietary patterns using hs-CRP and PLR as response variables. Multivariate logistic regression model was used to analyze the association between dietary pattern score and the risk for cognitive impairment. Restricted cubic spline was used to explore the dose response relationship, and mediation analysis was used to quantify the mediating effects of hs-CRP and PLR.Results:Two dietary patterns were identified with RRR. The primary pattern was characterized by higher intakes of flour, red meat, and dairy products, and lower intake of fresh vegetables, explaining 6.84% of the variance in food intake and 0.50% of the variance in inflammatory markers. Compared with the T1 group, the T3 group had significantly higher risk for cognitive impairment ( OR=1.242, 95% CI: 1.034-1.491). Each one standard deviation increase in the dietary pattern score was associated with an 8.7% increase in the risk for cognitive impairment ( OR=1.087, 95% CI: 1.008-1.172), with a significant linear trend (overall-model P<0.001, non-linear P=0.295). Mediation analysis indicated that hs-CRP mediated 6.2% of the association between the dietary pattern and the risk for cognitive impairment. Conclusion:The inflammation- related dietary pattern characterized by higher consumption of flour, red meat, and dairy products and lower consumption of fresh vegetables is associated with an increased risk for cognitive impairment in older adults, and hs-CRP partially mediates this association.
4.Ancient data mining on drug characteristics of knee osteoarthritis
Zihan MENG ; Yueyue YU ; Xiaoyi SHI ; Xinyu MA ; Dingding WU ; Xu ZHANG ; Heyi LI ; Jingya WANG ; Liyuan ZHANG ; Heli ZHAO
China Modern Doctor 2025;63(12):1-4,48
Objective To analyze ancient prescriptions for knee osteoarthritis(KOA),and explore their application patterns,for providing clinical reference value.Methods Prescriptions were collected from ancient documents,and a database was created by using Excel 2016 for frequency analysis.Association rules and hidden structures were analyzed by using SPSS Modeler 18.0 and Lantern 5.0.Results A total of 373 prescriptions and 421 herbs were collected,with 3894 times of frequency of medication.Danggui was the most frequently used herb.Herbs primarily tonified deficiencies,relieved exterior symptoms,and expelled wind-dampness,with warm properties and pungent,sweet,or bitter tastes,mainly targeting the spleen and kidney meridians.Thirteen strong association rules were identified,including Chuanxiong+Niuxi-Danggui,and Bixie-Niuxi.Hidden structure analysis revealed 10 variables,leading to 4 clusters and 4 core prescriptions.Common syndromes included wind-damp,wind-cold-damp,wind-damp-heat,and qi-blood deficiency.Conclusion The treatment of KOA in ancient literature focuses on dispelling wind and removing dampness,taking into account both positive deficiency and evil excess,flexible use of tonifying spleen and kidney,clearing dampness-heat,tonifying Qi and blood and other drugs.
5.Effects of medical tissue glue on skin repair after facial tumor resection
Qiang MENG ; Liehao YANG ; Lingda KONG ; Zihan NIU ; Hongyan LI
Chinese Journal of Medical Aesthetics and Cosmetology 2025;31(1):64-67
Objective:To observe the effects of medical tissue glue on skin repair after facial tumor resection.Methods:A retrospective analysis was performed for 32 patients who underwent facial tumor resection in the Shenshan Medical Center, Memorial Hospital of Sun Yat-sen University from October 2021 to May 2022, including 22 males and 10 females, with a median age of 36 (2-66) years. Patients were divided into the medical tissue glue group ( n=15) and the suture group ( n=17) based on the method of skin closure after surgery. The operation time, grade A wound healing rate and Vancouver scar scale (VSS) score were compared between the two groups. Satisfaction evaluation was performed independently by patients 6 months after incision healing. Results:The operation time of the medical tissue glue group and the suture group were (44.07±7.00) and (47.41±9.06) minutes, the VSS scores were (1.93±0.96) and (1.88±0.84) points, respectively. The differences were not statistically significant (all P>0.05). The grade A wound healing rate of patients in the medical tissue glue group was 100.0% (15/15), the satisfaction rate was 100.0% (15/15), of which 10 cases were satisfied and 5 cases were relatively satisfied. The grade A wound healing rate of patients in the suture group was 100.0% (17/17), the satisfaction rate was 100.0% (17/17), of which 13 cases were satisfied and 4 cases were relatively satisfied. Conclusion:Medical tissue glue can achieve good cosmetic results in facial tumor resection.
6.Association between inflammation-related dietary patterns and cognitive impairment in older adults aged 65 years and above in longevity areas of China: a reduced rank regression analysis
Yang LI ; Zihan LU ; Yangyang XIONG ; Wenjing CHEN ; Jun WANG ; Zenghang ZHANG ; Chen CHEN ; Wenhui SHI ; Xi MENG ; Zhenwei ZHANG ; Zinan XU ; Yuan XIA ; Yiqi LI ; Honglin LAI ; Yujie LI ; Cuipeng ZHANG ; Yuming ZHAO ; Yuebin LYU ; Xiaoming SHI
Chinese Journal of Epidemiology 2025;46(5):737-745
Objective:To analyze the association between inflammation-related dietary patterns and the risk for cognitive impairment in older adults aged ≥65 years in longevity areas in China by using reduced rank regression (RRR) analysis.Methods:This study used cross-sectional data from the 2021 Healthy Aging and Biomarkers Cohort Study, including the information about study participants' demographic characteristics, lifestyles, daily life activities, and disease histories. Dietary intake was obtained by using a simplified food frequency questionnaire. Cognitive impairment was evaluated based on the Mini-Mental State Examination Scale combined with years of education. Fasting venous blood samples were collected to detect inflammatory markers, especially high-sensitivity C-reactive protein (hs-CRP) and the platelet-to-lymphocyte ratio (PLR). RRR analysis was used to obtain inflammation-related dietary patterns using hs-CRP and PLR as response variables. Multivariate logistic regression model was used to analyze the association between dietary pattern score and the risk for cognitive impairment. Restricted cubic spline was used to explore the dose response relationship, and mediation analysis was used to quantify the mediating effects of hs-CRP and PLR.Results:Two dietary patterns were identified with RRR. The primary pattern was characterized by higher intakes of flour, red meat, and dairy products, and lower intake of fresh vegetables, explaining 6.84% of the variance in food intake and 0.50% of the variance in inflammatory markers. Compared with the T1 group, the T3 group had significantly higher risk for cognitive impairment ( OR=1.242, 95% CI: 1.034-1.491). Each one standard deviation increase in the dietary pattern score was associated with an 8.7% increase in the risk for cognitive impairment ( OR=1.087, 95% CI: 1.008-1.172), with a significant linear trend (overall-model P<0.001, non-linear P=0.295). Mediation analysis indicated that hs-CRP mediated 6.2% of the association between the dietary pattern and the risk for cognitive impairment. Conclusion:The inflammation- related dietary pattern characterized by higher consumption of flour, red meat, and dairy products and lower consumption of fresh vegetables is associated with an increased risk for cognitive impairment in older adults, and hs-CRP partially mediates this association.
7.Ancient data mining on drug characteristics of knee osteoarthritis
Zihan MENG ; Yueyue YU ; Xiaoyi SHI ; Xinyu MA ; Dingding WU ; Xu ZHANG ; Heyi LI ; Jingya WANG ; Liyuan ZHANG ; Heli ZHAO
China Modern Doctor 2025;63(12):1-4,48
Objective To analyze ancient prescriptions for knee osteoarthritis(KOA),and explore their application patterns,for providing clinical reference value.Methods Prescriptions were collected from ancient documents,and a database was created by using Excel 2016 for frequency analysis.Association rules and hidden structures were analyzed by using SPSS Modeler 18.0 and Lantern 5.0.Results A total of 373 prescriptions and 421 herbs were collected,with 3894 times of frequency of medication.Danggui was the most frequently used herb.Herbs primarily tonified deficiencies,relieved exterior symptoms,and expelled wind-dampness,with warm properties and pungent,sweet,or bitter tastes,mainly targeting the spleen and kidney meridians.Thirteen strong association rules were identified,including Chuanxiong+Niuxi-Danggui,and Bixie-Niuxi.Hidden structure analysis revealed 10 variables,leading to 4 clusters and 4 core prescriptions.Common syndromes included wind-damp,wind-cold-damp,wind-damp-heat,and qi-blood deficiency.Conclusion The treatment of KOA in ancient literature focuses on dispelling wind and removing dampness,taking into account both positive deficiency and evil excess,flexible use of tonifying spleen and kidney,clearing dampness-heat,tonifying Qi and blood and other drugs.
8.Effects of medical tissue glue on skin repair after facial tumor resection
Qiang MENG ; Liehao YANG ; Lingda KONG ; Zihan NIU ; Hongyan LI
Chinese Journal of Medical Aesthetics and Cosmetology 2025;31(1):64-67
Objective:To observe the effects of medical tissue glue on skin repair after facial tumor resection.Methods:A retrospective analysis was performed for 32 patients who underwent facial tumor resection in the Shenshan Medical Center, Memorial Hospital of Sun Yat-sen University from October 2021 to May 2022, including 22 males and 10 females, with a median age of 36 (2-66) years. Patients were divided into the medical tissue glue group ( n=15) and the suture group ( n=17) based on the method of skin closure after surgery. The operation time, grade A wound healing rate and Vancouver scar scale (VSS) score were compared between the two groups. Satisfaction evaluation was performed independently by patients 6 months after incision healing. Results:The operation time of the medical tissue glue group and the suture group were (44.07±7.00) and (47.41±9.06) minutes, the VSS scores were (1.93±0.96) and (1.88±0.84) points, respectively. The differences were not statistically significant (all P>0.05). The grade A wound healing rate of patients in the medical tissue glue group was 100.0% (15/15), the satisfaction rate was 100.0% (15/15), of which 10 cases were satisfied and 5 cases were relatively satisfied. The grade A wound healing rate of patients in the suture group was 100.0% (17/17), the satisfaction rate was 100.0% (17/17), of which 13 cases were satisfied and 4 cases were relatively satisfied. Conclusion:Medical tissue glue can achieve good cosmetic results in facial tumor resection.
9.Syndromes and Mechanisms of Depression Induced by Second Hit in Mice
Zihan GONG ; Ying WANG ; Jingwen YANG ; Wenqing LIANG ; Danhua MENG ; Kaijie SHE ; Yuan LIANG ; Guangxin YUE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(6):29-38
ObjectiveTo explore the syndromes and mechanisms of depression induced by maternal separation (MS) combined with chronic restraint stress (RS) in mice. MethodOn postnatal day 0 (PD0), the offspring mice were randomized into a blank group (NC) and a modeling group. The mouse model of depression was established by MS+RS for 21 days. After removal of female mice on PD21, the modeled mice were randomized into model, Wenyang, Jieyu, Wenyang Jieyu, and fluoxetine groups, with 15 mice in each group. The sucrose preference, tail suspension, and open field tests were carried out to evaluate the anxiety and depression-like behavior in mice. Enzyme-linked immunosorbent assay was used to measure the adrenocorticotrophic hormone (ACTH) and corticosterone (CORT) levels in mouse plasma. High performance liquid chromatography-electrochemical detector was used to determine the content of monoamine neurotransmitters in the hippocampus. Real-time fluorescence quantitative polymerase chain reaction was employed to determine the mRNA levels of genes in the 5-hydroxytryptamine (5-HT) system, hypothalamic-pituitary-adrenal (HPA) axis, and brain-derived neurotrophic factor (BDNF) signaling pathway in the hippocampus. Immunohistochemistry was employed to determine the expression levels of proteins in the 5-HT system and HPA axis in the hippocampus. The Simple Western system was used to determine the protein levels of BDNF and tyrosine kinase receptor B (TrkB) in the hippocampus. ResultCompared with the NC group, the model group exhibited depression-like behavior, which was significantly relieved by Wenyang Jieyu prescription and fluoxetine. Compared with the NC group, the model group showed elevated levels of CORT and ACTH in the plasma (P<0.01), which, however, were lowered by Wenyang Jieyu prescription and fluoxetine (P<0.05, P<0.01). Compared with the NC group, the model group showed inhibited expression of neurotransmitters in the hippocampus (P<0.05, P<0.01), while Wenyang Jieyu prescription and fluoxetine restored the expression of neurotransmitters (P<0.05, P<0.01). Compared with NC group, the model group showed inhibition of the 5-HTergic nerve and abnormal activation of the HPA axis, and Wenyang Jieyu prescription and fluoxetine regulated the abnormal state of the 5-HTergic nerve and HPA axis. Compared with NC group, the modeling down-regulated the mRNA and protein levels of BDNF and TrkB in the hippocampus (P<0.05, P<0.01), which, however, were recovered in Wenyang, Jieyu, Wenyang Jieyu, and fluoxetine groups (P<0.05, P<0.01). ConclusionThe mouse model of depression induced by MS+RS may present the syndrome of Yang deficiency and liver depression. Wenyang Jieyu prescription may increase the content of hippocampal neurotransmitters by regulating the 5-HT system and the BDNF signaling pathway mediated by the HPA axis, thereby alleviating depression-like behavior in mice.
10.Wenyang Jieyu Prescription Regulates Hippocampal Neuron Apoptosis and Improves Synaptic Plasticity in Depressed Mice via BDNF/Akt/mTOR Pathway
Danhua MENG ; Kaijie SHE ; Xiaoying MENG ; Zihan GONG ; Wenqing LIANG ; Ying WANG ; Yuan LIANG ; Guangxin YUE
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(6):48-57
ObjectiveTo explore the mechanism of Wenyang Jieyu prescription in regulating hippocampal neuron apoptosis and improving synaptic plasticity in the mouse model of depression induced by maternal separation combined with restraint stress. MethodThe mice on postnatal day 0 (PD0) were randomly assigned into a control group (n=10) and a modeling group (n=50). Maternal separation combined with restraint stress was adopted to establish the mouse model of depression, and the modeled mice were randomized into model, Wenyang prescription, Jieyu prescription, Wenyang Jieyu prescription, and fluoxetine groups (n=10) on the weaning day (PD21). From PD21 to PD111, the mice were fed with the diets mixed with corresponding medicines. The sucrose preference test, open field test, O-maze test, and novel object recognition test were then conducted to evaluate the depression, memory, and learning abilities of mice. Immunohistochemistry (IHC) was employed to measure the atomic absorbance (AA) of postsynaptic density protein 95 (PSD95) in the hippocampus. Terminal-deoxynucleoitidyl transferase-mediated nick-end labeling (TUNEL) was employed to detect the apoptosis of hippocampal neurons. Western blot was employed to determine the protein levels of brain-derived neurotrophic factor (BDNF), phosphorylated tyrosine kinase receptor B/tyrosine kinase receptor B (p-TrkB/TrkB), phosphorylated protein kinase B/protein kinase B (p-Akt/Akt), phosphorylated mammalian target of rapamycin/mammalian target of rapamycin (p-mTOR/mTOR), B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X (Bax), cysteinyl aspartate-specific proteinase-3 (Caspase-3), synaptophysin (Syn), and PSD95. ResultCompared with the control group, the modeling decreased the sucrose preference rate, time spent in central zone within 5 min, total movement distance, time spent in the open arm, and cognition index (P<0.01). Furthermore, it decreased the expression of PSD95, increased the neuron apoptosis in the hippocampus (P<0.01), down-regulated the protein levels of BDNF, p-TrkB/TrkB, p-Akt/Akt, p-mTOR/mTOR, Bcl-2, PSD95, and Syn (P<0.01), and up-regulated the protein levels of Bax and Caspase-3 (P<0.05) in the hippocampus. Compared with the model group, Wenyang Jieyu prescription and fluoxetine increased the sucrose preference rate, time spent in central zone within 5 min, total movement distance, time spent in the open arm, and cognition index (P<0.05, P<0.01). Moreover, the drugs increased the expression of PSD95, reduced the neuron apoptosis (P<0.01), up-regulated the protein levels of BDNF, p-TrkB/TrkB, p-Akt/Akt, p-mTOR/mTOR, Bcl-2, PSD95, and Syn (P<0.01), and down-regulated the protein levels of Bax and Caspase-3 (P<0.01). ConclusionWenyang Jieyu prescription outperformed Wenyang prescription and Jieyu prescription in the treatment of the depressive behavior induced by maternal separation combined with restraint stress in mice. It exerted the therapeutic effect by reducing the hippocampal neuron apoptosis and improving the synaptic plasticity via the BDNF/Akt/mTOR pathway.

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