Table of Content

21 October 2025, Volume 46 Issue 5

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A morphological description of the humerus based on statistical shape modeling

Gao Weilu , Jia Zhengfeng , Yang Changsen , Li Jiantao , Su Xiuyun , Zhang Licheng

2025, 46(5):  765-769.  doi:10.3969/j.issn.1006-7795.2025.05.001

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Objective  To construct a high-precision statistical shape model of the humerus and systematically describe its anatomical variation patterns. Methods  In this study, a statistical shape model of the humerus was constructed using the three-dimensional model data of 60 collected humerus cases. The principal component analysis method was adopted to reveal the main patterns of humerus anatomical variations and their contribution rates. Results  The results showed that the first five principal components (PC01-PC05) collectively explained 96. 6% of the total anatomical variations. Among them, PC01 and PC02 were the main components, contributing 66. 6% and 23. 5% of the variations respectively. PC01 mainly reflects the scaling effect of the overall size (length/width) of the humerus, while PC02 reveals the length variation characteristics independent of the overall scaling, which may reflect individualized differences. The subsequent principal components (PC03-PC05) depicted the local morphological characteristics and fine changes of the proximal and distal humerus. Conclusion  The statistical shape model constructed in this study provides a reliable digital basis for personalized prosthesis design, surgical planning and biomechanical simulation.

Efficacy comparison of robotic-assisted versus manual percutaneous vertebroplasty for vertebral compression fractures

Jiang Shuangpeng, Han Yuyang, Wang Jiaxi, Zhang Gang, Dong Chao, Song Hongxing, Yao Qi

2025, 46(5):  770-776.  doi:10.3969/j.issn.1006-7795.2025.05.002

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Objective  To evaluate the clinical outcomes of robot-assisted percutaneous vertebroplasty (PVP) versus manual PVP in treating osteoporotic vertebral compression fractures (OVCF), and explore the advantages of robotic assistance for clinical decision-making. Methods  Patients who underwent single-level PVP for OVCF at the Department of Joint Surgery and Bone Tumor, Beijing Shijitan Hospital, Capital Medical University, between April 2021 and April 2025 were enrolled. The robot group (n=29) and manual PVP group (control, n=88) were followed-up for 1 month. Parameters compared included: total hospital stay, operative time, cement volume, cement leakage rate, nerve injury rate, intraoperative fluoroscopy number, first-attempt success rate of puncture, postoperative versus preoperative anterior vertebral height difference, Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores preoperatively, at 1-day and 1-month postoperatively. Results  No statistically significant differences existed in baseline characteristics (gender, age, fracture-to-surgery interval, and fracture distribution) between groups (P>0.05). The number of intraoperative fluoroscopy times and the ODI index on the first day after surgery in the robot group were significantly lower than those in the control group (P<0.05), and the first-attempt success rate of puncture was significantly higher than that in the control group (P<0.05). There were no statistically significant differences in the other parameters between the two groups (P>0.05). Conclusion  Both robot-assisted PVP and manual PVP have good clinical efficacy in the treatment of OVCF. Robot-assisted PVP can reduce the number of intraoperative fluoroscopy times and may have more advantages in improving the first-attempt success rate of puncture and early postoperative lumbar function. However, its reliability needs to be further verified through large-sample randomized controlled studies with multivariate analysis.

Efficacy analysis of artificial intelligence-assisted diagnosis for osteoporotic vertebral compression fracture

Wang Yongjie, Cui Libin, Yuan Xin, Lu Qian, Chen Xueming, Liu Liang

2025, 46(5):  777-783.  doi:10.3969/j.issn.1006-7795.2025.05.003

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Objective  To compare the efficacy of artificial intelligence (AI) diagnostic group and artificial reading group in the diagnosis for osteoporotic vertebral compression fractures. Methods  From January 2023 to December 2023, 80 patients with osteoporotic vertebral compression fractures and 20 patients without fractures but with nonspecific low back pain were included in the study. According to the patient 's computed tomography(CT) image, the AI software diagnosis and physicians of different seniority (one senior physician, one intermediate physician and one junior physician) diagnosis were performed. The diagnostic efficacy of different detection methods was compared. Results  The sensitivity, specificity, positive predictive value, negative predictive value and area under the receiver operating characteristic(ROC) curve ( AUC )  and Kappa value of each group were as follows: AI image interpretation: 0.975,0.900,0.975,0.900,0.938, 0.875; senior physician: 0.950, 0.900, 0.974, 0.818, 0.925, 0.819; intermediate physician: 0.825, 0.850, 0.957, 0.548， 0.837, 0.560; and junior physician: 0.750, 0.750, 0.923, 0.429, 0.751, 0.390. Conclusion  The diagnostic performance of AI was comparable to that of senior physician, and significantly higher than that of intermediate and primary physicians.

Application and effectiveness verification of three-dimensional fracture map construction technology in Pilon fracture typing and surgical planning

Li Changhui, Song Lianxin, Luo Yang, Dong Tianhua, Ning Biao, Zhang Xuebin

2025, 46(5):  784-790.  doi:10.3969/j.issn.1006-7795.2025.05.004

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Objective  To explore the clinical value of three-dimensional (3D) fracture mapping in improving the consistency of Arbeitsgemeinschaft für Osteosynthesefragen (AO)/the Orthopaedic Trauma Association (OTA) classification and optimizing preoperative surgical planning for Pilon fractures. Methods  This single-center retrospective cohort study included 60 Pilon fracture patients admitted to the Trauma Emergency Center of the Third Hospital of Hebei Medical University between January 2022 and December 2024. All patients underwent preoperative computed tomography (CT) scans. Image standardization and expert manual segmentation/annotation of fracture lines and fragments were performed with 3D Slicer software. 3D fracture lines extracted from gold-standard models were registered to a unified standard tibial model. A 3D probability heatmap was constructed by counting spatial fracture frequency, with high-incidence zones analyzed via spatial clustering algorithms. Three orthopedic surgeons independently completed AO/OTA classification and preoperative planning with the assistance of  conventional CT only and CT with 3D fracture mapping. Accuracy, time consumption, inter-observer consistency (Cohen's κ), planning time, plan modification frequency, and subjective scores were evaluated. Results  The 3D fracture heatmap revealed that fracture lines predominantly concentrated in the anterolateral and posteromedial regions of the distal tibia, with an average of (4. 2±1. 1) hotspots, a coverage rate of (78. 3±5. 6)%, and (3. 5±1. 0) clustering areas. With 3D fracture mapping assistance, classification accuracy was improved to (88. 0±5. 0)% compared to (75. 0±8. 0)% with conventional CT (P=0. 001); classification time reduced to (10. 4±2. 5) min from (15. 2±3. 1) min (P<0. 001); and Cohen's κ increased from 0. 68±0. 05 to 0. 82±0. 03 (P=0. 002). For preoperative planning, the average planning time was (15. 8±3. 2) min in the 3D mapping-assisted group,  which was significantly shorter than that of conventional CT group (22. 5±4. 3) min (P<0. 001); the number of plan modifications was (1. 5±0. 7) times, lower than that of conventional CT group (3. 2±1. 1 ) times (P<0. 001), and the  subjective score was 8. 9±0. 9, higher than that of conventional CT group (6. 8±1. 2) (P<0. 001). Conclusion  The 3D fracture mapping accurately characterizes spatial distribution patterns of Pilon fractures, significantly improves classification accuracy, inter-observer consistency, and preoperative planning efficiency, and thus holds substantial clinical value.

A case-control study of minimally invasive internal fixation for pelvic fractures assisted by an orthopedic surgical robot

Long Anhua, Zhang Jiafan, Yang Qi, Wang Xiongfei, Zhang Yakui, Wang Xuefei, Liu Liang

2025, 46(5):  791-798.  doi:10.3969/j.issn.1006-7795.2025.05.005

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Objective  To explore the technical advantages and applicable scenarios of surgical robot-assisted versus conventional freehand minimally invasive surgery for pelvic fractures by comparing clinical indicators, thereby providing evidence for clinical decision-making. Methods  A retrospective case-control study was conducted on 59 patients with pelvic fractures treated with minimally invasive internal fixation between January 2022 and December 2024. Patients were divided into a conventional group (26 cases) and a robot-assisted navigation group (33 cases) based on the surgical technique. Pre- and postoperative pelvic computed tomography (CT) scans were performed, and anteroposterior, outlet, and inlet view radiographs were obtained. The maximum residual displacement after pelvic reduction and screw placement accuracy were measured based on radiographic and CT imaging. Intraoperative fluoroscopy frequency, radiation dose, operative time, blood loss, number of implanted screws , maximum residual displacement after reduction, and screw accuracy were recorded. Results  No significant differences were observed between the two groups in age, gender, injury mechanism, or fracture classification, indicating comparability. Blood loss and fracture reduction quality showed no significant differences. The operative time was 52.5(30.8, 62.3) min in the conventional group and 60(50, 82.5) min in the robot-assisted group. Intraoperative fluoroscopy frequency and radiation dose were (19.1 ± 5.4) times and 33.1(27.5, 43.9) mGy in the conventional group, compared to (12.1 ± 4.9) times and 123.1(101.1, 131.4) mGy in the robot-assisted group. The robot-assisted group demonstrated superior screw placement accuracy, increased utilization of anterior column screws, and shorter postoperative ambulation time. Conclusion  Robot-assisted minimally invasive surgery for pelvic fractures significantly outperforms conventional freehand techniques in improving screw placement accuracy and reducing radiation exposure for surgeons. It represents a preferable option for treating unstable pelvic fractures.

Retrospective analysis of fully robot-navigated intramedullary nail fixation for elderly patients with intertrochanteric femoral fractures

Han Dacheng, Wang Jialong, Yang Qi, Si Zhiyong, Zhang Yakui, Liu Liang, Wang Xuefei

2025, 46(5):  799-804.  doi:10.3969/j.issn.1006-7795.2025.05.006

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Objective  To investigate the clinical outcome differences between robotic-assisted intramedullary nailing and traditional manual surgery, and to analyze the advantages and feasibility of robotic-assisted intramedullary nail fixation in the treatment of intertrochanteric fractures in elderly patients. Methods  From December 2023 to December 2024, elderly patients with intertrochanteric fractures who underwent surgery at Department of Trauma Orthopedics, Beijing Luhe Hospital, Capital Medical University were included. Patients were divided into two groups based on the surgical method. The robotic-assisted group underwent robotic-assisted intramedullary nail fixation, while the traditional group received manual intramedullary nail fixation. Baseline data and observation indicators were collected and compared between the two groups to assess any differences. Results  There were no statistically significant differences in baseline data between the two groups (P > 0. 05). The intraoperative blood loss in the robotic-assisted group was (94. 28 ± 9. 43) mL, compared to (143. 00 ± 11. 11) mL in the traditional group (P<0. 001). The operative time in the robotic-assisted group was (53. 06 ± 9. 89) min, while in the traditional group, it was (66. 74 ± 10. 18) min (P<0. 001). The skin incision length for the main nail in the robotic-assisted group was (3. 23 ± 0. 64) cm, whereas in the traditional group, it was (4. 03 ± 0. 79) cm (P< 0. 01). Postoperative hemoglobin levels in the robotic-assisted group decreased by (12. 63 ± 4. 27) g/L, compared to (17. 29 ± 4. 32) g/L in the traditional group (P= 0. 018). At 6 months postoperatively, the Harris hip scores in the robotic-assisted group showed 30 cases of excellent, 10 good, and 3 poor outcomes, while in the traditional group, there were 22 excellent, 15 good, and 6 poor cases (P= 0. 198). Conclusion  Robotic-assisted intramedullary nailing for intertrochanteric fractures offers advantages such as minimally invasive and precise procedures, shorter operative times, and reduced blood loss. Compared to traditional surgical methods, it demonstrates certain benefits in reducing postoperative complications in elderly patients.

Correlation between auditory event-related potential and sedation depth during propofol sedation

Wang Xinxin, Liang Yi, Chen Yiwei, Ma Bo, Liu Haiyang, Han Ruquan, Jian Minyu

2025, 46(5):  805-811.  doi:10.3969/j.issn.1006-7795.2025.05.007

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Objective  To explore the neurophysiological signatures of auditory event-related potentials (AERP) during propofol-induced graded sedation depths,  and their correlations with sedation levels and behavioral responsiveness, and further to evaluate the feasibility of AERP components as potential biomarkers for quantifying consciousness states. Methods  An auditory Oddball paradigm was used to evoke AERP responses in healthy volunteers under propofol-induced graded sedation. Linear mixed model was applied to explore the relationships between the mean amplitudes of AERP components ［mismatch negativity(MMN); P300］and both sedation-induced conscious states ［Modified Observer's Assessment of Alertness/sedation Scale(MOAA/S) scores］ and behavioral performance (response accuracy). Results  Twenty-two healthy volunteers were included. Data analysis revealed significant negative correlations between the mean amplitudes of MMN components ［MMN -Dev:β=-0.62(-2.70--0.07)，P=0.04; MMN-Nov：β=-0.15(-0.27--0.03)，P=0.02］ and MOAA/S scores during propofol sedation. Novel stimulus-evoked MMN amplitudes also correlated with response accuracy ［MMN-Nov：β=-5.08(-7.78--2.37)，P<0.01］. There was a weak positive correlation between novel stimulus-evoked P300 amplitudes and MOAA/S scores ［β=0.16(0.04-0.39), P=0.04］, however, the correlation was no significant  difference  after adjusting for confounding factors including age, education level, and cognitive level. Conclusion  The mean amplitude of MMN component elicited during auditory tasks was correlated with conscious states and behavioral accuracy under propofol-induced graded sedation. MMN holds promise as a potential neurophysiological indicator for quantifying conscious states or behavioral responsiveness during sedation.

Effects of desflurane on the quality of the anesthesia emergence period in patients undergoing transnasal pituitary adenoma resection: a randomized controlled study

Fu Yuxuan, Zhou Yang, Cui Yidan, Wu Youxuan, Yu Yun, Han Ruquan

2025, 46(5):  812-819.  doi:10.3969/j.issn.1006-7795.2025.05.008

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Objective  To compare the effects of desflurane inhalation anesthesia versus propofol total intravenous anesthesia on postoperative recovery quality in patients undergoing endoscopic transnasal pituitary adenoma resection, and to provide evidence-based recommendations for optimizing anesthetic management in this surgical population. Methods  This single-center, prospective, randomized controlled trial enrolled 112 patients scheduled for endoscopic transnasal pituitary adenoma resection, who were randomly assigned to either the desflurane group (n=56) or the propofol group (n=56). The desflurane group received desflurane ［0.7-1.0 minimum alveolar concentration（MAC)］　combined with remifentanil for anesthesia maintenance, whereas the propofol group received propofol (4-6 mg·kg^-1·h^-1) with remifentanil. The primary outcome was defined as the time from discontinuation of anesthetics to achieving an Aldrete score of 9. Secondary outcomes included emergence time, extubation time, and incidences of postoperative agitation and vomiting. Results  Patients receiving desflurane achieved an Aldrete score of 9 significantly faster than those in the propofol group (13.0 min vs 16.5 min, P=0.003). Similarly, both emergence time (14.0 min vs 16.5 min, P=0.009) and extubation time (13.0 min vs 16.5 min, P=0.003) were significantly shorter in the desflurane group. However, the desflurane group had higher incidences of postoperative agitation (17.9% vs 3.6%, P=0.015) and vomiting (19.6% vs 5.4%, P=0.022). No significant difference was observed in severe agitation rates or 24 h postoperative recovery quality ［Quality of Recovery-15（QoR-15） scores］ between groups. Conclusion  Desflurane anesthesia significantly accelerates postoperative recovery in patients undergoing endoscopic transnasal pituitary adenoma resection, however, it may increase risks of mild agitation and vomiting. In clinical applications, it is necessary to balance recovery benefits against potential adverse effects, and take targeted prophylactic measures.

Comparison of laryngeal mask airway and endotracheal intubation general anesthesia for pulse generator implantation surgery in Parkinson's disease patients

Tong Yuanyuan, Xie Sining, Chen Liang, Li Xiangjiahui, Han Ruquan, Xiong Wei

2025, 46(5):  820-825.  doi:10.3969/j.issn.1006-7795.2025.05.009

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Objective  To analyze the application effects of laryngeal mask airway (LMA) general anesthesia versus endotracheal intubation (ETI) general anesthesia in Parkinson's disease (PD) patients undergoing deep brain stimulation (DBS) implantable pulse generator (IPG) surgery. Methods  A retrospective analysis was conducted on 164 PD patients who underwent IPG surgery at our hospital from August 2020 to February 2021. Patients were divided into two groups based on airway management: LMA group (n=61) and ETI group (n=103). Perioperative hemodynamic parameters, including mean arterial pressure (MAP) and heart rate (HR), were observed at five time points: pre-induction (T0), post-induction (T1), skin incision (T2), extubation (T3), and post-anesthesia care unit (PACU) admission (T4). Key outcomes, such as extubation time, intraoperative hypoxia events, LMA-to-ETI conversion rate, and postoperative complications (respiratory depression, pneumonia), were compared between the two groups. Results  The LMA group had a significantly lower body mass index than the ETI group ［(22.75±3.11 )kg/m² vs (23.85±3.49) kg/m², P=0.039］, while the other baseline characteristics were comparable. After induction, the LMA group exhibited a less decrease in MAP［ (85.46±11.63) mmHg vs (74.13±11.78) mmHg in the ETI group, P<0.001］. At extubation, the ETI group showed higher MAP ［(98.27±13.78) mmHg vs (89.66±10.50) mmHg in the LMA group, P<0.001］. The intraoperative use of vasoactive drugs was significantly lower in the LMA group (3.3%) than that in the ETI group (13.6%, P=0.032). The mean extubation time was shorter in the LMA group［ (8.43±5.25) min vs (14.28±7.66) min in the ETI group, P<0.001］. No intraoperative hypoxia or LMA-to-ETI conversion events occurred in either group. Postoperative respiratory depression and pneumonia rates showed no statistically significant differences between the groups. Conclusion  LMA general anesthesia can be safely applied in PD patients undergoing DBS IPG implantation. It shortens extubation time, reduces the use of vasoactive drugs, and does not increase the risk of intubation-related complications.

Survey on the current status of postoperative analgesia in neurosurgery in China

Fan Yifang, Jian Minyu, Liang Fa, Liu Haiyang, Han Ruquan

2025, 46(5):  826-832.  doi:10.3969/j.issn.1006-7795.2025.05.010

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Objective  To investigate the current status of postoperative analgesia practices among patients undergoing neurosurgical procedures in China to provide evidence-based support for formulating a standardized postoperative analgesia consensus and optimizing pain management strategies in the field of neurosurgery. Methods  A questionnaire was designed with Wenjuanxing, covering 42 items in aspects including general information of participating medical institutions, current practices of neurosurgical postoperative analgesia, anesthesiologists' understanding and implementation of analgesic concepts, and the status of postoperative analgesic management. Distributed through the Chinese Association of Anesthesiologists, the questionnaire data were exported for descriptive statistical analysis after collection. Results  A total of 116 medical institutions participated in this survey, with 178 valid questionnaires collected. Over 90% of respondents recognized the clinical necessity of postoperative analgesia for neurosurgical patients, while the actual implementation rate was only 53.9%. Although most hospitals adopted techniques such as local infiltration anesthesia, scalp nerve blocks, patient-controlled intravenous analgesia, and multimodal analgesia, their actual utilization rates remained low. Less than 50% of participating centers implemented preventive analgesia. Despite high awareness of chronic postoperative pain (96.9%), follow-up rates were relatively low. More than half of the institutions lacked acute pain service for neurosurgical analgesia management. Conclusion  Postoperative analgesia in clinical neurosurgical practice in China currently remains suboptimal, with inadequate management. There is an urgent need to enhance public education, facilitate multidisciplinary collaboration, and formulate standardized guidelines for clinical practice.

Effect of dexamethasone on postoperative cognitive dysfunction in neurosurgical patients

Ye Xinman, Jian Minyu, Han Ruquan

2025, 46(5):  833-838.  doi:10.3969/j.issn.1006-7795.2025.05.011

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Postoperative cognitive dysfunction (POCD) is a common complication of anesthesia and surgery. With advances in neurocognitive science, POCD has been classified under the category of perioperative neurocognitive disorders (PND). However its diagnostic criteria have not been standardized. Patients undergoing neurosurgery often have pre-existing  mild cognitive impairment. Moreover cognitive impairment can be directly exacerbated by structural and functional brain damage resulting from surgical procedures, which is significantly different from other surgical procedures. Dexamethasone, a commonly used neurosurgical agent, exerts neuroprotective effects through anti-inflammation, reduction of cerebral edema, and lowering of intracranial pressure. While some studies have indicated dexamethasone’s potential to mitigate POCD in non-neurosurgical settings, its performance and underlying mechanisms in neurosurgical procedures remain unclear. After a systematic search, only one randomized controlled trial for microvascular decompression was identified that directly addressed this issue. This article  aims to address the research gap concerning the relationship between dexamethasone and POCD in neurosurgery procedures to provide  insights  and implication for future investigations.

Comparative efficacy of a miniature, implantable pelvic floor neuromuscular stimulation system at different frequencies for the treatment of stress urinary incontinence based on a rat model

Long Bohong , Li Chen , Deng Han , Sun Haoyu , Liao Limin , Li Xing

2025, 46(5):  839-844.  doi:10.3969/j.issn.1006-7795.2025.05.012

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Objective  To investigate the comparative efficacy of different frequencies of pelvic floor electrical stimulation (PFES) on stress urinary incontinence (SUI) in rats.Methods  Twenty female Sprague-Dawley rats were randomly divided into 6, 15, 30 and 50 Hz group by random number table method. All rats underwent vaginal dilatation (VD) to simulate postpartum SUI. One week after VD, the sneeze test was conducted to determine whether the modeling was successful. If the sneeze test was positive, the modeling was successful. The miniature and wireless electric pelvic floor stimulator were implanted into the pelvic floor muscle of the modeled rats, and PFES were treated for 2 weeks in each group at the rates of 6, 15, 30 and 50 Hz, respectively. The Leak point pressure (LPP) of all rats before VD, 1 week after VD and 2 weeks after stimulation were measured by cystometrograms (CMGs) for comparison.Results  LPP was significantly reduced in all groups of rats after VD 1 week (P < 0.001). Compared with after VD 1 week, after two consecutive weeks of PFES at four different frequencies of 6, 15, 30 and 50 Hz, LPP was again significantly increased (P < 0.001) and reached the baseline level (P > 0.05) in all groups of rats. In the between-group comparison of the rats in each group, there was no significant difference in their LPP at baseline value, after VD 1 week and after stimulation 2 weeks (P > 0.05).Conclusion  The present study suggests that of the several stimulation frequencies explored so far, 6 Hz may be a more appropriate choice for PFES. Further studies are still needed to evaluate more frequencies and the long-term efficacy of PFES.

Curcumin suppresses RKO cell proliferation by targeting TRIM2-mediated regulation of the mTOR signaling pathway

Yu Hang, Wu Haikuo, Zhao Qianhui, Li Yudong, Liu Jian

2025, 46(5):  845-852.  doi:10.3969/j.issn.1006-7795.2025.05.013

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Objective  The study aims to elucidate the inhibitory effects of curcumin on the proliferation of colon cancer RKO cells, focusing on the regulatory mechanisms of tripartite motif-containing protein 2(TRIM2) expression and the mammalian target of rapamycin(mTOR) signaling pathway. Methods  Experimental concentrations of curcumin were determined by calculating the half maximal inhibitory concentration(IC50) value. Quantitative polymerase chain reaction(qPCR) was utilized to assess the level of TRIM2 expression in RKO and fetal human colon(FHC) cells. Western blotting analysis was conducted to investigate the level of TRIM2 expression and mTOR pathway-related proteins in curcumin-treated RKO cells. The impact of curcumin treatment, TRIM2-knockingdown, and mTOR signaling pathway on proliferation in RKO cells was quantified using the cell counting kit-8(CCK8) assay. Results  The expression of TRIM2 was found to be elevated in RKO cells as determined by qPCR, compared to FHC cells. Curcumin suppressed the level of TRIM2 expression, and subsequent knockdown of TRIM2 resulted in decreased expression of mTOR-related proteins in RKO cells. Both curcumin and TRIM2-knockdown demonstrated significant inhibition of proliferation in RKO cells, with reversion upon activation of mTOR signaling pathway. Conclusion  The study unveils the inhibitory effects of curcumin on RKO cells proliferation through modulation of TRIM2 expression and the mTOR signaling pathway.

Research on left ventricle image segmentation approach incorporating a denoising module

Li Geyuan#, Meng Wennan#, Xue Xinzhe, Wang Yu, Sun Zheng

2025, 46(5):  853-859.  doi:10.3969/j.issn.1006-7795.2025.05.014

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Objective  To address the issue of noise in medical images, this paper proposes a left ventricular image segmentation method integrated with a denoising module to improve segmentation accuracy. Methods   The denoising module is based on a denoising diffusion probabilistic model, and the segmentation model includes two branches: motion estimation and segmentation. This paper modifies the prediction target of the denoising module to the original signal instead of noise, enabling the end-to-end cascade training process of the denoising module and the segmentation model. Results   On the EchoNet-Dynamic dataset, the segmentation performance of traditional denoising methods was inferior to the benchmark model; the Noise2Noise model showed improvement in three metrics, while our proposed method achieved improvement in all four metrics. On the ACDC dataset, our method outperformed the benchmark model, while other methods either performed worse than the benchmark or showed no statistical difference. Conclusion   Traditional denoising methods can impair segmentation performance, whereas our proposed method can stably and effectively improve segmentation performance. Experiments verify the feasibility and potential clinical application value of the proposed method.

Analysis of the influencing factors for intradialytic hypotension in diabetic maintenance hemodialysis patients

Yao Weihua, Zhang Liling, Diao Zongli, Song Dongqi, Gao Qian, Liu Wenhu

2025, 46(5):  860-865.  doi:10.3969/j.issn.1006-7795.2025.05.015

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Objective  To study the influencing factors of intradialytic hypotension (IDH) in diabetic maintenance hemodialysis (MHD) patients, and to provide references for clinical prevention of IDH quality control. Methods  A total of 200 diabetic patients from four hemodialysis centers in Beijing from March 2022 to September 2022 were collected as the research objects. According to the definition of IDH ［systolic blood pressure during hemodialysis≤90 mmHg (1 mmHg=0.133 kPa) or systolic blood pressure reduction during dialysis≥30 mmHg］, the patients were divided into IDH group ( frequency of hypotension events during dialysis ≥30 % during 7 months of follow-up) and non-IDH group. Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of IDH. receive operating characteristic curve(ROC) curve analysis was used to evaluate the predictive value of each influencing factor for IDH. Results  Univariate analysis showed that compared with non-IDH group, IDH group had higher systolic blood pressure, higher blood glucose and lower serum albumin before dialysis (P<0.05). There were more patients with orthostatic hypotension in the IDH group than in the non-IDH group (P <0.05). Multivariate Logistic regression analysis showed that pre-dialysis systolic blood pressure, orthostatic hypotension and serum albumin were the influencing factors of IDH (P<0.05). ROC curve was used to evaluate the diagnostic accuracy of pre-hemodialysis systolic blood pressure for IDH. The area under the ROC curve was 0.787 (95% CI: 0.720-0.854, P<0.001), the threshold of IDH predicted by the Jorden index was 153 mmHg, the sensitivity was 75.5%, and the specificity was 75.4%. Conclusion  Pre-hemodialysis systolic blood pressure, blood albumin and postural hypotension are independent factors of IDH in diabetic patients. In order to predict the occurrence of IDH, the pre-hemodialysis systolic blood pressure threshold was 153 mmHg.

Effect of liraglutide on renal function and proteinuria level in patients with type 2 diabetes mellitus: a Meta-analysis

Feng Yiduo, Zhou Yilun

2025, 46(5):  866-876.  doi:10.3969/j.issn.1006-7795.2025.05.016

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Objective  This study aimed to explore the effect of liraglutide on estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) levels in patients with type 2 diabetes mellitus (T2DM). Methods  Databases including PubMed, Embase, Cochrane Library, WanFang, and China National Knowledge Infrastructure (CNKI) were systematically searched from inception to June 30, 2024. According to the inclusion criteria, randomized controlled trials (RCTs) involving intervention of liraglutide in T2DM were identified. Parameters of eGFR and UACR were extracted pre- and post-treatment in each study. A fixed or random-effects model was used for quantitative synthesis according to the heterogeneity, which was assessed with I² index.  Quality of eligible RCTs was evaluated based on the Cochrane criteria. Sensitivity test was conducted by using the standard method. Publication bias was evaluated according the Begg’s and Egger’s tests. Meta-analysis was performed with Revman 5.3 and Stata 12.0 softwares.  Results  A total of 10 studies, which included 11 RCTs and involved 657 patients, were ultimately identified after performing a systematic search. Of these, 322 patients were administered with liraglutide. The overall quality of eligible RCTs was rated as medium. Compared with control group, no significant changes of eGFR (WMD=4.52  mL/min/1.73 m²，95% CI: -2.79-11.84，I²=88%，P =0.23) was observed in liraglutide-treated participants. In contrast, liraglutide significantly improved levels of UACR (WMD=-13.48 mg/g，95% CI: -22.68 - -4.29，I² =75%，P =0.004）. The results were stable according to the sensitivity test. No significant publication bias was demonstrated after performing the Begg’s and Egger’s tests. Conclusions  The administration of liraglutide prevented the decline of eGFR and reduced UACR in T2DM. These results suggested that diabetic participants potentially benefit more from liraglutide treatment in clinical practice.

Reliability and validity of the repeatable battery for assessment of neuropsychological status scale in maintenance hemodialysis patients

Wang Xiaoqi, Liu Conghui, Shao Feng, Zhou Jingjing, Yang Fan, Li Zhongxin

2025, 46(5):  877-884.  doi:10.3969/j.issn.1006-7795.2025.05.017

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Objective  To evaluate the reliability and validity of the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in patients with maintenance hemodialysis (MHD). Methods  The general information and medical history of 84 MHD patients were collected, and the Mini-Mental State Exam (MMSE), Montreal Cognitive Assessment Scale (MoCA), and RBANS were conducted. The reliability of the scale was assessed by Cronbach α and split-half reliability. The structure and convergent validity of the scale were assessed by confirmatory factor analysis, and the RBANS scores’ correlation to MoCA and MMSE scores was analyzed by Spearman correlation analysis. The predictive value of the RBANS total score on cognitive impairment (CI) was analyzed by receiver operating characteristic (ROC) curve. '  The Cronbach's alpha coefficient of the RBANS total scale was 0.896, split-half reliability was 0.911， and reliability for the five dimensions of the RBANS ranged from 0.618 to 0.791. Confirmatory factor analysis indicated that the overall fit of the five-dimensional model of the RBANS scale was acceptable (χ²/df =1.587, root mean square error of approximation=0.084, comparative fit index=0.967, incremental fit index=0. 968, Tucker-Lewis index=0.947, goodness of fit index= 0.891). The average variance extracted (AVE) for the five dimensions of the RBANS ranged from 0.525 to 0.863, while the composite reliability (CR) ranged from 0.733 to 0.926, indicating good convergent validity of the scale. Furthermore, Spearman correlation analysis revealed that the total RBANS score was negatively correlated to the age of MHD patients and positively correlated to years of education, as well as the total scores of MMSE and MoCA (all P<0.01). The ROC curve analysis indicated that the area under the curve (AUC) for the total RBANS score in predicting CI was 0.891 (P<0.01), suggesting a high predictive value. Conclusion  The Chinese version of RBANS has good reliability and validity in MHD patients, and can be used as a measure of cognitive function in MHD patients.

Clinical outcomes of mitral valve repair in patients with rheumatic mitral valve disease and risk factors for long-term prognosis 

Li Xin, Jiang Wenjian, Han Jie, Zhang Hongjia

2025, 46(5):  885-891.  doi:10.3969/j.issn.1006-7795.2025.05.018

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Objective  To retrospectively analyze the clinical outcomes of mitral valve repair MVR for treating rheumatic mitral valve disease. Methods  A total of 537 patients with rheumatic mitral valve disease who underwent surgical repair at the Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, from January 2016 to August 2022 were retrospectively included. Clinical and follow-up data were collected. Kaplan-Meier survival curves were constructed to calculate event-free survival rates for the cohort. Additionally, multivariate Cox regression analysis was employed to identify independent risk factors affecting patient prognosis. Results  The mean age of all patients was (57.8 ± 7.5) years, with 144 (26.8%) males and 393 (73.2%) females. The median follow-up time for the cohort was 36.7 months. Survival analysis revealed that the 5-year composite endpoint-free survival rate was 94.1%, the 5-year overall survival rate was 96.7%, and the 5-year freedom from mitral valve reoperation rate was 97.2%. Multivariate Cox regression analysis identified systolic pulmonary artery pressure as an independent risk factor for adverse prognosis (P<0.05). Conclusion  Mitral valve repair can achieve favorable outcomes in appropriately selected patients with rheumatic mitral valve disease, while systolic pulmonary artery pressure serves as an independent risk factor for an adverse prognosis.

Perioperative oxygen concentration and postoperative organ damage in pediatric neurosurgery: a retrospective cohort study

Hu Zhengfang, Zhang Kangda, Wang Huiwen, Wang Chengwei

2025, 46(5):  892-897.  doi:10.3969/j.issn.1006-7795.2025.05.019

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Objective  To investigate the correlation between perioperative oxygen concentration and postoperative organ injury and other adverse reactions in children undergoing neurosurgery. Methods  This study is a single-center retrospective cohort study, including 512 children aged ≤14 years and operating duration ≥2 hours who were transferred after surgery to postanesthesia care unit (PACU), Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University from October 2018 to September 2023. His electronic medical record system was used to review and collect the patient's medical records during hospitalization. Including baseline data, anesthetic use, duration of anesthesia, intraoperative oxygen concentration, postoperative diagnosis, and surgical method; blood pressure, heart rate, oxygen saturation, pain score and special conditions during anesthesia recovery; infection during postoperative hospitalization (including wound infection, intracranial infection), respiratory complications ［confirmed by chest radiograph/chest computed tomography (CT) report］, changes in renal function (first postoperative serum creatinine value - last preoperative serum creatinine value), and incidence of delirium during recovery period during anesthesia were recorded. The area under oxygen concentration-time curve area under curve AUCFiO₂=the product of intraoperative oxygen concentration (%) and duration of anesthesia (min) was calculated, and then 512 children were divided into 3 groups according to the AUCFiO₂ tripartite (group 1:AUCFiO₂<8 720%min, group 2: 8 720%·min≤AUCFiO₂≤13 800%·min, group 3: AUCFiO₂ > 13 800%·min) were included in the data analysis. Results  The incidence of emergency delirium (ED)during postoperative recovery was 24%, 26. 9% and 19. 4%, and the incidence of acute kidney injury(AKI) was 0. 6%, 2. 3% and 0. 6%, respectively. There was no significant difference between the three groups (P > 0. 05). The incidence of postoperative pulmonary complications in the three groups was 20. 6%, 20. 8% and 31. 5%, respectively, and there was significant statistical difference among the three groups (P<0. 05). There were no significant differences in nausea, vomiting, hypoxemia, and PACU residence time among the three groups during anesthesia recovery room (P > 0. 05), and there were significant differences in intracranial infection, wound infection and hospital stay during hospitalization (P<0. 05). Conclusion  Although oxygen concentration AUCFiO₂ has no correlation with the occurrence of postoperative AKI and ED, the longer the exposure time of conventional oxygen administration strategy, the higher the incidence of postoperative pulmonary complications and postoperative infection, and the longer the hospitalization time of children.

Residual risk estimates of transfusion transmissible hepatitis B,hepatitis C and human immunodeficiency virus using P-WP model in Yantai,China,2018 through 2022

Shen Xintang , Song Hewei , Qu Jiali , Zhou Min , Wu Xiaoli , Wang Xiaohua

2025, 46(5):  898-906.  doi:10.3969/j.issn.1006-7795.2025.05.020

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Objective  Estimating the residual risk of transfusion-transmitted diseases  in voluntary blood donors is crucial for monitoring blood safety. and to analyze the evolution trend over a five-year period in Yantai, Shandong Province.   Methods  This study retrospectively reviewed screening data from Yantai Central Blood Station between 2018 and 2022.We compared the positivity rates between first-time and repeat donors, calculated the prevalence of each virus, and estimated the residual risk using the prevalence-window period model. Meanwhile, the age characteristics of all positive donors were analyzed. Results  Over the five-year period, a total of 320 016 individuals donated blood.     The overall reaction rate of transfusion-transmitted diseases was 0. 165%, with HBV (0. 129%) being the most common. The positivity rate among first-time donors ［P(FTDs)］ (0. 310%) was significantly higher than that among repeat donors ［P(RDs)］ (0. 054%)(χ²=312. 783,P<0. 05). The serological residual risks for HBV, HCV, and HIV were 1∶188 090, 1∶1 042 805, and 1∶392 995, respectively. During the five-year period, they decreased from 1∶129 495 to 1∶390 011, from 1∶697 002 to 1∶1 145 826, and from 1∶684 109 to 1∶1 067 317, respectively.The residual risks of HCV and HIV after NAT were 1∶22 369 329 and 1∶6 639 965, respectively, which were significantly reduced by 21. 5-fold and 16. 9-fold, and decreased steadily during the study period. Among the HBV-DNA (+) donors, 61. 8% (68/110) were RDs, and the residual risk was 1∶65  350.  Conclusion  This study demonstrates the remarkable effectiveness of introducing nucleic acid amplification technology (NAT) in reducing the residual risk of HBV, HCV, and HIV, particularly for HCV and HIV. The residual risk for HBV remains higher compared to HCV and HIV due to the discovery of occult HBV infections (OBI). Therefore, a crucial step toward further reducing this residual risk is the use of more sensitive reagents and detection platforms. Furthermore, implementing effective long-term incentive mechanisms and strategic planning to increase the proportion of repeat donors (RDs) is critical for enhancing transfusion safety.

  

2025, 46(5):  907-912.  doi:10.3969/j.issn.1006-7795.2025.05.021

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Research progress in mouse model of atherosclerosis

Ma Wei , Jiang Huimin , Zhou Yifan , Zhang Weiyue , Li Hui , Zhou Chen , Ji Xunming

2025, 46(5):  924-933.  doi:10.3969/j.issn.1006-7795.2025.05.024

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Cardiovascular disease is the leading cause of death worldwide, with atherosclerosis (AS)-its core pathological manifestation-representing a multifactorial-driven chronic inflammatory disorder. The pathogenesis of AS involves intricate pathological mechanisms including dyslipidemia, inflammatory cascades, and plaque vulnerability, whose complexity necessitates animal models capable of accurately recapitulating specific pathological features. Genetically engineered murine models have emerged as pivotal tools for deciphering AS mechanisms, owing to their genetic manipulability, phenotypic traceability, and molecular conservation with human pathophysiology. This review provides a systematic overview of current methodologies for establishing AS mouse models, with particular emphasis on evaluating the pathological fidelity of dietary induction approaches, genetic modification strategies ［notably apolipoprotein E (ApoE)^-/- and low density lipoproteins receptor (LDLr)^-/- models］, and physical injury paradigms.

Research advances in radiomics combined with multi-omics in hepatocellular carcinoma

Liu Yanyi, Zhang Yanyan, Li Hongjun

2025, 46(5):  934-939.  doi:10.3969/j.issn.1006-7795.2025.05.025

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Hepatocellular carcinoma (HCC) is the sixth most common malignant tumor in the world, accounting for 75%-85%. Due to the high incidence, strong heterogeneity and poor prognosis of HCC, early monitoring and fine assessment of high-risk populations are particularly important. In recent years, as a non-invasive method, radiomics has been widely used in the diagnosis, pathological characterization, selection of treatment methods and evaluation of curative effect of HCC. In addition, radiomics combined with next-generation sequencing technology and other multi-omics methods provide new ideas for HCC research. This paper reviews the research progress of radiomics combined with multi-omics in the field of HCC, in order to provide a new perspective for the diagnosis and treatment of HCC.

Dirk Görlich and Steven L. McKnight reveal new principles of intracellular transport and cellular organization——the 2025 Lasker Basic Medical Research Award 

Zhao Minghui, Shan Lin

2025, 46(5):  940-944.  doi:10.3969/j.issn.1006-7795.2025.05.026

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In 2025, The Lasker Award for Basic Medical Research were awarded to two scientists, Dirk Görlich and Steven L. McKnight, for their contributions to the structure and function of low-complexity domains (LCDs) in protein sequences. These discoveries reveal new principles of intracellular transport and cellular organization, overturning conventional knowledge and opening up novel horizons in the study of cellular transport and disease mechanisms.