Table of Content

21 February 2025, Volume 46 Issue 1

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Promoting the Stroke Prevention Project, National Health Commission: current status and strategy of stroke prevention and treatment in China

Stroke Prevention Project, National Health Commission, Ji Xunming

2025, 46(1):  11-14.  doi:10.3969/j.issn.1006-7795.2025.01.003

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In China, stroke has become a major public health issue. In response to the growing high-risk population and the substantial health and economic burden, the National Health Commission initiated “the Stroke Prevention Project, National Health Commission” in 2021. This program aims to systematically enhance the stroke prevention and control capacities, therebyreducing the harm caused by stroke. This report offers an overview of the program’s background and strategic implementation from a policy and governance perspective.

Cerebral angiographic features and prognostic study in patients with central retinal artery occlusion

Ya• Naren, Liu Yan, Zhou Xia, Zhu Dekun, Chen Feng, Ma Zhengfei, Li Chuanhui, Sun Zhongwu

2025, 46(1):  15-21.  doi:10.3969/j.issn.1006-7795.2025.01.004

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Objective  To analyze the cerebral angiographic characteristics of patients with central retinal artery occlusion (CRAO) and to study their prognosis.  Methods  A retrospective study was conducted, with 182 CRAO patients enrolled, who were treated at Xuanwu Hospital, Capital Medical University, the First Affiliated Hospital of Anhui Medical University, the Affiliated Suzhou Hospital of Anhui Medical University, and the People's Hospital of Shihezi City from January 1, 2014, to June 1, 2024. All patients underwent cerebral angiography within one month of onset. The baseline characteristics, treatment details, and follow-up data were collected. The Spearman rank correlation coefficient was used to evaluate the correlation between the characteristics of the ophthalmic artery and the ipsilateral carotid artery angiography, and Logistic regression analysis was performed to explore factors related to patient prognosis. Results  Cerebral angiography results showed that 81.3% of patients had ocular blood supply from the ipsilateral internal carotid artery, 12.1% from the ipsilateral external carotid artery, and 6.6% from the ipsilateral middle cerebral artery. Among the patients, 80 (44.0%) had varying degrees of stenosis or occlusion of the affected ophthalmic artery, with 69 patients (86.3%) showing stenosis at the origin of the ophthalmic artery. Additionally, 135 patients (74.2%) had varying degrees of stenosis or occlusion of the ipsilateral carotid artery, with 110 patients (60.4%) showing stenosis at the carotid bulb, 88 patients (48.3%) having unilateral carotid lesions, and 41 patients (22.5%) having multiple lesions. Correlation analysis indicated a significant correlation between the degree of stenosis in the ophthalmic artery and the carotid artery (r =0.76, P =0.006). Univariate and multivariate Logistic regression analyses revealed that the time from symptom onset to hospital admission (OR=0.93, 95% CI: 0.85 － 0.98, P=0.018), the grading of oxygenation-based hypoperfusion maculopathy (OHM) (OR=3.12, 95% CI: 1.09 － 6.34, P=0.005), intravenous thrombolysis (IVT) (OR=2.75, 95% CI: 1.08 － 5.35, P=0.031), and the absence of stenosis in the ophthalmic artery (OR=1.33, 95% CI: 1.02 － 3.41, P=0.026) were independent predictors of prognosis for CRAO patients. Conclusions  The degree of stenosis in the ophthalmic artery is significantly correlated with the degree of stenosis in the carotid artery in CRAO patients. Time from symptom onset to hospital admission, OHM grading, IVT, and the absence of stenosis in the ophthalmic artery are independent factors influencing the prognosis of CRAO patients.

Exploring the causal relationship between extensive perivascular space burden and ischemic stroke and its subtypes and transient ischemic attack based on Mendelian randomization

Chu Xuehong, Shen Yingjie, Wang Yaolou, Dong Xiao, Liu Yuanyuan, Feng Yan, Jiang Miaowen, Li Ming, Ji Xunming, Wu Chuanjie

2025, 46(1):  22-33.  doi:10.3969/j.issn.1006-7795.2025.01.005

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Objective  To investigate the association between extensive perivascular space (EPVS) burden in different locations and ischemic stroke (IS), its subtypes, and transient ischemic attack (TIA) through Mendelian randomization (MR) analysis. Methods  The summary data from large-scale Genome-wide Association Studies (GWAS) and various MR methods were employed. We applied multivariable MR to mitigate potential confounding factors and conduct sensitivity analyses to enhance result robustness. Subsequently, meta-analysis was utilized to integrate causal relationships between EPVS burden in different locations and IS from various sources. Additionally, reverse MR was employed to observe the impact of various IS types on EPVS burden. Finally, linkage disequilibrium score regression was conducted to assess genetic correlations between exposures and outcomes.  Results  EPVS burden in both the white matter (OR=1.12, 95% CI: 1.01-1.25; P = 0.04) and basal ganglia (OR=1.57, 95% CI:1.30-1.89; P < 0.01) are significant risk factors for IS. EPVS burden in the basal ganglia is also a risk for IS (small-vessel) (OR=4.56,95% CI:2.57-8.27; P = 5.95×10-7). After IS and TIA there seems to be a potential increase in extensive basal ganglia perivascular space burden. Conclusions  Extensive white matter perivascular space burden and extensive basal ganglia perivascular space burden may serve as important indicators to predict IS.

The expressions of CD62P, CD40L, and Rev-erbα after ischemic stroke on different onset times

Wang Yinping, Meng Cancan, Wu Wenjuan, Yang Zhitang

2025, 46(1):  34-40.  doi:10.3969/j.issn.1006-7795.2025.01.006

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Objective  To investigate the expression levels of platelet activating factor and rhythm nuclear receptor Rev-erbα in patients after ischemic stroke on different onset times. Methods  A total of 158 patients after ischemic stroke admitted from June 2022 to May 2023 were divided into four groups according to the onset time T₁ (0-6 o'clock), T₂ (6-12 o'clock), T₃ (12-18 o'clock), and T₄ (18-24 o'clock). Matched to the ischemic stroke groups, 126 patients hospitalized at the same time with non-ischemic stroke were divided into four groups. General data and serum samples of the subjects were collected, and the expression levels of CD62P, CD40L and Rev-erbα were detected with enzyme-linked immunosorbent assay (ELISA). Results  The expressions of platelet activating factor CD62P, tumor necrosis factor CD40L, and rhythm nuclear receptor Rev-erbα in T₂ group after ischemic stroke were significantly higher than that in the other groups (P< 0.05), whilst no significant difference were observed in other three groups （P>0.05). The expression of CD62P, CD40L and rev-erbα in ischemic stroke groups were significantly higher than that in control groups. Conclusion  The expression levels of the rhythm nuclear receptor Rev-erbα, CD62P, and CD40L in ischemic stroke groups is higher than that in control groups, and the expression of these cytokines is more significant in T₂ group (i.e. early in the morning) than other time slot. On the other hand, the expressions of CD62P and CD40L are consistent with Rev-erbα on the time slots, indicating a clear correlation. It is indicated Rev-erbα and platelet activation play a key role on attacking of ischemic stroke.

Analysis of the current status and efficacy of acute ischemic stroke treatment based on hierarchical medical service network

Zhan Yanli, Li Yiyin, Li Ping, Sun Jingping, Huang Liangtong, Cai Xueli

2025, 46(1):  41-47.  doi:10.3969/j.issn.1006-7795.2025.01.007

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Objective  To analyze the current status of stroke treatment in the hierarchical medical service network and the impact of referral on prognosis, to optimize the stroke treatment models, and to improve stroke treatment efficiency. Methods  Totally 573 patients with acute ischemic stroke who were referred by the hierarchical medical service network in Lishui, Zhejiang Province from January 2020 to December 2022 were selected for analysis of treatment and clinical data. Based on whether they received endovascular treatment at a high-level stroke center, they were divided into an effective referral group (261 cases) and an ineffective referral group (312 cases). Demographic data, influencing factors, clinical characteristics, and laboratory tests were compared between the two groups, and the differences were analyzed by using single-factor analysis, and prognosis of the two groups of patients was assessed. Results  Among 573 patients,197 received intravenous thrombolytic therapy and 261 received intravascular therapy. The effective referral rate was 45.55%. The proportion of patients in the effective referral group coronary artery disease and atrial fibrillation proportion is higher（χ² =5.34,8.67，P＜0.05), more likely to show dysarthria, gaze, and consciousness disorder（χ²=130.1,22.12,22.96，P ＜0.05), and the baseline NIHSS score was higher (F =3.25，P ＜0.05). Comparing the baseline blood cells counts of the two groups of patients at admission, the effective referral group showed lower eosinophil count, basophil count and lymphocyte (Z=－8.86,－5.39,F=0.598，P ＜0.05).  As for the prognosis, the proportion of neurological function improvement at discharge in the effective referral group was higher than that in the ineffective referral group. Binary Logistic regression analysis showed that baseline NIHSS score (OR=1.122, 95% CI:1.074-1.172), eosinophil (OR=0.085, 95% CI:0.013-0.564), and neutrophil count (OR=1.088, 95% CI:1.011-1.172) were independent influencing factors for effective referrals. Conclusions  The efficiency of the current regional stroke classification and treatment network needs to be further improved. Developing predictive models that include demographic characteristics, risk factors, symptoms, signs, and laboratory tests may help medical staff in stroke prevention and treatment centers quickly identify large vessel occlusion and improve acute ischemic stroke treatment efficiency.

Clinical observation on the efficacy and safety of intravenous thrombolysis in the treatment of acute mild non-disabling ischemic stroke: a single-center retrospective observational study

Zhang Meng, Ma Yongxin, Jia Qiong , Zhang Dongwei, Zhang Xinhong, Xu Yaoming

2025, 46(1):  56-62.  doi:10.3969/j.issn.1006-7795.2025.01.009

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Objective  To explore the clinical efficacy and safety of intravenous thrombolysis and dual antiplatelet therapy in the treatment of acute mild non-disabling ischemic stroke.  Methods  A retrospective cohort study was conducted, including 138 patients with acute mild non-disabling ischemic stroke［National Institutes of Health Stroke Scale（NIHSS） score≤5］from January 2022 to March 2024, within 6 h of onset. Patients were divided into an intravenous thrombolysis group (66 cases) and a dual antiplatelet group (72 cases). Propensity score matching was used to match patients 1∶1, resulting in 44 patients in each group after matching. Demographic data, clinical data, clinical outcome indicators, and adverse events were collected. The primary outcome was defined as a good functional outcome［modified Rankin Scale(mRS) score 0－2］ at 90 d post-onset. Secondary outcomes included NIHSS scores at 24 h, 72 h, and 7 d post-onset; the proportion of early neurological deterioration; intracranial and systemic hemorrhagic events within 90 d post-onset; and death within 90 d. Results  ①Before matching, the intravenous thrombolysis group had a lower age and admission mRS score than that of the dual antiplatelet group, with statistically significant differences (all P<0.05). After matching, there were no statistically significant differences between the two groups in terms of age, gender, hypertension, diabetes, cardiac disease, atrial fibrillation, hyper low density lipoprotein -cholesterol (LDL-C), hyperhomocysteinemia, prior stroke, prior smoking, admission NIHSS score, admission mRS score, location of stroke and TOAST classification (all P>0.05); ②There was no statistically significant difference in the proportion of patients with a good functional outcome at 90 d post-onset and the mRS score at 90 d between the intravenous thrombolysis group and the dual antiplatelet group［88.6% (39/44) vs 93.2% (41/44), P=0.458, P=0.308］; ③ The intravenous thrombolysis group had significantly lower median NIHSS scores at 24 h and 72 h post-onset compared to the dual antiplatelet group, with statistically significant differences［1 vs  2.5, 1 vs  2, P=0.018, 0.043］. There were no statistically significant differences in the other efficacy and safety outcomes. Conclusions Intravenous thrombolysis therapy can bring significant short-term benefits to patients with acute mild non-disabling ischemic stroke, helping to shorten the time to recovery to a good neurological functional outcome, and does not increase the risk of bleeding and mortality. However, in terms of good functional outcomes at 90 d post-onset, its effects are similar to those of dual antiplatelet therapy. Nevertheless, there is an urgent need for larger sample, higher quality clinical studies to further validate these findings.

Current situation and four-level prevention of stroke under the collaborative management model between medical  prevention and treatment in Nantong

Liu Xiaomeng, Zhou Shaojuan, Shao Xiaohong, Xu Wenping, Huan Feng, Zhu Xiangyang

2025, 46(1):  63-67.  doi:10.3969/j.issn.1006-7795.2025.01.010

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Objective  To analyze the innovative model and effectiveness of the four-level prevention of stroke in  Nantong Medical and Prevention Collaborative Center for Cardiovascular and Cerebrovascular Disease,so as to provide new practical experience for the prevention and treatment of cerebrovascular disease.  Methods  In practice, Nantong city has explored the “53343” mode of collaborative treatment and prevention of cardiovascular and cerebrovascular diseases, and innovatively integrated this mode into four-level prevention to form a practice mode of  zero-level guidance, first-level monitoring, second-level coordination and three-level leading. Data from the China Health Statistics Yearbook from 2011 to 2022 and the monitoring data of cardiovascular and cerebrovascular events in Nantong City on the Jiangsu Provincial Chronic Disease Management Information Platform from 2017 to 2023 were collected and processed by using Excel and SPSS 24.0, to analyze the changes of stroke surveillance data and effectiveness in Nantong City after applying the model. Results  According to the monitoring data of cardiovascular and cerebrovascular events in Nantong City from the Jiangsu Provincial Chronic Disease Management Information Platform, despite the continuous increase in the number of monitored individuals over five years, the monitoring data for stroke from the Nantong Medical and Prevention Collaborative Center for Cardiovascular and Cerebrovascular Disease witnessed a decline in the number of monitored individuals for the first time in 2022. The stroke monitoring data from the same monitoring agency showed a more stable fluctuation trend compared to the number of national stroke patients discharged from 2017 to 2021. We established a coherent health service operation mechanism, cultivated 14 interdisciplinary talents,  held a special continuing education class on stroke, strengthened the in-depth collaboration between clinical and public health, and provided a practical and innovative model for effective prevention and treatment of stroke. Conclusions  The four-level prevention based on the medical and preventive collaboration center for cardiovascular and cerebrovascular diseases can achieve process and cycle health management, effectively slow down the upward trend of stroke, and improve the ability and level of scientific research and teaching.

The current status and future directions of reperfusion therapy for acute ischemic stroke

Qiao Yue, Li Chuanhui, Zhao Wenbo

2025, 46(1):  68-70.  doi:10.3969/j.issn.1006-7795.2025.01.011

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Intravenous thrombolysis and mechanical thrombectomy are well-established reperfusion therapies for acute ischemic stroke, which can significantly improve clinical outcomes compared to conventional treatments. However, both strategies face the following challenges: although it is the first-line treatment, intravenous thrombolysis suffers from low recanalization rates and a narrow therapeutic time window (3-4.5 h), which limits its clinical benefit. Mechanical thrombectomy, while achieving over 80% recanalization, still results in disability or death in more than 50% of patients. Future efforts should focus on optimizing thrombolytic drugs by developing novel agents with higher fibrin specificity and safety profiles, thus expanding the population benefiting from thrombolysis. Moreover, reperfusion therapy based on the “tissue window” could be achieved with utilizing advanced imaging techniques to break the traditional time window limitation. The promotion of mobile stroke units could facilitate ultra-early reperfusion treatment. Additionally, optimization of post-thrombolysis antithrombotic strategies is essential to prevent neurological deterioration. For mechanical thrombectomy, it is crucial to enhance perioperative management and actively explore neuroprotective strategies for further improvement of outcomes.

Research advances on lipoprotein(a) in cerebrovascular diseases

Guo Yibing, Meng Ran

2025, 46(1):  71-75.  doi:10.3969/j.issn.1006-7795.2025.01.012

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Lipoprotein(a)［Lp(a)］ is a unique plasma lipoprotein particle with a distinct structure that has garnered significant research attention due to its strong association with various cerebrovascular diseases. Recent studies underscore elevated Lp(a) levels as a critical risk factor, with multiple Lp(a)-targeted therapies advancing through clinical trials.  This review explores the structural, functional, and genetic features of Lp(a), its connection to cerebrovascular diseases, and the latest therapeutic strategies aimed at reducing its impact. By consolidating these advancements, we aim to provide new insights for Lp(a)-centered research and propose innovative approaches for cerebrovascular disease prevention and management.

Detection of cerebral ischemia-reperfusion injury using BIBP-H fluorescent probe

Cui Wei, Pang Qidan, Xiang Hanyue, Xiao Nao, Jiang Dechun, Li Shen, Shen Guangli

2025, 46(1):  76-82.  doi:10.3969/j.issn.1006-7795.2025.01.013

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Objective  To evaluate the potential of the BIBP-H fluorescent probe in the detection of  the oxidative stress levels after cerebral ischemia-reperfusion (CIRI). Methods  In vitro, the potential of  BIBP-H probe was in detection of oxidative stress was first assessed with fluorescence imaging in rat neuroblastoma (B104) cells after L-glutamic acid stimulation. And then, the effects of edaravone and dexborneol (EDA) and glutathione (GSH) pretreatment on the fluorescence intensity were evaluated. Later, a totally of 28 male C57BL/ 6 mice were randomly assigned into four groups: transient middle cerebral artery occlusion (tMCAO) group, EDA+tMCAO group, GSH+tMCAO group, and sham group. After 1.5 h ischemia and 12 h  reperfusion, the mice were treated with BIBP-H via tail vein injection. In vivo, ex vivo, and tissue fluorescence imaging were utilized to evaluate the probe's cerebral ischemia - reperfusion injury (CIRI).Results  ① BIBP-H probe did not exhibit fluorescence signals in cultured B104 cells, but showed red fluorescence in B104 cells treated with L-glutamic acid. The signals significantly decreased when pretreated with EDA or GSH. ② Both the sham-operated mice intravenously injected with the BIBP-H probe and the tMCAO mice without injection of the probe showed negative results in in vivo fluorescence imaging.  ③ tMCAO mice treated with BIBP-H exhibited red fluorescence signals in the ischemic hemisphere in vivo, with significantly reduced fluorescence intensity after EDA or GSH infusion during reperfusion  ④ The fluorescence area examined with BIBP-H was consistent the cerebral infarction area detected with triphenyltertrazolium. Conclusion  The BIBP-H probe effectively monitored oxidative stress levels both in vivo and in vitro, demonstrating its potential in CIRI detection.

Panoramic and local histological observations of biotinylated dextran amine neural tracer labeling in the motor cortex of rat brain

Lu Jiaying, Xu Dongsheng, Cui Jingjing, Wang Yuqing, Su Yuxin, Liu Yihan, Wang Jia, Bai Wanzhu

2025, 46(1):  83-90.  doi:10.3969/j.issn.1006-7795.2025.01.014

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Objective  To reveal the detailed histological characteristics of pyramidal neuron cell bodies and their axonal projections along the corticospinal tract in the primary motor cortex (M1) of the brain, by using the biotinylated dextran amine (BDA) neural tracing technique combined with panoramic and local microscopic imaging technologies.  Methods  A total of 100 nL of 10% BDA (10,000 molecular weight) was injected into M1 region using stereotaxic system. The distribution of BDA labeling along the corticospinal tract was continuously tracked with panoramic tissue scanning analysis system. Detailed observations of the histological characteristics of BDA labeling were carried out with laser confocal microscope. Results  It is more convenient to observe the overall distribution of BDA neural labeling by using the panoramic tissue scanning analysis system. Around the injection site in M1, the BDA labeling was shown in the somas of pyramidal neurons in layer V. In the M1 region corresponding to the contralateral site of the injection site and ipsilateral primary sensory cortex, BDA showed predominantly the anterograde labeled nerve fibers accompanied by a few retrograde labeled neurons. Besides, BDA labeled nerve fibers-including bundles and terminals-projecting to regions such as the ipsilateral striatum, thalamus, internal capsule, cerebral peduncle, and pons, and further reaching the contralateral spinal cord via the brainstem pyramidal decussation. Confocal microscopy and its 3D reconstruction system facilitated detailed analysis of the local microscopic features of BDA labeling, revealing retrograde labeled neuron cell bodies, dendrites and their spines, as well as anterograde labeled nerve fibers and their terminals. Conclusions  These findings demonstrated that the integration of traditional BDA neural tracing with panoramic tissue scanning analysis and confocal microscopy provided an effective approach to the observation and analysis of long-projection neural circuits from panoramic to local perspectives, with broad application prospects.

Study of epileptic seizure prediction based on a small-scale neural network

Ouyang Hui, Li Yutang, Lou Xiaoyue, Liu Renshuo, Sun Jingxiao, Li Chunlin, Zhang Xu

2025, 46(1):  91-98.  doi:10.3969/j.issn.1006-7795.2025.01.015

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Objective  To explore an epileptic seizure prediction method for patients with refractory epilepsy to improve the classification and prediction efficiency of epileptic electroencephalogram (EEG) signals. Methods  The study used the long-term EEG database of patients with intractable epilepsy from Children's Hospital Boston (CHB-MIT). The EEG features of epileptic seizures and preictal periods were extracted from multiple dimensions such as EEG synchronization, complexity, and energy distribution, and then these features were input into the artificial neural network model for classification and identification, thereby achieving accurate prediction of epilepsy. The performance were optimized by adjusting the model parameters, and a comparative evaluation was conducted with existing deep learning models. Results  The model proposed in this study showed an accuracy rate of 99.29%, a precision of 91.44%, a sensitivity of 96.46%, and a specificity of 99.46%. Compared with current epilepsy seizure prediction studies based on machine learning or deep learning frameworks, the model in this study improved its classification prediction capabilities and demonstrated higher prediction accuracy. Conclusion   An effective prediction of epileptic seizures was achieved by manually extracting epileptic EEG features and constructing an artificial neural network model. The model demonstrated high accuracy and stability, providing reliable technique to support clinical treatment and prevention of epilepsy.

Research progress on imaging segmentation and quantification methods for epicardial adipose tissue and its clinical applications

Qu Junda, Yang Minfu, Li Chunlin, Sun Liwei, Gao He, Zhang Xu

2025, 46(1):  99-105.  doi:10.3969/j.issn.1006-7795.2025.01.016

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Epicardial adipose tissue (EAT) is a type of fat tissue that is closely adjacent to the coronary arteries and myocardium, and it caused physiological and pathological changes to the body through the secretion of autocrine and paracrine active factors. EAT is regarded as a diagnostic marker and a potential therapeutic target for cardiovascular diseases, and it is of great significance to segment and quantify EAT. This article introduced the evolution of the EAT segmentation and quantification methods from the aspects of traditional imaging, atlas, and artificial intelligence. Furthermore, it reviewed the research progresses on automatically quantified EAT indices in the diagnosis and treatment of cardiovascular diseases.

The effect and mechanism of valsartan on energy metabolism of mice

Ji Wenyi, Song Lini, Cao Xi

2025, 46(1):  106-114.  doi:10.3969/j.issn.1006-7795.2025.01.017

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Objective  To study the effect and possible mechanism of angiotensin Ⅱ receptor blocker (ARB) on energy metabolism in mice.   Methods  ① Male 6-week-old C57BL/6N mice were fed with normal diet (ND) and high-fat diet (HFD) for 6 weeks, then detect their body weight and fasting blood glucose. ② The diabetic mice induced by high-fat diet were randomly divided into  control group (Con) and  drug treatment group (ARB). They were administered with saline and valsartan at a dose of 3 mg/kg per day via gastric lavage for 6 weeks. After that, the body weight, body temperature, intraperitoneal glucose tolerance test, respiratory metabolism rate, hematoxylin-eosin staining of adipose tissue, and the expression of thermogenesis-related genes in brown adipose tissue were examined. ③ By using male 6-week-old db/db mice as the experimental subjects, they were also administered with saline and valsartan at a dose of 3 mg/kg per day via gastric lavage for 5 weeks. After that, the body weight, fasting blood glucose, and body temperature were measured.   Results  High-fat diet successfully induced the diabetic mouse model. Valsartan treatment significantly reduced the weight gain rate of HFD mice and the body weight of db/db mice, increased the body temperature of HFD mice in a 4 ℃ cold environment, and improved the energy expenditure of HFD mice, but had no significant improvement on glucose metabolism in HFD mice. Compared with the control group, the fasting blood glucose level of db/db mice was significantly reduced after valsartan treatment, and the body temperature showed an upward trend after 2 h and 3 h of cold treatment at 4 ℃, but the difference was not statistically significant. In addition, for HFD mice, valsartan treatment significantly reduced the cell volume of brown adipocyte, subcutaneous adipocyte, and epididymal adipocyte. At the mRNA level, valsartan promoted the expression of UCP1 in brown adipose tissue, while the expression of Prdm16,PGC1α and AP2 expression did not change significantly.   Conclusions  Valsartan can improve energy metabolism in obese mice, and its mechanism may be related to the positive effects of ARB on the thermogenesis of brown adipose tissue.

The impact of FOXP2 mediated by the Hedgehog signaling pathway on glycolysis participating in the proliferation and metastasis in uterine leiomyoma cells

Yang Yan, Tian Ni, Long Ling, Jia Zhenxiang

2025, 46(1):  115-124.  doi:10.3969/j.issn.1006-7795.2025.01.018

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Objective  To explore the role of forkhead box protein p2 (FOXP2) in the proliferation and metastasis of uterine fibroid cells by regulating glycolysis mediated by Hedgehog signaling pathway.  Methods  Fresh hysteromyoma tissue was obtained from 10 patients who underwent myomectomy in the Department of Gynecology of Guizhou Provincial Hospital of Workers, and hysteromyoma cells were digested and separated. Cells were transfected with lentivirus shRNA targeting FOXP2 (sh-FOXP2), negative control (sh-NC) and FOXP2 overexpression vectors (oe-FOXP2), and negative control (oe-NC). Colony formation test and Transwell assay were used to evaluate the cell proliferation and metastasis ability. Glucose uptake, lactic acid production and extracellular acidification rate (ECAR) were measured to detect the aerobic glycolysis ability of cells. A xenograft tumor model was established by up-regulating uterine leiomyoma cells with FOXP2 to explore the regulatory effect of FOXP2 in vivo. Results  Compared with oe-NC group, the cell viability, colony number, migrating cell number, glucose uptake, lactic acid production and ECAR in oe-FOXP2 group decreased significantly (P<0.05). Compared with sh-NC group, the cell viability, colony number, migrating cell number, glucose uptake, lactic acid production and ECAR of uterine fibroids in sh-FOXP2#1 and sh-FOXP2#2 groups increased significantly (P<0.05). Compared with oe-NC+vector group, the number of colonies, migrating cells, glucose uptake, lactic acid production, ECAR, Shh and Gli proteins in oe-FOXP2+vector group decreased significantly (P<0.05). Compared with oe-FOXP2+vector group, the number of colonies, migrating cells, glucose uptake, lactic acid production, ECAR, Shh and Gli proteins in oe-FOXP2+SAG group were significantly increased (P<0.05). Compared with oe-NC group, the tumor weight, the proportion of Ki-67 positive cells and the proteins of Shh, Gli, GLUT1 and PGAM1 in oe-FOXP2 group decreased significantly (P<0.05). Compared with oe-FOXP2 group, the tumor weight, the proportion of Ki-67 positive cells and the proteins of Shh, Gli, GLUT1 and PGAM1 in oe-FOXP2+SAG group increased significantly (P<0.05). Conclusions  FOXP2 participates in the proliferation and metastasis of uterine leiomyoma cells by regulating glycolysis mediated by Hedgehog signaling pathway. 

The relationship between sub-healthy individuals with spleen qi deficiency syndrome and attention network dysfunction

Wu Ziyao, Feng Sitong Jia Hongxiao, Dong Linrui, Ning Yanzhe

2025, 46(1):  125-129.  doi:10.3969/j.issn.1006-7795.2025.01.019

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Objective  To explore the attentional network function in sub-healthy individuals with spleen qi deficiency syndrome.  Methods  Twenty-seven individuals in the sub-healthy spleen qi deficiency syndrome group were recruited from September 2022 to August 2024 in communities and colleges. Twenty-five healthy controls were also recruited according to the principle of matching age, gender, and years of education components. Attention network tests were performed on subjects in both groups. Results  Compared with the control group, the executive control network function value of the spleen qi deficiency syndrome group was significantly decreased (P=0.012). The differences in correct rate, overall reaction time, alert network and orientation network between the two groups were not statistically significant (P > 0.05). The results of correlation analysis showed a significant negative correlation between Health Evaluating Questionnaire  H20  V2009 scores and executive control network efficiency of the subjects in the spleen qi deficiency syndrome (P<0.001), and a positive correlation between the spleen qi deficiency syndrome score and executive control network efficiency (P=0.038). Conclusions  Abnormal changes in the executive control of attention in sub-healthy subjects with spleen qi deficiency syndrome were closely related to the severity of the symptoms of spleen qi deficiency, which provided further scientific evidence for the cognitive psychological connotation of the theory of “spleen stores Yi”.

Analysis of influencing factors of time prolongation of time up and go test in maintenance hemodialysis patients

Zhang Xiao, Zhang Wei, Wang Zunli, Wen Nuan, Liu Conghui, Li Zhongxin

2025, 46(1):  130-135.  doi:10.3969/j.issn.1006-7795.2025.01.020

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Objective  To explore the influence factors of timed up and go test (TUG) in patients with maintenance hemodialysis (MHD). Methods  Cross-sectional investigation method was used to select patients who underwent regular hemodialysis in Beijing Luhe Hospital, Capital Medical University from June 1, 2023 to January 31, 2024, with complete data and cooperation. The patients were respectively treated with a simple mental state checklist and 5 times sit to stand test (STS-5) and TUG scale were used to assess cognitive function, lower limb muscle strength, balance and gait function. Grouping was carried out according to the results of TUG. If TUG ≤ 12s, it is judged as the TUG normal group; if TUG > 12s, it is judged as the TUG  prolonged group. Multi-factor Logistic regression was used to analyze the influencing factors in the TUG prolonged group, and the predictive value of influencing factors to TUG prolonged patients was analyzed by receiver operating characteristic (ROC) curve.   Results  A total of 146 patients with MHD were included in this study, including 86 patients in TUG prolonged group and 60 patients in TUG normal group. Gender, age, combined hypertension, combined diabetes, blood glucose, education level, Minimum Mental State Examination (MMSE) score, C-reactive protein were compared between groups. Serum albumin, serum creatinine, serum sodium, whole parathyroid hormone, low density lipoprotein-cholesterol, serum uric acid, STS-5 results, and single urea  clearance index（Kt/V） had statistical differences (P<0.05). Multivariate Logistic regression showed that old age, female, low MMSE score, low Kt/V, and STS-5 duration were independent risk factors for TUG prolonged (P<0.05). ROC curve showed that the  area under the curve （AUC）of age, gender, total MMSE score and STS-5 time in predicting TUG prolongation in MHD patients were 0.825, 0.678, 0.777 and 0.836, respectively (P<0.01), which had high predictive value. The AUC of Kt/V in predicting TUG prolongation was 0.602 (P=0.037), has a certain predictive value;AUC of TUG prolongation in MHD patients predicted by the above 5 indicators as a global model was 0.923 (P<0.01).Conclusions  The age, gender, MMSE score, STS-5 prolongation and Kt/V level of MHD patients are independent risk factors for TUG prolongation, and may be biological indicators for predicting TUG prolongation.

Analysis of anorectal functional characteristics in Parkinson's disease  constipation and functional constipation

Li Xiaocui, Liu Ziyu, Zhai Huihong

2025, 46(1):  136-142.  doi:10.3969/j.issn.1006-7795.2025.01.021

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Objective  To compare the changes in anorectal function between patients with Parkinson's disease  constipation (PDC) and with functional constipation (FC), and further understand the constipation characteristics of PDC patients.  Methods  From 2017 to 2022, 34 patients with PDC and 39 patients with FC who visited the Department of Neurology and the Department of Gastroenterology in Xuanwu Hospital, Capital Medical University were selected as the observation group and the control group. High resolution anorectal manometry was used to detect the motility, sensation and reflex of anorectal sphincter and pelvic floor muscles in the two groups of patients with constipation, and to compare the anorectal function changes of the two groups of patients. according to the results of manometry, the characteristics of constipation in the two groups of patients were analyzed and compared. Results  The resting anal sphincter pressure and intrarectal pressure in the PDC group were significantly lower than those in the FC group, with statistical significance［ (71.73 ± 20.01)mmHg  vs (85.02 ± 19.74)mmHg, (22.30 ± 21.12)mmHg vs  (38.10 ± 17.00)mmHg, respectively, 1 mmHg=0.133 kPa,all P<0.05］.The length of high pressure zone,maximum squeeze pressure, continuous systolic time and anal relaxation rate in PDC group were lower than those in FC group, but   no statistically significant differences; The maximum tolerance threshold of patients in the FC group was significantly higher than that in the PDC group, but there was no statistically significant difference between the two groups. There was no statistically significant difference in rectanal inhibitory reflex, initial sensory threshold, initial defecation threshold, and rectal compliance between the two groups. According to the pressure measurement results, it was found that both groups of patients mainly had insufficient defecation thrust.The proportions of insufficient defecation propulsion in PDC group and FC group were 88.2% (30/34) and 59.0% (23/39), the proportions of dyscoordination were 11.8%（4/34） and 30.8%（12/39）, and the proportions of normal defecation propulsion without uncoordinated defecation were 0% and 10.3%（4/39）, respectively. There was significant difference between the two groups in the type composition ratio of defecation disorder (χ²=8.623，P<0.05).Conclusions  Both PDC patients and FC patients have abnormal rectal and anal motility and sensation, and the main manifestation of pressure measurement classification is insufficient defecation thrust. However, compared to FC patients, PDC patients have significantly lower anal resting pressure and rectal defecation pressure. In depth research on the changes in anorectal function and constipation characteristics of PDC patients can help improve understanding of the disease and provide relevant evidence for developing reasonable treatment plans for PDC.

Analysis of risk factors and establishment of a prediction model for endometrial cancer in postmenopausal bleeding

Wang Jing, Zhou Qiaoyun, Wang Muyu, Xiao Yu, Song Dongmei, Guo Yan, Xia Enlan, Li Tinchiu, Huang Xiaowu

2025, 46(1):  143-149.  doi:10.3969/j.issn.1006-7795.2025.01.022

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Objective  To establish a method for predicting the risk of endometrial cancer (EC) and endometrial atypical hyperplasia (AH) in women with postmenopausal bleeding (PMB) by collecting clinical data on routine medical history.  Methods  The clinical data of a total of 408 PMB patients admitted to Fuxing Hospital, Capital Medical University were consecutively collected in this retrospective study from December 2013 to December 2023. According to the results of endometrial pathology, patients were divided into case group and control group. EC and AH were included in the malignant group (case group) and the other endometrial pathologies were included in the non-malignant group (control group). Clinical data, including clinical history, high risk factors, and common gynecological ultrasound measurement indicators, were collected and studied by univariate and multivariate Logistic regression analysis. Results  The mean age of 408 patients was (60.4±7.8) years. A total of 74 cases (18.1%) were in case group and 334 cases (81.9%) were in control group. Based on Logistic regression analysis, the best predictors of endometrial malignant lesions were selected to create a “LRDNT” (light bleeding, recurrent bleeding, diabetes, non-uniform echogenicity & thickness) model. LRDNT scores range from 0 to 22. The score of LRDNT ≥15 has the largest Yoden index, and the sensitivity to predict endometrial malignant lesions is 79.73%, the specificity is 80.84%, and the prediction accuracy is 80.64%. Conclusions  The risk prediction model LRDNT, which combines clinical information and common gynecological ultrasound measurement indicators of PMB patients, can help clinicians classify patients at high and low risk of endometrial malignant lesions, and optimize the strategy of diagnosis and treatment. 

Research progress on activated leukocyte adhesion molecules in lupus nephritis

Weng Kexia, Li Bing

2025, 46(1):  150-153.  doi:10.3969/j.issn.1006-7795.2025.01.023

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Lupus nephritis (LN) is a common and serious complication of systemic lupus erythematosus(SLE). The clinical course of  LN  is usually characterized by alternating phases of remission and exacerbation. The onset of LN can lead to deterioration of renal function and requires prompt diagnosis and treatment. Some studies have suggested that the presence and changes of activated leukocyte cell adhesion molecule (ALCAM) may be related to the development of LN as well as LN activity. Urinary activated leukocyte cell adhesion molecule (uALCAM) is promising as a non-invasive marker for evaluating LN activity in SLE patients. Determination of  uALCAM levels is helpful in early diagnosis, indication of disease activity and prediction of disease recurrence. ALCAM is expressed in a variety of cells and exerts different biological effects, including regulating cell differentiation, proliferation and migration. It is also pathologically expressed in various malignant tumors and has carcinogenic properties.This review will review the existing research on the role of ALCAM in the genesis and progression of LN, and the potential role of ALCAM as a new diagnostic marker and therapeutic target.

Writing norms for ethics in medical papers involving humans or laboratory animals

Zhang Jianjun

2025, 46(1):  154-160.  doi:10.3969/j.issn.1006-7795.2025.01.024

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Research ethics is an integral part of scientific research, encompassing the relationship between researchers and research subjects, as well as ethical issues that may arise during the research process. In research involving humans or laboratory animals, ethical issues become more complex and sensitive, necessitating stricter ethical norms and regulations. This article involves the examination 141 university journals in the field of medicine and health through the “China Academic Journal Database” in “Wanfang Data”, and the download of a total of 170 scientific papers involving humans or laboratory animals. Through the analysis and summarization of the ethical writing norms in these 170 papers, as well as suggestions for standardized writing, it is hopeful all to provide some references for medical researchers when writing papers. At the same time, it can also serve as a reference for medical journals in formulating ethical writing norms for medical papers involving humans or laboratory animals.

Research on the construction of ethical system for publishing medical science and technology journals in universities

Yan Hong, Gao Jian, Huang Fang, Zhang Jianjun

2025, 46(1):  161-166.  doi:10.3969/j.issn.1006-7795.2025.01.025

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Objective  To investigate the current situation of ethical system construction in the publication of medical science and technology journals in universities, to explore the problems in the construction of ethical system in the publication of medical science and technology journals in universities, and propose corresponding suggestions. Methods  A total of 55 medical university journals included in the 2023 edition of the China Science and Technology Journal Citation Reports (Core Edition) Natural Science Volume were selected as the research subjects, and their publishing ethics system construction was investigated through the journal's official website. Results  Only 18 journals have clear publishing ethics sections on their official websites, covering publishing ethics systems related to authors, reviewers, editors, and publishers, while other journals only mention publishing ethics systems related to authors, reviewers, editors, and publishers in their submission guidelines, peer reviews, and related statements published on their respective official websites, and the coverage is incomplete and the publishing process is opaque. Conclusion  Ethical systems and strengthen the prevention and handling of academic misconduct, to strengthen the promotion of publishing ethics system and enhance the integrity awareness of authors, to promote transparency in the publishing process and strengthen supervision and to early warning of various publishing processes.

Exploration of high-quality development of scientific and technological journals in medical universities: a case study of scientific and technological journals sponsored by Capital Medical University

Zhuang Ying, Gao Jian, Chen Ruifang, Huang Fang

2025, 46(1):  167-171.  doi:10.3969/j.issn.1006-7795.2025.01.026

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cademic journals constitute a vital component of national scientific research and cultural soft power, playing an irreplaceable role in flourishing academic research, fostering cultural innovation, and promoting economic and social development as well as advancements in science and technology. In recent years, China has made a series of policies aimed at promoting the prosperity and development of academic journals and enhancing the country's status and influence in the international academic community. Taking three scientific and technological journals sponsored by Capital Medical University as examples, this paper elucidates a series of measures to facilitate high-quality journal development in the context of the new era, including team building, enhancing journal impact, and initiating enhanced publications. The objective is to provide some preliminary insights into the sustainable and high-quality development of scientific and technological journals at medical universities