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Brief report on stroke prevention and treatment in China,2024 Stroke Prevention Project, National Health Commission, Ji Xunming Journal of Capital Medical University    2025, 46 (6): 947-960.   DOI: 10.3969/j.issn.1006-7795.2025.06.001 Abstract （2512）      PDF（pc） （5215KB）（1411）       Knowledge map    Save lthough China has a slight decline in stroke incidence in recent years, it still seems to be the leading health threat to Chinese citizens. China continues to bear a heavy stroke burden which has distinct epidemiological characteristics, while major risk factors remain prevalent and poorly controlled. Markedly, the government is putting effort into advancing the stroke prevention and treatment system, meanwhile, continuously funding cerebrovascular disease research, and driving steady improvements in diagnosis and treatment capabilities. However,  stroke prevention and control work in China still faces considerable challenges. This report systematically reviews the current state of stroke prevention and treatment in China during 2023 from five perspectives: epidemiological characteristics, risk factors, diagnostic and therapeutic advances, prevention system development and stroke center construction, aiming to provide references for clinical practice. Reference | Related Articles | Metrics

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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 Journal of Capital Medical University    2025, 46 (1): 11-14.   DOI: 10.3969/j.issn.1006-7795.2025.01.003 Abstract （2267）      PDF（pc） （392KB）（102）       Knowledge map    Save 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. Reference | Related Articles | Metrics

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The application of artificial intelligence in the diagnosis and treatment of cerebrovascular disease Zhang Wanwan, Dong Xiao, Yu Erlan, Ji Xunming, Wu Chuanjie Journal of Capital Medical University    2025, 46 (1): 6-10.   DOI: 10.3969/j.issn.1006-7795.2025.01.002 Abstract （2132）      PDF（pc） （413KB）（150）       Knowledge map    Save With the rapid development of artificial intelligence (AI) technology and its extensive application in the medical field, AI has gradually been applied to all aspects of cerebrovascular disease diagnosis and treatment, including but not limited to prevention, prediction, diagnosis, treatment, and prognosis assessment. This article reviewed the current application of AI technology in the field of cerebrovascular disease diagnosis and treatment and discussed the improvement of the diagnostic and therapeutic process with AI technology application. It provides novel insights and strategies for the clinical management of cerebrovascular diseases. Reference | Related Articles | Metrics

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Advances in the application of antiplatelet therapy in intravenous thrombolysis for acute ischemic stroke patients Zi Xiaohui, Xia Xue, Li jing, Zhang Xiaoli, Zhou Quan, Wang Anxin, Wang Yilong Journal of Capital Medical University    2025, 46 (2): 234-242.   DOI: 10.3969/j.issn.1006-7795.2025.02.009 Abstract （1794）      PDF（pc） （553KB）（197）       Knowledge map    Save Acute ischemic stroke (AIS) is associated with high mortality and disability rates, presenting a substantial challenge to global public health challenge. Intravenous thrombolysis (IVT) is recognized as a cornerstone of early AIS treatment and is recommended as the standard therapeutic approach by both national and international guidelines. However, the clinical efficacy of IVT remains suboptimal due to several limitations, including a narrow therapeutic time window and the inevitable activation of the coagulation system and platelet aggregagation during thrombolysis. These factors may contribute to adverse outcomes such as early neurological deterioration (END) and vascular re-occlusion. Antiplatelet therapy (APT), which inhibits platelet aggregations, reduces microthrombus formation, and stabilizes the vascular endothelium with multifaceted mechanisms, has emerged as a promising adjunctive strategy to IVT, offering potential synergistic effects. This review summarized the latest evidence from both domestic and international studies, focusing on the mechanisms of APT, recent clinical advancements in IVT combined with APT, and the safety and efficacy of APT administration at different time windows relative to IVT. Emphasis is placed on the influence of various antiplatelet agents, dosing regimens, and initiation timing on therapeutic outcomes, alongside a comprehensive evaluation in the context of current guideline recommendations and clinical practice. Current guidelines recommend initiating APT 24 h after IVT, following imaging confirmation to exclude the risk of intracranial hemorrhage. However, the efficacy and safety of earlier APT initiation remain inconclusive. Individualized treatment strategies, such as early administration of low-dose, short-acting APT or combination therapy in specific patient subgroups, may effectively balance therapeutic benefits and risks. The adjunctive use of APT in IVT holds promise for enhancing efficacy and improving clinical outcomes, but precise stratification of safety and efficacy is essential. Future research should focus on optimizing combination IVT and APT strategies through individualized patient profiling, appropriate drug selection, and dynamic imaging monitoring to achieve precision management in AIS treatment. Reference | Related Articles | Metrics

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The expressions of CD62P, CD40L, and Rev-erbα after ischemic stroke on different onset times Wang Yinping, Meng Cancan, Wu Wenjuan, Yang Zhitang Journal of Capital Medical University    2025, 46 (1): 34-40.   DOI: 10.3969/j.issn.1006-7795.2025.01.006 Abstract （1763）      PDF（pc） （1815KB）（43）       Knowledge map    Save 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. Reference | Related Articles | Metrics

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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 Journal of Capital Medical University    2025, 46 (1): 56-62.   DOI: 10.3969/j.issn.1006-7795.2025.01.009 Abstract （1755）      PDF（pc） （867KB）（158）       Knowledge map    Save 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. Reference | Related Articles | Metrics

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Statistical methods and application cases examples for multiplicity issues in multiple endpoints clinical trials Bai Xiudan, Xu Qin, Wang Anxin Journal of Capital Medical University    2025, 46 (2): 184-190.   DOI: 10.3969/j.issn.1006-7795.2025.02.002 Abstract （1753）      PDF（pc） （1550KB）（202）       Knowledge map    Save Performing multiple tests without adjusting the test level results in a higher-than-intended overall familywise error rate (FWER). This phenomenon is known as the multiplicity problem. In this paper, we  first introduced the mechanism of multiplicity problem based on the classification and characterization of clinical endpoints. Then,  strategies and methods to solve the multiplicity problem were introduced, including the parallel strategy/single-step method, the sequential strategy/multistep method/stepwise method, and their combinations. The results of different analytic strategies may vary. The practical application of the above common strategies and statistical methods were introduced through the case studies of domestic and foreign investigator initiated clinical trial. Multiplicity adjustment for multiple endpoints in clinical trials can be achieved by a single strategy or a combination of strategies. Depending on the selected strategy or combination, the statistical  methods and significance level (denoted as α) for each test hypothesis are determined to effectively control the multiplicity problem. Reference | Related Articles | Metrics

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Diagnostic value of renal tubular and glomerular markers in different stages of renal injury in patients with type 2 diabetes Zhang Lin, Xie Rongrong, Yang Fangyuan, Li Mei, Luo Sha, Wan Xiaohua, Tian Wei, Yang Jinkui Journal of Capital Medical University    2024, 45 (3): 429-437.   DOI: 10.3969/j.issn.1006-7795.2024.03.009 Abstract （1746）      PDF（pc） （1357KB）（137）       Knowledge map    Save Objective  To investigate the diagnostic value of renal tubular and glomerular markers in type 2 diabetes patients at different stages of renal injury. Methods  Totally 272 patients with type 2 diabetes mellitus (T2DM) admitted to the  Department of Endocrinology, Beijing Tongren Hospital，Capital Medical University,  from April 1, 2018 to October 31, 2019 were enrolled, to improve the clinical biochemical indicators and four items of urine protein: urinary microalbumin/creatinine (ACR), α1-microglobulin/creatinine (UA1CR), urinary immunoglobulin G to creatinine ratio (UIGG), transferrin/creatinine (UTRF); Perform fundus photography, nuclear medicine 99mTc-EC to measure renal effective plasma flow (ERPF), and 99mTc-DTPA to measure glomerular filtration rate (GFR). According to ACR, there were 164 cases in the normal proteinuria group, 78 cases in the microalbuminuria group, and 30 cases in the macroproteinuria group. The normal proteinuria group was divided into control group  ［132 cases without diabetes retinopathy (DR)］ and  diabetic kidney disease (DKD） early stage group (32 cases with DR)  according to fundus examination. Compare the levels of urinary protein, ERPF, and GFR among four groups, and evaluate the diagnostic value of the above indicators in different stages of renal injury through ROC curves. Results  There were statistical differences (P<0.05) in the levels of urinary protein, ERPF, and GFR among different groups. In the normal urine protein group, the markers representing renal tubular function in the DR group were significantly higher in UA1CR compared to the control group (P<0.01); The markers representing glomerular function, ACR, UTRF, and GFR, showed no significant statistical difference between the two groups (P>0.05), while UIGG increased compared to the control group (P<0.01). In the group of microalbuminuria and the group of macroproteinuria, the four urinary protein levels increased with the degree of renal injury, while ERPF and GFR decreased with the degree of renal injury. ROC curve analysis showed that the area under curve (AUC) of UA1CR and ERPF, the markers reflecting renal tubular function, in type 2 diabetes patients with DR who had normal urinary protein excretion, were 68.2% (P<0.01) and 60.5% (P<0.05), respectively, while the AUC of classic ACR and GFR reflecting glomerular function were less than 60% (P>0.05) without statistical significance. The AUC of urinary protein and GFR in both trace and high proteinuria groups was greater than 60% (P<0.05), while the AUC of ERPF in high proteinuria group was 67.2% (P<0.05). Conclusion  In the very early stage of T2DM, when ACR is normal and only DR is present, renal tubular markers UA1CR and ERPF undergo changes before glomerular markers ACR and GFR. In the early stage of renal injury, the diagnostic efficacy of renal tubular markers is superior to that of glomeruli; In the later stage of renal injury, the diagnostic efficacy of glomerular markers is due to the renal tubules. The changes in renal tubular function in DKD may occur earlier than in the glomerulus. Reference | Related Articles | Metrics

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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 Journal of Capital Medical University    2025, 46 (1): 22-33.   DOI: 10.3969/j.issn.1006-7795.2025.01.005 Abstract （1690）      PDF（pc） （23858KB）（182）       Knowledge map    Save 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. Reference | Related Articles | Metrics

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The current status and future directions of reperfusion therapy for acute ischemic stroke Qiao Yue, Li Chuanhui, Zhao Wenbo Journal of Capital Medical University    2025, 46 (1): 68-70.   DOI: 10.3969/j.issn.1006-7795.2025.01.011 Abstract （1661）      PDF（pc） （369KB）（284）       Knowledge map    Save 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. Reference | Related Articles | Metrics

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To explore the potential biomarkers of proliferative diabetic retinopathy by plasma proteomics Yang Fangyuan, Peng Shijie, Liu Jing, Yang Jinkui, Zhu Xiaorong Journal of Capital Medical University    2024, 45 (3): 385-391.   DOI: 10.3969/j.issn.1006-7795.2024.03.003 Abstract （1649）      PDF（pc） （5860KB）（148）       Knowledge map    Save Objective  To identify potential biomarkers of proliferative diabetic retinopathy (PDR) through the difference of protein expression between PDR patients and diabetes patients without retina diseases (NDR) by using isobaric tag for relative and absolute quantification (iTRAQ) proteomics. Methods  A total of 42 patients admitted to the Department of Endocrinology, Beijing Tongren Hospital from 2016 to 2017 were recruited, including 21 PDR patients and 21 gender- and age-matched NDR patients. After proteins extraction from patients' serum samples, iTRAQ labeling with liquid chromatograph-mass spectrometer and mass spectrometer (LC-MS/MS) analysis was performed to screen the differential proteins. Gene Ontology (GO）enrichment and Kyoto Encyclopedia of Genes and Genome(KEGG) pathway were analyzed. Comparisons were conducted using independent sample t-tests, to determine the changes in protein expression levels through fold change (FC) and P-values. Results  Totally 29 differentially expressed proteins were identified based on a FC>1.2 (up/down) and a P value ≤ 0.05. Among them, 8 proteins were upregulated and 21 proteins were downregulated in the PDR group. GO enrichment analysis showed that the functions of differentially expressed genes were classified into three categories: biological processes, cellular components, and molecular functions. The differential gene expressions were involved in biological regulation, cell composition, cellular metabolic processes, and cell binding or catalytic activity. KEGG pathway analysis showed that the most significantly upregulated angiotensin converting enzyme (ACE) is involved in the renin angiotensin system (RAS) and renin secretion pathways. The upregulated protein insulin like growth factor I (IGF-1) is involved in metabolic related signaling pathways, including HIF-1, FoxO, mTOR, PI3K-Akt, and AMPK. The significantly downregulated protein myosin-6 is involved in myocardial cell contraction and signaling pathways. Conclusion  The iTRAQ proteomics analysis suggested, many differential expressed proteins between PDR and NDR groups. ACE, IGF-1 and myosin-6 were potential serum diagnostic markers and maybe new therapeutic targets for diabetic retinopathy. Reference | Related Articles | Metrics

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Effect of large artery atherosclerosis subtype on the efficacy of Ginkgo Diterpene Lactone Meglumine in acute ischemic stroke Jing Jiao, Zhang Siyao, Liu Yanling, Wang Fen, Xiao Wei, Wang Zhenzhong Journal of Capital Medical University    2025, 46 (2): 228-233.   DOI: 10.3969/j.issn.1006-7795.2025.02.008 Abstract （1572）      PDF（pc） （1286KB）（148）       Knowledge map    Save Objective  To investigate the effect of large artery atherosclerosis (LAA) and non-LAA subtypes on the efficacy of Ginkgo Diterpene Lactone Meglumine (GDLM) in patients with acute ischemic stroke. Methods  This was a post-hoc analysis of multicenter, randomized, double-blind, placebo-controlled, and  parallel-group trial. A total of 3 448 patients who had acute ischemic stroke were randomly assigned in a 1∶1 ratio  to receive the injection of GDLM or the placebo once day within 48 h after symptoms and continued for 14 d. The primary outcome was the proportion of patients with a modified Rankin Scale (mRS) of 0 or 1 on day 90 after randomization. Results  A total of 3 448 patients were enrolled, with 1 604 (46.52%) patients with non-LAA and 1 844 (53.48%) with LAA. Compared to the placebo treatment. GDLM  injection effectively improve the functional prognosis, with a higher proportion of mRS score of 0-1 in both non-LAA (OR=1.24, 95% CI: 1.02-1.51; P=0.03) and LAA (OR=1.37, 95% CI:1.14-1.65; P<0.001) group. There was no significant interaction between LAA subtypes with treatment (P=0.48 for interaction). Conclusion  Among patients with acute ischemic stroke  in this randomized clinical trial, GDLM might improve the  favorable clinical outcomes at 90 d compared with placebo, regardless of LAA subtypes. Nevertheless, it is necessary to confirm the findings  in the future. Reference | Related Articles | Metrics

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Micro RNA-10b regulates the early tooth development homeostasis of miniature swine by targeting and suppressing Wnt9B Sun Meng, He Xiaoli, Tong Xiangyao, Li Ang Journal of Capital Medical University    2025, 46 (6): 992-999.   DOI: 10.3969/j.issn.1006-7795.2025.06.006 Abstract （1571）      PDF（pc） （5245KB）（37）       Knowledge map    Save Objective  To investigate of the regulatory role of micro RNA (miR)-10b in early tooth development homeostasis of miniature swine and its underlying molecular mechanisms.Methods  Miniature swine bud-stage first deciduous molar tooth germs were used to perform miRNA sequencing under monoculture and mandible co-culture conditions to identify differentially expressed miRNAs. Among these, miR-10b was selected for further study, and its expression was validated by real-time reverse transcription quantitative polymerase chain reaction (RT-qPCR). Dental mesenchymal cells were transfected with lentiviral vectors (LV) in vitro to establish a miR-10b overexpression model, and cell proliferation was evaluated using EdU and CCK-8 assays. Potential target genes of miR-10b were predicted through TargetScan and miRDB databases, and the binding sites within the 3'-untranslated region (3'-UTR) were further analyzed with RNAhybrid 2.2. To verify direct interactions, wild-type (WT) and mutant (MUT) pmirGLO dual-luciferase reporter constructs were generated, followed by dual-luciferase reporter assays and RT-qPCR to confirm the regulatory relationship.Results  Sequencing analysis revealed that miR-10b was significantly upregulated in the mandible co-culture group compared with the tooth germ monoculture group (log2FC=4.82, P<0.05), which was confirmed by RT-qPCR (2.03 ± 0.21 fold increase, P<0.001), suggesting its involvement in tooth development in miniature swine. To investigate the functional effects of miR-10b, it was overexpressed in dental mesenchymal cells, and further verified by RT-qPCR (P<0.01). EdU and CCK-8 assays showed that overexpression of miR-10b significantly inhibited the proliferation of dental mesenchymal cell. Bioinformatic analysis identified wingless-type MMTV integration site family, member 9B (Wnt9B) as a potential target gene of miR-10b and showed that specific binding sites were located within the 3'-UTR. Dual-luciferase reporter assays demonstrated direct interaction and showed that miR－10b mimics significantly decreased luciferase activity in Wnt9B-WT (P<0.01) but did not affect Wnt9B-MUT. Consequently, overexpression of miR-10b markedly downregulated Wnt9B mRNA levels in dental mesenchymal cells (P<0.01).Conclusion  miR-10b can decrease the proliferation activity of dental mesenchymal cells, regulate the homeostasis during early tooth development and maintain the balance of mandible-teeth communication by targeting and inhibiting the expression of Wnt9B in miniature swine. This study provides a new theoretical clue for revealing the molecular mechanisms of tooth development and regeneration strategies. Reference | Related Articles | Metrics

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Transition of body mass index and metabolic syndrome in patients with major depressive disorder Qi Han, Dong Chengcheng, Liu Rui, Zhu Xuequan, Lin Xuzhou, Qin Yanshu, Yu Zibo, Wang Haining, Li Lei, Feng Yuan, Zhang Ling, Yan Fang Journal of Capital Medical University    2025, 46 (2): 202-209.   DOI: 10.3969/j.issn.1006-7795.2025.02.005 Abstract （1556）      PDF（pc） （1780KB）（194）       Knowledge map    Save Objective  To evaluate the transition rules of   normal body mass index (BMI), overweight and metabolic syndrome (MetS) in patients with major depressive disorder (MDD). Methods  Patients with MDD who had multiple admission records between Jan 2016 and Nov 2021 in Beijing Anding Hospital, Capital Medical University were included. Based on the overweight and metabolic syndrome status assessed at each admission, the patients were categorized into three states: normal BMI, overweight and metabolic syndrome. A multi-state Markov model was used to analyze the transition intensity and transition frequency between three states and the influence of covariates on transitions. Results  A total of 892 records of 398 subjects were included, with a median age of 56 years old and 31.4% males. The median follow-up period was 40 months. The multi-state model showed that there were 494 transitions between the three states, of which 5.1% moved from normal BMI to overweight and 5.5% moved from overweight to MetS. The intensity of transition was the highest from overweight to MetS, 9.52 times greater than overweight to normal BMI. After 48.53 months, MDD patients with normal BMI began to transition to MetS. For overweight MDD patients, the transition to MetS started after 8.77 months. MDD patients with normal BMI or overweight had 31.4% and 50.4% probabilities of developing Mets after 36 months. For MDD patients comorbid with MetS, the probability of staying at MetS was 51.2% after 36 months. Multivariate analysis showed that being unmarried was a risk factor against developing overweight in normal BMI MDD patients, while  a higher level of education was a protective factor against developing MetS in overweight MDD patients. Conclusion  MDD patients exhibited a higher intensity and risk of developing MetS, and it is not easy to reverse MetS, suggesting that BMI management and MetS intervention should be strengthened in MDD patients. Reference | Related Articles | Metrics

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Speech recognition for standard Chinese-speaking bimodal cochlear implant users in competitive noise Zhang Xinyi, Chen Jingyuan, Chen Biao, Zou Xinyue, Shi Ying, Zhang Lifang, Liu Ping, Kong Ying, Li Yongxin Journal of Capital Medical University    2024, 45 (6): 938-945.   DOI: 10.3969/j.issn.1006-7795.2024.06.002 Abstract （1531）      PDF（pc） （928KB）（122）       Knowledge map    Save Objective  To investigate the utilization of competitive speech by standard Chinese bimodal cochlear implant (BIM) users under  talker sex and spatial.Methods  The speech reception thresholds (SRT) of 11 standard Chinese BIM users were tested under 4 different spatial competitive speech noises. The four spatial competitive speech noise environments were recorded as middle male voice, middle female voice, two sides male voice and two sides female voice according to the gender and orientation of the masked noise. Subjects were assessed with BIM and cochlear implantation (CI) alone hearing assistance. The target sound is one male voice directly in front (0°), and the masking sound is two male or two female voices, coming from separately directly in front (0°) or from both sides (±90°).Results  There was no significant difference in SRT between the two groups (P> 0.05). The BIM group obtained masking release (MR) under talker sex cues, spatial cues, and talker sex+spatial cues, while the CI group obtained MR under talker sex, but masking inhibition under spatial cues and talker sex + spatial cues. There were no significant differences in MR between the three cues. There was no significant difference in MR between BIM group and CI group under talker sex cues and spatial cues, but there was difference between BIM group and CI group under talker sex+spatial cue (P= 0.013).Conclusions  Standard Chinese BIM users can use talker sex cues and spatial cues to separate competitive noise, but there is no significant difference in the ability to use talker sex and spatial cues between BIM and CI alone hearing aid, and the ability to use talker sex + spatial cues under BIM is better than that of cochlear alone hearing aid. Reference | Related Articles | Metrics

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Protective effect of N-Acetyl-L-Cysteine on cryopreserved-thawed human ovarian tissue Li Yanglu, Ruan Xiangyan, Li Yanqiu, Gu Muqing, Du Juan, Wang Zecheng, Cheng Jiaojiao, Jin Fengyu, Jiang Lingling, Yang Yu, Alfred O. Mueck Journal of Capital Medical University    2024, 45 (4): 573-582.   DOI: 10.3969/j.issn.1006-7795.2024.04.003 Abstract （1523）      PDF（pc） （7511KB）（71）       Knowledge map    Save Objective  To investigate the protective effect of antioxidant N-Acetyl-L-Cysteine (NAC) on human ovarian tissue by human ovarian tissue xenotransplantation based on the current human ovarian tissue cryopreservation and thawing protocol in Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University.  Methods  The ovarian tissues from 4 patients were cryopreserved and thawed according to the currently-used protocol or the modified protocol (adding with 5 mm NAC). the fresh ovarian tissues underwent Calcein acetoxymethyl ester （Calcein-AM ）staining and hematoxylin-eosin (HE) staining to evaluate follicle activity and follicle counting. Thirty-six female nude mice who underwent ovariectomy were randomly divided into 4 groups. The thawing ovarian tissues were transplanted under the bilateral renal capsules of the nude mice. According to the different freezing-thawing protocol, the four group were divided as current freezing-thawing protocol group (control group), the modified protocol group (NAC group), ovariectomy group and normal group (no surgery). The nude mice were killed on day 3, day 7 and day 21 respectively, and serum and ovarian tissue grafts were taken. Serum samples were detected by enzyme-linked immunosorbent assay (ELISA) for estradiol (E2), follicle stimulating hormone (FSH) and anti-mullerian hormone (AMH). One ovarian graft was taken for HE staining to observe follicle development and one graft for total antioxidant capability (TAC).  Results  There was no significant difference in follicle development stages between the two transplantation groups at each time point after transplantation (P>0.05). The TAC level of NAC group was significantly higher than that of control group (P<0.05), but no difference was found between NAC group and fresh ovarian tissue (P>0.05). The level of serum E2 in control group was significantly higher than that in ovariectomy group on the 3rd day of transplantation (P<0.05), and there was no significant difference between the two transplantation groups and ovariectomy group at other time points (P>0.05). The level of FSH at day 3 and 21 after transplantation was lower than that in ovariectomy group (P<0.05), and had no significant difference from that in normal group (P>0.05). On the 3rd day after transplantation, AMH in the control group was significantly higher than that in the ovarian ovariectomy group (P<0.05), but no significant difference was found between the control group and the other groups (P>0.05). On 7th day after transplantation, AMH level in the two transplantation groups decreased, and was significantly lower than that in the normal group (P<0.05). On the 21st day after transplantation, AMH levels in both transplantation groups were significantly higher than those in ovariectomy group (P<0.05), but had no significant difference with normal group (P>0.05).  Conclusions  Both the currently-use protocol and the modified protocol can effectively restore the endocrine function of ovarian tissue. Compared with the currently-use cryopreservation regimen, the modified regimen can improve the antioxidant capacity of transplanted ovarian tissue, reduce the primordial follicle activation at the initial stage of transplantation, and preserve more primordial follicles. Reference | Related Articles | Metrics

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Effects of vitamin D2 on albuminuria in patients with diabetic kidney disease Zheng Xiaomin, Liu Mengyang, Xiao Xinhua, Cui Limei, Liu Cuiping Journal of Capital Medical University    2024, 45 (3): 420-428.   DOI: 10.3969/j.issn.1006-7795.2024.03.008 Abstract （1510）      PDF（pc） （1987KB）（223）       Knowledge map    Save Objective To explore the effects of vitamin D2 soft capsules and calcitriol soft capsules on albuminuria in type 2 diabetes mellitus(T2DM) patients with diabetic kidney disease(DKD). Methods Totally 95 T2DM patients with DKD and estimated glomerular filtration rate (eGFR)≥60 mL·(min·1.73 m2)-1 who hospitalized in the department of endocrinology  of a tertiary hospital in Beijing from October 2020 to March 2022 were analyzed retrospectively. According to the treatment protocols, the patients were divided into control group without vitamin D preparation (CON group, n=33), natural vitamin D group with vitamin D2 soft capsule (NVD group, n=31), and active vitamin D group with calcitriol soft capsule (AVD group, n=31). The clinical data and parameters of vitamin D and DKD, including serum 25-hydroxyvitamin D (25OHD), serum parathyroid hormone (PTH), blood calcium, urine calcium and urinary albumin-to-creatinine ratio (UACR) at baseline and after 12 weeks treatment were collected through the electronic medical records database system. Results In the baseline phase, there were 8 cases (24.24% ), 9 cases (29.03% ), and 7 cases (22.58% ) with macroalbuminuria in CON group, NVD group, and AVD group, respectively, with no significant difference（P=0.831）。After 12 weeks of treatment, the level of ln(UACR) decreased significantly（both P<0.001）, with no significant difference between the two treatment groups（P=0.371）. The total effective rates of NVD group and AVD group were 80.65%  and 74.19%  respectively, which were significantly higher than those of CON group（33.33% ）（P<0.001 and P=0.002）. There was no significant difference between NVD group and AVD group（P=0.245）. There were 1 case of blood calcium increased, 1 case of hypercalciuria, 1 case of hyperuricemia, 1 case of kidney stone, and 1 case of muscle spasm in CON group, 1 case of hypercalciuria and 1 case of hyperuricemia in NVD group, 1 case of blood calcium increased, 1 case of hypercalcaemia, 1 case of blood parathyroid hormone decreased, 2 cases of hypercalciuria, and 2 cases of hyperuricemia in AVD group. No drug withdrawal occurred in both treatment groups. Conclusion The administration of both Vitamin D2 soft capsule and calcitriol soft capsule can effectively reduce albuminuria levels in T2DM patients with DKD with good renal function and significantly. Natural vitamin D may be safer compared with active vitamin D. Reference | Related Articles | Metrics

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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 Journal of Capital Medical University    2025, 46 (1): 41-47.   DOI: 10.3969/j.issn.1006-7795.2025.01.007 Abstract （1498）      PDF（pc） （706KB）（135）       Knowledge map    Save 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. Reference | Related Articles | Metrics

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The impact of testosterone levels on female sexual function in menopausal transitional and postmenopausal women Wang Zhikun, Ruan Xiangyan, Liu Lili, Yang Yu, Jiang Lingling, Wang Zecheng, Alfred O.Mueck Journal of Capital Medical University    2024, 45 (4): 589-595.   DOI: 10.3969/j.issn.1006-7795.2024.04.005 Abstract （1488）      PDF（pc） （491KB）（414）       Knowledge map    Save Objective  To explore the impact of testosterone levels on female sexual function in menopausal transitional and postmenopausal women.  Methods  A total of 450 menopausal transitional and postmenopausal women who visited Beijing Obstetrics and Gynecology Hospital for the first time from January to December 2023 were recruited, including 201 menopausal transitional and 249 postmenopausal women. Demographic data and medical history were collected, female sexual function and climacteric symptoms were evaluated by using female sexual function index (FSFI) scale and modified Kupperman index (KMI). The sex hormone levels were tested for all women, including total testosterone(TT), free testosterone(FT), bioactive testosterone(BioT), 4-androstenedione(A4) and estrogen. Multiple linear regression is used to explore the impact of testosterone levels on female sexual function.  Results  Compared with menopausal transitional women, the FSFI scores in postmenopausal women decreased significantly (P<0.05). Multiple linear regression analysis showed that BioT level was positively correlated with arousal score (β=0.190, P<0.05) and FSFI total score (β=0.178, P<0.05), FT level was positively correlated with desire (β=0.166, P<0.05), satisfaction (β=0.176, P<0.05), and FSFI total score (β=0.126, P<0.05), while TT level was not associated with FSFI scores. The KMI score is negatively correlated with the FSFI scores (P<0.05).  Conclusions  Female sexual dysfunction (FSD) was associated with reduced FT and BioT levels, while not associated with TT level. Reference | Related Articles | Metrics

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Comparison of the prognostic value of 15 nutritional/inflammatory indicators in postoperative cancer patients Liu Xiaoqian, Sun Kai, Wang Xiaolin, Zhao Qianqian, Wu Xiaoxiao, Shen Fangqi, Chen Xi, Tian Chenxu, Wu Di, Song Chunhua, Xu HongXia, Cong Minghua, Shi Hanping, Jia Pingping Journal of Capital Medical University    2025, 46 (3): 410-419.   DOI: 10.3969/j.issn.1006-7795.2025.03.003 Abstract （1465）      PDF（pc） （6110KB）（156）       Knowledge map    Save Objective  To explore and identify the nutritional/inflammatory indicator with the highest predictive potential for overall survival (OS) in postoperative tumor patients so as to provide guidance for postoperative rehabilitation of tumor patients. Methods  Data from 3 191 surgical patients were collected, including 15 nutritional/inflammatory indicators. The maximum selection rank statistic method was used to calculate the optimal cut-off values for continuous indicators. The Kaplan-Meier method was used to assess OS, and Cox proportional hazards models were used to analyze the association between the aforementioned 15 indicators and survival. The predictive value of these 15 indicators was evaluated with receiver operating characteristic (ROC) curves and C-index. Results  Multivariate analysis showed that all 15 indicators were significantly associated with poorer OS in surgical patients (P<0.05 for all). Time-dependent area under the curve (AUC) and C-index analysis indicated that 3 indicators with the highest predictive potential in OS in postoperative tumor patients were the nutritional risk index (NRI) (C-index: 0.597), C-reactive protein-to-albumin ratio (CAR) (C-index: 0.587), and C-reactive protein-to-lymphocyte ratio (CLR) (C-index: 0.587). The optimal cut-off value for NRI was determined to be 104.31 (i.e., NRI<104.31 suggests malnutrition) with the maximum selection rank statistic method, the optimal cut-off value for CAR to be 0.05 (i.e., CAR≥0.05 suggests a strong inflammatory response, often accompanied by malnutrition), and the optimal cut-off value for CLR to be 1.18 (i.e., CLR≥1.18 suggests a strong inflammatory response). Subgroup analysis indicated that NRI, CAR, and CLR had good correlation with tumor staging, and there were significant differences between tumor node metastasis (TNM) Ⅲ/Ⅳ stage patients and TNM Ⅰ/Ⅱ stage patients when there was a strong inflammatory response or malnutrition. Conclusion In postoperative tumor patients, NRI, CLR, and CAR have high prognostic value. Combining  these with the patient's clinical stage, it enables more precise guidance for clinical diagnosis and treatment strategies.  Reference | Related Articles | Metrics