Table of Content

21 August 2025, Volume 46 Issue 4

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Impact of cryopreservation and thawing on human ovarian tissue

Li Yanglu, Ruan Xiangyan, Du Juan, Cheng Jiaojiao, Jin Fengyu, Gu Muqing, Li Yanqiu, Alfred O. Mueck

2025, 46(4):  594-600.  doi:10.3969/j.issn.1006-7795.2025.04.002

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Objective  To evaluate the impact of slow-freezing process on human ovarian tissue with the standard cryopreservation-thawing protocol of Fertility Protection Center of Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Methods  Ovarian tissues of 12 patients were divided into fresh ovarian tissue group （fresh group）and freezing-thawing ovarian tissue group (F-T group). The freezing-thawing protocol was the standard protocol in our center. The number and activity of follicle were examined with Hematoxylin-eosin (HE) staining and calcein-AM (calcein acetoxymethylester) staining, and the proliferation and apoptosis was evaluated with the immunohistochemical staining of Ki-67 and caspase-3. The expressions of apoptosis-related proteins such as caspase-3, bax and FasL between the two groups were compared with Western blotting. Results  There were no statistically significant differences in follicle counting and follicle activity in ovarian tissues pre- and post- freezing-thawing (P>0.05), and the positive rate of Ki-67 in ovarian tissues after freezing-thawing was significantly lower than that in fresh ovarian tissues (P<0.05), and there was no statistically significant difference in the positive rate of caspase-3 between the two groups (P>0.05). The expression of caspase-3 protein in ovarian tissues after freezing-thawing was significantly higher than that in fresh ovarian tissues (P<0.05), while the expressions of other apoptosis-related proteins such as bax and FasL were not significantly different (P>0.05). Conclusion  The standard cryopreservation-thawing regimen in our center can effectively maintain the follicle number, morphology, and activity in ovarian tissues. After freezing and thawing, the cell proliferation level is decreased. The expression of apoptosis-related proteins such as bax and FasL are not increased, and the expression of caspase-3 is relatively increased. These results suggest our freezing-thawing regimen is good for human ovarian tissue.

The current status of bone mineral density and influencing factors in early menopausal women

Liu Anming, Ruan Xiangyan, Wang Zecheng, Alfred O. Mueck

2025, 46(4):  601-606.  doi:10.3969/j.issn.1006-7795.2025.04.003

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Objective  To analyze the current status of bone mineral density (BMD) in women with early menopause and explore the correlations between BMD with age, body mass index (BMI), total body fat mass, spinal fat mass, femoral fat mass, follicle-stimulating hormone (FSH), estradiol (E2), and testosterone (T). Methods  A total of 106 women with early menopause, who first visited the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2023 to May 2025, were recruited after meeting the inclusion and exclusion criteria. The spinal BMD, femoral BMD, total body fat mass, femoral fat mass, and spinal fat mass were measured with dual-energy X-ray absorptiometry (DXA). The age, height, and weight of the patients were recorded, and serum levels of FSH, E2, and T were measured. Spearman correlation analysis was used to explore the correlations between spinal and femoral BMD and age, FSH, E2, T, BMI, total body fat content, femoral fat content, and spinal fat content. The patients were divided into three groups based on BMD: normal bone mass, osteopenia, and osteoporosis. Non-parametric Kruskal-Wallis H test was used to compare BMI, fat content, age, FSH, E2, and T levels among the three groups. Bonferroni-corrected Mann-Whitney U test was used for pairwise comparisons of significant differences. Multiple linear regression analysis was conducted to explore the influencing factors for femoral BMD T-score. Results  Among the 106 patients with early menopause, 30 (28.3%) had normal bone mass, 64 (60.4%) had osteopenia, and 12 (11.3%) had osteoporosis, with an average age of (43.99±0.16) years. Femoral BMD was positively correlated with BMI，total body fat mass，and spinal fat mass (all P<0.05). No significant differences were found in femoral fat mass, age, FSH, and T levels among the different bone mass groups, but, BMI, total body fat mass, spinal fat mass, and E2 were significantly different (P<0.05). BMI, total body fat mass, spinal fat mass and E2 were significantly higher in the normal bone mass group compared to the osteopenia group (P<0.05). The BMI of the normal bone mass group was significantly higher than that of the osteoporosis group (P<0.05).  Multiple linear regression analysis showed that FSH were influencing factors for femoral BMD T-scores (P<0.05).Conclusion  The osteoporosis is more prevalent in women with early menopause. Femoral BMD is positively correlated with BMI ,total body fat mass and spinal fat content. Elevated FSH is a risk factor for reduced femoral BMD T-score. Attention should be paid to the risk of osteoporosis in women with early menopause, and individualized treatment plans should be developed to reduce the prevalence of osteoporosis.

Comparison of ethinyl-estradiol/drospirenone tablets alone or in combination with orlistat on ovulation recovery rate and metabolic indices in overweight/obese patients with polycystic ovary syndrome

Jiang Lingling, Ruan Xiangyan, Li Yanqiu, Zhang Mingzhen, Wang Zecheng, Jin Jing, Tian Xuanxuan, Liu Anming, Alfred O. Mueck

2025, 46(4):  607-613.  doi:10.3969/j.issn.1006-7795.2025.04.004

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Objective  To compare ovulation recovery rate and metabolic indicators between ethinyl-estradiol/drospirenone (EE/DRSP) combined with orlistat and EE/DRSP alone in overweight/obese patients with polycystic ovary syndrome (PCOS). Methods  This study was a randomized controlled clinical trial conducted based on the 2004 Rotterdam criteria. From October 2020 to December 2023, 180 overweight/obese PCOS patients aged 20-40 were recruited from the Department of Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. The patients were randomly divided into two groups in a 1∶2 ratio. Among them, 60 patients received treatment with EE/DRSP (EE20 μg,DRSP 3 mg), while 120 patients received a combination treatment of EE/DRSP and orlistat (360 mg/d). The height, weight, waist circumference, hip circumference, and blood pressure of the patients were measured before treatment and after 12 weeks of treatment. Laboratory tests included measurements of follicle-stimulating hormone (FSH), luteinizing hormone (LH), fasting insulin（FINS）, homeostasis model assessment of insulin resistance (HOMA-IR), free androgen index (FAI), alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyl transferase (GGT), fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), lipoprotein(a) ［Lp(a)］, sex hormone-binding globulin (SHBG), total testosterone (T), and free testosterone (FT). After 12 weeks of treatment, the medication was discontinued, and natural ovulation was observed. Results  After 12 weeks of treatment, the ovulation rate of the EE/DRSP combined with orlistat group reached 70.8%, while the natural ovulation rate of the EE/DRSP group alone was only 35%, indicating that the ovulation rate was significantly increased after EE/DRSP combined with orlistat treatment. After 12 weeks of treatment, both groups showed a significant decrease in total testosterone, free testosterone, and low-density lipoprotein levels (all P<0.05), and the decrease in BMI, waist circumference, fasting insulin, and HOMA-IR in the EE/DRSP combined with orlistat group was greater than that in the EE/DRSP group alone (P<0.05). After treatment, both groups showed a significant increase in high-density lipoprotein and triglyceride levels (all P<0.05), with no significant changes in total cholesterol and fasting blood glucose (all P>0.05). Conclusion  After 12 weeks of treatment, EE/DRSP combined with orlistat can significantly improve the ovulation rate of PCOS patients. It is superior to EE/DRSP alone in reducing androgen levels, body weight, insulin resistance, and low-density lipoprotein levels. 

Effect of individualized lifestyle intervention on sexual function in obese patients with polycystic ovary syndrome

Tian Xuanxuan, Ruan Xiangyan, Zhao Yue, Jin Jing, Liu Shunyu, Jiang Lingling

2025, 46(4):  614-619.  doi:10.3969/j.issn.1006-7795.2025.04.005

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Objective To investigate the effect of individualized lifestyle intervention on sexual function in obese patients with polycystic ovarian syndrome (PCOS).  Methods The study was conducted on obese patients with PCOS in the Department of Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from October 2022 to December 2023. There were 160 cases in both the experimental group and the control group, progesterone was administered to both groups for 3 months to regulate menstruation. For women in the experimental group received individualized comprehensive lifestyle intervention combining diet, exercise, and behavior modifications, along with dedicated follow-up and weight management. The control group received routine clinical education for lifestyle intervention aimed at weight loss. Female Sexual Function Index (FSFI) and 12-item Short-Form Health Survey (SF-12) scale were applied to evaluate the sexual function and quality of life. The clinical data that may affect sexual function were collected and sex hormone levels were measured, including anthropometric indicators, estradiol, sex hormone-binding globulin, total testosterone, bioactive testosterone, and dehydroepiandrosterone sulfate in serum.  Results After 3 months of intervention, the body mass index, waist circumference, body fat percentage, insulin resistance index, total testosterone, bioactive testosterone and dehydroepiandrosterone sulfate in experimental groups were significantly lower（P<0.05）, and the sex hormone binding globulin level was significantly higher (P<0.001), compared with the control group. SF-12 mental health scores, FSFI total scores, sexual desire, orgasm and sexual satisfaction scores were significantly increased in experimental groups (P<0.05), however, there were no significant differences in SF-12 physical health scores, as well as the scores of sexual arousal, vaginal lubrication, and coital pain.  Conclusions Individualized lifestyle intervention can better improve the sexual function and mental health of obese patients with PCOS.

Clinical characteristics of the patients with follicular cysts and menstrual disorders

Jin Jing, Ruan Xiangyan, Hua Lin, Cheng Jiaojiao, Zhao Yue, Tian Xuanxuan

2025, 46(4):  620-625.  doi:10.3969/j.issn.1006-7795.2025.04.006

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Objective  To explore the clinical characteristics of the patients with follicular cysts and menstrual disorders. Methods  A total of 178 women with follicular cysts complicated by menstrual disorders were recruited, who were aged 23-53 (38.62±6.35) years and came to the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital between August 2022 and July 2024. The participants were divided into three groups according to the age, with 27 women in the age group of 21-30 years (Group 1), 77 in the age group of 31-40 years (Group 2), and 74 in the age group of>40 years (Group 3). The age and menstruation of these patients were collected, the body height, weight, follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (Po), total testosterone (TT), prolactin (PRL), anti-müllerian hormone (AMH) and thyroid function ［blood routine and blood clotting for patients with abnormal uterine bleeding (AUB) ］were measured, and the diameter of ovarian cyst and the thickness of endometrium were examined. The clinical characteristics of the patients with follicular cysts complicated by menstrual disorders were described and compared with each other among the three age groups. Results  ① Among 178 patients, 61 (34.3%) patients presented with complaints of cessation of regular menstruation or amenorrhea and 117 (65.7%) with complaints of AUB. Out of 178 patients, 13 (7.3%) patients developed anemia due to AUB, and all the patients were treated with medication. ② Follicular cysts disappeared in 1 month for 124 (69.7%) patients, disappeared in 2 months for 176 (98.9%) patients, and disappeared in 3 months for 178 (100%) patients. A total of 177 (99.4%) patients had follicular cysts with a diameter less than 5 cm, and only 1 (0.6%) patient had follicular cysts with a diameter ≥ 5 cm. ③ The overall prevalence of diminished ovarian reserve (DOR) in patients with follicular cysts complicated by menstrual disorders was 82.0%, and the prevalence of DOR was 70.2% for the patients under 40 years old. The prevalence of DOR in three age groups was 37.0% (10/27), 81.8% (63/77), and 98.6% (73/74), respectively. The prevalence of DOR gradually increased with age. ④ The median AMH values for Group 1, Group 2, and Group 3 were 1.55, 0.51, and 0.15 ng/mL, respectively. The FSH level in Group 3 was significantly higher than that in Groups 1 and 2 (adjusted P<0.05), while the AMH level was significantly lower than that in Groups 1 and 2 (adjusted P<0.05). The AMH level in Group 2 was lower than that in Group 1 (adjusted P<0.05). Conclusion  Patients with follicular cysts complicated by menstrual disorders are recommended to receive medication treatment, rather than just expecting treatment. The prevalence of DOR in patients with follicular cysts complicated by menstrual disorders is significantly higher than that in normal women, even in women younger than 40 years old. Therefore, it is essential to evaluate the ovarian reserve of these patients while treating menstrual disorders, particularly for young women with fertility needs.

Correlation between thyroid autoimmunity and gestational diabetes mellitus in Chinese euthyroid women

Zhao Yue, Ruan Xiangyan, Zou Liying, Ma Jun, Wang Yuejiao, Tian Xuanxuan, Jin Jing

2025, 46(4):  626-631.  doi:10.3969/j.issn.1006-7795.2025.04.007

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Objective  To explore the correlation between thyroid autoimmunity (TAI) and gestational diabetes mellitus (GDM) in Chinese euthyroid women. Methods  A total of 508 euthyroid women were enrolled in the cross-sectional study, who performed their entire clinical/biological workup and oral glucose tolerance test (OGTT) from the department of Gynecology and Endocrinology of the Beijing Obstetrics and Gynecology Hospital, Capital Medical University from June 2023 to June 2024. At median 8 (6-10) weeks of gestation, thyroid-stimulating hormone (TSH), free thyroxine (fT4), and thyroid peroxidase antibodies (TPOAb) were measured, baseline characteristics were recorded, and an OGTT was performed between 24 and 28 weeks of pregnancy. According to the OGTT results, they were divided into GDM group (n=169) and non GDM group (n=339). Thyroid parameters, the demographic and obstetric parameters, and the prevalence of TAI were compared with two groups. The factors associated with GDM were analyzed with multivariate Logistic regression analysis. Results  The age, body mass index (BMI), and proportion of obese women before pregnancy in the GDM group were all significantly higher than those in the non-GDM group, with statistically significant differences (P<0.001). The proportion of pregnant women over 30 years old in the GDM group was significantly higher than that in the non-GDM group (59.17% vs 6.79%, χ²=168.667, P<0.001). The proportion of obese mothers (BMI ≥ 28 kg/m²) before pregnancy in the GDM group was 24.26%, which was significantly higher than that in the non-GDM group (8.26%) (χ²=24.599, P<0.001). The incidence of TAI in the GDM group was 54.44%, while it was 15.93% in the non-GDM group. The difference between the two groups was statistically significant (χ²=81.659, P<0.001). The results of Logistic regression analysis showed that maternal age over 30 years and pre-pregnancy obesity increased the risk of GDM occurrence in TAI women by 6.08 times (OR=6.08, 95% CI 3.61-10.25, P<.001). Conclusion  Among early pregnancy women with normal thyroid function, as age increases during follow-up (especially over 30 years old), pre-pregnancy BMI increases (especially in obese individuals), and those with pre-pregnancy TAI, the risk of developing GDM during pregnancy significantly increases. It is necessary to explore preventive strategies for GDM in euthyroid TAI women, with a view to improving adverse pregnancy outcomes.

Clinical efficacy of letrozole combined with Zi Gui Nv Zhen Capsules in patients with PCOS complicated by thin endometrium-induced infertility

Ma Jun, Ruan Xiangyan, Xu Zhongting , Zhao Yue , Wang Yuejiao, Alfred O.Mueck,

2025, 46(4):  632-636.  doi:10.3969/j.issn.1006-7795.2025.04.008

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Objective  To investigate the curative effect of letrozole combined with Zi Gui Nv Zhen Capsules on patients with polycystic ovary syndrome (PCOS) complicated by thin endometrial infertility. Methods  140 patients with PCOS who met the diagnosis of endometrial thin infertility (endometrial thickness<0.8 cm and no pregnancy for 1 year without contraception) were recruited and randomly assigned to the control group and the experimental group for 3 cycles of treatment. The control group was given letrozole 2.5 mg/d on the 3rd day of menstruation, estradiol valerate 2 mg/d on the 8-10th day of menstruation, and dydrogesterone 10 mg/d in sequence. The experimental group was treated with Zi Gui Nv Zhen Capsules on the basis of the control group. During 3 cycles of treatment, endometrial thickness (EMT), ovulation rate and cumulative pregnancy rate on the day of ovulation were examined.Results  The EMT of the experiment group was significantly higher than that of the control group on the ovulation day of three cycles ［(0.86±0.23) cm vs (0.71±0.15) cm；(0.83±0.26) cm vs (0.68±0.19)cm; (0.87±0.26) cm vs (0.71± 0.11) cm］, the cumulative pregnancy rate of experimental group was significantly higher than that of control group (44.3% vs 25.7%). There was no significant difference in ovulation rate between the two groups (P>0.05). Conclusion  Our findings demonstrate that the combined use of Zi Gui Nv Zhen Capsule with basic conventional therapy significantly enhances endometrial thickness and improves pregnancy rates in PCOS patients with thin endometrium.

The role and mechanism of SOX4 in Helicobacter pylori-mediated gastric mucosal epithelial dysplasia

Du Feng, Xu Rui, Zhao Mengran, Ji Xu, Su Jiayi, Qiu Yuting, Zhu Shengtao, Wu Jing, Li Peng, Zhang Shutian

2025, 46(4):  644-653.  doi:10.3969/j.issn.1006-7795.2025.04.010

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Objective  To investigate the role and molecular mechanism of SOX4 in Helicobacter pylori (H. pylori)-mediated gastric mucosal epithelial dysplasia.Methods  The expression of SOX4 in gastric tissues and cells was analyzed with reverse transcription-polymerase chain reaction (RT-PCR), Western blotting, and immunohistochemical staining. The effects of SOX4 on gastric epithelial cell proliferation and colony formation were determined with CCK-8 and colony formation assays. A PCR array was used to screen downstream target genes involved in H. pylori-induced dysplasia mediated by SOX4. The transcriptional regulation and binding sites of the target gene MLH3 by SOX4 were elucidated with luciferase reporter assay, promoter truncation assay, and chromatin immunoprecipitation (ChIP).Results  SOX4 expression was significantly increased in H. pylori-infected gastric tissues (P<0.05). Overexpression of SOX4 markedly enhanced the proliferation and colony formation abilities of normal gastric epithelial cells (P<0.05). Elevated SOX4 led to the dysregulation of MLH3 and other DNA damage repair-related molecules after H. pylori infection in gastric epithelial cells (|logFC|>1, P<0.05). H. pylori promoted MLH3 expression in gastric epithelial cells through SOX4. SOX4 transcriptionally activated MLH3 expression by binding to the 5th site of the MLH3 promoter. The increased expression of SOX4 and MLH3 is associated with poor prognosis of gastric cancer patients.Conclusion  SOX4 is closely associated with H. pylori-induced dysplasia in gastric epithelial cells. Upregulation of SOX4 promotes H. pylori-related dysplasia by transcriptionally activating MLH3, leading to the imbalance of proliferation and colony formation in gastric epithelial cells.

The inhibitory mechanism of rhodiosin targeting the urease active centre of Helicobacter pylori and its protective effect on gastric mucosa

Sun Wenjing, Zhao Mengran, Xu Junxuan, Zhang Zheng, Li Peng

2025, 46(4):  654-662.  doi:10.3969/j.issn.1006-7795.2025.04.011

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Objective  To screen natural small-molecule compounds with anti-Helicobacter pylori urease (HPU) activity based on traditional Chinese medicine active ingredients and to systematically investigate their inhibitory mechanisms against HPU, as well as their regulatory effects on cellular inflammation and oxidative stress following Helicobacter pylori (Hp) infection. Methods  A multi-dimensional screening strategy was adopted. Firstly, virtual screening was performed on the traditional Chinese medicine monomer compound database based on the crystal structure of HPU, and the candidate molecules were selected in combination with bibliometric analysis. Subsequently, the modified Berthelot method was applied to verify urease inhibitory activity in vitro. Inhibition kinetics were analyzed with Lineweaver-Burk plots. The inhibitory sites were explored through sulfhydryl blocking agents and Ni²⁺ competitive inhibitors, followed by molecular docking simulations with AutoDock Vina (version 1.2.3). A Hp-infected human gastric mucosal epithelial cells (GES-1) model was established. The compound's cytotoxicity was assessed with the CCK-8 assay and lactate dehydrogenase release assay. The mRNA expression levels of interleulain (IL)-6, IL-8, and IL-1β were quantified with quantitative real-time PCR (qRT-PCR). Intracellular reactive oxygen species (ROS) levels were measured with a DCFH-DA fluorescent probe. Results  According to the screening results, the natural small-molecule compound rhodiosin (RHO) significantly inhibited HPU activity with a half-maximal inhibitory concentration (IC50) of (82.38±5.45) μmol/L. Enzyme kinetics analysis revealed that RHO acted as an anti-competitive inhibitor, showing an inhibition constant of (146.40±2.19) μmol/L; RHO-sulfhydryl/Ni²⁺-HPU interaction experiments confirmed that its target was located in the sulfhydryl group in the active center of HPU. Molecular docking simulations suggested that RHO is bound exactly to the Flap domain of the urease active pocket, with a binding energy of -8.678 kcal/mol. No significant cytotoxicity towards GES-1 cells was observed with RHO at 80 μmol/L in cellular experiments. Furthermore, RHO significantly down-regulates the mRNA overexpression of IL-6, IL-8, and IL-1β induced by Hp and reduces the production of ROS by 95%. Conclusion  The monomer RHO of traditional Chinese medicine inhibits HPU through anti-competitive binding to the sulfhydryl site. It can effectively alleviate the inflammatory response and oxidative stress injury of GES-1 caused by Hp infection, providing a theoretical foundation for developing novel anti-Hp treatment strategies.

Clinicopathologic features of gastric hyperplastic polyps with dysplasia/adenocarcinoma

Xu Rui, Gao Yang, Yue Bing, Zhang Zheng, Du Feng, Chen Guangyong, Li Peng

2025, 46(4):  663-669.  doi:10.3969/j.issn.1006-7795.2025.04.012

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Objective  To investigate the cIinicopathological features and immunohistochemical expression of gastric hyperplastic polyps（GHPs）with dysplasia/adenocarcinoma. Methods  A retrospective analysis of 24 cases(44 polyps) that were diagnosed as GHPs with dysplasia/adenocarcinoma in our hospital from January 2020 to December 2024 was reviewed，and clinical, histomorphological, immunophenotypic and follow-up data were analyzed．Results  There were 20 female and 4 male cases, with a mean age of （65.5±7.9）  (range 56~76 )years. Among 44 polyps, 3 occurred in the antrum of the stomach, 1 in the gastric horn, and 40 in the fundus/body. Among the polyps, 32 cases were diagnosed as high-grade dysplasia, 4 cases as low-grade dysplasia, 4 cases as coexistence of low-grade + high-grade dysplasia, 2 cases as mucinous adenocarcinoma, 1 cases as poorly differentiated adenocarcinoma, and 1 cases as signet-ring cell carcinoma. The histological manifestations of 23 cases of background mucosa were autoimmune metaplastic atrophic gastritis(AMAG). the P53 of 8 polyps showed a mutant expression pattern. Through MUC5/MUC6/MUC2/CD10 joint examination, 33 cases showed gastric type (25 cases of which were foveal epithelium type), 4 cases were intestinal type, 5 cases were mixed gastrointestinal type, and 2 cases were non-gastrointestinal type. Conclusion  The neoplastic transformation of GHPs is closely related to AMAG. It is necessary for clinicians and pathologists to strengthen their evaluation of background mucosa, to achieve early detection，early diagnosis and early treatment.

Clinical characteristics of autoimmune gastritis patients complicated with early gastric cancer

Liu Juan, Zhang Zheng, Li Peng

2025, 46(4):  670-675.  doi:10.3969/j.issn.1006-7795.2025.04.013

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Objective  To explore the clinical characteristics and improve the detection of early gastric cancer in  patients with autoimmune gastritis (AIG). Methods  A total 30 patients diagnosed with AIG who underwent endoscopic treatment for gastric early cancer at Beijing Friendship Hospital from 2018 to 2024 were enrolled retrospectively. The baseline characteristics, serological indicators, endoscopic and histopathological data of the patients were collected and analyzed. Further subgroup comparisons were conducted based on gender and Helicobacter pylori (Hp) infection status. Results  Among the 30 patients, 20 were female (66.7%), with a mean age of （64.93±7.68）years. Five patients (29.40%) were infected with Hp. The median values of pepsinogen Ⅰ (PG Ⅰ) and PG Ⅰ/Ⅱ ratio were 7.10 μg/L and 1.00, respectively, while the mean gastrin-17 (G17) level was （121.10 ± 120.15）pmol/L. The level of hemoglobin (Hb), free iron, ferritin, and vitamin B₁₂ were all within the normal range. There were 21 cases (70.00%) with lesions located in corpus，among which 16 cases (53.33%)  were type Ⅱa  lesions and 15 cases (50.00%)  were type Ⅰlesions. The predominant pathological type was tubular adenocarcinoma,with a total of  29 cases (96.67 %). Female patients exhibited significantly lower levels of Hb (P =0.012) and free iron (P <0.001) compared to male patients. Female also had lower vitamin B12 level ［ (161.25±76.49） pg/mL，P =0.012］, which was below the normal range and the difference was a statistically significant. No significant difference was observed between Hp-infected and non-infected patients. Conclusion  Among AIG patients with early gastric cancer, female, corpus elevated or flat lesion and tubular adenocarcinoma were predominated. For female AIG patients with vitamin B₁₂ deficiency, vigilance for the occurrence of gastric early cancer is warranted.

Analysis on risk factors of adverse events after non-sedated esophagogastroduo-denoscopy

Yang Shuyue, Liu Sifan, Ji Xu, Zhao Mengran, Zhang Zheng, Li Peng

2025, 46(4):  676-681.  doi:10.3969/j.issn.1006-7795.2025.04.014

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Objective  To investigate the risk factor for adverse events(AEs) after non-sedated esophagogastroduodenoscopy (EGD). Methods  The data on clinical manifestations, adverse events after non-sedated EGD and common risk factors were collected and retrospectively analyzed with statistical methods in patients who underwent non-sedated EGD from May 2018 to June 2019. These patients were divided into AEs group and non-AEs group. Results  Of 2 384 patients, 57.67%(1 375/2 384) presented with nausea, 12.79%(305/2 384) vomiting,  and 5.79%(138/2 384) presented with pharyngalgia. Multivariate Logistic regression analysis was performed. Advanced age(≥65 years old) (OR=0.683, 95%CI:0.506-0.921) was protective factors for nausea after non-sedated EGD. Hypertension (OR=1.361,95%CI:1.026-1.806), overweight (OR=1.399,95%CI:1.154-1.695), obesity(OR=2.594,95% CI:1.760-3.823) and inspection duration ＞15 min (OR=3.107, 95%CI:2.296-4.206) were independent risk factors for nausea after non-sedated EGD. Advanced age (OR=0.393, 95%CI: 0.221-0.699) and imported equipment (OR=0.697, 95%CI:0.546-0.890) were protective factors for vomiting after non-sedated EGD. Moreover, inspection duration ＞15 min (OR=1.641, 95%CI:1.008-2.699) was independent risk factors for vomiting after non-sedated EGD. There was no difference in success rate of non-sedated EGD between two groups(P<0.05). Conclusion  Hypertension, overweight and obesity were independent risk factors for nausea after non-sedated EGD. The advanced age and imported equipment were protective factors for vomiting after non-sedated EGD. In addition, inspection duration over 15 min is a risk factor for AEs such as nausea and vomiting after nonsedative EGD. Whether AEs occurred or not is non-related to success rate of non-sedated EGD.

Research on the role of gastric microbiome in the progression of gastric cancer

Liu Sifan, Yang Shuyue, Ji Xu, Zhang Zheng, Li Peng

2025, 46(4):  682-687.  doi:10.3969/j.issn.1006-7795.2025.04.015

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Gastric cancer is a common clinical tumor, and its incidence and mortality rates rank among the top of malignant tumors. Helicobacter pylori (Hp) is an important carcinogenic factor for gastric cancer. Studies have found that in addition to Hp, other microorganisms in the stomach also play a key role in the progression of gastric cancer. The composition and diversity of the gastric microbiota vary significantly under different gastric disease conditions, which may affect the progression of gastric cancer. Hp can induce gastric epithelial inflammation and oxidative stress through various virulence factors, thereby promoting the occurrence of gastric cancer. Non-Hp microorganisms can be involved in the process of gastric cancer through pathways such as metabolic changes and immune regulation. In recent years, with the development of high-throughput sequencing technology, the complexity of gastric microbiota has gradually been revealed, which provides new insights for the early warning and intervention of gastric cancer. This article comprehensively review the role of gastric microbiota in the progression of gastric cancer.

Analysis of the risk factors of the infarct growth rate in acute anterior circulation large vessel occlusion

Zhang Xiaowen, Tang Tao, Li Di, Li Shen, Xi Chunjiang

2025, 46(4):  688-693.  doi:10.3969/j.issn.1006-7795.2025.04.016

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Objective  To investigate the risk factors of the infarct growth rate (IGR) in patients with acute anterior circulation large vessel occlusion. Methods  This is a retrospective analysis of consecutive patients having acute anterior circulation large-vessel occlusion and being admitted to the Department of Neurointerventional Intervention, Central Hospital affiliated to Dalian University of Technology between September 2021 and July 2023. Patients were dichotomized into rapid and slow growth groups based on the median value of IGR, with 145 cases in each group. Univariate and multivariate Logistic regression models were used to analyze the risk factors of preoperative IGR. Results  Multivariable Logistic regression analysis, after univariate screening, showed that hypertension (OR=2.27, 95% CI: 1.39-3.71), atrial fibrillation (OR=1.95, 95% CI: 1.22-3.12), and intracranial internal carotid artery occlusion (OR=1.98, 95% CI: 1.19-3.28) were risk factors of preoperative IGR (P<0.05). Hypertension, atrial fibrillation, and internal carotid artery occlusion all exhibited relatively low predictive value for IGR (P<0.05). The area under the curve for predicting IGR by combining these three factors was 0.642 (95% CI: 0.579-0.704), indicating a slight improvement in predictive performance, yet it remained relatively low. Conclusion  Hypertension, atrial fibrillation, and proximal occlusion are risk factors of IGR in patients having acute anterior circulation large vessel occlusion.

The correlation and application value of transcranial color-code Duplex ultrasound combined with contrast-enhanced ultrasound and magnetic resonance angiography in the diagnosis of intracranial arterial stenosis

Xia Yan, Wang Rong, Zhang Lei, Lin Fa, Liu Ziqi, Wang Xiaoyan

2025, 46(4):  694-701.  doi:10.3969/j.issn.1006-7795.2025.04.017

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Objective  Magnetic resonance angiography (MRA) offers a non-invasive and radiation-free advantage in detecting and diagnosing intracranial artery stenosis; however, it is associated with high equipment costs. Transcranial color-coded Duplex ultrasound (TCCD) combined with contrast-enhanced ultrasound (CEUS) presents advantages such as non-invasiveness, real-time dynamic monitoring, and low cost. Nevertheless, there were no reports comparing the sensitivity, specificity, diagnostic agreement with MRA, or health economic evaluation of TCCD combined with CEUS for detecting major intracranial artery stenosis. Methods  From April 2023 to August 2024, a total of 55 patients suspected of having intracranial artery stenosis or occlusion were recruited at Beijing Tiantan Hospital, Capital Medical University. Both TCCD combined with CEUS and MRA were performed to evaluate the degree of stenosis in the terminal segment of the internal carotid artery, M1 and M2 segments of the middle cerebral artery, A1 and A2 segments of the anterior cerebral artery, P1 and P2 segments of the posterior cerebral artery, and the V4 segment of the vertebral artery. Intracranial artery stenosis was categorized into three groups: normal/mild, moderate, and severe/occlusion. Sensitivity, specificity, and consistency between the two methods were calculated. The Wilcoxon signed-rank test was used to compare the differences in examination costs and diagnostic time. Results  Fifty-five high-risk patients (110 cerebral hemispheres in total) with suspected cerebrovascular stenosis were included (median age: 46 years; 69.0% male). TCCD combined with CEUS and MRA were performed simultaneously. TCCD combined with CEUS showed high sensitivity and specificity in diagnosing intracranial artery stenosis, with good consistency compared to MRA. The highest diagnostic consistency was observed in the M2 segment (Kappa=0.704) and A2 segment (Kappa=0.650), while the M1 segment showed moderate consistency (Kappa=0.569). The average cost of TCCD combined with CEUS was 240 CNY with a diagnostic duration of 21 min, compared to 722 CNY and 287 min for MRA (P<0.001, effect sizer=0.89 － 0.91). Conclusion  Compared to MRA, TCCD combined with CEUS demonstrates higher consistency in screening for stenosis in the M2 segment of the middle cerebral artery and the A2 segment of the anterior cerebral artery. It is also more cost-effective. However, MRA has advantages in assessing deep intracranial vessels. A synergistic use of both methods can optimize the allocation of diagnostic resources for intracranial artery stenosis. It is recommended that primary healthcare institutions adopt TCCD as the initial screening tool, and, with standardized training and technical upgrades, combine it with CEUS. Complex cases should be referred for detailed evaluation by using MRA.

Correlation between serum glycoprotein non-metastatic melanoma protein B levels and disease severity and prognosis in patients with acute ischemic stroke

Guo Yu, Chen Weiguan, Zhou Sanlian, Tang Liqiao, Sun Wangyan, Zhang Dongmei, Lu Hongjian

2025, 46(4):  702-709.  doi:10.3969/j.issn.1006-7795.2025.04.018

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Objective  This study mainly focuses on the relationship between the serum glycoprotein non-metastatic melanoma protein B (GPNMB) concentration and the degree of neurological damage and prognosis in patients with acute ischemic stroke (AIS), and screens potential biomarkers to provide a reference for clinical diagnosis and treatment. Methods  A total of 105 AIS patients hospitalized in the Department of Neurology of the Hospital 2 of Nantong University from June 2023 to March 2024 were selected as the sample group. In this study, the patients were divided into mild group (n=42) and moderate to severe group (n=63) according to the National Institutes of Health Strobe Scale (NIHSS) score within 24 hours of admission. The Modified Rankin Scale (mRS) was used to evaluate the functional recovery 3 months after discharge. The samples were subdivided into good prognosis group (n=34) and poor prognosis group (n=71). The serum GPNMB protein level was detected by ELISA, and the correlation between serum GPNMB protein level and NIHSS and mRS scores was analyzed. The binary Logistic regression model was used to evaluate the predictive value and prognostic evaluation value of serum GPNMB protein level for AIS neurological function damage. Results  The serum GPNMB protein concentration in patients with moderate to severe neurological impairment and poor prognosis was significantly lower than that in patients with mild and good prognosis (P<0.05). The serum GPNMB protein level was significantly negatively correlated with the NIHSS score (r=－0.196, P<0.05) and the mRS score (r=－0.334, P<0.05). Multivariate regression analysis showed that GPNMB was still a key independent risk factor for AIS (P<0.05). The evaluation results obtained based on the receiver operating characteristic curve (ROC) showed that the serum GPNMB protein level had diagnostic value in predicting neurological impairment and poor prognosis (sensitivity reached 55.6%, specificity was 81.8%, and the overall accuracy was 63.81%, P<0.05).Conclusion  There is a significant positive correlation between the decrease in serum GPNMB protein concentration and the degree of neurological damage in AIS patients, and it is likely to become an important biological indicator for measuring the severity of the disease and long-term prognosis.

Changes of blood clinical parameters in patients with Graves' ophthalmopathy before and after treatment with tocilizumab

Xie Rongrong, Xu Xinyu, Song Zhihui, Xin Zhong, Hua Lin, Shi Tingting

2025, 46(4):  710-717.  doi:10.3969/j.issn.1006-7795.2025.04.019

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Objective  To systematically analyze the changes in clinical indicators including blood leukocytes and neutrophils, liver and kidney functions, coagulation function, lipids, and levels of thyroid hormones and antibodies in Graves ophthalmopathy (GO) patients who had undergone effective treatment with tocilizumab (TCZ) and to explore their clinical significance. Methods  Eighty-five patients with moderately or severely active GO who were effectively treated with TCZ were enrolled. Early morning fasting blood was collected and tested for routine blood, biochemical routine, coagulation function, thyroid hormone and antibodies, and basic information such as gender, age, duration of the disease, history of smoking, comorbidities, and medications were also collected from all patients, so changes in the clinical indicators before and after the treatment could be analyzed and correlation analyses could be carried out. Results  Patients with moderately to severely active GO treated with TCZ showed a significant decrease in absolute blood leukocyte and neutrophil values compared with before, and a significant decrease in liver function (alanine transaminase,aspartate aminotransferase,creatinine), cholesterol ( total cholesterol , high-density lipoprotein and low-density lipoprotein) levels were significantly higher than before, and concentrations of coagulation parameters ［prothrombin time , activated partial thromboplastin time,fibrinogen (FIB) and D-dimer］ were significantly decreased. The concentrations of thyroid hormone and thyroid-stimulating hormone levels increased significantly, and the antibody titer of thyrotropin receptor antibody (TRAB) was significantly down-regulated after treatment. TRAB levels were significantly correlated with FIB before treatment. Conclusion  Thyroid function and antibody levels improved after TCZ treatment in patients with moderately to severely active GO, but blood leukocytes, liver function and coagulation function changed significantly compared with before. The results of this study confirm the therapeutic effect of TCZ on immune disorders in GO ophthalmopathy, while underscoring the importance of monitoring potential  adverse effects in clinical treatment.

The predictive value of serum β2M level for prognosis in exacerbated COPD and the results of when it is compared with other inflammatory markers

Mao Wenping, Han Qian, Jiao Fengwei, Wang Jing, Huang Kewu

2025, 46(4):  718-723.  doi:10.3969/j.issn.1006-7795.2025.04.020

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Objective  To investigate the prognostic role of serum beta 2-microglobulin (β2M) as a systemic inflammatory biomarker in 
hospitalized patients with exacerbation of COPD, compared with other inflammatory biomarkers. Methods  We retrospectively analyzed hospitalized patients with exacerbated COPD as the first diagnosis at Beijing Chao-Yang hospital, P. R. China,  from December 31, 2012 to December 28, 2017. Serum β2M levels, laboratory and clinical indexes were measured or collected on admission, and all patients were followed up for 90 days. The prognostic performance of β2M was compared with the neutrophils-lymphocytes ratio (NLR), C-reactive protein values (CRP) and white blood cell (WBC) using MedCalc. Results  For 30-day mortality, β2M, NLR, and CRP showed significant predictive value (all P<0.001) and were better than WBC (P=0.044, 0.003 and 0.030, respectively) in hospitalized patients with exacerbated COPD , while WBC had no predictive significance. For 90-day mortality, β2M, NLR, CRP, and WBC were all statistically significant, but only NLR outperformed WBC (P=0.004). No significant differences were observed among β2M, NLR, and CRP. Conclusion  As a systemic inflammatory biomarker, serum β2M was a useful prognostic biomarker for short-term death in hospitalized patients with COPD exacerbations. It performed slightly better than NLR and CRP for 30-day mortality prediction and slightly superior to CRP and slightly inferior to NLR for 90-day mortality prediction. 



Multivariate analysis of pregnancy outcomes after transcervical resection of polyp in infertility patients

Guo Yan, Xia Enlan, Xiao Yu, Huang Xiaowu

2025, 46(4):  724-728.  doi:10.3969/j.issn.1006-7795.2025.04.021

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Objective  To investigate the influencing factors of pregnancy outcomes after transcervical resection of polyp (TCRP) in infertility patients. Methods  The data of 442 patients with infertility complicated with endometrial polyp (EP) underwent TCRP from March 2021 to March 2022 were retrospectively analyzed, and the postoperative follow-up time was 12-24 months, and they were divided into postoperative pregnancy group (pregnancy group) and non-pregnant group (control group). The two groups were compared with age, body mass index (BMI), infertility type, abnormal uterine bleeding, adverse pregnancy history, number of EP, EP size, intraoperative negative pressure uterine aspiration, endometritis, TCRP operation time, and uterine cavity depth, and multivariate analysis was conducted on the influencing factors of pregnancy outcomes after TCRP in infertility patients. Results  Among 442 infertility patients with EP, 274 cases (62.0%) were in the pregnancy group and 168 cases (38%) in the control group. The factors 


influencing pregnancy after TCRP were age (OR=0.925, 95%CI:0.881-0.972, P<0.05), abnormal uterine bleeding before surgery (OR=0.646, 95%CI: 0.432-0.967, P<0.05) and primary infertility (OR=2.105, 95%CI:1.295-3.423, P<0.05). Conclusion  TCRP can improve pregnancy outcomes in infertility patients with EP. Age and abnormal uterine bleeding before operation were the protective factors to increase pregnancy after TCRP in infertility patients. Primary infertility is a risk factor for pregnancy after TCRP in infertility patients.




Research progress on the long-term effects of subthalamic nucleus deep brain stimulation on non-motor symptoms in Parkinson's disease

Jiang Chenguan, Liu Yan, Yang Zhou, Li Bingxin, Zhang Jianguo, Shi Lin

2025, 46(4):  733-741.  doi:10.3969/j.issn.1006-7795.2025.04.023

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Deep brain stimulation (DBS) has witnessed rapid advancement as a neurosurgical intervention over the past four decades, addressing movement disorders and a spectrum of neuropsychiatric conditions. Notably, subthalamic nucleus deep brain stimulation (STN-DBS) is widely implemented in the management of Parkinson's disease（PD）patients experiencing refractory motor fluctuations and complications, and has shown promise in ameliorating non-motor symptoms (NMS). However, the long-term efficacy of STN-DBS on NMS remains a subject of scholarly discourse. This review endeavors to synthesize current knowledge regarding the long-term impacts, underlying mechanisms, and future research directions of STN-DBS in the context of NMS in Parkinson's disease.

The role and mechanism of gut microbiota in the development of diabetic nephropathy

Han Mei, , Zhang Gang , Zhao Jin , Wang Anjing , Hui Yueqing , Sun Shiren

2025, 46(4):  742-748.  doi:10.3969/j.issn.1006-7795.2025.04.024

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Diabetic nephropathy (DN) ranks as a frequent and serious complication in diabetes mellitus, and it's a key factor in chronic kidney disease and end-stage renal disease(ESRD), greatly diminishing the life quality of patients. Presently, the conventional treatment approaches for DN mainly involve strict regulation of blood sugar and pressure, in conjunction with the application of renin-angiotensin-aldosterone system inhibitors. While these therapies can slow down the advancement of DN, they are ineffective in stopping its final development into ESRD. Lately, the involvement of the gut-kidney axis in the development and advancement of DN has attracted growing interest. Individuals suffering from DN show changes in the variety of gut microbiota, which are crucial in the development and management of DN due to metabolic interactions with the host. The goal of this analysis is to explore the fundamental processes of gut microbiota's role in DN and explore treatment approaches focusing on gut microbiota, aiming to offer new perspectives for the clinical handling of DN. 

Research progress of Piezo mechanosensitive ion channel in overactive bladder

Shi Jiahui

2025, 46(4):  749-753.  doi:10.3969/j.issn.1006-7795.2025.04.025

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In order to explore the role of Piezo mechanosensitive ion channel in overactive bladder (OAB), it provides a new idea for the clinical treatment of bladder dysfunction. This paper systematically reviews the importance and characteristics of Piezo1 and Piezo2 in the bladder, including their biophysical properties, localization, and function, with a particular focus on their connection to the pathophysiology of OAB. Although it is still too early to fully uncover the exact mechanism by which the Piezo channel regulates bladder function, altering urination function by inhibiting the Piezo1/2 channel as a new therapeutic strategy for OAB, based on existing research. With the further study of Piezo channel, it will undoubtedly become a potential target and therapeutic strategy for the treatment of OAB.