四川大学学报(医学版)最新文献

{"title":"[Clinical Challenges in the Diagnosis and Management of Fetal Esophageal Atresia: From Prenatal Diagnosis and Surgical Intervention to Prognostic Management].","authors":"Mengmeng Sun, Fan Zhou, Xiaodong Wang, Li Wan, Haiyan Yu","doi":"10.12182/20260760111","DOIUrl":"10.12182/20260760111","url":null,"abstract":"<p><p>Congenital esophageal atresia (EA), a severe malformation of the digestive tract, has an incidence of approximately 1 in every 2500 to 3000 live births. It is characterized by an interruption in the continuity of the esophagus and is often accompanied by tracheoesophageal fistula (TEF) . The etiology of EA is complex. With continuous advancements in prenatal imaging technology, fetal medicine, and neonatal surgery, the prenatal detection rate, perinatal management, and postoperative outcomes of EA have improved. However, the clinical management of EA still faces significant challenges, including, primarily, the inefficiency of prenatal diagnostic techniques in detecting the most common Type C EA, the lack of quantitative decision-making criteria for individualized timing of surgical intervention, and prognostic evaluations that overemphasize short-term anatomical reconstruction while neglecting long-term quality of life. This article systematically reviews the latest research advances in the etiology, prenatal diagnostic strategies, surgical management, and prognostic evaluation of EA. Given the significant improvement in the overall survival rate of pediatric patients with EA, future clinical research and disease management urgently require a paradigm shift-transitioning from a sole focus on surgical anatomical reconstruction to overcoming technical limitations in prenatal diagnosis, optimizing decision-making for individualized surgical timing, and bridging the gap between short-term anatomical reconstruction and long-term quality of life. Furthermore, it is imperative to further strengthen the multidisciplinary collaborative model and establish standardized, whole-life-cycle follow-up and intervention protocols spanning from the prenatal period through adulthood, with the goal of comprehensively improving the long-term physiological and psychological outcomes of these patients.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1221-1227"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevalence of Refractive and Corneal Astigmatism in Children Aged 3-14 Years].","authors":"Yuxuan Zhao, Bi Yang, Hui Luo, Rong Li, Rui Chen, Longqian Liu, Naihong Yan","doi":"10.12182/20260760209","DOIUrl":"10.12182/20260760209","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prevalence of refractive astigmatism (RA) and corneal astigmatism (CA) among children aged 3 to 14 years in Chengdu, Sichuan Province, China.</p><p><strong>Methods: </strong>Using a random sampling method, astigmatism screening data were collected from school-aged children attending 500 schools, including kindergartens, primary schools, and junior middle schools, located in three administrative districts of Chengdu in 2024. Basic demographic information and ocular biometric parameters measured by noncycloplegic autorefractometry and optical biometry were collected. Only data from the right eye were included in the analysis. The mean astigmatism values and the prevalence of astigmatism were compared across age groups to examine the differences.</p><p><strong>Results: </strong>A total of 255959 sschool-aged children and adolescents aged 3 to 14 years in Chengdu were included in the analyses. The mean RA was (－0.56 ± 0.59) diopters (D), and the mean CA was (－1.23 ± 0.62) D, with with-the-rule (WTR) astigmatism being the predominant subtype. The prevalence rates of RA (≤ -1.00 D) and CA (≤－1.00 D) were 18.16% and 62.29%, respectively. The magnitude and prevalence of astigmatism exhibited age-dependent trends (<i>P</i> < 0.001). In the group of children aged 3-8 years, both the magnitude and prevalence of RA and CA gradually decreased or remained stable with increasing age, whereas in the 9-to-14-year age group, both the magnitude and prevalence increased progressively with increasing age.</p><p><strong>Conclusion: </strong>Among school-aged children and adolescents aged 3 to 14 years in Chengdu, the magnitude and prevalence of RA and CA exhibited an age-dependent pattern characterized by an initial decrease or stabilization followed by a subsequent increase. The prevalence of astigmatism was found to be higher in primary and junior middle school students.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1165-1170"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Anti-inflammatory Mechanisms of Human Resistin Through Activation of Peroxisome Proliferator-Activated Receptor γ].","authors":"Bowen Shi, Bin Han, Yulin Liu, Renping Liu","doi":"10.12182/20260760502","DOIUrl":"10.12182/20260760502","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To study the molecular mechanism and regulatory effect of resistin on lipopolysaccharide (LPS)-induced interleukin (IL)-1β and tumor necrosis factor-α (TNF-α) expression through activation of peroxisome proliferator-activated receptor γ (PPARγ).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An endotoxin-induced inflammation model was established by intraperitoneal injection of 5 mg/kg LPS in C57BL/6J mice, and the expression levels of resistin in mouse serum and spleen tissue were measured. Using resistin-treated RAW264.7 cells and C57BL/6J mice administered intraperitoneal injections as models, real-time quantitative PCR, Western blot, and ELISA were used to assess the mRNA and protein expression of PPARγ, total p65, phosphorylated p65, inhibitor of NF-κB alpha (IκBα), IL-1β, and TNF-α in LPS-induced RAW264.7 cells under conditions of resistin pretreatment or combined intervention with the PPARγ activator rosiglitazone or the inhibitor GW9662. Using C57BL/6J mice with intraperitoneal injection of 20 mg/kg LPS as a model, the effects of resistin on survival and serum IL-1β and TNF-α levels were evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After intraperitoneal injection of LPS, the mRNA and protein levels of resistin in the spleen of mice decreased by more than 80%, and the serum concentration dropped by 58%, which was statistically significant compared with the PBS control group (&lt;i&gt;P&lt;/i&gt; &lt; 0.001). Under pretreatment with 20 ng/mL resistin, the mRNA and relative protein expression levels of PPARγ in LPS-stimulated RAW264.7 cells increased from 0.58 ±0.07 and 0.34 ± 0.04 to 0.95 ± 0.03 and 1.78 ± 0.28, respectively, and further increased to 2.03 ± 0.16 and 2.82 ± 0.08 under the combined action of resistin and rosiglitazone, with statistically significant differences among the three treatments (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Resistin increased &lt;i&gt;PPARγ&lt;/i&gt; mRNA and relative protein expression levels in LPS- and GW9662-treated RAW264.7 cells from 0.44 ± 0.06 and 0.43± 0.03 to 1.19± 0.08 and 0.55 ± 0.04, respectively, with statistically significant differences between the two groups (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Meanwhile, intracellular &lt;i&gt;IL-1β&lt;/i&gt; mRNA levels decreased from 12.31 ± 1.50 to 7.45 ± 0.83, and cell culture supernatant protein levels dropped from (179.62 ± 9.27) pg/mL to (108.59 ± 17.32) pg/mL. Additionally, &lt;i&gt;TNF-α&lt;/i&gt; mRNA levels declined from 3.41 ± 0.11 to 2.50 ± 0.04, while supernatant protein levels decreased from (1265.30 ± 154.78) pg/mL to （1025.96±45.41） pg/mL. Statistical comparisons between the two groups showed significant differences (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), indicating that Retn partially inhibits GW9662's effect on promoting LPS-induced IL-1β and TNF-α expression. It was found that under the action of resistin, intracellular IκBα protein levels increased and p-p65/p65 expression decreased; meanwhile, &lt;i&gt;IL-1β&lt;/i&gt; and &lt;i&gt;TNF-α&lt;/i&gt; mRNA levels decreased by 24.7% and 26.9%, and protein expression levels decreased by 36.3% and 37.2%, respe","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1062-1072"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Relationship Between Pain and Depressive Symptoms in Middle-aged and Older Chinese Adults: A Cross-Lagged Longitudinal Analysis].","authors":"Honghong Xia, Wangmu, Hongxia Zhang, Ming Fu, Yang Wan, Peiyuan Qiu","doi":"10.12182/20260760603","DOIUrl":"10.12182/20260760603","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the longitudinal association between pain and depressive symptoms in middle-aged and older adults in China, and to provide a scientific basis for the management of pain and depression in this population.</p><p><strong>Methods: </strong>Data from 5 follow-up waves (conducted between 2011 and 2020) of the China Health and Retirement Longitudinal Study (CHARLS) were used in the study. A total of 7876 middle-aged and older adults aged 45 years or older who completed all 5 surveys were enrolled. A Random Intercept Cross-Lagged Panel Model (RI-CLPM) was applied to analyze the longitudinal relationship between pain and depressive symptoms across the 5 time points. The potential confounders controlled for in the model in a stepwise manner included time-invariant variables (sex, marital status, and household registration) and time-varying covariates (age, comorbidity, activities of daily living scores, smoking, drinking, and physical activity).</p><p><strong>Results: </strong>The RI-CLPM demonstrated a good model fit (Comparative Fit Index [CFI] = 0.906, Tucker and Lewis Index [TLI] = 0.879, Root Mean Square Error of Approximation [RMSEA] = 0.036, and Standardized Root Mean Square Residual [SRMR] = 0.060). After controlling for between-person differences, the RI-CLPM results showed that the lagged effects of pain on depressive symptoms were statistically significant across all time points from T1 to T5 (T1 to T2: <i>β</i> = 0.043, 95% CI [0.020-0.067]; T2 to T3: <i>β</i> = 0.047, 95% CI [0.023-0.070]; T3 to T4: <i>β</i> = 0.056, 95% CI [0.034-0.078]; T4 to T5: <i>β</i> = 0.050, 95% CI [0.028-0.071]). Additionally, the lagged effects of depressive symptoms on pain were statistically significant from T2 to T5 (T2 to T3: <i>β</i> = 0.121, 95% CI [0.099-0.143]; T3 to T4: <i>β</i> = 0.112, 95% CI [0.091-0.134]; T4 to T5: <i>β</i> = 0.070, 95% CI [0.049-0.090]), and the predictive effects of depressive symptoms on pain were greater.</p><p><strong>Conclusion: </strong>Pain and depressive symptoms have a bidirectional predictive relationship over time. The predictive performance of pain for depressive symptoms remains stable over time, while the predictive performance of depressive symptoms for pain is stronger. These findings suggest that screening for depressive symptoms should be emphasized in the diagnosis and treatment of patients presenting with pain.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"993-999"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Systemic Reprogramming of Cellular Senescence: Coordinated Regulation of Metabolism, Epigenetics, and Proteostasis].","authors":"Yulin Zheng, Qian Liu, Ruihong Wang, Chongkui Sun","doi":"10.12182/20260760105","DOIUrl":"10.12182/20260760105","url":null,"abstract":"<p><p>Cellular senescence has long been considered an irreversible process. However, recent breakthroughs in partial cellular reprogramming have demonstrated that senescent cells maintain a metastable state amenable to resetting. This review outlines a systemic framework for anti-aging interventions that integrate three core dimensions. First, metabolic reprogramming through the elevation of nicotinamide adenine dinucleotide (NAD⁺) levels provides the energetic and coenzymatic foundation necessary for a systemic reset. Second, spatiotemporally controlled epigenetic resetting, mediated by Oct4-Sox2-Klf4-c-Myc (OSKM) factors or small molecules, restores youthful transcriptional programs without compromising cellular identity. Third, the restoration of proteostasis via the autophagy-lysosome and ubiquitin-proteasome systems serves as the critical execution mechanism that eliminates damaged biomaterials and ensures the proper folding of newly synthesized proteins. Despite these advances, the research field still faces major challenges, including the lack of a clearly defined therapeutic window for safe reprogramming, limited efficiency of tissue-specific delivery, and insufficient evidence regarding the long-term safety of therapeutic interventions. Future studies should focus on integrating single-cell omics, DNA methylation clocks, and artificial intelligence-assisted analyses to establish precision-based evaluation metrics for evaluating cellular rejuvenation. In addition, the development of next-generation delivery platforms, including lipid nanoparticles (LNPs) and engineered exosomes, will facilitate precision-based regulation of multi-level synergistic interventions. Ultimately, anti-aging medicine is evolving from single-pathway interventions toward a comprehensive paradigm of systemic reprogramming driven by the multi-axial synergy of metabolism, epigenetics, and proteostasis.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"915-924"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Shashen Maidong Decoction Improves Pulmonary Function in Aged Mice With Chronic Obstructive Pulmonary Disease by Inhibiting cGAS-STING-NF-κB-Mediated Inflammaging].","authors":"Xiangnan Kuang, Xingran Liu, Xinyao Zhao, Xuexiao Chen, Shiqiao Liu","doi":"10.12182/20260760107","DOIUrl":"10.12182/20260760107","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the effect of Shashen Maidong Decoction (SMD) on inflammaging in a mouse model of chronic obstructive pulmonary disease (COPD), and to determine whether its efficacy is mediated by regulating the cyclic guanosine monophosphate-adenosine monophosphate synthase (cGAS)-stimulator of interferon genes (STING)-nuclear factor-kappa B (NF-κB) signaling pathway.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Female and male C57BL/6JNifdc mice (half male and half female) aged 18-20 months were selected to establish a COPD model was subsequently established via cigarette smoke exposure combined with intranasal lipopolysaccharide instillation. The mice were randomly assigned to 6 groups, including a normal control group, a model group, low-, medium-, and high-dose SMD groups (receiving 8.3, 16.5, and 33.0 g/kg, respectively), and a dexamethasone group (3 mg/kg), with 8 mice in each group (4 males and 4 females). Starting on the day after modelling, the mice received daily intragastric administration for 12 weeks (normal control and model groups received sodium carboxymethyl cellulose at 0.15 mL/10 g). Pulmonary function parameters, including resistance of the respiratory system (Rrs), elastance of the respiratory system (Ers), the ratio of forced expiratory volume in 0.2 seconds to forced vital capacity (FEV&lt;sub&gt;0.2&lt;/sub&gt;/FVC), and forced expiratory flow at 50% of vital capacity (FEF&lt;sub&gt;50%&lt;/sub&gt;), were measured. Lung histopathology was evaluated by hematoxylin and eosin (HE) and Masson's trichrome stains. Serum inflammatory factors, including interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), and tumor necrosis factor α (TNF-α), as well as oxidative stress markers, including superoxide dismutase (SOD) and malondialdehyde (MDA), were assessed. In addition, the mRNA and protein expression levels of senescence-associated proteins (p16 and p21) and the cGAS-STING-NF-κB pathway molecules in lung tissues were determined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with the normal control group, mice in the model group exhibited impaired pulmonary function, characterized by increased Rrs and decreased Ers, FEV&lt;sub&gt;0.2&lt;/sub&gt;/FVC, and FEF&lt;sub&gt;50%&lt;/sub&gt;. Histopathologic examination demonstrated massive inflammatory cell infiltration, bronchiolar wall thickening, and destruction of alveolar structures. The levels of serum inflammatory factors and MDA were increased, whereas SOD activity was decreased, demonstrating statistically significant differences (all &lt;i&gt;P&lt;/i&gt; &lt; 0.01). Furthermore, the mRNA and protein expression levels of senescence-associated proteins and cGAS-STING-NF-κB pathway molecules were significantly elevated in lung tissues (all &lt;i&gt;P&lt;/i&gt; &lt; 0.01). Compared with the model group, the medium- and high-dose SMD groups showed significantly improved lung function parameters, decreased serum inflammatory factors and MDA levels, and increased SOD activity (all &lt;i&gt;P&lt;/i&gt; &lt; 0.05). In addition, the expression levels of s","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"974-984"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Applications and Challenges of Deep Learning in Human Genome Research].","authors":"Yucong Li, Kailing Tu, Dan Xie","doi":"10.12182/20260760302","DOIUrl":"10.12182/20260760302","url":null,"abstract":"<p><p>In recent years, the advent of high-throughput omics technologies has fueled an explosive growth in human genomic data. Uncovering the latent functions within this vast data has become a significant challenge in functional genomics research. While traditional statistical methods have proved successful for analyzing smaller-scale datasets in the past, they exhibit clear limitations in analytical efficiency and integrating multi-dimensional data, struggling to meet the escalating demands of contemporary genomic analysis. The introduction of deep learning (DL) technologies offers a novel paradigm for this field. This review systematically examines the advances in applying deep learning to human genomics research. Studies demonstrate that when ample labeled data is available, discriminative DL computational methods-such as Convolutional Neural Networks (CNNs) and Long Short-Term Memory networks (LSTMs)-achieve high accuracy and efficiency in genomic variant discovery tasks. Furthermore, generative DL methods, particularly Large Language Models (LLMs) leveraging self-supervised pre-training strategies, effectively integrate complex genomic information and exhibit superior performance in functional genomic sequence annotation and gene regulation studies. This review also explores the application of LLMs in multi-omics data integration and prediction. Looking ahead, the continued accumulation of long-read sequencing and high-dimensional data is expected to enable DL technologies to integrate increasingly complex and heterogeneous genomic information, playing an increasingly crucial role in human genomics research.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1204-1211"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association Between Marital/Partner Relationship Quality and Accumulation Rate of Multiple Chronic Conditions in Middle-Aged and Older Adults: An Analysis Based on Data From English Longitudinal Study of Ageing].","authors":"Rui Chen, Yi Xiang, Minglun Xin, Xiong Xiao","doi":"10.12182/20260760608","DOIUrl":"10.12182/20260760608","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between marital/partner relationship quality and the accumulation rate of multiple chronic conditions in middle-aged and older adults.</p><p><strong>Methods: </strong>This study was based on the data from waves 4 to 11 of the English Longitudinal Study of Ageing (ELSA). Multiple imputation by chained equations was used to handle missing covariates. Linear mixed-effects models were fitted to examine the association between marital/partner relationship quality types and the accumulation rate of multiple chronic conditions. Effect heterogeneity was further explored through stratified analyses by sex and age.</p><p><strong>Results: </strong>A total of 7943 participants were included. Compared with individuals in supportive marital/partner relationships (with high support and low strain), all other relationship types and having no partner were associated with faster rates of accumulation of chronic diseases. Individuals with no partners showed the fastest accumulation rate (<i>β</i> = 0.042, 95% CI: 0.033-0.051), followed by those in indifferent relationships (with low support and low strain) and aversive relationships (with low support and high strain) (<i>β</i> = 0.029, 95% CI: 0.007-0.051; <i>β</i> = 0.027, 95% CI: 0.013-0.041). Those in ambivalent relationships (with high support and high strain) showed a relatively weaker effect (<i>β</i> = 0.018, 95% CI: 0.009-0.026). Women were more sensitive to this effect.</p><p><strong>Conclusion: </strong>Adverse marital/partner relationships (including ambivalent, indifferent, and aversive) and the absence of a partner are associated with an accelerated accumulation rate of multiple chronic diseases in middle-aged and older adults, and priority attention should be given to the female population.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1171-1178"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Risk Factors for Idiopathic Membranous Nephropathy Complicated by Acute Kidney Injury].","authors":"Jiaying Cai, Yaling Chen, Suren Lai, Shizhong Shen","doi":"10.12182/20260760207","DOIUrl":"10.12182/20260760207","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk factors for idiopathic membranous nephropathy (IMN) complicated by acute kidney injury (AKI) based on propensity score matching (PSM).</p><p><strong>Methods: </strong>A total of 310 IMN patients admitted between January 2020 and March 2025 were retrospectively enrolled and divided into an AKI group (<i>n</i> = 80) and a non-AKI group (<i>n</i> = 230). Patients in the non-AKI group were matched with those in the AKI group at a 1:1 ratio using PSM, resulting in 80 matched pairs. The general data of the patients were collected. The primary outcome measures included serum creatinine, estimated glomerular filtration rate (eGFR), uric acid, P-selectin, and urinary kidney injury molecule-1 (KIM-1) levels. Logistic regression analysis was performed to identify factors associated with risks for IMN complicated by AKI, and a nomogram prediction model was subsequently established.</p><p><strong>Results: </strong>After PSM, all 5 primary outcome measures differed significantly between the AKI and non-AKI groups (all <i>P</i> < 0.05). According to multivariate logistic regression analysis, 4 outcome measures, including serum creatinine, eGFR, serum uric acid, and serum P-selectin, were all identified as factors influencing the occurrence of AKI in patients with IMN (all <i>P</i> < 0.05). A combined prediction model (a nomogram model) incorporating these 4 variables yielded an area under the curve (AUC) of the receiver operating characteristic curve (ROC) of 0.945 (95% CI: 0.909-0.981). The calibration curve demonstrated a good fit between the predicted and the ideal curves. Findings from the Hosmer-Lemeshow goodness-of-fit test supported adequate calibration of the model (<i>χ</i>² = 7.366, <i>P</i> = 0.498). Shapley additive explanations (SHAP) importance ranking analysis showed that serum P-selectin was an important influencing factor for AKI in patients with IMN, and the importance of serum uric acid, eGFR, and serum creatinine was secondary.</p><p><strong>Conclusion: </strong>Serum creatinine, eGFR, blood uric acid, and serum P-selectin are independent influencing factors for patients with acute kidney injury, and they have certain predictive value.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1114-1120"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of Exercise Training Combined With β-Hydroxy-β-Methylbutyrate Supplementation on Physical Function in Older Adults With Frailty].","authors":"Yanxing Jiang, Haolun Yang, Ziwen Yin, Liming Zhang, Renjie Wang","doi":"10.12182/20260760110","DOIUrl":"10.12182/20260760110","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the additional effects of β-hydroxy-β-methylbutyrate (HMB) supplementation combined with multicomponent exercise training on physical function, muscle mass, and nutritional status in older adults with frailty.</p><p><strong>Methods: </strong>A randomized, double-blind, placebo-controlled trial was conducted. A total of 136 older adults with frailty admitted to West China Hospital, Sichuan University between March 2023 and March 2025 were enrolled and randomly assigned at a ratio of 1∶1 to an intervention group (<i>n</i> = 68) and a control group (<i>n</i> = 68). Participants in the intervention group received oral calcium HMB supplementation at 3 g/d in addition to exercise training, while those in the control group received maltodextrin placebo on top of the same exercise program. The intervention lasted 12 weeks. Assessments were performed at baseline and after 4 and 12 weeks. The primary outcome measure was the Short Physical Performance Battery (SPPB) score. Secondary outcome measures included the 6-minute walk test (6 MWT), handgrip strength, modified Barthel index (MBI), timed up-and-go test (TUGT), appendicular skeletal muscle index (ASMI), and serum albumin level.</p><p><strong>Results: </strong>Generalized estimating equation analysis showed that SPPB total score had significant time effect (Wald <i>χ</i> ² = 235.867, <i>P</i> < 0.001), group effect (Wald <i>χ</i> ² = 8.148, <i>P</i> = 0.004), and interaction effect (Wald <i>χ</i> ² = 13.846, <i>P</i> < 0.001), indicating greater overall improvement in physical function in the intervention group than that in the control group. After 4 weeks, the intervention group showed significantly better total SPPB score, balance score, 6MWT performance, MBI score, and serum albumin level than the control group did (all <i>P</i> < 0.05). These between-group differences further increased after 12 weeks, with the intervention group continuing to outperform the control group (all <i>P</i> < 0.05). Additionally, at week 12, the intervention group showed significantly better results than the control group did in gait score and ASMI (<i>P</i> < 0.05). Although TUGT was lower in the intervention group than that in the control group at week 12 in the single-timepoint comparison (<i>P</i> < 0.05), the generalized estimating equation analysis showed no significant group effect (<i>P</i> > 0.05). No significant differences were found between the two groups in chair stand test score or handgrip strength at any time point (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Among older adults with frailty, HMB supplementation (3 g/day for 12 weeks) in addition to conventional multicomponent exercise training further improves physical function, muscle mass, and nutritional status. The findings provide new evidence-based support for nonpharmacological intervention for frailty in older adults.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1000-1008"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}