四川大学学报(医学版)最新文献

{"title":"[Tongdu Zhiyu Acupuncture Improves Post-Stroke Depression by Upregulating miR-223-3p and Inhibiting NLRP3 Inflammasome: A Clinical Study].","authors":"Jingbo Zhang, Huixing Hu, Fajun Liang, Miaomiao Yin, Baoguo Wang, Xianbao Zhang, Zhijun Zheng, Zhen Wang","doi":"10.12182/20260760604","DOIUrl":"10.12182/20260760604","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the mechanism of Tongdu Zhiyu acupuncture in the treatment of post-stroke depression (PSD).</p><p><strong>Methods: </strong>A randomized controlled trial was conducted. Sixty-two PSD patients from the Department of Brain Disease, the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine were enrolled and randomly assigned in a 1∶1 ratio to a control group (<i>n</i> = 31) or an experimental group (<i>n</i> = 31). All patients received basic treatment. The control group received ordinary acupuncture, while the experimental group received ordinary acupuncture combined with Tongdu Zhiyu acupuncture. The treatment period was 8 weeks. The primary outcome was the total score on the 24-item Hamilton Depression Scale (HAMD-24). Secondary outcomes included the National Institutes of Health Stroke Scale (NIHSS) score, Barthel index, peripheral blood mononuclear cell miR-223-3p expression, and serum levels of NLRP3, IL-1β, and IL-18.</p><p><strong>Results: </strong>After treatment, all indicators in the experimental group improved significantly compared with baseline (all <i>P</i> < 0.05), and the improvements were significantly greater than those in the control group (all <i>P</i> < 0.05). The HAMD-24 score decreased from 17.87 ± 3.90 to 13.04 ± 3.55; the NIHSS score decreased from 23.29 ± 6.74 to 9.97 ± 5.81; the Barthel index increased from 32.29 ± 5.37 to 87.13 ± 6.82; miR-223-3p expression increased from 0.29 ± 0.07 to 0.98 ± 0.21; serum NLRP3 decreased from (65.84 ± 7.16) ng/L to (49.56 ± 4.89) ng/L; IL-1β decreased from (43.92 ± 7.25) pg/mL to (22.24 ± 4.76) pg/mL; and IL-18 decreased from (30.70 ± 4.13) pg/mL to (15.40 ± 3.09) pg/mL.</p><p><strong>Conclusion: </strong>Tongdu Zhiyu acupuncture can improve neurological function in PSD patients. Its mechanism may involve upregulating miR-223-3p expression, inhibiting NLRP3 inflammasome activation, and reducing the release of pro-inflammatory cytokines such as IL-1β and IL-18, thereby alleviating depressive symptoms.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1015-1021"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881880","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":"[Effect of Cancer Antigen-125 Elimination Rate Constant K and <i>BRCA</i> Mutation Status on the Prognosis of Interval Debulking Surgery in Advanced High-Grade Serous Ovarian Cancer].","authors":"Yuebo Li, Mengru Li, Xiuyun Zhang, Hanjie Xu, Jie Li, Hanyuan Liu, Cheng Peng","doi":"10.12182/20260760404","DOIUrl":"10.12182/20260760404","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of the cancer antigen-125 elimination rate constant K (KELIM) for treatment response and prognosis in patients with advanced high-grade serous ovarian cancer (HGSOC) undergoing neoadjuvant chemotherapy followed by interval debulking surgery (NACT-IDS), and to analyze the combined prognostic significance of KELIM and the mutation status of breast cancer susceptibility gene (<i>BRCA</i>).</p><p><strong>Methods: </strong>A total of 106 patients with advanced HGSOC who had undergone NACT-IDS were retrospectively enrolled. The KELIM values during neoadjuvant chemotherapy were calculated, and patients were divided into high- and low-KELIM groups using a cutoff value of 1.0. Clinicopathological characteristics, R0 resection rates, and platinum sensitivity rates were compared between the two groups. Logistic regression analysis was performed to identify predictive factors for R0 resection, while Kaplan-Meier survival analysis and Cox proportional hazards regression were performed to evaluate factors associated with progression-free survival (PFS). Furthermore, the patients were stratified according to both KELIM and <i>BRCA</i> status to assess the risk of platinum-resistant recurrence in each subgroup.</p><p><strong>Results: </strong>The R0 resection rate was higher in the KELIM ≥ 1 group than in the KELIM < 1 group (77.1% vs 55.2%), and the difference was statistically significant (<i>P</i> = 0.024). Multivariate logistic regression analysis showed that KELIM was an independent predictor of R0 resection (odds ratio [OR] = 2.922, 95% CI: 1.112-7.678). Survival analysis demonstrated longer PFS in the KELIM ≥1 group compared with that in the KELIM <1 group (33.0 months vs 18.0 months), and the difference was statistically significant (<i>P</i> < 0.001). Multivariate Cox regression analysis showed that KELIM ≥ 1 was associated with a reduced risk of disease progression (hazard ratio [HR] = 0.481, 95% CI: 0.280-0.826). Combined stratification analysis revealed that no platinum-resistant recurrence was observed in the subgroup with both KELIM ≥1 and a <i>BRCA</i>-positive status (0/21). Compared with patients with KELIM <1 and a <i>BRCA</i>-negative status, this subgroup exhibited a lower risk of platinum-resistant recurrence (OR = 0.053, 95% CI: 0.003-0.932, <i>P</i> = 0.006).</p><p><strong>Conclusion: </strong>KELIM is an effective dynamic biomarker for predicting surgical outcomes and PFS in patients undergoing NACT-IDS. Combined stratification by KELIM and <i>BRCA</i> status allows more precise identification of the patient population with both KELIM ≥1 and <i>BRCA</i>-positive status, who have an extremely low risk of platinum-resistant recurrence, thereby providing an important basis for individualized treatment and risk stratification management in patients with advanced HGSOC.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1073-1079"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881884","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 Identification and Standardized Prevention and Control Strategies for Outsourced Laboratory Testing in Healthcare Institutions].","authors":"Longyao Ran, Wenbo Zeng, Danni Liu, Xiaowei Guo","doi":"10.12182/20260760506","DOIUrl":"10.12182/20260760506","url":null,"abstract":"<p><p>With the high-quality development of China's medical and health care industry, the outsourcing of laboratory examinations by health care institutions has become an important supplementary approach to alleviate the shortage of medical resources and provide precise medical services. Drawing on management practices for outsourced laboratory examinations, this article systematically identifies legal, ethical, and management risks in outsourced laboratory testing, deeply analyzes the root causes of these risks, and in combination with the relevant regulatory requirements of health and wellness administrative departments, proposes targeted prevention and control strategies, The goal is to standardize the outsourcing of laboratory testing by health care institutions, prevent medical safety and integrity risks, protect patients' legitimate rights and interests, and maintain the public welfare and credibility of the medical industry.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1228-1234"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881964","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":"[Value of Multivariate Computed Tomography Angiography for Predicting Major Adverse Cardiac Events in Patients With Coronary Artery Heart Disease].","authors":"Bo Tu, Weiliang Xiao, Zhihua Pan, Jia Liu, Ke Xiao, Hongcheng Li, Jian Li, Dongmei Liu, Dechun Zhao, Hongying Xie","doi":"10.12182/20260760102","DOIUrl":"10.12182/20260760102","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the predictive value of computed tomography angiography (CTA)-derived fractional flow reserve (FFR), fat attenuation index (FAI), and plaque characteristics for the occurrence of major adverse cardiac events (MACE) in patients with coronary artery heart disease (CAD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 205 CAD patients were retrospectively enrolled at our hospital, and their demographic and clinical data were analyzed accordingly. All patients underwent CTA, and their FFR, FAI and plaque characteristics were measured. According to the occurrence of MACE within a 36-month follow-up period, the patients were divided into a MACE group (&lt;i&gt;n&lt;/i&gt; = 42) and a non-MACE group (&lt;i&gt;n&lt;/i&gt; = 163). The clinical data, FFR, FAI, and plaque characteristics were compared between the 2 groups, and logistic regression analysis was performed to identify factors associated with MACE in CAD patients. FFR, FAI, and plaque burden (PB) were further compared among patients with different degrees of coronary artery stenosis, and Spearman correlation analysis was performed to evaluate the associations of FFR, FAI, and PB with the severity of coronary artery stenosis. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of FFR, FAI, and PB for MACE in CAD patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with those in the non-MACE group, the body mass index (BMI), the proportion of patients with vascular lesions involving 2 or more coronary arteries, the proportion of patients with severe coronary stenosis, FAI, lipid plaque volume, non-calcified plaque volume, and PB were significantly higher (all &lt;i&gt;P&lt;/i&gt; &lt; 0.05) in the MACE group, whereas FFR was significantly lower (&lt;i&gt;P&lt;/i&gt; &lt; 0.05) in the MACE group. Variables with variance inflation factor (VIF) &lt; 3 on collinearity diagnostics were included in multivariate logistic regression analysis. The results showed that multivessel lesion (odds ratio [OR], 2.188; 95% CI, 1.304-3.671), severe coronary artery stenosis (OR, 2.918; 95% CI, 1.608-5.295), increased FAI (OR, 2.635; 95% CI, 1.510-4.598), and increased PB (OR, 2.396; 95% CI, 1.382-4.157) were risk factors for MACE in CAD patients (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), while increased FFR (OR, 0.373; 95% CI, 0.221-0.630) was a protective factor (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). Stratified analysis by the severity of coronary artery stenosis showed that patients with mild stenosis had significantly higher FFR and significantly lower FAI and PB than those with moderate or severe stenosis (all &lt;i&gt;P&lt;/i&gt; &lt; 0.05), and that patients with moderate stenosis had significantly higher FFR and significantly lower FAI and PB than those with severe stenosis (all &lt;i&gt;P&lt;/i&gt; &lt; 0.05). Spearman correlation coefficient analysis revealed that the severity of coronary artery stenosis was positively correlated with FAI (&lt;i&gt;r&lt;/i&gt; = 0.687; 95% CI, 0.598-0.760) and PB (&lt;i&gt;r&lt;/i&gt; = 0.664; 95% CI, 0.571-0.741) (&lt;i&gt;P&lt;/i&gt; &lt; 0.05), but negatively co","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1130-1136"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881954","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":"[<i>In Vitro</i> Biosafety Evaluation of Biodegradable Fluorinated Polyurethane Micelles].","authors":"Chaoyang Wang, Lu Sun, Ya Deng, Jiehua Li, Hong Tan, Jianguo Xu, Ruichao Liang","doi":"10.12182/20260760401","DOIUrl":"10.12182/20260760401","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the <i>in vitro</i> cytotoxicity and hemocompatibility of fluorinated polyurethane (FPU) micelles using international standardized methods, thereby providing a safety basis for their clinical application.</p><p><strong>Methods: </strong>Biodegradable FPU was synthesized using a two-step polymerization method. The hydrated particle size and the zeta potential of the micelles were measured by dynamic light scattering, and their morphology was observed by transmission electron microscopy. In accordance with the relevant standards for <i>in vitro</i> cytotoxicity testing specified in the biological evaluation guidelines for medical devices (ISO 10993-5:2009, GB/T 16886.5-2017, and GB/T 16886.4-2022) NIH/3T3 and SKOV3 cells were used to assess the effects of FPU micelles at various concentrations on cell proliferation, membrane permeability, and apoptosis after 24, 48, and 72 hours of treatment. Flow cytometry was used to analyze the effects of FPU micelles on the cell cycle of NIH/3T3 and SKOV3 cells. Additionally, an in vitro hemolysis assay was performed to evaluate the hemocompatibility of FPU micelles.</p><p><strong>Results: </strong>The particle size of FPU micelles was approximately 132.5 nm, with a polydispersity index (PDI) of 0.096, which is below 0.150, indicating uniform particle size. The zeta potential of FPU micelles was －21.5 mV. After treatment with FPU micelles at various concentrations, the proliferation activity of NIH/3T3 and SKOV3 cells was not affected, and no significant toxicity was observed. Furthermore, cell membrane permeability was not significantly altered, and no significant apoptosis was induced. Cell cycle analysis showed that after 72 hours of treatment, the proportion of cells in the G1 phase increased, while the proportions of cells in the S and G2 phases decreased, suggesting potential G1 phase arrest. However, no significant toxicity was observed. Furthermore, hemocompatibility experiments demonstrated that FPU micelles did not cause erythrocyte rupture or hemolysis, further confirming their favorable biocompatibility.</p><p><strong>Conclusion: </strong>FPU micelles did not exhibit significant cytotoxicity or hemolysis <i>in vitro</i>, and cell cycle analysis indicated no notable toxicity, demonstrating good biosafety.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1179-1186"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881846","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":"[Age-Related Changes in the Oral Microbiota].","authors":"Jingzhi Zhou, Xingchen Ye, Jing Zou, Ling Zou, Lei Cheng, Zhuoli Zhu, Ga Liao, Xuedong Zhou, Biao Ren","doi":"10.12182/20260760601","DOIUrl":"10.12182/20260760601","url":null,"abstract":"<p><p>The human microbiome consists of microbial communities inhabiting different body sites and their genetic information, and plays an important role in maintaining host health. As an important component of the human microbiome, the oral microbiota contributes to maintaining oral microbial homeostasis, regulating local immune responses, participating in nutrient metabolism, and modulating systemic health. Initial colonization of the oral microbiota in early life lays the foundation for subsequent microbial development and lifelong oral health, and alterations in the oral microbiota are closely associated with various oral and systemic diseases. This review systematically summarizes the age-related succession of the oral microbiota across infancy, childhood and adolescence, adulthood, and old age; analyzes oral diseases associated with microbial dysbiosis at different life stages; discusses host-related, microenvironmental, and exogenous factors influencing age-related changes in the oral microbiota; and summarizes intervention strategies based on microbial ecological regulation. This review aims to provide new insights into age-related changes in the oral microbiota and to support the development of a life-course oral microbial health management model.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"941-952"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881863","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":"[Structured Annotation and Information Extraction of Epilepsy Clinical Texts].","authors":"Ling Jin, Mengqiao He, Basangsijia, Duanyu Feng, Wenqiang Lei, Lei Chen","doi":"10.12182/20260760210","DOIUrl":"10.12182/20260760210","url":null,"abstract":"<p><strong>Objective: </strong>To develop a fine-grained, highly comprehensive Chinese clinical texts named entity annotation schema tailored to the needs of epilepsy specialty clinical practice and research, and to validate its effectiveness in named entity recognition (NER) tasks.</p><p><strong>Methods: </strong>A three-level annotation schema covering 25 entity types was designed across seven major dimensions, including disease, disease course timeline, clinical manifestations, medical examinations, non-pharmacological treatments, medication, and influencing factors, with explicit label boundary definitions and rules for handling special expressions. De-identified inpatient records of epilepsy patients admitted to West China Hospital, Sichuan University from 2009 to 2023 served as the data source. Three annotators with epilepsy clinical backgrounds completed high-quality annotation of 804 cases, with annotation quality ensured through double annotation, expert arbitration, and entity-level inter-annotator agreement (IAA) evaluation. NER performance was validated using 10 model combinations comprising five Chinese medical pre-trained language models (Base-BERT, chinese-bert, chinese-Roberta, MC-BERT, MedBERT) paired with two sequence labeling frameworks (BiLSTM-CRF and GlobalPointer), with additional cross-domain generalization evaluation on an external case dataset established on the basis of published literature.</p><p><strong>Results: </strong>The final corpus contains 25 categories of epilepsy-related entities, 804 annotated cases, and a total of 28 400 entities. The IAA among the three annotators ranged from 0.86 to 0.88, indicating annotation consistency that met the accepted standards in computational linguistics. In NER validation, the GlobalPointer framework outperformed BiLSTM-CRF, achieving an overall Micro-F1 score of 0.906 and Macro-F1 score of 0.760. High-frequency core entities (e.g., seizure symptoms, drug names, and temporal information) all yielded F1 scores exceeding 0.90. In cross-domain validation on literature-based cases, high-frequency entity F1 scores remained above 0.80, while low-frequency entities (e.g., factors with incomplete/ambiguous induction [fac-inc-amb], treatment information [trt], and adverse drug reactions [dru-adv]) achieved F1 scores of 0.31-0.57, primarily attributable to limited sample size and high linguistic variability.</p><p><strong>Conclusion: </strong>The epilepsy-specific Chinese clinical annotation schema developed in this study demonstrates broad coverage, fine granularity, and high inter-annotator consistency. It effectively supports the training and evaluation of NER models and provides a reusable corpus foundation for the structured analysis of epilepsy medical records and the development of downstream intelligent diagnostic and therapeutic tools.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1195-1203"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881893","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":"[Research Progress on the Application of CRISPR/Cas System in Rapid Testing of Drug-Resistant Bacteria in Clinical Practice].","authors":"Zhen Song, Hui Li, Yanan Zhao, Min Li","doi":"10.12182/20261360301","DOIUrl":"10.12182/20261360301","url":null,"abstract":"<p><p>The misuse of antimicrobial agents has made antimicrobial resistance one of the major threats to global public health. Efficient and rapid detection of drug-resistant bacteria and resistance genes is crucial for controlling infection spread and safeguarding human health. However, traditional detection methods (such as culture isolation, polymerase chain reaction, etc.) exhibit significant limitations in detection speed, cost-effectiveness, and convenience, increasingly failing to meet current clinical testing demands. In this context, the CRISPR/Cas system, as an emerging molecular diagnostic technology, offers innovative solutions for this field. This review details the developmental status of CRISPR/Cas systems and their research progress in rapid clinical detection of drug-resistant bacteria. It systematically explains the working principles and efficacy of various CRISPR/Cas-based detection platforms (e.g., SHERLOCK, DETECTR, HOLMES), highlighting the system's advantages in sensitivity, specificity, efficiency, real-time capability, portability, and low cost. Additionally, the article discusses challenges faced by CRISPR/Cas systems, including direct clinical sample detection, multiplex testing, cost reduction, clinical validation, and standardization. Finally, it outlines future development directions, emphasizing technological innovation and clinical translation to establish CRISPR/Cas systems as efficient tools for drug-resistant bacteria prevention and control.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1212-1220"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881904","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":"[Independent Risk Factors for Venous Thromboembolism After Gynecological Surgery and the Predictive Value of Postoperative D-Dimer].","authors":"Fei Fang, Yuchen Sun, Tianyi Sun, Chuhan Lü, Yali Miao, Zhiwei Zhao","doi":"10.12182/20260760606","DOIUrl":"10.12182/20260760606","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the independent risk factors for venous thromboembolism (VTE) after gynecological surgery, evaluate the predictive performance of postoperative D-dimer levels for VTE, and inform the development of individualized anticoagulation strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Perioperative data were collected from 307 female patients who underwent gynecological surgeries at West China Shangjin Nanfu Hospital, Sichuan University between March 2020 and March 2022. The inclusion criteria were a Caprini score ≥ 3 and the absence of any VTE prophylaxis. The data collected included age, body mass index (BMI), menopause, comorbidities (e.g., hypertension), preoperative and postoperative coagulation parameters (prothrombin time, activated partial thromboplastin time, fibrinogen, D-dimer, etc.), the surgical approach, anesthesia duration, surgery duration, American Society of Anesthesiologists (ASA) physical status classification, and postoperative VTE occurrence confirmed by imaging examinations. Patients were divided into VTE and non-VTE groups according to postoperative imaging findings. Univariate analysis was performed to compare differences between groups. Binary logistic regression was performed to identify independent risk factors. The receiver operating characteristic (ROC) curve was plotted, and the area under the curve (AUC), sensitivity, specificity, and Youden index were calculated to evaluate the predictive performance of D-dimer levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 307 patients, 42 (13.68%) developed postoperative VTE, including 30 cases (9.77%) of deep vein thrombosis (DVT) and 12 cases (3.91%) of pulmonary embolism (PE). Multivariable logistic regression analysis showed that independent risk factors for postoperative VTE included age (odds ratio [OR] = 1.122 per year, 95% CI: 1.070-1.176), increased BMI (OR = 1.180, 95% CI: 1.031-1.351), menopause (OR = 13.753, 95% CI: 3.692-51.229), hypertension (OR = 3.951, 95% CI: 1.837-8.498), prolonged surgery duration (OR = 1.047 per minute, 95% CI: 1.013-1.082), prolonged anesthesia duration (OR = 1.007 per minute, 95% CI: 1.002-1.011), higher ASA classification (OR = 8.122, 95% CI: 2.973-22.184), and elevated postoperative D-dimer levels (OR = 1.177 per mg/L, 95% CI: 1.029-1.346). Although the Caprini score was significantly higher in the VTE group than that in the non-VTE group (4.57 ± 1.21 vs. 3.64 ± 1.11, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), binary logistic regression analysis revealed no statistically significant association (&lt;i&gt;P&lt;/i&gt; = 0.877). A postoperative D-dimer level = 1.50 mg/L was the optimal threshold for diagnosing VTE, yielding a sensitivity of 54.76%, specificity of 73.58%. A preoperative-to-postoperative D-dimer change = 2.50 mg/L showed a sensitivity of 26.19%, specificity of 94.72%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Increased age, higher BMI, menopause, hypertension, prolonged surgery duration and anesthesia duration, and higher ASA classif","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1121-1129"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881727","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":"[Influencing Factors for Secondary Fungal Infections in Systemic Lupus Erythematosus].","authors":"Chunlin Li, Qiuyu Fan, Yu Xiao, Ting Song, Ziye Zong, Wei Yang","doi":"10.12182/20260760205","DOIUrl":"10.12182/20260760205","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the influencing factors for secondary fungal infections in patients with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>A total of 310 SLE patients admitted to our hospital between June 2021 and January 2025 were retrospectively enrolled. They were divided into an infection group and a non-infection group based on the presence or absence of secondary fungal infections. After 5:1 matching using propensity score matching (PSM), 230 patients in the non-infection group and 46 patients in the infection group were included in the final analysis. The characteristics of secondary fungal infections in patients with SLE were analyzed. Logistic regression analysis was performed to identify factors associated with secondary fungal infections, and receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of the model. A nomogram model for predicting secondary fungal infections in SLE patients was subsequently established.</p><p><strong>Results: </strong>Among the 310 SLE patients enrolled, fungal infection occurred in 46 cases (14.84%), predominantly involving the lung (50.0%) and the gastrointestinal tract (23.9%). After PSM, binary logistic regression analysis revealed that lupus disease activity (odds ratio [OR] = 10.734, 95% CI: 2.015-57.184), duration of antibiotic use (OR = 13.826, 95% CI: 2.995-63.822), C-reactive protein (CRP) (OR = 9.927, 95% CI: 1.024-96.188), white blood cell (WBC) count (OR = 11.784, 95% CI: 1.568-88.553), complement C4 (OR = 16.392, 95% CI: 3.899-68.909), and 24-hour urine protein (24 h Pro) (OR = 9.391, 95% CI: 1.195-73.813) were independent risk factors for secondary fungal infections in SLE patients (all <i>P</i> < 0.05). ROC curve analysis demonstrated that lupus disease activity, duration of antibiotic use, CRP, WBC count, complement C4, and 24 h Pro all demonstrated predictive value for secondary fungal infections. The combined model incorporating all 6 indicators achieved an area under the ROC curve (AUC) of 0.821 (95% CI: 0.720-0.922), outperforming any individual indicator (AUC range: 0.593-0.672). A nomogram prediction model was subsequently established based on these 6 indicators.</p><p><strong>Conclusion: </strong>Lupus activity, duration of antibiotic use, CRP, WBC, complement C4, and 24 h Pro are the influencing factors of secondary fungal infection in SLE patients.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"57 4","pages":"1098-1106"},"PeriodicalIF":0.0,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881800","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}