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- Abstract：Epithelial ovarian cancer （EOC）， particularly high-grade serous ovarian cancer （HGSOC）， commonly presents with intraperitoneal dissemination， peritoneal implants， and malignant ascites. The objective response rate to immune checkpoint inhibitor （ICI） monotherapy is approximately 8%-15%. A key underlying reason is that the distinctive intraperitoneal spread of EOC places tumor cells simultaneously within both a “solid” microenvironment （formed by solid lesions/peritoneal implants） and a “liquid” microenvironment （represented by malignant ascites）； these two compartments continuously interact through cellular trafficking， exosome-mediated transfer， cytokine diffusion， and lipid metabolic exchange， collectively shaping the typical “cold tumor” phenotype. Centered on this solid-liquid dual microenvironment， this review dissects， at the cellular level， the immunosuppressive network established by M2-polarized tumor-associated macrophages， enriched regulatory T cells， expanded myeloid-derived suppressor cells， and dysfunctional dendritic/NK and CD8+ T cells； and elucidates， at the molecular level， the central roles of IL-4/IL-6/TGF-β/VEGF cytokine axis imbalance， lipid metabolic reprogramming， lactate accumulation， and impaired antigen presentation in driving T-cell exhaustion and platinum resistance. On the therapeutic front， integrating the latest evidence from KEYNOTE-B96， DUO-O， FIRST/ENGOT-OV44， ATHENA-COMBO， MIRASOL， OVHIPEC-1 and PIPAC studies， this review summarizes the evidence supporting immune-combination regimens， anti-angiogenic agents， folate receptor alpha antibody-drug conjugates， hyperthermic intraperitoneal chemotherapy， and local intraperitoneal delivery from the dual perspectives of systemic immune modulation and local microenvironment intervention. The dual-microenvironment framework may help explain the poor response to immunotherapy and inform rational combination strategies in EOC； however， clinical translation should be based on precise stratification according to histology， BRCA/homologous recombination deficiency status， PD-L1 and folate receptor alpha expression， and spatial immune phenotypes.Keywords：ovarian cancer;tumor microenvironment;ascites;immune evasion;immune checkpoint inhibitors9|8|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：Multiple sclerosis （MS） is a chronic immune-mediated demyelinating disease of the central nervous system. As the resident innate immune cells of the CNS， microglia exert dual regulatory effects throughout the disease course， encompassing both detrimental and reparative functions. Numerous studies have confirmed that microglia exhibit significant heterogeneity across development， aging， and pathological states， and multiple subpopulations have been identified， including proliferative region-associated microglia， disease-associated microglia， interferon-responsive microglia， and microglia inflamed in MS. This review summarizes the current state of microglial heterogeneity research and its implications in MS， with a particular focus on the mechanisms underlying their regulation of neuroinflammation and remyelination. It provides a theoretical reference for precision therapies targeting microglial subpopulations and offers novel insights for the clinical management of MS.Keywords：multiple sclerosis;microglia;heterogeneity;neuroinflammation;remyelination9|6|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：The incidence of chronic metabolic diseases， including obesity， type 2 diabetes mellitus （T2DM） and metabolic dysfunction-associated steatotic liver disease （MASLD）， continues to rise globally. Disordered glucose and lipid metabolism represents their common pathophysiological foundation. Secreted fibroblast growth factor （FGF） is key regulators of glucose and lipid homeostasis. Among them， the paracrine FGFs， mainly comprising FGF1， FGF2， FGF4， FGF6， FGF8， FGF9， FGF10， and FGF16， require systematic integration regarding their metabolic regulatory functions. This review elucidates the molecular structural characteristics of paracrine FGFs and their central regulatory roles in maintaining glucose and lipid homeostasis， covering their modulation of metabolic networks over multiple tissues and organs including， adipose tissue， liver， skeletal muscle， pancreatic islets， and the nervous system. Furthermore， the expression alterations and functional abnormalities of these factors in chronic metabolic diseases are summarized. This review aims to highlight the critical position of paracrine FGFs in the pathogenesis of metabolic diseases and to provide novel therapeutic targets and theoretical foundations for the prevention and treatment of disorders associated with glucolipid metabolic dysregulation.Keywords：chronic metabolic diseases;glucose and lipid metabolic disorders;paracrine fibroblast growth factors;pathogenesis;therapeutic target8|5|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：Integrin αvβ3 is an important target for tumor imaging and therapy. It is highly expressed on tumor neovascular endothelial cells and various malignant tumor cells， while being nearly absent in normal tissues and quiescent endothelial cells. Positron emission tomography （PET） based on Arg-Gly-Asp （RGD） peptides has been widely applied， yet single-target strategies are limited by tumor heterogeneity. β- radionuclide-labeled RGD peptides exhibit problems of insufficient tumor uptake and renal accumulation. This review summarizes the preclinical progress in two frontier directions. Dual-targeting strategies combine integrin αvβ3 with prostate-specific membrane antigen （PSMA） or fibroblast activation protein （FAP） to construct heterodimeric probes. Preclinical and clinical studies have demonstrated that dual-targeting probes achieve significantly superior tumor uptake， target-to-background ratios， and lesion detection rates compared to single-target controls， effectively overcoming tumor heterogeneity and improving tumor uptake and detection rate. α radionuclides， by leveraging high linear energy transfer and short tissue range， demonstrate superior antitumor efficacy over β-radionuclides. In terms of clinical translation， the albumin-binding RGD dimer labeled with lutetium-177 （¹⁷⁷Lu-AB-3PRGD₂） has completed a first-in-human study， preliminarily validating the clinical feasibility of integrin-targeted radionuclide therapy， albeit with limited antitumor activity. Future directions include molecular imaging-based patient selection， optimization of dual-targeting molecular structures， and development of α radionuclide formulations.Keywords：integrin αvβ3;radionuclide therapy;dual-targeting strategy;α radionuclides;cancer theranostics7|6|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：Driven by the global trend of population aging， the prevalence of neurodegenerative diseases， including Alzheimer’s disease （AD）， Parkinson’s disease （PD）， Huntington’s disease （HD）， and amyotrophic lateral sclerosis （ALS）， has been rising consistently. The pathogenic mechanisms of these disorders are complex， and effective disease-modifying therapies remain an unmet clinical need. Ferroptosis， a regulated cell death modality driven by iron-dependent lipid peroxidation， has been widely implicated in the occurrence and evolution of the aforementioned conditions. Under pathological states， both perturbed iron metabolism and reactive oxygen species （ROS） accumulation can precipitate ferroptosis. Specifically， iron overload exacerbates oxidative injury via the Fenton reaction， disrupts the glutathione （GSH）-based antioxidant defense system， and induces extensive peroxidation of polyunsaturated fatty acids （PUFAs）， ultimately culminating in neuronal damage. Furthermore， ferroptosis interacts synergistically with other pathological hallmarks， such as oxidative stress， neuroinflammation， aberrant protein aggregation， and apoptosis， thereby accelerating disease progression. A synthesis of current evidence indicates that disrupted iron homeostasis， enhanced lipid peroxidation， GSH depletion， and impaired glutathione peroxidase 4 （GPX4） activity constitute the common basis for ferroptosis in these neurodegenerative diseases. Concurrently， ferroptosis also displays certain disease‑specific characteristics by engaging distinct pathogenic proteins and regulatory pathways in each disorder. In this review， we delineate the molecular regulatory framework of ferroptosis， summarize its research progress in AD， PD， HD， and ALS， and highlight both shared mechanisms and divergent regulatory pathways across these diseases， with the goal of informing future investigations into disease pathogenesis and the discovery of novel strategies.Keywords：ferroptosis;neurodegenerative disease;programmed cell death;iron metabolism disorder;oxidative stress5|4|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
Review
- Abstract：ObjectiveTo investigate the protective effect and underlying mechanisms of the Bawei Chenxiang Wan （BCW） against myocardial ischemic injury.MethodsMyocardial ischemia in vivo was induced in rats by subcutaneous injection of isoproterenol （ISO）， and ex vivo ischemia was established by coronary artery ligation in isolated rat hearts. The effects of BCW， alcohol extracts and its polar extracts were evaluated on ST segment on electrocardiogram （ECG）， myocardial damage， hemodynamic parameters， and infarct size. The phosphorylation level of phosphatidylinositol 3-kinase （PI3K）， the expression of cuproptosis-related proteins， and the content of Cu²⁺ in myocardial tissue were detected. The regulatory relationship of the signaling pathway was verified using an oxygen-glucose deprivation （OGD） myocardial cell injury model， combined with PI3K agonists and inhibitors.ResultsBCW ameliorated ST-segment elevation on electrocardiograms（P＜0.01）， reduced serum levels of myocardial injury markers， improved hemodynamic parameters， upregulated PI3K phosphorylation（P＜0.01）， and decreased Cu²⁺ accumulation in rats with myocardial ischemia（P＜0.01）. Moreover， BCW reduced the myocardial infarct size. In the isolated rat heart model of ischemia， both the ethanol extract and various solvent fractions of BCW exerted protective effects and reduced Cu²⁺ content， among which the n-butanol fraction exhibited the most potent activity（P＜0.01）. Specifically， the n-butanol fraction upregulated PI3K phosphorylation（P＜0.01） and downregulated the expression of cuproptosis-related proteins， including ferredoxin reductase 1（FDX1）（P＜0.05）， lipoic acid synthetase（LIAS）， and dihydrolipoamide S-acetyltransferase（DLAT） oligomerization（P＜0.05）. In the OGD-induced cardiomyocyte injury model， treatment with a PI3K agonist inhibited DLAT oligomerization（P＜0.05）， whereas co-administration of a PI3K inhibitor attenuated the inhibitory effect of the n-butanol fraction on DLAT oligomer formation（P＜0.05）.ConclusionThe n-butanol fraction of BCW exerts a significant protective effect against myocardial ischemic injury， and its mechanism may involve activation of the PI3K and inhibition of cuproptosis.Keywords：Bawei Chenxiang Wan;myocardial ischemia;n-butanol extract;phosphatidylinositol 3-kinase;cuproptosis;dihydrolipoamide S-acetyltransferase217|33|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：ObjectiveThis study aimed to elucidate the specific molecular mechanism by which PAGE5 promotes breast cancer cell invasion and hepatic metastasis through regulating the PI3K/AKT signaling pathway and its downstream effector， matrix metalloproteinase 1 （MMP1）.MethodsBioinformatics analysis using the TCGA database was performed to evaluate PAGE5 expression in metastatic breast cancer tissues. The effects of PAGE5 on the proliferation， migration， and invasion capabilities of breast cancer cells were analyzed using CCK-8， EdU， Transwell， and wound healing assays. A splenic injection hepatic metastasis model in NOD-SCID mice was employed to validate the impact of PAGE5 on breast cancer liver metastasis. Transcriptome sequencing and KEGG enrichment analysis were conducted to identify potential signaling pathways regulated by PAGE5. Western blot was used to detect AKT phosphorylation levels. Quantitative real-time polymerase chain reaction （qPCR） was applied to screen and validate downstream target molecules of PAGE5.ResultsBioinformatic analysis revealed that PAGE5 expression was significantly upregulated in distant metastasis of breast cancer. Both in vitro and in vivo experiments confirmed that PAGE5 overexpression markedly enhanced the migration and invasion abilities of breast cancer cells and promoted the formation of liver metastatic lesions， whereas PAGE5 knockdown suppressed breast cancer liver metastasis （P＜0.000 1）. Transcriptome sequencing and KEGG enrichment analysis indicated that PAGE5 significantly activated the PI3K-AKT signaling pathway （P=0.028 5）. Western blot confirmed that PAGE5 upregulated p-AKT levels， which could be reversed by MK2206. The qPCR results confirmed that MMP1 is a key downstream effector of PAGE5， and its expression can be inhibited by MK2206 （P＜0.000 1）.ConclusionsThis study preliminarily demonstrates that PAGE5 can activate the PI3K/AKT signaling pathway and mediate the invasion and liver metastasis of breast cancer through MMP1.Keywords：breast cancer;prostate-associated gene 5;breast cancer liver metastasis;matrix metalloproteinase 1;PI3K-AKT signaling pathway1|2|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：ObjectiveTo explore the host immunomodulatory effect and its molecular mechanism of gallic acid （GA） in Bacillus Calmette-Guérin （BCG） infected macrophages， and to provide experimental evidence for host-directed anti-tuberculosis research against Mycobacterium tuberculosis （Mtb）.MethodsThe minimum inhibitory concentration （MIC） of GA against BCG was determined by resazurin colorimetric assay. Bacterial growth-curve test and MTT colorimetric assay were used to evaluate the effects of GA on BCG proliferation and invasion. A BCG-infected RAW264.7 macrophage model was established， including infection control group （Ctrl）， isoniazid （INH） group， and low-， medium- and high-dose GA groups. Flow cytometry combined with colony-plate counting was performed to detect intracellular BCG survival. Cell apoptosis was measured by Annexin V-APC/7-AAD double staining， and qRT-PCR was used to detect the mRNA expression of apoptosis-related genes Caspase-3 and Bcl-2. Macrophage polarization phenotypes were analyzed by flow cytometry. Intracellular reactive oxygen species （ROS） were detected using DHE fluorescent probe. The Griess assay was applied to determine supernatant nitric oxide （NO） concentration. ELISA was used to detect the levels of TNF-α， IFN-γ， IL-6 and IL-10 in cell culture supernatant.ResultsThe MIC of GA against BCG was 1 250 μmol/L. GA inhibited BCG proliferation and invasion in a concentration-dependent manner （P＜0.05）. Safe concentrations of 20， 40 and 80 μmol/L were selected for subsequent cellular experiments. Thirty-six-hour GA pretreatment markedly reduced the intracellular BCG bacterial load （P＜0.05）. GA exerted bidirectional regulation on macrophage apoptosis： it inhibited apoptosis at the early-stage infection and promoted apoptosis at the late-stage infection. GA induced M1-type polarization in early infection and facilitated M2-type polarization in late infection （P＜0.05）. Meanwhile， GA decreased intracellular ROS and NO levels， down-regulated the secretion of pro-inflammatory cytokines and up-regulated the secretion of anti-inflammatory cytokine IL-10 （P＜0.05）.ConclusionGA inhibits BCG proliferation and invasion in vitro. It remodels host immune microenvironment via bidirectional regulation of macrophage apoptosis and polarization as well as anti-oxidative and anti-inflammatory effects， showing potential value for host-directed anti-mycobacterial therapy.Keywords：gallic acid;Bacillus Calmette-Guerin;macrophages;immune function;anti-mycobacterial activity4|4|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：ObjectiveTo assess changes in the incidence， prevalence， and disability-adjusted life-year （DALY） burden of ulcerative colitis （UC） in China and worldwide from 1990 to 2023 using data from the Global Burden of Disease Study 2023 （GBD 2023）， and to examine demographic drivers and future trends.MethodsUC data for China， the world， and 204 countries and territories were extracted from the GBD 2023 Results Tool. Age-standardized incidence rate （ASIR）， age-standardized prevalence rate （ASPR）， and age-standardized DALY rate （ASDR）， with 95% uncertainty interval （UI）， were obtained. Joinpoint regression was used to estimate average annual percent change （AAPC） and 95% confidence interval （CI）. Spearman rank correlation， inequality and frontier analyses， Das Gupta decomposition， and autoregressive integrated moving average （ARIMA） models were used to assess associations with the sociodemographic index （SDI）， cross-country burden disparities， demographic drivers， and trends from 2024 to 2035， respectively.ResultsIn 2023， the ASIR， ASPR， and ASDR in China were 0.94， 5.95， and 5.94 per 100 000 population， respectively， lower than the corresponding global estimates of 2.87， 28.48， and 13.82 per 100 000 population. From 1990 to 2023， China’s ASIR and ASPR increased， with AAPCs of 2.720% （95% CI： 2.133%-3.309%） and 2.261% （95% CI： 1.617%-2.908%）， whereas the ASDR decreased （AAPC=-3.056%， 95% CI： -3.449% to -2.662%）. Globally， ASIR increased slightly， whereas ASPR and ASDR decreased. In China， the crude incidence， prevalence， and DALY rates peaked at ages 50-54 years， 60-64 years， and ≥95 years， respectively. ASIR and ASPR were positively correlated with SDI （rs=0.5794 and 0.6177， both P<0.001）， whereas the correlation between ASDR and SDI was not statistically significant （rs=0.0666， P=0.343）. In China， epidemiological change contributed most to increases in incident and prevalent cases， and changes in age-specific rates contributed most to the decline in DALYs； globally， population growth and population aging contributed most to the increase in DALYs. By 2035， China’s ASIR， ASPR， and ASDR were projected to be 1.23， 6.37， and 2.55 per 100 000 population， respectively.ConclusionsFrom 1990 to 2023， the age-standardized incidence and prevalence rates of UC increased in China， whereas the age-standardized DALY rate decreased， and peaks in absolute burden generally shifted toward middle-aged and older age groups. The projected directions may persist. These findings may provide reference for long-term UC management and health-resource planning.Keywords：ulcerative colitis;global burden of disease;disability-adjusted life-year;demographic decomposition;trend projection1|7|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
Preclinic Research
- Abstract：ObjectiveTo investigate the value of preoperative dual-layer spectral detector CT （DLCT） parameters in predicting lymph node metastasis （LNM） of non-functional pancreatic neuroendocrine neoplasms （NF-pNENs）.MethodsA retrospective study was conducted on patients with pathologically confirmed NF-pNENs who underwent preoperative contrast-enhanced DLCT examination between September 2019 and July 2024. Regions of interest （ROIs） were manually delineated on three representative slices of the solid component of the lesion， and the mean values were recorded. Conventional CT parameters， monochromatic energy images （40 keV， 70 keV， 100 keV）， iodine concentration maps， and effective atomic number （Zeff） maps in the pancreatic parenchymal phase and portal venous phase were acquired. A total of 34 parameters， including clinical characteristics， imaging features， conventional CT and DLCT quantitative parameters， were analyzed. Intergroup differences were compared between the LNM and non-LNM groups. Independent predictive factors were screened using logistic regression and least absolute shrinkage and selection operator （LASSO） regression. Receiver operating characteristic （ROC） curves were generated for each predictive model， and the area under the curve （AUC） was calculated to evaluate the predictive efficacy.ResultsA total of 82 patients with NF-pNENs were enrolled， including 37 males and 45 females， with a mean age of 49.7±14.7 years. Thirty patients were performed with LNM and 52 were with non-LNM. After univariate logistic regression， LASSO regression and multivariate stepwise logistic regression analyses， body mass index （BMI）， organ invasion， normalized CT value in the portal venous phase （nCTv） and normalized iodine concentration in the portal venous phase （nICv） were identified as independent predictive factors. The AUCs of the clinical-radiological qualitative model （BMI+organ invasion）， conventional CT model （nCTv）， DLCT model （nICv） and comprehensive model （organ invasion+nICv） were 0.815 （0.719， 0.910）， 0.750 （0.642， 0.858）， 0.829 （0.733， 0.925） and 0.865 （0.879， 0.953）， respectively. The comprehensive model combining clinical-radiological and DLCT characteristics exhibited superior predictive performance.ConclusionDLCT parameters are more effective than conventional CT parameters in predicting LNM in NF-pNENs， enabling non-invasive preoperative prediction and assisting clinical decision-making.Keywords：nonfunctional pancreatic neuroendocrine tumor;lymph node metastasis;dual-layer spectral detector ct;least absolute shrinkage and selection operator analysis;diagnostic efficacy1|4|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：ObjectiveTo evaluate the diagnostic value of cone-beam computed tomography （CBCT） arthrography for temporomandibular joint disc perforation.MethodsA retrospective analysis was conducted on patients who were clinically diagnosed with temporomandibular joint osteoarthrosis （TMJOA） and underwent CBCT arthrography and open surgery between December 2013 and January 2023. The diagnostic results of CBCT arthrography were compared with the gold standard of open surgical exploration to determine the number of true and false positive and negative cases， thereby evaluating the overall accuracy of CBCT arthrography in diagnosing disc perforation.ResultsA total of 90 patients （106 joints） met the inclusion criteria of this study， including 10 males with an average age of 36.4 years and 80 females with an average age of 42.6 years. Among them， 74 joints exhibited unilateral lesions （82.22%）， and 16 joints exhibited bilateral lesions （17.78%）. Among these， 94 joints （88.68%） showed good contrast medium visualization， while 12 joints （11.32%） showed poor contrast medium visualization. CBCT arthrography clearly diagnosed disc perforation in 75 joints （70.75%）， and surgical exploration confirmed perforation in 75 joints. In 5 cases， poor contrast medium visualization was observed， and the imaging diagnosis suggested possible perforation， with surgical exploration confirming perforation in 5 cases； the true positive rate of imaging diagnosis was 100%. CBCT arthrography clearly diagnosed the absence of disc perforation in 19 joints （17.92%）， and surgical exploration confirmed the absence of perforation in 19 joints， with a true negative rate of 73.08%. In 7 cases， poor contrast medium visualization was observed， and the imaging results did not report disc perforation， but surgical exploration revealed perforation in 7 cases， with a false negative rate of 26.92%.ConclusionsCBCT arthrography demonstrates high diagnostic accuracy for temporomandibular joint disc perforation and may provide reliable imaging evidence for clinical decision-making.Keywords：temporomandibular joint;osteoarthrosis;disc perforation;cone-beam computed tomography;arthrography1|4|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：ObjectiveTo analyze the microbial culture positivity rate， pathogen spectrum， prevalence of multidrug-resistant organisms （MDROs）， and differences among donor procurement sources in corneas from the Eye Bank of Guangdong Province， and to provide evidence for eye bank quality control and the prevention of post-keratoplasty infections.MethodsThis retrospective study included 7 442 donor corneas procured by the Eye Bank of Guangdong Province and used for keratoplasty at Zhongshan Ophthalmic Center， Sun Yat-sen University， between 2018 and 2025. During surgery， donor corneoscleral rim tissue was excised for bacterial and fungal culture. Culture-positive specimens underwent microbial identification and antimicrobial susceptibility testing （AST）. Culture-positive corneas were compared across study years， pathogen categories， and donor procurement sources.ResultsOf the 7 442 donor corneas， 251 were culture-positive， corresponding to an overall culture positivity rate of 3.37%， with annual rates ranging from 1.50% to 5.31%. Among culture-positive corneas， 178 （70.92%） yielded bacteria alone， 72 （28.68%） yielded fungi alone， and 1 （0.40%） yielded both bacteria and fungi. Candida spp. and Aspergillus spp. were the predominant fungal isolates. Gram-negative bacteria were more frequently isolated than Gram-positive bacteria. The most common bacterial isolates were Acinetobacter baumannii， Staphylococcus epidermidis， Stenotrophomonas maltophilia， Enterococcus faecium， and Pseudomonas fluorescens. MDROs accounted for 75.47% of bacterial isolates， predominantly Acinetobacter baumannii， Staphylococcus epidermidis， and Enterococcus faecium， and demonstrated an increasing trend over the study period. Donor corneas procured through the Hospital Cornea Retrieval Program （HCRP） had a higher culture positivity rate than those obtained through Organ Procurement Organization （OPO） （P＜0.000 1）. Among culture-positive donor corneas， the proportion of fungal culture-positive corneas was significantly higher in the HCRP group than in the OPO group （P=0.001 5）， whereas the proportion of MDROs among bacterial culture-positive corneas was significantly higher in the OPO group than that in the HCRP group （P=0.005 2）.ConclusionsThe overall culture positivity rate of donor corneas from the Eye Bank of Guangdong Province is relatively low， indicating that the risk of microbial contamination is controlled. However， pathogen profiles and antimicrobial resistance patterns varies by procurement source. Ongoing microbiological and antimicrobial resistance surveillance， together with optimized donor risk assessment and timely reporting of culture results， may further improve eye bank quality management and help inform strategies for preventing post-keratoplasty infections.Keywords：donor cornea;eye bank;corneal transplantation;microbiological culture;multidrug-resistant organisms3|3|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：ObjectiveThis study examined KCCQ symptom score trajectories during the vulnerable phase of heart failure and their association with readmission within 6 months.MethodsThis prospective cohort study included 1 109 patients hospitalized for chronic heart failure at a tertiary hospital in Nanchang， China， between August 2020 and July 2025. KCCQ scores were assessed at six time points： day 3 after admission， discharge， and 1， 2， 3， and 6 months after discharge. Group-based trajectory modeling was used to identify patterns of change in KCCQ scores. Multiple logistic regression was used to assess the association between trajectory membership and readmission risk.ResultsDuring follow-up， 229 patients were readmitted， accounting for 20.6% of the cohort. Four KCCQ trajectories were identified： persistently declining scores （n=228， 20.6%）， persistently improving scores （n=110， 9.9%）， stable intermediate scores （n=545， 49.1%）， and stable high scores （n=226， 20.4%）. Compared with the stable intermediate group， the persistently declining group had a higher risk of readmission in the fully adjusted model （OR=2.099， 95% CI： 1.027–4.315， P=0.043）， whereas the stable high-score group had a lower risk （OR=0.260， 95% CI： 0.127–0.494， P<0.001）. The association between the persistently improving trajectory and readmission was not statistically significant （OR=0.614， 95% CI： 0.306–1.154， P=0.147）.ConclusionsKCCQ symptom score trajectories during the vulnerable phase of heart failure show marked heterogeneity and are associated with readmission within 6 months. A persistently declining trajectory is associated with higher readmission risk， whereas a stable high-score trajectory is associated with lower risk. Longitudinal monitoring of KCCQ score changes may help inform post-discharge risk stratification and follow-up management in patients with heart failure.Keywords：heart failure;vulnerable phase;KCCQ;readmission;latent class trajectory model3|3|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：ObjectiveTo compare the incidence of postoperative shivering between female patients undergoing gynecological and general surgery and to examine perioperative factors associated with postoperative shivering.MethodsThis retrospective study included 12 186 patients who underwent gynecological or general surgery between January 1， 2022， and March 15， 2024， of whom 10 884 female patients constituted the primary analysis population. Among the female patients， 1：1 nearest-neighbor propensity score matching was performed using a caliper of 0.02 on the raw propensity score scale， with exact matching on American Society of Anesthesiologists （ASA） physical status. After matching， the incidence of postoperative shivering was compared using the McNemar test. Conditional logistic regression stratified by matched pair was used to assess the associations of surgical categories and perioperative factors with postoperative shivering.ResultsBefore propensity score matching， the incidences of postoperative shivering were 2.98% （28/940） in the general surgery group and 4.94% （491/9 944） in the gynecological surgery group （P=0.007）. After matching， 881 matched pairs were obtained， and the absolute standardized mean differences （SMDs） for all covariates were < 0.10. The incidences of postoperative shivering were 3.06% （27/881） in the general surgery group and 4.99% （44/881） in the gynecological surgery group. The McNemar test without continuity correction yielded P=0.044， whereas the exact McNemar test showed a P value of 0.057. Unifactorial conditional logistic regression showed that gynecological surgery was associated with higher odds of postoperative shivering than general surgery ［odds ratio （OR）=1.63， 95% confidence interval （CI）： 1.01-2.63， P=0.046］. However， the association was not statistically significant in the multifactorial conditional logistic regression ［adjusted odds ratio （aOR）=1.62， 95%CI： 0.78-3.37， P=0.197］. Each 30-min increase in the duration of surgery was associated with 32% higher odds of postoperative shivering （aOR=1.32， 95%CI： 1.07-1.62， P=0.009）. Each 1 °C increase in the minimum intraoperative body temperature was associated with lower odds of postoperative shivering， although the association did not reach statistical significance （aOR=0.32， 95%CI： 0.10-1.02， P=0.053）.ConclusionAfter propensity score matching， the incidence of postoperative shivering was higher among female patients undergoing gynecological surgery than among those undergoing general surgery； however， neither the exact comparison nor the adjusted association reached statistical significance. A longer duration of surgery was associated with higher odds of postoperative shivering， whereas a higher minimum intraoperative body temperature may be associated with lower odds.Keywords：postoperative shivering;gynecological surgery;general surgery;propensity score matching;duration of surgery2|3|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：ObjectiveTo evaluate the safety and efficacy of oxycodone versus sufentanil for postoperative analgesia in patients with moderate to severe obstructive sleep apnea （OSA） undergoing uvulopalatopharyngoplasty （UPPP）.MethodsWe enrolled 73 consecutive patients with moderate-to-severe OSA （confirmed by polysomnography） scheduled for elective UPPP under general anesthesia at our institution between August 2023 and August 2025. Patients were randomly assigned to receive oxycodone （n = 37） or sufentanil （n = 36） using a random number table . The sufentanil group received 1.5 μg per kilogram of body weight， and the oxycodone group received 0.9 mg per kilogram； both groups used patient-controlled intravenous analgesia （PCIA） pumps with a total volume of 100 mL. A 2 mL loading dose was administered 10 minutes before the end of surgery， followed by a background infusion of 2 mL per hour， 2 mL bolus doses on demand， an 8-minute lockout interval， and a maximum hourly volume of 10 mL. We assessed pain scores （Numerical Rating Scale） at rest and during swallowing， Ramsay sedation scores， morphine-equivalent opioid consumption， PCIA bolus demands， patient satisfaction， time to first oral intake， and adverse events （including respiratory depression， nausea， and vomiting） at 4， 12， 24， and 48 hours postoperatively.ResultsBaseline characteristics were well balanced between the two groups （all P＞0.05）. No significant between-group differences were observed in resting and swallowing NRS scores or Ramsay sedation scores at each postoperative time point， PCIA satisfaction， time to first oral intake， or adverse event incidence across all postoperative time points （all P＞0.05）. Morphine-equivalent opioid consumption was significantly lower in the oxycodone group at all time points， as were unsuccessful PCIA bolus demands at 24 and 48 hours postoperatively （both P＜0.05）.ConclusionsLow-dose oxycodone provided analgesic efficacy similar to that of sufentanil for PCIA after UPPP in patients with moderate-to-severe OSA， with no significant between-group differences in adverse events， time to first oral intake， or satisfaction .The oxycodone group had numerically lower adverse event rates and a shorter time to first oral intake， suggesting a favorable safety profile and potential benefits for reducing opioid-related events and facilitating earlier recovery in this patient population.Keywords：oxycodone;postoperative analgesia;obstructive sleep apnea syndrome;uvulopalatopharyngoplasty;enhanced recovery after surgery2|4|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：ObjectiveTo explore the effects of different embolic materials for preoperative transarterial embolization （TAE） on surgical resections of sizeable （＞3 cm） Shamblin Ⅱ/Ⅲ carotid body tumors （CBTs）MethodsThis study retrospectively analyzed the data of patients with Shamblin type Ⅱ/Ⅲ carotid body tumors >3 cm in size who underwent TAE at our hospital between January 2010 and August 2025. Based on the adopted embolic agents， the patients were divided into two groups： temporary embolization group （TEG） and permanent embolization group （PEG）. General clinical data， periprocedural details， and postoperative outcomes were collected and compared between the two groups.ResultsA total of 50 patients with 50 lesions were included （n=25 in the TEG and n=25 in PEG group）. Tumor sizes were comparable between the two groups ［（41.22 vs. 42.13） mm， P=0.989］. For the TEG compared with PEG， intraoperative blood loss was （388.19 vs. 155.90） mL （P＜0.001） and operative time was （254.01 vs. 162.22） mins （P=0.007）. The intraoperative vascular reconstruction rate was 16% vs. 12% （P=0.684）， and the complication rate was 36% vs. 12% （P=0.047） in the TEG and PEG.ConclusionsOur results indicate that the use of permanent embolic agents during TAE is optimal. These agents are superior to temporary embolic agents in terms of intraoperative blood loss， operative time， and improved surgical field visualization， which thereby facilitate the surgical resection of Shamblin type Ⅱ/Ⅲ CBTs while reducing postoperative complications.Keywords：carotid body tumor;transarterial embolization;embolic materials;surgical resection;impact2|4|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
- Abstract：ObjectiveTo investigate the incidence of postherpetic neuralgia （PHN） and its associated risk factors in patients aged ≥50 years with herpes zoster （HZ） who received standard antiviral therapy at the dermatology outpatient clinic of our center.MethodsHZ patients were identified by searching the medical record system using "herpes zoster" as the keyword， and those diagnosed between July 2020 and July 2021. Patients meeting the inclusion criteria were followed up via telephone to retrospectively assess the occurrence of PHN. Patients were divided into a PHN group and a non-PHN group based on the presence of PHN. General patient information （gender， age， and underlying diseases）， prodromal pain intensity， and lesion characteristics （area， location， and acute-phase pain intensity） as well as treatment modalities （pharmacotherapy， physical therapy， and combined analgesic therapy） were compared between the two groups. Intergroup comparisons and multifactorial analyses were performed to identify factors associated with the development of PHN in HZ patients. Pain intensity was assessed using the Numerical Rating Scale （NRS） for PHN pain， acute-phase HZ pain， and prodromal pain. Intergroup comparisons were conducted using the chi-square test， Mann-Whitney U test， and t-test. Binary logistic regression was used for multivariate analysis to identify independent risk factors.ResultsA total of 238 HZ patients aged ≥50 years who received standard antiviral therapy were ultimately included， of whom 76 （31.9%） developed PHN. Unifactorial analysis showed that age， lesion area， acute-phase pain intensity， and the use of gabapentin or combined analgesic therapy significantly influenced the occurrence of PHN after HZ （P<0.05）. Statistically significant indicators （P<0.05） from the unifactorial analysis and the different analgesic regimens adopted by patients were included in the multifactorial analysis. Multifactorial analysis revealed that lesion area ≥1% （OR=2.501； 95%CI=1.408-4.443； P=0.002<0.05） and acute-phase pain score （OR=1.160； 95%CI=1.028-1.309； P=0.016<0.05） were independent risk factors for PHN. Age and the use of gabapentin or combined analgesic therapy showed no statistically significant association with the occurrence of PHN （P>0.05）.ConclusionsIn HZ patients aged ≥50 years receiving standard antiviral therapy， the incidence of PHN is 31.9%. A lesion area ≥1% and higher acute-phase pain NRS scores are identified as independent risk factors for the development of PHN in these patients.Keywords：herpes zoster;neuropathic pain;influencing factors;postherpetic neuralgia;the elderly2|4|0<HTML><L-PDF> <Meta-XML>Updated：2026-09-20
Clinical Research
