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    25 April 2025, Volume 46 Issue 4
    Research on efficacy evaluation of minimally invasive treatment of cervical spondylotic radiculopathy using percutaneous coblation nucleoplasty
    GUO Hong-sheng1, GAO Gang2, LI Qing-shan1, JIA Tian-yang1, ZHANG Kai1
    2025, 46(4):  386-392.  doi:10.3969/j.issn.1007-3205.2025.04.003
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    Objective To comparatively evaluate the clinical effectiveness of percutaneous coblation nucleoplasty (PCN) versus medication and physical therapy for cervical spondylotic radiculopathy (CSR), so as to provide clinical evidence to optimize treatment strategies. 
    Methods A total of 176 patients diagnosed with CSR from December 2019 to December 2022  in Department of Spinal Surgery, Handan Central Hospital, Hebei Province, were retrospectively analyzed and divided into three groups: medication group (n=51), physical therapy group (n=57), and PCN group (n=68). The medication group received intravenous mannitol, dexamethasone, and neurotropin for 14 d, the physical therapy group underwent cervical traction for 14 d, and the PCN group underwent PCN. The course of treatment for medication group and physical therapy group was 14 d, and PCN group received PCN guided by C-arm fluoroscopy. Visual analogue scale (VAS) score, neck disability index (NDI), Northwick Park Neck Pain Questionnaire (NPQ), and Yasuhisa Tanaka 20 score scale (YT20) scores were recorded before treatment and at 1 d, 2 weeks, 3 months, and 6 months after treatment. The modified Macnab criteria were used to assess overall therapeutic effectiveness at 3 months after treatment. 
    Results All the three groups showed significant improvement in VAS, NDI, and NPQ scores (decreasing trends), and YT20 scores (increasing trends) over time. The PCN group exhibited superior outcomes compared with the medication and physical therapy groups, demonstrated by significantly lower VAS, NDI, and NPQ scores and higher YT20 scores. Significant differences were observed in the interaction between groups, time points, and time points between groups (Fbetween groups=5.790, 72.607, 21.753, 21.416; Ftime points=753.315, 2 345.915, 2 549.043, 755.616; Ftime points between groups=4.276, 133.825, 20.694, 19.612; all P<0.05). At 3 months after treatment, the PCN group achieved a higher overall response rate (92.65%) compared with the medication group (47.06%) and physical therapy group (54.39%), showing significant differences (P<0.05). 
    Conclusion PCN significantly improves the symptoms of CSR, including neck pain, upper limb pain, numbness, daily work and quality of life, demonstrating substantial clinical effectiveness and promoting better cervical spine function, which is, therefore, worthy of clinical recommendation. 

    Evaluation of SMOT for the treatment of varus ankle arthritis using a gait analysis system
    FENG Feng-ming1, CUI Liang2, TAO Shi-wu2, SHI Ming-xin2, ZHANG Wang3, YANG Zong-yu1
    2025, 46(4):  393-399.  doi:10.3969/j.issn.1007-3205.2025.04.004
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    Objective To assess the clinical efficacy of supramalleolar osteotomy (SMOT) in the treatment of varus ankle arthritis using a gait analysis system. 
    Methods A retrospective analysis was conducted on 95 patients with ankle arthritis who underwent SMOT at the Department of Foot and Ankle Surgery, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province from January 2020 to December 2023. After strict screening based on inclusion and exclusion criteria, 78 patients were finally included. Preoperative and postoperative data on gait analysis, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Score, visual analogue scale (VAS) pain scores, tibial articular surface angle (TAS), and tibial lateral surface angle (TLS) were compared. 
    〖WTHZ〗Results〖HTSS〗At 12 months postoperatively, patients′ AOFAS ankle-hindfoot scores [(85.49±2.21)points], step length [(110.61±2.02)cm], gait speed [(100.19±2.05)cm/s], mean value of foot balance [(16.22±8.66)N], range of motion in sagittal plane [(22.53±1.12)°], TAS angle [(90.17±0.76)°], and TLS angle [(80.09±0.98)°] were higher than preoperative values [(49.68±2.75)points, (71.06±2.87)cm, (76.28±2.01)cm/s, (-36.73±13.98)N, (15.66±1.50)°, (77.87±1.86)°, (76.99±0.63)°], while VAS scores [(1.77±0.49) points] were lower than preoperative scores [(6.22±0.47) points], with significant differences (P<0.001). 
    Conclusion Based on the findings of the gait analysis system, SMOT shows good corrective effects and osteotomy healing in varus ankle arthritis, significantly improving ankle function. 

    Clinical features of UTPP-PVP and UTP-PVP in the treatment of thoracolumbar OVCF in the elderly
    YUAN Yu-fei1, FAN Kai-bin1, ZHANG Cun1, HE Juan1, LI Jian-fei2, MIAO Jie1
    2025, 46(4):  400-405.  doi:10.3969/j.issn.1007-3205.2025.04.005
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    Objective To investigate the clinical effectiveness of unilateral transverse process-pedicular percutaneous vertebroplasty (UTPP-PVP) in the treatment of thoracolumbar osteoporotic vertebral compression fracture (OVCF) in the elderly. 
     Methods The clinical data of 156 elderly patients with thoracolumbar OVCF who were hospitalized in the Department of Orthopedics of Handan Central Hospital from October 2019 to October 2022 were collected. Based on different surgical approaches, the patients were divided into UTPP group and unilateral transpedicular (UTP) group, and the duration of operation, bone cement injection volume, excellent rate of bone cement distribution and bone cement leakage rate were compared between the two groups. The visual analogue scale (VAS) scores and Oswestry disability index (ODI) scores were compared between the two groups before surgery, at 1 d, 1 month and 1 year after surgery. The anterior vertebral body height and the Cobb angle were compared between the two groups before surgery, and at 1 d and 1 year after surgery. 
     Results There was no significant difference in duration of operation between the UTPP group and the UTPP group [(48.38±3.55) min vs. (48.59±3.50) min, P>0.05], the cement injection volume was greater than that of the UTP group [(5.03±0.63) mL vs. (4.11±0.51) mL], the excellent distribution rate of bone cement was higher than that of the UTP-PVP group (92.96% vs. 61.18%), and the leakage rate of bone cement was significantly lower than that of the UTP group (7.04% vs. 18.82%,P<0.05). Over time, both VAS scores and ODI scores showed a decreasing trend, with significant differences in the interaction between time points and time points between groups (P<0.001), but no significant differences between groups (P>0.05). At 1 d and 1 year after surgery, the anterior vertebral body height of both groups was higher than that before surgery, and the Cobb angle was lower than that before surgery, with significant differences in interaction between time points (P<0.001). However, there was no significant difference in the interaction between groups and time points between groups (P>0.05). 
     Conclusion UTPP-PVP can ensure unilateral diffusion and bilateral diffusion as well as uniform distribution of bone cement, and early off-bed activity can be achieved with reduced thoracolumbar pain and good functional recovery after surgery. 

    The value of CRP/PA, PCT/ALB, MCP-1, and sICAM-1 in assessing the severity and prognosis of infectious pneumonia of the newborn
    SUN Xin1, ZHAI Meng1, ZHOU Wen2
    2025, 46(4):  412-417.  doi:10.3969/j.issn.1007-3205.2025.04.007
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    Objective To explore the diagnostic value of the serum C-reactive protein (CRP) to prealbumin (PA) ratio, procalcitonin (PCT) to albumin (ALB) ratio, monocyte chemotactic protein-1 (MCP-1), and soluble intercellular adhesion molecule-1 (sICAM-1) in assessing the severity and prognosis of infectious pneumonia of the newborn (IPN). 
     Methods A retrospective study was conducted on the clinical data of 146 IPN infants admitted to the Department of Neonatology, Xianyang Hospital of Yan′an University from January 2020 to January 2023. Patients were divided into severe (n=84) and non-severe (n=62) groups based on the severity of the condition, and into poor prognosis (n=44) and good prognosis (n=40) groups based on prognosis. Serum levels of CRP, PA, CRP/PA ratio,serum PCT and ALB levels, PCT/ALB ratio, and levels of MCP-1 and sICAM-1 were compared among groups. Pearson correlation analysis was used to analyze the correlation between CRP/PA ratio, PCT/ALB ratio, MCP-1, sICAM-1 levels, and the severity of IPN. Receiver operating characteristic(ROC) curve analysis was used to assess the diagnostic efficiency of serum levels of CRP, PA, CRP/PA ratio, serum PCT and ALB levels, PCT/ALB ratio, and levels of MCP-1 and sICAM-1 for the severity and prognosis of IPN.  
     Results The levels of CRP, PCT, CRP/PA ratio, PCT/ALB ratio, MCP-1, and sICAM-1 were higher in the severe group than in the non-severe group, while PA and ALB levels were lower (P<0.05). Similarly, the levels of CRP, PCT, CRP/PA ratio, PCT/ALB ratio, MCP-1, and sICAM-1 were higher, while PA and ALB levels were lower in the poor prognosis group compared with the good prognosis group (P<0.05). Pearson analysis showed a positive correlation between the CRP/PA ratio, PCT/ALB ratio, MCP-1, sICAM-1 levels and the severity of IPN in children (P<0.05). ROC analysis indicated that the diagnostic value of serum sICAM-1 levels was the highest for the severity of NIP, with an AUC of 0.978 (95%CI: 0.956-1.000), and also the highest for prognosis, with an AUC of 0.981 (95%CI: 0.958-1.000). 
     Conclusion The serum CRP/PA ratio, PCT/ALB ratio, MCP-1, and sICAM-1 have high diagnostic value for assessing the severity and prognosis of IPN. 
    Observation of the expression and significance of serum CC-16, SP-A, NT-proBNP, and IL-17 in neonatal respiratory distress syndrome
    NIE Shao-feng, HE Dan-ping
    2025, 46(4):  418-423.  doi:10.3969/j.issn.1007-3205.2025.04.008
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    Objective To explore the expression and significance of Clara cell secretory protein 16 (CC-16),pulmonary surfactant protein A (SP-A), N-terminal pro-B type natriuretic peptide(NT-proBNP) and interleukin-17 (IL-17) in neonatal respiratory distress syndrome (NRDS). 
     Methods In total, 98 children with NRDS admitted to Hanchuan People′s Hospital of Hubei Province from January 2021 to February 2023 were included in the NRDS group, including 38 mild cases, 33 moderate cases and 27 severe cases. In addition, another 50 healthy newborns born in our hospital during the same period were included in the healthy group. The levels of CC-16, SP-A, NT-proBNP and IL-17 were compared between the two groups. Receiver operating characteristic (ROC) curve was used to analyze the value of CC-16, SP-A, NT-proBNP, and IL-17 alone and in combination in evaluating NRDS. The baseline data and levels of CC-16, SP-A, NT-proBNP and IL-17 in NRDS children with different severity were compared. Spearman rank correlation analysis was used to examine the correlation between CC-16, SP-A, NT-proBNP, IL-17 levels and the severity of NRDS. 
     Results The levels of CC-16, SP-A, NT-proBNP and IL-17 in NRDS group [(60.21±3.85) mg/L, (74.96±6.35) mg/L, (5 063.44±992.65) ng/L, (99.75±30.42) ng/L] were significantly higher than those in the healthy group [(12.09±1.27) mg/L, (17.88±2.76) mg/L, (1 872.49±502.51) ng/L, (58.82±15.73) ng/L], with significant difference (P<0.05). The results of ROC curve analysis showed that the area under the ROC curve (AUC) of CC-16, SP-A, NT-proBNP and IL-17 for evaluating NRDS was 0.845, 0.870, 0.846 and 0.885, respectively; the AUC of the combination of the above indicators for evaluating NRDS was 0.927, and the sensitivity was 0.980. The levels of CC-16, SP-A, NT-proBNP and IL-17 in mild group [(37.69±10.52) mg/L, (46.85±7.36) mg/L, (3 472.57±295.14) ng/L, (39.86±12.45) ng/L] were lower than those in moderate group [(52.37±16.24) mg/L, (72.81±8.06) mg/L, (4 886.29±334.72) ng/L, (101.49±32.13) ng/L] and severe group [(85.13±14.44) mg/L, (97.23±12.37) mg/L, (6 379.36±362.47) ng/L, (146.52±35.08) ng/L], and the levels of CC-16, SP-A, NT-proBNP and IL-17 in moderate group were lower than those in severe group, with significant difference (P<0.05). CC-16, SP-A, NT-proBNP, and IL-17 were positively correlated with the severity of NRDS (r=0.549, 0.574, 0.607, 0.563,  all P<0.05). 
     Conclusion The expression levels of CC-16, SP-A, NT-proBNP and IL-17 in NRDS are increased, which can be used for the diagnosis of NRDS, and the sensitivity of combined diagnosis is higher. The above indicators are positively correlated with the severity of NRDS. 

    The clinical value of anti-ribosomal P protein antibody in childhood systemic lupus erythematosus
    YAN Hong, JIA Yong-ping, ZHANG Xiao-shuang, MA De-ran, GUO Ying-hui
    2025, 46(4):  424-429.  doi:10.3969/j.issn.1007-3205.2025.04.009
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    Objective To investigate the clinical value of anti-ribosomal P protein(Rib) antibody in childhood systemic lupus erythematosus(cSLE). 
     Methods A retrospective analysis was performed on clinical data from 125 patients with newly diagnosed cSLE (cSLE group) from Apirl 2019 to December 2023 in Hebei Children′s Hospital, 86 patients with non-SLE rheumatic disease (disease control group), and 62 healthy controls. The sensitivity and specificity of anti-Rib antibody and other autoantibodies alone and in combination in the diagnosis of cSLE were compared. The positivity rates of anti-Rib antibodies and other autoantibodies among different groups were compared. Logistic regression analysis was used to analyze the relationship between the high sensitivity of autoantibodies and the occurrence of cSLE in cSLE group, and to further compare the clinical characteristics and laboratory indexes of cSLE children in the positive anti-Rib antibody group and the negative group. 
     Results The sensitivity of anti-Rib antibody in cSLE group was 47.2%, which was significantly higher than that of disease control group and healthy control group. The sensitivity of anti-nucleosome + anti-Sm + anti-dsDNA + anti-Rib antibody for combined detection was 82.4%, which was significantly higher than that of single detection and anti-nucleosome + anti-Sm + anti-dsDNA. Anti-dsDNA and positive anti-Rib antibodies were independent risk factors for cSLE (P<0.05). In cSLE group, the incidence of lymph node enlargement and skin mucosal damage (rash, hair loss), as well as the positivity rates of anti-nucleosome and anti-histone antibodies,was significantly higher in the positive anti-Rib antibodies group than in the negative anti-Rib antibodies group, suggesting significant difference (P<0.05). 
     Conclusion Anti-Rib antibody may be involved in the pathogenesis of cSLE and is an independent risk factor for cSLE. Combined with anti-dsDNA, anti-Sm and other autoantibodies, it is of great significance for the correct diagnosis of cSLE.When anti-Rib antibody is positive, the incidence of lymph node enlargement and skin mucosal damage in children with cSLE is higher, which is associated with anti-nucleosome and anti-histone antibodies. 

    The effects of Bifidobacterium triple viable combined with thiabendazole treatment on clinical symptoms, immune function and intestinal flora of children with tic disorders
    WANG Mei-ling, WU Guo-lian, SI Yong-hua, WANG Xue, LI Hong-na, WANG Li-li
    2025, 46(4):  430-435.  doi:10.3969/j.issn.1007-3205.2025.04.010
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    Objective To observe the effects of Bifidobacterium triple viable combined with thiabendazole treatment on clinical symptoms, immune function and intestinal flora of children with tic disorders. 
     Methods In total, 104 children with tic disorders admitted to the Department of Paediatrics of Cangzhou People′s Hospital in Hebei Province from March 2021 to March 2023 were selected and divided into the control group and the observation group using the random number table method. The control group was given thiabendazole hydrochloride, and the observation group was given Bifidobacterium triple viable combined with thiabendazole. The Yale Global Tic Severity Scale (YGTSS) score, American Spinal Injury Association (ASIA) score, immune function, and α diversity of intestinal flora before and after treatment were compared between the two groups. The incidence of adverse reactions in the two groups was calculated. 
     Results Before treatment, the differences in each index between the two groups were not statistically significant (P>0.05). At 12 weeks after treatment, the total scores of motor tics, vocal tics, social function deficits, and YGTSS of the two groups were lower than those before treatment, while the motor and sensory scores of the ASIA score, CD3+, CD3+CD4+, CD4+/CD8+, Shannon index, Chao1 index, Sobs index, and Ace index were higher than those before treatment. The total scores of motor tics, vocal tics, social function deficits, and YGTSS of the observation group were lower than those of the control group, while the motor and sensory scores of the ASIA score, CD3+, CD3+CD4+, CD4+/CD8+, Shannon index, Chao1 index, Sobs index, and Ace index were higher than those of the control group, showing significant differences (P<0.05). The total effective rate of the observation group [94.23% (49/52)] was higher than that of the control group [80.77% (42/52)], suggesting no significant difference (P<0.05). The incidence rates of adverse reactions, such as dizziness, gastrointestinal discomfort, loss of appetite, and drowsiness, between the two groups [13.46% (7/52) vs. 3.85% (3/52)] showed no significant difference (P>0.05). 
     Conclusion Bifidobacterium triple viable combined with thiabendazole in the treatment of children with tic disorders regulates immune function, improves the α diversity of the intestinal flora, and repairs damaged neurological function. 

    Protective effect of picroside Ⅱ on myocardial injury in septic shock rats by regulatingc GAS-STING signaling pathway
    WANG Meng-meng1, YANG Kai-ning1, YAN Jin2, DING Qian3, HU Ju2
    2025, 46(4):  436-443.  doi:10.3969/j.issn.1007-3205.2025.04.011
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    Objective To analyze the protective effect of picroside Ⅱ (Pic-Ⅱ) on myocardial injury in septic shock rats by regulating the cyclic guanylate adenylate synthetase (cGAS)-stimulator of interferon genes (STING) signaling pathway. 
     Methods Rats were randomly separated into six groups: Sham group, model group, low, medium, and high Pic-Ⅱ treatment groups, and activator group, with 10 rats in each group. Except the Sham group, the other groups received cecal ligation and perforation surgery to construct a rat model of septic shock. Ultrasound echocardiography was applied to detect the cardiac function of rats in each group. HE staining was applied to observe pathological changes in myocardial tissue, and TUNEL staining was applied to observe myocardial cell apoptosis. The kit method was applied to detect myocardial injury markers, including cardiac troponin Ⅰ (cTnⅠ), brain natriuretic peptide (BNP), and creatine kinase-MB (CK-MB). Enzyme-linked immunosorbent assay (ELISA) was applied to measure interleukin (IL)-1β, IL-8, and tumor necrosis factor-α (TNF-α) in myocardial tissue, and Western blot was applied to measure cGAS-STING pathway proteins in myocardial tissue. 
     Results Compared with Sham group, the model group showed myocardial fiber disorder, myocardial cell degeneration and necrosis, decreased the left ventricular fraction shorting (LVFS) and left ventricular ejection fraction (LVEF), increased left ventricular end diastolic diameter (LVEDD) and myocardial cell apoptosis rate, and increased level of cTnⅠ, BNP, CK-MB, IL-1β, IL-8, TNF-α, cGAS, STING, p-TANK-binding kinase 1(TBK1)/TBK1, and phosphorylated-interferon regulatory factor 3 (p-IRF3)/interferon regulatory factor 3 (IRF3) (P<0.05). Compared with the model group, the degree of myocardial injury in low, medium, and high Pic-Ⅱ treatment groups was reduced, and the arrangement of myocardial cells was restored to a regular pattern; the LVFS and LVEF were increased, the LVEDD and myocardial cell apoptosis rate were reduced, and the cTnⅠ, BNP, CK-MB, IL-1β, IL-8, TNF-α, cGAS, STING, p-TBK1/TBK1, and p-IRF3/IRF3 were reduced (P<0.05). Compared with the high Pic-Ⅱ treatment group, the activator group had further aggravated myocardial injury, reduced LVFS and LVEF, increased LVEDD and myocardial cell apoptosis rate, and increased expression of cTnⅠ, BNP, CK-MB, IL-1β, IL-8, TNF-α, cGAS, STING, p-TBK1/TBK1, and p-IRF3/IRF3 (P<0.05). 
     Conclusion Pic-Ⅱ can protect against myocardial injury in septic shock rats, reduce cardiac dysfunction, and myocardial cell apoptosis and inflammation. The mechanism of action may be related to the inhibition of cGAS-STING signaling pathway. 

    Mechanism of hsa_circRNA_0073762 in promoting invasion, metastasis, and proliferation of papillary thyroid carcinoma cells
    JIA Heng-zhe, ZHANG Bo-lin, ZHANG Jie, WU Zhen-yu, JIANG Xia, TIAN Yan-feng
    2025, 46(4):  444-452.  doi:10.3969/j.issn.1007-3205.2025.04.012
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    Objective To investigate the regulatory role of hsa_circ_0073762 in papillary thyroid carcinoma (PTC) and to explore its underlying mechanisms. 
     Methods High-throughput sequencing was used to identify differentially expressed circular RNAs (circRNAs) in thyroid cancer and normal cells. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was performed to validate the differential expression between cell lines, PTC, and adjacent tissues. Nucleic acid electrophoresis, sanger sequencing, and RNA enzyme digestion experiments were conducted to verify the circularity and stability of hsa_circ_0073762. Cell counting kit-8 (CCK-8), wound healing, clone formation, and migration assays were used to analyze the effects of hsa_circ_0073762 on PTC cell proliferation, migration, and invasion. A dual-luciferase reporter assay was used to validate the interaction between hsa_circ_0073762, miR-548c-3p, and the ENAH gene. 
     Results RT-qPCR validation of sequencing results showed that hsa_circ_0073762 was significantly upregulated in PTC cells (P<0.001) and in cancer tissues (P<0.05). Knockdown of hsa_circ_0073762 significantly inhibited the invasion, migration, and proliferation of PTC cells. Bioinformatics prediction and dual-luciferase reporter assays indicated that hsa_circ_0073762, miR-548c-3p, and ENAH formed a ceRNA network (P<0.05). 
     Conclusion hsa_circ_0073762 has effects on the invasion, migration, and proliferation processes of PTC and may serve as a novel diagnostic biomarker and potential therapeutic target for PTC. 

    Genetic analysis of FLCN gene mutation in familial spontaneous pneumothorax
    FENG Yong1, LI Meng2, WEI Wei3, LIU Jun-feng1
    2025, 46(4):  453-458.  doi:10.3969/j.issn.1007-3205.2025.04.013
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    Objective To study the mutation and mechanism of folliculin (FLCN) gene in familial spontaneous pneumothorax (FSP). 
     Methods Clinical data were collected from three generations of patients with FSP. Computed tomography (CT) scans of the chest were used to observe the pulmonary condition. The mutation of FLCN gene in this family was detected by next generation sequencing (NGS) method. 
     Results CT scan revealed that this family developed pneumothorax or pulmonary cysts without skin lesions or kidney tumors.Through gene sequencing, it was found that the 147th amino acid of exon 6 of the FLCN gene was mutated from glutamine to a terminator (c.493C>T) in this family of pneumothorax patients. This mutation was also shown in both patients with pneumothorax and their children. 
     Conclusion A nonsense mutation of FLCN is found in patients with FSP. This result extends the mutation spectrum of FLCN in patients with Birt-Hogg-Dubé syndrome (BHD). This may be a new mutation, and further research is needed on larger samples to understand the pathogenesis of FSP. 

    Construction and validation of a risk early warning model for retinal vein occlusion in patients with primary hypertension
    GAO Wei, ELIYAR Erkin, DILSHAT Dolkun
    2025, 46(4):  459-464.  doi:10.3969/j.issn.1007-3205.2025.04.014
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    Objective To construct and validate a risk early warning model for retinal vein occlusion (RVO) in patients with primary hypertension. 
     Methods From January 2021 to December 2022, 32 patients with concurrent RVO were screened out from 1 046 patients with primary hypertension admitted to the Second People′s Hospital of Kashgar Prefecture, and they were designated as the RVO group. Another 50 patients were randomly selected from the remaining patients as the control group. The RVO patients were divided into a high central retinal thickness (CRT) group (n=10) and a low CRT group (n=22) according to whether the CRT of the macular center was greater than 369 μm. The general data between the RVO group and the control group were compared. The levels of blood platelet count (BPC) and mean platelet volume (MPV) in plasma were compared between the high CRT group and the low CRT group. The influencing factors of RVO complicated with primary hypertension were analyzed. According to the results of Logistic regression analysis, a risk early warning model for RVO complicated with primary hypertension was constructed, and a nomogram was drawn. Using RVO complicated with primary hypertension as the positive sample, a receiver operating characteristic (ROC) curve was established, and the goodness of fit of this risk early warning model was verified by Hosmer-Lemeshow test. 
     Results The levels of BPC [(271.31±31.42)×109/L] and MPV [(9.52±0.88) fL] in the RVO group were higher than those in the control group [(256.38±28.45)×109/L, (7.85±0.73) fL, P<0.05]. The levels of BPC [(288.31±34.42)×109/L] and MPV [(10.84±0.82) fL] in the high CRT group were higher than those in the low CRT group [(262.38±24.45)×109/L, (8.59±0.65) fL, P<0.05]. The results of multivariate Logistic regression analysis showed that BPC and MPV were the influencing factors of RVO complicated with primary hypertension (P<0.05). The ROC curve indicated that the area under the curve (AUC) value of the combined prediction of BPC and MPV (AUC=0.928, 95%CI: 0.876-0.981) was significantly better than the individual predictions of BPC (AUC=0.740, 95%CI: 0.629-0.851) and MPV (AUC=0.919, 95%CI: 0.862-0.976). And the goodness of fit of this risk model was verified to be good by Hosmer-Lemeshow test. 
     Conclusion BPC and MPV are significantly correlated with RVO complicated with primary hypertension and the severity of RVO, and the constructed risk model has a good fit. 

    Expression characteristics and significance of BST2 in laryngeal squamous cell carcinoma
    YANG Yu-wei, WANG Jian-xing, JIA Qiao-jing, YANG Zhi-chao, SHAN Chun-guang
    2025, 46(4):  465-473.  doi:10.3969/j.issn.1007-3205.2025.04.015
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    Objective To investigate the expression characteristics of bone marrow stromal cell antigen 2 (BST2) gene in human laryngeal squamous cell carcinoma and its relationship with the prognosis and pathological features of patients, and to determine the effects of BST2 gene silencing on the proliferation, invasion and migration of laryngeal cancer cell lines. 
     Methods Immunohistochemistry was used to detect the differential expression of BST2 in laryngeal cancer tissues and adjacent tissues. The effects of BST2 gene silencing on cell proliferation,migration ability and invasion ability were detected by cell counting kit 8 (CCK-8) method, cell scratch test, and Transwell test, respectively. Clinical data of patients were collected to analyze the correlation between clinical parameters and the expression level of BST2 protein. Kaplan-Meier survival curve was used to compare the survival time of patients with different expressions of BST2 protein. Univariate and multivariate Cox regression analyses were used to analyze the effects of clinical characteristics on survival time of patients. The predictive value of BST2 was evaluated by receiver operating characteristic (ROC) curve. 
     Results The immunohistochemical results showed that the expression of BST2 protein in laryngeal cancer tissues was higher than that in adjacent tissues, showing significant difference (P<0.001). In the TU686 cell line, the results of CCK-8 showed that the OD value of siRNA-3 group was 2.35±0.18 at 48 h, which was significantly lower than that of the normal control group 2.87±0.13 and negative control group 2.71±0.12 (F=16.330, P<0.001). The cell scratch test showed that the healing rate of the BST2 gene silencing group was (15.1±3.71)% at 12 h, which was significantly lower than that of the normal control group (35.07±5.25)% and the negative control group (33.03±5.04)% (F=16.280, P=0.004); the healing rate was (30.41±4.01)% at 24 h, which was significantly lower than that of the normal control group (75.05±4.44)% and the negative control group (70.6±4.97)% (F=89.951, P<0.001). The Tanswell experiment showed that the number of invasive cells in the BST2 gene silencing group was 82.67±2.51, which was significantly lower than that of the normal control group 134.67±2.52 and the negative control group 121.67±4.73 (F=188.314, P<0.001).  There were significant differences in the expression of BST2 in patients with different clinical stages (P=0.032) and survival time (P<0.001). Kaplan-Meier survival curve analysis showed that higher BST2 expression level was associated with shorter survival time (HR=5.102, P<0.0001). Univariate analysis results showed that, clinical stage (χ2=17.383, P<0.001), lymph node metastasis (χ2=14.928, P<0.001) and BST2 expression level (χ2=21.165, P<0.001) were significantly correlated with the survival time of laryngeal cancer patients. The results of multivariate COX regression model showed that, clinical stage (HR=4.228, 95%CI: 1.881-9.501, P<0.001) and BST2 expression level (HR=4.757, 95%CI: 2.259-10.019, P<0.001) was influencing factors of the survival time of these patients, and ROC analysis showed that the expression level of BST2 had a good predictive value for the prognosis of the patients (AUC=0.730). 
     Conclusion BST2 protein is highly expressed in laryngeal cancer tissues, and the high expression of BST2 can promote the proliferation, invasion and migration of laryngeal cancer cells. In addition, the high expression rate of BST2 is related to the survival of laryngeal cancer patients. 

    Value of key features of CT combined with clinical laboratory parameters in predicting cervical lymphatic metastasis in patients with PTC
    HAN Shu-ting, LIU De-shun
    2025, 46(4):  474-482.  doi:10.3969/j.issn.1007-3205.2025.04.016
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    Objective To identify the influencing factors for cervical lymph node metastasis (LNM) and lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC) by combining key CT imaging features, preoperative thyroid function tests, and clinical baseline information, and to construct a visualized predictive model for metastasis. 
     Methods We selected 122 PTC patients treated from January 2021 to Apirl 2024 at the First Affiliated Hospital of Anhui University of Science and Technology, and divided them into the metastasis group (n=51), including 30 patients with LLNM, and non-metastasis group (n=71). Clinical and pathological features of these patients were analyzed retrospectively. Logistic regression and random forest models were constructed to identify and validate variables potentially associated with LNM or LLNM. Visualized nomograms were developed to display the independent risk values related to lymphatic metastasis in PTC patients. 
     Results Significant differences were observed between the metastasis and non-metastasis groups in terms of multifocality, microcalcification, capsular invasion, tumor location, tumor size, serum thyroid-stimulating hormone (TSH), and free triiodothyronine (FT3) levels (P<0.05). Multivariate Logistic regression analysis identified microcalcification, tumor location, tumor size, serum TSH, and FT3 levels as risk factors for LNM (P<0.05). Significant differences in tumor location, tumor size, and serum TSH levels were found between the non-LLNM and LLNM groups (P<0.05). Multivariate Logistic regression analysis indicated that tumor size and serum TSH levels were risk factors for LLNM in the metastasis group (P<0.05). The receiver operating characteristic (ROC) curves [the area under curve (AUC) values of 0.884 and 0.894] demonstrated good predictive performance of the models. Clinical decision curves and calibration curves showed favorable clinical guidance functions. The random forest model validated the above models with consistent conclusions. Analysis of the training sets revealed that multifocality, TSH, FT3, tumor size, and tumor location were the highest-ranked factors associated with LNM, while TSH and tumor size were the highest-ranked factors associated with LLNM. The validation set ROC curves (AUC values of 0.845 and 0.862) further confirmed the good predictive ability of the models. 
     Conclusion The visualized nomograms reveal that clinical features such as multifocality, TSH, FT3, tumor size, and tumor location are closely associated with LNM, while TSH and tumor size are risk factors for LLNM. These findings could assist clinicians in developing personalized treatment plans for PTC patients.