Table of Content

20 July 2025, Volume 40 Issue 7

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Effect of transcranial direct current stimulation on cognitive rehabilitation in patients with mild-to-moderate cognitive impairment after stroke: A systematic review and meta-analysis

Su Guiting, Kang Yahong, Chen Ziqiong, Liu Fang

2025, 40(7):  581-588.  doi:10.3969/j.issn.1004-583X.2025.07.001

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Objective To systematically review the randomized controlled trials (RCTs) on the effect of transcranial direct current stimulation (tDCS) on cognitive function in patients with mild-to-moderate cognitive impairment after stroke, and conduct a meta-analysis. Methods Randomized clinical trials (RCTs) of cognitive function in patients with mild-to-moderate cognitive impairment after stroke treated with tDCS were retrieved from the Chinese-language and English-language databases. The quality of the included literatures was evaluated using the Cochrane bias risk assessment tool, and the related indicators were analyzed via a meta-analysis using RevMan 5.4 software. Results A total of 11 literatures involving 481 subjects were included. The results of meta-analysis showed that the Montreal Cognitive Assessment (MoCA) score (MD=1.44, 95%CI 0.86, 2.02, P<0.01), and Mini-Mental State Examination (MMSE) score (MD=1.39, 95%CI 0.52, 2.26, P=0.002) indicating overall cognitive function, and Rivermead Behavioural Memory Test(RBMT) score indicating memory ability (MD=1.30, 95%CI 0.43, 2.17, P=0.004) were significantly higher in the treated group than the control group. The Digit Span Test (DST) encompassing both forward (FDST for attention, MD=0.28, 95%CI -0.15, 0.72, P=0.20) and backward (BDST for working memory, MD=0.10, 95%CI -0.23, 0.44, P=0.55) recall were comparable between groups. Conclusion tDCS can effectively improve the overall cognitive function and memory function of patients with mild-to-moderate cognitive impairment after stroke.

The predictive value of the metabolic score for insulin resistance in essential hypertension patients complicated by aortic arch calcification

Liu Shenghua

2025, 40(7):  589-594.  doi:10.3969/j.issn.1004-583X.2025.07.002

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Objective To explore the predictive value of metabolic score for insulin resistance (METS-IR) in patients with essential hypertension combined with aortic arch calcification (AAC). Methods A total of 170 patients with essential hypertension admitted in the Beijing Renhe Hospital from February 2022 to February 2025 were retrospectively selected. According to the Symeonidis method, the aortic arch calcification score (AoACS) was measured and divided patients into the AoACS =0 group (n=60), AoACS =1 group (n=46), AoACS=2 group (n=33) and AoACS=3 group (n=31). Smoking history, drinking history, diabetes history, gender, age, blood pressure, body mass index (BMI), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and fasting plasma glucose (FPG) were compared. The correlation and predictive value of each index with AAC in patients with essential hypertension were analyzed. Results There were no significant differences in the proportions of drinking history, gender and TG level among the four groups (P>0.05). There were significant differences in the proportion of smoking history, the proportion of diabetes history, age, diastolic blood pressure, systolic blood pressure, LDL-C, HDL-C, FPG, BMI and METS-IR among the four groups (P<0.05). METS-IR, smoking history, diabetes history, age, LDL-C, HDL-C, FPG, BMI, systolic blood pressure and diastolic blood pressure were used as independent variables for ordinal logistic regression analysis. The results showed that HDL-C was a protective factor for AAC, and the other indicators were risk factors for AAC (P<0.05). The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of METS-IR in predicting primary hypertension complicated with AAC was 0.92, with a specificity of 96.67%, and a sensitivity of 80.00%(P<0.001). Conclusion METS-IR, age, smoking, LDL-C, diabetes history, FPG, BMI, and blood pressure (both systolic and diastolic) are significant risk factors for AAC in patients with essential hypertension, while HDL-C serves as a protective factor. METS-IR demonstrated superior predictive value for the presence and severity of AAC.

Predictive value of red cell distribution width-albumin ratio combined with C-reactive protein/lymphocyte ratio and bedside index for severity in acute pancreatitis in the severity of moderate-to-severe acute pancreatitis

Zhang Jingzhi, Zhang Yanli, Meng Qingshun

2025, 40(7):  595-601.  doi:10.3969/j.issn.1004-583X.2025.07.003

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Objective To investigate the predictive value of red cell distribution width-albumin ratio (RAR) combined with C-reactive protein/lymphocyte ratio (CLR) and bedside index for severity in acute pancreatitis (BISAP) score in the early assessment of the severity of acute pancreatitis (AP). Methods A total of 237 AP patients admitted to the First People's Hospital of Jining from April 2022 to October 2024 were selected. They were divided into the severe acute pancreatitis (SAP) group (n=110) and non-SAP group (n=127) according to the revised Atlanta classification criteria for AP. The general data and related laboratory indicators of the two groups were collected and compared. Results White blood cell count, C-reactive protein, CLR, serum amylase, lactate dehydrogenase, procalcitonin and BISAP scores in the SAP group were significantly higher, while albumin, lymphocyte ratio, serum calcium ion and RAR were significantly lower than those in the non-SAP group (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of RAR combined with CLR and BISAP score was significantly larger than the single indicator or RAR combined with CLR (P<0.005), with a sensitivity of 86.4% and a specificity of 79.5%. Conclusion BISAP score, RAR, CLR, RAR combined with CLR, and RAR combined with CLR and BISAP score are all valid indicators for assessing the severity of AP. In contrast, the predictive value of RAR combined with CLR and BISAP score is better and more accurate, which is applicable to the comprehensive assessment of AP, and can be promoted and widely used in clinical practice.

Epidemiological characteristics of the main pathogens causing acute respiratory infections in a hospital in Chengdu from 2024 to 2025

Fan Jiaxin, Xia Rujie, Zhou Xiaomei, Hu Chunxiao

2025, 40(7):  602-607.  doi:10.3969/j.issn.1004-583X.2025.07.004

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Objective To elucidate the distribution characteristics of respiratory pathogens in Chengdu City, and to provide a scientific basis for targeted regional prevention and clinical decision-making through systematic epidemiological analysis. Methods A total of 6, 795 cases meeting the diagnostic criteria for respiratory infections were collected from Chengdu Second People's Hospital between February 2024 and January 2025. Multiplex real-time quantitative PCR was employed to accurately detect six common respiratory pathogens: adenovirus (ADV), influenza A virus (FluA), influenza B virus (FluB), human rhinovirus (HRV), Mycoplasma pneumoniae (MP), and respiratory syncytial virus (RSV). Results The overall pathogen detection rate was 50.58%, with single-pathogen infections accounting for 44.06% and co-infections for 6.52%. Among single infections, HRV (17.29%) had the highest detection rate, followed by MP (13.89%) and ADV (12.91%). In co-infections, ADV combined with HRV was the predominant type. HRV was the only pathogen with a significant gender difference in the detection rate, showing a significantly higher detection rate in males than females (P<0.01). Detection rates varied by age and season, with the highest overall rate observed in the 1-18 age group. Pathogens exhibited seasonal “staggered peak” trends. Conclusion Respiratory infections in Chengdu are predominantly caused by single pathogens, with HRV being the most prevalent. The epidemiological characteristics of different pathogens are closely associated with age and season.

Bioinformatics-driven investigation into the molecular pathways of polycystic ovary syndrome

Guo Qian, Chen Jie, Ma Weirong, Zhang Yan, Yang Yingqian, Tan Yong

2025, 40(7):  608-618.  doi:10.3969/j.issn.1004-583X.2025.07.005

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Objective To identify novel genetic targets for polycystic ovary syndrome (PCOS) and to reveal the molecular basis underlying the development of PCOS using microarray datasets. Methods A comprehensive analysis was conducted on three independent PCOS datasets from the Gene Expression Omnibus database, and data processing and normalization were performed using R software. The evaluation of the relationship between differentially expressed genes (DEGs) and PCOS included differential expression analysis, expression quantitative trait locus analysis, and Mendelian randomization (MR) analysis. Gene Set Variation Analysis and Gene Ontology/Kyoto Encyclopedia of Genes and Genomes enrichment analysis were performed to explore the functional roles and pathways of these genes. Lasso regression, SVM machine learning, and random forest tree method were used to screen PCOS intersection feature genes, and then a cross validation was conducted with MR method. In addition, CIBERSORT analysis was used to evaluate the infiltration levels of 22 immune cells in PCOS. Finally, a single gene ceRNA regulatory network was constructed for visualization. Results This study identified 59 significant differentially expressed genes (DEGs), including 28 upregulated DEGs and 31 downregulated DEGs. Lasso regression, SVM machine learning, and random forest tree method were used to screen six intersection feature genes related to PCOS, including DNAJC3, ASPH, TLR4, SEC24D, SGK1 and AMFR. These genes were involved in important biological processes and pathways, including responses to endoplasmic reticulum stress, chemical stress, autophagy regulation, endogenous apoptosis, lipid and atherosclerosis, neurodegeneration, etc. The MR analysis method for the cross validation of the aforementioned three methods further suggested that SEC24D had a causal relationship with PCOS, and 37 miRNAs and 15 lncRNAs were closely related to SEC24D. CIBERSORT analysis showed a unique distribution of immune cells in PCOS, particularly a significant increase in neutrophil count, emphasizing the importance of immune processes in PCOS. Conclusion This study provides new insights into the molecular basis of PCOS and emphasizes the potential for therapeutic interventions and targeted molecular pathways for treating PCOS, laying the foundation for further research and clinical work.

Correlation of serum FGF1 expression with glucose and lipid metabolism in bipolar disorder

Lu Yuansi, Lv Jianjun, Guan Jibin, Cao Longbin

2025, 40(7):  619-623.  doi:10.3969/j.issn.1004-583X.2025.07.006

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Objective To study serum level of fibroblast growth factor 1 (FGF1) and the correlation with glucose and lipid metabolism in patients with stable bipolar disorder (BD). Methods A total of 110 patients with stable BD under the management of community health service centers from March 2024 to December 2024 were selected as the study objects, involving 52 patients in the bipolar disorder medication group (BD-M), and 58 in the bipolar disorder no medication group (BD-NM). During the same period, 60 healthy volunteers receiving physical examinations were selected as the control group. Serum FGF1 level and glucose and lipid metabolism were measured and compared. The correlation of FGF1 with glucose and lipid metabolism was analyzed. Results Blood glucose was significantly higher in the BD-NM group and BD-M group than the control group, while the high-density lipoprotein cholesterol (HDL-C) was significantly lower (all P<0.05). Compared to the control group, triglycerides (TG), cholesterol (CHOL), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (ApoA), apolipoprotein B (ApoB) and lipoprotein a (LPa) were significantly higher in the BD-M group (all P<0.05), while the total protein (TP) was significantly lower (P<0.01). TG, CHOL, ApoA, ApoB and LPa in the BD-M group were significantly higher than the BD-NM group (all P<0.05), while TP was significantly lower (P<0.05). The highest serum FGF1 was found in the BD-M group, followed by BD-NM group and control group (P<0.05). Spearman Correlation analysis showed that serum FGF1 levels in the BD-M group were positively correlated with blood glucose, TG, CHOL, LDL-C and ApoB (all P<0.05), but negatively correlated with TP (P<0.05). Conclusion Increase serum FGF1 in BD patients is correlated with medication-induced glucose and lipid metabolism disorders, and FGF1 may be used to monitor or prevent metabolic abnormalities induced by psychotropic drugs.

Predictive value of platelet and white blood cell parameters for bronchopulmonary dysplasia in premature infants

Wang Xiaofang, Cui Qingyang, Liu Xinyu

2025, 40(7):  624-633.  doi:10.3969/j.issn.1004-583X.2025.07.007

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Objective To explore the predictive value of platelet and leukocyte parameters for bronchopulmonary dysplasia (BPD) in preterm infants and to construct a logistic regression prediction model. Methods Medical records of preterm infants with gestational age ≤32 weeks admitted to the Neonatology Department and NICU of the First Affiliated Hospital of Xinxiang Medical University and Jincheng People's Hospital from October 2019 to October 2024 were retrospectively analyzed. Infants were divided into BPD and non-BPD groups based on BPD diagnosis. General characteristics, platelet parameters, and leukocyte parameters at 24 hours, 1 week, 2 weeks, and 4 weeks post-birth were compared between groups. Variables with statistical significance were included in multivariable logistic regression analysis to establish a predictive model, which was validated using the receiver operating characteristic (ROC) curve. Results A total of 258 preterm infants were included, and 93 (36%) were included in the BPD group. In comparison of general characteristics, infants in the BPD group had a significantly higher male-to-female ratio, longer length of stay and duration of non-invasive and invasive mechanical ventilation, younger gestational age, lower birth weight and 1-min and 5-min Apgar scores, higher proportion of pulmonary surfactant (PS) use and incidence of comorbidities (e.g., patent ductus arteriosus, retinopathy of prematurity, persistent pulmonary hypertension in newborns) than the non-BPD group (all P<0.05). In comparison of platelet and white cell parameters, infants in the BPD group had significantly lower platelet count at 2 weeks, platelet distribution width at 24 h, lymphocyte count at 24 h, and platelet quality index at 2 weeks, but higher mean platelet volume at 1 week, neutrophil count at 4 weeks, neutrophil to lymphocyte ratio at 24 h, 2 weeks, and 4 weeks, and platelet to lymphocyte ratio at 24 h than the non-BPD group (all P<0.05). A logistic regression model incorporating significant general characteristics and 24-hour platelet/leukocyte parameters was constructed. The model demonstrated an area under the curve (AUC) of 0.783(95%CI: 0.724-0.842) for predicting BPD. Conclusion Platelet and leukocyte parameters at 24 hours post-birth serve as early predictive biomarkers for BPD. The logistic regression model based on these parameters exhibits high predictive accuracy.

Tirofiban-induced delayed, profound, severe thrombocytopenia: A report of two cases and literature review

Zhong Yuan, Ni Jihao, Meng Fenglei

2025, 40(7):  634-638.  doi:10.3969/j.issn.1004-583X.2025.07.008

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Objective To explore the clinical manifestations, pathogenesis, and treatment of tirofiban-induced delayed, profound, severe thrombocytopenia. Methods Two cases of tirofiban-induced delayed, profound, severe thrombocytopenia were reported, and literature review was conducted. Results A 78-year old male patient experienced profound, severe thrombocytopenia on the 5th day of tirofiban, with a platelet count of 1×10⁹/L. The patient died of cerebral hemorrhage on the same day. Another 85-year-old female patient experienced profound, severe thrombocytopenia on the 5th day after receiving treatment with tirofiban, with a minimum platelet count of 7×10⁹/L. Platelets returned to normal on the 13th day after corticosteroids therapy and platelet transfusion. Conclusion Tirofiban-induced delayed, profound, severe thrombocytopenia is very rare, and its mechanism is still not clear. Bleeding may be the only symptom, and most of bleeding cases are mild. Severe bleeding caused by tirofiban is extremely rare. The treatment mainly includes platelet transfusion, intravenous immunoglobulin and corticosteroids.

Pseudo-hypoaldosteronism caused by urinary tract anomaly complicated with infection: A case report and literature review

Zhou Qiumei, Song Shaona, Liu Yan, Wang Wenhong

2025, 40(7):  639-642.  doi:10.3969/j.issn.1004-583X.2025.07.009

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Objective To explore the clinical features and diagnosis and treatment strategies of secondary pseudo-hypoaldosteronism (PHA). Methods Clinical characteristics, diagnostic approach and prognosis of a PHA patient caused by urinary tract anomaly combined with infection were retrospectively analyzed. Relevant literatures were reviewed. Results A 3-month-old male infant with hydronephrosis at 24 weeks of gestation was surgically treated with laparoscopic left pyeloureteroplasty and left nephropexy under general anesthesia at 2 months of age on June 15, 2022. The ureteral stent was removed on August 18, 2022. During the period of urinary tract infection on July 22 and September 12, 2022, he presented with hyponatremia, hyperkalemia and metabolic acidosis, accompanied by high renin and aldosterone levels. After active anti-infection and symptomatic treatment, re-examinations of blood sodium, blood potassium and blood gas analysis showed normal findings, and the levels of renin and aldosterone returned to normal. Conclusion Symptoms of mineralocorticoid resistance in children, such as hyperkalemia, hyponatremia and elevated aldosterone levels, pseudo-hypoaldosteronism alert a differentiation with PHA. Notably, the possibility of secondary PHA due to urinary tract infection and urinary system malformations should be concerned. For this disease, it is necessary to actively address urinary system malformations, control infections and maintain the stability of the internal environment.

Castleman's disease of the abdomen in children: Report of two cases and literature review

Wang Doudou, Jiang Jian, Zhao Wei, Li Xuerong, Sun Lirong, Wang Lingzhen

2025, 40(7):  643-646.  doi:10.3969/j.issn.1004-583X.2025.07.010

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Objective To summarize the clinical features of Castleman 's disease of the abdomen in children, thus improving the understanding of its diagnosis, treatment and prognosis. Methods Clinical data of two children with Castleman's disease of the abdomen admitted to the Affiliated Hospital of Qingdao University were retrospectively analyzed, and the related literatures were reviewed. Results Both patients underwent surgical resection and they were in complete remission during the follow-up period. In addition, anemia improved significantly after surgical resection, and the weight also increased compared with the pre-treatment value. Conclusion Castleman's disease of the abdomen in children is rare. Complete resection of the tumor is the main treatment for patients with abdominal single-center Castleman’s dissease, and the prognosis is good.