Table of Content

20 May 2025, Volume 40 Issue 5

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Interpretation of the Guidelines for the Assessment and Clinical Practice of Behavioral and Psychological Symptoms of Dementia 2025

Gao Yan, Qu Shuo, Li Yang, Qiu Huiqing, He Sha, Ma Xiaowei

2025, 40(5):  389-393.  doi:10.3969/j.issn.1004-583X.2025.05.001

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Currently, more than 55 million people suffer from dementia worldwide. Alzheimer's disease (AD) is the most common diagnostic cause of dementia, accounting for 50%-70% of all dementia cases. In March 2025, the Canadian Coalition for Seniors' Mental Health (CCSHM) released the Guidelines for the Assessment and Clinical Practice of Behavioral and Psychological Symptoms of Dementia 2025, targeting on the assessment and management of BPSD in AD patients. The present article focused on the five major symptoms of BPSD, including agitation, depression, anxiety, mental symptoms and potential risk sexual behavior manifestations, as well as the the reduction of antipsychotics and psychotropic drugs. Through interpreting key suggestions in the guideline, three aspects of diagnostic criteria, evaluation methods and treatment measures were discussed to provide references for clinical treatment of BPSD and optimizing the whole-process management of BPSD symptoms in AD patients.

Meta-analysis of postoperative complications of self-expanding valve and balloon-expanding valve in transcatheter aortic valve replacement for severe aortic stenosis

Wen Can, Peng Yong, Liu Dan, Fan Jianfeng

2025, 40(5):  394-399.  doi:10.3969/j.issn.1004-583X.2025.05.002

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Objective To compare the postoperative complications of self-expanding valve (SEV) versus balloon-expanding valve (BEV) in transcatheter aortic valve replacement. Methods Articles reporting the advantages and disadvantages concerning the postoperative complications of SEV versus BEV in TAVR were searched in the English-language databases, such as PubMed and Cochrance, and Chinese-language databases, such as China National Knowledge Infrastructure (CNKI), Wanfang and VIP. Results A total of 9 articles, involving 5, 939 patients were included. There was a significant difference in the postoperative all-cause mortality between the SEV and BEV groups (risk ratio [RR]: 1.34, 95% confidence interval [CI]: 1.08, 1.66). SEV outperformed BEV in the postoperative mortality. There were no significant differences in the incidence postoperative stroke, proportion of pacemaker implantation, and the incidence of moderate-to-severe perivalvular leak between the SEV and BEV groups (P>0.05). Conclusion SEV is superior to BEV in all-cause mortality, but comparable in postoperative stroke, moderate-to-severe perivalvular leakage, pacemaker implantation and other postoperative complications.

Correlation of new inflammatory indicators in the complete blood count with major adverse cardiovascular events in patients with acute anterior wall ST-segment elevation myocardial infarction after percutaneous coronary intervention

Liu Ping, Yu Meng, Liu Mingxin, Li Wenfeng

2025, 40(5):  400-407.  doi:10.3969/j.issn.1004-583X.2025.05.003

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Objective This study aims to explore the correlation of neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR) with major adverse cardiovascular events (MACEs) acute anterior wall ST The relationship between in-hospital major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with acute anterior wall ST-segment elevation myocardial infarction (STEMI). Methods This was a retrospective study involving 322 patients diagnosed with acute anterior wall STEMI who underwent their first PCI at the First Affiliated Hospital of Jinzhou Medical University between December 2021 and December 2023. Clinical data were collected, and patients were categorized into MACE and non-MACE groups based on the occurrence of in-hospital MACEs. Furthermore, patients were stratified into subgroups according to the presence of chronic diseases, including hypertension (hypertension and non-hypertension subgroups) and diabetes (diabetes and non- diabetes subgroups). Logistic regression analysis and receiver operating characteristic (ROC) curves were employed to investigate the correlation of NLR, dNLR, MLR, and PLR with the incidence of MACEs among the study subjects. Results Multivariate logistic regression analysis showed that NLR (OR=2.232, 95%CI: 1.233-4.041, P=0.008), dNLR (OR=2.128, 95%CI: 1.398-3.237, P=0.015), and the MLR (OR=1.764, 95%CI: 1.118-2.785, P<0.001) were independent risk factors for in-hospital MACEs following PCI in patients with acute anterior wall STEMI. In contrast, PLR did not demonstrate a significant correlation with MACEs. Subgroup analyses revealed that NLR in the hypertension subgroup, dNLR and MLR in the non-hypertension subgroup, and NLR, dNLR, and MLR in the non-diabetes subgroup were independent risk factors for in-hospital MACEs after PCI in patients with acute anterior STEMI (all P<0.05). However, none of the four indicators showed significant differences in the diabetes subgroup (all P>0.05). The ROC curve indicated that NLR (area under the curve [AUC]=0.781, 95%CI: 0.720-0.843, P<0.001), dNLR (AUC=0.687, 95%CI: 0.622-0.753, P<0.001), MLR (AUC=0.711, 95%CI: 0.641-0.781, P<0.001), and PLR (AUC=0.708, 95%CI: 0.639-0.777, P<0.001) all possessed predictive capabilities for the occurrence of MACEs among the study subjects. Furthermore, the combined predictive capability of these four indicators (AUC=0.831, 95%CI: 0.751-0.863, P<0.001) was superior to that of any individual indicator (all P<0.05). Conclusion NLR, dNLR, and MLR are independent risk factors for in-hospital MACEs following PCI in patients with acute anterior wall STEMI. Furthermore, NLR, dNLR, MLR, and PLR exhibit predictive value for in-hospital MACEs, with their combined predictive capability proving to be even more robust.

Effects of asthma and desensitization treatment on postinfectious cough

Li Yuanpeng, Liu Junan, Huang Qiaolu, Li Tianlin

2025, 40(5):  408-411.  doi:10.3969/j.issn.1004-583X.2025.05.004

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Objective To analyze the effects of asthma and desensitization on postinfectious cough (PIC). Methods This was a retrospective analysis involving 417 eligible PIC patients who visited the respiratory outdepartment from March 1, 2024 to December 31, 2024. Patients with the underlying disease of asthma were included into the experimental group (66 cases), and those without underlying disease were included into the control group (351 cases). Patients in the experimental group were subdivided into the desensitization therapy group (14 cases), and general treatment group (without desensitization therapy, 52 cases). Patients in the experimental group received anti-cough, anti-asthma therapy, and those in the control group received symptomatic anti-cough treatment. The course and severity of cough, and fractional exhaled nitric oxide (FeNO) levels among the experimental group versus control group, and desensitization therapy group versus general treatment group were compared. Results A total of 417 patients were included in the study, including 180 males with an average age of (39.26±14.67) years and 237 females with an average age of (40.41±14.33) years. There were 66 patients in the experimental group and 351 in the control group. FeNO and the severity of cough in the experimental group were significantly higher than those of the control group (P<0.05). The severity of cough in the desensitization therapy group was significantly lower than that of the general treatment group (P=0.000). Conclusion Asthma increases cough severity and FeNO in PIC patients, and desensitization helps to reduce cough severity.

Expression levels of TIPE2 and FOXP3 in patients with hepatocellular carcinoma and cirrhosis and their clinical significance

Kong Li, Zhao Suxian, Zhang Ying, Jin Meng, Wang Shanshan, Ren Weiguang, Zhang Yuguo, Kong Lingbo, Han Fang, Ji Lei

2025, 40(5):  412-416.  doi:10.3969/j.issn.1004-583X.2025.05.005

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Objective To detect the mRNA and protein levels of tumor necrosis factor-α-induced protein 8-like 2 (TIPE2) and FOXP3 in patients with cirrhosis and hepatocellular carcinoma (HCC) and their clinical significances. Methods A total of 60 surgical specimens from patients with HCC and cirrhosis were enrolled. The expression levels of TIPE2 and FOXP3 in liver tissues were evaluated using immunohistochemistry and real-time reverse transcription-polymerase chain reaction (RT-PCR). The correlation of TIPE2 and FOXP3 levels with pathological grading, alpha-fetoprotein (AFP), aspartate transaminase/alanine aminotransferase (AST/ALT), neutrophil-to-lymphocyte ratio (NLR) and other clinical data was analyzed. Results The mRNA and protein levels of TIPE2 were significantly down-regulated (P<0.01), while those of FOXP3 were significantly up-regulated in HCC tissues compared to cirrhosis tissues (P<0.01). Importantly, the mRNA and protein levels of TIPE2 were negatively correlated with FOXP3 expressions (P<0.05 and P<0.01, respectively). Furthermore, TIPE2 and FOXP3 levels were correlated with pathological grade of HCC tissue, and lower TIPE2 and higher FOXP3 levels indicated lower differentiation level. TIPE2 expression was negatively correlated with the AFP level, AST/ALT ratio, neutrophil count and neutrophil-to-lymphocyte ratio (NLR). Conclusion TIPE2 is involved in the liver diseases by negatively regulating the function of FOXP3⁺ Tregs-induced immune response, and negatively participates in the occurrence of HCC.

Analysis of risk factors for liver fibrosis in metabolic dysfunction-associated fatty liver disease and construction of a nomogram

Zhao Xueting, Bai Jiawen, Sun Jun

2025, 40(5):  417-422.  doi:10.3969/j.issn.1004-583X.2025.05.006

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Objective To explore the related risk factors for the occurrence of liver fibrosis in metabolic dysfunction-associated fatty liver disease (MAFLD), and to construct a nomogram to predict liver fibrosis. Methods Demographic data and blood biochemical indicators of MAFLD patients were retrospectively collected. Liver fibrosis was determined by the liver stiffness measure (LSM) detected via FibroScan. Logistic regression analysis was conducted to identify potential predictive indicators for liver fibrosis in MAFLD, and a nomogram was then created. The discrimination ability, consistency, and clinical applicability of the nomogram were assessed through C-index, calibration plots, and decision curves, respectively. Results A total of 282 MAFLD patients were included. Among them, 97 patients had liver fibrosis (LSM≥8 kPa), and 185 patients did not have liver fibrosis (LSM<8 kPa). Univariate analysis indicated that platelet count (PLT), platelet-to-white blood cell ratio (PWR), alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT), serum uric acid (UA), and homocysteine (HCY) were influencing factors for liver fibrosis in MAFLD patients (P<0.05). The multivariate Logistic regression analysis revealed that the PWR (OR=0.921, 95%CI: 0.877-0.967, P<0.001) was a protective factor for liver fibrosis, HCY(OR=1.101, 95%CI: 1.032-1.175, P=0.003), AST(OR=1.021, 95%CI: 1.011-1.031, P<0.001), and UA(OR=1.032, 95%CI: 1.001-1.066, P=0.048) were independent risk factors for liver fibrosis in MAFLD patients. The nomogram constructed based on these factors had good discrimination (area under the curve [AUC]=0.835, 95%CI: 0.779-0.891), and the calibration curve indicated that the predicted probability of liver fibrosis was highly consistent with the observed probability. The clinical decision curve determined that the nomogram had a high net benefit within the threshold probability range. Conclusion The nomogram constructed based on PWR, HCY, AST and UA can well predict the risk of liver fibrosis in MAFLD patients, thereby enabling early identification and intervention. It has high clinical application value.

Clinical characteristics and risk factor analysis of type 2 diabetes mellitus complicated with cryptococcal meningitis

Xiao Ke, Wang Qi

2025, 40(5):  423-427.  doi:10.3969/j.issn.1004-583X.2025.05.007

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Objective To analyze the clinical characteristics of type 2 diabetes mellitus (T2DM) complicated with cryptococcal meningitis, and to identify potential risk factors associated with an unfavorable prognosis. Methods Clinical data of 49 T2DM patients complicated with cryptococcal meningitis who were admitted from January 2021 to May 2023 were retrospectively analyzed. Forty-nine T2DM outpatients were randomly selected as the control group. The collected data encompassed basic information, medical history, laboratory test results, and prognosis. Results T2DM patients complicated with cryptococcal meningitis showed significantly elevated levels of white blood cell and neutrophil counts compared to the control group, while hemoglobin and albumin levels were significantly lower (P<0.05).Moreover, there was a significantly higher proportion of intracranial pressure >300 cmH₂O(1 cmH₂O=0.098 kPa) in T2DM patients complicated with cryptococcal meningitis who have complications than T2DM patients complicated with cryptococcal meningitis who have not complications (P=0.033). Significantly lower levels of neutrophil count and fasting blood glucose were seen in the good prognosis group compared to the poor prognosis group (P=0.046, and P=0.005, respectively). A significantly lower incidence of T2DM-associated complications was also detected in the good prognosis group than the poor prognosis group (P=0.047). Conclusion T2DM patients with lower levels of hemoglobin and albumin suffer from an increased susceptibility to cryptococcal meningitis. Furthermore, increased inflammation level, inadequate blood glucose control, and the presence of complications are associated with an elevated risk of poor prognosis in them.

Effect of motor imagery-brain-computer interface training system on brain functional connectivity in subacute stroke patients with upper limb dysfunction by functional near infrared spectroscopy

Xu Sheng, Yang Qingqing, Zhang Min

2025, 40(5):  428-433.  doi:10.3969/j.issn.1004-583X.2025.05.008

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Objective To observe the effect of motor imagery-brain-computer interface (MI-BCI) training system on brain functional connectivity (FC) in patients with subacute stroke and hemiplegia by functional near infrared spectroscopy (fNIRS). Methods According to the order of admission, 24 stroke patients with upper limb hemiplegia who were treated in the Rehabilitation Medical Center of Changzhou De'an Hospital from January 2023 to January 2024 were recruited. The resting data of patients immediately after resting and MI-BCI training for 20 minutes were collected by fNIRS. Taking FC as the observation index and the oxygenated hemoglobin (HbO2) of bilateral prefrontal cortex (PFC), primary motor cortex (M1) and primary sensory cortex (S1) were selected as the regions of interest, and the differences in the overall FC strength and the FC strength in the region of interest were analyzed. Results After training, the overall FC strength was significantly higher than that of the rest state (P<0.05). The results of region-of-interest (ROI) analysis showed that the FC strength, between affected ipsilateral prefrontal cortex (iPFC) and health contralateral prefrontal cortex (cPFC), between iPFC and affected ipsilateral primary motor cortex (iM1), between iPFC and health contralateral primary motor cortex (cM1), between iM1 and cM1, between cM1 and health contralateral primary somatosensory cortex (cS1) were significantly higher than those of the resting state (P<0.05). Conclusion MI-BCI training system is helpful to regulate bilateral brain balance and induce cortical reconstruction in patients, which may be the central mechanism of its clinical effectiveness.

The potential of hepcidin/serum ferritin ratio in assessing anemia in patients with maintenance peritoneal dialysis

Zhang Hongtao, Zhong Meijiao, Gao Jingyang, Li Shijie, Yu Naxin, Fan Xin, Chen Lining, Zhang Yang, Wang Zhikui, Bian Aishu

2025, 40(5):  434-438.  doi:10.3969/j.issn.1004-583X.2025.05.009

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Objective To investigate the value of hepcidin (HEP)/serum ferritin (SF) ratio in the evaluation of anemia in patients with maintenance peritoneal dialysis (PD). Methods A total of 238 PD patients who were regularly followed up in the PD Center of Linyi People 's Hospital from January 2020 to December 2021 were selected. There were 107 males and 131 females, with an average age of (50.21±13.92) years, and a median dialysis age of 16 months. According to the level of hemoglobin (HGB), patients were divided into the anemia group (HGB<110 g/L, n=130) and non-anemia group (HGB≥110 g/L, n=108). The clinical data of the two groups were compared. Pearson correlation analysis was performed on the relevant indicators. Multivariate logistic regression was used to analyze the risk factors for anemia in PD patients. The receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of HEP, SF and HEP/SF ratio in anemia among PD patients. Results Compared with the non-anemia group, the HEP and HEP/SF ratio in the anemia group were significantly higher, while SF was significantly lower (P<0.05). Pearson correlation analysis showed that SF was positively correlated with HGB (P<0.01), while HEP and HEP/SF ratio were negatively correlated with HGB (P<0.01). Logistic regression analysis showed that HEP, SF and HEP/SF ratio were independent risk factors for anemia in PD patients (P<0.05). ROC curve showed that the HEP/SF ratio was of great value in evaluating renal anemia in patients with maintenance PD, with an area under the curve (AUC) of 0.892 (95% confidence interval [CI]: 0.846-0.937, P<0.01). The optimal cut-off value was 0.63, with a sensitivity of 76.9%, and a specificity of 96.3%. Conclusion HEP, SF and HEP/SF ratio are independent risk factors for renal anemia in patients with maintenance PD that reflect the severity of anemia to a certain extent. They have certain evaluation value for renal anemia in patients with maintenance PD.

Effect of decitabine maintenance therapy on the survival of patients with low-to-medium risk of acute myeloid leukemia and suitable for intensive therapy

Zhao Yajing, Tao Qianshan, Shen Yuanyuan, Dong Yi

2025, 40(5):  439-444.  doi:10.3969/j.issn.1004-583X.2025.05.010

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Objective To investigate the effect of maintenance therapy with decitabine on the survival of patients with low-to-medium risk of acute myeloid leukemia (AML) and suitable for intensive chemotherapy. Methods A retrospective analysis was performed on 107 patients with low-to-medium risk of AML who were suitable for intensive chemotherapy and admitted in the Second Affiliated Hospital of Anhui Medical University from January 2017 to January 2024. Patients were divided into the maintenance treatment group (n=59) and control group (n=48) according to their willingness to receive maintenance treatment with decitabine. Patients in the maintenance treatment group were subdivided into the low-risk group (n=32) and medium-risk group (n=27) according to the prognosis stratification, or subdivided into the minimal residual disease (MRD)-positive group (n=20) and MRD-negative group (n=39) according to the MRD status. Patients in the maintenance treatment group were given intravenous drips of decitabine 15 mg/m2/d for 5 days per course, with a total of 6 courses after an interval of 2 months. Regular detections were given in the control group. The clinical data were collected and compared, including the relapse-free survival (RFS) and overall survival (OS). Results As of October 2024, the median RFS was 40 months (95%CI: 11.427-68.573) in the maintenance treatment group and 19 months (95%CI: 9.085-28.915) in the control group. The median OS was 46 months (95%CI: 21.538-70.462) in the maintenance treatment group, and 32 months (95%CI: 19.318-40.682) in the control group. The differences in the median RFS and OS were statistically significant between groups (P<0.05). There were no significant differences in the median RFS and OS among AML patients receiving the maintenance treatment between the low-risk group and medium-risk group (P>0.05). The median RFS in the MRD-positive group among AML patients receiving the maintenance treatment was 23 months (95%CI: 11.712-34.288), and the median OS was 28 months (95%CI: 22.336-33.664), while the median RFS and OS in the MRD-negative group did not reach (P<0.001). The changes in cellular immune function of decitabine before and after maintenance treatment were further analyzed. It was found that the level of regulatory T cells significantly decreased, and the level of CD8⁺ T cells and natural killer cells significantly increased (P<0.05). Conclusion AML patients with a low-to-medium risk and suitable for intensive chemotherapy can yield survival benefits from decitabine maintenance therapy, which can improve the cellular immune function.

Serum level of IL-33 in premature infants with bronchopulmonary dysplasia complicated with pulmonary hypertension and its clinical significance

Wei Jing, Cui Qingyang, Han Huizhen, Yan Huili, Liu Qingsheng

2025, 40(5):  445-449.  doi:10.3969/j.issn.1004-583X.2025.05.011

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Objective To investigate the correlation between serum interleukin 33 (IL-33) level and pulmonary hypertension in premature infants with bronchopulmonary dysplasia (BPD). Methods A total of 130 premature infants with BPD admitted to the Department of Neonatology, the First Affiliated Hospital of Xinxiang Medical University and the Department of Neonatology, Jiaozuo Maternal and Child Health Hospital from August 2022 to August 2024 were included. According to with the development of pulmonary hypertension, they were divided into the BPD group (n=74) and BPD combined with pulmonary hypertension group (n=56). In addition, 50 non-BPD premature infants in the Department of Neonatology of First Affiliated Hospital of Xinxiang Medical University and Maternal and Child Health Hospital of Jiaozuo City during the same period were included as the control group. The clinical data of all infants were collected, and 130 premature infants with BPD were followed up for 3 months. Based on the median serum IL-33 level, they were divided into the high expression group (n=66) and low expression group (n=64). Logistic analysis was used to analyze the risk factors for pulmonary hypertension in premature infants with BPD. The receiver operating characteristic (ROC) curve was used to analyze the clinical efficacy of IL-33 in predicting pulmonary hypertension in premature infants with BPD. Results There was a significant difference in serum IL-33 level among the three groups (P<0.001). Serum IL-33 remained the highest in the BPD combined with pulmonary hypertension group, followed by BPD group, and lowest in the control group (P<0.05). There was a significant difference in BPD classification between the BPD group and BPD combined with pulmonary hypertension group (P<0.05). Compared with the BPD group, proportions of amniotic fluid pollution, chorioamnionitis, respiratory failure, mechanical ventilation and ventilator-associated pneumonia were significantly higher in the BPD combined with pulmonary hypertension group, while the 5-min Apgar scores were significantly lower than the BPD group (P<0.05). Multivariate logistic regression analysis showed that BPD classification, ventilator-associated pneumonia and serum IL-33 level were independent risk factors for BPD combined with pulmonary hypertension in premature infants (P<0.05). The receiver operating characteristic curve showed that the area under the curve of serum IL-33 level in predicting pulmonary hypertension in infants with BPD was 0.931. When the cut-off value of serum IL-33 was 433.82 pg/ml, the sensitivity and specificity were 95.45% and 93.21%, respectively. All BPD children were followed up for 3 months. Compared with the low expression group, there was a significantly higher proportion of pulmonary infection in the high expression group (P=0.026). Conclusion Serum IL-33 level significantly increases in premature infants with BPD, and the higher serum IL-33 may be involved in the pathogenesis of pulmonary hypertension and also associated with poor short-term prognosis.

Anti-NMDAR encephalitis during the remission of optic neuritis: A case report and literature review

Kong Fancong, Wang Fangyu, Fan Kai, Liu Gengxi, Zhao Lianjiang, Liu Fei

2025, 40(5):  450-453.  doi:10.3969/j.issn.1004-583X.2025.05.012

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Objective To investigate the clinical characteristics of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis during the remission of optic neuritis. Methods A case of anti-NMDAR encephalitis during the remission of optic neuritis was retrospectively analyzed, and the published literatures at home and abroad were reviewed. Results A 28-year-old female presented with episodic unconsciousness, convulsions of the limbs and auditory hallucinations for 2 hours and 40 minutes. Epilepsy seizures occurred again during the hospitalization period. The patient had a history of epileptic seizures during the dosage reduction of hormone shock therapy for optic neuritis. Cranial magnetic resonance imaging showed marginal lobe encephalitis and meningitis. Serum and cerebrospinal fluid tests were positive for the anti-NMDAR1 antibody. The patient was then diagnosed with anti-NMDAR encephalitis during the remission of optic neuritis. Hormone treatment effectively relieved the symptoms, without recurrence at 1 year of follow-up. Conclusion Epilepsy symptoms in patients with optic neuritis alert testing for antibodies associated with autoimmune encephalitis. An early diagnosis favors the treatment.

Posterior reversible encephalopathy syndrome following liver transplantation: A case report and literature review

Wang Dongxia, Zhang Dong, Song Shifei, Yang Yimin

2025, 40(5):  454-457.  doi:10.3969/j.issn.1004-583X.2025.05.013

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Objective To investigate the clinical characteristics and treatment strategies for posterior reversible encephalopathy syndrome (PRES) following liver transplantation. Methods The clinical manifestations, imaging features, treatment and prognosis of a PRES patient after liver transplantation were retrospectively analyzed, and the related literatures were reviewed. Results A 50-year-old female patient presented with unexplained status epilepticus after liver transplantation. Clinical evaluation and imaging studies confirmed the diagnosis of calcineurin inhibitor (CNI)-associated PRES. After promptly adjusting for the immunosuppressive regimen (replacing CNIs with sirolimus), the patient's neurological symptoms resolved completely without sequelae. Conclusion The occurrence of PRES after liver transplantation is closely related to CNI immunosuppressive therapy. Early recognition and timely adjustment for the immunosuppressive regimen are crucial for improving the prognosis.

Paraquat poisoning-induced pulmonary fibrosis: A case report and literature review

Qiao Tong, Wang Xiaoran, Chen Jiaxing, Fu Qian, Yan Li, Zhang Aili

2025, 40(5):  458-462.  doi:10.3969/j.issn.1004-583X.2025.05.014

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Objective To investigate the typical imaging features of pulmonary fibrosis due to paraquat poisoning. Methods Imaging and clinical data of a patient with paraquat poisoning and hospitalized in the Department of Respiratory Medicine of Hebei General Hospital were retrospectively analyzed. Results A 18-year-old female patient presented with diarrhea for 5 days, and coughing, sputum production, chest tightness, shortness of breath for 3 days. After admission, a detailed medical history was taken and relevant laboratory tests were completed. She was initially diagnosed with pneumonia and treated with anti - infection and expectorant therapies. However, her condition worsened despite the treatment. After further detailed inquiry into her medical history, paraquat poisoning was suspected. She was then treated with a combination of methylprednisolone and cyclophosphamide as part of a comprehensive treatment regimen. Subsequently, she underwent lung transplantation at another hospital and had a good postoperative recovery. Conclusion In the absence of a known ingestion of paraquat, early imaging may show subpleural ground-glass opacity with band-like distributions, which can rapidly progress to pulmonary fibrosis. These imaging features have certain reference value for identifying paraquat poisoning.