Table of Content

20 December 2025, Volume 40 Issue 12

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Effects of tirzepatide on lipid profiles in type 2 diabetes mellitus： A meta-analysis

Xie Feifei, Zhang Weijian

2025, 40(12):  1061-1067.  doi:10.3969/j.issn.1004-583X.2025.12.001

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Objective To systematically evaluate the effects of tirzepatide on lipid parameters in patients with type 2 diabetes mellitus （T2DM）. Methods We searched CNKI，Wanfang，VIP，PubMed，Embase，and the Cochrane Library for randomized controlled trials （RCTs） up to the search date that compared tirzepatide with control interventions in T2DM patients. Pooled analyses were conducted using RevMan 5.4. Results Six RCTs met inclusion criteria. Pooled estimates demonstrated that tirzepatide produced statistically significant improvements in lipid profiles compared with control： Greater reductions in total cholesterol （TC） （MD=-5.58，95%CI -8.44 to -2.73），triglycerides （TG）（MD=-16.27，95%CI -20.90 to -11.64），low density lipoprotein cholesterol （LDL-C） （MD=-6.41，95%CI -10.57 to -2.25），and very low density lipoprotein cholesterol （VLDL-C）（MD=-16.03，95%CI -20.56 to -11.49）（all P<0.05），and a greater increase in high density lipoprotein cholesterol （HDL-C）（MD=4.33，95%CI 2.22 to 6.45； P<0.05）. Dose stratified analyses showed that 5 mg，10 mg，and 15 mg doses each produced superior lipid improvements versus control，with a trend toward larger effects at higher doses，consistent with a dose response relationship. Conclusion Tirzepatide significantly improves lipid profiles in patients with T2DM compared with control treatments，lowering TC，TG，LDL-C，and VLDL-C and increasing HDL-C in a dose-dependent manner.

Application values of PIV and CD93 in the differential diagnosis of viral encephalitis and autoimmune encephalitis

Ma Weifeng, Yu Chunyan, Ran Qian, Li Shuaiqi, Fan Chonggui

2025, 40(12):  1068-1072.  doi:10.3969/j.issn.1004-583X.2025.12.002

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Objective To investigate the application values of pan-immune-inflammation value （PIV） and cluster of differentiation 93 （CD93） in the differential diagnosis of viral encephalitis （VE） and autoimmune encephalitis （AE）. Methods A total of 160 patients with acute encephalitis admitted to Nanyang Central Hospital from January 2023 to January 2025 were retrospectively enrolled. Among them，74 patients were diagnosed with VE （VE group） and 86 with AE （AE group）. Clinical features，PIV，and CD93 levels were compared between the two groups. The efficacy of these indicators in distinguishing AE from VE was evaluated using the receiver operating characteristic （ROC） curve. Results Significant differences were observed between the two groups in clinical features，including mode of onset，affected hemisphere，prodromal symptoms，and temporal lobe involvement on imaging （P<0.05）. Compared with the AE group，patients in the VE group exhibited significantly lower serum CD93 and absolute lymphocyte count，and significantly higher absolute neutrophil count，absolute monocyte count and PIV （P<0.05）. There was no significant difference in platelet count between the two groups （P>0.05）. Multivariate logistic regression analysis indicated that the mode of onset，prodromal symptoms，serum CD93，and PIV were significant indicators that effectively distinguished VE from AE （P<0.05）. ROC curve analysis showed that the single indicator of serum CD93 had a larger area under the curve （AUC，0.936 vs 0.689），sensitivity （85.29% vs 75.00%） and specificity （90.27% vs 54.00%） than PIV in the differential diagnosis of VE and AE. Their combination significantly improved diagnostic performance，with an AUC of 0.976，a sensitivity of 95.00%，and a specificity of 88.00%（P<0.05）. Conclusion Serum CD93 and PIV are useful markers for distinguishing VE from AE. Their combination demonstrates significantly better diagnostic efficacy than either marker alone，with higher sensitivity and specificity.

Analysis of the clinical benefits of antihypertensive interventions to high-risk cardiovascular patients

Yan Guosheng, Shen Yujuan

2025, 40(12):  1073-1077.  doi:10.3969/j.issn.1004-583X.2025.12.003

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Objective To explore the clinical benefits of antihypertensive interventions to high-risk cardiovascular patients，thus providing evidence for clinical practice. Methods From January 2015 to December 2020，a total of 45 823 hypertension patients from Batan Town and its surrounding 5 towns and 2 fields who were treated in the Binhai County Second People's Hospital were selected. According to the timing of antihypertensive intervention，they were divided into the early antihypertensive group （standard antihypertensive treatment initiated within 3 months of diagnosis，n=22 938） and delayed antihypertensive group （standard antihypertensive treatment initiated 3 months later after diagnosis，n=22 885）. According to the target value of blood pressure reduction，patients were further divided into the intensive blood pressure reduction group （n=22 938） and conventional blood pressure reduction group （n=22 885）. All patients were treated with an individualized antihypertensive regimen of monotherapy or combined drug therapy. The blood pressure control compliance rate，the incidence of cardiovascular events （coronary atherosclerotic heart disease，stroke，heart failure，cardiovascular death） and the incidence of major adverse cardiovascular events were compared between the early antihypertensive group and the delayed antihypertensive group after interventions. Clinical benefits and safety in the intensive antihypertensive group and the conventional antihypertensive group were analyzed. Results The 1-year and 3-year blood pressure control rates in the early antihypertensive group were higher than those in the delayed antihypertensive group （P<0.05）. During the 3 years of follow-up，the incidence of cardiovascular events in the early antihypertensive group was 15.0%（3 440 cases），and the incidence of cardiovascular events in the delayed antihypertensive group was 25.0%（5 721 cases）. The incidence of cardiovascular events in the early antihypertensive group was lower than that in the delayed antihypertensive group （χ²=529.53，P<0.01）.Compared with the conventional antihypertensive group （target systolic blood pressure < 140 mmHg），the risk of major cardiovascular adverse events in the intensive antihypertensive group （target systolic blood pressure <130 mmHg） was significantly lower （P<0.01）. Compared with the delayed hypotension group，the risk of cardiovascular events was significantly lower in the early hypotension group （P<0.01）. Conclusion Early and intensive antihypertensive interventions for high-risk cardiovascular patients can reduce the risk of cardiovascular events.

Analysis of the association and predictive value of serum calcium，C-reactive protein，and D-dimer for severity of acute pancreatitis in children

Huang Lifang, Ye Hong, Zhang Rui, Chen Yuyun, Zhang Jingjing

2025, 40(12):  1078-1081.  doi:10.3969/j.issn.1004-583X.2025.12.004

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Objective To evaluate the associations and predictive value of admission serum calcium，C-reactive protein （CRP），and D-dimer （D-D） levels for disease severity in children with acute pancreatitis （AP）. Methods We retrospectively analyzed clinical data from 71 pediatric patients diagnosed with AP at our hospital from December 2021 to August 2025. Patients were classified by AP severity. Admission serum calcium，CRP，and D-D levels were compared between mild and severe groups. Spearman correlation assessed relationships between these biomarkers and AP severity. Receiver operating characteristic （ROC） curve analysis was used to evaluate the predictive performance of each marker. Results Serum calcium was significantly lower in the severe group than the mild group （1.9±0.5 mmol/L vs 2.2±0.3 mmol/L； P<0.05）. CRP levels were significantly higher in the severe group： Median （IQR） 78.6（24.8，104.5） mg/L vs 3.8（2.3，11.4） mg/L in the mild group （P<0.05）. D-D was significantly higher in the severe group： 3.1（1.7，8.1） mg/L vs 0.5（0.2，1.5） mg/L in the mild group （P<0.05）. Spearman analysis showed serum calcium was negatively correlated with AP severity，while CRP and D-D were positively correlated （all P<0.05）. ROC analysis yielded area under the curve （AUC） values of 0.766 for serum calcium，0.748 for CRP，and 0.741 for D-D （all P<0.05），indicating moderate discriminative ability. Conclusion Admission levels of serum calcium，CRP，and D-D differ significantly among pediatric patients with AP and correlate closely with disease severity. These biomarkers can serve as good indicators for assessing AP severity and for predicting clinical prognosis.

Impact of high flow dialysis on sleep quality in maintenance hemodialysis patients and analysis of related factors

Cui Zhijun, Ma Donghong, Chen Xiufeng

2025, 40(12):  1082-1086.  doi:10.3969/j.issn.1004-583X.2025.12.005

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Objective To evaluate the impact of high flow dialysis on sleep quality in maintenance hemodialysis （MHD） patients and to analyze related influencing factors. Methods Eighty two MHD patients who met inclusion criteria at Shanghai Junkang Hospital from October 2023 to March 2024 were enrolled and randomized into two groups （n=41 each） using a random number table. The control group received low flow hemodialysis （blood flow 250-300 ml/min），and the observation group received high flow dialysis （blood flow 300-350 ml/min）. The clinical baseline data，sleep quality，metabolic function and renal function before and after treatment were compared between the two groups. Results Baseline characteristics （sex，age，body mass index[BMI]，marital status，education level，primary disease，and dialysis vintage） did not differ significantly between groups （P>0.05）. Pre-treatment total PSQI and its seven domain scores were similar between groups （P>0.05）. Post-treatment，PSQI total and domain scores decreased in both groups versus baseline，with greater reductions in the observation group compared with the control group （P<0.05）. Baseline metabolic parameters did not differ significantly between groups （P>0.05）. Post-treatment，levels of serum uric acid，total cholesterol，low density lipoprotein-cholesterol（LDL-C），and triglycerides remained comparable between groups （P>0.05）. Both groups experienced decreases in leptin and serum uric acid and increases in high density lipoprotein-cholesterol （HDL-C） （P<0.05）； the observation group showed significantly lower leptin and higher HDL-C than the control group （P<0.05）. Renal function markers were also comparable at baseline （serum creatinine，blood urea nitrogen [BUN]，estimated glomerular filtration rate[eGFR]，β2 microglobulin； P>0.05）. After treatment，serum creatinine，BUN，and β2 microglobulin declined in both groups，with greater reductions in the observation group （P<0.05）. eGFR increased in both groups versus baseline，and the increase was significantly larger in the observation group （P<0.05）. Conclusion Compared with low flow dialysis，high flow dialysis was associated with greater improvement in sleep quality，metabolic parameters，and renal function in MHD patients.

Epidemiological characteristics of respiratory infection pathogens at a tertiary hospital in Tianjin，2024-2025

Yue Yingying, Wang Meng, Zhou Chunlei, Mu Hong

2025, 40(12):  1087-1092.  doi:10.3969/j.issn.1004-583X.2025.12.006

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Objective To characterize the epidemiology of six common respiratory pathogens-influenza A virus （IFV-A），influenza B virus （IFV-B），respiratory syncytial virus （RSV），adenovirus （ADV），Mycoplasma pneumoniae （MP），and human rhinovirus （HRV）-and severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） among patients presenting to a tertiary hospital in Tianjin from April 2024 to March 2025. Methods Nasopharyngeal swabs were obtained from outpatients and inpatients at Tianjin First Central Hospital who presented from April 2024 to March 2025 with symptoms of acute respiratory infection （fever，cough，nasal congestion，expectoration，sneezing，sore throat，dyspnea，etc.） or who had radiographic evidence of pneumonia. Nucleic acid was extracted from all specimens； detection of the six common respiratory pathogens was performed using a multiplex nucleic acid assay，and SARS-CoV-2 testing was conducted using an approved SARS-CoV-2 nucleic acid test kit. Results For the six pathogen panel，6，399 specimens were tested and 2，009 were positive （overall positivity 31.40%）. Pathogen-specific positivity rates were： IFV-A 8.28%，IFV-B 0.03%，RSV 1.06%，ADV 2.77%，MP 13.46%，and HRV 5.80%. By sex，overall positivity was 30.50% in males and 32.42% in females （χ²=2.707，P=0.100）. By age group，positivity was 61.93% in children，25.09% in young and middle-aged adults，and 18.90% in older adults （χ²=901.013，P<0.01）. Seasonal distribution showed positivity rates of 21.74% in spring，24.11% in summer，36.59% in autumn，and 39.04% in winter （χ²=171.520，P<0.01）. For SARS-CoV-2，12，554 specimens were tested and 2，304 were positive （overall positivity 18.35%）. SARS-CoV-2 positivity was 18.01% in males and 18.77% in females （χ²=1.203，P=0.273）. By age group，rates were 15.23% in children，16.36% in young and middle aged adults，and 19.75% in older adults （χ²=24.732，P<0.01）. Seasonal SARS-CoV-2 positivity rates were 16.94% in spring，23.08% in summer，20.54% in autumn，and 13.28% in winter （χ²=112.159，P<0.01）. Conclusion From April 2024 to March 2025，respiratory pathogen detection among patients with respiratory infections in Tianjin demonstrated distinct age related and seasonal patterns. These findings support the adoption of targeted prevention and treatment measures that account for population characteristics and seasonal trends.

Clinical characteristics and drug resistance analysis of patients with tuberculosis and non-tuberculous mycobacterial disease

Luan Junqin, Gao Yanjun

2025, 40(12):  1093-1097.  doi:10.3969/j.issn.1004-583X.2025.12.007

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Objective To provide insights for early differential diagnosis and treatment by comparatively analyzing the clinical features and drug-resistance patterns of tuberculosis （TB） and non-tuberculous mycobacterial （NTM） disease. Methods We retrospectively collected data on patients diagnosed with TB （TB group） and NTM disease （NTM group） from January 2022 to December 2024. Clinical characteristics and antimicrobial resistance profiles were analyzed and compared between the two groups. Results The specimens of TB group and NTM group mainly came from sputum. TB patients were predominantly young and middle-aged males aged 15-40 years，whereas NTM patients were mainly males aged 61 years and older. Compared with the NTM group，the TB group had significantly higher rates of cough （χ²=18.850，P<0.01），hemoptysis （χ²=31.780，P<0.01），and CT findings including patchy opacities （χ²=11.680，P=0.001），nodular lesions （χ²=12.590，P<0.01），and bronchial changes （χ²=22.640，P<0.01）. The TB group also showed higher prevalences of hypertension （χ²=12.600，P<0.01），anemia （χ²=4.637，P=0.031），diabetes history （χ²=34.330，P<0.01），leukopenia （χ²=9.470，P=0.002），and emphysema （χ²=16.430，P<0.001）. Drug-resistance analysis indicated a relatively high isoniazid resistance rate in the TB group （22.65%），whereas the NTM group exhibited high levels of resistance to most anti-tuberculosis drugs. Conclusion TB patients in this cohort were predominantly young to middle-aged adults，while NTM disease occurred mainly in elderly patients. The observed differences in clinical presentation and susceptibility profiles may assist early differential diagnosis and guide appropriate treatment strategies.

Curative effect of olanzapine combined with computerized cognitive remediation therapy in schizophrenia

Ma Xiaoliang, Wang Kaiting

2025, 40(12):  1098-1103.  doi:10.3969/j.issn.1004-583X.2025.12.008

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Objective To evaluate the efficacy of olanzapine combined with computerized cognitive remediation therapy （CCRT） on multidimensional clinical symptoms，social function and neurobiological indicators in patients with schizophrenia. Methods From May 2023 to April 2025，116 inpatients diagnosed with schizophrenia at Zhumadian Second People's Hospital were randomized （n=58 per group） to receive either olanzapine plus conventional cognitive training （control group） or olanzapine plus CCRT （observation group）. Interventions continued for 12 weeks. Outcomes measured at baseline and at weeks 4，8，and 12 included symptom severity （Positive and Negative Syndrome Scale，PANSS），cognitive performance （China Brief Cognitive Test battery，C-BCT），social function （Personal and Social Performance scale，PSP； Social Disability Screening Schedule，SDSS），and serum biomarkers of neural function （S100 calcium-binding protein B [S100B]，neuron specific enolase [NSE]，and brain derived neurotrophic factor [BDNF]）. Pearson correlation was used to assess relationships among outcome measures. Results Compared with the control group，the observation group showed significantly greater reductions in PANSS negative symptoms，positive symptoms，and general psychopathology at weeks 4，8，and 12. On the C-BCT，the observation group achieved higher scores on the line tracking test and sustained operation T-scores （P<0.05）. Social function improved more in the observation group，reflected by higher PSP scores and lower SDSS scores （P<0.05）. Neurobiologically，the observation group exhibited lower serum S100B and NSE levels and higher BDNF levels than control group （P<0.05）. Pairwise correlations among the outcome variables were of moderate magnitude and statistically significant （P<0.05）. Conclusion Adjunctive CCRT combined with olanzapine produces superior improvements in clinical symptoms，cognitive performance，social function，and neurobiological markers compared with olanzapine plus conventional cognitive training in patients with schizophrenia.

Purulent pericarditis after percutaneous coronary intervention： A case report and literature review

Wang Jiaqi, Xie Yuetao, Liu Huiliang, Zhang Feifei, Dang Yi, Li Yingxiao, Qi Xiaoyong

2025, 40(12):  1104-1107.  doi:10.3969/j.issn.1004-583X.2025.12.009

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Objective To describe the clinical presentation，diagnostic workup，and management of purulent pericarditis occurring after percutaneous coronary intervention （PCI），and to summarize relevant literature to provide clinical guidance. Methods We performed a retrospective case analysis of a patient who developed purulent pericarditis after PCI and conducted a targeted review of published reports on post PCI purulent pericarditis. Results An elderly male with a long history of intermittent chest tightness for over 20 years presented with worsening chest pain for 4 days. PCI had been performed shortly before symptom onset. Significant comorbidities included advanced age，diabetes mellitus，and recent herpes zoster infection. Transthoracic echocardiography and chest CT revealed a pericardial effusion. The patient underwent pericardiocentesis drainage，pericardial lavage with saline and antibiotics，and systemic intravenous antibiotics，resulting in clinical improvement. At one month outpatient follow up，the patient was clinically well，and echocardiography showed resolution of the effusion. Conclusion Prompt recognition，pericardial drainage，and early，aggressive antimicrobial therapy are crucial for favorable outcomes of purulent pericarditis.

A case of newly developed lung adenocarcinoma following liver transplantation for hepatocellular carcinoma

Wang Yuanyuan, Zhao Zhifang, Zhao Yunxia, He Yang, Zhang Qing

2025, 40(12):  1108-1112.  doi:10.3969/j.issn.1004-583X.2025.12.010

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Objective To explore the clinical characteristics，diagnostic methods and treatment challenges of newly developed lung adenocarcinoma in liver cancerpatients after liver transplantation，thus providing references for the diagnosis and treatment of such special cases in clinical practice. Methods A retrospective analysis was conducted on the clinical data of a 68-year-old liver cancer patient with newly developed lung adenocarcinoma after liver transplantation，including medical history，symptoms and signs，diagnostic methods and treatment process. Results The patient was diagnosed with lung adenocarcinoma by percutaneous lung biopsy. Lung cancer-related genes and programmed death ligand-1 （PD-L1） were all negative. After chemotherapy，a severe increase in liver transaminase forced to the termination of chemotherapy. The lung tumor continued to progress，leading to respiratory failure that was required for non-invasive ventilator-assisted ventilation. Conclusion Long-term immunosuppressive therapy after liver transplantation for liver cancer may increase the risk of new malignant tumors. Lung adenocarcinoma in such patients has an insidious onset and lacks typical clinical manifestations，and the diagnosis relies on pathological examination. Poor tolerance to chemotherapy is the main difficulty in its treatment. Clinically，individualized diagnosis and treatment plans should be formulated based on the basic post-transplantation conditions. While undergoing anti-tumor treatment，attention should also be paid to the protection of organ functions.

SARS-CoV-2 infection during autologous hematopoietic stem cell transplantation： A report of two cases and literature review

Zhang Yuanyuan, You Jiawen, Song Xiaoning, Zang Meirong, Wang Jiaqi, Meng Jianbo

2025, 40(12):  1113-1118.  doi:10.3969/j.issn.1004-583X.2025.12.011

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Objective To investigate the intervention strategies for multiple myeloma （MM） patients infected with severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） during autologous hematopoietic stem cell transplantation （ASCT） and to analyze the potential regulatory role of post-ASCT immune reconstitution in suppressing excessive inflammatory responses. Methods We report two clinical cases of MM patients （with IgA-λ and IgG-κ types） who contracted SARS-CoV-2 during ASCT，supplemented by a review of relevant literature. Results Following the early initiation of antiviral and antibacterial agents alongside aggressive supportive care，neutrophil recovery coincided with viral clearance in both cases （Case 1： at 10 days post-infection； Case 2： at 3 days post-infection）. Notably，inflammatory markers （C-reactive protein and procalcitonin） remained within reference ranges throughout the clinical course，with no progression to severe disease and no evidence of cytokine storm. Conclusion Although the risk of SARS-CoV-2 infection during ASCT is relatively low，strict protective measures and early，multidimensional intervention strategies are crucial. Furthermore，the unique lymphocyte-depleted state during early immune reconstitution post-ASCT may suppress the release of key proinflammatory cytokines such as IL-6 and TNF-α. This mechanism，coupled with the temporally prioritized reconstitution of the innate immune system，may synergistically reduce the risk of a cytokine storm，providing a critical window for clinical intervention.