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Sichuan Da Xue Xue Bao. Yi Xue Ban = Journal Of Sichuan University. Medical Science Edition[JOURNAL]
Sichuan Da Xue Xue Bao. Yi Xue Ban = Journal Of Sichuan University. Medical Science Edition[JOURNAL]
Sun
200 papers
[Analysis of Responsibilities and Coordination Among Key Stakeholders in Chronic Disease Prevention and Control in China Based on the Innovative Care for Chronic Conditions Framework].
Jiang H, Zhang T, Yang Y … +3 more , Zhou C, Pan J, Wang X
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536663 · Full text
Chronic diseases pose a major public health challenge in China. Clarifying the responsibilities of key stakeholders in chronic disease prevention and control and fostering synergy among them are essential to advancing th...
Chronic diseases pose a major public health challenge in China. Clarifying the responsibilities of key stakeholders in chronic disease prevention and control and fostering synergy among them are essential to advancing the goals of the Healthy China 2030 Initiative. Utilizing the World Health Organization's Innovative Care for Chronic Conditions (ICCC) framework, we systematically analyzed how stakeholder responsibilities are defined in China's chronic disease prevention and control system, along with current coordination efforts and persistent challenges. We propose the following reform recommendations: strengthening governmental leadership by improving legislation and policy implementation standards, expanding health insurance coverage, and enhancing capacity building at the primary care level alongside patient education; establishing cross-departmental coordination mechanisms, encouraging social sector engagement, and improving communication, referral, incentive, and oversight mechanisms; accelerating the development of information system in central/western and rural areas, and promoting the application of big data and artificial intelligence technologies; fostering a supportive social environment through implementing incentive measures, promoting primordial prevention, and advancing healthy community initiatives. The implementation of these multifaceted measures is expected to enhance the quality and efficiency of chronic disease prevention and control, thereby contributing to the achievement of the goals of the Healthy China Initiative.
[Treatment and Prospects of Focal Segmental Glomerulosclerosis].
Deng T, Wang W, Pu L … +4 more , Hou Y, Wu C, Li G, Ye C
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536662 · Full text
Focal segmental glomerulosclerosis (FSGS) is a refractory kidney disease that poses substantial clinical challenges. FSGS is primarily characterized by proteinuria and progressive loss of renal function. Its pathogenesis...
Focal segmental glomerulosclerosis (FSGS) is a refractory kidney disease that poses substantial clinical challenges. FSGS is primarily characterized by proteinuria and progressive loss of renal function. Its pathogenesis is complex and varied, involving immune-mediated injury, podocyte dysfunction, genetic factors, and changes in renal hemodynamics. According to pathologic features and etiology, FSGS can be classified into primary, hereditary, secondary, and undetermined-cause forms. Existing therapeutic strategies are mostly based on specific disease classifications and include the administration of hormones and drugs such as immunosuppressants, angiotensin-converting enzyme inhibitors (ACEIs), or angiotensin receptor blockers (ARBs). For drug-induced FSGS, the key measure is to discontinue the causative drug. On the other hand, for cases caused by hypertension and other factors, controlling blood pressure is a critical component of treatment. However, the effectiveness of current therapeutic strategies remains variable, and the relatively high rates of adverse effects and recurrence underscore the fact that they do not fully meet the clinical needs. Therefore, in-depth exploration and optimization of FSGS treatment strategies, along with the development of novel drugs with enhanced therapeutic efficacy and reduced risks of adverse effects and recurrence, have become the core direction of current renal disease research. With a deeper understanding of the pathogenesis of FSGS, new approaches such as immunomodulation, podocytoprotection, and genetic targeted interventions are emerging, which is expected to promote innovation in treatment modalities and improve prognosis and quality of life for patients. Against this background, this article reviews the status of existing treatments and outlines future directions for research and clinical practice, providing both theoretical basis and practical guidance for exploration in this field.
[Prevalence and Influencing Factors of Functional Gastrointestinal Disorders Among Infants Aged 0 to 9 Months With Gastrointestinal Discomfort in China: A Multicenter Cross-Sectional Survey].
Wang Z, Jia X, Hu C … +20 more , Wu J, Hu D, Zhong Y, Chen J, Hu Y, Li X, Li N, Li Y, Ni J, Xie X, Zhang L, Wang X, Zhang J, Guo J, Hu Z, Yu W, Yang C, Wang H, Yang F, Mao M
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536661 · Full text
OBJECTIVE: To determine the prevalence of functional gastrointestinal disorders (FGIDs) in infants aged 0-9 months with gastrointestinal (GI) discomfort in different cities in China, and to investigate the associated inf...
OBJECTIVE: To determine the prevalence of functional gastrointestinal disorders (FGIDs) in infants aged 0-9 months with gastrointestinal (GI) discomfort in different cities in China, and to investigate the associated influencing factors. METHODS: A multicenter cross-sectional survey was conducted. The questionnaire was developed based on the Rome Ⅳ Diagnostic Questionnaire for FGIDs in Neonates and Toddlers and published literature. Data were collected from infants aged 0-9 months with GI discomfort at 17 hospitals across 14 cities in eastern, central, and western China. Information on family demographics, neonatal records, feeding history, types and frequency of GI symptoms was collected. Logistic regression was performed to explore factors associated with FGIDs. RESULTS: A total of 2528 infants aged 0-9 months with GI discomfort were enrolled, with 1315 males (52.02%) and 1213 females (47.98%). Among the surveyed infants, 72.55% were diagnosed with FGIDs, with no statistically significant difference in prevalence between male and female infants ( = 0.397). Regurgitation, with a prevalence of 39.83%, was the most common FGID. The prevalence of regurgitation and colic in infants decreased with increasing age, while the prevalence of dyschezia and functional constipation increased with increasing age. The prevalence of a single symptom was 57.48%, and approximately 15% of infants presented with 2 or more symptoms. The proportion of those presenting with 2 or more symptoms was the highest in infants aged 0-3 months (22.02%), whereas infants aged 6 to 9 months predominantly presented with a single symptom (65.96%). Univariate logistic regression identified significant associations between FGIDs and the geographic region, parental educational attainment, monthly per capita household income, infant age in days, gestational age at birth, duration of exclusive breastfeeding, and probiotic use (all < 0.05). Logistic regression analysis results showed that residing in the western region (odds ratio [OR] = 0.407, 95% CI: 0.324-0.510), probiotic use (OR = 0.69, 95% CI: 0.560-0.847), gestational age at birth (OR = 0.914, 95% CI: 0.837-0.998), and the duration of exclusive breastfeeding > 4 months (OR = 0.75, 95% CI: 0.595-0.946) were significant factors influencing the occurrence of FGIDs (all < 0.05). CONCLUSION: FGIDs are highly prevalent among infants aged 0-9 months with gastrointestinal symptoms in China. Their occurrence is linked to geographic region, probiotic use, gestational age, and breastfeeding duration. Future studies should focus on whether improved feeding guidance and breastfeeding promotion can help prevent FGIDs.
[Archeological Research on Third Molar Degeneration].
Huang H, Zhou J, Zhou X
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536660 · Full text
The degeneration of the third molar (wisdom tooth) represents a key marker of human dental evolution. Archaeological investigations of this phenomenon provide important insights into the living environment, dietary compo...
The degeneration of the third molar (wisdom tooth) represents a key marker of human dental evolution. Archaeological investigations of this phenomenon provide important insights into the living environment, dietary composition, health status, and evolutionary relationships of ancient populations. In this article, we systematically reviewed archaeological evidence of third molar degeneration in China from the Paleolithic through historical periods, focusing on 3 principal manifestations-impaction, congenital absence, and morphological abnormalities. Evidence indicates that third molar impaction can be traced back to from approximately 2.3 million years ago, with a notable qualitative transition occurring during the Neolithic period, when frequencies increased substantially. Congenital absence has been documented in Lantian Man () and shows marked regional and temporal variations across different historical periods. Morphological abnormalities primarily manifested as peg-shaped teeth and size reduction, reflecting the ongoing evolutionary process of dental degeneration. These archeological findings not only provide crucial support for understanding the biological mechanisms underlying human adaptation to environmental changes, but also provide historical references for modern oral medicine, particularly in disease prevention and treatment strategies. Furthermore, these archeological findings lay the foundation for promoting a deeper integration of archeology with modern medicine and add new dimensions to the study of human civilization.
[Case Report of One Family With Coffin-Lowry Syndrome and Literature Review of 28 Cases in China].
Zhu D, Yang W, Zhang L
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536659 · Full text
OBJECTIVE: To investigate the clinical phenotypes and genotypic characteristics of Chinese patients with Coffin-Lowry syndrome. METHODS: The clinical data and genetic test results of a family with Coffin-Lowry syndrome w...
OBJECTIVE: To investigate the clinical phenotypes and genotypic characteristics of Chinese patients with Coffin-Lowry syndrome. METHODS: The clinical data and genetic test results of a family with Coffin-Lowry syndrome were retrospectively analyzed. A literature review was conducted to summarize the clinical characteristics and gene mutation characteristics of patients with Coffin-Lowry syndrome in China. RESULTS: The proband was a 1-year-old boy with distinctive facial features, puffy but tapered fingers, hypotonia, growth retardation, and delayed cognitive and motor development. Genetic analysis revealed a hemizygous mutation in intron 17 of the gene in the proband. His mother was a heterozygous carrier. The identified mutation has not been reported previously. The proband's maternal half-brother and half-sister also exhibited similar clinical manifestations and were diagnosed with Coffin-Lowry syndrome together with the proband. The proband was followed up until 3 years and 8 months old, by which time he was not capable of walking steadily independently or speech. Including the 4 members of this family, a total of 28 Chinese patients were identified. Their clinical manifestations included special facial features (100%), cognitive and language/motor developmental delays (92.6%), hypotonia (95.2%), tapered fingers (88.5%), and scoliosis or kyphosis (45%). Genetic sequencing was performed in 24 patients, revealing missense mutations in 3 cases (12.5%), frameshift mutations in 5 cases (20.8%), nonsense mutations in 9 cases (37.5%), splice-site mutations in 4 cases (16.7%), and exon deletions in 2 cases (8.3%). No mutation hotspots were identified. CONCLUSION: Coffin-Lowry syndrome should be considered in children with cognitive and language/motor developmental delays, distinctive facial features, tapered fingers, and hypotonia. Genetic testing can assist with early diagnosis.
[Development of a Reverse Transcription Loop-Mediated Isothermal Amplification Assay for the Detection of Genogroup Ⅱ Norovirus].
Liu Y, Zhang J, Zhao C … +1 more , Wang J
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536658 · Full text
OBJECTIVE: To establish a rapid testing method for genogroup Ⅱ (GⅡ) norovirus based on reverse transcription loop-mediated isothermal amplification (RT-LAMP). METHODS: The conserved region of norovirus was screened using...
OBJECTIVE: To establish a rapid testing method for genogroup Ⅱ (GⅡ) norovirus based on reverse transcription loop-mediated isothermal amplification (RT-LAMP). METHODS: The conserved region of norovirus was screened using the genomic data from the National Center for Biotechnology Information (NCBI) database, and specific primers were designed using the online software Primer Explorer V5. The testing system was established through optimization of experimental conditions, including reaction temperature, MgSO concentration, dNTP concentration, etc. The sensitivity and specificity of the method were evaluated. The optimized testing method was used to analyze clinical stool samples, and the results were compared with those of a commercially available kit. RESULTS: The established testing method exhibited high specificity, showing no cross-reactivity with adenovirus, human enterovirus, or rotavirus. The testing method also exhibited high sensitivity, with a detection limit of 51 copies/μL. The turnaround time was 45 min. For 34 stool samples from patients infected with norovirus, the testing results were highly consistent with those of the commercial kit, with a sensitivity of 100%, a specificity of 83.33%, and an area under the receiver operating characteristic (ROC) curve of 0.97 (95% CI: 0.92-1.00), indicating the high accuracy and reliability of the testing method. CONCLUSION: In this study, we successfully developed an RT-LAMP-based testing method for GⅡ norovirus, which exhibits excellent sensitivity, specificity, and practical performance in clinical sample testing, making it suitable for use in primary care laboratories and for rapid testing in field settings.
[Effect of Blood Biochemical Indicators on Exercise Duration in Patients With Stages 3-5 Chronic Kidney Disease: The Mediating Role of Physical Function Status].
Yang Y, Chen H, Liu W … +1 more , Qi X
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536657 · Full text
OBJECTIVE: To investigate the effects of blood biochemical indicators on physical functional status and exercise duration in patients with chronic kidney disease (CKD) in stages 3-5. METHODS: A total of 156 patients with...
OBJECTIVE: To investigate the effects of blood biochemical indicators on physical functional status and exercise duration in patients with chronic kidney disease (CKD) in stages 3-5. METHODS: A total of 156 patients with stages 3-5 CKD admitted to our hospital between March 2021 and February 2024 were enrolled in the study. General information questionnaires, the Karnofsky Performance Status (KPS) scale of functional status, and the International Physical Activity Questionnaire-Long Form (IPAQ-L) were used for data collection. Blood biochemical indicators were assessed through blood tests. Patients who engaged in physical activity meeting the recommended standards of the CKD clinical practice guidelines were defined as the high-level exercise group, while the others were defined as the low-level exercise group. Pearson correlation analysis was performed to examine the relationship between blood biochemical indicators, physical functional status, and exercise duration. Multiple linear regression was performed to identify factors influencing exercise duration. The SPSS macro program Process 4.1 was used to analyze the mediating effect. RESULTS: The average KPS score of the 156 patients with stage 3-5 CKD was 77.03 ± 11.99, and the average weekly exercise duration was (71.67 ± 10.16) min. Compared with the high-level group, the low-level group had lower hemoglobin (Hb) ([94.76 ± 16.98] g/L) and serum albumin (Alb) ([30.96 ± 6.35] g/L) levels and a higher blood urea nitrogen (BUN) ([13.45 ± 3.28] mmol/L) level ( < 0.05). Hb levels were positively correlated with physical functional status ( = 0.248, 95% CI: 0.085 to 0.402) and exercise duration ( = 0.231, 95% CI: 0.081 to 0.372). Alb was positively correlated with physical functional status ( = 0.192, 95% CI: 0.044 to 0.329) and exercise duration ( = 0.238, 95% CI: 0.071 to 0.380). BUN was negatively correlated with physical functional status ( = －0.277, 95% CI: －0.404 to －0.115) and exercise duration ( = －0.277, 95% CI: －0.397 to －0.142). Physical functional status was positively correlated with exercise duration (=0.240, 95% CI: 0.084 to 0.375). The factors influencing exercise duration were Hb ( = 0.160, 95% CI: 0.004 to 0.179), Alb ( = 0.162, 95% CI: 0.011 to 0.460), and BUN ( = －0.221, 95% CI: －1.199 to －0.220) levels ( < 0.05). The physical functional status played a partial mediating role between blood biochemical indicators and exercise duration, accounting for 20.45%, 16.14%, and 17.55% of the total effects of Hb, Alb, and BUN on exercise duration, respectively. CONCLUSION: Hb, Alb, and BUN can directly affect the exercise duration of patients with CKD in stages 3-5, and can also indirectly affect the exercise duration of patients through physical functional status.
[Current Status and Influencing Factors of Healthcare Satisfaction Among Chronic Disease Patients Under the Background of Compact County-Level Medical Alliances: A Mixed Methods Study].
Liao C, Weng L, Chen C
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536656 · Full text
OBJECTIVE: To analyze the current status of patient satisfaction with outpatient care and the relevant influencing factors among patients with chronic diseases in a compact county-level medical alliance, and to provide e...
OBJECTIVE: To analyze the current status of patient satisfaction with outpatient care and the relevant influencing factors among patients with chronic diseases in a compact county-level medical alliance, and to provide evidence for optimizing chronic disease management in primary care settings. METHODS: Based on the Andersen's Behavioral Model of Health Services Use, an explanatory sequential mixed-methods design was employed in the study. In the quantitative phase, a questionnaire survey was conducted among 297 patients with chronic diseases to collect data on patient satisfaction. The influencing factors were analyzed using ordinal logistic regression, and pathway effects were examined using structural equation modeling. In the qualitative phase, semi-structured interviews were conducted and 13 patients with the highest and lowest scores for patient satisfaction were involved. Then, the key themes were extracted using thematic analysis. RESULTS: The overall patient satisfaction score was rather high ([4.67 ± 0.58] points on a 5-point scale). Significant influencing factors included age (odds ratio [OR] = 1.03, 95% CI: 1.01-1.06), education (senior high school or above: OR = 3.34, 95% CI: 1.21-9.24), knowledge of health insurance reimbursement (moderately informed: OR = 0.54, 95% CI: 0.31-0.96), annual out-of-pocket expenditure for chronic diseases (> 1500 yuan: OR = 0.40, 95% CI: 0.17-0.90), satisfaction with facility environment (OR = 2.59, 95% CI: 1.38-4.84), and satisfaction with service capability (OR = 3.00, 95% CI: 1.29-6.97). By influencing the contextual characteristics, individual characteristics had a positive effect on healthcare provider behaviors and medical outcomes, and healthcare provider behaviors also had a direct positive effect on medical outcomes. Thematic analysis of the interviews revealed four key areas of improvement- suboptimal diagnosis and treatment processes, insufficient healthcare professional competence, underutilization of facilities, and inadequate health education and management. CONCLUSION: Measures such as strengthening training for village doctors, optimizing referral mechanisms, promoting telemedicine, and improving health education approaches are recommended to enhance patient experience and satisfaction.
[Multilevel Analysis of Value Alignment With Medical Care and Prevention Integration Among Family Doctors and Health Status of Chronic Disease Patients: The Mediating Role of Team Cohesion].
Pan Y, Zhang K, Huang Y … +2 more , Qing H, Tang S
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536655 · Full text
OBJECTIVE: To explore the association between the value alignment with medical care and prevention integration among family doctors and the health status of patients with chronic diseases, and to analyze the mediating ef...
OBJECTIVE: To explore the association between the value alignment with medical care and prevention integration among family doctors and the health status of patients with chronic diseases, and to analyze the mediating effect of team cohesion between them. METHODS: SA survey was conducted in 4 cities in the eastern, central and western regions of China. In each city, chronic disease patients and their contracted family doctors were enrolled in 6 randomly selected townships or neighborhoods. Self-developed scales were used to assess the value identification with medical care and prevention integration among family doctors, as well as their team cohesion. The Chinese version of the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire was used to assess the health status of patients. A multilevel regression model was applied to analyze variables at two levels-patients and family doctors. The mediating effect was analyzed using a multilevel structural equation model. RESULTS: A total of 5855 patients with chronic diseases and 164 family doctors were included. The correlation between value alignment with medical care and prevention integration among family doctors and the health status of patients was statistically significant ( = 0.089, 95% CI: 0.042-0.136). Team cohesion played a mediating role between them ( = 0.030), accounting for 5.23% of the total effect, with an indirect effect value of 0.054 and a 95% bootstrap confidence interval of 0.005-0.103. CONCLUSION: IIt is important to establish appropriate performance evaluation and incentive mechanisms and team collaboration mechanisms in the promotion of medical care and prevention integration, so as to improve the effect of health management for patients.
[Correlation of Serum Neuron-Specific Enolase, Angiopoietin-1, and Angiopoietin-Like Protein-3 With Disease Severity and Their Prognostic Value in Patients With Cerebral Infarction].
Liu J, Gao H, Liu Y
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536654 · Full text
OBJECTIVE: To investigate the association between the disease severity and prognosis of cerebral infarction patients and serum levels of neuron-specific enolase (NSE), angiopoietin-1 (Ang-1), and angiopoietin-like protei...
OBJECTIVE: To investigate the association between the disease severity and prognosis of cerebral infarction patients and serum levels of neuron-specific enolase (NSE), angiopoietin-1 (Ang-1), and angiopoietin-like protein-3 (ANGPTL3). METHODS: A total of 510 patients with cerebral infarction admitted to the Department of Neurology, the First People's Hospital of Jiujiang City, Jiangxi Province between February 2022 and May 2024 were enrolled. According to their disease severity, the patients were divided into a mild group ( = 192), a moderate group ( = 215), and a severe group ( = 103). After treatment, the patients were further divided into a good prognosis group ( = 384) and a poor prognosis group ( = 126). During the same period, 121 healthy individuals were included as a control group. During the same period, 121 healthy individuals were included in a control group. Serum levels of NSE, Ang-1, and ANGPTL3 of all patients were measured upon admission. The correlations between these biomarkers and disease severity were analyzed. The predictive value of each biomarker alone and that of the 3 biomarkers in combination for poor prognosis in patients with cerebral infarction were assessed using receiver operating characteristic (ROC) curves. RESULTS: Serum NSE and ANGPTL3 levels in the severe group were significantly higher than those in the moderate and mild groups, whereas the serum Ang-1 levels in the severe group were significantly lower than those in the moderate and mild groups (all < 0.05). Spearman correlation analysis showed that serum NSE and ANGPTL3 levels were positively correlated with disease severity ( = 0.179 and 0.313, respectively, < 0.05), while serum Ang-1 levels were negatively correlated with disease severity ( = －0.187, < 0.05). Prognostic analysis revealed that serum NSE and ANGPTL3 levels were higher, while serum Ang-1 levels were lower, in the poor prognosis group compared with the good prognosis group (all < 0.05). Multivariate logistic regression revealed that serum levels of NSE (odds ratio [OR] = 1.228, 95% CI: 1.146-1.316), Ang-1 (OR = 0.059, 95% CI: 0.020-0.178), and ANGPTL3 (OR = 1.334, 95% CI: 1.256-1.417) were major factors associated with prognosis in patients with cerebral infarction (all < 0.05). ROC curves showed that serum NSE, Ang-1, and ANGPTL3 levels in combination yielded an area under the curve (AUC) of 0.904 (95% CI: 0.871-0.936), with a sensitivity of 79.40% and a specificity of 89.60%. The Hosmer-Lemeshow test of the model showed a good predictive performance ( = 7.423, = 0.492). CONCLUSION: The severity and prognosis of cerebral infarction patients are strongly correlated with high serum NSE and ANGPTL3 levels and low Ang-1 levels. Monitoring changes in these 3 biomarkers may inform clinical treatment of patients with cerebral infarction.
[Bacterial Infection Spectrum and Antimicrobial Resistance in 2850 Cases of Community-Acquired Pneumonia in Children].
Zhong M, Xie J, Wang H … +4 more , Fan J, Li M, Zou F, Li L
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536653 · Full text
OBJECTIVE: To analyze the distribution characteristics and drug resistance of bacterial pathogens in children with community-acquired pneumonia (CAP) in a single center, and to provide evidence for clinical diagnosis and...
OBJECTIVE: To analyze the distribution characteristics and drug resistance of bacterial pathogens in children with community-acquired pneumonia (CAP) in a single center, and to provide evidence for clinical diagnosis and treatment. METHODS: A total of 2850 children with CAP admitted to the Department of Pediatrics of a tertiary hospital in Sichuan between January 2022 and December 2024 were enrolled. Clinical data, sputum culture and bacterial drug sensitivity results, and respiratory pathogen nucleic acid testing results were collected. A retrospective analysis was conducted on the clinical data, etiological testing results, and drug sensitivity data. RESULTS: Among the 2850 CAP children, the overall pathogen positivity rate was 73.4% (2093/2850), with viral, bacterial, and / infections accounting for 33.6% (958/2850), 32.6% (929/2850), and 24.7% (703/2850), respectively. The predominant bacterial pathogens identified were (38.8%), (29.7%), (21.4%), and (10.1%). Multivariable logistic regression analysis (Bonferroni-corrected) revealed that age was an independent risk factor for bacterial infection, although the risk profile varied by bacterial species. The risk of infection was highest during infancy (infancy adjusted odds ratio [aOR] = 1) and was significantly lower among the school-age children (aOR = 0.09, 95% CI: 0.02-0.52). The risk of infection peaked in the preschool children (aOR = 2.66, 95% CI: 1.75-4.05), followed by school-age children (aOR = 2.60, 95% CI: 1.48-4.57) and toddlers (aOR = 1.90, 95% CI: 1.26-2.87). The risk of infection significantly decreased in school-age children (aOR = 0.24, 95% CI: 0.08-0.69). Antimicrobial susceptibility testing demonstrated that the resistance rates of and to ampicillin were 75.45% and 41.53%, respectively. The resistance rate of to erythromycin was 93.75%, while that of to penicillin was 83.33%. CONCLUSION: In this pediatric CAP cohort, the main bacterial pathogens are , , , and . The distribution of bacterial pathogens exhibits distinct age-specific characteristics.
[Clinical Study of Different Doses of Glucocorticoids in the Treatment of Severe Pneumonia in Children].
Wang X, Wang Y, Li J … +1 more , Zou Y
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536652 · Full text
OBJECTIVE: To analyze the clinical characteristics of children with severe pneumonia (SMPP) treated with different doses of glucocorticoids (GC) and to investigate factors associated with GC treatment efficacy on the ba...
OBJECTIVE: To analyze the clinical characteristics of children with severe pneumonia (SMPP) treated with different doses of glucocorticoids (GC) and to investigate factors associated with GC treatment efficacy on the basis of propensity score matching (PSM). METHODS: Clinical data from 271 children who were hospitalized at Tianjin Children's Hospital between January 1, 2021 and December 31, 2022, and who received GC treatment for SMPP were retrospectively collected. The patients were divided into low-dose (methylprednisolone ≤ 2 mg/[kg·d]) and high-dose (methylprednisolone > 2 mg/[kg·d]) groups. A 1∶1 PSM based on the matching variables, including time from onset to admission, time from fever onset to GC administration, and time from GC administration to follow-up chest X-ray, was performed to reduce confounding factors, resulting in 90 matched pairs in total in the low-dose and high-dose groups. Clinical characteristics were compared between the two groups after PSM. Multivariate logistic regression was performed to identify risk factors for high-dose GC use. The 90 pairs of children were further divided into an ineffective group ( = 38) and an effective group ( = 142) on the basis of clinical treatment outcomes, and multivariate logistic regression was conducted to determine risk factors for clinical GC treatment failure. RESULTS: Children in the high-dose group were younger and had higher platelet counts and a higher incidence of atelectasis (all < 0.05). The high-dose group showed a shorter time to fever resolution and overall duration of fever, but higher rates of adverse drug reactions (nausea, vomiting, abdominal pain, diarrhea, rash, etc.) compared with the low-dose group (all < 0.05). No severe adverse events, such as hyperglycemia, hyperlipidemia, hypertension, gastrointestinal bleeding, or perforation, were observed in either group. Radiographic assessment showed a significantly higher rate of marked absorption in the high-dose group ( = 0.009). There were no significant differences between the groups in the length-of-stay, time to cough relief, or time to disappearance of pulmonary rales (all > 0.05). Younger age, atelectasis, and elevated platelet count were identified as risk factors for selecting high-dose GC therapy using multivariate logistic regression analysis. Compared with the GC-effective group, the GC-ineffective group had a higher proportion of refractory pneumonia (RMPP), a higher incidence of chest pain, and significantly increased levels of neutrophil-to-lymphocyte ratio, peak fever, procalcitonin, ferritin, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, and D-dimer (all < 0.05), along with decreased lymphocyte counts ( < 0.05). There were no significant differences between the 2 groups in age or the proportion of children receiving high-dose GC (all > 0.05). Multivariate analysis showed that RMPP and high peak fever were independent risk factors for GC treatment failure. CONCLUSION: High-dose GC therapy may facilitate fever resolution, shorten the duration of fever, and enhance radiological improvement. However, its overall efficacy is not significantly superior to low-dose therapy and is associated with a higher incidence of adverse reactions. Younger age, atelectasis, and elevated platelet count are key factors influencing the use of high-dose GC in children. Notably, RMPP and high peak fever are independent risk factors for GC treatment failure, irrespective of the GC dosage. Clinicians should carefully evaluate the individualized risk-benefit profile when considering high-dose GC therapy for pediatric SMPP.
[Performance of Plasma Multigene Methylation Testing in Early Diagnosis of Colorectal Cancer].
Sheng N, Guo Y, Hou X … +2 more , Wang Y, Xu Y
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Nov · PMID 41536651 · Full text
OBJECTIVE: To explore the performance of a predictive model based on plasma multigene methylation testing in the early diagnosis of colorectal cancer (CRC). METHODS: A total of 688 patients with suspected CRC who underwe...
OBJECTIVE: To explore the performance of a predictive model based on plasma multigene methylation testing in the early diagnosis of colorectal cancer (CRC). METHODS: A total of 688 patients with suspected CRC who underwent diagnostic examination at the Affiliated Hospital of Xuzhou Medical University between July 2022 and June 2024 were enrolled. The plasma methylation status of 5 genes, including (septin 9), (branched chain amino acid transaminase 1), (IKAROS family zinc finger 1), (brevican), and (vav guanine nucleotide exchange factor 3), was assessed before pathological biopsy. The negative or positive results of the methylation testing of the 5 genes were compared with the clinical pathological diagnosis results of the same participants to construct a predictive model based on the methylation status of , , , , and genes, and the performance of the predictive model in the early diagnosis of CRC patients was evaluated. RESULTS: Of the 688 patients, 48 had a pathologically confirmed diagnosis of colorectal carcinoma. The diagnostic performance of a single-gene methylation status for CRC was as follows: showed a sensitivity of 47.92%, specificity of 96.72%, and AUC of 0.804 (95% CI: 0.672-0.899); showed a sensitivity of 52.08%, specificity of 96.88%, and AUC of 0.753 (95% CI: 0.702-0.864); showed a sensitivity of 50.00%, specificity of 98.28%, and AUC of 0.740 (95% CI: 0.635-0.881); showed a sensitivity of 33.33%, specificity of 98.75%, and AUC of 0.690 (95% CI: 0.572-0.785); showed a sensitivity of 35.42%, specificity of 97.66%, and AUC of 0.686 (95% CI: 0.597-0.734). A diagnostic model integrating the 5 genes achieved a sensitivity of 85.42%, specificity of 93.40%, and AUC of 0.916 (95% CI: 0.835-0.972). The diagnostic sensitivities of the model for CRC of different stages were 85.71% for stage Ⅰ, 92.86% for stage Ⅱ, 78.95% for stage Ⅲ, and 87.50% for unstaged cases. CONCLUSION: A diagnostic model based on the methylation levels of the , , , , and genes in plasma demonstrates good diagnostic performance for CRC, particularly in early-stage cases.
[Cheng's Juanbi Decoction Inhibits Rheumatoid Arthritis Pathology by Blocking the WTAP-Wnt7b-Wnt/β-Catenin Signaling Axis].
Wu Y, Xu W, Yuan M … +6 more , Zhou X, Cai Y, Cao H, Duan Q, Tao T, Miao C
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Sep · PMID 41426011 · Full text
OBJECTIVE: Cheng's Juanbi Decoction (CSJBD) is a classic traditional Chinese medicine formula for treating rheumatoid arthritis (RA), exhibiting significant clinical efficacy, but the underlying mechanisms remain unclear...
OBJECTIVE: Cheng's Juanbi Decoction (CSJBD) is a classic traditional Chinese medicine formula for treating rheumatoid arthritis (RA), exhibiting significant clinical efficacy, but the underlying mechanisms remain unclear. We investigated whether CSJBD inhibited RA pathology by blocking the WTAP-Wnt7b-Wnt/β-catenin signaling axis using a collagen-induced arthritis (CIA) mouse model and fibroblast-like synoviocytes (FLSs) derived from RA patients (RA FLSs) and examined the underlying mechanisms. METHODS: We conducted experiments. Male C57BL/6 mice weighing 17 to 20 g were used to establish the CIA model. The mice were assigned to 6 groups, including the normal group, the model (CIA) group, the model + CSJBD-L (8.1 g/kg) group, the model + CSJBD-M (16.2 g/kg) group, the model + CSJBD-H (32.4 g/kg) group, and the model + leflunomide (LEF) (0.05 mg/10 g) group, with 10 mice in each group. CSJBD was administered twice daily via gastric gavage, while LEF was administered once daily via gastric gavage, for a duration of 28 days. We also conducted experiments. RA FLSs were assigned to 4 groups, including the RA FLSs + CSJBDS-L group receiving 10% CSJBDS-containing serum, the RA FLSs + CSJBDS-M group receiving 15% CSJBDS-containing serum, the RA FLSs + CSJBDS-H group receiving 20% CSJBDS-containing serum, and the RA FLSs + NC group (negative control). To study whether WTAP regulated Wnt7b, RA FLSs were divided into the RA FLSs group, the RA FLSs + si-#3 group, the RA FLSs + si-#3 + Wnt7b-OE group, and the RA FLSs + si-#3 + Wnt7b-NC group. To study the underlying mechanism by which CSJBT affected RA FLSs, RA FLSs were divided into the RA FLSs group, the RA FLSs + CSJBDS-M group, the RA FLSs+CSJBDS-M + Wnt7b-OE group, and the RA FLSs+CSJBDS-M + NC group. We used ultra-high performance liquid chromatography (UPLC) to identify and quantify key monomer compounds from CSJBD as quality criteria for CSJBD preparation. Bioinformatics, CCK-8, RT-qPCR, Western blot, immunofluorescence, and related methods were employed to assess the therapeutic efficacy and underlying mechanisms of CSJBD in treating RA. RESULTS: According to the UPLC analysis, ferulic acid, osthole, mulberroside A, notopterol, and gentiopicroside were identified as quality control standards for the preparation of CSJBD formula. CSJBD improved RA pathology in CIA mice, reduced the levels of interleukin (IL)-6, IL-1β, IL-8, and tumor necrosis factor-α (TNF-α) in their serum, and decreased the expression of RA pathological genes and fibronectin, with the difference between groups being statistically significant. Bioinformatics analysis suggested that CSJBD might inhibit RA pathology by suppressing the Wnt/β-catenin signaling pathway through Wnt7b. Experimental results showed that the expression of WTAP and Wnt7b was significantly increased in RA. After knocking down , the expression of Wnt7b was significantly reduced, and the Wnt/β-catenin signaling pathway was also inhibited, with the difference between groups being statistically significant ( < 0.05), confirming that WTAP regulated the pathway via Wnt7b. According to experimental verification, CSJBD significantly inhibited the Wnt/β-catenin signaling pathway and the proliferation of RA FLSs. Wnt7b overexpression reversed the inhibitory effect of CSJBD on the Wnt/β-catenin signaling pathway and the proliferation of RA FLSs, indicating that Wnt7b is the direct target of CSJBD. CONCLUSION: CSJBD inhibits RA pathology by blocking the WTAP-Wnt7b-Wnt/β-catenin signaling axis, with Wnt7b identified as a direct therapeutic target of CSJBD.
[Advances in the Application of Forensic Microbiome Analysis in Tissue Source Inference].
Yao H, Sun C, Wang S … +4 more , Zhou Y, Zhang Z, Song F, Luo H
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Sep · PMID 41416172 · Full text
Forensic microbiology, a pivotal discipline within forensic science, focuses on microorganisms as the primary subject of study and applies life science technologies to analyze microbial evidence in criminal and civil inv...
Forensic microbiology, a pivotal discipline within forensic science, focuses on microorganisms as the primary subject of study and applies life science technologies to analyze microbial evidence in criminal and civil investigations. Tissue source inference plays a crucial role in forensic investigations, facilitating case assessment and crime scene reconstruction. The application of microbiome analysis in tissue source inference benefits from the tissue specificity and spatiotemporal stability of human microbial communities. This article provides a systematic review of recent advances in tissue source inference based on microbiome analysis, covering technological development, research trends, and practical applications. Finally, the challenges confronted in practice in forensic microbiology and the future prospects for its development are summarized.
[Exploring the Core Influencing Factors in the Cultivation of Critical Thinking Skills Among Medical Students Using the Grounded Theory and the Decision-Making Trial and Evaluation Laboratory].
Wu Y, He W, Wang D … +1 more , Wang K
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Sep · PMID 41416171 · Full text
OBJECTIVE: To investigate the perspectives and consensus among high-level medical professionals in China regarding critical thinking skills, identify key factors influencing the cultivation of critical thinking skills am...
OBJECTIVE: To investigate the perspectives and consensus among high-level medical professionals in China regarding critical thinking skills, identify key factors influencing the cultivation of critical thinking skills among medical students, propose optimization strategies, and provide both theoretical and practical guidance for standardizing mechanisms of critical thinking training within the medical education system. METHODS: A mixed-methods approach was employed. Semi-structured in-depth interviews were conducted with 22 core personnel involved in critical thinking training from multiple medical universities, hospitals, and clinical research teams across China between March 2023 and June 2023. Grounded theory was applied to explore the influencing factors, and the decision-making trial and evaluation laboratory (DEMATEL) method was applied to construct a structural model of the influencing factors. Centrality and causality analyses were conducted to examine the interrelationships among factors. RESULTS: The grounded theory analysis revealed a shared conceptual understanding of critical thinking skills among the participants, who emphasized that the development of critical thinking skills was influenced by multiple factors, including individual traits, teaching methods, and institutional environments. According to the DEMATEL analysis, 13 core factors influencing the development of critical thinking skills in high-level medical professionals were identified. Among these, knowledge foundation was the most important influencing factor, exhibiting the highest centrality (22.35). Curriculum design was the second most important influencing factor. CONCLUSION: The cultivation of critical thinking skills in medical education exhibits a multi-level interactive structure that encompasses individual, organizational, and institutional dimensions. Future efforts should focus on reinforcing the cognitive scaffolding role of knowledge construction and interdisciplinary curriculum design.
[Archaeological Research on Periodontal Disease].
Zhou X, Zhou J
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Sep · PMID 41416170 · Full text
Periodontal disease is one of the most common infectious diseases affecting the oral cavity, with dental plaque biofilm and dental calculus being the primary pathogenic factors. Periodontal disease represents one of the...
Periodontal disease is one of the most common infectious diseases affecting the oral cavity, with dental plaque biofilm and dental calculus being the primary pathogenic factors. Periodontal disease represents one of the leading causes of tooth loss in adults. According to the Fourth National Oral Health Epidemiological Survey, the incidence of periodontal disease remains high in China. As an odontogenic lesion, periodontal disease is also one of the principal oral conditions that can aggravate or trigger systemic diseases. It is closely associated with the onset and progression of cardiovascular, respiratory, gastrointestinal, metabolic, and bone-related diseases, as well as adverse pregnancy outcomes and mental health problems. Periodontal disease is also among the oldest diseases afflicting humans, accompanying human evolution and development throughout history. Archaeological research on periodontal disease provides an in-depth understanding of the occurrence and characteristics of periodontal disease and dental calculus formation in ancient humans. Such studies also help elucidate the dietary structures, lifestyle habits, general health status, and the evolution of disease spectrum of ancient populations. Consequently, research on periodontal disease provides important historical evidence for the study of human evolution, the development of civilization, and strategies for the prevention and treatment of periodontal diseases at the population level.
[Advances in Novel Disinfection Technologies for Biofilm-Associated Nosocomial Infections].
Ke D, Tan X, Chen K … +6 more , Xue X, An N, Ye K, Zhang X, Li Y, Zeng J
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Sep · PMID 41416169 · Full text
The elimination of biofilms is a crucial step in controlling hospital-acquired infections. Once biofilms colonize luminal instruments, it is difficult to remove them using traditional disinfection methods. Conventional d...
The elimination of biofilms is a crucial step in controlling hospital-acquired infections. Once biofilms colonize luminal instruments, it is difficult to remove them using traditional disinfection methods. Conventional disinfection approaches now face a series of challenges, including microbial resistance, corrosiveness, cytotoxicity, residual disinfection byproducts, and environmental pollution. Therefore, developing novel disinfection technologies specifically targeting biofilm removal is vitally important. New disinfection technologies, such as slightly acidic electrolyzed water, plasma technology, surface modification techniques, nanomaterial-based disinfection, bacteriophage disinfection, and enzymatic disinfection, are constantly emerging. These technologies exhibit excellent performance against biofilms by leveraging the synergistic effects of multiple mechanisms, including the reactive oxygen species (ROS) burst, photocatalytic oxidation, physical disruption, and biological targeting. This review summarizes the characteristics, underlying mechanisms, and potential application scenarios of these novel disinfection technologies, with a particular focus on their effects against biofilms formed by common pathogenic bacteria on surfaces in hospital settings. It aims to provide a reference basis for the practical application and translation of these disinfection technologies and the development of new disinfection strategies.
[Evaluation of Gradient-Variant Quantum Dot Fluorescence Technology for Rapid Detection of ].
Li J, Wang X, Wang J … +7 more , Tian S, Zhao C, Wang X, Jian W, Li S, Zhang Q, Zhou L
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Sep · PMID 41416168 · Full text
OBJECTIVE: To establish a brucellosis monitoring and testing technique applicable for the rapid field screening of natural epidemic diseases. METHODS: A rapid testing technique for was developed based on a double-antibo...
OBJECTIVE: To establish a brucellosis monitoring and testing technique applicable for the rapid field screening of natural epidemic diseases. METHODS: A rapid testing technique for was developed based on a double-antibody sandwich testing model using gradient-variant quantum dots as fluorescent tracers. The sensitivity, linearity, precision, and specificity of the technique were evaluated using suspensions of standard strains. Methodological comparisons across different sample types were conducted to assess the consistency of the test results. RESULTS: The gradient-variant quantum dots detection method was evaluated with standard strains, exhibiting a sensitivity of 1 × 10 CFU/mL and a linear correlation coefficient () of 0.994 (95% CI, 0.933-1.055). The maximum coefficient of variation was 12.94% in repeated tests, showing good specificity. A comparative assessment of 305 clinical samples was conducted using the gradient-variant quantum dots detection method, the Rose Bengal plate agglutination test (RBT), and the serum agglutination test (SAT), yielding a Kappa value of 0.95, indicating almost perfect agreement. Additionally, a comparative assessment of 110 environmental samples collected on-site was conducted using the gradient-variant quantum dots detection method and quantitative real-time PCR (qPCR). The Kappa values for aerosol collection fluid, surface wipes, and wool samples were all above 0.83, demonstrating near-perfect agreement. For fecal and soil samples, the Kappa values were above 0.62, indicating substantial agreement. CONCLUSION: The detection method based on gradient-variant quantum dots technology is simple and can be conducted rapidly. The detection method demonstrates high sensitivity, linearity, precision, and specificity. It shows consistent performance in clinical sample testing. It is well-suited for field rapid screening of natural epidemic diseases in field settings and shows good application prospects in the monitoring, prevention, and rapid detection of zoonotic diseases.
[Association Between Obstructive Sleep Apnea and Behavioral Problems in Children].
Zhao X, Li W, Zhou J … +4 more , Jiang L, Wang X, Ou X, Zhang X
Sichuan Da Xue Xue Bao Yi Xue Ban · 2025 Sep · PMID 41416167 · Full text
OBJECTIVE: To investigate the effect of obstructive sleep apnea (OSA) on behavioral problems in children and the association between them. METHODS: A simple random sampling method was used to select 100 children aged 4 t...
OBJECTIVE: To investigate the effect of obstructive sleep apnea (OSA) on behavioral problems in children and the association between them. METHODS: A simple random sampling method was used to select 100 children aged 4 to 12 years for the case group. All of them were diagnosed with OSA through overnight polysomnography at the Sleep Medicine Center, West China Fourth Hospital, Sichuan University between October 2022 and October 2023. An additional 100 children without snoring symptoms and clinically evaluated and confirmed as not having OSA were enrolled as the control group. General demographic data of the participants were collected. The Caregiver Report Form of the Achenbach Child Behavior Checklist (CBCL) was used for behavioral problem assessment, and polysomnography data were collected. The chi-square/ test was used to analyze the inter-group differences in general data, the total score of behavioral problems, and scores for each dimension. Linear regression was performed to analyze the relationship between OSA and the total score for children's behavioral problems and those for the different dimensions. Logistic regression was applied to analyze the relationship between the obstructive apnoea-hypopnea index (OAHI) and behavioral problems in children with OSA. A logistic regression model integrating the OAHI × sex interaction term was constructed to evaluate the moderating effect of sex on the association between OAHI and behavioral problems. RESULTS: No significant differences were observed in general demographic data between the case and control groups. The total score for behavioral problems and those for each dimension were higher in the case group than those in the control group, with the total score of the case group being 24.60 ± 1.55 and that of the control group being 8.85 ± 0.75 ( < 0.001). The results of the linear regression analysis showed a positive association between OSA and both the total score for behavioral problems ( = 16.01; 95% CI, 12.56-19.47) and those for each dimension. The results of the logistic regression analysis showed that, after adjusting for covariates, OAHI was a risk factor for behavioral problems in children with OSA (odds ratio [OR] = 1.17; 95% CI, 1.04-1.31). After stratification by sex and adjustment for covariates, the OR value of the effect of OAHI on behavioral problems was slightly higher in female participants (1.57) than that in male participants (1.21). The interaction effect analysis showed that sex moderated the association between OAHI and behavioral problems (OR = 1.64; 95% CI, 1.02-2.64; = 0.04). CONCLUSION: Children with OSA are prone to developing behavioral problems. OAHI is a risk factor for behavioral problems in children with OSA, with a potentially greater effect observed in girls.
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