Table of Content

15 June 2025, Volume 28 Issue 17

Previous Issue    Next Issue

Special Report

DeepSeek Empowers General Medicine: Potential Application and Prospect

YAN Wenxin, LIU Jue, LIANG Wannian

2025, 28(17):  2065-2069.  DOI: 10.12114/j.issn.1007-9572.2025.0023

Asbtract ( )   HTML ( )   PDF (1084KB) ( )  

References | Related Articles | Metrics

In January 2025, DeepSeek launched its reasoning model DeepSeek-R1, characterized by open-source accessibility, cost-effectiveness, and strong reasoning capabilities, thus showing significant potential for applications within the medical domain. This paper examines the prospects for DeepSeek's implementation in general practice, demonstrating its potential to support clinical decision-making at primary care levels, facilitate comprehensive health education and management throughout the healthcare lifecycle, and bridge service gaps in remote, impoverished, and underserved regions. Additionally, DeepSeek-R1 enables to enhance research efficiency and promote innovative modes of medical education and training. However, its deployment also faces challenges concerning data governance, ethical standards, and technical specifications. Future exploration is recommended to facilitate the deep integration of large language models such as DeepSeek into multiple dimensions of general practitioners' activities-including clinical practice, scientific research, and medical education-thus maximizing the empowering role of artificial intelligence in general practice, developing an intelligent primary care ecosystem, and promoting high-quality development in general medicine.

Guidelines Interpretation

Interpretation of Updated NCCN Clinical Guidelines for Rectal Cancer (2024.V1/V2)

CAO Qinhan, ZHUO Xiao, XIA Yuhan, CHE Yangxi, CHEN Min

2025, 28(17):  2070-2074.  DOI: 10.12114/j.issn.1007-9572.2024.0323

Asbtract ( )   HTML ( )   PDF (1057KB) ( )  

Figures and Tables | References | Related Articles | Metrics

The incidence of colorectal cancer ranks second among cancers in China and colorectal cancer is also one of the most common malignant tumors in the digestive system. With the development of medical research and technology, the diagnostic and therapeutic strategies of colorectal cancer are continuously evolving. The National Comprehensive Cancer Network (NCCN) is closely following the forefront and released the 2024 V1/V2 versions of the NCCN Clinical Practice Guidelines for Rectal Cancer on January 29 and April 4, 2024 respectively. The two revisions of the guidelines mainly focus on the latest research progress in molecular detection, immunotherapy, targeted therapy, neoadjuvant therapy and disease surveillance. This article analyzed the key updates of the 2024 V1/V2 NCCN guidelines, aiming to provide a more accurate reference for clinical rectal cancer diagnosis and treatment practice.

Forum on Secondary Osteoporosis

The Dilemma of Prevention and Treatment of Secondary Osteoporosis and Its Countermeasures

LI Jia, TAN Wenbin

2025, 28(17):  2075-2081.  DOI: 10.12114/j.issn.1007-9572.2024.0682

Asbtract ( )   HTML ( )   PDF (1098KB) ( )  

Figures and Tables | References | Related Articles | Metrics

At present, China is faced with high prevalence of osteoporosis, low awareness rate, low treatment rate, diagnosis and treatment and follow-up management are still lack of normative problems. Osteoporosis can be secondary to multiple systemic diseases and is a multidisciplinary disease, which requires multidisciplinary medical workers to work closely together, give full play to their respective advantages, and develop a complete disease management program. In this paper, the author analyzes the status quo, difficulties and prevention and treatment measures of secondary osteoporosis (SOP), in order to provide effective inspiration for clinical workers in the standardized diagnosis and treatment of SOP.

Progress in the Research of Endocrine and Metabolic System Diseases and Secondary Osteoporosis

CHEN Beibei, LI Jia, TAN Wenbin

2025, 28(17):  2082-2091.  DOI: 10.12114/j.issn.1007-9572.2024.0696

Asbtract ( )   HTML ( )   PDF (1130KB) ( )  

References | Related Articles | Metrics

Secondary osteoporosis (OP) is mostly related to endocrine and metabolic diseases. The growth and development of bone is inseparable from the regulation of the endocrine system. Endocrine and metabolic diseases such as hyperthyroidism, hypogonadism, and hyperprolactinemia can break the balance between bone resorption and bone formation, and increase the risk of osteoporosis and fracture. In order to effectively manage secondary OP caused by endocrine and metabolic diseases, it is particularly important to explore its mechanism, diagnostic methods and treatment options. This article reviews the epidemiological characteristics of secondary osteoporosis in different groups of endocrine and metabolic diseases, the pathogenesis of hormone imbalance and cell signaling pathway abnormalities, the characteristics of bone damage such as bone metabolism indicators and bone mineral density, and the progress in the diagnosis and treatment of secondary osteoporosis, so as to provide reference for the prevention and treatment of secondary osteoporosis in patients with endocrine and metabolic diseases.

Research Progress on the Influence of Nervous System Diseases and Related Therapeutic Drugs on Osteoporosis

TAN Wenbin, LI Jia, LIU Mingyu, LU Yongxin, CHENG Yaxin

2025, 28(17):  2092-2100.  DOI: 10.12114/j.issn.1007-9572.2024.0198

Asbtract ( )   HTML ( )   PDF (1114KB) ( )  

References | Related Articles | Metrics

Patients with osteoporosis (OP) often suffer from a variety of diseases. In addition to general risk factors such as age, gender, race, comorbidities and related treatments can affect bone metabolism. At present, there are relatively few studies on the association between neurological disorders and OP. Therefore, this article intends to review the epidemiological characteristics, bone loss feature, related pathogenesis and progress of diagnosis and treatment, in order to provide reference for the mechanism of bone damage, OP prevention and anti-osteoporosis treatment in patients with nervous system diseases.

Research Progress of Circulatory System Diseases and Secondary Osteoporosis

HE Ting, LI Jia, TAN Wenbin

2025, 28(17):  2101-2112.  DOI: 10.12114/j.issn.1007-9572.2024.0687

Asbtract ( )   HTML ( )   PDF (1137KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Secondary osteoporosis (OP) is easy to be ignored in clinical practice, especially secondary OP caused by hypertension, coronary heart disease, chronic heart failure, atrial fibrillation and other circulatory system diseases. Due to the complexity of circulatory system diseases and adverse reactions of therapeutic drugs, the risk of secondary OP is often underestimated. Early prevention and treatment of secondary OP is very important to improve the quality of life of patients. The mechanism and treatment scheme of bone metabolism imbalance caused by different types of diseases are different. This article will review the common circulatory system diseases complicated with OP from the aspects of epidemiological characteristics, related risk factors and pathogenesis, changes of bone metabolism and characteristics of bone damage, as well as the progress of diagnosis and treatment, in order to provide reference for the prevention and treatment of circulatory system diseases complicated with OP.

Original Research

Association between Sleep Quality and Atherosclerosis among Population Aged 40-65 Years

SONG Xiaoling, ZHENG Li, JIN Juzhen, MAO Guangyan, SHANG Yuanhao, HU Jin, WANG Junhua, WANG Ziyun

2025, 28(17):  2113-2118.  DOI: 10.12114/j.issn.1007-9572.2024.0530

Asbtract ( )   HTML ( )   PDF (1210KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Background

Sleep quality is an important influence on arteriosclerosis (AS), but the category characteristics of sleep quality need to be further explored, and the association of each category with AS has not been clarified.

Objective

To explore the potential categories of sleep quality and analyze the association with AS, providing reference for refining individualized prevention strategies for AS.

Methods

The data of this study were obtained from the baseline survey of the "Follow-up Study of Sleep Characteristics and Chronic Diseases in the Middle-aged and Elderly Population in Guizhou Province", which was conducted from March to November 2022. Field questionnaires, physical examination and laboratory tests were conducted by uniformly trained investigators and professionals. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality problems, and latent class analysis (LCA) was performed using the scores of each dimension. Modified Poisson regression was used to analyze the association between sleep quality categories and AS. Stratification analysis was also conducted by gender, age and sleeping late.

Results

A total of 1 059 adults were included and a total of 558 patients with AS were detected, with a detection rate of 52.69%. Four sleep quality categories were identified via the LCA, including good sleep type (category 1, n=458), sleep deprivation with poor nighttime sleep quality (category 2, n=248), inefficient and insufficient sleep type (category 3, n=238), and multiple sleep problems type (category 4, n=115). The risk of AS was higher in the category 3 population than in category 1 (PR=1.14, 95%CI=1.00-1.30). Subgroup analyses revealed that in the female population, the risk of AS was higher in category 3 and category 4 compared to category 1, with PR=1.44 (95%CI=1.11-1.86) and 1.41 (95%CI=1.06-1.90). In addition, association between sleep quality categories and AS in the male population was not statistically significant. Compared with in category 1, higher risk of AS was detected in category 4 in the late-sleeping population and in category 3 in the non-late-sleeping group, with PR=1.26 (95%CI=1.02-1.56) and 1.20 (95%CI=1.00-1.43), respectively. No statistically significant difference in AS risk were found between category 2 and category 1 (P>0.05) .

Conclusion

Four categories characterizing sleep quality were identified among adults aged 40 to 65 years, each showing different associations with AS. Classification of sleep problems should be combined into individual interventions for better prevention against AS, especially for women and late sleepers.

Impact of Frailty on Cognitive Function in Chinese Older Adults: a Moderated Chain-mediated Effect

LIU Yuting, QIU Lixia, LI Yuling

2025, 28(17):  2119-2126.  DOI: 10.12114/j.issn.1007-9572.2024.0507

Asbtract ( )   HTML ( )   PDF (1096KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Background

Cognitive impairment is one of the serious risk factors affecting the quality of life in the elderly. Some studies have found an association between frailty and cognitive function, but research on mediating and moderating effects between the two is relatively scarce.

Objective

To explore the influence of frailty on cognitive function, and to investigate the mediating role of activities of daily living and depressive symptoms between frailty and cognitive function. Additionally, the moderating effect of social participation will be analysed.

Methods

Using data from the 2018 China Longitudinal Healthy Longevity Survey (CLHLS), 8 173 individuals aged 65 and older were selected to obtain relevant information on frailty, cognitive function, activities of daily living, depressive symptoms, social participation, and demographic data among the elderly. The differences in cognitive function among elderly individuals with different characteristics were analyzed. Pearson correlation analysis was employed to investigate the interrelationships between the variables. Stratified regression was utilised to examine the impact of frailty on cognitive function. The Process macro programme was used to test the chain mediating role of activities of daily living and depressive symptoms between frailty and cognitive function, and the moderating effect of social participation within it.

Results

Of the 8 173 participants, 1 769 (21.6%) had cognitive impairment and all variables were correlated. Stratified regression analyses showed frailty negatively predicts cognitive function (B=-2.862, P<0.001). The results of the chain-mediated effects analysis showed that the activities of daily living (B=-1.713, 95%CI=-1.944 to -1.498) and depressive symptoms (B=-0.435, 95%CI=-0.531 to -0.345) mediated the link between cognitive function and frailty to some extent. The interaction term between frailty and social participation (B=1.140, 95%CI=0.822 to 1.457) as well as the interaction term between depression and social participation (B=0.113, 95%CI=0.015 to 0.211) both significantly and positively predicted cognitive function, while the interaction term between activities of daily living and social participation was negatively correlated with cognitive function (B=-0.413, 95%CI=-0.560 to -0.266) .

Conclusion

Social participation moderated the direct and indirect effects of activities of daily living and depressive symptoms on the relationship between frailty and cognitive function. The findings indicate that interventions targeting older people's mental health and enhancing the quality of social relationships may facilitate the dissolution of the correlation between frailty and cognitive impairment.

Systematic Cluster Analysis of Comorbidity Patterns in Patients with Chronic Obstructive Pulmonary Disease and the Impact on Hospitalization Costs

CHENG Zhuozhuo, ZHANG Rui, XU Haofeng, HUANG Junting, LIANG Zijing, YAN Ping

2025, 28(17):  2127-2133.  DOI: 10.12114/j.issn.1007-9572.2024.0409

Asbtract ( )   HTML ( )   PDF (1116KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Background

Chronic obstructive pulmonary disease (COPD) patients often present with multiple comorbidities, which increase the complexity of treatment and the healthcare of burden. While comorbidities significantly impact the management of COPD patients, existing research primarily focuses on individual comorbidities, lacking systematic analysis of multiple comorbidity patterns and hospitalization costs.

Objective

To investigate the comorbidity characteristics and patterns in patients with COPD, analyzing how different features and comorbidity patterns affect hospitalization costs. The findings will provide a basis for personalized health management and resource allocation for COPD patients.

Methods

A retrospective analysis was conducted on 5 061 inpatients diagnosed with COPD at the First Affiliated Hospital, Guangzhou Medical University from 2020 to 2023. Systematic clustering analysis was employed to construct dendrograms, identifying comorbidity patterns among COPD patients. Multiple group comparisons were performed to assess the basic characteristics of these patterns, then multiple linear regression analysis was utilized to evaluate the impact of each comorbidity pattern on total hospitalization costs, western medicine costs, and antibacterial medication costs.

Results

There are a total of 4 343 patients with COPD, and the comorbidity was 85.81%. Systematic clustering analysis identified six comorbidity patterns among COPD patients: cardiovascular and metabolic diseases, hepatorenal diseases, digestive system diseases, arthropathy diseases, cancer and respiratory system diseases. There were significant differences in sex, age, BMI and smoking history among patients with 6 comorbidity models (P<0.05). Multiple linear regression analysis revealed that BMI, cancer pattern, and respiratory system diseases pattern all had impacts on total hospitalization costs, western medicine costs and antibacterial medication costs (P<0.05), with the respiratory system diseases pattern having the most substantial impact on total hospitalization costs (β=0.125, P<0.001) .

Conclusion

Comorbidity patterns in COPD can be categorized into six clusters. BMI, cancer pattern and respiratory system diseases pattern are the primary factors influencing hospitalization costs.

Clinical Characteristics and Correlation between Preoperative Frailty and Metabolic Syndrome among Older Patients with Gastric Cancer

JIANG Xiaoman, XU Xinyi, DING Lingyu, GUO Yinning, MIAO Xueyi, CHEN Li, XU Qin

2025, 28(17):  2134-2141.  DOI: 10.12114/j.issn.1007-9572.2023.0575

Asbtract ( )   PDF (1105KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Background

Frailty and metabolic syndrome (MetS) are both common geriatric conditions and may have potentially important links in terms of risk factors, body composition and metabolic mechanisms, which could jointly affect the prognosis of older patients with gastric cancer. Clearly distinguishing the characteristics of the two syndromes and elucidating their intrinsic relationship can help to develop precise and targeted preoperative management strategies.

Objective

To compare the characteristics of preoperative frailty and MetS in older patients with gastric cancer, focusing on general information, blood indicators and body compositions, then analyze their correlation.

Methods

A total of 286 patients aged 60 to 80 years who were admitted to the Gastrosurgery Department of the Jiangsu Province Hospital for gastric malignancy from August 2021 to August 2022 were included and divided into the four groups: the frailty group (n=45), the MetS group (n=58), the frailty+MetS group (n=12) and the normal group (n=171) based on the presence of frailty and MetS, and the clinical indicators of these groups were compared. With frailty as the dependent variable, Logistic regression analysis was conducted to investigate the correlation of MetS and the diagnostic indicators with preoperative frailty.

Results

Statistically significant differences were observed among the four groups in terms of age, comorbidities, Nutritional Risk Screening 2002 (NRS2002) scores>3, fasting blood glucose, triglyceride, high-density lipoprotein cholesterol (HDL-C), C-reactive protein (CRP), hemoglobin, albumin, height, body mass, waist circumference, BMI, fat content, fat mass index, body fat percentage, visceral fat area, skeletal muscle content, skeletal muscle mass index, limb skeletal muscle mass index, muscle percentage, fat to muscle ratio and muscle to fat ratio (P<0.05). Multivariate Logistic regression analysis showed that age (OR=1.115, 95%CI=1.046-1.190), history of smoking (OR=2.156, 95%CI=1.134-4.096), NRS2002 score>3 (OR=2.359, 95%CI=1.159-4.802), CRP (OR=1.038, 95%CI=1.003-1.073) and central obesity (OR=0.405, 95%CI=0.183-0.896) were the risk factors for frailty in older patients with gastric cancer (P<0.05) .

Conclusion

The frailty group showed advanced age, elevated levels of inflammation and increased nutritional risk, along with an overall decline in fat and muscle composition. The MetS group showed increased comorbidities, elevated inflammation and albumin levels, abnormal markers of glycolipid metabolism, and overall increased fat and muscle composition. The frailty+MetS group had increased comorbidities, abnormal fasting blood glucose and HDL-C levels with increases only in fat-related components but no significant changes in muscle components. Thus, frailty was not significantly associated with MetS in this study.

Study on the Association between Polymorphisms and Interaction of CCND1 and CCNE1 Genes with Preeclampsia

ZHOU Yunzhe, MIAO Junxiang, WEI Jiehua, CHEN Lizhang, WANG Tingting

2025, 28(17):  2142-2148.  DOI: 10.12114/j.issn.1007-9572.2024.0313

Asbtract ( )   HTML ( )   PDF (1095KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Background

Preeclampsia (PE) is a life-threatening multisystemic disorder that significantly endangers maternal and fetal health.

Objective

To investigate the association between CCND1 (Cyclin D1) and CCNE1 (Cyclin E1) gene polymorphisms, as well as their interactions with the risk of PE, and provide scientific evidence for its pathogenesis.

Methods

A case-control study was conducted. From October 2020 to October 2023, pregnant women diagnosed with PE were recruited from the Xiangya Third Hospital of Central South University and the Hunan Provincial Maternal and Child Health Hospital as the case group (n=202), while pregnant women with normal blood pressure were recruited as the control group (n=400). Multivariate Logistic regression analyses were performed to evaluate the association between CCND1 and CCNE1 gene polymorphisms and the risk of PE, with adjusted odds ratios (aOR) and 95% confidence intervals (95%CI) calculated. Interaction analysis was performed to investigate the association between gene-gene interactions and PE risk. Functional annotation of single nucleotide polymorphisms (SNP) was performed using the 3DSNP database.

Results

Multivariate Logistic regression analysis revealed that pregnant women with the CT/TT genotype at CCND1 rs1352075 had a lower risk of PE compared to CC genotype (dominant model: aOR=0.44, 95%CI=0.20-0.96). Pregnant women with the GG genotype at CCNE1 rs3218070 had a higher risk of PE compared to CC/GC genotype (recessive model: aOR=4.31, 95%CI=1.16-16.04). Analysis based on the 3DSNP database revealed a higher proportion of cellular regulatory factors related to vascularization and placentation in the open chromatin regions at rs1352075 and rs3218070 binding sites. Interaction analysis showed that the additive interaction between rs1352075 and rs3218070 was not significantly associated with PE risk.

Conclusion

The CCND1 rs1352075 locus harboring the CC genotype and the CCNE1 rs3218070 locus harboring the GG genotype may be associated with an elevated risk of developing PE.

Predictive Value of S-Detect Combined with Virtual Touch Tissue Imaging Quantification in Axillary Lymph Node Metastasis of Breast Cancer

DENG Yaqian, CAO Chunli, MA Jinmei, LI Wenxiao, XU Zelin, CHENG Jing, LI Jun

2025, 28(17):  2149-2155.  DOI: 10.12114/j.issn.1007-9572.2024.0160

Asbtract ( )   HTML ( )   PDF (1180KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Background

Axillary lymph node metastasis in breast cancer is an important factor in assessing disease progression and prognosis, and there is an urgent need for non-invasive and accurate methods to assess axillary lymph node status. In recent years, the integration of artificial intelligence and medical imaging technology has shown great potential. Among them, S-Detect technology, with its powerful image analysis capability, combined with the accurate quantitative assessment of virtual touch tissue imaging quantification (VTIQ) technology, provides new possibilities for the prediction of axillary lymph node metastasis in breast cancer.

Objective

To explore the value of the conventional ultrasound-based artificial intelligence S-Detect combined with VTIQ technique to predict axillary lymph node metastasis in breast cancer.

Methods

Data of 148 female breast cancer patients (166 masses in total) who underwent surgery at the First Affiliated Hospital, Shihezi University from February 2022 to February 2024 were retrospectively collected and divided into metastatic group (n=61) and non-metastatic group (n=105) based on axillary lymph node pathology results. All patients underwent routine ultrasound, VTIQ and S-Detect examinations before surgery. Univariate and multivariate Logistic regression analyses were used to explore the influence of each observational index on axillary lymph node metastasis, screen meaningful indexes and establish a Logistic regression prediction model. The predictive value of the model was evaluated by the ROC curve.

Results

The results of multivariate Logistic regression analysis showed that breast cancer mass border (OR=0.619, 95%CI=0.540-0.693), margin (OR=0.563, 95%CI=0.484-0.640), calcification (OR=0.559, 95%CI=0.480-0.636), aspect ratio (OR=0.540, 95%CI=0.461-0.617) and SWVmean (OR=0.794, 95%CI=0.725-0.853) were independent influences in predicting axillary lymph node metastasis in breast cancer (P<0.05). Logistic equations were constructed: Logistic (P) =-14.293+1.664×border+1.315×margin+1.757×calcification+1.341×aspect ratio+1.196×blood flow classification+0.736×SWVmax-3.942×SWVcentre+0.710×SWVmean. The AUC of this joint prediction model was 0.902 (95%CI=0.847-0.943), which was greater than the AUCs of each independent influencing factor (all P<0.05), and the AUC values of the joint prediction model were greater than the AUCs of the independent prediction models of conventional ultrasound (AUC=0.605, 95%CI=0.526-0.680), S-Detect (AUC=0.672, 95%CI=0.595-0.743), and VTIQ (AUC=0.794, 95%CI=0.725-0.853). The agreement between this joint prediction model and pathological results was good (Kappa=0.732, P<0.05) .

Conclusion

The prediction model constructed by combining S-Detect and VTIQ techniques based on conventional ultrasound has certain clinical predictive value for axillary lymph node metastasis in breast cancer.

Ergothionein Improves Cognitive Dysfunction in Vascular Dementia Rats by Activating NRF2/HO-1 Signaling Pathway

LIU Qingfang, WEI Youshi, XIAO Fei, ZHOU Chunxiang, LIU Qun, YUAN Hui, CAO Tianran

2025, 28(17):  2156-2162.  DOI: 10.12114/j.issn.1007-9572.2024.0316

Asbtract ( )   HTML ( )   PDF (1171KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Background

Ergothioneine is associated with the severity of cognitive impairment in Alzheimer's patients, and it has neuroprotective effects. However, whether it can improve cognitive dysfunction in rats with vascular dementia (VD) is indistinct, and the specific mechanism is still unclear.

Objective

To investigate the effect of ergothioneine on cognitive dysfunction in VD rats by activating NRF2/HO-1 signaling pathway.

Methods

From August 2021 to September 2023, 48 adult male SD rats were selected and randomly assigned to four groups (n=12/pergroup) : control, model, ergothioneine and ergothioneine + NRF2 inhibitor (ML385). The VD rat model was replicated by permanent ligation of bilateral common carotid arteries. Two weeks before VD replicated, ergothioneine rats was intraperitoneally injected with 2 mg/kg of ergothioneine daily for 4 weeks. And ergothioneine + ML385 group receiving ergothioneine 2 mg/kg and ML385 30 mg/kg daily for 4 weeks before VD operation. The effects of ergothioneine on cognitive dysfunction in VD rats were detected by Morris water maze test, HE staining and TUNEL staining. The level of various proteins was measured utilizing Western blotting. Oxidative stress factors level and inflammatory factors level were tested with ELISA.

Results

The model was successfully established. VD model group had longer escape latency and less residence time than control group (P<0.05). The number of neurons in rat hippocampal tissue decreased, the cells atrophied, the morphology was abnormal, and the nuclei were deeply stained. VD model group had more neurons apoptosis rate in brain tissue than control group (P<0.05). Decreased NRF2, HO-1, NQO1, SOD and GSH-Px levels were observed in VD model group (P<0.05). Increased MDA, IL-1β, IL-6 and TNF-α were also observed in VD model group (P<0.05). Ergothioneine group had shorter escape latency and more residence time than VD model group (P<0.05). The pathological degree hippocampal tissue reduced, and ergothioneine group had more neurons apoptosis rate in brain tissue than VD model group (P<0.05). Increased NRF2, HO-1, NQO1, SOD and GSH-Px levels were observed in ergothioneine group (P<0.05). Decreased MDA, IL-1β, IL-6 and TNF-α were also observed in ergothioneine group (P<0.05). Compared with ergothioneine group, the escape latency of rats in the ergothioneine + ML385 group was prolonged, the percentage of residence time in the target quadrant was decreased (P<0.05). The hippocampus was seriously damaged, and the apoptosis rate of brain neurons was increased (P<0.05). NRF2, HO-1, NQO1, SOD and GSH-Px levels were decreased (P<0.05). MDA, IL-1β, TNF-α and IL-6 levels were increased (P<0.05) .

Conclusion

Ergothioneine can improve cognitive dysfunction in VD rats by activating NRF2/HO-1 signaling pathway.

Epidemiological Study

Analysis of Changing Trends in Disease Burden of Multidrug-resistant Tuberculosis in China, 1992-2021

FANG Liangmei, MIAO Ruifen, WANG Rong, QIU Beibei, HONG Xin, WANG Lina

2025, 28(17):  2163-2171.  DOI: 10.12114/j.issn.1007-9572.2024.0660

Asbtract ( )   HTML ( )   PDF (1302KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Background

The epidemic of multidrug-resistant tuberculosis (MDR-TB) is a serious public health hazard. China is one of the countries with high MDR-TB disease burden.

Objective

To analyze the current status and changing trends of MDR-TB disease burden in China from 1992 to 2021, and to provide a reference for the development of prevention and control strategies.

Methods

Disease burden data of MDR-TB of China, the global and different socio-demographic index (SDI) regions from 1992-2021 were extracted from the Global Burden of Disease database 2021 (GBD 2021), and the Joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to describe changing trends. Age-period-cohort model was used to analyze the age, period and cohort effects of MDR-TB incidence and mortality in China.

Results

From 1992 to 2021, the standardized incidence rate and standardized mortality rate of MDR-TB in China decreased from 7.72/100 000 and 2.21/100 000 to 1.49/100 000 and 0.15/100 000, respectively, with decreases of 80.70% and 93.21%, respectively. In 2021, China's MDR-TB standardized incidence rate and standardized mortality rate were in the lower middle level among the global and different SDI regions, but the burden was still heavier compared with that in high SDI regions. The results of the Joinpoint analysis showed that, in terms of regional differences, the AAPC of MDR-TB standardized incidence rate and standardized mortality rate in China from 1992 to 2021 were -5.51% and -9.06%, respectively, which were on decreasing trends (P<0.05). In terms of gender differences, both the standardized incidence rate and standardized mortality rate of MDR-TB decreased more rapidly in females (AAPC was -5.91% and -10.08%, respectively, P<0.05) than in males (AAPC was -5.26% and -8.51%, respectively, P<0.05), and the disease burden was higher in males than in females. In terms of age differences, the fastest decrease of the incidence rate of MDR-TB occurred at 85-89 years old (AAPC=-6.04%, P<0.05), and the fastest decrease of the mortality rate was occurred at 15-19 years old (AAPC=-9.88%, P<0.05). The results of the APC analysis showed that the net shift values of the incidence rate of MDR-TB and the mortality rate in China from 1992 to 2021 were -7.78% and -11.07%, respectively. The age effect showed that the incidence rate fluctuated and increased with age increase, and the mortality rate showed a monotonous increment, both of which reached their maximum values at 85-89 years old, with 22.10/100 000 and 16.58/100 000, respectively. The period effect showed that the risk of incidence and mortality decreased with the passage of years, and the risk ratio (RR) of incidence and mortality decreased from 1.55 and 1.87 to 0.26 and 0.13, respectively. The cohort effect showed that the risk of incidence and mortality decreased with the backward movement of birth cohort, and the RR of incidence and mortality decreased from 44.01 and 185.33 to 0.02 and 0.01, respectively.

Conclusion

The disease burden of MDR-TB in China showed a decreasing trend overall from 1992 to 2021, but the speed of decrease gradually slowed down, and the disease burden was still heavier compared with that in high SDI regions. Males and the elderly are high disease burden groups, and the popularisation of MDR-TB health education and early diagnosis and treatment should be strengthened.

Disease Burden of Osteoarthritis in the World, China, and Regions with Different Socio-demographic Index from 1990 to 2021

CHEN Xingchao, GAO Zhenhua, XU Shenggang, ZOU Yonggang, QIAN Jun, WEI Jiantong

2025, 28(17):  2172-2178.  DOI: 10.12114/j.issn.1007-9572.2024.0664

Asbtract ( )   HTML ( )   PDF (1125KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Background

Osteoarthritis (OA) seriously endangers the physical and mental health of patients. Currently, systematic studies on the disease burden of OA are limited.

Objective

To analyze the current status and disease burden of OA disease in the world, China, and regions with different socio-demographic indexes (SDI) from 1990 to 2021, to formulate and adjust prevention strategies for OA.

Methods

The 2021 Global Burden of Disease database was used to analyze the incidence, prevalence, and disability-adjusted life years (DALYs) rates of OA in the world, China, and different SDI regions. The average annual percentage change (AAPC) was used to comprehensively evaluate the trend of OA burden in the world, China, and different SDI regions from 1990 to 2021.

Results

The global incidence, prevalence, and DALYs rate of OA increased from 391.86/100 000, 4 801.18/100 000, and 167.22/100 000 in 1990 to 590.93/100 000, 7 691.83/100 000 and 269.97/100 000 in 2021, respectively. The incidence, prevalence, and DALYs rate of OA in China increased from 395.61/100 000, 4 535.01/100 000, and 155.5/100 000 in 1990 to 641.62/100 000, 10 743.18/100 000, and 374.44/100 000 in 2021, respectively. In 2021, the incidence, prevalence, and DALYs rate of OA in females in China were 1 004.99/100 000, 13 332.37/100 000, and 465.35/100 000, respectively, which were significantly higher than 641.62/100 000, 8 272.97/100 000 and 287.71/100 000 in males. The global incidence, prevalence, and DALYs rate of OA showed an increasing trend from 1990 to 2021 (AAPC=1.35%, 95%CI=1.33%-1.37%; AAPC=1.54%, 95%CI=1.52%-1.56%; AAPC=1.56%, 95%CI=1.54%-1.59%) (P<0.05). The incidence, prevalence, and DALYs rate of OA in China increased from 1990 to 2021 (AAPC=2.47%, 95%CI=2.36%-2.59%; AAPC=2.90%, 95%CI=2.80%-3.00%; AAPC=2.94%, 95%CI=2.85%-3.04%) (P<0.05). From 1990 to 2021, the standardized incidence, prevalence and DALYs rate of OA in the world, China, and different SDI regions showed an upward trend, and the disease burden of OA was significantly different in different regions.

Conclusion

The incidence, prevalence, and DALYs rate of OA is increasing globally, in China, and different SDI regions, and the burden of OA is increasing. In addition, the disease burden of OA varies greatly among different regions, genders, and ages.

Evidence-based Medicine

Meta-analysis of the Incidence of Postpartum Depression among Maternal Spouses in China

FAN Yu, LI Rong, GONG Shuangying, YANG Xiaojuan, LI Rui

2025, 28(17):  2179-2185.  DOI: 10.12114/j.issn.1007-9572.2024.0436

Asbtract ( )   HTML ( )   PDF (1241KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Background

Postpartum depression may occur not only in the mother but also in spouses, which affects their quality of life, increases the social and family economic burden, and is not conducive to the growth and development of the child. Therefore, it is important to identify the factors that influence its occurrence at an early stage.

Objective

To clarify the incidence of postpartum depression in Chinese maternal spouses through meta-analysis.

Methods

A computerized search was performed for cohort studies, case-control studies, and cross-sectional studies on the incidence of postpartum depression in Chinese maternal spouses in the databases of CNKI, Wanfang Data, VIP, CBM, PubMed, Web of Science, CINAHL, Embase, and Cochrane Library, with the time of search being from the establishment of the databases to March 2024. The search was conducted from the time of database construction to 2024-03-19. Two researchers independently screened the literature, and the included studies were subjected to data extraction, literature quality assessment, and meta-analysis by Stata 14.0 software.

Results

39 papers were finally included, with a total sample size of 12 162 cases. Meta-analysis results showed that the prevalence of postpartum depression among maternal spouses in China was 14% (95%CI=12%-17%). The results of subgroup analysis showed that the incidence of postpartum depression in spouses was 17% (95%CI=13%-22%) within 1 month postpartum and 13% (95%CI=10%-15%) within 1 month-1 year postpartum; the incidence was 17% (95%CI=11%-23%) in inland areas and 13% (95%CI=11%-16%) in coastal regions; the measurement tool EPDS showed an incidence of 13% (95%CI=11%-16%) for spouses in studies using the EPDS and 18% (95%CI=10%-29%) for other study instruments; the incidence of postpartum depression was 15% (95%CI=11%-21%) for spouses of primiparous women and 14% (95%CI=11%-18%) for spouses of multiparous mothers. For the year of publication, the incidence was 16% (95%CI=10%-22%) for studies published from 2007 to 2016 and 14% (95%CI=12%-16%) for studies published from 2017 to 2023. Sensitivity analyses were performed by excluding literature one by one, and the combined effect sizes did not change significantly, suggesting that the meta-merged results were relatively robust. The distribution of each study point on both sides of the funnel plot was symmetrical, and the results of Egger's test showed t=1.79, P=0.082, suggesting that there was no significant publication bias.

Conclusion

The incidence of postpartum depression in Chinese maternal spouses is high, with an overall incidence of 14%, of which the incidence is as high as 17% within 1 month postpartum. Early screening and prevention should be emphasized.

Meta-analysis of Prevalence and Development Trend of Mild Cognitive Impairment in Elderly Hypertensive Patients in China

WANG Biqing, ZHANG Ping, YANG Hongxia, WANG Qian, JU Chunxiao, ZHAO Junnan, MEI Jun, ZHANG Ying, XU Fengqin

2025, 28(17):  2186-2192.  DOI: 10.12114/j.issn.1007-9572.2024.0322

Asbtract ( )   HTML ( )   PDF (1116KB) ( )  

Figures and Tables | References | Related Articles | Metrics

Background

Elderly hypertension combined with cognitive impairment has been one of the global public health problems. A systematic evaluation of the prevalence of mild cognitive impairment (MCI) in elderly hypertension patients in China helps provide data support for the prevention and treatment of cognitive impairment in elderly hypertension patients.

Objective

To analyze the prevalence rate of MCI in elderly hypertensive patients in China by meta-analysis, and further explore the development trend of the prevalence rate.

Methods

Chinese and English databases including CNKI, Wanfang Data, VIP, CBM, PubMed, Cochrane Library, Embase and Web of Science were systematically searched from self-built database to February 22, 2024. NoteExpress software was used for literature management and screening, and the American Institute for Agency for Healthcare Research and Quality (AHRQ) cross-section research evaluation criteria was used for literature quality evaluation. Meta-analysis and subgroup analysis were performed by StataMP 14.0 software.

Results

Twenty-seven cross-sectional studies from 2008 to 2023 were systematically analyzed, involving 57 461 elderly patients with hypertension and 11 812 patients with the disease. A random effects model was used for meta-analysis, and the overall prevalence was 21.3% (95%CI=18.4%-24.2%, P<0.001). A total of 11 provinces/cities/autonomous regions were included in the study, and the prevalence rate varied greatly among provinces/cities/autonomous regions and among geographical regions. The overall prevalence rate showed a fluctuating trend with time from 2008 to 2023. Subgroup analysis showed that the prevalence of MCI was 33.6% (95%CI=6.4%-60.7%, P<0.001) in rural and 21.8% (95%CI=18.1%-25.4%, P<0.001) in urban elderly patients with hypertension. The prevalence in North China (14.0%, 95%CI=9.3%-18.7%, P<0.001) was lower than that in other regions. The prevalence of MMSE+MoCA combined application was 25.9% (95%CI=15.8%-36.0%), and the prevalence of MoCA alone was 21.4% (95%CI=18.5%-24.4%) and MMSE alone was 17.9% (95%CI=13.9%-21.9%) .

Conclusion

The overall prevalence rate of MCI in elderly hypertensive patients in China is high, and there are great differences between different provinces and cities, urban and rural prevalence rate, and the trend of dynamic change with time. The detection rate of MCI varies greatly among different assessment tools, which is affected by the quantity and heterogeneity of literature studies. The conclusion needs to be confirmed by further high-quality studies.