Loading...

Table of Content

    20 December 2026, Volume 29 Issue 36
    Guidelines·Consensus·Interpretation
    Expert Consensus on Comprehensive Management of Diabetes-associated Cognitive Dysfunction (2026 Edition)
    Hubei Provincial Clinical Medical Research Center for Endocrinology and Metabolic Diseases, Metabolic Health and Disease Prevention & Professional Committee, Wuhan Preventive Medicine Association, Tongji Hospital Endocrine Subspecialty Alliance, PENG Ting, ZHANG Yanchao, LIU Xu, LI Chan
    2026, 29(36):  5313-5325.  DOI: 10.12114/j.issn.1007-9572.2026.0169
    Asbtract ( )   HTML ( )   PDF (1556KB) ( )  
    Figures and Tables | References | Related Articles | Metrics

    Diabetes-associated cognitive dysfunction (DACD) is one of the common chronic complications of diabetes mellitus. Its incidence has been increasing annually alongside the rising prevalence of diabetes and the acceleration of population aging. DACD significantly impairs patients' quality of life, escalates family caregiving burden and societal healthcare expenditure, and is closely associated with diminished self-management adherence in diabetic patients. Existing expert consensuses on DACD predominantly focus on clinical diagnosis and therapeutic strategies, whereas systematic guidance regarding practical norms for core management components including patients' daily self-management, health education implementation, cognitive function training, and comprehensive care, remains insufficient. In view of this, the working group has formulated the Expert Consensus on Comprehensive Management of Diabetes-associated Cognitive Dysfunction (2026 Edition) (hereinafter referred to as the Consensus). The development of the Consensus was based on a comprehensive systematic retrieval and evidence-based integration of domestic and international DACD-related guidelines, consensuses, and original studies. Through two rounds of expert Delphi survey and one round of expert panel deliberation, an adapted version of the evidence quality and recommendation grading approach was employed. The finalized Consensus systematically elaborates on screening and assessment methods and risk factors for DACD, stratified management, DACD-specific management (medication safety management, glycemic management, lifestyle intervention), cognitive intervention and digital management technologies, appropriate traditional Chinese medicine techniques, DACD complication management (environmental safety management, behavioral and psychological symptoms, wandering and elopement prevention), as well as DACD education and support, aiming to provide a scientific, comprehensive, and practical reference for clinical management.

    Interpretation and Discussion of the RACGP Guidelines for Preventive Activities in General Practice: Urinary Incontinence
    LI Tianzi, JIANG Yue
    2026, 29(36):  5326-5332.  DOI: 10.12114/j.issn.1007-9572.2025.0511
    Asbtract ( )   HTML ( )   PDF (1407KB) ( )  
    Figures and Tables | References | Related Articles | Metrics

    Urinary incontinence is a common and frequently occurring symptom in general practice. However, as a manifestation related to privacy, its identification and treatment in primary healthcare services in China remain insufficient. This article interprets and analyzes the recommendations on urinary incontinence from the 10th edition of the Royal Australian College of General Practitioners (RACGP) Guidelines for Preventive Activities in General Practice. It provides a detailed elaboration and analysis of the types of urinary incontinence, screening, oppotunistic case finding, and preventive activities for both the general population and specific populations, followed by in-depth reflection and discussion. The aim is to further advocate for general practitioners to enhance their sensitivity to urinary incontinence screening, recognize the importance of early case finding and disease screening, and clarify feasible strategies for identification, screening, prevention, and intervention of urinary incontinence at the primary level. It also promotes the implementation of early comprehensive management and interventions.

    Hot Topic Research·Weight Management
    Weight Management Dilemma among Chinese Immigrants Living with Excess Weight in Australia: a Qualitative Study Using Semi-structured Interviews and Photo Elicitation
    WANG Yixi, Choi Tammie S T, Kellow Nicole J, YANG Hui
    2026, 29(36):  5332-5339.  DOI: 10.12114/j.issn.1007-9572.2026.0161
    Asbtract ( )   HTML ( )   PDF (1483KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    Weight management is an important concern for individuals, society, and public policy. However, the voices of people living with overweight or obesity are often underrepresented in the design of weight-management interventions. Exploring their perceptions of overweight and obesity, lived experiences, and weight-loss challenges may inform more effective and acceptable strategies for the target population.

    Objective

    To explore obesity-related perceptions, experiences, and weight management challenges among Chinese immigrants living with overweight or obesity in Australia, and to provide a cross-cultural perspective on obesity perceptions and weight management.

    Methods

    From August to November 2024, Chinese immigrants living in Melbourne were recruited using purposive and snowball sampling. Eligible participants had lived in Australia for more than six months and had a BMI greater than 23 kg/m2. Maximum variation sampling was used to recruit participants with diverse backgrounds. Data were collected through semi-structured interviews incorporating photo elicitation. Data collection and analysis were conducted iteratively, and recruitment ceased when new data no longer added richness to the themes identified. Interviews were conducted in Mandarin or English, audio-recorded, and transcribed verbatim by the researcher. The data were analysed using reflexive thematic analysis.

    Results

    Twenty-five Chinese immigrants living with overweight or obesity participated in the study. Participants varied in their place of residence before migration, occupation, age, length of residence in Australia, gender, and health status. Most interviews were conducted face-to-face. Four themes related to participants' everyday weight-loss challenges were generated: (1) weight loss was viewed as an ongoing important life task but not a daily priority; (2) self-discipline and perseverance were regarded as the keys to successful weight loss; (3) generic weight loss advice failed to accommodate the diversity and complexity of individual circumstances; and (4) support from family and friends was often limited to verbal encouragement, with little behavioural support.

    Conclusion

    This study presents perceptions of obesity, attitudes towards weight, and weight-loss challenges from the perspectives of people living with overweight or obesity. Participants generally possessed common knowledge about weight loss but had a limited understanding of the complicated mechanisms underlying obesity and weight management. Improving both individuals' and health professionals' understanding of these challenges may facilitate the development of more individualised and effective weight-management strategies. The findings also indicate that support for weight management at the family, societal, and environmental levels remains insufficient, highlighting the need for greater attention to and further development of supportive systems.

    Current Status and Reflections on Weight Management Services in Community Health Centers in Shanghai: a Qualitative Study
    HUANG Jing, SUN Xianjin, LIU Meng, DU Zhaohui, YAN Yunyun, HUANG Yanyan
    2026, 29(36):  5340-5347.  DOI: 10.12114/j.issn.1007-9572.2026.0131
    Asbtract ( )   HTML ( )   PDF (1540KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    With the increasing prominence of overweight and obesity among Chinese residents, 16 departments, including the National Health Commission of the People's Republic of China, jointly launched the "Healthy Weight Management Year" plan. Weight management services in Community Health Centers (CHC) in China are currently in the initial exploratory stage, and a systematic analysis of their specific implementation is lacking.

    Objective

    To investigate the service models of weight management clinics in CHC in Shanghai, identify the implementation barriers during the service process, and explore feasible optimization strategies, aiming to provide a reference for the normalized and high-quality development of weight management services in CHC.

    Methods

    From September 10 to December 23, 2025, purposive sampling combined with snowball sampling was employed to recruit participants. Two administrators responsible for weight management affairs in Shanghai municipal health authorities were invited to participate. Additionally, one CHC was selected from each of the 12 districts in Shanghai, and the director of the weight management clinic or frontline healthcare workers at each CHC were invited to participate in semi-structured interviews. The interview guide was developed through a systematic review of relevant literature and policy documents, supplemented by a preliminary investigation. Thematic framework analysis was applied to organize and analyze the interview data.

    Results

    A total of 14 interviewees were included in this study. Through thematic analysis of the interview data, four themes were identified. (1) CHCs in different administrative areas developed differentiated service models tailored to local conditions; (2) Medical personnel face challenges including high workloads, limited professional resources, and a low sense of professional identity within weight management services; (3) The motivation to engage in weight management is shaped by external factors, such as professional identity and incentive structures; (4) From the standpoint of medical institutions, residents' personal perceptions and beliefs regarding weight management significantly influence their willingness and behavior towards self-management.

    Conclusion

    The majority of CHC in Shanghai have successfully integrated and specialized their weight management services. Nonetheless, numerous challenges persist in delivering standardized and sustainable weight management services. These challenges include the escalating demand for services, the absence of a comprehensive training system, ambiguous management objectives, inadequate incentive mechanisms, and the necessity to elevate residents' awareness. Consequently, there remains a need for improvement in CHC weight management services, particularly concerning institutional support, personnel training, resource allocation, and the provision of detailed weight management guidance to residents.

    Effectiveness and Development Strategies of a Medical Nutrition Weight-loss Clinic from the Perspective of the Three-Circle Theory
    WU Lixia, CHEN Hongjie, YANG Yi
    2026, 29(36):  5348-5353.  DOI: 10.12114/j.issn.1007-9572.2025.0322
    Asbtract ( )   HTML ( )   PDF (1489KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    Obesity has become a major public health issue. Medical nutrition weight-loss clinics align with the national health policy orientation, yet they face challenges such as mismatches between service supply and demand. Exploring optimization pathways for medical nutrition weight-loss clinics from the perspective of the Three-Circle Theory is of great practical significance for their sustainable and positive development.

    Objective

    Based on the Three-Circle Theory (value circle, capability circle, and support circle), this study analyzed the service status and existing problems of the medical nutrition weight-loss clinic at the People's Hospital of Leshan, with the aim of proposing optimization strategies to improve service quality and long-term weight-loss outcomes.

    Methods

    A total of 342 patients who visited the medical nutrition weight-loss clinic at the People's Hospital of Leshan from August 2024 to April 2025 were enrolled. During the observation period, all patients received a high-protein diet, exercise intervention, and behavioral intervention. The revisit rate and dropout rate at 1, 3, and 6 months after intervention were analyzed. A mixed-effects linear model was used to examine changes in body composition indicators over time (at baseline and at 1, 3, and 6 months after intervention). Patient satisfaction was assessed through a questionnaire survey (n=251), and the results were interpreted within the framework of the Three-Circle Theory.

    Results

    The 342 patients were aged 18 to 62 years, with a mean age of (35.4±8.7) years. There were 59 men (17.25%) and 283 women (82.75%). Among them, 285 patients (83.33%) had a BMI ≥24 kg/m2, and 156 patients (45.61%) had a BMI ≥28 kg/m2. As the intervention period lengthened, the revisit rate decreased and the dropout rate increased (χ2 trend=65.93, P<0.01). Mixed-effects linear model analysis showed that BMI, muscle mass, body fat, body fat percentage, visceral fat area, and basal metabolic rate differed significantly among baseline and the 1-, 3-, and 6-month post-intervention assessments (P<0.05). Except for muscle mass, which showed no statistically singnificant differences between 1 and 3 months, and 3 and 6 months, and basal metabolic rate, which showed no statistically significant difference between the 3-month and 6-month follow-up visits after intervention (P>0.05), pairwise comparisons among all time points for body composition indicators at baseline and at 1, 3, and 6 months after intervention showed statistically significant differences (P<0.05). In the satisfaction survey, the top three items in the value circle were, in descending order: willingness to recommend the clinic to others (4.77±0.46), overall satisfaction with the clinic (4.63±0.53), and satisfaction with the weight-loss effect (4.46±0.71). The top three items in the capability circle were daily follow-up ability (4.89±0.34), feasibility of the weight-loss plan (4.87±0.40), and individualization (4.86±0.38). The top three items in the support circle were service attitude (4.89±0.37), appropriateness of examination time (4.82±0.46), and clinical environment (4.78±0.53).

    Conclusion

    Through targeted interventions, the medical nutrition weight-loss clinic achieved favorable weight-loss outcomes, and patient satisfaction was high, with notable effects in the capability circle, value circle, and support circle. Based on the Three-Circle Theory, sustainable development strategies such as building a positive vision-oriented culture, promoting iterative optimization of professional capabilities, and creating a high-quality and efficient support environment can continuously improve the service quality and effectiveness of medical nutrition weight-loss clinics.

    Original Research
    Effectiveness of Two Internal Nourishment Regimens Combined with a Four-Step External Treatment Regimen for Pressure Injuries in Older Adults Based on the Skin-gut Axis Theory: a Randomized Controlled Trial
    ZHOU Jihong, JIANG Yan, ZHOU Wan, MAO Ning, Wu Lei, JIANG Qixia
    2026, 29(36):  5354-5359.  DOI: 10.12114/j.issn.1007-9572.2025.0565
    Asbtract ( )   HTML ( )   PDF (1586KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    The skin-gut axis theory suggests that the gut and skin barrier, as well as the microbiota, are highly similar and have a bidirectional relationship. Gut good bacteria can reduce the permeability of the gut barrier, alter skin symbiotic bacteria, and enhance skin barrier function, which is beneficial for wound healing. How to improve wound infection and promote healing by improving gut function has become a new research hotspot in recent years.

    Objective

    To compare the effectiveness of two internal nurturing and external treatment for older patients with pressure injury (PI) based on the skin-gut axis theory, and explore new ideas and methods for them.

    Methods

    Considering the skin-gut axis theory and guidelines, we discussed and designed two internal nurturing programs including prebiotics+probiotics or traditional Chinese medicines to regulate gastrointestinal function and replenish nutrients, and the "four-step external treatment", including debridement+negative pressure wound therapy with instillation (NPWTi) +surgical closure+ follow-up with wound care. A two-arms randomized controlled trial (RCT) was adopted and 80 inpatients with fourth stage of PI,≥ 60 years old in department of Medical Aesthetics and Burns, Nanjing Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine were included from August 2023 to July 2025, and were randomly divided into the trial group and the control group according to a 1∶1 ratio. The trial patients were treated by "prebiotics+probiotics" combined with "four-step external treatment". The control patients were treated by "prebiotics+traditional Chinese medicines" combined with "four-step external treatment" until 4 weeks and followed up for 3 months. Primary outcome measures included healing rate and healing time after 4 weeks of intervention and 3-month of follow-up. Secondary outcome measures included serum albumin, hemoglobin, blood glucose levels before and after intervention. Statistical analysis was applied to baseline data, primary and secondary outcomes.

    Results

    Among the 80 PI patients, there were 54 males (67.5%) and 26 females (32.5%), with an average age of (71.3±11.4) years. The trial group of 40 patients completed treatment and follow-up as planned, with no dropouts or deaths; Two patients in the control group of 40 died. There was no statistically significant difference in baseline data between the two groups of patients (P>0.05). There was no statistically significant difference in the 4-week healing rate and 4-week healing time between the two groups of patients (P>0.05); The 3-month healing rate of the trial group patients was higher than that of the control group (χ2 =5.952, P=0.015), and the 3-month healing time was shorter than that of the control group (t=3.440, P=0.001). Three weeks after intervention, there was no statistically significant difference in serum albumin, hemoglobin, and blood glucose levels between the two groups of patients (P>0.05). There was no statistically significant difference in hemoglobin and blood glucose levels between the two groups of patients before and after intervention (P>0.05); After intervention, the serum albumin levels of both groups of patients were higher than before intervention, and the difference was statistically significant (P<0.05).

    Conclusion

    Both internal nurturing combined with "four-step external treatment" can improve the efficacy of older patients with stage 4 PI, and the trial group showed better results after a 3-month follow-up treatment.

    Evaluation of Left Ventricular Systolic Function in Patients with Type 2 Diabetes Mellitus Complicated by Hyperlipidemia Using Layer-specific Strain Technology Combined with Non-traditional Lipid Parameters
    KONG Yiting, LIU Rong, YU Shuqi, DONG Zhizhi, TU Yifan, YAN Yulian, FU Qihuan, ZHANG Yue, ZHOU Yadong
    2026, 29(36):  5360-5367.  DOI: 10.12114/j.issn.1007-9572.2025.0151
    Asbtract ( )   HTML ( )   PDF (1904KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    Hyperlipidemia increases the risk of atherosclerotic cardiovascular disease (ASCVD), a leading cause of morbidity and mortality among patients with type 2 diabetes mellitus (T2DM). Non-traditional lipid parameters show strong performance in T2DM risk assessment and prediction and are closely associated with ASCVD. Layer-specific strain imaging based on two-dimensional speckle-tracking imaging (2D-STI) differentiates myocardial layers and segments, providing additional information on myocardial motion.

    Objective

    To evaluate structural and functional changes of the left ventricle (LV) in patients with T2DM and hyperlipidemia using layer-specific strain imaging in combination with non-traditional lipid parameters.

    Methods

    A total of 100 patients with T2DM and normal left ventricular ejection fraction (LVEF) who were hospitalized in the Department of Endocrinology at Yichang Central People's Hospital between January 2021 and June 2023 were included, 50 of whom had hyperlipidemia. An additional 50 age- and sex-matched healthy individuals served as controls. Patients were categorized into a T2DM group (n=50) and a T2DM with hyperlipidemia group (n=50); healthy participants formed the control group (n=50). Baseline data were collected, and nontraditional lipid parameters were calculated based on traditional lipid profiles. Echocardiographic results were gathered; software was utilized to calculate left ventricular global longitudinal strain (GLS) and global circumferential strain (GCS). Values for subendocardial, mid-myocardial, and subepicardial longitudinal strain (GLSendo, GLSmid, GLSepi) as well as subendocardial, mid-myocardial, and subepicardial circumferential strain (GCSendo, GCSmid, GCSepi) were derived. The differences between subendocardial and subepicardial longitudinal strain (ΔGLS) and between subendocardial and subepicardial circumferential strain (ΔGCS) were also calculated. Correlations between nontraditional lipid parameters and LVEF were assessed using Pearson or Spearman rank correlation analysis. Multivariable hierarchical regression analysis was performed to identify factors associated with left ventricular systolic function in patients with T2DM and hyperlipidemia.

    Results

    Compared with the control group, the T2DM group had higher SBP, DBP, FPG, HbA1c, non-HDL-C, non-HDL-C/HDL-C ratio, and LCI (all P<0.05). The T2DM with hyperlipidemia group had higher SBP, DBP, FPG, HbA1c, TC, TG, LDL-C, AIP, CRI, non-HDL-C/HDL-C ratio, and LCI than the control group (all P<0.05). Compared with the T2DM group, the T2DM with hyperlipidemia group had higher TC, TG, LDL-C, AIP, CRI, RLP-C, non-HDL-C, and LCI (all P<0.05). Echocardiographic findings showed that LAD was higher, whereas LVEF and the E/A ratio were lower, in both the T2DM and T2DM with hyperlipidemia groups than in the control group. The E/e' ratio was higher in the T2DM group than in the control group (P<0.05). LVPW also differed significantly among the three groups (P<0.05). Strain analysis showed that GLS and GCS were lower and peak strain dispersion (PSD) was higher in both the T2DM and T2DM with hyperlipidemia groups than in the control group (P<0.05). GLSendo, GLSmid, GLSepi, GCSendo, GCSmid, GCSepi, and ΔGCS were reduced in both T2DM groups compared with controls; moreover, GLSendo, GLSmid, GLSepi, GCSendo, GCSmid, ΔGLS, and ΔGCS were lower in the T2DM with hyperlipidemia group than in the T2DM group (all P<0.05). In patients with T2DM and hyperlipidemia, LVEF correlated negatively with AIP, CRI, RLP-C, non-HDL-C, the non-HDL-C/HDL-C ratio, and LCI (all P<0.05). In multivariable hierarchical regression, LCI was independently and negatively associated with LVEF (β= -0.564, P=0.034), whereas GLSendo was positively associated with LVEF (β=0.807, P=0.006); the model including both variables provided the best fit.

    Conclusion

    Layer-specific strain imaging enables layer-targeted assessment of LV myocardial mechanics and detects early impairment of LV systolic function in patients with T2DM and hyperlipidemia, even when conventional LVEF is preserved. The combination of GLSendo and nontraditional lipid parameters showed high diagnostic value for detecting impaired left ventricular systolic function in patients with T2DM and hyperlipidemia.

    Development of a multimodd Data-based Risk Prediction Model for Major Adverse Cardiovascular and Cerebrovascular Events in Patients with Essential Hypertension
    MA Xiaofan, PAN Yuying, CUI Weifeng, LOU Jing, WANG Weifeng, ZHANG Mingli, ZHANG Jie
    2026, 29(36):  5368-5375.  DOI: 10.12114/j.issn.1007-9572.2025.0018
    Asbtract ( )   HTML ( )   PDF (1945KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    Essential hypertension is a non-communicable global epidemic disease. When complicated by major adverse cardiovascular and cerebrovascular events (MACCE), essential hypertension in associated with high incidence and high disability. Traditional Chinese medicine (TCM) has significant advantages in the prevention and treatment of this disease. Constructing a risk prediction model that combines disease and syndrome and has the characteristics of TCM syndrome elements can provide a reliable strategy for the prevention and treatment of hypertension combined with MACCE.

    Objective

    To explore the risk factors for the occurrence of MACCE in patients with essential hypertension, and to construct a risk prediction model based on the fusion of multi-modal data,using a combined classifier as the basic algorithm and involving TCM syndrome elements.

    Methods

    A total of 985 outpatients and inpatients with essential hypertension who were treated in Henan Integrative Medicine Hospital (Henan Academy of Chinese Medicine) from 2020 to 2023 were selected. Clinical data such as general information (including demographics), laboratory indicators, and TCM syndromes were collected,and the occurrence of MACCE was followed up. Taking whether MACCE occurred or not as the outcome indicator, the patients were divided into the MACCE group (284 cases) and the non-MACCE group (701 cases). The Cox proportional hazards regression model was used to screen independent risk factors and determine the final modeling variables. The random forest algorithm and the AdaBoost algorithm were respectively used to establish models, and the effectiveness of the two models was compared through the confusion matrix.

    Results

    Through the collinearity diagnosis of the Cox proportional hazards regression model, combined with clinical observations, a total of 17 variables were finally established, including disease course, gender, family history of premature cardiovascular disease, BMI, homocysteine (Hcy), mean ankle-brachial index (ABI), mean arterial pressure, flow-mediated dilation (FMD), headache, Qi deficiency with blood stasis syndrome, Yin deficiency with Yang hyperactivity syndrome, liver-kidney Yin deficiency syndrome, Yin-Yang deficiency syndrome, impaired glucose tolerance, dyslipidemia, carotid-femoral pulse wave velocity (cfPWV), dizziness. A random forest model and an AdaBoost model were constructed. The effectiveness evaluated by the confusion matrix showed that the overall accuracy of the AdaBoost model in predicting the risk of MACCE in patients with essential hypertension was 85.57%, the precision was 91.02%, the recall was 92.09%, and the F1 value was 91.55%, which was much higher than those of the random forest model (the overall accuracy was 71.81%, the precision was 75.47%, the recall was 91.32%, and the F1 value was 82.64%).

    Conclusion

    Based on the condition of multi-modal data fusion, the risk prediction model of the combined classifier constructed with variables containing the characteristics of TCM syndrome elements has better effectiveness. It can preliminarily determine the occurrence of MACCE and play a scientific guiding role in clinical prevention and treatment decisions.

    A Mixed Methods Study of Factors Influencing Dietary Management Behaviors in Patients with Inflammatory Bowel Disease from the Perspective of Temporal Self-regulation Theory
    LIU Wenjing, LIU Ting, DONG Linpei, YANG Mengjie, ZHANG Mengfan
    2026, 29(36):  5376-5384.  DOI: 10.12114/j.issn.1007-9572.2025.0555
    Asbtract ( )   HTML ( )   PDF (2026KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    Inflammatory bowel disease is characterized by its chronicity and frequent relapses. A large number of studies have confirmed that a scientific and reasonable diet can help alleviate the condition and improve the prognosis. Therefore, exploring the influencing factors of dietary management behaviors in patients with inflammatory bowel disease is of great significance for their health management.

    Objective

    To investigate the current status and influencing factors of dietary management behaviors of patients with inflammatory bowel disease, and to provide reference for healthcare professionals in formulating specialized and targeted intervention measures.

    Methods

    A convergent mixed research design was adopted. In the quantitative component, convenience sampling was used to select patients with inflammatory bowel disease who visited the outpatient department or were hospitalized in the gastroenterology department of the Affiliated Hospital of Qingdao University and Qingdao Municipal Hospital from August 2024 to April 2025 for a questionnaire survey. Questionnaires were used to assess patients' dietary consistency beliefs, temporal valuation of dietary management behaviors, dietary management intention, behavioral prepotency for dietary management, self-regulatory capacity, and dietary management behaviors. Partial least squares structural equation modeling was employed to analyze the influencing factors of their dietary management behaviors. In qualitative part, purposive sampling was used to select 22 patients for semi-structured interviews, and thematic analysis was conducted on the interview data.

    Results

    The quantitative study included a total of 278 patients. The dietary beliefs (β=0.025, 95%CI=0.003-0.065) and the temporal valuation (β=0.150, 95%CI=0.084-0.232) could indirectly influence dietary management behaviors by affecting dietary management intentions. Behavioral prepotency (β=0.422, 95%CI=0.294-0.540) and self-regulation capacity (β=0.165, 95%CI=0.069-0.269) could directly affect dietary management behaviors (P<0.05). A total of 13 themes were extracted in the four aspects of motivation, the temporal event, outcome orientation, as well as needs and predicaments. Quantitative and qualitative research results mutually validate and complement each other at the motivational level; qualitative research results supplement quantitative research results at both the temporal event level and the outcome orientation aspects; and serves as an inspiration for quantitative research at the needs and predicament level.

    Conclusion

    The dietary management behaviors of patients with inflammatory bowel disease are not satisfactory and influenced by multiple factors at the individual and environment levels. Healthcare professionals need to timely identify the influencing factors and formulate targeted intervention plans to improve the prognosis of the disease, and enhance the quality of life of these patients.

    Clinical Characteristics of Hashimoto's Thyroiditis with Elevated Serum IgG4
    ZHAO Chenxu, LIU Liyuan, ZHANG Yang, LI Ge, CHEN Lei, GAO Ying
    2026, 29(36):  5385-5392.  DOI: 10.12114/j.issn.1007-9572.2025.0196
    Asbtract ( )   HTML ( )   PDF (1996KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    Hashimoto's thyroiditis (HT) can be classified into two types based on serum IgG4 levels: elevated serum IgG4 HT (≥135 mg/dL) and non-elevated serum IgG4 HT. Previous studies suggested that the elevated serum IgG4 HT was more susceptible to develop hypothyroidism and required higher dose of levothyroxine (L-T4). However, these findings remain inconsistent.

    Objective

    This study aims to explore the clinical characteristics of elevated serum IgG4 HT and evaluate the predictive role of serum IgG4 levels for disease progression in patients with HT.

    Methods

    A total of 426 HT patients with stored serum samples at Peking University First Hospital from April to September 2016 were retrospectively followed from January 2021 to January 2022. 200 HT patients with complete clinical and follow-up data were included in the analysis. Baseline serum IgG4 levels were measured using immunoturbidimetry. Sonographic features and clinical data were compared between groups with elevated and non-elevated serum IgG4 levels at both baseline and follow-up. Disease progression was defined as deterioration of thyroid function, or an increased L-T4 dosage required to maintain euthyroidism at follow-up. The Cox proportional hazards regression analysis was used to identify the risk factors for disease progression in HT.

    Results

    Among 200 patients with HT, the median serum IgG4 level was 43 (24, 72) mg/dL. Elevated serum IgG4 levels (≥135 mg/dL) were observed in 11 patients (5.5%), who were classified as the elevated serum IgG4 HT group. The median serum IgG4 level in this group was 172 (157, 219) mg/dL. Serum free triiodothyronine (FT3) and total triiodothyronine (TT3) levels at baseline in patients with elevated serum IgG4 HT were significantly lower than those in patients with non-elevated serum IgG4 HT (P<0.05). There were no significant differences in other clinical characteristics between these two groups at baseline or follow-up (P>0.05). A total of 189 HT patients were included in the disease progression assessment, comprising 57 patients (30.2%) in the disease progression group and 132 patients(69.8%) in the non-progression group. The follow-up duration was longer in the disease progression group [57.2(57.0, 64.0) months] than in the non-progression group [56.1(51.3, 62.0) months](P<0.05). At baseline, there were statistically significant differences between the two groups in the distribution of thyroid function status, thyroid peroxidase antibody (TPOAb) positivity, and thyroid echogenicity characteristics (P<0.05). Hypothyroidism at baseline was identified as an independent risk factor for disease progression of HT (HR=2.01, 95%CI=1.07-3.78, P=0.030). However, serum IgG4 levels (HR=0.52, 95%CI=0.25-1.08, P=0.348), TPOAb positivity (HR=1.71, 95%CI=0.67-4.38, P=0.502), thyroid echogenicity characteristics, including heterogeneous echogenicity (HR=0.21, 95%CI=0.02-2.17, P=0.644) and diffuse hypoechoic pattern (HR=0.38, 95%CI=0.13-1.13, P=0.105) and the presence of grid like patterns (HR=1.49, 95%CI=0.67-3.30, P=0.263) on ultrasound were not associated with disease progression.

    Conclusion

    HT patients with elevated serum IgG4 did not exhibit distinctive clinical or sonographic characteristics, nor did they show an increased tendency toward disease progression. Elevated serum IgG4 may not be an independent risk factor for the progression of HT.

    Effects of Rosuvastatin Calcium on Inflammatory Factors and Arterial Injury in Hyperuricemic Rats and Its Metabolomics Analysis
    LI Yan, YILIMINUER· Abuduwufuer, DILIDAER· Xilifu
    2026, 29(36):  5393-5400.  DOI: 10.12114/j.issn.1007-9572.2026.0114
    Asbtract ( )   HTML ( )   PDF (2078KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    Hyperuricemia is an important independent risk factor for cardiovascular disease. It can induce vascular endothelial injury through pathways such as activating inflammatory responses and triggering oxidative stress. However, the precise mechanisms of hyperuricemia-induced vascular injury and effective intervention strategies for this condition have not been fully elucidated.

    Objective

    This study aimed to investigate the regulatory effects of different doses of rosuvastatin calcium on renal function, inflammatory factor levels, and the structure of large and small arteries in hyperuricemic rats, so as to provide an experimental basis for the clinical prevention and treatment of hyperuricemia-related vascular injury.

    Methods

    The experiments were conducted from March 2021 to August 2024. Sixty 8-week-old Sprague-Dawley (SD) rats were selected and randomly divided into five groups using a random number table, with 12 rats in each group: blank control group, model group, low-dose rosuvastatin calcium group (5 mg·kg-1 ·d-1 ), high-dose rosuvastatin calcium group (10 mg·kg-1 ·d-1 ), and positive control group (allopurinol, 53.57 mg·kg-1 ·d-1 ). Except for the blank control group, hyperuricemia models were established in the remaining groups via intragastric administration of yeast extract powder (YEP, 21 g·kg-1 ·d-1 ) combined with intraperitoneal injection of potassium oxonate (OA, 200 mg·kg-1 ·d-1 ). Starting from the first day of modeling, each drug intervention group received the corresponding dose of drug by gavage daily for 4 consecutive weeks. After intervention, serum levels of uric acid, blood urea nitrogen (BUN), creatinine (Cr), C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured. Histopathological examination was performed to observe the morphological changes of large and small arteries, including the abdominal aorta and caudal artery. Isobaric tags for relative and absolute quantitation (iTRAQ)-based proteomics was applied to screen differentially expressed proteins between groups. Gene Ontology (GO) enrichment analysis combined with Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was then conducted to explore the functions of these differentially expressed proteins and the associated molecular mechanisms.

    Results

    Significant group-by-time interactions were observed for serum uric acid, BUN, Cr, CRP, TNF-α, and IL-6 (Pinteraction<0.05), and both the main effects of group and time on these indicators were statistically significant (Pgroup<0.05, Ptime<0.05). At week 2, serum uric acid levels in the model group, the low-dose rosuvastatin calcium group, the high-dose rosuvastatin calcium group, and the positive control group were significantly higher than those in the blank control group (P<0.05). Serum creatinine level in the model group was significantly higher than those in the blank control group, the high-dose rosuvastatin calcium group, and the positive control group (P<0.05). At the 4th experimental week, the three above-mentioned indicators in the model group were higher than those in both the blank control group and all drug intervention groups, while all three indicators in the high-dose rosuvastatin calcium group were lower than those in the low-dose rosuvastatin calcium group (P<0.05). At both the 2nd and 4th weeks of the experiment, serum levels of CRP, TNF-α, and IL-6 in the model group were higher than positive control group (P<0.05). At the 4th experimental week, serum CRP in the low-dose rosuvastatin calcium group was higher than that in the high-dose rosuvastatin calcium and positive control groups, and lower in the high-dose rosuvastatin calcium group than in the positive control group. TNF-α levels in both the low-dose rosuvastatin calcium and positive control groups were higher than those in the high-dose rosuvastatin calcium group. IL-6 in the low-dose rosuvastatin calcium group was higher than that in the high-dose rosuvastatin calcium group but lower than that in the positive control group, and lower in the high-dose rosuvastatin calcium group than in the positive control group (all P<0.05). Histopathological results showed that rats in the model group exhibited smooth muscle cell proliferation in the arterial tunica media, endothelial cell exfoliation, luminal narrowing, and fibrous connective tissue hyperplasia in the tunica adventitia. The most pronounced repair of arterial injury was observed in the high-dose rosuvastatin calcium group, where the vascular structure closely resembled that of the blank control group. Proteomic analysis showed that, after high-dose intervention, the protein expression profile of the rats most closely resembled that of the blank control group (12 proteins upregulated and 14 downregulated). GO enrichment analysis showed that the differentially expressed proteins were mainly involved in biological processes such as lipoprotein regulation and phospholipid efflux. KEGG pathway analysis indicated that the differentially expressed proteins were mainly enriched in pathways related to lipid metabolism.

    Conclusion

    Rosuvastatin calcium can effectively reduce serum uric acid levels and inflammatory factor expression in rats with hyperuricemia and exerts a significant reparative effect against hyperuricemia-mediated vascular injury in a dose-dependent manner; its mechanism may be associated with the regulation of lipid metabolism-related proteins and signaling pathways.

    Original Research·Research Trends of Traditional Chinese Medicine
    Evaluation of Evidence Grades and Reflections on 9 Commonly Used Chinese Patent Medicines for Treating Hashimoto's Thyroiditis Based on the Integrated Evidence Chain
    DENG Hongxiao, SI Xinying, WEI Guangcheng, JIAO Gena, LI Qi, CHEN Zhi, HU Rui, QI Shuo, DING Zhiguo
    2026, 29(36):  5401-5408.  DOI: 10.12114/j.issn.1007-9572.2025.0350
    Asbtract ( )   HTML ( )   PDF (1939KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    At present, there are no specific drugs targeting the immune-dysregulation mechanisms underlying Hashimoto's thyroiditis (HT). Although Chinese patent medicines are widely used in the adjuvant therapy of HT, the grade of evidence-based evidence for their efficacy has not been systematically and standardizedly evaluated.

    Objective

    To evaluate the evidence grades of 9 commonly used CPMs for HT using the integrated evidence chain based effectiveness evaluation of traditional Chinese medicine (Eff-iEC), and provide evidence-based basis for HT treatment with traditional Chinese medicine.

    Methods

    Literatures on CPMs for HT were retrieved from CNKI, VIP and Wanfang Data (from database establishment to June 15, 2025). After screening by criteria, CPMs mentioned ≥5 times were identified as common ones. Their evidence grades were evaluated via Eff-iEC from three aspects: clinical experience (Grade A-D), experimental research (Grade A-D) and clinical trials (Grade A-D).

    Results

    A total of 178 literatures were initially screened, 69 were finally included, and 9 common CPMs were confirmed. Eff-iEC evaluation showed: Prunella vulgaris preparations were high-level evidence (AA+B), Tripterygium wilfordii preparations were intermediate-level evidence (BAB); Bailing Capsules (BB+B), Jinshuibao Capsules (BB+B), Xiaojin preparations (ACB), Huobahuagen Tablets (CDB), Yougui preparations (ADB), Buyuan Capsules (CDB) and Jinkui Shenqi Pills (ADB) were all low-level evidence.

    Conclusion

    Eff-iEC is an innovative tool for efficacy evaluation of traditional Chinese medicine. Among the 9 CPMs, Prunella vulgaris preparations have the highest evidence grade, followed by Tripterygium wilfordii preparations, and the rest have low grades. In addition, the Eff-iEC evaluation criteria need further improvement to enhance scientificity and clinical applicability.

    Mechanism Analysis of the Effect of Danggui-Hongqi Medicine Against Myocardial Fibrosis: Based on Bioinformatics Technology
    YANG Kaiyan, LI Shuling, WEI Huiping, ZHEN Xiaolong, KOU Zongli, WANG Xinqiang, WANG Jie, XU Xin
    2026, 29(36):  5409-5419.  DOI: 10.12114/j.issn.1007-9572.2023.0702
    Asbtract ( )   HTML ( )   PDF (3483KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    The classic Chinese herbal pair of Danggui-Hongqi has shown certain effect in anti-myocardial fibrosis, but the underlying mechanisms remain unclear.

    Objective

    To explore the mechanisms underlying the effects of the Danggui-Hongqi herbal pair against myocardial fibrosis.

    Methods

    We searched the Web of Science Core Collection (WoSCC) to analyze the publication trends of literature on myocardial fibrosis. We used the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) to identify the major bioactive compounds of the Chinese herbal pair of Danggui-Hongqi. GeneCards.org was used to screen drug-disease intersection target genes, followed by GO enrichment analysis and KEGG enrichment analysis. Molecular docking technology was employed to dock the core proteins with the major bioactive compounds of Chinese herbal pair of Danggui-Hongqi.

    Results

    From 1992 to 2022, the number of publications on myocardial fibrosis in the WoSCC showed an increasing trend. A total of 13 major bioactive compounds of Chinese herbal pair of Danggui-Hongqi and 148 drug-disease intersection target genes were obtained. GO enrichment analysis indicated that, the effect in anti-myocardial fibrosis of Chinese herbal pair of Danggui-Hongqi involve biological processes such as responses to reactive oxygen species, drug responses, lipopolysaccharide responses, and oxidative stress responses. KEGG enrichment analysis showed that, the effect in anti-myocardial fibrosis of Chinese herbal pair of Danggui-Hongqi were mainly associated with inflammation-related signaling pathways, including the interleukin-17 signaling pathway, tumor necrosis factor signaling pathway, and hypoxia-inducible factor-1 signaling pathway. Molecular docking results showed that, the binding energies between the top three major bioactive compounds of Chinese herbal pair of Danggui-Hongqi (quercetin, β-sitosterol, and stigmasterol) and the top three core proteins (MAPK3, JUN, and MAPK1) were all less than 0 kcal/mol.

    Conclusion

    Myocardial fibrosis is one of the future research hotspots and directions. The Chinese herbal pair of Danggui-Hongqi exerts anti-myocardial fibrosis effect through various biological processes and multiple signaling pathways, with its major bioactive compounds, quercetin, β-sitosterol, and stigmasterol, being potential candidate drug molecules.

    Effect of Yifei Xuanfei Jiangzhuo Prescription on Autophagy Regulation Mechanism of AMPK/mTOR/ULK1 Signaling Pathway in Vascular Dementia Rats
    CHEN Wei, SU Mingyang, HUANG Deqing, ZHUO Guifeng, ZHU Xiaomin, ZHANG Jinzhi, FU Yulan, LI Zhongtong, JIANG Lingfei
    2026, 29(36):  5420-5427.  DOI: 10.12114/j.issn.1007-9572.2024.0325
    Asbtract ( )   HTML ( )   PDF (2403KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    Vascular dementia (VD) is one of the refractory neurological diseases, and its pathogenesis remains unclear. Therefore, it is crucial to explore key targets for the treatment of VD.

    Objective

    To investigate the intervention effect of Yifei Xuanfei Jiangzhuo prescription (YFXFJZF) on VD rats based on the AMP-activated protein kinase (AMPK)/mechanistic target of rapamycin (mTOR)/Unc-51-like autophagy activating kinase 1 (ULK1) pathway.

    Methods

    A total of 70 8-week-old SPF-grade male SD rats were used, with 10 assigned to the normal group (K group). The remaining rats were used to establish a VD rat model via bilateral common carotid artery ligation. After successful modeling, the rats were randomly divided into the VD model group (M group), YFXFJZF group (Z group), autophagy inhibitor group (Y group), autophagy activator group (D group), autophagy inhibitor+YFXFJZF group (YZ group), and VD model group+autophagy activator+YFXFJZF group (DZ group), with 10 rats in each group. The Z group was administered YFXFJZF at a dose of 1.2 g/kg via gavage. The K and M groups were given an equal volume of normal saline via gavage. Starting from day 15 of the experiment, the Y group was given intraperitoneal injections of 3-methyladenine (3-MA) at 1.5 mg/kg every other day for 14 days, and the D group was given intraperitoneal injections of rapamycin at 2 μg/kg every other day for 14 days. The intervention lasted for 28 days in total. After behavioral testing, blood samples and hippocampal tissues were collected from the rats. Hematoxylin-eosin (HE) staining was used to observe the pathological changes in the hippocampal tissue. Lead citrate staining (electron microscopy) was used to observe the condition of hippocampal neurons and autophagosomes. Western blotting was used to detect the protein expression of AMPK, p-AMPK, mTOR, p-mTOR, ULK1, phospho-Ser757-Unc-51-like autophagy activating kinase 1 (p-S757-ULK1), Microtubule-associated protein 1 light chain 3 (LC3), and P62 in the hippocampus. Real-time quantitative PCR was used to detect the mRNA expression of AMPK, mTOR, ULK1, LC3, and P62 in the hippocampus. Data conforming to a normal distribution were expressed as (±s). For comparisons among multiple groups with homogeneous variances, one-way analysis of variance was used, and the LSD method was used for pairwise comparisons between groups.

    Results

    Behavioral testing showed that compared with the K group, the escape latency of VD rats in the M group was significantly prolonged, and the number of platform crossings was significantly reduced (P<0.05). Compared with the M group, the escape latency was shortened in the Z, Y, D, YZ, and DZ groups, and the number of platform crossings was increased (P<0.05). HE staining showed that the cells in the CA1 region of the hippocampus in the K group were neatly arranged with normal morphology and structure. The M group had severe damage, with deeper cell staining, unclear boundaries between nuclei and cytoplasm, cytoplasmic vacuolization, and irregular shapes. The D, DZ, and YZ groups showed some repair of the damaged hippocampal tissue compared with the M group, while the Z and Y groups showed more obvious recovery of the damaged hippocampal tissue. Lead citrate staining showed that the neuronal cell membranes in the CA1 region of the hippocampus in the K group were intact and smooth, with clear nucleoli, evenly distributed chromatin in the nuclei, and intact nuclear membranes. Compared with the K group, the neurons in the M group were severely damaged, with intact cell membranes, edematous cytoplasm, sparse and dissolved cytoplasmic contents, and markedly swollen organelles. Most mitochondria were significantly swollen, with intact membranes, large amounts of dissolved matrix, and broken or disappeared cristae. Compared with the M group, the neuronal damage was improved in the Z, Y, D, YZ, and DZ groups, with reduced autophagy levels. Western blotting results showed that the p-AMPK/AMPK ratio was higher in the M, Y, and D groups than in the K group, while it was lower in the Z, YZ, and DZ groups than in the M group. The p-mTOR/mTOR ratio was lower in the M, Y, D, and DZ groups than in the K group, while it was higher in the Z and YZ groups than in the M group (P<0.05). The p-S757-ULK1/ULK1 ratio was higher in the M and D groups than in the K group, while it was lower in the Z, Y, YZ, and DZ groups than in the M group (P<0.05). The LC3II/LC3I ratio was higher in the M and D groups than in the K group, while it was lower in the Z, Y, YZ, and DZ groups than in the M group (P<0.05). P62 expression was lower in the M and D groups than in the K group, while it was higher in the Z, Y, YZ, and DZ groups than in the M group (P<0.05). Real-time quantitative PCR results showed that the mRNA expression of AMPK, mTOR, LC3, P62, and ULK1 in the M group was significantly different from that in the K group (P<0.05). The mRNA expression of AMPK was lower in the Z, DZ, and YZ groups than in the M group (P<0.05). The mRNA expression level of mTOR was lower in the Z, DZ, and YZ groups than in the M group (P<0.05). The mRNA expression level of LC3 was lower in the Z, YZ, and DZ groups than in the M group (P<0.05). The mRNA expression level of LC3 was lower in the Z and YZ groups than in the M group (P<0.05).

    Conclusion

    YFXFJZF may regulate the level of autophagy in the hippocampus by modulating the AMPK/mTOR/ULK1 signaling pathway, protect the function of hippocampal neurons, and delay the progression of VD.

    Original Research·Study of Evidence-based Medicine
    Meta-analysis of the Effect of Physical Exercise on Working Memory in Patients with Depression and Its Influencing Factors
    CHI Liaojing, LI Na, LI Yafang
    2026, 29(36):  5428-5441.  DOI: 10.12114/j.issn.1007-9572.2025.0258
    Asbtract ( )   HTML ( )   PDF (3670KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    Working memory impairment is a core cognitive feature of depression. Physical exercise may improve working memory through neuroplastic mechanisms, yet existing meta-analyses have yielded inconsistent conclusions and lack in-depth exploration of key moderators such as intervention dosage and age.

    Objective

    To systematically evaluate the effects of physical exercise on working memory in patients with depression and provide evidence for developing clinical exercise interventions for working memory impairment.

    Methods

    Searched PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, and WanFang Data for RCTs on exercise interventions for working memory in depression patients. Search period: database inception to December 2024. Independently screened and coded studies. Assessed RCT quality using the PEDro scale. Conducted meta-analysis with RevMan 5.3 and Stata 17.

    Results

    Twenty eligible studies (total sample: n=1 475) with 31 effect sizes were included. Physical exercise significantly improved working memory in depressed patients (SMD=0.18, 95%CI=0.03-0.32, P=0.02). Subgroup analyses showed that the form, frequency and duration of physical exercise intervention moderated the effect of exercise on improving working memory in patients with depression: Baduanjin/Tai Chi yielded the highest effect size (SMD=0.95, 95%CI=0.49-1.40, P<0.001); 7 sessions per week had the strongest effect (SMD=1.31, 95%CI=0.84-1.78, P<0.001), and 5 sessions per week still had a significant effect (SMD=0.30, 95%CI=0.09-0.52, P=0.005); a single 60-min exercise session produced a significant effect (SMD=0.48, 95%CI=0.23-0.73, P<0.001).

    Conclusion

    Physical exercise effectively improves working memory in depression, with efficacy moderated by exercise modality, frequency, and duration. Tai Chi and Baduanjin are recommended as primary mind-body interventions.

    Meta-integration of Qualitative Studies on Factors Promoting and Hindering Glycemic Control in Women with Gestational Diabetes Mellitus
    PAN Yao, DI Tietao, ZHANG Yaoyao, ZHANG Chunling, CHEN Lu, WU Hexiang, ZHANG Yimei
    2026, 29(36):  5442-5451.  DOI: 10.12114/j.issn.1007-9572.2025.0445
    Asbtract ( )   HTML ( )   PDF (2567KB) ( )  
    Figures and Tables | References | Related Articles | Metrics
    Background

    In recent years, the incidence of gestational diabetes mellitus has increased, posing a serious threat to maternal and infant health. Standardized glycemic management can effectively improve adverse maternal and infant outcomes. While current qualitative studies have explored patients' blood glucose management behaviors and experiences in depth, the findings are relatively fragmented. Therefore, a meta-synthesis is urgently needed to comprehensively understand the facilitating and hindering factors for patients' blood glucose management.

    Objective

    To systematically synthesize qualitative studies on factors promoting and hindering blood glucose management in patients with gestational diabetes, providing evidence-based guidance for optimizing management strategies.

    Methods

    We searched PubMed, Web of Science, Embase, CINAHL, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data VIP Database, and China Biomedical Literature Database for qualitative studies on factors promoting and hindering blood glucose management in patients with gestational diabetes. The search period spanned from database inception to June 30, 2025. Two researchers independently assessed study quality using the Joanna Briggs Institute (JBI) Australian Centre for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. Literature screening was conducted using NoteExpress software, and results were synthesized using a meta-synthesis approach.

    Results

    A total of 20 studies were included, yielding 44 research findings categorized into 10 themes and synthesized into 2 integrated results: facilitating factors included maternal-infant health responsibility, proactive self-regulation, diverse social support, and medical support and interventions. Barriers included endogenous cognitive impairments and exogenous stigma pressures, emotional burdens and difficulties in psychological adaptation, multiple practical challenges in managing blood glucose during pregnancy, an imperfect healthcare system, obstacles in implementing blood glucose monitoring, and socioeconomic and cultural environmental challenges.

    Conclusion

    Blood glucose management in women with gestational diabetes mellitus is influenced by multiple factors, including individual cognition, the healthcare system, and social support. Healthcare providers should enhance patients' blood glucose management by fostering patients' intrinsic motivation for self-management, strengthening cognitive and emotional interventions, and integrating diverse support resources.

    Review & Perspectives
    Research Progress of mTOR Pathway in Heart Failure Caused by Myocardial Aging
    WANG Yujia, ZHANG Jinying, TANG Junnan
    2026, 29(36):  5452-5457.  DOI: 10.12114/j.issn.1007-9572.2024.0650
    Asbtract ( )   HTML ( )   PDF (1937KB) ( )  
    References | Related Articles | Metrics

    Heart failure is the end-stage of many heart diseases with poor prognosis, and its risk increases significantly with age and myocardial cell aging. The mammalian target of rapamycin (mTOR) pathway plays a key role in the pathophysiology of cardiomyocyte aging. This article reviews the latest research progress of the mTOR pathway in heart failure caused by myocardial cell aging, and explores potential intervention strategies to delay cardiomyocyte aging. This article shows that the continued activation of mTORC1 during aging drives pathological cardiac changes and accelerates the progression of heart failure by regulating protein synthesis, lipid metabolism, and inhibiting autophagy. Conversely, inhibiting the overactivation of mTORC1 can slow cardiac aging and extend lifespan in elderly animals. This article provides new insights into alleviating heart failure caused by aging and could help reduce the societal burden of this disease.

    Cascade Mechanism of Inflammaging-driven Intervertebral Disc Degeneration: from Microenvironmental Evolution to Tissue Fibrosis and Frontier Intervention Strategies
    YAN Manli, LUO Junhua, ZHANG Baoqing
    2026, 29(36):  5458-5465.  DOI: 10.12114/j.issn.1007-9572.2026.0132
    Asbtract ( )   HTML ( )   PDF (2197KB) ( )  
    References | Related Articles | Metrics

    As the core pathological basis of chronic low back pain and spinal dysfunction, intervertebral disc degeneration (IVDD) is not caused solely by mechanical wear and tear, but rather is the result of a progressive process in which mechanical imbalances and biological dysregulation are deeply intertwined. The introduction of the concept of "inflammaging" provides a new dimension for elucidating its complex evolutionary law. Studies have shown that the pathological evolution of IVDD is not a stacking of isolated events, but a multi-dimensional molecular cascade response driven by inflammatory aging. Internal and external stress triggers the continuous release of the senescence-associated secretory phenotype (SASP) by inducing cells to enter the aging process, which not only reshapes the local immune microenvironment, but also leads to the gradual loss of the original immune privilege of the intervertebral disc. Under the action of chronic low-grade inflammation, cell metabolic reprogramming is becoming more and more significant: excessive lactic acid accumulation forms a feed-forward cycle of "microenvironment acidification-inflammation cascade-matrix degradation" by activating acid-sensitive ion channels. With the progression of the disease, the abnormal activation of the transforming growth factor-β signaling pathway further promotes the phenotypic transformation of cells, resulting in the transformation of the elastic matrix to pathological fibrosis, which eventually leads to the loss of spinal motor unit function. In view of the above pathological processes, this paper systematically reviews the cutting-edge intervention strategies to block the cascade reaction, including the use of senolytic drugs to target the removal of senescent cells to block the source of inflammation, the targeting of the inhibition of SASP paracrine effects with the help of functional carriers, and the reshaping of matrix homeostasis with the help of responsive hydrogels. In-depth analysis of the molecular cascade mechanism triggered by inflammatory aging and synergistic biomaterial technology to block the pathological circulation can provide important theoretical support for early intervention and tissue regeneration and repair of IVDD.

    Progress of Artificial Intelligence in Children with Attention Deficit Hyperactivity Disorder
    WU Li, WANG Haoyi, QIU Xiangyang, YUAN Jing, CHEN Runan
    2026, 29(36):  5466-5472.  DOI: 10.12114/j.issn.1007-9572.2025.0229
    Asbtract ( )   HTML ( )   PDF (2156KB) ( )  
    Figures and Tables | References | Related Articles | Metrics

    Attention deficit hyperactivity disorder (ADHD) is a neurological disorder that significantly affects children's growth and development. Accurate and efficient diagnosis and intervention strategies are crucial for promoting the physical and mental health of affected children and improving their quality of life. Currently, clinical diagnosis and treatment of ADHD face numerous challenges, including strong subjectivity in diagnosis, significant individual differences in treatment efficacy, and complex comorbidities. Artificial intelligence (AI), with its powerful algorithmic analysis and precise feature extraction capabilities, has shown great potential in the early diagnosis and efficacy evaluation of ADHD in children. It is expected to provide multi-dimensional clinical decision support and assess prognosis through AI technology. This article summarizes the research progress of AI in ADHD diagnosis, symptom and drug efficacy prediction, and cross-diagnosis in recent years. At the same time, it distills core common challenges and puts forward targeted suggestions to provide references for promoting the development and application of AI technology in ADHD.