Shimon Sakaguchi, a Japanese scientist, together with Mary E. Brunkow and Fred Ramsdell, American scientists, were jointly awarded the 2025 Nobel Prize in Physiology or Medicine for their pioneering discoveries in the field of peripheral immune tolerance. This review summarizes the Nobel Prize-winning research on immune tolerance and discusses the development, functions, and therapeutic applications of regulatory T cell (Treg)-based interventions. These seminal studies on immune tolerance underscore a central immunological concept-a healthy immune system relies not only on its robust capacity to eliminate pathogens and mutated cells, but also on the precise inhibitory (or "brake") and tolerance mechanisms. This concept will help deepen our understanding of key medical challenges such as autoimmune diseases, transplant rejection, and tumor immunity. It will spur the development of a series of therapeutic strategies targeting peripheral immune tolerance and Treg cells and advance research in precision immune regulation.
日本科学家坂口Shimon Sakaguchi与美国科学家Mary E. Brunkow和Fred Ramsdell共同获得2025年诺贝尔生理学或医学奖，以表彰他们在外周免疫耐受领域的开创性发现。本文综述了获得诺贝尔奖的免疫耐受研究，并讨论了基于调节性T细胞（Treg）的干预措施的发展、功能和治疗应用。这些关于免疫耐受的开创性研究强调了一个核心的免疫学概念——健康的免疫系统不仅依赖于其强大的消灭病原体和突变细胞的能力，还依赖于精确的抑制（或“制动”）和耐受机制。这一概念将有助于加深我们对自身免疫性疾病、移植排斥和肿瘤免疫等关键医学挑战的理解。这将促进一系列针对外周免疫耐受和Treg细胞的治疗策略的发展，并推进精确免疫调节的研究。
{"title":"[Guardians of Immune Tolerance: Regulatory T Cells].","authors":"Kang Ming, Huiyuan Zhang, Hongbo Hu","doi":"10.12182/20251160302","DOIUrl":"10.12182/20251160302","url":null,"abstract":"<p><p>Shimon Sakaguchi, a Japanese scientist, together with Mary E. Brunkow and Fred Ramsdell, American scientists, were jointly awarded the 2025 Nobel Prize in Physiology or Medicine for their pioneering discoveries in the field of peripheral immune tolerance. This review summarizes the Nobel Prize-winning research on immune tolerance and discusses the development, functions, and therapeutic applications of regulatory T cell (Treg)-based interventions. These seminal studies on immune tolerance underscore a central immunological concept-a healthy immune system relies not only on its robust capacity to eliminate pathogens and mutated cells, but also on the precise inhibitory (or \"brake\") and tolerance mechanisms. This concept will help deepen our understanding of key medical challenges such as autoimmune diseases, transplant rejection, and tumor immunity. It will spur the development of a series of therapeutic strategies targeting peripheral immune tolerance and Treg cells and advance research in precision immune regulation.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"56 6","pages":"1453-1458"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145970920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nursing Group Of Chinese Pediatric Society Chinese Medical Association, Association Nursing Branch China Maternal And Child Health
As an integral component of modern pediatric healthcare, child life services are designed to address the psychosocial issues that children may encounter during hospitalization and other medical care processes, and to mitigate the negative impacts of stressful experiences. Given that child life services in China are still in an early exploratory stage and lack unified and standardized clinical practice guidelines, a multidisciplinary expert consensus development group was jointly established by West China Second University Hospital, Sichuan University, Children's Hospital, Zhejiang University School of Medicine, Shenzhen Children's Hospital, Children's Hospital of Fudan University, and the Children's Cancer Foundation of the Hong Kong Special Administrative Region. Through a systematic literature review and expert deliberations, this consensus has been formulated. This consensus covers the target population, applicable settings, implementation environments, selection criteria for practitioners, training and assessment of practitioners, practice principles, core service content, implementation processes, and outcome evaluation, providing effective clinical practice guidance for child life services practitioners.
{"title":"[Expert Consensus on the Clinical Practice of Child Life Services].","authors":"Nursing Group Of Chinese Pediatric Society Chinese Medical Association, Association Nursing Branch China Maternal And Child Health","doi":"10.12182/20251160203","DOIUrl":"10.12182/20251160203","url":null,"abstract":"<p><p>As an integral component of modern pediatric healthcare, child life services are designed to address the psychosocial issues that children may encounter during hospitalization and other medical care processes, and to mitigate the negative impacts of stressful experiences. Given that child life services in China are still in an early exploratory stage and lack unified and standardized clinical practice guidelines, a multidisciplinary expert consensus development group was jointly established by West China Second University Hospital, Sichuan University, Children's Hospital, Zhejiang University School of Medicine, Shenzhen Children's Hospital, Children's Hospital of Fudan University, and the Children's Cancer Foundation of the Hong Kong Special Administrative Region. Through a systematic literature review and expert deliberations, this consensus has been formulated. This consensus covers the target population, applicable settings, implementation environments, selection criteria for practitioners, training and assessment of practitioners, practice principles, core service content, implementation processes, and outcome evaluation, providing effective clinical practice guidance for child life services practitioners.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"56 6","pages":"1566-1572"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145970938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To investigate the effect of the Yangyin Yiqi Huoxue formula on the oral microecology in a mouse model of Sjögren's syndrome (SS), and to explore the underlying mechanisms.
Methods: A total of 12 8-week-old non-obese diabetic (NOD) mice were randomly assigned to a model group, a traditional Chinese medicine (TCM) group, and a hydroxychloroquine (HCQ) group, with 4 mice in each group. In addition, 4 BALB/c mice were used as the normal control group. The TCM group was administered Yangyin Yiqi Huoxue formula (15 g/[kg·d]) via gavage and the HCQ group received HCQ (0.08 g/[kg·d]) via gavage. The normal control and model groups were maintained under standard feeding conditions without intervention. After 8 weeks of treatment, saliva samples were collected for 16S rRNA gene sequencing to analyze the oral microbiota. Alpha diversity, beta diversity, and functional prediction analyses were performed.
Results: Alpha diversity analysis showed that the Yangyin Yiqi Huoxue formula significantly increased oral microbiome diversity in NOD mice (P < 0.05). Species composition analysis indicated that the formula increased the abundance of the phylum Proteobacteria and decreased the abundance of the phylum Firmicutes (P < 0.01), while HCQ led to an abnormal decrease in the abundance of the phylum Firmicutes. Beta diversity analysis revealed distinct microbial clustering in the treatment groups and the model group, with the TCM group showing clustering in the phylum Proteobacteria and exhibiting lower intragroup dispersion than the HCQ group did. According to the functional prediction analysis, both the TCM and HCQ groups demonstrated regulatory potential in terms of amino acid transport and metabolism, transcription, and other related functions. KEGG analysis found greater microbial enrichment in cellular processes, environmental information processing, and disease-related pathways in the TCM group compared to the HCQ group (P < 0.05).
Conclusion: The Yangyin Yiqi Huoxue formula can restore oral microbiome diversity and improve the colony structure in in a mouse model of SS, providing experimental evidence for the advantages of TCM in regulating oral microecological functions.
{"title":"[Effects and Mechanisms of Yangyin Yiqi Huoxue Formula on the Oral Microecology in Sjögren's Syndrome Model Mice].","authors":"Fangping Wu, Wenwen Lu, Danbin Wu, Yangqing Zhou, Haifeng Lu, Lixiong Ying, Guolin Wu","doi":"10.12182/20251160603","DOIUrl":"10.12182/20251160603","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of the Yangyin Yiqi Huoxue formula on the oral microecology in a mouse model of Sjögren's syndrome (SS), and to explore the underlying mechanisms.</p><p><strong>Methods: </strong>A total of 12 8-week-old non-obese diabetic (NOD) mice were randomly assigned to a model group, a traditional Chinese medicine (TCM) group, and a hydroxychloroquine (HCQ) group, with 4 mice in each group. In addition, 4 BALB/c mice were used as the normal control group. The TCM group was administered Yangyin Yiqi Huoxue formula (15 g/[kg·d]) via gavage and the HCQ group received HCQ (0.08 g/[kg·d]) via gavage. The normal control and model groups were maintained under standard feeding conditions without intervention. After 8 weeks of treatment, saliva samples were collected for 16S rRNA gene sequencing to analyze the oral microbiota. Alpha diversity, beta diversity, and functional prediction analyses were performed.</p><p><strong>Results: </strong>Alpha diversity analysis showed that the Yangyin Yiqi Huoxue formula significantly increased oral microbiome diversity in NOD mice (<i>P</i> < 0.05). Species composition analysis indicated that the formula increased the abundance of the phylum Proteobacteria and decreased the abundance of the phylum Firmicutes (<i>P</i> < 0.01), while HCQ led to an abnormal decrease in the abundance of the phylum Firmicutes. Beta diversity analysis revealed distinct microbial clustering in the treatment groups and the model group, with the TCM group showing clustering in the phylum Proteobacteria and exhibiting lower intragroup dispersion than the HCQ group did. According to the functional prediction analysis, both the TCM and HCQ groups demonstrated regulatory potential in terms of amino acid transport and metabolism, transcription, and other related functions. KEGG analysis found greater microbial enrichment in cellular processes, environmental information processing, and disease-related pathways in the TCM group compared to the HCQ group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The Yangyin Yiqi Huoxue formula can restore oral microbiome diversity and improve the colony structure in in a mouse model of SS, providing experimental evidence for the advantages of TCM in regulating oral microecological functions.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"56 6","pages":"1556-1565"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Trained immunity is a state of enhanced immune responsiveness based on innate immune (epigenetic) memory. It has recently been reported that trained immunity plays an important role in the comorbidity of periodontitis and rheumatoid arthritis (RA). Epigenetic modifications in hematopoietic stem and progenitor cells (HSPCs) can activate trained immunity in bone marrow-derived cells, a mechanism closely associated with the onset and progression of periodontitis and other related systemic diseases. Exhibiting hyper-reactivity, trained immune cells are capable of migrating to distant joint sites and eliciting a more intense inflammatory response upon external stimulation. This review focuses on the underlying mechanisms of trained immunity and its involvement in both periodontitis and RA. Understanding the role of trained immunity in the association between periodontitis and RA provides valuable insights for further research and the development of therapeutic strategies for inflammatory comorbidities, such as periodontitis and RA.
{"title":"[Role of Trained Immunity in the Association Between Periodontitis and Rheumatoid Arthritis].","authors":"Renjing You, Yujia Cui, Jianxun Sun","doi":"10.12182/20250960503","DOIUrl":"10.12182/20250960503","url":null,"abstract":"<p><p>Trained immunity is a state of enhanced immune responsiveness based on innate immune (epigenetic) memory. It has recently been reported that trained immunity plays an important role in the comorbidity of periodontitis and rheumatoid arthritis (RA). Epigenetic modifications in hematopoietic stem and progenitor cells (HSPCs) can activate trained immunity in bone marrow-derived cells, a mechanism closely associated with the onset and progression of periodontitis and other related systemic diseases. Exhibiting hyper-reactivity, trained immune cells are capable of migrating to distant joint sites and eliciting a more intense inflammatory response upon external stimulation. This review focuses on the underlying mechanisms of trained immunity and its involvement in both periodontitis and RA. Understanding the role of trained immunity in the association between periodontitis and RA provides valuable insights for further research and the development of therapeutic strategies for inflammatory comorbidities, such as periodontitis and RA.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"56 6","pages":"1709-1714"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mingwu Li, Shuchao Qin, Weinan Ping, Chengcheng Zhang, Jun Duan, Jingjing Li
<p><strong>Objective: </strong>To investigate the regulatory mechanism of a circular RNA (circRNA), circ_001146, on the miR-1200/SP1 axis in spinal cord injury (SCI).</p><p><strong>Methods: </strong>In the animal model, male Sprague-Dawley rats of 8 weeks old, weighing 220-250 g, were randomly assigned to 5 groups (<i>n</i> = 5 per group), including the sham-operated (SHAM) group, SCI group, circ_0011462 knockdown (sh-circ_0011462) group, circ_0011462 knockdown + empty plasmid control (NC) group, and circ_0011462 knockdown + SP1 overexpression (overexpression-SP1) group. Motor function recovery of the rats in different groups was evaluated at multiple time points using the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale, tail-flick latency (TFL) test, and grid walking test. Nissl staining was performed to measure the number of motor neurons in the anterior horn of the spinal cord. Immunohistochemistry assays were performed to determine the expression of pNF and synaptophysin in the spinal tissue. The quantity of M1-type microglia was assessed using multiplex immunofluorescence. Enzyme-linked immunosorbent assay (ELISA) was performed to measure the levels of IL-1β, IL-6, and TNF-α in peripheral blood across the groups. In addition, cellular experiments included qPCR to determine the mRNA levels of circ_001146, miR-1200, and SP1 in different groups, Western blot (WB) to detect the protein levels of SP1, BCL-2, and Caspase-3, flow cytometry to assess cell apoptosis rates, and phase-contrast microscopy to observe cell morphological changes.</p><p><strong>Results: </strong>In the animal experiment, at 21 and 28 days post surgery, the sh-circ_0011462 group exhibited significantly higher BBB scores (7.00 ± 1.20 and 10.00 ± 2.21) and TFL scores (1.21 ± 0.41 and 1.19 ± 0.31) compared with the SP1 overexpression group (BBB: 5.00 ± 0.60 and 6.00 ± 0.80; TFL: 0.80 ± 0.25 and 0.70 ± 0.20) and the SCI group (BBB: 4.00 ± 0.60 and 5.00 ± 0.70; TFL: 0.60 ± 0.21 and 0.50 ± 0.18) (all <i>P</i> < 0.05). In contrast, Gridwalk scores in the sh-circ_0011462 group (1.38 ± 0.31 and 1.22 ± 0.33) were significantly lower than those in the overexpression-SP1 group (2.32 ± 0.37 and 2.40 ± 0.41) and the SCI group (2.72 ± 0.45 and 2.80 ± 0.42) (<i>P</i> < 0.05 for all comparisons). At day 28 post-surgery, the levels of IL-1β, IL-6, and TNF-α in the sham group were lower than those in all other groups (<i>P</i> < 0.05). The SCI and overexpression-SP1 groups showed elevated levels of these cytokines, all of which were significantly higher than those in the sh-circ_0011462 group (all <i>P</i> < 0.05). Immunostaining revealed that the number of iNOS-positive cells in the sh-circ_0011462 group was significantly lower than that in the SCI group and the overexpression-SP1 group (<i>P</i> < 0.05). Moreover, the number of motor neurons, axonal length, and synapse density in the anterior horn of rats in the sh-circ_0011462 group were all significantly greater than those in th
{"title":"[Underlying Mechanism of the circ_0011462/miRNA-1200/SP1 Axis in Regulating Inflammatory Response, Apoptosis, and Neural Regeneration in a Spinal Cord Injury Model].","authors":"Mingwu Li, Shuchao Qin, Weinan Ping, Chengcheng Zhang, Jun Duan, Jingjing Li","doi":"10.12182/20251160605","DOIUrl":"10.12182/20251160605","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the regulatory mechanism of a circular RNA (circRNA), circ_001146, on the miR-1200/SP1 axis in spinal cord injury (SCI).</p><p><strong>Methods: </strong>In the animal model, male Sprague-Dawley rats of 8 weeks old, weighing 220-250 g, were randomly assigned to 5 groups (<i>n</i> = 5 per group), including the sham-operated (SHAM) group, SCI group, circ_0011462 knockdown (sh-circ_0011462) group, circ_0011462 knockdown + empty plasmid control (NC) group, and circ_0011462 knockdown + SP1 overexpression (overexpression-SP1) group. Motor function recovery of the rats in different groups was evaluated at multiple time points using the Basso, Beattie, and Bresnahan (BBB) locomotor rating scale, tail-flick latency (TFL) test, and grid walking test. Nissl staining was performed to measure the number of motor neurons in the anterior horn of the spinal cord. Immunohistochemistry assays were performed to determine the expression of pNF and synaptophysin in the spinal tissue. The quantity of M1-type microglia was assessed using multiplex immunofluorescence. Enzyme-linked immunosorbent assay (ELISA) was performed to measure the levels of IL-1β, IL-6, and TNF-α in peripheral blood across the groups. In addition, cellular experiments included qPCR to determine the mRNA levels of circ_001146, miR-1200, and SP1 in different groups, Western blot (WB) to detect the protein levels of SP1, BCL-2, and Caspase-3, flow cytometry to assess cell apoptosis rates, and phase-contrast microscopy to observe cell morphological changes.</p><p><strong>Results: </strong>In the animal experiment, at 21 and 28 days post surgery, the sh-circ_0011462 group exhibited significantly higher BBB scores (7.00 ± 1.20 and 10.00 ± 2.21) and TFL scores (1.21 ± 0.41 and 1.19 ± 0.31) compared with the SP1 overexpression group (BBB: 5.00 ± 0.60 and 6.00 ± 0.80; TFL: 0.80 ± 0.25 and 0.70 ± 0.20) and the SCI group (BBB: 4.00 ± 0.60 and 5.00 ± 0.70; TFL: 0.60 ± 0.21 and 0.50 ± 0.18) (all <i>P</i> < 0.05). In contrast, Gridwalk scores in the sh-circ_0011462 group (1.38 ± 0.31 and 1.22 ± 0.33) were significantly lower than those in the overexpression-SP1 group (2.32 ± 0.37 and 2.40 ± 0.41) and the SCI group (2.72 ± 0.45 and 2.80 ± 0.42) (<i>P</i> < 0.05 for all comparisons). At day 28 post-surgery, the levels of IL-1β, IL-6, and TNF-α in the sham group were lower than those in all other groups (<i>P</i> < 0.05). The SCI and overexpression-SP1 groups showed elevated levels of these cytokines, all of which were significantly higher than those in the sh-circ_0011462 group (all <i>P</i> < 0.05). Immunostaining revealed that the number of iNOS-positive cells in the sh-circ_0011462 group was significantly lower than that in the SCI group and the overexpression-SP1 group (<i>P</i> < 0.05). Moreover, the number of motor neurons, axonal length, and synapse density in the anterior horn of rats in the sh-circ_0011462 group were all significantly greater than those in th","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"56 6","pages":"1591-1602"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ting Lan, Xiaohong Yao, Xiaoqing Zhou, Lin Shi, Jun Hou, Chengmin Zhou, Yang Liu, Min Shi
Objective: To investigate the clinicopathological characteristics and prognostic factors of cervical neuroendocrine carcinoma (NEC), and to clarify the independent prognostic value of the histological subtypes-mixed NEC (MiNEC) and pure NEC.
Methods: A total of 45 cases of cervical NEC treated with radical surgery plus concurrent chemoradiotherapy at our institution between 2015 and 2024 were enrolled. Their clinicopathological features and prognosis were evaluated using immunohistochemistry, HPV RNAScope in situ hybridization, and survival analysis. After 1∶1 propensity score-matched calibration for FIGO staging, 17 balanced cohorts were obtained. The overall survival (OS) and disease-free survival (DFS) were compared between the MiNEC (n = 22) and pure-NEC (n = 23) cases using the Kaplan-Meier analysis and the Cox model.
Results: The median patient age was 49 years (26-75 years) and the median follow-up was 24 months. The 1-, 3-, and 5-year OS rates were 75%, 61%, and 56%, respectively. According to the univariate analysis, FIGO stages Ⅲ and Ⅳ (hazards ratio [HR] = 3.78, 95% CI: 1.27-11.29, P = 0.017) and lymph node metastasis (HR = 3.72, 95% CI: 1.13-12.19, P = 0.030) were identified as adverse factors for OS. After propensity score matching, the difference in prognosis between MiNEC and pure-NEC was not statistically significant (HR = 0.80, 95% CI: 0.20-3.21, P = 0.583).
Conclusion: Under a treatment regimen of radical surgery combined with concurrent platinum-etoposide chemoradiotherapy, the FIGO stage is an independent prognostic factor for OS in cervical NEC. Due to the limited sample size, the association between histologic subtypes (MiNEC vs. pure-NEC) and long-term survival requires further validation with larger samples.
{"title":"[Clinicopathological Characteristics of Cervical Neuroendocrine Carcinoma and Their Relationship With Prognosis].","authors":"Ting Lan, Xiaohong Yao, Xiaoqing Zhou, Lin Shi, Jun Hou, Chengmin Zhou, Yang Liu, Min Shi","doi":"10.12182/20251160401","DOIUrl":"10.12182/20251160401","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinicopathological characteristics and prognostic factors of cervical neuroendocrine carcinoma (NEC), and to clarify the independent prognostic value of the histological subtypes-mixed NEC (MiNEC) and pure NEC.</p><p><strong>Methods: </strong>A total of 45 cases of cervical NEC treated with radical surgery plus concurrent chemoradiotherapy at our institution between 2015 and 2024 were enrolled. Their clinicopathological features and prognosis were evaluated using immunohistochemistry, HPV RNAScope <i>in situ</i> hybridization, and survival analysis. After 1∶1 propensity score-matched calibration for FIGO staging, 17 balanced cohorts were obtained. The overall survival (OS) and disease-free survival (DFS) were compared between the MiNEC (<i>n</i> = 22) and pure-NEC (<i>n</i> = 23) cases using the Kaplan-Meier analysis and the Cox model.</p><p><strong>Results: </strong>The median patient age was 49 years (26-75 years) and the median follow-up was 24 months. The 1-, 3-, and 5-year OS rates were 75%, 61%, and 56%, respectively. According to the univariate analysis, FIGO stages Ⅲ and Ⅳ (hazards ratio [HR] = 3.78, 95% CI: 1.27-11.29, <i>P</i> = 0.017) and lymph node metastasis (HR = 3.72, 95% CI: 1.13-12.19, <i>P</i> = 0.030) were identified as adverse factors for OS. After propensity score matching, the difference in prognosis between MiNEC and pure-NEC was not statistically significant (HR = 0.80, 95% CI: 0.20-3.21, <i>P</i> = 0.583).</p><p><strong>Conclusion: </strong>Under a treatment regimen of radical surgery combined with concurrent platinum-etoposide chemoradiotherapy, the FIGO stage is an independent prognostic factor for OS in cervical NEC. Due to the limited sample size, the association between histologic subtypes (MiNEC vs. pure-NEC) and long-term survival requires further validation with larger samples.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"56 6","pages":"1633-1640"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To analyze the current status of patient satisfaction with outpatient care and the relevant influencing factors among patients with chronic diseases in a compact county-level medical alliance, and to provide evidence for optimizing chronic disease management in primary care settings.
Methods: Based on the Andersen's Behavioral Model of Health Services Use, an explanatory sequential mixed-methods design was employed in the study. In the quantitative phase, a questionnaire survey was conducted among 297 patients with chronic diseases to collect data on patient satisfaction. The influencing factors were analyzed using ordinal logistic regression, and pathway effects were examined using structural equation modeling. In the qualitative phase, semi-structured interviews were conducted and 13 patients with the highest and lowest scores for patient satisfaction were involved. Then, the key themes were extracted using thematic analysis.
Results: The overall patient satisfaction score was rather high ([4.67 ± 0.58] points on a 5-point scale). Significant influencing factors included age (odds ratio [OR] = 1.03, 95% CI: 1.01-1.06), education (senior high school or above: OR = 3.34, 95% CI: 1.21-9.24), knowledge of health insurance reimbursement (moderately informed: OR = 0.54, 95% CI: 0.31-0.96), annual out-of-pocket expenditure for chronic diseases (> 1500 yuan: OR = 0.40, 95% CI: 0.17-0.90), satisfaction with facility environment (OR = 2.59, 95% CI: 1.38-4.84), and satisfaction with service capability (OR = 3.00, 95% CI: 1.29-6.97). By influencing the contextual characteristics, individual characteristics had a positive effect on healthcare provider behaviors and medical outcomes, and healthcare provider behaviors also had a direct positive effect on medical outcomes. Thematic analysis of the interviews revealed four key areas of improvement- suboptimal diagnosis and treatment processes, insufficient healthcare professional competence, underutilization of facilities, and inadequate health education and management.
Conclusion: Measures such as strengthening training for village doctors, optimizing referral mechanisms, promoting telemedicine, and improving health education approaches are recommended to enhance patient experience and satisfaction.
{"title":"[Current Status and Influencing Factors of Healthcare Satisfaction Among Chronic Disease Patients Under the Background of Compact County-Level Medical Alliances: A Mixed Methods Study].","authors":"Chuanyu Liao, Lingling Weng, Chu Chen","doi":"10.12182/20251160602","DOIUrl":"10.12182/20251160602","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the current status of patient satisfaction with outpatient care and the relevant influencing factors among patients with chronic diseases in a compact county-level medical alliance, and to provide evidence for optimizing chronic disease management in primary care settings.</p><p><strong>Methods: </strong>Based on the Andersen's Behavioral Model of Health Services Use, an explanatory sequential mixed-methods design was employed in the study. In the quantitative phase, a questionnaire survey was conducted among 297 patients with chronic diseases to collect data on patient satisfaction. The influencing factors were analyzed using ordinal logistic regression, and pathway effects were examined using structural equation modeling. In the qualitative phase, semi-structured interviews were conducted and 13 patients with the highest and lowest scores for patient satisfaction were involved. Then, the key themes were extracted using thematic analysis.</p><p><strong>Results: </strong>The overall patient satisfaction score was rather high ([4.67 ± 0.58] points on a 5-point scale). Significant influencing factors included age (odds ratio [OR] = 1.03, 95% CI: 1.01-1.06), education (senior high school or above: OR = 3.34, 95% CI: 1.21-9.24), knowledge of health insurance reimbursement (moderately informed: OR = 0.54, 95% CI: 0.31-0.96), annual out-of-pocket expenditure for chronic diseases (> 1500 yuan: OR = 0.40, 95% CI: 0.17-0.90), satisfaction with facility environment (OR = 2.59, 95% CI: 1.38-4.84), and satisfaction with service capability (OR = 3.00, 95% CI: 1.29-6.97). By influencing the contextual characteristics, individual characteristics had a positive effect on healthcare provider behaviors and medical outcomes, and healthcare provider behaviors also had a direct positive effect on medical outcomes. Thematic analysis of the interviews revealed four key areas of improvement- suboptimal diagnosis and treatment processes, insufficient healthcare professional competence, underutilization of facilities, and inadequate health education and management.</p><p><strong>Conclusion: </strong>Measures such as strengthening training for village doctors, optimizing referral mechanisms, promoting telemedicine, and improving health education approaches are recommended to enhance patient experience and satisfaction.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"56 6","pages":"1481-1491"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<p><strong>Objective: </strong>To explore the effect of obesity on obstructive sleep apnea (OSA) combined with hypertension and the associated risks, to clarify the value of different obesity assessment indicators (body mass index [BMI], neck circumference [NC], waist circumference [WC], body fat percentage [BF%], and visceral adiposity index [VAI]) in predicting hypertension risk in OSA patients, and to provide regional evidence for hypertension risk stratification of OSA patients in Southwest China.</p><p><strong>Methods: </strong>A total of 299 OSA patients were enrolled at the Sleep Medicine Center, West China Fourth Hospital, Sichuan University in 2024. The participants were divided into a simple OSA group (179 cases) and a group of those with OSA combined with hypertension (120 cases) according to their hypertension diagnosis. Logistic regression was performed to assess the risk association between obesity indicators and OSA combined with hypertension. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of each indicator, and age stratification (≤ 45 years or > 45 years) was performed to analyze risk differences.</p><p><strong>Results: </strong>Significant differences were observed between the two groups (the OSA combined with hypertension group and the OSA-only group) in terms of age (the proportion of middle-aged and older adults, 65.0% and 38.5%, respectively), educational attainment (high school or below, 37.5% and 22.9%, respectively), and family history of hypertension (60.0% and 33.0%, respectively) (<i>P</i> < 0.01). All obesity indicators were positively correlated with the risk of OSA combined with hypertension, with progressively increasing risk observed across higher indicator categories. VAI exhibited the most pronounced risk gradient: the risk for participants with VAI ≥ P<sub>75</sub> was 45.96 times that for those with VAI < P<sub>25</sub> (odds ratio [OR] = 45.96, 95% CI: 15.46-136.59), and the risk for participants with VAI between P<sub>50</sub> and P<sub>75</sub> was 8.06 times that for those with VAI < P<sub>25</sub> (OR = 8.06, 95% CI: 2.86-22.73). VAI demonstrated the best predictive performance (area under the curve [AUC] = 0.856; 95% CI: 0.819-0.893), outperforming traditional indicators (AUC<sub>BMI</sub> = 0.821, 95% CI: 0.782-0.860; AUC<sub>WC</sub> = 0.799, 95% CI: 0.760-0.838). The hypertension risk associated with each obesity indicator in the middle-aged and older adult group was higher than that in the younger group.</p><p><strong>Conclusion: </strong>Obesity is a key risk factor for OSA combined with hypertension. VAI demonstrates the best predictive performance for the risk of OSA combined with hypertension and can be used as a priority indicator for hypertension screening in OSA patients in Southwest China. Age and obesity indicators exhibit a cumulative risk effect, which highlights the need to strengthen obesity management in middle-aged and older populatio
{"title":"[Association Between Obesity and the Risk of Obstructive Sleep Apnea Combined With Hypertension].","authors":"Xin Zhao, Maosha Shu, Xiaoying Li, Lijuan Peng, Xiaoqing Zhang","doi":"10.12182/20251160107","DOIUrl":"10.12182/20251160107","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effect of obesity on obstructive sleep apnea (OSA) combined with hypertension and the associated risks, to clarify the value of different obesity assessment indicators (body mass index [BMI], neck circumference [NC], waist circumference [WC], body fat percentage [BF%], and visceral adiposity index [VAI]) in predicting hypertension risk in OSA patients, and to provide regional evidence for hypertension risk stratification of OSA patients in Southwest China.</p><p><strong>Methods: </strong>A total of 299 OSA patients were enrolled at the Sleep Medicine Center, West China Fourth Hospital, Sichuan University in 2024. The participants were divided into a simple OSA group (179 cases) and a group of those with OSA combined with hypertension (120 cases) according to their hypertension diagnosis. Logistic regression was performed to assess the risk association between obesity indicators and OSA combined with hypertension. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive performance of each indicator, and age stratification (≤ 45 years or > 45 years) was performed to analyze risk differences.</p><p><strong>Results: </strong>Significant differences were observed between the two groups (the OSA combined with hypertension group and the OSA-only group) in terms of age (the proportion of middle-aged and older adults, 65.0% and 38.5%, respectively), educational attainment (high school or below, 37.5% and 22.9%, respectively), and family history of hypertension (60.0% and 33.0%, respectively) (<i>P</i> < 0.01). All obesity indicators were positively correlated with the risk of OSA combined with hypertension, with progressively increasing risk observed across higher indicator categories. VAI exhibited the most pronounced risk gradient: the risk for participants with VAI ≥ P<sub>75</sub> was 45.96 times that for those with VAI < P<sub>25</sub> (odds ratio [OR] = 45.96, 95% CI: 15.46-136.59), and the risk for participants with VAI between P<sub>50</sub> and P<sub>75</sub> was 8.06 times that for those with VAI < P<sub>25</sub> (OR = 8.06, 95% CI: 2.86-22.73). VAI demonstrated the best predictive performance (area under the curve [AUC] = 0.856; 95% CI: 0.819-0.893), outperforming traditional indicators (AUC<sub>BMI</sub> = 0.821, 95% CI: 0.782-0.860; AUC<sub>WC</sub> = 0.799, 95% CI: 0.760-0.838). The hypertension risk associated with each obesity indicator in the middle-aged and older adult group was higher than that in the younger group.</p><p><strong>Conclusion: </strong>Obesity is a key risk factor for OSA combined with hypertension. VAI demonstrates the best predictive performance for the risk of OSA combined with hypertension and can be used as a priority indicator for hypertension screening in OSA patients in Southwest China. Age and obesity indicators exhibit a cumulative risk effect, which highlights the need to strengthen obesity management in middle-aged and older populatio","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"56 6","pages":"1668-1674"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Taking the county-level medical alliance in Luojiang District, Deyang City, Sichuan Province as an example, we analyzed the innovative mechanisms and implementation pathways of medical care and prevention integration of the county-level medical alliance, aiming to provide theoretical and empirical support for promoting the integration of treatment and prevention.
Methods: Using the SFIC model of the collaborative governance theory as the main analytical framework, we systematically analyzed the innovative practices and mechanisms of medical and preventive integration within the county-level medical alliance in Luojiang District from 4 dimensions, including starting conditions (S), facilitative leadership (F), institutional design (I), and collaborative process (C), and evaluated their operational effectiveness.
Results: The county-level medical alliance of Luojiang District has achieved enhanced effectiveness in medical care and prevention integration through top-level design, institutional restructuring, the empowerment of information platforms with digital intelligence technology, and the incentivization of multiple stakeholders to participate in the collaborative process. In 2024, the severe case rates of 2 chronic diseases (hypertension and diabetes mellitus) and the premature mortality rates of 4 chronic diseases (cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, and diabetes mellitus) in Luojiang District decreased by 4.4% and 5.53%, respectively, compared to those in 2023. The total medical insurance fund expenditure in the district in 2024 decreased by 9.13% compared to that in 2023.
Conclusion: According to the analysis based on the SFIC model, future efforts in medical care and prevention integration should focus on collaborative innovation at four levels-individual, community, institutional, and system-to further advance the transition toward a service model centered on population health.
{"title":"[Innovative Mechanisms of Medical Care and Prevention Integration in Compact County-Level Medical Alliances From the Perspective of Collaborative Governance-A Case Study of Luojiang District, Deyang City, China].","authors":"Xiyue Chen, Hongyu Lai, Kan Wu, Jie Pan","doi":"10.12182/20251160502","DOIUrl":"10.12182/20251160502","url":null,"abstract":"<p><strong>Objective: </strong>Taking the county-level medical alliance in Luojiang District, Deyang City, Sichuan Province as an example, we analyzed the innovative mechanisms and implementation pathways of medical care and prevention integration of the county-level medical alliance, aiming to provide theoretical and empirical support for promoting the integration of treatment and prevention.</p><p><strong>Methods: </strong>Using the SFIC model of the collaborative governance theory as the main analytical framework, we systematically analyzed the innovative practices and mechanisms of medical and preventive integration within the county-level medical alliance in Luojiang District from 4 dimensions, including starting conditions (S), facilitative leadership (F), institutional design (I), and collaborative process (C), and evaluated their operational effectiveness.</p><p><strong>Results: </strong>The county-level medical alliance of Luojiang District has achieved enhanced effectiveness in medical care and prevention integration through top-level design, institutional restructuring, the empowerment of information platforms with digital intelligence technology, and the incentivization of multiple stakeholders to participate in the collaborative process. In 2024, the severe case rates of 2 chronic diseases (hypertension and diabetes mellitus) and the premature mortality rates of 4 chronic diseases (cardiovascular and cerebrovascular diseases, cancer, chronic respiratory diseases, and diabetes mellitus) in Luojiang District decreased by 4.4% and 5.53%, respectively, compared to those in 2023. The total medical insurance fund expenditure in the district in 2024 decreased by 9.13% compared to that in 2023.</p><p><strong>Conclusion: </strong>According to the analysis based on the SFIC model, future efforts in medical care and prevention integration should focus on collaborative innovation at four levels-individual, community, institutional, and system-to further advance the transition toward a service model centered on population health.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"56 6","pages":"1475-1480"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145970974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yingjie Wang, Heting Li, Danli Shi, Xinyi Tan, Xiang Li, Xiaoqin Zhu, Min Liu, Wei Shi, Lihua Jiang, Li Zhao
Objective: To examine the mediating role of life satisfaction and the moderating role of social support in the relationship between family resilience and non-suicidal self-injury (NSSI) among adolescents.
Methods: A total of 8372 adolescents from the fourth wave (June 2022) of the Chengdu Positive Child Development (CPCD) cohort were included. Data were collected using questionnaires assessing NSSI, family resilience, life satisfaction, social support, and demographic characteristics. Chi-square tests and independent samples t-tests were used to analyze inter-group differences. Pearson correlation analysis was conducted to examine the associations among variables. Binary logistic regression was performed to identify factors associated with NSSI among adolescents. Structural equation modeling was conducted using Mplus 7.0.
Results: The prevalence of NSSI among the participants was 23.7%. Logistic regression analysis showed that higher family resilience (odds ratio [OR] = 0.932, 95% CI: 0.895-0.970), being female (OR = 0.873, 95% CI: 0.784-0.972), higher parental education level (OR = 0.816, 95% CI: 0.686-0.971), greater social support (OR = 0.801, 95% CI: 0.735-0.873), and higher life satisfaction (OR = 0.558, 95% CI: 0.532-0.587) were all significant protective factors against NSSI. Structural equation modeling further demonstrated that family resilience affected NSSI among adolescents indirectly (β = －0.031, 95% CI: －0.053 to －0.011]) and indirectly through the mediating effect of life satisfaction (indirect effect: β = －0.048, 95% CI:－0.057 to －0.039]). The interaction between family resilience and social support had a negative predictive effect on life satisfaction (β = －0.037, 95% CI: －0.059 to －0.014) and a positive predictive effect on NSSI (β = 0.024, 95% CI: 0.002-0.047), indicating that social support played a moderating role in the pathways from family resilience to life satisfaction and NSSI.
Conclusion: Family resilience influences adolescent NSSI both directly and indirectly through the mediating role of life satisfaction and the moderating effect of social support. These findings highlight the importance of enhancing family resilience, as well as promoting adolescents' life satisfaction and perceived social support, in the development of effective interventions to prevent NSSI.
{"title":"[Relationship Between Nonsuicidal Self-Injury and Family Resilience Among Adolescents: A Moderated Mediation Model].","authors":"Yingjie Wang, Heting Li, Danli Shi, Xinyi Tan, Xiang Li, Xiaoqin Zhu, Min Liu, Wei Shi, Lihua Jiang, Li Zhao","doi":"10.12182/20251160106","DOIUrl":"10.12182/20251160106","url":null,"abstract":"<p><strong>Objective: </strong>To examine the mediating role of life satisfaction and the moderating role of social support in the relationship between family resilience and non-suicidal self-injury (NSSI) among adolescents.</p><p><strong>Methods: </strong>A total of 8372 adolescents from the fourth wave (June 2022) of the Chengdu Positive Child Development (CPCD) cohort were included. Data were collected using questionnaires assessing NSSI, family resilience, life satisfaction, social support, and demographic characteristics. Chi-square tests and independent samples t-tests were used to analyze inter-group differences. Pearson correlation analysis was conducted to examine the associations among variables. Binary logistic regression was performed to identify factors associated with NSSI among adolescents. Structural equation modeling was conducted using Mplus 7.0.</p><p><strong>Results: </strong>The prevalence of NSSI among the participants was 23.7%. Logistic regression analysis showed that higher family resilience (odds ratio [OR] = 0.932, 95% CI: 0.895-0.970), being female (OR = 0.873, 95% CI: 0.784-0.972), higher parental education level (OR = 0.816, 95% CI: 0.686-0.971), greater social support (OR = 0.801, 95% CI: 0.735-0.873), and higher life satisfaction (OR = 0.558, 95% CI: 0.532-0.587) were all significant protective factors against NSSI. Structural equation modeling further demonstrated that family resilience affected NSSI among adolescents indirectly (<i>β</i> = －0.031, 95% CI: －0.053 to －0.011]) and indirectly through the mediating effect of life satisfaction (indirect effect: <i>β</i> = －0.048, 95% CI:－0.057 to －0.039]). The interaction between family resilience and social support had a negative predictive effect on life satisfaction (<i>β</i> = －0.037, 95% CI: －0.059 to －0.014) and a positive predictive effect on NSSI (<i>β</i> = 0.024, 95% CI: 0.002-0.047), indicating that social support played a moderating role in the pathways from family resilience to life satisfaction and NSSI.</p><p><strong>Conclusion: </strong>Family resilience influences adolescent NSSI both directly and indirectly through the mediating role of life satisfaction and the moderating effect of social support. These findings highlight the importance of enhancing family resilience, as well as promoting adolescents' life satisfaction and perceived social support, in the development of effective interventions to prevent NSSI.</p>","PeriodicalId":39321,"journal":{"name":"四川大学学报(医学版)","volume":"56 6","pages":"1683-1690"},"PeriodicalIF":0.0,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12796888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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