Zhengzhou City Hospital

To understand the current status and influencing factors of self-management ability in peritoneal dialysis (PD) patients. This study employed an interpretive sequential mixed-methods approach and followed the STROBE and CONDITION guidelines. From June 2024 to February 2025, convenience sampling was used to survey 507 PD patients from three tertiary hospitals. Quantitative data were collected using five scales. Concurrently,purposesampling was used to conduct semi-structured interviews with 13 patients until data saturation was reached. Quantitative data were analyzed using SPSS 26.0, and qualitative data were analyzed thematically using Nvivo15. The results were integrated to provide a comprehensive understanding. The quantitative results showed that PD patients had a self-management ability score of [55.00 (45.00, 60.00)] out of a possible 96, indicating a moderately low level. Multiple linear regression identified age, educational attainment, monthly household income, dialysis age, understanding of the disease, mastery of health education content, frequency of follow-up, and self-efficacy as significant influencing factors. The qualitative interviews identified two themes (obstructive and promoting factors) and nine sub-themes. The integration of results showed that qualitative findings confirmed and complemented the quantitative associations. The self-management ability of PD patients is moderately low. Medical staff should enhance the self-efficacy and social support of PD patients based on the influencing factors of their self-management ability, increase the frequency of follow-up, pay attention to PD patients with low education, advanced age and other types, strengthen training and monitoring for complications, and carry out targeted intervention to improve the self-management ability of PD patients.

Pregnancy loss represents a significant public health concern within the realm of female reproductive health. In the current landscape of research, post-traumatic stress disorder (PTSD), anxiety, and depression are often investigated as an undifferentiated whole. However, this approach overlooks the unique symptomatic relationships and nuances that may exist among these mental health conditions in women who have endured pregnancy loss. This study aimed to dissect the symptomatic interconnections among PTSD, anxiety, and depression in women who have experienced pregnancy loss. A cross-sectional study was carried out at a tertiary hospital in Zhengzhou, China. Women with pregnancy loss were surveyed using a general information questionnaire, the Posttraumatic Stress Disorder Checklist-Civilian Version, and the Hospital Anxiety and Depression Scale. Network analysis was performed using R software to examine pairwise associations among symptoms, identify core symptoms (i.e., key nodes with the strongest connectivity within the network), and detect bridge symptoms (i.e., symptoms that link post-traumatic stress, anxiety, and depressive symptom clusters). We also evaluated the accuracy and stability of the estimated network structure. Of the 691 women with pregnancy loss included in the analyses, PTSD entry 6 (Try to avoid thoughts and feelings that remind you of it) and PTSD entry 7 (Make an effort to avoid conversations, people, places and activities that remind you of the matter) had the strongest association, with a regularized partial correlation coefficient of 0.485. PTSD entry 7 was the most central symptom in the network, with a centrality strength of 1.748. Entry 5 (Muscle tension, shortness of breath, rapid heartbeat, dry mouth, and stomach cramps) had the strongest bridging effect. The accuracy and stability of the network was tested to be better, and the network model was more reliable. Through the innovative application of network analysis, this study successfully explored the associations between PTSD items and symptoms of anxiety and depression in women with pregnancy loss. By identifying the core and bridging symptoms, it provides valuable insights into the underlying mechanisms of these co-occurring mental health conditions.

ABSTRACT Traditional Chinese medicine (TCM), including herbal analgesic adjuvants and acupuncture‐based interventions, has gained increasing attention as an integrative strategy for perioperative pain management in oncology. Bioactive phytochemicals—such as terpenoids, flavonoids, alkaloids, and polyphenols—exert multimodal pharmacological effects relevant to perioperative analgesia through modulation of ion channels, GABAA receptors, inflammatory signaling pathways (MAPK/COX‐2), and redox homeostasis. In parallel, acupuncture activates endogenous analgesic systems, including opioid and monoaminergic descending inhibitory pathways, modulates autonomic balance via vagal anti‐inflammatory reflexes, and alters local perfusion, thereby influencing nociception and perioperative immune responses. Recent advances in nano‐enabled delivery systems—such as lipid and polymeric nanoparticles, micelles, enzyme‐responsive hydrogels, and acupoint‐targeted formulations—aim to overcome key pharmacokinetic limitations of phytochemicals by improving solubility, stability, and site‐selective release. These platforms may be combined with acupoint‐based approaches to enhance localized exposure in perioperative settings. Preclinical and early translational studies suggest that such integrative strategies can modulate nociceptive signaling and perioperative inflammatory or immune processes within the tumor microenvironment (TME). However, clinical translation remains limited. Most evidence is derived from animal models, small clinical studies, or nononcologic surgical populations, with substantial gaps in standardized formulations, pharmacokinetic and drug–drug interaction data, regulatory clarity, and randomized trials incorporating immunologic or oncologic end points. This narrative review critically synthesizes current mechanistic and emerging clinical evidence and outlines a translational roadmap emphasizing standardized analytics, integrated PK/toxicity assessment, biomarker‐informed patient stratification, and rigorously designed clinical trials to determine whether TCM modalities can safely provide opioid‐sparing analgesia without compromising perioperative immune function or oncologic outcomes.

Abstract Background Diabetic foot ulcers, as one of the serious chronic complications of diabetes, not only cause limb pain, restricted movement and increased risk of infection in patients, but also often accompany significant psychological distress, especially anxiety symptoms. Anxiety may further affect patients' treatment compliance, self-management behavior and overall rehabilitation process. However, systematic research on the association between anxiety symptoms and psychological rehabilitation in patients with diabetic foot ulcers is still relatively insufficient at present. Therefore, the study adopted a scheme combining cross-sectional investigation and longitudinal follow-up, aiming to explore the correlation between anxiety symptoms and the psychological rehabilitation level of patients with diabetic foot ulcers. Methods A total of 120 patients diagnosed with diabetic foot ulcers were recruited for the study. Their Anxiety symptoms were evaluated using the Generalized Anxiety Disorder-7 Scale (GAD-7). And the level of psychological Rehabilitation was evaluated using the Diabetes Psychosocial Rehabilitation Assessment Scale (DPRAS). Meanwhile, the sociodemographic data of the patients, the severity of ulcers, the course of the disease and clinical indicators such as glycated hemoglobin were collected. Three months later, the same batch of patients were followed up again to reevaluate the above psychological indicators, and the ulcer healing situation and readjustment rate were recorded. Correlation analysis, multiple linear regression and path analysis and other methods were adopted to investigate the association between anxiety symptoms and various dimensions of psychological rehabilitation and its changing patterns over time. Results The results showed that the anxiety symptoms (total score of GAD-7) of patients with diabetic foot ulcers were significantly negatively correlated with the total score of psychological rehabilitation (r = -0.62, p<.01). After controlling for factors such as clinical severity, anxiety symptoms remained an independent predictor of psychological rehabilitation level (β = -0.48, p<.001). The longitudinal analysis results indicated that the psychological rehabilitation score of the high anxiety group was (52.7 ± 6.1) during follow-up, which was significantly lower than that of the low anxiety group (73.4 ± 5.9) (p<.01). Meanwhile, the complete ulcer healing rate in the high anxiety group (32.4%) was significantly lower than that in the low anxiety group (58.6%) (p<.05). Discussion The research results show that anxiety symptoms are closely related to the psychological rehabilitation level of patients with diabetic foot ulcers. A higher degree of anxiety not only corresponds to poor psychological adaptation and quality of life, but may also have an adverse impact on ulcer healing and clinical prognosis. In the routine treatment of diabetic foot ulcers, anxiety should be systematically screened and actively intervened, and incorporated into the overall rehabilitation management framework. Future research can verify the effect of psychological and behavioral intervention integrating anxiety management on promoting the physical and mental recovery of patients by designing randomized controlled trials, and explore its potential mechanism of action in combination with physiological indicators (such as cortisol and inflammatory factors), thereby promoting the in-depth development of the rehabilitation model for diabetic foot ulcers towards the integration of body and mind.

Developing Cu-based nanocatalysts capable of generating sufficient reactive oxygen species (ROS) to effectively inhibit tumor cell growth remains a significant challenge. In this study, we introduce a distinctive copper oxide nanocarrier with a unique leaf-like lamina structure and layered mesopores. Indocyanine Green (ICG) is encapsulated within the mesopores, and poly(ethylene glycol) (PEG) groups are attached to the surface. This nanoplatform demonstrates efficient accumulation in tumor areas, serving as a near-infrared (NIR) fluorescent contrast agent for tumor imaging. Remarkably, under NIR laser irradiation, the nanoplatform exhibits high photothermal conversion efficiency, which enhances ROS production through localized heating. Both in vitro and in vivo experiments confirm that our nanoleaf structure effectively prevents tumor growth. These results underscore the potential of CuO-based nanocomposites activated by tumor microenvironment stimuli as chemodynamic nanoagents, enabling malignant cancer destruction through a synergistic effect with NIR light.

Osteosarcoma (OS) is a bone malignancy among adolescents with a poor prognosis. We aimed to explore the glycosylation-related features in OS. A sum of 185 glycosylation-related genes (GRGs) and the RNA-seq data were obtained from the TARGET database. ConsensusClusterPlus package was applied for the various subtypes based on the significant prognostic factors. Subsequently, the limma R package performed the Lasso analysis for a RiskScore model. The survminer package conducted Kaplan-Meier (KM) analysis, and the timeROC package was used for the classifier efficiency. In addition, the ssGSEA method and MCPcounter performed the immune infiltration analysis. Finally, the expression of the selected key genes, as well as their migration and invasion capabilities, were evaluated through PCR, wound healing, and transwell assays, respectively. High GRG score was associated with poor prognosis. Unsupervised clustering based on prognostic GRGs identified two subtypes (C1/C2), with C1 showing worse outcomes. A prognostic RiskScore model comprising CORT, LPAR5, CEBPA, MYH10, and MAGEA11 was constructed from subtype-specific differentially expressed genes. The model effectively stratified patients into high- and low-risk groups in both training and validation cohorts, with high-risk patients exhibiting significantly shorter survival. RiskScore is an independent prognostic factor, with lower infiltration levels of cells such as macrophages and NK cells observed in patients within the high-risk group. In external immunotherapy cohorts, high-risk patients had poorer survival and treatment response. Functionally, silencing the key model gene CORT impaired osteosarcoma cell migration and invasion in vitro. We developed a useful risk model and this study provided new insights for OS therapy.

BACKGROUNDEsophageal squamous cell carcinoma (ESCC) is a cancer with a poor prognosis, characterized by distinct geographical distribution and family clustering.AIMTo investigate if ethnic differences (Han vs Kazakh) cause molecular variations in ESCC patients via genomic sequencing 299 samples.METHODSHere, we sequenced samples from 299 ESCC patients collected from Henan Key Laboratory for Esophageal Cancer Research and National Key Laboratory of Metabolic Dysregulation and Esophageal Cancer Prevention and Treatment, The First Affiliated Hospital of Zhengzhou University, including Han and Kazakh ethnic groups, and performed a genomic comparative analysis of these two ethnic cohorts.RESULTSESCC patients of Kazakh ethnicity present with a later age of onset compared to Han. Kazakh patients exhibit a slightly higher tumor mutation burden compared to their Han counterparts. Three genes GIGYF1, CACNA1D, and ACOT11 exhibited mutation frequencies threefold higher in Kazakh patients than in Han. This enrichment may be associated with Kazakhs’ adaptation to cold climates and consumption of high-calorie diets. Among Han patients, the apolipoprotein B messenger RNA-editing enzyme catalytic polypeptide (APOBEC)-associated single base substitutions (SBS) 13 mutational signature is more prevalent, whereas SBS6, indicative of DNA mismatch repair deficiency, is more common in Kazakh patients. Additionally, Han Chinese patients with APOBEC-enriched tumors exhibit a significantly higher mutation load than those without. Moreover, patients lacking the APOBEC signature demonstrate superior survival probability compared to the APOBEC-enriched group.CONCLUSIONLiving environment and diet are major factors in the development of ESCC. Genomic difference may provide guidance for the formulation of clinical treatment plans for ESCC from different ethnics regions.

Background:Patellar dislocation is a common condition in adolescents, characterized by high rates of recurrent instability and an associated risk of osteochondral fracture (OCF). The risk of recurrent instability in this patient population, both with and without OCF, after a first-time dislocation remains unclear.Purpose:To determine and compare the incidence of recurrent patellar instability and the need for subsequent stabilization procedures between adolescents with and without OCF after first-time dislocation. A secondary objective was to report clinical outcomes of those patients.Study Design:Cohort study, Level of evidence, 3.Methods:This study was a retrospective analysis of adolescents who underwent their first-time patellar dislocation between 2016 and 2021 at a single orthopaedic hospital, with a minimum follow-up of 3 years. Patients were divided into 2 groups based on whether OCF was present: the OCF group and the non-OCF group. Baseline characteristics, radiographic measurements, and follow-up time were compared. Primary outcome measures included the incidence of recurrent patellar instability and the need for subsequent stabilization procedures. Secondary outcome variables included clinical outcome scores (such as Kujala score, Lysholm score, Tegner score, and International Knee Documentation Committee score), knee range of motion (ROM), as well as the ability to return to sport.Results:A total of 33 adolescents were included, with 15 in the OCF group and 18 in the non-OCF group. The only difference noted in baseline characteristics, radiographic measurements, and follow-up time was a higher tibial tuberosity-trochlear groove (TT-TG) in the OCF group (17.1 mm vs 14.5 mm; P = .048). Compared with the non-OCF group, the OCF group had a significantly higher incidence of recurrent patellar instability (66.7% vs 27.8%; P = .025) and a greater need for subsequent stabilization procedures (53.3% vs 16.7%; P = .026). No differences were noted in clinical outcome scores, ROM, and return to sport rate.Conclusion:Adolescents with first-time patellar dislocation combined with OCF face a significantly higher recurrence rate (66.7%) compared with those without OCF, leading to increased subsequent stabilization procedures (53.3%). High-risk anatomic factors, such as elevated TT-TG values, further exacerbate instability. Targeted interventions are recommended for this high-risk population to reduce the recurrence of this condition.

Study DesignRetrospective cohort comparative study.ObjectiveTo investigate whether specific upper instrumented vertebra (UIV) pedicle screw characteristics-particularly screw slope (UIV SS), tip-to-endplate distance (TED), and tip-to-anterior cortex distance (TAD)-are associated with the development of upper instrumented vertebra fracture (UIVF) following adult spinal deformity (ASD) surgery.MethodsThis retrospective study included 132 patients (mean age: 68.4years) who underwent corrective surgery from 2013 to 2022, with a minimum follow-up of 2years. The radiographic parameters and UIV screw characteristics were analyzed. Patients were categorized into UIVF and non-UIVF groups. Logistic regression and Receiver Operating Characteristic (ROC) curve analyses were used to identify the risk factors and cutoff values.ResultsUIVF occurred in 28.8% (38/132) of the patients. Post-thoracic kyphosis (Post-TK) and TED of the upper UIV screw (Post-TEDupper) were independently associated with UIVF. Cutoff values predictive of UIVF were post-TK > 36.5° and Post-TEDupper < 6.5mm. Patients with a TEDupper < 6.5mm had a significantly higher incidence of UIVF (HR = 2.417, P = 0.010). Kaplan-Meier analysis showed that UIVF commonly occurred within 3months postoperatively. Progressive reduction in TED was observed over time, particularly in the UIVF group.ConclusionPost- TK > 36.5° and Post-TEDupper < 6.5mm are significant predictors of UIVF. Based on the study findings, a postoperative TED of ≥ 6.5mm may be associated with a reduced risk, and could be considered as a potential target in surgical planning, while acknowledging the limitations of the retrospective design and the model's moderate predictive accuracy.