Table of Content

25 October 2026, Volume 43 Issue 5

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Nucleotide metabolism regulation and its reprogramming in tumors with targeted therapeutic strategies

Li Chenyang, Ke Chuchu, Li Wenjuan

2026, 43(5):  1-11.  DOI: 10.3969/j.issn.1674-490X.2026.05.001

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Nucleotide metabolism maintains intracellular dNTP balance and nucleotide pool homeostasis through de novo synthesis and salvage pathways, providing precursors for DNA replication and RNA transcription while also contributing to energy metabolism regulation and supplying substrates for epigenetic modifications. In tumors, this metabolic network undergoes reprogramming, driven by oncogenic signals and tumor microenvironment, which fuels abnormal proliferation and maintains genomic stability. However, the non-classical functions of key enzymes in nucleotide metabolism and the dynamic regulatory mechanisms of these pathways remain poorly understood. Clinically, available targeted therapies face significant bottlenecks, including insufficient tumor specificity, marked toxic side effects, and susceptibility to drug resistance. This review systematically elaborates on the regulatory mechanisms of tumor nucleotide metabolism, and its role in therapeutic resistance, aiming to provide new insights and a theoretical basis for precision targeted therapy of tumors.

Study on combining the ROX index and VOX index to predict the timing of tracheal intubation in patients with acute hypoxemic respiratory failure

Ju Hailong, Zhang Lingling, Li Jianqi, Zhang Hongqiang

2026, 43(5):  12-19.  DOI: 10.3969/j.issn.1674-490X.2026.05.002

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Objective To investigate the predictive value of the ROX index(SpO₂/FiO₂/RR)combined with the VOX index(SpO₂/FiO₂/VT)for the timing of endotracheal intubation in patients with acute hypoxemic respiratory failure(AHRF). Methods A total of 107 patients with acute hypoxemic respiratory failure(AHRF)admitted to the Emergency Intensive Care Unit of the Affiliated Hospital of Hebei University from April 2024 to April 2026 were enrolled. Based on whether they received invasive mechanical ventilation via endotracheal intubation during hospitalization, the patients were divided into an intubation group(n=54)and a non-intubation group(n=53). General data of the two groups were compared, as well as the ROX index and VOX index—measured before intubation in the intubation group and the worst value during hospitalization in the non-intubation group. Multivariate logistic regression analysis was used to identify independent risk factors for endotracheal intubation in AHRF patients. Receiver operating characteristic(ROC)curves were employed to evaluate the predictive performance of the ROX index, the VOX index, and their combination, and the optimal cutoff values were determined.Results There were no statistically significant differences between the two groups in terms of sex, age, medical history, or admission levels of white blood cell count, hemoglobin, platelet count, and prothrombin time(P>0.05). Patients in the intubation group had higher alanine aminotransferase and respiratory rate(RR)than those in the non intubation group, while pulse oxygen saturation(SpO₂), arterial partial pressure of oxygen(PaO₂), arterial partial pressure of carbon dioxide(PaCO₂), oxygenation index(PaO₂/FiO₂), ROX index, and VOX index were lower in the intubation group(P<0.05). Multivariate logistic regression analysis showed that the ROX index(OR=0.672, 95%CI: 0.451-0.991, P<0.05)and the VOX index(OR=0.351, 95% CI: 0.150-0.906, P<0.05)were influencing factors for the need for endotracheal intubation in AHRF patients. ROC curve analysis revealed that the areas under the curve(AUC)for the ROX index, the VOX index, and their combination in predicting endotracheal intubation were 0.710, 0.800, and 0.900, respectively. The AUC of the combined model was significantly greater than that of either single index(P<0.05), and the optimal cutoff values were 3.752, 21.031, and 0.420, respectively. After internal validation by Bootstrap, the bias corrected AUC was 0.890, indicating good model stability.Conclusion The ROX index and VOX index are effective indicators for predicting the need for endotracheal intubation in patients with AHRF. Their combined use significantly improves predictive performance and helps clinicians more accurately determine the optimal timing for endotracheal intubation.

Risk factors for full-term infants born small for gestational age and their impact on neonatal behavioral neurological assessment

Zheng Airu, Liu Fan

2026, 43(5):  20-28.  DOI: 10.3969/j.issn.1674-490X.2026.05.003

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Objective To explore the risk factors for full-term infants born small for gestational age(SGA)of different severities and the impact of SGA on neonatal behavioral neurological assessment(NBNA). Methods A retrospective study was conducted. A total of 148 term SGA born in Fuzhou First General Hospital were enrolled as the observation group(107 mild and 41 severe), and 152 non-SGA were enrolled as the control group. Maternal and neonatal baseline data were collected, and NBNA was performed at 3-7 days after birth. The study was divided into two modules:(1)For risk factor analysis, all 300 neonates were included, and ordinal multinomial logistic regression was used to analyze the risk factors for different severities of SGA.(2)For NBNA score influencing factors, only the 148 SGA were included, and univariate analysis and multiple linear regression were used to analyze the effects of neonatal factors on the total NBNA score. Results Through ordinal multinomial logistic regression, hypertensive disorders of pregnancy(OR=5.595, 95%CI: 2.166-14.902, P<0.001), oligohydramnios(OR=1.848, 95%CI: 1.463-2.338, P<0.001), and low maternal education level(OR=0.679, 95%CI: 0.537-0.859, P=0.001)were identified as independent risk factors for the severity of term SGA, while prepregnancy body mass index(BMI)was not found to be statistically significant(OR=0.908, 95%CI: 0.808-1.017, P=0.100). The total NBNA scores among the three groups were compared, and significant differences were observed between groups(P<0.001), with scores in the non-SGA group(37.11±0.87)higher than those in the mild SGA group(36.51±1.09)and severe SGA group(36.03±1.24). After confounding factors were adjusted for by multiple linear regression, active muscle tone(b=0.745, P<0.001)and passive muscle tone(b=0.524, P=0.003)were found to be independently associated with NBNA total scores. Conclusion Hypertensive disorders of pregnancy, oligohydramnios, and low maternal education level are confirmed as independent risk factors for the severity of term SGA. Early neurobehavioral development in neonates is found to be affected by SGA, and the NBNA score is decreased with increasing severity of SGA. The effect of SGA on NBNA may be mainly mediated by muscle tone.

Advances in the clinical application of intranasal dexmedetomidine

Yang Jie, Li Haozhen, Li Yongle

2026, 43(5):  29-39.  DOI: 10.3969/j.issn.1674-490X.2026.05.004

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Dexmedetomidine is a highly selective α₂-adrenergic receptor agonist that can cause a mild state of sedation by stimulating α₂ receptors in the locus coeruleus to reduce the release of noradrenaline from nerve cells, but it will not affect a person's consciousness or breathing. The intranasal way has a rich network of capillaries and a large surface area in the nasal mucosa; therefore, after rapid absorption into the blood, it is not degraded by the liver, has an absolute bioavailability of 65%-82%, and reaches a maximum concentration in the plasma in about 38 minutes. Recently, a large number of studies have been conducted in all these areas. Intranasal dexmedetomidine is suitable for the sedation of children in imaging examinations, preoperative anxiolysis and the prevention of emergence delirium under sevoflurane anaesthesia; it has a good overall sedation success rate of around 79.6% and is safer for the respiratory system than traditional oral sedatives. It has shown some good sedative and analgesic effects for older people in reducing preoperative anxiety, fibre-optic bronchoscopy, out-patient procedures, relief of labour pain and burn wound dressing changes. The advantage of the non-invasive way of intranasal delivery is that it is suitable for older people and those with dementia. For the sake of safety, the typical adverse reactions are dose-dependent bradycardia(about 5%)and hypotension(about 8%); most are mild or moderate in severity and can be corrected spontaneously, and the fluctuation in blood pressure is not as severe as that caused by intravenous drugs. In the future, research should be carried out to expand the application range of standardised nasal spray formulations and optimise personalised dosage regimens according to population pharmacokinetic models, as well as to increase the scope of use for these drugs in cases of emergency medical treatment when intravenous access is not available.

Syndrome differentiation and treatment of hemifacial spasm based on Xuanfu theory

He Chunmei, Fu Yuan, Pu Yuting, Zhang Yujie, Li Shuangyang, Bai Xue

2026, 43(5):  40-46.  DOI: 10.3969/j.issn.1674-490X.2026.05.005

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At present, clinical treatment of hemifacial spasm by traditional Chinese medicine mostly starts from wind, which is divided into internal wind and external wind. The therapeutic methods mainly include dispelling wind and relieving spasm, calming the liver and subduing yang, nourishing yin and blood, activating blood and dredging collaterals, and calming the liver and extinguishing wind. Based on the Xuanfu theory, the core pathogenesis of hemifacial spasm is systematically elucidated as obstruction of facial Xuanfu leading to impaired circulation of qi, blood, body fluids, and mental activities. Dynamically integrating the pathological states of Xuanfu, namely “stagnation-obstruction-atrophy,” a syndrome differentiation and treatment system of “three stages and four syndromes” is constructed, and the three therapeutic methods of “diffusing, dredging, and nourishing” are established. Wind medicinals are consistently used as the core drugs throughout the entire treatment process to achieve the goal of opening Xuanfu and relieving spasm.

Developments and practical significance of Daotan Tang He Siling San in the intervention of obesity

Li Yu, Li Jia, Ge Shaoqin

2026, 43(5):  47-54.  DOI: 10.3969/j.issn.1674-490X.2026.05.006

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Obesity and its associated metabolic syndrome and reproductive damage have become a global public health challenge. In view of the current purpose of national fat reduction and national health, it is of great practical significance to carry out the research and development of the classic prescription “Daotan Tang He Siling San”.Based on the theory of synergistic compatibility, our laboratory rationally used the medicine and food homologous Chinese medicine published by the state to replace the non-medicine and food homologous/toxic components in the original prescription, and modified the classical prescription to construct the Daotan Siling Decoction medicine and food homologous prescription( F-M DTSLD ), and carried out pharmacodynamic studies in rats. It was confirmed that F-M DTSLD had significant biological effects in reducing body weight, improving glucose and lipid metabolism disorders, inhibiting chronic inflammation, and reversing male reproductive damage caused by obesity(improving sperm quality and testicular ultrastructure). This review systematically reviews the research progress of F-M DTSLD and the research significance and prospects of F-M DTSLD, aiming to create a health product that can be integrated into the daily catering of the public, and provide solid theoretical support for promoting the scientific weight loss of the whole people and constructing the active health management model of chronic diseases.

Qualitative study on an integrated medical management approach for obese children involving hospitals, communities and families

Guo Jianjun, Li Xiao,Liu Jingxia, Zhang Yuanda, Liu Shuaixiong, Yang Yizhuo, Song Hanan, Zhang Jie, Zhang Hongjie

2026, 43(5):  55-62.  DOI: 10.3969/j.issn.1674-490X.2026.05.007

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Objective To explore the needs and perceptions of primary caregivers of obese children regarding an integrated health management model based on the theory of integrating sports and medicine and identify existing issues. Methods Semi-structured interviews were conducted with 15 primary caregivers of obese children. Interview data were analyzed using Colaizzi's seven-step analysis method. Results The analysis yielded 3 themes(program acceptability, program feasibility, and recommendations from the primary caregiver)and 13 subthemes. Conclusion The integrated health management program for obese children, which is developed based on the concept of integrated physical and medical care, demonstrates sound scientific validity, feasibility, and acceptability, and can provide a theoretical basis for the health management of obese children.

Advances on clinical nursing intervention models for patients with post-stroke dysphagia

Hong Qing, Li Shijian, Xiang Yunna, Shi Fuping

2026, 43(5):  63-72.  DOI: 10.3969/j.issn.1674-490X.2026.05.008

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Dysphagia is one of the prevalent complications after stroke. It not only elevates the risk of stroke recurrence, but also induces a variety of secondary complications including negative emotions, malnutrition, dehydration, choking, aspiration and speech disorders, which severely impair patients' prognosis and quality of life. This paper reviews the screening and assessment of post-stroke dysphagia, relevant complications and corresponding nursing interventions, clinical nursing models, so as to provide references for clinical nursing practice and promote the scientific and systematic development of nursing services for patients with post-stroke dysphagia.

Construction and practice of the internal teaching supervision system in medical universities based on the idea of institutional research

Jiang Hongquan, Wang Yi, Ma Xing, Zheng Dan, Li Baixiang, Han Yuxia

2026, 43(5):  73-80.  DOI: 10.3969/j.issn.1674-490X.2026.05.009

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Teaching supervision is the core mechanism of internal quality assurance in colleges and universities. Against the background of the connotative development of higher education, it is urgent to realize the scientific and professional upgrading of teaching supervision relying on institutional research. At present, teaching supervision in domestic universities is generally problematic such as being a mere formality, out of line with institutional reality, and fragmented data. Medical universities are confronted with more special contradictions, including insufficient coverage of clinical teaching supervision, weak adaptability of supervision standards to medical education, and difficult supervision of teaching in affiliated hospitals. As an important means to scientificize university management, institutional research provides an effective way to solve the dilemmas of teaching supervision by systematically collecting and analyzing institutional operation data to support decision-making. Based on the evidence-based idea of institutional research, this paper constructs a theoretical framework of internal teaching supervision system in medical universities covering four dimensions: objectives, contents, methods and guarantees. Combined with the 25 years practical case of Harbin Medical University, it expounds the implementation path of the system, verifies the practical effects from three aspects of teacher development, student training and management efficiency, and extracts regular experience for the construction of teaching supervision system applicable to medical universities. It provides a theoretical reference and practical paradigm for the optimization and upgrading of teaching supervision system in similar universities.