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Imaging analysis of polymorphous low-grade neuroepithelial tumor of the young : a case report and literature review

Available online:April 14, 2026, DOI:

[Abstract] (9) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To explore the clinical characteristics, imaging features, pathological manifestations and key points of diagnosis and treatment of polymorphous low-grade neuroepithelial tumor of the young (PLNTY), clarify the typical diagnostic criteria for this disease, and provide references for accurate clinical identification, standardized diagnosis and treatment. Methods: This study adopted a retrospective analysis approach, focusing on a 12-year-old male patient with PLNTY. Detailed clinical information (including medical history, past history, etc.), laboratory test results (blood routine, five coagulation indices, complete biochemical panel, etc.), imaging examination findings (CT, MRI) of the patient were collected. In addition, the surgical process and postoperative pathological examination results (routine pathology, immunohistochemistry, molecular pathology) were recorded. By integrating relevant literature, the diagnostic and therapeutic process of this patient was thoroughly reviewed to summarize the key diagnostic characteristics. Results: Polymorphous low-grade neuroepithelial tumor of the young is a rare, low-grade neuroepithelial tumor with indolent biological behavior. It predominantly occurs in children and adolescents and is often associated with a history of epileptic seizures. Key imaging features include:a single lesion with clear boundaries under the cortex; fine sand-like calcification with marginal cystic change; no obvious enhancement or peritumoral edema; and the “pepper-and-salt sign” and “transmantle sign”.

Leptomeningeal Metastases from Solid Tumors: Current Status of Diagnosis and Intrathecal Treatment

Cao Kai, Yong Jiaqi, Wang Yunchao

Available online:April 14, 2026, DOI:

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Leptomeningeal metastasis (LM) is a rare yet devastating complication of solid tumors, frequently occurring in patients with lung cancer, breast cancer, or malignant melanoma, with an incidence of approximately 1%-5%. Diagnosis remains difficult, prognosis is poor, and no standardized treatment currently exist. Intrathecal administration, as a therapeutic approach, enables the direct delivery of drugs into the subarachnoid space, thereby increasing local drug concentrations. Conventional intrathecal chemotherapeutic agents primarily include methotrexate (MTX), cytarabine, and thiotepa. In recent years, with advances in drug development, a variety of novel chemotherapeutics, targeted agents, and immune checkpoint inhibitors (ICI) have gradually been introduced into intrathecal therapy. Furthermore, in-depth investigation into the pathogenesis of LM, along with the development of diagnostic techniques such as detection of circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) in cerebrospinal fluid (CSF) is offering new opportunities for LM diagnosis and therapeutic strategies. This review provides a comprehensive summary of the current diagnostic approaches and research progress in intrathecal treatment for LM.

Research Progress on Antibody Profiles and Influencing Factors of Respiratory Syncytial Virus (Subtypes A/B) in Populations

penghonghong

Available online:April 14, 2026, DOI:

[Abstract] (4) [HTML] (0) [PDF 0.00 Byte] (0)

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Abstract: Respiratory syncytial virus (RSV) is a pathogen that seriously endangers the health of infants and young children, the elderly, and people with weakened immune systems. There are no specific drugs or ideal vaccines for it. The virus is divided into two subtypes, A and B, with different antigenicities, and it shows periodic epidemics with a heavy global disease burden. The pre-F protein is a key target for vaccine development, and the level of specific antibodies it induces is closely related to immune protection. Children usually have higher antibody levels, while infants and the elderly have lower immunity. The prevention and control measures during the COVID-19 period significantly changed the epidemic pattern of RSV, causing a general decline in antibody levels in the population. The overall distribution of antibodies in the post-pandemic era is still unclear. Neutralizing antibodies are important indicators for evaluating protective effects, but existing detection methods still have deficiencies in terms of throughput, standardization, and accuracy, and there is a lack of an ideal unified solution. Current research mainly focuses on the antibody response after vaccination, confirming its subtype cross-reactivity and dynamic changes, but the changing patterns of neutralizing antibodies after natural infection are not well understood. In addition, the influencing factors of antibody levels and the short-term dynamic changes before and after the epidemic season have not been adequately studied. This article systematically reviews the virological and epidemiological characteristics of RSV, the research progress of the pre-F protein, the influencing factors of antibody levels in the population, and the current research status of neutralizing antibodies.

The Role of Amino Acid Metabolism Disorders in the Pathogenesis and Clinical Significance of Coronary Heart Disease

wu wenjun, su yimeng, wang lilong, re qiongdi

Available online:April 14, 2026, DOI:

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Abstract：Objective: Given the close association between amino acid metabolism disorders and the occurrence and progression of CHD, this study aims to systematically summarize the correlations, mechanisms of action, and clinical application prospects of relevant amino acid metabolic abnormalities with CHD. Methods: A systematic review approach was adopted to analyze the role of metabolic abnormalities of Hcy, BCAAs, AAAs, and other amino acids in CHD-related pathological processes. Meanwhile, the potential impacts of amino acid metabolites and gut microbiota on CHD were explored. Results: Multiple amino acid metabolic abnormalities were confirmed to be associated with CHD risk, which influence disease progression by participating in pathological processes such as AS, thrombosis, and endothelial dysfunction. Amino acid metabolism indicators have shown promising clinical application potential in CHD risk prediction, auxiliary diagnosis, and therapeutic intervention. Conclusion: Despite existing contradictions and limitations in current research, amino acid metabolism disorders, as a new target for CHD prevention and treatment, hold clinical value and research potential, providing a new direction for cardiovascular disease research..

Clinicopathological analysis of sinonasal SMARCA4-deficient carcinoma with intracranial invasion

李云, Sun Yangyang, Wang Gengfang, 周晓莉

Available online:April 13, 2026, DOI:

[Abstract] (4) [HTML] (0) [PDF 0.00 Byte] (0)

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[Abstract] Objective：To explore the clinicopathological features, immunophenotype, and molecular characteristics of sinonasal SMARCA4-deficient carcinoma with intracranial invasion. Methods：Retrospective analysis of the histological features, immunophenotype, and molecular alterations in a case of SMARCA4-deficient carcinoma invading intracranially from the sinonasal region, with clinicopathological characterization and literature review. Results：A 70-year-old male patient presented with a sinonasal tumor invading intracranially. Microscopically, the tumor cells were arranged in nests and solid sheets with focal necrosis. The tumor cells exhibited a high nuclear-to-cytoplasmic ratio, round to oval nuclei, and brisk mitotic activity, resembling large cell neuroendocrine carcinoma. Immunohistochemistry showed partial positivity for AE1/AE3 and Syn, loss of BRG1 expression, retained INI-1, and a Ki-67 proliferation index of 70%. Molecular testing revealed a nonsense mutation in SMARCA4 exon 8(c. 1252C＞T, p. Q418*)and a missense mutation in CTNNB1 exon 3(c. 134C＞T, p. S45F). Pan-cancer survival analysis revealed that the difference in outcomes between the SMARCA4/CTNNB1 co-mutation group and the SMARCA4- only mutation group was statistically significant(P ＜0.001). Conclusion：Sinonasal SMARCA4-deficient carcinoma is a rare and highly aggressive sinonasal cancer with non-specific histological features. SMARCA4/BRG1 immunohistochemical screening is crucial for early diagnosis, while next-generation sequencing(NGS)can provide more precise diagnostic information for patients.

Progress in the application of temporary vascular shunt in the management of limb vascular injuries

Jinan Chen

Available online:April 13, 2026, DOI:

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Lower extremity major vascular injury is a common critical emergency in clinical practice, accounting for approximately 15%-20% of all vascular injuries. The core goal of managing limb arterial injuries is rapid hemostasis and restoration of peripheral arterial blood flow. Temporary Vascular Shunting (TVS), as an essential component of Damage Control Surgery (DCS), by establishing a temporary vascular shunt, distal blood supply can be effectively maintained, achieving the objective of injury control and repair. this creates favorable conditions for subsequent definitive repair. TVS plays a key role in the management of such injuries. The timing and technique of insertion and removal directly impact the final outcome of vascular repair and the patient's prognosis. Timely identification and effective management of complications are key to improving the success rate of treatment and enhancing the patient's quality of life. This article provides a comprehensive review of the history, efficacy, indications and contraindications, types and procedures, postoperative management, and future development directions of TVS technology, aiming to offer new insights for emergency care in limb vascular trauma.

Predictive value of renal allograft pathology for abnormal renal allograft function at different post-transplant periods

Gao Xiang, Xu Jie, Chen Hao, Sun Li, Fei Shuang, Tan Ruoyun, Wang Zijie, 顾民

Available online:April 13, 2026, DOI:

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Objective：To explore the correlation between pathological indicators of renal allograft biopsy and abnormal renal allograft function at different stages, to evaluate the diagnostic value of pathological indicators in abnormal renal allograft function, and to establish a model for predicting the prognosis of renal allografts. Methods：This study retrospectively analyzed the clinical data and pathological indicators of kidney transplant recipients who underwent renal allograft biopsy at the First Affiliated Hospital of Nanjing Medical University between 2015 and 2018. The total sample was statistically analyzed based on different post-biopsy times(at biopsy, 1 year after biopsy, 3 years after biopsy, and 5 years after biopsy). Univariate analysis was conducted to screen for indicators that affect abnormal renal allograft function. The model was established using binary Logistic regression to draw a nomogram. Mixed-effects Logistic regression was further applied to investigate the dynamic effects of factors consistently associated with abnormal renal allograft function across all stages. According to Receiver operating characteristic curve(ROC), corresponding Area under the curve(AUC)and calibration curve, the discriminant validity and consistency of the model with the actual situation were judged. Results：A total of 121 patients were included in this study. According to the time after biopsy of the transplanted kidney, the total samples were divided into four groups: at the time of biopsy, 1 year after biopsy, 3 years after biopsy, and 5 years after biopsy. I score ≥1 was significantly correlated with renal function at the time of biopsy and at 1, 3, and 5 years after biopsy. The dynamic effects analysis indicated that i-score ≥ 1 was associated with renal function deterioration within five years after kidney transplantation. A nomogram was constructed based on the above statistical results. The AUC indicated that the model had good discriminative validity. The calibration curve showed that the predicted probability of abnormal renal allograft function was in good agreement with the actual probability. Conclusion：This study constructed a nomogram model capable of predicting abnormal renal allograft function at different time points which demonstrated a good predictive ability and could effectively improve the precision of post-biopsy patient management for renal transplant recipients.

Classification and Grading Recognition of Gastric Cancer Pathological Images Based on Convolutional Neural Networks

WU Bangyu, WANG Zhishao, XIANG Jingxuan, SUN Li, 马玲

Available online:April 13, 2026, DOI:

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[Abstract] Objective：To establish classification and grading models for gastric cancer pathological sections based on deep learning technology and to evaluate the performance of these models. Methods：Classification and grading datasets for gastric cancer and non-cancerous tissues were collected from publicly available online resources. Data augmentation was performed, and the dataset were divided into training, validation, and test sets. In the initial stage, 17 convolutional neural network(CNN)architectures were constructed, and the initial training parameters were uniformly set to train these 17 models for the classification of gastric cancer and non-cancerous tissues. After training, the recognition accuracy on the test set and the training time were used as evaluation indicators to comprehensively assess the efficacy of different model architectures. Based on these indicators, the optimal architecture was selected for further optimization and training to construct the gastric cancer classification model. After the completion of the classification model, the gastric cancer grading model was built based on the foundation of the classification model. During the training of the gastric cancer grading model, 17 grading networks were trained, and suitable base models were selected according to performance indicators. After the base model was determined, Voting and Stacking methods were applied for ensemble learning and compared with single models to explore the impact of ensemble learning on performance improvement and to construct the gastric cancer grading model. Results：In the training of the gastric cancer classification model, the Xception network was selected as the final classification model after comparison. After parameter adjustment and training, the final gastric cancer classification model achieved an accuracy of 98.13%, sensitivity of 98.11%, specificity of 98.11%, F1 score of 98.12%, and AUC of 0.9983 on the test set. In the training of the gastric cancer grading model, the stacking method represented by random forest showed significant improvement compared to the voting method represented by hard voting. The ensemble model based on random forest was selected as the final grading model, with an accuracy of 95.06%, sensitivity of 94.77%, specificity of 98.36%, and F1 score of 94.82%. The AUC(Area Under the Receiver Operating Characteristic curve) values were 0.9994 for benign, 0.9811 for poorly differentiated tubular adenocarcinoma, 0.9896 for moderately differentiated tubular adenocarcinoma, and 0.9951 for well-differentiated tubular adenocarcinoma. Conclusion：Both models demonstrated excellent recognition performance, proving the feasibility of using convolutional neural networks to achieve high-precision classification and grading of gastric tumor pathological images. The transfer-learning and ensemble-learning framework was successfully applied to the grading of gastric tumor images and holds promise for integration into hospital intelligent diagnostic assistance systems.

Obesity Attenuates Cardiac Reverse Remodeling after Standard Medication Regimen in Heart Failure Patients

QIAN Zhijun, ZENG Jiaxin, ZHANG Enrui, WANG Yao, QIAN Zhiyong, HOU Xiaofeng, ZHU Xiaomei

Available online:March 31, 2026, DOI:

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Abstract: Objective: To investigate the impact of obesity on cardiac reverse remodeling in patients with heart failure with reduced or mildly reduced ejection fraction (HFrEF/HFmrEF) receiving guideline-directed medical therapy (GDMT). Methods: A retrospective analysis was conducted on patients with a left ventricular ejection fraction (LVEF) <50% treated at the First Affiliated Hospital of Nanjing Medical University between January 2022 and October 2024. All patients received GDMT and underwent baseline cardiac magnetic resonance (CMR) imaging to assess myocardial fibrosis using late gadolinium enhancement (LGE) and extracellular volume fraction (ECV). Obesity was defined as a body mass index (BMI) ≥28 kg/m2. Cardiac reverse remodeling was evaluated by echocardiography at baseline and after 6 months of GDMT. Treatment response was defined as an absolute increase in LVEF ≥5%. Results: Among the 80 enrolled patients (31 obese, 49 non-obese), the obese group showed a smaller improvement in LVEF and a lower treatment response rate compared to the non-obese group (ΔLVEF: 14.45% ± 2.08% vs. 20.80% ± 1.81%, P=0.024; response rate: 76.80% vs. 93.58%, P=0.036). Multivariable regression analysis confirmed that BMI was an independent negative predictor of LVEF improvement (β=-0.90, P=0.004). Both LGE (OR=0.68, P=0.025) and ECV (OR=0.89, P=0.012) were independent predictors of reduced treatment response. A predictive model combining BMI and ECV demonstrated the highest accuracy for identifying poor responders (AUC=0.923), which was significantly superior to the baseline model (P=0.043). Conclusion: In HFrEF/HFmrEF patients, obesity is associated with attenuated cardiac reverse remodeling and reduced responsiveness to GDMT. The combination of BMI and ECV improves the identification of patients at risk for diminished treatment response.

Clinical Features and Risk Factors Affecting the Course of Fever in Children and Adolescents with Histiocytic Necrotizing Lymphadenitis

WANG Wentin, LU Chao, LI Junxia, LI Yunjie, PU Yaning, HAN Tingting

Available online:March 31, 2026, DOI:

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Objective: To analyze the clinical features, treatment, outcomes, and risk factors influencing the duration of fever in children and adolescents with histiocytic necrotizing lymphadenitis (HNL). Methods: A retrospective analysis was conducted on the clinical data of 35 pediatric HNL patients admitted to the First Affiliated Hospital of Nanjing Medical University. The clinical characteristics and risk factors were compared between a short-duration fever group (≤2 weeks, n=17) and a long-duration fever group (>2 weeks, n=18). Results: Among the 35 patients, the mean age was 14.69 ± 2.42 years, with a male-to-female ratio of 1.06:1. All cases presented with lymphadenopathy, with cervical lymphadenopathy in 85.7%, tenderness in 74.3%, and fever in 97.14%. Common laboratory abnormalities included elevated lactate dehydrogenase (65.7%), increased erythrocyte sedimentation rate (65.7%), leukopenia (62.86%), neutropenia (51.43%), elevated high-sensitivity C-reactive protein (54.29%), and elevated ferritin (45.71%); 17.1% of patients tested positive for antinuclear antibody. The long-duration fever group had higher proportions of extra-cervical lymphadenopathy, leukopenia, neutropenia, antinuclear antibody positivity, and elevated inflammatory markers (P < 0.05). Logistic regression indicated that elevated ferritin was independent risk factor for prolonged fever duration. Antibiotics were ineffective in all 27 patients who received them. In 22 patients treated with glucocorticoids post-biopsy, the mean time to defervescence was 3.82 ± 4.79 days, with the short-duration fever group showing faster fever resolution (P < 0.05). During follow-up ranging from 6 months to 2 years, recurrence occurred in 2 patients, and none progressed to autoimmune diseases. Conclusion: HNL in children and adolescents primarily manifests with fever, painful cervical lymphadenopathy, leukopenia, and an elevated erythrocyte sedimentation rate. Elevated ferritin is independent risk factor for prolonged fever duration. Diagnosis relies on lymph node biopsy, antibacterial therapy is generally ineffective, and glucocorticoid treatment demonstrates favorable efficacy.

A survey on the knowledge, attitudes, and practices of college students in Nanjing regarding the impact of fine particulate matter pollution on respiratory health

Yixin huang, Zijie He, Yiqiang Da, Zirong Lu, Zhihao Wang, Peng Qin, Sicheng Zhou, Yu tang, Haiqi Gao, Mulong Du, Zheng Rui

Available online:March 27, 2026, DOI:

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Objective: To investigate the knowledge, attitudes, and practices (KAP) of university students in Nanjing regarding fine particulate matter (PM2.5) pollution and its impact on respiratory health, providing theoretical and practical guidance for respiratory health education. Methods: From August to November 2024, 550 university students in Nanjing were recruited as study participants. An online questionnaire survey was conducted to assess KAP related to PM2.5 pollution and respiratory health. Results: Among 451 valid responses, the accuracy rates of PM2.5-related knowledge and respiratory health knowledge were only 43.53% and 40.30%, respectively. The mean attitude score was 3.38 (out of a total of 4), while the mean behavior score was 3.00 (out of a total of 4). Multiple linear regression analysis revealed that economic status (monthly expenditure, household income) positively influenced knowledge (β = 0.162, P < 0.01) and behavior scores (β = 0.283, P < 0.01), whereas family history of respiratory diseases negatively affected knowledge scores (β = -0.108, P < 0.05). The structural equation model (SEM) confirmed the significant causal transmission effect of knowledge, attitude [standardized path coefficients, SPC = 0.270, P < 0.01)], and behavior (SPC = 0.148, P < 0.01). A total of 42 significant influence pathways were identified, though some knowledge components including respiratory protection exhibited negative associations with behavior, suggesting that contextual factors such as life stress and time constraints may hinder behavioral adoption. Conclusion: The awareness and countermeasures of PM2.5 pollution and its impact on respiratory health among college students in Nanjing City are generally weak. Respiratory health education based on factors such as college students' professional background, family income and age, targeted popularization of PM2.5 prevention and control knowledge and should be carried out, and the effective transformation of college students' knowledge, attitude and behavior should be promoted through multi-subject collaborative intervention.

Comparative Analysis of Sex-Specific Exosomal Proteomes and miRNA Profiles: Human Embryonic Stem Cells versus Human Amniotic Mesenchymal Stem CellsHUANG Beibei₁^,NING Song₂^,WU Huimin₂^,QIN Lianju₂^,DIAO Feiyang_^1,2

NING Song, WU Huimin, QIN Lianju

Available online:March 24, 2026, DOI:

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Objective: This study aims to investigate proteomic and transcriptomic differences between exosomes derived from sex-specific human embryonic stem cells (hESCs-exo) and human amniotic mesenchymal stem cells (hAMSCs-exo) at the molecular level. Methods: A defined cell culture system optimized for exosome research was established. High-quality exosomes were isolated via ultracentrifugation from male and female lines of hESCs and hAMSCs. Proteomic characterization was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS), while miRNA profiles were determined by high-throughput sequencing. Bioinformatics analysis subsequently identified key biological processes and pathways regulated by the exosomes. Results: At both proteomic and transcriptomic levels, exosomes derived from male and female hAMSCs exhibited similar molecular profiles, whereas those originating from male and female hESCs showed significant sex-based differences. Integrated miRNA profiling and proteomic analysis revealed that hESCs-exo were primarily associated with developmental and metabolic processes, while hAMSCs-exo predominantly participated in immune and metabolic functions. Conclusion: Through systematic proteomic and miRNA sequencing analyses of sex-specific exosomes derived from hAMSCs and hESCs, this study predicted their biological functions and revealed their potential applications across multiple domains. These findings provide novel perspectives for selecting optimal cell sources in preclinical and clinical trials.

A Preliminary Study on the Evaluation of Risk Stratification and Prediction of Early Chemotherapy Response in Children with B-ALL Using Quantitative Parameters of IDEAL-IQ and IVIM

杨洁

Available online:March 24, 2026, DOI:

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This study aims to explore the value of IDEAL-IQ combined with IVIM quantitative parameters in assessing the risk stratification of B-ALL children and predicting their early response to chemotherapy. Methods: Eighty-four B-ALL children were categorized into 5 low-risk, 61 medium-risk, and 18 high-risk cases based on WHO risk classification. Among them, 79 children underwent chemotherapy and received lumbar IDEAL-IQ and IVIM scans before chemotherapy and on day 36 of induction chemotherapy. According to day 33 bone marrow MRD after chemotherapy, the children were divided into a CR group (54 cases) and an N-CR group (25 cases). Clinical data such as age, gender, risk stratification, peripheral blood WBC, bone marrow blast percentage, LDH, and CNSL involvement were also collected. Results: Risk stratification: The lumbar vertebral f value in the high-risk group was significantly higher than in the medium-low risk group (P<0.001). Logistic regression analysis with peripheral blood WBC and lumbar vertebral f value as independent variables and clinical risk as the dependent variable revealed that f value is a high-risk factor for B-ALL (ORf=48082.101, P=0.000). Early chemotherapeutic response: Compared to the N-CR group, the CR group had significantly higher PDFF and R2* after chemotherapy (P=0.005 and P=0.008). Pretreatment risk stratification, D, and D* values differed significantly between the CR and N-CR groups (P<0.001, P=0.024, and P=0.03). Post-chemotherapy PDFF, pre-chemotherapy D and D* values were independent risk factors for N-CR. The pre-chemotherapy D+D* value showed a slightly higher AUC (0.817) for predicting N-CR than post-chemotherapy PDFF (AUC=0.807). Conclusion: The lumbar vertebral f value can predict B-ALL clinical risk stratification. Pre-chemotherapy D+D* values are significantly predictive of early chemotherapeutic responses.

CLEC5A is a Prognostic Biomarker and Correlated With Immune Infiltrates in Gastric Cancer

kaidierye.abudushalamu, Bing Lu, WeiMing Yang

Available online:March 24, 2026, DOI:

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Objective： The C-type lectin 5A (CLEC5A) is a key protein involved in the inflammatory response. However, the role of CLEC5A in the prognosis and tumor-infiltrating immune cells (TILs) of Gastric cancer (GC) remains unclear. Methods：In the current study, the raw data on CLEC5A expression in GC were obtained from TCGA data bases. TIMER2.0, CIBERSORT and Tissue microarray (TMA) analysis (145 GC tissues, 36 normal gastric mucosal tissues) method were used to investigate the association between CLEC5A and TILs invasion. The roles of CLEC5A expression and clinicopathologic characteristics in prognosis of GC patients were analyzed by univariate and multivariate Cox regression analysis. Results：CLEC5A protein expression was higher in GC tissues (114/145, 78.6%) than in normal gastric mucosal tissues (13/36, 36.1%, p < 0.05), demonstrated by IHC scores in TMA. Multivariate Cox regression analysis revealed that the up-regulated CLEC5A expression in tumor cells was associated with better overall survival (OS) of GC cases. Moreover, high CLEC5A expression in TILs was correlated with lower N stage and lower CEA level (p < 0.01). Specifically, a positive correlation was identified between increased CLEC5A expression and the more TILs using TIMER2.0 and CIBERSORT analysis. The Multiplex immunohistochemical (mIHC) demonstrated that that the expression of CLEC5A is associated with TILs, and CD4+T The infiltration levels of CD8+T, CD45RO+, FOXP3+T, PD1+, and PDL1+cells were higher in the low expression group (p < 0.05). Conclusion：Together, these results indicated that up-regulated CLEC5A expression correlated with the increased proportion of immune cells and favorable prognosis in GC.

Study of the effect of adding letrozole to ovarian stimulation for fertility preservation in female malignant tumor patients

Xu Siliang

Available online:March 24, 2026, DOI:

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Letrozole is a highly effective non-steroidal aromatase inhibitor that reduces estrogen levels by inhibiting aromatase activity. It has important application value in the field of fertility preservation, especially in patientswith malignant tumors. For patients with estrogen-sensitive malignant tumors such as breast cancer, letrozole can reduce the concentration of circulating estrogen in the body during ovulation induction, thereby reducing the adverse effects of high estrogen on tumors during traditional ovulation induction, and effectively promote follicular development. However, the low estrogen level environment in the body brought about by letrozole may lead to decreased oocyte maturity or embryo quality and reduced embryo implantation rate. Further large-scale clinical studies are needed in the future to clarify its long-term safety and efficacy in fertility preservation, and provide more precise treatment strategies for fertility preservation in patients with malignant tumors.

Research Progress on the Regulation of Macrophage Function by PFKM Through Classical and Non-Classical PathwaysYAO Chen_{1, 2}^{, YANG Jing}_{1, 2}^{, PAN Yuchen}_{^{1, 2*}}

Xuzhou Medical University

Available online:March 24, 2026, DOI:

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Phosphofructokinase, muscle type (PFKM), is a key rate-limiting enzyme in the glycolytic pathway, and its expression and activity are regulated by multiple signaling pathways, including HIF-1α, Myc, PI3K/AKT, and AMPK. Recent studies have demonstrated that PFKM can reprogram macrophage function by modulating glycolytic processes. On one hand, PFKM drives classical macrophage activation through the canonical glycolytic pathway, thereby promoting bactericidal and antitumor activities. On the other hand, emerging evidence indicates that PFKM also exerts “non-canonical” functions independent of its enzymatic activity, inhibiting macrophage phagocytosis and contributing to the formation of an immunosuppressive microenvironment. Importantly, physicochemical factors in the microenvironment, including mechanical forces, glucose, and citrate, can shift the equilibrium between the tetrameric and dimeric conformations of PFKM, thereby facilitating the switch between its classical and non?classical functions. While current research has largely focused on the classical glycolytic role of PFKM, its non?canonical functions and the underlying molecular mechanisms remain to be fully elucidated. This review summarizes the classical and non?canonical roles of PFKM in macrophages, its upstream regulatory signals, and its implications in infectious diseases and cancer, aiming to provide a theoretical foundation and insights for PFKM?targeted immunometabolic therapeutic strategies.

The Chemiluminescence Enzyme Immunoassay for Detection of Serum 1,5-Anhydro-D-Sorbitol (1,5-AG): Influencing Factors and Establishment of Reference Intervals

Fu Yu, Wang Jiachen, Liu Hechun, Fu Qi, Li Yue, Chen Heng

Available online:March 24, 2026, DOI:

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Objective To analyze the factors influencing serum 1,5-anhydro-D-glucitol (1,5-AG) levels and establish sex-specific reference intervals for 1,5-AG. Methods A total of 873 participants, aged 20 to 72 years, were enrolled from an epidemiological survey conducted between October and December 2020 in Nanjing, Jiangsu Province, and surrounding areas. General clinical data were collected via questionnaire. Physical examinations and laboratory assessments—including serum 1,5-AG and other routine clinical biochemical indicators—were conducted by trained professionals. Participants were categorized into different disease groups according to inclusion and exclusion criteria. After log-transformation of non-normally distributed data, Student's t-test was used to compare serum 1,5-AG levels among these groups. Pearson correlation analysis and multivariate linear regression were employed to assess associations between serum 1,5-AG and various clinical parameters. The reference interval for 1,5-AG was determined based on the 5th percentile among the apparently healthy population. Results Serum 1,5-AG levels were significantly associated with sex, body mass index (BMI), body roundness index (BRI), fasting blood glucose, fasting insulin, 2-hour postprandial blood glucose, glycated hemoglobin (HbA1c), estimated glomerular filtration rate (eGFR), total cholesterol, and carbohydrate-derived energy intake (all p < 0.05). Participants were divided into nine groups: apparently healthy, diabetes mellitus, hypertension, hyperlipidemia, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), hepatic dysfunction, renal dysfunction, and obesity. Significant differences in 1,5-AG levels were observed between the apparently healthy group and the hyperlipidemia, hepatic dysfunction, and obesity groups. The sex-specific reference intervals for serum 1,5-AG, defined by the 5th percentile in the apparently healthy population, were >99.8 μmol/L for males and >62.9 μmol/L for females. Conclusion Serum 1,5-AG levels are associated with glycemic status, lipid metabolism, and dietary patterns, and are influenced by age, sex, renal function, and dietary composition. Males exhibited significantly higher serum 1,5-AG levels than females; however, no significant differences were found across different age groups. The sex-specific reference intervals for serum 1,5-AG established in this study provide a valuable tool for monitoring glycemic variation and guiding the clinical management of diabetes.

A usability study of a soft hand rehabilitation robot for in-clinic and home-based upper limb training after stroke

SUN Huaiqing, YAN Peng, ZHANG Ruirui, CAO Hui, 吴婷

Available online:March 24, 2026, DOI:

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Objective： To evaluate the usability of a portable soft hand rehabilitation robot for upper limb training in patients after stroke. Methods： Thirteen stroke patients with hemiplegia were recruited to participate in a usability evaluation of the hand rehabilitation robot. Participants first received two weeks of supervised in-hospital training to learn device operation， followed by six weeks of unsupervised home-based rehabilitation （33 minutes per session， twice daily）. The System Usability Scale （SUS） and semi-structured interviews were used to assess usability after completion of the intervention. Upper limb motor function and activities of daily living were evaluated at baseline and during the intervention using the Fugl-Meyer Assessment for the upper extremity （FMA-UE）， the Action Research Arm Test （ARAT）， and the Activities of Daily Living Scale （ADL）. Results：The mean SUS score of the 13 participants was 85.8 ± 10.5， indicating an “Excellent” level of usability. Semi-structured interviews revealed that the device was easy to operate and portable, while highlighting areas requiring improvement, such as device connectivity, hardware stability, and training module diversity. After the 8-week intervention， several participants demonstrated improvements in FMA-UE, ARAT, and ADL scores compared with baseline, with changes reaching the mini clinical important difference （MCID）. Conclusions：The soft hand rehabilitation robot demonstrates high usability and safety for both clinical and home-based upper limb rehabilitation in stroke survivors with hemiparesis， suggesting its potential as a promising tool for post-stroke hand rehabilitation.

Surveillance of Adverse Reactions to Human Papillomavirus Vaccine in Pudong New Area, 2017-2024

Deng Peng-fei, Zhou Cui-ping, Feng Yong

Available online:March 17, 2026, DOI:

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Abstract: Objective To explore the situation of HPV vaccine adverse reactions in Pudong New Area, Shanghai, from 2017 to 2024, and to provide scientific basis for the safety evaluation of HPV vaccine after marketing. Methods Data on suspected adverse events following immunization (AEFI) to HPV vaccines in Pudong New Area from 2017 to 2024 were collected to analyze the incidence of AEFI reports following HPV vaccination. Results From 2017 to 2024, a total of 1,436,659 doses of HPV vaccine were administered in Pudong New Area, with 1,610 AEFI cases reported. with an overall AEFI reporting rate of 112.07 per 100,000 doses administered. The respective numbers of reports for general reactions, abnormal reactions, psychogenic reactions, and coincidental events were 1,578 (109.84 per 100,000 doses), 24 (1.67 per 100,000 doses) , 5 cases (0.35 per 100,000 doses), and 3 cases (0.21 per 100,000 doses), respectively. The AEFI reports for bivalent, quadrivalent, and nonavalent HPV vaccines were 208 cases (193.30 per 100,000 doses administered), 457 cases (107.10 per 100,000 doses administered), and 945 cases (104.72 per 100,000 doses administered), respectively. During 2017-2024, the highest AEFI incidence rates for bivalent, quadrivalent, and nonavalent HPV vaccines were 530.50/100,000 doses, 190.56/100,000 doses, and 194.38/100,000 doses, respectively. Statistically significant differences in AEFI incidence rates were observed among different HPV vaccine types (P< 0.05). The number of AEFI reports for bivalent liquid penicillin, bivalent liquid pre-filled, quadrivalent liquid pre-filled, nonavalent liquid penicillin, and nonavalent liquid pre-filled vaccines were 53 cases (101.90 per 100,000 doses) , 155 cases (278.82 per 100,000 doses), 457 cases (107.10 per 100,000 doses), 41 cases (198.26 per 100,000 doses), and 904 cases (102.53 per 100,000 doses), respectively. The incidence rates of AEFI differed significantly among different dosage strengths of both the bivalent and nonavalent HPV vaccines (P < 0.05). The peak period for HPV vaccine-associated AEFI occurred within 0–0.5 days post-vaccination, with 854 cases (59.44/100,000 doses administered). The temporal distribution of AEFI varied significantly among different HPV vaccine types (P < 0.05) . The distribution of local redness and swelling as a common reaction differed significantly among HPV vaccine types (P<0.05). Conclusion: HPV vaccines exhibit a low incidence of adverse reactions, and post-vaccination adverse reaction monitoring should be strengthened. Conclusion HPV vaccine has a low incidence of AEFIs, and the monitoring of AEFIs after HPV vaccination should continue to be strengthened.

GDF-15: A Novel Non-Invasive Early Warning Target for Coronary Slow Flow Phenomenon

Lun Limin, Jia Fenghao, Xu Longqiang, Liu Zhen, Hou Baoyu

Available online:March 17, 2026, DOI:

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Objective:?Coronary Slow Flow Phenomenon (CSFP)?is a patho[*通讯作者（Corresponding author）,E-mail: zhangxuezhi@qdyhospital.cn ]logical condition characterized by delayed coronary blood flow in the absence of significant stenosis on coronary angiography, which predisposes patients to angina pectoris and cardiovascular events. Current diagnosis relies heavily on invasive investigations, and simple, effective non-invasive predictive tools are lacking. This study aimed to investigate the expression level of serum Growth Differentiation Factor-15 (GDF-15) in CSFP and evaluate its predictive value, with the goal of providing an alternative to the current diagnostic paradigm dependent on invasive coronary angiography (the current gold standard). Methods:?Patients undergoing coronary angiography at the Affiliated Hospital of Qingdao University (December 2023–June 2024) were enrolled. Those with angiographically normal coronary arteries were assigned to the control group (n = 42), while patients exhibiting delayed coronary flow without significant stenosis comprised the CSFP group (n = 69). Clinical data were collected for all participants. Pre-angiography serum growth differentiation factor-15 (GDF-15) levels were measured using ELISA. Logistic regression and receiver operating characteristic (ROC) curve analyses assessed the association between GDF-15 levels and CSFP risk. Results:?GDF-15 levels were significantly higher in the CSFP group versus controls [median (IQR): 957.01 (716.27, 1373.16) ng/L vs. 745.14 (585.43, 812.41) ng/L;?*z*?= –4.14,?P?< 0.001]. Both univariate and multivariate logistic regression (adjusted for body mass index and other confounders) showed that each 1-unit increase in ln(GDF-15) (corresponding to a ~2.718-fold increase in raw concentration) was associated with a 7.22-fold higher CSFP risk (95% CI: 1.36–38.37,?P?< 0.05). Conversely, each 1 mmol/L increase in HDL-C reduced CSFP risk (OR = 0.19, 95% CI: 0.10–0.36,?P?< 0.05). ROC analysis indicated that GDF-15 alone had an AUC of 0.791 for diagnosing CSFP. Combining GDF-15 with HDL-C increased the AUC to 0.953, improving sensitivity from 57.97% to 91.30%. Conclusion:?Elevated serum GDF-15 levels in CSFP patients establish its potential as a non-invasive early warning biomarker. The combined GDF-15/HDL-C diagnostic model demonstrated substantially improved accuracy, suggesting its utility as a practical clinical screening tool. This approach could reduce dependence on invasive coronary angiography for CSFP detection.

Mitochondrial Metabolism in Tumor Drug Resistance

MA Xiao

Available online:March 17, 2026, DOI:

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Tumor drug resistance is the primary cause of treatment failure in cancer therapy, with its underlying mechanisms closely tied to cancer cells" adaptive responses to environmental stress during treatment. As the central hub of cellular energy metabolism and stress responses, mitochondria drive drug resistance by enhancing cancer cell metabolic plasticity and survival. This is mediated through mechanisms such as activation of oxidative phosphorylation, regulation of reactive oxygen species (ROS) homeostasis, aberrant metabolite accumulation, and alterations in mitochondrial dynamics, positioning mitochondria as pivotal contributors to therapeutic resistance. Targeting mitochondrial metabolism has demonstrated significant potential to reverse drug resistance in contemporary oncology. This article reviews the adaptive mitochondrial changes in tumor cells under therapeutic stress, explores the multifaceted mechanisms by which mitochondrial metabolism induces resistance across various treatment modalities, and summarizes ongoing research on mitochondria-targeted metabolic therapies. Therefore, future mitochondria-targeted interventions are poised to transition from foundational mechanistic studies to clinical applications, offering novel perspectives for advancing personalized cancer treatment.

The utilization of human induced pluripotent stem cell and brain organoid technologies in Huntington's disease research

LIU Yan, You Weiyan

Available online:March 17, 2026, DOI:

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Huntington's disease (HD) is an autosomal dominant genetic disorder caused by the abnormal CAG repeat expansion in the huntingtin (HTT) gene. It is clinically characterized by choreiform movements, progressive cognitive impairments, and psychiatric symptoms, with no cure currently available. Although the researches based on traditional animal models and human tissues have revealed key pathological features such as mutant HTT protein aggregation and selective striatal neuron loss, significant limitations remain in understanding human-specific disease mechanisms. The development of human induced pluripotent stem cell (hiPSC) and brain organoid technologies has enabled the construction of human-specific HD models, providing revolutionary platforms for elucidating pathological mechanisms and developing novel therapeutic strategies. This review summarizes the developmental trajectories of both HD patient-derived iPSC (HD-iPSC) and human brain organoid technologies, highlights the research findings and significance of HD iPSC-derived cells, various brain organoids, and assembloids in HD research, and discusses the current challenges and future prospects of brain organoid applications.

Comparative Efficacy of Surgical versus Medical Therapy for Atrial Functional Mitral Regurgitation Complicated by Atrial Fibrillation in Elderly Patients

pangsisi, Zhang linfei, zhan faliang, 叶涛

Available online:March 05, 2026, DOI:

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Objective:To evaluate the clinical efficacy and long-term prognosis of surgical mitral valve repair combined with atrial fibrillation (AF) ablation versus standardized medical therapy in elderly patients (≥70 years) suffering from persistent AF complicated by moderate-to-severe atrial functional mitral regurgitation (AFMR). Methods:A retrospective analysis was conducted on patients hospitalized with AFMR and AF between January 2019 and December 2024. Patients were stratified into a surgical group (n=91) and a medical therapy group (n=167) based on their treatment strategies. Propensity score matching (PSM) was applied at a 1:1 ratio to balance baseline characteristics, resulting in 91 matched pairs. The primary endpoint was all-cause mortality. Secondary endpoints included AF recurrence, recurrence of mitral regurgitation, and major adverse cardiac and cerebrovascular events (MACCE). Results:Baseline characteristics were balanced between the two groups after matching, with a mean age of approximately 73-75 years. The median follow-up duration was 3 years. The 5-year survival rates for the surgical and medical groups were 61.9% and 61.4%, respectively, showing no statistically significant difference in long-term survival (Log-Rank *P*=0.788). Compared with the medical group, the surgical group demonstrated a significantly reduced incidence of ischemic stroke (5.5% vs. 18.7%, *P*=0.012) and moderate-to-severe mitral regurgitation (28.6% vs. 100%, *P*<0.001). Although the incidence of cerebral hemorrhage was numerically lower in the surgical group (4.4% vs. 5.5%), the difference was not statistically significant (*P*=1.000). Regarding rhythm control, the AF recurrence rate in the surgical group was 78.0%; while this remains high, it was significantly lower than that of the medical group (*P*=0.002).Conclusion:For elderly patients with AFMR, surgical treatment did not significantly prolong overall survival but demonstrated significant advantages in correcting valvular pathology and preventing disabling ischemic stroke. Surgical therapy may serve as an effective strategy to improve prognosis in elderly patients with reasonable life expectancy, high stroke risk, and adequate surgical tolerance.

The association between physical activity and sedentary time with irregular menstrual cycles in reproductive women: A cross-sectional study

Huang Lingling, Wang Xinru, Zhang Yi, Zhao Mengjie, Zheng Hanyue, Wang Bei, Zhang Xuening

Available online:March 05, 2026, DOI:

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Objective To explore the relationship between physical activity, sedentary time, and irregular menstrual cycles in women of reproductive age. Methods Conducted between April and June 2024 using convenience sampling, the cross-sectional study assessed physical activity and sedentary time through the International Physical Activity Questionnaire-Short Form (IPAQ-SF), while menstrual cycles was self-reported. Associations were analyzed using logistic regression and restricted cubic spline models, with E-values calculated to assess the influence of potential unmeasured confounders. Results Among 1,259 participants averaging 25 years old, moderate physical activity was linked to a 40% lower risk of irregular menstrual cycles compared to low activity (OR = 0.60, 95% CI: 0.44, 0.81), and high physical activity was associated with a 46% reduced risk (OR = 0.54, 95% CI: 0.37, 0.79), after adjusting for all covariates. Meeting World Health Organization guidelines for moderate-to-vigorous activity was associated with a 36% decreased risk (OR = 0.64, 95% CI: 0.48, 0.85). Sedentary time showed no significant link to irregular menstrual cycles. E-value analysis suggested that unmeasured confounders would need a moderate association strength (1.8–2.1) with both exposure and outcome to negate these findings. The risk of irregular menstrual cycles began to rise when weekly total metabolic equivalents exceeded roughly 3,185 MET-minutes. Conclusion Moderate to high levels of physical activity are inversely related to irregular menstrual cycles in reproductive-aged women, though excessively high activity may increase risk. Ensuring adequate physical activity appears more crucial than merely reducing sedentary behavior.

Factors Influencing the Onset of Anterior Knee Pain After Total Knee Arthroplasty without Patellar Resurfacing: A Multivariate Analysis

Bao Xing''an, Huang Yi, Yang Hui, Le Linfeng

Available online:March 04, 2026, DOI:

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Objective:To analyze the factors influencing the occurrence of anterior knee pain after total knee arthroplasty?without patellar resurfacing.Methods:A retrospective analysis was conducted on 2,200 patients who underwent TKA without patellar resurfacing at the First Affiliated Hospital of Nanjing Medical University, between September 2020 and May 2025. According to the inclusion and exclusion criteria, 2,027 patients (766 males and 1,261 females) were finally included, with a mean age of 68.05±5.64 years (range, 47-86 years), and a mean body mass index (BMI) of 26.52±3.59 kg/m2 (range, 15.09~40.01 kg/m2). Based on the presence of postoperative anterior knee pain, patients were divided into?a non-AKP group (1,886 cases) and an AKP group (141 cases).Preoperative and postoperative radiographic parameters were measured and compared between the groups, including patellar tilt angle, patellar shift, patellar morphology (Wiberg classification), patellar thickness, patellar height, hip-knee-ankle (HKA) angle, and patellofemoral overstuffing. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for anterior knee pain.Results:All patients were followed up for more than 6 months. There were no statistically significant differences in gender, age, or BMI between the two groups (P > 0.05).There were statistically significant differences between the two groups in the preoperative patellar tilt angle, preoperative patellar shift, preoperative patellar morphology, postoperative patellar tilt angle, postoperative patellar shift, postoperative patellar morphology, and patellofemoral overstuffing (P < 0.05). The preoperative patellar thickness, ?preoperative patellar height, preoperative HKA angle, postoperative patellar thickness,?postoperative patellar height, and postoperative HKA angle showed no significant differences between the two groups (P > 0.05).Multivariate analysis identified?postoperative patellar tilt angle, postoperative patellar shift, patellofemoral overstuffing, and patellar height?as independent risk factors?(P < 0.05).?Mediation analysis demonstrated that?patellar morphology had no direct effect on anterior knee pain, and its influence?was completely mediated by?patellar tilt angle and patellar shift.Conclusion:Increased postoperative patellar tilt angle, increased postoperative patellar shift, postoperative patella baja, and patellofemoral overstuffing are independent risk factors for anterior knee pain after TKA without patellar resurfacing. Mediation analysis further revealed that the effect of patellar morphology on anterior knee pain was entirely mediated by patellar tilt angle and patellar shift.

Associated factors with early non-native liver survival for Biliary atresiaHuan Chen1^, Qiming Geng, Wei Li, Changgui Lu ^1*

Qiming Geng, Wei Li

Available online:March 04, 2026, DOI:

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Objective: To summarize the status of native liver survival (NLS) in the early stage after Kasai procedure in patients with biliary atresia and to analyze the factors associated with postoperative death or liver transplantation. Methods: From May 2020 to May 2024, 114 cases of biliary atresia underwent Kasai surgery in Children’s Hospital of Nanjing Medical University. Nine cases were lost to follow-up, leaving 105 cases included in the study, with a follow-up period ranging from 12 to 60 months. Kaplan-Meier survival analysis was used to summarize the characteristics of NLS after Kasai surgery, and univariate and multivariate Cox regression models were employed to identify associated factors for postoperative death or liver transplantation. Results: As of May 2025, 105 patients were followed up for 12 to 60 months, with a median follow-up time of 33 months. Among these, 41 cases died or underwent liver transplantation, resulting in a total NLS rate of 61.0%. Of these, 35 cases died or underwent liver transplantation within the first year after the Kasai procedure, accounting for 85.4% of all deaths or liver transplants. The Kaplan-Meier survival curve estimated an average NLS time of 38.4±2.51 months after Kasai surgery, with an actual NLS rate of 66.7% and an estimated 2-year cumulative NLS rate of 59.6%. The estimated 3-5 year cumulative survival rate was consistent with the 2-year cumulative survival rate. Univariate and multivariate Cox regression models revealed that the preoperative Liver stiffness measured by ultrasound（LSM） and a jaundice clearance time exceeding 3 months postoperatively are two independent associated factors with death or liver transplantation after the Kasai procedure (HR[95%CI]=1.031[1.001,1.064],p=0.049; HR[95%CI]=6.394[3.141,13.015], p<0.001). Among the 105 patients, 66 (62.9%) developed cholangitis within 3 months postoperatively, with 18 (27.27%) developing postoperative cholangitis within the first month. The jaundice clearance rate in patients who developed cholangitis within the first month was lower than in those who did not (50.0% vs 77.1%, χ2=4.546, p=0.031). Conclusion: Most deaths or liver transplants occur within the first year after Kasai, and stable NLS is typically achieved by the second year post-Kasai. The preoperative LSM and postoperative time to jaundice clearance are independent associated factors for postoperative non-NLS in children with biliary atresia. The preoperative LSM was higher than 11.6KPa, and the jaundice clearance time was greater than 3 months would significantly reduce the rate of early NLS. Postoperative cholangitis within the first month after Kasai surgery can reduce the jaundice clearance rate within three months post-surgery.

A Nomogram-Based Prediction Model for Clinical Mortality Risk in VA-ECMO Patients

Zhu Yi

Available online:March 04, 2026, DOI:

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Objective: Patients with acute myocardial infarction (AMI) requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support remain at high risk of mortality. This study aimed to identify risk factors associated with in-hospital death and to develop a nomogram-based predictive model for in-hospital mortality in AMI patients treated with VA-ECMO. Methods: A total of 162 consecutive patients with acute myocardial infarction who received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support at our institution between May 2021 and June 2025 were retrospectively enrolled. The time of ECMO initiation was defined as the start of follow-up, and patients were followed until hospital discharge or death, whichever occurred first. In-hospital all-cause mortality was defined as the primary endpoint. Cox proportional hazards regression analysis was performed to evaluate the associations between candidate variables and the risk of in-hospital mortality. Variables were selected using least absolute shrinkage and selection operator (LASSO) regression, and a multivariable Cox regression model was subsequently constructed. Based on the final model, a nomogram was developed to predict in-hospital survival probability. Model discrimination was assessed using the concordance index (C-index). The 28-day time point was used as a fixed landmark for time-dependent receiver operating characteristic (ROC) analysis to evaluate short-term predictive performance. Model calibration was evaluated using calibration curves, and clinical utility was assessed using decision curve analysis (DCA). Results: Multivariable analysis demonstrated that cardiac troponin T, soluble suppression of tumorigenicity-2 (sST2), hemoglobin concentration, prothrombin time, serum sodium level, and alanine aminotransferase were significantly associated with in-hospital mortality. White blood cell count and albumin showed borderline statistical significance in the model. The nomogram incorporating these eight variables exhibited good discriminative performance and satisfactory calibration, indicating favorable clinical applicability. Conclusions: This study identified key clinical variables associated with in-hospital mortality and successfully developed and validated a nomogram-based prediction model. The proposed model provides a simple and reliable tool for individualized risk stratification and may assist clinicians in optimizing decision-making and management strategies for this high-risk population.

Development of an all-cause mortality risk prediction model utilizing multiple machine learning algorithms for maintenance hemodialysis patients in Wuxi City

ZHOUYIJUN, Sunwenjuan, Zhoujingyi, 王依娜

Available online:March 03, 2026, DOI:

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Abstract: Objective：To construct prediction models for all-cause mortality in maintenance hemodialysis (MHD) patients in Wuxi City using diverse machine learning algorithms.Methods：Clinical data from 591 MHD patients across three tertiary hospitals in Wuxi City (January 2017 to December 2023) were collected.Predictors were selected via the least absolute selection and shrinkage operator (LASSO) method. Patients were randomly divided into training (n=414，70%) and validation (n=177，30%) sets. Ten machine learning algorithms were employed to develop risk prediction models. Receiver operating characteristic (ROC) curves were plotted to evaluate predictive performance. Shapley Additive exPlanations (SHAP) were applied to rank variable importance.Results：The all-cause mortality rate was 42.6%(252/591).Among the 10 models，the support vector machine (SVM) exhibited optimal performance，the area under the ROC curve (AUC) was 0.928，the sensitivity was 0.895，and the accuracy was 0.919.The SHAP plot showed that the importance ranking of the influencing factors for all-cause mortality was living alone，tunneled cuffed catheter (TCC)，prealbumin，albumin，Charlson Comorbidity Index (CCI) score，iPTH<300pg/mL，age，middle school education and lower，blood urea nitrogen-to-creatinine ratio，diabetic nephropathy，college degree or higher education and gender.Conclusion：The SVM-based prediction model demonstrates robust performance in forecasting all-cause mortality among MHD patients, facilitating early identification of high-risk individuals and supporting clinical decision-making.

Relationship between ultrasound echo characteristics of the diaphragm and peripheral skeletal muscles and clinical outcome in mechanically ventilated patients with sepsis

孙晨靓, WANG FAN, YU Lei, HUANG Lizhen, ZHAO Hongsheng, GUO Fengmei, 沈浩亮

Available online:March 03, 2026, DOI:

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Objective: To investigate the relationship between changes in ultrasound echo characteristics of the diaphragm and peripheral skeletal muscles and weaning outcome and prognosis in mechanically ventilated patients with sepsis, in order to explore the potential value of muscle ultrasound in guiding the early and accurate assessment of patients with sepsis. Methods: Mechanically ventilated septic patients admitted to the Department of Critical Care Medicine of Affiliated Hospital of Nantong University from January 2023 to December 2024 were selected as the study subjects, and the ultrasound images of diaphragm and quadriceps femoris were consecutively observed and analyzed at the time of admission to the ICU, 48h, and discharge from the ICU. The echogenicity of diaphragm (EDi)/echogenicity of rectus femoris (ERF) ratio (EDi/ERF) and the thickness of diaphragm (Tdi)/quadriceps muscle layer thickness (Q-MT) ratio (Tdi/Q-MT) were calculated. According to the trend of EDi/ERF and Tdi/Q-MT, the patients were categorized into the group with increasing ratio and the group with decreasing ratio. The weaning success rate, duration of mechanical ventilation, length of stay, and 28-day survival rate of the two groups were compared separately to evaluate the guiding value of changes in the ultrasound characteristics of the diaphragm and peripheral skeletal muscles on the clinical outcome of mechanically ventilated patients with sepsis. Results: A total of 110 patients were enrolled in the study, and the patients in the group with increased EDi/ERF ratio had a significantly lower weaning success rate(P=0.043), a significantly longer mechanical ventilation time(P=0.019), and a significantly lower 28-day survival rate(P=0.008) than those in the group with decreased EDi/ERF ratio. No statistically significant differences in weaning success rate, duration of mechanical ventilation, and 28-day survival rate were found between the group with increased Tdi/Q- MT ratio and decreased Tdi/Q-MT ratio (P>0.05). The Cox proportional hazards model showed that enhanced EDi and increased EDi/ERF ratio were significant risk factors affecting the 28-day cumulative weaning success rate (HR=0.306, P=0.045; HR=0.287, P=0.031, respectively). Conclusion: The early presence of increased echogenicity of diaphragm and increased diaphragm to peripheral skeletal muscle echogenicity ratio are both associated with lower weaning success rate and poorer clinical prognosis in mechanically ventilated patients with sepsis.

Development and Validation of a Risk Prediction Model For Post-Traumatic Epilepsy in Pediatric Traumatic Brain Injury based on Meta-Analysis of Cohort Studies

Qi Hongyu, Zhang Hua, Zhang Lijuan, Wang Jing, 陆巍峰

Available online:March 03, 2026, DOI:

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Objective: Post-traumatic epilepsy (PTE) is a common complication of traumatic brain injury (TBI) that significantly impacts the prognosis. Early prediction of PTE risk is crucialfor clinical management. Compared to adults, research on pediatric PTE remains limited, and there is currently no widely accepted high-performance predictive model for children with TBI.. This study aimed to develop and validate a nomogram prediction model for PTE risk in pediatric TBI patients. Methods:?We systematically searched the China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Biomedical Literature Database (CBM), VIP, PubMed, Embase, and Web of Science for studies on risk factors of pediatric PTE, with a search timeframe from database inception to October 2024. Meta-analysis was performed using Stata 15.0 to identify risk factors with statistically significant pooled effect sizes. A retrospective cohort of 262 TBI children admitted to the SICU of Nanjing Medical University Affiliated Children's Hospital from January 2019 to December 2023 was included. The dataset was randomly split into a training cohort (70%) and an internal validation cohort (30%). Based on the risk factors identified in the Meta-analysis, a multivariate logistic regression model was constructed using R software, and a nomogram was developed. The model's discriminative ability was evaluated using the area under the receiver operating characteristic curve (AUC), calibration was assessed via the Hosmer-Lemeshow test, and clinical utility was examined using decision curve analysis (DCA). Results:?A total of 13 observational studies involving 1,371,819 TBI children were included. Meta-analysis revealed that the incidence of PTE in Chinese children with TBI was 19% (95% CI: 17%-20%). Based on the Meta-analysis findings and clinical expertise, the final prediction model incorporated eight key risk factors: Glasgow Coma Scale (GCS) score, open head injury, early seizure activity, loss of consciousness, and abnormal neuroimaging findings including intracranial hematoma, cerebral contusion, subdural hemorrhage, and subarachnoid hemorrhage. The model demonstrated strong discriminative ability, with AUCs of 0.801 (95% CI: 0.735–0.867, P < 0.05) in the training cohort and 0.831 (95% CI: 0.728–0.934, P < 0.05) in the validation cohort. The Hosmer-Lemeshow goodness-of-fit test indicated good calibration (training cohort: P = 0.079; validation cohort: P = 0.082). DCA confirmed substantial clinical net benefit. Conclusion:?The PTE risk prediction model developed in this study, based on Meta-analysis-derived risk factors, exhibits excellent discrimination, calibration, and clinical utility, serving as an effective tool for PTE risk assessment in children with TBI.

Application of PET/MRI in the Diagnosis and Treatment of Breast Cancer

Ding Ziteng, Tang lijun

Available online:March 03, 2026, DOI:

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Breast cancer is one of the most common malignant tumors in women, with its incidence and mortality rates increasing annually. Early and accurate diagnosis and treatment of breast cancer patients are crucial for improving prognosis. Integrated positron emission tomography/magnetic resonance imaging (PET/MRI) as an emerging multimodal molecular imaging technology, combines the molecular metabolic imaging capabilities of PET with the high-resolution soft tissue imaging advantages of MRI. This allows for clearer identification of tumors and their relationships with surrounding tissues, holding significant clinical importance in the diagnosis and treatment of breast cancer. This article primarily reviews the applications and advancements of PET/MRI in the diagnosis, staging, molecular typing, and treatment monitoring of breast cancer.

THBS2 Secretion by Cancer-Associated Fibroblasts Drives Macrophage M2 Polarization via the PI3K/AKT Signaling Pathway to Promote Colorectal Cancer Progression

Li Mengqi

Available online:March 03, 2026, DOI:

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Objective: To investigate the mechanism by which cancer-associated fibroblasts (CAFs) promote macrophage M2 polarization through secretion of thrombospondin-2 (THBS2, TSP2). Methods: The expression and clinical significance of THBS2 in colorectal adenocarcinoma were analyzed using the TCGA database.The cellular origin of THBS2 was identified through the TISCH2 single-cell database combined with multiplex immunohistochemical staining, and its association with immune infiltration was assessed using TIMER2.0. Western blot, ELISA, and primary CAFs models were utilized to validate THBS2 secretion. qRT-PCR, Transwell assays, and PI3K/AKT pathway analysis were performed to systematically evaluate the regulatory effects of THBS2 on macrophage polarization, migration, and signaling. Results: THBS2 expression was significantly elevated in colon cancer tissues and closely correlated with advanced TNM stages and poor patient prognosis. Single-cell sequencing and experimental validation confirmed that THBS2 is specifically derived from CAFs and most strongly associated with M2 macrophage infiltration. Functional experiments demonstrated that CAFs-conditioned medium upregulated M2 markers (IL-10, CD206, ARG1) and enhanced macrophage migratory capacity. Recombinant TSP2 promotes p-PI3K/p-AKT phosphorylation levels in macrophages compared to the IL-4 group, augmenting M2 polarization. THBS2 knockdown significantly inhibited these pro-migratory and polarization effects. Conclusion: CAFs-derived THBS2 may drive macrophage M2 polarization and migration by activating the PI3K/AKT signaling pathway,thereby remodeling the colorectal cancer immune microenvironment and driving malignant progression. This study provides experimental evidence for immunotherapy strategies targeting the CAFs-THBS2 axis.

Altered Whole-Brain Neuromagnetic Networks in children with self-limited epilepsy with centrotemporal spikes: Associations with Cognitive Impairment

Zhou Xinyi, Wang Yingfan, Li Minghao, Zhu Yinjie

Available online:March 03, 2026, DOI:

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Objective：The objective was to examine changes in whole-brain neuromagnetic networks in children with self-limited epilepsy with centrotemporal spikes (SeLECTS) and to assess the association between these network alterations and cognitive performance. Methods： Magnetoencephalography (MEG) data were collected from 63 unmedicated children with SeLECTS and 30 healthy controls (HC). Corrected amplitude envelope correlation (AEC-c) analysis was performed to estimate the oscillatory functional connectivity (FC) of 68 brain regions based on the Desikan-Killiany atlas. Cognitive function was assessed in all children using the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV). Spearman"s correlation analysis was applied to determine the relationship between AEC-c values and WISC-IV indices. Results： Compared to the HC group, children with SeLECTS exhibited reduced FC in several networks, including the right entorhinal cortex and the left rostral anterior cingulate in the theta band, the right lateral orbitofrontal cortex and the right pericalcarine in the beta band, and the right fusiform gyrus and the left inferior parietal gyrus in the gamma2 band (P < 0.05). Conversely, increased FC was observed between the right fusiform gyrus and the left parahippocampal gyrus, the left insular gyrus and the left rostral anterior cingulate in the delta band, and the left postcentral gyrus and the right cuneus in the gamma1 band (P < 0.05). Regarding the relationship between FC and cognitive performance, in the theta band, WMI scores showed a positive correlation with the AEC-c value between the right fusiform gyrus and the left parahippocampal gyrus (r = 0.255; P < 0.05). Additionally, in the theta band, PSI scores were positively correlated with the AEC-c value between the left insular gyrus and the left rostral anterior cingulate (r = 0. 258; P < 0.05). In the gamma1 band, a negative correlation was found between PRI scores and the AEC-c value of the left postcentral gyrus and the right cuneus (r =-0.266; P < 0.05). Conclusion： The results showed that the FC networks of children with SeLECTS exhibited significant differences in theta, beta, and gamma bands compared to HC. Furthermore,most of these brain regions were located in key nodes of cognition-related networks, which may help to understand the mechanisms of impairment in cognitive function in children with SeLECTS. Second, the AEC-c of enhanced FC network showed linear correlation with cognitive-related metrics, explaining the potential of neuroimaging techniques in assessing cognitive impairment.

The Application of a Microplate Imaging System in Screening Monoclonal Cell Lines with High Fluorescence Protein Expression

GUAN Qiangdong, DING Jingjing, XIONG Jianping, WANG Li

Available online:March 03, 2026, DOI:

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Objective: To establish a program for screening monoclonal cell lines with high expression of fluorescent protein after stable transfection using a microplate imaging system. Methods: HBE cells were stably transfected with GFP (green fluorescent protein) by lentivirus and cells with high fluorescence intensity were seeded into a 96-well black plate (with clear bottom) by flow cytometric sorting. Single cells were seeded into all wells, except one well, into which 50 cells were seeded to acquire an appropriate setting during imaging. According to the screening protocol, the imaging and analysis functions of the microplate imaging system were employed four times to perform screening across 95 wells. Wells containing one single cell were picked out on the day of sorting and wells containing cell colonies were picked out after clone formation. After cells in the selected wells were individually disassociated and cultured in new wells, wells containing cells with high fluorescence intensity were picked out. After achieving 4-8× population expansion, wells containing cells exhibiting normal proliferative capacity were picked out. The fluorescence intensities of selected monoclonal cell lines were ultimately confirmed by flow cytometry and fluorescence imaging. Results: According to the screening program, 89 wells containing one single cell, 19 wells containing cell colonies, 6 wells containing cells with high fluorescence intensity and 3 wells containing cells exhibiting normal proliferative capacity were picked out sequentially. The selected cell lines from those 3 wells exhibited significantly higher mean fluorescence intensities and higher percentages of cells with strong fluorescence, compared to parental cells. Conclusion: Application of a microplate imaging system to the screening of monoclonal cell lines with high expression of fluorescent protein after stable transfection, based on the screening program, is simple and convenient (compared with traditional microscopy-based observation/imaging), showing considerable potential for widespread application.

Factors and Model Construction of Cognitive Impairment in Epilepsy Patients: Analysis Based on NHANES Database

葛怀廷

Available online:March 03, 2026, DOI:

[Abstract] (39) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective A predictive model for cognitive dysfunction in epileptic patients was constructed using LASSO regression, and the predictive efficacy of this model was analyzed. Methods A cross-sectional study was conducted, including epileptic patients from the NHANES database. Participants were categorized into cognitive dysfunction (DSST<34) and normal cognitive function groups (DSST≥34) based on the total score of the Digit Symbol Substitution Test (DSST). Data on demographics, socioeconomic characteristics, physical activity, medical history, as well as laboratory indicators such as 25-hydroxyvitamin D [25(OH)D] and neurofilament light chain (NfL) were collected. Lasso regression was used to select non-zero coefficient variables, and a multivariate logistic regression model was constructed to analyze factors affecting cognitive dysfunction in epileptic patients and to develop a nomogram prediction model. The model’s predictive ability was evaluated using receiver operating characteristic (ROC) curves, Bootstrap calibration curves, and Hosmer-Lemeshow goodness-of-fit tests. Results A total of 282 subjects were included, with a cognitive dysfunction incidence of 32.62% among the epileptic patients. Factors identified through Lasso reduction and logistic regression included blood uric acid (OR=2.098), NfL (OR=1.025), serum 25(OH)D (OR=0.989), and education level (OR=0.209~0.431). The nomogram prediction model based on these factors showed an area under the ROC curve of 0.833 (95% CI: 0.780–0.886), with a specificity of 0.784 and sensitivity of 0.761. The Bootstrap calibration curve demonstrated a high consistency between the observed probabilities and those predicted by the nomogram; the Hosmer-Lemeshow test also indicated good model fit (χ2=7.781, P=0.455). Conclusion Cognitive dysfunction in epileptic patients was influenced by factors including blood uric acid, NfL, serum 25(OH)D, and education level. The predictive model constructed based on Lasso regression exhibited good predictive efficacy. Identifying these factors provides important guidance for clinical assessment and intervention, contributing to improved management of prognosis in epileptic patients.

Exploration on the impact of the number of readout points on image quality in zero echo time imaging of the lumbar spine

XU Lulu, WU Puyeh

Available online:January 22, 2026, DOI:

[Abstract] (88) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the impact of different numbers of readout points (Nread) on image quality in zero echo time (ZTE) imaging of the lumbar spine, and to determine the optimal Nread. Methods: Sixteen healthy volunteers were recruited and underwent coronal ZTE scans of the lumbar spine with three different Nread (128, 144, and 160), to obtain three sets of images (Nread-128, Nread-144, and Nread-160). The signal intensity of the cortical bone, muscle, and cancellous bone was measured in each set, and the standard deviation of subcutaneous fat was defined as noise to calculate the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Two observers subjectively evaluated the three sets of images using a 4-point scale across four aspects: cortical bone depiction, anatomical structure clarity, perceived image noise, and overall image quality. Inter-observer agreement was assessed using weighted Kappa statistics. Repeated-measures ANOVA was used to compare SNR and CNR, and the Friedman test was used to compare subjective image quality scores, with Bonferroni correction applied for post-hoc analyses. Results: For the SNR in all measured regions (cortical bone, muscle, and cancellous bone) and the CNR between tissues (cortical bone-muscle, cortical-cancellous bone), the results consistently showed Nread-160 > Nread-144 > Nread-128 (P < 0.001). In terms of subjective evaluation, the scores for the Nread-160 set were significantly higher than those for the Nread-128 set (P < 0.001), while the difference between the Nread-160 set and the Nread-144 set was not statistically significant. (P > 0.05). Conclusion: In ZTE scanning of the lumbar spine, increasing Nread helps improve image quality. Nread-144 provides high SNR and CNR, and its subjective image quality scores are comparable to those of Nread-160. Considering both scanning time and image quality, 144 is recommended as the optimal Nread for ZTE imaging of the lumbar spine.

Diagnosis and Treatment Analysis of 19 Cases of Cholecystoduodenal Fistula with Gallstone Ileus

Wang Yiming, Zhou Haoming, Rao Jianhua, Yao Aihua, Cheng Feng, Ni Ming

Available online:January 21, 2026, DOI:

[Abstract] (105) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To investigate the diagnosis and treatment strategies for cholecystoduodenal fistula complicated with gallstone ileus. Methods: This study retrospectively analyzed clinical data from 19 patients with cholecystoduodenal fistula and gallstone ileus treated at Jiangsu Provincial People""s Hospital from October 2019 to October 2024. Results: Among the 19 patients (9 males and 9 females), the median age was 76 years (range 58–89). All patients presented with abdominal distension and pain, with a history of cholelithiasis spanning several years. After imaging confirmation, individualized surgical approaches—including enterolithotomy, single- or two-stage cholecystectomy, and fistula repair—were performed based on stone characteristics and patient status. Postoperatively, two cases developed incision infections, while all others recovered and were discharged without mortality. Conclusion: This study demonstrates that cholecystoduodenal fistula with gallstone ileus is clinically rare, manifests with complex presentations, often involves multiple complications, and carries high perioperative risks. Personalized treatment strategies should be tailored to individual patient conditions.

Influencing factors for the occurrence of mismatch between ASPECTS on noncontrast computed tomograpgy and infarct core volume on CT perfusion

Chu Yue, Ma Gao, Shen Guang-Chen, Shi Hai-Bin

Available online:January 21, 2026, DOI:

[Abstract] (90) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective To assess the influencing factors and the prognostic characteristics for the occurrence of mismatch between Alberta Stroke Program Early Computed Tomography Score (ASPECTS) on non-contrast computed tomography (NCCT) and infarct core volume on CT perfusion (CTP) maps in acute ischemic stroke (AIS) patients. Methods Four-hundred and forty-nine AIS patients with large vessel occlusion of anterior circulation who underwent NCCT and CTP evaluation from October 2019 to August 2023 were enrolled retrospectively. NCCT-ASPECTS and infarct core volume on CTP were both calculated by the automated RAPID software. NCCT-CTP mismatch was defined as low ASPECTS with small ischemic core (LASC, ASPECTS< 6 but infarct core volume<70ml) or high ASPECTS with large ischemic core (HALC, ASPECTS≥6 but infarct core volume≥70ml). Favorable clinical outcome after EVT was defined with a mRS score ≤ 0-2 at 90days. The multivariable logistic regression analysis were used to assess the independent influencing factors for NCCT-CTP mismatch. Results Among the enrolled 449 AIS patients, 145 patients presented with NCCT-CTP mismatch and 52 (35.9%) NCCT-CTP mismatch patients achieved good outcomes after EVT. In multivariate logistic regression analysis, the IVT using before baseline imaging (OR, 1.833; 95% CI, 1.205-2.790; P=0.005) and a higher admission NIHSS score (OR, 1.055; 95% CI, 1.028-1.083; P<0.001) were independently associated with the occurrence of NCCT-CTP mismatch for AIS patients. In the subgroup analysis for NCCT-CTP mismatch patients, patients with LASC exhibited longer stroke onset time [median, 306min vs 125min; P=0.004] and a higher rate of hemorrhagic infarction (66.9% vs 33.3%, P=0.021) after EVT than patients with HALC. Conclusions About 35% NCCT-CTP mismatch AIS patients could achieve good outcome after EVT. The IVT using before baseline imaging and a higher admission NIHSS score were independent influencing factors for the occurrence of NCCT-CTP mismatch.

甘晨云, 王晓东

Available online:January 21, 2026, DOI:

[Abstract] (96) [HTML] (0) [PDF 0.00 Byte] (0)

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As scientific research delves deeper into exercise physiology, our understanding of physical activity has advanced significantly. Current mainstream exercise modalities primarily include endurance training and resistance training. While each modality emphasizes distinct aspects such as improving muscle mass, cardiopulmonary function, neurocognition, and endocrine metabolism, their effects are not uniform but are significantly modulated by age. Existing research has predominantly focused on younger populations, leaving a gap in the systematic synthesis of how the effects of different exercise modalities evolve with aging. This review aims to summarize the characteristic effects of endurance training and resistance training on the human body. Building on this foundation, it focuses on examining the age-related heterogeneity in the impact of exercise on the skeletal muscle, cardiovascular, nervous, and endocrine/metabolic systems between older and younger populations, while analyzing the underlying mechanisms. This paper highlights that, compared to younger individuals, aging leads to functional decline and metabolic alterations in the aforementioned systems. Consequently, older adults exhibit distinct characteristics in their physiological responses, adaptive capacity, and degree of benefit from exercise. Examples include attenuated post-exercise muscle protein synthesis, more pronounced cardiovascular and neuroprotective effects, and diminished recovery capacity. Therefore, when designing safe and effective exercise regimens for the elderly, it is essential to consider age-specific factors and judiciously select the exercise modality, intensity, and duration. The significance of this review lies in its systematic integration of evidence on the interaction between exercise and aging. It provides a theoretical basis and novel insights for developing individualized and precise exercise intervention strategies for older adults, which holds considerable importance for promoting healthy aging.

Clinical significance of hsa-miR-130a-3p in the diagnosis and prognosis of heart failure with preserved ejection fraction

ZOU Yu, LI Xianqi, LIU Xinjian

Available online:January 21, 2026, DOI:

[Abstract] (83) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To identify and validate differentially expressed circulating microRNAs (miRNAs) and to evaluate their potential diagnosis and prognosis value in heart failure with preserved ejection fraction (HFpEF). Methods: This two-stage study included a discovery cohort and a validation cohort. A total of 45 participants were initially enrolled, including 30 patients with HFpEF and 15 non–heart failure (non-HF) controls. Pooled plasma samples were analyzed by high-throughput miRNA sequencing to screen for differentially expressed candidate miRNAs. In the validation cohort, 133 HFpEF patients and 53 non-HF hospitalized controls were consecutively enrolled. Quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) was used to validate the expression levels of candidate miRNAs. Receiver operating characteristic (ROC) analysis and the area under the curve (AUC) were calculated to assess diagnostic performance. Major adverse cardiovascular events (MACE) were defined as cardiovascular death or heart failure rehospitalization. HFpEF patients were followed up for a median duration of 216 days (interquartile range: 199–260 days). Kaplan–Meier analysis and Cox proportional hazards models were applied to explore the association between plasma miRNA levels and clinical outcomes. Results: Compared with controls, Plasma hsa-miR-130a-3p was significantly upregulated in HFpEF patients [1.93 (1.10,2.96) vs. 0.98 (0.79,1.19); p < 0.001]. ROC analysis showed that miR-130a-3p effectively differentiated HFpEF patients from controls, with an AUC of 0.791 (95% CI: 0.728–0.853, p < 0.001) and an optimal cutoff value of 1.459, with a sensitivity of 62.41% and specificity of 94.34%. Based on the levels of miR-130a-3p, HFpEF patients were categorized into high- and low-expression groups. Kaplan–Meier analysis revealed that patients with high miR-130a-3p expression had a significantly higher cumulative incidence of MACE than those with low expression (26.98% vs. 6.15%, log-rank p = 0.002). Multivariate Cox regression further confirmed that elevated plasma miR-130a-3p expression was an independent predictor of adverse outcomes in HFpEF (HR = 2.197, 95% CI: 1.254–3.847, p = 0.006). Conclusion: Circulating miR-130a-3p is a promising diagnostic and prognostic biomarker for HFpEF. Its high expression is closely associated with adverse cardiovascular outcomes, suggesting that circulating miR-130a-3p may serve as a novel biomarker for HFpEF diagnosis and risk stratification. Further validation in larger multicenter prospective cohorts is warranted.

Research Progress of Non-invasive biomarkers and artificial Intelligence multimodal Integration Technology in the early Diagnosis and screening of Alzheimer's Disease

Li Xinzhu

Available online:January 19, 2026, DOI:

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Abstract:
Alzheimer's Disease (AD) has emerged as a major global public health challenge in the 21st century. Current clinical diagnosis primarily relies on techniques such as cerebrospinal fluid biomarker testing and amyloid PET imaging, yet these methods have exhibit significant limitations: cerebrospinal fluid testing is invasive, and PET imaging involves high costs and radiation exposure. Although neuropsychological scales are widely used in clinical practice, heir strong subjectivity and lack of specificity considerably reduce diagnostic sensitivity, particularly in early-stage AD. In response to this situation, this study provides a systematic review of the latest advances in non-invasive diagnostic technologies for AD, with a focus on breakthroughs in peripheral biofluid (e.g., blood, saliva) biomarker detection techniques, as well as the application prospects and innovative value of artificial intelligence-driven multimodal data integration strategies in the early identification and precise diagnosis of AD.

Deciphering the Tumor Microenvironment of Breast Cancer from Metabolic and Immunological Perspectives: Challenges and Opportunities in Precision Medicine

刘进宇

Available online:January 19, 2026, DOI:

[Abstract] (85) [HTML] (0) [PDF 0.00 Byte] (0)

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Abstract: Breast cancer is one of the most common malignancies among women worldwide, with its incidence and mortality rates continuing to rise in recent years. Despite advancements in traditional treatment modalities such as surgery, chemotherapy, and targeted therapy, breast cancer patients still face significant challenges in long-term prognosis, particularly during tumor recurrence and metastasis. Recent breakthroughs in research on the tumor microenvironment (TME) have unveiled critical mechanisms underlying the occurrence, progression, and therapeutic resistance of breast cancer. Notably, metabolic reprogramming and immune evasion play pivotal roles in the biological processes of breast cancer. Breast cancer cells remodel their metabolism to support growth and regulate the local immune landscape through metabolic byproducts, promoting immune suppression and evasion. Moreover, distinct subtypes of breast cancer exhibit significant differences in their metabolic and immunological characteristics, offering both new opportunities and challenges for the application of precision medicine. This review explores the molecular mechanisms within the breast cancer TME from metabolic and immunological perspectives, examines key issues in precision medicine, and discusses potential future research directions and therapeutic strategies.

Study on the drug resistance of rifampicin and rifabutin to Mycobacterium tuberculosis with rpoB gene mutation but phenotypically sensitive

杨燕

Available online:January 19, 2026, DOI:

[Abstract] (84) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective：Examine the variations in medication resistance between rifampicin (RIF) and rifabutin (RFB) of MTB with rpoB gene mutationsbut but phenotype is sensitive . Methods：During January 2022 to December 2024, The sputum or bronchoalveolar lavage fluid samples from tuberculosis patients in our institution were collected and sent to the bacteriology laboratory for MTB culture and Xpert testing. Subsequently, rpoB gene sequencing was performed on molecularly resistant strains, and their drug susceptibility results were analyzed in the same time. Finally, We selected all RIF-sensitive and low-level resistant strains and some high-level resistant strains Among rpoB gene mutant strains, and determinedand the MICs of RIF and RFB using the concentration gradient method. Results：A total of 298 strains with both molecular and phenotypic drug susceptibility positive were collected. The molecular drug susceptibility method exhibited a sensitivity of 93.3%(95%confidence interval 87.7%-99.0%)for RIF resistance，and a specificity of 94.6%(95%confidence interval 91.4%-97.3%)，resulting in an overall accuracy rate of 94.3%.The 82 molecularly resistant strains，which were found to have rpoB gene mutations in 79 strains(94%).531, 526, and 511 residues were The common mutation sites . The results of the agar solid drug susceptibility testing indicated that the S531L，H526Y，H526R，H526Q，and D516V sites exhibited high resistance to RIF， while the S512G，S522L，and L533P sites demonstrated moderate resistance. In contrast，the H526L，D516Y，L511P，and P483L sites were found to be sensitive to RIF The rpoB mutant strains were used to test the MIC of RIF and RFB.Only H526L and L511P mutant forms were sensitive to both RIF and RFB. RIF-resistant but RFB-sensitive mutant forms included: one strain with a base mutation rate of 20.34% of S531L, L511P combined with D526Q double mutation, H526D, D516Y, S512G, S522L, L533P, and P483L. For all rpoB mutant strains, the log-transformed RIF MIC (Log 2RIF-MIC) value [3.5 (1.0, 4.0)] was significantly higher than the log-transformed RFB MIC (Log 2RFB-MIC) value [2.0 (-3.0, 3.75)] (Z = -4.481, P < 0.001). Conclusions：Studying the differences in RIF and RFB resistance among MTB strains with different rpoB gene mutation sites might be helpful in creating diagnostic tools and offering suggestions for stratified treatment for drug-resistant tuberculosis.

The Role of Lipid Uptake in the Ovarian Cancer Microenvironment-Induced Expression of PD-1/CTLA-4 in CD4+ Regulatory T Cells

Tao Ziqi, Huang Xi, Zhang Yuelu, Yan Lina, Zhou Lingfei, Huang Menghui

Available online:January 19, 2026, DOI:

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Abstract: Objective: This study aimed to investigate the lipid metabolism characteristics, particularly lipid uptake and accumulation, of regulatory CD4+ T cells (Tregs) in the ovarian cancer microenvironment, and its potential impact on their PD-1/CTLA-4. Methods: The lipophilic fluorescent dye BODIPY? 493/503 and the fluorescent fatty acid probe BODIPY? 500/510 C1 C12 were used to detect intracellular lipid content and lipid uptake capacity, respectively, in human CD4+Tregs isolated from ovarian cancer tissues or co-cultured with supernatants from various ovarian cancer cell lines (ES-2, SKOV3, CAOV3). Lipid metabolism was modulated using the fatty acid oxidation inhibitor Etomoxir, the fatty acid synthesis inhibitor C75, and the fatty acid uptake inhibitor Sulfo-N-succinimidyl oleate (SSO). Lipid content and the expression of immunosuppressive molecules PD-1 and CTLA-4 were analyzed by flow cytometry. Results: CD4+Tregs infiltrating ovarian cancer tissues exhibited significantly higher lipid content and lipid uptake capacity compared to conventional CD4+T cells (Tconv) (P < 0.01). Among the ovarian cancer TSNs tested in vitro, CAOV3-derived TSNs most significantly enhanced intracellular lipid content and uptake capacity in CD4+Tregs relative to basal medium (P < 0.05). Furthermore, CAOV3-conditioned medium upregulated PD-1 and CTLA-4 expression in CD4+Tregs (P < 0.05). This was accompanied by a concentration-dependent increase in both lipid accumulation and fluorescent fatty acid analog uptake (P < 0.05). Notably, the fatty acid uptake inhibitor SSO effectively reversed the CAOV3 supernatant-induced lipid accumulation (P < 0.05) in CD4?Tregs and the elevated expression of PD-1 (P < 0.01) and CTLA-4 (P < 0.05), but not by the oxidation inhibitor Etomoxir or the synthesis inhibitor C75. Conclusion: The ovarian cancer microenvironment promotes lipid uptake in CD4+Tregs, leading to intracellular lipid droplet accumulation, which in turn enhances their immunosuppressive function, as evidenced by upregulated PD-1 and CTLA-4 expression. Targeting the fatty acid uptake pathway may represent a potential strategy to reverse Treg-mediated immunosuppression in ovarian cancer. Key words: ovarian cancer; CD4+Tregs; Lipid; PD-1/CTLA-4

Analysis and Comparison of the Incidence Trends of Four Types of Hepatitis between Jiangsu Province and the National Level from 2004 to 2022

Wu Jing

Available online:December 31, 2025, DOI:

[Abstract] (108) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To analyze and compare the changes in the incidence trends of four types of hepatitis in Jiangsu Province and the national level, reveal the regional characteristics and current status of hepatitis incidence in Jiangsu Province, and provide reference for hepatitis prevention and control work both in Jiangsu Province and nationwide. Methods: Descriptive epidemiological methods, annual average change percentage and time-space scanning statistical methods were used to analyze and compare the incidence data of four types of hepatitis (hepatitis A, B, C and E) in Jiangsu Province and the national level from 2004 to 2022. Results: The average incidence rates (1/ 100,000) of four types of hepatitis in Jiangsu Province and nationwide from 2004 to 2022 were 1.55 and 2.72 for hepatitis A, 18.70 and 75.24 for hepatitis B, 3.50 and 11.85 for hepatitis C, and 3.80 and 1.77 for hepatitis E, respectively. The change trend of incidence rate in recent years is as follows: in the nationwide, hepatitis A remained a stable trend (2012 – 2022，P>0.10), hepatitis B remained a steady trend (2014-2022，P>0.5), hepatitis C displayed a downward trend (2019-2022, P<0.001), and hepatitis E remained a stable trend (2013-2022, P>0.5); In Jiangsu Province, hepatitis A remained a stable trend (2013-2022, P>0.20), hepatitis B showed an upward trend (2012-2022, P <0.05), hepatitis C showed an upward trend (2004-2022, P<0.001), and hepatitis E demonstrated a declining trend (2011-2022, P<0.001); the statistical analysis of time-space scanning shows that three low-incidence clusters for Hepatitis A in nationwide all included Jiangsu Province, one of three low-incidence clusters for Hepatitis B included Jiangsu Province, two of four low-incidence clusters for Hepatitis C included Jiangsu Province, and all three high-incidence clusters for Hepatitis E included Jiangsu Province. Conclusion: From 2004 to 2022, in the nationwide, the highest average incidence rate of hepatitis was for Hepatitis B, followed by Hepatitis C, Hepatitis A, and Hepatitis E. In Jiangsu Province, Hepatitis B also had the highest average incidence rate, followed by Hepatitis E, Hepatitis C, and Hepatitis A, the average incidence rates of Hepatitis A, B, and C in Jiangsu Province were lower than the national average, while that of Hepatitis E was higher than the national average. The national hepatitis prevention and control strategy should prioritize reducing the incidence of Hepatitis B and shifting the stable trends of Hepatitis A and Hepatitis E to downward trends. In Jiangsu Province, the strategy should focus on lowering the incidence of Hepatitis B and Hepatitis E, reversing the upward trends of Hepatitis C, and transforming the stable trend of Hepatitis A into a downward trend.

Downregulation of Dixdc1 expression suppresses astrocyte polarization following traumatic brain injury

Duan Chengwei, Chen Weiguan, Guo Yu, Sun Wangyan, Zai Tianyu, Liu Mengqi, Zhang Dongmei

Available online:December 31, 2025, DOI:

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Abstract:
Objective：To investigate the effects of DIX domain-containing protein 1 (Dixdc1) on the proliferation, migration, and polarization of astrocytes following traumatic brain injury (TBI) in mice. Methods：A mouse model of traumatic brain injury was established using the controlled cortical impact (CCI) device. Western blotting was employed to examine the expression changes of Dixdc1, glial fibrillary acidic protein (GFAP), the neurotoxic astrocyte marker complement 3 (C3), and the neuroprotective astrocyte marker S100 calcium-binding protein A10 (S100A10) before and after injury. Immunohistochemical staining was performed to observe the expression and distribution of Dixdc1 and GFAP, while immunofluorescence staining was used to assess the colocalization of Dixdc1 with GFAP. Short hairpin RNA (shRNA) was utilized to knock down Dixdc1 levels in astrocytes. Lipopolysaccharide (LPS) stimulation was then applied to mimic the activated state of astrocytes in vitro. Western blotting was conducted to detect expression changes of Dixdc1, GFAP, C3, S100A10, as well as cell proliferation and migration-related proteins. Flow cytometry was performed to analyze the cell cycle, accompanied by Western blot detection of S-phase-related proteins. RT-PCR was used to measure the expression of astrocyte phenotype polarization markers. Cellular immunofluorescence was employed to detect the fluorescence intensity of C3 and S100A10. Additionally, Western blotting was performed to assess the phosphorylation level of signal transducer and activator of transcription 3 (STAT3). Result：Compared with the Sham group, the protein expression levels of Dixdc1 and GFAP were upregulated in the cerebral cortex of TBI mice. Dixdc1 was expressed in astrocytes within the peri-lesional cortical regions. Following LPS stimulation, the protein expression levels of both Dixdc1 and GFAP were upregulated in C8-D1A cells. Scratch assay and EdU assay demonstrated that knockdown of Dixdc1 suppressed LPS-induced astrocyte proliferation and migration, downregulated the expression of associated proteins, reduced the proportion of cells in the S phase of the cell cycle, and decreased CyclinA and CDK2 protein levels. C3 showed elevated expression levels during the acute phase but declined thereafter, whereas S100A10 demonstrated an inverse temporal pattern. Dixdc1 knockdown inhibited LPS-induced A1-type astrocyte polarization by reducing STAT3 phosphorylation levels, which concurrently downregulated C3 protein expression and upregulated S100A10 protein expression. Conclusion：Following traumatic brain injury, Dixdc1 protein expression was upregulated in astrocytes. Knockdown of Dixdc1 markedly suppressed LPS-induced proliferation, migration, cell cycle and STAT3 phosphorylation of A1-type astrocytes.

Ocular-cerebral relevance of neurodegenerative diseases

GAO Junying

Available online:December 31, 2025, DOI:

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During embryonic development, the eyes originate from the neural tube and share a common origin with the brain, resulting in highly similar anatomical structures and functional characteristics. In recent years, increasing evidence has revealed significant pathological correlations between ocular degenerative diseases and central nervous system neurodegenerative disorders. Typical ocular degenerative diseases—such as age-related macular degeneration, glaucoma, and diabetic retinopathy—are not only major causes of visual impairment and blindness but also share close mechanistic links with neurodegenerative diseases like Alzheimer's disease and Parkinson's disease. This article systematically explores the potential common pathological pathways between the brain and the eye in neurodegenerative diseases. It elaborates on the intrinsic connections between ocular and cerebral degeneration from the perspectives of toxic protein accumulation, myeloid cell dysfunction, abnormal activation of inflammatory responses, synaptic dysfunction, and impairment of lymphatic clearance systems. The aim is to provide new perspectives and research insights into the mechanisms, early intervention, and targeted treatment of neurodegenerative diseases affecting both the eye and the brain.

Weakened B Antigen Expression Caused by a c.28G>A Mutation in the ABO*B Allele: Pedigree Analysis and Molecular Mechanism

Ren Xiaoyan, Cai Zhonghe, Li Meng

Available online:December 31, 2025, DOI:

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Abstract:
Objective: To investigate the serological characteristics and molecular mechanism underlying weakened B antigen expression caused by a c.28G>A (p.Gly10Arg) mutation in exon 1 of the ABO gene. Methods: Peripheral blood samples were collected from a proband and his parents. ABO phenotyping was performed using the microcolumn agglutination and saline tube methods. Sanger sequencing of exons 1-7 of the ABO gene was conducted to identify the mutation. Comprehensive bioinformatics analysis was performed using Jalview, PolyPhen-2, ESEfinder, RNAfold, TMHMM, and IUPred2A to assess evolutionary conservation, pathogenicity, splice regulation, RNA structure, transmembrane topology, and disordered regions. Results: Serological tests identified the proband and his mother as A?Bweak, while the father was A?. Sequencing revealed both the proband and mother carried ABO*A1.02/B.01 alleles, with a heterozygous c.28G>A mutation on the B* allele. Pedigree analysis confirmed co-segregation of the mutation with the phenotype. Evolutionary conservation analysis showed the Gly10 residue is highly conserved across multiple mammalian species. Bioinformatics prediction indicated the mutation was "benign", but potentially created a new SC35 splicing factor binding site. It did not alter the minimum free energy of the local RNA secondary structure. While the transmembrane topology remained unchanged, the ANCHOR score for interaction propensity slightly increased. Conclusion: The c.28G>A missense mutation in exon 1 of the ABO gene leads to weakened B antigen expression and the A?Bweak phenotype. This mutation occurs at an evolutionarily conserved site. Its molecular mechanism is primarily associated with the creation of an aberrant splicing enhancer that disrupts RNA processing, rather than directly impairing protein structure and function.

Construction and Analysis of a Preoperative Prediction Model for Central Lymph Node Metastasis in Medullary Thyroid Carcinoma Based on Multimodal Data

Liu Wei, Yang Qianqian

Available online:December 26, 2025, DOI:

[Abstract] (106) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
【Abstract】Objective: To develop and validate a multimodal data-based predictive model for central lymph node metastasis (CLNM) in patients with medullary thyroid carcinoma (MTC) and evaluate its clinical significance. Methods: We retrospectively analyzed clinical-pathological data, preoperative imaging features, and hematological parameters of 104 MTC patients treated at the First Affiliated Hospital of Nanjing Medical University between January 2017 and May 2025. Patients were classified into CLNM-positive (n=55) and CLNM-negative (n= 49) groups based on pathological findings. Significant predictors of CLNM were identified through univariate and multivariate logistic regression analyses. A nomogram was constructed, and model performance was assessed using the receiver operating characteristic (ROC) curve (discrimination), calibration curve (calibration), and decision curve analysis (DCA; clinical utility). Internal validation was performed via bootstrap resampling. Results: Compared to the CLNM-negative group, CLNM-positive patients showed significant differences in gender (P = 0.001), US tumor morphology (regularity; P < 0.001), US tumor margin (circumscribed status; P < 0.001), serum carcinoembryonic antigen (CEA) levels (P = 0.006), and serum calcitonin (CT) levels (P < 0.001). Multivariate analysis identified male gender (OR = 6.63, 95% CI: 2.04–21.57; P = 0.002), non-circumscribed US margins (OR = 10.49, 95% CI: 2.79–39.37; P < 0.001), and elevated serum CT (OR = 1.25 per 1-unit increase, 95% CI: 1.10–1.42; P < 0.001) as independent risk factors for CLNM. The nomogram integrating these factors demonstrated excellent discrimination (AUC = 0.873, 95% CI: 0.808–0.939), with good calibration and clinical utility on DCA. Bootstrap validation confirmed model stability (AUC = 0.874, 95% CI: 0.865–0.879). Conclusion: A multimodal model incorporating gender, US tumor margin status, and serum CT levels effectively predicts CLNM risk in MTC patients, providing a valuable tool for clinical decision-making.

Advances of Lon protease 1 in diseases

Li Shanshan

Available online:December 26, 2025, DOI:

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Abstract:
Mitochondria serve as the central hub of cellular energy metabolism. Beyond generating ATP via oxidative phosphorylation to sustain vital activities, they participate in regulating material metabolism, apoptosis, signal transduction, and reactive oxygen species homeostasis. Maintenance of mitochondrial homeostasis is indispensable for preserving intracellular microenvironmental stability and the physiological function of organs. LON protease 1 (LONP1) is an ATP-dependent protease encoded by the nuclear gene LONP1 (PRSS15), which is highly conserved and involved in various biological functions. LONP1, located in the mitochondrial matrix, plays a key role in maintaining mitochondrial homeostasis and protein quality control and participates in removing misfolded and oxidative modified protein, binding mitochondrial DNA (mtDNA), and being a molecular chaperone. To date, there is growing evidence that LONP1, through its regulation of mitochondrial quality and energy homeostasis, is involved in development, aging, and various diseases. This article will review the biological characteristics, structure, and function of LONP1, as well as the advances of LONP1 in embryonic development, aging, cancer, and various diseases.

Research Progress on Radionuclide-labeled Diagnostic and Therapeutic Probes Targeting the Siglec Family

LIN Jianguo

Available online:December 26, 2025, DOI:

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Abstract:
The sialic acid-binding immunoglobulin-like lectin (Siglec) family comprises a group of immunoregulatory receptors broadly expressed on the surface of immune cells. Their aberrant expression is closely linked to tumor immune evasion, systemic inflammatory responses, and the pathogenesis of autoimmune diseases. Currently, Siglec receptors have attracted extensive attention as potential molecular targets for tumors and inflammatory disorders. In the field of diagnosis, radiopharmaceutical probes targeted Siglec receptors have been developed and applied in molecular imaging such as positron emission computed tomography (PET) and single-photon emission computed tomography (SPECT). In the field of therapy, Siglec-targeted probes labeled with α nuclides (such as 22?Ac and 211At) or β nuclides (such as 1??Lu) enable precise ablation of the focal lesion through targeted radiotherapy, showing advantages particularly in the treatment of hematological malignancies. This article summarizes recent research progress in Siglec-targeted radiopharmaceuticals and analyzes their performance and clinical application value, aiming to provide insights for the development and clinical application of novel Siglec-targeted molecular probes.

Predictive value of hsa-miR-106b-5p combined with uric acid and homocysteine detection in preeclampsia

pan yingzi, zeng yu, ding hongjuan

Available online:December 26, 2025, DOI:

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Objective: Screening for differentially expressed microRNAs in the serum of normal pregnancy and preeclampsia patients, and combined with hematological and indicators analysis, in order to provide certain reference value for clinical diagnosis of early preeclampsia. Methods: Download the microRNA dataset related to preeclampsia from the GEO database, screen for differentially expressed microRNAs using the DESeq [1.36.0] package, and validate them in serum samples. Collecting serum from 37 pregnant women with preeclampsia (PE group) who had normal antenatal examinations and delivered at Nanjing Maternity and Child Health Care Hospital from January 2024 to July 2024, as well as 33 age and gestational week matched normal pregnant women (control group) who had antenatal examinations at the same period in our hospital. Total microRNA was extracted from serum samples and the expression of microRNA in the two groups of sera was detected by quantitative fluorescence PCR. At the time, hematological parameters and biochemical test data were collected. Independent sample t-test was used to analyze the differences in test results, and chi-square test was used to compare the differences in complications between the two groups. In addition, the value of the screened microRNAs and their combination with blood biochemical indicators in predicting and diagnosing preeclampsia was by using the receiver operating characteristic (ROC) curve. Results: Download the GEO database for the dataset GSE234611 of microRNAs expressed in the peripheral blood of early-onsetreeclampsia patients and normal pregnant women, and the dataset GSE118578 of microRNAs in primary hypertension patients and normal individuals, ?differential expression analysis was performed on the two datasets using the DESeq2 [1.36.0] package, and four commonly different expressed miRNAs were found between the two datasets (hsa-miR-106b-5p, hsa-mi-24-3p, hsa-miR-451a, and hsa-miR-92b-3p ). Further detection of serum samples found that the expression of hsa-miR-451a and hsa-miR-10b-5p in the PE group was significantly increased (P<0.05), while the expression of hsa-miR-24-3 and hsa-miR-92b-3p showed no significant difference (P>0.05).Hematological and biochemical indicators were compared between the two groups, and it was found that the PE group had significantly lower platelet count and neutil/lymphocyte ratio than the control group, while the lymphocyte count, mean platelet volume, uric acid, and homocysteine were significantly higher (P<0.05). ROC curve analysis showed that the area under the curve (AUC) for predicting preeclampsia diagnosis using serum hsa-miR451a, hsa-miR-106b-5p, uric acid, and homocysteine were 0.827, 0.931, 0.801, and 0.704, respectively; The AUC of combined diagnosis of hsa-miR-451a, uric acid and homocysteine was 0.908, with a sensitivity of 72.22% and a specificity of 94.12%; the AUC of combined of hsa-miR-106b-5p, uric acid and homocysteine was 0.941, with sensitivity of 94.44% and a specificity of 88.23%. The incidence of adverse pregnancy complications in the PE group was significantly higher than that in the control group (P<0.05). Conclusion：Combined detection of hsa-miR-106b-5p, uric acid, and homocysteine in serum has predictive and diagnostic value for preeclampsia.

Application Study on Improving Thyroid CT Image Quality Using Surgical Shoulder Pillow

Zhou Yan, Su GuoYi, Zhang Ling, Li DaPeng

Available online:December 26, 2025, DOI:

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[ABSTRACT] Objective: To investigate the value of a modified position utilizing surgical shoulder pillows in optimising the quality of thyroid CT images. Methods: A total of 176 patients who intended to get a CT scan for evaluating thyroid nodules were prospectively enrolled, and divided into control group (conventional position, n=88) and experimental group (modified position, n=88). The patients in the control group were positioned in the supine position with their arms on each side of their bodies and drooping naturally. The experimental group was adopted with the shoulders elevated by the surgical shoulder pillows, shoulders parallel to the upper edge of the shoulder pillows, arms placed on each side of the body, and the head in the hyperextension position. Subjective quality scores (overall image quality, subjective noise evaluation, artefacts), objective quality scores (signal-to-noise ratio SNR, contrast-to-noise ratio CNR) and radiation doses (CT dose index CTDIvol/ mGy, dose length product DLP/ mGy·cm, effective dose ED/ mSv) of arterial-phase and venous-phase CT images were compared between two groups. Results: The experimental group outperformed the control group in subjective picture quality scores, demonstrating superiority in overall image quality (Z=-5.385, P<0.001), subjective noise (Z=-5.609, P<0.001), and artefact suppression (Z=-3.473, P=0.001). The experimental group exhibited much superior SNR and CNR than control group in both arterial (SNR: Z=-6.533; CNR: Z=-6.475; both P<0.001) and venous phases (SNR: t=-7.193; CNR: Z=-5.705; both P<0.001). No significant differences in radiation dose were observed between the experimental and control groups for arterial phase CTDIvol (Z=-0.527, P=0.598), DLP (Z=-1.493, P=0.136), ED (Z=-1.493, P=0.136), and venous phase CTDIvol (Z=-0.611, P=0.541), DLP (Z=-1.151, P=0.250), and ED (Z=-1.151, P=0.250). Conclusion: The modified position utilising surgical shoulder pillows allows patients to fully stretch their necks, and improves the quality of CT images of the thyroid gland without increasing the radiation dose.

Study on the Mechanism of α-Ketoglutarate Inducing Acute Pancreatitis via XRCC3

ge wanli, peng yunpeng

Available online:December 16, 2025, DOI:

[Abstract] (97) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To screen potential pathogenic metabolites of acute pancreatitis (AP) and explore the molecular mechanism of α-ketoglutarate (αKG) regulating DNA damage repair protein, X ray repair cross-complementing protein 3 (XRCC3) to induce AP based on animal and cell models. Methods: The study first conducted a Mendelian randomization (MR) study combined with two rounds of independent meta-analysis to screen metabolites related to the onset of acute pancreatitis from a genetic perspective, and used the inverse variance weighted (IVW) method to evaluate the causal effect of metabolites on AP. Subsequently, AP animal models in C57BL/6 mice and AR42J cell models were constructed. The effects of αKG on pancreatic acinar cell injury and inflammatory response were verified by intraperitoneal injection of αKG and co-culture with the medium, respectively. The detection indicators included cell viability, levels of inflammatory factors, and histopathological changes. In addition, RNA sequencing was used to analyze the whole transcriptome differences in AR42J cells before and after αKG treatment, and the expression changes of XRCC3 and its role in the onset of AP were verified by immunohistochemistry and Western Blot techniques. Results: The MR study and meta-analysis results showed that αKG had a positive causal relationship with the onset of acute pancreatitis, while indolepropionate (INDO) showed a potential protective effect. Cell experiments indicated that 10 μmol/L of αKG could significantly inhibit the viability of AR42J cells and promote the secretion of inflammatory factors such as interleukin-6 (IL-6) and interleukin-1β (IL-1β). In the animal model, intraperitoneal injection of αKG could induce the occurrence of AP in mice, manifested as pancreatic tissue edema, acinar cell injury, and elevated serum inflammatory factor levels. Through in-depth mechanism research using RNA-seq, it was found that αKG exacerbated acinar cell injury by inhibiting the expression of XRCC3 and weakening the DNA damage repair ability. The expression of XRCC3 in AR42J cells was significantly down regulated after αKG treatment, which was verified by immunohistochemistry and Western Blot. Additionally, over expression of XRCC3 could partially reverse the damage effect of αKG on acinar cells. Conclusion: This study is the first to confirm at the genetic level that αKG is a pathogenic metabolite of AP, which exacerbates acinar cell injury and inflammatory response by inhibiting the XRCC3-mediated DNA repair pathway. This discovery provides a new perspective for the metabolic mechanism research of AP and suggests that targeting the αKG-XRCC3 axis may be a potential therapeutic strategy.

The expression of RBM7 in breast cancer cell MDA-MB-231 and its effects on AKAP12 expression

Xi Pei-Wen, Wu Jing, Zhang Xu

Available online:December 16, 2025, DOI:

[Abstract] (100) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the expression of RNA binding motif protein 7 (RBM7) in human breast cancer cell MDA-MB-231, and its effects on the expression of A kinase anchor protein 12 (AKAP12). Methods: MDA-MB-231 cells were respectively transfected with RBM7 overexpressing, knocking down lentivirus (experimental group) and corresponding control lentivirus (control group). Stable transfected cell lines were selected with puromycin and verified via fluorescence microscopy. Quantitative real time polymerase chain reaction (qRT-PCR) and Western blot assays were used to verify the expression of RBM7, and to investigate the effects of altered RBM7 expression on the expression of AKAP12. Gene Ontology (GO) enrichment analysis was performed on the differentially expressed genes obtained by RNA sequencing, and revealed significantly enriched pathways regulated by RBM7. At the same time, the UALCAN database was employed to assess AKAP12 expression in breast cancer. The relationship between RBM7 and AKAP12 was studied by RNA binding protein immunoprecipitation (RIP) assays. Furthermore, immunohistochemical analysis was performed to delineate the relationship between RBM7 and AKAP12 in breast cancer tissues. Results: RBM7 overexpression and knockdown lentiviruses were transfected in the breast cancer cell MDA-MB-231, respectively. Stable cell lines with RBM7 overexpression and knockdown were successfully established, within two weeks of puromycin selection. GO enrichment analysis of differentially expressed genes obtained by RNA-sequence revealed that RBM7-regulated genes were mainly enriched in the cell cycle pathway. Moreover, the UALCAN database analysis revealed that AKAP12 was lowly expressed in breast cancer (p<0.05). It was observed that overexpression of RBM7 could downregulate RNA and protein expression of AKAP12, and knockdown of RBM7 upregulated RNA and protein expression of AKAP12 via qRT-PCR and Western blot (p<0.05). RNA-binding protein immunoprecipitation (RIP) assays revealed that RBM7 could directly bind to mRNA of AKAP12 (p<0.05). Immunohistochemical analysis revealed an inverse correlation between RBM7 and AKAP12 expression in breast cancer tissues (p<0.05). Conclusion: RBM7 downregulated the expression of AKAP12 in breast cancer cell MDA-MB-231 and breast cancer tissues.

Artificial intelligence in the whole process of implant prosthodontics: research progress, application and challenges

ZHANG WEIFANG, ZHU Feifan, TUMAER Sailihan, ZHOU Yutao, DUAN Xiangyao, YAO Yi, YU Jiongmin, ADILI Maimaitituerxun

Available online:December 16, 2025, DOI:

[Abstract] (105) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Artificial intelligence is the "fourth industrial revolution" of human society, and dental implants have become the "third set of teeth" for humans. The 21st century is an era of digitization and artificial intelligence, characterized by the deep integration and robust rise of artificial intelligence in various fields of society. Implant prosthodontics is also rapidly developing towards high efficiency, precision, minimally invasive, and biomimetic direction with the assistance and acceleration of artificial intelligence. In the future, artificial intelligence will change the practice mode of implant prosthodontics and bring it to an extraordinary level. This article aims to review the research progress and application status of artificial intelligence in various aspects of oral implant prosthodontics, and to make prospects for the shortcomings and future challenges.

Accuracy comparison of 3 intraoral scanner-based complete arch implant impression techniques in 2 different intraoral scanners

Ye Liangyu, Zhang Chenyi, Yue Li

Available online:December 16, 2025, DOI:

[Abstract] (110) [HTML] (0) [PDF 0.00 Byte] (0)

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Abstract: Objective: To compare the accuracy of three intraoral scanner-based complete arch implant impression techniques using TRIOS 3 and Aoralscan 3 intraoral scanners. Methods: A standard edentulous maxillary implant model with 6 screw-retained abutment-level scan bodies was constructed. The scan bodies were numbered from 1 to 6, from the right molar to the left molar area. A control group was generated by scanning the implant model using a desktop scanner. Three intraoral scanner-based scanning techniques were tested: without any scan aids，with scan aids but without calibration, and with scan aids and perform calibration. The tests were performed on 2 intraoral scanners: 3Shape TRIOS 3 and Shining3d Aoralscan 3. Each technique was repeated 10 times on each scanner. Scan bodies in the tested groups were superimposed onto the control group using scan bodies #1 and #2 as references to simulate the single-screw test. For each scan body, the distance between the centers of the screw-retained abutments in the test and control groups was measured to calculate trueness. The distance between the centers of the screw-retained abutments in each pair of scans within each test group was also measured to calculate precision. Trueness and precision of the 3 tested impression techniques were compared. Results: In both tested scanners, the trueness of the scanning group with scan aids (272.32 μm for TRIOS 3; 240.00 μm for Aoralscan 3) was higher than that of the group without any scan aids (606.77 μm for TRIOS 3; 413.78 μm for Aoralscan 3) (all P<0.05). Furthermore, the calibration process further improved trueness (70.51% improvement for TRIOS 3; 28.00 % improvement for Aoralscan 3 ). For precision, the scanning group with scan aids (75.60 μm for TRIOS 3; 69.91 μm for Aoralscan 3) and the group with calibration (74.36 μm for TRIOS 3; 79.42 μm for Aoralscan 3) outperformed the group without any scan aids (487.75 μm for TRIOS 3; 160.74 μm for Aoralscan 3) (all P<0.05). However, there was no statistically significant difference between the scanning group with scan aids and the group with calibration (P>0.05). Conclusion: The accuracy of intraoral scanning for full-arch implant impressions can be significantly improved by using scan aids combined with a calibration process.

Application of "Rigid Registration" and "Non-Rigid Registration" in Digital Stomatology Three-dimensional Point Cloud Data

Zhao Yijiao

Available online:December 16, 2025, DOI:

[Abstract] (91) [HTML] (0) [PDF 0.00 Byte] (0)

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With the development of digital technology, three-dimensional (3D) point cloud data is becoming more and more widely used in oral clinical digital diagnosis and treatment, involving many aspects such as 3D morphological comparison analysis, virtual patient construction, and defect morphological reconstruction. At present, "rigid registration" and "non-rigid registration" technologies have played an important role in the clinical application of oral 3D point cloud data. The similarities and differences between the two technologies and the algorithm principles behind them are worth in-depth discussion and exploration, so that they can better serve the clinical practice and scientific research of stomatology. The author’s team has a certain working basis for the application and research of "rigid registration" and "non-rigid registration" technologies. This article will explain the concepts, algorithm principles and their application in the field of stomatology, and summarize and prospect them to provide reference for the application of oral clinical and scientific research to the two technologies.

Role and Mechanisms of PCBP2 in DBV InfectionYu Xinyi₁^, Dai Yan₁^{, Shi} Mengqi₁^{, Pu Qinqin}₁^{, Hu Nannan}₁^{, Jin Ke}₁^{, Li Jun}_^1*

Dai Yan, Shi Mengqi, Pu Qinqin, Hu Nannan, Jin Ke

Available online:December 16, 2025, DOI:

[Abstract] (101) [HTML] (0) [PDF 0.00 Byte] (0)

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[Abstract] Objective: To investigate the role of Poly(C)-Binding Protein 2 (PCBP2) in the pathogenic process following Dabie bandavirus (DBV) infection and its mechanism of action through the regulation of ferroptosis. Methods: Using the THP-1 cell line as a model, mitochondrial structural changes under viral infection were observed via transmission electron microscopy. PCBP2-overexpressing plasmids and lentivirus-mediated PCBP2-knockdown THP-1 cell lines were constructed. FerroOrange fluorescent probe was used to measure Fe2? levels, DCFH-DA assay was employed to determine Reactive oxygen species (ROS) levels, and Western blot was performed to assess the expression of SLC7A11 and GPX4 proteins, evaluating the impact of PCBP2 modulation on ferroptosis. The effect of ferroptosis regulators on DBV replication was examined by adding them to the experimental system. Viral replication levels were examined by qRT-PCR and immunofluorescence to explore whether PCBP2 influences DBV replication by regulating ferroptosis. Results: In DBV-infected cells, both mRNA and protein levels of PCBP2 were significantly downregulated. DBV infection induced typical ferroptosis features, including mitochondrial cristae reduction and swelling. PCBP2 knockdown and overexpression in THP-1 cells were confirmed by qRT-PCR and Western blot. PCBP2 knockdown downregulated the expression of ferroptosis-related genes SLC7A11 and GPX4, leading to increased ROS and Fe2?. Conversely, PCBP2 overexpression elevated SLC7A11 and GPX4 expression while reducing ROS and Fe2? accumulation. TCID50 and NP protein level assays further demonstrated that ferroptosis inducers partially counteracted the pro-viral effect of PCBP2 overexpression, while ferroptosis inhibitors partially reversed the antiviral effect caused by PCBP2 knockdown. Conclusion: This study reveals that PCBP2 inhibits ferroptosis by maintaining the SLC7A11/GPX4 system, thereby restricting DBV replication. These findings not only elucidate the regulatory role of PCBP2 in DBV infection but also provide novel insights into the pathogenesis of Severe Fever With Thrombocytopenia Syndrome (SFTS). Moreover, targeting the PCBP2-ferroptosis pathway may represent a potential therapeutic strategy for SFTS, offering new directions for antiviral drug development.

Research Advances and individualized treatment of adjuvant therapy for elderly patients with colorectal cancer

Wu Xinyu, Ling Rui

Available online:December 16, 2025, DOI:

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With the acceleration of global population aging, the disease burden of colorectal cancer in the elderly is escalating. However, postoperative adjuvant therapy for this population suffers from a long-standing lack of robust evidence-based medical evidence. Due to their unique physiological decline, high comorbidity burden, higher proportion of deficient mismatch repair/microsatellite instability-high (dMMR/MSI-H) tumors, and social psychological factors, treatment decisions have become more complicated. Comprehensive Geriatric Assessment (CGA) serves as the core tool for achieving individualized treatment. For patients with poor physical condition, metronomic chemotherapy holds promise as a low-toxicity maintenance strategy. Furthermore, strengthening supportive treatment (encompassing management of bone marrow suppression, nutritional support, anti-cachexia drugs, structured exercise programs, and fecal microbiota transplantation) is crucial for ensuring treatment safety and quality of life.In summary, managing adjuvant therapy for elderly colorectal cancer must abandon the age-dependent model and shift towards individualized, precision strategies guided by CGA, balancing efficacy, toxicity, and quality of life. Emerging directions such as immunotherapy, short-course chemotherapy, and organ preservation warrant attention. Future research should prioritize prospective studies specifically focused on the elderly population.

Genetic correlation analysis of phenotypes associated with depression and gastroesophageal reflux disease

邵燕婷, 徐亭亭#

Available online:December 16, 2025, DOI:

[Abstract] (95) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: A number of studies have shown that there is a significant correlation between depression and gastroesophageal reflux disease (GERD), but the causal relationship between the two and the direction of correlation are not clear. This paper aims to explore the bidirectional causal inference between depression and GERD and its subtypes and the underlying mechanism of the disease from the genetic level. Methods: Based on the aggregated data of the genome-wide association study (GWAS) of depression, GERD, reflux esophagitis (RE) and non-erosive gastroesophageal reflux disease (NERD), Mendelian randomization was used to explore the independent causal relationship between depression and GERD, RE and NERD. Multiple omics data such as GWAS and eQTL were integrated to explore the potential pathogenic genes of depression, GERD and its subtypes by SMR and FUMA methods, and the potential mechanism of depression affecting GERD and its subtypes was evaluated by enrichment analysis. Results: Depression increased the risk of GERD and NERD, but not RE. GERD, RE, and NERD do not increase the risk of depression. Through SMR and FUMA analysis, the potential susceptibility genes for depression were identified as GMPPB, and the potential susceptibility genes for GERD were identified as RP4-717I23.3, RAB7L1, BROX, TAF1B, RP11-95D17.1. The NERD potential susceptibility genes were GBP3, METTL18, SERPINC1, ZNF496, AC016683.6, PAX8GLS, LARS2, NCKIPSD, QRICH1 and AMT. Depression and GERD gene loci are mainly concentrated in T cell receptor signaling pathway, DNA-binding transcription factor activity, RNA polymerase II transcriptional regulation region sequence-specific DNA binding. The depression and NERD gene loci are mainly concentrated in nucleosome assembly, protein and complex subunit assembly, and T cell receptor signaling pathway. Conclusion: Depression can increase the risk of GERD and NERD, and the underlying mechanism may play a role through brain-gut axis, neuroimmune pathway, DNA and RNA transcription and regulation, protein metabolism, etc.

Mechanistic Dissection of Aberrant Splicing Patterns Induced by Intronic Variants in the Consensus Regions of the Splice Sites of the F9 Gene

马金, Shen Yan, Shen Guo Min

Available online:December 16, 2025, DOI:

[Abstract] (90) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: Our study aimed to identify key splicing regulatory sites within the introns of the F9 gene (the causative gene for hemophilia B) through the characterization of splice site consensus motifs and systematic screening for pathogenic variants in these regions. Methods: Based on the variations documented in the Factor IX Variant Database, we primarily focus on intronic variations that may influence pre-mRNA splicing. The variations were filtered through a comparative analysis based on sequence conservation and associated disease severity. Variations located within highly conserved loci that are linked to severe Hemophilia were selected as target variations and subjected to subsequent splicing predictions using three independent tools separately. The prediction results were then validated through minigene splicing assays, and specific splicing patterns were further investigated using capillary electrophoresis. For those in-frame aberrant splicing products, we assessed protein expression, protein secretion, and in vitro coagulation activity via Western Blotting (WB) and activated partial thromboplastin time (APTT). Results: (1) We identified 15 variants located near the splicing site of exon 4 in the F9 gene as target variants through sequence and variant analysis. Minigene splicing assay confirmed that 14 of these variants could lead to abnormal splicing. In comparison with the bioinformatic prediction results, it was further established that computational predictions have limitations and cannot accurately forecast specific splicing patterns or their proportions. (2) The classic GT-AG splice site on the intron was confirmed to be conserved. Additionally, it was observed that +5G at the donor end facilitates correct recognition of the splicing site, whereas the relatively conserved +7A does not play a significant regulatory role in this recognition process. Furthermore, deep intronic variants mimicking the classic splice donor "AG" motif cause misalignment of splice site recognition, significantly increasing the proportion of abnormal splicing. (3) Results from protein expression and activity analyses indicated notable differences in antigen synthesis and in vitro coagulation activity status between the two abnormal splicing variants—p.D93-G125delinsG and p.G94-D131del—and those of the wild-type FIX (P<0.01). Conclusion: (1) The splice site (GT-AG) is pivotal in determining precise splicing. The less conserved +5G at the consensus region of the splice donor site in the intron 4 of the F9 gene also has a regulatory effect on splicing. (2) Summarizing the differences in splice patterns caused by diverse variations can provide a solid theoretical basis for big data analysis and improve the accuracy of bioinformatics predictions.

Characteristics of organ injury in patients with severe fever with thrombocytopenia syndrome

Zhang Zhongman, Zhu Yi

Available online:December 01, 2025, DOI:

[Abstract] (106) [HTML] (0) [PDF 0.00 Byte] (0)

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Background: The incidence of severe fever with thrombocytopenia syndrome (SFTS) has been steadily increasing over the years, accompanied by a persistently high mortality rate. Organ injury may serve as a potential contributor to poor clinical outcomes. This study aimed to summarize the characteristics and patterns of organ injury in patients diagnosed with SFTS. Methods: A retrospective analysis was conducted on patients with SFTS admitted to the First Affiliated Hospital with Nanjing Medical University (Jiangsu Provincial Hospital) between January 2023 and December 2024. During hospitalization, concurrent organ injuries were recorded and statistically analyzed. Logistic regression analysis was performed to evaluate the association between organ injury and prognosis. Furthermore, a nomogram was developed to predict discharge outcomes based on organ injury assessment in SFTS patients. Results: A total of 284 SFTS patients were enrolled in this study, among whom 252 (88.7%) exhibited signs of organ injury. Cardiac injury was most commonly observed. Multivariate logistic regression analysis revealed that pancreatic injury (OR=3.17, 95%CI: 1.28-8.00, P=0.012), renal injury (OR=8.64, 95%CI: 3.54-22.29, P<0.001), pulmonary injury (OR=4.82, 95%CI: 2.01-11.98, P<0.001), and cerebral injury (OR=3.25, 95%CI: 1.34-7.90, P=0.009) were independently associated with increased risk of in-hospital mortality in SFTS patients. The constructed nomogram demonstrated strong predictive performance for discharge outcomes. Internal validation using the bootstrap method (resampling=1000) showed an average area under the ROC curve of 0.937 (95%CI: 0.910-0.965). Conclusion: The majority of SFTS patients experienced concurrent organ injuries. Among these, pancreatic, renal, pulmonary, and cerebral injuries were significantly associated with increased mortality risk.

New cutoff values of D-Dimer for Predicting Pulmonary Thromboembolism after Cesarean Section

Wang Xinyan, Wu Lan

Available online:November 27, 2025, DOI:

[Abstract] (134) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: The present study aimed to explore the D-Dimer cutoff values for predicting Pulmonary Thromboembolism after Cesarean Section. Methods: This study recruited 198 women after cesarean section with suspected PE symptoms in Women’s Hospital of Nanjing Medical University from January 2018 to December 2024. Among them, 33 patients who were diagnosed as PE by CTPA were divided intthe study group, and the 165 patients who were not diagnosed as PE by CTPA during the same period were divided into the control group. Analyze the age, Body Mass Index (BMI), gestational age at delivery (weeks)，number of fetuses, surgical indications, risk factors for VTE after delivery, D-dimer (mg/L) within postpartum 24 hours and the time of using LMWH after cesarean section. Draw the receiver operating characteristic curve (ROC) of D-dimer to determine the optimal sensitivity and specificity of the D-dimer value, with the area under the curve (AUC) used to evaluate the cut-off value. Analyze the risk factors for PE and calculate the odds ratio (OR) with a 95% confidence interval. Result: The D-dimer level in the PE group was (8.98 ± 6.91) mg/L, significantly higher than that in the non-PE group (4.03 ± 2.08) mg/L (P < 0.05), indicating that D-dimer is a strong predictor of PE and should be prioritized in clinical practice. The initiation of anticoagulation therapy in the PE group was delayed compared to the non-PE group, with a statistically significant difference, suggesting that early anticoagulation—when bleeding risk is low—plays a crucial role in preventing PE after cesarean delivery. The optimal cut-off value of D-dimer within 24 hours post-cesarean was 7.48 mg/L, with a specificity of 93.9% and sensitivity of 62.4%. The area under the curve (AUC) was 0.75 (95% CI: 0.652–0.848, P = 0.000), demonstrating significant diagnostic value for PE. When the D-dimer cut-off was adjusted to 1.59 mg/L, the sensitivity and specificity were 100% and 43.2%, respectively, with the highest Youden index for negative predictive value. This threshold may be particularly meaningful for early PE screening after cesarean delivery. Prolonged immobilization and D-dimer levels were identified as two independent risk factors for PE. Notably, D-dimer was a continuous risk factor (OR = 1.58), meaning that for every 1 mg/L increase in D-dimer, the risk of PE increased by 58%. Conclusion: This study conducted a preliminary exploration of the D-dimer cut-off value at 24 hours after cesarean delivery, aiming to establish a more convenient and safer screening method to improve the identification of postoperative PE. This approach could facilitate timely intervention and reduce unnecessary imaging examinations.

Construction of a Risk Prediction Model for Malnutrition in Elderly Diabetic Patients with Cognitive Frailty

邹蓉, 佟蔷薇

Available online:November 27, 2025, DOI:

[Abstract] (97) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To conduct an in-depth analysis of the key factors influencing the risk of malnutrition in elderly diabetic patients with cognitive frailty (CF) and to construct an accurate risk prediction nomogram model based on these factors. Methods: A cross-sectional study design was adopted, enrolling 124 elderly diabetic patients with CF admitted to the Department of Geriatric Endocrinology, the First Affiliated Hospital of Nanjing Medical University between January 2023 and December 2024. The study instruments included: a general information questionnaire, the Fried Phenotype Frailty scale, the Montreal Cognitive Assessment scale, the Geriatric Depression Scale (GDS), the Self-Rating Anxiety Scale, and the Mini Nutritional Assessment scale. Basic patient information was collected, and assessments were made for frailty, cognitive function, psychological status, and malnutrition risk. Multivariate logistic regression analysis was used to identify influencing factors for malnutrition risk, and the R language "rms" package was used to construct the prediction model and draw the nomogram. Model validation included Receiver Operating Characteristic (ROC) curve analysis, the Hosmer-Lemeshow test, assessment of the Concordance Index (C-index), and the plotting of a calibration curve. Results: The malnutrition risk rate among the 124 elderly diabetic patients with CF was 67.7% (84/124). These 84 patients were assigned to the malnutrition risk group, and the remaining 40 were assigned to the well-nourished group. Significant differences (P < 0.05) were found between the two groups in terms of age, marital status, body mass index (BMI), GDS score, albumin, prealbumin, transferrin, and hemoglobin levels. Age, marital status, BMI, GDS score, albumin, and prealbumin levels were identified as independent predictors of malnutrition risk in elderly diabetic patients with CF (P < 0.05). The nomogram model constructed based on these influencing factors had a C-index of 0.781 [95% CI (0.695-0.867)]. The Hosmer-Lemeshow test indicated a good fit for the nomogram model (χ2 statistic = 5.22, corresponding P-value = 0.73). Decision curve analysis showed that when the threshold probability ranged from 0 to 0.67, the net benefit rate of using this nomogram model to predict malnutrition risk in elderly diabetic patients with CF was > 0. Conclusion: In elderly diabetic patients with CF, age, marital status, BMI, GDS score, albumin, and prealbumin levels are key factors influencing the risk of malnutrition. The established risk prediction model demonstrates moderate predictive performance and good clinical application value for assessing the risk of malnutrition in this patient population.

Analysis of Risk Factors for Hospital Stay ≥30 Days After Distal Pancreatectomy: A Single-Center Retrospective Study

lu zi peng, Jiang kui rong

Available online:November 27, 2025, DOI:

[Abstract] (106) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Abstract: Objective:To analyze the factors associated with prolonged postoperative hospital stay (≥30 days) after distal pancreatectomy (DP), identify independent risk factors, and provide a basis for optimizing perioperative management. Methods:A retrospective analysis was conducted on 1215 patients who underwent DP at a single center from January 2020 to June 2024. Based on postoperative hospital stay, patients were divided into two groups: ≥30 days (80 cases) and <30 days (1135 cases). Univariate analysis was used to compare differences in clinical characteristics between the two groups, and multivariate logistic regression was employed to identify independent risk factors. Results: Among the 1215 DP cases, 80 (6.6%) had a postoperative hospital stay ≥30 days. Univariate analysis revealed that gender, age, tumor type, modified Appleby procedure, combined organ resection, combined vascular resection, dissection of the Heidelberg triangle, as well as complications such as pancreatic fistula, delayed gastric emptying (DGE), postoperative bleeding, and chylous fistula were significantly associated with prolonged postoperative hospital stay (P < 0.05). Multivariate logistic regression analysis demonstrated that modified Appleby procedure (OR = 3.167, P = 0.007), combined organ resection (OR = 3.334, P < 0.001), postoperative bleeding (OR = 4.148, P = 0.025), DGE (OR = 10.482, P < 0.001), intra-abdominal infection (OR = 5.718, P < 0.001), chylous fistula (OR = 2.457, P = 0.022), sepsis (OR = 13.485, P < 0.001), and postoperative invasive interventions (OR = 6.045, P < 0.001) were independent risk factors for a hospital stay ≥30 days. Conclusion: Prolonged postoperative hospital stay (≥30 days) after distal pancreatectomy is associated with various perioperative factors. Developing individualized diagnostic and treatment strategies targeting high-risk factors and optimizing management can help reduce the length of hospital stay.

Clinicopathological analysis of 31 cases of SWI/SNF complex deficient carcinoma in digestive system

Fang Haisheng, Gong Yuxi, Chen Gang, Bai Rumeng

Available online:November 27, 2025, DOI:

[Abstract] (113) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To investigate the clinicopathological features, immunophenotype and molecular genetic changes of switch/sucrose non-fermentable complex (SWI/SNF) complex deficient tumors in digestive system, and to analyze the diagnosis and differential diagnosis points. Methods: The clinical data of 31 patients with SWI/SNF complex deficient carcinoma of digestive system were collected. The histological morphology, immunohistochemical results and molecular changes were observed and analyzed. Results: Among the 31 patients, 19 were male and 12 were female, aged 43-80 years, mean age 64 years, median age 66 years. Location of disease: lower esophagus (gastroesophageal junction) 1 case, stomach 7 cases, right colon 3 cases, pancreas 18 cases, ampulla 2 cases. Histologically, 15 tumors were undifferentiated carcinoma, showing diffuse, solid, or nested, streaked, or pseudoglandular pattern of tumor cells, coagulative necrotic areas were seen in most cases. The tumor cells were mainly epithelioid cells with poor adhesion, rich cytoplasm, light staining or eosinophilic, slightly rough or vacuolar nuclear chromatin, obvious nucleoli, pathological mitotic figures were easy to see.16 cases were poorly to moderately differentiated ductal adenocarcinoma, adenosquamous carcinoma or intraductal papillary mucinous tumor (IPMN) with associated invasive carcinoma. Immunophenotype: 14/15 cases of undifferentiated carcinoma showed BRG1 loss expression, 1 case of undifferentiated carcinoma in pancreas showed INI1 partial loss expression, but BRG1 retained expression. CK-pan expression was negative or scattered in 4/15 cases of tumor cells, other epithelial markers were occasional positive or mostly negative in some tumor cells. 7/13 Syn tumor cells were weakly to moderately positive, 2 of them were weakly positive for CD56 or INSM1, and all of them were negative for CgA. BRG1 expression was retained in 16 pancreatic/ampullary carcinomas, INI1 expression was partially lost or decreased in 8 of 16 pancreatic/ampullary carcinomas, and retained in 8 of 16 pancreatic/ampullary carcinomas.22 patients were followed up, 6 patients died. Molecular pathology: SMARCB1 gene mutation was found in 14/16 cases of pancreatic or ampullary cancer, SMARCA4 gene mutation was found in 2/16 cases, KRAS gene mutation was found in all cases, and TP53 gene mutation was found in 14/16 cases. conclusion: SWI/SNF complex deficient tumor is a rare and highly malignant tumor, some of them are undifferentiated carcinomas without specific differentiation features. Extragastrointestinal SWI/SNF complex deficient carcinoma may have more differentiated adenocarcinoma morphology. Understanding its histological and immunohistochemical expression characteristics may suggest the detection of SWI/SNF proteins such as BRG1 and INI1 to reduce missed diagnosis and misdiagnosis. SWI/SNF-related gene mutations were associated with KRAS and TP53 gene mutations in pancreatic cancer.

Effect and mechanism of narrow-band ultraviolet B in promoting vitamin D metabolism and alleviating psoriasis like dermatitis in mice

ZHOU Yu, LI Xinyu

Available online:November 17, 2025, DOI:

[Abstract] (112) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective To investigate the effect and mechanism of narrow-band ultraviolet B (NB-UVB) in promoting vitamin D (VD) metabolism and alleviating imiquimod (IMQ) induced psoriasis like dermatitis in mice. Method C57BL/6 mice were treated with IMQ cream on the back skin to induce psoriasis like dermatitis. The levels of VD metabolites 25(OH)D3 and 1,25(OH)2D3 in serum were detected, as well as the expression of VD receptor (VDR) mRNA in the skin lesions; After determining the irradiation energy of NB-UVB irradiated mice, the model group combined with NB-UVB irradiation was performed to observe mouse skin lesions. The levels of 25(OH)D3, 1,25(OH)2D3 in serum, VDR and inflammatory factors (IL-17A, IL-23, TNF-α、IL-1β) mRNA expression and inflammatory factors protein contents in skin lesions, and the proportion of CD3+ CD4+ IL-17A+ T cells were detected. After pretreatment with the specific inhibitor Dafadine-A to block CYP27A1 activity (cytochrome P450 family 27 subfamily A, polypeptide 1, a key enzyme in vitamin D metabolism), the mice underwent psoriasiform dermatitis induction followed by NB-UVB irradiation. Skin lesions were observed, the proportion of CD3+ CD4+ IL-17A+ T cells, inflammatory factors and VDR mRNA expression in the skin lesions, and serum levels of 25(OH)D3 and 1,25(OH)2D3 were detected. Results The levels of 25(OH)D3 and 1,25(OH)2D3 in the serum of psoriasis like mouse models and the mRNA expression of VDR in skin lesions were significantly reduced. After NB-UVB irradiation on a psoriasis like mouse model, compared to the model group, the levels of 25(OH)D3, 1,25(OH)2D3 in the serum of the irradiated mice and the mRNA expression of VDR in the skin lesions were upregulated. The mRNA expression and content of inflammatory factors in the skin lesions were downregulated, and the proportion of IL-17A secreting CD3+ CD4+ T cells was significantly reduced. Compared to the IMQ+NB-UVB group, Dafadine-A pretreated mice showed significantly decreased serum levels of 25(OH)D3 and 1,25(OH)2D3, reduced VDR mRNA expression in skin lesions, along with significantly increased proportions of CD3+ CD4+ IL-17A+ T cells and elevated inflammatory cytokine levels in lesions. Conclusion NB-UVB irradiation ameliorates psoriasiform dermatitis and cutaneous inflammation in mice by promoting vitamin D metabolic pathways. Importantly, specific inhibition of CYP27A1 markedly attenuates the therapeutic effects of NB-UVB on both psoriatic skin lesions and associated inflammatory responses.

Separation and preparation of 5-Hydroxymethyl-2-furfural in cigarette smoke by liquid-liquid extraction coupled with sephadex LH-20

Zhang Daiwei, Peng Mengfan, Wang Li

Available online:November 17, 2025, DOI:

[Abstract] (102) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To separate a new important component 5-Hydroxymethyl-2-furfural (5-HMF) in cigarette smoke and provide material guarantee for evaluating its role in the respiratory system injury caused by smoking. Methods: A combination of liquid-liquid extraction and sephadex LH-20 column chromatography was used to extract and purify 5-HMF from the cigarette smoke extract (CSE) dissolved in chloroform. First, the total extract of cigarette smoke (CSE) was subjected to two consecutive liquid-liquid extractions with double-distilled water to transfer 5-HMF from the chloroform phase to the aqueous phase. Then, sephadex LH-20 was employed to separate 5-HMF from the aqueous phase. The efficiency of the extraction and separation processes was determined using high performance liquid chromatography-ultraviolet detection (HPLC-UV). GraphPad Prism software was used for two-way analysis of variance (Two-way ANOVA) and Tukey’s multiple comparisons test to evaluate the stability and reproducibility of the method. Results: The two-step liquid-liquid extraction transferred approximately 92.18% of 5-HMF from CSE to the aqueous phase. sephadex LH-20 enabled the separation and recovery of approximately 94.88% of 5-HMF from the aqueous phase.The coefficient of variation (CV) was 8.53% across three independent experiments. Two-way ANOVA indicated that although minor differences existed among different cigarette samples (P < 0.01), the elution profile of 5-HMF was highly consistent (tube number factor: P < 0.0001), accounting for 97.04% of the total variation, confirming the good reproducibility of the method. Based on the content calculation, this method achieved the separation of approximately 89.55% of 5-HMF from CSE, while the traditional component nicotine in cigarette smoke did not interfere with the separation and preparation of 5-HMF. Conclusion: This study realized the simple, rapid, efficient and stable separation and preparation of 5-HMF in cigarette smoke, which not only provided material and technical guarantee for the subsequent systematic study of the toxic effects of important components of cigarette smoke, but also provided methods and ideas for the separation and preparation of other components in the complex matrix of cigarette smoke.

A study on the correlation between unilateral temporomandibular joint anterior disc displacement without reduction and mandibular deviation

jiang yan qing, han zhen, liu yang, guo song song, xu rong yao, jiang hong bin

Available online:November 17, 2025, DOI:

[Abstract] (120) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To investigate the incidence and radiographic characteristics of mandibular deviation in patients with unilateral anterior disc displacement without reduction (anterior disc displacement without reduction，ADDWoR) of the temporomandibular joint, and to analyze the related factors influencing mandibular deviation. Methods: This retrospective study enrolled 210 patients (210 affected sides) with unilateral anterior disc displacement without reduction (ADDWoR) who visited the Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Nanjing Medical University between April 2020 and December 2023. Cone-beam computed tomography (CBCT) was used to analyze mandibular morphology and positional characteristics, while magnetic resonance imaging (MRI) assessed disc features. Multivariate logistic regression analysis was employed to identify factors associated with mandibular deviation. Results: Among the 210 patients, 104 were assigned to the deviation group (mean age 27.8±17.5 years) and 106 to the control group (mean age 34.0±19.2 years). The deviation group demonstrated significantly reduced ramus height and body length on the affected side compared to the unaffected side, with the entire mandible exhibiting posterior-superior rotation toward the affected side. This rotation pattern manifested as increased anterior joint space on the affected side, increased posterior/lateral/superior spaces on the unaffected side, while showing decreased posterior/lateral spaces on the affected side and reduced anterior space on the unaffected side. The articular disc in the deviation group was shorter in length and positioned farther from the condylar apex. In adolescent patients with deviation, besides mandibular morphological and positional changes, significant alterations in disc position were observed, whereas adult patients showed no remarkable changes in disc morphology or position. Multivariate logistic regression analysis revealed that mandibular positional parameters (including the ratio of anterior to posterior space on the affected side, lateral space on the affected side, the ratio of anterior to posterior space on the unaffected side, and superior space on the unaffected side) and mandibular morphological characteristics (ramus height discrepancy and mandibular body length discrepancy) were independent influencing factors for mandibular deviation (P < 0.05). Conclusion: The mandibular deviation associated with unilateral ADDWoR is closely related to changes in mandibular morphology and position. Sagittal shortening of the affected side and posterior-superior rotation of the entire mandible toward the affected side may be the primary contributing factors to mandibular deviation. Adolescent patients with ADDWoR are more prone to significant alterations in mandibular morphology, positional relationship, and disc status.

Machine Learning in Rheumatoid Arthritis: Advances in Clinical Diagnosis, Therapeutic Strategies, and Complication Prognostication

严舒桐, 刘琪

Available online:November 17, 2025, DOI:

[Abstract] (106) [HTML] (0) [PDF 0.00 Byte] (0)

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Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by synovitis and progressive joint destruction, leading to a high disability rate and complex complications that severely compromise patients' quality of life. Although traditional diagnosis and treatment have been shown to significantly enhance patient prognosis, challenges such as the difficulty of early diagnosis, substantial individual variability in treatment response, and the high prevalence of complications, including cardiovascular diseases and interstitial lung disease, continue to be focal points in clinical practice. Recent rapid advancements in artificial intelligence (AI) and machine learning (ML) technologies offer novel opportunities to overcome these bottlenecks in RA management. By deeply mining RA multimodal medical data, such as patient imaging, genomics, and electronic health records, ML models have shown potential advantages in early diagnosis, stratified management of treatment response, and modeling of complication risk, such as early warning of cardiovascular events. However, barriers such as data heterogeneity, limited model interpretability, and challenges in clinical translation hinder widespread adoption. This paper systematically reviews the latest research progress in applying ML to RA diagnosis and treatment, aiming to provide a theoretical foundation and practical reference for realizing ML-driven precision medicine in RA.

A Propensity Score Matched Study on the Impact of High-Fat Diet on Delayed Pleural Effusion After Single-port Video-assisted Thoracoscopic Lung Surgery

LIU Feng, ZHONG Jian, WANG Bo

Available online:November 13, 2025, DOI:

[Abstract] (116) [HTML] (0) [PDF 0.00 Byte] (0)

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Abstract: To explore the effect of high-fat diet on delayed pleural effusion after single-port video-assisted thoracoscopic lung surgery.. Methods:?A retrospective analysis was conducted on the clinical data of 571 patients who underwent single-port video-assisted thoracoscopic lung surgery at the Department of Thoracic Surgery, Nanjing Medical University Affiliated Brain Hospital from December 2021 to June 2023. Patients were divided into high-fat diet group and non-high-fat diet according to a high-fat diet was adopted postoperatively. Propensity score matching analysis was used to match the two groups of patients with a ratio of 1:1, and then the incidence of delayed pleural effusion and other postoperative complications was compared between the matched groups. Results: Before matching, the high-fat diet group included 166 patients, with 45 males and 121 females, and a median age of 56.0 (49.0–66.0) years. The control group included 405 patients, with 164 males and 241 females, and a median age of 57.0 (48.0–67.0) years. After propensity score matching, each group included 130 patients. The high-fat diet group showed significantly higher incidences of delayed pleural effusion (OR=1.080, 95% CI=1.013–1.152, P=0.019), postoperative cough (OR=1.203, 95% CI=1.091–1.326, P=0.001), and postoperative chest tightness (OR=1.166, 95% CI=1.038–1.311, P=0.010) compared to the non-high-fat diet group, with statistically significant differences. Conclusion: A high-fat diet after single-port thoracoscopic lung surgery can significantly increase the incidence of delayed pleural effusion.

The mechanism by which IFN-γ alleviates intestinal fibrosis in Crohn's disease through inhibiting the SRC/AREG signaling axis

Lin Junjie, Sun Junjian, Wang Lu, Wang Shu, Zhang Hongjie

Available online:November 13, 2025, DOI:

[Abstract] (123) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: Intestinal fibrosis in Crohn's disease (CD) remains a clinical challenge with incompletely understood molecular mechanisms. This study systematically investigated the regulatory role and mechanism of IFN-γ in CD-associated intestinal fibrosis. Methods: Primary intestinal fibroblasts isolated from CD patients were treated with various cytokines in vitro. Amphiregulin (Areg) gene expression was assessed by RT-PCR. Based on preliminary results, fibroblasts were treated with 20 ng/mL IFN-γ for 48 h for RNA sequencing (RNA-seq). Protein-protein interaction (PPI) networks were constructed using the STRING database. Myofibroblast markers (α-SMA, Ki67) were detected by immunofluorescence to evaluate IFN-γ's effects on fibroblast activation and proliferation. Results: Key findings include: 1) Areg significantly promoted fibroblast activation, proliferation, and collagen synthesis; 2) IFN-γ markedly suppressed Areg expression and downregulated fibrosis-related genes (α-SMA, Col1a1, Col6a1); 3) IFN-γ reduced fibroblast proliferation (decreased Ki67+ cells) and activation (reduced α-SMA expression); 4) Transcriptomic analysis revealed significant enrichment of IFN-γ-regulated genes in ECM remodeling pathways, with PPI network identifying Src as a central node potentially mediating IFN-γ's anti-fibrotic effects. Conclusion: This study is the first to demonstrate that IFN-γ exerts anti-fibrotic effects by inhibiting the SRC/AREG signaling axis. We confirmed Areg as a key pro-fibrotic mediator, revealed IFN-γ's transcriptional suppression of Areg, and identified Src as a critical downstream effector of IFN-γ. These findings provide a theoretical foundation for developing novel anti-fibrotic strategies targeting the IFN-γ/SRC/AREG pathway.

Nanobody preparation and functional studies for broad-spectrum neutralization of viruses and their variants

Jingyi Ni, Xinyue Liu, Xue Gong

Available online:November 13, 2025, DOI:

[Abstract] (115) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To produce broad-spectrum nanobodies (Nbs) targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants, and establish a strategy for producing Nbs broad-spectrum neutralizing the virus and its various variants. Methods: Alpacas were immunized with the receptor-binding domain (RBD) of the SARS-CoV-2 wild-type strain (WT-RBD) to construct a nanobody phage library, and the library was screened by biopanning and ELISA with the RBD of the Delta variant (Delta-RBD) to select nanobodies. The selected nanobodies were expressed and purified using the Pichia pastoris system, and their properties and functions characterized by ELISA, biolayer interferometry, pseudovirus neutralization experiments, and molecular modeling and docking. Results: The four nanobodies obtained not only have high affinity for WT-RBD, but can also effectively neutralize Delta-RBD and the RBD of the Omicron variant (Omicron-RBD). Nb34, Nb42, and Nb45 show strong binding ability to the RBD of Delta-RBD and Omicron variants, meanwhile Nb45 can effectively neutralize the pseudovirus of Omicron variants. We also found that the mechanism of these nanobodies for neutralizing SARS-CoV-2 and its variants may be related to interfering with the conserved sites on these RBD. Conclusion: The four nanobodies obtained have great potential for prevention and treatment of SARS-CoV-2 and its variants, and the strategy established in this study can also be widely used for the preparation of nanobodies broad-spectrum neutralizing viruses and their various variants.

METTL3-mediated m6A modification of KIF11 mRNA promotes colorectal cancer progression through the PI3K/AKT signaling pathway

qian mengsen, zhu jing, ding jie, luo qian, li jie, li juan, wang juan

Available online:November 13, 2025, DOI:

[Abstract] (126) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the biological functions and molecular regulatory mechanisms of kinesin family member 11 (KIF11) in colorectal cancer (CRC). Methods: The expression of KIF11 in CRC was examined by quantitative real-time PCR (qRT-PCR) techniques and publicSdatabases. CCK8 assay, colony formation assay, EDU assay, and transwell assay demonstrated the function of KIF11 in CRC progression, and Western blot(WB), RIP-qPCR, MeRIP-qPCR, and RNA stability assays elucidated the molecular mechanism of N6-methyladenosine(m6A)modification for KIF11.RNA sequencing (RNA-seq) and correlation analysis were used to examine the downstream mechanism of KIF11 regulation. Results: The results indicated that KIF11 was highly expressed in CRC and promoted CRC proliferation and migration. Mechanistically, METTL3/IGF2BP2 affected KIF11 mRNA stability and positively regulated KIF11 expression in an m6A-dependent way. Meanwhile, By means of the PROM1/PI3K/AKT pathway, KIF11 facilitated the progression of CRC. Conclusions: The m6A modification of KIF11 by METTL3/IGF2BP2 contributes to CRC progression via the PI3K/AKT signaling pathway, and it may function as a potential prognostic biomarker and therapeutic target for CRC.

Clinical Diagnosis and Treatment of Pancreatic Acinar Cell Carcinoma: A Single-Center Analysis of 23 Cases

Dai Cuncai, Jiang Kuirong

Available online:October 29, 2025, DOI:

[Abstract] (142) [HTML] (0) [PDF 0.00 Byte] (0)

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Abstract: Objective: To investigate the clinical, imaging, and pathological characteristics, diagnosis, treatment, and prognosis of pancreatic acinar cell carcinoma (ACC). Methods: A retrospective analysis was conducted on clinical data of patients with pathologically confirmed ACC admitted to our institution from April 2015 to December 2024. The clinical manifestations, imaging and pathological features, diagnosis, treatment, and prognosis were summarized. Results: A total of 23 ACC patients were enrolled, including 15 males, with a mean age of 62 years. The most common presenting symptom was abdominal pain (13 cases), followed by jaundice, abdominal distension, and back pain. Tumors were located in the pancreatic head (15 cases), pancreatic body/tail (7 cases), and diffusely involved the entire pancreas (1 case). The mean tumor diameter was 54 mm. Tumors presented as solid (8 cases, 44.4%), solid with necrosis (5 cases, 27.8%), or cystic-solid (5 cases, 27.8%). Surgical resection was performed in 22 cases, while one patient underwent endoscopic ultrasound-guided biopsy due to metastasis to the №16 lymph node group and received comprehensive therapy. Pathologically, 21 cases were pure ACC, one case was mixed with ductal adenocarcinoma, and one case was mixed with neuroendocrine tumor. Lymph node metastasis was observed in 10 cases, and neurovascular invasion was present in 20 cases. R0 resection was achieved in 19 cases. Postoperative adjuvant chemotherapy was administered to 15 patients, with regimens including nab-paclitaxel plus gemcitabine (AG), gemcitabine plus oxaliplatin (Gemox), tegafur-gimeracil-oteracil potassium plus oxaliplatin (SOX), gemcitabine plus capecitabine (Gemcap), paclitaxel plus cisplatin (TP), and FOLFIRINOX. Among 21 patients with effective follow-up, the median overall survival was 26 months, and the median recurrence-free survival was 15 months. The 1-year and 3-year survival rates were 90.5% and 44.4%, respectively. The most common sites of initial recurrence were the liver (7 cases) and retroperitoneal lymph nodes (5 cases), followed by bone, lung, mesenteric lymph nodes, and local recurrence. Conclusion: Pancreatic acinar cell carcinoma is a rare malignant tumor characterized mainly by abdominal pain, often presenting as a solid mass with aggressive features such as frequent neurovascular invasion and lymph node metastasis. Surgical resection combined with adjuvant chemotherapy is the main treatment approach. Postoperative surveillance should focus on the liver and retroperitoneal lymph nodes for early detection of recurrence and metastasis.

Application of Gastroscopic Biopsy Forceps Repositioning Technique in Peritoneal Dialysis Catheter Migration

吴晶晶

Available online:October 29, 2025, DOI:

[Abstract] (125) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To evaluate the efficacy and safety of gastroscopic biopsy forceps repositioning technique in peritoneal dialysis (PD) catheter drift. Methods: A retrospective analysis was conducted on clinical characteristics of PD catheter drift patients in the First Affiliated of Nanjing Medical University from January 2014 to December 2024. The technical success rate, procedure durations, cost, and complication rate were compared between conservative treatment, gastroscopic biopsy forceps repositioning and surgery repositioning. Results: Patients with catheter drift initially received conservative treatment, which achieved a success rate of 11.76% (2 out of 17). One patient requested laparoscopic repositioning, which was 100% successful (1 out of 1) at a cost of 3,000 yuan. The remaining 14 patients underwent gastroscopic biopsy forceps repositioning, with a success rate of 85.71% (12 out of 14). The procedure time for this method was 24.00 ± 6.65 minutes, and the cost was 130 yuan. The two patients who failed gastroscopic biopsy forceps repositioning had a long history of catheters placement over two years. They subsequently underwent successful open surgical repositioning, with a procedure time of 60 minutes and a cost of 400 yuan. No severe complications occurred in any of the cases, and all patients resumed dialysis function within 24 hours postoperatively. Conclusion: Gastroscopic biopsy forceps repositioning technique is a safe, cost-effective, and minimally invasive technique for PD catheter drift, with no radiation exposure.

Research on low-activity PET image quality restoration method based on Swin Transformer

Tang Lijun

Available online:October 29, 2025, DOI:

[Abstract] (121) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To explore the influence of 18F-FDG activity on PET/CT image quality and establish a PET image quality restoration method to achieve radiation protection for patients. Methods: This study proposed a global feature recognition low-activity PET image quality restoration deep learning network model, (i.e., SwinUNetR-GAN) based on Swin Transformer. 124 patients’ PET/CT images who underwent 18F-FDG PET/CT scanning in 2024 were randomly selected to explore the law of PET image quality degradation under different activities of 18F-FDG, and the low-activity PET images’ quality restoration are achieved based on the SwinUNetR-GAN network. Results: As the activity of 18F-FDG decreases, the SUVmean and SUVmax in normal tissues and tumor lesions in the PET images show an increasing trend. When the activity of 18F-FDG is reduced to 10% of the current clinical activity, the SUVmean of the tumor lesion increases by about 1.1 times, while the SUVmax increases by about 2 times. In addition, the use of the SwinUNetR-GAN network can reduce the noise of 10% activity PET images, MAE decreases from 0.21 to 0.15, and Rdev decreases from 0.33 to about 0.25. Conclusion: This study clarifies the change law of quantitative parameters of normal tissues and tumor tissues in patient PET images under activity of 18F-FDG, and then, SwinUNetR-GAN network dedicated to low 18F-FDG activity PET image quality restoration was proposed, which could achieve the disease diagnosis performance of PET images while reducing the radiation dose deposited in patient.

Association Between Triglyceride-Glucose Index and Subclinical Left Ventricular Dysfunction: A Study Based on Left Ventricular Global Longitudinal Strain and Myocardial Work

陈超, He An-xia, Tao Weiwei, Lu Meijuan

Available online:October 29, 2025, DOI:

[Abstract] (129) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the independent association between the triglyceride-glucose (TyG) index and subclinical left ventricular (LV) systolic dysfunction, and to analyze its impact on left ventricular global longitudinal strain (GLS) and myocardial work indices. Methods: A total of 103 patients admitted between August 2024 and February 2025 were enrolled. Clinical parameters, biochemical indicators, and echocardiographic data were collected, and the TyG index was calculated. GLS and LV myocardial work parameters (global work index, GWI; global constructive work, GCW; global wasted work, GWW; global work efficiency, GWE) were obtained using GE EchoPAC software. Multivariate logistic regression analysis was employed to assess the independent association between the TyG index and impaired LV function. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive efficacy of the TyG index for LV dysfunction, calculating the area under the curve (AUC), optimal cutoff value, sensitivity, and specificity. Results: The high-TyG group exhibited significantly higher prevalence rates of hypertension (67.31% vs. 43.14%), diabetes (42.31% vs. 7.84%), and dyslipidemia (34.62% vs. 3.92%) (all P < 0.05). Compared to the low-TyG group, the high-TyG group showed reduced absolute GLS (-17.60 ± 2.65 vs. -19.82 ± 2.12), lower GWI (1672.33 ± 308.58 vs. 1932.31 ± 280.26 mmHg%), and decreased GCW (1999.46 ± 324.11 vs. 2299.20 ± 323.32 mmHg%) (all P < 0.001). After adjusting for age, sex, body mass index (BMI), blood pressure, dyslipidemia, and other confounders, an elevated TyG index remained an independent risk factor for reduced GLS (OR = 2.982, 95% CI: 1.182-7.522, P = 0.021), reduced GWI (OR = 3.168, 95% CI: 1.302-7.706, P = 0.011), and diminished GCW (OR = 2.836, 95% CI: 1.250-7.309, P = 0.021). ROC analysis demonstrated the predictive efficacy of the TyG index for reduced GLS, GWI, and GCW, with AUC values of 0.725, 0.697, and 0.683, respectively. Conclusion: An elevated TyG index is independently associated with impaired LV global strain and myocardial work capacity, serving as a potential biomarker for subclinical LV dysfunction. This highlights its clinical utility in early risk assessment for metabolic cardiovascular diseases.

Prediction Model for Positive Lymph Node Ratio Based on RadiomicsLingchi Chen1^,2, Qianzheng Zhou1^, Qiong Li1^{, Fengyuan} Li1^{, Hao} Xu^1*

zhouqianzheng, liqiong, lifengyuan

Available online:October 29, 2025, DOI:

[Abstract] (102) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective To develop a predictive model for the lymph node ratio (LNR) in gastric cancer patients based on radiomics features extracted from preoperative imaging, and to construct a nomogram incorporating clinical factors to preoperatively predict LNR status. This model aims to assist in making more precise clinical decisions for gastric cancer treatment. Methods Clinical data of patients(n=380) who underwent radical gastrectomy at the First Affiliated Hospital of Nanjing Medical University between January 2014 and December 2018 were retrospectively collected. Patients with pathologically confirmed lymph node metastasis were selected. Preoperative imaging data were analyzed to extract radiomic features, followed by machine learning modeling. Three algorithms—Support Vector Machine (SVM), Random Forest (RF), and Logistic Regression (LR)—were evaluated. The RF model, which demonstrated the best performance based on the ROCcurve analysis, was selected for prediction. A nomogram was then developed using the RF score and clinically significant variables identified by multivariate logistic regression analysis. Results LNR was identified as an independent prognostic factor for patients undergoing gastric cancer resection. Three variables—RF score (p < 0.01), sex (p = 0.025), and clinical N stage (p < 0.01)—were included in the final nomogram model. The model’s performance was evaluated using ROC (The AUC value = 0.818)and decision curve analysis (DCA), both of which demonstrated good predictive ability. Conclusion The nomogram model based on radiomic and clinical information provides favorable predictive accuracy for preoperative LNR status in gastric cancer patients.

Anatomical Quantitative Study of Coracoclavicular Ligament using 3D-SPACE Sequence Based on Compressed Sensing

ZHAO Ru-sheng

Available online:October 23, 2025, DOI:

[Abstract] (130) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: Using the Three-Dimensional Sampling Perfection with Application optimized Contrast using different flip angle Evolution (3D-SPACE) sequence combined with Compressed Sensing (CS) technology, the anatomical parameters of trapezoid ligament and conoid ligament (the two components of the coracoclavicular ligament) were quantitatively measured in a healthy population, such as the length, the attachment footprint width, and the position of attachment footprint center. Methods: Prospective collection of 64 patients without shoulder trauma who underwent shoulder joint MRI examination, the coronal T1WI 3D CS-SPACE sequence scans were performed on these patients. Two radiologists performed multiplanar reconstruction on these images, measuring the length of the trapezoid and conoid ligaments, the attachment footprint width on the clavicle, and the distance from the attachment footprint center to the outer edge of the clavicle on the oblique coronal image. The attachment footprint width on the coracoid process were measured on the oblique sagittal image. And the distance from the attachment footprint center of these two ligaments to the outer edge of the coracoid process and the size of the coracoid process was measured on the oblique axial image. When the measurement results of two physicians are consistent, take the average for statistical analysis. Grouping by gender, comparing the consistency between each parameter, and conducting correlation analysis between anatomical quantitative data of the coracoclavicular ligament and age and coracoid process size. Results: The length of the trapezoid ligament, the attachment footprint width on the clavicle and coracoid process of the trapezoid ligament, the distance from attachment footprint center of the trapezoid ligament to the outer edge of the clavicle and coracoid process, and the distance from attachment footprint center of the conoid ligament to the outer edge of the clavicle and coracoid process all showed statistical differences between males and females (P<0.05). There is no correlation between age and various anatomical parameters (P>0.05). Except for the length of the conoid ligament, the anatomical quantitative parameters of the trapezoid ligament and conoid ligament have varying degrees of correlation with the size of the coracoid process (P>0.05). Conclusion: The 3D CS-SPACE sequence can clearly display the anatomical structures of the trapezoid ligament and conoid ligament, and obtain quantitative anatomical parameters of them, providing a basis for individualized surgical treatment of patients with acromioclavicular joint injuries and reducing the occurrence of complications.

The RNA binding protein RBMS3 inhibits breast cancer proliferation by stabilizing p21 mRNA

Xia Tian, Zhu Lei, Xi Peiwen, Wu Jing, Dingqiang

Available online:October 23, 2025, DOI:

[Abstract] (131) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To investigate the role and molecular mechanism of RNA binding motif single stranded interacting protein 3 (RBMS3) in the proliferation of breast cancer and its molecular mechanism by regulating the stability of cyclin-dependent kinase inhibitor 1A (p21) at the post-transcriptional level. Methods: Colony formation and 5-ethynyl-2′-deoxyuridine (EdU) incorporation assays were used to evaluate cell proliferation ability in vitro. Flow cytometry was applied to analyze cell cycle distribution and apoptosis rate. Xenograft tumor model in nude mice was established to observe the effect of RBMS3 on tumor growth in vivo. The correlation between RBMS3 and p21 expression was detected by Western blot (WB), quantitative reverse transcription polymerase chain reaction (qRT-PCR), and immunohistochemistry (IHC). Furthermore, actinomycin D (Act D) assay was performed to verify the effect of RBMS3 on p21 mRNA stability. RNA immunoprecipitation (RIP) assay, dual-luciferase reporter assay, and rescue experiment were conducted to confirm the direct binding and functional interaction between RBMS3 and p21. Results: Overexpression of RBMS3 inhibited the proliferation of breast cancer cells and the growth of xenograft tumors in nude mice，induced G0/G1 phase cell cycle arrest, and promoted apoptosis. Conversely, knockdown of RBMS3 promoted breast cancer cell proliferation. Furthermore, RBMS3 expression was significantly positively correlated with p21. RBMS3 directly bound to AU-rich elements in the 3' untranslated region of p21 mRNA and enhanced the stability of p21 transcripts. Knockdown of p21 reversed the decrease in breast cancer cell proliferation induced by RBMS3 overexpression. Conclusion: RBMS3 upregulates p21 expression by directly binding to the AREs in the 3′-UTR of p21 and enhancing its mRNA stability, thereby inhibiting the proliferation of breast cancer cells. These findings suggest that RBMS3 may serve as a potential therapeutic target for breast cancer. Keywords: RBMS3, p21, mRNA stability, Breast cancer

Research Progress on the Multifaceted Mechanisms of Neutrophil Extracellular Traps in Tumor Progression

Jin Chenchen, 张栩

Available online:October 23, 2025, DOI:

[Abstract] (153) [HTML] (0) [PDF 0.00 Byte] (0)

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Neutrophil extracellular traps (NETs), a reticular structure composed of DNA fibers, histones, and antibacterial proteins released by neutrophils, can trap and eliminate foreign pathogens and play a significant role in the initiation and development of tumors. The formation and release of NETs are regulated by various factors from the tumor microenvironment, including signaling molecules released by tumor cells, inflammatory cytokines, oxidative stress, and angiogenesis. In addition, NETs interact with immune cells in the tumor microenvironment, collectively shaping the immune characteristics of the tumor microenvironment and participating in critical biological processes such as metabolic regulation of tumor cells, tumor metastasis, tumor-related thrombosis, and tumor angiogenesis, all of which impact tumor progression and patient prognosis. This review focuses on the multiple mechanisms of NETs in tumor progression, explores the mechanisms of NETs in regulating tumor cell proliferation and metastasis, altering tumor microenvironment, affecting tumor angiogenesis, immune escape, and the potential application prospect of NETs as biomarkers for diagnosis and prognosis, which reveal the significant role of NETs in tumor biology and provide a theoretical foundation for future research and clinical application.

The Mechanistic Role of GPX4 in Non-Alcoholic Fatty Liver Disease and Intervention Studies Using Traditional Chinese Medicine Extracts

Yang Yufan, Ma Jiyan, Li Shuhua, Feng Jinke

Available online:October 23, 2025, DOI:

[Abstract] (169) [HTML] (0) [PDF 0.00 Byte] (0)

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Non-alcoholic fatty liver disease (NAFLD) is currently the most prevalent chronic liver disease worldwide, posing a significant threat to human health; however, its pathogenesis remains incompletely understood. Research on regulatory cell death has opened new avenues for disease treatment. Among these, ferroptosis is a form of iron-dependent non-apoptotic cell death, which can be triggered by disturbances in iron metabolism, oxidative stress, and the accumulation of lipid peroxides. Given the liver's critical role in iron storage and lipid metabolism, recent studies have established a close association between ferroptosis and NAFLD. Abnormal lipid accumulation within cells can lead to redox imbalance, which may be a key factor contributing to lipid metabolism disorders. Consequently, inhibiting ferroptosis has emerged as a potential therapeutic strategy for NAFLD. Glutathione peroxidase 4 (GPX4) is a pivotal regulatory protein in ferroptosis, capable of binding to reduced glutathione (GSH) to degrade reactive oxygen species (ROS) and hydrogen peroxide (H2O2), thereby mitigating lipid peroxidation damage. Current research indicates that active components from traditional Chinese medicines, such as Astragalus, green tea, and Coptis, can modulate GPX4 through multiple targets, thereby influencing NAFLD. This review explores the mechanisms by which GPX4 operates within the ferroptosis pathway and identifies herbal extracts that may offer therapeutic benefits for NAFLD through GPX4 regulation.

Enriched Environment alleviates social behavioral deficits in 5×FAD Mice

Wang Ze, She Yuzhu

Available online:October 10, 2025, DOI:

[Abstract] (129) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: Alzheimer’s disease (AD) is a progressive and irreversible neurodegenerative disorder, with patients often exhibiting social withdrawal at an early stage. Its primary pathological hallmarks include abnormal β-amyloid (Aβ) deposition, glial hyperactivation, synaptic impairment, and myelin dysfunction. Recently, the enriched environment (EE), a non-pharmacological intervention, has garnered attention for its potential to enhance neuroplasticity. However, research on the effects of EE on social behavior and related neuropathological changes in the early stages of AD remains insufficient. This study utilized the 5×FAD mouse model to systematically investigate the impact of EE on early pathological progression in AD, providing new evidence to support the application of EE in the prevention and treatment of AD. Methods: Two-month-old 5×FAD mice were randomly assigned to a standard environment (SE) group or an EE group (5 mice per cage) and maintained in their respective housing conditions for 4 weeks. Behavioral tests, including the Y-maze, open field, elevated plus maze, and three-chamber social interaction assays, were conducted. Histopathological analyses of the medial prefrontal cortex (mPFC) were performed to evaluate neuropathological changes. Results: EE did not affect short-term spatial memory or anxiety-like behaviors in 5×FAD mice but significantly enhanced their social interaction capabilities. Pathologically, 5×FAD mice exhibited marked Aβ deposition and glial activation in the mPFC. Compared to the SE group, EE mice showed significantly reduced Aβ accumulation and glial activation in the mPFC. Furthermore, EE improved myelin structural integrity in this region, while no significant effects were observed on synaptic proteins, synaptic ultrastructure, or neuronal survival. Conclusion: This study demonstrates that EE effectively mitigates AD-related pathology in 5×FAD mice and alleviates social behavioral deficits, highlighting its potential for addressing AD-associated social dysfunction. These findings suggest that environmental interventions may exert neuroprotective effects by modulating neuroinflammation, reducing Aβ deposition, and preserving myelin homeostasis during AD progression.Keywords: Enriched Physical Environment; Social Behavioral Deficits; Medial Prefrontal Cortex

Safety and efficacy study of indocyanine green near-infrared fluorescence imaging tracer technology in the application of D2 lymph node dissection in da Vinci Robotic gastrectomy

LIN Siying, ZHU Chen, JIANG Zhiwei, 邓正明

Available online:October 10, 2025, DOI:

[Abstract] (158) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: This study aims to explore the safety and efficacy of utilizing indocyanine green near-infrared (ICG-NIR) fluorescence imaging to guide lymph node (LN) dissection during Da Vinci robotic gastrectomy (RG). Materials and methods: The patients who underwent RG at the General Surgery Department of Affiliated Hospital of Nanjing University of Chinese Medicine from January 2021 to January 2024 were retrospectively analyzed. Among them, 60 patients underwent ICG fluorescence navigation-guided lymphadenectomy (ICG group), while 117 received conventional LN dissection (non-ICG group). Propensity score matching (1:1) was performed to balance baseline characteristics. The number of retrieved LNs, surgical outcomes, postoperative complications, hospital stay, and recovery data were compared between two groups. Results: After matching, each group comprised 60 patients with comparable baseline characteristics, including age, sex, body mass index, nutritional risk screening scores, tumor diameter, tumor location, differentiation, vascular invasion, and Lauren type(p>0.05). All patients completed D2 lymphadenectomy, and there were no fluorescent LNs remaining after surgery. The ICG group had a significantly higher mean number of retrieved LNs (33.73±12.66) compared to the non-ICG group (26.15±6.31, p<0.05). Nevertheless, there was no significant difference in the number of positive LNs detected by postoperative pathology between two groups (4.67±7.83 vs 3.08±5.08, p>0.05). The ICG group demonstrated superior LN retrieval in both D1 and D2 regions (p<0.05), particularly at stations 3, 4d, 6, 7, 8a, and 12a. No significant differences were found in operative time, intraoperative blood loss, postoperative hospital stay, complication rates, or postoperative inflammatory indicators on day 3 (including c-reactive protein, white blood cell, albumin, and aspartate aminotransferase to alanine aminotransferase ratios) (p>0.05). A statistically significant difference in postoperative ventilation time was observed between the two groups (p<0.05), the ventilation time in the ICG group was found to be superior to the non-ICG group. Conclusion: ICG-NIR fluorescence imaging significantly improves the precision and completeness of LN dissection in RG without compromising perioperative safety. These findings provide preliminary evidence supporting the standardized application of this technique in robotic gastric cancer surgery.

Evaluation of left ventricular mechanical contraction synchrony in obese patients using a novel CZT SPECT

WANG Cheng, LI Chunxiang

Available online:October 10, 2025, DOI:

[Abstract] (138) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: This study aimed to investigate the impact of obesity on left ventricular mechanical contraction synchrony parameters in patients with normal myocardial perfusion imaging. Methods: A retrospective analysis was conducted on patients who underwent CZT SPECT myocardial perfusion imaging at the First Affiliated Hospital of Nanjing Medical University from January 2023 to August 2024. 133 patients with normal MPI results and left ventricular ejection fraction were included. They were divided into three groups according to body mass index (BMI): 40 cases in the normal group (BMI≤23.9), 45 cases in the overweight group(24≤BMI≤27.9), and 48 cases in the obesity group (BMI≥28). The differences in left ventricular function parameters such as PBW, PSD, EDV, ESV, and LVEF among the three groups were analyzed, and the influence of BMI on these parameters was explored. Results: The PBW (22.00±4.24 vs 17.10±3.20, p<0.001; 26.13±5.74 vs 17.10±3.20, p<0.001) and PSD values (5.04±1.05vs3.74±0.68, p<0.001; 6.34±1.43vs3.74±0.68, p<0.001) in the overweight and obesity group were significantly higher than those in the normal group. The PBW (26.13± 5.74 vs 22.00±4.24, p<0.001) and PSD values (6.34±1.43 vs 5.04±1.05, p<0.001) in the obesity group were significantly higher than those of overweight, and the difference was statistically significant. Body mass index (BMI) was significantly positively correlated with PBW (r=0.446, p<0.001) and PSD (r=0.477, p<0.001) in overweight and obesity patients. Conclusion: Obese patients are more likely to develop LVMD, and the novel cadmium-zinc-telluride SPECT phase analysis can effectively evaluate LVMD in obese patients at an early stage. This has significant clinical guiding significance for the early detection of LVMD in obese patients and the implementation of intervention to reduce cardiovascular events.

Acetylated proline-glycine-proline in lung diseases

Xiao Xinru

Available online:October 10, 2025, DOI:

[Abstract] (155) [HTML] (0) [PDF 0.00 Byte] (0)

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The extracellular matrix (ECM) generates multiple bioactive fragments, termed matrikines, which play pivotal roles in ECM functions. Acetylated proline-glycine-proline (AcPGP) is a matrikine derived from collagen. By binding to the C-X-C chemokine receptor type 1 and 2, AcPGP exhibits complex biological effects such as inflammatory responses, vascular permeability, tissue repair and remodeling. In the lungs, the dys-regulation of AcPGP contributes to a variety of respiratory diseases, and serves not only as a biomarker for diagnosis and assessment but also as a potential therapeutic target. This article reviews the regulatory mechanisms, biological functions of AcPGP in the lungs, and its role in respiratory diseases such as chronic airway inflammation diseases, acute lung injury, and pulmonary fibrosis.

The Predictive Value of Clinical Features Combined with IVIM-DWI Parameters for Early Pregnancy Outcomes in Frozen-Thawed Embryo Transfer Patients

SONG Jiacheng, ZHANG Aining, LU Yao, XU Yichen, CHEN Ting, WANG Jing, MA Xiang

Available online:September 23, 2025, DOI:

[Abstract] (141) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To investigate the predictive value of clinical characteristics combined with intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters for early pregnancy outcomes in patients undergoing frozen-thawed embryo transfer (FET). Methods: This prospective study enrolled 70 infertile women who underwent in FET at our reproductive center between December 2023 and January 2025. All participants underwent standardized pelvic non-contrast MRI on the day of embryo transfer. Clinical and laboratory indicators, conventional MRI features, and IVIM-DWI parameters were collected. IVIM-DWI parameters (diffusion coefficient D, pseudodiffusion coefficient D*, and perfusion fraction f) were extracted using FireVoxel software, with histogram data generated via SPSS. Student’s t-test, Pearson’s chi-square test, or Fisher’s exact test were employed to compare differences in clinical characteristics, MRI features, and IVIM-DWI parameters between the successful pregnancy group (n=42) and the non-pregnancy group (n=28). The receiver operating characteristic (ROC) curve was utilized to assess the diagnostic value of each parameter, with the area under the curve (AUC) and DeLong test serving as evaluation metrics.Results: The successful pregnancy group exhibited a higher proportion of high-quality embryos compared to the non-pregnancy group [32 (76.2%) vs. 13 (46.4%%), P=0.011] The junctional zone Dmean was significantly higher in the successful pregnancy group [45.233 ± 7.930 vs. 41.223 ± 6.369, P=0.029]. ROC analysis revealed that embryo quality (high-grade embryos) predicted pregnancy success with an AUC of 0.65 (sensitivity 53.6%, specificity 73.2%), while junctional zone D*mean achieved an AUC of 0.68 (sensitivity 73.8%, specificity 67.9%). The combination of embryo quality and junctional zone D*mean demonstrated superior predictive efficacy (AUC=0.73, sensitivity 82.1%, specificity 60.0%). Conclusion: IVIM-DWI enables noninvasive assessment of microcirculatory perfusion characteristics of FET patients. Combining embryo quality with junctional zone D*mean enhances the prediction of early pregnancy outcomes.

Study on the influencing factors of adverse pregnancy outcomes in women with gestational diabetes mellitus combined with thrombocytopenia

Xu yetao

Available online:September 23, 2025, DOI:

[Abstract] (148) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: This study focuses on pregnant women with gestational diabetes mellitus (GDM) combined with thrombocytopenia, aiming to analyze their characteristics and pregnancy outcomes and reveal the influencing factors of the main adverse pregnancy outcomes. Methods: Pregnant women with GDM combined with thrombocytopenia who delivered in the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2024 were systematically screened. Maternal characteristics, including baseline, previous medical history, prenatal laboratory examinations, as well as maternal and neonatal outcomes, were analyzed. Logistic regression analysis was employed to identify the factors influencing the main adverse pregnancy outcomes. Results: A total of 233 women with GDM combined with thrombocytopenia were screened, accounting for 3.8‰ of all pregnant women. The mean maternal age was 31.95 years. Among them, 51.5% had a history of abortion, and 30.5% had other co-morbidities. In terms of maternal pregnancy outcome, 56.7% of them underwent the cesarean section. Additionally, 38 women (16.3%) experienced premature rupture of membranes, 30 (12.9%) had postpartum hemorrhage, and 26 (11.2%) had preterm delivery. Regarding neonatal outcomes, 24 newborns (10.3%) were macrosomia, 13 (5.6%) had low birthweight, 12 (5.2%) experienced neonatal distress, 17 (7.3%) had hyperbilirubinemia, and a total of 43 (18.5%) neonates were transferred to NICU. The multivariate logistic regression analysis showed that co-morbidities (OR=4.71, P=0.014) and fasting blood glucose (OR=2.48, P=0.044) were independent risk factors for preterm delivery in pregnant women with diabetes and thrombocytopenia. Prenatal D-dimer (OR=1.25, P=0.005) and platelet levels (OR=0.98, P=0.012) were significantly correlated with the risk of postpartum hemorrhage. In addition, higher body mass index in late pregnancy (OR=1.22, P=0.039) and fasting blood glucose (OR=1.93, P=0.047) independently impacted the risk of macrosomia. Conclusion: Pregnant women with gestational diabetes mellitus combined with thrombocytopenia are at higher risk of adverse maternal and infant pregnancy outcomes such as postpartum hemorrhage, preterm delivery, and macrosomia. For such pregnant women, comprehensive measures such as health education, dietary adjustments, moderate exercise, and medication treatment should be actively taken during pregnancy to control blood glucose and correct thrombocytopenia. Doctors and midwives should choose the appropriate mode of delivery to improve maternal and infant outcomes.

Research progress of cancer-associated fibroblasts in breast cancer metastasis

Gu Zhangqi

Available online:September 23, 2025, DOI:

[Abstract] (138) [HTML] (0) [PDF 0.00 Byte] (0)

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Cancer-associated fibroblasts (CAFs) are mainly derived from quiescent normal fibroblasts, and partially originated from mesenchymal stem cells, epithelial cells and endothelial cells. As an important part of the tumor microenvironment (TME), CAFs play a key role in the metastatic process of breast cancer. In recent years, researchers have paid more attention to the biological properties of CAFs and their interactions with breast cancer cells, which promote breast cancer cell invasion and metastasis by secreting various cytokines and exosomal microRNA (miRNA), altering extracellular matrix compositions, regulating intercellular signaling, and remodeling the TME. Although a large number of studies have revealed the importance of CAFs in breast cancer metastasis, their specific mechanisms of action need to be further explored. In this paper, we will systematically review the latest research progress of CAFs in breast cancer metastasis, and explore the core mechanism and function of CAFs in it, with a view to providing new ideas for future research.

Application Progress of Artificial Intelligence in the Diagnosis and Treatment of Early Gastrointestinal Cancers

阙煜轩, 周晓颖

Available online:September 23, 2025, DOI:

[Abstract] (156) [HTML] (0) [PDF 0.00 Byte] (0)

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Early gastrointestinal cancer (EGC) has subtle early symptoms and low screening rates, which leads to most patients being diagnosed at advanced stages, resulting in poor prognoses. Therefore, early diagnosis and timely treatment are crucial for improving patient outcomes. In recent years, artificial intelligence (AI) technology has been able to enhance the detection rate and diagnostic accuracy of early lesions through high-precision image analysis and data processing, thereby achieving early discovery, early diagnosis, and early treatment to improve patient prognoses. However, AI also faces challenges such as insufficient training data, algorithm bias, and uneven development across regions, which need to be addressed in future advancements. This review aims to provide a comprehensive overview of the current applications of AI in the diagnosis and treatment of EGC, exploring its advantages, challenges, and future directions to offer valuable references for researchers and clinicians in related fields.

Research Progress on Lactate Metabolism in Pancreatic Cancer

ZHU Chunfu

Available online:September 23, 2025, DOI:

[Abstract] (165) [HTML] (0) [PDF 0.00 Byte] (0)

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Lactate metabolism plays a central role in the metabolic reprogramming of tumors and is critically implicated in the progression, metastasis, and therapy resistance of pancreatic cancer. Beyond being a glycolytic byproduct, lactate functions as a key signaling molecule that regulates tumor proliferation, invasion, immune escape, and drug tolerance. Recent advances have identified lactate dehydrogenase A (LDHA) and monocarboxylate transporters (MCTs) as promising therapeutic targets in pancreatic cancer. Preclinical studies suggest that disrupting lactate metabolism can suppress tumor growth and remodel the immunosuppressive tumor microenvironment. Moreover, lactate-associated biomarkers show potential in enhancing the diagnosis and prognosis of pancreatic cancer. Despite these advances, current lactate-targeted therapies are limited by poor specificity, suboptimal safety, and pharmacological instability. This review outlines the mechanistic underpinnings of lactate metabolism in pancreatic cancer, highlights emerging therapeutic targets and strategies, and discusses the potential of integrating lactate-targeted approaches with immunotherapy to improve clinical outcomes.

Lactylation of PARP1 at K192 Inhibits the Migration and Proliferation of Ovarian Cancer Cells

ZhangShuPing, CaoYing, WuShaoJun, SunHongZhan, TangXueJun, YuanDongLan, YangLiLi, YingXiaoYan

Available online:September 17, 2025, DOI:

[Abstract] (152) [HTML] (0) [PDF 0.00 Byte] (0)

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Objectives: Ovarian cancer (OC) ranks first among the female cancers worldwide. Numerous studies have explored the development and progression of OC at multiple genetic regulatory levels. However, relatively few studies have explored the impact of post-translational modifications (PTMs) on OC progression, which is essential for uncovering new therapeutic targets. We aimed to address this research gap. Methods: Firstly, we utilized multiple general PTM antibodies to compare gross PTM levels between normal ovarian and OC tissues from clinical females. After identifying lactylation as the PTM with the most significant differences, we selected representative samples for label-free mass spectrometry to identify specific lactylation sites. Next, we transfected A2780 (OC) cells with either wild-type (WT) or mutant (K192A[Q]) poly(ADP-ribose) polymerase 1 (PARP1) conjugated to enhanced green fluorescent protein (EGFP) with a Strep II peptide tag and assessed various cellular indexes related to cell proliferation, apoptosis, migration, and reactive oxygen species levels. Results: Pan-lactylation was significantly upregulated in clinical OC samples, with PARP1 lactylation at K192 being one of the most common modifications. The growth and migration of A2780 cells were markedly suppressed by overexpressing WT but not mutant PARP1. Overexpressing WT PARP1 significantly downregulated the phosphorylation of extracellular signal-regulated kinases 1/2 (ERK1/2). Conclusion: This study uncovered a novel PTM of PARP1 in OC, lactylation, and demonstrated that lactylation at K192 is crucial in regulating OC cell growth and migration via the ERK1/2 pathway. Further investigations are required to elucidate the broader functional implications of PARP1 lactylation and its therapeutic potential.

Study on the Correlation between Arteriosclerosis Index and Non-alcoholic Fatty Liver Disease

ZHANG Lili, XIAO Libin

Available online:September 17, 2025, DOI:

[Abstract] (142) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective：To analyze the related influencing factors of hepatic steatosis and explore the relationship between the arterial sclerosis index (AI) and non-alcoholic fatty liver disease (NAFLD). Methods：This study was a secondary analysis based on the public data of a cross-sectional study conducted at the Medical Health Examination Center of Kurosawa Memorial Hospital in Japan, involving 856 participants aged 24 to 84 years. The participants were divided into the NAFLD group (n=209) and the non-NAFLD group ( n=647) according to whether they had non-alcoholic fatty liver disease. The differences in clinical general data, laboratory indicators, AI values, and the detection rate of arterial sclerosis between the two groups were compared. Logistic regression analysis was used to evaluate the related factors of NAFLD, and a regression model was constructed to assess the correlation between AI and NAFLD. The receiver operating characteristic (ROC) curve was used to test the value of AI as an indicator for risk assessment of NAFLD. Results：There was a statistically significant difference in the gender composition ratio between the NAFLD group and the non-NAFLD group (P < 0.001), with more males in the NAFLD group. Compared with the non-NAFLD group, the NAFLD group had higher levels of body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transferase (GGT), fasting blood glucose, uric acid, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and arterial pulse wave velocity of brachial artery (baPWV) (P < 0.001), lower levels of high-density lipoprotein cholesterol (HDL-C) (P < 0.001), and less exercise habits (P = 0.001). The AI values and the detection rate of arterial sclerosis in the NAFLD group were higher than those in the non-NAFLD group (P < 0.001). Binary multivariate Logistic regression analysis showed that AI, BMI, AST, fasting blood glucose, and baPWV were positively correlated with NAFLD. After fully adjusting for confounding factors, binary multivariate Logistic regression analysis showed that AI was positively correlated with NAFLD (OR = 1.846, 95% CI=1.541 - 2.121, P < 0.001), and the population in the highest AI group showed a significantly higher tendency of NAFLD compared to the lowest group (OR = 6.169, 95% CI = 3.006 - 12.661, P < 0.001). In the generalized additive model, there is a direct linear relationship between AI and NAFLD (log-likelihood ratio test, P = 0.949). The area under the ROC curve of AI is 0.775 (95% CI=0.739 - 0.811, P < 0.001), which is higher than that of baPWV and traditional lipid indicators [baPWV (AUC = 0.616, 95% CI = 0.574 - 0.659, P < 0.001), TC (AUC = 0.576, 95% CI = 0.532 - 0.621, P = 0.001), TG (AUC = 0.735, 95% CI = 0.696 - 0.774, P < 0.001), LDL-C (AUC = 0.639, 95% CI = 0.597 - 0.681, P < 0.001)].Conclusion：AI, BMI, AST, fasting blood glucose, and baPWV are independent related factors for NAFLD. Although AI cannot directly serve as a causal indicator for NAFLD, its potential in risk assessment is worthy of attention, especially when combined with imaging examinations, which can help improve the early diagnosis rate of NAFLD.

Exploring the risk of pulmonary arterial hypertension in patients with connective tissue disease based on nailfold video capillaroscopy

周张迪, Zhang Yixin, Dai Jiayi, Li Dongyu, Sun Xiaoxuan

Available online:September 17, 2025, DOI:

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Abstract:
Objective: This study aims to evaluate the predictive value of nailfold capillaroscopy (NVC) in the diagnosis of patients with connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH). Methods: A retrospective analysis was conducted on One hundred and forty-seven patients with connective tissue disease (CTD) who were hospitalised in the Department of Rheumatology and Immunology of the First Affiliated Hospital with Nanjing Medical University and underwent nailfold video capillaroscopy from September 2022 to June 2024. According to whether they were combined with pulmonary arterial hypertension (PAH) or not, CTD patients were divided into two groups: CTD-PAH and CTD-nonPAH. Risk factors for PAH in CTD patients were screened by multifactorial logistic regression analysis. A Nomogram prediction model was constructed based on this multifactorial logistic regression analysis and the model performance was evaluated using the receiver operating characteristic (ROC) curve. Results: Among the CTD patients, 52 (35.4%) were included in the CTD-PAH group. The capillary length was longer in the CTD-PAH group than in the CTD-nonPAH group [202.0 (160.0, 272.0) vs. 262.0 (207.0, 308.0), P<0.05], and the pericapillary score was higher than that in the CTD-nonPAH group [1.90 ( 0.40, 2.80) vs. 2.40 (0.80, 3.92),P<0.05]. Logistic regression analysis showed that both long capillary length and high pericapillary score increased the risk of PAH occurrence [OR=1.300 (95% CI: 1.100-1.500), OR=1.268 (95% CI: 1.025-1.568)]. The area under the ROC curve of the Nomogram prediction model amounted to 0.6913 (95% CI:0.6046~0.7781, P<0.05). Conclusion: The findings suggest that nailfold capillary characteristics, including capillary length and pericapillary score, may serve as independent predictors of PAH in patients with connective tissue diseases. These results provide a new basis for early screening and individualized therapeutic strategies in CTD-PAH patients.

Value of the product of urine/serum neutrophil gelatinase-associated lipocalin ratio and reticulocyte percentage in distinguishing acute kidney injury from chronic kidney disease

Li Li, Wu Lin, Geng Suheng, Zhang Bo, Huang Zhiming

Available online:September 17, 2025, DOI:

[Abstract] (152) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To investigate the value of neutrophil gelatinase-associated lipocalin (NGAL) and reticulocyte percentage (Ret%) in differentiating acute kidney injury (AKI) from chronic kidney disease (CKD). Methods: The study included 437 patients with nephropathy from the Department of Nephrology of the First Affiliated Hospital of Nanjing Medical University. The subjects were divided into AKI group (n = 140) and CKD group (n = 297). To control potential selection bias, propensity matching analysis of 19 variables was used to compare the urine/serum NGAL (u/sNGAL) and Ret% between the two groups. According to the stratification of renal function, the differentiation ability of u/sNGAL and Ret% in AKI and CKD was compared. Results: The product of u/sNGAL and Ret% (u/sNGAL ×Ret%) in AKI group was significantly higher than that in CKD group (1.74 (0.79- 4.16) vs 0.28 (0.15- 0.55), P < 0.001). Propensiy-matched analysis included 46 patients in each group. In matched patients with AKI and CKD, Ret%, u/s NGAL, and u/s NGAL×Ret% were significantly increased in the AKI group (1.75 (1.26- 2.53) vs 1.37 (1.16- 1.83)). 0.64 (0.33- 1.52) vs 0.31 (0.13- 0.76) and 1.27 (0.59- 3.31) vs 0.46 (0.25- 1.53)) . In all patients (n = 437), the receiver operating characteristic (ROC) analysis showed that Ret%, u/sNGAL and u/sNGAL×Ret% could distinguish AKI from CKD (the area under the curve was 0.701, 0.847 and 0.868, respectively). After stratified by renal function, subgroup analysis showed that there were significant differences in u/sNGAL×Ret% between AKI group and CKD group (P < 0.01). In the subgroup analysis of patients with eGFR > 60mL/min/1.73m2, both u/sNGAL×Ret% and Ret% were able to differentiate AKI from CKD. However, in the subgroup analysis of patients with eGFR < 60mL/min/1.73m2, u/sNGAL×Ret% demonstrated superior performance in distinguishing AKI from CKD compared to Ret% (P < 0.05). Conclusion: u/sNGAL×Ret% can be used as an indicator for the differential diagnosis of AKI and CKD patients in the Department of Nephrology.

Fibroblast-Derived LGALS3 Promotes Silicosis Fibrosis through Extracellular Matrix Accumulation

Keying Xu, Wei Zhang

Available online:September 12, 2025, DOI:

[Abstract] (126) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: This study aimed to investigate the expression of fibroblast-derived Galectin-3 (LGALS3) in lung tissue of a silica (silicon dioxide, SiO?)-induced pulmonary fibrosis mouse model and its relationship with extracellular matrix (ECM) deposition, further elucidating the role of LGALS3 in the mechanism of silicosis fibrosis. Methods: A pulmonary fibrosis mouse model was established by silica exposure, and collagen deposition and structural changes in lung tissues were observed using Sirius Red staining and polarized light microscopy. Then, single-cell clustering analysis was performed to classify cells into 20 clusters, and differentially expressed genes upregulated in fibroblasts after 56 days of SiO? treatment were identified. Gene Ontology enrichment analysis using Metascape was conducted to identify genes associated with ECM binding. In vitro, human lung fibroblasts (HPF-a) and mouse lung fibroblasts (MLg) were stimulated with transforming growth factor-β1 (TGF-β1), and the expression levels of LGALS3 and its deposition on the ECM were detected by Western Blot and immunofluorescence staining. Results: Single-cell clustering analysis showed a significant increase in fibroblast numbers after 56 days of SiO? treatment, with the top ten upregulated genes identified as Ccl6, Lyz2, Ftl1, Spp1, Lgals3, Cxcl2, Fth1, Psap, S100a9, and Ctss. GO enrichment analysis indicated that these genes were closely associated with ECM binding, with Ctss, Lgals3, and Spp1 being the core related genes. Dot plots and violin plots demonstrated that the expression level of Lgals3 was significantly higher in the SiO? 56-day group compared to the control group. Sirius Red staining and polarized light microscopy revealed significantly increased collagen deposition and dense structure in the lung tissues of the SiO?-exposed group, exhibiting typical pathological features of pulmonary fibrosis. Western Blot results showed that LGALS3 expression in HPF-a cells exhibited a time-dependent increase after TGF-β1 stimulation, peaking at 12 hours (P < 0.05). Animal model validation confirmed that LGALS3 expression in lung tissues of the SiO?-exposed group was significantly higher than in the control group (P < 0.001), and immunofluorescence staining revealed enhanced co-localization signals of LGALS3 with the fibroblast marker Vimentin (P < 0.01). Furthermore, after seeding TGF-β1-stimulated MLg cells onto ECM, LGALS3 expression levels significantly increased (P < 0.05); even after cell removal, LGALS3 expression on the ECM remained higher than in the control group (P < 0.05). Conclusion: This study confirms that fibroblast-derived LGALS3 is significantly upregulated in lung tissues of a silica-induced pulmonary fibrosis mouse model and participates in ECM deposition. The expression of LGALS3 is regulated by TGF-β1 and shows persistent accumulation on the ECM. These findings reveal the critical role of LGALS3 in pulmonary fibrosis and provide new theoretical insights into the pathological mechanisms of silicosis and potential therapeutic targets.

The Causal Association Between Helicobacter pylori and Esophageal Cancer: A Mendelian Randomization Study

houlizhao, dongxiaoge, luolanminghui, jiangwei, wangzhanjin, Xue Weiwei, 王展

Available online:September 12, 2025, DOI:

[Abstract] (153) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: This study aimed to explore the potential causal relationship between Helicobacter pylori (HP) infection and esophageal cancer (EC). We employed traditional two-sample Mendelian randomization (MR) methods, combined with Bayesian-weighted MR and linkage disequilibrium score regression (LDSC), and conducted a comprehensive meta-analysis on controversial findings to strengthen the evidence base. Methods: The analysis incorporated genome-wide association study (GWAS) data with HP infection as the exposure and EC as the outcome. We utilized a variety of MR methods, including inverse-variance weighted analysis, weighted median, MR-Egger, Simple mode, and Weighted mode to investigate the association between HP and EC. Additionally, Bayesian-weighted MR was introduced and results were corrected using the false discovery rate (FDR) to enhance precision. The study also involved outlier detection, heterogeneity testing, sensitivity analysis, pleiotropy assessment, and the removal of single nucleotide polymorphisms (SNPs) potentially affected by confounding factors. For results that were particularly contentious, a meta-analysis was performed to provide a broader perspective. Potential reverse causation was assessed using Steiger testing and reverse MR. Furthermore, LDSC was utilized to evaluate the genetic correlation between HP and EC. Results: The comprehensive analyses showed that both traditional two-sample MR and Bayesian-weighted MR after FDR correction indicated no statistically significant causal relationship between HP and EC（P>0.05）. No pleiotropy was evident（P>0.05）, and the robustness of the results was confirmed by the leave-one-out test. However, genetic correlation analyses of anti-Helicobacter pylori IgG serum positivity and Helicobacter pylori GroEL antibody levels suggested a potential genetic link with esophageal adenocarcinoma（P<0.05）. Conclusion: Despite the use of advanced statistical methodologies, the current evidence is insufficient to support a definitive causal relationship between HP and EC. This finding underscores the need for larger-scale GWAS data and more detailed subtype-specific analyses to further explore the relationship between these two conditions. Future research should include a broader range of populations and geographical areas to enhance the generalizability and applicability of findings, while also investigating the specific impacts of different HP strains and possible biological mechanisms, providing stronger scientific support for the prevention and treatment of esophageal cancer.

onstruction of a prediction model for pelvic lymph node metastasis in early-stage cervical squamous cell carcinoma

李俊玫

Available online:September 12, 2025, DOI:

[Abstract] (160) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To construct a model for predicting pelvic lymph node metastasis in early-stage cervical squamous cell carcinoma. Method:The clinical data of patients in the Department of Gynecology, Affiliated Hospital of Southwest Medical University from January 2019 to October 2023 were retrospectively analyzed. Two models were obtained by univariate logistic analysis , forward and backward stepwise regression analysis. The Akaike Information Criterion (AIC), Continuous Net Reclassification Improvement Index (NRI) and Integrated Discriminant Improvement Index (IDI) were used to determine the optimal model .The model was converted into a nomogram, and its efficacy was evaluated by the area under the receiver operating characteristic curve(AUC), Hosmer-Lemeshow test, calibration curve and clinical decision curve (DCA). Bootstrap self-samples 1000 times for internal validation. Results: A total of 221 patients were enrolled. Forward and backward stepwise regression methods were used to establish model 1 and model 2. According to the results of AIC, serial NRI and IDI, model 2 was the optimal model (indicators: age, SCCA, CA125, and lymph node status on MRI). The AUC was 0.818 ; The Hosmer-Lemeshow test χ2=0.942, P=0.332, and the adjusted AUC was 0.800 ; DCA showed that when the threshold probability was 0.03-0.5, the clinical net benefit was higher. The AUC of the internal verification was 0.784. Conclusion:Models based on age, SCCA, CA125, and MRI lymph node status can help predict pelvic lymph node status for cervical cancer before surgery.

Role and mechanism of NTQ in neural stem cell proliferation in AD mice

Li Qian-qian, Gong Xuan-wei, Yang Yi, Hou Lin, Wang Shu-kun

Available online:September 12, 2025, DOI:

[Abstract] (137) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To investigate the effect and molecular mechanism of Nao Tan Qing (NTQ) on neural stem cell (NSC) proliferation in Alzheimer's disease (AD) mice. Methods: 5×FAD mice were randomly assigned to two groups, the AD group treated with ddH2O and AD+NTQ group orally administered with NTQ by gavage. Immunofluorescence staining, real-time quantitative PCR, and western blotting were used to evaluate neural stem cell proliferation in hippocampus. In vitro, neural stem cells were isolated and cultured with PBS, NTQ. Cell apoptosis and proliferation were assessed using the apoptosis and CCK-8 assays. Immunofluorescence staining was used to detect the number of SOX2+, BrdU+, and DCX+ cells. The mRNA and protein levels of Sox2 and Dcx were measured by real-time quantitative PCR and western blotting. The expression of key molecules CyclinD1, P27/Kip1 and Gata2 was detected by real-time fluorescence quantitative PCR and protein blotting; the expression level of Sox2 was detected by fluorescence quantitative PCR and protein blotting after the in vitro treatment of neural stem cells using CyclinD1-CDK inhibitor.Results: In the AD+NTQ group, the number of SOX2+ cells in brain significantly increased, with a marked elevation in Sox2 mRNA and protein levels compared with the AD group. In vitro, the diameter of neurospheres treatment with NTQ were significantly larged, along with the increased number of BrdU+, SOX2+, and DCX+ cells. Moreover, Sox2 and Dcx mRNA levels, as well as SOX2 protein level, were notably elevated. Mechanistically, the expression of GATA2 and its downstream molecule p27/Kip1 was decreased in the hippocampus of AD+NTQ mice, and the inhibitory effect on cyclinD1 was weakened in NSC proliferation. Addition of CyclinD1-CDK inhibitor attenuated the increase in Sox2, Dcx expression triggered by NTQ. Conclusion: NTQ maintains neural stem cell proliferation and alleviates cognitive deficits in AD mice by modulating the GATA2-p27/Kip1-cyclinD1 signaling pathway.

PET/CT radiomics: a new perspective in the diagnosis and treatment of esophageal cancer

GU Yingying, Tang Lijun

Available online:August 28, 2025, DOI:

[Abstract] (138) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Esophageal cancer is a gastrointestinal malignancy with a high incidence and poor prognosis worldwide, with about 40% of cases concentrated in China, and the 5-year survival rate is less than 20%. Traditional imaging methods have obvious limitations in precision diagnosis and treatment, but PET/CT radiomics provides a new perspective for the accurate staging, dynamic monitoring of treatment response and individualized prognosis prediction of esophageal cancer by extracting and analyzing the morphological, metabolic and texture characteristics of tumors through high-throughput. This article systematically reviews the research progress of 18F-FDG PET/CT radiomics in the diagnosis and treatment of esophageal cancer, discusses its potential for cross-integration with genomics and dosimics, and looks forward to the future development direction, in order to provide more comprehensive theoretical support for clinical translation.

A study on the correlation between first-day serum albumin on ICU admission and in-hospital mortality risk in patients with acute pancreatitis

hou chaoqun, ge wanli, peng yunpeng, jiang kuirong

Available online:August 28, 2025, DOI:

[Abstract] (151) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: Acute pancreatitis (AP) is a common digestive emergency with high mortality in severe cases, making early risk identification crucial. This study aimed to investigate the association between first-day serum albumin (ALB) levels upon intensive care unit (ICU) admission and in-hospital mortality in patients with AP, and to explore its potential non-linear nature. Methods: This retrospective study analyzed data from 728 adult AP patients admitted to the ICU for the first time between 2008 and 2019, sourced from the MIMIC-IV database. First-day ICU ALB levels and relevant clinical data were extracted. Multivariable logistic regression models were used to assess the linear association between ALB and in-hospital mortality. Generalized additive models (GAM) and two-piecewise linear regression models were employed to explore non-linear relationships and identify inflection points. Results: After adjusting for multiple confounders, each 1 g/L increase in first-day ICU ALB was associated with a 27% reduction in in-hospital mortality risk (OR 0.73, 95% CI 0.59–0.92, P=0.007). GAM analysis further revealed a significant non-linear relationship between ALB and in-hospital mortality, with an inflection point at 28 g/L. When ALB was ≤ 28 g/L, each 1 g/L increase was associated with a 56% significant reduction in mortality risk (OR 0.44, 95% CI 0.26–0.73, P=0.001); however, this association was not statistically significant when ALB was > 28 g/L. Conclusion: First-day ICU serum albumin levels in patients with AP demonstrated a significant non-linear negative association with in-hospital mortality. An ALB level of 28 g/L was identified as an important clinical inflection point for distinguishing high-risk patients. Early monitoring and attention to ALB levels are crucial for risk stratification and clinical decision-making in AP patients.

Role of circ_0003633 in Osimertinib Resistance in Lung Adenocarcinoma CellsZHANG Ge₁^, Chen Xin₁^{, GU jingyao}₁^,WANG Zhaoxia₁_^*

Chen Xin, Gu Jing Yao

Available online:August 25, 2025, DOI:

[Abstract] (195) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To explore the role of circ_0003633 in osimertinib resistance of lung adenocarcinoma cells. Methods: By performing circRNA sequencing on osimertinib-resistant and sensitive cells, circ_0003633 was identified as significantly highly expressed in the resistant cells. The expression of circ_0003633 was knocked down in osimertinib-resistant cells, and its role in osimertinib-resistant lung adenocarcinoma cells was investigated through CCK8 assay, Transwell assay and colony formation assay. RNA Pull Down, transcriptome sequencing and bioinformatics analysis were used to screen downstream target genes and signaling pathways. Results: circ_0003633 is significantly highly expressed in osimertinib-resistant cells. Knockdown of circ_0003633 expression can significantly increase the sensitivity of osimertinib-resistant cells to osimertinib. circ_0003633 can bind to RNA-binding protein hnRNPA1 and regulate the downstream target gene ALDOC to exert biological functions. Conclusion: circ_0003633 is significantly highly expressed in osimertinib-resistant cells, binds to hnRNPA1 and regulates the downstream target gene ALDOC, activates the PI3K/AKT signaling pathway, promotes the resistance of lung adenocarcinoma cells to osimertinib, and can be used as a potential target for reversing drug resistance.

Research progress on the latest treatment of early complications of patients after spinal cord injury

LI Wenbo

Available online:August 25, 2025, DOI:

[Abstract] (197) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Spinal cord injury (SCI) is a severe central nervous system disorder with a high rate of disability and mortality. It is typically caused by traumatic vertebral burst fractures, with common causes including traffic accidents, falls from a height, and slips. After injury, patients often experience loss of motor and sensory functions, and may develop a variety of complications, such as respiratory dysfunction, cardiovascular dysfunction, neuropathic pain, muscle spasms, neurogenic bladder, and gastrointestinal dysfunction. These complications not only cause significant physical and psychological distress to patients but also severely impact their quality of life and prognosis. Early surgical intervention may salvage neural function, while rehabilitation training is also the essential therapeutic approach. The management of complications requires close collaboration among multidisciplinary teams. Effective preventive and therapeutic measures can significantly alleviate pain of patients and prolong survival. In recent years, with the deepening understanding of the pathophysiological mechanisms of SCI, clinical strategies for managing complications have been updated continuously. The application of new therapeutic methods and novel treatment strategies has brought hope for improving the quality of life of patients. This review summarizes the latest research progress on early complications of SCI, aiming to provide references for clinicians to optimize treatment plans and improve the quality of life for patients.

Mutation Characteristics of 39 STR Loci in 6,812 Paternity Testing Cases from the Han Population in Jiangsu Province

JU Xiaobin, WU Lei, CHEN Qun

Available online:August 25, 2025, DOI:

[Abstract] (188) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To analyze the mutation characteristic of 39 short tandem repeat (STR) loci in paternity testing from the Han population in Jiangsu Province. Methods:?A total of 6,812 paternity testing cases accepted by Forensic Identification Institute in the First Affiliated Hospital with Nanjing Medical University were collected from January 2019 to December 2024. The GoldenEye? DNA Identity System was used to detect mutations in 39 STR loci, and statistical analyses were performed on mutation rates, mutation origin and steps. Results:?Among the 6,812 confirmed paternity testing cases, there were 1,680 trios and 5,132 duos. A total of 214 mutation events were observed, with an overall mutation rate of?2.52%. The highest mutation rate occurred in?D12S391 (0.3297%, 28/8,492), followed by?Penta E, FGA, D21S11, D18S51 and?D3S1358 with mutation rates exceeding?0.2000%. In the analysis of mutation origin, 5 cases were of uncertain origin, while 189 cases were paternal mutations and 20 cases were maternal mutations. The mutations rate of paternal origin was significantly higher than that of maternal origin" (P<0.001). Among the mutations, 203 (94.86%) cases were single-step mutation, with 9 cases in two steps, and 2 cases in three steps observed at FGA and D21S11 loci. Conclusion:? The overall mutation rate of 39 STR loci used in paternity testing was relatively high, and there were significant gender and regional differences, which need to be given more attention in the practice of paternity testing. Our findings provide data support for the STR mutation status from the Han population in Jiangsu Province and contribute to improve the accuracy of complex kinship identification.

Research progress of human metapneumovirus vaccines

Zhang Ling

Available online:August 25, 2025, DOI:

[Abstract] (190) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Human metapneumovirus (hMPV) belongs to the genus Metapneumovirus of the family Pneumoviridae. It was first discovered in the Netherlands in 2001. hMPV can cause repeated infections in infants, the elderly and immunocompromised population, and is one of the major pathogens causing severe acute lower respiratory tract infections. hMPV has spread across the world, becoming a serious public health and financial burden. Vaccination is supposed to be one of the most important means to prevent hMPV infection, transmission and reduce severeness of symptoms. Up to now, there is no approved hMPV preventive vaccine, and most clinical treatments are limited to symptomatic reduction. In recent years, significant progress has been made in the research on hMPV vaccines. Many vaccines have entered the clinical research stage, and there are numerous studies in the preclinical stage. This review will discuss the virological characteristics, epidemiological features and molecular mechanisms of hMPV infection of host cells, introduce the latest clinical development of hMPV vaccines, and present the preclinical research and development of hMPV vaccine from the perspective of different technical strategies, hoping to provide references to accelerate hMPV vaccine development.

Screening qPCR-positive specimens based on histopathological characteristics: a rapid, accurate, and economical diagnosis of pulmonary tuberculosis

ZHANG Qianqian, JIN Xiaoyan, HU Huidi, DONG Yan

Available online:August 25, 2025, DOI:

[Abstract] (173) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
[Abstract]Objective: To screen specimens with high qPCR positive rates based on HE histopathological characteristics for the rapid, accurate, and economical diagnosis of pulmonary tuberculosis. Methods: A retrospective analysis was conducted on the clinical data and CT findings of 189 patients with pulmonary granulomatous diseases. Formalin-fixed paraffin-embedded(FFPE) specimens were initially screened by Hematoxylin and Eosin (H&E) staining, followed by Ziehl-Neelsen (Z-N) staining and qPCR assay for further verification. Results: 1) Based on CT Findings, 189 specimens were divided into two groups: the peripheral nodular group predominantly showed hilar and mediastinal lymphadenopathy(87/149, 58.4%), lobulation sign (66/149, 44.3%), and spiculation sign (63/149, 42.3%); the central mass group mainly exhibited bronchial obstruction (31/40, 77.5%) and atelectasis (29/40, 72.5%). These findings were often indistinguishable from neoplastic lesions, leading to diagnostic delays.2) HE staining results from 95 confirmed pulmonary tuberculosis specimens revealed that the percentage of necrotic area≥25% (χ2 = 41.649, P = 0.000) and granuloma diameter≥8 mm (χ2 = 8.071, P = 0.004) were correlated with qPCR positivity. 3) Binary logistic regression analysis showed that the percentage of necrotic area and granuloma diameter in pulmonary tuberculosis were independent predictors of qPCR positivity(OR =1.324, 95%CI:1.202-1.460, P＜0.001; OR =0.265, 95%CI:0.164-0.429, P＜0.001). For FFPE specimens of pulmonary tuberculosis, the area under the curve (AUC), sensitivity, and specificity for measuring necrotic area percentage and granuloma diameter were 0.794/0.600, 78.2%/88.5%, and 78.9%/43.7%, respectively. Conclusion: When CT findings of peripheral nodules show hilar and mediastinal lymphadenopathy, lobulation sign, spiculation sign, they are more likely to delay diagnosis of granulomatous diseases such as pulmonary tuberculosis. The measurement of necrotic area and granuloma diameter can improve the sensitivity of qPCR detection. Preliminary screening with HE staining to select high-quality specimens for testing can enhance the accuracy of tuberculosis diagnosis.

A case report of secondary carina reconstruction under uniportal video-assisted thoracic surgery

ZHU Hongyu

Available online:August 25, 2025, DOI:

[Abstract] (201) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
【Abstract】 Objective: To explore the technical feasibility and clinical value of Uni-VATS (Uniportal Video-Assisted Thoracoscopic Surgery) in complex airway reconstruction. Methods: A 71-year-old patient presented with an isolated bronchial lesion in the posterior segment of the left lower lobe, with no significant invasion observed in either lung. After comprehensive risk assessment and perioperative preparation, the patient underwent a Uni-VATS thoracoscopic left lower lobe posterior segment sleeve resection combined with secondary carina reconstruction. Upon pathological confirmation of malignancy, a systematic lymphadenectomy was performed. To prevent postoperative complications, the anastomotic site was circumferentially wrapped using autologous tissue. Postoperative evaluation of therapeutic efficacy was conducted using bronchoscopy and imaging studies. Results: The surgical procedure was successfully completed with an operative time of 150 minutes and an intraoperative blood loss of 50 ml. Postoperative bronchoscopy showed good secondary carina reconstruction, and no anastomotic fistula occurred. The postoperative pathology confirmed negative margins, and the patient was extubated on the 5th day after the operation and discharged smoothly on the 6th day. This was confirmed as the first case of similar surgery in Jiangsu Province. Conclusion: Uni-VATS enables safe and efficient segmental sleeve resection and secondary carina reconstruction, demonstrating feasibility in complex airway reconstruction. Compared with conventional surgical approaches, Uni-VATS balances oncological radicality with lung function preservation, offering an innovative and minimally invasive solution for localized airway tumors. This case provides critical practical evidence for the extension of Uni-VATS to highly complex procedures, supporting its role in facilitating rapid patient recovery. Given these advantages, Uni-VATS holds clinical value for broader application and dissemination. Key words：Secondary carina reconstruction; Sleeve resection; Uniportal video-assisted thoracic surgery

A comparative study of maximal wall thickness and anatomical parameters of left ventricular outflow tract for evaluating myocardial fibrosis in hypertrophic cardiomyopathy

SHI Xiayun, Yin Fan, Liu Wangyan, XU Yi, Wang Yunfei

Available online:August 25, 2025, DOI:

[Abstract] (187) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
[Abstract] Objective: To comparatively explore the value of left ventricular end-diastolic maximal wall thickness (MWT) and anatomical parameters of left ventricular outflow tract (LVOT) for evaluating myocardial fibrosis in hypertrophic cardiomyopathy (HCM) by cardiac magnetic resonance (CMR) and propose a prediction model. Methods: Seventy-seven HCM patients who underwent CMR examination were retrospectively analyzed. CMR data included partial anterior mitral leaflet length and total anterior mitral leaflet length. During end-diastole and end-systole, the diameter of LVOT and the thickness of basal anteroseptal were measured. Additionally, left ventricular end-diastolic MWT was collected and the percentage of late gadolinium enhancement (LGE%) was analyzed. LGE% was used to assess myocardial fibrosis. Seventy percent of the samples selected randomly by statistical software were assigned to the derivation cohort for establishing a prediction model of LGE% through univariable and multivariable analysis. The remaining thirty percent of the samples served as the internal validation cohort, and parameters of echocardiogram of all patients were used for external validation to assess the accuracy of the prediction model. Receiver operating characteristic curves were plotted, and the predictive efficacy of the prediction model was determined by calculating the area under the curve. The sensitivity and specificity of the prediction model were also evaluated. Results: In the derivation cohort, multivariable analysis indicated that MWT was an independent predictor of LGE% with the linear equation LGE% = -10.009 + 0.832 × MWT (r = 0.466, P < 0.001), while no anatomical parameters of LVOT were correlated with LGE%. In the validation cohort, there was no statistical difference between MWT measured by echocardiogram and MWT measured by CMR. Additionally, the predicted values from both internal and external validations showed no statistical difference from LGE%. The accuracy of predicting LGE%≥15% were 82.6% with a cutoff of 30mm for MWT measured by CMR and 81.7% with a cutoff of 25mm for MWT measured by echocardiogram respectively. Conclusion: When evaluating myocardial fibrosis in HCM, MWT has more predictive value than anatomical parameters of LVOT.

Clinical Study on a New L5 Entry Point for Pedicle Screw Placement

XuYinyang, FuJiaju, LiQingqing, SuiTao

Available online:August 25, 2025, DOI:

[Abstract] (169) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective：This study aimed to improve the L5 pedicle screw placement technique by proposing a novel entry point and validating its feasibility and accuracy compared with the traditional Magerl method.?Methods：Sixty patients requiring L5 pedicle screw fixation at the First Affiliated Hospital of Nanjing Medical University were enrolled and divided into two groups: the novel group (30 cases, 60 screws) and the traditional Magerl group (30 cases, 60 screws). Screw placement accuracy was evaluated using the Gertzbein and Robbins classification system. Outcomes including satisfactory screw placement rate, intraoperative radiation dose, operative time, blood loss, and postoperative nerve root injury symptoms were compared between the two groups.?Results：The novel group demonstrated a significantly higher satisfactory rate (95%) compared to the traditional group (80%，P?= 0.013). No significant intergroup differences were observed in operative time (183.93±40.00 vs. 193.33±55.05 min, P=0.452), intraoperative blood loss (334.09±218.43 vs. 318.52±253.87 mL, P=0.8), fluoroscopy exposure (88.72±42.52 vs. 106.09±43.10mGy·cm2, P=0.122). No neurological complications occurred in either group. Conclusion：The novel L5 entry point significantly improved screw placement accuracy (95% vs. 80%,?P?= 0.013) without increasing surgical risks, demonstrating potential for clinical application.

EZH2 promotes colorectal cancer proliferation, invasion, and migration by up-regulating the FAK/F-actin/ROS pathway

武雪亮

Available online:August 08, 2025, DOI:

[Abstract] (196) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Abstract: Objective To investigate the regulatory effect of EZH2 on the FAK/F-actin/ROS pathway, and analyze its effects on the proliferation, invasion, and migration of colorectal cancer cells. Methods Twenty-four subcutaneous transplanted tumor models of nude mice were divided into the EZH2 NC group, EZH2 mimic group, EZH2 NC+ cytochalasin D group, and EZH2 mimic+ cytochalasin D group with 6 mice in each group. The tumor growth was observed after 14 days of incubation. After culture of human CRC cell lines SW480 and SW620 cells, SW480 cells were divided into 4 groups of a, b, c, and d by liposome transfection method: EZH2 NC was group a, EZH2 mimic was group b, EZH2 NC added cytochalasin D intervention was group c, and EZH2 mimic added cytochalasin D intervention was group d. SW620 cells were divided into groups e, f, g, and h, and the cell grouping treatment was the same as that of SW480 cells. Western blot assay was used to detect the expression of FAK/F-actin/ROS pathway-related proteins in SW480 cells of each group, and immunofluorescence staining was used to observe the expression and distribution of F-actin. Cell scratch assay was used to detect the migration ability of two kinds of cells, and Transwell migration assay was used to detect the migration ability of two kinds of cells. CCK-8 assay was used to detect the activity of the two cells. Results The tumor volume of the EZH2 mimic group was significantly larger than that of the EZH2 NC group (P<0.05), and the tumor volume intervened by cytochalasin D was significantly reduced compared with that before (P<0.05), and there was no significant difference between the two groups (P>0.05). The protein expression levels of EZH2, p-FAK, p-Paxillin, NOX2, NOX4, and p-JNK in the EZH2 mimic group were significantly higher than those in the EZH2 NC group (P<0.05), and the protein expression level of RUNX3 was slightly lower than that in the EZH2 NC group (P<0.05). The number of F-actin distributions, migration capacity, and cell viability were increased. After cytochalasin D intervention, the protein expression levels of EZH2, p-FAK, and p-Paxillin were not significantly different from before (P>0.05), the protein expression levels of NOX2, NOX4, and p-JNK were significantly lower than before (P<0.05), and the protein expression level of RUNX3 was significantly higher than before (P<0.05). There was no significant difference between the two groups (P>0.05), and the F-actin distribution number, migration ability, and cell viability were reduced, with no significant difference between the two groups (P>0.05). Conclusion EZH2 can promote the proliferation, invasion and metastasis of colorectal cancer cells by up-regulating FAK/F-actin/ROS pathway activity.

Analysis of pathogenic characteristics and prognostic risk factors in 916 patients with positive catheter culture

JIN Fei, WANG Jue, XIA Wen-ying, NI Fang

Available online:August 08, 2025, DOI:

[Abstract] (161) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To investigate the distribution, drug resistance of pathogens and prognostic risk factors in patients with positive catheter culture, and to provide pathogenic basis and preventive measures for clinical catheter-related infection. Methods: The etiological data of patients with positive catheter culture in the First Affiliated Hospital of Nanjing Medical University from 2018 to 2023 were retrospectively analyzed, and the clinical data of the patients with the top three pathogens were collected to analyze the risk factors affecting the prognosis. Results: The overall positive rate of catheter culture was 14.7% (1240/8407). After removing the same pathogens isolated from the same patient, a total of 1096 strains of pathogens were isolated from 916 patients, 48.7% of which were gram-negative bacteria, mainly Klebsiella pneumoniae, Acinetobacter baumannii and Escherichia coli. Gram-positive bacteria accounted for 39.2%, mainly Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus. The resistance rate of Klebsiella pneumoniae to most antibiotics was higher than that of Escherichia coli. The resistance rate of Acinetobacter baumannii to most cephalosporins and carbapenems was higher (>85.0%). The detection rates of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis were 35.6% and 92.2%, respectively. No vancomycin and linezolid resistant Staphylococcus and Enterococcus were detected. Multivariate analysis showed that male, ≥65 years old, history of dialysis, combined catheter-associated bloodstream infection and tracheal intubation were independent risk factors for prognosis in patients with catheter-associated infection (P<0.05). Conclusion: The incidence of catheter-associated infection is high, which needs clinical attention. Continuous monitoring and analysis of etiological characteristics in the local area can provide theoretical basis for clinical empirical anti-infection treatment.

Predictive value of MELD 3.0 scores for the prognosis of patients with decompensated cirrhosis

WANG Peng, ZHEN Yuanru, ZHEN Jishun

Available online:August 08, 2025, DOI:

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Objective: Comparison of the predictive performance of MELD 3.0, MELD-Na, and MELD scores in assessing the 3-month and 1-year survival prognosis of patients with decompensated cirrhosis. Methods: We conducted a retrospective analysis of clinical data from 438 patients diagnosed with decompensated cirrhosis who received either outpatient or inpatient care from January 2013 to December 2022. Based on their survival status at 3 months and 1 year, the patients were categorized into survival and death groups. The predictive value of MELD 3.0, MELD-Na, and MELD scores for 3-month and 1-year mortality was compared using receiver operating characteristic (ROC) curves, the area under the curve (AUC), calibration curves, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA). Results: At the 3-month and 1-year follow-up points, 15.53% and 26.26% of patients had died, respectively. The area under the curve (AUC) for predicting 3-month and 1-year mortality for the MELD 3.0, MELD-Na, and MELD scores were 0.859 (0.805-0.913), 0.857 (0.802-0.912), 0.856 (0.800-0.911) and 0.841 (0.796-0.886), 0.832 (0.785-0.880), 0.830 (0.782-0.878), respectively. However, the differences were not statistically significant (P >0.05). The MELD 3.0 score can increase the score range for 18.0% of patients with MELD-Na scores, and 21.5% of patients with MELD scores are reclassified into a higher score category. On the calibration curve, all three models showed similar trends between predicted and actual probabilities at both time points. In terms of predicting 3-month mortality, the NRI for MELD 3.0 compared to MELD was 0.240 (0.009-0.401), a statistically significant difference (P = 0.032). For predicting 1-year mortality, the NRI and IDI for MELD 3.0 compared to MELD were 0.201 (0.079-0.401) and 0.032 (0.006-0.057), respectively, both of which were statistically significant (P < 0.05). In subgroup analyses, including male and female patients, viral and non-viral causes, and Child-Pugh Class B and C patients, no significant statistical differences were observed among the three models (P > 0.05). Conclusion: Compared to MELD or MELD-Na, MELD 3.0 demonstrates improved predictive performance, making it more effective for precise risk stratification in patients with decompensated cirrhosis.

The Value of Ultrasound-based Nomogram for Predicting Malignancy in Small and Non-parallel Breast Lesions

DING Zhiying, ZONG Qingqing, LI Ao

Available online:August 08, 2025, DOI:

[Abstract] (201) [HTML] (0) [PDF 0.00 Byte] (0)

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Background: This study was conduct to develop a predictive model for differentiating between benign and malignant Breast Imaging Reporting and Data System (BI-RADS) 4A, 4B breast lesions, which featured non-parallel and small on ultrasound. Methods: For this retrospective study, 327 patients were recruited in the First Affiliated Hospital of Nanjing Medical University from June 2020 to May 2024. Patients were divided into training set (N=229) and validation set (N=229) at the ratio of 7：3. Logistic regression analysis was used to identify risk factors and develop a predictive model to differentiate benign and malignant breast lesions. The effectiveness of the model was evaluated by the receiver operating characteristic (ROC) curve and the decision curve analysis (DCA). Results: The proportion of malignant tumors was 36.1% (118/327) in this study. With univariate and multivariate analyses, a predictive model compromised age, margin, elasticity assessment and US-BI-RADS was built and shown as a nomogram. The area under the ROC curve was 0.846 and 0.798 in the training and test cohort, respectively. DCA demonstrated that the model could achieve benefits for patients. Moreover, the study stratified the breast lesions into three risk groups according to the risk scores calculated by the nomogram. Patients were regarded as “high risk” with a risk score more than or equal to 0.7, and as “low risk” with a risk score less than or equal to 0.1. The proportion of malignancy was 8.8% and 82.1% in low- and high-risk group. Conclusion: The study established a predictive model based on clinical and ultrasound features. The model could effectively differentiate benign and malignant non-parallel and small BI-RADS 4A, 4B breast lesions. This model can distinguish different risks, with a lower probability (8.8%) of malignant breast lesions in the low-risk group and a higher probability (82.1%) in the high-risk group.

Predictive value of serum PDCD4 for Neurological deficits and Prognosis in Patients with Acute Ischemic Stroke

Chen Weiguan, Zhou Sanlian, Guo Yu, Tang Liqiao, Zhang Dongmei

Available online:July 11, 2025, DOI:

[Abstract] (166) [HTML] (0) [PDF 0.00 Byte] (0)

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[Abstract] Objective: To investigate the relationship between serum programmed cell death factor 4 (PDCD4) levels and neurological deficits and prognosis in patients with acute ischemic stroke (AIS). Methods: A cohort of 110 AIS patients from the Department of Neurology, Affiliated Hospital 2 of Nantong University, admitted between June 2023 and March 2024, was retrospectively included as the study subjects. Based on the National Institutes of Health Stroke Scale (NIHSS) scores, patients were divided into a mild group (n=70) and a moderate to severe group (n=40). According to the modified Rankin Scale (mRS), patients were further divided into a good prognosis group (n=69) and a poor prognosis group (n=41). The demographic data (Age, Gender, history of diabetes, etc.) and clinical data (Neutrophil count, lymphocyte count, Neutrophil/lymphocyte ratio, etc.) of each group of patients were collected. Serum PDCD4 levels were measured using an Enzyme-linked immunosorbent assay (ELISA). The association between PDCD4 levels and NIHSS scores, mRS scores, and other inflammatory markers was analyzed in this study. Logistic regression analysis was used to infer the risk factors for moderate to severe neurological deficits and poor prognosis in AIS patients. Receiver operating characteristic (ROC) curves were used to evaluate the effectiveness of serum PDCD4 levels in predicting the degree of neurological deficit and prognosis of AIS patients. Results: In comparison to individuals with mild neurological deficits and good prognosis, those with moderate to severe neurological deficits and poor prognosis had considerably greater serum PDCD4 levels. PDCD4 levels showed a positive correlation with NIHSS scores, mRS scores, Hs-CRP, Procalcitonin, and Neutrophil/lymphocyte ratio. After controlling for confounding factors, PDCD4 remained an independent risk factor for acute ischemic stroke (AIS). Serum PDCD4 has a strong predictive value for neurological deficits and prognosis in individuals with AIS, according to ROC curve analysis. Conclusions: In AIS patients with moderate to severe neurological deficits and poor prognosis, serum PDCD4 levels are significantly elevated and can serve as an independent predictor of neurological deficits and prognosis.

Efficacy and safety of CT-guided percutaneous liquid nitrogen cryoablation for the treatment of lung malignancies in the elderly

Zhou yong, liu yanhu, li yadong, zhen fuxi

Available online:July 11, 2025, DOI:

[Abstract] (220) [HTML] (0) [PDF 0.00 Byte] (0)

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Abstract: Objective: To investigate the efficacy and safety of CT-guided percutaneous liquid nitrogen cryoablation technique in the treatment of lung malignant tumors in the elderly. The focus is on analyzing the differences in the efficacy of this technique in different lesion types and treatment objectives (radical vs. palliative), as well as its impact on patients' quality of life and postoperative recovery. Methods: The clinical data of 56 elderly patients with lung malignant tumors who underwent CT-guided percutaneous liquid nitrogen cryoablation from January 2023 to December 2023 at the Second Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. The patients were ≥65 years old, including 44 males and 12 females, with a mean age of 76.4±8.3 years. They were divided into radical ablation group (49 cases) and palliative ablation group (7 cases) according to the purpose of treatment. All patients underwent detailed imaging examination and functional assessment before surgery, and the lesions were precisely localized under CT guidance using a cryoablation needle during the procedure. Postoperative follow-up was performed at 1, 3, and 6 months, respectively, to assess the ablation efficacy by the modified solid tumor efficacy evaluation criteria (mRECIST), and to record the intraoperative and postoperative complication rates, pain scores (VAS), changes in C-reactive protein (CRP), and quality of life scores (ECOG). Results: All 56 patients successfully completed the procedure with no serious intraoperative complications. Postoperatively, 16 cases (28.57%) developed pneumothorax, including 10 cases with mild pneumothorax (17.9%) and 6 cases with large pneumothorax (10.7%). All pneumothorax cases were treated conservatively or with chest tube drainage and recovered well. The postoperative pain scores were 4.5±1.2 on day 1, significantly decreased to 2.5±0.8 by 1 week, and further reduced to 1.3±0.5 at 1 month. CRP levels significantly increased to 45±10 mg/L on postoperative day 1, decreased to 20±8 mg/L at 1 week, and returned to near baseline levels (12±4 mg/L) at 1 month. Curative ablation group: The complete response (CR) rate at 1 month was 100%, 91.83% at 3 months, and 83.67% at 6 months, with a local recurrence rate of 16.33% (8/49). Palliative ablation group: The partial response (PR) rate at 1 month was 100%, decreased to 85.71% at 3 months, and further declined to 57.14% at 6 months. One patient in this group developed disease progression (PD) at 6 months. All patients showed improvement in quality of life, with ECOG scores decreasing from an average of 3.2±0.6 before surgery to 2.1±0.5 at 1 month and further improving to 1.3±0.4 at 6 months. Most patients were discharged within 3-5 days after the procedure, with a rapid recovery and no significant long-term decline in quality of life. Conclusion: CT-guided percutaneous liquid nitrogen cryoablation is a safe and effective minimally invasive treatment, especially for elderly lung cancer patients who cannot tolerate surgery. The technique has the advantages of less trauma, less pain, faster recovery, and significant short-term efficacy, especially in radical ablation with higher complete remission rate. Palliative ablation can effectively relieve symptoms and improve quality of life, but the long-term results may need to be further optimized in combination with other treatments. This study provides an important reference for the individualized treatment of elderly lung cancer patients and lays the foundation for the future application and development of cryoablation technology.

Construction and identification of an chronic antibody-mediated rejection model of renal graft in mice

Yang Zexin, Zhang Junqi, Gui Zeping, Ni Bin, Zheng Ming, Shen baixin, Wang Zijie

Available online:July 11, 2025, DOI:

[Abstract] (196) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: Construction and identification of an chronic antibody-mediated rejection model of renal graft in mice. Methods: Male 6-8 weeks old BALB/cH2d and C57BL/6H2b mice were used as experimental mice and randomly divided into following groups:①The syngeneic control group (SYN14D): no skin transplantation was performed，only C57BL/6H2b to C57BL/6H2b kidney transplantation was conducted，the transplanted kidney was removed 14 days later; ②T cellular-mediated rejection group (TCMR14D): no skin transplantation was performed，only BALB/cH2d to C57BL/6H2b kidney transplantation was conducted，the transplanted kidney was removed 14 days later; ③acute antibody-mediated rejection group (aABMR，BST5D+KT5D): full-thickness back skin transplantation was performed on C57BL/6 mice for 5 days (BALB/CH2d→C57BL/6H2b)，followed by BALB/cH2d to C57BL/6H2b kidney transplantation，the transplanted kidney was removed 5 days later; ④chronic antibody-mediated rejection group 1 (cABMR，TST2D+KT14D): tail skin transplantation was performed on C57BL/6 mice for 2 days(BALB/CH2d→C57BL/6H2b)， followed by BALB/cH2d to C57BL/6H2b kidney transplantation， the transplanted kidney was removed 14 days later; ⑤cABMR group 2 (TST3D+KT14D): tail skin transplantation was performed on C57BL/6 mice for 3 days(BALB/CH2d→C57BL/6H2b)， followed by BALB/cH2d to C57BL/6H2b kidney transplantation， the transplanted kidney was removed 14 days later; ⑥cABMR group 3 (TST4D+KT14D): tail skin transplantation was performed on C57BL/6 mice for 4 days(BALB/CH2d→C57BL/6H2b)， followed by BALB/cH2d to C57BL/6H2b kidney transplantation， the transplanted kidney was removed 14 days later. Pathological staining and Banff score were performed to diagnose the transplanted kidneys，survival curves were plotted，the levels of complement fragment C3d deposition，peripheral blood IgG class donor-specific antibody (DSA)，serum creatinine (Cr) and serum urea nitrogen (BUN) were detected in transplanted kidney tissues，the expression of CD3+T cells，CD19+B cells，F4/80 labelled macrophages，Ly6G labelled myeloid cells was detected. Results: The pathological injury of cABMR group 1 met the diagnostic criteria of ABMR，the postoperative survival rate was 80%，the expression of CD3+T cells was not obvious，so cABMR group 1 was subsequently selected as the model of cABMR for experimental demonstration. Compared with SYN14D，the C3d expression of cABMR was significantly enhanced，the average fluorescence intensity of peripheral blood IgG class DSA was significantly higher，peripheral blood serum Cr and BUN levels were significantly higher. Compared with aABMR，cABMR model of transplanted kidneys showed peritubular capillary haemorrhage and dilatation，single nucleus infiltration seen in the glomeruli，more typical tubular damage and brush border detachment in the tubules， higher Banff scores，significantly more positive areas of C3d expression，significantly higher mean fluorescence intensity of peripheral blood IgG class DSA，significantly higher peripheral blood serum Cr and BUN levels. Compared with aABMR，cABMR group renal interstitial and peritubular capillary CD19+B cells and CD3+T cells infiltration were not significant，renal interstitial F4/80 labelled macrophage and Ly6G labelled myeloid cell infiltration were more significant. Foxp3 and IL-10 expression was significantly reduced in cABMR model， infiltration of IL-1β，IL-6，TNF-α and CCL2 inflammatory cytokines was significantly increased in cABMR model. Conclusion: Our group constructed a cABMR model in which the survival cycle was prolonged，on the basis of which the effects of drug interventions on the prognosis of ABMR patients can be evaluated，which has high clinical application value.

Correlation between frailty and severity of coronary syndrome in elderly patients

Xu Yunfan, He YuLi, Xia Yudong

Available online:July 11, 2025, DOI:

[Abstract] (195) [HTML] (0) [PDF 0.00 Byte] (0)

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[Abstract] Objective：To investigate the correlation between frailty status and disease severity in elderly patients with coronary artery syndrome (CAS) and analyze risk factors in this population. Methods：This analytical cross-sectional study included 187 elderly patients diagnosed with CAS at the First Affiliated Hospital of Nanjing Medical University from September 2023 to September 2024, who underwent coronary angiography and intervention. Participants were categorized into non-frail, pre-frail, and frail groups using the FRAIL Scale. Coronary lesion severity was assessed using the Gensini score, and cardiac structure/function was evaluated via echocardiography. A Gensini score >43 (defined by the tertile method) was classified as high. Risk factors were screened using univariate analysis and further analyzed via multivariate logistic regression. Restricted cubic splines were applied to test nonlinear relationships. Results : The cohort comprised 74 non-frailty, 72 pre-frailty, and 41 frailty cases. Pre-frailty and frailty groups had higher mean ages and increased proportions of NYHA class III cardiac function (P<0.05). Atrial fibrillation and low glomerular filtration rates were more prevalent in frailty and pre-frailty groups compared to non-frailty (P<0.05). High Gensini scores occurred more frequently in frailty (36.6%) and pre-frailty (33.3%) groups than in non-frailty (20.3%), though differences were not statistically significant (P>0.05). Left atrial diameter progressively increased across non-frailty (36 mm), pre-frailty (38 mm), and frailty (40 mm) groups (P<0.05). Left ventricular end-diastolic diameter was larger in pre-frailty (50 mm) versus non-frailty (47.5 mm, P<0.05). Segmental wall motion abnormalities were higher in frailty (24.4%) and pre-frailty (38.9%) groups than in non-frailty (17.6%, P<0.05). Logistic regression identified hypertension, diabetes, fasting glucose, and segmental wall motion abnormalities as positively correlated with high Gensini scores (all P<0.05), while BMI showed a negative correlation (OR=0.872, 95% CI: 0.775–0.980, P=0.021). Spearman analysis revealed a weak negative correlation between BMI and Gensini scores (R=-0.161, P=0.028). Restricted cubic splines indicated no significant nonlinear relationships between BMI and Gensini scores overall or within frailty subgroups (P>0.05). Conclusion :Frailty status was not significantly associated with coronary lesion severity in elderly patients with coronary syndrome. However, frailty and pre-frailty were linked to increased cardiac structural abnormalities and impaired contractile function.

Research Progress on the Biological Characteristics and Therapeutic Strategies of Alpha-Fetoprotein-Producing Gastric Cancer

maling

Available online:July 11, 2025, DOI:

[Abstract] (170) [HTML] (0) [PDF 0.00 Byte] (0)

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As a common malignant tumor, the incidence and mortality rate of gastric cancer are still high in the world, among which the disease burden in China is significantly higher than the global average, and the mortality rate ranks third among malignant tumors in China. AFPGC is a special subtype of gastric cancer characterized by abnormally elevated serum AFP levels or positive AFP expression in tumor tissues detected by immunohistochemistry. The incidence of AFPGC in China accounts for approximately 2.3% to 4.6% of gastric cancer cases. Compared with conventional gastric cancer, AFPGC is more prone to distant metastasis, particularly liver metastasis, and has a poorer prognosis. Currently, there are no standardized treatment guidelines for AFPGC, and its management primarily relies on conventional gastric cancer treatment strategies. Research is ongoing to explore the differences between the occurrence and development of this tumor and general gastric cancer, as well as the related clinical features and efficacy of therapy. This article mainly reviews the biological features, clinicopathological characteristics and current treatment explorations of AFPGC in domestic and foreign research.

Research Progress of Multimodal Imaging Technology in Prostate Biopsy

guyingying

Available online:July 04, 2025, DOI:

[Abstract] (176) [HTML] (0) [PDF 0.00 Byte] (0)

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Prostate cancer is one of the most common malignant tumors in men. Prostate biopsy can directly obtain prostate tissue samples for pathological analysis to preoperatively diagnose or exclude prostate cancer. However, as an invasive examination method, it inevitably causes complications such as bleeding, infection, vagal reflex, and acute urinary retention. Therefore, reducing unnecessary biopsies and improving biopsy techniques are crucial. Currently, with the development of various imaging technologies and artificial intelligence, the techniques for guiding prostate biopsies are gradually improving. This article aims to elucidate the advantages and disadvantages of prostate biopsy techniques under different guidance methods and the research progress of new technologies.

Clinical Study on the Diagnostic Value of Hemopexin Multiplied by ApoB within Patients with Coronary Heart Disease

Jin Shijia, Cai Wenyu, Zhang Dengqing, Chen Zimin, Yang Jie, Zeng Jianxin, Zhang Yifan

Available online:July 04, 2025, DOI:

[Abstract] (167) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective Early identification of coronary artery disease (CAD) is crucial for improving prognosis. This study investigated the relationship between an oxidative stress-lipid metabolism composite biomarker (Hpx·apoB) and CAD, and evaluated its value for clinical risk stratification. Methods The study utilized liquid chromatography-tandem mass spectrometry (LC-MS/MS) to quantify plasma Hpx levels in 107 CAHD patients and 33 controls without CAHD, while also gathering relevant clinical data. We analyzed the correlation between Hpx·apoB and CHD and developed a clinical predictive model. Predictive performance was assessed using receiver operating characteristic (ROC) curve analysis and net reclassification improvement (NRI). Results The HPX·apoB levels were markedly higher in the CAHD group compared to the control group (P<0.01). Significant increases in Hpx·apoB were observed in patients with acute myocardial infarction, acute coronary syndrome, and multivessel diseased group (all P<0.01). Multivariate analysis identified Hpx·apoB as an independent risk factor for CAHD (OR=2.554, 95% CI: 1.336-4.881, P<0.01). ROC analysis demonstrated: Standalone predictive AUC=0.667;Combined with CRP+LDL-C: ΔAUC=+0.106 (P<0.05), NRI=15.6% (P<0.05);Integrated with Framingham score: ΔAUC=+0.076 (P=0.139), NRI=27.0% (P<0.01);Integrated with SCORE model: ΔAUC=+0.142 (P=0.093), NRI=37.6% (P<0.001). Further subgroup analysis revealed that the predictive strength of HPX·apoB for CAHD was particularly pronounced in males, smokers, and individuals with renal impairment(P<0.05). Conclusion Hpx·apoB, as a composite biomarker reflecting oxidative stress and lipid metabolism, independently predicts CAD risk. Its combination with clinical risk scores significantly improves risk prediction performance.

The mechanism study of Wnt/PCP pathway and extracellular matrix mechanical signaling regulating CNN2 to promote collective migration of hepatocellular carcinoma cells.

Liu Yiwei, Wu Xiaofeng

Available online:July 04, 2025, DOI:

[Abstract] (154) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: The research is focused on the biological mechanisms and roles of the Wnt/PCP pathway and extracellular matrix (ECM) regulation in promoting collective migration of liver cancer cells via CNN2 (Calponin2).

Biological characterization and biofilm removing ability of the broad-spectrum Pseudomonas aeruginosa phage PAPX

Xinjie Wang, Li Ba, Yu Rong, Shuhua Chen, Genyan Liu

Available online:July 02, 2025, DOI:

[Abstract] (188) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: Pseudomonas aeruginosa is a Gram-negative opportunistic pathogenic bacterium capable of causing various infectious diseases including pneumonia, urethritis, keratitis, and sepsis. The current misuse of antibiotics and the increasing annual isolation of multidrug-resistant (MDR) strains have posed significant challenges to clinical treatment. Recent studies highlight phage therapy as a promising therapeutic strategy. Our study aims to isolate and purify novel P. aeruginosa bacteriophages. Methods: Bacteriophages were isolated from campus lake water, followed by genome sequencing and biological characterization of purified phages. In vitro antibacterial assays including growth inhibition curves and biofilm eradication experiments were conducted. Results: A novel P. aeruginosa phage named PAPX was successfully isolated from campus pond water. Genomic analysis revealed 98% identity with Pseudomonas phage Epa12, classifying it within the Pbunavirus genus. Transmission electron microscopy demonstrated its myoviral morphology featuring an icosahedral head (～90 nm diameter) and a contractile tail (～50 nm length, 26 nm diameter). Biological characterization showed strong lytic activity against 17 of 24 clinical strains. In vitro experiments confirmed its ability to suppress bacterial growth during early proliferation phase and effectively eradicate P. aeruginosa biofilms. Conclusion: The successful isolation and characterization of phage PAPX, validated through biological profiling and in vitro assays, demonstrates its promising clinical potential for treating P. aeruginosa infections, particularly in combating antibiotic-resistant strains and biofilm-associated infections.

The functional and mechanistic role of ST3GAL3 in esophageal squamous cell carcinoma

SUN Chenchen, KONG Lingjie, ZHU Zihao, HAO Xin, HOU Sicong

Available online:July 02, 2025, DOI:

[Abstract] (177) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To explore the expression of β-galactoside-α2,3-sialyltransferase-3 (ST3GAL3) in esophageal squamous cell carcinoma (ESCC) and its relationship with patient prognosis and correlation with clinicopathologic characteristics, as well as to investigate the function and molecular mechanism of ST3GAL3 in cell proliferation and migration. Methods: The mRNA and protein expression of ST3GAL3 in ESCC and paired normal tissues were examined by GEO database, qRT-PCR and immunohistochemistry (IHC), respectively. Additionally, the relationship between ST3GAL3 expression and patient prognosis, as well as its correlation with clinicopathological characteristics, was analyzed. We analyzed the expression of ST3GAL3 gene in different ESCC cell lines by CCLE database, and established ST3GAL3-WT and its catalytic site mutant overexpression, as well as ST3GAL3 knockdown and its rescue cells. The cell proliferation, migration and spreading abilities on ECM was assessed using cell proliferation assay and Transwell assay, respectively. The effect of ST3GAL3 on the expression of proteins related to adhesion signaling and the α2,3-sialylation of Integrin α5 and β1catalyzed by ST3GAL3 was detected by Western blot (WB) and lectin-immunoprecipitation (Lectin-IP), respectively. Results: The mRNA expression level of ST3GAL3 was significantly higher in the ESCC tissues than in the normal tissues (P < 0.01). The protein expression level of ST3GAL3 was significantly upregulated in the ESCC specimens compared with the paired paracancer tissues, and the high expression of ST3GAL3 in ESCC was positively correlated with patient poor prognosis and TNM stage (P = 0.004), T classification (P < 0.001), and lymph node metastasis (P = 0.017). ST3GAL3 promoted ESCC cell migration on ECM in a catalytic function-dependent manner. Furthermore, ST3GAL3 mediated cell spreading and adhesion signaling under ECM-coating conditions. Moreover, ST3GAL3 catalyzed the α2,3-sialylation of Integrin α5 and β1. Conclusion: The expression of ST3GAL3 was increased in the ESCC, and its high expression was positively correlated with patient poor prognosis and TNM stage, T classification, and lymph node metastasis. ST3GAL3 enhanced ESCC cell spreading and adhesion signaling on ECM, therefore promoting ECM-mediated cell migration, possibly through the α-2,3 sialylation of adhesion receptors such as Integrin α5 and β1.

A Case Report on Recurrent Sinonasal Adenoid Cystic Carcinoma with Challenging Pathological Diagnosis

王莹, Li Hai, Shi Ya Wen, Wu Zhong Fei, Li Song, 陆美萍, Yin Min

Available online:July 02, 2025, DOI:

[Abstract] (164) [HTML] (0) [PDF 0.00 Byte] (0)

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Adenoid Cystic Carcinoma (ACC) is a malignant epithelial neoplasm originating in the salivary glands, marked by indolent growth, pronounced local recurrence, and neurotropic invasion, frequently exhibiting perineural spread and posing significant diagnostic challenges in differentiation from other salivary gland tumors. This report presents a case of a recurrent, low-grade sinonasal malignancy with a challenging pathological diagnosis, ultimately confirmed as ACC through fluorescence in situ hybridization (FISH). A comprehensive review of pertinent literature is included to outline the clinical and pathological features of sinonasal ACC and distinguish it from other sinonasal malignancies, aiming to enhance clinical recognition and facilitate diagnosis in complex cases.

Analysis of clinical characteristics of sepsis-associated encephalopathy patients with Gram-negative bacilli infection

Zhu Yi, Zhang Zhongman, Chen Jiahui, You Xiaodong, Li Wei, Chen Xufeng

Available online:July 02, 2025, DOI:

[Abstract] (173) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: Gram-negative (G-) bacterial bloodstream infections are an important cause of sepsis, and sepsis-associated encephalopathy (SAE) is a common complication in sepsis patients. In this study, the incidence of SAE and the clinical outcome of these patients were summarized by reviewing the data of patients with G- bacterial bloodstream infection. Methods: The data of patients treated in the Emergency Medicine Center of the First Affiliated Hospital of Nanjing Medical University from January 2021 to June 2024 were reviewed. Patients with first blood culture positive G- bacteria after emergency visit, the patients were divided into SAE and non-SAE groups based on the SAE, and the propensity score matching (PSM) was used to plot the 30-day Kaplan-Meier (K-M) survival curves after adjusting for confounding factors between SAE and non-SAE groups. Results: A total of 207 patients were included in the study, and 92 (44.4%) patients experienced SAE with lower 30-day survival in the SAE group than in the non-SAE group (69.6% VS 97.4%, p <0.001). After matching the baseline data of the SAE and non-SAE groups using the PSM method, the 30-day survival rate was even lower in the SAE group (72.3% VS 100.0%, p <0.001), longer ICU stay [5 (0, 11) VS 0 (0, 5), p <0.001], proportion of invasive mechanical ventilation (MV) (40.0% VS 1.5%, p <0.001), proportion of continuous renal replacement therapy (CRRT) (32.3% VS 4.6%, p <0.001), the proportion of vasoactive drugs used (50.8% VS 15.4%, p <0.001), the K-M curve shows that the 30-day survival status of the SAE group was significantly worse than that of the non-SAE group (HR = 8.730, 95%CI: 3.443-22.14, p <0.001). Conclusions:SAE is a common complication in septic patients with G- bloodstream infections and causes a poor prognosis.

Cheese Intake and the Risk of Healthspan Terminated: Association and Metabolic Mechanisms

Yifan Wang, Longhu Sun, Xiaoyu Zhao, Shuang Liang, Qingyin Bu, Qian Wang, Na Qin, Yue Jiang

Available online:July 02, 2025, DOI:

[Abstract] (174) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: Healthspan refers to the length of time an individual maintains good physical and mental health without serious chronic diseases or functional impairments. In recent years, the role of dietary factors in extending healthspan has received extensive attention. Cheese is considered as a healthy food but its effect on healthspan and remains unknown. This study aims to clarify the association between cheese intake and healthspan, and and further explore the underlying metabolic mechanisms. Methods: This study employed a nested case-control design and defined healthspan terminated (HST) based on eight reported sub-events of HST in UK Biobank (UKB). 93 214 HST participants and 279 642 controls were included. Conditional logistic regressions was used to evaluate the association between cheese intake and HST, and Mendelian randomization (MR) was used to assess the causal effect. Furthermore, we explored the mediating role of metabolites in this relationship by Two-step MR and observational analysis. Results: Cheese intake is a protective factor for healthspan (Ptrend＜0.05). Specifically, participants with high cheese intake (>5 times/week) had a lower risk of HST (OR=0.93, 95% CI: 0.89-0.98) compared to those who never intake cheese. MR analysis confirmed this protective effect. Mediation analysis suggested that plasma high density lipoprotein cholesterol (HDL-C) and glucose mediated 6.33% and 14.82% of this effect, respectively. Conclusion: These findings suggested that cheese intake might improve the healthspan by decreasing plasma glucose and increasing plasma HDL-C. As an important component of healthy diet, cheese intake might be recommended in our daily diet structure.

IGF2BP3 Drives the Metabolic-Epigenetic Crosstalk in Triple-Negative Breast Cancer Through m6A-EP300 Axis-Mediated Lactylation Modification

wangziwen, chenrui, yanghaiyan, caimengyuan, liyixun, wukefei, wangyuxin

Available online:July 02, 2025, DOI:

[Abstract] (223) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective:?Triple-negative breast cancer (TNBC), a clinically aggressive subtype characterized by the absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression, exhibits intrinsic therapeutic resistance and a propensity for rapid progression. TNBC displays unique metabolic reprogramming marked by heightened glycolytic dependence, manifested through upregulation of glycolytic enzymes and glucose transporters, augmented glucose uptake, and excessive lactate secretion. Emerging evidence suggests that the lactate-enriched tumor microenvironment may drive malignant progression, although the precise molecular mechanisms remain incompletely understood. The transcriptional coactivator EP300 (E1A-binding protein p300), which possesses histone acetyltransferase activity, serves as a critical epigenetic mediator by coupling metabolic cues with transcriptional regulation through post-translational modifications such as acetylation and lactylation. Mechanistically, lactate-induced histone lactylation facilitates EP300 recruitment to oncogenic promoters (e.g., HIF-1α, MYC), thereby activating proliferation- and metastasis-associated signaling pathways. This study elucidates the functional impact of lactate on TNBC malignancy and unveils an m6A-dependent epigenetic mechanism through which insulin-like growth factor 2 mRNA-binding protein 3 (IGF2BP3) orchestrates metabolic reprogramming via regulation of EP300.Methods:?TNBC cells were treated with exogenous sodium lactate supplementation to investigate its oncogenic effects. Cellular proliferative capacity was systematically assessed using CCK-8 assay, while clonogenic potential was evaluated through colony formation analysis. Two-dimensional migration dynamics were quantified via scratch wound healing assay, and three-dimensional invasive potential was determined using Transwell chambers. To establish IGF2BP3-knockdown models, lentiviral-delivered shRNA constructs were employed for stable gene silencing. Histone lactylation modification levels were analyzed by Western blotting. Genome-wide identification of IGF2BP3-associated m6A targets was performed through RNA immunoprecipitation sequencing (RIP-seq) and m6A-specific methylated RNA immunoprecipitation sequencing (MeRIP-seq). Key regulatory molecules were validated at transcriptional and protein levels using quantitative reverse transcription PCR (qRT-PCR) and Western blotting, respectively.Results: Sodium lactate treatment potentiated TNBC cell proliferation and migratory capacity, with pan-lactylation levels exhibiting concentration-dependent augmentation. Mechanistic interrogation revealed that IGF2BP3 depletion markedly attenuated histone lactylation modifications. Integrative analysis of RIP-seq and MeRIP-seq datasets identified 699 candidate genes whose transcripts were both specifically bound by IGF2BP3 and harbored m6A modifications. Pathway enrichment analysis demonstrated significant association of these genes with epigenetic regulation and metabolic pathways. Spatial mapping identified substantial overlap between IGF2BP3-binding regions and m6A modification sites on EP300 transcripts. Functional validation confirmed significant downregulation of EP300 expression at transcriptional and protein levels following IGF2BP3 knockdown.Conclusion: Exogenous lactate drives TNBC malignant progression by orchestrating pan-lactylation modifications. Mechanistically, IGF2BP3 governs EP300 expression through m6A-dependent post-transcriptional regulation, thereby mediating a synergistic interplay between histone lactylation and metabolic reprogramming that ultimately propels tumor progression. These findings lay the mechanistic foundation for developing innovative therapeutic strategies targeting the metabolic-epigenetic crosstalk in TNBC.

Imaging research advances in carotid artery perivascular adipose tissue

Li Cheng

Available online:July 02, 2025, DOI:

[Abstract] (165) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Perivascular adipose tissue (PVAT) of the carotid artery is a specialized type of adipose tissue closely adjacent to the arterial adventitia, possessing unique anatomical and functional characteristics. Unlike ordinary adipose tissue, PVAT releases a variety of bioactive molecules through endocrine and paracrine mechanisms, interacting with neighboring vascular wall cells and participating in the regulation of local inflammatory responses and vascular homeostasis. The inflammatory status of PVAT is closely associated with the formation, progression, and vulnerability of carotid atherosclerotic plaques, while also playing a significant role in the development and progression of cerebrovascular diseases. In recent years, with the rapid advancement of imaging technologies, non-invasive assessment of PVAT's inflammatory status has become feasible. The application of these technologies provides new tools for the early identification of high-risk patients with cerebrovascular diseases and holds promise for optimizing preventive strategies and personalized treatment. This article systematically reviews the pathophysiological mechanisms of carotid PVAT, the latest advances in imaging assessment techniques, and their clinical application value.

Research progress on the influence of frailty assessment on clinical outcome of cardiac surgery in elderly patients and intervention method

wanghaotian

Available online:July 02, 2025, DOI:

[Abstract] (173) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Frailty is a common multi-dimensional clinical syndrome in the elderly, with diverse definitions. Most literature considers frailty as a non-specific state characterized by a decline in physiological reserves and increased vulnerability. As the number of elderly patients undergoing cardiac surgery increases, the impact of frailty on elderly patients undergoing cardiac surgery has received increasing attention from clinicians. This article briefly describes the assessment methods of preoperative frailty, reviews the impact of frailty on the clinical outcomes after cardiac surgery, such as increasing the incidence of adverse prognosis and postoperative complications, reducing the postoperative quality of life of patients, and increasing medical costs, and summarizes the intervention and management methods for elderly patients with heart disease and frailty, which is helpful to clarify the goals of intervention and treatment and can improve the clinical prognosis and quality of life of patients.

Comparison of Postoperative Survival Outcomes Between Endoscopic Submucosal Dissection and Surgical Treatment in Patients with Early Siewert Type II Adenocarcinoma of the Esophagogastric Junction

YANG Ruoyun, CHEN Han, ZHOU Xiaoying

Available online:July 02, 2025, DOI:

[Abstract] (194) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: This study compared the long-term prognosis of endoscopic submucosal dissection (ESD) versus surgical treatment in patients with early Siewert type II adenocarcinoma of the esophagogastric junction (AEGJ). Methods: A retrospective analysis was conducted on 562 patients with early Siewert type II AEGJ who underwent ESD or radical surgery at a single tertiary hospital between January 2010 and February 2021, including 393 patients treated with ESD and 169 with surgery. Propensity score matching (PSM) was applied to balance baseline characteristics. Kaplan-Meier analysis was used to compare long-term survival outcomes between the two groups. Results: Among the 562 patients, 393 received ESD and 169 underwent surgery, with a median follow-uP of 57.7 months (range: 6.2–147 months). After PSM, two balanced cohorts of 163 patients each were generated. The 5-year overall survival (OS) rates showed no significant difference between the ESD and surgery groups (92.5% vs. 90.7%, P = 0.734). Similarly, no significant differences were observed in OS (P = 0.95) or disease-specific survival (P = 0.18) between the two groups. The analysis of adverse events showed no significant differences between the two groups in lymph node metastasis (6.7% vs. 7.4%, P = 0.829), local recurrence (4.9% vs. 9.2%, P = 0.130), postoperative stenosis (3.7% vs. 1.2%, P = 0.152), or bleeding (1.2% vs. 0.6%, P = 0.562). However, the incidence of acid reflux symptoms was significantly higher in the surgery grouP (11.0% vs. 3.1%, P = 0.005). Conclusion: Early Siewert type II AEGJ patients treated with ESD or surgery demonstrated comparable long-term survival outcomes, supporting the role of ESD as a viable therapeutic option for this population.

Construction and validation study of a puncture pathology prediction model for high-risk prostate cancer patients

ZANG Pan, DING Lei, WANG Yuhao, LIANG Chao, 李杰

Available online:July 02, 2025, DOI:

[Abstract] (171) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
[Abstract]: Objective: To optimise the current strategy of prostate puncture biopsy by analysing the clinical data of high-risk prostate cancer patients, establishing a model to predict the pathological nature of their prostate lesions, and identifying patients who can be exempted from systematic biopsy and undergo targeted puncture alone. Methods: Clinical data of patients who underwent prostate puncture at the First Affiliated Hospital of Nanjing Medical University from January 2022 to June 2024 were retrospectively analysed, and eligible patients were screened and divided into a training set and a validation set. Single-factor and multifactor logistic regression analyses were used to screen the significant correlates of the pathology of prostate targeted biopsy. A predictive model was constructed based on the data from the training set, and the model efficacy was verified in the validation set. Receiver Operating Characteristic (ROC) curves were used to assess the diagnostic performance of the model in both data sets.Results: Age (X1), number of lesions (X2), histological region in which the lesions are located (X3), Prostate Imaging Reporting and Data System (PI-RADS) score (X4), and prostate-specific antigen density (X5) were the variables associated with the patient's prostate targeted biopsy pathology. The mathematical expression of the predictive model is: p=1/[1+e^(-15.770+0.067×X1-0.658×X2+0.381×X3+2.271×X4+5.742×X5)]. The Area under the curve (AUC) of the prediction model was 0.856 (95% confidence interval: 0.812-0.900) in the training set and 0.886 (95% confidence interval: 0.776-0.995) in the validation set.Conclusion: The constructed prediction model for targeted biopsy pathology in high-risk prostate cancer patients can guide the clinical strategy of prostate puncture to maintain good diagnostic performance while reducing the number of puncture needles, thus reducing the occurrence of complications and the waste of medical resources. Keywords: prostate cancer; prostate puncture biopsy; MRI; predictive model;

Correlation between CKAP4 in urine extracellular vesicles and clinical pathology and prognosis of diabetic nephropathy

刘畅, Qian Li, Lu Fang, Wang Zitao, Li Qing, Duan Suyan, Wu Lin, Zhang BO, Mao Huijuan, Liang Hongwei, Yuan Yanggang

Available online:July 02, 2025, DOI:

[Abstract] (177) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
［］Objective: To investigate the ability of the histological level of the key protein cytoskeleton-associated protein 4 (CKAP4) in urine extracellular vesicles as a biomarker for the progression of diabetic kidney disease (DKD). Methods: A total of 143 type 2 diabetic patients with biopsy-proven DKD and 10 patients with renal malignant tumors were enrolled. Renal endpoints were defined as the doubling of serum creatinine level or progression to end-stage kidney disease (ESKD). The expression of CKAP4 in renal tissue was detected by immunohistochemistry. Spearman correlation analysis was used to analyze the correlation between CKAP4 expression level and clinical indicators. The area under the receiver operating characteristic (ROC) curve (AUC) was calculated to assess whether CKAP4 expression could effectively distinguish patients with poor renal prognosis. Receiver operating characteristic (ROC) curve analysis was used to determine the best cut-off value of CKAP4 score for renal events (highest Youden index). Time-dependent AUC analyses were also performed to characterize the predictive accuracy of CKAP4 beyond 6 months after renal biopsy. In addition, hazard ratios between CKAP4 and DN progression were followed up by Cox proportional hazards models. The clinicopathological factors with statistical significance (p<0.05) in univariate analysis were included as covariates in multivariate Cox proportional hazards model analysis. Kaplan-Meier analysis was used to evaluate the difference in renal survival over 6 months after renal biopsy between CKAP4 high and CKAP4 low groups. Results: Compared with the adjacent normal kidney tissues of tumor patients, the expression of CKAP4 in the kidney of DKD patients was significantly increased (P<0.05). The expression of CKAP4 in renal tissues of DKD patients was different in different stages, and the differences between stage Ⅱ and stage Ⅲ, stage Ⅱ and stage Ⅳ, and stage Ⅲ and stage Ⅳ were statistically significant (P<0.05). The expression of CKAP4 in DKD patients was positively correlated with serum creatinine, urea nitrogen and 24h urine protein, and negatively correlated with eGFR and hemoglobin. During a median follow-up period of 2.22 years, 63 patients (44.06%) had DKD progression. Pearson correlation analysis showed that histological CKAP4 increased with the increase of pathological grade of DKD (r=0.808,p<0.001). Of note, multivariate Cox regression analysis showed that elevated CKAP4 was associated with an increased risk of DKD progression (HR: 4.120,95%CI: 1.730-9.811,p=0.001). In addition, in Kaplan-Meier survival analysis, patients with high CKAP4 expression had a significantly higher incidence of renal endpoint events than those with low CKAP4 expression (P<0.0001). At the same time, we developed a good nomogram including CKAP4 classification to predict the risk of DKD progression (C-index 0.689). Conclusions: Our findings suggest that histological expression of CKAP4, derived from urine extracellular vesicles, is an independent risk factor for renal progression over 6 months after renal biopsy in DKD patients.

Niacin regulates the quality of in vitro maturation of oocytes derived from aged mice by modulating the SIRT3/SOD2 pathway

Man Ni, Li Cheng, ZhengJie Yan, Li Gao, Song Ning

Available online:July 02, 2025, DOI:

[Abstract] (192) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Abstract：Objective：This study aims to investigate whether the addition of niacin (NA) to in vitro maturation (IVM) cultures can improve the quality of oocytes derived from aged mice and its mechanism. Methods：Mice at 8 weeks of age were used as the young control group, and mice at 40 weeks of age were used as the old control group. Oocytes at the germinal vesicle (GV) stage were taken and supplemented with 100, 200, and 300 μM niacin, respectively, and the rates of 2 cell and blastocyst formation were observed to determine the optimal concentration. Oocyte quality was assessed by the first polar body extrusion rate, cortical granule distribution, spindle morphology abnormality rate and chromosomal abnormality rate. Mitochondrial function was assessed by mitochondrial membrane potential and adenosine triphosphate (ATP)levels. Oxidative stress levels were assessed by detecting the levels of reactive oxygen species (ROS) in oocytes and mitochondria. Oxidative stress-related proteins: silent information regulator 3 (SIRT3), superoxide dismutase (SOD2), and acetylated superoxide dismutase (AC-SOD2) were detected by western blot (WB). Results：Under the concentration of 200 μM niacin culture medium, the blastocyst formation rate reached its highest level (P <0.05), therefore this concentration was selected as the optimal concentration. Niacin significantly improved the first polar body extrusion rate and cortical granule distribution in M II oocytes, while reducing abnormal spindle rates and chromosomal aberration rates. It also decreased mitochondrial membrane potential, enhanced ATP production, and reduced ROS levels in both oocytes and mitochondria (all P <0.05). Western blot analysis demonstrated that nicotinic acid supplementation significantly increased SIRT3 and SOD2 protein expression (all P <0.05) while markedly decreasing acetylated SOD2 protein expression (P <0.05). Conclusion：Addition of 200 μM niacin to IVM culture medium improves oocyte quality in aged mice by ameliorating the level of mitochondrial oxidative stress and may act by affecting the SIRT3-SOD2 signaling pathway.

18F-FDG-PET/MR unveils altered features of brain metabolic and functional networks in early Parkinson's disease

li xiaoyuan, gao qing, wang bolin, li rushuai, zhang pengjun

Available online:July 02, 2025, DOI:

[Abstract] (164) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: This study aims to establish individualized cerebral metabolic networks in Parkinson's disease (PD) using integrated 18F-FDG-PET/MR imaging and Jensen-Shannon similarity estimation (JSSE) and characterize topological alterations in metabolic networks and their dynamic associations with functional networks. Methods: Twenty-eight patients with clinically confirmed Parkinson's disease [16 males, 12 females, age (63.4±11.3) years] who underwent 18F-FDG-PET/MR imaging at Nanjing First Hospital from August 2022 to May 2024 were retrospectively analyzed, and 20 age- and gender-matched normal controls (NC) with PD patients were included (10 males, 10 females, age 63.0±9.4 years). Individual brain metabolic networks were constructed using the JSSE method, and Matlab 2013b was used to analyze changes in network topological properties and metabolic connectivity between brain regions using Gretna. Data were analyzed using two independent samples t-test and Mann-Whitney U-test, and the Mantel test analyzed correlations between metabolic and functional network matrices in the PD group and the NC group. Results: Compared with the NC group, the PD group showed higher assortativity in terms of global attributes (t = -2.06,p=0.045); in terms of nodal attributes, the centrality of nodal degree in the right sarcolemmal gyrus (t = 3.32, p<0.001) was significantly reduced; 15 key metabolic connectivity parameters were reduced (p<0.001), with the reduction in metabolic connectivity between the left caudate nucleus and the left inferotemporal gyrus being the was the most pronounced. There was a significant positive correlation between the PD metabolic and functional network matrices (r = 0.242, p<0.05), and the correlation was greater than that in the NC group (r = 0.197, p<0.05). Conclusion: The integrated PET/MR and JSSE framework demonstrates clinical efficacy in detecting cerebral topological reorganization and metabolic connectivity aberrations in PD. 18F-FDG-PET/MR imaging is useful for the early diagnosis of PD and for exploring changes in the mechanisms of intrinsic remodeling of the brain in PD from the perspective of brain metabolism and function.

Efficacy and Safety of Anti-Angiogenic Agents Combined with PD-1 Inhibitors and Chemotherapy in Patients with Recurrent or Metastatic Nasopharyngeal Carcinoma

Zong dan, Xu jingshu, He Yiyue

Available online:June 24, 2025, DOI:

[Abstract] (186) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
【Abstract】 Objective Advanced nasopharyngeal carcinoma (NPC) that progresses after treatment is typically associated with a poor prognosis, and a significant proportion of patients fail to benefit from standard therapeutic regimens. Therefore, this study aims to explore novel combination treatment strategies by analyzing the short- and long-term efficacy and safety of adding anti-angiogenic agents to the PD-1 inhibitor plus chemotherapy regimen for patients with recurrent or metastatic NPC in non-endemic areas . Methods A retrospective analysis was conducted on 171 R/M NPC patients who were diagnosed by pathology or imaging at Jiangsu Cancer Hospital from January 2019 to December 2024. The study group received PD-1 inhibitors combined with chemotherapy and anti-angiogenic agents, while the control group received PD-1 inhibitors combined with chemotherapy. Patient data included basic clinical information, objective response rate (ORR), disease control rate (DCR), overall survival (OS), progression-free surv

Application of Transdermal Drug Delivery System for the Treatment of Central Nervous System Diseases

LU Yawen, LIN Ziming, GAO Huimin, HAN Feng, XU Huae

Available online:June 20, 2025, DOI:

[Abstract] (142) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
The classification of central nervous system diseases is complicated and the harm is serious. Due to the existence of blood brain barrier (BBB), the treatment of central nervous system diseases has great difficulties in drug delivery. Transdermal Drug Delivery System (TDDS), as a new drug delivery system that delivers drugs into the blood circulation through the skin, has played a huge role in the treatment of central nervous system diseases in recent years. Due to its unique advantages of painless and convenient administration, transdermal patch has good patient compliance and therapeutic effect, and significantly reduces the first pass effect and adverse reactions. This paper reviews the application of transdermal patches in the treatment of central nervous system diseases such as neurodegenerative diseases and mental diseases, and focuses on the research progress of new technologies such as nanocarriers and microneedles in improving the efficiency of drug delivery. However, individual differences and long-term drug safety are still urgent problems to be solved. Future research should focus on the development of new drug delivery technology and clinical transformation application, so as to promote the further development of TDDS in the treatment of central nervous system diseases.

Research progress of oncolytic viruses in breast cancer treatment

wuqiong

Available online:June 20, 2025, DOI:

[Abstract] (138) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Breast cancer (BC), as the most common malignant tumor among women globally, has become a significant public health issue worldwide.Despite improvements in early diagnosis and treatment technologies,the therapeutic outcomes remain less than satisfactory.Breast cancer,characterized by its high heterogeneity and multiple molecular subtypes, poses a considerable challenge for treatment due to its complex biological properties.Traditional chemotherapy and immunotherapy suffer from issues such as insufficient precision,severe side effects,and the propensity to develop drug resistance,thus highlighting the urgent need to develop new therapeutic strategies. Oncolytic viruses(OVs)have emerged as an innovative cancer treatment modality.Their uniqueness lies in the ability to precisely identify and attack cancer cells while simultaneously activating the body's immune system to combat cancer.Currently,various OVs have been applied in cancer therapy,including Herpes Simplex Virus(HSV),Newcastle Disease Virus(NDV),Vesicular Stomatitis Virus (VSV),Measles virus(MV),Adenovirus(AdV),and Vaccinia Virus(VV).Moreover, significant progress has been made in the construction of novel OVs and their combination with traditional therapies.This article reviews the research progress of common OVs in the field of BC treatment over the past five years,thereby affirming the great potential of OVs.

Research Progress on the Current Status of Nutritional Risk and Its Screening Methods for Infants and Young Children

石鑫玥, 李晓南

Available online:June 20, 2025, DOI:

[Abstract] (164) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Early childhood is a critical stage of growth and development, and the nutritional status of this period not only affects physical growth and development, but also lays a solid foundation for lifelong health. However, due to the rapid growth and metabolic characteristics of infants and young children, coupled with the immaturity of multiple physiological systems and the high incidence of infectious diseases, this population faces nutritional risks. This review synthesizes relevant domestic and international studies to elucidate the current landscape of infant nutrition risk, as well as the associated influencing factors such as life environment, age, disease, and high-risk conditions. The paper also shows the design, application, scope, and limitations of existing infant nutrition risk screening tools, along with the clinical significance of nutritional risk screening in hospitalized children, outpatient clinics, and specialized settings. The primary objective of this paper is to raise awareness among pediatric clinicians regarding infant nutrition issues and to promote proactive nutritional risk screening, thereby facilitating early identification of nutritional risks and ultimately achieving standardized and scientific nutrition management.

Changes in Routine Blood Parameters and Their Relationship with Disease Progression in Gastric Cancer Patients: A Cross-Sectional Study

zhuxia, liujia, yancaiwang, wanglu

Available online:June 20, 2025, DOI:

[Abstract] (162) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
【Abstract】 Objective This cross-sectional study aims to investigate the abnormalities in routine blood parameters among gastric cancer patients and analyze their trends over the course of the disease. Methods This study included the population who participated in the Taihu Tumour Biomarkers Biobank (TBTB) in Wuxi from August 2020 to December 2021, with 1920 cases who already had gastric cancer at baseline as the gastric cancer group and 7680 cancer-free cases matched 1:4 for age and sex as the healthy control group. A cross-sectional survey design was adopted to explore the association between routine blood tests and the prevalence of gastric cancer using multiple linear regression modelling, and the Kruskal-Wallis test was further used to compare the differences in routine blood tests across different stages of the disease between groups. Results Multiple linear regression model showed that hemoglobin (HGB), platelet count (PLT), red blood cell count (RBC), white blood cell count (WBC), mean hemoglobin content (MCH) and mean corpusular hemoglobin concerntration (MCHC) were lower in gastric cancer patients than in controls, with HGB decreasing the most (β=-0.77, 95% CI: -0.82 ~ -0.71, P<0.001), and red blood cell volume distribution width (RDW) (β=0.13, 95% CI: 0.06 ~ 0.17, P<0.001) and hematocrit (HCT) (β=0.16 , 95% CI: 0.10 ~ 0.22, P<0.001) levels were higher than those of the control group,, suggesting that anaemia-related signs were more common in gastric cancer patients. The study found that WBC showed a gradual decreasing trend during the disease progression in GC patients.(P<0.001), and HGB, RBC and hematocrit(HCT) tended to increase with the duration of gastric cancer(P<0.001), but they were still lower than those of the control group. Conclusions This study indicates that GC patients are more likely to exhibit anemia-related abnormalities compared to healthy individuals. Additionally, certain blood routine parameters show significant changing tends with disease progression, providing valuable insights for clinical monitoring and management of GC.

Genetic etiology analysis of 1096 patients with intellectual disability or global developmental delay based on whole exome sequencing

SHI WEI, ZHANG SHENG NAN, WANG CHUN LI, ZHENG BI XIA, JIA ZHAN JUN, ZHANG AI HUA

Available online:June 11, 2025, DOI:

[Abstract] (159) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective：To investigate the molecular diagnostic value of whole exome sequencing (WES)in the genetic etiology of intellectual disability (ID) or global developmental delay (GDD) and analysis of genetic characteristics in the Chinese cohort. Methods：1096 patients with ID/GDD who were enrolled in Children's Hospital of Nanjing Medical University from January 2019 to December 2021 were selected as the study objects. Inclusion criteria adhered to clinical guidelines for significant developmental milestone delays, with exclusion of non-genetic factors (e. g. , perinatal hypoxia, infection, metabolic abnormalities). We retrospectively analyzed sequence variants and copy number variations (CNVs) detected by Trio- whole exome sequencing (Trio-WES) or proband-only WES, classifying variants according to the American College of Medical Genetics and Genomics (ACMG) guidelines, with pathogenic（P）/likely pathogenic(LP) variants defined as positive results. Results：1096 patients with ID/GDD ranged in age from 1 month to 15 years, with a median age of 24(12, 48) months, including 716 males and 380 females. The overall positive diagnostic rate was 35.31%(387/1096), with monogenic variants identified in 271 patients and CNVs in 116 patients. Among the monogenic variants, MECP2 gene was the most common one（12/271, 4.43%），primarily associated with Rett syndrome, followed by SYNGAP1 and DDX3X. For CNVs, 5.17%（6/116）patients were aneuploidies，with 7q11.23 deletions (associated with Williams syndrome) being most common (8.62%, 10/116). Autosomal dominant inheritance accounted for 71.96% (195/271) of monogenic variants, while X-linked inheritance represented 19.93% (54/271). Sanger sequencing confirmed de novo origins in 68.27%（185/271）of detected variants. Clinical phenotypic analysis demonstrated a significantly higher positive rate in isolated ID/GDD cases compared to those with comorbid autism spectrum disorder(ASD) or attention-deficit/hyperactivity disorder(ADHD)(P＜0.05). Conclusion：The combined analysis of WES and CNV significantly enhances molecular diagnostic yield for ID/GDD. High frequencies of MECP2 variants and 7q11.23 deletions s represent high-frequency findings in Chinese pediatric cohort. De novo variants constitute the primary genetic etiology in this cohort. These findings support the implementation of WES as a first-line clinical diagnostic tool for ID/GDD.

Efficacy of 0.05% cyclosporine A and 0.1% tacrolimus eye drops in the treatment of severe dry eye associated with Sjogren's syndrome

殷丽, 姚勇

Available online:June 11, 2025, DOI:

[Abstract] (158) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To investigate the clinical effect of 0.05% cyclosporine A and 0.1% tacrolimus eye drops in the treatment of severe dry eye associated with sjogren's syndrome. Methods: 112 eyes of 56 sjogren's syndrome patients with severe dry eye were continuously included between October 2021 and November 2023, all of them were divided into tacrolimus group (n=28, 56 eyes) and cyclosporine A group (n=28, 56 eyes) according to random comparison table method. The tacrolimus group received 0.1% tacrolimus eye drops twice a day, and the cyclosporine A group received 0.05% cyclosporine A eye drops four times a day. Both groups were treated for 8 weeks. Dry eye symptoms, tear film rupture time, tear secretion test and corneal fluorescein sodium staining score were followed up before and after treatment. Results: (1) There was no significant difference in general clinical data among all patients; (2) There was no significant difference in SPEED score and TBUT time between the two groups before treatment; Compared with before treatment, SPEED score and TBUT time were improved in both groups after treatment. Compared with each other, TBUT time in Tacrolimus group improved better, while SPEED score in cyclosporine A group improved better. (3) There were no significant differences between the two groups before treatment in FL score and SIt index; Compared with before treatment, FL score and SIt were improved in both groups after treatment. The improvement of FL score was similar between the two groups, but the improvement of SIt in cyclosporin A group was better. (4) There were no significant differences in the morphology of meibomian gland and lipid layer thickness between the two groups before treatment; Compared with the same group before treatment, the morphology and lipid layer thickness of meibomian gland were improved in both groups after treatment. Compared with each other, tacrolimus group had better improvement in meibomian gland morphology and lipid layer thickness. (5) Some patients experience transient irritation symptoms after using two eye drops, and their irritation symptoms are relieved within 20 minutes after medication. Conclusion: Both 0.1% tacrolimus and 0.05% cyclosporine A have good therapeutic effects in severe dry eye associated with Sjogren's syndrome, of which 0.05% cyclosporine A has more obvious advantages in improving patient comfort and reducing dry eye symptoms, while 0.1% tacrolimus has better effects in improving meibomian gland morphology and lipid layer thickness.

Combined analysis of scRNA-seq and bulk RNA-seq evealed that MTRNR2L1 mediated the downregulation of PANoptosis in COPD

sun si yi, ren hong qin, yao xue xin, zhao qian, li wen qiang, chen wei bin, bai jing, yu chang li, dong ai ying, liu tie jun, 付爱双

Available online:June 11, 2025, DOI:

[Abstract] (133) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To explore the mechanism of MT-RNR2-like protein 1 (MTRNR2L1)-mediated regulation of PANoptosis during the development of Chronic Obstructive Pulmonary Disease (COPD), and to provide new ideas for finding the pathogenesis of COPD. Methods: Bulk RNA Sequencing (Bulk RNA-seq) data and Single Cell RNA Sequencing (scRNA-Seq) data from COPD patients in Gene Expression Omnibus (GEO) were used to explore the cellular composition in COPD patients' lung tissues and to analyse the pathways involved in the development of the disease. PANoptosis was simulated in smoke/lipopolysaccharide (LPS)-exposed mice, and MTRNR2L1 and PANoptosis protein expression was assessed to clarify their roles in the development of COPD. Results: Bulk RNA-seq demonstrated altered expression of T cell response-related genes in COPD patients. Single-cell RNA-seq confirmed decreased CD8+ T cells and increased epithelial cells compared to controls. The anti-apoptotic gene MTRNR2L1 was upregulated in COPD patient immune and epithelial cells. PANoptosis-related genes were reduced in lungs, CD8+ T cells and epithelial cells of COPD patients; Smoke/LPS-exposed mouse lungs exhibit alveolar damage, increased PANoptosis proteins, while MTRNR2L1 overexpression significantly inhibited cellular PANoptosis and downregulated the levels of ZBP1, Caspase-3, GSDMD, and MLKL.Conclusion: The differentially expressed genes in CD8+ T cells and epithelial cells were enriched in pathways related to PANoptosis , suggesting the involvement of PANoptosis in the development of COPD. The process of PANoptosis in the onset and development of COPD was associated with increased expression of PANoptosis-related proteins. MTRNR2L1 exhibited an inhibitory effect on PANoptosis, and regulating PANoptosis may provide new therapeutic opportunities for reducing lung injury and improving lung ventilatory function.

Predictive Value of Cardiac Biomarkers for Post-Stroke Mortality Risk

JIAO Jincheng, CAO Yuezhou, LIU Sheng, LI Mingfang

Available online:June 11, 2025, DOI:

[Abstract] (174) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
[Abstract] Objective: To investigate the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) in predicting long-term mortality risk in patients with acute ischemic stroke (AIS) and to develop and validate predictive models. Methods: This study is a single-center, retrospective study. AIS patients who underwent thrombectomy at the First Affiliated Hospital of Nanjing Medical University between January 2022 and December 2022 were enrolled and followed up for two years. Cox regression and LASSO regression were used to identify factors associated with all-cause mortality. Three predictive models were constructed: basic model, Model 1 (basic model + NT-proBNP), and Model 2 (basic model + hs-cTnT), and their predictive performances were compared. Results: A total of 230 AIS patients were included in the final analysis and were randomly assigned to the training set (n=146) and testing set (n=84). During the follow-up period, 83 all-cause deaths were recorded, with a mortality rate of 37.2%. Multivariate Cox regression showed that each 1000 pg/mL increase in NT-proBNP was associated with a 27% higher risk of 2-year all-cause death (HR = 1.27, 95% CI: 1.15-1.40, p < 0.001). In contrast, ln(hs-cTnT) was not significantly associated with mortality risk (HR = 1.11, 95% CI: 0.89-1.38, p = 0.372). Cox regression and LASSO identified the following mortality-related variables: history of atrial fibrillation, postoperative national institutes of health stroke scale (NIHSS), baseline hemoglobin, white blood cell count, and random blood glucose. These were used to build basic model. Area under the curve (AUC) of basic model was 0.816 in the training set and 0.778 in the testing set. Model 1 had an AUC of 0.866 in the training set and 0.799 in the testing set, showing improved predictive performance. Model 2 had an AUC of 0.811 in the training set and 0.788 in the testing set, with no significant improvement. Conclusion: NT-proBNP is an independent predictor of all-cause mortality in AIS patients and can enhance the predictive ability of mortality risk based on traditional clinical parameter models, contributing to the individualized management of AIS patients.

Research progress on high-risk prognostic factors and postoperative adjuvant therapy for stage IA lung adenocarcinoma

leyanchen

Available online:June 05, 2025, DOI:

[Abstract] (232) [HTML] (0) [PDF 0.00 Byte] (0)

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Current domestic and international lung cancer screening guidelines recommend the use of low-dose spiral computed tomography(LDCT)for lung cancer screening,which has significantly improved the detection rate of early-stage lung adenocarcinoma.According to the Chinese Medical Association's Lung Cancer Clinical Diagnosis and Treatment Guidelines(2024 Edition),patients with stage IA(T1a/b/cN0)lung adenocarcinoma who undergo surgery with negative surgical margins(R0)can have regular follow-ups postoperatively without the need for adjuvant therapy(Class I recommendation, evidence-based).Recent clinical studies have revealed that the prognosis of patients with stage IA lung adenocarcinoma who only receive surgical treatment is influenced by various factors. To further improve patient outcomes, discussions on the need for postoperative adjuvant therapy continue to emerge. Although a unified treatment standard has not yet been formed, this topic remains of significant research value. This article reviews the impact of factors such as tumor size, solid component ratio, micropapillary and solid subtype proportions, lymphovascular invasion(LVI),and the presence of spread through air spaces(STAS)on the prognosis of stage IA lung adenocarcinoma, and discusses the latest postoperative adjuvant treatment plans and their outcomes, providing new insights into the postoperative treatment of stage IA lung adenocarcinoma.

Potential and Prospects of Event-Related Potentials in the Diagnosis and Treatment of Depressive Disorders

zhaohaiqiang, 鲍天昊

Available online:June 05, 2025, DOI:

[Abstract] (159) [HTML] (0) [PDF 0.00 Byte] (0)

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Depressive disorder, as a common mental health condition, imposes a significant burden on both patients and society. However, its early diagnosis and precise treatment remain challenging, highlighting the urgent need for objective and reproducible neural biomarkers. In recent years, event-related potentials (ERPs), as a neurophysiological tool characterized by high temporal resolution, cost-effectiveness, and non-invasiveness, have opened new avenues for the diagnosis and treatment of depressive disorders. The article reviews the latest advances in the research of various ERP components in depressive disorders, with a particular focus on their potential applications and current challenges in the diagnosis, differential diagnosis, and treatment outcome evaluation of depressive disorders. The aim is to provide insights and references for future research and application of ERPs as neurobiological markers in the diagnosis and therapeutic evaluation of depressive disorders.

Baicalin activates autophagy, inhibits inflammation and promotes odontogenic/osteogenic differentiation of dental pulp stem cells

susiyi, qinziyi, shaying, xuhai, jiangfei

Available online:June 05, 2025, DOI:

[Abstract] (156) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: This study aims to verify the anti-inflammatory effect of baicalin in an inflammatory environment and explore its influence on the odontogenic/osteogenic differentiation of human dental pulp stem cells (hDPSCs), providing a reference for the treatment of pulpitis. Methods: Select early inflammatory dental pulp tissue from humans to make frozen sections and perform HE staining and IL-1β immunohistochemical staining. Human monocyte leukemia cells (THP-1) were differentiated into macrophages and polarized to the M1 subtype under the induction of lipopolysaccharide (LPS) and interferon-γ (IFN-γ). Then, baicalin (50 μM) was used for treatment. The expression levels of INOS, IL-1β, and IL-8 were analyzed using immunofluorescence, real-time quantitative PCR (RT-qPCR), and Western blot. Additionally, the expression changes of LC3B, Beclin-1, and P62 were assessed by Western blot to monitor autophagic flux alterations in macrophages. To further investigate the relationship between inflammation inhibition and autophagy, we employed the autophagy inhibitor 3-MA to block autophagic flux and re-evaluated the expression changes of IL-1β and IL-8. Supernatants from macrophages treated under various conditions were collected, and the conditioned medium was prepared to act on human dental pulp stem cells. The odontogenic/osteogenic differentiation ability of hDPSCs in an inflammatory environment was analyzed by ALP staining, alizarin red (ARS) staining, RT-PCR, and Western blot. Results: The expression of IL-1β around the inflamed area of early pulpitis tissue was significantly increased. After LPS and IFN-γ induced THP-1, THP-1 macrophages polarized from M0 to M1, and the expressions of INOS, IL-1β and IL-8 significantly increased. After co-incubation with 50μM BA for 24 hours, the polarization degree of M1 macrophages significantly decreased, the mRNA levels of IL-1β and IL-8 significantly decreased, while the expression level of IL-6 showed no statistical difference compared with the M1 group. After adding the supernatant of M1 macrophages to hDPSCs and inducing mineralization for 7~21 days, the alkaline phosphatase activity of hDPSCs decreased, the calcium salt deposition significantly reduced, and the expressions of ALP, DSPP, RUNX2, OPN and COL-1 significantly decreased. When adding the supernatant of M1 macrophages treated with BA, the alkaline phosphatase activity of hDPSCs significantly increased, the calcium salt deposition significantly increased, and the expressions of ALP, DSPP, RUNX2, OPN and COL-1 significantly increased. Conclusion: Baicalin can inhibit inflammatory responses by activating autophagy, thereby enabling hDPSCs to function in an inflammatory microenvironment.

Research progress on the relationship between intestinal flora and HPV infection and cervical lesions

ZHANG Ying

Available online:June 05, 2025, DOI:

[Abstract] (168) [HTML] (0) [PDF 0.00 Byte] (0)

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Persistent high-risk HPV infection is the main cause of cervical lesions. Cervical cancer is the fourth most frequent malignancy among women globally, posing a severe threat to women's health and lives. Intestinal flora can have anti-tumor effects through immunomodulation, inflammatory response, and metabolite synthesis, according to numerous research conducted in recent years. Research on the relationship between intestinal flora and cervical cancer has revealed notable variations in the diversity and composition of intestinal flora between patients with the disease and healthy controls. These findings have also raised the possibility that certain intestinal flora may serve as biomarkers for cervical cancer prevention and early detection. Furthermore, through the estrogen-mediated "gut-vaginal axis," intestinal flora can interact with the vaginal microbiome, thereby affecting vaginal microecology, HPV infection, and cervical lesions. However, existing studies are mainly based on cross-sectional analyses with small sample sizes and a lack of longitudinal studies and experimental evidence. More thorough research is still required to elucidate the precise linkages and mechanisms of action. The article reviews the research progress on the relationship between intestinal flora and HPV infection and cervical lesions by summarizing the existing research results.

Comparison of the performance of multimodal imaging for the assessment of lesion extent in ductal carcinoma in situ and invasive lobular carcinoma of the breast

Yue Huang, Minghui Li, Chang Sun

Available online:May 26, 2025, DOI:

[Abstract] (190) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To compare the efficacy of three conventional imaging tests, mammography (MG), ultrasonography (US), and magnetic resonance imaging (MRI), in assessing the size of ductal carcinoma in situ (DCIS) or ductal carcinoma with microinvasion (DCIS-MI) lesions in breast-conserving patients. The efficacy of three conventional imaging tests, US and magnetic resonance imaging (MRI), in assessing the size of ductal carcinoma in situ (DCIS) or ductal carcinoma in situ with microinvasion (DCIS-MI), and the potential value of these tests in assisting the clinical management of breast-conserving patients.Methods: Retrospectively collected data from pathologically confirmed DCIS/DCIS-MI cases in our hospital were analyzed. The lesion sizes estimated by the three imaging modalities were compared with the "gold standard" pathological sizes. McNemar"s test and Bland-Altman plots were used to evaluate the accuracy and consistency of the different imaging methods. Univariate and multivariate analyses were performed to identify clinical,

The clinical value of deep learning reconstruction algorithm in pancreatic HASTE-T2WI sequence

徐思雨, Zhang Yong Jie, Tian Shui, 王建伟

Available online:May 26, 2025, DOI:

[Abstract] (152) [HTML] (0) [PDF 0.00 Byte] (0)

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Abstract: Objective To evaluate the clinical value of half-Fourier acquisition single-shot turbo spin sequence based on deep learning reconstruction algorithm (HASTE-DL) T2WI sequence in MRI of pancreas. Methods Sixty-nine patients underwent pancreatic conventional BLADE-TSE-T2WI and based on deep learning HASTE-DL-T2WI sequences scanning using 3.0T MRI. The overall quality, pancreatic sharpness, biliary duct clarity and artifacts of the two groups were qualitatively scored by the Likert 5-point scale method for subjective evaluation. The contrast to noise ratio (CNR) and signal to noise ratio (SNR) of normal tissue and the lesion of the pancreatic of the two groups of images were measured and analyzed. The scanning time of the two sequences were also recorded. Results The overall image quality of the HASTE-DL sequence, the scores of pancreatic sharpness and biliary clarity were better than those of BLADE-TSE sequence (P<0.001).There was no statistically significant difference in the scores of image artifacts between the two groups (P >0.05). The SNR of normal pancreatic tissue, the SNR of lesion and CNR of HASTE DL sequence were better than those of BLADE-TSE sequence (P<0.001). The scanning time of HASTE-DL sequence was 78% shorter than that of BLADE-TSE sequence. Conclusion Compared with BLADE-TSE sequence, the overall quality of HASTE-DL is better, and the pancreatic sharpness and bile duct display clarity are higher, SNR and CNR are better, and the scanning time is shorter. Therefore, HASTE-DL T2WI sequence has good clinical application value in the MRI of pancreas.

Efficacy and Safety of Remimazolam vs Propofol in Standford B Type Aortic Dissection Intervention

Li Qian, Zhang ChunYan

Available online:May 26, 2025, DOI:

[Abstract] (153) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective:To compare the hemodynamic effects of propofol and remimazolam during the perioperative period in Stanford type B aortic dissection patients. Methods:eighty patients were randomized to receive propofol (Group P) or remimazolam (Group R) for anesthesia. Mean arterial pressure (MAP) and bispectral index (BIS) value were recorded at anesthesia onset (T0), tracheal intubation (T1), 5 minutes after intubation (T2), procedure completion (T3), airway extubation (T4), and 5 minutes after airway extubation (T5). The percentage change in MAP during anesthesia induction was computed as (MAPT2 -MAPT0) / MAPT0, and during the periextubation period, it was calculated as (MAPT5 - MAPT3) /MAPT3. Results:No significant differences in BIS values were observed between the two groups at any time point (P < 0.05). The percentage change in MAP during anesthesia induction was 22.6%±6.5% in Group P and 13.7%±6.9% in Group R, showing a significant difference (P < 0.001). Similarly, during the periextubation period, the mean percentage change in MAP was 21.3%±6.2% in Group P and 11.7%±5.8% in Group R, also indicating a significant difference (P< 0.001). Conclusion：These findings indicate that remimazolam exerted a milder cardiovascular depression effect compared to propofol when delivering same sedation, which has certain positive significance for reducing perioperative complications in these patients.

A case of atypical pantothenic kinase-associated neurodegenerative disease caused by PANK2 mutation and review of the literature

Yu Xiaotian, Ma Bodun, Feng Hongxuan, Hou Xiaoxia, Hu Ruiyao, Gui Qian, Zhu Wei

Available online:May 26, 2025, DOI:

[Abstract] (159) [HTML] (0) [PDF 0.00 Byte] (0)

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Pantothenate kinase-associated neurodegeneration (PKAN) is a rare, autosomal recessive neurodegenerative disorder caused by mutations in the PANK2 gene located on chromosome 20p13. The mutation leads to iron deposition in the basal ganglia region of the brain, which causes progressive exacerbation of extrapyramidal symptoms, speech disorders, psychiatric symptoms, cognitive hypoplasia, and retinitis pigmentosa [1]. Here, we report a case of adult-onset atypical PKAN in a patient with psychiatric disorder as the first symptom, followed by dystonia, dysarthria, gait abnormalities, and limb tremor. Neuroimaging showed a typical “tiger's eye sign”. The patient was found to have a heterozygous PANK2NM_1386393.1:c.1172T>A(p.Ile391Asn)/ c.1039G>C(p.Asp347His) mutation by whole-exon sequencing. In addition, we review the pathogenesis, genetic features, clinical manifestations, imaging characteristics, and therapeutic strategies of PKAN patients.

A preliminary study on the International Classification of Functioning, Disability and Health Core Sets for urinary incontinence in older women

Fan Jia Yu, Tao Yuan Yuan, Jiao Le, Zhang Da Wei, Cheng Qin Mei, Shen Fang Rong, Li Miao

Available online:May 26, 2025, DOI:

[Abstract] (125) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To identify the International Classification of Functioning, Disability, and Health (ICF) core Sets for Urinary Incontinence in Older Women. Methods: A preliminary questionnaire was developed through a literature search on urinary incontinence in older women across Chinese and international databases. Two professional researchers extracted key concepts from the literature, which were mapped to corresponding items in ICF. A total of 100 eligible patients with urinary incontinence were invited to complete the questionnaire. Items that over 30% of respondents identified as affecting them were designated as Core Item I. Subsequently, the questionnaire was distributed to 35 relevant healthcare workers. Items identified by over 50% of these professionals as impacting older women with urinary incontinence were compiled into Core Items II. The over-lapping items between Core Items I and II will constitute the ICF core items for urinary inconti-nence in older women. For this study, all items within the Core Items Set were presented in the second level. Results: The ICF Core Sets for urinary incontinence in older women includes 29 core items: 8 for "body function (b)," 2 for "body structure (s)," 8 for "activity and participation (d)," and 11 for "environmental factors (e)."Conclusion: The study initially established a core set of ICF items for urinary incontinence in older women, providing an actionable theoretical model for the development of evidence-based rehabilitation management in the clinic.

Correlation of frailty and recurrence after catheter ablation in elderly patients with atrial fibrillation

Liu Qianhui, Wang Han, Ma Liang, Yao Zijun, Xu Yunfan, Xia Yudong

Available online:May 26, 2025, DOI:

[Abstract] (130) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective：To explore the relationship between frailty and recurrence of atrial fibrillation after catheter ablation in elderly patients with atrial fibrillation (AF). Methods：This is a prospective study. A total of 292 elderly patients who were selected to undergo AF catheter ablation surgery in the First Affiliated Hospital of Nanjing Medical University, the Third People’s Hospital of Nantong City and the Department of Jingjiang People’s Hospital from June 2023 to? December 2023. Collect the baseline data of the subjects before the operation, and divide the subjects into the frail group (≥3 points), the pre-frail group (1-2 points) and the non-frail group (0 points) according to the Frail scale, and compare the differences between the three groups of patients. After 1 year of postoperative follow-up, it was divided into recurrent group and non-recurrence group according to whether there was AF recurrence during the follow-up period. Comparing the two groups of clinical data, single-factor and multi-factor logistic regression was used to analyze the relationship between frailty and recurrence after catheter ablation and other risk factors for AF recurrence. Through Kaplan-Meier analysis of the survival status of non-atrial fibrillation recurrence event 1 year after surgery, log-rank test to compare the survival differences between groups. Results：A total of 292 elderly patients with AF were enrolled, including 94 patients in the non-frail group, 138 patients in the pre-frail group and 60 patients in the frail group. During 1 year follow-up, 52 patients (17.8%) developed AF recurrence, and the recurrence rate in the frail group was significantly higher than that in the non-frail group and the pre-frail group[38.33%(23/60)vs.10.64%(10/94)vs.13.77%(19/138), P<0.001].Multivariate logistic analysis showed that after adjusting for demographic data and clinical factors, frailty was significantly associated with a higher risk of senile AF recurrence after catheter ablation (OR=3.430,95% CI:1.219-10.233,P=0.022). And AF type (persistent AF), BMI, pro-BNP, LAD are independent risk factors for postoperative recurrence. Conclusions：There is a significant correlation between frailty and recurrence after senile AF catheter ablation, which is a reliable predictor of recurrence after AF ablation.

A study on the correlation between stroke history and clinical manifestations in patients with coronary heart disease

陈琦, liuqiao, wangjing, wangjunhong, hanzhijun, zhanglizhu, zhangkaixin, 高明珠

Available online:May 19, 2025, DOI:

[Abstract] (134) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To explore the relationship between past history of stroke and clinical features of heart attack and NYHA (New York Heart Association, American Society of Cardiology) cardiac function grading in patients with coronary heart disease. Method: This study included a total of 2327 coronary heart disease patients who were hospitalized at Jiangsu Provincial People's Hospital and Wuxi Second People's Hospital from February 2019 to September 2021. The clinical manifestations and general information of coronary heart disease were collected. According to the clinical characteristics of coronary heart disease patients, they are divided into angina group and myocardial infarction group; The NYHA functional classification is divided into groups of less than three levels, and groups of three levels and above. Use multiple logistic regression analysis to evaluate the relationship between stroke history, clinical characteristics of coronary heart disease patients, and NYHA functional classification. Perform statistical analysis on the data using SPSS 20.0, with P<0.05 indicating statistical significance. Result: In this study, there were 2327 patients with coronary heart disease, including 280 patients with a history of stroke and 2047 patients without a history of stroke. In the general characteristics of patients, age, systolic blood pressure, TC, TG, LDL, HDL, CRP, diabetes, hypertension and renal insufficiency history were significantly different among patients with or without past stroke history (P<0.05). The results of a multivariate logistic regression analysis adjusted for important covariates such as age, gender, and BMI showed that a history of stroke was independently correlated with NYHA functional classification in patients with coronary heart disease (OR=1.85, 95% CI=1.14-3.01, P=0.013).The correlation between stroke history and NYHA functional classification in coronary heart disease patients was further confirmed in subgroup analysis. Conclusion: Past history of stroke is closely associated with cardiac function classification in patients with coronary heart disease, which may have a potential suggestive role for cardiac function classification in patients with coronary heart disease.

Comparison of Clinical Efficacy between Laparoscopic Enucleation and Anatomic Resection for Right Posterior Lobe Hepatic HemangiomasJIANG Hanlin, NIU Weiqiao, JIANG Zongying, YANG Guang, WU Jianwu, HUANG Lining, JIANG Xinwei

Niu wei qiao, Jiang zong ying, yang guang, wu jian wu, huang li ning

Available online:May 19, 2025, DOI:

[Abstract] (150) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: Comparison of short-term efficacy of laparoscopic enucleation versus anatomical resection for hepatic hemangiomas in the right posterior lobe. Methods: A total of 58 patients with hepatic hemangiomas in the right posterior lobe were selected from our hospital between January 2020 and August 2024. The cases were divided into two groups based on the surgical technique: 28 patients underwent laparoscopic enucleation of the hepatic hemangioma, and 30 patients underwent laparoscopic anatomical resection. Various perioperative indicators were observed. Results: There were no statistically significant differences in the preoperative data between the two groups (all P > 0.05). The enucleation group had a significantly shorter surgical duration [(158.9 ± 25.0) min vs. (189.6 ± 66.8) min, P < 0.05], less intraoperative blood loss [(306.4 ± 81.5) mL vs. (378.8 ± 154.5) mL, P < 0.05], and lower total postoperative drainage volume [(422.4 ± 100.0) mL vs. (732.5 ± 318.0) mL, P < 0.05]. On the first postoperative day, the serum levels of aspartate aminotransferase (AST) [(356.4 ± 70.8) U/L vs. (392.8 ± 55.1) U/L, P < 0.05], alanine aminotransferase (ALT) [(369.1 ± 22.2) U/L vs. (405.5 ± 35.9) U/L, P < 0.05], and total bilirubin (TBIL) [(21.6 ± 4.1) μmol/L vs. (25.9 ± 6.8) μmol/L, P < 0.05] in the enucleation group were significantly lower than those in the resection group. There were no statistically significant differences in postoperative inflammatory markers (P > 0.05) or the overall incidence of postoperative complications between the two groups (P > 0.05). Conclusion: Both laparoscopic enucleation and anatomical resection are effective surgical options for treating hepatic hemangiomas in the right posterior lobe. However, laparoscopic enucleation offers advantages such as reduced surgical time, less intraoperative blood loss, and lower total postoperative drainage volume, along with a lesser impact on liver function on the first postoperative day. Therefore, the choice of surgical approach should be guided by individual clinical circumstances.

The Application of Two Mouse Models in Cholestatic Liver Injury Experiments

Zhang Xuefei, Sun Xuewei, Zhang Ruonan, Zhang Xinrui, Zhang Mingyan, Tang Chengliang, Yang Zhan, Zhu Jin

Available online:May 19, 2025, DOI:

[Abstract] (197) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To compare the differences between bile duct ligation (BDL) and α-naphthylisothiocyanate (ANIT)-induced mouse models in cholestatic liver injury experiments, and to explore the applicability of both models in such studies. Methods: C57BL/6 male mice were divided into control, sham surgery (Sham), BDL, BDL+SCFA, ANIT, and ANIT+SCFA groups. The BDL and BDL+SCFA groups underwent BDL surgery, while the ANIT and ANIT+SCFA groups were administered ANIT. The BDL+SCFA and ANIT+SCFA groups received water containing short-chain fatty acids (SCFAs) for 14 days. Samples were collected for liver histology, liver function serum biomarker analysis, and inflammatory cytokine detection. Statistical analysis was performed on the data. Results: Mice in the BDL group developed noticeable jaundice and continuous weight loss at one week, with severe jaundice by two weeks. Mice in the ANIT group exhibited mild jaundice early on, which gradually worsened over time, with mild early weight loss and no significant later changes. Gross liver appearance and histopathological analysis revealed common characteristics between the two models, including partial liver fibrosis, hepatocellular necrosis, portal tract fibrosis, inflammatory cell infiltration, and bile duct proliferation. However, these changes were more prominent and occurred earlier in the BDL group, indicating more severe cholestatic liver injury. In contrast, the ANIT group showed milder early changes that progressively worsened over time. Serum biomarkers revealed significant increases in liver transaminase levels in both groups. Early increases in alkaline phosphatase (ALP) and total bilirubin (TBIL) levels were observed in the BDL group, while the ANIT group showed mild early increases, which gradually worsened over time. Serum inflammatory cytokine levels were significantly elevated early in the BDL group, with gradual elevation in the ANIT group. After two weeks of SCFA treatment, there were no significant improvements in jaundice, weight loss, liver serum biomarkers, or inflammatory markers in the BDL group, but significant improvements were observed in the ANIT group, including reduced jaundice, weight loss, liver serum biomarkers, and inflammatory markers. Conclusion: The BDL model has a rapid onset and severe liver injury, making it suitable for studying acute cholestatic liver injury, whereas the ANIT model has a slow onset with progressively worsening liver injury, making it more appropriate for modeling chronic cholestatic liver injury.

Application progress of robotic-assisted bronchoscopy

陈淑娟, Fang Shencun, 侯志波

Available online:May 19, 2025, DOI:

[Abstract] (138) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
With the widespread use of chest low-dose computed tomography, the detection rate of peripheral pulmonary lesions (PPLs) is increasing year by year. Tissue biopsies of PPLs are required to obtain a pathological diagnosis. PPLs are far away from the central airway and close to the pleura, which is difficult to reach by conventional bronchoscopy, and the diagnostic rate and sensitivity are not ideal. Although the diagnostic rate of percutaneous lung biopsy has been improved, it has high complications. Robot-assisted bronchoscopy (RAB) is a new technology for the diagnosis of lung lesions, which improves navigation accuracy, expands the reachable range of the lens, and has the advantages of high accuracy, stability and flexibility, providing higher diagnostic rate and safety than traditional bronchoscopy. RAB can also be used as an interventional platform to combine with the existing ablation therapy for the ablation of lung tumors. With the continuous improvement of science and technology, the application of RAB will be more and more widespread and is the development trend of bronchoscopy.

Application of near-infrared functional brain imaging in the field of stroke

Wang Zhaolu

Available online:May 19, 2025, DOI:

[Abstract] (189) [HTML] (0) [PDF 0.00 Byte] (0)

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Stroke, as an acute cerebrovascular disease, is characterised by high morbidity, recurrence, disability, mortality and heavy economic burden, posing an extremely serious threat to human life and health. As a non-invasive, portable and anti-electromagnetic interference brain optical imaging method, functional near-infrared spectroscopy (fNIRS) has been widely used in neuroscience and clinical rehabilitation in recent years. Especially in the neurological rehabilitation of stroke, fNIRS provides a powerful support for rehabilitation assessment, treatment optimisation and neural mechanism research with its unique advantages. In this paper, we will review the main application directions and research progress of fNIRS in this field, the controversies, and the future research directions, aiming to provide a reference for the research and practice of neurological rehabilitation in stroke.

Significance of the total renal chronicity score in predicting renal and cardical outcome in patients with diabetic kidney disease

YUAN Yanggang, ZHANG Chengning, MAO Huijuan, DUAN Suyan

Available online:May 19, 2025, DOI:

[Abstract] (158) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: This study aimed to explore the prognostic value of the chronicity score in patients with diabetic kidney disease (DKD) patients and compare it with the traditional DKD RPS pathological classification. Methods: The clinical data and pathological examination results of 129 patients, who were hospitalized in the First Affiliated Hospital of Nanjing Medical University and pathologically diagnosed with DKD by renal biopsy from January 2014 and September 2020,were retrospectively analyzed in this study. Based on the renal chronicity score, patients were divided into three groups: mild (n=34), moderate (n=50), and severe (n=45). The clinical characteristics and pathological indicators of each group were compared, and the results were evaluated against the DKD RPS pathological classification. Cox regression analysis was used to identify factors influencing poor renal outcomes, Kaplan-Meier survival curves were employed to compare cumulative renal event-free survival rates, and receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic value of the chronicity score alone and in combination with estimated glomerular filtration rate (eGFR) and 24-hour urinary protein in predicting renal outcomes. Results: Patients with higher chronic lesion scores exhibited worse renal function,more pronounced anemia, and a higher pathological grade according to the DKD RPS classification. The Kaplan-Meier survival analysis revealed that patients with higher chronic lesion scores had significantly lower cumulative survival rates without renal endpoint events, indicating poorer prognosis (P<0.05). Cox regression analysis identified a high chronic lesion score as an independent risk factor for renal endpoint events (P<0.05). The ROC curve analysis demonstrated that the diagnostic value of the chronic lesion score was slightly lower than that of the DKD RPS pathological grade (AUC=0.651 vs. 0.875), though no statistical difference was observed between the two. When combined with eGFR and 24-hour urinary protein, the AUC value of the chronic lesion score increased to 0.810.

The effects of Akt1-increased FBXO6 expression on the proliferation and invasive of glioma cells

CAO Dandan, NI Siqi, ZHANG Jing, WANG Yingwei, ZHAO Chenhui

Available online:May 19, 2025, DOI:

[Abstract] (153) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective: To examine the expression of FBXO6 in glioma tissues and cells and its impact on the proliferation and invasion of glioma cells, and to explore the upstream regulatory mechanism of FBXO6 expression. Methods: The CGGA database was used to analyze the expression of FBXO6 in tumor tissues of glioma patients and its correlation with patient prognosis. RT-PCR and Western blot were performed to check the expression levels of FBXO6 in glioma cell lines (U251, U373, and U87), and U87 cells with the highest expression were screened out. RT-PCR, Western blot, CCK-8, and Transwell experiments were carried out to detect the effects of FBXO6 overexpression and silencing on the proliferation and invasion of U87 cells. U87 cells were treated with U0126 (an ERK1/2 inhibitor), SP600125 (a JNK inhibitor), and Perifosine (an Akt1 inhibitor), and Western blot was conducted to examine the expression and phosphorylation levels of relevant proteins. Subsequently, RT-PCR and Western blot were used to detect the expression changes of FBXO6, and then CCK-8 and Transwell experiments were performed to measure the proliferation and invasion capabilities of U87 cells. FBXO6 was overexpressed in U87 cells, which were then treated with Perifosine, and RT-PCR, Western blot, CCK-8, and Transwell experiments were carried out to investigate the levels of FBXO6 expression, cell proliferation, and invasion. Results: In glioma patients, the expression of FBXO6 in cancer tissues was significantly higher than that in adjacent tissues and was closely associated with poor patient prognosis. All three glioma cell lines, namely U251, U373, and U87, expressed FBXO6, with U87 cells showing the most significant expression. The proliferation and invasion of U87 cells were significantly enhanced after FBXO6 overexpression, while they were significantly weakened after FBXO6 silencing. The Akt1 inhibitor could significantly down-regulate the expression of FBXO6 in U87 cells, whereas the ERK1/2 and JNK inhibitors had no significant effect on FBXO6 expression. The Akt1 inhibitor could significantly reduce the proliferation and invasion of U87 cells, and FBXO6 overexpression could antagonize the above effects. Conclusion: Activation of Akt1 in glioma cells up-regulates the expression of the FBXO6 gene, promoting cell proliferation and invasion.

The application of three-dimensional reconstruction images of coronary CT angiography in preoperative planning of off-pump coronary artery bypass grafting

YU Wan, GENG Le, CHEN Aidong

Available online:May 19, 2025, DOI:

[Abstract] (161) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective：To evaluate the clinical effect of 3D reconstruction images of coronary CT angiography in preoperative planning of off-pump coronary artery bypass grafting.Methods：The clinical data of 158 patients who underwent coronary artery bypass grafting from January 2021 to March 2023 in the Department of Cardiac Macrovascular Surgery of the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. Among them, 113 patients underwent conventional coronary artery bypass grafting guided by coronary angiography (conventional group) and 45 patients underwent coronary artery bypass grafting guided by coronary angiography and Three-dimensional reconstruction of coronary artery CT angiography (3D group). The outcome measures included operation time, Intraoperative blood loss,ventilator use time, postoperative monitoring time and hospital stay, postoperative atrial fibrillation, acute kidney injury and other complications, and 1 year postoperative cardiac ultrasound and coronary CT angiography follow-up results.Results：There was no significant difference between the two groups in the time of ventilator use, the time of postoperative monitoring, the time of hospital stay, and the results of coronary CT angiography and cardiac ultrasound follow-up 1 year after surgery (p>0.05) However, the operation time of the 3D group (250.69±41.42) and the conventional group (270.97±57.19), the difference between the two groups was statistically significant (p<0.05), and the amount of blood loss during the 3D operation was less than that of the conventional group (p<0.05)..Conclusion：Compared with conventional CAG guided off-pump coronary artery bypass grafting, the addition of coronary CT angiography can shorten the operation time, reduce the amount of intraoperative blood loss, and obtain better surgical results.

Adult hippocampal neurogenesis and depression: hypothesis and evidences

ZHANG Jing

Available online:May 19, 2025, DOI:

[Abstract] (127) [HTML] (0) [PDF 0.00 Byte] (0)

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Depression, as a neuropsychiatric disorder with high prevalence, strong invisibility and high relapse rate, is a serious threat to human physical and mental health. The hippocampus, a key brain region for regulating emotional and cognitive functions, has been found to have persistent neurogenesis in its dentate gyrus during adulthood. In recent years, a large body of evidence suggests that adult hippocampal neurogenesis processes are closely related to the pathophysiology of depression. However, the causal relationship between adult hippocampal neurogenesis and the pathology of depression has not been systematically summarized. In this review, we analyzed four aspects of evidence supporting the ‘adult hippocampal neurogenesis hypothesis’ of depression: reduction of adult hippocampal neurogenesis induces depressive phenotypes and related pathologies; depression models reduce adult hippocampal neurogenesis; increased adult hippocampal neurogenesis exerts antidepressant effect; and current antidepressants treatment increases adult hippocampal neurogenesis. This review is the first to comprehensively summarize the causal role of adult hippocampal neurogenesis in depression, providing new perspectives on the mechanisms of depression and antidepressants.

Research status of obstructive sleep apnea in women

唐小庆, Guo Hua, 崔小川

Available online:May 06, 2025, DOI:

[Abstract] (185) [HTML] (0) [PDF 0.00 Byte] (0)

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Obstructive Sleep Apnea (OSA) is a potentially life-threatening condition characterized by disordered breathing during sleep, which can result in a range of adverse health outcomes. The prevalence of OSA in women varies across different life stages, with a notable increase observed during pregnancy and post-menopause. The pathophysiological mechanisms underlying OSA in women involve anatomical, physiological, and hormonal alterations, leading to clinical manifestations that differ from those observed in males. Consequently, this article aims to review the current research landscape of female OSA, encompassing epidemiology, pathophysiological mechanisms, diagnostic and evaluative approaches, as well as treatment and management strategies, with the goal of providing novel insights to enhance the diagnosis and treatment of female OSA.

Non-vesicular extracellular nanoparticles：a critical mode of intercellular communication

王静晓, 朱国庆

Available online:May 06, 2025, DOI:

[Abstract] (162) [HTML] (0) [PDF 0.00 Byte] (0)

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Non-vesicular extracellular nanoparticle (NVEP) are newly discovered nanoscale-sized particles released by cells. Two types of NVEPs with important intercellular communication functions are exomere (EM) and supermere (SM). They differ from extracellular vesicle (EV) in that they are not enclosed by a plasma membrane and have a smaller diameter. Both EMs and SMs contain various signaling molecules including proteins, nucleic acids, and lipids, and their primary function is to realize intercellular communication. The EMs or SMs transport signal molecules to target cells, and are taken up by the target cells, thereby regulating the phenotype and function of the cells. This review mainly focused on the latest research progress of EMs and SMs in the aspects of cell biology, pathophysiology, pathogenesis and potential value.

The Research Progress on KMT2A-Rearranged Acute Myeloid Leukemia

李佳欣, TAOShandong

Available online:May 06, 2025, DOI:

[Abstract] (238) [HTML] (0) [PDF 0.00 Byte] (0)

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The lysine methyltransferase 2A (KMT2A) gene, also known as the mixed lineage leukemia (MLL) gene, is involved in normal hematopoiesis and metabolism in humans. KMT2A-rearranged acute myeloid leukemia (KMT2A-r AML) is a specific type of AML characterized by high malignancy. It is insensitive to the conventional AML chemotherapy regimen of anthracycline daunorubicin (DNR) combined with cytarabine (Ara-C) "3+7", resulting in low remission rates and high relapse rates. In recent years, preclinical and clinical studies on KMT2A-r AML have been progressively undertaken. At present, the Menin inhibitor revumenib is the first targeted drug approved by the United States Food and Drug Administration (FDA) for the treatment of relapsed or refractory KMT2A-r acute leukemia, and research on the DOT1L inhibitor pinometostat in combination with various other drugs is ongoing. Additionally, hematopoietic stem cell transplantation (HSCT) and chimeric antigen receptor T-cell (CAR-T) therapies have been subjects of clinical application studies. This article will review the pathogenesis of KMT2A-r AML, targeted drugs, ongoing clinical trials, potential therapeutic targets, and the application of HSCT and CAR-T therapies, aiming to provide new perspectives for the research and treatment of this condition.

Significance of anti-SSA positive with or without anti-SSB positive in children with lupus nephritis

cheruochen, zhaosanlong, dingguixia, zhaofei

Available online:May 06, 2025, DOI:

[Abstract] (148) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the clinical significance of anti-SSA positive with or without anti-SSB positive in children with lupus nephritis.Methods:The clinicopathological data of children with lupus nephritis newly diagnosed in the nephrology Department of Nanjing Children""s Hospital from January 1, 2018 to January 1, 2023 were retrospectively analyzed. According to the test results of autoantibodies, they were divided into two groups: anti-SSA positive group with or without anti-SSB positive group and anti-SSA and anti-SSB negative group. The clinical manifestations, SLEDA scores and pathological features were compared among all groups, and the remission of lupus nephritis after six months of treatment was followed up. Results: Eighty-five children with lupus nephritis were enrolled in this study, including 34 children in the anti-SSA positive group with or without anti-SSB positive group (12 children in the anti-SSA positive group with or without SSB positive group, 22 children in the SSA positive group with or without SSB positive group), and 51 children in the anti-SSA negative group with or without SSB positive group. The anti-SSA positive group with or without anti-SSB positive group and the omly anti-SSA positive group had no statistical significance compared with the anti-SSA and anti-SSB negative group, respectively (P > 0.05). The incidence of rash in the anti-SSA and SSB positive group was lower than that in the anti-SSA and SSB negative group, the difference was statistically significant (P < 0.05), and the non-remission rate in the anti-SSA and SSB positive group was higher than that in the anti-SSA and SSB negative group, the difference was statistically significant (P < 0.05).Conclusion:Children with anti-SSB positive lupus nephritis are all accompanied by anti-SSA positive, and children with both anti-SSA and SSB positive lupus nephritis have a lower incidence of rash clinically, but a higher renal unremission rate for half a year, which may require more aggressive renal treatment.

Research Advances of Hydrogels in the Treatment of Retinal Diseases

HuZizhong

Available online:April 29, 2025, DOI:

[Abstract] (166) [HTML] (0) [PDF 0.00 Byte] (0)

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Hydrogels are cutting-edge polymeric materials with potential for application across various fields. They have become one of the hot topics in research areas such as tissue engineering and biomedical engineering, thanks to their good biocompatibility, efficient drug-loading capacity, and intelligently tunable mechanical and biological properties. In recent years, hydrogels have also been widely studied in the field of ophthalmology. This review first introduces the preparation methods and gelation characteristics of hydrogels, and then discusses their application prospects in major retinal diseases such as age-related macular degeneration, diabetic retinopathy, and retinal detachment from aspects of anti-angiogenesis, antioxidant and anti-inflammatory effects, and as vitreous substitutes, providing important reference and guidance for future research and clinical applications.

Prediction of prognosis in patients with node-positive gastric cancer by modified lymph node ratio

张嘉男, Li Fengyuan, Li Qingya, Wang Linjun, Zhang Diancai, Wang Guoliang, Yang Li, Xu Zekuan, 徐皓

Available online:April 29, 2025, DOI:

[Abstract] (157) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To combine lymph node ratio (LNR) with central lymph node metastasis (CnLNs) to construct modified lymph node ratio (mLNR), and then investigated the impact mLNR had on prognosis of patients with gastric cancer. Methods: Chi-square analysis was performed to analyze the differences between groups of CnLNs- and CnLNs+ gastric cancer patients, Cox regression analysis was performed to analyze the factors affecting the survival of gastric cancer patients, receiver operating characteristic (ROC) curve was constructed to determine the cut-off value of LNR classification, Kaplan-Meier curve was drawn to visually analyze the survival of gastric cancer patients, and nomogram was constructed to predict the survival and prognosis of gastric cancer patients. Results: Way of gastrectomy (P =0.042), tumor size (P =0.043), degree of differentiation (P =0.001), vascular invasion (P <0.001), neural invasion (P <0.001), T stage (P =0.001) and N stage (P <0.001), CEA (P =0.002) and CA199 (P =0.026) were significantly different between the two groups. Both LNR and CnLNs were able to distinguish the survival of gastric cancer patients, but LNR seemed more effective than CnLNs. In addition, mLNR could well predict the survival of patients with gastric cancer and was an independent risk factor affecting the survival of patients with gastric cancer. Conclusion: Utilizing CnLNs to construct mLNR was an independent risk factor for the survival of gastric cancer patients and was expected to be a novel prognostic indicator for patients with gastric cancer.

The impact of myocardial scar and drug treatment response on the risk of ventricular arrhythmia in nonischemic myocardial disease

zhang en rui, zhang xin wei

Available online:April 29, 2025, DOI:

[Abstract] (117) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the impact of myocardial scar and drug treatment response on the risk of ventricular arrhythmia in patients with nonischemic cardiomyopathy(NICM). Methods: A retrospective analysis was conducted on 77 NICM patients with left ventricular ejection fraction (LVEF)≤35% who underwent cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE) and received drug treatment. The LVEF change during the one-year follow-up period were collected. Response to drug treatment was defined as LVEF increase≥10% within one year. The primary outcome endpoint is ventricular tachyarrhythmia (VTA), which includes persistent ventricular tachycardia (VT), ventricular fibrillation (VF), sudden cardiac death (SCD), and aborted SCD. The secondary endpoint is the long-term composite endpoint of VTA, all-cause mortality, and heart failure hospitalization (HFH).Kaplan Meier curves and Log rank tests were used for survival analysis, while Cox proportional hazards regression was used for multivariate analysis.Results: After a median of 34(16-49) months follow-up,The change in LVEF within one year after drug treatment were not related to LGE (P=0.379), but negatively correlated with LGE burden, with a correlation coefficient of -0.295 (95% CI: -0.487~-0.076, P=0.009).During follow up,five patients experienced VTA events. In survival analysis,VTA events were associated with LGE burden (P=0.005) and not with the presence of LGE and drug response (P=0.309,P=0.890). In the multivariate Cox regression model, LGE burden was an independent risk factor of VTA events (HR=1.075, 95% CI 1.002-1.054, P=0.043). The long-term composite endpoint of NICM patients is related to LGE burden and changes in LVEF (P=0.040, P=0.025).Conclusion: LGE burden is an independent risk factor of VTA events in NICM patients, and the occurrence of VTA events is not related to drug treatment response.

The clinical significance of thrombotic events in newly diagnosed multiple myeloma patients treated with IMiDs and comparison of the predictive efficacy of thrombosis risk assessment scales.

SHI Qinglin, JIN Yuanyuan, SHEN Xuxing

Available online:April 28, 2025, DOI:

[Abstract] (170) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective This study aimed to examine the relationship between venous thromboembolism and the prognosis of newly diagnosed multiple myeloma (MM) treated with immunomodulatory drugs (IMiDs), and to analyze the risk factors for venous thromboembolism (VTE). To compare the predictive efficacy of the three thrombosis risk assessment scores (Padua, SAVED and IMPEDE score) in VTE in MM patients. Methods A retrospective examination was conducted on the clinical data of 221 NDMM patients treated with IMiDs at Jiangsu Provincial People's Hospital from January 2016 to October 2020, the correlation between VTE and the prognosis of MM patients was analyzed. The VTE risk of patients was quantitatively assessed with Padua, SAVED and IMPEDE scores. The predictive value of the three scales for VTE was compared based on the area under the ROC curve (AUC). Results Of the 221 patients, the incidence of VTE was 15.8%. Patients with age over 75 years, central venous catheterization (CVC), recent surgery, braking on the bed, extramedullary disease, anthracycline using, autoimmune disease and hypoalbuminemia had a higher incidence of VTE. Age over 75 years, CVC, autoimmune disease and hypoalbuminemia were independent unfavorable factors for VTE. Among Paudua, SAVED, and IMPEDE scores, IMPEDE score is superior to the other two scores in efficacy evaluation of predicting the formation of VTE in newly diagnosed MM patients. Conclusion Age over 75 years, CVC, autoimmune disease and hypoalbuminemia were independent unfavorable factors for VTE. IMPEDE score is suitable for predicting VTE in patients with NDMM.

CT Radiomics Combined with Clinical-Pathological Features Predict Disease-Free Survival in Non-Metastatic Grades 2-3 Clear Cell Renal Cell Carcinoma

chen chen, yang ya wen, chai shun

Available online:April 28, 2025, DOI:

[Abstract] (175) [HTML] (0) [PDF 0.00 Byte] (0)

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Abstract: Objective: To evaluate the predictive value of preoperative enhanced CT radiomic feature models in comparison with clinical-pathological feature models for disease-free survival (DFS) in patients with non-metastatic grades 2-3 clear cell renal cell carcinoma (ccRCC). Methods: A retrospective analysis was conducted on 315 patients with non-metastatic ccRCC who underwent surgical treatment and were pathologically graded as grades 2-3 between January 2013 and December 2020. Preoperative enhanced CT images, clinical-pathological information, and DFS data were collected. The region of interest (ROI) of the lesion was delineated using ITK-SNAP, and radiomic features were extracted using Python. Patients' radiomic scores were calculated using the least absolute shrinkage and selection operator (LASSO) and Cox regression analysis. Clinical-pathological feature models, radiomic models (corticomedullary phase, parenchymal phase, corticomedullary + parenchymal phase), and combined radiomic and clinical-pathological feature models were constructed to predict patients' DFS efficacy. Results: When predicting DFS in non-metastatic grades 2-3 ccRCC patients, the combined radiomic model of corticomedullary + parenchymal phase demonstrated superior predictive efficacy (C-index: training set 0.848, validation set 0.754) compared to single-phase radiomic models (corticomedullary phase C-index: training set 0.832, validation set 0.701; parenchymal phase C-index: training set 0.842, validation set 0.720). However, the combined model incorporating both radiomic and clinical-pathological features exhibited the highest predictive efficacy (C-index: training set 0.857, validation set 0.832). Conclusion: The model combining radiomic features extracted from preoperative enhanced CT images of corticomedullary and parenchymal phases with clinicopathological features assists in predicting postoperative DFS in non-metastatic grades 2-3 ccRCC.

Expression of CYB5R2 in diffuse large B-cell lymphoma and its clinical significance

Gong Yuxi, Yang Yefan, Gan Wenyuan, Chen Gang, Xiao Jingjiao, Zhang Shiting

Available online:April 14, 2025, DOI:

[Abstract] (170) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective To investigate the expression of NADH-Cytochrome b5 reductase 2 (CYB5R2) in diffuse large B-cell lymphoma (DLBCL) and its clinical significance. Methods GO enrichment analysis was performed on DLBCL differentially expressed genes in TCGA database by DAVID online platform, and CYB5R2 was screened. The CYB5R2 expression of DLBCL in TCGA database and GTEX database was analyzed by bioinformatics method. The correlation between CYB5R2 expression and clinicopathological features and prognosis in 59 cases of DLBCL with complete follow-up data in our hospital was retrospectively analyzed. Results The expression of CYB5R2 in DLBCL was higher than that in normal lymphoid tissue (P < 0.05). The positive expression of CYB5R2 in the cases with elevated lactate dehydrogenase (LDH) was higher than that in the cases with normal LDH (χ2=4.832, P= 028). The positive expression of Non-GCB subtype cases was higher than that of GCB subtype cases (χ2=4.468, P= 035), and the positive expression of CD10-positive cases was higher than that of CD10-negative cases (χ2=4.468, P= 035). survival analysis showed that the 5-year overall survival (OS) of patients with high CYB5R2 expression was significantly lower than that of patients with zero or low CYB5R2 expression (χ2=4.799, P=0.028). The rate of complete response (CR) in patients with high expression was significantly lower than that of CYB5R2 expression was significantly lower than that of patients with zero or low CYB5R2 expression (χ2=4.799, P=0.028). The complete response (CR) rate in patients with high expression was significantly lower than that in patients with zero/low expression of CYB5R2 (χ2=4.015, P=0.045). Conclusion The high expression of CYB5R2 is associated with poor prognosis in DLBCL patients, suggesting that CyB5R2 plays an important role in the development of DLBCL.

Neutrophils: a stumbling block in stroke reperfusion therapy

WU Haiyin

Available online:April 14, 2025, DOI:

[Abstract] (197) [HTML] (0) [PDF 0.00 Byte] (0)

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Stroke is an acute neurologic injury caused by ischemia or hemorrhage that stems from a wide range of pathologies, with high rates of morbidity, mortality, and disability. Thrombolysis and endovascular thrombectomy are the only FDA approved methods for the treatment of acute ischemic stroke (AIS), but the clinical benefits of reperfusion therapy are significantly limited by hemorrhagic transformations (HT), resistance to thrombolytic drugs, and reperfusion no-reflow. Although the factors leading to these problems are complex, neutrophils play the most critical role in them. Based on the latest research progress in recent years, this review focuses on the role of neutrophils in mediating the pathophysiological events of AIS, the specific mechanisms by which neutrophils cause HT, thrombolytic drug resistance, and no-reflow after reperfusion therapy, as well as strategies targeting neutrophils to prevent or alleviate these complications following reperfusion therapy, offering new insights for the clinical therapy and drug development of ischemic stroke.

Iguratimod Alleviates Interstitial Fibrosis in Chronic Allograft Dysfunction by Inhibiting Macrophage-to-Myofibroblast TransitionObjective: To investigate the role and mechanism of Iguratimod in interstitial fibrosis of chronic allograft dysfunction (CAD) in transplanted kidneys.

Ni Bin, Zheng Ming, Tan Ruoyun, Gu Min

Available online:April 14, 2025, DOI:

[Abstract] (178) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the role and mechanism of Iguratimod in interstitial fibrosis of chronic allograft dysfunction (CAD) in transplanted kidneys. Methods: We constructed and validated a mouse model of chronic allograft dysfunction. Iguratimod was administered via gavage. Histological staining was used to assess injury and fibrosis in transplanted kidneys. Immunofluorescence staining , Western blot, and qRT-PCR were utilized to detect fibrosis markers and changes in macrophage-to-myofibroblast transition (MMT) in the transplanted kidneys of CAD mice. TGF-β was used to induce MMT in primary mouse bone marrow-derived macrophages (BMDMs) in vitro, followed by Iguratimod intervention. Transcriptome sequencing was employed to explore the downstream molecular mechanisms by which Iguratimod regulates MMT. Results: We successfully constructed and validated the mouse CAD model. HE, PAS, and Masson staining revealed significant interstitial fibrosis in the transplanted kidneys of CAD mice at 16 weeks post-transplantation. Immunofluorescence staining showed a significant upregulation of MMT in the transplanted kidneys. However, Iguratimod treatment significantly reduced interstitial fibrosis and the number of MMT cells in CAD mice at 16 weeks. In vitro experiments indicated that Iguratimod significantly reduced TGF-β-induced MMT. Transcriptome sequencing results suggested that Iguratimod mitigates fibrosis by inhibiting MMT via the ferroptosis-related pathway. Conclusion: We successfully constructed and validated a mouse CAD model. Iguratimod alleviates interstitial fibrosis in transplanted kidneys and slows the progression of CAD by upregulating the ferroptosis-related pathway to inhibit MMT. This may provide new insights for the further application of Iguratimod in allograft kidney transplantation.

Progress in the mechanism of drug resistance of antibody drug conjugates in Breast cancer

Fei Qu, Kai Yang

Available online:April 14, 2025, DOI:

[Abstract] (169) [HTML] (0) [PDF 0.00 Byte] (0)

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Antibody-drug conjugates (ADCs) are synthesized by conjugating monoclonal antibodies with linkers and cytotoxic drugs. This conjugation harnesses the highly specific targeting capabilities of antibodies along with the potent cytotoxic effects of the drugs, demonstrating significant efficacy in the treatment of breast cancer. Nonetheless, the extensive clinical application of ADCs has revealed instances of resistance in breast cancer patients. In this paper, we provide a comprehensive overview of the structure and mechanism of ADCs, along with their current applications in the treatment of breast cancer. We categorize the mechanisms of ADC resistance into several distinct types: reduction in target antigen-antibody binding, impaired internalization and transport pathways of ADCs, dysfunctional lysosomal activity, abnormal payload release, tumor insensitivity to the payload, and the involvement of Cyclin. Additionally, we discuss the current challenges associated with ADC resistance, ongoing research into novel ADCs, and potential combination treatment strategies.

Adhesive capsulitis of the shoulder: research progress in pathogenesis, diagnosis and treatment

ZENG Lingqing

Available online:April 07, 2025, DOI:

[Abstract] (230) [HTML] (0) [PDF 0.00 Byte] (0)

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Adhesive capsulitis of the shoulder is a prevalent cause of shoulder pain, characterized by pain, limited range of motion and functional impairment. Currently, the etiology and pathogenesis of the disease remain unclear, with clinical diagnosis primarily based on medical history, physical examination and imaging data. There are various treatment approaches available both domestically and internationally, but consensus has yet to be reached. This article will review the latest research on the pathogenesis, diagnosis, and treatment advancements of adhesive capsulitis of the shoulder.

The Transcriptional Heterogeneity of Astrocytes in Huntington's Disease

Yang Qinghu, Yuan Zengqiang

Available online:April 07, 2025, DOI:

[Abstract] (150) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: This study aims to elucidate the activation status and transcriptional heterogeneity of astrocytes in the mouse brain during the progression of Huntington’s disease (HD) and to screen for and identify differentially expressed molecules on the key issue. Methods: (1) Immunofluorescence was employed to examine the transformation of HD astrocytes into reactive astrocytes at both the early and late stages of the disease, and this transformation was subsequently verified by RT-qPCR; (2) Single-cell dissociation and magnetic bead sorting techniques were utilized to isolate astrocytes from mouse brains for subsequent transcriptome sequencing; (3) Bioinformatics analysis was conducted to identify differentially expressed genes (DEGs) and to perform GO functional enrichment analysis on the transcriptome data from the early and late stages of HD; (4) Genes related to the progression of HD were selected for Protein-protein interaction network (PPI-network) analysis, and the expression of core genes was validated. Results: In the late stage of HD, astrocytes transform into A1-type reactive astrocytes; in the early stage of the disease, DEGs in HD mouse astrocytes were predominantly associated with synaptic functions, such as synaptic cleft and the maintenance of synaptic structure, whereas in the late stage, they were mainly involved in chemotactic activity, signal transduction, and cellular response functions; core genes of astrocytes during HD progression were mainly related to angiogenesis, RNA splicing, metabolism, and muscle movement. Conclusion: In the early stage of HD, astrocytes influence neuronal development and synaptogenesis. Later in the disease course, they transform into neurotoxic type A1 reactive astrocytes. Astrocyte heterogeneity genes that are independent of the aging process can serve as effective molecular markers for the progression and prediction of HD, and the findings are expected to provide a new reference for the early detection and treatment of HD.

Amphiregulin facilitates intestinal fibrosis in Crohn's disease by upregulating the expression of LPA-LPAR3 to regulate activation of intestinal fibroblasts

WANG Shua, ZHAO XiaoJinga

Available online:April 07, 2025, DOI:

[Abstract] (172) [HTML] (0) [PDF 0.00 Byte] (0)

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To elucidate the potential involvement of amphiregulin (AREG) in the pathogenesis of intestinal fibrosis in Cronh’s disease(CD). Methods: Differentially expressed genes were identified through transcriptome sequencing following AREG(100ng/ml) treatment of human intestinal fibroblasts for 48h, aiming to uncover the underlying mechanisms by which AREG contributes to intestinal fibrosis; Fibrotic and non-fibrotic tissues were obtained from CD patients undergoing surgical resection for clinical validation; cell proliferation and migratory capacity were assessed via Ki67 immunofluorescence and scratch assays, while expression levels of Col1a1、Col6a1、and Col6a3 were quantified using qRT-PCR and α-smooth muscle actin(α-SMA) was quantified by Western blot. Results: Analysis of RNA-seq data revealed that AREG enhances the expression of lysophosphatidic acid receptor 3(LPAR3) in human intestinal fibroblasts. Additionally, elevated levels of lysophosphatidic acid (LPA) were found in the plasma of CD patients with intestinal fibrosis compared to those without it, while LPAR3 expressions increased at the sites affected by fibrosis as opposed to nonfibrotic sites from CD patients. In vitro experiments demonstrated that AREG promotes the secretion of LPA by human intestinal fibroblasts, which subsequently increases the protein expression of LPAR3 and stimulates cell migration, proliferation, activation, and collagen production. The effects on cells can be attenuated by LPAR3 inhibitors. Conclusion: AREG may play a significant role in the pathogenesis of CD-related intestinal fibrosis through the LPA-LPAR3 signaling pathway; thus, targeting the AREG-LPA-LPAR3 axis could represent a promising therapeutic strategy for managing intestinal fibrosis.

Clinical pattern of Crohn's disease in children: a single-centre, 3-year follow-up study

郭红梅

Available online:April 07, 2025, DOI:

[Abstract] (154) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective To investigate the clinical pattern and influencing factors of pediatric Crohn's disease. Methods To conduct a retrospective analysis of 59 patients who were originally diagnosed with Crohn's disease and treated at the Children's Hospital Affiliated to Nanjing Medical University, from November 2015 to November 2020. All patients’ baseline datum were gathered, including demographics like age and sex, clinical presentation, laboratory, radiological, and endoscopic tests, as well as details on their treatment plan. Patients were followed up until December 31, 2023, and we analyzed the factors which influence the clinical pattern of children with Crohn's disease by logistic regression. Results There were 59 children with Crohn's disease. 11 patients were lost to follow-up, and 48 patients completed long-term follow-up, with a median follow-up of 42 months (range: 36-82 months). The median age of the 48 patients was 12.6 years (range: 1.1-15.9 years) and 29.2% (14 cases) were female. During the follow-up, 1 patient died, 1 underwent partial enterectomy, 7 patients (14.58%) developed new stenotic disease behavior, and 29 patients (60.4%) recurred. During the follow-up period, 31 patients (64.6%) reported a decrease in the severity of intestinal symptoms . Only 2 patients (4.2%) reported an increase in symptom severity, while 5 patients (10.4%) reported chronic persistent symptoms and 10 patients (20.8%) reported chronic recurrent symptoms .The regression models indicated that wasting at the time of initial diagnosis could be a risk factor for patients to progress to the 'severe' pattern (OR, 4.009, 95% CI, 1.047-15.346, P=0.043); the percentage of patients with combined stenosis or perforation was significantly higher in the "severe" pattern than in the "quiescent" pattern (41.2% versus 16.1%); the Crohn's disease pattern was not influenced by the treatment regimen at the time of initial diagnosis. Conclusion Wasting at the time of initial diagnosis could potentially increase the risk of progressing to a 'severe' disease pattern, which may require more aggressive treatment and closer follow-up.

Advances in the treatment of immune checkpoint inhibitor-related pneumonitis

Ji Chenfei, Wang Jiayue, Miao Xue

Available online:March 27, 2025, DOI:

[Abstract] (177) [HTML] (0) [PDF 0.00 Byte] (0)

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Immune checkpoint inhibitors have been widely used in cancer treatment. Although they are generally better tolerated than chemotherapy, they can cause immune-related adverse events. Among these, immune checkpoint inhibitor-related pneumonitis (CIP) has a relatively high mortality rate, with limited evidence from evidence-based medicine and limited experience in diagnosis and treatment. This article reviews the therapeutic advancements in CIP based on domestic and international guidelines, expert consensus, and relevant studies, with particular focus on the treatment progress of steroid-refractory CIP.

Prospective Analysis of Early Gut Microbiota Changes in Elderly Patients with Severe Burns based on high-throughput sequencing of 16S ribosomal RNA

XIE wei guo, CHEN xiao hong, LIU meng

Available online:March 27, 2025, DOI:

[Abstract] (157) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To analyze the early changes in the gut microbiota of elderly patients with severe burns using high-throughput sequencing of 16S ribosomal RNA (16S rRNA). Methods: Thirteen patients with severe burns (Burn group) and twelve healthy volunteers (Control group) were enrolled according to the inclusion and exclusion criteria. Clinical data and fecal samples were collected from both groups, and 16S rRNA V4 region gene sequencing was performed to assess the relative abundance of various bacterial taxa. The Rarefy method was employed to generate operational taxonomic units (OTUs), and Z-score normalization was applied to identify differentially abundant bacteria. A heatmap for differential bacterial communities was constructed. The number of fecal microbiota OTUs and diversity indices were analyzed using QIIME (version 1.9.1). Linear discriminant analysis effect size (LEfSe) was used to identify dominant bacterial groups. The functional abundance of the microbiota was predicted using PICRUSt2 software. The correlations among differential bacterial taxa at the genus level were visualized using the igraph package in R language. Data were analyzed using independent sample t-tests, Wilcoxon rank-sum tests, chi-square tests, and Kruskal-Wallis tests, with a significance threshold of P < 0.05. Results: The early gut microbiota of severe burn patients was predominantly composed of Firmicutes and Bacteroidota. Twenty-three bacterial genera exhibited significant differences between the two groups (P < 0.05). The heatmap of differential bacterial communities indicated that the Burn group had a slightly lower abundance of microbial taxa than the Control group. LEfSe analysis indicated that the LDA scores for Clostridia in the Control group and Bacilli in the Burn group were both greater than 4. Compared to the Control group, the Burn group exhibited a significant increase in bacterial species in one phylum, two classes, six orders, six families, and ten genera. The microbial distribution dendrogram suggested that Bacilli were the primary distinguishing marker for the Burn group, while Clostridia were the main marker for the Control group. KEGG functional prediction analysis indicated no significant differences between the two groups (P > 0.05). Combined network visualization analysis revealed that Firmicutes exerted the greatest influence, with 136 bacterial genera showing significant positive or negative correlations (| cor | > 0.3; P < 0.05), primarily through synergistic interactions. Conclusion: There are significant differences in the early gut microbiota of elderly patients with severe burns compared to their healthy peers, characterized by a reduction in beneficial bacterial species and abundance, an increase in the proportion of anaerobic bacteria, and decreased microbial diversity, along with certain synergistic and antagonistic interactions among different microbiota.

Advances in non-pharmacologic treatment of cancer patients with depression

Zhang Qiaoyang, Dong Guanzhong

Available online:March 27, 2025, DOI:

[Abstract] (145) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Cancer patients are often combined with depressive symptoms, which is not conducive to the recovery of the disease. Currently, the treatment of cancer with depression is based on drugs, but it is prone to interact with antitumor drugs, and the excessive drug burden may lead to poor patient compliance, affecting the treatment and prognosis of the disease. Therefore, it is particularly important to discover safer and more effective treatments. This article reviews the progress of non-pharmacological therapies at home and abroad in recent years, with a view to providing ideas for optimizing the treatment of cancer with depression.

Analysis of clinical features and diagnostic value of hematologic index in etiology of terminal ileum lesions

Zhang Li, Wang Lu, Wang Shu, Lin Junjie, Zhang Hongjie

Available online:March 26, 2025, DOI:

[Abstract] (161) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the spectrum distribution and prognosis of patients with terminal ileum lesions, and to explore the diagnostic value of clinical, endoscopic features and peripheral blood indexes in the etiology of the disease. Methods: This study was a retrospective study, including patients who underwent colonoscopy and found terminal ileum lesions in Jiangsu Province Hospital from January 2014 to June 2021. General information, medical records, endoscopy and pathological reports of the patients were collected, and clinical and endoscopic characteristics and etiological diagnosis were statistically analyzed. The patients with CD and non-specific terminal ileum ulcer were screened, and the clinical and endoscopic characteristics and peripheral blood indexes of the two groups were compared. Results: A total of 956 patients with terminal ileal lesions were included, 93 of whom had a clear diagnosis, including CD, intestinal tuberculosis, benign tumors, adenocarcinoma, etc., 425 were lost to follow-up, and another 438 patients with unknown causes. Among the patients with unknown diagnoses, 293 had a repeat colonoscopy, and 182 of them showed that the lesions disappeared. Finally, 22 patients with CD and 73 patients with non-specific terminal ileal ulcer were screened out. Compared with the latter, patients with CD have a higher incidence of abdominal pain at initial diagnosis and are more likely to show endoscopic features of ileocecal valve involvement. Peripheral blood inflammation-related indicators such as platelets, hemoglobin, albumin, platelet/lymphocyte ratio, and neutrophil/lymphocyte ratio have certain value in assisting in the diagnosis of CD. The combined diagnostic value of the five indicators is higher, with an area under the curve of 0.83. Conclusion: Most terminal ileal lesions are non-specific benign lesions and have a good prognosis. For patients whose terminal ileal lesions, especially ulcers, are first discovered under colonoscopy, attention should be paid to their clinical symptoms and endoscopic characteristics, and combined with changes in peripheral blood inflammation-related indicators, it is helpful to diagnose the cause of terminal ileal lesions.

The correlation between the triglyceride-glucose index and the risk of progression of diabetic retinopathy

WANG Wanying, LU Xiaofan, XU Chong, ZHOU Hui

Available online:March 26, 2025, DOI:

[Abstract] (169) [HTML] (0) [PDF 0.00 Byte] (0)

Abstract:
Objective To investigate the correlation between triglyceride-glucose (TyG) index and the risk of progression of diabetic retinopathy (DR). Methods 521 patients with type 2 diabetes mellitus who were hospitalized in the Department of Endocrinology of the Affiliated Suqian Hospital of Xuzhou Medical University from June 2022 to June 2023 were included in the study, and the patients were classified into 206 cases in the no-diabetic retinopathy (NDR) group, 159 cases in the non-proliferative diabetic Retinopathy (NPDR) group, and 156 cases in the proliferative diabetic retinopathy (PDR) group, according to the criteria of diagnosis and staging of DR. General data and major biochemical indexes of patients in each group were compared, TyG index was calculated, and the correlation between TyG index and the risk of DR progression was analyzed. Results Multifactorial logistic regression showed that TyG index was an independent risk factor for DR. Ordered logistic regression showed that corrected confounders included sex, age, body mass index (BMI), disease duration, glycated haemoglobin (HbAlc), total cholesterol (TC), low-density lipoprotein (LDL), high density lipoprotein (HDL), creatinine (CR), uric acid (UA) and diabetic peripheral neuropathy (DPN), there was a significant correlation between TyG index and the risk of DR progression, Q3 vs Q1 OR=4. 18 (2.55-6.85), and the risk of DR progression increases with the TyG index. Subgroup analysis proved that the Q3 group was still more likely to develop severe DR. The results of interaction analysis showed that there was a significant interaction between TyG index and age&BMI, patients aged >60 years and BMI >24 were at higher risk of DR. Conclusion TyG index is an independent risk factor for DR, and there is a significant correlation between TyG index and the risk of DR progression. The risk of DR progression increases with the TyG index. The risk of DR was higher among older and overweight patients.

Evaluate the efficacy of neoadjuvant chemoradiotherapy for locally advanced rectal cancer based on clinical and MR image data

孟慧慧, Yu Jing

Available online:March 26, 2025, DOI:

[Abstract] (155) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective:Based on clinical and magnetic resonance imaging data,to explore the risk factors of pathological complete remission after neoadjuvant chemoradiotherapy for locally advanced rectal cancer.Methods:From December 2014 to November 2022,175 patients with locally advanced rectal cancer diagnosed by biopsy and clinical diagnosis who underwent TME after neoadjuvant chemoradiotherapy were retrospectively analyzed,including 117 males and 58 females,aged from 22 to 82 years,with an average of (56.93±11.886) years.There were 122 cases in the training group (pathological complete response group n=30,non-pathological complete response group n=92) and 53 cases in the verification group (pCR group n=10,non-pCR group n=43).Clinical data,imaging examination and pathological data of patients before and after treatment were collected.The differences between groups were compared by independent sample T test or Kruskal Wallis rank sum test .χ2 test or Fisher exact test were used to compare the counting data sets.For all statistical analysis results,P<0.05 is considered as a statistical difference.We use the univariate and multivariate Logistic regression to analyze the efficacy of LARC neoadjuvant chemoradiotherapy.The diagnostic efficacy of predictive factors was evaluated by receiver's operating characteristic (ROC) curve.Patients were randomly divided into testing set and validation set according to the ratio of 7:3.The model was validated,and the area under the curve (AUC),cutoff value,sensitivity and specificity were calculated,and the differences of AUC values were compared by DeLong test.Results: There were significant differences in some clinical features between the training set and the validation set between the pCR group and the non-pCR group (the length and diameter of the tumor before and after treatment,the depth of tumor infiltration,the CEA value after treatment,the number of lymph nodes around the tumor after treatment,extramural vascular invasion before and after treatment,the mrT stage after treatment,mesorectal fascia and mrN).After univariate and multivariate logistic regression analysis,The extramural depth after treatment was an independent risk factor for evaluating the efficacy of neoadjuvant chemoradiotherapy.The extramural depth has a good diagnostic efficiency in predicting the curative effect of nCRT in testing set and verification set.The AUC values of the testing set and the validation set were 0.783 and 0.765,the cutoff values were 0.555 and 0.627,the sensitivity was 0.870 and 0.852,and the specificity was 0.733 and 0.773 respectively.There was no statistical difference after Hosmer-Lemeshow goodness of fit test.Conclusion: Evaluating the extramural depth is helpful to evaluate the pCR rate of locally advanced rectal cancer after nCRT,which provides a convenient and noninvasive diagnostic method for clinic and guides clinical individualized treatment.

The Clinical Value of Imaging Model Based on Tumor-pleural relationship on CT for Predicting Occult Lymph Node Metastasis in Lung Cancer

Jia Yizhen, Li Hai, Yu Tongfu, Xu Hai

Available online:March 26, 2025, DOI:

[Abstract] (138) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective:To construct a predictive model based on the clinical and imaging features of lung adenocarcinoma to predict occult mediastinal lymph node metastasis. Methods:A retrospective analysis was conducted on the patients of First Affiliated Hospital of Nanjing Medical University from 2009 to 2019 who underwent surgical treatment and lymph node dissection with/without occult mediastinal lymph node metastasis on pathology.Multiple clinical and imaging features of the patient were collected.Univariate and multivariate analyses were used to screen independent predictors and construct imaging models for multiple CT characteristics.A receiver operating characteristic (ROC) was established to evaluate the predictive efficacy and clinical utility value of each model. Results:Of the 2,287 patients , there were 780 cases of lung adenocarcinoma, of which 145 had lymph node metastases.Univariate analysis suggested that tumor size, axial location, nodal nature, morphological features, pleural pulling sign, and type of pleural adjacency were significantly associated with lymph node metastasis.Multivariate analysis indicated that tumor size (OR = 1.019; 95% CI: 1.002-1.036; p = .028), nodal nature (OR = 0.361; 95% CI: 0.202-0.646; p = .001), pleural involvement (OR = 1.835; 95% CI: 1.152-2.924; p = .011), and presence of mediastinal pleural adjacency (OR = 1.796; 95% CI: 1.106-2.919; p = .018) were independent predictors of occult mediastinal lymph node metastasis.The AUC value of the imaging model was 0.75, with the sensitivity and specificity of 86.2% and 53.1%, respectively. Conclusion:The imaging model based on chest CT plain scan shows an excellent clinical value in predicting occult mediastinal lymph node metastasis of lung adenocarcinoma，which can provide clinicians with a basis for noninvasive preoperative decision making and help thoracic surgeons choose more appropriate surgical treatment options.

The effect of remaining a certain degree of flexion deformities during surgery on efficacy of TKA

Yang Hui, Wang Jinwen, Tan Zhenggang, Bao Xingan, Chen Youquan, Fan Weimin

Available online:March 26, 2025, DOI:

[Abstract] (142) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the effect of remaining a certain degree of flexion deformities(FD) during total knee arthroplasty(TKA) on efficacy of knee osteoarthritis with severe FD. Methods: A total of 95 patients with knee osteoarthritis with severe FD who underwent primary TKA in the First Affiliated Hospital of Nanjing Medical University from October 2013 to September 2021 were retrospectively analyzed. There were 24 males and 71 females, aged 68.85±4.83 years(range from 58 to 79 years). The body mass index was 26.01±4.50 kg/m2(range from 19.70 to 39.39 kg/m2). Based on intraoperative correction of severe FD, the group was divided into an intraoperatively completely-extended group(52 cases)and an intraoperatively incompletely-extended group(43 cases). The operation time, operative blood loss, postoperative swelling degree of lower limbs and the incidence of postoperative complications were recorded, and the hospital for special surgery(HSS)score, activities of daily living(ADLs)and visual analogue scale(VAS)were recorded to compare the differences between the two groups. Results: All patients successfully completed the operation and were followed up for 35.85±1.99 months(range from 33 to 39 months). The intraoperatively incompletely-extended patients got a shorter operation time(P=0.001), less operative blood loss(P<0.001)and milder swelling of the lower limbs(the postoperative circumference of 15 cm above the patella, P<0.001; the postoperative circumference of 10 cm below the patella, P<0.001). The incompletely-extended patients had greater FD than the completely-extended patients at 3 months(P=0.016)after surgery, but gained less pain(P=0.014). No significant differences were observed in postoperative HSS and ADLs scores between the two groups of patients. At 6 months, 12 months, 24 months and 36 months postoperatively, there were no statistically significant differences in FD, HSS, ADLs and VAS between the two groups. There was no statistically significant difference in the HSS improvement between the two groups within 3-6 months, 6-12 months, 12-24 months and 24-36 months after surgery as well. The incompletely-extended patients during TKA had a lower incidence of deep vein thrombosis(P=0.048)compared with the completely-extended patients. There was no statistical difference in the incidence of medium-term and long-term complications between the two groups. Conclusion: When treating knee osteoarthritis with severe FD, remaining a certain degree of FD during TKA does not affect the recovery of knee range of motion and function, while the incidence of deep vein thrombosis is lower.

Carotid intima-media thickness is associated with cognitive impairment in Parkinson's disease

Peng Liya, Xu Yao, Qiao Tingting, Ma Cancan

Available online:March 17, 2025, DOI:

[Abstract] (213) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate whether carotid intima-media thickness (CIMT) and carotid plaque are associated with cognitive impairment in patients with Parkinson's disease (PD). Methods: According to the Monterill Cognitive Assessment Scale, 225 PD patients were divided into three groups: normal cognitive function (NC) group(n=41), mild cognitive impairment (MCI) group (n=76) and dementia (PDD) group (n=108). The differences of clinical and carotid ultrasound indexes were compared, and the independent factors of PD cognitive impairment were analyzed by multiple linear regression. Results: The educational level of NC, MCI and PDD groups showed a downward trend (P < 0.05); H&Y rating, UPDRS-III, Hamilton Depression Scale, Pittsburgh Sleep Quality Index Scale, cystatin C level, CIMT, carotid plaque detection rate and carotid plaque vulnerability score showed an increasing trend (P < 0.05). Regression analysis showed that high education level (P < 0.001) was an independent protective factor for PD cognitive impairment, and CIMT thickness (P=0.002) and high H&Y (P=0.001) were independent risk factors for PD cognitive impairment. Conclusion: Carotid atherosclerosis was associated with cognitive impairment in PD patients.

Mitochonic acid 5 attenuated renal fibrosis via regulating mitochondrial homeostasis

Chenchen, Liqing, Wulin, Xingchangying, Maohuijuan

Available online:March 17, 2025, DOI:

[Abstract] (235) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the effect of mitochondrial targeting drug Mitochonic acid 5 (MA-5) on renal fibrosis and its mechanism. Methods: Twenty-four 8-week-old SPF C57BL/6J male mice were randomly divided into four groups: control group, MA-5 group, unilateral ureteral ligation (UUO) group and UUO+MA-5 group. The ureter and kidney were exposed by modeling operation, and the UUO group and the UUO+MA-5 group were sutured after ligation,while the other two groups were directly sutured after exposure. From the 2nd day after operation, the MA-5 and the UUO+MA-5 group were given MA-5 by gavage continuously until the 7th day, and the control and UUO group were given corn oil by gavage. The mice were sacrificed on the 7th day after UUO, and the kidney and blood samples were collected. Subsequently, Masson and Sirius Red staining were used to detect the degree of renal fibrosis. The expression of α-SMA and Collagen I were explored by immunohistochemistry. Furthermore, Western Blot was used to detect the expression of mitochondrial related proteins. Mouse renal tubular epithelial cells were cultured in vitro and stimulated with transforming growth factor-β (TGF-β). Western Blot was used to detect the expression of α-SMA, Fibronectin and Vimentin in tubular epithelial cells with or without MA-5 intervention. Results: Seven days after UUO, Masson and Sirius Red staining of renal tissue showed that the UUO group had severe renal fibrosis, and the UUO+MA-5 group had significantly reduced renal fibrosis compared with the UUO group. The results of Western Blot and immunohistochemistry showed that the expression of α-SMA and Collagen I in the UUO+MA-5 group was significantly lower than that in the UUO group (p<0.05). Further study showed that mitochondrial biosynthesis, fusion and movement were decreased in the UUO group, and the expression of manganese superoxide dismutase (SOD2) was decreased. MA-5 treatment significantly increased the expression of Mitofilin in the kidney of UUO mice, improved mitochondrial function, and increased the expression of PGC1-α, Mfn1, Miro1 and SOD2 (p<0.05). The results in vitro showed that MA-5 could reduce the expression of fibrosis-related proteins induced by TGF-β in cultured tubular epithelial cells (p<0.05). Conclusions: Renal fibrosis occurs in mice after UUO, and MA-5 can reduce renal fibrosis by maintaining mitochondrial homeostasis. In vitro experiments showed that MA-5 could attenuate TGF-β induced tubular epithelial cells fibrosis.

The study of total flavonoids of Desmodium styracifolium on polarization of M1 macrophages and the formation of renal calcium oxalate stones in mice

Zhang Junqi, Wang Zijie, Han Peng, Zhang Wei

Available online:March 17, 2025, DOI:

[Abstract] (229) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the effect and possible mechanism of total flavonoids of Desmodium styracifolium (TFDS) on the formation of renal calcium oxalate stones. Method: Selective macrophage Rictor gene knockout mice (Csf1r Cre -/-, Rictorfl/fl, C57BL/6J) and their control group mice (Csf1r Cre+/-, Rictorfl/fl, C57BL/6J) were used to establish renal calcium oxalate stone models, and TFDS intervention was administered. Collect kidney tissues from various groups of mice for routine staining, immunohistochemical fluorescence staining, flow cytometry, and other examinations to explore the effect of TFDS on the formation of renal calcium oxalate stones; Primary extraction of bone marrow-derived macrophages (BMDMs) from the two types of mice was performed, and TFDS intervention was administered to investigate the mechanism through PCR, cell fluorescence staining, flow cytometry, and other examinations. Result: The number of renal calcium oxalate stones in the renal tissue of mice with renal calcium oxalate stones+knockout group was significantly higher than that in the renal calcium oxalate stone group, accompanied by a significant increase in polarization of M1 macrophages; After TFDS intervention in two groups of mice, the renal tissue of the TFDS+renal calcium oxalate stone group showed a significant decrease in renal calcium oxalate stones and M1 macrophage polarization, while the formation of renal calcium oxalate stones in the TFDS+renal calcium oxalate stone+knockout group showed no significant changes compared to the non-intervention group. Cell experiments showed that after Rictor knockout, BMDM exhibited significant polarization of M1 macrophages, while polarization of M1 macrophages was significantly reduced in the TFDS+BMDM group; however, there was no significant change in polarization after TFDS intervention in Rictor knockout of BMDM compared to before intervention. Conclusion: TFDS can effectively and safely reduce the formation of renal calcium oxalate stones in vitro, possibly by inhibiting Rictor regulated polarization of M1 macrophages.

Results and significance of chromosomal karyotype analysis of 3591 sperm donors in Jiangsu Province

wang jiaxiong, Yan jing, Sun hongyong

Available online:March 17, 2025, DOI:

[Abstract] (219) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective：To analyze the genetic characteristics of chromosomes of sperm donor volunteers in our sperm bank for more than ten years, and to explore the role of sperm bank chromosomal karyotypes analysis and screening in avoiding adverse pregnancy outcomes after sperm donor treatment. Methods：The chromosomalkaryotypes examination results of 3591 sperm donors who underwent sperm screening at the Jiangsu Human Sperm Bank from January 2012 to December 2023 were retrospectively analyzed to classify the distribution and types of chromosomal karyotypes abnormalities. Results：Among the 3591 sperm donors, there were 62 cases of karyotype abnormalities, accounting for 1.73% of all volunteers, of which the most common were pericentric inversions (30/62), followed by secondary constriction region enlargement (13/62), and then short-arm enlargement (7/62) andtranslocation (6/62). In addition to this, there were 3 cases of satelliteenlargement, 1 case of double enlargement, 1 case of enlarged centromere and 1 case of markerchromosome. Conclusion:In view of the known or potential adverse effects of karyotype abnormalities on pregnancy outcomes and offspring health, sperm banks are required to conduct rigorous cytogenetic screening of sperm donor volunteers to circumvent the risk of failure of subsequent sperm donor treatments and to fulfil the societal role of assisted conception and eugenics.

Research progress of fibroblasts in gastric mucosal carcinogenesis and drug therapy of gastric cancer

Qiang Zhan

Available online:March 17, 2025, DOI:

[Abstract] (220) [HTML] (0) [PDF 0.00 Byte] (0)

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Fibroblasts play important functions in the synthesis and remodeling of extracellular matrix and are involved in physiopathological processes such as maintaining tissue structure, mediating immune regulation, inflammation and tumorigenesis. Fibroblasts participate in and maintain the atrophy and chemotaxis of the gastric mucosa in the precancerous stage. When the gastric mucosa becomes cancerous, the activated fibroblasts interact with gastric cancer cells and other components of the tumor microenvironment, shaping a microenvironment suitable for the growth of gastric cancer and thus promoting gastric cancer proliferation, invasion, and metastasis, but the mechanism of action is complex and needs to be further explored. Meanwhile, fibroblasts have been found to be closely associated with chemoresistance in gastric cancer. Therefore, drugs targeting fibroblasts may provide a new direction for cancer treatment and play an important role in reducing the risk of cancer recurrence and metastasis, decreasing chemoresistance and improving cancer prognosis.In this study, we provide a review on the mechanism of fibroblasts promoting gastric mucosal carcinogenesis and their role in evaluating the effect of gastric cancer drug therapy, in order to provide a theoretical basis for the study of the role of fibroblasts in the pathogenesis and treatment of gastric cancer.

Pheochromocytoma brain metastases with cranial invasion: a case report and literature review

Xu Lei, Zhang Liuchao

Available online:March 12, 2025, DOI:

[Abstract] (209) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective To summarize the clinical characteristics of paraphysial metastasis of pheochromocytoma with skull invasion and review the related literature. Methods A retrospective analysis was conducted on the case data of a patient with paraphysial metastasis of pheochromocytoma with skull invasion, admitted to the Department of Neurosurgery at the First Affiliated Hospital of Nanjing Medical University in February 2023. In addition, 17 cases of brain metastasis from pheochromocytoma were retrieved from PubMed, and the challenges in diagnosis and treatment options were discussed. Results The tumor was completely resected through a transnasal approach exposing the sellar floor and clival recess. Postoperative pathological diagnosis confirmed pheochromocytoma. Conclusions Parasellar metastasis of pheochromocytoma with skull invasion is rare, which poses significant diagnostic challenges. The primary treatment of choice is complete surgical resection.

A risk prediction model for hyperinflation in patients with COPD constructed based on spirometry

CHEN Youhua, XU Xiaojun

Available online:March 12, 2025, DOI:

[Abstract] (184) [HTML] (0) [PDF 0.00 Byte] (0)

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Objective: To investigate the relationship between symptoms, exercise capacity and hyperinflation in chronic obstructive pulmonary disease (COPD) patients; and to try to establish a nomogram prediction model based on spirometry to predict the occurrence of hyperinflation in COPD. Methods: COPD patients and controls with normal lung function were recruited to perform the 6-minute walk test (6MWT). The COPD patients were divided into a hyperinflation group (39 patients) and a non-hyperinflation group (62 patients) according to the GOLD guidelines. Clinical data, 6MWT and lung function were analysed in the three groups. Variables were screened by the Boruta algorithm combined with Lasso regression, and the variables were analysed by univariate and multivariate logistic regression, to establish a nomogram prediction model of the occurrence of hyperinflation in COPD patients and to assess its predictive effect. Results: Compared to the non-hyperinflation group, patients in the hyperinflation group had a shorter 6-minute walk distance (6MWD), a smaller 6MWD as a percentage of predicted value (6MWD%pred), and a mean 6MWD%pred of （86.74 ± 12.54）%, accompanied by the symptoms of a more severe drop in walking pulse-oximetry and a more severe post-exercise leg fatigue. The hyperinflation group had a higher proportion of patients with mMRC ≥2 and CAT ≥10. The results of logistic regression analysis suggested that vital capacity(VC) (β=-2.636, OR=0.072 , 95% CI: 0.022 ~ 0.232), Maximal mid-expiratory flow of predicted(MMEF%pred) (β=-0.147, OR=0.863, 95% CI: 0.790 ~ 0.944) were independent predictors of the occurrence of hyperinflation in COPD patients. The mean values of VC and MMEF%pred in the hyperinflation group were （2.51 ± 0.60）L and （23.05 ± 6.48）%, respectively. The area under curve (AUC) of the reciever operating characteristic (ROC) curve of the nomogram model was 0.897 (95% CI: 0.836~ 0.957, P<0.01). The mean absolute error of the calibration curve was 0.023. Conclusion: The nomogram model based on the spirometer parameters VC and MMEF%pred can predict the occurrence of hyperinflation in COPD patients. When ventilatory dysfunction was present on spirometry testing in COPD patients, a decrease in the parameters VC and MMEF%pred predicted an increased risk of combined hyperinflation. These patients tend to have reduced exercise tolerance and are multisymptomatic, suggesting the need for clinical focus. This predictive model provides primary community care with an easy-to-implement, method of assessing patients with COPD and facilitates guidance for individualised treatment and rehabilitation.

Research progress of α-syn aggregation inhibitors for Parkinson"s diseaseLI Qi1^, QIN Yajuan1^, LI Tingyou1^, TANG Lijun1.²^*

QIN YAjuan, LI Tingyou

Available online:March 11, 2025, DOI:

[Abstract] (194) [HTML] (0) [PDF 0.00 Byte] (0)

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Parkinson"s disease (PD) is the second most common neurodegenerative disease. The pathological aggregation of α-synuclein (α-syn) is a biomarker of PD, which is closely related to the occurrence and development of PD. Finding an inhibitor that can inhibit the formation of pathological aggregates such as α-syn Oligomer and α-syn fibrils at the early stage of the disease is of great significance for the treatment of PD. In recent years, significant progress has been made in the research of aggregation inhibitors targeting α-syn. This review summarizes the structure, physiological function, pathological mechanism and aggregation inhibitors of α-synuclein, aiming to provide a reference for the further research and development of α-syn aggregation inhibitors.

Evaluation of tooth spatial movement and tracking of microstructural changes in the alveolar bone in rats

Jiang Di, Xie Yuting, Wu Bin, Tang Wen, Lu Lingbo, Li Yujiang, Xie Lizhe

Available online:March 07, 2025, DOI:

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Objective: This study aimed to observe and quantify the continuous changes in dental movement and trabecular microstructure in tension and pressure zones of rats under orthodontic force using in vivo Micro-CT scanning. Methods: A 50g orthodontic force was applied to the left maxillary first molar of five male 8-week-old SD rats. The rats were scanned in vivo at different time points using Micro-CT. The distance of orthodontic tooth movement was calculated in a unified spatial coordinate system. Additionally, trabecular micro-morphological and mechanical property-related parameters in the tension and pressure zones of the moved teeth were measured and statistically analyzed. Results: There was significant displacement of the rat molars within the first 0-3 days, with a decrease in movement rate between 3-14 days, followed by an increase in rate from 21-28 days (P<0.001). Multiple trabecular parameters in both tension and pressure zones showed turning points at 7 days and 14 days, respectively. Specifically, bone volume fraction (BV/TV) and trabecular thickness (Tb. Th) first decreased and then increased, while total porosity volume [Po. V(tot)], structure model index (SMI), trabecular separation (Tb. Sp), and fractal dimension (FD) exhibited the opposite trend. During the early stage of tooth movement, the slope of increase in trabecular parameters was greater in the tension zone compared to the pressure zone. In the later stage of tooth movement, there were significant differences in the values of BV/TV, Po. V(tot), SMI, and Tb. Sp between the tension and pressure zones (P<0.05). Conclusion: Orthodontic tooth movement in rats occurs in three stages. There are differences in trabecular microstructure remodeling between tension and pressure zones, with bone mass and bone quality both decreasing first and then increasing, reaching their lowest points around 7 days and 14 days, respectively. The active phase of bone resorption in the tension zone occurs earlier, and bone formation in the alveolar bone of the tension zone lags behind bone resorption in the pressure zone.

A diagnostic model of polycystic ovary syndrome based on the genes associated with pyroptosis

Chen wen xin, Zhang wen, Yu chi yuan

Available online:March 07, 2025, DOI:

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Objective:To explore the role of genes related to pyroptosis in the pathogenesis of Polycystic ovary syndrome (PCOS) and construct an accurate prediction model for PCOS. Methods: Three micro RNA(mRNA) expression profiles were obtained from the Gene Expression Omnibus (GEO) database ,and analysis was carried out on the differential expression of pyroptosis-related genes (PRGs) between PCOS patients and normal healthy women.Four machine learning algorithms, namely the Generalized Linear Model (GLM), Random Forest (RF), Support Vector Machine (SVM), and Extreme Gradient Boosting (XGB), were employed to identify the gene characteristics of PCOS. Real?time quantitative PCR(RT-qPCR) method was utilized to detect the expression levels of specific genes in the plasma of 10 PCOS patients and 10 normal healthy women.Results: A predictive model and a nomogram were established based on PRGs to accurately predict PCOS. Among the four machine learning algorithms,the XGB method demonstrated the highest accuracy in validating the model using two independent datasets, which was further supported by decision curve analysis. Consensus clustering revealed two distinct subgroups within PCOS cases, with Cluster2 exhibiting higher level of immune infiltration compared to Cluster1. Differential expression analysis was then conducted to identify differentially expressed genes (DEGs) between the two subtypes, followed by pathway enrichment analysis on the model genes. Clinical verification showed that the expression levels of PYD and CARD domain containing(PYCARD), Absent in melanoma 2(AIM2), Chromatin modif-ying protein 4B(CHMP4B) and NOD-like receptor family pyrin domain containing 2(NLRP2) in the plasma of PCOS patients were significantly higher than those of the healthy control group, with statistical differences. This verifies the accuracy of the PCOS prediction model based on PRGs.Conclusion: This study offers preliminary insights into the association between PCOS and pyroptosis,a precise predictive model for PCOS.

Research Progress and Application Prospects of Speech Recognition Technology in Autism Spectrum Disorder Diagnosis

李进宇, 赵太宏

Available online:March 07, 2025, DOI:

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Autism spectrum disorder (ASD) is a neurodevelopmental disorder that typically arises in early childhood, with core symptoms predominantly manifesting in language and social interaction. Although traditional diagnostic tools, such as the Autism Diagnostic Observation Schedule-2 (ADOS-2), are widely used, they often have limited accessibility and objectivity in younger children and in primary healthcare settings. Due to its strong quantitative capabilities, relatively low cost, and high sensitivity to early speech anomalies in infants, speech recognition technology has emerged as a promising avenue for ASD diagnostic support. This paper systematically reviews the latest research on the application of speech recognition in early screening across different age groups, diagnosis of comorbid emotional issues, assessment of disease severity, and multimodal data integration. The findings show that extracting acoustic features—such as fundamental frequency, speech rate, and pauses—can effectively distinguish individuals with ASD from typically developing children, while also identifying comorbidities like anxiety, depression, and ADHD. Furthermore, multimodal fusion (e.g., neuroimaging, physiological signals, and behavioral data) can further improve diagnostic accuracy. Nevertheless, challenges persist, including inadequate data diversity, limitations related to dialect and age applicability, confounding effects of comorbid conditions, and concerns over privacy.

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About Journal

Editor in chief ：HU Zhibin
Editorial director ：XIAO Ming
Address ：101 Longmian Avenue, Jiangning District, Nanjing 211166, P.R. China
Telephone ：(025)86869293
Email：nyxb@njmu.edu.cn
ISSN：1007-4368
CN：32-1442/R

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