最新刊期
卷 50 ， 期 11 ， 2025
- “最新研究揭示了自身免疫性早发性卵巢功能不全的发病机制、诊断难点及治疗挑战，为精准诊疗提供新思路。”摘要：Autoimmune premature ovarian insufficiency (POI) is a gynecological endocrine disease mediated by autoimmune responses. It is characterized by a decline in ovarian function before the age of 40, which severely affects female fertility and overall health. In recent years, studies on the pathogenesis, diagnosis, and treatment of autoimmune POI have achieved significant progress with the deepening of research in immunology and reproductive medicine. In terms of pathogenesis, this disease involves a variety of autoantibodies, abnormal T-cell activation, and cytokine imbalance, but the specific molecular mechanism remains incompletely understood. In terms of diagnosis, it primarily relies on clinical symptoms, assessment of ovarian reserve function, and autoantibody screening. However, there is a lack of specific biomarkers to confirm immune factors (the key to diagnosing immune-mediated POI), making early diagnosis difficult. Regarding treatment, hormone replacement therapy (HRT) can alleviate hypoestrogenic symptoms, and assisted reproductive technology (ART) may address fertility issues in a subset of patients. Nevertheless, immunomodulatory therapies currently lack evidence-based regimens and proven efficacy, and long-term prognosis remains suboptimal. This review systematically summarizes the pathogenesis, diagnostic difficulties, and therapeutic challenges of autoimmune POI, aiming to provide references for clinical practice and future research, and to promote precise diagnosis, treatment, and management of this disease.关键词：autoimmune premature ovarian insufficiency;pathogenesis;diagnosis;treatment;challenges8|0|0更新时间：2025-12-11
- “虚拟现实技术在ICU患者早期活动中的应用进展，为重症患者康复提供新方向。”摘要：As early mobilization of patients in the intensive care unit (ICU) is increasingly recognized as a key measure for improving patient prognosis and reducing complications, related research is increasing. However, conventional early mobilization methods are often limited by factors such as patient condition, nursing resources, and environmental factors, making it difficult to achieve optimal results. In recent years, virtual reality (VR) technology, owing to its unique immersion and interactive features, has emerged as a focus of research in the field of ICU patient rehabilitation. This review summarizes the advances in the application of VR technology in the early mobilization of ICU patients, focusing on its advantages over traditional methods, specific implementation approaches, clinical outcomes, and challenges encountered during application. By synthesizing existing evidence, this review aims to provide valuable references for clinical practice and to explore future directions for VR technology in ICU rehabilitation, with the goal of promoting its widespread application in the early mobilization of critically ill patients.关键词：virtual reality technology;intensive care unit;early mobilization;rehabilitation;critically ill patients11|0|0更新时间：2025-12-11
Expert Review
- “据最新研究，成人传染性单核细胞增多症并发肺炎的危险因素被揭示，专家构建列线图预测模型，为预后评估提供量化工具。”
摘要：ObjectiveTo investigate the risk factors for pneumonia complicating infectious mononucleosis (IM) in adults and construct a nomogram prediction model.MethodsA retrospective analysis was conducted on 198 IM patients admitted to the Second Affiliated Hospital of Air Force Medical University from January 2015 to December 2021. Patients were divided into pneumonia group (n=52) and non-pneumonia group (n=146) based on whether pulmonary infection occurred during hospitalization. The baseline data (age, gender, place of onset, etc.), clinical manifestations (maximum body temperature, lymph node enlargement, splenomegaly, etc.), and inflammatory indicators [white blood cell count (WBC), C-reactive protein (CRP), etc.] were compared between the two groups. Kaplan-Meier curves were plotted to analyze the key indicators affecting the hospital stay of IM patients. Multivariate logistic regression was used to analyze the independent risk factors for pneumonia complicating IM in adults and construct a nomogram prediction model based on the identified risk factors. The predictive efficacy of the model was evaluated using the receiver operating characteristic (ROC) curve and the consistency of the model was assessed using the calibration curve. The fit of the model was evaluated using the Hosmer-Lemeshow test. Additionally, the sensitivity, specificity, and accuracy of the model were assessed using confusion matrix.ResultsCompared with non-pneumonia group, the pneumonia group had a significantly higher proportion of patients from rural areas, with body mass index (BMI)≥24 kg/m², smoking history, hepatomegaly, fever duration of ≥7 d, as well as increased total hospitalization costs and average daily hospitalization costs, and prolonged hospital stay (P<0.05). The proportion of patients with a history of antibiotic use was lower in the pneumonia group (P<0.05). Kaplan-Meier survival analysis showed that patients from rural areas, with BMI ≥24 kg/m2, smoking history, no prophylactic use of antibiotics, fever duration ≥7 d, and hepatomegaly had significantly prolonged hospital stays (P<0.05). Multivariate logistic regression analysis revealed that living in a rural area (OR=4.089, P<0.05), hepatomegaly (OR=4.082, P<0.05), and elevated WBC (OR=1.205, P<0.05) were independent risk factors for pneumonia complicating IM in adults, while the prophylactic use of antibiotics (OR=0.142, P<0.05) was an independent protective factor. The area under the ROC curve of the constructed nomogram prediction model was 0.827 (95%CI 0.762-0.892), and the slope of the calibration curve was close to 1, and the Hosmer-Lemeshow test showed χ2=5.299, P=0.725, indicating good consistency and fit of the prediction model. The results of the confusion matrix assessment showed that the sensitivity of the model was 0.669 (0.624-0.773), the specificity was 0.827 (0.724-0.930), and the accuracy was 0.732 (0.665-0.793).ConclusionThe nomogram prediction model based on place of onset, hepatomegaly, the prophylactic use of antibiotics and WBC has excellent fit and discrimination, providing an effective quantitative tool for prognosis assessment of IM.关键词：Epstein-Barr virus;infectious mononucleosis;clinical features;pneumonia;risk factors;nomogram model13|0|0更新时间：2025-12-11 - “最新研究揭示，性别、BUN、Cr、LDL-C、FT3、FT4是2型糖尿病合并代谢相关脂肪性肝病患者肝纤维化中高风险的独立影响因素。”
摘要：ObjectiveTo explore the clinical characteristics and influencing factors in type 2 diabetes mellitus (T2DM) patients with metabolic-associated fatty liver disease (MAFLD) who are at moderate-to-high risk of metabolic-associated fatty liver fibrosis.MethodsA retrospective analysis was conducted on the clinical data of 495 T2DM patients with MAFLD who were treated in the Department of Endocrinology, the Seventh People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, from August 2022 to May 2024. According to the fibrosis-4 (FIB-4) index, the patients were divided into two groups: low risk group for metabolic-associated fatty liver fibrosis (n=311) and moderate-to-high risk group for metabolic-associated fatty liver fibrosis (n=184). Differences in clinical characteristics and laboratory test results between the two groups were compared. Univariate and multivariate binary logistic regression analyses were used to screen the influencing factors of moderate-to-high risk of metabolic-associated fatty liver fibrosis in T2DM patients with MAFLD. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were employed to evaluate the predictive value of these factors for moderate-to-high risk of metabolic-associated fatty liver fibrosis in T2DM patients with MAFLD.ResultsCompared with low risk group, moderate-to-high risk group had significantly higher age, proportions of patients with a history of hypertension and coronary heart disease, as well as higher levels of aspartate aminotransferase (AST), blood urea nitrogen (BUN), and creatinine (Cr) (P<0.05). In contrast, moderate-to-high group had a lower proportion of male patients, and lower levels of platelet count (PLT), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), glycated hemoglobin (HbA1c), free triiodothyronine (FT3), free thyroxine (FT4), and thyroid feedback quantile-based index (TFQI) (P<0.05). Univariate binary logistic regression analysis showed that male (P=0.020), HbA1c (P=0.014), BUN (P<0.001), Cr (P<0.001), TC (P=0.001), LDL-C (P<0.001), FT3 (P<0.001), FT4 (P<0.001), and TFQI (P=0.039) were influencing factors for moderate-to-high risk of metabolic-associated fatty liver fibrosis in T2DM patients with MAFLD. Multivariate binary logistic regression analysis revealed that BUN (OR=1.165, 95%CI 1.006-1.348, P=0.042) and Cr (OR=1.020, 95%CI 1.005-1.036, P=0.008) were independent risk factors for moderate-to-high risk of metabolic-associated fatty liver fibrosis in T2DM patients with MAFLD, while male (OR=0.574, 95%CI 0.339-0.972, P=0.039), LDL-COR=0.659, 95%CI 0.483-0.898, P=0.008), FT3 (OR=0.590, 95%CI 0.404-0.864, P=0.007), and FT4 (OR=0.863, 95%CI 0.762-0.977,P=0.020) were independent protective factors. ROC curve analysis showed that the AUC of the combined 6 influencing factors for predicting moderate-to-high risk of metabolic-associated fatty liver fibrosis in T2DM patients with MAFLD was 0.728(95%CI 0.682-0.774), with a sensitivity of 0.620 and a specificity of 0.759. ConclusionsGender, BUN, Cr, LDL-C, FT3, and FT4 are independent influencing factors for moderate-to-high risk of metabolic-associated fatty liver fibrosis in T2DM patients with MAFLD. Monitoring and early intervention for the above abnormal biochemical indices are beneficial in delaying the occurrence and development of liver fibrosis in T2DM patients with MAFLD.关键词：diabetes mellitus, type 2;metabolic-associated fatty liver disease;metabolic-associated fatty liver fibrosis14|0|0更新时间：2025-12-11 - “据最新研究，高原地区军人膝骨关节炎患病率为17.9%，年龄大、BMI高、吸烟等是独立危险因素，为预防提供科学依据。”摘要：ObjectiveTo investigate the epidemiological characteristics of knee osteoarthritis (KOA) among military personnel in plateau regions and to explore its risk factors.MethodsFrom July 2023 to July 2024, a multi-stage stratified cluster random sampling method was employed to survey the prevalence of KOA and related risk factors among military personnel in the northwest plateau regions of China, covering different altitudes (1500-4500 m) and geographical areas (Gansu, Qinghai, Tibet, and Xinjiang). All study subjects were divided into KOA and non-KOA groups based on the presence or absence of KOA. Variables including age, gender, body mass index (BMI), education level, smoking status, military rank, military branch, service duration, regional altitude, annual average temperature, training duration, perceived training intensity, and history of knee injury were selected for univariate analyses between groups. Variables with P<0.05 in the univariate analyses were included in the binary multifactor logistic regression to identify risk factors for KOA.ResultsA total of 3000 questionnaires were distributed, and 2854 valid questionnaires were collected, with a response rate of 95.13%. The sample included 2584 males and 270 females, with 510 cases of KOA, resulting in a prevalence rate of 17.9%. Univariate analysis showed that there were statistically significant differences between KOA and non-KOA groups in terms of age, BMI, smoking status, military rank, military branch, service duration, regional altitude, annual average temperature, training duration, perceived training intensity, and history of knee injury (P<0.05). However, no significant differences were found in gender and education level (P>0.05). Binary multivariate logistic regression analysis revealed that older age (OR=1.382, P=0.017), higher BMI (P<0.01), smoking (OR=1.929, P<0.01), higher military rank (OR=1.485, P=0.007), being a member of the Armed Police (P<0.01), longer service duration (P<0.01), higher regional altitude (OR=1.459, P<0.01), lower annual average temperature (OR=1.188, P=0.001), longer training duration (P<0.01), higher perceived training intensity (OR=2.450, P<0.01), and history of knee injury (OR=2.768, P=0.002) were independent risk factors for KOA.ConclusionsOlder age, overweight/obesity, smoking, higher military rank, being a member of the Armed Police, longer service duration, higher altitude, cold climate, longer training duration, higher training intensity, and history of knee injury are independent risk factors for KOA among military personnel in the northwest plateau regions of China.关键词：knee osteoarthritis;epidemiologi;ultrasonography;prevalence;risk factors10|0|0更新时间：2025-12-11
- “解放军总医院研究揭示，肌钙蛋白T峰值升高、QRS波时限延长、罪犯血管为前降支的STEMI患者心脏整体纵向应变受损更严重，心肌梗死程度更严重，且左心室功能更差。”
摘要：ObjectiveTo investigate the factors influencing global longitudinal strain (GLS) measured by cardiac magnetic resonance (CMR) in patients with acute ST-segment elevation myocardial infarction (STEMI).MethodsClinical data of 315 hospitalized patients diagnosed with acute STEMI who underwent percutaneous coronary intervention (PCI) at the First Medical Center of Chinese PLA General Hospital from June 2016 to September 2021 were retrospectively collected. After analyzing CMR images of all patients, GLS and other strain parameters were obtained, and then the patients were divided into two groups according to the median GLS. In order to balance gender and age differences, 1:1 propensity score matching was performed, and 206 patients were eventually included: GLS>-11.3% group (indicating severe GLS impairment, n=103) and GLS≤-11.3% group (n=103). Baseline characteristics, laboratory indicators, coronary angiographic parameters, electrocardiogram (ECG) features, and CMR parameters were compared between the two groups. Variables showing significant differences were analyzed for their correlation with GLS. Multivariate logistic regression and multiple stepwise linear regression analyses were performed to identify factors associated with GLS impairment.ResultsCompared with GLS≤-11.3% group, GLS>-11.3% group had significantly higher peak levels of creatine kinase-MB (CK-MB) and troponin T (TnT) (P<0.001). A higher proportion of patients in GLS>-11.3% group had the left anterior descending artery (LAD) as the culprit vessel, while a lower proportion had the right coronary artery (RCA) as the culprit vessel (P<0.001). Additionally, GLS>-11.3% group had longer QRS duration (P<0.001) and a higher incidence of pathological Q waves (P=0.001). Regarding CMR parameters, GLS>-11.3% group exhibited larger global circumferential strain (GCS), infarct size (IS), and left ventricular end-systolic volume (LVESV), as well as lower global radial strain (GRS) and left ventricular ejection fraction (LVEF) (P<0.001). Multivariate logistic regression indicated that peak TnT (OR=1.092, P=0.001), LAD culprit vessel (OR=3.744, P<0.001), and QRS duration (OR=1.026, P<0.001) were significantly associated with severely impaired GLS. Multiple stepwise linear regression analysis showed that the logarithmic value of peak TnT, LAD as the culprit vessel, and the square root of QRS duration were linearly correlated with GLS values (adjusted R²=0.301, P<0.001), and these independent variables explained 30.1% of the variation in GLS.ConclusionElevated peak TnT, prolonged QRS duration, and LAD as the culprit vessel are significantly associated with severe GLS impairment in STEMI patients, indicating more severe myocardial infarction and worse left ventricular function.关键词：acute ST-segment elevation myocardial infarction;cardiac magnetic resonance;global longitudinal strain13|0|0更新时间：2025-12-11 - “在原发性肝细胞癌领域，青岛大学医学院附属烟台毓璜顶医院专家分析了HLA基因多态性与临床病理特征及术后预后的关系，为肝癌治疗提供新思路。”
摘要：ObjectiveTo investigate the correlation between single nucleotide polymorphisms (SNPs) of human leukocyte antigen (HLA) genes and the clinicopathological features and postoperative prognosis of primary hepatocellular carcinoma (HCC).MethodsA retrospective analysis was conducted on 328 patients with primary HCC who underwent surgery and had complete clinical data at Yantai Yuhuangding Hospital Affiliated to Qingdao University Medical College from January 2014 to September 2022. The genotypes of HLA-DRB1 rs2647073, rs3997872 and HLA-DQB1 rs1049055 loci were detected in all patients using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technology. Binary logistic regression was employed to examine the association between SNPs in the HLA gene and the clinicopathological features of primary HCC. Age, gender, drinking history, and HBV/HCV infection history were used as stratification factors for stratified analysis. Univariate Cox regression was used to analyze the correlation between HLA gene SNPs and postoperative prognosis, and the Kaplan-Meier survival curve of patients with primary HCC after surgery was drawn. Multivariate Cox regression was utilized to evaluate the independent risk factors affecting the postoperative prognosis of patients with primary HCC.ResultsBinary logistic regression analysis showed that rs2647073 CC genotype patients had a higher risk of tumor diameter ≥5 cm than AA genotype patients (P=0.005). Patients with TT genotype of rs3997872 had a higher risk of vascular invasion than those with AA genotype (P=0.003). Stratified analysis showed that age ≥60 years, history of HBV/HCV infection, female, male, no drinking history, and drinking history, HLA-DRB1 rs2647073 CC genotype had a higher risk of tumor diameter ≥5 cm than AA+AC genotype (P<0.05). In patients ≥60 years old, the TT genotype of HLA-DRB1 rs3997872 had a higher risk of vascular invasion than the AA+AT genotype (P<0.001). Moreover, regardless of whether the patients were male or female, with or without a drinking history, and with or without a history of HBV/HCV infection, patients with the TT genotype of HLA-DRB1 rs3997872 had a higher risk of vascular invasion than those with the AA+AT genotype (P<0.05). Patients with TT genotype of HLA-DRB1 rs3997872 had a poorer postoperative prognosis than those with the AT+AA genotype (P<0.001). HLA-DRB1 rs3997872 SNP (P=0.019), older age (P<0.001), history of HBV/HCV infection (P<0.001), capsular invasion (P=0.005), vascular invasion (P=0.018), advanced BCLC stage (P<0.001), non-radical surgery (P=0.024), and higher PS score (P=0.023) were independent risk factors for the postoperative prognosis of HCC patients.ConclusionThe SNPs of rs2647073 and rs3997872 in HLA-DRB1 gene are associated with the clinicopathological features of primary HCC, and the SNP of rs3997872 is associated with the postoperative prognosis of patients with HCC.关键词：primary hepatocellular carcinoma;single nucleotide polymorphism;human leukocyte antigen;clinicopathological features;prognosis14|0|0更新时间：2025-12-11 - “最新研究揭示肠道微生物与病毒性肺炎的因果关系，为预防和治疗提供新思路。”
摘要：ObjectiveTo investigate the causal relationship between gut microbiota and viral pneumonia, as well as the underlying mechanisms, using two-sample and two-step Mendelian randomization (MR) approaches, thereby providing novel insights for the prevention and treatment of viral pneumonia.MethodsAll data were obtained from publicly available genome-wide association studies (GWAS) pooled datasets, including gut microbiota data from the MiBioGen Consortium and the Netherlands Microbiome Project, viral pneumonia data from the FinnGen R10 database, and plasma metabolome data from the publicly available GWAS Catalog. Instrumental variables (IVs) were extracted according to the predefined threshold values. MR analyses were conducted using inverse variance weighting (IVW), MR-Egger, weighted median (WME), weighted mode (WM), and Bayesian-weighted Mendelian randomization (BWMR) methods. Reverse MR analysis was performed to determine whether there was a reverse association. Two-step MR analysis was used to explore the potential mediating role of plasma metabolites, and a series of sensitivity analyses were performed to test the stability of the results.ResultsAmong 196 gut microbiota taxa from the MiBioGen consortium GWAS, 11 taxa were associated with viral pneumonia. An increase in the abundance of 4 taxa increased the risk of viral pneumonia, while an increase in the abundance of 7 taxa had a protective effect against viral pneumonia. Among the 207 gut microbiota taxa from the Dutch Microbiome Project GWAS data, 10 taxa were associated with viral pneumonia, with 6 risk-increasing and 4 protective taxa identified. Mediation analysis results showed that the causal effect of Defluviitaleaceae on viral pneumonia (OR=0.708, 95%CI 0.540-0.929, P=0.013) was mediated to some extent by the N6-acetyllysine levels, with a mediation ratio of 18.4%. Sensitivity analyses did not reveal significant heterogeneity or horizontal pleiotropy.ConclusionsSpecific gut microbiota are causally associated with viral pneumonia and show potential differences across different populations; the protective effect of Defluviitaleaceae against viral pneumonia may be mediated by the N6-acetyllysine levels. Targeting metabolites may become a potential therapeutic approach for viral pneumonia.关键词：gut microbiota;viral pneumonia;plasma metabolites;Mendelian randomisation;mediation analysis14|0|0更新时间：2025-12-11 - “在足踝部创面修复领域，合肥市第二人民医院专家采用Masquelet技术联合超薄ALTP治疗，有助于皮瓣存活、骨愈合及踝关节功能恢复，提升患者日常生活能力，降低术后并发症发生率。”
摘要：ObjectiveTo investigate the clinical efficacy of membrane induction technique (Masquelet) combined with free ultrathin anterolateral thigh perforator flap (ALTP) in reconstructing foot and ankle wounds.MethodsThis is a prospective study. Sixty-three patients with foot and ankle wounds complicated with bone defects admitted to Hefei Second People's Hospital from January 2022 to June 2023 were selected and randomly divided into control group (n=32) and study group (n=31). Control group was treated with traditional bone grafting combined with ultrathin ALTP, while study group was treated with Masquelet technique combined with ultrathin ALTP. Clinical data of both groups were collected, and flap efficacy, bone healing, ankle joint function, and daily living ability were compared at 6 and 12 months after surgery. The incidence of complications was compared between the two groups after 12 months of postoperative follow-up.ResultsThere were no statistically significant differences in clinical data such as age, gender, cause of injury, injury site, and wound area between the two groups (P>0.05). By the end of follow-up, the median follow-up time was 17 (12-28) months, and the follow-up rate at 12 months after surgery was 100.0%. There was no statistically significant difference in flap survival rate between study group and control group [100.0% (31/31) vs. 87.5% (28/32), P=0.129]. There were no statistically significant differences in the excellent and good rates of wound healing, flap sensation, flap morphology, flap temperature, donor site scar at 6 months after surgery, as well as wound healing, flap temperature, donor site scar, and bone healing at 12 months after surgery between the two groups (P>0.05). The excellent and good rates of bone healing at 6 months after surgery, the excellent and good rates of flap sensation and flap morphology at 12 months after surgery, and the scores of American Orthopaedic Foot and Ankle Society (AOFAS) and Activities of Daily Living (ADL) scale at 6 and 12 months after surgery in study group were significantly higher than those in control group (P<0.05). The incidence of complications in study group at 12 months after surgery was significantly lower than that in control group (P<0.05).ConclusionMasquelet technique combined with ultrathin ALTP in reconstructing foot and ankle wounds is beneficial to flap survival, bone healing, and recovery of ankle joint function, which can improve patient's daily living ability and reduce the incidence of postoperative complications.关键词：foot and ankle wounds;free ultrathin anterolateral thigh perforator flap;membrane induction technique7|0|0更新时间：2025-12-11 - “据最新研究报道，小檗碱四联方案与传统克拉霉素四联方案在根除幽门螺杆菌感染方面疗效相当，但不良反应发生率和治疗成本更低，有望成为安全、有效且经济的治疗选择。”
摘要：ObjectiveTo evaluate the efficacy, safety, and cost-effectiveness of berberine-based quadruple therapy vs. the clarithromycin-based quadruple therapy for Helicobacter pylori (H. pylori) eradication in treatment-naïve patients.MethodsThis was a single-center, prospective, open-label randomized controlled trial. A total of 404 treatment-naive patients with H. pylori infection who visited the Outpatient Department of Gastroenterology, the First Medical Center of Chinese PLA General Hospital from September 2021 to May 2024 were enrolled. The patients were randomly assigned in a 1:1 ratio to two groups: berberine quadruple therapy group (berberine+amoxicillin+esomeprazole+colloidal bismuth pectin; n=202) and clarithromycin quadruple therapy group (clarithromycin+amoxicillin+esomeprazole+colloidal bismuth pectin; n=202). Both groups received a 14-day treatment course. The H. pylori eradication rate, incidence of adverse reactions, medication compliance, and treatment costs were compared between the two groups.ResultsBy intention-to-treat (ITT) analysis, eradication rate did not differ significantly between the two groups [89.1% (180/202) in berberine quadruple therapy group vs. 89.6% (181/202) in clarithromycin quadruple therapy group, P=0.872]. The per-protocol (PP) analysis also showed no significant difference in the eradication rate between the two groups [90.4% (179/198) vs. 91.3% (178/195), P=0.763]. The incidence of adverse reactions in berberine quadruple therapy group was significantly lower than that in clarithromycin quadruple therapy group [18.2% (36/198) vs. 38.5% (75/195), P<0.001]. Specifically, the incidence of taste disturbance in berberine quadruple therapy group was significantly lower than that in clarithromycin quadruple therapy group (3.0% vs. 15.4%, P<0.001). There was no statistically significant difference in medication compliance between the two groups [98.5% (195/198) in berberine quadruple therapy group vs. 97.9% (191/195) in clarithromycin quadruple therapy group, P=0.688]. The fixed direct medical cost per patient was significantly lower in berberine quadruple therapy group than that in clarithromycin quadruple therapy group (402.08 yuan vs. 693.94 yuan).ConclusionsThe berberine-based quadruple therapy is as effective as traditional clarithromycin-based quadruple therapy for eradicating H. pylori, with the advantages of a lower incidence of adverse reactions and lower cost. It represents a safe, effective, and economical treatment option worthy of further promotion and application.关键词：Helicobacter pylori;berberine;clarithromycin;quadruple therapy;eradication rate;safety6|0|0更新时间：2025-12-11 - “在医学领域，报道了一例罕见胫骨滑膜肉瘤病例，通过影像、病理学特征及基因检测明确诊断，为治疗提供依据。”
摘要：ObjectiveTo report a case of tibial synovial sarcoma and review relevant literature to enhance understanding of this disease.MethodsThe clinical data of a patient with tibial synovial sarcoma treated at Kaifeng Central Hospital were retrospectively analyzed. A literature search was conducted in domestic and international databases, including China National Knowledge Infrastructure (CNKI), Wanfang Data, PubMed, Web of Science, and Embase, up to July 2024. Relevant literature was comprehensively reviewed to summarize the imaging and pathological characteristics, treatment, and prognosis of synovial sarcoma.ResultsA 29-year-old female patient was admitted with left lower extremity pain. X-ray examination revealed a proximal tibia space-occupying lesion suggestive of malignancy, and a mid-tibial space-occupying lesion considered benign. Contrast-enhanced computed tomography (CT) and plain magnetic resonance imaging (MRI) of the proximal tibial lesion also suggested malignancy. Ultrasound-guided biopsy of the proximal tibial tumor revealed a poorly differentiated malignant tumor. Immunohistochemistry results indicated monophasic synovial sarcoma, requiring genetic testing for definitive diagnosis. The patient underwent wide resection of the proximal left tibial malignancy with tumor-type artificial joint replacement, combined with curettage and bone cement filling for the left mid-tibial lesion under anesthesia. Postoperative pathology of space-occupying lesions in the proximal tibia confirmed monophasic synovial sarcoma, and fluorescence in situ hybridization (FISH) demonstrated a rupture of the synovial sarcoma translocation gene (SYT) (i.e., SS18 positive). There was no recurrence or metastasis found in the patient during the reexamination 6 months after postoperative chemotherapy. As of July 2024, 15 cases of genetically confirmed primary intraosseous synovial sarcoma have been reported internationally. Symptoms included pain and swelling, with a medical history of 1-2 years. The X-ray and CT findings showed osteolytic destruction with bone cortical discontinuity. In 13 cases, the intraosseous masses extended to the extraosseous area; in 2 cases, punctate calcifications were detected within the masses. Plain MRI scan showed iso-signal or hypo-signal on T1WI and hyper-signal, iso-signal, and hypo-signal on fat-suppressed T2WI, and enhanced MRI scan demonstrated heterogeneous enhancement. Pathological examination showed spindle-shaped cells under microscopy. Immunohistochemistry results showed positive epithelial membrane antigen (EMA), broad-spectrum cytokeratin (AE1/AE3), Ewing's sarcoma marker (CD99), and transducin-like enhancer of Split 1 (TLE1). Twelve patients underwent surgical treatment; 6 patients received adjuvant chemotherapy after surgery, of whom 4 developed local recurrence or distant metastasis at initial diagnosis, and 3 died during follow-up. Among the 6 patients who did not receive adjuvant chemotherapy, 3 suffered from recurrence or distant metastasis.ConclusionsPrimary intraosseous synovial sarcoma is a rare malignant tumor with non-specific clinical manifestations. Imaging features typically include osteolytic destruction and intraosseous masses extending extraosseously, suggesting an intraosseous origin. Pathology and immunohistochemistry aid diagnosis, but definitive confirmation relies on further genetic testing. At present, the main treatment regimens for synovial sarcoma involve comprehensive therapies such as surgery and adjuvant chemotherapy, and the prognosis of patients is poor.关键词：intraosseous synovial sarcoma;imaging findings;diagnosis and treatment11|0|0更新时间：2025-12-11
Clinical Research
- “最新研究揭示，脑静脉窦狭窄程度与跨狭窄压力梯度关系密切，为治疗提供新思路。”
摘要：ObjectiveTo analyze the relationship between different degrees of cerebral venous sinus stenosis and the trans-stenotic pressure gradient using a 3D-printed hemodynamic simulation system for cerebral venous sinuses.MethodsBased on the double elastic cavity model, a complete morphological model of the superior sagittal sinus, transverse sinus, and sigmoid sinuses was constructed using 3D printing technology. An in vitro hemodynamic simulation system incorporating pulsatile blood flow was established to simulate the hemodynamic environment of cerebral venous sinus stenosis. Using this system, both unilateral dominant drainage and bilateral balanced drainage were simulated. The degree of stenosis and the pressure upstream and downstream of the stenosis were measured. The pressure difference and pressure ratio were calculated to analyze the correlation between stenosis degree and the trans-stenotic pressure gradient.ResultsIn the unilateral dominant drainage model, as the stenosis severity increased, the upstream pressure increased, whereas the downstream pressure remained relatively stable, leading to an increased pressure gradient between the two ends. The regression equation for stenosis degree (X) and pressure gradient (pressure difference ΔP) was: YΔP=1.962X-1.417 (R=0.867, R2=0.753, P<0.001). In the bilateral balanced drainage model of cerebral venous sinuses, when the stenosis degree on one side of the model increased, the pressure gradient between the two ends changed slightly and eventually reached a stable state. The regression equation between X and ΔP was: YΔP=0.62X+1.047 (R=0.98, R2=0.96, P<0.001).ConclusionsStenosis in cerebral venous sinuses with unilateral dominant drainage has a more significant impact on the pressure gradient, while unilateral stenosis in bilateral cerebral venous sinuses with balanced drainage has a smaller impact on the pressure gradient. This result suggests that for bilateral venous sinus stenosis, stent implantation can be prioritized in one side of the cerebral venous sinuses.关键词：cerebral venous sinus stenosis;3D-printed model;pressure gradient;hemodynamics;stents10|0|0更新时间：2025-12-11 - “最新研究发现，TGF-β、WTAP、JUNB与胶质母细胞瘤恶性进展密切相关，为治疗提供新思路。”
摘要：ObjectiveTo explore the role and mechanism of RNA m6A methyltransferase Wilms' tumor 1-associated protein (WTAP) in epithelial-mesenchymal transition (EMT) of glioblastoma cells and its association with transcription factor JUNB.Methods(1) Based on the Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) databases, the expression levels of transforming growth factor β (TGF-β), WTAP, and JUNB in glioblastoma multiforme (GBM) and normal brain tissues were analyzed, as well as their diagnostic and prognostic values for GBM. The correlation of TGF-β, WTAP, and JUNB with gliomas of different WHO grades was analyzed using the Chinese Glioma Genome Atlas (CGGA) database. Spearman correlation analysis was performed to assess the correlation between TGF-β and m6A methyltransferases. (2) An EMT model was established in human astrocytoma U87-MG cells through TGF-β1 induction. qRT-PCR and Western blotting were employed to detect the expression levels of WTAP, JUNB, matrix metalloproteinase 2 (MMP2), and N-cadherin. The migration capacity of U87-MG cells was evaluated by wound-healing and Transwell assays. An m6A RNA methylation quantification kit (colorimetric) was used to detect RNA m6A methylation modification levels. A stable cell line with low expression of WTAP was constructed to investigate the effects of WTAP knockdown on the migration ability of U87-MG cells, as well as the expression of JUNB. (3) A protein-protein interaction network was constructed using STRING database and GeneMANIA database, followed by gene ontology (GO) and KEGG pathway enrichment analyses to explore the biological processes, molecular functions, cellular components, and signaling pathways potentially involved in TGF-β/WTAP/JUNB. Gene set enrichment analysis (GSEA) was performed on JUNB-related genes to investigate their potential downstream signaling pathways.Results(1) The expression levels of TGF-β, WTAP, and JUNB were significantly higher in GBM (P<0.001), positively correlated with WHO grades of glioma (P<0.001). Glioma patients with high expression of all three genes had shorter overall and disease-free survival (P<0.001). Spearman analysis showed that the expression of TGF-β in GBM was positively correlated with WTAP (r=0.175, P=0.023), but no significant correlation with other m6A methyltransferases (P>0.05). (2) After TGF-β1 treatment, the level of m6A methylation modification of total RNA in U87-MG cells significantly increased (P<0.001). Wound-healing assay and Transwell assay results showed that the migration ability of U87-MG cells was significantly increased after TGF-β1 treatment (P<0.01), while WTAP knockdown significantly reduced the migration ability of U87-MG cells (P<0.01). qRT-PCR and Western blotting results showed that the mRNA and protein expression levels of WTAP, N-Cadherin, MMP2, and JUNB in U87-MG cells were significantly increased after 48 h of TGF-β1 induction (P<0.001), while WTAP knockdown significantly reduced the mRNA and protein expression of JUNB (P<0.001). (3) The TGF‑β/WTAP/JUNB-related protein-protein interaction network was constructed, which was primary involved in mRNA modification and EMT. GSEA results showed that JUNB-related signaling pathways were closely associated with glioma malignant progression.ConclusionsTGF-β, WTAP, and JUNB are all associated with GBM malignant progression and poor patient prognosis. TGF-β may enhance total RNA m6A modification by promoting the expression of m6A methyltransferase WTAP, and WTAP subsquentaly upregulates transcription factor JUNB, thereby promoting EMT and malignant progression of GBM.关键词：glioblastoma;epithelial-mesenchymal transition;RNA m6A methylation;Wilms' tumor 1-associated protein9|0|0更新时间：2025-12-11 - “最新研究发现，ANXA1拟肽Ac2-26能有效减轻重症中暑小鼠的炎症反应和脏器损伤。”
摘要：ObjectiveTo investigate the protective effects of the ANXA1 (Annexin A1) mimetic peptide Ac2-26 on mice with severe heatstroke (HS) and its underlying mechanisms.MethodsTwenty-four adult healthy male C57BL/6J mice weighing 20-25 g were randomly divided into four groups using a simple random sampling method: control group (Con group), Con+Ac2-26 group, severe heatstroke group (HS group), and severe heatstroke+Ac2-26 group (HS+Ac2-26 group), with 6 mice in each group. Mice in Con+Ac2-26 group and HS+Ac2-26 group were injected intraperitoneally with Ac2-26 (6 mg/kg), and the remaining mice of two groups were injected intraperitoneally with normal saline of equivalent volume. One hour after drug administration, mice in HS group and HS+Ac2-26 group were placed in a high-temperature and high-humidity simulated environment [(37.0±0.5) ℃, 75%±5% humidity], while mice in Con group and Con+Ac2-26 were kept in a room temperature and humidity environment [(24±0.5) ℃ and 40±5% humidity] throughout the experiment. The anal temperature of the mice was recorded every 5 minutes; when the anal temperature of mice in HS group and HS+Ac2-26 group reached 42 ℃, they were removed from the high-temperature environment and placed in a room temperature environment for 6 hours of rewarming, after which blood samples of mice in each group were collected. Flow cytometry was used to detect the proportion of neutrophils and the expression levels of Cd11b and Cd62L (molecules related to neutrophil activation). Enzyme-linked immunosorbent assay (ELISA) was used to measure the plasma levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), IL-10, and IL-4. Hematoxylin-eosin staining (HE staining) was performed to observe the pathological changes in lung, kidney and liver tissues. Furthermore, RNA sequencing (RNA-seq) was conducted to detect changes in neutrophil gene expression.ResultsCompared with Con group, Con+Ac2-26 group showed no significant increase in neutrophil proportion, decreased expression of CD62L and CD11b, no significant changes in cytokine levels, and no obvious pathological changes in lung, kidney, or liver tissues. Compared with HS group, the time for mice in HS+Ac2-26 group to reach an anal temperature of 42 ℃ and the time to develop hypothermia after model establishment were both prolonged (P<0.05); the proportion of neutrophils was reduced (P<0.05); the plasma levels of pro-inflammatory cytokines TNF-α and IL-6 were decreased (P<0.05); and the plasma level of anti-inflammatory cytokine IL-10 was increased (P<0.05). HE staining results showed that compared with HS group, HS+Ac2-26 group had a reduced range of inflammatory cell infiltration in lung, kidney, and liver tissues. RNA-seq results revealed that compared with HS group, HS+Ac2-26 group had decreased expression levels of molecules related to the oxidative phosphorylation signaling pathways and neutrophil extracellular trap (NETs).ConclusionAnnexin A1 mimetic peptide Ac2-26 may reduce the pro-inflammatory response and alleviate the heatstroke-induced organ histopathologic damage in heatstroke mice by inhibiting oxidative phosphorylation in heat-stressed cells and NETs formation.关键词：severe heatstroke;annexin A1;neutrophil;inflammation11|0|0更新时间：2025-12-11
Basic Research
- “动脉粥样硬化研究新进展：线粒体质量控制系统失调推进疾病发展，为治疗提供新方向。”
摘要：Atherosclerosis (AS) is an inflammatory cardiovascular disease characterized by plaque accumulation in the arterial wall, leading to increased morbidity and mortality of related cardiovascular disorders. The main pathological mechanisms of AS include lipid deposition, oxidative stress, and chronic inflammation, with disease progression involving endothelial cell dysfunction, macrophage polarization, foam cell formation, and smooth muscle cell proliferation or apoptosis. Mitochondria are essential organelles that provide energy for cellular metabolism, and the mitochondrial quality control (MQC) system is the fundamental mechanism maintaining mitochondrial functional homeostasis. MQC dysfunction can induce vascular phenotype changes through pathways such as oxidative stress, apoptosis, and inflammation, thereby promoting the progression of AS. Therefore, targeting MQC to regulate mitochondrial function may become a new direction for the treatment of AS. This review summarizes the molecular mechanisms of MQC, including mitochondrial biogenesis, mitochondrial dynamics, and mitochondrial autophagy (mitophagy), and further elucidates the role of abnormal MQC in the pathological processes of AS, aiming to provide a scientific basis for identifying potential targets to delay the progression of AS and developing related drugs.关键词：atherosclerosis;mitochondrial dynamics;autophagy;mitochondrial quality control13|0|0更新时间：2025-12-11 - “最新研究发现，tRNA衍生小RNA在呼吸系统疾病中具有调控基因表达等多种生物学功能，为诊治提供新思路。”
摘要：Transfer RNA-derived small RNAs (tsRNAs) are a novel class of non-coding small RNAs, which have various biological functions such as regulating gene expression, protein translation, epigenetic inheritance, cell proliferation and apoptosis, and communication. tsRNA is abnormally expressed in respiratory system cancers, lung injury, pulmonary hypertension, childhood obstructive sleep apnea-hypopnea syndrome and respiratory virus infections, affecting the occurrence and development of these diseases. However, the regulatory mechanism of tsRNAs in respiratory diseases has not been fully elucidated yet. Therefore, this review introduces the sources, classification and detection methods of tsRNA, summarizes the biological functions of tsRNA in respiratory diseases, related regulatory mechanisms, and its application prospects as biomarker in clinical diagnosis and prognosis evaluation, aiming to provide new ideas for the diagnosis and treatment of respiratory diseases, and to provide reference for in-depth research on tsRNA regulation of respiratory diseases.关键词：respiratory diseases;transfer RNA-derived small RNA (tsRNA);regulatory mechanism;clinical value11|0|0更新时间：2025-12-11 - “最新研究发现，胆碱能抗炎通路(CAP)激活可抑制过度炎症反应，为炎症免疫性疾病治疗提供新思路。”
摘要：The cholinergic anti-inflammatory pathway (CAP) is a neuroimmunoregulatory pathway that has attracted much attention in recent years. This pathway releases acetylcholine (ACh) by activating the vagus nerve. The binding of ACh to α7 nicotinic acetylcholine receptor receptors on the surface of macrophages can inhibit the release of proinflammatory factors, so as to effectively regulate the inflammatory response in the body. CAP plays a key role in suppressing excessive inflammatory responses and maintaining immune balance, providing a potential therapeutic pathway for a variety of inflammatory immune diseases. Research progress on the physiological function of CAP and its activation and blocking methods are reviewed in this paper, in order to provide new methods and ideas for treatment of inflammation-related diseases and exploring therapeutic drugs targeting CAP pathway.关键词：cholinergic anti-inflammatory pathway;α7 nicotinic acetylcholine receptor;vagus nerve;inflammation11|0|0更新时间：2025-12-11 - “药物性肝损伤研究新进展：巨噬细胞极化调控机制为精准免疫治疗提供理论基础。”
摘要：Drug-induced liver injury (DILI) is a common adverse drug reaction in clinical practice, which can lead to acute liver failure and even death in severe cases. In recent years, with the continuous introduction of new drugs and the expansion of their usage, the incidence and mortality rates of DILI have shown an upward trend, posing significant challenges to public health and clinical treatment. Macrophages, as a crucial component of the innate immune system, exhibit high plasticity and heterogeneity. They can polarize into pro-inflammatory M1 type or anti-inflammatory M2 type in response to microenvironmental signals. Research has demonstrated that macrophage polarization plays a central regulatory role in the occurrence and progression of DILI by influencing various processes such as inflammatory responses, cell apoptosis, and tissue repair. This review focuses on elucidating the regulatory mechanisms and roles of macrophage polarization in DILI, providing a theoretical framework for developing precise immunotherapeutic strategies.关键词：drug-induced liver injury;macrophages;macrophage polarization14|0|0更新时间：2025-12-11
Review
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