30 December 2025, Volume 47 Issue 6
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 863-872. https://doi.org/10.3881/j.issn.1000-503X.16503
Objective To explore the effects and mechanisms of Wendan Decoction(WDT)on anxiety-like and fear-like behaviors,as well as sleep,in the rat model of insomnia due to heart-gallbladder qi deficiency. Methods SD male rats were randomly allocated into blank,model,Anshen Dingzhi pills(0.54 g/kg),low-,medium-,and high-dose(8.7,17.4,and 34.8 g/kg)WDT groups.Plantar electric stimulation combined with forced exercise was used for modeling,and the rats were administrated with corresponding agents by gavage for 7 consecutive days after the modeling.Behavioral tests were performed,and the c-Fos protein level,neuron firing rate,and hippocampal neurotransmitter content in brain regions were determined. Results Compared with the model group,medium-dose WDT shortened the avoidance time,freezing time,and sleep latency(P<0.001,P<0.001,P=0.010).Furthermore,medium-dose WDT attenuated the elevated c-Fos expression in emotion-related brain regions,including the prelimbic cortex(P<0.001),infralimbic cortex(P<0.001),basolateral amygdala(P<0.001),central amygdala(P<0.001),ventral hippocampus(P=0.004),periaqueductal gray(P<0.001),and dorsal raphe nucleus(P<0.001),as well as the increased firing rate of ventral hippocampal interneurons(P=0.005).In addition,it reduced the hippocampal glutamate content and the glutamate/gamma-aminobutyric acid ratio(P<0.001,P=0.013). Conclusions WDT can reduce the excitatory drive of glutamic acid to interneurons by inhibiting the release of glutamic acid from pyramidal neurons of ventral hippocampus,thus playing a role in improving sleep and mitigating the anxiety-like,fear-like,and depression-like behaviors in the rat model of insomnia due to heart-gallbladder qi deficiency.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 873-887. https://doi.org/10.3881/j.issn.1000-503X.16594
Objective To identify key genes of lipid metabolism in diabetic nephropathy(DN) through machine learning models and animal model validation. Methods The limma R package was used for differential gene expression analysis on 69 samples from two transcriptome datasets of the Gene Expression Omnibus and 2 184 differentially expressed genes were identified.Subsequently,we adopted undifferentiated consensus clustering to classify DN samples into two specific subtypes.At the same time,we performed weighted gene co-expression network analysis to mine the gene modules significantly associated with DN.In addition,using least absolute shrinkage and selection operator,support vector machine-recursive feature elimination,and random forest machine learning techniques,combined with protein-protein interaction network analysis,we screened out three core genes.Finally,we constructed a mouse model of type 2 diabetes mellitus to verify the effectiveness of the expression of these key genes. Results Three core genes,APOO,ALDH7A1,and ALB,were predicted as potential biomarkers of lipid metabolism in DN,and their expression levels were downregulated in DN.Through experimental validation in a diabetic mouse model,we confirmed the altered expression of APOO,ALDH7A1,and ALB in DN,which supported their potential as diagnostic markers. Conclusions Our findings suggest that APOO,ALDH7A1,and ALB are new diagnostic markers associated with lipid metabolism in DN,which provides new perspectives for understanding the molecular mechanisms of lipid metabolism in DN.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 888-895. https://doi.org/10.3881/j.issn.1000-503X.16574
Objective To explore the association between dietary chili intake and cognitive function in the elderly population and the modifying effect of body mass index. Methods On the basis of the baseline survey data of the West China Elderly Health Cohort,a cross-sectional design was adopted,and 1 961 older adults aged 60 and above who had completed a dietary survey were included in this study.Multivariate linear regression and multivariate Logistic regression models were used to explore the associations of chili intake with cognitive function score and cognitive decline,respectively.Stratified analysis was performed to explore whether the associations varied among different body mass index groups. Results Among the surveyed older adults,1 119(57.06%) were diagnosed as with cognitive decline by minimum mental state examination.The results of multivariate linear regression analysis showed that after adjusting for possible confounding factors in turn,the score of chili intake had a stable positive correlation with cognitive function score(β=0.086,95%CI=0.010-0.163,P=0.027).Compared with those who did not have chili intake,the following groups had increased cognitive function scores:those with low chili intake(β=0.559,95%CI=0.023-1.096,P=0.041) or moderate chili intake(β=0.641,95%CI=0.075-1.207,P=0.026),those who had chili intake 1-5 days per week(β=0.994,95%CI=0.430-1.558,P=0.001),those who began chili intake over the age of 18(β=0.797,95%CI=0.172-1.422,P=0.013),those who began chili intake at the age of 18 and under(β=0.476,95%CI=0.045-0.907,P=0.031),those had mild chili intake(β=0.471,95%CI=0.047-0.896,P=0.030),and those who had high chili intake(β=0.982,95%CI=0.275-1.689,P=0.007).Logistic regression analysis showed that chili intake 1-5 days per week(OR=0.634,95%CI=0.474-0.849,P=0.002) was associated with a lower risk of cognitive decline than those without chili intake.Stratified analysis showed that the positive association between chili intake and cognitive function was more significant in the group with body mass index ≥24 kg/m2,and the higher score of chili intake corresponded to the lower risk of cognitive decline(OR=0.924,95%CI=0.875-0.975,P=0.004). Conclusions Appropriate chili intake may have a protective effect on cognitive function in the elderly population,especially in the overweight and obese elderly.Prospective studies are needed to further verify the causal relationship.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 896-909. https://doi.org/10.3881/j.issn.1000-503X.16518
Objective To investigate the expression of opioid growth factor(OGF),OGF receptor(OGFR),P16,and P21 in elderly patients with colorectal cancer and their correlations with clinicopathological characteristics. Methods Bioinformatic analysis of OGFR was performed via differential expression analysis,survival analysis,single-cell RNA sequencing,and spatial transcriptomics.A total of 167 elderly patients with colorectal cancer were enrolled,with 30 fresh tissue samples collected from January 2023 to December 2024 and 137 paraffin-embedded tissue samples collected from January 2016 to January 2020.All the specimens were collected from confirmed cases at the First Affiliated Hospital of Hebei North University.OGF expression in the 30 fresh tissue samples was detected by ELISA,while the protein levels of OGFR,P16,and P21 were measured by Western blot.Immunohistochemistry was employed to assess OGFR,P16,and P21 expression in the 137 paraffin-embedded samples.SPSS 20.0 was used to analyze the correlations of OGFR,P16,and P21 expression with clinicopathological characteristics.The Spearman method was adopted to evaluate correlations among OGFR,P16,and P21 expression.Overall 5-year survival and differences between groups were assessed by Kaplan-Meier survival curves and the log-rank test. Results Differential expression analysis revealed that the expression of OGFR was upregulated in colorectal cancer tissue samples(P<0.001).Survival analysis revealed a significant correlation between high OGFR expression and poor prognosis(disease-free interval:P=0.019,disease-specific survival:P=0.015).Single-cell and spatial omics analyses indicated that OGFR was primarily expressed in tumor cells.ELISA results showed that compared with that in the adjacent normal tissue,the OGF expression levels elevated in pathological stages Ⅰ(P<0.001),Ⅱ(P=0.042),Ⅲ(P<0.001),and Ⅳ(P=0.001).Western blot results demonstrated that compared with that in the adjacent normal tissue,the protein level of OGFR was up-regulated in pathological stages Ⅰ(P<0.001),Ⅱ(P=0.047),Ⅲ(P=0.045),and Ⅳ(P=0.012).Compared with those in the adjacent normal tissue,the protein levels of P16 and P21 were down-regulated in pathological stages Ⅰ(P=0.001,P<0.001),Ⅱ(P=0.031,P=0.008),Ⅲ(P=0.026,P=0.024),and Ⅳ(P=0.018,P=0.015).Immunohistochemistry results demonstrated that OGFR had higher expression in cancer tissue samples than in adjacent normal tissue samples(P<0.001),and its expression level was correlated with T stage(P=0.047),lymph node metastasis(P=0.035),TNM stage(P=0.013),differentiation degree(P=0.043),and distant metastasis(P=0.030).Conversely,the protein levels of P16 and P21 were lower in cancer tissue samples(all P<0.001).P16 expression was correlated with T stage(P=0.009),lymph node metastasis(P=0.035),TNM stage(P=0.001),and differentiation degree(P=0.021).P21 expression showed correlations with T stage(P=0.009),lymph node metastasis(P=0.002),and TNM stage(P=0.046).The 5-year overall survival rate of the 137 elderly patients with colorectal cancer was 55.47%.The patients with positive expression of OGFR had a lower 5-year overall survival rate than those with negative expression(P=0.001).The patients with negative expression of P16 or P21 had a lower 5-year overall survival rate than those with positive expression(P16:P<0.001;P21:P=0.007). Conclusions In the colorectal cancer tissue of elderly patients,the expression of OGFR was negatively correlated with that of P16 and P21.The OGF-OGFR signaling pathway may promote colorectal cancer progression by suppressing P16 and P21 expression.The combined detection of these markers shows potential as a valuable reference for assessing disease progression.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 910-920. https://doi.org/10.3881/j.issn.1000-503X.16558
Objective To explore the clinical significance of roundabout guidance receptor 4(ROBO4) and protocadherin 12(PCDH12) in the human serum in the screening,diagnosis,and staging of colorectal cancer(CRC) through proteomics and bioinformatics,thus providing a novel screening method with high specificity,sensitivity,and accuracy for the early screening and diagnosis of CRC in clinical practice. Methods Proteomics and bioinformatics approaches were employed to select the target proteins ROBO4 and PCDH12,and the correlation between ROBO4 and PCDH12 was analyzed.A total of 121 CRC patients(cancer group),112 patients with polyps(polyp group),and 108 healthy volunteers(normal group) who received treatment or physical examination from January 2023 to June 2024 were enrolled in this study.ELISA was employed to determine the expression levels of ROBO4,PCDH12,carcinoembryonic antigen(CEA),and carbohydrate antigen 199(CA199) in the samples of each group.The expression levels of the four proteins in the serum were compared among the three groups of patients mentioned above,and the relationships of the serum levels of ROBO4 and PCDH12 with the pathological characteristics of the CRC patients were analyzed.Furthermore,the receiver operating characteristic(ROC) curves were established to evaluate the diagnostic efficacy of the serum levels of ROBO4 and PCDH12 for CRC patients in early and progressive stages. Results The target proteins ROBO4 and PCDH12 were screened out through proteomics.Bioinformatics analysis showed that ROBO4 and PCDH12 were highly expressed in CRC patients.Further correlation analysis revealed a positive correlation between ROBO4 and PCDH12 in CRC(R=0.870,P<0.001).The ELISA results of clinical samples showed that compared with the normal group and polyp group,the cancer group presented elevated expression levels of ROBO4 and PCDH12(all P<0.001).There was no statistically significant difference in the expression level of ROBO4 or PCDH12 between the normal group and the polyp group(P=0.586,P=0.550).The ROC curves showed that the diagnostic efficacy of ROBO4,PCDH12,and ROBO4+PCDH12 was 0.787,0.757,and 0.812,respectively,all of which were higher than the diagnostic efficacy of CEA and CA199.Further analysis of serum levels of ROBO4 and PCDH12 with the pathological data of CRC showed that the serum level of ROBO4 was correlated with differentiation degree(P=0.013),pathological stage(P=0.002),lymph node metastasis(P=0.001),and distant metastasis(P=0.026).The serum level of PCDH12 was correlated with differentiation degree(P=0.043),pathological stage(P=0.012),and lymph node metastasis(P=0.001).The ROC curves showed that the diagnostic efficacy of ROBO4,PCDH12,and ROBO4+PCDH12 was 0.637,0.758,and 0.787 for early CRC and 0.872,0.757,and 0.882 for progressive CRC,respectively. Conclusions The serum levels of ROBO4 and PCDH12 demonstrate high diagnostic efficacy for CRC patients and are correlated with the pathological features of CRC.The two proteins are expected to be novel serum biomarkers for the diagnosis and screening of CRC.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 921-930. https://doi.org/10.3881/j.issn.1000-503X.16562
Objective To analyze the relationship between combined lifestyle and cognitive function among older adults in rural communities. Methods A multi-stage stratified whole-group sampling method was employed to select older adults aged ≥60 years in four villages of Chongming District,Shanghai as the participants.Their somatic indicators were measured by trained personnel,and data on demographic characteristics,cognitive function,and lifestyle were collected through face-to-face interviews.Binary Logistic regression and trend tests were adopted to explore the relationship between combined lifestyle and cognitive function.Additionally,the subgroup analysis and the test for multiplicative interactions were conducted for the relationship between combined lifestyle and cognitive function.Furthermore,sensitivity analysis was performed to verify the robustness of the results. Results A total of 1 449 older adults were investigated,and 1 408 were effective.The older adults showed the average age of(73.25±5.69) years and the cognitive impairment prevalence of 15.63%.Among them,163 older adults lived unhealthy lifestyles,accounting for 11.6%.After adjusting for demographic factors,disease history,and medication history,moderate lifestyles(OR=0.609,95%CI=0.394-0.944,P=0.026) and healthy lifestyles(OR=0.377,95%CI=0.212-0.672,P=0.001) had negative associations with the prevalence of cognitive impairment.Among combined lifestyle components,dietary diversity(OR=0.404,95%CI=0.211-0.771,P=0.006),physical activity intensity(OR=0.460,95%CI=0.235-0.901,P=0.024),and sleep duration(OR=0.611,95%CI=0.416-0.897,P=0.012) had negative associations with the prevalence of cognitive impairment.The trend test revealed that the negative association between cognitive impairment and combined lifestyle enhanced with the sequential increase in combined lifestyle score(Pfor trend=0.011).The subgroup analysis revealed an interaction effect between gender and lifestyle subgroups,and a healthy lifestyle exerted a protective effect on women(Pfor interaction=0.013). Conclusions Among older adults in rural communities,cognitive impairment has a significantly negative association with healthy lifestyles.As the combined lifestyle score increases,the risk of developing cognitive impairment shows a decreasing trend,which suggests that comprehensive lifestyle interventions may have a protective effect on cognitive function.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 931-938. https://doi.org/10.3881/j.issn.1000-503X.16609
Objective To investigate the characteristics of symptom clusters and sentinel symptoms in lung cancer patients before and at the completion of radiotherapy,thus providing a theoretical basis for targeted symptom management. Methods A convenience sampling method was used to recruit patients from the Department of Radiotherapy at Yunnan Cancer Hospital between January and October 2024.A general information questionnaire and the Anderson symptom inventory-lung cancer module(revised) were employed for data collection.The exploratory factor analysis was performed for the symptoms with an incidence rate greater than 20% one day before and at the completion of radiotherapy to identify symptom clusters at different time points.The Apriori algorithm was then adopted to model the associations among symptoms within each cluster and to identify the sentinel symptoms. Results A total of 244 patients were included in this study.Three symptom clusters existed before radiotherapy:psychological symptom cluster(sadness,distress,and sleep disorder),lung cancer-related respiratory symptom cluster(cough,expectoration,chest tightness,and shortness of breath),and perception symptom cluster(pain and numbness).Distress and cough were the sentinel symptoms of psychological symptom cluster and lung cancer related respiratory symptom cluster,respectively.At the end of radiotherapy,the psychological symptom cluster and lung cancer-related respiratory symptom cluster remained unchanged.The radiotherapy side effect symptom cluster(dry mouth,pain,loss of appetite) appeared,and the perception symptom cluster expanded to encompass 5 items(amnesia,drowsiness,fatigue,nausea,and constipation).Pain and drowsiness were the sentinel symptoms of radiotherapy side effect symptom cluster and perception symptom cluster,respectively. Conclusions There are several symptom clusters in lung cancer patients before and at the completion of radiotherapy,and sentinel symptoms exist in symptom clusters at different periods.Nurses can take sentinel symptoms as the intervention targets to formulate effective and targeted nursing measures and reduce the incidence or severity of other symptoms in the cluster,thus diminishing the whole symptom cluster and reducing the burden of patients’ symptoms.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 939-946. https://doi.org/10.3881/j.issn.1000-503X.16539
Objective To assess the human papillomavirus(HPV)testing and infection status among men who have sex with men(MSM)using geosocial networking apps in China and explore the influencing factors,thus providing evidence for designing effective prevention and control strategies for this population. Methods The participants were recruited via the Blued7.23 app from July 15 to August 2,2024.Univariate and multivariate Logistic regression models were used to analyze the factors associated with HPV testing and infection among MSM. Results Among the 1 080 participants,23.3% had undergone HPV testing,and 43.3% of those tested were positive for HPV.The main reason for HPV testing was the presence or suspicion of HPV-related symptoms(n=224,58.9%).The multivariate Logistic regression analysis showed that the MSM who had higher levels of HPV knowledge,had higher income,and self-identified as homosexuals were more likely to undergo HPV testing.Moreover,the MSM who had higher levels of HPV knowledge,self-identified as homosexuals,had sex with women in the past six months,and had infected human immunodeficiency virus were identified as high-risk groups for HPV infection. Conclusions In China,the HPV testing rate is low among MSM using geosocial networking apps.However,the prevalence of HPV infection remains high.Therefore,the government and communities should enhance HPV knowledge dissemination,promote HPV testing,and improve the accessibility and quality of HPV testing services.These measures can increase the testing coverage and effectively control the spread of HPV among MSM.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 947-953. https://doi.org/10.3881/j.issn.1000-503X.16469
Objective To explore the value of amide proton transfer-weighted imaging(APTw) and T2 mapping in assessing microsatellite instability(MSI) in endometrial adenocarcinoma. Methods The patients with clinically suspected endometrial cancer were prospectively enrolled and underwent APTw and T2 mapping before operation.Two radiologists independently outlined the regions of interest and measured the quantitative parameters.The intragroup correlation coefficients were calculated to assess the agreement of MRI parameters measured by the two radiologists.The independent samples t-test and Mann-Whitney U test were conducted to compare quantitative variables between the MSI and microsatellite stability(MSS) groups.The receiver operator characteristic curve was established to evaluate the prediction performance of different parameters.The DeLong test was implemented to compare the area under the curve(AUC) between single parameters and their combination. Results Twenty-one patients in the MSI group and 37 patients in the MSS group were finally enrolled in this study.The results showed excellent agreement between two radiologists in assessing MRI parameters.The MSI group had higher APTw values[(2.72±0.52)% vs.(2.08±0.39)%,P<0.001]and lower T2 values[92.25(90.82,99.91) ms vs.101.80(96.15,112.13) ms,P<0.001]than the MSS group.The receiver operating characteristic curve showed that the AUC of APTw and T2 values were 0.821(95%CI=0.698-0.909) and 0.793(95%CI=0.666-0.888),respectively.No significant difference in diagnostic efficacy was observed between the two sequences(P=0.692).The combination of APTw and T2 mapping yielded the highest AUC of 0.897(95%CI=0.789-0.961),which was higher than that of APTw and T2 mapping alone(P=0.042,P=0.025,respectively). Conclusions APTw and T2 mapping are valuable in assessing the MSI of endometrial adenocarcinoma,and the combination of the two demonstrates higher diagnostic efficacy,thus providing a basis for the selection of preoperative therapeutic modalities for the patients.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 954-959. https://doi.org/10.3881/j.issn.1000-503X.16505
Objective To develop the belief scale of conducting the standardized prevention and treatment of allergic diseases for medical practitioners,thus assessing their beliefs of conducting the standardized approaches and providing an evaluation tool for the further research. Methods With the Health Belief Model as the theoretical framework,the dimensions and items of the scale were preliminarily developed through literature review and semi-structured interviews.The Delphi method was used to conduct 2 rounds of consultation with 25 experts for revising the scale.The positive coefficient,authority coefficient,degree of concentration,and degree of coordination were calculated as the criteria to build the scale. Results The recovery rates of the two rounds were 100% and 96%.The authority coefficients were 0.838 in both rounds,and the Kendall’s coefficients of concordance were 0.127(χ2=145.803,P<0.001) and 0.084(χ2=78.520,P<0.001).The final scale was developed,encompassing 39 items in 6 dimensions. Conclusion The belief scale of conducting standardized prevention and treatment of allergic diseases for medical practitioners is preliminarily developed via the Delphi method,which demonstrates high rationality.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 960-968. https://doi.org/10.3881/j.issn.1000-503X.16511
Objective To analyze the research hotspots and development trends in the field of social frailty of the elderly,thus providing reference for further research in this field. Methods The literature related to social frailty was retrieved from CNKI and Web of Science core collection and analyzed in terms of authors,institutions,countries,keywords,and burst terms by CiteSpace. Results A total of 165 articles in both Chinese and English were included.The annual number of papers published in the field of social frailty showed an increasing trend year by year.The authors,institutions,and countries with the largest number of papers were from Japan.The available studies of social frailty mainly focused on the causes and mechanisms,assessment methods,occurrence status,and adverse health outcomes.The social frailty of patients with heart failure and the survival status of patients with social frailty are major research trends in this field. Conclusions The research on social frailty is in the preliminary stage of exploration.The research focus is on the occurrence status and adverse effects of social frailty.In the future,the causes and mechanisms of social frailty in different populations and different contexts can be further explored,and targeted prevention,intervention,and management can be carried out.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 969-981. https://doi.org/10.3881/j.issn.1000-503X.16605
Currently,the artificial intelligence for science paradigm is evolving rapidly,with the new generation of artificial intelligence technologies represented by large language models(LLM)having injected transformative momentum into biological and medical research.Systematically examining the innovative applications of LLM in biomedical contexts under the artificial intelligence for science paradigm can provide critical references for methodological innovation and research paradigm transformation in deciphering complex disease mechanisms and advancing precision medicine.Through comparative analysis of high-impact peer-reviewed publications and preprints in the past two years,we elucidate cutting-edge research progress,developmental trajectories,and persistent challenges in LLM applications across biological and medical domains.Furthermore,we make an outlook on the future of this rapidly evolving field and proposes essential considerations for addressing emerging interdisciplinary challenges.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 987-996. https://doi.org/10.3881/j.issn.1000-503X.16564
Soft tissue sarcomas represent a rare and highly heterogeneous category of malignant tumors,with the diagnosis and treatment contingent upon the precise identification of histopathological subtypes.Due to their complex molecular mechanisms and diverse clinical behaviors,histological classification methods sometimes struggle to accurately distinguish different subtypes,highlighting the need for effective biomarkers for early diagnosis.As an emerging technology,liquid biopsy provides real-time tumor dynamic information for the diagnosis,recurrence monitoring,and treatment effect evaluation of soft tissue sarcomas by analyzing biomarkers in body fluids.This article comprehensively reviews the advancements in the research and clinical application of tumor biomarkers in the liquid biopsy of soft tissue sarcomas.It emphasizes biomarkers such as circulating tumor cells,cell-free DNA,non-coding RNA,and extracellular vesicles.Although liquid biopsy has shown great potential in the study of soft tissue sarcoma biomarkers,its clinical application still faces the challenges of low sensitivity and specificity,difficulty in tracing tissue origin,and the need for integration of multi-omics techniques.In the future,it is necessary to further develop conventional,non-invasive,and highly specific liquid biopsy markers and incorporate multi-omics technology and other clinical detection methods to promote the precise diagnosis and treatment of soft tissue sarcomas.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 997-1005. https://doi.org/10.3881/j.issn.1000-503X.16463
Narcolepsy type 1(NT1) is a chronic sleep disorder caused by the specific depletion of hypocretin(HCRT) neurons.The pathogenesis of NT1 involves human leukocyte antigen(HLA)-related genes(most NT1 patients carry the HLA-DQB1*06∶02 allele) and environmental factors.In Europe,there was a notable increase in NT1 cases among children and adolescents following the H1N1 pandemic in 2009 and 2010,particularly associated with the Pandemrix vaccination.Similarly,in China,the surge in NT1 incidence has been linked to H1N1 virus infections.It has been postulated that H1N1 virus infection may be a predisposing factor for NT1 development.In susceptible individuals,the confluence of the immune response triggered by the Pandemrix vaccine and the H1N1 virus infection could instigate autoimmunity against HCRT,leading to the loss of HCRT neurons mediated by T cells.This paper examines the involvement of influenza A H1N1 virus and its vaccines in the pathogenesis of NT1.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 1006-1014. https://doi.org/10.3881/j.issn.1000-503X.16528
Arsenic is a widespread carcinogen in the environment,and chronic arsenic exposure results in dysfunction or even cancer development of multiple organs,including the skin,liver,lung,brain,and ovary.RNA N6-methyladenosine(m6A)is a ubiquitous epigenetic modification of RNA in eukaryotes,regulating numerous physiological and pathological processes in cells.Increasing studies have shown that m6A plays a crucial role in arsenic-induced damage of multiple organs and systems,including the skin,liver,lung,nervous system,reproductive system,and embryo.This paper summarizes the recent studies on the regulatory role of m6A in arsenic-induced damage,providing new ideas and directions for the investigation of the mechanism and treatment strategy of arsenic toxicity.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 1015-1027. https://doi.org/10.3881/j.issn.1000-503X.16534
Non-thyroidal illness syndrome(NTIS)is commonly observed in critically ill patients.Sepsis is one of the leading causes of mortality among patients in intensive care units,where the incidence of NTIS is higher than that in general wards.Recently,increasing attention has been paid to thyroid metabolic abnormalities in sepsis patients.This article reviews the pathogenesis and clinical significance of NTIS in sepsis,aiming to offer evidence-based medical insights for future research directions for clinicians.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 1026-1036. https://doi.org/10.3881/j.issn.1000-503X.16487
Colorectal cancer(CRC),a common malignant tumor in the digestive system,has seen increases in global incidence and mortality.The occurrence and development of CRC is a multi-level complex process,which includes genetic variations within cancer cells and multiple influencing factors in the surrounding tumor microenvironment.More and more evidence suggests that tumor-associated macrophages(TAM),the main innate immune cell group in the tumor microenvironment,play a crucial role in CRC.Given the prognosis and clinical value of TAM,this article reviews the different roles of TAM in CRC and the potential applications of TAM-targeted technology.Although there is still controversy over the clinical evidence regarding the roles of TAM in CRC,elucidating the roles of TAM in the development of CRC and their importance in treatment may provide new insights for optimizing TAM-centered targeted therapies.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 1037-1044. https://doi.org/10.3881/j.issn.1000-503X.16492
Alcoholic liver disease(ALD) is chronic liver disease that significantly impacts global health,posing challenges in both diagnosis and treatment.Therefore,delving into the pathogenesis of ALD is of utmost importance.The advent of cutting-edge multi-omics has paved a new way for exploring ALD.Genomics,proteomics,transcriptomics,metabolomics,and gut microbiota investigations have shed light on the pathogenesis of ALD.Alterations in gene and protein expression,variations in metabolome,and the impact of gut microbiota are deemed pivotal in the progression of ALD.This paper comprehensively reviews the research progress of multi-omics in pinpointing prospective biomarkers and therapeutic targets in ALD,aiming to steer the forthcoming fundamental research and clinical practices for ALD.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 1045-1050. https://doi.org/10.3881/j.issn.1000-503X.16386
Isolated adrenocorticotropic hormone(ACTH)deficiency(IAD)is a rare disease first reported by Steinberg from Japan in 1954,and there have been few clinical reports about IAD to date.IAD is characterized by secondary adrenal cortical insufficiency,low or absent cortisol production,normal or transiently reversible increases in secretion of pituitary hormones other than ACTH,no structural pituitary defects,and exclusion of ACTH deficiency caused by exogenous glucocorticoid use and postoperative pituitary adenoma.This paper retrospectively analyzes the clinical data of three adult patients with IAD and summarizes their clinical characteristics,aiming to improve clinical awareness of this rare disease.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 1051-1056. https://doi.org/10.3881/j.issn.1000-503X.16380
Undifferentiated uterine sarcoma with SMARCA4 gene deletion is a rare malignant tumor.The incidence of this type of tumor is low,and fewer than 40 cases have been reported worldwide.Most of the cases are advanced at the time of diagnosis,and the tumor is aggressive and difficult to be diagnosed.The lack of large-sample studies,unclear treatment plan,and individualized treatment in most cases lead to poor prognosis and high mortality.We report two cases of undifferentiated uterine sarcoma at the ⅣB stage in young women with SMARCA4 gene deletion,providing reference for future treatment.
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Acta Academiae Medicinae Sinicae. 2025, 47(6): 1057-1062. https://doi.org/10.3881/j.issn.1000-503X.16509
Macro-aspartate aminotransferase(AST)is a macro-enzyme formed by self-polymerization or binding to other serum components that are difficult to be cleared by the kidneys,resulting in an isolated elevation in serum AST.Macro-AST is a rare disease.In this report,a case with isolated AST elevation as the main manifestation is presented.The diagnosis of macro-AST was established by the polyethylene glycol precipitation assay.The comprehensive history and exclusion of other factors suggest that this case of macro-AST may be secondary to metabolic dysfunction-associated fatty liver disease.
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