Journal of Shanghai Jiao Tong University (Medical Science)

Optimization of a genetically encoded fluorescent sensor for the detection of 5-HT

XU Mufan, ZHANG Kun, WANG Jingyi, GAO Xinke, CHENG Aobing, ZHANG Peng

2025, 45 (5): 529-539.
doi: 10.3969/j.issn.1674-8115.2025.05.001

Abstract ( 419 )

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Objective ·To optimize iSeroSnFR, a genetically encoded 5-hydroxytryptamine (5-HT) fluorescent sensor based on bacterial periplasmic binding proteins (PBPs), to enhance its performance for both in vivo and in vitro 5-HT detection. Methods ·iSeroSnFR1.2 was engineered by replacing the circularly permuted superfolder green fluorescence protein (cpsfGFP) sequence in iSeroSnFR1.0 with that from the acetylcholine sensor iAChSnFR using Gibson assembly. The fluorescence response and kinetic properties of iSeroSnFR1.0 and iSeroSnFR1.2 were compared by overexpressing the sensors in HEK293 cells and puffing with exogenous 5-HT. Additionally, to mimic physiological conditions, cultured mouse cortical neurons infected with Sindbis virus carrying each sensor were electrically stimulated to induce endogenous 5-HT release and further evaluate sensor performance. Results ·iSeroSnFR1.2 showed significantly improved performance over iSeroSnFR1.0. In HEK293 cells, it exhibited a 1.5-fold increase in fluorescence response (ΔF/F₀) to exogenous 5-HT, along with faster kinetics (rise time: 36.3 ms vs 44.9 ms; decay time: 1 003.6 ms vs 1 730.4 ms). In cortical neurons, it demonstrated a 2.7-fold increase in response to endogenously released 5-HT, with rise and decay times reduced by 44.0% and 26.7%, respectively. Notably, iSeroSnFR1.2 showed increased basal fluorescence, enabling better imaging in high-background environments. Conclusion ·The optimized iSeroSnFR1.2 sensor offers a markedly improved fluorescent response and temporal resolution for 5-HT detection, providing an advanced tool for studying 5-HT dynamics in neuroscience and psychiatric research.

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Research progress and considerations for thalassemia gene therapy

GAO Xinjie, LIU Yan, WANG Dawei

2025, 45 (5): 540-548.
doi: 10.3969/j.issn.1674-8115.2025.05.002

Abstract ( 774 )

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Traditional treatment modalities for thalassemia include regular blood transfusions and allogenic hematopoietic stem cell transplantation (allo-HSCT). In recent years, autologous transplantation of gene-modified hematopoietic stem cells has emerged as a new curative strategy for transfusion-dependent thalassemia (TDT),which has the potential to replace conventional treatments, and provide lifelong benefits for patients. There are two existing technical approaches for gene therapy of β-thalassemia: gene addition, which involves transducing exogenous β-globin genes into hematopoietic stem cells (HSCs), and gene editing, which utilizes CRISPR-Cas9 or other editing systems to re-activate the expression of γ-globin gene. This article summarizes the marketed products and research progress in clinical trials, aiming to analyze the respective advantages and limitations of these two approaches, and discusses the effectiveness and safety of current gene therapies for β-thalassemia, as well as the future directions for associated technologies, including ex vivo HSC expansion with maintenance of stemness and vector-mediated in vivo gene modification. In terms of clinical translational medicine, this article provides in-depth insights into promising solutions for contemporary challenges confronted in clinical trials, including process development challenges, clinical trial conduct, regulatory approval processes, commercialization and payment systems.

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Integrated single-cell and transcriptome sequencing to construct a prognostic model of M2 macrophage-related genes in prostate cancer

TANG Kairan, FENG Chengling, HAN Bangmin

2025, 45 (5): 549-561.
doi: 10.3969/j.issn.1674-8115.2025.05.003

Abstract ( 518 )

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Objective To explore the prognostic value of M2 macrophage-related genes in prostate cancer (PCa), aiming to predict tumor prognosis more accurately and enable personalized treatment. Methods ·RNA sequencing (RNA-seq) data of PCa were downloaded from The Cancer Genome Atlas (TCGA) database, and single-cell RNA sequencing (scRNA-seq) data were obtained from the Gene Expression Omnibus (GEO) database. The immune infiltration of TCGA samples was assessed using the CIBERSORTx algorithm. Differential genes in scRNA-seq data were identified using the FindMarkers function, and immune cell subtypes were characterized. M2 macrophage-related pathways and interactions with surrounding cells were explored through Gene Set Enrichment Analysis (GSEA) and the CellChat algorithm. M2 macrophage signature genes were selected to construct a prognostic model for PCa using univariate Cox and LASSO analyses. Based on the risk model, clinical characteristics, immune suppression, drug resistance, and drug sensitivity analyses were conducted. Results ·In TCGA samples, patients with high M2 macrophage infiltration exhibited significantly lower progression-free survival (PFS). scRNA-seq analysis identified multiple subpopulations of tumor microenvironment (TME) cells. M2 macrophages interacted with various immune cells in TME, contributing to an immunosuppressive microenvironment and playing a key role in tumor promotion. Based on these findings, a PCa risk model was developed, incorporating TREM2, OTOA, SIGLEC1, and PLXDC1, which showed robust predictive performance in both training and validation cohorts. Patients with higher risk scores demonstrated a more immunosuppressive TME, decreased androgen receptor (AR) signaling activity, and worse clinical characteristics, leading to poorer outcomes. Drug prediction and sensitivity analyses identified six potential therapeutic agents that may offer improved efficacy for patients with higher risk scores. Conclusion ·A prognostic model based on M2 macrophage-related genes in the TME has been constructed, providing a theoretical foundation for precision treatment in PCa.

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Promotion of Nd:YAP laser biostimulation on the proliferation and osteogenic differentiation of human periodontal ligament cells through WNT/β-catenin signaling pathway

XU Muxin, LIU Xian, JIANG Lishan, SUN Qing

2025, 45 (5): 562-569.
doi: 10.3969/j.issn.1674-8115.2025.05.004

Abstract ( 320 )

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Objective ·To study the effect of neodymium-doped yttrium aluminum perovskite (Nd:YAP) laser biostimulation on the proliferation and osteogenic differentiation of human periodontal ligament cells (hPDLCs) and its possible mechanism. Methods ·Five premolars removed for orthodontic reasons were collected from Changzhou Stomatological Hospital, and the periodontal ligament tissues from the middle 1/3 of the roots were taken to culture hPDLCs in vitro. The cells were irradiated with the biostimulation function [G (－) mode] of the Nd:YAP laser. According to the irradiation time, the cells were divided into a control group (without laser irradiation), and groups irradiated for 5 s, 10 s, 15 s, 20 s and 30 s. The cell counting kit-8 (CCK-8) method was used to detect the proliferation of hPDLCs in each group. After osteogenic differentiation was induced, the alkaline phosphatase (ALP) content and activity level of the cells were detected using an ALP staining kit and an ALP activity detection kit. The calcium salt level of the cells was evaluated by alizarin red S staining and calcium quantitative analysis. The expression of genes and proteins related to the WNT/β-catenin signaling pathway, including dickkopf-related protein 1 (DKK-1), β-catenin, and runt-related transcription factor 2 (RUNX2), was analyzed by quantitative real-time PCR (qPCR) and Western blotting. Results ·The results of CCK-8 showed that the proliferation level of cells in the 10 s, 15 s, 20 s, and 30 s groups was enhanced from 3 d after irradiation (all P<0.05). After induction of osteogenic differentiation, ALP content, activity, and calcium salt level in the laser irradiation groups increased with the extension of irradiation time (all P<0.05). The results of qPCR and Western blotting analysis showed that the expression levels of the DKK-1 gene and protein in the laser irradiation groups decreased with the extension of irradiation time. However, the expression levels of β-catenin and RUNX2 genes and proteins increased significantly with the extension of irradiation time; there were statistically significant differences between the 15 s, 20 s, and 30 s groups and the control group (all P<0.05). Conclusion ·Nd:YAP laser biostimulation may promote proliferation and osteogenic differentiation of hPDLCs through WNT/β-catenin signaling pathway.

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Therapeutic effect of combined vitamin D and DHA supplementation on preschool children with attention deficit hyperactivity disorder

ZHANG Yue, ZHANG Lishan, DING Xiaoyuan, SHEN Zhimin, BIAN Zouji, YU Xiaodan

2025, 45 (5): 570-577.
doi: 10.3969/j.issn.1674-8115.2025.05.005

Abstract ( 564 )

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Objective ·To investigate the therapeutic effect of combined vitamin D and docosahexaenoic acid (DHA) supplementation on preschool children with attention deficit hyperactivity disorder (ADHD). Methods ·From April 2021 to May 2021, a total of 1 412 children aged 4 to 6 years from eight kindergartens in Pudong New Area of Shanghai, including Tangqiao Street, Chuansha Town, and Heqing Town, were randomly selected by stratified cluster random sampling method. Attention and hyperactivity symptom assessment was performed using the Conner′s Scale, Diagnosis and Statistical Manual of Mental Disorders(fifth edition, DSM-Ⅴ), and Swanson, Nolan, and Pelham (version Ⅳ, SNAP-Ⅳ) Scale, and other neurodevelopmental disorders were excluded using the Wechsler Intelligence Scale. A total of 82 preschool children with ADHD were enrolled, and after fully informing them of the intervention measures, they were divided into an intervention group (n=64) and a control group (n=18) based on their parents′ choice. The control group received routine health education. In addition to routine health education, the intervention group received daily supplementation of Vitamin D (800 IU) and DHA (400 mg). Venous blood samples were collected from both groups at baseline, 3 months, and 12 months for the measurement of serum 25 hydroxy vitamin D [25 (OH) D] and DHA levels. ADHD symptoms were evaluated using Conner′s Scale, SNAP-Ⅳ Scale, and DSM-Ⅴ. Results ·After 3 and 12 months of intervention in the intervention group, serum 25 (OH) D levels and DHA levels were significantly higher (P<0.05), the ADHD symptom scores, including impulsivity-hyperactivity and hyperactivity index scores in Conner′s Scale, the attention and hyperactivity/impulsivity scores in SNAP-Ⅳ Scale, and the attention and hyperactivity/impulsivity scores in DSM-Ⅴ, were significantly reduced compared with the scores before the intervention (P<0.05). There was no significant difference in serum 25 (OH) D and DHA levels, or ADHD symptom scores, at the 3- and 12-month follow-ups compared to baseline. After 3 months of nutritional intervention in the intervention group, the hyperactivity/impulsivity scores in SNAP-Ⅳ Scale and DSM-Ⅴ were significantly improved compared to the control group (P<0.05). After 12 months of intervention, conduct problems, impulsive-hyperactivity and hyperactivity index scores in Conner′s Scale, and hyperactivity/ impulsivity scores in SNAP-Ⅳ Scale and DSM-Ⅴ showed significant improvement compared to the control group (P<0.05). Conclusion ·Combined supplementation with vitamin D and DHA significantly improves serum 25 (OH) D and DHA levels and alleviates ADHD symptoms in preschool children.

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Serum osteoglycin level in relation to renal function and blood pressure in non-diabetic patients with hypertension

ZHAI Wenhui, HUANG Qifang, CHEN Yilin, LI Xiaodong, WANG Jiguang

2025, 45 (5): 578-584.
doi: 10.3969/j.issn.1674-8115.2025.05.006

Abstract ( 299 )

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Objective ·To investigate the association of serum osteoglycin (OGN) levels with renal function and blood pressure in non-diabetic patients with hypertension. Methods ·Hypertensive patients without a diagnosis of diabetes mellitus were recruited from the Hypertension Department of Ruijin Hospital, Shanghai Jiaotong University School of Medicine. A total of 36 renal dysfunction patients (renal dysfunction group) and 38 normal renal function patients (normal renal function group), matched for age, gender and clinic blood pressure, were included in this study. Serum OGN concentrations were measured by the enzyme-linked immunosorbent assay (ELISA). Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The serum OGN levels were compared between the renal dysfunction group and the normal renal function group. The correlations of serum OGN level with eGFR and blood pressure were analyzed. Results ·There was no significant statistical difference in serum OGN levels between the renal dysfunction group and the normal renal function group (P=0.708). Serum OGN levels were not significantly associated with eGFR (P=0.952). In the renal dysfunction group, mean arterial pressure, age and current smoking status were relevant factors of serum OGN levels (P<0.05). After adjustment for confounders, serum OGN levels were independently associated with clinic systolic and diastolic blood pressure, 24-hour ambulatory mean systolic and diastolic blood pressure in the renal dysfunction group (P<0.05), but not in the normal renal function group (P˃0.05). Conclusion ·In non-diabetic patients with hypertension, serum OGN levels are not significantly associated with eGFR. In patients with renal dysfunction, higher serum OGN levels are independently associated with higher clinic systolic blood pressure, clinic diastolic blood pressure, 24-hour ambulatory mean systolic and diastolic blood pressure.

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Preliminary study on the value of high-order functional magnetic resonance imaging in the evaluation of bone and soft tissue tumors

ZHANG Zhengjia, LI Xiaomin, ZHOU Xin, MA Hairong, AI Songtao

2025, 45 (5): 585-596.
doi: 10.3969/j.issn.1674-8115.2025.05.007

Abstract ( 360 )

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Objective ·To preliminarily investigate the value of high-order functional magnetic resonance imaging in the evaluation of benign and malignant bone and soft tissue tumors and the changes after chemotherapy. Methods ·Patients clinically diagnosed with bone and soft tissue tumors at the Department of Orthopaedics, Shanghai Ninth People 's Hospital, Shanghai Jiao Tong University School of Medicine, from October 2014 to December 2024 were enrolled. The patients were divided into a control group and an amide proton transfer-weighted imaging (APTw) group according to the imaging method. All patients underwent conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCE) before surgery. Patients in the APTw group received additional APTw imaging. Both groups were divided into non-malignant and malignant lesion subgroups according to pathological results. According to whether the patients received chemotherapy before enrollment, the patients with malignant lesions in the APTw group were further divided into malignant group without chemotherapy and malignant group with chemotherapy. Clinical and imaging data, including APT values, apparent diffusion coefficient (ADC), and time-intensity curves (TICs) from the largest tumor section, were collected and analyzed to assess the diagnostic performance of APTw, DWI, and DCE, and to evaluate changes after chemotherapy. Results ·Eighty-five patients were enrolled, including 51 males and 34 females, with ages ranging from 10 to 84 years, and a mean age of (43.05±17.62) years. There were 51 patients in the control group (16 with non-malignant lesions and 35 with malignant lesions) and 34 patients in the APTw group (5 with non-malignant lesions and 29 with malignant lesions; 23 malignant lesions without chemotherapy and 6 malignant lesions with chemotherapy). The clinical and imaging data showed that only the tumor margin of the control group and the maximum tumor diameter of the APTw group had statistically significant differences in their malignant and non-malignant lesion groups ( P<0.05). In the APTw group, there was a statistically significant difference in APT values between the malignant lesion group and the non-malignant lesion group ( P<0.001). Further analysis showed that the APT values in the malignant group without chemotherapy were significantly lower than that in the malignant group with chemotherapy ( P<0.001). However, there were no statistically significant differences in APT values between the malignant group with chemotherapy and the non-malignant lesion group ( P>0.05). There were no significant differences in ADC values and TIC types between malignant and non-malignant lesion groups in the control group and the APTw group ( P>0.05). The area under the curve (AUC) of the diagnostic model in the APTw group (MRI+DWI+DCE+APTw) for distinguishing malignant from benign tumors was significantly higher than that of the control group (MRI+DWI+DCE) ( P<0.05). The Youden index and specificity of the diagnostic model in the APTw group were higher than those in the control group. Conclusion ·As a high-order functional MRI technique, APTw imaging is capable of evaluating the nature (benign or malignant) of bone and soft tissue tumors and detecting changes after chemotherapy. It serves as a valuable supplement to conventional MRI, DWI, and DCE imaging, providing a novel noninvasive tool for the diagnosis and treatment evaluation of bone and soft tissue tumors.

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Cone-beam CT measurement of root canal diameter and taper for mandibular first molar

LI Wenmiao, XING Li, PAN Yingyu, HUANG Ying, YANG Guofang, LIU Deda

2025, 45 (5): 597-604.
doi: 10.3969/j.issn.1674-8115.2025.05.008

Abstract ( 342 )

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Objective ·To analyze the root canal diameter and taper of mandibular first molars using cone-beam CT (CBCT), investigate age-related changes in these parameters, and propose optimized clinical protocols for root canal preparation. Methods ·From October 2022 to October 2023, CBCT images of 240 healthy mandibular first molars (120 three-canal type cases and 120 four-canal type cases) were collected from patients aged 20‒59 years at the Stomatology Center, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine. The three-canal type and the four-canal type samples were respectively divided into four age groups (20‒29, 30‒39, 40‒49, and 50‒59 years), with 30 cases in each group. Root canal length was measured, and buccolingual and mesiodistal diameters were recorded at four levels (coronal, middle, apical, and foramen). The tapers of the coronal 1/3, middle 1/3, and apical 1/3 segments were calculated in both buccolingual and mesiodistal directions. Differences among the age groups were compared. Results ·The buccolingual diameters of all root canals exceeded the corresponding mesiodistal diameters. At several levels of most root canals, the diameters in the <50-year-old groups were significantly larger than those in the 50‒59-year-old group (P<0.05). The buccolingual tapers exceeded the corresponding mesiodistal tapers in all root canals of mandibular first molars. The mean mesiodistal tapers in different age groups ranged from 0.07 to 0.34 in the coronal 1/3 segment, 0.03 to 0.09 in the middle 1/3 segment, and 0.05 to 0.11 in the apical 1/3 segment. At several levels of most root canals, the tapers in the <50-year-old groups were significantly larger than those in the 50‒59-year-old group (P<0.05). Conclusion ·Mandibular first molars exhibit age-related narrowing of root canal diameter and reduced taper in individuals aged ≥50 years. For initial apical file selection, #15 files are recommended for the distal canals in the three-canal type, while #10 files are advised for all other canals in the three-canal type and all canals in the four-canal type. For patients aged 50 years or older, the files for the distal canals in the three-canal type can be adjusted to #10, and the files for the mesiobuccal and distallingual canals in the four-canal type to #8. Regarding preparation taper, a 0.08-taper orifice opener is recommended for the coronal 1/3 segment. During mid-lower segment preparation, 0.04-taper master apical files are suggested for the mesiobuccal and mesiolingual canals in the three-canal type and the mesiolingual and distallingual canals in the four-canal type, 0.06-taper files for the distal canals in the three-canal type and the mesiobuccal canals in the four-canal type, and 0.08-taper files for the distobuccal canals in the four-canal type. Root canal obturation is recommended to be performed using vertical compaction with large-taper gutta-percha cones combined with bioceramic sealer.

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Causal association between plasma phosphatidylethanolamine and risk of colorectal adenocarcinoma: a two-sample Mendelian randomization study

XU Ling, HUANGFU Yuchan, SHEN Lisong, MA Yanhui

2025, 45 (5): 605-613.
doi: 10.3969/j.issn.1674-8115.2025.05.009

Abstract ( 314 )

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Objective ·To employ the two-sample Mendelian randomization (TSMR) method, using genetic variants as instrumental variables, to investigate the causal relationship between phosphatidylethanolamine (PE) and the risk of colorectal adenocarcinoma. Methods ·The single-nucleotide polymorphism (SNP) data associated with PE and colorectal adenocarcinoma were obtained from the Medical Research Council Integrative Epidemiology Unit (MRC IEU) at the University of Bristol and the Finnish Biobank, respectively. A secondary data analysis was conducted using summary statistics from genome-wide association studies (GWAS), and genetic loci strongly associated with PE were selected as instrumental variables. Four Mendelian randomization (MR) methods, inverse-variance weighted (IVW) method, MR-Egger regression, weighted median (WME) method, and weighted mode (WM) method, were employed to assess the causal effect. The IVW method was used as the primary statistical approach, while MR-Egger, WME, and WM served as supplementary methods. Rigorous assessments for robustness included MR-Egger regression, MR-PRESSO global tests for horizontal pleiotropy, and Cochran′s Q test to evaluate heterogeneity. Results ·Ten instrumental variables were selected, and the Steiger test indicated that all PE-associated SNPs exhibited a consistent direction of causal effect on colorectal cancer. Among the 10 SNPs, rs102275 and rs9393903 showed the strongest positive associations with colorectal adenocarcinoma risk, with effect sizes of 0.45 (P=8.01×10^-5) and 0.82 (P=2.31×10^-2), respectively. Consistent findings from MR analyses demonstrated that PE elevated the risk of colorectal adenocarcinoma across all four methods. In the IVW analysis, the OR was 1.36 (95%CI 1.17‒1.59, P=7.24×10^-5). In the MR-Egger regression, the OR was 1.44 (95%CI 0.97‒2.14, P=1.12×10^-1). In the WEM analysis, the OR was 1.33 (95%CI 1.07‒1.65, P=8.81×10^-3). In the WM analysis, the OR was 1.41 (95%CI 1.12‒1.77, P=1.70×10^-2). Cochran′s Q test revealed no heterogeneity among the effect estimates of the 10 SNPs on colorectal adenocarcinoma. Both MR-Egger regression intercept and MR-PRESSO test indicated no evidence of horizontal pleiotropy among the SNPs. Leave-one-out analysis showed overlapping confidence intervals after excluding any single SNP, indicating that the results were not sensitive to individual SNPs and were highly robust. Conclusions ·There is a causal association between circulating PE levels and the risk of colorectal adenocarcinoma. A genetically predicted increase of one standard deviation in plasma PE levels is associated with a 1.36-fold higher risk of developing colorectal adenocarcinoma (95%CI 1.17‒1.59, P=7.24×10^-5).

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Efficacy of hydrodynamic debridement in the treatment of burns: a systematic review of randomized controlled trials

ZHAO Jianlei, ZHAO Jingqi, LIU Chang, HUANG Jingjun, JIN Shengyuan

2025, 45 (5): 614-623.
doi: 10.3969/j.issn.1674-8115.2025.05.010

Abstract ( 307 )

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Objective ·To compare the effectiveness of hydrodynamic debridement versus conventional debridement in the treatment of burn wounds through a systematic review, focusing on differences in time to complete healing after graft, time to debride a 1% total body surface area (TBSA) wound, hospitalization duration, skin graft survival rate at 7 d post-surgery, secondary debridement rate, and positive rate of bacterial culture of wound exudate at 3 d post-surgery, aiming to select a more effective debridement method for burn wounds requiring debridement. Methods ·A systematic literature search was conducted in PubMed, Embase, Web of Science, Cochrane Library, CNKI, SinoMed, China Science and Technology Journal Database,and Wanfang Database, for studies comparing hydrodynamic debridement and conventional debridement in the treatment of burns. The search included articles published in Chinese and English, and the search period was from the inception of the databases to October 1, 2024. The study type was randomized controlled trials (RCTs). After literature search and screening, the included studies was evaluated for quality, and relevant data were extracted. Qualitative variables were presented as relative risk (RR), and quantitative variables as mean difference (MD). Forest plots were created by using RevMan 5.4 software with fixed- or random- effects models. Funnel plots were generated and Egger's test was performed by using Stata 14.0 software. Results ·Fifteen high-quality RCTs were included in this study, involving 1 261 patients with burn injuries requiring debridement. The analysis results showed that compared to the conventional debridement group, the hydrodynamic debridement group had significantly shorter time to complete healing after graft (MD=-3.29,95%CI -3.88‒-2.70, P<0.001), shorter time required to debride a 1% TBSA wound (MD=-0.63, 95%CI -0.76‒-0.50, P<0.001), and reduced hospitalization duration (MD=-4.22, 95%CI -6.17‒-2.28, P<0.001). The skin graft survival rate at 7 d post-surgery in the hydrodynamic debridement group (MD=8.62, 95%CI 7.21‒10.04, P<0.001) was significantly higher, while the secondary debridement rate (RR=0.21, 95%CI 0.12‒0.37, P<0.001) and the positive rate of bacterial culture of wound exudate at 3 d post-surgery (RR=0.30, 95%CI 0.17‒0.53, P<0.001) were significantly lower compared with the conventional debridement group. There was no statistically significant difference in the postoperative infections rates between the two groups (RR=1.06, 95%CI 0.66‒1.69, P=0.820). Conclusion ·In the treatment of burn wounds, hydrodynamic debridement outperforms traditional debridement. In the management of burn wounds, hydrodynamic debridement outperforms conventional debridement by shortening debridement and hospitalization durations, reducing the need for secondary debridement, decreasing early bacterial colonization, and improving skin graft survival. In terms of postoperative infection risk, no significant difference was observed between the two methods, indicating comparable safety profiles.

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Effects of 2 different flap techniques on clinical outcomes after epulis excision

SUN Wentao, DONG Jiachen, SUN Mengjun, LIAO Yue, SONG Zhongchen

2025, 45 (5): 624-629.
doi: 10.3969/j.issn.1674-8115.2025.05.011

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Objective ·To evaluate the effects of normally positioned flap (NPF) and coronally advanced flap (CAF) techniques on clinical results after epulis excision. Methods ·A total of 55 patients with epulis who visited the Department of Periodontology, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine from August 2022 to December 2023 were included. The patients were divided into the NPF group and the CAF group. After epulis excision, the surgical area was closed using NPF or CAF technique. The following parameters were recorded: baseline epulis width (EW) and epulis height (EH); papilla width (PW) and papilla height (PH) at 6 months post-surgery; probing depth (PD), attachment loss (AL), and keratinized gingiva width (KGW) at both baseline and 6 months post-surgery. The esthetic outcomes were evaluated using a visual analog scale (VAS) by 2 periodontal specialists. t test was used to compare the differences in periodontal indices between baseline and 6 months post-surgery, as well as between the 2 flap techniques. Results ·At 6 months post-surgery, PD of the CAF group was (1.68±0.79) mm, significantly lower than at baseline (P<0.001), but not significantly different from that in the NPF group (P=0.365); the AL in the CAF group was (1.26±1.18) mm, not significantly different from baseline (P=0.746), but significantly lower than in the NPF group (P<0.001). At 6 months post-surgery, PH of the CAF group was (3.74±0.62) mm, significantly higher than that in the NPF group (P<0.001), and the VAS score of the CAF group was significantly higher than that of the NPF group (P<0.001). Conclusion ·Compared with NPF, CAF could effectively improve post-surgical KGW and reduce AL, which could prevent periodontal soft tissue defects, and improve esthetic outcome after epulis excision.

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Research progress on the role and mechanisms of microglia in inflammatory diseases of central nervous system

YU Kai, SHUAI Zhewei, HUANG Hongjun, LUO Yan

2025, 45 (5): 630-638.
doi: 10.3969/j.issn.1674-8115.2025.05.012

Abstract ( 690 )

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Microglia are the resident immune cells in the central nervous system (CNS), and play a dual role in maintaining brain homeostasis and mediating neuroprotection. Under normal conditions, microglia maintain brain homeostasis by monitoring environmental changes. When nerve damage or certain pathological stimuli occur, microglia are rapidly activated and initiate a series of complex immune responses to induce neuroinflammation. This proper activation of microglia can protect the brain by inhibiting or clearing various pathogens, but excessive neuroinflammation can lead to neuronal damage ^{and even death. This imbalance of inflammatory response is one of the core features of pathological development of many CNS inflammatory diseases, such as Alzheimer′s disease, Parkinson′s disease, sepsis-associated encephalopathy, and ischemic strokes. In recent years, with the rapid development of frontier biotechnology such as single-cell sequencing, proteinomics and gene editing, important progress has been made in understanding the molecular mechanism by which microglia participate in CNS inflammatory diseases, especially in the activation of inflammatory corpuscles, epigenetic modifications, and metabolic reprogramming. However, due to the heterogeneity and duality of microglia under different pathological conditions, therapeutic methods targeting microglia have not yet been widely used in clinical practice. In summary, this article takes microglia as the starting point and introduces the molecular mechanisms of their involvement in the occurrence and development of CNS inflammatory diseases and its targeted regulatory treatment strategy, aiming to provide theoretical reference for the subsequent precise regulation of microglia function and the development of more targeted therapeutic drugs.}

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Progress in retinal features and underlying mechanisms in schizophrenia

XING Yuxi, CHENG Ying, CHEN Jianhua

2025, 45 (5): 639-645.
doi: 10.3969/j.issn.1674-8115.2025.05.013

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The diagnosis of schizophrenia usually relies on the assessment of clinical symptoms, and the search for objective biomarkers is particularly important for the diagnosis and treatment of the disease. Since the retina can reflect the state of the central nervous system, more and more studies are focusing on retina-specific alterations in neuropsychiatric disorders. This review summarizes recent studies on the retinal nerve layer, vascular characteristics, and electrophysiological features in patients with schizophrenia, showing that patients with schizophrenia often have thinner retinal ganglion cell-inner plexiform layer and retinal nerve fiber layer. The changes in the retinal layers vary in different stages of schizophrenia. Studies of the fundus vasculature in schizophrenic patients have also suggested the presence of altered retinal vascular density and microvascular morphology in schizophrenic patients. Studies of electroretinography suggest that patients in the acute phase of schizophrenia tend to exhibit reduced a-wave amplitudes of cone cells, while those at genetic high risk often show a tendency for reduced b-wave amplitudes of rod cells. However, the current retina-related studies in schizophrenia mostly focus on clinical manifestations, with fewer studies on related mechanisms and inconsistent findings. This review attempts to discuss a variety of potential pathophysiological mechanisms, including trans-synaptic retrograde degeneration hypothesis, neurotransmitter disturbance, genetics, brain structural changes, and metabolism, in the context of the retinal nerve layer, microcirculation, and electrophysiology alterations, in order to provide new insights into the pathophysiological mechanisms and objective biomarkers of schizophrenia.

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Current research status of imaging markers for cognitive impairment in Parkinson′s disease

CAO Mingming, WANG Hui, YIN Yafu

2025, 45 (5): 646-652.
doi: 10.3969/j.issn.1674-8115.2025.05.014

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Parkinson′s disease (PD), the second most prevalent neurodegenerative disease, has shown an increasing incidence in recent years, significantly impacting the quality of life of elderly individuals and their families. The onset of cognitive impairment and Parkinson′s disease dementia (PDD) are critical milestones in the progression of PD. Imaging examinations, serving as essential detection and evaluation tools for neurodegenerative diseases, have been increasingly applied to PD-related research. Different imaging techniques demonstrate distinct advantages and features in screening cognitive dysfunction in PD. Choosing a reliable imaging method not only maximizes the advantages of the examination, enhancing the sensitivity and specificity in identifying PD patients at risk of cognitive impairment, but also reduces the frequency of examinations and the radiation dose received by patients. This review summarizes the existing findings on imaging markers of cognitive impairment in PD from three aspects, structural imaging, functional imaging, and multimodal techniques. Furthermore, it explores future research directions, aiming to provide powerful imaging support for the clinical diagnosis and treatment of PD.

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Features of oral peripheral T-cell lymphoma, not otherwise specified

HUANG Runyu, ZHANG Chunye, ZHANG Ying, ZHAO Zhengyan, YANG Yang, WU Lan

2025, 45 (5): 653-660.
doi: 10.3969/j.issn.1674-8115.2025.05.015

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Objective ·To investigate the clinical manifestations and immunophenotypic features of peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), involving the oral cavity. Methods ·The medical histories and pathology records of patients diagnosed with oral PTCL-NOS in the Department of Oral Mucosal Diseases of Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine, between August 2020 and August 2024 were retrospectively analyzed. In addition, 5 databases, including PubMed, Web of Science, Embase, Scopus, and CNKI, were searched, and relevant cases reported internationally from January 2014 to September 2024 were reviewed. Results ·A total of 20 oral PTCL-NOS cases were included, comprising 11 males (55.0%) and 9 females (45.0%). The patients′ ages at initial diagnosis ranged from 25 to 77 years, with a mean age of (52.53±12.94) years. The most common sites were the tongue (25.0%), palate (25.0%), and buccal mucosa (20.0%). Nineteen cases (95.0%) had no B symptoms. The cases were positive for CD3 (19/19), CD4 (11/13), CD8 (7/12), CD2 (5/6), CD7 (5/5), TIA-1 (6/7), GB (9/13), perforin (4/6). EBER expression was negative (8/8). The Ki-67 proliferation index was ≥60% in 85% of cases. Conclusions ·Oral PTCL-NOS is extremely rare and has an aggressive clinical behavior. The oral manifestation presents as deep and large mucosal ulcers with uneven bases, and nodules can be palpable. The pathological features are heterogeneous. Immunophenotype detection is useful for early diagnosis and classification. It is essential for stomatologists to enhance their awareness of this malignancy to avoid delayed diagnosis and treatment.

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