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    Molecular mechanisms of miRNA expression dysregulation in SHH-activated subtype medulloblastoma
    Zhu Ying, Sui Yi, Tang Yujie
    2026, 46 (1):  1-14. 
    doi: 10.3969/j.issn.1674-8115.2026.01.001

    Abstract ( 19 )   HTML ( 2 )   PDF (8907KB) ( 90 )  

    Objective ·To investigate the role of miRNA expression dysregulation in sonic hedgehog-activated subtype medulloblastoma (SHH-MB), and to compare the dysregulated miRNA features between subcutaneous xenograft models in nude mice and patients with solid tumors. Methods ·Mouse SHH-MB cell lines (SmoWT and SMB56) were used to establish subcutaneous xenograft models in nude mice. For each model, mice were randomly divided into groups treated with the smoothened inhibitor (SMOi) GDC-0449 (SmoWT experimental group and SMB56 experimental group) or dimethyl sulfoxide (DMSO) (SmoWT control group and SMB56 control group), and tumor samples from these 4 groups were collected. Cerebellar tissues from normal P7 (postnatal day 7) and P60 nude mice were collected as controls (P7 normal cerebellum group and P60 normal cerebellum group). Following the same procedure, cerebellar tissues were also collected from P7 normal nude mice treated with GDC-0449 (P7 cerebellum treatment group) or DMSO (P7 cerebellum control group). mRNA sequencing (mRNA-seq) and microRNA sequencing (miRNA-seq) were performed on these eight sample groups to obtain mRNA and miRNA expression profiles. Subsequently, differential expression analysis was systematically employed to elucidate: ① the core transcriptomic features of tumors in mouse SHH-MB models; ② transcriptomic features associated with normal cerebellar development; ③ Hedgehog (Hh)-dependent and Hh-independent transcriptomic features in both tumors and developing cerebellum. Target genes of key differentially expressed miRNAs were predicted by integrating data from the miRDB, TargetScan, and miRTarBase databases, combined with mRNA differential expression results. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was then performed to identify core signaling pathways involving these target genes. Specifically, for the Hh-dependent miRNA miR-204-5p identified in the P7 developing cerebellum, target genes were predicted and subjected to KEGG pathway enrichment analysis. Finally, mRNA and miRNA expression profiles from SHH-MB patient tumors and healthy control cerebella were obtained from the R2 and Gene Expression Omnibus (GEO). Conservation of differentially expressed miRNAs/mRNAs and their regulatory relationships between humans and mice was then systematically assessed through differential expression and Venn analysis. Results ·Analysis of mRNA expression profile correlations revealed a high correlation between the SmoWT control and SMB56 control groups. Both tumor control groups showed higher correlation with the P7 normal cerebellum group than with the P60 normal cerebellum group. Treatment with GDC-0449 did not significantly alter the overall transcriptomic profiles of either control group. The miRNA expression profile correlation results were consistent with those observed in the mRNA profiles. Differential expression analysis comparing the SmoWT control and SMB56 control groups with the P7 and P60 normal cerebellum groups identified 95 commonly upregulated and 126 commonly downregulated miRNAs in the two control groups. Among these, 50 upregulated and 38 downregulated miRNAs showed the same expression trends in the P7 and P60 normal cerebellum comparison. Differential expression analysis between the SmoWT experimental and control groups and between the SMB56 experimental and control groups identified Hh-dependent and Hh-independent differentially expressed miRNAs in each model. Venn diagram showed that the Hh-dependent miRNAs (accounting for 10%-20% of all differentially expressed miRNAs) showed minimal overlap between mouse SHH-MB models, whereas Hh-independent miRNAs were highly conserved across models. KEGG pathway enrichment analysis of the target genes of Hh-dependent differentially expressed miRNAs showed significant enrichment in the phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) pathway, phospholipase D (PLD) pathway, RAS/mitogen-activated protein kinase (RAS/MAPK) pathway, and DNA replication pathways. Comparison between the P7 cerebellum treatment group and the P7 cerebellum control group identified 7 miRNAs and 285 mRNAs whose expression was promoted by the Hh pathway, and 1 miRNA and 72 mRNAs whose expression was inhibited by the Hh pathway in the P7 cerebellum. The target genes of miR-204-5p were enriched in the cell cycle pathway. Differential expression analysis of SHH-MB patient tumors vs healthy cerebellar controls identified 22 conserved human‑mouse miRNAs, with their target genes enriched in the cyclic adenosine monophosphate (cAMP) signaling pathway and the cell cycle pathway. Conclusion ·Mouse SHH-MB models exhibit extensive miRNA expression dysregulation. However, SMOi treatment reverses only a small subset of these dysregulated miRNAs, indicating a limited effect of the Hh pathway on miRNA dysregulation. Only Hh-independent dysregulated miRNAs show partial overlap between mouse SHH-MB models. Furthermore, there are conserved dysregulated miRNA features between mouse SHH-MB models and patients with solid tumors.

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    Basic research
    Centromere proteomic analysis of Down syndrome-derived amniocytes
    Zhou Peng, Liu Yanna, Yan Jingbin
    2026, 46 (1):  15-24. 
    doi: 10.3969/j.issn.1674-8115.2026.01.002

    Abstract ( 14 )   HTML ( 3 )   PDF (4207KB) ( 108 )  

    Objective ·To explore differentially expressed proteins in the centromere proteome of amniocytes from fetuses with Down syndrome (DS). Methods ·Amniocytes from DS and normal fetuses were used as models. A lentiviral vector encoding the centromere protein A-enhanced green fluorescent protein-ascorbate peroxidase 2 (CENPA-EGFP-APEX2) fusion protein was constructed and transfected into amniocytes to target and label centromere-proximal proteins. The expression and location of the target protein were determined by immunofluorescence co-localization, and protein labeling was verified by biotinylation treatment and Western blotting. Quantitative proteomics analysis using 4D label-free technology was used on three DS samples and three normal samples. Functional annotation of the labeled proteins was performed using the Gene Ontology (GO), Clusters of Orthologous Groups/Eukaryotic Orthologous Groups (COG/KOG), and Kyoto Encyclopedia of Genes and Genomes (KEGG) databases. Differentially expressed proteins (DEPs) between DS and normal amniocytes were screened with thresholds of P<0.05 and |log₂FC|>0.585, and a protein-protein interaction (PPI) network was constructed using the STRING database to identify core hub proteins. Results ·A centromere-proximal protein labeling model using DS amniocytes was successfully established, and immunofluorescence co-localization and Western blotting confirmed that CENPA-EGFP-APEX2 was precisely anchored at the centromere and labeled proximal proteins. Proteomic analysis identified 999 high-confidence proteins, and bioinformatics analysis showed that these proteins were enriched in redox-related and cancer-related pathways. Differential expression analysis revealed significant upregulation of MX dynamin-like GTPase 1 (MX1) and signal transducer and activator of transcription 1 (STAT1), as well as downregulation of actin β (ACTB). The PPI network further identified small ubiquitin-like modifier 2 (SUMO2), heterogeneous nuclear ribonucleoprotein A/B (HNRNPAB), and mitogen-activated protein kinase (MAPK) as key hub proteins. Conclusion ·There are various differentially expressed proteins in the centromere proteome of DS fetal amniocytes, with abnormal activation of MX1 and STAT1, downregulation of ACTB, and interactions among these differential proteins centered on SUMO2, MAPK, and HNRNPAB.

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    Procoagulant platelets regulate H1N1-induced thrombosis formation
    Yin Xuying, Wang Xuanjia, Yang Mina, Jiang Haojie, Dai Jing, Sun Xiaoyu, Xu Yanyan
    2026, 46 (1):  25-33. 
    doi: 10.3969/j.issn.1674-8115.2026.01.003

    Abstract ( 16 )   HTML ( 5 )   PDF (15906KB) ( 105 )  

    Objective ·To investigate the role of procoagulant platelets in thrombosis induced by H1N1 influenza virus infection in mice. Methods ·A viral infection model was established in mice by intranasal instillation of the H1N1 influenza virus. Body weight was continuously monitored post-infection, and whole blood was collected from the retro-orbital venous plexus to measure platelet counts. Plasma samples were prepared from abdominal aortic blood. Thrombin time (TT), fibrinogen, D-dimer, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels were measured by using enzyme-linked immunosorbent assay (ELISA). Lung and liver tissue sections from infected mice were prepared, and hematoxylin-eosin (HE) staining was employed to observe thrombus formation in lung and liver tissues of mice. Tyramide signal amplification (TSA)-based multiplex immunohistochemistry was performed on lung and liver tissues to analyze thrombus composition. Flow cytometry was used to monitor the monocyte-platelet aggregates and the proportion of procoagulant platelets in mice after viral infection. A platelet depletion model was established by tail vein injection of anti-mouse GP1b (R300). Body weight and platelet counts were continuously monitored in infected mice. Plasma TT, fibrinogen, and D-dimer levels were measured to evaluate coagulation function in mice. Results ·Following H1N1 infection, mice exhibited progressive weight loss and abnormal coagulation parameters, including prolonged TT, decreased fibrinogen levels, and elevated D-dimer levels (all P<0.05).Plasma levels of IL-6 and TNF-α were also elevated. HE staining revealed prominent thrombus formation in the pulmonary and hepatic vasculature of infected mice (all P<0.05). Flow cytometry demonstrated a significant increase in the proportion of procoagulant platelets after infection. The proportion of procoagulant platelets showed a positive correlation with viral dose, and was associated with D-dimer levels, fibrinogen levels, and thrombus area (all P<0.05). TSA staining further confirmed that the thrombi primarily consisted of fibrin and procoagulant platelets. Depletion of platelets in mice prior to H1N1 infection markedly reduced thrombosis in lung and liver tissues and alleviated coagulation abnormalities (all P<0.05). Conclusion ·H1N1 virus infection may significantly elevate the proportion of procoagulant platelets in mice, leading to coagulation dysfunction and subsequent thrombosis in multiple tissues.

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    Mass cytometry reveals prognostic immune microenvironment features in breast cancer
    Zhang Yue, Chen Qingjian
    2026, 46 (1):  34-42. 
    doi: 10.3969/j.issn.1674-8115.2026.01.004

    Abstract ( 21 )   HTML ( 2 )   PDF (15775KB) ( 100 )  

    Objective ·To analyze the expression of multiple antigens in tumor tissues from breast cancer patients using cytometry by time-of-flight (CyTOF), with the aim of investigating their associations with the tumor microenvironment and patient prognosis. Methods ·A panel of optimally combined metal-labeled antibodies (or probes) was designed by employing Maxpar® Panel Designer v2.0.1 software in conjunction with relevant antigenic proteins and histiocytic markers. Antibodies targeting panel proteins were conjugated with lanthanide (Ln) metal isotopes using the Maxpar X8 Antibody Labeling Kit. Breast cancer tissue microarrays were then stained using imaging mass cytometry staining (IMC). Protein expression profiles and spatial distributions were acquired using the Hyperion Imaging System. Raw data were processed using R, including data normalization, noise reduction/removal, signal compensation, transformation, and dimensionality reduction. Cellular subpopulations were annotated via clustering algorithms, while spatial neighborhood analysis was performed to map the spatial organization of diverse cell types within the breast cancer microenvironment and assess their clinical relevance. Results ·Successful metal-antibody conjugation resulted in high-quality staining suitable for IMC analysis. Analysis of breast cancer tissue microarrays using 26 markers identified nine distinct cell populations (410 000 cells) within the tumor microenvironment. Paired comparisons of tumor and adjacent tissues revealed that the microenvironment predominantly consisted of B cells, CD4+ T cells, CD8+ T cells, epithelial cells, endothelial cells, macrophages, myoepithelial cells, neutrophils, and fibroblasts. Quantitative analysis showed statistically significant differences in the abundance of macrophages and CD4+ T cells between malignant and adjacent tissues (P<0.05). Spatial analysis identified 15 distinct cellular neighborhoods, and the colocalization of CD8+ T cells and macrophages with tumor cells was significantly associated with improved patient survival (P=0.011, P<0.001). Conclusion ·CyTOF is a powerful tool for high-throughput detection of multiple antigens in tissue samples, enabling detailed analysis of tumor-immune interactions in the breast cancer microenvironment. The presence and spatial organization of CD8+ T cells and macrophages within the breast cancer microenvironment are positively associated with favorable patient outcomes.

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    Hypericin alleviates podocyte injury in diabetic nephropathy by inhibiting the NF-κB signaling pathway
    Han Zhen, Wang Hao, Su Xiuxiu, Fang Ji
    2026, 46 (1):  43-53. 
    doi: 10.3969/j.issn.1674-8115.2026.01.005

    Abstract ( 18 )   HTML ( 0 )   PDF (33861KB) ( 101 )  

    Objective ·To investigate the protective effect of the natural compound hypericin (HYP) on podocyte injury in diabetic nephropathy (DN) and its underlying molecular mechanism. Methods ·A total of eighteen db/db mice were selected to establish the DN model and were randomly divided into three groups: the model group, the db/db + HYP low-dose group (db/db+HYP-L, 1.5 mg/kg), and the db/db+HYP high-dose group (db/db+HYP-H, 3 mg/kg). Additionally, six db/m mice were designated as the normal control group. The following parameters were measured in mice from each group: fasting blood glucose (FBG), insulin (INS), total cholesterol (TC), triglyceride (TAG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), serum creatinine (Scr), blood urea nitrogen (BUN), urinary albumin-to-creatinine ratio (UACR), as well as levels of inflammatory cytokines, including tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and monocyte chemoattractant protein-1 (MCP-1). Renal pathological changes and podocyte ultrastructure in mice from each group were examined by hematoxylin-eosin (HE) staining, periodic acid-Schiff (PAS) staining, and transmission electron microscopy. The expression of the podocyte marker Wilms tumor 1 (WT-1) in renal tissues from each group was assessed using immunohistochemistry and Western blotting. The protein expression level of nuclear factor-κB (NF-κB) was also measured by Western blotting. Human podocyte lines were cultured in vitro to establish a high-glucose-induced podocyte injury model. The experiment was divided into five groups: normal glucose (5.5 mmol/L glucose, NG), mannitol (5.5 mmol/L glucose+24.5 mmol/L mannitol, MA), high glucose (30.0 mmol/L glucose, HG), high glucose+0.05 μg/mL HYP, and high glucose+0.20 μg/mL HYP. Cells were harvested after 48 h of incubation. The protein levels of WT-1, phospho-NF-κB p65 (p-NF-κB p65), and NF-κB p65 were determined by Western blotting. The mRNA expression levels of inflammatory cytokines (TNF-α, IL-1β, IL-6, and MCP-1) in human podocytes across all groups were measured by quantitative real-time PCR (qPCR). Results ·Compared with the model group, HYP administration significantly reduced the levels of FBG, INS, TC, TAG, LDL, Scr, BUN, and UACR in db/db mice, while significantly increasing the level of HDL (all P<0.05). Concomitantly, HYP alleviated podocyte injury in db/db mice, as evidenced by a marked reduction in foot process effacement and restoration of a comb-like alignment of the foot processes. Both in vivo and in vitro studies demonstrated that HYP upregulated the expression of WT-1 while concurrently suppressing the phosphorylation of NF-κB p65 and the subsequent release of NF-κB-mediated inflammatory cytokines (TNF-α, IL-1β, IL-6, and MCP-1) (all P<0.05). Conclusion ·HYP alleviates podocyte injury in db/db mice, an effect that may be attributed to the upregulation of WT-1 expression and inhibition of the NF-κB signaling pathway, leading to reduced expression of downstream inflammatory cytokines.

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    Clinical research
    High-dose vitamin D for pediatric short bowel syndrome with vitamin D insufficiency/deficiency
    Wu Qingqing, Cao Yi, Lu Lina, Tao Yijing, Feng Haixia, Yan Weihui, Wang Ying
    2026, 46 (1):  54-59. 
    doi: 10.3969/j.issn.1674-8115.2026.01.006

    Abstract ( 23 )   HTML ( 2 )   PDF (966KB) ( 32 )  

    Objective ·To explore the safety and efficacy of a single high-dose intramuscular injection of vitamin D in children with short bowel syndrome (SBS) complicated by vitamin D insufficiency/deficiency. Methods ·The retrospective study included 32 children with SBS complicated by vitamin D insufficiency/deficiency. When the serum 25-hydroxyvitamin D [25-(OH)D] concentration was lower than 50 nmol/L, a single intramuscular injection of 200 000 IU vitamin D2 was administered. Clinical data, including gender, age, primary disease, remaining length of the small intestine, presence of the ileocecal valve, and colonic integrity, were collected. Skin conditions at the intramuscular injection site and the levels of serum 25-(OH)D, calcium, phosphorus, and alkaline phosphatase before and one month after vitamin D supplementation were recorded. Results ·The median age at enrollment was 5.0 (3.0, 7.0) months. Intestinal atresia and necrotizing enterocolitis were the main causes of SBS, accounting for 28.13% and 21.88%, respectively. The average length of the remaining small intestine was (57.27±24.55) cm. Before vitamin D supplementation, 65.63% (21/32) of children had vitamin D deficiency and 34.38% (11/32) had vitamin D insufficiency. After supplementation, serum 25-(OH)D levels increased significantly compared with baseline (53.10 nmol/L vs. 28.87 nmol/L, P<0.001). In children with vitamin D insufficiency, the serum 25-(OH)D levels increased from 37.30 nmol/L to 58.51 nmol/L (P=0.010), while in those with vitamin D deficiency, the levels increased from 26.91 nmol/L to 44.82 nmol/L (P<0.001). Overall, 62.50% (20/32) of children achieved normal serum 25-(OH)D levels. Moreover, no complications, including vitamin D toxicity, hypercalcemia, skin induration, or local infection, were observed in any of the children. Conclusion ·A single high-dose (200 000 IU) intramuscular injection of vitamin D can safely and effectively improve the vitamin D level in children with SBS complicated by vitamin D insufficiency/deficiency.

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    Analysis of clinical characteristics and pregnancy outcomes of pregnancy-related acute kidney injury among high-risk pregnancy populations
    Ying Yiwen, Li Shu, Zhang Zhen, Yu Jingran, Zhang Ning, Mou Shan
    2026, 46 (1):  60-65. 
    doi: 10.3969/j.issn.1674-8115.2026.01.007

    Abstract ( 15 )   HTML ( 4 )   PDF (1115KB) ( 21 )  

    Objective ·To investigate the incidence and clinical features of pregnancy-related acute kidney injury (Pr-AKI) in high-risk populations and its correlation with adverse pregnancy outcomes. Methods ·This retrospective single-center cohort study included 17 468 singleton pregnancies delivered at Renji Hospital, Shanghai Jiao Tong University School of Medicine between January 2018 and December 2023. General demographic characteristics, comorbidities, pregnancy complications, serum creatinine levels, and pregnancy outcomes were collected. Pr-AKI was diagnosed according to Kidney Disease: Improving Global Outcomes criteria. Adverse pregnancy outcomes, including stillbirth, early preterm birth (gestational age < 34 weeks at delivery), and low birth weight (birth weight<2 500 g), were defined as the primary observation endpoints. Univariate and multivariate Logistic regression analyses were used to assess the impact of Pr-AKI on adverse pregnancy outcomes. Results ·The incidence of Pr-AKI was 0.3% (61/17 468). Compared with the non-AKI group, patients in the AKI group had higher rates of chronic hypertension, chronic kidney disease, and autoimmune diseases (P<0.05). Additionally, the risks of stillbirth, early preterm birth, low birth weight, and preeclampsia of the patients in the AKI group were increased (P<0.001). Multivariate Logistic regression analysis confirmed Pr-AKI as an independent risk factor for adverse pregnancy outcomes (adjusted OR=5.868, 95% CI 3.142—10.957, P<0.001). Conclusion ·Pr-AKI significantly contributes to adverse pregnancy outcomes in high-risk pregnant populations, underscoring the need for early monitoring and intervention.

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    Clinical characteristics and surgical outcome analysis of quadrigeminal cistern arachnoid cysts in children: a quantitative retrospective cohort study
    Liu Meiling, Bao Lei, Min Lingzhao, Wei Jia, Hua Li, Wang Xiaoqiang
    2026, 46 (1):  66-74. 
    doi: 10.3969/j.issn.1674-8115.2026.01.008

    Abstract ( 13 )   HTML ( 3 )   PDF (1329KB) ( 23 )  

    Objective ·To quantify the volume of quadrigeminal cistern arachnoid cysts (QACs) and hydrocephalus indicators, and analyze the clinical features of QACs in children and the efficacy of different surgical techniques, with the goal of improving understanding, diagnosis, and treatment of this condition. Methods ·A retrospective analysis was conducted on 27 pediatric patients with QACs treated at Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, between January 2015 and June 2025. The volume of QACs and the Evans index were calculated by using cranial magnetic resonance imaging (MRI) and computed tomography (CT). Clinical data, including demographics, symptoms/signs, imaging findings, surgical procedures, and follow-up outcomes, were reviewed. Results ·The cohort (age range: 0 d‒150 months; male-to-female ratio: 1.08∶1) had a median preoperative QAC volume of 34 402 (15 022, 138 478) mm³ and a median Evans index of 0.29 (0.24, 0.48). Among the cases, twelve were asymptomatic and were predominantly infants under 6 months of age, whereas fifteen symptomatic cases—presenting with intracranial hypertension, seizures, limb weakness, or frequent blinking—were mostly older than 6 months. A total of 33 surgeries were performed (one surgery: 22 cases; two surgeries: 4 cases; three surgeries: 1 case). Reoperation rates were 15.8% for endoscopic fenestration (EF), 40.0% for EF combined with endoscopic third ventriculostomy (ETV), and 0 for ventriculoperitoneal shunt (VP). The overall reoperation rate was 18.5%, with infants under 6 months having a higher probability of requiring repeat surgeries. During follow-up, 88.9% of patients showed significant QAC volume reduction at 3 months postoperatively, and 92.3% exhibited clinical improvement. No efficacy differences were found among EF, EF+ETV, and VP procedures to date. Patients with larger preoperative QACs (≥50 000 mm³) showed more pronounced reductions in QAC volume and Evans index at 12 and 24 months postoperatively. Conclusion ·QACs exhibit no gender predilection and may present with limb weakness or frequent blinking as initial symptoms. Age and symptoms may be correlated. Surgical outcomes are favorable, with low reoperation rates, significant short-term volume reduction, and symptom resolution. No difference in efficacy is observed among EF, EF+ETV, and VP procedures. Larger QACs are associated with a better long-term prognosis.

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    Public health
    Mendelian randomization study of loneliness, subjective well-being, and frailty index
    Aikeremu Aierken, Chen Xingjuan, Niu Yueyue
    2026, 46 (1):  75-81. 
    doi: 10.3969/j.issn.1674-8115.2026.01.009

    Abstract ( 19 )   HTML ( 0 )   PDF (1394KB) ( 21 )  

    Objective ·To employ a two-sample Mendelian randomization (MR) design to examine whether the associations between loneliness, subjective well-being, and the frailty index reflect causal relationships. Methods ·Summary data from published genome-wide association studies (GWAS) were utilized, and an MR approach was employed to analyze the causal relationships between loneliness, subjective well-being, and the frailty index (as a surrogate measure of frailty). Data on loneliness were derived from a study comprising 445 024 individuals of European ancestry, including 80 134 cases and 364 890 controls. Data for subjective well-being were obtained from 298 420 participants of European ancestry. Summary statistics for frailty were sourced from a meta-analysis of GWAS conducted within the UK Biobank and the Swedish TwinGene cohort, which included 175 226 individuals of European ancestry. The inverse variance weighted (IVW) method served as the primary MR analytical approach to derive causal estimates, with the weighted median estimator (WME) used as a supplementary approach. Cochran′s Q test was applied to assess heterogeneity in the IVW estimates. The presence of horizontal pleiotropy was evaluated using the MR-Egger intercept test. When significant heterogeneity was detected, the MR-PRESSO global test was utilized to identify and subsequently remove outlier variants. MR analyses were then repeated. A Leave-One-Out sensitivity analysis was conducted to evaluate whether the overall estimates were unduly influenced by any single nucleotide polymorphism (SNP). To ensure data consistency and analytical reliability during effect allele harmonization between exposure and outcome datasets, palindromic SNPs (for which the effect allele direction could not be definitively determined) were excluded. Results ·The IVW method revealed a significant positive association between loneliness and the frailty index, with an OR of 3.87 (95% CI 2.33‒6.46, P<0.001). This result was further confirmed by the WME, yielding an OR of 2.81 (95% CI 1.49‒5.29, P<0.001). Subjective well-being showed a significant negative association with the frailty index (OR=0.80, 95% CI 0.69‒0.94, P=0.005). The WME demonstrated a consistent direction of effect, though with borderline significance (OR=0.86, 95% CI 0.74‒1.01, P=0.065). The analysis revealed no significant heterogeneity (Cochran′s Q test, P=0.054 and P=0.074) or horizontal pleiotropy (MR-Egger intercept test, P=0.470 and P=0.260). Conclusion ·This study, supported by the MR methodology, indicates that loneliness is associated with an increased risk of frailty, while subjective well-being serves as a protective factor against frailty.

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    Techniques and methods
    Construction of a rat model of temporomandibular joint osteoarthritis induced by monosodium iodoacetate
    Li Ziyu, Zhu Zeyu, Qian Jiakang, Chen Yulu, Lu Jiayu
    2026, 46 (1):  82-89. 
    doi: 10.3969/j.issn.1674-8115.2026.01.010

    Abstract ( 20 )   HTML ( 0 )   PDF (40226KB) ( 27 )  

    Objective ·To optimize the method of injecting monosodium iodoacetate (MIA) into the joint cavity, shorten the experimental duration, and evaluate the feasibility of constructing temporomandibular joint osteoarthritis (TMJOA) models in rats with different degrees of injury. Methods ·Eighteen male Sprague-Dawley rats were randomly divided into 6 groups. The control group was injected with 50 μL of normal saline into the bilateral articular cavities of each rat, and the other 5 groups were injected with MIA at concentrations of 0.5, 1.0, 1.5, 2.0 or 2.5 mg/50 μL. The groups were recorded as the NS group, and MIA 1~5 groups. After 7 days, the condyles of the temporomandibular joint (TMJ) were collected for observation and analysis. The surface morphology of the condyles was observed under a stereomicroscope. Micro-computed tomography (micro-CT) was used to scan and analyze the subchondral bone of the condyles [bone volume/total tissue volume (BV/TV), trabecular separation/spacing (Tb.Sp), and trabecular bone number (Tb.N)]. Hematoxylin-eosin (HE) and safranin O-fast green staining were used for histological observation of the condyle specimens, and the modified Mankin scores were used for evaluation. Results ·Compared with the control group, under a stereomicroscope, minor changes were observed on the condylar surface of the MIA1 and MIA2 groups at 7 days after modeling, while obvious and evenly distributed bone destruction was observed in the condyles of the MIA3, MIA4, and MIA5 groups. Micro-CT three-dimensional reconstruction showed obvious bone resorption in the condyles of the MIA3, MIA4 and MIA5 groups, and local destruction of the condylar surface in the MIA1 and MIA2 groups. Bone parameter analysis revealed a significant decrease in BV/TV (P=0.039, P=0.019) and a significant increase in Tb.Sp in the MIA4 and MIA5 groups (P=0.030, P=0.003); Tb.N was significantly reduced in the MIA5 group (P=0.004). HE and safranin O-fast green staining results showed that the fibrous layer in the MIA1 group was not smooth, and the proteoglycan content (red-stained area) did not change significantly. The structure of the MIA2 group was unclear, cell-free areas appeared, and proteoglycan began to decrease. The structure of the MIA3 group was disordered and the number of cells was significantly reduced. The cartilage layer in the MIA4 and MIA5 groups was almost invisible. The modified Mankin scores in the MIA3, MIA4 and MIA5 groups were higher than those in the control group (P=0.008, P<0.001, P<0.001). Conclusion ·When the modeling time is 1 week, 1.5 mg/50 μL is an intermediate dose that induces typical TMJOA manifestations in cartilage without significant destruction of subchondral bone, and can be used to construct an animal model with cartilage defects as the main lesion.A dose of 2.0 mg/50 μL MIA can be used to establish a rat TMJOA model with subchondral bone destruction as the main feature.

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    Review
    Mechanisms and therapeutic progress of Chinese materia medica in the prevention and treatment of renal fibrosis in diabetic nephropathy
    Zhang Xianjing, Chen Suzhen
    2026, 46 (1):  90-99. 
    doi: 10.3969/j.issn.1674-8115.2026.01.011

    Abstract ( 18 )   HTML ( 0 )   PDF (2088KB) ( 25 )  

    Diabetic nephropathy (DN), one of the most severe microvascular complications of diabetes, can progressively lead to irreversible end-stage renal disease (ESRD), posing a major global public health challenge. Renal fibrosis, a core pathological feature of DN progression, has become a key therapeutic target for intervention. Current clinical management strategies (including blood glucose/blood pressure control and the use of renin-angiotensin system inhibitors) can delay disease progression, but their effectiveness in blocking renal fibrosis, a critical pathological process, remains limited. Recent studies have shown that Chinese materia medica demonstrates unique therapeutic value in the prevention and treatment of DN. Through multi-component, multi-target, and multi-pathway synergistic mechanisms, Chinese materia medica has shown significant advantages in regulating glucose and lipid metabolism, inhibiting inflammatory responses, reducing oxidative stress, and attenuating renal fibrosis. Clinical research has confirmed that Chinese materia medica formulas and active ingredients not only effectively improve clinical symptoms and reduce proteinuria excretion but also exert clear renal protective effects and retard the progression of renal lesions. Based on these findings, the molecular mechanisms the molecular mechanisms by which Chinese materia medica regulates renal fibrosis in DN have become an important research direction for the development of novel anti-fibrosis drugs. This review systematically summarizes the mechanisms of action of Chinese materia medica and its active ingredients with clear anti-fibrosis effects, aiming to provide scientific evidence and translational insights for the development of innovative therapeutic strategies targeting renal fibrosis in DN.

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    Advances in music therapy for the treatment of agitation
    Yang Vivien, Chen Yiming, Hong Wu
    2026, 46 (1):  100-106. 
    doi: 10.3969/j.issn.1674-8115.2026.01.012

    Abstract ( 22 )   HTML ( 0 )   PDF (898KB) ( 18 )  

    Agitation is a common symptom in psychiatric clinical practice, typically accompanied by emotional fluctuations and aggressive behaviors, which significantly impair patients′ treatment outcomes and pose safety risks to healthcare providers. Abnormal prefrontal cortex function and various neurotransmitter imbalances are considered the primary biological mechanisms underlying the onset of agitation. Music therapy, as a non-pharmacological intervention, has been shown to effectively alleviate agitation by enhancing brain functional connectivity, modulating neurotransmitter activity, and regulating physiological stress responses. Furthermore, music therapy has demonstrated positive therapeutic effects in clinical applications for patients with specific psychiatric conditions, such as Alzheimer′s disease, traumatic brain injury, and schizophrenia. Future research should focus on further elucidating the neurobiological mechanisms by which music therapy mitigates agitation, exploring the integration of multimodal interventions, and evaluating long-term efficacy, in order to facilitate its widespread clinical implementation and continuous optimization.

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    Overview of mechanisms of adult major depressive disorder comorbid attention deficit hyperactivity disorder and the prospects of transcranial direct current stimulation
    Xie Yixia, Wang Fan, Liu Xirui, Chen Ningning, Zhang Wenxuan, Wu Jialin, Ma Ting, Hong Wu
    2026, 46 (1):  107-114. 
    doi: 10.3969/j.issn.1674-8115.2026.01.013

    Abstract ( 18 )   HTML ( 4 )   PDF (927KB) ( 18 )  

    In recent years, the comorbidity of major depressive disorder (MDD) and attention deficit hyperactivity disorder (ADHD) has received increasing attention. In adult patients, MDD comorbid with ADHD usually implies high treatment costs, poor drug response, and an unfavorable disease prognosis. However, there are certain limitations in current drug therapies. As executive dysfunction is a key shared feature of MDD and ADHD, it is of great importance to explore the potential mechanisms of this comorbidity in terms of neuroimaging and to seek more effective treatment methods from the perspective of executive function. Research in recent years has shown that transcranial direct current stimulation (tDCS), a non-invasive physical therapy capable of regulating the activity of specific brain regions, can effectively improve relevant symptoms of MDD and adult ADHD. This article aims to review the treatment dilemmas faced by adult patients with MDD comorbid with ADHD, summarize the possible mechanisms underlying this comorbidity from multiple dimensions, such as brain structure and functional networks related to executive function, and simultaneously explore the application prospects of tDCS in the treatment of adult MDD comorbid with ADHD.

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    Research progress on mitochondrial pathological mechanisms and targeted therapy in children with autism spectrum disorder
    Wu Di, Ma Jun
    2026, 46 (1):  115-122. 
    doi: 10.3969/j.issn.1674-8115.2026.01.014

    Abstract ( 23 )   HTML ( 2 )   PDF (2643KB) ( 17 )  

    Autism spectrum disorder (ASD) is a chronic neurodevelopmental disorder with onset in childhood, characterised by core clinical features including impaired social interaction and communication, as well as restricted and repetitive behaviours and interests. Its pathogenesis involves interactions between genetic and environmental factors, while the specific biological mechanisms remain incompletely elucidated. Recent studies have demonstrated that mitochondrial structural and functional disorders may be a key contributor to the pathogenesis of ASD. As the primary organelles responsible for energy production, mitochondria play a crucial role in neurodevelopmental processes, including neurogenesis, neuronal migration, synapse formation, and synaptic pruning. Current research has identified widespread mitochondrial-related abnormalities in individuals with ASD, including mitochondrial DNA mutations, elevated oxidative stress levels, and metabolic dysregulation. Mechanistic studies indicate that mitochondrial dysfunction, including energy metabolism defects and mitochondrial dynamics imbalances, collectively impair synaptic plasticity and abnormal neural circuitry, ultimately leading to the core behavioural manifestations of ASD. Based on the aforementioned findings, researchers have further explored various potential intervention strategies targeting mitochondria, including gene editing, mitochondrial transplantation, antioxidant therapy, metabolic reprogramming, and modulation of the gut-brain axis through microbiome-based interventions. This article hypothesizes that mitochondria may serve as a critical integrative hub linking genetic susceptibility and environmental risk factors. Their structural and functional dysfunctions not only provide a biological basis for the neurodevelopmental abnormalities characteristic of ASD but also point the way toward future interventions targeting the core pathophysiological mechanisms of ASD.

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    Application of VA-ECMO in high-risk percutaneous coronary interventions under different clinical conditions
    Deng Yuying, Huang Xiuxian, Wang Sheng
    2026, 46 (1):  123-131. 
    doi: 10.3969/j.issn.1674-8115.2026.01.015

    Abstract ( 12 )   HTML ( 0 )   PDF (1037KB) ( 22 )  

    Although coronary artery bypass grafting (CABG) remains the preferred treatment for most patients with complex coronary artery lesions, percutaneous coronary intervention (PCI) supported by mechanical circulatory support (MCS) may be a non-inferior or even superior alternative in specific cases, particularly in critically ill patients with hemodynamic instability. Recent real-world evidence has led to a downgrade in guideline recommendations for the intra-aortic balloon pump (IABP), which has been the most commonly used circulatory assist device in clinical practice. Due to limited availability, the Impella device has not yet been widely adopted in China. In contrast, veno-arterial extracorporeal membrane oxygenation (VA-ECMO), owing to its comprehensive and robust cardiopulmonary replacement capabilities, has seen an increase in utilization across China in recent years. This article reviews current evidence on the application of VA-ECMO in high-risk PCI (HR-PCI) under various clinical conditions, aiming to provide valuable references for clinical practice.

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    Brief original article
    Efficacy of topical narrow-band ultraviolet B combined with desonide cream in children with moderate-to-severe atopic dermatitis
    Wan Pengjie, Yang Shaofang, Qi Jun
    2026, 46 (1):  132-136. 
    doi: 10.3969/j.issn.1674-8115.2026.01.016

    Abstract ( 12 )   HTML ( 0 )   PDF (1096KB) ( 18 )  

    Objective ·To investigate the clinical efficacy and safety of topical narrow-band ultraviolet B (NB-UVB) combined with desonide cream in the treatment of moderate-to-severe atopic dermatitis (AD) in children and to provide an optimized regimen for clinical practice. Methods ·A total of 166 children with moderate-to-severe AD admitted to the Department of Dermatology, Shanghai Children′s Medical Center, Shanghai Jiao Tong University School of Medicine and its Guizhou Branch were enrolled. They were divided into an experimental group (86 cases) and a control group (80 cases) according to different treatment regimens. The control group was treated with topical desonide cream combined with basic emollient therapy, while the experimental group received additional topical NB-UVB irradiation on the basis of the control group′s regimen (twice weekly, initial dose of 0.2 J/cm2, adjusted as needed). The SCORing Atopic Dermatitis (SCORAD) index and Visual Analogue Scale for Pruritus (VAS) scores of the two groups were compared after 2 and 4 weeks of treatment, as well as the recurrence rate during the 8-week follow-up and the incidence of adverse reactions during treatment. Results ·After 4 weeks of treatment, both SCORAD and VAS scores in the experimental group were significantly lower than those in the control group (P<0.001, P=0.017); the total effective rate of the experimental group was 90.7% (78/86), which was significantly higher than that of the control group [76.3% (61/80); χ2=6.210, P=0.012]. During the 8-week follow-up, the recurrence rate in the experimental group was 11.5% (9/78), which was lower than that in the control group [24.6% (15/61); χ2=4.082, P=0.043]. The incidence of adverse reactions in the experimental group was 7.0% (6/86), mainly mild erythema and hypopigmentation, whereas that in the control group was 3.8% (3/80), mainly folliculitis and hypopigmentation. There was no statistically significant difference between the two groups, and no severe adverse reactions occurred in either group. Conclusion ·Topical NB-UVB combined with desonide cream has a definite efficacy in the treatment of moderate-to-severe AD in children. It can rapidly resolve skin lesions and alleviate pruritus, significantly reduce the recurrence rate, and does not increase the risk of severe adverse reactions. It provides a better option for the clinical treatment of moderate-to-severe AD in children, and is worthy of wide clinical promotion and application.

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