Table of Content

28 April 2026, Volume 46 Issue 4 Previous Issue   
---
Frontier review
Basic research
Clinical research
Techniques and methods
Review
Case report


For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Frontier review

Select

Breakthroughs in basic mechanism research and clinical translation prospects of regulatory T cells Wang Zhen, Zhang Nan, Shen Yibing, Li Dan, Peng Cheng, Gu Zhidong, Li Bin 2026, 46 (4):  415-426.  doi: 10.3969/j.issn.1674-8115.2026.04.001 Abstract ( 7 )   HTML ( 3 )   PDF (1457KB) ( 9 )   Immune tolerance serves as the core cornerstone for maintaining the homeostasis of the body's immune system. Once this sophisticated regulatory mechanism is disrupted, it will directly induce a series of major diseases, including autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus, as well as tumor immune escape and organ transplant rejection, seriously endangering human life and health. The 2025 Nobel Prize in Physiology or Medicine was awarded to Mary E. Brunkow, Fred Ramsdell, and Shimon Sakaguchi in recognition of their pioneering contributions to the field of peripheral immune tolerance—successfully identifying CD4+CD25+FOXP3+ regulatory T cells (Treg) and their core regulatory gene, forkhead box P3 (FOXP3), and establishing the core theoretical framework of the “FOXP3-Treg-immune tolerance” axis, which has laid a solid foundation for subsequent research in this field. This review systematically combs the historical context of Treg and FOXP3 research, clearly presenting the evolutionary trajectory of the field from the early exploration of immune tolerance phenomena to the identification of key cell subsets and regulatory genes. It focuses on key advances in recent years, comprehensively covering core contents such as the refined classification and developmental characteristics of Treg subtypes, the multi-dimensional expansion of the FOXP3 regulatory network, the functional mechanisms of Treg in various diseases, and breakthrough achievements in clinical translation. Finally, focusing on the bottlenecks in the clinical translation of Treg therapies, this review provides perspectives on future development directions. Figures and Tables | References | Related Articles | Metrics

Basic research

Select

Expression of chemokine CCL20 in spontaneous preterm birth Yu Tiantian, Huang Zixuan, Li Yanan, Zhang Yuan, Lu Danyang, Zeng Weihong, Fan Jianxia 2026, 46 (4):  427-433.  doi: 10.3969/j.issn.1674-8115.2026.04.002 Abstract ( 3 )   HTML ( 1 )   PDF (17286KB) ( 4 )   Objective ·To analyze the expression levels of C-C motif chemokine ligand 20 (CCL20) in peripheral blood, umbilical cord blood, and placental maternal surface of women with spontaneous preterm birth (S-PTB), and to explore the potential role of chemokine CCL20 in preterm labor. Methods ·The expression of CCL20 protein in plasma from peripheral blood and umbilical cord blood of pregnant women with spontaneous preterm delivery (S-PTB group, n=20) and term delivery (Term group, n=20), collected at the International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, between October 2020 and February 2022, was assessed by enzyme-linked immunosorbent assay (ELISA). Pearson correlation analysis was used to evaluate the relationship between CCL20 expression levels in peripheral blood and umbilical cord blood plasma and gestational age. Western blotting and immunohistochemistry were used to detect the expression of CCL20 protein in the placental maternal surface tissues. Meanwhile, the levels of total nuclear factor-κB (NF-κB) and phosphorylated NF-κB proteins in placental tissues were detected by Western blotting. Results ·Among women at different gestational ages at delivery onset, the expression level of CCL20 protein in peripheral blood plasma was higher than that in umbilical cord blood plasma (P<0.001). In the S-PTB group, the level of CCL20 protein in the plasma of umbilical cord blood was higher than that in the Term group, with a statistically significant difference (P<0.05). In addition, the expression level of CCL20 in umbilical cord blood plasma was negatively correlated with gestational age (R=-0.319, P<0.05). Western blotting and immunohistochemistry showed that the expression of CCL20 protein was significantly increased in the placental maternal surface tissues of the S-PTB group (P<0.05). The relative expression level of phosphorylated NF-κB protein in placenta tissues of the S-PTB group was higher than that of the Term group (P<0.05). Conclusion ·The expression of chemokine CCL20 is up regulated at the maternal-fetal interface in women with S-PTB, and CCL20 may be involved in the occurrence of S-PTB through activation of the NF-κB pathway. Figures and Tables | References | Related Articles | Metrics

Select

Effects of nickel-titanium file systems on relationship between cleanliness and fracture resistance of long-oval root canals Zhang Zhuoyang, Wang Yiwei, Chen Xiyao, Wang Ying, Sun Shuntao, Tang Zisheng 2026, 46 (4):  434-441.  doi: 10.3969/j.issn.1674-8115.2026.04.003 Abstract ( 5 )   HTML ( 0 )   PDF (3097KB) ( 4 )   Objective ·To investigate the relationship between the cleanliness and fracture resistance of long-oval root canals using small field-of-view cone-beam CT (CBCT), computer-aided technologies, and a universal testing machine, and to explore the effects of commonly used nickel-titanium (NiTi) file systems on this relationship. Methods ·Mandibular premolars with single straight roots extracted for orthodontic reasons between April 2024 and April 2025 in the Department of Stomatology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, were collected. CBCT was used to analyze canal morphology, and 40 teeth with long-oval canals were selected. The crowns were removed to prepare standardized root samples with a length of 13 mm. The samples were randomly and equally divided into Group A (X-GOLD, n=10), Group B (Reciproc Blue, n=10), Group C (ProTaper Universal, n=10), and a control group (n=10). Root canal preparation was performed in Groups A, B, and C using different NiTi file systems. All samples were scanned before and after preparation using CBCT, and three-dimensional models were reconstructed to calculate canal cleanliness by comparing pre- and post-preparation morphologies. The experimental groups were obturated using the single-cone technique, while the control group was left unobturated. All roots were embedded and subjected to static loading using a universal testing machine to determine fracture load. Data were analyzed to evaluate differences and trends in cleanliness and fracture resistance among the groups, and to assess their relationship. Results ·Group C showed significantly higher overall cleanliness compared to Groups A and B, and the differences were statistically significant (P<0.05), while no statistically significant difference was observed between Groups A and B (P>0.05). CBCT-based 3D reconstruction illustrated that long-oval canals tended to be over-prepared in the mesiodistal direction and under-prepared in the buccolingual direction. The control group demonstrated significantly higher fracture resistance than Groups A, B and C, and the differences were statistically significant (P<0.05). There was no statistically significant difference in the fracture load between Group A and Group B (P>0.05). Group C had significantly lower fracture resistance compared to Group A and the control group, and the difference were statistically significant (P<0.05). A significant negative correlation was found between canal cleanliness and fracture resistance in long-oval root canals (r=-0.379, P=0.039). Conclusion ·NiTi file systems affect the relationship between cleanliness and fracture resistance in long-oval root canals. In mandibular premolars with long-oval single straight canals, cleanliness is negatively correlated with fracture resistance. The ProTaper Universal NiTi file system achieves higher cleanliness while maintaining a certain level of fracture resistance in such cases. Figures and Tables | References | Related Articles | Metrics

Select

Effects of triclosan exposure on the invasion ability of triple-negative breast cancer cells Tong Youhua, Guo Sinan, Nie Yu, Gao Yaxuan, Liu Shiyan, Zhang Haohao, Hou Yinghao, Zhi Hui 2026, 46 (4):  442-450.  doi: 10.3969/j.issn.1674-8115.2026.04.004 Abstract ( 6 )   HTML ( 0 )   PDF (16267KB) ( 5 )   Objective ·To investigate the effect of triclosan (TCS) exposure on the progression of triple-negative breast cancer (TNBC) and to explore the underlying mechanism. Methods ·Cell counting kit-8 (CCK-8) assay was used to detect the half-maximal inhibitory concentration of TCS in the TNBC cell line MDA-MB-231 to screen the exposure concentrations of TCS. The effects of TCS on the migration and invasion abilities of MDA-MB-231 cells were detected by wound-healing assay and Transwell invasion assays, respectively. The effect of TCS on miR-21 expression in MDA-MB-231 cells was detected by quantitative real-time PCR (qPCR). The effects of TCS on the expression of epithelial-mesenchymal transition (EMT)-related proteins, including E-cadherin (E-cad) and vimentin in MDA-MB-231 cells, were detected by Western blotting. The effect of TCS exposure on the miR-21/signal transducer and activator of transcription 3 (STAT3) signaling pathway were detected by immunohistochemistry and Western blotting. Meanwhile, miR-21 mimics were transfected into MDA-MB-231 cells to examine the effects of TCS exposure on the migration and invasion of the cells. Results ·According to the CCK-8 assay, the exposure concentrations of TCS were screened to be 0.001, 0.01, 0.1, and 1 μmol/L. Wound-healing assay and Transwell invasion assay both showed that exposure to 0.01, 0.1, and 1 μmol/L TCS enhanced the migration and invasion abilities of MDA-MB-231 cells (all P<0.05). qPCR results indicated that the expression level of miR-21 in TNBC cells was decreased after exposure to 0.01, 0.1, and 1 μmol/L TCS (all P<0.05). Western blotting results revealed that 0.1 and 1 μmol/L TCS downregulated the expression of the epithelial marker E-cad, and 0.01, 0.1, and 1 μmol/L TCS upregulated the expression of the mesenchymal marker vimentin (all P<0.05). Immunohistochemistry and Western blotting results demonstrated that exposure to 0.01, 0.1, and 1 μmol/L TCS increased the phosphorylation of STAT3 in a dose-dependent manner (all P<0.05). Upregulation of miR-21 by transfection with miR-21 mimics attenuated the promoting effect of TCS on the migration and invasion of TNBC cells (both P<0.05). Conclusion ·TCS exposure enhances the migration and invasion of TNBC cells via the miR-21/STAT3 signaling axis, suggesting that TCS exposure may exert a promoting effect on the progression of TNBC. Figures and Tables | References | Related Articles | Metrics

Select

Bioinformatic analysis and validation of the RNA-binding protein HuR promoting non-small cell lung cancer progression via ITGB1 Peng Qianqian, Song Jinghan, Xu Xingyi, Xiao Hui 2026, 46 (4):  451-466.  doi: 10.3969/j.issn.1674-8115.2026.04.005 Abstract ( 5 )   HTML ( 0 )   PDF (23289KB) ( 7 )   Objective ·To systematically identify the key downstream target genes of the RNA-binding protein human antigen R (HuR) in non-small cell lung cancer (NSCLC) and to elucidate the molecular mechanisms through which HuR influences tumor progression by regulating this target. Methods ·Based on the The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx), and Clinical Proteomic Tumor Analysis Consortium (CPTAC) databases, the differential expression of HuR in NSCLC and adjacent tissues was analyzed. HuR protein levels were detected via immunohistochemistry and validated by using the GSE19188 dataset. Using TCGA data, the relationship between HuR expression and clinicopathological parameters was analyzed; survival analysis was performed, and univariate and multivariate Cox regression analyses were conducted to assess prognostic factors, followed by the construction of a nomogram model to predict survival rates. The ESTIMATE package and CIBERSORT algorithm were used to analyze the correlation between HuR expression and the tumor immune microenvironment. A Transwell assay was employed to detect changes in the migration and invasion capabilities of A549 cells after HuR knockdown. RNA-seq was used to screen for differentially expressed genes (DEGs), and hub genes were identified by combining protein-protein interaction (PPI) network analysis. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed for functional enrichment. Mechanistically, RNA immunoprecipitation (RIP) was used to validate the direct binding between HuR and integrin β 1 (ITGB1) mRNA. Furthermore, real-time quantitative PCR (RT-qPCR) and Western blotting were performed to detect the expression changes of ITGB1 at the mRNA and protein levels, respectively, after HuR knockdown. Results ·HuR was significantly overexpressed in lung cancer tissues, independently associated with poor prognosis (P=0.045), and negatively correlated with characteristics of an immunosuppressive microenvironment. Functional experiments demonstrated that HuR knockdown significantly inhibited the migration (P<0.001) and invasion (P=0.002) capabilities of lung cancer cells. Bioinformatic analysis identified ITGB1 as the core hub gene downstream of HuR, and enrichment analysis revealed its significant involvement in pathways such as the extracellular matrix (ECM)-receptor interaction. RIP assays confirmed that HuR directly binds to ITGB1 mRNA. Further RT-qPCR and Western blotting results indicated that HuR knockdown led to significant downregulation of ITGB1 at both the mRNA (P=0.001) and protein levels, suggesting that HuR primarily exerts its post-transcriptional regulatory role by maintaining ITGB1 mRNA stability. Conclusion ·HuR promotes NSCLC progression by directly binding to and stabilizing ITGB1 mRNA, thereby activating downstream signaling pathways. The discovery of the HuR-ITGB1 regulatory axis not only provides a novel perspective for understanding the pathogenesis of lung cancer but also offers a potential target for prognosis assessment and targeted therapy. Figures and Tables | References | Related Articles | Metrics

Select

Study on the cutting effects of Er:YAG laser on fresh ex vivo porcine tongue Ouyang Wenjun, Tao Jiang 2026, 46 (4):  467-474.  doi: 10.3969/j.issn.1674-8115.2026.04.006 Abstract ( 3 )   HTML ( 0 )   PDF (22844KB) ( 6 )   Objective ·To systematically investigate the effects of different parameter combinations of erbium-doped yttrium aluminum garnet (Er:YAG) laser on the cutting depth and thermal damage extent in fresh ex vivo porcine tongue tissue, and to explore its potential application value in precise cutting of tongue tissue. Methods ·Fresh ex vivo porcine tongue specimens were selected as experimental models. The tissues were irradiated under various parameter settings, including different power, frequencies, scanning speeds, and water-to-air ratios. Following irradiation, the samples were fixed, embedded, and sectioned. Hematoxylin and eosin (H-E) staining was performed, and the cutting areas were observed under a microscopy to measure the cutting depth and the extent of thermal damage. The cutting depth was defined as the maximum depth of tissue ablation, while the extent of thermal damage was assessed based on the average width of the thermally affected zone. Results ·The experiments were conducted in long pluse mode. Under the conditions of a frequency of 20 Hz, a scanning speed of 0.250 mm/s, and a water-to-air ratio of 4:4, as the power increased from 1.6 W to 3.2 W, the ablation depth increased from (2.336±0.049) mm to (4.271±0.147) mm, while the width of the thermal damage zone increased from (12.849±0.834) μm to (19.649±1.055) μm, indicating that although higher power enhances ablation, it simultaneously increases thermal effects. At a power of 2.4 W, a scanning speed of 0.250 mm/s, and a water-to-air ratio of 4:4, when the frequency increased from 10 Hz to 20 Hz, the ablation depth increased from (1.272±0.120) mm to (3.042±0.021) mm, while the width of thermal damage zone decreased from (17.647±0.726) μm to (12.944±0.815) μm, suggesting that under the same power, a higher frequency (with lower pulse energy) can improve cutting efficiency while reducing instantaneous thermal damage. At a power of 2.4 W, a frequency of 20 Hz, and a water-to-air ratio of 4:4, when the scanning speed increased from 0.125 mm/s to 0.500 mm/s, the ablation depth decreased from (3.824±0.060) mm to (2.230±0.206) mm, and the width of thermal damage zone decreased from (17.711±1.177) μm to (10.203±0.475) μm, indicating that increasing the scanning speed reduces energy deposition and thermal diffusion. At a power of 2.4 W, a frequency of 20 Hz, and a scanning speed of 0.250 mm/s, the thermal damage widths at water-to-air ratios of 2:2, 4:4, and 6:6 were (16.276±0.316) μm, (12.944±0.815) μm, and (10.764±0.270) μm, respectively, indicating that the water-to-air ratio has a significant cooling effect on thermal damage. Under all tested parameter combinations, the average width of the thermal damage zone remained below 25 μm, suggesting that the thermal effects induced by the Er:YAG laser during soft tissue cutting are relatively controllable. Conclusion ·By appropriately selecting the combination of Er:YAG laser parameters, effective cutting can be ensured while keeping low thermal damage, thereby achieving a balance between tissue protection and precise surgical operation. Figures and Tables | References | Related Articles | Metrics

Clinical research

Select

Comprehensive analysis of the function, prognosis, and immune infiltration characteristics of SF3B1 mutations in uveal melanoma Wang Yiran, Zhang Zhe, Shen Jianfeng 2026, 46 (4):  475-485.  doi: 10.3969/j.issn.1674-8115.2026.04.007 Abstract ( 8 )   HTML ( 0 )   PDF (4016KB) ( 7 )   Objective ·To comprehensively analyze the role, prognosis, and immune infiltration characteristics of splicing factor 3B subunit 1 (SF3B1) mutations in uveal melanoma (UVM). Methods ·A total of 20 patients diagnosed with primary UVM who underwent enucleation at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, between 2018 and 2021 were included. DNA and RNA were extracted from tumor tissue samples and used for Sanger sequencing and RNA sequencing, respectively. In addition, gene expression data, mutation information, and clinical data from 80 UVM patients were obtained from The Cancer Genome Atlas (TCGA) database. Raw gene expression data (STAR-counts) were converted into transcripts per million (TPM) and subsequently normalized using log2(TPM+1) for downstream analyses. According to SF3B1 mutation status, the TCGA-UVM cohort was divided into the SF3B1 mutant group and the SF3B1 wild-type group. The mutation frequency of SF3B1 was compared between the local cohort and the TCGA-UVM cohort, and Kaplan-Meier survival analysis was performed to evaluate patient prognosis in the TCGA-UVM cohort. Gene sets of common oncogenic pathways were obtained from the Molecular Signatures Database (MSigDB), and single-sample gene set enrichment analysis (ssGSEA) was used to evaluate the activity of relevant biological pathways in the TCGA-UVM cohort. Differential expression analysis was conducted using the R package limma, followed by functional enrichment and signaling pathway analyses using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). Immune cell infiltration levels in the TCGA-UVM cohort were evaluated using the Tumor Immune Estimation Resource (TIMER) database. Combined with transcriptomic data of immune checkpoint-related genes, such as programmed cell death protein 1 (PDCD1) and cytotoxic T-lymphocyte-associated protein 4 (CTLA4), the association between SF3B1 mutation status and tumor immune microenvironment characteristics was further analyzed. The Tumor Immune Dysfunction and Exclusion (TIDE) algorithm was applied to predict the impact of SF3B1 mutation on responsiveness to immune checkpoint inhibitor therapy. Alternative splicing (AS) events were analyzed based on RNA-sequencing data from local cohort to identify SF3B1 mutation-associated differential AS events and transcript isoform alterations. Results ·Comparison between the local cohort and the TCGA-UVM cohort showed that the mutation frequency of SF3B1 in Chinese patients was markedly higher than that in the TCGA-UVM cohort. Survival analysis indicated that patients in the SF3B1 mutant group had significantly better overall survival and disease-specific survival than those in the SF3B1 wild-type group (both P<0.05). ssGSEA analysis indicated that SF3B1 mutation was associated with increased activities of several tumor-related pathways, including inflammatory response, hypoxia response, epithelial-mesenchymal transition, and angiogenesis. GO and KEGG analyses indicated that differentially expressed genes were primarily enriched in nuclear receptor activity and the peroxisome proliferator-activated receptor (PPAR) signaling pathway. Immune infiltration analysis showed that SF3B1 mutation was associated with increased B-cell infiltration and lower expression of immune checkpoint-related genes (P<0.05). The TIDE algorithm suggested that SF3B1 mutation was associated with a higher response rate to immunotherapy (P<0.05). AS analysis further revealed that SF3B1 mutation was associated with multiple differential alternative splicing events and transcript isoform changes. Conclusion ·SF3B1 mutation occurs at a relatively high frequency in Chinese patients with UVM, and is associated with favorable survival outcomes and distinct immune infiltration characteristics, suggesting its potential as a biomarker for predicting prognosis and immunotherapy response in UVM. Figures and Tables | References | Related Articles | Metrics

Select

Association between hyperuricemia and metabolic syndrome in adults Lu Bohan, Hu Cuirong, Wang Jinkun, Lu Jifang, Jin Haijiao, Wang Ling, Jiang Na, Mou Shan 2026, 46 (4):  486-495.  doi: 10.3969/j.issn.1674-8115.2026.04.008 Abstract ( 6 )   HTML ( 0 )   PDF (1648KB) ( 8 )   Objective ·To analyze the prevalence of hyperuricemia (HUA) and its correlation with metabolic syndrome (MS) and MS components among adults in the Ningbo Hangzhou Bay area of Zhejiang Province. Methods ·A cross-sectional study was conducted among adults who underwent health examinations at Ningbo Hangzhou Bay Hospital from January to December 2022. Demographic data and clinical examination results were collected. The prevalence of HUA was calculated based on serum uric acid (SUA) levels. The estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. MS was defined according to body mass index (BMI), blood pressure, fasting blood glucose, triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). The association between HUA and MS, as well as its individual components, was analyzed. Results ·A total of 9 196 adults were included, with a mean age of (34.3±11.8) years; 75.2% were males. The mean SUA level was (371.8±95.6) μmol/L, and the overall prevalence of HUA was 31.3%. Compared with the non-HUA group, the HUA group demonstrated a higher proportion of males, younger age, lower eGFR, and a higher prevalence of MS (all P<0.001). Regarding MS components, the HUA group showed significantly higher BMI, blood pressure, and TG levels, along with lower HDL-C levels (all P<0.001). Patients with MS had significantly higher SUA levels and a higher prevalence of HUA compared to those without MS (both P<0.001). Furthermore, both SUA levels and the prevalence of HUA increased progressively with the increasing number of MS components present. Multivariable Logistic regression analysis identified male sex (OR=3.74, 95%CI 3.12‒4.48), younger age (per 5-year decrease, OR=1.22, 95%CI 1.19‒1.26), eGFR<90 mL/(min·1.73 m2) (OR=2.45, 95%CI 2.11‒2.84), BMI≥25 kg/m2 (OR=2.31, 95%CI 2.06‒2.60), elevated blood pressure (OR=1.18, 95%CI 1.04‒1.32), TG≥1.7 mmol/L (OR=2.08, 95%CI 1.81‒2.37), and low HDL-C (OR=1.33, 95%CI 1.15‒1.55) as independent risk factors for HUA. Conclusion ·The prevalence of HUA is high among the adult population in the Ningbo Hangzhou Bay area. Male sex, younger age, decreased renal function, and the presence of MS components are risk factors for HUA in this population, with the prevalence increasing as the number of MS components accumulates. Figures and Tables | References | Related Articles | Metrics

Select

Physiological distribution characteristics and influencing factors of hepatic background and mediastinal blood pool on 18F-FDG PET/CT in children and adolescents of different ages Wang Shaoyan, Li Chao, Huang Shuo, Wu Shuqi, Chen Suyun 2026, 46 (4):  496-501.  doi: 10.3969/j.issn.1674-8115.2026.04.009 Abstract ( 4 )   HTML ( 0 )   PDF (1845KB) ( 6 )   Objective ·To investigate the physiological distribution characteristics of fluorine-18 fluorodeoxyglucose(18F-FDG) in the liver background and mediastinal blood pool on positron emission tomography/computed tomography (PET/CT) in children and adolescents, and to analyze the influencing factors. Methods ·A total of 271 pediatric patients (<18 years) with pathologically confirmed or suspected malignant tumors were retrospectively analyzed. Patients were divided into four age groups: ≤2 years, 3‒5 years, 6‒10 years, and ≥11 years. The maximum standardized uptake value and mean standardized uptake value (SUVmax and SUVmean) of the liver and mediastinal blood pool were measured. Their associations with age, weight, height, body mass index (BMI), gender, liver function, and chemotherapy status were assessed. Results ·The SUVmax and SUVmean of the liver were 1.89±0.62 and 1.36±0.44, respectively.The mediastinal blood pool SUVmax and SUVmean were 1.11±0.37 and 0.98±0.32. Pearson correlation analysis showed that SUVmax and SUVmean values of the liver and mediastinal blood pool were significantly positively correlated (r=0.78‒0.86, P<0.001). All SUV parameters were positively correlated with age, weight, height, and BMI (r=0.47‒0.73, P<0.05), but showed no significant correlation with gender (r=0.02‒0.04, P>0.05). 18F-FDG uptake in both the liver and mediastinal blood pool increased significantly with age. Hepatic SUVmax increased from 1.41±0.32 in the ≤2-year group to 2.57±0.60 in the ≥11-year group (P<0.001), while mediastinal SUVmax increased from 0.91±0.27 to 1.42±0.41 (P<0.001). Children with abnormal liver function had lower hepatic uptake compared to those with normal liver function (1.71±0.61 vs 1.93±0.61, P=0.034), while no significant difference was observed before and after chemotherapy. Multivariate regression analysis identified weight and age as independent influencing factors for hepatic SUV values (P<0.001), and body weight had the greatest impact on mediastinal blood pool SUV values (P<0.001). Conclusion ·Hepatic background and mediastinal blood pool 18F-FDG uptake increases with age and weight in children and adolescents, with SUV values typically below 2 in children under 5 years old. The SUV values of the liver and mediastinal blood pool show good consistency and reproducibility as non-target reference parameters for therapeutic response evaluation in pediatric PET/CT, which may improve the accuracy and standardization of image interpretation. Figures and Tables | References | Related Articles | Metrics

Select

Clinical efficacy of intra-abdominal anastomosis in laparoscopic right hemicolectomy Jiang Shuang, Yu Jiwei 2026, 46 (4):  502-508.  doi: 10.3969/j.issn.1674-8115.2026.04.010 Abstract ( 3 )   HTML ( 0 )   PDF (2028KB) ( 3 )   Objective ·To explore the clinical effects of intra-abdominal anastomosis in laparoscopic right hemicolectomy. Methods ·Clinical data were collected from 92 patients diagnosed with right-sided colon cancer who underwent laparoscopic right hemicolectomy at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, from January 2020 and February 2024. The patients were divided into an intra-abdominal anastomosis group and an extra-abdominal anastomosis group according to the intraoperative anastomosis method. Perioperative general data, intraoperative conditions, postoperative recovery, and short-term complications within 30 d after surgery were collected and compared between the two groups. Results ·After propensity score matching, 64 well-matched patients were obtained, with 32 cases in the intra-abdominal anastomosis group and 32 cases in the extra-abdominal anastomosis group. The intraoperative blood loss in the intra-abdominal anastomosis group was significantly lower than that in the extra-abdominal anastomosis group (P<0.001), and the length of the auxiliary incision was also shorter (P<0.001). Patients in the intra-abdominal anastomosis group had shorter time to first flatus (P=0.012) and time to first defecation (P=0.003), as well as lower postoperative pain scores (P<0.001). The overall incidence of short-term complications and the incidence of surgical site infection in the intra-abdominal anastomosis group were 21.88% and 6.25%, respectively, which were significantly lower than those in the extra-abdominal anastomosis group (37.50% and 28.13%, respectively; P=0.041 and P=0.032). Within 30 d postoperatively, the intra-abdominal anastomosis group had significantly lower severe complication (Clavien-Dindo≥grade Ⅱ) rate compared with the extra-abdominal anastomosis group (12.50% vs 31.25%, P=0.045). Conclusion ·Compared with extra-abdominal anastomosis in laparoscopic right hemicolectomy, intra-abdominal anastomosis demonstrates significant advantages in terms of reduced intraoperative blood loss, less surgical trauma, faster recovery of intestinal function, lower postoperative pain, and a lower incidence of short-term complications. Figures and Tables | References | Related Articles | Metrics

Techniques and methods

Select

Prediction of delayed post-polypectomy bleeding using a multimodal model Zhu Menglin, Liu Xiao, Xu Xiaodan, Wang Ganhong, Xia Kaijian, Chen Jian 2026, 46 (4):  509-520.  doi: 10.3969/j.issn.1674-8115.2026.04.011 Abstract ( 3 )   HTML ( 0 )   PDF (21375KB) ( 7 )   Objective ·To develop a multimodal prediction model that integrates endoscopic wound images with clinical features, leveraging deep learning and machine learning techniques to predict the risk of delayed post-polypectomy bleeding (DPPB). Methods ·The clinical data and postoperative endoscopic wound images of patients who underwent endoscopic colorectal polypectomy at two hospitals were retrospectively collected. The study was designed in three stages. In the first stage, a YOLOv11 model trained via transfer learning was used to automatically detect and segment wound areas, extracting regions of interest (ROI). In the second stage, ROI images were input into a deep neural network based on the ResNet50 architecture. Supervised learning was performed using DPPB occurrence as the label, and a standardized endoscopic imaging score (E-Score) was generated. In the third stage, the E-Score was combined with clinical features. Feature selection was conducted using LASSO regression, and the selected variables were input into multiple machine learning algorithms to construct a multimodal DPPB prediction model. Finally, a web-based application was developed using the Streamlit framework to facilitate clinical use. Results ·A total of 2 782 patients who underwent colorectal polypectomy were included, among whom 228 (8.20%) developed DPPB. In the test set, the multimodal prediction model built using the XGBoost algorithm (PrismDPPB) achieved the best performance, with an area under the curve(AUC) of 0.831 (95%CI 0.81‒0.85), outperforming other models. It also showed superior performance in accuracy (79.78%), sensitivity (77.28%), positive predictive value (81.32%), and F1 score (79.25%). Feature importance analysis revealed that the six most contributive variables were E-Score, maximum polyp base diameter, sex, presence of a stalk, body mass index, and polyp location. For model interpretability, SHAP plots were used to visualize and explain the prediction results. Conclusion ·The multimodal prediction model developed by integrating image-based features with clinical characteristics, along with the accompanying web application, demonstrates strong practicality and clinical potential for DPPB risk assessment. Figures and Tables | References | Related Articles | Metrics

Review

Select

Arachidonic acid metabolism in tumor immune microenvironment remodeling Miao Keyan, Jia Hao, Yang Xi 2026, 46 (4):  521-528.  doi: 10.3969/j.issn.1674-8115.2026.04.012 Abstract ( 8 )   HTML ( 0 )   PDF (1160KB) ( 9 )   The tumor microenvironment (TME) constitutes a pivotal component in tumorigenesis and progression, with its inherent complexity and dynamic nature playing a central role in metastatic dissemination. Arachidonic acid (AA), a key polyunsaturated fatty acid, produces metabolites that not only orchestrate inflammatory responses and maintain tissue homeostasis but also profoundly influence tumor initiation, progression, and therapeutic response within the TME by modulating the distribution, polarization, activation, and functional states of immune cells. Recent studies have revealed that these lipid mediators act on diverse immune cell types via distinct receptor pathways, thereby remodeling the immune microenvironment and impacting immune evasion and therapeutic resistance. Despite accumulating insights, the precise mechanisms by which AA metabolism reprograms the TME and contributes to tumor development remain incompletely understood. This review systematically elaborates on the molecular interplay between AA metabolites and major immune cells, outlines their functional characteristics in tumor immune regulation, focuses on the key roles of related metabolic pathways in TME remodeling, and summarizes the research advances and applications of AA metabolism-targeting strategies in tumor immunotherapy. An in-depth understanding of the dynamic crosstalk between AA metabolism and the immune system may provide a conceptual framework for the development of more precise and personalized immunotherapeutic interventions. Figures and Tables | References | Related Articles | Metrics

Select

Clinical research progress in multidisciplinary collaborative diagnosis and treatment of temporomandibular disorders Liu Li, Fan Haixia, Geng Haixia 2026, 46 (4):  529-536.  doi: 10.3969/j.issn.1674-8115.2026.04.013 Abstract ( 6 )   HTML ( 0 )   PDF (1034KB) ( 6 )   Temporomandibular disorders (TMD) affect 5%‒12% of the global population, significantly impairing orofacial health and overall quality of life. Currently, no consensus exists regarding multidisciplinary management protocols for these patients, and the joint-jaw-occlusion multidisciplinary diagnosis and treatment model—a collaborative approach involving temporomandibular joint specialists, orthodontists, and orthognathic surgeons—has attracted increasing attention in recent years. As a commonly employed conservative treatment, functional splints demonstrate significant short-term efficacy in patients with early-to-moderate TMD, although their long-term stability remains to be verified. Temporomandibular joint surgery and orthognathic surgery can effectively restore temporomandibular joint function and correct jaw deformities in patients with moderate-to-advanced TMD, whereas the impact of orthognathic surgery on the temporomandibular joint requires further investigation. For patients with complex TMD accompanied by (skeletal) malocclusion, the joint-jaw-occlusion collaborative diagnosis and treatment model enables personalized interventions through multidisciplinary management: functional splints adjust the disc-condyle relationship, orthodontic treatment eliminates occlusal interferences, and surgical treatment restores the structure and function of the joint and jaw. Meanwhile, individualized treatment plans should be formulated based on patients' growth and developmental potential, aiming to promote the long-term stability of the three-dimensional relationship among the joint, jaw, and occlusion with minimal trauma. This review aims to provide a reference for the multidisciplinary evaluation and personalized management of patients with TMD in clinical practice. References | Related Articles | Metrics

Select

Research progress of macrophage metabolic reprogramming in recurrent spontaneous abortion Du Xin, Li Xuebing, Li Yongwei 2026, 46 (4):  537-544.  doi: 10.3969/j.issn.1674-8115.2026.04.014 Abstract ( 4 )   HTML ( 0 )   PDF (1082KB) ( 4 )   The mechanisms underlying recurrent spontaneous abortion (RSA) remain unclear, as its pathogenesis is complex and involves multiple immune and metabolic factors. In recent years, increasing attention has been directed toward the mechanisms by which macrophages influence embryo implantation and pregnancy maintenance through metabolic pathways. Macrophage metabolism primarily encompasses glucose metabolism, lipid metabolism, and amino acid metabolism. Glucose metabolism drives M1 macrophage polarization primarily through glycolysis, while reduced fatty acid oxidation is associated with impaired anti-inflammatory functions of macrophages. Cholesterol accumulation exacerbates local inflammatory responses, and lipid metabolism imbalances may also affect decidual angiogenesis and placental development. Current research has confirmed that metabolic disturbances in the local decidual microenvironment, such as hypoxia and oxidative stress, can directly induce metabolic reprogramming of macrophages, subsequently affecting their pro-inflammatory or anti-inflammatory conversion. However, the specific mechanisms of key metabolic nodes of macrophages of pregnancy immune regulation, as well as the feasibility of targeted intervention through metabolic pathways, still require further investigation. This article reviews the role of macrophages in recurrent spontaneous abortion, focusing on metabolic reprogramming as a core regulatory node. It delves into how imbalances in glucose, lipid, and amino acid metabolism drive macrophage dysfunction, thereby affecting the establishment and maintenance of the immune-tolerant microenvironment at the maternal-fetal interface, aiming to provide new perspectives for the prevention and treatment of RSA. Figures and Tables | References | Related Articles | Metrics

Select

Advances in empathy research from the perspective of the integration of neurobiology and computer science Zhou Xinyu, Qiu Jianyin 2026, 46 (4):  545-554.  doi: 10.3969/j.issn.1674-8115.2026.04.015 Abstract ( 6 )   HTML ( 0 )   PDF (1073KB) ( 5 )   Empathy, which enables individuals to share and understand others' feelings, is of great significance for human survival and social interaction and serves as one of the key elements in psychotherapy. Evidence from animal models, as well as clinical and non-clinical populations, indicates that the core brain network of empathy involves the anterior cingulate cortex, anterior insula, amygdala, anterior cingulate cortex,etc. Empathy also involves activities in the autonomic nervous and endocrine systems. Based on the neurobiological foundation of empathy, researchers have combined behavioral experiments with neuroimaging and physiological signal measurements to further understand and quantify empathy. Breakthroughs in computational empathy, driven by advances in artificial intelligence, have enabled the automated assessment of empathy through features extracted from multimodal data and the simulation of empathy. Future research needs to develop behavioral paradigms with higher ecological validity, integrate multimodal data from visual, linguistic, and physiological signals, and optimize algorithmic ethics and cross-cultural applicability to facilitate the application of empathy research in domains such as psychotherapy, education, and human-computer interaction.The paper reviews recent advances in empathy research from an interdisciplinary perspective, integrating neurobiology and computer science. It covers the neurobiological mechanisms of empathy, methods for measuring and assessing empathy, and the application of artificial intelligence techniques in empathy research. Figures and Tables | References | Related Articles | Metrics

Case report

Select

A case report of Wilson's disease presenting with thrombocytopenia and splenomegaly as the inital manifestations Yan Xiaoqian, Yang Jie, Yang Yongbin, Chen Yu, Li Yan, Li Jie 2026, 46 (4):  555-560.  doi: 10.3969/j.issn.1674-8115.2026.04.016 Abstract ( 2 )   HTML ( 0 )   PDF (4259KB) ( 5 )   Wilson's disease is a rare hereditary metabolic disorder that is reversible with treatment. Early diagnosis and timely treatment are critical factors in improving its prognosis. Thrombocytopenia and splenomegaly are common clinical manifestations but lack specificity. Their underlying causes are complex and diverse, often involving the hematologic system, immune system, digestive system, infectious diseases, and malignancies, which poses significant challenges in clinical diagnosis and easily leads to misdiagnosis. This article analyzes the clinical data of a case of Wilson's disease presenting with thrombocytopenia and splenomegaly as the initial manifestations, aiming to enhance clinicians' awareness of potential rare diseases when encountering non-specific clinical manifestations, thereby avoiding misdiagnosis and missed diagnosis and facilitating early diagnosis and intervention. Figures and Tables | References | Related Articles | Metrics