中南大学学报(医学版)最新文献

Langerhans cell histiocytosis (LCH) is a group of myeloid neoplastic disorders characterized by infiltration of Langerhans cells, which can accumulate in tissues and cause multisystem manifestations. Erdheim-Chester disease (ECD) is a rare non-LCH histiocytosis, characterized by multisystem infiltration of lipid-laden foamy macrophages. Both ECD and LCH can lead to severe systemic disease, but reports of their overlap remain rare. We describe a female patient with ECD-LCH overlap syndrome presenting predominantly with pericardial effusion. She was admitted to the Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, on November 10, 2020, due to dyspnea and bilateral lower-extremity edema, with a disease course of 13 months. Computed tomography revealed multi-system involvement, and genetic testing identified a BRAF^V600E mutation. Immunohistochemical staining analysis eventually confirmed ECD-LCH overlap syndrome. Symptomatic treatment was initiated, and follow-up showed stable clinical symptoms. To our knowledge, this is the first reported case worldwide of adult ECD-LCH overlap syndrome with pericardial involvement.

Breast cancer is one of the most common and fatal malignancies among women worldwide, and its treatment efficacy is often limited by drug resistance and the presence of undruggable targets. Traditional small-molecule drugs have difficulty effectively modulating certain critical targets such as transcription factors and non-coding RNAs, necessitating new therapeutic strategies. Proteolysis-targeting chimeras (PROTACs) function by recruiting pathogenic proteins to the cellular ubiquitin-proteasome system, thereby inducing their specific degradation. In contrast, ribonuclease-targeting chimeras (RIBOTACs) utilize small-molecule ligands but bind to RNA and direct endogenous RNases to selectively degrade pathogenic RNA molecules. By employing a "degradation rather than inhibition" mechanism, targeting chimera technology broadens the druggable landscape and offers a novel precision therapeutic strategy for breast cancer, particularly for refractory and drug-resistant cases. This approach not only overcomes the limitations of traditional drugs, such as the absence of suitable binding sites or poor selectivity, but also reduces required dosages and potential adverse effects. Recent studies have preliminarily demonstrated the therapeutic potential of PROTACs and RIBOTACs in breast cancer, encompassing target design, mechanistic investigation, and preclinical as well as early clinical applications. Research into these technologies reveals their ability to tackle previously undruggable targets, thereby providing theoretical support for the development of safer and more effective precision therapies for breast cancer. In the future, with advances in drug delivery systems and clinical trials, PROTACs and RIBOTACs are expected to be used synergistically with immunotherapy and chemotherapy, offering breast cancer patients more promising comprehensive treatment options and potentially driving oncology toward broader intervention of undruggable targets.

Objectives: Non-suicidal self-injury (NSSI) among college students has become a significant public health concern, highlighting the need for effective early identification tools. This study aims to construct a predictive model for NSSI among college students using the least absolute shrinkage and selection operator (LASSO) regression analysis.

Methods: From April to June 2022, an online questionnaire survey was conducted among college students in 6 provinces: Hunan, Jiangxi, Hubei, Shandong, Guangdong, and Jilin. Sociodemographic information was collected, along with assessments using the Adolescent Non-suicidal Self-injury Assessment Questionnaire, Patient Health Questionnaire-9, Anger Rumination Scale, Multiple Forms of Violence Scale, Childhood Trauma Questionnaire-28 item Short Form, and Community Assessment of Psychic Experiences. LASSO regression analysis was performed to identify predictors of NSSI, construct the predictive model, and develop a nomogram. Calibration curves and receiver operating characteristic (ROC) curves were used to evaluate the calibration and discrimination of the model.

Results: A total of 4 121 college students participated in this study, among whom 650 reported NSSI behaviors, yielding a detection rate of 15.8%. LASSO regression identified 5 predictors of NSSI: Experiences of bullying in primary school, history of alcohol use, depressive symptoms, anger rumination, and psychotic-like experiences. The predictive model was expressed as: Risk of NSSI = (bullying in primary school × 0.41) + (history of alcohol use × 0.76) + (depressive symptoms × 0.08) + (anger rumination × 0.04) + (psychotic-like experiences × 0.05). The area under the curve (AUC) of the predictive model was 0.782 for the training set and 0.769 for the testing set. Calibration curves indicated good agreement between predicted and observed values.

Conclusions: The predictive model demonstrated strong predictive ability and was visualized using a nomogram. This model can be used to assess the risk of NSSI among college students based on identified risk factors and may assist clinicians and educators in identifying high-risk individuals for early interventions.

Fractional flow reserve (FFR), an established modality for functionally assessing coronary artery disease, is increasingly applied to diagnose and manage lower extremity arterial disease. By incorporating functional parameters, FFR enhances revascularization precision by quantifying the hemodynamic impact of stenotic lesions, thereby overcoming limitations of conventional imaging. Key clinical applications in lower extremity disease include functional assessment in moderate intermittent claudication, post-vascular preparation strategy optimization, and predicting revascularization outcomes and complications. Advances in pressure wire and microcatheter systems, alongside non-invasive imaging-derived FFR techniques, are improving its feasibility and applicability. However, widespread adoption is challenged by the complex anatomy of the lower extremity arterial system, frequent severe calcification and diffuse disease, and a current lack of standardized FFR cutoff values. Promoting the standardized use of FFR is crucial for shifting the clinical management paradigm from anatomy-based repair toward functional reconstruction.