中国医学科学院学报最新文献

Arsenic is a widespread carcinogen in the environment,and chronic arsenic exposure results in dysfunction or even cancer development of multiple organs,including the skin,liver,lung,brain,and ovary.RNA N⁶-methyladenosine(m⁶A)is a ubiquitous epigenetic modification of RNA in eukaryotes,regulating numerous physiological and pathological processes in cells.Increasing studies have shown that m⁶A plays a crucial role in arsenic-induced damage of multiple organs and systems,including the skin,liver,lung,nervous system,reproductive system,and embryo.This paper summarizes the recent studies on the regulatory role of m⁶A in arsenic-induced damage,providing new ideas and directions for the investigation of the mechanism and treatment strategy of arsenic toxicity.

Objective To analyze the relationship between combined lifestyle and cognitive function among older adults in rural communities. Methods A multi-stage stratified whole-group sampling method was employed to select older adults aged ≥60 years in four villages of Chongming District,Shanghai as the participants.Their somatic indicators were measured by trained personnel,and data on demographic characteristics,cognitive function,and lifestyle were collected through face-to-face interviews.Binary Logistic regression and trend tests were adopted to explore the relationship between combined lifestyle and cognitive function.Additionally,the subgroup analysis and the test for multiplicative interactions were conducted for the relationship between combined lifestyle and cognitive function.Furthermore,sensitivity analysis was performed to verify the robustness of the results. Results A total of 1 449 older adults were investigated,and 1 408 were effective.The older adults showed the average age of(73.25±5.69) years and the cognitive impairment prevalence of 15.63%.Among them,163 older adults lived unhealthy lifestyles,accounting for 11.6%.After adjusting for demographic factors,disease history,and medication history,moderate lifestyles(OR=0.609,95%CI=0.394-0.944,P=0.026) and healthy lifestyles(OR=0.377,95%CI=0.212-0.672,P=0.001) had negative associations with the prevalence of cognitive impairment.Among combined lifestyle components,dietary diversity(OR=0.404,95%CI=0.211-0.771,P=0.006),physical activity intensity(OR=0.460,95%CI=0.235-0.901,P=0.024),and sleep duration(OR=0.611,95%CI=0.416-0.897,P=0.012) had negative associations with the prevalence of cognitive impairment.The trend test revealed that the negative association between cognitive impairment and combined lifestyle enhanced with the sequential increase in combined lifestyle score(P_{for trend}=0.011).The subgroup analysis revealed an interaction effect between gender and lifestyle subgroups,and a healthy lifestyle exerted a protective effect on women(P_{for interaction}=0.013). Conclusions Among older adults in rural communities,cognitive impairment has a significantly negative association with healthy lifestyles.As the combined lifestyle score increases,the risk of developing cognitive impairment shows a decreasing trend,which suggests that comprehensive lifestyle interventions may have a protective effect on cognitive function.

Macro-aspartate aminotransferase(AST)is a macro-enzyme formed by self-polymerization or binding to other serum components that are difficult to be cleared by the kidneys,resulting in an isolated elevation in serum AST.Macro-AST is a rare disease.In this report,a case with isolated AST elevation as the main manifestation is presented.The diagnosis of macro-AST was established by the polyethylene glycol precipitation assay.The comprehensive history and exclusion of other factors suggest that this case of macro-AST may be secondary to metabolic dysfunction-associated fatty liver disease.

Objective To analyze the research hotspots and development trends in the field of social frailty of the elderly,thus providing reference for further research in this field. Methods The literature related to social frailty was retrieved from CNKI and Web of Science core collection and analyzed in terms of authors,institutions,countries,keywords,and burst terms by CiteSpace. Results A total of 165 articles in both Chinese and English were included.The annual number of papers published in the field of social frailty showed an increasing trend year by year.The authors,institutions,and countries with the largest number of papers were from Japan.The available studies of social frailty mainly focused on the causes and mechanisms,assessment methods,occurrence status,and adverse health outcomes.The social frailty of patients with heart failure and the survival status of patients with social frailty are major research trends in this field. Conclusions The research on social frailty is in the preliminary stage of exploration.The research focus is on the occurrence status and adverse effects of social frailty.In the future,the causes and mechanisms of social frailty in different populations and different contexts can be further explored,and targeted prevention,intervention,and management can be carried out.

Isolated adrenocorticotropic hormone(ACTH)deficiency(IAD)is a rare disease first reported by Steinberg from Japan in 1954,and there have been few clinical reports about IAD to date.IAD is characterized by secondary adrenal cortical insufficiency,low or absent cortisol production,normal or transiently reversible increases in secretion of pituitary hormones other than ACTH,no structural pituitary defects,and exclusion of ACTH deficiency caused by exogenous glucocorticoid use and postoperative pituitary adenoma.This paper retrospectively analyzes the clinical data of three adult patients with IAD and summarizes their clinical characteristics,aiming to improve clinical awareness of this rare disease.

Currently,the artificial intelligence for science paradigm is evolving rapidly,with the new generation of artificial intelligence technologies represented by large language models(LLM)having injected transformative momentum into biological and medical research.Systematically examining the innovative applications of LLM in biomedical contexts under the artificial intelligence for science paradigm can provide critical references for methodological innovation and research paradigm transformation in deciphering complex disease mechanisms and advancing precision medicine.Through comparative analysis of high-impact peer-reviewed publications and preprints in the past two years,we elucidate cutting-edge research progress,developmental trajectories,and persistent challenges in LLM applications across biological and medical domains.Furthermore,we make an outlook on the future of this rapidly evolving field and proposes essential considerations for addressing emerging interdisciplinary challenges.

Undifferentiated uterine sarcoma with SMARCA4 gene deletion is a rare malignant tumor.The incidence of this type of tumor is low,and fewer than 40 cases have been reported worldwide.Most of the cases are advanced at the time of diagnosis,and the tumor is aggressive and difficult to be diagnosed.The lack of large-sample studies,unclear treatment plan,and individualized treatment in most cases lead to poor prognosis and high mortality.We report two cases of undifferentiated uterine sarcoma at the ⅣB stage in young women with SMARCA4 gene deletion,providing reference for future treatment.

Objective To investigate the characteristics of symptom clusters and sentinel symptoms in lung cancer patients before and at the completion of radiotherapy,thus providing a theoretical basis for targeted symptom management. Methods A convenience sampling method was used to recruit patients from the Department of Radiotherapy at Yunnan Cancer Hospital between January and October 2024.A general information questionnaire and the Anderson symptom inventory-lung cancer module(revised) were employed for data collection.The exploratory factor analysis was performed for the symptoms with an incidence rate greater than 20% one day before and at the completion of radiotherapy to identify symptom clusters at different time points.The Apriori algorithm was then adopted to model the associations among symptoms within each cluster and to identify the sentinel symptoms. Results A total of 244 patients were included in this study.Three symptom clusters existed before radiotherapy:psychological symptom cluster(sadness,distress,and sleep disorder),lung cancer-related respiratory symptom cluster(cough,expectoration,chest tightness,and shortness of breath),and perception symptom cluster(pain and numbness).Distress and cough were the sentinel symptoms of psychological symptom cluster and lung cancer related respiratory symptom cluster,respectively.At the end of radiotherapy,the psychological symptom cluster and lung cancer-related respiratory symptom cluster remained unchanged.The radiotherapy side effect symptom cluster(dry mouth,pain,loss of appetite) appeared,and the perception symptom cluster expanded to encompass 5 items(amnesia,drowsiness,fatigue,nausea,and constipation).Pain and drowsiness were the sentinel symptoms of radiotherapy side effect symptom cluster and perception symptom cluster,respectively. Conclusions There are several symptom clusters in lung cancer patients before and at the completion of radiotherapy,and sentinel symptoms exist in symptom clusters at different periods.Nurses can take sentinel symptoms as the intervention targets to formulate effective and targeted nursing measures and reduce the incidence or severity of other symptoms in the cluster,thus diminishing the whole symptom cluster and reducing the burden of patients' symptoms.

Objective To identify key genes of lipid metabolism in diabetic nephropathy(DN) through machine learning models and animal model validation. Methods The limma R package was used for differential gene expression analysis on 69 samples from two transcriptome datasets of the Gene Expression Omnibus and 2 184 differentially expressed genes were identified.Subsequently,we adopted undifferentiated consensus clustering to classify DN samples into two specific subtypes.At the same time,we performed weighted gene co-expression network analysis to mine the gene modules significantly associated with DN.In addition,using least absolute shrinkage and selection operator,support vector machine-recursive feature elimination,and random forest machine learning techniques,combined with protein-protein interaction network analysis,we screened out three core genes.Finally,we constructed a mouse model of type 2 diabetes mellitus to verify the effectiveness of the expression of these key genes. Results Three core genes,APOO,ALDH7A1,and ALB,were predicted as potential biomarkers of lipid metabolism in DN,and their expression levels were downregulated in DN.Through experimental validation in a diabetic mouse model,we confirmed the altered expression of APOO,ALDH7A1,and ALB in DN,which supported their potential as diagnostic markers. Conclusions Our findings suggest that APOO,ALDH7A1,and ALB are new diagnostic markers associated with lipid metabolism in DN,which provides new perspectives for understanding the molecular mechanisms of lipid metabolism in DN.

Colorectal cancer(CRC),a common malignant tumor in the digestive system,has seen increases in global incidence and mortality.The occurrence and development of CRC is a multi-level complex process,which includes genetic variations within cancer cells and multiple influencing factors in the surrounding tumor microenvironment.More and more evidence suggests that tumor-associated macrophages(TAM),the main innate immune cell group in the tumor microenvironment,play a crucial role in CRC.Given the prognosis and clinical value of TAM,this article reviews the different roles of TAM in CRC and the potential applications of TAM-targeted technology.Although there is still controversy over the clinical evidence regarding the roles of TAM in CRC,elucidating the roles of TAM in the development of CRC and their importance in treatment may provide new insights for optimizing TAM-centered targeted therapies.