中国医学科学院学报最新文献

Objective To explore the effects and mechanisms of Wendan Decoction(WDT)on anxiety-like and fear-like behaviors,as well as sleep,in the rat model of insomnia due to heart-gallbladder qi deficiency. Methods SD male rats were randomly allocated into blank,model,Anshen Dingzhi pills(0.54 g/kg),low-,medium-,and high-dose(8.7,17.4,and 34.8 g/kg)WDT groups.Plantar electric stimulation combined with forced exercise was used for modeling,and the rats were administrated with corresponding agents by gavage for 7 consecutive days after the modeling.Behavioral tests were performed,and the c-Fos protein level,neuron firing rate,and hippocampal neurotransmitter content in brain regions were determined. Results Compared with the model group,medium-dose WDT shortened the avoidance time,freezing time,and sleep latency(P<0.001,P<0.001,P=0.010).Furthermore,medium-dose WDT attenuated the elevated c-Fos expression in emotion-related brain regions,including the prelimbic cortex(P<0.001),infralimbic cortex(P<0.001),basolateral amygdala(P<0.001),central amygdala(P<0.001),ventral hippocampus(P=0.004),periaqueductal gray(P<0.001),and dorsal raphe nucleus(P<0.001),as well as the increased firing rate of ventral hippocampal interneurons(P=0.005).In addition,it reduced the hippocampal glutamate content and the glutamate/gamma-aminobutyric acid ratio(P<0.001,P=0.013). Conclusions WDT can reduce the excitatory drive of glutamic acid to interneurons by inhibiting the release of glutamic acid from pyramidal neurons of ventral hippocampus,thus playing a role in improving sleep and mitigating the anxiety-like,fear-like,and depression-like behaviors in the rat model of insomnia due to heart-gallbladder qi deficiency.

Soft tissue sarcomas represent a rare and highly heterogeneous category of malignant tumors,with the diagnosis and treatment contingent upon the precise identification of histopathological subtypes.Due to their complex molecular mechanisms and diverse clinical behaviors,histological classification methods sometimes struggle to accurately distinguish different subtypes,highlighting the need for effective biomarkers for early diagnosis.As an emerging technology,liquid biopsy provides real-time tumor dynamic information for the diagnosis,recurrence monitoring,and treatment effect evaluation of soft tissue sarcomas by analyzing biomarkers in body fluids.This article comprehensively reviews the advancements in the research and clinical application of tumor biomarkers in the liquid biopsy of soft tissue sarcomas.It emphasizes biomarkers such as circulating tumor cells,cell-free DNA,non-coding RNA,and extracellular vesicles.Although liquid biopsy has shown great potential in the study of soft tissue sarcoma biomarkers,its clinical application still faces the challenges of low sensitivity and specificity,difficulty in tracing tissue origin,and the need for integration of multi-omics techniques.In the future,it is necessary to further develop conventional,non-invasive,and highly specific liquid biopsy markers and incorporate multi-omics technology and other clinical detection methods to promote the precise diagnosis and treatment of soft tissue sarcomas.

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.

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.

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.

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.

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.

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.