Table of Content

05 November 2026, Volume 46 Issue 11

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Original Articles

Down-regulation of L-PGDS induced by high-glucose is involved in the inflammation of the human chorionic trophoblast cell line HTR-8/SVneo

HUANG Na, ZHANG Xiao, YANG Jie, LI Dongfang, ZHANG Ying, GAO Yahan, YU Lan

2026, 46(11):  1447-1454.  doi:10.16352/j.issn.1001-6325.2026.11.1447

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Objective To investigate the regulatory effect of lipocalin-type prostaglandin D2 synthase (L-PGDS) on the inflammation of occurred in placenta of patients with gestational diabetes mellitus (GDM). Methods Clinical data from 150 GDM and 150 normal glucose-tolerant (NG) pregnant women were collected and analyzed. Placental tissues from 30 GDM and 30 NG women were selected, respectively; Placental structure was examined by HE staining microscopy, and L-PGDS mRNA and protein expression were detected using RT-qPCR and Western blot. Human trophoblast cells(HTR-8/SVneo) were divided into eight groups: normal-glucose control(NC), high-glucose(HG,25 mg/L), HG + empty vector(HG+vector), HG + L-PGDS over-expression(HG+OE-L PGDS), HG+empty vector+CAY10471[prostaglandin D2 receptor(DP₂) antagonist](HG+vector+CAY10471), HG + OE-L-PGDS + CAY10471, HG + empty vector + AZD1981 (prostaglandin D2 receptor antagonist)(HG+vector+AZD1981) and HG + OE-L-PGDS + AZD1981. The level of mRNA and protein expression of L-PGDS, TNF-α, and IL-1β was measured by RT-qPCR and Western blot. Results Clinical blood glucose and inflammatory markers were significantly more in the GDM group than in the NG group(P＜0.05). L-PGDS expression in GDM placenta was significantly lower than in NG group (P＜0.05) and was negatively correlated with inflammatory factors. In high glucose-treated cells, L-PGDS expression was down-regulated(P＜0.05), while inflammatory factor expression increased(P＜0.05). Over-expression of L-PGDS reversed the high glucose-induced up-regulation of inflammatory factors, and this anti-inflammatory effect was inhibited by DP2 antagonists. Conclusions High-glucose-induced reduction of L-PGDS is involved in placental inflammatory responses, which is believed to be a potential target for intervention in placental damage in GDM.

miR-199a-5p alleviates irradiation-induced injury in human umbilical vein endothelial cell line

LIU Chenxi, WEN Wen, QU Mingyue, JIN Zhitao, LU Xiaojiong, XU Jiaojiao, ZHANG Zheng

2026, 46(11):  1455-1462.  doi:10.16352/j.issn.1001-6325.2026.11.1455

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Objective To investigate the protective effect of miR-199a-5p on irradiation-induced injury in human umbilical vein endothelial cells (HUVECs) as well as underlying mechanism. Methods In order to determine the optimal irradiation dose for establishing the injury model.HUVECs were irradiated with X-rays of varying doses (3, 6, 9, and 12 Gy). Cell viability was assessed by CCK-8 assay. Apoptosis was examined by annexin V/PI double staining. The level of intracellular reactive oxygen species (ROS) was evaluated by dithydroethidium (DHE) fluorescent probe. The cells were divided into following four groups as control (Ctrl), irradiation alone (Ir), irradiation + negative control transfection (Ir+NC), and irradiation + miR-199a-5p mimic (Ir+miR-199a-5p). The effects of miR-199a-5p on apoptosis and ROS level were examined. Mitochondrial super oxide production and mitochondrial membrane potential (ΔΨm) were measured by MitoSOX^TM Red and JC-1 probes, respectively. Results Irradiation at 9 Gy significantly suppressed HUVECs viability (P＜0.05),induced apoptosis and enhanced intracellular ROS level(P＜0.05). Over-expression of miR-199a-5p markedly attenuated irradiation-induced apoptosis and oxidative stress (P＜0.05). Furthermore, miR-199a-5p effectively suppressed mitochondrial super oxide generation (P＜0.05) and maintained mitochondrial membrane potential stability after irradiation. Conclusions miR-199a-5p may alleviate irradiation-induced HUVECs injury by inhibiting mitochondrial oxidative stress and stabilizing mitochondrial membrane potential.

Establishment of reference intervals for four urinary kidney injury biomarkers in healthy children in Beijing

LIU Ying, SONG Wenqi, TIAN Xiaoyi

2026, 46(11):  1463-1469.  doi:10.16352/j.issn.1001-6325.2026.11.1463

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Objective To explore and preliminarily establish reference intervals for four urinary kidney injury biomarkers in healthy children aged 0~18 years in Beijing. Methods Healthy children aged 0~18 years were enrolled from physical examination program at maternal and child health hospitals, kindergartens, schools and Beijing Children′s Hospital from December 2016 to October 2018. Subjects with familial genetic disorders or acute/chronic diseases were excluded via questionnaires. All participants underwent clinical physical examinations to evaluate health and growth/development status. The laboratory parameters—including whole blood cell count, liver and kidney function, electrolytes, and routine urinalysis—were examined. The level of four urinary kidney injury biomarkers, including immunoglobulin G(IgG), microalbumin(mAlb), transferrin(TRF), and α1-microglobulin(A1M), was quantitatively measured using immuno-turbidimetry. The relationships of these biomarkers with age and gender were analyzed using scatter plots, quadratic regression, Wilcoxon rank-sum test, Spearman correlation and nonparametric tests. Reference intervals were established by the nonparametric method (97.5th percentile), and 90% confidence intervals for the upper reference limits were calculated using the bootstrap method. An additional 135 urine specimens from healthy children undergoing health checkups in Beijing were collected to validate the reference intervals in accordance with the Chinese health industry standard 《WS/T 402—2024 Establishment of Reference Intervals for Quantitative Test Items in Clinical Laboratories》. Results A total of 1 861 healthy children (964 males, 897 females) aged from 5 days to 18 years met the inclusion and exclusion criteria. In this study, IgG level showed an age-dependent inverted U-shaped distribution, necessitating age-specific reference intervals: ＜9 years: ＜9.12 mg/L; 9-14 years: ＜14.08 mg/L; ＞14 years: ＜10.36 mg/L.mAlb exhibited significant gender differences(males: ＜21.68 mg/L, females: ＜41.67 mg/L, P＜0.001) and a weak positive correlation with age within each gender group(P＜0.001), that result suggested the necessity of a modified establishment of gender- and age-stratified reference intervals(e.g., upper limit for males ≥9 years: 31.24 mg/L; females ≥9 years: 52.21 mg/L). TRF was below the lower limit of detection(2.00 mg/L) in the vast majority(98.71%) of healthy children, and thus its reference interval could be defined as “＜2.00 mg/L”. A1M exhibited an interaction between age and gender, the upper reference limit for males ≥9 years(16.70 mg/L) was higher than that for males ＜9 years(12.40 mg/L), and for females ≥9 years(15.98 mg/L) higher than that for females ＜9 years(13.00 mg/L). Validation using the 135 independent samples showed that the proportions of results within the reference intervals for all four biomarkers were ≥95%. Conclusions This study established reference intervals for four urinary kidney injury biomarkers in healthy children in Beijing. IgG level showed a significant age dependency and should be reported with age-specific intervals. TRF was below the detection limit in the vast majority of healthy children. mAlb and A1M displayed unique age- and gender-related patterns. These results may support the assessment of kidney health in children.

Intrafamilial clinical heterogeneity and protein structure prediction of central hypothyroidism caused by a novel missense mutation (p.F650L) in the IGSF1

ZHAO Yuxing, WANG Linjie, GONG Fengying, DUAN Lian, YANG Hongbo, PAN Hui, ZHU Huijuan

2026, 46(11):  1470-1476.  doi:10.16352/j.issn.1001-6325.2026.11.1470

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Objective To report a central hypothyroidium(CeH) family with a novel immanoglobulin super family member 1(IGSF1) mutation and elucidates its clinical heterogeneity through a systematic review. Methods Clinical data of the family were collected and The level of thyroid and pituitary hormone was evaluated. Genetic diagnosis was performed using whole-exome sequencing and Sanger sequencing, and AlphaFold2 was used to predict the impact of the mutation on protein conformation. A systematic search of Plumbed/MEDLINE was conducted, 137 male patients and 104 female carriers were included for comprehensive analysis. Results A novel mis-sense mutation(c.1948T＞C, p.F650L) in IGSF1 was identified and validated by family co-segregation analysis. Three male patients in the family presented with CeH: The proband exhibited severe neonatal jaundice, macrosomia (birth weight 4.8 kg), and markedly elevated alpha-fetoprotein; The other two patients presented with mild hypothyroidism accompanied by obesity and neuro-developmental delay. Female carriers showed normal thyroid function. AlphaFold2 predicted that this mutation alters the spatial structure of the IGSF1 protein. Literature synthesis revealed that growth retardation (82.3%) and neonatal jaundice (67.1%) were the most common presenting symptoms. Conclusions Phenotypic heterogeneity in the families exists in IGSF1 mutation-related CeH. Neonatal jaundice, macrosomia, and metabolic abnormalities are important clinical manifestations of this condition. This result expands the IGSF1 mutation database, and the structural biology evidence provides a molecular basis for interpreting genotype-phenotype correlations.

Aspirin inhibits vascular damage caused by circulating microparticles from stable angina patients

CHANG Fengjun, WANG Ai, CHENG Gong, LI Hongwen

2026, 46(11):  1477-1482.  doi:10.16352/j.issn.1001-6325.2026.11.1477

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Objective To detect whether aspirin affects the function of circulating particles (MPs). Methods MPs of healthy subjects and stable angina (SA) patients before and after taking aspirin were examined. Then, the thoracic aorta of rats was incubated with MPs from each group to test the effects of MPs on ERK1/2 and p38 MAPK expression with Western blot, the level of adhesion molecule 1(VCAM-1) with ELISA, nitric oxide(NO) and superoxide radical with chemical method. Results Compared with healthy subjects[(3.01±0.72)mg/mL], MPs increased in SA patients[(5.70±0.76)mg/mL](P＜0.05), but decreased after taking of aspirin[(4.08±0.95)mg/mL](P＜0.05). MPs in SA patients reduced the expression of ERK1/2(P＜0.05), increased the expression of p38 (P＜0.05), increase VCAM-1[control:(0.55±0.09)ng/mg protein; SA:(1.17±0.13)ng/mg protein]and super oxide radical[control:(0.53±0.07)RLU/sec/mg protein; SA:(1.64±0.23)RLU/sec/mg protein] levels(P＜0.05), and reduce NO generations compared to control:(2.23±0.67)μmol/g protein; SA:(1.16±0.37)μmol/g protein(P＜0.05). Aspirin partly inhibits the functions of MPs. Conclusions Aspirin can partially block the pro-inflammatory, oxidative stress, procoagulant, and adhesive properties of MPs by regulating ERK/p38 protein and oxidative stress, which is believed to be a new protective mechanism in addition to antithrombotic effect.

Nrf1 alleviates high-fat-induced ferroptosis of murine cardiomyocyte cell line HL-1

SONG Zhiping, HOU Xingzhi, LI Junya, LI Fuxiang, HUANG Bo, FENG Jian

2026, 46(11):  1483-1490.  doi:10.16352/j.issn.1001-6325.2026.11.1483

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Objective To investigate the effect of nuclear factor-erythroid 2-related factor 1(Nrf1) on ferroptosis of murine cardiomyocyte cell line HL-1 induced by high-fat (HF) and its underlying mechanism. Methods HL-1 cells were incubated with different doses of 0 palmitic acid(PA) as 100, 200, 300, 400, and 500 μmol/L PA for 24 hours, and 300 μmol/L PA acid was selected as the subsequent HF intervention concentration. The cells were divided into the following groups: control group, vehicle group (HF + solvent), ferrostatin-1 group (HF+ferroptosis inhibitor), tert-butylhydroquinone (tBHQ) group (HF+Nrf1 agonist), Erastin group (HF+ferroptosisagonist), and tBHQ+Erastin group (HF + Nrf1 agonist + ferroptosis agonist). Cell viability of HL-1 cells was determined by the CCK-8 assay. Intracellular reactive oxygen species (ROS) level was measured by DCFH-DA fluorescent probe assay. The concentration of malondialdehyde(MDA),glutathione(GSH),and glutathione peroxidase 4(GPX4)was determined by commercial available kits. The expression level of ferroptosis marker prostaglandin-endoperoxide synthase 2(PTGS2) and Nrf1 was detected by RT-qPCR and Western blot. Results With the increase of palmitic acid concentration, the viability of HL-1 cells decreased significantly, and after intervention with 300 μmol/L PA, the viability of HL-1 cells was significantly lower than that of the control group(P＜0.001). Under high-fat conditions, the level of myocardial ferroptosis marker PTGS2 increased significantly, while the level of GSH and GPX4 decreased significantly(all P＜0.05 or P＜0.01). On the contrary, after incubation with ferrostatin-1, a specific inhibitor of ferroptosis, cell viability was significantly improved(P＜0.01), and high-fat-induced ferroptosis was significantly reversed(P＜0.05). At the same time, the expression of Nrf1(both mRNA and protein levels) in high-fat group was significantly decreased(P＜0.01). After adding Nrf1 agonist(tBHQ), cell viability increased significantly(P＜0.01), and the degree of ferroptosis decreased significantly(P＜0.01). Further use of the ferroptosis agonist Erastin reversed the myocardial protective effect of Nrf1 agonist(P＜0.05). Conclusions High-fat can aggravate ferroptosis of cardiomyocytes by causing oxidative stress and reducing antioxidant capacity. Nrf1 can play a myocardial protective role in high-fat environment by inhibition of ferroptosis.

Curcumin ameliorates immune dysregulation and bone destruction in rat models with collagen-induced arthritis via inhibiting the mTOR signaling pathway

YU Jiawen, TANG Yuqi, CHEN Wu, XU Liping, ZHANG Yan, DAI Qiaoding

2026, 46(11):  1491-1500.  doi:10.16352/j.issn.1001-6325.2026.11.1491

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Objective To investigate the therapeutic effects of curcumin on immune dys-regulation and bone destruction in collagen-induced arthritis (CIA) rats. Methods A rat model of CIA was established. After successful modeling, the rats were divided into the model group, curcumin group, rapamycin group, and normal group. The general condition and degree of paw swelling in the rats were evaluated before and after treatment. Serum level of cytokines and matrix metalloproteinases(MMPs) was measured by ELISA. Histopathological changes in synovitis were observed by HE staining microscopy. The ratio of Treg to Th17 in peripheral blood was determined by flow cytometry. The number of osteoclasts in the foot joints was shown by using TRAP staining. Bone metabolism markers,RANK/RANKL/ OPG proteins, as well as the expression of mTOR, AKT, and p70S6K in synovial tissue were detected by Western blot analysis. Results Compared with the normal group, the model group exhibited synovial hyperplasia and inflammatory infiltration along with significantly elevated serum level of IL-1β, TNF-α, MMP-1, and MMP-3(P＜0.01). The Treg/Th17 ratio was decreased(P＜0.05), while osteoclast counting was increased(P＜0.01). Serum 1 collagen C-terminal peptide(CTX-1) level was elevated while that of osteocalcin(OC) was reduced(P＜0.001). The RANKL/RANK pathway was up-regulated, whereas OPG expression was down-regulated. Additionally, the expression level of AKT1, mTOR, and p70S6K in synovial tissue was increased(P＜0.01). Compared to model group, curcumin treatment significantly alleviated arthritis in CIA rats, reduced the level of pro-inflammatory cytokines and MMPs(P＜0.01), and up-regulated Treg/Th17 ratio(P＜0.01). IL-10 level was increased, while IL-17 level was decreased(P＜0.01). Osteoclast numbers and activity were reduced, and the imbalance in the RANKL/RANK/OPG system was ameliorated. Furthermore, the expression level of AKT1, mTOR, and p70S6K was down-regulated(P＜0.05). Conclusions Curcumin restores the Treg/Th17 balance and suppresses osteoclast differentiation and activity, the potential mechanism is considered to be the inhibition of the mTOR signaling pathway.

Rosiglitazone inhibits hypertrophic scar formation in rabbit ears

CAI Yuan, JIA Changsha, WANG Li, ZHANG Lanfang, YAN Wen

2026, 46(11):  1501-1507.  doi:10.16352/j.issn.1001-6325.2026.11.1501

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Objective To investigate the inhibitory effect of peroxisome proliferator-activated receptor-γ (PPARγ) agonist rosiglitazone (RSG) on hypertrophic scars of rabbit ears and potential mechanism. Methods Sixteen hypertrophic scar model rabbits were established with 8 adult New Zealand white rabbits. Randomly, 2 rabbits (4 scars in total) were selected for comparative verification with normal rabbit ear skin to verify the successful establishment of the scar model. Remaining 12 scars were randomly divided into two groups: the phosphate baffer saline(PBS) control group (local injection of 1 mL, PBS, n=6) and the RSG group (local injection of 1 mL PBS suspension containing 10 mg RSG, n=6).After the intervention, the changes in the appearance of scars of both groups were observed. Additionally, HE staining and Masson staining were performed to examine the tissue structure, immunohistochemistry was used to detect α-smooth muscle actin (α-SMA), and Q-PCR was used to detect the expression of fibrosis markers type Ⅰ collagen (Col Ⅰ), type Ⅲ collagen (Col Ⅲ), α-SMA, transforming growth factor-β1 (TGF-β1)and adipogenic signaling molecules CCAAT/enhancer-binding protein α(C/EBPα) and PPARγ mRNA. Results Compared with normal rabbit ear skin, red, elevated, and firm hypertrophic scars were observed in the modeled areas. HE staining showed that the dermal thickness of rabbit ear scars was significantly greater than that of normal rabbit ear skin(P＜0.05). Results at each time point after intervention showed that, compared with the PBS control group, the scars in the RSG group became flatter, narrower, and softer in texture. HE and Masson staining demonstrated that the RSG group exhibited clearer skin structure, thinner dermis, reduced collagen deposition with regular arrangement, and the presence of newly formed adipocytes. Immuno-histochemistry showed a decreased expression of α-SMA in the RSG group (P＜0.05). Additionally, mRNA expression of ColⅠ, Col Ⅲ, α-SMA, and TGF-β1 was down-regulated, while the mRNA expression of C/EBPα and PPARγ was up-regulated in the RSG group (P＜0.05). Conclusions Rosiglitazone can effectively inhibit the formation of hypertrophic scars in rabbit ears. Its mechanism may involve down-regulation of fibrosis markers expression while up-regulation of adipogenic signals, thereby promotes formation of new adipocytes. This finding provides a new evidence to support clinical treatment of hypertrophic scars.

Clinical value of digital PCR in patients with severe pneumonia

HOU Yanlin, LIU Zhenya, YAN Liru, GAO Guangsheng

2026, 46(11):  1508-1512.  doi:10.16352/j.issn.1001-6325.2026.11.1508

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Objective To explore the laboratory strengthens and clinical value of digital polymerase chain reaction (dPCR) in patients with severe pneumonia. Methods A total of 93 patients with severe pneumonia admitted to the intensive care unit (ICU) at the Central Hospital Affiliated to Shandong First Medical University from March 2021 to May 2023 were selected and broncho-alveolar lavage fluid was sampled. Both dPCR and classic culture method were performed simultaneously. A retrospective analysis was conducted to evaluate the strengthens of the methodology and clinical value of dPCR in patients with severe pneumonia. Results Pathogen detection showed a higher positive rate by dPCR as compared to the classic method (P＜0.05); Specifically, the positive detection rate of Gram-positive bacteria was significantly higher than that of classic bacteria culture(P＜0.05). Furthermore, dPCR was significantly superior to conventional culture in detecting ≥2 pathogens(all P＜0.001). The McNemar′s test indicated that the positive rate of dPCR alone was significantly higher than that of routine culture(P＜0.001). Conclusions Dihiysl PCR method shows a higher sensitivity than classic bacteria culture in pathogen detection, especially used for the samples from multiple pathogens infections, so is of great value in guiding clinical adjustments to antibiotic therapy.

Creatine combined with exercise regulates skeletal muscle atrophy and mitophagy in rat models of sarcopenia

Maojudan·AZATI, Jianaer·MOLEDABIEKE, BAI Rui, Maierdang·AILIMU

2026, 46(11):  1513-1518.  doi:10.16352/j.issn.1001-6325.2026.11.1513

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Objective To investigate the regulatory effects of creatine supplementation combined with exercise on skeletal muscle atrophy and mitophagy in a rat model of sarcopenia. Methods Thirty rats were randomly divided into the control, model, creatine administration, exercise, and creatine plus exercise groups (n=6 per group). Except for the control group, all groups underwent bilateral ovariectomy combined with dexamethasone administration to establish a sarcopenia model. The creatine group received anhydrous creatine solution of 0.3 g/(kg·d) for 5 weeks; The exercise group underwent training for 5 weeks (3 sessions/week); And the creatine plus exercise group received both interventions. Parameters included the sarcopenia index (SI; wet skeletal muscle weight-to-bodyweight ratio), and protein expression was determined by Western blot. Results Compared with the control group, the model group exhibited a reduced SI value (P＜0.05), decreased cross-sectional area of muscle fibers (1 244 μm² vs. 2 156 μm², P＜0.05) and an increased proportion of centralized nuclei (28.67% vs. 12.43%, P＜0.05), down-regulated protein kinase B(AKT) expression, and up-regulated autophage related 12 gene(ATG12) expression (all P＜0.05).Compared to model group, the creatine, exercise group and creatine + exercise groups all demonstrated significant increases in SI values and muscle fiber cross-sectional areas (all P＜0.05) and centralized nuclei proportion (all P＜0.05). The creatine plus exercise group showed significantly higher SI values and cross-sectional areas of muscle fiber than either the creatine or exercise group alone (all P＜0.05). Moreover, ATG12 expression in the creatine plus exercise group was significantly down-regulated as compared to both the creatine and exercise groups (all P＜0.05). Conclusions Creatine supplementation combined with exercise alleviates skeletal muscle atrophy and mitigates mitophagy imbalance in a rat model of sarcopenia by synergistically up regulating the SI value, improving muscle fiber morphology, and modulating the expression of AKT, ATG12, Beclin1, and ULK1.

Traditional Chinese medicine Jin-Mai-Tong promotes differentiation of nMSC phenotype to MSC phenotype in Schwann cells under high-glucose conditions through p38 MAPK pathway

SHI Yue, LIANG Xiaochun, SUN Qing, WANG Xiaowan

2026, 46(11):  1519-1525.  doi:10.16352/j.issn.1001-6325.2026.11.1519

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Objective To investigate the effect of the Chinese herbal medicine Jin-Mai-Tong (JMT) on the differentiation of Schwann cells (SCs) under high-glucose conditions. Methods Primary Schwann cells were cultured to establish a high-glucose injury model, and intervened with JMT. The number of myelinating phenotype Schwann cells(MSCs) was counted; The protein expression levels of brain-derived neurotrophic factor(BDNF) and glial cell line-derived neurotrophic factor(GDNF) in culture supernatant were determined via ELISA; The expression levels of p38 mitogen-activated protein kinase(p38 MAPK), c-JUN, early growth response protein 2(EGR2) at both protein and mRNA levels were detected. Results The p38 MAPK pathway was activated under high-glucose conditions, accompanied by up regulated c-JUN protein expression and down regulated EGR2 expression. JMT extract significantly inhibited the activation of the p38 MAPK pathway, suppressed c-JUN protein expression, up regulated EGR2 expression, and increased the secretion of BDNF and GDNF proteins. Conclusions JMT can promote the differentiation of MSCs and increase the synthesis of neurotrophic factors by inhibiting the p38 MAPK pathway.

Clinical Sciences

Detection and assessment value of serum lactate dehydrogenase in pediatric patient with Mycoplasma pneumoniae pneumonia

ZHONG Meifeng, DING Shuai, ZHANG Xu

2026, 46(11):  1526-1531.  doi:10.16352/j.issn.1001-6325.2026.11.1526

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Objective To analyze the detection and assessment value of serum lactate dehydrogenase (LDH) in children with Mycoplasma pneumoniae pneumonia(MPP), and to explore the threshold of LDH in MPP children with different clinical features/disease indications. Methods Totally 257 children with MPP who were hospitalized in Huai′an Hospital from February 2020 to July 2023 were selected as the case(test) group and 257 healthy children who underwent physical examinations in the outpatient department of Huai′an Hospital in same period were selected as the control group. Serum LDH level of two groups before and after treatment were compared and analyzed. According to the severity of MPP in children, they were divided into ordinary MPP and severe MPP. The medical records of MPP patients were collected. The serum LDH levels of children with different clinical characteristics were analyzed, and the diagnostic/predictive evaluation value and threshold of serum LDH under different clinical characteristics/disease indications were explored by receiver operation characteristic (ROC). Results 1)The serum LDH level gradually increased in control group, normal MPP group and severe MPP group(P＜0.05); 2)The group of children with respiratory virus mixed infection, lung lesions accounting for≥1/3 of the total lung volume, post-infections bronchiolitis obliterans(PIBO), pleural effusion, and extra-pulmonary complications showed a significantly higher serum LDH level compared to the group of children without these conditions or with negative corresponding indicators (P＜0.05).3)On the first day of admission, there was a positive correlation between serum LDH level and the total duration of fever in MPP patients (P＜0.001); 4)ROC analysis showed that serum LDH level had an impact on respiratory virus coinfection, pneumonia severity PIBO, The ROC-AUC (95% CI) of detection and assessment values for the diagnostic indicators of pleural effusion and extra-pulmonary complications were 0.723 (0.456-0.970), 0.772 (0.563-0.966), 0.699 (0.401-0.980), 0.750 (0.502-0.981), and 0.725 (0.507-0.927),respectively. The highest was the detection evaluation of pneumonia severity, and the lowest was the detection evaluation of PIBO. The corresponding detection evaluation thresholds (U/L) were 860, 880, 850, 830, and 900, respectively; The predictive value of serum LDH levels for the severity of MPP in children: ROC-AUC (95% CI) was 0.777 (0.636-0.920), corresponding to a predictive evaluation threshold (U/L) of 760. Conclusions Serum LDH is closely related with respiratory virus co-infection and severe pneumonia shown by chest X-rays in children with MPP PIBO. Elevated level of serum LDH is observed in cases of pleural effusion, extra-pulmonary complications and severe illness. LDH may support diagnosis or prediction of clinical course and indications of MPP in children.

Preliminary safety evaluation of intramuscular administration of SeV-hFGF2/dF for chronic lower limb ischemia

LIAN Wenzhuo, WANG Peng, DI Xiao, SONG Xitao, ZHENG Yuehong, NI Leng, LIU Changwei

2026, 46(11):  1532-1538.  doi:10.16352/j.issn.1001-6325.2026.11.1532

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Objective To evaluate the safety and preliminary therapeutic efficacy of intramuscular injection of SeV-hFGF2/dF (BF30), a viral vector carrying the hFGF2 gene, in patients with peripheral arterial disease (PAD). Methods Twelve male PAD patients, aged(48±13) years(range: 28-66 years), were enrolled. Rutherford classifications were as follows: stage 2(n=1, 8.3%), stage 3(n=1, 8.3%), stage 4(n=3, 25%), and stage 5(n=7, 66.7%). All patients were ineligible for or unlikely to benefit from surgical intervention and received varying doses of BF30 via intramuscular injection in the affected limb based on enrollment order. Adverse events were monitored during follow-up and viral genome concentration, angiogenic factors, pro-inflammatory cytokines, and anti-drug antibody levels were measured. Therapeutic efficacy was preliminarily evaluated using pain scores, ankle-brachial index (ABI), Rutherford classification, and quality-of-life scales. Results During the 6-month follow-up, no severe adverse events or grade 3/4 adverse reactions related to BF30 injections were observed. Viral genome levels in all subjects were below the detection limit, with seven cases testing negative in hemagglutination assays. Serum levels of hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), and pro-inflammatory cytokines showed no significant changes from baseline. Anti-drug antibodies were undetectable in all participants. patients exhibited significant alleviation of resting pain(P＜0.05). Conclusions Intramuscular injection of SeV-hFGF2/dF demonstrates favorable safety in PAD patients, though further studies are needed to confirm efficacy.

Clinical characteristics of 148 cases of patients with hypereosinophilia of unknown origin

CHEN Chunyue, YIN Yue, ZHANG Yun, CHEN Jialin, ZENG Xuejun

2026, 46(11):  1539-1545.  doi:10.16352/j.issn.1001-6325.2026.11.1539

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Objective To improve the recognition of hypereosinophilia (HE) of unknown origin and provide a reference for its clinical diagnosis and management. Methods Patients with HE of unknown origin admitted to the Department of General Medicine at Peking Union Medical College Hospital between February 2012 and April 2025 were retrospectively enrolled. Baseline characteristics, laboratory findings, organ system involvement, etiological classification, treatment, and follow-up data were collected. Clinical characteristics and outcomes were compared between patients with secondary HE and those with idiopathic HE. Results Total of 148 patients with HE of unknown origin were included, predominantly young and middle-aged men, with median disease duration of 7.5 months; 98.0% had sought medical care at other hospitals before admission. Severe HE was observed in 60.8% of patients and 98.6% had organ involvement, most commonly affecting the skin, respiratory, and digestive systems. An etiological diagnosis was established in 82 patients (55.4%), with secondary HE accounting for 54.1% of the total cohort and autoimmune diseases being the most common cause; Idiopathic HE accounted for 44.6%. Compared with patients with idiopathic HE, those with secondary HE had higher hypersensitive C-reactive protein(sharp) levels and a higher incidence of lymphadenopathy, as well as more frequent involvement of the nervous system, vasculature/thrombotic system, kidneys, and ear, nose, and throat(ENT) system(P＜0.05). Following etiology-directed treatment, patients with secondary HE had a lower long-term relapse rate. Conclusions HE of unknown origin is mainly found in young and middle-aged males with multisystem involvement and diagnostic challenges. Autoimmune diseases represent the most common underlying causes of secondary HE. The hsCRP level and patterns of organ involvement may help differentiate HE of unknown origin subtypes. Etiology-directed treatment should be emphasized in secondary HE, while patients with idiopathic HE require long-term follow-up.

Hypertonic glucose combined with lidocaine and continuons negative pressure suction for treating prolonged air leak after pulmonary resection

DING Haibing, WANG Yi, QIN Haifeng, QIAN Xiaowei, YOU Jijun

2026, 46(11):  1546-1549.  doi:10.16352/j.issn.1001-6325.2026.11.1546

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Objective To evaluate the efficacy and safety of intrapleural injection of 50% glucose (hypertonic glucose) combined with 2% lidocaine and continuous negative pressure suction for treatment of prolonged pulmohay air leak (PAL) after thoracoscopic pulmonary resection. Methods A retrospective cohort study was conducted in a group of 56 patients who developed PAL (＞5 days) after thoracoscopic pulmonary resection during the period from January 2023 to December 2024. Patients were divided into two groups: the control group (n=26) who received continuous negative pressure suction alone; The combination group (n=30) who received intrapleural injection of 50% glucose plus lidocaine combined with continuous negative pressure suction. The primary comparisons included were duration of air leak, chest tube indwelling time, post-operative hospital stay, treatment efficacy, and complication rates. Results The combination group showed significantly shorter duration of air leak, chest tube indwelling time, and post-operative hospital stay as compared to control group (P＜0.001). The overall treatment efficacy rate in the combination group was 93.3%,that was significantly higher than 76.9% in the control group (P＜0.05). No significant difference was found in the incidence of complications between the two groups. Conclusions Intrapleural injection of 50% glucose combined with lidocaine and continuous negative pressure suction is a safe and effective method for treatment of PAL after thoracoscopic pulmonary resection. Through multiple synergistic mechanisms, this combined approach significantly shortens the duration of air leak and demonstrates superior outcomes compared to negative pressure suction alone.

Mini Reviews

Progress of research on the role of uncoupling protein 2 in hepatocellular carcinoma

SUN Fengqi, YU Yingjie, SONG Yunjia, YANG Jing, ZHAO Weiming

2026, 46(11):  1550-1553.  doi:10.16352/j.issn.1001-6325.2026.11.1550

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Uncoupling protein 2 (UCP2) is a proton transport protein in the inner membrane of mitochondria, which promotes the malignant progression of hepatocellular carcinoma (HCC) by inducing uncoupling effect through proton leakage. UCP2 promotes metabolic reprogramming of tumor cells and enhances glycolysis to meet the energy requirements for rapid proliferation; Reduction of mitochondrial membrane potential may decrease reactive oxygen species and prevent oxidative stress damage to tumor cells; It can also regulate apoptosis and autophagy processes, and promote chemotherapy resistance, and so on.

Multifaceted role of Piezo-type mechanosensitive ion channel component 1(Piezo1) in aging and age-related diseases

ZHANG Bei, LIU Kun, HOU Yibing, ZHANG Heng, ZHU Bing

2026, 46(11):  1554-1559.  doi:10.16352/j.issn.1001-6325.2026.11.1554

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Aging and age-related diseases have a significant impact on the health of the growing global elderly population. The Piezo-type mechano-sensitive ion channel component 1(Piezo1) senses changes in the mechanical micro-environment of tissues and plays a critical role in the pathological processes of aging and aging-related diseases. This review summarizes recent research progress on Piezo1 in aging and age-related diseases focusing on multi-dimensional mechanisms of action in these processes at the tissue, cellular and whole-organism nutritional sensing level. Also, that briefly summarizes the current approaches to targeting at Piezo1 in aging intervention, to highlight the strengthens and weaknesses. Future perspectives include the use of emerging technologies to precisely elucidate the spatiotemporal roles of Piezo1, with the aim of exploring safer and more accurate therapeutic strategies and solid evidence for management of aging-associated disorders.

Progression of prostate-specific membrane antigen (PSMA) PET/CT in the diagnosis and treatment of prostate cancer

CHEN Zhixin, LIU Xuan

2026, 46(11):  1560-1565.  doi:10.16352/j.issn.1001-6325.2026.11.1560

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To systematically summarize the progress of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) can accurately identify primary prostate lesions, lymph node micro metastases, and distant metastases. It performs significantly better than traditional imaging in early diagnosis, precise staging, locating biochemical recurrence, and treatment evaluation. It can revise the initial staging in 20%-30% of intermediate- to high-risk patients, with a detection rate exceeding 80% when serum prostate-specific antigen(PSA) is above 0.2 ng/mL. PSMA PET/CT has become a core imaging method for precision diagnosis and treatment of prostate cancer. Clinical practice should strictly follow guideline-based standards, and future developments are likely to focus on multimodal integration and combined targeted diagnosis and treatment.

Advances in parameters for evaluating preoperative preparation of pheochromocytoma and paraganglioma

HAN Geyang, LI Yuke, HAN Wencong, ZHANG Zheng, LI Nan

2026, 46(11):  1566-1572.  doi:10.16352/j.issn.1001-6325.2026.11.1566

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Pheochromocytoma and paraganglioma (PPGL) are rare neuroendocrine tumors, and intraoperative hemodynamic instability (IHI) represents a major challenge in their perioperative management. This article systematically reviews three routinely used parameters for evaluating preoperative preparation: preoperative blood pressure, duration of α-adrenergic blockade, and clinical symptoms. These parameters primarily reflect static hemodynamic status or indirect pharmacological effects and therefore may not comprehensively characterize vascular reactivity and peripheral perfusion. Moreover, their predictive value for IHI remains limited. As a noninvasive and continuous measure of dynamic perfusion, the peripheral perfusion index (PPI) reflects changes in peripheral vascular tone and tissue perfusion and may provide complementary information for assessing the adequacy of preoperative preparation in patients with PPGL.

Medical Education

Digital intelligence technology empowers the teaching of “Basic Medical Experimental”course in nursing

JI Chao, KANG Jingting, YE Caiying

2026, 46(11):  1573-1576.  doi:10.16352/j.issn.1001-6325.2026.11.1573

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Objective To explore the application and supportive effect of digital intelligence technology in the course of “Basic Medical Experiment” for nursing students at Peking Union Medical College(PUMC). Methods After a round of teaching practice of the integrated experimental course “Basic Medical Experiment” supported by digital intelligence among nursing students, comprehensive scores were given to students′ performance in experimental course. The scores of the theoretical course supported by this experimental course were analyzed, and students′ feedback was also analyzed. Results Students performed well overall in this course, which significantly promoted their mastery of corresponding theoretical knowledge (P＜0.05) and positive feedback was received from students. Conclusions This study provides a basis for PUMC to further optimize the experimental teaching system, expands experimental teaching methods, and explores ways of accumulating and inheriting teaching resources.

Exploration of integrating medical humanities education into allergology course

WANG Zixi, CAO Jingwen, WEN Liping

2026, 46(11):  1577-1581.  doi:10.16352/j.issn.1001-6325.2026.11.1577

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The value of medical humanities education in modern medical training has become increasingly recognized. Strong professional competence in this area not only facilities doctor-patient communication and patients′ satisfaction, but also improves treatment adherence and clinical outcomes. In the field of allergology, however, teaching has long been dominated by a “technical orientation with excessive emphasis on clinical procedures and technology but neglect patients′ psychological experiences and social challenges. This study explored an approach to systematically integrate medical humanities with doctors′ training in the field of allergy management. That education model proposed a four-dimensional teaching framework-covering communication, psychological support, ethical decision-making, and narrative reflection-supported by a three-pronged mechanism of faculty development, modularized curricula, and scenario-based practice. In addition, digital innovations such as virtual simulation and AI-empowered assessment methodology were introduced to enhance the measurability and sustainability of humanities training. This model provides a feasible pathway for innovation in allergology caurse and education so to strengthen the safety and outcomes of clinical performance

Current status and optimization of strategy guiding epilepsy teaching during clinical clerkship and internship for medical students

CHEN Jianhua

2026, 46(11):  1582-1586.  doi:10.16352/j.issn.1001-6325.2026.11.1582

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To analyze the educational tasks and current problems of epilepsy teaching during clinical clerkship and internship for medical students and to optimize training strategies. A narrative review of epileptology education standards, medical education guidance and relevant studies were conducted focusing on curricular objectives, clinical exposure, electroencephalogram(EEG) education, emergency training, assessment, faculty development and communication. Current teaching mainly relies on classic lectures, bedside teaching and case discussion. Major weaknesses are fragmented knowledge-oriented objectives, separation of theory from practice, insufficient representative seizure and EEG resources, incomplete feedback loops for emergency training and assessment, limited communication and liberal education. Proposed strategies include competency-based and clinical performance oriented objectives, a spiral curriculum, a progressive video-standardized patient-simulation-real patient pathway, minimum EEG competencies, mastery learning, programmatic assessment and multicenter validation. Aligning objectives, teaching and assessment through observable clinical task may improve graduate students′ clinical competencies in seizure recognition, initial management, communication and thus to promote standardized epilepsy education.