Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences最新文献

{"title":"[Metabolomics study on anti-inflammatory effects of Guanjie Zhentong Babu plaster in collagen-induced arthritis rats].","authors":"Tian Xu, Jinling Xu, Xiaolin Yang, Rong Shi, Liqiang Ni","doi":"10.3724/zdxbyxb-2025-0640","DOIUrl":"10.3724/zdxbyxb-2025-0640","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the anti-inflammatory effects of Guanjie Zhentong Babu plaster on collagen-induced arthritis (CIA) rats and its potential mechanisms.</p><p><strong>Methods: </strong>Rats were randomly divided into normal control group and experimental group. The experimental group was immunized with bovine type Ⅱ collagen emulsion to establish the CIA rat model, and then subdivided into the following groups: cold syndrome model group, heat syndrome model group, high-dose cold syndrome group, high-dose heat syndrome group, low-dose cold syndrome group, positive control cold syndrome group, positive control heat syndrome group, and blank plaster cold syndrome group, with eight rats in each group. Arthritis index (AI) scores of paw joints were evaluated on day 0, day 4, day 7, and day 14 after drug administration. A plethysmometer was used to assess hind paw joint swelling. After completion of the pharmacodynamic evaluation, the rats were sacrificed, and hematoxylin and eosin staining was performed to observe histopathological changes in ankle joint tissues. Serum metabolite profiles were analyzed using ultra performance liquid chromatography coupled with linear ion trap quadrupole-Orbitrap mass spectrometry, and metabolic pathway enrichment analysis was conducted to explore the potential mechanisms of drug intervention. In addition, immunohistochemistry and enzyme-linked immunosorbent assay were performed to investigate the levels of tumor necrosis factor-α (TNF-α), IL-17, and IL-10.</p><p><strong>Results: </strong>Compared with the cold syndrome model group, the high-dose cold syndrome group showed a significant improvement in AI scores on day 14 (<i>P</i><0.05) and a significant reduction in hind paw joint swelling (<i>P</i><0.01), accompanied by markedly alleviated histopathological damage in the ankle joint. In contrast, no significant changes were observed in the high-dose heat syndrome group compared with the heat syndrome model group. Metabolomics analysis revealed that arginine biosynthesis and purine metabolism pathways were markedly disrupted in the cold-syndrome model group, and compared with the cold syndrome model group, the contents of <i>L</i>-citrulline were significantly increased, whereas the contents of uric acid and xanthine were significantly decreased in the high-dose cold syndrome group (all <i>P</i><0.05). Immunohistochemistry and enzyme-linked immunosorbent assay results indicated that, compared with the cold syndrome model group, TNF-α and IL-17 levels in synovial tissue and serum were significantly decreased (all <i>P</i><0.05), whereas IL-10 levels were significantly increased (all <i>P</i><0.01) in the high-dose cold syndrome group.</p><p><strong>Conclusions: </strong>Guanjie Zhentong Babu plaster alleviates joint injury in CIA rats with cold syndrome by regulating arginine and purine metabolism-related pathways to restore inflammatory balance.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"222-233"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Perinatal tuberculosis presenting as endobronchial tuberculosis diagnosed by bronchoscopy: a case report].","authors":"Hujun Wu, Yanfen Lin, Xiaofen Tao, Lei Wu","doi":"10.3724/zdxbyxb-2025-0806","DOIUrl":"10.3724/zdxbyxb-2025-0806","url":null,"abstract":"<p><p>A 3-month and 17-day-old male infant presented with a 4-week history of cough and was initially diagnosed with pneumonia. Despite over 20 days of antibiotic therapy (including ceftriaxone, piperacillin-tazobactam, and vancomycin), his symptoms did not improve. Chest CT revealed worsening pulmonary infiltrates. Bronchoscopic findings revealed stenosis of the left main bronchus with mucosal erosion, granuloma, and caseous necrosis. Rapid on-site evaluation of bronchoalveolar lavage fluid demonstrated positivity on acid-fast staining. Together with positive T-SPOT and high-throughput sequencing results for <i>Mycobacterium tuberculosis</i>, the infant was diagnosed with perinatal endobronchial tuberculosis. The infant was started on an HRZLzd anti-tuberculosis regimen (isoniazid 10 mg·kg^－¹·d^－¹ intravenous infusion, rifampicin 12.5 mg·kg^－¹·d^－¹ orally, pyrazinamide 30 mg·kg^－¹·d^－¹ orally, and linezolid 10 mg·kg^－¹·d^－¹ intravenous infusion). After one month of treatment, his clinical symptoms and pulmonary imaging findings markedly improved.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":"55 3","pages":"278-282"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Screening of the anti-<i>Malassezia furfur</i> active fraction from <i>Rosa chinensis</i> Jacq. and study on its mechanism against seborrheic dermatitis].","authors":"Zejun Guo, Xiangyu Xi, Xiaoming Zhong, Fengmei Qiu, Zhen Huang","doi":"10.3724/zdxbyxb-2025-0616","DOIUrl":"10.3724/zdxbyxb-2025-0616","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To screen Chinese herbal medicines for optimal inhibitory activity against &lt;i&gt;Malassezia furfur&lt;/i&gt; (&lt;i&gt;M. furfur&lt;/i&gt;), isolate and identify the most potent antimicrobial fraction, and investigate its underlying mechanism of action.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The Chinese herbal extract and its polar fractions exhibiting the strongest inhibitory effect against &lt;i&gt;M. furfur&lt;/i&gt; were initially screened from 20 Chinese herbal medicines using the Oxford cup method and broth microdilution assay. A highly active subfraction was subsequently obtained through silica gel column chromatography. The effects of this active subfraction on the growth and cell structural integrity of &lt;i&gt;M. furfur&lt;/i&gt; were evaluated by turbidimetry, exogenous sorbitol hypertonic protection assay, extracellular alkaline phosphatase activity assay, propidium iodide fluorescence staining, and crystal violet staining. &lt;i&gt;M. furfur&lt;/i&gt;-induced inflammatory models in HaCaT keratinocytes and SZ95 sebocytes were employed. The safety of the active subfraction was assessed by MTT assay for cell viability. Nitric oxide release was measured by Griess test, and the levels of IL-6 and tumor necrosis factorinduced inflammatory models in HaCaT keratinocytes and SZ95 sebocytes were employed. The safety of the active subfraction was assessed by MTT assay for cell viability. Nitric oxide release was measured by Griess test, and the levels of IL (TNF)-α in cell supernatants were determined by ELISA. Lipid synthesis in SZ95 cells was evaluated by Nile red staining. The chemical constituents of the highly active fraction obtained by silica gel column chromatography were analyzed and identified by ultra performance liquid chromatography-mass spectrometry (UPLC-MS). Potential anti-seborrheic dermatitis targets and pathways were predicted through construction of a protein-protein interaction network, Gene Ontology (GO) functional annotation, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the extracts of 20 Chinese herbal medicines, the extract of &lt;i&gt;Rosa chinensis&lt;/i&gt; Jacq&lt;i&gt;.&lt;/i&gt; demonstrated superior inhibitory activity against &lt;i&gt;M. furfur&lt;/i&gt;. Its ethyl acetate fraction exhibited the most potent antimicrobial effect, from which subfraction Fr.2 was isolated as the most active component, with an inhibition zone diameter of (25.30±0.49) mm and a minimum inhibitory concentration of 1 mg/mL. Fr.2 effectively inhibited the growth of &lt;i&gt;M. furfur&lt;/i&gt; (&lt;i&gt;P&lt;/i&gt;&lt;0.05) and disrupted cellular structures, including the cell wall, cell membrane, and biofilm. Within a safe concentration range (25-100 μg/mL), Fr.2 showed no cytotoxicity toward HaCaT and SZ95 cells and dose-dependently reduced the release of inflammatory factors and lipid synthesis in SZ95 cells. A total of 27 constituents were identified from Fr.2 by UPLC-MS, including organic acids, flavonoids (such as myricetin, quercetin, and kaempferol),","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"234-245"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prediction and <i>in vitro</i> validation of potential indications for ginkgolide B based on network pharmacology strategies].","authors":"Huiying Zhang, Qing Fan, Yihua Zhang, Mengchen Liu, Guozhen Cui","doi":"10.3724/zdxbyxb-2025-0696","DOIUrl":"10.3724/zdxbyxb-2025-0696","url":null,"abstract":"<p><strong>Objectives: </strong>To predict potential indications for ginkgolide B (GB) based on network pharmacology strategies.</p><p><strong>Methods: </strong>GB targets were comprehensively identified by integrating data from the Therapeutic Target Database, the Comparative Toxicogenomics Database, and BindingDB, followed by further validation based on literature. A standardized disease-gene dataset was established by integrating data from the genome-wide association study and the Online Mendelian Inheritance in Man Database. The topological proximity between GB targets and disease modules within the human protein-protein interaction network was quantified using network proximity metrics, with statistical significance evaluated via <i>Z</i>-score and permutation testing (<i>Z</i><0, <i>P</i><0.05). Candidate diseases were classified according to MeSH terms, visualized through network mapping, and further characterized by gene set similarity based on the Jaccard index. Experiments in RAW 264.7 macrophages were conducted to validate the inhibitory effect of GB on nitric oxide and proinflammatory cytokines.</p><p><strong>Results: </strong>Twelve potential GB targets were identified, and a disease-gene dataset encompassing 680 diseases was established. Network proximity analysis revealed significant associations between GB and 22 diseases, of which 11 had prior literature support. Disease classification indicated that the predicted indications of GB were primarily enriched in immune-mediated inflammatory diseases, with notable examples including juvenile idiopathic arthritis (<i>Z</i>=－3.10) and Crohn disease (<i>Z</i>=－3.05). Network analysis suggested that GB may exert pleiotropic regulatory effects across multiple diseases via key targets such as MAPK1. The strongest gene set similarity was observed between juvenile idiopathic arthritis and ankylosing spondylitis (Jaccard index=0.60). <i>In vitro</i> experiments with macrophages demonstrated that GB suppresses the production of nitric oxide and proinflammatory cytokines, thereby supporting its potential as a therapeutic agent for immune-mediated inflammatory diseases.</p><p><strong>Conclusions: </strong>This study systematically predicted 22 potential indications for GB and confirmed its therapeutic potential for immune-mediated inflam-matory diseases through <i>in vitro</i> experiments.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"267-277"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association between dynamic elevation of high-sensitivity cardiac troponin T and functional outcomes in patients with acute ischemic stroke].","authors":"Zhenhua Xi, Haitao Hu, Xin Huang, Yang Gao, Fengying Wu, Xinchun Jin, Xiaofeng Zhu, Yaode He, Yuping He, Lingqun Mao","doi":"10.3724/zdxbyxb-2025-0435","DOIUrl":"10.3724/zdxbyxb-2025-0435","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between in-hospital dynamic elevation of high-sensitivity cardiac troponin T (hs-cTnT) and early neurological deterioration (END) as well as 3-month functional outcomes in patients with acute ischemic stroke (AIS).</p><p><strong>Methods: </strong>Data of AIS patients who underwent two hs-cTnT measurements during hospitalization between March 2017 and November 2024 were extracted from the Comparison Influence to Prognosis of CTP and MRP in AIS Patients (CIPPIS) database (NCT03367286) for retrospective analysis. Patients were categorized into a dynamic elevation group and a non-elevation group based on whether their hs-cTnT increased by more than 20% from the baseline level. The incidences of END and 3-month functional independence were compared between the two groups. END was defined as a ≥4-point increase in the National Institutes of Health Stroke Scale (NIHSS) score within 7 days of onset, and functional independence was defined as a modified Rankin Scale (mRS) score 0-2. Binary logistic regression was used to analyze the relationship between hs-cTnT dynamic elevation and the outcomes. Sensitivity analysis (excluding patients with acute myocardial infarction or severe renal dysfunction) and subgroup analyses were performed to assess the robustness of the findings.</p><p><strong>Results: </strong>A total of 1049 patients were included (median age 73 years). Among them, 406 patients (38.7%) were female, 226 patients (21.5%) exhibited hs-cTnT dynamic elevation. Compared with the non-elevation group, the dynamic elevation group had a significantly higher incidence of END (9.71% <i>vs</i>. 15.42%, <i>P</i><0.05) and lower proportions of patients with 3-month mRS scores of 0-1 (37.75% <i>vs.</i> 26.57%, <i>P</i><0.01), 0-2 (48.71% <i>vs.</i> 36.71%, <i>P</i><0.01), and 0-3 (63.87% <i>vs.</i> 55.56%, <i>P</i><0.05). The 3-month all-cause mortality was also higher in the dynamic elevation group (9.20% <i>vs.</i> 14.01%, <i>P</i><0.05). After adjusting for confounders (including age, sex, baseline NIHSS score, baseline hs-cTnT level, TOAST classification, and reperfusion therapy), dynamic elevation of hs-cTnT remained independently associated with a higher risk of END (adjusted OR=1.73, 95%CI: 1.07-2.82, <i>P</i><0.05) and lower odds of achieving 3-month mRS scores of 0-1 (adjusted OR=0.65, 95%CI: 0.44-0.96, <i>P</i><0.05) and 0-2 (adjusted OR=0.67, 95%CI: 0.47-0.97, <i>P</i><0.05). The results were consistent in sensitivity analysis, and no significant interactions were observed across various subgroups (all interactions <i>P</i>>0.05).</p><p><strong>Conclusions: </strong>In patients with AIS, dynamic elevation of hs-cTnT is independently associated with an increased risk of END and poorer 3-month functional outcomes. This association may reflect the adverse impact of acute myocardial injury on stroke prognosis.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"137-144"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association of sodium-glucose linked transporter 2 inhibitors with functional outcomes at discharge in diabetic patients with acute ischemic stroke].","authors":"Xin Huang, Xiaoxiang Wang, Yiqing Jiang, Ke Shen, Zhenlei Jia, Xiangdong Ma, Bifeng Zhong, Yuping He, Min Lou","doi":"10.3724/zdxbyxb-2025-0474","DOIUrl":"10.3724/zdxbyxb-2025-0474","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between the use of sodium-glucose linked transporter 2 (SGLT2) inhibitors and functional outcomes at discharge in diabetic patients with acute ischemic stroke (AIS).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the Acute Stroke Patients for Stroke Management Quality Evaluation online database (CASE-Ⅱ, NCT04487340) for patients admitted between January 2022 and November 2024. Diabetic patients with AIS were categorized as SGLT2 inhibitor users or non-users (control group). Patients' functional outcomes were assessed using the modified Rankin Scale (mRS) score. Propensity score matching (PSM) was performed in a 1∶2 ratio. Multivariate logistic regression models were used to assess the association between SGLT2 inhibitor use and outcomes. Stratified analyses were performed based on pre-existing diabetes versus newly diagnosed diabetes during the hospitalization and the impact of long-term and short-term use of SGLT2 inhibitors on patients' functional outcomes at discharge was analyzed.</p><p><strong>Results: </strong>The study included 9220 patients (mean age 67±11 years; 39.38% female), of whom 1915 (20.77%) were SGLT2 inhibitor users. There were 1912 cases in the user group and 3683 cases in the non-user group after PSM. Before PSM, the proportion of patients with an mRS score 0-2 at discharge was significantly higher in the SGLT2 inhibitor group than that in the control group (79.84% <i>vs</i>. 69.19%, <i>P</i><0.01). After multivariable adjustment, SGLT2 inhibitor use remained significantly associated with higher proportion of mRS score 0-2 (adjusted OR=1.24, 95%CI: 1.08-1.42, <i>P</i><0.01) and mRS score 0-3 (adjusted OR=1.62, 95%CI: 1.32-1.99, <i>P</i><0.01) at discharge. Results were consistent after PSM. In stratified analyses, SGLT2 inhibitor use was associated with improved functional outcomes in both patients with pre-existing diabetes and those with newly diagnosed diabetes.</p><p><strong>Conclusions: </strong>Among diabetic patients with AIS, SGLT2 inhibitor use is independently associated with better functional outcomes at discharge, showing a potential benefit for short-term neurological recovery.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"129-136"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Advances in targeted therapies for chronic spontaneous urticaria].","authors":"Linrun Zhou, Chenji Hu, Shiyan Wang, Rui Zhang","doi":"10.3724/zdxbyxb-2025-0784","DOIUrl":"10.3724/zdxbyxb-2025-0784","url":null,"abstract":"<p><p>Chronic spontaneous urticaria (CSU) is a common dermatological disorder marked by significant patient heterogeneity. Existing treatment strategies often fall short of adequately addressing patients' clinical needs. In the past decade, insights into the pathophysiology of CSU have catalyzed the development of novel targeted therapies, which can be categorized into three main approaches: targeting mast cells, targeting cytokines, and targeting Janus kinase (JAK) signaling. Mast cell-targeted strategies focus on surface receptors (<i>e.g</i>., activating receptors, the KIT receptor governing mast cell proliferation/survival, and inhibitory receptors) and intracellular pathways such as Bruton's tyrosine kinase. Cytokine-targeted therapies aim at specific mediators including IL-4, thymic stromal lymphopoietin, IL-17, IL-23, and IL-5. Regarding JAK-targeted therapy, besides approved JAK inhibitors, several novel agents, including dual-target inhibitors, are under investigation. This review systematically delineates recent advances in targeted therapies for CSU, comparing the features and clinical potential of different agents, with the aim of informing evidence-based and personalized management of CSU.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"163-172"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on external cervical resorption].","authors":"Ran Chen, Mengyao Bian, Jin Zhao, Linna Qian, Ying Shi, Zhifang Wu","doi":"10.3724/zdxbyxb-2025-0778","DOIUrl":"10.3724/zdxbyxb-2025-0778","url":null,"abstract":"<p><p>External cervical resorption (ECR) is a progressive, osteoclast-mediated destructive disease of dental hard tissues that originates at the cervical region of the root. Characterized by its insidious onset and diagnostic challenges at early stages, ECR can lead to severe tooth structure loss and even tooth extraction. Although the precise patho-genesis remains unclear, it is thought to be associated with local stimuli, certain medications, and systemic conditions. Cone beam computed tomography (CBCT) is currently the key imaging modality for three-dimensional assessment and accurate staging of ECR. Treatment should be based on such three-dimensional evaluation and follow a stepwise strategy tailored to the extent, depth, and pulpal involvement of the lesion: minimally invasive restoration with bioactive materials for early or localized defects; comprehensive manage-ment including root canal treatment, intentional replantation, or combined guided tissue regeneration for lesions involving the pulp or exhibiting extensive spread; and extraction with site preservation as a final restorative-oriented option for non-retainable teeth. This review systematically elaborates on the etiological factors, pathological mechanisms, clinical manifestations, image-based classification systems, diagnosis, and management of ECR, aiming to provide insights for precise clinical decision-making. Future research directions, such as early biomarker identification and targeted pharmacological intervention, are also discussed.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"173-184"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparison of functional outcomes between tenecteplase and alteplase as bridging thrombolysis prior to mechanical throm-bectomy for acute ischemic stroke patients with large vessel occlusion].","authors":"Zhenghao Shi, Jiansheng Yang, Zhenchan Lu, Yaojie Cai, Yi Zhu, Gongchun Huang, Hui Zhu, Min Lou, Jianhua Cheng","doi":"10.3724/zdxbyxb-2025-0639","DOIUrl":"10.3724/zdxbyxb-2025-0639","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficacy and safety of tenecteplase versus alteplase as bridging intravenous thrombolysis before mechanical thrombectomy in acute ischemic stroke (AIS) patients with large vessel occlusion.</p><p><strong>Methods: </strong>In this retrospective cohort study, data were extracted from the Acute Stroke Patients for Stroke Management Quality Evaluation online database (CASE-Ⅱ, NCT04487340). Patients with AIS and large vessel occlusion who received tenecteplase or alteplase followed by mechanical thrombectomy within 24 hours of symptom onset from December 2022 to March 2025 were included. The patients were divided into the tenecteplase group and the alteplase group. Propensity score matching (1∶4) was performed based on age, sex, door-to-needle time (DNT), door-to-puncture time (DPT), and onset-to-door time. Binary logistic regression and general linear models were used to compare 3-month functional and safety outcomes. Sensitivity analysis was conducted for patients with onset-to-needle time (ONT)≤4.5 h, and subgroup analyses were performed based on age, sex, baseline National Institutes of Health Stroke Scale (NIHSS) score, occlusion site, DNT and DPT.</p><p><strong>Results: </strong>Among 1505 enrolled patients, 250 received tenecteplase and 1255 received alteplase. No significant differences were observed in 3-month functional outcomes between the two groups (all <i>P</i>>0.05). However, the tenecteplase group had lower 3-month all-cause mortality (OR=0.676, 95%CI: 0.470-0.972, <i>P</i>=0.032). After matching, 224 tenecteplase-treated and 767 alteplase-treated patients were included. There were no significant differences in functional or safety outcomes between the two groups (all <i>P</i>>0.05). Sensitivity analysis showed that among patients with an onset-to-needle time (ONT) ≤4.5 hours, there were no statistically significant differences in 3-month functional or safety outcomes between the tenecteplase group and the alteplase group (all <i>P</i>>0.05). Subgroup analyses indicated that no statistically significant differences in 3-month functional independence were observed across all subgroups (all <i>P</i>>0.05).</p><p><strong>Conclusions: </strong>In AIS patients with large vessel occlusion undergoing bridging thrombolysis before mechanical thrombectomy, tenecteplase and alteplase showed comparable 3-month functional and safety outcomes.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"121-128"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Spatial omics in pulmonary fibrosis: advancing mechanistic insights and therapeutic strategies].","authors":"Yunpeng Peng, Yunyun Xie, Fan Yang, Xin Qiao, Yange Tian","doi":"10.3724/zdxbyxb-2025-0785","DOIUrl":"10.3724/zdxbyxb-2025-0785","url":null,"abstract":"<p><p>Pulmonary fibrosis, a group of chronic interstitial lung diseases charac-terized by persistent inflammation and aberrant deposition of fibrous connective tissue, poses a significant therapeutic challenge, with idiopathic pulmonary fibrosis (IPF) being its most representative and severe form. Spatially resolved omics technologies-encompassing spatial metabolomics, transcriptomics, and proteomics-have emerged as transformative tools that preserve the architectural context of tissues while enabling high-throughput, visualization-capable analysis of metabolites, genes, and proteins. Spatial metabolomics facilitates the visualization and intelligent annotation of metabolic landscapes; spatial transcriptomics deciphers regional heterogeneity and refines the molecular timeline of early disease events; and spatial proteomics elucidates protein interaction networks and uncovers novel drug-resistance mechanisms. Collectively, spatial omics provides unprece-dented insights into disease pathogenesis, offering a powerful framework for advancing precision diagnosis, identifying therapeutic targets, and guiding drug development. This article synthesizes recent progress in applying spatial omics to pulmonary fibrosis research, underscoring its potential to translate into more effective clinical strategies.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"154-162"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}