中国医学科学院学报最新文献

{"title":"Role of Brain Insulin Resistance in the Pathogenesis of Alzheimer's Disease.","authors":"Xiao-Tong Zhang, Sang-Sang Chen, Yue-Wen Liu, Hao-Ran Huang, Ying Yu","doi":"10.3881/j.issn.1000-503X.16614","DOIUrl":"10.3881/j.issn.1000-503X.16614","url":null,"abstract":"<p><p>Alzheimer's disease (AD) is the most common type of dementia,in which brain insulin resistance (BIR) plays a key role.BIR affects the response of brain cells to insulin and is associated with cognitive decline and pathological features of AD.This study explores the role of BIR in the pathogenesis of AD and evaluates potential treatment strategies,aiming to provide new directions for the prevention and treatment of AD.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"48 2","pages":"347-354"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Enhancement Parameters of Dual-Layer Detector Spectral CT in the Assessment of Hepatic Functional Reserve.","authors":"Meng-Qi Liu, Ya-Zhong Tian, Zhi-Ye Chen","doi":"10.3881/j.issn.1000-503X.16626","DOIUrl":"10.3881/j.issn.1000-503X.16626","url":null,"abstract":"<p><p>Objective To evaluate the value of dual-layer spectral CT-derived iodine concentration (IC) and extracellular volume (ECV) in the portal venous phase in assessing hepatic functional reserve. Methods A total of 24 patients who underwent triphasic abdominal spectral CT enhancement scanning between January 2020 and August 2022 were retrospectively enrolled.IC and ECV maps were generated from spectral base data of the portal venous phase,and IC and ECV values were measured in the left lobe,right lobe,and caudate lobe of the liver.Differences in parameters among hepatic lobes were compared by the Kruskal-Wallis test.Pearson or Spearman correlation analysis was performed to assess the relationships of IC and ECV with parameters of the indocyanine green (ICG) clearance test.The key parameters analyzed included the ICG retention rates at 5 min (ICGR5),at 10 min (ICGR10),at 15 min (ICGR15),and the ICG clearance rate (ICG-CR).On the basis of correlation results,multivariate linear regression models were constructed. Results ECV in the right hepatic lobe showed negative correlations with ICGR5 (<i>r</i>=-0.48,<i>P</i>=0.019),ICGR10 (<i>r</i>=-0.48,<i>P</i>=0.019),and ICGR15 (<i>r</i>=-0.47,<i>P</i>=0.021) and a positive correlation with ICG-CR (<i>r</i>=0.48,<i>P</i>=0.019).IC in the right hepatic lobe also showed negative correlations with ICGR5 (<i>r</i>=-0.52,<i>P</i>=0.009),ICGR10 (<i>r</i>=-0.52,<i>P</i>=0.009),and ICGR15 (<i>r</i>=-0.53,<i>P</i>=0.008) and a positive correlation with ICG-CR (<i>r</i>=0.52,<i>P</i>=0.009).IC in the right hepatic lobe demonstrated the best predictive performance for ICGR5 (<i>y</i>=0.62-0.16×IC,<i>R</i>²=0.26,<i>P</i>=0.011) and ICG-CR (<i>y</i>=0.09-0.07×IC,<i>R</i>²=0.32,<i>P</i>=0.004),whereas ECV was not selected in the multivariate regression model. Conclusion The dual-layer spectral CT-derived IC in the portal venous phase of the right hepatic lobe demonstrates significant clinical relevance with hepatic functional reserve,potentially serving as a non-invasive imaging biomarker for liver function assessment.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"48 2","pages":"238-243"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretable Prediction of Mortality Risk in Elderly Patients With Type 2 Diabetes Mellitus and Cerebral Infarction Based on the Medical Information Mart for Intensive Care-Ⅳ Database.","authors":"Si-Qi Gao, Yun-Shu Jia, Shuo Zhang, Ai-Bin Cheng, Feng-Mei Xing, Jun-Jie Liu","doi":"10.3881/j.issn.1000-503X.16719","DOIUrl":"10.3881/j.issn.1000-503X.16719","url":null,"abstract":"<p><p>Objective To develop an interpretable machine learning model for predicting mortality risk in elderly intensive care unit (ICU) patients with type 2 diabetes mellitus (T2DM) and cerebral infarction,and to identify critical prognostic factors. Methods We extracted data of 514 elderly patients with T2DM and cerebral infarction from the Medical Information Mart for Intensive Care-Ⅳ database.The dataset was partitioned into training and test sets (7∶3 ratio) via scikit-learn.Within the training set,collinearity analysis was conducted,and features with variance inflation factor >5 were excluded.Lasso regression was further adopted to refine the feature selection.Six machine learning models-eXtreme Gradient Boosting (XGBoost),Logistic regression,LightGBM,AdaBoost,decision tree,and gradient boosting decision tree-were constructed and subjected to rigorous five-fold cross-validation.The optimal model was interpreted by SHAP analysis on the test set to determine the hierarchy of mortality-associated predictors and their nonlinear interactions. Results The XGBoost model demonstrated the best training performance and prediction generalization ability.The area under the curve for 30-day and 365-day mortality risk were 0.928 (95%<i>CI</i>=0.853-0.995) and 0.882 (95%<i>CI</i>=0.800-0.963),respectively.SHAP analysis revealed that the Oxford Acute Severity of Illness Score,length of hospital stay,congestive heart failure,length of ICU stay,peripheral capillary oxygen saturation,and heart rate were the top six predictive factors for 30-day mortality risk,while blood urea nitrogen,Oxford Acute Severity of Illness Score,peripheral capillary oxygen saturation,age,heart rate,and respiratory rate were the top six predictive factors for 365-day mortality risk. Conclusion The XGBoost model shows significant potential in predicting mortality risk in elderly ICU patients with T2DM and cerebral infarction,underscoring the importance of key clinical predictors.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"48 2","pages":"284-295"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive Administration of Siltuximab Monotherapy for Idiopathic Multicentric Castleman Disease-TAFRO Subtype:Report of One Case.","authors":"Na Wei, Lu Zhang, Wen-Qi Zheng","doi":"10.3881/j.issn.1000-503X.16580","DOIUrl":"10.3881/j.issn.1000-503X.16580","url":null,"abstract":"<p><p>This article reports on the diagnosis and treatment of a 75-year-old male patient who presented with abdominal distension,fatigue,and elevated inflammatory markers.After multiple examinations and tissue biopsies,he was diagnosed with severe idiopathic multicentric Castleman disease-TAFRO subtype.Due to concurrent peptic ulcer bleeding,the initial treatment did not follow the recommended combination of high-dose corticosteroids or chemotherapy containing corticosteroids as per international/Chinese guidelines.Instead,only siltuximab monotherapy with a weekly dosing regimen was adopted,which also yielded significant efficacy.This case aims to highlight the diversity of treatment options for idiopathic multicentric Castleman disease.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"48 2","pages":"390-392"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Key Elements in Informed Consent Forms for Biobanks.","authors":"Ming-Tao Huang, Xiao-Mei Zhai","doi":"10.3881/j.issn.1000-503X.16823","DOIUrl":"10.3881/j.issn.1000-503X.16823","url":null,"abstract":"<p><p>With the rapid development of biomedical research in China,biobanks have been widely established as crucial infrastructure supporting precision medicine and big data research.However,at the practical level,informed consent-central to safeguarding the rights and interests of research participants-often shows a disconnection between ethical principles and technological realities.This study first examines the Chinese translation of the term \"biobank\", arguing that \"biological sample data bank\" better reflects both the data-centric nature and governance complexity of such entities.It then systematically reviews the ethical debates surrounding various models of informed consent,including blanket consent,broad consent,dynamic consent,and meta-consent.Building on this analysis,this paper identifies key ethical elements that an effective informed consent form should include.Special attention is paid to the legitimacy and practical challenges of components such as research purpose,data collection,data use,storage duration,risk disclosure,and return of results.This study aims to provide an ethical foundation and practical guidance for improving the informed consent framework in China's biobank governance,thereby promoting a shift from mere regulatory compliance to robust ethical engagement and fostering a virtuous cycle between public trust and sustainable research development.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"48 2","pages":"302-308"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kleine-Levin Syndrome Accompanied With Complex Headache:Report of One Case.","authors":"Li Zhang, Zun-Bo Li, Hua Liu, Xiao-Lin Wang, Ruo-Zhuo Liu","doi":"10.3881/j.issn.1000-503X.16650","DOIUrl":"10.3881/j.issn.1000-503X.16650","url":null,"abstract":"<p><p>Kleine-Levin syndrome is an extremely rare sleep disorder.In addition to recurrent daytime sleepiness,symptoms such as overeating,hypersexuality,cognitive impairment,and mental and behavioral abnormalities usually occur.Hypothalamic dysfunction may be the underlying pathogenesis.Cases with headache are rare.We reported a case of Kleine-Levin syndrome with headache symptoms during narcolepsy,and his headache was characterized by both migraine and cluster headache.It is hypothesized that Kleine-Levin syndrome may have a potential common pathogenesis with functional headaches such as migraine or cluster headache,which may be related to hypothalamic dysfunction.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"48 2","pages":"385-389"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Progress in the Relationship Between <i>Porphyromonas Gingivalis</i> Lipopolysaccharide and Atherosclerosis.","authors":"Rui-Rui Xue, Xiao-Jia Xie, Jin-Kun Xu, Zhe-Hui Wu, Rong Liu, Yang Meng, Yu-Yang Xiao, Yang-Yang Yu, Ming-Yi Zhao","doi":"10.3881/j.issn.1000-503X.16619","DOIUrl":"10.3881/j.issn.1000-503X.16619","url":null,"abstract":"<p><p>Atherosclerosis (AS) is characterized by lipid deposition and the formation of arterial intimal plaques,which can lead to serious cardiovascular events such as acute coronary syndrome,myocardial infarction,or stroke.It is one of the leading causes of mortality among Chinese residents.Recent studies have demonstrated that <i>porphyromonas gingivalis</i> lipopolysaccharide activates the inflammatory pathway through binding to Toll-like receptors,thereby stimulating the expression of inflammatory mediators.This process induces functional impairments in macrophages and endothelial cells,promotes foam cell formation,and consequently accelerates the progression of AS.This article reviews the latest research progress in the roles and mechanisms of <i>porphyromonas gingivalis</i> lipopolysaccharide in AS and explores its potential value as a clinical therapeutic target,aiming to provide new insights for the prevention and treatment of AS.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"48 2","pages":"338-346"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances and Future Prospects in Thyroid Contrast-Enhanced Ultrasound (2021-2024).","authors":"Xiao-Ting Wang, Bo Zhang","doi":"10.3881/j.issn.1000-503X.16621","DOIUrl":"10.3881/j.issn.1000-503X.16621","url":null,"abstract":"<p><p>Thyroid nodules are a common clinical condition of the endocrine system,and their diagnosis and differential diagnosis remain a serious challenge in the medical community.Since the first observation of acoustic enhancement in 1969,contrast-enhanced ultrasound (CEUS) has gradually matured through two major phases:the development of contrast agents (1990s) and the innovation of imaging algorithms (early 21st century).Since being introduced into clinical practice in China,2003,CEUS has undergone over two decades of localized development.Its capability for microcirculation perfusion imaging has established it as a core imaging tool for dynamic blood flow assessment in critical clinical scenarios,including the distinguishing between benign and malignant nodules,early cancer screening,and the formulation of individualized treatment plans.In recent years,with the advancements in instrument performance and the emergence of novel contrast agents,CEUS has demonstrated increasingly prominent roles in the diagnosis and treatment of thyroid diseases.This article reviews the application progress of CEUS in the diagnosis and treatment of thyroid diseases in China from 2021 to 2024.It explores the clinical application value of CEUS in thyroid nodule diagnosis,lymph node evaluation,assessment of thyroid cancer invasiveness,and guidance for thermal ablation therapy.Additionally,it makes an outlook on the future integration of CEUS with emerging technologies such as molecular ultrasound,artificial intelligence,and robotic technology,aiming to provide new insights and approaches for the precise diagnosis and treatment of thyroid diseases.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"48 2","pages":"365-372"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Different Vascular Lesions on the Clinical,Pathological, and Prognostic Features of Lupus Nephritis.","authors":"Wake Ma-Heshati Qiao, Wen-Ling Ye, Wei Ye, Yu-Bing Wen, Gang Chen, Peng Xia, Ke Zheng, Hang Li, Li-Meng Chen, Xue-Mei Li","doi":"10.3881/j.issn.1000-503X.16694","DOIUrl":"10.3881/j.issn.1000-503X.16694","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Objective To investigate the relationships of various types of renal vascular lesions with the clinical,pathological,and prognostic features of lupus nephritis (LN). Method A retrospective analysis was performed on the clinical and pathological data of LN patients treated in the Peking Union Medical College Hospital over the past 10 years to explore the relationships of different vascular lesions with clinical and pathological features and analyze the effects of renal vascular lesions on kidney prognosis from multiple perspectives. Results Among 644 enrolled LN patients,females accounted for 82.6%,and LN Ⅳ/Ⅳ+Ⅴ (60.4%) was the predominant pathological type.According to the types of renal vascular lesions,the patients were classified into four groups:atherosclerosis (AS)(&lt;i&gt;n&lt;/i&gt;=171,26.6%),thrombotic microangiopathy (TMA)(&lt;i&gt;n&lt;/i&gt;=78,12.1%),uncomplicated immune complex deposition (ICD)(&lt;i&gt;n&lt;/i&gt;=29,4.5%),and lupus vasculopathy (LV)(&lt;i&gt;n&lt;/i&gt;=19,3.0%). No renal vascular lesion (NRVL)(&lt;i&gt;n&lt;/i&gt;=347,53.9%) was taken as the control group.The average age of patients in the AS group was higher than that in the other groups (all &lt;i&gt;P&lt;/i&gt;&lt;0.001).The TMA (&lt;i&gt;P&lt;/i&gt;=0.009,&lt;i&gt;P&lt;/i&gt;=0.025) and LV groups (&lt;i&gt;P&lt;/i&gt;=0.007,&lt;i&gt;P&lt;/i&gt;=0.005) had lower levels of complement C3,and higher disease activity index of systemic lupus erythematosus and incidence of acute kidney injury (both &lt;i&gt;P&lt;/i&gt;&lt;0.001) than the NRVL and AS groups.The TMA (&lt;i&gt;P&lt;/i&gt;&lt;0.001),LV (&lt;i&gt;P&lt;/i&gt;&lt;0.001),and AS (&lt;i&gt;P&lt;/i&gt;=0.037) groups had lower estimated glomerular filtration rate (eGFR) than the NRVL group,and the eGFR of the TMA group was lower than that of the LV,AS,and ICD groups (all &lt;i&gt;P&lt;/i&gt;&lt;0.001).The renal pathological activity index (AI) of each renal vascular lesion group was higher than that of the NRVL group (all &lt;i&gt;P&lt;/i&gt;&lt;0.001),and the AI value of the TMA and LV groups was higher than that of the AS group (both &lt;i&gt;P&lt;/i&gt;&lt;0.001).There was no significant difference in AI value between TMA and LV groups (&lt;i&gt;P&lt;/i&gt;=0.675),while the proportion of fibrinoid necrosis in the LV group was higher than that in the TMA group (&lt;i&gt;P&lt;/i&gt;=0.012).The TMA group had the highest degree of chronicity and higher chronic index than the AS (&lt;i&gt;P&lt;/i&gt;=0.021),LV (&lt;i&gt;P&lt;/i&gt;&lt;0.001),ICD (&lt;i&gt;P&lt;/i&gt;&lt;0.001),and NRVL (&lt;i&gt;P&lt;/i&gt;&lt;0.001) groups.The AS group had the secondary highest degree of chronicity and higher median chronic index than the NRVL group (&lt;i&gt;P&lt;/i&gt;=0.004).The TMA group had the lowest 1-year clinical remission rate and the highest proportion of annual eGFR decline &gt;5 mL/(min·1.73 m&lt;sup&gt;2&lt;/sup&gt;).Both TMA and AS groups showed lower long-term renal survival rates than the NRVL group (&lt;i&gt;P&lt;/i&gt;&lt;0.001,&lt;i&gt;P&lt;/i&gt;=0.023) respectively. Conclusions Intrarenal vascular lesions are strongly associated with clinical severity and prognosis in LN.LV correlates with acute kidney injury and severe active renal injury,while TMA is the most severe subtype and characterized by high pathological activity,chronicity,poor treatment respo","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"48 2","pages":"228-237"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Therapeutic Effects and Mechanisms of Estrogen on Diabetes, Alzheimer's Disease,and Their Comorbidity:A Review.","authors":"Chun-Wei Liu, Zheng-Xing Shan, Wen-Juan Li, Qing-Wen Qu, Xue-Qin Hou","doi":"10.3881/j.issn.1000-503X.16649","DOIUrl":"10.3881/j.issn.1000-503X.16649","url":null,"abstract":"<p><p>Estrogen is a lipid-soluble steroid hormone and one of the most important female sex hormones.It mainly functions by interacting with estrogen receptors,maintaining normal physiological and pathophysiological functions of the body,and playing a crucial role in regulating blood glucose homeostasis,metabolism,and physiological processes associated with brain learning and memory.Recent studies have shown that estrogen has potential therapeutic effects on diabetes,cognitive impairment and other diseases.It will provide new ideas and treatment strategies for diabetes,Alzheimer's disease,and their comorbidity by regulating the activity of estrogen and the interaction with estrogen receptors to modulate related pathological and physiological processes.This article reviews the latest research progress in the relationship between estrogen and these diseases,providing a new perspective and prospect for the prevention and treatment of diabetes,Alzheimer's disease,and their comorbidity.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"48 2","pages":"328-337"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}