1.Predictive Modeling of Symptomatic Intracranial Hemorrhage Following Endovascular Thrombectomy: Insights From the Nationwide TREAT-AIS Registry
Jia-Hung CHEN ; I-Chang SU ; Yueh-Hsun LU ; Yi-Chen HSIEH ; Chih-Hao CHEN ; Chun-Jen LIN ; Yu-Wei CHEN ; Kuan-Hung LIN ; Pi-Shan SUNG ; Chih-Wei TANG ; Hai-Jui CHU ; Chuan-Hsiu FU ; Chao-Liang CHOU ; Cheng-Yu WEI ; Shang-Yih YAN ; Po-Lin CHEN ; Hsu-Ling YEH ; Sheng-Feng SUNG ; Hon-Man LIU ; Ching-Huang LIN ; Meng LEE ; Sung-Chun TANG ; I-Hui LEE ; Lung CHAN ; Li-Ming LIEN ; Hung-Yi CHIOU ; Jiunn-Tay LEE ; Jiann-Shing JENG ;
Journal of Stroke 2025;27(1):85-94
Background:
and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking.
Methods:
This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance.
Results:
Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal.
Conclusions
The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.
2.Longitudinal profile of plasma pregenomic RNA in patients with chronic hepatitis B infection on long-term nucleoside analogues and its interaction with clinical parameters
Lung-Yi MAK ; Mark ANDERSON ; Michael STEC ; Matthew Shing-Hin CHUNG ; Danny Ka-Ho WONG ; Rex Wan-Hin HUI ; Wai-Kay SETO ; Gavin CLOHERTY ; Man-Fung YUEN
Clinical and Molecular Hepatology 2025;31(2):460-473
Background:
s/Aims: Plasma pregenomic hepatitis B virus RNA (pgRNA) is a novel biomarker in chronic hepatitis B infection (CHB). We aimed to describe the longitudinal profile of pgRNA and factors influencing its levels in CHB patients on nucleoside analogue (NUC).
Methods:
Serial plasma samples from 1,354 CHB patients started on first-line NUC were evaluated. Time of NUC initiation was taken as baseline (year 0), followed by 1-year, 3-year and 5-year of NUC therapy. pgRNA was measured by Research Use Only RealTime HBV RNA v2.0 (0.2 mL) (Abbott Diagnostics) with lower limit of detection of 0.8 log U/mL (~20 copies/mL).
Results:
Among 1,354 subjects (median age at baseline 49.8 [interquartile range, IQR 40.2–57.3]) years, 65.2% male, 16.1% hepatitis B e antigen (HBeAg)-positive, 28.6% cirrhotic), baseline median HBV RNA was 3.68 (IQR 2.42–5.19) log U/mL. Upon NUC therapy, median pgRNA levels were 2.45 (IQR 1.82–3.62), 2.23 (IQR 1.67–3.05) and 2.14 (IQR 1.48–2.86) log U/mL at 1, 3 and 5 years, respectively, with the corresponding log U/mL reductions of 0.82, 1.20 and 1.54. Undetectable/ unquantifiable pgRNA was achieved in 13.5%, 15.9% and 20.1% of patients at 1, 3 and 5 years, respectively. Older age, male sex, HBeAg-negativity and high PAGE-B score were associated with lower pgRNA.
Conclusions
Plasma pgRNA declines are modest under NUC therapy, with only 16.3% achieving RNA undetectability after 5 years of first-line NUC indicating cccDNA silencing has not been achieved in the majority of patients. Clinical characteristics should be taken into consideration when interpreting the plasma pgRNA level.
3.Prospect of emerging treatments for hepatitis B virus functional cure
Rex Wan-Hin HUI ; Lung-Yi MAK ; James FUNG ; Wai-Kay SETO ; Man-Fung YUEN
Clinical and Molecular Hepatology 2025;31(Suppl):S165-181
Functional cure, defined as sustained hepatitis B surface antigen (HBsAg) seroclearance with unquantifiable hepatitis B virus (HBV) DNA at 24 weeks off treatment, is a favorable treatment endpoint in chronic hepatitis B (CHB). Nonetheless, functional cure is rarely attained with the current treatment modalities of nucleos(t)ide analogues (NUCs) and pegylated interferon alpha. Multiple novel virus-targeting agents and immunomodulators are under development for HBV with functional cure as the treatment goal. Among virus-targeting agents, antisense oligonucleotides and small-interfering RNAs are the most advanced in the developmental pipeline, and can induce potent and sustainable HBsAg suppression. The other virus-targeting agents have varying effects on HBsAg and HBV DNA, depending on the drug mechanism. In contrast, immunomodulators have modest effects on HBsAg and have limited roles in monotherapy. Multiple combination regimens incorporating RNA interference agents with immunomodulators have been studied through many ongoing clinical trials. These combination strategies demonstrate synergistic effects in inducing functional cure, and will likely be the future direction of development. Despite the promising results, research is warranted to optimize treatment protocols and to establish criteria for NUC withdrawal after novel therapies. Functional cure is now an attainable target in CHB, and the emerging novel therapeutics will revolutionize CHB management.
4.Mechanisms of hepatocellular carcinoma and cirrhosis development in concurrent steatotic liver disease and chronic hepatitis B
Saisai ZHANG ; Lung-Yi MAK ; Man-Fung YUEN ; Wai-Kay SETO
Clinical and Molecular Hepatology 2025;31(Suppl):S182-S195
Chronic hepatitis B (CHB) poses a major global public health challenge and is a leading cause of cirrhosis and liver cancer. Hepatic steatosis is common in individuals with CHB compared to the non-CHB population and is particularly prevalent in hepatitis B virus (HBV)-endemic regions, affecting about one-third of CHB patients. The interaction between hepatic steatosis and CHB-related disease progression is complex and still under debate. Evidence demonstrates that co-existing steatosis may worsen liver fibrosis while paradoxically increasing the likelihood of achieving better HBV control. In particular, despite the association of steatotic liver disease (SLD) with lower HBV viral loads and higher rates of HBsAg seroclearance, the coexistence of CHB and SLD can potentially accelerate liver disease progression. Factors such as fat deposition, lipotoxicity, oxidative stress, and chronic inflammation in SLD may foster a pro-fibrotic and pro-carcinogenic environment, accelerating the disease progression. Additionally, loss of global DNA methylation, changes in the immune microenvironment, and genetic susceptibility further contribute to the development of CHB-related cirrhosis and hepatocellular carcinoma (HCC). This review examines the mechanisms driving liver disease progression and the heightened risk of cirrhosis and HCC in patients with concurrent CHB and steatotic liver disease, underscoring the importance of prioritizing antiviral therapy for CHB in addition to addressing SLD.
5.Application of third-generation dual-source CT ultra-low tube voltage combined with advanced analog iterative reconstruction in bronchial artery CTA in patients with hemoptysis
Chinese Medical Equipment Journal 2025;46(10):60-64
Objective To explore the effects of ultra-low tube voltage of the third-generation dual-source CT combined with advanced modeled iterative reconstruction(ADMIRE)in bronchial artery CTA for hemoptysis patients.Methods Totally 70 hemoptysis patients admitted to some hospital from March to August 2023 had their clinical and imaging data collected retrospectively,and then divided into Group A and B with the numerical table method.In Group A image reconstruction was carried out with 120 kV tube voltage and filtered back projection(FBP)(named as Group A-FBP);In Group B image reconstruction was performed with 70 kV tube voltage respectively combined with FBP,ADMIRE Ⅲ,Ⅳ and Ⅴ(named as Group B-FBP,B-ADMIRE Ⅲ,B-ADMIRE Ⅳ and B-ADMIRE Ⅴ).All the patients were scanned with Siemens third-generation dual-source CT.The groups were compared in terms of radiation dose covering volume CT dose index,dose length product and effective dose,subjective score and objective evaluation.The subjective score agreement between 2 radiologists was evaluated with Kappa test.SPSS 26.0 software was used for statistical analysis.Results The radiation dose parameters of Group B were all lower than those of Group A,and the differences were statistically significant(P<0.001).Group B-FBP and ADMIRE Ⅳ had the lowest and highest subjective scores for bronchial artery images,res-pectively,and the five groups were significantly different in subjective score(P<0.05).The two radiologists had high agree-ment for Kappa values of the subjective scores,with the Kappa values being not lower than 0.75.Group A-FBP showed the lowest vessel CT value,Group B-FBP exhibited the highest image noise and the lowest SNR and CNR,and the five groups differed significantly in the objective evaluation of image quality(P<0.05).Group B-ADMIRE Ⅲ,B-ADMIRE Ⅳ and B-ADMIRE Ⅴ had statistically significant differences with Group A-FBP in objective evaluation of image quality(all P<0.05),with Group B-ADMIRE Ⅴ exhibiting the lowest image noise while highest SNR and CNR.Conclusion Ultra-low tube voltage of the third-generation dual-source CT combined with ADMIRE decreases the radiation dose and ensures image quality when applied to hemoptysis patient CTA,and ADMIRE Ⅳ behaves well in noise reduction and image quality enhancement.[Chinese Medical Equipment Journal,2025,46(10):60-64]
6.Mechanism of ganglioside regulating PIM-1/PI3K/Akt signaling pathway mediated pyroptosis to improve ischemic and hypoxemic brain injury in neonatal rats
Lin-lin XU ; Yi WANG ; Feng LI ; Man ZHAO
Chinese Pharmacological Bulletin 2025;41(8):1517-1523
Aim To investigate the protective effect of ganglioside(GM1)on ischemic-hypoxic brain injury(HIBI)in neonatal rats and the related mechanism.Methods Eighty,7-day old SD neonatal rats were randomly divided into four groups:sham operated group(sham),HIBM group,GM1 group and GM1+PIM-1 inhibitor group(GM1+PIM-1 inhibitor),with 20 rats in each group.After successful construction of the HIBI model,the neonatal rats were injected intrap-eritoneally with GM1(20 mg·kg-1·d-1)for three days in the GM1 group.The neonatal rats were given intraperitoneal injection of GM1(20 mg·kg-1·d-1)after a one-time injection of PIM-1 inhibitor(5 mg·kg-1)into the lateral ventricle for three days in the GM1+PIM-1 inhibitor group.Sham and HIBI groups were injected intraperitoneally with equal amounts of saline.Longa method was uses to assess the neurologi-cal impairment;TTC staining was used to detect the volume ratio of cerebral infarction;HE staining was used to observe the hippocampal histopathology;TUNEL staining was used to detect the apoptosis of hippocampal neurons;ELISA was used to detect the levels of IL-1β and IL-18 in hippocampal tissues;Western blot was used to detect PIM-1/PI3K/Akt sig-naling pathway proteins and pyroptosis-related proteins(NLRP3,ASC,caspase-1 p20,GSDMD-N).Results Compared with the sham group,the Longa score,cere-bral infarct volume,hippocampal neuronal apoptosis rate,IL-1 β,IL-18 levels,and pyroptosis-related protein expression were significantly higher(P<0.05),while PIM-1 protein expression,p-PI3K/PI3K,and p-Akt/Akt ratio were significantly lower(P<0.05)in the HIBI group.Compared with the HIBI group,the Longa score,cerebral infarct volume ratio,hippocampal neuro-nal apoptosis rate,IL-1 β,IL-18 levels,and pyroptosis-related protein expression were significantly lower(P<0.05),while PIM-1 protein expression,p-PI3K/PI3K,and p-Akt/Akt ratio were significantly higher(P<0.05)in the GM1 group of neonatal rats.Compared with the GM1 group,the Longa score,cerebral infarct volume ratio,hippocampal neuronal apoptosis rate,IL-1 β,IL-18 levels,and pyroptosis-related protein expres-sion were significantly higher(P<0.05),while PIM-1 protein expression,p-PI3K/PI3K,and p-Akt/Akt ratio were significantly lower(P<0.05)in the GM1+PIM-1 inhibitor group of neonatal rats.Conclusion GM1 ameliorates HIBI in neonatal rats by a mechanism related to activation of the PIM-1/PI3K/Akt signaling pathway and inhibition of hippocampal neuronal pyrop-tosis.
7.The application and prospects of dental implant robot technology in clinical teaching of oral implant specialty
Weikai ZHOU ; Yi MAN ; Yuhuan JIANG ; Jing WANG
STOMATOLOGY 2025;45(3):213-217,228
Objective To utilize the dental implant robot in the clinical instruction of oral implantology in order to popularize the technology and serve the medical education.Methods The effectiveness of the robotics teaching approach was assessed through a questionnaire.Results The dental implant robot technology has certain advantages in the clinical teaching of oral implant majors.Conclusion With the increasing popularity of digital implantation,the emerging dental implant robot has a wide range of applications and many advantages.It is very necessary to introduce it into the clinical teaching of oral implant majors.
8.Evaluation of effectiveness of reagent burstbead applied to field blood transfusion compatibility testing
Yi ZHANG ; Xiao-di LIU ; Yi-man ZHAO ; Jing-yan ZHOU ; Shu-mei YANG ; Hao YAN ; Yin-tu MA
Chinese Medical Equipment Journal 2025;46(2):39-42
Objective To explore the reliability of the reagent burstbead for field blood transfusion compatibility testing by applying it to bloodtype detection,antibody screening and cross matching tests and conduting parallel contrast with the existing arrays.Methods A field treatment shelter was used as the testing site to simulate the scene of emergency blood transfusion for the wounded under the conditions of field blood station,and 1 358 pieces of blood samples sent to some hospital for examination before transfusion were considered as the objects.Parallel contrast tests were carried out between the reagent burstbead method and the tube method for bloodtype detection and between the reagent burstbead method and the manual polybrene method for antibody screening and cross matching.The reagent burstbead method was compared with other methods in terms of the coin-cidence rate of the bloodtype detection results,the detection rate of positive samples for antibody screening and crossmatch incompatibility.Results The reagent burstbead method and the tube method had high consistency when used for bloodtype detection,with the coincidence rate being 100%.During antibody screening and cross matching tests,the reagent burstbead method found 5 cases of antibody-positive samples leading to major crossmatch incompatibility(positive rate being 0.37%),the manual polybrene method detected 2 cases of irregular antibody-positive samples(positive rate being 0.15%),and the two methods both identified 3 cases of minor crossmatch incompatibility.Conclusion The reagent burstbead has high accuracy and reliability when applied to bloodtype detection,antibody screening and cross matching tests,and thus can be used for blood transfusion compatibility testing in field conditions.[Chinese Medical Equipment Journal,2025,46(2):39-42]
9.Effects of Japan Tallow on Alleviating Liver Injury and Modulating Gut Microbiota in Type 2 Diabetic Mice
Kai-ya XIE ; Xin YU ; En-ya LI ; Li-ping HUA ; Xiao-man LI ; Ying-zhen SU ; Meng-chun SHU ; Yi-jian YANG
Progress in Modern Biomedicine 2025;25(19):3041-3047
Objective:To investigate the effects of Japan tallow(JT)on liver injury and gut microbiota regulation in type 2 diabetes mellitus(T2DM)mice,thereby providing a theoretical basis for developing therapeutic edible oils for diabetes treatment.Methods:T2DM animal model was established through a combined approach of nutritional intervention and chemical induction.Experimental animals were first fed a high-fat diet(HFD)for 6 weeks,followed by intraperitoneal injection of freshly prepared streptozotocin(STZ).After successful model establishment,the mice were divided into five groups(n=6 per group):control group without any intervention;T2DM group;HFD reversion to standard chow group;metformin group;and JT intervention group,which received respective treatments for 4 weeks.At the endpoint,fresh fecal samples were collected from all groups,and the gut microbiota composition was analyzed using 16s rDNA high-throughput sequencing.Liver histopathological changes were examined using histological methods.Results:Compared with the normal control(ND),T2DM mice showed significantly increased fasting blood glucose(FBG)levels,with evident hepatocyte lipid accumulation,steatosis,inflammatory cell infiltration,and widespread vacuolar and fatty degeneration.After Japan tallow(JT)intervention,FBG levels decreased significantly,liver color approximated normal appearance,and pathological morphology improved noticeably.16s rDNA sequencing analysis demonstrated that JT treatment could effectively regulate the intestinal microbiota structure in T2DM mice.Increased microbial α-diversity indices(Chao1,observed_species,Faith_pd,Simpson);At the phylum level,increased Verrucomicrobia abundance while decreased Proteobacteria were detected;At the family level,elevated Bifidobacteriaceae and reduced Porphyromonadaceae were seen;At the genus level,Bifidobacterium was promoted and Akkermansia proliferat while Escherichia and Klebsiella were downregulated.Conclusions:Japan tallow exhibits significant effects in alleviating liver tissue damage and regulating intestinal microbiota disorders in T2DM mice,our study indicated new theoretical basis for the research and development of potential strategy for diabetes.
10.Research progress on mechanism of curcumin in treatment of depression
Lin WANG ; Qi-fei PAN ; Wen-juan LONG ; Jia-rong DU ; Zhong-yang HU ; Xin-yao LI ; Yi-shu CHEN ; Dong-dong QIN ; Xiao-man LYU
Chinese Pharmacological Bulletin 2025;41(9):1618-1623
Depression is a prevalent mental and emotional disor-der that often results in significant emotional disturbances,cog-nitive dysfunction,and memory impairments.It is characterized by a high incidence rate,a substantial disability burden,and limited therapeutic efficacy.Currently,the long-term use of medications for the treatment of depression can result in a range of adverse reactions,highlighting the urgent need to explore no-vel approaches that can effectively alleviate depressive symptoms while minimizing side effects.Curcumin,a natural polyphenolic compound derived from the rhizome of turmeric,demonstrates considerable potential in the prevention and treatment of depres-sion,owing to its diverse array of biological activities.In recent years,numerous studies have investigated the use of curcumin for the treatment of depression.This article aims to provide a comprehensive review of the mechanisms of action underlying curcumin's efficacy in treating depression.Specifically,it focu-ses on its ability to improve neurotransmitter imbalances,restore neural plasticity,alleviate neural damage,mitigate dysfunction of the hypothalamic-pituitary-adrenal(HPA)axis,regulate in-flammatory factors and neuroinflammatory signaling pathways,and inhibit oxidative stress.This review is intended to offer in-sights and methodological references for basic research on curcu-min,as well as for the development of novel therapeutic agents for the treatment of depression.

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