Objective: High-risk psychosis before schizophrenia includes individuals at clinical high risk (CHR) and genetic high risk (GHR). Methylenetetrahydrofolate Reductase (MTHFR) gene variants have been identified as risk factors for schizophrenia onset and symptom severity, though the effects of these polymorphisms in high-risk individuals remain unexplored. This study investigated the impact of MTHFR polymorphisms on clinical features of high-risk psychosis. We hypothesized that MTHFR variants may influence the progression of high-risk psychosis before schizophrenia. Methods: A total of 163 individuals were enrolled, comprising 76 healthy controls, 31 GHR, and 56 CHR. MTHFR polymorphisms (C677T, A1298C, and G1793A) were detected. The MATRICS Consensus Cognitive Battery was administered to assess cognitive ability. Additional recorded clinical features included sex, age, family history, cognitive scores, and the Structured Interview for Psychosis Risk Syndromes (SIPS) scores. Results: Higher MTHFR polymorphism levels were observed in high-risk individuals at the C677T site (p=0.006) and in multi-site variant analysis (p=0.012) compared to controls. Stratified by sex, both males and females showed similar increases in MTHFR polymorphism. Cognitive ability scores decreased in the high-risk group with an increase in MTHFR variant allele amounts. In the CHR group, SIPS scores non-significantly increased with the number of variant alleles. Conclusion Increased MTHFR polymorphism was associated with the risk progression of schizophrenia, being more pronounced in males than in females. Higher amounts of hypofunctional MTHFR variants tended to decrease the cognitive ability in both high-risk and healthy subjects, while higher risk levels are observed in CHR subjects.

Objective: High-risk psychosis before schizophrenia includes individuals at clinical high risk (CHR) and genetic high risk (GHR). Methylenetetrahydrofolate Reductase (MTHFR) gene variants have been identified as risk factors for schizophrenia onset and symptom severity, though the effects of these polymorphisms in high-risk individuals remain unexplored. This study investigated the impact of MTHFR polymorphisms on clinical features of high-risk psychosis. We hypothesized that MTHFR variants may influence the progression of high-risk psychosis before schizophrenia. Methods: A total of 163 individuals were enrolled, comprising 76 healthy controls, 31 GHR, and 56 CHR. MTHFR polymorphisms (C677T, A1298C, and G1793A) were detected. The MATRICS Consensus Cognitive Battery was administered to assess cognitive ability. Additional recorded clinical features included sex, age, family history, cognitive scores, and the Structured Interview for Psychosis Risk Syndromes (SIPS) scores. Results: Higher MTHFR polymorphism levels were observed in high-risk individuals at the C677T site (p=0.006) and in multi-site variant analysis (p=0.012) compared to controls. Stratified by sex, both males and females showed similar increases in MTHFR polymorphism. Cognitive ability scores decreased in the high-risk group with an increase in MTHFR variant allele amounts. In the CHR group, SIPS scores non-significantly increased with the number of variant alleles. Conclusion Increased MTHFR polymorphism was associated with the risk progression of schizophrenia, being more pronounced in males than in females. Higher amounts of hypofunctional MTHFR variants tended to decrease the cognitive ability in both high-risk and healthy subjects, while higher risk levels are observed in CHR subjects.

Objective: High-risk psychosis before schizophrenia includes individuals at clinical high risk (CHR) and genetic high risk (GHR). Methylenetetrahydrofolate Reductase (MTHFR) gene variants have been identified as risk factors for schizophrenia onset and symptom severity, though the effects of these polymorphisms in high-risk individuals remain unexplored. This study investigated the impact of MTHFR polymorphisms on clinical features of high-risk psychosis. We hypothesized that MTHFR variants may influence the progression of high-risk psychosis before schizophrenia. Methods: A total of 163 individuals were enrolled, comprising 76 healthy controls, 31 GHR, and 56 CHR. MTHFR polymorphisms (C677T, A1298C, and G1793A) were detected. The MATRICS Consensus Cognitive Battery was administered to assess cognitive ability. Additional recorded clinical features included sex, age, family history, cognitive scores, and the Structured Interview for Psychosis Risk Syndromes (SIPS) scores. Results: Higher MTHFR polymorphism levels were observed in high-risk individuals at the C677T site (p=0.006) and in multi-site variant analysis (p=0.012) compared to controls. Stratified by sex, both males and females showed similar increases in MTHFR polymorphism. Cognitive ability scores decreased in the high-risk group with an increase in MTHFR variant allele amounts. In the CHR group, SIPS scores non-significantly increased with the number of variant alleles. Conclusion Increased MTHFR polymorphism was associated with the risk progression of schizophrenia, being more pronounced in males than in females. Higher amounts of hypofunctional MTHFR variants tended to decrease the cognitive ability in both high-risk and healthy subjects, while higher risk levels are observed in CHR subjects.

Objective: High-risk psychosis before schizophrenia includes individuals at clinical high risk (CHR) and genetic high risk (GHR). Methylenetetrahydrofolate Reductase (MTHFR) gene variants have been identified as risk factors for schizophrenia onset and symptom severity, though the effects of these polymorphisms in high-risk individuals remain unexplored. This study investigated the impact of MTHFR polymorphisms on clinical features of high-risk psychosis. We hypothesized that MTHFR variants may influence the progression of high-risk psychosis before schizophrenia. Methods: A total of 163 individuals were enrolled, comprising 76 healthy controls, 31 GHR, and 56 CHR. MTHFR polymorphisms (C677T, A1298C, and G1793A) were detected. The MATRICS Consensus Cognitive Battery was administered to assess cognitive ability. Additional recorded clinical features included sex, age, family history, cognitive scores, and the Structured Interview for Psychosis Risk Syndromes (SIPS) scores. Results: Higher MTHFR polymorphism levels were observed in high-risk individuals at the C677T site (p=0.006) and in multi-site variant analysis (p=0.012) compared to controls. Stratified by sex, both males and females showed similar increases in MTHFR polymorphism. Cognitive ability scores decreased in the high-risk group with an increase in MTHFR variant allele amounts. In the CHR group, SIPS scores non-significantly increased with the number of variant alleles. Conclusion Increased MTHFR polymorphism was associated with the risk progression of schizophrenia, being more pronounced in males than in females. Higher amounts of hypofunctional MTHFR variants tended to decrease the cognitive ability in both high-risk and healthy subjects, while higher risk levels are observed in CHR subjects.

Objective: High-risk psychosis before schizophrenia includes individuals at clinical high risk (CHR) and genetic high risk (GHR). Methylenetetrahydrofolate Reductase (MTHFR) gene variants have been identified as risk factors for schizophrenia onset and symptom severity, though the effects of these polymorphisms in high-risk individuals remain unexplored. This study investigated the impact of MTHFR polymorphisms on clinical features of high-risk psychosis. We hypothesized that MTHFR variants may influence the progression of high-risk psychosis before schizophrenia. Methods: A total of 163 individuals were enrolled, comprising 76 healthy controls, 31 GHR, and 56 CHR. MTHFR polymorphisms (C677T, A1298C, and G1793A) were detected. The MATRICS Consensus Cognitive Battery was administered to assess cognitive ability. Additional recorded clinical features included sex, age, family history, cognitive scores, and the Structured Interview for Psychosis Risk Syndromes (SIPS) scores. Results: Higher MTHFR polymorphism levels were observed in high-risk individuals at the C677T site (p=0.006) and in multi-site variant analysis (p=0.012) compared to controls. Stratified by sex, both males and females showed similar increases in MTHFR polymorphism. Cognitive ability scores decreased in the high-risk group with an increase in MTHFR variant allele amounts. In the CHR group, SIPS scores non-significantly increased with the number of variant alleles. Conclusion Increased MTHFR polymorphism was associated with the risk progression of schizophrenia, being more pronounced in males than in females. Higher amounts of hypofunctional MTHFR variants tended to decrease the cognitive ability in both high-risk and healthy subjects, while higher risk levels are observed in CHR subjects.

Objective:To investigate the relationship between sarcopenia and the long-term prognosis of elderly patients with locally advanced colorectal cancer.Methods:A retrospective analysis was conducted on clinical data from 205 elderly colorectal cancer patients aged 70 years and above who underwent radical resection with TNM staging of stage Ⅱ to Ⅲ at Beijing Hospital between January 2014 and December 2018.The study utilized abdominal CT scans taken within 30 days before surgery to measure the skeletal muscle area(SMA)of the 3rd lumbar vertebrae cross-section.Sarcopenia was defined as a skeletal muscle index(SMI) of ≤52.4 cm 2/m 2 in men and ≤38.5 cm 2/m 2 in women(SMI=SMA/height 2).A comparison was made between the clinical and pathological conditions of patients with and without sarcopenia in the two groups, with an analysis of the impact of sarcopenia on the long-term prognosis of elderly postoperative colorectal cancer patients. Results:Among the 205 patients assessed, 63.4%(130/205)were diagnosed with sarcopenia.The group with sarcopenia had a higher percentage of individuals aged 80 years and older( χ2=6.420, P=0.011)compared to those without sarcopenia.Additionally, this group had a lower proportion of overweight or obese patients( χ2=9.366, P=0.009), fewer patients who underwent adjuvant chemotherapy, and a lower 5-year disease-free survival rate post-surgery( χ2=6.257, 7.347, P=0.012, 0.007).Kaplan-Meier analysis indicated that disease-free survival rate was better in elderly patients with locally advanced colorectal cancer who did not have sarcopenia compared to those with sarcopenia(Log-rank χ2=6.919, P=0.009).Moreover, in elderly patients without sarcopenia, those who received adjuvant chemotherapy had a more favorable disease-free survival outcome than those who did not receive such treatment(Log-rank χ2=4.745, P=0.029).Multifactorial Cox regression analysis showed that TNM stage Ⅲ( HR=1.634, 95% CI: 1.110-2.404, P=0.013)and the presence of sarcopenia( HR=1.509, 95% CI: 1.017-2.238, P=0.041)were significant factors influencing the poor long-term prognosis of elderly patients with locally advanced colorectal cancer. Conclusions:Sarcopenia is associated with aging and body mass index, and has been found to be a significant factor in the long-term prognosis of elderly colorectal cancer patients.Those with sarcopenia tend to have a poorer prognosis, while those without may experience benefits from adjuvant chemotherapy.

Objective:To investigate the tissue methylation features of adenocarcinoma patients presenting as pulmonary nodules on CT scans.Methods:A retrospective analysis was conducted on 70 adenocarcinoma patients with pulmonary nodules diagnosed at the Shanghai General Hospital from June 1, 2022 to January 20, 2024. Participants were assigned to two groups using the random number table, with 40 in the discovery group and 30 in the validation group. In the discovery group, tissue samples were analyzed using reduced representation bisulfite sequencing (RRBS) technology to compare the average methylation levels between cancer tissues and paired adjacent non-cancerous tissues. Differentially methylated regions (DMRs) were screened for analysis of their distribution across various genomic functional elements, and hierarchical clustering was plotted. GO and KEGG pathway enrichment analyses were further conducted on the DMRs. Subsequently, candidate DMRs associated with lung adenocarcinoma were validated using TCGA lung adenocarcinoma cohort and targeted bisulfite sequencing technology in the validation group. The comparison of methylation levels between groups was conducted using t-tests or non-parametric tests, while rates and composition ratios were analyzed using chi-square tests or Fisher′s exact test.Results:In discovery cohort, the average methylation level in cancer tissues was lower compared to adjacent normal tissues [(42.369±4.627) vs (44.370±4.046), t=?2.059, P=0.043]. A total of 37 995 DMRs were identified, including 16 889 upregulated regions and 21 106 downregulated regions, predominantly locating in promoter regions (48.917%), introns (36.457%), and exons (10.812%). The DMR clustering heatmap revealed two distinct clusters corresponding to cancer tissues and adjacent non-cancerous tissues. GO analysis showed that DMRs associated genes were mainly located in the cell membrane and nuclear chromatin, and were primarily involved in RNA polymerase Ⅱ-related transcription and regulation. KEGG pathway enrichment analysis indicated that DMRs associated genes were mainly involved in neuroactive ligand-receptor interaction, cancer pathways, calcium signaling pathway, cAMP signaling pathway, and MAPK signaling pathway. Validation in the TCGA cohort confirmed 11 potential characteristic DMRs. In the validation group, TBS confirmed that the methylation levels of DMRs associated with MIR10B, DMRTA2, HOPX, TFAP2B and MARCH11 in cancer tissues were significantly higher than those in adjacent non-cancerous tissues [11.200(4.305, 27.088) vs 2.650(1.298, 4.645), Z=?4.539, P<0.05; 18.610(13.600, 33.025) vs 8.675(5.488, 13.085), Z=?4.554, P<0.05; 17.600(2.183, 76.015) vs 1.085(0.898, 1.835), Z=?5.131, P<0.05; 5.250(3.220, 7.693) vs 3.495(2.165, 4.383), Z=?2.861, P<0.05; 11.515(7.525, 21.033) vs 7.830(5.518, 11.488), Z=?2.440, P<0.05 ], and the differences were statistically significant. Conclusions:Lung adenocarcinoma tissue exhibits different methylation patterns compared with adjacent normal lung tissue. The identified DMRs are involved in the regulation of several key pathways. Results from the TCGA cohort and an independent validation group support the potential diagnostic value of DMRs such as MIR10B, DMRTA2, HOPX, TFAP2B, and MARCH11 in lung adenocarcinoma, though their clinical application requires further validation.

Objective·To verify the performance and explore the clinical application value of a multi-modal pulmonary nodule diagnosis model combined with metabolic fingerprints,protein biomarker CEA and Image-AI via random forest(MPI-RF).Methods·This study enrolled 289 patients with pulmonary nodules who were admitted to the Shanghai Chest Hospital,Shanghai Jiao Tong University School of Medicine and were detected by low-dose helical computed tomography(LDCT).The patients were divided into malignant nodule group(n=197)and benign nodule group(n=92)based on postoperative pathological results,and the basic information of the two groups was collected and compared.Electrochemiluminescence was used to detect the preoperative serum CEA levels of the patients in the two groups,matrix-assisted laser desorption/ionization mass spectrometry(MALDI-MS)was used to detect the serum metabolic fingerprints,and the CT image artificial intelligence model Image-AI was used to calculate the image scores.CEA data,serum metabolic fingerprints data and image scores were integrated and input into MPI-RF to calculate the malignant probability score of each patient.The receiver operator characteristic curve(ROC curve)and area under the curve(AUC)were used to evaluate the performance of different models,and the DeLong test was used for comparative analysis,including the diagnostic performance of MPI-RF in different types(solid nodule,pure ground-glass nodule and part-solid nodule)and sizes(diameter<8 mm and diameter≥8 mm)of pulmonary nodules,the diagnostic performance comparison of MPI-RF with Mayo Clinic model,veterans administration(VA)model and Brock model,and the diagnostic performance comparison of MPI-RF with lung imaging reporting and data system(Lung-RADS)in benign and malignant nodules.Results·MPI-RF had good diagnostic performance in the differentiation of benign and malignant pulmonary nodules(AUC=0.887,95%CI 0.848?0.925,sensitivity 81.22%,specificity 83.70%).Among them,the AUC of MPI-RF for solid nodules was 0.877(95%CI 0.820?0.934),for part-solid nodules was 0.858(95%CI 0.771?0.946),and for pure ground-glass nodules was 0.978(95%CI 0.923?1.000).The AUC of MPI-RF was 0.840(95%CI 0.716?0.963)for nodules within 8 mm diameter and 0.891(95%CI 0.849?0.933)for nodules larger than 8 mm diameter.Compared with the existing models,the diagnostic performance of MPI-RF was better than that of Mayo Clinic model,VA model and Brock model(all P=0.000).Compared with Lung-RADS,MPI-RF had better diagnostic performance in the total samples and different types of nodules(all P=0.000).Conclusion·MPI-RF is a model for the differential diagnosis of benign and malignant pulmonary nodules with excellent performance,and has potential clinical application value.

OBJECTIVE Cognitive deficit is a com-mon comorbidity in temporal lobe epilepsy(TLE)and that is not well controlled by current therapeutics.Currently,how epileptic seizure affects cognitive performance remains largely unclear.The subiculum is the major out-put of the hippocampus,which projects to entorhinal cor-tex and other more distinct brain regions.Physiologically,the subiculum codes spatial working memory and naviga-tion information including place,speed,and trajectory.Importantly,prior studies have noted the importance of the subiculum in the beginning,spreading,and generaliz-ing process of hippocampal seizure.How seizure-activated neurons in subiculum participate in cognitive impairment remains largely elusive.METHODS In this study,we sought to label the subicular seizure-activated c-fos+ neu-rons with a special promoter with enhanced synaptic activity-responsive element E-SARE in the subiculum,combined with chemogenetics and designer receptors exclusively activated by designer drugs(DREADDs),Ca2+ fiber photometry approaches,and behavioral tasks,to reveal the role of these neurons in cognitive impairment in epilepsy.RESULTS We found that chemogenetic inhibi-tion of subicular seizure-tagged c-fos+ neurons(mainly CaMK Ⅱ α+ glutamatergic neurons)alleviates seizure generalization and improves cognitive performance in the hippocampal CA3 kindling TLE model.While inhibition of seizure-labeled c-fos+ GABAergic interneuron shows no effect on seizure and cognition.As a comparison,che-mogenetic inhibition of the whole subicular CaMK Ⅱ α+ neuron impairs cognitive function in na?ve mice in basal condition.Notably,inhibition of subicular seizure-tagged c-fos+ neurons enhances the recruitment of cognition-responsive c-fos+ neurons via increasing neural excitability during cognition tasks.CONCLUSION Our results dem-onstrate that subicular seizure-activated c-fos+ neurons contribute to cognitive impairment in TLE,suggesting sei-zure-tagged c-fos+ neurons as the potential therapeutic target to alleviate cognitive impairment in TLE.