1.Incidence and Risk Factors of Postoperative Neuropsychiatric Dysfunctions After Deep Brain Stimulation Surgery in Patients with Parkinson's Disease: A Prospective Cohort Study
Sining XIE ; Chenguan JIANG ; Xiangjiahui LI ; Ruquan HAN ; Zhou YANG ; Bingxin LI ; Lin SHI
Medical Journal of Peking Union Medical College Hospital 2025;16(2):300-306
To investigate the incidence of postoperative neuropsychic dysfunction (PND) in Parkinson's disease (PD) patients undergoing deep brain stimulation (DBS) and to analyze its influencing factors. A prospective study was conducted between January 2020 and December 2022, recruiting PD patients from the Functional Neurosurgery Outpatient Clinic of Beijing Tiantan Hospital, Capital Medical University. All patients were scheduled to undergo bilateral subthalamic nucleus (STN)-DBS surgery. Perioperative clinical data were collected, and PND (outcome measure) within 3 days postoperatively was assessed using the Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE), Hamilton depression and anxiety scales, and 3-minute diagnostic interview for confusion assessment method (3D-CAM). Multivariate Logistic regression was used to analyze the influencing factors of PND. A total of 216 PD patients were enrolled. Within 3 days after DBS surgery, 77 patients (35.6%) developed PND, including 24 cases (31.2%) of depression or worsening depression, 16 cases (20.8%) of anxiety or worsening anxiety, 13 cases (16.9%) of cognitive decline, and 24 cases (31.2%) of delirium. Univariate analysis revealed that dural opening method, dural opening time, intraoperative improvement rate of the unified Parkinson's disease rating scale -Ⅲ (UPDRS-Ⅲ) score, and postoperative intracranial air volume were significantly different between PND and non-PND patients (all PD patients have a high incidence of PND after DBS surgery. Sex, postoperative intracranial air volume, and the degree of improvement in PD motor symptoms can influence the risk of PND. These findings highlight the importance of individualized management based on sex, improving surgical techniques, and enhancing monitoring of neuropsychiatric status to optimize the efficacy of DBS surgery.
2.Therapeutic Study on The Inhibition of Neuroinflammation in Ischemic Stroke by Induced Regulatory T Cells
Tian-Fang KANG ; Ai-Qing MA ; Li-Qi CHEN ; Han GONG ; Jia-Cheng OUYANG ; Fan PAN ; Hong PAN ; Lin-Tao CAI
Progress in Biochemistry and Biophysics 2025;52(4):946-956
ObjectiveNeuroinflammation plays a crucial role in both the onset and progression of ischemic stroke, exerting a significant impact on the recovery of the central nervous system. Excessive neuroinflammation can lead to secondary neuronal damage, further exacerbating brain injury and impairing functional recovery. As a result, effectively modulating and reducing neuroinflammation in the brain has become a key therapeutic strategy for improving outcomes in ischemic stroke patients. Among various approaches, targeting immune regulation to control inflammation has gained increasing attention. This study aims to investigate the role of in vitro induced regulatory T cells (Treg cells) in suppressing neuroinflammation after ischemic stroke, as well as their potential therapeutic effects. By exploring the mechanisms through which Tregs exert their immunomodulatory functions, this research is expected to provide new insights into stroke treatment strategies. MethodsNaive CD4+ T cells were isolated from mouse spleens using a negative selection method to ensure high purity, and then they were induced in vitro to differentiate into Treg cells by adding specific cytokines. The anti-inflammatory effects and therapeutic potential of Treg cells transplantation in a mouse model of ischemic stroke was evaluated. In the middle cerebral artery occlusion (MCAO) model, after Treg cells transplantation, their ability to successfully migrate to the infarcted brain region and their impact on neuroinflammation levels were examined. To further investigate the role of Treg cells in stroke recovery, the changes in cytokine expression and their effects on immune cell interactions was analyzed. Additionally, infarct size and behavioral scores were measured to assess the neuroprotective effects of Treg cells. By integrating multiple indicators, the comprehensive evaluation of potential benefits of Treg cells in the treatment of ischemic stroke was performed. ResultsTreg cells significantly regulated the expression levels of both pro-inflammatory and anti-inflammatory cytokines in vitro and in vivo, effectively balancing the immune response and suppressing excessive inflammation. Additionally, Treg cells inhibited the activation and activity of inflammatory cells, thereby reducing neuroinflammation. In the MCAO mouse model, Treg cells were observed to accumulate in the infarcted brain region, where they significantly reduced the infarct size, demonstrating their neuroprotective effects. Furthermore, Treg cell therapy notably improved behavioral scores, suggesting its role in promoting functional recovery, and increased the survival rate of ischemic stroke mice, highlighting its potential as a promising therapeutic strategy for stroke treatment. ConclusionIn vitro induced Treg cells can effectively suppress neuroinflammation caused by ischemic stroke, demonstrating promising clinical application potential. By regulating the balance between pro-inflammatory and anti-inflammatory cytokines, Treg cells can inhibit immune responses in the nervous system, thereby reducing neuronal damage. Additionally, they can modulate the immune microenvironment, suppress the activation of inflammatory cells, and promote tissue repair. The therapeutic effects of Treg cells also include enhancing post-stroke recovery, improving behavioral outcomes, and increasing the survival rate of ischemic stroke mice. With their ability to suppress neuroinflammation, Treg cell therapy provides a novel and effective strategy for the treatment of ischemic stroke, offering broad application prospects in clinical immunotherapy and regenerative medicine.
3.Effect of The Hydrophilic Amino Acids on Self-assembly Behavior of Short Bola-like Peptides
Xin-Xin GAO ; Yu HAN ; Yi-Lin ZHOU ; Xi-Ya CHEN ; Yu-Rong ZHAO
Progress in Biochemistry and Biophysics 2025;52(5):1290-1301
ObjectiveBola-like short peptides exhibit novel self-assembly properties due to the formation of peptide dimers via hydrogen bonding interactions between their C-terminals. In this configuration, hydrophilic amino acids are distributed at both terminals, making these peptides behave similarly to Bola peptides. The electrostatic repulsive interactions arising from the hydrophilic amino acids at each terminal can be neutralized, thereby greatly promoting the lateral association of β-sheets. Consequently, assemblies with significantly larger widths are typically the dominant nanostructures for Bola-like peptides. To investigate the effect of hydrophilic amino acids on the self-assembly behavior of Bola-like peptides, the peptides Ac-RI3-CONH2 and Ac-HI3-CONH2 were designed and synthesized using the Bola-like peptide Ac-KI3-CONH2 as a template. Their self-assembly behavior was systematically examined. MethodsAtomic force microscopy (AFM) and transmission electron microscopy (TEM) were employed to characterize the morphology and size of the assemblies. The secondary structures of the assemblies were analyzed using circular dichroism (CD) and Fourier transform infrared (FTIR) spectroscopy. Small-angle neutron scattering (SANS) was used to obtain detailed structural information at a short-length scale. Based on these experimental results, the effects of hydrophilic amino acids on the self-assembly behavior of Bola-like short peptides were systematically analyzed, and the underlying formation mechanism was explored. ResultsThe aggregation process primarily involved three steps. First, peptide dimers were formed through hydrogen bonding interactions between their C-terminals. Within these dimers, the hydrophilic amino acids K, R, and H were positioned at both terminals, enabling the peptides to self-assemble in a manner similar to Bola peptides. Next, β-sheets were formed via hydrogen bonding interactions along the peptide backbone. Finally, self-assemblies were generated through the lateral association of β-sheets. The results demonstrated that both Ac-KI3-CONH2 and Ac-RI3-CONH2 could self-assemble into double-layer nanotubes with diameters of approximately 200 nm. These nanotubes were formed by the edge fusion of helical ribbons, which initially emerged from twisted ribbons. Notably, the primary assemblies of these peptides exhibited opposite chirality: nanofibers formed by Ac-KI3-CONH2 displayed left-handed chirality, whereas those formed by Ac-RI3-CONH2 exhibited right-handed chirality. This reversal in torsional direction was primarily attributed to the different abilities of K and R to form hydrogen bonds with water. In contrast, Ac-HI3-CONH2 formed narrower twisted ribbons with a significantly reduced width of approximately 30 nm, which was attributed to the strong steric hindrance caused by the imidazole rings. The multilayer height of these ribbons was mainly due to the unique structure of the imidazole rings, which can function as both hydrogen bond donors and acceptors, thereby promoting aggregate growth in the vertical direction. ConclusionThe final morphology of the self-assemblies resulted from a delicate balance of various non-covalent interactions. By altering the types of hydrophilic amino acid residues in Bola-like short peptides, the relative strength of non-covalent interactions that drive assembly formation can be effectively regulated, allowing precise control over the morphology and chirality of the assemblies. This study provides a simple and effective approach for constructing diverse self-assemblies and lays a theoretical foundation for the development of functional biomaterials.
4.Mechanisms of Traditional Chinese Medicine in Prevention and Treatment of Stroke by Regulating Ferroptosis: A Review
Mingyan WEI ; Shanze LI ; Rui HAN ; Qingbi LI ; Xingyi SUN ; Han ZHANG ; Lin LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):313-321
Stroke is one of the leading causes of death and disability worldwide, ranking as the second leading cause of mortality globally and the primary cause of adult disability. Its pathological process involves complex cascade mechanisms, with high incidence and disability rates, posing a major threat to human health. According to statistics from the World Health Organization, more than 13 million new cases of stroke occur globally each year, resulting in direct medical costs and socioeconomic burdens amounting to hundreds of billions of dollars. In recent years, breakthroughs in the study of programmed cell death mechanisms have provided new insights into stroke treatment. Among them, ferroptosis, a novel form of cell death driven by iron-dependent lipid peroxidation, has attracted widespread attention in the pathological process of stroke. Ferroptosis is closely associated with iron metabolism disorders, oxidative stress, and lipid peroxidation, and exhibits unique regulatory effects in key pathological processes of stroke, such as ischemia-reperfusion injury, disruption of the blood-brain barrier, and neuronal apoptosis. It plays an important role in post-stroke neurological damage. Chinese medicine, as an essential component of traditional Chinese medicine (TCM), has demonstrated advantages in modulating ferroptosis and exerting neuroprotective effects. This review systematically summarizes current research on the neuroprotective mechanisms of Chinese medicine compound formulas and monomers through the regulation of ferroptosis pathways in post-stroke conditions, aiming to provide a basis for optimizing clinical treatment strategies and exploring new therapeutic approaches, and to offer new strategies and approaches for stroke treatment.
5.Mechanisms of Traditional Chinese Medicine in Prevention and Treatment of Stroke by Regulating Ferroptosis: A Review
Mingyan WEI ; Shanze LI ; Rui HAN ; Qingbi LI ; Xingyi SUN ; Han ZHANG ; Lin LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):313-321
Stroke is one of the leading causes of death and disability worldwide, ranking as the second leading cause of mortality globally and the primary cause of adult disability. Its pathological process involves complex cascade mechanisms, with high incidence and disability rates, posing a major threat to human health. According to statistics from the World Health Organization, more than 13 million new cases of stroke occur globally each year, resulting in direct medical costs and socioeconomic burdens amounting to hundreds of billions of dollars. In recent years, breakthroughs in the study of programmed cell death mechanisms have provided new insights into stroke treatment. Among them, ferroptosis, a novel form of cell death driven by iron-dependent lipid peroxidation, has attracted widespread attention in the pathological process of stroke. Ferroptosis is closely associated with iron metabolism disorders, oxidative stress, and lipid peroxidation, and exhibits unique regulatory effects in key pathological processes of stroke, such as ischemia-reperfusion injury, disruption of the blood-brain barrier, and neuronal apoptosis. It plays an important role in post-stroke neurological damage. Chinese medicine, as an essential component of traditional Chinese medicine (TCM), has demonstrated advantages in modulating ferroptosis and exerting neuroprotective effects. This review systematically summarizes current research on the neuroprotective mechanisms of Chinese medicine compound formulas and monomers through the regulation of ferroptosis pathways in post-stroke conditions, aiming to provide a basis for optimizing clinical treatment strategies and exploring new therapeutic approaches, and to offer new strategies and approaches for stroke treatment.
6.Effects of Methylenetetrahydrofolate Reductase Polymorphism on Clinical Features of High-Risk Psychosis Before Schizophrenia
Psychiatry Investigation 2025;22(4):442-450
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.
7.Fisher discriminant analysis of multimodal ultrasound in diagnosis of cervical metastatic lymph nodes in papillary thyroid cancer
Yixuan WANG ; Yue HAN ; Fei LI ; Yuyang LIN ; Bei WANG
The Korean Journal of Internal Medicine 2025;40(1):103-114
Background/Aims:
The purpose of this study was to develop a diagnostic model utilizing multimodal ultrasound parameters to aid in the detection of cervical lymph node metastasis in papillary thyroid cancer (PTC) patients.
Methods:
The study included 84 suspicious lymph nodes from 69 PTC patients, all of whom underwent fine needle aspiration with pathological results. Data from conventional grayscale ultrasound, shear wave elastography (SWE), and superb microvascular imaging were analyzed. Key ultrasound features were compared between benign and metastatic groups to create a diagnostic model using Fisher’s stepwise discriminant analysis. The model’s effectiveness was assessed with self-testing, cross-validation, and receiver operating characteristic curve analysis.
Results:
Four features, namely lymphatic hilum (X1), cortical hyperechogenicity (X2), vascular pattern (X4), and SWEmean (X7), were integral to the discriminant analysis, resulting in the equation: Y1 = -3.461 + 2.423X1 + 0.321X2 + 1.620X4 + 0.109X7, Y2 = -8.053 + 0.414X1 + 2.600X2 + 2.504X4 + 0.192X7. If Y1 < Y2, the LN would be diagnosed as metastatic lymph nodes. The model demonstrated an area under the curve of 0.833, with a sensitivity of 83.33% and specificity of 83.33%.
Conclusions
The multimodal ultrasound diagnostic model, established through Fisher’s stepwise discriminant analysis, proved effective in identifying metastatic lymph nodes in PTC patients.
8.Vitamin D Attenuates Non-Alcoholic Fatty Liver Disease in High-Fat Diet-Induced Obesity Murine Model
Sook In CHUNG ; Lin LIANG ; Heejae HAN ; Kyung Hee PARK ; Jae-Hyun LEE ; Jung-Won PARK
Yonsei Medical Journal 2025;66(2):75-86
Purpose:
Obesity and metabolic syndrome are acknowledged as key factors contributing to the development of non-alcoholic fatty liver disease (NAFLD). Vitamin D (VitD) is a multifaceted secosteroid hormone known for its anti-fibrotic and anti-inflammatory properties, with its deficiency often linked to obesity. Our study aimed to investigate whether VitD supplementation could mitigate the liver pathology associated with NAFLD.
Materials and Methods:
The NAFLD model was developed by subjecting male C57BL/6 mice to a high-fat diet (HFD) for 14 weeks.These mice were supplemented with VitD through intraperitoneal injection at a dosage of 7 μg/kg, administered three times per week for 7 weeks.
Results:
HFD resulted in VitD deficiency, insulin resistance, and increased liver weight. It elevated serum levels of liver aminotransferases and triglyceride, ultimately leading to steatohepatitis with fibrosis. This model exhibited increased levels of transforming growth factor (TGF)-β1, pro-inflammatory cytokines, HNF4α transcription factors, reactive oxygen species (ROS), renin-angiotensin system activity, and epithelial-mesenchymal transitions (EMT) within the liver. Supplementation with VitD resulted in the recovery of liver weight, improvement in histologic features associated with steatohepatitis, and reduction in alanine aminotransferases and triglyceride levels induced by the HFD. Additionally, it mitigated the HFD-induced over-expressions of TGF-β1 and fibrosis-related genes, along with pro-inflammatory cytokines and ROS. Notably, no adverse effect was found due to VitD supplementation in this model.
Conclusion
VitD ameliorates steatohepatitis within obesity-induced NAFLD through its multifaceted pathways. VitD supplementation emerges as a potentially safe, cost-effective, and direct treatment approach for NAFLD patients dealing with obesity or metabolic dysfunction.
10.Long-term Outcomes of Endoscopic Radiofrequency Ablation versus Endoscopic Submucosal Dissection for Widespread Superficial Esophageal Squamous Cell Neoplasia
Xin TANG ; Qian-Qian MENG ; Ye GAO ; Chu-Ting YU ; Yan-Rong ZHANG ; Yan BIAN ; Jin-Fang XU ; Lei XIN ; Wei WANG ; Han LIN ; Luo-Wei WANG
Gut and Liver 2025;19(2):198-206
Background/Aims:
Endoscopic radiofrequency ablation (ERFA) is a treatment option for superficial esophageal squamous cell neoplasia (ESCN), with a relatively low risk of stenosis; however, the long-term outcomes remain unclear. We aimed to compare the long-term outcomes of patients with widespread superficial ESCN who underwent endoscopic submucosal dissection (ESD) or ERFA.
Methods:
We retrospectively analyzed the clinical data of patients with superficial ESCN who underwent ESD or ERFA between January 2015 and December 2021. The primary outcome measure was recurrence-free survival.
Results:
Ninety-two and 33 patients with superficial ESCN underwent ESD and ERFA, respectively. The en bloc, R0, and curative resection rates for ESD were 100.0%, 90.2%, and 76.1%, respectively. At 12 months, the complete response rate was comparable between the two groups (94.6% vs 90.9%, p=0.748). During a median follow-up of 66 months, recurrence-free survival was significantly longer in the ESD group than in the ERFA group (p=0.004), while no significant differences in overall survival (p=0.845) and disease-specific survival (p=0.494) were observed.Preoperative diagnosis of intramucosal cancer (adjusted hazard ratio, 5.55; vs high-grade intraepithelial neoplasia) was an independent predictor of recurrence. Significantly fewer patients in the ERFA group experienced stenosis compare to ESD group (15.2% vs 38.0%, p=0.016).
Conclusions
The risk of recurrence was higher for ERFA than ESD for ESCN but overall survival was not affected. The risk of esophageal stenosis was significantly lower for patients who underwent ERFA.

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