Abuse of amphetamine-based stimulants is a primary public health concern. Recent studies have underscored a troubling escalation in the inappropriate use of prescription amphetamine-based stimulants. However, the neurophysiological mechanisms underlying the impact of acute methamphetamine exposure (AME) on sleep homeostasis remain to be explored. This study employed non-human primates and electroencephalogram (EEG) sleep staging to evaluate the influence of AME on neural oscillations. The primary focus was on alterations in spindles, delta oscillations, and slow oscillations (SOs) and their interactions as conduits through which AME influences sleep stability. AME predominantly diminishes sleep-spindle waves in the non-rapid eye movement 2 (NREM2) stage, and impacts SOs and delta waves differentially. Furthermore, the competitive relationships between SO/delta waves nesting with sleep spindles were selectively strengthened by methamphetamine. Complexity analysis also revealed that the SO-nested spindles had lost their ability to maintain sleep depth and stability. In summary, this finding could be one of the intrinsic electrophysiological mechanisms by which AME disrupted sleep homeostasis.
Animals ; Methamphetamine ; Electroencephalography ; Male ; Sleep/drug effects* ; Central Nervous System Stimulants ; Delta Rhythm/drug effects* ; Sleep Stages/drug effects*

Previous studies have found associations between color discrimination deficits and cognitive impairments besides aging. However, investigations into the microstructural pathology of brain white matter (WM) associated with these deficits remain limited. This study aimed to examine the microstructural characteristics of WM in the non-demented population with abnormal color discrimination, utilizing Neurite Orientation Dispersion and Density Imaging (NODDI), and to explore their correlations with cognitive functions and cognition-related plasma biomarkers. The tract-based spatial statistic analysis revealed significant differences in specific brain regions between the abnormal color discrimination group and the healthy controls, characterized by increased isotropic volume fraction and decreased neurite density index and orientation dispersion index. Further analysis of region-of-interest parameters revealed that the isotropic volume fraction in the bilateral anterior thalamic radiation, superior longitudinal fasciculus, cingulum, and forceps minor was significantly correlated with poorer performance on neuropsychological assessments and to varying degrees various cognition-related plasma biomarkers. These findings provide neuroimaging evidence that WM microstructural abnormalities in non-demented individuals with abnormal color discrimination are associated with cognitive dysfunction, potentially serving as early markers for cognitive decline.
Humans ; White Matter/pathology* ; Male ; Female ; Cognitive Dysfunction/physiopathology* ; Middle Aged ; Aged ; Color Perception/physiology* ; Brain/pathology* ; Neuropsychological Tests ; Diffusion Tensor Imaging

Periodontitis is a common oral disease characterized by progressive alveolar bone resorption and inflammation of the periodontal tissues. Dimethyl fumarate (DMF) has been used in the treatment of various immune-inflammatory diseases due to its excellent anti-inflammatory and antioxidant functions. Here, we investigated for the first time the therapeutic effect of DMF on periodontitis. In vivo studies showed that DMF significantly inhibited periodontal destruction, enhanced mitophagy, and decreased the M1/M2 macrophage ratio. In vitro studies showed that DMF inhibited macrophage polarization toward M1 macrophages and promoted polarization toward M2 macrophages, with improved mitochondrial function, inhibited oxidative stress, and increased mitophagy in RAW 264.7 cells. Furthermore, DMF increased intracellular mitochondrial Tu translation elongation factor (TUFM) levels to maintain mitochondrial homeostasis, promoted mitophagy, and modulated macrophage polarization, whereas TUFM knockdown decreased the protective effect of DMF. Finally, mechanistic studies showed that DMF increased intracellular TUFM levels by protecting TUFM from degradation via the ubiquitin-proteasomal degradation pathway. Our results demonstrate for the first time that DMF protects mitochondrial function and inhibits oxidative stress through TUFM-mediated mitophagy in macrophages, resulting in a shift in the balance of macrophage polarization, thereby attenuating periodontitis. Importantly, this study provides new insights into the prevention of periodontitis.
Dimethyl Fumarate/pharmacology* ; Mitophagy/drug effects* ; Animals ; Mice ; Macrophages/metabolism* ; Periodontitis/prevention & control* ; RAW 264.7 Cells ; Oxidative Stress/drug effects* ; Peptide Elongation Factor Tu/metabolism* ; Mice, Inbred C57BL ; Male ; Mitochondria/drug effects*

Objective To investigate the perioperative use of antimicrobial agents in class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City,and provide a basis for the rational use of antimicrobial agents in such surgeries.Methods Perioperative antimicrobial prophylaxis(PAP)in patients undergoing class Ⅰ incisional ophthalmic surgery reported by secondary first-class and above hospitals in Shanghai City from 2017 to 2022 was collected retrospectively.The prophylactic use rate,types,rationality of selection,and timing of use of antimicrobial agents were analyzed comprehensively.Results From 2017 to 2022,a total of 54 868 cases of class Ⅰ incisional ophthalmic surgeries were reported from secondary first-class and above hospitals in Shanghai City.The PAP rates in tertiary comprehensive hospitals,tertiary specialty hospitals,tertiary traditional Chinese medicine hospitals,and secondary comprehensive hospitals were 4.72％,1.79％,3.22％,and 6.63％,re-spectively.The overall PAP rate showed a yearly decreasing trend,from 6.39％in 2017 to 2.31％in 2021.Among different types of hospitals,the PAP rate in secondary comprehensive hospitals decreased most significantly,from 12.72％in 2017 to 0.53％in 2022.The main types of prophylactic antimicrobial use were first-,second-and third-generation cephalosporins,and quinolones.The rational selection rates of antimicrobial agents were highest in ter-tiary comprehensive hospitals(17.13％)and lowest in tertiary specialty hospitals(1.08％).The PAP rates in sys-temic veins 0.5-1 hour before surgery were highest in tertiary specialty hospitals(88.17％)and lowest in tertiary comprehensive hospitals(71.53％).The withdrawal rates of antimicrobial agents within 24 hours after surgery were highest in tertiary traditional Chinese medicine hospitals(80.87％)and lowest in tertiary specialty hospitals(13.26％).Conclusion The PAP for class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City still presents certain irrational phenomena in terms of antimicrobial types and administration routes.The administration rate 0.5-1 hour before surgery and withdrawal rate of antimicrobial agents within 24 hours after surgery need to be further improved.Enhanced management is necessary to promote more rational use of antimicrobial agents.

Objective:To explore the risk factors for contralateral central lymph nodes (Cont-CLNs) metastasis of unilateral papillary thyroid carcinoma (PTC) and to guide the decision-making of clinical surgical scope.Methods:The data of 362 patients who underwent total thyroidectomy and bilateral central lymph node dissection at the Sichuan Cancer Hospital from September 2020 to April 2022 and were confirmed as unilateral PTC by postoperative pathology were retrospectively analyzed. Among them, 87 were male and 275 were female, aged from 11 to 76 years. According to whether presence of Cont-CLNs metastasis, they were divided into the metastasis group (115 cases) and the non-metastasis group (247 cases). The relationship between the demographic characteristics, clinicopathological characteristics and other indicators of the two groups of patients and their metastases of Cont-CLNs was analyzed. Univariate analysis, multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were used to screen the risk factors for Cont-CLNs metastasis. Postoperative follow up was performed in the patients.Results:Univariate analysis showed that age, gender, combined Hashimoto′s thyroiditis, extranodal invasion, pretracheal and prelaryngeal lymph node metastasis, ipsilateral central lymph nodes (Ipsi-CLNs) metastasis on the affected side, lateral cervical lymph node metastasis on the affected side, lesion location, and tumor diameter were associated with Cont-CLNs metastasis (all P values<0.05). Multivariate revealed that: each of male gender, Ipsi-CLNs metastasis, pretracheal and prelaryngeal lymph node metastasis, cancer focus location in the isthmus, and unilateral glandular lobe combined with isthmus was an independent risk factor for Cont-CLNs metastasis. For predicting the metastasis risk of Cont-CLNs, the optimal critical value of the number of metastasized Ipsi-CLNs was 2.5, and the area under the ROC curve (AUC) was 0.700; the optimal cut-off value of the number of metastasized pretracheal and prelaryngeal lymph nodes was 1, with an AUC of 0.681. The AUC of gender was 0.630, and the AUC of the cancer lesion location was 0.545. Multivariate ROC curve analysis for Cont-CLNs metastasis based on gender, the number of metastasized Ipsi-CLNs, the number of metastasized pretracheal and prelaryngeal lymph nodes, and the location of cancer foci showed an AUC of 0.794. The patients were followed up until January 2025. Excluding 3 cases with hoarseness caused by recurrent laryngeal nerve invasion before the operation and 3 cases with resection and reconstruction of invaded recurrent laryngeal nerves discovered during the operation, there were no patients with permanent recurrent laryngeal nerve palsy after the operation. There were 3 cases with postoperative permanent hypoparathyroidism. There no patients with postoperative recurrence. Conclusion:Risk factors for Cont-CLNs metastasis include male sex, Ipsi-CLNs metastasis, pretracheal and prelaryngeal lymph nodes metastasis, and tumor location in the isthmus or unilateral lobe plus isthmus. In unilateral PTC with the risk factors, Cont-CLNs dissection may be considered.

Lung transplantation is currently the only recognized effective treatment for end-stage lung disease and has improved the quality of life for patients. However, lung transplantation still faces many challenges, including rejection, infection, post-transplant acute kidney injury, post-transplant diabetes mellitus, ischemia-reperfusion injury and donor shortage, etc. Chinese lung transplantation scholars made a series of important progress in the field of clinical research in 2024, focusing on the study and solution of the above problems, and providing new ideas for lung transplantation surgery. This article systematically reviews the clinical research and technological innovation in the field of lung transplantation in 2024, summarizes the achievements of clinical research in the field of lung transplantation in China in 2024, and aims to providing new directions and strategies for future research.

Objective To assess the clinical value of a novel surgical technique—Tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device in the resection of anterior mediastinal masses. Methods Patients who underwent tubeless subxiphoid uniportal video-assisted thoracoscopic surgery via balance-shaped sternal elevation device in anterior mediastinal masses process at the Department of Thoracic Surgery, West China Hospital, Sichuan University from March to April 2025 were included, and their clinical data were analyzed. Results A total of 4 patients were included, with 2 males and 2 females, aged 58-75 years. The diameter of the tumor was 2.5-3.0 cm. The operation time was 60.0-150.0 min, intraoperative blood loss was 5-10 mL, pain score on the 3rd day after surgery was 0 points, and postoperative hospital stay was 2-3 days. All patients achieved complete resection of the masses and thymus without perioperative complications. Conclusion The tubeless subxiphoid uniportal video-assisted thoracoscopic surgery with percutaneous suspension technique via balance-shaped sternal elevation device technique optimizes surgical visualization and instrument maneuverability while avoiding complications related to conventional anesthesia and tubing, thereby markedly enhancing the minimally invasive profile of anterior mediastinal masses resections. In addition to maintaining procedural safety, this approach effectively reduces postoperative pain and accelerates patient recovery, highlighting its potential for widespread clinical adoption.

Objective To investigate the changes in the tumor microenvironment of pancreatic cancer(PDAC)complicated with diabetes mellitus(DM)in a mouse model of hyperglycemia and orthotopic pancreatic cancer by analyzing transcriptome and single-cell transcriptome data in order to identify potential therapeutic targets.Method By integrating single-cell transcriptome and bulk transcriptome data,bioinformatics analysis was conducted to compare the characteristics of tumor cells and tumor immune microenvironment between PDAC patients with DM(DM group)and those without DM(non-DM group).Twenty male C57BL/6 mice(6 weeks old,weighing 18～20 g)were randomly divided into a hyperglycemic group[STZ group,continuous intraperitoneal injection of 50 mg/kg streptozocin(STZ)(final concentration of 1％)dissolved in citrate buffer],and a control group(Control group,an equivalent volume of citrate buffer without STZ at the same time points),with 10 mice in each group.Tail-tip blood glucose level was measured to monitor glycemic status.After orthotopic inoculation of pancreatic cancer cells in both Control and STZ groups,tumor-infiltrating immune cells were harvested.Flow cytometry was employed to determine the effects of hyperglycemia on:total CD8+T cell and Treg cell populations;CD8+T cell subsets expressing Ki67,TNF-α,granzyme B(GZMB)and IFN-γ;surface expression of PD-1,lymphocyte activation gene-3(LAG-3)and T cell immunoglobulin and mucin domain-3(Tim-3)on CD8+T cells;programmed death-ligand 1(PD-L1)expression on tumor cells;and tumor-associated macrophage surface expression of major histocompatibility complex classⅠ(MHC-Ⅰ)and cluster of differentiation 206(CD206).Results Bioinformatics analysis revealed that,compared to the non-DM group,the genes significantly up-regulated in the DM group were associated with poor prognosis(P＜0.001).The proportion of type 2 ductal cells was increased in the DM group,exhibiting higher levels of copy number variation(P＜0.001).In the tumor immune microenvironment of the DM group,there was an increase in the proportion of Treg cells(P＜0.05)and an elevated exhaustion score for CD8+T cells(P＜0.001),accompanied by down-regulated expression of effector molecules,up-regulated expression of inhibitory checkpoints,and a significant increase in the M2 score of M2-like macrophages(P＜0.001).Animal experiments and flow cytometry found that,compared to the Control group,the STZ group had a shorter survival time(P＜0.001),with decreased proportions of total CD8+T cells(P＜0.01)and CD8+T cells expressing Ki67,TNF-α,GZMB and IFN-γ(P＜0.01),increased proportion of Treg cells(P＜0.001),up-regulated expression of PD-1,LAG-3 and Tim-3 on the surface of CD8+T cells(P＜0.001),and up-regulation of PD-L1 on tumor cell surface(P＜0.001)and enhanced expression of CD206 on the surface of tumor-associated macrophages,while down-regulated expression of MHC-Ⅰ(P＜0.001).Conclusion High glucose promotes the formation of an immunosuppressive microenvironment in PDAC,and targeting type 2 ductal cells and immunosuppressive cells in the tumor microenvironment,combined with dual immune checkpoint antibody therapy,may improve patient prognosis.

Objective:To investigate the feasibility and safety of radical thyroidectomy through a small incision in the side neck of the sternocleidomastoid intermuscular approach.Methods:Clinical data of newly treated patients with papillary thyroid carcinoma admitted to the Department of Thyroid-Otolaryngology and Head and Neck Surgery,Sichuan Cancer Hospital from Feb. 2022 to Mar. 2024 were collected. They were divided into SMIA group and LACA group according to surgical methods. In the SMIA group, 52 cases were treated by the sternocleidomastoid intermuscular approach with a small incision on the side of the neck. In the LACA group, 100 cases were treated by the cervical white line approach with a low cut incision on the front of the neck. Clinical data of the two groups, such as perioperative related indicators,postoperative aesthetic effects and postoperative complications were collected. Independent sample t test or Mann-Whitney U test were compared between the measurement data groups. Chi-square test was used for comparison between data sets. Results:There was no significant difference in demographic and clinical characteristics of tumor between the two groups. Compared with the control group,the operation time of the observation group was longer (83.85±18.72minvs71.33±15.50min, t=4.39, P<0.001) , the total postoperative drainage volume was significantly reduced (61.29±41.80ml vs. 99±35.80ml, Z=-4.65, P<0.001) , and the extubation time was significantly shortened (2.81±0.82d vs. 3.19±0.66d, Z=-3.31, P<0.001) , and the difference was statistically significant. There was no difference in postoperative transient hoarseness between the two groups ( χ 2=0.01, P=0.932) . Patient’s self-feeling was followed up one month after surgery. The number of patients with swallowing discomfort in the SMIA group was significantly lower than that in the LACA group ( χ2=4.30, P=0.017) . There was no significant difference between the two groups in neck stiffness ( χ2=3.16, P=0.075) , scar hyperplasia ( χ2=0.04, P=0.840) , and incision aesthetic effect score ( Z=-0.73, P=0.468) . Conclusions:Radical thyroidectomy through a small incision in the side neck of the sternocleidomastoid muscle is a safe, feasible and aesthetic mode of operation. It’s worth promoting in clinical practice,especially for patients with unilateral tumor and early tomur T stage.

Objective:To investigate the feasibility and safety of radical thyroidectomy through a small incision in the side neck of the sternocleidomastoid intermuscular approach.Methods:Clinical data of newly treated patients with papillary thyroid carcinoma admitted to the Department of Thyroid-Otolaryngology and Head and Neck Surgery,Sichuan Cancer Hospital from Feb. 2022 to Mar. 2024 were collected. They were divided into SMIA group and LACA group according to surgical methods. In the SMIA group, 52 cases were treated by the sternocleidomastoid intermuscular approach with a small incision on the side of the neck. In the LACA group, 100 cases were treated by the cervical white line approach with a low cut incision on the front of the neck. Clinical data of the two groups, such as perioperative related indicators,postoperative aesthetic effects and postoperative complications were collected. Independent sample t test or Mann-Whitney U test were compared between the measurement data groups. Chi-square test was used for comparison between data sets. Results:There was no significant difference in demographic and clinical characteristics of tumor between the two groups. Compared with the control group,the operation time of the observation group was longer (83.85±18.72minvs71.33±15.50min, t=4.39, P<0.001) , the total postoperative drainage volume was significantly reduced (61.29±41.80ml vs. 99±35.80ml, Z=-4.65, P<0.001) , and the extubation time was significantly shortened (2.81±0.82d vs. 3.19±0.66d, Z=-3.31, P<0.001) , and the difference was statistically significant. There was no difference in postoperative transient hoarseness between the two groups ( χ 2=0.01, P=0.932) . Patient’s self-feeling was followed up one month after surgery. The number of patients with swallowing discomfort in the SMIA group was significantly lower than that in the LACA group ( χ2=4.30, P=0.017) . There was no significant difference between the two groups in neck stiffness ( χ2=3.16, P=0.075) , scar hyperplasia ( χ2=0.04, P=0.840) , and incision aesthetic effect score ( Z=-0.73, P=0.468) . Conclusions:Radical thyroidectomy through a small incision in the side neck of the sternocleidomastoid muscle is a safe, feasible and aesthetic mode of operation. It’s worth promoting in clinical practice,especially for patients with unilateral tumor and early tomur T stage.