Journal of Sichuan University (Medical Science Edition)
Journal of Sichuan University (Medical Science Edition) was established in 1959. It is one of the key scientific journals in China and has been awarded the first-rank national and provincial prizes for several times. As the first grade medical journal in China ,we devote to spreading the fresh and dominant medical information of China's western region. The content of the journal covers the domain of scientific researches in medicine, which includes biomedicine, biomedical engineering (e.g. tissue and cellular engineering), medicine genetics, pharmaceutical development, pathogenesis, preventive medicine, and clinical medicine. ISSN 1672-173X (Online) To date, the journal has been successively included in authoritative databases, such as: The Index Medical (IM), Scopus, the Chemical Abstracts (CA), the Biological Abstracts (BA), the Excerpta Medical (EM), the Chinese Science Citation Database (CSCD) and the Chinese BioMedical Literature Database (CBM)) have indexed the journal since 1986. In the past decade, various foundations, including the National Natural Science Foundation of China and the China Medical Board of New York Corporation, supported the large amounts of the articles published in the journal, and authors from the universities and institutes in China, as well as those from the USA, the Netherlands, Canada, Australia, Japan, New Zealand, and Germany contributed these articles. Our Editor in Chief, Prof. WEI Yu-quan, Academian of the Chinese Academy of Sciences who is devoting himself to biotherapy of human diseases. Our editorial committee members are the pioneers in the academic fields, research programs, and scientific activities in the West China Center of Medical Sciences of Sichuan University, and some of them are well-known in the fields of biomedical science and engineering. With the editorial committee 's guidance, we got honor by our exertion and perseverance. We enjoyed the 1989 first Grade Award of Excellent Quality for Editing the Universiy Journal, the 1990 and 1993 First Grade Awards for Excellent Scintific and Techonol Journal in Sichuan Province, the 1997 First Grade National Award for Excellent Scientific and Technological Journal, the 1999 First Nominated Award for Journals in China, the 2002 Awards for One-hundred Outstanding Journals in China., and the 2006 to 2012 National Outstanding Scientific and Technological University Journal in the Ministry of Education. Sponsored by: Sichuan University. Address: 17, Section 3, Renmin Nanlu, Chengdu, Sichuan, 610041, People's Republic of China E-mail: mailbox@jsu-mse.com Tel：028-85501322
The Clinical Application and Development of Tumor Biomarkers in China
Tumor biomarkers play an increasingly prominent role in early screening, auxiliary diagnosis, efficacy evaluation, and prognosis assessment, becoming an essential component of the precision oncology system. This article systematically reviews the nearly two-century development history of tumor markers, from early protein-based markers to the genomics era. It focuses on the fundamental principles of standardized application of tumor markers in China, the current laboratory application status, and clinical application recommendations for key cancer types such as lung cancer and liver cancer. Additionally, it delves into multidimensional marker research supported by liquid biopsy technologies, including ctDNA genetic markers, DNA methylation, exosomes, and circulating tumor cells, as well as cutting-edge advancements and clinical translation challenges in areas such as artificial intelligence model construction. This review aims to provide insights for the innovative development and standardized application of tumor markers in China, thereby enhancing the precision of cancer prevention and control. Keywords: Tumor biomarkers, Precision diagnosis and treatment, Clinical application, Review
Copyright (c) 2026 Journal of Sichuan University (Medical Science Edition)
Advances in the Application of Artificial Intelligence in Clinical Microbiological Testing
Traditional microbiological detection methods have inherent limitations in detection speed, sensitivity, and specificity, making them increasingly unable to meet growing clinical demands. In recent years, artificial intelligence (AI) has been rapidly integrated into clinical microbiological testing, with numerous studies demonstrating its significant potential to enhance pathogen identification, predict antimicrobial susceptibility testing, and advance laboratory automation. This article systematically reviews classical AI algorithms and their latest advancements in this field. For visual data applications, deep learning-based models are used to automatically analyze microscopy images or colony morphology, significantly improving recognition efficiency and diagnostic accuracy. For non-visual data, AI has achieved breakthroughs in analyzing multi-omics data such as genomics, transcriptomics, and metagenomics, and is widely used for rapid pathogen identification and prediction of antimicrobial resistance. Despite its promising prospects, the application of AI in clinical microbiological testing remains in the early stages of transitioning from scientific research to clinical practice. This paper further discusses the key challenges and opportunities encountered during this technological translation, aiming to help clinical professionals comprehensively understand the current status, future trends, and potential impact of AI in this field, thereby promoting its development into reliable and scalable routine diagnostic methods. Keywords: Artificial intelligence, Machine learning, Clinical microbiological testing, Antimicrobial resistance, Review
Liquid Biopsy Revolutionizes the Precise Management of Tumors Across the Entire Course: Current Situation and Future Prospects
Tumors represent a global public-health concern, accounting for approximately one-sixth of all fatalities worldwide annually. Attaining precise management of patients across all stages of diagnosis, treatment, and surveillance is not merely a significant challenge in contemporary clinical practice but also a crucial strategy for enhancing patient survival rates. In comparison with traditional testing approaches, liquid biopsy offers the benefits of being less invasive and enabling repeated sampling. Through the examination of biological specimens that can be readily and repeatedly obtained from the patient's body, liquid biopsy can furnish information throughout the entire continuum of disease diagnosis, treatment, and follow-up prognosis. Consequently, it emerges as a highly prospective substitute for tissue samples in the minimally invasive, real-time, and comprehensive monitoring of tumors in clinical contexts. This article conducts a systematic review of the common liquid biopsy markers in the oncology field and their latest detection technologies. It encompasses detection schemes for non-blood samples such as cerebrospinal fluid and feces. Moreover, it proposes a novel framework for the precise management of the entire tumor process based on "multi-marker combination + full sample coverage". The article further deliberates on a series of challenges currently encountered in developing liquid biopsy into a mature clinical testing project. These challenges include the standardization of sample testing procedures, the establishment of standardized reporting systems, and how to strike a balance between the popularity of detection methods and cost control, with the aim of promoting the development of liquid biopsy in tumor early screening, treatment innovation, and extensive application. We anticipate constructing a full-chain system spanning from basic research to transformational production and clinical application. We aim to develop an integrated detection platform, establish standardized reporting procedures and a well-established regulatory mechanism, offer patients full-cycle precise management from diagnosis to rehabilitation, and ultimately convert cancer from an "incurable disease" into a "preventable and controllable" chronic disease. Keywords: Liquid biopsy, Tumor biomarker, Minimal residual disease, Disease management, Review
Nanomaterial-driven Lateral Flow Immunoassay: Technological Development and Application
In clinical testing, traditional research has focused on developing large analytical instruments capable of processing high sample volumes with fully automated and highly sensitive measurements. In recent years, however, there has been increasing demand for analytical reagents for point-of-care testing (POCT), which do not require a specific location or professional operators. This trend is exemplified by the lateral flow immunoassay (LIFA), favored for its simple operation, rapid results, and user-friendly design. The fiber membrane-based structure of LIFA provides both cost-effectiveness and ease of disposal, addressing key concerns related to testing budgets and environments. Despite its compact size, LIFA incorporates multiple technological innovations, reflecting years of research and development. Current studies focus on advancing LIFA technology, paving the way for next-generation diagnostic devices. These advancements aim to redefine testing convenience and enhance the capacity to respond effectively to urgent public health challenges. The future of LIFA is gradually unfolding, with deeper integration into daily health management and emergency response systems. In this review, we present the historical development of LIFA and several cutting-edge LIFA technologies, including gold nanoparticle-based, magnetic, photothermal, fluorescent, and surface-enhanced Raman scattering approaches, aiming to inspire future LIFA research and development. Keywords: Lateral flow immunoassay, Point-of-care diagnostic tool, Nanomaterials, Fluorescence, Raman spectrum, Review
Research Progress on the Biological Functions of Intestinal Eosinophils and Related Diseases
Intestinal eosinophils are multifunctional immune cells that play a crucial role in maintaining intestinal homeostasis and participating in various disease processes. Under physiological conditions, these cells contribute to maintaining intestinal barrier function, regulating local microbiota homeostasis, promoting tissue repair, and modulating local immune responses by secreting various cytokines and bioactive mediators, thereby playing an essential role in sustaining intestinal homeostasis. In pathological conditions, however, eosinophils can release cytotoxic proteins and pro-inflammatory mediators, contributing to the pathogenesis of various intestinal diseases. This paper systematically reviews the biological characteristics and functional diversity of intestinal eosinophils, as well as their mechanisms of action in diseases such as parasitic infections, inflammatory bowel disease, intestinal fibrosis, food allergy, eosinophilic enteritis, and functional bowel disorders, aiming to provide a theoretical basis for the clinical intervention of related diseases. Keywords: Eosinophils, Intestinal barrier, Intestinal homeostasis, Immunomodulation, Intestinal disorders, Review
Nanoparticle Delivery Systems in Rheumatoid Arthritis: More Than Vehicles
Rheumatoid arthritis (RA) is one of the most prevalent systemic autoimmune inflammatory diseases worldwide, causing chronic, progressively worsening arthritis that may ultimately lead to disability. Despite the availability of numerous therapeutic agents, limitations exhibit, including poor aqueous solubility, suboptimal stability, inadequate permeability, short half-lives, and multi-organ toxicity during long-term or high-dose administration. Nanoparticle-based drug delivery offers a robust strategy to mitigate these deficiencies while maximizing therapeutic efficacy through controlled-release mechanisms and rational administration route design. This review systematically summarizes recent advancements in nanoparticle drug delivery strategies for RA treatment from the perspective of three distinct mechanisms. It details the design rationales, therapeutic principles, and effects of various delivery systems, with particular emphasis on their interactions with the disease microenvironment and the entire body. Keywords: Nanoparticle, Drug delivery, Rheumatoid arthritis, Controlled release, Review
ZHANG Keyi, GUO Yixue, ZENG Xianghu, CAI Bei, ZHANG Junlong, LI Yi, NIU Qian
Analysis of Clinical Characteristics and Diagnostic Indicators in Patients With Heparin-induced Thrombocytopenia After Cardiac Surgery
Objective To investigate the diagnosis rate of heparin-induced thrombocytopenia (HIT), the incidence of new thrombosis, the dynamic evolution pattern of platelets, and the clinical characteristics in patients with suspected HIT after cardiac surgery; and to evaluate the diagnostic value of HIT antibodies (HIT-Ab), 4T's score, and Lillo-Le Louet (LLL) score for HIT. Methods A retrospective cohort study was conducted. A total of 307 patients with suspected HIT after cardiac surgery at Fuwai Hospital of the Chinese Academy of Medical Sciences from April 2023 to December 2024 were included. Clinical and laboratory data were collected. All patients underwent 4T's score, LLL score, and HIT-Ab testing. Patients were divided into the non-HIT group (n = 269) and the HIT group (n = 38) based on the final clinical diagnosis. The platelet evolution patterns and other clinical characteristics of the two groups were compared. HIT-Ab concentration was divided into four groups: negative (< 1.0 U/mL, n = 257), weakly positive (1.0-4.9 U/mL, n = 34), moderately positive (5.0-9.9 U/mL, n = 11), and strongly positive (≥ 10 U/mL, n = 5). Differences in the incidence of new thrombosis and the diagnosis rate of HIT among the groups were analyzed, and the diagnostic efficacy of HIT-Ab concentration, 4T's score, and LLL score for HIT was evaluated using receiver operating characteristic (ROC) curves. Results The diagnosis rate of HIT was 12.38% (38/307), and the incidence of new thrombosis in the HIT group was 63.16%, higher than the 34.57% in the non-HIT group (P < 0.001). Among HIT patients, 76.32% showed a biphasic decline pattern of platelets (pattern A), and their risk of HIT was significantly higher than that of patients with pattern B (odds ratio [OR] = 10.32, 95% confidence interval [CI]: 4.64-22.95). The incidence of new thrombosis increased stepwise with higher HIT-Ab concentration (32.7% in the negative group to 100% in the strongly positive group, P < 0.001), and the diagnosis rate of HIT increased from 0 in the negative group to 64.71% in the weakly positive group, reaching 100% in the moderate/strong positive group. The areas under the ROC curves for HIT-Ab concentration, 4T's score, and LLL score for diagnosing HIT were 0.996 (95% CI: 0.991-1.000), 0.799 (95% CI: 0.727-0.870), and 0.860 (95% CI: 0.811-0.908), respectively. When the HIT-Ab concentration was 1 U/mL, the diagnostic sensitivity and negative predictive value (NPV) were both 100%. Compared with the traditional diagnostic criteria for high-risk HIT populations (4T's score cutoff of 4, LLL score cutoff of 2), the optimal cutoff value of 4T's score selected by the maximum Youden index was 5, and the optimal cutoff value of LLL score was 3. Conclusion The incidence of new thrombosis in patients with suspected HIT after cardiac surgery increases stepwise with higher HIT-Ab levels. The diagnostic value of the LLL score for HIT is superior to that of the 4T's score. HIT-Ab testing has high sensitivity and negative predictive value, making it a reliable tool for guiding early discontinuation of heparin and excluding HIT. Combining HIT-Ab concentration, platelet evolution pattern, and clinical scores helps more accurately identify HIT risk, initiate alternative anticoagulation therapy, and optimize anticoagulation management strategies. Keywords: Heparin-induced thrombocytopenia, Cardiac surgery, Thrombosis, HIT antibodies. Thrombocytopenia
WANG Guoqiang, YUE Pinli, ZHU Guoyan, XU Qiang, WANG Ximing, SONG Danyu, GAO Zhangwei, WANG Yue, LIU Jianru, ZHAN
Association Between T Lymphocyte Mitochondrial Function and Disease Activity in Anti-NMDAR Encephalitis
Objective To investigate mitochondrial functional alterations in T lymphocytes of patients with anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDAR encephalitis, NMDAR-E) and their association with immune exhaustion. Methods Twenty-five patients with NMDAR-E diagnosed in the Department of Neurology, West China Hospital, Sichuan University, between January and March 2025 (14 mild cases and 11 severe cases) and 16 healthy controls were enrolled. Flow cytometry was performed to characterize immune-cell distributions in paired peripheral blood and cerebrospinal fluid (CSF), and to evaluate the percentage of cells with low mitochondrial membrane potential (MMP-Low%), mitochondrial mass (MM), and PD-1 expression. Results In severe patients, the proportions of CD3+ and CD4+ T cells in CSF, the MMP-Low% of CD3+, CD4+, and CD8+ T cells (P < 0.01), and the MM of CD3+ (P < 0.01) and CD8+ T cells (P < 0.05) were all significantly higher than those in matched peripheral blood. Compared with healthy controls, the MMP-Low% of naïve and central memory CD4+ and CD8+ T-cell subsets in peripheral blood was significantly decreased (P < 0.05), whereas the proportion of PD-1-positive cells was significantly increased in CD4+naïve and central memory T-cell subsets (P < 0.01). Conclusion CSF T cells in patients with anti-NMDAR encephalitis display a state of dysfunctional mitochondrial accumulation, suggesting a possible dysregulation of mitochondrial mass homeostasis under the central inflammatory milieu. Mitochondrial features of peripheral T cells indicate the presence of systemic immune exhaustion. The MMP-Low% of CSF CD8+ T cells and the peripheral blood lymphocyte percentage may serve as potential immunometabolic biomarkers for distinguishing disease severity in NMDAR-E. Keywords: Anti-NMDAR encephalitis, T-lymphocytes, Mitochondria, PD-1
MA Yuwen, ZHANG Erdi, CAO Lin, WANG Zhiyin, WANG Minjin, LI Feng5, YING Binwu, YAN Lin
Analysis of the Advantages and Clinical Validation of Real-Time Fluorescence Nucleic Acid Isothermal Amplification Detection Technology in Detecting Low Viral Load Samples From HBV-Infected Patients
Objective This paper examines the advantages and clinical application value of simultaneous amplification and testing (SAT) real-time fluorescent nucleic acid isothermal amplification detection technology for detecting low viral load samples in individuals infected with hepatitis B virus (HBV). Methods Using reverse transcription real-time fluorescence quantitative PCR (RT-qPCR) as the reference, the detection performance of real-time fluorescence nucleic acid isothermal amplification detection technology (SAT) was evaluated, including linear range, precision, and detection limit. Both methods were used to detect samples, which were the national standard substances of hepatitis B virus ribonucleic acid (HBV RNA). A total of 170 patients with chronic HBV infection were included for methodological comparison. They were divided into a high-level group (serum HBV DNA > 100 IU/mL, n = 111) and a low-level group (serum HBV DNA ≤ 100 IU/mL, n = 59) based on serum HBV DNA levels. The correlation and consistency of the test results from the two methods were evaluated. Additionally, the distribution characteristics of HBV RNA and its correlation with HBV markers were analyzed using data from 1006 patients with chronic HBV infection. Results Compared with the RT-qPCR method for detecting HBV RNA, the SAT method demonstrated a wider linear range (102-108 copies/mL vs. 103-108 copies/mL), higher precision for low-concentration samples (intra-assay coefficient of variation: 4.23% vs. 12.82%), and a lower detection limit (50 copies/mL vs. 500 copies/mL). In clinical sample testing, the overall detection rate of the SAT method was higher than that of the RT-qPCR method (72.35% vs. 57.64%, P < 0.01), and the detection rate of the SAT method was also higher in the HBV DNA low-level group (50.85% vs. 28.81%, P = 0.007). Large-sample analysis showed that among patients with HBV DNA < 20 IU/mL, 40.4% still had detectable HBV RNA, and the positive rate for HBsAg ≥ 100 IU/mL was 55.5%. Correlation analysis indicated that HBV RNA was moderately positively correlated with HBsAg (r = 0.506) and HBeAg (r = 0.454), and weakly negatively correlated with ALT (r = －0.098) and AST (r = －0.082) (all P < 0.05). Conclusion The SAT method offers higher sensitivity and stability in detecting low-level HBV RNA. HBV RNA can serve as a serological marker for evaluating viral transcription activity and has clinical application value in managing patients who are HBV DNA-negative or have low HBV DNA levels. Keywords: Hepatitis B virus, Simultaneous amplification and testing, Clinical trial, Ultra-low limit detection, Covalently closed circular DNA (cccDNA)
HUANG Qunfang, XIE Rubing, LAN Yanpinя, XUN Zhen, OU Qishui, LIU Can
Pathogen Profile and Risk Factors for Hospital-Acquired Infection in Stroke Patients
Objective To investigate the risk factors for hospital-acquired infection in patients with stroke and to analyze the distribution of pathogens and characteristics of infection sites. Methods A retrospective cohort study was conducted, enrolling 393 patients with stroke hospitalized at Beijing Tiantan Hospital, Capital Medical University, from January 2024 to July 2025. Among them, 184 patients were assigned to the infection group and 209 to the non-infection group. Multivariable logistic regression analysis was used to identify risk factors for hospital-acquired infection, and a nomogram prediction model was constructed. Results Multivariable logistic regression analysis identified cerebral infarction (odds ratio = 25.09, 95% confidence interval: 5.38-117.10), no history of alcohol consumption (odds ratio = 4.47, 95% confidence interval: 1.51-13.18), no history of cerebrovascular disease (odds ratio = 5.04, 95% confidence interval: 1.35-18.76), elevated neutrophil count (odds ratio = 1.29, 95% confidence interval: 1.08-1.55), and elevated C-reactive protein (odds ratio = 1.03, 95% confidence interval: 1.01-1.06) as independent risk factors for hospital-acquired infection in patients with stroke. Absence of nasogastric tube feeding (odds ratio = 0.09, 95% confidence interval: 0.03-0.31), no indwelling urinary catheterization (odds ratio = 0.21, 95% confidence interval: 0.06-0.77), and absence of postoperative coma (odds ratio = 0.07, 95% confidence interval: 0.01-0.36) were identified as protective factors. The nomogram model achieved an area under the curve of 0.96 (95% confidence interval: 0.94-0.98) in the training set and 0.94 (95% confidence interval: 0.90-0.99) in the validation set, with good calibration. Gram-negative bacteria were the predominant pathogens (70.2%), and the respiratory tract was the most common infection site (92.9%). Endotracheal intubation and impaired consciousness were identified as common risk factors for both pulmonary and Gram-negative bacterial infections. Conclusion This study identified independent risk factors for hospital-acquired infection in patients with stroke, developed a nomogram model with good predictive performance, and preliminarily characterized the risk profiles associated with different infection types and sites. These findings provide a reference for early identification of high-risk patients and the formulation of targeted prevention and control strategies. Keywords: Stroke, Hospital-acquired infection, Risk factors, Predictive model
XU Ting, HAN Bingqing, ZHANG Hanyu, SHAO Chunqing, WANG Yufei, JIAO Yang, ZHANG Guojun
Diagnostic Performance of Metagenomic Next-Generation Sequencing for Mucormycosis: A Retrospective Cohort Study
Objective Mucormycosis is a life-threatening invasive fungal infection with high mortality, yet traditional diagnostic methods are limited by low positivity rates. This study aims to evaluate the diagnostic performance and clinical utility of metagenomic next-generation sequencing (mNGS) in mucormycosis. Methods A retrospective analysis was conducted on 135 patients with mNGS results positive for Mucorales fungi at West China Hospital of Sichuan University from November 1, 2022, to October 31, 2024. Based on comprehensive clinical diagnostic criteria (including proven and probable cases), patients were classified into a confirmed mucormycosis group and a non-mucormycosis group. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of normalized read counts (lgRPM) from different specimen types. Fungal species distribution and laboratory parameters were compared between the two groups. Results Among the 135 patients with positive mNGS results for Mucorales, 100 (74.1%) were ultimately diagnosed with mucormycosis. ROC curve analysis revealed that the diagnostic performance of mNGS varied by specimen type. For blood specimens, the area under the curve (AUC) was 0.772, with a specificity of 87.5% at the optimal cutoff value of 0.11 RPM. For bronchoalveolar lavage fluid specimens, the AUC was 0.717, with a sensitivity of 76.5% at the optimal cutoff value of 0.02 RPM. Combined analysis of all specimens showed that at the optimal cutoff value of 0.08 RPM (approximately 8 reads/100M), the sensitivity and specificity were 62.0% and 71.4%, respectively. Species distribution analysis showed that the proportions of Cunninghamella elegans (11.0% vs. 2.9%) and Rhizomucor pusillus (9.0% vs. 2.9%) were significantly higher in the confirmed group than in the non-mucormycosis group (P < 0.05). Levels of C-reactive protein and interleukin-6 were also significantly higher in the confirmed group (P < 0.05). Notably, all seven renal perfusion fluid samples yielded false-positive mNGS results. Conclusion mNGS technology can effectively improve the diagnostic yield for mucormycosis. However, results should be interpreted in conjunction with specimen type, read count, and clinical characteristics. BALF specimens offer high sensitivity, making them suitable for screening, while blood specimens demonstrate high specificity, making them valuable for confirmation. Positive results from low-biomass samples such as renal perfusion fluid warrant caution against false positivity. Fungal species identification and inflammatory markers may serve as adjunctive evidence for clinical diagnosis. Keywords: Mucormycosis, Metagenomic next-generation sequencing, Diagnostic performance, Species distribution
ZHANG Weili, ZHONG Shan, LU Sifen5, XIAO Xia, XIE Yi
Construction of an Early-stage Risk Prediction Model for Trauma-Induced Coagulopathy
Objective Based on prospectively collected early clinical and laboratory data from trauma patients at admission, a risk prediction model for the early assessment of trauma-induced coagulopathy (TIC) in emergency trauma patients was constructed and validated. Methods This study analyzed the clinical data and laboratory results of 285 emergency trauma patients admitted between January 2024 and December 2024. The patients were randomly divided into a training set (n = 199) and a test set (n = 86) at a 7∶3 ratio. Univariate and multivariate logistic regression analyses were performed to identify independent predictors of TIC and to construct a risk prediction model. The diagnostic efficacy of the model was evaluated by the area under the receiver operating characteristic curve (AUC). The calibration curve was plotted using the Bootstrap method to assess calibration, and the clinical net benefit was evaluated by decision curve analysis (DCA). Results Multivariate logistic regression analysis identified head trauma, mean arterial pressure (MAP), prothrombin time (PT), and thrombin time (TT) as independent predictors of TIC, and a predictive model was developed. The AUC of the model was 0.804 (95% CI: 0.737-0.871) in the training set and 0.847 (95% CI: 0.767-0.927) in the test set. The calibration curve showed a high level of agreement between the predicted and actual probabilities. DCA indicated that the model provided significant clinical net benefit across a broad range of risk thresholds (0.2-1.0). Conclusion This study developed and validated a TIC risk prediction model that demonstrated excellent early predictive efficacy for TIC in emergency trauma patients. Keywords: Wounds and injuries, Blood coagulation disorders, Logistic models, Risk assessment
XU Xu, HE Meina, SHAO Min, LIU Xin, YI Qi, ZHANG Bingyan, HUANG Ying, TAN Chaochao
Next-Generation Sequencing-Based Detection of Gene Mutations and Its Association With Clinicopathological Features in Gastric Cancer
Objective To analyze the gene mutation profile of Chinese patients with gastric cancer and to explore its correlations with clinicopathological characteristics and prognosis. Methods Fifty-five patients with gastric cancer were enrolled. Next-generation sequencing was performed to detect mutations in cancer-related genes, microsatellite instability, and tumor mutational burden. The associations of high-frequency mutated genes with clinicopathological features and progression-free survival (PFS) were analyzed. Key findings were validated and ethnic heterogeneity was assessed using The Cancer Genome Atlas stomach adenocarcinoma cohort (n = 436). Results Somatic mutations were identified in 85.45% (47/55) of patients. The most frequently mutated genes were TP53 (29.09%), ARID1A (16.36%), CDH1 (14.55%), LRP1B (14.55%), and PIK3CA (12.73%). TP53 mutations were associated with T4 stage (P = 0.028) and diffuse-type gastric cancer (P = 0.008). CDH1 mutations were enriched in signet-ring cell carcinoma (P = 0.012) and poorly differentiated tumors (P = 0.006). Pathogenic germline mutations were identified in 20% (11/55) of patients. Univariate survival analysis revealed that CDH1 mutation was an independent poor prognostic factor for PFS (hazard ratio = 3.110, 95% confidence interval: 3.370-20.000). Validation in The Cancer Genome Atlas cohort confirmed that the poor prognostic effect of CDH1 mutation was present only in the Asian subgroup (hazard ratio = 5.00, 95% confidence interval: 2.01-12.43), demonstrating significant ethnic heterogeneity. Conclusion Chinese patients with gastric cancer exhibit a distinct gene mutation profile, and key gene mutations are closely associated with tumor aggressiveness. This multi-cohort validation study indicates ethnic differences in the prognostic value of genes such as CDH1, highlighting the importance of precision molecular classification in the Chinese population. Keywords: Stomach neoplasms, Next-generation sequencing, Gene mutation, Prognosis, Precision medicine
Combined Analysis of Dyslipidemia and Tumor Markers for the Diagnosis of Gastric Cancer
Objective To investigate changes in serum lipid profile parameters combined with tumor markers in gastric cancer (GC) patients and their value in GC screening. Methods A total of 100 patients diagnosed with GC at Renji Hospital (West) between May and September 2025 were consecutively enrolled as the GC group (54 cases in stage Ⅰ/Ⅱ and 46 cases in stage Ⅲ/Ⅳ). Additionally, 100 age- and sex-matched healthy individuals undergoing routine physical examinations were included as the healthy control (HC) group. The serum levels of nine lipid indicators (high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], total cholesterol [TC], triglycerides [TG], small and dense low-density lipoprotein cholesterol [sdLDL-C], apolipoprotein [Apo] A1, ApoB, ApoC2, and ApoC3) and five tumor markers (carcinoembryonic antigen [CEA], carbohydrate antigen [CA] 19-9, CA50, CA242, and CA72-4) were measured using an automatic biochemical analyzer and an electrochemiluminescence instrument. Intergroup differences were analyzed using the Mann–Whitney U test. A stepwise Fisher discriminant analysis was used to establish a screening model based on lipid profiles and tumor markers. Diagnostic performance was evaluated using receiver operating characteristic (ROC) curve analysis, and the model's diagnostic performance was validated using 30 GC patients and 30 healthy controls consecutively enrolled from September to December 2025. Results Compared with the HC group, the GC group showed significantly lower levels of ApoA1, ApoC3, TC, HDL-C, LDL-C, and sdLDL-C (P < 0.05), while CEA and CA50 levels were significantly higher (P < 0.05). Patients with stage Ⅲ-Ⅳ GC had lower levels of ApoA1, ApoB, TC, HDL-C, LDL-C, and sdLDL-C compared to those with stage Ⅰ-Ⅱ GC (P < 0.05). ROC analysis showed that among individual indicators, HDL-C had the highest diagnostic performance, with an area under the curve (AUC) of 0.797 (95% CI: 0.734-0.850), sensitivity of 78%, and specificity of 74%. The screening model including ApoA1, ApoC3, HDL-C, LDL-C, TC, sdLDL-C, CEA, CA50, and age achieved an AUC of 0.940 (95% CI: 0.891-0.971), with 83.75% sensitivity and 92.5% specificity, outperforming any single biomarker in diagnostic efficacy. Conclusion The combined panel of ApoA1, ApoC3, HDL-C, LDL-C, TC, sdLDL-C, CEA, CA50 and age offers a potential auxiliary tool for detecting gastric cancer. Keywords: Gastric cancer, Blood lipid, Tumor markers, Diagnostic efficacy, Fisher discriminant model
LU Jingbo, XU Runhao, LI Tinghua, ZHENG Bing, LI Min
Protein Expression Levels of the DCAF4-MEN1-hTERT Axis in Patients With Colon Adenocarcinoma and Their Relationship With Clinicopathological Characteristics and Prognosis
Objective To explore the relationship between the expression levels of DNA damage binding protein 1 and cullin 4-related factor 4 (DCAF4) complex, which degrades the tumor suppressor menin 1 (MEN1)–human telomerase reverse transcriptase (hTERT) axis protein, and the clinicopathological characteristics and prognosis of patients with colon adenocarcinoma. Methods Ninety-four patients with colon adenocarcinoma were included. The expression of DCAF4, MEN1, and hTERT in cancer tissues and adjacent tissues was detected by immunohistochemistry. The expression levels of DCAF4, MEN1, and hTERT in patients with different pathological grades and T stages were compared. Spearman rank correlation was used for correlation analysis, and survival analysis was conducted to investigate the impact of DCAF4, MEN1, and hTERT expression levels on the overall survival of patients with colon adenocarcinoma. Results The expression levels of DCAF4 and MEN1 proteins in cancer tissues of colon adenocarcinoma patients (10.83 ± 2.89; 9.71 ± 3.57) were higher than those in adjacent tissues (2.39 ± 1.57; 4.92 ± 2.71, P < 0.001). The expression level of DCAF4 in patients with grade Ⅱ colon adenocarcinoma (14.16 ± 4.67) was lower than in patients with grade Ⅲ (20.79 ± 5.06, P < 0.01), while the expression of MEN1 (10.74 ± 3.06) was higher than in patients with grade Ⅲ (8.07 ± 2.88, P < 0.001), while there was no statistically significant difference in the protein expression scores of MEN1 and hTERT between the two groups. Compared with colon adenocarcinoma patients carrying the wild-type BRAF gene (5.47 ± 1.81), those with the mutant-type BRAF gene had a higher expression score of DCAF4 protein (9.30 ± 0.42, P < 0.001). The expression of MEN1 was correlated with the positive rate of PD1 (Spearman ρ = 0.219, P = 0.034). Compared with patients in stage T2 (3.93 ± 2.47), patients in stage T3 had a higher expression score of hTERT protein (6.25 ± 3.04, P < 0.05). Survival analysis showed that the expressions of MEN1, hTERT, and DCAF4 were not significantly associated with overall survival. Conclusion High expression of DCAF4 and hTERT, as well as low expression of MEN1, is associated with unfavorable clinical and pathological features but has no significant relationship with prognosis. Keywords: Colonic adenocarcinoma, DNA damage-binding protein 1 and cullin 4-associated factor 4 (DCAF4), Tumor suppressor menin 1 (MEN1), Human telomerase reverse transcriptase (hTERT), Clinicopathological characteristics, Overall survival
ZHU Shun, CHEN Siyuan, ZHENG Qin, LIU Hong
Construction and Efficacy Evaluation of a Highly Efficient Diagnostic Model for Neurosyphilis Driven by the Cerebrospinal Fluid/Serum Free Light Chain Index
Objective To determine free light chains (FLC) in cerebrospinal fluid (CSF) and serum, calculate the FLC index, and establish a model to evaluate its application value in diagnosing neurosyphilis. Methods This study included 87 syphilis patients, comprising 48 neurosyphilis patients (NS group) and 39 non-neurosyphilis patients (n-NS group). CSF and serum samples were collected from all patients to measure kappa free light chains (FLC-κ) and lambda free light chains (FLC-λ). The FLC index, FLC-κ index, and FLC-λ index were calculated. Receiver operating characteristic (ROC) curves were used to evaluate these indices. A neurosyphilis diagnostic model based on the FLC index was established and its visualization was verified. Results Statistically significant differences were observed between the two groups in serological syphilis screening, CSF nucleated cell count, CSF microprotein, CSF IgG, IgG synthesis rate, IgG index, and albumin quotient (P < 0.05). The areas under the ROC curves (AUC) for the FLC-κ index, FLC-λ index, and albumin quotient were 0.998 (95% CI: 0.990-1.000), 0.988 (95% CI: 0.961-1.000), and 0.635 (95% CI: 0.496-0.751), respectively. In the FLC-κ index model, the FLC-κ index (P < 0.05) significantly affected the diagnosis of neurosyphilis, while in the FLC-λ index model, only the FLC-λ index (P < 0.05) had a significant effect. The training ROC curve AUC for the diagnosis model based on the FLC-κ index was greater than 0.950. Its calibration curve showed good predictive performance when the predicted probability was close to 80%, but poor performance when the predicted probability was 40%-60%. The AUC for the diagnosis model based on the FLC-λ index was 0.926, with good predictive performance when the predicted probability was close to 85%, and poor performance when the predicted probability was 40%-70%. Conclusion FLC-κ and FLC-λ have high diagnostic performance for neurosyphilis, and the FLC index has certain application value in the diagnosis of neurosyphilis. Keywords: Neurosyphilis, Kappa free light chains, Lambda free light chains, Free light chains index, Diagnostic model
DENG Jielun, WU Sirui, YE Fei, HUANG Xiyue, LI Dongdong, LIU Jinbo
Characterization of Immune Reconstitution Patterns in B-cell Subsets Mediated by B-cell Targeted Therapies
Objective To analyze the reconstitution patterns of fine B-cell subsets in patients following treatment with the CD20 monoclonal antibody ofatumumab and the CD19 monoclonal antibody inebilizumab, and to evaluate the clinical application value of individualized fine B-cell subset dynamic profiling in guiding targeted therapy strategies. Methods This prospective study enrolled 30 patients with pemphigus receiving ofatumumab and 26 patients with neuromyelitis optica spectrum disorders (NMOSD) receiving inebilizumab at West China Hospital of Sichuan University between October 2023 and May 2025. Thirty healthy individuals were enrolled as controls for baseline comparison. Dynamic monitoring of fine B-cell subsets, anti-desmoglein (Dsg) antibodies, and immunoglobulins was performed at three post-treatment time points (1 month, 3 months, and 6 months). A natural cubic spline model was used to fit trend curves, combined with differential analysis to assess population-level immune reconstitution. Results At baseline (T0), patients in the pemphigus group had higher levels of several B-cell subsets compared to healthy controls. Total B-cell counts were 347.50 (250.40-621.8) cells/μL versus 217.50 (143.50-275.30) cells/μL, memory B-cell counts were 127.30 (74.63-196.70) cells/μL versus 57.00 (41.75-88.25) cells/μL, and plasmablast counts were 5.63 (2.02-11.48) cells/μL versus 1.00 (1.00-2.00) cells/μL. These differences were significant (P < 0.05). In contrast, NMOSD patients showed significantly higher plasmablast counts compared to healthy controls (2.07 [1.60-3.58] cells/μL vs. 1.00 [1.00-2.00] cells/μL) (P = 0.04). After three months, the proliferation rate of naive B cells increased, with counts rising from 0.95 cells/μL at T3 to 3.25 cells/μL at T6 (P = 0.001). Throughout the entire monitoring period, the proportion of memory B cells consistently remained higher than that of naive B cells and plasmablasts. In NMOSD patients, B-cell regeneration was slow after treatment. Total B-cell counts showed a significant increase only by T6 compared to T1 (from 0 cells/μL to 2.65 cells/μL, P = 0.026), with the increase primarily due to naive B cells. Plasmablast counts in the pemphigus group were significantly higher than those in the NMOSD group at T1 and T3 (P < 0.01), but this difference disappeared by T6. Among the cohort, two pemphigus patients showed abnormal B-cell reconstitution, characterized by persistently elevated plasmablasts or undetectable Dsg antibody decline. One NMOSD patient exhibited a reversal in B-cell subset proportions, with memory B-cell counts exceeding naive B-cell counts, along with increased plasma cell counts and elevated IgG immunoglobulin levels. Conclusion Targeted therapies against CD19 and CD20 induce distinctly different patterns of B-cell reconstitution. Ofatumumab treatment leads to a phased regenerative process in B cells, whereas inebilizumab treatment results in delayed regeneration. Increased plasmablasts, aberrant memory B-cell proliferation, and rebounding Dsg antibodies may signal potential adverse events. These findings support monitoring fine B-cell subsets for precise immunological assessment to guide personalized treatment. Keywords: Pemphigus, Neuromyelitis optica spectrum disorders, B-cell subsets, Ofatumumab, Inebilizumab, Immune reconstitution
WANG Xueqiao, ZHANG Yang, DUAN Zhikai, WEI Mintong, GUO Yixue, FENG Weihua, YAN Lin, TAO Yanxin, CAI Bei, ZHANG Junl
A Study on the Relationship Between Cyclic Inflammatory Protein Fibroblast Growth Factor 21, Osteoporosis, and Fractures
Objective Systematically conduct a screening of the potential targets within circulating inflammatory proteins (CIPs) that have an impact on osteoporosis (OP) and fractures. Validate their association with bone mineral density (BMD) via clinical samples, thereby offering novel evidence for the regulation of bone metabolism. Methods The study employs bidirectional Mendelian randomization analysis to investigate the causal relationship between CIPs and OP, as well as fractures. Two groups are included: patients with type 2 diabetes mellitus (T2DM) and healthy individuals. General patient data are collected, and fibroblast growth factor 21 (FGF21) and bone metabolism indicators are measured and compared among the T2DM group with OP (DOP), the T2DM group without OP (NDOP), and the control group. Results Among the 91 types of CIPs retrieved from the EBI GWAS Catalog database, the inverse variance weighting (IVW) analysis indicated that FGF21 potentially had a causal relationship with both OP and fractures that transpired within the past five years. An elevation in its level augmented the risk of OP (odds ratio [OR] = 1.003, 95% CI: 1.001-1.005; P = 0.004) and the risk of fractures in the past five years (OR = 1.004, 95% CI: 1.000-1.008; P = 0.038). Reverse Mendelian randomization demonstrated that OP and fractures in the past five years had no causal impact on the eight CIPs, including FGF21, identified in the forward analysis. Clinical investigations showed that the plasma FGF21 level in the DOP group (396.92 [308.98, 523.94] pg/mL) was higher than that in the NDOP group (346.88 [283.82, 466.86] pg/mL) and the control group (233.66 [169.95, 327.78] pg/mL) (all P < 0.05). In all samples, subsequent to adjusting for age, body mass index, glycated hemoglobin, calcium, and phosphorus, FGF21 was negatively correlated with the T-value of the lumbar spine (β = －0.003, 95% CI: －0.004 to －0.002, P < 0.0001) and the T-value of the total hip (β = －0.002, 95% CI: －0.003 to －0.001, P < 0.0001). In T2DM, FGF21 was negatively correlated with the T-value of the lumbar spine (β = －0.003, 95% CI: －0.004 to －0.0014, P < 0.0001) and the T-value of the total hip (β = －0.001, 95% CI: －0.0022 to －0.0005, P = 0.002), and this negative correlation persisted after adjusting for the aforementioned covariates. Conclusion FGF21 elevates the risk of OP and fractures that have occurred over the past five years, and a causal relationship exists. It serves as a potential risk factor for impaired bone health in T2DM. Keywords: Fibroblast growth factor 21, Bone mineral density, Osteoporosis, Fracture, Mendelian randomization analysis
The Prevalence and Clinical Significance of the Centromere Protein-F-Like Immunofluorescence Staining Pattern in a Large ANA-positive Cohort
Objective To investigate the prevalence and clinical significance of the centromere protein-F-like (CENP-F-like) immunofluorescence staining pattern in a large patient cohort and through literature review. Methods We retrospectively analyzed antinuclear antibody (ANA) immunofluorescence assay results from 191274 patients at West China Hospital of Sichuan University between March 2018 and November 2020. Specific immunological markers were tested in sera with CENP-F-like patterns. Additionally, a narrative review of seven relevant studies was performed for comparison. Results In Southwest China, ANA positivity was found in 32.09% of patients, with the CENP-F-like pattern detected in 0.015% of all cases and 0.05% of ANA-positive individuals. The CENP-F-like pattern appeared predominantly at titers ≥ 1∶320, most often in isolation (68.97%), but also mixed with cytoplasmic speckled patterns. Patients with cancers accounted for the highest proportion (31.03%), including solid tumors and hematologic malignancies. Metastasis was observed in patients with solid tumors, while graft-versus-host disease (GVHD) occurred in those with hematologic malignancies post-transplantation. Autoimmune diseases (AIDs) were diagnosed in 20.69% of cases, all showing disease-specific autoantibodies. These findings were broadly consistent with previous reports and suggest a possible association between the CENP-F-like pattern and malignancies. Conclusion The CENP-F-like pattern is rare in ANA tests but may be associated with clinically important conditions, particularly cancers and AIDs. The occurrence of metastasis and GVHD in patients with this pattern highlights its potential clinical relevance, and concurrent autoantibodies may assist in diagnosing AIDs. Keywords: Antibodies, antinuclear, Fluorescent antibody technique, indirect, Clinical relevance. Neoplasms, Autoimmune diseases
SU Zhenzhen, ZHANG Feng, ZHANG Lijing, HAYISAER YEERKEN, YANG Bin, HU Jing, WANG Li, GAO Xuedan, ZHANG Junlong, HU
Tibetan Medicine Classic Formula Srolo Bzhtang Granules Ameliorates Pulmonary Fibrosis via Dual Pathways of Nrf2/HO-1 and PI3K/AKT/mTOR Regulating Oxidative Stress
Objective To investigate how Srolo Bzhtang (SBT), a classical Tibetan medicine formula, improves oxidative stress and ultimately alleviates pulmonary fibrosis in rats through the Nrf2/HO-1 and PI3K/AKT/mTOR pathways. Methods Seventy-two SD rats were randomly assigned to 12 sham surgery groups (Sham group, receiving equal volumes of normal saline) and 60 model groups (established by intratracheal instillation of bleomycin to induce pulmonary fibrosis). Twenty-four hours after modeling, the model groups were randomly divided into the model group (Model), the positive drug group (pirfenidone, 150 mg/kg), and low, medium, and high dose Soroxisol groups (SBT-L 0.5 g/kg, SBT-M 1.5 g/kg, SBT-H 4.5 g/kg), with 12 rats in each group. Each group received the drug by gavage once daily for 21 days.The Sham and Model groups received equal volumes of normal saline. HE and Masson staining were used to observe the pathological changes of pulmonary fibrosis in each group. ELISA was used to measure the levels of inflammatory factors (TNF-α, IL-8) and matrix metalloproteinases (MMP-2, MMP-9) in serum. The activities of malondialdehyde (MDA) and superoxide dismutase (SOD) in serum were also measured. The expression levels of Nrf2/HO-1 and proteins in the PI3K/AKT/mTOR signaling pathway in lung tissue were determined by Western blot. Results HE and Masson staining showed that pulmonary fibrosis was more severe in the Model group than in the Sham group, and each drug administration group could reverse this process to varying degrees. SBT inhibited the levels of inflammatory factors TNF-α and IL-8 (all P < 0.05), and compared with the Model group, the levels of matrix metalloproteinases MMP-2 and MMP-9 were decreased (all P < 0.05). Pathological section results showed that SBT improved lung tissue damage in pulmonary fibrosis rats to some extent. Compared with the Model group, MDA levels in the low-, medium-, and high-dose SBT groups decreased (all P < 0.05), and SOD enzyme activity showed an increasing trend. Western blot results indicated that, compared with the Model group, the low-, medium-, and high-dose SBT groups activated the protein expression of Nrf2 and HO-1 (all P < 0.05) and downregulated the expression levels of p-PI3K/PI3K, p-AKT/AKT, and p-mTOR/mTOR (all P < 0.05). Conclusion SBT affects the Nrf2/HO-1 and PI3K/AKT/mTOR signaling pathways, inhibits oxidative stress, and thereby delays the progression of pulmonary fibrosis in rats. Keywords: Tibetan Medicine Classic Formula, Srolo Bzhtang Granules, Pulmonary fibrosis, Oxidative stress, Mechanism pathway
DU Jinyang, BAIMALAZONG, DEJIBAIZHEN, BASANGDEJI, BIANBACIREN, YE Bengui
A Randomized Controlled Clinical Trial of Acupuncture at the Sphenopalatine Ganglion for the Treatment of Allergic Rhinitis
Objective To evaluate the clinical efficacy and safety of acupuncture at the sphenopalatine ganglion (SPG) for the treatment of allergic rhinitis (AR). Methods A randomized controlled trial design was used. A total of 120 patients with AR were randomly assigned in a 1∶1 ratio to either the experimental group (acupuncture on the SPG, twice a week for 2 weeks) or the control group (oral lupatadine fumarate tablets, 10 mg daily for 2 weeks). The primary outcome measures were nasal symptom and sign scores at 1 and 2 weeks after treatment. Secondary outcome measures included the total non-nasal symptom score (TNNSS) and the rhinoconjunctivitis quality of life questionnaire (RQLQ) score. Results Four cases were excluded from both the experimental group and the control group. Ultimately, 56 cases in each group completed the study. After two weeks of treatment, the total effective rates were 82.1% for the experimental group and 87.5% for the control group, with no statistically significant difference. At each time point after treatment, the symptom scores, sign scores, TNNSS, and RQLQ scores in both groups decreased compared to baseline, and these differences were statistically significant (P < 0.001). Generalized estimating equation (GEE) analysis showed that the improvement trends for most indicators were consistent between the two groups, but there was a "group × time" interaction, indicating that improvement in nasal congestion symptoms in the experimental group was greater than in the control group during the first week of treatment (experimental group: 2.0 [1.0, 2.0] vs. control group: 2.0 [1.0, 2.0], interaction P = 0.023). Forest plot analysis further showed that the standardized mean difference (SMD) for nasal congestion symptoms at one week of treatment was －0.420 (95% confidence interval: －0.795, －0.046), and the 95% confidence intervals for all indicators' SMD at two weeks crossed zero. Regarding safety, there was no statistically significant difference in the incidence of adverse events between the experimental and control groups. Conclusion Acupuncture on the SPG and oral administration of lupatadine fumarate can both effectively alleviate symptoms and improve the quality of life for patients with AR. The overall short-term efficacy is comparable. However, acupuncture on the SPG is more effective in relieving nasal congestion and has a good safety profile. Keywords: Acupuncture, Sphenopalatine ganglion, Allergic rhinitis, Randomized controlled trial
HUANG Juezhi, ZHONG Binyu, WANG Fengyao, ZHANG Yingxia, QIU Yan, WEI Xueyu, DENG Jing, SONG Hongmei
ROMO1 Promotes the Repair of Radiation-induced Skin Injury by Regulating Mitochondrial Function and Keratinocyte Proliferation
Objective To investigate the molecular mechanisms of early mitochondrial stress in keratinocytes induced by ionizing radiation (IR), focusing on the key role of ROMO1 in radiation-induced skin injury (RISI). Methods HaCaT keratinocytes were used to assess cellular status, mitochondrial dysfunction and oxidative stress at various time points after different irradiation doses. Mitochondrial proteomics at 24 hours post-20 Gy irradiation identified ROMO1 as the protein with the greatest reduction in expression. ROMO1-overexpressing HaCaT cells and skin-specific Romo1 knockout (Romo1-sKO) mice were established to investigate its functional mechanisms. ROMO1 expression and localization were analyzed by Western blot and immunofluorescence; flow cytometry measured ROS, mtROS, and mitochondrial membrane potential in ROMO1-overexpressing cells, while CCK-8, LDH release, and colony formation assays evaluated viability and proliferation. The role of Romo1 in the progression and repair of radiation-induced skin injury was further examined in Romo1-sKO mice. Results At 24 hours post-20 Gy irradiation, HaCaT cells exhibited inhibited proliferation (P < 0.05) and mitochondrial dysfunction (P < 0.0001). Mitochondrial proteomics identified 43 differentially expressed proteins (26 upregulated, 17 downregulated), with enrichment analysis indicating their involvement in oxidative phosphorylation, mitochondrial assembly and stress response. Among these, reactive oxygen species modulator 1 (ROMO1) was identified as the most significantly downregulated key protein in the early radiation response (P < 0.01, FDR = 0.03). In vitro, ROMO1 overexpression increased mtROS levels and mitochondrial membrane potential (P < 0.0001) but suppressed cell viability and promoted reproductive death (P < 0.05) after radiation. In vivo, Romo1-sKO mice showed accelerated wound healing, with a reduction in skin injury score by approximately 1 point, along with enhanced tissue regeneration at 25 days post-irradiation compared to control mice. Conclusion The mitochondrial protein ROMO1 is a key regulator of the early keratinocyte stress response to radiation. It impedes the repair of radiation-induced skin injury by suppressing cell proliferation via modulation of mitochondrial function. Targeted inhibition of ROMO1 may represent a novel therapeutic strategy to promote healing and prevent chronic progression of radiation-induced skin injury. Keywords: ROMO1, Radiation-induced skin injury, Mitochondrial stress response, Keratinocyte proliferation
YANG Tingyi, TU Wenling, TANG Xiaoyou, DU Mengjie, Maheliya Adili, YU Zuxiang, QU Shuai, BAI Hao, ZHANG Shuyu