Journal of Shandong University (Health Sciences)

Active peptide SK-14 derived from snail mucus promotes fibroblast proliferation and migration

LI Guanqiang, SHI Yucheng, ZHU Kehan, HU Bo, HUANG Xianchen, SUN Yuan, LI Duxin, ZHANG Xicheng

Journal of Shandong University (Health Sciences). 2025, 63(11): 1-7. doi:10.6040/j.issn.1671-7554.0.2025.0529

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Objective To screen and synthesize the active peptide sequence, and to evaluate its effects on the proliferation and migration of fibroblasts based on the isolation, enzymatic digestion and sequencing of snail mucus. Methods Snail mucus protein was extracted and digested with trypsin for 4 h. The peptide sequence with proliferation promotion was screened by liquid chromatography-mass spectrometry and bioinformatics analysis, and then prepared by solid phase synthesis. Human adventitial fibroblasts(HAFs)were cultured and treated with different concentrations of active peptides to evaluate their effects on cell proliferation and migration. Results The synthesized peptide sequence was SK-14(N-terminal sequence: SSTIFPPTSGGAAK), with a molecular weight of 1,268 Da. Compared with the control group, SK-14 could significantly promote fibroblast proliferation at different concentrations(P<0.001). The cell proliferation ability increased in a concentration-dependent manner with the increase of SK-14 concentration. Within the test concentration range, the proliferation ability significantly increased with the increase of drug SK-14 concentration, and reached the plateau at 500 μg/mL. SK-14 can also significantly promote the migration ability of HAFs(P<0.001), and its effect increased with the increase of SK-14 concentration, with the most obvious effect at 1,000 μg/mL in the test concentration range. Conclusion The active peptide SK-14 derived from snail mucus can promote the proliferation and migration of HAFs, which may be one of the active components of snail mucus in promoting wound healing.

NEDD4L regulates ferroptosis by mediating ubiquitination of ALDOA in glioblastoma cells

NIE Qiucheng, LI Yunfeng, TIAN Jing, LIU Xinjing, SUN Lili, WEI Yiju

Journal of Shandong University (Health Sciences). 2025, 63(11): 8-17. doi:10.6040/j.issn.1671-7554.0.2025.0294

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Objective To investigate the role of the E3 ubiquitin ligase neural precursor cell expressed developmentally down-regulated 4 like(NEDD4L)-mediating ferroptosis in glioblastoma, aiming to elucidate molecular mechanism of NEDD4L-mediated ubiquitination of aldolase A(ALDOA)which regulates ferroptosis pathway. Methods The effects of knockdown of NEDD4L on ferroptosis in glioblastoma(GBM)were assessed through cell death and lipid peroxidation assays. ALDOA was identified as a potential substrate modified by NEDD4L using protein Western blotting and co-immunoprecipitation(Co-IP)techniques. The impact of NEDD4L or ALDOA on ferroptosis and ferroptosis-related pathways in GBM cells were further investigated using siRNA/shRNA or CRISPR-Cas9 technology. Results Knockdown of NEDD4L significantly inhibited IKE-induced ferroptosis and reduced lipid peroxidation levels in GBM cells. This study validated NEDD4L as a novel E3 ubiquitin ligase for ALDOA, demonstrating its interaction with ALDOA to mediate monoubiquitination, thereby modulating GBM cell susceptibility to ferroptosis. Additionally, the knockdown of both NEDD4L and ALDOA promoted phosphorylation of 4EBP1 and ACC, and increased the expression of GPX4 protein, which suggested that NEDD4L-mediated ubiquitination of ALDOA might regulate ferroptosis susceptibility in GBM cells through the mTORC1-4EBP1 signalling pathway and lipid metabolism. All data were statistically analyzed using GraphPad Prism 9.0 software. Conclusion NEDD4L has been shown to mediate monoubiquitination of ALDOA, with potential to promote ferroptosis sensitivity by affecting the mTORC1-4EBP1 signaling pathway and lipid metabolism in GBM cells.

Construction of polysaccharide probe based on upconversion nanoparticles and its application in tumor bioimaging

GONG Jie, YU Miao, LI Xiuyong, CHEN Ying, XU Qianru, LI Meijuan, LI Yitong, LIU Xiumei

Journal of Shandong University (Health Sciences). 2025, 63(11): 18-26. doi:10.6040/j.issn.1671-7554.0.2024.0430

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Objective To develop a probe for early diagnosis of hepatocellular carcinoma(HCC)by connecting upconversion nanoparticles(UCNPs)with chondroitin sulfate(CS). Methods The UCNPs-CS nanoprobe was constructed using adipic acid hydrazide(ADH)as a bridging agent. First, CS, which exhibits tumor-targeting properties and serves as the targeting moiety of the probe, was functionalized to synthesize CS-ADH under the catalysis of 1-(3-dimethylaminopropyl)-3-ethylcarbodiimide hydrochloride(EDC)and N-hydroxysuccinimide(NHS). Subsequently, NaYF4:Yb,Tm@NaYF4 UCNPs with a core-shell structure were prepared via a solvothermal method. The synthesized UCNPs exhibited fluorescence emission bands around 800 nm, making them suitable as fluorescent reporters for in vivo imaging. The UCNPs were rendered water-dispersible through polyacrylic acid(PAA)surface modification and then conjugated with CS-ADH via carboxyl-amine coupling to form the UCNPs-CS nanoprobe. The morphology, optical properties, and chemical composition of the UCNPs were characterized using spectroscopy, nuclear magnetic resonance(NMR), transmission electron microscopy(TEM), and other analytical techniques. The cytotoxicity of the probe was evaluated via MTT assay. To assess the probes in vivo imaging performance and tumor-targeting efficacy, hepatoma-bearing mouse models were established. Furthermore, the activity of different antitumor drugs was evaluated using in vivo imaging. Results The prepared UCNPs with core-shell structures had uniform morphology and size, with a size of about 35 nm and a shell thickness of about 3-4 nm. They had good dispersibility in water. The constructed UCNPs-CS probe had good luminescence performance(excitation wavelength 980 nm, fluorescence emission wavelength 800 nm), cell compatibility(cell survival rate greater than 60% after 24 hours at a concentration of up to 500 μg/mL), strong tissue penetration ability, and could achieve in vivo imaging at the animal level. The imaging results of liver cancer mice showed that the constructed UCNPs-CS probe had good tumor targeting ability, and the imaging radiation intensity was positively correlated with tumor volume. Conclusion The UCNPs-CS probe provides a new tool for early visual diagnosis of HCC, and also provides a new idea for the activity screening of anti-tumor drugs.

Correlation between the pre-endothelial activation and stress index and the mortality risk of patients with heart failure

LIU Wenzhao, ZHANG Yuan, MA Xiangping, WEI Fengtao, BU Peili

Journal of Shandong University (Health Sciences). 2025, 63(11): 27-35. doi:10.6040/j.issn.1671-7554.0.2025.0168

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Objective To provide a novel reference indicator for the clinical assessment of heart failure(HF)prognosis by exploring the correlation between the pre-endothelial activation and stress index(pre-EASIX)and mortality risk in HF patients. Methods Data from 7,146 HF patients in the open-source database MIMIC-IV v3.1 were used. The endothelial activation and stress index(EASIX)was calculated for each patient and converted into a log₂ value(pre-EASIX). Patients were categorized based on the tertiles of pre-EASIX. The correlation between pre-EASIX and mortality risk in HF patients was evaluated using restricted cubic spline(RCS)analysis, Kaplan-Meier survival curve, and Cox regression model. Results RCS analysis revealed a J-shaped curve relationship between pre-EASIX and mortality risk in HF patients, suggesting that the predictive capacity of pre-EASIX for HF patient mortality risk was statistically significant(P<0.05). Kaplan-Meier survival curve demonstrated that with increasing pre-EASIX, the survival rate of HF patients declined, and its predictive capacity for the survival rate of HF patients was statistically significant(P<0.001). Multivariate Cox regression analysis confirmed that pre-EASIX was an independent risk factor for 30-, 90-, 180-, and 365-day mortality in HF patients, with statistical significance(P<0.01). Following a subgroup analysis of Cox regression in HF patients stratified by left ventricular ejection fraction, pre-EASIX remained an independent risk factor for mortality in HF subgroup patients, with statistical significance(P<0.001). Conclusion Pre-EASIX is closely associated with the risk of mortality in HF patients. It aids in the early identification of high-risk patients and can serve as an important indicator for evaluating the prognosis of HF patients and different subgroups.

Value of tNGS testing and conventional culture for BALF in the diagnosis of NSCLC complicated with IPFD

LIU Zhenkun, LYU Jiling, XU Weiwei, MA Litian, ZHANG Caiqing

Journal of Shandong University (Health Sciences). 2025, 63(11): 36-45. doi:10.6040/j.issn.1671-7554.0.2025.0344

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Objective To investigate the diagnostic value of targeted next-generation sequencing(tNGS)for pathogens in bronchoalveolar lavage fluid(BALF)compared with traditional culture in non-small cell lung cancer(NSCLC)complicated with invasive pulmonary fungal disease(IPFD). Methods A retrospective analysis was conducted on the clinical data of 40 patients clinically diagnosed with NSCLC complicated with IPFD at Shandong Second Provincial General Hospital from September 1, 2022, to April 1, 2025. BALF samples were collected for tNGS detection and traditional culture, and the pathogen detection rates and diagnostic efficacy were compared and analyzed. Results Among the 40 IPFD patient samples, the positive detection rates for fungi by tNGS and traditional culture were 85.0% and 52.5%, respectively(corrected χ2=6.86, P=0.01), and for bacteria, they were 70.0% and 50.0%, respectively(corrected χ2=4.08, P=0.04). The detection sensitivities for bacteria by tNGS and traditional culture were 95.5% and 86.4%, respectively(corrected χ2=0.25, P=0.62). All patients improved and were discharged after antifungal, antibacterial, and antitumor treatments. Conclusion tNGS technology demonstrates significantly superior detection efficacy for both fungi and bacteria in pathogen detection for NSCLC complicated with IPFD compared to traditional BALF culture. Clinically, tNGS can be used as an early screening tool, and combined with BALF culture and clinical features for comprehensive interpretation, to optimize diagnosis and treatment and avoid overtreatment.

Influence of the duration of estrogen treatment prior to frozen embryo transfer in hormone replacement protocols in endometrial preparation on neonatal birth weight

HAN Xinwei, NIU Yue, WEI Daimin

Journal of Shandong University (Health Sciences). 2025, 63(11): 46-52. doi:10.6040/j.issn.1671-7554.0.2024.1447

Abstract ( 26 )

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Objective To investigate the optimal estrogen exposure duration prior to embryo transfer in frozen embryo transfer(FET)cycles with hormone replacement therapy(HRT)for endometrial preparation. Methods This was a retrospective cohort study. Patients who underwent HRT regimen for endometrial preparation before FET and single blastocyst transfer and achieved singleton live birth between 2012 and 2020 were included in the analysis. Overall, 4,577 FET cycles were included for analyses. According to the duration of estrogen treatment before embryo transfer, we divided the cycles into three groups: 12-16 days group(n=1,078), 17-20 days group(n=2,924), and 21-31 days group(n=575). The main outcome measures were neonatal birthweight, and secondary outcomes were gestational diabetes mellitus(GDM), gestational hypertension(HDP), preeclampsia, cesarean section, premature abruption, placenta previa, postpartum hemorrhage, sex of neonates, preterm delivery, small-for-gestational age(SGA), large-for-gestational age(LGA), low birth weight(LBW)and macrosomia. Results There was no significant difference in neonatal birthweight, SGA, LGA, macrosomia among the three groups. The rate of LBW was higher in the 21-31 days group than the 12-16 days group(aOR=1.780, 95%CI: 1.055-3.003, P=0.031). The rates of other pregnancy and neonatal outcomes such as preterm delivery, GDM, HDP, preeclampsia, cesarean section, premature abruption, placenta previa, and postpartum hemorrhage, neonatal outcomes, including sex of neonates were also comparable among the three groups(P>0.05). Conclusion There is no significant difference in birthweight among the three groups, but longer estrogen treatment duration before embryo transfer is associated with a higher rate of LBW in HRT regimen for endometrial preparation before FET. These findings suggest that clinical protocols should individualize estrogen exposure duration based on patient characteristics.

Effect of ear acupoint electroacupuncture combined with high-frequency repetitive transcranial magnetic stimulation on post-stroke depression

WANG Litong, WANG Zhan, WU Jingyi, WU Yanying, LI Yongna, TANG Hong

Journal of Shandong University (Health Sciences). 2025, 63(11): 53-60. doi:10.6040/j.issn.1671-7554.0.2022.0302

Abstract ( 37 )

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Objective To observe the efficacy of ear-point electroacupuncture combined with high-frequency repetitive transcranial magnetic stimulation(rTMS)on patients with post-stroke depression, thereby providing a new clinical treatment regimen. Methods A total of 140 patients with post-stroke depression, who attended the Second Affiliated Hospital of Dalian Medical University from February 2023 to December 2024, were randomly divided into a control group and three experimental groups(ear-point electroacupuncture group, rTMS group, and ear-point combined with rTMS group). The patients scores on the Hamilton Depression Scale-17(HAMD-17), Self-Rating Depression Scale(SDS), Montreal Cognitive Assessment(MoCA), Modified Barthel Index(MBI), and Clinical Neurological Deficit Scale(CNDS), as well as the levels of 5-hydroxytryptamine(5-HT)and brain-derived neurotrophic factor(BDNF)were compared. Results After treatment, significant reductions were observed in HAMD-17, SDS, and CNDS scores(P<0.05), with significant increases in MoCA and MBI scores(P<0.05), and elevated levels of 5-HT and BDNF(P<0.05), in all groups compared to pre-treatment. The ear-point combined with rTMS group, ear-point electroacupuncture group, and rTMS group showed more significant reductions in HAMD-17, SDS, and CNDS scores, and increases in MBI scores and 5-HT and BDNF levels, compared to the control group(P<0.05). The ear-point combined with rTMS group demonstrated superior outcomes in these measures compared to the other two experimental groups(P<0.05). Conclusion Ear-point electroacupuncture combined with high-frequency rTMS significantly improves various indicators in patients with PSD.

Mendelian randomization analysis of the causal association between pain and muscle strength in knee osteoarthritis

ZHOU Kun, LIU Ting, JIANG Yanju, HU Zekai, LI Yujia, FENG Wuyi, HUANG Jili, YE Wangquan, ZHAO Xiaofeng, HU Jun

Journal of Shandong University (Health Sciences). 2025, 63(11): 61-67. doi:10.6040/j.issn.1671-7554.0.2025.0319

Abstract ( 41 )

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Objective To investigate the decline in knee flexor and extensor muscle strength in patients with knee osteoarthritis(KOA)through clinical trials and to explore the causal relationship between KOA and thigh muscle volume using genome-wide association studies(GWAS), as well as to analyse the characteristics and potential factors influencing the decrease in thigh muscle strength in KOA patients. Methods Female patients aged 50 to 80 years diagnosed with KOA who visited the orthopaedic clinic of Shanghai Zhongye Hospital from January 2023 to December 2024 were selected and divided into a bilateral knee pain group(n=19)and a unilateral knee pain group(n=33). Healthy adults were recruited as a healthy control group(n=65). Analysis of variance was used to compare the maximum peak torque of the knee flexor and extensor muscles among 3 groups. Bidirectional two-sample Mendelian randomization analysis was performed using inverse variance weighting, MR-Egger, and weighted median methods to examine the association between knee osteoarthritis, pain, and muscle volume in the anterior and posterior thigh. Results The maximum torque for knee extension and flexion in the bilateral knee pain group was significantly different from that of the healthy control group(P<0.05); peak torque on the unaffected and affected sides in the unilateral knee pain group was significantly different from that of the healthy control group(P<0.001); the difference between the unaffected and affected sides in the unilateral knee pain group was not statistically significant(P>0.05). There was no correlation between knee osteoarthritis and pain and volume of the anterior thigh muscles(KOA: P=0.16; pain: P=0.08), while there was a negative correlation with the volume of the posterior thigh muscles(KOA: P=0.01; pain: P<0.05). There was no negative correlation between the volume of the anterior thigh muscles and the volume of the posterior thigh muscles with KOA and pain. Conclusion Patients with KOA and pain symptoms exhibit a significant decrease in the maximum torque of the flexor muscle group. A reduction in posterior thigh muscle volume may be one of the causes of decreased flexor muscle strength, while a decrease in extensor muscle strength is not related to anterior thigh muscle volume, indicating that factors influencing decreased flexor and extensor muscle strength differ in patients with KOA and pain symptoms.

Application and evaluation of Vision-LSTM model in diagnostic ultrasound imaging of Thyroid Imaging Reporting and Data System Category 4b thyroid nodules

ZHANG Xinru, LI Yang, SUN Meng, NIE Wei, MA Zhe

Journal of Shandong University (Health Sciences). 2025, 63(11): 68-74. doi:10.6040/j.issn.1671-7554.0.2025.0696

Abstract ( 29 )

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Objective To evaluate the diagnostic accuracy and clinical utility of a Vision-LSTM-based artificial intelligence(AI)model in classifying Thyroid Imaging Reporting and Data System Category 4b(TI-RADS 4b)thyroid nodules on ultrasound. Methods This study utilized ultrasound imaging data from 401 TI-RADS 4b thyroid nodules. A Vision-LSTM model was developed and validated. The AIs diagnostic performance was compared against that of junior and senior physicians using key metrics, including the area under the curve(AUC)and the precision-recall curve(PRC). Results On an independent validation set, the Vision-LSTM model achieved an AUC of 0.88 and an accuracy of 89.4%, significantly outperforming junior physicians(AUC: 0.624)and performing on par with senior physicians(AUC: 0.787). The model demonstrated a high capability for identifying complex sonographic features and delivering consistent diagnostic outcomes.The AI model was able to accurately identify the complex features in ultrasound images, and consistently produced consistent diagnostic results, demonstrating a high degree of accuracy and reliability. Conclusion The Vision-LSTM-based AI model significantly improves the diagnostic efficiency and accuracy for TI-RADS 4b thyroid nodules, showing great potential as an effective tool to support clinical decision-making and reduce physician workload.

Visual analysis of rehabilitation research on patients with paraplegia caused by spinal cord injury based on Web of Science

LIU Xiang, GAO Wei, WANG Chao, ZHANG Xiaoyan

Journal of Shandong University (Health Sciences). 2025, 63(11): 75-86. doi:10.6040/j.issn.1671-7554.0.2025.0321

Abstract ( 47 )

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Objective To provide a comprehensive scientometric analysis of the research landscape, international collaborations, thematic evolution, and emerging trends in the rehabilitation of patients with paraplegia resulting from spinal cord injury. Methods Relevant literatures on the rehabilitation of patients with paraplegia resulting from spinal cord injury, published between January 1, 2005, and December 31, 2024, were retrieved from the Web of Science Core Collection. Bibliometric and visualization analyses were conducted using CiteSpace, VOSviewer, and R-bibliometrix. Key indicators such as publication volume, national and institutional collaboration networks, highly cited articles, keyword co-occurrence, and thematic evolution trends were systematically analyzed. Results A total of 584 articles met the inclusion criteria. Research output and citation frequency were predominantly concentrated in the United States, Switzerland, and other Western countries, where relatively stable international collaboration networks had been established. The focus of research had undergone a progressive shift from fundamental investigations into pathological mechanisms to technology-driven interventions and neurorehabilitation strategies, which reflectd a trend toward multidisciplinary integration and precision rehabilitation. Conclusion The rehabilitation of SCI-induced paraplegia is undergoing a paradigm shift from traditional approaches towards integrated models driven by technological innovation and holistic health management. Future directions should prioritize interdisciplinary collaboration, the dissemination of low-cost technological solutions, the strengthening of psychological and community-based rehabilitation systems, and the development of inclusive, intelligent health management frameworks to ensure broader accessibility and sustainability.

Causal relationship of MMP1 and MMP9 genes with chronic periodontitis: an exploratory study based on two-sample Mendelian randomization

YANG Chuntao, ZUO Yu

Journal of Shandong University (Health Sciences). 2025, 63(11): 87-97. doi:10.6040/j.issn.1671-7554.0.2025.0135

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Objective To investigate whether the MMP1/MMP8/MMP9 genes have a causal relationship with chronic periodontitis using a two-sample Mendelian randomization(MR)analysis. Methods Genome-wide association study(GWAS)was used to summarize data on chronic periodontitis(phenotype code: K11_PERIODON_CHRON)from the FinnGen R10 database(publicly available since December 2023). Single nucleotide polymorphisms significantly associated with exposure(MMP1/MMP8/MMP9 genes)and meeting the criteria were chosen as instrumental variables. The MMP1, MMP8 and MMP9 genes were defined as exposure variables and chronic periodontitis was defined as the outcome variable. MR analyses were performed using MR-Egger regression, weighted median, inverse variance weighted(IVW), weighted mode and simple mode methods. Heterogeneity was assessed using the Cochrans Q test and MR-Egger regression. Horizontal pleiotropy was evaluated using the MR-Egger intercept test and MR-PRESSO analysis. The general stability of the MR results was examined by leave-one-out analysis. The causal relationship between the MMP1/MMP8/MMP9 genes and chronic periodontitis was quantified using odds ratio(OR)and 95% confidence interval(CI). Results Based on inverse variance weighted(IVW)analysis, a significant causal relationship was observed between genetically predicted MMP1 expression and the risk of chronic periodontitis in the ebi-a-GCST90012033 dataset(P=0.005, OR=0.955, 95%CI=0.924-0.986)and the eqtl-a-ENSG00000196611 dataset(P=0.048, OR=0.912, 95%CI=0.832-0.999). In contrast, IVW results did not show a significant causal association between genetically predicted MMP8 expression and chronic periodontitis in the prot-a-1920 dataset(P=0.087, OR=0.993, 95%CI=0.985-1.001)and the eqtl-a-ENSG00000118113 dataset(P=0.883, OR=0.992, 95%CI=0.887-1.109). Similarly, no significant causal relationship was found between genetically predicted MMP9 expression and chronic periodontitis in the prot-a-1921 dataset(P=0.450, OR=0.985, 95%CI=0.948-1.024). Although IVW analysis based on the dataset eqtl-a-ENSG00000100985 yielded a statistically significant result(P=2.405×10^-5, OR=1.123, 95%CI=1.064-1.184), the general evidence consistently support a robust causal association between MMP9 expression and chronic periodontitis. Conclusion From a genetic point of view, the results of the MR analysis support a potential pathogenic role for MMP1 and MMP9 in the development of chronic periodontitis. From an etiological perspective, MMP1 and MMP9 may be contributing factors, although not exclusive, involved in the pathogenesis of chronic periodontitis.

Association between low-temperature exposure and emergency call frequency in Dezhou City from 2020 to 2023: modification effect of ambient PM_2.5 components

SUN Shufan, ZHONG Yu, ZHAO Qi, QU Yinan, WANG Cheng, WANG Dongmei

Journal of Shandong University (Health Sciences). 2025, 63(11): 98-104. doi:10.6040/j.issn.1671-7554.0.2025.0145

Abstract ( 31 )

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Objective To investigate the association between low-temperature exposure and emergency call frequency during the cold season in Dezhou City, Shandong Province, China, and to evaluate the modification effects of fine particulate matter(PM_2.5)and its components on this relationship, with the aim of providing addressing health risks associated with adverse atmospheric environments. Methods Emergency call data and meteorological data from Dezhou City during 2020-2023 were collected. The impact of low-temperature exposure during the cold-season(November to next February)on emergency call frequency was assessed using a generalized additive model(GAM)with distributed lag non-linear models(DLNM). The modifying effects were explored by including interaction terms between temperature and PM_2.5 and its components. Results A total of 150, 408 emergency calls were recorded during the cold season from 2020 to 2023 in Dezhou City. The daily average temperature during the study period was(1.52±6.23)℃, and the daily average concentrations of PM_2.5 was 57.60±53.65 μg/m³. The cumulative exposure-response curve between low-temperature exposure and emergency call frequency over 0-30 days displayed an approximate “U” shape. The relative risks(RR)and 95% confidence interval(CI)for emergency calls corresponding to extreme low-temperature exposure(-6.03 ℃)and moderate low-temperature exposure(-1.02 ℃)were 1.61(1.36-1.91)and 1.40(1.27-1.54), respectively. Under extreme low-temperature exposure, black carbon and organic matter significantly increased the low-temperature-related risk of emergency calls(P<0.05). Under moderate low-temperature exposure, PM_2.5 and components significantly elevated the low-temperature-related risk of emergency calls(P<0.01). Conclusion Cold-season low-temperature exposure was positively associated with emergency call frequency in Dezhou City, Shandong Province. High concentrations of PM_2.5 and its components exacerbated the strength of association.

Energy selection strategy for atrial fibrillation ablation: cryo, heat, laser, and electroporation

ZHANG Yan, YANG Xinyan, LIN Mingjie, ZHANG Kai, RONG Bing, CHEN Tongshuai, XU Xingsheng, SUN Hui, HAN Wenqiang, LAN Qingsu, LIU Xinlei, WANG Juntao, ZHONG Jingquan

Journal of Shandong University (Health Sciences). 2025, 63(11): 105-116. doi:10.6040/j.issn.1671-7554.0.2024.1218

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Catheter ablation has become the primary treatment for atrial fibrillation(AF). Compared with antiarrhythmic drugs, catheter ablation significantly reduces the recurrence rate of AF, lowers the mortality and cardiovascular hospitalization rates, and improves quality of life. Traditional ablation energies include cryoballoon ablation(cryo)and radiofrequency ablation(heat). The cryoballoon technology has evolved to its fourth generation,and radiofrequency ablation has developed a very high-power, short-duration(vHPSD)ablation mode based on force-sensing and multiport perfusion technologies. These technological innovations have further improved the efficiency and safety of catheter ablation procedures. New ablation energies include laser balloon ablation and pulsed field ablation(electroporation). These new energies have achieved good results in treating AF, especially in pulmonary vein isolation(PVI). Recently, pulsed field ablation(PFA)has become a popular technology in the field of catheter ablation due to its high efficiency and safety. PFA uses the electroporation effect and controls the electric field strength to selectively damage myocardial cells while avoiding injury to surrounding tissues, such as the phrenic nerve and esophagus. This review summarizes the latest clinical progress of four energy ablation technologies and compares their safety and effectiveness in AF ablation. Our results demonstrate that all four energies are suitable for PVI. PFA technology significantly reduces procedure time and the learning curve for operators,while also reduces the incidence of traditional complications, such as phrenic nerve and esophageal injury. However, confirmation of the long-term effectiveness and safety of new energies, as well as their application in structures outside the pulmonary veins, requires larger-scale and longer-term clinical studies.

Research progress of magnetic resonance imaging in autoimmune nodopathies

SHAN Tixiao, DU Weichen, WANG Qinzhou, LI Anning, LI Chunhai

Journal of Shandong University (Health Sciences). 2025, 63(11): 117-122. doi:10.6040/j.issn.1671-7554.0.2024.1330

Abstract ( 31 )

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Autoimmune nodopathies(AN)is a type of autoimmune disease involving autoantibodies, particularly the lgG4 subtype, that act on demyelinating pathological changes on the node of Ranvier. These changes produce a series of clinical manifestations of peripheral neuropathy, collectively referred to as nodo-paranodopathy. Currently, research on AN primarily focuses on their clinical, pathological, and immunological characteristics. Diagnosis mainly depends on invasive examinations, such as antibody detection and cerebrospinal fluid analysis. Magnetic resonance imaging(MRI)of the peripheral nerves has been increasingly used as a noninvasive method to evaluate peripheral nerve diseases. Focusing on the morphological and quantitative changes of different peripheral nerve diseases continuously can help us better understand the potential pathophysiological processes of these diseases, providing theoretical support for their diagnosis and treatment evaluation. Thus, this article reviews the application of lumbosacral plexus magnetic resonance imaging in AN to provide supporting evidence for early clinical diagnosis, differential diagnosis, and the development of accurate treatment plans.

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