1.Elevated SLC3A2 Expression Promotes the Progression of Gliomas and Enhances Ferroptosis Resistance through the AKT/NRF2/GPX4 Axis
Yuqian ZHENG ; Shaolong ZHOU ; Yiran TAO ; Zimin SHI ; Xiang LI ; Xudong FU ; Jian MA ; Weihua HU ; Wulong LIANG ; Xinjun WANG
Cancer Research and Treatment 2026;58(1):71-94
Purpose:
The aim of this study is to determine the impact of solute carrier family 3 member 2 (SLC3A2) on the malignant phenotype of gliomas and its role in regulating ferroptosis sensitivity.
Materials and Methods:
The malignant phenotype of glioma was assessed by cell proliferation assay, colony formation assay, EdU assay, wound healing, and Transwell experiments. We further validated the impact of reduced SLC3A2 expression on the sensitivity to ferroptosis in glioma cells through Cell Counting Kit-8 assays, flow cytometry, western blotting, and transmission electron microscopy. Western blot was used to explore how SLC3A2 affects glioma sensitivity to ferroptosis through the AKT/NF-E2-related factor 2 (NRF2)/glutathione peroxidase 4 (GPX4) axis. By establishing a subcutaneous xenograft tumor model in BALB/c-nude mice, we investigated the growth of tumors following the knockout of SLC3A2 in glioma cells.
Results:
Downregulation of SLC3A2 suppressed the malignant phenotype of glioma by blocking the cell cycle and epithelial-mesenchymal transition processes. On the other hand, loss of SLC3A2 not only downregulated SLC7A11 but also prevented the activation of the AKT/NRF2/GPX4 axis. These lead to increased accumulation of reactive oxygen species and lipid peroxides, ultimately enhancing the susceptibility of glioma to ferroptosis.
Conclusion
Our findings suggest that SLC3A2 is an oncogene in gliomas, promoting their occurrence and development. It plays a critical role in ferroptosis resistance through the AKT/NRF2/GPX4 axis.
2.Umbrella decision-making model for diagnosis and treatment of elderly lung cancer patients: Construction and practice
Lunxu LIU ; Jian ZHOU ; Xiang DING ; Nan CHEN ; Jianxin XUE ; Xuelei MA ; Ye WANG ; Weiya WANG ; Liqing PENG ; Xin YOU ; Minggang SU ; Xu CHENG ; Jiao WANG ; Ning GE ; Deying KANG ; Yuchen HUANG ; Jinghan WANG ; Yu TONG ; Yaoxi ZHANG ; Jirong YUE ; Hu LIAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(06):833-839
With the accelerating trend of population aging, the number of elderly patients with lung cancer continues to rise, and the disease burden is becoming increasingly heavy. The clinical management of these patients faces severe challenges due to their decreased physiological reserve, complex comorbidities, and significant individual heterogeneity. Consequently, under traditional diagnosis and treatment models, doctors often struggle to identify the individualized risks of elderly patients in a timely and comprehensive manner, which can easily lead to decision biases such as undertreatment or overtreatment. In view of this, this study advocates for the establishment of an umbrella decision-making model specifically tailored for elderly lung cancer patients. Grounded in a multidisciplinary team (MDT) platform, this model deeply integrates oncological indicators with the comprehensive geriatric assessment (CGA) system. By holistically considering multidimensional variables including tumor burden, organ function, frailty index, cognitive status, and social support, the model establishes an operational mechanism characterized by "single entry, precise stratification, and targeted selection". Accordingly, patients can be scientifically triaged into distinct intervention tiers, such as active surveillance, minimally invasive surgery, drug therapy, radiotherapy, and best supportive care, thereby achieving real-time alignment between treatment intensity and patient fitness. This article elaborates on the construction logic and key operational procedures of this novel decision-making framework, aiming to guide clinical practice beyond the limitations of a tumor-centric perspective toward a holistic, dynamic, whole-course management strategy. This transition seeks to ensure optimal quality of life and clinical net benefit for elderly patients alongside survival prolongation.
3.The impact of the Guangzhou voluntary blood donation privilege certificate on blood donation behavior
Minxin HUANG ; Yang ZHANG ; Liqiao ZHOU ; Jian OU-YANG ; Wei SU ; Manyu HUANG ; Weifeng LUO
Chinese Journal of Blood Transfusion 2026;39(6):768-775
Objective: To evaluate the causal effects and population heterogeneity of Guangzhou′s Voluntary Blood Donation Privilege Certificate Policy on blood donation behavior, and to provide empirical evidence for optimizing blood management policies. Methods: Using an interrupted time series (ITS) design, we analyzed 30 quarters of blood collection data from Guangzhou Blood Center (from July 2018 to December 2025). Taking the third quarter of 2021 as the intervention node, we constructed ordinary least squares (OLS) regression models incorporating level and trend effects, and conducted stratified analyses by gender, age group, previous donation frequency, and per-donation volume. Results: The tiered incentive policy demonstrated significant heterogeneous effects. Apheresis donations showed sustained growth, with 2 units of component blood exhibiting a significant trend effect (β=304.58, P<0.001); high-frequency donors (11+ times) demonstrated sustained growth trends in apheresis donations. For whole blood, immediate effects were significant for donors with 1-2 previous donations (β=4 537.55, P<0.001) and 3-10 previous donations (β=2 159.69, P<0.05); high-frequency donors (11-30 times) showed sustained growth trends (P<0.01). Stratified by per-donation volume, 400 mL whole blood demonstrated a significant immediate effect (β=4 391.01, P<0.1), while 200 mL whole blood showed a significant declining trend (β=-893.24, P<0.01). Conclusion: The tiered incentive policy effectively enhanced blood donation participation while maintaining the donors’ altruistic motivations. Young and middle-aged adults primarily drove apheresis donations. The policy demonstrated immediate incentive effects on low-frequency whole blood donors and long-term retention effects on high-frequency donors. Per-donation volume showed an "upward migration" trend, optimizing the blood collection structure. Differentiated outreach, conversion and retention strategies are recommended to further strengthen blood supply security.
4.Clinical features and multimodal quantitative radiological features of primary liver cancer patients with different traditional Chinese medicine syndrome types
Feng WU ; Muqing LUO ; Wantingting WEN ; Ziwei CAI ; Yinqi LIU ; Jian XIANG ; Xiaona ZHOU ; Qian GUO ; Kun ZHANG
Journal of Clinical Hepatology 2026;42(5):1093-1100
ObjectiveTo investigate the association of the traditional Chinese medicine (TCM) syndrome types of primary liver cancer (PLC) with clinical features and multimodal quantitative radiological features on computed tomography (CT) and magnetic resonance imaging (MRI), and to provide a reference for the objectification of TCM syndrome differentiation and precise diagnosis and treatment. MethodsA retrospective analysis was performed for the clinical data of 312 patients who were diagnosed with PLC in The First Affiliated Hospital of Hunan University of Chinese Medicine from March 2020 to June 2025, and according to the TCM syndrome type, they were divided into stagnation of liver Qi group with 40 patients, stagnation of liver Qi and spleen deficiency group with 109 patients, Qi stagnation and blood stasis group with 62 patients, dampness-heat toxin amassment group with 81 patients, and liver-kidney Yin deficiency group with 20 patients. Clinical features and multimodal quantitative radiological features were compared between the patients with different TCM syndrome types. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Dunn’s multiple test was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups, and the Bonferroni method was used for further comparison between two groups. ResultsThere were significant differences between the patients with different TCM syndrome types in China liver cancer staging (CNLC), Child-Pugh class, alanine aminotransferase, aspartate aminotransferase, albumin, direct bilirubin, total bilirubin, prothrombin time, neutrophil, and albumin-bilirubin score (all P<0.05). In the stagnation of liver Qi group, the patients with Child-Pugh class A accounted for 75.00%; among the patients with CNLC stage I PLC, the patients with stagnation of liver Qi accounted for 60.00%, and those with Qi stagnation and blood stasis syndrome accounted for 59.68%, while among the patients with CNLC stage IV PLC, the distribution proportion of dampness-heat toxin amassment (27.16%) and liver-kidney Yin deficiency (30.00%) was significantly higher than that of stagnation of liver Qi (2.50%) (all P<0.05). Radiological examination showed that there were significant differences between the patients with different TCM syndrome types in the number of tumors, ascites, venous tumor thrombus, maximum tumor diameter, intrahepatic metastasis, and lymph node metastasis in the hepatic hilar and retroperitoneal regions (all P<0.05). Compared with the patients with stagnation of liver Qi, the patients with liver depression and spleen deficiency or liver-kidney Yin deficiency were more likely to develop intrahepatic metastasis; the patients with liver depression and spleen deficiency, dampness-heat toxin amassment, or liver-kidney Yin deficiency were more likely to develop lymph node metastasis in the hepatic hilar and retroperitoneal regions; the patients with liver-kidney Yin deficiency were more likely to experience multiple tumors; the patients with liver depression and spleen deficiency or dampness-heat toxin amassment were more likely to develop ascites (all P<0.05). Compared with the patients with Qi stagnation and blood stasis syndrome, the patients with liver depression and spleen deficiency had a significantly longer maximum tumor diameter and a significantly higher proportion of patients with venous tumor thrombus (both P<0.05). Furthermore, among the 184 patients with MRI diffusion-weighted imaging sequences, the patients with dampness-heat toxin amassment or Qi stagnation and blood stasis syndrome had significantly higher ADC values and relative ADC values than those with stagnation of liver Qi (all P<0.05). ConclusionThere are significant differences in CT/MRI radiological features and clinical features between PLC patients with different TCM syndrome types, among whom the patients with liver depression and spleen deficiency, dampness-heat toxin amassment, and liver-kidney Yin deficiency tend to exhibit progressive radiological features, and those with dampness-heat toxin amassment or Qi stagnation and blood stasis syndrome tend to have higher ADC values. These findings provide an objective basis for TCM syndrome differentiation in PLC.
5.LSS deficiency ameliorates MASLD by downregulating NPC1L1 and activating the CD36/TLR4/JNK pathway
Zihan WANG ; Hongmei BAI ; Qingya HE ; Wenjing ZHOU ; Jian ZHONG ; Xiaoli JIANG ; Sumei ZHANG ; Shengquan ZHANG
Acta Universitatis Medicinalis Anhui 2026;61(5):812-818
ObjectiveTo investigate whether intestinal deficiency of lanosterol synthase (LSS), a key enzyme in cholesterol synthesis, influences the progression of metabolic dysfunction-associated steatotic liver disease (MASLD) by regulating intestinal cholesterol absorption and immune response. MethodsLSS heterozygous knockout (LSS+/-) mice and wild-type (WT) controls were generated using CRISPR/Cas9 technology and fed either a high-fat diet (HFD) or regular chow (CHOW). The model was validated by genotyping. Hepatic steatosis was assessed by HE and oil red O staining. Immunohistochemistry was used to detect the localization and expression of NPC1L1 and CD36 proteins in the intestine. Western blot analysis was performed to measure JNK phosphorylation and TLR4 protein levels in intestinal tissues. Real-time quantitative polymerase chain reaction (qPCR) was employed to examine the mRNA expression of TLR4 and IL-6. ResultsLSS+/- mice were successfully validated by genotyping and reduced intestinal LSS protein expression. HE and oil red O staining of liver sections showed that, compared with WT mice fed a CHOW diet, WT mice fed a HFD exhibited a marked increase in hepatic lipid vacuoles. In contrast, compared with HFD-fed WT mice, HFD-fed LSS+/- mice displayed significantly attenuated hepatic lipid deposition and reduced serum ALT levels (P<0.05). Immunohistochemical analysis revealed that, compared with WT mice, the expression of the cholesterol absorption protein NPC1L1 in the intestinal villi of LSS+/- mice was downregulated under both CHOW and HFD conditions (PHFD<0.001). Conversely, the expression of the fatty acid transporter CD36 was upregulated in the intestines of LSS+/- mice (PCHOW<0.05, PHFD<0.01). Western blot analysis demonstrated that, compared with WT mice, TLR4 protein expression in the intestines of LSS+/- mice significantly increased under both CHOW and HFD conditions (both P<0.05). JNK phosphorylation level was significantly elevated in LSS+/- mice under CHOW condition (both P<0.05). Under HFD condition, total JNK protein expression increased, but its phosphorylation level showed no significant change. qPCR analysis showed that, compared with WT mice, the mRNA levels of TLR4 (PCHOW<0.01, PHFD<0.000 1) and IL-6 (PCHOW<0.001, PHFD<0.01) were significantly upregulated in the intestines of LSS+/-mice. ConclusionLSS deficiency counteracts hepatic lipid deposition by orchestrating a synergistic reprogramming involving restricted intestinal cholesterol absorption, enhanced fatty acid utilization, and activation of immune pathways, suggesting intestinal LSS as a potential therapeutic target of MASLD.
6.Development and clinical translation of intelligent assistive devices for minimally invasive thoracic surgery
Jiwei ZHU ; Honghai MA ; Chunlin ZHOU ; Zhehao HE ; Tong SHEN ; Haojie YU ; Luming WANG ; Jian HU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(07):1013-1022
Although video-assisted thoracoscopic surgery (VATS) offers clear advantages, including minimal trauma and rapid recovery, stable intraoperative visualization still depends heavily on the camera assistant. Traditional manual endoscope holding is therefore susceptible to several limitations, including image instability, assistant fatigue, and poor coordination with the primary surgeon. Operating in complex and confined anatomical spaces with a rigid thoracoscope further increases the demands on hand-eye coordination. Thoracoscopic camera-holding technology has progressively evolved from passive support systems to active camera holders and robot-assisted thoracic surgery (RATS) platforms, and is now advancing toward artificial intelligence-driven tracking and intelligent control. Based on this, a series of devices, including multifunctional intelligent assistant arms and active camera-holding arms for thoracic surgery, have been developed and have attracted increasing attention. This article reviews the development of intelligent camera-holding assistant arms and discusses related advances and future directions in the field.
7.Exploring Potential Biomarkers of Blood Stasis Syndrome in Coronary Heart Disease and Association Between Platelet Metabolic Disorder and Myocardial Injury Based on Platelet Metabolomics
Yanzhen ZHAO ; Siyang BAI ; Weixiong JIAN ; Manli ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(17):239-247
ObjectiveTo investigate the platelet metabolomic characteristics of the rat model of coronary heart disease (CHD) with blood stasis syndrome (BSS) based on ultra-high performance liquid chromatography coupled with quadrupole-Orbitrap high-resolution mass spectrometry (UPLC-Q-Exactive Orbitrap-MS), screen potential biomarkers and metabolic pathway information, and elucidate the association mechanism between platelet metabolic disorders and myocardial injury. MethodsA total of 12 rats were randomized into a normal group and a modle group. The rat model of CHD-BSS was established by continuous high-fat feeding, intragastric administration of vitamin D3 in divided doses combined with subcutaneous injection of isoproterenol. Additionally, changes in standard lead Ⅱ electrocardiogram (ECG) and myocardial histopathological alterations of rats in the two groups were observed to evaluate myocardial injury in the modle group. After preprocessing of the untargeted metabolomic data of platelet samples from the two groups, multivariate statistical analysis and differential screening were performed sequentially. Principal component analysis (PCA) was performed to verify the separation of metabolic profiles of samples between groups. An orthogonal partial least squares-discriminant analysis (OPLS-DA) model was then constructed to preliminarily screen potential differential metabolites based on model parameters. Secondary screening was conducted with the fold change of metabolite expression to finally identify metabolites with significant intergroup differences, and metabolic pathway enrichment analysis was carried out based on these differential metabolites. Finally, potential platelet-specific biomarkers were identified based on receiver operating characteristic(ROC) curves. ResultsCompared with the normal group, the modle group presented obvious elevation of the J point and an ST-segment elevation greater than 0.1 mV on ECG, as well as pathological injuries such as loose arrangement of fibers and cellular vacuolar degeneration in the myocardial tissue. A total of 370 differentially expressed metabolites were dysregulated in the modle group, involving 8 significantly enriched metabolic pathways,such as purine metabolism, arachidonic acid metabolism, oxidative phosphorylation and adenosine monophosphate-activated protein kinase (AMPK) signaling pathway. Nine differential metabolites enriched in these pathways showed statistically significant differences in content. ROC curve analysis revealed that the area under the curve(AUC) of all characteristic metabolites was higher than 0.8. Among them, the AUC values of four metabolites, including sphinganine 1-phosphate, sphingosine 1-phosphate, 12-ketoleukotriene B4 and 14,15-dihydroxyeicosatrienoic acid, reached 1.0, indicating their potential as biomarkers. ConclusionPlatelet metabolic characteristics are significantly altered in the rat model of CHD-BSS. The screened potential biomarkers possess favorable diagnostic performance. The pathological changes mediated by these metabolites, including inflammatory response, thrombosis, and energy metabolism disorders, serve as critical mechanisms for abnormal platelet activation and subsequent myocardial injury. Platelet metabolomics provides a new perspective for the screening of biomarkers and research on pathological mechanisms of CHD-BSS.
8.Self-Supervised Multi-Organ Segmentation in Pediatric Abdominal CT Based on Vision Foundation Models
Qinghua ZHANG ; Ming LI ; Zhedian ZHOU ; Jian ZHENG ; Huadan XUE ; Qiuxia WANG ; Yu DU ; Zhen LI
Medical Journal of Peking Union Medical College Hospital 2026;17(4):954-962
To address the scarcity of annotated data for pediatric abdominal CT imaging and the insufficient generalization capability of existing models, we constructed a self-supervised pretraining architecture tailored for pediatric CT domain adaptation based on the visual foundation model DINOv3, and validated its performance in the task of pediatric abdominal multi-organ segmentation. We built a general-purpose radiological visual representation using the large-scale adult CT dataset CT-3M, and introduced a Gram-anchoring mechanism that employs a frozen adult pretrained model as a structural teacher to guide domain alignment of local topological structures on unlabeled pediatric CT data. Combined with a multi-scale feature aggregation strategy and a lightweight Primus decoder, downstream segmentation tasks were evaluated on a public pediatric CT dataset. Based on case-wise paired results, we compared the mean Dice similarity coefficient (DSC) and mean intersection over union (IoU) between our model and the baseline nnU-Net using the Wilcoxon signed-rank test, and computed the relative performance improvements. A total of 867 abdominal CT imaging cases were collected, constituting a pretraining dataset comprising 367 588 two-dimensional CT slices. On the public Pediatric-CT-SEG dataset (359 cases), our model achieved a mean DSC of (71.38±1.08)% and a mean IoU of (63.73±1.01)%, representing improvements of 3.22% and 3.59% over the baseline nnU-Net, respectively, with statistically significant differences ( The self-supervised pretraining framework proposed in this study effectively alleviates the domain shift between adult and pediatric abdominal CT images, significantly enhances segmentation accuracy for pediatric abdominal multi-organs-particularly small organs and structures with complex boundaries-and provides a reliable technical solution for intelligent pediatric imaging analysis in scenarios with limited annotated data.
9.Research progress on mechanism of active ingredients of traditional Chinese medicine in ameliorating skeletal muscle atrophy
Qin JIANG ; Wenya GUO ; Ying ZHOU ; Jian ZHOU ; Zhenyu ZHANG ; Yanchun GONG ; Lihua YAO ; Yuhua LI
China Pharmacy 2026;37(15):2057-2062
Skeletal muscle atrophy refers to a pathological condition characterized by muscle fiber atrophy as well as decreased muscle mass and muscle strength induced by various predisposing factors. It falls under the category of “flaccidity syndrome” in traditional Chinese medicine, and its pathogenesis is mainly associated with disturbed protein homeostasis, mitochondrial dysfunction and oxidative stress injury. Active ingredients of traditional Chinese medicine exerts synergistic regulatory effects via multiple pathways, thus possessing unique advantages in the clinical prevention and treatment of skeletal muscle atrophy. This paper reviews the mechanisms by which active ingredients of traditional Chinese medicine alleviate skeletal muscle atrophy. Existing studies have demonstrated that such active ingredients can ameliorate skeletal muscle atrophy through multiple approaches: regulating protein metabolic balance (geniposide, matrine, schisandrin A, etc.) and oxidative stress (astragaloside Ⅳ, Gastrodia elata polysaccharide, Angelica sinensis polysaccharide, etc.), improving mitochondrial function (parthenolide, berberine, curcumin, etc.), facilitating myogenesis and myogenic differentiation (cucurbitacin Ⅱb, saikosaponin A, saikosaponin D, etc.), suppressing inflammatory response (ursolic acid, triptolide, emodin, etc.), ameliorating insulin resistance (akebiasaponin D, etc.). In the future, active ingredients of traditional Chinese medicine are expected to achieve breakthroughs in clinical treatment for skeletal muscle atrophy, providing novel ideas and strategies for the prevention and treatment of degenerative disorders.
10.Effect of hypoxic environment on tumor cell apoptosis mediated by the antitumor drug pemetrexed
Wenjing ZHOU ; Ruomu GE ; Zihan WANG ; Xiaoli JIANG ; Jian ZHONG ; Qingya HE ; Shengquan ZHANG ; Sumei ZHANG
Acta Universitatis Medicinalis Anhui 2026;61(7):1208-1214
ObjectiveTo investigate the effect of hypoxia on pemetrexed (PE)-mediated apoptosis in non-small cell lung cancer cells. MethodsA549 cells were cultured under 21% O₂ (normoxia) or 1% O₂ (hypoxia), and treated with 8 μmol/L PE for 48 h. The cells were divided into normoxic control group, normoxic vehicle group, normoxic drug-treated group, hypoxic control group, hypoxic vehicle group and hypoxic drug-treated group. Trypan blue staining was used to observe cell death after PE intervention under normoxia and hypoxia. Flow cytometry was adopted to detect cell apoptosis rate. Wound healing assay was used to assess cell migration. Western blot was performed to detect the protein levels of MRP-1, Cleaved Caspase-3, E-Cadherin and N-Cadherin. ResultsTrypan blue staining results showed that the cell death rate was reduced in PE-treated cells under hypoxia compared with the normoxic PE group (P<0.001). Flow cytometry results indicated that PE induced cell apoptosis under both normoxic and hypoxic conditions.However, the apoptosis rate of the normoxic PE group was significantly higher than that of the hypoxic PE group (P<0.000 1). Wound healing assay showed that the migration distance of A549 cells decreased after PE treatment for 24 h and 48 h under normoxia and hypoxia when compared with the control group (P<0.05), while no significant difference was found between the normoxic PE group and the hypoxic PE group. Western blot results revealed that MRP-1 expression was markedly higher in hypoxic PE-treated cells than in normoxic PE-treated cells (P<0.000 1). Compared with the control group, Cleaved Caspase-3 expression was upregulated in A549 cells following PE intervention under normoxia (P<0.05), whereas no obvious alteration in Cleaved Caspase-3 expression was detected in hypoxic PE-treated cells. Under both normoxic and hypoxic conditions, PE treatment downregulated the expression of E-Cadherin (P<0.000 1,P<0.001) and N-Cadherin (P<0.05,P<0.000 1). In addition, the expression levels of E-Cadherin and N-Cadherin in the hypoxic PE group were significantly lower than those in the normoxic PE group (all P<0.000 1). ConclusionHypoxia significantly attenuates the pro-apoptotic effect of PE on A549 cells and blocks Cleaved Caspase-3 activation. This mechanism may be related to hypoxia-induced MRP-1 overexpression and reduced drug accumulation. Interfering with MRP-1 or restoring the activity of the apoptosis pathway may serve as a novel strategy to overcome hypoxia-induced drug resistance.

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