1.TGF-β1-engineered Biomimetic Platelet Nanoparticles for Targeted Therapy of Ischemic Stroke
Li-Qi CHEN ; Tian-Fang KANG ; Guo-Jun HUANG ; Ting YIN ; Ai-Qing MA ; Lin-Tao CAI ; Hong PAN
Progress in Biochemistry and Biophysics 2026;53(3):697-710
ObjectivePost-ischemic acute inflammation and the subsequent persistent dysregulation of the immune microenvironment represent major pathological drivers that aggravate neuronal injury and severely restrict functional recovery following ischemic stroke. Although current reperfusion therapies partially restore blood flow, they fail to effectively modulate the secondary inflammatory cascade and oxidative stress, which remain critical barriers to neurological restoration. To address this challenge, this study aimed to engineer and systematically evaluate a biomimetic nanosystem composed of transforming growth factor-β1 (TGF-β1)-loaded platelet membrane-camouflaged lipid nanoparticles (PLP). This nanosystem was designed to achieve dual lesion-targeted delivery and immune microenvironment remodeling. By verifying its spatiotemporal accumulation, anti-inflammatory activity, and neuroprotective efficacy, we sought to establish an integrated therapeutic strategy that simultaneously enables lesion targeting, immune regulation, and functional recovery after ischemic injury. MethodsThe physicochemical properties of PLP, including hydrodynamic particle size, zeta potential, structural stability, and morphology, were characterized using dynamic light scattering, zeta potential analysis, and transmission electron microscopy. The preservation of platelet membrane-derived adhesion and immunoregulatory proteins was confirmed by SDS-PAGE through comparative analysis of protein band profiles between PLP and native platelet membranes. The in vitro biological activities of PLP were evaluated using two complementary cellular models. LPS-induced M1-polarized RAW264.7 macrophages were employed to assess inflammatory modulation, while oxygen glucose deprivation/reperfusion (OGD/R)-induced BV2 microglial cells and SH-SY5Y neuronal cells were utilized to investigate neuroinflammatory regulation and neuronal protection. For in vivo validation, a transient middle cerebral artery occlusion (tMCAO) mouse model was established to mimic ischemia-reperfusion injury. The spatiotemporal biodistribution and lesion-targeting capability of the PLP were monitored through live fluorescence imaging. Therapeutic efficacy was comprehensively evaluated by triphenyltetrazolium chloride (TTC) staining, glial fibrillary acidic protein (GFAP) immunofluorescence analysis, body weight monitoring, and neurological severity score (NSS) assessment. ResultsPLP nanoparticles displayed a uniform spherical morphology, nanoscale particle size distribution, and stable negative surface charge, indicating favorable colloidal stability and circulation potential. SDS-PAGE results confirmed the effective retention of key platelet membrane proteins associated with endothelial adhesion, immune evasion, and inflammatory regulation, demonstrating the successful biomimetic construction. Optimal therapeutic concentrations were determined in OGD/R-induced BV2 cells, where PLP exhibited excellent cytocompatibility and anti-inflammatory activity.In vitro experiments demonstrated that PLP significantly inhibited the polarization of RAW264.7 macrophages toward the pro-inflammatory M1 phenotype and markedly reduced neuronal apoptosis under ischemia-reperfusion conditions. In vivo fluorescence imaging revealed that PLP rapidly accumulated in the ischemic brain hemisphere and maintained prolonged retention for up to 7 d, suggesting enhanced lesion-specific targeting and sustained drug release. Compared with control group, PLP treatment significantly reduced cerebral infarct volume, attenuated reactive astrogliosis, improved weight recovery, and accelerated neurological functional restoration, as reflected by significantly improved NSS scores. ConclusionThis study establishes a multifunctional biomimetic nanoplatform that integrates platelet membrane-mediated active targeting with the anti-inflammatory, antioxidative, and neuroprotective properties of TGF-β1. The PLP system enables rapid lesion homing and long-term retention while synergistically regulating the post-stroke inflammatory microenvironment by suppressing pro-inflammatory immune activation, reducing neuronal apoptosis, and limiting excessive astrocyte reactivity. Importantly, this study proposes a conceptually therapeutic paradigm that combines targeted delivery with immune microenvironment remodeling to achieve comprehensive neurovascular protection. These findings provide strong experimental evidence supporting the translational potential of biomimetic nanotherapeutics as next-generation precision interventions for ischemic stroke.
2.Analysis of the hotspots and advantages of adverse drug reaction automatic monitoring system based on CiteSpace and systematic review
Yan WANG ; Le KANG ; Wen CHEN ; Qi FANG ; Zhongwang YU ; Li CAO
Journal of Pharmaceutical Practice and Service 2026;44(7):362-369
Objective To provide a reference for the establishment, development and application of the adverse drug reaction (ADR) automated monitoring system, through verifying and quantifying the research hotspots and advantages of the system by CiteSpace software and systematic review. Methods Literature on ADR automated monitoring up to December 2023 were retrieved and screened from CNKI and web of science databases. CiteSpace 6.4.R1 software was used to conduct co-occurrence, clustering and emergence analysis, and to visualize and comparatively analyze the research hotspots, rules and distribution in the field of automated monitoring of ADR at home and abroad. In compliance with the preferred reporting items for systematic reviews and Meta-analyses (PRISMA), literature covering publications in English and Chinese including detection rates of ADR collected using Incident Reporting Systems (IRSs) and/or automated monitoring systems were retrieved and screened. The advantages and disadvantages of automated monitoring systems were analyzed by comparing the differences between these two systems in terms of the number of ADR reports and the types of positive signals. Results A total of 56 articles in English and 80 articles in Chinese were indexed by CiteSpace. The research hotspots in recent years included data mining, deep learning, text classification techniques, machine learning and so on. A total of seven studies compiled with the inclusion criteria for the systematic evaluation, all of which were completed between 1991 and 2021 in hospitals in four countries. 150 526 medical records were reviewed from 15 institutions. A total of 194 ADR reports were collected by IRSs. A total of 2 090 ADR reports were collected by the automated monitoring system over the same period, indicating a 977% increase in the number of ADR reports (P=0.0156) compared with the IRSs. Conclusion The ADR automatic monitoring system had significantly improved the level of drug risk identification and reduced costs, but it was necessary to optimize the algorithm, expand the data source and carry out standardization construction to overcome the current limitations.
3.Prognostic Utility of the Albumin-to-Alkaline Phosphatase Ratio in Head and Neck Cancer: A Systematic Review and Meta-Analysis
Yun-Ting WANG ; Adarsh KUDVA ; Yen-Ting LU ; Liang-Tseng KUO ; Chia-Hsuan LAI ; Yuan-Hsiung TSAI ; Chun-Ta LIAO ; Ku-Hao FANG ; Chung-Jan KANG ; Ethan I. HUANG ; Cheng-Ming HSU ; Geng-He CHANG ; Ming-Shao TSAI ; Yao-Te TSAI
Clinical and Experimental Otorhinolaryngology 2026;19(1):45-54
Objectives:
. The prognostic value of the pretreatment albumin-to-alkaline phosphatase ratio (AAPR) in head and neck cancer (HNC) remains uncertain. This meta-analysis aimed to evaluate the predictive role of AAPR for survival outcomes in patients with HNC.
Methods:
. A comprehensive search of the Cochrane Library, PubMed, and Embase databases was conducted to identify relevant studies published up to July 30, 2024. We included studies on AAPR and survival outcomes in HNC patients.
Results:
. Eight studies comprising 1,737 HNC patients were analyzed using random-effects models. Lower AAPR values were significantly correlated with worse overall survival (hazard ratio [HR], 2.08), progression-free survival (HR, 2.00), and disease-free survival (HR, 2.18). Sensitivity analyses confirmed the robustness of these results, with no significant publication bias detected.
Conclusion
. Our findings suggest that pretreatment AAPR could serve as a valuable and cost-effective prognostic indicator in HNC, potentially aiding clinicians in risk stratification and treatment decision-making. However, additional validation studies are warranted to confirm its clinical applicability.
4.Effect of ultrasound-guided superior laryngeal nerve block on tracheal tube-related responses during postoperative recovery in craniotomy patients: a randomized controlled trial
Jie XIAO ; Tao ZHU ; Renqing LIU ; Shudong WANG ; Fang KANG
Korean Journal of Anesthesiology 2026;79(3):360-369
Background:
Coughing and hemodynamic fluctuations during emergence from anesthesia after a craniotomy can result in serious complications. This study evaluated whether the ultrasound-guided superior laryngeal nerve block (SLNB) attenuates these tracheal tube-related responses.
Methods:
Eighty patients scheduled for elective craniotomy were randomized into the control (Group C, 2 ml 0.9% saline per side) and SLNB (Group S, 2 ml 1% lidocaine per side) group. The primary outcome was the incidence of coughing during the recovery period. Secondary outcomes included the severity of coughing, hemodynamic fluctuations, need for rescue interventions, anesthesia-related parameters, and complications.
Results:
Compared to controls, the patients in Group S experienced a significantly reduced incidence (78.9% vs. 48.6%; P = 0.006) and severity (P < 0.001) of coughing during emergence. The mean arterial pressure and heart rate were also more stable during and after extubation in Group S than in Group C. Furthermore, Group S required a significantly lower dose of nicardipine during the emergence period (P = 0.032), and both the incidence of and visual analog scale scores for postoperative sore throat at 6 h after extubation were markedly reduced (P = 0.035). No significant differences were noted between the groups in terms of propofol consumption, emergence agitation, extubation time, post-anesthesia care unit stay duration, or complications.
Conclusions
The SLNB significantly suppressed extubation-related responses during anesthetic emergence after craniotomy by reducing coughing and attenuating hemodynamic fluctuations, thereby contributing to a smoother emergence profile.
5.Exploratory Study on the Ultrasound Characteristics of the Vagus Nerve in a Healthy Han Population in a Hospital in Qujing,Yunnan
Lingli HOU ; Yan CHENG ; Fang YANG ; Junsu YANG ; Zizhen ZHANG ; Jianjian BAO ; Guohui ZHANG ; Kang DU
Journal of Kunming Medical University 2025;46(1):129-135
Objective To explore the characteristics of the cross-sectional area(CSA)of the vagus nerve in a healthy population in Qujing,Yunnan,and its correlation with demographic characteristics.Methods High-resolution nerve ultrasound examinations were conducted on the vagus nerve of 201 healthy volunteers from a hospital in Qujing,Yunnan from September 2022 to March 2023.The CSA was measured through transverse scans of the vagus nerve.The correlation of vagus nerve CSA with age,body mass index(BMI),and gender was assessed.Results The mean CSA of the bilateral VN were 1.9 mm2(right)and 1.3 mm2(left),respectively.The average CSA of the right vagus nerve was significantly greater than that of the left(P<0.001).In the high-age group(>50 years),the average CSA of the right vagus nerve was significantly higher than that of the low-age group(≤50 years)(P=0.0142).However,there was no statistically significant difference in the average CSA of the right vagus nerve between the BMI>24 kg/m2 group and the≤24 kg/m2 group(P=0.0852).The average CSA of the left vagus nerve showed no statistically significant differences across different age groups and BMI groups(P>0.05),but the average CSA of the bilateral vagus nerve in the male group was greater than that in the female group,with a statistically significant difference(P<0.05).Correlation analysis further confirmed a negative correlation between the average CSA of the right vagus nerve and age(r=-0.17,P=0.0139).Multiple linear regression models indicated that age(P=0.007)and gender(P=0.001)were independent influencing factors for the average CSA of the right vagus nerve.Conclusion In the healthy population of Qujing,Yunnan,the CSA of the right vagus nerve is significantly greater than that of the left,and males also exhibit a significantly greater CSA than females.With increasing age,the vagus nerve gradually becomes thinner.
6.Expert recommendations on the health benefits and use of vitamin and mineral supplements in healthy individuals and patients with chronic diseases (2025 edition)
Fang WANG ; Junren KANG ; Kang YU
Chinese Journal of Clinical Nutrition 2025;33(4):257-265
Vitamin-mineral supplements have clear health benefits in specific populations, but the needs for these nutrients vary among different physiological stages: Periconceptional folic acid supplementation reduces the risk of fetal neural tube defects; iron supplementation prevents iron-deficiency anemia; combined use of calcium and vitamin D helps maintain bone density in middle-aged and older adults; and multivitamin-mineral supplementation may delay age-related cognitive decline in elderly adults. For patients with chronic diseases, regular multivitamin-mineral intake may reduce the risk of respiratory infections and may even alleviate symptoms in specific subpopulations. Studies in Linxian have suggested lower mortality from esophageal cancer after multivitamin-mineral supplementation, although β-carotene may increase lung cancer risk among smokers. A combination of vitamin C and E, zinc, and β-carotene may slow the progression of age-related macular degeneration. Due to the synergistic effects among nutrients, combination formulations may be more advantageous. However, the use of fat-soluble vitamins must be lower than the tolerable upper intake levels to avoid accumulation and toxicity. For individuals at high risk of nutrient deficiency, the vitamin and mineral levels should be tested before supplementation, along with regular monitoring to facilitate dose adjustment. Liver and kidney function should be monitored in patients with chronic diseases after starting supplementation. In summary, vitamin and mineral supplements can improve health outcomes in specific populations. However, the use of these nutrients should be evidence-based and individualized, and vitamin-mineral supplements are not substitutes for medications or a balanced diet.
7.Expert consensus on nutritional therapy for patients with common chronic diseases (2025)
Junren KANG ; Fang WANG ; Peipei CHEN ; Wei WEI ; Kang YU
Chinese Journal of Clinical Nutrition 2025;33(4):246-256
The dramatically rising incidence of chronic diseases decreases quality of life, increases complications and all-cause mortality, and raises medical costs. Scientifically sound nutritional therapy is currently the most affordable and safest basic treatment for patients with chronic diseases, as it can help improve nutritional status, clinical outcomes, quality of life, and survival rates for patients with chronic diseases. The Nutrition Oncology Branch of Chinese Nutrition Society has developed the Expert consensus on nutritional therapy for patients with common chronic diseases (2025) based on the latest research evidence, clinical practice, and clinical nutrition guidelines to inform the nutritional diagnosis and treatment of chronic disease.
8.Cross-border high-quality clinical nutrition internship program for Hong Kong college students at the Department of Clinical Nutrition of Peking Union Medical College Hospital
Rongrong LI ; Fumin HUANG ; Kang YU ; Fang WANG ; Wei CHEN ; Yanping LIU ; Junren KANG ; Wenyan SUN ; Pengju LIU ; Jin FU ; Peipei CHEN ; Wei WEI
Chinese Journal of Clinical Nutrition 2025;33(4):311-314
Cross-border teaching provides new opportunities for college students to gain diverse insights amid the globalization and internationalized education, In July 2024, guided by the Chinese Association for Science and Technology, the Chinese Nutrition Society and the Hong Kong Nutrition Association collaborated to host a three-week clinical nutrition internship at Peking Union Medical College Hospital for five college students from Hong Kong SAR, China. This program included participating in outpatient rounds, attending in inpatient nutrition management, and attending lectures, aiming to enhance students' professional skills and clinical experience. Cultural exchange and value-based education also enriched students' social responsibility and cultural understanding. The Hong Kong students also brought diverse cultural backgrounds and inputs, enabling multidimensional communication during the training. Post-internship feedback survey showed that the students found the inernship valuable for their career development and hoped for more learning opportunities. This cross-border high-quality internship program fostered skill enhancement, cultural exchange between young students in Beijing and Hong Kong and contributed to advancement of clinical nutrition.
9.Changes in the nutrition status and body composition in patients with cervical cancer during concurrent chemoradiotherapy
Fang WANG ; Hongnan ZHEN ; Kang YU ; Yuan ZHANG
Chinese Journal of Clinical Nutrition 2025;33(2):81-89
Objective:To explore the changes in nutritional status and body composition of cervical cancer patients during concurrent chemoradiotherapy (CCRT) and their correlation with CCRT toxicities.Methods:In this prospective and observational clinical study, eligible treatment -na?ve patients with stage IB-IV primary cervical cancer were consecutively enrolled in the Department of Radiotherapy of Peking Union Medical College Hospital from September 2022 to August 2023. The patients were screened for nutritional risks, received dietary assessment, and were measured for body composition using multi-frequency bioelectrical impedance at baseline (prior to treatment), 4 weeks, and 8 weeks since treatment initiation. Insufficient muscle mass was diagnosed ccording to the Asian Working Group for Sarcopenia 2019 criteria. The severity of nausea, vomiting, abdominal pain, diarrhea, and hematological toxicity was assessed by the U.S. National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0).Results:A total of 109 patients were included. At baseline, there were 11 (10.1%) patients who were lean, 17 (15.6%) patients with insufficient muscle mass, and 28 patients (25.7%) at nutritional risk; at Week 8 of CCRT, patients at nutritional risk increased to 61 (56.0%). Compared to baseline, weight [(59.34±9.67) kg vs. (61.30±9.64) kg, P<0.001], skeletal muscle index [SMI, (6.15±0.74) kg/m 2vs. (6.39±0.74) kg/m 2, P<0.001], body fat percentage [(31.13±7.67) % vs. (32.07±7.70) %, P=0.004] were significantly decreased at Week 8 of CCRT. Besides, ≥10% SMI loss was only related to baseline body fat percentage ( HR=0.216, 95% CI: 0.001-0.724, P=0.038), but not related to age, nutritional status, or muscle mass (all P>0.05). At baseline and 8 weeks since CCRT, 8 (28.6%) and 40 (65.6%) patients at nutritional risk received nutritional support, respectively. During CCRT, the rates of grade ≥2 nausea and vomiting, diarrhea, and grade 3/4 hematological toxicity were 37.6%, 28.4% and 44.0%, respectively. Baseline nutritional risk was a risk factor for diarrhea ( HR=2.447, 95% CI: 1.017-6.068, P=0.047), and an advanced International Federation of Gynecology and Obstetrics (FIGO) stage was a risk factor for severe nausea and vomiting ( HR=1.735, 95% CI: 1.005-2.995, P=0.048). Patients presenting with severe nausea and vomiting had more significant reductions in body mass index [(-1.44±1.29) kg/m 2vs. (-0.59±0.84) kg/m 2, P<0.001] and SMI [(-0.37±0.41) kg/m 2vs. (-0.12±0.27) kg/m 2, P=0.013] compared to those without nausea and vomiting, while there was no significant difference in visceral fat area between these two groups [(-9.95±19.48) cm 2vs. (-5.12±15.79) cm 2, P=0.161]. Conclusions:Patients with cervical cancer have increased nutritional risk and more loss of body weight and muscle mass during CCRT. The presence of nutritional risk at baseline is a risk factor for diarrhea, while nausea and vomiting exacerbate the losses of body weight, muscle, and fat. Close monitoring, intensive symptomatic therapy, and appropriate nutritional interventions should be performed in the clinical setting to improve patients' tolerance of treatment and maintenance of body weight.
10.Impact of cancer-specific foods for special medical purposes on nutritional adequacy, safety, and efficacy in postoperative cancer patients
Fang WANG ; Pengju LIU ; Rongrong LI ; Jin FU ; Wei WEI ; Kang YU
Chinese Journal of Clinical Nutrition 2025;33(4):266-274
Objective:To evaluate the impact of a high-energy-density, high-protein, immune-modulating, cancer-specific foods for special medical purposes (FSMP) on nutritional adequacy, safety, and efficacy in postoperative cancer patients.Methods:This multicenter randomized controlled trial enrolled patients with gastrointestinal or head and neck cancer scheduled for surgery and at nutritional risk. Participants were randomized 1∶1 to receive either the investigational cancer-specific FSMP (FSMP group) or a commercially available tumor-specific enteral nutrition (EN) formula (control group). The "nutritional transition phase" (postoperative days 0-3) provided the assigned EN, with energy deficits supplemented by parenteral nutrition (PN). This was followed by the "full EN phase" (intervention period: 10±3 days), with a target energy intake of 105-146 kJ/kg/day. Nutritional adequacy was considered achieved if the actual intake reached ≥80% of the target in both phases. The primary outcomes were the body weight and prealbumin improvement rates after intervention , and the secondary outcomes were the improvement rates of handgrip strength, gait speed, serum albumin, and hemoglobin. Non-inferiority was tested using the confidence intervals, with the least squares mean difference and its 95% CI derived from a Logistic regression model (non-inferiority margin: -0.12).Results:A total of 220 patients from 17 centers completed the study (FSMP group: n=109; control group: n=111). After the nutrition support, the weight loss was (-0.9±2.1) kg and (-1.3±1.8) kg in the FSMP and control groups ( P=0.162), whereas prealbumin increased in both groups (59.0±69.0 mg/L vs. 50.0±62.0 mg/L, P=0.418). The lower bounds of the 95% CIs were -0.08 for both weight and prealbumin improvement rates, exceeding the predefined non-inferiority margin (-0.12). No significant differences were observed in the improvements in albumin, hemoglobin, handgrip strength, or gait speed (all P>0.05). No serious adverse events related to the formulas occurred. The FSMP group had a higher incidence of diarrhea (31.9% vs. 17.8%) and lower compliance rate (<80% intake: 13.4% vs. 5.9%), but the percentages of total energy intake over the estimated energy requirements (% of target) were comparable (89.9%±24.5% vs. 94.0%±22.3%, P=0.310). Conclusions:The cancer-specific FSMP can improve postoperative nutritional status in cancer patients, demonstrating non-inferiority to existing tumor-specific EN formulas in terms of nutritional adequacy, safety, and efficacy.

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