1.Diagnosis and treatment of colorectal liver metastases: Chinese expert consensus-based multidisciplinary team (2024 edition).
Wen ZHANG ; Xinyu BI ; Yongkun SUN ; Yuan TANG ; Haizhen LU ; Jun JIANG ; Haitao ZHOU ; Yue HAN ; Min YANG ; Xiao CHEN ; Zhen HUANG ; Weihua LI ; Zhiyu LI ; Yufei LU ; Kun WANG ; Xiaobo YANG ; Jianguo ZHOU ; Wenyu ZHANG ; Muxing LI ; Yefan ZHANG ; Jianjun ZHAO ; Aiping ZHOU ; Jianqiang CAI
Chinese Medical Journal 2025;138(15):1765-1768
2.BNC1 promotes cell migration and invasion of lung squamous cell carcinoma
Longyao ZHANG ; Longjin ZENG ; Linpeng ZHENG ; Fenglin LIN ; Dingqin CAI ; Ping CAI ; Jianguo SUN
Journal of Army Medical University 2024;46(7):678-687
Objective To explore the mechanism and effects of Basonuclin 1(BNC1)on the migration and invasion abilities of lung squamous cell carcinoma.Methods Bioinformatics technology was used to analyze the expression patterns and survival impact of BNC1 in patients with lung squamous cell carcinoma in online databases;Tissue microarrays were stained by immunohistochemistry assay and analyzed for BNC1 protein level.Cell lines for lung squamous cell carcinoma with high and low BNC1 expression were screened in the Cancer Cell Line Encyclopedia(CCLE)database.Wound healing experiment and transwell assay were performed on lung squamous cell carcinoma cell models with knockdown and overexpression of BNC1,and the migration and invasion rates of each cell line were detected;Quantitative reverse transcription PCR(RT-qPCR)was used to validate the migration and invasion of 10 highly related genes derived from literature.Western blotting was used to validate the selected regulatory genes.Results Bioinformatics technology found that BNC1 was highly expressed in lung squamous cell carcinoma tissues and was associated with lower survival rate(P=0.047).The expression of BNC1 in lung squamous cell carcinoma was higher than that in paracancerous tissues(P<0.05).BNC1 had higher expression in the H226 cells and lower expression in the SK-MES1 cells.BNC1 knockdown inhibited the migration and invasion abilities of lung squamous cell carcinoma cells(P<0.05),and BNC1 overexpression enhanced the migration and invasion abilities of lung squamous cell carcinoma cells(P<0.05).Screening of BNC1 downstream regulatory molecules at the mRNA level showed that CDH1 was decreased when BNC1 was overexpressed(P<0.05),and increased when BNC1 was knocked down(P<0.05).The results of mRNA level were consistent with the results verified by Western blotting(P<0.05).Conclusion BNC1 may be a gene predicting poor prognosis for lung squamous cell carcinoma patients,and BNC1 may likely to promote cell migration and invasion of lung squamous cell carcinoma by downregulating CDH1 expression.
3.Survival Status of Patients with Cervical Cancer Registered in Nantong
Chunyan ZHAO ; Haizhen CHEN ; Bo CAI ; Jianguo CHEN ; Juan CAI
Cancer Research on Prevention and Treatment 2024;51(1):61-66
Objective To analyze the survival status of inpatients with cervical cancer registered in Nantong admitted in Nantong Cancer Hospital from 2002 to 2017. Methods Inpatients with cervical cancer in Nantong Cancer Hospital were followed up from 2017 until December 31, 2020 using active and passive methods to determine their survival outcome. The rate of follow-up loss was statistically analyzed by Chi-square test, the observed survival rate for each year was calculated using the life table, the survival curve was drawn with R language, and the survival rates of patients in different age groups and from different regions were compared with log-rank test (Mantel-Cox). Results A total of 5645 cervical cancer cases were registered. Among them, the survival outcome was recorded for 5512 cases. The success rate of follow-up was 97.64%, and the loss of follow-up rate was 2.36%. The average age of onset was 56.67±12.78 years. The median survival time was 6.54 years, and the 1-, 3-, 5-, and 10-year observed survival rates were 91.50%, 76.95%, 60.99%, and 28.51%, respectively. Among the age groups, significant differences in survival rate were observed between the 15- and 60-year-old groups (
4.Construction and validation of a nomogram model of early related factors for hepatic insufficiency after hemihepatectomy
Bolun ZHANG ; Xinyu BI ; Hong ZHAO ; Jianping CHANG ; Xiaoshi ZHANG ; Bowen XU ; Jianjun ZHAO ; Jianguo ZHOU ; Jianqiang CAI
Chinese Journal of Surgery 2024;62(1):49-56
Objectives:To investigate the early related factors for hepatic insufficiency after hemihepatectomy and to construct and validate a nomogram model.Methods:This is a retrospective cohort study.There were 207 patients with liver tumor who underwent hemihepatectomy in the Department of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences from October 2016 to December 2022. Using the random number method, patients were randomly divided into a model group( n=166) and a validation group( n=41) according to an 4∶1 ratio. There were 118 males and 48 females in the modeling group,with an age ( M(IQR)) of 59.0(13.3) years (range: 22.0 to 81.0 years),42 patients in the group with postoperative liver insufficiency and 124 patients in the group without postoperative liver insufficiency. There were 32 males and 9 females in the validation group, with an age of 54.0(19.0) years (range: 25.0 to 81.0 years). The first results of the peripheral blood test of patients within 24 hours after surgery were collected,and the independent related factors for incomplete postoperative liver function were determined by multivariate Logistic regression analysis,and related factors of postoperative incomplete liver function were screened by best subset selection. A nomogram model of the related factors of postoperative hepatic insufficiency after hemihepatectomy was constructed using R software,validated by internal and external validation of the model. Results:Multivariate logistic regression analysis showed that elevated D-dimer level and decreased antithrombin Ⅲ (AT-Ⅲ) activity within 24 hours after surgery were independent related factors for the development of postoperative hepatic insufficiency in hemihepatectomized patients. The results of the best subset selection showed that ALT, D-dimer, and AT-Ⅲ activity levels within 24 hours postoperatively were the most relevant factors for postoperative hepatic insufficiency. The R software was applied to build a nomogram prediction model based on the above three indicators in the model set, and the receiver operating characteristic(ROC) curve of the model showed an area under the curve of 0.803 and the calibration curve showed a U-index of -0.012 for the model( P=0.977). The results of the clinical decision analysis and the clinical impact curve indicated that the model had good clinical utility. The internal validation results of the Bootstrap method suggested that the model had reasonable consistency. The area under the ROC curve of the validation group model was 0.806, suggesting that the model had a good generalization prediction ability. Conclusions:The levels of ALT, D-dimer, and AT-Ⅲ activity within 24 hours after hemihepatectomy are valuable indicators for predicting liver insufficiency after hemihepatectomy. The nomogram model is reliable and can be used as an indicator for close postoperative monitoring.
5.Trends and age-period-cohort analysis of leukemia incidence in Qidong from 1972 to 2021
Jian ZHU ; Yongsheng CHEN ; Jun WANG ; Yonghui ZHANG ; Lulu DING ; Yuanyou XU ; Yongfeng YAN ; Jianguo CHEN ; Hong CAI
Chinese Journal of Oncology 2024;46(10):961-967
Objective:To describe the epidemiological characteristics and trends of leukemia incidence in Qidong between 1972 and 2021, and provide guidelines for prevention and control measures and strategies.Methods:The cancer registry data was collected and analyzed on leukemia incidence during 1972—2021 in Qidong by sex, age and time. Crude incidence rate (CR), China age-standardized rate (ASRC), world age-standardized rate (ASRW), and average annual change percentage (AAPC) was calculated by Joinpoint software. Age-period-cohort (APC) model was used to analyze the influence of age, period and birth cohort on the changes in the incidence trend of leukemia patients.Results:From 1972 to 2021, there were 2 948 patients with leukemia in Qidong, accounting for 2.00% of all cancer new cases, CR of leukemia was 5.26/10 5, ASRC was 4.34/10 5, ASRW was 4.35/10 5. The truncated incidence of 35—64 years old was 5.29/10 5, the cumulative incidence rate between the ages of 0 and 74 years old was 0.40%, the cumulative risk was 0.40%. There were 1 608 male patients, the CR, ASRC, and the ASRW were 5.81/10 5, 4.88/10 5 and 4.85/10 5. The number of female patients were 1 340, and the CR, ASRC, and the ASRW were 4.71/10 5, 3.86/10 5 and 3.91/10 5, respectively. Temporal trends indicated significant upward trends in ASRC among both gender, males and females with AAPC values of 1.41% ( P<0.001), 1.15% ( P<0.001), and 1.73% ( P<0.001), respectively. The results of the APC model showed that the average net drift value of leukemia incidence in all age groups was 1.57% (95% CI, 1.24%-1.89%), and the highest value of local drift was 3.20% (95% CI, 1.63%-4.78%) in the 80~ years old group. The incidence of leukemia increased with age. With the passage of time, the risk of leukemia incidence increased gradually compared with the rate ratio of leukemia incidence (risk ratio [ RR], 1.00) in 1992—1996, the RR of leukemia incidence increased from 0.70 during 1972—1976 to 1.57 during 2017—2021. The later the cohort was born, the greater the risk of leukemia incidence compared with the relative risk of leukemia incidence ( RR, 1.00) in 1952—1956 cohort, the RR of leukemia incidence increased from 0.24 in the 1892—1896 cohort to 2.73 in the 2017—2021 cohort. Conclusions:The incidence of the leukemia has presented a rising trend in the past fifty years. Leukemia incidence increased with age, and the period and cohort effects on the risk of incidence increase. Further research is needed to investigate the risk factors related to leukemia.
6.Enhancing metformin-induced tumor metabolism destruction by glucose oxidase for triple-combination therapy
Fan RANGRANG ; Cai LINRUI ; Liu HAO ; Chen HONGXU ; Chen CAILI ; Guo GANG ; Xu JIANGUO
Journal of Pharmaceutical Analysis 2024;14(3):321-334
Despite decades of laboratory and clinical trials,breast cancer remains the main cause of cancer-related disease burden in women.Considering the metabolism destruction effect of metformin(Met)and cancer cell starvation induced by glucose oxidase(GOx),after their efficient delivery to tumor sites,GOx and Met may consume a large amount of glucose and produce sufficient hydrogen peroxide in situ.Herein,a pH-responsive epigallocatechin gallate(EGCG)-conjugated low-molecular-weight chitosan(LC-EGCG,LE)nanoparticle(Met-GOx/Fe@LE NPs)was constructed.The coordination between iron ions(Fe3+)and EGCG in this nanoplatform can enhance the efficacy of chemodynamic therapy via the Fenton reaction.Met-GOx/Fe@LE NPs allow GOx to retain its enzymatic activity while simultaneously improving its stability.Moreover,this pH-responsive nanoplatform presents controllable drug release behavior.An in vivo biodistribution study showed that the intracranial accumulation of GOx delivered by this nano-platform was 3.6-fold higher than that of the free drug.The in vivo anticancer results indicated that this metabolism destruction/starvation/chemodynamic triple-combination therapy could induce increased apoptosis/death of tumor cells and reduce their proliferation.This triple-combination therapy approach is promising for efficient and targeted cancer treatment.
7.Trends and age-period-cohort analysis of leukemia incidence in Qidong from 1972 to 2021
Jian ZHU ; Yongsheng CHEN ; Jun WANG ; Yonghui ZHANG ; Lulu DING ; Yuanyou XU ; Yongfeng YAN ; Jianguo CHEN ; Hong CAI
Chinese Journal of Oncology 2024;46(10):961-967
Objective:To describe the epidemiological characteristics and trends of leukemia incidence in Qidong between 1972 and 2021, and provide guidelines for prevention and control measures and strategies.Methods:The cancer registry data was collected and analyzed on leukemia incidence during 1972—2021 in Qidong by sex, age and time. Crude incidence rate (CR), China age-standardized rate (ASRC), world age-standardized rate (ASRW), and average annual change percentage (AAPC) was calculated by Joinpoint software. Age-period-cohort (APC) model was used to analyze the influence of age, period and birth cohort on the changes in the incidence trend of leukemia patients.Results:From 1972 to 2021, there were 2 948 patients with leukemia in Qidong, accounting for 2.00% of all cancer new cases, CR of leukemia was 5.26/10 5, ASRC was 4.34/10 5, ASRW was 4.35/10 5. The truncated incidence of 35—64 years old was 5.29/10 5, the cumulative incidence rate between the ages of 0 and 74 years old was 0.40%, the cumulative risk was 0.40%. There were 1 608 male patients, the CR, ASRC, and the ASRW were 5.81/10 5, 4.88/10 5 and 4.85/10 5. The number of female patients were 1 340, and the CR, ASRC, and the ASRW were 4.71/10 5, 3.86/10 5 and 3.91/10 5, respectively. Temporal trends indicated significant upward trends in ASRC among both gender, males and females with AAPC values of 1.41% ( P<0.001), 1.15% ( P<0.001), and 1.73% ( P<0.001), respectively. The results of the APC model showed that the average net drift value of leukemia incidence in all age groups was 1.57% (95% CI, 1.24%-1.89%), and the highest value of local drift was 3.20% (95% CI, 1.63%-4.78%) in the 80~ years old group. The incidence of leukemia increased with age. With the passage of time, the risk of leukemia incidence increased gradually compared with the rate ratio of leukemia incidence (risk ratio [ RR], 1.00) in 1992—1996, the RR of leukemia incidence increased from 0.70 during 1972—1976 to 1.57 during 2017—2021. The later the cohort was born, the greater the risk of leukemia incidence compared with the relative risk of leukemia incidence ( RR, 1.00) in 1952—1956 cohort, the RR of leukemia incidence increased from 0.24 in the 1892—1896 cohort to 2.73 in the 2017—2021 cohort. Conclusions:The incidence of the leukemia has presented a rising trend in the past fifty years. Leukemia incidence increased with age, and the period and cohort effects on the risk of incidence increase. Further research is needed to investigate the risk factors related to leukemia.
8.Construction and validation of a nomogram model of early related factors for hepatic insufficiency after hemihepatectomy
Bolun ZHANG ; Xinyu BI ; Hong ZHAO ; Jianping CHANG ; Xiaoshi ZHANG ; Bowen XU ; Jianjun ZHAO ; Jianguo ZHOU ; Jianqiang CAI
Chinese Journal of Surgery 2024;62(1):49-56
Objectives:To investigate the early related factors for hepatic insufficiency after hemihepatectomy and to construct and validate a nomogram model.Methods:This is a retrospective cohort study.There were 207 patients with liver tumor who underwent hemihepatectomy in the Department of Hepatobiliary Surgery, Cancer Hospital, Chinese Academy of Medical Sciences from October 2016 to December 2022. Using the random number method, patients were randomly divided into a model group( n=166) and a validation group( n=41) according to an 4∶1 ratio. There were 118 males and 48 females in the modeling group,with an age ( M(IQR)) of 59.0(13.3) years (range: 22.0 to 81.0 years),42 patients in the group with postoperative liver insufficiency and 124 patients in the group without postoperative liver insufficiency. There were 32 males and 9 females in the validation group, with an age of 54.0(19.0) years (range: 25.0 to 81.0 years). The first results of the peripheral blood test of patients within 24 hours after surgery were collected,and the independent related factors for incomplete postoperative liver function were determined by multivariate Logistic regression analysis,and related factors of postoperative incomplete liver function were screened by best subset selection. A nomogram model of the related factors of postoperative hepatic insufficiency after hemihepatectomy was constructed using R software,validated by internal and external validation of the model. Results:Multivariate logistic regression analysis showed that elevated D-dimer level and decreased antithrombin Ⅲ (AT-Ⅲ) activity within 24 hours after surgery were independent related factors for the development of postoperative hepatic insufficiency in hemihepatectomized patients. The results of the best subset selection showed that ALT, D-dimer, and AT-Ⅲ activity levels within 24 hours postoperatively were the most relevant factors for postoperative hepatic insufficiency. The R software was applied to build a nomogram prediction model based on the above three indicators in the model set, and the receiver operating characteristic(ROC) curve of the model showed an area under the curve of 0.803 and the calibration curve showed a U-index of -0.012 for the model( P=0.977). The results of the clinical decision analysis and the clinical impact curve indicated that the model had good clinical utility. The internal validation results of the Bootstrap method suggested that the model had reasonable consistency. The area under the ROC curve of the validation group model was 0.806, suggesting that the model had a good generalization prediction ability. Conclusions:The levels of ALT, D-dimer, and AT-Ⅲ activity within 24 hours after hemihepatectomy are valuable indicators for predicting liver insufficiency after hemihepatectomy. The nomogram model is reliable and can be used as an indicator for close postoperative monitoring.
9.Different Radiological Indices of Patellar Height Predict Patients’ Diverse Outcomes Following Total Knee Arthroplasty
Zhiguo BI ; Yimeng CAI ; Chao SUN ; Xiaotong SHI ; Shiyu LIAO ; Jianguo LIU
Clinics in Orthopedic Surgery 2024;16(5):741-750
Background:
Total knee arthroplasty (TKA) is a common surgical procedure for patients with knee osteoarthritis. The patellar component plays a crucial role in knee biomechanics and can influence postoperative outcomes. This study aimed to investigate the relationship between radiological indices of patellar height and patient outcomes following TKA.
Methods:
A retrospective analysis was conducted on patients who underwent TKA for osteoarthritis. Radiographic measurements of patellar height, including the Insall-Salvati (IS) ratio, modified Blackburne-Peel (mBP) ratio, Caton-Deschamps ratio, and plateaupatellar angle (PPA), were obtained. Clinical outcomes were assessed using the Knee Society Score (KSS) and the Forgotten Joint Score-12 (FJS-12). Patient satisfaction and postoperative complications were also evaluated. Statistical analyses, including correlation analysis and multiple regression models, were performed to determine the association between radiological indices and patient outcomes.
Results:
The study included 330 cases that met the inclusion criteria. The analysis revealed significant correlations between different radiological indices of patellar height and patient outcomes. Lower postoperative PPA was correlated with worse KSS and range of motion scores. A decreased mBP ratio was associated with poorer FJS-12 responses and higher risks of dissatisfaction and patellar clunk or crepitus. Increased IS ratio was linked to a lower likelihood of incidental giving way of the knee. Advanced age was associated with reduced dissatisfaction and incidental giving way probabilities.
Conclusions
The findings of this study demonstrate that radiological indices of patellar height can predict patient outcomes following TKA. Assessing patellar height using various radiographic measurements provides valuable information for surgical planning and prognostic evaluation. Understanding the impact of patellar height on clinical outcomes can aid in optimizing TKA procedures and improving patient satisfaction. These findings emphasize the importance of considering patellar height as a predictive factor in TKA and highlight its potential role in guiding postoperative management and rehabilitation strategies.
10.A systematic evaluation of teaching effect of PBL+CBL versus LBL in medical students' surgical internships
Liuyun CAI ; Xiaodong LUO ; Xinru DENG ; Jianguo HU
Chinese Journal of Medical Education Research 2023;22(10):1499-1504
Objective:To systematically evaluate the teaching effect of problem-based learning (PBL) plus case-based learning (CBL) versus lecture-based learning (LBL) in surgical internships in Chinese medical students.Methods:We searched PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure, VIP, and WanFang Data for randomized controlled studies evaluating PBL+CBL versus LBL in surgical internships in Chinese medical students. The retrieval time was from database establishment to June 2019. Data analysis was performed using RevMan 5.2 software.Results:Seventeen randomized controlled trials were included, involving a total of 1161 students, including 581 in the PBL+CBL group and 580 in the LBL group. Meta-analysis results showed that the PBL+CBL group had significantly higher scores of theory examination [mean difference ( MD)=6.15, 95%CI=4.14-8.15, P<0.001], skill examination ( MD=7.67, 95%CI=3.66-11.69, P<0.001), and case analysis ( MD=6.06, 95%CI=2.89-9.23, P=0.000 2) compared with the control group. The PBL+CBL group had a significantly higher percentage of satisfaction with the teaching results than the LBL group [odds ratio( OR)=2.98, 95%CI=1.88-4.73, P<0.001]. Conclusion:PBL+CBL is superior to LBL in medical students' surgical internships, which needs verification by more high-quality studies due to limitations in the number and quality of the included studies.

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