1.Application of contrast-enhanced ultrasound in the full-course management of precise locoregional diagnosis and treatment for hepatocellular carcinoma
Yan ZHOU ; Jianmin DING ; Xiang JING
Journal of Clinical Hepatology 2026;42(7):1513-1518
Hepatocellular carcinoma (HCC) is one of the major malignancies with the heaviest disease burden in China. Many patients have lost the opportunity for radical surgical resection at the time of diagnosis, with locoregional interventional therapy playing an increasingly important role in full-course HCC management. Contrast-enhanced ultrasound (CEUS) enables real-time dynamic assessment of tumor microvascular perfusion and has several practical advantages including bedside availability, no ionizing radiation, and repeatability, and its role has therefore expanded from an adjunctive diagnostic method to the full-course management of precise locoregional diagnosis and treatment for HCC. Before treatment, CEUS can assist in the qualitative diagnosis of lesions, lesion localization, delineation of the viable tumor, and planning of the puncture route, especially for lesions that are poorly visualized on conventional ultrasound. During and after treatment, CEUS can help to detect residual viable tumor, related complications, and local tumor progression, thereby providing a basis for additional ablation, transcatheter arterial chemoembolization, or adjustment of combined treatment strategies. In recent years, the CEUS LI-RADS treatment response assessment system has provided a standardized framework for evaluating response after locoregional therapy, and in addition, the development of unimodal and multimodal fusion imaging techniques has further promoted the standardized application of CEUS in precise locoregional therapy for HCC. As increasing attention is paid to the ablation margin, the goal of response evaluation for local ablation has shifted from “the achievement of imaging-defined complete ablation” to a new treatment paradigm of “no contrast-enhanced imaging, no ablation; no fusion imaging, no curative ablation”. This article reviews the technical advantages, clinical application value, treatment response assessment, fusion imaging strategies, and current limitations of CEUS in locoregional interventional diagnosis and treatment of HCC, in order to provide a reference for the individualized and precise management of HCC.
2.Sini San Treats Liver Fibrosis by Regulating Polarization of Intrahepatic Kupffer Cells
Yanyu QU ; Qiao GENG ; Zhuxiu ZHOU ; Dongyang ZHENG ; Jianmin YAN ; Huan LIU ; Li CHEN ; Feng ZHANG ; Desong KONG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(23):34-46
ObjectiveTo investigate the mechanism by which Sini San (SNS) treats liver fibrosis through regulating the polarization of intrahepatic Kupffer cells. MethodsSixty SPF-grade male Balb/c mice were randomized into blank control, model, silymarin (0.2 g·kg-1), and low-, medium-, and high-dose (2.93, 5.85, 11.70 g·kg-1, respectively) SNS groups. A mouse model of liver fibrosis was induced by intraperitoneal injection of CCl4. After 5 weeks of administration, the body mass, liver pathological changes [Hematoxylin and Eosin (HE), Masson, and Sirius red staining], serum biochemical indicators [alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT)], liver fibrosis markers [procollagen type Ⅲ (PCⅢ), laminin (LN), and hyaluronic acid (HA)], inflammatory cytokines [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and interleukin-10 (IL-10)], and fibrosis-related proteins [α-smooth muscle actin (α-SMA), collagen type Ⅰ (Col Ⅰ), and collagen type Ⅲ (Col Ⅲ)] were assessed. A co-culture system of THP-1 cells (M1 macrophages) and human hepatic stellate cells (LX-2) was established. The cell experiment was designed with blank control (LX-2 alone), model (LX-2 + M1 macrophages), and low-, medium-, and high-dose SNS (co-culture with 5%, 10%, or 20% SNS-containing serum, respectively) groups. Cell viability, inflammatory cytokines, and macrophage phenotype were examined. Human primary hepatic Kupffer cells were allocated into blank control, M1 (LPS 100 μg·L-1+IFN-γ 20 μg·L-1), M2 (IL-4 20 μg·L-1+IL-13 20 μg·L-1), M1+M2, M1+SNS (supplemented with 10% SNS-containing serum for 2 h after culture under M1 conditions for 24 h), M2+SNS (supplemented with 10% SNS-containing serum for 2 h after culture under M2 conditions for 24 h), and M1+M2+SNS groups (supplemented with 10% SNS-containing serum for 2 h after culture under M1+M2 conditions for 24 h), and the expression of nuclear factor-κB (NF-κB) p65 and signal transducer and activator of transcription 3 (STAT3) at protein and mRNA levels was determined. ResultsCompared with the blank group, the model group exhibited increased serum levels of ALT, AST, ALP, PCⅢ, LN, HA, IL-6, and TNF-α, upregulated protein and mRNA levels of α-SMA, Col Ⅰ, and Col Ⅲ in the liver tissue (P<0.05, P<0.01), and decreased IL-10 level and STAT3 mRNA level (P<0.05, P<0.01), accompanied by marked collagen deposition and inflammatory infiltration in the liver. Compared with the model group, all doses of Sini San reversed these alterations (P<0.05, P<0.01), with the high-dose group showing the most pronounced effects. Cell experiments demonstrated that, compared with the blank control group, the model group had elevated levels of pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) and upregulated protein and mRNA levels of M1 markers [cluster of differentiation 86 (CD86, inducible nitric oxide synthase (iNOS), and monocyte chemoattractant protein-1 (MCP-1)] (P<0.01), along with declined level of IL-10 and downregulated expression of M2 markers [(CD163, CD206, and arginase-1 (Arg-1)] (P<0.05,P<0.01). Compared with the model group, treatment with Sini San-containing serum at various concentrations lowered the levels of pro-inflammatory cytokines and expression of M1 markers (P<0.05, P<0.01), while increasing the IL-10 level and M2 marker expression (P<0.05, P<0.01). Additionally, Sini San downregulated the mRNA level of NF-κB and upregulated the mRNA level of STAT (P<0.05, P<0.01). In the experiment with human primary Kupffer cells, compared with the blank group, the M1 group showed increased NF-κB p65 expression (P<0.01) and decreased STAT3 expression (P<0.05), whereas the M2 group exhibited increased STAT3 expression (P<0.01). Compared with the respective model groups, Sini San-containing serum reversed the M1-induced overexpression of NF-κB p65 (P<0.05, P<0.01) and further enhanced the M2-induced STAT3 expression (P<0.05, P<0.01). ConclusionSini San can inhibit the NF-κB p65/STAT3 signaling pathway and repolarize intrahepatic Kupffer cells from the pro-inflammatory M1 to the anti-inflammatory M2 phenotype to attenuate inflammation and suppress hepatic stellate cell activation and collagen deposition, thereby exerting anti-fibrotic effect.
3.Diffusion-based generative drug-like molecular editing with chemical natural language
Jianmin WANG ; Peng ZHOU ; Zixu WANG ; Wei LONG ; Yangyang CHEN ; Tai-No KYOUNG ; Dongsheng OUYANG ; Jiashun MAO ; Xiangxiang ZENG
Journal of Pharmaceutical Analysis 2025;15(6):1215-1225
Recently,diffusion models have emerged as a promising paradigm for molecular design and optimization.However,most diffusion-based molecular generative models focus on modeling 2D graphs or 3D geom-etries,with limited research on molecular sequence diffusion models.The International Union of Pure and Applied Chemistry(IUPAC)names are more akin to chemical natural language than the simplified molecular input line entry system(SMILES)for organic compounds.In this work,we apply an IUPAC-guided conditional diffusion model to facilitate molecular editing from chemical natural language to chemical language(SMILES)and explore whether the pre-trained generative performance of diffusion models can be transferred to chemical natural language.We propose DiffIUPAC,a controllable molecular editing diffusion model that converts IUPAC names to SMILES strings.Evaluation results demonstrate that our model out-performs existing methods and successfully captures the semantic rules of both chemical languages.Chemical space and scaffold analysis show that the model can generate similar compounds with diverse scaffolds within the specified constraints.Additionally,to illustrate the model's applicability in drug design,we conducted case studies in functional group editing,analogue design and linker design.
4.Current Status and Challenges of Ultrasound-Guided Ablation Therapy for Liver Cancer
Yan ZHOU ; Jianmin DING ; Yandong WANG ; Xiang JING
Cancer Research on Prevention and Treatment 2025;52(4):274-280
Ultrasound-guided local ablation therapy for liver tumors has extensive clinical application because of its minimal invasiveness, proven effectiveness, low complication rates, and suitability for repeat treatments. Ultrasound-guided interventional therapy has continuously evolved in terms of the following: technological advancements, from the initial utilization of percutaneous ethanol injection to thermal ablation therapies exemplified by radiofrequency ablation and microwave ablation and presently advancing toward emerging techniques such as irreversible electroporation; imaging methods, from conventional ultrasound guidance to contrast-enhanced ultrasound and fusion imaging for precise guidance and assessment; supplementary strategies, from monotherapy to auxiliary method and synergistic therapy; and innovative treatment concepts, from early-stage small hepatocellular carcinoma to intermediate and even large liver cancers. The development of ultrasound-guided local ablation of liver cancers has progressed from an initial phase of rapid advancement to a mature stage characterized by further enhancements. This article provides a comprehensive overview of the status of technical equipment, treatment processes, efficacy, complications, and challenges encountered in ultrasound-guided local ablation for liver tumors, with the objective of offering valuable insights for interventional ultrasound physicians.
5.Outcome after spleen-preserving distal pancreatectomy by Warshaw technique for pancreatic body cancer
Endi ZHOU ; Guodong SHI ; Hongyuan SHI ; Kai ZHANG ; Jishu WEI ; Min TU ; Zipeng LU ; Feng GUO ; Jianmin CHEN ; Kuirong JIANG ; Wentao GAO
Annals of Hepato-Biliary-Pancreatic Surgery 2025;29(2):177-186
Background:
s/Aims: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer.
Methods:
We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R.
Results:
Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices.
Conclusions
SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.
6.Outcome after spleen-preserving distal pancreatectomy by Warshaw technique for pancreatic body cancer
Endi ZHOU ; Guodong SHI ; Hongyuan SHI ; Kai ZHANG ; Jishu WEI ; Min TU ; Zipeng LU ; Feng GUO ; Jianmin CHEN ; Kuirong JIANG ; Wentao GAO
Annals of Hepato-Biliary-Pancreatic Surgery 2025;29(2):177-186
Background:
s/Aims: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer.
Methods:
We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R.
Results:
Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices.
Conclusions
SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.
7.Outcome after spleen-preserving distal pancreatectomy by Warshaw technique for pancreatic body cancer
Endi ZHOU ; Guodong SHI ; Hongyuan SHI ; Kai ZHANG ; Jishu WEI ; Min TU ; Zipeng LU ; Feng GUO ; Jianmin CHEN ; Kuirong JIANG ; Wentao GAO
Annals of Hepato-Biliary-Pancreatic Surgery 2025;29(2):177-186
Background:
s/Aims: Distal pancreatectomy with splenectomy (DPS) is a common surgical procedure for pancreatic body cancer.However, spleen-preserving distal pancreatectomy (SPDP) utilizing the Warshaw technique (WT) in malignancies is generally not favored due to concerns about inadequate resection. This study aims to assess the feasibility and oncologic outcomes of employing SPDP with WT in pancreatic body cancer.
Methods:
We conducted a retrospective analysis comparing 21 SPDP patients with 63 DPS patients matched by propensity score from January 2018 to November 2022. Clinical outcomes and follow-up data were analyzed using R.
Results:
Both groups exhibited similar demographic, intraoperative, and pathological characteristics, with the exception of a reduced number of total lymph nodes (p = 0.006) in the SPDP group. There were no significant differences in the rates of postoperative complications, recurrence, or metastasis. Local recurrence predominantly occurred in the central region as opposed to the spleen region.There were no cases of isolated recurrences in the splenic region. Median overall survival and recurrence-free survival times were 51.5 months for SPDP vs 30.5 months for DPS and 18.7 months vs 16.8 months, respectively (p > 0.05). The incidence of partial splenic infarction and left-side portal hypertension in the SPDP group was 28.6% (6/21) and 9.5% (2/21), respectively, without necessitating splenic abscess puncture, splenectomy, or causing bleeding from perigastric varices.
Conclusions
SPDP did not negatively impact local recurrence or survival rates in selected pancreatic body cancer patients. Further studies are necessary for validation.
8.Diffusion-based generative drug-like molecular editing with chemical natural language.
Jianmin WANG ; Peng ZHOU ; Zixu WANG ; Wei LONG ; Yangyang CHEN ; Kyoung Tai NO ; Dongsheng OUYANG ; Jiashun MAO ; Xiangxiang ZENG
Journal of Pharmaceutical Analysis 2025;15(6):101137-101137
Recently, diffusion models have emerged as a promising paradigm for molecular design and optimization. However, most diffusion-based molecular generative models focus on modeling 2D graphs or 3D geometries, with limited research on molecular sequence diffusion models. The International Union of Pure and Applied Chemistry (IUPAC) names are more akin to chemical natural language than the Simplified Molecular Input Line Entry System (SMILES) for organic compounds. In this work, we apply an IUPAC-guided conditional diffusion model to facilitate molecular editing from chemical natural language to chemical language (SMILES) and explore whether the pre-trained generative performance of diffusion models can be transferred to chemical natural language. We propose DiffIUPAC, a controllable molecular editing diffusion model that converts IUPAC names to SMILES strings. Evaluation results demonstrate that our model outperforms existing methods and successfully captures the semantic rules of both chemical languages. Chemical space and scaffold analysis show that the model can generate similar compounds with diverse scaffolds within the specified constraints. Additionally, to illustrate the model's applicability in drug design, we conducted case studies in functional group editing, analogue design and linker design.
9.Comparison of the efficacy of continuous VA chemotherapy and I/HDAC consolidation in postremission therapy for acute myeloid leukemia fit for standard chemotherapy
Li SUN ; Pengpeng ZHANG ; Simei REN ; Nan ZHOU ; Liyuan LI ; Zhenzhen WANG ; Weiguang CUI ; Fan YANG ; Jianmin LUO ; Lin YANG
Chinese Journal of Hematology 2025;46(4):343-348
Objective:To compare the efficacy and safety of continuous venetoclax combined azacitidine (VA) chemotherapy and intermedium/high-dose cytarabine (I/HDAC) consolidation in patients with acute myeloid leukemia (AML) fit for standard chemotherapy (transform from UNFIT) .Methods:Clinical data of patients who were fit for standard chemotherapy were collected among those with AML who underwent VA induction in the Department of Hematology, the Second Hospital of Hebei Medical University. The overall survival (OS), relapse-free survival (RFS), event-free survival (EFS), and incidence of adverse events were analyzed retrospectively.Results:This study enrolled 69 patients, consisting of 46 cases in the VA group and 23 cases in the I/HDAC group. We revealed the following. ① The median OS, RFS, EFS were 26.18, 24.69, 20.34 months in the VA group, and 34.14, 30.99, 28.42 months in the I/HDAC group, respectively, with no statistically significant difference (all P>0.05). Median OS of patients who underwent I/HDAC consolidation with European Leukemia Net (ELN) favorable-risk, positive measurable residual disease (MRD), wild type FLT3, or IDH1/2 mutation was significantly longer than those who received VA ( P<0.05). ②Adverse events rate of grade 3 - 4 neutropenia, grade 3 - 4 thrombocytopenia, and bacteremia were significantly lower in the VA group than in the I/HDAC group ( P<0.05) . Conclusions:I/HDAC consolidation was more likely to help get survival benefits for patients with ELN favorable-risk, positive MRD, wild type FLT3, or IDH1/2 mutation. Continuous VA chemotherapy exhibited superior safety than I/HDAC consolidation.
10.Comparison of the efficacy of continuous VA chemotherapy and I/HDAC consolidation in postremission therapy for acute myeloid leukemia fit for standard chemotherapy
Li SUN ; Pengpeng ZHANG ; Simei REN ; Nan ZHOU ; Liyuan LI ; Zhenzhen WANG ; Weiguang CUI ; Fan YANG ; Jianmin LUO ; Lin YANG
Chinese Journal of Hematology 2025;46(4):343-348
Objective:To compare the efficacy and safety of continuous venetoclax combined azacitidine (VA) chemotherapy and intermedium/high-dose cytarabine (I/HDAC) consolidation in patients with acute myeloid leukemia (AML) fit for standard chemotherapy (transform from UNFIT) .Methods:Clinical data of patients who were fit for standard chemotherapy were collected among those with AML who underwent VA induction in the Department of Hematology, the Second Hospital of Hebei Medical University. The overall survival (OS), relapse-free survival (RFS), event-free survival (EFS), and incidence of adverse events were analyzed retrospectively.Results:This study enrolled 69 patients, consisting of 46 cases in the VA group and 23 cases in the I/HDAC group. We revealed the following. ① The median OS, RFS, EFS were 26.18, 24.69, 20.34 months in the VA group, and 34.14, 30.99, 28.42 months in the I/HDAC group, respectively, with no statistically significant difference (all P>0.05). Median OS of patients who underwent I/HDAC consolidation with European Leukemia Net (ELN) favorable-risk, positive measurable residual disease (MRD), wild type FLT3, or IDH1/2 mutation was significantly longer than those who received VA ( P<0.05). ②Adverse events rate of grade 3 - 4 neutropenia, grade 3 - 4 thrombocytopenia, and bacteremia were significantly lower in the VA group than in the I/HDAC group ( P<0.05) . Conclusions:I/HDAC consolidation was more likely to help get survival benefits for patients with ELN favorable-risk, positive MRD, wild type FLT3, or IDH1/2 mutation. Continuous VA chemotherapy exhibited superior safety than I/HDAC consolidation.

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