1.Expert consensus on holistic integrative management of oral squamous cell carcinoma
Moyi SUN ; Zongxuan HE ; Haoyue XU ; Xiaoying LI ; Jie ZHANG ; Haijun LU ; Xiaohong ZHAN ; Dapeng HAO ; Shizhu BAI ; Wei GUO ; Zhangui TANG ; Guoxin REN ; Jian MENG ; Zhijun SUN ; Jichen LI ; Yue HE ; Chunjie LI ; Lizheng QIN ; Kai YANG ; Qing XI ; Lin KONG ; Bing HAN ; Lingxue BU ; Yuanyong FENG ; Kai SONG ; Hongyu HAN ; Jieying LI ; Qianwei NI ; Yun LI ; Juan CHAI ; Xiaochen YANG ; Man HU ; Mingjin XU ; Wei SHANG
Journal of Practical Stomatology 2025;41(4):437-449
Oral squamous cell carcinoma(OSCC)is a malignant lesion originating from the oral mucosal squamous epithelium,account-ing for over 80%of oral and maxillofacial malignancies.Key etiological factors include tobacco,alcohol abuse,and betel quid chewing.In China,its incidence has shown an overall upward trend,posing a significant threat to public health.OSCC exhibits high local invasive-ness,making early diagnosis critical for improving prognosis.Its clinical management requires close multidisciplinary collaboration among oral and maxillofacial surgery,head and neck surgery,radiation oncology,medical oncology,reconstructive surgery,radiology,patholo-gy,and nutritional support teams.Given the increasing disease burden of OSCC and rapid development of multidisciplinary collaborative models,an expert panel has formulated this integrated management consensus based on evidence-based medicine and extensive deliber-ation.Centered on the'Prevention-Screening-Diagnosis-Treatment-Rehabilitation'framework,the consensus provides comprehensive guidance for the entire disease course of OSCC patients,aiming to standardize clinical practice.
2.Mechanism of mitochondrial oxidative phosphorylation disorder in male infertility.
Kai MENG ; Qian LIU ; Yiding QIN ; Wenjie QIN ; Ziming ZHU ; Longlong SUN ; Mingchao JIANG ; Joseph ADU-AMANKWAAH ; Fei GAO ; Rubin TAN ; Jinxiang YUAN
Chinese Medical Journal 2025;138(4):379-388
Male infertility has become a global concern, accounting for 20-70% of infertility. Dysfunctional spermatogenesis is the most common cause of male infertility; thus, treating abnormal spermatogenesis may improve male infertility and has attracted the attention of the medical community. Mitochondria are essential organelles that maintain cell homeostasis and normal physiological functions in various ways, such as mitochondrial oxidative phosphorylation (OXPHOS). Mitochondrial OXPHOS transmits electrons through the respiratory chain, synthesizes adenosine triphosphate (ATP), and produces reactive oxygen species (ROS). These mechanisms are vital for spermatogenesis, especially to maintain the normal function of testicular Sertoli cells and germ cells. The disruption of mitochondrial OXPHOS caused by external factors can result in inadequate cellular energy supply, oxidative stress, apoptosis, or ferroptosis, all inhibiting spermatogenesis and damaging the male reproductive system, leading to male infertility. This article summarizes the latest pathological mechanism of mitochondrial OXPHOS disorder in testicular Sertoli cells and germ cells, which disrupts spermatogenesis and results in male infertility. In addition, we also briefly outline the current treatment of spermatogenic malfunction caused by mitochondrial OXPHOS disorders. However, relevant treatments have not been fully elucidated. Therefore, targeting mitochondrial OXPHOS disorders in Sertoli cells and germ cells is a research direction worthy of attention. We believe this review will provide new and more accurate ideas for treating male infertility.
Male
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Humans
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Infertility, Male/metabolism*
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Oxidative Phosphorylation
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Mitochondria/metabolism*
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Spermatogenesis/physiology*
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Sertoli Cells/metabolism*
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Oxidative Stress/physiology*
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Animals
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Reactive Oxygen Species/metabolism*
3.Mitochondrial Transfer Promotes Immune Escape in Osteosarcoma Cells: Mechanisms and Research Advances
Qishun QIN ; Xingsheng WANG ; Kai LI ; Pei PENG ; Shihong XU
Medical Journal of Peking Union Medical College Hospital 2025;16(5):1250-1259
Osteosarcoma is a highly aggressive malignant bone tumor whose immuno evasion mechanisms play a pivotal role in tumor progression and therapeutic resistance. Recent studies have identified mitochondrial transfer as a novel mode of intercellular communication that significantly influences metabolic reprogramming and immune evasion in osteosarcoma cells. This mechanism operates through three principal pathways: (1) enhancing energy metabolic efficiency in tumor cells; (2) mitigating intracellular oxidative stress; and (3) modulating immune checkpoint molecule expression. Collectively, these alterations impair host immune surveillance while promoting tumor proliferation, invasion, and distant metastasis through metabolic remodeling, immune tolerance induction, and tumor microenvironment reconstruction. This review systematically elucidates the molecular mechanisms by which mitochondrial transfer regulates immune evasion in osteosarcoma and its dynamic impact on the tumor microenvironment. Furthermore, we discuss the translational potential of targeting this pathway for precision therapy and outline future research directions in this emerging field.
4.Mechanisms of aryl hydrocarbon receptor in liver diseases
Jing QIN ; Zhilong HE ; Yu LIU ; Kai HU
Journal of Clinical Hepatology 2025;41(9):1943-1948
Aryl hydrocarbon receptor (AhR) plays an important role in the development and progression of liver diseases. This article elaborates on the structure of AhR and its function in liver development and provides a detailed analysis of its molecular mechanisms in diseases such as metabolic associated fatty liver disease, alcoholic liver disease, viral hepatitis, drug-induced liver injury, autoimmune hepatitis, liver cirrhosis, and liver cancer. This article also reviews the research advances in AhR agonists and antagonists and analyzes their potential application prospects in disease treatment. At the same time, it points out that although AhR is a promising therapeutic target, there are still various challenges in its clinical application. It is suggested that future research should focus on developing AhR modulators with high specificity and low toxicity and further explore its mechanism of action in different liver diseases.
5.Efficacy of alpha-lipoic acid in patients with ischemic heart failure: a randomized, double-blind, placebo-controlled study
Hanchuan CHEN ; Qin YU ; Yamei XU ; Chen LIU ; Jing SUN ; Jingjing ZHAO ; Wenjia LI ; Kai HU ; Junbo GE ; Aijun SUN
Chinese Journal of Clinical Medicine 2025;32(4):717-719
Objective To explore the safety and effects of alpha-lipoic acid (ALA) in patients with ischemic heart failure (IHF). Methods A randomized, double-blind, placebo-controlled trial was designed (ClinicalTrial.gov registration number NCT03491969). From January 2019 to January 2023, 300 patients with IHF were enrolled in four medical centers in China, and were randomly assigned at a 1∶1 ratio to receive ALA (600 mg daily) or placebo on top of standard care for 24 months. The primary outcome was the composite outcome of hospitalization for heart failure (HF) or all-cause mortality events. The second outcome included non-fatal myocardial infarction (MI), non-fatal stroke, changes of left ventricular ejection fraction (LVEF) and 6-minute walking distance (6MWD) from baseline to 24 months after randomization. Results Finally, 138 patients of the ALA group and 139 patients of the placebo group attained the primary outcome. Hospitalization for HF or all-cause mortality events occurred in 32 patients (23.2%) of the ALA group and in 40 patients (28.8%) of the placebo group (HR=0.753, 95%CI 0.473-1.198, P=0.231; Figure 1A-1C). The absolute risk reduction (ARR) was 5.6%, the relative risk reduction (RRR) associated with ALA therapy was approximately 19.4% compared to placebo, corresponding to a number needed to treat (NNT) of 18 patients to prevent one event. In the secondary outcome analysis, the composite outcome of the major adverse cardiovascular events (MACE) including the hospitalization for HF, all-cause mortality events, non-fatal MI or non-fatal stroke occurred in 35 patients (25.4%) in the ALA group and 47 patients (33.8%) in the placebo group (HR=0.685, 95%CI 0.442-1.062, P=0.091; Figure 1D). Moreover, greater improvement in LVEF (β=3.20, 95%CI 1.14-5.23, P=0.002) and 6MWD (β=31.7, 95%CI 8.3-54.7, P=0.008) from baseline to 24 months after randomization were observed in the ALA group as compared to the placebo group. There were no differences in adverse events between the study groups. Conclusions These results show potential long-term beneficial effects of adding ALA to IHF patients. ALA could significantly improve LVEF and 6MWD compared to the placebo group in IHF patients.
6.Epidemiological characteristics and spatiotemporal clustering analysis of varicella in Lu'an City in 2005 - 2023
Huan ZHANG ; Bingxin MA ; Yafei CHEN ; Yao WANG ; Fan PAN ; Lei ZHANG ; Kai CHENG ; Ling SHAO ; Wei QIN
Journal of Public Health and Preventive Medicine 2025;36(6):58-61
Objective To analyze the epidemiological characteristics and spatiotemporal clustering of varicella in Lu'an City from 2005 to 2023, and to provide a scientific basis for optimizing varicella prevention and control strategies. Methods Data on varicella cases were collected through the Chinese Center for Disease Control and Prevention Information System. Descriptive epidemiology, temporal trend analysis, seasonal analysis, spatiotemporal clustering analysis, and spatial autocorrelation analysis were conducted using QGIS, JoinPoint, SaTScan and GeoDa software. Results The average annual reported incidence rate of varicella in Lu'an City from 2005 to 2023 was 34.55/100,000, showing a trend of initial increase followed by a decrease. The peak incidence occurred from October to January of the following year (RR=1.97, LLR=1743.95, P=0.001). Students aged 0 to 19 was the primary affected group. Spatiotemporal scan analysis revealed four types of spatiotemporal clusters, with the cluster in Jin'an District from October 2017 to December 2023 being particularly prominent (RR=2.87,LLR=1734.15,P<0.001). Spatial autocorrelation analysis indicated significant clustering of varicella cases in the main urban area (Moran's I=0.216,Z=4.786,P=0.003). Conclusion The incidence of varicella in Lu'an City exhibits distinct seasonal and spatial clustering, and schools and kindergartens in the main urban area are the key to varicella prevention and control. It is necessary to enhance the monitoring of disease outbreaks during peak periods and in key areas, and to increase the two-dose vaccination rate for varicella in areas with case aggregation and among key populations.
7.The impact of continuous nebulization therapy on pulmonary function and related complications after lung transplantation
Pengfei LI ; Zhi QIN ; Zhidan DING ; Kai ZHAO ; Yuebin WANG ; Fengke LI ; Jinrui LI ; Gaofeng ZHAO
Organ Transplantation 2025;16(6):914-920
Objective To investigate the impact of continuous nebulization therapy after lung transplantation on pulmonary function and related complications in lung transplant recipients. Methods A retrospective analysis was conducted on the general data of 71 recipients who underwent allogeneic lung transplantation at the Department of Thoracic Surgery, the First Affiliated Hospital of Zhengzhou University, from June 2013 to December 2024. Recipients were divided into observation group (those who continued nebulization therapy for more than 3 months after discharge) and control group (those who discontinued nebulization therapy on their own). The main observation indicators were pulmonary function indicators at 6 months after surgery, including forced expiratory volume in the first second as a percentage of predicted value (FEV1% pred), forced vital capacity as a percentage of predicted value (FVC% pred), ratio of forced expiratory volume in the first second to forced vital capacity as a percentage of predicted value (FEV1/FVC% pred), forced expiratory flow at 25%, 50% and 75% of forced vital capacity as a percentage of predicted value, and the percentage of predicted value of corrected carbon monoxide diffusion capacity measured by single-breath method, as well as the ratio of corrected carbon monoxide diffusion capacity to alveolar volume as a percentage of predicted value. Additionally, the annual incidence of postoperative pulmonary infections, survival rate and the rate of no severe airway complications were analyzed. Results At 6 months after lung transplantation, the FEV1% pred and FVC% pred of the observation group were better than those of the control group [FEV1% pred was 76% (60%, 91%) vs. 67% (62%, 78%), FVC% pred was (75 ± 13)% vs. (69 ± 11)%, both P<0.05]. The observation group had a lower annual incidence of pulmonary infections compared to the control group (P = 0.023), with a risk of 0.485 times that of the control group. There were no statistically significant differences between the two groups in median survival time and the rate of no severe airway complications (both P>0.05). Conclusions Continuous nebulization therapy after lung transplantation may effectively improve pulmonary function, reduce the annual incidence of pulmonary infections, and play a positive role in the long-term maintenance of pulmonary function.
8.Mechanism of IL-23/STAT3/Th17 axis in severe acute pancreatitis and intervention effect of Qingjie Huagong decoction
Minchao FENG ; Fang LUO ; Baijun QIN ; Xiping TANG ; Kai LI ; Guozhong CHEN
Chinese Journal of Immunology 2025;41(4):792-797,802
Objective:To investigate the mechanism of IL-23/STAT3/Th17 axis in severe acute pancreatitis(SAP)and the in-terventional effect of the Qingjie Huagong decoction(QJHGD).Methods:A rat model of SAP was established by injecting sodium tau-rocholate into the retrograde pancreatic duct.The blank group,model group,different doses of QJHGD administration groups and posi-tive group were set up respectively.HE staining was used to observe the pathology of pancreatic tissue.ELISA was used to detect serum lipase,α-amylase and inflammatory markers.By combining RT-qPCR,IHC,Western blot,and IF techniques,we elucidated the mechanism of QJHGD in protecting pancreatic tissue in SAP rats.Results:The levels of amylase,lipase,IL-1β,IL-6,IL-17,IL-23,TNF-α and TGF-β in the serum of SAP model rats in all dose groups of QJHGD were significantly reduced,and the effect was the best in medium dose group(P<0.05).The results of IHC and RT-qPCR revealed that the medium-and high-dose groups of QJHGD sig-nificantly reduced the expression of IL-23,STAT3,IL-17 protein and mRNA in the pancreatic tissue of this model(P<0.05).More-over,the Western blot results demonstrated that the expression of IL-23,STAT3,p-STAT3,and IL-17 proteins in SAP rats were sig-nificantly decreased in the medium-dose group of QJHGD(P<0.05);the IF assay indicated that Th17 cell differentiation in SAP rats was inhibited by all dose groups of QJHGD,with the most significant inhibition effect in the middle dose(P<0.05).Conclusion:QJH-GD regulates the activation of IL-23/STAT3/Th17 axis,thereby inhibiting Th17 cell differentiation and exerting a protective effect on pancreatic tissue.
9.Impacts of chrysophanol on cartilage injury in rats with osteoarthritis and its mechanism
Jianwei LI ; Feng HU ; Qin YIN ; Kai LIAN ; Jin XU ; Yang HU ; Hanbing HUA
Chinese Journal of Immunology 2025;41(4):808-814
Objective:To investigate the effect of chrysophanol(CHR)on cartilage injury in rats with osteoarthritis and its mechanism of regulating SIRT1/HMGB1/NF-κB signal pathway.Methods:Rat models of osteoarthritis were established and divided into negative control group,chrysophanol low(CHR-L,10 mg/kg),middle(CHR-M,20 mg/kg),high dose group(CHR-H,40 mg/kg),SIRT1 inhibitor(sirtinol 5 mg/kg)+chrysophanol high dose group(sirtinol+CHR-H),and normal healthy control group was set up.The degree of joint swelling was measured,and the inflammatory index was evaluated;the pain threshold(tenderness and heat pain)was measured;HE staining and safranine O staining were applied to detect the pathological changes of rat articular cartilage;the levels of serum inflammatory factors(IL-6,IL-1β,TNF-α)were detected by ELISA method;oxidative stress indexes(MDA,SOD,GSH-PX)were detected by micro method;TUNEL staining was used to detect apoptosis;Western blot was used to detect the protein expressions of SIRT1,HMGB1,NF-κB p65,p-NF-κB p65,MMP-13 and C-Caspase-3.Results:Compared with the normal healthy control group,the rats in negative control group had obvious pathological injury,such as destruction of articular cartilage structure,necrosis and reduction of chondrocytes,the joint swelling degree,arthritis index,levels of IL-6,IL-1β,TNF-α,content of MDA,chondrocyte apoptosis rate,expressions of apoptotic protein C-Caspase-3,HMGB1,NF-κB p65/p-NF-κB p65,MMP-13 proteins increased obviously,the tenderness threshold,heat pain threshold,activities of SOD,GSH-PX,and the expression of SIRT1 protein decreased obviously(P<0.05);compared with negative control group,the pathological injury of articular cartilage in CHR group improved obviously with the increase of dosage,the joint swelling degree,arthritis index,levels of IL-6,IL-1β,TNF-α,content of MDA,chondrocyte apoptosis rate,expression of apoptotic protein C-Caspase-3,HMGB1,NF-κB p65/p-NF-κB p65,MMP-13 proteins decreased obviously,the tenderness threshold,heat pain threshold,activities of SOD,GSH-PX,and the expression of SIRT1 protein increased obviously(P<0.05);compared with CHR-H group,sirtinol+CHR-H group was able to reverse the protective effect of CHR on cartilage injury to a certain extent.Conclusion:CHR can reduce the inflammation of articular cartilage,inhibit the apoptosis of chondrocytes and play a protective role in the cartilage injury of osteoarthritis rats by up-regulating the expression of SIRT1 and down-regulating the expressions of HMGB1 and NF-κB p65/p-NF-κB p65.
10.Neferine alleviates intervertebral disc degeneration through KEAP1/NRF2/GPX4 and NF-κB signaling pathways
Hongjin WAN ; Yibin HU ; Xin WANG ; Kai ZHANG ; An QIN ; Peixiang MA ; Hui MA ; Jie ZHAO
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(3):261-270
Objective·To investigate the therapeutic effects of neferine(Nef)on intervertebral disc degeneration(IDD)and the underlying regulatory pathways.Methods·The effects of Nef on the viability and proliferation of nucleus pulposus cells were assessed using the cell counting kit-8(CCK-8)assay.Molecular docking software was employed to analyze the potential binding sites of Nef within the Kelch domain of kelch-like ECH-associated protein 1(KEAP1).Tumor necrosis factor-α(TNF-α)was used to induce ferroptosis and inflammation in nucleus pulposus cells.Western blotting was performed to detect the expression levels of nuclear factor erythroid 2-related factor 2/glutathione peroxidase 4(NRF2/GPX4)pathway-and nuclear factor-KB(NF-κB)pathway-related proteins under TNF-α stimulation with or without Nef.The effect of Nef on the metabolism of extracellular matrix in nucleus pulposus cells was evaluated using high-density cell culture.A needle puncture-induced IDD rat model was established,and 5 μL of 1.5 μmol/L Nef was injected twice into the intervertebral disc at the Co3/4 level(IDD+Nef group),while an equivalent volume of PBS was injected into the Co2/3 disc(IDD group).After 4 weeks,the intervertebral space height was detected by X-ray,disc degeneration was detected by magnetic resonance imaging,and disc structure was evaluated by histological staining.Results·The CCK-8 assay revealed that Nef at concentrations of 1.5 μmol/L and below did not inhibit the viability and proliferation of nucleus pulposus cells.Molecular docking results suggested that Nef might activate NRF2 by directly binding to the KEAP1 Kelch domain,thereby reducing the interaction between KEAP1 and NRF2.Western blotting indicated that Nef significantly increased the expression of the key ferroptosis-inhibiting proteins NRF2 and GPX4,while decreasing the expression of the phospho-P65 protein in the NF-κB pathway(all P<0.05).The high-density culture of nucleus pulposus cells demonstrated that Nef mitigated the TNF-α-induced degradation of the extracellular matrix(P<0.05).Animal study results showed that compared to the IDD group,the IDD+Nef group exhibited a greater intervertebral disc space height,a lower Pfirrmann grade(both P<0.05),and a reduced degree of histological degeneration.Conclusion·Nef may inhibit TNF-α-induced ferroptosis in nucleus pulposus cells by activating the KEAP1/NRF2/GPX4 pathway and reduce TNF-α-induced inflammation and extracellular matrix degradation by suppressing the NF-κB pathway,thereby alleviating IDD in rats.


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