1.B7-H3 molecule inhibits apoptosis of non-small cell lung cancer cells via the SIRT1/p53 signaling pathway
Lin ZHENG ; Jianxin ZHONG ; Ke NIU ; Qing XU ; Huijuan LING ; Yayu ZHU ; Bing CHEN ; Liwen CHEN
Acta Universitatis Medicinalis Anhui 2026;61(2):232-238
ObjectiveTo explore the role of the histone deacetylase Sirtuin-1 (SIRT1)/p53 signaling pathway in promoting apoptosis of non-small cell lung cancer cells (NSCLC) induced by the co-stimulatory molecule B7 homolog 3 (B7-H3). MethodsThe GEPIA 2 platform was used for survival analysis of NSCLC patients based on B7⁃H3 gene expression levels. The Gene Enrichment Analysis (GSEA) method was used to analyze the enrichment characteristics of B7⁃H3 molecules in the gene set of cell apoptosis. In the non-small cell lung cancer A549 cell line, B7⁃H3 was knocked down, and the protein expression levels of SIRT1 and p53 were detected by Western blot. B7⁃H3 was overexpressed in A549 cells and the apoptosis rate was analyzed by flow cytometry after Annexin V/PI double staining. Overexpression of B7⁃H3 and knockdown of SIRT1 were performed in A549 cell line. The expression levels of p53 and apoptosis-related proteins B-cell lymphoma/leukemia-2 (Bcl-2) and Bcl-2-associated X protein (Bax) were detected respectively by Western blot. Cell apoptosis rate was analyzed by flow cytometry after Annexin V/PI double staining. ResultsThe overall survival of the B7-H3 high-expression group was significantly lower than that of the low-expression group (P<0.01). B7-H3 was significantly enriched in the cell apoptosis signaling pathway and the p53 signaling pathway (P<0.05). Compared with the control group, the expression of SIRT1 was significantly downregulated, and p53 was significantly upregulated in the B7⁃H3 knockdown group (both P<0.001). Overexpression of B7-H3 significantly up-regulated SIRT1 protein expression (P<0.05), down-regulated p53 expression (P<0.01), and markedly increased the Bcl-2/Bax ratio of apoptosis-related proteins (P<0.001). The results of Annexin V/PI double staining showed that the apoptosis rate of A549 cells with overexpressed B7⁃H3 decreased (the apoptosis rate of the control group was 26.72%±4.13%, while that of the B7⁃H3 overexpression group was 13.87%±0.82%; P<0.01). In B7-H3-overexpressing cell lines, SIRT1 knockdown significantly reversed apoptosis (P<0.05), up-regulated p53 protein expression (P<0.001), and markedly reduced the Bcl-2/Bax ratio (P<0.001). ConclusionB7-H3 molecule inhibits the apoptosis of non-small cell lung cancer cells via the SIRT1/p53 signaling pathway.
2.Changes in Astronaut Brain Function and Behavior Associated With Habitation on Low-Earth-orbit Space Stations
Hong-Ting JIANG ; You-Fu LUO ; Zheng-Jiang YANG ; Yuan YAO ; De-Zhong YAO ; Ke CHEN
Progress in Biochemistry and Biophysics 2026;53(10):2786-2796
During habitation on low-Earth-orbit (LEO) space stations, astronauts are exposed to a combination of orbital microgravity, space radiation, an enclosed and artificially controlled cabin environment, altered sleep-wake rhythms, and sustained operational and psychosocial demands. These factors can modify sensorimotor inputs, body-fluid distribution, arousal state, and task-related neural processing, thereby affecting brain function and behavior. Because evidence from real spaceflight remains limited by small samples, heterogeneous mission durations, and different measurement time points, this review integrates findings from real human spaceflight with relevant ground-based analog studies while treating real orbital studies as the primary source of evidence. We focus on electroencephalography (EEG) and event-related potentials (ERPs), structural and functional neuroimaging, and sensorimotor and cognitive outcomes, with particular attention to the direction, anatomical distribution, temporal course, and possible physiological significance of the reported changes. EEG studies indicate that long-duration spaceflight is associated with increased resting-state beta activity, particularly in sensorimotor and frontotemporal regions, together with state-dependent alterations in beta-band functional connectivity. In contrast, alpha source power and functional connectivity associated with the default mode network are reduced during long-duration missions, and some of these effects may persist into the early postflight period. Task-related electrophysiological findings further suggest that sustained mental workload can weaken frontocentral theta-temporoparietal gamma phase-amplitude coupling, whereas in-flight decision-making is accompanied by reduced P300 amplitude and reorganization of feedback-related potentials. Short-duration missions, however, have shown relative preservation of posterior dominant rhythms and some ERP measures, indicating that mission duration, recording state, and task demands substantially influence the observed electrophysiological phenotype. Neuroimaging provides complementary evidence at structural and network levels. Long-duration spaceflight has been associated with upward brain displacement, ventricular and cerebrospinal fluid expansion, regional gray- and white-matter remodeling, and alterations in white-matter structural connectivity. Functional magnetic resonance imaging (fMRI) studies further indicate reorganization of vestibular-sensorimotor, visual, and default mode networks. Some network changes recover after return to Earth, whereas others may remain detectable for months. Importantly, most MRI measurements are obtained after landing rather than in orbit; therefore, postflight findings may reflect a mixture of in-flight adaptation, the rapid transition back to 1 g, and subsequent readaptation rather than a single spaceflight effect. Behavioral evidence is most consistent for sensorimotor function. Early after return, astronauts frequently show impaired postural control, gait, spatial orientation, and coordination, consistent with reweighting among vestibular, visual, and proprioceptive information. By comparison, simple cognition and some critical operational tasks are often preserved. More subtle or high-load processes-including sustained attention, feedback evaluation, temporal processing, error monitoring, and metacognitive calibration may be more sensitive than global cognitive performance. This dissociation between neural change and preserved behavior suggests that altered brain activity should not automatically be interpreted as functional deterioration. Integrating the available modalities, we propose that LEO space-station habitation is better characterized by system-specific and stage-dependent neural adaptation than by a generalized increase or decline in brain function. The most coherent cross-modal pattern involves sensorimotor reorganization: reduced gravitational reference and weight-bearing feedback under microgravity may drive reweighting of vestibular, visual, and proprioceptive inputs, accompanied by changes in beta activity and vestibular-sensorimotor networks and followed by transient postflight sensorimotor deficits. A second major process involves fluid-related structural remodeling, in which cephalad fluid shifts and altered hydrostatic gradients may contribute to changes in cerebrospinal fluid spaces, ventricular volume, and brain tissue configuration. Resting-state and cognitive electrophysiological changes likely represent additional adjustments in network regulation and resource allocation, but their functional interpretation remains more dependent on sleep, workload, recording conditions, and individual differences. Future studies should move beyond isolated pre-post comparisons and group averages toward standardized longitudinal designs spanning preflight, multiple in-flight time points, and postflight recovery. Synchronized assessment of brain function, behavior, sleep, and key environmental parameters should be used to characterize individual adaptation trajectories and determine which neural changes reflect successful compensation, which predict delayed recovery, and which have genuine value for brain-health risk prediction and individualized countermeasures.
3.Effect of "Fahan" on Metabolites of Blumea balsamifera Analyzed by Non-targeted Metabolomics
Jiayuan CAO ; Xin XU ; Xiangsheng ZHANG ; Bingnan LIU ; Yongyao WEI ; Ke ZHONG ; Yuxin PANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):200-207
ObjectiveTo characterize the changes of metabolites of Blumea balsamifera in the process of sweating by non-targeted metabolomics, and to investigate the influence of sweating processing on the constituents of B. balsamifera. MethodsUltra performance liquid chromatography-quadrupole/electrostatic field orbitrap high resolution mass spectrometry(UPLC-Q-Exactive Orbitrap-MS) metabolomics was used to identify the metabolites in no sweating group(F1), sweating 2 d group(F2) and sweating 4 d group(F3), the differences of metabolites between the groups were compared by principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA), and differential metabolites were screened according to the variable importance in the projection(VIP) value>1 and P<0.05, and the pathway enrichment of the differential metabolites was analyzed by Kyoto Encyclopedia of Genes and Genomes(KEGG). ResultsThe results of PCA and OPLS-DA showed a clear distinction between the three groups of samples, indicating significant differences in the compositions of the three groups of samples. A total of 433 differential metabolites were screened between the F1 and F2, with 154 up-regulated and 279 down-regulated, the significant up-regulated metabolites were tangeritin, 5-O-demethylnobiletin and so on, while the metabolites with significant down-regulation included alternariol, fortunellin, etc. A total of 379 differential metabolites were screened between the F2 and F3, with 150 up-regulated and 229 down-regulated, the significant up-regulated metabolites were isoimperatorin, helianyl octanoate and so on, and the significant down-regulated metabolites were hovenoside I, goyasaponin Ⅲ, etc. KEGG pathway enrichment analysis showed that tyrosine metabolism, isoquinoline alkaloid biosynthesis, phenylalanine, tyrosine and tryptophan biosynthesis, tryptophan metabolism, valine, leucine and isoleucine biosynthesis, pantothenate and coenzyme A biosynthesis may be the key pathways affecting metabolite differences of B. balsamifera after sweating treatment. ConclusionSweating can reduce the content of endophytic mycotoxins in B. balsamifera and has a great impact on the synthesis and metabolic pathways of total flavonoids and auxin. This study can provide a reference for the process research on the sweating conditions of B. balsamifera.
4.The Critical Roles of GABAergic Interneurons in The Pathological Progression of Alzheimer’s Disease
Ke-Han CHEN ; Zheng-Jiang YANG ; Zi-Xin GAO ; Yuan YAO ; De-Zhong YAO ; Yin YANG ; Ke CHEN
Progress in Biochemistry and Biophysics 2025;52(9):2233-2240
Alzheimer’s disease (AD), a progressive neurodegenerative disorder and the leading cause of dementia in the elderly, is characterized by severe cognitive decline, loss of daily living abilities, and neuropsychiatric symptoms. This condition imposes a substantial burden on patients, families, and society. Despite extensive research efforts, the complex pathogenesis of AD, particularly the early mechanisms underlying cognitive dysfunction, remains incompletely understood, posing significant challenges for timely diagnosis and effective therapeutic intervention. Among the various cellular components implicated in AD, GABAergic interneurons have emerged as critical players in the pathological cascade, playing a pivotal role in maintaining neural network integrity and function in key brain regions affected by the disease. GABAergic interneurons represent a heterogeneous population of inhibitory neurons essential for sustaining neural network homeostasis. They achieve this by precisely modulating rhythmic oscillatory activity (e.g., theta and gamma oscillations), which are crucial for cognitive processes such as learning and memory. These interneurons synthesize and release the inhibitory neurotransmitter GABA, exerting potent control over excitatory pyramidal neurons through intricate local circuits. Their primary mechanism involves synaptic inhibition, thereby modulating the excitability and synchrony of neural populations. Emerging evidence highlights the significant involvement of GABAergic interneuron dysfunction in AD pathogenesis. Contrary to earlier assumptions of their resistance to the disease, specific subtypes exhibit vulnerability or altered function early in the disease process. Critically, this impairment is not merely a consequence but appears to be a key driver of network hyperexcitability, a hallmark feature of AD models and potentially a core mechanism underlying cognitive deficits. For instance, parvalbumin-positive (PV+) interneurons display biphasic alterations in activity. Both suppressing early hyperactivity or enhancing late activity can rescue cognitive deficits, underscoring their causal role. Somatostatin-positive (SST+) neurons are highly sensitive to amyloid β-protein (Aβ) dysfunction. Their functional impairment drives AD progression via a dual pathway: compensatory hyperexcitability promotes Aβ generation, while released SST-14 forms toxic oligomers with Aβ, collectively accelerating neuronal loss and amyloid deposition, forming a vicious cycle. Vasoactive intestinal peptide-positive (VIP+) neurons, although potentially spared in number early in the disease, exhibit altered firing properties (e.g., broader spikes, lower frequency), contributing to network dysfunction (e.g., in CA1). Furthermore, VIP release induced by 40 Hz sensory stimulation (GENUS) enhances glymphatic clearance of Aβ, demonstrating a direct link between VIP neuron function and modulation of amyloid pathology. Given their central role in network stability and their demonstrable dysfunction in AD, GABAergic interneurons represent promising therapeutic targets. Current research primarily explores three approaches: increasing interneuron numbers (e.g., improving cortical PV+ interneuron counts and behavior in APP/PS1 mice with the antidepressant citalopram; transplanting stem cells differentiated into functional GABAergic neurons to enhance cognition), enhancing neuronal activity (e.g., using low-dose levetiracetam or targeted activation of specific molecules to boost PV+ interneuron excitability, restoring neural network γ‑oscillations and memory; non-invasive neuromodulation techniques like 40 Hz repetitive transcranial magnetic stimulation (rTMS), GENUS, and minimally invasive electroacupuncture to improve inhibitory regulation, promote memory, and reduce Aβ), and direct GABA system intervention (clinical and animal studies reveal reduced GABA levels in AD-affected brain regions; early GABA supplementation improves cognition in APP/PS1 mice, suggesting a therapeutic time window). Collectively, these findings establish GABAergic interneuron intervention as a foundational rationale and distinct pathway for AD therapy. In conclusion, GABAergic interneurons, particularly the PV+, SST+, and VIP+ subtypes, play critical and subtype-specific roles in the initiation and progression of AD pathology. Their dysfunction significantly contributes to network hyperexcitability, oscillatory deficits, and cognitive decline. Understanding the heterogeneity in their vulnerability and response mechanisms provides crucial insights into AD pathogenesis. Targeting these interneurons through pharmacological, neuromodulatory, or cellular approaches offers promising avenues for developing novel, potentially disease-modifying therapies.
5.Current status and progress of mechanical thrombectomy for intracranial distal medium vessel occlusion
Kun CHENG ; Xing ZHONG ; Weiwei KE ; Gang DENG
Journal of Interventional Radiology 2025;34(12):1389-1394
In recent years,with the rapid development of mechanical thrombectomy(MT)for acute large vessel occlusion,an increasing number of clinical studies begin to focus on the acute distal medium vessel occlusion(DMVO).This article systematically reviews the existing literature,summarizes the definition and classification of DMVO,the advance in MT,the imaging evaluation methods,and the clinical application of emerging technologies.Currently,the definition of DMVO is mostly based on vascular anatomical features and clinical functional deficits,the etiology of DMVO can be classified as primary and secondary.Due to the small diameter and tortuous running course of distal medium vessels,individualized treatment strategies are often required for patients with DMVO.This review focuses on the efficacy and safety of the therapeutic techniques,including direct thrombectomy,aspiration thrombectomy,stent retriever thrombectomy,and bridging therapy,in treating DMVO,besides,this review also discusses the role of imaging methods,including non-enhanced CT(NCCT),CT perfusion(CTP),CT angiography(CTA),and MRI in the patient screening and treatment decision-making.Meanwhile,the emergence of novel small-scale thrombectomy devices and techniques offers new possibilities for improving recanalization rates and reducing complication risks.Overall,although preliminary studies suggest that MT has promising clinical benefits for the treatment of DMVO,the available evidence remains limited.High-quality randomized controlled trials are urgently needed to further formulate the optimal treatment strategies and promote the precision interventional therapy.
6.Diagnostic Value of Intestinal Ultrasound for Patients With Chronic Abdominal Pain or Diarrhea.
Ke-Xin CHEN ; Min-Ying ZHONG ; Qin-Xue LIU ; Guo-Liang JIAN
Acta Academiae Medicinae Sinicae 2025;47(5):751-757
Objective To evaluate the diagnostic value of intestinal ultrasound (IUS) for organic lesions in the intestines of patients with chronic abdominal pain or diarrhea. Methods The IUS signs in 263 patients with chronic abdominal pain or diarrhea were retrospectively analyzed.With the endoscopic examination results as the gold standard,comparison was performed for the IUS signs between the groups with positive and negative endoscopic results,as well as between the inflammatory bowel disease group and the non-specific intestinal inflammation group of positive cases.Furthermore,the detection rates of IUS in different intestinal segments were analyzed to evaluate the accuracy of IUS in the diagnosis and localization of intestinal lesions. Results Among the 263 patients,194 (73.8%) and 69 (26.2%) patients were in the groups with positive and negative endoscopic results,respectively.The diagnosis sensitivity,specificity,and accuracy of IUS were 82.0%,71.0%,and 79.1%,respectively.The proportions of positive IUS signs in the group with positive endoscopic results were higher than that in the group with negative endoscopic results (all P<0.001).The proportions of positive IUS signs in the inflammatory bowel disease group were higher than those in the non-specific bowel inflammation group (all P<0.001).When the lesion was located in the ileum,ileocecal region,and colon,IUS demonstrated good consistency with endoscopic results in locating the lesion (kappa=0.642,0.686,and 0.601,respectively),with sensitivity and specificity of 82.7% (95%CI=75.4%-88.6%) and 81.5% (95%CI=73.5%-87.9%),73.7% (95%CI=62.3%-83.1%) and 93.0% (95%CI=88.4%-96.2%),and 68.9% (95%CI=58.3%-78.2%) and 89.6% (95%CI=84.1%-93.7%),respectively. Conclusions IUS can be used for screening the patients with chronic abdominal pain or diarrhea to detect organic lesions in the intestines. Moreover,it can effectively locate the affected intestinal segment,which is helpful for the monitoring and follow-up of intestinal diseases.
Humans
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Diarrhea/diagnostic imaging*
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Female
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Male
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Abdominal Pain/diagnostic imaging*
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Middle Aged
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Adult
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Ultrasonography
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Retrospective Studies
;
Aged
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Young Adult
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Intestines/diagnostic imaging*
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Adolescent
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Chronic Disease
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Sensitivity and Specificity
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Aged, 80 and over
7.Regulatory effects of miR-205 on proliferation,migration,and epithelial-mesenchymal transition in colon cancer cells
MAIERDAN·SAILIMU ; Zhong JIN ; ALIDAN·AIERLKEN ; Yu-bi KE
Journal of Regional Anatomy and Operative Surgery 2025;34(8):663-668
Objective To investigate the expression of microRNA-205(miR-205)in colon cancer and its regulatory effects on the proliferation,migration,and epithelial-mesenchymal transition(EMT)of colon cancer cells.Methods The expression levels of miR-205 in colon cancer tissues,adjacent normal tissues,and colon cancer cell HT-29 were detected by qRT-PCR.HT-29 cells were divided into three groups,cells transfected with miR-205 mimics were named the miR-205 mimic group,cells transfected with miR-205 inhibitors were named the miR-205 inhibitor group,and cells treated only with Lipo2000 transfection reagent were named the Buffer group.The proliferative activity of cells in each group was detected by CCK-8 assay and EDU assay;the migration invasion ability of cells was detected by Transwell assay;the expressions of EMT-related proteins N-cadherin,Vimentin,and E-cadherin in each group were detected by Western blot.Results Compared with adjacent normal tissues,the relative expression level of miR-205 in colon cancer tissues was significantly down-regulated(P<0.05).Compared with the Buffer group,the relative expression level of miR-205 in the cells of the miR-205 mimic group was up-regulated,while that in the miR-205 inhibitor group was down-regulated,the differences were statistically significant(P<0.05).Overexpression of miR-205 significantly inhibited the proliferation activity and migration ability of colon cancer cells(P<0.05),while inhibition of miR-205 promoted the proliferation activity and migration ability of colon cancer cells(P<0.05).Compared with the Buffer group,the levels of N-cadherin and Vimentin were down-regulated and the level of E-cadherin was up-regulated in the cells of the miR-205 mimic group,while the levels of N-cadherin and Vimentin were up-regulated and the level of E-cadherin was down-regulated in the cells of the miR-205 inhibitor group,the differences were all statistically significant(P<0.05).Conclusion The expression of miR-205 in colon cancer tissues is significantly decreased,and miR-205 exerts its tumor-suppressive effects by downregulating the proliferation,migration,and EMT of colon cancer cells.
8.Analysis on the TCM Syndrome Characteristics of Aging in Female Insomnia Patients
Ke NIE ; Ying CHEN ; Juanjuan AI ; Weiwei ZHONG ; Deyu YANG ; Rujin ZHENG ; Xin SONG ; Wenzheng ZHANG ; Lifeng YUE
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(12):148-153
Objective To analyze the characteristics of TCM symptoms of aging in female insomnia patients;To provide syndrome differentiation evidence for clinical prevention and treatment of female aging.Methods A cross-sectional study method was used to include female insomnia patients who attended outpatient clinics at Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing Changping District Hospital of Traditional Chinese Medicine,and the Third Affiliated Hospital of Beijing University of Chinese Medicine from August 2021 to July 2024.The patients'clinical information was collected,and frequency analysis,factor analysis,and clustering analysis of the relevant clinical information of the 107 female insomnia patients were conducted,which,together with the experts'opinions,resulted in characteristics of TCM syndrome elements and syndrome distribution of aging in female insomnia patients.Results Totally 20 core items were screened and 7 common factors were obtained from the factor analysis.There were 5 types of syndrome elements of disease location associated with aging symptoms in female patients with insomnia,including heart,liver,spleen,kidney and lung;and there were 7 types of syndrome elements of disease property,including qi deficiency,yin deficiency,qi stagnation,blood deficiency,heat,phlegm,and dampness.There were 4 types of syndromes were obtained from the systematic clustering,including heart-kidney disharmony syndrome,heart-liver stagnation syndrome,spleen deficiency and qi stagnation syndrome,lung-spleen qi deficiency syndrome.Conclusion By analyzing the TCM syndrome characteristics of aging symptoms in female patients with insomnia,four types of syndromes are obtained.The heart-kidney disharmony syndrome is the common syndrome.The internal relationship between insomnia and aging process in female patients with insomnia is revealed from the perspective of pathogenesis,which can provide a research basis for the clinical practice of TCM anti-aging guided by syndrome differentiation and treatment in the future.
9.Preliminary clinical study of a novel FAP-targeted PET tracer 64Cu-FAPI-XT117 in malignant solid tumors: a comparative study with 18F-FDG
Xi HE ; Meijuan ZHOU ; Peng HOU ; Kaixiang ZHONG ; Youcai LI ; Jie LYU ; Miao KE ; Ruiyue ZHAO ; Shaoyu LIU ; Yimin FU ; Huizhen ZHONG ; Xinlu WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2025;45(12):708-713
Objective:To systematically evaluate the safety and efficacy of the novel fibroblast activation protein (FAP)-targeted tracer 64Cu-FAP inhibitor (FAPI)-XT117 in patients with malignant solid tumors, and to compare with 18F-FDG. Methods:This self-controlled study was conducted on fifteen patients (8 males, 7 females; age (60 ±9) years) with malignant solid tumors from the First Affiliated Hospital of Guangzhou Medical University between July 2023 and December 2023. Each subject underwent 64Cu-FAPI-XT117 PET/CT at 30, 60, and 120min post-injection and was assigned to three dose cohorts (111MBq, 148MBq, and 185MBq; 5 patients in each cohort), and safety assessments were conducted within 24h after injection. In addition, all patients underwent 18F-FDG PET/CT at 60min post-injection. Time-activity curves were generated for 64Cu-FAPI-XT117, and the dosimetry was calculated. Image quality was evaluated using a 5-point Likert scale, and the optimal injected activity and imaging time point were determined. The paired t test was used to compare differences of the lesion detection count and SUV max between 64Cu-FAPI-XT117 and 18F-FDG PET/CT. Results:64Cu-FAPI-XT117 was well tolerated, with no adverse events reported. Time-activity curves of 68Ga-FAPI-XT117 revealed prominent uptake in the uterus, while the background activity in other organs remained low, with the whole-body effective dose of (0.0084±0.0021)mSv/MBq. The optimal imaging time point for 64Cu-FAPI-XT117 PET/CT was 60min post-injection, with an optimal administered activity of 111MBq. Compared with 18F-FDG, 64Cu-FAPI-XT117 demonstrated significantly higher uptake and more lesions in lymph-node metastases (SUV max: 8.6±3.8 vs 15.3±6.8, t=2.33, P=0.048; number of lesions: 8.3±5.4 vs 15.0±6.4; t=4.21, P=0.003) and distant metastases (SUV max: 11.8±3.7 vs 20.9±7.2, t=3.66, P=0.022; number of lesions: 7.0±3.2 vs 12.4±3.7, t=2.86, P=0.046). Conclusions:64Cu-FAPI-XT117 PET/CT is well tolerated in patients with solid tumors, with a controllable radiation risk. Moreover, it outperforms 18F-FDG PET/CT in the assessment of metastases.
10.Comparison of the efficacy and safety of nanomicroneedle- versus ultrasound-mediated delivery of tranexamic acid for the treatment of melasma: a randomized controlled study
Jiemin ZHONG ; Wei LI ; Shujuan ZHANG ; Yan YANG ; Rujun XUE ; Xinyi LI ; Yanan KE ; Xiaoyin CHEN ; Quan CHEN
Chinese Journal of Dermatology 2025;58(9):829-833
Objective:To compare the clinical efficacy and safety of nanomicroneedle- versus ultrasound-mediated delivery of tranexamic acid for the treatment of melasma.Methods:A prospective, randomized, controlled study was conducted. Patients with melasma were collected from the Department of Dermatology, Guangzhou Dermatology Hospital from March 2023 to May 2024, and divided into a nanomicroneedle group (receiving nanomicroneedle-mediated delivery of tranexamic acid) and an ultrasound group (receiving ultrasound-mediated delivery of tranexamic acid) using the random number table method. Both groups underwent the treatment once a week for a total of 8 sessions. At week 12, outcomes including melasma area and severity index (MASI) scores, treatment response rates, VISIA brown spot scores, pain scores, and adverse reactions were evaluated and compared between the two groups. Statistical analyses were carried out using two-independent-sample t test, Mann-Whitney U test, and chi-square test. Results:A total of 80 patients with melasma were included, with 40 in each group. In the nanomicroneedle group, the patients were aged 40.35 ± 7.39 years (range: 25 - 55 years), with the disease duration being 8.45 ± 4.77 months (range: 1 - 16 months) ; in the ultrasound group, the patients were aged 40.25 ± 7.76 years (range: 25 - 55 years), and their disease duration was 10.45 ± 5.07 months (range: 2 - 17 months) ; there were no significant differences in ages or disease duration between the two groups (both P > 0.05). At week 12, both groups demonstrated reduced MASI scores compared to baseline scores, and the MASI scores were significantly lower in the nanomicroneedle group ( M[ Q1, Q3]: 5.80[4.20, 9.35]) than in the ultrasound group (8.65[5.70, 10.80], Z = 2.50, P = 0.012). The overall response rate was significantly higher in the nanomicroneedle group (97.5%, 39/40) than in the ultrasound group (55.0%, 22/40; χ2 = 19.95, P < 0.001). The lateral facial VISIA brown spot scores were also significantly lower in the nanomicroneedle group (left side: 126.18 ± 36.54 points; right side: 138.50 ± 40.76 points) than in the ultrasound group (left side: 142.37 ± 32.40 points; right side: 157.13 ± 39.59 points; t = -2.10, -2.07, P = 0.039, 0.041, respectively). In the nanomicroneedle group, the pain scores were 4.12 ± 1.47 points, and varying severity of adverse reactions such as erythema, edema and dryness occurred after operation, all of which resolved spontaneously within 48 hours. No marked adverse reactions were observed in the ultrasound group. Conclusion:Nanomicroneedle-mediated delivery of tranexamic acid demonstrated superior clinical efficacy and favorable safety profiles compared to the ultrasound-mediated delivery, providing more options for the treatment of melasma.

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