Loss of protein homeostasis is a hallmark of cellular senescence, and ribosome pausing plays a crucial role in the collapse of proteostasis. However, our understanding of ribosome pausing in senescent cells remains limited. In this study, we utilized ribosome profiling and G-quadruplex RNA immunoprecipitation sequencing techniques to explore the impact of RNA G-quadruplex (rG4) on the translation efficiency in senescent cells. Our results revealed a reduction in the translation efficiency of rG4-rich genes in senescent cells and demonstrated that rG4 structures within coding sequence can impede translation both in vivo and in vitro. Moreover, we observed a significant increase in the abundance of rG4 structures in senescent cells, and the stabilization of the rG4 structures further exacerbated cellular senescence. Mechanistically, the RNA helicase DHX9 functions as a key regulator of rG4 abundance, and its reduced expression in senescent cells contributing to increased ribosome pausing. Additionally, we also observed an increased abundance of rG4, an imbalance in protein homeostasis, and reduced DHX9 expression in aged mice. In summary, our findings reveal a novel biological role for rG4 and DHX9 in the regulation of translation and proteostasis, which may have implications for delaying cellular senescence and the aging process.
G-Quadruplexes ; Cellular Senescence ; Ribosomes/genetics* ; Humans ; Animals ; Mice ; DEAD-box RNA Helicases/genetics* ; Protein Biosynthesis ; RNA/chemistry* ; Neoplasm Proteins

The 2025 American Thyroid Association Guidelines for the Management of Differentiated Thyroid Cancer in Adults incorporate the latest evidence-based medical research to systematically update the strategies for diagnosis, treatment, and follow-up of thyroid cancer. Integrating multidisciplinary perspectives from internal medicine, surgery, radiology, pathology, and other fields—and for the first time including input from patient representatives—the guidelines comprehensively cover the entire management process of differentiated thyroid cancer, significantly enhancing their clinical applicability. Regarding the current focus on active surveillance, the new edition provides clear recommendations based on a rigorous evaluation of existing evidence and multidisciplinary input. This article reviews and discusses key updates and practical aspects of the active surveillance section in the guidelines, with reference to relevant Japanese and Korean guidelines, with the aim of improving the application of active surveillance in thyroid cancer management.

To promote the development of extracellular vesicles of herbal medicine especially the establishment of standardization, led by the National Expert Committee on Research and Application of Chinese Herbal Vesicles, research experts in the field of herbal medicine and extracellular vesicles were invited nationwide with the support of the Expert Committee on Research and Application of Chinese Herbal Vesicles, Professional Committee on Extracellular Vesicle Research and Application, Chinese Society of Research Hospitals and the Guangdong Engineering Research Center of Chinese Herbal Vesicles. Based on the collation of relevant literature, we have adopted the Delphi method, the consensus meeting method combined with the nominal group method to form a discussion draft of "Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023)". The first draft was discussed in online and offline meetings on October 12, 14, November 2, 2022 and April and May 2023 on the current status of research, nomenclature, isolation methods, quality standards and research applications of extracellular vesicles of Chinese herbal medicines, and 13 consensus opinions were finally formed. At the Third Academic Conference on Research and Application of Chinese Herbal Vesicles, held on May 26, 2023, Kewei Zhao, convenor of the consensus, presented and read the consensus to the experts of the Expert Committee on Research and Application of Chinese Herbal Vesicles. The consensus highlights the characteristics and advantages of Chinese medicine, inherits the essence, and keeps the righteousness and innovation, aiming to provide a reference for colleagues engaged in research and application of Chinese herbal vesicles at home and abroad, decode the mystery behind Chinese herbal vesicles together, establish a safe, effective and controllable accurate Chinese herbal vesicle prevention and treatment system, and build a bridge for Chinese medicine to the world.

ObjectiveTo explore the syndrome elements and evolving patterns of patients with hepatitis B virus-related acute on chronic liver failure （HBV-ACLF） at different stages. MethodsClinical information of 1,058 hospitalized HBV-ACLF patients， including 618 in the early stage， 355 in the middle stage， and 85 in the late stage， were collected from 18 clinical centers across 12 regions nationwide from January 1， 2012 to February 28， 2015. The “Hepatitis B-related Chronic and Acute Liver Failure Chinese Medicine Clinical Questionnaire” were designed to investigate the basic information of the patients， like the four diagnostic information （including symptoms， tongue， pulse） of traditional Chinese medicine （TCM）， and to count the frequency of the appearance of the four diagnostic information. Factor analysis and cluster analysis were employed to determine and statistically analyze the syndrome elements and patterns of HBV-ACLF patients at different stages. ResultsThere were 76 four diagnostic information from 1058 HBV-ACLF patients， and 53 four diagnostic information with a frequency of occurrence ≥ 5% were used as factor analysis entries， including 36 symptom information， 12 tongue information， and 5 pulse information. Four types of TCM patterns were identified in HBV-ACLF， which were liver-gallbladder damp-heat pattern， qi deficiency and blood stasis pattern， liver-kidney yin deficiency pattern， and spleen-kidney yang-deficiency pattern. In the early stage， heat （39.4%， 359/912） and dampness （27.5%， 251/912） were most common， and the pattern of the disease was dominated by liver-gallbladder damp-heat pattern （74.6%， 461/618）； in the middle stage， dampness （30.2%， 187/619） and blood stasis （20.7%， 128/619） were most common， and the patterns of the disease were dominated by liver-gallbladder damp-heat pattern （53.2%， 189/355）， and qi deficiency and blood stasis pattern （27.6%， 98/355）； and in the late stage， the pattern of the disease was dominated by qi deficiency （26.3%， 40/152） and yin deficiency （20.4%， 31/152）， and the patterns were dominated by qi deficiency and blood stasis pattern （36.5%， 31/85）， and liver-gallbladder damp-heat pattern （25.9%， 22/85）. ConclusionThere are significant differences in the distribution of syndrome elements and patterns at different stages of HBV-ACLF， presenting an overall trend of evolving patterns as "from excess to deficiency， transforming from excess to deficiency"， which is damp-heat → blood stasis → qi-blood yin-yang deficiency.

Papillary thyroid microcarcinoma(PTMC),which lacks lymph node metastasis,distant metastasis,extra-thyroid invasion,high-risk subtypes,and invasion of the trachea or recurrent laryngeal nerve,may be classified as low-risk PTMC based on clinical assessment.Surgical intervention such as lobectomy or total thyroidectomy is the primary treatment modality for PTMC.This study comprised 124 patients who underwent conformal thyroidectomy and revealed that this innovative surgical approach yielded long-term oncological outcomes comparable to those who received lobectomy or total thyroidectomy.The surgical intervention may play a significant role in the comprehensive management of PTMC,while the implementation of PTMC precision medicine necessitates the utilization of genetic testing,molecular typing,and other advanced technologies to detect early-stage high-risk factors like lymph node microinvasion and integrate biology-based surgery concept for optimal outcomes.

Objective:To investigate the role of indocyanine green(ICG) fluorescence imaging in laparoscopic anterior resection for rectal cancer.Methods:A retrospective analysis was performed on 7 patients who had undergone laparoscopic anterior resection with the use of ICG fluorescence imaging at Peking University People′s Hospital between Oct 2018 and Mar 2019. The clinicopathological variables, surgical factors, short-term outcome and complications were analyzed.Results:The median operation time was 185 min. The median estimated blood loss was 50 ml. The median time from ICG injection to anastomotic perfusion was 45 s. One patient received extended proximal resection of bowel due to poor perfusion as suggested by ICG imaging. The median time to soft diet was 4 days, and the median hospital stay was 8 days. The median number of lymph nodes harvested was 16. There were no major complications in all these patients. No adverse events related to ICG were recorded.Conclusions:ICG fluorescence imaging was safe and effective in detecting insufficient blood supply around newly established bowel anastomsis, hence potentially reducing the anastomotic leakage rate.

Objective To investigate the influence of mismatch repair status on clinicopathological characteristics and prognosis in patients with colon cancer.Methods Patients who underwent radical excision for colon cancer between Nov 2012 and Mar 2016 at Peking University People's Hospital were enrolled.Clinicopathological data and prognosis were collected.Multivariate analysis were used to identify independent characteristics of MMR-deficient colon cancer.The influence of MMR-deficient on prognosis of colon cancer were analyzed through Kaplan-Meier curve.Results The overall rate of MMR-deficient in colon cancer was 17.1％ (51/299).Multivariate logistic regression analysis showed that low differentiation (OR =3.555,95％ CI:1.685-7.640,P ＜ 0.001),right-sided colon cancer (OR =5.645,95％ CI:2.483-14.715,P ＜ 0.001) and UICC Stage Ⅰ-Ⅱ (OR =4.099,95％ CI:1.863-9.840,P ＜0.001) were associated with MMR-deficient colon cancer.Conclusion Low differentiation,right-sided colon cancer and UICC Stage Ⅰ-Ⅱ were more common in MMR-deficient colon cancer.

Objective Energy based surgical devices such as high frequency electrotome,Harmonic scalpel and LigaSure are widely used in thyroid operations.This study is to demonstrate the difference of tissue thermal damage among different surgical instruments.Methods 12 beagle dogs were randomly divided into 3 groups,electrotome 15 W groups (group A),three-speed Harmonic scalpel (group B) and LigaSure middle gear group (group C).Patients of each group received energy instruments operating on their thyroid tissue which mimics traditional thyroidectomy.The temperatures of gland tissue during procedures were monitored by infrared thermal imager,and the operated thyroid tissues were histologically analyzed.Results The highest temperature was (83.9±8.2)℃ in the electrotome group,(70.7±7.5)℃ in three-speed Harmonic scalpel group,and (56.6±5.7)℃ in LigaSure group.The highest temperature among the three groups was statistically significant.The electrotome (15 W) caused more serious thermal damage to thyroid tissues than that caused by either the Harmonic scalpel or LigaSure (thermal damaged depth:(0.96±0.07) mm vs (0.74±0.07) mm,P＜0.01;(0.96±0.07) mm vs (0.72± 0.11) mm,P＜0.01).Nevertheless,the thermal damage had no significant differences between the Harmonic scalpel and LigaSure group (P=0.845).The thermal damage caused by the 15 W electrotome was significantly larger than that in the other two groups,and the difference had statistical significance (P＜0.01).Conclusion Compared to the high frequency electrotome,Harmonic scalpel and LigaSure lead less tissue thermal damage during thyroid surgeries,owing to less heat production.In that way,Harmonic scalpel and LigaSure are superior to electrotome in terms of safety.

OBJECTIVETo compare the safety and efficacy between extralevator abdominoperineal excision(ELAPE) and traditional abdominoperineal excision(APE) in patients with low rectal cancer.

METHODSFrom January 2011 to December 2013, 61 patients undergoing abdominoperineal excision for low rectal cancer at the Department of Gastrointestinal Surgery, Peking University People's Hospital were enrolled. The safety and efficacy of two procedure groups, ELAPE group (33 patients) and traditional APE group (28 patients) were reviewed retrospectively.

RESULTSLess intraoperative blood loss [(201 ± 147) ml vs. (343 ± 308) ml, P=0.022], shorter exhaust time [(3.8 ± 1.5) d vs. (4.6 ± 1.6) d, P=0.039] and lower perineal wound complication rate (9.1% vs. 25.0%, P=0.042) were observed in the ELAPE group as compared to the traditional APE group. However, longer operation time [(292 ± 46) min vs. (256 ± 28) min, P=0.008] and perineal drainage removal time [(11.1 ± 4.8) d vs. (7.1 ± 2.7) d, P<0.01] were noted in the ELAPE group than those in the traditional APE group. Number of lymph node retrieved and positive lymph node retrieved was not significantly different between two groups. The ELAPE group had lower rate of IOP (intraoperative perforation) (6.1% vs. 17.9%, P=0.055), but no significant difference was found. There were no significant differences in bowel movement, diet restoring time, average perineal drainage, postoperative hospitalization time and removing perineal stitches time between the two groups (all P>0.05).

CONCLUSIONELAPE possesses less intraoperative blood loss and lower perineal wound complication rate than traditional APE. ELAPE is associated with better safety and efficacy than traditional APE.

Objective To investigate the prevalence of anti-HCV positive among volunteer blood donors in Zhouk-ou city. Methods A total of 200 950 blood specimens from voluntary blood donors in Zhoukou from 2007 to 2012 were detected for anti-HCV by double-antibody sandwich enzyme-linked immunosorbent assay,results were ana-lyzed. Results The total positive rate of anti-HCV was 0.21% (416/200 950),there were significant difference in positive rates of anti-HCV among populations of different genders,ages and educational background(χ2= 24.01 , 142.31,45.8,respectively,allP<0.01),the positive rate of anti-HCV in female was higher than that of male ([0.27% ,205/75 658]vs [0.17% ,211/125 292]);the positive rate of anti-HCV was the lowest in donors aged 21-30 years (0.06% ,38/63 719),and highest in donors aged>40 years (0.33% ,162/48 871);the lower donors re-ceived education,the higher positive rate of anti-HCV they had,the positive rate of anti-HCV in donors with j unior high school education was 0.26% (107/41 154). The positive rate of anti-HCV in blood donors decreased gradually from 2007 to 2012(χ2= 14.576,P<0.05).Conclusion The positive rate of anti-HCV is low in voluntary blood do-nors in Zhoukou and is significantly different among different populations.