Objective: To investigate the potential therapeutic mechanisms of kaempferol , an active component in the traditional Chinese medicine gardenia , for lung cancer treatment using a network pharmacology approach . Methods: The main active ingredients and potential targets of Gardenia jasminoides were obtained through the Tra⁃ditional Chinese Medicine Pharmacology Database and Analysis Platform (TCMSP) , and combined with the lung cancer related target information collected from Gene Cards and OMIM databases , the intersection targets of Garde⁃nia jasminoides and lung cancer treatment were determined by drawing Venn diagrams . Further screening of core targets was conducted through PPI network analysis , and gene ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes ( KEGG) pathway enrichment analysis were performed using the Metascape platform . Auto dock software was used to evaluate the binding affinity between the active ingredients of Gardenia jasminoides and target proteins . In terms of experiments , cell proliferation ability was evaluated through CCK⁃8 assay , cell migration and invasion ability were detected through cell scratch healing assay and Transwell assay , and the expression levels of epithelial mesenchymal transition ( EMT) protein and inflammatory factors were detected by Western blot and RT⁃qPCR . Results: The active ingredient kaempferol in Gardenia jasminoides exhibited significant binding ability invasion of lung cancer cells . The results of Western blot and RT⁃qPCR further confirmed that kaempferol could promote an increase in E ⁃cadherin , a decrease in N ⁃cadherin and Vimentin , and reduce the expression of inflam⁃matory factors . Conclusion The active ingredient of Gardenia jasminoides , kaempferol , inhibits the proliferation ,migration and invasion of lung cancer cells by targeting BCL⁃2 , while reversing EMT progression and suppressing the expression levels of inflammatory cytokines in lung cancer cells , thus preventing lung cancer progression .

Objective To explore the reasons for the activation of the RNA-binding protein ZC3H15 in non-small cell lung canc-er and its biological functions in the tumorigenesis of non-small cell lung cancer.Methods Based on the whole genome sequencing data of The Cancer Genome Atlas(TCGA)database,the relationship between ZC3H15 copy number variation and its expression was analyzed,and the differential expression of ZC3H15 between normal and non-small cell lung cancer groups,its variation across different TNM sta-ges,and its prognostic analysis were investigated.A549 cells and PC9 cells were divided into si-NC group and si-c-Myc group,re-spectively.Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)and chromatin immunoprecipitation were used to explore the regulatory relationship between the transcription factor c-Myc and ZC3H15.A549 cells and PC9 cells were divided into si-NC group,si-ZC3H15 1# group,si-ZC3H15 2# group,Vector group,pcDNA-ZC3H15group.RT-qPCR was used to detect the ex-pression of ZC3H15,MTT assay was used to detect cell viability,colony formation assay was used to examine cell proliferation capacity,and Transwell assay was used to measure cell migration ability.The A549 cells were stably transfected with sh-Ctrl and sh-ZC3H15,and the nude mouse xenograft model was used to detect the impact of ZC3H15 on the proliferation ability of non-small cell lung cancer cells in vivo.Results TCGA non-small cell lung cancer data analysis showed that the expression level of ZC3H15 in the copy-number-amplified group was higher than that in the copy-number-deleted group(P＜0.05).ZC3H15 copy number was positively correlated with expression level(P＜0.05).In both paired and unpaired non-small cell lung cancer groups,the expression level of ZC3H15 was up-regulated compared to the normal group(P＜0.05).The expression level of ZC3H15 was higher in stage Ⅲ/Ⅳ group than that in stage Ⅰ/Ⅱ group(P＜0.05).The low-expression ZC3H15group had a higher survival rate than the high-expression group(P＜0.05).Compared to the si-NC group,the expression level of ZC3H15 and Input reference percentage after c-Myc antibody treatment in the si-c-Myc group were both decreased(P＜0.05).The results of RT-qPCR showed that in A549 cells and PC9 cells,the expression level of ZC3H15 in the si-ZC3H15 1# and si-ZC3H15 2# groups were lower than those in the si-NC group(P＜0.05),while the expression level of ZC3H15 in the pcDNA-ZC3H15group was higher than that in the Vector group(P＜0.05).Further cell func-tion studies found that the proliferation and migration capacity of non-small cell lung cancer cells with ZC3H15 knockdown were decreased(P＜0.05),and the overexpression of ZC3H15 could enhance the proliferation and migration capacity of non-small cell lung cancer cells(P＜0.05).At the in vivo level,subcutaneous tumor-bearing experiments in nude mice showed that ZC3H15 knockdown could significant-ly reduced the tumor growth rate(P＜0.05).Conclusion Copy number amplification and c-Myc transcriptional activation were important reasons for ZC3H15 activation in non-small cell lung cancer.ZC3H15 is a key functional molecule to promote the tumorigenesis of non-small cell lung cancer,and can provide some theoretical basis for clinical diagnosis and treatment of non-small cell lung cancer.

Objective To explore the reasons for the activation of the RNA-binding protein ZC3H15 in non-small cell lung canc-er and its biological functions in the tumorigenesis of non-small cell lung cancer.Methods Based on the whole genome sequencing data of The Cancer Genome Atlas(TCGA)database,the relationship between ZC3H15 copy number variation and its expression was analyzed,and the differential expression of ZC3H15 between normal and non-small cell lung cancer groups,its variation across different TNM sta-ges,and its prognostic analysis were investigated.A549 cells and PC9 cells were divided into si-NC group and si-c-Myc group,re-spectively.Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)and chromatin immunoprecipitation were used to explore the regulatory relationship between the transcription factor c-Myc and ZC3H15.A549 cells and PC9 cells were divided into si-NC group,si-ZC3H15 1# group,si-ZC3H15 2# group,Vector group,pcDNA-ZC3H15group.RT-qPCR was used to detect the ex-pression of ZC3H15,MTT assay was used to detect cell viability,colony formation assay was used to examine cell proliferation capacity,and Transwell assay was used to measure cell migration ability.The A549 cells were stably transfected with sh-Ctrl and sh-ZC3H15,and the nude mouse xenograft model was used to detect the impact of ZC3H15 on the proliferation ability of non-small cell lung cancer cells in vivo.Results TCGA non-small cell lung cancer data analysis showed that the expression level of ZC3H15 in the copy-number-amplified group was higher than that in the copy-number-deleted group(P＜0.05).ZC3H15 copy number was positively correlated with expression level(P＜0.05).In both paired and unpaired non-small cell lung cancer groups,the expression level of ZC3H15 was up-regulated compared to the normal group(P＜0.05).The expression level of ZC3H15 was higher in stage Ⅲ/Ⅳ group than that in stage Ⅰ/Ⅱ group(P＜0.05).The low-expression ZC3H15group had a higher survival rate than the high-expression group(P＜0.05).Compared to the si-NC group,the expression level of ZC3H15 and Input reference percentage after c-Myc antibody treatment in the si-c-Myc group were both decreased(P＜0.05).The results of RT-qPCR showed that in A549 cells and PC9 cells,the expression level of ZC3H15 in the si-ZC3H15 1# and si-ZC3H15 2# groups were lower than those in the si-NC group(P＜0.05),while the expression level of ZC3H15 in the pcDNA-ZC3H15group was higher than that in the Vector group(P＜0.05).Further cell func-tion studies found that the proliferation and migration capacity of non-small cell lung cancer cells with ZC3H15 knockdown were decreased(P＜0.05),and the overexpression of ZC3H15 could enhance the proliferation and migration capacity of non-small cell lung cancer cells(P＜0.05).At the in vivo level,subcutaneous tumor-bearing experiments in nude mice showed that ZC3H15 knockdown could significant-ly reduced the tumor growth rate(P＜0.05).Conclusion Copy number amplification and c-Myc transcriptional activation were important reasons for ZC3H15 activation in non-small cell lung cancer.ZC3H15 is a key functional molecule to promote the tumorigenesis of non-small cell lung cancer,and can provide some theoretical basis for clinical diagnosis and treatment of non-small cell lung cancer.

Background::Lymph node staging of prostate cancer (PCa) is important for planning and monitoring of treatment. 18F-prostate specific membrane antigen positron emission tomography/computerized tomography ( 18F-PSMA PET/CT) has several advantages over 68Ga-PSMA PET/CT, but its diagnostic value requires further investigation. This meta-analysis focused on establishing the diagnostic utility of 18F-PSMA PET/CT for lymph node staging in medium/high-risk PCa. Methods::We searched the EMBASE, PubMed, Cochrane library, and Web of Science databases from inception to October 1, 2022. Prostate cancer, 18F, lymph node, PSMA, and PET/CT were used as search terms and the language was limited to English. We additionally performed a manual search using the reference lists of key articles. Patients and study characteristics were extracted and the QUADAS-2 tool was employed to evaluate the quality of included studies. Sensitivity, specificity, the positive and negative likelihood ratio (PLR and NLR), diagnostic odds ratio (DOR), area under the curve (AUC), and 95% confidence interval (CI) were used to evaluate the diagnostic value of 18F-PSMA PET/CT. Stata 17 software was employed for calculation and statistical analyses. Results::A total of eight diagnostic tests including 734 individual samples and 6346 lymph nodes were included in this meta-analysis. At the patient level, the results of each consolidated summary were as follows: sensitivity of 0.57 (95% CI 0.39-0.73), specificity of 0.95 (95% CI 0.92-0.97), PLR of 11.2 (95% CI 6.6-19.0), NLR of 0.46 (95% CI 0.31-0.68), DOR of 25 (95% CI 11-54), and AUC of 0.94 (95% CI 0.92-0.96). At the lesion level, the results of each consolidated summary were as follows: sensitivity of 0.40 (95% CI 0.21-0.62), specificity of 0.99 (95% CI 0.95-1.00), PLR of 40.0 (95% CI 9.1-176.3), NLR of 0.61 (95% CI 0.42-0.87), DOR of 66 (95% CI 14-311), and AUC of 0.86 (95% CI 0.83-0.89).Conclusions::18F-PSMA PET/CT showed moderate sensitivity but high specificity in lymph node staging of medium/high-risk PCa. The diagnostic efficacy was almost equivalent to that reported for 68Ga-PSMA PET/CT. Registration::International Prospective Register of Systematic Reviews (PROSPERO), No. CRD42023391101.

With the increasing proportion of human papilloma virus(HPV)infection in the pathogenic factors of oro-pharyngeal cancer,a series of changes have occurred in the surgical treatment.While the treatment mode has been im-proved,there are still many problems,including the inconsistency between diagnosis and treatment modes,the lack of popularization of reconstruction technology,the imperfect post-treatment rehabilitation system,and the lack of effective preventive measures.Especially in terms of treatment mode for early oropharyngeal cancer,there is no unified conclu-sion whether it is surgery alone or radiotherapy alone,and whether robotic minimally invasive surgery has better func-tional protection than radiotherapy.For advanced oropharyngeal cancer,there is greater controversy over the treatment mode.It is still unclear whether to adopt a non-surgical treatment mode of synchronous chemoradiotherapy or induction chemotherapy combined with synchronous chemoradiotherapy,or a treatment mode of surgery combined with postopera-tive chemoradiotherapy.In order to standardize the surgical treatment of oropharyngeal cancer in China and clarify the indications for surgical treatment of oropharyngeal cancer,this expert consensus,based on the characteristics and treat-ment status of oropharyngeal cancer in China and combined with the international latest theories and practices,forms consensus opinions in multiple aspects of preoperative evaluation,surgical indication determination,primary tumor re-section,neck lymph node dissection,postoperative defect repair,postoperative complication management prognosis and follow-up of oropharyngeal cancer patients.The key points include:① Before the treatment of oropharyngeal cancer,the expression of P16 protein should be detected to clarify HPV status;② Perform enhanced magnetic resonance imaging of the maxillofacial region before surgery to evaluate the invasion of oropharyngeal cancer and guide precise surgical resec-tion of oropharyngeal cancer.Evaluating mouth opening and airway status is crucial for surgical approach decisions and postoperative risk prediction;③ For oropharyngeal cancer patients who have to undergo major surgery and cannot eat for one to two months,it is recommended to undergo percutaneous endoscopic gastrostomy before surgery to effectively improve their nutritional intake during treatment;④ Early-stage oropharyngeal cancer patients may opt for either sur-gery alone or radiation therapy alone.For intermediate and advanced stages,HPV-related oropharyngeal cancer general-ly prioritizes radiation therapy,with concurrent chemotherapy considered based on tumor staging.Surgical treatment is recommended as the first choice for HPV unrelated oropharyngeal squamous cell carcinoma(including primary and re-current)and recurrent HPV related oropharyngeal squamous cell carcinoma after radiotherapy and chemotherapy;⑤ For primary exogenous T1-2 oropharyngeal cancer,direct surgery through the oral approach or da Vinci robotic sur-gery is preferred.For T3-4 patients with advanced oropharyngeal cancer,it is recommended to use temporary mandibu-lectomy approach and lateral pharyngotomy approach for surgery as appropriate;⑥ For cT1-2N0 oropharyngeal cancer patients with tumor invasion depth＞3 mm and cT3-4N0 HPV unrelated oropharyngeal cancer patients,selective neck dissection of levels ⅠB to Ⅳ is recommended.For cN+HPV unrelated oropharyngeal cancer patients,therapeutic neck dissection in regions Ⅰ-Ⅴ is advised;⑦ If PET-CT scan at 12 or more weeks after completion of radiation shows intense FDG uptake in any node,or imaging suggests continuous enlargement of lymph nodes,the patient should undergo neck dissection;⑧ For patients with suspected extracapsular invasion preoperatively,lymph node dissection should include removal of surrounding muscle and adipose connective tissue;⑨ The reconstruction of oropharyngeal cancer defects should follow the principle of reconstruction steps,with priority given to adjacent flaps,followed by distal pedicled flaps,and finally free flaps.The anterolateral thigh flap with abundant tissue can be used as the preferred flap for large-scale postoperative defects.

Effective cost control and structure optimization of medical consumables in public hospitals can facilitate a shift from extensive cost control to scientific and refine management.On the premise of ensuring medical quality,reducing the burden of patients'diagnosis and treatment and meeting the actual needs of hospital management,this approach aims to realize valuable healthcare outcomes.This study was conducted in a tertiary hospital,which balanced both the medical and economic val-ue of medical consumables.Using an integrated approach to specialty capacity building and disease structure optimization,the hospital restructured the use of medical consumables in Transcatheter Arterial Embolization(TAE)procedures.It developed standardized pathways and usage protocols tailored to specific diseases and surgical requirements.A targeted consumable usage policy framework was introduced,comprising"one department,one policy;one surgery type,one policy;and one consumable,one policy."This included initiatives such as validating the use of drug-loaded embolic microspheres,conducting multi-depart-mental review meetings,strictly regulating indications for these microspheres,limiting personnel involvement,and negotiating re-duced pricing on imported microspheres.Following implementation,the average case-mix index(CMI)for discharged patients undergoing TAE increased from 2.23 to 2.34(P＜0.001),while the average per-case cost of consumables decreased from 19 600 to 15 600(P＜0.001).These measures offer valuable decision-making and operational reference for hospitals nation-wide,supporting efficient,quality-focused consumables management.

Purpose To investigate the diagnosis and staging performance of 18F-FAPI-42 PET/CT compared to 18F-FDG PET/CT in primary hepatic tumours. Materials and Methods We performed a retrospective study including all primary hepatic tumours patients who underwent both 18F-FAPI-42 and 18F-FDG PET/CT scans within two weeks at the First Affiliated Hospital of Guangzhou Medical University from October 2020 to May 2023. With histopathologic proof (surgical resection and/or percutaneous biopsies) or multimodality radiographic follow-up (CT/MRI-enhanced) as the final diagnostic reference standard. The maximum standard uptake value,tumor-to-background ratio and diagnostic rates (positive lesion/total lesion) between 18F-FAPI-42 and 18F-FDG were compared. Results Thirty-four primary hepatic tumours patients were enrolled in this study,including 27 hepatocellular carcinoma,5 intrahepatic cholangiocarcinoma and 2 combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma. It was found that 18F-FAPI-42 PET/CT significantly outperformed 18F-FDG in diagnosing intrahepatic lesions and lymph node metastases (intrahepatic lesions:93.33％ vs. 52.22％,P<0.001;lymph node metastases:100％ vs. 87.50％,P=0.021). The detection rates for distant metastases were comparable between the two radioactive tracers (100％ vs. 96.20％,P>0.05). 18F-FAPI-42 showed higher maximum standard uptake value and tumor-to-background ratio in intrahepatic lesions,regional lymph node metastases,bone and peritoneal metastases compared to 18F-FDG (Z=-5.261--1.183,all P<0.05). For primary hepatic tumours initial staging,18F-FAPI-42 PET/CT upstaged the T stage in 20.8％ (5/24) of patients,the N stage in 8.3％ (2/24) and the M stage in 8.3％ (2/24) of patients,consistent with multimodal imaging diagnostic results. The evaluation of post-treatment patient outcomes showed that 18F-FAPI-42 had a detection rate of 92.86％ (13/14) for hepatic tumours recurrence,higher than 18F-FDG (64.28％,9/14). 18F-FAPI-42 identified more recurrent primary lesions and intrahepatic metastatic foci,demonstrating greater sensitivity than 18F-FDG. Conclusion The diagnostic efficacy of 18F-FAPI-42 PET/CT for primary hepatic tumours is significantly better than 18F-FDG,showing excellent performance in the staging and restaging of primary hepatic tumours,which suggesting that the application of 18F-FAPI-42 is helpful to improve the clinical management of primary hepatic tumours patients.

Purpose To investigate the diagnosis and staging performance of 18F-FAPI-42 PET/CT compared to 18F-FDG PET/CT in primary hepatic tumours. Materials and Methods We performed a retrospective study including all primary hepatic tumours patients who underwent both 18F-FAPI-42 and 18F-FDG PET/CT scans within two weeks at the First Affiliated Hospital of Guangzhou Medical University from October 2020 to May 2023. With histopathologic proof (surgical resection and/or percutaneous biopsies) or multimodality radiographic follow-up (CT/MRI-enhanced) as the final diagnostic reference standard. The maximum standard uptake value,tumor-to-background ratio and diagnostic rates (positive lesion/total lesion) between 18F-FAPI-42 and 18F-FDG were compared. Results Thirty-four primary hepatic tumours patients were enrolled in this study,including 27 hepatocellular carcinoma,5 intrahepatic cholangiocarcinoma and 2 combined hepatocellular carcinoma and intrahepatic cholangiocarcinoma. It was found that 18F-FAPI-42 PET/CT significantly outperformed 18F-FDG in diagnosing intrahepatic lesions and lymph node metastases (intrahepatic lesions:93.33％ vs. 52.22％,P<0.001;lymph node metastases:100％ vs. 87.50％,P=0.021). The detection rates for distant metastases were comparable between the two radioactive tracers (100％ vs. 96.20％,P>0.05). 18F-FAPI-42 showed higher maximum standard uptake value and tumor-to-background ratio in intrahepatic lesions,regional lymph node metastases,bone and peritoneal metastases compared to 18F-FDG (Z=-5.261--1.183,all P<0.05). For primary hepatic tumours initial staging,18F-FAPI-42 PET/CT upstaged the T stage in 20.8％ (5/24) of patients,the N stage in 8.3％ (2/24) and the M stage in 8.3％ (2/24) of patients,consistent with multimodal imaging diagnostic results. The evaluation of post-treatment patient outcomes showed that 18F-FAPI-42 had a detection rate of 92.86％ (13/14) for hepatic tumours recurrence,higher than 18F-FDG (64.28％,9/14). 18F-FAPI-42 identified more recurrent primary lesions and intrahepatic metastatic foci,demonstrating greater sensitivity than 18F-FDG. Conclusion The diagnostic efficacy of 18F-FAPI-42 PET/CT for primary hepatic tumours is significantly better than 18F-FDG,showing excellent performance in the staging and restaging of primary hepatic tumours,which suggesting that the application of 18F-FAPI-42 is helpful to improve the clinical management of primary hepatic tumours patients.

Biofilms are closely associated with the tough healing and dysfunctional inflammation of chronic wounds. Photothermal therapy (PTT) emerged as a suitable alternative which could destroy the structure of biofilms with local physical heat. However, the efficacy of PTT is limited because the excessive hyperthermia could damage surrounding tissues. Besides, the difficult reserve and delivery of photothermal agents makes PTT hard to eradicate biofilms as expectation. Herein, we present a GelMA-EGF/Gelatin-MPDA-LZM bilayer hydrogel dressing to perform lysozyme-enhanced PTT for biofilms eradication and a further acceleration to the repair of chronic wounds. Gelatin was used as inner layer hydrogel to reserve lysozyme (LZM) loaded mesoporous polydopamine (MPDA) (MPDA-LZM) nanoparticles, which could rapidly liquefy while temperature rising so as to achieve a bulk release of nanoparticles. MPDA-LZM nanoparticles serve as photothermal agents with antibacterial capability, could deeply penetrate and destroy biofilms. In addition, the outer layer hydrogel consisted of gelatin methacryloyl (GelMA) and epidermal growth factor (EGF) promoted wound healing and tissue regeneration. It displayed remarkable efficacy on alleviating infection and accelerating wound healing in vivo. Overall, the innovative therapeutic strategy we came up with has significant effect on biofilms eradication and shows promising application in promoting the repair of clinical chronic wounds.

Objective:To investigate the clinical features, diagnosis, treatment and prognosis of primary urethral carcinoma.Methods:The clinical and follow-up data of 12 patients with primary urethral carcinoma admitted to Beijing Hospital from July 2016 to December 2020 were retrospectively analyzed.Results:There were four males and eight females, with an average age of 66.3(53~75)years.Nine patients underwent magnetic resonance examination before operation, and eight patients presented with abnormal urethral signals.The clinical stage of female patients was generally later than those of male patients, and all patients received surgical treatment.Four male patients did not receive post-operative adjuvant treatment, and all of them attained disease-free survival.Among the eight female patients, four patients received postoperative adjuvant radiotherapy or chemotherapy, five patients had recurrence or metastasis during follow-up, and two patients died.Conclusions:The clinical stage of female urethral cancer is later than that of male.MRI examination is beneficial to the determination of local invasion of urethral cancer.For female proximal urethral cancer and male posterior urethral cancer, radical resection has a good therapeutic effect.