1.Cuproptosis: A novel therapeutic target for non-small cell lung cancer
Dong DONG ; Yajie ZHANG ; Hecheng LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(05):826-832
Cuproptosis, recently defined as a unique form of cell death distinct from programmed cell death, is triggered by copper overload within mitochondria. Genes associated with cuproptosis have been found to correlate with tumorigenesis and tumor progression, making the targeting of cuproptosis pathways a promising direction for anti-tumor therapies. Copper ion carriers can transport copper ions into cells, inducing cuproptosis and laying the foundation for its application in cancer treatment. This article elaborates on the homeostasis of copper and the mechanisms related to cuproptosis, further clarifying the relationship between cuproptosis and lung cancer treatment targets. This review aims to summarize current progress in research related to cuproptosis and lung cancer, providing new theories and bases for the clinical treatment of lung cancer.
2.Effect and mechanism of action of 2,5-dihydroxybenzoic acid on an in vitro cell model of metabolic dysfunction-associated fatty liver disease
Junjiao XU ; Tong LIU ; Sutong LIU ; Lihui ZHANG ; Yijia SONG ; Wenjing WU ; Beilei CUI ; Yajie GUAN ; Minghao LIU
Journal of Clinical Hepatology 2026;42(7):1586-1596
ObjectiveTo investigate the potential targets of 2,5-dihydroxybenzoic acid (2,5-DHBA) in the treatment of metabolic dysfunction-associated fatty liver disease (MAFLD) and the molecular mechanism by which it regulates the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. MethodsA network pharmacology analysis was performed at first, and related databases were used to obtain the common action targets of 2,5-DHBA and MAFLD, followed by molecular docking and pathway enrichment analysis to predict the potential biological processes and signaling pathways regulated by these targets. Then mouse normal hepatocytes AML-12 were used for cell experiments, and CCK-8 assay was used to determine the three optimal intervention concentrations of 2,5-DHBA. AML-12 cells were divided into control group, model group (cells cultured in a medium containing 2 mmol/L free fatty acid [FFA] to establish a cell model of MAFLD), and three 2,5-DHBA intervention groups (cells cultured with FFA and 2,5-DHBA at the three different concentrations of 1.25, 5, and 20 μmol/L, respectively). Oil red O staining was used to observe intracellular lipid accumulation; the fluorescent probe DCFH-DA was used to measure the level of intracellular reactive oxygen species (ROS); biochemical assays were used to measure the content of triglyceride (TG) and total cholesterol (TC); quantitative real-time PCR and Western Blot were used to measure the expression levels of related genes and proteins. A one-way analysis of variance was used for comparison between multiple groups, and the Tukey’s test was used for further comparison between two groups. ResultsA total of 32 common targets were obtained for 2,5-DHBA and MAFLD. Within a concentration range of 1.25 — 20 μmol/L, 2,5-DHBA treatment, starting from the concentration of 2.5 μmol/L, increased the viability of AML-12 cells in a dose-dependent manner. The minimum effective concentration of 1.25 μmol/L, the intermediate gradient concentration of 5 μmol/L, and the maximum safe concentration within the effective range of 20 μmol/L were selected for low-, middle-, and high-dose intervention, respectively. Compared with the model group, 2,5-DHBA intervention at concentrations of 1.25, 5, and 20 μmol/L could significantly reduce lipid droplet accumulation in cells (all P<0.05), and there were significant differences in TG and TC between the model group and the three intervention groups (all P<0.05). Compared with the control group, the model group had a significant increase in ROS fluorescence intensity (P<0.05), and compared with the model group, there was a dose-dependent reduction in intracellular ROS level after treatment with 5 μmol/L or 20 μmol/L 2,5-DHBA (P<0.05). Compared with the model group, 2,5-DHBA treatment at concentrations of 5 and 20 μmol/L significantly downregulated the mRNA expression levels of the lipogenic genes SREBf1 and FASN and upregulated the mRNA expression levels of the key antioxidant gene Nrf2 and its downstream target gene HO-1 (all P<0.05). Compared with the control group, the expression of p-PI3K/PI3K and p-Akt/Akt in the model group was significantly increased (all P<0.05). Compared with the model group, the protein expression levels of p-PI3K/PI3K and p-Akt/Akt were significantly decreased after 5 μmol/L 2,5-DHBA treatment (P<0.05). Compared with the control group, the expression levels of Nrf2 and HO-1 protein in the model group were significantly decreased (all P<0.05). The protein levels of Nrf2 and HO-1 were significantly increased after treatment with 1.25 μmol/L 2,5-DHBA (P<0.05). ConclusionNetwork pharmacology and cellular experiments confirm that 2,5-DHBA can alleviate lipid deposition and oxidative stress by regulating the PI3K/Akt signaling pathway, thereby exerting a therapeutic effect on MAFLD.
3.Clinical characteristics of pediatric primary intracranial germ cell tumors and risk factors for neuroendocrine dysfunction
Yixuan HE ; Chuhong TONG ; Juanyu XU ; Yaxian DENG ; Bo LI ; Yajie WANG
Chinese Journal of Pediatrics 2025;63(12):1325-1330
To explore the clinical characteristics of primary intracranial germ cell tumors (iGCT) and analyze the risk factors for the occurrence of neuroendocrine dysfunction.Methods:A case series study was conducted. The data of 130 children diagnosed with iGCT who were admitted to the Department of Pediatrics, Beijing Tiantan Hospital, Capital Medical University, from February 2021 to December 2023 was collected. The clinical characteristics of iGCT were summarized, including general information, clinical manifestations, imaging findings, laboratory tests and outcomes. Children were divided into groups aged 0-9 and 10-18 years, and divided into group non-neuroendocrine dysfunction, group partial neuroendocrine dysfunction and group combined hypothalamic and pituitary-target gland axis dysfunction. Multivariate Logistic regression was employed for statistical analysis to identify risk factors for neuroendocrine dysfunction in iGCT children.Results:A total of 130 iGCT children were included, with an age of (10±3) years, 87 males and 43 females. Among them, 82 children (63.1%) had germinoma and 48 children (36.9%) had non-germinomatous germ cell tumors (NGGCT). One hundred and ten children (84.6%) had single lesions, including 47 cases in the sellar region, 29 cases in the pineal region and 34 cases in the basal ganglia region. Multi-leisions presented in the 20 children (15.4%), with 10 cases in the sellar+pineal region, 6 cases in the sellar+basal ganglia region, 3 cases in the pineal+ganglia region and 1 case in the sellar+pineal+basal ganglia region. Dissemination was presented to 26 children (20.0%). Initial clinical manifestations presented with symptoms of cranial hypertension like headache and vomiting in 75 cases, vision changes in 28 cases, limb movement disorders in 42 cases, diabetes insipidus in 67 cases, precocious puberty in 23 cases, growth retardation in 22 cases and delayed puberty in 2 cases. Among the 72 children aged 0-9 years, 37 cases (51.4%) had germinoma and 35 cases (48.6%) had NGGCT, while among the 58 children aged 10-18 years, 45 cases (77.6%) had germinoma and 13 cases (22.4%) had NGGCT. Non neuroendocrine dysfunction group included 39 children, partial neuroendocrine dysfunction group 54 children, and combined hypothalamic and pituitary-target gland axis dysfunction group 37 children. Univariate analysis showed statistical difference in gender, disease duration, tumor location, and serum human chorionic gonadotropin level among the 3 groups (all P<0.05). Multivariate Logistic regression analysis revealed that girl ( OR=5.29, 95% CI 1.54-18.16) and long disease duration ( OR=1.07, 95% CI 1.01-1.14) were risk factors for neuroendocrine dysfunction in iGCT patients (both P<0.05). Conclusions:iGCT occurs in children of all ages, with a higher incidence in males. The proportions of germinoma and NGGCT are similar in children aged 0-9 years, while germinoma is more common in patients aged 10-18 years. The clinical symptoms are atypical and diverse. Female gender and longer disease duration demonstrate the presence of neuroendocrine dysfunction in iGCT.
4.Clinical characteristics of pediatric primary intracranial germ cell tumors and risk factors for neuroendocrine dysfunction
Yixuan HE ; Chuhong TONG ; Juanyu XU ; Yaxian DENG ; Bo LI ; Yajie WANG
Chinese Journal of Pediatrics 2025;63(12):1325-1330
To explore the clinical characteristics of primary intracranial germ cell tumors (iGCT) and analyze the risk factors for the occurrence of neuroendocrine dysfunction.Methods:A case series study was conducted. The data of 130 children diagnosed with iGCT who were admitted to the Department of Pediatrics, Beijing Tiantan Hospital, Capital Medical University, from February 2021 to December 2023 was collected. The clinical characteristics of iGCT were summarized, including general information, clinical manifestations, imaging findings, laboratory tests and outcomes. Children were divided into groups aged 0-9 and 10-18 years, and divided into group non-neuroendocrine dysfunction, group partial neuroendocrine dysfunction and group combined hypothalamic and pituitary-target gland axis dysfunction. Multivariate Logistic regression was employed for statistical analysis to identify risk factors for neuroendocrine dysfunction in iGCT children.Results:A total of 130 iGCT children were included, with an age of (10±3) years, 87 males and 43 females. Among them, 82 children (63.1%) had germinoma and 48 children (36.9%) had non-germinomatous germ cell tumors (NGGCT). One hundred and ten children (84.6%) had single lesions, including 47 cases in the sellar region, 29 cases in the pineal region and 34 cases in the basal ganglia region. Multi-leisions presented in the 20 children (15.4%), with 10 cases in the sellar+pineal region, 6 cases in the sellar+basal ganglia region, 3 cases in the pineal+ganglia region and 1 case in the sellar+pineal+basal ganglia region. Dissemination was presented to 26 children (20.0%). Initial clinical manifestations presented with symptoms of cranial hypertension like headache and vomiting in 75 cases, vision changes in 28 cases, limb movement disorders in 42 cases, diabetes insipidus in 67 cases, precocious puberty in 23 cases, growth retardation in 22 cases and delayed puberty in 2 cases. Among the 72 children aged 0-9 years, 37 cases (51.4%) had germinoma and 35 cases (48.6%) had NGGCT, while among the 58 children aged 10-18 years, 45 cases (77.6%) had germinoma and 13 cases (22.4%) had NGGCT. Non neuroendocrine dysfunction group included 39 children, partial neuroendocrine dysfunction group 54 children, and combined hypothalamic and pituitary-target gland axis dysfunction group 37 children. Univariate analysis showed statistical difference in gender, disease duration, tumor location, and serum human chorionic gonadotropin level among the 3 groups (all P<0.05). Multivariate Logistic regression analysis revealed that girl ( OR=5.29, 95% CI 1.54-18.16) and long disease duration ( OR=1.07, 95% CI 1.01-1.14) were risk factors for neuroendocrine dysfunction in iGCT patients (both P<0.05). Conclusions:iGCT occurs in children of all ages, with a higher incidence in males. The proportions of germinoma and NGGCT are similar in children aged 0-9 years, while germinoma is more common in patients aged 10-18 years. The clinical symptoms are atypical and diverse. Female gender and longer disease duration demonstrate the presence of neuroendocrine dysfunction in iGCT.
5.The impact of impulsivity on digital addiction tendencies and related factors in Wilson disease patients
Jieru KE ; Yajie CHENG ; Gongqiang WANG ; Ping JIN ; Xinfeng MA ; Kang LIN ; Guangan TONG ; Qunrong YE ; Yongzhu HAN
Chinese Journal of Nervous and Mental Diseases 2024;50(7):423-429
Objective To explore the influence of impulsivity on digital addiction tendencies in patients with Wilson disease(WD)and its related factors.Methods A total of 66 patients with WD were included in the study which were divided into neurological WD group(42 cases)and hepatic WD group(24 cases)according to clinical manifestations.Sixty-six WD patients were included as the study subjects,including 24 cases of hepatic WD and 42 cases of neurological WD.The Chinese version of the Barratt impulsiveness scale(BIS-11-C)was used to assess patients'impulsiveness.Mobile phone addiction index(MPAI)evaluates the degree of dependence on mobile phone use.Cranial MRI was used to examine the location and cumulative frequency of the diseased brain region.Results Among the 66 WD patients,45 cases(68.2% )had the tendency of digital addiction,including 35 cases(53.0% )in the neurological WD group and 10 cases(15.2% )in the hepatic WD group.There was a statistically significant difference in the proportion of the two types of WD patients(P=0.001).The scores of BIS-11-C and MPAI scales in neurological WD group were higher than those in hepatic WD group(P<0.05).The out-of-control score in the MPAI scale is positively correlated with the attention impulsivity score(r=0.499,P=0.001),motor impulsivity score(r=0.553,P=0.001),unplanned impulsivity score(r=0.535,P=0.001),and impulse control score(r=0.653,P=0.001)in the BIS-11-C scale.Linear regression analysis showed a correlation between attention impulsivity score and frontal lobe lesions(B=-1.634,P=0.018).There was a correlation between loss of control score and frontal lobe lesions(B=-3.609,P=0.023).The withdrawal score was associated with the thalamus lesions(B=-5.047,P=0.007)and frontal lobe lesions(B=-2.204,P=0.024).Avoidance score was associated with parietal lobe lesions(B=-1.867,P=0.032).The low efficacy score was associated with the putamen lesions(B=-1.789,P=0.016)and frontal lobe lesions(B=-1.592,P=0.044).Conclusion Neurological WD patients have higher tendency of digital addiction than hepatic WD patients and the tendency of digital addiction is related to impulsivity.The digital addiction tendency of WD patients may be related to impulse control disorders caused by lesions in multiple brain regions such as the putamen,thalamus,and frontal lobe.
6.Interpretation of the NCCN clinical practice guidelines in oncology: Lung cancer screening (version 2.2024)
Dong DONG ; Yajie ZHANG ; Hecheng LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(09):1253-1257
The National Comprehensive Cancer Network (NCCN) updates the "NCCN clinical practice guidelines in oncology: Lung cancer screening" annually, and the second edition of 2024 was released in October 2023. The 2024 edition of the guidelines builds on the 2023 edition with some updates on description and assessment of risk factors for lung cancer, evaluation and follow-up of lung nodules found during initial and subsequent screening, and low-dose CT screening protocols and imaging modalities. In this article, we will introduce the above updates and provide reference for lung cancer screening in China by combining the relevant guidelines and consensus in China.
7.Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2023 edition): An interpretation
Dong DONG ; Yiheng HUANG ; Yajie ZHANG ; Hecheng LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(11):1533-1538
Chinese Medical Association Guidelines for Clinical Diagnosis and Treatment of Lung Cancer (2023 Edition) has been released in July 2023. Based on the 2022 edition, the 2023 edition of the guideline has been updated in the aspects of lung cancer screening, pathology, surgical standards, neoadjuvant therapy, targeted therapy and treatment of advanced lung cancer. This article will give a brief introduction to these updated parts.
8.Electromagnetic navigation bronchoscopy-guided preoperative localization of pulmonary nodules in 183 patients: A clinical analysis in a single center
Xiang CHEN ; Yajie ZHANG ; Dingpei HAN ; Hecheng LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(11):1539-1544
Objective To investigate the clinical efficacy of preoperative location of pulmonary nodules guided by electromagnetic navigation bronchoscopy (ENB). Methods Patients who received preoperative ENB localization and then underwent surgery from March 2021 to November 2022 in the Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were collected. The clinical efficacy and safety of ENB localization and the related factors that may affect the success of ENB localization were analyzed. Results Initially 200 patients were included, among whom 17 undergoing preoperative localization and biopsy were excluded and a total of 183 patients and 230 nodules were finally included. There were 62 males and 121 females with a mean age of 49.16±12.50 years. The success rate of navigation was 88.7%, and the success rate of ENB localization was 67.4%. The rate of complications related to ENB localization were 2.7%, and the median localization time was 10 (7, 15) min. Multi-variable analysis showed that factors related to successful localization included distance from localization site (OR=0.27, 95%CI 0.13-0.59, P=0.001), staining material (OR=0.40, 95%CI 0.17-0.95, P=0.038), and staining dose (OR=60.39, 95%CI 2.31-1 578.47, P=0.014). Conclusion ENB-guided preoperative localization of pulmonary nodules is safe and effective, and the incidence of complications is low, which can be used to effectively assist the diagnosis and treatment of early lung cancer.
9.Application of immunotherapy in malignant pleural mesothelioma
Xiang CHEN ; Yajie ZHANG ; Hecheng LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(07):935-938
In recent years, immune checkpoint inhibitor therapy has changed the treatment of various malignant tumors. Immunotherapy for specific targets currently plays an important role in melanoma, lung cancer and other tumors. Malignant pleural mesothelioma (MPM) is an aggressive malignant tumor. Although the treatments include surgery, chemotherapy and radiotherapy, the clinical efficacy is limited, and the prognosis of advanced patients is poor. With the application of monoclonal antibodies such as programmed death 1/programmed death ligand 1 and cytotoxic T-lymphocyte antigen 4, MPM patients have more treatment options. And compared with traditional chemotherapy, immunotherapy may have the effect of improving survival and shrinking tumors. This article will summarize the current clinical trials of immunotherapy in MPM, and explain the current application and progress of immunotherapy in MPM from both single-agent immunotherapy and combined immunotherapy.
10.Clinical application and research progress of uniportal video-assisted thoracoscopic anatomic segmentectomy
Yuxin JIA ; Jiahao ZHANG ; Xueyu CHEN ; Yajie ZHANG ; Hecheng LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(10):1376-1383
With the development of precision diagnosis and treatment of lung cancer, anatomical segmentectomy has become an important surgical procedure for the treatment of early-stage lung cancer. After the widespread popularization of video-assisted thoracoscopic surgery (VATS), the treatment of lung cancer has entered the era of minimally invasive surgery. Since it was first reported in 2012, uniportal video-assisted anatomical segmentectomy has gained increasing clinical application. Uniportal VATS is less invasive than thoracotomy and traditional VATS. At present, the main research hotspots around uniportal video-assisted anatomical segmentectomy include specific indications, short-term and long-term efficacy, and learning curve. This article will introduce the characteristics, indications and surgical techniques of this procedure, then summarize and discuss the latest research progress of uniportal video-assisted anatomical segmentectomy based on the latest evidence-based evidence.

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