1.Development and dissemination of precision medicine approaches in gastric cancer management.
Zhemin LI ; Jiafu JI ; Guoxin LI ; Ziyu LI ; Zhaode BU ; Xiangyu GAO ; Di DONG ; Lei TANG ; Xiaofang XING ; Shuqin JIA ; Ting GUO ; Lianhai ZHANG ; Fei SHAN ; Xin JI ; Anqiang WANG
Journal of Peking University(Health Sciences) 2025;57(5):864-867
Gastric cancer is a high-incidence malignancy that poses a serious threat to public health in China, ranking among the top three cancers in both incidence and mortality. The majority of patients are diagnosed at an advanced stage, resulting in limited treatment options and poor prognosis. To address key challenges in gastric cancer diagnosis and treatment, a research team led by Professor Jiafu Ji at Peking University Cancer Hospital has focused on the project "Development and Dissemination of Precision Medicine Approaches in Gastric Cancer Management". Through a series of high-quality multicenter clinical studies, the team established a set of new international standards in perioperative treatment, individua-lized drug selection, intelligent noninvasive diagnostics, and novel immunotherapy strategies. These advances have significantly improved treatment efficacy and reduced surgical trauma, achieving key technological breakthroughs in diagnosis, therapy, and mechanistic understanding, and systematically enhancing outcomes for gastric cancer patients. The project ' s findings had a broad international impact, including hosting China ' s first International Gastric Cancer Congress. Through nationwide dissemination, they have promoted the development of precision diagnosis and treatment of gastric cancer as a discipline, and led the formulation of the National Health Commission's guidelines for gastric cancer diagnosis and treatment. In recognition of its achievements, the project was awarded the First Prize of the 2024 Chinese Medical Science and Technology Award.
Stomach Neoplasms/genetics*
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Humans
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Precision Medicine/methods*
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China
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Immunotherapy/methods*
2.Comparative analysis of the efficacy of cold snare polypectomy and endoscopic mucosal resection in treatment of colonic adenoma in proximity to the orifice of appendix
Bin LIU ; Qinqin QI ; Xinglin CHEN ; Ke WEI ; Yuanyuan CAI ; Zhemin WANG ; Liuyong CHEN
China Journal of Endoscopy 2025;31(2):63-69
Objective To investigate the feasibility,efficacy and safety of cold snare polypectomy(CSP)and endoscopic mucosal resection(EMR)in treatment of colonic adenoma in proximity to the orifice of appendix.Methods Clinical data of 41 cases of colonic adenoma in the orifice of appendix treated with CSP(CSP group)and 15 cases treated with EMR(EMR group)from January 2018 to January 2023 were collected.The clinicopathological features and outcomes were analyzed.The main outcome was postoperative complications,including bleeding,perforation and postoperative appendicitis,while the secondary outcome was the total resection rate,block resection rate and local recurrence rate.Results The operation time and treatment cost of CSP group were shorter than EMR group,and the differences were statistically significant(P<0.05).The diameter of applicable lesions in CSP group was smaller than that in EMR group,and the proportion of lesions with tubular adenoma was significantly higher than that in EMR group.There were no significant differences in the time of admission,intestinal preparation score,length of stay,lesion morphology and lesion type between the two groups(P>0.05).Perforation and postoperative appendicitis were not observed in both groups,and delayed postoperative hemorrhage occurred in 1 case in the CSP group,but it could heal itself after surgery without endoscopic intervention.The complete resection rate was 100.0%in both groups.The total removal rate of CSP group was 100.0%,which was significantly higher than that of EMR group(86.7%),and the difference was statistically significant(P<0.05).The local recurrence rate was 2.4%(1/41)in CSP group,and no local recurrence was observed in EMR group(0/15),with no statistical significance(P>0.05).Conclusion CSP and EMR are safe and effective in the treatment of colonic adenoma in proximity to the orifice of appendix,and they are trustworthy.Compared with EMR,CSP is more applied to small diameter tubular adenomas,which has the characteristics of economy and time saving,but at the same time there is the risk of recurrence.EMR obviously has a wider application range,but there is a disadvantage in price and time,and individual cases need to be segmented resection.
3.Influencing factors of quality of life and their pathways of action in patients with cardiovascular disease
Junyan HE ; Dongdong WANG ; Zili QIN ; Minghui HUANG ; Yanyao JIA ; Zhemin MA ; Zhongmin TANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(2):138-145
Objective:To analyze the current status, influencing factors and action pathways of quality of life in patients with cardiovascular disease.Methods:From July 2023 to June 2024, a convenience sampling method was used to obtain 2 702 patients with cardiovascular disease from 9 hospitals in Guangxi Zhuang Autonomous Region.The general information questionnaires, item short form health survey, self-rating depression scale, self-rating anxiety scale, type D personality scale-14, and type A behavior pattern scale were used for investigation.SPSS 26.0 and AMOS 24.0 softwares were used for data statistical analysis.The current status of quality of life were analyzed through descriptive statistics, the influencing factors of quality of life were analyzed using multiple linear regression analysis models, and the relationship between statistical variables was analyzed through paths.Results:The overall quality of life score of patients with cardiovascular disease was (59.29±17.59).Compared with the domestic normal population norm, the 8 factors had statistically significant differences ( t=16.50-44.16, all P<0.001).The results of multiple regression analysis showed that age, marital status, low per capita monthly income, lack of exercise, irregular daily life, poor appetite, unhealthy diet, poor sleep quality, hypertension, coronary heart disease, chronic heart failure, heart valve disease, multiple types of medication taken daily, anxiety level, depression level, type D personality, and type A personality all had negative predictive effects on quality of life ( B=-0.862--0.205, all P<0.05).Demographic and life factors affected the quality of life through 4 paths, and their direct effect and indirect effect were -0.183, 0.224 respectively (there was a masking effect).Disease-related factors affected life through 2 paths, and its direct effect and indirect effect were -0.341, 0.255 respectively (there was a masking effect).Psychological factors directly and negatively affected the quality of life through one path, and its effect value was -0.651. Conclusion:The quality of life of patients with cardiovascular disease is generally at a moderate to low level.The factors that affect the quality of life of patients with cardiovascular disease produce effects through multiple pathways in a multi-combined state.
4.Influencing factors of quality of life and their pathways of action in patients with cardiovascular disease
Junyan HE ; Dongdong WANG ; Zili QIN ; Minghui HUANG ; Yanyao JIA ; Zhemin MA ; Zhongmin TANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(2):138-145
Objective:To analyze the current status, influencing factors and action pathways of quality of life in patients with cardiovascular disease.Methods:From July 2023 to June 2024, a convenience sampling method was used to obtain 2 702 patients with cardiovascular disease from 9 hospitals in Guangxi Zhuang Autonomous Region.The general information questionnaires, item short form health survey, self-rating depression scale, self-rating anxiety scale, type D personality scale-14, and type A behavior pattern scale were used for investigation.SPSS 26.0 and AMOS 24.0 softwares were used for data statistical analysis.The current status of quality of life were analyzed through descriptive statistics, the influencing factors of quality of life were analyzed using multiple linear regression analysis models, and the relationship between statistical variables was analyzed through paths.Results:The overall quality of life score of patients with cardiovascular disease was (59.29±17.59).Compared with the domestic normal population norm, the 8 factors had statistically significant differences ( t=16.50-44.16, all P<0.001).The results of multiple regression analysis showed that age, marital status, low per capita monthly income, lack of exercise, irregular daily life, poor appetite, unhealthy diet, poor sleep quality, hypertension, coronary heart disease, chronic heart failure, heart valve disease, multiple types of medication taken daily, anxiety level, depression level, type D personality, and type A personality all had negative predictive effects on quality of life ( B=-0.862--0.205, all P<0.05).Demographic and life factors affected the quality of life through 4 paths, and their direct effect and indirect effect were -0.183, 0.224 respectively (there was a masking effect).Disease-related factors affected life through 2 paths, and its direct effect and indirect effect were -0.341, 0.255 respectively (there was a masking effect).Psychological factors directly and negatively affected the quality of life through one path, and its effect value was -0.651. Conclusion:The quality of life of patients with cardiovascular disease is generally at a moderate to low level.The factors that affect the quality of life of patients with cardiovascular disease produce effects through multiple pathways in a multi-combined state.
5.Comparison of clinical efficacy of different mucosal incision methods in endoscopic submucosal dissection for the treatment of gastric submucosal tumors
Xinglin CHEN ; Ke WEI ; Yuanyuan CAI ; Qinqin QI ; Zhemin WANG ; Liuyong CHEN ; Bin LIU
China Journal of Endoscopy 2025;31(3):7-12
Objective To explore the clinical efficacy of different mucosal incision methods in endoscopic submucosal dissection(ESD)for the treatment of gastric submucosal tumors.Methods A retrospective analysis was conducted on the clinical data of 30 patients with gastric submucosal tumors treated with ESD from July 2022 to March 2024.They were divided into a circular group(n=15)and a longitudinal group(n=15)based on different mucosal incision methods.Then compare the pathological data,clinical efficacy,surgical outcomes,and complications between the two groups.Results There were no statistically significant differences between the two groups in length of hospital stay,hospitalization costs,lesion diameter,lesion location and lesion nature(P>0.05).The surgical time of the longitudinal group was significantly shorter than that of the circular group,and the difference was statistically significant(P<0.05);There was no statistical significant in the incidence of intraoperative complications in the longitudinal group and the circular group(P>0.05);The complete resection rate of the longitudinal group was lower than that of the circular group,but the difference was not statistically significant(P>0.05).Conclusion ESD treatment for gastric submucosal tumors is safe and effective,and the longitudinal incision can shorten the surgical time compared to the circular incision.Both methods have the characteristics of low incidence of complications and high complete resection rate,and are worthy of clinical application.
6.Comparison of clinical efficacy of different mucosal incision methods in endoscopic submucosal dissection for the treatment of gastric submucosal tumors
Xinglin CHEN ; Ke WEI ; Yuanyuan CAI ; Qinqin QI ; Zhemin WANG ; Liuyong CHEN ; Bin LIU
China Journal of Endoscopy 2025;31(3):7-12
Objective To explore the clinical efficacy of different mucosal incision methods in endoscopic submucosal dissection(ESD)for the treatment of gastric submucosal tumors.Methods A retrospective analysis was conducted on the clinical data of 30 patients with gastric submucosal tumors treated with ESD from July 2022 to March 2024.They were divided into a circular group(n=15)and a longitudinal group(n=15)based on different mucosal incision methods.Then compare the pathological data,clinical efficacy,surgical outcomes,and complications between the two groups.Results There were no statistically significant differences between the two groups in length of hospital stay,hospitalization costs,lesion diameter,lesion location and lesion nature(P>0.05).The surgical time of the longitudinal group was significantly shorter than that of the circular group,and the difference was statistically significant(P<0.05);There was no statistical significant in the incidence of intraoperative complications in the longitudinal group and the circular group(P>0.05);The complete resection rate of the longitudinal group was lower than that of the circular group,but the difference was not statistically significant(P>0.05).Conclusion ESD treatment for gastric submucosal tumors is safe and effective,and the longitudinal incision can shorten the surgical time compared to the circular incision.Both methods have the characteristics of low incidence of complications and high complete resection rate,and are worthy of clinical application.
7.Comparative analysis of the efficacy of cold snare polypectomy and endoscopic mucosal resection in treatment of colonic adenoma in proximity to the orifice of appendix
Bin LIU ; Qinqin QI ; Xinglin CHEN ; Ke WEI ; Yuanyuan CAI ; Zhemin WANG ; Liuyong CHEN
China Journal of Endoscopy 2025;31(2):63-69
Objective To investigate the feasibility,efficacy and safety of cold snare polypectomy(CSP)and endoscopic mucosal resection(EMR)in treatment of colonic adenoma in proximity to the orifice of appendix.Methods Clinical data of 41 cases of colonic adenoma in the orifice of appendix treated with CSP(CSP group)and 15 cases treated with EMR(EMR group)from January 2018 to January 2023 were collected.The clinicopathological features and outcomes were analyzed.The main outcome was postoperative complications,including bleeding,perforation and postoperative appendicitis,while the secondary outcome was the total resection rate,block resection rate and local recurrence rate.Results The operation time and treatment cost of CSP group were shorter than EMR group,and the differences were statistically significant(P<0.05).The diameter of applicable lesions in CSP group was smaller than that in EMR group,and the proportion of lesions with tubular adenoma was significantly higher than that in EMR group.There were no significant differences in the time of admission,intestinal preparation score,length of stay,lesion morphology and lesion type between the two groups(P>0.05).Perforation and postoperative appendicitis were not observed in both groups,and delayed postoperative hemorrhage occurred in 1 case in the CSP group,but it could heal itself after surgery without endoscopic intervention.The complete resection rate was 100.0%in both groups.The total removal rate of CSP group was 100.0%,which was significantly higher than that of EMR group(86.7%),and the difference was statistically significant(P<0.05).The local recurrence rate was 2.4%(1/41)in CSP group,and no local recurrence was observed in EMR group(0/15),with no statistical significance(P>0.05).Conclusion CSP and EMR are safe and effective in the treatment of colonic adenoma in proximity to the orifice of appendix,and they are trustworthy.Compared with EMR,CSP is more applied to small diameter tubular adenomas,which has the characteristics of economy and time saving,but at the same time there is the risk of recurrence.EMR obviously has a wider application range,but there is a disadvantage in price and time,and individual cases need to be segmented resection.
8.Effect analysis of arthroscopic acromioplasty in the treatment of subacromial impingement syndrome
Ao LI ; Zhemin WANG ; Qin WANG ; Shuan LIU
Journal of Clinical Surgery 2024;32(12):1310-1313
Objective To analyze the effect of arthroscopic acromioplasty on subacromial impingement syndrome.Methods 100 SIS patients admitted to our joint surgery department from August 2018 to August 2022 were selected as the observation group,all of whom underwent shoulder arthroscopic acromioplasty.Additionally,100 patients who underwent conservative treatment during the same period were selected as the control group.Compare the University of California Shoulder Score(UCLA),American Association of Shoulder and Elbow Surgeons Score(ASES),Fudan University Shoulder Function Score(FUSS),incidence of complications,and short-term efficacy between the control and observation groups at different times before and after surgery in the observation group.Results All patients will undergo a follow-up period of 12 months.The incidence of postoperative complications in the observation group was relatively low;The short-term efficacy of the observation group was significantly higher than that of the control group(P<0.05);At 1 month,6 months,and 12 months after surgery,the UCLA,ASES,and FUSS scores of the observation group patients were significantly higher than the preoperative scores of the above indicators(P<0.05).Conclusion Arthroscopic acromioplasty in the treatment of subacromial impingement syndrome has a good short-term effect.
9.Efficacy of Endoscopic Mucosal Resection in Treatment of Colonic Diverticulum Adenoma
Bin LIU ; Xinglin CHEN ; Qinqin QI ; Yuanyuan CAI ; Ke WEI ; Zhemin WANG ; Liuyong CHEN
Chinese Journal of Gastroenterology 2024;29(1):36-39
Background:When colonic adenoma involves diverticulum,inflammation in the diverticulum will increase the risk of adenomatous dysplasia.Therefore,patients with colonic diverticulum adenoma are at a higher risk of colon cancer,and the adenoma needs to be resected to avoid poor outcome and improve prognosis.Aims:To explore the efficacy and safety of endoscopic mucosal resection(EMR)in treatment of colonic diverticulum adenoma.Methods:Fourteen consecutive cases of colonic adenoma near or involving a diverticulum treated by EMR from Jun.2018 to Jan.2022 at the First People's Hospital of Hangzhou Lin'an District were collected,and their clinical characteristics and outcomes were analyzed.The primary outcome was complications,including bleeding,perforation,and electrocoagulation syndrome,while the secondary outcomes were the en bloc resection rate,complete resection rate and local recurrence rate.Results:Among the 14 patients with colonic diverticulum adenoma,13 were type A(near a diverticulum)while 1 was type B(involving a diverticulum).The diameter of the lesion was(0.76±0.25)cm,and the operation time was(19.67±5.33)minutes.The main histological type was tubular adenoma,and the pathological results was intraepithelial neoplasia in most of the cases.Delayed hemorrhage was observed in 1 patient(7.1%),and electrocoagulation syndrome in 1 patient(7.1%).No perforation event occurred.The en bloc resection rate and complete resection rate were 100%.Ten patients accepted reexamination of colonoscopy within 1 year after surgery,and no local recurrence was found.Conclusions:EMR is safe and effective for treatment of colonic diverticulum adenoma.However,patients using antiplatelet drugs and adenoma involving both appendiceal orifice and diverticulum should be alert to postoperative complications.
10.Treatment methods for patients with gastric cancer liver metastasis and prognostic factors analysis
Zijian JIANG ; Kan XUE ; Fei SHAN ; Yan ZHANG ; Hongmei DAI ; Zhouqiao WU ; Zhemin LI ; Yinkui WANG ; Ziyu LI ; Jiafu JI
Chinese Journal of Digestive Surgery 2024;23(12):1511-1517
Objective:To investigate the treatment methods for patients with gastric cancer liver metastasis and prognostic factors.Methods:The retrospective cohort study was conducted. The clinicopathological data of 282 patients with gastric cancer liver metastasis who were admitted to Peking University Cancer Hospital from January 1st,2010 to January 1st,2020 were collected. There were 237 males and 45 females, aged (66±10)years. Of the 282 patients, there were 94 cases with liver oligometastasis and 188 cases with liver multiple metastases. Patients underwent surgical treatment, systemic treatment or local treatment based on the individual condition. Observation indicators: (1) treatment methods for patients with gastric cancer liver metastasis; (2) follow-up and prognosis of patients with gastric cancer liver metastasis; (3) prognostic factors analysis in patients with gastric cancer liver metastasis. Comparison of count data between groups was conducted using the chi-square test. Comparison of ordinal data was conducted using the nonparameter rank sum test. The univariate analysis was conducted using the log-rank test. The multivariate analysis was conducted using the Cox proportional hazards regression model, and relevant variables were screened through stepwise regression forward method. The Kaplan-Meier method was used to calculate survival rate and plot survival curve, and the log-rank test was used for survival analysis.Results:(1) Treat-ment methods for patients with gastric cancer liver metastasis. There were significant differences in surgical treatment methods, hepatic artery infusion chemotherapy, and radiofrequency ablation between the 94 patients with gastric cancer liver oligometastasis and the 188 patients with gastric cancer liver multiple metastases ( χ2=21.97, 6.04, 8.78, P<0.05). (2) Follow-up and prognosis of patients with gastric cancer liver metastasis. All 282 patients with gastric cancer liver metastasis were followed up for 781(range, 3-4 100)days, and the 1-, 3-, 5-year overall survival rates were 61.0%, 19.5%, 11.0%, respectively. The overall survival time and 1-, 3-, 5-year overall survival rates were 659(range, 549-769)days and 69.1%, 30.9%, 18.1% in patients with gastric cancer liver oligometastasis, versus 519(range, 451-587)days and 56.9%, 13.8%, 7.4% in patients with gastric cancer liver multiple metastases, showing a significant difference in survival situations between them ( χ2=8.45, P<0.05).(3) Prognostic factors analysis in patients with gastric cancer liver metastasis. Results of multi-variate analysis showed that Eastern Cooperative Oncology Group (ECOG) score, surgical treatment methods, chemotherapy, targeted therapy, radiofrequency ablation were all independent factors affecting prognosis of patients with gastric cancer liver metastasis ( odds ratio=3.68, 0.82, 0.58, 0.64, 0.52, 95% confidence interval as 1.85-7.33, 0.67-1.00, 0.40-0.86, 0.44-0.92, 0.30-0.90, P<0.05). Conclusions:The treatment methods for patients with gastric cancer liver oligometastasis and multiple liver metastases are different, with the former mostly using surgical treatment and the latter mostly using non-surgical treatment. Patients with gastric cancer liver oligometastasis have better prognosis than patients with multiple liver metastases. ECOG score, surgical treatment methods, chemo-therapy, targeted therapy, radiofrequency ablation are independent factors affecting prognosis of patients with gastric cancer liver metastasis.

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