1.Mechanisms and Molecular Networks of Hypoxia-regulated Tumor Cell Dormancy
Mao ZHAO ; Jin-Qiu FENG ; Ze-Qi GAO ; Ping WANG ; Jia FU
Progress in Biochemistry and Biophysics 2025;52(9):2267-2279
Dormant tumor cells constitute a population of cancer cells that reside in a non-proliferative or low-proliferative state, typically arrested in the G0/G1 phase and exhibiting minimal mitotic activity. These cells are commonly observed across multiple cancer types, including breast, lung, and ovarian cancers, and represent a central cellular component of minimal residual disease (MRD) following surgical resection of the primary tumor. Dormant cells are closely associated with long-term clinical latency and late-stage relapse. Due to their quiescent nature, dormant cells are intrinsically resistant to conventional therapies—such as chemotherapy and radiotherapy—that preferentially target rapidly dividing cells. In addition, they display enhanced anti-apoptotic capacity and immune evasion, rendering them particularly difficult to eradicate. More critically, in response to microenvironmental changes or activation of specific signaling pathways, dormant cells can re-enter the cell cycle and initiate metastatic outgrowth or tumor recurrence. This ability to escape dormancy underscores their clinical threat and positions their effective detection and elimination as a major challenge in contemporary cancer treatment. Hypoxia, a hallmark of the solid tumor microenvironment, has been widely recognized as a potent inducer of tumor cell dormancy. However, the molecular mechanisms by which tumor cells sense and respond to hypoxic stress—initiating the transition into dormancy—remain poorly defined. In particular, the lack of a systems-level understanding of the dynamic and multifactorial regulatory landscape has impeded the identification of actionable targets and constrained the development of effective therapeutic strategies. Accumulating evidence indicates that hypoxia-induced dormancy tumor cells are accompanied by a suite of adaptive phenotypes, including cell cycle arrest, global suppression of protein synthesis, metabolic reprogramming, autophagy activation, resistance to apoptosis, immune evasion, and therapy tolerance. These changes are orchestrated by multiple converging signaling pathways—such as PI3K-AKT-mTOR, Ras-Raf-MEK-ERK, and AMPK—that together constitute a highly dynamic and interconnected regulatory network. While individual pathways have been studied in depth, most investigations remain reductionist and fail to capture the temporal progression and network-level coordination underlying dormancy transitions. Systems biology offers a powerful framework to address this complexity. By integrating high-throughput multi-omics data—such as transcriptomics and proteomics—researchers can reconstruct global regulatory networks encompassing the key signaling axes involved in dormancy regulation. These networks facilitate the identification of core regulatory modules and elucidate functional interactions among key effectors. When combined with dynamic modeling approaches—such as ordinary differential equations—these frameworks enable the simulation of temporal behaviors of critical signaling nodes, including phosphorylated AMPK (p-AMPK), phosphorylated S6 (p-S6), and the p38/ERK activity ratio, providing insights into how their dynamic changes govern transitions between proliferation and dormancy. Beyond mapping trajectories from proliferation to dormancy and from shallow to deep dormancy, such dynamic regulatory models support topological analyses to identify central hubs and molecular switches. Key factors—such as NR2F1, mTORC1, ULK1, HIF-1α, and DYRK1A—have emerged as pivotal nodes within these networks and represent promising therapeutic targets. Constructing an integrative, systems-level regulatory framework—anchored in multi-pathway coordination, omics-layer integration, and dynamic modeling—is thus essential for decoding the architecture and progression of tumor dormancy. Such a framework not only advances mechanistic understanding but also lays the foundation for precision therapies targeting dormant tumor cells during the MRD phase, addressing a critical unmet need in cancer management.
2.Clinical Results of Implantation of Subcutaneous Implantable Cardioverter Defibrillator After Transvenous Lead Extraction
Cuizhen YUAN ; Feng ZE ; Ding LI ; Jiangbo DUAN ; Cuncao WU ; Jinshan HE ; Xu ZHOU ; Long WANG ; Xuebin LI
Chinese Circulation Journal 2024;39(8):781-784
Objectives:To evaluate the safety and efficacy of implantation of subcutaneous implantable cardioverter defibrillator(S-ICD)after transvenous lead extraction(TLE)in ICD patients without pacing indications. Methods:All patients who underwent TLE at Peking University People's Hospital from June 2018 to October 2023 were consecutively included.TLE indication,S-ICD implantation indication,defibrillation threshold(DFT)test,complications and postoperative follow-up were collected and analyzed. Results:A total of 11 patients with TV-ICD underwent S-ICD implantation after TLE,eight patients were males and median age were 56(44,65)years.The indications for TLE were infection and lead dysfunction.Nine patients were implanted with S-ICD for secondary prevention,and the most common cause of implantation was ion channelopathies(5 cases).The operative time for S-ICD was 51(48,58)minutes and no perioperative complications were noted.Eight patients underwent DFT testing,and 100%were successful.During a median follow up of 30(9,39)months,a total of six appropriate treatments occurred in two patients,and no complications occurred,including inappropriate treatment,ineffective treatment,infection,lead malfunction and death. Conclusions:Our study provides evidence for S-ICD implantation as a replacement after TV-ICD removal.The S-ICD implantation after TLE is safe and effective.
3.Analysis of Clinical Characteristics and Lead Extraction in Patients With Venous Occlusion Related to Infection of Cardiovascular Implantable Electronic Devices
Wenqiong ZHANG ; Feng ZE ; Ding LI ; Cuncao WU ; Xu ZHOU ; Yi WEI ; Xuebin LI
Chinese Circulation Journal 2024;39(9):859-864
Objectives:To assess the clinical characteristics and lead extraction in patients with venous occlusion related to infection of cardiovascular implantable electronic devices. Methods:Clinical data of 405 patients(147 men,mean age[62.4±13.2]years)who underwent lead extraction from January 2020 to January 2024 in Peking University People's Hospital were reviewed.Contrast venography of the access vein was retrospectively analyzed.The patients were divided into venous occlusion group(n=119)and non-venous occlusion group(n=286)according to the presence or absence of venous occlusion.The clinical characteristics and lead extraction of patients in two groups were analyzed. Results:Occlusion of the access vein occurred in 119 patients(29.4%).The subclavian vein was occluded in 48 cases(40.3%),brachiocephalic vein was occluded in 37 cases(31.1%),axillary vein was occluded in 30 cases(25.2%),superior vena cava was occluded in 4 cases(3.4%).There were no significant differences between venous occlusion group and non-venous occlusion group in terms of age,sex,device type,number of leads,or anticoagulation therapy(all P>0.05).Time from implant of the initial leads was significantly longer in the venous occlusion group than in the non-venous occlusion group([10.4±3.8]years vs.[5.9±4.1]years,P=0.042).Clinical extraction success rate and complications were similar between the venous occlusion group and the non-venous occlusion group(both P>0.05).Procedural duration and fluoroscopy exposure time were significantly lower in non-venous occlusion group than in the venous occlusion group(both P<0.05).Patients in the venous occlusion group required more advanced tools(such as laser sheaths,evolution sheaths,and needle's eye snares)for lead extraction compared to patients in the non-venous occlusion group(84.0%vs.67.1%,P=0.001). Conclusions:The incidence of venous occlusion related to infection of cardiovascular implantable electronic devices is 29.4%.Time from implant of the initial leads is significantly longer and lead extraction is more difficult in patients with venous occlusion,and requires more advanced tools and more time to achieve the successful lead extraction.
4.Effects of Reimplantation of Biventricular Cardiac Resynchronization Therapy Devices After Removal of Coronary Sinus Left Ventricular Leads due to Infections
Cuizhen YUAN ; Feng ZE ; Ding LI ; Jiangbo DUAN ; Cuncao WU ; Dandan YANG ; Xuebin LI
Chinese Circulation Journal 2024;39(11):1098-1102
Objectives:To evaluate the strategy and clinical outcomes of reimplanting biventricular cardiac resynchronization therapy (Biv-CRT) devices after transvenous removal of coronary sinus left ventricular leads due to device-related infections. Methods:A retrospective analysis was conducted on the clinical data and surgical outcomes of all patients who underwent transvenous removal of infectious coronary sinus left ventricular leads and subsequent reimplantation of Biv-CRT devices at Peking University People's Hospital from January 2013 to December 2022.Follow-up was performed to assess the incidence of complications and all-cause mortality. Results:A total of 167 patients underwent coronary sinus left ventricular lead removal due to infection,removal was successful in 161 cases (96.4%) and failed in 6 cases (3.6%).Among the patients with successful removal,109 cases (67.7%) were scheduled for Biv-CRT device reimplantation.After a median time of 7 (5,7) days,6 cases (5.5%) of reimplantation failed,while 103 reimplantations (94.5%) were successful.Among these successful reimplantation cases,102 patients (99.0%) were through the right-side approach,and 1 case (1.0%) through the left-side approach due to bilateral pocket infections.Of the 161 patients with successful removal,58 cases (36.0%) did not undergo left ventricular lead reimplantation,including 39 cases (24.2%) where the initial indications for Biv-CRT were questionable or had resolved.During the one-year postoperative follow-up,among the 103 patients who had undergone Biv-CRT device reimplantation,7 patients (6.8%) died,1 patient (1.0%) experienced pocket infection,and 1 patient (1.0%) had right atrial lead dislodgment. Conclusions:Reimplantation of Biv-CRT devices after removal of coronary sinus left ventricular leads due to infections is feasible,with a high success rate,low complication rate,and low mortality rate for right-side approach implantation.Therefore,for patients re-evaluated to have indications for repeated Biv-CRT after lead removal,right-side reimplantation of the coronary sinus left ventricular lead should be recommended.
5.Application value of ultrasound technology in transurethral enucleation and resection of the prostate
Yu XIONG ; Feng-Feng LU ; Qi JIANG ; Zhen-Qian SONG ; Xiao-Feng ZHU ; Ze-Peng ZHU ; Zhi-Feng WEI ; Ai-Bing YAO
National Journal of Andrology 2024;30(4):300-305
Objective:To investigate the application value of ultrasound technology in transurethral enucleation and resection of the prostate(TUERP).Methods:This study included 78 BPH patients admitted in our hospital from June 2021 to June 2023,aged 70.68±8.63 years and with the indication of surgery.We randomly divided them into two groups to receive TUERP(the control group,n=39)and ultrasound-assisted TUERP(the US-TUERP group,n=39).We statistically analyzed and compared the rele-vant parameters obtained before and after operation between the two groups.Results:No statistically significant differences were ob-served in the operation time and bladder irrigation time between the two groups(P>0.05).More glandular tissues were removed but less intraoperative bleeding and fewer perioperative complications occurred in the US-TUERP group than in the control.Compared with the baseline,IPSS,postvoid residual urine volume(PVR),quality of life score(QOL)and maximum urinary flow rate(Qmax)were significantly improved in both groups at 1 and 3 months after surgery,even more significantly in the US-TUERP than in the control group(P<0.05).Conclusion:US-TUERP helps achieve complete resection of the hyperplastic prostatic tissue along the surgical capsule at the anatomical level,with a higher safety,fewer perioperative complications,and better therapeutic effects.
6.Application of China-made Toumai? Robot in laparoscopic radical prostatectomy
Zhi-Feng WEI ; Yu-Hao CHEN ; Ze-Peng ZHU ; Qi JIANG ; Yu XIONG ; Feng-Feng LU ; Zhen-Qian SONG ; Bin JIANG ; Xiao-Feng ZHU ; Tian-Hao FENG ; Xiao-Feng XU ; Gang YANG ; Wu WEI ; Ai-Bing YAO ; Jing-Ping GE
National Journal of Andrology 2024;30(8):696-700
Objective:To evaluate the safety and efficiency of China-made Toumai Robot-assisted laparoscopic radical prosta-tectomy(LRP).Methods:This study included 40 cases of PCa treated from January 2023 to May 2023 by robot-assisted LRP with preservation of the bladder neck and maximal functional urethral length,15 cases with the assistance of Toumai Robot(the TMR group)and the other 25 with the assistance of da Vinci Robot as controls(the DVR group).We recorded the docking time,laparo-scopic surgery time,vesico-urethral anastomosis time,intraoperative blood loss and postoperative urinary continence,and compared them between the two groups.Results:Operations were successfully completed in all the cases.No statistically significant differ-ences were observed between the TMR and DVR groups in the docking time(6 min vs 5 min,P>0.05)or intraoperative blood loss(200 ml vs 150 ml,P>0.05).The TMR group,compared with the DVR group,showed a significantly longer median laparoscopic surgery time(146 min vs 130 min,P<0.05)and median vesico-urethral anastomosis time(19 min vs 16 min,P<0.05).There were no statistically significant differences between the TMR and DVR groups in the rates of urinary continence recovery immediately af-ter surgery(60.0%[9/15]vs 64.0%[16/25],P>0.05)or at 1 month(80.0%[12/15])vs(76.0%[19/25],P>0.05),3 months(93.3%[14/15])vs(92.0%[23/25],P>0.05)and 6 months postoperatively(100%[15/15])vs(96%[24/25],P>0.05).Conclusion:China-made Toumai? Robot surgical system is safe and reliable for laparoscopic radical prosta-tectomy,with satisfactory postoperative recovery of urinary continence.
7.Analysis of prognostic factors in patients with resectable gastric cancer with vascular cancer thrombus
Ze-Feng YANG ; Xiang-Yu CHENG ; Hong-Mei YU ; Yu-Sheng WANG
Modern Interventional Diagnosis and Treatment in Gastroenterology 2024;29(2):151-157
Objective To explore the factors influencing the prognosis of patients with Resectable gastric adenocarcinoma with vascular cancer thrombus(RGAVCT)and to develop a relevant columnar graphic prognostic model.Methods Clinicopathologic data of 530 patients with gastric adenocarcinoma combined with vascular cancer embolization who underwent radical gastrectomy for gastric cancer at the Affiliated Cancer Hospital of Shanxi Medical University were retrospectively collected from January 2017 to January 2022,and were randomly assigned to the training cohort and the validation cohort in a 7∶3 ratio.Kaplan-Meier curves and Log-rank test and multifactorial Cox regression were used to analyze the risk factors for death in the training cohort patients,and to construct Nomogram Model for the probability of survival at 1,2,and 4 years in RGAVCT patients.ROC curves were used to analyze the efficacy of the Nomogram model in the training cohort and validation cohort patients.Results Age,postoperative chemotherapy,tumor size,Ki67 expression status,T-stage,N-stage,and clinical stage of patients in the training cohort were the influencing factors on survival(OS)of patients with RGAVCT(P<0.05);postoperative chemotherapy(P<0.001,HR=0.302,95%CI:0.219-0.418),T-stage[T3(P=0.015,HR=11.782,95%CI:1.628-85.283),T4a+4b(P=0.005,HR=17.219,95%CI:2.343-126.559)],N staging[N2(P=0.309,HR=1.310,95%CI:0.779-2.201)N3a(P=0.001,HR=2.268,95%CI:1.407-3.657),N3b(P<0.001,HR=2.836,95%CI:1.708-4.709)]were independent influences on OS in patients with RGAVCT.Cox regression results were used to develop nomogram models for predicting the probability of patients'survival at 1,2,and 4 years after surgery.The AUROC area and C index were>0.7 for the training cohort and>0.67 for the validation cohort.Conclusion In this study,we developed a nomogram model of 1-,2-,and 4-year postoperative survival probabilities of RGAVCT patients,which can better predict the postoperative survival of RGAVCT patients.
8.Advances in actuation technology of wearable exoskeletons
Yi-Fei PENG ; Hua-Jun WANG ; Ze-Feng WANG ; PEYRODIE LAURENT ; Zhao ZHANG ; Xia HAN
Chinese Medical Equipment Journal 2024;45(4):104-110
The research status of the actuation technology of wearable exoskeletons was introduced.Kinds of actuation technologies and actuators were analyzed in terms of advantage,disadvantage and applicable scenario.It's pointed out the actuation technology of wearable exoskeletons should be oriented to high-performance micro-motors,new actuators,actuation modularity and intellectualization.[Chinese Medical Equipment Journal,2024,45(4):104-110]
9.Maintenance and improvement program for WYD2000 field surgical lamp
Ming-Ming ZHU ; Ji-Su CAO ; Ze-Rui ZHANG ; Jiang-Hui HAO ; Rui-Zhe WANG ; Feng ZHOU ; Lu-Chuan XUN
Chinese Medical Equipment Journal 2024;45(4):116-118
The steps for installation and withdrawal of WYD2000 field surgical lamp were introduced.The failures and causes of broken cross-arm connector of WYD2000 field surgical lamp were analyzed.The problems of WYD2000 field surgical lamp in vulnerability to breaking and difficulty in maintenance were solved by designing and manufacturing a special maintenance tool and optimizing the materials and fixing mode of cross-arm connection.References were provided for main-tenance and improvement of WYD2000 field surgical lamp.[Chinese Medical Equipment Journal,2024,45(4):116-118]
10.Research status of hand rehabilitation robots
Ge-Ge ZHANG ; Lian-Xin HU ; Ze-Feng WANG ; Shi-Jia HU ; Dan WANG ; Xin-Xin NI ; Hua-Jun WANG ; Shan-Qi GU
Chinese Medical Equipment Journal 2024;45(11):88-96
The current research status of different structures,driving modes and training modes of hand rehabilitation robots at home and abroad was introduced.The disadvantages of the existing hand rehabilitation robots were analyzed.It's pointed out hand rehabilitation robots in the future would involve in the combination of rigid and flexible wearing,new intelligent driving mode and multi-mode rehabilitation training.[Chinese Medical Equipment Journal,2024,45(11):88-96]

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