1.Research progress of nano drug delivery system based on metal-polyphenol network for the diagnosis and treatment of inflammatory diseases
Meng-jie ZHAO ; Xia-li ZHU ; Yi-jing LI ; Zi-ang WANG ; Yun-long ZHAO ; Gao-jian WEI ; Yu CHEN ; Sheng-nan HUANG
Acta Pharmaceutica Sinica 2025;60(2):323-336
Inflammatory diseases (IDs) are a general term of diseases characterized by chronic inflammation as the primary pathogenetic mechanism, which seriously affect the quality of patient′s life and cause significant social and medical burden. Current drugs for IDs include nonsteroidal anti-inflammatory drugs, corticosteroids, immunomodulators, biologics, and antioxidants, but these drugs may cause gastrointestinal side effects, induce or worsen infections, and cause non-response or intolerance. Given the outstanding performance of metal polyphenol network (MPN) in the fields of drug delivery, biomedical imaging, and catalytic therapy, its application in the diagnosis and treatment of IDs has attracted much attention and significant progress has been made. In this paper, we first provide an overview of the types of IDs and their generating mechanisms, then sort out and summarize the different forms of MPN in recent years, and finally discuss in detail the characteristics of MPN and their latest research progress in the diagnosis and treatment of IDs. This research may provide useful references for scientific research and clinical practice in the related fields.
2.Expert consensus on the assessment and rehabilitation management of speech disorders following oral and maxillofacial tumor surgery
Xiaoying LI ; Moyi SUN ; Wei GUO ; Zhangui TANG ; Longjiang LI ; Guoxin REN ; Zhijun SUN ; Wei SHANG ; Jie ZHANG ; Jian MENG ; Jichen LI ; Kai YANG ; Yue HE ; Chunjie LI ; Lizheng QIN ; Bo LI ; Wei WU ; Qinlong LI-ANG ; Qianwei NI ; Jianhu LI ; Xiangming YANG ; Xiaoyan ZHOU ; Fan YANG ; Jiacun LI ; Tao GAO
Journal of Practical Stomatology 2025;41(1):5-15
The advancement of surgical techniques enables effective treatment for many patients with oral and maxillofacial tumors.How-ever,post-surgery problems such as chewing,swallowing and speech difficulty may arise due to the defects in speech organs and inade-quate compensatory function of tissue flap repair.Speech disorders,in particular,isolate patients by making it difficult for them to com-municate with others,not only impact their quality of life but also potentially lead to psychological problems and social interaction disor-ders.Although the decline in life quality and other related issues caused by speech dysfunction due to surgery and radiotherapy or chemo-therapy have been widely recognized,there is currently no standardized and universally applicable assessment method and standardized re-habilitation treatment management guideline or consensus for speech disorders following oral and maxillofacial tumor surgery at home and abroad.Based on previous clinical practice,combined with the characteristics of speech disorders in patients after oral and maxillofacial tumor surgery,the clinical experience of the experts in maxillofacial tumor surgery and rehabilitation and the relevant domestic and foreign literature,relevant experts organized discussions and modifications,reach a consensus on core content such as the assessment of speech disorders and the implementation plan for early rehabilitation treatment management,providing a reference for clinical practice,in order to improve patients'speech-related life quality and enhance the assessment and rehabilitation treatment techniques for speech disorders after oral and maxillofacial tumor surgery.
3.Advances in circulating biomarkers for early diagnosis of alpha-fetoprotein-negative hepatocellular carcinoma
Ang LIU ; Xin SU ; Jian LI ; Xiao XU ; Changchun ZHAO ; Xiangyong HAO
Chinese Journal of General Surgery 2025;34(1):150-159
Hepatocellular carcinoma(HCC)is the most common type of liver cancer and a leading cause of cancer-related deaths worldwide.While early detection significantly improves prognosis,patients with alpha-fetoprotein-negative hepatocellular carcinoma(ANHCC)often face diagnostic challenges due to the lack of reliable biomarkers.This review systematically explores the potential of various circulating biomarkers in the early diagnosis of ANHCC,including AFP-L3,PIVKA-Ⅱ,lymphocyte-to-monocyte ratio,exosomes,circulating cell-free DNA(cfDNA),circulating tumor cells,osteopontin,paraoxonase 1,autoantibodies,and RNA-related biomarkers.The combined use of these markers,particularly AFP-L3 and PIVKA-Ⅱ,demonstrates enhanced diagnostic accuracy and specificity compared to single markers.Emerging evidence also highlights the diagnostic potential of exosomes,cfDNA,and RNA markers due to their non-invasive nature and high stability.Despite promising results,further large-scale,multicenter studies are needed to validate these findings,address challenges such as standardization of detection methods,and elucidate underlying mechanisms.These advances are anticipated to significantly improve early detection and personalized management of ANHCC.
4.Bedside transesophageal echocardiography-guided atrial septostomy under extracorporeal membrane oxygenation support
Ang LIU ; Ke WANG ; Fu-jian DUAN ; Wen-ying KANG ; Jun-song GONG ; PINGCUO-YUNDAN ; Chao-wu YAN
Chinese Journal of Interventional Cardiology 2025;33(4):189-194
Objective To investigate the feasibility and safety of bedside transesophageal echocardiography(TEE)-guided atrial septostomy in patients undergoing extracorporeal membrane oxygenation(ECMO)support.Methods Eight patients(2 females and 6 males)who developed pulmonary edema during VA-ECMO treatment between January 2020 and October 2024 were enrolled.All patients underwent bedside TEE-guided atrial septal puncture,followed by gradual balloon dilation using an Inoue balloon(diameter:18-24 mm).The endpoint for dilation was defined as mean left atrial pressure<15 mmHg.Post-procedure evaluation included assessment of the septal defect size,mean left atrial pressure,and improvement in bilateral pulmonary edema.Results The mean age of all 8 patients was(43.50±16.84)years old.Atrial septostomy was successfully performed in all patients.The mean balloon dilation diameter was(22.75±2.68)mm,resulting in a mean septal defect size of(6.31±0.37)mm.The mean left atrial pressure significantly decreased from(26.63±1.77)mmHg pre-procedure to(12.75±1.28)mmHg post-procedure(P<0.001).All patients demonstrated marked improvement in bilateral pulmonary edema,and six patients also showed a significant reduction in the severity of mitral regurgitation following the procedure.No procedure-related complications were observed.Conclusions Bedside TEE-guided atrial septostomy is safe and effective for reducing left heart loading during ECMO support and improving pulmonary edema.
5.Bedside transesophageal echocardiography-guided atrial septostomy under extracorporeal membrane oxygenation support
Ang LIU ; Ke WANG ; Fu-jian DUAN ; Wen-ying KANG ; Jun-song GONG ; PINGCUO-YUNDAN ; Chao-wu YAN
Chinese Journal of Interventional Cardiology 2025;33(4):189-194
Objective To investigate the feasibility and safety of bedside transesophageal echocardiography(TEE)-guided atrial septostomy in patients undergoing extracorporeal membrane oxygenation(ECMO)support.Methods Eight patients(2 females and 6 males)who developed pulmonary edema during VA-ECMO treatment between January 2020 and October 2024 were enrolled.All patients underwent bedside TEE-guided atrial septal puncture,followed by gradual balloon dilation using an Inoue balloon(diameter:18-24 mm).The endpoint for dilation was defined as mean left atrial pressure<15 mmHg.Post-procedure evaluation included assessment of the septal defect size,mean left atrial pressure,and improvement in bilateral pulmonary edema.Results The mean age of all 8 patients was(43.50±16.84)years old.Atrial septostomy was successfully performed in all patients.The mean balloon dilation diameter was(22.75±2.68)mm,resulting in a mean septal defect size of(6.31±0.37)mm.The mean left atrial pressure significantly decreased from(26.63±1.77)mmHg pre-procedure to(12.75±1.28)mmHg post-procedure(P<0.001).All patients demonstrated marked improvement in bilateral pulmonary edema,and six patients also showed a significant reduction in the severity of mitral regurgitation following the procedure.No procedure-related complications were observed.Conclusions Bedside TEE-guided atrial septostomy is safe and effective for reducing left heart loading during ECMO support and improving pulmonary edema.
6.Expert consensus on the assessment and rehabilitation management of speech disorders following oral and maxillofacial tumor surgery
Xiaoying LI ; Moyi SUN ; Wei GUO ; Zhangui TANG ; Longjiang LI ; Guoxin REN ; Zhijun SUN ; Wei SHANG ; Jie ZHANG ; Jian MENG ; Jichen LI ; Kai YANG ; Yue HE ; Chunjie LI ; Lizheng QIN ; Bo LI ; Wei WU ; Qinlong LI-ANG ; Qianwei NI ; Jianhu LI ; Xiangming YANG ; Xiaoyan ZHOU ; Fan YANG ; Jiacun LI ; Tao GAO
Journal of Practical Stomatology 2025;41(1):5-15
The advancement of surgical techniques enables effective treatment for many patients with oral and maxillofacial tumors.How-ever,post-surgery problems such as chewing,swallowing and speech difficulty may arise due to the defects in speech organs and inade-quate compensatory function of tissue flap repair.Speech disorders,in particular,isolate patients by making it difficult for them to com-municate with others,not only impact their quality of life but also potentially lead to psychological problems and social interaction disor-ders.Although the decline in life quality and other related issues caused by speech dysfunction due to surgery and radiotherapy or chemo-therapy have been widely recognized,there is currently no standardized and universally applicable assessment method and standardized re-habilitation treatment management guideline or consensus for speech disorders following oral and maxillofacial tumor surgery at home and abroad.Based on previous clinical practice,combined with the characteristics of speech disorders in patients after oral and maxillofacial tumor surgery,the clinical experience of the experts in maxillofacial tumor surgery and rehabilitation and the relevant domestic and foreign literature,relevant experts organized discussions and modifications,reach a consensus on core content such as the assessment of speech disorders and the implementation plan for early rehabilitation treatment management,providing a reference for clinical practice,in order to improve patients'speech-related life quality and enhance the assessment and rehabilitation treatment techniques for speech disorders after oral and maxillofacial tumor surgery.
7.Advances in circulating biomarkers for early diagnosis of alpha-fetoprotein-negative hepatocellular carcinoma
Ang LIU ; Xin SU ; Jian LI ; Xiao XU ; Changchun ZHAO ; Xiangyong HAO
Chinese Journal of General Surgery 2025;34(1):150-159
Hepatocellular carcinoma(HCC)is the most common type of liver cancer and a leading cause of cancer-related deaths worldwide.While early detection significantly improves prognosis,patients with alpha-fetoprotein-negative hepatocellular carcinoma(ANHCC)often face diagnostic challenges due to the lack of reliable biomarkers.This review systematically explores the potential of various circulating biomarkers in the early diagnosis of ANHCC,including AFP-L3,PIVKA-Ⅱ,lymphocyte-to-monocyte ratio,exosomes,circulating cell-free DNA(cfDNA),circulating tumor cells,osteopontin,paraoxonase 1,autoantibodies,and RNA-related biomarkers.The combined use of these markers,particularly AFP-L3 and PIVKA-Ⅱ,demonstrates enhanced diagnostic accuracy and specificity compared to single markers.Emerging evidence also highlights the diagnostic potential of exosomes,cfDNA,and RNA markers due to their non-invasive nature and high stability.Despite promising results,further large-scale,multicenter studies are needed to validate these findings,address challenges such as standardization of detection methods,and elucidate underlying mechanisms.These advances are anticipated to significantly improve early detection and personalized management of ANHCC.
8.Progress in the diagnosis and treatment of pancreatic cancer with acute pancreatitis as the initial symptom
Rui JIANG ; Chongchong GAO ; Jian BAI ; Ang LI ; Xiaohui WANG ; Feng CAO ; Fei LI
Chinese Journal of Surgery 2024;62(10):971-975
Pancreatic cancer patients often have complaints such as upper abdominal pain and obstructive jaundice when seeking diagnosis and treatment. However, acute pancreatitis as a rare initial clinical manifestation of pancreatic cancer is often overlooked in clinical practice. This oversight often leads to a delayed diagnosis of pancreatic cancer, uncertainty in treatment strategies, and significantly affects patients′ quality of life and prognosis. Therefore, early diagnosis and treatment, and active follow-up are crucial for patients with acute pancreatitis as an initial symptom of pancreatic cancer. Upon admission to such patients, common causes such as gallstones, alcohol abuse, and hyperlipidemia should be initially ruled out. Evaluation with tumor markers, CT and MRI, and endoscopic ultrasound are essential to confirm the diagnosis of pancreatic cancer. For patients with mild pancreatitis, managing peripancreatic inflammation first before radical resection of pancreatic cancer could reduce postoperative complications. Moreover, pancreatitis serves as a high-risk factor for pancreatic cancer, so it is crucial to closely follow up patients with pancreatitis to detect pancreatic cancer early.
9.Progress in the diagnosis and treatment of pancreatic cancer with acute pancreatitis as the initial symptom
Rui JIANG ; Chongchong GAO ; Jian BAI ; Ang LI ; Xiaohui WANG ; Feng CAO ; Fei LI
Chinese Journal of Surgery 2024;62(10):971-975
Pancreatic cancer patients often have complaints such as upper abdominal pain and obstructive jaundice when seeking diagnosis and treatment. However, acute pancreatitis as a rare initial clinical manifestation of pancreatic cancer is often overlooked in clinical practice. This oversight often leads to a delayed diagnosis of pancreatic cancer, uncertainty in treatment strategies, and significantly affects patients′ quality of life and prognosis. Therefore, early diagnosis and treatment, and active follow-up are crucial for patients with acute pancreatitis as an initial symptom of pancreatic cancer. Upon admission to such patients, common causes such as gallstones, alcohol abuse, and hyperlipidemia should be initially ruled out. Evaluation with tumor markers, CT and MRI, and endoscopic ultrasound are essential to confirm the diagnosis of pancreatic cancer. For patients with mild pancreatitis, managing peripancreatic inflammation first before radical resection of pancreatic cancer could reduce postoperative complications. Moreover, pancreatitis serves as a high-risk factor for pancreatic cancer, so it is crucial to closely follow up patients with pancreatitis to detect pancreatic cancer early.
10.Pancreas multidisciplinary team optimizes the diagnosis and treatment of pancreas-related diseases and improves the prognosis of pancreatic cancer patients
Jian′ang LI ; Yaolin XU ; Ni DING ; Yuan JI ; Lingxiao LIU ; Shengxiang RAO ; Yiqun ZHANG ; Xiuzhong YAO ; Yue FAN ; Cheng HUANG ; Yuhong ZHOU ; Lili WU ; Yi DONG ; Lei ZHANG ; Yefei RONG ; Tiantao KUANG ; Xuefeng XU ; Liang LIU ; Dansong WANG ; Dayong JIN ; Wenhui LOU ; Wenchuan WU
Chinese Journal of Surgery 2022;60(7):666-673
Objectives:To evaluate the role of pancreas multidisciplinary team(MDT) clinic in the diagnosis of pancreatic diseases,patient compliance with MDT advice,and the impact of MDT on the postoperative survival of patients with pancreatic cancer.Methods:The study included 927 patients(554 males,373 females,aged (58.1±13.3)years (range: 15 to 89 years)) that had visited the pancreas MDT clinic of Zhongshan Hospital from May 2015 to December 2021,and 677 patients(396 males, 281 females, aged (63.6±8.9)years(range: 32 to 95 years)) who underwent radical surgery and with pathologically confirmed pancreatic adenocarcinoma from January 2012 to December 2020,of whom 79 patients had attended the pancreas MDT. The clinical and pathological data were collected and analyzed retrospectively. Diseases were classified in accordance with 2010 WHO classification of tumors of the digestive system and usual clinical practices. The Kaplan-Meier method was used for drawing the survival curve and calculating the survival rate. The univariate analysis was done by Log-rank test and the multivariate analysis was done by COX proportional hazards model. Survival rates were compared using χ 2 test. Results:Among the 927 patients that had visited the MDT clinic,233 patients(25.1%) were referred due to undetermined diagnosis. A direct diagnosis was made in 109 cases (46.8%,109/233) by the MDT clinic, of which 98 were consistent with the final diagnosis,resulting in an accuracy of 89.9%(98/109). The direct diagnosis rate in the recent years(36.6%(41/112),from June 2019 to December 2021) decreased compared to that in the previous years(56.2%(68/121),from May 2015 to May 2019),yet the accuracy in the recent years(90.2%,37/41) was basically the same as before (89.7%,61/68). The rate of compliance of the entire cohort was 71.5%(663/927), with the compliance rate in the recent two and a half years(81.4%,338/415) remarkably higher than that in the previous four years(63.4%,325/512). Patients with pancreatic cancer that attended the MDT exhibited a trend toward longer median postoperative survival than patients that did not attend the MDT,but the difference was not statistically significant(35.2 months vs.30.2 months, P>0.05). The 1-year and 3-year survival rates of patients that attended the MDT were significanly higher than patients that did not attend the MDT(88.6% vs. 78.4%, P<0.05;32.9% vs. 21.9%, P<0.05,respectively),but the 5-year survival rate was not statistically different(7.6% vs. 4.8%, P>0.05). Conclusions:The pancreas MDT clinic is an accurate and convenient way to diagnose intractable pancreatic diseases,and in the recent years the patients′ compliance rate with MDT advice has increased. Pancreatic cancer patients that have attended the MDT have higher 1-year and 3-year postoperative survival rates,but the long-term survival benefits of MDT still needs to be proved by clinical studies on a larger scale.

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