1.Clinical characteristics and prognostic analysis of patients with locally advanced or metastatic pulmonary neuroendocrine tumors
Zhang YI ; Fang JIAN ; Ma XU ; Mi LAN ; Han SEN
Chinese Journal of Clinical Oncology 2025;52(5):234-239
Objective:To investigate the clinical characteristics and prognosis of patients with locally advanced or metastatic pulmonary neuroendocrine tumors(NETs).Methods:The clinical records of patients with locally advanced or metastatic pulmonary NETs in Peking Uni-versity Cancer Hospital&Institute were selected from January 2014 to June 2024.The clinical characteristics,treatment,and survival pro-gnosis were then analyzed.Results:There were 32 patients,of which 18 were male and 14 female.The median age was 56 years.Nine pa-tients had typical carcinoid and 23 had atypical carcinoid,with six in stage Ⅲ and 26 in stage Ⅳ.The common metastatic sites included the bones(18 cases),lungs(8 cases),pleura(7 cases),and liver(7 cases).The median length of the measurable primary tumor was 5.2 cm,which was mostly located centrally(22 cases).Five among the 16 patients who underwent somatostatin receptor(SSTR)imaging had high SSTR ex-pression.The initial symptoms mainly included respiratory symptoms,and none of them were combined with carcinoid syndrome.For the first-line treatment,19 patients were treated with chemotherapy,seven were treated with targeted therapy,four were treated with soma-tostatin analogs(SSAs),and two were treated with surgery.The best efficacy was evaluated as a partial response in one case(3.1%),stable disease in 23 cases(71.9%),and non-evaluable or unknown in eight cases(25%)in the first-line treatment.The median progression-free sur-vival(mPFS)of patients who received first-line treatment was 5.2 months(95%CI:0.0-13.9).The PFS of targeted therapy was the longest(11.0 months,95%CI:0.0-29.6),but there was no significant difference compared with the PFS of chemotherapy and SSA groups(P>0.05).The longest PFS(24.5 months,95%CI:0.0-58.7)was found in patients treated with chemotherapy combined with radiotherapy,but there was no significant difference compared to the PFS of the combined immunotherapy and combined anti-angiogenesis groups(P>0.05).The survival rates at 1,3,and 5 years were 79.1%,65.5%,and 58.9%,respectively.Cox regression analysis did not identify independent risk factors for prognosis.Conclusions:The initial symptoms of patients with locally advanced or metastatic NETs were mainly respiratory symp-toms but without specific manifestations.Some of them were accompanied by high SSTR expression,and there was generally no carcinoid syndrome.The first-line systemic therapy mainly included chemotherapy and target therapy,with relatively low objective response and high disease control rates.Targeted therapy and combined radiotherapy have longer PFS than that of chemotherapy.The overall survival of pa-tients with pulmonary NETs was good.
2.Scoliosis among middle school students and the correlation between axial trunk rotation angle and Cobb angle
Kun LIU ; Liu HU ; Ting FANG ; Yali WAN ; Jialei GE ; Yan MA ; Jian XIONG
Chinese Journal of Physical Medicine and Rehabilitation 2025;47(7):614-618
Objective:To investigate the prevalence of scoliosis among middle school students through school-based screening, and to analyze the correlations between axial trunk rotation (ATR) angle and Cobb angle among those with scoliosis considering gender, age, body mass index (BMI) and curve type, so as to provide references for early prevention and treatment.Methods:Random cluster sampling was used to enroll 9501 middle school students from 11 schools in the Hanyang District of Wuhan. They underwent a six-step scoliosis screening with a forward bending test, scoliometer measurements, and confirmatory X-ray examinations. The students exhibiting scoliosis were stratified by gender, age, BMI, and curve type. The correlation between ATR angle and Cobb angle was subsequently analyzed within each subgroup.Results:Scoliosis was observed in 358 of the students (150 boys and 208 girls), a positive screening rate of 3.8%. Moreover, the positive screening rate was significantly higher among the girls (4.8%) than among the boys (2.9%). There was a moderate Spearman correlation ( r=0.69) between the ATR and Cobb angles in 358 of the students with scoliosis, both the boys ( r=0.69) and the girls ( r=0.70). When it came to age, there was a positive correlation between the ATR and Cobb angles for students aged 13 to 16 irrespective of their BMI classification, except that there was no significant correlation between the two angles for those classified as obese. In terms of Peking Union Medical College (PUMC) classification, there was a positive correlation for those in types Ia, Ib, Ic, IIa, IIb, IIc and IId, but there was no significant correlation between the two angles for those in type III. Conclusions:Scoliosis is prevalent among the group of adolescents studied. Society, schools and parents need to prioritize prevention, heightened awareness, timely diagnosis and early treatment, particularly for girls. The ATR angle may serve as a practical surrogate for estimating Cobb angle severity in scoliosis screening for single-curve or double-curve cases. However, ATR measurements may yield false-negative results among those with triple-curve deformities or the obese, underscoring the need for supplementary diagnostic methods among such populations.
3.Predictive value of color Doppler ultrasound combined with electrocardiogram for right heart dys func-tion in patients with pulmonary heart disease
Wan-wan WU ; Hai-bo SHEN ; Chun-lian MA ; Dian-dong HUANG ; Fang-hong WANG ; Hui-qin WANG ; Li KAN ; Jian SUN ; Ji-wen SHEN ; Meng HUANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2025;34(3):332-337
Objective:To investigate the predictive value of color Doppler ultrasound combined with electrocardio-gram for right heart dys function in patients with pulmonary heart disease(PHD).Methods:A total of 100 PHD patients admitted in Dongcheng Branch of First Affiliated Hospital of Anhui Medical University between January 2020 and December 2023 were retrospectively analyzed.According to results of 6min walking test(6MWT),pa-tients were divided into good right heart function group(n=64,≥350m)and right heart dysfunction group(n=36,<350m).The indexes of cardiac color ultrasound[isovolumic relaxation time(IVRT),isovolumetric contraction time(IVCT)and right ventricular Tei index],ECG[24h mean R-R interval standard deviation(SDNN),normal R-R interval standard deviation per 5min(SDANN)and the ratio of low frequency components to high frequency components(LF/HF)]were compared between two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of color Doppler ultrasound,ECG and their combination for right heart dys-function in PHD patients.Spearman correlation coefficient was used to analyze the association of color Doppler ul-trasound,ECG and their combination with right heart dysfunction in PHD patients.Results:Compared with those in good right heart function group,patients in right heart dysfunction group had significant higher IVRT[(120.64±14.08)ms vs.(97.87±10.93)ms],IVCT[(84.28±12.33)ms vs.(71.92±10.61)ms]and Tei index[(0.85±0.11)vs.(0.63±0.07)](P<0.001 all),and significant lower SDNN[(75.52±12.58)ms vs.(85.58±11.75)ms],SDANN[(63.86±10.92)ms vs.(76.75±11.71)ms]and LF/HF[(1.33±0.19)vs.(1.84±0.27)](P<0.001 all).ROC curve indicated that the AUC of color Doppler ultrasound combined ECG in diagnosing right heart dysfunction in PHD patients was 0.911(95%CI 0.838~0.959),which was significantly higher than those of color Doppler ultrasound[0.775(95%CI 0.681~0.853),Z=2.404,P=0.016]and ECG[0.688(95%CI 0.588~0.777),Z=3.968,P=0.001]alone.Spearman correlation analysis indicated that there was a significant positive correlation of color Doppler ultrasound(r=0.547),ECG(r=0.375)and their combination(r=0.810)with right heart dysfunction in PHD patients(P<0.001 all),and the correlation between combined detection and right heart dysfunction in PHD patients was significantly higher.Conclusion:Color Doppler ultrasound combined with ECG possesses high diagnostic performance for right heart dysfunction in PHD patients.
4.Scoliosis among middle school students and the correlation between axial trunk rotation angle and Cobb angle
Kun LIU ; Liu HU ; Ting FANG ; Yali WAN ; Jialei GE ; Yan MA ; Jian XIONG
Chinese Journal of Physical Medicine and Rehabilitation 2025;47(7):614-618
Objective:To investigate the prevalence of scoliosis among middle school students through school-based screening, and to analyze the correlations between axial trunk rotation (ATR) angle and Cobb angle among those with scoliosis considering gender, age, body mass index (BMI) and curve type, so as to provide references for early prevention and treatment.Methods:Random cluster sampling was used to enroll 9501 middle school students from 11 schools in the Hanyang District of Wuhan. They underwent a six-step scoliosis screening with a forward bending test, scoliometer measurements, and confirmatory X-ray examinations. The students exhibiting scoliosis were stratified by gender, age, BMI, and curve type. The correlation between ATR angle and Cobb angle was subsequently analyzed within each subgroup.Results:Scoliosis was observed in 358 of the students (150 boys and 208 girls), a positive screening rate of 3.8%. Moreover, the positive screening rate was significantly higher among the girls (4.8%) than among the boys (2.9%). There was a moderate Spearman correlation ( r=0.69) between the ATR and Cobb angles in 358 of the students with scoliosis, both the boys ( r=0.69) and the girls ( r=0.70). When it came to age, there was a positive correlation between the ATR and Cobb angles for students aged 13 to 16 irrespective of their BMI classification, except that there was no significant correlation between the two angles for those classified as obese. In terms of Peking Union Medical College (PUMC) classification, there was a positive correlation for those in types Ia, Ib, Ic, IIa, IIb, IIc and IId, but there was no significant correlation between the two angles for those in type III. Conclusions:Scoliosis is prevalent among the group of adolescents studied. Society, schools and parents need to prioritize prevention, heightened awareness, timely diagnosis and early treatment, particularly for girls. The ATR angle may serve as a practical surrogate for estimating Cobb angle severity in scoliosis screening for single-curve or double-curve cases. However, ATR measurements may yield false-negative results among those with triple-curve deformities or the obese, underscoring the need for supplementary diagnostic methods among such populations.
5.Accuracy of PI-RADS score in diagnosing prostate cancer at different PSA levels
Hanchang WU ; Fang LIU ; Chao MA ; Jian WANG
Academic Journal of Naval Medical University 2025;46(2):223-228
Objective To investigate the accuracy of prostate imaging and reporting data system(PI-RADS)score in diagnosing prostate cancer(PCa)with different prostate-specific antigen(PSA)levels.Methods Patients who underwent multiparametric magnetic resonance imaging scanning with biopsy of the prostate to obtain pathological confirmation in The First Affiliated Hospital of Naval Medical University(Second Military Medical University)between Jan.2017 and Jun.2023 were enrolled,and serum total PSA(t-PSA),free PSA(f-PSA),the ratio of free PSA to total PSA(f/t PSA)and PI-RADS scores were summarized in all patients.The accuracy of PI-RADS score in diagnosing PCa was analyzed at different PSA levels using pathology of the prostate biopsy as the gold standard.Results A total of 2 526 patients were enrolled and categorized into 7 groups according to the PSA level:0-4 ng/mL,>4-10 ng/mL(f/t PSA≥0.16),>4-10 ng/mL(f/t PSA<0.16),>10-20 ng/mL,>20-50 ng/mL,>50-100 ng/mL,and>100 ng/mL.In all patients,the sensitivity of PI-RADS≥3 in diagnosing PCa was 90.0%,which was superior to PI-RADS≥4(sensitivity:76.3%).Among the patients with PSA≤4 ng/mL,the accuracy of PI-RADS≥4 in diagnosing PCa was higher than that of PI-RADS≥3(87.7%vs 64.0%).With the increase of PSA levels,the diagnostic accuracies of PI-RADS≥4 and PI-RADS≥3 were gradually increased and tended to be the same.When PSA was>50-100 ng/mL,the diagnostic accuracies of PI-RADS≥4 and≥3 were 90.7%and 92.0%,respectively.Conclusion At higher PSA levels,the accuracies of PI-RADS scores in diagnosing PCa are higher,which can reduce unnecessary puncture of patients.
6.Predictive value of color Doppler ultrasound combined with electrocardiogram for right heart dys func-tion in patients with pulmonary heart disease
Wan-wan WU ; Hai-bo SHEN ; Chun-lian MA ; Dian-dong HUANG ; Fang-hong WANG ; Hui-qin WANG ; Li KAN ; Jian SUN ; Ji-wen SHEN ; Meng HUANG
Chinese Journal of cardiovascular Rehabilitation Medicine 2025;34(3):332-337
Objective:To investigate the predictive value of color Doppler ultrasound combined with electrocardio-gram for right heart dys function in patients with pulmonary heart disease(PHD).Methods:A total of 100 PHD patients admitted in Dongcheng Branch of First Affiliated Hospital of Anhui Medical University between January 2020 and December 2023 were retrospectively analyzed.According to results of 6min walking test(6MWT),pa-tients were divided into good right heart function group(n=64,≥350m)and right heart dysfunction group(n=36,<350m).The indexes of cardiac color ultrasound[isovolumic relaxation time(IVRT),isovolumetric contraction time(IVCT)and right ventricular Tei index],ECG[24h mean R-R interval standard deviation(SDNN),normal R-R interval standard deviation per 5min(SDANN)and the ratio of low frequency components to high frequency components(LF/HF)]were compared between two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of color Doppler ultrasound,ECG and their combination for right heart dys-function in PHD patients.Spearman correlation coefficient was used to analyze the association of color Doppler ul-trasound,ECG and their combination with right heart dysfunction in PHD patients.Results:Compared with those in good right heart function group,patients in right heart dysfunction group had significant higher IVRT[(120.64±14.08)ms vs.(97.87±10.93)ms],IVCT[(84.28±12.33)ms vs.(71.92±10.61)ms]and Tei index[(0.85±0.11)vs.(0.63±0.07)](P<0.001 all),and significant lower SDNN[(75.52±12.58)ms vs.(85.58±11.75)ms],SDANN[(63.86±10.92)ms vs.(76.75±11.71)ms]and LF/HF[(1.33±0.19)vs.(1.84±0.27)](P<0.001 all).ROC curve indicated that the AUC of color Doppler ultrasound combined ECG in diagnosing right heart dysfunction in PHD patients was 0.911(95%CI 0.838~0.959),which was significantly higher than those of color Doppler ultrasound[0.775(95%CI 0.681~0.853),Z=2.404,P=0.016]and ECG[0.688(95%CI 0.588~0.777),Z=3.968,P=0.001]alone.Spearman correlation analysis indicated that there was a significant positive correlation of color Doppler ultrasound(r=0.547),ECG(r=0.375)and their combination(r=0.810)with right heart dysfunction in PHD patients(P<0.001 all),and the correlation between combined detection and right heart dysfunction in PHD patients was significantly higher.Conclusion:Color Doppler ultrasound combined with ECG possesses high diagnostic performance for right heart dysfunction in PHD patients.
8.Conserved translational control in cardiac hypertrophy revealed by ribosome profiling.
Bao-Sen WANG ; Jian LYU ; Hong-Chao ZHAN ; Yu FANG ; Qiu-Xiao GUO ; Jun-Mei WANG ; Jia-Jie LI ; An-Qi XU ; Xiao MA ; Ning-Ning GUO ; Hong LI ; Zhi-Hua WANG
Acta Physiologica Sinica 2025;77(5):757-774
A primary hallmark of pathological cardiac hypertrophy is excess protein synthesis due to enhanced translational activity. However, regulatory mechanisms at the translational level under cardiac stress remain poorly understood. Here we examined the translational regulations in a mouse cardiac hypertrophy model induced by transaortic constriction (TAC) and explored the conservative networks versus the translatome pattern in human dilated cardiomyopathy (DCM). The results showed that the heart weight to body weight ratio was significantly elevated, and the ejection fraction and fractional shortening significantly decreased 8 weeks after TAC. Puromycin incorporation assay showed that TAC significantly increased protein synthesis rate in the left ventricle. RNA-seq revealed 1,632 differentially expressed genes showing functional enrichment in pathways including extracellular matrix remodeling, metabolic processes, and signaling cascades associated with pathological cardiomyocyte growth. When combined with ribosome profiling analysis, we revealed that translation efficiency (TE) of 1,495 genes was enhanced, while the TE of 933 genes was inhibited following TAC. In DCM patients, 1,354 genes were upregulated versus 1,213 genes were downregulated at the translation level. Although the majority of the genes were not shared between mouse and human, we identified 93 genes, including Nos3, Kcnj8, Adcy4, Itpr1, Fasn, Scd1, etc., with highly conserved translational regulations. These genes were remarkably associated with myocardial function, signal transduction, and energy metabolism, particularly related to cGMP-PKG signaling and fatty acid metabolism. Motif analysis revealed enriched regulatory elements in the 5' untranslated regions (5'UTRs) of transcripts with differential TE, which exhibited strong cross-species sequence conservation. Our study revealed novel regulatory mechanisms at the translational level in cardiac hypertrophy and identified conserved translation-sensitive targets with potential applications to treat cardiac hypertrophy and heart failure in the clinic.
Animals
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Humans
;
Cardiomegaly/physiopathology*
;
Ribosomes/physiology*
;
Protein Biosynthesis/physiology*
;
Mice
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Cardiomyopathy, Dilated/genetics*
;
Ribosome Profiling
9.Quality evaluation of Bidentis Herba derived from different original plants based on HPLC fingerprints, characteristic chromatograms, multi-component content determination combined with chemical pattern recognition.
Guo-Li SHI ; Yun MA ; Feng-Xia SHEN ; Han-Wen DU ; Cong-Min LIU ; Rui-Xia WEI ; Yan-Fang LI ; Jian-Wei FAN ; Yong-Xia GUAN
China Journal of Chinese Materia Medica 2025;50(15):4284-4292
This study established the HPLC fingerprints, characteristic chromatograms, and a multi-component content determination method for Bidens bipinnata and B. biternata. The chemical pattern recognition analysis was then employed to clarify the characteristic indexes of quality differences between the two original plants of Bidentis Herba, providing a reference for establishing the quality standards of Bidentis Herba. HPLC was launched on an Agilent Poroshell 120 EC-C_(18) chromatographic column(4.6 mm×250 mm, 4 μm) by gradient elution with a mobile phase of 0.1% aqueous phosphoric acid-acetonitrile at a flow rate of 0.7 mL·min~(-1), detection wavelength of 270 nm, column temperature of 25 ℃, and an injection volume of 5 μL. The similarity between the fingerprints of 18 batches of Bidentis Herba samples and the common pattern(R) ranged from 0.572 to 0.933. A total of 23 chromatographic peaks were calibrated. Through comparison with the reference substances, six components(neochlorogenic acid, chlorogenic acid, isochlorogenic acid A, isochlorogenic acid B, rutin, and hyperoside) were identified and subjected to quantitative analysis. The characteristic fingerprints of B. bipinnata and B. biternata were calibrated with 20 and 17 characteristic peaks, respectively. Among them, peaks 8, 9, 22, and 23 were the characteristic peaks of B. bipinnata, and peak 7 was the characteristic peak of B. biternata, which can be used to distinguish the two original plants of Bidentis Herba. The relative standard deviation of the content of the above-mentioned six components ranged from 36% to 123%. The cluster analysis, principal component analysis, and orthogonal partial least squares-discriminant analysis(OPLS-DA) classified the 18 batches of Bidentis Herba samples into two categories. Additionally, through the analysis of variable importance in projection(VIP) under OPLS-DA, three characteristic indexes, rutin, isochlorogenic acid A, and isochlorogenic acid B, were identified. The analytical method established in this study can comprehensively evaluate the consistency of Bidentis Herba samples derived from different original plants, specifically identify the differential components between them, and effectively distinguish the two original plants of Bidentis Herba, providing a basis for the differentiation between different original plants and the quality control of Bidentis Herba.
Chromatography, High Pressure Liquid/methods*
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Drugs, Chinese Herbal/chemistry*
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Quality Control
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Bidens/chemistry*
10.Observation on the therapeutic effect of atezolizumab combined with anlotinib in treating advanced non-small cell lung cancer
Fang ZHAO ; Guorong JIANG ; Shuyue SHI ; Jian XIAO ; Shaolin MA ; Runpu LI
Journal of International Oncology 2025;52(8):495-501
Objective:To explore the efficacy of atezolizumab combined with anlotinib in treating advanced non-small cell lung cancer (NSCLC) .Methods:A total of 80 patients with advanced NSCLC treated in the Baoding No.2 Central Hospital from September 2019 to September 2023 after second-line treatment were selected as research subjects. Patients who received only anlotinib treatment were included in the monotherapy group ( n=40), while patients who received atezolizumab combined with anlotinib treatment were included in the combination group ( n=40). The clinical efficacy and serum levels of carcinoembryonic antigen (CEA) and vascular endothelial growth factor (VEGF) of the two groups were compared. Kaplan-Meier survival curve was used to analyze the survival of the two groups. The functional assessment of cancer therapy-lung cancer (FACT-L) was used to assess the quality of life of patients in both groups before and after treatment. The incidence of adverse reactions was compared between the two groups. Results:After four cycles of treatment, the objective response rate (ORR) of the combination group was 37.50% (15/40), which was higher than that of the monotherapy group [17.50% (7/40) ], with a statistically significant difference ( χ2=4.01, P=0.045). The disease control rates (DCRs) of the two groups were 85.00% (34/40) and 75.00% (30/40), respectively, with no statistically significant difference ( χ2=1.25, P=0.264). Before treatment, the CEA levels in combination group and monotherapy group were (10.18±2.15) and (10.14±2.02) μg/L, and the VEGF levels were (804.04±46.58) and (809.10±43.63) ng/L, respectively, with no statistically significant difference (both P>0.05). After treatment, the serum CEA levels of patients in combination group and monotherapy group were (4.35±1.05) and (6.63±1.37) μg/L, and the VEGF levels were (431.26±50.19) and (549.92±55.27) ng/L, respectively, with statistically significant differences ( t=8.35, P<0.001; t=10.05, P<0.001), and the levels of serum CEA and VEGF in the two groups after treatment were lower than before treatment ( t=32.47, P<0.001; t=21.73, P<0.001; t=88.65, P<0.001; t=58.27, P<0.001). Survival analysis showed that the median progression-free survival (PFS) of the monotherapy group and the combination group were 4.12 and 6.06 months, respectively, with a statistically significant difference ( χ2=17.70, P<0.001), the median overall survival (OS) were 11.8 and 12.7 months, respectively, with no statistically significant difference ( χ2=3.09, P=0.079). Before treatment, the FACT-L scores of patients in combination group and monotherapy group were 61.20±6.98 and 60.52±7.14, respectively, with no statistically significant difference ( t=0.43, P=0.668). After treatment, the FACT-L scores of the two groups were 83.24±9.38 and 74.58±7.86, respectively, with a statistically significant difference ( t=4.48, P<0.001), and the FACT-L scores of the two groups after treatment were all higher than before treatment ( t=29.36, P<0.001; t=21.51, P<0.001). During treatment, the total incidence of drug-related adverse reactions in two groups was 42.50% (17/40) and 55.00% (22/40), respectively, with no statistically significant difference ( χ2=1.25, P=0.263) . Conclusions:Atezolizumab combined with anlotinib in the treatment of advanced NSCLC can enhance the short-term efficacy, prolong the PFS of patients, improve the quality of life, and the related adverse reactions are tolerable.

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