1.Predictive value of DCE-MRI quantitative parameters for lymph node metastasis in breast cancer
Liping XU ; Jiangang YE ; Ying GUO
Chinese Journal of Endocrine Surgery 2025;19(5):683-687
Objective:To investigate the predictive value of quantitative parameters of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in lymph node metastasis of breast cancer.Methods:A retrospective study was conducted on 98 breast cancer patients admitted to our hospital from Jan. 2021 to Dec. 2022. All patients underwent DCE-MRI before surgery and were followed up for 2 years. Finally, 16 cases of lymph node metastasis were confirmed and included in the metastasis group, and the remaining 82 cases without metastasis were included in the non- metastasis group. The clinical data, preoperative routine MRI features and DCE-MRI quantitative parameters of the two groups were analyzed and compared, and the predictive value of DCE-MRI quantitative parameters was analyzed by receiver operating characteristic curve (ROC) .Results:There was no statistically significant difference in age, course of disease and pathological type between the two groups ( t=0.65, 1.43, χ2=1.33, P>0.05) ; The proportion of patients with middle or high pathological grade in metastasis group was higher than that in non-metastasis group ( χ2=11.29, P<0.05). The maximum diameter, shape, internal enhancement pattern and time intensity curve type showed no statistically significant difference ( t=0.54, χ2=3.51, 0.67, 0.42, P>0.05) ; The proportion of patients with blurred edge features in metastasis group was higher than that in the other group ( χ2=4.53, P<0.05). The volume transfer constant (K trans) and reflux rate constant (Kep) in the metastasis group were higher than those in the other group ( t=2.97, 3.22, P<0.05), and extracellular space volume ratio (Ve) showed no statistically significant difference ( t=0.42, P>0.05). Receiver operating characteristic curve (ROC) results showed that the area under the curve (AUC) of K trans, Kep and their combined prediction of breast cancer lymph node metastasis was 0.758, 0.710 and 0.764, respectively, and the sensitivity was 56.25%, 42.75% and 62.50%, respectively. The specificity was 86.59%, 89.02% and 86.59% (all P<0.05) . Conclusions:Quantitative parameters of DCE-MRI can be used to predict lymph node metastasis of breast cancer, among which K trans, Kep and their combination are more effective in diagnosis.
2.Predictive value of DCE-MRI quantitative parameters for lymph node metastasis in breast cancer
Liping XU ; Jiangang YE ; Ying GUO
Chinese Journal of Endocrine Surgery 2025;19(5):683-687
Objective:To investigate the predictive value of quantitative parameters of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) in lymph node metastasis of breast cancer.Methods:A retrospective study was conducted on 98 breast cancer patients admitted to our hospital from Jan. 2021 to Dec. 2022. All patients underwent DCE-MRI before surgery and were followed up for 2 years. Finally, 16 cases of lymph node metastasis were confirmed and included in the metastasis group, and the remaining 82 cases without metastasis were included in the non- metastasis group. The clinical data, preoperative routine MRI features and DCE-MRI quantitative parameters of the two groups were analyzed and compared, and the predictive value of DCE-MRI quantitative parameters was analyzed by receiver operating characteristic curve (ROC) .Results:There was no statistically significant difference in age, course of disease and pathological type between the two groups ( t=0.65, 1.43, χ2=1.33, P>0.05) ; The proportion of patients with middle or high pathological grade in metastasis group was higher than that in non-metastasis group ( χ2=11.29, P<0.05). The maximum diameter, shape, internal enhancement pattern and time intensity curve type showed no statistically significant difference ( t=0.54, χ2=3.51, 0.67, 0.42, P>0.05) ; The proportion of patients with blurred edge features in metastasis group was higher than that in the other group ( χ2=4.53, P<0.05). The volume transfer constant (K trans) and reflux rate constant (Kep) in the metastasis group were higher than those in the other group ( t=2.97, 3.22, P<0.05), and extracellular space volume ratio (Ve) showed no statistically significant difference ( t=0.42, P>0.05). Receiver operating characteristic curve (ROC) results showed that the area under the curve (AUC) of K trans, Kep and their combined prediction of breast cancer lymph node metastasis was 0.758, 0.710 and 0.764, respectively, and the sensitivity was 56.25%, 42.75% and 62.50%, respectively. The specificity was 86.59%, 89.02% and 86.59% (all P<0.05) . Conclusions:Quantitative parameters of DCE-MRI can be used to predict lymph node metastasis of breast cancer, among which K trans, Kep and their combination are more effective in diagnosis.
3.Establishment of a nomogram model for predicting pelvic lymph node metastasis in prostate cancer based on systemic immune-infiltration inflammation index
Junzhi LIU ; Lei QIU ; Kun XU ; Jianwei LIU ; Dehua HU ; Hua ZHU ; Cheng SHEN ; Ming LU ; Jiangang CHEN
The Journal of Practical Medicine 2025;41(15):2349-2354
Objective To develop and validate a nomogram model that integrates systemic inflammatory markers to predict the likelihood of pelvic lymph node metastasis(PLNM)in prostate cancer patients prior to surgery.Methods This study retrospectively analyzed the clinical data and preoperative inflammatory markers—including neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune-inflammation index(SII),and monocyte-to-lymphocyte ratio(MLR)—of patients diagnosed with prostate cancer.Univariate and multi-variate logistic regression analyses were conducted to identify markers that were significantly associated with PLNM.Based on the results of the multivariate analysis,a nomogram was developed and its predictive accuracy was assessed using receiver operating characteristic curves(ROC)and calibration plots.Results Among the 334 enrolled patients with prostate cancer,107 were identified with PLNM.Univariate analysis revealed statistically significant differences in free prostate-specific antigen(fPSA),Gleason score,NLR,PLR,MLR,and SII between the PLNM and non-pelvic lymph node metastasis(NPLNM)groups(P<0.05).Multivariate analysis confirmed that fPSA,Gleason score,and SII were independent predictors of PLNM(P<0.05).A nomogram incorporating these predic-tors exhibited strong discriminative ability,with an area under the ROC curve(AUC)of 0.79(95%CI:0.73~0.84).Calibration analysis further demonstrated good consistency between the predicted and observed probabilities of PLNM.Conclusions This study successfully developed a nomogram model based on systemic inflammatory markers for preoperative prediction of pelvic lymph node metastasis in prostate cancer.Owing to its user-friendly design and high predictive accuracy,this tool may serve as a valuable complementary method to conventional imaging techniques,thereby supporting personalized treatment decision-making.
4.Establishment of a nomogram model for predicting pelvic lymph node metastasis in prostate cancer based on systemic immune-infiltration inflammation index
Junzhi LIU ; Lei QIU ; Kun XU ; Jianwei LIU ; Dehua HU ; Hua ZHU ; Cheng SHEN ; Ming LU ; Jiangang CHEN
The Journal of Practical Medicine 2025;41(15):2349-2354
Objective To develop and validate a nomogram model that integrates systemic inflammatory markers to predict the likelihood of pelvic lymph node metastasis(PLNM)in prostate cancer patients prior to surgery.Methods This study retrospectively analyzed the clinical data and preoperative inflammatory markers—including neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune-inflammation index(SII),and monocyte-to-lymphocyte ratio(MLR)—of patients diagnosed with prostate cancer.Univariate and multi-variate logistic regression analyses were conducted to identify markers that were significantly associated with PLNM.Based on the results of the multivariate analysis,a nomogram was developed and its predictive accuracy was assessed using receiver operating characteristic curves(ROC)and calibration plots.Results Among the 334 enrolled patients with prostate cancer,107 were identified with PLNM.Univariate analysis revealed statistically significant differences in free prostate-specific antigen(fPSA),Gleason score,NLR,PLR,MLR,and SII between the PLNM and non-pelvic lymph node metastasis(NPLNM)groups(P<0.05).Multivariate analysis confirmed that fPSA,Gleason score,and SII were independent predictors of PLNM(P<0.05).A nomogram incorporating these predic-tors exhibited strong discriminative ability,with an area under the ROC curve(AUC)of 0.79(95%CI:0.73~0.84).Calibration analysis further demonstrated good consistency between the predicted and observed probabilities of PLNM.Conclusions This study successfully developed a nomogram model based on systemic inflammatory markers for preoperative prediction of pelvic lymph node metastasis in prostate cancer.Owing to its user-friendly design and high predictive accuracy,this tool may serve as a valuable complementary method to conventional imaging techniques,thereby supporting personalized treatment decision-making.
5.Research progress on the role and mechanism of PANoptosis in lung diseases.
Yumei KANG ; Tao YANG ; Ling DING ; Lei WANG ; Licheng GENG ; Jiangang XU
Chinese Critical Care Medicine 2025;37(7):688-692
PANoptosis is a newly defined type of programmed cell death (PCD), which is triggered by a variety of stimuli and covers three known forms of PCD: apoptosis, pyroptosis and necroptosis. In physiological state, cell death plays an important protective role against pathogen invasion, but its over-activation may aggravate inflammatory response and cause tissue damage. Studies have shown that the occurrence and progression of acute lung injury/acute respiratory distress syndrome (ALI/ARDS), asthma, chronic obstructive pulmonary disease (COPD) and other lung diseases are closely related to PANoptosis. The purpose of this review is to deeply explore the molecular mechanism of PANoptosis and its regulatory factors in lung diseases, in order to discover potential therapeutic targets and provide new targets and innovative ideas for clinical treatment for lung diseases.
Humans
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Lung Diseases
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Apoptosis
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Pyroptosis
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Pulmonary Disease, Chronic Obstructive
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Necroptosis
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Acute Lung Injury
6.Effect of hydrogen on lipopolysaccharide and nigericin-induced pyroptosis in macrophages and the role of lncRNA NEAT1
Tao YANG ; Man LI ; Ling DING ; Shenyue PANG ; Lei WANG ; Licheng GENG ; Jiangang XU
Chinese Journal of Anesthesiology 2024;44(2):232-237
Objective:To evaluate the effect of hydrogen on lipopolysaccharide (LPS) and nigericin-induced pyroptosis in macrophages and the role of long non-coding RNA (lncRNA) nuclear-enriched abundant transcript 1 (NEAT1).Methods:Human monocyte-derived macrophages THP-1 cells were cultured in vitro and divided into 4 groups ( n=25 each) using a random number table method: control group (group C), LPS and nigericin group (group LN), hydrogen-rich medium+ LPS and nigericin group (group H+ LN), and lentiviral transfection+ hydrogen-rich medium+ LPS-nigericin group (group LV+ H+ LN). THP-1 cells were cultured in the common culture medium for 24 h in group C. LPS at a final concentration of 100 ng/ml and nigericin 10 μmol/L were added to the culture medium, and the cells were incubated for 24 h in group LN. In group H+ LN, the culture medium was replaced with 0.6 mmol/L hydrogen-rich medium, then LPS at a final concentration of 100 ng/ml and nigericin 10 μmol/L were immediately added, and the cells were incubated for 24 h. In group LV+ H+ LN, THP-1 cells over-expressing NEAT1 stably after being transfected with lentivirus were used, then LPS at a final concentration of 100 ng/ml and nigericin 10 μmol/L were immediately added, and the cells were incubated for 24 h. Cell viability was detected by CCK-8 assay. Lactic dehydrogenase (LDH) release was assessed by colorimetric method. The amount of LDH released was measured by colorimetry. The concentrations of interleukin-1beta (IL-1β) and IL-18 in culture medium were measured by enzyme-linked immunosorbent assay. The pyroptotic rate was detected by flow cytometry. The expression of nucleotide-binding oligomerization domain-like receptor-containing pyrin domain 3 (NLRP3), apoptosis-associated speck-like protein (ASC), caspase-1 and gasdermin D (GSDMD) was detected by Western blot. The expression of NEAT1 gene was determined by quantitative real-time polymerase chain reaction. Results:Compared with group C, the cell viability was significantly decreased, the amount of LDH released, concentrations of IL-1β and IL-18, and pyroptotic rate were increased, and the expression of NEAT1 gene, NLRP3, ASC, caspase-1 and GSDMD was up-regulated in group LN ( P<0.05). Compared with group LN, the cell viability was significantly increased, the amount of LDH released, concentrations of IL-1β and IL-18, and pyroptotic rate were decreased, and the expression of NEAT1 gene, NLRP3, ASC, caspase-1 and GSDMD was down-regulated in group H+ LN ( P<0.05). Compared with group H+ LN, the cell viability was significantly decreased, the amount of LDH released, concentrations of IL-1β and IL-18, and pyroptotic rate were increased, and the expression of NEAT1 gene, NLRP3, ASC, caspase-1 and GSDMD was up-regulated in group LV+ H+ LN ( P<0.05). Conclusions:Hydrogen can ameliorate LPS and nigericin-induced pyroptosis in macrophages, and the mechanism may be associated with down-regulating the expression of lncRNA NEAT1.
7.Comparison of mid-to-long term outcomes between mitral valve repair and biological valve replacement in patients over 60 with rheumatic mitral valve disease based on a propensity score matching study
Wenbo ZHANG ; Jie HAN ; Tiange LUO ; Baiyu TIAN ; Fei MENG ; Wenjian JIANG ; Yuqing JIAO ; Xiaoming LI ; Jintao FU ; Yichen ZHAO ; Fei LI ; Xu MENG ; Jiangang WANG
Chinese Journal of Surgery 2024;62(11):1016-1023
Objective:To compare and discuss the mid-to-long-term outcomes of mitral valve repair (MVP) versus biological mitral valve replacement (bMVR) in patients aged 60 years and above with rheumatic mitral valve disease.Methods:This is a retrospective cohort study. A total of 765 patients aged 60 years and older, diagnosed with rheumatic mitral valve disease and who underwent MVP or bMVR at Beijing Anzhen Hospital from January 2010 to January 2023, were retrospectively included. Among them, 186 were male and 579 were female, with an age of (66.1±4.5) years (range: 60 to 82 years). Patients were divided into two groups based on the surgical method: the mitral valve repair group (MVP group, n=256) and the bioprosthetic mitral valve replacement group (bMVR group, n=509). A 1∶1 propensity score matching was performed using a caliper value of 0.2 based on preoperative data. Paired sample t-tests, χ2 tests, or Fisher′s exact tests were used for intergroup comparisons. Kaplan-Meier method was employed to plot survival curves and valve-related reoperation rate curves for both groups before and after matching, and Log-rank tests were used to compare the mid-to long-term survival rates and valve-related reoperation rates between the two groups. Results:A total of 765 patients who completed follow-up were ultimately included, with a follow-up period ( M(IQR)) of 5.1(5.0) years (range: 1.0 to 12.9 years). After matching, each group consisted of 256 patients. The incidence of early postoperative atrial fibrillation (39.1% vs. 49.2%, χ2=4.95, P=0.026) and early mortality rates (2.0% vs. 6.2%, χ2=4.97, P=0.026) were lower in the MVP group. Unadjusted Kaplan-Meier analysis showed significantly higher 5-year and 10-year survival rates for the MVP group (92.54% vs. 83.02%, 86.22% vs. 70.19%, Log-rank: P=0.001). After adjustment with propensity scores, the Kaplan-Meier analysis still indicated higher 5-year and 10-year survival rates in the MVP group compared to the bMVR group (92.54% vs. 85.89%, 86.22% vs. 74.83%, Log-rank: P=0.024). There were no significant differences in the rates of valve-related reoperation between the two groups before and after matching (5-year and 10-year reoperation rates pre-matching: 1.75% vs. 0.57%, 5.39% vs. 7.54%, Log-rank: P=0.207; post-matching: 1.75% vs. 0, 5.39% vs. 9.27%, Log-rank: P=0.157). Conclusion:For patients aged 60 years and above with rheumatic mitral valve disease, mitral valve repair offers better mid-to-long-term survival compared to biological valve replacement.
8.Effects of Yiqi Huoxue Tuodu Prescription on Keap1/Nrf2/HO-1 Signaling Pathway in Rats with Chronic Nonbacterial Prostatitis
Yiwen TANG ; Xiong WANG ; Haote CHEN ; Yanyan ZHOU ; Jiasen DING ; Yongqiang WEI ; Jiangang LIU ; Qinghe GAO ; Zhan GAO ; Feng XU
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(1):72-77
Objective To observe the effects of Yiqi Huoxue Tuodu Prescription on Keap1Nrf2/HO-1 signaling pathway in rats with chronic nonbacterial prostatitis(CNP);To explore its mechanism for the treatment of CNP.Methods CNP rat model was prepared using castration combined with estrogen induction method.Totally 48 SD rats were divided into blank group,model group,celecoxib group and Yiqi Huoxue Tuodu Prescription group according to the random number table method,with 12 rats in each group.In the celecoxib group,celecoxib suspension was instilled 0.035 g/kg,and in the Yiqi Huoxue Tuodu Prescription group,Yiqi Huoxue Tuodu Prescription water decoction was instilled 8.64 g/kg,and the blank group and the model group were instilled with equal volume of normal saline for 28 days.Mechanical pain threshold in rats was measured using Von Frey fiber optic pain gauge,HE staining was used to observe pathological changes in prostate tissue and pathological scoring,the content of reactive oxygen species(ROS)in prostate tissue were detected by chemical fluorescence method and the glutathione peroxidase(GSH-Px)activity and malondialdehyde(MDA)content in prostate tissue were detected by colorimetric method,Western blot was used to detect the expressions of Kelch like ECH related protein 1(Keap1),nuclear factor E2 related factor 2(Nrf2),and heme oxygenase-1(HO-1)protein in prostate tissue.Results Compared with the blank group,rats in the model group had significantly lower mechanical pain threshold and significantly decreased prostate index(P<0.01);the size of the glandular cavity in prostate tissue varied,with the disappearance of secretions in the cavity,interstitial looseness and edema,a large amount of fibrous tissue hyperplasia and inflammatory cell infiltration,and a significant increase in pathological scores(P<0.01);the contents of ROS and MDA in prostate tissue significantly increased,the activity of GSH-Px significantly decreased(P<0.01),the expression of Keap1 and Nrf2 proteins significantly decreased,and the expression of HO-1 protein significantly increased(P<0.01,P<0.05).Compared with the model group,the mechanical pain threshold of the rats in the Yiqi Huoxue Tuodu Prescription group was significantly higher(P<0.01);there was mild damage to prostate tissue,with a small amount of fibrous hyperplasia and inflammatory cell infiltration,and a significant decrease in pathological scores(P<0.01,P<0.05);the contents of ROS and MDA in prostate tissue significantly decreased,and the GSH-Px activity significantly increased(P<0.01),the Keap1 and Nrf2 protein expressions significantly increased and HO-1 protein expression significantly decreased in prostate tissue(P<0.01,P<0.05).Conclusion Yiqi Huoxue Tuodu Prescription can effectively improve the histopathological morphology and increase the pain threshold of the prostate gland in CNP rats,and its mechanism of action may be related to the regulation of Keap1/Nrf2/HO-1 signaling pathway and reduction of oxidative stress damage in prostate tissue of rats.
9.Comparison of mid-to-long term outcomes between mitral valve repair and biological valve replacement in patients over 60 with rheumatic mitral valve disease based on a propensity score matching study
Wenbo ZHANG ; Jie HAN ; Tiange LUO ; Baiyu TIAN ; Fei MENG ; Wenjian JIANG ; Yuqing JIAO ; Xiaoming LI ; Jintao FU ; Yichen ZHAO ; Fei LI ; Xu MENG ; Jiangang WANG
Chinese Journal of Surgery 2024;62(11):1016-1023
Objective:To compare and discuss the mid-to-long-term outcomes of mitral valve repair (MVP) versus biological mitral valve replacement (bMVR) in patients aged 60 years and above with rheumatic mitral valve disease.Methods:This is a retrospective cohort study. A total of 765 patients aged 60 years and older, diagnosed with rheumatic mitral valve disease and who underwent MVP or bMVR at Beijing Anzhen Hospital from January 2010 to January 2023, were retrospectively included. Among them, 186 were male and 579 were female, with an age of (66.1±4.5) years (range: 60 to 82 years). Patients were divided into two groups based on the surgical method: the mitral valve repair group (MVP group, n=256) and the bioprosthetic mitral valve replacement group (bMVR group, n=509). A 1∶1 propensity score matching was performed using a caliper value of 0.2 based on preoperative data. Paired sample t-tests, χ2 tests, or Fisher′s exact tests were used for intergroup comparisons. Kaplan-Meier method was employed to plot survival curves and valve-related reoperation rate curves for both groups before and after matching, and Log-rank tests were used to compare the mid-to long-term survival rates and valve-related reoperation rates between the two groups. Results:A total of 765 patients who completed follow-up were ultimately included, with a follow-up period ( M(IQR)) of 5.1(5.0) years (range: 1.0 to 12.9 years). After matching, each group consisted of 256 patients. The incidence of early postoperative atrial fibrillation (39.1% vs. 49.2%, χ2=4.95, P=0.026) and early mortality rates (2.0% vs. 6.2%, χ2=4.97, P=0.026) were lower in the MVP group. Unadjusted Kaplan-Meier analysis showed significantly higher 5-year and 10-year survival rates for the MVP group (92.54% vs. 83.02%, 86.22% vs. 70.19%, Log-rank: P=0.001). After adjustment with propensity scores, the Kaplan-Meier analysis still indicated higher 5-year and 10-year survival rates in the MVP group compared to the bMVR group (92.54% vs. 85.89%, 86.22% vs. 74.83%, Log-rank: P=0.024). There were no significant differences in the rates of valve-related reoperation between the two groups before and after matching (5-year and 10-year reoperation rates pre-matching: 1.75% vs. 0.57%, 5.39% vs. 7.54%, Log-rank: P=0.207; post-matching: 1.75% vs. 0, 5.39% vs. 9.27%, Log-rank: P=0.157). Conclusion:For patients aged 60 years and above with rheumatic mitral valve disease, mitral valve repair offers better mid-to-long-term survival compared to biological valve replacement.
10.Utilization of 3D printing technology in hepatopancreatobiliary surgery
SHI WUJIANG ; WANG JIANGANG ; GAO JIANJUN ; ZOU XINLEI ; DONG QINGFU ; HUANG ZIYUE ; SHENG JIALIN ; GUAN CANGHAI ; XU YI ; CUI YUNFU ; ZHONG XIANGYU
Journal of Zhejiang University. Science. B 2024;25(2):123-134
The technology of three-dimensional(3D)printing emerged in the late 1970s and has since undergone considerable development to find numerous applications in mechanical engineering,industrial design,and biomedicine.In biomedical science,several studies have initially found that 3D printing technology can play an important role in the treatment of diseases in hepatopancreatobiliary surgery.For example,3D printing technology has been applied to create detailed anatomical models of disease organs for preoperative personalized surgical strategies,surgical simulation,intraoperative navigation,medical training,and patient education.Moreover,cancer models have been created using 3D printing technology for the research and selection of chemotherapy drugs.With the aim to clarify the development and application of 3D printing technology in hepatopancreatobiliary surgery,we introduce seven common types of 3D printing technology and review the status of research and application of 3D printing technology in the field of hepatopancreatobiliary surgery.

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