1.Research progress in radiation-induced heart disease associated with radiotherapy for breast cancer
Wenji PU ; Haiman JING ; Zhiyuan XU ; Jing JIN
Chinese Journal of Radiation Oncology 2025;34(2):189-195
With the great improvement in the prognosis and survival of breast cancer patients, coupled with the widespread use of cardiotoxic drugs, the cardiotoxicity caused by radiation-induced heart disease (RIHD) partially offsets the overall survival benefits of breast cancer patients. Heart damage occurs in many structures, such as left and right coronary arteries, the cardiac conduction system, the pericardium, and heart valves. RIHD has a long incubation period, most of which occur more than 10 years after radiotherapy, and the clinical manifestations become prominent with the extension of time. Advanced modern radiotherapy concepts such as respiratory gating, image-guided radiotherapy, conformal intensity-modulated radiotherapy, and intensity-modulated proton therapy can effectively reduce the radiation dose of breast cancer radiotherapy-related heart and left anterior descending coronary artery. The study of precise radiotherapy protection technology for the heart and large vessels is expected to reduce non-tumor-related death and achieve long-term survival in patients with breast cancer. The important direction in the future is to study the mechanism of RIHD, to find the best cardiac dose reference point, and to define the ideal dose-response relations. Combined with hematological markers, auxiliary examination parameters and cardiovascular risk factors, a predictive model will be established to estimate the probability of radiation-related cardiotoxicity in patients with breast cancer. As the radiation-related cardiotoxicity of breast cancer has become increasingly prominent, the purpose of this article is to summarize the related studies of RIHD in order to improve the long-term survival rate and quality of life of these sufferers.
2.Research progress in radiation-induced heart disease associated with radiotherapy for breast cancer
Wenji PU ; Haiman JING ; Zhiyuan XU ; Jing JIN
Chinese Journal of Radiation Oncology 2025;34(2):189-195
With the great improvement in the prognosis and survival of breast cancer patients, coupled with the widespread use of cardiotoxic drugs, the cardiotoxicity caused by radiation-induced heart disease (RIHD) partially offsets the overall survival benefits of breast cancer patients. Heart damage occurs in many structures, such as left and right coronary arteries, the cardiac conduction system, the pericardium, and heart valves. RIHD has a long incubation period, most of which occur more than 10 years after radiotherapy, and the clinical manifestations become prominent with the extension of time. Advanced modern radiotherapy concepts such as respiratory gating, image-guided radiotherapy, conformal intensity-modulated radiotherapy, and intensity-modulated proton therapy can effectively reduce the radiation dose of breast cancer radiotherapy-related heart and left anterior descending coronary artery. The study of precise radiotherapy protection technology for the heart and large vessels is expected to reduce non-tumor-related death and achieve long-term survival in patients with breast cancer. The important direction in the future is to study the mechanism of RIHD, to find the best cardiac dose reference point, and to define the ideal dose-response relations. Combined with hematological markers, auxiliary examination parameters and cardiovascular risk factors, a predictive model will be established to estimate the probability of radiation-related cardiotoxicity in patients with breast cancer. As the radiation-related cardiotoxicity of breast cancer has become increasingly prominent, the purpose of this article is to summarize the related studies of RIHD in order to improve the long-term survival rate and quality of life of these sufferers.
3.Screening for α-glucosidase and tyrosinase inhibitors from Forsythia suspensa leaves by LC-MS technology combined biochemical analysis method
Jing-pu XU ; Xing-long TAO ; Li-ya ZHENG ; De-qiang LI
The Chinese Journal of Clinical Pharmacology 2024;40(23):3453-3457
Objective To build a liquid chromatography mass spectrometry technology combined biochemical analysis method for screening α-glucosidase and tyrosinase inhibitors from Forsythia suspense leaves extract.Method Forsythia suspense leaves extract was injected into the high performance liquid chromatography system for the separation and 10 fractions were collected manually according to the peak time of each injection.The bioassays were determined by spectrophotometric method,the high performance liquid chromatography mass spectrometry was used for the characterization.Results A total of 7 fractions were screened from forsythia leaf extract which had inhibitory effects on α-glucosidase and tyrosinase inhibitors,5 compounds were characterized,and the qualitative results showed that fraction 3 was calceolarioside B or plantainoside B,fraction 4 was(+)-epicatechol-4-O-β-D-glucoside,fraction 5 was phillyrin,fraction 6 was the isomeride of phillyrin,and fraction 7 was calceolarioside C.Fraction 3,4 and 5 showed inhibitory effect on both tyrosinase and α-glucosidase,fraction 6 showed inhibitory effect on α-glucosidase only.Conclusion The test results showed that the proposed method was a simple,effective,rapid method for drug discovery in natural products,and it can be extended to screen other bioactive compounds from natural products and other complex samples.
4.Evidence-based application of neoadjuvant immunotherapy in locally advanced rectal cancer
Pu WENJI ; Su XIAOYE ; Feng LINGLING ; Chen WENQI ; Xu ZHIYUAN ; Jin JING
Chinese Journal of Clinical Oncology 2024;51(9):472-479
Deficient mismatch repair(dMMR)is currently recognized as a biomarker for predicting the efficacy of immune checkpoint inhib-itors(ICIs),and domestic and foreign guidelines recommend first-line immunotherapy for patients with solid dMMR tumors.For rectal can-cer,only 5%of patients are classified as dMMR/microsatellite instability-high(MSI-H),and most have"immune desert type"or mismatch re-pair proficient(pMMR)/microsatellite stabilization(MSS)diseases,which respond poorly to ICIs.Therefore,recently,the synergistic effect of immune drugs and neoadjuvant chemoradiotherapy has been the focus of basic and clinical research.An increasing number of clinical trials of phase Ⅱ/Ⅲ immuno-total neoadjuvant therapy(iTNT)have emerged,and the management of locally advanced rectal cancer(LARC)has begun to enter the non-operative treatment era.Furthermore,an increasing number of studies support the efficacy of neoadjuvant immun-otherapy in patients with dMMR/MSI-H LARC,which exempts such patients from surgery and chemoradiotherapy as follow-up treatment and results in a pivot in the treatment paradigm of a watch-and-wait strategy.Regarding the LARC with pMMR/MSS,the preliminary iTNT findings support ICIs as a shift from an initial posterior-line palliative scheme to a first-line selection strategy and the continuation of large-scale clinical trials.However,no definitive conclusion has been reached regarding the best iTNT application for LARC.Recent studies have shown that short-course radiotherapy and sequential neoadjuvant chemotherapy,combined with immunotherapy,can achieve good short-term outcomes.Finally,identifying other new biomarkers may facilitate the identification of patients with pMMR/MSS who are sensitive to immune drugs(especially for low rectal cancer).In the future,the treatment strategy of LARC should be combined with the stratification of clinical recurrence risk and patient willingness for organ retention to achieve stratified and accurate treatment.This article will review the re-lated research background,basic and clinical research progress and existing problems of iTNT in LARC.
5.Research and Application Progress of Near Infrared Spectroscopy Analytical Technology in China in the Past Five Years
Pu CHEN ; Jian YANG ; Xiao-Li CHU ; Jing-Yan LI ; Yu-Peng XU ; Dan LIU
Chinese Journal of Analytical Chemistry 2024;52(9):1213-1224
Near infrared spectroscopy is a molecular absorption spectrum with rich compositional and structural information,and its applications are very extensive.In recent years,driven by the background of artificial intelligence,the Internet of Things,and smart factories,the near-infrared spectroscopy analysis technology in China has achieved rapid and high-quality development.Research and application in many fields have been further strengthened,achieving good results.In this paper,the research and application progresses of near infrared spectroscopy in China in the past five years(from 2019 to 2023)were reviewed with 105 references.The content involved methodology research,practical technology research,application research and so on,and some suggestions were put forward for the research and development of the key technologies of near infrared spectroscopy in the future.
6.Correlation between interleukin 1β-511C/T polymorphism and essential hypertension in the Yi ethnic group of Yunnan province
Tong YANG ; Yuan XU ; Xingyun PU ; Yiting MA ; Jing YANG ; Xin SHU ; Hongyu PENG ; Yanrui WU ; Li LONG
Basic & Clinical Medicine 2024;44(12):1651-1655
Objective To investigate the correlation between interleukin 1β gene-511C/T polymorphism of and essential hypertension in the Yi ethnic group of Yunnan province.Methods-511C/T polymorphism of interleukin 1β gene was detected by PCR-RFLP in 85 Yi patients with essential hypertension(EH group)and 106 Yi healthy people(control group)in Shuanghe Township,Jinning County,Yunnan Province.Genotype and allele frequencies were analyzed by SPSS 27.0 software,and association analysis was performed.Results The frequency distribution of CC,CT and TT genotypes at the mutation site 511 of the IL-1βgene in EH group was 18.82%,44.71%and 36.47%,respectively,and it was 5.66%,26.42%and 67.92%in the control group.The difference in genotype frequency between the two groups was statistically significant(P<0.05).The allele frequency of C and T in EH group was 41.18%and 58.82%,respectively,and the allele frequency of C and T in control group was 18.87%and 81.13%.The frequency difference of alleles between the two groups was statistically significant(P<0.05).Both genotype frequency and allele frequency found in males and females had statistical differences(P<0.05).Conclusions The distribution of IL-1β gene-511C/T polymorphism is related to the incident of essential hyper-tension among the Yi ethnic group Yunnan Province,and is the susceptibility gene of the Yi ethnic group to essen-tial hypertension.
7.Simultaneous determination of gefitinib,erlotinib,nilotinib and imatinib concentrations in plasma by HPLC-MS/MS
Tian-Lun ZHENG ; Jing-Pu XU ; Zhu-Hang HAN ; Wen-Li LI ; Wei-Chong DONG ; Zhi-Qing ZHANG
The Chinese Journal of Clinical Pharmacology 2024;40(6):899-903
Objective To establish a high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS)for the simultaneous determination of gefitinib,erlotinib,nillotinib and imatinib plasma concentrations and analyze the results.Methods The plasma samples were treated with acetonitrile precipitation and separated by Diamonsil C18 column(150 mm ×4.6 mm,3.5 μm)with mobile phase of 0.1%formic acid water(A)-0.1%formic acid acetonitrile(B).The flow rate of gradient elution was 0.7 mL·min-1,and the column temperature was 40 ℃ and the injection volume was 3 μL.Using arotinib as the internal standard,the scanning was carried out by using electrospray ionization source in positive ionization mode with multi-reaction monitoring.The specificity,standard curve,lower limit of quantitation,precision,accuracy,recovery rate,matrix effect and stability of the method were investigated.The concentrations of imatinib and erlotinib in 20 patients with chronic myelogenous leukemia(CML)and gefitinib and erlotinib in 3 patients with non-small cell lung cancer were measured.Results The standard curves of the four drugs were as follows,gefitinib:y=2.536 × 10-3x+9.362 × 10-3(linear range 20-2 000 ng·mL-1,R2=0.996 6);erlotinib:y=3.575× 10-3x+7.406 × 10-3(linear range 50-5 000 ng·mL-1,R2=0.994 9);nilotinib:y=1.945 x 10-3x+0.015 643(linear range 50-5 000 ng·mL-1,R2=0.990 6);imatinib:y=4.56 x 10-3x+0.010 451(linear range 100~104 ng·mL-1,R2=0.9963).RSD of intra-day and inter-day were less than 10%,and the accuracy ranged from 90%to 110%,and the recovery rates were 91.35%to 98.93%(RSD<10%);the matrix effect ranged from 91.64%to 107.50%(RSD<10%).Determination of 23 patients showed that the blood concentration of nilotinib ranged from 623.76 to 2 934.13 ng·mL-1,and the blood concentration of imatinib ranged from 757.77 to 2 637.71 ng·mL-1,and the blood concentration of gefitinib ranged from 214.76 to 387.40 ng·mL-1.The serum concentration of erlotinib was 569.57 ng·mL-1.Conclusion The method of this research is simple,fast,sensitive and dedicated,which can be monitored by the concentration of clinical blood.
8.Prevalence of central obesity among the elderly with different body mass indexes in Xuhui District, Shanghai
Zhanyu JIANG ; Xiaolin QIAN ; Xiaohong ZHANG ; Zhenmei PU ; Jing ZHU ; Weiqi XU ; Chaowei FU ; Haiyan GU
Shanghai Journal of Preventive Medicine 2024;36(3):289-296
ObjectiveTo investigate the prevalence and influencing factors of overweight, obesity and central obesity among elderly residents in Xuhui District, and to analyze the epidemiological status of central obesity in elderly people with different body mass indexes. MethodsThe third round of health status and health service utilization monitoring data in Xuhui District was used. The information collected from questionnaire survey and physical examination were analyzed. SPSS 20.0 software was used for χ2 test, trend χ2 test and multinominal logistic regression analysis. Results5 096 survey subjects were included. The prevalence of overweight, general obesity, and central obesity in the residents aged 60 and above in Xuhui District were 34.3%, 6.5%, and 29.2%, respectively. There was gender difference in the rates of overweight, obesity, and central obesity among the residents. The overweight and central obesity rates in males were higher than those in females, while the obesity rate was lower than that in females (P<0.05). Multinominal logistic regression analysis showed that in comparison with the normal weight non-central obesity group drinking only at party (OR=1.729, 95%CI: 1.184‒2.525), and hypertension (OR=1.637, 95%CI: 1.305‒2.053), were highly associated with normal weight with central obesity. Aged 60‒ years (OR=1.589, 95%CI: 1.190‒2.120), aged 70‒ years (OR=1.763, 95%CI: 1.327‒2.342), male (OR=1.379, 95%CI: 1.134‒1.676), hypertension (OR=2.231, 95%CI: 1.878‒2.649), former smokers (OR=1.437, 95%CI: 1.027‒2.011), drinking at party only (OR=1.491, 95%CI: 1.107‒2.006), and drinking ≥3 times per week (OR=1.611, 95%CI: 1.116‒2.325), were highly associated with overweight combined with central obesity. Aged 60‒ years (OR=3.817, 95%CI: 2.251‒6.474), aged 70‒ years (OR=3.084, 95%CI: 1.838‒5.175), hypertension (OR=3.683, 95%CI: 2.753‒4.929), diabetes (OR=2.085, 95%CI: 1.511‒2.878), former smokers (OR=1.835, 95%CI: 1.043‒3.226), were highly associated with compound obesity. Central obesity was found in the elderly residents with different BMI categories, and the rate of central obesity increased with the increase of BMI grade. ConclusionThe prevalence of overweight, obesity and central obesity among the elderly aged 60 years and above in Xuhui District is not optimistic. Attention should be paid to the elderly under 80 years old who are with hypertension and/or diabetes, alcohol consumption, low educational level and not doing physical exercise. Especially for the central obesity population with normal BMI, measures should be taken to prevent and intervene the occurrence of obesity and related diseases.
9.Practice and thinking of building active learning general practice team based on learning health system
Fei SHENG ; Tiantian DENG ; Dongjian XU ; Liling MAO ; Jing PU ; Yu LIU ; Ping YU ; Weifang LIU ; Fulai SHEN ; Puyang ZHENG
Chinese Journal of General Practitioners 2024;23(4):399-405
By sorting out the differences and connections between family doctor teams and specialized disease teams, role competency and mutual collaboration, and introducing the learning health system (LHS) mechanism, a comprehensive operating system for community general practice learning organizations based on LHS was constructed, focusing on five single disease types. The system includes a combination of general and specialized medicine that links three levels of medical institutions, thereby opening up the business cooperation process between professionals in different institutions, and establishing a sustainable collaboration mechanism. This allows medical institutions at three levels to continuously tap the potential of their disciplines, achieve their own ability growth and feel higher work value, and also bring better health solutions to residents, guided by the common goal of "health centered, patient centered".
10.Distribution range of Himalayan marmots and plague risk analysis in Gaotai County,Gansu Province
Wen-jing AN ; Jin-xiao XI ; Ai-wei HE ; Ding-sheng WANG ; Da-qin XU ; Xiu-hua PU ; Huan YANG ; Bin-guo RONG
Chinese Journal of Zoonoses 2024;40(12):1194-1198
This study was aimed at surveying the distribution of Himalayan marmots in Gaotai County,Zhangye City,Gan-su Province,and analyzing the risk of plague occurrence,to provide a scientific basis for plague prevention and control in the area.On the basis of preliminary evidence,we used a combined approach of on-site investigation and Global Positioning System(GPS)positioning to survey the distribution and natural geographical landscape characteristics of the Himalayan marmot in Gaotai County.Population information and customs in the marmot distribution area were investigated through methods such as data retrieval and household visits.Himalayan marmots were captured through bow-shaped trapping,and blood,liver,spleen,heart,lung,kidney,femur,and surface-intermediate host samples were collected.Pathological and serological tests were conducted according to the Plague Diagnosis Criteria(WS279-2008).In Xinba Town,Gaotai County,Himalayan marmots were found in 16 villages(53.33%).Heping Village had the largest distribution area(100%),and was followed by Zhaoyi Village(79.17%)and Xishang Village(55.32%),whereas the other areas had values below 50%.Regarding the direct threats posed by marmots,Heping Village,Dongda Vil-lage,and Zhaoyi Village had values of 100%,Xishang Village had a value of 90.59%,and the other areas had values below 50%.The flea infestation rate on marmots'bodies was 59.62%,and the flea index was 1.48%(77/52).The main surface-in-termediate hosts were steppe ticks,body lice,Xenopsylla siberica,and Nosopsyllus laeviceps,accounting for 72.31%(517/715),16.92%(121/715),6.43%(46/715),and 4.20%(30/715),respectively,with steppe ticks being the dominant species.A total of 52 liver and spleen tissue samples from marmots,and 715 surface-intermediate hosts samples,were collected for bacterial culture.No Yersinia pestis was found.RIHA testing for plague F1 antigen was negative in all samples.Additionally,52 blood serum samples from marmots were collected,and IHA testing for plague-specific F1 antibodies was negative in all samples.The natural plague foci of marmots in the Qilian Mountains and Altyn Mountains is affected by factors including con-tinuing increases in temperature and grassland degradation.As a result,the marmot plague hosts continually migrate to sur-rounding non-epidemic areas,particularly in Gaotai County,Zhangye City.Local residents often hunt wild rabbits and mar-mots,thus posing a risk of human plague outbreaks if animal plague occurs.This county is recommended to be included in the province's plague surveillance and epidemic source investigation.Additionally,efforts should be strengthened in health educa-tion,medical personnel training,and management of key individuals and emergency reserves.If necessary,protective measures should be taken in marmot and flea control,to prevent the occurrence and spread of plague.

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