1.Key Points for Quality Management in Phase Ⅰ Clinical Trials of Anti-Tumor Drugs
Li GONG ; Bin LIAO ; Jie SHEN ; Juan ZHAO ; Yi GONG ; Xiaoxiao LU ; Huiyao YANG ; Sha LI ; Yongsheng LI
Cancer Research on Prevention and Treatment 2025;52(5):347-354
Phase Ⅰ clinical trials play a crucial role in the research and development of new drugs, serving as the initial studies to assess their safety, tolerability, effectiveness, and pharmacokinetic properties in humans. These trials involve uncertainties regarding safety and efficacy. Comprehensive management of all aspects of phase Ⅰ clinical trials for anti-tumor drugs is crucial to protect the rights and safety of participants. This article provides an in-depth analysis of the key points and precautions necessary for effective quality control throughout the process. The analysis is informed by guidelines such as the “Good Clinical Practice for Drugs” “Key Points and Judgment Principles for Drug Registration Verification” “Key Points and Judgment Principles for Supervision and Inspection of Drug Clinical Trial Institutions” and the standard operating procedures for quality control of the center. Topics discussed include informed consent, inclusion criteria, experimental drugs, biological samples, adverse events, and serious adverse events. The goal is to standardize quality control in phase Ⅰ clinical trials of anti-tumor drugs, ensure the authenticity and reliability of clinical trial data, and protect the rights and safety of participants.
2.Hand Dexterity Recovery Capacity for Degenerative Cervical Myelopathy With Varying Levels of Impairment: A Prospective 1-Year Follow-up Study
Guoyan LIANG ; Tianying LIAO ; Yongyu YE ; Yi CAI ; Junying CHEN ; Yunbing CHANG
Neurospine 2025;22(1):202-210
Objective:
This study aimed to elucidate the hand function recovery capacity of degenerative cervical myelopathy (DCM) patients with different severities of hand dexterity impairment.
Methods:
Hand functional outcome measures such as the 10-second grip and release (10s-G&R) test, modified Japanese Orthopaedic Association (mJOA) upper extremity score and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) upper extremity function were collected before surgery and at the 1-year follow-up. A total of 102 DCM patients were categorized into mild, moderate and severe group based on the preoperative 10s-G&R test result. Hand functional parameters were compared across the 3 groups. Multivariate linear regression was conducted to explore predictive factors. Receiver operating characteristic curve analysis was performed to assess the predictive efficacy of the preoperative 10s-G&R test and establish the cutoff value for incomplete recovery of hand dexterity.
Results:
At the 1-year follow-up, significant improvements were observed in all hand functional parameters across all 3 groups. However, the incomplete recovery rates of the mild, moderate, severe groups were 26.67%, 46.88%, and 57.50%, respectively (p < 0.05). Multivariate regression revealed that preoperative 10s-G&R test result, age, Hoffmann sign, duration of symptom, and mJOA Upper score serve as significant predictors for postoperative 10s-G&R test outcomes. Patients with a preoperative 10s-G&R test < 15 cycles have a 1.9 times higher risk of incomplete recovery of hand function (p = 0.005).
Conclusion
Most patients, regardless of their preoperative hand function, exhibit potential for improvement in hand dexterity. However, worse initial hand dexterity correlates with poorer outcomes. Surgical treatment is recommended before the 10s-G&R test drops below 15 cycles.
3.Hand Dexterity Recovery Capacity for Degenerative Cervical Myelopathy With Varying Levels of Impairment: A Prospective 1-Year Follow-up Study
Guoyan LIANG ; Tianying LIAO ; Yongyu YE ; Yi CAI ; Junying CHEN ; Yunbing CHANG
Neurospine 2025;22(1):202-210
Objective:
This study aimed to elucidate the hand function recovery capacity of degenerative cervical myelopathy (DCM) patients with different severities of hand dexterity impairment.
Methods:
Hand functional outcome measures such as the 10-second grip and release (10s-G&R) test, modified Japanese Orthopaedic Association (mJOA) upper extremity score and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) upper extremity function were collected before surgery and at the 1-year follow-up. A total of 102 DCM patients were categorized into mild, moderate and severe group based on the preoperative 10s-G&R test result. Hand functional parameters were compared across the 3 groups. Multivariate linear regression was conducted to explore predictive factors. Receiver operating characteristic curve analysis was performed to assess the predictive efficacy of the preoperative 10s-G&R test and establish the cutoff value for incomplete recovery of hand dexterity.
Results:
At the 1-year follow-up, significant improvements were observed in all hand functional parameters across all 3 groups. However, the incomplete recovery rates of the mild, moderate, severe groups were 26.67%, 46.88%, and 57.50%, respectively (p < 0.05). Multivariate regression revealed that preoperative 10s-G&R test result, age, Hoffmann sign, duration of symptom, and mJOA Upper score serve as significant predictors for postoperative 10s-G&R test outcomes. Patients with a preoperative 10s-G&R test < 15 cycles have a 1.9 times higher risk of incomplete recovery of hand function (p = 0.005).
Conclusion
Most patients, regardless of their preoperative hand function, exhibit potential for improvement in hand dexterity. However, worse initial hand dexterity correlates with poorer outcomes. Surgical treatment is recommended before the 10s-G&R test drops below 15 cycles.
4.Hand Dexterity Recovery Capacity for Degenerative Cervical Myelopathy With Varying Levels of Impairment: A Prospective 1-Year Follow-up Study
Guoyan LIANG ; Tianying LIAO ; Yongyu YE ; Yi CAI ; Junying CHEN ; Yunbing CHANG
Neurospine 2025;22(1):202-210
Objective:
This study aimed to elucidate the hand function recovery capacity of degenerative cervical myelopathy (DCM) patients with different severities of hand dexterity impairment.
Methods:
Hand functional outcome measures such as the 10-second grip and release (10s-G&R) test, modified Japanese Orthopaedic Association (mJOA) upper extremity score and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) upper extremity function were collected before surgery and at the 1-year follow-up. A total of 102 DCM patients were categorized into mild, moderate and severe group based on the preoperative 10s-G&R test result. Hand functional parameters were compared across the 3 groups. Multivariate linear regression was conducted to explore predictive factors. Receiver operating characteristic curve analysis was performed to assess the predictive efficacy of the preoperative 10s-G&R test and establish the cutoff value for incomplete recovery of hand dexterity.
Results:
At the 1-year follow-up, significant improvements were observed in all hand functional parameters across all 3 groups. However, the incomplete recovery rates of the mild, moderate, severe groups were 26.67%, 46.88%, and 57.50%, respectively (p < 0.05). Multivariate regression revealed that preoperative 10s-G&R test result, age, Hoffmann sign, duration of symptom, and mJOA Upper score serve as significant predictors for postoperative 10s-G&R test outcomes. Patients with a preoperative 10s-G&R test < 15 cycles have a 1.9 times higher risk of incomplete recovery of hand function (p = 0.005).
Conclusion
Most patients, regardless of their preoperative hand function, exhibit potential for improvement in hand dexterity. However, worse initial hand dexterity correlates with poorer outcomes. Surgical treatment is recommended before the 10s-G&R test drops below 15 cycles.
5.Therapeutic effect and mechanism of umbilical cord mesenchymal stem cells in rats with primary graft dysfunction after lung transplantation
Hailin LIAO ; Xiaohua WANG ; Yi LU ; Chunrong JU
Organ Transplantation 2025;16(1):91-98
Objective To explore the therapeutic effect and mechanism of umbilical cord mesenchymal stem cells (UC-MSC) in rats with primary graft dysfunction after lung transplantation. Methods Twenty-four male Lewis rats were randomly divided into donor and recipient groups, with 12 rats in each group. The recipients were further divided into 3 groups: blank control group, negative control group, and treatment group, with 4 rats in each group. The color, size and texture of the transplanted lungs were observed 72 h after lung transplantation. The ventilation status and progression of consolidation in the transplant lungs of rats in each group were evaluated by micro-CT. Plasma, transplant lung tissue and alveolar lavage fluid samples of recipient rats were collected. The wet/dry ratio of lung tissue was measured to evaluate the degree of pulmonary edema. Hematoxylin-eosin (HE) staining was used to evaluate the degree of lung tissue damage. Terminal deoxyribonucleic acid transferase mediated dUTP nick end labeling (TUNEL) staining was used to evaluate cell apoptosis. Myeloperoxidase (MPO) activity in lung tissue was detected, and enzyme-linked immunosorbent assay (ELISA) was used to detect interleukin (IL)-6, IL-10 and tumor necrosis factor (TNF)-α levels in plasma and alveolar lavage fluid. Results The appearance of the transplant lungs in the negative control group was significantly different from that of the autologous lungs, while the transplant lungs in the treatment group were almost identical in color to the autologous lungs compared to the blank control group. Compared with the negative control group, the treatment group showed reduced alveolar exudate and more intact airway epithelial cell structure. No alveolar exudate was observed in the blank control group, and the structure of the airways and alveoli remained normal. The treatment group had lower apoptosis rate of airway epithelial cells, lung tissue wet/dry ratio, and MPO activity compared to the negative control group (all P < 0.05). The levels of IL-6 and TNF-α in the bronchoalveolar lavage fluid of the treatment group were lower than those in the negative control group, while the level of IL-10 was higher than that in the negative control group and the blank control group (all P < 0.05). There were no statistically significant differences in the levels of cytokines in plasma among each group (all P > 0.05). Conclusions UC-MSC may effectively alleviate the severity of primary graft dysfunction in rats by reducing the apoptosis rate of cells in lung tissue and inhibiting inflammatory responses.
6.Construction of a prognostic prediction model for invasive lung adenocarcinoma based on machine learning
Yanqi CUI ; Jingrong YANG ; Lin NI ; Duohuang LIAN ; Shixin YE ; Yi LIAO ; Jincan ZHANG ; Zhiyong ZENG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(01):80-86
Objective To determine the prognostic biomarkers and new therapeutic targets of the lung adenocarcinoma (LUAD), based on which to establish a prediction model for the survival of LUAD patients. Methods An integrative analysis was conducted on gene expression and clinicopathologic data of LUAD, which were obtained from the UCSC database. Subsequently, various methods, including screening of differentially expressed genes (DEGs), Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis and Gene Set Enrichment Analysis (GSEA), were employed to analyze the data. Cox regression and least absolute shrinkage and selection operator (LASSO) regression were used to establish an assessment model. Based on this model, we constructed a nomogram to predict the probable survival of LUAD patients at different time points (1-year, 2-year, 3-year, 5-year, and 10-year). Finally, we evaluated the predictive ability of our model using Kaplan-Meier survival curves, receiver operating characteristic (ROC) curves, and time-dependent ROC curves. The validation group further verified the prognostic value of the model. Results The different-grade pathological subtypes' DEGs were mainly enriched in biological processes such as metabolism of xenobiotics by cytochrome P450, natural killer cell-mediated cytotoxicity, antigen processing and presentation, and regulation of enzyme activity, which were closely related to tumor development. Through Cox regression and LASSO regression, we constructed a reliable prediction model consisting of a five-gene panel (MELTF, MAGEA1, FGF19, DKK4, C14ORF105). The model demonstrated excellent specificity and sensitivity in ROC curves, with an area under the curve (AUC) of 0.675. The time-dependent ROC analysis revealed AUC values of 0.893, 0.713, and 0.632 for 1-year, 3-year, and 5-year survival, respectively. The advantage of the model was also verified in the validation group. Additionally, we developed a nomogram that accurately predicted survival, as demonstrated by calibration curves and C-index. Conclusion We have developed a prognostic prediction model for LUAD consisting of five genes. This novel approach offers clinical practitioners a personalized tool for making informed decisions regarding the prognosis of their patients.
7.Hand Dexterity Recovery Capacity for Degenerative Cervical Myelopathy With Varying Levels of Impairment: A Prospective 1-Year Follow-up Study
Guoyan LIANG ; Tianying LIAO ; Yongyu YE ; Yi CAI ; Junying CHEN ; Yunbing CHANG
Neurospine 2025;22(1):202-210
Objective:
This study aimed to elucidate the hand function recovery capacity of degenerative cervical myelopathy (DCM) patients with different severities of hand dexterity impairment.
Methods:
Hand functional outcome measures such as the 10-second grip and release (10s-G&R) test, modified Japanese Orthopaedic Association (mJOA) upper extremity score and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) upper extremity function were collected before surgery and at the 1-year follow-up. A total of 102 DCM patients were categorized into mild, moderate and severe group based on the preoperative 10s-G&R test result. Hand functional parameters were compared across the 3 groups. Multivariate linear regression was conducted to explore predictive factors. Receiver operating characteristic curve analysis was performed to assess the predictive efficacy of the preoperative 10s-G&R test and establish the cutoff value for incomplete recovery of hand dexterity.
Results:
At the 1-year follow-up, significant improvements were observed in all hand functional parameters across all 3 groups. However, the incomplete recovery rates of the mild, moderate, severe groups were 26.67%, 46.88%, and 57.50%, respectively (p < 0.05). Multivariate regression revealed that preoperative 10s-G&R test result, age, Hoffmann sign, duration of symptom, and mJOA Upper score serve as significant predictors for postoperative 10s-G&R test outcomes. Patients with a preoperative 10s-G&R test < 15 cycles have a 1.9 times higher risk of incomplete recovery of hand function (p = 0.005).
Conclusion
Most patients, regardless of their preoperative hand function, exhibit potential for improvement in hand dexterity. However, worse initial hand dexterity correlates with poorer outcomes. Surgical treatment is recommended before the 10s-G&R test drops below 15 cycles.
8.Hand Dexterity Recovery Capacity for Degenerative Cervical Myelopathy With Varying Levels of Impairment: A Prospective 1-Year Follow-up Study
Guoyan LIANG ; Tianying LIAO ; Yongyu YE ; Yi CAI ; Junying CHEN ; Yunbing CHANG
Neurospine 2025;22(1):202-210
Objective:
This study aimed to elucidate the hand function recovery capacity of degenerative cervical myelopathy (DCM) patients with different severities of hand dexterity impairment.
Methods:
Hand functional outcome measures such as the 10-second grip and release (10s-G&R) test, modified Japanese Orthopaedic Association (mJOA) upper extremity score and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) upper extremity function were collected before surgery and at the 1-year follow-up. A total of 102 DCM patients were categorized into mild, moderate and severe group based on the preoperative 10s-G&R test result. Hand functional parameters were compared across the 3 groups. Multivariate linear regression was conducted to explore predictive factors. Receiver operating characteristic curve analysis was performed to assess the predictive efficacy of the preoperative 10s-G&R test and establish the cutoff value for incomplete recovery of hand dexterity.
Results:
At the 1-year follow-up, significant improvements were observed in all hand functional parameters across all 3 groups. However, the incomplete recovery rates of the mild, moderate, severe groups were 26.67%, 46.88%, and 57.50%, respectively (p < 0.05). Multivariate regression revealed that preoperative 10s-G&R test result, age, Hoffmann sign, duration of symptom, and mJOA Upper score serve as significant predictors for postoperative 10s-G&R test outcomes. Patients with a preoperative 10s-G&R test < 15 cycles have a 1.9 times higher risk of incomplete recovery of hand function (p = 0.005).
Conclusion
Most patients, regardless of their preoperative hand function, exhibit potential for improvement in hand dexterity. However, worse initial hand dexterity correlates with poorer outcomes. Surgical treatment is recommended before the 10s-G&R test drops below 15 cycles.
9.The Role of AMPK in Diabetic Cardiomyopathy and Related Intervention Strategies
Fang-Lian LIAO ; Xiao-Feng CHEN ; Han-Yi XIANG ; Zhi XIA ; Hua-Yu SHANG
Progress in Biochemistry and Biophysics 2025;52(10):2550-2567
Diabetic cardiomyopathy is a distinct form of cardiomyopathy that can lead to heart failure, arrhythmias, cardiogenic shock, and sudden death. It has become a major cause of mortality in diabetic patients. The pathogenesis of diabetic cardiomyopathy is complex, involving increased oxidative stress, activation of inflammatory responses, disturbances in glucose and lipid metabolism, accumulation of advanced glycation end products (AGEs), abnormal autophagy and apoptosis, insulin resistance, and impaired intracellular Ca2+ homeostasis. Recent studies have shown that adenosine monophosphate-activated protein kinase (AMPK) plays a crucial protective role by lowering blood glucose levels, promoting lipolysis, inhibiting lipid synthesis, and exerting antioxidant, anti-inflammatory, anti-apoptotic, and anti-ferroptotic effects. It also enhances autophagy, thereby alleviating myocardial injury under hyperglycemic conditions. Consequently, AMPK is considered a key protective factor in diabetic cardiomyopathy. As part of diabetes prevention and treatment strategies, both pharmacological and exercise interventions have been shown to mitigate diabetic cardiomyopathy by modulating the AMPK signaling pathway. However, the precise regulatory mechanisms, optimal intervention strategies, and clinical translation require further investigation. This review summarizes the role of AMPK in the prevention and treatment of diabetic cardiomyopathy through drug and/or exercise interventions, aiming to provide a reference for the development and application of AMPK-targeted therapies. First, several classical AMPK activators (e.g., AICAR, A-769662, O-304, and metformin) have been shown to enhance autophagy and glucose uptake while inhibiting oxidative stress and inflammatory responses by increasing the phosphorylation of AMPK and its downstream target, mammalian target of rapamycin (mTOR), and/or by upregulating the gene expression of glucose transporters GLUT1 and GLUT4. Second, many antidiabetic agents (e.g., teneligliptin, liraglutide, exenatide, semaglutide, canagliflozin, dapagliflozin, and empagliflozin) can promote autophagy, reverse excessive apoptosis and autophagy, and alleviate oxidative stress and inflammation by enhancing AMPK phosphorylation and its downstream targets, such as mTOR, or by increasing the expression of silent information regulator 1 (SIRT1) and peroxisome proliferator-activated receptor‑α (PPAR‑α). Third, certain anti-anginal (e.g., trimetazidine, nicorandil), anti-asthmatic (e.g., farrerol), antibacterial (e.g., sodium houttuyfonate), and antibiotic (e.g., minocycline) agents have been shown to promote autophagy/mitophagy, mitochondrial biogenesis, and inhibit oxidative stress and lipid accumulation via AMPK phosphorylation and its downstream targets such as protein kinase B (PKB/AKT) and/or PPAR‑α. Fourth, natural compounds (e.g., dihydromyricetin, quercetin, resveratrol, berberine, platycodin D, asiaticoside, cinnamaldehyde, and icariin) can upregulate AMPK phosphorylation and downstream targets such as AKT, mTOR, and/or the expression of nuclear factor erythroid 2-related factor 2 (Nrf2), thereby exerting anti-inflammatory, anti-apoptotic, anti-pyroptotic, antioxidant, and pro-autophagic effects. Fifth, moderate exercise (e.g., continuous or intermittent aerobic exercise, aerobic combined with resistance training, or high-intensity interval training) can activate AMPK and its downstream targets (e.g., acetyl-CoA carboxylase (ACC), GLUT4, PPARγ coactivator-1α (PGC-1α), PPAR-α, and forkhead box protein O3 (FOXO3)) to promote fatty acid oxidation and glucose uptake, and to inhibit oxidative stress and excessive mitochondrial fission. Finally, the combination of liraglutide and aerobic interval training has been shown to activate the AMPK/FOXO1 pathway, thereby reducing excessive myocardial fatty acid uptake and oxidation. This combination therapy offers superior improvement in cardiac dysfunction, myocardial hypertrophy, and fibrosis in diabetic conditions compared to liraglutide or exercise alone.
10.Relationship between serum CTSB and lncRNA MALAT1 levels and the severity of sepsis-associated acute kidney injury and their prognostic value
Chunyan LIAO ; Hairong WANG ; Yi LIU
International Journal of Laboratory Medicine 2024;45(20):2485-2490,2495
Objective To investigate the relationship between serum cathepsin B(CTSB)and long non-coding RNA metastasis-associated lung adenocarcinoma transcript 1(lncRNA MALAT1)levels and disease severity in patients with sepsis-associated acute kidney injury(SA-AKI)and their prognostic value.Methods A total of 80 patients with SA-AKI admitted to Deyang People's Hospital from January 2021 to January 2023 were selected as the SA-AKI group,and 80 patients with simple sepsis in the same period were selected as the simple sepsis group.According to the severity of the disease,SA-AKI patients were divided into stage 1(22 cases),stage 2(27 cases),and stage 3(31 cases).According to the 28 d clinical outcome,the pa-tients were divided into death group(35 cases)and survival group(45 cases).Enzyme-linked immunosorbent assay and real-time fluorescence quantitative PCR were used to detect serum CTSB and lncRNA MALAT1 levels.Multivariate Logistic regression analysis was used to analyze the influencing factors of poor prognosis in patients with SA-AKI.Receiver operating characteristic curve was used to analyze the predictive value of se-rum CTSB and lncRNA MALAT1 levels for death in patients with SA-AKI.Results Compared with the sim-ple sepsis group,the serum levels of CTSB and lncRNA MALAT1 were significantly increased in the SA-AKI group(P<0.05).The serum levels of CTSB and lncRNA MALAT1 in patients with stage 1,stage 2,and stage 3 SA-AKI were increased in turn(P<0.05).The 28 d mortality of the 80 patients was 43.75%.AKI stage 3,acute physiology and chronic health evaluation Ⅱ score,sequential organ failure assessment score,ele-vated blood lactate,CTSB and lncRNA MALAT1 were independent risk factors for death in patients with SA-AKI(P<0.05).The area under the curve of serum CTSB combined with lncRNA MALAT1 for predicting the death of patients with SA-AKI was 0.894,which was higher than 0.797 and 0.793 predicted by serum CTSB or lncRNA MALAT1 levels alone(P<0.05).Conclusion The increased levels of serum CTSB and ln-cRNA MALAT1 in patients with SA-AKI are closely related to the aggravation of the disease and poor prog-nosis.Serum CTSB combined with lncRNA MALAT1 levels have a high predictive value for the prognosis of patients with SA-AKI.

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