1.Research progress on polydopamine in the treatment of oral diseases
LU Xiangxiang ; JIANG Zhen ; XING Aili ; ZHAO Bin ; SUN Bin
Journal of Prevention and Treatment for Stomatological Diseases 2026;34(3):302-3014
Due to the moist environment in the mouth, there are many challenges that arise, such as difficult biofilm removal, short drug retention time, and low tissue repair efficiency, while treating dental caries, periodontal disease, and other oral diseases. As a biomimetic biomaterial, polydopamine (PDA) possesses multifunctional properties, including mussel-inspired adhesion and stimuli-responsive drug release. PDA adhesion properties originate from its surface catechol and amino functional groups, which maintain strong wettability in aqueous environments. With smart responsiveness encompassing photothermal, pH, and enzymatic stimuli, PDA enables controlled drug release under specific conditions. Additionally, PDA exhibits antibacterial, anti-inflammatory, and osteoblast-promoting functions, thus demonstrating significant application potential in the treatment of oral diseases. In hard tissue therapies, specifically for dental caries, PDA promotes enamel remineralization by inducing hydroxyapatite crystal growth and enhances dentin collagen mineralization through Ca2+ chelation while inhibiting cariogenic bacteria. In mandibular defect repair, functionalized PDA coatings on bone implants facilitate mesenchymal stem cell adhesion and differentiation, activate osteogenic signaling pathways, and synergistically promote vascularization to improve bone-implant integration. For soft tissue treatments, specifically for periodontitis, PDA alleviates alveolar bone resorption via antibacterial and anti-inflammatory effects coupled with osteoclast inhibition. In denture stomatitis management, PDA’s strong wet adhesion prolongs drug retention, while its photothermal effect and reactive oxygen generation provide both broad-spectrum antibacterial activity and wound healing promotion. This review summarizes PDA’s synthesis mechanisms and biological functions, with an emphasis on its therapeutic applications in oral diseases, providing innovative strategies for oral healthcare.
2.Mechanism of Jinyang Dingtong Plaster in Improving Peripheral Pain Sensitization and Synovial Fibrosis in Knee Osteoarthritis by Blocking Ion Channels of TRPs
Jinliang HE ; Lu ZHANG ; Shixin XING ; Xilu REN ; Jingxing JIANG ; Junfeng KANG ; Xuliang HAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):108-116
ObjectiveThis paper aims to investigate the mechanism of Jinyang Dingtong plaster in improving the peripheral pain sensitization and synovial fibrosis in rats with knee osteoarthritis (KOA) by blocking the ion channels of transient receptor potentials (TRPs). MethodsThe active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by using ultra-high performance liquid chromatography-electrospray ionization-quadrupole ion trap tandem mass spectrometry (UPLC-MS/MS) technology. A KOA rat model was established through intra-articular injection of monoiodoacetic acid. The rats were randomly divided into blank control group, KOA group, compound Nanxing Zhitong plaster Group, and Jinyang Dingtong plaster group, with eight rats per group. Among them, the rats in the compound Nanxing Zhitong plaster group and the Jinyang Dingtong plaster group were intervened with external application treatment. After the intervention period, the cold and mechanical stimulus pain thresholds of rats in each group were detected, and the transverse diameter of the knee joint was measured. The levels of inflammatory factors in the serum such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), nerve growth factor (NGF), and calcitonin gene-related peptide (CGRP) were determined by enzyme-linked immunosorbent assay (ELISA). Protein expression levels of transient receptor potential ankyrin 1 (TRPA1), transient receptor potential melastatin 8 (TRPM8), transient receptor potential vanilloid 1 (TRPV1), transient receptor potential vanilloid 4 (TRPV4), transforming growth factor-β (TGF-β), and vascular endothelial growth factor (VEGF) in synovial tissue were detected by Western blot. Histopathological changes in synovial tissue were observed by using hematoxylin and eosin (HE), Masson, and Sirius red staining, while the expression of type Ⅰ collagen and alpha-smooth muscle actin (α-SMA) was detected by multiplex immunofluorescence. ResultsA total of 35 active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by UPLC-MS/MS, including phenolic acids, flavonoids, quinones, alkaloids, terpenes, lignans, and coumarins. Among them, the constituents such as berberine, paeoniflorin, ferulic acid, and caffeic acid exhibit clear anti-inflammatory, analgesic, and anti-fibrotic pharmacological effects. Compared to the blank control group, rats in the KOA group showed a significant decrease in cold and mechanical stimuli pain thresholds (P<0.01). After 14 and 28 days of Jinyang Dingtong plaster intervention, the pain threshold in this group was significantly increased compared to that in KOA group (P<0.01), showing no significant difference from that in compound Nanxing Analgesic plaster group. Additionally, Jinyang Dingtong plaster reduced the levels of IL-1β, TNF-α, NGF, and CGRP in the serum of KOA rats (P<0.01), lowered the expression of TRPA1, TRPM8, TRPV1, TRPV4, TGF-β, and VEGF proteins in synovial tissue (P<0.01), improved synovial pathological damage in KOA rats, and significantly decreased fluorescence intensity of type Ⅰ collagen and α-SMA (P<0.01). ConclusionJinyang Dingtong plaster can improve the peripheral pain sensitization and synovial fibrosis in KOA rats by downregulating the expression of ion channels of TRPs and related inflammatory and fibrotic factors.
3.Mechanism of Jinyang Dingtong Plaster in Improving Peripheral Pain Sensitization and Synovial Fibrosis in Knee Osteoarthritis by Blocking Ion Channels of TRPs
Jinliang HE ; Lu ZHANG ; Shixin XING ; Xilu REN ; Jingxing JIANG ; Junfeng KANG ; Xuliang HAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(8):108-116
ObjectiveThis paper aims to investigate the mechanism of Jinyang Dingtong plaster in improving the peripheral pain sensitization and synovial fibrosis in rats with knee osteoarthritis (KOA) by blocking the ion channels of transient receptor potentials (TRPs). MethodsThe active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by using ultra-high performance liquid chromatography-electrospray ionization-quadrupole ion trap tandem mass spectrometry (UPLC-MS/MS) technology. A KOA rat model was established through intra-articular injection of monoiodoacetic acid. The rats were randomly divided into blank control group, KOA group, compound Nanxing Zhitong plaster Group, and Jinyang Dingtong plaster group, with eight rats per group. Among them, the rats in the compound Nanxing Zhitong plaster group and the Jinyang Dingtong plaster group were intervened with external application treatment. After the intervention period, the cold and mechanical stimulus pain thresholds of rats in each group were detected, and the transverse diameter of the knee joint was measured. The levels of inflammatory factors in the serum such as interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), nerve growth factor (NGF), and calcitonin gene-related peptide (CGRP) were determined by enzyme-linked immunosorbent assay (ELISA). Protein expression levels of transient receptor potential ankyrin 1 (TRPA1), transient receptor potential melastatin 8 (TRPM8), transient receptor potential vanilloid 1 (TRPV1), transient receptor potential vanilloid 4 (TRPV4), transforming growth factor-β (TGF-β), and vascular endothelial growth factor (VEGF) in synovial tissue were detected by Western blot. Histopathological changes in synovial tissue were observed by using hematoxylin and eosin (HE), Masson, and Sirius red staining, while the expression of type Ⅰ collagen and alpha-smooth muscle actin (α-SMA) was detected by multiplex immunofluorescence. ResultsA total of 35 active components in the transdermal absorption solution of Jinyang Dingtong plaster were identified by UPLC-MS/MS, including phenolic acids, flavonoids, quinones, alkaloids, terpenes, lignans, and coumarins. Among them, the constituents such as berberine, paeoniflorin, ferulic acid, and caffeic acid exhibit clear anti-inflammatory, analgesic, and anti-fibrotic pharmacological effects. Compared to the blank control group, rats in the KOA group showed a significant decrease in cold and mechanical stimuli pain thresholds (P<0.01). After 14 and 28 days of Jinyang Dingtong plaster intervention, the pain threshold in this group was significantly increased compared to that in KOA group (P<0.01), showing no significant difference from that in compound Nanxing Analgesic plaster group. Additionally, Jinyang Dingtong plaster reduced the levels of IL-1β, TNF-α, NGF, and CGRP in the serum of KOA rats (P<0.01), lowered the expression of TRPA1, TRPM8, TRPV1, TRPV4, TGF-β, and VEGF proteins in synovial tissue (P<0.01), improved synovial pathological damage in KOA rats, and significantly decreased fluorescence intensity of type Ⅰ collagen and α-SMA (P<0.01). ConclusionJinyang Dingtong plaster can improve the peripheral pain sensitization and synovial fibrosis in KOA rats by downregulating the expression of ion channels of TRPs and related inflammatory and fibrotic factors.
4.Expert consensus on precise intervention with repetitive transcranial magnetic stimulation for sleep disorders in the elderly
Yuan SHAO ; Jian WANG ; Wei LIANG ; Yingli ZHANG ; Gangqiang HOU ; Xia LI ; Yi XING ; Lu WANG ; Shi TANG ; Yongjun WANG
Sichuan Mental Health 2026;39(2):97-105
In recent years, repetitive transcranial magnetic stimulation (rTMS) has garnered significant attention as a therapeutic approach for sleep disorders in the elderly. However, the prevailing rTMS protocols are predominantly developed based on normative neurophysiological data derived from young adults and fail to incorporate individualized parameters tailored to the brain characteristics of the elderly. To address this gap, the consensus development group synthesized the latest evidence from 2010 to 2025 and established a standardized rTMS protocol specifically for elderly patients with sleep disorders. Adhering to the Appraisal of Guidelines for Research and Evaluation II (AGREE II) framework, systematically screened randomized controlled trials (RCTs) and systematic reviews regarding rTMS in the treatment of sleep disorders across various conditions. Meanwhile, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was employed to rigorously grade the quality of evidence and the strength of recommendations. This consensus guideline delineates precise rTMS protocols for the management of sleep disorders in the elderly, highlights the adjustment of stimulation intensity according to scalp-cortex distance recommends either MRI‑guided neuronavigation or the Beam F3/F4 heuristic approach for accurate target localization, thereby providing precise rTMS intervention protocol for sleep disorders in the elderly, aiming to enhance clinical efficacy while ensuring treatment safety. [Funded by National Key Research and Development Program (number, 2023YFC3603200); General Program of Shenzhen Science and Technology Innovation Commission (number, JCYJ20240813112859008, JCYJ20240813112900002); Youth Program of Shenzhen Kangning Hospital (number, KN2023A004); www.guidelines-registry.cn number, PREPARE-2026CN530]
5.The epidemiologic characteristics of parasitic and vector-borne diseases in Minhang and Jinshan districts, Shanghai
Dun-jia WANG ; Xiao-lu HE ; Tian-tian ZHANG ; Tang WANG ; Zhao-peng DONG ; Can-lei SONG ; Shi-ji TAO ; Zheng-xing HOU ; Yu-ping CHENG ; Yi-bin ZHOU
Acta Parasitologica et Medica Entomologica Sinica 2026;33(3):173-179
Objective The aim of the study is to analyze the incidence patterns and epidemiological characteristics of parasitic and vector-borne diseases in the Minhang and Jinshan districts of Shanghai, and provide evidence-based information for optimizing prevention and control measures. Methods We collected information from epidemic reports and epidemiological investigation forms for cases of parasitic and vector-borne diseases from 2005 to 2024 in Shanghai's Minhang and Jinshan districts. Descriptive epidemiological method were adopted to conduct a comparative analysis of incidence trends, epidemic characteristics, and infection sources. Results A total of 229 cases in 7 categories were reported between 2005 and 2024, with an average annual incidence rate of 0.36/100 000. The average annual incidence rate in Minhang District was significantly higher than that in Jinshan District. The most prevalent diseases were malaria and dengue fever, followed by Japanese encephalitis. Monthly case reports were available, predominantly from June to October, with a peak in July-August. A statistically significant difference was observed between the two districts in case distribution during June-October (P<0.001), whereas no significant difference was found for July-August (P=0.331). The majority of cases were young men (111/229,48.47%), aged 20-39 years. Migrant workers/farmers constituted the largest occupational group (55/229, 24.02%). Registered residents of other provinces and cities (147/229,64.19%), and the main source of infection was overseas importation (112/229,48.91%). There were no statistically significant differences in gender and household-registration composition between the two districts (P>0.05). Significant differences existed in age, occupation, and source of infection (P<0.05). The imported diseases were malaria and dengue fever, with Africa and Southeast Asia being the primary source locations. Malaria was the predominant disease imported from other provinces and cities, with cases having been imported from abroad since 2012. Local infections were mainly Japanese encephalitis, followed by malaria (with the last local case reported in 2010). Cases between 2005 and 2009 were predominantly imported from other provinces and cities. The proportion of cases imported from abroad increased sharply after 2010, particularly in Minhang District. Local infections sometimes arise in Jinshan District, with Japanese encephalitis serving as the primary type. Conclusions Incidence rates of parasitic and vector-borne diseases in Minhang and Jinshan districts have generally remained low. To further reduce this disease burden, it will be necessary to strengthen joint measures for prevention and control, eliminate the environmental risk factors of vector organisms, enhance monitoring and precise control of the environment and inbound personnel to prevent the occurrence and transmission of parasitic and vector-borne diseases.
6.Mechanisms of Shuangshen Ningxin Capsules in Modulating NF-κB and MAPK Signaling Pathways to Reduce Cardiac Inflammation and Alleviate Myocardial Ischemia-reperfusion Injury in Rats
Shujuan XU ; Gaojie XIN ; Ce CAO ; Zixin LIU ; Yuanyuan CHEN ; Ran ZHAO ; Lu XING ; Yehao ZHANG ; Yue SHI ; Yanlei MA ; Jianhua FU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(23):83-91
ObjectiveTo investigate the effect and mechanism of Shuangshen Ningxin capsules (SSNX) in regulating the nuclear factor-κB (NF-κB) and mitogen-activated protein kinase (MAPK) pathways to inhibit inflammation and alleviate myocardial ischemia-reperfusion injury (MIRI) in rats. MethodsThe 45 healthy male Sprague-Dawley (SD) rats were divided into sham operation group, model group, and SSNX capsules group (90 mg·kg-1). The left anterior descending coronary artery was ligated to establish the MIRI model. Cardiac function was evaluated by echocardiography, and microvascular reperfusion was analyzed using contrast echocardiography. Myocardial inflammation and injury were assessed by hematoxylin and eosin (HE) staining, immunohistochemistry, and TdT-mediated dUTP nick end labeling (TUNEL). The expression levels of cardiac inflammatory cytokines, including interleukin-1α (IL-1α), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA). Core differentially expressed genes (DEGs) and enriched pathways were screened by transcriptome sequencing. Real-time quantitative polymerase chain reaction (Real-time PCR) and Western blot were used to verify the mRNA expression of Toll-like receptor 2 (TLR2), chemokine (C-X-C motif) ligand 1 (CXCL1) and prostaglandin-endoperoxide synthase 2 (PTGS2), as well as the protein expression of Caspase-3, cleaved Caspase-3, p-NF-κB/NF-κB, phosphorylated extracellular signal-regulated kinase 1/2 (p-ERK1/2/ERK1/2) and p-p38 MAPK/p38 MAPK. ResultsCompared with the sham operation group, the ejection fraction (EF), fractional shortening (FS), stroke volume (SV) and cardiac output (CO) of the model group were significantly decreased (P<0.01), the peak time of myocardial perfusion was prolonged (P<0.01), hypoxia-inducible factor (HIF)-1α and α-smooth muscle actin (SMA) expression increased (P<0.01), the concentrations of inflammatory factors IL-1α, IL-6, TNF-α, TLR2, CXCL1 and PTGS2 increased (P<0.01), and the expression of cleaved Caspase-3, p-NF-κB/NF-κB, p-ERK1/2/ERK1/2 and p-p38 MAPK/p38 MAPK proteins was significantly increased (P<0.01). SSNX could improve cardiac function (P<0.05, P<0.01), and significantly shorten the peak time of myocardial perfusion (P<0.01). Moreover, it could also down-regulate HIF-1α and a-SMA expression (P<0.05, P<0.01), and reduce the concentrations of IL-1α, IL-6, TNF-α (P<0.01), and the mRNA expression of TLR2, CXCL1 and PTGS2 (P<0.01). Additionally, SSNX inhibited the apoptosis rate (P<0.01) and significantly reduced the expression of Cleaved Caspase-3, p-NF-κB/NF-κB, p-ERK1/2/ERK1/2 and p-p38 MAPK/p38 MAPK proteins (P<0.01). ConclusionSSNX can alleviate cardiac inflammation by regulating the NF-κB and MAPK signaling pathways, thereby effectively preventing and alleviating myocardial reperfusion injury.
7.Application of Engineered Exosomes in Tumor-targeted Therapy
Jia-Lu SONG ; Yi-Xin JIN ; Xing-Yu MU ; Yu-Huan JIANG ; Jing WANG
Progress in Biochemistry and Biophysics 2025;52(5):1140-1151
Tumors are the second leading cause of death worldwide. Exosomes are a type of extracellular vesicle secreted from multivesicular bodies, with particle sizes ranging from 40 to 160 nm. They regulate the tumor microenvironment, proliferation, and progression by transporting proteins, nucleic acids, and other biomolecules. Compared with other drug delivery systems, exosomes derived from different cells possess unique cellular tropism, enabling them to selectively target specific tissues and organs. This homing ability allows them to cross biological barriers that are otherwise difficult for conventional drug delivery systems to penetrate. Due to their biocompatibility and unique biological properties, exosomes can serve as drug delivery systems capable of loading various anti-tumor drugs. They can traverse biological barriers, evade immune responses, and specifically target tumor tissues, making them ideal carriers for anti-tumor therapeutics. This article systematically summarizes the methods for exosome isolation, including ultracentrifugation, ultrafiltration, size-exclusion chromatography (SEC), immunoaffinity capture, and microfluidics. However, these methods have certain limitations. A combination of multiple isolation techniques can improve isolation efficiency. For instance, combining ultrafiltration with SEC can achieve both high purity and high yield while reducing processing time. Exosome drug loading methods can be classified into post-loading and pre-loading approaches. Pre-loading is further categorized into active and passive loading. Active loading methods, including electroporation, sonication, extrusion, and freeze-thaw cycles, involve physical or chemical disruption of the exosome membrane to facilitate drug encapsulation. Passive loading relies on drug concentration gradients or hydrophobic interactions between drugs and exosomes for encapsulation. Pre-loading strategies also include genetic engineering and co-incubation methods. Additionally, we review approaches to enhance the targeting, retention, and permeability of exosomes. Genetic engineering and chemical modifications can improve their tumor-targeting capabilities. Magnetic fields can also be employed to promote the accumulation of exosomes at tumor sites. Retention time can be prolonged by inhibiting monocyte-mediated clearance or by combining exosomes with hydrogels. Engineered exosomes can also reshape the tumor microenvironment to enhance permeability. This review further discusses the current applications of exosomes in delivering various anti-tumor drugs. Specifically, exosomes can encapsulate chemotherapeutic agents such as paclitaxel to reduce side effects and increase drug concentration within tumor tissues. For instance, exosomes loaded with doxorubicin can mitigate cardiotoxicity and minimize adverse effects on healthy tissues. Furthermore, exosomes can encapsulate proteins to enhance protein stability and bioavailability or carry immunogenic cell death inducers for tumor vaccines. In addition to these applications, exosomes can deliver nucleic acids such as siRNA and miRNA to regulate gene expression, inhibit tumor proliferation, and suppress invasion. Beyond their therapeutic applications, exosomes also serve as tumor biomarkers for early cancer diagnosis. The detection of exosomal miRNA can improve the sensitivity and specificity of diagnosing prostate and pancreatic cancers. Despite their promising potential as drug delivery systems, challenges remain in the standardization and large-scale production of exosomes. This article explores the future development of engineered exosomes for targeted tumor therapy. Plant-derived exosomes hold potential due to their superior biocompatibility, lower toxicity, and abundant availability. Furthermore, the integration of exosomes with artificial intelligence may offer novel applications in diagnostics, therapeutics, and personalized medicine.
8.Hemolysis rates of three red blood cell components at the end of storage: a 5-year retrospective study
Zhenping LU ; Fufa LIU ; Meiyan KANG ; Xianbin WU ; Yanting WANG ; Xing LONG ; Xinlu QIU ; Jin LI
Chinese Journal of Blood Transfusion 2025;38(6):828-832
Objective: To evaluate the suitability of the existing hemolysis rate standards for locally processed red blood cell components by retrospectively analyzing 5-year hemolysis rate data at the end of storage. Methods: A total of 720 blood samples of three types of red blood cell components from our blood station from January 2019 to December 2023 were collected. Parameters included hemoglobin concentration (Hb), hematocrit (Hct), and free hemoglobin concentration (fHb). Hemolysis rate were taken as the control standard of 0.8% in accordance with the national standard. The hemolysis rates were compared against the national standard threshold of 0.8% (GB18469-2012), and annual trends of the detection parameters were observed. Results: The hemolysis rates (x-+s,%) of leukocyte-depleted whole blood at the end of storage were (0.038±0.023 8) in 2019, (0.049±0.039 5) in 2020, (0.043±0.040 7) in 2021, (0.049±0.030 7) in 2022, and (0.058±0.054 8) in 2023, respectively; The hemolysis rates (x-+s" />,%) of leukocyte-depleted suspended red blood cells at the end of storage were (0.093±0.050 2) in 2019, (0.086±0.049 5) in 2020, (0.123±0.072 3) in 2021, (0.122±0.052 1) in 2022, and (0.106±0.058 6) in 2023, respectively; The hemolysis rates (x-+s,%) of washed red blood cells at the end of storage were (0.127±0.038 2) in 2019, (0.150±0.066 5) in 2020, (0.121±0.052 2) in 2021, (0.124±0.038 9) in 2022, and (0.128±0.044 3) in 2023, respectively. Conclusion: Hemolysis rates at the end of blood storage of three red blood cell components were significantly lower than the limits specified in Quality Requirements for Whole Blood and Components (GB18469-2012), as well as standards from the EU, AABB and the United States. The results demonstrate excellent product quality control. A regional internal control standard of <0.2% is proposed for hemolysis rates at the end of storage.
9.Recommendations for Standardized Reporting of Systematic Reviews and Meta-Analysis of Animal Experiments
Qingyong ZHENG ; Donghua YANG ; Zhichao MA ; Ziyu ZHOU ; Yang LU ; Jingyu WANG ; Lina XING ; Yingying KANG ; Li DU ; Chunxiang ZHAO ; Baoshan DI ; Jinhui TIAN
Laboratory Animal and Comparative Medicine 2025;45(4):496-507
Animal experiments are an essential component of life sciences and medical research. However, the external validity and reliability of individual animal studies are frequently challenged by inherent limitations such as small sample sizes, high design heterogeneity, and poor reproducibility, which impede the effective translation of research findings into clinical practice. Systematic reviews and meta-analysis represent a key methodology for integrating existing evidence and enhancing the robustness of conclusions. Currently, however, the application of systematic reviews and meta-analysis in the field of animal experiments lacks standardized guidelines for their conduct and reporting, resulting in inconsistent quality and, to some extent, diminishing their evidence value. To address this issue, this paper aims to systematically delineate the reporting process for systematic reviews and meta-analysis of animal experiments and to propose a set of standardized recommendations that are both scientific and practical. The article's scope encompasses the entire process, from the preliminary preparatory phase [including formulating the population, intervention, comparison and outcome (PICO) question, assessing feasibility, and protocol pre-registration] to the key writing points for each section of the main report. In the core methods section, the paper elaborates on how to implement literature searches, establish eligibility criteria, perform data extraction, and assess the risk of bias, based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement, in conjunction with relevant guidelines and tools such as Animal Research: Reporting of in Vivo Experiments (ARRIVE) and a risk of bias assessment tool developed by the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE). For the presentation of results, strategies are proposed for clear and transparent display using flow diagrams and tables of characteristics. The discussion section places particular emphasis on how to scientifically interpret pooled effects, thoroughly analyze sources of heterogeneity, evaluate the impact of publication bias, and cautiously discuss the validity and limitations of extrapolating findings from animal studies to clinical settings. Furthermore, this paper recommends adopting the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to comprehensively grade the quality of evidence. Through a modular analysis of the entire reporting process, this paper aims to provide researchers in the field with a clear and practical guide, thereby promoting the standardized development of systematic reviews and meta-analysis of animal experiments and enhancing their application value in scientific decision-making and translational medicine.
10.Preliminary clinical practice of radical prostatectomy without preoperative biopsy.
Ranlu LIU ; Lu YIN ; Shenfei MA ; Feiya YANG ; Zhenpeng LIAN ; Mingshuai WANG ; Ye LEI ; Xiying DONG ; Chen LIU ; Dong CHEN ; Sujun HAN ; Yong XU ; Nianzeng XING
Chinese Medical Journal 2025;138(6):721-728
BACKGROUND:
At present, biopsy is essential for the diagnosis of prostate cancer (PCa) before radical prostatectomy (RP). However, with the development of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and multiparametric magnetic resonance imaging (mpMRI), it might be feasible to avoid biopsy before RP. Herein, we aimed to explore the feasibility of avoiding biopsy before RP in patients highly suspected of having PCa after assessment of PSMA PET/CT and mpMRI.
METHODS:
Between December 2017 and April 2022, 56 patients with maximum standardized uptake value (SUVmax) of ≥4 and Prostate Imaging Reporting and Data System (PI-RADS) ≥4 lesions who received RP without preoperative biopsy were enrolled from two tertiary hospitals. The consistency between clinical and pathological diagnoses was evaluated. Preoperative characteristics were compared among patients with different pathological types, T stages, International Society of Urological Pathology (ISUP) grades, and European Association of Urology (EAU) risk groups.
RESULTS:
Fifty-five (98%) patients were confirmed with PCa by pathology, including 49 (89%) with clinically significant prostate cancer (csPCa, defined as ISUP grade ≥2 malignancy). One patient was diagnosed with high-grade prostatic intraepithelial neoplasia (HGPIN). CsPCa patients, compared with clinically insignificant prostate cancer (cisPCa) and HGPIN patients, were associated with a higher level of prostate-specific antigen (22.9 ng/mL vs . 10.0 ng/mL, P = 0.032), a lower median prostate volume (32.2 mL vs . 65.0 mL, P = 0.001), and a higher median SUVmax (13.3 vs . 5.6, P <0.001).
CONCLUSIONS
It might be feasible to avoid biopsy before RP for patients with a high probability of PCa based on PSMA PET/CT and mpMRI. However, the diagnostic efficacy of csPCa with PI-RADS ≥4 and SUVmax of ≥4 is inadequate for performing a procedure such as RP. Further prospective multicenter studies with larger sample sizes are necessary to confirm our perspectives and establish predictive models with PSMA PET/CT and mpMRI.
Humans
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Male
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Prostatectomy/methods*
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Prostatic Neoplasms/diagnosis*
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Middle Aged
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Aged
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Positron Emission Tomography Computed Tomography/methods*
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Biopsy
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Multiparametric Magnetic Resonance Imaging
;
Prostate-Specific Antigen/metabolism*


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