1.Reconceptualizing Critical Illness in Cancer Through the Lens of Host Unregulated Response
Yun CHU ; Shiyi GONG ; Xin DING ; Hua ZHAO ; Huan CHEN ; Qing ZHANG ; Xiaoting WANG
Medical Journal of Peking Union Medical College Hospital 2026;17(1):1-9
Onco-critical care has emerged as an important subspecialty at the intersection of critical care medicine and oncology, attracting increasing attention in recent years. With continuous innovations in cancer therapies, patient survival has improved significantly; however, the incidence of associated critical complications has also increased. The reasons for cancer patients requiring intensive care unit admission are diverse and can be broadly categorized into three groups: progression of the underlying malignancy, treatment-related complications, and coexisting classical critical illnesses. Traditional critical care concepts and practices face limitations in addressing the multidimensional and heterogeneous challenges of onco-critical care. Based on the core mechanism of critical illness development—host/organ unregulated response (HOUR)—this article systematically elaborates on how this framework advances understanding and clinical practice into onco-critical care, with emphasis on its manifestations in neuroendocrine, immune-inflammatory, and coagulation-metabolic pathways. The review summarizes recent advances in clinical assessment and phenotyping systems for onco-critical illness and discusses a multidisciplinary, integrated management strategy centered on the "Disease Control, Host Response Modulation, Organ Support" triad. Finally, major challenges and future directions in this field are outlined. By integrating existing evidence and theoretical insights, this review aims to provide new perspectives and a theoretical foundation for the clinical management of onco-critical illness, thereby promoting its evolution toward precision and standardization.
2.Treatment Strategies for Tumor Immunotherapy-Related Organ Dysfunction Based on Host Unregulated Response
Medical Journal of Peking Union Medical College Hospital 2026;17(1):16-22
Cancer immunotherapy, particularly immune checkpoint inhibitors (ICIs), has significantly improved the prognosis of patients with various malignancies. However, the immune-related adverse events (irAEs) and associated organ dysfunction they trigger have become key issues affecting treatment safety and long-term patient survival. Pathophysiologically, irAEs share common features with classical critical illnesses like sepsis, both involving host/organ unregulated response (HOUR). The key distinction lies in irAEs primarily manifesting as overactivation of the immune system. Clinically, differentiating irAEs from infection in ICI-treated patients presenting with new-onset organ dysfunction is often challenging. Building upon the HOUR theoretical framework, this article proposes a PRISM management strategy integrating multi-omics technology, aiming to provide a personalized approach for the diagnosis and treatment of immunotherapy-related organ dysfunction. The PRISM strategy encompasses five key components: Precise etiological differentiation, Regulation of host response, Immunotherapy risk prediction, Support of organ function, and Multidisciplinary collaboration. By integrating multi-omics biomarkers and patient clinical characteristics, the PRISM strategy enables early warning and precise phenotyping of organ dysfunction and offers individualized intervention plans. It holds promise for significantly improving the clinical management of irAEs, enhancing patients' quality of life and long-term prognosis, thereby providing a theoretical foundation and practical guidance for the precise prevention and treatment of critical illnesses associated with immunotherapy.
3.Expert Consensus on Blood Flow and Oxygen Delivery Phenotyping and Clinical Management of Septic Shock(2025)
Wei HUANG ; Xinchen WANG ; Wenzhao CHAI ; Keliang CUI ; Bo YAO ; Zhiqun XING ; Cui WANG ; Jingjing LIU ; Shiyi GONG ; Dongkai LI ; Wanhong YIN ; Xiaoting WANG ; Wei DU
Medical Journal of Peking Union Medical College Hospital 2026;17(1):40-58
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is the primary cause of mortality in sepsis, with its core pathophysiological mechanism being severe ischemia and hypoxia in critical units—composed of microcirculation and the mitochondria of functional cells—resulting from disruptions in blood flow and oxygen flow following a dysregulated host response. Due to the systemically convergent yet clinically heterogeneous nature of the host response, current understanding and management strategies for hemodynamics remain inconsistent, often leading to inadequate resuscitation or overtreatment. To improve the quality of care, based on a systematic review of the "blood flow-oxygen flow" theory, an expert panel emphasizes reevaluating septic shock from an integrated perspective of blood flow and oxygen flow, and has formulated the
4.Research Progress of Efficacy Biomarkers Related to Immune Checkpoint Inhibitors
Wenwen YANG ; Hongwei TIAN ; Caining LEI ; Xianbin HUANG ; Wutang JING ; Chuanwei JIN ; Shaoming SONG ; Shiyi GONG ; Tiankang GUO
Cancer Research on Prevention and Treatment 2022;49(5):484-489
In recent years, immunotherapy with immune checkpoint as the target has made revolutionary breakthroughs in the treatment of a variety of advanced solid tumors. Notwithstanding the impressive long-term therapeutic benefits, their efficacy is limited to a small subset of cancer patients. Some patients experienced drug resistance and immune-related adverse events (irAEs). Immune checkpoint inhibitors (ICIs) primarily include antibodies targeting CTLA-4 and antibodies targeting PD-1 and its ligands. Thus, it is of utmost importance to screen potential biomarkers in populations that may benefit from immunotherapy, to maximize therapeutic benefits. This review summarizes the mechanism of ICIs and its related efficacy biomarker, to better guide the application of immunotherapy in clinical practice.
5.Research Progress of Biodegradable Vascular Stent.
Yangyang WANG ; Hongmei WU ; Wenqiang ZHEN ; Tao GONG ; Duan LI ; Yao CAI ; Shiyi FAN
Chinese Journal of Medical Instrumentation 2021;45(4):410-415
Biodegradable vascular stents have better biocompatibility than drug-eluting stents. The blood vessels are rebuilt and degraded after normal physiological functions are restored. Due to it will not stay in the body for a long time and the patients don't need taking anti-rejection drugs all the time, it becomes the focus of attention in the treatment of coronary heart disease. This article introduced the development history of biodegradable stents and reviewed the research status of several different materials of vascular stents (animals or humans)
Absorbable Implants
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Animals
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Drug-Eluting Stents
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Humans
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Stents
6.Clinical application and research progress of apatinib in cancer treatment
Xiaobin GONG ; Shiyi LIU ; Tianyi XIA ; Hua WEI ; Wansheng CHEN
Journal of Pharmaceutical Practice 2018;36(2):103-107,130
Antiangiogenic target therapy has been a hot topic in cancer treatment recently.Apatinib is a category 1.1 new medication developed domestically.It effectively inhibits angiogenic and exhibits promising anti-tumor activity in preclinical studies.Apatinib has been successfully applied in clinical trials of multiple malignancies,such as gastric cancer,lung cancer and breast cancer with satisfactory safety and efficacy profile.However,its mechanism of action is still not fully understood. Further researches should be carried on to improve its safety,effectiveness and marketability.This review summarized the mechanism of action,pharmacokinetics,clinical efficacy,safety and biomarkers,discussed the recent progress,hot issues and clinical prospects of apatinib,

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