1.New perspectives on ferroptosis and its role in liver cancer
Xinyi JIANG ; Yanran WANG ; Pinru DI ; Shiyi QIAN ; Yahui LIU ; Haitao JIANG
Chinese Journal of Hepatobiliary Surgery 2025;31(5):388-391
Primary liver cancer is the second most common cause of cancer-related mortality, and exploring effective cure methods for liver cancer has become a major challenge. Ferroptosis is an iron-dependent pattern of cell death caused by the accumulation of lipid peroxides. The main mechanisms of ferroptosis include iron metabolism disorders, imbalance of the antioxidant system, and accumulation of lipid peroxides. Inducing ferroptosis of hepatoma cells is regarded as a potential therapeutic strategy for liver cancer. This article aims to outline the key regulatory signaling pathways of ferroptosis in the occurrence and development of liver cancer, and to deeply analyze the potential application prospects of the ferroptosis mechanism in the field of liver cancer treatment.
2.Role of"HA coat"in modulating stemness and endocrine resistance in ER+breast cancer
Shiyi WU ; Si CHEN ; Bohan LIU ; Yuting LIU ; Yiwen LIU ; Yiqing HE ; Yan DU ; Guoliang ZHANG ; Qian GUO ; Feng GAO ; Cuixia YANG
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(10):1298-1307
Objective·To determine hyaluronan(HA)expression in the endocrine-resistant microenvironment of estrogen receptor-positive(ER+)breast cancer and elucidate its impact on the acquired resistance.Methods·Chemiluminescent immunoassay was used to quantify HA levels in the culture supernatants of fulvestrant-resistant breast cancer cells.An immunofluorescence(IF)assay was performed to visualize the colocalization of CD44 and HA in MCF7/FulR cells.Using an established adaptive endocrine-resistant breast cancer mouse model,HA expression in resistant breast cancer tissues was assessed by immunohistochemistry(IHC)assay.Single-cell RNA sequencing(scRNA-seq)and RNA sequencing(RNA-seq)were conducted to examine transcriptomic profiles and alterations in HA-related genes in resistant breast cancer cells.Flow cytometry(FCM)was utilized to measure the proportion of CD44+CD24-cells in MCF7/FulR.The correlation between HA synthesis genes and cell stemness was investigated in clinical ER+breast cancers from GEO data sets.Hyaluronidase(HAase)treatment was applied to remove the"HA coat",and RT-qPCR and Western blotting analysis were carried out to monitor changes in stemness-related molecules.CCK-8 assays,flow cytometry(FCM),and Hoechst 33258 staining were performed to determine changes in apoptosis and fulvestrant efficiency after HAase treatment.Results·IF results revealed that compared with MCF7 cells,the"HA coat"on the surface of MCF7/FulR cells was significantly thickened.IHC demonstrated markedly increased HA retention in fulvestrant-resistant mouse breast cancer tissues.ScRNA-seq and RNA-seq analyses indicated elevated expression of stemness-related genes and HA synthesis-associated genes in fulvestrant-resistant breast cancer cells.Correlation analysis revealed a positive association between HA synthesis and cancer stemness in ER+breast cancer.IF and RT-qPCR results demonstrated that removing the HA coating from the surface of MCF7/FulR cells led to a significant reduction in the expression of stemness-related molecules;concurrently,CCK-8 assays,FCM analysis,and Hoechst 33258 staining revealed that"HA coat"clearance reduced MCF7/FulR'tolerance to fulvestrant and increased apoptosis.Conclusion·Endocrine-resistant breast cancer cells develop an enriched"HA coat",which promotes stemness in fulvestrant-resistant tumors.Disruption of this HA coat through HAase treatment effectively reduces cell stemness,induces apoptosis,and re-sensitizes breast cancer cells to fulvestrant.
3.Research progress of systemic therapy for pancreatic cancer
Shiyi QIAN ; Haitao JIANG ; Yahui LIU
Chinese Journal of General Surgery 2025;34(3):546-554
Pancreatic cancer(PC)is a highly malignant digestive system tumor with extremely high mortality and recurrence rates.While traditional surgical resection and chemotherapy remain the main treatment options,challenges such as high postoperative recurrence and poor prognosis persist.Therefore,exploring more effective comprehensive treatment strategies is crucial for improving patient survival and prognosis.This review systematically summarizes recent advances in systemic therapy for PC,with a focus on the application and efficacy of chemotherapy,targeted therapy,and immunotherapy.Additionally,it discusses the potential of neoadjuvant therapy,integrated traditional Chinese and Western medicine approaches,and conversion therapy in enhancing the effects of conventional chemotherapy.Studies have shown that targeted therapy can enhance antigen presentation and reduce side effects,while immune checkpoint inhibitors,cancer vaccines,and adoptive cell immunotherapy help mitigate tumor immune evasion and improve the tumor microenvironment.Despite continuous innovation in treatment approaches,clinical management of PC,particularly for advanced-stage patients,still faces significant challenges.Future research should focus on early diagnosis,precision medicine,and personalized treatment strategies to further improve cure rates and patient survival quality,providing more effective therapeutic options for clinical practice.
4.Role of"HA coat"in modulating stemness and endocrine resistance in ER+breast cancer
Shiyi WU ; Si CHEN ; Bohan LIU ; Yuting LIU ; Yiwen LIU ; Yiqing HE ; Yan DU ; Guoliang ZHANG ; Qian GUO ; Feng GAO ; Cuixia YANG
Journal of Shanghai Jiaotong University(Medical Science) 2025;45(10):1298-1307
Objective·To determine hyaluronan(HA)expression in the endocrine-resistant microenvironment of estrogen receptor-positive(ER+)breast cancer and elucidate its impact on the acquired resistance.Methods·Chemiluminescent immunoassay was used to quantify HA levels in the culture supernatants of fulvestrant-resistant breast cancer cells.An immunofluorescence(IF)assay was performed to visualize the colocalization of CD44 and HA in MCF7/FulR cells.Using an established adaptive endocrine-resistant breast cancer mouse model,HA expression in resistant breast cancer tissues was assessed by immunohistochemistry(IHC)assay.Single-cell RNA sequencing(scRNA-seq)and RNA sequencing(RNA-seq)were conducted to examine transcriptomic profiles and alterations in HA-related genes in resistant breast cancer cells.Flow cytometry(FCM)was utilized to measure the proportion of CD44+CD24-cells in MCF7/FulR.The correlation between HA synthesis genes and cell stemness was investigated in clinical ER+breast cancers from GEO data sets.Hyaluronidase(HAase)treatment was applied to remove the"HA coat",and RT-qPCR and Western blotting analysis were carried out to monitor changes in stemness-related molecules.CCK-8 assays,flow cytometry(FCM),and Hoechst 33258 staining were performed to determine changes in apoptosis and fulvestrant efficiency after HAase treatment.Results·IF results revealed that compared with MCF7 cells,the"HA coat"on the surface of MCF7/FulR cells was significantly thickened.IHC demonstrated markedly increased HA retention in fulvestrant-resistant mouse breast cancer tissues.ScRNA-seq and RNA-seq analyses indicated elevated expression of stemness-related genes and HA synthesis-associated genes in fulvestrant-resistant breast cancer cells.Correlation analysis revealed a positive association between HA synthesis and cancer stemness in ER+breast cancer.IF and RT-qPCR results demonstrated that removing the HA coating from the surface of MCF7/FulR cells led to a significant reduction in the expression of stemness-related molecules;concurrently,CCK-8 assays,FCM analysis,and Hoechst 33258 staining revealed that"HA coat"clearance reduced MCF7/FulR'tolerance to fulvestrant and increased apoptosis.Conclusion·Endocrine-resistant breast cancer cells develop an enriched"HA coat",which promotes stemness in fulvestrant-resistant tumors.Disruption of this HA coat through HAase treatment effectively reduces cell stemness,induces apoptosis,and re-sensitizes breast cancer cells to fulvestrant.
5.Research progress of systemic therapy for pancreatic cancer
Shiyi QIAN ; Haitao JIANG ; Yahui LIU
Chinese Journal of General Surgery 2025;34(3):546-554
Pancreatic cancer(PC)is a highly malignant digestive system tumor with extremely high mortality and recurrence rates.While traditional surgical resection and chemotherapy remain the main treatment options,challenges such as high postoperative recurrence and poor prognosis persist.Therefore,exploring more effective comprehensive treatment strategies is crucial for improving patient survival and prognosis.This review systematically summarizes recent advances in systemic therapy for PC,with a focus on the application and efficacy of chemotherapy,targeted therapy,and immunotherapy.Additionally,it discusses the potential of neoadjuvant therapy,integrated traditional Chinese and Western medicine approaches,and conversion therapy in enhancing the effects of conventional chemotherapy.Studies have shown that targeted therapy can enhance antigen presentation and reduce side effects,while immune checkpoint inhibitors,cancer vaccines,and adoptive cell immunotherapy help mitigate tumor immune evasion and improve the tumor microenvironment.Despite continuous innovation in treatment approaches,clinical management of PC,particularly for advanced-stage patients,still faces significant challenges.Future research should focus on early diagnosis,precision medicine,and personalized treatment strategies to further improve cure rates and patient survival quality,providing more effective therapeutic options for clinical practice.
6.New perspectives on ferroptosis and its role in liver cancer
Xinyi JIANG ; Yanran WANG ; Pinru DI ; Shiyi QIAN ; Yahui LIU ; Haitao JIANG
Chinese Journal of Hepatobiliary Surgery 2025;31(5):388-391
Primary liver cancer is the second most common cause of cancer-related mortality, and exploring effective cure methods for liver cancer has become a major challenge. Ferroptosis is an iron-dependent pattern of cell death caused by the accumulation of lipid peroxides. The main mechanisms of ferroptosis include iron metabolism disorders, imbalance of the antioxidant system, and accumulation of lipid peroxides. Inducing ferroptosis of hepatoma cells is regarded as a potential therapeutic strategy for liver cancer. This article aims to outline the key regulatory signaling pathways of ferroptosis in the occurrence and development of liver cancer, and to deeply analyze the potential application prospects of the ferroptosis mechanism in the field of liver cancer treatment.
7.Association of Estimated Glucose Disposal Rate With the Stenosis Severity of Coronary Artery Disease: A Cross-sectional Study
Yubin WU ; Zhiteng CHEN ; Maoxiong WU ; Wenhao LIU ; Qian CHEN ; Shiyi ZHOU ; Yan-xin CHEN ; Min XIA
Journal of Sun Yat-sen University(Medical Sciences) 2024;45(1):136-145
ObjectiveTo investigate the association between estimated glucose disposal rate (eGDR) and the severity of coronary heart disease. MethodsWe conducted a hospital-based cross-sectional study that included 1258 patients (mean age: 62(53-68) years) who underwent coronary angiography for suspected coronary artery disease (53.9% were male). Insulin resistance level (IR) was calculated according to eGDR formula: eGDR = 21.158 - (0.09 × WC) - (3.407 × hypertension) - (0.551 × HbA1c) [hypertension (yes = 1 / no = 0), HbA1c = HbA1c (%)]. Subjects were grouped according to the eGDR quantile. CAD severity was determined by the number of narrowed vessels: no-obstructive CAD group (all coronary stenosis were<50%, n=704), Single-vessel CAD group (only one involved major coronary artery stenosis≥50%, n=205), Multi-vessel CAD group (two or more involved major coronary arteries stenosis≥50%, n=349); Multivariate logistic regression model was used to analyze the association between eGDR and CAD severity. The linear relationship between eGDR and CAD in the whole range of eGDR was analyzed using restricted cubic spline. Subgroup analyses were used to assess the association between eGDR and CAD severity in different diabetic states. Receiver operating characteristic (ROC) curve analysis were used to evaluate the value of eGDR in improving CAD recognition. ResultsA decrease in the eGDR index was significantly associated with an increased risk of CAD severity (OR: 2.79; 95%CI: 1.72~4.55; P<0.001). In multivariate logistic regression models, individuals with the lowest quantile of eGDR (T1) were 2.79 times more likely to develop multi-vessel CAD than those with the highest quantile of eGDR (T3) (OR: 2.79; 95%CI: 1.72~4.55; P<0.001). Multivariate restricted cubic spline analysis showed that eGDR was negatively associated with CAD and multi-vessel CAD (P-nonlinear>0.05). In non-diabetic patients, compared with the reference group (T3), the T1 group had a significantly increased risk of CAD (OR: 1.42; 95% CI: 1.00~2.01; P<0.05) and multi-vessel CAD (OR: 1.86; 95%CI: 1.21~2.86; P<0.05). No statistical association was found between eGDR and CAD in diabetic patients. In ROC curve analysis, when eGDR was added to traditional model for CAD, significant improvements were observed in the model's recognition of CAD and multi-vessel CAD. ConclusionOur study shows eGDR levels are inversely associated with CAD and CAD severity. eGDR, as a non-insulin measure to assess IR, could be a valuable indicator of CAD severity for population.
8.Research progress on commonly used visual acuity charts for preschool children
Shiyi WANG ; Lingxian XU ; Ningning QIAN ; Huang WU
International Eye Science 2024;24(1):101-105
Preschool age(3-6 years old)is a critical period for visual development, and it is crucial to detect and treat visual problems in preschool children as early as possible. Visual acuity charts are important tools for screening visual issues in children. In China, the commonly used charts are the standard logarithmic visual acuity chart and the pediatric optotype chart, while overseas, the Lea, HOTV, and ETDRS visual acuity charts are frequently employed. Numerous studies have reported the measurability, repeatability, and sensitivity of these three charts in diagnosing visual-related problems in children. However, the application of these three charts is relatively limited in China. This article provides a comprehensive review of the design principles, clinical applications, and characteristics of these three visual acuity charts, so as to better understand their applicability and limitations in preschool children, and provide reference for the selection and improvement of vision examination methods in the future.
9.Comparisons of the efficacy of drug injections for the treatment of keloid: a network meta-analysis
Hongfan DING ; Xiao XU ; Shiyi LI ; Yichen WANG ; Qian WU ; Ruiqi BAI ; Guiwen ZHOU ; Qiang FU ; Yue LIU ; Minliang CHEN
Chinese Journal of Plastic Surgery 2023;39(12):1311-1323
Objective:To conduct a network meta-analysis comparing the efficacy and safety of various drug injections for treating keloids.Methods:The search terms of "triamcinolone acetonide, 5-fluorouracil, verapamil, botulinum toxin, platelet rich plasma, keloid, scar, drug injection" were retrieved in PubMed, Embase, Web of Science, CNKI and Wanfang database to obtain the publicly published randomized controlled trials comparing single or combined drug injection for treating keloid from January 2010 to February 2023. The outcome index was the effective proportion of treatment, incidence proportion of adverse reactions, and recurrence proportion. NoteExpress, RevMan 5.4, and Stata 16.0 statistical software were utilized to perform a network meta-analysis of eligible studies that met the inclusion and exclusion criteria.Results:A total of 1 679 patients were enrolled in 21 studies that evaluated nine treatment modalities: triamcinolone (TAC), 5-fluorouracil (5-FU), botulinum toxin type A (BTA), platelet-rich plasma (PRP), Verapamil, BTA+ 5-FU, TAC+ 5-FU, TAC+ BTA, and TAC+ PRP. The network diagram revealed that there were 36 pairwise comparisons among the 9 treatment measures, with direct comparisons in 13 of them. The funnel plot demonstrated a symmetrical distribution of effect size points, and both Beggs test and Eggers test yielded P values greater than 0.05, indicating a low likelihood of publication bias. Nine treatment measures formed five closed loops with good consistency. The result of the network meta-analysis indicated that BTA+ 5-FU was more effective than TAC, 5-FU, or PRP alone; TAC+ 5-FU was more effective than TAC, 5-FU, or PRP alone; TAC+ BTA was more effective than TAC, 5-FU, BTA, or PRP alone; Verapamil was more effective than 5-FU and BTA was more effective than 5-FU. All result were found to be statistically significant ( P<0.05). A surface under the cumulative ranking area (SUCRA) map was generated, displaying the efficacy ranking and corresponding SUCRA values for each treatment: BTA+ 5-FU (85.6%)>TAC+ 5-FU (84.8%)>BTA+ TAC (76.7%)>Verapamil (48.9%)>BTA (45.0%)>TAC+ PRP (43.8%)>PRP (32.1%)>TAC (24.7%)>5-FU(8.3%). In terms of recurrence rate, the incidence of recurrence was higher with 5-FU compared to BTA or TAC+ 5-FU, and the incidence of recurrence was higher with TAC compared to TAC+ 5-FU; these differences were statistically significant ( P<0.05). A SUCRA map was generated with the ranking and SUCRA value for each treatment as follows: 5-FU (80.4%)>TAC (73.5%)>Verapamil (65.7%)>TAC+ BTA (52.5%)>PRP (34.8%)>BTA+ 5-FU (33.7%)>TAC+ 5-FU (30.2%)>BTA (29.3%). The qualitative analysis revealed a significantly lower incidence of systemic and local adverse reactions following combined drug injection compared to single drug injection. Conclusion:In the treatment of keloids using drug injection, combination therapy utilizing multiple drugs has demonstrated superior efficacy, lower recurrence rates, and fewer adverse reactions in comparison to single-drug therapy. Notably, the utilization of BAT, 5-FU, and TAC in combination may yield the most favorable outcomes.
10.Macrophage LMO7 deficiency facilitates inflammatory injury via metabolic-epigenetic reprogramming.
Shixin DUAN ; Xinyi LOU ; Shiyi CHEN ; Hongchao JIANG ; Dongxin CHEN ; Rui YIN ; Mengkai LI ; Yuseng GOU ; Wenjuan ZHAO ; Lei SUN ; Feng QIAN
Acta Pharmaceutica Sinica B 2023;13(12):4785-4800
Inflammatory bowel disease (IBD) is a formidable disease due to its complex pathogenesis. Macrophages, as a major immune cell population in IBD, are crucial for gut homeostasis. However, it is still unveiled how macrophages modulate IBD. Here, we found that LIM domain only 7 (LMO7) was downregulated in pro-inflammatory macrophages, and that LMO7 directly degraded 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3) through K48-mediated ubiquitination in macrophages. As an enzyme that regulates glycolysis, PFKFB3 degradation led to the glycolytic process inhibition in macrophages, which in turn inhibited macrophage activation and ultimately attenuated murine colitis. Moreover, we demonstrated that PFKFB3 was required for histone demethylase Jumonji domain-containing protein 3 (JMJD3) expression, thereby inhibiting the protein level of trimethylation of histone H3 on lysine 27 (H3K27me3). Overall, our results indicated the LMO7/PFKFB3/JMJD3 axis is essential for modulating macrophage function and IBD pathogenesis. Targeting LMO7 or macrophage metabolism could potentially be an effective strategy for treating inflammatory diseases.

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