Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

Objective To explore the relationship between the expression levels of serum long chain non coding RNA Kinectin 1 antisense RNA 1(LncRNA KTN1-AS1)and retinoblastoma binding protein 4(RBBP4)with postoperative recurrence and metastasis in esophageal cancer patients.Methods From May 2018 to May 2021,119 patients with esophageal cancer who underwent surgical treatment in our hospital were included as the study group.They were separated into an occurrence group(n=51)and a non occurrence group(n=68)based on whether there was recurrence or metastasis during a 3-year follow-up.Additionally,100 patients with benign esophageal tumors treated at the same stage were selected as the control group.ELISA method was applied to detect the expression levels of serum LncRNA KTN1-AS1 and RBBP4.Multivariate Logistic regression was applied to analyze the influencing factors of postoperative recurrence and metastasis in esophageal cancer patients.ROC curve was applied to analyze the predictive value of serum LncRNA KTN1-AS1 and RBBP4 for postoperative recurrence and metastasis in esophageal cancer patients.Results The expression levels of serum LncRNA KTN1-AS1 and RBBP4 in the study group were obviously higher than those in the control group(P＜0.05).The expression levels of serum LncRNA KTN1-AS1 and RBBP4,and the proportions of mucosal/submucosal infiltration depth,and low differentiation degree and proportion of lymph node metastasis in the occurrence group were obviously higher than those in the non occurrence group(P＜0.05).Serum LncRNA KTN1-AS1,RBBP4,proportion of lymph node metastasis,degree of differentiation,and depth of infiltration were influencing factors for postoperative recurrence and metastasis in esophageal cancer patients(P＜0.05).The area under the curve(AUC)of the combined prediction of serum LncRNA KTN1 AS1 and RBBP4 for postoperative recurrence and metastasis in esophageal cancer patients was 0.912,which was better than their individual predictions(Zcombination LncRNA KTN1 AS1=2.470,Zcombination-RBBp4=1.994,P=0.014,P=0.046),the sensitivity and specificity of the combined prediction were 90.20％and 85.29％,respectively.Conclusion The expression levels of serum LncRNA KTN1-AS1 and RBBP4 in esophageal cancer patients are obviously increased,which is closely related to postoperative recurrence and metastasis.The combined detection of the two has good predictive value for postoperative recurrence and metastasis in patients.

Objective To explore the relationship between the expression levels of serum long chain non coding RNA Kinectin 1 antisense RNA 1(LncRNA KTN1-AS1)and retinoblastoma binding protein 4(RBBP4)with postoperative recurrence and metastasis in esophageal cancer patients.Methods From May 2018 to May 2021,119 patients with esophageal cancer who underwent surgical treatment in our hospital were included as the study group.They were separated into an occurrence group(n=51)and a non occurrence group(n=68)based on whether there was recurrence or metastasis during a 3-year follow-up.Additionally,100 patients with benign esophageal tumors treated at the same stage were selected as the control group.ELISA method was applied to detect the expression levels of serum LncRNA KTN1-AS1 and RBBP4.Multivariate Logistic regression was applied to analyze the influencing factors of postoperative recurrence and metastasis in esophageal cancer patients.ROC curve was applied to analyze the predictive value of serum LncRNA KTN1-AS1 and RBBP4 for postoperative recurrence and metastasis in esophageal cancer patients.Results The expression levels of serum LncRNA KTN1-AS1 and RBBP4 in the study group were obviously higher than those in the control group(P＜0.05).The expression levels of serum LncRNA KTN1-AS1 and RBBP4,and the proportions of mucosal/submucosal infiltration depth,and low differentiation degree and proportion of lymph node metastasis in the occurrence group were obviously higher than those in the non occurrence group(P＜0.05).Serum LncRNA KTN1-AS1,RBBP4,proportion of lymph node metastasis,degree of differentiation,and depth of infiltration were influencing factors for postoperative recurrence and metastasis in esophageal cancer patients(P＜0.05).The area under the curve(AUC)of the combined prediction of serum LncRNA KTN1 AS1 and RBBP4 for postoperative recurrence and metastasis in esophageal cancer patients was 0.912,which was better than their individual predictions(Zcombination LncRNA KTN1 AS1=2.470,Zcombination-RBBp4=1.994,P=0.014,P=0.046),the sensitivity and specificity of the combined prediction were 90.20％and 85.29％,respectively.Conclusion The expression levels of serum LncRNA KTN1-AS1 and RBBP4 in esophageal cancer patients are obviously increased,which is closely related to postoperative recurrence and metastasis.The combined detection of the two has good predictive value for postoperative recurrence and metastasis in patients.

This study aims to investigate the effects of aerobic exercise on neuroinflammation in AD mice and explore the mechanisms of neuroinflammation regulated by the blood-brain barrier,lipopolysaccharide(LPS)displacement,and glial cell activation.Twenty 3-month-old male APP/PS1 double transgenic mice were used,which were randomly divided into a sedentary group(SE-AD)and an aerobic exercise group(Run-AD),and 10 3-month-old male C57BL/6 mice were used as the control group(WT).The Run-AD group underwent 12 weeks of aerobic training.The results of the water maze showed that aerobic exercise improved the learning and memory capacity of AD mice(P＜0.05).The results of H&E stai-ning and Nissl staining showed that aerobic exercise reduced necrotic cells and inflammatory cell infiltra-tion in the cerebral cortex,as well as nuclear condensation in the CA1 and GD regions of the hippocam-pus(P＜0.05,P＜0.01),and increased the area of Nissl bodies in the cerebral cortex and hippocam-pal CA3 and DG regions.Western blotting and ELISA results showed that aerobic exercise increased the expression of Occludin,ZO-1 and Claudin-5 proteins in the brain(P＜0.01),and decreased the levels of LPS in the brain(P＜0.01).The qRT-PCR results exhibited that aerobic exercise decreased the ex-pression of TLR4,MyD88,NF-κB,IL-1β,and TNF-α mRNA(P＜0.05,P＜0.01).The results of immunofluorescence staining revealed that aerobic exercise reduced the fluorescence area of brain IL-1βand TNF-α proteins(P＜0.05,P＜0.01),as well as the fluorescence area of Iba-1,GFAP,and TLR4 proteins in the cerebral cortex and hippocampus(P＜0.05,P＜0.01).There was a high degree of overlap between Iba-1 and TLR4 fluorescence in the cerebral cortex,and GFAP was localized around Iba-1.In summary,aerobic exercise attenuates neuroinflammation in AD mice by protecting the blood-brain barrier,reducing the displacement of LPS,and subsequently weakening the immune activation of microglia to regulate the TLR4/MyD88/NF-κB signaling pathway to alleviate neuroinflammation.

An integrated extraction-purification process was established in this work for efficient phycocyanin production from dried Spirulina platensispowder.Initially,phycocyanin was extracted from algal biomass using a combined swelling-enzymatic lysis strategy.Single-factor experiments were carried out to systematically evaluate the effects of critical parameters,including system pH,enzymatic hydrolysis duration,and temperature,on phycocyanin extraction yield.Subsequently,a three-factor,three-level Box-Behnken response surface methodology design was employed to optimize the extraction process,with phycocyanin concentration and purity in the extract serving as response variables.A predictive regression model identified optimal conditions as follows:pH 6.4,hydrolysis time 3.2 h,and temperature 35.4℃.Experimental validation under these conditions yielded a phycocyanin recovery of 26.6%.Following extraction,purification was achieved via a polyethylene glycol-phosphate aqueous two-phase extraction system,which elevated the final purity to 4.21.Results demonstrated that the swelling-enzymatic lysis approach effectively disrupted algal cellular structures,significantly enhancing phycocyanin release efficiency.Concurrently,the aqueous two-phase system enabled selective partitioning and enrichment of the target protein under mild conditions.The integrated process exhibited high extraction efficiency,gentle purification,and robust operability,rendering it suitable for the scalable production of natural phycocyanin.This work provided both methodological foundations and technical support for advancing phycocyanin applications in natural pigments,biomedicine,and analytical detection.

Qualitative and quantitative analysis methods for chemical components of different processed products of Corni Fructus were established to systematically characterize and identify these components, and the content of the main differential components was determined. The chemical components of different processed products of Corni Fructus were collected using ultra-high performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry(UPLC-Q-TOF-MS). Through analysis of self-built databases, literature, and reference standards, a total of 93 components were obtained, including 19 iridoids, 15 flavonoids, 16 organic acids, eight triterpenoids, eight tannins, four amino acids, two polysaccharides, five olefins, and 16 other compounds. Additionally, by using multivariate statistical methods, the differential components between different processed products of Corni Fructus were screened under the conditions of VIP>1.0 and FC<0.5 or FC>2.0 and P<0.05. The PCA and OPLS-DA results showed differences in the chemical components between different processed products of Corni Fructus. A total of 21 differential components were screened, including tartaric acid, morroniside, and rutin. On this basis, ultra-high performance liquid chromatography-triple quadrupole tandem mass spectrometry(UPLC-QqQ-MS/MS) was used to determine the content of 10 main common differential components, including gallic acid, morroniside, ursolic acid, loganin, swertiamarin, rutin, 5-hydroxymethylfurfural, cornuside Ⅰ, quercetin, and oleanolic acid. The above 10 components showed a good linear relationship within the determined concentration range, with the precision, stability, repeatability, and sample recovery rate all meeting the requirements. Compared with that in Corni Fructus, the content of iridoid glycosides in wine-prepared Corni Fructus and wine-and honey-prepared Corni Fructus decreased, while the content of gallic acid, rutin, quercetin, 5-hydroxymethylfurfural, ursolic acid, and oleanolic acid increased. Compared with wine-prepared Corni Fructus, wine-and honey-prepared Corni Fructus showed varying degrees of increase in all other components, except for a slight decrease in gallic acid content. In summary, this study clarified the influence of different processing methods on the chemical components of Corni Fructus, providing a theoretical basis for the scientific connotation, overall quality evaluation, and clinically rational application of Corni Fructus processing in the future.
Tandem Mass Spectrometry/methods* ; Chromatography, High Pressure Liquid/methods* ; Cornus/chemistry* ; Drugs, Chinese Herbal/chemistry* ; Fruit/chemistry*

To determine the optimal cultivation duration and harvest period for cultivated Notopterygium incisum and promote its industrial development, this study established a characteristic chromatographic profile of cultivated N. incisum and employed chemometrics combined with entropy-weighted grey correlation analysis to assess differences in agronomic traits and quality indicators across different cultivation years and harvest periods. By comparing with reference substances, ten common peaks were identified, including chlorogenic acid, p-coumaric acid, ferulic acid, marmesinin, nodakenin, isochlorogenic acid B, notopterol, phenethyl ferulate, isoimperatorin, and falcarindiol. The similarity between the characteristic chromatographic profiles of N. incisum at different cultivation years and the reference profile was all above 0.932. Principal component analysis(PCA) and orthogonal partial least squares discriminant analysis(OPLS-DA) revealed that the quality of 1-to 3-year-old cultivated N. incisum was highly dispersed and unstable, whereas the quality of 4-year-old cultivated N. incisum remained relatively stable across different harvest periods. This suggests that the accumulation of relevant compounds in the medicinal material had reached a plateau, confirming that the optimal cultivation period for N. incisum is four years. Entropy-weighted grey correlation analysis indicated that the quality of 4-year-old cultivated N. incisum across different harvest periods ranked from highest to lowest as follows: November, December, October, August, July, and September, demonstrating that November is the optimal harvest time. The findings of this study establish the suitable cultivation duration and optimal harvest period for N. incisum, providing a scientific basis for cultivation guidance and quality standardization.
Chromatography, High Pressure Liquid/methods* ; Apiaceae/chemistry* ; Entropy ; Chemometrics/methods* ; Drugs, Chinese Herbal/chemistry* ; Principal Component Analysis ; Quality Control

INTRODUCTION: Trastuzumab deruxtecan (T-DXd) has revolutionised treatment for metastatic breast cancer (MBC). While effective, its high cost and toxicities, such as fatigue and nausea, pose challenges. METHOD: Medical records from the Joint Breast Cancer Registry in Singapore were used to study MBC patients treated with T-DXd (February 2021-June 2024). This study was conducted to address whether reducing dose intensity and density may have an adverse effect on treatment outcomes. RESULTS: Eighty-seven MBC patients were treated with T-DXd, with a median age of 59 years. At the time of data cutoff, 32.1% of patients were still receiving T-DXd. Over half (54%) of the patients received treatment with an initial relative dose intensity (RDI) of <;85%. Overall median real-world progression-free survival (rwPFS) was 8.1 months. rwPFS was similar between RDI groups (<85%: 8.7 months, <85%: 8.1 months, P=0.62). However, human epidermal growth receptor 2 (HER2)-positive patients showed significantly better rwPFS outcomes compared to HER2-low patients (8.8 versus 2.5 months, P<0.001). Only 16% with central nervous system (CNS) involvement had CNS progressive disease on treatment. No significant progression-free survival (PFS) differences were found between patients with or without CNS disease, regardless of RDI groups. Five patients (5.7%) developed interstitial lung disease (ILD), with 3 (3.4%) having grade 3 events. Two required high-dose steroids and none were rechallenged after ILD. There were no fatalities. CONCLUSION Our study demonstrated that reduced dose intensity and density had no significant impact on rwPFS or treatment-related toxicities. Furthermore, only 5.7% of patients developed ILD. T-Dxd provided good control of CNS disease, with 82% of patients achieving CNS disease control.
Humans ; Female ; Breast Neoplasms/mortality* ; Middle Aged ; Trastuzumab/adverse effects* ; Aged ; Adult ; Singapore/epidemiology* ; Antineoplastic Agents, Immunological/adverse effects* ; Camptothecin/adverse effects* ; Immunoconjugates/adverse effects* ; Retrospective Studies ; Progression-Free Survival ; Receptor, ErbB-2/metabolism* ; Neoplasm Metastasis ; Dose-Response Relationship, Drug ; Treatment Outcome ; Registries

The renin-angiotensin-aldosterone system (RAAS) is crucial for regulating blood pressure and maintaining fluid balance, while clock genes are essential for sustaining biological rhythms and regulating metabolism. There exists a complex interplay between RAAS and clock genes that may significantly contribute to the development of various cardiovascular and metabolic diseases. Although current literature has identified correlations between these two systems, the specific mechanisms of their interaction remain unclear. Moreover, the interaction patterns under different physiological and pathological conditions need further investigation. This review summarizes the synergistic roles of the RAAS and clock genes in cardiovascular diseases, explores their molecular mechanisms and pathophysiological connections, discusses the application of chronotherapy, and highlights potential future research directions, aiming to provide novel insights for the prevention and treatment of related diseases.
Humans ; Renin-Angiotensin System/genetics* ; Cardiovascular Diseases/genetics* ; CLOCK Proteins/physiology* ; Animals