1.VEGF Inhibitor–Associated Side Effects in Antitumor Therapy and Intervention Strategies
Lu LIU ; Wanting SUN ; Shuning YAO ; Zhenyu CHEN ; Yuefei WANG ; Jing YANG
Cancer Research on Prevention and Treatment 2026;53(4):289-300
Vascular endothelial growth factor (VEGF) inhibitors are drugs that target and inhibit tumor angiogenesis. By blocking the signaling pathway of VEGF and its receptor, they suppress tumor proliferation and play a crucial role in tumor treatment. However, their side effects, such as hypertension, proteinuria, hand-foot skin reactions, and myelosuppression, during treatment seriously affect patients' treatment compliance and quality of life. The development of intervention strategies for the side effects of VEGF inhibitors is of great importance for tumor treatment. This article reviews the clinical characteristics and toxic mechanisms of common side effects caused by VEGF inhibitors during tumor treatment and summarizes intervention strategies that combine traditional Chinese and Western medicines. Drug dosages were precisely monitored and adjusted to achieve antitumor treatment. Patients' discomfort symptoms are improved through prescriptions that act by tonifying qi and promoting blood circulation, strengthening the spleen, and tonifying the kidney. The combination of traditional Chinese and Western medicines is used to treat patients, thus providing a safe and effective treatment plan for patients with cancer.
2.Clinical Utility of Whole Exome Sequencing in the Diagnosis of Fetal Short Femur
Manqi CHEN ; Zewei HUANG ; Qi XU ; Shuning ZHANG ; Xiaojun CHEN ; Haiyan YAN ; Xiang LI ; Shuai FU
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(2):368-378
ObjectiveTo enhance the genetic diagnostic yield for fetal short femur length (FL) and to evaluate the integration of whole exome sequencing (WES) with chromosomal abnormality detection in prenatal diagnosis. MethodsA total of 27 mid-to-late trimester fetuses diagnosed with short FL [FL < 5th percentile for gestational age or < -2 SD (Standard Deviation)] at the Prenatal Diagnosis And Medical Genetics Center,Shenshan Medical Center,Memorial Hospital of Sun Yat-Sen University between November 2023 and May 2025 were included. Amniotic fluid or umbilical cord blood samples were collected and subjected to chromosomal karyotyping (19cases), chromosomal microarray analysis (CMA) or low-coverage whole genome copy number variation(CNV-Seq) (27 cases), and trio-based whole exome sequencing (trio-WES) (27 cases). The pathogenicity of genetic variants were interpreted according to the American College of Medical Genetics and Genomics (ACMG) guidelines. ResultsTwenty-six genomic variants were detected in 17 of the 26 fetuses, including numerical chromosomal abnormalities (mosaic type), copy number variations (CNVs), single nucleotide variants (SNVs) and insertions-deletions (INDELs). Genomic variants detected in 11 cases could explain the short femur phenotype.The overall diagnostic rate was 11/27, with pathogenic/likely pathogenic variants explaining 9 cases and variants of uncertain significance (VUS) accounting for 1 cases. In addition Chromosomal karyotype analysis revealed chromosome mosaicism explaining 1 case. The diagnostic rate of CNV detection (CMA/CNV-seq) was 2/27, while WES achieved a diagnostic rate of 10/27, with an incremental yield of 8/27 in cases with negative or inconclusive CNV results. Pathogenic mutations involved genes such as FGFR3, SHOX, DUOX2, CLCN5, and HBA1/HBA2. ConclusionTrio-WES significantly improves the genetic diagnostic rate for fetal short femur length, particularly in cases where chromosomal analysis fails to identify a cause. Karyotyping remains valuable for detecting low-level mosaicism in large-scale chromosomal abnormalities, thereby complementing WES and CNV detection. A stepwise or parallel genetic testing strategy is recommended in prenatal diagnosis to optimize diagnostic efficiency and support clinical decision-making.
3.Mechanisms of Hematopoietic Promotion by Hedysari Radix-Angelicae Sinensis Radix and Their Active Components: A Review
Shuning LIU ; Xiaotong WANG ; Huanhuan SUN ; Yaohui XIE ; Nan NAN ; Na LI ; Xu LI ; Xiaocheng WEI ; Chengyi LI
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(23):322-330
The herb pair Hedysari Radix-Angelicae Sinensis Radix is a classic combination embodying the theory of replenishing Qi and tonifying blood in traditional Chinese medicine. The two herbs are often used together to achieve the effects of replenishing Qi, tonifying blood, activating blood, and unblocking collaterals. Clinically, this herb pair is widely applied in the treatment of blood deficiency syndrome and hematopoietic dysfunction disorders such as myelosuppression induced by radiotherapy and chemotherapy. Modern research indicates that Hedysari Radix-Angelicae Sinensis Radix and their active components can synergistically promote hematopoiesis through multiple targets and pathways. At the cellular level, the active components directly activate hematopoietic stem cells (HSCs) and hematopoietic progenitor cells (HPCs), promoting their proliferation and differentiation, while simultaneously stimulating the production and release of peripheral blood cells. Regarding molecular regulation, this herb pair can regulate the expression of various hematopoietic-related cytokines, such as stem cell factor and erythropoietin. Additionally, it modulates key signaling pathways, including phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) and Wnt/β-catenin, providing signal support for the hematopoietic process. Furthermore, Hedysari Radix-Angelicae Sinensis Radix can improve the hematopoietic microenvironment, protect bone marrow stromal cells, and eliminate free radicals through antioxidant effects, thereby reducing damage to hematopoietic cells. Furthermore, this herb pair regulates apoptosis-related proteins to inhibit excessive apoptosis of hematopoietic cells and increase their survival rate. Its material basis primarily includes active components such as Hedysarum polybotrys polysacchcrides and flavonoids, as well as Angelica sinensis polysaccharides and ferulic acid, which synergistically contribute to its hematopoietic-promoting effects. By elaborating on the active components and mechanisms of Hedysari Radix-Angelicae Sinensis Radix in promoting hematopoiesis, this paper aims to elucidate the molecular mechanisms underlying their hematopoietic effects and provide a reference for further research and clinical application.
4.Expression and significance of serum miR-503 and miR-186 in patients with vascular dementia caused by ischemic stroke
International Journal of Laboratory Medicine 2025;46(1):65-69
Objective To explore the expression and clinical significance of serum microRNA(miR)-503 and miR-186 in patients with vascular dementia(VD)caused by ischemic stroke.Methods A total of 126 pa-tients with ischemic stroke admitted to this hospital from December 2020 to December 2022 were selected as the observation group,and were divided into VD group(35 cases)and non-VD group(91 cases)according to the results of follow-up visits 3 months after treatment.Another 61 healthy subjects who underwent physical examination in the same period were selected as the health group.The expression levels of serum miR-503 and miR-186 were detected by quantitative fluorescence PCR(qPCR),and the general data of VD group and non-VD group were compared.Logistic regression model was used to analyze the factors affecting the occurrence of VD in patients with ischemic stroke,and ROC curve was drawn to analyze the efficacy of serum miR-503 and miR-186 in predicting the occurrence of VD after ischemic stroke.Results Serum miR-503 and miR-186 ex-pression levels in non-VD group and VD group were higher than those in healthy group(P<0.05),and serum miR-503 and miR-186 expression levels in VD group were higher than those in non-VD group(P<0.05).Pearson analysis showed that there was a significant positive correlation between serum miR-503 and miR-186 expression level in patients with VD caused by ischemic stroke(r=0.462,P<0.001).There were statistical-ly significant differences in hypertension,NIHSS score,smoking proportion and mRS score between the two groups(P<0.05).Smoking,hypertension,NIHSS score,mRS score,serum miR-503 expression level and ser-um miR-186 expression level were risk factors for VD in patients with ischemic stroke(P<0.05).The area under the curve(AUC)of serum miR-503 and miR-186 combined to predict VD in ischemic stroke patients was 0.948,and the sensitivity and specificity were 85.70%and 92.30%,respectively.The prediction efficacy was better than that of serum miR-503 and miR-186 alone(Z=2.784,2.275,P=0.005,0.023).Conclusion Serum miR-503 and miR-186 are highly expressed in patients with VD caused by ischemic stroke,and which have predictive value for the occurrence of VD in patients with ischemic stroke.
5.Research progress on the role and related mechanisms of small integral membrane proteins encoded by lncRNAs in tumors
Shiting ZHANG ; Rumeng BAI ; Jingjiao XIAO ; Shuning SUN ; Zhihong ZHANG
Chinese Journal of Clinical and Experimental Pathology 2025;41(2):228-232
Long non-coding RNAs(lncRNAs)regulate gene expression at the transcriptional,post-transcription-al,or epigenetic levels,and play crucial roles in tumor cell proliferation,invasion,apoptosis,and metabolism.With ongoing research,an increasing number of human microproteins encoded by lncRNAs have been discovered,although their complete functional characterization remains to be explored.This article reviews the research progress on the func-tions and partial mechanisms of the small integral membrane protein(SMIM)family encoded by lncRNAs in tumor ini-tiation and progression.
6.Clinical characteristics of patients with brucellosis complicated with epididymo-orchitis
Lei ZOU ; Yao CHENG ; Qingfeng GAO ; Luo SUN ; Ci WANG ; Shuning SUI ; Jingyao LIU ; Baiqiang ZHANG ; Huimei BI
Chinese Journal of Endemiology 2025;44(10):836-840
Objective:To explore the clinical characteristics of patients with brucellosis complicated with epididymo-orchitis (Brucellar epididymo-orchitis, BEO), so as to provide reference for clinical diagnosis and treatment of BEO.Methods:General and clinical data of 293 male patients with acute brucellosis admitted to the Beidahuang Industry Group General Hospital from January 2023 to December 2024 were retrospectively collected. They were divided into a BEO group (30 cases) and a non-BEO group (263 cases) based on the presence or absence of epididymo-orchitis. Epidemic characteristics, clinical manifestations and laboratory examination results were compared and analyzed.Results:Among 293 male patients with acute brucellosis, the incidence of BEO was 10.24% (30/293). Their age was mainly concentrated in 45 - < 60 years old (53.33%, 16/30), and occupation was mostly farmers (63.33%, 19/30). There were no statistically significant differences in the distribution of age, occupation, exposure history and onset season between the BEO group and the non-BEO group ( P > 0.05). The distribution of abdominal pain and urinary frequency/urgency/pain symptoms was compared, and the differences were statistically significant ( P < 0.05). White blood cell count (WBC), neutrophil count (NEUT), and C-reactive protein (CRP) levels in the BEO group were higher than those in the non-BEO group ( P < 0.05), while the levels of cytokines interleukin (IL)-6 and interferon-γ (IFN-γ) were lower than those in the non-BEO group ( P < 0.05). After 6 - 8 weeks of hospitalization, the levels of WBC, NEUT, CRP, albumin, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase, alkaline phosphatase, α-hydroxybutyrate dehydrogenase, lactate dehydrogenase, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor-α, and IFN-γ in patients of the BEO group were significantly different from before treatment ( P < 0.05). Twenty-eight patients were cured, 1 patient underwent orchiectomy, and 1 patient experienced recurrence. Conclusions:Middle-aged male patients with brucellosis are more prone to BEO. Clinical manifestations and laboratory tests have certain diagnostic value for BEO. Suspected BEO patients should be diagnosed and treated as early as possible to reduce the occurrence of adverse prognosis.
7.Clinical characteristics of 22 patients with neurobrucellosis
Lei ZOU ; Qingfeng GAO ; Huijiao XU ; Hong WU ; Yao CHENG ; Luo SUN ; Yan ZHANG ; Jingyao LIU ; Baiqiang ZHANG ; Shuning SUI
Chinese Journal of Endemiology 2025;44(8):674-678
Objective:To learn about the clinical characteristics of patients with neurobrucellosis (NB) and provide references for clinical diagnosis and treatment of NB.Methods:The clinical data of 22 NB patients diagnosed and treated at Beidahuang Industry Group General Hospital from January 2018 to November 2024 and 178 healthy individuals undergoing physical examinations during the same period were retrospectively collected. The epidemiological characteristics, clinical manifestations, laboratory tests, treatment and prognosis of NB patients were analyzed.Results:Among the 22 NB patients, 12 were males (54.55%) and 10 were females (45.45%). The age was (51.77 ± 12.75) years old, ranging from 27 to 80 years old. Most of the patients were farmers (95.45%, 21/22), and 16 cases (72.73%) had contacted with cattle/sheep. The onset seasons were mainly in summer (40.91%, 9/22) and spring (31.82%, 7/22). Among all NB patients, there were 10 cases of encephalitis/meningoencephalitis, 9 cases of myelitis, and 3 cases of meningitis. The general symptoms were mainly fever (68.18%, 15/22), the neurological symptoms were mainly nausea and vomiting (36.36%, 8/22), and the physical signs were mainly muscle weakness (50.00%, 11/22) and pathological signs (45.45%, 10/22). The laboratory test results showed that the levels of hemoglobin, hematocrit, C-reactive protein, total protein, albumin, γ-glutamyl transpeptidase, α-hydroxybutyric acid dehydrogenase, lactate dehydrogenase, and glutathione reductase in NB patients were significantly different from those in healthy individuals ( P < 0.001). Brain magnetic resonance imaging revealed ischemic changes in 5 cases (22.73%), abnormal brain signals in 2 cases (9.09%), and demyelinating lesions in white matter in 1 case (4.55%). After treatment, 18 NB patients were followed up and showed good prognosis, with only 2 cases exhibiting varying degrees of sequelae (walking disorders or memory impairment). Conclusions:The clinical manifestations of NB patients are diverse. A comprehensive judgment should be made by combining epidemiological characteristics, clinical manifestations, laboratory tests and imaging examinations.
8.Research progress of artificial intelligence based on deep learning in the diagnosis and treatment of triple-negative breast cancer
Jingjiao XIAO ; Yefan YANG ; Shiting ZHANG ; Shuning SUN ; Zhihong ZHANG
Chinese Journal of Clinical and Experimental Pathology 2025;41(4):491-497
In recent years,artificial intelligence(AI)technologies,particularly those represented by deep learn-ing,have demonstrated tremendous potential in the advancement of medical applications.This article reviews recent re-search progress in AI applications for the diagnosis and treatment of triple-negative breast cancer,aiming to inform the development of clinically relevant AI algorithms that align with real-world practice scenarios.The ultimate objectives in-clude enhancing diagnostic accuracy through efficient computational approaches,reducing manual labor burdens,im-proving patient prognosis,and facilitating the identification of therapeutic targets in oncology through AI-driven predic-tive modeling.
9.Research progress on the role and related mechanisms of small integral membrane proteins encoded by lncRNAs in tumors
Shiting ZHANG ; Rumeng BAI ; Jingjiao XIAO ; Shuning SUN ; Zhihong ZHANG
Chinese Journal of Clinical and Experimental Pathology 2025;41(2):228-232
Long non-coding RNAs(lncRNAs)regulate gene expression at the transcriptional,post-transcription-al,or epigenetic levels,and play crucial roles in tumor cell proliferation,invasion,apoptosis,and metabolism.With ongoing research,an increasing number of human microproteins encoded by lncRNAs have been discovered,although their complete functional characterization remains to be explored.This article reviews the research progress on the func-tions and partial mechanisms of the small integral membrane protein(SMIM)family encoded by lncRNAs in tumor ini-tiation and progression.
10.Relapse-related candidate genes and their clinicopathological connections of diffuse large B cell lymphoma
Yuxi GONG ; Yefan YANG ; Shuning SUN ; Rumeng BAI ; Shuaishuai ZHUO ; Yang SHAO ; Kaihua LIU ; Yuqian SHI ; Zhihong ZHANG
Chinese Journal of Pathology 2025;54(4):348-353
Objective:To explore the relapse-related genes and their clinicopathological connections of diffuse large B cell lymphoma (DLBCL).Methods:Targeted panel sequencing was conducted on 32 eligible DLBCL samples; the patients were diagnosed, treated, and went into complete remission at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, including 14 cases with recurrence (relapsed group) and 18 cases with long-term complete remission of over five years (remission group). Clinical and pathological data were further reviewed. Fisher′s exact test was employed to compare the differences in clinicopathological characteristics and mutation patterns between the two groups.Results:Among the 32 patients, there were 18 males and 14 females, with a male to female ratio of 1.3∶1.0 and a median age of 53 (45.5, 67.0) years. In the relapsed group, PIM1 (11/14), KMT2D (7/14), PRDM1 (6/14), MYD88 (6/14), DTX1 (6/14) emerged as the most frequently mutated genes. In the remission group, while recurrent PIM1, KMT2D and MYD88 mutations were also observed, the TP53 gene exhibited the highest mutation frequency (6/18). Compared to the remission group, relapsed group showed elevated mutation frequencies of PIM1 ( P=0.013) and FAT4 ( P=0.010), alongside a reduced incidence of TP53 mutations. In all 32 patients, DLBCL with CD79B, CCND3, DTX1, KMT2D and PRDM1 mutations demonstrated a propensity towards advanced clinicopathologic stage. Conclusions:Relapsed DLBCL has distinctive clinicopathological and genetic features. PIM1 and FAT4 may be served as potential biomarkers for screening relapsed DLBCL-NOS and as targets for novel therapeutic strategies.

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