1.Advances in(neo)adjuvant therapy for resectable high-risk malig-nant melanoma
Yongting YANG ; Shuxin HAN ; Xiaojing KANG
Chinese Journal of Clinical Pharmacology and Therapeutics 2025;30(6):849-857
Malignant melanoma represents a highly aggressive form of skin cancer.At present,surgical resection remains the primary treatment modality for the majority of patients diagnosed with this condition.However,the five-year disease-free survival rate for high-risk melanoma patients undergoing surgery alone ranges from 40%to 60%.The implementation of preoperative and postoper-ative(neo)adjuvant therapies has been demon-strated to diminish recurrence rates and improve survival outcomes for high-risk surgical patients.Consequently,various(neo)adjuvant treatments for melanoma-including radiotherapy,biochemo-therapy,immunotherapy,and targeted therapy-have been the subject of extensive research in re-cent years.This review aims to summarize the lat-est advancements in(neo)adjuvant therapies for resectable high-risk melanoma patients,with the objective of providing an effective(neo)adjuvant therapy strategy that may improve patient survival and overall prognosis.
2.Impact of surgical margin on the prognosis of liver resection in patients with hepatocellular carcinoma based on propensity score-matched analysis
Sichang WU ; Xinli GAN ; Shuxin HUANG ; Yujun ZHONG ; Haojie YANG ; Bangde XIANG
Chinese Journal of Hepatobiliary Surgery 2025;31(7):510-514
Objective:To study the influence of surgical margins on the prognosis of anatomical hepatectomy in patients with hepatocellular carcinoma (HCC) based on a propensity score-matched (PSM) analysis.Methods:Clinical data of 200 patients with HCC undergoing anatomical hepatectomy at the Affiliated Cancer Hospital of Guangxi Medical University from December 2019 to December 2023 were retrospectively analyzed, including 169 males and 31 females, aged 53.4±12.0 years. Patients were divided into the narrow margin group (surgical margin ≤10 mm, n=133) and wide margin group (>10 mm, n=67) according to the width of the surgical margin. PSM was used to compare preoperative indicators such as the maximum diameter of the tumor, the integrity of the tumor capsule, sublesions, and the clinical stage of Barcelona liver cancer (BCLC), perioperative indicators such as intraoperative blood loss, and 24-hour postoperative laboratory indicators such as alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase between the two groups of patients. The prognosis was analyzed by the Kaplan-Meier method, and the postoperative recurrence-free survival rate of the two groups was compared by the log-rank test. Yates corrected chi-square test was used to analyze the postoperative liver function of the two groups of patients. Results:Before PSM, 133 cases were included in the narrow margin group and 67 cases in the wide margin group. There were statistically significant differences in the clinical stage of BCLC, intraoperative blood loss, alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase between the two groups (all P<0.05). After PSM, 55 cases were included in both the narrow margin group and the wide margin group. There were no statistically significant differences in the clinical stage, intraoperative blood loss, alanine aminotransferase and other indicators of BCLC between the two groups (all P>0.05). The 1-year, 2-year, and 3-year recurrence-free survival rates of the wide margin group were 94.2%, 80.1%, and 75.1% respectively, which were higher than those of the narrow margin group (71.8%, 52.9%, and 44.1%), the difference was statistically significant ( χ2=6.25, P=0.012). After PSM, a total of 12 patients (10.9%, 12/110) in the two groups developed liver dysfunction after the operation, among which 10 cases (18.2%, 10/55) were in the wide margin group and 2 cases (3.6%, 2/55). The incidence of postoperative liver dysfunction in the wide margin group was higher than that in the narrow margin group, the difference was statistically significant difference ( χ2=4.58, P=0.032). Conclusion:A surgical margin >10 mm can improve the relapse free survival rate, but it will increase the incidence of postoperative liver dysfunction.
3.Advances in(neo)adjuvant therapy for resectable high-risk malig-nant melanoma
Yongting YANG ; Shuxin HAN ; Xiaojing KANG
Chinese Journal of Clinical Pharmacology and Therapeutics 2025;30(6):849-857
Malignant melanoma represents a highly aggressive form of skin cancer.At present,surgical resection remains the primary treatment modality for the majority of patients diagnosed with this condition.However,the five-year disease-free survival rate for high-risk melanoma patients undergoing surgery alone ranges from 40%to 60%.The implementation of preoperative and postoper-ative(neo)adjuvant therapies has been demon-strated to diminish recurrence rates and improve survival outcomes for high-risk surgical patients.Consequently,various(neo)adjuvant treatments for melanoma-including radiotherapy,biochemo-therapy,immunotherapy,and targeted therapy-have been the subject of extensive research in re-cent years.This review aims to summarize the lat-est advancements in(neo)adjuvant therapies for resectable high-risk melanoma patients,with the objective of providing an effective(neo)adjuvant therapy strategy that may improve patient survival and overall prognosis.
4.Impact of surgical margin on the prognosis of liver resection in patients with hepatocellular carcinoma based on propensity score-matched analysis
Sichang WU ; Xinli GAN ; Shuxin HUANG ; Yujun ZHONG ; Haojie YANG ; Bangde XIANG
Chinese Journal of Hepatobiliary Surgery 2025;31(7):510-514
Objective:To study the influence of surgical margins on the prognosis of anatomical hepatectomy in patients with hepatocellular carcinoma (HCC) based on a propensity score-matched (PSM) analysis.Methods:Clinical data of 200 patients with HCC undergoing anatomical hepatectomy at the Affiliated Cancer Hospital of Guangxi Medical University from December 2019 to December 2023 were retrospectively analyzed, including 169 males and 31 females, aged 53.4±12.0 years. Patients were divided into the narrow margin group (surgical margin ≤10 mm, n=133) and wide margin group (>10 mm, n=67) according to the width of the surgical margin. PSM was used to compare preoperative indicators such as the maximum diameter of the tumor, the integrity of the tumor capsule, sublesions, and the clinical stage of Barcelona liver cancer (BCLC), perioperative indicators such as intraoperative blood loss, and 24-hour postoperative laboratory indicators such as alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase between the two groups of patients. The prognosis was analyzed by the Kaplan-Meier method, and the postoperative recurrence-free survival rate of the two groups was compared by the log-rank test. Yates corrected chi-square test was used to analyze the postoperative liver function of the two groups of patients. Results:Before PSM, 133 cases were included in the narrow margin group and 67 cases in the wide margin group. There were statistically significant differences in the clinical stage of BCLC, intraoperative blood loss, alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase between the two groups (all P<0.05). After PSM, 55 cases were included in both the narrow margin group and the wide margin group. There were no statistically significant differences in the clinical stage, intraoperative blood loss, alanine aminotransferase and other indicators of BCLC between the two groups (all P>0.05). The 1-year, 2-year, and 3-year recurrence-free survival rates of the wide margin group were 94.2%, 80.1%, and 75.1% respectively, which were higher than those of the narrow margin group (71.8%, 52.9%, and 44.1%), the difference was statistically significant ( χ2=6.25, P=0.012). After PSM, a total of 12 patients (10.9%, 12/110) in the two groups developed liver dysfunction after the operation, among which 10 cases (18.2%, 10/55) were in the wide margin group and 2 cases (3.6%, 2/55). The incidence of postoperative liver dysfunction in the wide margin group was higher than that in the narrow margin group, the difference was statistically significant difference ( χ2=4.58, P=0.032). Conclusion:A surgical margin >10 mm can improve the relapse free survival rate, but it will increase the incidence of postoperative liver dysfunction.
5.Effect of total flavones of Dracocephalum moldavica L.on high-glucose in-duced oxidative damage to retinal ganglion cells and its mechanism
Liying GU ; Shengfu YANG ; Qiming ZHANG ; Shuxin WANG
Recent Advances in Ophthalmology 2024;44(12):937-942
Objective To investigate the effects of total flavones of Dracocephalum moldavica L.(TFDM)on oxida-tive damage to retinal ganglion cells(RGCs)induced by high glucose(HG)and its mechanism.Methods RGCs of mice were taken as the research subjects.RGCs were inoculated in 24-well plates(with 2.5 × 104 cells in each well)and divided into control group(cultured with medium containing 10%fetal bovine serum for 48 h),HG group(cultured with medium containing 30 mmol·L-1 glucose for 48 h),HG+TFDM-L group(cultured with medium containing 30 mmol·L-1 glucose and 25 mg·L-1 TFDM for 48 h),HG+TFDM-M group(cultured with medium containing 30 mmol·L-1 glucose and 50 mg·L-1 TFDM for 48 h),HG+TFDM-H group(cultured with medium containing 30 mmol·L-1 glucose and 100 mg·L-1 TFDM for 48 h),miR-NC group(transfected with miR-NC and then cultured with medium containing 30 mmol·L-1 glu-cose for 48 h),miR-93-5p group(transfected with miR-93-5p mimics and then cultured with medium containing 30 mmol·L-1 glucose for 48 h),anti-miR-NC group(transfected with anti-miR-NC and then cultured with medium containing 100 mg·L-1 TFDM and 30 mmol·L-1 glucose for 48 h),and anti-miR-93-5p group(transfected with anti-miR-93-5p and then cultured with medium containing 100 mg·L-1 TFDM and 30 mmol·L-1 glucose for 48 h).Levels of RGCs oxidative stress indexes in each group were detected according to the kit instructions.The thiobarbituric acid method was used to measure the level of malondialdehyde(MDA),the colorimetric method was adopted to detect the levels of catalase(CAT)and 8-hydroxydeoxyguanosine(8-OHdG),apoptosis rate was detected by flow cytometry,the messenger ribonucleic acid(mR-NA)expressions were analyzed by real-time quantitative polymerase chain reaction,the targeting regulation of miR-93-5p and E2F transcription factor 1(E2F1)were verified by dual luciferase reporter assay,and the protein expressions were de-tected by Western blot.Statistical analysis was conducted on the data of each group.Results In the HG group,the lev-els of MDA and 8-OHdG,apoptosis rate and Bax protein expression of RGCs were higher than those in the control group(all P<0.05);the CAT level and Bcl-2 protein expression were lower than those in the control group(both P<0.05).In the HG+TFDM-L group,HG+TFDM-M group and HG+TFDM-H group,the levels of MDA and 8-OHdG,apoptosis rate and Bax protein expression of RGCs were lower than those in the HG group(all P<0.05);the CAT level and Bcl-2 protein expression were higher than those in the HG group,and those indexes gradually tended to those in the control group with the increase of TFDM concentrations(all P<0.05).In the HG group,the miR-93-5p expression in RGCs was lower than that in the control group,and the mRNA and protein expressions of E2F1 were higher than those in the control group(all P<0.05).In the HG+TFDM-L group,HG+TFDM-M group and HG+TFDM-H group,the miR-93-5p expression in RGCs was higher than that in the HG group,and the mRNA and protein expressions of E2F1 were lower than those in the HG group(all P<0.05).The protein expression of E2F1 in RGCs of the miR-93-5p group was lower than that in the miR-NC group,and the protein expression of E2F1 in RGCs of the anti-miR-93-5p group was higher than that in the anti-miR-NC group(both P<0.05).In the miR-93-5p group,the miR-93-5p expression was higher than that in the miR-NC group,the levels of MDA and 8-OHdG,apoptosis rate,and protein expressions of Bax and E2F1 were lower than those in the miR-NC group,and the CAT level and Bcl-2 protein expression were higher than those in the miR-NC group(all P<0.05).Con-clusion TFDM can inhibit oxidative stress and cell apoptosis,and then reduce the damage to RGCs induced by HG.The mechanism may involve the regulation of miR-93-5p/E2Fl expression.
6.Chinesization of the HEMO-FISS-QoL questionnaire and its reliability and validity
Songpeng SUN ; Shan JIA ; Fangfang XU ; Tianyu LI ; Zhiyun ZHANG ; Qiaorong CAO ; Xinjian LI ; Yao WU ; Weiping WAN ; Bin SHI ; Jianguo WANG ; Hong NI ; Longyu LIANG ; Xingxiao HUO ; Tianqing YANG ; Lei TIAN ; Ying TIAN ; Mei LIN ; Zhanjun WANG ; Yangyang ZHOU ; Hongchuan CHU ; Riyu LIAO ; Kuerban XIEYIDA ; Junhong LONG ; Shuxin ZHANG
Chinese Journal of Behavioral Medicine and Brain Science 2024;33(1):75-82
Objective:To evaluate the reliability and validity of the Chinese version of HEMO-FISS-QoL(HF-QoL) questionnaire (HF-QoL-C) in the Chinese population with hemorrhoids.Methods:From November 2021 to November 2022, a self-constructed general information questionnaire, HF-QoL-C, and the 36-item short form health survey (SF-36), Goligher classification, and Giordano severity of hemorrhoid symptom questionnaire (GSQ) were used to conduct a questionnaire survey on 760 hemorrhoid patients in the anorectal department of six hospitals. The data was analyzed for reliability and validity using SPSS 21.0 and AMOS 26.0 software.Results:The Cronbach's α coefficient of HF-QoL-C and its dimension ranged from 0.831 to 0.960, and the split coefficient was 0.832-0.915. Four common factors were extracted through principal component exploratory factor analysis. Confirmatory factor analysis indicated acceptable structural validity( χ2/ df=8.152, RSMEA=0.097, CFI=0.881, IFI=0.881, NFI=0.867). HF-QoL-C was correlated with SF36 and GSQ( r=-0.694, 0.501, both P<0.01). There were differences in the total score and dimensional scores of HF-QoL-C between surgical and drug treated patients, different grades of Goligher classification for hemorrhoidal disease, and different ranges of hemorrhoid prolapse (all P<0.001). No ceiling effect was found in the total score and the scores of each dimension(0.3%-2.0%). There was a floor effect in both psychological function and sexual activity dimensions (16.7%, 35.1%). Conclusion:HF-QoL-C has good reliability and validity, which can be used to measure the quality of life of Chinese hemorrhoid patients.
7.Danggui Shaoyao powder improves hepatic lipid metabolism in atherosclerosis mice via PPARγ-LXRα-ABCA1 pathway regulation
Xue Pian ; Yang Tang ; Yuemeng Sun ; Yuhan Sheng ; Shuxin Yan ; Huimin Yuan ; Yan Sun ; Jian Cui ; Yuhuang Li
Journal of Traditional Chinese Medical Sciences 2024;11(2):199-206
Objective:
To observe the effects of Danggui Shaoyao powder (DSP) on hepatic lipid metabolism and further explore its mechanism of action by peroxisome proliferator-activated receptor (PPARγ)-liver X receptor (LXRα)-adenosine triphosphate (ATP)-binding cassette transporter A1 (ABCA1) pathway regulation.
Methods:
Eight C57BL/6J male mice were selected as the control group, and 24 ApoE−/− male mice were randomly divided into the atherosclerosis model (AS) group, atorvastatin calcium (AC) group, and DSP group (n = 8 each group). To establish an AS model, ApoE−/− mice were fed a high-fat diet for 16 weeks. Pathologic changes in the aortic vasculature and liver were identified using Oil Red O staining. Triglyceride (TG), cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) levels were determined in the livers using a single-reagent GPO-PAP method. Fluorescence quantitative polymerase chain reaction and western blot were used to observe and evaluate the mRNA and protein expression of the PPARγ-LXRα-ABCA1 intermediates in the liver.
Results:
After 16 weeks of a high-fat diet, ApoE−/− mice showed more Oil Red O staining in the aorta and liver compared to the CONT group. Compared to the AS group, the DSP and AC treatment reduced aortic plaque and hepatic lipid deposition to varying degrees. Furthermore, DSP significantly reduced the hepatic lipid area in ApoE−/− mice (P < .001) and decreased the levels of TG, TC, and LDL-C in liver (P < .001, P = .027, P < .001, respectively). DSP also significantly increased the levels of PPARγ, LXRα, ABCA1, and ABCG1 mRNA expression, as well as the PPARγ, LXRα, ABCA1, and ABCG1 protein expression in liver.
Conclusion
DSP improved hepatic lipid metabolism via PPARγ-LXRα-ABCA1 pathway modulation for AS treatment.
8.Acupuncture Combined with Auricular Acupoints Patches for Moderate to Severe Nicotine Dependence:a Randomized Controlled Study
Kaisong JI ; Yalin SHE ; Yuexuan CHEN ; Liming LU ; Hongzhu LI ; Ziyu YANG ; Guohua LIN ; Shuxin WANG ; Jingchun ZENG
Journal of Traditional Chinese Medicine 2023;64(17):1771-1776
ObjectiveTo compare the efficacy and safety of acupuncture combined with auricular acupoints patches and nicotine transdermal patch in treating moderate to severe nicotine dependence. MethodsIn a rando-mized controlled trial, 64 quit smoking voluntary subjects with moderate to severe nicotine dependence were randomly divided at a ratio of 1∶1 into a treatment group and a control group, with 32 cases in each group. The treatment group was given acupuncture combined with auricular acupoints patches, twice weekly, four weeks as a course for two courses. The control group was given nicotine transdermal patch, one patch per day for 24 hours, 8 weeks. The cure rate was assessed after treatment and at follow-up (the 16th week after treatment).The daily smoking volume, exhaled carbon monoxide (CO) value, Nicotine Dependence Scale (FTND), Minnesota Nicotine Withdrawal Symptoms Scale (MNWS), and Pittsburgh Sleepiness Index Inventory (PSQI) were evaluated before and after treatment and at follow-up, and adverse effects were recorded. ResultsIn terms of the cure rate, there were both six cured cases (20%) after treatment and at follow-up in the treatment group, while in the control group, seven (23.3%) and five (16.7%) patients were cured after treatment and at follow-up, respectively, with no statistically significant differences between the two groups both after treatment and at follow-up (P>0.05). The daily smoking volume and exhaled CO value significantly decreased after treatment and at follow-up in both groups (P<0.05), but were not significantly different between the groups after treatment and at follow-up (P>0.05). After treatment and at follow-up, FTND, MNWS, and PSQI scores were significantly reduced in both groups compared with those before treatment (P<0.05). There was no statistically significant difference in the FTND scale scores between the two groups after treatment and at follow-up (P>0.05), while the MNWS and PSQI scale scores were lower in the treatment group than in the control group (P<0.05). ConclusionAcupuncture combined with auricular acupoint patches for moderate to severe nicotine dependence has comparable effect with the first-line drug nicotine patch in terms of increasing the cure rate and decreasing the degree of nicotine dependence, and is superior to nicotine patch in terms of relieving withdrawal symptoms and improving sleep, with stable long-term effect.
9.Analysis of PRX gene variants in a child with Charcot-Marie-Tooth disease type 4F
Ya′nan YANG ; Shuxin YE ; Yuqiang LYU ; Hongmei XIN ; Min GAO ; Jian MA ; Dong WANG ; Zhongtao GAI ; Yi LIU
Chinese Journal of Medical Genetics 2022;39(7):749-753
Objective:To explore the genetic etiology of a child suspected for peroneal muscular atrophy.Methods:The child and his parents were analyzed by using next generation sequencing.Results:The child was found to harbor compound heterozygous variants of c. 52G>T (p.Glu18X) and c. 1390C>T (p.Arg464X) of the PRX gene, which were inherited from his father and mother, respectively. Among these, the c. 52G>T variant was previously unreported. Based on the standards and guidelines of the American College of Medical Genetics and Genomics, both variants were predicted to be pathogenic (PVS1+ PM2+ PM3, PVS1+ PM3-Strong+ PM2+ BS2). Conclusion:The compound heterozygous variants of the PRX gene probably underlay the Charcot-Marie-Tooth disease type 4F in this child. Above finding has enriched the mutational spectrum of the PRX gene.
10.The role of STAT-6/KLF-4/PPAR-γ activation in alveolar macrophage polarization changes in silica-induced pulmonary fibrosis
Zhuomeng YAO ; Xiang ZHANG ; Shuxin YANG ; Jiaojiao ZHU ; Xinxin HU ; Tong SHEN
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(7):481-486
Objective:To observe the effect of silicon dioxide (SiO 2) on the polarization of alveolar macrophages (AMs) , and to explore the expressions and the significance of signal transducer and activator of transcription-6 (STAT-6) /Krüppel-like factor-4 (KLF-4) /peroxisome proliferators-activated receptors-γ (PPAR-γ) signaling molecules in AMs. Methods:In November 2020, C57BL/6 mice were randomly divided into crystalline SiO 2 group and normal saline (NS) group, and 12 mice in each group. Mice were intratracheally instillated with 100 μl crystalline SiO 2 suspension (20 mg/ml) or 100 μl NS, and were sacrificed after 28 days. Masson staining was used to observe the degree of pulmonary fibrosis of mice and hydroxyproline (HYP) level were assessed. The proportions of M1-typed and M2-typed AMs in bronchoalveolar lavage fluid (BLAF) were analyzed by flow cytometry. The mRNA relative expression levels of inducible nitric oxide synthase (iNOS) , arginidase-1 (Arg-1) , interleukin (IL) -1β, tumor necrosis factor-α (TNF-α) , IL-6, IL-10, transforming growth factor-β (TGF-β) , STAT-6, KLF-4 and PPAR-γ were detected by real-time fluorescence quantitative PCR. Activities of iNOS and Arg-1, as well as contents of IL-1β, TNF-α, IL-6, IL-10 and TGF-β were assessed by the enzyme-linked immunosorbent. The protein relative expression levels of phosphorylation-signal transducer and activator of transcription-6 (p-STAT-6) , KLF-4 and PPAR-γ were evaluated by immunofluorescence. Results:After 28 days of treatment, the structure of the lung tissue of the mice was destroyed, and the deposition of collagen was significantly increased in the crystalline SiO 2 group. Compared with NS group, HYP level of lung tissue in crystalline SiO 2 group were increased, the proportion of M2-typed AMs in crystalline SiO 2 group was increased, the proportion of M1-typed AMs in crystalline SiO 2 group was decreased, the mRNA relative expressions and contents of Arg-1, IL-10, TGF-β in crystalline SiO 2 group were significantly increased, the mRNA relative expressions and contents of iNOS, IL-1β, TNF-α, IL-6 in crystalline SiO 2 group were significantly decreased, the mRNA of STAT-6, KLF-4, PPAR-γ and the protein relative expression levels of p-STAT-6, KLF-4, PPAR-γ were significantly increased in crystalline SiO 2 group, and the the differences were statistically significant ( P<0.05) . Conclusion:Crystalline SiO 2 may mediate the process of pulmonary fibrosis through promote AMs polarization toward M2-typed by activating the STAT-6/KLF-4/PPAR-γ signaling pathway.


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