1.Sleep Traits and Malignant Risk of Pulmonary Nodules: Evidence Triangulation From Questionnaire, Cohort, and Mendelian Randomization
Xiangyu CHEN ; Yiqiao XUE ; Mengqing LIU ; Yile HU ; Weizuo LIANG ; Hanqing LIU ; Yizheng WANG ; Mingfang ZHAO
Medical Journal of Peking Union Medical College Hospital 2026;17(3):663-676
To investigate the association between sleep-related phenotypes and the risk of malignancy in pulmonary nodules, and to provide complementary evidence from a general population cohort and genetic analyses. This study comprised three parts. Part 1 was a cross-sectional study that consecutively enrolled patients with imaging-confirmed pulmonary nodules at the First Hospital of China Medical University from November 2024 to December 2025. Nine sleep domains were constructed using items from the Pittsburgh sleep quality index (PSQI), with domain severity coded on a 0-6 scale according to the frequency of occurrence. Benign or malignant status of pulmonary nodules was determined based on pathological results or clinical follow-up. Multivariable Logistic regression models with progressive adjustment were constructed. Stratified, interaction, and dose-response analyses (including categorical grouping and restricted cubic splines) were performed focusing on the insomnia symptom domain to explore the association between sleep-related phenotypes and the risk of malignant pulmonary nodules. Part 2 was a prospective cohort study using the China Health and Retirement Longitudinal Study (CHARLS) to investigate the association between sleep duration and incident lung cancer risk in the general population. Part 3 comprised genetic causality analyses, including two-sample Mendelian randomization (MR) and linkage disequilibrium score regression (LDSC), using data from the OpenGWAS database, to assess whether directionally consistent genetic association signals exist between sleep-related phenotypes and lung cancer risk. In the cross-sectional study, a total of 800 patients with pulmonary nodules were included, of whom 288 (36.0%) were in the malignant group. In the continuous-variable main model fully adjusted for baseline confounders, all nine sleep domains, imaging findings, and depression and anxiety status, the severity of the insomnia symptom domain showed a positive association signal with the risk of malignant pulmonary nodules (fully adjusted model: per 1-point increase, In patients with pulmonary nodules, an association signal exists between insomnia-related symptoms and the risk of malignancy, but the dose-response relationship remains unclear. The CHARLS cohort and genetic analyses provide supplementary directional clues for the above associations, albeit with limited statistical strength and result consistency. Definitive conclusions regarding the association between sleep phenotypes and the risk of malignant pulmonary nodules require further validation in prospective studies.
2.Effects of Cortical Bone Modeling Methods on Biomechanical Responses of Chinese 95th Percentile Pelvis Finite Element Model
Shihai CUI ; Weizuo CHEN ; Haiyan LI ; Lijuan HE ; Wenle LÜ
Journal of Medical Biomechanics 2025;40(1):187-193
Objective The finite element pelvis model with detailed anatomical structures which meets the Chinese human 95th percentile characteristics is developed,and the influence of cortical bone modeling method on the biomechanical response of the real pelvis is explored.Methods Based on the pelvic medical images of a 95th percentile male volunteer,two finite element pelvis models with real hip bone cortical bone thickness(REA-M)and 2 mm uniform cortical bone thickness(CON-M)dominated by hexahedral elements were constructed.Using the simulation method to reconstruct the loading conditions of cadaver experiments,the validation of models was verified by comparing the cadaver experimental results and simulation results,and biomechanical response differences of two models under different working conditions were discussed.Results The simulation data showed that there was a strong correlation between the overall biomechanical responses of two pelvic models and the cadaver experiment,and the mechanical response difference between two models was mostly within 8%,and the correlation score difference between two models was smaller than 2%.Conclusions The validation of two pelvic models established in this study is verified by rebuilding multiple simulation experiments.Although the biomechanical responses of CON-M and REA-M models were different,the difference was small.From the perspective of model simplification,the CON-M model can be used to study the biomechanical response of the pelvis.
3.Impact of carbon ion radiotherapy on immune response
Yu RONG ; Xiong XIANGZHI ; Pan TINGTING ; Liu QIANG ; Liu YUAN ; Dong JINGJING ; Chen WEIZUO
Chinese Journal of Clinical Oncology 2025;52(14):748-752
Carbon ion radiotherapy(CIRT)is an advanced radiotherapy method with unique physical and biological properties.It increases the dose to the tumor target area while providing better protection to normal tissues.CIRT can be used for hypoxic tumors resistant to photon radiotherapy.It also has the potential superiority of inducing immune responses and can produce the"abscopal effect"when com-bined with different immunotherapies.Radioimmunotherapy can not only ablate tumors at the irradiated site but also partially control dis-tant metastases at the unirradiated site.However,the underlying mechanism has not been fully elucidated.Due to the protection of the tu-mor microenvironment,tumors can sometimes be difficult to completely clear through CIRT-mediated anti-tumor immunity;this can also in-dicate functional limitations of some immune organs after CIRT.Therefore,this study reviewed the impact of CIRT on both innate and adapt-ive immune responses.It also examined the relationship between different radiation doses/fractions and immune protein expression,as well as compared the differences in imaging techniques between carbon ion radiotherapy and traditional radiotherapy.We have also proposed future directions to enhance the superiority of CIRT.This study aimed to provide a strong theoretical basis for improving the efficacy of CIRT and its combination therapy,ultimately benefiting more patients with cancer.
4.Effects of Cortical Bone Modeling Methods on Biomechanical Responses of Chinese 95th Percentile Pelvis Finite Element Model
Shihai CUI ; Weizuo CHEN ; Haiyan LI ; Lijuan HE ; Wenle LÜ
Journal of Medical Biomechanics 2025;40(1):187-193
Objective The finite element pelvis model with detailed anatomical structures which meets the Chinese human 95th percentile characteristics is developed,and the influence of cortical bone modeling method on the biomechanical response of the real pelvis is explored.Methods Based on the pelvic medical images of a 95th percentile male volunteer,two finite element pelvis models with real hip bone cortical bone thickness(REA-M)and 2 mm uniform cortical bone thickness(CON-M)dominated by hexahedral elements were constructed.Using the simulation method to reconstruct the loading conditions of cadaver experiments,the validation of models was verified by comparing the cadaver experimental results and simulation results,and biomechanical response differences of two models under different working conditions were discussed.Results The simulation data showed that there was a strong correlation between the overall biomechanical responses of two pelvic models and the cadaver experiment,and the mechanical response difference between two models was mostly within 8%,and the correlation score difference between two models was smaller than 2%.Conclusions The validation of two pelvic models established in this study is verified by rebuilding multiple simulation experiments.Although the biomechanical responses of CON-M and REA-M models were different,the difference was small.From the perspective of model simplification,the CON-M model can be used to study the biomechanical response of the pelvis.
5.Impact of carbon ion radiotherapy on immune response
Yu RONG ; Xiong XIANGZHI ; Pan TINGTING ; Liu QIANG ; Liu YUAN ; Dong JINGJING ; Chen WEIZUO
Chinese Journal of Clinical Oncology 2025;52(14):748-752
Carbon ion radiotherapy(CIRT)is an advanced radiotherapy method with unique physical and biological properties.It increases the dose to the tumor target area while providing better protection to normal tissues.CIRT can be used for hypoxic tumors resistant to photon radiotherapy.It also has the potential superiority of inducing immune responses and can produce the"abscopal effect"when com-bined with different immunotherapies.Radioimmunotherapy can not only ablate tumors at the irradiated site but also partially control dis-tant metastases at the unirradiated site.However,the underlying mechanism has not been fully elucidated.Due to the protection of the tu-mor microenvironment,tumors can sometimes be difficult to completely clear through CIRT-mediated anti-tumor immunity;this can also in-dicate functional limitations of some immune organs after CIRT.Therefore,this study reviewed the impact of CIRT on both innate and adapt-ive immune responses.It also examined the relationship between different radiation doses/fractions and immune protein expression,as well as compared the differences in imaging techniques between carbon ion radiotherapy and traditional radiotherapy.We have also proposed future directions to enhance the superiority of CIRT.This study aimed to provide a strong theoretical basis for improving the efficacy of CIRT and its combination therapy,ultimately benefiting more patients with cancer.
6.Advances in targeted therapy of gastric cancer
Chinese Journal of Clinical Oncology 2018;45(4):209-213
Progress in the treatment of gastric cancer(GC)is a major concern because GC is a common cancer worldwide.Recently,by studying the molecular mechanisms of GC,researchers learned that GC progression involved a series of changes at the molecular lev-el,including the activation of signaling pathways,abnormal expression and mutation of genes,and response to related targeted drugs used in clinics.However,many targeted drugs produce resistance in a short period of time because of complicated cellular,microenvi-ronmental,and genetic instabilities.Therefore,it is important to find new targets against GC.In this review,we present the current re-search status and progress with respect to GC targets.

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