1.The Predictive Value of Dual-layer Spectral Detector CT Parameters on Lymph Node Metastasis of Nonfunctional Pancreatic Neuroendocrine Tumor
Mingjie CHEN ; Ke LI ; Jiadan LUO ; Jiayi YANG ; Huasong CAI ; Shiting FENG ; Yanji LUO ; Siya SHI
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):868-879
ObjectiveTo investigate the value of preoperative dual-layer spectral detector CT (DLCT) parameters in predicting lymph node metastasis (LNM) of non-functional pancreatic neuroendocrine neoplasms (NF-pNENs). MethodsA retrospective study was conducted on patients with pathologically confirmed NF-pNENs who underwent preoperative contrast-enhanced DLCT examination between September 2019 and July 2024. Regions of interest (ROIs) were manually delineated on three representative slices of the solid component of the lesion, and the mean values were recorded. Conventional CT parameters, monochromatic energy images (40 keV, 70 keV, 100 keV), iodine concentration maps, and effective atomic number (Zeff) maps in the pancreatic parenchymal phase and portal venous phase were acquired. A total of 34 parameters, including clinical characteristics, imaging features, conventional CT and DLCT quantitative parameters, were analyzed. Intergroup differences were compared between the LNM and non-LNM groups. Independent predictive factors were screened using logistic regression and least absolute shrinkage and selection operator (LASSO) regression. Receiver operating characteristic (ROC) curves were generated for each predictive model, and the area under the curve (AUC) was calculated to evaluate the predictive efficacy. ResultsA total of 82 patients with NF-pNENs were enrolled, including 37 males and 45 females, with a mean age of 49.7±14.7 years. Thirty patients were performed with LNM and 52 were with non-LNM. After univariate logistic regression, LASSO regression and multivariate stepwise logistic regression analyses, body mass index (BMI), organ invasion, normalized CT value in the portal venous phase (nCTv) and normalized iodine concentration in the portal venous phase (nICv) were identified as independent predictive factors. The AUCs of the clinical-radiological qualitative model (BMI+organ invasion), conventional CT model (nCTv), DLCT model (nICv) and comprehensive model (organ invasion+nICv) were 0.815 (0.719, 0.910), 0.750 (0.642, 0.858), 0.829 (0.733, 0.925) and 0.865 (0.879, 0.953), respectively. The comprehensive model combining clinical-radiological and DLCT characteristics exhibited superior predictive performance. ConclusionDLCT parameters are more effective than conventional CT parameters in predicting LNM in NF-pNENs, enabling non-invasive preoperative prediction and assisting clinical decision-making.
2.The Predictive Value of Dual-layer Spectral Detector CT Parameters on Lymph Node Metastasis of Nonfunctional Pancreatic Neuroendocrine Tumor
Mingjie CHEN ; Ke LI ; Jiadan LUO ; Jiayi YANG ; Huasong CAI ; Shiting FENG ; Yanji LUO ; Siya SHI
Journal of Sun Yat-sen University(Medical Sciences) 2026;47(5):868-879
ObjectiveTo investigate the value of preoperative dual-layer spectral detector CT (DLCT) parameters in predicting lymph node metastasis (LNM) of non-functional pancreatic neuroendocrine neoplasms (NF-pNENs). MethodsA retrospective study was conducted on patients with pathologically confirmed NF-pNENs who underwent preoperative contrast-enhanced DLCT examination between September 2019 and July 2024. Regions of interest (ROIs) were manually delineated on three representative slices of the solid component of the lesion, and the mean values were recorded. Conventional CT parameters, monochromatic energy images (40 keV, 70 keV, 100 keV), iodine concentration maps, and effective atomic number (Zeff) maps in the pancreatic parenchymal phase and portal venous phase were acquired. A total of 34 parameters, including clinical characteristics, imaging features, conventional CT and DLCT quantitative parameters, were analyzed. Intergroup differences were compared between the LNM and non-LNM groups. Independent predictive factors were screened using logistic regression and least absolute shrinkage and selection operator (LASSO) regression. Receiver operating characteristic (ROC) curves were generated for each predictive model, and the area under the curve (AUC) was calculated to evaluate the predictive efficacy. ResultsA total of 82 patients with NF-pNENs were enrolled, including 37 males and 45 females, with a mean age of 49.7±14.7 years. Thirty patients were performed with LNM and 52 were with non-LNM. After univariate logistic regression, LASSO regression and multivariate stepwise logistic regression analyses, body mass index (BMI), organ invasion, normalized CT value in the portal venous phase (nCTv) and normalized iodine concentration in the portal venous phase (nICv) were identified as independent predictive factors. The AUCs of the clinical-radiological qualitative model (BMI+organ invasion), conventional CT model (nCTv), DLCT model (nICv) and comprehensive model (organ invasion+nICv) were 0.815 (0.719, 0.910), 0.750 (0.642, 0.858), 0.829 (0.733, 0.925) and 0.865 (0.879, 0.953), respectively. The comprehensive model combining clinical-radiological and DLCT characteristics exhibited superior predictive performance. ConclusionDLCT parameters are more effective than conventional CT parameters in predicting LNM in NF-pNENs, enabling non-invasive preoperative prediction and assisting clinical decision-making.
3.Effects of clesmatine on myelination and neuronal activity during sleep in the hippocampus of adult APP/PS1 mice
Ye YANG ; Haibo ZHANG ; Yanji LIU ; Zhongxiang YAO ; Bo HU
Journal of Army Medical University 2025;47(16):1838-1848
Objective To investigate the effects of clesmatine on the myelination and neural oscillation-related firing activities during sleep in the hippocampus of adult APP/PS1 mice.Methods Oral administration of clemastine in drinking water was given to APP/PS1 mice for 3 months to enhance myelination in adulthood.Based on the treatment regimens,the mice were randomly assigned into APP/PS1 group,APP/PS1+clemastine group,and wild-type(WT)group.Local field potentials combined with three-dimensional acceleration of the head and neck were employed to determine the brain states,that is,wakefulness,non-rapid eye movement(NREM)sleep,REM sleep.In vivo multi-electrode arrays were utilized to continuously monitor neuronal firing activities in the dorsal hippocampus across the 3 sleep states.Results ① Oral clemastine administration via drinking water significantly increased MBP+protein expression levels in APP/PS1+Clemastine mice than the APP/PS1 controls(P<0.001).② Clemastine administration did not alter the time proportions of NREM sleep,REM sleep and wakefulness during the daytime phase in APP/PS1 mice(Ps>0.05).③ Clemastine administration obviously reduced the mean firing rate of hippocampal pyramidal cells(P<0.05)while increasing that of hippocampal interneurons(P<0.05)in APP/PS1 mice.④ Clemastine administration increased the occurrence rate of hippocampal sharp wave-ripple(SWR)oscillations during NREM sleep and specifically reduced the firing rate of pyramidal cells during SWR oscillations in APP/PS1 mice(P<0.05).⑤ Clemastine administration had no significant effect on the hippocampal neuronal firing activity during theta oscillation in REM sleep in APP/PS1 mice(Ps>0.05).Conclusion Clemastine administration not only enhances the adult myelination,but also rescues both the SWRs and associated hippocampal neuronal firing during NREM sleep in APP/PS1 mice.
4.Mechanism of 1,25(OH)2D3 improving liver inflammation in a rat model of nonalcoholic steatohepatitis induced by choline-deficient L-amino acid-defined diet
Haiyang ZHU ; Jingshu CUI ; Liu YANG ; Mengting ZHOU ; Jian TONG ; Hongmei HAN
Journal of Clinical Hepatology 2025;41(2):254-262
ObjectiveTo investigate the effect of 1,25(OH)2D3 on the level of peroxisome proliferator-activated receptor-γ (PPAR-γ) in the liver, the phenotype of hepatic macrophages, and liver inflammation in a rat model of nonalcoholic steatohepatitis (NASH), as well as the mechanism of 1,25(OH)2D3 improving liver inflammation. MethodsAfter 1 week of adaptive feeding, 24 specific pathogen-free Wistar rats were randomly divided into normal group [choline-supplemented L-amino acid-defined (CSAA) diet], normal+1,25(OH)2D3 group [CSAA diet+1,25(OH)2D3], model group [choline-deficient L-amino acid-defined diet (CDAA) diet], and model+1,25(OH)2D3 group [CDAA diet+1,25(OH)2D3], with 6 rats in each group. The dose of 1,25(OH)2D3 was 5 μg/kg for intraperitoneal injection twice a week for 12 weeks. The serum levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were measured, liver histopathology was observed, and SAF score was assessed. M1 hepatic macrophages and M2 hepatic macrophages were measured to analyze in the change in the phenotype of hepatic macrophages, and ELISA was used to measure the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-4 (IL-4), and interleukin-10 (IL-10) in liver tissue, and qPCR was used to measure the mRNA level of PPAR-γ. The two-factor analysis of variance was use for comparison between groups, and the least significant difference t-test was used for further comparison; the Pearson method was used for correlation analysis. ResultsCompared with the normal group, the model rats with CDAA diet-induced NASH had significant increases in the serum levels of AST and ALT (P=0.019 and P<0.001), the SAF score of liver histopathology (P<0.001), the level of M1 hepatic macrophages (P<0.001), and the ratio of M1 and M2 hepatic macrophages (P<0.001), as well as a significant increase in the level of TNF-α (P<0.001) and a significant reduction in the level of IL-4 in liver tissue (P=0.025). The 1,25(OH)2D3 group had significant reductions in the serum levels of ALT (P<0.001), the SAF score of liver histopathology (P<0.001), the level of M1 hepatic macrophages (P<0.001), and the ratio of M1 and M2 hepatic macrophages (P=0.001), the level of IL-1β (P<0.001) and a significant increase in the level of M2 hepatic macrophages (P=0.017), the level of IL-10 (P=0.039), the level of IL-4 (P<0.001), the level of PPAR-γ (P=0.016). There were significant interactions between CDAA diet-induced NASH model and 1,25(OH)2D3 in serum the levels of AST and ALT (P=0.007 and P=0.008), the SAF scores of liver histopathology (P<0.001), the level of M1 hepatic macrophages (P<0.001), the level of M2 hepatic macrophages (P=0.008), the ratio of M1 and M2 of hepatic macrophages (P=0.005), the level of TNF-α (P<0.001), the level of IL-10 (P=0.038), the level of IL-4 (P<0.001) and the level of PPAR-γ (P=0.009). The correlation analysis showed that PPAR-γ was negatively correlated with the ratio of M1 and M2 hepatic macrophages (r=-0.415, P=0.044) and was positively correlated with M2 hepatic macrophages (r=0.435, P=0.033), IL-10 (r=0.433, P=0.035), and IL-4 (r=0.532, P=0.007). ConclusionThis study shows that 1,25(OH)2D3 improves liver inflammation in NASH by activating PPAR-γ to regulate the phenotypic transformation of hepatic macrophages.
5.The expression of C1QTNF3 in liver cancer and its prognostic value
Liying JIN ; Shuhan WANG ; Yang YANG
Journal of Clinical Hepatology 2025;41(5):934-941
ObjectiveTo investigate the expression of C1q tumor necrosis factor-related protein 3 (C1QTNF3) in liver cancer tissue, its association with the clinicopathological features of patients, and its potential value in predicting the prognosis of liver cancer. MethodsRelated data were collected from TIMER, UALCAN, TNMplot, and GEO databases, and the bioinformatics methods were used to measure the expression level of C1QTNF3 in pan-cancer, normal tissue/liver cancer tissue, and cancerous tissue/paracancerous tissue. Cancerous and paracancerous tissue samples were collected from 90 patients with liver cancer, and related clinical data were collected, including age, sex, tumor diameter, and tumor number. The independent-samples t test or the paired t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was used to investigate the association between the expression level of C1QTNF3 and the survival of patients with liver cancer. The Cox regression model was used to identify the risk factors for the prognosis of patients with liver cancer, and the receiver operating characteristic (ROC) curve was used to analyze the ability of C1QTNF3 expression at different time points for predicting the prognosis of patients with liver cancer. ResultsThe bioinformatics analysis showed that the expression of C1QTNF3 was upregulated in various malignant tumors, especially in liver cancer tissue (P<0.001), and the expression level of C1QTNF3 in liver cancer tissue was significantly higher than that in normal tissue and paracancerous tissues (all P<0.01). The immunohistochemical staining results of 90 patients with liver cancer showed that C1QTNF3 was mainly expressed in cytoplasm, with a small amount in nucleus, and it had negative expression in paracancerous tissue and positive expression in liver cancer tissue. The positive expression rate and strong positive expression rate of C1QTNF3 protein in liver cancer tissue were significantly higher than those in paracancerous tissue (positive expression rate: 76.67% vs 33.33%, χ2=34.141, P<0.01; strong positive expression rate: 54.44% vs 5.56%, χ2=51.217, P<0.01). The liver cancer patients with a tumor diameter of ≥5 cm, an advanced stage, the presence of liver cirrhosis, negative HBsAg, and gamma-glutamyl transpeptidase (GGT)≥50 U/L had a significantly higher strong positive expression rate of C1QTNF3 protein than those with a tumor diameter of <5 cm, an early stage, the absence of liver cirrhosis, positive HBsAg, and GGT<50 U/L (all P<0.05). The univariate Cox regression analysis showed that tumor diameter, recurrence, and C1QTNF3 expression were influencing factors for the prognosis of patients with liver cancer (all P<0.05), and the multivariate Cox regression analysis showed that the expression level of C1QTNF3 and recurrence were independent risk factors for the survival of patients with liver cancer (both P<0.05). The survival curve analysis showed that for all patients with liver cancer, the patients with high (strong positive) expression of C1QTNF3 had significantly lower overall survival rate and disease-free survival rate than those with low expression (χ2=17.010 and 13.647, both P<0.001); for liver cancer patients with a tumor diameter of ≥5 cm, an early/advanced stage, recurrence, the presence of liver cirrhosis, positive HBsAg, alanine aminotransferase (ALT) <40 U/L, ALT≥40 U/L, and GGT≥50 U/L, the patients with high expression of C1QTNF3 had a significant reduction in overall survival rate (χ2=11.086, 5.578, 5.295, 19.159, 16.391, 13.774, 10.119, 8.152, and 12.035, all P<0.05). The ROC curve analysis showed that C1QTNF3 expression had the strongest predictive potential at 5 years, with an area under the ROC curve of 0.77. ConclusionC1QTNF3 is highly expressed in liver cancer tissue, and the expression level of C1QTNF3 and recurrence are closely associated with the survival of patients with liver cancer. Patients with high expression of C1QTNF3 protein tend to have a lower survival rate.
6.Application and progress of intelligent responsive hydrogels in articular cartilage injury repair.
Qingyu XU ; Baojian ZHANG ; Hongri LI ; Chengri LIU ; Shuhao BI ; Zhixiang YANG ; Yanqun LIU
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(2):250-256
OBJECTIVE:
To review clinical application and research progress of different types of intelligent responsive hydrogels in repairing articular cartilage injury.
METHODS:
The animal experiments and clinical studies of different types of intelligent responsive hydrogels for repairing articular cartilage injury were summarized by reviewing relevant literature at home and abroad.
RESULTS:
The intrinsic regenerative capacity of articular cartilage following injury is limited. Intelligent responsive hydrogels, including those that are temperature-sensitive, light-sensitive, enzyme-responsive, pH-sensitive, and other stimuli-responsive hydrogels, can undergo phase transitions in response to specific stimuli, thereby achieving optimal functionality. These hydrogels can fill the injured cartilage area, promote the proliferation and differentiation of chondrocytes, and expedite the repair of the damaged site. With advancements in cartilage tissue engineering materials research, intelligent responsive hydrogels offer a novel approach and promising potential for the treatment of cartilage injuries.
CONCLUSION
Intelligent responsive hydrogel is a kind of flexible, controllable, efficient, and stable polymer, which has similar structure and functional properties to articular cartilage, and has become one of the important biomaterials for cartilage repair. However, there is still a lack of unified treatment standards and simple and efficient preparation technology.
Hydrogels/therapeutic use*
;
Cartilage, Articular/injuries*
;
Tissue Engineering/methods*
;
Humans
;
Animals
;
Chondrocytes/cytology*
;
Biocompatible Materials/chemistry*
;
Tissue Scaffolds/chemistry*
7.Pathogenesis and management of renal fibrosis induced by unilateral ureteral obstruction
Qi Yan NAN ; Shang Guo PIAO ; Ji Zhe JIN ; Byung Ha CHUNG ; Chul Woo YANG ; Can LI
Kidney Research and Clinical Practice 2024;43(5):586-599
Regardless of the underlying etiology, renal fibrosis is the final histological outcome of progressive kidney disease. Unilateral ureteral obstruction (UUO) is an ideal and reproducible experimental rodent model of renal fibrosis, which is characterized by tubulointerstitial inflammatory responses, accumulation of extracellular matrix, tubular dilatation and atrophy, and fibrosis. The magnitude of UUO-induced renal fibrosis is experimentally manipulated by the species chosen, animal age, and the severity and duration of the obstruction, while relief of the obstruction allows the animal to recover from fibrosis. The pathogenesis of renal fibrosis is complex and multifactorial and is orchestrated by activation of renin-angiotensin system (RAS), oxidative stress, inflammatory response, transforming growth factor beta 1-Smad pathway, activated myofibroblasts, cell death (apoptosis, autophagy, ferroptosis, and necroptosis), destruction of intracellular organelles, and signaling pathway. The current therapeutic approaches have limited efficacy. Inhibition of RAS and use of antioxidants and antidiabetic drugs, such as inhibitors of sodium-glucose cotransporter 2 and dipeptidyl peptidase-4, have recently gained attention as therapeutic strategies to prevent renal scarring. This literature review highlights the state of the art regarding the molecular mechanisms relevant to the management of renal fibrosis caused by UUO.
8.Peiminine inhibits the proliferation of colon cancer cells by inducing G0/G1 phase arrest
SUN Lili1 ; BAI Bing2 ; YANG Xia1 ; LI Yue2 ; LI Yiquan2 ; HAN Jicheng2 ; FANG Jinbo2 ; LI Xiao3 ; SHANG Chao3 ; ZHU Yilong2 ; JIN Ningyi1
Chinese Journal of Cancer Biotherapy 2024;31(4):326-332
[摘 要] 目的:探讨贝母素乙对结肠癌HCT116细胞增殖的抑制作用及其分子机制。方法:利用不同浓度的贝母素乙处理人结肠癌细胞HCT116和正常结肠上皮细胞CCD841 CON,通过CCK-8法和结晶紫染色法检测贝母素乙对HCT116和CCD841 CON细胞增殖活力的影响,流式细胞术和WB法检测贝母素乙对HCT116细胞周期及其细胞周期相关蛋白表达的影响。构建HCT116移植瘤裸鼠模型和AOM/DSS结肠癌小鼠模型,观察贝母素乙对小鼠模型肿瘤生长和OS的影响,免疫组化法和WB法检测对移植瘤或肿瘤组织中细胞周期相关蛋白CDK4、CDK6和cyclin D1表达的影响。结果:贝母素乙可显著抑制结肠癌HCT116细胞的增殖能力(P<0.01),诱导HCT116细胞周期G0/G1期阻滞(P<0.01),降低CDK4、CDK6和cyclin D1的蛋白表达水平(均P<0.01)。荷瘤小鼠实验结果显示,贝母素乙(0.75 mg/kg)显著抑制HCT116细胞移植瘤的生长并延长荷瘤裸鼠的OS(P<0.05或P<0.01),降低AOM/DSS模型小鼠的体质量、延长OS、减少癌变肠组织的肿瘤个数和肿瘤体积,下调肿瘤组织中CDK4、CDK6和cyclin D1的蛋白表达(P<0.01或P<0.05)。结论:贝母素乙通过下调CDK4、CDK6和cyclin D1的表达水平,引起细胞周期G0/G1期阻滞,从而抑制结肠癌HCT116细胞的增殖。
9.Pathogenesis and management of renal fibrosis induced by unilateral ureteral obstruction
Qi Yan NAN ; Shang Guo PIAO ; Ji Zhe JIN ; Byung Ha CHUNG ; Chul Woo YANG ; Can LI
Kidney Research and Clinical Practice 2024;43(5):586-599
Regardless of the underlying etiology, renal fibrosis is the final histological outcome of progressive kidney disease. Unilateral ureteral obstruction (UUO) is an ideal and reproducible experimental rodent model of renal fibrosis, which is characterized by tubulointerstitial inflammatory responses, accumulation of extracellular matrix, tubular dilatation and atrophy, and fibrosis. The magnitude of UUO-induced renal fibrosis is experimentally manipulated by the species chosen, animal age, and the severity and duration of the obstruction, while relief of the obstruction allows the animal to recover from fibrosis. The pathogenesis of renal fibrosis is complex and multifactorial and is orchestrated by activation of renin-angiotensin system (RAS), oxidative stress, inflammatory response, transforming growth factor beta 1-Smad pathway, activated myofibroblasts, cell death (apoptosis, autophagy, ferroptosis, and necroptosis), destruction of intracellular organelles, and signaling pathway. The current therapeutic approaches have limited efficacy. Inhibition of RAS and use of antioxidants and antidiabetic drugs, such as inhibitors of sodium-glucose cotransporter 2 and dipeptidyl peptidase-4, have recently gained attention as therapeutic strategies to prevent renal scarring. This literature review highlights the state of the art regarding the molecular mechanisms relevant to the management of renal fibrosis caused by UUO.
10.The expression and clinicopathological significance of structural maintenance of chromosome 4 in breast cancer
LIN Yuboa,b ; LU Keyua,b ; YANG Yanga,b
Chinese Journal of Cancer Biotherapy 2024;31(9):888-894
[摘 要] 目的:探究染色体结构维持蛋白4(SMC4)在乳腺癌中的表达及其评估患者预后的价值。方法: 利用TIMER、GEPIA等数据库数据分析SMC4在乳腺癌组织中的表达及其与患者临床病理特征间的相关性;用免疫组化法检测SMC4蛋白在乳腺癌组织中的表达,并探讨其与乳腺癌临床病理特征之间的关系;通过Cox回归模型、Kaplan-Meier生存曲线、GEPIA数据库数据评估SMC4表达与乳腺癌患者生存期之间的关系。结果:生物信息学分析结果显示,SMC4 mRNA在乳腺癌组织中的表达水平明显高于癌旁组织(P < 0.01),并与临床分期、淋巴结转移及化疗耐药密切相关(均P < 0.05)。免疫组化法检测结果显示,在乳腺癌组织中SMC4的阳性及强阳性表达率均显著高于癌旁组织(均P < 0.05);SMC4蛋白的高表达与乳腺癌患者年龄、临床分期和淋巴结转移密切相关(均P < 0.05)。SMC4蛋白低表达组的患者累积生存率显著高于SMC4蛋白高表达组,尤其是在HER2阳性乳腺癌患者中(均P < 0.05),且SMC4是乳腺癌患者预后的独立危险因素。结论:SMC4在乳腺癌组织中呈高表达,SMC4高表达与乳腺癌患者的淋巴结转移、临床分期及预后密切相关,可作为乳腺癌诊断与预后评判的潜在标志物。

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