1.Systematic interpretation of the 2025 Chinese Guidelines for Integrated Diagnosis and Treatment of Tumors(CACA)—Thyroid Cancer
Yanjun SU ; Ying PENG ; Zhizhong DONG ; Ruochuan CHENG
Chinese Journal of General Surgery 2025;34(5):867-878
Thyroid cancer has become one of the fastest-growing malignancies in recent years,with a significant improvement in the 5-year relative survival rate among Chinese patients.Accurate diagnosis,standardized treatment,and effective follow-up are essential to improve clinical outcomes,while the promotion and implementation of clinical guidelines are critical for achieving standardized and homogeneous management.In 2022,the China Anti-Cancer Association(CACA)released the 2022 Chinese Guidelines for Integrated Diagnosis and Treatment of Tumors(CACA)—Thyroid Cancer,which systematically applied the concept of multidisciplinary integrated management to the entire care continuum of thyroid cancer,reflecting both Chinese characteristics and local experience.Building upon this,the 2025 edition of the guidelines was updated and revised based on the latest evidence and clinical practices.This article provides a systematic interpretation of the 2025 CACA guidelines,focusing on the diagnosis,treatment,and follow-up of thyroid cancer,with the aim of offering practical guidance for clinicians and promoting standardized,integrated management of thyroid cancer in clinical practice.
2.Construction of a nomogram prediction model for the efficacy of EGFR-TKI targeted therapy in advanced lung adenocarcinoma with EGFR mutation based on lung cancer autoantibodies
Linge Sun ; Jiao Su ; Yanjun Liu ; Liping Dai ; Ruiying Chen ; Songyun Ouyang
Acta Universitatis Medicinalis Anhui 2025;60(7):1325-1332
Objective :
To explore the factors influencing the efficacy of first-generation EGFR tyrosine kinase inhibitors(EGFR-TKIs) in patients with EGFR-mutated advanced lung adenocarcinoma and to construct and validate a corresponding nomogram prediction model.
Methods :
A total of 220 patients with EGFR-mutated advanced lung adenocarcinoma treated with icotinib were enrolled and randomly divided into a training group(154 cases) and a validation group(66 cases) in a 7 ∶3 ratio. Cox regression analysis was performed to identify factors affecting the efficacy of first-generation EGFR-TKIs in the training group. A prediction model was constructed, and calibration curves and receiver operating characteristic(ROC) curves were plotted to validate the model′s performance.
Results:
In the training group, the objective response rate was 35.71%, the disease control rate was 77.27%, the median progression-free survival(PFS) was 12.5 months, the median overall survival was 18 months, the 2-year OS rate was 66.23%, and the PFS rate was 42.21%. Univariate analysis showed that brain metastasis, bone metastasis, TNM stage, differentiation degree, neutrophil-to-lymphocyte ratio(NLR), post-treatment p53 levels, p53 difference(Δp53), post-treatment cancer antigen gene(CAGE) levels, and CAGE difference(ΔCAGE) were associated with PFS(P2=4.429, P=0.351). ROC curve analysis in the training group showed that the nomogram model had a sensitivity of 80.00%, specificity of 77.53%, and AUC of 0.864 for predicting therapeutic efficacy, while the validation group showed a sensitivity of 74.08%, specificity of 71.43%, and AUC of 0.835.
Conclusion
Changes in lung cancer autoantibodies(Δp53 and ΔCAGE), TNM stage, and NLR are key factors influencing the efficacy of first-generation EGFR-TKIs in EGFR-mutated advanced lung adenocarcinoma. The nomogram prediction model based on p53 and CAGE demonstrates good predictive performance.
3.Interpretation of the update points of China CACA Thyroid Cancer Guidelines (2025 edition) from a surgical perspective
Ying PENG ; Yanjun SU ; Ruochuan CHENG
Chinese Journal of Endocrine Surgery 2025;19(1):8-13
Based on the latest clinical research results and evidence-based medicine evidence, CACA Guidelines for the Diagnosis and Treatment of Thyroid Cancer (2025 edition) , on account of the 2022 edition of CACA Guidelines, integrated personalized diagnosis and treatment strategies, promoted the development of multi-disciplinary collaboration, and strive to provide more comprehensive and accurate guidance for tumor diagnosis and treatment. While surgical resection is still the key treatment to improve the prognosis of the vast majority of patients with thyroid cancer (TC) . However, the scope of initial surgery should vary from person to person, and developing a more standardized surgical strategy and a more reasonable individualized treatment plan for TC patients is the key to achieving the optimal treatment effect. This paper will interpret the key points of updating the 2025 CACA guidelines from a surgical perspective, and explore the important value of surgical treatment strategies that conform to China’s national conditions in the entire management of TC diagnosis and treatment.
4.Interpretation of the update points of China CACA Thyroid Cancer Guidelines (2025 edition) from a surgical perspective
Ying PENG ; Yanjun SU ; Ruochuan CHENG
Chinese Journal of Endocrine Surgery 2025;19(1):8-13
Based on the latest clinical research results and evidence-based medicine evidence, CACA Guidelines for the Diagnosis and Treatment of Thyroid Cancer (2025 edition) , on account of the 2022 edition of CACA Guidelines, integrated personalized diagnosis and treatment strategies, promoted the development of multi-disciplinary collaboration, and strive to provide more comprehensive and accurate guidance for tumor diagnosis and treatment. While surgical resection is still the key treatment to improve the prognosis of the vast majority of patients with thyroid cancer (TC) . However, the scope of initial surgery should vary from person to person, and developing a more standardized surgical strategy and a more reasonable individualized treatment plan for TC patients is the key to achieving the optimal treatment effect. This paper will interpret the key points of updating the 2025 CACA guidelines from a surgical perspective, and explore the important value of surgical treatment strategies that conform to China’s national conditions in the entire management of TC diagnosis and treatment.
5.Systematic interpretation of the 2025 Chinese Guidelines for Integrated Diagnosis and Treatment of Tumors(CACA)—Thyroid Cancer
Yanjun SU ; Ying PENG ; Zhizhong DONG ; Ruochuan CHENG
Chinese Journal of General Surgery 2025;34(5):867-878
Thyroid cancer has become one of the fastest-growing malignancies in recent years,with a significant improvement in the 5-year relative survival rate among Chinese patients.Accurate diagnosis,standardized treatment,and effective follow-up are essential to improve clinical outcomes,while the promotion and implementation of clinical guidelines are critical for achieving standardized and homogeneous management.In 2022,the China Anti-Cancer Association(CACA)released the 2022 Chinese Guidelines for Integrated Diagnosis and Treatment of Tumors(CACA)—Thyroid Cancer,which systematically applied the concept of multidisciplinary integrated management to the entire care continuum of thyroid cancer,reflecting both Chinese characteristics and local experience.Building upon this,the 2025 edition of the guidelines was updated and revised based on the latest evidence and clinical practices.This article provides a systematic interpretation of the 2025 CACA guidelines,focusing on the diagnosis,treatment,and follow-up of thyroid cancer,with the aim of offering practical guidance for clinicians and promoting standardized,integrated management of thyroid cancer in clinical practice.
6.Study on Ecological Suitability Regionalization of Sophora japonica cv.jinhuai Based on MaxEnt Model and ArcGIS
Yanjun WANG ; Xinyu SU ; Chenghao ZHU ; Shurui ZHANG ; Siyu MA ; Pingguo FU ; Zhirong SUN
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(6):1-6
Objective To predict the potential suitable distribution areas of Sophora japonica cv.jinhuai in China;To provide a references for resource development and expanded cultivation of Sophora japonica cv.jinhuai.Methods Totally 85 pieces of information on the distribution of sample sites were collected and combined data on 72 environmental factors,and the dominant environmental factors affecting the suitability distribution of Sophora japonica cv.jinhuai were analyzed using the maximum entropy(MaxEnt)model and geographic information system software ArcGIS.Results The five dominant environmental factors influencing the suitability distribution of Sophora japonica cv.jinhuai were dry month precipitation,May light radiation,November precipitation,September mean temperature,and October light radiation.The potentially suitable distribution area of Sophora japonica cv.jinhuai in China was mainly concentrated in the transition zone between south-central Hunan Province and northeast Guangxi Zhuang Autonomous Region.Conclusion The results of this study can provide references for the selection of the cultivation areas of Sophora japonica cv.jinhuai and protection of wild reso of Sophora japonica cv.jinhuai.
7.Experience of TCM Master Zhou Xinyou in the Treatment of Bile Reflux Gastritis
Yuanyuan NIU ; Longde WANG ; Haiyan SU ; Junhong LIU ; Xiaoyan LIU ; Huaixia CHEN ; Yanjun HU
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(8):162-166
Bile reflux gastritis is a common and frequently occurring disease of the digestive system,and the pathology is diverse.Professor Zhou Xinyou emphasized that the disease primarily affects the gallbladder,liver and stomach,advocating for a comprehensive differentiation of its etiology and pathogenesis across three distinct stages.In the early stage,the gallbladder is dysfunctional,which then affects the stomach;In the intermediate stage,there is congestion in the liver and gallbladder,leading to excessive wood element suppressing the earth element;in the late stage,gastric collaterals damage,with qi deficiency and blood stasis.Professor Zhou Xinyou follows the diagnosis and treatment ideas of"multiple compound methods,comprehensive application,and overall adjustment".For typical clinical symptoms,he has formulated the treatment principles and treatment methods of pain separation,general use,oral bitterness and upset,purging heat and stomach,treating gallbladder and stomach,regulating qi and resolving depression,so as to achieve both symptoms and root causes of treatment,gallbladder and stomach regulation.
8.Effects of quercetin on periodontal tissue angiogenesis during orthodontic tooth movement in rats by regulating HIF-1α/VEGF signaling pathway
Yaru ZHENG ; Yibin HUANG ; Xiaoping SU ; Yanjun ZHANG
Tianjin Medical Journal 2024;52(12):1251-1255
Objective To investigate the impacts of quercetin(QUE)on angiogenesis and hypoxia inducible factor-1α/vascular endothelial growth factor(HIF-1α/VEGF)signaling pathway in periodontal tissue of orthodontic tooth movement in rats.Methods A rat model of orthodontic tooth movement was constructed,and the modeled rats were randomly separated into the model group,the low-dose quercetin treatment(QUE-L)group,the high-dose quercetin treatment(QUE-H)group and the QUE-H+pathway inhibitor YC-1(QUE-H+YC-1)group,with 12 rats in each group.Another 12 rats were regarded as the control group.The movement distance of the first molar of rats in each group was measured.HE staining was applied to observe the pathological changes of periodontal tissue and count the number of blood vessels generated in periodontal tissue.Immunohistochemistry was applied to detect expression levels of bone morphogenetic protein 2(BMP2)and bone morphogenetic protein 4(BMP4)in periodontal tissue.Western blot assay was applied to detect the expression of HIF-1α/VEGF signaling pathway related proteins.Results Compared with the control group,the periodontal tissue fibers were scattered and disordered in the model group,with an increased intercellular space,infiltration of a large number of inflammatory cells and bone resorption pits,the movement distance of the first molar increased,the number of periodontal tissue blood vessels decreased,and the expression of BMP2,BMP4,HIF-1α and VEGF decreased(P<0.05).The fibrous arrangement of periodontal tissue was relatively tight in the QUE-L group and the QUE-H group compared to the model group,with reduced infiltration of inflammatory cells and reduced alveolar bone resorption.The movement distance of the first molar decreased,the number of periodontal tissue blood vessels increased,and the expression of BMP2,BMP4,HIF-1α and VEGF increased(P<0.05).Compared with the QUE-H group,the periodontal tissue fibers in the QUE-H+YC-1 group were scattered and disordered,with obvious intercellular gaps,increased infiltration of inflammatory cells and increased bone resorption pits,the movement distance of the first molar increased,the number of blood vessels in periodontal tissue decreased,and the expression of BMP2,BMP4,HIF-1α and VEGF decreased(P<0.05).Conclusion Quercetin can promote angiogenesis in periodontal tissue during orthodontic tooth movement in rats,and its mechanism is related to the activation of the HIF-1α/VEGF signaling pathway.
9.Comparison of New and Old Versions of Guidelines for Diagnosis and Treatment of Thyroid Nodules and Differentiated Thyroid Carcinoma in China from A Surgical Perspective
Tingting YANG ; Yanjun SU ; Ruochuan CHENG
Cancer Research on Prevention and Treatment 2024;51(1):16-21
The set of guidelines for the diagnosis and treatment of thyroid nodules and differentiated thyroid cancer (the second edition) was published in 2023 in China. Based on the first (2012) edition, the current set was revised jointly by nearly 100 experts in endocrinology, thyroid surgery, oncology, nuclear medicine, ultrasound medicine, and pathology from seven national societies for one year. The new version of the guideline is still divided into two parts, namely, thyroid nodules and differentiated thyroid cancer. The writing mode of asking clinical questions, explaining and giving recommendations is adopted, and a total of 117 recommendations are provided. This article aims to compare the variations in the differentiation of benign and malignant thyroid nodules and surgical treatment of differentiated thyroid cancer between the new and old versions from the perspective of surgery. The author's own understanding and experiences are also discussed.
10.Effects of Wheat Grain Moxibustion on the Expression of TLR4/MyD88/NF-κB Signaling Pathway in Spinal Cord Tissue of Rats with Sciatic Nerve Injury
Hong SU ; Xi ZHANG ; Jing LI ; Yanjun GUO ; Shengyong SU ; Pu YANG ; Qiongxiao WANG ; Caiyun XIE
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(1):78-83
Objective To observe the effects of wheat grain moxibustion for"Huantiao"on sciatic nerve function,pathological morphology of sciatic nerve stem and expressions of TLR4/MyD88/NF-κB signaling pathway expression in spinal cord tissue of rats with sciatic nerve injury(SNI);To explore the possible mechanism of wheat grain moxibustion for the treatment of SNI.Methods Totally 24 SD male rats were randomly divided into blank group,sham-operation group,model group and wheat grain moxibustion group,with 6 rats in each group.The model group and the wheat grain moxibustion group used a rat model with sciatic nerve clamping injury.From the 7th day after modeling,the rats were treated with moxibustion on the affected side of"Huantiao"for 6 strokes each time,once a day,for consecutive 10 days.The sciatic nerve function index(SFI)of rats on the 7th day after modeling and after intervention were observed,mechanical withdraw threshold(MWT)in rats were measured using a fiber optic pain gauge,ELISA was used to detect NO and iNOS content in spinal cord tissue,HE staining was used to observe the morphology of sciatic nerve stem,the expression of TLR4,NF-κBp65,p-NF-κBp65,MyD88,IκBα and p-IκBα in spinal cord tissue were detected by Western blot.Results Compared with the sham-operation group,the SFI and MWT of the rats in the model group significantly decreased(P<0.01),the arrangement of nerve fibers in sciatic nerve stem was disordered,with a significant increase in the number of Schwann cells and a large number of vacuolar degeneration,the content of NO,iNOS and the expression of TLR4,p-NF-κBp65,MyD88,p-IκBα protein in spinal cord tissue significantly increased(P<0.01).Compared with the model group,the SFI and MWT of the rats in the wheat grain moxibustion group increased significantly(P<0.01),the damage of sciatic nerve stem was reduced,with orderly cell arrangement,a decrease in the number of Schwann cells,and a decrease in axonal demyelination and cellular vacuolar degeneration,the content of NO,iNOS and the expression of TLR4,p-NF-κBp65,MyD88,p-IκBα in spinal cord tissue significantly decreased(P<0.05).Conclusion Wheat grain moxibustion for"Huantiao"can down-regulate TLR4,p-NF-κBp65,MyD88 and p-IκBα protein expressions in spinal cord tissue of SNI rats,reduce the secretion of NO and iNOS,thereby relieve pain and damaged nerve tissue inflammation response.


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