1.Pre-operative risk assessment of hepatocellular carcinoma recurrence in liver transplant recipients by non-invasive detection of pre-existing genetic lesions
Suqin YANG ; Sunbin LING ; Jianhua LI ; Yan WANG ; Jiapei WANG ; Qiwei HUANG ; Fanming LIU ; Yiqi ZHUANG ; Yingyu ZHENG ; Rui WANG ; Zhe YANG ; Xiaoping ZHENG ; Kai WANG ; Zhikun LIU ; Jun CHEN ; Jianguo WANG ; Haiyang XIE ; Lin ZHOU ; Leiming CHEN ; Guoqiang CAO ; Dandan CHEN ; Junfang JI ; Bin ZHAO ; Chao JIANG ; Di LU ; Xuyong WEI ; Hangjin JIANG ; Qiaonan SHAN ; Hengbo SHI ; Yong-Zhen XU ; Shusen ZHENG ; Zhengxin WANG ; Shengda LIN ; Xiao XU
Clinical and Molecular Hepatology 2026;32(2):884-903
Background/Aims:
Liver transplantation (LT) following total hepatectomy is a life-saving treatment for hepatocellular carcinoma (HCC). The HCC recurrence after LT hinders the effectiveness of the procedure. The objective of this study is to develop a pre-operative risk stratification model based on a liquid biopsy.
Methods:
We conducted a comprehensive multi-omics study of 260 HCC patients from three centers, including clinical data, low-coverage whole-genome sequencing of cell-free DNA (cfDNA) from plasma, as well as whole-exome, single-nucleus RNA, and spatial transcriptomics from matched tumor and non-tumor tissues.
Results:
We identified cfDNA-derived copy number alteration (CNA) signatures associated with post-transplant recurrence. By integrating cfDNA-derived CNA profiles with single-cell transcriptomic data, we traced recurrence-associated cfDNA to a distinct subpopulation of malignant cells within the primary tumor. These cells were embedded in a pro-metastatic microenvironment of specialized endothelial subtypes and cancer-associated fibroblasts. Notably, most recurrence-associated lesions were detectable in cfDNA prior to liver transplantation (LT). Building on these insights, we developed the ZJU Criteria based on CNA fragments and tumor markers, a pre-LT risk prediction tool that integrates conventional clinical factors with cfDNA-derived CNA signatures, and validated it using internal and independent external cohorts.
Conclusion
Our findings suggest that post-transplant recurrence commonly originates from advanced subclones that emerge late during tumor evolution. The ZJU Criteria provides an accurate, non-invasive strategy that significantly improves pre-LT risk stratification and clinical decision-making for patients with HCC.
2.An analysis of clinical pharmacist training bases and pharmacist staffing status based on field research
Liang HUANG ; Jiancun ZHEN ; Li YOU ; Jing BIAN ; Yishan BU ; Quanzhi LI ; Zining WANG ; Xiaofen YE ; Ping ZHENG ; Rui YANG ; Jun YANG ; Yangui XU ; Jin LU
China Pharmacy 2026;37(13):1661-1666
OBJECTIVE To clarify the current development status of clinical pharmacist training bases and the pharmacist workforce in China, and to provide evidence for standardizing base construction and promoting the high-quality development of hospital pharmacy. METHODS Questionnaires were distributed to all clinical pharmacist training bases for urgently-needed health professionals and clinical pharmacist training bases under the Chinese Hospital Association that had been approved by the end of 2023 to collect data including base profiles and pharmacist staffing conditions. Expert teams carried out field investigations to verify the collected data. Descriptive statistical analyses were conducted on the quantity, type and regional distribution of training bases, and the influencing factors of pharmacist staffing in the bases were analyzed. RESULTS Field surveys were completed covering 297 training bases across 31 provincial-level administrative regions. Among the base hospitals, 87.88% were Grade A tertiary general hospitals, and 65.32% were located in provincial capitals. The eastern region had the largest number of bases (136, accounting for 45.79%), followed by the western region (79, 26.60%). Great disparities existed among provinces in terms of base quantity and hospital scale. The median proportion of pharmaceutical technical personnel in base hospitals was 4.05%, and the median number of clinical pharmacists per 100 hospital beds was 0.53. Both indicators reached the highest in the eastern region (0.57, 4.43%) and the lowest in the northeastern region (0.45, 3.01%). A total of 3 627 full-time clinical pharmacists were employed in all surveyed bases, among whom 83.68% held clinical pharmacist training certificates, 35.43% possessed senior professional titles, and 78.19% had postgraduate or higher educational background. The total annual training capacity of the surveyed bases was 4 291 trainees, with obvious differences in annual training capacity across regions and provinces. Training specialties covered 19 specialized disciplines plus one general discipline, and no province could deliver training for all 20 specialties simultaneously. Multivariate Logistic regression analysis showed that geographic region exerte d a significant impact on the proportion of pharmaceutical technical personnel (≥4%) ( P <0.05), while the approval time of training bases and hospital scale had significant effects on the number of clinical pharmacists per 100 beds (≥0.6) ( P <0.05). CONCLUSIONS China’s clinical pharmacist training system has basically matured and taken initial shape. The distribution of clinical pharmacist training resources is generally consistent with regional population and economic development levels. However, the allocation of pharmaceutical staff and clinical pharmacists has not yet met national standards and clinical service demands.
3.An analysis of clinical pharmacist training bases and pharmacist staffing status based on field research
Liang HUANG ; Jiancun ZHEN ; Li YOU ; Jing BIAN ; Yishan BU ; Quanzhi LI ; Zining WANG ; Xiaofen YE ; Ping ZHENG ; Rui YANG ; Jun YANG ; Yangui XU ; Jin LU
China Pharmacy 2026;37(13):1661-1666
OBJECTIVE To clarify the current development status of clinical pharmacist training bases and the pharmacist workforce in China, and to provide evidence for standardizing base construction and promoting the high-quality development of hospital pharmacy. METHODS Questionnaires were distributed to all clinical pharmacist training bases for urgently-needed health professionals and clinical pharmacist training bases under the Chinese Hospital Association that had been approved by the end of 2023 to collect data including base profiles and pharmacist staffing conditions. Expert teams carried out field investigations to verify the collected data. Descriptive statistical analyses were conducted on the quantity, type and regional distribution of training bases, and the influencing factors of pharmacist staffing in the bases were analyzed. RESULTS Field surveys were completed covering 297 training bases across 31 provincial-level administrative regions. Among the base hospitals, 87.88% were Grade A tertiary general hospitals, and 65.32% were located in provincial capitals. The eastern region had the largest number of bases (136, accounting for 45.79%), followed by the western region (79, 26.60%). Great disparities existed among provinces in terms of base quantity and hospital scale. The median proportion of pharmaceutical technical personnel in base hospitals was 4.05%, and the median number of clinical pharmacists per 100 hospital beds was 0.53. Both indicators reached the highest in the eastern region (0.57, 4.43%) and the lowest in the northeastern region (0.45, 3.01%). A total of 3 627 full-time clinical pharmacists were employed in all surveyed bases, among whom 83.68% held clinical pharmacist training certificates, 35.43% possessed senior professional titles, and 78.19% had postgraduate or higher educational background. The total annual training capacity of the surveyed bases was 4 291 trainees, with obvious differences in annual training capacity across regions and provinces. Training specialties covered 19 specialized disciplines plus one general discipline, and no province could deliver training for all 20 specialties simultaneously. Multivariate Logistic regression analysis showed that geographic region exerte d a significant impact on the proportion of pharmaceutical technical personnel (≥4%) ( P <0.05), while the approval time of training bases and hospital scale had significant effects on the number of clinical pharmacists per 100 beds (≥0.6) ( P <0.05). CONCLUSIONS China’s clinical pharmacist training system has basically matured and taken initial shape. The distribution of clinical pharmacist training resources is generally consistent with regional population and economic development levels. However, the allocation of pharmaceutical staff and clinical pharmacists has not yet met national standards and clinical service demands.
4.Study on the current status of quality management of clinical pharmacist training bases in China
Ping ZHENG ; Jiancun ZHEN ; Li YOU ; Yangui XU ; Liang HUANG ; Jing BIAN ; Jin LU ; Yishan BU ; Quanzhi LI ; Zining WANG ; Xiaofen YE ; Jun YANG ; Rui YANG
China Pharmacy 2026;37(14):1826-1831
OBJECTIVE To investigate the current status of quality management in clinical pharmacist training bases in China, and to provide references for the standardized development and improvement of these bases. METHODS A combined approach of questionnaire survey and on-site investigation was adopted, targeting the healthcare highly sought-after talent (clinical pharmacist) training bases in 31 provinces of China as well as the clinical pharmacist training bases affiliated with the Chinese Hospital Association. A training quality management evaluation index system consisting of 25 tertiary indicators was established. Investigations were conducted from two dimensions: structural quality of training and quality management of training processes. Data were statistically analyzed using descriptive statistical methods. RESULTS On-site investigations were completed for 297 clinical pharmacist training bases across the 31 provinces, among which 284 were affiliated with the Chinese Hospital Association and 271 were healthcare highly sought-after talent (clinical pharmacist) training bases. In terms of structural quality, the core indicator compliance rate for hospital-level training systems exceeded 80%, the rate of special fund utilization for designated purposes reached 80.13%, and the overall compliance rate for software and hardware facilities surpassed 88%. A total of 1 348 preceptors were employed across the training bases, among whom those with senior professional titles and full-time specialist clinical pharmacists as lead preceptors accounted for 62.91% and 94.36%, respectively. Regarding process quality, the compliance rate for “establishment of clinical practice teaching groups in accordance with regulations during clinical department rotations” was 85.19%, and 79.80% and 76.09% of the bases were found to implement strict confidentiality in theoretical examinations and meet the required scale of assessment cases, respectively. However, formal documents of corresponding training management regulations were formulated in only 57.91% of the bases, and the completeness and standardization rate of training manual completion was merely 47.47%. In addition, considerable disparities in quality management levels were observed among provinces, with issues in training process quality being particularly prominent. CONCLUSIONS The management system, hardware facilities, and preceptor staffing of clinical pharmacist training bases in China are relatively well-established, yet notable variations in quality management exist among training bases across different provinces.
5.Self-Supervised Multi-Organ Segmentation in Pediatric Abdominal CT Based on Vision Foundation Models
Qinghua ZHANG ; Ming LI ; Zhedian ZHOU ; Jian ZHENG ; Huadan XUE ; Qiuxia WANG ; Yu DU ; Zhen LI
Medical Journal of Peking Union Medical College Hospital 2026;17(4):954-962
To address the scarcity of annotated data for pediatric abdominal CT imaging and the insufficient generalization capability of existing models, we constructed a self-supervised pretraining architecture tailored for pediatric CT domain adaptation based on the visual foundation model DINOv3, and validated its performance in the task of pediatric abdominal multi-organ segmentation. We built a general-purpose radiological visual representation using the large-scale adult CT dataset CT-3M, and introduced a Gram-anchoring mechanism that employs a frozen adult pretrained model as a structural teacher to guide domain alignment of local topological structures on unlabeled pediatric CT data. Combined with a multi-scale feature aggregation strategy and a lightweight Primus decoder, downstream segmentation tasks were evaluated on a public pediatric CT dataset. Based on case-wise paired results, we compared the mean Dice similarity coefficient (DSC) and mean intersection over union (IoU) between our model and the baseline nnU-Net using the Wilcoxon signed-rank test, and computed the relative performance improvements. A total of 867 abdominal CT imaging cases were collected, constituting a pretraining dataset comprising 367 588 two-dimensional CT slices. On the public Pediatric-CT-SEG dataset (359 cases), our model achieved a mean DSC of (71.38±1.08)% and a mean IoU of (63.73±1.01)%, representing improvements of 3.22% and 3.59% over the baseline nnU-Net, respectively, with statistically significant differences ( The self-supervised pretraining framework proposed in this study effectively alleviates the domain shift between adult and pediatric abdominal CT images, significantly enhances segmentation accuracy for pediatric abdominal multi-organs-particularly small organs and structures with complex boundaries-and provides a reliable technical solution for intelligent pediatric imaging analysis in scenarios with limited annotated data.
6.From Spleen Deficiency with Dampness Excess to Stasis-toxin Damaging Collaterals: Dynamic Management Path in Whole-course Treatment Strategies for Ulcerative Colitis
Zhili ZHENG ; Hongzheng LI ; Shaoli WANG ; Tiantong JIANG ; Yuan DING ; Qiongqiong LU ; Zhen LIU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(19):147-153
Ulcerative colitis (UC), a chronic nonspecific inflammatory bowel disease characterized by unclear etiology, complex contributing factors, and a refractory course with malignant transformation potential, imposes a substantial burden on both individual patients and healthcare systems. There is an urgent need to explore effective therapeutic strategies and pharmacological interventions. Professor LIU Zhen, based on years of clinical practice, proposed a dynamic pathogenesis chain of UC: Spleen deficiency with dampness excess as the foundation, dampness obstruction as the nexus, stasis-toxin interaction as the key, and stasis-toxin damaging intestinal collaterals as the terminal outcome. The treatment, following the progression of deficiency (depression)-dampness-toxin-stasis (toxin), should focus on invigorating the spleen and resolving dampness. A stage-specific treatment approach is emphasized. During the susceptible stage, prevention is recommended, which relies on regulating the diet, maintaining a positive mental state, and adjusting daily routines to invigorate the spleen and replenish Qi. During the acute attack and remission stages, the treatment should be tailored according to clinical typing and disease severity, flexibly employing therapeutic strategies such as tonifying deficiency, resolving depression, eliminating dampness, clearing heat, detoxifying, arresting bleeding, and resolving stasis in order to interrupt disease progression. In the recovery stage, latent pathogenic factors should be addressed while the postnatal constitutional foundation be preserved to prevent recurrence. According to the TCM principle of treating disease before its onset, a whole-course management path of early protection-interception-stratified care-consolidation has been developed, covering all stages of UC, to inform its clinical prevention and treatment.
7.Dual-modal Magnetic Resonance Imaging Contrast Agents Based on Polymetallic Nanoclusters for Targeted Diagnosis of Prostate Cancer
Qing-Dong LI ; Peng WANG ; Jian-Min XIAO ; Wen-Juan GAO ; Zhen-Hong XIA ; Gui-Long ZHANG ; Zheng-Yan WU
Chinese Journal of Analytical Chemistry 2025;53(4):602-611
Fe/Mn/Gd polymetallic nanooxide(FMGN)were prepared by one-step solvent thermal reaction by using Fe(acac)3,Mn(acac)2 and Gd(acac)3 as reaction precursors.Next,hyaluronic acid(HA)was used to modify FMGN to fabricate tumor-targeting T 1-T 2 dual-mode magnetic resonance imaging(MRI)contrast agent(HA-FMGN)for accurate diagnosis of prostate cancer.The structure and morphology of FMGN were observed by transmission electron microscope(TEM).It was found that FMGN exhibited a uniform nanocluster spherical structure when the feeding ratio of iron acetylacetonate,manganese acetylacetonate,and gadolinium acetylacetonate was 3:2:1.X-ray diffraction(XRD)analysis showed that FMGN had a typical inverse spinel structure of Mn doped Fe 3O 4,with Gd existing in the form of amorphous gadolinium oxide.The longitudinal relaxivity(r 1)and transverse relaxivity(r 2)of FMGN were 13.395 and 428.535 L/(mmol·s),respectively,measured by 0.5 T MRI analyzer,which proved that FMGN had excellent T 1-T 2 dual-mode MRI contrast capability.The cytotoxicity and hemolysis test found that HA-FMGN didn't damage red cells and induce toxicity for normal cells,indicating that HA-FMGN had excellent cell biocompatibility.The internalization efficacy of HA-FMGN was observed by CLSM,and the results showed that HA-FMGN possessed excellent prostate tumor-targeting ability.In vivo MRI experiment showed that HA-FMGN significantly enhanced T 1 and T 2 weighted MRI signal to noise ratio(SNR)of prostate tumor,which promoted the accurate diagnosis of orthotopic prostate cancer.
8.Discovery and proof-of-concept study of a novel highly selective sigma-1 receptor agonist for antipsychotic drug development.
Wanyu TANG ; Zhixue MA ; Bang LI ; Zhexiang YU ; Xiaobao ZHAO ; Huicui YANG ; Jian HU ; Sheng TIAN ; Linghan GU ; Jiaojiao CHEN ; Xing ZOU ; Qi WANG ; Fan CHEN ; Guangying LI ; Chaonan ZHENG ; Shuliu GAO ; Wenjing LIU ; Yue LI ; Wenhua ZHENG ; Mingmei WANG ; Na YE ; Xuechu ZHEN
Acta Pharmaceutica Sinica B 2025;15(10):5346-5365
Sigma-1 receptor (σ 1R) has become a focus point of drug discovery for central nervous system (CNS) diseases. A series of novel 1-phenylethan-1-one O-(2-aminoethyl) oxime derivatives were synthesized. In vitro biological evaluation led to the identification of 1a, 14a, 15d and 16d as the most high-affinity (K i < 4 nmol/L) and selective σ 1R agonists. Among these, 15d, the most metabolically stable derivative exhibited high selectivity for σ 1R in relation to σ 2R and 52 other human targets. In addition to low CYP450 inhibition and induction, 15d also exhibited high brain permeability and excellent oral bioavailability. Importantly, 15d demonstrated effective antipsychotic potency, particularly for alleviating negative symptoms and improving cognitive impairment in experimental animal models, both of which are major challenges for schizophrenia treatment. Moreover, 15d produced no significant extrapyramidal symptoms, exhibiting superior pharmacological profiles in relation to current antipsychotic drugs. Mechanistically, 15d inhibited GSK3β and enhanced prefrontal BDNF expression and excitatory synaptic transmission in pyramidal neurons. Collectively, these in vivo proof-of-concept findings provide substantial experimental evidence to demonstrate that modulating σ 1R represents a potential new therapeutic approach for schizophrenia. The novel chemical entity along with its favorable drug-like and pharmacological profile of 15d renders it a promising candidate for treating schizophrenia.
9.VIRMA-mediated SHQ1 m6A modification enhances liver regeneration through an HNRNPA2B1-dependent mechanism.
Hao CHEN ; Haichuan WANG ; Jiwei HUANG ; Guoteng QIU ; Zheng ZHANG ; Lin XU ; Xiao MA ; Zhen WANG ; Xiangzheng CHEN ; Yong ZENG
Acta Pharmaceutica Sinica B 2025;15(10):5212-5230
N6-Methyladenosine (m6A) modification is a crucial post-transcriptional regulatory mechanism and the most abundant and highly conserved RNA epigenetic modification in eukaryotes. Previous studies have indicated the involvement of m6A modification in various tissue regeneration processes, including liver regeneration. Vir-like m6A methyltransferase associated protein (VIRMA) is an m6A methyltransferase with robust methylation capability. However, its role in liver regeneration remains poorly understood. In this study, we generated liver-specific Virma knockout mice using the Cre-loxP system and investigated the biological functions of VIRMA in liver regeneration using both the Associating Liver Partition and Portal vein Ligation for Staged Hepatectomy (ALPPS) mouse model and the carbon tetrachloride (CCl4) mouse model. The expression level of VIRMA was rapidly up-regulated after ALPPS surgery and gradually down-regulated during liver repair. Virma deficiency significantly impaired liver regeneration capacity and disrupted cell cycle progression. Methylated RNA immunoprecipitation sequencing (MeRIP-seq) analysis revealed that Shq1 is an effective downstream target of VIRMA-mediated m6A modification. The upregulation of Shq1 enhanced the proliferation ability of cells, which was attenuated by the specific AKT inhibitor ipatasertib. Supplementation of Shq1 in vivo alleviated the liver cell proliferation inhibition caused by Virma deficiency. Furthermore, the m6A-binding protein heterogeneous nuclear ribonucleoprotein a2b1 (HNRNPA2B1) enhanced the mRNA stability of Shq1. Mechanistically, Virma deficiency resulted in decreased m6A modification on Shq1 mRNA, leading to reduced binding ability of m6A-binding protein HNRNPA2B1 with Shq1, thereby decreasing the mRNA stability of Shq1 and reducing its protein expression level. Downregulation of Shq1 inhibited the PI3K/AKT pathway, thereby suppressing cell proliferation and cell cycle progression, ultimately impeding liver regeneration. In summary, our results demonstrate that VIRMA plays a critical role in promoting liver regeneration by regulating m6A modification, providing valuable insights into the epigenetic regulation during liver regeneration.
10.Exploration of Party-building leadership in promoting hospital culture construction in the new era: taking Xi’an No. 9 Hospital as an example
Louyan MA ; Yi WANG ; Zhen ZHEN ; Mi PANG ; Ting HE ; Puyan WEN ; Juxian ZHENG
Chinese Medical Ethics 2025;38(3):398-402
Hospital culture is the sum of common values, codes of conduct, and working methods formed by internal employees within the hospital, and it is the spiritual pillar and core of cohesion of the hospital. Party-building leadership plays an important role in promoting hospital culture construction, including strengthening values guidance, enhancing team cohesion, facilitating management system innovation, and shaping social image and brand value. By analyzing the effectiveness of a series of Party-building activities carried out by Xi’an No. 9 Hospital in recent years, this paper explored the effect and significance of Party-building leadership in promoting hospital culture construction in the new era, as well as proposed guiding strategies for strengthening Party-building work in promoting hospital culture construction in the new era, so as to promote high-quality development of the hospital.

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