1.Chinese expert consensus on postoperative follow-up for non-small cell lung cancer (version 2025)
Lunxu LIU ; Shugeng GAO ; Jianxing HE ; Jian HU ; Di GE ; Hecheng LI ; Mingqiang KANG ; Fengwei TAN ; Fan YANG ; Qiang PU ; Kaican CAI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(03):281-290
Surgical treatment is one of the key approaches for non-small cell lung cancer (NSCLC). Regular postoperative follow-up is crucial for early detection and timely management of tumor recurrence, metastasis, or second primary tumors. A scientifically sound and reasonable follow-up strategy not only extends patient survival but also significantly improves quality of life, thereby enhancing overall prognosis. This consensus aims to build upon the previous version by incorporating the latest clinical research advancements and refining postoperative follow-up protocols for early-stage NSCLC patients based on different treatment modalities. It provides a scientific and practical reference for clinicians involved in the postoperative follow-up management of NSCLC. By optimizing follow-up strategies, this consensus seeks to promote the standardization and normalization of lung cancer diagnosis and treatment in China, helping more patients receive high-quality care and long-term management. Additionally, the release of this consensus is expected to provide insights for related research and clinical practice both domestically and internationally, driving continuous development and innovation in the field of postoperative management for NSCLC.
2.Yttrium-90 selective internal radiation therapy on liver cancer: the past, the present, and the future
Jingqin MA ; Linhong ZHANG ; Minjie YANG ; Jiabin CAI ; Ying FANG ; Rong LIU ; Xudong QU ; Lingxiao LIU ; Zhiping YAN
Chinese Journal of Clinical Medicine 2025;32(1):3-8
Yttrium-90 selective internal radiation therapy (90Y-SIRT) is a treatment technique that delivers radioactive microspheres precisely to the arterial vascular bed of neoplasms, utilizing beta radiation to administer a high local dose of radiation to the neoplasm tissues. This technology has demonstrated significant efficacy in patients with unresectable pirmary liver cancers and liver metastases. This article systematically reviews the development history and clinical application status of 90Y-SIRT in the treatment of liver cancer, and looks forward to future development directions.
3.Follow-up study of left heart valve regurgitation after implantation of left ventricular assist device
Junjiang LIU ; Wenrui MA ; Dingqian LIU ; Yun ZHAO ; Lili DONG ; Zhe LUO ; Kefang GUO ; Chunsheng WANG ; Xiaoning SUN
Chinese Journal of Clinical Medicine 2025;32(1):72-77
Objective To explore the valve regurgitation status of left heart after the implantation of left ventricular assist device (LVAD) and its effect on prognosis of patients with LVAD implantation. Methods A total of 35 patients with cardiomyopathy who underwent magnetic levitation LVAD implantation at Zhongshan Hospital, Fudan University from February 2021 to July 2024 were retrospectively selected. Clinical data during hospitalization were collected, including preoperative basic data and postoperative valve regurgitation status. Telephone follow-ups were conducted to monitor patients’ survival status and transthoracic echocardiography was used to assess left valve function. Kaplan-Meier survival curves and log-rank test were employed to compare the survival rate of patients with different levels of valve regurgitation. Results The 35 patients had a mean age of (53.9±11.1) years, with 85.7% male, and 3 patients (8.6%) died during hospitalization. Preoperatively, 17 patients (48.6%) had moderate or greater mitral regurgitation, while all 35 patients had less than moderate aortic regurgitation. One month postoperatively, thirty patients were followed up, among which 24 patients (80%) had less than moderate mitral regurgitation, including 11 cases with alleviated regurgitation compared to pre-surgery; 6 patients (20%) had moderate or greater mitral regurgitation, including 4 cases with stable regurgitation and 2 cases with progression of regurgitation compared to pre-surgery; 2 patients (6.7%) had progression of aortic regurgitation to moderate or greater. The follow-up time was 1.2 (1.0, 2.1) years, with 1-year survival rate of 91.4% and 3-year survival rate of 71.1%. Survival analysis showed that the 3-year survival rate of patients with moderate or greater mitral regurgitation one month postoperatively was significantly lower than that of patients with less than moderate regurgitation (66.7% vs 83.3%, P=0.046). Conclusions After the implantation of magnetic levitation LVAD, most patients showed improvement in mitral regurgitation, while aortic regurgitation remained unchanged. The degree of mitral regurgitation one month postoperatively is associated with prognosis.
4.Effect of hemodialysis on the biotransformation of oxo-eicosatetraenoic acids in peripheral tissues
Tong LIU ; Gollasch MAIK ; C. Luft FRIEDRICH ; Pan LIN ; Jun JI ; Yao MENG
Chinese Journal of Clinical Medicine 2025;32(1):93-100
Objective To analyze the differences of free and esterified oxo-eicosatetraenoic acids (oxo-ETEs) in blood cells and plasma from arterial and venous blood in hemodialysis (HD) patients. Methods Arterial and venous blood samples from 12 patients with end-stage renal disease (ESRD) before and after HD treatment at Charité – Universitätsmedizin Berlin, Germany, from June to December 2020 were collected. The esterified and free oxo-ETEs derived from arachidonic acid in blood cells and plasma were measured by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Results Neither esterified nor free oxo-ETEs in blood cells displayed significant arteriovenous differences before and after HD. HD predominantly affected the metabolic levels of esterified and free oxo-ETEs in plasma. HD reduced the arteriovenous differences of esterified 12-oxo-ETE, free 15-oxo-ETE, and free 5-oxo-ETE in plasma, while raised the arteriovenous differences of esterified 15-oxo-ETE. Conclusions The oxo-ETEs in blood cells are relatively well-stabilized responding to HD treatment, whereas arteriovenous differences of free and esterified oxo-ETEs in plasma are present and active in response to HD treatment, potentially contributing to the cardiovascular disease.
5.Study on Cardiac Aging Phenotypes of SHJHhr Mice
Rongle LIU ; Hao CHENG ; Fusheng SHANG ; Shufu CHANG ; Ping XU
Laboratory Animal and Comparative Medicine 2025;45(1):13-20
ObjectiveTo investigate the spontaneous premature cardiac aging in SHJHhr mice. MethodsA comparative study was conducted between SHJHhr mice (SHJHhr group) and wild-type ICR mice (WT group) at different ages (10 and 24 weeks). Cardiac function was analyzed using a small animal in vivo ultrasound imaging system. After euthanasia, organs were collected and weighed to assess the extent of cardiac atrophy. Cardiac pathological damage was observed using hematoxylin-eosin (HE) staining. Cardiac fibrosis was analyzed using Masson staining. Myocardial cell area was analyzed after wheat germ agglutinin (WGA) staining. The activities of oxidative damage indicators in myocardial tissue, including superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase (CAT), as well as the content of 8-hydroxy-2'-deoxyguanosine (8-OHdG), were measured using enzyme-linked immunosorbent assay. Real-time fluorescence quantitative PCR was used to measure the mRNA expression levels of factors associated with inflammation, fibrosis, and oxidative stress. Colorimetric assay was used to measure malondialdehyde (MDA) levels. ResultsCompared to WT group mice of the same age, 10-week-old mice in the SHJHhr group showed no significant differences in stroke volume (SV), ejection fraction (EF), fractional shortening (FS), or heart and lung weights. However, at 24 weeks of age, mice in the SHJHhr group had significantly lower SV, EF, and FS values compared to mice of the same age in the WT group (P<0.05), with no significant change in lung weight but a significant reduction in heart weight (P<0.05). Histological analysis of heart tissue from 24-week-old mice revealed no significant difference in cardiac fibrosis levels between SHJHhr and WT groups, but WGA staining showed a significant reduction in myocardial cell area in mice in the SHJHhr group (P<0.05). PCR analysis revealed a significant downregulation of mRNA levels of oxidative stress factors Sod2, Gpx1, and Cat genes (P<0.05). Biochemical assays indicated significantly reduced activities of oxidative damage-related enzymes SOD, GPX, and CAT in myocardial tissue (P<0.05), while the levels of oxidative damage markers 8-OHdG and MDA significantly increased (P<0.05). ConclusionMice in the SHJHhr group exhibit premature cardiac aging, which may be associated with oxidative stress damage in myocardial tissue.
6.Causal relationship between gout and Alzheimer's disease: a two-sample Mendelian randomization analysis
Chuijia KONG ; Ying ZHANG ; Zhenkun TAN ; Junjiao PING ; Haibo ZHANG ; Jie ZHANG ; Jiali LUO ; Xinxia LIU
Sichuan Mental Health 2025;38(2):115-122
BackgroundDementia seriously affects the quality of life and lifespan of elderly people, with Alzheimer's disease (AD) being the most common type of dementia. Previous studies have suggested that gout may reduce the risk of developing AD, but the causal relationship between the two still requires further research. ObjectiveTo investigate the potential causal relationship between gout and AD through a two-sample Mendelian randomization (MR) analysis, so as to provide references for the prevention and treatment of AD. MethodsData from Genome-Wide Association Studies (GWAS) extracted in 2024 were analyzed, using pooled data on gout (6 810 cases in the case group and 477 788 cases in the control group) published by UK Biobank in 2021 as the exposure variable, and data on AD (3 899 cases in the case group and 214 893 cases in the control group) published by FinnGen in the same year as the outcome variable. The inverse-variance weighted, MR-Egger regression, weighted median estimation, simple model and weighted model were used to analyze the potential causal relationship between gout and AD. Pleiotropic effects were assessed using MR-Egger regression. Heterogeneity assessment was conducted using Cochran's Q test. The leave-one-out analysis was carried out for sensitivity analysis. And a funnel plot was drawn to detect potential publication bias. ResultsThe inverse-variance weighted analysis demonstrated a negative causal relationship between gout and AD (OR=0.004, 95% CI: 0~0.700, P<0.05). The plot resembled a symmetrical inversed funnel, indicating the absence of publication bias. No heterogeneity was detected by Cochran's Q test. The MR-Egger regression indicated no significant horizontal pleiotropy. Concerning the reverse directions, no significant associations between AD and gout were noted. ConclusionThere is a negative causal relationship between gout and AD, with gout potentially reducing the risk of developing AD. [Funded by The Third Batch of Social Welfare and Basic Research Projects (Medical and Health) of Zhongshan City in 2022 (number, 2022B3017)]
7.Role and mechanism of caffeic acid in a mouse model of severe acute pancreatitis
Siyu XU ; Tao LIU ; Lulu LAN ; Yining XUE ; Wei WEI ; Yi HAN ; Sucheng MU ; Haiyan SONG ; Shilin DU
Journal of Clinical Hepatology 2025;41(4):722-730
ObjectiveTo investigate the effect and potential mechanism of caffeic acid (CA) on severe acute pancreatitis (SAP) induced by caerulein combined with lipopolysaccharide (LPS), and to provide a basis for the research on novel drugs for the treatment of SAP. MethodsC57BL/6J mice, aged 6 weeks, were divided into control group, model group, CA group, and octreotide acetate (OA) group, with 6 mice in each group. The mice in the control group were given injection of normal saline, and those in the other groups were given intraperitoneal injection of caerulein combined with LPS to establish a mouse model of SAP. At 1 hour after the first injection of caerulein, the mice in the CA group and the OA group were given intraperitoneal injection of CA or subcutaneous injection of OA at an interval of 8 hours. The general status of the mice was observed after 24 hours of modeling, and serum, pancreas, lung, and colon samples were collected. HE staining was used to observe the histopathological changes of the pancreas and lungs, and the serum levels of α-amylase, lipase, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), alanine aminotransferase, aspartate aminotransferase, and creatinine were measured. RT-PCR was used to measure the expression of proinflammatory factors in the pancreas and lungs; myeloperoxidase (MPO) immunohistochemistry was used to observe the degree of neutrophil infiltration; Western blot was used to measure the activation of nuclear factor-kappa B (NF-κB) and the level of citrullinated histone H3 (CitH3), a marker for the formation of neutrophil extracellular traps (NETs), in the pancreas and lungs, as well as the expression level of ZO-1 in colon tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the Dunnett’s t-test was used for further comparison between two groups. ResultsCompared with the control group, the model group had severe injury in the pancreas and lungs and significant increases in the activity of serum α- amylase and lipase and the levels of the proinflammatory cytokines IL-6, interleukin-1β (IL-1β), and TNF-α in serum and lung tissue (all P<0.05), as well as significant increases in NF-κB activation, neutrophil infiltration, and the formation of NETs in the pancreas and lungs (all P<0.05). Compared with the model group, the CA group had alleviated pathological injury of the pancreas and lungs and significant reductions in the activity of serum α-amylase and the levels of the proinflammatory cytokines IL-6, IL-1β, and TNF-α in serum and lung tissue (all P<0.05), as well as significant reductions in NF-κB activation, neutrophil infiltration, and the formation of NETs in the pancreas and lungs (all P<0.05). ConclusionCA can alleviate SAP induced by caerulein combined with LPS in mice, possibly by inhibiting neutrophil recruitment and the formation of NETs.
8.Value of three-dimensional inversion-recovery with real reconstruction sequence using an ultralong repetition time for endolymphatic hydrops
Menglong ZHAO ; Huaili JIANG ; Shujie ZHANG ; Zhuang LIU ; Kai LIU ; Di WU ; Xinsheng HUANG ; Mengsu ZENG
Chinese Journal of Clinical Medicine 2025;32(2):200-206
Objective To evaluate the value of an optimized three-dimensional inversion-recovery with real reconstruction (3D-real IR) sequence with a longer repetition time (TR, 16 000 ms) based on modulated flip angle technique in refocused imaging with extended echo train (MATRIX) in the endolymphatic hydrops (EH) imaging after intratympanic gadolinium (Gd) administration, and to compare it with a conventional 3D-real IR based on the turbo spin echo (TSE) sequence. Methods From July 2021 to November 2022, twenty-seven patients received both the conventional and optimized 3D-real IR sequences after bilateral intratympanic Gd administration. Images of the two sequences were qualitativly evaluated and compared. Contrast-to-noise ratio (CNR), signal-to-noise ratio (SNR), and area ratio of endolymph against the total lymphatic space from the two sequences were measured and compared. Results 14(25.9%) ears with insufficient contrast for the EH diagnosis on the conventional sequence were clearly displayed on the optimized sequence. Image score, CNR and SNR of the optimized sequence were significantly higher than those of the conventional sequence (P < 0.001). The scanning time of two sequences was similar. The area ratio of endolymph against the total lymphatic space in the cochlear was significantly higher on the conventional 3D-real IR than that on the optimized 3D-real IR (P < 0.001); there was no statistical difference in the vestibule between the two sequences. Conclusions Compared with conventional sequence, optimized 3D-real IR sequence with a longer TR may be better for evaluation of EH after intratympanic Gd administration.
9.Application of three-dimensional fluid-attenuated inversion recovery sequence using artificial intelligence-assisted compressed sensing technique in intravenous gadolinium contrast-enhanced magnetic resonance imaging of inner ear
Kai LIU ; Jian WANG ; Huaili JIANG ; Shujie ZHANG ; Di WU ; Xinsheng HUANG ; Mengsu ZENG ; Menglong ZHAO
Chinese Journal of Clinical Medicine 2025;32(2):212-217
Objective To investigate the value of artificial intelligence-assisted compressed sensing (ACS) technology for intravenous gadolinium contrast-enhanced magnetic resonance imaging of the inner ear using three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) sequence. Methods The patients received gadolinium contrast-enhanced magnetic resonance imaging using ACS and united compressed sensing (uCS) 3D-FLAIR at Zhongshan Hospital, Fudan University from January to November 2024 were prospectively enrolled. The repetition time was 16 000 ms, and acquisition time was 6 min 40 s and 10 min 24 s in ACS 3D-FLAIR and uCS 3D-FLAIR, respectively. The images on the two sequences were evaluated independently by two radiologists. The image quality of the two sequences was subjectively evaluated and compared. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were compared between the two sequences. The grading consistencies using two sequences and between the two doctors were analyzed. Results There was no statistically difference in subjective score of image quality between the two sequences. SNR and CNR of the ACS 3D-FLAIR sequence were significantly higher than those of the uCS 3D-FLAIR sequence (P<0.001). The kappa values of grades of cochlear and vestibular endolymphatic hydrops were 0.942 and 0.888 using two sequences (P<0.001). The kappa values of grades of cochlear and vestibular endolymphatic hydrops using the ACS 3D-FLAIR sequence between the two doctors were 0.784 and 0.831, respectively (P<0.001); the kappa values of grades of cochlear and vestibular endolymphatic hydrops using uCS 3D-FLAIR sequence between the two doctors were 0.725 and 0.756, respectively (P<0.001). Conclusions ACS 3D-FLAIR could provide higher SNR and CNR than uCS 3D-FLAIR, and is more suitable for intravenous gadolinium contrast-enhanced magnetic resonance imaging of the inner ear; the endolymphatic hydrops grades using ACS 3D-FLAIR is similar to use uCS 3D-FLAIR.
10.Hippocampal neuroinflammation and neuronal injury in the acute phase of pentylenetetrazol induced epilepsy mouse model
Linyu ZHI ; Wanruo HAN ; WANG BENJAMIN HONGYE ; Guoxiang WANG ; Xu LIU
Chinese Journal of Clinical Medicine 2025;32(2):238-247
Objective To investigate the activation of microglia and astrocytes, the secretion of pro-inflammatory factors, and the survival of neurons in the hippocampus of mice with acute seizures induced by pentylenetetrazol (PTZ) 24 hours after the onset of seizures. Methods Adult male C57BL/6 mice were randomly assigned to the control group and the PTZ-induced acute epileptic seizure group using random numbers, with 28 mice in each group. The activation status of microglia and astrocytes in the CA1 region of the hippocampus was evaluated by immunofluorescence 24 hours after the onset of seizures. RNA was extracted from the hippocampal tissue to detect the expression level of inflammatory factor mRNA, and HE staining was used to assess the survival of neurons in the hippocampus. Results Twenty-four hours after PTZ-induced acute seizures in mice, the numbers of activated Iba1+ microglia (55.72±4.29 vs 35.71±9.66, P<0.001) and GFAP+ astrocytes (51.61±8.21 vs 37.64±5.27, P<0.01) in the CA1 region were significantly increased compared with the control group; the proportion of M1 microglia was significantly increased (0.58±0.02 vs 0.35±0.08, P<

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