1.Lipidomics Combined with Machine Learning for Screening Biomarkers of Early-Stage Lung Cancer in the Elderly
Qing WANG ; Yue HE ; Xu LIU ; Zifan LI ; Kezhong CHEN
Medical Journal of Peking Union Medical College Hospital 2026;17(3):652-662
Based on plasma lipidomics combined with machine learning approaches, this study aimed to screen molecular biomarkers for the diagnosis of early-stage lung cancer in elderly patients and to evaluate their diagnostic performance. This was a retrospective diagnostic study consisting of two parts. The first part involved molecular biomarker screening. Elderly patients with early-stage lung cancer (early lung cancer group), patients with benign pulmonary nodules (benign nodule group), and contemporaneous healthy individuals undergoing physical examinations (healthy control group) were enrolled from Peking University People's Hospital between November 2023 and November 2024. In addition, early-stage lung cancer patients and healthy controls meeting the inclusion criteria from a previous study of our research group were included as an independent validation cohort. Plasma samples were collected from all subjects, and untargeted lipidomics analysis was performed using high-performance liquid chromatography-mass spectrometry. Principal component analysis and orthogonal partial least squares discriminant analysis were used to evaluate metabolic differences between groups. L1-regularized support vector machine combined with incremental feature selection was employed to screen diagnostic biomarkers for early-stage lung cancer. Model performance was assessed using receiver operating characteristic curves, calibration curves, Brier scores, and decision curve analysis. The second part involved functional validation of the molecular biomarkers using the human lung adenocarcinoma cell line A549, with palmitoylcarnitine (CAR 16∶0) selected as a representative biomarker for functional validation via CCK-8 and cell scratch assays. A total of 36 patients in the early lung cancer group, 35 patients in the benign nodule group, and 41 healthy controls were enrolled, along with an independent validation cohort of 110 individuals (59 patients with early-stage lung cancer and 51 healthy controls). The principal component analysis results demonstrated that quality control samples were tightly aggregated at the centroid of all samples, reflecting robust instrument performance and dependable data quality.Orthogonal partial least squares discriminant analysis revealed significant metabolic differences between the early lung cancer group and the control group (benign nodule group + healthy control group) (R2X=0.406, R2Y=0.529, Q2Y=0.44). L1-regularized support vector machine identified five carnitine-related lipids-palmitoleoylcarnitine(CAR 16∶1), palmitoylcarnitine, The five plasma carnitine-related lipids screened based on untargeted lipidomics and machine learning may serve as potential molecular biomarkers for the diagnosis of early-stage lung cancer in elderly patients. The high-sensitivity characteristic of the model makes it particularly suitable for screening scenarios in early-stage lung cancer.
2.Research progress on the application of virtual reality technology in amblyopia visual training
Kang WANG ; Qiao WANG ; Pengfei LI ; Yunfan ZHANG ; Zifan QIN ; Jing LI
International Eye Science 2026;26(8):1411-1416
The therapeutic concept of amblyopia has gradually shifted from improving the visual acuity of the amblyopic eye to restoring binocular visual function.Conventional occlusion therapy and routine visual training have issues such as long treatment cycles, insufficient entertainment value and poor patient compliance, which limits the stability of therapeutic effects. Virtual reality(VR)technology, characterized by immersion, interactivity, and adjustable stimulus parameters, has been increasingly applied to visual training for amblyopia.Current evidence suggests that VR-based training can improve visual acuity and binocular visual function in amblyopia patients to a certain extent.Moreover, its gamified interactions and feedback-driven design may also enhance patient motivation and treatment adherence. This review begins with the mechanisms and theoretical basis of VR training for amblyopia, proceeds to summarizeits advantages over conventional methods, current systems, training modes, clinical efficacy, commonly used outcome measures, as well as safety and acceptability, aiming to provide a reference for its standardization, clinical translation, and widespread adoption.
3.Neonatal alloimmune thrombocytopenia complicated with piperacillin drug antibody: a case report
Zifan MENG ; Shaoqiang ZHANG ; Qiang JU ; Ying LI ; Songxia YAN ; Haiyan WANG
Chinese Journal of Blood Transfusion 2025;38(7):969-974
Objective: To investigate the clinical symptoms, laboratory tests, and treatment strategies of a case of fetal/neonatal alloimmune thrombocytopenia (FNAIT) complicated with piperacillin drug antibody. Methods: The platelet antibodies in the mother were screened and identified by ELISA. The HLA antigens of the newborn were genotyped through PCR-SSO, while the specificity of HLA antibodies in the mother was determined using a Single Antigen kit. The drug antibody was detected by a piperacillin kit. Results: Maternal antibodies against paternally-derived platelet antigens were detected. The HLA genotypes of the newborn were identified as HLA A
33∶03 and HLA B
58∶01. The mother exhibited strong positive antibodies against the specific platelet antigens of the newborn, namely anti-HLA-A33 and anti-HLA-B58 antibodies. The piperacillin antibody was detected in the newborn. Following treatment of continuous intravenous immunoglobulin (IVIG), platelet transfusions, red blood cell transfusions and discontinuation of piperacillin treatment, the platelet count and hemoglobin levels increased in the newborn. Conclusion: The newborn in this case was diagnosed with FNAIT complicated by the presence of anti-HLA-A33 and anti-HLA-B58 antibodies, as well as drug-induced hemolytic anemia caused by piperacillin drug antibody. The condition is more complicated under the influence of dual immune antibodies. Laboratory detection techniques such as platelet antibody and drug antibody tests can assist in early clinical diagnosis. At the same time, more active drug and blood transfusion treatments should be given in clinical practice to improve the prognosis.
4.Neonatal alloimmune thrombocytopenia complicated with piperacillin drug antibody: a case report
Zifan MENG ; Shaoqiang ZHANG ; Qiang JU ; Ying LI ; Songxia YAN ; Haiyan WANG
Chinese Journal of Blood Transfusion 2025;38(7):969-974
Objective: To investigate the clinical symptoms, laboratory tests, and treatment strategies of a case of fetal/neonatal alloimmune thrombocytopenia (FNAIT) complicated with piperacillin drug antibody. Methods: The platelet antibodies in the mother were screened and identified by ELISA. The HLA antigens of the newborn were genotyped through PCR-SSO, while the specificity of HLA antibodies in the mother was determined using a Single Antigen kit. The drug antibody was detected by a piperacillin kit. Results: Maternal antibodies against paternally-derived platelet antigens were detected. The HLA genotypes of the newborn were identified as HLA A
33∶03 and HLA B
58∶01. The mother exhibited strong positive antibodies against the specific platelet antigens of the newborn, namely anti-HLA-A33 and anti-HLA-B58 antibodies. The piperacillin antibody was detected in the newborn. Following treatment of continuous intravenous immunoglobulin (IVIG), platelet transfusions, red blood cell transfusions and discontinuation of piperacillin treatment, the platelet count and hemoglobin levels increased in the newborn. Conclusion: The newborn in this case was diagnosed with FNAIT complicated by the presence of anti-HLA-A33 and anti-HLA-B58 antibodies, as well as drug-induced hemolytic anemia caused by piperacillin drug antibody. The condition is more complicated under the influence of dual immune antibodies. Laboratory detection techniques such as platelet antibody and drug antibody tests can assist in early clinical diagnosis. At the same time, more active drug and blood transfusion treatments should be given in clinical practice to improve the prognosis.
5.Safety evaluation of therapeutic plasma exchange in patients with lower hematocrit levels
Ying LI ; Yuanming YANG ; Zifan MENG ; Zheng LIU ; Haiyan WANG
Chinese Journal of Blood Transfusion 2025;38(5):699-703
Objective: To retrospectively assess whether a lower hematocrit level (between 18% and 20%) had any impact on the safety of patients undergoing therapeutic plasma exchange (TPE), and to further determine the threshold for red blood cell supplementation prior to TPE. Methods: Clinical data from 181 adult patients who underwent TPE treatment at the Department of Blood Transfusion of our hospital from March 2023 to July 2024 were collected. The patients were divided into a study group of 44 patients (Hct ≥18% and <20%) and a control group of 137 patients (Hct≥20%). In two groups, blood volume-related safety indicators including respiration rate, heart rate, systolic blood pressure, and blood oxygen saturation levels before and after TPE were compared using t-test. Between-group differences in the grading of adverse reactions such as allergies and hypotension were analyzed using chi-square test. Results: A total of 659 TPE treatments were performed on 181 patients, with 169 TPE treatments on 44 patients in the study group (Hct≥18% and <20%) and 490 TPE treatments on 137 patients in the control group (Hct≥20%). There were no statistically significant differences in age, gender, BMI category, and the presence of cardiac insufficiency between the two groups. In the study group, there were no statistically significant differences in safety indicators such as respiration rate, heart rate, systolic blood pressure, and blood oxygen saturation level before and after TPE. In the control group, there were no statistically significant differences in heart rate and systolic blood pressure before and after TPE, but there were statistically significant differences in respiration rate and blood oxygen saturation level (P<0.05). There were no statistically significant differences in the grading of adverse reactions such as allergic reactions and hypotension between the two groups. Conclusion: For adult patients with stable conditions, maintaining a lower hematocrit level (Hct ≥18% and <20%) during TPE is relatively safe. It is feasible to lower the TPE red blood cell supplementation threshold to 18%≤Hct<20%,which may save blood resources while potentially benefit patients by avoiding unnecessary red blood cell transfusion.
6.The significance and advancements of circulating tumor DNA in the diagnosis and treatment of operable non-small cell lung cancer
Zifan LI ; Yue HE ; Kezhong CHEN
Chinese Journal of Surgery 2025;63(2):171-176
Non-small cell lung cancer, characterized by high incidence and mortality rates, significantly threatens human health. Precisely assessing patient prognosis and implementing adaptive treatment strategies have emerged as pivotal issues in contemporary thoracic oncology. Postoperative minimal residual disease (MRD) detection through liquid biopsy has demonstrated substantial potential. Circulating tumor DNA (ctDNA) enables real-time dynamic monitoring of tumor alterations. With advancements in ctDNA detection technologies, ctDNA has become a core method for MRD assessment. In the context of postoperative surveillance, ctDNA detection facilitates more accurate prognostic stratification and early prediction of tumor recurrence. Regarding therapeutic interventions, ctDNA detection can predict the efficacy of neoadjuvant and adjuvant therapies. In the future, further elucidating the value of assessing ctDNA status in predicting patient prognosis and guiding drug therapies will contribute to the advancement of precision medicine and adaptive treatments.
7.Clinicopathological characteristics of SEMA5A and PD-L1 expression and correla-tion of the two genes in gastric cancer
Shilan PENG ; Zifan XU ; Jiarong YANG ; Sha LI ; Yuanyuan XU ; Guoqing PAN
Chinese Journal of Clinical and Experimental Pathology 2025;41(3):304-310,316
Purpose To investigate the expression of semaphorin 5 A(SEMA5A)and programmed death ligand-1(PD-L1)and their clinicopathological significance in gastric cancer.Methods Clinical data of 41 cases of gastric cancer tissues and paired adjacent tissues were collected.Immunohistochemical staining and RT-qPCR were used to de-tect the expression levels of SEMA5A and PD-L1,and analysed the correlation between SEMA5A and PD-L1 and clini-copathological features.In addition,we used lentivirus to construct SEMA5A stable low-expression cell lines.RT-qPCR and Western blot were used to analyse the correlation between the expression of SEMA5A and PD-L1 in gastric cancer tissues.Results The high expression rate of SEMA5A was 65.9%(27/41)in gastric cancer tissues and 39.0%(16/41)in paracancerous tissues,respectively.The positive rates of PD-L1 were 58.5%(24/41)and 14.6%(6/41),respectively.RT-qPCR showed that the relative expression levels of SEMA5A mRNA in gastric cancer and paracancerous tissues were 1.30±0.50 and 0.81±0.48,respectively,while the relative expression levels of PD-L1 mRNA were 0.70±0.42 and 0.12±0.09,respectively.SEMA5A expression was correlated with histological typ-ing of gastric cancer and lymph node metastasis(P<0.05).PD-L1 expression was correlated with tumour size,T stage,and pathological stage of gastric cancer(P<0.05).Pearson correlation analysis showed a positive correlation between the expression of SEMA5A and PD-L1 mRNA in gastric cancer tissues,and spearman correlation analysis showed that there was no correlation between the expression of the two in paracancerous tissues.Knockdown of SE-MA5A gene in human gastric adenocarcinoma cell lines resulted in down-regulation of PD-L1 expression.Conclusion Both SEMA5A and PD-L1 are highly expressed in gastric cancer tissues,and there is a correlation between the ex-pressions of SEMA5A and PD-L1.They can serve as potential molecular markers for prognostic evaluation and combi-nation therapy of gastric cancer.
8.Clinicopathological characteristics of SEMA5A and PD-L1 expression and correla-tion of the two genes in gastric cancer
Shilan PENG ; Zifan XU ; Jiarong YANG ; Sha LI ; Yuanyuan XU ; Guoqing PAN
Chinese Journal of Clinical and Experimental Pathology 2025;41(3):304-310,316
Purpose To investigate the expression of semaphorin 5 A(SEMA5A)and programmed death ligand-1(PD-L1)and their clinicopathological significance in gastric cancer.Methods Clinical data of 41 cases of gastric cancer tissues and paired adjacent tissues were collected.Immunohistochemical staining and RT-qPCR were used to de-tect the expression levels of SEMA5A and PD-L1,and analysed the correlation between SEMA5A and PD-L1 and clini-copathological features.In addition,we used lentivirus to construct SEMA5A stable low-expression cell lines.RT-qPCR and Western blot were used to analyse the correlation between the expression of SEMA5A and PD-L1 in gastric cancer tissues.Results The high expression rate of SEMA5A was 65.9%(27/41)in gastric cancer tissues and 39.0%(16/41)in paracancerous tissues,respectively.The positive rates of PD-L1 were 58.5%(24/41)and 14.6%(6/41),respectively.RT-qPCR showed that the relative expression levels of SEMA5A mRNA in gastric cancer and paracancerous tissues were 1.30±0.50 and 0.81±0.48,respectively,while the relative expression levels of PD-L1 mRNA were 0.70±0.42 and 0.12±0.09,respectively.SEMA5A expression was correlated with histological typ-ing of gastric cancer and lymph node metastasis(P<0.05).PD-L1 expression was correlated with tumour size,T stage,and pathological stage of gastric cancer(P<0.05).Pearson correlation analysis showed a positive correlation between the expression of SEMA5A and PD-L1 mRNA in gastric cancer tissues,and spearman correlation analysis showed that there was no correlation between the expression of the two in paracancerous tissues.Knockdown of SE-MA5A gene in human gastric adenocarcinoma cell lines resulted in down-regulation of PD-L1 expression.Conclusion Both SEMA5A and PD-L1 are highly expressed in gastric cancer tissues,and there is a correlation between the ex-pressions of SEMA5A and PD-L1.They can serve as potential molecular markers for prognostic evaluation and combi-nation therapy of gastric cancer.
9.The significance and advancements of circulating tumor DNA in the diagnosis and treatment of operable non-small cell lung cancer
Zifan LI ; Yue HE ; Kezhong CHEN
Chinese Journal of Surgery 2025;63(2):171-176
Non-small cell lung cancer, characterized by high incidence and mortality rates, significantly threatens human health. Precisely assessing patient prognosis and implementing adaptive treatment strategies have emerged as pivotal issues in contemporary thoracic oncology. Postoperative minimal residual disease (MRD) detection through liquid biopsy has demonstrated substantial potential. Circulating tumor DNA (ctDNA) enables real-time dynamic monitoring of tumor alterations. With advancements in ctDNA detection technologies, ctDNA has become a core method for MRD assessment. In the context of postoperative surveillance, ctDNA detection facilitates more accurate prognostic stratification and early prediction of tumor recurrence. Regarding therapeutic interventions, ctDNA detection can predict the efficacy of neoadjuvant and adjuvant therapies. In the future, further elucidating the value of assessing ctDNA status in predicting patient prognosis and guiding drug therapies will contribute to the advancement of precision medicine and adaptive treatments.
10.Astragalus membranaceus (Fisch.) Bge. administered by dissolving microneedles achieves systemic therapeutic effects at low doses
Yiwen Chen ; Zihan Zhou ; Luzheng Zhang ; Zifan Ding ; Pengyue Li ; Cong Yan
Journal of Traditional Chinese Medical Sciences 2024;11(3):340-350
Objective:
To determine the main components of Astragalus membranaceus (Fisch.) Bge (A. membranaceus, Huang Qi), Astragaloside IV (AIV) and Astragalus polysaccharides (AP), to characterize their properties, evaluate their in vivo efficacy, and to analyze drug diffusion using dissolving microneedle (DMN) technology in vivo.
Methods:
Respectively, AIV- and AP-loaded DMNs comprising chitosan (CTS) and polyvinyl alcohol (PVA) were prepared via dual-mold forming. Their morphology, mechanical properties, in vivo solubility, and skin irritation characteristics were tested. In vivo efficacy was assessed in cyclophosphamide-induced immunosuppressed mice, in vivo diffusion of AIV and AP by DMNs and conventional methods was compared, and the rheological properties of AIV-CTS-PVA and AP-CTS-PVA mixtures were measured.
Results:
Subcutaneous dissolution and absorption of AIV-CTS-PVA and AP-CTS-PVA microneedles (MNs) at low doses (50%–17% of intraperitoneal AIV injection and 12%–4% of intravenous AP injection) reduced the spleen index and acid phosphatase activity in immunosuppressed mouse models, increased the thymus index, and achieved equivalent or better systemic therapeutic effects. Compared with injections, AIV and AP achieved controllable solid-liquid conversion through delivery with CTS-PVA MNs, resulting in highly localized aggregation within 48 h, reducing the initial explosive effect of the drug, and achieving stable and slow drug release.
Conclusion
The present study enhances our understanding of the efficacy and remote effects of drug-loaded DMNs from a traditional Chinese medicine (TCM) perspective, thereby promoting the development of precise and efficient delivery of TCM and further expanding the drug-loading range and application scenarios for DMNs.


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