1.Efficacy test of mp-MRI-based VI-RADS score for diagnosis of muscle-invasive bladder cancer,a Meta-analysis
Qingyang YU ; Kangkang CHEN ; Tonglei ZHAO ; Weipu MAO ; Zejun WANG ; Xinyang PENG ; Zihui ZHAO ; Xingui PENG ; Ming CHEN ; Jianping WU
Chinese Journal of Urology 2025;46(6):430-438
Objective:To evaluate the diagnostic performance of the Vesical Imaging-Reporting and Data System(VI-RADS)based on multiparametric magnetic resonance imaging(mp-MRI)for muscle-invasive bladder cancer(MIBC).Methods:A systematic search was conducted in PubMed,Web of Science,and Embase databases for studies published between September 2018 and December 2023 that investigated the use of VI-RADS for diagnosing MIBC. Inclusion criteria were studies utilizing mp-MRI-based VI-RADS scoring to determine MIBC. Exclusion criteria were studies with fewer than 10 patients,overlapping study populations,or those failing to assess the diagnostic performance of VI-RADS for MIBC. After quality assessment,RevMan 5.4 and Stata 15.1 were used to calculate pooled sensitivity and specificity,generate forest plots and summary receiver operating characteristic(SROC)curves,and determine the area under the curve(AUC). Publication bias was assessed using Deeks funnel plot. Heterogeneity was evaluated using the I2 statistic,with meta-regression and subgroup analyses to explore its sources. Results:Twenty-nine studies involving 3 577 patients were included. At a VI-RADS cutoff of 3,the pooled sensitivity and specificity for MIBC diagnosis were 93%(95%CI 0.90-0.95)and 82%(95%CI 0.76-0.88),respectively. At a cutoff of 4,these values were 83%(95%CI 0.78-0.87)and 93%(95%CI 0.90-0.95). The hierarchical SROC(HSROC)AUCs were 0.95 and 0.94 for cutoffs of 3 and 4,respectively. Subgroup and meta-regression analyses revealed that at a cutoff of 3,patient sample size,study design,MRI field strength,number of radiologists,surgical approach,and DWI/DCE imaging planes contributed to sensitivity heterogeneity( P < 0.05). All factors except study design and DWI plane were sources of specificity heterogeneity( P < 0.05). At a cutoff of 4,all factors significantly influenced heterogeneity in both sensitivity and specificity( P < 0.05). Meta-regression confirmed that both cutoffs(3 and 4)were significant sources of heterogeneity( P < 0.05). Conclusions:VI-RADS demonstrates excellent diagnostic performance for MIBC at both cutoffs(3 and 4),with VI-RADS ≥ 3 showing superior sensitivity and VI-RADS ≥ 4 offering higher specificity. The cutoff of 3 provides better overall diagnostic efficacy.
2.Comparative study and optimization of management discipline layout in"double first-class"traditional Chinese medicine universities
Shijie XU ; Churou ZHANG ; Zhao GUO ; Zihui ZHAI ; Yuanli RAO
Modern Hospital 2025;25(7):985-990
Objective This study aims to explore the layout and optimization of management disciplines in"Double First-Class"Traditional Chinese Medicine(TCM)universities,providing talent support and management guidance for the devel-opment of TCM.Methods Based on an overview of the development of management disciplines in TCM universities,six"Doub-le First-Class"TCM universities were selected as research subjects.Data were collected and compared using web retrieval and lit-erature research methods.Results Management disciplines in TCM universities still face challenges,such as weak foundational infrastructure and difficulties in interdisciplinary integration,insufficient faculty and suboptimal curriculum systems,and a single teaching model with a disconnect between theory and practice.Conclusion This paper proposes targeted suggestions and strate-gies for optimizing the layout of management disciplines in TCM universities,including strengthening support for management dis-ciplines and deepening TCM management characteristics,optimizing curriculum design and enhancing faculty resources,and in-novating teaching models to promote the deep integration of theory and practice.
3.Value of multiparametric MRI-based radiomics in predicting HER2 expression in bladder cancer
Tonglei ZHAO ; Weipu MAO ; Zihui ZHAO ; Zejun WANG ; Dakun ZHANG ; Ming CHEN ; Jianping WU
Journal of Modern Urology 2025;30(8):662-670,688
Objective To evaluate the value of radiomics models and comprehensive models based on multiparametric magnetic resonance imaging(mpMRI)in predicting the expression of human epidermal growth factor receptor 2(HER2)in bladder cancer(BCa).Methods A total of 76 pathologically confirmed BCa patients undergoing pelvic mpMRI during Jan.2022 and Nov.2024 at the Affiliated Zhongda Hospital of Southeast University were retrospectively included.After the volume of interest(VOI)was sketched,7 modal features were obtained,including T2WI,DWI,DCE,T2WI+DWI,T2WI+DCE,DWI+DCE,and T2WI+DWI+DCE,which were analyzed with logistic regression to obtain the predictive values.After that,the best sequences were screened with receiver operating characteristic(ROC)curves,and then combined with support vector machine,logistic regression,K-nearest neighbor,plain Bayes and adaptive enhancement,to construct the radiomics prediction models.Logistic regression analysis was used to screen the predictors of high HER 2 expression and to construct a comprehensive prediction model and a nomogram.Finally,decision curve analysis(DCA)was used to quantify the clinical benefits.Results Among the radiomics models based on the T2WI+DWI+DCE sequence,the AdaBoost model demonstrated the best predictive performance,with area under the ROC curve(AUC)being 0.863(95%CI:0.807-0.920)in the training set and 0.716(95%CI:0.601-0.830)in the validation set.Based on radiomics features and clinical imaging characteristics,logistic regression analysis identified tumor pedicle and risk group as the predictors of high HER2 expression.The comprehensive prediction model based on the two factors achieved the AUC of 0.869(95%CI:0.772-0.965)in the training set and 0.875(95%CI:0.712-0.986)in the validation set.Conclusion The radiomics model based on the T2WI+DWI+DCE sequence has high accuracy in predicting HER2 expression,outperforming single-sequence models.The nomogram based on the comprehensive prediction model has high clinical decision-making efficacy and is useful for non-invasive identification of HER2 expression.
4.Exosome Linc00665 regulates radiotherapy resistance in oral squamous cell carcinoma by regulating T cell immunoreactivity
Huan LI ; Junhong HUANG ; Yating HU ; Yahui LI ; Zihui YANG ; Zhenyan ZHAO ; Xinjie YANG ; Jianhua WEI
Journal of Practical Stomatology 2025;41(6):744-749
Objective:To investigate the function and mechanism of exosome Linc00665 in modulating CD8+T cell immunoreactivity to promote radiotherapy resistance in OSCC.Methods:HOEC,SCC9 and SCC9-RR exosomes were extracted and identified,and the expression of Linc00665 was detected by qRT-PCR in cell lines and exosomes.The expression of TNF-α,IFN-γ,perforin and granzyme B in each treatment group was detected by ELISA(PBS,SCC9 exo,SCC9-RR exo).The killing ability of CD8+T cells against SCC9 cells in each treatment group was detected by CCK-8 assay.The targets of Linc00665 were further bioinformatically ana-lyzed and verified by qRT-PCR and Western blot.The expression of Linc00665,miR-28-5p and PD-1 in CD8+T cells was exogenous-ly regulated,the expression of immunoreactive factors in the supernatants of each treatment group was detected by ELISA(NC,sh-Linc00665,miR-28-5p inhibitor,sh-PD-1),and the killing ability of cells in each group was detected by CCK-8 method.Results:The concentrations of TNF-α,IFN-γ,perforin and granzyme B in the supernatants of cell culture in the SCC9-RR exo/CD8+T group were significantly decreased compared with those in the PBS/CD8+T group and the SCC9 exo/CD8+T group(P<0.05),and the kill-ing ability of the cells in the SCC9-RR exo group was significantly decreased compared with those in the PBS group and the SCC9 exo group(P<0.05),suggesting that SCC9-RR exo could inhibit the tumor killing ability of CD8+T cells.qRT-PCR results suggested that Linc00665 was highly expressed in the SCC9-RR cell line as well as exosome(P<0.05).It was further verified by bioinformat-ics analysis that Linc00665 could regulate PD-1 expression via miR-28-5p,thereby modulating CD8+T cell immunoreactivity to pro-mote OSCC radiotherapy resistance.Conclusion:Exosome Linc00665 regulates CD8+T cell immunoreactivity through miR-28-5p/PD-1 axis to promote OSCC radiotherapy resistance.
5.A preliminary study on horizontal sound localization in patients with unilateral sudden hearing loss during the acute phase
Mengyuan ZHU ; Xiaolin HE ; Jiaying LI ; Xing WANG ; Hongping DING ; Linan DIAO ; Xin FU ; Jiaxing LIU ; Zihui ZHAO ; Ningyu WANG ; Juan ZHANG
Chinese Archives of Otolaryngology-Head and Neck Surgery 2025;32(5):288-293
OBJECTIVE To preliminarily assess the horizontal sound localization and its influencing factors in patients with unilateral sudden sensorineural hearing loss during the acute phase.METHODS The azimuth discrimination test and azimuth identification test were completed,with the speech sound(65 dB SPL)as the stimulus.The minimum audible angle(MAA)and root-mean-square error(RMSE)were obtained,and the RMSE of the affected side and the healthy side were calculated respectively.According to the WHO(2021)hearing loss classification criteria,the data were analyzed based on the pure-tone average(PTA)of the affected ear.And the best resident hearing at each frequency of the affected ear was recorded.RESULTS The performance of the unilateral sudden sensorineural hearing loss patients in the sound localization varied greatly.Some performed close to the normal level,while others completely lost the ability to localize sound.The RMSE of the moderate hearing loss group(≥35 dB HL)was significantly higher than that of the normal hearing group(P<0.01),the MAA of the moderate to severe hearing loss group(≥50 dB HL)showed statistically significant differencescompared with normal hearing group(P<0.001).The RMSE of the affected side of patients in the severe and above hearing loss group was significantly larger than that of the healthy side.Regression analysis showed that the best resident hearing at each frequency of the affected ear was the most significant factor affecting MAA(R2=0.572,P<0.001)and RMSE(R2=0.768,P<0.001).CONCLUSION The horizontal sound localization of unilateral sudden sensorineural hearing loss patients in the acute phase varies greatly.When the PTA of the affected side reaches moderate hearing loss,the localization ability is significantly lower than that of normal-hearing individuals.The best resident hearing at each frequency of the affected ear is the key factor affecting the localization ability.
6.Design and synthesis of novel saponin-triazole derivatives in the regulation of adipogenesis.
Yongsheng FANG ; Zhiyun ZHU ; Chun XIE ; Dazhen XIA ; Huimin ZHAO ; Zihui WANG ; Qian LU ; Caimei ZHANG ; Wenyong XIONG ; Xiaodong YANG
Chinese Journal of Natural Medicines (English Ed.) 2025;23(8):920-931
Saponins associated with Panax notoginseng (P. notoginseng) demonstrate significant therapeutic efficacy across multiple diseases. However, certain high-yield saponins face limited clinical applications due to their reduced pharmacological efficacy. This study synthesized and evaluated 36 saponin-1,2,3-triazole derivatives of ginsenosides Rg1/Rb1 and notoginsenoside R1 for anti-adipogenesis activity in vitro. The research revealed that the ginsenosides Rg1-1,2,3-triazole derivative a17 demonstrates superior adipogenesis inhibitory effects. Structure-activity relationships (SARs) analysis indicates that incorporating an amidyl-substituted 1,2,3-triazole into the saponin side chain via Click reaction enhances anti-adipogenesis activity. Additionally, several other derivatives exhibit general adipogenesis inhibition. Compound a17 demonstrated enhanced potency compared to the parent ginsenoside Rg1. Mechanistic investigations revealed that a17 exhibits dose-dependent inhibition of adipogenesis in vitro, accompanied by decreased expression of preadipocytes. Peroxisome proliferator-activated receptor γ (PPARγ), fatty acid synthase (FAS), and fatty acid binding protein 4 (FABP4) adipogenesis regulators. These findings establish the ginsenoside Rg1-1,2,3-triazole derivative a17 as a promising adipocyte differentiation inhibitor and potential therapeutic agent for obesity and associated metabolic disorders. This research provides a foundation for developing effective therapeutic approaches for various metabolic syndromes.
Adipogenesis/drug effects*
;
Triazoles/chemical synthesis*
;
Ginsenosides/chemical synthesis*
;
Saponins/chemical synthesis*
;
Animals
;
Mice
;
Structure-Activity Relationship
;
PPAR gamma/genetics*
;
3T3-L1 Cells
;
Adipocytes/metabolism*
;
Panax notoginseng/chemistry*
;
Drug Design
;
Molecular Structure
;
Humans
;
Cell Differentiation/drug effects*
;
Fatty Acid-Binding Proteins/genetics*
7.Comparative study and optimization of management discipline layout in"double first-class"traditional Chinese medicine universities
Shijie XU ; Churou ZHANG ; Zhao GUO ; Zihui ZHAI ; Yuanli RAO
Modern Hospital 2025;25(7):985-990
Objective This study aims to explore the layout and optimization of management disciplines in"Double First-Class"Traditional Chinese Medicine(TCM)universities,providing talent support and management guidance for the devel-opment of TCM.Methods Based on an overview of the development of management disciplines in TCM universities,six"Doub-le First-Class"TCM universities were selected as research subjects.Data were collected and compared using web retrieval and lit-erature research methods.Results Management disciplines in TCM universities still face challenges,such as weak foundational infrastructure and difficulties in interdisciplinary integration,insufficient faculty and suboptimal curriculum systems,and a single teaching model with a disconnect between theory and practice.Conclusion This paper proposes targeted suggestions and strate-gies for optimizing the layout of management disciplines in TCM universities,including strengthening support for management dis-ciplines and deepening TCM management characteristics,optimizing curriculum design and enhancing faculty resources,and in-novating teaching models to promote the deep integration of theory and practice.
8.Value of multiparametric MRI-based radiomics in predicting HER2 expression in bladder cancer
Tonglei ZHAO ; Weipu MAO ; Zihui ZHAO ; Zejun WANG ; Dakun ZHANG ; Ming CHEN ; Jianping WU
Journal of Modern Urology 2025;30(8):662-670,688
Objective To evaluate the value of radiomics models and comprehensive models based on multiparametric magnetic resonance imaging(mpMRI)in predicting the expression of human epidermal growth factor receptor 2(HER2)in bladder cancer(BCa).Methods A total of 76 pathologically confirmed BCa patients undergoing pelvic mpMRI during Jan.2022 and Nov.2024 at the Affiliated Zhongda Hospital of Southeast University were retrospectively included.After the volume of interest(VOI)was sketched,7 modal features were obtained,including T2WI,DWI,DCE,T2WI+DWI,T2WI+DCE,DWI+DCE,and T2WI+DWI+DCE,which were analyzed with logistic regression to obtain the predictive values.After that,the best sequences were screened with receiver operating characteristic(ROC)curves,and then combined with support vector machine,logistic regression,K-nearest neighbor,plain Bayes and adaptive enhancement,to construct the radiomics prediction models.Logistic regression analysis was used to screen the predictors of high HER 2 expression and to construct a comprehensive prediction model and a nomogram.Finally,decision curve analysis(DCA)was used to quantify the clinical benefits.Results Among the radiomics models based on the T2WI+DWI+DCE sequence,the AdaBoost model demonstrated the best predictive performance,with area under the ROC curve(AUC)being 0.863(95%CI:0.807-0.920)in the training set and 0.716(95%CI:0.601-0.830)in the validation set.Based on radiomics features and clinical imaging characteristics,logistic regression analysis identified tumor pedicle and risk group as the predictors of high HER2 expression.The comprehensive prediction model based on the two factors achieved the AUC of 0.869(95%CI:0.772-0.965)in the training set and 0.875(95%CI:0.712-0.986)in the validation set.Conclusion The radiomics model based on the T2WI+DWI+DCE sequence has high accuracy in predicting HER2 expression,outperforming single-sequence models.The nomogram based on the comprehensive prediction model has high clinical decision-making efficacy and is useful for non-invasive identification of HER2 expression.
9.Exosome Linc00665 regulates radiotherapy resistance in oral squamous cell carcinoma by regulating T cell immunoreactivity
Huan LI ; Junhong HUANG ; Yating HU ; Yahui LI ; Zihui YANG ; Zhenyan ZHAO ; Xinjie YANG ; Jianhua WEI
Journal of Practical Stomatology 2025;41(6):744-749
Objective:To investigate the function and mechanism of exosome Linc00665 in modulating CD8+T cell immunoreactivity to promote radiotherapy resistance in OSCC.Methods:HOEC,SCC9 and SCC9-RR exosomes were extracted and identified,and the expression of Linc00665 was detected by qRT-PCR in cell lines and exosomes.The expression of TNF-α,IFN-γ,perforin and granzyme B in each treatment group was detected by ELISA(PBS,SCC9 exo,SCC9-RR exo).The killing ability of CD8+T cells against SCC9 cells in each treatment group was detected by CCK-8 assay.The targets of Linc00665 were further bioinformatically ana-lyzed and verified by qRT-PCR and Western blot.The expression of Linc00665,miR-28-5p and PD-1 in CD8+T cells was exogenous-ly regulated,the expression of immunoreactive factors in the supernatants of each treatment group was detected by ELISA(NC,sh-Linc00665,miR-28-5p inhibitor,sh-PD-1),and the killing ability of cells in each group was detected by CCK-8 method.Results:The concentrations of TNF-α,IFN-γ,perforin and granzyme B in the supernatants of cell culture in the SCC9-RR exo/CD8+T group were significantly decreased compared with those in the PBS/CD8+T group and the SCC9 exo/CD8+T group(P<0.05),and the kill-ing ability of the cells in the SCC9-RR exo group was significantly decreased compared with those in the PBS group and the SCC9 exo group(P<0.05),suggesting that SCC9-RR exo could inhibit the tumor killing ability of CD8+T cells.qRT-PCR results suggested that Linc00665 was highly expressed in the SCC9-RR cell line as well as exosome(P<0.05).It was further verified by bioinformat-ics analysis that Linc00665 could regulate PD-1 expression via miR-28-5p,thereby modulating CD8+T cell immunoreactivity to pro-mote OSCC radiotherapy resistance.Conclusion:Exosome Linc00665 regulates CD8+T cell immunoreactivity through miR-28-5p/PD-1 axis to promote OSCC radiotherapy resistance.
10.Efficacy test of mp-MRI-based VI-RADS score for diagnosis of muscle-invasive bladder cancer,a Meta-analysis
Qingyang YU ; Kangkang CHEN ; Tonglei ZHAO ; Weipu MAO ; Zejun WANG ; Xinyang PENG ; Zihui ZHAO ; Xingui PENG ; Ming CHEN ; Jianping WU
Chinese Journal of Urology 2025;46(6):430-438
Objective:To evaluate the diagnostic performance of the Vesical Imaging-Reporting and Data System(VI-RADS)based on multiparametric magnetic resonance imaging(mp-MRI)for muscle-invasive bladder cancer(MIBC).Methods:A systematic search was conducted in PubMed,Web of Science,and Embase databases for studies published between September 2018 and December 2023 that investigated the use of VI-RADS for diagnosing MIBC. Inclusion criteria were studies utilizing mp-MRI-based VI-RADS scoring to determine MIBC. Exclusion criteria were studies with fewer than 10 patients,overlapping study populations,or those failing to assess the diagnostic performance of VI-RADS for MIBC. After quality assessment,RevMan 5.4 and Stata 15.1 were used to calculate pooled sensitivity and specificity,generate forest plots and summary receiver operating characteristic(SROC)curves,and determine the area under the curve(AUC). Publication bias was assessed using Deeks funnel plot. Heterogeneity was evaluated using the I2 statistic,with meta-regression and subgroup analyses to explore its sources. Results:Twenty-nine studies involving 3 577 patients were included. At a VI-RADS cutoff of 3,the pooled sensitivity and specificity for MIBC diagnosis were 93%(95%CI 0.90-0.95)and 82%(95%CI 0.76-0.88),respectively. At a cutoff of 4,these values were 83%(95%CI 0.78-0.87)and 93%(95%CI 0.90-0.95). The hierarchical SROC(HSROC)AUCs were 0.95 and 0.94 for cutoffs of 3 and 4,respectively. Subgroup and meta-regression analyses revealed that at a cutoff of 3,patient sample size,study design,MRI field strength,number of radiologists,surgical approach,and DWI/DCE imaging planes contributed to sensitivity heterogeneity( P < 0.05). All factors except study design and DWI plane were sources of specificity heterogeneity( P < 0.05). At a cutoff of 4,all factors significantly influenced heterogeneity in both sensitivity and specificity( P < 0.05). Meta-regression confirmed that both cutoffs(3 and 4)were significant sources of heterogeneity( P < 0.05). Conclusions:VI-RADS demonstrates excellent diagnostic performance for MIBC at both cutoffs(3 and 4),with VI-RADS ≥ 3 showing superior sensitivity and VI-RADS ≥ 4 offering higher specificity. The cutoff of 3 provides better overall diagnostic efficacy.

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