1.Intestinal metabolites in colitis-associated carcinogenesis: Building a bridge between host and microbiome.
Yating FAN ; Yang LI ; Xiangshuai GU ; Na CHEN ; Ye CHEN ; Chao FANG ; Ziqiang WANG ; Yuan YIN ; Hongxin DENG ; Lei DAI
Chinese Medical Journal 2025;138(16):1961-1972
Microbial-derived metabolites are important mediators of host-microbial interactions. In recent years, the role of intestinal microbial metabolites in colorectal cancer has attracted considerable attention. These metabolites, which can be derived from bacterial metabolism of dietary substrates, modification of host molecules such as bile acids, or directly from bacteria, strongly influence the progression of colitis-associated cancer (CAC) by regulating inflammation and immune response. Here, we review how microbiome metabolites short-chain fatty acids (SCFAs), secondary bile acids, polyamines, microbial tryptophan metabolites, and polyphenols are involved in the tumorigenesis and development of CAC through inflammation and immunity. Given the heated debate on the metabolites of microbiota in maintaining gut homeostasis, serving as tumor molecular markers, and affecting the efficacy of immune checkpoint inhibitors in recent years, strategies for the prevention and treatment of CAC by targeting intestinal microbial metabolites are also discussed in this review.
Humans
;
Gastrointestinal Microbiome/physiology*
;
Animals
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Carcinogenesis/metabolism*
;
Colitis-Associated Neoplasms/microbiology*
;
Fatty Acids, Volatile/metabolism*
;
Bile Acids and Salts/metabolism*
;
Colitis/microbiology*
2.Mechanism of Modified Shengjiangsan in Improving Diabetic Kidney Disease by Activating Mitochondrial Autophagy Based on PINK1/Parkin Signaling Pathway
Jiaxin LI ; Liya ZHOU ; Yishuo ZHANG ; Ziqiang CHEN ; Yijun HOU ; Jian SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):121-128
ObjectiveTo investigate the mechanism by which modified Shengjiangsan (MSJS) improves diabetic kidney disease (DKD) by activating mitochondrial autophagy. MethodsSixty SPF-grade male Sprague-Dawley rats aged 7-8 weeks were selected. A DKD model was established using a high-sugar, high-fat diet combined with intraperitoneal injection of streptozotocin (STZ). After successful modeling, the rats were randomly divided into six groups: a normal control group, a model group, low-, medium-, and high-dose MSJS groups (7.7, 15.4, 30.8 g·kg-1, respectively), and an irbesartan group (0.384 g·kg-1). Each group received either normal saline or the corresponding drug by gavage once daily for 28 consecutive days. Blood glucose, body weight, and kidney weight were recorded. Serum creatinine (SCr) and blood urea nitrogen (BUN) levels were detected using an automatic blood analyzer. Enzyme-linked immunosorbent assay (ELISA) was used to determine urinary microalbumin (mALB), and serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6). Histopathological changes in renal tissues were observed using hematoxylin-eosin (HE) staining, periodic acid-Schiff (PAS) staining, and transmission electron microscopy (TEM). The expression levels of mitochondrial autophagy-related proteins in renal tissues were analyzed by Western blot. Immunofluorescence co-localization was employed to detect the co-expression of microtubule-associated protein 1 light chain 3 beta (LC3B) and cytochrome c oxidase subunit Ⅳ (COX Ⅳ). ResultsCompared with the normal control group, the model group exhibited significant increases in renal index, blood glucose, and 24-hour urinary microalbumin (24 h mALB) (P<0.05, P<0.01). The levels of serum SCr and BUN were significantly elevated (P<0.01), and the serum levels of TNF-α, IL-1β, and IL-6 were markedly upregulated (P<0.01). Histopathological examination revealed glomerular hypertrophy, mesangial expansion and increased deposition, podocyte foot process flattening and fusion, a decreased number of autophagosomes accompanied by mitochondrial swelling, vacuolar degeneration of renal tubular epithelial cells, and inflammatory cell infiltration in the renal interstitium. The expression levels of autophagy-related proteins LC3B, PTEN-induced putative kinase 1 (PINK1), and E3 ubiquitin-protein ligase (Parkin) were significantly decreased (P<0.05, P<0.01), while expression of the selective autophagy adaptor protein p62 was significantly increased (P<0.01). Immunofluorescence signal intensity and LC3B-COX Ⅳ co-expression were both diminished. Compared with the model group, the MSJS treatment groups and the irbesartan group showed significant reductions in renal index, blood glucose, and 24 h mALB (P<0.05, P<0.01). The serum SCr and BUN levels decreased significantly (P<0.05) and TNF-α, IL-1β, and IL-6 levels were significantly downregulated (P<0.05, P<0.01). Histopathological damage was alleviated, including reduced glomerular hypertrophy, decreased mesangial deposition, and attenuated podocyte foot process fusion. The number of autophagosomes increased, and mitochondrial swelling was improved. The expression levels of LC3B, PINK1, and Parkin in renal tissues were significantly upregulated, whereas p62 expression was significantly downregulated (P<0.05, P<0.01) in MSJS groups. Immunofluorescence signal intensity was enhanced, and LC3B-COX Ⅳ co-expression was increased. ConclusionMSJS alleviates the inflammatory response in DKD rats and exerts renal protective effects by regulating the PINK1/Parkin signaling pathway and activating mitochondrial autophagy.
3.Mechanism of Modified Shengjiangsan in Improving Diabetic Kidney Disease by Activating Mitochondrial Autophagy Based on PINK1/Parkin Signaling Pathway
Jiaxin LI ; Liya ZHOU ; Yishuo ZHANG ; Ziqiang CHEN ; Yijun HOU ; Jian SUN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(12):121-128
ObjectiveTo investigate the mechanism by which modified Shengjiangsan (MSJS) improves diabetic kidney disease (DKD) by activating mitochondrial autophagy. MethodsSixty SPF-grade male Sprague-Dawley rats aged 7-8 weeks were selected. A DKD model was established using a high-sugar, high-fat diet combined with intraperitoneal injection of streptozotocin (STZ). After successful modeling, the rats were randomly divided into six groups: a normal control group, a model group, low-, medium-, and high-dose MSJS groups (7.7, 15.4, 30.8 g·kg-1, respectively), and an irbesartan group (0.384 g·kg-1). Each group received either normal saline or the corresponding drug by gavage once daily for 28 consecutive days. Blood glucose, body weight, and kidney weight were recorded. Serum creatinine (SCr) and blood urea nitrogen (BUN) levels were detected using an automatic blood analyzer. Enzyme-linked immunosorbent assay (ELISA) was used to determine urinary microalbumin (mALB), and serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6). Histopathological changes in renal tissues were observed using hematoxylin-eosin (HE) staining, periodic acid-Schiff (PAS) staining, and transmission electron microscopy (TEM). The expression levels of mitochondrial autophagy-related proteins in renal tissues were analyzed by Western blot. Immunofluorescence co-localization was employed to detect the co-expression of microtubule-associated protein 1 light chain 3 beta (LC3B) and cytochrome c oxidase subunit Ⅳ (COX Ⅳ). ResultsCompared with the normal control group, the model group exhibited significant increases in renal index, blood glucose, and 24-hour urinary microalbumin (24 h mALB) (P<0.05, P<0.01). The levels of serum SCr and BUN were significantly elevated (P<0.01), and the serum levels of TNF-α, IL-1β, and IL-6 were markedly upregulated (P<0.01). Histopathological examination revealed glomerular hypertrophy, mesangial expansion and increased deposition, podocyte foot process flattening and fusion, a decreased number of autophagosomes accompanied by mitochondrial swelling, vacuolar degeneration of renal tubular epithelial cells, and inflammatory cell infiltration in the renal interstitium. The expression levels of autophagy-related proteins LC3B, PTEN-induced putative kinase 1 (PINK1), and E3 ubiquitin-protein ligase (Parkin) were significantly decreased (P<0.05, P<0.01), while expression of the selective autophagy adaptor protein p62 was significantly increased (P<0.01). Immunofluorescence signal intensity and LC3B-COX Ⅳ co-expression were both diminished. Compared with the model group, the MSJS treatment groups and the irbesartan group showed significant reductions in renal index, blood glucose, and 24 h mALB (P<0.05, P<0.01). The serum SCr and BUN levels decreased significantly (P<0.05) and TNF-α, IL-1β, and IL-6 levels were significantly downregulated (P<0.05, P<0.01). Histopathological damage was alleviated, including reduced glomerular hypertrophy, decreased mesangial deposition, and attenuated podocyte foot process fusion. The number of autophagosomes increased, and mitochondrial swelling was improved. The expression levels of LC3B, PINK1, and Parkin in renal tissues were significantly upregulated, whereas p62 expression was significantly downregulated (P<0.05, P<0.01) in MSJS groups. Immunofluorescence signal intensity was enhanced, and LC3B-COX Ⅳ co-expression was increased. ConclusionMSJS alleviates the inflammatory response in DKD rats and exerts renal protective effects by regulating the PINK1/Parkin signaling pathway and activating mitochondrial autophagy.
4.Efficacy of bilateral mini-open Wiltse approach transforaminal lumbar interbody fusion in the treat-ment of lumbar degenerative diseases in the elderly
Qiushui LIN ; Yan LIU ; Zhicai SHI ; Yushu BAI ; Qiulin ZHANG ; Ziqiang CHEN
Chinese Journal of Spine and Spinal Cord 2025;35(4):384-389
Objectives:To investigate the clinical efficacy of bilateral mini-open Wiltse approach transforami-nal lumbar interbody fusion(MO-TLIF)in the treatment of degenerative lumbar diseases in the elderly.Meth-ods:A retrospective analysis was conducted on 62 elderly patients with single-segment degenerative lumbar diseases who underwent MO-TLIF or minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)inthe First Affiliated Hospital of Naval Medical University between September 2017 and August 2020.Among them,37 were male and 25 were female,aged 68.0±5.5 years.The patients were divided into the MO-TLIF group(32 cases)and the MIS-TLIF group(30 cases).There were no statistically significant differences between the two groups in terms of gender ratio,age,body mass index(BMI),surgical segment,disease duration,or follow-up time(P>0.05).The differences between the two groups were compared in terms of operative time,in-traoperative blood loss,intraoperative fluoroscopy,postoperative wound drainage,time to ambulation,hospital stay,complications,and fusion rate.The visual analogue scale(VAS),lumbar Japanese Orthopedic Association(JOA)scores,and Oswestry disability index(ODI)before surgery,at 3 months postoperatively,and at the final follow-up were recorded and compared.Results:The two groups of patients all successfully completed the surgery without significant surgery-related complications.There were no statistically significant differences be-tween the MO-TLIF and MIS-TLIF groups in terms of intraoperative blood loss(80.3±25.1mL vs.72.3±21.8mL),postoperative wound drainage volume(30.7±10.2mL vs.29.3±9.0mL),or hospital stay(5.4±0.9d vs.5.4±0.8d)(P>0.05).Compared with the MIS-TLIF group,the MO-TLIF group had shorter operative time(90.8±8.8min vs.98.3±8.0min,P=0.001)and fewer number of intraoperative fluoroscopy(4.7±0.7 times vs.7.2±1.4 times,P<0.001).Both groups showed significant improvement in low back pain VAS score,lumbar JOA score,and ODI at postoperative 3 months and final follow-up compared with preoperative values(P<0.001),but there were no statistically significant differences between the two groups at the same time points(P>0.05).At the fi-nal follow-up,no internal fixation-related complications such as screw or rod breakage were observed in both groups,and all the cases achieved bone fusion.Conclusions:Bilateral MO-TLIF can achieve good therapeutic outcomes in treating single-segment degenerative lumbar diseases,which can reduce intraoperative fluoroscopy frequency and shorten operative time comparing with MIS-TLIF.
5.Proximal pericolic lymph node metastasis beyond 10 cm in rectal cancer: patterns of prognostic impact of extended resection in a prospective cohort study
Xuyang YANG ; Yang ZHANG ; Lina YE ; Qingbin WU ; Tinghan YANG ; Mingtian WEI ; Xiangbing DENG ; Haining CHEN ; Wenjian MENG ; Ziqiang WANG
Chinese Journal of Gastrointestinal Surgery 2025;28(9):1015-1025
Objective:To determine the actual metastasis rate of paracolic lymph nodes (PCN) more than 10 cm proximal to rectal tumors and explore the significance of PCN dissection in the prognosis of patients with rectal cancer. ?Methods:This was a prospective observational cohort study. The clinical data of 457 consecutive patients with rectal cancer who underwent radical surgery at the Colorectal Tumor Center of West China Hospital, Sichuan University from January 2015 to May 2022 were included. Inclusion criteria: (1) Pathologically confirmed rectal adenocarcinoma (anal margin ≤ 12 cm); (2) R0 resection was performed with a proximal margin ≥ 10 cm (measured on the in vivo specimen during surgery after intestinal mobilization); (3) For stage IV patients, only those with resectable metastatic lesions by R0 were included; (4) Patients who completed the full course of neoadjuvant therapy (TNT) must meet the surgical window of 8-12 weeks after radiotherapy. Exclusion criteria: tumors located more than 15 cm from the anal margin, synchronous multiple primary colorectal cancers, positive tumor margins, preoperative imaging suggesting lateral lymph node metastasis (LLNM), presence of Lynch syndrome or familial adenomatous polyposis, emergency surgery, recurrence after rectal cancer surgery, T4b tumors requiring combined organ resection, previous radiotherapy and chemotherapy for non-rectal cancer, and those with cardiac, pulmonary, renal and other organ dysfunction that could not tolerate surgery. After standard total mesorectal excision (TME), the proximal intestinal tube was transected at a level more than 10 cm above the lesion, and then intestinal anastomosis or enterostomy was completed. The distance from the tumor edge was marked and measured in vivo during the operation, and lymph nodes were harvested from the fresh specimen. Patients with PCN metastasis beyond 10 cm proximal to the tumor were classified into the positive lymph node group (pPCN group), while those without PCN metastasis beyond 10 cm proximal to the tumor were classified into the negative lymph node group (nPCN group). The differences in clinicopathological characteristics, overall survival (OS) and disease-free survival (DFS) between the two groups were compared, and risk factor analysis and survival analysis of pPCN were performed.Results:There were 16 cases (3.5%) in the pPCN group, 15 cases (3.3%) had central lymph node metastasis; the nPCN group included 441 cases. When comparing the baseline characteristics between the pPCN group and the nPCN group, there was no statistically significant difference in other aspects except that the cN stage was more advanced in the pPCN group ( P=0.006) (all P>0.05). The number of positive mesenteric lymph nodes in the pPCN group was higher than that in the nPCN group ( P<0.001), and the proportion of patients with a total number of harvested lymph nodes ≥12 and the number of lymph nodes with a short diameter >5 mm were both higher (all P<0.05). The proportion of patients with positive lymph nodes within 10 cm and the number of positive lymph nodes within 10 cm were also higher in the pPCN group (both P<0.001). Similar to the clinical TNM staging, the proportions of patients with pT3 and N2 stages, as well as the incidence of poorly differentiated tumors (G3, G4) were higher in the pPCN group ( P<0.001). The results of multivariate analysis showed that among the preoperative pathological characteristic variables, the presence of positive lymph nodes within 10 cm (OR=14.869, 95%CI: 2.993-73.858, P=0.001) and low tumor differentiation grade (OR=7.189, 95%CI: 2.091- 24.714, P=0.002) were independent risk factors for pPCN. The median follow-up time of the patients in this group was 63 (0-63) months. No local recurrence occurred in the pPCN group, and the 5-year OS was 50.0%, which was significantly lower than 78.0% in the nPCN group (HR=2.496, 95%CI: 1.263-4.930, P=0.008). The 3-year DFS was 43.8%, also significantly lower than 77.7% in the nPCN group (HR=2.950, 95%CI:1.488-5.846, P=0.002). Multivariate Cox prognostic analysis suggested that age ≥65 years (HR=2.041, 95%CI: 1.375-3.031, P<0.001), female (HR=1.838, 95%CI: 1.171-2.884, P=0.008), tumor length ≥3 cm (HR=1.747, 95%CI: 1.076-2.834, P=0.024), more advanced cT stage (HR=2.865, 95%CI: 1.234-6.653, P=0.014), and cM1 (HR=4.368, 95%CI: 2.480-7.694, P<0.001) were independent risk factors affecting OS. No neoadjuvant therapy (HR=0.636, 95%CI: 0.413-0.980, P=0.040) and cM1 (HR=5.556, 95%CI: 3.335-9.256, P<0.001) were independent risk factors affecting DFS. pPCN showed a tendency to be an independent risk factor for DFS (HR=1.942, 95%CI: 0.966-3.906, P=0.063). Conclusion:The incidence of pPCN is higher than expected, and the prognosis of patients is poor. Patients with high-risk factors may benefit from extended proximal intestinal resection (>10 cm) to avoid residual positive PCN, thereby reducing local recurrence.
6.Efficacy of bilateral mini-open Wiltse approach transforaminal lumbar interbody fusion in the treat-ment of lumbar degenerative diseases in the elderly
Qiushui LIN ; Yan LIU ; Zhicai SHI ; Yushu BAI ; Qiulin ZHANG ; Ziqiang CHEN
Chinese Journal of Spine and Spinal Cord 2025;35(4):384-389
Objectives:To investigate the clinical efficacy of bilateral mini-open Wiltse approach transforami-nal lumbar interbody fusion(MO-TLIF)in the treatment of degenerative lumbar diseases in the elderly.Meth-ods:A retrospective analysis was conducted on 62 elderly patients with single-segment degenerative lumbar diseases who underwent MO-TLIF or minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF)inthe First Affiliated Hospital of Naval Medical University between September 2017 and August 2020.Among them,37 were male and 25 were female,aged 68.0±5.5 years.The patients were divided into the MO-TLIF group(32 cases)and the MIS-TLIF group(30 cases).There were no statistically significant differences between the two groups in terms of gender ratio,age,body mass index(BMI),surgical segment,disease duration,or follow-up time(P>0.05).The differences between the two groups were compared in terms of operative time,in-traoperative blood loss,intraoperative fluoroscopy,postoperative wound drainage,time to ambulation,hospital stay,complications,and fusion rate.The visual analogue scale(VAS),lumbar Japanese Orthopedic Association(JOA)scores,and Oswestry disability index(ODI)before surgery,at 3 months postoperatively,and at the final follow-up were recorded and compared.Results:The two groups of patients all successfully completed the surgery without significant surgery-related complications.There were no statistically significant differences be-tween the MO-TLIF and MIS-TLIF groups in terms of intraoperative blood loss(80.3±25.1mL vs.72.3±21.8mL),postoperative wound drainage volume(30.7±10.2mL vs.29.3±9.0mL),or hospital stay(5.4±0.9d vs.5.4±0.8d)(P>0.05).Compared with the MIS-TLIF group,the MO-TLIF group had shorter operative time(90.8±8.8min vs.98.3±8.0min,P=0.001)and fewer number of intraoperative fluoroscopy(4.7±0.7 times vs.7.2±1.4 times,P<0.001).Both groups showed significant improvement in low back pain VAS score,lumbar JOA score,and ODI at postoperative 3 months and final follow-up compared with preoperative values(P<0.001),but there were no statistically significant differences between the two groups at the same time points(P>0.05).At the fi-nal follow-up,no internal fixation-related complications such as screw or rod breakage were observed in both groups,and all the cases achieved bone fusion.Conclusions:Bilateral MO-TLIF can achieve good therapeutic outcomes in treating single-segment degenerative lumbar diseases,which can reduce intraoperative fluoroscopy frequency and shorten operative time comparing with MIS-TLIF.
7.Proximal pericolic lymph node metastasis beyond 10 cm in rectal cancer: patterns of prognostic impact of extended resection in a prospective cohort study
Xuyang YANG ; Yang ZHANG ; Lina YE ; Qingbin WU ; Tinghan YANG ; Mingtian WEI ; Xiangbing DENG ; Haining CHEN ; Wenjian MENG ; Ziqiang WANG
Chinese Journal of Gastrointestinal Surgery 2025;28(9):1015-1025
Objective:To determine the actual metastasis rate of paracolic lymph nodes (PCN) more than 10 cm proximal to rectal tumors and explore the significance of PCN dissection in the prognosis of patients with rectal cancer. ?Methods:This was a prospective observational cohort study. The clinical data of 457 consecutive patients with rectal cancer who underwent radical surgery at the Colorectal Tumor Center of West China Hospital, Sichuan University from January 2015 to May 2022 were included. Inclusion criteria: (1) Pathologically confirmed rectal adenocarcinoma (anal margin ≤ 12 cm); (2) R0 resection was performed with a proximal margin ≥ 10 cm (measured on the in vivo specimen during surgery after intestinal mobilization); (3) For stage IV patients, only those with resectable metastatic lesions by R0 were included; (4) Patients who completed the full course of neoadjuvant therapy (TNT) must meet the surgical window of 8-12 weeks after radiotherapy. Exclusion criteria: tumors located more than 15 cm from the anal margin, synchronous multiple primary colorectal cancers, positive tumor margins, preoperative imaging suggesting lateral lymph node metastasis (LLNM), presence of Lynch syndrome or familial adenomatous polyposis, emergency surgery, recurrence after rectal cancer surgery, T4b tumors requiring combined organ resection, previous radiotherapy and chemotherapy for non-rectal cancer, and those with cardiac, pulmonary, renal and other organ dysfunction that could not tolerate surgery. After standard total mesorectal excision (TME), the proximal intestinal tube was transected at a level more than 10 cm above the lesion, and then intestinal anastomosis or enterostomy was completed. The distance from the tumor edge was marked and measured in vivo during the operation, and lymph nodes were harvested from the fresh specimen. Patients with PCN metastasis beyond 10 cm proximal to the tumor were classified into the positive lymph node group (pPCN group), while those without PCN metastasis beyond 10 cm proximal to the tumor were classified into the negative lymph node group (nPCN group). The differences in clinicopathological characteristics, overall survival (OS) and disease-free survival (DFS) between the two groups were compared, and risk factor analysis and survival analysis of pPCN were performed.Results:There were 16 cases (3.5%) in the pPCN group, 15 cases (3.3%) had central lymph node metastasis; the nPCN group included 441 cases. When comparing the baseline characteristics between the pPCN group and the nPCN group, there was no statistically significant difference in other aspects except that the cN stage was more advanced in the pPCN group ( P=0.006) (all P>0.05). The number of positive mesenteric lymph nodes in the pPCN group was higher than that in the nPCN group ( P<0.001), and the proportion of patients with a total number of harvested lymph nodes ≥12 and the number of lymph nodes with a short diameter >5 mm were both higher (all P<0.05). The proportion of patients with positive lymph nodes within 10 cm and the number of positive lymph nodes within 10 cm were also higher in the pPCN group (both P<0.001). Similar to the clinical TNM staging, the proportions of patients with pT3 and N2 stages, as well as the incidence of poorly differentiated tumors (G3, G4) were higher in the pPCN group ( P<0.001). The results of multivariate analysis showed that among the preoperative pathological characteristic variables, the presence of positive lymph nodes within 10 cm (OR=14.869, 95%CI: 2.993-73.858, P=0.001) and low tumor differentiation grade (OR=7.189, 95%CI: 2.091- 24.714, P=0.002) were independent risk factors for pPCN. The median follow-up time of the patients in this group was 63 (0-63) months. No local recurrence occurred in the pPCN group, and the 5-year OS was 50.0%, which was significantly lower than 78.0% in the nPCN group (HR=2.496, 95%CI: 1.263-4.930, P=0.008). The 3-year DFS was 43.8%, also significantly lower than 77.7% in the nPCN group (HR=2.950, 95%CI:1.488-5.846, P=0.002). Multivariate Cox prognostic analysis suggested that age ≥65 years (HR=2.041, 95%CI: 1.375-3.031, P<0.001), female (HR=1.838, 95%CI: 1.171-2.884, P=0.008), tumor length ≥3 cm (HR=1.747, 95%CI: 1.076-2.834, P=0.024), more advanced cT stage (HR=2.865, 95%CI: 1.234-6.653, P=0.014), and cM1 (HR=4.368, 95%CI: 2.480-7.694, P<0.001) were independent risk factors affecting OS. No neoadjuvant therapy (HR=0.636, 95%CI: 0.413-0.980, P=0.040) and cM1 (HR=5.556, 95%CI: 3.335-9.256, P<0.001) were independent risk factors affecting DFS. pPCN showed a tendency to be an independent risk factor for DFS (HR=1.942, 95%CI: 0.966-3.906, P=0.063). Conclusion:The incidence of pPCN is higher than expected, and the prognosis of patients is poor. Patients with high-risk factors may benefit from extended proximal intestinal resection (>10 cm) to avoid residual positive PCN, thereby reducing local recurrence.
8.Intelligent assessment of pedicle screw canals with ultrasound based on radiomics analysis
Tianling TANG ; Yebo MA ; Huan YANG ; Changqing YE ; Youjin KONG ; Zhuochang YANG ; Chang ZHOU ; Jie SHAO ; Bingkun MENG ; Zhuoran WANG ; Jiangang CHEN ; Ziqiang CHEN
Academic Journal of Naval Medical University 2024;45(11):1362-1370
Objective To propose a classification method for ultrasound images of pedicle screw canals based on radiomics analysis,and to evaluate the integrity of the screw canal.Methods With thoracolumbar spine specimens from 4 fresh cadavers,50 pedicle screw canals were pre-established and ultrasound images of the canals were acquired.A total of 2 000 images(1 000 intact and 1 000 damaged canal samples)were selected.The dataset was randomly divided in a 4∶1 ratio using 5-fold cross-validation to form training and testing sets(consisting of 1 600 and 400 samples,respectively).Firstly,the optimal radius of the region of interest was identified using the Otsu's thresholding method,followed by feature extraction using pyradiomics.Principal component analysis and the least absolute shrinkage and selection operator algorithm were employed for dimensionality reduction and feature selection,respectively.Subsequently,3 machine learning models(support vector machine[SVM],logistic regression,and random forest)and 3 deep learning models(visual geometry group[VGG],ResNet,and Transformer)were used to classify the ultrasound images.The performance of each model was evaluated using accuracy.Results With a region of interest radius of 230 pixels,the SVM model achieved the highest classification accuracy of 96.25%.The accuracy of the VGG model was only 51.29%,while the accuracies of the logistic regression,random forest,ResNet,and Transformer models were 85.50%,80.75%,80.17%,and 75.18%,respectively.Conclusion For ultrasound images of pedicle screw canals,the machine learning model performs better than the deep learning model as a whole,and the SVM model has the best classification performance,which can be used to assist physicians in diagnosis.
9.Advances in prostate cancer biomarkers.
Zibin CHU ; Ye XU ; Ziqiang YIN ; Jingfeng CAO ; Chengyu JIN ; Xiaoyang CHEN ; Zhao YANG
Chinese Journal of Biotechnology 2024;40(11):3951-3973
Prostate cancer is one of the most common malignant tumors in men and posing a serious threat to men's health. Detection methods such as prostate-specific antigen (PSA), prostate biopsy, and magnetic resonance imaging are widely used for prostate cancer screening, but they have low specificity, high cost, and significant risks. Therefore, there is an urgent need to develop highly specific, low-cost, easily obtained, stable, and reliable biomarkers, and use them as the basis to establish non-invasive screening and diagnostic methods for prostate cancer. This paper reviewed the recent advances in the use of prostate cancer biomarkers and combined detection methods for prostate cancer diagnosis and prognosis assessment and provides an in-depth analysis and comparison of different biomarkers and combined detection methods, as well as points out the directions and challenges for future research. The paper emphasizes the importance of developing efficient, cost-effective and easy-to-implement biomarkers to increase the early diagnosis rate of prostate cancer, improve patient prognosis, and reduce the waste of healthcare resources. This paper provides an important theoretical basis and technical guidance for early diagnosis, precise treatment and prognostic evaluation of prostate cancer, and has important reference value for promoting clinical research and practice of prostate cancer.
Humans
;
Male
;
Prostatic Neoplasms/diagnosis*
;
Biomarkers, Tumor/blood*
;
Early Detection of Cancer/methods*
;
Prognosis
;
Prostate-Specific Antigen/blood*
;
Glutamate Carboxypeptidase II/metabolism*
;
Antigens, Neoplasm/blood*
;
Antigens, Surface
;
Serine Endopeptidases
10.A Ten-Year Comparative Study on Ethical Cognition of Experimental Animals among Medical Students in a University
Xuan LEI ; Xiangyi MING ; Han YANG ; Zixu CHEN ; Dandan FENG ; Jing DENG ; Ziqiang LUO
Chinese Medical Ethics 2024;35(5):533-537
The study was carried out to understand the changes in the ethical cognition status of laboratory animals and the effectiveness of laboratory animal ethics education among medical students in Xiangya School of Medicine of Central South University (CSU), and provide new enlightenment for further strengthening the ethical education of laboratory animals. In the study, the same self-compiled questionnaire was used to investigate the ethical cognition of experimental animals among medical students in Xiangya School of Medicine of CSU in 2011 and 2021, and 359 and 363 questionnaires were collected respectively. Through comparative analysis of the questionnaire results before and after ten years, it was found that medical students’ animal experiment operation and attitudes towards laboratory animals, cognition of experimental animal ethics knowledge and their attitude to animal experiment ethics education were significantly improved. It showed that the state of experimental animal ethics cognition among medical students in Xiangya School of Medicine of CSU had improved significantly in recent 10 years, but the cognition of experimental animal ethics knowledge was higher than the actual behavior of caring for experimental animals, and there was the phenomenon of "separation of knowledge and action". The ethics education of experimental animals needs to pay more attention to the development of students’ behavior of caring for experimental animals.

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