1.Marginal Zone Lymphoma with Recurrent Intestinal Obstruction After Multiple Chemotherapy: A Case Report
Sirui HAN ; Yan ZHANG ; Guannan ZHANG ; Peijun LIU ; Wen SHI ; Wenbo LI ; Rongrong LI ; Congwei JIA ; Jian CAO ; Wei WANG
Medical Journal of Peking Union Medical College Hospital 2025;16(5):1344-1351
This article reports a diagnostically and therapeutically challenging case of small intestinal marginal zone lymphoma. The patient presented with recurrent abdominal pain as the chief complaint, and imaging revealed multifocal small bowel wall thickening with high uptake, multisegmental luminal stenosis, and proximal dilation. Initial diagnostic workup, including gastroscopy, colonoscopy, and enteroscopy with biopsy, failed to establish a definitive diagnosis. Empirical anti-tuberculosis therapy was ineffective. A repeat enteroscopic biopsy performed over eight months after symptom onset eventually confirmed the diagnosis of mucosa-associated lymphoid tissue (MALT) extranodal marginal zone lymphoma. Despite three different chemotherapy regimens, the patient's intestinal obstruction symptoms persisted, with imaging still showing multifocal bowel wall thickening and hypermetabolic activity. A critical diagnostic dilemma arose regarding whether the PET/CT-positive lesions represented residual lymphoma or fibrotic scarring, whether further chemotherapy adjustments were warranted, and whether surgical resection was necessary. Multidisciplinary discussion concluded that imaging had limited discriminatory value in this scenario and that surgical intervention should be pursued if feasible. The patient successfully underwent partial small bowel resection, with postoperative pathology confirming no residual lymphoma but significant fibrotic changes. The patient has since resumed a normal diet, with body weight nearly restored to pre-illness levels. This case highlights that fibrotic transformation is a common sequela of treated marginal zone lymphoma and that PET/CT may misleadingly suggest residual disease, potentially leading to unnecessary chemotherapy. Timely surgical intervention is crucial in such scenarios.
2.Validation of breast cancer as a risk factor for anxiety and depression: Insights from Mendelian randomization analysis.
Guannan HE ; Man XI ; Tianhao ZHANG ; Shuang WANG ; Gang LIU
Journal of Pharmaceutical Analysis 2025;15(9):101378-101378
This study employed Mendelian randomization (MR) analysis to confirm the association between breast cancer and the risk of anxiety and depression, and to explore the molecular mechanisms by which lipid nanoparticles of ketamine (LNP@Ket) modulate these behaviors in a mouse model of breast cancer. Through single-cell transcriptomic analysis, the study aimed to clarify nuclear factor erythroid 2-related factor 2 (Nrf2)'s role in the development of anxiety and depression in these mice. Analysis of patient data from genome-wide association study (GWAS) databases supported the link between breast cancer, anxiety, and depression. In vivo experiments demonstrated that treating breast cancer mice with LNP@Ket significantly reduced anxiety and depression behaviors. The synthesis of LNP@Ket and its subsequent analysis highlighted its inhibitory effects on these behaviors. Single-cell transcriptomic sequencing identified key cells and genes affected by LNP@Ket treatment, particularly emphasizing Nrf2. Upregulation of Nrf2 in astrocytes increased the expression of antioxidant enzymes and reduced pro-inflammatory cytokines, alleviating anxiety and depression symptoms by inhibiting neuroinflammation and neurodegeneration. This comprehensive study highlights the pivotal role of Nrf2 in the therapeutic efficacy of LNP@Ket for treating anxiety and depression in breast cancer mice.
3.Acupuncture with Manipulation for Lumbar Disc Herniation in Remission of 50 Cases:A Randomized Controlled Trial
Chun CHEN ; Jiao JIN ; Jingxuan MO ; Hai LIN ; Fudong SHI ; Guojun WANG ; Guannan WU ; Shimin ZHANG
Journal of Traditional Chinese Medicine 2024;65(10):1026-1032
ObjectiveTo evaluate the clinical effectiveness and safety of acupuncture with manipulation for lumbar disc herniation in remission period. MethodsOne hundred and four patients with lumbar disc herniation in remission were randomly divided into a treatment group and a control group, with 52 cases in each group. Treatment group applied acupuncture with manipulation of pointing, pulling, and shaking. Acupoints were selected as lumbar Jiaji (EX-B2, bilateral), Ashi point, Shenshu (BL 23, bilateral), Huantiao (GB 30, bilateral), Weizhong (BL 40, opposite side of the affected area), Chengshan (BL 57, opposite side of the affected area). The control group applied lumbar traction plus acupoint ultrasonic pulse penetration therapy (acupoints selection same as the treatment group); 20 minutes each time, 3 times a week, a total of 3 weeks for both groups. The primary outcome was the improvement rate of lumbar disc herniation symptoms and signs, which was calculated at 1 week of treatment, 3 weeks of treatment, 1 month follow-up, and 3 months follow-up, respectively; the secondary outcome were the Japanese Orthopaedic Association (JOA) scores, Visual Analogue Scale (VAS) scores, and Oswestry Disability Index (ODI) scores (including ODI total scores, sitting scores and standing scores), which were evaluated before treatment, 1 week of treatment, 3 weeks of treatment, 1 month follow-up, and 3 months follow-up; clinical effectiveness was assessed at 3 months follow-up; and the occurrence of adverse events in the participants, as well as blood routine, urine routine, stool routine, and electrocardiograms before and after the treatment were recorded to evaluate safety. ResultsTwo patients from each group fell out, and 50 patients of each group were included in the outcome analysis ultimately. The scores of lumbar disc herniation symptoms and signs improved more in the treatment group than in the control group at 1 week of treatment, 3 weeks of treatment, 1 month follow-up and 3 months follow-up (P<0.01). The JOA scores of participants in both groups at 1 week of treatment, 3 weeks of treatment, 1 month follow-up and 3 months follow-up were higher than those before treatment in the same group, and the VAS scores, ODI total scores, ODI sitting scores and standing scores were significantly lower than those before treatment in the same group (P<0.05), and the JOA scores of patients in the treatment group were higher than those of the control group at all time points, and the VAS scores, ODI total scores, ODI sitting scores and standing score were lower than those of the control group (P<0.05). At the 3 months follow-up, the excellent rate of the treatment group was 70.00% (35/50) better than that of the control group, which was 50.00% (25/50) (P<0.05). There were no abnormalities in blood, urine, stool routines and electrocardiograms before and after treatment in both groups, and no adverse events occurred. ConclusionAcupuncture with manipulation of pointing, pulling, and shaking for treating patients with lumbar disc herniation in remission has a better safety on pain relief and improving quality of life, and the effectiveness is better than lumbar traction plus acupoint ultrasonic pulse penetration therapy.
4.The First Application of Domestically Produced Self-expanding Transcatheter Aortic Valve Controllable Bending Delivery System in China
Yang CHEN ; Guoliang CHEN ; Di SONG ; Hongliang ZHANG ; Moyang WANG ; Guannan NIU ; Zheng ZHOU ; Qian ZHANG ; Qingrong LIU ; Zhenyan ZHAO ; Jie ZHAO ; Bin ZHANG ; Dejing FENG ; Wence SHI ; Jicheng XI ; Yongjian WU
Chinese Circulation Journal 2024;39(3):285-289
A domestically produced self-expanding transcatheter aortic valve controllable bending delivery system(VitaFlow? Ⅲcontrollable bending retrievable delivery system)was first used to perform transcatheter aortic valve replacement(TAVR)in a symptomatic severe aortic valve stenosis patient with severe heart failure and high risk of surgery in China on September 22,2023.The patient successfully completed TAVR under general anesthesia,with good valve position and function after the operation.Before discharge and at one month of follow-up,the patient's symptoms and degree of heart failure were significantly improved.The follow-up results of this case showed that the VitaFlow? Ⅲ controllable bending retrievable delivery system for TAVR is safe and feasible,and future prospective,multicenter clinical trials are expected to evaluate its efficacy.
5.Comparison of interoperability among the standard systems of Chinese,the United States,European,and Japanese Pharmacopoeias and other standard systems
Xinyi XU ; Zhen LIU ; Leran TAO ; Haoyun SONG ; Dan LI ; Wenli YU ; Guannan WANG ; Heng LI ; Yun WANG ; Zhaopeng YANG
China Pharmacist 2024;27(2):233-241
Objective To provide reference for the optimization and improvement of interoperability between the standard system of the Chinese Pharmacopoeia and other standards.Methods The interoperability of various pharmacopoeia standard systems was compared by searching for citations from the Chinese Pharmacopoeia,the United States Pharmacopoeia-National Formulary,the European Pharmacopoeia,the Japanese Pharmacopoeia,and other standards,including references to domestic regulations and guidelines,standards of the International Organization for Standardization,guidelines from the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use,documents of the World Health Organization,and standards from other countries and international organizations.Results In recent years,pharmacopoeias in the world had continuously increased the citation of non pharmacopoeial standards.The types,quantities,and fields of the United States Pharmacopoeia-National Formulary referencing other standards far exceed those of other pharmacopoeias.The Chinese Pharmacopoeia cites the least number of other standards.Conclusion It is suggested that the Chinese Pharmacopoeia should enhance the interoperability with other standard systems in the standards of various professional fields,enhance the openness,harmonization and advantages,and form a more complete standard system.
6.Application of indocyanine green fluorescence imaging in laparoscopic surgery for pancreatic cancer
Shihang XI ; Xiaoming WANG ; Guannan WANG ; Yaqi JIANG ; Daohai QIAN ; Xiaosan FANG
Chinese Journal of Hepatobiliary Surgery 2024;30(3):193-196
Objective:To analyze the application of indocyanine green (ICG) fluorescence imaging in laparoscopic resection of pancreatic cancer.Methods:Data of 15 patients undergoing laparoscopic surgery for pancreatic cancer in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Wannan Medical College from June 2022 to March 2023 were retrospectively analyzed, including 13 males and 2 females, aged (67.0±8.6) years. ICG were intraoperatively injected to visualize the lesion and guide surgical resection. The surgical methods, postoperative pathology, ICG fluorescence imaging and tumor margins were reviewd.Results:Among the patients, seven underwent laparoscopic pancreaticoduodenectomy, seven underwent laparoscopic radical antegrade modular pancreaticosplenectomy, and one conversed to open pancreaticoduodenectomy due to combined superior mesenteric vein reconstruction. Postoperative pathology confirmed pancreatic moderately differentiated adenocarcinoma in nine cases, pancreatic moderately-low differentiated adenocarcinoma in four cases, pancreatic follicular cell carcinoma in one case, and inflammatory lesion in one case. Negative surgical margins were confirmed in all cases. Pancreatic lesion were visualized in 14 cases (fluorescent delineation of the tumor capsule) but not well visualized in one case (with moderately differentiated adenocarcinoma). In the case of inflammatory disease, the lesion parenchyma were visualized.Conclusion:ICG injection in laparoscopic surgery enables visualization of pancreatic tumor, which facilitates tumor localization and margin determination.
7.High grade B cell lymphoma with concurrent MYC rearrangement and 11q aberrations:a clinicopathological analysis
Susu LU ; Guannan WANG ; Wugan ZHAO ; Dandan ZHANG ; Yanping ZHANG ; Sixia HUANG ; Enjie LIU ; Weiwei WANG ; Lan ZHANG ; Wencai LI
Chinese Journal of Clinical and Experimental Pathology 2024;40(1):24-28
Purpose To investigate the clinicopathological features,molecular genetics and prognosis of high grade B cell lymphoma with concurrent MYC rearrangement and 11q aberra-tions(HGBCL-MYC-11q).MethodsThree cases of HGBCL-MYC-11q were reviewed and analyzed using hematoxylin-eosin staining,immunohistochemistry,EBER in situ hybridization and fluorescence in situ hybridization.Clinical data were collected with follow-up.Results All three patients were male,age was 10,61,and 74 years,respectively.All patients had Ann Arbor stage Ⅳ disease.All three cases were biopsies occurring in the nasopharynx,upper pharynx and ileocecus,respectively.Three cases were morphologically similar to diffuse infiltrative growth of tumor cells,moderate or moderately large cells,round to slightly irregular nuclei and easily visible mitotic figures.Focal necrosis was noted in one case.One case exhibited the distinct"starry sky"pattern.All cases expressed CD20,BCL6 and MUM1 and high Ki67 index,two cases expressed CD10 and two cases ex-pressed BCL2.CD3,CD30 and TDT were all negative.EBER in situ hybridization was all negative.FISH analyses using C-MYC break-apart probes were all positive and all cases had 11q aberrations.One case only had the 11q23.3 amplification;and one case only had the 11q24.3 loss.After a follow-up for 1-18 months,one patient died and two patients survived with disease.ConclusionHGBCL-MYC-11q is rare,morphologically similar to BL/HGBCL,with MYC rearrangement and 11q abnormali-ties.We should enhance awareness of the disease and improve more accurate diagnosis and differential diagnosis of the disease.
8.Reducing language barriers, promoting information absorption, and communication using fanyi
Difei WANG ; Guannan CHEN ; Lin LI ; Shaodi WEN ; Zijing XIE ; Xiao LUO ; Li ZHAN ; Shuangbin XU ; Junrui LI ; Rui WANG ; Qianwen WANG ; Guangchuang YU
Chinese Medical Journal 2024;137(16):1950-1956
Interpreting genes of interest is essential for identifying molecular mechanisms, but acquiring such information typically involves tedious manual retrieval. To streamline this process, the fanyi package offers tools to retrieve gene information from sources like National Center for Biotechnology Information (NCBI), significantly enhancing accessibility. Additionally, understanding the latest research advancements and sharing achievements are crucial for junior researchers. However, language barriers often restrict knowledge absorption and career development. To address these challenges, we developed the fanyi package, which leverages artificial intelligence (AI)-driven online translation services to accurately translate among multiple languages. This dual functionality allows researchers to quickly capture and comprehend information, promotes a multilingual environment, and fosters innovation in academic community. Meanwhile, the translation functions are versatile and applicable beyond biomedicine research to other domains as well. The fanyi package is freely available at https://github.com/YuLab-SMU/fanyi.
9.Research progress on antimicrobial mechanism and application of metal-based nanoenzymes
Journal of Shenyang Medical College 2024;26(5):449-453
Diseases caused by bacteria have attracted extensive human attention.In recent years,bacterial resistance has been gradually increasing,so there is an urgent need to develop new antimicrobial agents.With the rapid development of nanomaterials,nanomaterials with enzyme-like catalytic activity(nanoenzymes)have gradually attracted attention.Nanoenzymes have the unique physicochemical properties of nanomaterials and enzyme catalytic activity,with stable structure and low production cost.Among them,metal-based nanoenzymes play a great application value in the field of antibacterial.This paper provides an overview based on metal-based nanoenzymes materials and further reviews the antimicrobial mechanism and application of metal-based nanoenzymes,as well as the future challenges and prospects of bacteriostatic nanoenzymes.
10.Comparison of the anorectal function before and after neoadjuvant radiotherapy in mid-low rectal cancer: a retrospective observational study from single center
Zhen SUN ; Zhifeng WANG ; Xiyu SUN ; Lai XU ; Guannan ZHANG ; Junyang LU ; Yi XIAO
Chinese Journal of Gastrointestinal Surgery 2024;27(1):63-68
Objective:The aim of this study was to evaluate the impact of neoadjuvant radiotherapy on anorectal function of patients with mid-low rectal cancer by means of high-resolution anorectal manometry.Methods:A retrospective observational study was conducted. Information on patients with mid-low rectal cancer was collected from the prospective registry database of Rectal Cancer at Peking Union Medical College Hospital (PUMCH) from June 2020 to April 2023. Anorectal functions were detected using three-dimensional high-resolution manometry system. Logistic regression analysis was performed to identify the factors associated with the changed anorectal manometry.Results:A total of 45 patients with mid-low rectal cancer were included in the study. Thirty-two (71.1%) patients were male, 13 (28.9%) patients were female. The mean age was 60±11 years, and the mean BMI was 23.4±3.7 kg/m 2. The mean distance between the lower edge of the tumor and the anal verge was 5.4±1.5 cm. The median size of the tumor was 3.4 (2.9-4.5) cm, and the median circumferential extent of the tumor was 66.0 (45.5-75.0) %. 41 (81.1%) patients were MRI T3-4 and 40 (88.9%) patients were MRI N positive. The resting pressure has a decreasing trend after neoadjuvant radiotherapy (55.3±32.0 mmHg vs. 48.0±28.5 mmHg, t=1.930, P=0.060). There was no significant change in maximum squeezing and the length of the high-pressure zone after neoadjuvant radiotherapy. All volumes describing rectal sensitivity (first sensation, desire to defecate, and maximum tolerance) were lower after neoadjuvant radiotherapy. And maximum tolerance was significantly lower (66.0 [49.0,88.0] ml vs. 52.0 [39.0,73.5] ml, Z=-2.481, P=0.013). Univariate analysis demonstrated that the downstage of N-stage was associated with the decrease in maximum tolerance (OR=6.533, 95%CI:1.254-34.051, P=0.026). Conclusion:Neoadjuvant radiotherapy damages anorectal function by decreasing the resting pressure and rectal sensory threshold of patients. The N-stage downstaging was associated with a decrease in maximum tolerance.

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