1.Key Points for Quality Management in Phase Ⅰ Clinical Trials of Anti-Tumor Drugs
Li GONG ; Bin LIAO ; Jie SHEN ; Juan ZHAO ; Yi GONG ; Xiaoxiao LU ; Huiyao YANG ; Sha LI ; Yongsheng LI
Cancer Research on Prevention and Treatment 2025;52(5):347-354
Phase Ⅰ clinical trials play a crucial role in the research and development of new drugs, serving as the initial studies to assess their safety, tolerability, effectiveness, and pharmacokinetic properties in humans. These trials involve uncertainties regarding safety and efficacy. Comprehensive management of all aspects of phase Ⅰ clinical trials for anti-tumor drugs is crucial to protect the rights and safety of participants. This article provides an in-depth analysis of the key points and precautions necessary for effective quality control throughout the process. The analysis is informed by guidelines such as the “Good Clinical Practice for Drugs” “Key Points and Judgment Principles for Drug Registration Verification” “Key Points and Judgment Principles for Supervision and Inspection of Drug Clinical Trial Institutions” and the standard operating procedures for quality control of the center. Topics discussed include informed consent, inclusion criteria, experimental drugs, biological samples, adverse events, and serious adverse events. The goal is to standardize quality control in phase Ⅰ clinical trials of anti-tumor drugs, ensure the authenticity and reliability of clinical trial data, and protect the rights and safety of participants.
2.Mechanism of Medicated Serum of Buyang Huanwutang in Inhibiting Endothelial-to-mesenchymal Transition of Human Pulmonary Artery Endothelial Cells Based on Wnt1/β-catenin Signaling Pathway
Qifen YANG ; Jinglian QU ; Huiliang ZHAO ; Yongsheng GUO ; Long CHEN
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(7):49-58
ObjectiveTo investigate the role of the Wnt1/β-catenin signaling pathway in the intervention of medicated serum of Buyang Huanwutang (BYHWT) in endothelial-to-mesenchymal transition (EndMT) of human pulmonary artery endothelial cells (HPAECs) as well as its related mechanisms. MethodMedicated serum of BYHWT was prepared by gavage to New Zealand rabbits with a dosage of 53.36 g·kg-1·d-1 after decocting the medicine as usual. In addition, the same volume of normal saline was used to prepare blank serum. The HPAECs were cultured in vitro, and then induced by the transforming growth factor-β1 (TGF-β1) to establish the EndMT model. Five groups were established: blank group (10% blank serum), model group (TGF-β1+10% blank serum), low-dose BYHWT group (TGF-β1+2.5% medicated serum+7.5% blank serum), medium-dose BYHWT group (TGF-β1+5% medicated serum+5% blank serum) and high-dose BYHWT group (TGF-β1+10% medicated serum). Through Western blot, the expressions of Wnt1, β-catenin, and glycogen synthase kinase-3β (GSK-3β) were detected. In order to further clarify the mechanism of the Wnt1/β-catenin signaling pathway in the intervention of the medicated serum of BYHWT in inhibiting EndMT, the overexpression of β-catenin was confirmed by polymerase chain reaction after plasmid of overexpression β-catenin was constructed and transfected into the HPAECs. The HPAECs were intervened by 10% medicated serum with the optimal effect in previous studies. Then, they were divided into another five groups: the blank group (10% blank serum), the model group (TGF-β1+10% blank serum), the BYHWT group (TGF-β1+10% medicated serum), the BYHWT+overexpression plasmid control group (TGF-β1+10% medicated serum+blank plasmid) and the BYHWT+β-catenin overexpression plasmid group (TGF-β1+10% medicated serum+β-catenin). Apart from that, cell proliferation ability was detected by the methyl thiazolyl tetrazolium (MTT) method and cell migration ability by scratch assay and Transwell assay together. Immunofluorescence was adopted to detect the expressions of platelet endothelial cell adhesion molecule (PECAM-1/CD31), vascular endothelial cadherin (VE-cadherin), fibroblast-specific protein 1 (FSP1), and α-smooth muscle actin (α-SMA). ResultIn comparison to the blank group, the expressions of Wnt1 and β-catenin were significantly increased (P<0.01) while the expression of GSK-3β significantly decreased (P<0.01) in the model group. In comparison to the model group, the expressions of Wnt1 and β-catenin were significantly decreased (P<0.01) while the expression of GSK-3β was significantly increased (P<0.01) in the high-dose BYHWT group. The expression of β-catenin was significantly decreased (P<0.01) while the expression of GSK-3β was significantly increased (P<0.01) in the medium-dose BYHWT group. There was no significant difference in these indexes of the low-dose BYHWT group. In comparison to the blank group, proliferation and migration abilities were remarkably increased (P<0.01) and the immunofluorescence intensities of CD31 and VE-cadherin were decreased, while those of FSP1 and α-SMA were increased in the model group. In comparison to the model group, proliferation and migration abilities were significantly decreased (P<0.01) and the immunofluorescence intensities of CD31 and VE-cadherin were increased, while those of FSP1 and α-SMA diminished in the BYHWT group. Beyond that, the change trend of those indexes in the BYHWT+β-catenin overexpression plasmid group was consistent with that in the model group. In comparison to the BYHWT+overexpression plasmid control group, proliferation and migration abilities were significantly increased (P<0.01) and the immunofluorescence intensities of CD31 and VE-cadherin were decreased, while those of FSP1 and α-SMA were increased in the BYHWT+β-catenin overexpression plasmid group. ConclusionMedicated serum of BYHWT can inhibit EndMT of HPAECs by the Wnt1/β-catenin signaling pathway.
3.Chlorogenic acid induces mitochondrial dysfunction in lung cancer A549 cells by inhibiting the PI3K-Akt pathway
Keping ZHANG ; Yongsheng ZHAO ; Juan YANG ; Maoyong FU
Journal of International Oncology 2024;51(1):21-28
Objective:To investigate whether chlorogenic acid can inhibit the proliferation, migration, invasion and promote apoptosis of lung cancer A549 cells by causing mitochondrial dysfunction through PI3K-Akt pathway.Methods:A549 cells were treated with chlorogenic acid at concentrations of 0, 25, 50, 100, 150, and 200 μg/ml for 48 h. CCK-8 assay was used to detect the cell proliferation rate and calculate the half maximal inhibitory concentration (IC 50). A549 cells were divided into three groups: control group, chlorogenic acid group (IC 50) and chlorogenic acid + 740-YP group (IC 50 chlorogenic acid +50 μg/ml 740YP). After 48 h of intervention, the cell migration distance was detected by cell scratch assay. Cell invasion assay was used to detect cell invasion ability. Cell cycle, apoptosis and mitochondrial membrane potential were detected by flow cytometry. The content of malondialdehyde (MDA) in cell supernatant was detected by enzyme-linked immunosorbent assay (ELISA). Western blotting was used to detect the protein expression of p-PI3K, p-Akt and Caspase3. Results:The IC 50 of chlorogenic acid to A549 cells was 57.45 μg/ml. The results of cell scratch assay showed that the 48 h migration distances of the control group, chlorogenic acid group and chlorogenic acid + 740YP group were (424.80±14.43), (289.67±18.93) and (402.22±17.99) μm, respectively. The results of cell invasion assay showed that the numbers of invasive cells after 48 h were 96.00±6.24, 35.33±7.64 and 83.00±2.00, and the results of flow cytometry showed that the 48 h apoptosis rates were (6.15±0.17) %, (54.63±0.72) % and (17.27±0.39) %, respectively, among the three groups with statistically significant differences ( F=105.98, P<0.001; F=90.62, P<0.001; F=8 321.99, P<0.001). Compared with the control group, the cell migration distances and invasive numbers of chlorogenic acid group and chlorogenic acid + 740YP group were decreased (all P<0.05), while the apoptosis rates were significantly increased (both P<0.001). Compared with chlorogenic acid group, the cell migration distance of chlorogenic acid + 740YP group increased ( P<0.001), the number of cell invasion increased ( P<0.001), and the apoptosis rate decreased ( P<0.001). The results of flow cytometry showed that the proportions of cells in G 0/G 1 phase in the control group, chlorogenic acid group and chlorogenic acid + 740YP group were (65.75±0.58) %, (55.84±0.78) % and (55.24±1.37) %, respectively. The proportions of G 2/M phase were (11.21±1.03) %, (20.23±0.62) % and (9.96±0.33) %, and the proportions of S phase were (23.04±0.49) %, (23.92±1.36) % and (34.80±1.15) %, respectively, with statistically significant differences ( F=111.02, P<0.001; F=181.26, P<0.001; F=113.05, P<0.001). Compared with the control group, the proportions of G 0/G 1 phase cells in chlorogenic acid group and chlorogenic acid + 740YP group decreased (both P<0.001), and the proportion of G 2/M phase in chlorogenic acid group increased ( P<0.001), and the proportion of S phase cells in chlorogenic acid + 740YP group increased ( P<0.001). Compared with chlorogenic acid group, the proportion of G 2/M phase cells decreased and the proportion of S phase cells increased in chlorogenic acid + 740YP group (both P<0.001). The results of mitochondrial membrane potential detection showed that the JC-1 fluorescence intensity of mitochondria in the control group, chlorogenic acid group and chlorogenic acid + 740YP group were 39.51±1.32, 10.05±0.19 and 21.85±1.45, respectively, with a statistically significant difference ( F=508.82, P<0.001). Compared with the control group, the fluorescence intensity of chlorogenic acid group and chlorogenic acid + 740YP group decreased (both P<0.001). Compared with chlorogenic acid group, the fluorescence intensity of chlorogenic acid + 740YP group increased ( P<0.001). ELISA results showed that the MDA contents of the control group, chlorogenic acid group and chlorogenic acid + 740YP group were (0.47±0.01), (0.61±0.01) and (0.56±0.01) nmol/ml, respectively, with a statistically significant difference ( F=162.30, P<0.001). Compared with the control group, MDA contents in chlorogenic acid group and chlorogenic acid + 740YP group increased (both P<0.001). Compared with chlorogenic acid group, MDA content in chlorogenic acid + 740YP group decreased ( P=0.001). Western blotting results showed that the relative protein expression levels of p-PI3K in the control group, chlorogenic acid group and chlorogenic acid + 740YP group were 1.01±0.33, 0.28±0.14 and 0.34±0.20, respectively. The relative protein expression levels of p-Akt were 1.00±0.16, 0.43±0.05 and 0.95±0.14, and the relative protein expression levels of Caspase3 were 1.00±0.04, 1.41±0.05 and 0.70±0.13, respectively, and there were statistically significant differences ( F=8.48, P=0.018; F=19.11, P=0.002; F=57.50, P<0.001). Compared with the control group, the expressions of p-PI3K and p-Akt protein in chlorogenic acid group decreased, and the expression of Caspase3 protein increased (all P<0.05). The expressions of p-PI3K and Caspase3 protein in chlorogenic acid + 740YP group decreased (both P<0.05). Compared with chlorogenic acid group, the expression of p-Akt protein in chlorogenic acid + 740YP group increased, and the expression of Caspase3 protein decreased (both P<0.05) . Conclusion:Chlorogenic acid may inhibit the PI3K-Akt pathway by reducing the phosphorylation of PI3K and Akt proteins, resulting in the damage of mitochondrial function and the accumulation of MDA, which eventually leads to the damage of lung cancer A549 cells function and the reduction of cells activity, and then promotes cells apoptosis.
4.Effects of PRELID1 expression on malignant biological behaviors of gastric cancer based on JAK/STAT signaling pathway
Yongsheng XIA ; Meng ZHAO ; Yiqun YANG ; Zhenli MA ; Mengqian SANG ; Deli CHEN
Chinese Journal of Clinical and Experimental Pathology 2024;40(2):164-171
Purpose To investigate the expression of pro-tein of relevant evolutionary and lymphoid interest domain-con-taining 1(PRELID1)in gastric cancer tissues and to analyze its effect on prognosis,and the mechanism of influencing the prolif-eration and invasion ability of gastric cancer cells.Methods Using TCGA data and clinical data of 111 patients with gastric cancer,we analyzed the relationship between the expression of PRELID1 and clinicopathological parameters and the impact on clinical prognosis.The biological function of PRELID1 was pre-dicted by bioinformatics,and further verified by in vitro and in vivo experiments.Lentivirus was applied to regulate the level of PRELID 1 in gastric cancer cell line(MGC803)in vitro,and its effect on the proliferation,migration,and invasion of gastric cancer cells was observed.The nude mouse subcutaneous tumor-igenesis was used to observe the effect of PRELID1 on the growth of gastric cancer tissue in vivo.Results The expression of PRELID1 was significantly higher in gastric cancer tissues than that in the adjacent tissues(P<0.001)and was positively cor-related with the cell proliferation indicator Ki67(P<0.001).Cox regression model analysis showed that the high expression of PRELID 1 was an independent risk factor affecting the 5-year survival rate after radical gastrectomy(HR=2.336;95%CI=1.354-4.029).Gene enrichment results showed that the func-tion of PRELID1 was related to proliferation and JAK/STAT sig-naling.CCK-8 and Transwell experiments found that up-regula-tion of PRELID1 promoted the proliferation(P=0.016),mi-gration(P=0.016)and invasion(P=0.025)of gastric cancer cells,while down-regulation inhibited the proliferation(P=0.026),migration(P=0.048)and invasion(P=0.029).Subcutaneous tumor formation experiments in nude mice found that up-regulation of PRELID1 promoted the growth of gastric cancer tissue(P=0.047),while down-regulation was the oppo-site(P=0.005).Western blot detecting gastric cancer cells and gastric cancer tissues found that up-regulation of PRELID1 promoted the expression of JAK and STAT proteins(all P<0.05),while down-regulation inhibited them(all P<0.05).Conclusion The high expression of PRELID1 associated with poor prognosis may regulate the proliferation,migration and in-vasion of gastric cancer cells by up-regulating JAK/STAT signa-ling in gastric cancer.
5.Problems and Reflections on Salary System of Public Hospitals in China from the Policy Perspective
Cui LIAO ; Gelin ZHENG ; Yongsheng YANG
Chinese Health Economics 2024;43(9):18-22
Objective:It sorts out the relevant policies of China's public hospital salary system reform,summarizes the short-comings of public hospital salary policy in the process of formulation,and provides references for the subsequent adjustment and opti-mization of salary system.Methods:Based on Policy Modeling Consistency(PMC)index model,public hospital salary policies were collected and preprocessed,high-frequency words were extracted by text mining method,and an evaluation index system of sal-ary policies of public hospitals was constructed.By calculating the score of PMC index and first-level variables,the common prob-lems of various policies are analyzed,and specific suggestions were put forward.Results:The average PMC index of 12 public hos-pital compensation policies was 6.00,the overall quality of the policies was good,but there was still much room for improvement.The main common problems are the lack of internal and external linkage,the neglect of the incentive function of non-economic com-pensation and the unreasonable compensation structure.Conclusion:From the perspective of policy,the reform of public hospital salary system is a systematic project.It is suggested to take holistic thinking as the guide in the follow-up policy making process,en-hance the internal and extemal coordination of the policy,attach importance to the incentive role of non-economic compensation and optimize the salary structure,so as to promote the steady operation of the salary system reform of public hospitals.
6.Multiple correspondence analysis of the detection and risk factors of non-alcoholic fatty liver disease in middle-aged and young adult population undergoing physical examination
Yang GAO ; Yongsheng LIU ; Suli JIANG ; Kun FANG
Chinese Journal of Health Management 2024;18(1):42-47
Objective:To analyze the detection of non-alcoholic fatty liver disease (NAFLD) and the multiple corresponding relationships of its risk factors in a middle-aged and young adult population undergoing health check-ups.Methods:This study was a cross-sectional study conducted on 15 423 individuals aged between 18 and 59 who underwent health check-ups at the Health Management Center of Henan Provincial Hospital of Traditional Chinese Medicine from January to December 2021. Relevant health examination data was collected, including basic information (age, gender, past medical history, smoking and alcohol consumption), physical examination, laboratory indicators such as blood lipids and blood glucose, and abdominal ultrasound results. The chi-square test was used to compare the prevalence of NAFLD among different characteristics of the population, and multiple correspondence analysis was employed for statistical analysis of related influencing factors.Results:A total of 5 859 cases of NAFLD were detected in this study, with a detection rate of 37.99%. The detection rate of NAFLD gradually increased with age ( χ2=828.841, P<0.001) and body mass index (BMI) ( χ2=1 889.809, P<0.001). The detection rates of NAFLD were higher in individuals with hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, low high-density lipoprotein cholesterolemia, high low-density lipoprotein cholesterolemia, and hyperuricemia compared to those without these conditions ( χ2 value was 1 223.673, 364.808, 444.074, 2 436.765, 1 323.736, 591.478, and 943.069, respectively, all P<0.001). Multiple correspondence analysis revealed that NAFLD was closely related to hypertension, hypertriglyceridemia, diabetes, hyperuricemia, overweight, obesity, and the age group of 45-49 years. Correspondence analysis graphs for males and females showed associations between NAFLD and hypertension, hypertriglyceridemia, hyperuricemia, overweight, and obesity. In males, NAFLD was closely related to the age group of 35-49 years, while in females, it was closely associated with the age group of 45-49 years and diabetes. Conclusions:The detection rate of non-alcoholic fatty liver disease is relatively high in middle-aged and young adult populations. Males, those who are overweight or obese, and individuals with hypertension, diabetes, hyperuricemia, or abnormal blood lipids are more susceptible to non-alcoholic fatty liver disease.
7.Three-dimensional finite element modeling and mechanical analysis of knee joint in patients with mild knee osteoarthritis
Taoyong ZHOU ; Yongsheng YANG ; Ning LU ; Hao TANG ; Yandong YANG ; Xiechuan HAN
Chinese Journal of Medical Physics 2024;41(3):382-388
Objective To establish a three-dimensional finite element model of knee joint in patients with mild knee osteoarthritis in the absence of CT and MRI with thin layer thickness,and to analyze the stress distributions of the tibial plateau.Methods A female patient with mild knee osteoarthritis was selected as the study object,and received serial CT scan from pelvis to distal tibia of fibula.The obtained files in DICOM format were imported into Mimics software for extracting the bony structures of knee joint through threshold segmentation,and then optimizing the extracted structures with Edit Masks,Cavity Fill and Region Grow.The generated model of bony structures was imported into 3-matic for smoothing and wrapping,and Geomagic Wrap was used for bony structure processing with mesh doctor inspection,surface defect repair and surface fitting.The cartilages,meniscus and ligaments were established by contour extension,and assembled with bony structures in SolidWorks in the way of origin coincidence.After defining material properties and contact relationships,meshing,and setting constraints and loads in ANSYS software,the stress distributions of the tibial plateau when standing with both legs were analyzed.Results A complete knee joint model including bony structure,cartilage and ligament was successfully established.When standing with two legs,the peak value of contact stress was about 1.21 MPa,and the maximum stress was 0.72 MPa at the medial middle of tibial plateau and lateral tibial plateau.The 62.7%and 37.3%of the total load were borne by the inner and outer compartments.Conclusion The model of the total knee joint is established with CT extraction and software rendering,and the finite element analysis results meet clinical expectations,indicating that the model established by the proposed method is reliable and can be used for follow-up research.
8.Linarin inhibits microglia activation-mediated neuroinflammation and neuronal apoptosis in mouse spinal cord injury by inhibiting the TLR4/NF-κB pathway
Linyu XIAO ; Ting DUAN ; Yongsheng XIA ; Yue CHEN ; Yang SUN ; Yibo XU ; Lei XU ; Xingzhou YAN ; Jianguo HU
Journal of Southern Medical University 2024;44(8):1589-1598
Objective To investigate the mechanism underlying the neuroprotective effect of linarin(LIN)against microglia activation-mediated inflammation and neuronal apoptosis following spinal cord injury(SCI).Methods Fifty C57BL/6J mice(8-10 weeks old)were randomized to receive sham operation,SCI and linarin treatment at 12.5,25,and 50 mg/kg following SCI(n=10).Locomotor function recovery of the SCI mice was assessed using the Basso Mouse Scale,inclined plane test,and footprint analysis,and spinal cord tissue damage and myelination were evaluated using HE and LFB staining.Nissl staining,immunofluorescence assay and Western blotting were used to observe surviving anterior horn motor neurons in injured spinal cord tissue.In cultured BV2 cells,the effects of linarin against lipopolysaccharide(LPS)-induced microglia activation,inflammatory factor release and signaling pathway changes were assessed with immunofluorescence staining,Western blotting,RT-qPCR,and ELISA.In a BV2 and HT22 cell co-culture system,Western blotting was performed to examine the effect of linarin against HT22 cell apoptosis mediated by LPS-induced microglia activation.Results Linarin treatment significantly improved locomotor function(P<0.05),reduced spinal cord damage area,increased spinal cord myelination,and increased the number of motor neurons in the anterior horn of the SCI mice(P<0.05).In both SCI mice and cultured BV2 cells,linarin effectively inhibited glial cell activation and suppressed the release of iNOS,COX-2,TNF-α,IL-6,and IL-1β,resulting also in reduced neuronal apoptosis in SCI mice(P<0.05).Western blotting suggested that linarin-induced microglial activation inhibition was mediated by inhibition of the TLR4/NF-κB signaling pathway.In the cell co-culture experiments,linarin treatment significantly decreased inflammation-mediated apoptosis of HT22 cells(P<0.05).Conclusion The neuroprotective effect of linarin is medicated by inhibition of microglia activation via suppressing the TLR4/NF-κB signaling pathway,which mitigates neural inflammation and reduce neuronal apoptosis to enhance motor function of the SCI mice.
9.Problems and Reflections on Salary System of Public Hospitals in China from the Policy Perspective
Cui LIAO ; Gelin ZHENG ; Yongsheng YANG
Chinese Health Economics 2024;43(9):18-22
Objective:It sorts out the relevant policies of China's public hospital salary system reform,summarizes the short-comings of public hospital salary policy in the process of formulation,and provides references for the subsequent adjustment and opti-mization of salary system.Methods:Based on Policy Modeling Consistency(PMC)index model,public hospital salary policies were collected and preprocessed,high-frequency words were extracted by text mining method,and an evaluation index system of sal-ary policies of public hospitals was constructed.By calculating the score of PMC index and first-level variables,the common prob-lems of various policies are analyzed,and specific suggestions were put forward.Results:The average PMC index of 12 public hos-pital compensation policies was 6.00,the overall quality of the policies was good,but there was still much room for improvement.The main common problems are the lack of internal and external linkage,the neglect of the incentive function of non-economic com-pensation and the unreasonable compensation structure.Conclusion:From the perspective of policy,the reform of public hospital salary system is a systematic project.It is suggested to take holistic thinking as the guide in the follow-up policy making process,en-hance the internal and extemal coordination of the policy,attach importance to the incentive role of non-economic compensation and optimize the salary structure,so as to promote the steady operation of the salary system reform of public hospitals.
10.Problems and Reflections on Salary System of Public Hospitals in China from the Policy Perspective
Cui LIAO ; Gelin ZHENG ; Yongsheng YANG
Chinese Health Economics 2024;43(9):18-22
Objective:It sorts out the relevant policies of China's public hospital salary system reform,summarizes the short-comings of public hospital salary policy in the process of formulation,and provides references for the subsequent adjustment and opti-mization of salary system.Methods:Based on Policy Modeling Consistency(PMC)index model,public hospital salary policies were collected and preprocessed,high-frequency words were extracted by text mining method,and an evaluation index system of sal-ary policies of public hospitals was constructed.By calculating the score of PMC index and first-level variables,the common prob-lems of various policies are analyzed,and specific suggestions were put forward.Results:The average PMC index of 12 public hos-pital compensation policies was 6.00,the overall quality of the policies was good,but there was still much room for improvement.The main common problems are the lack of internal and external linkage,the neglect of the incentive function of non-economic com-pensation and the unreasonable compensation structure.Conclusion:From the perspective of policy,the reform of public hospital salary system is a systematic project.It is suggested to take holistic thinking as the guide in the follow-up policy making process,en-hance the internal and extemal coordination of the policy,attach importance to the incentive role of non-economic compensation and optimize the salary structure,so as to promote the steady operation of the salary system reform of public hospitals.

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