1.Advances in nanocarrier-mediated cancer therapy: Progress in immunotherapy, chemotherapy, and radiotherapy.
Yue PENG ; Min YU ; Bozhao LI ; Siyu ZHANG ; Jin CHENG ; Feifan WU ; Shuailun DU ; Jinbai MIAO ; Bin HU ; Igor A OLKHOVSKY ; Suping LI
Chinese Medical Journal 2025;138(16):1927-1944
Cancer represents a major worldwide disease burden marked by escalating incidence and mortality. While therapeutic advances persist, developing safer and precisely targeted modalities remains imperative. Nanomedicines emerges as a transformative paradigm leveraging distinctive physicochemical properties to achieve tumor-specific drug delivery, controlled release, and tumor microenvironment modulation. By synergizing passive enhanced permeation and retention effect-driven accumulation and active ligand-mediated targeting, nanoplatforms enhance pharmacokinetics, promote tumor microenvironment enrichment, and improve cellular internalization while mitigating systemic toxicity. Despite revolutionizing cancer therapy through enhanced treatment efficacy and reduced adverse effects, translational challenges persist in manufacturing scalability, longterm biosafety, and cost-efficiency. This review systematically analyzes cutting-edge nanoplatforms, including polymeric, lipidic, biomimetic, albumin-based, peptide engineered, DNA origami, and inorganic nanocarriers, while evaluating their strategic advantages and technical limitations across three therapeutic domains: immunotherapy, chemotherapy, and radiotherapy. By assessing structure-function correlations and clinical translation barriers, this work establishes mechanistic and translational references to advance oncological nanomedicine development.
Humans
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Neoplasms/radiotherapy*
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Immunotherapy/methods*
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Nanoparticles/chemistry*
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Animals
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Nanomedicine/methods*
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Drug Delivery Systems/methods*
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Drug Carriers/chemistry*
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Radiotherapy/methods*
2.Guiding significance of intra-articular sagittal reduction in the treatment of tibial plateau fractures.
Jia-Fan ZHANG ; An-Hua LONG ; Da-Cheng HAN ; Zi-Chao JIA ; Ya-Kui ZHANG
China Journal of Orthopaedics and Traumatology 2025;38(1):100-104
Tibial plateau fracture is a fracture involving the proximal articular surface of the tibia, and its injury mechanism is complex, the fracture morphology is different, and it is often accompanied by different degrees of soft tissue injury, which is difficult to diagnose and treat. In recent years, the research hotspot has focused on solving the reduction and fixation of the posterior lateral column of the tibial plateau, because it has been clinically found that the residual sagittal plane after tibial plateau fracture is insufficient reduction or loss of reduction leads to knee joint dysfunction. The posterior inclination angle of the tibial plateau is an important parameter to describe the sagittal alignment of the tibia. In the natural state, the posterior tibial slope(PTS) is altered to involve the soft tissues around the knee joint such as anterior cruciate ligament(ACL) and posterior cruciate ligament(PCL), which affects the stability of the knee joint. In total knee arthroplasty(TKA), choosing the appropriate PTS can effectively increase the prosthesis survival rate, improve the flexion and extension knee efficacy, which is beneficial to knee joint stability. In the field of orthopedic trauma, correction of sagittal deformity is equally important, following the principle of "reverse mechanism of injury". Quantitative evaluation of postoperative sagittal realignment of tibial plateau fractures and investigation of the effect of sagittal realignment on long-term outcomes and complications are still poorly understood and require further clinical and biomechanical studies.
Humans
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Tibial Fractures/physiopathology*
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Fracture Fixation, Internal/methods*
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Tibial Plateau Fractures
3.Advances in Immunotherapy of KRAS-mutated Non-small Cell Lung Cancer.
Xinyue YANG ; Zhiwei TANG ; Li MA ; Ran CHEN
Chinese Journal of Lung Cancer 2025;28(5):343-352
In epidemiological statistics, the incidence rate and mortality rate of malignant lung tumors rank among the top. Non-small cell lung cancer (NSCLC) constitutes an important part of lung cancer and has become a key focus of clinical research and treatment. Among the genomic characteristics of NSCLC, the Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation is one of the main tumor drivers, accounting for approximately 25% of all NSCLC cases. The existence of this mutation is closely related to the treatment response and prognosis of patients. Therefore, the treatment strategy for KRAS-mutated NSCLC is an important topic in the field of tumor research. In the current era, immunomodulatory therapy has rapidly gained popularity and developed rapidly in oncology due to its unique mechanism of action and remarkable clinical efficacy. The treatment strategies targeting the KRAS-mutated of NSCLC have gradually become a research hotspot. The advent of immune checkpoint inhibitors (ICIs) has opened up a new therapeutic avenue for patients with such cancers, and clinical studies have shown significant effects in improving survival rates. Nevertheless, there are still many challenges in the application of immunotherapy, such as the complexity of the tumor microenvironment, individual differences among patients, and drug resistance mechanisms. This article reviews the progress of immunotherapy for KRAS-mutated NSCLC, focusing on the specific application of immunotherapy, the exploration of combination therapies, and the results of related clinical trials. At the same time, it discusses the possible future development directions of KRAS-mutated NSCLC treatment, providing a reference for clinical treatment practice.
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Humans
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Carcinoma, Non-Small-Cell Lung/immunology*
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Lung Neoplasms/immunology*
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Proto-Oncogene Proteins p21(ras)/immunology*
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Immunotherapy/methods*
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Mutation
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Animals
4.Real-world efficacy and safety of azvudine in hospitalized older patients with COVID-19 during the omicron wave in China: A retrospective cohort study.
Yuanchao ZHU ; Fei ZHAO ; Yubing ZHU ; Xingang LI ; Deshi DONG ; Bolin ZHU ; Jianchun LI ; Xin HU ; Zinan ZHAO ; Wenfeng XU ; Yang JV ; Dandan WANG ; Yingming ZHENG ; Yiwen DONG ; Lu LI ; Shilei YANG ; Zhiyuan TENG ; Ling LU ; Jingwei ZHU ; Linzhe DU ; Yunxin LIU ; Lechuan JIA ; Qiujv ZHANG ; Hui MA ; Ana ZHAO ; Hongliu JIANG ; Xin XU ; Jinli WANG ; Xuping QIAN ; Wei ZHANG ; Tingting ZHENG ; Chunxia YANG ; Xuguang CHEN ; Kun LIU ; Huanhuan JIANG ; Dongxiang QU ; Jia SONG ; Hua CHENG ; Wenfang SUN ; Hanqiu ZHAN ; Xiao LI ; Yafeng WANG ; Aixia WANG ; Li LIU ; Lihua YANG ; Nan ZHANG ; Shumin CHEN ; Jingjing MA ; Wei LIU ; Xiaoxiang DU ; Meiqin ZHENG ; Liyan WAN ; Guangqing DU ; Hangmei LIU ; Pengfei JIN
Acta Pharmaceutica Sinica B 2025;15(1):123-132
Debates persist regarding the efficacy and safety of azvudine, particularly its real-world outcomes. This study involved patients aged ≥60 years who were admitted to 25 hospitals in mainland China with confirmed SARS-CoV-2 infection between December 1, 2022, and February 28, 2023. Efficacy outcomes were all-cause mortality during hospitalization, the proportion of patients discharged with recovery, time to nucleic acid-negative conversion (T NANC), time to symptom improvement (T SI), and time of hospital stay (T HS). Safety was also assessed. Among the 5884 participants identified, 1999 received azvudine, and 1999 matched controls were included after exclusion and propensity score matching. Azvudine recipients exhibited lower all-cause mortality compared with controls in the overall population (13.3% vs. 17.1%, RR, 0.78; 95% CI, 0.67-0.90; P = 0.001) and in the severe subgroup (25.7% vs. 33.7%; RR, 0.76; 95% CI, 0.66-0.88; P < 0.001). A higher proportion of patients discharged with recovery, and a shorter T NANC were associated with azvudine recipients, especially in the severe subgroup. The incidence of adverse events in azvudine recipients was comparable to that in the control group (2.3% vs. 1.7%, P = 0.170). In conclusion, azvudine showed efficacy and safety in older patients hospitalized with COVID-19 during the SARS-CoV-2 omicron wave in China.
5.Bioactive metallic nanoparticles for synergistic cancer immunotherapy.
Lulu WANG ; Demin LIN ; Muqing LI ; Yu JIANG ; Yanfang YANG ; Hongliang WANG ; Hongqian CHU ; Jun YE ; Yuling LIU
Acta Pharmaceutica Sinica B 2025;15(4):1869-1911
Cancer immunotherapy has emerged as a promising strategy. However, low response rates and immune-related side effects have plagued immunotherapy. Metallic nanoparticles, utilizing metals as their framework, are gaining prominence in cancer immunotherapy. Metal ions have shown the ability to modulate immune status by activating the cGAS-STING pathway and inducing immunogenic cell death (ICD), thereby enabling multidimensional activation of immunotherapy. Metallic nanoparticles offer significant advantages in cancer immunotherapy, leading to their increasing use in enhancing therapeutic outcomes. In view of the ever-increasing research on metallic nanoparticles, this review presents the construction, characterization, and enhanced cancer immunotherapeutic effects of different types of metal nanosystems from the perspective of the immunoregulatory mechanisms of metal ions. We delve into the current limitations and future directions of metallic nanoparticles in this rapidly evolving field. To the best of our knowledge, this review offers the most up-to-date and systematic analysis of metallic nanoparticles in immunotherapeutic applications. It is anticipated that this review of metallic nanoparticles will inspire a more refined and intelligent design of metallic nanoparticles for future research, paving the way for advancing their clinical applications.
6.Increased Tertiary Lymphoid Structures are Associated with Exaggerated Lung Tissue Damage in Smokers with Pulmonary Tuberculosis.
Yue ZHANG ; Liang LI ; Zi Kang SHENG ; Ya Fei RAO ; Xiang ZHU ; Yu PANG ; Meng Qiu GAO ; Xiao Yan GAI ; Yong Chang SUN
Biomedical and Environmental Sciences 2025;38(7):810-818
OBJECTIVE:
Cigarette smoking exacerbates the progression of pulmonary tuberculosis (TB). The role of tertiary lymphoid structures (TLS) in chronic lung diseases has gained attention; however, it remains unclear whether smoking-exacerbated lung damage in TB is associated with TLS. This study aimed to analyze the characteristics of pulmonary TLS in smokers with TB and to explore the possible role of TLS in smoking-related lung injury in TB.
METHODS:
Lung tissues from 36 male patients (18 smokers and 18 non-smokers) who underwent surgical resection for pulmonary TB were included in this study. Pathological and immunohistological analyses were conducted to evaluate the quantity of TLS, and chest computed tomography (CT) was used to assess the severity of lung lesions. The correlation between the TLS quantity and TB lesion severity scores was analyzed. The immune cells and chemokines involved in TLS formation were also evaluated and compared between smokers and non-smokers.
RESULTS:
Smoker patients with TB had significantly higher TLS than non-smokers ( P < 0.001). The TLS quantity in both the lung parenchyma and peribronchial regions correlated with TB lesion severity on chest CT (parenchyma: r = 0.5767; peribronchial: r = 0.7373; both P < 0.001). Immunohistochemical analysis showed increased B cells, T cells, and C-X-C motif chemokine ligand 13 (CXCL13) expression in smoker patients with TB ( P < 0.001).
CONCLUSION
Smoker TB patients exhibited increased pulmonary TLS, which was associated with exacerbated lung lesions on chest CT, suggesting that cigarette smoking may exacerbate lung damage by promoting TLS formation.
Humans
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Male
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Tuberculosis, Pulmonary/immunology*
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Middle Aged
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Tertiary Lymphoid Structures/pathology*
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Adult
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Lung/pathology*
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Smoking/adverse effects*
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Smokers
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Aged
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Tomography, X-Ray Computed
7.Clinical and CT findings of 25 patients with bronchiolar adenoma
Minghui ZHANG ; Minghua SUI ; Tiantian QIU ; Xue SUN ; Xiao TAN ; Dailun HOU
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2024;31(08):1127-1132
Objective To study the clinical and CT findings of bronchiolar adenoma. Methods Patients diagnosed with bronchiolar adenoma confirmed by surgical pathology at Linyi People's Hospital and Yantai Yuhuangding Hospital from 2016 to 2021 were collected. Their clinical and CT imaging features were retrospectively analyzed. Results Finally, 25 patients were collected, including 6 males and 19 females, aged 32-73 (58.6±10.1) years. The immunohistochemical Ki-67 (MIB1) of all lesions was <5%. The lesions were located in the upper and middle lobe of both lungs in 9 patients, lower lobes in 16 patients, extrapulmonary zone in 22 patients, intrapulmonary middle zone in 3 patients, round in 11 patients, irregular in 14 patients, well-defined in 22 patients, pure ground-glass/mixed ground-glass nodules in 6 patients, solid nodules in 19 patients. There were 11 patients with central small cavity, 18 patients with single bronchioles sign, 19 patients without adhesion with adjacent pleura, and 24 patients without mediastinal lymph node enlargement. Conclusion Bronchiolar adenomas usually occur in the middle-aged and elderly, mostly in the lower lobe of both lungs and the distribution of the peripheral lung field, most of the patients do not have any clinical symptoms, and the postoperative prognosis is good. CT may show large nodules or masses, pure ground-glass/mixed ground-glass nodules, irregular solid nodules and central small cavities. Irregular stellate nodules, central small cavity shadow, and single bronchiolar vascular bundle connected with the lesions are relatively specific imaging findings of bronchiolar adenoma.
8.Development of lung organoid models and their application in health effect assessment of occupational exposure
Yixia LI ; Hanqing CHEN ; Yi HAN
Journal of Environmental and Occupational Medicine 2024;41(10):1103-1108
The lungs, being the principal respiratory organs in humans, are highly vulnerable to occupational exposure hazards. The rapid industrialization and urbanization in China, coupled with the rise of new industries, have heightened the risk of lung-related occupational hazards for workers, thereby presenting substantial challenges to research in lung-related occupational toxicology. The emerging technology of lung organoids, a three-dimensional cell culture technique, has the potential to replicate human lung structure and function in a laboratory setting, enabling direct observation and assessment of various impacts. Furthermore, the organoid model's short cycles and high throughput play a critical role in the simulation of the occurrence and development of lung impairments and the screening and evaluation of potential therapeutic drugs for occupational lung diseases. As such, the utilization of lung-related organoid technology not only improves the assessment level of the health effects of lung-related occupational exposure, but also enhances researchers' understanding of the pathological mechanisms underlying lung diseases and aids in the development of prevention and treatment strategies, rendering it a valuable tool for investigating occupational lung diseases. This paper provided a comprehensive overview of the advancements in lung organoid models and their biomedical applications, particularly in the evaluation of the potential application in the heath effects of lung-related occupational exposures.
9.Design, synthesis and antituberculosis activity of 2-aryl substituted benzothiopyranone compounds
Xia-xia TANG ; Wen-yi LI ; Peng LI ; Bin WANG ; Yu LU ; Hai-hong HUANG ; Gang LI
Acta Pharmaceutica Sinica 2024;59(4):987-996
A novel series of 2-aryl substituted benzothiopyranone compounds was designed and synthesized based on our previously obtained benzothiopyranone scaffold with significant antituberculosis activity. All target compounds were evaluated for their antimycobacterial activity and preliminary druggability was subsequently investigated for some selected compounds with good activity. The results indicated that most compounds showed good activity against
10.Increased Incidence of Severe Adverse Events in Non-Small Cell Lung Cancer Patients with Previous Tuberculosis Episode Treated with PD-1 Inhibitors
Zhang HUI ; Yuan JINFENG ; Xu YUANYUAN ; Yang MENGJIE ; Lyu JIALIN ; Yang XINJIE ; Sheng SHUYAN ; Qian ZHE ; Wang QUNHUI ; Pang YU ; Hu YING
Biomedical and Environmental Sciences 2024;37(7):785-789
Lung cancer is the top cause of cancer deaths globally.Advances in immune checkpoint inhibitors(ICIs)have transformed cancer treatment,but their use in lung cancer has led to more side effects.This study examined if past pulmonary tuberculosis(TB)affects ICIs'effectiveness and safety in lung cancer treatment.We reviewed lung cancer patients treated with ICIs at Beijing Chest Hospital from January 2019 to August 2022.We compared outcomes and side effects between patients with and without prior TB.Of 116 patients(40 with TB history,76 without),prior TB didn't reduce treatment effectiveness but did increase severe side effects.Notably,older patients(≥65 years)faced a higher risk of severe side effects.Detailed cases of two patients with severe side effects underscored TB as a risk factor in lung cancer patients receiving ICIs,stressing the need for careful monitoring and personalized care.

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