1.Advances in the application of microspheres and nanoparticles in transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma
Chuyue ZHANG ; Jianing SHI ; Mingda WANG ; Han WU ; Lijun SHI ; Tian YANG
Journal of Clinical Hepatology 2024;40(4):816-821
In recent years, transcatheter arterial chemoembolization (TACE) has emerged as a common treatment modality for the treatment of hepatocellular carcinoma (HCC). However, with the ongoing development of embolic agent techniques, the new advances in microspheres and nanoparticles have brought new hope for improving the efficacy and safety of TACE. This article reviews the latest advances and applications of microspheres and nanoparticles in TACE for HCC. First, this article introduces the background of TACE as a therapeutic approach and the emergence of microsphere and nanoparticle techniques, and then it describes the application of various types of microspheres and nanoparticles in TACE and discusses the requisite attributes of an ideal embolic agents. The article focuses on the advances in material science and engineering, as well as the clinical efficacy of drug-eluting microspheres and nanoparticles versus conventional TACE. Furthermore, it discusses the importance of radiological examination in TACE and summarizes the research advances in the radiopaque and magnetic resonance-visible embolic agents. This article also explores the future development directions and challenges of TACE. It also points out the combination of microspheres and nanoparticles with other treatment modalities, the application of personalized and precision medicine in TACE, and the potential regimen of TACE in clinical translation, and meanwhile, it raises the issues of ethics and regulation that need to be further discussed. It is believed that microspheres and nanoparticles have a potential effect in TACE, which provides a theoretical basis and technical support for innovating HCC treatment regimens and improving the prognosis of patients through TACE interventions.
2.Effects of complement C1q on motor function and postsynaptic density protein 95 of rats with cere-bral ischemia-reperfusion injury
Qingtong ZHANG ; Chenyao JIAN ; Mingda LIU ; Shenquan CAI ; Manlin DUAN
The Journal of Clinical Anesthesiology 2024;40(8):855-859
Objective To explore the effects of complement C1q on postsynaptic density protein 95(PSD95)and motor function of rats with cerebral ischemia-reperfusion injury.Methods Thirty-six clean male SD rats,aged 6-8 weeks,weighing 220-250 g,were randomly divided into three groups:sham group(group S),middle cerebral artery occlusion(MCAO)group(group M),and MCAO+C1q neutralization group(group A),12 rats in each group.Group S only received anatomical separation of common carotid ar-tery without insertion of monofilament,group M established the MCAO model was prepared by insertion of monofilament,and group A received C1q neutralizing antibody 10 μl injected into the lateral ventricle on the first day after establishing MCAO model.Three days after modeling,the adhesion removal experiment was used to record the adhesion stimulus removal time,and the balance beam experiment was used to evaluate the limb motor function of the rats.After the rats were sacrificed,the ELISA method was used to detect the C1q and C3 levels in the hippocampus tissue,the Western blot method was used to detect the C1q subcom-ponent subunit A(C1qa)and PSD95 protein levels in the hippocampus tissue,and the Nissl staining was used to record the number of Nissl bodies.Results Compared with group S,group M exhibited a signifi-cantly longer adhesion removal time,significantly elevated balance beam experiment score,significantly higher levels of C1q,C3,and C1qa in the hippocampus,and significantly lower levels of PSD95 and Nissl's body count in the hippocampus(P<0.05).Compared with group M,group A exhibited significantly shor-ter adhesion removals,a significantly lower balance beam experiment score,significantly lower levels of C1q,C3,and C1qa in the hippocampus,significantly higher PSD95 content,and a significantly higher Nissl's body count in the hippocampus(P<0.05).Conclusion Cerebral ischemia-reperfusion injury in rats can induce extensive activation of the complement system and aggravate the loss of synaptic protein PSD95 and motor dysfunction in rat hippocampal tissue through complement protein C1q.Neutralizing com-plement therapy can effectively improve cerebral ischemia-reperfusion injury in rats.
3.Mouse nerve growth factor combined with rehabilitation in the treatment of global developmental delay: a prospective multicenter clinical randomized controlled trial
Jiulai TANG ; Xiaojie LI ; De WU ; Wei PANG ; Hujie SONG ; Yan HUANG ; Jin GUO ; Ling LI ; Li YANG ; Ran HUA ; Fuxiang SONG ; Yutang LIU ; Mingda ZHANG ; Yang LYU
Chinese Journal of Applied Clinical Pediatrics 2023;38(11):857-862
Objective:To observe the clinical efficacy of mouse nerve growth factor (mNGF) combined with rehabilitation on children with global developmental delay(GDD).Methods:It was a prospective multicenter clinical randomized controlled trial (RCT) involving 120 children with GDD admitted to 5 hospitals in China from May 2020 to January 2022.They were randomly divided into mNGF group and conventional rehabilitation group using block randomization method.All children were managed by standardized rehabilitation after recruitment, and those in the mNGF group were additionally given mNGF injections.All subjects were surveyed using the Gesell Development Diagnosis Schedules(GDDS) at baseline, 90 days and 120 days after treatment, and their developmental quotient (DQ) was recorded.Clinical efficacy was analyzed by the paired t-test, rank sum test and Chi- squared test. Results:After 90 days of treatment and the continuous follow-up to 120 days, the increases in the DQ of gross motor (7.520±13.900 vs.0.450±11.459), fine motor (7.800±15.346 vs.1.250±11.581), adaptive behavior (7.730±13.428 vs.2.100±12.022) and personal-social behavior (6.780±11.651 vs.1.780±10.120) than baseline were significantly higher in mNGF group than those of conventional rehabilitation group (all P<0.05). Serious adverse events and important drug-related medical events were not reported. Conclusions:mNGF combined with rehabilitation effectively enhances the development levels of gross motor, fine motor, adaptive behavior and personal-social behavior, and continuously improves the condition of GDD in children with a high safety.
4.Prognostic Value of the Evolution of HER2-Low Expression after Neoadjuvant Chemotherapy
Youzhao MA ; Mingda ZHU ; Jingyang ZHANG ; Minhao LV ; Xiuchun CHEN ; Zhenzhen LIU
Cancer Research and Treatment 2023;55(4):1210-1221
Purpose:
Patients with human epidermal growth factor receptor 2 (HER2)–low advanced breast cancer can benefit from trastuzumab deruxtecan. Given the unclear prognostic characteristics of HER2-low breast cancer, we investigated the prognostic characteristics of HER2-low expression from primary tumor to residual disease after neoadjuvant chemotherapy (NACT).
Materials and Methods:
The data of HER2-negative patients receiving NACT at our center were collected. Pathological complete response (pCR) rate were compared between HER2-0 and HER2-low patients. The evolution of HER2 expression from primary tumor to residual disease and its impact on disease-free survival (DFS) were examined.
Results:
Of the 690 patients, 494 patients had HER2-low status, of which 72.3% were hormone receptor (HR)–positive (p < 0.001). The pCR rates of HER2-low and HER2-0 patients (14.2% vs. 23.0%) showed no difference in multivariate analysis regardless of HR status. No association was observed between DFS and HER2 status. Of the 564 non-pCR patients, 57 (10.1%) changed to HER2-positive, and 64 of the 150 patients (42.7%) with HER2-0 tumors changed to HER2-low. HER2-low (p=0.004) and HR-positive (p=0.010) tumors before NACT were prone to HER2 gain. HER2 gain patients had a better DFS compared with HER2-negative maintained patients (87.9% vs. 79.5%, p=0.048), and the DFS of targeted therapy group was better than that of no targeted therapy group (92.4% vs. 66.7%, p=0.016).
Conclusion
Although HER2-low did not affect the pCR rate and DFS, significant evolution of HER2-low expression after NACT creates opportunities for targeted therapy including trastuzumab.
5.Investigation and research on We-Media platforms opened and operated by surgeons in tertiary first-class hospitals
Jianhong ZHONG ; Mingda WANG ; Haotian LIU ; Zhanguo ZHANG ; Guole LIN ; Lei ZHAO ; Linlin SHEN ; Min CHEN ; Tian YANG
Chinese Journal of Digestive Surgery 2022;21(4):475-482
Objective:To investigate the status of We-Media platforms opened and opera-ted by surgeons in tertiary first-class hospitals nationwide and analyze its influence on patients and surgeons.Methods:The retrospective cross-sectional investigation study was conducted. The investigation was conducted on the surgeons who had opened We-Media platforms in their units or associations through the contact of all members of the second Elite Committee of Chinese Digestive Surgery of the Chinese Journal of Digestive Surgery from November 5 to 30, 2021. Questionnaires were distributed through wechat, and the software platform was Questionnaire Star. Observation indicators: (1) results of questionnaire survey; (2) basic information of surgeons running We-Media platforms; (3) daily workload and research background of surgeons running We-Media platforms; (4) information related to We-Media platforms; (5) influence of running We-Media platforms on patients; (6) influence of running We-Media platforms on surgeons; (7) feelings and suggestion of surgeons after running We-Media platforms. Measurement data with normal distribution were expressed as Mean± SD, and count data were expressed as absolute numbers and percentages. Results:(1) Results of questionnaire survey: a total of 229 complete and valid questionnaires were collected in this survey. (2) Basic information of surgeons running We-Media platforms: of 229 surgeons, there were 195 males and 34 females, aged (40±8)years. There were 120 surgeons aged from 36-45 years, 80 surgeons aged <35 years and 29 surgeons aged >45 years. There were 86.46% (198/229) of surgeons from teaching hospitals and 74.67%(171/229) of surgeons from provincial cities. Of 229 surgeons, junior, intermediate, deputy senior and senior titles accounted for 17.90%(41/229), 27.51%(63/229), 37.12%(85/229) and 17.47%(40/229), respectively. Surgeons with working years ≤5 years, 6-10 years, 11-15 years and ≥16 years accounted for 19.21%(44/229), 22.27%(51/229), 26.64%(61/229) and 31.88%(73/229), respectively. Hepatobiliary and pancreatic surgeons, esophageal and gastrointestinal surgeons were the main specialties, accounting for 48.03%(110/229) and 14.41%(33/229), respectively. The original intentions of opening We-Media platforms (multiple choice) included increasing patient population and improving the income, accumulating cases to facilitate clinical research projects, increasing the popularity of the industry and gain peer recognition, increasing social awareness and improving spiritual satisfaction, passive assignments form units or hospitals, which accounted for 52.84% (121/229), 54.15%(124/229), 64.19%(147/229), 58.08%(133/229), 17.90%(41/229), respectively. (3) Daily workload and research background of surgeons running We-Media platforms: 60.26%(138/229) of surgeons participated in offline social welfare activities 1-3 times per year and 26.64%(61/229) of surgeons participated >3 times per year. There were 47.60% (109/229) of surgeons performing 5-10 operations per week and 33.19%(76/229) of surgeons performing >10 operations per week. In terms of scientific researches, 38.43%(88/229) of surgeons had not published high-quality English articles as the first author or co-first author, 24.89%(57/229) of surgeons had published 1-3 articles and 36.68%(84/229) of surgeons had published >3 articles. There were 51.09%(117/229) of surgeons without any longitu-dinal projects, 13.54%(31/229) of surgeons with national projects, 35.37%(81/229) of surgeons with provincial and ministerial projects. (4) Information related to We-Media platforms: there were 65.50%(150/229) of surgeons running wechat public account, 55.02%(126/229) of surgeons running consultation platform, 31.44%(72/229) of surgeons running TikTok, 21.40%(49/229) of surgeons running wechat video account (some surgeons operated multiple We-Media platforms). The time of operating the platform was <1 year in 35.81%(82/229) of surgeons, 1-3 years in 42.79%(98/229) of surgeons, >3 years in 21.40%(49/229) of surgeons, respectively. The contents of We-Media platforms were updated >2 weeks in 45.85%(105/229) of surgeons. There were 63.32%(145/229) of surgeons with We-Media platforms win-ning emotional support from their department or hospital, 12.66%(29/229) of surgeons with We-Media platforms winning financial support. There were 82.53%(189/229) of surgeons operating We-Media platforms by theirselves. The We-Media plat-form operation was smooth in 47.16%(108/229) of surgeons, unsustainable in 50.22%(115/229) of surgeons and suspended in 2.62%(6/229) of surgeons. On average, it took less than 30 minutes for 60.70%(139/229) of surgeons and 30-60 minutes for 27.07%(62/229) of surgeons to operate the We-Media platforms of surgeons every times, respec-tively. The background message or consulta-tion was allowed in 89.08%(204/229) of surgeons. The number of leaving messages was <5 times in 52.84%(121/229) of surgeons and >50 times in 6.99%(16/229) of surgeons. On average, each content in 59.39%(136/229) of surgeons were "liked" or "viewed" <100 times, and each content in 29.26%(67/229) of surgeons were "liked" or "viewed" 100-300 times. There were 60.26%(138/229) of surgeons having content with the highest "liked" or "viewed" clicks <1 000 times and 6.99%(16/229) of surgeons having content with the highest "liked" or "viewed" clicks >10 million times. On average, each content in 74.67%(171/229) of surgeons were "forwarded" <100 times, and each content in 6.55%(15/229) of surgeons were "forwarded" >300 times, respectively. The number of followers was <1 million in 87.34%(200/229) of surgeons. The We-Media audiences (multiple choices) included related professional peers, related health care professionals, patients of surgeons, general public, accounting for 42.36%(97/229), 31.00%(71/229), 52.40%(120/229), 53.71%(123/229), respectively. (5) Influence of running We-Media platforms on patients: 34.93%(80/229) of surgeons believed that the operation of We-Media platform significantly increased the number of outpatient and inpatient patients of themselves, 29.69%(68/229) of surgeons believed that the operation of We-Media platform significantly increased the number of outpatient and inpatient patients in their departments, respectively. In the view of 75.98%(174/229) of surgeons, the percent of outpatient and inpatient patients by We-Media platforms was <10%. After 6 months of We-Media operation, 39.74%(91/229) and 25.33%(58/229) of surgeons believed that inpatient and outpatient compliance was significantly improved, respectively, and 46.29% (106/229) of surgeons believed that preopera-tive and pre-chemotherapy or pre-radiotherapy conversations saved more time. (6) Influence of running We-Media platforms on surgeons: 20.09%(46/229) and 6.55%(15/229) of surgeons attributed the success to "long-term, sustainable, absorbed operation" and "important contents of We-Media platforms and wide audiences". There were 72.49%(166/229) of surgeons yet to be successful. There were 26.64% (61/229) and 22.27%(51/229) of surgeons believing that opening We-Media platforms was conducive to the association's employment and multicenter clinical research. Operating We-Media platforms was conducive to professional knowledge improvement, clinical research ability enhancement and teaching level of students, which was believed by 54.59%(125/229), 40.17%(92/229) and 48.91%(112/229) of surgeons, respectively. Although the total income in 88.65%(203/229) of surgeons increased less than 20% after 6 months of operation, 47.60%(109/229) of surgeons believed that "the sense of achievement or pleasure in work has been significantly improved", and 48.91%(112/229) of surgeons did not have the idea of quitting. There were 7.42%(17/229) of surgeons with the idea of quitting the operation of We-Media platforms. (7) Feelings and suggestions of surgeons after running We-Media platforms: the proportion of surgeons who hoped to get help from departments, hospitals, associations and the society were 61.57%(141/229), 72.05%(165/229), 47.16%(108/229) and 53.28%(122/229), respectively. Only 9.61%(22/229) of surgeons did not require help. Commercial advertisement was allowed by 40.17%(92/229) of surgeons and forbidden by 59.83%(137/229) of surgeons. In terms of alternative suggestion, 70.74%(162/229) of surgeons believed that it was necessary for the We-Media platforms to involve more doctors of different specialties, but 40.61%(93/229) of surgeons believed that relevant departments or associations should strengthen supervision under the current situation. In addition, 32.75%(75/229) of surgeons believed that the operation of We-Media platform requires more investment. The were 27.95%(64/229) of surgeons giving specific suggestions on running We-Media platforms, 7.81%(5/64) of which did not suggest a blind try.Conclusions:Most surgeons who open and operate We-Media platforms in China are faced with problems such as busy work, limited time and energy, low-income increase, and lack of professional promotion and maintenance teams and external support. Even so, there are still many surgeons who have achieved success through long-term persistence and high-quality content output, thus increasing the number of patient visits, improving their own ability and industry influence, and bringing a greater sense of professional achievement.
6.Association between nonalcoholic fatty liver disease and colorectal neoplasms
Xiangqian HUANG ; Xiaomeng YAN ; Mingda ZHANG ; Jing WU ; Jianhong CHEN
Journal of Clinical Hepatology 2021;37(12):2947-2950
Nonalcoholic fatty liver disease (NAFLD) is considered the liver manifestation of metabolic syndrome and is closely associated with the development and progression of colorectal neoplasms. This article reviews the association of NAFLD with colorectal adenoma (CRA) and colorectal cancer (CRC) and possible mechanism, and it is believed that NAFLD promotes the development of CRA and CRC and affects their prognosis, and various factors, such as insulin resistance, adipocytokine, inflammatory response, intestinal flora, and immunity, may be involved in this process.
7.MicroRNA-132 in the Adult Dentate Gyrus is Involved in Opioid Addiction Via Modifying the Differentiation of Neural Stem Cells.
Meng JIA ; Xuewei WANG ; Haolin ZHANG ; Can YE ; Hui MA ; Mingda YANG ; Yijing LI ; Cailian CUI
Neuroscience Bulletin 2019;35(3):486-496
MicroRNA-132 (miR-132), a small RNA that regulates gene expression, is known to promote neurogenesis in the embryonic nervous system and adult brain. Although exposure to psychoactive substances can increase miR-132 expression in cultured neural stem cells (NSCs) and the adult brain of rodents, little is known about its role in opioid addiction. So, we set out to determine the effect of miR-132 on differentiation of the NSCs and whether this effect is involved in opioid addiction using the rat morphine self-administration (MSA) model. We found that miR-132 overexpression enhanced the differentiation of NSCs in vivo and in vitro. Similarly, specific overexpression of miR-132 in NSCs of the adult hippocampal dentate gyrus (DG) during the acquisition stage of MSA potentiated morphine-seeking behavior. These findings indicate that miR-132 is involved in opioid addiction, probably by promoting the differentiation of NSCs in the adult DG.
Animals
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Cell Differentiation
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Cell Line, Tumor
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Dentate Gyrus
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metabolism
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Gene Expression Regulation
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Male
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MicroRNAs
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metabolism
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Neural Stem Cells
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metabolism
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Opioid-Related Disorders
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metabolism
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Rats, Sprague-Dawley
8.Magnetic resonance imaging of the femoral head morphology of the hip after normal children and DDH with closed and open reduction
Minglei LI ; Mingda WANG ; Guoqiang JIA ; Lijun ZHANG ; Enbo WANG
International Journal of Pediatrics 2018;45(12):968-972
Objective To investigate the shaping rules of the femoral heads in the morphological perspective.The research objects are hips of normal children and children who have developmental dysplasia of the hip(DDH) and after closed reduction or limited open reduction.At the same time measuring and analyzing normal hip femoral head form changing with the children's age.Methods Collecting the DDH cases that after closed reduction and limited open reduction from June 2013 to December 2015.The follow-up period was more than 1 year.MRI images were collected before surgery,6 months after surgery,1 year after surgery,and 2 years after surgery.In addition,normal hip joint MRI images from 0 to 18 years old were collected for controlled study.Descriptive data on the affected side,healthy side and normal hip joint morphology of the hip dislocation were statistically analyzed.Results (1) The mean eccentricity of femoral head in normal hip decreased from (0.362 ±0.069) at 1-2 years to(0.141 ±0.028) at 18-19 years.(2) The eccentricity of femoral head before closed reduction and limited open reduction were both greater than those of healthy side.There was no significant difference in the eccentricity of the femoral head between the healthy side and the affected side at 1 year after closed reduction (P =0.211).There was no significant difference in the diameter of the bilateral femoral heads (P =0.871).The eccentricity of the bilateral femoral heads remained different at 2 years after limited open reduction (P =0.028),and the diameter of the affected femoral head exceeded the healthy side 1 year after surgery (P =0.001).Conclusion The shape of the femoral head of normal children gradually approaches the spherical shape with age.One year after closed reduction of DDH,the shape and size of the affected femoral head are close to the healthy side,and the femoral head of the affected side increases more than the healthy side in 1 ~ 2 years after open reduction and the morphology is still different.
9.Application of nasal continuous positive airway pressure preferential ventilation strategy in the treatment of infant severe pneumonia
Jiuwei DONG ; Bin ZHU ; Xiaohua JIANG ; Mingda TIAN ; Yujing SUN ; Weiqiang ZHANG
Chinese Journal of Postgraduates of Medicine 2016;39(11):989-992
Objective To investigate the value of nasal continuous positive airway pressure (NCPAP) in the treatment of severe pneumonia. Methods The clinical data of 59 severe pneumonia infants who received NCPAP preferential ventilation strategy were retrospectively analyzed. Results After treatment, 50 infants were effective and 9 infants were ineffective. Before treatment, the age, RR, HR between effective group and ineffective group had no significant differences (P>0.05). But the levels of PaCO2, PaO2/FiO2 in ineffective group were significantly higher than those in effective group and the level of PaO2 in ineffective group was significantly lower than that in effective group (P<0.05). In effective group, the levels of PaO2 and PaO2/FiO2 were significantly increased after treatment for 1, 12 and 24 h, and the levels of PaCO2, RR and HR were significantly decreased (P<0.01). Conclusions NCPAP preferential ventilation strategy can reduce the use of invasive mechanical ventilation, improve oxygenation, ease dyspnea and make vital signs stable.
10.Expression and association of IMP3 and MVD in squamous carcinoma of the cervix
Yajun ZHANG ; Xin JIANG ; Yue JIANG ; Mingda CHENG ; Ming LI
Chinese Journal of Clinical and Experimental Pathology 2014;(9):996-999
Purpose To investigate the expression of insulin-like growth factorIImRNA binding protein 3 ( IMP3 ) and microvessel density (MVD) in squamous carcinoma of the cervix (SCC) and analysis their relationship in SCC. Methods The expression of IMP3 and MVD was examined by immunohistochemistry SP method in normal cervical epithelium ( NCE) , low-grade cervical intraepi-thelial neoplasia (CIN-L), high-grade cervical intraepithelial neoplasia (CIN-H) and SCC. Results (1)The positive expression rates of IMP3 in NCE, CIN-L, CIN-H, SCC tissues were 0(0/15), 0(0/11), 37.5%(9/24) and 86.0%(43/50), the difference was statistically significant (x 2 =53.345, P=0.000). IMP3 expression was significant difference among NCE and CIN-H, SCC (P<0.008 3), and that was also among SCC and CIN-L, CIN-H (P<0.008 3). (2)The MVD count was increased with the development of cervical squamous lesion, there was significant difference among those groups (F=145.968, P<0.01), and the difference was al-so statistically significant between every two groups (P<0.05). The positive expression of IMP3 and MVD count in 50 cases of SCC tissues showed statistical difference in different pathologic grade, lymph node metastasis, and depth of tumor invasion groups ( P<0.05), but didn't in different patients’age groups (P>0.05). And the positive expression of IMP3 was closely related with MVD count in SCC tissues (rs =0.323, P<0.05). Conclusion IMP3 plays an important role in the occurrence, infiltration and metasta-sis of SCC, and the abnormal expression of IMP3 may relate with the angiogenesis of tumors.

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