1.Long-term Outcomes of Endoscopic Radiofrequency Ablation versus Endoscopic Submucosal Dissection for Widespread Superficial Esophageal Squamous Cell Neoplasia
Xin TANG ; Qian-Qian MENG ; Ye GAO ; Chu-Ting YU ; Yan-Rong ZHANG ; Yan BIAN ; Jin-Fang XU ; Lei XIN ; Wei WANG ; Han LIN ; Luo-Wei WANG
Gut and Liver 2025;19(2):198-206
Background/Aims:
Endoscopic radiofrequency ablation (ERFA) is a treatment option for superficial esophageal squamous cell neoplasia (ESCN), with a relatively low risk of stenosis; however, the long-term outcomes remain unclear. We aimed to compare the long-term outcomes of patients with widespread superficial ESCN who underwent endoscopic submucosal dissection (ESD) or ERFA.
Methods:
We retrospectively analyzed the clinical data of patients with superficial ESCN who underwent ESD or ERFA between January 2015 and December 2021. The primary outcome measure was recurrence-free survival.
Results:
Ninety-two and 33 patients with superficial ESCN underwent ESD and ERFA, respectively. The en bloc, R0, and curative resection rates for ESD were 100.0%, 90.2%, and 76.1%, respectively. At 12 months, the complete response rate was comparable between the two groups (94.6% vs 90.9%, p=0.748). During a median follow-up of 66 months, recurrence-free survival was significantly longer in the ESD group than in the ERFA group (p=0.004), while no significant differences in overall survival (p=0.845) and disease-specific survival (p=0.494) were observed.Preoperative diagnosis of intramucosal cancer (adjusted hazard ratio, 5.55; vs high-grade intraepithelial neoplasia) was an independent predictor of recurrence. Significantly fewer patients in the ERFA group experienced stenosis compare to ESD group (15.2% vs 38.0%, p=0.016).
Conclusions
The risk of recurrence was higher for ERFA than ESD for ESCN but overall survival was not affected. The risk of esophageal stenosis was significantly lower for patients who underwent ERFA.
2.Long-term Outcomes of Endoscopic Radiofrequency Ablation versus Endoscopic Submucosal Dissection for Widespread Superficial Esophageal Squamous Cell Neoplasia
Xin TANG ; Qian-Qian MENG ; Ye GAO ; Chu-Ting YU ; Yan-Rong ZHANG ; Yan BIAN ; Jin-Fang XU ; Lei XIN ; Wei WANG ; Han LIN ; Luo-Wei WANG
Gut and Liver 2025;19(2):198-206
Background/Aims:
Endoscopic radiofrequency ablation (ERFA) is a treatment option for superficial esophageal squamous cell neoplasia (ESCN), with a relatively low risk of stenosis; however, the long-term outcomes remain unclear. We aimed to compare the long-term outcomes of patients with widespread superficial ESCN who underwent endoscopic submucosal dissection (ESD) or ERFA.
Methods:
We retrospectively analyzed the clinical data of patients with superficial ESCN who underwent ESD or ERFA between January 2015 and December 2021. The primary outcome measure was recurrence-free survival.
Results:
Ninety-two and 33 patients with superficial ESCN underwent ESD and ERFA, respectively. The en bloc, R0, and curative resection rates for ESD were 100.0%, 90.2%, and 76.1%, respectively. At 12 months, the complete response rate was comparable between the two groups (94.6% vs 90.9%, p=0.748). During a median follow-up of 66 months, recurrence-free survival was significantly longer in the ESD group than in the ERFA group (p=0.004), while no significant differences in overall survival (p=0.845) and disease-specific survival (p=0.494) were observed.Preoperative diagnosis of intramucosal cancer (adjusted hazard ratio, 5.55; vs high-grade intraepithelial neoplasia) was an independent predictor of recurrence. Significantly fewer patients in the ERFA group experienced stenosis compare to ESD group (15.2% vs 38.0%, p=0.016).
Conclusions
The risk of recurrence was higher for ERFA than ESD for ESCN but overall survival was not affected. The risk of esophageal stenosis was significantly lower for patients who underwent ERFA.
3.Long-term Outcomes of Endoscopic Radiofrequency Ablation versus Endoscopic Submucosal Dissection for Widespread Superficial Esophageal Squamous Cell Neoplasia
Xin TANG ; Qian-Qian MENG ; Ye GAO ; Chu-Ting YU ; Yan-Rong ZHANG ; Yan BIAN ; Jin-Fang XU ; Lei XIN ; Wei WANG ; Han LIN ; Luo-Wei WANG
Gut and Liver 2025;19(2):198-206
Background/Aims:
Endoscopic radiofrequency ablation (ERFA) is a treatment option for superficial esophageal squamous cell neoplasia (ESCN), with a relatively low risk of stenosis; however, the long-term outcomes remain unclear. We aimed to compare the long-term outcomes of patients with widespread superficial ESCN who underwent endoscopic submucosal dissection (ESD) or ERFA.
Methods:
We retrospectively analyzed the clinical data of patients with superficial ESCN who underwent ESD or ERFA between January 2015 and December 2021. The primary outcome measure was recurrence-free survival.
Results:
Ninety-two and 33 patients with superficial ESCN underwent ESD and ERFA, respectively. The en bloc, R0, and curative resection rates for ESD were 100.0%, 90.2%, and 76.1%, respectively. At 12 months, the complete response rate was comparable between the two groups (94.6% vs 90.9%, p=0.748). During a median follow-up of 66 months, recurrence-free survival was significantly longer in the ESD group than in the ERFA group (p=0.004), while no significant differences in overall survival (p=0.845) and disease-specific survival (p=0.494) were observed.Preoperative diagnosis of intramucosal cancer (adjusted hazard ratio, 5.55; vs high-grade intraepithelial neoplasia) was an independent predictor of recurrence. Significantly fewer patients in the ERFA group experienced stenosis compare to ESD group (15.2% vs 38.0%, p=0.016).
Conclusions
The risk of recurrence was higher for ERFA than ESD for ESCN but overall survival was not affected. The risk of esophageal stenosis was significantly lower for patients who underwent ERFA.
4.Long-term Outcomes of Endoscopic Radiofrequency Ablation versus Endoscopic Submucosal Dissection for Widespread Superficial Esophageal Squamous Cell Neoplasia
Xin TANG ; Qian-Qian MENG ; Ye GAO ; Chu-Ting YU ; Yan-Rong ZHANG ; Yan BIAN ; Jin-Fang XU ; Lei XIN ; Wei WANG ; Han LIN ; Luo-Wei WANG
Gut and Liver 2025;19(2):198-206
Background/Aims:
Endoscopic radiofrequency ablation (ERFA) is a treatment option for superficial esophageal squamous cell neoplasia (ESCN), with a relatively low risk of stenosis; however, the long-term outcomes remain unclear. We aimed to compare the long-term outcomes of patients with widespread superficial ESCN who underwent endoscopic submucosal dissection (ESD) or ERFA.
Methods:
We retrospectively analyzed the clinical data of patients with superficial ESCN who underwent ESD or ERFA between January 2015 and December 2021. The primary outcome measure was recurrence-free survival.
Results:
Ninety-two and 33 patients with superficial ESCN underwent ESD and ERFA, respectively. The en bloc, R0, and curative resection rates for ESD were 100.0%, 90.2%, and 76.1%, respectively. At 12 months, the complete response rate was comparable between the two groups (94.6% vs 90.9%, p=0.748). During a median follow-up of 66 months, recurrence-free survival was significantly longer in the ESD group than in the ERFA group (p=0.004), while no significant differences in overall survival (p=0.845) and disease-specific survival (p=0.494) were observed.Preoperative diagnosis of intramucosal cancer (adjusted hazard ratio, 5.55; vs high-grade intraepithelial neoplasia) was an independent predictor of recurrence. Significantly fewer patients in the ERFA group experienced stenosis compare to ESD group (15.2% vs 38.0%, p=0.016).
Conclusions
The risk of recurrence was higher for ERFA than ESD for ESCN but overall survival was not affected. The risk of esophageal stenosis was significantly lower for patients who underwent ERFA.
5.A whole genome analysis of two coxsackievirus A2 strains isolated from patients with herpetic angina in Shanghai
Jingyi ZHANG ; Jiayu WANG ; Run LI ; Fanghao FANG ; Wencheng WU ; Wanju ZHANG ; Min CHEN ; Xin CHEN ; Zheng TENG
Shanghai Journal of Preventive Medicine 2025;37(3):215-221
ObjectiveTo understand the whole genome characteristics and the information for genetic evolution in the two coxsackievirus A2 (CVA2) strains isolated from patients with herpangina in Shanghai, and to provide a scientific basis for the prevention and treatment of herpetic angina. MethodsTwo CAV2 strains isolated from patients with herpetic angina in Shanghai were performed whole genome sequencing and analysis for phylogenetics, nucleotide homology, and evolution. ResultsA phylogenetic analysis of the VP1 region revealed that the two Shanghai strains both belonged to CVA2 genotype D, with the highest homology to OL357660, a strain from Yunnan. The average nucleotide identity (ANI) of the whole genome between the two Shanghai strains was 98.88%, and the ANI of the whole genome comparisons to other CVA2 genotype D strains and CVA2 genotypes A-C strains ranged from 84.64% to 97.42% and from 79.21% to 84.20%, respectively. The two Shanghai strains had low homology in the 3D region compared to the existing CVA2 strains. The phylogenetic analysis and sliding window nucleotide similarity analysis indicated that the two Shanghai strains and the Yunnan OL357660 strain might constitute a new genetic lineage. ConclusionThe two CVA2 strains isolated for the first time in Shanghai are assigned to genotype D (GenBank: PQ130039 and PQ130040), which is identical to the existing subtype prevalent in China. As represented by the Shanghai strains, a new CVA2 genetic lineage is been identified. This study has enriched the data on genetic evolution and genetic variation of CVA2 in Shanghai, indicating the requirement to strengthen surveillance for the epidemiological pattern of CVA2.
6.Discussion on Research Paradigm and Layout Based on Disease (Psoriasis) Specifically Responding to Traditional Chinese Medicine
Liu LIU ; Xiaoying SUN ; Mei MO ; Zihan FANG ; Yaqiong ZHOU ; Bin LI ; Xiaoxiao ZHANG ; Xin LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):203-211
To implement the Opinions of the State Council of the Central Committee of the Communist Party of China on Promoting the Inheritance and Innovative Development of Traditional Chinese Medicine, delve into the diseases specifically responding to traditional Chinese medicine (TCM), and serve the building of advantageous specialties, clinical talent cultivation, national research layout, and academic innovation, the Chinese Association of Chinese Medicine sponsored the salons in multiple fields to discuss the diseases specifically responding to TCM. On August 26, 2023, the 25th salon on the diseases specifically responding to TCM was held in Shanghai. In view of the advantages of TCM and integrated traditional Chinese and Western medicine in the diagnosis and treatment of psoriasis, Chinese and western medicine experts and interdisciplinary researchers carried out extensive and in-depth discussions and formed specific suggestions and consensus on the diagnosis and treatment of psoriasis with TCM and integrated traditional Chinese and Western medicine. However, there was still a lack of detailed research path. Under the guidance of the Chinese Association of Chinese Medicine, this paper analyzes the problems in the diagnosis and treatment of psoriasis from the occurrence and development of psoriasis. According to the advantages and characteristics of TCM and integrated traditional Chinese and Western medicine in the diagnosis and treatment of psoriasis, this paper puts forward the main points of research layout for psoriasis from the three aspects of psoriasis diagnosis and treatment, comorbidity prevention, and chronic disease management as follows: ① optimization of the syndrome differentiation system for psoriasis, ② optimization of assessment indicators for psoriasis, ③ recurrence mechanisms of psoriasis, ④ construction and research of TCM prevention and treatment of psoriasis recurrence, ⑤ construction of the comorbidity spectrum and TCM theoretical system of psoriasis, ⑥ comorbidity mechanisms of psoriasis. Furthermore, this article proposed the research layout and directions, expected goals and values, and funding priorities. Therefore, on the basis of the series of salons about psoriasis as a disease specifically responding to TCM, this article puts forward the research paradigm of psoriasis, aiming to facilitate the high-quality development of TCM and provide reference for the national research layout, the research and development of new TCM preparations, the selection of research topics, and the formulation of guidelines and consensus.
7.The lysine methyltransferase SMYD2 facilitates neointimal hyperplasia by regulating the HDAC3-SRF axis.
Xiaoxuan ZHONG ; Xiang WEI ; Yan XU ; Xuehai ZHU ; Bo HUO ; Xian GUO ; Gaoke FENG ; Zihao ZHANG ; Xin FENG ; Zemin FANG ; Yuxuan LUO ; Xin YI ; Ding-Sheng JIANG
Acta Pharmaceutica Sinica B 2024;14(2):712-728
Coronary restenosis is an important cause of poor long-term prognosis in patients with coronary heart disease. Here, we show that lysine methyltransferase SMYD2 expression in the nucleus is significantly elevated in serum- and PDGF-BB-induced vascular smooth muscle cells (VSMCs), and in tissues of carotid artery injury-induced neointimal hyperplasia. Smyd2 overexpression in VSMCs (Smyd2-vTg) facilitates, but treatment with its specific inhibitor LLY-507 or SMYD2 knockdown significantly inhibits VSMC phenotypic switching and carotid artery injury-induced neointima formation in mice. Transcriptome sequencing revealed that SMYD2 knockdown represses the expression of serum response factor (SRF) target genes and that SRF overexpression largely reverses the inhibitory effect of SMYD2 knockdown on VSMC proliferation. HDAC3 directly interacts with and deacetylates SRF, which enhances SRF transcriptional activity in VSMCs. Moreover, SMYD2 promotes HDAC3 expression via tri-methylation of H3K36 at its promoter. RGFP966, a specific inhibitor of HDAC3, not only counteracts the pro-proliferation effect of SMYD2 overexpression on VSMCs, but also inhibits carotid artery injury-induced neointima formation in mice. HDAC3 partially abolishes the inhibitory effect of SMYD2 knockdown on VSMC proliferation in a deacetylase activity-dependent manner. Our results reveal that the SMYD2-HDAC3-SRF axis constitutes a novel and critical epigenetic mechanism that regulates VSMC phenotypic switching and neointimal hyperplasia.
8.Establishment and application of a prospective follow-up research method for acute infectious diseases in Shanghai community residents
Yaxu ZHENG ; Xiao YU ; Huanyu WU ; Liming WU ; Jian CHEN ; Wenjia XIAO ; Zhuoying HUANG ; Sheng LIN ; Qiwen FANG ; Rui LIU ; Hao ZHANG ; Xin CHEN
Shanghai Journal of Preventive Medicine 2024;36(1):5-10
ObjectiveTo present the exploration and application of a prospective follow-up research method for acute infectious disease surveillance based on natural community populations, using COVID-19 infection as an example, and to provide a reference for improving the infectious disease surveillance and early warning system. MethodsA multi-stage probability proportional sampling method was employed to sample residents from all communities of 16 administrative districts in Shanghai, with households as the units. A cohort for acute infectious diseases based on natural community populations was established. The baseline survey was conducted for all cohort subjects, and COVID-19 antigen test kits were distributed. From December 21, 2022 to September 30, 2023, prospective follow-up monitoring of COVID-19 antigen and nucleic acid was carried out on the study subjects on a weekly basis. The baseline characteristics and follow-up information of the cohort subjects were described. ResultsThe cohort for acute infectious diseases included a total of 12 881 subjects, comprising 6 098 males (47.3%) and 6 783 females (52.7%). The baseline survey revealed that 35.2% (4 540/12 881) of the subjects had a history of COVID-19 infection. During the follow-up period from December 21, 2022 to September 30, 2023, the average incidence density in the cohort was 0.61/person-year, with a higher incidence density in females (0.63/person-year) compared to males (0.59/person-year). Individuals aged 60 and above (0.64/person-year) and those with underlying health conditions (0.67/person-year) had a higher incidence density. Healthcare workers showed a notably higher incidence density (0.84/person-year) than that in other occupational groups. As of September 30, 2023, a total of 340 subjects in the cohort experienced secondary infections, with a median interval of 170 days between the first and second infections. ConclusionThis study applies cohort study method to acute infectious disease surveillance, providing crucial data support for estimating infection rates and forecasting alerts for acute infectious diseases in the community. This method can be promoted and applied as a new approach for acute infectious disease surveillance.
9.Protective effect and mechanism of Longshengzhi capsules on cerebral ischemia-reperfusion injury in rats
Huanle FANG ; Xiaoming LI ; Yaming ZHOU ; Xin ZHANG ; Xiaoxi LIU ; Yanbin CHEN
China Pharmacy 2024;35(7):813-818
OBJECTIVE To explore the protective effect and mechanism of Longshengzhi capsules on cerebral ischemia- reperfusion injury in rats. METHODS The model of middle cerebral artery occlusion (MCAO) was established by using the improved thread occlusion method. The experiment was divided into six groups: sham surgery group (only separating blood vessels without inserting thread plugs, given the same volume of normal saline), model group (modeling, given the same volume of normal saline), nimodipine group (positive control, modeling, dose of 20 mg/kg), and low-dose, medium-dose, and high-dose groups of Longshengzhi capsules (modeling, doses of 0.72, 1.44 and 2.88 g/kg, respectively), with 10 mice in each group. Each group was given corresponding medication solution/normal saline by gavage, once a day, for 7 consecutive days. One hour after the last administration, the Zea Longa scoring method was used to score the neurological deficits in each group of rats, and the ABC enzyme-linked immunosorbent assay was used to detect the serum levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in rats; TTC staining was used to observe the volume of cerebral infarction in rats and calculate the cerebral infarction volume ratio. Hematoxylin eosin staining was used to observe the pathological changes in the brain tissue of rats. Immunohistochemical staining was used to detect the positive expression of NLRP3 protein in the brain tissue of rats. Real-time fluorescence quantitative PCR was used to detect mRNA relative expressions of Toll-like receptor 4 (TLR4) and nuclear factor-κB (NF-κB) in the brain tissue of rats. Western blot assay was adopted to detect the relative expressions of TLR4, NLRP3 and phosphorylated NF-κB (p-NF-κB) protein in the brain tissue of rats and its intracellular NF-κB protein. RESULTS Compared with the sham surgery group, the neural dysfunction score, serum levels of TNF-α and IL-6, cerebral infarction volume ratio, relative expression levels of NF-κB and TLR4 mRNA, as well as protein relative expressions of TLR4, NLRP3 and p-NF-κB in the brain tissue, and relative protein expression of intracellular NF-κB were increased significantly in the model group (P<0.01); the enlarged gap and significant edema were observed in cortical nerve cells of brain tissue in rats, with a large amount of inflammatory cell infiltration; the positive expression of NLRP3 protein in brain tissue of rats obviously increased. Compared with the model group, the levels of the above indicators in the medium-dose and high-dose groups of Longshengzhi capsules, as well as the Nimodipine group, were reversed to varying degrees, and most differences were statistically significant (P<0.05 or P<0.01); the pathological morphology observation showed a significant improvement, and the positive expression of NLRP3 protein in the brain tissue of rats was obviously reduced. CONCLUSIONS Longshengzhi capsules may inhibit TLR4/NF-κB/NLRP3 signaling pathway and neuroinflammatory response, thereby achieving a protective effect against cerebral ischemia-reperfusion injury in rats.
10.Clinical Observation on the Therapeutic Effect of Lingnan Traditional Vesiculating Moxibustion No.4 Recipe in the Treatment of Mild Depressive Disorder
Yi-Rong ZHOU ; Hui FANG ; Wan-Xin ZHANG ; Xiang JI ; Wen-Bin FU
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(4):959-964
Objective To observe the clinical efficacy of Lingnan Traditional Vesiculating Moxibustion No.4 Recipe(mainly composed of Brassicae Junceae Semen,Euodiae Fructus,and Curcumae Radix)in the treatment of mild depressive disorder(DD),and to provide a novel approach to the treatment of mild DD population.Methods Sixty-one patients with mild DD were randomly divided into 31 cases in the trial group and 30 cases in the control group.The trial group was given medicinal vesiculation treatment with Lingnan Traditional Vesiculating Moxibustion No.4 Recipe,and the control group was given medicinal vesiculation treatment with the placebo of Lingnan Traditional Vesiculating Moxibustion No.4 Recipe.The treatment was performed twice a week and with an interval of 3-4 days between the treatment,and the course of treatment covered 6 weeks.The changes of Hamilton Depression Scale-17(HAMD-17)scores and Patient Health Questionnaire-9(PHQ-9)scores in the two groups were observed before and after the treatment.After treatment,the clinical efficacy and safety of the patients in the two groups were evaluated.Results(1)After 6 weeks of treatment,the total efficacy rate of the trial group was 77.42%(24/31),and that of the control group was 26.67%(8/30).The intergroup comparison(tested by rank sum test)showed that the efficacy of the trial group was significantly superior to that of the control group,and the difference was statistically significant(P<0.01).(2)After treatment,the HAMD-17 scores and PHQ-9 scores of patients in the two groups were lower than those before treatment(P<0.01),and the decrease of HAMD-17 and PHQ-9 scores in the trial group was significantly superior to that of the control group,the difference being statistically significant(P<0.01).(3)During the trial,there were 5 cases of adverse events related to the vesiculating moxibustion treatment,and all 5 cases of adverse events occurred in the trial group,manifested as minor blisters at the acupoint application region.The 5 cases kept on participating in the trial after relevant treatment.Conclusion Lingnan Traditional Vesiculating Moxibustion No.4 Recipe can effectively relieve the clinical symptoms of patients with mild DD,and has high safety.

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