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    Frontier review
    Clinical values and advances in computed tomography evaluation after cochlear implantation
    GU Wenxi, JIA Huan, WU Hao
    2023, 43 (12):  1463-1469. 
    doi: 10.3969/j.issn.1674-8115.2023.12.001

    Abstract ( 149 )   HTML ( 27 )   PDF (2881KB) ( 149 )  

    Cochlear implantation has been a standard rehabilitation for children and adult patients with severe to profound sensorineural deafness. The intracochlear localization of the electrode array is one of the key factors related to the postoperative auditory and speech outcomes. Preservation of the residual hearing is related to the trauma to the inner ear structures caused in the insertion process. Optimal insertion depth and positioning of the electrode array is important for frequency discrimination. The post-operative position of the electrode array is evaluated by using plain X ray or computed tomography (CT). Compared to the plain X ray, CT produces three-dimensional (3D) imaging. With the application of post-operative CT evaluation, the integrity of the electrode array can be verified for surgical safety and improving programming accuracy. Different 3D reconstruction techniques and methods based on the post-operative CT imaging have been proposed to facilitate the precise recognition of position of each electrode, thus helpful to evaluate the possible insertion trauma to inner ear structures and the potential effect on auditory and speech outcomes. The post-operative CT evaluation has helped the electrode array design, brought progress to the soft surgery procedure and promoted new technologies such as robotic surgery and navigation. Therefore, it is getting more and more attention. This article reviews the clinical application values and the progress of techniques in post-operative CT evaluation of cochlear implantation.

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    FBXO38 regulates ocular melanoma proliferation through the PI3K-Akt signaling pathway
    WU Yijia, FANG Yan, SHEN Feiyang, HUANG Rui, SHEN Jianfeng, FAN Xianqun
    2023, 43 (12):  1470-1479. 
    doi: 10.3969/j.issn.1674-8115.2023.12.002

    Abstract ( 147 )   HTML ( 21 )   PDF (3651KB) ( 92 )  

    Objective ·To investigate the effect of F-box only protein 38 (FBXO38) on the ocular melanoma proliferation and the potential regulatory pathway. Methods ·Human skin cutaneous melanoma A375 and human uveal melanoma OMM2.3 cell lines with FBXO38 knockdown and overexpression were constructed by FBXO38 short hairpin RNA (shRNA) and FBXO38 overexpression plasmids respectively. Knockdown and overexpression efficiency of FBXO38 at transcription and protein levels were verified by using quantitative real-time PCR (qRT-PCR) and Western blotting. The effects of FBXO38 on melanoma cell proliferation were detected through clonal formation assay, BrdU immunofluorescence staining and CCK8 cell proliferation assay. By using The Cancer Genome Atlas (TCGA) database, differentially expressed genes were analyzed in the high and low expression groups of FBXO38. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment was performed to reveal the signaling pathways associated with FBXO38. CCK8 cell proliferation assay was used to detect the inhibition rates of the signaling pathway inhibitors on cells with different FBXO38 expression levels. qRT-PCR and Western blotting were used to detect whether the signaling pathway was activated after knocking down FBXO38. Results ·qRT-PCR and Western blotting verified that mRNA and protein expression levels of FBXO38 in FBXO38 knockdown A375 and OMM2.3 cell lines decreased compared with the control group, while the expression levels of FBXO38 in the overexpression cell lines increased compared with wild type group (P<0.05). Clonal formation assay, BrdU immunofluorescence staining and CCK8 cell proliferation assay showed that FBXO38 knockdown significantly enhanced the proliferation of A375 and OMM2.3 cells (P<0.05), while overexpression of FBXO38 inhibited melanoma cell proliferation (P<0.05). Enrichment analysis showed that in skin cutaneous melanoma and uveal melanoma, FBXO38 expression influenced the phosphoinositide 3-kinase/protein kinase B (PI3K-Akt) pathway activation. Compared with those in the control group, the inhibition rates of PI3K inhibitor LY294002 and mTOR1 inhibitor Everolimus in the FBXO38 knockdown group significantly improved (P<0.05), while their inhibition rates of the overexpression group significantly decreased compared with those of control cells (P<0.05). Western blotting results showed that after knocking down FBXO38, expression levels of PTEN, P21 and P53 proteins decreased, while expression level of MDM2 protein increased. The qRT-PCR results showed a significant decrease in P53 transcription level (P<0.05) and a significant increase in MDM2 transcription level in FBXO38 knockdown cells (P<0.05). Conclusion ·FBXO38 plays a role in regulating the proliferation of ocular melanoma, and this regulatory effect is related to the PI3K-Akt signaling pathway.

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    Basic research
    Fabrication of self-healing injectable hyaluronic acid hydrogel for promoting angiogenesis
    YANG Shu, CUI Wenguo, WEI Jie, CAI Zhengwei
    2023, 43 (12):  1480-1492. 
    doi: 10.3969/j.issn.1674-8115.2023.12.003

    Abstract ( 157 )   HTML ( 15 )   PDF (7495KB) ( 202 )  

    Objective ·To construct a self-healing injectable hyaluronic acid (HA)-based hydrogel (HAPD-Cu) and investigate the effects of different copper ions on the properties of the hydrogel and its vasogenic efficacy to evaluate its feasibility for clinical wound healing. Methods ·Bisphosphonated hyaluronic acid (HAPD) was prepared via a blue-light mediated thiol-ene click reaction between thiolated hyaluronic acid (HASH) and acrylated bisphosphonate (Ac-PD) in the presence of photoinitiator 2959. Then, HAPD was further interacted with Cu2+ through metal coordination to prepare HAPD-Cu hydrogels with different Cu2+ concentrations, i.e. HAPD-Cu1, HAPD-Cu2, HAPD-Cu3 and HAPD-Cu4. The molecular structures of HASH, Ac-PD, HAPD and HAPD-Cu were verified with 1HNMR and FTIR. Microscopic morphology of HAPD-Cu was observed under SEM. The shear-thinning and self-healing properties of HAPD-Cu were verified by rheometer. The Cu2+ release from HAPD-Cu was determined with ICP. Live-dead staining and CCK-8 assay were applied to evaluate the biocompatibility of HAPD-Cu. The in vitro vasculogenic activity of HAPD-Cu was determinedby a tubule-forming assay with human umbilical vein vascular endothelial cells and the in vivo vasculogenic activity of HAPD-Cu was assessed by CD31 tissue staining. A rat wound defect model was established in vitro to evaluate its actual repair effect. Results ·The preparation of the materials was demonstrated through chemical qualitative and quantitative analytical means. In vitro studies showed that all HAPD-Cu with a loose porous internal structure exhibited outstanding self-healing, injectability and degradability, with a one-week degradation cycle and abrupt release behavior, which can meet the needs of wound healing cycle. All HAPD-Cu showed good biocompatibility except HAPD-Cu4, due to its high Cu2+ concentrations. Moreover, its angiogenic effect in vitro or in vivo was enhanced with increasing Cu2+ concentrations within the permissible Cu2+ concentration range. In vitro wound model experiments also showed that the HAPD-Cu hydrogel significantly promoted wound healing compared with the control group. Conclusion ·HAPD-Cu hydrogel constructed via the metal coordination shows excellent shape plasticity, allowing the filling of defective sites in a minimally invasive form, and the release of Cu2+ greatly facilitates the establishment of early vascular networks, with giant potential for use in the repair of clinically irregular wounds.

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    Regulation of high-fat diet-induced microglial metabolism by transient receptor potential vanilloid type 1
    SHA Xudong, WANG Chenfei, LU Jia, YU Zhihua
    2023, 43 (12):  1493-1506. 
    doi: 10.3969/j.issn.1674-8115.2023.12.004

    Abstract ( 94 )   HTML ( 16 )   PDF (12986KB) ( 43 )  

    Objective ·Transcriptomic and lipidomic analysis techniques were used to investigate the role of transient receptor potential vanilloid type 1 (TRPV1) channel activation in the regulation of high-fat diet-induced microglial metabolism. Methods ·Eight-week-old C57BL/6J mice (WT) and Trpv1-/- (KO) mice were used as experimental animals, and fed high-fat diet (HFD) for 3 days, 7 days, and 8 weeks to induce modelling (WT and KO groups, n = 3; WT-HFD and KO-HFD groups, n = 4). TRPV1 channel expression and cellular localisation were measured by immunofluorescence in the brains of mice in the WT-HFD and KO-HFD group. RNA sequencing and liquid chromatography-mass spectrometry were performed to determine the brain phenotype of mice in the WT-HFD and KO-HFD groups. Results ·The expression level of Trpv1 mRNA in microglia was significantly increased in mice in the WT-HFD group compared to mice in the WT group. The expression levels of genes related to brain lipid metabolism, mitochondrial function, glucose transfer, and glycolysis were down-regulated in the KO-HFD group of mice compared with the WT-HFD group of mice. Lipidomic analysis showed that although lipids accumulated in the brain tissue of mice in the KO-HFD group, Trpv1 knockdown attenuated HFD-induced microglia activation, and in addition the TRPV1 agonist capsaicin attenuated palmitate-induced depolarisation of mitochondrial membrane potential in vitro. Conclusion ·Together, these findings suggest that TRPV1 regulates lipid and glucose metabolism in microglia via fuel availability driven by a mitochondrial mechanism.

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    Deciphering the suppressive effects of CBX8 on prostate cancer cell invasion
    YANG Wanli, SONG Juan, LI Bing, LAO Yimin
    2023, 43 (12):  1507-1519. 
    doi: 10.3969/j.issn.1674-8115.2023.12.005

    Abstract ( 119 )   HTML ( 15 )   PDF (11216KB) ( 74 )  

    Objective ·To elucidate the regulatory mechanisms of the chromobox protein homolog 8 (CBX8) in prostate cancer metastasis from transcriptome and epigenetic modification perspectives. Methods ·The correlation between the expression of CBX proteins and prostate adenocarcinoma (PRAD) in The Cancer Genome Atlas (TCGA) was examined through an analysis based on cBioPortal database. A stable CBX8 knockdown DU145 prostate cancer cell line was established via short hairpin RNA (shRNA) transfection. Subsequently, the proliferation and invasion of the CBX8 knockdown cells were analyzed by CCK-8 assay and Transwell assay, respectively. Transcriptome changes of the CBX8 knockdown cells were investigated through RNA sequencing (RNA-seq) coupled with Gene Set Enrichment Analysis (GSEA). To further evaluate the functional implications of these transcriptomic alterations, Gene Ontology (GO) for functional analysis was deployed. Moreover, to identify potentially affected signalling pathways, the Kyoto Encyclopedia of Genes and Genomes (KEGG) was utilized for pathway enrichment analysis. Lastly, the levels of H3K27me3, a key histone modification associated with CBX8, in the knockdown cells were determined by chromatin immunoprecipitation sequencing (ChIP-seq). Results ·Bioinformatic analysis with cBioPortal database, based on TCGA-PRAD cohorts, unveiled a high CBX8 mRNA expression in PRAD. Knockdown of CBX8 did not significantly affect the proliferation of DU145 cells (P>0.05), but caused a a significant increase in their invasiveness (P<0.05). The RNA-seq analysis revealed that CBX8 knockdown led to the upregulation of 750 genes and the downregulation of 951 genes. Notably, branched-chain-amino-acid aminotransferase 1 (BCAT1), a gene implicated in the metastasis of various types of cancers, showed a significant increase in expression following CBX8 knockdown. GSEA showed that the expression levels were of the affected genes were related to the functions of the polycomb repressive complex 1 (PRC1). A further investigation using GO and KEGG analyses identified several enriched pathways in the CBX8 knockdown cells, including transfer RNA (tRNA) aminoacylation, DNA replication, changes in aminoacyl-tRNA ligase activity, and cadherin binding. Interestingly, in terms of cell component of GO functional analysis, cell-substrate junction-related genes associated with tumor metastasis appeared to be enriched. ChIP-seq results showed a global decrease in H3K27me3 levels. Significantly, 97 reduced H3K27me3 peaks were found located nearby genes that were upregulated upon CBX8 knockdown, including the transcriptional start site of BCAT1. Conclusion ·CBX8 is highly expressed in prostate cancer. CBX8 suppresses prostate cancer cell invasion, possibly by recruiting the transcriptional repressive PRC1 complex to the transcription site of BCAT1, thereby inhibiting BCAT1 transcription and tumor metastasis.

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    Analysis of tumor-related features of non-small cell lung cancer based on TCR repertoire workflow
    ZHAO Zhuoming, LIU Zhenhao, LU Manman, ZHANG Yu, XU Linfeng, XIE Lu
    2023, 43 (12):  1520-1528. 
    doi: 10.3969/j.issn.1674-8115.2023.12.006

    Abstract ( 109 )   HTML ( 15 )   PDF (11205KB) ( 63 )  

    Objective ·To explore the immune-related characteristics of non-small cell lung cancer (NSCLC), discover potential tumor markers in V-J genes, and lay the foundation for establishing a TCR-antigen recognition prediction model. Methods ·A total of 704 NSCLC samples were collected to establish a comprehensive T-cell receptor (TCR) repertoire analysis workflow. The upstream analysis included steps such as raw data processing, quality control, filtering, TCR sequence identification, and extraction. The downstream analysis included repertoire clone distribution, clone typing, V-J gene sharing, CDR3 distribution characteristics, and clone tracking. The sample clone distribution was analyzed by using indices such as Shannon-Weiner index and Chao1 index. Clone typing was performed based on the number of clone amplifications to explore differences among different types. The degree of V-J gene segment sharing was analyzed, and the sharing of low-frequency clone types was determined through clone amplification weight analysis of V-J genes by using two samples of papillary thyroid carcinoma. Finally, analysis of the distribution characteristics of V genes and high-frequency clone type CDR3, and clone tracking analysis were conducted to monitor changes in tumor immune clone frequencies before and after analysis, aiming to identify potential tumor markers. Results ·① Significant differences were observed in clone distribution and clone typing among different NSCLC tissues, as well as among different ages and genders. ② Specific highly-shared V-J genes were identified in the analysis of V-J gene sharing, and non-normal distribution of high-clone V genes and amino acid high-frequency clone types were found in the CDR3 distribution analysis. ③ In the analysis of high-frequency clone type clone tracking, highly expressed or newly expressed high-frequency clone types were observed in NSCLC, suggesting that these clone types could serve as potential tumor-associated antigens or bind with CDR3 reference sequences of new antigens. ④ It was found that the expression frequency of TRBJ2-5 gene, originally low-expressed, significantly increased, indicating its potential role as a key low-frequency gene in tumor immune response. Conclusion ·The TRAV21 and TRBV6.5 genes show high clone amplification in NSCLC and could serve as potential tumor biomarkers.

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    Clinical research
    Application of extracorporeal membrane oxygenation to adults with cardiogenic shock and cardiac arrest in hospital
    SUI Mingliang, TANG Weibing, WU Changjiang, HUANG Chaofa, YANG Yadi, XIA Damei
    2023, 43 (12):  1529-1534. 
    doi: 10.3969/j.issn.1674-8115.2023.12.007

    Abstract ( 90 )   HTML ( 15 )   PDF (1318KB) ( 67 )  

    Objective ·To assess the effect of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) treatment on the mortality rate of patients suffering from cardiogenic shock and cardiac arrest in hospital. Methods ·A total of 19 patients with cardiogenic shock or cardiac arrest who were treated with VA-ECMO treatment in Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine from September 2017 to March 2022 were included in the retrospective study. Patients were divided into extracorporeal cardiopulmonary resuscitation (ECPR) group (n=9) and VA-ECMO for cardiogenic shock (E-CS) group (n=10) according to whether cardiac arrest had occurred. The general demographic data, clinical data, Sequential Organ Failure Assessment (SOFA) scores, postoperative complications and prognostic indicators of the two groups of patients were collected. Univariate and multivariate Cox proportional hazard regression analyses were used to evaluate the correlation between each covariate and hospital mortality. Results ·Among the included patients, there were 15 males (78.9%), with an average age of 46.5 (34.5, 61.6) years. The incidence of postoperative complications was as follows: bleeding (47.4%), AKI (36.8%), infection (31.6%), limb ischemia (15.8%) and cerebrovascular accident (5.3%). The duration of VA-ECMO was 4.0 (2.0, 6.8) days, and the intensive care duration was 11.5 (5.8, 26.2) days; the ECMO withdrawal success rate was 63.2%, and the hospital mortality was 63.2%. The results of univariate Cox proportional hazard regression analysis showed that AKI (prior to VA-ECMO initiation), postoperative complications of infection and limb ischemia were correlated with the hospital mortality of patients (all P<0.05). The results of multivariate Cox proportional hazard regression analysis showed that AKI (prior to VA-ECMO initiation), postoperative complications of infection and limb ischemia were also independent risk factors for the hospital mortality of patients (all P<0.05). Conclusion ·For patients with cardiogenic shock and cardiac arrest treated with VA-ECMO, AKI (prior to VA-ECMO initiation), postoperative infection and limb ischemia are independently associated with higher hospital mortality.

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    Coronary angiography review in 21 children with Kawasaki disease complicated with coronary artery disease
    ZHANG Meng, CUI Qing, ZHU Diqi, ZHANG Yuqi, ZHONG Yumin, SHEN Jie
    2023, 43 (12):  1535-1541. 
    doi: 10.3969/j.issn.1674-8115.2023.12.008

    Abstract ( 89 )   HTML ( 16 )   PDF (2229KB) ( 75 )  

    Objective ·To analyze the progression of children with severe coronary artery lesions due to Kawasaki disease by coronary artery angiography, and evaluate the diagnostic value of echocardiography in these children. Methods ·A retrospective analysis was performed to enroll children with Kawasaki disease whose coronary artery lesions were graded Ⅳ or above from Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, from January 2013 to January 2023. The subjects were required to have received at least 2 times of coronary angiogram, and their clinical and imaging data were collected to analyze the progression of the lesions. Echocardiography results were compared with the results of the coronary angiogram. Results ·A total of 21 children were included, including 15 males and 6 females, with a median age at onset of 3 years and 6 months, a median age at initial coronary angiography of 7 years and 11 months, a median interval of 4 years and 5 months between the time of onset and initial angiography, a median age at angiographic review of 9 years and 2 months, and a median interval of 1 year and 3 months between the time of initial angiography and review. Coronary stenosis or occlusion was detected in 13 children in the initial angiography, of whom 6 underwent coronary artery bypass grafting (CABG) and had their angiography reviews 1 year later. The review results showed that the bridging vessels were unobstructed and no obvious stenosis was observed. Fifteen children had progression of the lesions detected by echocardiography in the subsequent follow-up and had their angiogram reviews, of whom 8 had significant progression of the coronary lesions. Intracoronary balloon dilatation was performed in 1 case, and CABG was performed in another case. Sixteen lesions of coronary stenosis or occlusion were detected in the initial angiography in 21 children, while only 1 lesion of coronary stenosis was detected by echocardiography during the same period of time. Twenty-eight medium- to large-sized coronary aneurysms were detected in the initial angiography in the 21 children, and the diameters of the 28 aneurysms measured by echocardiography and coronary angiogram were subjected to the Bland-Altman analysis. The Bland-Altman analysis showed that the difference in maximum diameter between 2 methods was (1.63±2.33) mm, with 95%CI of -2.95?6.21 mm. Conclusion ·Coronary artery lesions due to Kawasaki disease may be progressive; in the children with severe lesions, coronary artery stenosis or occlusion may be missed or misdiagnosed and some errors may exist in the measurement of diameters of aneurysms by echocardiography. Regular review of coronary angiography is needed.

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    Anesthetic application of PetCO2 monitoring nasopharyngeal airway to magnifying endoscopy in patients with obstructive sleep apnea syndrome
    WU Lei, XIA Yimeng
    2023, 43 (12):  1542-1547. 
    doi: 10.3969/j.issn.1674-8115.2023.12.009

    Abstract ( 110 )   HTML ( 13 )   PDF (1293KB) ( 78 )  

    Objective ·To investigate the anesthetic effect of PetCO2 monitoring nasopharyngeal airway on preventing hypoxia in patients with obstructive sleep apnea syndrome (OSAS) during magnifying endoscopy. Methods ·Eighty OSAS patients who underwent magnifying endoscopy anesthesia in Xuchang Central Hospital of Henan Province from February to June 2023 were randomly divided into PetCO2 monitoring nasopharyngeal airway group (group T) and traditional nasopharyngeal airway group (group B), with 40 cases in each group. General information, perioperative data and total anesthetic dosage of the two groups of patients were collected and compared. The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and pulse oxygen saturation (SpO2) of the two groups of patients before anesthesia (T0), at the time of entering the endoscopy (T1), 3 min after entering the endoscopy (T2), 10 min after entering the endoscopy (T3) and at the end of endoscopy (T4) were observed and recorded, respectively. The incidence of body movement and hypoxemia, and the effects of preventing hypoxia (including mask ventilation, jaw-lift support and chest compressions to assist breath) of the two groups of patients were recorded. Results ·There were no significant differences in general information, perioperative data and total anesthetic dosage between the two groups. At T1 and T2, SpO2 in group T was higher than that in group B (T1: P=0.041,T2: P=0.012), and there was no statistically significant difference in SBP, DBP and HR between the groups; at other time points, there was no statistically significant difference in the four indicators between the two groups. Compared with group B, the incidences of body movement, hypoxemia, mask ventilation, jaw-lift support and chest compressions to assist breath in group T were all decreased (all P=0.000). Conclusion ·PetCO2 monitoring nasopharyngeal airway can reduce the incidence of hypoxia during magnifying endoscopy in patients with OSAS, with minimal adverse events. Also, it can detect the status of lung ventilation in time, guide clinical intervention, reduce complications and improve the safety of magnifying endoscopy anesthesia.

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    Public health
    Analysis on life quality of children with high myopia
    LIU Zhehui, XIE Hui, WANG Jingjing, YANG Jinliuxing, ZHANG Bo, HE Xiangui, XU Xun
    2023, 43 (12):  1548-1553. 
    doi: 10.3969/j.issn.1674-8115.2023.12.010

    Abstract ( 107 )   HTML ( 18 )   PDF (1352KB) ( 105 )  

    Objective ·To explore the association between high myopia and life quality among children. Methods ·Cross-sectional study method was adopted in this study. Highly myopic children aged 4?10 from 16 districts in Shanghai were enrolled through Shanghai Child and Adolescent Large-scale Eye Study-High Myopia Registration Study. Baseline data for spherical equivalent after cycloplegia and questionnaire data in 2020 were collected. Emmetropic children aged 4?10 from 16 kindergartens and elementary schools in Jing'an District and Pudong New Area were enrolled. The uncorrected visual acuity, corrected visual acuity and spherical equivalent without cycloplegia were measured through myopia screening in schools, and the questionnaire on quality of life was filled out. Quality of life was measured by the Strengths and Difficulties Questionnaire (SDQ) and EuroQol Five Dimensions Questionnaire Visual Analogue Scale (EQ-VAS). After describing and testing the differences in variable distributions between the highly myopic children group and the emmetropic children group, the differences in life quality between the two groups, and the association between spherical equivalent and life quality scores of the highly myopic children were examined by a linear regression model. Results ·A total of 193 children with high myopia and 209 children with emmetropia were enrolled. There were statistically significant differences in age [(9.58±0.94) years vs (7.63±1.50) years, P<0.001] and gender distribution (46.6% males vs 62.7% males, P=0.001) between the highly myopic children and emmetropic children. After adjusting for age and gender, it was found that there was no statistically significant difference in SDQ score between the highly myopic children and emmetropic children (β=0.313, 95%CI -0.723?1.349, P=0.553), but the EQ-VAS score in the highly myopic children was lower than that in the emmetropic children (β=-3.805, 95%CI -6.593? -1.017, P=0.008). There was no significant relationship between spherical equivalent and SDQ score (β=0.297, 95%CI -0.035?0.628, P=0.079) and EQ-VAS score (β=0.579, 95%CI -0.330?1.489, P=0.211) in the highly myopic children. Conclusion ·In children with high myopia, self-evaluated overall health status reflected by EQ-VAS score is poorer compared with that in children with emmetropia. However, the EQ-VAS score is not associated with the degree of high myopia.

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    Progress in application of peritoneal lavage fluid circulating tumor DNA to predicting peritoneal metastasis of gastrointestinal cancer
    BAI Long, XIA Xiang, CAO Hui, ZHANG Zizhen
    2023, 43 (12):  1554-1561. 
    doi: 10.3969/j.issn.1674-8115.2023.12.011

    Abstract ( 119 )   HTML ( 14 )   PDF (1385KB) ( 76 )  

    Peritoneal metastasis is one of the important causes of death in patients with gastrointestinal cancer and is also a difficult point in clinical diagnosis and treatment. How to predict the occurrence of peritoneal metastasis in patients with high-risk factors, advance the threshold of diagnosis and treatment before the occurrence of peritoneal metastasis, and improve the survival benefit of patients is an unsolved problem in clinical work. In the case of low positive rate of cytology and difficulty in diagnosing occult peritoneal metastasis, new molecular markers and detection techniques for early diagnosis of peritoneal metastasis need to be verified. Peritoneal lavage fluid has the characteristics of less leukocyte-derived cell-free DNA interference, higher concentration of circulating tumor DNA (ctDNA), and direct contact with the primary lesion or potential peritoneal metastasis at physical distance, making it a unique advantage in gastrointestinal cancer. At present, the detection methods of ctDNA in peritoneal lavage fluid include digital PCR, epigenetic-based analysis, and next-generation sequencing. With the iteration of technology, the application of next-generation sequencing and personalized panels to ctDNA detection has not only shown great potential in predicting postoperative peritoneal metastasis, but also promoted the idea of preventive escalation treatment of peritoneal metastasis. This article reviews the current application of ctDNA to peritoneal lavage fluid in predicting peritoneal metastasis of gastrointestinal cancer.

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    Research progress in the treatment of bladder cancer based on nanotechnology
    YANG Chenkai, LI Wei, CAO Xiangqian, HE Lei, LI Shengzhou, SHEN Bing
    2023, 43 (12):  1562-1568. 
    doi: 10.3969/j.issn.1674-8115.2023.12.012

    Abstract ( 130 )   HTML ( 25 )   PDF (1310KB) ( 84 )  

    Bladder cancer is the most common malignant tumor in the urinary system. Currently, the clinical treatment options for bladder cancer mainly include surgery, chemotherapy, radiotherapy, immunotherapy, targeted therapy, photodynamic therapy, combination therapy, etc. The conventional treatment and administration strategies for bladder cancer primarily depend on the tumor stage and the extent of metastasis. However, in the process of non-surgical treatment, drugs lack specificity and targeting. Once the dosage is improperly controlled, drugs will damage normal cells when attacking cancer cells, which will lead to poor efficacy and multiple side effects. Nanomedicine is an emerging interdisciplinary field that utilizes nanomaterials and technologies in nanomedicine to provide disruptive technologies for traditional treatments, with advantages such as targeted delivery and high efficiency with low toxicity. Many nanotechnologies have become hot topics in clinical research in the field of medicine. Functionalized nanoparticles can actively or passively target specific cells within target organs, such as bladder cancer cells, by altering their surface properties, thereby enhancing drug delivery precision, reducing damage to normal cells, and improving treatment efficacy. This article provides an overview of the progress in classical and novel treatment approaches to bladder cancer, with a particular focus on the potential applications and future development directions of nanotechnology in the treatment of bladder cancer, providing important reference for personalized therapy and clinical translation in bladder cancer.

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    Review of the role of pyroptosis in benign prostatic hyperplasia in old males
    CHEN Zixuan, LI Dong, LIU Min
    2023, 43 (12):  1569-1576. 
    doi: 10.3969/j.issn.1674-8115.2023.12.013

    Abstract ( 137 )   HTML ( 27 )   PDF (2204KB) ( 99 )  

    Pyroptosis, a new mode of programmed cell death, is primarily characterized by persistent cellular swelling that culminates in cell rupture. This process results in the release of large amounts of inflammatory factors, subsequently triggering an inflammatory response. Benign prostatic hyperplasia (BPH) is the most frequent urological disease in old males and is closely associated with changes in hormones and inflammation response. In recent years, the role of pyroptosis in the occurrence and development of BPH has also received increasing attention. This article summarizes the mechanisms of pyroptosis, concludes the pathogenesis associated with BPH in old males, and outlines the role of pyroptosis in BPH, to provide new ideas for finding more effective therapeutic measures for BPH through pyroptosis.

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    Review of the role of collagen in tumorigenesis and development
    TANG Lei, XU Yingchun, ZHANG Fengchun
    2023, 43 (12):  1577-1584. 
    doi: 10.3969/j.issn.1674-8115.2023.12.014

    Abstract ( 241 )   HTML ( 22 )   PDF (1399KB) ( 155 )  

    Collagen is one of the most abundant proteins in the body and is the main component of the extracellular matrix. Collagen regulates cellular behavior, and its dysregulation can cause a variety of diseases, including cancer. Collagen in tumors is mainly produced by fibroblasts and plays an important role in cancer progression and metastasis. Collagen can act as a prognostic predictor for cancer patients and may be an effective target for the treatment and prevention of tumor progression and metastasis. Anti-tumor drugs targeting collagen and its receptors may be developed in the future. This review focuses on the newly discovered role of collagen in cancer in recent years, specifically the role of collagen in tumor cell dormancy and immune evasion, and the participation of collagen in tumor cell metabolism.

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    Research progress of the impact of nonalcoholic fatty liver disease on chronic hepatitis B infection
    BENEDICK Jun Er Chin, SON Peng, ZHANG Yifan, WANG Junqing, GUO Simin
    2023, 43 (12):  1585-1590. 
    doi: 10.3969/j.issn.1674-8115.2023.12.015

    Abstract ( 101 )   HTML ( 16 )   PDF (1234KB) ( 53 )  

    Chronic hepatitis B (CHB) is an infectious disease caused by persistent infection with the hepatitis B virus (HBV) and is highly prevalent worldwide. Non-alcoholic fatty liver disease (NAFLD) is a group of liver diseases related to metabolic abnormalities, excluding those caused by alcohol consumption or other liver injury factors. In recent years, with improvement of living standards and changes in lifestyle, the incidence of NAFLD has been increasing substantially, becoming the most common type of liver diseases in China and Western countries, and the second leading cause of liver transplantation in the West. The rising prevalence of NAFLD has also led to an increase in the incidence of NAFLD in patients with chronic HBV infection. However, there is considerable controversy both domestically and internationally regarding the relationship between these two diseases, including the disease progression, pathogenesis, impact on antiviral treatment efficacy, and prognosis of these concomitant CHB and NAFLD patients. Currently, both domestic and international guidelines lack detailed descriptions of diagnostic and treatment strategies for these conditions. This article summarizes the recent research progress in concomitant CHB and NAFLD, including epidemiology, diagnostic criteria, the impact of NAFLD on the virology of HBV infection, potential mechanisms of NAFLD-induced negative regulation of HBV, the effect of NAFLD on antiviral therapy efficacy, and prognosis. This article aims to gain a deeper understanding of the diseases themselves and provide new insights for basic and clinical research as well as diagnostic and treatment approaches.

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