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Management Algorithm for Prevention of Mother-to-child Transmission of Hepatitis B Virus(2022)

Journal of Clinical and Translational Hepatology 2022年第5期10卷 1004-1010页

作者： Zhihua Liu Zhongdan Chen Fuqiang Cui Yang Ding Yunfei Gao Guorong Han Jidong Jia Jie Li Zengde Li Yingxia Liu Qing Mao Ailing Wang Wei Wang Lai Wei Jianhong Xia Qing Xie Xizhong Yang Xueru Yin Hua Zhang Liaoyun Zhang Wenhong Zhang Hui Zhuang Xiaoguang Dou Jinlin Hou department of Infectious Diseases Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongChina World Health Organization Office of the WHO Representative in ChinaBeijingChina school of Public Health Peking UniversityBeijingChina department of Infectious Diseases Shengjing HospitalChina Medical UniversityShenyangLiaoningChina department of gynecology and obstetrics Zengcheng Branch of Nanfang HospitalSouthern Medical UniversityGuangzhouGuangdongChina department of gynecology and obstetrics The Second Affiliated Hospital of the Southeast UniversityNanjingJiangsuChina Liver Research Center Beijing Friendship HospitalCapital Medical UniversityBeijingChina school of Basic medical Sciences Peking University Health Science CenterBeijingChina Chinese Foundation for Hepatitis Prevention and Control BeijingChina The Third People’s Hospital of Shenzhen ShenzhenGuangdongChina department of Infectious Diseases Southwest HospitalArmy Medical UniversityChongqingChina National Center for Women and Children’s Health China CDCBeijingChina department of Health Care Shenzhen Baoan Women’s and Children’s HospitalShenzhenGuangdongChina Beijing Tsinghua Changgung Hospital School of Clinical MedicineTsinghua UniversityBeijingChina Guangdong Maternal and Child Health Hospital GuangzhouGuangdongChina department of Infectious Diseases Ruijin HospitalShanghai Jiaotong University School of MedicineShanghaiChina department of gynecology and obstetrics Beijing Youan HospitalCapital Medical UniversityBeijingChina department of Infectious Diseases First Hospital of Shanxi Medical UniversityTaiyuanShanxiChina department of Infectious Diseases Huashan HospitalFudan UniversityShanghaiChina

The World Health Organization(WHO)has set the goal of eliminating hepatitis as a threat to public health by 2030.Blocking mother-to-child transmission(MTCT)of hepatitis B virus(HBV)is not only the key to eliminating viral hepatitis,but also a hot issue in the field of hepatitis B prevention and treatment.To standardize the clinical management of preventing MTCT of HBV and achieve zero HBV infection among infants,the Chinese Foundation for Hepatitis Prevention and Control organized experts to compile a management algorithm for prevention of MTCT of HBV based on the latest research progress and guidelines,including 10 steps of pregnancy management and postpartum follow-up,among which screening,antiviral treatment,and infant immunization are its core components.

关键词： Hepatitis B Mother-to-child transmission Algorithm

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Analysis of the Predictive Factors for the Recurrence of Deep Infiltrating Endometriosis:A 2-Year Prospective Study

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Reproductive and Developmental Medicine 2019年第4期3卷 213-221页

作者： Yun-Xi Zheng Qi Cheng Kai-Kai Chang Jing-Yao Ruan Qi Tian Shou-Xin Gu Yun Chen Xiao-Fang Yi department of gynecology Obstetrics and Gynecology HospitalFudan UniversityShanghai 200011China department of obstetrics and gynecology Shanghai Medical SchoolFudan UniversityShanghai 200011China department of gynecology Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai 200011China

Objective:To investigate factors that may be associated with the recurrence of deep infiltrating endometriosis(DIE)and DIE-related symptoms.Methods:Starting in September 2014,women with a confirmed diagnosis of DIE based on surgical and histological findings were included in the prospective study with a 2-year follow-up in our hospital.A total of 84 consecutive patients were included,all of whom underwent laparoscopic surgery.The data were obtained from the medical records of the patients.Follow-up data,including presence of pain as assessed using the visual analog scale(VAS)score and ultrasonography/magnetic resonance imaging findings,were obtained at 3,6,9,12,and 24 months postoperatively.Variables,such as age,body mass index,severity and duration of symptoms,size and location of the lesion,and pre-and postoperative medical treatment,were evaluated using univariate and multivariate analyses to identify factors correlated to recurrence.Results:A total of 11(13.1%)patients presented with recurrence,with a mean time to recurrence of 14.2 months.The univariate analysis showed that the longer duration of menstruation(7.4 vs.6.0,P=0.010),the more advanced revised American Fertility Society(rAFS)stage(Stages I and II vs.III and IV,χ^(2)=9.964,P=0.001),the higher VAS score for dysmenorrhea(9.4 vs.5.2,P=0.001),and the more severe pain during defecation(7.8 vs.4.8,P=0.016)were positively correlated to DIE recurrence.However,the multivariate analysis also revealed that a more severe dysmenorrhea and advanced rAFS stage were the independent factors associated with the recurrence of DIE,with an odds ratio of 1.895(confidence interval[CI]:1.061-3.385,P=0.031)and 4.310(CI:1.091-17.028,P=0.037),respectively.Conclusions:More than 10%of patients presented with recurrence of DIE 2 years after surgery.Recurrence of DIE was more common in patients who complained of more severe dysmenorrhea and had an advanced rAFS stage.

关键词： Deep Infiltrating Endometriosis Laparoscopic Surgery Recurrence Revised American Fertility Society Stage Visual Analog Scale

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Efficacy and Safety of SanJieZhenTong Capsules,a Traditional Chinese Patent Medicine,on Long-term Management of Endometriosis:A Randomized Controlled Trial

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Reproductive and Developmental Medicine 2021年第1期5卷 15-22页

作者： Jing-Yao Ruan Yun-Xi Zheng Qi Tian Jun-Ya Ke Li Wang Yan Du Zhi-Ling Zhu Xiao-Fang Yi Cong-Jian Xu department of gynecology Obstetrics and Gynecology HospitalFudan UniversityShanghai 200011China department of obstetrics and gynecology Shanghai Medical SchoolFudan UniversityShanghai 200011China department of gynecology Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai 200011China department of Integrated Traditional and Western Medicine Obstetrics and Gynecology HospitalFudan UniversityShanghai 200011China department of Integrated Traditional and Western Medicine Shanghai Key Laboratory of Female Reproductive Endocrine Related DiseasesShanghai 200011China Office of Clinical Epidemiology Obstetrics and Gynecology HospitalFudan UniversityShanghai 200011China

Objective:To compare the efficacy of the traditional Chinese medicine SanJieZhenTong(SJZT)capsules versus gonadotropin-releasing hormone analogs(GnRHa)or oral contraceptives(OCs)in the postoperative treatment of moderate-to-severe endometriosis.Methods:In this prospective clinical trial,women with stage III-IV endometriosis according to the revised American Fertility Society scoring system received three doses of GnRHa immediately after laparoscopic conservative surgery,followed by random assignment to receive treatment with SJZT,GnRHa,or OCs for another 6 months.The primary endpoint was 2-year recurrence,and the secondary endpoints were adverse events,changes in physical function,and quality of life(QoL).Recurrence was assessed using Kaplan-Meier curves and log-rank tests.Generalized estimating equations were used to determine the parameters of the secondary endpoints.Results:A total of 66 women were randomly assigned to the SJZT(n=21),GnRHa(n=21),and OCs(n=24)groups.At a median follow-up of 22 months,no difference in recurrence was found(P=0.72),with one(4.8%),two(9.5%),and one(4.2%)incidence in the SJZT,GnRHa,and OCs groups,respectively.Expectedly,the incidence of side effects such as hot flush,insomnia,and arthralgia in the SJZT and OCs groups was significantly lower than that in the GnRHa group(P=0.00).In addition,the female sexual function index was significantly improved in the SJZT group,with a higher value than that in the GnRHa(odds ratio[OR]=5.25,95%confidence interval[CI]:2.09-13.14,P=0.00)and OCs(OR=3.94,95%CI:1.58-9.83,P=0.00)groups.Conclusions:SJZT showed more effective pain relief and QoL improvement in patients with moderate-to-severe endometriosis than GnRHa or OCs did.Fewer adverse events than those observed with other agents indicate that this alternative medicine,SJZT,could be a novel option for the long-term management of endometriosis.

关键词： Alternative Medicine Endometriosis Long-term Management SanJieZhenTong Capsules

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A Summary of Chinese Expert Consensus on Fetal Growth Restriction (An Update on the 2019 Version)

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Maternal-Fetal Medicine 2022年第3期4卷 162-168页

作者： Fetal Medicine Subgroup,Chinese Society of Perinatal Medicine,Chinese medical Association Maternal-Fetal Medicine Committee,Chinese Society of obstetrics and gynecology,Chinese medical Association Luming Sun Yali Hu Hongbo Qi 不详 shanghai Key Laboratory of Maternal Fetal Medicine Department of Fetal Medicine&Prenatal Diagnosis CenterShanghai First Maternity and Infant HospitalSchool of MedicineTongji UniversityShanghai 201204China department of obstetrics and gynecology Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical SchoolNanjing 210008China department of obstetrics Women and Children’s Hospital of Chongqing Medical UniversityChongqing 400021China

Fetal growth restriction(FGR)is a common complication of pregnancy associated with higher rates of perinatal mortality and morbidity,as well as a variety of long-term adverse outcomes.To standardize the clinical practice for the management of FGR in China,Fetal Medicine Subgroup,Chinese Society of Perinatal Medicine,Chinese medical Association and Maternal-Fetal Medicine Committee,Chinese Society of obstetrics and gynecology,Chinese medical Association organized an expert committee to provide official consensus-based recommendations on FGR.We evaluated the evidence provided by relevant high-quality literature,performed a three-round Delphi study and organized face-to-face meetings with experts from multidisciplinary backgrounds.The consensus includes the definition,prenatal screening,prevention,diagnosis,monitoring and management of FGR.

关键词： Delphi technique Fetal growth restriction Practice guideline

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Towards key scientific questions in the diagnosis and treatment of rare diseases: Summary from the 297th Meeting of the Shuangqing Forum

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Zoological Research 2022年第2期43卷 234-236页

作者： Cai-Yun Zhu Wei Hong Lei Wang Li-Jun Ding Xue Zhang department of Health Sciences National Natural Science Foundation of ChinaBeijing 100085China State Key Laboratory of medical Molecular Biology Institute of Basic Medical SciencesChinese Academy of Medical SciencesSchool of Basic Medicine Peking Union Medical CollegeBeijing 100005China Institute of Pediatrics Children’s Hospital of Fudan University and Shanghai Key Laboratory of Medical EpigeneticsInternational Co-laboratory of Medical Epigenetics and MetabolismMinistry of Science and Technology and Institutes of Biomedical SciencesState Key Laboratory of Genetic EngineeringFudan UniversityShanghai 200032China Center for Reproductive Medicine and obstetrics and gynecology Affiliated Drum Tower Hospital of Nanjing University Medical SchoolNanjingJiangsu 210008China McKusick-Zhang Center for Genetic Medicine Institute of Basic Medical SciencesChinese Academy of Medical Sciences/School of Basic MedicinePeking Union Medical CollegeBeijing 100005China

In China,rare diseases are defined as having a birth incidence of less than 1/10000,or a prevalence of less than 1/10000 or less than 140000 patients.Over 7000 rare diseases affect more than 20 million people in China.Many conditions are misdiagnosed or undiagnosed and most have no treatment,resulting in a huge burden on patients,their families,and the national economy.At the 297th Shuangqing Forum of the National Natural Science Foundation of China,we highlighted the challenges and potential solutions to achieve precision medicine for undiagnosed and rare diseases.

关键词： diagnosis treatment Forum

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Effects of humanized nursing care on negative emotions and complications in patients undergoing hysteromyoma surgery

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世界临床病例杂志 2023年第28期11卷 6763-6773页

作者： Li Liu Ya-Hong Xiao Xue-Hua Zhou Operating Room Fudan University Affiliated Obstetrics and Gynecology HospitalShanghai 200092China Operating Room Cardiovascular Hospital of The Second Affiliated Hospital of Hainan Medical CollegeHaikou 571199Hainan ProvinceChina department of Nursing Chongzuo People's HospitalChongzuo 532200Guangxi Zhuang Autonomous RegionChina

BACKGROUND Uterine fibroids,are prevalent benign tumors affecting women of reproductive age.However,surgical treatment is often necessary for symptomatic hysteromyoma cases.This study examines the impact of humanized nursing care on reducing negative emotions and postoperative complications in patients receiving hysteromyoma surgery.AIM To investigate the impact of humanized nursing care on patients undergoing hysteromyoma surgery.METHODS Among patients who underwent hysteromyoma surgery at the fudan university Affiliated obstetrics and gynecology Hospital,200 were randomly assigned to either the control group(n=100)or the humanized nursing care group(n=100).The control group received traditional nursing care,while the humanized nursing care group received a comprehensive care plan encompassing psychological support,pain management,and tailored rehabilitation programs.In addition,anxiety and depression levels were assessed using the hospital anxiety and depression scale preoperatively and postoperatively.Postoperative complications were evaluated during follow-up assessments and compared between both groups.RESULTS The humanized nursing care group demonstrated a significant decrease in anxiety and depression levels compared to the control group(P<0.05).The rate of postoperative complications,including infection,bleeding,and deep venous thrombosis,was also markedly lower in the humanized nursing care group(P<0.05).CONCLUSION Humanized nursing care can effectively alleviate negative emotions and reduce the incidence of postoperative complications in patients undergoing hysteromyoma surgery.This approach should be considered a crucial component of perioperative care for these patients.Further research may be needed to explore additional benefits and long-term outcomes of implementing humanized nursing care in this population.

关键词： Hysteromyoma Humanized nursing care Anxiety Depression Postoperative complications

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The Construction of an Intrauterine Diagnosis and Treatment System and Comprehensive Lifecycle Health Service of Congenital Heart Disease:Xinhua Hospital Model

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Cardiology Discovery 2023年第3期3卷 191-202页

作者： Shiwei Jiang Jiajun Ye Hualin Wang Jian Wang Sun Cheni Yongjun Zhang Qing Du Ling Yang Lei Wang Kun Sun department of Pediatric Cardiology Xinhua HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200092China department of Rehabilitation Medicine Xinhua HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200092China department of obstetrics and gynecology School of MedicineShanghai Jiao Tong UniversityShanghai 200092China

With the growing influence of slow population growth and population aging,China has established the birth policy and issued a series of documents to promote maternal and fetal health and improve the birth rate.With the increase in prevalence of birth defects,timely diagnosis and intervention in utero provide possibilities to reduce unnecessary abortions and offer better prognosis.Congenital heart disease(CHD),as one of the most common congenital birth defects,is the leading cause of mortality in patients agedobstetrics and pediatrics,a novel diagnosis and treatment system has been established for the management of CHD in the past 2 decades in shanghai Xinhua Hospital.This Intrauterine Diagnosis and Treatment System and Comprehensive Lifecycle Health Service of Congenital Heart Disease model provides prenatal diagnosis,intrauterine intervention,delivery room service and neonatal therapies,and postintrauterine rehabilitation for children with CHD.We have developed a four-dimensional spatiotemporal image correlation echocardiography and a three-dimensional cardiac virtual endoscopy system for the intrauterine diagnosis of CHD,dramatically raising the diagnostic utility.Our innovative and independent newborn-intervention technique has effectively reduced the re-intervention rate in patients with pulmonary atresia with intact ventricular septum and critical pulmonary stenosis.In 2018,Xinhua Hospital independently performed the case of fetal aortic valvuloplas

关键词： Congenital heart disease Comprehensive lifecycle health service Intrauterine diagnosis and treatment

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Benzyl Alcohol-Benzyl Benzoate Clearing Reveals the Dose-Dependent Effect of Cyclophosphamide on Follicle Damage in Mice

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Reproductive and Developmental Medicine 2020年第4期4卷 204-211页

作者： Lin Qi-Wang Fei He Jin Yun-Feng Wu Kun-Peng Dai Xin Qu Ying Jiang Hua department of gynecology Obstetrics and Gynecology HospitalFudan UniversityShanghai 200011China department of Hematology Huashan HospitalFudan UniversityShanghai 200040China

Objective:Cyclophosphamide(CTX),which is commonly used in clinical chemotherapy,has a damaging effect on ovarian follicles.This study aimed to establish a new method to count the number of follicles in mouse ovaries using benzyl alcohol-benzyl benzoate(BABB)-based tissue-clearing technology and evaluate the follicle-damaging effects of different doses of CTX.Methods:C57BL/6 mice were divided into four groups and administered intraperitoneal injections of 0,40,80,or 120 mg/kg CTX.The serum levels of estradiol(E 2)and follicle-stimulating hormone(FSH)were detected using an ELISA kit.Mouse ovaries were subjected to BABB clearing and labeled with DAPI,β-actin,and DDX4 to observe the ovarian structure and follicles.A three-dimensional software,Imaris,was used to reconstruct the ovarian structure and automatically count the number of follicles.The effects of different CTX doses on the total follicle number and estrous cycle were determined.Results:As the CTX dose increased,E 2 levels in CTX mice declined from 212.3 to 57.7 pg/mL;the FSH levels increased from 3.2 to 29 ng/mL.Mouse ovaries became transparent after BABB treatment.After fixation,microscopy,and Imaris processing,immunofluorescence signals ofβ-actin and DAPI from all levels in intact ovaries could be obtained and follicle number in half ovaries could be automatically counted using anti-DDX4 antibody labeling.In the NC,CTX40,CTX80,and CTX120 groups,the proportion of mice in the diestrus phase was 26.67%,51.67%,73.33%,and 95.00%,respectively,and the total follicle number was 2,603,1,761,1,043,and 262,respectively.E 2 levels were positively correlated with follicle number and FSH levels were negatively correlated with follicle number,indicating that the damaging effect of CTX on follicle number may be dose dependent.Conclusion:BABB can be used to clear intact ovaries from adult mice,and follicle number in half ovaries can be automatically counted.The damaging effect of CTX on follicles and the endocrine system is dose dependent.

关键词： Benzyl Alcohol-Benzyl Benzoate Cyclophosphamide Follicle Damage Tissue-Clearing Technology

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Niclosamide(NA)overcomes cisplatin resistance in human ovarian cancer

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Genes & Diseases 2023年第4期10卷 1687-1701页

作者： Linjuan Huang Jing Zhang Youling Deng Hao Wang Piao Zhao Guozhi Zhao Wei Zeng Yonghui Wang Connie Chen William Wagstaff Rex C.Haydon Russell R.Reid Tong-Chuan He Le Shen Hue H.Luu Ling Zhao departments of obstetrics and gynecology Orthopaedic Surgery and UrologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqing 400046China Molecular Oncology Laboratory Department of Orthopaedic Surgery and Rehabilitation MedicineThe University of Chicago Medical CenterChicagoIL 60637USA Ministry of Education Key Laboratory of Diagnostic Medicine and Department of Clinical BiochemistryThe School of Laboratory MedicineChongqing Medical UniversityChongqing 400016China department of Neurology The Second Affiliated Hospital of Jianghan UniversityWuhanHubei 430050China department of Clinical Laboratory Medicine Shanghai Jiaotong University School of MedicineShanghai 200000China Laboratory of Craniofacial Suture Biology and Development Department of Surgery Section of Plastic SurgeryThe University of Chicago Medical CenterChicagoIL 60637USA department of Surgery The University of Chicago Medical CenterChicagoIL 60637USA

Ovarian cancer(OC)is one of the most lethal malignancies of the female reproduc-tive system.OC patients are usually diagnosed at advanced stages due to the lack of early diag-nosis.The standard treatment for OC includes a combination of debulking surgery and platinum-taxane chemotherapy,while several targeted therapies have recently been approved for maintenance treatment.The vast majority of OC patients relapse with chemoresistant tu-mors after an initial response.Thus,there is an unmet clinical need to develop new therapeu-tic agents to overcome the chemoresistance of OC.The anti-parasite agent niclosamide(NA)has been repurposed as an anti-cancer agent and exerts potent anti-cancer activities in human cancers including OC.Here,we investigated whether NA could be repurposed as a therapeutic agent to overcome cisplatin-resistant(CR)in human OC cells.To this end,we first established two CR lines SKOV3CR and OVCAR8CR that exhibit the essential biological characteristics of cisplatin resistance in human cancer.We showed that NA inhibited cell proliferation,sup-pressed cell migration,and induced cell apoptosis in both CR lines at a low micromole range.Mechanistically,NA inhibited multiple cancer-related pathways including AP1,ELK/SRF,HIF1,and TCF/LEF,in SKOV3CR and OVCAR8CR cells.NA was further shown to effectively inhibit xenograft tumor growth of SKOV3CR cells.Collectively,our findings strongly suggest that NA may be repurposed as an efficacious agent to combat cisplatin resistance in chemoresistant hu-man OC,and further clinical trials are highly warranted.

关键词： Chemotherapy resistance Cisplatin Drug repurposing Niclosamide Ovarian cancer

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Cancer metabolism and tumor microenvironment:fostering each other?

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Science China(Life Sciences) 2022年第2期65卷 236-279页

作者： Yiyuan Yuan Huimin Li Wang Pu Leilei Chen Dong Guo Hongfei Jiang Bo He Siyuan Qin Kui Wang Na Li Jingwei Feng Jing Wen Shipeng Cheng Yaguang Zhang Weiwei Yang Dan Ye Zhimin Lu Canhua Huang Jun Mei Hua-Feng Zhang Ping Gao Peng Jiang Shicheng Su Bing Sun Shi-Min Zhao obstetrics&gynecology Hospital of fudan university State Key Laboratory of Genetic EngineeringFudan UniversityShanghai 200438China State Key Laboratory of Cell Biology Center for Excellence in Molecular Cell ScienceChinese Academy of SciencesShanghai 200031China Molecular and Cell Biology Lab Institutes of Biomedical Sciences and School of Life SciencesFudan UniversityShanghai 200032China Zhejiang Provincial Key Laboratory of Pancreatic Disease The First Affiliated Hospitaland Institute of Translational MedicineZhejiang University School of MedicineHangzhou 310029China West China school of Basic medical Sciences&Forensic Medicine Sichuan Universityand State Key Laboratory of Biotherapy and Cancer CenterWest China Hospitaland Collaborative Innovation Center for BiotherapyChengdu 610041China department of Biochemistry and Molecular Cell Biology Shanghai Key Laboratory of Tumor Microenvironment and InflammationShanghai Jiao Tong University School of MedicineShanghai 200025China Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation Medical Research CenterSun Yat-Sen Memorial HospitalSun Yat-Sen UniversityGuangzhou 510120China school of Life Science and Technology ShanghaiTech UniversityShanghai 201210China CAS Centre for Excellence in Cell and Molecular Biology the CAS Key Laboratory of Innate Immunity and Chronic DiseaseSchool of Basic Medical SciencesDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230027China school of Medicine Institutes for Life SciencesSouth China University of TechnologyGuangzhou 510006China Tsinghua university school of Life Sciences and Tsinghua-Peking Center for Life SciencesBeijing 100084China

The changes associated with malignancy are not only in cancer cells but also in environment in which cancer cells live.Metabolic reprogramming supports tumor cells’high demand of biogenesis for their rapid proliferation,and helps tumor cells to survive under certain genetic or environmental stresses.Emerging evidence suggests that metabolic alteration is ultimately and tightly associated with genetic changes,in particular the dysregulation of key oncogenic and tumor suppressive signaling pathways.Cancer cells activate HIF signaling even in the presence of oxygen and in the absence of growth factor stimulation.This cancer metabolic phenotype,described firstly by German physiologist Otto Warburg,ensures enhanced glycolytic metabolism for the biosynthesis of macromolecules.The conception of metabolite signaling,i.e.,metabolites are regulators of cell signaling,provides novel insights into how reactive oxygen species(ROS)and other metabolites deregulation may regulate redox homeostasis,epigenetics,and proliferation of cancer cells.Moreover,the unveiling of noncanonical functions of metabolic enzymes,such as the moonlighting functions of phosphoglycerate kinase 1(PGK1),reassures the importance of metabolism in cancer development.The metabolic,microRNAs,and ncRNAs alterations in cancer cells can be sorted and delivered either to intercellular matrix or to cancer adjacent cells to shape cancer microenvironment via media such as exosome.Among them,cancer microenvironmental cells are immune cells which exert profound effects on cancer cells.Understanding of all these processes is a prerequisite for the development of a more effective strategy to contain cancers.

关键词： cancer metabolism cancer microenvironment epigenetics cancer immunology

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