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chinese Medicine Combined with Adjuvant Chemotherapy for Improving Myelosuppression in Colorectal Cancer Patients: A Systematic Review and Network Meta-Analysis

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chinese Journal of Integrative Medicine 2024年第7期30卷 643-652页

作者： LI Rui ZHANG Tong YAN Shao-hua YAN Yun-zi DING Ya-cong WANG Yan-song YANG Yu-fei Department of Oncology China Academy of Chinese Medical Sciences Xiyuan Hospital Department of Oncology Dongfang Hospital Beijing University of Chinese Medicine Graduate School Beijing University of Chinese Medicine

Objective: To assess the effectiveness of chinese herbal medicine(CHM) combined with adjuvant chemotherapy on myelosuppression for colorectal cancer(CRC) patients using network meta-analysis(NMA). Methods: Literature searches in both international(PubMed, Embase, Web of Science, and Cochrane Library) and chinese(China Science and Technology Journal Database, Wanfang Data, China National Knowledge Infrastructure) databases for relevant randomized controlled trials(RCTs) were conducted from inception until October 10, 2022. We included RCTs of patients who received CHM combined with chemotherapy, including FOLFOX, XELOX, FOLFIRI, and other relevant regimens in the CHM treatment group. The outcomes included the incidence of myelosuppression, leukopenia, hemoglobin reduction, and thrombocytopenia. Two reviewers independently screened the databases, extracted the data, and assessed the risk of bias and credibility of evidence. RevMan 5.4.1 software and STATA 14.0 were used to perform the NMA. Results: A total of 31 RCTs were included, published from 2008 to 2021 in chinese. Among these, 2,314 participants comparing the following 9 CHMs were identified: Shengbai Recipe(SBR), Bazhen Decoction(BZD), Jianpi Jiedu Recipe(JJR), Jianpi Recipe(JR), Compound Cantharis Capsule(CCC), Zaofan Pill(ZFP), Guilu Erxian Gel(GL), Buzhong Tiaogan Decoction(BZ), and Qiamagu Capsule(QM). The results of NMA found an indirect comparison. Based on the surface under the cumulative ranking curve(SUCRA), the ZFP+ chemotherapy group had the lowest incidence of myelosuppression, with an odds ratio(OR) of 0.08 [95% confidence interval(CI): 0.01, 0.76], whereas the GL+ chemotherapy group had the lowest incidence of leukopenia, hemoglobin reduction, and thrombocytopenia, with an OR of 5.25(95% CI: 2.41, 11.43), 4.66(95% CI: 2.23, 9.72), and 0.27(95% CI: 0.13, 0.54), respectively. Moreover, BZD + chemotherapy could alleviate leukopenia, hemoglobin reduction, and thrombocytopenia(P<0.01). Pairwise comparison showed that there was no difference in the

关键词： chinese herbal medicine colorectal cancer network meta-analysis systematic review myelosuppression chemotherapy

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Study on sex differences and potential clinical value of threedimensional computerized tomography pelvimetry in rectal cancer patients

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 773-786页

作者： Xiao-Cong Zhou Fei-Yue Ke Gaurav Dhamija Hao Chen Qiang Wang Department of Colorectal Surgery The Dingli Clinical Institute of Wenzhou Medical University(Wenzhou Central Hospital)Wenzhou 325000Zhejiang ProvinceChina Postgraduate Training Base Alliance of Wenzhou medical university Wenzhou Central HospitalWenzhou 325000Zhejiang ProvinceChina School of International Studies Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina Department of Radiology The Dingli Clinical Institute of Wenzhou Medical University(Wenzhou Central Hospital)Wenzhou 325000Zhejiang ProvinceChina

BACKGROUND Laparoscopic rectal cancer radical surgery is a complex procedure affected by various factors.However,the existing literature lacks standardized parameters for the pelvic region and soft tissues,which hampers the establishment of consistent conclusions.AIM To comprehensively assess 16 pelvic and 7 soft tissue parameters through computerized tomography(CT)-based three-dimensional(3D)reconstruction,providing a strong theoretical basis to address challenges in laparoscopic rectal cancer radical surgery.METHODS We analyzed data from 218 patients who underwent radical laparoscopic surgery for rectal cancer,and utilized CT data for 3D pelvic reconstruction.Specific anatomical points were carefully marked and measured using advanced 3D modeling software.To analyze the pelvic and soft tissue parameters,we emp-loyed statistical methods including paired sample t-tests,Wilcoxon rank-sum tests,and correlation analysis.RESULTS The investigation highlighted significant sex disparities in 14 pelvic bone parameters and 3 soft tissue parameters.Males demonstrated larger measurements in pelvic depth and overall curvature,smaller measurements in pelvic width,a larger mesorectal fat area,and a larger anterior-posterior abdominal diameter.By contrast,females exhibited wider pelvises,shallower depth,smaller overall curvature,and an increased amount of subcutaneous fat tissue.However,there were no significant sex differences observed in certain parameters such as sacral curvature height,superior pubococcygeal diameter,rectal area,visceral fat area,waist circumference,and transverse abdominal diameter.CONCLUSION The reconstruction of 3D CT data enabled accurate pelvic measurements,revealing significant sex differences in both pelvic and soft tissue parameters.This study design offer potential in predicting surgical difficulties and creating personalized surgical plans for male rectal cancer patients with a potentially“difficult pelvis”,ultimately improving surgical outcomes.Further research and utilization of these parameters

关键词： Computerized tomography Rectal cancer Three-dimensional reconstruction Pelvimetry Sex differences

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Response of ocean acidification to atmospheric carbon dioxide removal

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Journal of Environmental Sciences 2024年第6期140卷 79-90页

作者： Jiu Jiang Long Cao Xiaoyu Jin Zechen Yu Han Zhang Jianjie Fu Guibin Jiang School of Environment Hangzhou Institute for Advanced StudyUniversity of Chinese Academy of SciencesHangzhou 310024China State Key Laboratory of Environmental Chemistry and Ecotoxicology Research Center for Eco-Environmental SciencesChinese Academy of SciencesBeijing 100085China Key Laboratory of Geoscience Big Data and Deep Resources of zhejiang Province School of Earth SciencesZhejiang UniversityHangzhou 310058China zhejiang Climate Center Hangzhou 310052China

Artificial CO_(2)removal from the atmosphere(also referred to as negative CO_(2)emissions)has been proposed as a potential means to counteract anthropogenic climate change.Here we use an Earth system model to examine the response of ocean acidification to idealized atmospheric CO_(2)removal scenarios.In our simulations,atmospheric CO_(2)is assumed to increase at a rate of 1%per year to four times its pre-industrial value and then decreases to the pre-industrial level at a rate of 0.5%,1%,2%per year,respectively.Our results show that the annual mean state of surface ocean carbonate chemistry fields including hydrogen ion concentration([H^(+)]),pH and aragonite saturation state respond quickly to removal of atmospheric CO_(2).However,the change of seasonal cycle in carbonate chemistry lags behind the decline in atmospheric CO_(2).When CO_(2)returns to the pre-industrial level,over some parts of the ocean,relative to the pre-industrial state,the seasonal amplitude of carbonate chemistry fields is substantially larger.Simulation results also show that changes in deep ocean carbonate chemistry substantially lag behind atmospheric CO_(2)change.When CO_(2)returns to its pre-industrial value,the whole-ocean acidity measured by[H^(+)]is 15%-18%larger than the pre-industrial level,depending on the rate of CO_(2)decrease.Our study demonstrates that even if atmospheric CO_(2)can be lowered in the future as a result of net negative CO_(2)emissions,the recovery of some aspects of ocean acidification would take decades to centuries,which would have important implications for the resilience of marine ecosystems.

关键词： Carbon dioxide removal Net negative CO_(2)emission Ocean acidification Climate change Earth system modeling

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Protective eff ect and mechanism of nanoantimicrobial peptide ND-C14 against Streptococcus pneumoniae infection

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World Journal of Emergency Medicine 2024年第1期15卷 28-34页

作者： Yangyang Guo Yaqi Sun Hongxia Wu Jian Lu Yuan Lin Jiaqing Zhu Meihong Lai Meiqi Zhang Jun Wang Jungang Zheng Department of Intensive Care Medicine Hangzhou Traditional Chinese Medicine Hospital Affi liated to Zhejiang Chinese Medical UniversityHangzhou 310021China National Children’s Regional medical Center National Clinical Research Center for Child HealthChildren’s HospitalZhejiang University School of MedicineHangzhou 310052China Department of Spleen and Stomach Diseases Hangzhou Traditional Chinese Medicine Hospital Affi liated to Zhejiang Chinese Medical UniversityHangzhou 310021China Department of Ultrasonic Medicine the First Affi liated Hospital of Ningbo UniversityNingbo 315010China Department of Anesthesiology the First Affi liated Hospital of Ningbo UniversityNingbo 315010China zhejiang university School of Medicine Hangzhou 310058China The First People’s Hospital of Yuexi County Yuexi 616650China

BACKGROUND:Streptococcus pneumoniae(S.pneumoniae)is a common pathogen that causes bacterial pneumonia.However,with increasing bacterial resistance,there is an urgent need to develop new drugs to treat S.pneumoniae infections.Nanodefensin with a 14-carbon saturated fatty acid(ND-C14)is a novel nanoantimicrobial peptide designed by modifying myristic acid at the C-terminus of humanα-defensin 5(HD5)via an amide bond.However,it is unclear whether ND-C14 is effective against lung infections caused by S.pneumoniae.METHODS:In vitro,three groups were established,including the control group,and the HD5 and ND-C14 treatment groups.A virtual colony-count assay was used to evaluate the antibacterial activity of HD5 and ND-C14 against S.pneumoniae.The morphological changes of S.pneumoniae treated with HD5 or ND-C14 were observed by scanning electron microscopy.In vivo,mice were divided into sham,vehicle,and ND-C14 treatment groups.Mice in the sham group were treated with 25μL of phosphate-buffered saline(PBS).Mice in the vehicle and ND-C14 treatment groups were treated with intratracheal instillation of 25μL of bacterial suspension with 2×108 CFU/mL(total bacterial count:5×10^(6) CFU),and then the mice were given 25μL PBS or intratracheally injected with 25μL of ND-C14(including 20μg or 50μg),respectively.Survival rates were evaluated in the vehicle and ND-C14 treatment groups.Bacterial burden in the blood and bronchoalveolar lavage fluid were counted.The lung histology of the mice was assessed.A propidium iodide uptake assay was used to clarify the destructive eff ect of ND-C14 against S.pneumoniae.RESULTS:Compared with HD5,ND-C14 had a better bactericidal eff ect against S.pneumoniae because of its stronger ability to destroy the membrane structure of S.pneumoniae in vitro.In vivo,ND-C14 significantly delayed the death time and improved the survival rate of mice infected with S.pneumoniae.ND-C14 reduced bacterial burden and lung tissue injury.Moreover,ND-C14 had a membrane permeation eff ect on S.pneumoniae,and its destruct

关键词： Streptococcus pneumoniae Antimicrobial peptides Humanα-defensin 5 Infection

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Pleomorphic rhabdomyosarcoma of the vagina: A case report

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World Journal of Clinical Cases 2024年第14期12卷 2396-2403页

作者： Pan Xu Shan-Shan Ling E Hu Bi-Xia Yi Department of Gynecology The Affiliated Jinhua Hospital of Wenzhou Medical UniversityJinhua 321000Zhejiang ProvinceChina zhejiang university School of Medicine Hangzhou 310006Zhejiang ProvinceChina

BACKGROUND Rhabdomyosarcoma(RMS)of the vagina in postmenopausal women is an extre-mely rare malignant tumor that was originally described as a unique group of soft tissue sarcomas originating from primitive mesenchymal cells.It was first re-ported in postmenopausal women in 1970,and fewer than 50 postmenopausal patients have been reported to date.CASE SUMMARY A 68-year-old multiparous female was admitted to the hospital on October 11,2023,with the chief complaint of a mass causing vaginal prolapse with incomplete urination that had persisted for 4 months.The vaginal mass was approximately the size of a pigeon egg;after lying down,the vaginal mass retracted.Complete resection was performed,and vaginal pleomorphic RMS was diagnosed based on pathology and immunohistochemical staining features.The patient is currently undergoing chemotherapy.The present study also reviewed the clinical,histolo-gical,and immunohistochemical features and latest treatment recommendations for vaginal RMS.Any abnormal vaginal mass should be promptly investigated through pelvic examination and appropriate imaging.The current initial treat-ment for vaginal RMS is biopsy and primary chemotherapy.CONCLUSION When surgery is planned for vaginal RMS,an organ-preserving approach should be considered.

关键词： Rhabdomyosarcoma Vagina Postmenopausal woman Pleomorphic Case report

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The Wnt-dependent and Wnt-independent functions of BCL9 in development,tumorigenesis,and immunity:Implications in therapeutic opportunities

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Genes & Diseases 2024年第2期11卷 701-710页

作者： Minjie Wu Heng Dong Chao Xu Mengqing Sun Haojin Gao Fangtian Bu Jianxiang Chen College of Pharmacy and Department of Hepatology Institute of Hepatology and Metabolic DiseasesThe Affiliated Hospital of Hangzhou Normal UniversityHangzhou Normal UniversityHangzhouZhejiang 311121China Laboratory of Cancer Genomics Division of Cellular and Molecular ResearchNational Cancer CentreSingapore 169610Singapore Key Laboratory of Elemene Class Anti-Cancer chinese Medicines Engineering Laboratory of Development and Application of Traditional Chinese MedicinesCollaborative Innovation Center of Traditional Chinese Medicines of Zhejiang ProvinceHangzhou Normal UniversityHangzhouZhejiang 311121China

B-cell CLL/lymphoma 9(BCL9)is considered a key developmental regulator and a well-established oncogenic driver in multiple cancer types,mainly through potentiating the Wnt/β-catenin signaling.However,increasing evidences indicate that BCL9 also plays multiple Wnt-independent roles.Herein,we summarized the updates of the canonical and non-canonical functions of BCL9 in cellular,physiological,or pathological processes.Moreover,we also concluded that the targeted inhibitors disrupt the interaction ofβ-catenin with BCL9 reported recently.

关键词： BCL9 Development Immunity Multifaceted functions Therapeutic target Tumorigenesis

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Fusobacterium nucleatum-induced imbalance in microbiome-derived butyric acid levels promotes the occurrence and development of colorectal cancer

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World Journal of Gastroenterology 2024年第14期30卷 2018-2037页

作者： Qi-Long Wu Xiao-Ting Fang Xin-Xin Wan Qing-Yong Ding Yan-Jun Zhang Ling Ji Yong-Liang Lou Xiang Li School of Laboratory Medicine and Life Sciences Wenzhou Medical UniversityKey Laboratory of Laboratory MedicineMinistry of EducationWenzhou 325035Zhejiang ProvinceChina Department of Health Inspection and Quarantine School of Laboratory Medicine and Life SciencesWenzhou 325035Zhejiang ProvinceChina School of Laboratory Medicine and Life Sciences Wenzhou Medical UniversityZhejiang Provincial Key Laboratory of Medical GeneticsMinistry of EducationWenzhou 325035Zhejiang ProvinceChina Department of General Surgery The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325035Zhejiang ProvinceChina School of Laboratory Medicine and Life Sciences Institute of One HealthWenzhou Medical UniversityZhejiang Provincial Key Laboratory of Medical GeneticsMinistry of EducationWenzhou 325035Zhejiang ProvinceChina Department of Health Inspection and Quarantine School of Laboratory Medicine and Life SciencesInstitute of One HealthWenzhou Medical UniversityZhejiang Provincial Key Laboratory of Medical GeneticsMinistry of EducationWenzhou 325035Zhejiang ProvinceChina

BACKGROUND Colorectal cancer(CRC)ranks among the most prevalent malignant tumors globally.Recent reports suggest that Fusobacterium nucleatum(F.nucleatum)contributes to the initiation,progression,and prognosis of CRC.Butyrate,a short-chain fatty acid derived from the bacterial fermentation of soluble dietary fiber,is known to inhibit various cancers.This study is designed to explore whether F.nucleatum influences the onset and progression of CRC by impacting the intestinal metabolite butyric acid.AIM To investigate the mechanism by which F.nucleatum affects CRC occurrence and development.METHODS Alterations in the gut microbiota of BALB/c mice were observed following the oral administration of F.nucleatum.Additionally,DLD-1 and HCT116 cell lines were exposed to sodium butyrate(NaB)and F.nucleatum in vitro to examine the effects on proliferative proteins and mitochondrial function.RESULTS Our research indicates that the prevalence of F.nucleatum in fecal samples from CRC patients is significantly greater than in healthy counterparts,while the prevalence of butyrate-producing bacteria is notably lower.In mice colonized with F.nucleatum,the population of butyrate-producing bacteria decreased,resulting in altered levels of butyric acid,a key intestinal metabolite of butyrate.Exposure to NaB can impair mitochondrial morphology and diminish mitochondrial membrane potential in DLD-1 and HCT116 CRC cells.Consequently,this leads to modulated production of adenosine triphosphate and reactive oxygen species,thereby inhibiting cancer cell prolif-eration.Additionally,NaB triggers the adenosine monophosphate-activated protein kinase(AMPK)signaling pathway,blocks the cell cycle in HCT116 and DLD-1 cells,and curtails the proliferation of CRC cells.The combined presence of F.nucleatum and NaB attenuated the effects of the latter.By employing small interfering RNA to suppress AMPK,it was demonstrated that AMPK is essential for NaB’s inhibition of CRC cell proliferation.CONCLUSION F.nucleatum can promote cancer progression through

关键词： Colorectal cancer Fusobacterium nucleatum Butyric acid Gut microbiota Adenosine monophosphate-activated protein kinase signal pathway

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Application and progress of artificial intelligence technology in the segmentation of hyperreflective foci in OCT images for ophthalmic disease research

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International Journal of Ophthalmology(English edition) 2024年第6期17卷 1138-1143页

作者： Jia-Ning Ying Hu Li Yan-Yan Zhang Wen-Die Li Quan-Yong Yi Ningbo Eye Hospital Wenzhou Medical UniversityNingbo 315042Zhejiang ProvinceChina Health Science Center Ningbo UniversityNingbo 315211Zhejiang ProvinceChina

With the advancement of retinal imaging,hyperreflective foci(HRF)on optical coherence tomography(OCT)images have gained significant attention as potential biological biomarkers for retinal neuroinflammation.However,these biomarkers,represented by HRF,present pose challenges in terms of localization,quantification,and require substantial time and resources.In recent years,the progress and utilization of artificial intelligence(AI)have provided powerful tools for the analysis of biological markers.AI technology enables use machine learning(ML),deep learning(DL)and other technologies to precise characterization of changes in biological biomarkers during disease progression and facilitates quantitative assessments.Based on ophthalmic images,AI has significant implications for early screening,diagnostic grading,treatment efficacy evaluation,treatment recommendations,and prognosis development in common ophthalmic diseases.Moreover,it will help reduce the reliance of the healthcare system on human labor,which has the potential to simplify and expedite clinical trials,enhance the reliability and professionalism of disease management,and improve the prediction of adverse events.This article offers a comprehensive review of the application of AI in combination with HRF on OCT images in ophthalmic diseases including age-related macular degeneration(AMD),diabetic macular edema(DME),retinal vein occlusion(RVO)and other retinal diseases and presents prospects for their utilization.

关键词： artificial intelligence deep learning hyperreflective foci image analysis

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Hierarchical Spinning of Janus Textiles with Anisotropic Wettability for Wound Healing

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Research 2024年第1期2023卷 97-105页

作者： Han Zhang Lingyu Sun Jiahui Guo Yuanjin Zhao Department of Rheumatology and Immunology Nanjing Drum Tower HospitalSchool of Biological Science and Medical EngineeringSoutheast UniversityNanjingJiangsu 210096China Oujiang Laboratory(zhejiang Lab for Regenerative Medicine Vision and Brain Health)Wenzhou InstituteUniversity of Chinese Academy of SciencesWenzhouZhejiang 325001China

Wound healing and tissue repair are recognized as basic human health problems worldwide.Attempts to accelerate the reparative process are focused on developing functional wound dressings.Herein,we present novel Janus textiles with anisotropic wettability from hierarchical microfluidic spinning for wound healing.The hydrophilic hydrogel microfibers from microfluidics are woven into textiles for freeze-drying treatment,followed by the deposition of electrostatic spinning nanofibers composed of hydrophobic polylactic acid(PLA)and silver nanoparticles.The electrospun nanofiber layer can be well coupled with the hydrogel microfiber layer to generate Janus textiles with anisotropic wettability due to the roughness of the hydrogel textile surface and the incomplete evaporation of PLA solution when reaching the surface.For wound treatment with the hydrophobic PLA side contacting the wound surface,the wound exudate can be pumped from the hydrophobic to the hydrophilic side based on the wettability differential derived drainage force.During this process,the hydrophobic side of the Janus textile can prevent excess fluid from infiltrating the wound again,preventing excessive moisture and preserving the breathability of the wound.In addition,the silver nanoparticles contained in the hydrophobic nanofibers could impart the textiles with good antibacterial effect,which further promote the wound healing efficiency.These features indicate that the described Janus fiber textile has great application potential in the field of wound treatment.

关键词： silver spinning healing

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Two different autorefractors for vision screening in children and adolescents

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International Journal of Ophthalmology(English edition) 2024年第2期17卷 331-338页

作者： Xiao-Jun Chen Lin-Jie Liu Bing Sun Dan-Dan Jiang Shu-Shu Zuo Yan-Hui Wang Chun-Hua Zhang Yan-Yan Chen School of Optometry and Ophthalmology Wenzhou Medical UniversityWenzhou 325027Zhejiang ProvinceChina National Clinical Research Center for Ocular Diseases Eye HospitalWenzhou Medical UniversityWenzhou 325027Zhejiang ProvinceChina

AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 909 subjects(age 4–18y)were measured using both autorefractors without cycloplegia.The data were analyzed using Fourier decomposition and the correlation coefficients,intraclass correlation coefficients(ICC),and Bland-Altman limits of agreement(LoA)for each parameter were calculated.RESULTS:There was a strong correlation between the spherical equivalent(SE),sphere diopter(DS),and cylinder diopter(DC)readings of the Tianle RM-9000 and those of the Topcon KR-800,with correlation coefficient values of 0.98,0.98 and 0.83 and ICC values of 0.99,0.99 and 0.93,respectively.However,the correlation coefficients and ICC values of J0 and J45 were unreliable(R=-0.004,-0.034;both ICC<0.10).Bland-Altman analysis revealed that SE,DS,and DC measured by the Tianle RM-9000 were significantly biased toward myopia compared with the Topcon KR-800,and the mean differences were-0.072,-0.026,-0.091 D,respectively(all P<0.01).The minimum absolute value of the difference within the 95%LoA for SE,DS,and DC was 0.63 D,0.50 D,0.62 D,respectively;all these values were in the clinically acceptable range.For J0 and J45,the mean differences were close to zero(P=0.43,0.84);however,the 95%LoA were relatively wide(J0 SD:0.53;95%CI:-1.00,1.10;J45 SD:0.52;95%CI:-1.00,1.00).CONCLUSION:The two autorefractors are consistent with each other,as the differences in SE,DS,and DC were within the clinically acceptable range.Readers can compare the data measured by either device in different studies and use the two devices in the same study to generate a dataset that can be analyzed together.However,the J0 and J45 vectors are unreliable and should not be used to assess astigmatism.

关键词： refractive error autorefractors school-age myopia children

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