Table of Content

20 April 2025, Volume 25 Issue 02

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Original Articles and Clinical Research

Fatty acid metabolism regulated by FATP1 promotes lymph node colonization in cholangiocarcinoma

LI Xiu-xian, SONG Zhi-xiao, ZHANG Hong-hua, LIU Chao

2025, 25(02):  75-83.  DOI: 10.3969/j.issn.1009-976X.2025.02.001

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Objective To investigate the mechanism and therapeutic strategy of fatty acid transport protein 1 （FATP1） on lymph node colonization of cholangiocarcinoma （CCA）. Methods Subcutaneous tumor-bearing mouse models and lymph node orthotopic tumor-bearing mouse models were established. Tumor tissues at different tumor stages were collected, and proteomics was used to screen key proteins in cholangiocarcinoma colonization in lymph nodes. Immunohistochemical staining was used to evaluate the correlation between FATP1 expression in lymph node metastases of cholangiocarcinoma and poor prognosis of patients. CCK-8 cell proliferation assay and Nile red staining were used to detect the changes in lipid metabolism and proliferation ability of cholangiocarcinoma cells （HUCCT1, HCCC9810） before and after knockdown or overexpression of FATP1. In vitro and in vivo experiments were used to verify that FATP1 inhibitor （FATP1-IN-1） inhibited cholangiocarcinoma colonization in lymph nodes by targeting lipid metabolism. Results Proteomic screening results suggested that FATP1 played a key role in the process of cholangiocarcinoma colonization of lymph nodes. Immunohistochemical staining showed that FATP1 was more highly expressed in lymph node metastases and was associated with poor prognosis of patients. In vitro experiments showed that knocking down FATP1 inhibited cholangiocarcinoma proliferation and lipid accumulation, while overexpression of FATP1 enhanced the above phenotypes. FATP1 inhibitor （FATP1-IN-1） significantly inhibited cancer cell proliferation in vitro and reduced tumor burden and lipid accumulation in an in vivo model. Conclusion Fatty acid metabolism regulated by FATP1 promotes cholangiocarcinoma colonization in lymph nodes, and targeting FATP1 can effectively inhibit the progression of lymph node colonized tumors.

Comparative study of 3D gradient spin echo and 3D volumetric scanning based on compressed sensing technology in MRCP

CHEN Wen-shi, ZHU Yin-he, ZHONG Jing-lian

2025, 25(02):  84-90.  DOI: 10.3969/j.issn.1009-976X.2025.02.002

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Objective To study the image quality of three-dimensional gradient spin echo （3D-BH-GraSE-MRCP） and three-dimensional volumetric scan based on compressed sensing technology（3D-CS-MRCP） in magnetic resonance cholangiopancreatography（MRCP）. Methods A retrospective analysis was performed on 81 patients who underwent MRCP examination in Sun Yat-sen Memorial Hospital, Sun Yat-sen University from July 2023 to November 2023, and 3D-BH-GraSE-MRCP sequence and 3D-CS-MRCP sequence were used to scan the same patient. Image contrast noise ratio （CNR）, signal-to-noise ratio （SNR） and scanning time in common bile duct, pancreatic duct, cholecystic duct, hepatic duct and secondary bile duct were analyzed and compared according to the obtained images. The image quality of gallbladder, cholecystic duct, common bile duct, pancreatic duct and hepatic duct were subjectively scored. Results The scanning time of 3D-BH-GraSE-MRCP and 3D-CS-MRCP sequences was equal（P>0.05）. There was no significant difference in CNR and SNR of common bile duct, cholecystic duct and hepatic duct between the two images. The CNR（19.73, 13.71） and SNR（27.19, 18.52） of pancreatic duct and secondary bile duct in 3D-BH-GraSE-MRCP sequence image were higher than those in 3D-CS-MRCPsequence image （11.60, 8.76） and SNR（15.23, 12.28）（P<0.05）. 3D-BH-GraSE-MRCP sequence in the gallbladder, cystic duct, common bile duct, the overall image quality rating of intrahepatic duct, background suppression effect and image pseudo reviews points （4.32, 4.46, 4.46, 4.56, 4.79, 4.83） were higher than 3D-CS-MRCP sequence （3.65, 3.79, 4.12, 4.16, 4.48, 4.31） （P<0.05）. Conclusion Compared with 3D-CS-MRCP sequence, 3D-BH-GraSE-MRCP sequence has better image quality and no difference in scanning time in MRCP inspection.

Machine learning-based NETs gene signature predicts recurrence in non-muscle-invasive bladder cancer

HUANG Xiao-dong, WANG Bo, HUANG Jian

2025, 25(02):  91-100.  DOI: 10.3969/j.issn.1009-976X.2025.02.003

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Objective Neutrophil extracellular traps （NETs） can be stimulated by various factors, including drug perfusion and tumor cell stimulation, thereby influencing the prognosis of cancer patients. However, the prognostic impact and key functional genes of NETs in the recurrence of non-muscle-invasive bladder cancer （NMIBC） remain unclear. This study aims to identify critical NETs-related genes associated with NMIBC recurrence and provide a reliable predictive tool for clinical recurrence assessment. Methods Transcriptomic data and clinical information from bladder cancer patients were obtained from the GEO database （GSE13507, GSE128959, GSE19423, GSE154261, GSE31684, GSE169455）, and somatic copy number variation （CNV） data were retrieved from TCGA. Using machine learning algorithms and weighted gene co-expression network analysis （WGCNA）, we identified 153 NETs-related genes and constructed a recurrence prediction score （NRG）, which was validated in a training cohort. We comprehensively analyzed the impact of this score on gene expression, the immune microenvironment, and functional pathways in bladder cancer. Additionally, we explored potential sensitivities to NRG-associated small-molecule compounds to identify therapeutic targets for clinical intervention. Results This study identified three NETs-related genes （G0S2, CCL5, and CLEC7A） as independent prognostic predictors for postoperative recurrence in NMIBC patients. The NRG score effectively predicted recurrence outcomes in the training cohort, demonstrating diagnostic AUC values of 0.671 and 0.645 in two independent NMIBC datasets, with significant prognostic stratification （P=0.039）. Genomic and immune infiltration analyses revealed that high-NRG patients exhibited more frequent PIK3CA mutations and increased infiltration of immunosuppressive cell subsets. Functional enrichment indicated hyperactivation of immune checkpoint pathways in high-NRG cases. Drug sensitivity analysis suggested that targeting NRG may reduce recurrence risk by inhibiting the PI3K-mTOR and ERK signaling axes, providing potential therapeutic strategies for NMIBC. Conclusion This study established a NETs-derived recurrence prediction signature （NRG） for NMIBC and elucidated its immunomodulatory effects within the tumor microenvironment, functional pathway alterations, and potential small-molecule therapeutic targets.

Research on the role of cancer-associated fibroblasts-secreted IGF-1 in regulating macrophage GGT5 expression within the tumor microenvironment of esophageal squamous cell carcinoma

ZHANG Xiao-ping, LI Lei

2025, 25(02):  101-111.  DOI: 10.3969/j.issn.1009-976X.2025.02.004

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Objective This research focuses on identifying a subset of macrophages that specifically and highly express the GGT5 gene. To date, there have been no reports on the GGT5+ macrophage subset. Our objective is to elucidate the role of GGT5+ macrophages in the progression of ESCC and the mechanisms regulating their expression. Methods Using TCGA, we conducted differential gene expression analysis to identify key genetic changes. Subsequently, with the aid of the TIMER database, we conducted an in-depth analysis of the relationship between GGT5 expression levels and immune cell infiltration, with a particular focus on macrophages.To further validate these analytical results, we employed immunohistochemical and immunofluorescence techniques to visually confirm the expression of GGT5 at the sample level. Finally, through Western blotting experiments, we conducted thorough exploration and validation of the regulatory mechanisms of GGT5. Results Bioinformatics analysis revealed that GGT5 exhibits significantly high expression characteristics in ESCA, and its expression level was closely related to the activity of macrophages. Immunohistochemical and immunofluorescence experiments showed that GGT5 was specifically highly expressed mainly in M2-macrophages and its expression was also significantly increased in LNM. In the study of regulatory mechanisms, it was found that CAFs significantly regulate the expression of GGT5 in macrophages by secreting the IGF-1 cytokine, leading to a marked upregulation of GGT5 expression levels. Conclusion The results indicate that CAFs in the TME regulate the expression of GGT5 in macrophages by secreting the IGF-1 cytokine, thereby participating in the initiation and progression of ESCC. This discovery provides important insights for understanding the pathogenesis of ESCC and exploring new therapeutic strategies.

Effect of laparoscopic sleeve gastrectomy on thyroid function in obese patients

REN Xue-kang, LI Rong-zhen, ZHU Shao-gong, XIA Yun-zhan

2025, 25(02):  112-117.  DOI: 10.3969/j.issn.1009-976X.2025.02.005

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Objective To explore the effects of laparoscopic sleeve gastrectomy （LSG） on thyroid function in obese patients and the potential factors affecting thyroid function after surgery. Methods Sixty-seven obese patients who received standardized LSG in Zhengzhou People's Hospital from October 2019 to October 2021 and completed 1-year follow-up were selected as the study objects. The height, weight, thyroid function indexes （TSH、FT3、FT4）, LDL, HDL and other clinical data before and 1 year after LSG were retrospectively collected. The changes of parameters before and after operation were calculated. The related indexes of thyroid function were compared before and 1 year after surgery, and the potential factors affecting the changes of TSH, FT3 and FT4 after surgery were explored. Results TSH level decreased from （2.84±1.60） mIU/L to （1.45±0.71） mIU/L 1 year after surgery （P<0.001）. FT3 decreased from （5.51±0.58） pmol/L to （5.16±0.51） pmol/L （P<0.001）, and there was no significant difference in FT4 level 1 year after operation. Postoperative BMI （P<0.001） and LDL （P=0.013） were important factors affecting TSH changes. The change of postoperative LDL （P=0.004） was an important factor affecting the change of postoperative FT3. Conclusion LSG has a significant effect on thyroid function in obese patients, and the changes of body mass index （BMI） and LDL are important parameters to predict thyroid function after surgery.

The correlational study of different surgical approaches on anxiety and depression in breast cancer patients

WU Chun-hua, ZHAO Chen, ZHU Zi-peng, YONG Guo-zhong, LI Zi-yi, QIAN Hao

2025, 25(02):  118-126.  DOI: 10.3969/j.issn.1009-976X.2025.02.006

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Objective To explore the current status of anxiety and depression among breast cancer surgery patients and their influencing factors, providing a basis for clinical diagnosis and treatment. Methods Patients who underwent surgical treatment in the Breast and Thyroid and Rectal Surgery Department of Chengde City Central Hospital from November 2022 to April 2024 were selected as the research subjects. They were divided into lumpectomy group （n=32） and mastectomy group （n=52） based on the surgical method. A longitudinal study was conducted using the Self-Rating Depression Scale （SDS） and Self-Rating Anxiety Scale （SAS） to assess the patients before surgery, three months after surgery, and six months after surgery. The general information and clinical characteristics of the patients were collected to analyze the occurrence of depression and anxiety among breast cancer surgery patients and their influencing factors. Results There was no significant difference in SAS and SDS scores between the two groups before surgery （P=0.770）. Three months after surgery, both groups showed a significant increase in SAS and SDS scores, with the lumpectomy group showing a more significant increase in anxiety scores （an increase of 7.6 points on average, P<0.001）, and the mastectomy group showing a more significant increase in depression scores （an increase of 7.2 points on average, P=0.010）. Six months after surgery, the anxiety and depression scores of the lumpectomy group returned to preoperative levels, while the depression scores of the mastectomy group were still higher than before surgery （P=0.048）, but there was no significant difference in depression scores between the two groups （P>0.05）. The analysis of the influencing factors on their psychological status showed that being young, having a low level of education, and having a low family monthly income were the main independent risk factors for anxiety and depression at all three time points （P<0.05）. Conclusion Breast cancer surgery patients have a high incidence of depression and anxiety, and the surgical method can directly affect patients′ depressive and anxious emotions. Compared to preoperative levels, anxiety increases more significantly in the lumpectomy group, and depression increases more significantly in the mastectomy group three months after surgery. Six months after surgery, the psychological state of the lumpectomy group recovers better, while the improvement in depression in the mastectomy group is relatively delayed. Medical staff should strengthen psychological care for breast cancer patients at all stages, especially three months after surgery. Different intervention strategies should be implantated for different groups to mitigate patients′ anxiety and depression.

Impact of the ultrasonographic assessment of lung and diaphragmatic function on postoperative respiratory function in patients undergoing abdominal surgery

HUANG Wei-hong, YAO Zhi-xiong

2025, 25(02):  127-134.  DOI: 10.3969/j.issn.1009-976X.2025.02.007

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Objective To observe whether lung ultrasound （LUS） and diaphragm ultrasound can be used to evaluate and intervene in lung ventilation and diaphragm function in patients undergoing abdominal surgery during the recovery period of general anesthesia. Methods This study included a total of 130 patients who underwent elective abdominal surgery in our hospital and were planned to be sent to the post-anaesthesia care unit （PACU）. The patients were randomized into ultrasound group （group U） and control group （group N）. In group U, LUS and diaphragm ultrasonography were performed at admission in operating room （T₀）, at admission in PACU （T₁）, 15 minutes after extubation （T₂）, and at discharge of PACU （T₃）. LUS score and the diaphragm thickening fraction （DTF） at each time point were recorded and intervention based on the ultrasound results were performed in group U, Conventional resuscitation without ultrasound assessment was used in group N. Arterial blood gas analysis and oxygenation index were recorded at T3 of patients in both groups. The all patients were followed up for seven days after operation for pulmonary complications（PPCs）. Results Compared with T0, DTF decreased significantly （P<0.01） and LUS score increased significantly （P<0.01） after T₁, T₂, and T₃ in the U group, and did not return to the preoperative level at T₃ （P<0.01）. Compared with group N, the total number of intervention measures in group U and the number of taking intervention measures in group U at T₁ increased （P<0.05）. Compared with group N, the incidence of postoperative hypoxemia,extubation time,and PACU lengthofstay at T3 in the group U were significantly reduced （P<0.01）. Conclusion Ultrasound evaluation of lung and diaphragm function can dynamically monitor the ventilation status and diaphragm function recovery degree of patients during anesthesia recovery, enabling timely interventions to improve the recovery of respiratory function in patients undergoing general anesthesia after abdominal surgery.

Review

Research progress on the role of ganglioside GD2 in triple-negative breast cancer

WEI Tian-tian, SUN Zhu-sheng

2025, 25(02):  135-139.  DOI: 10.3969/j.issn.1009-976X.2025.02.008

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Triple-negative breast cancer is a subtype of breast cancer with stronginvasiveness and poor prognosis. At the same time, it has found that ganglioside GD2 is abnormally expressed in many malignant tumors. In recent years, the research on GD2 in triple negative breast cancer has made some progress. It was found that GD2 was highly expressed on the surface of triple negative breast cancer cells, which was closely related to the proliferation, invasion and metastasis of tumor cells. GD2 may be a potential therapeutic target for triple negative breast cancer. It is believed that the research around GD2 will open up a new way for the prevention and treatment of triple negative breast cancer. This article reviews the biological characteristics of GD2 and the research progress in triple-negative breast cancer.

Endoluminal treatment of Stanford type B aortic dissection and its optimal timing of intervention

LI Zi-yi, ZHANG Yang-yi, WU Chun-hua, LIU Da-wei

2025, 25(02):  140-145.  DOI: 10.3969/j.issn.1009-976X.2025.02.009

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Stanford B aortic dissection is an aortic disease with a high mortality rate, and its treatment is extremely important. With the advancement of TEVAR technology, an increasing number of clinicians perform endovascular treatment for patients with aortic dissections beyond the traditional scope of type B. However, no study has yet clarified the optimal time window for endovascular treatment of patients with StanfordB aortic dissection. The current mainstream view is that intervention during the acute phase is more conducive to patient prognosis, while intervention during the subacute phase is safer. However, how to choose the timing of the operation remains inconclusive.

Conservative and surgical treatment strategies for degenerative scoliosis

ZHU Ming-xi, JIN Song

2025, 25(02):  146-150.  DOI: 10.3969/j.issn.1009-976X.2025.02.010

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Degenerative scoliosis, a prevalent spinal disorder among the elderly, presents scoliosis resulting from spinal degeneration and associated nerve compression symptoms, which influences the quality of life of patients. The therapeutic approaches are mainly categorized into conservative treatment and surgical treatment. Conservative treatment encompasses drug therapy, orthotic therapy, and physical therapy, and etc., which is appropriate for patients with mild symptoms, aiming to alleviate pain, reduce inflammation, and enhance function. Surgical treatment is applicable to patients with ineffective conservative treatment or severe symptoms. Common surgical methods include simple decompression surgery, spinal fusion and internal fixation surgery, and minimally invasive surgery. With the advancement of technology, minimally invasive surgery has gradually emerged as the mainstream due to its advantages of minor trauma and rapid recovery. Future research should be concentrated on optimizing treatment plans, reducing complications, exploring novel minimally invasive technologies, and personalized treatment to enhance the therapeutic effect and the quality of life of patients.