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关键词： 肿瘤异质性   无监督域适应   图结构   耐药细胞识别  

摘要： 针对肿瘤异质性导致患者对相同药物治疗反应存在显著差异,进而引发肿瘤复发或转移的问题,提出一种基于图结构与无监督域适应的肿瘤耐药细胞识别方法 GCDrug。该方法首先基于k最近邻分别构建源域(批量转录组测序)与目标域(单细胞转录组测序)样本的相似性图,利用图卷积网络提取特征;随后引入Deep CORAL损失,实现跨域分布自适应。在10个单细胞药物注释数据集上的实验结果表明,GCDrug在3项分类指标上均优于现有主流方法,其中,在Etoposide数据集上的F1分数达0.956,显著优于现有方法。消融实验进一步验证:图结构模块与域适应模块的协同作用,能提升模型的判别性能与泛化能力。实验结果表明,所提方法能够准确识别肿瘤中的耐药个体细胞。

关键词： Duration of response   Oncology clinical trials   Restricted mean duration of response   Statistical inference  

摘要： In oncology clinical trials, the duration of response (DOR) is limited by the inclusion of only responders, leading to selection bias and violating the principle of randomization. To address this limitation, this study introduces the restricted mean duration of response (RMDOR) as a novel composite efficacy endpoint. The definition, parameter estimation, and hypothesis testing procedures of RMDOR were systematically described, and an example analysis was conducted using data from a phase Ⅲ non-small cell lung cancer clinical trial with the package "PBIR". RMDOR integrates information from the objective response rate, time to response, and DOR at the intention-to-treat population level, effectively compensating for the limitations of single endpoints. The example analysis demonstrated that RMDOR provides a stable and rational quantification of treatment differences between therapeutic regimens. RMDOR offers a new methodological tool for oncology trials that preserves the advantages of randomization under the intention-to-treat principle while comprehensively reflecting treatment benefits. Its combined use with traditional endpoints is recommended in future clinical studies. © 2026, Chinese Medical Association

关键词： 三焦气化   营卫   NSCLC   肿瘤相关巨噬细胞   时空异质性  

摘要： 肿瘤微环境及肿瘤相关巨噬细胞(tumor-associated macrophages, TAMs)的时空异质性是近年来非小细胞肺癌(Non-small cell lung cancer,NSCLC)的研究热点,“三焦气化-营卫”循环是机体维持正常免疫功能和生命活动的核心机制。病理状态时三焦气化失常,可导致营卫不固,进一步气机郁滞并发痰浊、瘀血,日久化为癌毒。这一病机演变的动态过程是NSCLC肿瘤微环境及TAMs时空异质性的微观体现。未来有望针对TAMs时空异质性选用不同治法的中药辅助免疫治疗NSCLC。

摘要： 蛹虫草是一种药食兼用的真菌,其活性成分主要包括虫草素、虫草多糖、麦角甾醇及硒元素等。近年来,蛹虫草活性成分因其抗氧化、抗炎、抗肿瘤和免疫调节等多种作用而备受关注。目前大量研究聚焦于其生物活性成分、药理作用及其产业化应用方面。全文系统综述了蛹虫草活性成分在抗肿瘤分子机制中的进展,比较了虫草素和虫草多糖在细胞周期阻滞、细胞凋亡、自噬、调节免疫及耐药逆转等方面的作用差异,并总结了提高虫草素生物利用度的最新策略。以期为天然产物的深入研究提供理论基础,也为其在恶性肿瘤治疗中的开发应用提供新的思路。

关键词： 亲水印迹树脂   石墨烯气凝胶   水相识别   固相萃取   肿瘤标志物   高效液相色谱  

摘要： 近年来,分子印迹聚合物在分析检测和疾病早期诊断领域展现出显著潜力,但其实际应用仍面临传统制备方法的诸多限制,包括有机溶剂依赖性强、水相识别能力弱以及吸附容量低等问题.针对这些挑战,本研究将亲水性树脂与石墨烯气凝胶复合,在水相体系下成功制备了超亲水印迹石墨烯气凝胶材料(HMIR-GA),显著提升了分子印迹材料的水相识别能力和吸附能力.本研究系统优化了制备参数,最终得到了水相识别能力强和吸附容量高的HMIR-GA.吸附试验结果表明,HMIR-GA对肿瘤标志物 5-羟吲哚乙酸表现出优异的吸附性能和显著的特异识别能力(印迹因子可达 8.8),能够有效区分待测组分与共存干扰物质.此外,制备的 HMIR-GA对 5-羟吲哚乙酸的回收率显著优于商业化吸附剂.将制备的新型 HMIR-GA作为管尖固相萃取吸附剂,对关键萃取参数进行优化,在最优萃取条件下结合液相色谱开发了一种高效、灵敏的生物样品中痕量肿瘤标志物检测的新方法,检出限低至 3.7 ng/mL,日内和日间精密度分别为 2.9%和 4.1%(n=6),加标回收率为 75.7%~92.5%,且相对标准偏差(RSD)≤3.4%,可以实现神经内分泌肿瘤的早期诊断.本研究为功能化亲水分子印迹材料的设计与开发提供了新的研究思路和技术参考,也为生物样品中肿瘤标志物的精准分离和高灵敏检测提供了可靠技术方案.

关键词： Diagnosis, differential   Epstein-Barr virus   Soft tissue neoplasms  

摘要： Objective To investigate the clinicopathological and prognostic features, immunophenotypic characteristics, and key points of differential diagnosis of multifocal EBV-associated smooth muscle tumors (EBV-SMT). Methods The clinicopathological data of 7 cases of EBV-SMT diagnosed in Sun Yat-sen University Cancer Center from June 2020 to March 2025 were retrospectively analyzed. Immunohistochemical staining, Epstein-Barr virus-encoded small RNAs (EBERs) in situ hybridization, and next-generation sequencing were performed, and the relevant literature was reviewed. Results All 7 patients were children or young adults, with a median age of 7 (2, 33) years. Five patients were immunocompromised due to congenital immune deficiency, autoimmune disease or post-transplant treatment. All the 7 cases presented with multifocal lesions, involving the brain, liver, lungs and adrenal glands. Histologically, 3 cases exhibited a classic spindle cell leiomyoma-like morphology, while the other 4 showed a more primitive round cell morphology resembling smooth muscle cells. All cases expressed smooth muscle markers, such as SMA, calponin, HHF35, h-caldesmon, and desmin, among others. The proliferation index of Ki-67 ranged from 1% to 30%. All cases were diffusely and strongly positive for EBERs by in situ hybridization. Next-generation sequencing identified an ITK gene deletion in one case (case 2). During a follow-up period of 1 to 44 months after diagnosis, 2 patients died, while the remaining 5 survived. Conclusions EBV-associated smooth muscle tumors are more likely to occur in children or young adults with immune deficiency, often manifesting as multifocal lesions in different organs. Accurate diagnosis relies on a comprehensive assessment incorporating clinical history, histopathological features, and findings of immunohistochemistry and EBERs in situ hybridization. 2026, Chinese Medical Association

摘要： 开发高效多功能声敏剂对提升声动力治疗(SDT)疗效至关重要.本研究制备了一种具有双酶仿生功能的声敏剂“sonozyme”,通过级联产氧和活性氧(ROS)风暴效应增强SDT抗肿瘤疗效.Sonozyme由定制的共价有机框架(Y-COF)负载铂纳米颗粒(PtNPs)组成.供体-受体结构设计优化了Y-COF的能带位置,赋予sonozyme优异的声动力活性.值得注意的是,PtNPs可改善超声激发的激子分离与转移能力,进一步增强sonozyme超声触发的ROS生成能力.Sonozyme同时具有类过氧化氢酶(CAT)和类过氧化物酶(POD)的双重酶活性,能将内源性H2O2转化为O2和·OH,在缓解肿瘤缺氧的同时增强氧化应激,从而显著提升SDT效应并诱导肿瘤细胞死亡.体内实验证实,在超声辐照下sonozyme能有效抑制肿瘤生长并且具有良好的生物安全性.因此,本研究不仅为开发高效多功能声敏剂提供了范例,更为癌症治疗提供了一个有前景的策略.

关键词： 颅眶沟通性肿瘤   围手术期护理   预康复  

摘要： 总结我科于2024年4月收治的1例经眶联合内镜下经鼻蝶入路手术的颅眶沟通性肿瘤患者的围手术期护理经验。通过前期多学科团队的组建,聚焦全病程的综合管理;基于入院评估制订患者预康复护理策略并精准实施入院指导、术前预康复、术中和术后多学科协作风险防控以及出院延续性护理。经过21 d精心治疗与护理,患者病情好转出院,随访3个月,患者已回归社会。

关键词： 邪盛正衰   扶正祛邪   超级竞争   上皮抗癌   癌症  

摘要： “正邪相争”理论是中医学病因病机学说的核心内容,认为正气与邪气的消长盛衰贯穿于疾病发生、发展及转归的全过程,特别对理解肿瘤等复杂疾病的病机具有重要理论价值。但是,这一经典理论的现代生物学基础尚缺乏深入且清晰的科学阐释。近年来,现代生物学关于“细胞竞争”的深入研究为诠释“正邪相争”理论提供了新的科学视角。“细胞竞争”是维持组织稳态的关键生物学机制,特别是在肿瘤发生发展中发挥了重要作用。一方面,肿瘤细胞可通过“超级竞争”机制实现克隆扩张,进而取代正常细胞;另一方面,正常细胞可通过“上皮抗癌”机制将恶性转化细胞从上皮组织中清除。这一发现与中医学“邪盛正衰”的病机理论及“扶正祛邪”的防治原则具有高度契合性。基于此,本文创新性地提出将“正邪相争”理论与“细胞竞争”机制相结合的学术观点,旨在通过传统医学与现代生物学的深入对话,为阐释中医学原理提供现代科学的研究证据,同时为中西医协同防治恶性肿瘤提供理论支撑,从而推动中西医理论体系的相互验证、融合与创新发展。

关键词： covalent organic frameworks   sonosensitizers   sonodynamic therapy   nanozyme   biomimetic  

摘要： Developing efficient and multifunctional sonosensitizers is critical for enhancing the efficacy of sonodynamic therapy (SDT). Herein, a dual enzyme-mimicking sonosensitizer, termed sonozyme, is prepared for improving the management of malignancy in SDT via cascade oxygenation and reactive oxygen species (ROS) storm, which consists of a tailored covalent organic framework (Y-COF) integrated with platinum nanoparticles (Pt NPs). Spatially separated donor-acceptor structural design optimizes the band position of Y-COF, which endows sonozyme with good intrinsic sonodynamic activity. Notably, Pt NPs improve the sono-generated exciton separation and transfer dynamics, further enhancing the ultrasound-triggered ROS generation ability of sonozyme. Particularly, sonozyme exhibits dual enzymatic activities, resembling both catalase (CAT) and peroxidase (POD), which enable the conversion of endogenous H2O2 into O2 and OH, thereby alleviating hypoxia while augmenting oxidative stress to enhance the SDT effect, ultimately resulting in significant tumor cell death. Further in vivo experiments demonstrate that sonozyme effectively suppresses tumor progression with concomitant absence of observable systemic toxicity under ultrasound irradiation. Therefore, sonozyme provides a paradigm for pioneering high-performance multifunctional sonosensitizers and presents a promising strategy for cancer therapy. (sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(SDT)(sic)(sic)(sic)(sic)(sic)(sic). (sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(sic)"sonozyme", (sic)(sic)(sic)(sic) (sic)(sic)(sic)(sic)(sic)(sic)(ROS)(sic)(sic)(sic)(sic)(sic)(sic)SDT(sic)(sic)(sic)(sic)(sic). Sonozyme(sic)(sic)(sic) (sic)(sic)(sic)(sic)(sic)(sic)(sic)(Y-COF)(sic)(sic)(sic)(sic)(sic)(sic)(sic)(Pt NPs)(sic)(sic). (sic)(sic)-(sic)(sic)(sic) (sic)(sic)(sic)(sic)(sic)(sic)Y-COF(sic)(sic)(sic)(sic)(sic), (sic)(sic)sonoz