北京大学学报（医学版）最新文献

{"title":"[Clinical strategies for perioperative management of esophageal squamous cell carcinoma in the immunotherapy era].","authors":"Hao Fu, Luyan Shen, Bingyang Huang, Shaohua Ma","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Esophageal squamous cell carcinoma (ESCC) is a highly prevalent and lethal malignancy in China and other East Asian countries. For patients with locally advanced disease, neoadjuvant chemotherapy or chemoradiotherapy followed by surgery has become the standard treatment paradigm. However, despite improvements in local tumor control and surgical outcomes, long-term survival remains unsatisfactory, largely due to the high incidence of distant metastasis and systemic disease progression. Therefore, optimizing perioperative systemic therapy represents a critical unmet clinical need in ESCC. In recent years, the introduction of immune checkpoint inhibitors (ICIs) has profoundly reshaped the perioperative treatment landscape of ESCC. This review comprehensively summarizes recent clinical advances in perioperative immunotherapy for ESCC, including neoadjuvant immunotherapy alone, neoadjuvant immunotherapy combined with chemotherapy, neoadjuvant immunotherapy combined with chemoradiotherapy, and postoperative adjuvant immunotherapy. Current data indicate that neoadjuvant chemoradiotherapy remains highly effective in improving local control, downstaging tumors, and increasing the rate of R0 resection. Nevertheless, its ability to translate these advantages into durable survival benefit is limited, and distant recurrence remains a major cause of treatment failure. In contrast, neoadjuvant immunotherapy combined with chemotherapy has demonstrated a marked improvement in pathological complete response (pCR) rates across multiple early-phase trials. More importantly, this strategy appears to provide supe-rior systemic disease control, thereby reducing the risk of distant metastasis and offering a promising avenue for improving long-term survival. Neoadjuvant immunotherapy combined with chemoradiotherapy has shown further enhancement of local response and tumor regression; however, this approach is asso-ciated with increased treatment-related toxicity, and robust evidence supporting a clear survival advantage is still lacking. As a result, the optimal integration of radiotherapy into immunotherapy-based perioperative regimens remains an area of active investigation. Given the heterogeneity of ESCC, perioperative treatment strategies should evolve toward individualized, risk-adapted approaches. For patients with a high local tumor burden (advanced T stage), the incorporation of radiotherapy may be beneficial to reinforce local control and improve resectability. Conversely, for patients with extensive lymph node involvement (advanced N stage) and a high risk of distant relapse, immunotherapy-based systemic treatment should be prioritized. In the postoperative setting, adjuvant immunotherapy has been shown to improve outcomes in patients who fail to achieve pCR after neoadjuvant chemoradiotherapy. Looking forward, the integration of dynamic biomarkers, such as circulating tumor DNA (ctDNA), along with the identification of novel immune targets and predictiv","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 2","pages":"266-271"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Super microsurgical lymphaticovenular anastomosis for limb lymphedema: An outcome analysis based on clinical stage and indocyanine green pattern].","authors":"Jingheng Wu, Yunhao Xue, Shanlin Chen, Yintao Guo, Yuntao Liu, Wei Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the differential efficacy of super-microsurgical lymphaticovenular anastomosis (LVA) for limb lymphedema stratified by International Society of Lymphology (ISL) stage and indocyanine green (ICG) lymphographic Yamamoto pattern, and to provide evidence-based guidance for patient selection.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 32 patients with unilateral limb lymphedema admitted between December 2023 and April 2025. Preoperatively, the patients were classified into ISL stage Ⅰ-Ⅱ (30 cases) and stage Ⅲ (2 cases), and into ICG patterns of splash (6 cases), stardust (14 cases), and diffuse (12 cases). The primary endpoint was percentage reduction of limb volume (%REV) and limb circumferential reduction at 6 months postoperatively; secondary endpoints included anastomotic patency rate, cellulitis recurrence rate, compression garment downgrade rate, and patient satisfaction. One-way ANOVA with Bonferroni correction was used to compare %REV between ISL stages Ⅰ-Ⅱ and different ICG patterns; effect size was calculated with Cohen's <i>d</i>; multi-variate linear regression identified independent predictors of %REV; descriptive analysis was only performed for stage Ⅲ patients. All statistical tests were two-tailed.</p><p><strong>Results: </strong>(1) ISL stratification: the overall %REV of the patients with stages Ⅰ-Ⅱ was 53%±9%, including 63%±8% for stage Ⅰ and 50%±7% for stage Ⅱ; the %REV of the patients with stage Ⅲ was 36%±5% (descriptive result). (2) ICG stratification: %REV was 63%±6% for splash, 56%±7% for stardust, and 36%±4% for diffuse patterns (<i>P</i> < 0.001, <i>d</i>=3.5). (3) A clinically observed trend of efficacy attenuation was found between diffuse pattern and stage Ⅲ (not included in the statistical model under two-tailed test). Anastomotic patency at the end of 1 year was 92.2 %. Cellulitis recurrence decreased from 28.1 % to 0.0 % (<i>P</i>=0.01). Compression garment was downgraded in 26 patients (81.3%), and overall satisfaction reached 96.9%.</p><p><strong>Conclusion: </strong>LVA efficacy was significantly associated with both ISL stage and ICG pattern. The patients with splash pattern or at stage Ⅱ and below could achieve > 55% volume reduction and should be considered the primary indications for LVA. The patients with diffuse pattern or at stage Ⅲ disease might require adjunctive liposuction or vascularized lymph node transfer to improve outcomes. Preoperative evaluation combining ISL staging and ICG lymphography can provide a reliable basis for the selection of LVA surgical indications and the formulation of treatment plans.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 2","pages":"359-364"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Accuracy of dynamic navigation-assisted trephine method for bone harvesting].","authors":"Jiayu Liu, Ning Zhu, Yuchen Chang, Xianming Gao, Yu Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the positional accuracy of dynamic navigation-assisted trephine bone harvesting in the symphysis and external oblique ridge.</p><p><strong>Methods: </strong>Ten standardized mandibular models were 3D-printed using polyetheretherketone (PEEK), mimicking natural mandibular mechanical properties. Pre-operative cone beam CT (CBCT) scans (70 kV, 70 mA, 0.25 mm×0.25 mm ×0.25 mm voxel) were acquired, and data were imported into dynamic navigation software (Dcarer, China). Two donor sites were designed in both the symphysis (≥15 mm from anterior teeth) and external oblique ridge (≥6 mm from molars), with 8 mm-diameter, 6 mm-deep cylindrical osteotomy tracts planned for each site.After calibrating the navigation system with 20 mm and 50 mm spherical burs, an 8 mm outer-diameter trephine prepared 40 tracts under real-time guidance. Post-operative CBCT scans were taken, and Mimics 20.0 software fitted actual tracts to standard cylinders. Superimposing actual and designed tracts via metal registration markers, we measured coronal/apical center point deviation, depth deviation, and axis angle deviation in order to compare site-specific accuracy.</p><p><strong>Results: </strong>Deviations of the dynamic navigation-assisted trephine method for bone harvesting was (1.91±0.69) mm at the coronal center point, (1.54±0.66) mm at the apical center point, (－0.83±0.77) mm at the depth of the apical center point and 3.02°±0.38° at the axis angle. The four deviations in symphysis and external oblique ridge were (1.32±0.36) mm and (2.50±0.35) mm at the coronal center point (<i>P</i> < 0.01), (1.06± 0.31) mm and (2.02±0.56) mm at the apical center point (<i>P</i> < 0.01), (－0.30±0.52) mm and (－1.38±0.57) mm at the depth of apical center point (<i>P</i> < 0.01), 3.03°± 0.38° and 3.00°± 0.39° at axis angle (<i>P</i>=0.80).</p><p><strong>Conclusion: </strong>Within the limitations of this study, dynamic navigation-assisted trephine harvesting shows good accuracy. The symphysis exhibits higher accuracy than the external oblique ridge, possibly due to surface morphology and operability differences. These findings support its clinical potential, but future clinical studies are needed to validate results.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 2","pages":"365-371"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Establishment of rabbit model of benign circumferential esophageal stricture].","authors":"Lingyu Meng, Yonghui Huang, Xiu'e Yan, Yingchun Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To explore the method of establishing benign esophageal stricture in rabbits by using argon plasma coagulation under endoscopy, and to provide a convenient and stable animal model for subsequent research on the prevention of esophageal stricture.</p><p><strong>Methods: </strong>Twenty-two male New Zealand rabbits were randomly divided into three groups after completing esophageal radiography under X-ray. The blank control group (<i>n</i>=4) only received endoscopic examination. In the experimental group Ⅰ (<i>n</i>=9) and experimental group Ⅱ (<i>n</i>=9), argon knife was performed on the esophagus at 30 W and 50 W power, respectively, under endoscopy. Endoscopy was performed 1, 2, and 4 weeks after the operation to observe the changes in the esophagus, and the body weight and mental state were recorded. Four weeks after the operation, esophageal radiography under X-ray was performed to measure the inner diameter of the esophageal stricture and calculate the stricture index. All the experimental animals were sacrificed and esophageal specimens were obtained for histopathological examination and detection of hydroxyproline content in esophageal tissue.</p><p><strong>Results: </strong>In the blank control group, the body weight significantly increased 4 weeks after the operation compared with that before the operation [(4.13±0.25) kg <i>vs</i>. (3.10±0.39) kg, <i>P</i> < 0.05], and there was no significant change in the esophageal inner diameter [(12.89±0.83) mm <i>vs</i>. (12.83±1.07) mm, <i>P</i>>0.05]. In the experimental group Ⅰ, there was no significant change in the body weight and esophageal inner diameter 4 weeks after the operation compared with that before the operation [(2.91±0.28) kg <i>vs</i>. (2.91±0.54) kg; (11.19±0.97) mm <i>vs</i>. (12.06±0.32) mm; <i>P</i>>0.05]. In the experimental group Ⅱ, the body weight and esophageal inner diameter significantly decreased 4 weeks after the operation compared with that before the operation [(2.02±0.31) kg <i>vs</i>. (3.51±0.37) kg; (10.49±1.76) mm <i>vs</i>. (12.58±1.11) mm; <i>P</i> < 0.05]. The esophageal stricture index 4 weeks after the operation was significantly higher in the experimental group Ⅱ than in the experimental group Ⅰ (1.242±0.148 <i>vs</i>. 1.083±0.104, <i>P</i> < 0.05). The histopathological score and hydroxyproline content in the experimental group Ⅰ [2.55±0.52, (182.90±72.75) μg/g] and experimental group Ⅱ [4.55±0.52, (210.81±54.28) μg/g] were significantly higher than those in the blank control group [0, (91.37±29.74) μg/g] (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The induction of esophageal stricture in male New Zealand rabbits using 50 W argon knife under endoscopic guidance is a feasible, depth-controllable, and reproducible method. This animal model provides a reliable platform for the development and evaluation of novel therapeutic strategies for esophageal stricture.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 2","pages":"380-387"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current status and future perspectives of precision treatment for locally advanced rectal cancer].","authors":"Jiale Gao, Zhongtao Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The treatment paradigm for locally advanced rectal cancer is undergoing a fundamental transformation from the traditional fixed triad of \"radiotherapy-surgery-chemotherapy\" to a holistic eco-system centered on precision stratification and multidisciplinary collaboration. This review synthesizes the current landscape and future perspectives of this evolution across four key dimensions. First, in surgical innovation, robotic-assisted surgery has demonstrated superiority over conventional laparoscopy in the narrow pelvis. High-quality evidence indicates that robot-assisted surgery (RAS) not only ensures better oncological outcomes, such as lower circumferential resection margin positivity, but also significantly improves functional recovery, including urinary and sexual functions. The field is further advancing towards the integration of intraoperative navigation, fluorescence imaging, and 5G remote collaboration. Second, molecular-guided immunotherapy is reshaping neoadjuvant strategies. While patients with deficient mismatch repair/microsatellite instability-high (dMMR/MSI-H) status achieve high rates of clinical complete response with immune checkpoint inhibitors, creating opportunities for organ preservation strategies like \"Watch and Wait\", research in the proficient mismatch repair/microsatellite stable (pMMR/MSS) population is pivoting towards synergistic radio-immunotherapy combinations to overcome immune-cold microenvironments. Third, artificial intelligence and radiomics are enabling non-invasive quantitative risk stratification and treatment response prediction. Beyond preoperative assessment, computer vision is entering the operating room to identify critical anatomical structures (<i>e.g</i>., nerves, ureters) in real-time and objectively assess surgical quality. Finally, liquid biopsy, particularly circulating tumor DNA, has emerged as a critical biomarker for minimal residual disease. Dynamic monitoring complements morphological imaging to guide decisions on treatment intensification or de-escalation. Collectively, these advances are driving locally advanced rectal cancer management towards a \"biologically-driven\" and \"function-preserving\" model. Future efforts must focus on establishing standardized protocols for these technologies and validating their long-term benefits in survival and quality of life through high-quality, multi-center clinical trials.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 2","pages":"247-250"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[False positives in female testosterone testing and the diagnostic value of mass spectrometry].","authors":"Man Wu, Yingying Luo, Linong Ji","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the proportion of pseudo-elevated testosterone levels detected by chemiluminescent immunoassay (CLIA) in female patients and to evaluate the application value of liquid chromatography-tandem mass spectrometry (LC-MS/MS) in improving the accuracy of testosterone detection in this population.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on data collected from female patients who presented at Peking University People' s Hospital from January 1, 2020 to May 1, 2024. These patients were initially identified with elevated testosterone levels through CLIA and subsequently underwent additional blood sampling for confirmatory testing using LC-MS/MS. Based on LC-MS/MS results, the patients were categorized into the pseudo-elevated group and the true-elevated group. Dif-ferences in the testosterone levels between the two groups were compared, the false-positive rate of CLIA was calcula-ted, and further evaluations conducted in the pseudo-elevated group were analyzed.</p><p><strong>Results: </strong>A total of 287 female patients with elevated testosterone levels detected by CLIA were included in the study. According to the LC-MS/MS results, 178 cases (62.0%) were classified into the pseudo-elevated group, while 109 cases (38.0%) were classified into the true-elevated group. The mean testosterone levels measured by CLIA were (3.63±1.60) nmol/L in the pseudo-elevated group and (4.13±2.20) nmol/L in the true-elevated group, showing a statistically significant difference (<i>P</i> < 0.05). The false-positive rate of CLIA in detecting testosterone levels in women was 62.0%, and the area under the receiver operating characteristic (ROC) curve (AUC) for CLIA was 0.601 (95%<i>CI</i>: 0.534-0.668) indicating low diagnostic accuracy. Among the pseudo-elevated group, 40.45% of patients underwent multiple CLIA retests, and some patients were subjected to unnecessary clinical evaluations, including imaging and hormonal testing, which significantly increased patient burden.</p><p><strong>Conclusion: </strong>This study highlights the high false-positive rate of CLIA in detecting testosterone levels in female patients, which can result in misdiagnosis, repeated testing, and unnecessary clinical evaluations, thereby increasing patient burden and resulting in inefficient use of medical resources.LC-MS/MS significantly enhances the accuracy of testosterone detection in women and is strongly recommended as the confirmatory test for female patients with elevated testosterone levels initially detected by CLIA.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 2","pages":"332-336"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Progress in regulating stem cell functions for repair and regeneration of craniomaxillofacial tissues].","authors":"Han Zhang, Fujia Yang, Ruili Yang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Craniofacial tissue regeneration remains a pivotal challenge in oral and regenerative medicine. Mesenchymal stem/stromal cells (MSCs) are central effector cells in this process, and their functions are regulated by a sophisticated, multidimensional network. This article provides a comprehensive overview of the regulatory mechanisms governing MSCs in craniofacial regeneration. We highlight the interactive roles of metabolism, epigenetics, and immunity in precisely controlling MSC stemness, lineage-specific differentiation, and immunomodulatory capabilities. Key regulatory dimensions are explored in detail. Metabolic reprogramming, such as serine one-carbon metabolism and mitochondrial dynamics under hyperosmotic stress, couples energy production with epigenetic modifications to dictate MSC fate. The gasotransmitter hydrogen sulfide (H₂S) exerts tissue-specific effects, modulating immunoregulation <i>via</i> the Fas/FasL axis in gingival MSCs and promoting odontogenic differentiation in dental pulp stem cells (DPSCs) <i>via</i> the transient receptor potential action channel subfamily vanilloid member 1 (TRPV1)/β-catenin pathway. Epigenetic mechanisms, including DNA demethylation by ten-eleven translocation (TET) enzymes and chromatin remodeling by special AT-rich sequence-binding protein 2 (SATB2), finely tune MSC homeostasis and differentiation potential. Crucially, MSCs do not function in isolation. Their bidirectional crosstalk with immune cells, mediated by exosomes and soluble factors, is essential for bone homeostasis. Mechanical overloading can trigger MSCs to promote T helper 17 (Th17) cell polarization <i>via</i> metabolic reprogramming, exacerbating bone destruction. Conversely, H₂S-modified exosomes from M2 macrophages can enhance MSC osteogenesis, demonstrating a synergistic metabolic-immune axis for bone regeneration. Exosomes themselves serve as versatile therapeutic carriers, capable of delivering miRNAs (<i>e.g</i>., miR-125a/b) or functional mitochondrial DNA to modulate immunity or repair cellular metabolism. The clinical translation of MSCs holds great promise for treating conditions like periodontitis and temporomandibular joint disorders. Advances in engineered exosomes and biomaterial carriers (<i>e.g</i>., hydrogels) offer strategies for targeted delivery and enhanced efficacy. Future research must focus on developing tissue-specific delivery systems, refining exosome engineering for precise cargo loading, and leveraging multi-omics technologies to decipher the complex stem cell niche. This progression from empi-rical application to rationally designed, precision therapies will be critical for addressing clinical challenges in craniofacial reconstruction.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 2","pages":"285-289"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Conversion therapy for hepatoid adenocarcinoma of the stomach: A case report].","authors":"Jialin Li, Liqiao Chen, Jiatian Tang, Yan Wu, Anqiang Wang","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Hepatoid adenocarcinoma of the stomach (HAS) is a rare and highly malignant variant of gastric cancer, distinguished by histological features resembling hepatocellular carcinoma and frequent elevation of serum alpha-fetoprotein (AFP). It demonstrates aggressive biological behavior, early metasta-tic potential, and intrinsic resistance to conventional platinum-based chemotherapy, resulting in poor outcomes. No standard systemic therapy exists for initially unresectable HAS, making conversion strategies a critical therapeutic goal. We present a 56-year-old male with biopsy-proven locally advanced HAS and markedly elevated AFP (1 729.53 μg/L). Imaging revealed bulky lymphadenopathy (largest node: 39 mm×27 mm), rendering the tumor unresectable. Molecular profiling confirmed human epidermal growth factor receptor 2 (HER2) amplification. First-line conversion therapy with oxaliplatin, fluoropyrimidine, sintilimab (a programmed death-1 inhibitor), and later trastuzumab yielded only transient stabilization followed by clear progression: After six cycles, AFP rose to 1 546.07 μg/L and target lymph nodes enlarged to 46 mm×31 mm on CT. Given treatment failure and persistent HER2 positivity, a second-line, biology-informed regimen was initiated: Disitamab vedotin (an HER2-targeted antibody-drug conjugate delivering monomethyl auristatin E), lenvatinib (a multi-targeted tyrosine kinase inhibitor blocking vascular endothelial growth factor receptor and other pro-angiogenic pathways), tislelizumab (a programmed death-1 inhibitor), and short-course capecitabine (discontinued after 7 days due to grade 3 thrombocytopenia). This combination produced rapid and sustained antitumor activity. Serum AFP declined drama-tically to 102.3 μg/L after two cycles. Radiological reassessment showed progressive shrinkage of metastatic lymph nodes (from 46 mm to 25 mm after cycle two, and further to 14 mm after cycle three) consistent with partial response according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (&lt;sup&gt;18&lt;/sup&gt;F-FDG PET-CT) confirmed reduced metabolic activity in residual lesions. These results enabled successful R0 radical distal gastrectomy in June 2024. Final pathology revealed minimal residual disease (ypT1bN1) with hepatoid morphology and positive immunostaining for AFP, glypican-3, Sal-like protein 4, and HER2 (2 +). The patient received two adjuvant cycles of the same targeted-immunotherapy backbone before transitioning to observation due to cumulative toxicity. Eighteen months postoperatively, he remained free of recurrence. This case underscores that in HER2-positive, chemotherapy-refractory HAS, a rationally designed, multimodal regimen integrating an HER2-directed antibody-drug conjugate, antiangiogenic agent, and immune checkpoint blockade can overcome therapeutic resistance, achieve meaningful downstaging, and enable long-term disease control. Earl","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 2","pages":"399-404"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of concentrated growth factors in guided tissue regeneration for the treatment of mandibular molar furcation lesions].","authors":"Xinying Wang, Xueyuan Cheng, Mengjun Zhang, Fei Li, Jinyu Duan, Jing Qiao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the potential of concentrated growth factors (CGF) to enhance the regenerative efficacy of guided tissue regeneration (GTR) when combined with bone graft in the treatment of grade Ⅱ furcation defects in mandibular molars.</p><p><strong>Methods: </strong>This study was approved by the Ethics Committee of Peking University School and Hospital of Stomatology. A total of 16 patients (aged 20-60 years) with chronic periodontitis requiring periodontal surgical intervention were enrolled. All the participants had completed initial periodontal therapy. This involved a total of 20 mandibular molars, which comprised 36 instances of grade Ⅱ furcation lesions located on the buccal or lingual aspects. The 36 furcation lesions were randomly assigned to two groups, with each group containing 18 lesions. The experimental group received treatment with CGF combined with GTR and bone grafting, while the control group was treated with GTR and bone grafting alone. Clinical examinations and cone beam CT (CBCT) assessments were conducted on the affected teeth prior to the surgery, 6 months and 1 year post surgery. Clinical parameters recorded included probing depth (PD), vertical clinical attachment level (CAL-V), horizontal clinical attachment level (CAL-H). CBCT scans were acquired. The radiographic outcomes assessed included bone loss in the vertical direction (BL-V) and horizontal direction (BL-H). Changes in both clinical parameters and CBCT data at baseline and 1 year post surgery were compared between the experimental group and control group.</p><p><strong>Results: </strong>At baseline, no statistically significant differences were observed between the two groups in terms of PD, CAL-V, CAL-H, and BL-V, BL-H as assessed by CBCT (<i>P</i>>0.05), indicating good baseline balance. Six months and 1 year post surgery, both groups demonstrated significant improvements in clinical indicators compared with baseline (<i>P</i> < 0.01). Notably, one year post surgery, the enhancement observed in the experimental group was significantly greater than that of the control group (<i>P</i> < 0.05): the reduction in PD was (4.75±1.87) mm in the experimental group versus (3.43±1.76) mm in the control group; the decrease in CAL-V was (5.55±1.04) mm in the experimental group <i>versus</i> (4.41±1.08) mm in the control group; the decrease in CAL-H was (3.89±1.22) mm in the experimental group versus (3.07±1.02) mm in the control group. One year post surgery, CBCT results demonstrated that the reduction in BL-V was (4.05±1.37) mm in the experimental group compared with (3.17±1.09) mm in the control group, and the reduction in BL-H was (4.02±1.32) mm <i>versus</i> (3.27±1.08) mm.</p><p><strong>Conclusion: </strong>The one-year observational findings demonstrate that CGF enhances the regenerative efficacy of GTR combined with bone graft in the treatment of grade Ⅱ furcation defects in mandibular molars.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 2","pages":"372-379"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical characteristics and relevant factors of rheumatoid arthritis patients with anemia of chronic disease].","authors":"Hui Wei, Jingfeng Zhang, Zhongqiang Yao, Jinxia Zhao","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the related factors of rheumatoid arthritis (RA) patients with anemia of chronic disease (ACD) and to guide the clinical diagnosis and treatment.</p><p><strong>Methods: </strong>A retrospective study was used to analyze the patients admitted to Department of Rheumatology and Immunology in Peking University Third Hospital from January 2013 to December 2018. Clinical data (including general conditions, joint lesions, extra-articular manifestations, and comorbidities), laboratory examinations, and treatment were collected to analyze the differences in clinical characteristics between group RA with ACD (RA-A) and group RA without ACD (RA-nA). Univariate and multivariate Logistic regression analysis was conducted to screen for relevant factors of RA with ACD.</p><p><strong>Results: </strong>A total of 468 RA patients were included, including 194 cases (41.5%) in RA-A group and 274 cases (58.5%) in RA-nA group. There were no significant differences in age, gender, onset age, or course of disease between the two groups (<i>P</i>>0.05). The RA-A group had more joint swelling [13 (2, 14) <i>vs</i>. 10 (2, 11)], more tenderness [10 (2, 12) <i>vs</i>. 7 (2, 10)], and higher 28 joint disease activity scores (DAS28) [DAS28-CRP (C-reactive protein): 5.2±1.4 <i>vs</i>. 4.6±1.5; DAS28-ESR (erythrocyte sedimentation rate): 5.9±1.5 <i>vs</i>. 5.1±1.8] compared with the RA-nA group (<i>P</i> < 0.05). The incidence of pleural effusion (4.6% <i>vs</i>. 1.1%) and venous thrombosis (5.7% <i>vs</i>. 1.5%) were higher in RA-A group (<i>P</i> < 0.05). The platelet count, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, ESR, CRP, immunoglobulin G (IgG) in RA-A group were significantly higher than those in RA-nA group (<i>P</i> < 0.05). Elevated ESR and CRP levels, DAS28 > 5.1 were relevant factors for anemia in the RA patients.</p><p><strong>Conclusion: </strong>RA patients with ACD had more severe joint involvement, higher inflammatory indicators, and more active conditions, making them more prone to pleural effusion and venous thrombosis. High disease activity, high inflammatory status, and venous thrombosis were risk factors for RA with ACD.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"58 2","pages":"307-312"},"PeriodicalIF":0.0,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147669988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}