Objective: To analyze the changes and related factors of influenza vaccine hesitancy among college students in Shanghai from 2022 to 2025, so as to provide evidence for influenza prevention and control in universities. Methods: A stratified random cluster sampling method was used to select 1 393 college students from Shanghai universities for electronic questionnaire surveys in June 2022 and January to February 2025. The survey mainly included influenza vaccination status, sources of vaccine related information, and potential related factors. Data were analyzed using the Chi-square test, Mann-Whitney U test, and binary Logistic regression. Results: The influenza vaccine hesitancy rate among college students in Shanghai was higher in 2025 ( 40.63 %) than in 2022 (31.95%) ( χ 2=22.73), and the hesitancy score [2022:0 (0,5);2025:0 (0,5)] also increased ( Z = -4.16 ) (both P <0.01). The proportion of students exposed to reports of vaccine adverse events rose from 36.90% in 2022 to 59.22 % in 2025 ( χ 2=139.08, P <0.01). Binary Logistic regression analysis showed that basic influenza knowledge (2022: OR = 0.79 , 95% CI =0.68-0.92; 2025: OR =0.79, 95% CI =0.69-0.90) and previous self paid vaccination with other vaccines (2022: OR =0.52, 95% CI =0.37-0.75; 2025: OR =0.63, 95% CI =0.48-0.83) were associated with influenza vaccine hesitancy among college students in both years; medical professional background ( OR =0.34, 95% CI =0.17-0.67) and trust in healthcare providers recommendations ( OR =0.31, 95% CI =0.11-0.86) were associated with influenza vaccine hesitancy among college students in 2025 (all P <0.05). Conclusions The phenomenon of influenza vaccine hesitancy among college students in Shanghai has intensified. Increased knowledge has failed to offset concerns arising from exposure to negative information. Medical background and recommendations from healthcare providers have become new related factors.

Objective: To investigate the current status and related factors of human papillomavirus (HPV) vaccination intention among male college students in Shanghai, so as to provide references for promoting HPV vaccination among males. Methods: From January to February 2025, a stratified random cluster sampling method was used to select 548 male college students in 10 universities from Shanghai for a self questionnaire survey. The survey included socio demographic characteristics, vaccine hesitancy, vaccine beliefs (complacency, confidence, convenience), HPV knowledge level, health status, social support, and information acquisition channels. Latent class analysis (LCA) was used to identify latent classes of vaccine beliefs, and multinomial Logistic regression was used to analyze the related factors of vaccination intentions. Results: The acceptance, hesitancy, and refusal rates of HPV vaccine among college students in Shanghai were 39.4% ( n =216), 35.2% ( n =193), and 25.4% ( n =139), respectively. LCA identified four vaccine belief groups: low complacency high confidence (21.4%), high complacency high confidence (36.1%), low complacency low confidence (18.8%), and high complacency low confidence (23.7%). Multinomial Logistic regression showed that vaccine belief category was an important factor affecting vaccination intentions among college students in Shanghai. Compared with the low complacency high confidence group, high complacency low confidence group had the highest risk of vaccine refusal ( OR =24.80， P <0.05). Medical majors ( OR =0.13), participation in basic medical insurance ( OR =0.37), and recommendations from relatives, friends ( OR =0.39) or healthcare professionals ( OR =0.33) reduced the risk of vaccine refusal among male college students in Shanghai (all P <0.05). The Internet (70.6%) was the main source of HPV related information for male college students, and recommendations from healthcare professionals were associated with more positive vaccination intentions. Conclusions HPV vaccine hesitancy and refusal are common among male college students in Shanghai, with significant heterogeneity in vaccine belief structures. Targeted health education based on belief categories should be conducted to improve the vaccination intentions of male college students.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

In recent years, mesenchymal stem cell-derived exosomes (MSC-EXO) have garnered increasing attention in the field of stomatology and have become an established research area in biomedical research. This article reviews the engineering of exosomes derived from mesenchymal stem cells and their application in the field of stomatology, in order to provide new ideas for the development of stomatology. Exosomes are nanoscale membrane vesicles secreted by cells and contain a variety of proteins, RNAs, lipids, and other biomolecules. They are transported through the circulatory system and can interact with other cells to regulate their biological behavior and participate in a variety of physiological and pathological processes. In the treatment of oral diseases, exosomes have shown great potential due to their natural biological activity and versatility. However, studies have found that relying solely on the function of natural exosomes may not fully meet the complex clinical requirements. Therefore, the concept of engineered exosomes has emerged. Engineered exosomes can be modified by bioengineering technology to enhance their targeting, allowing them to reach the lesion site more accurately. At the same time, engineered exosomes can also be surface modified or loaded internally to carry specific therapeutic molecules, such as drugs, gene editing tools or signaling molecules to improve the therapeutic effect. In addition, this engineered treatment can also confer greater stability to exosomes, making them better able to resist clearance by the immune system when circulating in the body, extending their half-life, and improving the effectiveness of treatment. Although engineered exosomes have attracted extensive attention in the fields of stomatology and other fields, their application is still mainly in the stage of basic research. To promote the clinical application of engineered exosomes, it is necessary to provide more sufficient evidence of biocompatibility and clarify their therapeutic effect and mechanism.

Objective To analyze the expression and diagnostic value of procalcitonin(PCT),white blood cell count(WBC),and C-reactive protein(CRP)in respiratory infections in the intensive care unit(ICU),and their correlation with the clinical pulmonary infection score(CPIS).Methods A total of 105 patients with respiratory infections admitted to the ICU from March 2019 to June 2024 were selected as the observation group,while 117 patients with no respiratory infection in the ICU were selected as the control group.PCT levels in both groups were measured using the Zybio-Q7 immunoquantitative analyzer,WBC levels were measured using XT-4000i white blood cell analyzer,and CRP levels were measured using the immunoturbidimetric method.The relationship between the expression of PCT,WBC and CRP and the clinical characteristics and CPIs score of respiratory infection in ICU were analyzed.Results The proportion of patients in the observation group with ICU stay>15 days and mechanical ventilation>7 days was significantly higher than that in the control group(P<0.05).Compared to the control group,the levels of PCT,WBC,CRP and CPIS score in the observation group were elevated,with statistically significant differences(P<0.05).Multivariate logistic regression analysis showed that ICU stay>15 days(OR=4.087),PCT(OR=6.543),WBC(OR=2.652),and CRP(OR=8.964)were risk factors for the occurrence of respiratory infections in the ICU.Pearson correlation analysis indicated a positive correlation between PCT and CPIS scores(r=0.925,P=0.001),a positive correlation between WBC and CPIS scores(r=0.739,P=0.001);and a positive correlation between CRP and CPIS scores(r=0.948,P=0.001).The ROC curve demonstrated that the combined diagnostic value of the three markers for ICU respiratory infections was higher than that of PCT,WBC,or CRP alone(P=0.002).Conclusion The combination of PCT,WBC,and CRP has high diagnostic value for ICU respiratory infections and is positively correlated with CPIs scores.Therefore,the above indicators can provide a reliable basis for the early diagnosis of respiratory infection in ICU.

Objective : To explore the effect and mechanism of CD151 on vascular permeability by regulating vesicle internalization and recycling. Methods: Wild-type mice and CD151 knockout mice were divided into WT-con group, WT-model group, KO-con group and KO-model group, with 6 mice in each group. WT-model group and KO-model group were intraperitoneally injected with LPS to prepare sepsis ALI model, and WT-con group and KO-con group were intraperitoneally injected with phosphate buffer saline(PBS) as a control. 24 h after modeling, pulmonary vascular permeability was measured by Miles test. The siRNA silencing CD151 expression(si-CD151) and negative control si-NC were transfected into EA.hy 926 cells. The permeability of endothelial cell layer to FITC-dextran at different time points was observed under basic conditions and vascular endothelial growth factor-A(VEGF-A) stimulation conditions. Transcriptome sequencing of endothelial cells in si-CD151 group and si-NC group; the distribution and internalization of CD151 in each group were measured using immunofluorescence. Western blot and real-time quantitative RT-qPCR were used to detect the expression of VE-cadherin in si-CD151 groupand other groups. The distribution and internalization of VE-cadherin in each group were measured using immunofluorescence. Results : Miles experiment results indicated that dye exudation in lung tissue of WT-model group was significantly higher than that of WT-con group(P<0.01). The dye exudation in the lung tissue of KO-model group increased compared with WT-model group(P<0.05). The results of endothelial cell layer permeability test showed that the permeability of FITC-dextran in si-CD151 group was significantly higher than that in control group after VEGF-A stimulation for 30, 60 and 120 min(P<0.05). Transcriptome sequencing results suggested that CD151 in endothelial cells was closely related to vesicle-mediated transport. Compared with other groups, protein and mRNA levels of VE-cadherin in CD151 knockdown endothelial cells was significantly lower(allP<0.01). The immunofluorescence assay demonstrated that after VEGF-A stimulation, the decrease of CD151 expression significantly impaired the expression of VE-cadherin at cell-cell contacts and reduced the CD151-VE-cadherin colocalization in the perinuclear region compared with other groups. Conclusion The absence of CD151 affects the internalization and recycling of endothelial cell vesicles, affects the expression and internalization of VE-cadherin, and then influences vascular permeability.

Objective:To explore the efficacy of different second-line treatment strategies in the real world after progression of first-line immunotherapy and its combination therapies in patients with driver gene-negative advanced non-small cell lung cancer (NSCLC) .Methods:A retrospective analysis was conducted on the clinical data of 93 driver gene-negative advanced NSCLC patients who received first-line immunotherapy and its combination therapies from January 1, 2018 to December 31, 2023 at the First Affiliated Hospital of Xinxiang Medical University and Xinxiang Central Hospital. Patients were categorized into immune checkpoint inhibitors (ICIs) -resistant ( n=43) and ICIs-responsive ( n=50) groups according to whether progression free survival (PFS) exceeded 6 months after first-line treatment. Patients were categorized into ICIs-treated ( n=55) and non-ICIs-treated ( n=38), anti-angiogenic-treated ( n=51) and non-anti-angiogenic-treated ( n=42) groups according to the different second-line treatment strategies after progression of first-line immunotherapy and its combination therapies. The median PFS2 (mPFS2) and median overall survival (mOS) 2 after second-line treatment of each group were compared. The Kaplan-Meier method was used for survival analysis. Results:The mPFS2 and mOS2 of 93 advanced NSCLC patients who progressed after first-line ICIs treatment were 4.9 months (95% CI: 4.1-5.7 months) and 14.7 months (95% CI: 11.2-18.2 months). The mPFS2 of patients in the first-line ICIs-responsive and ICIs-resistant groups were 6.0 and 3.8 months, respectively, with no statistically significant difference ( χ2=2.00, P=0.157), and the mOS2 were 25.3 and 11.3 months, respectively, with a statistically significant difference ( χ2=12.13, P<0.001). The mPFS2 of patients in the second-line ICIs-treated group and the non-ICIs-treated group were 5.2 and 4.6 months, respectively, with no statistically significant difference ( χ2=0.16, P=0.687). The mOS2 were 15.1 and 12.7 months, respectively, with no statistically significant difference ( χ2=0.01, P=0.930). The mPFS2 of patients in the second-line anti-angiogenic-treated and non-anti-angiogenic-treated groups were 4.5 and 6.0 months, respectively, with no statistically significant difference ( χ2=0.41, P=0.525), the mOS2 were 14.7 and 16.8 months, respectively, with no statistically significant difference ( χ2=0.01, P=0.943) . Conclusions:After progression of first-line ICIs therapy in patients with driver gene-negative advanced NSCLC, first-line ICIs-responsive patients have significantly longer OS after second-line treatment compared with ICIs-resistant patients. The efficacy of second-line therapy in patients after progression of first-line ICIs therapy does not show significant differences due to the type of treatment strategies.

The US.is the first country to establish a systematic and comprehensive rare disease protection mechanism to provide protection for patients with rare diseases.Based on the perspective of the whole process,it systematically comprehends the rare disease protection mechanism and its operation from five aspects:rare disease legislation,therapy R&D and marketing support,screening and treatment,medical insurance reimbursement,patient registration and information sharing,so as to provide useful references for China to improve the protection mechanism for rare diseases.

Objective:To analyze the experiences of implementing coverage with evidence development for cell and gene therapy products in the UK.to provide references for the future access of cell and gene therapy products in China.Methods:By systematically combing the strategies of coverage with evidence development adopted by National Health Service(NHS)in the UK.,and summarizing the four links of assessment,payment,further evidence collection and final decision-making,the implementation experience of coverage with evidence development of cell and gene therapy products was analyzed by taking the reimbursement of four typical cell gene therapy products as an example,and suggestions were made for the access of this type of products in China.Results:Access to cell and gene therapy products in the UK.is cautious,with assessment focused on clinical utility.Management access agreement is used to control the risk of overspending during specialized fund reimbursement,while a unified data collection system has been established.Conclusion:China could learn from the experience of the UK.and promote the admission of cell gene therapy products from three aspects:exploring the evidence-based reimbursement model for universal commercial medical insurance;developing a targeted data collection framework based on actual data needs;establishing a unified data collection platform to provide the support for product access decision.

In order to explore the effects of lipopolysaccharide(LPS)on the repair of bovine endo-metrial stromal cells(BESCs)during inflammatory response,BESCs were treated by LPS in this study.Cell apoptosis rate was detected using flow cytometry,cell viability was measured using the CCK-8 assay,cell migration ability was observed using a scratch assay,and the expression of con-nective tissue growth factor(CTGF),transforming growth factor-beta 3(TGF-β3)and vascular endothelial growth factor(VEGF)mRNA was measured using qRT-PCR.Additionally,the expression of key proteins in the PI3K/AKT and Wnt/β-catenin signaling pathways was assessed using Western blot analysis.The results showed that cell viability of BESCs significantly decreased(P＜0.01),cell migration ability decreased(P＜0.05),apoptosis rate of BESCs increased(P＜0.01),CTGF and TGF-β3 mRNA expression levels decreased(P＜0.01),while VEGF mRNA ex-pression increased after treatment with LPS(P＜0.01).The phosphorylation levels of PI3K,AKT and GSK-3β proteins decreased(P＜0.05),as well as the expression levels of c-Myc and Cyclin-D1 proteins also decreased(P＜0.01).These results indicated that LPS can inhibit the proliferation of BESCs and promote cell apoptosis possibly through the inhibition of the PI3K/AKT and Wnt/β-catenin signaling pathways.