Radiotherapy (RT) is one of the most common treatments for cancer. However, intracellular glutathione (GSH) plays a key role in protecting cancer from radiation damage. Herein, we have developed a platelet membrane biomimetic nanomedicine (PMD) that induces double GSH consumption to enhance tumor radioimmunotherapy. This biomimetic nanomedicine consists of an external platelet membrane and internal organic mesoporous silica nanoparticles (MON) loaded with 2-deoxy-D-glucose (2-DG). Thanks to the tumor-targeting ability of the platelet membranes, PMD can target and aggregate to the tumor site, which is internalized by tumor cells. Within tumor cells overexpressing GSH, MON reacts with GSH to degrade and release 2-DG. This step initially depletes the intracellular GSH content. The subsequent release of 2-DG inhibits glycolysis and adenosine triphosphate (ATP) production, ultimately leading to secondary GSH consumption. This nanodrug combines dual GSH depletion, starvation therapy, and RT to promote immunogenic cell death and stimulate the systemic immune response. In the bilateral tumor model in vivo, distal tumor growth was also well suppressed. The proportion of mature dendritic cells (DC) and CD8⁺ T cells in the mice was increased. This indicates that PMD can promote anti-tumor radioimmunotherapy and has good prospects for clinical application.

Objective To estimate the clinical characteristic and relevant problems of Roux-en-y surgical therapy for patients with gastric carcinoma in elderly patients. Method The clinical data of 86 elderly patients with gastric carcinoma over over years old were analyzed retrospectively. Result 86 cases received operations research,59 eases received distal end subtotal gastreetomy, 5 cases received total gastrectomy ,20 cases received proximal endsub-total gastrectomy, and 2 cases received short circuit,stoma or exploratory laparotomy. Conduslon Gastric carcinoma in elderly patients is not easy to find, and it is with more exist diseases, more postoperative complication. So it ineces-sary to enforce perioperative period management, and the options of operation methods should follow individual princi-ple.

Objective To clarify whether the mRNA expression level of glucocorticoid receptor (GR) in the peripheral blood mononuclear cells (PBMCs) can predict the clinical response to glucocorticoid (GC) in patients with pemphigus. Methods Reverse-transcription polymerase chain reaction (RT-PCR) was applied to determine the mRNA expression of GR? and GR? in PBMCs from 30 patients with pemphigus and 30 healthy volunteers. Results GR? mRNA was detected in all patients and all healthy volunteers, and the expression of GR? mRNA in pemphigus patients was significantly lower than that in healthy volunteers (P = 0.044), but no significant difference was found between patients insensitive and sensitive to glucocorticoid. In contrast, GR? mRNA was detected in 10 of 12 patients insensitive to glucocorticoid, 3 of 18 patients sensitive to glucocorticoid, and 9 of 30 healthy Volunteers. The positive rate of GR? in the insensitive group was significantly higher than that in the sensitive group (P