Cancer immunotherapy has emerged as a promising strategy. However, low response rates and immune-related side effects have plagued immunotherapy. Metallic nanoparticles, utilizing metals as their framework, are gaining prominence in cancer immunotherapy. Metal ions have shown the ability to modulate immune status by activating the cGAS-STING pathway and inducing immunogenic cell death (ICD), thereby enabling multidimensional activation of immunotherapy. Metallic nanoparticles offer significant advantages in cancer immunotherapy, leading to their increasing use in enhancing therapeutic outcomes. In view of the ever-increasing research on metallic nanoparticles, this review presents the construction, characterization, and enhanced cancer immunotherapeutic effects of different types of metal nanosystems from the perspective of the immunoregulatory mechanisms of metal ions. We delve into the current limitations and future directions of metallic nanoparticles in this rapidly evolving field. To the best of our knowledge, this review offers the most up-to-date and systematic analysis of metallic nanoparticles in immunotherapeutic applications. It is anticipated that this review of metallic nanoparticles will inspire a more refined and intelligent design of metallic nanoparticles for future research, paving the way for advancing their clinical applications.

An ideal dermal filler should integrate filling, repair, and anti-aging effects, with immediate tissue augmentation, slow degradation, and progressive stimulation of collagen regeneration. However, commonly used hyaluronic acid (HA) hydrogels, while effective for rapid filling, suffer from limited duration of support, weak cell adhesion, and an inability to promote collagen regeneration. Silk fibroin (SF), a natural protein from silkworm cocoons, is known for its excellent cell adhesion and collagen-stimulating abilities. However, its limited gelation capability restricts its potential application as a standalone injectable hydrogel. Based on a complementary strategy, this study combines the rapid gelling properties of HA with the collagen regenerative properties of SF to create a co-crosslinked HA-SF hydrogel. The composite hydrogel merges HA's rapid filling effect with SF's strong tissue adhesion and collagen-stimulating abilities. The formulation, physicochemical properties, degradation, biocompatibility, and filling effects of the HA-SF hydrogel were systematically investigated. HA-SF hydrogel exhibits excellent mechanical properties and ensures long-term support while maintaining injectability. Interestingly, after intradermal injection in the UVB-induced photoaging model, HA-SF hydrogel not only enhances hydrogel-cell interaction but also continues to stimulate collagen regeneration, especially type III collagen. This dual action achieves the biological effects of repair and anti-aging while maintaining the filling effect. Proteomic analysis confirms that repair and anti-aging effects are enhanced by the regulation of skin fibroblasts and modulation of amino acid and lipid metabolism. This composite hydrogel holds strong promise for clinical applications, offering a safer, long-lasting, and more natural injectable filler that combines filling, repair, and anti-aging into one system.

The construction of clinical research management system in public hospitals is an important platform for China's clinical research workers to achieve new products conversion and application.At present,China have basically realized the informatization of clinical trial management process and scientific research project,improved the efficiency and quality of scientific research management,but there is still a large distance from the requirements of digital management platform.The core problem is that there is no unified standard for clinical data collection,disjointed management of the whole process,and backward communication and collaboration mode.The establishment of a standardized disease database has become an effective means to achieve standardized clinical data,and it is the basis for opening up the clogging point of the whole process management and realizing multi-department data sharing.

To solve the problems such as decentralized management of transportation needs and personnel, a tertiary hospital launched an intelligent scheduling management information system for " one-stop" transportation service in March 2022, which included the business layer, data layer, and control layer. The system used graph neural network algorithm to train multi feature transportation service data and established an artificial intelligence model for transportation service scheduling, which was used to assist the hospital transportation command center in intelligent scheduling, achieving unified application, task scheduling, process control, and personnel assessment of hospital transportation services.The coverage of transportation services had increased from 188 departments before the system online (March 2021 to February 2022) to 268 departments after the system online (March 2022 to February 2023), as well as the service types and the per capita efficiency coefficient of transportation personnel had increased from 36 categories and 4 086.53 orders/person to 52 categories and 5 839.83 orders/person, respectively. This system met the growing demand for hospital transportation services, improved the level of transportation scheduling management and user satisfaction, which could provide references for other hospitals to promote intelligent management of transportation services.

AIM:Autophagy levels in lung cancer cisplatin-resistant A549/DDP cells and cisplatin-sensitive A549 cells were compared.The effects of microRNA-126(miRNA-126)on autophagy in lung cancer cisplatin-resistant cells were assessed,and the role of miRNA-126 in lung cancer cisplatin-resistant cells was discussed.METHODS:An MTT assay was used to detect the half maximal inhibitory concentration of cisplatin.The miRNA-126 expression was de-tected by RT-qPCR.Autophagolysosomes were observed under a fluorescence microscope using acridine orange staining.Protein levels of autophagy-associated molecule microtubule-associated protein 1 light chain 3(LC3)in lung cancer cells were determined by Western blot.RESULTS:Autophagy was significantly elevated in A549/DDP cells compared with A549 cells(P<0.01).The expression level of miRNA-126 was significantly elevated in A549/DDP cells after transfection with miRNA-126(P<0.01).miRNA-126 reversed cisplatin resistance of A549/DDP cells,and the level of intracellular acid dye follicular bright red fluorescence in the A549/DDP cells was significantly reduced after transfection with miRNA-126(P<0.01).The LC3-Ⅱ protein level in A549/DDP cells was significantly reduced after transfection with miRNA-126(P<0.01),and inhibition of cell autophagy by 3-methyladenine(3-MA)enhanced cisplatin sensitivity of A549/DDP cells(P<0.01).Compared with 3-MA+NC group,miRNA-126 combined with 3-MA further increased cisplatin sensitivity of A549/DDP cells(P<0.01).CONCLUSION:miRNA-126 reverses the cisplatin resistance in lung cancer A549/DDP cells by inhibiting autophagy.

Objective To observe the value of ultrasound assessment of diaphragm function combined with the Medical Research Council(MRC)muscle strength score and acute physiology and chronic health Ⅱ(APACHE Ⅱ)score for predicting weaning outcome in severe pneumonia patients after mechanical ventilation.Methods Totally 102 patients with severe pneumonia who underwent mechanical ventilation were retrospectively enrolled.Spontaneous breathing trial(SBT)was performed,and diaphragmatic mobility and contraction velocity were measured before and after SBT to evaluate diaphragm function.All patients were divided into successful weaning(successful group,n=76)and failed weaning group(failure group,n=26)according to breathing condition after weaning.Univariate analysis and multivariate logistic regression were used to analyze clinical data,MRC and APACHE Ⅱ scores before SBT,as well as diaphragm function parameters before and after SBT,and the independent risk factors for weaning failure were screened,based which a combined regression model was established.The diagnostic efficacy of each independent risk factor and combined regression model was evaluated by receiver operating characteristic curve and the area under the curve(AUC).Results MRC and APACHE Ⅱ scores,diaphragmatic mobility and contraction velocity before SBT were all independent risk factors for weaning failure in severe pneumonia patients after mechanical ventilation(all P＜0.05),with AUC of 0.682,0.667,0.785 and 0.685,respectively.The AUC of combined regression model established with the above independent risk factors was 0.898,higher than that of each independent risk factor(all P＜0.05).Conclusion Ultrasound assessment of diaphragm function combined with MRC muscle strength and APACHE Ⅱ scores could effectively predict weaning outcome in severe pneumonia patients who underwent mechanical ventilation.

The discussion and research on the clinical dominant diseases of traditional Chinese medicine （TCM） have attracted increasing attention. Through approaches including modern technology， evidence-based medical methods， and multi-disciplinary treatment， we should construct a sound TCM inheritance and innovation system， establish a collaborative innovation mechanism， and integrate major research projects， striving to make breakthroughs in TCM theory， methodology， standards， and regulation system， promoting the scientific and technological progress of TCM， and thereby improving its curative effect. The China Association of Chinese Medicine （CACM） carried out a series of youth salon seminars for clinical dominant diseases in TCM， discussing and sorting out the advantages of the dominant diseases in clinical diagnosis and treatment of TCM and integrated traditional Chinese and western medicine in specific diseases or fields. Authoritative experts in the industry were invited to give comment and guidance to form a report. Centering on clinical research of dominant diseases， thematic research was carried out in the aspects of practice， human experience-based evidence， and transformation path. Through the systematic study of the dominant diseases， the advantages of TCM in different stages of disease treatment were excavated to constantly improve the prevention and treatment ability of TCM and carry forward the advancement of TCM theory and practice. At the same time， the communication and understanding between traditional Chinese and western medicine were improved， laying the foundation for the further formation of industry guidelines or consensus and comprehensive promotion. These seminars are expected to provide references for the development of policy planning， clinical diagnosis and treatment， health economy， and social services in TCM and lay the foundation for the formation of a new modern diagnosis and treatment system with Chinese characteristics.

Polyhydroxyalkanoate depolymerase (PHAD) can be used for the degradation and recovery of polyhydroxyalkanoate (PHA). In order to develop a PHAD with good stability under high temperature, PHAD from Thermomonospora umbrina (TumPHAD) was heterelogously expressed in Escherichia coli BL21(DE3). At the same time, a mutant A190C/V240C with enhanced stability was obtained via rational design of disulfide bonds. Characterization of enzymatic properties showed that the mutant A190C/V240C had an optimum temperature of 60 ℃, which was 20 ℃ higher than that of the wild type. The half-life at 50 ℃ was 7 hours, at 50 ℃ which was 21 times longer than that of the wild type. The mutant A190C/V240C was used for the degradation of polyhydroxybutyrate (PHB), one of the typical PHA. At 50 ℃, the degradation rate of PHB being treated for 2 hours and 12 hours was 2.1 times and 3.8 times higher than that of the wild type, respectively. The TumPHAD mutant A190C/V240C obtained in this study shows tolerance to high temperature resistance, good thermal stability and strong PHB degradation ability, which may facilitate the degradation and recovery of PHB.
Thermomonospora ; Actinomycetales ; Escherichia coli/genetics* ; Polyhydroxyalkanoates

Gastroesophageal reflux disease （GERD） is a frequently and commonly occurring disease in clinic. In recent decades， with the development in pathophysiology and drug researches， modern medicine has achieved remarkable progress and results in diagnosis and treatment. However， the treatments for non-erosive reflux disease， refractory gastroesophageal reflux disease， proton pump inhibitor resistance， overlap of disease symptoms， and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine （TCM） was widely used in clinical practice， which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine （CACM） and undertaken by the Spleen and Stomach Disease Branch of CACM， "the 12^th Youth Salon of Clinical Predominance Disease Series （GERD）" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions， improvement and maintenance of symptoms， response to overlapping disease symptoms， reduction and withdrawal of acid suppressors， and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths， combing the difficulties of modern medical diagnosis and treatment， which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.