AIM: To detect the distribution and expression of vascular endothelial growth factor(VEGF)in radiation retinopathy(RR)through fluorescence targeted imaging.METHODS:Covalent binding of fluorescein FITC with VEGF antibody ranibizumab to prepare targeted fluorescent imaging probe ranibizumab-FITC. SD rats were randomly divided into three groups based on the principle of weight balance: a normal control group(Con group), a low-dose radiation group(10 Gy group), and a high-dose radiation group(30 Gy group). Medical linear accelerators and lead blocks were used to locally irradiate the rat eyeballs for modeling. Western blot and qRT-PCR were used to detect the expression levels of VEGF-A in each group and to screen for appropriate modeling dose. The inverted fluorescence microscope and the confocal microscope were used to observe the distribution of VEGF and imaging probes in the retinas of control and RR model group rats, and to verify the effectiveness of targeted probes.RESULTS:The expression level of VEGF-A in the retina of rats in the high-dose radiation group(30 Gy group)was higher than that in the normal control group(Con group). In early RR, VEGF expression was observed to be associated with microaneurysms and abnormal microvessels in the retina. VEGF accumulation was observed at the site of capillary wall damage. When retinal capillary endothelial damage occurred, targeted probes gathered on the outer surface of the vessel wall.CONCLUSION:The expression level of VEGF in the retina of RR model rats is elevated, and fluorescent targeted molecular imaging probes can detect the spatial distribution of VEGF at the microvascular lesions in the retina of RR rats.

Definitive chemoradiotherapy (dCRT) has become a cornerstone in the treatment of locally advanced esophageal cancer; however, local control remains suboptimal, and persistent lesions or locoregional recurrences after treatment are not uncommon. For patients without distant metastases but with local failure, whether surgical intervention can still offer curative potential remains a major clinical dilemma. Salvage esophagectomy (SE) offers potential long-term survival for selected patients, but this procedure is performed in the context of severe fibrosis, impaired local blood supply, and obscured anatomical planes following chemoradiotherapy, resulting in significantly higher perioperative risk compared to primary esophagectomy. Consequently, controversies exist regarding patient selection, preoperative restaging, choice of surgical approach, extent of lymphadenectomy, gastrointestinal reconstruction, and perioperative management. In recent years, with the refinement of restaging modalities such as PET/CT, the accumulation of experience in high-volume centers, and emerging evidence from clinical studies, the clinical role of SE has gradually shifted from a "high-risk salvage measure" to a "selective curative strategy aimed at achieving long-term survival in carefully selected patients". Nevertheless, standardized guidelines for patient selection, technical approaches, and perioperative management are still lacking. Based on current evidence and clinical experience, experts organized by the Integrated Esophageal Cancer Committee of Chinese Anti-Cancer Association systematically reviewed key issues regarding SE, including its definition, indications, preoperative evaluation, choice of surgical approach, lymphadenectomy, gastrointestinal reconstruction, and perioperative management, and formulated a Chinese expert consensus. This consensus aims to provide guidance for standardized assessment, appropriate referral, individualized surgical decision-making, and optimized perioperative management of patients with locoregional failure after dCRT. Ultimately, this will increase the likelihood of R0 resection, reduce the risk of severe complications, and promote the safer, more judicious, and standardized implementation of SE in high-risk scenarios.

Objective To explore the clinical effect of using the Brisson technique combined with a precise measurement scheme in the treatment of hidden penis.Methods The clinical data of 120 children with hidden penis treated in our hospital from January 2021 to June 2024 were retrospectively analyzed.The enrolled children were randomly divided into the study group(n=60)and the control group(n=60).The study group was treated with the Brisson technique combined with a precise measurement scheme,and the cutting of the penile skin was designed according to the data.The control group was treated with the traditional Devine technique.The surgical effects,penile lengths before and after surgery,and the incidence of postoperative complications of the children in the two groups were compared and analyzed.Results The effective rate of the study group reached 100％,which was significantly higher than that of the control group(93％,P＜0.05).Six months after surgery,the penile length of the children in the study group was longer than that in the control group,and the difference was statistically significant(P＜0.05).The incidence of surgical complications in the study group was 5％,which was significantly lower than that in the control group(17％,P＜0.05).Conclusion Using the Brisson technique combined with a precise measurement scheme to treat hidden penis has a good effect,a high effective rate,and a low incidence of complications.

Objective: To understand the influenza vaccination rate and related factors of children in Xiqing District of Tianjin, so as to provide a scientific basis for improving the influenza vaccination coverage rate among children. Methods: A stratified random cluster sampling method was employed to select junior high school students and below students from 15 schools in five directions(east, west, south, north, midland) in Xiqing District, Tianjin, involving 13 075 students. A questionnaire survey was conducted among parents of students to analyze the influenza vaccination rate of children in 2023-2024 flu season (October to March of the following year). A binary Logistic regression model was used to analyze the factors affecting influenza vaccination. Results: The influenza vaccination rate was 16.66% for children in Xiqing District of Tianjin, in 2023-2024 flu season, among them, the vaccination rate in kindergartens was the highest (28.86%), followed by primary schools (18.87%) and junior high schools (12.61%). Binary Logistic regression analysis showed that having received the influenza vaccine during the 2020-2022 ( OR=10.55, 95%CI =9.48-11.73), parents awareness of influenza related knowledge ( OR=1.38, 95%CI =1.24-1.54), kindergarten children ( OR= 2.33 , 95%CI =1.91-2.83), primary school students ( OR=1.26, 95%CI =1.12-1.42), parents with a postgraduate degree or above ( OR=1.62, 95%CI =1.13-2.31), and a monthly average family income of 10 000-<20 000 yuan ( OR=1.67, 95%CI = 1.41- 1.99) were positive correlation factors with influenza vaccination of children ( P <0.05). Among parents of children who have not received the flu vaccine, 61.61% fully accepted flu vaccination or accepted but still considered. The most popular way for parents to obtain flu knowledge was flu prevention and control information from professional institutions during the flu season ( 77.38 %). Conclusions The influenza vaccination rate among kindergarten, as well as primary and junior high school students in Xiqing District of Tianjin is low. Promotion of influenza vaccination among children and increase the vaccination rate of influenza among children might help reduce the risk of campus flu outbreak.

Objective:To compare the efficacy and safety of crisaborole ointment 2% versus pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged 2 years or older.Methods:A multicenter, randomized, open-label, controlled clinical trial was conducted. A total of 120 pediatric patients aged 2 - 17 years with mild to moderate atopic dermatitis were enrolled from departments of dermatology of 8 hospitals in China between March 2022 and February 2023. The participants were randomly assigned in a 1∶1 ratio to the crisaborole group and the pimecrolimus group, and received the treatment with crisaborole ointment 2% and pimecrolimus cream 1% respectively, twice a day for 4 weeks. Visits were scheduled at baseline/on day 1, as well as on days 8, 15, and 29. The primary efficacy outcome was the percentage of patients achieving the Investigator's Static Global Assessment (ISGA) success (defined as clear [0] or almost clear [1] on the ISGA scale, combined with ≥ 2‐grade improvement from baseline) on day 29. The secondary efficacy outcomes included changes in the Eczema Area and Severity Index (EASI) total scores from baseline to day 29, percentages of patients achieving ISGA improvement (defined as clear [0] or almost clear [1] on the ISGA scale), as well as changes in the Peak Pruritus Numerical Rating Scale (NRS) scores, Dermatology Life Quality Index (DLQI) /Infants' Dermatology Life Quality Index (IDLQI) /Children's Dermatology Life Quality Index (CDLQI) scores, and in the Dermatitis Family Impact (DFI) scores. Drug safety was evaluated according to the incidence of adverse events. Categorical data were compared using the chi-square test. Since measurement data did not follow a normal distribution, the rank sum test was used for comparisons of measurement data between groups.Results:A total of 106 children with mild to moderate atopic dermatitis were included in the per-protocol analysis set, with 52 in the crisaborole group (26 males and 26 females) and 54 in the pimecrolimus group (27 males and 27 females). There were no significant differences in age, disease duration, ISGA and EASI scores at baseline between the two groups (all P > 0.05). On day 29, 22 patients (42.31%) in the crisaborole group and 25 (46.30%) in the pimecrolimus group achieved ISGA success, with no significant difference between the two groups ( χ2 = 0.17, P = 0.68) ; 35 patients (67.31%) in the crisaborole group and 45 (83.33%) in the pimecrolimus group achieved ISGA improvement, also with no significant difference between the two groups ( χ2 = 3.68, P = 0.06) ; additionally, there were no significant differences in the EASI, pruritus NRS, DLQI/IDLQI/CDLQI, or DFI scores between the two groups (all P > 0.05). Adverse reactions to the two topical agents were mainly local reactions such as mild to moderate pain, itching, or worsening of itching, and no obvious systemic adverse reactions occurred. The incidence of drug-related adverse reactions was 46.15% (24 cases) in the crisaborole group and 37.04% (20 cases) in the pimecrolimus group, with no significant difference between the two groups ( χ2 = 0.91, P = 0.34) . Conclusion:The efficacy of crisaborole ointment 2% was comparable to that of pimecrolimus cream 1% in the treatment of mild to moderate atopic dermatitis in children aged ≥ 2 years, and it yielded early and rapid improvement in the quality of life of patients and their families, with good safety and tolerability profiles.

Objective To evaluate the application of modified chairside case-based learning(CBL)in the teaching of dental residents in the prosthodontic clinic.Methods Dental residents in Peking Union Medical College Hospital from September 2022 to September 2024 were enrolled.Traditional CBL was conducted in control group.Modified chairside CBL was conducted in test group.The scores of department rotation examination and questionnaire results were analyzed with t-test statistical analysis.Results The score of"patient reception"in test group was significantly higher than control group(P＜0.05).24 valid questionnaires were collected in two groups each.The rate of approval in test group was significantly higher than control group in the following items of questionnaire,including"reduce learning pressure or burden""improve the capacity of doctor-patient communication""improve the capacity of literature review""improve the capacity of group cooperation"(P＜0.05).Conclusions Modified chairside CBL has showed good teaching effects in improving the capacity of patient reception,doctor-patient communication,literature review,group cooperation,and meanwhile reduced learning pressure or burden.

Objective To explore the need and evaluate the effectiveness for head-simulator in the teaching of sto-matology within the eight-year program of clinical medicine.Methods Questionnaire survey was conducted among the students from 2017 cohort of the eight-year program of clinical medicine at Peking Union Medical College.The survey results were statistically analyzed and described.Results Totally 87.9％of the students believed that incor-porating head-simulator into the clinical practice course of stomatology were necessary,and 93.9％expressed will-ingness to join the training.Most students preferred to practice peri-odontal scaling and cavity preparation for caries during the simulated training sessions.The majority of students considered two or four class hours of simulated head teaching to be reasonable.The pilot head simulation training was successfully implemented;75.0％of the students acknowledged clear teaching and convincible demonstrations.All the trainees agreed that the head simulation course helped them better understand stomatology knowledge,stimulated their interest in learning and expressed a desire for increased head simulation sessions during clinical practice course of stomatology.Additionally,87.5％of the students preferred head simulation training course to be applied in classic clinical clerkships.Conclusions There is strong demand among students of eight-year program of clinical medicine for incorporating head-simulator into the education of stomatology.The pilot simulation training received positive evaluations.Further exploration is needed to optimize specific scheduling and content arrangement.

Photodynamic immunotherapy is a promising strategy for cancer treatment. However, the dysfunctional tumor vasculature results in tumor hypoxia and the low efficiency of drug delivery, which in turn restricts the anticancer effect of photodynamic immunotherapy. In this study, we designed photosensitive lipid nanoparticles. The synthesized PFBT@Rox Lip nanoparticles could produce type I/II reactive oxygen species (ROS) by electron or energy transfer through PFBT under light irradiation. Moreover, this nanosystem could alleviate tumor hypoxia and promote vascular normalization through Roxadustat. Upon irradiation with white light, the ROS produced by PFBT@Rox Lip nanoparticles in situ dysregulated calcium homeostasis and triggered endoplasmic reticulum stress, which further promoted the release of damage-associated molecular patterns, enhanced antigen presentation, and stimulated an effective adaptive immune response, ultimately priming the tumor microenvironment (TME) together with the hypoxia alleviation and vessel normalization by Roxadustat. Indeed, in vivo results indicated that PFBT@Rox Lip nanoparticles promoted M1 polarization of tumor-associated macrophages, recruited more natural killer cells, and augmented infiltration of T cells, thereby leading to efficient photodynamic immunotherapy and potentiating the anti-primary and metastatic tumor efficacy of PD-1 antibody. Collectively, photodynamic immunotherapy with PFBT@Rox Lip nanoparticles efficiently program TME through the induction of immunogenicity and oxygenation, and effectively suppress tumor growth through immunogenic cell death and enhanced anti-tumor immunity.

Objective To investigate the age-dependent modulatory effects of treadmill exercise on spatial learning and memory in mice and to elucidate the potential neurobiological mechanisms underlying these effects.Methods Male C57BL/6J mice at three distinct developmental stages were subjected to a controlled treadmill training protocol for a duration of four weeks.Cognitive performance was assessed in terms of spatial learning and memoryusing a series of behavioral tests.To examine exercise-induced neurogenesis,proliferating adult neural stem cells in the hippocampal region were labeled via intraperitoneal administration of BrdU.Meanwhile,physiological parameters,including body and muscle weight,were monitored throughout the experiment.Results The study revealed significant age-specific effects of treadmill training.In one-month-old mice,exercise intervention markedly enhanced spatial learning and memory,along with increased proliferation of hippocampal neural stem cells,but no significant alterations were observed in body or muscle weight.In six-month-old mice,treadmill training selectively improved spatial memory and led to increased muscle weight.Notably,three-month-old mice exhibited no significant exercise-induced changes in cognitive performance,hippocampal neurogenesis,or muscle weight.Conclusion These findings demonstrate that treadmill exercise exerts significant,age-dependent regulatory effects on spatial learning and memory,with the most pronounced and comprehensive improvements observed in one-month-old mice.The cognitive enhancements may be mediated,at least partially,through exercise-induced promotion of hippocampal neurogenesis.This study provides data for elucidation of the mechanistic basis of exercise-mediated cognitive enhancement and contributes to the potential applications of exercise interventions in cognitive optimization and neuroplasticity across different developmental stages.

Objective:To evaluate the efficacy of almonertinib,a third-generation epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI),as a first-line treatment for patients with EGFR-mutated advanced non-small cell lung cancer(NSCLC)in the real-world clinical practise,and to systematically analyze the independent risk factors influencing their prognosis.Methods:This retrospective cohort study enrolled 73 patients with EGFR-mutated advanced NSCLC who received first-line treatment with aumolertinib from April 1,2020 to December 31,2021.Survival curves were generated by using the Kaplan-Meier method,and intergroup comparisons were performed via log-rank test.Univariate and multivariate analyses of prognostic factors were conducted by using the COX proportional hazards regression model,with a focus on identifying prognostic factors in the subgroup of baseline brain metastases.Results:Among 73 patients,the median progression-free survival(mPFS)was 19.4 months,and the disease control rate(DCR)was 93.2%.Multivariate COX regression analysis revealed that central nervous system(CNS)metastasis status,EGFR mutation subtype,ECOG performance status(PS)score,and gender might be independent risk factors for PFS.Among 33 patients with baseline brain metastases,combined almonertinib with radiotherapy or bevacizumab,maximum diameter of brain metastases(≥3 cm),and ECOG PS score might be independent risk factors of PFS.Conclusion:This first real-world study confirms that aumolertinib demonstrates favorable efficacy as first-line treatment for EGFR-mutated locally advanced or metastatic NSCLC patients,aligning with findings from phase Ⅲ clinical trials.For patients in subgroup of baseline brain metastases,combining almonertinib with radiotherapy or bevacizumab is recommended to optimize outcomes.