Recently, photodynamic therapy (PDT) has gained considerable attention as a promising therapeutic approach for the treatment of psoriasis. Unfortunately, the activation of high mobility group box 1 protein (HMGB1) by PDT triggers innate and adaptive immune responses, which exacerbate skin inflammation. Herein, we combined glycyrrhizic acid (GA), a natural anti-inflammatory compound and immunomodulator derived from the herb Glycyrrhiza uralensis Fisch., with PDT actuated by the photosensitizer chlorin e6 (Ce6) by co-loading them in GA-based lipid nanoparticles coated with a catechol-modified quaternary chitosan salt (GC NPs/QCS-C). GC NPs/QCS-C exhibited high drug loading efficacy, uniform size distribution, an ideal topical adhesive property, enhanced skin retention and penetration in psoriasis-like lesions, and high intracellular uptake in epidermal cells compared with the counterparts. Subsequently, the transdermal administration of GC NPs/QCS-C followed by near-infrared laser radiation in an imiquimod-induced psoriasis-like mouse model significantly ameliorated psoriasis symptoms, promoted the apoptosis of hyperproliferative epidermal cells, and alleviated the inflammatory cascade. The significant therapeutic outcomes of GC NPs/QCS-C were attributed to the synergistic effects of GA and PDT on modulating immune cell recruitment and inhibiting dendritic cell maturation. Our results demonstrated that the topical bio-adhesive nanosystem that combines GA and Ce6 offers a synergistic chemo-phototherapeutic strategy for psoriasis treatment.

Objective:To analyze application effect of trend analysis for safe risk in management and control for infection of medical devices,so as to optimize the management path for medical devices.Methods:Focusing on the main factors affecting the safety risks of medical devices,the least squares method of linear regression was applied for trend analysis to optimize the device management path and strengthen management.A total of 70 clinically used medical devices in the First Affiliated Hospital of Xi'an Jiaotong University from January to December 2024 were selected.These devices were managed using two models:the conventional management model and the trend analysis management model,with 35 devices under each model.The infection risk rate of medical equipment and the equipment management quality score were compared between the two management models.Additionally,160 patients managed under the two models(80 patients per model)were included to compare the patient infection rate.Results:In the 450 diagnostic and treated records of sampling inspection and consultation for medical devices from treatment equipment,diagnosis equipment,auxiliary imaging equipment and surgical equipment,the rate of infectious risk of using management mode with trend analysis were respectively 1.78%(8/450),2.22%(10/450),2.22%(10/450)and 2.44%(11/450),all of which were significantly lower than these of using conventional management mode,and the differences were significant(x2=9.904,8.902,10.465,10.770,P＜0.05).The scores of cleaning quality,the quality of disinfection and sterilization,the quality of distribution,and the retrieving quality of the management mode with trend analysis for medical devices were significantly higher than those of the conventional management mode,and the differences were statistically significant(t=15.889,13.172,15.872,17.399,P＜0.05).The infection rate of patients in the trend analysis management mode was 6.25%(5/80),which was significantly lower than that in the conventional management mode[22.50(18/80)],and the difference was statistically significant(x2=11.006,P＜0.05).Conclusion:The trend analysis for safe risk can analyze the risk factors in use and operation for medical devices from multiple perspectives,and mining main factors and conduct intervention for the devices,and reduce the incidence of safe risks of medical devices and the patients'infection rate,and improve the quality of clinical services.

Objective:To explore the effect of 3D printing extravascular stent implantation on the hemodynamics of the relevant large vessels in patients with nutcracker syndrome（NCS），and to discuss the clinical safety of this new procedure.Methods:A total of 30 NCS patients admitted to Tangdu Hospital Affiliated to Air Force Military Medical University from May to December 2023 were prospectively included. All the patients were received laparoscopic 3D printing extravascular stent implantation for NCS treatment. Whether the lumbago，abdominal pain，hematuria，proteinuria and varicocele had improved after the stent implantation were observed. The inner diameter，blood flow velocity of left renal vein，abdominal aorta，superior mesenteric artery and the diameter of inferior vena cava were measured by ultrasound 1 day before surgery and 8 days after surgery，respectively.In addition，the carotid-femoral pulse wave velocity（cfPWV）was measured by a newly developed method，by which the arterial stiffness could be detected based on Doppler ultrasound. The blood flow Doppler spectra of each subject were recorded at the right common carotid artery and the right common femoral artery，respectively，then based on that，the cfPWV was automatically calculated by this new technique. The above internal diameters，blood flow velocity and cfPWV were compared before and after the laparoscopic 3D printing extravascular stent implantation.Results:Among the 30 patients，the postoperative blood flow velocity at the left renal vein compression site was significantly lower than that before surgery［（50.7 ± 14.8）cm/s vs（122.1 ± 24.1）cm/s， P<0.001）］，and the clinical symptoms，including lumbago and abdominal pain，hematuria，proteinuria and varicocele were significantly improved（all P<0.05）. There were no significant changes in the internal diameter，blood flow velocity of abdominal aorta，superior mesenteric artery and the diameter of inferior vena cava，and cfPWV before and after operation（all P>0.05）. Conclusions:The 3D printing extravascular stent implantation through laparoscope can effectively improve left renal vein compression in patients with NCS，and cause no significant change in large arterial hemodynamics，suggesting that this surgical method is a safe and reliable treatment for patients with NCS.

Immunotherapy based on immune checkpoint inhibitor (ICI) has shown remarkable efficacy in the treatment of microsatellite instability (MSI)-high CRC. However, the monotherapy of ICI in microsatellite stable (MSS) CRC has not been satisfactory. Some patients with MSS CRC can benefit from various combination immunotherapy regimens. Identifying appropriate biomarkers to select MSS-type CRC patients who will benefit from ICI treatment prior to therapy initiation and dynamically monitoring treatment efficacy during the therapeutic course have become crucial components of precision medicine in clinical practice. This article reviews the current research status of traditional biomarkers such as tumor mutation burden (TMB) and PD-L1 expression. It also explores the latest research progress and clinical translation potential of emerging biomarkers, including POLE/POLD1 mutations, immune score, circulating tumor DNA, and gut microbiome. Furthermore, it addresses the challenges in the clinical application of biomarkers, such as the controversy over TMB cutoff values and the heterogeneity of PD-L1 expression. Finally, it outlines future research directions with the aim of providing a basis for clinical decision-making in immunotherapy and facilitating the realization of precision medicine.

Immunotherapy based on immune checkpoint inhibitor (ICI) has shown remarkable efficacy in the treatment of microsatellite instability (MSI)-high CRC. However, the monotherapy of ICI in microsatellite stable (MSS) CRC has not been satisfactory. Some patients with MSS CRC can benefit from various combination immunotherapy regimens. Identifying appropriate biomarkers to select MSS-type CRC patients who will benefit from ICI treatment prior to therapy initiation and dynamically monitoring treatment efficacy during the therapeutic course have become crucial components of precision medicine in clinical practice. This article reviews the current research status of traditional biomarkers such as tumor mutation burden (TMB) and PD-L1 expression. It also explores the latest research progress and clinical translation potential of emerging biomarkers, including POLE/POLD1 mutations, immune score, circulating tumor DNA, and gut microbiome. Furthermore, it addresses the challenges in the clinical application of biomarkers, such as the controversy over TMB cutoff values and the heterogeneity of PD-L1 expression. Finally, it outlines future research directions with the aim of providing a basis for clinical decision-making in immunotherapy and facilitating the realization of precision medicine.

Objective:To analyze application effect of trend analysis for safe risk in management and control for infection of medical devices,so as to optimize the management path for medical devices.Methods:Focusing on the main factors affecting the safety risks of medical devices,the least squares method of linear regression was applied for trend analysis to optimize the device management path and strengthen management.A total of 70 clinically used medical devices in the First Affiliated Hospital of Xi'an Jiaotong University from January to December 2024 were selected.These devices were managed using two models:the conventional management model and the trend analysis management model,with 35 devices under each model.The infection risk rate of medical equipment and the equipment management quality score were compared between the two management models.Additionally,160 patients managed under the two models(80 patients per model)were included to compare the patient infection rate.Results:In the 450 diagnostic and treated records of sampling inspection and consultation for medical devices from treatment equipment,diagnosis equipment,auxiliary imaging equipment and surgical equipment,the rate of infectious risk of using management mode with trend analysis were respectively 1.78%(8/450),2.22%(10/450),2.22%(10/450)and 2.44%(11/450),all of which were significantly lower than these of using conventional management mode,and the differences were significant(x2=9.904,8.902,10.465,10.770,P＜0.05).The scores of cleaning quality,the quality of disinfection and sterilization,the quality of distribution,and the retrieving quality of the management mode with trend analysis for medical devices were significantly higher than those of the conventional management mode,and the differences were statistically significant(t=15.889,13.172,15.872,17.399,P＜0.05).The infection rate of patients in the trend analysis management mode was 6.25%(5/80),which was significantly lower than that in the conventional management mode[22.50(18/80)],and the difference was statistically significant(x2=11.006,P＜0.05).Conclusion:The trend analysis for safe risk can analyze the risk factors in use and operation for medical devices from multiple perspectives,and mining main factors and conduct intervention for the devices,and reduce the incidence of safe risks of medical devices and the patients'infection rate,and improve the quality of clinical services.

Objective:To explore the effect of 3D printing extravascular stent implantation on the hemodynamics of the relevant large vessels in patients with nutcracker syndrome（NCS），and to discuss the clinical safety of this new procedure.Methods:A total of 30 NCS patients admitted to Tangdu Hospital Affiliated to Air Force Military Medical University from May to December 2023 were prospectively included. All the patients were received laparoscopic 3D printing extravascular stent implantation for NCS treatment. Whether the lumbago，abdominal pain，hematuria，proteinuria and varicocele had improved after the stent implantation were observed. The inner diameter，blood flow velocity of left renal vein，abdominal aorta，superior mesenteric artery and the diameter of inferior vena cava were measured by ultrasound 1 day before surgery and 8 days after surgery，respectively.In addition，the carotid-femoral pulse wave velocity（cfPWV）was measured by a newly developed method，by which the arterial stiffness could be detected based on Doppler ultrasound. The blood flow Doppler spectra of each subject were recorded at the right common carotid artery and the right common femoral artery，respectively，then based on that，the cfPWV was automatically calculated by this new technique. The above internal diameters，blood flow velocity and cfPWV were compared before and after the laparoscopic 3D printing extravascular stent implantation.Results:Among the 30 patients，the postoperative blood flow velocity at the left renal vein compression site was significantly lower than that before surgery［（50.7 ± 14.8）cm/s vs（122.1 ± 24.1）cm/s， P<0.001）］，and the clinical symptoms，including lumbago and abdominal pain，hematuria，proteinuria and varicocele were significantly improved（all P<0.05）. There were no significant changes in the internal diameter，blood flow velocity of abdominal aorta，superior mesenteric artery and the diameter of inferior vena cava，and cfPWV before and after operation（all P>0.05）. Conclusions:The 3D printing extravascular stent implantation through laparoscope can effectively improve left renal vein compression in patients with NCS，and cause no significant change in large arterial hemodynamics，suggesting that this surgical method is a safe and reliable treatment for patients with NCS.

Objective To investigate the effects of eicosanoic acid(C20DC)on the proliferation and migration of human retinal endothelial cells(HRECs)and its mechanism.Methods The optimal working concentration of C20DC in human retinal pigment epithelium 19(ARPE-19)cells and HRECs was determined as 30 mg·L-1 and 25 mg·L-1,respec-tively.HRECs were divided into the C20DC treatment group(HRECs treated with C20DC)and the control group[HRECs treated with dimethyl sulfoxide(DMSO)].The effects of C20DC on the migration and proliferation of HRECs were detec-ted by cell proliferation and migration experiments.The molecular docking method was used to simulate the binding ability of C20DC to peroxisome proliferator-activated receptor δ(PPARδ).ARPE-19 cells were divided into the C20DC+ARPE-19 group(ARPE-19 cells treated with C20DC)and the DMSO+ARPE-19 group(ARPE-19 cells treated with DMSO).The ex-pression levels of PPARδ and angiopoietin-like protein 4(ANGPTL4)in ARPE-19 cells and ANGPTL4 protein in HRECs were detected using Western blot.The ANGPTL4 protein expression levels in ARPE-19 cells and HRECs were quantitatively analyzed using enzyme-linked immunosorbent assay(ELISA).Results Compared with the control group,the prolifera-tion and migration of cells in the C20DC treatment group significantly increased(both P＜0.05),and C20DC could stably bind to PPAR8(binding energy:-7.20 kcal·mol-1).Western blot showed that the expression level of ANGPTL4 protein in the C20DC+ARPE-19 group was higher than that in the DMSO+ARPE-19 group,and the difference was statistically sig-nificant(P＜0.05);there was no statistically significant difference in the expression level of PPARδ receptor protein be-tween the two groups(P＞0.05).The expression level of ANGPTL4 protein in the C20DC treatment group was higher than that in the control group,and the difference was statistically significant(P＜0.05).ELISA quantitative analysis showed that the expression level of ANGPTL4 in the C20DC+ARPE-19 group was higher than that in the DMSO+ARPE-19 group(P＜0.001);the expression level of ANGPTL4 in the C20DC treatment group was higher than that in the control group,and the difference was statistically significant(P＜0.05).Conclusion C20DC can promote the expression of ANGPTL4 pro-tein by binding to PPARδ and thus increase the proliferation and migration of retinal related cells(HRECs and ARPE-19 cells).Its mechanism may be related to the increased angiogenesis in retinopathy of prematurity.

Objective The objective of this study was to explore the key genes regulating the metastasis of breast cancer,de-termine the effects of DLX2 on proliferation,migration,invasion,and apoptosis of breast cancer cells,and explore the role and mecha-nism of DLX2 in regulating the characteristics of breast cancer stem cells.Methods A DLX2 gene knockdown breast cancer MCF7 cell line was constructed.The cell viability was detected in breast cancer cells by CCK-8 assay,apoptosis was detected in breast canc-er cells by flow cytometry,cell migration and invasive abilities were detected by Transwell assay,the expression of SOX4 protein was detected by immunofluorescence(IF)in breast cancer cells and xenografts,the expression of CD44 and ALDH1 protein was detected in breast cancer cells and xenografts by Western blot,apoptosis was detected in xenografts by TUNEL assay,and the malignancy degree of tumor tissues was assessed by HE staining.Results After knocking down DLX2,the cell viability decreased(P＜0.001),apoptosis increased(P＜0.001),and cell migration and invasion abilities decreased in breast cancer cells(P＜0.05).The results of IF showed that the expression of SOX4 was inhibited.The results of Western blot showed a decrease in the expression of CD44 and ALDH1 pro-teins in breast cancer cells,which are cellular stemness markers(P＜0.05).In the Balb/c nude mouse breast cancer transplantation tumor model,the volume of xenografts in the sh-DLX2 group was significantly smaller than that in the model group(P＜0.001),the xenografts grew slowly,and the volume and weight of xenografts were also lower than those of the model group(P＜0.05).Apoptosis in the sh-DLX2 group was higher than that in the model group,and the expression of SOX4,CD44 and ALDH1 was consistent with the cellular level,all of which were inhibited(P＜0.05).Conclusion DLX2 inhibits proliferation,migration and invasion of breast cancer cells,promotes apoptosis of breast cancer cells,and regulates the characteristics of breast cancer stem cells through SOX4.

Objective:To explore the pathological differences of surgically resected specimens of advanced esophageal squamous cell carcinoma (ESCC) to different neoadjuvant therapies (neoadjuvant radiochemotherapy and toripalimab combined with neoadjuvant radiochemotherapy).Methods:Thirty patients diagnosed with advanced ESCC who underwent surgical operation after neoadjuvant therapy in Jiangsu Cancer Hospital from October 2020 to September 2021 were included. Among them, 15 patients received neoadjuvant radiochemotherapy (radiochemotherapy group) and 15 patients were treated with toripalimab combined with radiochemotherapy (immunotherapy combined with radiochemotherapy group). Surgically resected specimens were collected. The histopathological features of primary esophageal lesions and the responses of involved lymph nodes were analyzed and compared between two groups.Results:The major pathological response (MPR) rate in the radiochemotherapy group was 10/15, and 14/15 in the immunotherapy combined with radiochemotherapy group ( P=0.17). The pathological complete response (pCR) rate of the primary lesions in the radiochemotherapy group was 7/15, and 10/15 in the immunotherapy combined with radiochemotherapy group ( P=0.46). In the radiochemotherapy group, the incidence rate of tertiary lymphoid structure (TLS) was 7/15, and 12/15 in the immunotherapy combined with radiochemotherapy group ( P=0.02). The incidence rate of necrosis in the radiochemotherapy group was 6/15, and 1/15 in the immunotherapy combined with radiochemotherapy group ( P=0.03). In addition, the incidence rate of foam cell infiltration in the radiochemotherapy group was 6/15, and 13/15 in the immunotherapy combined with radiochemotherapy group ( P=0.01). Furthermore, the pCR rate of involved lymph nodes in the radiochemotherapy group was 7/33, and 11/12 in the immunotherapy combined with radiochemotherapy group ( P<0.001). Conclusion:Compared with the radiochemotherapy group, the incidence of TLS and foam cell infiltration is higher, the incidence of necrosis is lower and clinical efficacy of involved lymph nodes is higher in the immunotherapy combined with radiochemotherapy group, prompting that toripalimab combined with neoadjuvant radiochemotherapy exert higher synergistic immune effect.