OBJECTIVE To evaluate the efficacy and safety of immune checkpoint inhibitors （ICIs） combined with neoadjuvant chemotherapy in the treatment of early triple-negative breast cancer （TNBC）. METHODS Randomized controlled trials （RCTs） comparing ICIs combined with neoadjuvant chemotherapy （experimental group） versus neoadjuvant chemotherapy alone （control group） were retrieved from PubMed， Cochrane Library， Embase， Web of Science， CNKI， Wanfang Data， and VIP databases， as well as relevant studies published at oncology academic conferences. The search period was from database inception to June 30， 2025. After literature screening， data extraction， and quality assessment， a meta-analysis was performed by using RevMan 5.4 software. RESULTS A total of 6 RCTs involving 3 786 patients were finally included. The meta-analysis results showed that the experimental group had superior event-free survival [HR＝0.73， 95%CI （0.62， 0.85）， P＜0.000 1]， overall survival [HR＝0.69， 95%CI （0.57， 0.84）， P＝0.000 3]， and pathological complete response （pCR） [OR＝1.57， 95%CI （1.37， 1.80）， P＜0.000 01] compared to the control group. The incidence of ≥grade 3 adverse event （AE）， severe AE （SAE）， and ≥ grade 3 immune-related adverse event （irAE） in the experimental group was significantly higher than that in the control group. There was no statistically significant difference between the two groups in the incidence of any AE or any irAE （P＞0.05）. Subgroup analysis revealed that， regardless of programmed cell death ligand 1 expression status （negative or positive），the pCR in the experimental group was significantly higher than that in the control group （P＜0.05）. Additionally， the pCR of the patients with positive lymph nodes in the experimental group was significantly higher to that in the ontrol group （P＜0.05）. There was no statistically significant difference in pCR between the two groups with negative lymph nodes （P＝0.09）. CONCLUSIONS ICIs combined with neoadjuvant chemotherapy can significantly improve event-free survival and overall survival in patients with TNBC， providing patients with long-term survival benefits. However， the risk of ≥ grade 3 AE， SAE and ≥ grade 3 irAE has increased.

Objective: To analyze the distribution characteristics of school bullying related contents on the Douyin platform, and to provide a scientific basis for the prevention and intervention of school bullying in the online environment. Methods: Web crawler technology was employed to collect data related to school bullying from Douyin in May 2025, using 21 keywords including "school violence" and "child being beaten". A dataset comprising video titles, publisher types, and interaction metrics was constructed. After manual screening and classification, the content themes, engagement characteristics, and sentiment tendencies of titles were analyzed. Results: A total of 2 388 valid videos released between January 2019 and May 2025 were included. Physical bullying (767 cases, 32.12%) and verbal bullying (534 cases, 22.36%) were the most common types. Content themes differed significantly across account types ( χ 2=782.85, P <0.01). Official media accounts predominantly focused on case reports ( AR = 14.52 ) and legal updates ( AR =5.49), and social media influencer accounts preferred scenario reenactments ( AR =4.07) and film clips ( AR =3.83), while ordinary users focused on coping strategies ( AR =8.76). Account types had a stronger effect on engagement metrics than content themes (all P <0.01). Sentiment analysis of titles revealed that official media accounts tended toward negative sentiment ( AR = 6.41), social media influencer accounts toward neutral sentiment ( AR =2.47), and ordinary users toward positive sentiment ( AR =4.44). Keyword analysis showed high frequency terms related to responsible parties such as "children" "parents", and "classmates" , while demand oriented words like "how" were prominent. Conclusions School bullying related contents on Douyin demonstrate significant dissemination stratification by account type, and the dissemination effect is significantly influenced by the type of content publisher. There is a clear public demand for practical guidance on bullying prevention and intervention strategies.

Objective : To explore the role and mechanism of plasmalemma vesicle-associated protein(PLVAP) in the progression of hepatocellular carcinoma(HCC). Methods : Bioinformatic analysis, quantitative real-time PCR, Western blot and immunohistochemistry were used to analyze the expression level of PLVAP in HCC and paracancerous tissues, and its correlation with clinicopathological characteristics. Stable HCC cell lines with knockdown and overexpression of PLVAP were constructed, then cell proliferation, migration and invasion of HCC cells were examined by CCK-8, foci formation assays, wound-healing assays and Transwell assays. Western blot was used to detect the protein levels of phosphatidylinositol 3-kinase PI3K, phosphorylated phosphatidylinositol 3-kinase p-PI3K, protein kinase B AKT and phosphorylated protein kinase B p-AKT in the PI3K/AKT pathway after PLVAP knockdown and overexpression. Cell proliferation, migration and invasion were also examined in PLVAP-overexpressed cells after treatment of LY294002, an inhibitor of the PI3K/AKT pathway. Results : The expression of PLVAP was significantly higher in HCC tissues than that in adjacent non-tumor tissues(P<0.05), and was positive correlated with tumor stage, T stage, M stage, and microvascular invasion(P<0.05). Knockdown of PLVAP significantly reduced the proliferation, migration and invasion of HCC cells(P<0.001), while overexpression of PLVAP significantly increased the proliferation, migration and invasion of HCC cells(P<0.01). Western blot analysis revealed that knockdown of PLVAP decreased the protein expression levels of p-PI3K and p-AKT, overexpression of PLVAP increased the protein expression levels of p-PI3K and p-AKT, whereas the PI3K/AKT inhibitor LY294002 eliminated the effects of PLVAP on cell proliferation, migration and invasion(P<0.01). Conclusion PLVAP is highly expressed in HCC and may promote HCC progression by activating the PI3K/AKT signaling pathway.

Objective To compare functional differences of CD8+T cells in lung tissues between young and aged C57BL/6J mice during the contraction phase and memory immune response phase after infection with influenza A(H1N1)virus.Methods Lung tissues from young(3-month-old)and aged(24-month-old)C57BL/6J female mice without influenza virus infection were collected to prepare single-cell suspensions,which were stimulated with phorbol 12-myristate 13-acetate(PMA)/ionomycin or cluster of differentiation(CD)3/CD28 antibodies(T-cell antigen receptor/co-stimulatory signals)respectively(non-specific antigens stimulation).Flow cytometry intracellular cytokine staining(ICS)was performed on lung CD8+T cells to detect their secretion capacity of tumor necrosis factor-α(TNF-α)and interferon-γ(IFN-γ).Young and aged C57BL/6J mice were infected intranasally with 490 PFU PR8 influenza virus,and reinfected with homologous influenza virus 28 days later.Lung tissues were isolated on day 28(the contraction phase)and day 32(the memory immune response phase)after primary infection.Influenza virus-specific MHC-Ⅰ tetramer staining was used to detect the proportion of virus-specific CD8+T cells in lung tissue CD8+T cells,and ICS was used to analyze TNF-α,IFN-γ,and granzyme B expression in CD8+CD44high T cell subset.Results After non-specific antigen stimulation,TNF-α and IFN-γ secretion capacity in lung tissue CD8+T cells of aged group mice was significantly higher than that of young group(P＜0.05).After virus-specific antigen stimulation,there were no statistically significant differences in the proportion of virus-specific CD8+T cells and the expression levels of TNF-α,IFN-γ,and granzyme B between the two groups of mice during the contraction phase(P＞0.05),while during the memory immune response phase,the proportion of virus-specific CD8+T cells and the expression levels of TNF-α,IFN-γ,and granzyme B in the aged group mice were significantly lower than those in the young group(P＜0.05).Conclusion CD8+T cells in aged mice maintain normal immune-related factor expression function under non-specific antigen stimulation,but show impaired immune-related factor expression function during antigen-specific memory immune response phase,suggesting that aging leads to defects in the formation or maintenance of CD8+T cell immune memory.

Schizophrenia is a prevalent mental-behavioral disorder characterized by perceptual disturbances,affective dysregulation,and behavioral abnormalities.In traditional Chinese medicine,it is classified under"manic depressive psychosis"according to its symptomatology.The concepts of"spirit,soul,and inferior spirit"originate from Lingshu·Benshen.Drawing on the concept of"spirit governs the soul and inferior spirit"from Lei Jing,this study explored schizophrenia pathogenesis and treatment from the perspective of the three-level regulation of spirit,soul,and inferior spirit.The core pathogenesis involves failure of spirit to govern as the root cause,disruption of soul homing as the pathodynamic process,and the loss of inferior spirit's somatic functional expression as the manifestation.The pathological locations are the heart,liver,and lungs.Therapeutic strategies are developed according to the pathological transmission pattern"spirit derangement,soul floating,inferior spirit dissipation,"forming a treatment system that emphasizes"calming the heart and tranquillization,restoring its control to solidify the root;suppressing the liver soul and regulating the central mechanism to pacify excess to stop mania;purifying the lungs and calming the inferior spirit to restore its clarity and regulate sensory perception and restore cognition."The treatment emphasizes the synergistic use of"calming the spirit,stabilizing the soul,and soothing the inferior spirit,"and combines acupuncture and repetitive transcranial magnetic stimulation and other treatments to treat both the manifestation and root cause of schizophrenia.Exploring the syndrome differentiation and treatment of schizophrenia from the perspective of spirit,soul,and inferior spirit,aiming to provide a theoretical basis for the treatment of schizophrenia with traditional Chinese medicine.

Probiotics are natural systems bridging synthetic biology, physical biotechnology, and immunology, initiating innate and adaptive anti-tumor immune activity. We previously constructed an all-in-one engineered food-grade probiotic Lactococcus lactis (FOLactis) which could boost the crosstalk among different immune cells such as dendritic cells (DCs), natural killer cells, and T cells. Herein, considering the limited clinical efficacy of naked personalized neoantigen peptide vaccines, we decorate FOLactis with tumor antigens by employing a Plug-and-Display system comprising membrane-inserted peptides. Intranodal injection of FOLactis coated with neoantigen peptides (Ag-FOLactis) induces robust DCs presentation and neoantigen-specific cellular immunity. Notably, Ag-FOLactis not only triggers a 45-fold rise in the quantity of locally reactive neoantigen-specific T cells but also induces epitope spreading in both subcutaneous and metastatic tumor-bearing models, leading to potent inhibition of tumor growth. These findings imply that Ag-FOLactis represents a powerful platform to rapidly and easily display antigens, facilitating the development of a bio-activated platform for personalized therapy.

Enzyme based immune balance is rather complicated subject that both biochemistry and immunology are involved in.It means that in human body,activity of enzymes and immune system network are interconnected and communicated together keeping a mobile balanced state.This state plays critically important role in maintaining normal physiological function of body.Once this balance is broken there must be something wrong with body.This article reviews functions of enzymes,regulation of immune sys-tem,as well as interaction between them.

Objective:To compare the safety, number of lymph nodes removed, rate of lymph node metastasis, and prognosis between proximal gastrectomy (PG) and total gastrectomy (TG) in patients with Siewert types II and III adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, clinical data of patients diagnosed with adenocarcinoma of the esophagogastric junction at Changzhi People's Hospital, affiliated with Changzhi Medical College, between December 2019 and November 2022, were collected. Patients who had received neoadjuvant therapy, had multiple malignant lesions in the stomach, had concomitant malignancies in other organs, had incomplete clinical data, or had been lost to follow-up were excluded. The study cohort comprised 308 patients, 99 in the PG group and 209 in the TG group. To reduce confounding bias, propensity score matching was performed, matching patients for age, sex, body mass index, tumor diameter, and pathological stage in a 1:1 ratio, resulting in 73 patients in each group. The primary outcomes assessed were operative details, number of lymph nodes dissected, rate of lymph node metastasis, postoperative complications, duration of hospital stay, and follow-up and survival outcomes.Results:The PG group had a significantly shorter median operative time than did the TG group (250 vs. 280 minutes, Z = -4.970, P<0.001), with fewer cases of intraoperative blood loss >100 mL (30.1%[22/73] vs. 46.6%[34/73], χ2=4.171, P=0.041), and a smaller number of lymph nodes removed (median 33 vs. 46, Z =-4.774, P<0.001); all of these differences are statistically significant (all P<0.05). Differences between the two groups in postoperative hospital stay and postoperative complications were not statistically significant (both P>0.05). Furthermore, no statistically significant differences were found between the PG and TG groups in the number of lymph nodes dissected or the lymph node metastasis rates at stations No. 1, No. 2, No. 3, No. 4sa, No. 4sb, and No. 7 (all P> 0.05). Among the 209 patients in the TG group, analysis of risk factors for metastasis to distal perigastric lymph nodes (No.4d, No.5, and No.6) showed that patients with tumor diameters ≤4 cm and T1–T3 stage disease had significantly lower rates of metastasis to these lymph nodes than did patients with tumor diameters >4 cm and/or T4 stage disease (0/78 vs. 12/131 [9.2%]); these differences are statistically significant ( P=0.014). The median duration of follow-up for the entire cohort was 26 months. The 3-year overall survival rates for the PG and TG groups were 62.5% and 63.3%, respectively; this difference is not statistically significant (χ 2=0.330, P = 0.565). Multivariate analysis showed that older age ( P = 0.035) and advanced pathological stage ( P = 0.018) were significant independent risk factors that affected overall survival in patients with Siewert type II and III adenocarcinoma of the esophagogastric junction. Conclusions:PG is safe and feasible for patients with Siewert types II and III adenocarcinoma of the esophagogastric junction. The number of lymph nodes dissected and metastasis status were similar in the TG and PG groups.

Robotic surgery, as an increasingly widespread application in the treatment of gastric and colorectal cancer, still faces obvious discrepancies in recommendations, indications, and evidence strength across existing guidelines. This study systematically analyzed 31 relevant guidelines and consensus statements (retrieved from Chinese and English databases from January 2010 to May 2025) from two dimensions: feasibility (effectiveness, safety, etc.) and training quality control.The results showed that colorectal cancer guidelines had a higher proportion (4 guidelines) of "clear recommendations" for robotic surgery, while gastric cancer guidelines predominantly presented "conditional recommendations" or no recommendations. In the training and quality control dimension, although structured suggestions received positive recommendations, more than half were based on low or very low-quality evidence. Evidence mapping indicated insufficient matching between "case-specific recommendations" and evidence grades in the feasibility dimension, while training processes emphasized the importance of standardized systems and team collaboration.The study highlights the existing heterogeneity in evidence-based guidelines for robotic gastrointestinal surgery, with colorectal cancer demonstrating a more mature evidence base and gastric cancer showing notable evidence gaps. It is recommended that future guideline development should strengthen the consistency between recommendation grades and evidence levels, promote high-quality research in upper gastrointestinal surgery, and improve surgeon training and certification systems to facilitate standardized clinical translation of robotic gastrointestinal surgery.

Objective:To explore the correlation between skeletal muscle mass and strength with metabolic syndrome in children.Methods:This cross-sectional study was conducted involving 383 children aged 10 to 15 years who visited the Department of Child Health Care, Children′s Hospital of Nanjing Medical University from June 2021 to December 2022. Their height, weight, waist circumference, body composition, grip strength and blood pressure were measured. Relative skeletal muscle mass, muscle-to-fat ratio, and grip strength-to-body weight index were calculated. The levels of fasting blood glucose, lipids and insulin were tested. Homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. Children were divided into the metabolic syndrome group and the non-metabolic syndrome group. Independent t test or Mann-Whitney U test etc. was used to compare the difference between groups. Spearman correlation analysis and binary Logistic regression were used to investigate the correlation between skeletal muscle mass and strength and metabolic syndrome. The area under the curve (AUC) of receiver operating characteristic (ROC) curve was used to compare the accuracy of the index of skeletal muscle in predicting metabolic syndrome in children. Results:Among the 383 children, 282 (73.6%) were male, at the age of 11.4 (10.6, 12.5) years. There were 216 children (56.4%) diagnosed with obesity and 90 children (23.5%) diagnosed with metabolic syndrome. Relative skeletal muscle mass, muscle-to-fat ratio, and grip strength-to-body weight index of the metabolic syndrome group were all lower than those in the non-metabolic syndrome group (all P<0.001). After adjusting for sex and age, relative skeletal muscle mass, muscle-to-fat ratio, and grip strength-to-body weight index were all negatively correlated with body mass index ( r=-0.84, -0.38, -0.63), waist circumference ( r=-0.76, -0.36, -0.70), systolic blood pressure ( r=-0.42, -0.21, -0.38), diastolic blood pressure ( r=-0.33, -0.18, -0.24), triglycerides ( r=-0.29, -0.13, -0.23), fasting insulin ( r=-0.28, -0.20, -0.29), and HOMA-IR ( r=-0.26, -0.18, -0.26) (all P<0.05), and positively correlated with high-density lipoprotein cholesterol ( r=0.38, 0.13, 0.31, all P<0.01). After adjusting for sex and age, high relative skeletal muscle mass, high muscle-to-fat ratio, and high grip strength-to-body weight index all decreased the risks of metabolic syndrome ( OR=0.80, 0.55, 0.90), obesity ( OR=0.53, 0.64, 0.82), hypertension ( OR=0.86, 0.58, 0.92), low high-density lipoprotein cholesterol ( OR=0.83, 0.62, 0.92), hypertriglyceridemia ( OR=0.88, 0.78, 0.96). After adjusting for sex and age, high relative skeletal muscle mass and high grip strength-to-body weight index all decreased the risks of hyperglycemia ( OR=0.93 and 0.95, all P<0.05). ROC curve analysis showed that the relative skeletal muscle mass, muscle-to-fat ratio, and grip strength-to-body weight index all had good predictive accuracy of metabolic syndrome in children (AUC=0.79, 0.71, 0.76), with optimal cutoff values of 40%, 1.2, and 35%, respectively. Conclusions:High relative skeletal muscle mass, high muscle-to-fat ratio, and high grip strength-to-body weight index are all protective factors for metabolic syndrome in children. Regular measurement of skeletal muscle mass and grip strength can aid in the early identification and prevention of obesity and metabolic syndrome during childhood .