Immunomodulatory cancer therapy is witnessing the rise of viral immunotherapy. The oncolytic influenza A virus, although promising in preclinical investigations, remains to be implemented in clinical practice. Recent progress in genetic engineering, coupled with experiential insights, offers opportunities to enhance the therapeutic efficacy of the influenza A virus. This review explores the use of the influenza virus, its attenuated forms, and associated vaccines in cancer immunotherapy, highlighting their respective advantages and challenges. We further elucidate methods for engineering influenza viruses and innovative approaches to augment them with cytokines or immune checkpoint inhibitors, aiming to maximize their clinical impact. Our goal is to provide insights essential for refining influenza A virus-based viral tumor immunotherapies.
Humans ; Neoplasms/immunology* ; Immunotherapy/trends* ; Influenza A virus/immunology* ; Oncolytic Virotherapy/trends* ; Animals ; Cancer Vaccines/therapeutic use* ; Oncolytic Viruses ; Genetic Engineering ; Immune Checkpoint Inhibitors/therapeutic use*

Objective:To investigate the reliability and validity of different measurement methods under 30° arthroscopy for quantifying the proportion of glenoid bone defect in bony Bankart lesions of the shoulder joint and validate its preliminary application effect.Methods:Eight intact shoulder glenoid specimens were selected, with no existing defects or deformities, from donors of 4 females and 4 males, with their age at death of 43-67 years [(54.4±8.0)years]. Bone defects of 12.5% and 25% were created in the glenoid at 0° and 45° relative to the longitudinal axis, with two specimens per defect category. The defect proportion in each specimen was quantified using direct measurement and CT-based digital reconstruction and these values served as reference standards for subsequent statistical analysis. Using a combined approach of arthroscopic simulation equipment and cadaveric study, five investigators performed simulated examinations through the standard posterior portal (2 cm medial and 1.5 cm inferior to the posterolateral acromial corner) and the modified posteroinferior portal (2 cm medial and 3 cm inferior to the posterolateral acromial corner) separately. Under 30° arthroscopy, the glenoid bone loss percentage was measured using the bare spot method and secant chord method. The reliability was analyzed for these measurements. Furthermore, using direct physical measurements and CT-based three-dimensional reconstruction data from the same specimens as reference standards, the comprehensive validity of four measurement methods was evaluated (standard posterior portal-bare spot method, standard posterior portal-secant chord method, modified posteroinferior portal-bare spot method, and modified posteroinferior portal-secant chord method). The independent validity of each method was assessed according to bone defect morphology classification to determine differences in measurement accuracy across defect types. In an arthroscopic procedure for a patient with Bigliani type IIIB bony Bankart lesion, the standard posterior portal-secant chord method was applied to quantify the proportion of glenoid bone defects.Results:The mean reference values from direct measurement and CT measurement of glenoid bone defect proportion in eight bony Bankart lesion specimens were 12.71%/12.37%, 13.17%/13.10%, 25.71%/24.9%, 26.6%/26.95%, 13.41%/13.10%, 12.90%/12.59%, 26.42%/25.94%, and 26.73%/27.06%, respectively. Measurements obtained by the five investigators showed intraclass correlation coefficients (ICCs) all greater than 0.90, indicating excellent interobserver agreement. In the validity analysis, the standard posterior portal-secant chord method demonstrated the highest overall validity. Using direct measurement and CT-based measurement as reference standards, the overall validity was (0.90±0.38)% and (1.07±0.53)% for the standard posterior portal-bare spot method, (1.33±0.40)% and (1.51±0.54)% for the modified posteroinferior portal-bare spot method, and (0.53±0.17)% and (0.70±0.38)% ( P<0.05) for the modified posteroinferior portal-secant chord method. In contrast, the standard posterior portal-secant chord method showed an overall validity of (0.10±0.10)% and (0.28±0.39)% ( P>0.05). In subsequent independent validity analyses, the standard posterior portal-secant chord method also demonstrated superior validity across all bone defect subtypes over the other three methods. In a patient with a Bigliani type IIIB bony Bankart lesion, we used the standard posterior portal-secant chord method to quantify the glenoid bone loss in 2 minutes, revealing a defect proportion of 26.6%. An arthroscopic autologous iliac bone graft procedure with single-tunnel elastic fixation guided by this measurement achieved favorable outcomes, with stable reduction, secure internal fixation and favorable recovery of shoulder function at 2 months postoperatively. Conclusion:For various types of bony Bankart lesions, the 30° arthroscopic standard posterior portal-secant chord method provides the most accurate quantification of glenoid bone loss and its preliminary clinical application yields satisfactory results.

Objective To evaluate the safety and efficacy of enteroscopy in the treatment of rare small intestinal diseases,including Peutz-Jeghers syndrome(PJS),blue rubber bleb nevus syndrome(BRBNS),and cryptogenic multifocal ulcerative stenosing enteritis(CMUSE),thereby providing a reference for clinical diagnosis and treatment.Methods Patients with rare small intestinal diseases diagnosed and treated in the De-partment of Gastroenterology,Shanghai Changhai Hospital,from January 2020 to December 2024 were included.Detailed records of patients' general information,clinical manifestations,auxiliary examinations,and endoscopic treatment data were collected and systematically analyzed.Results A total of 30 PJS patients un-derwent 88 small intestinalpolypectomies under enteroscopy,including 62 procedures via the oral approach(mean operative time:92.8±30.1 min;largest polyp diameter:2.9±1.2 cm)and 26 via the anal approach(95.0±29.4 min;1.9±1.3 cm).Six adverse events occurred in the oral approach group.Ten BRBNS patients received 26 endoscopic treatments(25 sclerosing agent injection under enteroscopy and 1 sclerosing agent injec-tion combined with ligation session),with a mean operative time of 68.1±17.4 min.Eleven intestinal venous aneurysms were ligated,and 4 adverse events were reported.Five CMUSE patients underwent 6 endoscopic treatments(5 samll intestinal stenosis balloon dilations and 1 samll intestinal stenosis incision),with no ad-verse events observed.Conclusions Small intestinal endoscopy is feasible,safe,and effective for treating rare small intestinal diseases such as PJS,BRBNS,and CMUSE.For PJS patients,the oral approach should be pri-oritized.Sclerosing agent injection under enteroscopy for intestinal venous aneurysms in BRBNS via small bowel endoscopy is safe and effective,though the safety of ligation of venous aneurysms under enteroscopy requires further investigation.Stenosis balloon dilation and incision under enteroscopy are both feasible options for CMUSE,and these two approaches can complement each other.

Helicobacter pylori(H.pylori)infection is the most significant controllable risk factor for gastric cancer,and its eradication is a critical component of gastric cancer prevention in China.A family-based screening and treatment strategy for H.pylori aligns well with China's public health needs.It demonstrates higher eradication success rate,lower recurrence rate,and superior cost-effectiveness,making it suitable for both high-and low-prevalence regions.Implementation of this family-based strategy can lead to greater precision,higher efficiency,and overall coverage in gastric cancer prevention in China,offering a scalable"China model"for global gastric cancer control.

As China is a country with high incidence of gastric cancer,it is of great significance to actively carry out mass screening at the population level for early diagnosis and treatment of gastric cancer.Current practical experience shows that the selection of screening methods and patterns is closely related to the compliance of the target population,screening coverage and lesion detection rate.Currently,mature gastric cancer screening methods include serologic examination,gastroscopy,liquid biopsy,etc.,while screening patterns include"one-step strategy"based on gastroscopy and"sequential strategy"combining serologic examination and gastroscopy.The purpose of this paper is to review the current mainstream status of gastric cancer screening methods and patterns,and to draw on the potential advantages of other cancer screening methods,with a view to providing reference for the exploration of feasible pathways for gastric cancer screening,and further contributing to the standardization of gastric cancer screening in China.

Background::An evidence gap still exists regarding the efficacy and safety of tegoprazan in patients with erosive esophagitis (EE) in China. This study aimed to verify the efficacy and safety of tegoprazan vs. esomeprazole in patients with EE in China. Methods::This study was a multicenter, randomized, double-blind, parallel, active-controlled, non-inferiority phase III trial of patients with EE randomized 1:1 to tegoprazan 50 mg/day vs. esomeprazole 40 mg/day. This study was conducted in 32 sites between October 24, 2018 and October 18, 2019. The primary endpoint was the cumulative endoscopic healing rate at week 8. The secondary endpoint included endoscopic healing rate at week 4, changes in the reflux disease questionnaire (RDQ) and gastroesophageal reflux disease health-related quality of life (GERD-HRQL) scores, and symptom improvement. Results::A total of 261 patients were randomized: 132 to the tegoprazan group and 129 to the esomeprazole group. The cumulative endoscopic healing rate at 8 weeks in the tegoprazan group was non-inferior to that of the esomeprazole group (91.1% vs. 92.8%, difference: -1.7%, 95% confidence interval [CI]: -8.5%, 5.0%, P = 0.008). There were no statistically significant differences in the changes in RDQ (total, severity, and frequency) and GERD-HRQL scores between the two groups (all P >0.05). The percentages of days without symptoms, including daytime and nighttime symptoms based on patients' diaries, were similar between the two groups (all P >0.05). In the tegoprazan and esomeprazole groups, 71.5% (93/130) and 61.7% (79/128) of the participants reported adverse events (AEs), 2.3% and 0 experienced serious AEs, while 70.0% and 60.2% had treatment-emergent AEs, respectively. Conclusion::Tegoprazan 50 mg/day demonstrated non-inferior efficacy in healing EE, symptom improvement, and quality of life, and it has similar tolerability compared with esomeprazole 40 mg/day.

Small bowel Crohn's disease(CD)is a multi-ulcerative lesion that tends to occur in the small intestine,which leads to intestinal obstruction,stricture,and bleeding easily.With the clinical application of capsule endoscopy and balloon-assisted enteroscopy,the detection rate of small bowel CD has increased significantly.However,the treatment of small bowel CD is still a difficult issue which troubles clinical practice.It is of great significance to standardize the diagnosis and treatment process,optimize the diagnosis and treatment strategy,and further improve the diagnosis and treatment efficiency.Therefore,it is necessary to formulate an expert consensus on the endoscopic diagnosis and treatment of small bowel CD.Based on the evidence-based medicine and expert experience,the consensus focus on the clinical issues including the epidemiology,endoscopic and imaging diagnosis,enteroscopy treatment,drug treatment and follow-up of small bowel CD,and formulated relevant recommendations,so as to standardize the diagnosis and treatment process of small bowel CD and improve the prognosis of patients.

Objective To evaluate the safety and efficacy of enteroscopy in the treatment of rare small intestinal diseases,including Peutz-Jeghers syndrome(PJS),blue rubber bleb nevus syndrome(BRBNS),and cryptogenic multifocal ulcerative stenosing enteritis(CMUSE),thereby providing a reference for clinical diagnosis and treatment.Methods Patients with rare small intestinal diseases diagnosed and treated in the De-partment of Gastroenterology,Shanghai Changhai Hospital,from January 2020 to December 2024 were included.Detailed records of patients' general information,clinical manifestations,auxiliary examinations,and endoscopic treatment data were collected and systematically analyzed.Results A total of 30 PJS patients un-derwent 88 small intestinalpolypectomies under enteroscopy,including 62 procedures via the oral approach(mean operative time:92.8±30.1 min;largest polyp diameter:2.9±1.2 cm)and 26 via the anal approach(95.0±29.4 min;1.9±1.3 cm).Six adverse events occurred in the oral approach group.Ten BRBNS patients received 26 endoscopic treatments(25 sclerosing agent injection under enteroscopy and 1 sclerosing agent injec-tion combined with ligation session),with a mean operative time of 68.1±17.4 min.Eleven intestinal venous aneurysms were ligated,and 4 adverse events were reported.Five CMUSE patients underwent 6 endoscopic treatments(5 samll intestinal stenosis balloon dilations and 1 samll intestinal stenosis incision),with no ad-verse events observed.Conclusions Small intestinal endoscopy is feasible,safe,and effective for treating rare small intestinal diseases such as PJS,BRBNS,and CMUSE.For PJS patients,the oral approach should be pri-oritized.Sclerosing agent injection under enteroscopy for intestinal venous aneurysms in BRBNS via small bowel endoscopy is safe and effective,though the safety of ligation of venous aneurysms under enteroscopy requires further investigation.Stenosis balloon dilation and incision under enteroscopy are both feasible options for CMUSE,and these two approaches can complement each other.

Small bowel Crohn's disease(CD)is a multi-ulcerative lesion that tends to occur in the small intestine,which leads to intestinal obstruction,stricture,and bleeding easily.With the clinical application of capsule endoscopy and balloon-assisted enteroscopy,the detection rate of small bowel CD has increased significantly.However,the treatment of small bowel CD is still a difficult issue which troubles clinical practice.It is of great significance to standardize the diagnosis and treatment process,optimize the diagnosis and treatment strategy,and further improve the diagnosis and treatment efficiency.Therefore,it is necessary to formulate an expert consensus on the endoscopic diagnosis and treatment of small bowel CD.Based on the evidence-based medicine and expert experience,the consensus focus on the clinical issues including the epidemiology,endoscopic and imaging diagnosis,enteroscopy treatment,drug treatment and follow-up of small bowel CD,and formulated relevant recommendations,so as to standardize the diagnosis and treatment process of small bowel CD and improve the prognosis of patients.

Objective:To investigate the reliability and validity of different measurement methods under 30° arthroscopy for quantifying the proportion of glenoid bone defect in bony Bankart lesions of the shoulder joint and validate its preliminary application effect.Methods:Eight intact shoulder glenoid specimens were selected, with no existing defects or deformities, from donors of 4 females and 4 males, with their age at death of 43-67 years [(54.4±8.0)years]. Bone defects of 12.5% and 25% were created in the glenoid at 0° and 45° relative to the longitudinal axis, with two specimens per defect category. The defect proportion in each specimen was quantified using direct measurement and CT-based digital reconstruction and these values served as reference standards for subsequent statistical analysis. Using a combined approach of arthroscopic simulation equipment and cadaveric study, five investigators performed simulated examinations through the standard posterior portal (2 cm medial and 1.5 cm inferior to the posterolateral acromial corner) and the modified posteroinferior portal (2 cm medial and 3 cm inferior to the posterolateral acromial corner) separately. Under 30° arthroscopy, the glenoid bone loss percentage was measured using the bare spot method and secant chord method. The reliability was analyzed for these measurements. Furthermore, using direct physical measurements and CT-based three-dimensional reconstruction data from the same specimens as reference standards, the comprehensive validity of four measurement methods was evaluated (standard posterior portal-bare spot method, standard posterior portal-secant chord method, modified posteroinferior portal-bare spot method, and modified posteroinferior portal-secant chord method). The independent validity of each method was assessed according to bone defect morphology classification to determine differences in measurement accuracy across defect types. In an arthroscopic procedure for a patient with Bigliani type IIIB bony Bankart lesion, the standard posterior portal-secant chord method was applied to quantify the proportion of glenoid bone defects.Results:The mean reference values from direct measurement and CT measurement of glenoid bone defect proportion in eight bony Bankart lesion specimens were 12.71%/12.37%, 13.17%/13.10%, 25.71%/24.9%, 26.6%/26.95%, 13.41%/13.10%, 12.90%/12.59%, 26.42%/25.94%, and 26.73%/27.06%, respectively. Measurements obtained by the five investigators showed intraclass correlation coefficients (ICCs) all greater than 0.90, indicating excellent interobserver agreement. In the validity analysis, the standard posterior portal-secant chord method demonstrated the highest overall validity. Using direct measurement and CT-based measurement as reference standards, the overall validity was (0.90±0.38)% and (1.07±0.53)% for the standard posterior portal-bare spot method, (1.33±0.40)% and (1.51±0.54)% for the modified posteroinferior portal-bare spot method, and (0.53±0.17)% and (0.70±0.38)% ( P<0.05) for the modified posteroinferior portal-secant chord method. In contrast, the standard posterior portal-secant chord method showed an overall validity of (0.10±0.10)% and (0.28±0.39)% ( P>0.05). In subsequent independent validity analyses, the standard posterior portal-secant chord method also demonstrated superior validity across all bone defect subtypes over the other three methods. In a patient with a Bigliani type IIIB bony Bankart lesion, we used the standard posterior portal-secant chord method to quantify the glenoid bone loss in 2 minutes, revealing a defect proportion of 26.6%. An arthroscopic autologous iliac bone graft procedure with single-tunnel elastic fixation guided by this measurement achieved favorable outcomes, with stable reduction, secure internal fixation and favorable recovery of shoulder function at 2 months postoperatively. Conclusion:For various types of bony Bankart lesions, the 30° arthroscopic standard posterior portal-secant chord method provides the most accurate quantification of glenoid bone loss and its preliminary clinical application yields satisfactory results.