Cancer-associated fibroblasts (CAFs) are core regulators in the tumor microenvironment. Their high heterogeneity and plasticity remarkably influence the infiltration and function of CD8+ T cells, thereby determining the response to immunotherapy. However, the mechanisms by which CAFs impede CD8+ T cell infiltration exhibit substantial heterogeneity across different cancer types. This review proposes a dichotomous model of CAFs-mediated immune exclusion: Type Ⅰ active exclusion (exemplified by pancreatic ductal adenocarcinoma, where CAFs create physical and chemical barriers through excessive extracellular matrix deposition and secretion of TGF-β/CXCL12) and Type Ⅱ immune ignorance (exemplified by a subset of microsatellite-stable colorectal cancers, where loss of CAFs function results in insufficient chemokine production). Under this framework, we systematically review the specific regulatory mechanisms of CAFs subsets, specifically myofibroblastic CAFs and inflammatory CAFs, in pancreatic cancer, triple-negative breast cancer, non-small cell lung cancer, and colorectal cancer, highlighting their multidimensional roles in extracellular matrix remodeling, metabolic reprogramming, and construction of immunosuppressive networks. Furthermore, by integrating single-cell and spatial multi-omics perspectives, we propose immune phenotype-based CAFs-targeting strategies, namely, "barrier-breaking" strategies (TGF-β inhibition and FAP targeting) for Type Ⅰ tumors and "activating" strategies (reprogramming CAFs toward an immune-supportive phenotype) for Type Ⅱ tumors, and discuss their temporally sequenced combination with immune checkpoint inhibitors.

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Objective:To explore the application effect of nursing based on transtheoretical model in patients with oral surgery.Methods:A total of 120 patients with oral surgery who were admitted to Department of Stomatology of the First Affiliated Hospital of Xinxiang Medical University from October 2019 to January 2020 were selected as research objects by the convenient sampling method. According to random number table, they were divided into the control group and the observation group, with 60 cases in each group. Patients in the control group were given routine nursing while patients in the observation group were given transtheoretical model-based nursing at basis of the control group. The amount of dental plaque, comfort of oral cavity, score of psychological state and degree of oral cleanliness before and after nursing were compared between the two groups.Results:After intervention, the amount of dental plaque and the score of oral comfort in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . After intervention, SAS and SDS scores in the observation group were lower than those in the control group, and the differences were statistically significant ( P<0.05) . The degree of oral cleanliness of the observation group was better than that of the control group after intervention, and the difference was statistically significant ( P<0.05) . Conclusions:Nursing based on transtheoretical model can effectively reduce postoperative amount of oral plaque of patients with oral surgery, improve comfort of oral cavity and oral cleanliness and correct bad mood of patients, which is worthy of clinical application.