Respiratory tract infections are common types of infectious diseases in children，involving a variety of immune responses. Understanding the immune mechanisms between viruses and hosts during respiratory infections helps to improve the prevention and treatment of viral infections. The mucosal immune system，as the first line of defense for the body，protects the respiratory tract from pathogen invasion through physical barriers，chemical barriers，microbial barriers，immune cells，and lymphatic tissue. In addition，mucosal immunity also contributes to tissue repair after infection. This article briefly reviews the composition of mucosal immunity and its immune mechanisms in respiratory viral infections，providing a reference for the research of anti-respiratory viral infections and mucosal vaccines.

Objective:To evaluate the efficacy and feasibility of a domestically developed robotic surgical system based on fiber-optic dedicated line communication in cross-regional urological telesurgery.Methods:This was multicenter，single-arm，retrospective case series study. The data of patients who underwent urological telesurgeries using the telesurgical system between January 2023 and December 2024 were analyzed. The cohort included 59 patients from seven hospitals across China. Among the patients，47 were male（79.7%）and 12 were female（20.3%），with a median age of 63.0（56.0，68.0）years and a body mass index of（24.7 ± 3.0）kg/m 2. Surgical procedures included 32 radical prostatectomies，24 partial nephrectomies，one radical nephrectomy，one adrenalectomy，and one ureteral reconstruction. The perioperative indicators，pathological results and postoperative complications were analyzed. The network monitoring data were collected，and the perioperative data of patients，remote system monitoring data and costs were compared between the two communication modes of optical transport network（OTN）and cloud-connect network（CCN）. Results:All 59 remote surgeries were successfully completed，with a mean operative time of（138.0 ± 54.0）minutes，median intraoperative blood loss of 50.0（30.0，100.0）ml and a postoperative hospital stay of 5.0（4.0，6.0）days. No cases required reoperation，Clavien-Dindo grade ≥3 complications，or readmission. The geographical distance between the primary and remote surgical sites ranged from 450 to 2 800 km. Network monitoring revealed increased bidirectional latency with distance increasing：the shortest latency time（Hefei-Hangzhou，450 km）was（16.59 ± 0.80）ms，while the longest（Harbin-Hangzhou，2 200 km）latency time was（53.31 ± 0.31）ms. Average frame loss per procedure was 0?1.27 frames. The results of subgroup analysis comparing OTN and CCN communication modes showed no significant differences in operative time［（130.7 ± 70.5）minutes vs.（142.1 ± 42.9）minutes， P = 0.442］，postoperative hospitalization［6.0（4.0，8.0）d vs. 5.0（4.0，6.0）d， P = 0.581］，or readmission rates（0 vs. 0）. However，CCN demonstrated significant cost advantages with 500 RMB per operation vs. 3 000 RMB per operation for OTN. Conclusions:Urological telesurgery using fiber-optic communication is feasible. The CCN mode，with its cost-effectiveness，excellent usability，and multi-point interconnection flexibility，is currently the preferred communication model for telesurgical applications.

Objective:To identify risk factors influencing clinical efficacy of endoscopic resection of small rectal neuroendocrine tumor (NETs).Methods:A retrospective analysis was conducted on patients with rectal NETs ≤10 mm who underwent endoscopic resection from 2013 to 2022. Patients were divided into the endoscopic submucosal dissection (ESD) group and the endoscopic mucosal resection with ligation (EMRL) group according to the treatment methods. After comparing the baseline data, propensity score matching was performed to compare the rates of R1 resection and adequacy of vertical margin distance.Results:A total of 186 patients were included in this study, with 139 receiving ESD and 47 receiving EMRL. The R1 resection rates were 12.2% (17/139) and 2.1% (1/47) in the ESD and EMRL group, respectively ( χ2=3.027, P=0.082). A significant difference in vertical margin adequacy was observed between the two groups [69.1% (96/139) VS 85.1% (40/47), χ2=4.598, P=0.032]. After propensity score matching, 46 pairs of cases were included, and there were no significant differences in the R1 resection rate [6.5% (3/46) VS 2.2% (1/46), χ2=0.261, P=0.609] and vertical margin adequacy [78.3% (36/46) VS 84.8% (39/46), χ2=0.649, P=0.420] between the two groups. Univariate and multivariate Logistic regression analyses revealed that operator experience and preoperative biopsy were independent risk factors for inadequate margin. Conclusion:Treatment method may not be the key factor affecting the distance of the vertical margin after endoscopic resection, but preoperative biopsy and operator experience have a significant impact on margins. Biopsy before endoscopic resection should be avoided, and less experienced doctors are recommended to use EMRL method for small NETs due to its ease of execution.

Objective To systematically construct patient-derived tumor organoid(PDO)and patient-derived xenograft(PDX)models of prostate cancer(PCa),and to explore the inhibitory effect and mechanism of gambogic acid(GA)on PCa.Methods The PubChem,SwissTargetPrediction,SuperPred,SEA,GeneCards,OMIM,and STRING databases,and the Venny 2.1.0 online website,Cytoscape 3.8.2,and DAVID software were used to construct a protein-protein interaction network.Gene ontology(GO)and kyoto encyclopedia of genes and genomes(KEGG)enrichment analyses were carried out,and visualization processing was performed to identify the targets and pathways of GA acting on PCa.GA was applied to PDOs and PCa cells(22Rv1,PC3,and DU145)for 48 hours and its effects on cell viability were assessed by CellTiter-Glo and CCK-8 assays.Changes in gene and protein levels of the targets were analyzed by quantitative real-time polymerase chain reaction and Western Blot,respectively.The PDX model was treated with GA and the tumor volume and weight were measured.Changes in expression levels of the targets in tumor tissues were detected by immunohistochemistry.Results Network pharmacology identified signal transducer and activator of transcription 3(STAT3)as the core target of GA inhibiting PCa,related to the hypoxia-inducible factor(HIF)-1α signaling pathway.GA reduced the viability of cells and PDOs and significantly down-regulated HIF-1α,STAT3,and P-STAT3 protein levels.In vivo experiments,tumor volume and weight were significantly reduced in the GA group,and immunohistochemistry showed that STAT3 and HIF-1α expression levels were decreased.Conclusions The clinically representative PDO and PDX models,combined with cell lines,verified the prediction result of network pharmacology,confirming a significant killing effect of GA on PCa,possibly via a mechanism related to the STAT3/HIF-1α signaling pathway.

Objective To systematically construct patient-derived tumor organoid(PDO)and patient-derived xenograft(PDX)models of prostate cancer(PCa),and to explore the inhibitory effect and mechanism of gambogic acid(GA)on PCa.Methods The PubChem,SwissTargetPrediction,SuperPred,SEA,GeneCards,OMIM,and STRING databases,and the Venny 2.1.0 online website,Cytoscape 3.8.2,and DAVID software were used to construct a protein-protein interaction network.Gene ontology(GO)and kyoto encyclopedia of genes and genomes(KEGG)enrichment analyses were carried out,and visualization processing was performed to identify the targets and pathways of GA acting on PCa.GA was applied to PDOs and PCa cells(22Rv1,PC3,and DU145)for 48 hours and its effects on cell viability were assessed by CellTiter-Glo and CCK-8 assays.Changes in gene and protein levels of the targets were analyzed by quantitative real-time polymerase chain reaction and Western Blot,respectively.The PDX model was treated with GA and the tumor volume and weight were measured.Changes in expression levels of the targets in tumor tissues were detected by immunohistochemistry.Results Network pharmacology identified signal transducer and activator of transcription 3(STAT3)as the core target of GA inhibiting PCa,related to the hypoxia-inducible factor(HIF)-1α signaling pathway.GA reduced the viability of cells and PDOs and significantly down-regulated HIF-1α,STAT3,and P-STAT3 protein levels.In vivo experiments,tumor volume and weight were significantly reduced in the GA group,and immunohistochemistry showed that STAT3 and HIF-1α expression levels were decreased.Conclusions The clinically representative PDO and PDX models,combined with cell lines,verified the prediction result of network pharmacology,confirming a significant killing effect of GA on PCa,possibly via a mechanism related to the STAT3/HIF-1α signaling pathway.

Objective:To evaluate the efficacy and feasibility of a domestically developed robotic surgical system based on fiber-optic dedicated line communication in cross-regional urological telesurgery.Methods:This was multicenter，single-arm，retrospective case series study. The data of patients who underwent urological telesurgeries using the telesurgical system between January 2023 and December 2024 were analyzed. The cohort included 59 patients from seven hospitals across China. Among the patients，47 were male（79.7%）and 12 were female（20.3%），with a median age of 63.0（56.0，68.0）years and a body mass index of（24.7 ± 3.0）kg/m 2. Surgical procedures included 32 radical prostatectomies，24 partial nephrectomies，one radical nephrectomy，one adrenalectomy，and one ureteral reconstruction. The perioperative indicators，pathological results and postoperative complications were analyzed. The network monitoring data were collected，and the perioperative data of patients，remote system monitoring data and costs were compared between the two communication modes of optical transport network（OTN）and cloud-connect network（CCN）. Results:All 59 remote surgeries were successfully completed，with a mean operative time of（138.0 ± 54.0）minutes，median intraoperative blood loss of 50.0（30.0，100.0）ml and a postoperative hospital stay of 5.0（4.0，6.0）days. No cases required reoperation，Clavien-Dindo grade ≥3 complications，or readmission. The geographical distance between the primary and remote surgical sites ranged from 450 to 2 800 km. Network monitoring revealed increased bidirectional latency with distance increasing：the shortest latency time（Hefei-Hangzhou，450 km）was（16.59 ± 0.80）ms，while the longest（Harbin-Hangzhou，2 200 km）latency time was（53.31 ± 0.31）ms. Average frame loss per procedure was 0?1.27 frames. The results of subgroup analysis comparing OTN and CCN communication modes showed no significant differences in operative time［（130.7 ± 70.5）minutes vs.（142.1 ± 42.9）minutes， P = 0.442］，postoperative hospitalization［6.0（4.0，8.0）d vs. 5.0（4.0，6.0）d， P = 0.581］，or readmission rates（0 vs. 0）. However，CCN demonstrated significant cost advantages with 500 RMB per operation vs. 3 000 RMB per operation for OTN. Conclusions:Urological telesurgery using fiber-optic communication is feasible. The CCN mode，with its cost-effectiveness，excellent usability，and multi-point interconnection flexibility，is currently the preferred communication model for telesurgical applications.

Objective:To identify risk factors influencing clinical efficacy of endoscopic resection of small rectal neuroendocrine tumor (NETs).Methods:A retrospective analysis was conducted on patients with rectal NETs ≤10 mm who underwent endoscopic resection from 2013 to 2022. Patients were divided into the endoscopic submucosal dissection (ESD) group and the endoscopic mucosal resection with ligation (EMRL) group according to the treatment methods. After comparing the baseline data, propensity score matching was performed to compare the rates of R1 resection and adequacy of vertical margin distance.Results:A total of 186 patients were included in this study, with 139 receiving ESD and 47 receiving EMRL. The R1 resection rates were 12.2% (17/139) and 2.1% (1/47) in the ESD and EMRL group, respectively ( χ2=3.027, P=0.082). A significant difference in vertical margin adequacy was observed between the two groups [69.1% (96/139) VS 85.1% (40/47), χ2=4.598, P=0.032]. After propensity score matching, 46 pairs of cases were included, and there were no significant differences in the R1 resection rate [6.5% (3/46) VS 2.2% (1/46), χ2=0.261, P=0.609] and vertical margin adequacy [78.3% (36/46) VS 84.8% (39/46), χ2=0.649, P=0.420] between the two groups. Univariate and multivariate Logistic regression analyses revealed that operator experience and preoperative biopsy were independent risk factors for inadequate margin. Conclusion:Treatment method may not be the key factor affecting the distance of the vertical margin after endoscopic resection, but preoperative biopsy and operator experience have a significant impact on margins. Biopsy before endoscopic resection should be avoided, and less experienced doctors are recommended to use EMRL method for small NETs due to its ease of execution.

Objective:To analyze the significance of total vitamin D(tVD),total procollagen type Ⅰ amino-terminal propeptide(tPINP)and β-CrossLaps(β-CTx)in the staging and prognosis of patients with multiple myeloma(MM).Methods:A total of 54 patients with newly diagnosed MM admitted to the Second Affiliated Hospital of Fujian Medical University from 2020 to 2022 were selected as the observation group(MM group),and 50 healthy persons who underwent physical examinations in our hospital were selected as the control group.The expression levels of tVD,tPINP and β-CTx in the two groups were detected by chemiluminescence method.The differences in the expression levels of tVD,tPINP and β-CTx among MM patients at different ISS stages were analyzed.The expression levels of tVD,tPINP and β-CTx in MM patients with different levels of hemoglobin(Hb),serum calcium(Ca),creatinine(Crea),albumin(ALB),β2-microglobulin(β2-MG)and lactate dehydrogenase(LDH)were compared.The correlations between the expression levels of tVD,tPINP,β-CTx and the aforementioned clinical parameters were analyzed,respectively.The relationship between the expression levels of tVD,tPINP,β-CTx and the progression-free survival(PFS)of MM patients was analyzed.Results:The expression level of tVD in the MM group was significantly lower than that in the control group(21.73±14.45 ng/ml vs 30.78±9.94 ng/ml,P=0.022).The expression level of β-CTx in the MM group was significantly higher than that in the control group(1.43±0.99 ng/ml vs 0.53±0.29 ng/ml,P=0.013).The tVD level in MM patients with ISS stage Ⅰ-Ⅱ was significantly higher than that of MM patients with ISS stage Ⅲ(29.50±14.59 ng/ml vs 12.62±7.73 ng/ml,P=0.028),indicating that the higher the ISS stage,the lower the tVD level.The tPINP andβ-CTx levels in MM patients with high Ca levels(＞2.65 mmol/L)were significantly higher than those in patients with low Ca levels(≤ 2.65 mmol/L)(P=0.016,P=0.021).The tVD level of MM patients was positively correlated with the ALB level(r=0.570),tPINP was positively correlated with Ca and β2-MG levels(r=0.791,r=0.673),and β-CTx was positively correlated with tPINP level(r=0.616).The PFS of the low tVD expression group was significantly lower than that of the high tVD expression group(P=0.041).Conclusion:The expression level of tVD is decreased in MM patients,which can be used as an indicator to evaluate the disease stage and prognosis of the patients.The β-CTx expression level is increased in MM patients.tPINP and β-CTx may be correlated with clinical symptoms such as osteolytic lesions and renal function changes in MM patients.

Objective: This study compared the outcomes of laparotomic radical hysterectomy (LRH) and minimally invasive radical hysterectomy (MISRH) in patients with early-stage cervical cancer. Methods: The clinical data of patients with early-stage cervical cancer who underwent LRH or MISRH (laparoscopic/robotic) at Chang Gung Memorial Hospital, Linkou Branch, from 2002 to 2017 were retrospectively reviewed. The surgical safety (operation time, blood loss, blood transfusion rate, length of postoperative stay, and perioperative complications), overall survival (OS), disease-free survival (DFS), and recurrence pattern were analyzed. Propensity score matching (PSM) at a 3:1 ratio was performed to balance prognostic variables. Results: Of the 760 patients (entire cohort), 614 underwent LRH and 146 underwent MISRH.After PSM, 394 and 140 patients were included in the LRH and MISRH groups, respectively.The 5-year OS rate was significantly lower in the MISRH group than in the LRH group (85.6% vs. 93.2%, p=0.043), and the 5-year DFS rate (p=0.21) did not differ significantly. After PSM, the 5-year OS rates did not differ significantly between the MISRH and LRH groups (87.1% vs. 92.1%, p=0.393). The MISRH group had a significantly shorter operation time (p<0.001), lower intraoperative blood loss (p<0.001), lower blood transfusion rate (p<0.001), and shorter postoperative stay (p<0.001) but a significantly higher rate of intraoperative bladder injury (p<0.001) than the LRH group. Conclusion After PSM, MISRH is associated with nonsignificantly lower OS but a significantly higher risk of intraoperative urological complications than LRH.

Objective To compare the short-term clinical effects of unilateral dual-channel endoscopic discectomy(UBED)and percutaneous endoscopic intervertebral discectomy(PEID)in the treatment of L5S,Lumbar disc herniation,LDH.Methods From January 2019 to January 2021,a total of 57 cases of L5S,LDH treated by UBED or PEID were analyzed retrospectively,including 30 cases in UBED group and 27 cases in PEID group.The operation time,intraoperative fluoroscopy times,postoperative hospitalization days and surgical complications were compared between the two groups.The visual analogue scale(VAS)and oswestry disability index(ODI)were used to compare the postoperative quality of life of the two groups,and the modified MacNab criteria was used to evaluate the clinical efficacy in the last follow-up.Results The operation time of UBED group and PEID group was(75.30±8.44)minutes and(68.37±4.63)minutes,respectively,and the difference between the two groups was statistically significant(P＜0.05).VAS and ODI of 1 week,3 months,1 year and 1.5 years after surgery in 2 groups were significantly decreased compared with those before surgery,with statistical significance(P＜0.05).The VAS score of low back pain in UBED group was higher than that in PEID group[(3.87±1.14)points vs(2.70±0.67)points]at 1 week after surgery(P＜0.05),and there was no significant difference in VAS and ODI at the other time points(P＞0.05).There was no statistical difference in the results of modified MacNab criteria in the last follow-up(P＞0.05).There were 2 cases of dural tear in PEID group,1 case of dural tear in UBED group and 1 case of temporary nerve root injury in PEID group after operation,all of which were cured after symptomatic treatment.Conclusion Compared with PEID,UBED has a longer operation time,more trauma and more obvious low back pain in the short term after operation.The short-term curative effect of the two operations on L5S1 LDH is similar,the incidence of complications is low,and the times of fluoroscopy are few.Both operations are safe and effective.