Objective To investigates the inhibitory and cytotoxic effects of chimeric antigen receptor-engineered natural killer(CAR-NK)cells targeting cellular-mesenchymal epithelial transition factor(c-Met)against gastric cancer(GC)cells in vitro.Methods c-Met expression at protein and mRNA levels was evaluated in GC cell lines(MKN-45,GTL-16,NCI-N87)and gastric mucosal epithelial cells(GES-1)by using flow cytometry(FCM),Western blot,and reverse transcription quantitative polymerase chain reaction.Immunofluorescence assays were conducted to confirm c-Met CAR-mediated specificity toward c-Met-overexpressing GTL-16 cells.Lentiviral vectors were utilized to construct c-Met-targeting CAR-NK cells,with transduction efficiency and phenotypic integrity verified by FCM.Cytotoxic activity against GC cells and normal epithelial cells was quantified via lactate dehydrogenase(LDH)release assays and cytokine secretion measured by enzyme-linked immunosorbent assay.Results c-Met exhibited significantly higher expression in GTL-16 and MKN-45 cells at both transcriptional and protein levels compared to NCI-N87 and GES-1 cells(P＜0.05).CAR-NK cells demonstrated a transduction efficiency of(14.97±0.25)％ without altering NK-92 cell phenotypes.Immunofluorescence confirmed specific binding of c-Met CAR-expressing Lenti-X-293T cells to GTL-16 targets.LDH assays revealed enhanced cytotoxicity of c-Met CAR-NK cells against c-Met-high GC cells(GTL-16,MKN-45)versus untransduced NK-92 controls(P＜0.05).At a 10∶1 effector-to-target ratio,c-Met CAR-NK cells co-cultured with c-Met-high GC cells secreted significantly elevated tumor necrosis factor(TNF-α)and interferon(IFN)-γ(P＜0.05).Conclusion The c-Met CAR-NK cells constructed in this study have the ability to specifically recognize and target to kill gastric cancer cells with high expression of c-Met,and have a strong killing effect function,which can release more TNF-α and IFN-γ.

Objective To investigate the impact of linked color imaging(LCI)combined with a transparent cap on the detection rate of colorectal sessile serrated lesion(SSL).Methods A total of 492 patients who underwent colonoscopy the First People's Hospital of Huzhou from February 2024 to January 2025 were randomly assigned to three groups:White light imaging(WLI)group,LCI group,and LCI combined with transparent cap group,with 164 cases in each group.The general clinical data,cecal intubation time(CIT),withdrawal time,SSL detection rate,small(≤5mm)SSL detection rate,and proximal colon SSL detection rate were analyzed and compared among three groups.Results There were no significant differences in general clinical data,CIT,or withdrawal time among three groups(P>0.05).Statistical analysis revealed that the SSL detection rates for WLI group,LCI group,and LCI combined with transparent cap group were 6.10％,12.20％,and 18.90％,respectively;In the proximal colon,the SSL detection rates for WLI group,LCI group,and LCI combined with transparent cap group were 3.66％,9.15％,and 16.46％,respectively;For small(≤5mm)SSL,the detection rates were 1.22％,2.44％,and 7.32％in WLI group,LCI group,and LCI combined with transparent cap group,respectively also showing statistically significant differences(P<0.001).Conclusion Colonoscopy using LCI combined with a transparent cap significantly improves the detection rate of SSL,particularly for small SSL.

This study aimed to comprehensively examine the association of gallstones, cholecystectomy, and cancer risk. Multivariable logistic regressions were performed to estimate the observational associations of gallstones and cholecystectomy with cancer risk, using data from a nationwide cohort involving 239 799 participants. General and gender-specific two-sample Mendelian randomization (MR) analysis was further conducted to assess the causalities of the observed associations. Observationally, a history of gallstones without cholecystectomy was associated with a high risk of stomach cancer (adjusted odds ratio (aOR)=2.54, 95% confidence interval (CI) 1.50-4.28), liver and bile duct cancer (aOR=2.46, 95% CI 1.17-5.16), kidney cancer (aOR=2.04, 95% CI 1.05-3.94), and bladder cancer (aOR=2.23, 95% CI 1.01-5.13) in the general population, as well as cervical cancer (aOR=1.69, 95% CI 1.12-2.56) in women. Moreover, cholecystectomy was associated with high odds of stomach cancer (aOR=2.41, 95% CI 1.29-4.49), colorectal cancer (aOR=1.83, 95% CI 1.18-2.85), and cancer of liver and bile duct (aOR=2.58, 95% CI 1.11-6.02). MR analysis only supported the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer. This study added evidence to the causal effect of gallstones on stomach, liver and bile duct, kidney, and bladder cancer, highlighting the importance of cancer screening in individuals with gallstones.
Humans ; Mendelian Randomization Analysis ; Gallstones/complications* ; Female ; Male ; Cholecystectomy/statistics & numerical data* ; Middle Aged ; Risk Factors ; Aged ; Adult ; Neoplasms/etiology* ; Stomach Neoplasms/epidemiology*

Objective To investigates the inhibitory and cytotoxic effects of chimeric antigen receptor-engineered natural killer(CAR-NK)cells targeting cellular-mesenchymal epithelial transition factor(c-Met)against gastric cancer(GC)cells in vitro.Methods c-Met expression at protein and mRNA levels was evaluated in GC cell lines(MKN-45,GTL-16,NCI-N87)and gastric mucosal epithelial cells(GES-1)by using flow cytometry(FCM),Western blot,and reverse transcription quantitative polymerase chain reaction.Immunofluorescence assays were conducted to confirm c-Met CAR-mediated specificity toward c-Met-overexpressing GTL-16 cells.Lentiviral vectors were utilized to construct c-Met-targeting CAR-NK cells,with transduction efficiency and phenotypic integrity verified by FCM.Cytotoxic activity against GC cells and normal epithelial cells was quantified via lactate dehydrogenase(LDH)release assays and cytokine secretion measured by enzyme-linked immunosorbent assay.Results c-Met exhibited significantly higher expression in GTL-16 and MKN-45 cells at both transcriptional and protein levels compared to NCI-N87 and GES-1 cells(P＜0.05).CAR-NK cells demonstrated a transduction efficiency of(14.97±0.25)％ without altering NK-92 cell phenotypes.Immunofluorescence confirmed specific binding of c-Met CAR-expressing Lenti-X-293T cells to GTL-16 targets.LDH assays revealed enhanced cytotoxicity of c-Met CAR-NK cells against c-Met-high GC cells(GTL-16,MKN-45)versus untransduced NK-92 controls(P＜0.05).At a 10∶1 effector-to-target ratio,c-Met CAR-NK cells co-cultured with c-Met-high GC cells secreted significantly elevated tumor necrosis factor(TNF-α)and interferon(IFN)-γ(P＜0.05).Conclusion The c-Met CAR-NK cells constructed in this study have the ability to specifically recognize and target to kill gastric cancer cells with high expression of c-Met,and have a strong killing effect function,which can release more TNF-α and IFN-γ.

Objective To investigate the impact of linked color imaging(LCI)combined with a transparent cap on the detection rate of colorectal sessile serrated lesion(SSL).Methods A total of 492 patients who underwent colonoscopy the First People's Hospital of Huzhou from February 2024 to January 2025 were randomly assigned to three groups:White light imaging(WLI)group,LCI group,and LCI combined with transparent cap group,with 164 cases in each group.The general clinical data,cecal intubation time(CIT),withdrawal time,SSL detection rate,small(≤5mm)SSL detection rate,and proximal colon SSL detection rate were analyzed and compared among three groups.Results There were no significant differences in general clinical data,CIT,or withdrawal time among three groups(P>0.05).Statistical analysis revealed that the SSL detection rates for WLI group,LCI group,and LCI combined with transparent cap group were 6.10％,12.20％,and 18.90％,respectively;In the proximal colon,the SSL detection rates for WLI group,LCI group,and LCI combined with transparent cap group were 3.66％,9.15％,and 16.46％,respectively;For small(≤5mm)SSL,the detection rates were 1.22％,2.44％,and 7.32％in WLI group,LCI group,and LCI combined with transparent cap group,respectively also showing statistically significant differences(P<0.001).Conclusion Colonoscopy using LCI combined with a transparent cap significantly improves the detection rate of SSL,particularly for small SSL.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Due to the difference of cultural background, the psychological, social and spiritual needs of dying people are very different, so there are great differences in the care and nursing concept of dying people in different countries and nationalities. In order to construct the modern hospice care, we should actively learn from the western experience, but more important is to dig the local ideological resources from the traditional culture, build a set of caring care theory and practice rooted in China and originated from the concept of a good end of Chinese traditional culture, with the characteristics of the times and the cultural confidence of the Chinese nation, serving the Chinese people, and with Chinese characteristics.

Objective:To explore the effect of physical-medical integration training on the rehabilitation of inpatients with schizophrenia and metabolic syndrome.Methods:From January 2019 to January 2020, convenience sampling was used to select 105 patients with schizophrenia and metabolic syndrome who received treatment in Beijing Huilongguan Hospital as the research object. Patients were divided into research group ( n=53) and control group ( n=52) . Control group conducted psychiatric routine nursing, and research group implemented physical-medical integration training model (doctor-nurse-technician participation) on the basis of routine nursing. We compared the body mass index (BMI) , blood glucose, blood pressure and social function score of the two groups of patients after three months of training. Results:Finally, 50 patients in each group completed the study. After three months of training, the BMI, fasting blood glucose, systolic blood pressure and diastolic blood pressure of research group were lower than those of control group, and the total score and all dimension scores of social function were higher than those of control group with statistical differences ( P<0.05) . Conclusions:Physical-medical integration training can directly affect the BMI, blood pressure, and blood glucose of patients with schizophrenia and metabolic syndrome, and can improve the social function of the patient and increase the patient's sense of satisfaction.

Objective:To investigate the expression of serum microRNA (miR)-92 in patients with liver cancer and its relationship with poor prognosis.Methods:The clinical data of 70 patients with liver cancer in the First People′s Hospital of Huzhou City, Zhejiang Province and the Central Hospital of Huzhou City, Zhejiang Province from May 2015 to May 2018 were retrospectively analyzed. The miR-92 expression level was detected by real-time quantitative polymerase chain reaction method and compared with that of 80 healthy subjects. Receiver operating characteristic (ROC) curve was drawn to evaluate the efficacy of serum miR-92 in diagnosing liver cancer and early stage (stage Ⅰ to Ⅱ) liver cancer. The relationship between serum miR-92 expression level and clinicopathological characteristic was analyzed. Independent risk factors affecting the prognosis in patients with liver cancer were analyzed by multivariate Cox regression model.Results:The expression level of serum miR-92 in patients with liver cancer was significantly higher than that in healthy subjects (4.10 ± 1.74 vs 1.88 ± 0.78), and there was statistical difference ( P<0.05). ROC curve analysis result showed that the area under curve (AUC) of serum miR-92 for the diagnosis liver cancer was 0.874, the best cut-off value was 2.43, the sensitivity was82.86%, and the specificity was 86.25%; the AUC of serum miR-92 for the diagnosis early liver cancer was 0.755, the best cutoff value was 2.38, the sensitivity was 68.57%, and the specificity was 84.42%. The serum miR-92 expression level was related to TNM stage and lymph node metastasis ( P<0.01), but not related to gender, age, tumor diameter, history of hepatitis, liver cirrhosis, degree of differentiation and portal vein tumor thrombus ( P>0.05). The 5-year overall survival rate in liver cancer patients with high serum miR-92 expression was significantly lower than that in liver cancer patients with low serum miR-92 expression (17.1% vs. 31.5%), and there was statistical difference ( χ2 = 5.561, P<0.05). Multivariate Cox regression analysis result showed that miR-92 was an independent risk factor affecting the prognosis in patients with liver cancer ( HR = 0.282, 95% CI 1.179 to 3.562, P<0.05). Conclusions:The expression level of serum miR-92 in patients with liver cancer is significantly increased, which plays an important role in the progression of the disease. Serum miR-92 can be used as an indicator for early diagnosis and prognosis evaluation of liver cancer.