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.

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.

Objective:To investigate the application value of pepsinogen, Helicobacter pylori combined with endoscopic Kimura-Takemoto classification in the diagnosis of early gastric cancer. Methods:Sixty patients with gastric cancer who received treatment in the Department of Gastroenterology, the First People's Hospital of Huzhou from January to June 2022 were included in the gastric cancer group. An additional 60 patients with benign gastric lesions (benign gastric lesion group) and 60 patients with precancerous lesions of the stomach (precancerous lesion group) were also included in this study. Serologic testing for pepsinogen and Helicobacter pylori antibody combined with endoscopic Kimura-Takemoto classification was performed to evaluate their application value in the diagnosis of early gastric cancer. Results:Compared with the benign gastric lesion and precancerous lesion groups, the pepsinogen I/pepsinogen II ratio was significantly lower, and the pepsinogen II level and Helicobacter pylori infection rate [71.67% (43/60)] were significantly higher in the gastric cancer group ( F = 108.14, 71.75, 38.43, χ2 = 6.89, all P < 0.05). Compared with the benign gastric lesion and precancerous lesion groups, the Kimura-Takenmoto classification in the gastric cancer group was significantly higher ( H = 38.91, P < 0.05). In the gastric cancer group, pepsinogen I level and pepsinogen I/pepsinogen II ratio decreased and pepsinogen II level increased with the increase of pathological stage ( F = 65.79, 5.66, 53.32, all P < 0.01). There was no significant difference in Helicobacter pylori infection rate between different stages of gastric cancer ( P < 0.05) in the gastric cancer group. There was no significant difference in Kimura-Takenmoto classification between different stages of gastric cancer (all P > 0.05) in the gastric cancer group. The area under the receiver operating characteristic curve plotted for evaluating pepsinogen I, pepsinogen II, and pepsinogen I/pepsinogen II ratio for diagnosis of gastric cancer was 0.865, 0.664, and 0.881, respectively. Conclusion:Serum pepsinogen, Helicobacter pylori combined with endoscopic Kimura-Takemoto classification can increase the diagnostic rate of early gastric cancer. The Kimura Takemoto classification is helpful for risk stratification in the endoscopic screening of gastric cancer, and its results are consistent with pepsinogen levels. The combined application is of a high application value.

Objective:To investigate the mediating effect of inflammatory factors in the association between low density lipoprotein-cholesterol(LDL-C) and thyroid associated ophthalmopathy(TAO).Methods:This study was a prospective study, which icluded a total of 86 patients with Graves′ disease who attended the Department of Endocrinology of the First Affiliated Hospital of Zhengzhou University from January 2021 to June 2022. Among them, there were 56 patients with Graves′ disease accompanied by TAO, including 30 cases in the inactive group and 26 in the active group. Additionally, there were 30 cases having Graves′ disease alone. The relationship between LDL-C, inflammatory factors, and the onset and activity of TAO were analyzed using binary logistic regression. Mediation analysis was used to explore the mediating effect of inflammatory factors in the association between LDL-C and TAO onset and activity.Results:Interleukin(IL) -6 was a potential mediator that linking the association between LDL-C and TAO onset: LDL-C had a direct effect on TAO(Total effect value=0.274, 95% CI 0.161-0.386), while IL-6(mediated effect=0.067, 95% CI 0.011-0.123) and IL-17(mediated effect=0.042, 95% CI 0.007-0.077) partially mediated the effect of LDL-C on TAO, accounting for 24.45% and 15.33% of the total effect, respectively. IL-6 was a potential mediator of the association between LDL-C and TAO activity: LDL-C had a direct effect on TAO activity(Total effect value=0.320, 95% CI 0.204-0.435), and IL-6(mediated effect=0.103, 95% CI 0.021-0.185) partially mediated the effect of LDL-C on TAO activity, with a mediation effect of 32.19%. Conclusion:IL-6 plays a partiall mediating role in the association of LDL-C with TAO onset and activity.

Objective To explore the effect of Naikan cognitive-music reminiscence therapy on coping style in female patients with chronic schizophrenia.Methods In May, 2020, 72 female patients with chronic schizophrenia from Beijing Huilongguan Hospital were assigned into control group (n = 48) and music group (n = 24) after trait matching. Both groups accepted routine medicine, while the control group accepted Naikan cognitive therapy, and the music group accepted Naikan cognitive therapy combined music reminiscence, for twelve weeks. They were blind assessed with Simplified Coping Style Questionnaire, Self-rating Depression Scale and Self-rating Anxiety Scale before and after intervention.Results There were five cases in the control group removed for erroneous response. The main effects of group were not significant for all the assessments (F < 0.567, P > 0.05). The main effect of time was significant for negative coping style score (F = 6.968, P = 0.01), and the interaction effects were significant for positive coping style score and Self-rating Depression Scale score (F > 4.227, P < 0.05).Conclusion Combining with music reminiscence, Naikan cognitive therapy may be advantageous for the coping style of female patients with chronic schizophrenia.

Objective:To investigate the correlation between the level of thyrotropin receptor antibody(TRAb) and bone turnover markers(BTMs) in the patients with newly-diagnosed Graves′ disease(GD).Methods:The clinical data of GD patients who were newly-diagnosed in the First Affiliated Hospital of Zhengzhou University from October 2016 to June 2021 were collected, including free triiodothyronine(FT 3), free thyroxine(FT 4), thyroid stimulating hormone, thyroid related antibodies, N-terminal procollagen of type I collagen(PINP), N-terminal osteocalcin(N-MID), β-cross-linked C-telopeptide of type I(β-CTX), blood lipid and renal function, etc. Results:There were 618 GD patients with an average age of(43.7±13.2) years(male∶female=1∶1.99). The PINP and β-CTX level in male GD patients were significantly higher than those in female(all P<0.05). Spearman correlation analysis showed that PINP, N-MID and β-CTX were positively correlated with FT 3, FT 4, TRAb, serum calcium and serum phosphorus; and negatively correlated with body mass index and low density lipoprotein cholesterol(all P<0.05). Linear regression analysis showed that TRAb was positively correlated with lg-PINP, lg-N-MID and sqrt-β-CTX in the univariate model of total GD patients( β were 0.006, 0.005, and 0.006, respectively; all P<0.001); positive correlation remained after adjusting for thyroid function(all β=0.004, all P<0.001); and for multiple confounding factors(model 3 and 4, all P<0.05). Results of univariate and adjusted thyroid function models with GD in different genders were consistent with the total patients(all P<0.05). Conclusion:TRAb is a risk factor for accelerated bone turnover in GD patients which is independent of thyroid function.

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.