Hepatocellular carcinoma （HCC）， the predominant subtype of primary liver cancer， ranks among the top in both incidence and mortality rates of malignant tumors in China. In its early stages， the disease may present with subtle or nonspecific symptoms， often leading to poor clinical prognosis and low patient survival rates， which makes it a significant public health concern. The pathogenesis is associated with multiple factors， including hepatitis virus infection， alcohol consumption， obesity， drug-induced liver injury， and immune disorders， which may interact synergistically to promote disease development. Currently， mainstream therapeutic approaches for HCC in modern medicine encompass surgical resection， liver transplantation， radiofrequency ablation， radiotherapy， and chemotherapy， but they all have certain limitations， such as large side effects and poor prognosis， imposing substantial psychological distress and financial strain on affected individuals. With a rich historical background in hepatic malignancy management， traditional Chinese medicine offers therapeutic benefits characterized by multi-targeted mechanisms， multi-level regulation， minimal adverse effects， and reduced likelihood of disease recurrence. It can not only enhance the curative effect， but also reduce the side effects of radiotherapy， chemotherapy， and surgery. Thus， it has attracted widespread attention. Extensive research has demonstrated that traditional Chinese medicine exhibits significant antitumor properties， along with notable anti-inflammatory and oxidative stress-reducing capabilities， and its mechanism may be related to the regulation of nuclear factor-kappa B （NF-κB） signaling pathway， which can affect multiple stages of hepatocarcinogenesis， such as cell proliferation， invasion， metastasis， and apoptosis. The mechanism of NF-κB signaling pathway in traditional Chinese medicine for HCC treatment has emerged as one of the pivotal research directions in current oncology studies. Based on the existing research foundation， a systematic literature review method was adopted to retrieve and analyze relevant Chinese and English literature in recent years. Integrating the molecular regulatory mechanisms of the NF-κB signaling pathway and its pivotal role in HCC pathogenesis and progression helped further explore the latest research advances in traditional Chinese medicine interventions targeting this pathway for HCC treatment. This approach may provide novel theoretical foundations and translational strategies for the prevention and management of HCC using traditional Chinese medicine.

[摘 要] 目的：构建了一种靶向成纤维细胞活化蛋白（FAP）且能分泌CTLA-4单链抗体（scFv）的CAR-T细胞，并探讨其联合血管靶向药物阿帕替尼对胶质母细胞瘤（GBM）的抗肿瘤效果及机制。方法：构建FAP-CTLA-4 CAR过表达载体，转导至T细胞中制备FAP-CTLA-4 CAR-T细胞。流式细胞术检测FAP-CTLA-4 CAR-T细胞表面分子CD69表达，ELISPOT检测其分泌IFN-γ的能力，细胞增殖实验分析FAP-CTLA-4 CAR-T细胞的增殖情况，杀伤实验分析其联合阿帕替尼处理对人脑星形胶质母细胞瘤U-87 MG细胞治疗效果的影响。建立小鼠U-87 MG细胞异种移植瘤模型。分别用FAP-CTLA-4 CAR-T细胞单独治疗或联合阿帕替尼治疗荷瘤小鼠，命名为FAP-CTLA-4 CAR-T组、阿帕替尼组和FAP-CTLA-4 CAR-T + 阿帕替尼组，观察各组小鼠肿瘤生长情况，免疫组化、TUNEL染色与免疫荧光法检测各组肿瘤组织中Ki-67、CD31表达及细胞凋亡情况，流式细胞术分析FAP-CTLA-4 CAR-T细胞在荷瘤小鼠体内的存活状况，H-E染色和血清生化分析评估联合治疗的安全性。结果：与FAP-CTLA-4 CAR-T组、阿帕替尼组相比，FAP-CTLA-4 CAR-T + 阿帕替尼组中CAR-T细胞的活化水平显著提高，细胞增殖能力明显增强，IFN-γ分泌细胞比例及对靶细胞的杀伤效率均提高（P < 0.01或P < 0.05）。在荷瘤小鼠模型中，联合治疗显著抑制肿瘤生长并延长小鼠生存时间（P < 0.01或P < 0.05），同时抑制肿瘤细胞增殖、降低微血管密度、促进肿瘤细胞凋亡，并延长CAR-T细胞在肿瘤组织中的存活时间（P < 0.01或P < 0.05），且未对主要组织器官造成毒性损伤。结论：FAP-CTLA-4 CAR-T细胞与阿帕替尼联合应用在GBM治疗中显示出协同增效作用与良好的安全性。

Effective symptom management can alleviate the physical and psychological distress experienced by patients with cancer, improve quality of life, and contribute to treatment adherence and improve clinical outcomes. However, most existing guidelines are developed for healthcare professionals, and patients and the public have limited access to standardized and comprehensible guidance on symptom management. To address this gap and to facilitate effective communication and shared decision-making, this study proposes the development of a patient version of the cancer symptom management guideline. The development process will adhere to the methodological framework recommended by the Guidelines International Network and the World Health Organization. The GRADE approach will be employed to assess the certainty of evidence and to formulate recommendations. In addition, the process will be informed by the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ) instrument and the Reporting Items for Practice Guidelines in Healthcare-Public or Patient Versions of Guidelines (RIGHT-PVG). This protocol outlines the establishment of the guideline working group, the identification and prioritization of key questions, evidence retrieval and appraisal, and the formulation of recommendations, with the aim of ensuring methodological rigor and transparency in the development of the patient guideline and providing methodological reference for similar guideline initiatives.

Objective To explore the clinical value of preoperative assessment and intraoperative frozen section pathology in screening patients suitable for testicular preservation surgery, so as to provide reference for reducing unnecessary radical orchiectomy in patients with benign testicular tumors. Methods A retrospective analysis was conducted on 121 patients who underwent surgical treatment for testicular tumors in the First Affiliated Hospital of Xi'an Jiaotong University during Jan. 2021 and Sep. 2025. Data were collected, including demographic information, preoperative imaging, serum tumor markers, surgical procedures, intraoperative frozen section, postoperative pathology, and postoperative testicular volume changes. Results Among the 121 patients, 105 underwent radical orchiectomy, with 91 malignant and 14 benign cases confirmed by postoperative pathology; 16 received testicular tumor enucleation, all confirmed as benign. Benign lesions accounted for 24.79% (30/121) of all cases. In patients undergoing tumor enucleation, intraoperative frozen section results were fully consistent with final pathological findings. Conclusion Preoperative differentiation between benign and malignant testicular tumors is crucial for selecting the appropriate surgical approach. For patients with preoperative findings suggesting benign lesions, testicular tumor enucleation combined with intraoperative frozen section can achieve precise treatment while maximizing testicular preservation.

Objective:To observe the clinical efficacy of modified painless suppurative moxibustion with wheat-grain sized moxa cones plus Western medication in treating cough variant asthma(CVA)due to wind-cold attacking the lung and its effects on pulmonary function,serum immunoglobulin(Ig)-E,hypersensitive C-reactive protein(hs-CRP),and interleukin(IL)-6.Methods:A total of 98 CVA patients were randomly divided into an observation group and a control group using the random number table method,with 49 cases in each group.The control group was treated with salmeterol xinafoate and fluticasone propionate powder for inhalation,and the observation group was treated with additional modified painless suppurative moxibustion with wheat-grain sized moxa cones.The treatment lasted for 8 weeks.The traditional Chinese medicine(TCM)symptom score of the patients in both groups was observed before treatment,after treatment,and at 1-month follow-up after treatment for its changes.The clinical efficacy after treatment and at 1-month follow-up was compared between the two groups.The pulmonary function[forced expiratory volume in the first second(FEV1),FEV1/forced vital capacity(FVC),and peak expiratory flow(PEF)]and serum IgE,hs-CRP,and IL-6 levels were compared between the two groups before and after treatment.The adverse reactions that occurred during the treatment in both groups were observed and recorded.Results:The total effective rate of the observation group after treatment and at follow-up was higher than that of the control group(P<0.05).The TCM symptom scores in both groups after treatment and at follow-up were lower compared to the baseline(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).The FEV1,FEV1/FVC,and PEF after treatment in both groups were higher compared to the baseline(P<0.05),and the levels in the observation group were higher than those in the control group(P<0.05).The serum levels of IgE,IL-6,and hs-CRP after treatment in both groups were lower than the baseline(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).There were no adverse reactions in either group during the course of the study.Conclusion:Modified painless suppurative moxibustion with wheat-grain sized moxa cones plus salmeterol xinafoate and fluticasone propionate powder for inhalation is effective in treating CVA due to wind-cold attacking the lung;it can relieve the clinical symptoms of the patients,improve their pulmonary function,and also reduce serum IgE,hs-CRP,and IL-6 levels.

Due to the poor ionization efficiency and the weak mass spectrometry(MS)intensity of weakly polar substances,direct analysis using the traditional electrospray ionization mass spectrometry(ESI-MS)is a big challenge.In this study,a novel rapid on-site detection method of four prohibited sex hormones in cosmetics was proposed using online derivatization strategy coupled with a miniature mass spectrometer.The target substances in the samples were extracted by a custom-made polyaniline/multi-walled carbon nanotube solid-phase microextraction(SPME)probe.The stirring speed was 200 r/min,the extraction temperature was 40℃,and the extraction time was 2 min.A pulled dual-channel θ borosilicate glass capillary emitter was used as the nano-ESI ion source.The SPME probe was inserted into the channel containing methanol in theθborosilicate glass capillary.When the spray voltage was applied,the four sex hormones were desorbed and formed spray microdroplets,which then collided with the hydroxylamine microdroplets generated from the other channel.The microdroplets of reaction product entered into the miniature mass spectrometer for direct analysis.The limits of detection(LOD)and limits of quantification(LOQ)for the four sex hormones were 10-20 ng/mL and 20-50 ng/mL,respectively.The recoveries were from 84.6%to 107.8%with the relative standard deviations(RSD)from 4.1%to 11.6%.Compared to detection without derivatization,the MS signals of the four target substances were increased by 3 to 15 times.This method was simple,rapid,highly efficient and sensitive,and suitable for on-site rapid analysis of weakly polar sex hormones in cosmetics.

Objective To construct a nomogram prediction model for predicting hemoglobin A1c(HbA1c)failure in type 2 diabetes mellitus(T2DM)patients.Methods A total of 936 inpatients with T2DM admitted to the Department of Endocrinology of the Affiliated Hospital of Shandong Second Medical University from January 2021 to January 2022 were selected as the research objects and divided into the non-standard group(HbA1c≥7%,n=801)and the standard group(HbA1c<7%,n=135).Univariate analysis was used to screen the related factors of HbA1c failure.Logistic regression multivariate model was used to analyze the influencing factors of HbA1c failure in T2DM patients.The R language was used to construct a nomogram,and the area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the predictive ability of the model.The C-index and Hosmer-Lemeshow test were used to evaluate the discrimination and calibration of the model.Results There were statistically significant differences in triglyceride(TG),low-density lipoprotein cholesterol,direct bilirubin,urinary albumin/creatinine ratio(UACR),self-monitoring of blood glucose(SMBG),meat and vegetable pairing,hot pot,whole grain and animal viscera consumption between the two groups(P<0.05).Logistic regression analysis showed that TG(OR 1.699,95%CI 1.298～2.222),UACR(OR 1.003,95%CI 1.001～1.005),SMGB(OR 0.480,95%CI 0.313～0.735),more meat and less vegetables(OR 1.432,95%CI 1.062～1.931)were the influencing factors of HbA1c failure.The AUC of the nomogram prediction model based on the influencing factors was 0.711,with C-index 0.710(95%CI 0.663～0.758)and good calibration(χ2=11.185,P=0.191).Conclusions The nomogram prediction model for HbA1c failure in T2DM patients established based on TG,UACR,SMGB,meat and vegetarian mix has good discrimination and calibration,which can provide certain reference value for warning of poor blood glucose control.

BACKGROUND:Currently,spinal cord injury imposes a huge psychological and economic burden on patients and the National Health Service.The prevention,treatment,and rehabilitation of spinal cord injury have become an important topic in the field of medicine.Therefore,it is important to explore new effective therapeutic strategies based on an in-depth understanding of the underlying molecular mechanisms of spinal cord injury.OBJECTIVE:To review the research progress on the mechanism of action of mesenchymal stem cell-derived exosomes loaded with various miRNAs in improving the function of spinal cord injury,and based on the current status of clinical translation,to put forward a few thoughts and outlooks on their clinical use.METHODS:The first author searched CNKI and PubMed databases using"mesenchymal stem cells,exosomes,spinal cord injury,miRNA,pathophysiology,clinical translation,clinical trials,good manufacturing practice"as Chinese and English search terms.The types of literature included treatises and reviews,and the language types were English and Chinese.Finally,72 papers were screened and analyzed.RESULTS AND CONCLUSION:(1)This article outlines the biological properties of exosomes and the advantages that they can serve as good vectors for loading miRNAs.A variety of miRNAs mediated by mesenchymal stem cell-derived exosomes mainly promote the recovery of neuronal function by regulating the expression of nerve regeneration-associated proteins,repressing RAS homologous gene family member A,activating cyclophosphoadenosine effector-binding proteins,and signaling and transcriptional activation proteins 3,and regulating phosphoinositide and tensin homologue/programmed cell death factor 4 pathways.Inflammatory responses were improved by regulating endoplasmic reticulum-to-nucleus signaling 1,expression of interferon regulatory factor 5,Toll-like receptor 4/nuclear factor-kappa B pathway,and down-regulating related pro-inflammatory factors.Angiogenesis was promoted by inhibition of germination-associated domain 1-containing EVH1 and phosphatidylinositol 3-kinase regulatory subunit 2.(2)Further comparative analyses revealed that miR-216-5p,miR-145-5p,and miR-146b improved inflammatory responses by regulating related pathways.Combining these miRNAs may produce more significant effects;hypoxic preconditioning may be a preconditioning method to increase the efficacy of exosomal therapy.(3)There are currently no clinical trials applying mesenchymal stem cell-derived exosomes to spinal cord injury,which is related to the need to meet good manufacturing practices before they can be put into clinical use.Challenges such as the need for large-scale,high-volume cell production,the lack of an efficient and uniform method for isolating exosomes,and the need to pass a strict regulatory approval mechanism prior to clinical use have impeded the clinical entry.(4)miRNAs have great potential as exosomal contents of mesenchymal stem cells in the treatment of spinal cord injury,and their mechanism of action should be explored in depth as well as accelerated to the clinical trial stage in order to provide a new and effective method for the treatment of spinal cord injury.

In recent decades,the incidence of human papillomavirus(HPV)-associated oropharyngeal squamous cell carcinoma(OPSCC)has shown a marked increase.Significant changes have also occurred in the OPSCC diagnosis and treatment paradigm.Deter-mining HPV status prior to treatment is now essential,and radiotherapy/chemotherapy,immunotherapy,and minimally invasive surgical techniques have progressively emerged as key modalities for managing OPSCC.However,alongside these paradigm shifts,a comprehen-sive technical consensus guiding the entire diagnostic and therapeutic process for OPSCC patients is currently lacking.Given China's large population base and the rising incidence of OPSCC,an expert panel convened to develop a clinical technical consensus on OPSCC diagno-sis and management tailored to China's specific context.This consensus aims to further enhance and standardize understanding of OPSCC management techniques among relevant healthcare professionals.