Objective To explore the application value of small airway function measurement in chil-dren with cough variant asthma(CVA).Methods A total of 155 children with chronic cough who visited the hospital from January to December 2022 were selected as the research subjects and divided into the CVA group(n=78)and the non-CVA group(n=77)according to the results of the bronchial provocation test.The small airway function was evaluated by three indicators in the basic lung function:the percentage of the maximum mid-expiratory flow to the predicted value(MMEF％pred),and the percentage of the instantaneous expiratory flow to the predicted value when forcefully exhaling 50％and 75％of the vital capacity(FEF50％％pred,FEF75％％ pred).If any one of the three indicators is lower than the lower limit of the normal value(＜65％),it is determined as small airway dysfunction.The incidence of small airway dysfunction and the indica-tors of atmospheric airway function[percentage of forced expiratory volume in one second to the predicted value(FEV1％pred),percentage of maximum expiratory flow to the predicted value(PEF％ pred)]and small airway(MMEF％pred,FEF50％％pred,FEF75％％)before and after bronchial provocation tests were compared between the two groups.Results Among 55 children with chronic cough,47 cases were found to have small airway dysfunction,with 33 cases in the CVA group and 14 cases in the non-CVA group.The incidence of small airway dysfunction in the CVA group was higher than that in the non-CVA group[42.3％(33/78)vs.18.2％(14/77)],and the difference was statistically significant(P＜0.05).Compared with before the bron-chial provocation test,the levels of large and small airway function indicators in both groups decreased after the bronchial provocation test.The decrease rate in the CVA group was higher than that in the non-CVA group,and the decrease rates of MMEF％pred,FEF50％％pred,and FEF75％％ pred were higher than those of FEV1％ pred and PEF％ pred,the differences were statistically significant(P＜0.05).Conclusion Small air-way function measurement can be performed in children with CVA for early diagnosis and therapeutic effect e-valuation.

Objective:To explore the value of an integrated modeling approach combining radiomics, dosiomics, and clinical factors in the prediction of the locoregional recurrence (LRR) risk after radiotherapy for patients with locoregionally advanced hypopharyngeal squamous cell carcinoma (HPSCC), in order to provide supplementary clinical evidence and decision-making basis for personalized treatment for this rare disease characterized by low incidence and poor prognosis.Methods:The clinical images and pathological data were retrospectively enrolled from 76 HPSCC patients treated at the Peking University Cancer Hospital from October 2011 to July 2020. The planning gross tumor volumes (PGTVs) were taken as the volumes of interest (VOIs). A total of 1 316 radiomic and dosiomic features were extracted from the planning CT and dose distribution images. After stability testing, feature dimensionality reduction was achieved using least absolute shrinkage and selection operator (LASSO) regression and principal component analysis (PCA), with radiomic principal components (RPCs) and dosiomic principal components (DPCs) obtained, respectively. Using various combinations of RPCs, DPCs, and clinical variables as predictors, multivariate Cox regression models were developed after 5-fold cross-validation 100 times. The model performance was evaluated based on the Akaike information criterion (AIC) and concordance index (C-index).Results:Using two RPCs and three DPCs selected, dosiomics and radiomic Cox proportional hazards models were constructed, with C-index values of 0.781 and 0.778 and AIC values of 94.44 and 92.27, respectively. The result indicated that one RPC and three DPCs showed significant associations in Cox regression ( P < 0.05). Other prediction models were established by integrating the clinical data of patients with radiomic features, dosiomic features, or both. The prediction result demonstrated that compared to models based on individual factors or dual components, the multi-omics model yielded the highest prediction accuracy (C-index: 0.823, AIC: 84.94). Conclusions:Integrated models that combine radiomic features, dosiomic features, and clinical factors demonstrate great potential for enhancing the accuracy of LRR risk prediction. These models are expected to provide decision-making support for devising personalized treatment strategies and ultimately improve the prognosis of HPSCC patients.

Objective:To evaluate the outcomes of intensive conservative treatment compared to conventional conservative treatment in patients with acute aortic syndrome(AAS).Methods:The study prospectively enrolled consecutive patients with AAS who were admitted to Beijing Anzhen Hospital, affiliated with Capital Medical University, and Beijing Dawanglu Emergency Rescue Hospital from January 2024 to December 2024. These patients with surgical contraindications or refused surgery for various reasons opted for conservative treatment. A total of 282 patients were included, and 15 patients with missing data or those who died without any treatment were excluded. Finally, 267 patients were enrolled, of whom 94 received intensive conservative treatment, and 173 received conventional conservative treatment, the inverse probability of treatment weighting (IPTW) was used to reduce the influence of confoundings. After adjusting of baseline datas via IPTW, the survival outcomes of the two groups were compared at 14 days, 30 days, and at the end of follow-up.Results:The results showed significant differences in acute phase survival rates between the enhanced conservative treatment group and the conventional conservative treatment group at 14 days(82.40%vs.53.20%, P<0.0001). Significant survival differences were also observed at 30 days and at 276-day mid-term follow-up (96.29% vs.51.60%, P<0.0001; 78.50% vs.48.50%, P<0.0001). In the subgroup analysis, for type A aortic dissection, the enhanced conservative treatment group had higher survival rates compared to the conventional conservative treatment group at 14, 30 and 276 days (63.46% vs.41.35%, P<0.05; 52.17% vs.37.90%, P<0.05; 50.00% vs. 31.97%, P<0.05). However, for type B aortic dissection, although the enhanced conservative treatment group had higher survival rates than the conventional conservative treatment group, no statistically significant differences were observed (96.29% vs. 80.00%, P=0.054; 95.65% vs.78.37%, P=0.067; 94.12% vs.74.20%, P=0.088). Conclusion:For patients diagnosed with AAS are forced to choose conservative treatment if emergency surgery is not possible in the first place, intensive conservative treatment strategies can significantly reduce the mortality in the acute phase compared with conventional conservative treatment. Mid-term follow-up, intensive conservative treatment still has a significant survival advantage.

Objective:To explore the value of an integrated modeling approach combining radiomics, dosiomics, and clinical factors in the prediction of the locoregional recurrence (LRR) risk after radiotherapy for patients with locoregionally advanced hypopharyngeal squamous cell carcinoma (HPSCC), in order to provide supplementary clinical evidence and decision-making basis for personalized treatment for this rare disease characterized by low incidence and poor prognosis.Methods:The clinical images and pathological data were retrospectively enrolled from 76 HPSCC patients treated at the Peking University Cancer Hospital from October 2011 to July 2020. The planning gross tumor volumes (PGTVs) were taken as the volumes of interest (VOIs). A total of 1 316 radiomic and dosiomic features were extracted from the planning CT and dose distribution images. After stability testing, feature dimensionality reduction was achieved using least absolute shrinkage and selection operator (LASSO) regression and principal component analysis (PCA), with radiomic principal components (RPCs) and dosiomic principal components (DPCs) obtained, respectively. Using various combinations of RPCs, DPCs, and clinical variables as predictors, multivariate Cox regression models were developed after 5-fold cross-validation 100 times. The model performance was evaluated based on the Akaike information criterion (AIC) and concordance index (C-index).Results:Using two RPCs and three DPCs selected, dosiomics and radiomic Cox proportional hazards models were constructed, with C-index values of 0.781 and 0.778 and AIC values of 94.44 and 92.27, respectively. The result indicated that one RPC and three DPCs showed significant associations in Cox regression ( P < 0.05). Other prediction models were established by integrating the clinical data of patients with radiomic features, dosiomic features, or both. The prediction result demonstrated that compared to models based on individual factors or dual components, the multi-omics model yielded the highest prediction accuracy (C-index: 0.823, AIC: 84.94). Conclusions:Integrated models that combine radiomic features, dosiomic features, and clinical factors demonstrate great potential for enhancing the accuracy of LRR risk prediction. These models are expected to provide decision-making support for devising personalized treatment strategies and ultimately improve the prognosis of HPSCC patients.

Objective:To evaluate the outcomes of intensive conservative treatment compared to conventional conservative treatment in patients with acute aortic syndrome(AAS).Methods:The study prospectively enrolled consecutive patients with AAS who were admitted to Beijing Anzhen Hospital, affiliated with Capital Medical University, and Beijing Dawanglu Emergency Rescue Hospital from January 2024 to December 2024. These patients with surgical contraindications or refused surgery for various reasons opted for conservative treatment. A total of 282 patients were included, and 15 patients with missing data or those who died without any treatment were excluded. Finally, 267 patients were enrolled, of whom 94 received intensive conservative treatment, and 173 received conventional conservative treatment, the inverse probability of treatment weighting (IPTW) was used to reduce the influence of confoundings. After adjusting of baseline datas via IPTW, the survival outcomes of the two groups were compared at 14 days, 30 days, and at the end of follow-up.Results:The results showed significant differences in acute phase survival rates between the enhanced conservative treatment group and the conventional conservative treatment group at 14 days(82.40%vs.53.20%, P<0.0001). Significant survival differences were also observed at 30 days and at 276-day mid-term follow-up (96.29% vs.51.60%, P<0.0001; 78.50% vs.48.50%, P<0.0001). In the subgroup analysis, for type A aortic dissection, the enhanced conservative treatment group had higher survival rates compared to the conventional conservative treatment group at 14, 30 and 276 days (63.46% vs.41.35%, P<0.05; 52.17% vs.37.90%, P<0.05; 50.00% vs. 31.97%, P<0.05). However, for type B aortic dissection, although the enhanced conservative treatment group had higher survival rates than the conventional conservative treatment group, no statistically significant differences were observed (96.29% vs. 80.00%, P=0.054; 95.65% vs.78.37%, P=0.067; 94.12% vs.74.20%, P=0.088). Conclusion:For patients diagnosed with AAS are forced to choose conservative treatment if emergency surgery is not possible in the first place, intensive conservative treatment strategies can significantly reduce the mortality in the acute phase compared with conventional conservative treatment. Mid-term follow-up, intensive conservative treatment still has a significant survival advantage.

Bladder cancer （BCa） is the most common malignant tumor of the urinary system， and its incidence is increasing year by year. At present， for all patients with resectable non-metastatic muscle-invasive BCa， radical cystectomy + bilateral pelvic lymph node dissection is strongly recommended， but they still face the risk of recurrence， metastasis and death. In recent years， the proportion of patients with advanced and metastatic BCa is increasing among patients with newly diagnosed BCa. Although current treatment models are diverse， they often struggle to achieve significant efficacy due to their low effectiveness and adverse effects， resulting in low survival rates for patients with advanced and metastatic BCa. Therefore， the treatment of BCa still faces great challenges， and there is an urgent need to discover an effective new antitumor drug. With the improvement of medical standards， traditional Chinese medicine has shown great advantages in the treatment of BCa. Traditional Chinese medicine is mild and easy to accept， and can inhibit tumor progression through a multi-pathway， multi-way and multi-target manner， so as to exert its anticancer effect. Taraxaci Herba is a medicinal and food homologous plant， which has many biological activities， such as antibacterial， anti-inflammatory， anti-oxidation， anti-tumor， protecting liver and gallbladder， reducing blood sugar and enhancing immunity， and it has shown a clear anticancer effect in breast cancer， liver cancer， gastric cancer， tongue cancer and lung cancer. By reviewing previous studies worldwide， this article summarizes the mechanism of Taraxaci Herba extract in inducing autophagy and apoptosis， inhibiting cell migration and invasion， regulating cell cycle and proliferation， regulating cell metabolism， inhibiting tumor angiogenesis， combining the effects of chemotherapeutic drugs， and regulating the transduction of related signal pathways. On this basis， this study systematically elaborates on the potential mechanism of Taraxaci Herba against BCa， in order to provide a theoretical basis for the research and treatment of BCa.

Objective:To evaluate the accuracy and stability of stereotactic radiosurgery (SRS) algorithm in optical surface imaging (OSI) system in non-coplanar radiotherapy.Methods:Three OSI imaging systems were used to measure the phantom repeatedly at different couch rotation angles to analyze the accuracy and stability of OSI system. Seven patients with multiple brain metastases who underwent single-center non-coplanar radiotherapy were randomly selected, and the accuracy and stability of OSI for patient imaging were analyzed. Stability is defined as the difference between the two OSI measurements when the couch is turned from 0° to a non 0° angle, and then back to 0°, using the 0° cone beam CT (CBCT) as the "gold standard". Accuracy is defined as the difference between OSI and CBCT (at 0° couch angle) measurement data. The measurement data with normal distribution were described as Mean ± SD. The data with non-normal distribution were expressed as M (Q). The difference of the former data was compared by one-way ANOVA, and the difference of the latter data was assessed by Kruskal-Wallis H nonparametric test. Results:For non-coplanarity, the translation accuracy of the phantom and the patient was ≤ 1.30 mm and ≤ 1.00 mm, and the rotation accuracy was ≤ 0.50° and ≤ 0.60°, respectively. The translation errors mainly occurred in the left-right and head-foot directions. In terms of stability, the maximum standard deviation of phantom coplanar translation and rotation was 0.06 mm and 0.06°. The maximum standard deviation of patient translation and rotation was 0.17 mm and 0.19°.Conclusions:Although the new SRS algorithm improves the non-coplanar accuracy, it still cannot meet the precise requirements of non-coplanar single isocenter radiotherapy for multiple brain metastases, especially in the left-right and head-foot directions. When the couch rotation angle is large, OSI is not recommended for image-guided radiotherapy. However, its high stability can be used to monitor the intrafractional motion of patients.

OX40 is a costimulatory receptor that is expressed primarily on activated CD4⁺, CD8⁺, and regulatory T cells. The ligation of OX40 to its sole ligand OX40L potentiates T cell expansion, differentiation, and activation and also promotes dendritic cells to mature to enhance their cytokine production. Therefore, the use of agonistic anti-OX40 antibodies for cancer immunotherapy has gained great interest. However, most of the agonistic anti-OX40 antibodies in the clinic are OX40L-competitive and show limited efficacy. Here, we discovered that BGB-A445, a non-ligand-competitive agonistic anti-OX40 antibody currently under clinical investigation, induced optimal T cell activation without impairing dendritic cell function. In addition, BGB-A445 dose-dependently and significantly depleted regulatory T cells in vitro and in vivo via antibody-dependent cellular cytotoxicity. In the MC38 syngeneic model established in humanized OX40 knock-in mice, BGB-A445 demonstrated robust and dose-dependent antitumor efficacy, whereas the ligand-competitive anti-OX40 antibody showed antitumor efficacy characterized by a hook effect. Furthermore, BGB-A445 demonstrated a strong combination antitumor effect with an anti-PD-1 antibody. Taken together, our findings show that BGB-A445, which does not block OX40-OX40L interaction in contrast to clinical-stage anti-OX40 antibodies, shows superior immune-stimulating effects and antitumor efficacy and thus warrants further clinical investigation.
Mice ; Animals ; Receptors, Tumor Necrosis Factor/physiology* ; Receptors, OX40 ; Membrane Glycoproteins ; Ligands ; Antibodies, Monoclonal/pharmacology* ; Antineoplastic Agents/pharmacology*

Objective:To explore the effects of mouth opening breathing for different reasons on children's maxillofacial development. Methods:One hundred and fifty-one children were selected as the research objects of this experiment. They were divided into 49 cases of adenoid hypertrophy group（group A）, 52 cases of tonsillar hypertrophy group（group B） and 50 cases of adenoid with tonsillar hypertrophy group（Group C）. Healthy children in the same period were selected as the control group, a total of 45 cases. The reflex nasopharyngeal measurement parameters, facial development indexes and cephalometric parameters of group A, group B, group C and control group were analyzed, and the incidence of Angle ClassⅡand Angle Class Ⅲ in group A, group B and group C were studied. Results:Compared with the control group, the reflex nasopharyngeal measurement parameters in group A, group B and group C was significantly different（P<0.05）, and the cephalometric parameters changed with variation in groups（P<0.05）. The incidence of Angle Class Ⅱ facial pattern in group A and group C was higher, but the incidence of Angle Class Ⅲ facial pattern in group B and group C was higher（P<0.05）. Conclusion:Adenoid hypertrophy leads to mandibular retraction; tonsil hypertrophy leads to anterior mandibular arch; adenoid hypertrophy and tonsil hypertrophy are easy to lead to clockwise rotation of the mandible. In clinical practice, to avoid children's uncoordinated maxillofacial development, we should correct the maxillofacial situation of children as soon as possible.
Child ; Humans ; Maxillofacial Development ; Malocclusion, Angle Class III/complications* ; Nasopharynx ; Adenoids ; Palatine Tonsil ; Mouth Breathing/etiology* ; Hypertrophy/complications* ; Mouth

Bronchial asthma is a common chronic airway inflammatory disease in children characterized by hyper-responsiveness, airway inflammation, and airway remodeling caused by immune responses.Currently, some limitations of glucocorticoid and allergen-specific immunotherapy restrict their application to asthma treatment.Based on the results of many animal experiments, mesenchymal stem cells (MSCs) are validated to reduce airway inflammation, improve airway hyper-responsiveness, and reverse airway remodeling through immunomodulation.Therefore, it has great application prospects as an effective therapeutic strategy for children with asthma.To explore the value of MSCs in the treatment of asthma, its underlying mechanisms are reviewed in the present study.