Objective To analyze the causal relationship between immune cell phenotype and gastric cancer. Methods Bidirectional two-sample Mendelian randomization (MR) analysis was used to select 731 genetic variants involving immune cell phenotypes from the GWAS dataset as instrumental variables. Inverse-variance weighting method (IVW), weighted median method (WM), and MR-Egger regression were used for sensitivity analysis. Cochran Q test, MR-Egger regression, MR-PRESSO method, and remain-one method were also conducted. Results Changes in the absolute count of IgD+ B cells and CD14-CD16- cells were significantly associated with the risk of gastric cancer. A lower proportion of IgD+ B cells was associated with a lower risk of gastric cancer (OR=0.86, 95%CI: 0.79-0.94), while an increased number of CD4-CD8-T cells was associated with an increased risk of gastric cancer (OR=1.2, 95%CI: 1.1-1.3). Conclusion A causal relationship exists between immune cell phenotype and the risk of gastric cancer. Changes in specific immune markers may regulate the development of gastric cancer by affecting the tumor microenvironment.

Radiation-induced lung injury is a prevalent side effect of radiotherapy for chest cancer. The "three phases and three methods "is an innovative theory based on the evolution of the core pathogenesis of radiation-induced lung injury. Its formation also considers the understanding of radiation-induced lung injury by ancient and modern medical practitioners, pathological characteristics, clinical manifestations, and the development patterns of radiation-induced lung injury. The "three phases and three methods" refers to the three phases of the course and the three treatment methods. The core pathogenesis of radiation-induced lung injury from the beginning, middle and late stages is heat toxicity, yin deficiency, and blood stasis. Therefore, the course of radiation-induced lung injury is divided into three phases: blazing heat toxin, yin deficiency and heat accumulation, and static blood obstruction. The method of clearing the lung and resolving toxins, enriching yin and venting heat, invigorating blood and dissolving stasis are used respectively. Traditional Chinese medicines commonly used in each phase include Flos Lonicerae, Atrina Glass, heartleaf houttuynia herb, Radix Ophiopogonis, American Ginseng, Forsythiae Fructus, Radix Salviae Miltiorrhizae, Rhizoma Ligustici chuanxiong, Scorpio, etc. This article presents the theoretical origins of the "three phases and three methods" concept by reviewing of ancient literature, inheriting experience, and summarizing disease pathogenesis, as well as elaborating on the academic connotations of the "three phases and three methods". The scientific validity of the "three phases and three methods" is verified by literature, clinical, and basic research. The "three phases and three methods" interprets the core characteristics of each stage of radiation-induced lung injury, improves the traditional Chinese medicine prevention and treatment system for radiation-induced lung injury, and provides theoretical basis for achieving complete process management.

Vitiligo is a dermatological condition of autoimmune origin, characterized by the acquired loss of pigmentation in the skin and mucous membranes. Inflammatory cytokines, including interferon (IFN)-γ, interleukin (IL)-17, tumor necrosis factor (TNF)-α, IL-6, IL-8, IL-21, IL-33, phosphodiester enzyme (PDE)-4, and transforming growth factor (TGF)-β, play a crucial role in the progression of vitiligo. Among these, the IFN-γ/chemokine ligand (CXCL) 10 axis is particularly significant. In recent times, the advent of targeted therapeutic approaches, focusing on modulating cytokines and their corresponding receptors implicated in the pathogenesis of vitiligo, has assumed paramount significance. JAK inhibitors and their combination therapy with phototherapy have been clinically proven to have promising therapeutic prospects. This review undertakes a comprehensive appraisal of the therapeutic efficacy and tailored drug selection pertaining to diverse biological agents employed in the management of vitiligo, aiming to provide valuable insights for clinical therapeutic decisions.

BACKGROUND:Human placental mesenchymal stem cells have been shown to be effective in inhibiting the development of pulmonary fibrosis,but the underlying mechanisms remain unclear. OBJECTIVE:To investigate the therapeutic effect and related mechanism of human placental mesenchymal stem cells on silica-induced pulmonary fibrosis in human embryonic lung fibroblasts(MRC-5). METHODS:CCK-8 assay was used to detect the effects of different mass concentrations of silica on the proliferation of MRC-5 at different time points.Immunofluorescence staining was used to screen out the best stimulating mass concentration and time of silica for subsequent experiments.MRC-5 cells were divided into blank group,silica group,and silica + human placental mesenchymal stem cell group.In the blank group,cells were not treated.In the silica group,MRC-5 cells were stimulated with 100 μg/mL silica for 48 hours.In the silica + human placental mesenchymal stem cell group,MRC-5 cells were stimulated with 100 μg/mL silica for 48 hours and then co-cultured with human placental mesenchymal stem cells for 24 hours.Immunofluorescence staining was used to detect the expression of α-smooth muscle actin and collagen type I in cells of each group.Western blot assay was used to detect the expressions of pulmonary fibrosis-related proteins and TGF-β1/Smad 3 signaling pathway-related proteins in cells of each group. RESULTS AND CONCLUSION:(1)CCK-8 assay results suggested that 100 μg/mL silica was the best mass concentration and time to stimulate MRC-5 cells for 48 hours.(2)Immunofluorescence staining results showed that the expression of α-smooth muscle actin and collagen type I in the silica + human placental mesenchymal stem cell group was significantly lower than that in the silica group.(3)Western blot assay results showed that compared with the silica group,the protein expression levels of α-smooth muscle actin,collagen type I,N-cadherin,fibronectin,transforming growth factor-β1,p-Smad3,and Smad3 in the silica + human placental mesenchymal stem cell group were decreased,and the expression of E-cadherin was increased.The difference was statistically significant(P<0.05).(4)The results showed that human placental mesenchymal stem cells had a significant therapeutic effect on silica-induced pulmonary fibrosis.Human placental mesenchymal stem cells can inhibit the development of pulmonary fibrosis by regulating transforming growth factor-β1/Smad3 signaling pathway.

Radiation-induced lung injury （RILI） is caused by the "heat toxin" of radiation. Based on the clinical manifestation and the pathological characteristics of RILI in different phases in modern medicine， RILI is divided into three phases， that is intense heat toxin phase， yin deficiency and heat accumulation phase， and static blood obstruction phase， for which "three phases and three methods" has been proposed to prevent and treat RILI. For the early stage of RILI， that is intense heat toxin phase， it is recommended to use the method of clearing the lung and resolving toxins， usually with Yin Qiao Powder （银翘散） in modifications. Regarding the middle stage which is yin deficiency and heat accumulation phase， the method of enriching yin and venting heat is recommended， often using self-made Yangyin Qingfei Formula （养阴清肺方）. In terms of the late stage， that is the static blood obstruction phase， It is recommended to invigorate blood and dissolve stasis， usually with self-made Qingfei Huoxue Formula （清肺活血方）.

Robotic surgery is known as the"third technological revolution"in the field of surgery,and is an important milestone in the development of modern surgery.However,our country's innovative surgical robot industry is still in its early stages,and it is only being utilized in certain surgical fields.To explore the effectiveness of the application of do-mestic surgical robot in oral and maxillofacial surgery,the author successfully completed a case of benign parotid tumor resection with the assistance of a domestic autonomous robot.The operation was successful,facial nerve function was preserved,and postoperative wound healing was good.

Objective To construct c-Met CAR-T cells secreting PD-1 antibodies to reduce immune inhibitory effect of tumor cells and enhance the efficacy of CAR-T cell therapy against pancreatic cancer.Methods Kaplan-Meier Plotter,GEPIA,and Timer 2.0 bioinformatics databases were used to analyze c-Met expression in pancreatic cancer and its correlation with survival and immune infiltration status.In clinical samples of pancreatic cancer and pancreatic cancer Aspc-1 cells,c-Met and PD-L1 expressions were detected using immunohistochemistry or flow cytometry.Using gene editing technology,PD-1 secretory antibodies and HIS tags were linked to second-generation c-Met CAR molecules to construct PD-1/c-Met CAR plasmids,which were then packaged into lentiviruses for infection of activated T cells.The positive rate and cell subset distribution of CAR-T cells were analyzed with flow cytometry,and secretory PD-1 antibodies in cell supernatants were detected using Western blotting.The target cell killing efficiency and proliferative activity of the modified CAR-T cells were evaluated after activation,and cytokine secretion was analyzed using ELISA.Results The expression of c-Met was significantly higher in pancreatic cancer than in normal tissues,and its expression level was negatively correlated with the patients'survival and positively correlated with immune cell infiltration.The clinical samples of pancreatic cancer tissues expressed significantly higher levels of c-Met and PD-L1 than the adjacent tissues,and 90.7%and 57.7%of Aspc-1 cells were positive for c-Met and PD-L1,respectively.The constructed PD-1/c-Met CAR-T cells were capable of secreting PD-1 antibodies and showed a significantly higher killing efficiency against tumor cells than c-Met CAR-T cells at an effector-to-target ratio of 20:1,with also a higher proliferative activity after target cell stimulation and higher levels of IL-2 and TNF-α secretin.Conclusion PD-1/c-Met CAR-T cells have higher killing efficiency against pancreatic cancer cells with also higher proliferative activity than c-Met CAR-T cells.

Objective: To investigate the association of parental knowledge and skills in myopia prevention and control with healthy eye behavior in primary school children, so as to provide a basis for accurate family education. Methods: A total of 4 979 students in grades 1-5 from eight elementary schools in Pudong New Area were sampled between October and December in 2022 by using a stratified cluster sampling method. A self administered questionnaire was used to assess healthy eye behavior in primary school children and parental knowledge and skills in myopia prevention and control. The Chi squared test, independent samples t-test and Logistic regression were used to analyse the association between parental knowledge and skills in myopia prevention and control and healthy eye behaviour in primary school children. Results: Parents of primary school children with a high level of knowledge and skills in myopia prevention and control were 50.97% and 56.36%, respectively. The knowlegde entry scores for parents of lower and middle elementary school students were higher than those of parents of upper primary students with respect to their understanding, on the main causes of myopia in their children, the correct knowledge of myopia prevention and control, the role of family members in helping each other to manage and treat myopia in their children and the parents responsibility to teach their children to use their eyes correctly and scientifically (3.05±1.21, 2.97±1.20; 5.92±0.68, 5.83±0.86; 4.46±0.88, 4.40±0.93; 3.88±1.04, 3.72±1.07); all differences were statistically significant (t=2.04, 3.39, 2.00, 4.87, P<0.05). The differences in the scores of parents of primary school children in different grades for all items were statistically significant (t=2.93-7.31, P<0.05) in the skill entries. Parental knowledge levels were poor for items of full scores that assessed the following: knowing the main causes of their childrens myopia, awareness of the correct knowledge of myopia prevention and control measures, awareness of Comprehensive Prevention and Control Strategy for Children and Adolescents with Myopia, and concerning that their childrens future education and employment will be affected by myopia, understanding the responsibility of parents for guiding children to use their eyes scientifically and correctly, with 12.71%, 22.90%, 19.30%, 21.83% and 22.47% respectively. Parental skills were poor for items of full scores that assessed the following:reminding their children to rest their eyes when doing homework, reading or writing, deliberately avoiding mobile phone use when spending time with their children, the number of times which taking children to the hospital for refractive screening in the past year, and giving their children extra learning tasks, with 33.26%, 15.12%, 9.00% and 5.36% respectively. Compared to parental knowledge in myopia prevention and control, parental skills had a more pronounced effect on the four dimensions of healthy eye behavior (reading and writing, screen time, outdoor activities, and sleep duration) among students in different grades (OR=1.41-3.37, P<0.05). Conclusions Parental knowledge and skills in myopia prevention and control are still insafficient, associated with healthy eye behavior in primary school children. There is a need to strengthen accurate health education for parents on the prevention and control of myopia, to cultivate healthy eye behaviour among primary school students and reduce the incidence of myopia among them.

BackgroundVestibular neuritis is a common clinical acute peripheral vertigo disorder. Some patients may experience negative emotions states， leading to chronic exacerbation of vestibular neuritis and a poorer prognosis. Further research is needed to understand the psychological state of patients with vestibular neuritis and its influencing factors. ObjectiveTo explore the relationship between depressive symptoms and vestibular symptoms in patients with vestibular neuritis and its influencing factors， so as to provide references for clinical intervention. MethodsA total of 86 patients with vestibular neuritis， hospitalized in the Department of Neurology of the Third Hospital of Mianyang from June 2021 to June 2023， were included in the study. Assessments were conducted using the Hamilton Depression Scale-17 item （HAMD-17）， Dizziness Assessment Rating Scale （DARS） and Dizziness Handicap Inventory （DHI）. Patients were divided into depression group（n=46） and non-depression group（n=40） based on HAMD-17 score. Pearson correlation analysis was used to examine the correlation among each scale score. Binary Logistic regression was used to identify influencing factors for depressive symptoms. ResultsAmong the 86 patients， 46 （53.49%） exhibited depressive symptoms. Statistically significant differences were observed between depression group and non-depression group in terms of age， disease duration， years of education， DARS score and DHI score （t=4.512， 4.921， 2.712， 3.529， 5.471， P<0.01 ）. In depression group， HAMD-17 score was positively correlated with DARS score and DHI score （r=0.345， 0.335， P<0.01）. Binary Logistic regression analysis showed that age （OR=4.352， 95% CI： 1.520~12.462）， disease duration（OR=3.772， 95% CI： 1.339~10.630）， years of education （OR=0.074， 95% CI： 0.235~0.923）， DARS score （OR=1.213， 95% CI： 0.405~3.628） and DHI score （OR=3.619， 95% CI： 1.246~10.514） were the influencing factors of depressive symptoms among patients with vestibular neuritis. ConclusionDepressive symptoms in patients with vestibular neuritis are positively correlated with vestibular symptoms. Risk factors for depressive symptoms in patients with vestibular neuritis include age， disease duration， DARS score and DHI score， while years of education serve as a protective factor.

Objective To construct c-Met CAR-T cells secreting PD-1 antibodies to reduce immune inhibitory effect of tumor cells and enhance the efficacy of CAR-T cell therapy against pancreatic cancer.Methods Kaplan-Meier Plotter,GEPIA,and Timer 2.0 bioinformatics databases were used to analyze c-Met expression in pancreatic cancer and its correlation with survival and immune infiltration status.In clinical samples of pancreatic cancer and pancreatic cancer Aspc-1 cells,c-Met and PD-L1 expressions were detected using immunohistochemistry or flow cytometry.Using gene editing technology,PD-1 secretory antibodies and HIS tags were linked to second-generation c-Met CAR molecules to construct PD-1/c-Met CAR plasmids,which were then packaged into lentiviruses for infection of activated T cells.The positive rate and cell subset distribution of CAR-T cells were analyzed with flow cytometry,and secretory PD-1 antibodies in cell supernatants were detected using Western blotting.The target cell killing efficiency and proliferative activity of the modified CAR-T cells were evaluated after activation,and cytokine secretion was analyzed using ELISA.Results The expression of c-Met was significantly higher in pancreatic cancer than in normal tissues,and its expression level was negatively correlated with the patients'survival and positively correlated with immune cell infiltration.The clinical samples of pancreatic cancer tissues expressed significantly higher levels of c-Met and PD-L1 than the adjacent tissues,and 90.7%and 57.7%of Aspc-1 cells were positive for c-Met and PD-L1,respectively.The constructed PD-1/c-Met CAR-T cells were capable of secreting PD-1 antibodies and showed a significantly higher killing efficiency against tumor cells than c-Met CAR-T cells at an effector-to-target ratio of 20:1,with also a higher proliferative activity after target cell stimulation and higher levels of IL-2 and TNF-α secretin.Conclusion PD-1/c-Met CAR-T cells have higher killing efficiency against pancreatic cancer cells with also higher proliferative activity than c-Met CAR-T cells.