The NKG2D receptor-ligand axis is a major pathway through which natural killer (NK) cells and subsets of effector T cells recognize stressed or malignant cells; thus, it plays an important role in immune surveillance, immune evasion and therapeutic responses in solid tumors. During tumor initiation and progression, however, tumor cells can reduce the density of membrane-bound ligands through epigenetic silencing, protease-mediated ligand shedding, and exosome release, and the tumor microenvironment further induces downregulation of the receptor on effector cells. These processes collectively disrupt the function of the NKG2D axis and promote tumor immune evasion. In recent years, translational efforts targeting these barriers have mainly included NKG2D ligand-targeting agents, NKG2D-engineered cell therapies, and NKG2D-related NK cell engagers, which act at different levels, including ligand stabilization, restoration of effector-cell cytotoxicity, and recruitment and activation of endogenous effector cells. Current developments indicate a trend toward stratified and combinational application on the basis of ligand status, effector-cell function, and microenvironmental features. This review summarizes the immune evasion mechanisms of NKG2D axis-mediated immune evasion in solid tumors and the recent progress in its therapeutic translation, with particular focus on comparing the major advantages and limitations of different treatment strategies and discussing key issues in their clinical translation.

Objective:To analyze the clinical characteristics and related factors of cognition disorders in elderly hypertensive patients.Methods:It was a cross-sectional study. A total of 612 hypertensive patients with the age of (69.06±6.58) years (median 68.00 years) admitted in the Department of Cardiology, General Hospital of Chinese People′s Liberation Army from October 2022 to April 2024 were enrolled. The demographic and clinical data were collected, the cognition status was assessed with Mini-Mental State Examination (MMSE) at admission. The related factors of cognition disorders were analyzed with univariate and multivariate logistic regression.Results:The results showed that female hypertensive patients and those with older age, lower education, higher fasting blood glucose (FBG) and diabetes mellitus, higher low-density lipoprotein cholesterol (LDL-C) level, higher systolic blood pressure (SBP) and more cardiovascular comorbidities were likely to have cognition disorders (all P<0.05). Multivariate logistic regression analysis showed that smoking history, elevated SBP, elevated heart rate, elevated FBG, and elevated LDL-C were independent risk factors for cognition disorders in elderly hypertensive patients,while higher education level was an independent protective factor (all P<0.05). Conclusion:Smoking, increased SBP, increased heart rate, increased FBG, increased LDL-C and lower education level are independently associated with cognition disorders in elderly hypertensive patients.

Objective:To analyze the clinical characteristics and related factors of cognition disorders in elderly hypertensive patients.Methods:It was a cross-sectional study. A total of 612 hypertensive patients with the age of (69.06±6.58) years (median 68.00 years) admitted in the Department of Cardiology, General Hospital of Chinese People′s Liberation Army from October 2022 to April 2024 were enrolled. The demographic and clinical data were collected, the cognition status was assessed with Mini-Mental State Examination (MMSE) at admission. The related factors of cognition disorders were analyzed with univariate and multivariate logistic regression.Results:The results showed that female hypertensive patients and those with older age, lower education, higher fasting blood glucose (FBG) and diabetes mellitus, higher low-density lipoprotein cholesterol (LDL-C) level, higher systolic blood pressure (SBP) and more cardiovascular comorbidities were likely to have cognition disorders (all P<0.05). Multivariate logistic regression analysis showed that smoking history, elevated SBP, elevated heart rate, elevated FBG, and elevated LDL-C were independent risk factors for cognition disorders in elderly hypertensive patients,while higher education level was an independent protective factor (all P<0.05). Conclusion:Smoking, increased SBP, increased heart rate, increased FBG, increased LDL-C and lower education level are independently associated with cognition disorders in elderly hypertensive patients.

[摘 要] 目的：评价肿瘤特异性个体化多靶点树突状细胞-细胞因子诱导的杀伤细胞（DC-CIK）治疗晚期非小细胞肺癌（NSCLC）患者的临床疗效和安全性。方法：回顾性分析2019年10月1日至2022年10月31日东部战区总医院生物治疗科行肿瘤特异性个体化多靶点DC-CIK治疗晚期NSCLC患者的临床资料。统计NSCLC患者的临床疗效和不良反应，分析治疗前后血清中肿瘤标志物的变化，FCM检测患者治疗前后的淋巴细胞亚群和各种细胞因子的表达情况，用质谱仪检测治疗前后靶点的变化。结果: 共入组52例晚期NSCLC患者，其中女性21例、男性31例；年龄32~71岁，平均年龄（50.97±10.72）岁，中位年龄47.5岁。经DC-CIK治疗后，CR 0例，PR 0例，SD 27例，PD 25例。与治疗前比较，DC-CIK治疗后：（1）CEA和CYFRA21-1水平无显著改变，CA125水平显著低于治疗前（P<0.01）；（2）治疗后患者淋巴细胞亚群无显著变化；（3）治疗后患者外周血IL-2、IL-4、IFN-γ和TNF-α水平显著升高（均P<0.01），IL-6、IL-10及IL-17水平无明显变化；（4）治疗后靶点数下降明显。DC-CIK治疗过程中无严重不良反应发生。结论: 晚期NSCLC患者行肿瘤特异性个体化多靶点自体DC-CIK治疗是安全的，能使患者产生抗肿瘤免疫反应并得到一定的临床获益。

Objective:To discuss the advantages and importance of endoscope assisted type Ⅱ and type Ⅲ biplane technique in axillary augmentation mammoplasty, and to summarize the operation points and improvement.Methods:There were 49 patients enrolled in our study. After the posterior space of pectoralis major was formed and the pectoralis major was severed above the lower breast fold, the breast tissue above the broken end of pectoralis major was released and separated from pectoralis major by a self-made reverse stripper to form type Ⅱ and type Ⅲ biplane.Results:All the patients were followed up for 13-24 months. All cases got ideal breast shape and feeling, especially the plumpness of the lower breast pole. There was no capsular contracture, hematoma, infection and other complications. The breast with lower pole narrowing and/or sagging was basically corrected.Conclusions:The application of self-made reverse pectoralis major stripper can change the mechanical direction of the operation, easily separate and release the front of pectoralis major muscle, and form the exact type Ⅱ biplane, or even type Ⅲ biplane breast augmentation effect. It can further improve the stretching of the lower breast fullness, increase the fullness of the breast curve, and achieve the breast effect of aesthetic.

ObjectiveTo determine the complications of hypertension among local residents in Minhang district of Shanghai， and provide scientific evidence for key preventive intervention. MethodsWe retrieved the data from the electronic health records， in which hypertensive patients were included for community-based management， in Minhang district of Shanghai from January 1st， 2014 to December 31st， 2018. A total of 38 599 hypertensive patients who had not had hypertension related clinical symptom when included in the electronic health records were enrolled in our study. Chi-square test and Cochran-Mantel-Haenszel test were used to determine the complications of hypertension. ResultsThe incidence proportion of complications was 10.77%， of which cerebrovascular damage was the highest （7.44%）， followed by cardiac damage （3.55%） and peripheral vascular damage （0.81%）. The incidence proportions in patients aged 18‒59， 60‒69， 70 and above were 5.53%， 9.61% and 16.19%， respectively. There was significant difference in the incidence proportions of complications among age groups （χ²=668.670， P<0.05）. Cochran-Mantel-Haenszel test showed that in the hypertensive patients aged 60‒69， the incidence proportion of complications in females was lower than that in males （χ²=5.937， P<0.05）. However， in those aged above 70， the incidence proportion of complications in females was higher than that in males （χ²=11.619， P<0.05）. ConclusionIn patients with hypertension， the incidence proportions of cardiovascular and cerebrovascular diseases remains relatively high in Minhang district of Shanghai. Additionally， both age and gender have influence on the incidence of complications.

Objective:To evaluate the comprehensive strength of the specialties included in the medical service capacity improvement project of Henan provincial medical and health institutions, analyze the influencing factors, and provide scientific basis for the specialty construction.Methods:A total of 52 specialties were included in the project. According to the content of construction assessment and acceptance, the questionnaire was designed and filled in by the persons in charge of the specialties from the aspects of basic conditions, medical technical team, medical service ability, medical quality, scientific research and teaching ability. TOPSIS method was used to evaluate the comprehensive strength of specialty, and the main influencing factors were analyzed by single factor analysis, Mann-Whitney U test, correlation analysis and multiple stepwise regression analysis. Results:The research and teaching ability of the specialties had the strongest correlation with the comprehensive strength of the specialties. The scientific research and teaching ability was strongly related to the medical service ability. The number of people holding the post of academic institutes at or above provincial level, the number of industry standards or national guidelines, the number of academic conferences hosted at or above the provincial level, the number of postgraduate training, the number of papers published in SCI and core journals were the main influencing factors of scientific research and teaching ability.Conclusions:It is necessary to improve the level of scientific research and teaching in key specialty to promote the improvement of medical service ability. We should pay more attention to the construction of high-level talents, the cultivation of research-oriented talents, the application of new medical technology and original research.

Molecular markers are research hotspot in the field of malignant tumor research, and have important clinical significance for early diagnosis, prognosis monitoring and treatment of tumors. The precise treatment of individualized patients through molecular diagnosis has gradually become the consensus of clinical treatment of tumors. This article introduces the research progress of molecular diagnostic techniques in lung cancer.

Objective: To investigate the safety of argatroban in vertebral artery stenting and its effect on postoperative restenosis. Methods: From January 2013 to September 2017, patients undergoing vertebral artery stenting in the Department of Neurology, Jinling Hospital were enrolled prospectively. They were divided into agatraban group and heparin group by random number table method. The argatroban group received argatroban anticoagulation during the procedure, and was continuously used for 5 d after procedure; while the heparin group underwent heparin anticoagulation during the procedure, and used saline as placebo after procedure. Clinical follow-up was performed at 1, 3, and 6 months after procedure. Digital subtraction angiography, CT angiography, or magnetic resonance angiography were performed at 6 months to evaluate the restenosis of the treated blood vessels. The primary endpoints included intraoperative safety, in-stent restenosis after procedure, and any clinical events that occurred during the follow-up period, including stroke, cardiovascular events, and death. Major safety events included bleeding from various organs, allergic reactions, liver dysfunction, and embolism events. Kaplan-Meier survival curve was used to evaluate the incidence of vascular events during the follow-up period. Results: A total of 105 patients were enrolled in the analysis, including 53 in the argatroban group and 52 in the heparin group. During the periprocedural period, no hemorrhagic events, allergic reactions, liver dysfunction or embolism events occurred in both groups. There were no significant differences in preoperative vertebral artery stenosis degree, postoperative residual stenosis degree, and stenosis degree at 6 months after procedure between the two groups, but the increase of stent stenosis at 6 months after procedure in the agatroban group was significantly lower than that in the heparin group (13.56%±26.41% vs. 4.25%±15.76%; P=0.031). There was no significant difference in the incidence of stroke recurrence (P=1.000) and clinical events (P=0.739) between the two groups during the long-term follow-up period. Conclusions It is safe to use agatraban anticoagulant therapy in the vertebral artery stenting. Continuous use of agatraban anticoagulation after procedure may effectively reduce the increase of stent stenosis at 6 months after procedure.

Objective?To explore the safety of hydrophilic fiber containing silver dressings used on the wound of the patient with pressure sore. Methods?From January 2014 to January 2017, 60 elderly patients with pressure sore from inpatient and outpatient of Geriatrics Department of Shenzhen People's Hospital were selected as the research object. They were divided randomly into control group and experimental group, 30 patients for each group. Patients in the experimental group used hydrophilic fiber containing silver dressings on half of the area of the wound. Patients in the control group used hydrophilic fiber containing silver dressings on the whole area of the wound. All the treatment lasted for 4 weeks. Silver concentration of serum, serum creatinine and alanine aminotransferase value were detected in two groups of patients. Data were analyzed by SPSS 17.0 statistical software. Results?After the use of hydrophilic fibers containing silver dressing, the silver concentration of serum in the two groups increased, the value reached a peak in the third week and a downtrend in the fourth week; There were no significant differences in silver concentration of serum between the two groups in the first 3 weeks (P＞ 0.05), but the difference was statistically significant only in the fourth week (P＜ 0.05). There were no significant differences between the serum creatinine and alanine transaminase in the two groups (P＞0.05). Conclusions?The usage of hydrophilic fibers containing silver dressing cannot directly affect serum creatinine and alanine transaminase within four weeks.