Sonodynamic therapy (SDT) can potentially induce immunogenic cell death in tumor cells, leading to the release of ATP, and facilitating the initiation of an immune response. Nevertheless, the enzymes CD39 and CD73 can swiftly convert ATP into immunosuppressive adenosine (ADO), resulting in an immunosuppressive tumor microenvironment (TME). This study introduced a nanomedicine (QD/POM1@NP@M) engineered to reprogram TME by modulating the CD39/CD73/ADO pathway. The nanomedicine encapsulated sonosensitizers silver sulfide quantum dots, and the CD39 inhibitor POM1, while also incorporating homologous tumor cell membranes to enhance targeting capabilities. This integrated approach, on the one hand, stimulates the release of ATP via SDT, thereby initiating the immune response. In addition, it reduced the accumulation of ADO by inhibiting CD39 activity, which ameliorated the immunosuppressive TME. Upon administration, the nanomedicine demonstrated substantial anti-tumor efficacy by facilitating the infiltration of anti-tumor immune cells, while reducing the immunosuppressive cells. This modulation effectively transformed the TME from an immunologically "cold" state to a "hot" state. Furthermore, combined with the checkpoint inhibitor α-PDL1, the nanomedicine augmented systemic anti-tumor immunity and promoted the establishment of long-term immune memory. This study provides an innovative strategy for combining non-invasive SDT and ATP-driven immunotherapy, offering new ideas for future cancer treatment.

Objective To analyze the efficacy of the"sandwich"technique for treating varicocele(VC).Methods A total of 310 patients with VC(365 affected veins)were selected and divided into interventional treatment group and non-interventional treatment group.The baseline data,hospitalization data,and 6-month follow-up data of the two groups were analyzed.Results The age of patients in the interventional treatment group was significantly lower than that in the non-interventional treatment group(P＜0.05).The surgical time and hospital stay in the interventional treatment group were significantly lower than those in the non-interventional treatment group(P＜0.05).In the non-interventional treatment group,two patients experienced surgical site infections,and one patient opted for interventional treatment due to recurrence after non-interventional treatment.After surgery,the diameter of the spermatic vein significantly decreased in both the interventional and non-interventional treatment(P＜0.05).Conclusion The"sandwich"technique(embolization coil combined with foam sclerotherapy)is an effective treatment for VC.

Objective:To establish and validate a prediction model based on least absolute shrinkage and selection operator（LASSO）regression and classification and regression tree（CART）algorithm for acute kidney injury（AKI）in PICU.Methods:The prospective derivation cohort consisted of 350 critically ill children admitted to the PICU of Children′s Hospital of Soochow University from September 2020 to January 2021.The external data set consisting of 866 critically ill children admitted to the PICU of Children′s Hospital of Soochow University from February 2021 to February 2022 was employed for the external validation.Clinical data was obtained from the electronic medical record system，including demographic characteristics，laboratory data and the pediatric risk of mortality Ⅲ（PRISM Ⅲ）score.The variables associated with AKI were identified using LASSO regression.Subsequently，a decision tree prediction model was built using the CART algorithm.The predictive value of decision tree prediction model was evaluated using the receiver operating characteristic（ROC）curve，calibration curve，and decision curve analysis.Results:Among the 350 children in the derivation cohort，107（30.6%）developed AKI during the PICU stay；and of 866 children in the external validation cohort，165（19.1%）developed AKI during the PICU stay.The LASSO regression screened 16 candidate variables for further analysis，and the decision tree model ultimately identified 4 variables more closely associated with AKI，including fold change in serum creatinine from baseline，urine volume，PRISM Ⅲ，and C-reactive protein.The decision tree model exhibited high accuracy with AUC of 0.92，0.88，and 0.86 in the training，internal validation，and external validation cohorts，respectively.The model demonstrated good calibration and clinical applicability based on the calibration curve and decision curve analysis.Conclusion:The decision tree model based on the 4 identified clinical indicators，including fold change in serum creatinine from baseline，urine volume，PRISM Ⅲ，and C-reactive protein，is effective for the early prediction of AKI.

Objective:To investigate the differential expression profiles of long non-coding RNAs(LncRNAs) and messenger RNAs(mRNAs) regulated by soluble dipeptidyl peptidase-4(sDPP4) during vascular smooth muscle cell calcification, and to explore the potential underlying calcification mechanisms.Methods:DPP4 levels in blood vessels and peripheral blood of diabetic patients were measured using Western blotting(WB) and real-time quantitative PCR(RT-qPCR). A cellular calcification model was established by treating human aortic vascular smooth muscle cells(HASMCs) with sDPP4. The effects of sDPP4 on HASMCs were assessed by WB, RT-qPCR, alizarin red staining, and calcium content determination. High-throughput sequencing was performed to analyze the differential expression profiles of LncRNA and mRNA following sDPP4 treatment. Among them, LncRNA ENST00000540293, which exhibited the most pronounced downregulation and was located adjacent to the matrix metalloproteinase-1(MMP-1) gene, was selected for further investigation. The osteogenic transdifferentiation of HASMCs after silencing LncRNA ENST00000540293 was evaluated using WB, RT-qPCR, alizarin red staining, and immunofluorescence-based cytoskeletal staining.Results:DPP4 expression was significantly elevated in both blood vessels and peripheral blood of diabetic patients. sDPP4 stimulation upregulated the protein levels of osteopontin(OPN) and runt-related transcription factor 2(RUNX2) in HASMCs, enhanced alizarin red staining, and increased intracellular calcium deposition. RNA sequencing revealed significant downregulation of LncRNA ENST00000540293 following sDPP4 exposure, while GO and pathway analysis indicated a marked increase in extracellular matrix binding activity(GO: 0050840). Silencing LncRNA ENST00000540293 suppressed α-smooth muscle actin(α-SMA) expression, promoted OPN and RUNX2 expression, increased calcification as shown by positive alizarin red staining, and cytoskeletal staining demonstrated osteogenic transdifferentiation of HASMCs, accompanied by a significant rise in MMP-1 protein level.Conclusion:sDPP4 promotes osteogenic transdifferentiation of HASMCs, potentially by downregulating LncRNA ENST00000540293. MMP-1 may be a potential target regulated by LncRNA ENST00000540293.

OBJECTIVE To investigate and analyze the current situation and problems of the advanced personnel en-gaging in the hospital-acquired infection control during their training period and explore the existing countermeas-ures and future development.METHODS The literatures regarding to the advanced study in China were retrieved from databases,the subjects of the literatures covered infection control-related advanced study practice,discipline construction,position competence,talent cultivation,scientific research innovation,professional title evaluation,laws,regulations and development plans.From Aug.2024 to Nov.2024,a questionnaire survey and face-to-face interviews were conducted among 36 advanced study personnel from 9 provinces of China who engaged in hos-pital-acquired infection control in the First Medical Center of Chinese PLA General Hospital.Eventually,36 ques-tionnaires were retrieved,all of which were valid with a questionnaire recovery rate of 100.00％.RESULTS Among the 36 advanced study personnel of hospital-acquired infection control,58.33％were medium-grade professional ti-tle;preventive medicine(41.67％),clinical medicine(25.00％)and nursing(16.67％)ranked the top 3 majors.The personnel engaged in the infection control for more than 6 years,and the duration of the advanced study was generally 3 or 6 months.In reality,the personnel faced the choices in terms of the purposes of further education,learning approaches and learning contents.The advanced study personnel also encountered the problems of challenges from promotion,improvement of position competency,integration with clinical training,supervision and practice,as well as physiological,psychological and family pressure.CONCLUSION Aiming at the problems that the advanced study personnel are generally concerned about,such as how to scientifically and effectively carry out hospital-acquired infection control advanced study and preset and solve the problems that may encounter,it is necessary to formulate targeted training programmes so as to provide bases and enlightenment for establishment of a long-term mechanism for advanced study of infection control in China.

Objective:To investigate the differential expression profiles of long non-coding RNAs(LncRNAs) and messenger RNAs(mRNAs) regulated by soluble dipeptidyl peptidase-4(sDPP4) during vascular smooth muscle cell calcification, and to explore the potential underlying calcification mechanisms.Methods:DPP4 levels in blood vessels and peripheral blood of diabetic patients were measured using Western blotting(WB) and real-time quantitative PCR(RT-qPCR). A cellular calcification model was established by treating human aortic vascular smooth muscle cells(HASMCs) with sDPP4. The effects of sDPP4 on HASMCs were assessed by WB, RT-qPCR, alizarin red staining, and calcium content determination. High-throughput sequencing was performed to analyze the differential expression profiles of LncRNA and mRNA following sDPP4 treatment. Among them, LncRNA ENST00000540293, which exhibited the most pronounced downregulation and was located adjacent to the matrix metalloproteinase-1(MMP-1) gene, was selected for further investigation. The osteogenic transdifferentiation of HASMCs after silencing LncRNA ENST00000540293 was evaluated using WB, RT-qPCR, alizarin red staining, and immunofluorescence-based cytoskeletal staining.Results:DPP4 expression was significantly elevated in both blood vessels and peripheral blood of diabetic patients. sDPP4 stimulation upregulated the protein levels of osteopontin(OPN) and runt-related transcription factor 2(RUNX2) in HASMCs, enhanced alizarin red staining, and increased intracellular calcium deposition. RNA sequencing revealed significant downregulation of LncRNA ENST00000540293 following sDPP4 exposure, while GO and pathway analysis indicated a marked increase in extracellular matrix binding activity(GO: 0050840). Silencing LncRNA ENST00000540293 suppressed α-smooth muscle actin(α-SMA) expression, promoted OPN and RUNX2 expression, increased calcification as shown by positive alizarin red staining, and cytoskeletal staining demonstrated osteogenic transdifferentiation of HASMCs, accompanied by a significant rise in MMP-1 protein level.Conclusion:sDPP4 promotes osteogenic transdifferentiation of HASMCs, potentially by downregulating LncRNA ENST00000540293. MMP-1 may be a potential target regulated by LncRNA ENST00000540293.

Objective To analyze the efficacy of the"sandwich"technique for treating varicocele(VC).Methods A total of 310 patients with VC(365 affected veins)were selected and divided into interventional treatment group and non-interventional treatment group.The baseline data,hospitalization data,and 6-month follow-up data of the two groups were analyzed.Results The age of patients in the interventional treatment group was significantly lower than that in the non-interventional treatment group(P＜0.05).The surgical time and hospital stay in the interventional treatment group were significantly lower than those in the non-interventional treatment group(P＜0.05).In the non-interventional treatment group,two patients experienced surgical site infections,and one patient opted for interventional treatment due to recurrence after non-interventional treatment.After surgery,the diameter of the spermatic vein significantly decreased in both the interventional and non-interventional treatment(P＜0.05).Conclusion The"sandwich"technique(embolization coil combined with foam sclerotherapy)is an effective treatment for VC.

OBJECTIVE To investigate and analyze the current situation and problems of the advanced personnel en-gaging in the hospital-acquired infection control during their training period and explore the existing countermeas-ures and future development.METHODS The literatures regarding to the advanced study in China were retrieved from databases,the subjects of the literatures covered infection control-related advanced study practice,discipline construction,position competence,talent cultivation,scientific research innovation,professional title evaluation,laws,regulations and development plans.From Aug.2024 to Nov.2024,a questionnaire survey and face-to-face interviews were conducted among 36 advanced study personnel from 9 provinces of China who engaged in hos-pital-acquired infection control in the First Medical Center of Chinese PLA General Hospital.Eventually,36 ques-tionnaires were retrieved,all of which were valid with a questionnaire recovery rate of 100.00％.RESULTS Among the 36 advanced study personnel of hospital-acquired infection control,58.33％were medium-grade professional ti-tle;preventive medicine(41.67％),clinical medicine(25.00％)and nursing(16.67％)ranked the top 3 majors.The personnel engaged in the infection control for more than 6 years,and the duration of the advanced study was generally 3 or 6 months.In reality,the personnel faced the choices in terms of the purposes of further education,learning approaches and learning contents.The advanced study personnel also encountered the problems of challenges from promotion,improvement of position competency,integration with clinical training,supervision and practice,as well as physiological,psychological and family pressure.CONCLUSION Aiming at the problems that the advanced study personnel are generally concerned about,such as how to scientifically and effectively carry out hospital-acquired infection control advanced study and preset and solve the problems that may encounter,it is necessary to formulate targeted training programmes so as to provide bases and enlightenment for establishment of a long-term mechanism for advanced study of infection control in China.

Objective:To establish and validate a prediction model based on least absolute shrinkage and selection operator（LASSO）regression and classification and regression tree（CART）algorithm for acute kidney injury（AKI）in PICU.Methods:The prospective derivation cohort consisted of 350 critically ill children admitted to the PICU of Children′s Hospital of Soochow University from September 2020 to January 2021.The external data set consisting of 866 critically ill children admitted to the PICU of Children′s Hospital of Soochow University from February 2021 to February 2022 was employed for the external validation.Clinical data was obtained from the electronic medical record system，including demographic characteristics，laboratory data and the pediatric risk of mortality Ⅲ（PRISM Ⅲ）score.The variables associated with AKI were identified using LASSO regression.Subsequently，a decision tree prediction model was built using the CART algorithm.The predictive value of decision tree prediction model was evaluated using the receiver operating characteristic（ROC）curve，calibration curve，and decision curve analysis.Results:Among the 350 children in the derivation cohort，107（30.6%）developed AKI during the PICU stay；and of 866 children in the external validation cohort，165（19.1%）developed AKI during the PICU stay.The LASSO regression screened 16 candidate variables for further analysis，and the decision tree model ultimately identified 4 variables more closely associated with AKI，including fold change in serum creatinine from baseline，urine volume，PRISM Ⅲ，and C-reactive protein.The decision tree model exhibited high accuracy with AUC of 0.92，0.88，and 0.86 in the training，internal validation，and external validation cohorts，respectively.The model demonstrated good calibration and clinical applicability based on the calibration curve and decision curve analysis.Conclusion:The decision tree model based on the 4 identified clinical indicators，including fold change in serum creatinine from baseline，urine volume，PRISM Ⅲ，and C-reactive protein，is effective for the early prediction of AKI.

Objective To observe the effect of in situ needle fenestration thoracic endovascular aortic repair(TEVAR)for treating aortic dissection(AD)involving aortic arch.Methods Data of 16 patients with AD involving aortic arch who underwent in situ needle fenestration TEVAR for reconstruction of aortic arch branches were retrospectively analyzed,and the number of fenestration,technical success rate and TEVAR related complications were recorded.Regular follow-up was conducted after TEVAR,the repair of dissection and the patency of fenestrated branch blood vessels were evaluated,the endoleak was assessed,and the survival of patients were recorded.Results The main aortic stent was successfully implanted in all 16 cases.Among them,4 received triple fenestration stent implantation in zones Z0,Z1 and Z2,6 received double fenestration stent implantation in zones Z1 and Z2,2 received double fenestration stent implantation in zones Z0 and Z1 and 4 received single fenestration stent implantation in zone Z2.The success rate of brachiocephalic trunk(BCT)fenestration was 83.33%(5/6).Left common carotid artery(LCCA)-right common carotid artery bypass was performed in 1 case without successful fenestration.The success rate of LCCA fenestration was 100%(12/12).The success rate of left subclavian artery(LSA)fenestration was 87.50%(14/16),2 cases with not successful fenestration were treated with axillar-axillary artery artificial vascular bypass.The technical success rate of intervention was 100%(16/16).Type Ⅰa endoleak occurred in 1 case during TEVAR process and improved after embolization with spring coil.One patient died of pericardial tamponade at the end of TEVAR.Fifteen patients were followed up for a median follow-up time of 20 months.During this period,transient ischemic attack and local small dissection at the proximal beginning of the main stent occurred each in 1 case,which improved after no special treatment.Type Ⅰ endoleak occurred in 1 case,type Ⅲ endoleak occurred in 2 cases,all improved after proximal fenestrated membrane stent implantation or spring coil embolization treatment.One case died of coronary heart disease.Conclusion In situ needle fenestration TEVAR was effective and safe for treating AD involving aortic arch.