γδ T cells possess both innate and adaptive immune characteristics. Their antigen recognition is independent of major histocompatibility complex presentation， and they can directly recognize abnormal tumor metabolism， showing unique application potential in tumors with low immune infiltration. This paper systematically sorts out the biological characteristics and antitumor immune functions of γδ T cells， and mainly reviews the relevant mechanisms by which active ingredients of traditional Chinese medicine regulate γδ T cells to exert antitumor immune functions. Glycyrrhiza polysaccharide and Astragalus polysaccharide can enhance the antitumor immune function of γδ T cells by promoting the expression of various cytokines， regulating intestinal flora and alleviating immunosuppressive state. Quercetin and puerarin can strengthen γδ T cell-mediated tumor cell killing by regulating the proliferation of γδ T cells， the expression of cytotoxic effector molecules and related signaling pathways. Toosendanin can potentiate γδ T cell-induced tumor cell killing by down-regulating the expression of anti-apoptotic protein in tumor cells. Artesunate can boost γδ T cell-mediated antitumor immune responses by enhancing the effector function of γδ T cells and weakening tumor immune escape. Future research shall focus on exploring the synergistic effects and molecular mechanisms of the combined application of active ingredients of traditional Chinese medicine and γδ T cell immunotherapy， and identifying the key targets for γδ T cells to exert antitumor immune functions.

γδ T cells possess both innate and adaptive immune characteristics. Their antigen recognition is independent of major histocompatibility complex presentation， and they can directly recognize abnormal tumor metabolism， showing unique application potential in tumors with low immune infiltration. This paper systematically sorts out the biological characteristics and antitumor immune functions of γδ T cells， and mainly reviews the relevant mechanisms by which active ingredients of traditional Chinese medicine regulate γδ T cells to exert antitumor immune functions. Glycyrrhiza polysaccharide and Astragalus polysaccharide can enhance the antitumor immune function of γδ T cells by promoting the expression of various cytokines， regulating intestinal flora and alleviating immunosuppressive state. Quercetin and puerarin can strengthen γδ T cell-mediated tumor cell killing by regulating the proliferation of γδ T cells， the expression of cytotoxic effector molecules and related signaling pathways. Toosendanin can potentiate γδ T cell-induced tumor cell killing by down-regulating the expression of anti-apoptotic protein in tumor cells. Artesunate can boost γδ T cell-mediated antitumor immune responses by enhancing the effector function of γδ T cells and weakening tumor immune escape. Future research shall focus on exploring the synergistic effects and molecular mechanisms of the combined application of active ingredients of traditional Chinese medicine and γδ T cell immunotherapy， and identifying the key targets for γδ T cells to exert antitumor immune functions.

Objective This study applies Roy adaptation theory to deeply explore the experience of food avoid-ance behavior in patients with inflammatory bowel disease(IBD),offering insights for developing dietary management strategies.Methods A descriptive qualitative research method was employed.By purposive sampling,24 IBD pa-tients hospitalized in the gastroenterology department of a tertiary hospital in Nanjing from July 2022 to December 2024 were selected for semi-structured interviews.Data were analyzed using a directed content analysis approach.Results This study identified 4 main themes and 11 sub-themes,encompassing overattribution leading to inappro-priate avoidance(recurrent symptoms triggering overattribution,disease staging triggering inappropriate avoidance),negative self-perception leading management struggles(illness fear diminishing self-efficacy,disease trauma eroding self-identity,knowledge deficiency constraining self-determination),functional impairment intensifying role challenges(role internalization undermining social function,social roles relinquishing dietary management),and external con-straints amplifying practical difficulties(family and friend oversight heightening dietary stress,healthcare gaps foster-ing practical helplessness,traditional beliefs restricting dietary exploration,economic hardship limiting balanced nu-trition).Conclusion The interplay of overattribution,negative self-perception,functional impairment,and external constraints in IBD patients hinders their ability to adapt to disease fluctuations,ensnaring them in the adaptive predicament of food avoidance behavior.Healthcare professionals should comprehensively address these factors by fostering accurate perceptions,enhancing psychological support,guiding effective coping strategies,and optimizing ex-ternal resources,thereby improving patients' overall adaptive capacity and promoting their recovery.

Objective This study applies Roy adaptation theory to deeply explore the experience of food avoid-ance behavior in patients with inflammatory bowel disease(IBD),offering insights for developing dietary management strategies.Methods A descriptive qualitative research method was employed.By purposive sampling,24 IBD pa-tients hospitalized in the gastroenterology department of a tertiary hospital in Nanjing from July 2022 to December 2024 were selected for semi-structured interviews.Data were analyzed using a directed content analysis approach.Results This study identified 4 main themes and 11 sub-themes,encompassing overattribution leading to inappro-priate avoidance(recurrent symptoms triggering overattribution,disease staging triggering inappropriate avoidance),negative self-perception leading management struggles(illness fear diminishing self-efficacy,disease trauma eroding self-identity,knowledge deficiency constraining self-determination),functional impairment intensifying role challenges(role internalization undermining social function,social roles relinquishing dietary management),and external con-straints amplifying practical difficulties(family and friend oversight heightening dietary stress,healthcare gaps foster-ing practical helplessness,traditional beliefs restricting dietary exploration,economic hardship limiting balanced nu-trition).Conclusion The interplay of overattribution,negative self-perception,functional impairment,and external constraints in IBD patients hinders their ability to adapt to disease fluctuations,ensnaring them in the adaptive predicament of food avoidance behavior.Healthcare professionals should comprehensively address these factors by fostering accurate perceptions,enhancing psychological support,guiding effective coping strategies,and optimizing ex-ternal resources,thereby improving patients' overall adaptive capacity and promoting their recovery.

Objective:To evaluate the prognosis of patients with primary thyroid malignant lymphoma (PTL) treated with total thyroidectomy alone or in combination with R-CHOP chemotherapy, and analyze the factors influencing their prognosis.Methods:A retrospective analysis was conducted on 62 patients with PTL admitted to the Hematology Department of Shanxi Provincial Cancer Hospital from Jan. 2009 to Jan. 2020. The patients were with an average age of (63.51±9.83) years, with 20 males and 42 females. According to Ann Arbor staging and patients' wishes, 10 cases received simple thyroidectomy, 47 cases received total thyroidectomy +R-CHOP, and 5 cases received total thyroidectomy +R-CHOP+ radiotherapy. After 3 months of treatment, the short-term curative effect was collected. According to the prognosis of patients after 24 months of follow-up, the dead cases were classified into bad group and the surviving cases into good group. Single factor and LASSO regression dimensionality reduction were used to screen the influencing factors, and Logistic regression analysis was used to analyze the influencing factors of PTL prognosis.Results:Among 62 patients with PTL, 21 (33.87%) had complete response (CR), 27 (43.55%) had partial response (PR), 9 (14.52%) had stable disease (SD), and 5 (8.06%) had progressive disease (PD). After a follow-up of 24 months, the mortality rate among 10 patients who underwent surgical treatment alone was 90% (9/10), the mortality rate among those who underwent surgical treatment combined with R-CHOP therapy was 19.15% (9/47) ,18 deaths were categorized as having a poor prognosis, while 44 survivors were classified as having a favorable prognosis.Univariate, LASSO regression screening, and Logistic regression analysis showed that Ann Arbor staging ( OR=5.105), pathological type ( OR=3.622), international prognostic index (IPI) score ( OR=2.709), treatment method ( OR=0.730), hemoglobin ( OR=0.392), and lactate dehydrogenase (LDH) ( OR=6.469) were factors affecting the prognosis of PTL (all P<0.05) . Conclusions:The combined use of total resection and R-CHOP treatment for patients has a superior prognosis compared to patients undergoing total resection alone. Furthermore, the prognosis of patients is also influenced by factors such as Ann Arbor staging and IPI scoring. Based on this, clinical care plans can be refined to improve the prognosis.

Objective To analyze the characteristics of conventional ultrasound and contrast-enhanced ultrasound(CEUS)in hypovascular renal tumors,and to explore the application value of combining the 2 methods in diagnosing benign and malignant hypovascular renal tumors.Methods The conventional ultrasound and CEUS data of 104 hypovascular renal tumors(76 benign lesions[benign group]and 28 malignant lesions[malignant group])from 99 patients,who were confirmed by postoperative pathology,biopsy pathology or computed tomography(CT)/magnetic resonance imaging(MRI)enhancement combined with long-term follow-up in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine and its Wuxi Branch from Oct.13,2009 to Oct.26,2022,were retrospectively analyzed.The location,size,internal echo,morphology,internal and peripheral blood supply of the lesions were observed by conventional ultrasound,and the perfusion mode,regression pattern,perfusion uniformity and ring enhancement signs were observed by CEUS.Taking the pathological results or confirmed results of CT/MRI enhancement combined with long-term follow-up as the gold standard,the value of conventional ultrasound combined with CEUS in the differential diagnosis of benign and malignant hypovascular renal tumors was analyzed.Results There were significant differences in gender,age of patients and internal echo,contrast agent regression and ring enhancement signs of lesions between the 2 groups(all P＜0.05).The malignant tumors were mostly found in males(78.6％,22/28)with an average age of(58.29±11.76)years old;the masses were mostly hypoechoic(64.3％,18/28),and rapid washout was predominant with CEUS(60.7％,17/28).In the benign group,most of the patients were female(55.3％,42/76),with an average age of(50.64±14.88)years old;the majority of the masses were hyperechoic(64.5％,49/76),and CEUS showed simultaneous washout as the main lesion(56.6％,43/76).Three patients(10.7％,3/28)with ring enhancement signs were all malignant.The diagnostic accuracy(82.7％)and specificity(88.2％)for benign and malignant hypovascular renal tumors were relatively high when combining the diagnostic indicators of ring enhancement signs and hypoechoic.The diagnostic sensitivity(85.7％)and negative predictive value(92.3％)were relatively high when combining the 3 diagnostic indicators of ring enhancement,hypoechoic,and rapid washout.Conclusion Conventional ultrasound combined with CEUS has significant clinical practical value in the differential diagnosis of benign and malignant hypovascular renal tumors.The ring enhancement sign is highly specific in the diagnosis of malignant hypovascular renal tumors.However,if this sign is not significant and conventional ultrasound shows hypoechoic or CEUS exhibits rapid washout,there is a strong suggestion that the mass may be a malignant lesion.

Objective To explore the potential categories and influencing factors of the fear of progression in patients with inflammatory bowel diseases(IBD).Methods IBD patients who received inpatient treatment in a tertiary hospital in Nanjing from July 2022 to July 2023 were selected as the study subjects by convenience sampling method.The General Demographic Information Questionnaire,the Chinese version of the Fear of Progression Questionnaire-Short Form(FoP-Q-SF),the Chinese version of Inflammatory Bowel Disease Self-efficacy Scale(IBD-SES),and Social Support Rating Scale(SSRS)were administered to the participants.We applied one-way ANOVA and Logistic regression analysis to identify the factors associated with the potential categories of the fear of progression.Results A total of 303 retumed questionnaires(out of the 310)were valid,resulting an effective response rate of 97.74％.According to the results of latent profile analysis,we classified the respondents into 3 categories by the fear of progression,namely"low risk fear of disease adaptation group"(n=127,41.91％),"medium risk fear of illness distress group"(n=139,45.88％),"high risk fear of dysfunction group"(n=37,12.21％).3 groups showed statistically significant differences in permanent address,self-rated financial pressure,current disease status and self-efficacy(P＜0.05).Conclusion Patients with IBD had obvious differences in characteristics on the fear of progression.Nursing personnel should formulate personalized intervention strategies based on the classification characteristics of the fear of progression of IBD patients.Moreover,nurses should focus on improving patients'self-efficacy and promoting patients to treat medical care,stress and emotion management correctly.

S-adenosyl-l-methionine (SAM) is ubiquitous in living organisms and plays important roles in transmethylation, transsulfuration and transamination in organisms. Due to its important physiological functions, production of SAM has attracted increasing attentions. Currently, researches on SAM production mainly focus on microbial fermentation, which is more cost-effective than that of the chemical synthesis and the enzyme catalysis, thus easier to achieve commercial production. With the rapid growth in SAM demand, interests in improving SAM production by developing SAM hyper-producing microorganisms aroused. The main strategies for improving SAM productivity of microorganisms include conventional breeding and metabolic engineering. This review summarizes the recent research progress in improving microbial SAM productivity to facilitate further improving SAM productivity. The bottlenecks in SAM biosynthesis and the solutions were also addressed.
S-Adenosylmethionine/metabolism* ; Plant Breeding ; Fermentation ; Metabolic Engineering

Objective To investigate the clinical value of contrast-enhanced ultrasound(CEUS)in differential diagnosis between benign and malignant gallbladder lesions which diameter more than 1 cm.Methods A retrospective analysis included CEUS data of 142 cases with gallbladder lesions diameter more than 1 cm.All lesions were confirmed by surgical pathology,enhanced CT/MRI or clinical diagnosis with following up more than 2 years.To summarize the CEUS characteristics of benign and malignant gallbladder lesions over 1 cm in diameter,the CEUS characteristics of benign and malignant gallbladder lesions diameter more than 1 cm were analyzed,referring to the gallbladder CEUS guidelines.The contrast medium washout before 35 s and 60 s were used as the combined diagnosis with CEUS standard to identify gallbladder cancer,and the diagnostic efficiency was calculated respectively.Results There were statistical differences between the malignant group and the benign group in terms of CEUS enhancement pattern,contrast arrival time,washout time,and gallbladder wall continuity,as well as enhancement levels(P<0.001).The sensitivity,specificity,accuracy in the diagnosis of gallbladder malignant lesions were 93.0%,83.8%,and 86.6%based on CEUS standard.The sensitivity,specificity and accuracy of diagnosis gallbladder malignant lesions were increased to 93.0%,92.9%and 93.0%when combined with washout before 35 s of contrast medium.Conclusions CEUS is highly valuable in differentiating benign and malignant gallbladder lesions diameter more than 1 cm.Combined with contrast medium washout before 35 s is helpful to improve the ability of differentiating benign and malignant gallbladder lesions.

Objective:To investigate the predictive efficacy of the established prognostic nomogram of rituximab in treatment of diffuse large B-cell lymphoma (DLBCL) patients with bone marrow infiltration.Methods:The clinicopathological data of 71 DLBCL patients with bone marrow infiltration who received first-line treatment with rituximab between January 2014 and June 2016 in Shanxi Province Cancer Hospital were retrospectively analyzed. Progression-free survival (PFS) analysis was performed by using Kaplan-Meier method, and influencing factors of PFS were analyzed by using univariate and multivariate Cox proportional hazards models. The nomogram was drawn with R software based on independent influencing factors of PFS from Cox regression analysis. Receiver operating characteristic (ROC) curve was applied to evaluate the effects of nomogram models predicting the PFS of patients; Bootstrap method was used for internal validation of the model. A nomogram calibration curve was plotted to compare the consistency between the nomogram model prediction and the actual PFS.Results:The median follow-up time of all patients was 48 months (12-84 months), and the 3-year and 5-year PFS rates were 39.44% and 26.76%, respectively. Age > 60 years ( HR = 1.593, 95% CI 1.379-1.840, P < 0.001), Ann-Arbor staging Ⅲ-Ⅳ ( HR = 1.444, 95% CI 1.092-1.910, P = 0.010), international prognostic index (IPI) score 3-5 ( HR = 1.648, 95% CI 1.249-2.333, P < 0.001), complicated with type 2 diabetes ( HR = 5.880, 95% CI 1.645-21.023, P = 0.006) were independent influencing factors of PFS in DLBCL patients with bone marrow infiltration. The independent influencing factors of PFS were included to establish the prognostic nomogram model. Bootstrap method internal validation showed that the consistency index of the prediction model was 0.71 (95% CI 0.69-0.78), and the ROC curve showed that the area under the curve (AUC) of 3-year PFS predicted by nomogram model was 0.708, 5-year PFS predicted by nomogram model was 0.716, indicating that nomogram model had a good degree of differentiation; and the calibration curve results showed that the 3-year and 5-year PFS rates predicted by nomogram model had a good consistency with the actual 3-year and 5-year PFS rates. Conclusions:The nomogram model constructed by age, Ann-Arbor staging, IPI score, complicated with or without type 2 diabetes could be used to predict the prognosis of DLBCL patients with bone marrow infiltration treated with rituximab, which is helpful for clinicians to implement treatment strategies.