Lung cancer is the most common malignant tumor worldwide, ranking first in both incidence and mortality rates. According to the latest statistics from the International Agency for Research on Cancer (IARC), approximately 2.5 million new cases and around 1.8 million deaths from lung cancer occurred in 2022, placing a tremendous burden on global healthcare systems. The high mortality rate of lung cancer is closely linked to its subtle early symptoms, which often lead to diagnosis at advanced stages. This not only complicates treatment but also results in substantial economic losses. Current treatment options for lung cancer include surgery, radiotherapy, chemotherapy, targeted drug therapy, and immunotherapy. Among these, immunotherapy has emerged as the most groundbreaking advancement in recent years, owing to its unique antitumor mechanisms and impressive clinical benefits. Unlike traditional therapies such as radiotherapy and chemotherapy, immunotherapy activates or enhances the patient’s immune system to recognize and eliminate tumor cells. It offers advantages such as more durable therapeutic effects and relatively fewer toxic side effects. The main approaches to lung cancer immunotherapy include immune checkpoint inhibitors, tumor-specific antigen-targeted therapies, adoptive cell therapies, cancer vaccines, and oncolytic virus therapies. Among these, immune checkpoint inhibitors and tumor-specific antigen-targeted therapies have received approval from the U.S. Food and Drug Administration (FDA) for clinical use in lung cancer, significantly improving outcomes for patients with advanced non-small cell lung cancer. Although other immunotherapy strategies are still in clinical trials, they show great potential in improving treatment precision and efficacy. This article systematically reviews the latest research progress in lung cancer immunotherapy, including the development of novel immune checkpoint molecules, optimization of treatment strategies, identification of predictive biomarkers, and findings from recent clinical trials. It also discusses the current challenges in the field and outlines future directions, such as the development of next-generation immunotherapeutic agents, exploration of more effective combination regimens, and the establishment of precise efficacy prediction systems. The aim is to provide a valuable reference for the continued advancement of lung cancer immunotherapy.

Objective To explore the clinical value of artificial intelligence (AI) quantitative parameters in distinguishing pathological grades of stageⅠ invasive adenocarcinoma (IAC). Methods Clinical data of patients with clinical stageⅠ IAC admitted to Yantaishan Hospital Affiliated to Binzhou Medical University from October 2018 to May 2023 were retrospectively analyzed. Based on the 2021 WHO pathological grading criteria for lung adenocarcinoma, IAC was divided into gradeⅠ, grade Ⅱ, and grade Ⅲ. The differences in parameters among the groups were compared, and logistic regression analysis was used to evaluate the predictive efficacy of AI quantitative parameters for grade Ⅲ IAC patients. Parameters were screened using least absolute shrinkage and selection operator (LASSO) regression analysis. Three machine learning models were constructed based on these parameters to predict grade Ⅲ IAC and were internally validated to assess their efficacy. Nomograms were used for visualization. Results A total of 261 IAC patients were included, including 101 males and 160 females, with an average age of 27-88 (61.96±9.17) years. Six patients had dual primary lesions, and different lesions from the same patient were analyzed as independent samples. There were 48 patients of gradeⅠ IAC, 89 patients of grade Ⅱ IAC, and 130 patients of grade Ⅲ IAC. There were statitical differences in the AI quantitive parameters such as consolidation/tumor ratio (CTR), ect among the three goups. (P<0.05). Univariate analysis showed that the differences in all variables except age were statistically significant (P<0.05) between the group gradeⅠ+grade Ⅱand the group grade Ⅲ . Multivariate analysis suggested that CTR and CT standard deviation were independent risk factors for identifying grade Ⅲ IAC, and the two were negatively correlated. Grade Ⅲ IAC exhibited advanced TNM staging, more pathological high-risk factors, higher lymph node metastasis rate, and higher proportion of advanced structure. CTR was positively correlated with the proportion of advanced structures in all patients. This correlation was also observed in grade Ⅲ but not in gradeⅠand grade ⅡIAC. CTR and CT median value were selected by using LASSO regression. Logistic regression, random forest, and XGBoost models were constructed and validated, among which, the XGBoost model demonstrated the best predictive performance. Conclusion Cautious consideration should be given to grade Ⅲ IAC when CTR is higher than 39.48% and CT standard deviation is less than 122.75 HU. The XGBoost model based on combined CTR and CT median value has good predictive efficacy for grade Ⅲ IAC, aiding clinicians in making personalized clinical decisions.

OBJECTIVE To evaluate the differences between the sampling methods of peristaltic pump+membrane filtration and rinsing for monitoring the cleaning and disinfection effectiveness of flexible endoscopes,and to pro-vide a reference for selecting an efficient sampling method for monitoring the cleaning and disinfection effectiveness of flexible endoscopes.METHODS A total of 305 cases of monitoring data on the cleaning and disinfection of flexi-ble endoscopes from People's Hospital of Rizhao in Shandong Province from Jan.2021 to Dec.2024 were selected.The results of 93 cases sampled by rinsing from Jan.2021 to Dec.2022 were compared with those of 212 cases sampled by peristaltic pump+membrane filtration from Jan.2023 to Dec.2024.The monitoring capabilities of different sampling methods for flexible endoscopes after cleaning and disinfection were evaluated,and the con-sumable costs of different sampling methods were also calculated.RESULTS The detection rate of pathogenic bac-teria after biological monitoring of the peristaltic pump+membrane filtration sampling method was 25.94％(55/212),which was higher than that of the rinsing sampling method(8.60％,8/93)(P＜0.05).There was no sta-tistically significant difference in the sampling qualification rate between the two methods(P=0.075).There was no statistically significant difference in the qualification rate between manual and mechanical cleaning and dis-infection methods under the same sampling method.However,there was a statistically significant difference in the detection rate of pathogenic bacteria between manual cleaning and disinfection(36.21％)and mechanical cleaning and disinfection(22.08％)under the peristaltic pump+membrane filtration sampling method(P=0.036).The detection rate of pathogenic bacteria of the peristaltic pump+membrane filtration sampling method was higher than that of the rinsing sampling method for both cleaning and disinfection methods(P＜0.05).The consumable cost per endoscope of the peristaltic pump+membrane filtration sampling method was(84.90±2.91)yuan,which was higher than that of the rinsing sampling method(32.24±4.73)yuan(P＜0.001).CONCLUSION Al-though the peristaltic pump+membrane filtration sampling method has higher consumable costs,it can effec-tively improve the detection rate of pathogenic bacteria and enhance the sensitivity of biological monitoring of cleaning and disinfection.

Objective The aim of this study was to analyze the incidence and mortality of lymphoma and their changing trends in cancer registration areas of Liaoning Province from 2016 to 2020,and to provide data support for lymphoma prevention and treatment.Methods The data of tumor registration areas in Liaoning province from 2016 to 2020 were collected and sorted out,and the crude incidence,mortality,China standardized incidence and mortality,world standardized incidence and mortality,and cumulative rate of lymphoma were calculated;Joinpoint 5.0.2 software was used to analyze the changing trends of the above indicators from 2016 to 2020.Results From 2016 to 2020,the crude incidence of lymphoma in tumor registration areas of Liaoning Province was 7.43/100,000,age-standardized incidence by Chinese standard population(ASIRC)was 4.07/100,000,and age-standardized incidence by world standard population(ASIRW)was 3.95/100,000;the crude mortality was 4.29/100,000,age-standardized mortality by Chi-nese standard population(ASMRC)was 2.07/100,000,and age-standardized mortality by world standard population(ASMRW)was 2.02/100,000.The ASIRC and ASMRC were higher in males(4.62/100,000 and 2.53/100,000,respectively)than in females(3.56/100,000 and 1.61/100,000,respectively),also higher in urban areas(4.65/100,000 and 2.32/100,000,respectively)than in rural areas(2.46/100,000 and 1.65/100,000,respectively).The incidence and mortality of lymphoma increased with age.The in-cidence reached its peak in the 70-79 age group,and the mortality reached its peak in the 80+age group.From 2016 to 2020,the crude incidence of lymphoma increased from 6.86/100,000 to 8.22/100,000,with a statistically significant trend(APC=5.06％,95％CI;1.13％-9.14％,P=0.026).ASIRC increased from 4.01/100,000 to 4.45/100,000,with no statistical significance(P＞0.05).The crude mortality increased from 3.85/100,000 to 4.53/100,000,while ASMRC decreased from 2.02/100,000 to 2.01/100,000,with no statistically significant trend in the two changes(P＞0.05).Conclusions The incidence and mortality of lymphoma in cancer registration areas of Liaoning Province are higher in men than those of women,and higher in cities than those in rural areas,and reach the peak in the elderly group.The prevention and control of key populations and health management should be strength-ened,especially pay attention to the health needs of the elderly population,and explore possible directions for multidisciplinary collab-orative diagnosis and treatment to reduce the disease burden.

Objective The aim of this study was to analyze the incidence and mortality of lymphoma and their changing trends in cancer registration areas of Liaoning Province from 2016 to 2020,and to provide data support for lymphoma prevention and treatment.Methods The data of tumor registration areas in Liaoning province from 2016 to 2020 were collected and sorted out,and the crude incidence,mortality,China standardized incidence and mortality,world standardized incidence and mortality,and cumulative rate of lymphoma were calculated;Joinpoint 5.0.2 software was used to analyze the changing trends of the above indicators from 2016 to 2020.Results From 2016 to 2020,the crude incidence of lymphoma in tumor registration areas of Liaoning Province was 7.43/100,000,age-standardized incidence by Chinese standard population(ASIRC)was 4.07/100,000,and age-standardized incidence by world standard population(ASIRW)was 3.95/100,000;the crude mortality was 4.29/100,000,age-standardized mortality by Chi-nese standard population(ASMRC)was 2.07/100,000,and age-standardized mortality by world standard population(ASMRW)was 2.02/100,000.The ASIRC and ASMRC were higher in males(4.62/100,000 and 2.53/100,000,respectively)than in females(3.56/100,000 and 1.61/100,000,respectively),also higher in urban areas(4.65/100,000 and 2.32/100,000,respectively)than in rural areas(2.46/100,000 and 1.65/100,000,respectively).The incidence and mortality of lymphoma increased with age.The in-cidence reached its peak in the 70-79 age group,and the mortality reached its peak in the 80+age group.From 2016 to 2020,the crude incidence of lymphoma increased from 6.86/100,000 to 8.22/100,000,with a statistically significant trend(APC=5.06％,95％CI;1.13％-9.14％,P=0.026).ASIRC increased from 4.01/100,000 to 4.45/100,000,with no statistical significance(P＞0.05).The crude mortality increased from 3.85/100,000 to 4.53/100,000,while ASMRC decreased from 2.02/100,000 to 2.01/100,000,with no statistically significant trend in the two changes(P＞0.05).Conclusions The incidence and mortality of lymphoma in cancer registration areas of Liaoning Province are higher in men than those of women,and higher in cities than those in rural areas,and reach the peak in the elderly group.The prevention and control of key populations and health management should be strength-ened,especially pay attention to the health needs of the elderly population,and explore possible directions for multidisciplinary collab-orative diagnosis and treatment to reduce the disease burden.

The aim of this study was to understand the internal genetic diversity and population history dynamics of ticks in Inner Mongolia,to provide data for designing effective vector control programs and revealing ticks'transmission mechanisms.From 2022 to 2023,the manual collection method was used to collect samples in Inner Mongolia.The 16S rDNA and COI gene sequences of ticks were used to identify Hyalomma marginatum,Haemaphysalis concinna,and Argas persicus,and analyze the sequence characteristics and genetic diversity within the populations.Base composition analysis indicated that the average A+T content of the 16S rDNA gene and CO I gene in the three ticks was significantly higher than that of C+G.Moreover,22 haplotypes of the COI gene and 12 haplotypes of the 16S rDNA sequence were identified in Hyalomma marginatum.Eleven haplotypes were identified according to the COI gene,and nine haplotypes were identified according to the16S rDNA sequence of Haemaphysalis concinna.Two haplotypes were identified on the basis of the COI gene,and six haplotypes were identified on the basis of the 16S rDNA sequence of Ar gas persicus.The minimum 16S rDNA haplotype diversity was 0.264 for Ar gas persicus and 0.579 for the other two species.The nucleotide diversity of the three tick species was less than 0.05.Tajima's val-ue and Fu's Fs value of the neutrality test were negative.Base saturation substitution analysis indicated that neither of the two genes in the three tick species reached saturation.The phylogenetic tree revealed that Hyalomma marginatum,Haema physalis concinna,and Ar gas persicus in Inner Mongolia independently aggregated into branches.In conclusion,the base content of Hyalomma marginatum,Haemaphysalis concinna,and Argas persicus genes in Inner Mongolia was consist-ent with the characteristics of insect mitochondrial DNA content.Furthermore,the three tick populations showed rapid evolu-tionary population expansion,and the phylogeny of three tick species showed independent aggregation into clades,with no pop-ulation isolation.

OBJECTIVE To evaluate the differences between the sampling methods of peristaltic pump+membrane filtration and rinsing for monitoring the cleaning and disinfection effectiveness of flexible endoscopes,and to pro-vide a reference for selecting an efficient sampling method for monitoring the cleaning and disinfection effectiveness of flexible endoscopes.METHODS A total of 305 cases of monitoring data on the cleaning and disinfection of flexi-ble endoscopes from People's Hospital of Rizhao in Shandong Province from Jan.2021 to Dec.2024 were selected.The results of 93 cases sampled by rinsing from Jan.2021 to Dec.2022 were compared with those of 212 cases sampled by peristaltic pump+membrane filtration from Jan.2023 to Dec.2024.The monitoring capabilities of different sampling methods for flexible endoscopes after cleaning and disinfection were evaluated,and the con-sumable costs of different sampling methods were also calculated.RESULTS The detection rate of pathogenic bac-teria after biological monitoring of the peristaltic pump+membrane filtration sampling method was 25.94％(55/212),which was higher than that of the rinsing sampling method(8.60％,8/93)(P＜0.05).There was no sta-tistically significant difference in the sampling qualification rate between the two methods(P=0.075).There was no statistically significant difference in the qualification rate between manual and mechanical cleaning and dis-infection methods under the same sampling method.However,there was a statistically significant difference in the detection rate of pathogenic bacteria between manual cleaning and disinfection(36.21％)and mechanical cleaning and disinfection(22.08％)under the peristaltic pump+membrane filtration sampling method(P=0.036).The detection rate of pathogenic bacteria of the peristaltic pump+membrane filtration sampling method was higher than that of the rinsing sampling method for both cleaning and disinfection methods(P＜0.05).The consumable cost per endoscope of the peristaltic pump+membrane filtration sampling method was(84.90±2.91)yuan,which was higher than that of the rinsing sampling method(32.24±4.73)yuan(P＜0.001).CONCLUSION Al-though the peristaltic pump+membrane filtration sampling method has higher consumable costs,it can effec-tively improve the detection rate of pathogenic bacteria and enhance the sensitivity of biological monitoring of cleaning and disinfection.

OBJECTIVE: Several epidemiological observational studies have related particulate matter (PM) exposure to Inflammatory bowel disease (IBD), but many confounding factors make it difficult to draw causal links from observational studies. The objective of this study was to explore the causal association between PM _2.5 exposure, its absorbance, and IBD. METHODS: We assessed the association of PM _2.5 and PM _2.5 absorbance with the two primary forms of IBD (Crohn's disease [CD] and ulcerative colitis [UC]) using Mendelian randomization (MR) to explore the causal relationship. We conducted two-sample MR analyses with aggregated data from the UK Biobank genome-wide association study. Single-nucleotide polymorphisms linked with PM _2.5 concentrations or their absorbance were used as instrumental variables (IVs). We used inverse variance weighting (IVW) as the primary analytical approach and four other standard methods as supplementary analyses for quality control. RESULTS: The results of MR demonstrated that PM _2.5 had an adverse influence on UC risk (odds ratio [ OR] = 1.010; 95% confidence interval [ CI] = 1.001-1.019, P = 0.020). Meanwhile, the results of IVW showed that PM _2.5 absorbance was also causally associated with UC ( OR = 1.012; 95% CI = 1.004-1.019, P = 0.002). We observed no causal relationship between PM _2.5, PM _2.5 absorbance, and CD. The results of sensitivity analysis indicated the absence of heterogeneity or pleiotropy, ensuring the reliability of MR results. CONCLUSION Based on two-sample MR analyses, there are potential positive causal relationships between PM _2.5, PM _2.5 absorbance, and UC.
Humans ; Mendelian Randomization Analysis ; Particulate Matter/analysis* ; Polymorphism, Single Nucleotide ; Inflammatory Bowel Diseases/genetics* ; Air Pollutants/analysis* ; Crohn Disease/genetics* ; Colitis, Ulcerative/genetics* ; Genome-Wide Association Study ; Risk Factors ; Environmental Exposure

Objective:To analyze the application value of three-dimensional visualization combined with indocyanine green fluorescence staining in laparoscopic resection of patients with complex liver cancer.Methods:The data of patients with complex liver cancer (liver cancer located in liver segments Ⅶ, Ⅷ, Ⅳa, Ⅴ and caudate lobe) who underwent laparoscopic anatomical liver resection in Zhengzhou University People's Hospital from August 2018 to August 2023 were retrospectively analyzed. A total of 334 patients were enrolled, including 249 males and 85 females, with the age of (57.0±10.6) years. Among the 334 patients, patients who underwent laparoscopic liver resection using three-dimensional visualization combined with indocyanine green fluorescence staining were included in the combined group ( n=128), and the other patients who underwent traditional laparoscopic liver resection were included in the traditional group ( n=206). Propensity score was used to match the preoperative indicators and postoperative pathology between the two groups. The two groups were compared in terms of gender, age, maximum diameter of tumor, alpha-fetoprotein, number of tumors, tumor location, American Society of Anesthesiologists (ASA) grade, operation time, portal occlusion time, intraoperative blood loss, surgical margin and postoperative aspartate transaminase (ALT), alanine transaminase (AST), albumin, total bilirubin, and severe postoperative complications (Clavien-Dindo grade≥grade Ⅲ). The Kaplan-Meier method was used to analyze the prognosis, and the log-rank test was used to compare the survival rate. Results:After propensity score matching, 120 cases were included in the combined group and the traditional group, respectively. There were no significant differences in gender, age, maximum diameter of tumor, alpha-fetoprotein, number of tumors, tumor location, and ASA grade between the two groups (all P>0.05). The intraoperative blood loss in the combined group was 200.0 (150.0, 300.0) ml, and the positive surgical margin rate was 6.7% (8/120), which were lower than 300.0 (150.0, 500.0) ml and 15.8% (19/120) in the traditional group, with statistically significant differences ( Z=-2.43, P=0.015, χ2=5.05, P=0.025). There were no statistically significant differences in the operation time, portal occlusion time, and postoperative ALT, AST, albumin, and total bilirubin between the two groups (all P>0.05). Eight cases (6.7%) in the combined group and 11 cases (9.2%) in the traditional group had severe complications after surgery, and all were discharged after treatment. The 1-, 3-, and 5-year recurrence-free survival rates of the combined group were 83.3%, 61.7%, and 58.3% respectively, while that of the traditional group were 71.7%, 52.5%, and 49.2%, respectively, with significant difference ( χ2=4.57, P=0.031). There was no significant difference in the cumulative survival rate between the combined group and the traditional group ( χ2=0.66, P=0.417). Conclusion:Compared with laparoscopic liver resection, laparoscopic liver resection for patients with complex liver cancer using three-dimensional visualization technology combined with indocyanine green fluorescence staining technology can reduce intraoperative blood loss, positive margin rate, and postoperative recurrence.

OBJECTIVE To analyze the correlation between styloid process related parameters and symptoms in patients with styloid process syndrome.METHODS A retrospective study was conducted on the 3D reconstruction CT results of the styloid process in 68 patients diagnosed with styloid process syndrome who visited the Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xi'an Jiaotong University from January 2010 to December 2024.The relationship between parameters such as styloid process length,angle,distance from styloid process tip to pharynx,and specific symptoms in patients with styloid process syndrome was analyzed.RESULTS Among 68 patients with styloid process syndrome,44 had unilateral symptoms and 24 had bilateral symptoms.The length of the styloid process on the symptomatic side of patients with unilateral symptoms(3.86±0.16)cm was significantly longer than that on the asymptomatic side(2.98±0.17)cm(Z=-2.191,P=0.028);The length of the styloid process on the side with severe symptoms in patients with bilateral symptoms(3.98±0.37)cm was also significantly longer than that in patients with mild symptoms(3.37±0.15)cm(t=2.448,P=0.024).Patients with styloid process syndrome mainly present with pharyngalgia(64.71%,44/68).There were no significant differences in the length,inclination angle,anteversion angle,and distance between the styloid process tip and the pharynx among those with unilateral pharyngalgia(n=29),bilateral pharyngalgia(n=15),and non pharyngalgia(n=24)(P>0.05).However,among the 68 patients with styloid syndrome,12 had calcification of the styloid hyoid ligament,while 56 did not.The incidence of unilateral pharyngalgia was significantly higher in patients with calcification of the styloid hyoid ligament than in patients without calcification(66.7%vs.35.7%,χ2=3.909,P=0.048).CONCLUSION The severity of symptoms in patients with styloid process syndrome is related to the length of the styloid process,and those with calcification of the styloid hyoid ligament are more likely to experience pharyngalgia.