Protein tyrosine phosphatase nonreceptor type 2 (PTPN2) is a promising target for sensitizing solid tumors to immune checkpoint blockades. However, the highly polar active sites of PTPN2 hinder drug discovery efforts. Leveraging small interfering RNA (siRNA) technology, we developed a novel glutathione-responsive nano-platform HPssPT (HA/PEIss@siPtpn2) to silence PTPN2 and enhance immunotherapy efficacy in hepatocellular carcinoma (HCC). HPssPT showed potent transfection and favorable safety profiles. PTPN2 deficiency induced by HPssPT amplified the interferon γ signaling in HCC cells by increasing the phosphorylation of Janus-activated kinase 1 and signal transducer and activator of transcription 1, resulting in enhanced antigen presentation and T cell activation. The nano-platform was also able to promote the M1-like polarization of macrophages in vitro. The unique tropism of HPssPT towards tumor-associated macrophages, facilitated by hyaluronic acid coating and CD44 receptor targeting, allowed for simultaneous reprogramming of both tumor cells and tumor-associated macrophages, thereby synergistically reshaping tumor microenvironment to an immunostimulatory state. In HCC, colorectal cancer, and melanoma animal models, HPssPT monotherapy provoked robust antitumor immunity, thereby sensitizing tumors to PD-1 blockade, which provided new inspiration for siRNA-based drug discovery and tumor immunotherapy.

Objective:To evaluate preoperative high-resolution thin-layer cervical enhanced CT used to predict the venous route of the submental flap reflux vein and its relationship with adjacent structures in order to guide the anatomical understanding and protection of submental flap in pharyngeal cancer surgery.Methods:Sixty consecutive patients with pharyngeal cancer who underwent submental flap repair surgery in our department from March 2022 to December 2024, as well as 60 patients who were accepted neck dissection suffering other cancers, were selected. Before surgery, high-resolution cervical enhanced CT scans were performed, and the position of the transverse section of the facial vein in the venous phase horizontal image gradually variation tendency was focused layer by layer. The direction and adjacent relationship of the submental flap reflux veins were determined and recorded. Combined with 60 patients with other head and neck tumors who underwent neck dissection in our department during the same period (a total of 120 cases, 240 sides), the classification and management of the draining veins of Fang′s mental flap were conducted. Type Ⅰ mainly drains into the internal jugular vein; Type Ⅱ mainly drains into the external jugular vein and Type Ⅲ mainly drains into the anterior jugular vein (often accompanied by an external jugular draining branch). The status and proportion of venous drainage were analyzed.Results:Vascular predictive coincidence rate was 98.3% (59/60) among the 60 patients with pharyngeal cancer. Only one patient was predicted to have a simple return to the external jugular vein. However, during the operation, in addition to the main return to the external jugular vein, a small portion also returned to the internal jugular vein. Submental flap reflux vessels were classified into three types based on intraoperative submental flap venous return in 60 cases of laryngopharyngeal cancer, in conjunction with the analysis of venous return patterns from 240 cervical CT scans. Type Ⅰ mainly refluxed to the internal jugular vein, accounting for 42.1%. Type Ⅱ mainly refluxed to the external jugular vein (47.9%). Type Ⅲ mainly refluxed to the anterior jugular vein (10.0%). The total detection rate of CT reading of 240 venous reflux was 98.7% (237/240). Vascular predictive coincidence rate was 97.9%(235/240).Conclusion:The detailed analysis of submental venous return vessels can accurately predict the direction of reflux veins and its surrounding areas by preoperative high-resolution enhanced CT scan. This provides reliable guidance for the anatomy and protection of the submental flap reflux veins during surgery.

This article explores the technological innovations and clinical prospects of robot-assisted hiatal hernia repair (RAHHR). RAHHR demonstrates outstanding performance in hiatal hernia repair, particularly for complex hernias, owing to its advantages such as 3D visualization and 7-degree-of-freedom robotic arms, which contribute to reduced recurrence rates and accelerated recovery. However, challenges remain, including high costs and limited operative space. Future directions include the development of single-port robotic systems, force feedback technology, and AI-powered surgical navigation. Standardized training and technological innovations are expected to promote its widespread application.

Objective:To evaluate preoperative high-resolution thin-layer cervical enhanced CT used to predict the venous route of the submental flap reflux vein and its relationship with adjacent structures in order to guide the anatomical understanding and protection of submental flap in pharyngeal cancer surgery.Methods:Sixty consecutive patients with pharyngeal cancer who underwent submental flap repair surgery in our department from March 2022 to December 2024, as well as 60 patients who were accepted neck dissection suffering other cancers, were selected. Before surgery, high-resolution cervical enhanced CT scans were performed, and the position of the transverse section of the facial vein in the venous phase horizontal image gradually variation tendency was focused layer by layer. The direction and adjacent relationship of the submental flap reflux veins were determined and recorded. Combined with 60 patients with other head and neck tumors who underwent neck dissection in our department during the same period (a total of 120 cases, 240 sides), the classification and management of the draining veins of Fang′s mental flap were conducted. Type Ⅰ mainly drains into the internal jugular vein; Type Ⅱ mainly drains into the external jugular vein and Type Ⅲ mainly drains into the anterior jugular vein (often accompanied by an external jugular draining branch). The status and proportion of venous drainage were analyzed.Results:Vascular predictive coincidence rate was 98.3% (59/60) among the 60 patients with pharyngeal cancer. Only one patient was predicted to have a simple return to the external jugular vein. However, during the operation, in addition to the main return to the external jugular vein, a small portion also returned to the internal jugular vein. Submental flap reflux vessels were classified into three types based on intraoperative submental flap venous return in 60 cases of laryngopharyngeal cancer, in conjunction with the analysis of venous return patterns from 240 cervical CT scans. Type Ⅰ mainly refluxed to the internal jugular vein, accounting for 42.1%. Type Ⅱ mainly refluxed to the external jugular vein (47.9%). Type Ⅲ mainly refluxed to the anterior jugular vein (10.0%). The total detection rate of CT reading of 240 venous reflux was 98.7% (237/240). Vascular predictive coincidence rate was 97.9%(235/240).Conclusion:The detailed analysis of submental venous return vessels can accurately predict the direction of reflux veins and its surrounding areas by preoperative high-resolution enhanced CT scan. This provides reliable guidance for the anatomy and protection of the submental flap reflux veins during surgery.

This article explores the technological innovations and clinical prospects of robot-assisted hiatal hernia repair (RAHHR). RAHHR demonstrates outstanding performance in hiatal hernia repair, particularly for complex hernias, owing to its advantages such as 3D visualization and 7-degree-of-freedom robotic arms, which contribute to reduced recurrence rates and accelerated recovery. However, challenges remain, including high costs and limited operative space. Future directions include the development of single-port robotic systems, force feedback technology, and AI-powered surgical navigation. Standardized training and technological innovations are expected to promote its widespread application.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

Objective To establish a rapid surface-enhanced Raman spectroscopy(SERS)method for detection of five banned benzodiazepines in blood,including alprazolam,nitrovalam,Temazepam,diazepam and cloazepine.Methods Ethanol was used as extraction agent to extract nitrodiazepam,nitrazepam,diazepam and clonazepam from blood,a mixture of PSA and C18 was added for optimization,and SERS technology was used for detection.Results Experiments showed that nitalprazolam,nitrodiazepam,Temazepam,diazepam and chlorazepine all had corresponding Raman characteristic signal peaks,which could be used as the basis for qualitative discrimination.The detection limits of these benzodiazepines in blood were between 0.5 and 1 μg/mL.Conclusion This method is simple to operate and has a fast analysis speed.It is suitable for the rapid detection of drugs in blood samples.

Objective To observe the role of empagliflozin tablets combined with benazepril hydrochloride tablets on clinical efficacy and renal outcomes in treating type 2 diabetic kidney disease(DKD).Methods Patients with type 2 DKD were divided into treatment group and control group by means of the random number table method.The control group was treated with benazepril hydrochloride tablets(10 mg,qd)and the treatment group was treated with empagliflozin tablets on the basis of the control group.The initial dose was 10 mg,qd,adjusted to 25 mg after tolerance,qd.Two groups were treated for 3 months.The clinical efficacy,blood glucose indexes[fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1 c)],renal function indexes[serum creatinine(SCr),glomerular filtration rate(eGFR)],oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)],renal outcomes and safety were compared between the two groups before and after treatment.Results In the treatment group,63 cases were enrolled,2 cases were lost,and 61 cases were finally included in the statistical analysis.In the control group,63 cases were enrolled,2 cases were lost,and finally 61 cases were included in the statistical analysis.After treatment,the total effective rates in treatment group and control group were 88.52％(54 cases/61 cases)and 73.77％(45 cases/61 cases),respectively(P＜0.05).After treatment,the peripheral blood FPB levels in treatment group and control group were(5.64±0.58)and(6.31±0.79)mmol·L-1;HbA1c levels were(6.09±0.75)％and(6.94±0.96)％;SCr levels were(111.88±11.45)and(119.41±8.31)μmol·L-1;eGFR values were(64.11±9.04)and(58.92±4.79)mL·min-1·1.73 m-2;SOD levels were(45.72±5.53)and(39.54±3.97)U·mL-1;MDA levels were(26.18±3.22)and(30.31±3.65)nmol·mL-1;the incidence rates of adverse renal outcomes were 6.56％(4 cases/61 cases)and 19.67％(12 cases/61 cases),respectively,with statistical differences(all P＜0.05).The adverse drug reactions in treatment group were mainly urinary tract infection,hypoglycemia and headache,and those in control group were mainly hypotension and headache.The incidence rates of adverse drug reactions were 9.84％(6 cases/61 cases)and 6.56％(4 cases/61 cases),respectively(P＞0.05).Conclusion The clinical efficacy of empagliflozin tablets combined with benazepril hydrochloride tablets in the treatment of type 2 DKD is better,which can reduce the incidence of adverse renal outcomes without increasing adverse drug reactions.

Objective To observe the role of empagliflozin tablets combined with benazepril hydrochloride tablets on clinical efficacy and renal outcomes in treating type 2 diabetic kidney disease(DKD).Methods Patients with type 2 DKD were divided into treatment group and control group by means of the random number table method.The control group was treated with benazepril hydrochloride tablets(10 mg,qd)and the treatment group was treated with empagliflozin tablets on the basis of the control group.The initial dose was 10 mg,qd,adjusted to 25 mg after tolerance,qd.Two groups were treated for 3 months.The clinical efficacy,blood glucose indexes[fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1 c)],renal function indexes[serum creatinine(SCr),glomerular filtration rate(eGFR)],oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA)],renal outcomes and safety were compared between the two groups before and after treatment.Results In the treatment group,63 cases were enrolled,2 cases were lost,and 61 cases were finally included in the statistical analysis.In the control group,63 cases were enrolled,2 cases were lost,and finally 61 cases were included in the statistical analysis.After treatment,the total effective rates in treatment group and control group were 88.52％(54 cases/61 cases)and 73.77％(45 cases/61 cases),respectively(P＜0.05).After treatment,the peripheral blood FPB levels in treatment group and control group were(5.64±0.58)and(6.31±0.79)mmol·L-1;HbA1c levels were(6.09±0.75)％and(6.94±0.96)％;SCr levels were(111.88±11.45)and(119.41±8.31)μmol·L-1;eGFR values were(64.11±9.04)and(58.92±4.79)mL·min-1·1.73 m-2;SOD levels were(45.72±5.53)and(39.54±3.97)U·mL-1;MDA levels were(26.18±3.22)and(30.31±3.65)nmol·mL-1;the incidence rates of adverse renal outcomes were 6.56％(4 cases/61 cases)and 19.67％(12 cases/61 cases),respectively,with statistical differences(all P＜0.05).The adverse drug reactions in treatment group were mainly urinary tract infection,hypoglycemia and headache,and those in control group were mainly hypotension and headache.The incidence rates of adverse drug reactions were 9.84％(6 cases/61 cases)and 6.56％(4 cases/61 cases),respectively(P＞0.05).Conclusion The clinical efficacy of empagliflozin tablets combined with benazepril hydrochloride tablets in the treatment of type 2 DKD is better,which can reduce the incidence of adverse renal outcomes without increasing adverse drug reactions.

Objective To establish a rapid surface-enhanced Raman spectroscopy(SERS)method for detection of five banned benzodiazepines in blood,including alprazolam,nitrovalam,Temazepam,diazepam and cloazepine.Methods Ethanol was used as extraction agent to extract nitrodiazepam,nitrazepam,diazepam and clonazepam from blood,a mixture of PSA and C18 was added for optimization,and SERS technology was used for detection.Results Experiments showed that nitalprazolam,nitrodiazepam,Temazepam,diazepam and chlorazepine all had corresponding Raman characteristic signal peaks,which could be used as the basis for qualitative discrimination.The detection limits of these benzodiazepines in blood were between 0.5 and 1 μg/mL.Conclusion This method is simple to operate and has a fast analysis speed.It is suitable for the rapid detection of drugs in blood samples.