The underlying cause of low response rates to existing immunotherapies is that tumor cells dominate tumor immune escape through surface antigen deficiency and inducing tumor immunosuppressive microenvironment (TIME). Here, we proposed an in situ tumor cell engineering strategy to disrupt tumor immune escape at the root by restoring tumor cell MHC-I/tumor-specific antigen complex (MHC-I/TSA) expression to promote T-cell recognition and by silencing tumor cell CD55 to increase the ICOSL⁺ B-cell proportion and reverse the TIME. A doxorubicin (DOX) and dual-gene plasmid (MAC pDNA, encoding both MHC-I/ASMTNMELM and CD55-shRNA) coloaded drug delivery system (LCPN@ACD) with tumor targeting and charge/size dual-conversion properties was prepared. LCPN@ACD-induced ICD promoted DC maturation and enhanced T-cell activation and infiltration. LCPN@ACD enabled effective expression of MHC-I/TSA on tumor cells, increasing the ability of tumor cell recognition and killing. LCPN@ACD downregulated tumor cell CD55 expression, increased the proportion of ICOSL⁺ B cells and CTLs, and reversed the TIME, thus greatly improving the efficacy of αPD-1 and CAR-T therapies. The application of this in situ tumor cell engineering strategy eliminated the source of tumor immune escape, providing new ideas for solving the challenges of clinical immunotherapy.

Objective To develop a virtual reality rehabilitation support system and evaluate its effects on improving discharge readiness in caregivers of laryngectomy patients.Methods The system is equipped with a virtual reality-based home nursing skills guidance module for post-laryngectomy patients and an evidence-based artificial intelligence Q&A module.A convenience sampling method was adopted to select 64 caregivers of patients who underwent laryngectomy for the first time in the otorhinolaryngology head and neck surgery department of a tertiary A hospital in Beijing from July 2024 to January 2025 for a systematic study on application effects.To avoid cross-contamination between an experimental group and a control group,ward-based grouping was applied.A coin toss was used to assign Ward 1 to an experimental group and Ward 2 to a control group,with 32 cases in each group.The experimental group received discharge guidance based on the virtual reality technology,while the control group was provided with conventional verbal and written discharge instructions.The readiness for hospital discharge and the quality of discharge teaching scores of caregivers were compared between the 2 groups after the intervention.Results No sample detachment.After the intervention,the patient caregivers in the experimental group scored significantly higher than those in the control group in terms of discharge readiness and quality of discharge guidance,with a statistically significant difference(P＜0.001).Conclusion This study developed the virtual reality rehabilitation system for laryngeal cancer patients demonstrated good feasibility and effectiveness.The application of this system for discharge education significantly improved discharge readiness of caregivers and quality of discharge guidance for post-laryngectomy patients.It also helped with the optimization of health education models,enhancement of nursing resource utilization efficiency,and improvement of transitional care.

Objective To observe the clinical and echocardiographic manifestations of Williams syndrome(WS).Methods Two children with WS were retrospectively enrolled,and 21 cases of WS in literature were reviewed,and clinical and echocardiographic manifestations of WS were observed.Results Clinical manifestations of 23 cases including 21 cases of"elf"face,8 cases of intellectual disability,7 cases of developmental delay,7 cases of inguinal hernia,6 cases of hypothyroidism,4 cases of hypercalcemia,3 cases of urinary system abnormalities(1 case of hydrocele,1 case of ureteral dilation and tortuosity,and 1 case of kidney stones),2 cases of behavioral abnormalities,2 cases of feeding difficulties,1 case of congenital hypertrophic pyloric stenosis,1 case of binocular esotropia,1 case of hyperbilirubinemia,and 1 case of corpus callosum dysplasia.Echocardiography showed cardiovascular malformations in all 23 cases,including 20 cases of supravalvular aortic stenosis(SVAS),18 cases of pulmonary artery stenosis(PAS)and 10 cases of other cardiovascular malformations.Conclusion WS presented multiple system abnormalities in clinic,and cardiovascular malformations,especially SVAS and PAS could often be detected with echocardiography.

Objective To explore the effect of different ventilation modes during laparoscopic radical resection of colorectal cancer(LRRCC)on respiratory function in patients with complicated mild obstructive ventilatory disorder(OVD).Methods 68 patients with mild OVD who underwent elective LRRCC from June 2022 to March 2024 were randomly divided into a volume controlled ventilation(VCV)group(n=34,with intraoperative VCV)and a pressure controlled ventilation-volume guaranteed(PCV-VG)mode group(n=34,with intraoperative PCV-VG).Changes in hemodynamics[mean arterial pressure(MAP)and heart rate(HR)],blood gas indicators[partial pressure of carbon dioxide in arterial blood(PaCO2)and arterial partial pressure of oxygen(PaO2)],lung exchange function indicators[oxygenation index(OI),alveolar-arterial oxygen partial pressure difference(PA-aO2)],respiratory mechanics indicators[tidal volume,end-tidal carbon dioxide partial pressure(PetCO2),peak airway pressure(Ppeak),and dynamic lung compliance(Cldyn)]before pneumoperitoneum(T1),30 min after establishing pneumoperitoneum(T2),1 h after pneumoperitoneum(T3),and 20 min after the end of pneumoperitoneum(T4)were observed in both groups.And incidence of intraoperative complications and the positive rate of postoperative pulmonary complication(PPC)in both groups were counted.Results There were no statistically significant differences in MAP and HR between the two groups at T1,T2,T3 and T4 time points(P>0.05).The PaCO2 level in both groups at T2,T3,and T4 time points was higher than that at T1 time point,but the PCV-VG group was lower than that in the VCV group,the differences were statistically significant(P<0.05).The PaO2,OI,and Cldyn in the two groups at T2 and T3 time points were lower than those at T1 time point,but the PCV-VG group was higher than that in the VCV group,the differences were statistically significant(P<0.05).The PA-aO2,tidal volume,PetCO2 and Ppeak of the two groups of patients at T2 and T3 time points were significantly higher than those at time point T1,and the differences were statistically significant(P<0.05).At T2 and T3,the PA-aO2 and Ppeak in the PCV-VG group were significantly lower than those in the VCV group,and the differences were statistically significant(P<0.05).The incidence of intraoperative complications and PPC positivity rate in the PCV-VG group were 8.82%and 2.94%,respectively,which were lower than 29.41%and 23.53%in the VCV group,the differences were statistically significant(P<0.05).Conclusion Compared with VCV,implementing PCV-VG mode during LRRCC surgery is more conducive to reducing the impacts of pneumoperitoneum on blood gas analysis,lung ventilation function,and respiratory mechanics,and reducing the incidence of complications such as hypoxemia and hypercapnia rate.It is worthy for clinical application.

In this study,the carboxylated magnetic beads were coupled with bivalent nanobodies a-gainst porcine epidemic diarrhea virus(PEDV)M protein to construct immunomagnetic beads(IM-NBs-Ⅱ),The capture and enrichment function of IMNBs-Ⅱ was verified by using PEDV propaga-ted in Vero cells.A one-step RT-qPCR detection method for PEDV was established by combining the characteristics of IMNBs-Ⅱ with the detection advantages of reverse transcription fluorescence quantitative polymerase chain reaction(RT-qPCR).Specific analysis found that this method has no cross reactivity with swine fever virus,porcine reproductive and respiratory syndrome virus,por-cine parvovirus,porcine circovirus,indicating that it has good specificity.Sensitivity analysis re-vealed that the detection sensitivity of the RT-qPCR based on IMNBs-Ⅱ was increased 10 times compared to traditional RT-qPCR methods.Detection of the clinical samples confirm that the RT qPCR method based on IMNBs-Ⅱ is suitable for rapid and accurate detection of clinical feces and tissue samples.The method established in this study effectively avoids contamination issues during nucleic acid extraction,simplifies experimental procedures,and saves detection time,which pro-vides a method for efficient detection of PEDV.

Objective To compare the effects of ultrasound cycloplasty(UCP)and 810 nm laser photocoagulation for the treatment of refractory glaucoma.Methods In this prospective study,40 patients(40 eyes)with refractory glau-coma admitted to the hospital between June 2022 and March 2024 were selected and divided by the random number table method into a UCP group(20 cases)and an 810 laser group(20 cases).The UCP group received UCP treatment and the 810 laser group underwent transscleral 810 nm laser cyclophotocoagulation.The general data of the patients and their in-traocular pressures before surgery,1 day,2 weeks and 3 months after surgery were compared.Moreover,the ocular hemo-dynamics[including resistance index(RI)and peak systolic velocity(PSV)of the posterior short ciliary artery,central ret-inal artery and ocular artery],numerical rating scale(NRS)scores and visual acuity 3 months after surgery were compared with those before surgery.The occurrence of complications within 3 months after surgery was compared between the two groups.Results The intraocular pressure was decreased in both groups and the intraocular pressure in the UCP group was lower than that in the 810 laser group 1 day,2 weeks and 3 months after surgery(all P＜0.05).Compared with the 810 laser group,the UCP group had lower RI,PSV and NRS scores but higher visual acuity 3 months after surgery(all P＜0.05).There was no significant difference in incidence of complications between UCP and 810 laser groups at the end of the follow-up(10.00％vs.15.00％,P＞0.05).Conclusion Compared with transscleral 810 nm laser cyclophotocoagu-lation,UCP can more effectively lower the intraocular pressure,promote the recovery of visual acuity and relieve pain in patients with refractory glaucoma while having comparable safety.

In this study,the carboxylated magnetic beads were coupled with bivalent nanobodies a-gainst porcine epidemic diarrhea virus(PEDV)M protein to construct immunomagnetic beads(IM-NBs-Ⅱ),The capture and enrichment function of IMNBs-Ⅱ was verified by using PEDV propaga-ted in Vero cells.A one-step RT-qPCR detection method for PEDV was established by combining the characteristics of IMNBs-Ⅱ with the detection advantages of reverse transcription fluorescence quantitative polymerase chain reaction(RT-qPCR).Specific analysis found that this method has no cross reactivity with swine fever virus,porcine reproductive and respiratory syndrome virus,por-cine parvovirus,porcine circovirus,indicating that it has good specificity.Sensitivity analysis re-vealed that the detection sensitivity of the RT-qPCR based on IMNBs-Ⅱ was increased 10 times compared to traditional RT-qPCR methods.Detection of the clinical samples confirm that the RT qPCR method based on IMNBs-Ⅱ is suitable for rapid and accurate detection of clinical feces and tissue samples.The method established in this study effectively avoids contamination issues during nucleic acid extraction,simplifies experimental procedures,and saves detection time,which pro-vides a method for efficient detection of PEDV.

Objective To observe the clinical and echocardiographic manifestations of Williams syndrome(WS).Methods Two children with WS were retrospectively enrolled,and 21 cases of WS in literature were reviewed,and clinical and echocardiographic manifestations of WS were observed.Results Clinical manifestations of 23 cases including 21 cases of"elf"face,8 cases of intellectual disability,7 cases of developmental delay,7 cases of inguinal hernia,6 cases of hypothyroidism,4 cases of hypercalcemia,3 cases of urinary system abnormalities(1 case of hydrocele,1 case of ureteral dilation and tortuosity,and 1 case of kidney stones),2 cases of behavioral abnormalities,2 cases of feeding difficulties,1 case of congenital hypertrophic pyloric stenosis,1 case of binocular esotropia,1 case of hyperbilirubinemia,and 1 case of corpus callosum dysplasia.Echocardiography showed cardiovascular malformations in all 23 cases,including 20 cases of supravalvular aortic stenosis(SVAS),18 cases of pulmonary artery stenosis(PAS)and 10 cases of other cardiovascular malformations.Conclusion WS presented multiple system abnormalities in clinic,and cardiovascular malformations,especially SVAS and PAS could often be detected with echocardiography.

Objective To develop a virtual reality rehabilitation support system and evaluate its effects on improving discharge readiness in caregivers of laryngectomy patients.Methods The system is equipped with a virtual reality-based home nursing skills guidance module for post-laryngectomy patients and an evidence-based artificial intelligence Q&A module.A convenience sampling method was adopted to select 64 caregivers of patients who underwent laryngectomy for the first time in the otorhinolaryngology head and neck surgery department of a tertiary A hospital in Beijing from July 2024 to January 2025 for a systematic study on application effects.To avoid cross-contamination between an experimental group and a control group,ward-based grouping was applied.A coin toss was used to assign Ward 1 to an experimental group and Ward 2 to a control group,with 32 cases in each group.The experimental group received discharge guidance based on the virtual reality technology,while the control group was provided with conventional verbal and written discharge instructions.The readiness for hospital discharge and the quality of discharge teaching scores of caregivers were compared between the 2 groups after the intervention.Results No sample detachment.After the intervention,the patient caregivers in the experimental group scored significantly higher than those in the control group in terms of discharge readiness and quality of discharge guidance,with a statistically significant difference(P＜0.001).Conclusion This study developed the virtual reality rehabilitation system for laryngeal cancer patients demonstrated good feasibility and effectiveness.The application of this system for discharge education significantly improved discharge readiness of caregivers and quality of discharge guidance for post-laryngectomy patients.It also helped with the optimization of health education models,enhancement of nursing resource utilization efficiency,and improvement of transitional care.

Objective To compare the effects of ultrasound cycloplasty(UCP)and 810 nm laser photocoagulation for the treatment of refractory glaucoma.Methods In this prospective study,40 patients(40 eyes)with refractory glau-coma admitted to the hospital between June 2022 and March 2024 were selected and divided by the random number table method into a UCP group(20 cases)and an 810 laser group(20 cases).The UCP group received UCP treatment and the 810 laser group underwent transscleral 810 nm laser cyclophotocoagulation.The general data of the patients and their in-traocular pressures before surgery,1 day,2 weeks and 3 months after surgery were compared.Moreover,the ocular hemo-dynamics[including resistance index(RI)and peak systolic velocity(PSV)of the posterior short ciliary artery,central ret-inal artery and ocular artery],numerical rating scale(NRS)scores and visual acuity 3 months after surgery were compared with those before surgery.The occurrence of complications within 3 months after surgery was compared between the two groups.Results The intraocular pressure was decreased in both groups and the intraocular pressure in the UCP group was lower than that in the 810 laser group 1 day,2 weeks and 3 months after surgery(all P＜0.05).Compared with the 810 laser group,the UCP group had lower RI,PSV and NRS scores but higher visual acuity 3 months after surgery(all P＜0.05).There was no significant difference in incidence of complications between UCP and 810 laser groups at the end of the follow-up(10.00％vs.15.00％,P＞0.05).Conclusion Compared with transscleral 810 nm laser cyclophotocoagu-lation,UCP can more effectively lower the intraocular pressure,promote the recovery of visual acuity and relieve pain in patients with refractory glaucoma while having comparable safety.