Immunotherapy, including immune checkpoint inhibitors, tumor vaccine therapy, oncolytic virotherapy, and adoptive cell therapy, has made remarkably breakthroughs in the field of oncology. Immune checkpoint inhibitors, which block programmed death receptor 1 or programmed death ligand 1, have been included in the first-line clinical treatment for advanced solid tumors, such as non-small cell lung cancer and malignant melanoma. However, primary or secondary drug resistance in tumors severely limits the survival benefits for patients. Immune-related adverse reactions, such as pneumonia, hypothyroidism, hypophysitis, and myocarditis, also greatly affect the quality of life of patients. Fuzheng Jiedu Huayu is an important concept guiding the prevention and treatment of tumors with traditional Chinese medicine (TCM). It is also a curative principle and therapeutic TCM method to reduce the toxicity and enhance the efficacy of immunotherapy. This article summarizes the research progress of immunotherapy and discusses how TCM reduces the toxicity and enhances the efficacy of immunotherapy, hoping to provide a reference for the integrated treatment of tumors with TCM and immunotherapy.

Esophageal squamous cell carcinoma(ESCC)is a common malignant tumor with insidious early symptoms and a poor prognosis.In traditional Chinese medicine(TCM),ESCC is classified as"ye ge."Drawing on clinical experience,we believe that kidney deficiency leads to the deficiency of vital qi and immune dysfunction,providing the foundation for cancerous growth by depleting qi and damaging essence,toxic stasis and stagnation,forming a local hypoxic and acidic microenvironment that promotes tumor invasion,metastasis,and recurrence.Considering the effect of modern comprehensive treatments,the occurrence and development of ESCC are summarized as kidney deficiency being the root cause and toxic stasis being the driving force.The pathogenesis and treatment of ESCC in the preoperative,postoperative,and non-surgical treatment stages are discussed.The pathogenesis of the disease is summarized as follows:preoperatively,toxicity and stasis intertwine,depleting the kidney;postoperatively,the kidney loses its vitality,allowing various pathogenic factors to persist;during non-operative treatment,vital qi and pathogens contend,resulting in entrenched toxicity.During the preoperative neoadjuvant phase,therapy should resolve stasis,eliminate toxins,enhance kidney function,tonify essence,and support the body.During the postoperative adjuvant phase,therapy should strengthen the root and consolidate the foundation while detoxifying and expelling stasis.The non-surgical treatment stage uses"balanced interruption,"targeting tumor progression and metastasis by harmonizing yin and yang,thus preventing recurrence.This article will provide insights into the integrative Chinese-Western management of ESCC.

Objective:To evaluate the clinical efficacy of total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the concept of enhanced recovery after surgery (ERAS).Methods:Clinical data from the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2012 to January 2024 were collected and analyzed retrospectively. Patients were divided into the non-ERAS group (total thoracoscopic mitral valve surgery combined with beating-heart tricuspid annuloplasty without ERAS intervention) and the ERAS group (the same surgical procedures under the concept of ERAS). Propensity score matching (PSM) was used to reduce selection bias. Differences in perioperative blood transfusion, 24-hour postoperative drainage volume, incidence of severe postoperative complications [such as low cardiac output syndrome, liver failure, renal failure, stroke (ischemic/hemorrhagic), perivalvular leakage, re-thoracotomy during hospitalization, etc.], surgery and hospitalization-related indicators (operation time, cardiopulmonary bypass time, aortic cross-clamp time, length of hospital stay, etc.), and echocardiographic results at 1 month after surgery [mitral valve peak pressure difference, mitral valve peak flow velocity, mitral valve pressure half-time (PHT), tricuspid regurgitation area, right ventricular diameter, right atrial diameter] were compared between the two matched groups.Results:After PSM, the selection bias of covariates in the two groups was corrected. There were no statistically significant differences in operation time, cardiopulmonary bypass time, or aortic cross-clamp time between the two groups (all P>0.05). The ICU monitoring time, ventilator use time, and postoperative hospital stay in the ERAS group were significantly shorter than those in the non-ERAS group, with statistically significant differences (all P<0.05). There were no statistically significant differences in 24-hour postoperative drainage volume, perioperative red blood cell transfusion volume, plasma transfusion volume, or total hospitalization cost between the two groups (all P>0.05). Both the ERAS group and the non-ERAS group had 1 case of re-thoracotomy for hemostasis, and the non-ERAS group had 1 case of perivalvular leakage, with no statistically significant differences between the groups ( P>0.05). Echocardiographic results at 1 month after surgery showed that in the ERAS group, tricuspid regurgitation area, right atrial diameter, and right ventricular diameter were significantly improved compared with those before surgery (all P<0.05); in the non-ERAS group, tricuspid regurgitation area was improved compared with that before surgery, with a statistically significant difference ( P<0.05). There were statistically significant differences in the right ventricular diameter and right atrial diameter between the two groups one month after surgery (all P<0.05). Conclusions:Total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the intervention of the ERAS concept is safe and effective, but further confirmation from more large-sample clinical studies is needed.

Objective:To evaluate the effectiveness of a patient-family-centered visiting model in improving caregivers'beliefs and attitudes toward visiting patients with mental disorders.Methods:A total of 140 caregivers of inpatients diagnosed with mental disorders according to the ICD-10 were randomly assigned to an intervention group(n=71)and a control group(n=69).The intervention group participated a patient-family-centered visiting model for 4 weeks,while the control group followed routine visitation.Caregivers' beliefs and attitudes were assessed using the Beliefs and Attitudes toward Visitation in ICU Questionnaire(BAVIQ)was used to assess the improvement in caregivers' beliefs and attitudes before the intervention and at the end of the 1st,2nd,3rd,and 4th weeks after the intervention.Results:Repeated measures ANOVA showed that the belief score and attitude score of the BAVIQ questionnaire in the intervention group were significantly higher than those in the control group(Ps＜0.05)across time points.Chi-square test further confirmed that the improvement in the intervention group were significantly bet-ter than in the control group(Ps＜0.05).Conclusion:The patient-family-centered visiting model is more effective than routine visiting model in improving the caregivers' visiting beliefs and attitudes in mental health settings.

Objective To analyze the predictive value of patient-reported outcomes(PRO)com-bined with hematological indicators for moderate-to-severe endoscopic activity in patients with ulcera-tive colitis(UC).Methods Clinical data of UC patients were retrospectively collected,including PRO,hematological parameters and endoscopic findings.Based on the Mayo endoscopic score,pa-tients were divided into remission and mild activity group(＜2 points)and moderate-to-severe activity group(≥ 2 points).Independent influencing factors for moderate-to-severe endoscopic activity were screened through multivariate Logistic regression analysis,and a binary Logistic regression model was constructed.The receiver operating characteristic(ROC)curve was used to evaluate the discriminato-ry ability of the predictive model.The calibration of the model was assessed using calibration curves and the Spiegelhalter Z-test,and the model's performance was further validated in an external valida-tion cohort.Results Rectal bleeding(RB),C-reactive protein/albumin(CAR)and erythrocyte sed-imentation rate(ESR)were independent influencing factors for moderate-to-severe endoscopic activity(P＜0.05).The area under the curve(AUC)of the nomogram predictive model constructed based on the logistic regression analysis results was 0.848(95％CI,0.798 to 0.900),with sensitivity of 76.6％and specificity of 79.6％.In the external validation cohort,the model's AUC was 0.778(95％CI,0.699 to 0.857),and there was no statistically significant difference compared with the AUC of the training cohort model(P＞0.05).In both the training and validation cohorts,the Spiegelhalter Z-test results indicated that the model had good goodness-of-fit(P＞0.05).Conclu-sion RB,CAR and ESR are independent influencing factors for moderate-to-severe endoscopic ac-tivity in UC patients.The combination of RB,CAR and ESR has high predictive value for moderate-to-severe endoscopic activity in UC patients,with good discriminatory and calibration abilities.

Ubiquitination is a crucial post-translational modification that is extensively involved in the regulation of protein activity,signal transduction,and the maintenance of genomic stability.As an important member of the deubiquitinating enzyme(DUB)family,ubiquitin-specific protease 11(USP11)dynamically regulates the stability and function of key tumor proteins by targeting specific substrates for deubiquitination.This,in turn,influences various biological behaviors of tumor cells,including proliferation,apoptosis,migration,invasion,metastasis,and drug resistance,ultimately exhibiting a dual role in either promoting or inhibiting cancer.This article systematically reviewed the relevant research progress on the role of USP11 in tumorigenesis and development and provided an in-depth analysis of the specific mechanisms by which USP11 participates in cellular biological behav-iors,aiming to offer a theoretical basis for the future development of small-molecule inhibitors targeting USP11,the formulation of combination drug strategies,and the identification of effective biomarkers.

Objective:To evaluate the effectiveness of a patient-family-centered visiting model in improving caregivers'beliefs and attitudes toward visiting patients with mental disorders.Methods:A total of 140 caregivers of inpatients diagnosed with mental disorders according to the ICD-10 were randomly assigned to an intervention group(n=71)and a control group(n=69).The intervention group participated a patient-family-centered visiting model for 4 weeks,while the control group followed routine visitation.Caregivers' beliefs and attitudes were assessed using the Beliefs and Attitudes toward Visitation in ICU Questionnaire(BAVIQ)was used to assess the improvement in caregivers' beliefs and attitudes before the intervention and at the end of the 1st,2nd,3rd,and 4th weeks after the intervention.Results:Repeated measures ANOVA showed that the belief score and attitude score of the BAVIQ questionnaire in the intervention group were significantly higher than those in the control group(Ps＜0.05)across time points.Chi-square test further confirmed that the improvement in the intervention group were significantly bet-ter than in the control group(Ps＜0.05).Conclusion:The patient-family-centered visiting model is more effective than routine visiting model in improving the caregivers' visiting beliefs and attitudes in mental health settings.

Esophageal squamous cell carcinoma(ESCC)is a common malignant tumor with insidious early symptoms and a poor prognosis.In traditional Chinese medicine(TCM),ESCC is classified as"ye ge."Drawing on clinical experience,we believe that kidney deficiency leads to the deficiency of vital qi and immune dysfunction,providing the foundation for cancerous growth by depleting qi and damaging essence,toxic stasis and stagnation,forming a local hypoxic and acidic microenvironment that promotes tumor invasion,metastasis,and recurrence.Considering the effect of modern comprehensive treatments,the occurrence and development of ESCC are summarized as kidney deficiency being the root cause and toxic stasis being the driving force.The pathogenesis and treatment of ESCC in the preoperative,postoperative,and non-surgical treatment stages are discussed.The pathogenesis of the disease is summarized as follows:preoperatively,toxicity and stasis intertwine,depleting the kidney;postoperatively,the kidney loses its vitality,allowing various pathogenic factors to persist;during non-operative treatment,vital qi and pathogens contend,resulting in entrenched toxicity.During the preoperative neoadjuvant phase,therapy should resolve stasis,eliminate toxins,enhance kidney function,tonify essence,and support the body.During the postoperative adjuvant phase,therapy should strengthen the root and consolidate the foundation while detoxifying and expelling stasis.The non-surgical treatment stage uses"balanced interruption,"targeting tumor progression and metastasis by harmonizing yin and yang,thus preventing recurrence.This article will provide insights into the integrative Chinese-Western management of ESCC.

Objective:To evaluate the clinical efficacy of total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the concept of enhanced recovery after surgery (ERAS).Methods:Clinical data from the People′s Hospital of Guangxi Zhuang Autonomous Region from January 2012 to January 2024 were collected and analyzed retrospectively. Patients were divided into the non-ERAS group (total thoracoscopic mitral valve surgery combined with beating-heart tricuspid annuloplasty without ERAS intervention) and the ERAS group (the same surgical procedures under the concept of ERAS). Propensity score matching (PSM) was used to reduce selection bias. Differences in perioperative blood transfusion, 24-hour postoperative drainage volume, incidence of severe postoperative complications [such as low cardiac output syndrome, liver failure, renal failure, stroke (ischemic/hemorrhagic), perivalvular leakage, re-thoracotomy during hospitalization, etc.], surgery and hospitalization-related indicators (operation time, cardiopulmonary bypass time, aortic cross-clamp time, length of hospital stay, etc.), and echocardiographic results at 1 month after surgery [mitral valve peak pressure difference, mitral valve peak flow velocity, mitral valve pressure half-time (PHT), tricuspid regurgitation area, right ventricular diameter, right atrial diameter] were compared between the two matched groups.Results:After PSM, the selection bias of covariates in the two groups was corrected. There were no statistically significant differences in operation time, cardiopulmonary bypass time, or aortic cross-clamp time between the two groups (all P>0.05). The ICU monitoring time, ventilator use time, and postoperative hospital stay in the ERAS group were significantly shorter than those in the non-ERAS group, with statistically significant differences (all P<0.05). There were no statistically significant differences in 24-hour postoperative drainage volume, perioperative red blood cell transfusion volume, plasma transfusion volume, or total hospitalization cost between the two groups (all P>0.05). Both the ERAS group and the non-ERAS group had 1 case of re-thoracotomy for hemostasis, and the non-ERAS group had 1 case of perivalvular leakage, with no statistically significant differences between the groups ( P>0.05). Echocardiographic results at 1 month after surgery showed that in the ERAS group, tricuspid regurgitation area, right atrial diameter, and right ventricular diameter were significantly improved compared with those before surgery (all P<0.05); in the non-ERAS group, tricuspid regurgitation area was improved compared with that before surgery, with a statistically significant difference ( P<0.05). There were statistically significant differences in the right ventricular diameter and right atrial diameter between the two groups one month after surgery (all P<0.05). Conclusions:Total thoracoscopic mitral valve surgery combined with beating-heart tricuspid valvuloplasty under the intervention of the ERAS concept is safe and effective, but further confirmation from more large-sample clinical studies is needed.

Ground-glass nodule (GGN) lung cancer often progresses slowly in clinical and there are few clinical studies on long-term follow-up of patients with operable GGN lung cancer treated with stereotactic body radiation therapy (SBRT). We present a successful case of GGN lung cancer treated with SBRT, but a new GGN was found in the lung adjacent to the SBRT target during follow-up. The nodule progressed rapidly and was confirmed as lung adenocarcinoma by surgical resection. No significant risk factors and related driving genes were found in molecular pathological findings and genetic tests. It deserves further study whether new GGN is related to the SBRT. This case suggests that the follow-up after SBRT should be vigilant against the occurrence of new rapidly progressive lung cancer in the target area and adjacent lung tissue.
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Humans ; Lung Neoplasms/pathology* ; Radiosurgery ; Retrospective Studies ; Adenocarcinoma of Lung/surgery* ; Lung/pathology*