The activation proteins released by fibroblasts in the tumor microenvironment regulate tumor growth, migration, and treatment response, thereby influencing tumor progression and therapeutic outcomes. Owing to the proliferation and metastasis of tumors, fibroblast activation protein (FAP) is typically highly expressed in the tumor stroma, whereas it is nearly absent in adult normal tissues and benign lesions, making it an attractive target for precision medicine. Radiolabeled agents targeting FAP have the potential for targeted cancer diagnosis and therapy. This comprehensive review aims to describe the evolution of FAPI-based radiopharmaceuticals and their structural optimization. Within its scope, this review summarizes the advances in the use of radiolabeled small molecule inhibitors for tumor imaging and therapy as well as the modification strategies for FAPIs, combined with insights from structure-activity relationships and clinical studies, providing a valuable perspective for radiopharmaceutical clinical development and application.

Objective This study aims at establishing a teaching catalog and content for breast rare dis-eases and developing the syllabus for the breast rare disease using integrated multimodality of case-/problem-/resource-based learning(CBL+PBL+RBL).Methods By conducting bibliometrics co-occurrence analysis,we collected 6291 articles on breast rare disease published from January,1975 to June,2024.Additionally,we re-trieved the Textbook on Rare Diseases,the Catalog of Chinese Rare Disease,and Second Batch of Rare Dis-ease Catalog and then decided the teaching content.Results From 16,387 keywords,1000(6.1％)keywords were identified through co-occurrence analysis,including 50(0.3％)candidate diseases.These were classified into three categories:rare primary breast diseases,rare genetic mutation-related diseases associated with breast cancer,and rare systemic multi-system diseases involving the breast.From the candidate list,20(0.1％)rare primary breast diseases were further selected for their notable clinical teaching significance,and significant multi-systemic diseases affecting the breast,whether related to gene mutations or not.Teaching plans were draf-ted using a diversified parallel teaching approaches,taking into account the characteristics of different diseases and the focus of different teaching methods.Conclusions This study initiated the development of the teaching content for breast rare diseases and developed the teaching syllabus using the CBL+PBL+RBL integrated multi teaching model and targeting each rare breast disease for the critical point for teaching.

Liver fibrosis is a reversible pathological process caused by chronic liver damage and a major risk factor for hepatocellular carcinoma (HCC). Hepatic stellate cell (HSC) activation is considered the main target for liver fibrosis therapy. However, the efficiency of this strategy is limited due to the complex microenvironment of liver fibrosis, including excessive extracellular matrix (ECM) deposition and hypoxia-induced imbalanced ECM metabolism. Herein, nilotinib (NIL)-loaded hyaluronic acid (HA)-coated Ag@Pt nanotriangular nanozymes (APNH NTs) were developed to inhibit HSCs activation and remodel the microenvironment of liver fibrosis. APNH NTs efficiently eliminated intrahepatic reactive oxygen species (ROS) due to their inherent superoxide dismutase (SOD) and catalase (CAT) activities, thereby downregulating the expression of NADPH oxidase-4 (NOX-4) and inhibiting HSCs activation. Simultaneously, the oxygen produced by the APNH NTs further alleviated the hypoxic microenvironment. Importantly, the released NIL promoted collagen depletion by suppressing the expression of tissue inhibitor of metalloproteinase-1 (TIMP-1), thus synergistically remodeling the microenvironment of liver fibrosis. Notably, an in vivo study in CCl₄-induced mice revealed that APNH NTs exhibited significant antifibrogenic effects without obvious long-term toxicity. Taken together, the data from this work suggest that treatment with the synthesized APNH NTs provides an enlightening strategy for remodeling the microenvironment of liver fibrosis with boosted antifibrogenic activity.

Acute respiratory distress syndrome (ARDS) is a common clinical critical condition of the respiratory system, with a high fatality rate and lack of effective drug treatment, hence it is a global medical problem to be solved urgently. Recently, with the in-depth research on extracellular vesicles (EVs) at home and abroad, more and more evidences suggest that EVs play a critical role in the initiation, development and progression of ARDS and have potential clinical application value. The role of different cells derived EVs in ARDS will be reviewed in this paper.

Objective:To evaluate the impact of sample pooling strategy on 2019-nCoV RNA detection results.Methods:Ten negative swabs were stored in 6 ml virus transport medium, mixed thoroughly and diluted 1∶2 and 1∶10. Inactivated 2019-nCoV culture medium was added to simulate pooling samples: 10 pooling samples, 5 pooling samples and 1 swab sample. Extraction and amplification were made using three nucleic acid extraction reagents a, b, and c with different extraction methods and systems, as well as five 2019-nCoV detection reagents A-E with various template loading volumes and sensitivities respectively.Results:For the same sample, the Ct values of extracted templates a were 2.10±0.47 and 3.46±0.62 earlier than extracted templates b and c. For samples with identical amplifying, the Ct valves of N and ORF1ab gene of A reagent were 1.16±0.48 and 2.36±0.54 earlier than that of reagent B. Adding nucleic acid of 10 negative swabs to the amplification system lagged the Ct values of reagent A by about 1.36±0.32 Ct, while Ct values of reagent B were not affected. Extracted by regent a, a lag of 1.66±0.39 Ct on average was observed in C, D, and E reagents in detecting pooling samples of ten swabs as compared with one swab sample. When extracting 400 copies/ml pooling samples of ten swabs by reagent a, N gene could be detected by reagents C and E, but not by reagent D.Conclusion:Large amount of extraneous DNA is introduced by sample pooling, which could interfere the effiency of extraction and amplification. Strategies of using extraction reagents with large loading volume and high effiency, together with amplification reagents with large template volume and low limit of detection are helpful for ensuring detection sensitivity of pooling samples, and greatly reducing the risk of false negative results.

Objective:To study the safety and effectiveness of endoscopic full-thickness resection(EFR) in the treatment of large gastric stromal tumors with diameter of 5-7 cm.Methods:Data of 36 patients with large gastric stromal tumors (5-7 cm) who received EFR or surgery (including laparoscopic and open surgery) in the First Affiliated Hospital of Zhengzhou University and confirmed by postoperative histopathology from January 2017 to October 2018 were retrospectively analyzed. Patients were divided into endoscopic group (9 cases) and surgical group (27 cases) according to different resection methods. The perioperative indicators and the total incidence of complications in the two groups were compared.Results:In terms of perioperative indicators, the median operation time of the endoscopic group was significantly longer than that of the surgical group (4.0 hours VS 2.0 hours, P<0.01), and the postoperative fasting time (4.55±0.88 days VS 6.22±2.24 days, t=-2.15, P=0.03) and hospital stay (6.88±1.26 days VS 10.03±2.90 days, t=-3.13, P<0.01) were significantly shorter than those of the surgical group. The median visual analogue scores (VAS) of abdominal pain of the endoscopic group on the first postoperative day (3 VS 6, P<0.01)and the third postoperative day (1 VS 3, P<0.01) were significantly lower than those of the surgical group. The hospitalization cost was significantly less than that of the surgical group (55±14.7 thousand yuan VS 73±24.3 thousand yuan, t=-2.11, P=0.04). In term of the total incidence of complications, the endoscopic group was 11.1% (1/9), which was higher than that of the surgical group [7.4% (2/27)], but there was no statistically significant difference( P=1.00). Conclusion:EFR is safe and effective in the treatment of large gastric stromal tumors (5-7 cm), and has the advantages of less invasiveness, rapid postoperative recovery, and lower hospitalization cost. But how to shorten the operation time is an urgent problem to be solved.

Objective To investigate the effect of insulin pump combined with dipeptidyl peptidase-Ⅳ (DPP-Ⅳ) inhibitor on the treatment of newly diagnosed type 2 diabetes mellitus (T2 DM). Methods Totally 51 newly diagnosed patients with T2 DM were randomly divided into experimental group (insulin pump combined with DPP-Ⅳ inhibitor) and control group (insulin pump alone). After 15 days of treatment, the clinical effect was compared between two groups. Results After treatment, the blood sugar related indexes in both groups significantly improved (P ＜ 0. 05), and the blood sugar control of the experimental group was significantly better than that of the control group (P ＜ 0. 05). The pancreatic β cell function index, area under curve of C-peptide and insulin resistance index in the experimental group were significantly better than those in the control group (P ＜0. 05). The dosage of insulin, the ratio of patients with blood sugar reaching the standard completely, the time of blood sugar reaching the standard and the increase value of body mass in the experimental group were significantly better than those in the control group (P ＜ 0. 01). The incidence rate of hypoglycemia was 8. 00％ (2/26) in the experimental group and 12. 00％ (3/25) in the control group, and there was no significant difference between the two groups (P＞ 0. 05). During the treatment, no severe hypoglycemic events and liver and kidney function damage occurred in both groups. Conclusion Insulin pump combined with DPP-Ⅳ inhibitor is effective in the treatment of newly diagnosed T2 DM, which can effectively control blood sugar, reduce insulin resistance and weight gain.

Objective To investigate the effect of insulin pump combined with dipeptidyl peptidase-Ⅳ (DPP-Ⅳ) inhibitor on the treatment of newly diagnosed type 2 diabetes mellitus (T2 DM). Methods Totally 51 newly diagnosed patients with T2 DM were randomly divided into experimental group (insulin pump combined with DPP-Ⅳ inhibitor) and control group (insulin pump alone). After 15 days of treatment, the clinical effect was compared between two groups. Results After treatment, the blood sugar related indexes in both groups significantly improved (P ＜ 0. 05), and the blood sugar control of the experimental group was significantly better than that of the control group (P ＜ 0. 05). The pancreatic β cell function index, area under curve of C-peptide and insulin resistance index in the experimental group were significantly better than those in the control group (P ＜0. 05). The dosage of insulin, the ratio of patients with blood sugar reaching the standard completely, the time of blood sugar reaching the standard and the increase value of body mass in the experimental group were significantly better than those in the control group (P ＜ 0. 01). The incidence rate of hypoglycemia was 8. 00％ (2/26) in the experimental group and 12. 00％ (3/25) in the control group, and there was no significant difference between the two groups (P＞ 0. 05). During the treatment, no severe hypoglycemic events and liver and kidney function damage occurred in both groups. Conclusion Insulin pump combined with DPP-Ⅳ inhibitor is effective in the treatment of newly diagnosed T2 DM, which can effectively control blood sugar, reduce insulin resistance and weight gain.

Objective To investigate the clinical manifestations, treatment and prognosis of streptococcal toxic shock syndrome (STSS) in children. Methods One case of STSS was reported in a child who was admitted to Children's Hospital of Fudan University. Search terms such as "streptococcal toxic shock syndrome", "children" and "case report" were used to identify relevant reports from PubMed database, as well as Chinese databases including Chongqing VIP, Wanfang, and China National Knowledge Infrastructure for further review. Results The patient in this report was a 11-year-old female. The main clinical manifestations were fever, red, swelling, and pain in the right lower extremity, associated with impaired walking and hypotension. Imaging examination suggested diffuse abnormal signals in the soft tissue of right thigh. Group A Streptococcus (namely Streptococcus pyogenes) was isolated from the puncture fluid. The patient was improved after active shock-correcting and anti-infective treatment. A total of 6 STSS cases were identified from Chinese databases between January 1, 1996 and May 1, 2017. All the 7 cases (including this one, 4 males and 3 females, 15 months to 13 years of age) reported fever and skin rashes, and rapidly progressed to shock. Respiratory failure was reported in 4 cases and supported with a ventilator. Three patients died, including 2 within 24 hours after hospitaladmission. A total of 38 STSS cases (40 days to 18 years of age) were identified from PubMed database. The main clinical manifestations of these cases were respiratory tract or digestive tract symptoms, and skin and soft tissue infection. In addition, chickenpox was found in 3 cases, Kawasaki disease in 2 cases, neonatal bullous impetigo, pancreatitis, infectious mononucleosis, and lymphohistiocytosis in one case each. Of the 38 patients, 22 survived and 16 died. Conclusions STSS is a rare and severe form of invasive streptococcal infection in children. The early manifestations are not specific, which may be mistaken for upper respiratory tract infection, gastrointestinal dysfunction symptoms, skin and soft tissue infection, or muscle and joint disorder, or even similar to or associated with Kawasaki disease. But rapid progression to shock and multiple organ failure of STSS pose a serious threat to children. Pediatricians should keep alert on STSS. Early identification, timely diagnosis, and adequate treatment are key to improving patient outcome.

OBJECTIVE: To explore the application effect of clinical nursing pathway( CNP) in nursing care on patients with occupational noise-induced deafness( ONID) under medical observation.METHODS: The patients with ONID under medical observation in hospital were randomly selected and divided into CNP group( 50 cases) and control group( 50 cases) by random number table method.The control group was given routine nursing care,and the CNP group was given CNP care according to the nursing path table.Self-Rating Anxiety Scale,Self-rating Depression Scale and SF-36 Scale were used to observe the anxiety, depression and quality of life of these two groups.The time and expenses of hospitalization,and degree of nursing satisfaction were also observed.RESULTS: Before nursing care implementation,the scores of anxiety,depression and 8 dimension of quality of life did not show statistical significance between these two groups( P > 0.05).After nursing care implementation,the improvement of anxiety,depression and quality of life in the CNP group were significantly better than that of the control group( P < 0.01).The patients in the CNP group had shorter duration of hospitalization( P < 0.01),decreased hospitalization expenses( P < 0.05),and increased nursing satisfaction( P < 0.01) compared with the control group.CONCLUSION: CNP implementation can effectively reduce the anxiety and depression symptoms of patient with ONID under medical observation during the diagnostic process of occupational diseases.It can reduce the time and costs of hospitalization,improve their quality of life and satisfaction of nursing care.CNP can be widely used in clinical practice.