Acute lung injury (ALI) has been a kind of acute and severe disease that is mainly characterized by systemic uncontrolled inflammatory response to the production of huge amounts of reactive oxygen species (ROS) in the lung tissue. Given the critical role of ROS in ALI, a Fe₃O₄ loaded bovine serum albumin (BSA) nanocluster (BF) was developed to act as a nanomedicine for the treatment of ALI. Combining with NIR irradiation, it exhibited excellent ROS scavenging capacity. Significantly, it also displayed the excellent antioxidant and anti-inflammatory functions for lipopolysaccharides (LPS) induced macrophages (RAW264.7), and Sprague Dawley rats via lowering intracellular ROS levels, reducing inflammatory factors expression levels, inducing macrophage M2 polarization, inhibiting NF-κB signaling pathway, increasing CD4⁺/CD8⁺ T cell ratios, as well as upregulating HSP70 and CD31 expression levels to reprogram redox homeostasis, reduce systemic inflammation, activate immunoregulation, and accelerate lung tissue repair, finally achieving the synergistic enhancement of ALI immunotherapy. It finally provides an effective therapeutic strategy of BF + NIR for the management of inflammation related diseases.

Schizophrenia (SZ) stands as a severe psychiatric disorder. This study applied diffusion tensor imaging (DTI) data in conjunction with graph neural networks to distinguish SZ patients from normal controls (NCs) and showcases the superior performance of a graph neural network integrating combined fractional anisotropy and fiber number brain network features, achieving an accuracy of 73.79% in distinguishing SZ patients from NCs. Beyond mere discrimination, our study delved deeper into the advantages of utilizing white matter brain network features for identifying SZ patients through interpretable model analysis and gene expression analysis. These analyses uncovered intricate interrelationships between brain imaging markers and genetic biomarkers, providing novel insights into the neuropathological basis of SZ. In summary, our findings underscore the potential of graph neural networks applied to multimodal DTI data for enhancing SZ detection through an integrated analysis of neuroimaging and genetic features.
Humans ; Schizophrenia/pathology* ; Diffusion Tensor Imaging/methods* ; Male ; Female ; Adult ; Brain/metabolism* ; Young Adult ; Middle Aged ; White Matter/pathology* ; Gene Expression ; Nerve Net/diagnostic imaging* ; Graph Neural Networks

BACKGROUND: Lung cancer is currently the most prevalent malignancy and the leading cause of cancer deaths worldwide. Although the early stage non-small cell lung cancer (NSCLC) presents a relatively good prognosis, a considerable number of lung cancer cases are still detected and diagnosed at locally advanced or late stages. Surgical treatment combined with perioperative multimodality treatment is the mainstay of treatment for locally advanced NSCLC and has been shown to improve patient survival. Following the standard methods of neoadjuvant therapy, perioperative management, postoperative adjuvant therapy, and other therapeutic strategies are important for improving patients' prognosis and quality of life. However, controversies remain over the perioperative management of NSCLC and presently consensus and standardized guidelines are lacking for addressing critical clinical issues in multimodality treatment. METHODS: The working group consisted of 125 multidisciplinary experts from thoracic surgery, medical oncology, radiotherapy, epidemiology, and psychology. This guideline was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The clinical questions were collected and selected based on preliminary open-ended questionnaires and subsequent discussions during the Guideline Working Group meetings. PubMed, Web of Science, Cochrane Library, Scopus, and China National Knowledge Infrastructure (CNKI) were searched for available evidence. The GRADE system was used to evaluate the quality of evidence and grade the strengths of recommendations. Finally, the recommendations were developed through a structured consensus-building process. RESULTS: The Guideline Development Group initially collected a total of 62 important clinical questions. After a series of consensus-building conferences, 24 clinical questions were identified and corresponding recommendations were ultimately developed, focusing on neoadjuvant therapy, perioperative management, adjuvant therapy, postoperative psychological rehabilitation, prognosis assement, and follow-up protocols for NSCLC. CONCLUSIONS This guideline puts forward reasonable recommendations focusing on neoadjuvant therapy, perioperative management, adjuvant therapy, postoperative psychological rehabilitation, prognosis assessment, and follow-up protocol of NSCLC. It standardizes perioperative multimodality treatment and provides guidance for clinical practice among thoracic surgeons, medical oncologists, and radiotherapists, aiming to reduce postoperative recurrence, improve patient survival, accelerate recovery, and minimize postoperative complications such as atelectasis.
Humans ; Carcinoma, Non-Small-Cell Lung/therapy* ; Lung Neoplasms/therapy* ; Combined Modality Therapy ; Perioperative Care

Objective:To analyze the influencing factors of knee joint stiffness in patients with tibial plateau fractures after arthroscopy and construct a predictive model.Methods:The clinical data of 154 patients with tibial plateau fractures from June 2020 to May 2023 in Xi'an Daxing Hospital were retrospectively analyzed. All patients were treated with arthroscopic assisted internal fixation surgery. The gender, age, body weight, fracture cause, Schatzker classification, osteoporosis, meniscus and ligament structure injury, lower limb malalignment, bone graft, knee extension device injury, internal fixation method, external fixation time, heterotopic ossification, Tscherne classification, drainage tube placement, debridement times, operation opportunity and anesthesia method were recorded. The patients were followed up for 1 year, and the occurrence of knee joint stiffness was recorded. The patients were divided into knee joint stiffness group and normal knee joint group. Multivariate Logistic regression was used to analyze the independent risk factors of knee joint stiffness after arthroscopy in patients with tibial plateau fractures. R language software package was used to construct the nomogram model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures, calibration curve was drawn, and the Bootstrap method was used to verify the model discrimination. The predictive value of model was evaluated by the receiver operating characteristics (ROC) curve.Results:Among 154 patients with tibial plateau fractures, 28 patients developed knee joint stiffness after arthroscopy (knee joint stiffness group), with an incidence rate of 18.18%; 126 patients had normal knee joints (normal knee joint group). The proportions of obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification in knee joint stiffness group were significantly higher than those in normal knee joint group, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in gender composition, age, fracture cause, osteoporosis, Schatzker classification, bone graft, internal fixation method, external fixation time, Tscherne classification, drainage tube placement, debridement times, operation opportunity and anesthesia method between the two groups ( P>0.05). Multivariate Logistic regression analysis result showed that obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification were independent risk factors for knee joint stiffness after arthroscopy in patients with tibial plateau fractures ( OR = 5.387, 4.613, 3.308, 3.178 and 4.579; 95% CI 1.207 to 24.034, 1.447 to 14.709, 1.063 to 10.291, 1.155 to 8.745 and 1.540 to 13.613; P<0.05 or <0.01). The body weight, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification were used as predictors to construct a nomogram model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures. The calibration curve analysis result showed that the theoretical curve was basically consistent with the actual curve trend trajectory ( C- index = 0.861). The ROC curve analysis result showed that the model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures had good accuracy (area under curve was 0.861), with the sensitivity of 92.9% and specificity of 73.0%. Conclusions:The patients with tibial plateau fractures have the risk of knee joint stiffness after arthroscopy, which may be related to patient obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification. Based on these risk factors, a column chart risk prediction model can be constructed to visualize the risk and have certain predictive value for knee joint stiffness within 1 year after surgery.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Epitope vaccine is a novel strategy for vaccine development in recent years,exhibiting ad-vantages such as safety,and the ability to induce specific humoral and cellular immune responses a-gainst pathogens.Among them,the identification and delivery of epitopes are crucial in the design of multi-epitope vaccines.Compared to traditional methods of antigenic epitope identification,vari-ous new techniques such as bioinformatics,ELIspot,and intracellular cytokine staining have been developed.Since the direct immunization of multi-epitope peptides results in low protective effica-cy,efficient delivery systems are urgently needed.The antigenic epitopes commonly used delivery systems include viral vectors,and non-virus vectors such as nanoparticles,etc.Additionally,to en-hance the immunization efficacy of vaccines,antigenic epitopes are usually modified,including mul-tiple epitopes in tandem and epitope targeting modification and other strategies.This review sum-marizes the methods for accurate identification of antigenic epitopes with well immunogenicity as well as effective delivery strategies for antigenic epitopes,providing new insight into the develop-ment of novel multi-epitope vaccines.

Immune checkpoint inhibitor-related pneumonitis(CIP)is a relatively common immune-related adverse event.The current treatment for CIP mainly relies on glucocorticoids,with 70％～80％of patients being controlled by conventional glucocorticoid therapy.However,steroid-unresponsive CIP is often se-vere and can be life-threatening.There is no standard treatment protocol for steroid-unresponsive CIP,highlighting a significant unmet clinical need.This paper reviews the diagnosis,treatment progress,and exploratory research of steroid-unresponsive CIP to provide evidence-based guidelines and directions for clinical and translational research.

Immune checkpoint inhibitor-related pneumonitis(CIP)is a relatively common immune-related adverse event.The current treatment for CIP mainly relies on glucocorticoids,with 70％～80％of patients being controlled by conventional glucocorticoid therapy.However,steroid-unresponsive CIP is often se-vere and can be life-threatening.There is no standard treatment protocol for steroid-unresponsive CIP,highlighting a significant unmet clinical need.This paper reviews the diagnosis,treatment progress,and exploratory research of steroid-unresponsive CIP to provide evidence-based guidelines and directions for clinical and translational research.

Epitope vaccine is a novel strategy for vaccine development in recent years,exhibiting ad-vantages such as safety,and the ability to induce specific humoral and cellular immune responses a-gainst pathogens.Among them,the identification and delivery of epitopes are crucial in the design of multi-epitope vaccines.Compared to traditional methods of antigenic epitope identification,vari-ous new techniques such as bioinformatics,ELIspot,and intracellular cytokine staining have been developed.Since the direct immunization of multi-epitope peptides results in low protective effica-cy,efficient delivery systems are urgently needed.The antigenic epitopes commonly used delivery systems include viral vectors,and non-virus vectors such as nanoparticles,etc.Additionally,to en-hance the immunization efficacy of vaccines,antigenic epitopes are usually modified,including mul-tiple epitopes in tandem and epitope targeting modification and other strategies.This review sum-marizes the methods for accurate identification of antigenic epitopes with well immunogenicity as well as effective delivery strategies for antigenic epitopes,providing new insight into the develop-ment of novel multi-epitope vaccines.

Objective:To analyze the influencing factors of knee joint stiffness in patients with tibial plateau fractures after arthroscopy and construct a predictive model.Methods:The clinical data of 154 patients with tibial plateau fractures from June 2020 to May 2023 in Xi'an Daxing Hospital were retrospectively analyzed. All patients were treated with arthroscopic assisted internal fixation surgery. The gender, age, body weight, fracture cause, Schatzker classification, osteoporosis, meniscus and ligament structure injury, lower limb malalignment, bone graft, knee extension device injury, internal fixation method, external fixation time, heterotopic ossification, Tscherne classification, drainage tube placement, debridement times, operation opportunity and anesthesia method were recorded. The patients were followed up for 1 year, and the occurrence of knee joint stiffness was recorded. The patients were divided into knee joint stiffness group and normal knee joint group. Multivariate Logistic regression was used to analyze the independent risk factors of knee joint stiffness after arthroscopy in patients with tibial plateau fractures. R language software package was used to construct the nomogram model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures, calibration curve was drawn, and the Bootstrap method was used to verify the model discrimination. The predictive value of model was evaluated by the receiver operating characteristics (ROC) curve.Results:Among 154 patients with tibial plateau fractures, 28 patients developed knee joint stiffness after arthroscopy (knee joint stiffness group), with an incidence rate of 18.18%; 126 patients had normal knee joints (normal knee joint group). The proportions of obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification in knee joint stiffness group were significantly higher than those in normal knee joint group, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in gender composition, age, fracture cause, osteoporosis, Schatzker classification, bone graft, internal fixation method, external fixation time, Tscherne classification, drainage tube placement, debridement times, operation opportunity and anesthesia method between the two groups ( P>0.05). Multivariate Logistic regression analysis result showed that obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification were independent risk factors for knee joint stiffness after arthroscopy in patients with tibial plateau fractures ( OR = 5.387, 4.613, 3.308, 3.178 and 4.579; 95% CI 1.207 to 24.034, 1.447 to 14.709, 1.063 to 10.291, 1.155 to 8.745 and 1.540 to 13.613; P<0.05 or <0.01). The body weight, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification were used as predictors to construct a nomogram model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures. The calibration curve analysis result showed that the theoretical curve was basically consistent with the actual curve trend trajectory ( C- index = 0.861). The ROC curve analysis result showed that the model for predicting the knee joint stiffness after arthroscopy in patients with tibial plateau fractures had good accuracy (area under curve was 0.861), with the sensitivity of 92.9% and specificity of 73.0%. Conclusions:The patients with tibial plateau fractures have the risk of knee joint stiffness after arthroscopy, which may be related to patient obesity, meniscus and ligament structure injury, knee extension device injury, lower limb malalignment and heterotopic ossification. Based on these risk factors, a column chart risk prediction model can be constructed to visualize the risk and have certain predictive value for knee joint stiffness within 1 year after surgery.