Cancer is one of the major diseases of high morbidity and mortality worldwide,and its therapeutic approaches are facing great challenges.Immunotherapy,especially the activation of innate immunity represented by the cGAS-STING signaling pathway,is the current research hotspot in tumor immunotherapy.Activation of innate immune response by gas therapy is the latest development in tumor therapeutic approaches,especially the use of gas signaling molecules(NOx CO,H2S and SO2)to activate the cGAS-STING signaling pathway to induce intrinsic immunity of the organism,which leads to anti-tumor immunotherapy.Although intrinsic immunity activated by gas signaling molecules plays an important role in tumor immunotherapy,few reviews have been reported on its association with the cGAS-STING signaling mechanism.In this paper,we will comprehensively describe how gas signaling molecules damage the mitochondrial matrix and DNA damage through oxidative/nitrosative stress,thereby activating the cGAS-STING signaling pathway and triggering the innate immune cascade,aiming to summarize the process of activation of anti-tumor immune effects by gas signaling molecules,and to provide more references for the gas therapies in the future anti-tumor immunity research.

With the increasing proportion of critically ill pregnant and postpartum women, extracorporeal membrane oxygenation (ECMO) has become the ultimate treatment for severe obstetric diseases. However, the application of ECMO for pregnant and postpartum women in China is facing the prominent contradiction of " unbalanced growth between quantity and quality system construction", which is manifested as systemic challenges such as uneven regional development, inconsistent treatment capabilities, and lack of unified standards. To address the above issues, this paper proposes the construction of a regional ECMO treatment system for pregnant and postpartum women based on the " Hub-and-Spoke" model. This system aims to achieve early identification, rapid transportation, and homogeneous and efficient treatment of critically ill pregnant and postpartum women by concentrating high-quality medical resources, establishing standardized multidisciplinary team (MDT) diagnosis and treatment processes, and setting up professional mobile ECMO transportation teams. The construction of this regional treatment system is a key measure to improve the success rate of treating critically ill pregnant and postpartum women and reduce maternal mortality in China, and is of great significance for ensuring maternal and infant safety.

Objective:To explore the application indications, clinical characteristics and influencing factors of extracorporeal membrane oxygenation (ECMO) in the treatment of critically ill pregnant and postpartum women in Bao′an district, Shenzhen, and summarize regional experience.Methods:A retrospective analysis was conducted on 5 cases of pregnant and postpartum women who received ECMO treatment at the CUHK Women′s and Children′s Medical Centre (Shenzhen) and the Shenzhen Bao′an People′s Hospital from 2020 to 2024. Baseline characteristics, ECMO parameters, complications and maternal-infant outcomes of the patients were collected.Results:The patients′ age was 29(24, 36) years old, gestational age was 39(31, 39) weeks, and ECMO maintenance time was 8(4, 8) days. ECMO indications included 2 cases of cardiac arrest, 1 case of respiratory and circulatory failure, 1 case of cardiogenic shock, and 1 case of acute respiratory distress syndrome. There were 4 cases of veno-arterial (VA)-ECMO and 1 case of veno-venous (VV)-ECMO. Complications included 3 cases of bleeding, 4 cases of acute renal failure, 2 cases of thrombosis, and 2 cases of infection. Both maternal and infant survival were 3 cases. Successful cases benefited from the multidisciplinary rapid response team and regional transportation cooperation, while failed cases were mostly accompanied by severe bleeding and disseminated intravascular coagulation.Conclusions:ECMO improves the success rate of treating critically ill pregnant and postpartum women in Bao′an District. Amniotic fluid embolism and severe pulmonary hypertension are the main indications. Regional multidisciplinary cooperation, accurate initiation timing and individualized anticoagulation management are the keys. It is recommended to establish a national ECMO registration system for pregnant and postpartum women to optimize treatment strategies and improve maternal and infant prognosis.

Extracorporeal membrane oxygenation (ECMO) serves as an advanced life support technology and plays a critical role in treating critically ill patients with severe cardiopulmonary failure. However, the unique physiological and pathological changes during pregnancy present numerous challenges and special considerations for the application of ECMO in obstetrics. Given the current lack of unified guidelines specifically for obstetric ECMO, clinical practice often relies on adapting general ECMO guidelines in combination with obstetric-specific factors. This article systematically reviews the core principles of existing general ECMO guidelines, provides an in-depth analysis of the impact of gestational physiological and pathological characteristics on ECMO application, and discusses the particularities and necessary adaptations of obstetric ECMO in terms of indications, anticoagulation strategies, parameter adjustment, multidisciplinary collaboration, and emergency management. Furthermore, it proposes strategies suitable for domestic clinical practice. The article also addresses existing difficulties and limitations not covered by current guidelines and calls for the urgent development of specialized obstetric ECMO guidelines to provide clinicians with more standardized and safer decision-making support, ultimately improving outcomes for critically ill pregnant patients and newborns.

Cancer is one of the major diseases of high morbidity and mortality worldwide,and its therapeutic approaches are facing great challenges.Immunotherapy,especially the activation of innate immunity represented by the cGAS-STING signaling pathway,is the current research hotspot in tumor immunotherapy.Activation of innate immune response by gas therapy is the latest development in tumor therapeutic approaches,especially the use of gas signaling molecules(NOx CO,H2S and SO2)to activate the cGAS-STING signaling pathway to induce intrinsic immunity of the organism,which leads to anti-tumor immunotherapy.Although intrinsic immunity activated by gas signaling molecules plays an important role in tumor immunotherapy,few reviews have been reported on its association with the cGAS-STING signaling mechanism.In this paper,we will comprehensively describe how gas signaling molecules damage the mitochondrial matrix and DNA damage through oxidative/nitrosative stress,thereby activating the cGAS-STING signaling pathway and triggering the innate immune cascade,aiming to summarize the process of activation of anti-tumor immune effects by gas signaling molecules,and to provide more references for the gas therapies in the future anti-tumor immunity research.

With the increasing proportion of critically ill pregnant and postpartum women, extracorporeal membrane oxygenation (ECMO) has become the ultimate treatment for severe obstetric diseases. However, the application of ECMO for pregnant and postpartum women in China is facing the prominent contradiction of " unbalanced growth between quantity and quality system construction", which is manifested as systemic challenges such as uneven regional development, inconsistent treatment capabilities, and lack of unified standards. To address the above issues, this paper proposes the construction of a regional ECMO treatment system for pregnant and postpartum women based on the " Hub-and-Spoke" model. This system aims to achieve early identification, rapid transportation, and homogeneous and efficient treatment of critically ill pregnant and postpartum women by concentrating high-quality medical resources, establishing standardized multidisciplinary team (MDT) diagnosis and treatment processes, and setting up professional mobile ECMO transportation teams. The construction of this regional treatment system is a key measure to improve the success rate of treating critically ill pregnant and postpartum women and reduce maternal mortality in China, and is of great significance for ensuring maternal and infant safety.

Objective:To explore the application indications, clinical characteristics and influencing factors of extracorporeal membrane oxygenation (ECMO) in the treatment of critically ill pregnant and postpartum women in Bao′an district, Shenzhen, and summarize regional experience.Methods:A retrospective analysis was conducted on 5 cases of pregnant and postpartum women who received ECMO treatment at the CUHK Women′s and Children′s Medical Centre (Shenzhen) and the Shenzhen Bao′an People′s Hospital from 2020 to 2024. Baseline characteristics, ECMO parameters, complications and maternal-infant outcomes of the patients were collected.Results:The patients′ age was 29(24, 36) years old, gestational age was 39(31, 39) weeks, and ECMO maintenance time was 8(4, 8) days. ECMO indications included 2 cases of cardiac arrest, 1 case of respiratory and circulatory failure, 1 case of cardiogenic shock, and 1 case of acute respiratory distress syndrome. There were 4 cases of veno-arterial (VA)-ECMO and 1 case of veno-venous (VV)-ECMO. Complications included 3 cases of bleeding, 4 cases of acute renal failure, 2 cases of thrombosis, and 2 cases of infection. Both maternal and infant survival were 3 cases. Successful cases benefited from the multidisciplinary rapid response team and regional transportation cooperation, while failed cases were mostly accompanied by severe bleeding and disseminated intravascular coagulation.Conclusions:ECMO improves the success rate of treating critically ill pregnant and postpartum women in Bao′an District. Amniotic fluid embolism and severe pulmonary hypertension are the main indications. Regional multidisciplinary cooperation, accurate initiation timing and individualized anticoagulation management are the keys. It is recommended to establish a national ECMO registration system for pregnant and postpartum women to optimize treatment strategies and improve maternal and infant prognosis.

Extracorporeal membrane oxygenation (ECMO) serves as an advanced life support technology and plays a critical role in treating critically ill patients with severe cardiopulmonary failure. However, the unique physiological and pathological changes during pregnancy present numerous challenges and special considerations for the application of ECMO in obstetrics. Given the current lack of unified guidelines specifically for obstetric ECMO, clinical practice often relies on adapting general ECMO guidelines in combination with obstetric-specific factors. This article systematically reviews the core principles of existing general ECMO guidelines, provides an in-depth analysis of the impact of gestational physiological and pathological characteristics on ECMO application, and discusses the particularities and necessary adaptations of obstetric ECMO in terms of indications, anticoagulation strategies, parameter adjustment, multidisciplinary collaboration, and emergency management. Furthermore, it proposes strategies suitable for domestic clinical practice. The article also addresses existing difficulties and limitations not covered by current guidelines and calls for the urgent development of specialized obstetric ECMO guidelines to provide clinicians with more standardized and safer decision-making support, ultimately improving outcomes for critically ill pregnant patients and newborns.

Objective:The quality of domestic diagnostic accuracy research was evaluated to explore the quality level of domestic diagnostic accuracy research based on Standards for Reporting of Diagnostic Accuracy 2015 (STARD2015).Methods:The Chinese core journals of CNKI and Wanfang Database were searched, and research literature on diagnostic accuracy published from 2017 to 2022 were collected. The main search terms are diagnostic test, sensitivity, specificity, receiver operating characteristic (ROC) curve, etc. The literature was selected according to the inclusion criteria, and the quality of the included literature was evaluated independently by two reviewers, and the conformity rate of the STARD2015 report and the STARD2015 article was calculated. The report quality of the literature was divided into three levels (low, medium and high) according to the conformity rate of the STARD2015 report. The proportion of literature at each level and the proportion of literature at medium and high level in each year were counted. According to quality analysis on the contents of the included articles, articles were divided into standardized reports and unstandardized reports. Intragroup correlation coefficient ( ICC) was used to analyze the consistency of two reviewers. The trend Chi-square test was used to analyze the trend of the proportion of medium and high level literature in each year. One-way analysis of variance was used to compare the coincidence rates evaluated by STARD2015 for each year. Results:A total of 6 771 studies on diagnostic accuracy published from 2017 to 2022 were included. The compliance rate sccording to STARD2015 was 39.56%±4.90%, and the reported compliance rate ranged from 17.65% to 64.71% (the number of reported items ranged from 6 to 22), and 93.53% (6 333/6 771) literatures were in the middle level. Compliance rate of STARD2015 reports varied significantly among different years ( F=25.023, P<0.01), and the compliance rate of 2021 was significantly higher than that of other years ( P<0.01). The proportion of medium and high level literatures according to STARD2015 showed an increasing trend ( χ 2=14.099, P<0.01). The reporting situation of each item varied significantly, and the conformity rate of items raned from 0 to 100%. According to report item, non-standard report rate was 10.34% (569/5 503) for item 6, 4.15% (277/6 677) for item 8, 21.84% (1 447/6 626) for item 20, 66.67% (24/36) for item 22, and 26.03% (877/3 369) for item 26. Conclusions:The overall report quality of published domestic literature on diagnostic accuracy from 2017 to 2022 is at a medium level according to STARD2015, and the reports conformity rate of each item vary significantly, indicating significant knowledge gap on STARD2015 among domestic researchers. The promotion of STARD2015 needs to be strengthened.

Studies have suggested that the nucleus accumbens (NAc) is implicated in the pathophysiology of major depression; however, the regulatory strategy that targets the NAc to achieve an exclusive and outstanding anti-depression benefit has not been elucidated. Here, we identified a specific reduction of cyclic adenosine monophosphate (cAMP) in the subset of dopamine D1 receptor medium spiny neurons (D1-MSNs) in the NAc that promoted stress susceptibility, while the stimulation of cAMP production in NAc D1-MSNs efficiently rescued depression-like behaviors. Ketamine treatment enhanced cAMP both in D1-MSNs and dopamine D2 receptor medium spiny neurons (D2-MSNs) of depressed mice, however, the rapid antidepressant effect of ketamine solely depended on elevating cAMP in NAc D1-MSNs. We discovered that a higher dose of crocin markedly increased cAMP in the NAc and consistently relieved depression 24 h after oral administration, but not a lower dose. The fast onset property of crocin was verified through multicenter studies. Moreover, crocin specifically targeted at D1-MSN cAMP signaling in the NAc to relieve depression and had no effect on D2-MSN. These findings characterize a new strategy to achieve an exclusive and outstanding anti-depression benefit by elevating cAMP in D1-MSNs in the NAc, and provide a potential rapid antidepressant drug candidate, crocin.