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.

To address the issue of reduced signal quality of photoplethysmography caused by local fluctuation,an approach called locally orthogonal weighted polynomial fitting(LOWPF)is proposed for signal smoothing.After determining the positions of the fluctuation sequences using the forward-backward difference XOR method,weighted polynomial fitting is applied to these sequences,and the fitted values are used to replace the fluctuation sequences to achieve signal smoothing.By constructing orthogonal basis functions,the condition number of the coefficient matrix is reduced,and the stability of the equation system solution for higher-order fitting is improved.Simulation results demonstrate that the smoothed signal's XOR smoothness of the proposed method surpasses that of the moving average algorithm and the empirical mode decomposition reconstruction algorithm.The smoothing results on 241 sets of measured PPG signals show that LOWPF achieves an efficiency of smoothness of 89.10%,significantly higher than the 78.05%of empirical mode decomposition and the 59.13%of the 5-point moving average algorithm.LOWPF has promising application prospects for smoothing signals with significant local fluctuations.

Objective:To explore the latent-classes of HIV high risk behaviors among college students, and the association between experiences of intimate partner violence (IPV) and HIV high risk behaviors, to provide evidence for reducing the HIV high risk behaviors among them.Methods:A cross-sectional study was conducted from October to December 2019 among university students from six higher education institutions in Zhuhai City, using a multi-stage cluster sampling method, with an estimated sample size of 1 318. The study included participants who self-reported being in a romantic relationship and having sexual experience within the past year. Data on sociodemographic characteristics, IPV experiences, and HIV high risk behaviors were collected. Latent-class analysis was performed on HIV high risk behaviors, and chi-squared tests and multivariable logistic regression were used to analyze the associations between IPV experiences and different latent classes of HIV high risk behaviors.Results:The effective response rate for the survey was 95.4% (12 235/12 821). 1 382 college students from Zhuhai were included as participants in the study, with 19.4% (268/1 382) self-reporting having experienced IPV. Latent-class analysis of HIV high risk behaviors classified the participants into three latent groups: low-risk group (78.1%, 1 079/1 382), multiple sexual partners/alcohol use before sex group (15.8%, 219/1 382), and high-risk group (6.1%, 84/1 382). Multivariable logistic regression analysis showed that students who had experienced psychological violence were more likely to be in the group that had multiple sexual partners/alcohol use before sex (a OR=2.51, 95% CI:1.48-4.27). Those who had experienced IPV (a OR=5.74, 95% CI:3.45-9.55), physical violence (a OR=9.26, 95% CI: 5.24-16.35), sexual violence (a OR=8.46, 95% CI:4.93-14.52), or psychological violence (a OR=15.99, 95% CI:8.64-29.57) were more likely to be in the high-risk group. Students who experienced two (a OR=9.37, 95% CI:3.55-24.71) or three types of IPV (a OR=50.09, 95% CI: 21.06-119.14) were more likely to be in the high-risk group compared to those with no IPV experiences. Conclusions:HIV high risk behaviors among college students in Zhuhai exhibited heterogeneity across different latent groups, and these groups have different associations with IPV experiences. Universities should tailor targeted HIV/AIDS education and prevention strategies based on the characteristics of each latent group to reduce HIV high risk behaviors among college students.

Myxedema coma is a rare condition, typically arising from long-standing, untreated hypothyroidism and triggered by factors such as infection, hypothermia, or severe illness. This report details a successfully treated case of myxedema coma with cardiac attest, accompanied by a literature review, to enhance clinical awareness and improve the diagnosis and management of this critical condition.

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.

Lipoatrophic diabetes(LD) is a rare and distinct form of diabetes characterized by notable clinical heterogeneity. It is often considered one of the manifestations of lipodystrophy syndrome(LDS). In clinical practice, LD is frequently misdiagnosed as type 2 diabetes; however, its management protocols and prognostic outcomes differ significantly from those of other diabetes subtypes. Therefore, timely and accurate diagnosis is of great clinical importance. This paper presents two detailed case reports of female patients with LD. Through an in-depth analysis of their clinical features, it also provides an comprehensive review of the key clinical manifestations of LDS, potential pathogenic mechanisms, and current approaches to genetic diagnosis. The aim is to enhance clinicans′ awareness of LDS and improve corresponding diagnostic and therapeutic strategies.

Coronavirus disease 2019(COVID-19)is a respiratory syndrome caused by severe acute respiratory syn-drome coronavirus 2(SARS-CoV-2).Once SARS-CoV-2 was detected in Wuhan(Hubei Province,China),it rap-idly spread widely across China and the world,posing a serious threat to global health and the economy.With the development of Artificial Intelligence(AI)technology and the openness and application of open-source software,tremendous progress has been achieved in the quantitative study of chest radiology for COVID-19,enabling the quantitative dataization of radiological image data,which adds a powerful indicator to the prognosis study of COV-ID-19.Therefore,we reviewed the current literature on the factors predicting the severity and prognosis of COV-ID-19,and summarized demographic,laboratory and radiological factors to help with risk stratification and prog-nosis assessment for COVID-19 patients and assist in their clinical management and treatment.

Objective:To analyze and compare differences in cortical functioning between patients with post-stroke dysphagia (PSD) following a left hemisphere stroke and healthy individuals using functional near-infrared spectroscopy (fNIRS).Methods:Twenty-six patients recovering from post-stroke dysphagia following a left hemisphere stroke formed the study′s PSD group, and 26 age-matched healthy subjects serves as the HC group. A 41-channel infrared spectroscope was used to record any changes in oxyhemoglobin (HbO) concentration while swallowing and at rest. The fNIRS data were statistically analyzed using Nirspark software. The β-values, reflecting the level of cortical activation, and the swallowing-related specific functional connectivity (FC) strength values (ΔFCs), representing task-specific FC strength, were extracted. The β-values and ΔFCs of the two groups were compared.Results:Compared with the HC group, the PSD group showed significantly reduced activation in Brodmann area (BA) 3/4/6/43 and BA4/6 of the left hemisphere during swallowing. Those areas correspond to the left primary motor cortex (M1), primary somatosensory cortex (S1), premotor cortex, and supplementary motor area (PM). Significantly reduced activation was observed in the PSD group in the right hemisphere at BA45/46/47, BA45/38/48, and BA10, corresponding to the right prefrontal cortex (PFC). The ΔFC values between the left PM-left M1, left PM-left S1, left M1-right S1, and left S1-right M1 in the PSD group were significantly lower than those in the HC group.Conclusions:Left hemispheric PSD is associated not only with decreased activation in the ipsilesional sensorimotor cortex (M1, S1, PM) but also with functional decline in the contra-lesional PFC. During swallowing, persons with left hemispheric PSD exhibit extensive impairment in inter-cortical network connectivity, with particularly marked reductions in connectivity between their ipsilesional and contra-lesional sensorimotor cortices.

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. Surgical resection remains the preferred treatment modality, offering the potential for cure. However, over half of HCC patients present as intermediate to advanced stages at diagnosis, with multiple factors precluding surgical resection. Conversion therapy represents an important treatment strategy by enabling tumor downstaging, offering future resectability for patients with intermediate-to-advanced HCC who are initially unresectable. This article reviews the relevant concepts and research progress in conversion therapy for HCC.

Human carboxylesterase 2A (hCES2A) plays pivotal roles in prodrug activation and hydrolytic metabolism of ester-bearing chemicals. Targeted inhibition of intestinal hCES2A represents a feasible strategy to mitigate irinotecan-triggered gut toxicity (ITGT), but the orally active, selective, and efficacious hCES2A inhibitors are rarely reported. Here, a novel drug-like hCES2A inhibitor was developed via three rounds of structure-based drug design (SBDD) and structural optimization. Initially, donepezil was identified as a moderate hCES2A inhibitor from 2000 US Food and Drug Administration (FDA)-approved drugs. Following two rounds of SBDD and structural optimization, a donepezil derivative (B7) was identified as a strong reversible hCES2A inhibitor. Subsequently, nine B7 carbamates were rationally designed, synthesized and biologically assayed. Among all synthesized carbamates, C3 showed the most potent time-dependent inhibition on hCES2A (IC₅₀ = 0.56 nmol/L), excellent specificity and favorable drug-like properties. C3 could covalently modify the catalytic serine of hCES2A with high selectivity, while this agent also showed favorable safety profiles, high intestinal exposure, and impressive effects for ameliorating ITGT in both human intestinal organoids and tumor-bearing mice. Collectively, this study showcases a rational strategy for developing drug-like and serine-targeting covalent inhibitors against target serine hydrolase(s), while C3 emerges as a promising orally active drug candidate for ameliorating ITGT.