Immune checkpoint blockade therapy has demonstrated remarkable efficacy in treating various malignancies; however, its clinical application remains challenged by low response rates and immune-related adverse events. Immunoglobulin superfamily member 11 (IGSF11), an inhibitory immune checkpoint molecule, serves as a specific ligand for the V-domain immunoglobulin suppressor of T cell activation (VISTA). Through the IGSF11/VISTA axis, it suppresses T cell function and represents a promising novel target for cancer immunotherapy. IGSF11 is widely expressed across multiple tumor types, though its regulatory mechanisms vary depending on the malignancy. Studies have confirmed that blocking the IGSF11-VISTA interaction or specifically inhibiting IGSF11 exerts antitumor effects. While IGSF11 is closely associated with patient prognosis, its prognostic significance differs among cancer types. This review systematically summarizes the structural characteristics of IGSF11, its regulatory mechanisms, interaction with VISTA, and functional role within the tumor microenvironment.
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Humans ; Immunotherapy ; Neoplasms/metabolism* ; B7 Antigens/chemistry* ; Animals ; Molecular Targeted Therapy ; Tumor Microenvironment

Endovascular interventional therapy is currently the main treatment for acute ischemic stroke，but some patients still have not achieved neurological function independence. Analysis of the predictive value of various factors for postoperative neurological function changes can provide more reference for selecting appropriate patient groups and treatment plans.

A 44-year-old male presented with a 19-year history of urinary calculi and a 1-year history of polydipsia and weight loss. Laboratory tests revealed hyperparathyroidism and evidence of glucagonoma-associated diabetes. Imaging studies identified masses in the pancreatic head and body/tail, suggestive of glucagonoma and a parathyroid adenoma. Furthermore, the patient exhibited hypercalcitoninemia and elevated cortisol and adrenocorticotropic hormone levels. Genetic testing revealed a heterozygous MEN1 mutation [c.65T>G (p.Leu22Arg)], confirming the diagnosis of multiple endocrine neoplasia type 1 (MEN-1). The patient subsequently underwent near-total parathyroidectomy and total pancreatectomy. Postoperative immunohistochemical staining of the pancreatic tail tumor was positive for glucagon and calcitonin. The patient′s postoperative hormone levels (calcitonin, glucagon, adrenocorticotropic hormone, cortisol) normalized, suggesting a rare pancreatic neuroendocrine tumor (pNET) that was co-secreting multiple hormones. Postoperative management included pancreatic enzyme supplementation, calcium supplementation, vitamin D supplementation, and insulin for glycemic control. Follow-up evaluations at 10 months demonstrated a stable clinical condition, well-controlled blood glucose and biochemical parameters, and an acceptable quality of life. This case study highlights that the presence of pNETs should be considered in patients with MEN-1 and multiple abnormal hormone levels. Timely surgical management of the involved glands and postoperative complications can effectively improve prognosis.

Objective:To investigate the ability of 18F-fibroblast activation protein inhibitor (FAPI) PET/CT imaging to identify involved myocardium in patients with hypertrophic cardiomyopathy (HCM) compared with cardiac MRI. Methods:A prospective study was conducted on 50 patients (32 males, 18 females, age (43±13) years) with HCM confirmed by ultrasound or cardiac MRI in Beijing Chaoyang Hospital from July 2021 to January 2022. All patients underwent both cardiac 18F-FAPI PET/CT and MRI. The SUV max and maximum target-to-background ratio (TBR max) of the left ventricular myocardium were obtained using post-processing software. Regions with 18F-FAPI uptake not less than predefined thresholds (SUV max 40%, 50%, 60%) were defined as myocardium with positive uptake. The FAPI amount was defined as the product of TBR max and the extent of FAPI-positive uptake (FAPI%). Cardiac MRI post-processing software was used to measure the extent of left ventricular myocardial late gadolinium enhancement (LGE) (expressed as LGE%), native T 1 value, extracellular volume fraction (ECV), and myocardial deformation characteristics. Spearman rank correlation analysis was employed to assess the correlation between 18F-FAPI imaging parameters and cardiac MRI parameters, as well as the correlation between FAPI amount and the 5-year risk score for sudden cardiac death (SCD). Linear regression analysis was utilized to identify factors associated with FAPI amount. Results:When the threshold for 18F-FAPI-positive uptake in the left ventricular myocardium was set at 60%, the correlations between FAPI amount, FAPI%, and MRI parameters were optimal ( rs values: from -0.465 to 0.460, all P<0.05). Multivariate linear regression analysis revealed that HCM duration ( β=0.128, 95% CI: 0.022-0.233, P=0.008), serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels ( β=0.190, 95% CI: 0.099-0.280, P<0.001), and left ventricular ejection fraction ( β=-0.005, 95% CI: -0.011 to 0.000, P=0.041) were independent predictors of FAPI amount. FAPI amount was positively correlated with the 5-year SCD risk score across different thresholds (40%: rs=0.32, P=0.026; 50%: rs=0.29, P=0.039; 60%: rs=0.29, P=0.040). Conclusions:When the threshold for 18F-FAPI-positive uptake is set at 60%, 18F-FAPI PET/CT imaging can more effectively identify the involved myocardium in HCM. FAPI amount is correlated with the 5-year SCD risk score in patients with HCM.

OBJECTIVE: To review clinical application and research progress of different types of intelligent responsive hydrogels in repairing articular cartilage injury. METHODS: The animal experiments and clinical studies of different types of intelligent responsive hydrogels for repairing articular cartilage injury were summarized by reviewing relevant literature at home and abroad. RESULTS: The intrinsic regenerative capacity of articular cartilage following injury is limited. Intelligent responsive hydrogels, including those that are temperature-sensitive, light-sensitive, enzyme-responsive, pH-sensitive, and other stimuli-responsive hydrogels, can undergo phase transitions in response to specific stimuli, thereby achieving optimal functionality. These hydrogels can fill the injured cartilage area, promote the proliferation and differentiation of chondrocytes, and expedite the repair of the damaged site. With advancements in cartilage tissue engineering materials research, intelligent responsive hydrogels offer a novel approach and promising potential for the treatment of cartilage injuries. CONCLUSION Intelligent responsive hydrogel is a kind of flexible, controllable, efficient, and stable polymer, which has similar structure and functional properties to articular cartilage, and has become one of the important biomaterials for cartilage repair. However, there is still a lack of unified treatment standards and simple and efficient preparation technology.
Hydrogels/therapeutic use* ; Cartilage, Articular/injuries* ; Tissue Engineering/methods* ; Humans ; Animals ; Chondrocytes/cytology* ; Biocompatible Materials/chemistry* ; Tissue Scaffolds/chemistry*

Objective To study the basic features,judicial identification and trial characteristics of medical malpractice cases related to gastrointestinal endoscopy,enhance the awareness of risks of gastrointestinal endoscopy among medical staffand patients.,emphasize the importance of preoperative education and provide judicial identification and trial personnel with ideas for handling such cases,ensuring standardization and consistency in handling similar cases.Methods A total of 100 medical dispute cases involving gastrointestinal endoscopy from May 2010 to May 2024 were included from the China Judgments Online database.The analysis focused on document types,years,regions,court levels,details of judicial expertise,the proportion of court decision responsibility.Results The number of cases has increased significantly since 2017,with the highest incidence in 2020 and 2021(collectively accounting for 39%);Regions with the most disputes included Fujian,Guangdong,Shandong,Shanghai,Liaoning,Beijing,Jiangsu,collectively accounting for 58%of cases.The primary method of forensic expertise was medical damage identification,accounting for 82.0%of cases;Among these,4 cases underwent reappraisal,all of which resulted in modifications to the original expertise.Male patients outnumbered female patients,with"Digestive tract discomfort"being the main reason for consultation(63%).The most common medical injury was digestive tract perforation(37%),among which colon perforation was the most common;Of the 100 cases,60 cases were found to have errors in gastrointestinal endoscopy,and the medical errors were concentrated in"Improper operation during Operation"(42 cases),The contributory roles of various negligence types in the damage consequence ranged from"no causation"to"complete causation"in varing proportions.Notably,negligence categories such as"improper intraoperative manipulation"and"delayed treatment due to untimely examination"consistently demonstrated contributory roles of"secondary causation or higher."Regarding court rulings,the majority of cases(23 cases)assigned liability proportions of 31%-50%,followed by 20 cases with liability proportions of 71%-100%.

Objective To investigate the expression and mechanistic role of the M2-type pyruvate kinase(PKM2)/signal transducer and activator of transcription 3(STAT3)signaling pathway in the development of experimental autoim-mune uveitis(EAU).Methods Eighteen 4-to 5-week-old C57BL/6J mice were selected and randomly divided into a control group(normal breeding,set as the 0-day state post-modeling),Experimental Group A,and Experimental Group B(both established as stable EAU mouse models using the interphotoreceptor retinoid-binding protein peptide 651-670,com-plete Freund's adjuvant,and pertussis toxin,designated as the 14-day and 21-day states post-modeling,respectively),with 6 mice in each group.The anterior segment of the mice was observed using a slit-lamp microscope,fundus findings were collected using a fundus camera,and clinical and histopathological scores were evaluated after hematoxylin-eosin stai-ning.The protein expression level of serum interleukin(IL)-17A was detected by ELISA.The expression level of PKM2 protein in retinal tissue was detected by immunohistochemistry.The protein expression levels of PKM2,phosphorylated STAT3(p-STAT3),and STAT3 in mouse retinal tissue were detected by Western blot.Results The clinical scores of the anterior segment and fundus,as well as the retinal histopathological scores in Experimental Group A and Experimental Group B,were all significantly higher than those in the control group(all P＜0.05).The serum IL-17A protein expression levels in the control group,Experimental Group A,and Experimental Group B were(69.05±0.45)ng·L-1,(75.06±0.46)ng·L-1,and(72.04±0.82)ng·L-1,respectively.The optical density values of PKM2 protein expression in retinal tissue were(18.51±2.59)％,(37.35±4.67)％,and(29.75±2.17)％,respectively.The expression levels of serum IL-17A protein,retinal PKM2 protein,and retinal STAT3 and p-STAT3 proteins in Experimental Group A and Experimental Group B were all significantly higher than those in the control group(all P＜0.05).Conclusion The expression levels of key factors in the PKM2/STAT3 signaling pathway are positively correlated with the severity of EAU,indicating that this sig-naling pathway,as a positive regulator of the immune response,is involved in the pathological process of EAU.

Objective To systematically search,evaluate,and summarize the evidence for risk management of breast and ovarian cancers in carriers of breast cancer susceptibility gene 1/2(BRCA1/2)mutations.Methods A systematic search was conducted in BMJ Best Practice,UpTo-Date,the National Guideline Clearinghouse(NGC),the National Institute for Health and Care Ex-cellence(NICE),the Scottish Intercollegiate Guidelines Network(SIGN),the Guidelines Interna-tional Network(GIN),the New Zealand Guidelines Group(NZGG),the Canadian Medical Associa-tion Infobase(CMA InfoBase),the Registered Nurses' Association of Ontario(RNAO),the National Comprehensive Cancer Network(NCCN),Cancer Care Ontario(CCO),the Medlive website,the American Society of Clinical Oncology(ASCO),the European Society for Medical Oncology(ESMO),the American Cancer Society(ACS),the American College of Obstetricians and Gynecologists(ACOG),the Joanna Briggs Institute(JBI),the Cochrane Library,PubMed,Web of Science,Em-base,CINAHL,ProQuest,ClinicalTrials.gov,China National Knowledge Infrastructure,Wanfang Data,VIP Database,and SinoMed for evidence related to risk management of breast and ovarian canc-ers in BRCA1/2 mutation carriers,including clinical decisions,guidelines,systematic reviews,expert consensus,and evidence summaries.The search period was from the inception of each database to September 20,2024.Results A total of 14 articles were included,comprising 1 clinical decision,8 guidelines,and 5 expert consensus documents.Based on five themes-risk assessment,risk moni-toring,risk-reducing surgery,pharmacologic prevention,and health guidance,a total of 24 pieces of evidence were summarized.Conclusion The evidence summarization process in this study is standardized,and the summarized evidence is relatively comprehensive.Healthcare professionals should comprehensively consider patients' individual characteristics,family history,personal prefer-ences,and the accessibility of healthcare resources to achieve effective prevention and control of he-reditary tumor risks.

Objective To investigate the effects of active respiratory circulation technique(ACBT)combined with resistance breathing training on pulmonary function and exercise capacity in patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD).Methods A total of 60 hospitalized AECOPD patients from the Geriatrics Department of a tertiary hospital in Kunming were selected as research subjects from January to May 2024.Patients were randomly divided into two groups,with 30 patients in each group.The control group received conventional pulmonary rehabilitation nursing,and the observation group received ACBT combined with resistance breathing training.Pulmonary function indicators,modified British Medical Council(mMRC)dyspnea scores,6-minute walk test(6MWT)distances,and the COPD Assessment Test(CAT)scores were collected 4 weeks after discharge to evaluate the intervention's effectiveness.Results After the intervention,the observation group showed significant improvements in lung function,mMRC scores,6M WT distances,and CAT scores compared to pre-intervention levels,and all were superior to the control group(P＜0.05).Conclusion ACBT combined with resistance breathing training can more effectively promote sputum clearance,reduce respiratory muscle fatigue,increase exercise endurance,and improve dyspnea severity and lung function in AECOPD patients.

Endovascular interventional therapy is currently the main treatment for acute ischemic stroke,but some patients still have not achieved neurological function independence.Analysis of the predictive value of various factors for postoperative neurological function changes can provide more reference for selecting appropriate patient groups and treat-ment plans.