Acquired immunodeficiency syndrome (AIDS), a disease caused by human immunodeficiency virus (HIV), has plagued human being for nearly 40 years and continues to pose a significant challenge to our society. Development of an effective vaccine against HIV is still the most ideal approach for AIDS elimination. However, to date, no effectively preventive HIV vaccine has emerged for widespread use. HIV is a highly variable virus, and traditional vaccine strategies have encountered difficulties in preventing HIV infection. Consequently, there is a growing emphasis in the scientific community on the development of a novel vaccine capable of eliciting broadly neutralizing antibodies (bNAb) against multiple HIV variants. This article outlines the current progress in the design of new immunogens and candidate vaccines, highlighting recent clinical trials and preliminary research. It also offers insights into future directions for HIV vaccine development.

Recent advances in tumor immunology have made immunotherapy a new direction for neoadjuvant treatment of gastric cancer. Multiple clinical trials have confirmed that combining immunotherapy with chemotherapy and targeted therapy in the neoadjuvant treatment of gastric cancer can effectively improve treatment response and prolong patient survival time. This article aims to comment on the application of immunotherapy in the neoadjuvant treatment of gastric cancer, exploring its mechanisms, integration strategies with traditional treatments, safety, and personalized precision therapy in the hope of providing new insights and directions for the field of gastric cancer treatment.

Objectives:To report the sexual functional outcomes of vaginal dilation therapy in Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome patients.Methods:From March 2020 to February 2023, 97 MRKH syndrome patients performed vaginal dilation therapy with guidance from Peking Union Medical College Hospital, and 45 of them engaged in penetrative intercourse and were included in this prospective cohort study. The Chinese version of female sexual function index (FSFI) was used to assess sexual function. Functional success was defined as FSFI>23.45. Forty age-matched healthy women were selected as controls. Kaplan-Meier survival analysis was used to calculate the median time to success. Pearson correlation analysis was used to explore the relationship between neovagina length and sexual function. Complications were collected using follow-up questionnaires.Results:The functional success rate of vaginal dilation therapy was 89% (40/45) with a median time to success of 4.3 months (95% CI: 3.0-6.1 months). Compared to controls, MRKH syndrome patients had significantly lower scores in the orgasm domain (4.72±1.01 vs 4.09±1.20; P=0.013) and pain domain (5.03±0.96 vs 4.26±0.83; P<0.001). However, there were no significant differences in the FSFI total score (26.77±2.70 vs 26.70±2.33; P=0.912), arousal domain (4.43±0.77 vs 4.56±0.63; P=0.422) and satisfaction domain (4.88±0.98 vs 4.65±0.86; P=0.269) between MRKH syndrome patients and controls. MRKH syndrome patients had significantly higher scores in the desire domain (3.33±0.85 vs 3.95±0.73; P<0.001) and lubrication domain (4.37±0.56 vs 5.20±0.67; P<0.001). The prevalence of sexual dysfunction in MRKH patients was non-inferior to controls: low desire [3% (1/40) vs 23% (9/40); P=0.007], arousal disorder [3% (1/40) vs 3% (1/40); P>0.999], lubrication disorder [5% (2/40) vs 25% (10/40); P=0.012], orgasm disorder [40% (16/40) vs 20% (8/40); P=0.051], sexual pain [30% (12/40) vs 15% (6/40); P=0.108]. Conclusions:MRKH syndrome patients undergoing non-invasive vaginal dilation therapy could achieve satisfactory sexual life. Given its high functional success rate and slight complication, vaginal dilation therapy should be recommended as the first-line option, reducing the need for unnecessary surgeries.

The technology of three-dimensional(3D)printing emerged in the late 1970s and has since undergone considerable development to find numerous applications in mechanical engineering,industrial design,and biomedicine.In biomedical science,several studies have initially found that 3D printing technology can play an important role in the treatment of diseases in hepatopancreatobiliary surgery.For example,3D printing technology has been applied to create detailed anatomical models of disease organs for preoperative personalized surgical strategies,surgical simulation,intraoperative navigation,medical training,and patient education.Moreover,cancer models have been created using 3D printing technology for the research and selection of chemotherapy drugs.With the aim to clarify the development and application of 3D printing technology in hepatopancreatobiliary surgery,we introduce seven common types of 3D printing technology and review the status of research and application of 3D printing technology in the field of hepatopancreatobiliary surgery.

Recent advances in tumor immunology have made immunotherapy a new direction for neoadjuvant treatment of gastric cancer. Multiple clinical trials have confirmed that combining immunotherapy with chemotherapy and targeted therapy in the neoadjuvant treatment of gastric cancer can effectively improve treatment response and prolong patient survival time. This article aims to comment on the application of immunotherapy in the neoadjuvant treatment of gastric cancer, exploring its mechanisms, integration strategies with traditional treatments, safety, and personalized precision therapy in the hope of providing new insights and directions for the field of gastric cancer treatment.

Objective:To explore the characteristics of a fetus with chromosome 1p36 deletion syndrome and 3p26.3p25.2 duplication.Methods:A pregnant woman who had attended the Genetic Counseling Clinic of Linyi People′s Hospital on February 22, 2022 and her fetus were selected as the study subjects. Clinical data were collected. Chromosomal karyotyping, fluorescence in situ hybridization (FISH) and chromosomal microarray analysis (CMA) were carried out for the prenatal diagnosis. Result:Ultrasonography at 24th gestational week revealed that the fetus had ventricular septal defect, single umbilical artery, and slight widening of left lateral ventricle (12 mm). The woman was found to have a karyotype of 46, XX, t(1; 3)(p36.22; p25.2), and the result of FISH was t(1; 3)(3pter+, 1qter+ ; 1pter+, 3qter+ ). The fetus was found to have a karyotype of 46, X?, add(1)(p36), and CMA confirmed that it has a 9.0 Mb deletion at 1p36.33p36.22 and a 12.6 Mb duplication at 3p26.3p25.2. Combining the maternal karyotype, the molecular karyotype of the fetus was determined as 46, X?, der(1)t(1; 3)(p36.22; p25.2)mat.arr[hg19]1p36.33p36.22(849467_9882666)×1, 3p26.3p25.2(61892_12699607)×3, with the former known to be associated with 1p36 deletion syndrome.Conclusion:The fetus was diagnosed with 1p36 deletion syndrome, and its 1p36.33p36.22 deletion and 3p26.3p25.2 duplication had both derived from the balanced translocation carried by its mother.

Objective:To investigate the clinicopathological, immunophenotypic and molecular genetic characteristics, and differential diagnosis of NTRK-rearranged spindle cell neoplasms (NTRK-RSCNs) in the gastrointestinal tract.Methods:Two NTRK-RSCNs diagnosed at the Department of Pathology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China and one case diagnosed at Zhengzhou Central Hospital, Zhengzhou, China from 2019 to 2022 were collected. The clinical data, histopathology, immunophenotypes and prognosis were analyzed. Fluorescence in situ hybridization (FISH) and next-generation sequencing (NGS) were used to detect NTRK gene rearrangements, while relevant literature was also reviewed and discussed.Results:Two patients were male and one was female, with the age of 17, 47 and 62 years, respectively. The tumors were located in the duodenum, ascending colon and descending colon, respectively. The tumors were protuberant masses with gray and rubbery sections. Their maximum diameter was 2.5, 5.0 and 10.0 cm, respectively. Histologically, the tumors invaded mucosa, intrinsic muscle and serosal adipose tissue. Tumor cells consisted of spindle or oval shaped cells with monotonous morphology and arranged in bundles or stripes pattern. Spindle cells were mildly to moderately atypical, with slightly eosinophilic cytoplasm and inconspicuous nucleoli. Necrosis and mitotic figures were observed in one high-grade tumor. All tumors expressed CD34, S-100 and pan-TRK in varying degrees. FISH analysis showed that NTRK1 gene was break-apart in 1 case and NTRK2 gene break-apart in 2 cases. NGS technologies showed LMNA::NTRK1 fusion in one case, STRN::NTRK2 fusion in another case. All patients recovered well after the surgery without recurrence at the end of the follow-up.Conclusions:NTRK-RSCN is rarely diagnosed in the gastrointestinal tract and has significant variations in morphology. It overlaps with various other mesenchymal tumors which should be considered as differential diagnoses. Be familiar with the features of histological morphology in combination with immunophenotype and molecular genetic characteristics can not only help diagnose NTRK-RSCNs, but provide therapeutic targets for clinical treatment.

The optimal drug treatment for preterm infants with hemodynamically significant patent ductus arteriosus (hsPDA) is still controversial.The prophylactic intravenous injection of indomethacin can be considered for extremely preterm infants or extremely low birth weight infants with a high risk of severe intraventricular hemorrhage.The expectant management without drug intervention can be chosen in the following situations: asymptomatic; preterm infants with gestational age ≥28 weeks or birth weight ≥1 000 g are born within 7-14 days; and there are few risk factors affecting spontaneous closure of hsPDA.The drug intervention can be given if the expectant management fails.Oral administration of high-dose Ibuprofen, Acetaminophen and standard-dose Ibuprofen are recommended.

Objectives:To compare the efficacies of operations under unilateral biportal endoscopy(UBE)and uniportal endoscopy(UE)in the treatment of lumbar spinal stenosis(LSS)with meta analysis.Methods:The clinical controlled studies of UBE and UE in the treatment of LSS were searched in PubMed,Cochrane Li-brary,Web of science,Embase,Medline,CNKI,Wanfang,and VIP database from their establishments to May 2024.Newcastle-Ottawa scale(NOS)was used to evaluate the quality of the included studies.Outcome data including visual analogue scale(VAS)score of lower back and leg pain,Oswestry disability index(ODI),opera-tive time,intraoperative blood loss,length of hospital stay,complications,and dural sac area were extracted and analyzed with Review Manager 5.3 software for meta analysis.Results:A total of 15 articles were in-cluded,including 1 prospective cohort study and 14 retrospective studies,which were of medium and high quality according to the NOS.The total sample size was 1277,including 650 patients in the UBE group and 627 patients in the UE group.Meta analysis showed that there was a statistical difference in the operative time between the two groups,and the UBE group was shorter[MD=-12.30,95％CI(-20.90,-3.71),P=0.005].There was a no statistically significant difference in intraoperative blood loss[MD=7.41,95％CI(-0.55,15.31),P=0.07],length of hospital stay[MD=0.02,95％CI(-0.09,0.14),P=0.71],postoperative back pain VAS score[MD=-0.22,95％CI(-0.45,0.02),P=0.07],postoperative leg pain VAS score[MD=-0.18,95％CI(0.39,0.02),P=0.08],ODI[MD=-0.91,95％CI(-2.22,0.39),P=0.17],complication rate[OR=0.75,95％CI(0.46,1.24),P=0.27],or preoperative dural sac cross-sectional area[MD=0.37,95％CI(-3.18,2.44),P=0.80]between the two groups.However,the dural sac area expansion after operation was statistically larger in UBE group than that in UE group[MD=-12.51,95％CI(7.44,17.59),P＜0.00001].Conclusions:Both operations under UBE and UE can achieve significant clinical efficacy in the treatment of LSS,and UBE is superior to UE in operative time and the degree of spinal canal decompression.

Objective:Taking the main international collaborative innovation network management modes for clinical research as a reference, to promote the construction of a collaborative innovation network for clinical research in China.Methods:Using literature research, case study, comparative analysis, and interview methods, this study systematically studied the collaborative innovation network management modes of clinical research in the United States, the United Kingdom, Japan, South Korea, and China from the perspective of integrating and sharing clinical research resources.Results:Based on the comparative results and drawing on foreign experience, suggestions were proposed to optimize the management mode of the clinical research collaborative innovation network in China and promote the construction of clinical research collaborative innovation network.Conclusions:It is recommended to establish national medical research institutions, increase investment in clinical research funds, build a platform for integrating volunteer resources based on clinical research collaborative innovation networks, and establish a clinical sample resource service platform to further supplement and improve the structure and layout of China’s clinical research collaborative innovation network.