Lymphoma is one of the most common malignancies in China. Lymphoma exhibited complex pathological subtypes with significant heterogeneity, the treatment strategies varied. In recent years, with a deeper understanding of the mechanisms of oncogenesis and disease progression of lymphoma, significant development has been made in diagnosis and treatment, leading to the improvement of patients' clinical outcomes. In order to update the progress in the diagnosis and treatment of lymphoma. The Medical Oncology Branch of China International Exchange and Promotive Association for Medical and Health Care, the China Anti-cancer Association Lymphoma Committee, and the Chinese Association for Clinical Oncologists organized experts to developed the "China lymphoma diagnosis and treatment guideline (2026 edition)". The updated guideline offers systematic and comprehensive revisions on methodology, epidemiological data, clinical manifestations, auxiliary examinations, new drugs, new treatment regimens, and new indications. It also incorporates treatment recommendations along with their evidence levels and grades of recommendation, covering common clinical issues in the diagnosis and management of lymphoma patients, thus providing improved guidance for standardized diagnosis and patient management.

Glioblastoma (GBM) remains uniformly lethal due to pronounced intratumoral heterogeneity and a highly immunosuppressive microenvironment that limits the efficacy of targeted therapies.

We engineered chimeric antigen receptor (CAR) T cells targeting Epidermal Growth Factor Receptor variant III (EGFRvIII) and armored them with a single-chain interleukin-12 (scIL12) payload. These cells were tested in syngeneic, orthotopic GBM mouse models exhibiting heterogeneous EGFRvIII expression. CAR T cells were delivered intracranially without lymphodepletion.

Intracranial administration of scIL12-secreting CAR-T cells eradicated tumors without requiring lymphodepletion, achieving 50% long-term survival. Survival benefits depended entirely on endogenous CD8⁺ T cells, as efficacy was abolished in CD8-deficient hosts and unaffected by natural killer cell depletion. Notably, therapeutic efficacy was abrogated by lymphodepletion, underscoring the necessity of an intact endogenous immune response. Mechanistically, scIL12 enhanced CAR-T cell persistence and reprogrammed tumor-associated microglia, indicating potential antigen spreading through polyclonal endogenous CD8+T cell responses, which facilitate the elimination of EGFRvIII-negative tumor cells.

This study demonstrates the pleiotropic benefits of IL-12 armored CAR-T cells with improved targeting of antigen-positive tumor cells and simultaneous remodeling of the microenvironment to engage adaptive immunity against antigen-negative clones. This strategy offers a potential clinically actionable approach to improve outcomes in GBM by circumventing the need for toxic lymphodepletion and addressing tumor heterogeneity.

Immune checkpoint inhibitors (ICIs) and chimeric antigen receptor T-cell (CAR-T) immunotherapies have revolutionized the treatment of hepatocellular carcinoma (HCC). However, the frequent emergence of treatment resistance significantly limits the clinical efficacy of HCC immunotherapy. The molecular mechanisms underlying therapy resistance remain poorly understood.

To delineate the immune impact of nuclear factor erythroid 2-related factor 2 (Nrf2) inhibition, we integrated allograft tumor models with bulk and single-cell RNA sequencing analyses. Biochemical assays were performed to investigate the mechanisms underlying Nrf2 inhibition in immune resistance. The combined activity of Nrf2 inhibition with anti-programmed death-1 (PD-1) antibody and CAR-T cell therapy was also explored in vivo.

We show that brusatol (BRU), a specific inhibitor of Nrf2, an emerging regulator of the tumor immune microenvironment, potentiates antitumor immunity in HCC mouse models. Mechanistically, inhibition of Nrf2 downregulates surface programmed death ligand-1 (PD-L1) expression via transcriptional repression in tumor cells, while upregulating major histocompatibility complex (MHC)-I expression via nuclear factor kappa-light-chain-enhancer of activated B cells activation. Inhibition of Nrf2 in tumor cells enhances the activation of immune-related signaling pathways and promotes CD8⁺ T-cell infiltration into tumor tissues. Furthermore, inhibition of Nrf2 with BRU significantly enhances the efficacy of PD-1 antibody and CAR-T cells against HCC in vivo, indicating that therapeutic targeting of Nrf2 in HCC cells sensitizes them to ICIs and CAR-T immunotherapies.

Our findings offer a novel strategy to enhance HCC immunotherapy by blocking Nrf2, which has the potential to address the low response rates observed with current HCC immunotherapies.

Despite significant advancements in immunotherapy for advanced esophageal cancer, there remains a critical need for reliable biomarkers to predict long-term clinical outcomes. The C-PLAN index, a novel composite score integrating C-Reactive Protein (CRP), lymphocyte dynamics, nutritional risk, and the Neutrophil-to-Lymphocyte Ratio (NLR), was developed to serve as a potential prognostic tool in this setting.

This study included 228 patients with advanced esophageal cancer who received PD-1/PD-L1 inhibitors between January 2018 and March 2023. Patients were stratified into low-risk (score ≤ 2), Medium-risk (score 3-4), or high-risk (score ≥ 5) groups based on the C-PLAN index. Clinical outcomes, including Overall Survival (OS) and Progression-Free Survival (PFS), were assessed over a 24-month follow-up period. Nonlinear associations between the C-PLAN index and OS/PFS were evaluated using restricted cubic splines. Cox proportional hazards models identified independent prognostic factors for OS, while time-dependent Receiver Operating Characteristic (ROC) curves compared the predictive accuracy of the C-PLAN index with that of NLR.

Of the 228 patients enrolled, 189 were included in the final analysis. Significant differences in baseline characteristics were observed across risk groups: low-risk patients exhibited higher Body Mass Index (BMI) and albumin levels, whereas high-risk patients had larger tumor sizes, elevated CRP, Lactate Dehydrogenase (LDH), NLR, and C-PLAN scores. The median PFS was significantly longer in the low-risk group compared with intermediate- and high-risk groups (p < 0.001). A significant nonlinear relationship between the C-PLAN index and both OS and PFS was observed (p for nonlinearity < 0.001). Multivariable analysis identified NLR, poorly differentiated histology, and the C-PLAN index as independent predictors of mortality. Time-dependent ROC analyses revealed that the C-PLAN index demonstrated superior predictive accuracy compared to NLR at both 12-months (Area Under the Curve [AUC], 0.710 vs. 0.496) and 24-months (AUC, 0.897 vs. 0.740).

The C-PLAN index provides a robust and clinically meaningful prognostic tool for patients with advanced esophageal cancer treated with immune checkpoint inhibitors. Its superior predictive performance compared to traditional markers such as NLR highlights its potential utility in risk stratification and guiding treatment decisions.

Oxidative stress, inflammatory response, and cell apoptosis play important roles in the occurrence, development, and outcome of many diseases, including some lung diseases. During ischemia, hypoxia, or inflammation, the body produces excessive reactive oxygen species (ROS), which non-selectively react with nucleic acids, lipids, and proteins, leading to cellular oxidative damage. Traditional antioxidants exhibit limitations due to their non-specific actions and safety concerns, whereas hydrogen (H₂), as a novel selective antioxidant, can readily cross the blood-brain barrier and blood-tissue barriers to rapidly reach target tissues, effectively eliminating ROS. Beyond its antioxidant properties, H₂ possesses anti-inflammatory, anti-apoptotic, and autophagy-regulating effects. This review summarizes recent research findings on the therapeutic application of H₂ in oxidative stress-related pulmonary diseases, aiming to provide theoretical foundations and research directions for the clinical application of H₂ in the prevention and treatment of lung diseases.

To investigate the factors influencing the apnea test (AT) and its clinical effects in brain death determination under updated criteria, and to provide evidence for optimizing and reducing the risk of false-negative results and complications.

Based on the data from the Anhui Provincial Brain Injury Evaluation Quality Control Center, the data of brain-dead patients who completed AT with an off ventilator duration of 5-11 minutes were analyzed retrospectively. Data from January 2018 to March 2025 were used as the model development cohort, and the data from June to December 2025 were used as the external validation cohort. Demographic characteristics, clinical data, evaluation and examination indicators, AT operation details, etc. were extracted using standardized case report form. Temporal trends of AT positive rate and the incidences of severe hypercapnia, acidosis, hypoxemia and other complications when offline for 5-11 minutes were evaluated using the Cochran-Armitage trend test, and the key factors affecting the change of arterial partial pressure of carbon dioxide (PaCO₂) and pH were analyzed by multiple linear regression model.

The model development cohort included 384 patients with brain death, and the external validation cohort included 47 patients with brain death. There was no significant difference in baseline characteristics between the two cohorts (all P>0.05). With the extension of offline time, the positive rate of AT was gradually increased (Cochran-Armitage trend test: Z=3.52, P<0.001), rising from 76.5% (13/17) at 5 minutes to 91.7% (11/12) at 7 minutes, and plateaued after 7 minutes. The trend analysis of complications in the same period showed that the incidence of severe hypercapnia (PaCO₂>80 mmHg, 1 mmHg=0.133 kPa) showed a significant increasing trend (Z=4.09, P<0.001), and was higher at 10 minutes than at 9 minutes [44.7% (59/132) vs. 21.6% (8/37), P<0.05]. Severe acidosis (pH<7.20) became more frequent over time (Z=-4.69, P<0.001), and was higher at 10 minutes than at 7 minutes [73.5% (97/132) vs. 58.3% (7/12), P<0.05]. The incidence of hypoxemia [arterial partial pressure of oxygen (PaO₂) <60 mmHg] showed a decreasing trend (Z=-5.21, P<0.001), with no statistically significant difference in incidence between 7-11 minutes (F=0.859, P=0.525). The prediction model was established by multiple regression, indicated that offline time, pre-AT PaCO₂, pre-AT pH, heart rate, and body weight collectively influenced post-AT PaCO₂ (R²=0.284, P<0.001). Offline time, pre-AT pH, heart rate, and hemoglobin were associated with post-AT pH (R²=0.455, P<0.001). External validation indicated good performance for the pH model (mean absolute error was 0.038, R²=0.69) and acceptable performance for the PaCO₂ model (mean absolute error was 6.21 mmHg, R²=0.62).

When implementing the dual-criteria standard (PaCO₂ and pH), an offline time window of 7 to 9 minutes can balance diagnostic efficacy for brain death with patient safety. Pre-intervention strategies, such as lowering pH or raising PaCO₂ before disconnection, may shorten the time needed to reach AT targets. However, should be guided by a comprehensive assessment of individualized patient factors, including baseline pH, PaCO₂, heart rate, hemoglobin, and body weight.

To identify the risk factors for the progression of severe pneumonia to acute respiratory distress syndrome (ARDS) and to construct a prediction model based on the random forest algorithm, providing a basis for disease assessment, early intervention, and prognosis improvement in severe pneumonia.

A retrospective observational study was conducted. Patients with severe pneumonia admitted to the intensive care unit (ICU) of the Second Affiliated Hospital of Zunyi Medical University from January 2020 to May 2024 were enrolled. Data including general patient information, vital signs, blood test results, disease assessment indicators within 24 hours of ICU admission, and outcome measures were collected. Patients were divided into ARDS group and non-ARDS group according to whether they progressed to ARDS. Univariate Logistic regression analysis was used to screen the risk factors for the progression of severe pneumonia to ARDS, and a random forest based prediction model was constructed. Model performance and stability were validated using 1 000 resampling iterations.

A total of 181 severe pneumonia patients were included, of whom 73 progressed to ARDS, with an incidence rate of 40.3%. Compared to the non-ARDS group, the ARDS group had significantly lower lowest systolic blood pressure, lowest diastolic blood pressure, lowest oxygenation index, pH value, and albumin level, while showing significantly higher maximum activated partial thromboplastin time (APTT), Acute Physiology and Chronic Health Evaluation (APACHE), and Lung Injury Prediction Score (LIPS; all P<0.05). There were no statistically significant differences in other baseline data comparisons (all P>0.05). Univariate Logistic regression analysis showed that pH, lowest systolic blood pressure, albumin, APACHE score, and LIPS score were risk factors for the progression to ARDS in severe pneumonia patients [pH: odds ratio (OR)=0.04, 95% confidence interval (95%CI) was 0.00-0.96, P=0.047, cut-off was 7.34; lowest systolic blood pressure: OR=0.98, 95%CI was 0.97-1.00, P=0.044, cut-off was 90 mmHg (1 mmHg=0.133 kPa); albumin: OR=0.94, 95%CI was 0.89-0.99, P=0.032, cut-off was 28.05 g/L; APACHE score: OR=1.08, 95%CI was 1.02-1.14, P=0.008, cut-off was 23; LIPS: OR=1.37, 95%CI was 1.09-1.72, P=0.007, cut-off was 5]. A random forest model constructed with these risk factors ranked the importance of the indicators from high to low as follows: pH, lowest systolic blood pressure, albumin, APACHE score, and LIPS (with Gini Index of 31.08, 30.74, 29.35, 28.01, and 24.92, respectively). Validation with 1 000 bootstrap resamplings showed that the model had an area under the receiver operator characteristic curve (AUC) of 0.909 (95%CI was 0.870-0.943), a sensitivity of 0.823 (95%CI was 0.699-0.932), and a specificity of 0.869 (95%CI was 0.741-0.963).

pH<7.34, lowest systolic blood pressure<90 mmHg, albumin<28.05 g/L, APACHE>23, and LIPS>5 are risk factors for the progression of severe pneumonia to ARDS. The model constructed based on these factors using the random forest algorithm can effectively predict whether severe pneumonia patients will progress to ARDS.

American Indian/Alaska Native (AI/AN) people represent a culturally diverse people group within the United States. AI/AN people experience some of the most severe health disparities in the United States, including behavioral health. A quarter of AI/AN people in the United States live on tribal lands, experiencing significant barriers to mental health resources and broadband infrastructure for telehealth. We developed Amplifying Resilience Over Restricted Internet Access (ARORA)-a mobile health (mHealth) smartphone app, promoting mindfulness practices and community building through AI/AN culture and values. Originally co-designed with both Hopi/Tewa and Navajo youth and adults, this study evaluated app resonance among Hopi/Tewa youth, supporting its iterative design. While we initially planned in-person user testing, this was moved online due to the COVID-19 pandemic.

This study assessed the potential and acceptability of an mHealth app supporting Hopi/Tewa youth practicing mindfulness inspired by their culture, values, and beliefs. This research served as preliminary work for an ongoing, iterative participatory action research study, identifying points of improvement to align with our partner community's goals.

After meeting with 6 community advisory board members and focus groups prior to this study, we developed a prototype for ARORA. This study evaluated intuitiveness and usability through testing and interviews with Hopi/Tewa youth. All meetings with stakeholders were moved online due to the COVID-19 pandemic. Using screen-sharing via Zoom (Zoom Communications, Inc) and Android emulators, we received feedback for the iterative design process.

This study involved 9 participants aged 16-24 years. Of these participants, 1 was male and 8 were female; all identified as Hopi/Tewa and/or Tewa. This study included a quantitative assessment using a modified version of the User Version of the Mobile Application Rating Scale. The mean score across all questions was 3.71 (SD 0.427), suggesting generally positive reception. Qualitative results from thematically analyzing open-ended focus group data produced 5 open codes and 12 axial themes, reaching thematic saturation after engaging with 9 participants. Qualitative feedback revealed that while its use was generally enjoyable, the ARORA app could be more specific to Hopi/Tewa culture. Finally, we reflect on adaptations made to our initial protocol in response to the COVID-19 pandemic, offering guidelines for future mHealth work involving rural or hard-to-reach communities.

In this evaluation and usability testing of the ARORA prototype, participants expressed interest and engagement in the mindfulness activities. Participants also identified spaces in which the app could improve, both in usability and in cultural groundedness, especially with the visual dimensions of the app. Reflecting on our experience in facilitating remote user testing, we encourage future work in rural mHealth to consider practices for conducting research when in-person meetings are not feasible.

Objective: To understand the clinical and epidemiological characteristics of influenza virus and respiratory syncytial virus (RSV) infection in hospitalized children aged <5 years in Changzhou, Jiangsu Province, and compare their severity. Methods: Children aged <5 years and hospitalized for acute respiratory infections in Changzhou Children's Hospital from January 2024 to January 2025 were included, the information collection was conducted, multi-pathogen testing was carried out by fluorescent quantitative PCR, and χ² test was used to compare the socio-demographic and clinical characteristics of children infected with influenza virus and RSV. Multivariate logistic regression analysis was then used to evaluate the association of severe acute respiratory infection (SARI) and severe respiratory infection with influenza virus and RSV. Results: A total of 1 946 cases were included, with 147 cases (7.6%) being infected with influenza virus and 371 cases(19.1%) being infected with RSV. The RSV infection rate (28.2%) was significantly higher than that of influenza virus infection (7.5%) in the children under 1 year old. Both influenza virus and RSV infection mainly occurred in winter and spring, with the incidence of RSV infection exhibiting greater fluctuation. Compared with influenza virus infection, children with RSV infection exhibited significantly higher proportions of wheezing and asthma, as well as difficulty of feeding, however, fever and rhinorrhoea occurred less frequently, the differences were significant (all P<0.05). After adjusting for age, multivariate logistic regression analyses revealed that RSV infection had higher risk for severe respiratory symptoms (aOR=2.7, 95%CI: 1.2-7.4) and SARI (aOR=2.7, 95%CI: 1.1-8.2)in age group <1 year. Furthermore, children infected with RSV were at a higher risk for severe respiratory infection in age group 1-4 years (aOR =2.9, 95%CI: 1.3-7.0). Conclusions: RSV-related respiratory infection was more severe than influenza virus infection in children under 5 years old. Children under 1 year old are at high risk for RSV infection, and further etiological surveillance is needed to reduce the risk for serious illness.

This study explored the lived experiences of internet addiction among Taiwanese junior college students. Specifically, it examined their perceptions of addiction, experiences of excessive use and attempts to manage their online behaviours.

A descriptive phenomenological approach involving one-on-one, semi-structured, in-depth interviews was employed. Data analysis was conducted using Giorgi's phenomenological method assisted by NVivo V.12.

The interviewees were from a junior college with two campuses in northern Taiwan.

Purposive and snowball sampling of 15 junior college students. All participants met the criteria for internet addiction using the Chen Internet Addiction Scale.

Three main themes and eight subthemes were identified: continuous provocation (childhood exposure and unexpected pandemic), continuous promotion (irresistible immersion and compensatory self-isolation) and continuous resistance (varied self-awareness, dilemmas, perceived insignificance and futility). This study also explored how junior college students with internet addiction repeatedly struggle to resist a seamless virtual world.

From the perspective of adolescents with internet addiction, early exposure to the internet, the boost of the pandemic, the growing demand, and negative beliefs and attitudes all contribute to the inability to overcome internet addiction. These findings offer valuable insights into the underlying mechanisms of internet addiction, providing mental health professionals with a deeper understanding and establishing a foundation for the development of future intervention strategies.