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Extracellular vesicles (EVs) have garnered significant attention in cancer research, as they enable the regulation of the occurrence, progression, and metastasis of tumors. This narrative review summarizes studies published between 2020 and 2025 from PubMed, focusing on nasopharyngeal carcinoma and extracellular vesicles. We analyze the function and mechanism of EVs in the tumor microenvironment, biomarkers, and treatment. Numerous studies have attempted to explain the mechanism of NPC-EVs affecting tumor microenvironments through the transmission of its cargo. And liquid-biopsy technology using EVs as biomarkers, such as exosomal cyclophilin A, the phosphatase and tensin homolog, and EVs-miR-30a-5p, has been studied for diagnosis and prognostic evaluation. In the therapy aspect, researchers are attempting to explore the role of EVs in the resistance process of NPC treatment, with the aim of clinical translation. Current limitations include biological distribution of EVs and so on. Future research should focus on establishing the standardized production system and more convenient separation and purification techniques for EVs. This review provides a comprehensive overview of the nasopharyngeal carcinoma-related EVs.

Purpose A well display of the spatial location of thyroid nodules in the thyroid is important for surgical path planning and surgeon‐patient communication. The aim of this study was to establish a three‐dimensional (3D) reconstruction method of the thyroid gland, thyroid nodule, and carotid artery with automatic detection based on two‐dimensional (2D) ultrasound videos, and to evaluate its clinical value. Methods Ultrasound videos, including the thyroid gland with nodule, isthmus of thyroid gland, and ipsilateral carotid artery, were recorded. BC‐UNet, MTN‐Net, and RDPA‐U‐Net network models were innovatively employed for segmentation of the thyroid glands, the thyroid nodules, and the carotid artery respectively. Marching Cubes algorithm was used for reconstruction, while Laplacian smoothing algorithm was employed to smooth the 3D model surface. Using this model, 20 patients and 15 surgeons completed surveys on the effectiveness of this model for the pre‐surgery demonstration of nodule location as well as surgeon‐patient communication. Results The thyroid gland with nodule, isthmus of gland, and carotid artery were reconstructed and displayed. With the 3D model, the understanding of the spatial location of thyroid nodules improved in all three surgeon groups, eliminating the influence of professional levels. In the patient survey, the patients’ understanding of the thyroid nodule location and procedure for surgery were significantly improved. In addition, with the 3D model, the time for doctors to explain to patients was significantly reduced (16.75  vs. 8.85 min, p = 0.001). Conclusion To our knowledge, this is the first report of constructing a 3D thyroid model using a deep learning technique for personalized thyroid segmentation based on 2D ultrasound videos. The preliminary clinical application showed that it was conducive to the comprehension of the location of thyroid nodules for surgeons and patients, with significant improvement on the efficiency of surgeon‐patient communication.

Reprogramming of NK cells with a chimeric antigen receptor (CAR) proved an effective strategy to increase NK cell reactivity and recognition specificity toward tumor cells. To enhance the cytotoxicity of NK cells against CD138-positive multiple myeloma (MM) cells, we generated genetically modified NK-92MI cells carrying a CAR that consists of an anti-CD138 single-chain variable fragment (scFv) fused to the CD3ζ chain as a signaling moiety. The genetic modification through a lentiviral vector did not affect the intrinsic cytolytic activity of NK-92MI toward human erythroleukemic cell line K562 cells or CD138-negative targets. However, these retargeted NK-92MI (NK-92MI-scFv) displayed markedly enhanced cytotoxicity against CD138-positive human MM cell lines (RPMI8226, U266 and NCI-H929) and primary MM cells at various effector-to-target ratios (E:T) as compared to the empty vector-transfected NK-92MI (NK-92MI-mock). In line with the enhanced cytotoxicity of NK-92MI-scFv, significant elevations in the secretion of granzyme B, interferon-γ and proportion of CD107a expression were also found in NK-92MI-scFv in response to CD138-positive targets compared with NK-92MI-mock. Most importantly, the enhancement in the cytotoxicity of NK-92MI-scFv did not attenuate with 10Gy-irradiation that sufficiently blocked cell proliferation. Moreover, the irradiated NK-92MI-scFv exerted definitely intensified anti-tumor activity toward CD138-positive MM cells than NK-92MI-mock in the xenograft NOD-SCID mouse model. This study provides the rationale and feasibility for adoptive immunotherapy with CD138-specific CAR-modified NK cells in CD138-positive plasmacytic malignancies, which potentially further improves remission quality and prolongs the remission duration of patients with MM after upfront chemotherapy. •We generated genetically modified NK cells targeting CD138 positive myeloma cells.•The retargeted NK cells exerted markedly enhanced ex vivo anti-myeloma activities.•The enhancement in cytotoxicity may be due to elevated NK cell degranulation.•Irradiation of retargeted NK cells did not attenuate their cytotoxicity.•The retargeted NK cells after irradiation had potent anti-MM effect in xenografts.

Background: The optimal treatment for gastric cancer with peritoneal metastasis (GCPM) remains debatable. This study aimed to compare the efficacy and safety of neoadjuvant intraperitoneal and systemic chemotherapy (NIPS) versus neoadjuvant systemic chemotherapy (NSC) for GCPM. Methods: Patients of GCPM received neoadjuvant chemotherapy with docetaxel, oxaliplatin and S-1 between January 2011 and June 2019 were retrospectively evaluated. Propensity score matched (PSM) analysis was carried out to reduce the selection bias. Multivariate Cox regression model was applied to screen the prognostic factors. Results: After PSM processing, 71 patients in each group were matched among the 186 GCPM patients included. NIPS yielded a better ascites and cytology response to chemotherapy, higher conversion resection rate and R0 resection rate than NSC. The overall survival (OS) rate in NIPS group was better than that in NSC group. Multivariate analysis revealed that the P stage, ascites response, conversion surgery rate and R0 resection rate were independent prognostic factors. Subgroup analysis indicated that NIPS showed a survival benefit over NSC only in patients with cT3-4a, P1-2, whose cytology turned negative, and who received conversion surgery; while not in patients with cT4b, P0 or P3, whose cytology did not turn negative, or who did not receive conversion surgery. Conclusions: NIPS is a safe and feasible treatment for GCPM, which showed more benefit than NSC.

Gastric cancer remains a major clinical issue and little progress has been made in the treatment of gastric cancer patients during recent decades. Nanoparticles provide a versatile platform for the diagnosis and treatment of gastric cancer. We prepared 7-ethyl-10-hydroxycamptothecin (SN-38) I-radiolabelled biodegradable nanoparticles with folate surface modification ( I-SN-38-FA-NPs) as a novel nanoplatform for targeted gastric carcinoma theranostics. We characterized this system in terms of particle size, morphology, radiostability, and release properties and examined the in vitro cytotoxicity and cellular uptake properties of I-SN-38-FA-NPs in MNK 7 and NCI-N7 cells. The pharmacokinetics and biodistribution of I-SN-38-FA-NPs were imaged by single photon emission computer tomography (SPECT). An MNK7 tumor-bearing model were established and the in vivo antitumor activity of I-SN-38-FA-NPs was evaluated. SN-38 was readily radiolabeled with I and exhibited high radiostability. Poly-lactic-co-glycolic acid (PLGA) nanoparticles (NPs) were formed by solvent exchange, and displayed spherical morphology of 100 nm in diameter as characterized by dynamic light scattering (DLS) and transmission electron microscopy (TEM). A 2.5-fold greater uptake of I-radiolabelled SN-38-loaded folate-decorated PLGA nanoparticles ( I-SN-38-FA-NPs) than I-radiolabelled SN-38-loaded PLGA nanoparticles ( I-SN-38-NPs) were record in MKN7 tumor cells. NPs and folate-decorated PLGA nanoparticles (FA-NPs) also had good biocompatibility in methyl thiazolyl tetrazolium (MTT) assays. Pharmacokinetic, biodistribution and SPECT imaging studies showed that I-SN-38-FA-NPs had prolonged circulation, were distributed in the reticuloendothelial system, and had high uptake in tumors with a higher tumor accumulation of I-SN-38-FA-NPs than I-SN-38-NPs recorded at 24 h postinjection. In vivo SN-38-FA-NPs significantly inhibited tumor growth without causing obvious side effects. Folate receptor alpha (FOLR1) targeted drug-loaded nanoparticles enable SPECT imaging and chemotherapy, and provide a novel nanoplatform for gastric carcinoma active targeting theranostics.

Zhang X, Yan R, Wei Z, et al. Int J Nanomedicine. 2022;17:2493–2502. The authors wish to correct Figure 6 on page 2500 after it was found an incorrect H&E image for Liver, FA-NPs had been used. The error occurred during figure preparation and the correction does not impact the conclusions of the study. The correct Figure 6 is in Download Article. The authors apologise for this error.

What is the optimal neoadjuvant chemotherapy (NAC) regimen for locally advanced gastric cancer (LAGC) remains debatable. The objective of this study was to compare the efficacy of docetaxel+oxaliplatin+S-1 (DOS) vs oxaliplatin+S-1 (SOX) as NAC for LAGC. Data of 248 LAGC patients who received either DOS or SOX as NAC in our hospital between January 2010 and January 2018 were reviewed retrospectively. Propensity score matched (PSM) analysis was applied to minimize the selection bias in both groups. Prognostic factors were screened by univariate and multivariate Cox regression analyses. Of the 248 LAGC patients included, 180 patients were subjected to the PSM analysis. Patients in DOS group showed a better tumor response to NAC, higher radical resection rate and R0 resection rate than those in SOX group. The overall survival (OS) rate in DOS group was better than that in SOX group, although the overall incidence of Grade 3/4 NAC-related toxicity in DOS group was higher, as represented by leukopenia and neutropenia. Multivariate analysis revealed that the NAC regimen, cTNM stage and the R0 resection rate were independent prognostic factors. In addition, patients with TLND less than 16 population showed a worse OS rate. Subgroup analysis indicated that patients benefited from the addition of docetaxel regardless of the clinical T stage, but those with high clinical N stages (N2-3) did not. DOS is a safe and feasible NAC regimen for LAGC, which is worth popularizing in clinical practice.

The unfolded protein response (UPR) is an essential pathway for both normal and malignant plasma cells to maintain endoplasmic reticulum (ER) homeostasis in response to the large amount of immunoglobulin (Ig) output. The inositol-requiring enzyme 1-X-box binding protein-1 (IRE1-XBP-1) arm of the UPR pathway has been shown to play crucial roles not only in relieving the ER stress by up-regulating a series of genes favoring ER-associated protein degradation and protein folding, but in mediating terminal plasmacytic differentiation and maturation. Myeloma cells comprise various subsets arrested in diverse differentiated phases, and the immaturity of myeloma cells has been taken as a marker for poor prognosis, suggesting that differentiation induction would be a promising therapeutic strategy for myeloma. Herein, we used low-dose pharmacological UPR inducers such as tunicamycin (TM) and dithiothreitol (DTT) to efficiently activate the IRE1-XBP-1 pathway in myeloma cells characterized by transcriptional expression increase in spliced XBP-1 and molecular chaperons, accompanied by significant differentiation and maturation of these myeloma cells, without concomitant cytotoxicity. These differentiated myeloma cells exhibited a more mature appearance with well-developed cytoplasm and a reduced nucleocytoplasmic ratio, and a further differentiated phenotype with markedly increased expression of CD49e together with significantly elevated cellular secretion of Ig light chain as shown by flow cytometry and ELISA, in contrast to the control myeloma cells without exposed to TM or DTT. Moreover, siRNA knockdown of XBP-1 disrupted TM- or DTT-induced myeloma cell differentiation and maturation. Our study, for the first time, validated that the modest activation of the UPR pathway enables myeloma cells to further differentiate, and identified that XBP-1 plays an indispensable role in UPR-mediated myeloma cell differentiation and maturation. Thus, we provided the rationale and feasibility for the exploration of the novel therapeutic strategy of differentiation induction for plasmacytic malignancies.

Background The \"Weekend Warrior (WW)\" physical activity (PA) pattern, involving intensive exercise on 1–2 days per week, has become increasingly popular. The WW PA pattern demonstrates protective effects against a broad spectrum of chronic diseases; however, regarding a comprehensive investigation into the disease-specific protective mechanisms and long-term health outcomes of the subject, it remains unclear. WW exhibits protective effects against various diseases; however, there is a conspicuous scarcity of literature investigating its protective mechanisms across different disease conditions. The objective of this meta-epidemiology study was to exam WW’s protective effects by synthesizing data from published observational studies. Methods A systematic search was conducted across databases including PubMed, Embase, Cochrane Library and Web of Science through February 19, 2025. The search focused on observational studies reporting the association between the WW PA pattern and various health outcomes, including cardiovascular diseases, mortality, metabolic syndrome, and mental health, compared to inactive individuals. Odds ratios (ORs) were pooled using random-effects models. Subgroup analyses were performed to investigate the association with ORs of factors, such as sex, study type, and PA assessment. Results Twenty-seven studies encompassing 1,204,486 participants were included. The pooled analysis indicated that the WW exercise pattern significantly reduced the risk of CVD mortality (OR = 0.742, 95% CI: 0.568–0.968), I 2  = 71.3%, P  = 0.028). Additionally, WW showed lower risks of mental disorders and metabolic syndrome. Conclusion The WW PA pattern is associated with significant health benefits, including reduced risks of mortality, cardiovascular diseases, and metabolic syndrome. This pattern may be a viable alternative for individuals unable to engage in daily physical activity. Future research should further explore the long-term effects and refine exercise recommendations for various population subgroups. PROSPERO registration number CRD42024587216.