Endometriosis(EMs)is a chronic inflammatory disease.It has been proved that inflammatory microenvironment is the key role in EMs occurance and development.Chinese medicine posits that the theory of"same disease of blood and water",which generally refers to"intermingling dampness and blood stasis",serves as a crucial pathogenesis in EMs.The inflammatory microenvironment is the main manifestation of dampness and blood stasis in EMs,while the insufficiency of vital qi results in endogenous dampness.The stagnation of blood stasis serves as the foundation for the formation of intermingling dampness and blood stasis.Based on contemporary theories in molecular biology,the macrophage-mediated inflammatory microenvironment serves as the foundation for the formation of dampness,while the participation of macrophages in angiogenesis is crucial for the formation of blood stasis.Investigating the intrinsic connection between the inflammatory microenvironment in EMs and the theory of"same disease of blood and water"can contribute to a better understanding of the pathogenesis of EMs from a novel perspective.Remodeling of the inflammatory microenvironment in endometriosis by targeting macrophages may provide a new strategy for EMs treatment.

The incidence of osteoporotic thoracolumbar vertebral fracture (OTLVF) in the elderly is gradually increasing. The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention. Its clinical manifestations include pain, delayed nerve damage, sagittal imbalance, etc. Currently, the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear. Although there are many treatment options, they are controversial. Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity. To this end, the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly ( version 2024), based on evidence-based medical advancements and the principles of scientificity, practicality, and advanced nature, which provided 18 recommendations to standardize the clinical diagnosis and treatment.

Objective:To evaluate the effect of autologous hematopoietic stem cell transplantation (ASCT) on the treatment of relapsed/refractory multiple myeloma (RRMM) with chimeric antigen receptor T cell (CAR-T) therapy.Methods:A retrospective cohort study. The clinical data of 168 patients with RRMM who underwent CAR-T therapy at the Department of Hematology, Xuzhou Medical University Hospital from 3 January 2020 to 13 September 2022 were analyzed. Patients were classified into a transplantation group (TG; n=47) and non-transplantation group (NTG; n=121) based on whether or not they had undergone ASCT previously. The objective response rate (ORR), progression-free survival (PFS), overall survival (OS) and the levels of CD3, CD4, CD8, CD19, CD56 and natural killer (NK) cells before CAR-T infusion were analyzed by χ2 test, Kaplan-Meier method and independent sample t-test. Results:Among 168 patients with RRMM, 98 (58.3%) were male. The median age of onset was 57 (range 30-70) years. After CAR-T therapy, the ORR of patients was 89.3% (92/103) in the NTG and 72.9% (27/73) in the TG. The ORR of the NTG was better than that of the TG ( χ2=5.71, P=0.017). After 1 year of CAR-T therapy, the ORR of the NTG was 78.1% (75/96), and that of the TG was 59.4% (19/32). The ORR of the NTG was better than that of the TG ( χ2=4.32, P=0.038). The median OS and PFS in the NTG were significantly longer than those in the TG (OS, 30 vs. 20 months; PFS, 26 vs. 12 months; both P<0.05). The CD4 level before CAR-T infusion in the TG was significantly lower than that in the NTG (25.65±13.56 vs. 32.64±17.21; t=-2.15, P=0.034), and there were no significant differences in the counts of CD3, CD8, CD19, CD56, and NK cells between the TG and NTG (all P>0.05). Conclusion:Among patients suffering from RRMM who received CAR-T therapy, patients who did not receive ASCT had significantly better outcomes than those who had received ASCT previously, which may have been related to the CD4 level before receiving CAR-T therapy.

Background: ASF was first reported in Kenya in 1910 in 1921. In China, ASF spread to 31 provinces including Henan and Jiangsu within six months after it was first reported on August 3, 2018. The epidemic almost affected the whole China, causing direct economic losses of tens of billions of yuan. Cause great loss to our pig industry. As ELISA is cheap and easy to operate, OIE regards it as the preferred serological method for ASF detection. P54 protein has good antigenicity and is an ideal antigen for detection. Objective: To identify a conservative site in the African swine fever virus (ASFV) p54 protein and perform a Cloth-enzyme-linked immunosorbent assay (ELISA) for detecting the ASFV antibody in order to reduce risks posed by using the live virus in diagnostic assays.Method: We used bioinformatics methods to predict the antigen epitope of the ASFV p54 protein in combination with the antigenic index and artificially synthesized the predicted antigen epitope peptides. Using ASFV-positive serum and specific monoclonal antibodies (mAbs), we performed indirect ELISA and blocking ELISA to verify the immunological properties of the predicted epitope polypeptide. Results: The results of our prediction revealed that the possible antigen epitope regions were A23–29, A36–45, A72–94, A114–120, A124–130, and A137–150. The indirect ELISA showed that the peptides A23–29, A36–45, A72–94, A114–120, and A137–150 have good antigenicity.Moreover, the A36–45 polypeptide can react specifically with the mAb secreted by hybridoma cells, and its binding site contains a minimum number of essential amino acids in the sequence 37DIQFINPY44. Conclusions Our study confirmed a conservative antigenic site in the ASFV p54 protein and its amino acid sequence. A competitive ELISA method for detecting ASFV antibodies was established based on recombinant p54 and matching mAb. Moreover, testing the protein sequence alignment verified that the method can theoretically detect antibodies produced by pigs affected by nearly all ASFVs worldwide.

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.

Objective To evaluate the effects of surgery under ketamine anesthesia during mid-pregnancy on cognitive function of offspring rats.Methods Thirty healthy pregnant Sprague-Dawley rats at14 days of gestation,aged 9-10 weeks,weighing 270-310 g,were assigned to 3 groups (n=10 each)using a random number table method:exploratory laparotomy under ketamine anesthesia group (KSgroup),ketamine anesthesia group (K group) and control group (C group).In KS group,ketamine 20mg/kg was injected via the caudal vein,and then ketamine was continuously infused at a rate of 130mg · kg-1 · h-1 after loss of right reflex to maintain anesthesia for 2 h,and exploratory laparotomy was per-formed after anesthesia was stable.Group K received no exploratory laparotomy and the other treatmentswere similar to those previously described in group KS.The equal volume of normal saline was given insteadin group C.The cliff avoidance,passive avoidance,and Morris water maze tests were used to evaluate the spatial perception and learning and memory ability of the offspring rats on postnatal days 7,23 and 30.Hippocampal tissues of rat offsprings were obtained at 24 h after the end of Morris water maze test to determine neural precursor cell-expressed developmentally downregulated protein 9 (NEDD9) and postsynaptic density 95 (PSD-95) protein and mRNA expression by quantitative polymerase chain reaction or Western blot.Results Compared with group C,the score of cliff avoidance was significantly decreased,the results of Morris water maze test showed that the escape latency was significantly prolonged,the platform-crossing times were decreased,the time spent in the second quadrant was shortened,the expression of NEDD9 and PSD-95 was down-regulated (P ＜ 0.05),and no significant changes were found in the expression of NEDD9 and PSD-95 mRNA in KS group,and no significant changes were found in the indexes mentioned above in K group (P＞0.05).There was no significant difference in the numberof errors in passive avoidance test among the three groups (P＞0.05).Conclusion Ketamine anesthesia during mid-pregnancy exerts no effect on the cognitive function of offspring rats,abdominal surgery under ketamine anesthesia impairs the spatial perception and learning and memory ability of offspring rats,and the mechanism is related to down-regulating the expression of NEDD9 and PSD-95 in hippocampi of offspring rats.

Objective To investigate the potential of a novel preservation solution,raffinose-low potassium dextran lung preservation solution with blood (BR-LPDS) in the preservation of the isolated lungs in rats,when compared to low-potassium dextran solution (LPDS).Methods Fifty donor lungs of Sprague-Dawley rats were randomly flushed with either R-LPDS (R-LPDS group,n =25) or RLPDS modified by the addition of blood (BR-LPDS group,n =25).After reperfusion,the double lungs were kept half inflate and then the pulmonary artery and bronchus were clamped.Then the grafts were flushed with and submerged in cold preservation solution at 4 C for 24 h.And they were excised for measurement of wet-to-dry ratio,as well as histologic examination to evaluate pulmonary edema,inflammation and cleaved caspase-3 expression at 0,2,4,5,6,8,10,12,14,16,24 h.Results As compared with the R-LPDS group,the mean wet-to-dry ratio of lungs in the BR-LPDS group was significantly reduced from 4 to 10 h after reperfusion.Upon histologic examination,less inflammatory cell aggregates and lower caspase-3 activity were seen in the lungs of the BR-LPDS group from 10 to 12 h and 10 to 14 h after reperfusion,respectively.Conclusion The addition of blood to the R-LPDS solution was shown to be more effective in reducing swelling,inflammation and caspase-3 expression of donor lungs than the R-LPDS solution.Further investigation is needed to evaluate lung preservation in BR-LPD solution as a viable option for transplant.

Objective:To analyze one case of delayed diarrhea caused by irinotecan. Methods:The pathogeny, mechanism, ge-netics and treatment of the case were analyzed. Results:Delayed diarrhea was the dose-limited toxicity of irinotecan, which was related with the cytotoxicity of the active metabolite 7-ethyl-10-hydroxycamptothecin (SN-38). Genetic polymorphism was one of important risk factors, especially UGT1A1 polymorphisms could be used as a predictor for the diarrhea. The pharmacotherapy of the diarrhea was ef-fective and rational, and the clinical pharmacist provided rational pharmaceutical care for the patient. Conclusion:It is very important to enhance pharmaceutical care for the patients treated with irinotecan.

Objective:To observe the effect and its mechanism of hemoperfusion on injured myocardium under acute toxication of methomyl in rabbits. Methods:Twenty-four rabbits were randomly divided into three groups:control group ( N group) , acute metho-myl intoxication group ( P group) , hemoperfusion group ( HP group) . P group and HP group was treated by methomyl intoxication, and with 2-hour sham-hemoperfusion and hempoperfusion respectively. Then the pathological changes of myocardium were observed under optical microscope. The activity of SOD and content of MDA in myocardium were measured by colorimetry. The experimental data were analyzed by SPSS 16. 0 package. Results:There were congestion, edema and other pathological changes in group P, while no obvious changes in N group and HP group. The activity of SOD decreased while MDA content increased in P group versus N and HP group ( P< 0. 05). Conclusion:Hemoperfusion can alleviate the myocardial injury induced by methomyl poisoning through the mechanism of the resistance to oxidative damage.

This article was aimed to study immunomodulatory effect of chemical split fractions ofMori Cortex, in order to initially explain effective parts that played a role in immunomodulatory effect ofMori Cortex. The carbon clearance test, serum hemolysin test, E-rosette test, and lymphocyte transformation test were carried out to explore influence of these chemical split fractions ofMori Cortex on immune organs, nonspecific immunity, humoral immunity and cellular immunity. The results showed that in the carbon clearance test, 50% ethanol fraction markedly reduced the thymus index (P<0.01) and the correction indexα (P<0.05). In hemolysin test, the half value hemolysis (HC50) was improved by 30% ethanol fraction and fatty oil fraction (P<0.05). Besides, in the E-rosette test, the E-rosette ration was increased in the 30% ethanol fraction group (P<0.05). In the lymphocyte transformation test, the 30% ethanol fraction can promote the thymus and spleen lymphocytes proliferation (P<0.05 orP<0.01), while the 50% ethanol fraction inhibited the proliferation (P<0.05 orP<0.01). It was concluded that the 30% ethanol fraction can boost both the humoral immunity and cellular immunity; the 50% ethanol fraction can induce the growth of thymus with a suppressive effect on nonspecific immunity and cellular immunity; the fatty oil fraction can improve humoral immunity.