Objective: To investigate the effect of different volumes of isotonic washing solution (0.9% NaCl) on the quality of intraoperative autologous blood salvage in craniocerebral surgery. Methods: Thirty patients who underwent neurosurgical procedures with intraoperative salvaged blood volumes exceeding 800 mL between August 2022 and July 2024 were enrolled as study subjects. The salvaged blood was divided into four groups: group A, group B, group C, and group D. Group A was washed with 500 mL of isotonic solution (blood-to-washing solution ratio of 1∶2), group B with 1000 mL (ratio of 1∶4), and group C with 1 500 mL (ratio of 1∶6). After centrifugation, the washed blood was stored in designated blood bags (A, B, and C, respectively). Blood gas analysis was performed on 5 mL samples obtained from the centrifuged blood in groups A, B, and C, and from the unwashed blood in the reservoir of the control group (group D). Parameters including red blood cell (RBC) count, pH, hemoglobin (Hb), hematocrit (HCT), potassium ion (K ), sodium ion (Na ), and lactate levels were also measured using these samples. Additionally, blood samples from each group were examined microscopically to assess red blood cell morphology. Results: No significant differences were observed among groups A, B, and C in terms of RBC recovery rate, HCT, Na concentration, or lactate clearance rate (P>0.05). All three groups exhibited a reduction in pH, with group C showing a more pronounced decrease compared to groups A and B. Similarly, K clearance was achieved in all groups, with group C demonstrating superior efficiency. Microscopic analysis revealed a reduction in spiculated red blood cells across all groups, with group C achieving the highest clearance rate. Conclusion: Group C (washed with 1 500 mL solution) demonstrated optimal performance in reducing pH levels, clearing K , and removing spherocytes, while maintaining red blood cell recovery rate. Additionally, it did not significantly increase the risk of hypernatremia in critically ill neurosurgical patients, making it more suitable for craniocerebral surgeries.

Objective To study the application effects of different inferior vena cava filters(IVCF)placed in the renal vein for the treatment of deep vein thrombosis(DVT).Methods A total of 102 patients with lower limb DVT who underwent renal vein IVCF at the Second People's Hospital of Baoshan from January 2021 to June 2022 were selected.According to the type of IVCF,patients were divided into a retrievable group(n=51)and a permanent group(n=51).The two groups were compared in terms of filter placement conditions,perioperative limb circumference differences,D-dimer,fibrinogen,venous recanalization scores,venous recanalization rates,as well as complications and recurrence-free survival status 12 months post-operation.Results The surgical success rate was 100%.The differences in limb circumference above the knee(15 cm)and below the knee(10 cm)at 1 day,3 days,and 7 days post-operation were significantly reduced compared to pre-operative measurements and showed a downward trend(P<0.05).D-dimer and fibrinogen levels at 1 day,3 days,and 7 days post-operation were also significantly reduced compared to pre-operative levels,with a downward tren(P<0.05).The venous recanalization scores at 7 days post-operation were significantly lower than pre-operative scores in both groups(P<0.05).The incidence of postoperative complications in the retrievable group was lower than that in the permanent group(P<0.05).Conclusion The placement of a retrievable IVCF on the renal vein for endovascular treatment of DVT has significant therapeutic effects,can adjust the circumference difference of the lower limb,improve coagulation function,and reduce the incidence of complications and recurrence.

Objective To investigate the effects of polybutylene terephthalate(PBT)grafted with various monomers,such as acrylic acid(AA),acrylamide(AM),sodium styrene sulfonate(SSS),AA+AM and AA+SSS on platelet adhesion and function.Methods The AA,AM,SSS,AA+AM,and AA+SSS were grafted onto the surface of PBT by γ-ray irradia-tion,and the grafted PBT was characterized by fourier transform infrared spectrometry(FTIR)and wetting time.Platelet ac-tivation and aggregation of different monomers grafted with PBT were observed by scanning electron microscopy(SEM).Platelet concentration,maximum aggregation ability,positive expression rate of CD62p and hypotonic shock rate(HSR)of PBT grafted with different monomers were tested to study their effect on platelet adhesion and function.Results The char-acteristic absorption peaks of AA,AM and SSS appeared in FTIR,and the hydrophilicity of the grafted material was im-proved obviously,indicating that the monomer was grafted successfully.The results of SEM showed that the degree of platelet activation and aggregation caused by the original PBT was significantly higher than that of modified ones.Compared with the original platelets,the platelet concentration of PBT was(533.00±4.58 vs 672.00±3.61)×109/L,the maximum platelet ag-gregation rate was(48.80±0.96 vs 58.60±1.37)%,the positive expression rate of CD62p was(45.35±0.58 vs 39.90±0.52)%,and the platelet HSR was(48.74±0.46 vs 51.86±0.93)%(P<0.05).Compared with the original PBT,the platelet loss and platelet function damage caused by PBT grafted with different monomers decreased significantly(P<0.05).PBT-(AA+AM)had the least comprehensive effect on platelets[platelet concentration(637.00±2.65)×109/L,maximum plate-let aggregation rate(62.45±0.61)%,positive expression rate of CD62p(37.39±0.42)%,platelet HSR(53.51±0.58)%].Conclusion The comprehensive effect of PBT grafted with AA+AM on platelet adhesion and function is significantly lower than that of PBT grafted with other monomers,so it is anticipated to apply filtering and removing leukocytes in platelet prep-arations.

Objective To investigate the occurrence and influencing factors of oral frailty in elderly residents of elderly care facilities and to provide a basis for the development of effective intervention programs for oral frailty in this population.Methods A combination of subjective and objective measurements of oral frailty,a general information questionnaire,a leisure activity questionnaire,the Dietary Variety Score(DVS),the Short Nutritional Assessment Questionnaire(SNAQ),the Short-Form Mini Nutritional Assessment(MNA-SF),Barthel Index(BI),the Mini-Mental State Examination(MMSE),15-Item Geriatric Depression Scale(GDS-15),and the Generalized Anxiety Disorder Scale-2(GAD-2)were used to survey 348 elderly residents in three elderly care facilities in Chengdu and to analyze the factors related to oral frailty.Results The prevalence of oral frailty in elderly residents of elderly care facilities was 31.0%(108/348).Multivariate logistic regression analysis revealed that advanced age(odds ratio[OR]=1.347,95%confidence interval[CI]:1.237-1.496,P＜0.001),cognitive impairment(OR=6.769,95%CI:2.628-18.916,P＜0.001),and depression(OR=8.632,95%CI:1.931-44.387,P=0.007)were risk factors for oral frailty in elderly residents of elderly care facilities.High scores in leisure activities(OR=0.883,95%CI:0.786-0.986,P=0.030),and dietary diversity(OR=0.199,95%CI:0.069-0.530,P=0.002)were protective factors against oral frailty.Conclusion The prevalence of oral frailty is relatively high among elderly residents of elderly care facilities.Risk factors for oral frailty include advanced age,cognitive impairment,and depression,while increased levels of leisure activities and dietary diversity can help prevent the occurrence of oral frailty in elderly individuals.

[摘 要] 以靶向PD-1/PD-L1和CTLA-4为代表的免疫检查点阻断治疗在实体瘤的治疗中取得了不俗疗效，但仅有不到30%的患者能够从中受益的现实表明，还存在其他免疫检查点分子介导的免疫抑制。B7H3属于免疫球蛋白超家族B7家族成员，与CTLA-4/PD-1主要表达在T细胞并介导后者的免疫抑制或耗竭不同，B7H3蛋白不仅诱导性表达在免疫细胞，还组成性高表达在多种肿瘤细胞和肿瘤相关脉管系统。B7H3不仅能够激活多条信号通路直接促进肿瘤细胞恶性表型，还可以通过重塑肿瘤免疫抑制微环境间接促进肿瘤的进展、转移和耐药。因此，基于B7H3的多项靶向抗肿瘤策略，包括特异性抗体、抗体偶联药物及CAR-T细胞等均已进入临床试验并展示出较好的应用前景。但总体而言，该领域的研究依然处于探索阶段，在相互作用受体的鉴定、降低毒性、打破耐药及联合用药策略优化等方面还面临着许多问题和挑战亟待突破。

In the case of cardiac dysfunction， energy metabolism changes and the metabolism of myocardial substrates is reconstructed， as manifested by variation in the selection and utilization of energy substrates such as fatty acids and glucose. Persistent metabolic disorders of substrates will decrease energy supply， thus resulting in the occurrence and development of heart failure. Metabolic remodeling of substrate is resulted from the decline of visceral function and the accumulation of pathological products. Deficient Qi stagnation is the core pathogenesis. Deficient Qi （heart Qi deficiency， insufficient energy） is the root cause， which exists in the whole disease course. Stagnation （phlegm， blood stasis， fluid， lipid toxic products， lactic acid， etc.） is the symptom， which evidences the aggravation of the disease. Deficient Qi and stagnation are intertwined and causal， which form a spiral vicious circle. The typical syndrome is excess resulted from deficiency and deficiency-excess in complexity. The treatment principle is reinforcing healthy Qi and tonifying deficiency， dredging and removing pathogen. At the early stage， the method of reinforcing healthy Qi and tonifying deficiency （benefiting Qi） should be used， and the method of dredging and removing pathogen （activating blood） can be applied according to the conditions of patients. At the middle and late stages， both reinforcing healthy Qi and tonifying deficiency （benefiting Qi and warming Yang） and dredging and removing pathogen （activating blood， resolving stasis， and excreting water） should be emphasized. Chinese medicine can be applied according to the pathogenesis， thereby promoting the utilization of fatty acids， glucose， and other substrates and reducing the accumulation of toxic products derived from metabolic remodeling of substrate. Thus， both the root cause and symptoms can be alleviated， further improving cardiac energy metabolism and heart function.

Uveal melanoma (UM) is the most common intraocular malignancy in adults. Recently, great progresses have been made in the diagnosis, treatment and prognosis of UM, however, nearly 50% of patients still develop liver metastases, which severely affects on the survival of UM patients. Whether UM patients will benefit from the immune checkpoint blockade similarly as the cutaneous melanoma (CM)? Whether the specific gene mutations targeting UM could improve the anti-tumor efficacy? Whether chimeric antigen receptor T cell or T cell receptor T cell immunotherapy is effective to UM patients with liver metastases? How about the combinational therapies in UM and the clinical effects? This review summarizes the anti-tumor research and novel treatment options of UM, analyzes the current achievements and problems.

【Objective】 To study the genotypes of ABO ambiguous blood group samples(n=20) and identify their molecular biological characteristics. 【Methods】 The serological phenotype of the samples was analyzed by serological techniques. Seven exons of ABO gene were amplified by polymerase chain reaction (PCR) and the PCR products were directly sequenced; the genotypes and sequences of ABO subtypes were analyzed. 【Results】 The serological phenotypes of 20 samples presenting ABO ambiguous blood group were as follows: weak A antigen (n=5), weak A antigen combined with anti-A1 antibody (n=5), normal A antigen combined with anti-A1 antibody (n=2), weak B antigen (n=8). The genotypes of them were as follows: Ax02/O01 (n=3), Ael07/O01 (n=2), B313/O01 (n=2), A204/O02 (n=1), A220/O01 (n=1), Ael07/O02 (n=1), Ael02/O01 (n=1), Ael02/O02 (n=1), Ax03/O01 (n=1), Ax03/O02 (n=1), B313/O02 (n=1), B302/O01 (n=1), B302/O02 (n=1), Bw19/O02 (n=1), A102/B313 (n=1) and A101/Bw37 (n=1). 【Conclusion】 ABO genotyping technology can accurately identify the ambiguous blood group of samples, provide definite genetic information of blood group and ensure the safety of clinical transfusion.

Tripterygium glycosides tablet(TGT),the classical commercial drug of Tripterygium wilfordii Hook.F.has been effectively used in the treatment of rheumatoid arthritis,nephrotic syndrome,leprosy,Behcet's syndrome,leprosy reaction and autoimmune hepatitis.However,due to its narrow and limited treatment window,TGT-induced organ toxicity(among which liver injury accounts for about 40％of clinical reports)has gained increasing attention.The present study aimed to clarify the cellular and molecular events underlying TGT-induced acute liver injury using single-cell RNA sequencing(scRNA-seq)technology.The TGT-induced acute liver injury mouse model was constructed through short-term TGT exposure and further verified by hematoxylin-eosin staining and liver function-related serum indicators,including alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase and total bilirubin.Using the mouse model,we identified 15 specific subtypes of cells in the liver tissue,including endothelial cells,hepatocytes,cholangiocytes,and hepatic stellate cells.Further analysis indicated that TGT caused a significant inflammatory response in liver endothelial cells at different spatial locations;led to marked inflammatory response,apoptosis and fatty acid metabolism dysfunction in hepatocytes;activated he-patic stellate cells;brought about the activation,inflammation,and phagocytosis of liver capsular macrophages cells;resulted in immune dysfunction of liver lymphocytes;disturbed the intercellular crosstalk in liver microenvironment by regulating various signaling pathways.Thus,these findings elaborate the mechanism underlying TGT-induced acute liver injury,provide new insights into the safe and rational applications in the clinic,and complement the identification of new biomarkers and ther-apeutic targets for liver protection.

OBJECTIVE To study the tissue distribution and pharmacokinetic characteristics of polyethylene glycol-（polylactic acid-hydroxyacetic acid） -polyethylene glycol triblock copolymer （PELGE） -crebanine nanoparticles （PELGE-Cre-NPS） in rats. METHODS The SD rats were divided into 9 groups （1 group at each time point）， with 6 rats in each group，half male and half female. After PELGE-Cre-NPs（5 mg/kg） was injected into tail vein of rats， appropriate amounts of heart， liver， spleen， lung， kidney and brain tissues were taken at 5， 15， 30， 60， 90， 120， 180， 240 and 300 min， respectively. With verapamil hydrochloride as internal standard， the content of crebanine （Cre） in each tissue was determined by HPLC， and the main pharmacokinetic parameters such as area under the drug-time curve （AUC0－）t and mean retention time （MRT0－）t were calculated.RESULTS At 5-90 min after medication， the content of Cre in each tissue of rats from large to small was lung， kidney， spleen， liver， brain and heart； at 120-300 min after medication， the sequence was lung， spleen， kidney， liver， brain and heart. AUC0－t of Cre in heart， liver， spleen， lung， kidney and brain were （18.86±1.66）， （43.36±4.99）， （51.36±5.34）， （81.86±12.34）， （53.31±3.19） and （27.73±4.76） mg·h/L， respectively. MRT0－t of Cre were （1.94±0.12）， （1.97±1.02）， （1.98±1.23）， （1.89±0.21）， （1.88± 0.06）， （1.85±0.19） h， respectively. CONCLUSIONS PELGE-Cre-NPs mainly distribute in lung tissue， but less in heart tissue， and the elimination of PELGE-Cre-NPs in heart， lung and liver tissue is slow.