Multiple myeloma is a type of hematological malignancy caused by clonal plasma cell proliferation. In recent years, the application of proteasome inhibitors and immune drugs (IMiDs) in multiple myeloma has prolonged the survival period of patients and improved the quality of life. However, due to the heterogeneity, recurrence and drug resistance of the disease, MM is still incurable. Relatively good response rates of immune checkpoint inhibitors such as Pembrolizumab, Nivolumab, Pidilizumab, Atezolizumab and Durvalumab offer MM a new hope. This article reviews the relevant literature in recent years, introduces the immune pathogenesis of MM, PD-1/PD-L1/2-related immune pathway and the current status of immunotherapy, to provide reference for the immunotherapy of MM.

Epilepsy surgery is an effective treatment of drug-resistant epilepsy.Once patients became seizure free for certain period after epilepsy surgery,whether anti-seizure medications(ASMs)could be withdrawn is the primary concern of clinicians and patients.However,there is no consensus about management of anti-seizure medications in patients after epilepsy surgery.Patients after epilepsy surgery can withdraw ASMs when they become seizure free for 1 to 2 years.The dose reduction is usually done at every 2 to 3 months.For patients receiving multiple ASMs,each one should be individually tapered completely prior to the subsequent medication and the primary medication is always withdrawn in the end.Longer epilepsy duration prior to surgery,older age at surgery,patients with focal cortical dysplasia,incomplete resection of the epileptogenic zone and presence of interictal epileptiform discharges in postoperative EEG may predict the risk of seizure relapse in patients who underwent ASM withdrawal after epilepsy surgery.Patients with seizure relapse on ASM withdrawal generally have benign outcome after reinstitution of medical treatment.

Objective To investigate the expression of PD-1 and PD-L1/2 in T cell subsets and myeloma cells in the bone marrow from newly diagnosed multiple myeloma (NDMM) patients and their relation with clinical features. Methods We collected the bone marrow and clinical data of 22 NDMM patients and 18 cases of healthy controls. We sorted CD4⁺T cells, CD8⁺T cells and myeloma cells by flow cytometry, and observed the expression of PD-1 and PD-L1/2. Results Compared with the control group, the proportion of CD8⁺T cells in the NDMM group was significantly higher, while the ratio of CD4⁺/CD8⁺ was significantly lower (both P < 0.05). The expression levels of PD-1 and PD-L2 in CD4⁺T cells in the NDMM group were significantly higher than those in the control group (both P < 0.05). The expression levels of PD-1, PD-L1 and PD-L2 in T cell subsets and myeloma cells of NDMM patients were not correlated with the gender, age, immune typing, Durie-Salmon stage and subtypes, ISS stage or mSMART3.0 stratification (both P > 0.05). Conclusion Most of MM patients suffering immune abnormality, which may be associated with the mutual immunosuppressive effects between T lymphocytes and plasma cells which expressing PD-1 and PD-L1/2.

Objective To investigate the difference of depressive symptoms between adolescents and adults,and to provide possible basis for early detection of adolescent depression.Methods From July 2021 to June 2022,a total of 4 096 patients with"depression"in the psychiatric clinic of the First Affiliated Hospital of Chongqing Medical University were selected as the research objects.They were divided into the adolescent group(n=2 439)and adult group(n=1 657)according to their ages,and the results of self-rating depression scale(SDS)and symptom checklist 90(SCL-90)were collected and analyzed.Results There were significant differences in nationality,residence,native place,family history and degree of depression between the two groups(P<0.05).The adolescent group has more severe depressive symptoms,which were mainly manifes-ted in negative ideas,obsessive-compulsive symptoms,hostile and interpersonal relationship,and psychotic symptoms(P<0.05).The adult group showed more obvious in sleep(P<0.05).Conclusion Early inter-vention should be carried out for adolescents'depressive symptoms such as negative thoughts.

Cognitive dysfunction is the impairment of higher brain functions.Cognitive impairment caused by neuropsychiatric diseases has caused serious impact on patients'quality of life and the outcome of the disease.The transcranial alternating current stimulation(tACS)improves cognitive function by modulating neural oscillations of specific frequencies,affecting the release of neurotransmitters such as serotonin and dopamine,and enhancing local and distal synchronization of brain networks.Specific frequencies of tACS can improve the cognitive impairment caused by Alzheimer disease(AD),schizophrenia,and depression,among which the gamma and theta frequencies of tACS have the most significant effects on cognitive function.tACS has high safety and low operational difficulty,and has great potential to improve cognitive function.

In recent years, gene engineering is developing rapidly and many recombinant proteins have been expressed. The use of plant bioreactor to express specific pharmaceutical proteins provides a new way for the prevention and treatment of some important diseases in human beings. Nowadays, chloroplast genetic transformation and expression system has become a research hotspot in plant bioreactor. Higher plant chloroplasts have unique advantages in the expression of recombinant proteins due to their special structures and inherited characteristics: such as high expression, site-specific integration, and the maternal inheritance characteristics of exogenous genes. The maternal inheritance of chloroplast is helpful for biological safety of transgene escaping by pollens. Many important pharmaceutical proteins have been successfully expressed in plant chloroplasts. As a chloroplast transformation model of higher plants, tobacco has made significant progress in the expression of pharmaceutical proteins, such as vaccine antigens, antibodies, and other important recombinant proteins. Chloroplast genetic transformation in higher plants also provides new techniques and methods for the study of chloroplast gene expression and regulation mechanisms. In order to provide a new idea for the development of chloroplast expression platform and the expression of important pharmaceutical proteins, this review outlined the progress of chloroplast genetic transformation system in higher plants, including the chloroplast transformation principle, vector construction, expression of recombinant proteins and important pharmaceutical proteins, and the effects of recombinant proteins expression on plant metabolism and traits.

Ferroptosis is a non-apoptotic regulated cell death caused by iron accumulation and subsequent lipid peroxidation. Currently, the therapeutic role of ferroptosis on cancer is gaining increasing interest. Baicalin an active component in