Cerebral ischemia reperfusion injury(CIRI)is a secondary brain injury that may occur in patients with ischemic stroke during the process of blood flow recovery.NOD-like receptor protein 3(NLRP3)inflammasome plays an important role in the occurrence and development of CIRI.Regulating the activity of NLRP3 inflammasome can induce cell pyroptosis,induce neuroinflammatory response,promote macrophage/microglial polarization,destroy the blood-brain barrier,affect angiogenesis and neurogenesis,thereby affecting CIRI.Traditional Chinese medicine has obvious advantages in the treatment of CIRI.In this paper,with NLRP3 inflammasome as the core,we systematically elucidated the mechanism of action of traditional Chinese medicines on CIRI,and found that traditional Chinese medicines monomers(such as baicalin,polygalasaponin F)and traditional Chinese medicines compound formulas(such as Huangqi guizhi wuwu decoction,Yiqi shengqing formulation)can inhibit NLRP3 inflammasome activity,reduce inflammatory response and oxidative stress,and improve neuronal injury,thereby reducing CIRI.

Stroke is a disease that seriously threatens human health.Traditional Chinese medicine believes that turbid phlegm and sthenia fever are common pathological factors of stroke.The early diagnosis of stroke usually depends on advanced imaging techniques,such as MRI and CT,and there is still a lack of diagnostic biomarkers.Therefore,exploring the biological markers of Phlegm-Heat and Bowel-Excess Syndrome of stroke,combining macro-dialectics with micro-dialectics,can provide objective data support for the prevention and treatment of stroke by traditional Chinese medicine,which is of great significance for the diagnosis,treatment and prognosis evaluation of stroke.This paper reviews and summarizes the clinical biochemical indicators,microbiome,genomics,transcriptomics,proteomics,metabolomics and other aspects,aiming to find specific biomarkers related to Phlegm-Heat and Bowel-Excess Syndrome of stroke,so as to provide molecular basis for the objective research system of stroke"syndrome"and new ideas for the study of syndrome essence.

Cerebral ischemia-reperfusion injury(CIR1)refers to the recovery of blood supply after cerebral ischemia,which leads to further damage and the dysfunction of brain tissue.Modern medicine has made some progress in the prevention and treatment of CIRI,but it still faces some challenges and limitations.Therefore,it is of great clinical value to find effective interventions to prevent and treat CIRI.AMP-activated protein kinase(AMPK)and its downstream proteins are important targets for the treatment of CIRI and play key roles in the regulation of cellular energy homeostasis.Traditional Chinese medicine for CIRI has multi-target and multi-pathway activities and multiple effects.It can activate a cascade of reactions in the AMPK signaling pathway and can be used to treat CIRI by regulating autophagy,oxidative stress,inflammatory response,and apoptosis,and has achieved certain result.Therefore,this paper summarizes the structure and mechanisms of the AMPK-related signaling pathway,elaborates on its relationship with CIRI,and systematically summarizes the research status of traditional Chinese medicine's ability to regulate the AMPK signaling pathway in the prevention and treatment of CIRI.This paper aims to provide new ideas for the prevention and treatment of CIRI using traditional Chinese medicine and the development of new drugs.

Stroke is a disease that seriously threatens human health.Traditional Chinese medicine believes that turbid phlegm and sthenia fever are common pathological factors of stroke.The early diagnosis of stroke usually depends on advanced imaging techniques,such as MRI and CT,and there is still a lack of diagnostic biomarkers.Therefore,exploring the biological markers of Phlegm-Heat and Bowel-Excess Syndrome of stroke,combining macro-dialectics with micro-dialectics,can provide objective data support for the prevention and treatment of stroke by traditional Chinese medicine,which is of great significance for the diagnosis,treatment and prognosis evaluation of stroke.This paper reviews and summarizes the clinical biochemical indicators,microbiome,genomics,transcriptomics,proteomics,metabolomics and other aspects,aiming to find specific biomarkers related to Phlegm-Heat and Bowel-Excess Syndrome of stroke,so as to provide molecular basis for the objective research system of stroke"syndrome"and new ideas for the study of syndrome essence.

Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.

Objective:To investigate the risk factors for Gleason score upgrading after radical prostatectomy in clinical low-risk prostate cancer patients aged≥65 years.Methods:A total of 485 clinical low-risk prostate cancer patients aged≥65 years at five centers of the national multi-center PC-follow database from January 2015 to March 2019 were retrospectively analyzed.Data including age at diagnosis, prostate-specific antigen(PSA), MRI prostate imaging, puncture Gleason score, operation method, puncture method, positive incision margin and capsule penetration were collected.Differences in Gleason scores before and after operation were compared, and the risk factors for Gleason score upgrading after radical resection were evaluated by univariate and multivariate Logistic regression analysis.Results:Of 485 patients with a puncture Gleason score of 3+ 3=6, 261(53.8%)cases had postoperative pathological upgrading, in whom 228(87.4%)cases had Gleason score upgrading of 7, 22(8.4%)had Gleason score upgrading of 8, and 11(4.2%)had Gleason score upgrading of 9 or more.The rate of Gleason score upgrading was elevated with increased preoperative PSA levels, positive pelvic MRI, and higher positive rates of puncture biopsy.The incidences of postoperative capsule penetration(27.2% vs.12.5%, P<0.001)and positive incision margin(25.2% vs.17.4%, P=0.036)had statistically significant differences between the pathologically upgraded group and the pathologically non-upgraded group.Multivariate analysis showed that preoperative PSA level, percentage of positive puncture biopsies, biopsy Gleason score and pelvic MRI were independent predictors of prostate cancer. Conclusions:For clinical low-risk prostate cancer patients aged≥65 years with high risk factors for Gleason score upgrading, repeated biopsies should be carried out when necessary and the treatment plan should be adjusted accordingly.

Objective:To establish a nomogram model for predicting positive resection margins after prostate cancer surgery, and to perform the corresponding verification, in order to predict the risk of positive resection margins after surgery.Methods:A total of 2 215 prostate cancer patients from The First Affiliated Hospital of Naval Medical University, Hospital, Peking University First Hospital, Peking University Third Hospital, Peking University, and First Affiliated Hospital of Xi′an Jiaotong University were included in the PC-follow database from 2015 to 2018, and a simple random sampling method was used. They were divided into 1 770 patients in the modeling group and 445 patients in the verification group. In the modeling group, the age (<60 years, 60 to 70 years, >70 years), PSA (<4 ng/ml, 4-10 ng/ml, 11-20 ng/ml, >20 ng/ml), pelvic MRI (negative, suspicious, positive), clinical stage of the tumor (T 1-T 2, ≥T 3), percentage of positive needles (≤33%, 34%-66%, >66%), Gleason score of biopsy pathology (≤6 points, 7 points, ≥8 points). Univariate and multivariate logistic analysis were performed to screen meaningful indicators to construct a nomogram model. The model was used for validation in the validation group. Results:The results of multivariate analysis showed that preoperative PSA level ( OR=2.046, 95% CI 1.022 to 4.251, P=0.009), percentage of puncture positive needles ( OR=1.502, 95% CI 1.136 to 1.978, P=0.002), Gleason score of puncture pathology ( OR=1.568, 95% CI 1.063 to 2.313, P=0.028), pelvic MRI were correlated ( OR=1.525, 95% CI 1.160 to 2.005, P=0.033). Establish a nomogram model for independent predictors of positive margin of prostate cancer. The area under the receiver operating characteristic (ROC) curve of the validation group is 0.776. The area under the ROC curve of the preoperative PSA level, percentage of puncture positive needles, puncture pathology Gleason score, pelvic MRI, postoperative pathology Gleason score were 0.554, 0.615, 0.556, 0.522, and 0.560, respectively. The difference between the nomogram model and other indicators was statistically significant ( P<0.05). Conclusions:The constructed nomogram model has higher diagnostic value than the preoperative PSA level, percentage of puncture positive needles, Gleason score of puncturing pathology, pelvic MRI, and postoperative pathological Gleason score in predicting positive margin.

Objective:To establish the identification method for Aucklandia Lappa and Picrorhiza kurrooa Royle ex Benth and the content determination of hydroxysaffor yellow A in Liangxue Shiwei San. Methods:The identification was carried out by TLC. The con-tent of hydroxysaffor yellow A was determined by HPLC. The column was Kormasil C18 (250 mm × 4. 6 mm, 5 μm) and the flow rate was 1. 0 ml·min-1. The mobile phase was methanol-0. 5% acetic acid (30∶70). The detection wavelength was 403 nm and the col-umn temperature was 25℃,and the sample size was 10 μl. Results:The TLC spots were clear with high resolution without interference from the negative sample. A good linearity of hydroxysaffor yellow A was within the range of 1.212-48.480μg·ml-1(r=0.999 8). The average recovery was 98. 13%(RSD=1. 6%,n=6). Conclusion:The established TLC and HPLC methods are simple and accu-rate with good reproducibility, which can be used in the quality control of Liangxue Shiwei San.

Objective To study the clinicopathologic features,effective therapeutic regimen and prognosis of human immunodeficiency virus (HIV) infection with acute promyelocytic leukemia (APL) and chronic myeloid leukemia (CML).Methods Two cases of HIV infection concurrent with leukemia,one with APL,one with CML,were studied and relevant literatures were reviewed.Results Case 1 was HIV infection concurrent with APL,ATO was used to induce remission,in the eight day of therapy,the patient died of brain disorder.Case 2 was HIV infection concurrent with CML,hydroxycarbamide and interferon were used to induce remission,three month later,state of an illness progressed to acute phase,after combination chemotherapy,concurrent with lung multiple infection (fungus and pneumocystis carinii),at last,the patient died of respiratory failure.Conclusion HIV infection concurrent with acute and chronic leukemia has poor therapeutic effect,and is easy to infect seriously.