Objective To preliminarily investigate the safety and efficacy of donor pancreas needle biopsy in simultaneous pancreas-kidney transplantation. Methods Clinical data of 7 cases undergoing donor pancreas biopsy were collected retrospectively. All cases underwent donor pancreas biopsy before or during simultaneous pancreas-kidney transplantation. Frozen section or paraffin sectioning techniques were used for tissue preparation, and hematoxylin-eosin and Masson staining were performed to histologically evaluate the donor pancreas. The quality of donor pancreas was comprehensively assessed by combining histological findings with the donor's clinical data. Postoperative follow-up data of 5 simultaneous pancreas-kidney transplant recipients were collected to summarize the safety of donor pancreas biopsy and the prognosis of transplant recipients. Results The 7 pancreas donors were aged 28 to 62 years, with a body mass index ranging from 20.76 to 27.68 kg/m². Liver ultrasound indicated fatty liver in 3 cases, while pancreatic ultrasound did not reveal any significant abnormalities. Among them, biopsy was performed on 2 donors after completion of pancreatic procurement and processing, and the frozen section histology showed moderate acute pancreatitis changes (edema of acinar cells, necrosis and inflammatory cell infiltration). Combined with a serum amylase level elevated more than 3 times the upper limit of normal value, these two donor pancreases were finally discarded. The remaining 5 cases underwent biopsy immediately after pancreatic vascular anastomosis during simultaneous pancreas-kidney transplantation, and histological evaluation was performed on paraffin-embedded sections. No biopsy-related complications (such as bleeding, pancreatic fistula, etc.) occurred after transplantation. One recipient died of severe infection 2 months after transplantation, while the other 4 recipients were followed up for more than 5 years, with well-functioning transplant kidneys and pancreases. Conclusions Donor pancreas biopsy is relatively safe, and the risk of biopsy-related complications after transplantation is controllable. Comprehensive assessment of donor pancreas quality by combining histological evaluation with the donor's clinical indicators is conducive to improving the accuracy of donor pancreas selection and organ utilization.

Patients with gastric cancer undergoing postoperative chemotherapy often develop myelosuppression due to direct injury to the spleen and stomach caused by surgery， depletion of healthy qi by chemotherapy， impaired generation of ying （荣） qi due to spleen and stomach deficiency， and the accumulation of drug toxicity， which prevents ying qi from reaching and nourishing the bone marrow. Consequently， the bone marrow loses its nourishment and becomes unable to generate blood， leading to myelosuppression. This paper proposes that the core pathogenesis involves failure of the middle jiao （焦） pivot function， dysfunction of ying qi circulation， and insufficient nourishment of essence and marrow. Accordingly， Shengxian Decoction （升陷汤） combined with Danggui Buxue Decoction （当归补血汤） is used as the principal prescription to tonify the middle jiao and uplift center qi， thereby remedying the fundamental insufficiency of ying qi. Modified Compound Danshen Decoction （复方丹参饮） is applied to promote qi circulation， resolve stasis， remove toxin， and unblock collaterals， thereby resolving the obstruction preventing ying qi from reaching the bone marrow. Modified Dabuyuan Decoction （大补元煎） combined with Erzhi Pill （二至丸） is taken as the foundational formula to cultivate the root， replenish marrow， thereby modulating hematopoiesis in bone marrow.

The concept of holism is the core idea of traditional Chinese medicine （TCM）. Various organs and tissues coordinate with each other to maintain the body's life activities， with a close and mutual influence between the spleen， stomach， and the central nervous system （brain）. The gut-brain axis plays an important bridging role between the digestive system and the central nervous system， achieving bidirectional information exchange between the brain and the gastrointestinal tract through complex neuroendocrine and immune mechanisms. The theory of cross-organ interaction involves the mutual influence， coordination， and integration between different organs and systems； multimodality， on the other hand， utilizes multiple sensory modalities， such as vision， hearing， and touch， to convey information. By combining TCM theory with the gut-brain axis theory， a cross-organ multimodal characterization system is established to explore its mechanism and application value in refractory diseases such as functional gastrointestinal disorders， precancerous gastrointestinal diseases， Alzheimer's disease， Parkinson's syndrome， type 2 diabetes， and depression.

It is believed that the occurrence and development of squamous cell carcinoma （SCC） is closely associated with inflammatory responses. The theory of fire and heat， advocated by LIU Wansu， provides significant clinical guidance for understanding the pathogenesis and treatment of SCC. Based on this theory， the pathological mechanisms and clinical characteristics of SCC at different stages were analyzed. In the precancerous and early stages， the primary pathogenesis is qi stagnation leading to internal generation of constrained heat； in post-surgery， the condition shifts to qi deficiency with latent yin fire； during the treatment phase， the pathogenesis involves accumulation of pathogenic factors， excess toxins， and severe heat toxicity； in the late stage， the main pathology is yin deficiency with toxic heat， and phlegm-stasis obstruction of the internal organs. Corresponding stage-based treatment strategies are proposed. In the early stage， regulating qi movement to dissipate constrained heat； for post-surgery， tonifying qi and raising yang to dispel latent fire； during treatment stage， clearing heat and detoxifying to eliminate cancerous toxins； and in the late stage， nourishing yin and unblocking the bowels to clear deficiency heat.

"Stagnation" is an important pathological state in the development and progression of malignant tumors. However， its intrinsic connection with different stages of tumor evolution has not been clearly elucidated in previous studies. Drawing on clinical practice， this paper proposes the theory of stagnant toxin， emphasizing stage-specific pathogenesis and differentiated treatment strategies for tumors based on the varying manifestations of stagnation at each phase. The theory interprets the pathogenesis of stagnant toxin across the stages of tumor development through the five elements "wood， fire， earth， metal， and water" corresponding respectively to wood stagnation in the precancerous stage， metal stagnation in the postoperative phase， fire stagnation during adjuvant therapy， earth stagnation in the progressive stage， and water stagnation in the advanced stage. Each type of stagnation reflects a distinct pathogenic mechanism， such as wood stagnation giving rise to disease， metal stagnation inducing residual symptoms， fire stagnation resulting in ulceration， earth stagnation spreading toxin transmission， and water stagnation leading to critical deterioration. Accordingly， the treatment principles include guiding wood stagnation with counterflow， dispersing metal stagnation to harmonize symptoms， venting fire stagnation to regress ulcers， depleting earth stagnation to block progression， and controlling water stagnation to preserve vitality. This theoretical framework offers a traditional Chinese medicine perspective for understanding and treating malignant tumors based on the concept of stagnant toxin.

This study explored the effect of the Mycobacterium tuberculosis(Mtb)PE/PPE family protein PE_PGRS37 on the growth of Mycobacterium smegmatis(Ms)and macrophage autophagy during Mtb infection.The pe_pgrs37 gene was amplified from Mtb genome through PCR,and the recombinant vector pAIN-PE_PGRS37 was successfully constructed through homologous recombi-nation.pAIN-PE_PGRS37 and pAIN were integrated into Ms through electroshock to construct pAIN-PGRS37/Ms and pAIN/Ms re-combinant bacteria.Western blotting indicated that the PE_PGRS37 protein was correctly expressed in pAIN-PE_PGRS37/Ms.The re-combinant bacteria were inoculated in 7H9/7H10 medium,and their colony morphology and growth curves were observed.No signifi-cant difference in colony morphology was observed between pAIN-PE_PGRS37/Ms and pAIN/Ms.The growth rate significantly in-creased between 10 and 16 h,and a plateau was reached at 26 h.After infection of U937 cells with pAIN-PE_PGRS37/Ms and pAIN/Ms,macrophage autophagy flow was detected with western blotting and immunofluorescence.In the pAIN-PE_PGRS37/Ms-infected group,compared with the pAIN/Ms-infected group,macrophage LC3-II and p62 protein expression was significantly up-regulated(P<0.001)and inhibited autophagosome and lysosome fusion.The intracellular survival of the recombinant bacteria was detected through colony counting,and pAIN-PE_PGRS37/Ms showed significantly greater survival in macrophages at 12 h,24 h,and 48 h than pAIN/Ms(P<0.05).Our results suggested that PE_PGRS37 protein promotes Mycobacterium survival in macrophages by blocking macro-phage autophagy flow,thus inhibiting macrophage autophagy.

Recurrent spontaneous abortion(RSA)is a pregnancy complication with a complex etiology that seriously threatens the fertility and physical and mental health of women of childbearing age.As the main component of the maternal-fetal interface,the placenta plays a central role in maternal and fetal health during pregnancy,and its dysfunction is closely associated with the development of RSA.Iron homeostasis is essential for supporting maternal needs,placental function,and fetal development.In recent years,ferroptosis,a novel form of cell death triggered by iron overload and the accumulation of lipid peroxides,has garnered increasing attention regarding its regulatory mechanisms in the physiological and pathological processes of the female reproductive system.Ferroptosis has been confirmed to correlate with placental pathology and to influence the pathogenesis of RSA.The placenta plays a crucial role in regulating iron transport.This paper systematically reviewed the mechanisms of ferroptosis in placental cells and its involvement in the pathogenesis of RSA by affecting trophoblast cell function,causing decidualization disorders,inducing angiogenesis defects,and the potential of ferroptosis-related molecules in the treatment of RSA was analyzed,with the aim of providing research directions for improving the pregnancy outcomes in patients with RSA.

Under the current situation of "low prevalence and low infection" of schistosomiasis in China, and to provide a basis for achieving the goal of eliminating schistosomiasis by 2030 proposed by the Healthy China Action (2019 - 2030) as scheduled, the Hunan Provincial Corps Hospital of the Chinese People's Armed Police Force established a schistosomiasis monitoring and early warning index system based on the previous studies on schistosomiasis early warning index system and the recent literature analysis, combined with the current potential risk factors affecting the transmission and prevalence of schistosomiasis, and organized two rounds of expert consultation and carried out project promotion meetings. The experts reached a consensus on the comprehensiveness and practicability of the index system, aiming to lay a solid foundation for construction of China's schistosomiasis prevention and control early warning system.

Morphea alopecia is a rare secondary cicatricial alopecia, often caused by linear scleroderma of the scalp. When hair loss appears as the only symptom of morphea, it is easily confused with other localized alopecia. The diagnosis of morphea alopecia depends on histopathologic and dermoscopic examinations. In order to improve the understanding of morphea alopecia among clinicians, this review summarizes research progress in its pathogenesis, clinical and pathological characteristics, diagnosis and treatment.

Objective:To investigate the relationship between the early pregnancy triglyceride-glucose (TyG) index and gestational diabetes mellitus (GDM) in twin pregnancies.Methods:This retrospective study involved twin-pregnant women who visited Beijing Obstetrics and Gynecology Hospital, Capital Medical University from October 2015 to February 2021. Based on the results of the 75 g oral glucose tolerance test (OGTT) performed at 24-28 weeks of gestation, the women were divided into the GDM and the control groups. The groups were further stratified based on maternal age (<35 years or ≥35 years), pre-pregnancy body mass index (BMI) (<24.0 or ≥24.0 kg/m2), and conception method [assisted reproductive technology (ART) or natural conception]. The correlation between early pregnancy TyG index and GDM, as well as the predictive value of the early pregnancy TyG index for the risk of GDM in twin pregnancies, were analyzed. The TyG index in early pregnancy was then divided into tertiles, and the risks of GDM in low, medium, and high TyG index groups were analyzed. Statistical analyses were performed using independent sample t-test, non-parametric test, Chi-square test, and binary logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of the early pregnancy TyG index for GDM in twin pregnancies. Results:(1) A total of 1 684 twin-pregnant women were included, with an average age of 32.3 years (29.8-34.9 years) and a pre-pregnancy BMI of 22.0 kg/m2 (20.0-24.3 kg/m2). Among them, 319 (18.9%) were multiparas, 982 (58.3%) conceived through ART, and 357 (21.2%) were monochorionic twins. Of the 1 684 women, 367 (21.8%) were diagnosed with GDM (GDM group), whereas the remaining 1 317 were classified as the control group. (2) Compared to the control group, the GDM group had older maternal age [(32.2±3.7) years vs. (33.3±3.8) years, t=－4.92], higher pre-pregnancy weight, and BMI [57.5 kg (52.0-65.0 kg) vs. 60.0 kg (55.0-67.3 kg), U=279 901.50; 21.8 kg/m2 (19.8-24.0 kg/m2) vs. 22.9 kg/m2 (20.9-25.5 kg/m2), U=288 435.00]. The proportions of a family history of diabetes, history of GDM and polycystic ovary syndrome (PCOS) were all higher in the GDM group compared to the control group [9.6% (127/1 317) vs. 19.1% (70/367), χ 2=24.71; 0.8% (2/1 317) vs. 10.8% (8/367), χ 2=20.00; 9.1% (120/1 317) vs. 15.3% (56/367), χ 2=11.59] (all P<0.001). The GDM group had higher early pregnancy fasting blood glucose, triglyceride, and TyG indices compared to the control group [4.51 mmol/L (4.28-4.75 mmol/L) vs. 4.68 mmol/L (4.42-4.97 mmol/L), U=7.14; 1.23 mmol/L (0.93-1.57 mmol/L) vs. 1.43 mmol/L (1.09-1.89 mmol/L), U=4.81; 8.39±0.41 vs. 8.59±0.43, t=6.46]. The incidence of gestational anemia and weight gain were lower in the GDM group compared to the control group [39.2% (516/1 317) vs. 33.0% (121/367), χ 2=4.71; 17.0 kg (13.7-20.5 kg) vs. 15.0 kg (12.0-18.3 kg), U=187 966.00] (all P<0.05). The proportion of male newborns in the GDM group was higher than in the control group [52.5% (1 384/2 634) vs. 46.7% (343/734), χ 2=7.77, P=0.005]. (3) Early pregnancy TyG index was associated with GDM in twin pregnancies ( OR=3.164, 95% CI: 2.371-4.220, P<0.001). After adjusting for maternal age, pre-pregnancy BMI, history of GDM, history of macrosomia, and family history of diabetes, the early pregnancy TyG index remained associated with GDM ( OR=2.560, 95% CI: 1.884-3.478, P<0.001). Analysis of the early pregnancy TyG index divided into tertiles (corresponding TyG indices of 8.25 and 8.59) revealed that, compared to those with a low TyG index, those with a mid TyG index had a 0.555-fold increased risk of GDM ( OR=1.555, 95% CI: 1.119-2.159, P=0.008), and those with a high TyG index had a 1.564-fold increased risk of GDM ( OR=2.564, 95% CI: 1.836-3.530, P<0.001). Stratified analysis by age, BMI, and mode of conception showed that the early pregnancy TyG index was associated with GDM in twin pregnancies (all P<0.001). (4) The threshold value for the early pregnancy TyG index to predict GDM in twin pregnancies was 8.33, with an area under the curve (AUC) of 0.632, 95% CI: 0.600-0.665, sensitivity of 0.744, and specificity of 0.436. The AUC in twin pregnancies for those who conceived via ART was 0.635 (95% CI: 0.593-0.676, P<0.001), slightly higher than in those who conceived naturally (AUC=0.628, 95% CI: 0.576-0.681, P<0.001). After adjusting for maternal age, pre-pregnancy BMI, history of GDM, and family history of diabetes, the AUC for the early pregnancy TyG index to predict GDM in twin pregnancies was 0.675 (95% CI: 0.644-0.707). For those who conceived via ART, the AUC (95% CI) was 0.675 (0.634-0.717), slightly lower than for those who conceived naturally [0.682 (0.632-0.733)] (all P<0.001). Conclusion:A high TyG index in the first trimester is a risk factor for GDM in twin pregnancies, but its predictive value for GDM in twin pregnancies needs further research to be confirmed.