In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

OBJECTIVE To explore t he protective mechanism of Yangxin dingji capsules on the cardiomyocytes of diabetic cardiomyopathy（DCM）model golden hamsters. METHODS In this study ，golden hamsters were divided into control group （n＝ 10，no modeling ，no drug administration ），model group （n＝9，modeling，no drug administration ），TCM high-dose group [ n＝8， modeling，Yangxin dingji capsules 2 g/（kg·d）]，TCM low-dose group [ n＝8，modeling，Yangxin dingji capsules 1 g/（kg·d）] and empagliflozin group [ n＝9，positive control ，modeling，10 mg/（kg·d）]. All the golden hamsters were gavaged continuously for 8 weeks. The general conditions of golden hamsters were observed during the experiment. Blood glucose ，total cholesterol （TC）and creatine kinase MB （CK-MB），ejection fraction （EF），fractional shortening （FS），interleukin 1β（IL-1β）and transforming growth factor β1（TGF-β1）were detected ；the histopathological changes of myocardium were observed. mRNA and protein expression of nucleotide-binding oligomerization domain-like receptor protein 3（NLRP3），caspase-1，aspirin D （GSDMD），nuclear factor κB （NF-κB）and IL- 1β were detected and observed；DNA damage in myocardial was detected. RESULTS Compared with control group，the blood glucose ，TC，CK-MB，serum IL- 1β，TGF-β1 levels，the mRNA expressions and positive protein expression of NLRP 3，caspase-1，GSDMD，NF-κ B and IL-1 β and protein expression of GSDMD in golden hamsters were significantly increased in model group （P＜0.05 or P＜0.01） EF and FS were significantly decreased （P＜0.01）；the fibers of myocardial cells was disordered ， and the blue-stained collagen fibers between the myocardium increased ； DNA damaged positive cells in myocardial tiss ue of gold hamsters increased significantly. Compared with model group，the above indexes of administration groups were reversed to varying degrees ；the gap of myocardial cells were clear ，and the fibers disorder was improved ；the DNA damaged positive cells in the myocardial tissue were reduced to varying degrees. CONCLUSIONS Yangxin dingji capsule can inhibit the cardiomyocyte pyroptosis and relieve the inflammatory injury of DCM in DCM model golden hamsters by regulating the NLRP 3/caspase-1/GSDMD signaling pathway ，so as to protect the cardiomyocytes.

Objective:To compare the positioning errors of individual head-rest combined with thermoplastic fixation mask versus thermoplastic fixation mask alone in patients with head and neck tumors. Methods:Twenty-eight patients who received irradiation with helical tomotherapy in Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) between October 2019 and April 2020 were included in this study. They were randomly assigned to receive position fixation with either individual head-rest combined with thermoplastic fixation mask (N1 group, n = 14) or thermoplastic fixation mask alone (N2 group, n = 14). Megavoltage computed tomography (MVCT) scanning registration was used to obtain the positioning errors in translation and rotation (ROLL) in the left-right (X), head-food (Y), and belly-back (Z) directions. There were a total of 841 CT scans, consisting of 425 scans in group N1 and 416 scans in group N2. Results:The positioning errors in X, Y, Z and ROLL directions in the N1 group were (1.37 ± 1.04) mm, (1.38 ± 1.12) mm, (1.47 ± 1.62) mm and (1.47 ± 1.62) ° respectively, and they were (1.57 ± 1.21) mm, (2.10 ± 1.51) mm, (1.61 ± 1.50) mm and (1.40 ± 1.30) ° respectively in the N2 group. There was significant difference in positioning errors in the Y direction between N1 and N2 groups ( P = 0.013). In the N1 group, the outward expansion boundaries in X, Y and Z directions was 4.15 mm, 4.23 mm and 4.81 mm respectively, and it was 4.77, 6.31 and 5.08 mm, respectively in the N2 group. In the X direction, there was significant difference in positioning errors taking 3 mm as the dividing point between N1 and N2 groups ( χ2 = 10.516, P < 0.001). In the Y direction, there was significant difference in positioning errors taking 1, 2 and 3 mm as the dividing points between N1 and N2 groups ( χ2 = 24.889, P < 0.001; χ2 = 42.202, P < 0.001; χ2 = 46.204, P < 0.001). In the Z direction, there was significant difference in positioning errors taking 2 mm as the dividing point between N1 and N2 groups ( χ2 = 7.335, P = 0.007). In the N1 group, the percentage of positioning errors < 3 mm in the X, Y and Z directions was 92%, 90% and 92%, respectively. Conclusion:Compared with thermoplastic fixation mask alone, individual head-rest combined with thermoplastic fixation mask can better effectively improve the positioning stability and reduce positioning errors in patients receiving irradiation with helical tomotherapy for head and neck tumors. The combined method is of certain innovation.

Objective To study the effect of salidroside (Sal) on learning and memory abilities and expression of p75NTR signal transducers and Aβ in AD rat hippocampus.Methods Totally,ninety-six male SD rats were randomly divided into sham-operation group,model control group,Sal low,medium and high dose group,Hup-A group (16 rats in each group).Except for sham-operation group,AD model in the other group was established by slowly injecting 1μL(10 μg)Aβ1-40 in tobilateral hippocampal CA1 area.Sham-operation group was given the same volume of 0.9％ sodium chloride solution.Sal low,medium and high dose group took orally as early as 24 h postoperatively with salidroside 25,50,100 mg· kg-1 for 21days,while Hup-A group took 50 mg kg-1 of Hup-A orally.The same volume of 0.9％ sodium chloride solution was administrated in shanmoperation group and model control group.After administration,the learning and memory function of rats were tested by Morris water maze.The contents of Aβ in serum and hippacampus were determined by ELISA,and protein expression of p75NTR and p-JNK in the hippocampus of the rats were measured by ELISA.Results Compared with model control group,the latent time in water maze training of Sal low,medium and high dose groups were significantly shortened (P ＜ 0.05 or P ＜ 0.01),the number of times of crossing platform of Sal low,medium and high dose group was significantly increased.The contents of Aβ in the hippocampus and the protein expression levels of p75NTR and p-JNK in the hippocampus of Sal low,medium and high dose group were decreased significantly (P ＜ 0.05,P ＜ 0.01).Conclusion Salidroside has protective effects on learning and memory consolidation of dysmnesia rats caused by Aβ.Its mechanism might be related to inhibition of p75NTR regulation pathways for Aβ,reducing the neurotoxic effect of Aβ,so as to reduce cell apoptosis of hippocampus neuron.

BACKGROUND:Our prior experiments have confirmed that 10 μmol/L oxytocin can induce transformation of bone marrow mesenchymal stem cels into myocardial cels. OBJECTIVE: To investigate the effects of Ginsenoside Rh2 on oxytocin-induced transformation of bone marrow mesenchymal stem cels into myocardial cels. METHODS:Rat bone marrow mesenchymal stem cels were isolated by differential adherence method. These isolated cels were randomly divided into five groups. In the blank control group, cels were routinely cultured. In the oxytocin group, cels were cultured with 10 μmol/L oxytocin for 2 consecutive weeks. In the Ginsenoside Rh2 low-, middle-, and high-dose groups, cels were treated with 0.5, 1, 2 μmol/L Ginsenoside Rh2respectively for 24 hours and then with oxytocin for additional 2 consecutive weeks. RESULTS AND CONCLUSION: Optical microscopy showed that compared to the blank control group, some cels in the oxytocin group exhibited an increased soma and some cels grew in clusters and the cel clusters enlarged with the increase in Ginsenoside Rh2 dose. Immunocytochemical staining and western blot analysis showed that cardiac Troponin T and connexin 43 protein expression in the oxytocin, Ginsenoside Rh2 low-, middle-, and high-dose groups were significantly greater than in the blank control group (P < 0.05), and cardiac Troponin T and connexin 43 protein expression in the Ginsenoside Rh2 groups was increased with the increase in Ginsenoside Rh2 dose and was significantly higher than that in the oxytocin group (P < 0.05). Confocal laser scanning microscopy showed that the relative fluorescence intensity of free calcium in the bone marrow mesenchymal stem cels in the oxytocin group was significantly increased after induction by oxytocin for 2 weeks (P < 0.05), while the relative fluorescence intensity in the Ginsenoside Rh2 groups was significantly higher than that in the Ginsenoside Rh2 groups and was positively correlated with the dose of Ginsenoside Rh2. These findings suggest that Ginsenoside Rh2 can obviously promote oxytocin-induced transformation of bone marrow mesenchymal stem cels into myocardial celsin vitro.

BackgroundThe relationship between lipids and coronary artery disease has been well established. However, this is not the case between lipids and heart failure. Ironically, high lipid levels are associated with better outcomes in heart failure, but the mechan-isms underlying the phenomenon are not fully understood. This study was performed to test the hypothesis that reduced intestinal lipid absorption due to venous congestion may lead to low lipid levels.MethodsWe collected data of clinical characteristics, echocardio-graph, and lipid profile in 442 unselected patients with congestive heart failure. Correlations between lipid levels[including total cho-lesterol(TCL), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), and triglycerides(TG)]and right ventricle end diastolic diameter (RVEDD), left ventricle end diastolic diameter (LVEDD), right atrium diameter (RA), left atrium diameter (LA), or left ventricle ejection fraction (LVEF) were analyzed using Pearson correlation and partial correlation. RVEDD, LVEDD, RA, and LA were indexed to the body surface area.ResultsThere was a significantly inverse correlation between TCL le-vels and RVEDD (r=-0.34,P<0.001) and RA (r=-0.36,P<0.001). Other lipids such as LDL-C, HDL-C, and TG had asimilar inverse correlation with RVEDD and RA. All these correlations remained unchanged after adjusting for age, gender, smoking status, physical activity levels, comorbidities, and medication use.ConclusionsLipid levels were inversely correlated to RVEDD in patients with congestive heart failure; however, because this was an observational study, further investigation is needed to verify our results as wellas identify a causal relationship, if any.

Objective To investigate the expression and effect of FOXC2 (forkhead box C2) and Vimentin in gastric carcinoma tissues .Methods To detect the protein expression of FOXC2 and Vimentin in 20 normal gastric tissues and 65 gastric carcinoma tissues with immunochemistry .Results FOXC2 and Vimentin were highly expressed in all gastric carcinoma tissues .In all gastric carcinoma cases ,the FOXC2 expression rate was 41 .53% ,the rate of Vimentin was 35 .38% .The average expression rates of FOXC2 and Vimentin in TNM ( Ⅲ + Ⅳ ) group were significantly higher than those in TNM (Ⅰ + Ⅱ ) group ,respectively (58 .60% vs .27 .78% ,P=0 .012 ;55 .88% vs .29 .03% ,P=0 .018) .The expression rates of FOXC2 and Vimentin in lymph node transfer group were statistically higher than those in no lymph node transfer group (51 .72% vs .22 .22% ,P=0 .013;41 .20% vs . 14 .80% ,P=0 .010) .The correlation between FOXC2 and Vimentin was positive (P= 0 .037) .Conclusion It is possible that FOXC2 and Vimentin are involved in the transformation of epithelial cells into the mesenchymal cells .And they may play an impor-tant role in the metastasis of gastric carcinoma .

Background Hyperuricemia is frequently present in patients with heart failure. Many pathological conditions, such as tissue ischemia, renal function impairment, cardiac function impairment, metabolic syndrome, and inflammatory status, may impact uric acid (UA) metabolism. This study was to assess their potential relations to UA metabolism in heart failure. Methods We retrospectively assessed clinical characteristics, echocardiological, renal, metabolic and inflammatory variables selected on the basis of previous evidence of their involvement in cardiovascular diseases and UA metabolism in a large cohort of randomly selected adults with congestive heart failure (n = 553). By clustering of indices, those variables were explored using factor analysis. Results In factor analysis, serum uric acid (SUA) formed part of a principal cluster of renal functional variables which included serum creatinine (SCr) and blood urea nitrogen (BUN). Univariate correlation coefficients between variables of patients with congestive heart failure showed that the strongest correlations for SUA were with BUN (r = 0.48, P < 0.001) and SCr (r = 0.47, P < 0.001). Conclusions There was an inverse relationship between SUA levels and measures of renal function in patients with congestive heart failure. The strong correlation between SUA and SCr and BUN levels suggests that elevated SUA concentrations reflect an impairment of renal function in heart failure.

The objective of this experiment was to study the sequential pathologic changes in the remodeling of the internal structure of the tibia, caused by controlled excessive jumping and running. Eighteen rabbits were exercised separately in two electrical cages with high voltage and low current. They were forced to jump and run in a manner which simulated athletic activity. Two additional rabbits served as controls. The rabbits were sacrificed periodically to obtain the required specimens. Radiographic and histologic methods were applied to observe the development of the pathologic changes of the tibia throughout the sixty-day experimental period.Vascular changes and circulatory disturbances within the cortical bone occurred before osteoclastic resorption. Degeneration and necrosis of osteocytes due to circulatory disturbances also occurred. Periosteal new bone formation found on and after 14 days of the experiment was a compensatory reaction to support the tibia which was weakened by the accelerated ostoclastic resorption. A Small crack appeared at the cement line and propagated through the neighboring cement line of the Haversian systems. After 21 days, incomplete fracture of the tibial cortex was found in two rabbits. Complete fracture on one side of the cortex was seen in 1 animal on the 50th day of the experiment. In addition, degeneration and necrosis of the surrounding muscles were also observed microscopically. In this study, however, most of the tibias did not have visible fracture lines after a period of strenuous exercise. This result suggests that most tibias can adapt to changes under stress through proper internal remodeling, so that a complete fracture rarely occurs.