As the core vehicle for preserving and transmitting traditional Chinese medicine（TCM） academic thought and clinical experience， the establishment of a robust quality evaluation system for TCM clinical case reports is a crucial component in the current standardization and modernization of TCM. Based on the practical experience of constructing the China Clinical Cases Library of Traditional Chinese Medicine by the China Association of Chinese Medicine， this study conducted a comprehensive analysis of critical challenges， including insufficient authenticity and unfocused evaluation criteria. It proposed a three-dimensional evaluation framework grounded in the structure-process-outcome logic， encompassing three dimensions of authenticity and standardization， characteristics and advantages， application and translational impact. This framework integrated 12 key evaluation indicators in a systematic manner. The model preserved the academic characteristics of TCM syndrome differentiation and treatment， while aligning with modern scientific research standards， achieving a balance between individualized TCM experience and standardized evaluation. Concurrently， this study provided theoretical foundations and methodological guidance for evaluating the quality of TCM clinical cases， contributing significantly to the inheritance of TCM knowledge， evidence-based practice， and the reform of talent evaluation mechanisms.

This study aimed to investigate the efficacy and safety of blinatumomab in adult patients with acute B-lymphoblastic leukemia (B-ALL) by conducting a retrospective analysis of the clinical data from 16 patients with B-ALL receiving blinatumomab at the Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from June 2022 to April 2024. Among the 16 patients, 10 were classified as relapsed/refractory B-ALL and 6 were newly diagnosed Ph - B-ALL. Of the 10 patients with relapsed/refractory B-ALL, 8 achieved complete remission (CR) and minimal residual disease (MRD) negativity after one blinatumomab treatment cycle. In the 6 newly diagnosed patients, the bone marrow MRD was negative after one blinatumomab treatment cycle after initial induction chemotherapy followed by sequential blinatumomab treatment. Among them, four completed allogeneic hematopoietic stem cell transplantation and continuously maintained CR. This indicates that blinatumomab exhibits a high remission rate in both patients with relapsed/refractory and newly diagnosed B-ALL, thereby providing the possibility of bridging to transplantation and extending patient survival, with manageable adverse reactions.

This study aimed to investigate the efficacy and safety of blinatumomab in adult patients with acute B-lymphoblastic leukemia (B-ALL) by conducting a retrospective analysis of the clinical data from 16 patients with B-ALL receiving blinatumomab at the Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, from June 2022 to April 2024. Among the 16 patients, 10 were classified as relapsed/refractory B-ALL and 6 were newly diagnosed Ph - B-ALL. Of the 10 patients with relapsed/refractory B-ALL, 8 achieved complete remission (CR) and minimal residual disease (MRD) negativity after one blinatumomab treatment cycle. In the 6 newly diagnosed patients, the bone marrow MRD was negative after one blinatumomab treatment cycle after initial induction chemotherapy followed by sequential blinatumomab treatment. Among them, four completed allogeneic hematopoietic stem cell transplantation and continuously maintained CR. This indicates that blinatumomab exhibits a high remission rate in both patients with relapsed/refractory and newly diagnosed B-ALL, thereby providing the possibility of bridging to transplantation and extending patient survival, with manageable adverse reactions.

Objective:To investigate clinical efficacy and safety of venetoclax (VEN)-based regimens in the treatment of acute myeloid leukemia (AML).Methods:The clinical data of 41 AML patients treated with venetoclax-based regimens from January 2021 to December 2021 in Ruijin Hospital North of Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. The treatment regimens included VEN+demethylating drugs ± gene mutation inhibitors or VEN+chemotherapy with a median number of 2 courses (1- 5 courses).Results:The median age of all patients was 60 years (18-73 years), and there were 24 males and 17 females. After 1 course of VEN-based therapy, 22 (53.7%) patients achieved complete remission (CR) or morphological complete remission without complete blood count recovery (CRi), including 5 patients achieving minimal residual disease (MRD) negative. After 2 courses of treatment, of 17 patients available for efficacy evaluation, 7 patients achieved MRD negative. Among 20 relapsed/refractory AML patients, 9 cases achieved CR/CRi after 1 course of treatment, of which 1 patient had MRD negative. Among 21 patients initially treated and re-treated, 13 cases achieved CR/CRi and 1 case achieved partial remission after 1 course of treatment, of which 4 cases had MRD negative.Conclusions:VEN-based treatment regimens for AML have a high remission rate and tolerable adverse effects.

Humans ; Hypertension, Pulmonary/surgery* ; Learning Curve ; Angioplasty, Balloon ; Pulmonary Embolism/therapy* ; Chronic Disease ; Pulmonary Artery/surgery*

Exosomes are extracellular vesicles released from various cellular sources and are widely present in body fluids. Bioactive substances such as microRNAs, mRNAs, and proteins are encapsulated in exosomes, which can activate various signaling pathways and play important roles in early warning of stroke and neurovascular unit repair. This article reviews the signal transduction of exosomes in cerebral ischemia.

Mesenchymal stem cells are a kind of pluripotent stem cells that play a role in stroke treatment mainly through paracrine mechanisms. Recent studies have shown that mesenchymal stem cell-derived exosomes play an important role in reducing post-stroke injury, promoting neural repair and angiogenesis. This article describes the research progress of bone marrow mesenchymal stem cell-derived exosomes in the treatment of stroke, and investigates the therapeutic mechanism and application prospects of exosomes bioactive substances represented by microRNAs.

Objective:To investigate the therapeutic effect of monosialoganglioside sodium (GM1) injection combined with hyperbaric oxygen(HBO) in the treatment of sudden deafness and to analyze its related mechanism.Methods:A total of 200 patients with sudden deafness admitted into the Department of Otorhinolaryngology, Head and Neck Surgery of Qingdao Municipal Hospital from May 2016 to July 2018 were selected and randomly divided into four groups: conventional group (conventional medical treatment), GM1 group (conventional medical treatment+ GM1 injection), HBO group (conventional medical treatment+ HBO treatment), and GM1+ HBO group (conventional medical treatment+ GM1 injection+ HBO), each consisting of 50 patients. The clinical effects of the four groups after treatment were compared, the changes of the average air-conduction hearing threshold, symptom score, and the levels of whole blood viscosity, plasma viscosity, fibrinogen and vascular endothelial growth factor (VEGF), intercellular adhesion factor-1 (ICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) before and after treatment were recorded and compared. The incidences of adverse reactions during the treatment in each group were observed.Results:The total effective rate of the GM1+ HBO group was 98.00%, which was significantly higher than those of the other three groups (78.00%, 82.00%, and 86.00%) ( P<0.05); in each group, after treatment, the average air-conduction hearing threshold of the patients was significantly lower than that before treatment ( P<0.05), and the symptom score of the patient was significantly lower than that before treatment ( P<0.05); after treatment, the average air-conduction hearing threshold and symptom score of the patients in the GM1+ HBO group were significantly lower than those in the other three groups ( P<0.05); after treatment, the levels of whole blood viscosity, plasma viscosity, and fibrinogen in each group were significantly lower than those before treatment, especially, those in the GM1+ HBO group were significantly lower than those in the other three groups ( P<0.05); after treatment, the level of VEGF in each group was significantly higher than that before treatment, especially, that in the GM1+ HBO group was significantly higher than those in the other three groups ( P<0.05); the levels of ICAM-1 and sVCAM-1 were lower than those before treatment, and those in the GM1 + HBO group were significantly lower than those in the other three groups ( P<0.05). The total incidence of adverse reactions in the GM1+ HBO group was slightly higher than those in the other three groups, but the differences were not statistically significant ( P>0.05). Conclusion:GM1 injection combined with HBO is effective in the treatment of sudden deafness, which can significantly improve the hearing of patients. It may be achieved by repairing the damaged endothelium through improving the coagulation and vascular endothelial function of patients. The therapy is worthy of clinical application.

Micro RNAs are a kind of conserved short non-coding RNAs that regulate life activities at molecular level. Micro RNAs are active in various stages of autophagy after ischemic stroke; micro RNAs play protective or destructive roles in autophagy after stroke. Based on the autophagy process, we discuss the possible mechanism of autophagy regulated by micro RNAs through autophagy related genes or pathways, and analyze the application prospect of micro RNAs in stroke diagnosis and treatment.

Objective:To investigate the therapeutic effect of monosialoganglioside sodium (GM1) injection combined with hyperbaric oxygen(HBO) in the treatment of sudden deafness and to analyze its related mechanism.Methods:A total of 200 patients with sudden deafness admitted into the Department of Otorhinolaryngology, Head and Neck Surgery of Qingdao Municipal Hospital from May 2016 to July 2018 were selected and randomly divided into four groups: conventional group (conventional medical treatment), GM1 group (conventional medical treatment+ GM1 injection), HBO group (conventional medical treatment+ HBO treatment), and GM1+ HBO group (conventional medical treatment+ GM1 injection+ HBO), each consisting of 50 patients. The clinical effects of the four groups after treatment were compared, the changes of the average air-conduction hearing threshold, symptom score, and the levels of whole blood viscosity, plasma viscosity, fibrinogen and vascular endothelial growth factor (VEGF), intercellular adhesion factor-1 (ICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) before and after treatment were recorded and compared. The incidences of adverse reactions during the treatment in each group were observed.Results:The total effective rate of the GM1+ HBO group was 98.00%, which was significantly higher than those of the other three groups (78.00%, 82.00%, and 86.00%) ( P<0.05); in each group, after treatment, the average air-conduction hearing threshold of the patients was significantly lower than that before treatment ( P<0.05), and the symptom score of the patient was significantly lower than that before treatment ( P<0.05); after treatment, the average air-conduction hearing threshold and symptom score of the patients in the GM1+ HBO group were significantly lower than those in the other three groups ( P<0.05); after treatment, the levels of whole blood viscosity, plasma viscosity, and fibrinogen in each group were significantly lower than those before treatment, especially, those in the GM1+ HBO group were significantly lower than those in the other three groups ( P<0.05); after treatment, the level of VEGF in each group was significantly higher than that before treatment, especially, that in the GM1+ HBO group was significantly higher than those in the other three groups ( P<0.05); the levels of ICAM-1 and sVCAM-1 were lower than those before treatment, and those in the GM1 + HBO group were significantly lower than those in the other three groups ( P<0.05). The total incidence of adverse reactions in the GM1+ HBO group was slightly higher than those in the other three groups, but the differences were not statistically significant ( P>0.05). Conclusion:GM1 injection combined with HBO is effective in the treatment of sudden deafness, which can significantly improve the hearing of patients. It may be achieved by repairing the damaged endothelium through improving the coagulation and vascular endothelial function of patients. The therapy is worthy of clinical application.