Ischemic stroke(IS)is a common cerebrovascular disease,and its pathogenesis is closely associated with brain cell death due to insufficiency of cerebral blood supply.In recent years,cell apoptosis has become a research hotspot in the pathogenesis of IS.The B-cell lymphoma-2(Bcl-2)family proteins associated with cell apoptosis are the key regulators for apoptosis and are mainly in-volved in the intrinsic apoptotic pathway,and they regulate cell apoptosis by mediating the two pathways of mitochondrial membrane permeability and Ca2? overload,thereby delaying the progression of IS.Starting from the anti-apoptotic mechanisms of Bcl-2 family proteins,this article summarizes the research advances in traditional Chinese medicine for the prevention and treatment of IS by regu-lating B-cell lymphoma-2 family proteins from the aspects of the structural features of Bcl-2 family proteins,their anti-apoptotic role in IS,and traditional Chinese medicine regulation.The results show that the anti-apoptotic strategies in IS mainly focus on the regula-tion of Bcl-2 and Bax proteins,and monomers of Chinese herbs,traditional Chinese medicine extracts,and compound traditional Chi-nese medicine prescriptions were used for treatment,which further confirms the great potential of traditional Chinese medicine in the prevention and treatment of IS and provides a theoretical basis for future experimental research and clinical treatment.

Objective:To establish a one-pot lyophilized detection system based on recombinase polymerase amplification (RPA) and Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and CRISPR-associated protein (Cas13a) technology for the rapid diagnosis of cytomegalovirus (CMV) infection in liver transplantation recipients.Methods:This study is a methodology study. CRISPR RNA (crRNA) and RPA primers were designed targeting the CMV gene sequence. Optimal RPA primer sets were screened to establish the RPA-CRISPR/Cas13a-based CMV detection system. The limit of detection (LOD) was evaluated using gradient-diluted CMV plasmid standards. Cross-reactivity was assessed using genomic DNA from common opportunistic viruses in organ transplant recipients. Lyophilized reagents were validated with CMV-negative and positive samples. P-values were computed using two-sample t-tests for pairwise comparisons and one-way ANOVA for multi-group analyses to assess fluorescence value differences. Subsequently, lyophilized reagents were employed to detect 22 plasma samples from liver transplantation recipients collected at Renji Hospital, Shanghai Jiao Tong University School of Medicine, from June 3, 2024, to May 31, 2025. The test results were then compared with those obtained using quantitative real-time polymerase chain reaction (qPCR). Consistency between the two methods was evaluated using the Kappa coefficient calculated by Kappa test.Result:The established RPA-CRISPR/Cas13a system achieved a detection sensitivity of 1 copy/reaction and exhibited no cross-reactivity with other common opportunistic viruses in organ transplantation. Lyophilized RPA-CRISPR/Cas13a reagents demonstrated performance equivalent to non-lyophilized reagents. Concordance between lyophilized reagent detection and qPCR results for 22 clinical samples was 100% (22/22).Conclusion:A lyophilized CMV detection method based on RPA-CRISPR/Cas13a technology was successfully developed and validated for convenient diagnosing CMV infection in liver transplant recipients.

Objective:To establish a one-pot lyophilized detection system based on recombinase polymerase amplification (RPA) and Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and CRISPR-associated protein (Cas13a) technology for the rapid diagnosis of cytomegalovirus (CMV) infection in liver transplantation recipients.Methods:This study is a methodology study. CRISPR RNA (crRNA) and RPA primers were designed targeting the CMV gene sequence. Optimal RPA primer sets were screened to establish the RPA-CRISPR/Cas13a-based CMV detection system. The limit of detection (LOD) was evaluated using gradient-diluted CMV plasmid standards. Cross-reactivity was assessed using genomic DNA from common opportunistic viruses in organ transplant recipients. Lyophilized reagents were validated with CMV-negative and positive samples. P-values were computed using two-sample t-tests for pairwise comparisons and one-way ANOVA for multi-group analyses to assess fluorescence value differences. Subsequently, lyophilized reagents were employed to detect 22 plasma samples from liver transplantation recipients collected at Renji Hospital, Shanghai Jiao Tong University School of Medicine, from June 3, 2024, to May 31, 2025. The test results were then compared with those obtained using quantitative real-time polymerase chain reaction (qPCR). Consistency between the two methods was evaluated using the Kappa coefficient calculated by Kappa test.Result:The established RPA-CRISPR/Cas13a system achieved a detection sensitivity of 1 copy/reaction and exhibited no cross-reactivity with other common opportunistic viruses in organ transplantation. Lyophilized RPA-CRISPR/Cas13a reagents demonstrated performance equivalent to non-lyophilized reagents. Concordance between lyophilized reagent detection and qPCR results for 22 clinical samples was 100% (22/22).Conclusion:A lyophilized CMV detection method based on RPA-CRISPR/Cas13a technology was successfully developed and validated for convenient diagnosing CMV infection in liver transplant recipients.

Objective:To evaluate the effects of different subanesthetic doses of esketamine on lung injury in elderly patients undergoing robot-assisted radical prostatectomy.Methods:Ninety American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients, aged 65-80 yr, with body mass index of 19-27 kg/m 2, scheduled for elective robot-assisted radical prostatectomy under general anesthesia, identified as having middle and high risk using the Assess Respiratory Risk in Surgical Patients in Catalonia, were divided into 3 groups ( n=30 each) using a random number table method: low-dose esketamine group (ES1 group), extremely low-dose esketamine group (ES2 group) and control group (C group). In ES1 group, esketamine was intravenously injected as a bolus of 0.2 mg/kg during anesthesia induction followed by an infusion of 0.125 mg·kg -1·h -1 until 30 min before the end of operation. In ES2 group, esketamine was intravenously injected as a bolus of 0.1 mg/kg during anesthesia induction followed by an infusion of 0.015 mg·kg -1·h -1 until 30 min before the end of operation. The equal volume of normal saline was given instead in C group. Radial artery blood samples were collected before anesthesia induction (T 0) and at the end of operation for determination of concentrations of Clara cell secretory protein (CC-16) and soluble form of advanced glycation end products receptor (sRAGE) in serum by enzyme-linked immunosorbent assay. The parameters of respiratory mechanics such as the driving pressure, dynamic lung compliance and mechanical power were recorded at 5 min after mechanical ventilation (T 1), and at 1 and 2 h after Trendelenburg position combined with pneumoperitoneum (T 2-3), and at 5 min before the end of operation (T 4). Blood samples were collected from the radial artery at T 0, T 1, T 3 and in the postanesthesia care unit for blood gas analysis, and the alveolar-arterial partial oxygen pressure difference and oxygenation index were recorded. The adverse reactions within 24 h after operation and the occurrence of postoperative pulmonary complications within 7 days after operation were recorded. Results:Compared with C group, the serum CC-16 and sRAGE concentrations were significantly decreased at the end of operation, the oxygenation index was increased and the alveolar-arterial partial oxygen pressure difference was decreased in the postanesthesia care unit, and the incidence of postoperative nausea reactions within 24 h after operation was decreased in ES1 and ES2 groups ( P<0.05 or 0.01). Compared with ES2 group, the serum CC-16 and sRAGE concentrations were significantly decreased at the end of operation in ES1 group ( P<0.05). There were no statistically significant differences in the driving pressure, dynamic lung compliance and mechanical power at T 1-4 and the incidence of postoperative pulmonary complications within 7 days after surgery among the three groups ( P>0.05). Conclusions:Esketamine given as a subanesthetic bolus of 0.2 mg/kg during anesthesia induction followed by an infusion of 0.125 mg·kg -1·h -1 can alleviate lung injury in elderly patients undergoing robot-assisted radical prostatectomy.

Objective:To evaluate the efficacy of omalizumab in the treatment of chronic spontaneous urticaria (CSU), and to analyze its influencing factors.Methods:CSU patients treated with omalizumab were prospectively enrolled from the Department of Dermatology, General Hospital of Ningxia Medical University from October 2021 to October 2023. These patients received subcutaneous injections of omalizumab at a dose of 300 mg every 4 weeks (150 mg for patients aged under 12 years) for at least 3 consecutive sessions. Data on general information, blood routine test, and serum total IgE levels were collected, and the 7-day Urticaria Activity Score (UAS7), Urticaria Control Test (UCT), Dermatology Life Quality Index (DLQI), Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL), and the Beck Anxiety Inventory (BAI) were evaluated by dermatologists at baseline, and after 4, 8, and 12 weeks of treatment. A decrease in UAS7 score of ≥ 11 points was defined as good disease control, while a decrease in UAS7 score of < 11 points was defined as poor control. Univariate binary logistic regression and multivariate logistic regression models were used to identify factors influencing the efficacy.Results:A total of 81 CSU patients were enrolled, including 34 males (42.0%) and 47 females (58.0%) ; their ages ranged from 6 to 66 years (39.2 ± 17.9 years), and the disease duration was 42.3 ± 6.9 months; the serum total IgE levels were 249.5 ± 216.3 IU/ml, with 54 patients (66.7%) showing elevated IgE levels (> 100 IU/ml). Compared with baseline levels, the UAS7, DLQI, and CU-Q2oL scores all significantly decreased at weeks 4, 8, and 12, while the UCT scores significantly increased (all P < 0.05). According to the UAS7 change values, 68 patients (83.9%) were well controlled, and 13 (16.1%) were poorly controlled. Univariate logistic regression analysis showed that higher total IgE levels and higher mean platelet volume (MPV) were associated with better efficacy, while higher body mass index (BMI), higher BAI, and the complication of other allergic diseases were associated with poorer efficacy (all P < 0.05). Multivariate logistic regression analysis indicated that BMI, BAI, and MPV significantly affected efficacy: higher MPV was associated with better efficacy ( OR = 3.36, 95% CI: 1.196 - 9.465, P = 0.020), while higher BMI ( OR = 0.76, 95% CI: 0.599 - 0.957, P = 0.016) and higher BAI ( OR = 0.92, 95% CI: 0.870 - 0.985, P = 0.021) were associated with poorer efficacy. During the whole study, only 4 patients (5%) experienced drowsiness, low fever, redness or discomfort at the injection sites, and no serious adverse events were reported. Conclusion:Omalizumab exhibited significant efficacy and high safety in the 12-week treatment of CSU, and BMI and BAI appeared to be risk factors for efficacy, while MPV seemed to be a protective factor affecting efficacy.

Objective:To evaluate the efficacy of omalizumab in the treatment of chronic spontaneous urticaria (CSU), and to analyze its influencing factors.Methods:CSU patients treated with omalizumab were prospectively enrolled from the Department of Dermatology, General Hospital of Ningxia Medical University from October 2021 to October 2023. These patients received subcutaneous injections of omalizumab at a dose of 300 mg every 4 weeks (150 mg for patients aged under 12 years) for at least 3 consecutive sessions. Data on general information, blood routine test, and serum total IgE levels were collected, and the 7-day Urticaria Activity Score (UAS7), Urticaria Control Test (UCT), Dermatology Life Quality Index (DLQI), Chronic Urticaria Quality of Life Questionnaire (CU-Q2oL), and the Beck Anxiety Inventory (BAI) were evaluated by dermatologists at baseline, and after 4, 8, and 12 weeks of treatment. A decrease in UAS7 score of ≥ 11 points was defined as good disease control, while a decrease in UAS7 score of < 11 points was defined as poor control. Univariate binary logistic regression and multivariate logistic regression models were used to identify factors influencing the efficacy.Results:A total of 81 CSU patients were enrolled, including 34 males (42.0%) and 47 females (58.0%) ; their ages ranged from 6 to 66 years (39.2 ± 17.9 years), and the disease duration was 42.3 ± 6.9 months; the serum total IgE levels were 249.5 ± 216.3 IU/ml, with 54 patients (66.7%) showing elevated IgE levels (> 100 IU/ml). Compared with baseline levels, the UAS7, DLQI, and CU-Q2oL scores all significantly decreased at weeks 4, 8, and 12, while the UCT scores significantly increased (all P < 0.05). According to the UAS7 change values, 68 patients (83.9%) were well controlled, and 13 (16.1%) were poorly controlled. Univariate logistic regression analysis showed that higher total IgE levels and higher mean platelet volume (MPV) were associated with better efficacy, while higher body mass index (BMI), higher BAI, and the complication of other allergic diseases were associated with poorer efficacy (all P < 0.05). Multivariate logistic regression analysis indicated that BMI, BAI, and MPV significantly affected efficacy: higher MPV was associated with better efficacy ( OR = 3.36, 95% CI: 1.196 - 9.465, P = 0.020), while higher BMI ( OR = 0.76, 95% CI: 0.599 - 0.957, P = 0.016) and higher BAI ( OR = 0.92, 95% CI: 0.870 - 0.985, P = 0.021) were associated with poorer efficacy. During the whole study, only 4 patients (5%) experienced drowsiness, low fever, redness or discomfort at the injection sites, and no serious adverse events were reported. Conclusion:Omalizumab exhibited significant efficacy and high safety in the 12-week treatment of CSU, and BMI and BAI appeared to be risk factors for efficacy, while MPV seemed to be a protective factor affecting efficacy.

Objective: To evaluate the efficacy and prognostic factors in core binding factor (CBF) acute myeloid leukemia (AML) under current therapy modalities, therefore optimizing the treatment strategies. Methods: Standard cytological and immune methods including next generation sequencing (NGS) were used for risk stratification. Complete remission (CR) rate, disease-free survival (DFS) and overall survival (OS) were assessed by multivariate Logistic and Cox regression models in a total of 206 adults (aged 16-65 years) with CBF-AML, including 152 AML patients with t(8;21) and 54 with inv(16). Results: The CR rate of inv(16) patients after first course was 54/54(100%), significantly higher than that of t(8;21) patients [127/147(86.4%), P=0.005]. The fusion transcript level and KIT mutation were independent factors related to CR rate in t(8;21) patients (P=0.044 and 0.027; respectively). DFS and OS in inv(16) patients tended to be more superior than that in t(8;21) patients (P=0.066 for DFS; P=0.306 for OS; respectively). Multivariate Cox identified negative expression of CD₁₉ and female gender the independent predictors of inferior DFS in t(8;21) patients (P=0.000 for CD₁₉; P=0.006 for sex; respectively). Analysis of combining CD₁₉ with gender indicated that females/CD₁^9-subpopulation had significantly poor DFS than did males/CD₁₉⁺ ones (Bonferroni-P<0.000 01). The number of mutations in each patient, FLT3-ITD and additional karyotype abnormalities did not affect CR rate and DFS (all P>0.05). Conclusions Patients with inv(16) have better induction response than those with t(8;21). High level of fusion transcripts and positive KIT mutation are associated with low CR rate in t(8;21) patients. Negative CD₁₉ expression and female gender are independent predictors of inferior DFS in t(8;21) patients.

Objective To investigate the effect of the overexpression of NeuroD1 on mediating transdifferentiation of spinal reactive astrocytes into neurons. Methods Spinal cord astrocytes were cultured from the SD rat, and reactive astrocytes were prepared by scratches treatment. Cells were divided into blank groups (NV group), control virus group (GFP group) and NeuroD1 virus group (NeuroD1 group). At 7 d after scratches treatment, GFP and NeuroD1 groups were infected with retroviruses carrying the GFP gene and and GFP gene plus NeuroD1 gene, respectively,whereas NV group was not infected with the virus. Twenty-four hours late, the culture medium were replaced by neuron conditioned medi?um. Cell morphology was examined at 1, 2, 3, 5, 7 and 14 d. DCX positive and NeuN positive cells were detected at 7 d and 14 d after infection by using immunofluorescence staining method, respectively. Results After replacement with the neuron conditioned medium, the nucleus was obviously plump, the cytoplasm was thin and neurites was reduced and ex?tended. Compared with the NeuroD1 group, neurites of NV group and GFP group were shorter with many branches and the nucleus was smaller. At 7 d after infection, cell morphology of NV group and GFP group gradually recovered, but cell morphology of NeuroD1 group did not. Compared with NV group and GFP group, NeuroD1 group had more DCX(9.84 ± 2.06%)and NeuN(8.25±2.78%)positive cells [F values 40.107 for DCX and 21.73 for NeuN (P<0.05)]. Conclusion The overexpression of NeuroD1 can mediate the transdifferentiation of spinal reactive astrocytes into neurons.

Objective To investigate the effect of mild hypothermia on proliferation and differentiation of neural stem cells (NGCs) in hippocampal subgranular zone after traumatic brain injury (TBI) and the underlying mechanism.Methods SD rats were divided into sham-injured group (only left dura mater exposed),hypothermia group (sham injury + mild hypothermia therapy for 72 hours),TBI group (unilateral fluid percussion was used to generate severe TBI),and TBI + hypothermia group (TBI + mild hypothermia therapy for 72 hours) according to the random number table,with 8 rats per group.Hippocampal homogenates or brain tissues were harvested after BrdU (100 mg/kg) was intraperitoneally administered to rats once a day for 7 days postTBI.Expressions of BrdU and double cortin in hippocampal subgranular zone were respectively detected by immunohistochemical or immunofiuorescence staining.Level of Sirt1 (silence information regulatory proteins,Sirt1) in hippocampus was detected by Western blot.Results BrdU-and double cortin-positive cells in rat hippocampal subgranular zone greatly increased at 7 days after TBI in comparison with sham-injured group (P ＜ 0.01).Moreover,BrdU and double cortin in rat hippocampal subgranular zone in TBI + hypothermia group was significantly higherthan that in TBI group [(257.4 ± 34.3) vs (196.4 ± 23.8) ; (346.4 ± 42.2) vs (245.7 ± 33.2),P ＜0.01].Moreover,mild hypothermia reversed TBI-induced over-expression of Sirt1 [(0.62 ± 0.075) vs(1.18 ± 0.11),P ＜ 0.01].Conclusion Mild hypothermia therapy can promote proliferation andneuronal differentiation of NSCs in hippocampal subgranular zone after TBI and the possible mechanismmay relate to the inhibition of over-expression of Sia1.

Objective To investigate the effect of silence regulatory protein 1 (Sirt1) on axonal outgrowth. Methods The hippocampal neurons was first isolated in vitro from rat embryos. The distribution and expression of Sirt1 were then detected 72 h later. The down-regulation of Sirt1 was induced by RNAi technology and up-regulation of Sirt1 was in-duced by overexpression of Sirt1 and resveratrol (RES). Immunofluorescence staining was used to examine the axon length. Results Immunofluorescence staining showed that Sirt 1 was located in neuronal cell body and neurite, especially in the distal axons. Down-regulation of Sirt1 significantly decreased axonal length compared with siRNA control group [(178.3 ± 3.2) μm vs. (110.2 ± 18.30) μm, P< 0.01 ]; Overexpression of Sirt1 significantly increased axonal length com-pared with eGFP control group [(178.3±3.2)μm vs (310.6±39.5)μm, P<0.01 ];Activation of Sirt1 by RES treatment al-so significantly increased axonal length compared with vehicle control group (DMSO treated group) [(291.7±13.2)μm vs. (525.1±49.1)μm, P<0.01 ]. Conclusions Sirt1 plays a key role in axonal growth which may be used as a potential thera-peutic target of axon regeneration.