Background/Aims: Natural killer (NK) cell function is generally considered dampened in chronic hepatitis B virus (HBV) infection; however, the NK cell pool exhibits phenotypic and functional heterogeneity, and the antibody--mediated effect of NK cells remains less characterized. This study evaluated the dynamic changes in antibody-mediated NK cell responses and the involvement of distinct NK subsets across disease stages and during antiviral treatment. Methods: A T-cell receptor-like antibody specific for the HBV core 18–27 peptide (cTCRL-Ab) was used to determine the antibody-mediated effect of NK cells, and an array of NK cell surface markers were analyzed in cross-sectional and longitudinal cohorts of patients with chronic HBV infection. Single-cell RNA sequencing (scRNA-seq) was performed to identify the heterogeneity of NK subsets. Results: The cTCRL-Ab enabled the detection of NK cell cytolytic activity and IFNγ production. Notably, cTCRL-Ab-mediated NK cell responses were compromised in chronically HBV-infected patients, particularly in those receiving pegylated interferon-α (Peg-IFNα), which was associated with the downregulation of CD16 expression. Correspondingly, Peg-IFNα inhibited cTCRL-Ab-mediated NK cell function by reducing CD16 expression in vitro. scRNA-seq revealed that CD16 downregulation occurred mainly within a dysfunctional CD16hi NK subset exhibiting exhaustion properties. In contrast, an activated CD16hiNK subpopulation (CX3CR1⁺KLRC2–CD16hi) with high cytotoxicity was enriched in patients who experienced favorable treatment responses. Furthermore, the intrahepatic CX3CR1+KLRC2–CD16hi subset tended to exhibit functional restoration in HBsAg-loss individuals. Conclusions Our data contribute to the understanding of antibody-mediated responses of NK cells in chronic HBV infection, and highlight a previously unappreciated functional CX3CR1+KLRC2–CD16hiNK subset as a potential therapeutic target.

BACKGROUND:Duhuo Jisheng Decoction is a classic prescription for the treatment of rheumatoid arthritis,but its specific mechanism is not clear.Extracellular vesicles have the powerful function of inter-cell communication and signal transmission,and may be the signal carrier for the Decoction.OBJECTIVE:To explore the effects of serum extracellular vesicles treated with Duhuo Jisheng Decoction on the proliferation,migration,invasion,and apoptosis of rheumatoid arthritis fibroblast-like synovial cells.METHODS:The rheumatoid arthritis fibroblast-like synovial cell model was established by co-culturing with tumor necrosis factor-α in vitro.The experiment was divided into five groups:normal group,model group,serum treated with Duhuo Jisheng Decoction group,extracellular vesicles treated with Duhuo Jisheng Decoction group,and extracellular vesicles treated with normal saline group.The optimal concentration and time of drug-containing serum and extracellular vesicles were screened by CCK-8 assay.Expression of inflammatory cytokines in the supernatants of cells in each group was detected by ELISA.The migration ability of rheumatoid arthritis fibroblast-like synovial cells was detected by scratch assay.The invasive ability of cells was measured by Transwell Invasion assay.Hoechst staining was adoped to detect cell apoptosis.The expression levels of apoptosis-related genes and proteins were detected by qRT-PCR and western blot assay.RESULTS AND CONCLUSION:(1)The optimal volume fraction of serum treated with Duhuo Jisheng Decoction was 10%and optimal mass concentration of extracellular vesicles treated with Duhuo Jisheng Decoction was 10 ng/mL;the optimal time for the interaction between the two was 24 hours.(2)Compared with the model group,serum treated with Duhuo Jisheng Decoction,extracellular vesicles treated with Duhuo Jisheng Decoction,and extracellular vesicles treated with normal saline could suppress the expression of inflammatory factors of rheumatoid arthritis fibroblast-like synovial cells(P<0.05),scratch healing(P<0.05),migration and invasion(P<0.05).Moreover,the inhibition of extracellular vesicles treated with Duhuo Jisheng Decoction was more significant(P<0.05).(3)Drug-containing serum and extracellular vesicles treated with Duhuo Jisheng Decoction promoted the apoptosis of rheumatoid arthritis fibroblast-like synovial cells.(4)Compared with the model group,serum treated with Duhuo Jisheng Decoction,extracellular vesicles treated with Duhuo Jisheng Decoction,and extracellular vesicles treated with normal saline could increase the expression of proapoptotic factors Caspase-3,Caspase-9,and Bax(P<0.05)and decrease the expression of antiapoptotic factor Bcl-2(P<0.05).Moreover,extracellular vesicles treated with Duhuo Jisheng Decoction had a more significant regulatory effect on apoptosis-related factors.Above findings indicate that extracellular vesicles treated with Duhuo Jisheng Decoction can inhibit the excessive proliferation,migration,and invasion of rheumatoid arthritis fibroblast-like synovial cells and promote their apoptosis.

BACKGROUND:Duhuo Jisheng Decoction is a classic prescription for the treatment of rheumatoid arthritis,but its specific mechanism is not clear.Extracellular vesicles have the powerful function of inter-cell communication and signal transmission,and may be the signal carrier for the Decoction.OBJECTIVE:To explore the effects of serum extracellular vesicles treated with Duhuo Jisheng Decoction on the proliferation,migration,invasion,and apoptosis of rheumatoid arthritis fibroblast-like synovial cells.METHODS:The rheumatoid arthritis fibroblast-like synovial cell model was established by co-culturing with tumor necrosis factor-α in vitro.The experiment was divided into five groups:normal group,model group,serum treated with Duhuo Jisheng Decoction group,extracellular vesicles treated with Duhuo Jisheng Decoction group,and extracellular vesicles treated with normal saline group.The optimal concentration and time of drug-containing serum and extracellular vesicles were screened by CCK-8 assay.Expression of inflammatory cytokines in the supernatants of cells in each group was detected by ELISA.The migration ability of rheumatoid arthritis fibroblast-like synovial cells was detected by scratch assay.The invasive ability of cells was measured by Transwell Invasion assay.Hoechst staining was adoped to detect cell apoptosis.The expression levels of apoptosis-related genes and proteins were detected by qRT-PCR and western blot assay.RESULTS AND CONCLUSION:(1)The optimal volume fraction of serum treated with Duhuo Jisheng Decoction was 10%and optimal mass concentration of extracellular vesicles treated with Duhuo Jisheng Decoction was 10 ng/mL;the optimal time for the interaction between the two was 24 hours.(2)Compared with the model group,serum treated with Duhuo Jisheng Decoction,extracellular vesicles treated with Duhuo Jisheng Decoction,and extracellular vesicles treated with normal saline could suppress the expression of inflammatory factors of rheumatoid arthritis fibroblast-like synovial cells(P<0.05),scratch healing(P<0.05),migration and invasion(P<0.05).Moreover,the inhibition of extracellular vesicles treated with Duhuo Jisheng Decoction was more significant(P<0.05).(3)Drug-containing serum and extracellular vesicles treated with Duhuo Jisheng Decoction promoted the apoptosis of rheumatoid arthritis fibroblast-like synovial cells.(4)Compared with the model group,serum treated with Duhuo Jisheng Decoction,extracellular vesicles treated with Duhuo Jisheng Decoction,and extracellular vesicles treated with normal saline could increase the expression of proapoptotic factors Caspase-3,Caspase-9,and Bax(P<0.05)and decrease the expression of antiapoptotic factor Bcl-2(P<0.05).Moreover,extracellular vesicles treated with Duhuo Jisheng Decoction had a more significant regulatory effect on apoptosis-related factors.Above findings indicate that extracellular vesicles treated with Duhuo Jisheng Decoction can inhibit the excessive proliferation,migration,and invasion of rheumatoid arthritis fibroblast-like synovial cells and promote their apoptosis.

BACKGROUND:Diabetes exacerbates intervertebral disc degeneration in a number of ways,and good glycemic control is beneficial in preventing intervertebral disc degeneration.OBJECTIVE:To review the relationship between diabetes and intervertebral disc degeneration to provide a reference for the clinical treatment of disc degeneration in patients with diabetes.METHODS:Literature searches were performed in CNKI and PubMed databases for articles published from 1980 to 2023.The Chinese and English search terms were"diabetes,intervertebral disc degeneration,cartilage endplate degeneration,apoptosis,advanced glycation end products,osmotic stress."Finally,73 articles were included for summary and analysis.RESULTS AND CONCLUSION:(1)The pathophysiological process of diabetes-induced intervertebral disc degeneration is different from that of physiological degeneration.The main mechanisms of diabetes-induced intervertebral disc degeneration include:intracellular hyperglycemia,impaired blood supply to the intervertebral discs due to microvascular pathology,cellular senescence,apoptosis,and autophagy,accumulation of advanced glycation end products,osmotic stress,and destruction of the extracellular matrix components due to other pathways.(2)Drugs such as curcumin,resveratrol,and lupeol have therapeutic effects on intervertebral disc degeneration,but their safety and effectiveness need to be further demonstrated in clinical treatment.

Atherosclerosis(AS)is a multifactorial disease,in which mitochondrial dysfunction of macrophages plays a key role.Mitochondrial dysfunction of macrophages affects polarization direction of macrophages and leads to severe inflammatory reac-tions,is a potential therapeutic target for AS.This article mainly reviews the latest research progress on role of macrophage mitochon-drial dysfunction in occurrence and development of AS,as well as treatment methods for improving macrophage mitochondrial function.

Atherosclerosis(AS)is a multifactorial disease,in which mitochondrial dysfunction of macrophages plays a key role.Mitochondrial dysfunction of macrophages affects polarization direction of macrophages and leads to severe inflammatory reac-tions,is a potential therapeutic target for AS.This article mainly reviews the latest research progress on role of macrophage mitochon-drial dysfunction in occurrence and development of AS,as well as treatment methods for improving macrophage mitochondrial function.

ObjectiveBy exploring the influencing factors of readmission in patients with stable angina of coronary heart disease （CHD） based on real-world clinical data， to establish a risk prediction model of integrated traditional Chinese and western medicine， in order to provide a basis for early identification of high-risk populations and reducing readmission rates. MethodsA prospective clinical study was conducted involving patients with stable angina pectoris of CHD， who were divided into a training set and a validation set at a 7∶3 ratio. General information， traditional Chinese medicine （TCM）-related data， and laboratory test results were uniformly collected. After a one-year follow-up， patients were classified into a readmission group and a non-readmission group based on whether they were readmitted. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for readmission. A risk prediction model of integrated traditional Chinese and western medicine was constructed and visualized using a nomogram. The model was validated and evaluated in terms of discrimination， calibration， and clinical decision curve analysis. ResultsA total of 682 patients were included， with 477 in the training set and 205 in the validation set， among whom 89 patients were readmitted. Multivariate logistic regression analysis identified heart failure history ［OR = 6.93， 95% CI （1.58， 30.45）］， wiry pulse ［OR = 2.58， 95% CI （1.42， 4.72）］， weak pulse ［OR = 3.97， 95% CI （2.06， 7.67）］， teeth-marked tongue ［OR = 4.38， 95% CI （2.32， 8.27）］， blood stasis constitution ［OR = 2.17， 95% CI （1.06， 4.44）］， phlegm-stasis mutual syndrome ［OR = 3.64， 95% CI （1.87， 7.09）］， and elevated non-high-density lipoprotein cholesterol ［OR = 1.30， 95% CI （1.01， 1.69）］ as influencing factors of readmission. These factors were used as predictors to construct a nomogram-based risk prediction model for readmission in patients with stable angina. The model demonstrated moderate predictive capability， with an area under the receiver operating characteristic curve （AUC） of 0.818 ［95% CI （0.781， 0.852）］ in the training set and 0.816 ［95% CI （0.779， 0.850）］ in the validation set. The Hosmer-Lemeshow test showed good calibration （χ² = 4.55， P = 0.80）， and the model's predictive ability was stable. When the threshold probability exceeded 5%， the clinical net benefit of using the model to predict readmission risk was significantly higher than intervening in all patients. ConclusionHistory of heart failure， teeth-marked tongue， weak pulse， wiry pulse， phlegm-stasis mutual syndrome， blood stasis constitution， and non-high-density lipoprotein cholesterol are influencing factors for readmission in patients with stable angina of CHD. A clinical prediction model was developed based on these factors， which showed good discrimination， calibration， and clinical utility， providing a scientific basis for predicting readmission events in patients with stable angina.

Objective To analyze the epidemiological and pathogenic characteristics and incidence trend of hand-foot-mouth disease (HFMD) in Jinshan District, Shanghai, and to provide data support for the prevention and control of HFMD． Methods Case information and etiological data of HFMD in Jinshan District from 2018 to 2023 were collected. Descriptive epidemiological methods were used to analyze the temporal, spatial and population distribution of HFMD cases and their etiological composition and changes. An autoregressive integrated moving average (ARIMA) model was established to predict the incidence trend of HFMD in 2024. Results From 2018 to 2023, a total of 5,979 cases of HFMD were reported in Jinshan District, with an average annual incidence rate of 123.00/100,000. There were no reports of severe cases or deaths. The incidence of HFMD showed unimodal distribution in 2018 and 2023, bimodal distribution in 2019, and there was no obvious peaks in 2020—2022. The town with the highest average annual incidence rate was Jinshanwei Town, and the town with the lowest average annual incidence rate was Fengjing Town. The male-to-female ratio of the cases was 1.42:1. Most of the cases were under 5 years old, and scattered children were the most common occupation. CVA6 was the predominant pathogen, but EV-A71 was not detected. The optimal fitting prediction model was SARIMAX (2, 0, 0) × (1, 0, 0, 12), and the model predicted a trend of decline after rising first in the incidence of HFMD in Jinshan District in 2024. Conclusion There are obvious temporal, spatial and population differences in HFMD incidence in Jinshan District, and the dominant pathogen of HFMD is CVA6. Prediction data can be used to further strengthen epidemic monitoring, timely detect new variants, and provide the basis for timely adjustment of prevention and control measures of HFMD.

BACKGROUND:Diabetes exacerbates intervertebral disc degeneration in a number of ways,and good glycemic control is beneficial in preventing intervertebral disc degeneration.OBJECTIVE:To review the relationship between diabetes and intervertebral disc degeneration to provide a reference for the clinical treatment of disc degeneration in patients with diabetes.METHODS:Literature searches were performed in CNKI and PubMed databases for articles published from 1980 to 2023.The Chinese and English search terms were"diabetes,intervertebral disc degeneration,cartilage endplate degeneration,apoptosis,advanced glycation end products,osmotic stress."Finally,73 articles were included for summary and analysis.RESULTS AND CONCLUSION:(1)The pathophysiological process of diabetes-induced intervertebral disc degeneration is different from that of physiological degeneration.The main mechanisms of diabetes-induced intervertebral disc degeneration include:intracellular hyperglycemia,impaired blood supply to the intervertebral discs due to microvascular pathology,cellular senescence,apoptosis,and autophagy,accumulation of advanced glycation end products,osmotic stress,and destruction of the extracellular matrix components due to other pathways.(2)Drugs such as curcumin,resveratrol,and lupeol have therapeutic effects on intervertebral disc degeneration,but their safety and effectiveness need to be further demonstrated in clinical treatment.

With the aging of the population, the number of patients with degenerative scoliosis continues to increase. Surgical treatment of degenerative scoliosis is challenging. Patients with degenerative scoliosis often present with multiple comorbidities, osteoporosis, and sarcopenia. Traditional open surgeries are associated with high risks and multiple complications, whereas minimally invasive surgeries have increasingly gained acceptance among patients and physicians. Lateral Lumbar Interbody Fusion (LLIF) offers advantages such as minimal trauma, less blood loss, rapid postoperative recovery, reduced risk of neural complications, and larger interbody cages with more grafting capacity. Mini-open lateral-anterior lumbar interbody fusion is a new standardized LLIF technique with smaller incisions, which does not require splitting the psoas muscle, thereby reducing the risk of muscle and nerve injuries, and involves vertical implantation of the fusion device. Posterior instrumentation via the Wiltse approach is characterized by shorter operational times, minimal radiation exposure, reduced muscular damage, increased graft fusion capabilities, and the ability to perform de-rotation maneuvers. Therefore, the Wiltse approach is particularly suitable for patients with degenerative scoliosis. Staged surgery significantly reduces the duration of each surgery and anesthesia, lowering surgical risks and enhancing postoperative recovery. Staged mini-open lateral-anterior lumbar interbody fusion and posterior instrumentation via the Wiltse approach maximizes the reduction of surgical trauma, significantly decreases surgical complications, and offers marked clinical outcomes, providing an alternative minimally invasive treatment for degenerative scoliosis.