B and T lymphocyte attenuator (BTLA) is an inhibitory immune checkpoint, which typically interacts with herpesvirus entry mediator (HVEM) and plays a crucial role in regulating immune balance. BTLA interacts with its ligand HVEM in a cis manner on the surface of the same immune cell to maintain immune tolerance, while trans interactions on the surface of different immune cells mediate immunosuppressive effects. Dysregulation of the BTLA/HVEM axis can impair the functions of immune cells, particularly T lymphocytes, promoting immune escape of tumor cells and ultimately leading to tumor progression. Researchers have found that BTLA and HVEM are abnormally expressed in various tumors and are associated with prognosis, suggesting that they may be potential targets for tumor immunotherapy. This review summarizes the molecular structures of BTLA and HVEM, immunomodulatory mechanisms, recent advances in hematologic malignancies, potential inhibitors of BTLA/HVEM interaction, and their applications in immunotherapy for hematologic malignancies.
Humans ; Receptors, Tumor Necrosis Factor, Member 14/chemistry* ; Receptors, Immunologic/immunology* ; Hematologic Neoplasms/genetics* ; Immunotherapy/methods* ; Animals

On August 31， 2025， the Asian Pacific Association for the Study of the Liver （APASL） updated and released management of acute variceal bleeding： updated APASL guidelines （2025 edition）， which systematically elaborates on the definition， diagnosis， assessment， and treatment of acute variceal bleeding. This article gives an excerpt of the recommendations in this guideline.

ObjectiveTo understand the prevalence of tobacco use among residents aged 15 years old and above in Jiading District of Shanghai, and to provide a scientific basis for formulating effective regional tobacco control policies. MethodsThe Probability Proportional to Size (PPS) sampling method was employed to select one neighborhood committee (village) from each of Jiading District’s 11 subdistricts as survey monitoring sites. From the household registry of each selected neighborhood committee (village), 50 residential households were randomly sampled, resulting in a total of 550 households surveyed. Within each selected household, one permanent resident aged 15 years old or above was randomly chosen to complete the questionnaire. The content covered general information, exposure to secondhand smoke, awareness of tobacco related health hazards, etc. Statistical analyses were performed using SPSS 27.0 software. ResultsA total of 550 questionnaires were distributed, with 549 valid responses collected, and the effective response rate was 99.82%. The survey findings revealed that in 2023, the current smoking rate among individuals aged 15 years old and above in Jiading District of Shanghai was 18.76%, with males accounting for 38.93% and females accounting for 2.62%. Male gender was identified as a relative factor for smoking (OR=34.108, 95%CI: 14.440‒80.722), whereas higher education attainment emerged as a protective factor against smoking (OR=0.388, 95%CI: 0.184‒0.820). Among non-smokers aged 15 years old and above in Jiading District, the secondhand smoke exposure rate was 46.86%, with statistically significant differences observed across different age groups and occupations (P<0.001). Restaurants exhibited the highest secondhand smoke exposure rate of 42.14%, followed by households bearing (36.79%). The overall awareness rate among individuals aged 15 years old and above in Jiading District regarding four smoking-related diseases, namely stroke, heart disease, lung cancer, and impotence, was 48.45%, while the awareness rate for three secondhand smoke-induced diseases, namely adult heart disease, pediatric pulmonary disease, and adult lung cancer, was 64.29%. ConclusionThere is still room for reduction in the prevalence of tobacco use among individuals aged 15 yeas old and above in Jiading District. The exposure to secondhand smoke is severe, and residents have low awareness of the harm of tobacco. Tobacco control law enforcement should be strengthened, smoke-free-home health education should be included in tobacco control efforts, and targeted health education should be carried out.

Objective To investigate the status of self-management ability in elderly patients with type 2 diabetes mellitus(T2DM)in community,and to analyze the influencing factors using structural equation model.Methods A convenient sampling method was used to investigate patients aged 65 years and above with T2DM in Hongkou district of Shanghai.The patients were assessed using diabetes self-management questionnaire(DSMQ),Beck depression inventory(BDI),diabetes management self-efficacy scale(DMSES),and diabetes distress scale(DDS).Spearman correlation analysis was conducted to explore the relationship among the variables.A structural equation model was constructed to analyze the effect of depression,self-efficacy,and diabetes distress on self-management levels among the patients.Results A total of 588 elderly patients with T2DM were included in this survey,the DSMQ score was 32.00(28.00,38.00),the DMSES score was 158.50(135.25,172.00),the BDI score was 0.00(0.00,2.00),and the DDS score was 23.00(18.00,31.00).The final model demonstrated good fit to the sample data,self-efficacy had a positive impact on self-management levels(β=0.558,P＜0.001),and depression had a positive impact on diabetes distress(β=0.599,P＜0.001).Conversely,depression had a negative impact on self-efficacy(β=-0.314,P＜0.001),and diabetes distress also had a negative impact on self-efficacy(β=-0.267,P＜0.001).Self-efficacy had the greatest impact on self-management level(the total effect was 0.558),and it was a direct impact.Depression(the total effect was-0.264)and diabetes distress(the total effect was-0.149)had indirect effects.Self-efficacy played a mediating role between depression and self-management,with an indirect effect of-0.175,accounting for 66.3%of the total effect.Self-efficacy and diabetes distress played a chain mediating role between depression and self-management,with an indirect effect of-0.089,accounting for 33.7%of the total effect.Conclusion Self-efficacy has the greatest effect on the self-management level of elderly patients with diabetes mellitus.Depression and diabetes distress indirectly affect self-management levels through the mediating role of self-efficacy.Community and clinical healthcare workers should focus on enhancing the self-efficacy of patients with diabetes mellitus and implementing targeted interventions for their symptoms of depression and diabetes distress,so as to improve their self-management capabilities.

Objective To investigate the efficacy of Xingpi Huazhuo Prescription in treating pre-diabetic patients with phlegm-damp constitution and its impacts on blood glucose levels and renal func-tion indicators.Methods A total of 104 pre-diabetic patients with phlegm-damp constitution admitted to the hospital between January 2021 and December 2023 were selected and randomly divided into west-ern medicine group(n=52)and combined group(n=52)using a random number table method.The western medicine group received metformin treatment,while the combined group received metformin combined with Xingpi Huazhuo Prescription.Clinical efficacy was recorded after 3 months of treatment,and blood glucose indexes such as[fasting blood glucose(FPG),glycated hemoglobin(HbA1c),and 2-h plasma glucose(2 hPG)]levels,lipid indicators[triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)],and renal function indicators[serum creatinine(Scr),urea nitrogen(BUN),β2-microglobulin(β2-MG)]were compared before and after 3 months of treatment.Results After 3 months of treatment,the total clinical effectiveness in the combined group was higher than that in the western medicine group(P＜0.05).After 3 months of treatment,the levels of FPG,HbA1c,and 2 hPG decreased in both groups,and the combined group showed lower levels than the western medicine group(P＜0.05).After 3 months of treatment,the levels of TG,TC,and LDL-C decreased in both groups compared with before treatment,and the combined group showed lower levels than the western medicine group(P＜0.05);the levels of HDL-C increased in both groups,and the combined group showed higher levels than the western medicine group(P＜0.05).After 3 months of treatment,the levels of Scr,BUN,and β2-MG decreased in both groups,with the combined group showing lower levels than the western medicine group(P＜0.05).Conclusion In pre-diabetic patients with phlegm-damp con-stitution,metformin combined with Xingpi Huazhuo Prescription can effectively improve blood glu-cose levels and exert renal protective effects.

Objective: To construct and validate a prognostic model for lung cancer based on acrolein-related genes using bioinformatics methods . Methods: Lung cancer datasets GSE30219 and GSE68465 were obtained from the GEO database , and acrolein-related gene sets were retrieved from the CTD database . Differentially expressed genes (DEGs) between cancer and adjacent tissues were identified in the GSE30219 dataset. The intersection of these DEGs and acrolein-related genes was then used to identify candidate genes . Gene set variation analysis ( GSVA) was performed to assess functional alterations based on the intersection genes . A protein-protein interaction (PPI) network was constructed based on the STRING database to identify core hub genes . Subsequently , support vector machine recursive feature elimination (SVM-RFE) and LASSO-Cox regression analyses were employed to develop a prognostic model based on acrolein-related genes , which was independently validated using the GSE68465 dataset. The CIBERSORT algorithm was applied to evaluate the immune cell infiltration characteristics between high- and low-risk groups , and functional enrichment analysis of DEGs between the two groups was conducted to further ex- plore the potential molecular mechanisms underlying the prognostic model . Results : A total of 361 acrolein-related DEGs were identified in lung cancer , and 7 key genes were selected for model construction . Kaplan-Meier survival analysis revealed that patients in the high-risk group had significantly lower survival rates compared to those in the low-risk group (P < 0. 000 1) . Receiver operating characteristic (ROC) curve analysis demonstrated that the mod- el possessed good predictive performance . Moreover , immune infiltration analysis indicated that the risk score was closely associated with multiple immune cell subsets , suggesting a potential role of acrolein-related genes in modula- ting the lung cancer immune microenvironment. Conclusion The prognostic model for lung cancer based on acro- lein-related genes demonstrates significant application value in predicting the prognosis of lung cancer , providing new insights into the potential mechanisms of acrolein in the onset and progression of lung cancer.

OBJECTIVE To identify the chemical constituents of the modified Yupingfengsan formula. METHODS UPLC-Q- Exactive Orbitrap-MS technology was adopted. The separation was performed on Waters BEH C18 column with acetonitrile （A）-0.1% formic acid solution （B） as mobile phase for gradient elution. The heating electrospray ionization was used for positive and negative ion mode scanning. The scanning range was m/z 50-1 500， and the spray voltage was 2 kV （positive ion mode） and 1.5 kV （negative ion mode）. The information of chemical constituents of modified Yupingfengsan formula was collected through literature review to establish a database； the structure of the constituent was identified based on the above database， relevant literature， and chromatography and mass spectrometry information of reference standards. RESULTS & CONCLUSIONS Totally 114 chemical constituents were identified from modified Yupingfengsan formula， including 31 flavonoids， 39 phenylpropanoids， 5 saponins， 8 terpenoids， 3 chromones， 3 curcuminoids， etc. Based on the comparison of reference standards， 8 constituents were ultimately determined， including magnoflorine， calycosin， calycosin glycoside， cimifugin， 5-O-methylvisammioside， sec-O- glucosylhamaudol， luteolin and mangiferin. These constituents mainly involved glycosylation cleavage， retro Diels-Alder fragmentation， glycosylation loss， neutral molecule loss and other fragmentation pathways.

Objective:Laboratory evaluation of the relationship between cerebrospinal fluid and plasma indicators and intrathecal immunoglobulin G(IgG) synthesis in patients with neurological diseases, and establishment of a new diagnostic method for intrathecal IgG synthesis.Methods:This study retrospectively analyzed the content of IgG in cerebrospinal fluid samples and blood albumin in blood samples, and other test results of 410 patients with neurological diseases who visited Beijing Tiantan Hospital from 2019 to 2022. According to the results of oligoclonal bands in cerebrospinal fluid, patients were divided into intrathecal IgG synthesis group and non-intrathecal IgG synthesis group. The Mann Whitney U test was used for inter group comparison, and a bilateral test with P<0.05 indicates a statistically significant difference. Include indicators with differences between groups in logistic regression analysis, construct a predictive model, and compare it with the established quantitative formula IgG index. Results:There were significant differences in 10 indicators, including cerebrospinal fluid leukocyte count and 24-hour intrathecal IgG synthesis rate, between the intrathecal IgG synthesis group and the non-intrathecal IgG synthesis group, with P<0.05. The area under the curve (AUC) of intrathecal IgG synthesis was higher than the IgG index (AUC=0.920, 0.809, Z=31.178, P<0.001), the sensitivity was higher than the IgG index (0.825, 0.618), and the specificity was lower than the IgG index (0.876, 0.908). Conclusion:The combination of 10 indicators such as cerebrospinal fluid white blood cell count and 24-hour intrathecal IgG synthesis rate can improve the diagnostic efficacy and sensitivity of intrathecal IgG synthesis.

Objective To investigate the effect of dioscin on uric acid(UA)-induced oxidative stress injury of human renal tubular epithelial cells(HK-2)and its molecular mechanism.Methods HK-2 cells were cultured and divided into four groups:blank group(normal group),model group(uric acid-stimulation modeling),condition control group(UA+DMSO)and dioscin group(UA+dioscin).Oxidative stress injury model was induced by UA in HK-2 cells.Cells viability was detected by CCK-8.ROS level was detected by flow cytometry.Real-time PCR was used to detect the expressions of glycogen synthase kinase 3β(GSK3β),nuclear factor erythroid 2-related factor 2(Nrf2)and heme oxygenase 1(HO-1)at mRNA level,and Western Blot was used to detect the expressions of phosphorylated glycogen synthesis kinase 3β(p-GSK3β),GSK3β,Nrf2 and HO-1 at protein level.Results After stimulation by UA,HK-2 cells viability was obviously decreased,and ROS level was significantly increased(all P＜0.001).When treated with dioscin,HK-2 cells viability was obviously increased,and the ROS level of HK-2 cells was significantly decreased(all P＜0.001).The expressions of Nrf2 and HO-1 decreased at the protein and mRNA levels after stimulation with UA.But the expressions of Nrf2 and HO-1 significantly increased after treated with dioscin(all P＜0.001).Compared with the blank group,the p-GSK3β/GSK3β ratio in the model group decreased significantly at the protein level,but the p-GSK3β/GSK3β ratio increased after treated with dioscin(all P＜0.001).Conclusion Dioscin can alleviate UA-induced oxidative stress injury in HK-2 cells.The mechanism might be that dioscin can promote phosphorylation of GSK3β,and activate Nrf2/HO-1 pathway.