[Objective]To elucidate the pathogenesis of acquired aplastic anemia(AA)by integrating the traditional Chinese medicine(TCM)theory of"congenital deficiency and acquired malnourishment"with contemporary medical advancements.[Methods]Based on the etiological and pathogenesis theory of"congenital deficiency and acquired malnourishment"in TCM,combined with the research results of genetics,immunology,epigenetics,metabolism and other studies of modern medicine,this paper systematically discusses the specific mechanisms of"congenital deficiency",such as genetic predisposition factors and germline mutations,and"acquired malnourishment",such as lifestyle,environmental factors,immune abnormalities,metabolic and epigenetic abnormalities,and analyzes their association with disease onset,progression and treatment response.[Results]Studies have revealed that the occurrence of acquired AA is the result of the combined effect of"congenital deficiency"and"acquired malnourishment".The generalized concept of"congenital deficiency"encompasses non-pathogenic germline genetic variations,such as specific human leukocyte antigen(HLA)haplotypes,heterozygous mutations in genes like Fanconi anemia nucleotide-core complex(FANC)that significantly influence disease susceptibility,response to immunosuppressive therapy(IST),and risk of malignant transformation."Acquired malnourishment"manifests as environmental factor,such as proximity to chemical plants,newly renovated residences,lifestyle including high-fat diet,chronic sleep deprivation,consumption of contaminated water and infectious risk factors.These factors trigger hematopoietic failure through mechanisms including somatic mutations,epigenetic dysregulation involving DNA methyltransferase 3A(DNMT3A),ten-eleven translocation 2(TET2),metabolic disturbances,immune imbalance and gut microbiota dysbiosis,acting alone or synergistically with genetic susceptibility(the"Two-Hit"theory).In treatment,it is necessary to take into account both congenital deficiency and acquired malnourishment:for the"congenital deficiency"caused by germ line mutations(caused by germ line mutations),it is recommended that transplant intervention should be considered for key germline mutations,and transplantation should be considered for key germline mutations.In response to"acquired malnourishment",TCM shows multi-target treatment by improving telomerase through"nourishing the kidney"and"strengthening the spleen"to regulate immune,metabolism and microbiota combined with lifestyle intervention.[Conclusion]A profound understanding of the multidimensional mechanisms underlying the generalized concepts of"congenital deficiency"and"acquired malnourishment"is crucial for precision diagnostics and therapeutics,including optimizing transplant indications and developing targeted TCM/western integrated interventions to improve prognosis.Future research necessitates the integration of disease differentiation and syndrome differentiation to advance personalized treatment strategies.

[Objective]To elucidate the pathogenesis of acquired aplastic anemia(AA)by integrating the traditional Chinese medicine(TCM)theory of"congenital deficiency and acquired malnourishment"with contemporary medical advancements.[Methods]Based on the etiological and pathogenesis theory of"congenital deficiency and acquired malnourishment"in TCM,combined with the research results of genetics,immunology,epigenetics,metabolism and other studies of modern medicine,this paper systematically discusses the specific mechanisms of"congenital deficiency",such as genetic predisposition factors and germline mutations,and"acquired malnourishment",such as lifestyle,environmental factors,immune abnormalities,metabolic and epigenetic abnormalities,and analyzes their association with disease onset,progression and treatment response.[Results]Studies have revealed that the occurrence of acquired AA is the result of the combined effect of"congenital deficiency"and"acquired malnourishment".The generalized concept of"congenital deficiency"encompasses non-pathogenic germline genetic variations,such as specific human leukocyte antigen(HLA)haplotypes,heterozygous mutations in genes like Fanconi anemia nucleotide-core complex(FANC)that significantly influence disease susceptibility,response to immunosuppressive therapy(IST),and risk of malignant transformation."Acquired malnourishment"manifests as environmental factor,such as proximity to chemical plants,newly renovated residences,lifestyle including high-fat diet,chronic sleep deprivation,consumption of contaminated water and infectious risk factors.These factors trigger hematopoietic failure through mechanisms including somatic mutations,epigenetic dysregulation involving DNA methyltransferase 3A(DNMT3A),ten-eleven translocation 2(TET2),metabolic disturbances,immune imbalance and gut microbiota dysbiosis,acting alone or synergistically with genetic susceptibility(the"Two-Hit"theory).In treatment,it is necessary to take into account both congenital deficiency and acquired malnourishment:for the"congenital deficiency"caused by germ line mutations(caused by germ line mutations),it is recommended that transplant intervention should be considered for key germline mutations,and transplantation should be considered for key germline mutations.In response to"acquired malnourishment",TCM shows multi-target treatment by improving telomerase through"nourishing the kidney"and"strengthening the spleen"to regulate immune,metabolism and microbiota combined with lifestyle intervention.[Conclusion]A profound understanding of the multidimensional mechanisms underlying the generalized concepts of"congenital deficiency"and"acquired malnourishment"is crucial for precision diagnostics and therapeutics,including optimizing transplant indications and developing targeted TCM/western integrated interventions to improve prognosis.Future research necessitates the integration of disease differentiation and syndrome differentiation to advance personalized treatment strategies.

BACKGROUND:Fibrin glue is a natural biodegradable scaffold, which can be used for tissue-engineered scaffolds, and is increasingly used as seed cel carrier for tissue engineering repair. OBJECTIVE:To investigate the biocompatibility in vitro of rabbit fascia fibroblasts and fibrin glue. METHODS:Tissue explants adherent method was used to culture fibroblasts from subcutaneous deep fascia tissue of New Zealand white rabbits. The fibroblasts could be passaged with trypsin digestion method. Suspension of passage four fibroblasts was co-cultured with fibrin glue. Morphology and proliferation of fibroblasts on the surface of fibrin glue were dynamical y observed under the inverted phase contrast microscope. At 5 days after co-culture, fibroblasts were identified by immunofluorescence staining under the laser scanning confocal microscope. The fibroblast growth and adhesion were observed under the scanning electron microscope. RESULTS AND CONCLUSION:There was no significant difference in fibroblast morphology between co-culture fibroblasts and pure culture fibroblasts with inverted phase contrast microscope. Scanning electron microscope demonstrated that fibroblasts ful y extended in fibrin glue surface, and showed a good adhesion between the“pseudopodium”and fibrin glue, and secreted matrix material. It is clear that the fibrin glue did not alter the morphologic features of fibroblasts. Laser scanning confocal microscope revealed that fibroblasts were positive for vimentin. These verified that properties of fibroblasts did not change after they were seeded in fibrin glue surface and did not be induced to differentiate. There is a very good biocompatibility between fascia fibroblasts and fibrin glue in vitro.

OBJECTIVETo investigate the pathological characteristics of draining pulmonary lymph nodes in coal workers' pneumoconiosis (CWP) and study their significance for the early diagnosis of CWP.

METHODSThe autopsy materials of 12 coal workers were subjected to HE staining and observed under a light microscope, and a retrospective analysis was performed considering the occupational history.

RESULTSThe age range of 12 cases was 46∼71 years (mean, 58 years), and the exposure time range was 3∼32 years (mean, 22.8 years). The draining pulmonary lymph nodes of 1 case with dust reaction mostly had coal dust deposition, mild pulmonary fibrosis, and local dust fibrosis in the medullary sinus; 1 case of stage I anthracosilicosis mainly showed extensive dust fibrosis and coal dust deposition; 8 cases of stage II anthracosilicosis mainly showed dust fibrosis and silicotic nodules; 1 case of stage III anthracosilicosis and 1 case of stage III silicosis mainly showed silicotic nodules' fusion with each other, and lymph nodes' adhesion and formation of massive fibrosis, and the formation of silicotic nodules was especially obvious in cases of stage III silicosis.

CONCLUSIONThe dust lesions of draining pulmonary lymph nodes become severer with higher severity of pulmonary lesions in cases of CWP. The cases of simple silicosis have earlier and severer lesions in draining pulmonary lymph nodes than in lung tissue.

Aged ; Anthracosis ; pathology ; Autopsy ; Coal Mining ; Humans ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo study the pathological features of progressive massive fibrosis (PMF) in the lung tissues of patients with coal workers' pneumoconiosis (CWP).

METHODSA retrospective analysis was made on the autopsies from 8 patients with CWP, which were observed under a microscope by HE staining, given their occupational history.

RESULTSThe age of 8 cases ranged 47-71 years (mean, 59.9 years), and their dust exposure time was 18-32 years (mean, 25.1 years). All the 8 cases were complicated by chronic bronchitis as well as emphysema, 7 cases by pulmonary heart disease, and 4 cases by pulmonary tuberculosis. In this group of patients, PMF was mainly distributed in the hilum and the upper lobe of the lung, including 7 cases of nodular fusion type and 1 case of PMF type. The collagen fibers around PMF extended radially and destroyed its surrounding tissue.

CONCLUSIONNodular fusion type is the main form of PMF in the lung tissues of CWP patients. It has a progressive and destructive process, which is the manifestation of advanced CWP.

Aged ; Anthracosis ; pathology ; Coal Mining ; Dust ; Humans ; Lung ; pathology ; Male ; Middle Aged ; Pneumoconiosis ; pathology ; Retrospective Studies

Objective To evaluate the characteristics and efficacy of microscope-assisted bilateral decompression via unilateral approach for the treatment of lumbar stenosis. Methods From June 2007 to June 2010, Sixty case lumbar stenosis with bilateral decompression were treated via unilateral approach under microscopy. Patients were followed up from 6 to 24 months, average (12 ± 4.7) months. Results The pain level of each patient was assessed both before and after the opeartion, using a visual analogue scale (VAS). Intermittent claudication was completely relieved in 57 out of 60 cases, moderately relieved in 3 cases. VAS score decreased from pre-operational 9.08 ± 0.76 to post-operational 2.33 ± 1.43, and there was significantly difference between them. There was no recurrent case during the whole follow-up. Conclusion Bilateral decompression via unilateral approach under microscope is proved to be an effective and safe procedure for the treatment of lumbar stenosis, and have the advantages of minimal invasion, less pain, quick recovery, better effect, little influence on the spinal stability.