Objective: Therapeutic plasma exchange (TPE) rapidly removes harmful substances from the blood by physical means, while replacing with exogenous fluids such as fresh frozen plasma and/or albumin, thus alleviating clinical symptoms and mitigating organ injury. It is widely used in the treatment of renal, hematological, digestive, and immune-mediated diseases. This review summarizes the application of plasma exchange in hematological diseases based on the latest research evidence, focusing on its current clinical status in autoimmune hemolytic anemia, thrombotic microangiopathy, hyperviscosity syndrome secondary to hypergammaglobulinemia, and cryoglobulinemia. Based on recent evidence, we analyze its efficacy, safety management, and optimized therapeutic strategies. We also discuss the limitations and future directions of TPE in hematological diseases, aiming to provide a reference for clinical practice and research.

Objective With the development of manned space missions to the moon and space exploration,extravehicular activities become more frequent and extravehicular mission become more complex,which puts forward higher requirements for the extravehicular spacesuit.In order to ensure the ergonomics of spacesuit,the flexible joints are usually adopted in the limbs of spacesuit.The structural design of large angle of movement and low resistance joints is the basic for ensuring the ergonomics of spacesuit.Methods This study established a method of spacesuit joint structure to analysis the motion characteristic of typical joints.Firstly,the structure and activity characteristics of the spacesuit and lunar space suits were comprehensively analyzed,and the activity characteristics of different typical structure are qualitatively analyzed based on existing empirical method.Then,the dynamics of typical structure was analyzed by finite element model.By studying the change trend of motion of spacesuit joint with motion angle,and the motion characteristic curve was obtained.Finally,the model was studied according to different structural size parameters.The influence of structural parameters on the motion characteristics was analyzed,and the curves was obtained to provide a basis for design of spacesuit motion joint structure.Results Through the above analysis,the motion characteristics of different typical structure are obtained qualitatively.And the influence of different structure parameters on the motion characteristics was analyzed.This establishes the method basis for structure design.Conclusion The study was carried out a method based on finite element model for joint motion analysis,which is suitable for the design of typical joint structure of spacesuit.

Objective To investigate the factors influencing global longitudinal strain(GLS)measured by cardiac magnetic resonance(CMR)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Clinical data of 315 hospitalized patients diagnosed with acute STEMI who underwent percutaneous coronary intervention(PCI)at the First Medical Center of Chinese PLA General Hospital from June 2016 to September 2021 were retrospectively collected.After analyzing CMR images of all patients,GLS and other strain parameters were obtained,and then the patients were divided into two groups according to the median GLS.In order to balance gender and age differences,1:1 propensity score matching was performed,and 206 patients were eventually included:GLS>-11.3%group(indicating severe GLS impairment,n=103)and GLS≤-11.3%group(n=103).Baseline characteristics,laboratory indicators,coronary angiographic parameters,electrocardiogram(ECG)features,and CMR parameters were compared between the two groups.Variables showing significant differences were analyzed for their correlation with GLS.Multivariate logistic regression and multiple stepwise linear regression analyses were performed to identify factors associated with GLS impairment.Results Compared with GLS≤-11.3%group,GLS>-11.3%group had significantly higher peak levels of creatine kinase-MB(CK-MB)and troponin T(TnT)(P<0.001).A higher proportion of patients in GLS>-11.3%group had the left anterior descending artery(LAD)as the culprit vessel,while a lower proportion had the right coronary artery(RCA)as the culprit vessel(P<0.001).Additionally,GLS>-11.3%group had longer QRS duration(P<0.001)and a higher incidence of pathological Q waves(P=0.001).Regarding CMR parameters,GLS>-11.3%group exhibited larger global circumferential strain(GCS),infarct size(IS),and left ventricular end-systolic volume(LVESV),as well as lower global radial strain(GRS)and left ventricular ejection fraction(LVEF)(P<0.001).Multivariate logistic regression indicated that peak TnT(OR=1.092,P=0.001),LAD culprit vessel(OR=3.744,P<0.001),and QRS duration(OR=1.026,P<0.001)were significantly associated with severely impaired GLS.Multiple stepwise linear regression analysis showed that the logarithmic value of peak TnT,LAD as the culprit vessel,and the square root of QRS duration were linearly correlated with GLS values(adjusted R2=0.301,P<0.001),and these independent variables explained 30.1%of the variation in GLS.Conclusion Elevated peak TnT,prolonged QRS duration,and LAD as the culprit vessel are significantly associated with severe GLS impairment in STEMI patients,indicating more severe myocardial infarction and worse left ventricular function.

Objective To investigate the associations of serum transforming growth factor-β1(TGF-β1)and klotho expression levels with the severity of epilepsy and cognitive function in patients with epilepsy.Methods A total of 188 patients with epilepsy were enrolled as epilepsy group,and 188 healthy volunteers(without epilepsy)who underwent physical examinations during the same peri-od were recruited as control group.Based on seizure types,188 patients with epilepsy were further di-vided into partial seizure group(n=84)and generalized seizure group(n=104).According to the Mini-Mental State Examination(MMSE)scores,the patients were also divided into cognition normal group(n=76)and cognition impairment group(n=112).Enzyme-linkedimmunosorbent assay(ELISA)was utilized to measure the serum levels of TGF-β1 and klotho.Spearman correlation analy-sis was conducted to explore the correlations of serum levels of TGF-β1 and klotho with the severity of epilepsy as well as cognitive function.Multivariate Logistic regression analysis was performed to iden-tify the factors influencing cognitive function in patients with epilepsy.Results The serum levels of TGF-β1 and klotho in the epilepsy group were significantly lower than those in the control group(P＜0.05).The serum levels of TGF-β1 and klotho in the generalized seizure group were significantly lower than those in the partial seizure group,and the National Hospital Seizure Severity Scale(NHS3)score was significantly higher than that in the partial seizure group(P＜0.05).There were negative correlations of serum levels of TGF-β1 and klotho with the severity of epilepsy(P＜0.05).The levels of TGF-β1 and klotho in the cognition impairment group were significantly lower than those in the cognition normal group(P＜0.05).Negative correlations were observed between serum levels of TGF-β1 as well as klotho and cognitive function(P＜0.05).TGF-β1 and klotho were identified as significant factors influencing cognitive function in patients with epilepsy(P＜0.05).Conclusion The serum levels of TGF-β1 and klotho are significantly decreased in patients with ep-ilepsy,and they are negatively correlated with the severity of epilepsy and closely associated with cognitive function.

Objective To investigate the effects of miR-34a on proliferation and osteogenic differentiation of human periodontal stem cells.Methods Twenty healthy teeth that needed to be extracted for orthodontic treatment were collected.Human periodontal stem cells(hPDLSCs)were isolated and cultured in vitro,and miR-34a mimetics were constructed and transfected into hPDLSCs.The experimental groups were subsequently categorized into the mimics group(miR-34a overexpression group)and the mimics-NC group(control group without load).The transfection efficiency was assessed using real-time fluorescence quantitative PCR(qRT-PCR),while CCK-8 assays were used to evaluate the proliferation capacity of hPDLSCs post-transfection.Osteogenic differentiation of miR-34a-transfected hPDLSCs was induced,with samples being collected at day 0 and day 14 after the osteogenic induction.The expression level of Runx2-associated transcription factor 2(Runx2)was quantified via qRT-PCR,protein levels of Runx2-associated proteins were analyzed through Western blot,and mineralized nodule formation was examined using alizarin red staining.Results The expression level of miR-34a in the mimics group was significantly higher than that in the mimics-NC group(P<0.05).There was no significant difference in the value-added rate between the mimics group and the mimics-NC group on days 1～5(P>0.05),and the value-added rate between the mimics group and the mimics-NC group was significantly lower than that between the mimics-NC group and the mimics-NC group on days 5～11,and the difference was statistically significant.After the osteogenic induction,the mRNA expression level of Runx2 in the mimics group was higher than that in the mimics-NC group(P<0.05),and the expression level of Runx2 protein in the mimics group was also higher than that in the mimics-NC group(P<0.05),and there were more mineralized nodules in the mimics group than in the mimics-NC group after 14 days of osteogenic induction.Conclusion Under in vitro conditions,miR-34a inhibits the proliferative activity of hPDLSCs and promotes the osteogenic differentiation of human periodontal ligament stem cells.

Objective:To Analysis of the current status of occupational hazard factors of 1, 2-dichloroethane (1, 2-DCE) in workplaces of enterprises in a certain district of Chongqing City, to provide a basis for its prevention and control.Methods:In January 2024, the monitoring data from the 2023 key occupational disease survey in the district were collected and organized. Qualitative analysis was conducted on the organic solvents used by enterprises in their production processes, and the detection results of 1, 2-DCE were statistically analyzed.Results:A total of 88 organic solvent samples were collected, with a qualitative detection rate of 21.6% (19/88) for 1, 2-DCE. A total of 30 enterprises using organic solvents were surveyed and tested, with an enterprise detection rate of 36.7% (11/30) for 1, 2-DCE. The workplace exceedance rate for 1, 2-DCE was 37.0% (34/92), and the post exceedance rate was 15.4% (4/26) .Conclusion:The degree of occupational exposure hazard related to 1, 2-DCE remains severe. It is necessary to strengthen the management of organic solvents used by enterprises and implement effective measures to prevent acute and chronic poisoning caused by 1, 2-DCE.

Objective:To explore the prognostic factors of seroma after endoscopic thyroidectomy by breast ap-proach,and construct a nomogram to predict the possibility of cervical seroma.Methods:Data of patients undergoing endoscopic thyroid surgery in Dongguan Tungwah Hospital from January 2022 to May 2024 and Dongguan Songshan Lake Tungwah Hospital from May 2023 to August 2024 were retrospectively analyzed,and 1493 patients meeting the in-clusion criteria were selected.Among them,there were 1048 patients in Dongguan Tungwah Hospital as the training co-hort,1015 patients without seroma group and 33 patients with seroma group.There were 445 patients in Dongguan Songshan Lake Tungwah Hospital as the verification cohort,including 424 patients without seroma and 21 patients with seroma.Multivariate logistic regression analysis was used to obtain relevant independent prognostic factors,and R soft-ware established a nomogram model.Calibration curves,Hosmer-Lemeshow goodness of fit,ROC curves were used to evaluate the calibrability of the nomogram model,and clinical utility was assessed by clinical decision curves.Results:Multivariate logistic regression analysis showed that central lymph node dissection,diabetes,hyperthyroidism,and nod-ule size were independent prognostic factors related to seroma.Based on the prognostic factors,the nomogram of se-roma after ETBA was constructed.The calibration curves of the training and the verification group were in good agree-ment with the observed results,and the Hosmer-Lemeshow goodness of fit test was good,with the training cohort P=0.244 and the verification cohort P=0.803.The ROC curve of the training cohort showed that the area under the curve was 0.810(95%CI:0.740～0.879),and the ROC curve of the verification cohort showed that the area under the curve was 0.815(95%CI:0.722～0.909).Conclusion:The nomogram model based on the relevant prognostic factors ob-tained by multivariate logistic regression analysis has a good prediction effect on the seroma after ETBA,and can provide reasonable and individualized treatment plan for patients.

BACKGROUND:In recent years,human pluripotent stem cell derived kidney organoids and rodent models of diabetic kidney disease have also made some progress.However,because the pathogenesis of diabetic kidney disease is affected by environmental factors and genetic factors,the pathogenesis is complex,and the clinical treatment for diabetic kidney disease patients needs to vary from person to person.Therefore,more flexible and integrated approaches need to be developed,leading to the discovery of strong preclinical evidence to support more targeted interventions in patients with diabetic kidney disease.OBJECTIVE:To reviewthe research progress of diabetic kidney disease model from the aspects of diabetic kidney disease animal model,two-dimensional cell culture simulation diabetic kidney disease model,and three-dimensional organoid diabetic kidney disease model,to provide clues and ideas for further research.METHODS:China National Knowledge Network and PubMed databases were searched with"diabetes,diabetic nephropathy,diabetic kidney diseases,diabetic nephropathy models,diabetic nephropathy animal models,organoids,diabetic and organoids,diabetic and kidney organoids,kidney organoids,diabetic nephropathy cell models,diabetic nephropathy syndrome combined animal models"as Chinese and English search terms.Totally 101 articles were finally included for review and analysis.RESULTS AND CONCLUSION:Both in vivo and in vitro models of diabetic kidney disease are powerful tools to further study the pathogenesis of diabetic kidney disease.The interactions between multiple systems can be observed in animal models.Two-dimensional cell culture is easy to operate and low cost.The emerging kidney organoids fill the gap between two-dimensional and global levels,without species differences,and simulate the complexity of human kidney to a certain extent.With the continuous development of organoid technology,kidney organoids are expected to provide a new perspective for exploring the pathogenesis,pathophysiology,and drug screening of diabetic kidney disease.

Objective To analyze the characteristics of colorectal adenoma onset,traditional Chinese medicine(TCM)syndromes,and factors influencing advanced colorectal adenoma.Methods A cross-sectional study was conducted to retrospectively analyze the data of 480 patients with colorectal adenoma admitted to the Department of Gastroenterology of Wangjing Hospital,China Academy of Chinese Medical Sciences,between January 2024 and January 2025 who met the inclusion and exclusion criteria.The hospital case system was used to collect demographic information,basic medical history,general conditions associated with colorectal adenoma,and records of TCM syndrome types,which were compiled into a clinical information Excel spreadsheet.Descriptive statistics were calculated to determine the distribution of demographic information,basic medical history,and TCM syndrome types.The chi-square test or Monte Carlo simulation method was used to analyze the differences in the number,size,pathological type and location of colorectal adenomas,as well as the distribution of TCM syndrome types.Univariate chi-square test was used to analyze the related factors of patients with advanced colorectal adenoma,and the statistically significant variables were included in the multivariate logistic regression analysis to analyze the influencing factors of advanced colorectal adenoma.Results Among the 480 patients with colorectal adenoma,296 were male with an onset age of(60.51±11.17)years,and 184 were female with age of(61.65±11.87)years.There were 233 patients(46.46％)aged 45 to 64.There were 269 cases(56.04％)of overweight individuals.Adenomas smaller than 1 cm accounted for 73.33％(352/480).Among the number of adenomas,single adenomas accounted for 66.46％(319/480).Among the pathological types,tubular adenoma accounted for 86.67％(416/480).The left colon accounted for 80.0％(384/480)of the affected sites.The main clinical manifestations included abdominal distension(20.63％,99/480),abdominal pain(16.25％,78/480),diarrhea(9.79％,47/480),among others.The main syndrome types in traditional Chinese medicine are damp-heat syndrome of the large intestine(25.83％,124/480)and spleen deficiency with excessive dampness syndrome(22.94％,110/480).There was a statistically significant difference in the distribution of TCM syndrome types among patients of different age groups(P=0.010).Multitype adenoma(OR=4.504,95％CI:2.819～7.198,P<0.001)and the right colon site(OR=2.166,95％CI:1.146～4.092,P<0.05)are independent risk factors for advanced colorectal adenoma.Conclusion Colorectal adenomas are more common in men and tend to occur in middle-aged people.Adenomas under 1 cm are the most common.Single adenomas and tubular adenomas are more common.The left half of the colon is a common site of occurrence.Common clinical symptoms include abdominal distension,abdominal pain,diarrhea,etc.Damp-heat syndrome of the large intestine is the most common type of syndrome in traditional Chinese medicine.The number of multiple adenomas and the location of the right colon are independent risk factors for advanced colorectal adenomas.

Purpose To investigate the prenatal ultrasound features and prognosis of fetal patent urachal.Materials and Methods The prenatal ultrasound characteristics of six cases with patent urachal diagnosed in Women and Children's Hospital of Chongqing Medical University from September 2018 to March 2023 were retrospectively analyzed,their pregnancy and postnatal conditions were followed up.Results In the first and second trimester of pregnancy,the prenatal ultrasonography of six fetuses showed that the epurachus was occluded.Among them,two cases were diagnosed as bladder diverticulum.The ultrasonography showed that the bladder was malformed,the top of the bladder was changed like a beak,and was connected to the umbilical cord entrance of the abdominal wall through an abnormal tube.Four cases were diagnosed as urachal fistula with allantoic cyst.Ultrasound showed that the cyst was at the root of the umbilical cord,and the cyst communicated with the bladder through an abnormal duct.The size of the cyst changed with the filling and emptying of the bladder.Color Doppler showed that the cysts were surrounded by the umbilical artery.None of the six fetuses were abnormal by chromosome examination.Among them,two fetuses with simple urachal fistula and allantoic cyst were born with good prognosis,and the remaining four fetuses were induced by other malformations.One of the six fetuses was female,and five fetuses were male.Conclusion Prenatal ultrasound of patent urachus has typical features and low correlation with chromosomal abnormalities.It is more common in males clinically and has a good prognosis without other structural abnormalities.