Objective:To investigate the impact of plasma exchange (PE) on T lymphocytes and natural killer (NK) cells in patients after kidney transplantation.Methods:The study retrospectively collected clinical data from patients who underwent their first ABO-compatible kidney transplantation at the Kidney Transplantation Center of the First Affiliated Hospital of Zhengzhou University between January 1, 2021, and November 30, 2023. Based on whether the patients received PE after transplantation, they were divided into a PE group and a non-PE group. A total of 38 patients were included in the retrospective cohort study, 18 in the PE group (8 males and 10 females) and 20 in the non-PE group (11 males and 9 females), with median ages of 37.5 (19.0, 56.0) years and 40.7 (22.0, 60.0) years, respectively. The immune cell subpopulations of the two groups were analyzed and compared at three time points: before PE, after PE, and 7 to10 days post-PE (for the non-PE group, data were collected at equivalent time points). The primary focus was on the proportions and absolute counts of T cells, NK cells, and activated T cells (CD4CD25+T cells, CD8CD25+T cells, and CD8HLA-DR+T cells). A generalized estimating equation (GEE) was used for longitudinal analysis of these repeated measurements to evaluate the effects of PE on changes in these cell populations.Results:From 7 to 10 days after PE, the absolute count of CD4 T cells in the non-PE group increased from 42 (24, 152) cells/μl to 461 (309, 608) cells/μl, while in the PE group, it increased from 57 (11, 262) cells/μl to 212 (141, 576) cells/μl. According to the generalized estimating model, the difference in changes between the two groups was statistically significant ( Z=-2.9, P=0.004). For NK cell absolute counts, the non-PE group increased from 20 (16, 36) cells/μl to 43 (26, 81) cells/μl, while the PE group increased from 22 (12, 63) cells/μl to 90 (28, 142) cells/μl. The difference in changes between the two groups was also statistically significant ( Z=1.87, P=0.049). Regarding T cell activation, the proportion of CD8HLA-DR+T cells in the non-PE group decreased from 25.8% (18.4%, 45.0%) to 22.7% (15.2%, 31.6%), while in the PE group, it increased from 19.2% (8.1%, 33.2%) to 22.7% (15.2%, 31.6%). The difference in changes between the two groups was statistically significant ( Z=2.88, P=0.005). From 7 to 10 days after PE, there were significant differences in the changes of CD4CD25+T cells ( Z=2.70, P=0.009), CD8CD25+T cells ( Z=2.75, P=0.007), and CD8HLA-DR+T cells ( Z=4.04, P=0.001) between the PE group and the non-PE group. Conclusion:Plasma exchange after kidney transplantation can suppress the proliferation of CD4 T lymphocytes, increase the number of NK cells relatively, and maintain a high proportion of activated T lymphocytes.

Objective:To investigate the effect of plasma exchange (PE) in improving renal function among patients with delayed graft function (DGF)following kidney transplantation.Methods:This was a retrospective cohort study. Data were collected from 76 patients who underwent their first-time ABO-compatible kidney transplantation at the Kidney Transplantation Center of the First Affiliated Hospital of Zhengzhou University between January 1, 2022, and November 30, 2023, and subsequently developed DGF and received PE treatment. The cohort included 39 males and 37 females, with a median age of 37.5 years (30.8-46.0 years). Patients were categorized into three groups based on pre-PEhuman leukocyte antigen (HLA) antibody status: HLA antibody-negative group, HLA antibody-unknown group, and HLA antibody-positive group. Additionally, immunological status prior to PE categorized patients into four groups: (1) stable lymphocyte subsetand antibody profiles (21 cases); (2) elevated B cell proportions or antibody production, or increased antibody titers (26 cases); (3) increased proportions of T/NK/macrophages (13 cases); (4) increased proportions of T/NK/macrophages combined with antibody production or increased antibody titers (16 cases). The Wilcoxon rank-sum test was used to analyze changes in serum creatinine (Scr) levels and 24-hour urine output before and after PE in the different patient groups.Results:In the HLA antibody-negative group, Scr decreased significantly from 467 (260, 571) μmol/L before PE to 176 (123, 307) μmol/L after PE ( Z=-2.22, P<0.01), and 24-hour urine output increased significantly from 1 295 (480, 2 020) ml to 1 960 (1 632, 2 870) ml ( Z=1.76, P<0.01). In the HLA antibody-positive group, Scr decreased significantly from 420 (254, 660) μmol/L before PE to 177 (151, 287) μmol/L after PE ( Z=-3.26, P<0.01), and 24-hour urine output increased significantly from 1 355 (928, 1 925) ml to 2 440 (1 760, 2 797) ml ( Z=2.47, P<0.01). For patients grouped by immunological status, Scr levels in Group 2 decreased significantly from 407 (242, 699) μmol/L to 201 (157, 274) μmol/L ( Z=-2.92, P<0.001), while in Group 3, Scr decreased significantly from 330 (258, 594) μmol/L to 164 (152, 280) μmol/L ( Z=-1.97, P=0.017). Regarding 24-hour urine output, Group 2 showed a significant increase from 1 353 (850, 1 770) ml to 1 995 (1 740, 2 630) ml ( Z=3.43, P=0.003), while in Group 3, urine output increased from 1 850 (1 350, 2 480) ml to 2 200 (1 900, 2 850) ml, but the difference was not statistically significant ( Z=1.10, P>0.05). Conclusion:PE effectively reduces Scr levels and increase 24-hour urine output in patients with DGF after kidney transplantation, regardless of pre-treatment HLA antibody status. Additionally, for patients with post-transplant changes primarily in T/NK/macrophages without significant antibody changes, PE can also effectively reduce Scr levels.

Objective:To explore the risk factors for malnutrition after a traumatic brain injury and to construct a model which usefully predicts that risk.Methods:This was a retrospective study of 374 patients with a craniocerebral injury for whom the relevant clinical data were available. Based on their nutritional status, they were stratified into a malnutrition group ( n=220) and a control group ( n=154). Univariate and multivariate logistic regressions were evaluated seeking to identify the independent risk factors associated with malnutrition, and a prediction model was constructed based on the results. The model′s discrimination ability and accuracy were assessed using a receiver operating characteristics (ROC) curve. Results:A total of 220 patients (58.8%) developed malnutrition. Multifactorial logistic regression analysis showed that the independent risk factors for malnutrition were: age ≥60 years, pulmonary infection, dysphagia, cognitive impairment, a GCS score ≤8, or a Barthel index ≤40. In the ROC curve analysis, the area under the curve quantifying the model′s ability to predict malnutrition was 0.924 (95% CI: 0.896, 0.951), with a sensitivity of 0.868 and a specificity of 0.857, indicating its good prediction performance. Conclusions:Age ≥60 years, pulmonary infection, dysphagia, cognitive impairment, a GCS score ≤8 or a Barthel index ≤40 are independent predictors of malnutrition after a traumatic brain injury. The prediction model constructed based on those risk factors has demonstrated useful predictive power for malnutrition.

Objective:To explore the molecular mechanism of a case with RhD-phenotype.Methods:A proband with RhD-phenotype who attended the clinic of the First Affiliated Hospital of Zhengzhou University on January 29, 2024 was selected as the study subject. Peripheral blood samples were collected from the proband (8 mL) and her close relatives (father, mother and brother; 3 mL each) for Rh phenotyping and irregular antibodies testing with gel card and test tube methods. Direct agglutination reaction and absorption-elution test were used to detect the c antigen on the red blood cells of the proband. PCR-sequence specific primers (PCR-SSP) typing and gene sequencing were used to determine the RHCE gene of the proband and her relatives. The origin of the proband′s variant was traced by pedigree analysis. Three-dimensional structural models of the wild-type RhCE*cE protein and the RhD-phenotype protein were constructed to predict the alterations of the RhD-phenotype protein caused by the variant. The procedures of this study were approved by the Medical Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Ethics No.: 2023-KY-0870-003). Results:The red blood cells of the proband did not agglutinate with anti-C, anti-c, anti-E, and anti-e. The result of the serum irregular antibody test was negative. The results of direct agglutination reaction and absorption-elution test of the proband were both negative. Her Rh blood group was identified as RhD-. The results of the Rh blood grouping of her close relatives were normal. PCR-SSP detection showed that the RHCE genotypes of the proband and her close relatives were cE/cE and Ce/cE, respectively. Gene sequencing analysis showed that the RHCE genotypes of the proband and her close relatives were RHCE* cE (c.365C>A)/ RHCE* cE (c.365C>A) and RHCE* Ce/ RHCE* cE (c.365C>A), respectively. Pedigree analysis revealed that the variants in the proband were inherited from her father and mother, respectively. Homology modeling of RhCE*cE protein showed that the RhD-type peptide chain with a significantly shortened C-terminal was encoded by only 121 amino acid resides, which was 296 amino acid resides shorter compared to the wild-type RhCE*cE peptide chain encoded by 417 amino acid residues. Conclusion:Above results revealed the molecular biological mechanism of a RhD-phenotype. The c. 365C>A variant in the RHCE gene has rendered the RHCE* cE alleles invalid, which ultimately led to the RhD-phenotype.

Viruses,as important biological agents influencing human health and social development,have played a key role in the spread of epidemics and the evolution of diseases since ancient times.Upon infecting hosts,viruses often trigger a series of com-plex responses,including innate and adaptive immunity,inflammatory responses and pathological damage.Despite advances in mod-ern antiviral drugs development,chemical drugs typically rely on a single molecular target within the viral life cycle,making them highly susceptible to the emergence of drug resistance and the induction of systemic toxic side effects.In contrast,traditional Chi-nese medicines(TCMs),posing the distinctive advantage of multi-component,multi-target,and multi-pathway,have exerted a pivotal role in viral prevention and viral treatment.In recent years,fresh herbs have gained increasing attention for their ability to preserve intact bioactive components.Fresh herb-derived nanovesicles possess excellent biocompatibility,targeting and cross-species regula-tory capabilities.These fresh herb-derived nanovesicles can effectively encapsulate and deliver a variety of antiviral components,demonstrating significant potential in antiviral immunomodulation,inflammation control and viral-induced pathologies.This review systematically sorts out the mechanisms of viral infection,and summarizes the advantages of fresh herbs,and the application pros-pects of fresh herb-derived nanovesicles in antiviral therapy.Furthermore,it focuses on summarizing the research progress of fresh herb-derived nanovesicles in the field of antiviral therapy,with the aim of providing insights and references for the development of fresh herb-derived nanovesicles-based antiviral strategies,as well as offering novel approaches and perspectives for the clinical treat-ment of viral diseases.

The development of bio-psycho-social medical models has focused attention on the impact of chronic psychological stress on diseases.Chronic psychological stress falls within the category of emotional etiology in traditional Chinese medicine.This paper systematically reviews research progress into the chronic psychological stress-related combination of disease and syndrome,and analyzes the advantages and limitations of different models.We also provide insights into the direction and improvements of future research into chronic psychological stress-related disease pattern models.

Lipidomics is an emerging discipline that systematically studies the various types, functions, and metabolic pathways of lipids within living organisms. This field compares changes in diseases or drug impact, identifying biomarkers and molecular mechanisms present in lipid metabolic networks across different physiological or pathological states. Through employing analytical chemistry within the realm of lipidomics, researchers analyze traditional Chinese medicine (TCM). This analysis aids in uncovering potential mechanisms for treating diverse physiopathological conditions, assessing drug efficacy, understanding mechanisms of action and toxicity, and generating innovative ideas for disease prevention and treatment. This manuscript assesses recent literature, summarizing existing lipidomics technologies and their applications in TCM research. It delineates the efficacy, mechanisms, and toxicity research related to lipidomics in Chinese medicine. Additionally, it explores the utilization of lipidomics in quality control research for Chinese medicine, aiming to expand the application of lipidomics within this field. Ultimately, this initiative seeks to foster the integration of traditional medicine theory with modern science and technology, promoting an organic fusion between the two domains.

Objective: To delineate the epidemiologic profile of rifampicin resistant pulmonary tuberculosis (RR-PTB) among students in Chongqing, so as to provide evidence for effectively controlling RR-PTB outbreaks in schools. Methods: Individual level surveillance records of 395 student RR-PTB cases reported from 2015 to 2024 were extracted from the China Information System for Disease Control and Prevention. The Joinpoint regression analysis was employed to quantify temporal trends in the registration rate of student RR-PTB cases, and the comparison of RR-PTB registration rates with different demographic characteristics and different regions was performed using Chi-square test. Results: From 2015 to 2024, a total of 395 student RR-PTB cases were identified, with the registration rate ranged from 0.07 per 100 000 to 1.47 per 100 000, showed a fluctuating upward trend ( AAPC= 35.22%, t =4.13, P <0.01). A turning point was detected in 2017, rates rose during 2015-2017 (APC=295.23%， t =4.62， P < 0.01 ) and plateaued thereafter (APC=-0.47%， t =-0.12， P =0.91). The proportion of RR-PTB cases occurring among students increased both among all RR-PTB cases (1.54% in 2015, 7.48% in 2024) and all student pulmonary tuberculosis cases (0.20% in 2015, 7.17% in 2024), with significant linear trends ( χ 2 trend =33.55,159.98, both P <0.01). The majority of cases were enrolled in senior high school (50.38%), classified as retreatment (53.92%), of Han ethnicity (75.95%), and diagnosed with multidrug resistant tuberculosis(53.16%). There were significant differences in the composition of different ethnicity, registration category and resistance pattern between different years( χ 2=23.47, 17.23, 59.64，all P <0.05). The South-Eastern Wuling Mountainous Region exhibited the highest notification rate (3.96 per 100 000), whereas the western region had the lowest rate ( 0.47 per 100 000). County level jurisdictions reported higher rates than district level ones (2.16 per 100 000 vs 0.63 per 100 000 ). Statistically significant differences were observed in the RR-PTB reported rates among students across different districts and counties( χ 2=418.05,167.05,both P <0.01). Conclusions From 2015 to 2024, the registration rate of detected student RR-PTB cases in Chongqing showed an increasing trend. Students have become one of the key populations for drug resistant TB prevention and control. Intensified health education and active case finding should be implemented to enhance proactive surveillance capabilities.

Objective:To investigate the correlation between cerebral blood flow (CBF) in different brain regions and gait disorder (GD) in patients with cerebral small vessel disease (CSVD).Methods:Patients with CSVD visited the Department of Neurology, the Second Affiliated Hospital of Xuzhou Medical University from November 2023 to October 2024 were included prospectively. They were divided into GD group (<0.8 m/s) and non-GD group (≥0.8 m/s) based on their step speed. CBF was measured using 3D pseudo-continuous arterial spin labeling (3D-pCASL) perfusion imaging. Gait parameters were quantitatively evaluated using a wearable gait analyzer. Multivariate logistic regression analysis was used to determine independent factors associated with GD in patients with CSVD. Partial correlation analysis was used to determine the correlation between gait parameters and CBF in different brain regions. Results:A total of 52 patients with CSVD were enrolled, including 26 males and 26 females, aged 67.00±6.84 years. Thirty-eight cases (73.1%) had mild overall burden of CSVD, and 14 cases (26.9%) had a moderate to severe overall burden of CSVD. There were 17 patients (32.7%) in the GD group and 35 (67.3%) in the non-GD group. Compared with the non-GD group, the body mass index was significantly higher, the CBF of the left occipital lobe and bilateral cerebellum decreased significantly, the step speed, step length, stride length, step frequency, swing phase, peak arm angular velocity, arm swing amplitude, maximum calf anterior/posterior swing angle, peak calf angular velocity, foot swing speed, and peak sagittal plane angular velocity in the torso decreased significantly, while the number of steps, stance phase, step length asymmetry, stride length, and step length variability increased significantly in the GD group (all P<0.05). Multivariate logistic regression analysis showed that left cerebellar CBF was an independent protective factor for GD in patients with CSVD (odds ratio 0.902, 95% confidence interval 0.827-0.982; P=0.019). For every 1 ml/(100 g.min) decreased in left cerebellar CBF, the patients with CSVD had an increased risk of developing GD by approximately 9.8%. Partial correlation analysis showed that left occipital lobe CBF was significantly positively correlated with step speed ( r=0.305, P=0.032), maximum calf back swing angle ( r=0.314, P=0.026), and peak calf angular velocity ( r=0.356, P=0.011). The left cerebellar CBF was significantly positively correlated with step speed ( r=0.295, P=0.037) and significantly negatively correlated with step length variability ( r=-0.335, P=0.017); the right cerebellar CBF was significantly positively correlated with step speed ( r=0.309, P=0.029) and significantly negatively correlated with step length variability ( r=-0.344, P=0.014). Conclusion:GD in patients with CSVD is associated with decreased CBF in the left occipital lobe and bilateral cerebellum, and decreased CBF in the left cerebellum significantly increased the risk of GD in patients with CSVD.

Lipidomics is an emerging discipline that systematically studies the various types,functions,and metabolic pathways of lipids within living organisms.This field compares changes in diseases or drug impact,identifying biomarkers and molecular mechanisms present in lipid metabolic networks across different physiological or pathological states.Through employing analytical chemistry within the realm of lipidomics,researchers analyze traditional Chinese medicine(TCM).This analysis aids in uncovering potential mechanisms for treating diverse physiopathological conditions,assessing drug efficacy,un-derstanding mechanisms of action and toxicity,and generating innovative ideas for disease prevention and treatment.This manuscript assesses recent literature,summarizing existing lipidomics technologies and their applications in TCM research.It delineates the efficacy,mechanisms,and toxicity research related to lipidomics in Chinese medicine.Additionally,it explores the utilization of lipidomics in quality control research for Chinese medicine,aiming to expand the application of lipidomics within this field.Ultimately,this initiative seeks to foster the integration of traditional medicine theory with modern science and technology,promoting an organic fusion between the two domains.