BACKGROUND:Autologous bone,allogeneic bone or artificial bone has been used to promote bone defect repair in the clinic,but the rate of non-healing is still high.The key is to ignore the importance of periosteum in the bone healing process.In the early stage of the project,the project team constructed an electrospinning membrane loaded with vascular endothelial growth factor to highly simulate the intramembranous osteogenesis of natural periosteum at the bone defect site,which promoted bone regeneration to a certain extent.However,the injured area often faces the dilemma of severe inflammatory response mediated by macrophages and lack of seed cells,resulting in the risk of inactivation or diffusion of delivered biological factors.Therefore,it is necessary to further optimize and coordinate the immune regulation and angiogenesis functions of biomimetic periosteum to promote bone repair.OBJECTIVE:To investigate the physicochemical properties of stem cell-engineered bionic periosteum and its role in regulating the inflammatory microenvironment to promote bone repair.METHODS:By combining L-polylactic acid-based microsol electrospinning,type Ⅰ collagen self-assembly and gel stem cell transplantation technology,a bionic periosteum(M@C-B)was constructed,in which the core layer loaded with vascular endothelial growth factor and the shell layer delivered bone marrow mesenchymal stem cells to regulate the immune microenvironment of bone defects.The physicochemical properties of the periosteum were characterized by scanning electron microscopy,transmission electron microscopy,and Fourier transform infrared spectroscopy.A co-culture system was established between the bionic periosteum and macrophages,bone marrow mesenchymal stem cells and human umbilical vein endothelial cells to explore immune regulation and in vitro osteogenic and angiogenic abilities.Finally,the osteogenic properties of the stem cell engineered bionic periosteum were further verified in a rat femoral condyle defect model.RESULTS AND CONCLUSION:(1)Transmission electron microscopy results showed that the micro-sol electrospinning(MS)formed a distinct core-shell structure.Scanning electron microscopy indicated that after the assembly of the collagen-l artificial periosteum(M@C)on the surface of the vascular endothelial growth factor-loaded micro-sol,a distinct"spider web-like"fibrous structure was deposited.Infrared spectroscopy further confirmed the successful self-assembly of collagen-l.Release experiments demonstrated that the M@C group mitigated the burst release phenomenon compared to the MS group,maintaining internal vascular endothelial growth factor activity and sustained release.(2)Live/dead cell staining and CCK-8 assay showed that bone marrow mesenchymal stem cells proliferated well and survived on three types of artificial periosteum:MS,purely aligned poly(L-lactic acid)(PLLA)surface self-assembled collagen-l artificial periosteum(PLLA@C),and vascular endothelial growth factor-loaded micro-sol fiber surface self-assembled collagen-l-bone marrow mesenchymal stem cells artificial periosteum(M@C-B).Among them,the M@C-B group had the highest number of live cells and the fastest proliferation rate.(3)Alkaline phosphatase staining,alizarin red staining,and osteopontin immunofluorescence staining showed that the PLLA@C and M@C-B groups significantly promoted osteogenic differentiation of bone marrow mesenchymal stem cells.Angiogenesis experiments demonstrated that the vascular endothelial growth factor-loaded groups(MS and M@C-B)had longer blood vessel lengths and more reticular vascular-like structures with more cross-linked nodes,with the M@C-B group being the most prominent.(4)Immunofluorescence and flow cytometry showed that artificial periosteum in the M@C-B group significantly inhibited the pro-inflammatory macrophage phenotype and promoted the polarization of macrophages towards the anti-inflammatory M2 phenotype.(5)In vivo studies further confirmed that the M@C-B group showed superior bone mineral density,trabecular thickness,relative bone volume,and trabecular spacing compared to other groups.(6)These results indicate that bone marrow mesenchymal stem cell-engineered artificial periosteum,through the rapid regulation of the bone defect immune microenvironment by the collagen-l-bone marrow mesenchymal stem cells outer phase and the sustained release of vascular endothelial growth factor by the micro-sol electrospinning core-shell structure of the inner phase,synergistically promotes bone healing.

BACKGROUND:Autologous bone,allogeneic bone or artificial bone has been used to promote bone defect repair in the clinic,but the rate of non-healing is still high.The key is to ignore the importance of periosteum in the bone healing process.In the early stage of the project,the project team constructed an electrospinning membrane loaded with vascular endothelial growth factor to highly simulate the intramembranous osteogenesis of natural periosteum at the bone defect site,which promoted bone regeneration to a certain extent.However,the injured area often faces the dilemma of severe inflammatory response mediated by macrophages and lack of seed cells,resulting in the risk of inactivation or diffusion of delivered biological factors.Therefore,it is necessary to further optimize and coordinate the immune regulation and angiogenesis functions of biomimetic periosteum to promote bone repair.OBJECTIVE:To investigate the physicochemical properties of stem cell-engineered bionic periosteum and its role in regulating the inflammatory microenvironment to promote bone repair.METHODS:By combining L-polylactic acid-based microsol electrospinning,type Ⅰ collagen self-assembly and gel stem cell transplantation technology,a bionic periosteum(M@C-B)was constructed,in which the core layer loaded with vascular endothelial growth factor and the shell layer delivered bone marrow mesenchymal stem cells to regulate the immune microenvironment of bone defects.The physicochemical properties of the periosteum were characterized by scanning electron microscopy,transmission electron microscopy,and Fourier transform infrared spectroscopy.A co-culture system was established between the bionic periosteum and macrophages,bone marrow mesenchymal stem cells and human umbilical vein endothelial cells to explore immune regulation and in vitro osteogenic and angiogenic abilities.Finally,the osteogenic properties of the stem cell engineered bionic periosteum were further verified in a rat femoral condyle defect model.RESULTS AND CONCLUSION:(1)Transmission electron microscopy results showed that the micro-sol electrospinning(MS)formed a distinct core-shell structure.Scanning electron microscopy indicated that after the assembly of the collagen-l artificial periosteum(M@C)on the surface of the vascular endothelial growth factor-loaded micro-sol,a distinct"spider web-like"fibrous structure was deposited.Infrared spectroscopy further confirmed the successful self-assembly of collagen-l.Release experiments demonstrated that the M@C group mitigated the burst release phenomenon compared to the MS group,maintaining internal vascular endothelial growth factor activity and sustained release.(2)Live/dead cell staining and CCK-8 assay showed that bone marrow mesenchymal stem cells proliferated well and survived on three types of artificial periosteum:MS,purely aligned poly(L-lactic acid)(PLLA)surface self-assembled collagen-l artificial periosteum(PLLA@C),and vascular endothelial growth factor-loaded micro-sol fiber surface self-assembled collagen-l-bone marrow mesenchymal stem cells artificial periosteum(M@C-B).Among them,the M@C-B group had the highest number of live cells and the fastest proliferation rate.(3)Alkaline phosphatase staining,alizarin red staining,and osteopontin immunofluorescence staining showed that the PLLA@C and M@C-B groups significantly promoted osteogenic differentiation of bone marrow mesenchymal stem cells.Angiogenesis experiments demonstrated that the vascular endothelial growth factor-loaded groups(MS and M@C-B)had longer blood vessel lengths and more reticular vascular-like structures with more cross-linked nodes,with the M@C-B group being the most prominent.(4)Immunofluorescence and flow cytometry showed that artificial periosteum in the M@C-B group significantly inhibited the pro-inflammatory macrophage phenotype and promoted the polarization of macrophages towards the anti-inflammatory M2 phenotype.(5)In vivo studies further confirmed that the M@C-B group showed superior bone mineral density,trabecular thickness,relative bone volume,and trabecular spacing compared to other groups.(6)These results indicate that bone marrow mesenchymal stem cell-engineered artificial periosteum,through the rapid regulation of the bone defect immune microenvironment by the collagen-l-bone marrow mesenchymal stem cells outer phase and the sustained release of vascular endothelial growth factor by the micro-sol electrospinning core-shell structure of the inner phase,synergistically promotes bone healing.

Lung cancer constitutes the most prevalent and lethal malignant tumor in China. Approximately 85% of lung cancer diagnoses correspond to the non-small cell histological subtype [non-small cell lung cancer (NSCLC)]. Despite surgery being the mainstay for early-stage disease, postoperative recurrence remains high and adjuvant chemotherapy offers limited benefit. In recent years, targeted therapy has demonstrated substantial advantages in driver mutation-positive NSCLC. To this end, the Lung Cancer Medical Education Committee of the Chinese Medical Education Association developed guidelines based on a systematic review of evidence through November 2025, using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach and a modified Delphi method. Focusing on epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK), and addressing ROS proto-oncogene 1 (ROS1), B-Raf proto-oncogene serine/threonine kinase (BRAF) V600E mutation, and mesenchymal-epithelial transition factor (MET) exon 14 (METex14) skipping, the guideline covers molecular testing, neoadjuvant/adjuvant therapy, perioperative strategies, minimal residual disease monitoring, and postoperative surveillance. It defines testing requirements, specifies stage-directed and subtype-specific treatments, and standardizes minimal residual disease monitoring. These recommendations emphasize precision and feasibility to improve survival and quality of life.

AIM: To investigate the efficacy of pars plana vitrectomy(PPV)with or without inner limiting membrane(ILM)peeling in refractory diabetic macular edema.METHODS:Totally 80 patients with refractory diabetic macular edema were retrospectively selected and assigned into groups according to the treatment method. Among them, 38 patients treated with PPV were included as group A, and 42 patients treated with PPV combined with ILM peeling were included as group B. The relevant data of patients in the two groups were collected, and the efficacy of the two groups was compared.RESULTS: At 1, 3, and 6 mo after surgery, the best corrected visual acuity(BCVA), central macular thickness(CMT), and severity of macular edema in the group B were all superior to those in the group A(all P<0.05). At 6 mo after the surgery, the incidence of complications in the group B was 12%, with no prominent difference compared to 18% of the group A(P>0.05).CONCLUSION:PPV combined with or without ILM peeling can improve visual function and relieve macular edema in patients with refractory diabetic macular edema. However, the combination of PPV and ILM peeling is superior to PPV alone in improving vision and relieving macular edema, and does not increase postoperative complications.

Huaihuasan， first recorded in Experiential Prescriptions for Universal Relief （Pu Ji Ben Shi Fang）， is a classic prescription for the treatment of ''hematochezia due to intestinal wind''. In 2018， it was included by the National Administration of Traditional Chinese Medicine as one of the first 100 classic prescriptions. This formula consists of four ingredients， i.e.， Sophorae Flos， Platycladi Cacumen， Schizonepetae Spica， and Aurantii Fructus. It is known for its ability to clear the intestines， dispel wind， cool the blood， and stop bleeding. In modern clinical practice， Huaihuasan， often with modifications， is widely used to treat various digestive tract diseases， including ulcerative colitis （UC）， with significant long-term effects. UC is a chronic， non-specific inflammatory bowel disease. Currently， Western medicine primarily treats UC with glucocorticoids， aminosalicylates， and immunosuppressants， which have good short-term efficacy but numerous adverse reactions， high recurrence rates， and the need for lifelong medication. Modern clinical studies have shown that Huaihuasan can significantly improve symptoms of UC， such as abdominal pain and diarrhea， reduce disease activity scores （Sutherland）， promote intestinal mucosal healing， alleviate anxiety and depression， and significantly improve the quality of life of patients. Pharmacological studies have shown that the main active components of Huaihuasan include quercetin， rutin， kaempferol， naringenin， and volatile oils. These compounds exert their effects by inhibiting inflammatory responses and protecting the intestinal mucosal barrier. They also exhibit antioxidant properties and regulate various signaling pathways， including tumor necrosis factor-α （TNF-α）， interleukin-2 （IL-2）， interleukin-4 （IL-4）， interleukin-1β （IL-1β）， monocyte chemoattractant protein-1 （MCP-1）， nuclear factor-κB （NF-κB）， Janus kinase （JAK）/signal transducer and activator of transcription （STAT）， and the KRAS-regulated mitogen-activated protein kinase （MEK）-extracellular signal-regulated kinase （ERK） pathway. These multi-target pathways improve UC symptoms， inhibit inflammation-cancer transition， and help maintain intestinal homeostasis. However， the precise mechanism of action has not yet been systematically elucidated. This paper reviews the research progress on Huaihuasan and main ingredients from its component drugs， focusing on their effects against UC. It also discusses current research limitations and suggests strategies for improvement， aiming to provide a reference for further studies on Huaihuasan in the treatment of UC and the development of new drugs.

AIM: To predict diabetic retinopathy(DR)progression through macular layer thickness in diabetic patients detected by optical coherence tomography(OCT).METHODS: Retrospective study. The clinical data of 100 cases(200 eyes)of diabetic patients admitted to our hospital from January 2023 to September 2024 were collected. According to the international clinical DR classification, they were divided into the non-diabetic retinopathy(NDR)group with 32 cases(64 eyes), the non-proliferative diabetic retinopathy(NPDR)group with 38 cases(76 eyes), and the proliferative diabetic retinopathy(PDR)group with 30 cases(60 eyes). At the same time, 49 cases(98 eyes)of healthy controls whose age and gender were matched with those of the diabetic patients were collected as the normal group. All patients underwent OCT examination. The thickness changes of the retinal nerve fiber layer(RNFL), ganglion cell layer(GCL), inner plexiform layer(IPL), outer nuclear layer(ONL), photoreceptor cell layer and total retinal thickness(RT)in the subregions of the macular area were compared among the groups. The Eta coefficient was used to analyze the correlation between them and the severity of DR.RESULTS: The thickness of RNFL, GCL, IPL, ONL and photoreceptor cell layer in each sub-region and the average of macular area in the PDR group was significantly lower than that in the NDR and normal groups, while the average RT thickness was significantly higher than that in the NPDR, NDR and normal groups(all P<0.05). The thickness of RNFL(central area, upper inner and outer rings and lower inner and outer rings and average), GCL(upper inner and outer rings and lower inner and outer rings and average), IPL(upper inner ring), ONL(central, upper inner ring and lower inner ring)and photoreceptor cell layer(upper inner and outer rings and lower inner and outer rings and average)in macular area of the PDR group was significantly thicker than that in the NPDR group(all P<0.05). The thickness of RNFL, GCL, IPL, ONL and photoreceptor cell layer in each sub-region and the average of macular area in the NPDR group was significantly lower than that in the NDR and normal groups, while the average RT thickness was significantly thicker than that in the NDR and normal groups(all P<0.05). There was no statistically significant difference in the above indicators between the NDR group and the normal group(all P>0.05). The severity of DR was significantly correlated with the average thickness of RNFL, GCL, IPL, ONL, photoreceptor cell layer and RT in macular area(all P<0.001).CONCLUSION: OCT measurement of the thickness of RNFL, GCL, IPL, ONL, photoreceptor cell layer and RT in the macular area in the diabetic patients can evaluate the progression of DR.

Objective To study the relationship between serum visfatin, neutrophil-to-lymphocyte ratio (NLR) and disease severity of coronary heart disease (CHD) in elderly patients (≥90 years old). Methods One hundred and two elderly patients (≥90 years old) with CHD who received coronary CT angiography (CTA) were selected from January 2020 to June 2024. In addition, thirty-five elderly patients (≥90 years old) without CHD who underwent coronary CTA during the same period were included in the control group. The CHD patients were divided into mild group, moderate group and severe group by CT-SYNTAX score. The clinical data and levels of serum visfatin and NLR were compared, and the correlation and diagnostic value of the above levels with disease severity of CHD in elderly patients were analyzed. Results Serum visfatin and NLR were manifested as severe group>moderate group>mild group>control group (P<0.05). Pearson correlation analysis found that serum visfatin and NLR were moderately positively correlated with CT-SYNTAX score (r=0.574, 0.482, P<0.001). Receiver operating characteristics (ROC) curve indicated that the area under the curve (AUC) of combination of serum visfatin and NLR in diagnosing severe lesion in elderly patients (≥90 years old) with CHD was 0.882, which was higher than that of visfatin or NLR alone, and its 95%CI was 0.803-0.938. Conclusion There is a certain correlation between serum visfatin, NLR and disease severity of CHD in elderly patients. The combination of the above indicators has a higher predictive value on severe lesion.

Ocular trauma is a leading cause of permanent visual impairment and loss of working a-bility.Among them,orbital foreign body injuries are often accompanied by multiple injuries to the eye-ball and surrounding tissues,adversely affecting the quality of life.This paper reported a 33-year-old male patient with right orbital foreign body resulting in eyeball contusion,extraocular muscle injury,and restricted ocular movement.After surgical removal of the foreign body combined with integrated traditional Chinese and western medicine treatment,the patient's visual acuity improved from 0.4 to 0.8,and ocular motility function significantly improved.This suggests that comprehensive treatment contributes to promoting functional recovery and enhancing clinical efficacy.

To summarize the nursing experience of a patient with relapsed/refractory diffuse large B-cell lymphoma who suffered from cytokine release syndrome after chimeric antigen receptor T-cell therapy.The main nursing experiences include:implementing emergency care for distributive shock caused by cytokine storm;carrying out the nursing of lung ventilation protection strategies;strengthening detailed skin care;prevention,control and care of hospital-acquired infections in an immunosuppressed state.After active treatment,the patient was transferred to the general ward 9 days later and discharged 27 days later.

Leukocyte-specific protein 1 (LSP1) is an F-actin binding protein expressed in various leukocytes, including lymphocytes, mononuclear macrophages, and neutrophils. LSP1 is highly conserved across different species. Human LSP1 protein contains 339 amino acids, featuring a Ca²⁺ binding site in the acidic NH2-terminal region and multiple F-actin binding domains along with phosphorylatable sites in the basic COOH-terminal region. Under Ca²⁺ regulation, the COOH-terminal domain of LSP1 binds to F-actin to regulate cell movement and signal transduction. Additionally, LSP1 activates the mitogen-activated protein kinase (MAPK) signaling pathway through phosphorylation mediated by protein kinase C (PKC) and MAPK-activated protein kinase-2, thereby regulating leukocyte proliferation and chemotaxis. The main effects of LSP1 on leukocytes are as follows: LSP1 plays important roles in neutrophil and macrophage migration, affecting cell adhesion, polarization and movement. LSP1 also functions in endothelial cells to regulate leukocyte transendothelial migration. In addition, LSP1 regulates macrophage phagocytosis through interaction with myosin 1e. Moreover, LSP1 regulates leukocyte proliferation and differentiation and plays significant roles in the development of leukemia and other tumors. In summary, LSP1 regulates leukocyte morphology, movement and function through interactions with cytoskeletal and signaling proteins. This review provides a comprehensive summary of these aspects.
Humans ; Leukocytes/cytology* ; Animals ; Cytoskeleton/metabolism* ; Microfilament Proteins/physiology* ; Cell Movement ; Signal Transduction