The pathogenesis of aplastic anemia(AA)is complex and associated with hematopoietic stem cell defect,abnormal bone marrow microenvironment,immune dysfunction,and somatic mutation,in which the immune mechanism plays an important role.This article reviews the pathogenesis of AA from the following aspects:regulatory T cell reduction,hematopoietic stem cell reduction caused by factor-related apoptosis/factor-related apoptosis ligand signaling pathway,aberrant target gene expression induced by inflammatory factor-stimulated microRNAs,and regulatory T cell dysfunction,so as to provide ideas and methods for clinical practice.

Objective:To explore the impact of different preoperative fluid supplementation methods (oral multidimensional carbohydrates and conventional fluid supplementation) on early postoperative recovery and pain management in patients undergoing unilateral biportal endoscopic (UBE) spine surgery.Methods:A retrospective cohort study was conducted to analyze the data of 386 patients who underwent UBE lumbar spine surgery under general anesthesia in the two courtyards of Beijing Friendship Hospital Affiliated to Capital Medical University from May 2023 to April 2024. All patients were divided into oral multidimensional carbohydrates ( "Outfast" supplementation, composed mainly of water, sugars, salts, and vitamins) group (referred to as oral "Outfast" group, 189 patients) and conventional fluid supplementation group (197 patients) according to the type of fluid replenishment. Patients in the oral "Outfast" group were given one oral dose in the morning of the first surgery, and another oral infusion before 10∶00 in the morning of the next surgery or afternoon surgery. Patients in the conventional fluid supplementation group received intravenous infusion in the morning of the first surgery, and were given intravenous infusion of glucose and sodium chloride injection in the morning of the next surgery or afternoon surgery. The two groups were compared for the proportion of patients receiving preoperative intravenous fluids on the day of surgery, intraoperative and postoperative fluid volumes, average daily fluid volumes over the first three postoperative days, time to first postoperative ambulation, time to first bowel movement, post-anesthesia care unit (PACU) stay duration, 4-hour and 24-hour postoperative visual analog scale (VAS) pain scores, incidence of anesthesia-related adverse reactions, and incidence of severe gastrointestinal adverse reactions. The measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for inter-group comparison. The measurement data of skewed distribution were expressed as M ( Q1, Q3) and rank sum test was used for inter-group comparison. Count data was presented in terms of examples and percentages, and a chi-square test was used for comparison between two groups. Results:In the oral "Outfast" group, 8 patients (4.2%) received preoperative intravenous fluids on the day of surgery, compared to 136 patients (69.0%) in the conventional fluid supplementation group, showing a significant difference ( P<0.001). The postoperative fluid volumes, average daily fluid volumes over the first three postoperative days, and shorter time to first ambulation in the oral multidimensional carbohydrates group were 700.0(600.0, 1 100.0) mL, 200.0(200.0, 300.0) mL, and 6.0(6.0, 11.0) h, respectively. The conventional fluid supplementation group was 1 100.0(700.0, 1 200.0) mL, 600.0(500.0, 700.0) mL, and 12.0(6.0, 19.0) h, respectively. The oral "Outfast" group was lower than the conventional fluid supplementation group ( P<0.001).There were no significant differences between the two groups in intraoperative fluid volumes, time to first bowel movement, PACU stay duration, 4-hour and 24-hour VAS pain scores, incidence of anesthesia-related adverse reactions, or incidence of severe gastrointestinal adverse reactions ( P>0.05). Conclusions:Preoperative oral multidimensional carbohydrates supplementation effectively reduces the amount of preoperative and postoperative intravenous fluid required, shortens the time to first ambulation. Preoperative oral multidimensional carbohydrates is safe and does not adversely impact gastrointestinal reactions or pain management in the postoperative period.

Objective To study the effect of morin on LPS induced acute lung injury mouse model and its mechanism .Meth‐ods Thirty male C57B/L mice were randomly divided into control group ,LPS group and LPS+ morin group ,with 10 in each group .5 mg/kg LPS was instilled into the lung from an trachea intubation in LPS group and LPS+morin group .Then the mice in LPS+morin group received an intraperitoneal injection of morin (40 mg/kg) every day for the next 3 d .Others received an equal a‐mount of saline .After 72 h ,the mice were sacrificed .The bronchoalveolar lavage fluid (BALF) was collected and centrifuged;the sediments were stained with Wright‐Giemsa for total cell and neutrophil count and the supernates were prepared for ELISA .The wet and dry weight of lung was weighed to calculate the wet/dry weight ratio .HE staining was performed to examine the pathologi‐cal change of lung .Western blot was used to determined the expression of TLR4 ,IKK and NF‐κB .Results Intratracheal instillation of LPS successfully established ALI model in mouse .LPS caused significant pathological changes including inflammatory cells infil‐tration ,alveolar septa thickness ,hemorrhage and edema .The wet/dry weight ratio ,the total cell count ,neutrophil count ,TNF and IL‐1βlevel in BALF ,and the expression of TLR4 ,NF‐κB ,and IKK were all increased significantly (P<0 .05) ,which were allevia‐ted by intraperitoneal injection of morin .Conclusion Morin can dampen the inflammatory response during LPS induced ALI in mouse ,which is potentially attributed to its inhibitory effect on the activation of NF‐κB .

OBJECTIVE:To observe the clinical efficacy and ADR of ultrasound debridement combined with Huangma tinc-ture in the treatment of diabetic foot ulcer. METHODS:90 diabetic foot ulcer patients were randomly divided into combination treatment group(ultrasound debridement combined with Huangma tincture wet compress),Huangma tincture group(Huangma tinc-ture wet compress) and control group (vaseline) with 30 cases in each group. 3 months after treatment,Ulcer healing rate,cure time,effective time,recovery time,cure rate and ADR were observed in each group. RESULTS:The ulcer healing rate of combi-nation treatment group was significantly higher than that of Huangma tincture group and control group,with statistical significance (P<0.05);there was statistical significance between Huangma tincture group and control group(P<0.05). Mean cure time,effec-tive time and recovery time of combination treatment group were all significantly lower than Huangma tincture group and control group,with statistical significance(P<0.05);there was statistical significance between Huangma tincture group and control group (P<0.05). Cure rate of combination treatment group was higher than that of Huangma tincture group and control group,with statis-tical significance (P<0.05);there was statistical significance between Huangma tincture group and control group (P<0.05). No ADR was found in combination treatment group and Huangma tincture group. CONCLUSIONS:The ultrasound debridement com-bined with Huangma tincture in the treatment of diabetic foot ulcer improve healing rate and shorten healing time significantly with-out obvious ADR. It has good clinical efficacy.

OBJECTIVE:To observe clinical efficacy and ADR of Yin-nourishing and qi-tonifying recipe in the treatment of type 2 diabetic stress urinary incontinence. METHODS:Sixty female patients with stress urinary incontinence based on T2DM were random-ly divided into the treatment group(n=30)and the control group(n=30). Control group received diet control,blood glucose control, blood pressure control,elvic muscles exercise. Based on control group,treatment group additionally received Yin-nourishing and qi-toni-fying recipe decoction,one dose a day(200 ml/dose),morning and night,for 4 weeks. Clinical efficacy and ADR of 2 groups were observed. RESULTS:Compared with control group, total effective rate of TCM syndrome efficacy and clinical efficacy both were in-creased significantly in treatment group,while urinary incontinence score and average leakage frequency of daily urine were decreased significantly;there was statistical significance(P<0.05). 2 patients in treatment group suffered from aggravated thirsty and dry phar-ynx,and those symptoms disappeared after adjusting the dose. CONCLUSIONS:Yin-nourishing and qi-tonifying recipe decoction com-bined with pelvic muscles exercise has definite clinical effect on female patients with type 2 diabetic stress urinary incontinence.