Multiple myeloma bone disease(MBD)is a common clinical complication in patients with multiple myeloma(MM),and the occurrence of bone-related events seriously affects the quality of survival and prognosis of patients.The pathogenesis of MBD involves an imbalance in physiologic bone remodeling:overactivation of osteoclasts,suppression of osteoblasts,and multiple cell-cytokine interactions in the microenvironment,including osteoblasts,bone marrow stromal cells,and immune cells.The current treatment of MBD is based on standard antimyeloma therapy to control tumor progression,along with the use of bone-related drugs act-ing on bone remodeling within the indications.To prevent bone destruction.In order to prevent bone destruction,it is essential to in-duce new bone formation to repair the existing lesions while resisting bone resorption,and a variety of novel bone-targeting drugs are currently demonstrating anti-osteopathic effects in preclinical and clinical trials.This article summarizes new advances in the mecha-nisms of bone remodeling and treatment of MBD.

Multiple myeloma(MM)is a malignant proliferative disease of plasma cells,ranking as the second most common hematologic tu-mor.Although the use of proteasome inhibitors and immunotherapeutic regimens has improved the prognosis of patients with MM,it re-mains incurable in most patients,mainly because of the eventual development of drug resistance in MM cells.Myeloid-derived suppressor cells(MDSCs)are a heterogeneous group of cells causing significant suppression of the T-cell immune response.They arise from bone mar-row myeloid progenitor cells that are blocked from differentiation and promote MM development by resisting immune destruction.Recent studies indicate that MDSCs stimulate MM cell proliferation,inducing drug resistance and metastasis.In this paper,we review multiple mechanisms exhibited by MDSCs in MM pathogenesis and discuss the feasibility and challenges of current therapeutic strategies targeting MDSCs,aiming to provide pertinent references regarding MM treatment.

Myeloid cell leukemia-1 (MCL-1) is an anti-apoptotic protein that plays a key role in promoting cell survival in multiple myeloma, acute myeloid leukemia and non-Hodgkin lymphoma. MCL-1 is highly expressed in a variety of hematological malignancies, which is one of the important factors leading to poor prognosis and chemoresistance in patients with hematological malignancies. Therefore, MCL-1 is an important therapeutic target for hematological malignancies. Several MCL-1 inhibitors have entered clinical trials, including S63845, AZD5991, S64315, AMG-176, and AMG-397. The treatment plans used for hematological malignancies include monotherapy with MCL-1 inhibitors, as well as combination therapy with B cell lymphoma 2 inhibitors or immunomodulatory drugs, all indicating that MCL-1 inhibitors may be a breakthrough point for targeted treatment of hematological malignancies.

Objective To compare the clinical efficacy and short-term prognosis of laparoscopic radical resection of right colon cancer guided by superior mesenteric artery and superior mesenteric vein.Methods 80 patients with right colon cancer of cT2-4 and/or N0-2M0 admitted from January 2020 to October 2022 were selected as the research objects,and they were randomly divided into observation group and control group,with 40 patients in each group.The observation group was treated with SMA-oriented laparoscopic radical resection of right colon cancer,while the control group was treated with SMV-oriented laparoscopic radical resection of right colon cancer.The curative effect and prognosis of the two groups were compared.Results There was no significant difference between the two groups in general condition,operation time,gastric tube placement time,recovery time of farting,postoperative fasting time,postoperative drainage time,postoperative nutritional index,total incidence of complications and postoperative hospitalization time(P>0.05).The lymph nodes in the observation group were significantly more than those in the control group,and the difference was statistically significant(P<0.05).In the observation group,the lymph nodes in the anterior and left side of superior mesenteric artery were examined(No.D3),and 273 lymph nodes were detected,and Seven patients(17.5% )were diagnosed with D3 metastasis,and 13 lymph nodes were positive(5.2% ).Conclusion Laparoscopic radical resection of right colon cancer guided by superior mesenteric artery,without increasing the incidence of complications and high safety,can more thoroughly clean lymph nodes and reduce tumor recurrence,which is expected to significantly improve the prognosis of patients.

ObjectiveTo develop traditional Chinese medicine （TCM） formulae for the treatment of nonsevere coronavirus disease 2019 （COVID-19） and to explore its anti-inflammatory mechanism. MethodsThe dysregulated signaling pathways were determined in macrophages from bronchoalveolar lavage fluid of COVID-19 patients and in lung epithelial cells infected with SARS-CoV-2 in vitro based on transcriptome analysis. A total of 102 TCM formulae for the clinical treatment of nonsevere COVID-19 were collected through literature. The pathway-reversing rates of these formulae in macrophages and lung epithelial cells were evaluated based on signature signaling pathways， and the basic formula was determined in conjunction with TCM theory. The commonly used Chinese materia medica for nonsevere COVID-19 were summarized from the 102 TCM formulae as abovementioned. And together with the screening results from the Pharmacopoeia of the People's Republic of China， a “Chinese materia medica pool” was esta-blished for the development of TCM formulae for COVID-19. The regulatory effects of each herb on signaling pathways were obtained based on targeted transcriptome analysis. Oriented at reversing dysregulated signaling pathways of COVID-19， the calculation was carried out， and the artificial intelligent methods for compositing formulae， that are exhaustive method and parallel computing， were used to obtain candidate compound formulas. Finally， with reference to professional experience， an innovative formula for the treatment of nonsevere COVID-19 was developed. The ethanol extract of the formula was evaluated for its anti-inflammatory effects by detecting the mRNA expression of interleukin 1b （Il1b）， C-X-C motif chemokine ligand 2 （Cxcl2）， C-X-C motif chemokine ligand 10 （Cxcl10）， C-C motif chemokine ligand 2 （Ccl2）， nitric oxide synthase 2 （Nos2）， and prostaglandin-endoperoxide synthase 2 （Ptgs2） using reverse transcription-quantitative polymerase chain reaction （RT-qPCR） in RAW264.7 cells treated with lipopolysaccharide （LPS）. ResultsIn macrophages and lung epithelial cells， 34 dysregulated signaling pathways associated with COVID-19 were identified respectively. The effects of the 102 formulae for clinical treatment of nonsevere COVID-19 were evaluated based on the dysregulated signaling pathways and targeted transcriptome， and the result showed that Yinqiao Powder and Pingwei Powder （银翘散合平胃散， YQPWP） ranked first， reversing 91.18% of the dysregulated signaling pathways in macrophages and 100% of the dysregulated signaling pathways in lung epithelial cells. Additionally， YQPWP had the function of scattering wind and clearing heat， resolving toxins and removing dampness in accordance with the pathogenesis of wind-heat with dampness in COVID-19. It was selected as the basic formula， and was further modified and optimized to develop an innovative fomula Qiaobang Zhupi Yin （翘蒡术皮饮， QBZPY） based on expert experience and artificial intelligence in composing formulae. QBZPY can reverse all the dysregulated signaling pathways associated with COVID-19 in macrophages and lung epithelial cells， with the reversing rates of 100%. The chief medicinal of QBZPY， including Lianqiao （Fructus Forsythiae）， Xixiancao （Herba Siegesbeckiae） and Niubangzi （Fructus Arctii）， can down-regulate multiple signaling pathways related with virus infection， immune response， and epithelial damage. RT-qPCR results indicated that compared with the model group， the QBZPY group down-regulated the mRNA expression of Il1b， tumor necrosis factor （Tnf）， Cxcl2， Cxcl10， Ccl2， Nos2 and Ptgs2 induced by LPS in RAW264.7 cells （P＜0.05 or P＜0.01）. ConclusionBased on targeted transcriptome analysis， expert experience in TCM and artificial intelligence， QBZPY has been developed for the treatment of nonsevere COVID-19. The ethanol extract of QBZPY has been found to inhibit mRNA expression of several pro-inflammatory genes in a cellular inflammation model.

[摘 要] 目的：探究伴有肾损害（RI）的多发性骨髓瘤（MM）患者与无RI患者间是否存在免疫学指标差异。方法：用2017年1月至2023年8月在兰州大学第二医院收治的134例首次确诊为MM的患者相关信息进行回顾性分析，研究对比RI组和非RI组及Durie⁃Salmon（DS）分期和危险分层两个亚组的10种免疫学指标和6个常规血液学参数的差异。结果：RI组外周血中性粒细胞/淋巴细胞比值（NLR）、外周血单核细胞/淋巴细胞比值（MLR）、CD8+ T细胞比例、IL-10均较非RI组高（均P<0.05），淋巴细胞绝对值、CD4/CD8比值均较非RI组低（均P<0.05）。DS-Ⅲ分期患者中，RI组NLR、MLR、CD8+ T细胞比例、IL-8、IL-10均较非RI组升高（均P<0.05），而DS-Ⅰ和DS-Ⅱ患者中，RI组和非RI组患者免疫指标无明显差异。高危MM患者RI组淋巴细胞数、NLR、IL-10均较非RI有明显差异（均P<0.05）。结论：伴RI的MM患者免疫相关指标异常更为明显，DS-Ⅲ分期和高危险度分层表现出明显的免疫指标异常，本研究结果对进一步阐明MM伴有RI患者预后较差的原因及个体化治疗提供参考依据。

Objective To observe the effect of Cardamonin(CDN)on pulmonary fibrosis in mice,and explore the effect of CDN on transforming growth factor-β1(TGF-β1)/Smad signaling pathway.Methods The mice were grouped into:Sham group,Bleomycin(BLM)group,low dose of Cardamonin(CDN-L)group,medium dose of Cardamonin(CDN-M)group,high dose of Cardamonin(CDN-H)group and Dexamethasone(DXM)group.Injectioning of BLM induce pulmonary fibrosis in mice,the lung index was measured.Enzyme-linked immunosorbent assay kit measured serum tumor necrosis factor-α(TNF-α)levels,the hydroxyproline(HYP)content in lung tissue was detectioned by kits.Pathological changes were observed by Htoxylin Eosin and Masson staining,and the level of genes related to TGF-β1/smad signaling pathway was detected by RT-PCR.Results Compared with the Sham group,the lung index,Szapiel score and Ashcroft score of the BLM group were significantly increased(P<0.05),and the degree of pulmonary inflammation and fibrosis was more severe.The levels of TNF-α in serum and HYP in lung tissue were increased(P<0.05),lung tissue TGF-β1[(1.02±0.21)vs.(3.25±0.14)],smad2[(1.00±0.05)vs.(1.59±0.20)],smad3[(1.00±0.06)vs.(1.59±0.20)],α-smooth muscle actin(α-SMA)[(1.00±0.10)vs.(2.15±0.10)and E-Cadherin[(1.01±0.16)vs.(0.57±0.09)]mRNA level decreased(P<0.05).The intervention of CDN-M and CDN-H could decrease the lung index,alleviate the inflammation and Pulmonary fibrosis,and decrease the levels of TNF-α and HYP(P<0.05).The expression of TGF-β1,smad2,smad3 and α-SMA in lung tissue of mice with pulmonary fibrosis was down-regulate.CDN-L had no significant effect,while CDN-H had similar effects to DXM.Conclusion Cardamonin may play an anti-fibrotic role by mediating epithelial-mesenchymal transition through the TGF-β1/Smad pathway.

T cell immunoglobulin and immunoreceptor tyrosine-based inhibitory motif domain (TIGIT) is a new immune checkpoint protein. Studies have shown that TIGIT can cause dysfunction of immune cells, weaken the anti-tumor effect, thus leading to tumor immune tolerance and immune escape. Blocking TIGIT can reverse immune cell failure and exert anti-tumor effect, which is expected to become a new therapeutic target for multiple myeloma.

Severe aplastic anemia (SAA) is a severe bone marrow failure syndrome caused by multiple causes, which is clinically manifested with severe anemia, infection and bleeding. The complex pathogenesis of SAA has not been fully understood. SAA is characterized with acute onset, severe disease condition and rapid progression. At present, with the in-depth study of SAA and the improvement of diagnosis and treatment, the therapeutic strategy for SAA has been evolved from classical immunosuppressive therapy based on antithymocyte globulin and cyclosporine to the application of thrombopoietin receptor agonist and combined treatment based on allogeneic hematopoietic stem cell transplantation, which may promote the reconstruction of hematopoietic function of SAA patients to varying degree and significantly improve survival and clinical prognosis, becoming the research hotspot of SAA treatment. In this article, new advances in the treatment of SAA at home and abroad were reviewed.

Humans ; Depressive Disorder, Major ; Motor Cortex ; Magnetic Resonance Imaging