Aromatherapy refers to the method of using the aromatic components of plants in appropriate forms to act on the entire body or a specific area to prevent and treat diseases. Essential oils used in aromatherapy are hydrophobic liquids containing volatile aromatic molecules， such as limonene， linalool， linalool acetate， geraniol， and citronellol. These chemicals have been extensively studied and shown to have a variety of functions， including reducing anxiety， relieving depression， promoting sleep， and providing pain relief. Terpenoids are a class of organic molecules with relatively low lipid solubility. After being inhaled， they can pass through the nasal mucosa for transfer or penetrate the skin and enter the bloodstream upon local application. Some of these substances also have the ability to cross the blood-brain barrier， thereby exerting effects on the central nervous system. Currently， the academic community generally agrees that products such as essential oils and aromatherapy from aromatic plants have certain health benefits. However， the process of extracting a single component from it and successfully developing it into a drug still faces many challenges. Its safety and efficacy still need to be further verified through more rigorous and systematic experiments. This article systematically elaborated on the efficacy of aromatic substances， including plant extracts and natural small molecule compounds， in antibacterial and antiviral fields and the regulation of nervous system activity. As a result， a deeper understanding of aromatherapy was achieved. At the same time， the potential of these aromatic substances for drug development was thoroughly explored， providing important references and insights for possible future drug research and application.

Objective:To explore the relapse-related genes and their clinicopathological connections of diffuse large B cell lymphoma (DLBCL).Methods:Targeted panel sequencing was conducted on 32 eligible DLBCL samples; the patients were diagnosed, treated, and went into complete remission at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, including 14 cases with recurrence (relapsed group) and 18 cases with long-term complete remission of over five years (remission group). Clinical and pathological data were further reviewed. Fisher′s exact test was employed to compare the differences in clinicopathological characteristics and mutation patterns between the two groups.Results:Among the 32 patients, there were 18 males and 14 females, with a male to female ratio of 1.3∶1.0 and a median age of 53 (45.5, 67.0) years. In the relapsed group, PIM1 (11/14), KMT2D (7/14), PRDM1 (6/14), MYD88 (6/14), DTX1 (6/14) emerged as the most frequently mutated genes. In the remission group, while recurrent PIM1, KMT2D and MYD88 mutations were also observed, the TP53 gene exhibited the highest mutation frequency (6/18). Compared to the remission group, relapsed group showed elevated mutation frequencies of PIM1 ( P=0.013) and FAT4 ( P=0.010), alongside a reduced incidence of TP53 mutations. In all 32 patients, DLBCL with CD79B, CCND3, DTX1, KMT2D and PRDM1 mutations demonstrated a propensity towards advanced clinicopathologic stage. Conclusions:Relapsed DLBCL has distinctive clinicopathological and genetic features. PIM1 and FAT4 may be served as potential biomarkers for screening relapsed DLBCL-NOS and as targets for novel therapeutic strategies.

Objective:To explore the clinical and pathological features of EBV-positive diffuse large B cell lymphoma (EBV +DLBCL) and to analyze the prognostic significance of CD30 expression in this entity. Methods:A retrospective analysis was conducted from 34 cases of EBV +DLBCL and 198 cases of EBV -DLBCL diagnosed and treated at the First Affiliated Hospital of Nanjing Medical University, from January 2017 to June 2023. Based on CD30 expression, 34 patients with EBV +DLBCL were categorized into CD30-positive and CD30-negative groups. Fisher exact test and Kaplan-Meier survival curves were employed to analyze the relationship between CD30 expression and clinicopathological parameters as well as its prognostic implications. Chi-square tests were used to compare the clinicopathological features between EBV +DLBCL and EBV -DLBCL. Results:There were 19 males and 15 females with a median age of 69.5 (15-83) years in the EBV +DLBCL group. Compared with EBV -DLBCL, EBV +DLBCL was more likely to present with clinical features such as B symptoms ( χ2=23.818, P<0.001), Ann Arbor stage Ⅲ-Ⅳ ( χ2=8.540, P=0.003), ECOG (Eastern Cooperative Oncology Group Performance Status) score 2-4 ( χ2=6.722, P=0.010), IPI score 3-5 ( χ2=9.953, P=0.002), and involvement of more than one extranodal site ( χ2=6.825, P=0.009). Additionally, EBV +DLBCL exhibited higher frequencies of elevated LDH ( χ2=4.307, P=0.038), CRP ( χ2=5.596, P=0.018), and β2-MG ( χ2=7.008, P=0.008) levels. Histopathologically, EBV +DLBCL was more commonly of the non-GCB subtype ( χ2=12.421, P<0.001), with higher frequencies of CD30-positive ( χ2=62.706, P<0.001),CD10-negative ( χ2=8.687, P=0.003),bcl-6-negative ( χ2=11.123, P<0.001), and bcl-2-negative ( χ2=22.779, P=0.003) expression. Using 20% as the positive threshold for CD30, the CD30-positive group had a higher proliferation index ( P=0.045). No significant differences were observed in overall survival between the two groups. Conclusions:EBV +DLBCL is more prevalent in the elderly and often exhibits aggressive clinical features. The expression of CD30 is not associated with the overall prognosis of EBV +DLBCL.

Objective:To explore the relapse-related genes and their clinicopathological connections of diffuse large B cell lymphoma (DLBCL).Methods:Targeted panel sequencing was conducted on 32 eligible DLBCL samples; the patients were diagnosed, treated, and went into complete remission at the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, including 14 cases with recurrence (relapsed group) and 18 cases with long-term complete remission of over five years (remission group). Clinical and pathological data were further reviewed. Fisher′s exact test was employed to compare the differences in clinicopathological characteristics and mutation patterns between the two groups.Results:Among the 32 patients, there were 18 males and 14 females, with a male to female ratio of 1.3∶1.0 and a median age of 53 (45.5, 67.0) years. In the relapsed group, PIM1 (11/14), KMT2D (7/14), PRDM1 (6/14), MYD88 (6/14), DTX1 (6/14) emerged as the most frequently mutated genes. In the remission group, while recurrent PIM1, KMT2D and MYD88 mutations were also observed, the TP53 gene exhibited the highest mutation frequency (6/18). Compared to the remission group, relapsed group showed elevated mutation frequencies of PIM1 ( P=0.013) and FAT4 ( P=0.010), alongside a reduced incidence of TP53 mutations. In all 32 patients, DLBCL with CD79B, CCND3, DTX1, KMT2D and PRDM1 mutations demonstrated a propensity towards advanced clinicopathologic stage. Conclusions:Relapsed DLBCL has distinctive clinicopathological and genetic features. PIM1 and FAT4 may be served as potential biomarkers for screening relapsed DLBCL-NOS and as targets for novel therapeutic strategies.

Objective:To explore the clinical and pathological features of EBV-positive diffuse large B cell lymphoma (EBV +DLBCL) and to analyze the prognostic significance of CD30 expression in this entity. Methods:A retrospective analysis was conducted from 34 cases of EBV +DLBCL and 198 cases of EBV -DLBCL diagnosed and treated at the First Affiliated Hospital of Nanjing Medical University, from January 2017 to June 2023. Based on CD30 expression, 34 patients with EBV +DLBCL were categorized into CD30-positive and CD30-negative groups. Fisher exact test and Kaplan-Meier survival curves were employed to analyze the relationship between CD30 expression and clinicopathological parameters as well as its prognostic implications. Chi-square tests were used to compare the clinicopathological features between EBV +DLBCL and EBV -DLBCL. Results:There were 19 males and 15 females with a median age of 69.5 (15-83) years in the EBV +DLBCL group. Compared with EBV -DLBCL, EBV +DLBCL was more likely to present with clinical features such as B symptoms ( χ2=23.818, P<0.001), Ann Arbor stage Ⅲ-Ⅳ ( χ2=8.540, P=0.003), ECOG (Eastern Cooperative Oncology Group Performance Status) score 2-4 ( χ2=6.722, P=0.010), IPI score 3-5 ( χ2=9.953, P=0.002), and involvement of more than one extranodal site ( χ2=6.825, P=0.009). Additionally, EBV +DLBCL exhibited higher frequencies of elevated LDH ( χ2=4.307, P=0.038), CRP ( χ2=5.596, P=0.018), and β2-MG ( χ2=7.008, P=0.008) levels. Histopathologically, EBV +DLBCL was more commonly of the non-GCB subtype ( χ2=12.421, P<0.001), with higher frequencies of CD30-positive ( χ2=62.706, P<0.001),CD10-negative ( χ2=8.687, P=0.003),bcl-6-negative ( χ2=11.123, P<0.001), and bcl-2-negative ( χ2=22.779, P=0.003) expression. Using 20% as the positive threshold for CD30, the CD30-positive group had a higher proliferation index ( P=0.045). No significant differences were observed in overall survival between the two groups. Conclusions:EBV +DLBCL is more prevalent in the elderly and often exhibits aggressive clinical features. The expression of CD30 is not associated with the overall prognosis of EBV +DLBCL.

Objective:To investigate effect of curcumin on sepsis-induced acute lung injury rats based on Nrf2/Keap1 signaling pathway.Methods:Thirty rats were randomly divided into sham operation group,model group,curcumin low,medium and high doses groups,with 6 rats in each group.Rats in sham operation group were exposed by removing cecum and then returned to abdominal cavity,while rest of rats were constructed a model of acute lung injury in sepsis,and drugs were administered immediately after surgery for 3 consecutive days.After anaesthesia with 40 mg/kg pentobarbital,blood and alveolar lavage fluid were collected from common carotid arteries,and lung tissues were taken after death.Severity of sepsis in rats was evaluated;total cell count and neutrophil count of alveo-lar lavage fluid were detected;HE staining was performed to observe pathological damage of lung tissues;colorimetric method was used to detect SOD and MDA activities of lung tissues;ELISA was used to detect TNF-α,IL-1β and IL-6 levels;qRT-PCR was used to detect Nrf2,Keap1 and HO-1 mRNA expressions in lung tissues;Western blot was used to detect Nrf2,Keap1 and HO-1 protein expressions in lung tissues.Results:Compared with sham operation group,severity scores of sepsis in model group,curcumin low,medium and high doses groups were increased,total number of cells and neutrophil number were increased,SOD level was decreased,MDA level was increased,TNF-α,IL-1β and IL-6 levels were increased,Nrf2,HO-1 mRNA and protein expressions were decreased,Keap1 mRNA and protein expressions were increased(P<0.05);compared with model group,sepsis severity scores of curcumin low,medium and high doses groups were decreased,total number of cells and neutrophil number were decreased,SOD level was increased,MDA level was decreased,TNF-α,IL-1β and IL-6 levels were decreased,Nrf2 and HO-1 mRNA and protein expressions were increased,Keap1 mRNA and protein expressions were decreased in a dose-dependent manner(P<0.05).Conclu-sion:Curcumin can improve acute lung injury in rats with sepsis,improve lung pathological injury and protect lung tissue,which may be achieved by regulating Nrf2/Keap1 pathway and expressions of related factors.

Objective:To investigate the clinicopathological and molecular genetic characteristics of Crohn′s disease (CD).Methods:A retrospective analysis was conducted on 52 CD patients who underwent surgical resection at the First Affiliated Hospital of Nanjing Medical University between January 2014 and June 2023. Clinical presentations and histopathological features were assessed. Whole-genome sequencing was performed on 17 of the samples, followed by sequencing and pathway enrichment analyses. Immunohistochemistry was used to assess the expression of frequently mutated genes.Results:Among the 52 patients, 34 were males and 18 were females, male-to-female ratio was 1.9∶1.0, with a median age of 45 years at surgery and 35 years at diagnosis. According to the Montreal classification, A3 (51.9%,27/52), B2 (61.5%, 32/52), and L3 (50.0%,26/52) subtypes were the most predominant. Abdominal pain and diarrhea were the common symptoms. Histopathological features seen in all 52 patients included transmural inflammation, disruption of cryptal architecture, lymphoplasmacytic infiltration, varying degrees of submucosal fibrosis and thickening, increased enteric nerve fibers and neuronal proliferation. Mucosal defects, fissure ulcers, abscesses, pseudopolyps, and adenomatous proliferation were also observed in 51 (98.1%), 38 (73.1%), 28 (53.8%), 45 (86.5%), and 28 (53.8%) cases, respectively. Thirty-one (59.6%) cases had non-caseating granulomas, and 3 (5.8%) cases had intestinal mucosal glandular epithelial dysplasia. Molecular analysis showed that 12/17 CD patients exhibited mutations in at least one mucin family gene (MUC2, MUC3A, MUC4, MUC6, MUC12, MUC17), and MUC4 was the most frequently mutated in 7/17 of cases. Immunohistochemical stains showed reduced MUC4 expression in epithelial cells, with increased MUC4 expression in the epithelial surface, particularly around areas of inflammatory cell aggregation; and minimal expression in the lower half of the epithelium.Conclusions:CD exhibits diverse clinical and pathological features, necessitating a comprehensive multidimensional analysis for diagnosis. Mutations and expression alterations in mucin family genes, particularly MUC4, may play crucial roles in the pathogenesis of CD.

Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the efficacy of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects who were previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extended or switched TMF treatment for 48 weeks. Efficacy was evaluated based on virological, serological, biological parameters, and fibrosis staging. Statistical analysis was performed using the McNemar test, t-test, or Log-Rank test according to the data. Results:593 subjects from the initial TMF group and 287 subjects from the TDF group were included at week 144, with the proportions of HBV DNA<20 IU/ml at week 144 being 86.2% and 83.3%, respectively, and 78.1% and 73.8% in patients with baseline HBV DNA levels ≥8 log10 IU/ml. Resistance to tenofovir was not detected in both groups. For HBeAg loss and seroconversion rates, both groups showed a further increase from week 96 to 144 and the 3-year cumulative rates of HBeAg loss were about 35% in each group. However, HBsAg levels were less affected during 96 to 144 weeks. For patients switched from TDF to TMF, a substantial further increase in the alanine aminotransferase (ALT) normalization rate was observed (11.4%), along with improved FIB-4 scores.Conclusion:After 144 weeks of TMF treatment, CHB patients achieved high rates of virological, serological, and biochemical responses, as well as improved liver fibrosis outcomes. Also, switching to TMF resulted in significant benefits in ALT normalization rates (NCT03903796).

Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the safety profile of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects that previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extending or switching TMF treatment for 48 weeks. Safety profiles of kidney, bone, metabolism, body weight, and others were evaluated.Results:666 subjects from the initial TMF group and 336 subjects from TDF group with at least one dose of assigned treatment were included at week 144. The overall safety profile was favorable in each group and generally similar between extended or switched TMF treatments from week 96 to 144. In subjects switching from TDF to TMF, the non-indexed estimated glomerular filtration rate (by non-indexed CKD-EPI formula) and creatinine clearance (by Cockcroft-Gault formula) were both increased, which were (2.31±8.33) ml/min and (4.24±13.94) ml/min, respectively. These changes were also higher than those in subjects with extending TMF treatment [(0.91±8.06) ml/min and (1.30±13.94) ml/min]. Meanwhile, switching to TMF also led to an increase of the bone mineral density (BMD) by 0.75% in hip and 1.41% in spine. On the other side, a slight change in TC/HDL ratio by 0.16 (IQR: 0.00, 0.43) and an increase in body mass index (BMI) by (0.54±0.98) kg/m 2 were oberved with patients switched to TMF, which were significantly higher than that in TMF group. Conclusion:CHB patients receiving 144 weeks of TMF treatment showed favorable safety profile. After switching to TMF, the bone and renal safety was significantly improved in TDF group, though experienceing change in metabolic parameters and weight gain (NCT03903796).