Myasthenia gravis (MG) is mainly mediated by pathogenic autoantibodies secreted by effector B cells. Cytokines secreted by various immune cells can participate in MG development by regulating B lymphocyte activity and modulating lymphocyte differentiation. This article reviews the recent advance in role of cytokines such as interleukin (IL)-4, IL-6, IL-17, and transforming growth factor-β in MG development and cytokine-targeted MG treatment, with the aim of providing new ideas for MG diagnosis, treatment, and prognosis assessment.

Objective To addresses the challenges arising from the rapid expansion of pharmaceutical clinical trials and the growing demands for quality management,this paper investigates the application of low-code technology in project management.Its goals are to enhance the operational efficiency and execution capabilities of clinical trial institutions,ensure trial quality and safety,and accelerate the translation of pharmaceutical scientific achievements.Methods A brainstorming session was conducted to analyze the technical and functional requirements for managing pharmaceutical clinical trial projects.Utilizing the ＂template design＂ and ＂decision analysis＂ functionalities of low-code technology,the study adopted a modular and visually driven data management approach to develop a system compliant with Good Clinical Practice(GCP)standards.This system integrates key functionalities,including project progress management,funding management,drug inventory management,and quality control.Its effectiveness was evaluated through real-world operation and performance validation.Results The system had demonstrated stable operation with substantial improvements in practical application.Compared with conventional management approaches,it significantly enhanced project management efficiency:the time required for project schedule management was reduced by 80%,the efficiency of financial processing increased by 95%,drug inventory management efficiency improved by 75%,and the time spent on quality control was shortened by 60%.Conclusion The pharmaceutical clinical trial project management system developed using low-code technology offers substantial advantages and promising application potential.It represents a critical practice in applying digital and intelligent tools to advance pharmaceutical productivity in the medical and healthcare sectors.

Objective To addresses the challenges arising from the rapid expansion of pharmaceutical clinical trials and the growing demands for quality management,this paper investigates the application of low-code technology in project management.Its goals are to enhance the operational efficiency and execution capabilities of clinical trial institutions,ensure trial quality and safety,and accelerate the translation of pharmaceutical scientific achievements.Methods A brainstorming session was conducted to analyze the technical and functional requirements for managing pharmaceutical clinical trial projects.Utilizing the ＂template design＂ and ＂decision analysis＂ functionalities of low-code technology,the study adopted a modular and visually driven data management approach to develop a system compliant with Good Clinical Practice(GCP)standards.This system integrates key functionalities,including project progress management,funding management,drug inventory management,and quality control.Its effectiveness was evaluated through real-world operation and performance validation.Results The system had demonstrated stable operation with substantial improvements in practical application.Compared with conventional management approaches,it significantly enhanced project management efficiency:the time required for project schedule management was reduced by 80%,the efficiency of financial processing increased by 95%,drug inventory management efficiency improved by 75%,and the time spent on quality control was shortened by 60%.Conclusion The pharmaceutical clinical trial project management system developed using low-code technology offers substantial advantages and promising application potential.It represents a critical practice in applying digital and intelligent tools to advance pharmaceutical productivity in the medical and healthcare sectors.

Myasthenia gravis (MG) is mainly mediated by pathogenic autoantibodies secreted by effector B cells. Cytokines secreted by various immune cells can participate in MG development by regulating B lymphocyte activity and modulating lymphocyte differentiation. This article reviews the recent advance in role of cytokines such as interleukin (IL)-4, IL-6, IL-17, and transforming growth factor-β in MG development and cytokine-targeted MG treatment, with the aim of providing new ideas for MG diagnosis, treatment, and prognosis assessment.

Objective:To evaluate the effects of preoperative transversus abdominis plane block (TAPB) and intraoperative deep wound local anesthesia on improving postoperative pain in kidney transplant recipients.Methods:A retrospective study was conducted on 62 recipients who underwent allogeneic kidney transplantation at Beijing Friendship Hospital, Capital Medical University from January 2020 to June 2023. The recipients were divided into three groups according to the different methods of postoperative analgesia: group A ( n=11), group B ( n=28) and group C ( n=23). Group A received preoperative TAPB anesthesia, group B received intraoperative deep wound local anesthesia, and group C received conventional anesthesia. Demographic characteristics, intraoperative parameters, postoperative pain visual analog scale (VAS) scores at 0, 2, 12 and 24 hours, postoperative analgesic medication requirement, time to postoperative oral intake, and incidence of complications were compared among the three groups. The normality of measurement data was tested by Shapiro-Wilk method. Measurement data conforming to normal distribution were expressed as mean ± standard deviation ( ± s). ANOVA was used for comparison between groups, and S-N-K method was used for pairwise comparison between groups with differences. Measurement data that did not conform to the normal distribution were expressed as the median (interquartile distance) [ M( Q1, Q3)], Kruskal-Wallis H test was used for comparison between groups, and Bonferroni was used for pairwise comparison after the fact if there were differences between groups. The Chi-square test or Fisher exact probability method was used for comparison between data groups. Results:There were no significant differences in demographic characteristics and intraoperative parameters among the three groups ( P>0.05). The pain VAS scores at 0, 2, 12 and 24 h after surgery in group A and group B were significantly lower than those in group C ( P<0.001), and the pain VSA scores at 0 and 24 h were no difference between group A and group B, while the pain VAS scores at 2 and 12 h were lower in group A than those in group B. The postoperative analgesic medication requirement was also significantly lower in group A and group B than those in group C, the requirement rate of nonsteroidal antiinflammatory drug in group A was lower than that in group B. Moreover, the time to postoperative oral intake was significantly shorter in group A and group B compared to group C. These differences were statistically significant ( P< 0.05). There were no statistically significant differences in postoperative nausea and vomiting or major complications among the three groups ( P> 0.05). Conclusions:Preoperative TAPB and intraoperative deep wound local anesthesia can effectively alleviate postoperative pain in kidney transplant recipients, reduce the use of analgesic medication, promote early recovery of gastrointestinal function in donors, and do not increase the incidence of postoperative complications. The analgesic effect of deep wound local anesthesia was similar to preoperative TAPB.

Objective:To investigate the diagnosis of malignancy with upper limb lymphedema as the initial sign and symptoms.Methods:Clinical data of 6 patients with malignant lymphedema admitted at the Department of Lymphatic Surgery, Beijing Shijitan Hospital, Capital Medical University, from May 2007, to Dec 2018 were retrospectively analyzed.Results:The age of these 6 patients ranged from 50 to 78 years. The time from the occurrence of lymphedema to the diagnosis of malignant tumors ranged from 1 month to 15 years. Limb swelling occurred in all 6 cases. Local lymphadenopathy occurred in 4 cases and limb paresthesia occurred in 2 cases. Pathological diagnosis showed that the tumor originated from epithelial tissue in 3 cases, mesenchymal tissue in 2 cases and lymphatic system in 1 case. Pathological diagnosis showed that the tumor originated from epithelial tissue in 3 cases, mesenchymal tissue in 2 cases and lymphatic system in 1 case.Conclusions:To avoid delays in the diagnosis and therapy of malignant lymphedema, physicians should actively look for signs or symptoms of lymphedema during the follow-up period and promptly manage patients developing problems.

Objective: To analyze the clinicopathological characteristics of ovarian pseudomyxoma peritonei (PMP). Methods: Clinical and pathological data from a total of 272 PMP patients diagnosed at Beijing Shijitan Hospital from January 2010 to January 2019 were collected from a database and retrospectively analyzed to study the origin of PMP tumors. Pathological slides marked with antigens were further studied using immunohistochemical staining, including CK7, CK20, CEA, Villin, CDX2, SATB2, CA125, ER, PR, MUC1, and MUC2. Results: Among the 272 PMP patients studied, the tumors of 245 (90.1%) originated from the appendix, while the remaining 27 (9.9%) originated from non-appendix tissues, including 5 (1.8%) from the ovaries. Ovarian cases included two ovarian teratomas, two ovarian mucinous cystadenomas, and one borderline ovarian mucinous cystadenoma. Histopathological analysis of peritoneal me-tastases further revealed two acellular mucins, two low-grade mucinous carcinoma peritonei, and one high-grade mucinous carcinoma peritonei, while immunohistochemistry revealed positive staining for CK20, CEA, Villin, and CDX2; SATB2 was also found to be partially positive in teratomas with mucinous tumors: negative in two cases and partially positive in one case. Conclusions: The occurrence of ovarian PMP is rare. Its precise diagnosis demands for a serial section of the whole appendix or suspected tissue to exclude any appen-diceal mucinous neoplasms, as well as the combination of a comprehensive analysis of its clinical signs and symptoms, imaging find-ings, surgical findings, histopathological characteristics, and immunohistochemistry.

AIM: To study medical effect of the antioxidation activity of essential oil from smell storusbill(Pelargonium graveolens,L'Her)(PLO) METHODS: Free radicals(O?_2、?OH and DPPH?)scavenging activities were investigated in different special chemical systems.Its anti-lipoperoxidantion activity was studied with MDA generation model in vitro.The effect of the hemolysis of cavy RBC induced by H_2O_2 was also studied.The components of PLO was identified by GC-FID. RESULTS: It was found that PLO showed higher anti-lipoperoxidantion on MDA generation spontaneously in homogenates of cavy heart,liver and kidney.There were significant differences on lipid peroxidant of the cavy liver homogenate induced by CCl_4 between control group and PLO.There were higher scavenging effect of the extracts of foliage on O?_2 and DPPH?PLO could strongly inhibit the hemolysis of cavy RBC induced by H_2O_2.The result of GC-FID and DPPH? scavenging activities indicated that the antioxidantion of citronellol was similar with PLO. CONCLUSION: PLO is a good antioxidation and citronellol is the main antioxidated substance in PLO.