Psoriasis is an incurable chronic inflammatory disease that requires new interventions. Here, we found that fibroblasts exacerbate psoriasis progression by promoting macrophage recruitment via CCL2 secretion by single-cell multi-omics analysis. The natural small molecule celastrol was screened to interfere with the secretion of CCL2 by fibroblasts and improve the psoriasis-like symptoms in both murine and cynomolgus monkey models. Mechanistically, celastrol directly bound to the low-density lipoprotein receptor-related protein 1 (LRP1) β-chain and abolished its binding to the transcription factor c-Jun in the nucleus, which in turn inhibited CCL2 production by skin fibroblasts, blocked fibroblast-macrophage crosstalk, and ameliorated psoriasis progression. Notably, fibroblast-specific LRP1 knockout mice exhibited a significant reduction in psoriasis like inflammation. Taken together, from clinical samples and combined with various mouse models, we revealed the pathogenesis of psoriasis from the perspective of fibroblast-macrophage crosstalk, and provided a foundation for LRP1 as a novel potential target for psoriasis treatment.

The view of youth moral cultivation clearly defines the scope of “morality” and puts forward the requirement of “cultivating morality” for the youth. This is a systematic concept aligned with the main theme of the times and is worth deeply exploring and integrating into the practice of medical ethics education for medical students. With the requirements for innovation and development in medical education， the cultivation of medical students has also been endowed with new connotations. Guided by the connotations of the view of youth moral cultivation and aligned with the objective requirements of medical students’ cultivation， this paper leveraged the core values of traditional Chinese medicine as its entry point. It also explored the realization paths of medical ethics education for medical students that reflect advantages， highlight characteristics， and maintain clear orientation through strengthening the medical ethics education of “dedicated study of medicine，” “honesty and prudence in words and deeds，” “benevolence in heart and skills，” and “doctor-patient trust and harmony，” aiming to cultivate guardians of people’s health with noble medical ethics and superb medical skills.

Objective:To investigate the temporal expression of Growth Differentiation Factor-15 (GDF15) in the serum of patients with Acute Coronary Syndrome (ACS) and explore the clinical significance of GDF15 in protecting cardiomyocytes in ACS.Methods:A retrospective study was conducted on 289 ACS patients admitted to the emergency departments from February to October 2023. Data on gender, age, troponin T (TnT), creatine kinase isoenzyme (CK-MB), GDF15, and B-type natriuretic peptide (BNP) within 30 minutes of admission were recorded. Differences in these indicators among different groups were compared. Receiver Operating Characteristic (ROC) curves were plotted to evaluate the diagnostic value of GDF15, TnT, and BNP for ACS. Among the patients, 15 exhibited a temporal expression pattern of GDF15, and their blood samples were re-measured using a GDF15 fluorescent quantitative immunochromatographic assay kit. Fifteen patients without temporal expression were randomly selected as controls, and their samples were also re-measured to exclude detection errors. Fifteen patients with temporal expression were included in the temporal expression group, and 15 without temporal expression were included in the non-temporal expression group. Laboratory indicators such as fasting blood glucose, glycated hemoglobin, triglycerides, creatinine, and uric acid were compared between the groups. Additionally, patient age, gender, body mass index (BMI), coronary angiography results, echocardiography, Gensini score, left ventricular ejection fraction (LVEF), and GRACE risk score were recorded to assess their correlation with GDF15 temporal expression. Statistical analysis was performed using SPSS 27 software, with continuous data expressed as mean ± standard deviation (Mean ± SD) and compared using t-tests and χ2 tests. Results:The overall trend in ACS patients showed a higher proportion of males than females (73.36% vs. 26.64%). The oldest group was the Unstable Angina (UA) group, with a mean age of (63.98 ± 15.19) years, while the youngest group was the non-ACS chest pain group, with a mean age of (54.29 ± 16.39) years. A higher proportion of patients in the UA, ST-segment elevation myocardial infarction (STEMI), and non-ST-segment elevation myocardial infarction (NSTEMI) groups had a history of smoking. The combination of GDF15 and TnT showed high diagnostic value for ACS, with an area under the ROC curve (AUC) of 0.843, consistent with previous studies. Among all ACS patients, 15 exhibited a temporal expression pattern of GDF15, where GDF15 levels peaked at 4 hours, gradually decreased, and peaked again at 24 hours. Patients in the temporal expression group had higher LVEF and left ventricular end-systolic diameter compared to the non-temporal expression group. The Gensini score was lower in the temporal expression group, and the GRACE risk score was significantly lower in the temporal expression group (00.7±14.72) compared to the non-temporal expression group (116.1±23.46), with a statistically significant difference ( P = 0.0115). There were no significant differences in general characteristics (age, gender, BMI) or clinical biochemical indicators (fasting blood glucose, glycated hemoglobin, triglycerides, total cholesterol, high-density lipoprotein, low-density lipoprotein, creatinine, uric acid) between the temporal and non-temporal expression groups ( P > 0.05). Conclusions:GDF15 demonstrates significant diagnostic and prognostic predictive value in ACS. Patients with temporally dynamic expression of serum GDF15 exhibit milder myocardial injury and a lower probability of mortality. These findings provide novel therapeutic targets and research directions for further exploring the role of GDF15 in ACS management.

Objective To analyze the changes of neutrophil-to-albumin ratio(NPAR),monocyte-to-lymphocyte ratio(MLR),neutrophil-to-lymphocyte ratio(NLR)and interleukin-17A(IL-17A)in patients with severe autoimmune encephalitis(AE)and the predictive value of their combined detection for prognosis.Methods A total of 105 patients with severe AE admitted from May 2021 to April 2025 were selected as the severe group.During the same period,35 patients with mild-to-moderate AE and 35 healthy controls were enrolled in a 3:1:1 ratio as the mild-to-moderate group and control group respectively.The levels of NPAR,MLR,NLR and IL-17A were compared among the three groups.Patients with severe AE were observed for one month.According to the prognosis of patients,they were divided into poor prognosis subgroup[modified Rankin scale(mRS)score≥3,n=31]and good prognosis subgroup(mRS score<3,n=74).The levels of NPAR,MLR,NLR and IL-17A in the two groups were compared,to analyze the correlation between NPAR,MLR,NLR and IL-17A levels and mRS score in patients with severe AE,and to evaluate the predictive value of combined detection of the four indicators for prognosis in these patients.Results The levels of NPAR,MLR,NLR and serum IL-17A in mild-to-moderate group and severe group were higher than those in control group,which were higher in the severe group than in the mild-to-moderate group(P<0.05).The course of disease in the poor prognosis group was longer than that in the good prognosis group,and the proportion of patients with γ-aminobutyric acid B receptor antibody and the levels of NPAR,MLR,NLR and serum IL-17A were higher than those in the good prognosis group(P<0.05).Higher levels of NPAR,MLR,NLR and serum IL-17A were all risk factors for poor prognosis of patients with severe AE(OR=2.445,4.319,2.502,1.791,P<0.05).The levels of NPAR,MLR,NLR and serum IL-17A were positively correlated with the mRS score of patients with severe AE(r=0.546,0.519,0.554,0.561,P<0.001).The area under the receiver operating characteristic(ROC)curve(AUC)of NPAR,MLR,NLR and IL-17A detected in combination in predicting the prognosis of patients with severe AE was higher than that of the four indicators detected alone(P<0.05).Conclusion The changes in NPAR,MLR,NLR and IL-17A levels in patients with AE were closely related to the severity and prognosis of the disease.In the meantime,higher levels of NPAR,MLR,NLR and serum IL-17A were risk factors for poor prognosis,and the combined detection of the four indicators could effectively improve the predictive value for prognosis in patients with severe AE.

Objective To analyze the changes of neutrophil-to-albumin ratio(NPAR),monocyte-to-lymphocyte ratio(MLR),neutrophil-to-lymphocyte ratio(NLR)and interleukin-17A(IL-17A)in patients with severe autoimmune encephalitis(AE)and the predictive value of their combined detection for prognosis.Methods A total of 105 patients with severe AE admitted from May 2021 to April 2025 were selected as the severe group.During the same period,35 patients with mild-to-moderate AE and 35 healthy controls were enrolled in a 3:1:1 ratio as the mild-to-moderate group and control group respectively.The levels of NPAR,MLR,NLR and IL-17A were compared among the three groups.Patients with severe AE were observed for one month.According to the prognosis of patients,they were divided into poor prognosis subgroup[modified Rankin scale(mRS)score≥3,n=31]and good prognosis subgroup(mRS score<3,n=74).The levels of NPAR,MLR,NLR and IL-17A in the two groups were compared,to analyze the correlation between NPAR,MLR,NLR and IL-17A levels and mRS score in patients with severe AE,and to evaluate the predictive value of combined detection of the four indicators for prognosis in these patients.Results The levels of NPAR,MLR,NLR and serum IL-17A in mild-to-moderate group and severe group were higher than those in control group,which were higher in the severe group than in the mild-to-moderate group(P<0.05).The course of disease in the poor prognosis group was longer than that in the good prognosis group,and the proportion of patients with γ-aminobutyric acid B receptor antibody and the levels of NPAR,MLR,NLR and serum IL-17A were higher than those in the good prognosis group(P<0.05).Higher levels of NPAR,MLR,NLR and serum IL-17A were all risk factors for poor prognosis of patients with severe AE(OR=2.445,4.319,2.502,1.791,P<0.05).The levels of NPAR,MLR,NLR and serum IL-17A were positively correlated with the mRS score of patients with severe AE(r=0.546,0.519,0.554,0.561,P<0.001).The area under the receiver operating characteristic(ROC)curve(AUC)of NPAR,MLR,NLR and IL-17A detected in combination in predicting the prognosis of patients with severe AE was higher than that of the four indicators detected alone(P<0.05).Conclusion The changes in NPAR,MLR,NLR and IL-17A levels in patients with AE were closely related to the severity and prognosis of the disease.In the meantime,higher levels of NPAR,MLR,NLR and serum IL-17A were risk factors for poor prognosis,and the combined detection of the four indicators could effectively improve the predictive value for prognosis in patients with severe AE.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Polycystic ovary syndrome (PCOS) is one of the most common gynaecological endocrine diseases in women and the main cause of anovulatory infertility. Compared with women with normal ovulation, PCOS patients are more likely to face ovarian hyperstimulation syndrome, poor-quality of oocyte and fertilization failure in assisted reproduction treatment, so ovulation induction in PCOS patients has attracted much attention in the reproductive field. Progestin-primed ovarian stimulation (PPOS) protocol uses exogenous progesterone effectively to block luteinizing hormone surge to achieve ideal number of retrieved oocytes, embryo quality and pregnancy outcomes. This article reviews the mechanism, clinical application and development of PPOS protocol in PCOS patients.

Polycystic ovary syndrome (PCOS) is one of the most common gynaecological endocrine diseases in women and the main cause of anovulatory infertility. Compared with women with normal ovulation, PCOS patients are more likely to face ovarian hyperstimulation syndrome, poor-quality of oocyte and fertilization failure in assisted reproduction treatment, so ovulation induction in PCOS patients has attracted much attention in the reproductive field. Progestin-primed ovarian stimulation (PPOS) protocol uses exogenous progesterone effectively to block luteinizing hormone surge to achieve ideal number of retrieved oocytes, embryo quality and pregnancy outcomes. This article reviews the mechanism, clinical application and development of PPOS protocol in PCOS patients.

Natural products, and especially the active ingredients found in traditional Chinese medicine (TCM), have a thousand-year-long history of clinical use and a strong theoretical basis in TCM. As such, traditional remedies provide shortcuts for the development of original new drugs in China, and increasing numbers of natural products are showing great therapeutic potential in various diseases. This paper reviews the molecular mechanisms of action of natural products from different sources used in the treatment of inflammatory diseases and cancer, introduces the methods and newly emerging technologies used to identify and validate the targets of natural active ingredients, enumerates the expansive list of TCM used to treat inflammatory diseases and cancer, and summarizes the patterns of action of emerging technologies such as single-cell multiomics, network pharmacology, and artificial intelligence in the pharmacological studies of natural products to provide insights for the development of innovative natural product-based drugs. Our hope is that we can make use of advances in target identification and single-cell multiomics to obtain a deeper understanding of actions of mechanisms of natural products that will allow innovation and revitalization of TCM and its swift industrialization and internationalization.