Ankylosing spondylitis is a chronic immunoinflammatory disease that mainly affects the spine and the sacroiliac joint， the mechanism of which is closely related to signaling pathways， such as osteoprotegerin （OPG）/receptor activator of nuclear factor-κB （RANK）/RANK ligand， mitogen-activated protein kinase （MAPK）， Wnt/β-catenin （β-catenin）， phosphoinositide 3- kinase/protein kinase B/mammalian target of rapamycin （PI3K/Akt/mTOR）. Traditional Chinese medicine has the characteristics of multiple components and targets， and is widely used for the treatment of autoimmune diseases due to its low toxicity， strong specificity， and high efficacy. This review found that monomers and compounds of traditional Chinese medicine can exert anti ankylosing spondylitis effects by intervening in the aforementioned signaling pathways， regulating immune inflammatory responses， and inhibiting biological processes such as bone destruction， ectopic osteogenic differentiation， cell apoptosis， and autophagy.

[Objective] To analyze the loss rate of platelet donors and evaluate the strategies for establishing a platelet donor bank. [Methods] A total of 1 443 donors who joined the HLA and HPA gene donor bank for platelets in Henan Province from 2018 to 2020 were included in this study. Data on the total number of apheresis platelet donations, annual donation frequency, age at enrollment, donation habits (including the number of platelets donated per session and whether they had previously donated whole blood), and enrollment location were collected from the platelet donor information management system. Donor loss was determined based on the date of their last donation. The loss rates of different groups under various conditions were compared to assess the enrollment strategies. [Results] By the time the platelet bank was officially operational in 2022, 421 donors had been lost, resulting in an loss rate of 29% (421/1 443). By the end of 2023, the overall cumulative loss rate reached 52% (746/1 443). The loss rate was lower than the overall level in groups meeting any of the following conditions: total apheresis platelet donations exceeding 50, annual donation frequency of 10 or more, age at enrollment of 40 years or older, donation of more than a single therapeutic dose per session, or a history of whole blood donation two or more times. Additionally, loss rates varied across different enrollment locations, with higher enrollment numbers generally associated with higher loss rates. [Conclusion] Through a comprehensive analysis of donor loss, our center has adjusted its strategies for establishing the donor pool. These findings also provide valuable insights for other blood collection and supply institutions in building platelet donor banks.

ObjectiveTo investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps. MethodsA retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications. ResultsBoth the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed. ConclusionOral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.

AIM:To investigate the relationship between the level of monocyte chemoattractant protein-1(MCP-1)in the aqueous humor and macular microcirculation in patients with macular edema secondary to retinal vein occlusion(RVO-ME).METHODS:A total of 327 patients(327 eyes)with RVO-ME treated in our hospital from July 2022 to July 2024 were selected as the research objects. According to the recurrence or not, they were divided into non-recurrence group(291 cases, 291 eyes)and recurrence group(36 cases, 36 eyes). The clinical data, macular microcirculation index and MCP-1 level were collected. Unordered multinomial Logistic regression was used to analyze the effect of MCP-1 on RVO-ME recurrence after excluding the influence of other factors. Cubic spline was used to analyze the dose-response relationship between macular microcirculation indexes and MCP-1 expression level and RVO-ME recurrence. Multiple linear regression was used to analyze the relationship between macular microcirculation parameters and MCP-1 expression level, and the difference of MCP-1 expression level in recurrence under different macular microcirculation parameters was analyzed. Bootstrap method was used to test the mediating effect of macular microcirculation indexes on MCP-1 expression level and RVO-ME recurrence.RESULTS: The course of ME, the incidence of vitreomacular traction(VMT), the incidence of fibrous membrane epiretinal membrane(ERM), best corrected visual acuity(BCVA), hyperreflective foci in the inner and outer retinal layers(HRF), the frequency and dose of anti-vascular endothelial growth factor(VEGF)injection in the recurrence group were significantly higher than those in the non-recurrence group(all P<0.05). The external limiting membrane(ELM)integrity and ellipsoid zone(EZ)integrity in the recurrence group were significantly worse than those in the non-recurrence group(all P<0.05). The central foveal thickness(CFT), central macular thickness(CMT), superficial capillary plexus(SCP)vascular density, deep capillary plexus(DCP)vascular density and MCP-1 in the recurrence group were higher than those in the non-recurrence group(all P<0.05), and the foveal avascular zone(FAZ)area was lower than that in the non-recurrence group(P<0.05). Logistic analysis showed that MCP-1 was a risk factor for RVO-ME recurrence before and after adjusting for confounding factors. There was a significant non-linear dose-response relationship between macular microcirculation indexes and MCP-1 expression and the risk of RVO-ME recurrence(non-linear test, all P<0.001). The vascular density of CFT, CMT, SCP and DCP was positively correlated with the expression level of MCP-1(all P<0.05), while the FAZ was negatively correlated with MCP-1 expression level(P<0.05). With the increase of vessel density in CFT, CMT, SCP and DCP, and the decrease of FAZ, the expression level of MCP-1 increased, and the risk of RVO-ME recurrence showed an upward trend. The proportion of MCP-1 in Q3(>28.47 pg/mL)group was the highest(P<0.05). Macular microcirculation parameters play a mediating effect between MCP-1 expression level and RVO-ME recurrence.CONCLUSION: The level of MCP-1 in aqueous humor is positively correlated with RVO-ME recurrence, and it is closely related to macular microcirculation. Macular microcirculation has a mediating effect between MCP-1 level and RVO-ME recurrence.

OBJECTIVE To investigate the efficacy and safety of tirofiban for early neurological deterioration in patients with acute ischemic stroke. METHODS A total of 126 patients with early neurological deterioration of acute ischemic stroke who were admitted to the Department of Neurology， Heji Hospital Affiliated to Changzhi Medical College from January 2022 to December 2023 were selected and divided into observation group and control group according to random number table method， with 63 cases in each group. All patients received standardized treatment such as lipid-lowering and blood pressure-lowering therapy. Based on the standard treatment， patients in the control group additionally took Aspirin enteric-coated tablets 100 mg+Clopidogrel bisulfate tablets 75 mg orally （once a day， for 14 consecutive days）. The patients in the observation group received Tirofiban hydrochloride and sodium chloride injection based on the standardized treatment [first intravenous infusion of 0.40 μg/（kg·min） for 30 min， and then continuous intravenous infusion of 0.10 μg/（kg·min） for 47.5 h]； subsequently， patients were given Aspirin enteric-coated tablets （100 mg） and Clopidogrel bisulfate tablets （75 mg） once a day for 14 consecutive days. The clinical efficacy， the National Institutes of Health Stroke Scale （NIHSS） score， modified Rankin Scale （mRS） score， and hemorheological indexes before and after treatment were compared between the two groups， and the adverse reactions were recorded. RESULTS The total effective rate （87.30%） of the observation group was significantly higher than that of the control group （71.43%） （P＜0.05）. NIHSS scores of the two groups at 1st， 7th and 14th day after treatment， the mRS score at 90th day after treatment， and the platelet aggregation rate， whole blood viscosity， plasma viscosity and fibrinogen at 14th day after treatment were significantly lower than those before treatment in the same group， and the observation group was significantly lower than the control group at the same period （P＜0.05）. The total incidences of adverse reactions such as nausea， headache， fever， gastrointestinal bleeding， oral and nasal mucosal bleeding and thrombocytopenia in both groups of patients were 28.57% respectively， with no statistically significant difference （P＞0.05）. CONCLUSIONS For patients with early neurological deterioration in acute ischemic stroke， the addition of tirofiban can accelerate the recovery of neurological function， improve blood hyperviscosity and platelet aggregation， and improve the prognosis of patients with good safety.

Retinal vein occlusion(RVO), the second most prevalent retinal vascular disease, has complex pathophysiological mechanism. Except for mechanical pressure on blood vessel, inflammation and endothelin have been confirmed to be involved in the pathogenesis of RVO. However, its specific mechanism remains unclear. Hypertension, diabetes and dyslipidemia have been previously shown to be the most common risk factors in elder population, while recent studies found that coagulation and hemorheological abnormalities are more common in people under 50 years old. Ocular risk factors including glaucoma, high corrected intraocular pressure and retinal vessels abnormality, have gained more and more attention. These factors probably exert a synergistic effect when present simultaneously in the same patient. Therefore, early identification and intervention of those factors could lower the incidence of RVO. This article aims to review recent research and summarize existing mechanism and theories, giving some new research ideas for potential therapy targets and providing references for identification and management of risk factors.

BACKGROUND:The repair and clinical outcome of bone defects remains a hot and difficult area of clinical research,which is a common problem that plagues clinicians.Constructing suitable,reproducible and infinitely close to clinical animal experimental models and their scientific evaluation are essential for further clinical treatment of related diseases. OBJECTIVE:To retrospectively analyze the preparation methods and characteristics of common animal models of femoral bone defects and to assess their strengths and weaknesses,thereby providing some reference for relevant researchers to select appropriate animal models of femoral bone defects. METHODS:PubMed,Web of Science,Medline,and CNKI were retrieved for relevant literature published from January 1,2000 to August 1,2022.The keywords were"bone defect,bone,bones,defect,defects,defective,animal model,animal,model,laboratory,laboratory animal,animal laboratory"in English and"bone defect,animal model,experiment"in Chinese. RESULTS AND CONCLUSION:Twenty-seven randomized controlled animal experiments involving rats,mice,New Zealand rabbits,and sheep were included,analyzed and assessed.The most common types of bone defects were cylindrical bone defects and segmental osteotomy bone defects,generally found in the middle and distal femur.These models are mostly used to evaluate the effects of bone repair materials,drugs,drug-loaded active substances and physical therapy on bone defect repair and explore defect healing mechanisms,particularly the weight-bearing bone defect repair mechanism.Different defect kinds and femoral bone defect ranges have been found in different animal experiments.Researchers can select the suitable animal model and bone defect type based on the goal of the experiment and then set an acceptable bone defect value.Current studies have shown that cylindrical and segmental osteotomy-induced bone defects,mainly in the distal and middle femur,are mostly used in the animal models of femoral bone defects and that the surgical methods and postoperative management are more mature and operable to provide mature experimental animal models.In terms of cylindrical bone defects,rats and New Zealand rabbits are more suitable,whereas segmental osteotomy has no special requirements and all types of animals can meet the experimental requirements.

BACKGROUND:Lower limb peri-knee muscle strength training and neuromuscular electrical stimulation are generally safe and effective rehabilitation methods for patellofemoral joint pain,but the mechanism of their intervention is still unclear. OBJECTIVE:To determine the effect of muscle strength training combined with neuromuscular electrical stimulation on pain,lower extremity function and biomechanical characteristics in patients with patellofemoral pain. METHODS:Thirty-seven patients with patellofemoral pain were randomly divided into muscle strength training combined with electrical stimulation group(trial group,n=19)and muscle strength training group(control group,n=18).Both groups underwent intervention training for 6 weeks,three times a week.The visual analog scale and anterior knee pain scale were used to evaluate the pain level and functional level of the knee.Kinematic and kinetics data during running were collected by using an infrared motion capture system and a three-dimensional force platform simultaneously.A two-way analysis of variance with repeated measures(group*time)was applied to analyze the data. RESULTS AND CONCLUSION:(1)After the intervention,the visual analog scale scores of the trial group and the control group were significantly decreased(P<0.001),and the anterior knee pain scale scores were significantly increased(Ptrial group<0.001,Pcontrol group=0.001)in the trial group and control group.The anterior knee pain scale scores of the trial group were significantly higher compared to the control group after the intervention(P=0.001).(2)The peak knee flexion angle(P=0.011),peak knee extension moment(P<0.001),the peak knee internal rotation moment(P=0.008),the peak patellofemoral stress(P<0.001)and the peak patellofemoral contact force(P<0.001)were significantly decreased in the trial and control groups during running after the intervention compared with those before the intervention.(3)In conclusion,both muscle strength training and muscle strength training combined with electrical stimulation training are helpful to improve the subjective pain and lower limb function of patellofemoral pain patients,enhance the movement pattern during running and reduce the stress of the patellofemoral joint.Compared with muscle strength training alone,muscle strength training combined with electrical stimulation can improve lower limb function more significantly.

【Objective】 To study and compare the effects of different storage temperature and time on coagulation factor after cryoprecipitated antihemophilic factor(CAF) melting, and to provide reference for the establishment of industry standards. 【Methods】 From June 2021 to May 2023, a total of 96 bags of CAF were sampled in 4 bags per month, and timely detected in the same month. After the CAF was melted in a 37℃ water bath, the mild to moderate lipemic blood was labeled. Each bag of CAF and two 50 mL transfer bags were divided into two bags and two groups of 20 mL each using a sterile adapter. One group was placed in a 4℃ refrigerator and the other in a 22℃ water bath for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h. Then 2 mL of aseptic sample was taken separately and put into the test tube, and 1mL of sample and 3 mL of buffer were added into the other test tube with the sampling gun and mixed on the machine for testing. The experimental data of 60 bags without mild to moderate lipemic blood cryoprecipitation and coagulation factor were randomly selected and statistically analyzed by SPSS21.0. 【Results】 After melting, CAF was stored for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h to detect the average content and growth rate of coagulation factor in the two groups: 1) Storage at 4℃, factor Ⅷ content was 118.62, 111.57(-5.95%), 105.51(-11.05%), 103.30(-12.92%), 94.35(-20.46%) and 83.25(-29.82%) IU/ bag, respectively; Storage at 22℃, the factor Ⅷ content was 118.62, 112.69(-5.00%), 111.41(-6.08%), 109.01(-8.10%), 101.55(-14.39%) and 92.75(-21.81%) IU/ bag, and the storage results of the two groups were compared. At 24 h at 4℃ and 48 h at 22℃, the content of factor Ⅷ had significant statistical significance(P<0.01), and when stored at 22℃, the decay rate of factor Ⅷ was slower; 2) When stored at 4℃, the content of factor V was 41.19, 41.31(0.29%), 40.52(-1.64%), 40.27(-2.23%), 39.05(-5.19%) and 36.99(-10.21%) IU/ bag, respectively; Stored at 22℃, the factor V content was 41.19, 41.71(1.25%), 42.54(3.28%), 41.94(1.80%), 39.21(-4.80%) and 35.64(-13.48%) IU/ bag, respectively. Comparison of storage results between the two groups showed that the content of factor V was statistically significant(P<0.05) and significantly significant(P<0.01) at 4℃48 h and 22℃48 h, respectively, and the decay rate of factor V was faster when stored at 22℃; 3) When stored at 4℃, the Fbg content was 268.86, 268.17(-0.26%), 262.46(-2.38%), 270.50(0.61%), 267.52(-0.50%) and 261.92(-2.58%) mg/ bag, respectively; Stored at 22℃, the Fbg content was 268.86, 265.86(-1.12%), 264.12(-1.77%), 265.89(-1.11%), 266.04(-1.05%) and 261.04(-2.91%) mg/ bag, respectively. There was no statistical significance between the 2 groups and the original 0 h content in each time period(P>0.05). 【Conclusion】 After CAF melting, coagulation factor decreased with the extension of storage time, especially the decrease of factor Ⅷ, followed by factor V, while Fbg basically unchanged. Comparison between the two groups showed that, factor Ⅷ decay rate is slower, factor V decay rate is faster of storage at 22℃. CAF should be transfused as soon as possible after melting. If the delay is unavoidable, for the delay time less than 12 h, storage at 4℃ is recommended, fot the delay time more than 12 h and less than 24 h, storage at 22℃ is recommended.

Objective:To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on learning-memory and the expression of synaptic plasticity proteins in hippocampus of rats with post-stroke sleep deprivation.Methods:A total of 28 SPF grade healthy male Wistar rats with 8-week old were randomly divided into four groups (control group, sham operation group, model group and rTMS group) according to random number table method, with 7 rats in each group. The rats in the model group and the rTMS group were treated with middle cerebral artery occlusion and p-chlorophenylalanine intraperitoneal injection to establish the post-stroke sleep deprivation model. The rats in the rTMS group were treated with rTMS intervention for consecutive 14 days after modeling. The rats in the sham operation group were only separated arteries but not ligated and inserted. The rats in control group were fed normally. The open field test (OFT) was used to observe the autonomous behavior of rats.The water maze test(WMT) was used to observe the spatial learning and memory ability of rats.The content of tyrosine kinase receptor type B(TrkB) in hippocampus was detected by Western blot.The expressions of brain-derived neurotrophic factor(BDNF) and immediate early gene c-fos in hippocampus were detected by immunofluorescence.The morphology and structure of neurons in hippocampus were observed by optical microscopy and transmission electron microscopy. SPSS 21.0 software was used for statistical analysis, and repeated measurement ANOVA was used for the escape latency data, one-way ANOVA was used for the comparison of other data among multiple groups, and LSD test was used for further pairwise comparison.Results:(1) The OFT results showed that there were statistical differences in the numbers of crossing squares, upright times and total points of rats in the four groups after intervention ( F=27.638, 10.425, 30.690, all P<0.001). The numbers of crossing squares ((72.71±10.10)), upright times ((6.57±0.87)times) and total points ((79.29±10.03) points) of rats in rTMS group were all higher than those in model group after intervention ((43.71±6.96), (3.43±0.65)times, (47.14±6.82)points) (all P<0.05). As for the escape latency of WMT among the four groups of rats, the interaction effect was not significant( F=1.108, P=0.37), and the time main effect( Ftime=27.295, Ptime<0.01) and group main effect ( Fgroup=8.691, Pgroup<0.01) were significant after rTMS intervention.On the 3rd and 4th day, the escape latency of rTMS group rats was lower than that of the model group (both P<0.01). There were statistically significant differences in the numbers of crossing platform, swimming distance and residence time in target quadrant of rats in the four groups after intervention( F=8.569, 3.308, 3.547, all P<0.05). The numbers of crossing platform ((2.00±0.31)times), swimming distance in target quadrant ((196.95±24.57) cm) and residence time ((17.72±1.36)s) of rats in rTMS group were all higher than those in model group after intervention ((1.57±0.30)times, (146.61±4.79) cm, (13.58±0.98)s)(all P<0.05). (2)Optical microscopy and transmission electron microscopy showed that the hippocampal cells arranged irregularly, the organelles' integrity was destroyed in the model group compared with the normal control group. In rTMS group the arrangement and structure of nerve cells in the hippocampus were improved after rTMS intervention. (3) The immunofluorescence results showed that c-fos (1.49±0.09) and BDNF (0.84±0.06) in the hippocampus of rats in rTMS group were both higher than those in model group ((1.24±0.12), (0.48±0.08))(both P<0.05). The Western blot results showed that the expression level of TrkB (1.81±0.03) in the hippocampus of rats in rTMS group was higher than that in model group (0.96±0.02) ( P<0.05). Conclusion:The rTMS can improve the learning-memory ability and autonomous capacity of rats with post-stroke sleep deprivation, which may be related to promoting the expression of c-fos, BDNF and TrkB in hippocampus tissue.