Autoimmune diseases of the nervous system are a category of conditions in which a malfunction of the body's immune system leads to damage of nerve tissues, with B cells playing a critical role in their pathogenesis. Currently, the therapeutic approaches used in clinical practice (such as monoclonal antibodies targeting B cells) can effectively control the progression of these diseases, but fail to achieve a radical cure. Chimeric antigen receptor (CAR)-T cell therapy uses genetic engineering to modify T cells derived from either patients or donors, enabling them to specifically target and durably eliminate peripheral B cells, which might remit or even functionally cure these diseases. Currently, multiple clinical studies on efficacy and safety of CAR-T cell therapy in neurological autoimmune diseases have been carried out successively, and initial results have been achieved. This article reviews the clinical research progress in this field, discusses its application prospects and challenges, aiming to provide some references for in-depth research in this area.

Objective To investigate the correlations of CALLY index in early pregnancy with the onset and severity of preeclampsia.Methods A total of 987 pregnant women were prospectively en-rolled as study subjects,with 42 lost during follow-up,resulting in a final inclusion of 945 subjects.Based on the occurrence and severity of preeclampsia during follow-up,the pregnant women were di-vided into preeclampsia group(n=47),severe preeclampsia group(n=49),and normal group(n=849).General information and laboratory test results were collected from all pregnant women,and the CALLY index was calculated.The Pearson correlation analysis was used to explore the correlation be-tween CALLY index and severity of preeclampsia(mean arterial pressure);the receiver operating characteristic(ROC)curve was plotted to analyze the predictive efficacy of each indicator for pre-eclampsia;Cox regression analysis was used to explore the influencing factors for the onset of preeclamp-sia.Results The mean arterial pressure and 24-hour urine protein levels were higher in the severe pre-eclampsia group than those in the preeclampsia group and normal group,and higher in the preeclampsia group than those in the normal group(P＜0.05).The CALLY index was lower in the severe preeclamp-sia group than in the preeclampsia group and normal group,and lower in the preeclampsia group than in the normal group(P＜0.05).Pearson correlation analysis showed a negative correlation between CALLY index and mean arterial pressure(r=-0.571,P＜0.001).The ROC curve showed that the area under the curve(AUC)of CALLY index for predicting preeclampsia was 0.941(95％CI,0.900 to 0.981).Multivariate Cox regression analysis showed that an increased CALLY index was an independent protective factor for the onset of preeclampsia(HR=0.185,95％CI,0.092 to 0.374,P＜0.001).Conclusion The CALLY index is negatively correlated with the severity of preeclampsia and is an independent influencing factor for the onset of preeclampsia,which can be used as an auxiliary indicator to assess the onset and severity of preeclampsia in pregnant women.

Autoimmune diseases of the nervous system are a category of conditions in which a malfunction of the body's immune system leads to damage of nerve tissues, with B cells playing a critical role in their pathogenesis. Currently, the therapeutic approaches used in clinical practice (such as monoclonal antibodies targeting B cells) can effectively control the progression of these diseases, but fail to achieve a radical cure. Chimeric antigen receptor (CAR)-T cell therapy uses genetic engineering to modify T cells derived from either patients or donors, enabling them to specifically target and durably eliminate peripheral B cells, which might remit or even functionally cure these diseases. Currently, multiple clinical studies on efficacy and safety of CAR-T cell therapy in neurological autoimmune diseases have been carried out successively, and initial results have been achieved. This article reviews the clinical research progress in this field, discusses its application prospects and challenges, aiming to provide some references for in-depth research in this area.

Objective:To explore the interaction effects on brain activity between the smoking addiction and weight status by resting-state functional magnetic resonance imaging.Methods:Retrospective analysis of clinical data and resting-state functional magnetic resonance imaging data were analyzed from 99 recruited subjects from January 2019 to December 2021. All participants were divided into four groups: overweight smokers ( n=24), normal-weight smokers ( n=28), overweight non-smokers ( n=19), and normal weight non-smokers ( n=28). Calculate regional homogeneity (ReHo) to reflect the internal brain activity of the subjects. Two-way ANOVA was used to detect the interaction effects between smoking addiction and overweight on ReHo by SPM12 software, correcting for age, years of education and head motion. Results:The interaction effect between smoking addiction and overweight on ReHo was significant in right superior frontal gyrus(x, y, z=15, 9, 60)(GRF corrected, Pvoxel<0.005, Pcluster<0.05). The ReHo value in the right superior frontal gyrus of overweight smokers was significantly higher than that of normal weight smokers ( t=3.768, P<0.001, Bonferroni corrected). The ReHo values in the right superior frontal gyrus of overweight non-smokers were significantly lower than those of normal weight non-smokers ( t=-3.242, P=0.002, Bonferroni corrected). The ReHo values in the right superior frontal gyurs of normal-weight smokers were significantly lower than those of normal weight non-smokers( t=-3.540, P=0.001, Bonferroni corrected). The ReHo values in the right superior frontal gyrus of overweight smokers were significantly higher than those of overweight non-smokers ( t=3.392, P=0.002, Bonferroni corrected). Correlation analyses showed that the strengthen ReHo value in right superior frontal gyrus was positively associated with pack-year in smoking addicts( r=0.387, P=0.007, Bonferroni corrected). Conclusion:Smoking addiction and overweight have an antagonistic effect on brain activity in the right superior frontal gyrus, which may provide potential therapeutic targets for individuals with comorbidity of smoking addiction and overweight.

Objective:To investigate the correlation between brain gray matter volume (GMV) and interactive effects of smoking addiction and overweight.Methods:We retrospectively analyzed the clinical data and resting-state functional magnetic resonance imaging data of 99 subjects recruited from January 2019 to December 2021 through online platforms such as WeChat, including the following four groups: overweight smoking addiction group ( n=24), normal-weight smoking addiction group ( n=28), overweight non-smoking group ( n=19), and normal-weight non-smoking group ( n=28). All subjects underwent 3.0T MRI. We used voxel-based morphometry (VBM) to compare gray matter volume (GMV) among the four groups. A two-way analysis of variance was conducted with age, years of education, and head motion as covariates to explore the interaction effects between smoking addiction and weight status on GMV, the main effect of smoking addiction and main effect of overweight, which were then correlated with clinical data. Results:Significant interactive effects of smoking addiction and overweight were observed in the left dorsolateral prefrontal cortex (DLPFC) (GRF corrected, voxel-level P<0.001, cluster-level P<0.05). Correlation analysis showed a quadratic effect between body mass index and left DLPFC GMV (β=-3.846, t=-2.134, P=0.036). Additionally, the main effect of smoking addiction was primarily manifested in the bilateral orbitofrontal cortex (OFC)(GRF corrected, P voxel<0.001, P cluster<0.05). Left OFC GMV was negatively associated with the FTND (Fagerstrom Test of Nicotine Dependence) scores ( r=-0.391, P=0.006). And right OFC GMV was negatively correlated with the smoking index ( r=-0.335, P=0.019). No statistically significant main effect of overweight was found at the aforementioned threshold. Conclusion:Smoking addiction and overweight have antagonistic effects on left DLPFC GMV.

Objective:This study aims to investigate the dynamic patterns of intrinsic neural activity and their relationships with Internet Addiction Test (IAT) scores in individuals with internet gaming disorder (IGD).Methods:Resting state functional magnetic resonance imaging (fMRI) scanning was performed on 33 individuals with IGD (IGD group) who were admitted to the psychiatric department of First Affiliated Hospital of Zhengzhou University and 40 healthy volunteers (control group) recruited through the online platform. The dynamic regional homogeneity (dReHo) values were calculated. The two-sample t test was used to analyze the differences of dReHo values between two groups (Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). Spearman correlation analyses were used to analyze the correlations between IAT scores and dReHo values of brain regions with statistically significant differences between IGD group and control group. Results:Compared with the control group, the IGD group showed increased dReHo values in the right thalamus, right caudate nucleus, left putamen, bilateral medial superior frontal gyrus, bilateral supplementary motor area, and bilateral superior frontal gyrus ( t=3.84-4.94, Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). The dReHo value in the right medial superior frontal gyrus was positively correlated with IAT scores ( r=0.395, P=0.023) in IGD group. Conclusion:Individuals with IGD exhibited a wide range of abnormal dynamic patterns of intrinsic neural activity in pivotal regions associated with reward processing and cognitive control functions (the fronto-striato-thalamic circuit), providing new insights into the underlying neural mechanisms of IGD.

Objective:To investigate the correlation between brain gray matter volume (GMV) and interactive effects of smoking addiction and overweight.Methods:We retrospectively analyzed the clinical data and resting-state functional magnetic resonance imaging data of 99 subjects recruited from January 2019 to December 2021 through online platforms such as WeChat, including the following four groups: overweight smoking addiction group ( n=24), normal-weight smoking addiction group ( n=28), overweight non-smoking group ( n=19), and normal-weight non-smoking group ( n=28). All subjects underwent 3.0T MRI. We used voxel-based morphometry (VBM) to compare gray matter volume (GMV) among the four groups. A two-way analysis of variance was conducted with age, years of education, and head motion as covariates to explore the interaction effects between smoking addiction and weight status on GMV, the main effect of smoking addiction and main effect of overweight, which were then correlated with clinical data. Results:Significant interactive effects of smoking addiction and overweight were observed in the left dorsolateral prefrontal cortex (DLPFC) (GRF corrected, voxel-level P<0.001, cluster-level P<0.05). Correlation analysis showed a quadratic effect between body mass index and left DLPFC GMV (β=-3.846, t=-2.134, P=0.036). Additionally, the main effect of smoking addiction was primarily manifested in the bilateral orbitofrontal cortex (OFC)(GRF corrected, P voxel<0.001, P cluster<0.05). Left OFC GMV was negatively associated with the FTND (Fagerstrom Test of Nicotine Dependence) scores ( r=-0.391, P=0.006). And right OFC GMV was negatively correlated with the smoking index ( r=-0.335, P=0.019). No statistically significant main effect of overweight was found at the aforementioned threshold. Conclusion:Smoking addiction and overweight have antagonistic effects on left DLPFC GMV.

Objective:This study aims to investigate the dynamic patterns of intrinsic neural activity and their relationships with Internet Addiction Test (IAT) scores in individuals with internet gaming disorder (IGD).Methods:Resting state functional magnetic resonance imaging (fMRI) scanning was performed on 33 individuals with IGD (IGD group) who were admitted to the psychiatric department of First Affiliated Hospital of Zhengzhou University and 40 healthy volunteers (control group) recruited through the online platform. The dynamic regional homogeneity (dReHo) values were calculated. The two-sample t test was used to analyze the differences of dReHo values between two groups (Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). Spearman correlation analyses were used to analyze the correlations between IAT scores and dReHo values of brain regions with statistically significant differences between IGD group and control group. Results:Compared with the control group, the IGD group showed increased dReHo values in the right thalamus, right caudate nucleus, left putamen, bilateral medial superior frontal gyrus, bilateral supplementary motor area, and bilateral superior frontal gyrus ( t=3.84-4.94, Gaussian random field corrected, voxel level P<0.001, cluster level P<0.05). The dReHo value in the right medial superior frontal gyrus was positively correlated with IAT scores ( r=0.395, P=0.023) in IGD group. Conclusion:Individuals with IGD exhibited a wide range of abnormal dynamic patterns of intrinsic neural activity in pivotal regions associated with reward processing and cognitive control functions (the fronto-striato-thalamic circuit), providing new insights into the underlying neural mechanisms of IGD.

Remote pharmaceutical care refers to the process that pharmacists provide pharmaceutical care to patients remotely through information technology. Remote pharmaceutical care in China starts late and develops slowly. Therefore ，this paper discusses the pharmaceutical care modes that pharmacists at home and abroad can provide under the remote mode by collecting literature. The results show that foreign remote pharmaceutical care starts early and is relatively mature. The service mainly included remote follow-up and intervention ，24-hour online prescription and order review ，24-hour online drug reorganization ，and guidance on rational drug use in remote areas or community hospitals. The service population covers patients with cardiovascular disease ， diabetes，asthma，AIDS and so on. Some hospitals have established an integrated pharmaceutical care system of “Internet+Medical Consortium”in China ，with which pharmacists can provide patients with pharmaceutical care such as remote follow-up and intervention，drug consultation and so on. With the promotion of telemedicine ，domestic pharmacists can gradually expand the scope of services ，expand pharmaceutical services such as remote consultation and remote popular science push ，and realize the sharing of high-quality pharmaceutical care for the whole people.

Lipedema is secondary to local fat deposition, a disease characterized by the symmetric thickening of lower limbs, mostly occurs in women, especially in adolescence and pregnancy. In its early stage, it could be easily confused with lymphedema. Extensive literature review on primary fat edema in recent years, as well as a summary of the clinical symptoms and signs and diagnosis and treatment of lipedema were conducted, so as to provide a useful reference for clinicians.