Objective We tried to investigate the effects of human umbilical cord mesenchymal stem cell exosomes(hUCMSC-Exos)on the proliferation of human dermal papilla cells(HDPCs)and the mechanism of hUCMSC-Exos promoting hair growth.Methods HDPCs were isolated using two-step enzymatic method and cul-tured in vitro.Human umbilical cord mesenchymal stem cells(hUC-MSCs)were cultured.Cell culture supernatant was collected,and exosomes were isolated and extracted using high-speed centrifugation.Electron microscopy,particle size,and surface marker identification were performed on them.Dihydrotestosterone(DHT)induces HDPCs and establishment of an androgenic alopecia cell model.Co-culture hUCMSC-Exos with HDPCs,cell proliferation experiment(EdU)was used to detect the relative activity of induced HDPCs.Real-time qPCR was used to detect the expression level of alkaline phosphatase(ALP),and Western blot was used to detect β-catenin,Wnt10b,GSK-3β expression at the protein level.Results The obtained primary HDPCs,hUC-MSCs,and hUCMSC-Exos were all conformed to the characteristics of dermal papilla cells,mesenchymal stem cells,and exosomes.The num-ber of EdU positive cells significantly increased,and exosomes could effectively promote the proliferation of HDPCs(P<0.05),enhance the vitality of HDPCs and alleviate the damage caused by DHT(P<0.05).Real-time qPCR showed that exosomes could enhance the expression level of ALP gene(P<0.05)and hair follicle induction ability.Western Blot confirmation β-catenin,Wnt10b,GSK-3β were differences in expression at the protein level(P<0.05).Conclusions HUCMSC-Exos could promote DHT induced proliferation of HDPCs,enhance their hair follicle regeneration and repair ability,and its mechanism may be related to the activation of Wnt/β-catenin signaling pathway.

Liver failure is a common clinical syndrome of severe liver disease with rapid progression and high mortality. The Guideline for diagnosis and treatment of liver failure（2024 version） was released recently，which was developed on base of the 2018 edition and the latest research progress，offering standardized protocols and evidence-based recommendations for the management of liver failure. This article interprets the key upgrates of the guideline，including the definition and diagnostic criteria，early warning and prognosis assessment of acute-on-chronic liver failure（ACLF），and the treatment of liver failure.

Liver failure is a common clinical syndrome of severe liver disease with rapid progression and high mortality. The Guideline for diagnosis and treatment of liver failure（2024 version） was released recently，which was developed on base of the 2018 edition and the latest research progress，offering standardized protocols and evidence-based recommendations for the management of liver failure. This article interprets the key upgrates of the guideline，including the definition and diagnostic criteria，early warning and prognosis assessment of acute-on-chronic liver failure（ACLF），and the treatment of liver failure.

The thalamocortical (TC) circuit is closely associated with pain processing. The hyperpolarization-activated cyclic nucleotide-gated (HCN) 2 channel is predominantly expressed in the ventral posterolateral thalamus (VPL) that has been shown to mediate neuropathic pain. However, the role of VPL HCN2 in modulating TC circuit activity is largely unknown. Here, by using optogenetics, neuronal tracing, electrophysiological recordings, and virus knockdown strategies, we showed that the activation of VPL TC neurons potentiates excitatory synaptic transmission to the hindlimb region of the primary somatosensory cortex (S1HL) as well as mechanical hypersensitivity following spared nerve injury (SNI)-induced neuropathic pain in mice. Either pharmacological blockade or virus knockdown of HCN2 (shRNA-Hcn2) in the VPL was sufficient to alleviate SNI-induced hyperalgesia. Moreover, shRNA-Hcn2 decreased the excitability of TC neurons and synaptic transmission of the VPL-S1HL circuit. Together, our studies provide a novel mechanism by which HCN2 enhances the excitability of the TC circuit to facilitate neuropathic pain.
Animals ; Mice ; Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels/genetics* ; Neuralgia ; RNA, Small Interfering ; Thalamus/metabolism* ; Up-Regulation

Objective Constructing a risk prediction model of IgA nephropathy proteinuria treated by traditional Chinese medicine based on random survival forest model,Screening prognostic risk factors of IgA nephropathy proteinuria.Methods Collecting retrospectively clinical data of 129 cases diagnosed with IgA nephropathy,randomly divided them into training set(60%)and test set(40%).The risk prediction model of IgA nephropathy proteinuria was constructed in the training set with the random survival forest model,and the prognostic risk factors were screened by VIMP method.The accuracy of risk prediction model was validated in the test set with time-dependent ROC curve(tdROC).Results According to the result of VIMP,the prognostic risk factors for IgA nephropathy proteinuria are in the order of eGFR,hypertension,traditional Chinese medicine,24 hUPRO>1 g,genomo sclerosis ratio,Lee grading,fat,hyperlipidemia,hypertrophymia,hyparmane ledmia,Anemia,age and gender.The eGFR was negatively and non-linearly associated with the risk rate of developing persistent proteinuria.Glomerulosclerosis ratio greater than 0.3 is approximately linearly and positively associated with the risk rate of persistent proteinuria.Conclusion Random survival forest model has good predictive performance in the risk prediction model of IgA nephropathy proteinuria treated by traditional Chinese medicine.This risk model can determine the result of IgA nephropathy treated by traditional Chinese medicine,and which is helpful for clinical follow-up monitoring and formulation of individualized treatment plans.

ObjectiveTo explore the mechanism of Yishen Huoxue prescription in renal interstitial fibrosis （RIF） from the perspective of endothelial cell and cell energy metabolism. MethodThe model was successfully established by unilateral ureteral obstruction （UUO）. Seventy-five SPF C57BL/6 mice were randomly divided into a model group， a resveratrol group （50 mg·kg^-1·d^-1）， three Yishen Huoxue prescription low， medium， and high-dose groups （7.1， 14.2， 28.4 g·kg^-1·d^-1）， with 15 mice in each group. In addition， another 15 mice were used to prepare sham operation model. Mice in the sham operation group and the model group were gavaged with equal volume of normal saline. All mice were sacrificed on 7， 14， and 21 d after modeling. The protein expression of platelet endothelial cell adhesion molecule 31 （CD31） was detected by immunohistochemical S-P method. The expression of α-smooth muscle actin （α-SMA）， collagen Ⅳ （Col-Ⅳ）， angiopoietin 1（Ang-1） and tyrosine kinase receptors 2 （Tie-2）， vascular endothelial growth factor （VEGF）， vascular endothelial cadherin （VE-cadherin）， and occludin in renal tissues was detected by Western blotting. The mRNA expressions of Ang-1/Tie-2， VEGF， VE-cadherin， and occludin in renal tissues were detected by Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）， and the levels of reactive oxygen species （ROS） in mice were detected by enzyme linked immunosorbent assay （ELISA）. ResultAs compared with the sham operation group， the expression of CD31 in renal tissues of the model group was significantly decreased and worsened with the extension of modeling time （P<0.05）， α-SAM and Col-Ⅳ protein expression levels were significantly increased （P<0.01）， but the expression of CD31 was stable in 14-21 d. ROS levels were significantly increased （P<0.01）， and the protein and mRNA expressions of Ang-1/Tie-2， VEGF， VE-cadherin， and occludin were significantly down-regulated （P<0.01）. As compared with the model group， the expression of CD31 was increased （P<0.05）， and α-SAM and Col-Ⅳ in the resveratrol group and the medium and high-dose Yishen Huoxue prescription groups were significantly decreased （P<0.01）. The ROS content was significantly decreased （P<0.01）， and the protein and mRNA expressions of Ang-1/Tie-2， VEGF， VE-cadherin， and occludin were up-regulated （P<0.01）， As compared with the resveratrol group， the protein expressions of Ang-1/Tie-2， VEGF， VE-cadherin， and occludin in the medium and low-dose Yishen Huoxue prescription groups were significantly different （P<0.01）. There was no significant difference in the mRNA expressions of CD31 and Ang-1/Tie-2 in the high-dose Yishen Huoxue prescription group， and no significant difference in the ROS level in the medium-dose Yishen Huoxue prescription group. ConclusionThe anti-RIF effect of Yishen Huoxue prescription may be related to promoting vascular endothelial repair， regulating mitochondrial ROS to reduce oxidative stress， protecting the integrity of renal endothelial structure， delaying cell apoptosis， and maintaining cell energy metabolism.

Objective:To investigate the diagnostic and prognostic value of D-dimer level in patients with hepatitis B-related acute-on-chronic liver failure (HBV-ACLF).Methods:A total of 142 cases diagnosed with ACLF were randomly selected as research objects in the open cohort using the Chinese Group on the Study of Severe Hepatitis B-ACLF (COSSH-ACLF). Plasma D-dimer levels were compared between patients with ACLF and non-ACLF and patients with different ACLF grades. Survival and death group D-dimer levels were compared with the end points of 28 days and 90 days, respectively. The correlation between D-dimer and other laboratory indicators and prognostic scores were investigated. Area under receiver operating characteristic curve (AUROC) was used to evaluate the D-dimer value for predicting the prognosis of ACLF patients. 125 external ACLF cases were used for validation. A Student t test or Mann-Whitney U test was used to compare continuous measurement data between two groups. Kruskal-Wallis test was used to compare continuous measurement data between multiple groups.Results:Plasma D-dimer levels in the ACLF [2 588.5 (1 142.8, 5 472.8) μg/L] ] and non-ACLF group [1 385.5 (612.0, 3 840.3) μg/L] had a significant difference ( P<0.001). ACLF-3 patients had significantly higher D-dimer levels than ACLF-1/2 patients (ACLF-3 vs. ACLF-1, P<0.001; ACLF-3 vs. ACLF-2, P<0.05). Patients who died at 28/90 days had significantly higher D-dimer levels than those whom survived ( P<0.001). There was a significant positive correlation between D-dimer level with prothrombin time (PT), international normalized ratio (INR), high-density lipoprotein C, as well as various prognostic scores (COSSH-ACLFs, CLIF-C ACLFs, CLIF-OFs, MELDs). AUROC of D-dimer in predicting the prognosis of ACLF patients at 28 days and 90 days was 0.751 (95% CI: 0.649-0.852) and 0.787 (95% CI: 0.695-0.878), respectively, which did not differ significantly compared with the predictive ability of other scores ( P<0.05), and similar results were confirmed by an external validation group of 125 cases. Conclusion:D-dimer level is significantly higher in patients with ACLF, so it is an independent predictor of prognosis at 28 and 90 days.

Ras-associated domain family 1A (RASSF1A) genes are members of the RASSF family, which bind to Ras in a guanosine triphosphate(GTP)-dependent manner and then induce Ras-mediated apoptosis. The protein encoded by the RASSF1A gene is similar to the Ras effector protein, which can interact with DNA repair protein XPA, and can also inhibit the accumulation of cyclin D1, thereby inducing cell cycle arrest. The deletion or abnormal expression of RASSF1A gene is related to the pathogenesis of various malignant tumors, indicating that it has tumor suppressor function. RASSF1A gene methylation has been found in at least 37 tumors, and RASSF1A gene may be the most frequently described methylated gene in human cancers. In this paper, the abnormal methylation of RASSF1A gene in different malignant tumors was introduced, and the research progress of its related effects and mechanisms in malignant tumors of the respiratory system, digestive system, genitourinary system, and nervous system in recent years was reviewed, with a view to malignant tumors early diagnosis, individual molecular targeted therapy and prognostic evaluation provide important guidance.

Retrospective analysis of the clinical data of a child with type 102 mental retardation caused by DDX3X gene mutation in the pediatric diagnosis of the First Affiliated Hospital of Zhengzhou University in April 2019.A 2 years and 3 months old girl with " delay for more than 1 year" , using second-generation sequencing technology for full exon detection, and the result is DDX3X gene 13 th exon c. 1463G>A hybridization mutation, this is a new mutation.There are no Chinese cases reported with DDX3X gene mutations, and there are 8 related cases were reported in foreign literature, all children have different degrees of intellectual disability.So patients with unexplained intellectual disability(especially female patients) need to be wary of the possibility of DDX3X gene mutation.

Objective: To investigate the early clinical efficacy of bone cement modified with mineralized collagen in the treatment of osteoporotic vertebral compression fractures with percutaneous vertebroplasty(PVP). Methods: All 98 cases of sin-gle vertebral osteoporotic compression fracture from June 2017 to August 2018 were studied. Forty-eight cases were treated with bone cement modified with mineralized collagen (modified group) and 50 cases were treated with traditional bone cement (traditional group). The basic clinical information including age, sex and bone mineral density of all patients were analyzed. The injectable time, volume, distribution (bone cement in the vertebra showing a whole mass without interruption or loss is known as type O while bone cement in the vertebra showing two masses with a small amount or none in the middle is known as type H) and leakage of bone cement during operation, visual analogue score(VAS), Oswestry disability index (ODI), height of anterior, middle and posterior columns of injured vertebrae and the incidence of adjacent vertebral fractures were compared between the two groups. Results: There were no significant differences in age, sex, bone mineral density T value and bone ce-ment injection volume between the two groups. VSA score, ODI, anterior and middle column heights were significantly improved on the first day and 6 months after operation (P<0.05), but there was no significant difference between the two groups (P>0.05). In-traoperative cement injectable time was shorter in the traditional group than the modified group,and there was significant different between the two groups (t=3.428, P=0.002). The incidence of adjacent vertebral re-fracture was 12% in the traditional group and 2% in the modified group. There was significant different between the two groups (χ²=7.061, P=0.029). The leakage rate of bone cement was 10% in the traditional group and 6% in the modified group, andthere was significant difference between the two groups (χ²=7.963, P=0.019). The distribution of bone cement (O/H) in the traditional group was 20/30 and that in the modified group was 19/29, and there was significant difference between the two groups (χ²=38.992, P<0.001). Conclusion Modified bone cement has the same clinical effect as traditional bone cement in relieving pain and restoring the height of injured vertebra in the treat-ment of osteoporotic vertebral compression fractures with PVP. However, the injectable time of modified bone cement is longer. The leakage rate and the incidence of re-fracture of adjacent vertebrae are significantly reduced.