BACKGROUND:A large number of studies have demonstrated that stem cell exosomes play an important role in the repair of bone defects,either directly as carriers for loading other small molecules or surface modifications,or by binding to biomaterials to promote the repair and regeneration of bone tissue.OBJECTIVE:To summarize the osteogenic mechanisms of stem cell exosomes from different sources and their research progress in bone defect repair.METHODS:Chinese search terms"stem cell,exosome,bone,biomaterial,carrier,bioceramic,polymer,metal,hydrogel,engineered exosome"were used to search CNKI.English search terms"stem cell,exosome,bone defect,biomaterial,carrier,bioceramic,ploymer,metal material,hydrogel,engineering exosome"were used to search PubMed database.According to the inclusion and exclusion criteria,77 relevant articles were finally included for summary.RESULTS AND CONCLUSION:Exosomes from stem cells of different origins can promote osteoblast proliferation and differentiation,promote angiogenesis,and regulate osteoclast activity and macrophage phenotype to promote bone formation and bone mineralization.In addition,many achievements of exosomes in the field of bone defect repair were described from two aspects:biomaterial-assisted exosomes and engineered exosomes.However,the current research on stem cell exosomes in bone tissue engineering is still insufficient,and most of these studies are limited to small animal models,while the treatment of bone defects in large animals,including humans,will be more complex,which will also become a major challenge for the treatment of bone defects.This will also be a great challenge in the dissemination of exosome therapy.

Functional dyspepsia （FD） is a prioritized disease category where traditional Chinese medicine （TCM） demonstrates distinct therapeutic advantages. The current western medicine treatment for FD is mainly based on proton pump inhibitors and prokinetic agents， with digestive enzymes， probiotics and antidepressants serving as adjuvant medication， yet such therapies still have certain limitations. TCM treatment for FD includes oral administration of Chinese herbal formulas and Chinese patent medicines， as well as external TCM therapies such as acupuncture and moxibustion， acupoint application， hot medicinal compress therapy， rubbing with ointment， medicinal iontophoresis， auricular acupoint therapy and tui na （Chinese medical massage）. The combined treatment of FD with integrated TCM and western medicine can significantly improve clinical effectiveness and reduce adverse reactions. The common mechanisms underlying the therapeutic effects of both TCM and western medicine revolve around the core pathological processes of FD， mainly focusing on restoring gastrointestinal motility， regulating the levels of brain-gut peptides， modulating intestinal microecology， and ameliorating inflammatory status. The differential mechanisms lie in the precise targeting feature of western medicine versus the holistic-regulating and multi-target characteristics of TCM， and the two approaches exert a synergistic effect to enhance efficacy. This paper proposes to leverage the advantages of TCM in holistic regulation and the strengths of western medicine in targeted treatment， so as to provide personalized and comprehensive treatment regimens for FD patients.

Objective To explore the potential molecular mechanism of Sangma Xingbei Tang （SMXBT） in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. Methods TCMSP and TCMID databases were searched for the active ingredients of SMXBT, the targets of the active ingredients were predicted by SwissTargetPrediction database, and the AECOPD-related targets were searched by GeneCards and OMIM databases; the drug-active ingredient-target network and protein interaction network were constructed, and the GO enrichment and KEGG pathway enrichment were analyzed by the DAVID database. The drug-active ingredient-target network and protein interaction network were constructed, and the GO enrichment and KEGG pathway enrichment were analyzed by DAVID database, and molecular docking was performed by AutoDock Tools software. Animal experiments were conducted for validation. Results 192 active ingredients were obtained and 1066 targets were predicted in SMXBT. Network analysis showed that the top 3 active ingredients in SMXBT were quercetin, kaempferol, and glycyrrhizin, and the top 3 therapeutic targets were TNF, ALB, and IL-1β, etc. The GO analysis and KEGG showed that the main pathways were the cancer pathway, the MAPK signaling pathway, and the PI3K-Akt signaling pathway. Molecular docking showed that the binding energies of glycyrrhizin and AKT1, IL-1β, GFR, SRC, and quercetin and kaempferol and IL-1β were all <−5 kcal·mol. Animal experiments showed that Sangma Xingbei Decoction could treat AECOPD by anti-inflammatory effects and reduce changes in lung tissue structure. Additionally, it could lower the serum inflammatory levels of TNF-α, IL-6, and IL-8. Conclusion SMXBT may act on the targets of AKT1, IL-1β, EGFR, SRC, etc., reduce the serum inflammation levels of TNF-α, IL-6, IL-8, and improve the lung tissue structure and inflammatory response to achieve the therapeutic effect on AECOPD through the modulation of the PI3K/Akt signaling pathway, the MAPK signaling pathway, the cancer pathway, and other pathways of action.

BACKGROUND:A large number of studies have demonstrated that stem cell exosomes play an important role in the repair of bone defects,either directly as carriers for loading other small molecules or surface modifications,or by binding to biomaterials to promote the repair and regeneration of bone tissue.OBJECTIVE:To summarize the osteogenic mechanisms of stem cell exosomes from different sources and their research progress in bone defect repair.METHODS:Chinese search terms"stem cell,exosome,bone,biomaterial,carrier,bioceramic,polymer,metal,hydrogel,engineered exosome"were used to search CNKI.English search terms"stem cell,exosome,bone defect,biomaterial,carrier,bioceramic,ploymer,metal material,hydrogel,engineering exosome"were used to search PubMed database.According to the inclusion and exclusion criteria,77 relevant articles were finally included for summary.RESULTS AND CONCLUSION:Exosomes from stem cells of different origins can promote osteoblast proliferation and differentiation,promote angiogenesis,and regulate osteoclast activity and macrophage phenotype to promote bone formation and bone mineralization.In addition,many achievements of exosomes in the field of bone defect repair were described from two aspects:biomaterial-assisted exosomes and engineered exosomes.However,the current research on stem cell exosomes in bone tissue engineering is still insufficient,and most of these studies are limited to small animal models,while the treatment of bone defects in large animals,including humans,will be more complex,which will also become a major challenge for the treatment of bone defects.This will also be a great challenge in the dissemination of exosome therapy.

AIM:To assess the influence of preoperative lacrimal passage probing and dilation on the therapeutic effectiveness of nasolacrimal silicone intubation in cases of incomplete primary acquired nasolacrimal duct obstruction(PANDO).METHODS: A retrospective case-control clinical study was conducted. The study included patients with incomplete PANDO who underwent nasolacrimal silicone intubation at the hospital between October 2022 and October 2024. Participants were categorized into two groups based on their receipt of nasolacrimal duct probing and dilation prior to intubation. Group A consisted of patients who had undergone one or more sessions of nasolacrimal duct probing and dilation before nasolacrimal silicone intubation, while Group B included patients who did not receive nasolacrimal duct probing and dilation before intubation. All patients had their nasolacrimal silicone tubes removed 3 mo postoperatively and were monitored for 6 mo following tube removal to evaluate surgical success rates.RESULTS: A total of 136 patients(152 eyes)completed the six-month follow-up period. The overall surgical success rate for both groups was 72.4%(110/152 eyes).Group A included 22 males and 36 females, mean age 58.09±11.07 y, and achieved a success rate of 82.8%(53/64 eyes), while Group B included 27 males and 51 females, mean age 59.35±8.84 y and attained a success rate of 64.8%(57/88 eyes). The difference in surgical success rates between the two groups was statistically significant(P=0.014). Furthermore, Group A achieved a complete success rate of 67.2%(43/64 eyes), compared to 47.7%(42/88 eyes)in Group B, with this difference also reaching statistical significance(P=0.017). No serious postoperative complications were observed in either group.CONCLUSION: Nasolacrimal silicone intubation is a safe and effective intervention for incomplete PANDO, with preoperative nasolacrimal duct probing and dilation potentially enhancing therapeutic outcomes.

ObjectiveTo develop and validate a diagnostic prediction model for differentiating pulmonary tuberculosis from community-acquired pneumonia based on routine blood parameters. MethodsA total of 642 patients with pulmonary tuberculosis and 503 patients with community-acquired pneumonia were retrospectively enrolled from the Seventh Hospital of Tangshan. They were randomly divided into a training set and an internal validation set at a 7∶3 ratio. Additionally， 218 patients from the 981st Hospital were independently included as an external validation set. The Boruta algorithm and recursive feature elimination were employed to select predictors from 82 blood parameters， sex， and age. A multivariate Logistic regression model was established and evaluated using receiver operating characteristic （ROC） curves， calibration curves， and decision curve analysis. ResultsThe final model incorporated eight predictors， namely uric acid， urea nitrogen， alkaline phosphatase， monoamine oxidase， alanine aminotransferase， glutathione， neutrophil percentage， and age. The model achieved areas under the curve （AUCs） of 0.800 （95%CI： 0.769-0.830）， 0.787 （95%CI： 0.738-0.836）， and 0.736 （95%CI： 0.667-0.835） in the training， internal validation， and external validation sets， respectively. The model demonstrated good calibration， and decision curve analysis showed clinical net benefit within the threshold probability range of 10%-80%. ConclusionThe developed model exhibits good discriminative ability and clinical utility， serving as an effective early screening tool for primary healthcare institutions.

Objective To investigate the preventive and therapeutic effects of ethanol extracts derived from three sources of traditional Chinese medicine: Stellera chamaejasme L., Euphorbia fischeriana Steud. and Euphorbia kansuensis Prokh., on imiquimod （IMQ）-induced psoriasis in mice. Methods Thirty-six male BALB/c mice were randomly divided into the following 6 groups with 6 mice in each group: blank control, model, Stellera chamaejasme, Euphorbia fischeriana, Euphorbia kansuensis, and calcipotriol. Psoriasis area and severity index（PASI） scores were used to record the changes of skin lesions in every group; Hematoxylin-eosin（HE） staining was used to observe the pathological morphology of skin and measure the thickness of the epidermis. Immunohistochemistry was used to detect the expression of nuclear antigen Ki67 in the skin tissues of mice. Results Compared with the model group, the three kinds of ethanol extracts could reduce the PASI score, inhibit epidermal thickening, and decrease expression of Ki67 in the psoriasis mice. Among them, the therapeutic effect of Stellera chamaejasme was the most significant and it was better than the commonly used topical drug calcipotriol. Conclusion The ethanol extract of Stellera chamaejasme had good anti-psoriatic activity, which could inhibit the abnormal proliferation of keratinocytes, reduce the expression of Ki67, and significantly improve psoriasis-like skin lesions.

ObjectiveTo investigate the potential mechanism of Renshen Yangrongtang in alleviating myelosuppression by regulating the expression of reactive oxygen species （ROS）， myeloperoxidase （MPO）， and neutrophil extracellular traps （NETs）. MethodsK562 cells were divided into blank group， etoposide group （40 μmol·L^-1）， and etoposide+Renshen Yangrongtang freeze-dried powder groups with low-， medium-， and high-dose （2， 4， 8 g·L^-1）. Liquid chromatography-mass spectrometry （LC-MS） was used to determine the freeze-dried powder of Renshen Yangrongtang. Enzyme-Linked Immunosorbent Assay （ELISA） was used to detect ROS， MPO， and NETs expression in each group. Western blot analysis was performed to assess intracellular MPO and NE expressions. Twenty 8-week-old male mice were randomly divided into blank group， etoposide group （100 mg·kg^-1）， and etoposide + Renshen Yangrongtang groups with low-， medium-， and high-dose （0.1， 0.5， 2.0 g·kg^-1）. Except for the blank group that received PBS via gavage at room temperature， and the etoposide group that received an intraperitoneal injection for 3 days， the remaining groups received gavage of Renshen Yangrongtang for 14 consecutive days after 3 days of etoposide administration. The peripheral blood related indicators were detected through an automated hematology analyzer； Western blot analysis was performed to assess MPO and neutrophil elastase （NE） expression changes in the marrow cells of mice. Enzyme-linked immunosorbent assay （ELISA） was used to detect ROS， MPO， and NETs changes in the marrow cells of mice. MPO and NE on femur bones were stained through immunohistochemistry. Scanning electron microscopy was used to analyze the structural changes of NETs in the marrow cells of mice after drug administration. ResultsLC-MS results showed that the freeze-dried powder of Renshen Yangrongtang contained complete technical materials such as Chinese angelica， Astragalus mongholicus， and ginseng. In K562 cells， compared with the etoposide group， ELISA results indicated that the concentrations of MPO， ROS， and NETs in the etoposide + Renshen Yangrongtang medium and high-dose groups were decreased （P<0.05， P<0.01）， and Western blot data showed that the etoposide high-dose group significantly reduced the expression of MPO and NE protein in K562 cells （P<0.05， P<0.01）. In vivo， compared with the etoposide group， the number of RBC， WBC， and PLT in the etoposide+Renshen Yangrongtang high-dose group increased significantly （P<0.05）. ELISA results suggested that in the etoposide+Renshen Yangrongtang low-， medium-， and high-dose groups， the concentration of mice ROS， MPO， and NETs significantly decreased （P<0.05， P<0.01）. Western blot results revealed that compared with the etoposide group， the expressions of MPO and NE in the marrow cells of mice in the etoposide + Renshen Yangrongtang low-， medium- and high-dose groups were significantly decreased （P<0.05， P<0.01）. Scanning electron microscopy observations revealed that Renshen Yangrongtang reduced the NETs structure generation in the marrow cells of mice after the influence of etoposide. ConclusionRenshen Yangrongtang can alleviate etoposide-induced myelosuppression by inhibiting ROS/MPO and reducing the formation of intracellular NETs.

This study analyzed soil-transmitted nematode infection surveillance data for children 3-9 years of age in Shaanxi Province from 2016 to 2023,to provide a scientific basis for control strategies for soil-transmitted nematode infections in children in the province.Since 2016,according to the requirements of the National Schistosomiasis and Soil-transmitted Nematode Surveillance Program(Trial),several counties and districts in Shaanxi Province were selected as surveillance sites every year.According to geo-graphical position,the surveillance sites were divided into five areas:east,west,south,north and middle,and one administrative vil-lage(community)was selected in each area for monitoring.The eggs of soil-transmitted nematodes(hookworm,Ascaris lumbricoides,Trichuris trichiura,and Enterobius vermicularis)were detected with the Kato-Katz technique in children 3-9 years of age at each sur-veillance site,and the eggs of Enterobius vermicularis were detected again with the cellophane tape anal swab method.The infection rate and intensity for E.vermicularis were calculated.Detection was performed in 12 462 children 3-9 years old at 75 surveillance sites in Shaanxi Province from 2016 to 2023;84 cases of soil-borne nematode infections were detected,and the overall infection rate was 0.67%.The infection rates for Ascaris lumbricoides and E.vermicularis were 0.18%(22/12 462)and 0.50%(62/12 462),respec-tively,and the infection rates for Trichuris trichiura and hookworm were not found.The infection rates of soil-transmitted nematodes in children were 1.28%(16/1 250),0.16%(2/1 252),1.25%(17/1 365),1.20%(18/1 494),0.17%(2/1 169),1.45%(20/1 382),0.00,and 0.36%(9/251),respectively.A linear trend was observed among years(χ2=11.973,P<0.001).The infection rates in the Weifen Basin ecological region,Loess Plateau ecological region,and Qinba Mountains ecological region were 0.51%,1.19%,and 0.72%,respectively,and the differences were statistically significant(χ2=9.726,P=0.008).Significant differences in infection rates were observed among scattered children(1.63%),preschool children(0.66%),and students(0.57%)(χ2=11.189,P=0.004).No significant differences in infection rates were observed by gender,age,and education level.Compared with the infection rates in the entire country and other provinces,the infection rate of soil-transmitted nematodes among children in Shaanxi Province was low,and the main infection species were Ascaris lumbricoides and E.vermicularis.The infection rates greatly varied within Shaanxi Prov-ince,possibly because of differences in economic development levels,children′s living habits,and personal hygiene status across re-gions.In the future,comprehensive control measures should be taken to strengthen the monitoring and control of key areas,popula-tions,and parasite species.

Purpose This study aims to investigate the clinicopathological features of diffuse pulmonary menin-gotheliomatosis(DPM).Methods The clinical data of 10 patients with DPM undergoing video-assisted thoracic sur-gery(VATS)were collected,and their clinical and pathological characteristics were analyzed using immunohistochem-istry.Results The detection rate of DPM was 1.19‰,with 90％of the patients being female.DPM predominantly occurred in the age range of 40-60 years,with an average age at diagnosis of 50.7 years.Most patients had no smok-ing history.Pathological diagnosis combined with imaging findings was the main method for diagnosing DPM.80％of the patients were prone to concurrent early-stage invasive pulmonary adenocarcinoma.Laboratory indicators,including pulmonary function,were generally normal.Chest CT showed diffuse multiple ground-glass opacity or cystic nodules in both lungs,with the number of nodules in both lungs ranging from dozens to hundreds,and the maximum diameter of the nodules was 2-6 mm.The median volume and CT value of the pulmonary nodules were 35.32 mm3 and-566 HU,respectively.Pathological features mainly included multiple meningothelial-like nodules observed under the micro-scope.Immunophenotypically,CD56,EMA,PR,and vimentin were often positive.Conclusion DPM is a rare lung disease with no obvious clinical symptoms,and is more common in middle-aged and elderly women.Diffuse multiple nodules in both lungs are its main imaging features.Most DPM patients are complicated with lung adenocarcinoma,and regular follow-up is recommended.