Objective Based on 25 indicators including immune factors, cell count classification, and smear results of the knee joint fluid, machine learning models were established to distinguish between osteoarthritis (OA) and rheumatoid arthritis (RA). Methods 100 OA and 40 RA patients scheduled for total knee arthroplasty were enrolled respectively. Each patient's knee joint fluid was collected preoperatively. Nucleated cells were counted and classified. The expression levels of immune factors, including tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), IL-6, IL-8, IL-15, matrix metalloproteinase 3 (MMP3), MMP9, MMP13, rheumatoid factor (RF), serum amyloid A (SAA), C-reactive protein (CRP), and others were measured. Smears and microscopic classification of all the immune factors were performed. Independent influencing factors for OA or RA were identified using univariate binary logistic regression, Lasso regression, and multivariate binary logistic regression. Based on the independent influencing factors, three machine learning models were constructed which are logistic regression, random forest, and support vector machine. Receiver operating characteristic curve (ROC), calibration curve and decision curve analysis (DCA) were used to evaluate and compare the models. Results A total of 5 indicators in the knee joint fluid were screened out to distinguish OA and RA, which were IL-1β(odds ratio(OR)=10.512, 95× confidence interval (95×CI) was 1.048-105.42, P=0.045), IL-6 (OR=1.007, 95×CI was 1.001-1.014, P=0.022), MMP9 (OR=3.202, 95×CI was 1.235-8.305, P=0.017), MMP13 (OR=1.002, 95× CI was 1-1.004, P=0.049), and RF (OR=1.091, 95×CI was 1.01-1.179, P=0.026). According to the results of ROC, calibration curve and DCA, the accuracy (0.979), sensitivity (0.98) and area under the curve (AUC, 0.996, 95×CI was 0.991-1) of the random forest model were the highest. It has good validity and feasibility, and its distinguishing ability is better than the other two models. Conclusion The machine learning model based on immune factors in the knee joint fluid holds significant value in distinguishing OA and RA. It provides an important reference for the clinical early differential diagnosis, prevention and treatment of OA and RA.
Humans ; Arthritis, Rheumatoid/metabolism* ; Machine Learning ; Male ; Female ; Middle Aged ; Aged ; Synovial Fluid/immunology* ; Osteoarthritis, Knee/metabolism* ; Knee Joint/metabolism* ; ROC Curve ; Diagnosis, Differential

Chimeric antigen receptor-T (CAR-T) cell therapy has achieved remarkable efficacies in the treatment of B-cell leukemia/lymphoma and multiple myeloma (MM). Nevertheless, how to maintain a sustainable remission remains a significant concern. One of the underlying factors for the recurrence after CAR-T cell therapy is the acquired resistance in tumor cells to apoptosis. bcl-2 protein belongs to the anti-apoptotic protein family and plays a key role in regulating endogenous apoptosis. The overexpression of bcl-2 indicates a poor prognosis in hematological malignancies such as chronic lymphocytic leukemia (CLL), acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML) and MM. BH3 is a key protein domain involved in the process of programmed cell death, and bcl-2 inhibitors promote tumor cell apoptosis by competitively binding to BH3. bcl-2 inhibitors have been previously verified to sensitize tumor cells to the cytotoxicity of CAR-T cell. This paper reviews the preclinical and clinical results of CAR-T cell in combination with bcl-2 inhibitors for treatment of hematologic malignancies, aiming to intricate molecular mechanisms of the synergistic effect of CAR-T cell combined with bcl-2 inhibitors and further to improve the efficacy of tumor immunotherapy.

OBJECTIVE To investigate the efficacy and safety of hetrombopag combined with low-dose prednison in the treatment of patients with refractory/recurrent primary immune thrombocytopenia(ITP). METHODS A total of 40 patients with ITP who failed to respond to previous treatment or relapsed in the Department of Hematology of Gansu Provincial People’s Hospital From July 2021 to August 2022 were selected. Used randomized controlled trial research methods, according to the treatment plan, they were divided into observation group and control group, with 20 cases in each group. The control group was treated with low-dose prednison alone. The observation group was combined with hetrombopag treatment on this basis. The efficacy and adverse reactions were compared between the two groups. RESULTS Treatment 6 weeks, patients who's proportion of platelet counts(PLT) reached≥50×109·L−1 and ≥30×109·L−1 in observation group were higher than control group with statistically significant differences in both groups[90%(18/20) vs 50%(10/20), P＝0.006; 90%(18/20) vs 65%(13/20), P＝0.130]; The study also indicated a statistically significant difference in favour of observation group compared with control group in the odds of achieving the outcome of a PLT≥50×109·L−1at least once during 6-week treatment[90%(18/20) vs 55%(11/20), P＝0.147], was more than placebo-treated one. The median time of PLT ≥ 50×109·L−1 for the first time within 6 weeks of treatment in the observation group was 3 weeks, which was the same as that in the control group. After 6 weeks of treatment, the median platelet count in the observation group was higher than that in the control group[97.50(58.25−166.75)×109·L−1 vs 45.50(13.25−82.50)×109·L−1 , P<0.05]. The median PLT count in the observation group was higher than that in the control group at week 1−6 after treatment, and the curative effect was significant. The two groups of patients tolerated the regimen well, and the degree of adverse reactions was mild, which improved quickly after symptomatic treatment. CONCLUSION Hetrombopag combined with low-dose prednison has a high effective rate in the treatment of refractory/recurrent ITP, which is better than that of single use, and the adverse reactions are tolerable, so it can be widely used in clinical practice.

Objective To conduct Rh blood group serological testing and third-generation sequencing(TGS)on 22 RhD variant voluntary blood donors in Chongqing and explore the phenotypic distribution and genotyping of RhD variants in Chongqing.Methods From January to August 2023,individuals who participated in blood donation in our blood center were selected as the study objects.RhD variant phenotype identification was performed using routine serological methods.Once the RhD variants were identified,tests on different antigenic epitopes of RhD were conducted using a D-screen assay kit.Furthermore,after the genomic DNA from 22 RhD variant blood samples was extracted,imbraided primers design and multi-segment amplification and splicing were used to sequence the full-length RHD gene for TGS.The RHD gene sequence was analyzed using SnapGene software.Results Among the 22 RhD variants,8 were DVI type 3(36.36%),with the main mutation of RHD-CE(3-6)-D hybrid allele.Six cases(27.27%)showed partial weak D15 type,with the main mutation of c.845G>A.There were 6 cases of Asia type Del(27.27%),with the main mutation of c.1227G>A.One case was weak D17 type with a mutation of c.340C>T and 1 case speculated to be partial D(c.491A>T,p.Asp164Val,missense mutation).Conclusion The most common RhD variant phenotype among blood donors in Chongqing is DVI type 3,and the full-length haplotype sequence of RHD variant alleles can be obtained by Pacific Bioscience single-molecule real-time sequencing(SMRT).

Raman spectroscopy, amplified by surface-enhanced Raman scattering (SERS) nanoparticles, can provide an imaging modality due to its high molecular specificity, high sensitivity, and negligible autofluorescence. The basis, composition, and methodologies developed for SERS nanoparticles are herein described. The research hotspots that are the focus in this paper are tumor imaging-guided theranostics and biosensing. The next breakthrough may be the development of biocompatible SERS nanoparticles and spectroscopic devices for clinical applications.

OBJECTIVE:To optimize the clarification and purification technology of Perillae folium extract. METHODS:The effects of 3 clarification and purification methods as chitosan flocculation clarification,ZTC 1+1-Ⅱflocculation clarification,water precipitation on retention rate of total flavonoids and removal rate of solid of Perillae folium extract were compared to screen suit-able clarification and purification technology. With the retention rate of total flavonoids and removal rate of solid as comprehensive evaluation index,single factor and orthogonal test were designed to investigate the optimal value of concentration proportion,the amount of the flocculant,flocculation temperature and whisking speed in optimal clarification and purification method. RESULTS:Among 3 methods,the chitosan flocculation clarification was the best with concentration proportion of 1∶4,chitosan of 1.0 g/L, flocculation temperature at 60 ℃,whisking speed of 100 r/min,whisking time of 4 min,standing time of 12 h. Under the condi-tion of optimal processing,the retention rate of total flavonoids was (85.1 ± 0.75)%,and the removal rate of solid was (24.6 ± 1.33)%(n=5). CONCLUSIONS:Chitosan flocculation can be used to effectively remove the impurity of Perillae folium extract, and optimized clarification and purification technology is stable and feasible.

Bilingual teaching is a innovative method of higher education of China to gear the need of the world. Acupuncture and Moxibustion, a higher international TCM course, has been the model of bilingual teaching in many colleges and universities of TCM successively. To meet the aim and original intention of bilingual education in China, we have supplemented international acupuncture and moxibustion in teaching program for many years. The related contents about acupuncture and moxibustion of World Health Organization (WHO) and International Standardization Organization(ISO) have been added into the chapters of introduction, meridians and acupoints, the technology of acupuncture and moxibustion, the therapy of acupuncture and moxibustion. Teaching international acupuncture and moxibustion not only enlarges the international perspective of students, but also makes them more interested in learning Acupuncture and Moxibustion with a bigger sense of mission.
Acupuncture ; education ; Acupuncture Points ; Books ; China ; Humans ; Internationality ; Language ; Learning ; Meridians ; Teaching ; manpower ; methods ; Universities

Objective To observe clinical therapeutic effect of treating insomnia by moxibustioning Balhui (DU20)and Sisbencong(EX-HN 1) . Methods 276 cases of insomnia were divided into treatment group and control group. The treatment group was treated by moxibustioning on Baihui (DU 20) and Sishencong(EX-HN 1); while the control group was treated by moxibutioning on Zusanli (ST 36). Evaluate the therapeutic effects and PSQI index of the two groups. Results Clinical symptoms got improvement in the both groups. The treatment group was better than the control group in terms of therapeutic effect of the (P＜0.05) and the improvement of PSQI (P＜0.01). Conclusion Moxibustioning on Baihui(DU 20)and Sishencong (EX-HN 1) has a good therapeutic effect for insomnia.

Objective To observe the renal expression of cyclooxygenase-2(COX-2) in diabetic nephropathy rats and the effects of Losartan as angiotensin II type 1(AT1) receptor antagonist.Methods Twenty-eight diabetic Sprague-Dawley(SD) rats induced with intraperitoneal injection of streptozotocin were randomly divided into two groups: diabetic rats without therapy(group D,n=14) and diabetic rats treated with Losartan(group L,n=14).Twenty SD rats were used as the control(group N).The urine and blood samples in 24h were collected after the treatment with Losartan for 10 weeks.The rats were killed and the renal expression of COX-2 was determined with immunohistochemistry.Results Expression of COX-2 in the nephridial tissue and the concentration of urinary thromboxane B_2(TXB_2) in group D were significantly higher than those in group N(P

Objective To optimize the extraction process for icariin from Herba Epimedii. Methods The content of icariin in the extracts obtained by different extraction methods was determined with HPLC. The effect of solvents, boiling time, extracting time and temperature, and the size of the medicinal powder was observed. Results Different extraction methods had great influence on the extraction rate of icariin. Conclusion This research can provide evidence for the extraction of active component from Herba Epimedii in industrial production.