Aortic dissection is a serious cardiovascular disease characterized by acute onset and high mortality rates. Although advancements in surgical techniques and anesthesia methods have significantly reduced surgical mortality, postoperative complications, particularly pulmonary complications, remain a challenge for the recovery of patients with aortic dissection. Existing studies indicate that respiratory rehabilitation plays a crucial role in preventing and alleviating postoperative pulmonary complications, and its application is gradually expanding. However, current understanding of respiratory rehabilitation treatment for patients with aortic dissection is still insufficient, and there is a lack of standardized protocols in clinical practice. This article aims to review the existing research evidence, comprehensively analyze common pulmonary complications after aortic dissection surgery, their pathogenesis, the latest advancements in perioperative respiratory rehabilitation, and the main challenges faced, in order to provide references for clinical practice and future research.

ObjectiveTo screen and identify the key proteins of Monkeypox Virus （MPXV） that regulate the NOD-like receptor family pyrin domain containing 3 （NLRP3） inflammasome. MethodsUsing the genomic sequence of the domestic epidemic strain of MPXV as a template to construct an expression plasmid library containing 82 viral genes. To screen for viral genes that significantly inhibit the production of interleukin-1β （IL-1β）， the expression plasmids encoding NLRP3， apoptosis-associated speck-like protein containing a CARD （ASC）， cysteine protease-1（Caspase-1）， and pro-IL-1β-Luc reporter gene were co-transfected into HEK293T cells， along with the viral gene plasmids. The signal of the NLRP3 inflammasome was monitored by measuring luciferase activity in the cell supernatant. The inhibition effects were further confirmed by Western Blot （WB）， and the interactions between the viral proteins and the components of the NLRP3 inflammasome were determined by Co-immunoprecipitation （Co-IP）. Additionally， site-directed mutagenesis was performed to identify the specific interaction motifs. ResultsAn NLRP3 inflammasome signal screening system were successfully established and optimized. Screening the MPXV plasmids using this system revealed that B10R most significantly inhibits IL-1β maturation in a dose-dependent manner （P＜0.000 1）. Further characterization demonstrated that B10R interacts directly with pro-IL-1β. Notably， the C-terminal motif mutant of B10R （B10Rmut-C， T96A， Y97A， I98A） lost its ability to interact with pro-IL-1β. ConclusionsThe MPXV B10R protein interacts with pro-IL-1β， thereby inhibiting the IL-1β maturation. The C-terminal motif （T96， Y97， I98） of the B10R protein is crucial for function. This study provides important clues and a foundation for further elucidating the molecular mechanisms by which MPXV regulates the NLRP3 inflammasome.

OBJECTIVE To summarize the current situation of pharmaceutical clinic service in our hospital over the past five years， and explore sustainable development strategies for service models of pharmaceutical clinics. METHODS A retrospective analysis was conducted on the consultation records of patients who registered and established files at the pharmaceutical clinic in our hospital from January 2019 to December 2023. Statistical analysis was performed on patients’ general information， medication- related problems， and types of pharmaceutical services provided by pharmacists. RESULTS A total of 963 consultation records were included， among which females aged 20-39 years accounted for the highest proportion （66.04%）； obstetrics and gynecology- related consultations accounted for the largest number of cases. Additionally， 80 patients attended follow-up visits at our hospital’s pharmaceutical clinic. A total of 1 029 medication-related issues were resolved， including 538 cases of drug consultations （52.28%）， 453 medication recommendations （44.02%）， 22 medication restructuring（2.14%）， and 16 medication education （1.55%）； the most common types of medication-related problems identified were adverse drug events（70.07%）. CONCLUSIONS Although the pharmaceutical clinic has achieved recognition from clinicians and patients， challenges such as low awareness among healthcare providers and the public persist. Future efforts should focus on strengthening information technology construction， enhancing pharmacist training， and establishing various forms of outpatient pharmaceutical service models.

Activated specific T cells possess the capability to directly recognize and eradicate tumor cells, a process pivotal in the anti-tumor immune response. In recent years, the field of tumor immunotherapy, particularly T cell-based strategies, has seen rapid advancements, resulting in several drugs receiving clinical approval and the initiation of numerous basic research endeavors and clinical trials. Among these strategies, adoptive T cell transfer therapy emerges as a principal focus, encompassing approaches such as chimeric antigen receptor T-cell (CAR-T), T-cell receptor-engineered T cell (TCR-T), tumor-infiltrating lymphocytes (TILs), and cytotoxic T lymphocytes (CTLs) therapies. This review endeavors to encapsulate the global research and development strides made in four categories of adoptive T cell therapies, while also dissecting their individual merits and limitations. The objective is to furnish insights that may bolster the development of tumor immunotherapy pharmacopeia and their efficacious clinical application in cancer treatment.

Objective:To analyze the incidence rate and disability-adjusted life year (DALY) rate of Chlamydia trachomatis ( C. trachomatis) infection in women aged 15-49 years in China from 1990 to 2021, identify the vulnerable populations, and provide evidence for the prevention and control of C. trachomatis infection. Methods:The data from Global Burden of Disease Study 2021 were used to analyze the incidence rate and DALY rate of C. trachomatis infection in women aged 15-49 years in China from 1990 to 2021 by using Joinpoint regression model. The age-period-cohort analysis method was used to decompose the age effect, period effect and cohort effect of incidence rate and DALY rate of C. trachomatis infection. Results:From 1990 to 2021, the incidence rate of C. trachomatis infection increased from 5 892.02/100 000 in 1990 to 7 402.23/100 000 in 2021 in women aged 15-49 years in China. The DALY rate increased from 1.92/100 000 person-years in 1990 to 2.00/100 000 person-years in 2021. Joinpoint regression showed that, from 1990 to 2021, the annual incidence of C. trachomatis infection in Chinese women age aged 15-49 years increased by 0.74% [average annual percent change (AAPC) =0.74%, 95% CI: 0.67%-0.81%, t=21.94, P<0.001] and the annual average DALY rate increased by 0.11% (AAPC=0.11%, 95% CI: -0.09%-0.30%, t=1.06, P=0.287). Age-period-cohort model analyses showed that women aged 30-34 years were at high risk to be infected with C. trachomatis and women aged 40-44 years were at high risk to have high DALY. The period effect showed that the risk for C. trachomatis infection began to increase in 1990, peaked during 2000-2004, then gradually decreased. During 2015-2019, the infection risk increased again, while the risk for high DALY showed a decreasing trend. The cohort effect showed that the risks for C. trachomatis infection and DALY were lower in later birth cohorts. Conclusions:From 1990 to 2021, the incidence rate and DALY rate of C. trachomatis infection showed fluctuations in women aged 15-49 years in China. It is necessary to pay close attention to the prevention and control of C. trachomatis infection in women aged 30-34 years.

Objective:To analyze the application of antitoxin therapy in severe infant botulism.Methods:A retrospective analysis was conducted on 14 cases of severe infant botulism treated at 3 pediatric medical centers from July 2020 to August 2024. This study investigated antitoxin dosage, treatment duration, discontinuation criteria and adverse reactions.Results:A total of 14 cases (12 males and 2 females) were included, with an age of 5.0 (3.8, 7.0) months. Botulinum toxin typing revealed 10 cases of Type B, 2 cases of Type A and 2 untyped cases. The interval from symptom onset to antitoxin administration was 9.0 (6.0, 11.5) d. The initial dosage of type A antitoxin was 12 500 (10 000, 22 500) U, while type B was 5 000 (5 000, 5 000) U. The dosage was tapered in some cases after symptom improvement, the duration of treatment was 16.5 (9.8, 25.3) d. In total, 11 infants discontinued medications after improvement in muscle strength, while 3 infants discontinued treatment after obtaining negative results from fecal mouse bioassays. Adverse events were reported in 2 cases, both of which resulted in rash, and 1 case was complicated with anaphylactic shock. All the patients survived upon discharge with a follow-up period of 11 d to 3 years and 8 months. Totally 12 infants had fully recovered, while 2 infants were still recovering after discharge.Conclusion:Antitoxin therapy is a feasible and safe approach which showed favorable prognosis in severe infant botulism.

Objective To investigate the differences in BMD,T-scores,lumbar HU values,and modified VBQ scores in patients with thoracolumbar fractures,analyze their correlations,and evaluate their predictive efficacy for thoracolumbar fractures.Methods Patients with thoracolumbar fragility fractures and hospitalized in the Department of Orthopedics at the Second Affiliated Hospital of Kunming Medical University from January 2022 to March 2025 were retrospectively enrolled.Among them,132 eligible patients were divided into the fracture group(n=63)and the non-fracture group(n=69).BMD and T-scores of L1～L4 vertebrae were measured via DEXA,lumbar HU values were obtained from CT scans,and modified VBQ scores were calculated using lumbar MRI.Intergroup comparisons were performed using independent samples t-tests.Pearson's correlation analysis was used to assess the relationships among BMD,T-scores,HU values,and modified VBQ scores.Receiver operating characteristic(ROC)curve analysis was conducted to evaluate their predictive performance for thoracolumbar fractures.Results The fracture group exhibited significantly lower mean BMD,T-scores,and HU values in L1～L4 compared to the non-fracture group,while modified VBQ scores were significantly higher(P<0.001).Correlation analysis revealed a significant positive correlation between BMD,T-scores,and HU values in L1～L4,whereas all three parameters showed a significant negative correlation with modified VBQ scores(P<0.001).The AUC values for predicting thoracolumbar fractures were 0.826(T-score),0.836(BMD),0.759(HU value),and 0.875(modified VBQ score),with optimal cutoff thresholds of-1.65(T-score),0.836 g/cm2(BMD),68.4(HU value),and 3.01(modified VBQ score),respectively.Conclusion BMD,T-scores,HU values,and modified VBQ scores in L1～L4 vertebrae are significantly correlated and can serve as the predictive indicators for thoracolumbar fractures.Among them,the modified VBQ score demonstrates the best predictive performance,making it a valuable auxiliary tool for assessing the vertebral bone quality.

Ursodeoxycholic acid(UDCA)is a naturally occurring,low-toxicity,and hydrophilic bile acid(BA)in the human body that is converted by intestinal flora using primary BA.Solute carrier family 7 member 11(SLC7A11)functions to uptake extracellular cystine in exchange for glutamate,and is highly expressed in a variety of human cancers.Retroperitoneal liposarcoma(RLPS)refers to liposarcoma originating from the retroperitoneal area.Lipidomics analysis revealed that UDCA was one of the most significantly down-regulated metabolites in sera of RIPS patients compared with healthy subjects.The augmentation of UDCA concentration(≥25 μg/mL)demonstrated a suppressive effect on the proliferation of liposarcoma cells.[15N2]-cystine and[13Cs]-glutamine isotope tracing revealed that UDCA impairs cystine uptake and glutathione(GSH)synthesis.Mechanistically,UDCA binds to the cystine transporter SLC7A11 to inhibit cystine uptake and impair GSH de novo synthesis,leading to reactive oxygen species(ROS)accumulation and mitochondrial oxidative damage.Furthermore,UDCA can promote the anti-cancer effects of ferroptosis inducers(Erastin,RSL3),the murine double minute 2(MDM2)inhibitors(Nutlin 3a,RG7112),cyclin dependent kinase 4(CDK4)inhibitor(Abemaciclib),and glutaminase inhibitor(CB839).Together,UDCA functions as a cystine exchange factor that binds to SLC7A11 for antitumor activity,and SLC7A11 is not only a new transporter for BA but also a clinically applicable target for UDCA.More importantly,in combination with other antitumor chemotherapy or physiotherapy treatments,UDCA may provide effective and promising treatment strategies for RLPS or other types of tumors in a ROS-dependent manner.

Integration for clinical application (ICA) is a compulsory course in clinical medicine at University of Leicester in the United Kingdom. ICA aims to enhance students' ability to integrate medical knowledge in different organs and systems, as well as facilitate the multidimensional integration of medical and social sciences. In collaboration with the University of Leicester, Chongqing Medical University introduced ICA, and the first iteration of this course was completed. Based on the experience obtained during studying at University of Leicester and the current situation of integrated medicine education in China, our study suggests that ICA should be designed based on constructivist cognitive theory and multiple intelligences theory. By focusing on the underlying logic of "reintegration", ICA can effectively fill the gap in multidimensional integrated courses in integrated medicine education in China. However, the course still requires large-scale localization in the future, with improvements needed in various aspects of course design, including content, form, evaluation, and support systems. It is also necessary to leverage the unique advantages of this course in humanities and social sciences, fully integrating ideological and political elements to support the development of a new integrated course system that combines social sciences, natural sciences, and medical knowledge.

Oligodendrocyte lineage cells, including oligodendrocyte precursor cells (OPCs) and oligodendrocytes (OLs), are essential in establishing and maintaining brain circuits. Autophagy is a conserved process that keeps the quality of organelles and proteostasis. The role of autophagy in oligodendrocyte lineage cells remains unclear. The present study shows that autophagy is required to maintain the number of OPCs/OLs and myelin integrity during brain aging. Inactivation of autophagy in oligodendrocyte lineage cells increases the number of OPCs/OLs in the developing brain while exaggerating the loss of OPCs/OLs with brain aging. Inactivation of autophagy in oligodendrocyte lineage cells impairs the turnover of myelin basic protein (MBP). It causes MBP to accumulate in the cytoplasm as multimeric aggregates and fails to be incorporated into integral myelin, which is associated with attenuated endocytic recycling. Inactivation of autophagy in oligodendrocyte lineage cells impairs myelin integrity and causes demyelination. Thus, this study shows autophagy is required to maintain myelin quality during aging by controlling the turnover of myelin components.
Animals ; Autophagy/physiology* ; Oligodendroglia/metabolism* ; Myelin Sheath/physiology* ; Aging/pathology* ; Myelin Basic Protein/metabolism* ; Cell Lineage/physiology* ; Mice ; Oligodendrocyte Precursor Cells ; Mice, Inbred C57BL ; Brain/cytology* ; Cells, Cultured ; Cell Count