Systemic lupus erythematosus (SLE) is a diffuse, systemic autoimmune disorder that can impact multiple organs and systems, with patients exhibiting abnormal levels of various autoantibodies and immune markers in their serum. It is currently understood that dysregulation of B cells activation plays a pivotal role in the pathogenesis of SLE, as aberrantly activated B cells produce autoantibodies that inflict damage on multiple organs through complement activation and antibody-dependent cell-mediated cyto-toxicity. Traditional therapies for SLE may prove ineffective for certain patients or lead to adverse reactions. In most instances, conventional treatment merely alleviates symptoms and necessitates lifelong immunotherapy. A limited number of clinical cases have explored chimeric antigen receptor T cells (CAR-T) therapy as a potential treatment for autoimmune diseases such as SLE. Research indicates that CAR-T can specifically target CD19 expressed on the surface of B cells and plasma cells, achieving profound depletion while minimizing drug-related side effects. This report details a female patient diagnosed with SLE and lupus nephritis who was successfully treated using dual-targeting B cells maturation antigen CAR-T by our research team; following treatment, she ceased steroid and immunomodulator use, attaining sustained remission without these medications. The patient was a 23-year-old female. Multiple examinations in other hospitals and in our hospital showed positive anti-double-stranded DNA (dsDNA) antibody and low complement C3. Renal biopsy in our hospital showed lupus nephritis Ⅳ-G (A/C), and National Institutes of Health (NIH) activity index (AI) score=4. She was diagnosed with "SLE, lupus nephritis (LN)". She was treated with hormones, immunosuppressants and Chinese medicine, but the effect was not good. After the CAR-T treatment, She stopped using hormones and immune agents and achieved continuous remission with zero hormones and zero immune agents. She became pregnant six months after CAR-T infusion, and gave birth to a healthy full-term, full-weight baby successfully. She is the first patient in China who successfully discontinued hormone, immune preparations and gave birth after CAR-T therapy. During the follow-up of the patient, we found that the immune indexes had basically returned to normal, and the safety was good. It indicates that CAR-T therapy may represent a promising and innovative therapeutic approach for the management of SLE. This offers hope and establishes a precedent for SLE women of childbearing age.
Female ; Humans ; Pregnancy ; B-Lymphocytes/immunology* ; Immunotherapy, Adoptive/methods* ; Lupus Erythematosus, Systemic/therapy* ; Lupus Nephritis/immunology* ; Receptors, Chimeric Antigen/therapeutic use* ; Young Adult

Objective: To evaluate the value of Kirschner wire internal fixation in the treatment of sagittal mandibular condylar fractures. .Methods : From January 2019 to January 2020, 13 patients (19 sides) with mandibular condylar sagittal fracture treated by Kirschner wire internal fixation at the Stomatological Medical Center, Foshan Hospital of Traditional Chinese Medicine were retrospectively analyzed. After conventional surgical incision and exposure and reduction of the mandibular condyle, 2-4 Kirschner wires were used for fixation, and other maxillofacial fractures were treated simultaneously. The reduction accuracy and stability of the free mandibular condyle were evaluated by CBCT one week after the operation, and the occlusion relationship, opening degree and opening type were evaluated by clinical examination. Results: All patients had good fracture alignment and no twisting, breaking or loosening of the Kirschner wire. The occlusion relationship, opening degree and opening shape recovered well after the operation. Conclusion Kirschner wire is effective in treating sagittal fractures of mandibular condyles.

Objective : To explore the effect of negative pressure sealing drainage on the treatment of maxillofacial-neck-mediastinal infection in multiple spaces. Methods: Vacuum sealing drainage (VSD) was applied in five patients with maxillofacial-neck-mediastinal infection caused by odontogenic infection accompanied by diabetes or renal failure and other systemic diseases. After extensive debridement, a negative pressure drainage sponge was placed in the pus cavity and then the wound was closed. Continuous negative pressure drainage was continued after the operation. At the same time, multidisciplinary consultation was applied to control basic diseases and, strengthen anti-inflammatory responses, and nutrition and other systemic treatments were applied. Results: Four patients underwent continuous negative pressure drainage and successful removal of the negative pressure sponge after inflammatory symptoms subsided. One patient′s inflammatory symptoms became more serious after the operation, and we performed another operation to change the placement of the negative pressure sponge. All 5 patients underwent VSD with negative pressure sponge replacement ranging from 1 to 3 times during treatment. After multidisciplinary consultation, they were all cured and discharged from the hospital. Conclusion For infection of the mediastinum, maxillofacial region and neck, local treatment and systemic treatment are emphasized, as well as the treatment of infected lesions and basic diseases. Negative pressure closure and drainage technology promotes the alleviation of inflammation, and multidisciplinary combined treatment is beneficial for the control of basic diseases.

Objective To investigate the effect of Astragalus injection combined with low molecular weight heparin and nifedipine on levels of related indexes and pregnancy outcomes in patients with preeclampsia.Methods A total of 60 patients with preeclampsia from March 2013 to December 2016 in Cixi Municipal Maternal and Child Care Hospital were selected and randomly divided into the study group and control group, with 30 cases in each group.All patients were given spasmolysis, diuretic and other conventional treatment.The control group were treated with low molecular weight heparin and nifedipine while the study group were additionally treated with Astragalus injection.The blood pressure, blood coagulation and other laboratory indicators in the two groups were monitored before and after treatment , and the incidence of pregnancy complications and pregnancy outcomes in the two groups were statistically analyzed.Results There was no significant difference in blood pressure, human chorionic gonadotropin (β-hCG), alpha fetoprotein (AFP) and blood coagulation function indexes in the two groups before treatment .After treatment, the blood pressure,β-hCG, AFP, platelet count (PLT), prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (FIB) and D-dimer (D-D) were significantly improved, the difference was statistically significant ( P<0.05).After treatment, the diastolic and systolic blood pressure, β-hCG, AFP, PLT, FIB and D-D levels in the study group were significantly lower than those in the control group, the difference was statistically significant ( P<0.05), PT and APTT were significantly longer than those in the control group, the difference was statistically significant (P<0.05).The incidence rates of pregnancy complications ( uterine inertia, premature rupture of membrane, fetal distress, placental abruption) and adverse pregnancy outcomes (cesarean section, neonatal asphyxia) in the study group were significantly lower than those in the control group, the difference was statistically significant (P<0.05).Conclusion The application of Astragalus injection combined with low molecular weight heparin and nifedipine in the clinical treatment of patients with preeclampsia can effectively control the blood pressure level and other parameters , reduce pregnancy complications and improve pregnancy outcomes.

Osseointegration plays an important role in the functions and aesthetics of dental implant. This paper focus on the hormones closely related to the bone metabolism, including glucocorticoid, parathyroid hormone, calcitonin, melatonin, and oestrogen, and reviews the influence of hormones on the osseointegration.