BACKGROUND:Exosomes derived from mesenchymal stem cells play pivotal roles in cell communication and epigenetic regulation due to their low immunogenicity and targeted delivery effects,and have been clinically applied in the treatment of various diseases.OBJECTIVE:To review the isolation,purification,identification methods,and application progress of mesenchymal stem cell-derived exosomes,and to facilitate the development of large-scale preparation techniques and clinical translation of mesenchymal stem cell-derived exosomes.METHODS:The Chinese search terms"exosome,mesenchymal stem cells,isolation,purification,characterization,clinical application"and the English search terms"exosome,extracellular vesicles,mesenchymal stem cells,isolation,characterization,application"were used to search the literature published before September 2024 in CNKI,PubMed,and Web of Science databases.Articles with poor relevance to the topic,outdated,or duplicated content were excluded,and finally,109 articles were included for review.RESULTS AND CONCLUSION:(1)This paper reviews recent methods for isolating and purifying exosomes,comparing the characteristics of ultracentrifugation,ultrafiltration,size-exclusion chromatography,polymer precipitation,immunoaffinity,microfluidic methods,and other novel approaches based on their underlying principles.(2)Methods for identifying exosomes can be categorized into physical and biochemical analyses,characterizing exosomes based on their shape,size,and characteristic proteins.(3)Mesenchymal stem cell-derived exosomes have broad applications in multiple fields such as medical aesthetics,wound repair,and cancer treatment,due to their immune-regulatory properties and ability to cross biological barriers.(4)The clinical translation of exosomes faces challenges due to their complex structure,lack of universal isolation techniques,and poor stability,making it difficult to achieve in a short period of time.

BACKGROUND:Exosomes derived from mesenchymal stem cells play pivotal roles in cell communication and epigenetic regulation due to their low immunogenicity and targeted delivery effects,and have been clinically applied in the treatment of various diseases.OBJECTIVE:To review the isolation,purification,identification methods,and application progress of mesenchymal stem cell-derived exosomes,and to facilitate the development of large-scale preparation techniques and clinical translation of mesenchymal stem cell-derived exosomes.METHODS:The Chinese search terms"exosome,mesenchymal stem cells,isolation,purification,characterization,clinical application"and the English search terms"exosome,extracellular vesicles,mesenchymal stem cells,isolation,characterization,application"were used to search the literature published before September 2024 in CNKI,PubMed,and Web of Science databases.Articles with poor relevance to the topic,outdated,or duplicated content were excluded,and finally,109 articles were included for review.RESULTS AND CONCLUSION:(1)This paper reviews recent methods for isolating and purifying exosomes,comparing the characteristics of ultracentrifugation,ultrafiltration,size-exclusion chromatography,polymer precipitation,immunoaffinity,microfluidic methods,and other novel approaches based on their underlying principles.(2)Methods for identifying exosomes can be categorized into physical and biochemical analyses,characterizing exosomes based on their shape,size,and characteristic proteins.(3)Mesenchymal stem cell-derived exosomes have broad applications in multiple fields such as medical aesthetics,wound repair,and cancer treatment,due to their immune-regulatory properties and ability to cross biological barriers.(4)The clinical translation of exosomes faces challenges due to their complex structure,lack of universal isolation techniques,and poor stability,making it difficult to achieve in a short period of time.

OBJECTIVE To systematically evaluate the correlation between dynamic changes in inflammatory markers during treatment with epidermal growth factor receptor-tyrosine kinase inhibitors （EGFR-TKIs） in non-small cell lung cancer （NSCLC） patients and therapeutic efficacy， with the aim of providing evidence-based support for clinical prognosis assessment and treatment strategy adjustment. METHODS Databases including PubMed， Embase， Cochrane Library， CNKI， Wanfang Data， and CBM were searched from the inception to July 20， 2025. Following literature screening， data extraction and quality assessment， descriptive analysis was conducted on the outcomes of included studies. RESULTS A total of eight studies were included to analyze the correlation of 6 inflammatory markers before and after treatment with EGFR-TKIs with therapeutic efficacy. The risk of bias assessment identified six high-quality studies and two moderate-quality studies. Among these studies， seven studies demonstrated that lower levels of neutrophil-to-lymphocyte ratio （NLR）， derived neutrophil-to-lymphocyte ratio （dNLR）， platelet-to-lymphocyte ratio （PLR）， and monocyte-to-lymphocyte ratio （MLR）， higher lymphocyte-to-monocyte ratio （LMR） before treatment， as well as decreased NLR and MLR and increased LMR after treatment were associated with longer median progression-free survival. Five studies indicated that lower levels of NLR， dNLR， PLR， and interleukin-6 （IL-6）， higher LMR before treatment as well as decreased NLR and dNLR and increased LMR were associated with longer median overall survival. Three studies indicated that lower levels of IL-6 were associated with a higher objective response rate， while the association of these markers after treatment remained controversial； another study showed that an early decline in NLR， MLR， and PLR after treatment may be associated with objective response benefit. CONCLUSIONS Lower inflammatory levels during EGFR-TKIs therapy correlate with better therapeutic efficacy in NSCLC patients.

Objective: To evaluate the causal effects and population heterogeneity of Guangzhou′s Voluntary Blood Donation Privilege Certificate Policy on blood donation behavior, and to provide empirical evidence for optimizing blood management policies. Methods: Using an interrupted time series (ITS) design, we analyzed 30 quarters of blood collection data from Guangzhou Blood Center (from July 2018 to December 2025). Taking the third quarter of 2021 as the intervention node, we constructed ordinary least squares (OLS) regression models incorporating level and trend effects, and conducted stratified analyses by gender, age group, previous donation frequency, and per-donation volume. Results: The tiered incentive policy demonstrated significant heterogeneous effects. Apheresis donations showed sustained growth, with 2 units of component blood exhibiting a significant trend effect (β=304.58, P<0.001); high-frequency donors (11+ times) demonstrated sustained growth trends in apheresis donations. For whole blood, immediate effects were significant for donors with 1-2 previous donations (β=4 537.55, P<0.001) and 3-10 previous donations (β=2 159.69, P<0.05); high-frequency donors (11-30 times) showed sustained growth trends (P<0.01). Stratified by per-donation volume, 400 mL whole blood demonstrated a significant immediate effect (β=4 391.01, P<0.1), while 200 mL whole blood showed a significant declining trend (β=-893.24, P<0.01). Conclusion: The tiered incentive policy effectively enhanced blood donation participation while maintaining the donors’ altruistic motivations. Young and middle-aged adults primarily drove apheresis donations. The policy demonstrated immediate incentive effects on low-frequency whole blood donors and long-term retention effects on high-frequency donors. Per-donation volume showed an "upward migration" trend, optimizing the blood collection structure. Differentiated outreach, conversion and retention strategies are recommended to further strengthen blood supply security.

Objective: To evaluate the methodological quality and reporting quality of clinical practice guidelines or expert consensus on blood transfusion and blood use (BTBU) in China (hereinafter referred to as "guidelines/consensus"), providing reference for the development and updating of future BTBU guidelines/consensus. Methods: A systematic search was conducted in Chinese databases such as China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP Data-base, relevant guideline release platforms, and professional association websites. BTBU-related guidelines/consensus published between January 2006 and December 2025 were included. According to the inclusion and exclusion criteria, after completing literature screening and data extraction, three evaluators independently assessed the quality of the included literature using the Scientificity, Transparency, and Applicability of Guidelines Rating Tool (STAR), the Appraisal of Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ), and the International Practice Guideline Reporting Standards (RIGHT). Results: A total of 29 documents were included, including 5 guidelines, 22 consensus statements, and 2 protocols. The results of the STAR assessment showed that the total score was (21.7±8.8)%. The domain score ratios for registration, research protocol, funding, working group, conflict of interest, clinical question, evidence, consensus method, recommendation, accessibility and other domains were (2.2±12.1)%, 0, (36.7±25.1)%, (18.3±7.6)%, (19.2±15.3)%, (16.6±23.1)%, (15.1±6.3)%, (9.6±21.2)%, (54.3±18.4)%, (31.7±10.4)% and (10.3±31.0)%, respectively. For the AGREE Ⅱ assessment, the methodological quality of 26 articles was rated Grade B and 3 articles Grade C. The results of the RIGHT assessment indicated that the overall reporting rate of all guidelines/consensuses was (65.3±4.0)%. Conclusion: The methodological and reporting quality of current expert guidelines/consensus on BTBU in China still need improvement, and guidelines and consensus should be strictly formulated and standardized according to the standards of STAR, AGREE II and RIGHT.

Puerariae Lobatae Radix and Puerariae Thomsonii Radix are the dried roots of Pueraria lobata and Pueraria thomsonii of the Leguminosae family， respectively. Since their separate inclusion in the 2005 edition of Pharmacopoeia of the People's Republic of China， the two herbs have been individually recorded. Although they share the same functions and indications， the required content of puerarin differs by a factor of up to eightfold between them. The current quality standard relies solely on a single indicator， puerarin， which fails to reflect the correlation between chemical constituents and core therapeutic effects. This has resulted in prominent issues of mixed use in clinical practice and production， thereby constraining the high-quality development of the industry. Modern research has demonstrated that Puerariae Lobatae Radix contains a comprehensive range and higher content of isoflavonoid constituents， while Puerariae Thomsonii Radix is rich in starch and polysaccharides. Puerariae Lobatae Radix exhibits stronger effects in antipyresis， cardiovascular and cerebrovascular protection， and central analgesia， while Puerariae Thomsonii Radix demonstrates greater advantages in anti-inflammation， hypoglycemia， and peripheral analgesia. Based on this， the chemical material bases of Puerariae Lobatae Radix and Puerariae Thomsonii Radix at both the macromolecule and micromolecule levels were systematically reviewed and compared. The pharmacodynamic material bases and mechanisms of action underlying their three core therapeutic effects， namely "relieving exterior syndrome and clearing heat"， "promoting fluid production to quench thirst"， and "dredging channels and activating collaterals"， were summarized. The most highly correlated common metabolic pathway shared by both herbs for these three therapeutic effects is the arachidonic acid metabolic pathway， and their common core target is prostaglandin-endoperoxide synthase 2 （PTGS2）. This review provided clinical application recommendations based on the therapeutic differences between the two herbs， elucidated the scientific connotation of their "same origin but different effects"， and， grounded in the quality marker （Q-Marker）， proposed the concept of efficacy-related Q-Marker based on "substance-efficacy-syndrome" association， as well as a novel strategy for efficacy-oriented quality evaluation. Preliminary screening of quality markers associated with different therapeutic effects was also conducted. This study aims to provide critical scientific evidence for the precise clinical application of Puerariae Lobatae Radix and Puerariae Thomsonii Radix， the improvement of quality standards， and the high-quality development of the industry.

Objective To analyze the monitoring results of occupational hazard factors (OHF) in the workplace of key industries in Shaoguan City from 2021 to 2024. Methods A total of 486 enterprises of key industries in Shaoguan City, selected from the "Occupational Diseases Hazardous Items Reporting System" and the "Guangdong Provincial Occupational Health Quality Control Platform" from 2021 to 2024, were used as the research subjects. Data on the declaration of occupational hazard projects, the exposure to OHF and the occupational medical examinations for workers, the usage of protective equipment and the setup of protection facilities in enterprises, and the monitoring results of OHF were analyzed. Results From 2021 to 2024, a total of 486 enterprises of key industries in Shaoguan City were monitored, and the detection rate of OHF exceeding national standard was 57.0%. The exceedance rates in medium/large enterprises and small/micro enterprises were 67.1% and 55.0%, respectively. A total of 51 771 worker-exposures to OHF were recorded, with an exposure rate of 55.8%. Training coverage for enterprise managers, occupational health personnel, and workers were 96.7%, 97.1%, and 98.7%, respectively. Abnormal rates in occupational medical examinations were 3.3%, 0.2%, and 0.8% among workers exposed to noise, dust, and chemical factors, respectively. Provision rates of dust respirators, chemical respirators, hearing protection devices (earplugs and earmuffs) were 93.2%, 85.4% and 86.8%, respectively, with wearing compliance rates of 98.7%, 98.8% and 97.1%. Installation rates of dust control, chemical hazard control, and noise control facilities were 97.2%, 90.3%, and 69.9%, respectively, and all facilities were 100.0% effective. Exceedance rates for OHF and noise increased annually (all P<0.05), whereas those for dust and chemical factors decreased (all P<0.05). The exceedance rates of work position from high to low were dust (18.1%), noise (17.1%) and chemical factors (6.4%). Lead-related position had the highest exceedance rate (31.9%). Industries with higher exceedance rates included metal products manufacturing (27.3%), ferrous metal smelting and rolling (24.1%), and non-metallic mineral products manufacturing (23.7%). Conclusion Workplaces in key industries of Shaoguan City face relatively high risks of occupational hazards. It is essential to focus on noise management, with efforts to strengthen occupational health supervision and guidance for small/micro enterprises as well as industries with severe occupational hazards, promoting the standardization of occupational health management.

Objective To compare the clinical efficacy and safety of 1 470 nm laser en bloc resection of bladder tumor(1 470 nm-EBRBT)and transurethral resection of bladder tumor(TUR-BT).Methods Clinical data of 85 non-muscle-invasive bladder cancer(NMIBC)patients from June 2018 to June 2021 were analyzed retrospectively.The patients were divided into 1 470 nm-EBRBT group(n=40)and TUR-BT group(n=45)according to different surgical methods,the postoperative chemotherapy regimen of bladder perfusion was the same in both groups.The surgical safety,clinical efficacy,pathological results and recurrence free survival rate of two groups were recorded.Results There were no statistically significant differences in operation time,incidence of bladder perforation,and incidence of postoperative delayed hemorrhage between the two groups(P＞0.05).Compared with the TUR-BT group,the 1 470 nm-EBRBT group had less blood loss,shorter bladder irrigation time,catheter indwelling time and postoperative hospital time,and no obturator nerve reflex,the differences were statistically significant(P＜0.05).The proportion of detrusor in the first resected pathological specimens in 1 470 nm-EBRBT group was higher than that in TUR-BT group(P＜0.05).There were no statistically significant differences in tumor recurrence rate of one year,tumor cumulative recurrence rate of two years and recurrence free survival time between the two groups(P＞0.05).Conclusion Compared with traditional TUR-BT,1 470 nm-EBRBT is a safe and effective method,which has the advantages of complete pathological specimens,fewer complications,faster recovery and so on.Therefore,it is worthy of clinical application.

Objective The data related to adverse drug reaction of trastuzumab deruxtecan(T-DXd)were mined to provide references for its clinical management and adverse event handling.Methods Based on the Food and Drug Administration Adverse Event Reporting System(FAERS)database,the data reported from the post-marketing period of T-DXd until the fourth quarter of 2024 were extracted.The proportion imbalance method,specifically the reporting odds ratio(ROR)method,was used to mine and analyze the data related to adverse events of T-DXd.Results A total of 13 134 cases of adverse events related to T-DXd were obtained from the FAERS database.Gastrointestinal disorders were the most common,with 2348 adverse reaction signals,accounting for 17.88％.The most frequent adverse reactions were nausea(n=809),interstitial lung disease(n=732),and fatigue(n=579).The one with the highest ROR value was Listeriosis gastroenteritis(ROR=1228.74).The highest number of deaths were from interstitial lung disease(226),pneumonitis(90),and nausea(67).Conclusion By mining data on real-world adverse drug reaction related to T-DXd,suggests that pulmonary function,cardiac function,complete blood count and other parameters should be closely monitored during treatment for early diagnosis and treatment of corresponding complications.

Objective:To investigate the role of ubiquitin-specific protease 21 (USP21) in enterovirus group A type 71 (EV-A71) infection.Methods:Peripheral blood mononuclear cells (PBMC) were obtained from a cohort of 24 children infected with EV-A71 and 24 healthy children. Expression of USP21 was determined by real-time fluorescence quantitative PCR (qPCR). Additionally, the impact of USP21 overexpression or knockout on EV-A71 replication was evaluated using a combination of qPCR and western blot (WB) analysis. Furthermore, WB was employed to measure the levels of EV-A71 structural protein VP1, phosphorylated interferon regulatory factor 3 (IRF3) and other key molecules in the RIG-I-like receptor (RLR) signaling pathway. Co-immunoprecipitation (Co-IP) was utilized to investigate the effects of USP21 on the ubiquitin levels of EV-A71 nonstructural protein 2A protease (2A pro). Results:In comparison to healthy children, the expression of USP21 mRNA in PBMC of children infected with EV-A71 was notably elevated. The overexpression of USP21 significantly enhanced the cytopathic effects induced by EV-A71, upregulated levels of VP1 mRNA and protein, and facilitated EV-A71 replication, leading to a decrease in cell activity with increasing levels of USP21 transfection. Following the knockout of the USP21 gene, the VP1 mRNA levels were significantly declined in comparison to the control group. Furthermore, the overexpression of USP21 was found to have no impact on the transcriptional activity of EV-A71 2A pro. However, it was observed to enhance the expression of 2A pro protein, reduce the ubiquitination of 2A pro, suppress the protein levels of mitochondrial antiviral signaling protein (MAVS) and melanoma differentiation-associated gene 5 (MDA5), as well as decrease the phosphorylation of IRF3. Additionally, the induction of IFN-β mRNA by EV-A71 infection was downregulated. Conclusions:USP21 has been shown to enhance the replication of EV-A71 through the downregulation of 2A pro ubiquitination, suppression of MAVS and MDA5 protein expression, and inhibition of the interferon signaling pathway.