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

Mood disorders/psychosis have been associated with dysfunctions in the default mode network (DMN). However, the relative contributions of DMN regions to state and trait disturbances in pediatric bipolar disorder (PBD) remain unclear. The aim of this study was to investigate the possible mechanisms of PBD through brain imaging and explore the influence of psychotic symptoms on functional alterations in PBD patients. Twenty-nine psychotic and 26 non-psychotic PBD patients, as well as 19 age- and sex-matched healthy controls underwent a resting-state functional MRI scan and the data were analyzed by independent component analysis. The DMN component from the fMRI data was extracted for each participant. Spearman's rank correlation analysis was performed between aberrant connectivity and clinical measurements. The results demonstrated that psychotic PBD was characterized by aberrant DMN connectivity in the anterior cingulate cortex/medial prefrontal cortex, bilateral caudate nucleus, bilateral angular gyri, and left middle temporal gyrus, while non-psychotic PBD was not, suggesting further impairment with the development of psychosis. In summary, we demonstrated unique impairment in DMN functional connectivity in the psychotic PBD group. These specific neuroanatomical abnormalities may shed light on the underlying pathophysiology and presentation of PBD.

Objective To discuss the application of endoscopic ultrasound-guided needle-based confocal laser endomicroscopy ( EUS-nCLE) in the diagnosis of pancreatic neoplasms. Methods Patients with pancreatic neoplasms were diagnosed by endoscopic ultrasonography and punctured by 19 G needle, and then the confocal microprobe was implanted through the needle. The lesions nature was estimated according to obtained images. The diagnostic yield and complication was evaluated and compared with pathology. Results A total of 28 patients successfully underwent EUS-nCLE, and high quality images were obtained in all patients. The final diagnosis were 5 cases of serous cystadenoma ( SCN ) , 3 cases of mucinous cystadenoma, 3 cases of intraductal papillary mucinous neoplasms ( IPMN) , 1 case of pseudocyst, 10 cases of ductal adenocarcinoma, 1 case of neuroendocrine tumor, 2 cases of solid pseudopapillary tumor, 2 cases of chronic pancreatitis, and 1 cases of lymphoma. The diagnostic yield in 26 patients with pathology was 73. 1%(19/26) and the specificity of SCN and IPMN was 100%(7/7). The complications, mostly pancreatitis and intracystic hemorrhage, occurred in 10. 7% ( 3/28) patients. Conclusion EUS-nCLE is a safe and feasible method in the diagnosis of pancreatic neoplasms, and shows high specificity in SCN and IPMN.

It has been a general trend to open the 5+3 medical personnel training mode of radiology in China.But at present,there are still a lot of problems during the process,such as,lack of training plan,unified teaching materials and examination index for reference,lack of learning consciousness and self-discipline among the students who participate in the standardization training,lack of adequate teaching resources in the standardization training base,and so on.In order to cultivate qualified and high-quality radiologists,this paper discussed the ways of forming a new set mode of 5+3 medical personnel training in the radiology department through exploration and practice,including strengthening teachers' construction and building a professional teachers troop,reforming the teaching method of standardization training,improving the teaching base infrastructure,establishing and perfecting the assessment evaluation mechanism.

Objective:Dual-track teaching mode in higher colleges and universities of Chinese medicine in clinical pathology teaching reform and practice, so as to change the phenomenon of university students of traditional Chinese medicine western medicine foundation weak, and improve the teaching quality of clinical pathology.Methods: We use the traditional teaching method (LBL) and teaching method of the problem-based learning (PBL) to make double-track recess internship teaching model in clinical pathology, and in practice use the access type, interactive type and potential mining methods to motivate the students’ learning.Results: The dual-track teaching model realizes complementary teaching effect of a variety of teaching methods, makes the teaching quality enhance unceasingly. It not only exercises the students’ ability of autonomous learning, cultivate the students’ clinical thinking, but also stimulates students’ imagination and improves the students’ ability to analyze and solve practical problems.Conclusion: The dual-track teaching mode is worth popularizing in the higher colleges and universities of traditional Chinese medicine, and it can improve the students’ comprehensive quality and innovation and make it better from students to the role of the doctor.

In view of the problems existing in medical image network teaching, such as redundant and rigid curriculum system, obsolete structure, untimely updates, lack of supervision system and poor stability of network security and so on, we explored how to improve the medical image network teaching from the fusion of traditional teaching, optimizing curriculum system, perfecting the medical imaging system of autonomous learning, encouraging online communication, creating a good atmosphere, increasing invest-ment in software development and multi-sectoral collaboration, in order to complete the transfer of knowl-edge more effectively, and promote the good development of medical imaging teaching.

Objective To research the expression of Neuritin in gastric cancer .and the relationship between the expression of Neuritin with the occurrence and development of gastric cancer .Methods Collected 58 surgical specimens of gastric cancer from 2010 to 2013 in the first affiliated hospital of Shihezi University ,immunohistochemistry was used to examine the expression of Neu-ritin in gastric cancer and normal tissues near the cancer of the stomach .Results Immunohistochemical staining showed that Neu-ritin was moderately or highly expressed in 96 .55% (56/58) of gastric cancer ,and Neuritin was moderately or highly expressed in 94 .83% (55/58) of normal tissues near the cancer .There was no statistically significantly difference between two groups (P>0 .05);Neuritin was highly expressed in 82 .76% (48/58) of gastric cancer ,and Neuritin was highly expressed in 15 .52% (9/58) of normal tissues near the cancer ,differences between the two groups had statistically significantly (P<0 .05) .Expression of Neuritin was not correlated with gender ,age ,TNM stage ,infiltration depth ,lymph node metastasis ,differentiated degree ,the pathologic type or distant metastasis(P> 0 .05) .Conclusion The Neuritin expression level between gastric cancer and normal tissues near the cancer exist differences .There is overexpression of neuritin in gastric cancer .

OBJECTIVE: To summarize the clinical experience of endoscopic repair for cerebrospinal fluid (CSF) rhinorrhea in our department in the last 4 years. METHOD: Clinical data of 16 patients with CSF rhinorrhea who underwent nasal endoscopic repair was analyzed retrospectively. The effect of etiology, image data, location of CSF leaks and surgical techniques on treatment were discussed. RESULT: Among the 16 patients, 10 were diagnosed with spontaneous CSF rhinorrhea, 2 were diagnosed with traumatic CSF rhinorrhea, 3 were diagnosed with CSF rhinorrhea after catching cold and 1 was diagnosed with meningo-encephalocele in with CSF rhinorrhea. The leak was located by CT scan in 11 cases, by MRI in 7 cases. The common locations of the defect were the frontal sinus (3 cases), cribriform roof (3 cases), sphenoid sinus (6 cases) and the nasal cavity top (4 cases). All the cases were successfully cured after the first nasal endoscopic repair with autologous materials. None of patients had a reoccurrence during 10 to 42 months follow-up time. CONCLUSION The application of CT and MRC before surgery which could make an accurate diagnosis of the location and the size of the defect. The correct selection of repair materials, processing planting bed around the leakage and complete contacting leakage with graft bed are the key points to the successful surgery of CSF rhinorrhea.
Adolescent ; Adult ; Cerebrospinal Fluid Rhinorrhea ; surgery ; Child ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Failure ; Treatment Outcome ; Young Adult

Objective To observe the role and mechanism of CO-releasing molecules (CORMs) -2in the injured lung induced by ischmia-reperfusion (IR) of hind limbs of rat.Methods The rat model of lung injury was made by ischemia in hind limbs of rat for two hours and then reperfusion for two hours as well.There were 40 SD rats randomly ( random number) divided into 5 groups ( n =8 ),namely sham ischemia-reperfusion (I/R) group,sham I/R + CORM-2 group,I/R group,I/R + CORM-2 group and I/R + DMSO (Dimethylsulfoxide) group. Rats in sham I/R group underwent laparotomy without infrarenal aorta occlusion.The lung tissue structure,polymorphonuclear neutrophil (PMN) count,wet-to-dry weight ratio (W/D), malondialdehyde (MDA) content, myeloperoxidase (MPO) activity, intercellular adhesion molecule-1 ( ICAM-1 ),nuclear IκBα degradation and NF-κB activity in the lung were measured.Results Compared with the sham I/R group,the number of PMNs in lung,W/D,MDA content,MPOactivity,ICAM-1 and NF-κB activity significantly increased in I/R group,whereas nuclear IκBα decreased (P ＜ 0.01).Compared with the I/R group,the number of PMNs in lung,W/D,MDA content,MPO activity and ICAM-1 significantly decreased in I/R + COMR-2 group ( P ＜ 0.01 ), while nuclear IkBαincreased. Conclusions These data demonstrate that CORM-2 attenuates limb I/R-induced lung injury by inhibiting ICAM-1 protein,NF-κB pathway and the leukocytes sequestration in the lung following limb I/R in rats,suggesting that CORM-2 could be used as one of the most valuable therapeutic agents.

The protective roles of alpha-lipoic acid in the rat model of mitochondrial DNA (mtDNA) 4834bp deletion in inner ear were investigated. Forty female Wistar rats at 4 weeks of age were divided into four groups: group A (D-galactose group, n=10), group B (D-galactose+alpha-lipoic acid group, n=10), group C (alpha-lipoic acid group, n=10), and group D (control group, n=10). Auditory brainstem response (ABR) was used to detect the hearing threshold. Colorimetry was used to analyze activity of superoxide dismutase (SOD) and concentration of malondialdehyde (MDA). The percentage of mtDNA4834bp deletion in inner ear was identified by real-time PCR. There was no significant difference in ABR threshold shift among all groups. The percentage of mtDNA4834bp deletion in group A was higher than that in other groups, but there was no significant difference in percentage of mtDNA4834bp deletion among groups B, C, and D. The activity of SOD in group A was lower than that in other groups. The concentration of MDA in group A was higher than that in other groups. It was concluded that there was no significant hearing loss when the percentage of mtDNA4834bp deletion was lower than 12.5%. alpha-Lipoic acid could prevent the reactive oxygen species (ROS)-induced mtDNA4834bp deletion in inner ear of rats.