Objective To detect and identify the differentially expressed tsRNA in the serum of patients with Sj?gren's syndrome(SS),and preliminarily explore their potential application value in the diagnosis of SS.Methods The serum samples from SS patients diagnosed at the Rheumatology Department of Nanjing Drum Tower Hospital and healthy controls(HCs)matched age and gender were collected,and the differentially expressed tsRNA were screened by small RNA sequencing.Fluorescence quantitative real-time PCR(qRT-PCR)was used to valid the sequence data.The receiver operating characteristic(ROC)curve was used to evaluate the diagnos-tic efficiency of tRNA-Gly-GCC-1-1.KEGG and GO analysis were used to predict the potential mechanism of tRNA-GLy-GCC-1-1 in the occurrence and development of SS.Results Compared with HCs(13.34[10.45,18.74]fmol/L),the levels of serum tRNA-Gly-GCC-1-1 in SS patients(8.82[7.26,12.20]fmol/L)were significantly reduced(P＜0.000 1),and its area under the ROC curve(AUCROC)in distinguishing SS patients from HCs was 0.766(95%CI:0.671-0.861).When the cut-off value was 9.97 fmol/L,its sensitivity and specificity were 83.33%and 64.58%,respectively.Bioinformatics analysis showed that serum tRNA-Gly-GCC-1-1 might be involved in the regulation of signaling pathways such as PI3K-Akt.Conclusion Serum tRNA-Gly-GCC-1-1 in SS patients is significantly down-regulated,which has potential clinical application value in assisting the diagnosis of SS.

Prescription optimization is a crucial aspect in the study of traditional Chinese medicine （TCM） compounds. In recent years， the introduction of mathematical methods， data mining techniques， and artificial neural networks has provided new tools for elucidating the compatibility rules of TCM compounds. The study of TCM compounds involves numerous variables， including the proportions of different herbs， the specific extraction parts of each ingredient， and the interactions among multiple components. These factors together create a complex nonlinear dose-effect relationship. In this context， it is essential to identify methods that suit the characteristics of TCM compounds and can leverage their advantages for effective application in new drug development. This paper provided a comprehensive review of the cutting-edge optimization experimental design methods applied in recent studies of TCM compound compatibilities. The key technical issues， such as the optimization of source material selection， dosage optimization of compatible herbs， and multi-objective optimization indicators， were discussed. Furthermore， the evaluation methods for component effects were summarized during the optimization process， so as to provide scientific and practical foundations for innovative research in TCM and the development of new drugs based on TCM compounds.

Objective:To evaluate the efficacy of an etoposide (Vp16) -intensified conditioning regimen in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of relapsed/refractory acute myeloid leukemia (AML).Method:A retrospective analysis was conducted on the clinical data of 27 recipients with relapsed/refractory AML who underwent allo-HSCT using a Vp16-intensified conditioning regimen at Aerospace Center Hospital from January 2019 to January 2022. Transplantation-related complications and treatment outcomes were observed. Kaplan-Meier survival analysis was used to assess the overall survival (OS) and disease-free survival (DFS) rates.Result:Among the 27 recipients, there were 14 males and 13 females, with a median age of 41 years (range: 12~55 years). Except for one recipient who experienced primary graft failure, the remaining 26 recipients achieved hematopoietic reconstitution. The median neutrophil and platelet engraftment times were 13 days (range: 9~20 days) and 13.5 days (range: 11~33 days), respectively. Regimen-related toxicity (RRT) was mainly gastrointestinal toxicity and oral mucositis, and no deaths were attributed to RRT. A total of 12 recipients (44.44%) developed acute graft-versus-host disease (aGVHD), of whom 3 cases (11.11%) had grade III~IV aGVHD. Chronic GVHD (cGVHD) occurred in 13 recipients (48.15%), including 8 cases (29.63%) of extensive cGVHD. The median follow-up time after transplantation was 17 months (range: 1~48 months). Fifteen recipients (55.56%) survived without disease, while 12 recipients (44.44%) died— 9 due to relapse and 3 due to transplant-related complications. The 1-year overall survival and DFS rates were 74.07% and 59.26%, respectively; the 2-year overall survival and DFS rates were 59.26% and 55.56%, respectively. The 2-year relapse rate and transplant-related mortality (TRM) were 33.33% and 11.11%, respectively.Conclusion:The Vp16-intensified conditioning regimen in allo-HSCT appears to be a viable treatment option for patients with relapsed/refractory AML, offering favorable efficacy and manageable safety.

Checkpoint blockade immunotherapy has emerged as a transformative approach in cancer treatment by activating tumor-infiltrating T cells. However, the efficacy of PD-L1 blockade is restricted in "cold" tumors, which are characterized by low immunogenicity, presenting a challenge to immunotherapy. This study introduces an innovative strategy, utilizing cathepsin-cleavable N-(2-hydroxypropyl) methacrylamide (HPMA) polymer-assisted combined photodynamic therapy (PDT) and PD-L1 degradation for the first time, effectively treating T cell-deficient tumors. The degradable main-chain polymer, conjugated with photosensitizer porphyrin, facilitates the accumulation of reactive oxygen species (ROS), triggering immunogenic cell death (ICD) and promoting cytotoxic T lymphocytes (CTLs) infiltration into tumors. Multivalent peptide antagonists of PD-L1 promote PD-L1 degradation in lysosomes through receptor crosslinking, overcoming the adaptive cycling of PD-L1 to the tumor cell surface. These findings demonstrate that polymer-assisted PDT and PD-L1 crosslinking degradation represent a potential novel strategy for anti-tumor immunotherapy, providing valuable tools for expanding immunotherapy applications in immunosuppressive cancers.

Objective To detect and identify the differentially expressed tsRNA in the serum of patients with Sj?gren's syndrome(SS),and preliminarily explore their potential application value in the diagnosis of SS.Methods The serum samples from SS patients diagnosed at the Rheumatology Department of Nanjing Drum Tower Hospital and healthy controls(HCs)matched age and gender were collected,and the differentially expressed tsRNA were screened by small RNA sequencing.Fluorescence quantitative real-time PCR(qRT-PCR)was used to valid the sequence data.The receiver operating characteristic(ROC)curve was used to evaluate the diagnos-tic efficiency of tRNA-Gly-GCC-1-1.KEGG and GO analysis were used to predict the potential mechanism of tRNA-GLy-GCC-1-1 in the occurrence and development of SS.Results Compared with HCs(13.34[10.45,18.74]fmol/L),the levels of serum tRNA-Gly-GCC-1-1 in SS patients(8.82[7.26,12.20]fmol/L)were significantly reduced(P＜0.000 1),and its area under the ROC curve(AUCROC)in distinguishing SS patients from HCs was 0.766(95%CI:0.671-0.861).When the cut-off value was 9.97 fmol/L,its sensitivity and specificity were 83.33%and 64.58%,respectively.Bioinformatics analysis showed that serum tRNA-Gly-GCC-1-1 might be involved in the regulation of signaling pathways such as PI3K-Akt.Conclusion Serum tRNA-Gly-GCC-1-1 in SS patients is significantly down-regulated,which has potential clinical application value in assisting the diagnosis of SS.

Objective:To evaluate the efficacy of an etoposide (Vp16) -intensified conditioning regimen in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of relapsed/refractory acute myeloid leukemia (AML).Method:A retrospective analysis was conducted on the clinical data of 27 recipients with relapsed/refractory AML who underwent allo-HSCT using a Vp16-intensified conditioning regimen at Aerospace Center Hospital from January 2019 to January 2022. Transplantation-related complications and treatment outcomes were observed. Kaplan-Meier survival analysis was used to assess the overall survival (OS) and disease-free survival (DFS) rates.Result:Among the 27 recipients, there were 14 males and 13 females, with a median age of 41 years (range: 12~55 years). Except for one recipient who experienced primary graft failure, the remaining 26 recipients achieved hematopoietic reconstitution. The median neutrophil and platelet engraftment times were 13 days (range: 9~20 days) and 13.5 days (range: 11~33 days), respectively. Regimen-related toxicity (RRT) was mainly gastrointestinal toxicity and oral mucositis, and no deaths were attributed to RRT. A total of 12 recipients (44.44%) developed acute graft-versus-host disease (aGVHD), of whom 3 cases (11.11%) had grade III~IV aGVHD. Chronic GVHD (cGVHD) occurred in 13 recipients (48.15%), including 8 cases (29.63%) of extensive cGVHD. The median follow-up time after transplantation was 17 months (range: 1~48 months). Fifteen recipients (55.56%) survived without disease, while 12 recipients (44.44%) died— 9 due to relapse and 3 due to transplant-related complications. The 1-year overall survival and DFS rates were 74.07% and 59.26%, respectively; the 2-year overall survival and DFS rates were 59.26% and 55.56%, respectively. The 2-year relapse rate and transplant-related mortality (TRM) were 33.33% and 11.11%, respectively.Conclusion:The Vp16-intensified conditioning regimen in allo-HSCT appears to be a viable treatment option for patients with relapsed/refractory AML, offering favorable efficacy and manageable safety.

Objective::To determine the role of regular diet recovery after restoration of normal muscle strength of both lower extremities in promoting postoperative recovery in women undergoing elective cesarean section.Methods::This was a prospective observational cohort study. Patients who underwent elective cesarean section at Xiangya Hospital, Central South University, from October 2022 to December 2022, were categorized into two groups based on the duration of postoperative fasting: the observation group resumed eating after regaining lower extremity muscle strength, while the control group adhered to traditional postoperative fasting guidelines, waiting 6 hours before eating. Primary outcomes included postoperative pain levels assessed by visual analog scale (VAS) pain scores and time to first flatus. Demographic characteristics, time to first lactation, hospital stay length, and patient satisfaction were also assessed. Statistical analysis was conducted using Student’s t test and Chi-squared test, with significance set at P < 0.05. Results::Out of a total of 300 patients, 240 were included in the analysis, comprising 112 in the control group and 128 in the observation group. There were no significant differences in baseline demographic characteristics. The median values of the first flatus time and the first lactation time were 33.37 ± 1.22 vs. 18.06 ± 6.34 hours ( P = 0.003) and 26.34 ± 8.21 vs. 7.05 ± 1.26 hours ( P = 0.001) in the control and observation groups, respectively. The median hospital stay duration in the control and observation groups was 6.54 ± 0.53 vs. 4.84 ± 0.18 days ( P = 0.000), respectively. Median postoperative VAS pain scores and patient satisfaction values were 8.57 ± 0.11 vs. 4.91 ± 0.27 ( P = 0.000) and 9.36 ± 0.16 vs. 9.72 ± 0.08 ( P = 0.005) in the control and observation groups, respectively. There were no statistically significant differences in other postoperative outcomes, such as intestinal obstruction, infection, and readmission within 42 days ( P > 0.05). Conclusion::Food intake after restoration of lower extremity muscle strength improves first flatus, relieves postoperative pain, shortens hospital stay, and enhances satisfaction after elective cesarean section, without adverse effects. It is crucial for postoperative rehabilitation and should be encouraged.

Objective::To determine the role of regular diet recovery after restoration of normal muscle strength of both lower extremities in promoting postoperative recovery in women undergoing elective cesarean section.Methods::This was a prospective observational cohort study. Patients who underwent elective cesarean section at Xiangya Hospital, Central South University, from October 2022 to December 2022, were categorized into two groups based on the duration of postoperative fasting: the observation group resumed eating after regaining lower extremity muscle strength, while the control group adhered to traditional postoperative fasting guidelines, waiting 6 hours before eating. Primary outcomes included postoperative pain levels assessed by visual analog scale (VAS) pain scores and time to first flatus. Demographic characteristics, time to first lactation, hospital stay length, and patient satisfaction were also assessed. Statistical analysis was conducted using Student’s t test and Chi-squared test, with significance set at P < 0.05. Results::Out of a total of 300 patients, 240 were included in the analysis, comprising 112 in the control group and 128 in the observation group. There were no significant differences in baseline demographic characteristics. The median values of the first flatus time and the first lactation time were 33.37 ± 1.22 vs. 18.06 ± 6.34 hours ( P = 0.003) and 26.34 ± 8.21 vs. 7.05 ± 1.26 hours ( P = 0.001) in the control and observation groups, respectively. The median hospital stay duration in the control and observation groups was 6.54 ± 0.53 vs. 4.84 ± 0.18 days ( P = 0.000), respectively. Median postoperative VAS pain scores and patient satisfaction values were 8.57 ± 0.11 vs. 4.91 ± 0.27 ( P = 0.000) and 9.36 ± 0.16 vs. 9.72 ± 0.08 ( P = 0.005) in the control and observation groups, respectively. There were no statistically significant differences in other postoperative outcomes, such as intestinal obstruction, infection, and readmission within 42 days ( P > 0.05). Conclusion::Food intake after restoration of lower extremity muscle strength improves first flatus, relieves postoperative pain, shortens hospital stay, and enhances satisfaction after elective cesarean section, without adverse effects. It is crucial for postoperative rehabilitation and should be encouraged.

Objective To investigate the design of cuffed pediatric tracheal tubes and compare the effects of different tracheal intubation depth placement strategies on the position of the tracheal tube tip and cuff of 5 tracheal tube brands.Methods A total of 180 children who were admitted to Tianjin Children's Hospital from October 2020 to December 2021,with endotracheal intubation under general anesthesia,aged 1-6 years,were enrolled.The length of the subglottic airway was measured by electronic bronchoscopy.Dimensional data from 5 cuffed pediatric tracheal tube brands were recorded,including the length of the tracheal tube cuff,the distance from the tip of the tracheal tube to the upper edge of the cuff,and the tip of the tracheal tube to the lower edge of the tube glottis marker line the distance.Calculation of the required cuffed endotracheal tube internal diameter(ID)for 180 pediatric patients was performed based on the Motoyama formula,the positions of tracheal tube tip and upper cuff border were calculated for each of the 180 tracheas using depth mark to based tracheal tube placement,placement of the tracheal tube tip at 2 cm above the carina,and mid-tracheal tube placement.Results There were differences in the dimensional data of the 5 cuffed pediatric tracheal tube brands.Depth mark-based tracheal tube placement resulted in the incidence rate of tube tip to carina placement less than 1 cm was 3.9%-67.8%,and the highest incidence of bronchial intubation is Ruijing,up to 17.8%.The tracheal tube tip was placed 2 cm above the carina,and no improper placement of the tracheal tube cuff and tube tip was found in all brands.Mid-tracheal tube placement led to 100%subglottic and supraglottic tracheal tube cuff positions,except Weili.Conclusions There are differences in design between different brands of cuffed pediatric tracheal tube,and some of the design deficiencies may lead to the risk of airway complications.The method used to guide the insertion depth and the brand of cuffed tracheal tubes can affect the tracheal tube position.Placement of the tracheal tube tip at 2 cm above the carina allowed safe tracheal tube placement in children aged 1-6 years.