Objective To investigate the performance of serum epithelial fatty acid-binding protein (E-FABP) and epithelial neutrophil-activating peptide-78 (ENA-78) levels combined with computed tomography angiography (CTA) in assessing the severity of coronary atherosclerotic (CA) stenosis in patients with coronary heart disease (CHD). Methods A total of 160 CHD patients admitted to our hospital between October 2021 and October 2023 were enrolled. Based on coronary angiography results, patients were divided into a mild stenosis group (65 cases) and a moderate-to-severe stenosis group (95 cases). All patients underwent CTA. Serum levels of E-FABP and ENA-78 were measured using ELISA. Receiver operating characteristic curves were plotted to determine the diagnostic cutoff value of CTA combined with serum E-FABP and ENA-78 for assessing CA stenosis severity. A fourfold table was used to evaluate the diagnostic performance of CTA combined with serum E-FABP and ENA-78. Results CTA identified 64 patients with stenosis <50% and 96 patients with stenosis ≥50%. The agreement rates between CTA and coronary angiography were 87.69% in the mild group and 92.63% in the moderate-to-severe group. Serum levels of E-FABP and ENA-78 were significantly higher in the moderate-to-severe group than in the mild group (P<0.05). According to receiver operating characteristic analysis, the areas under the curve for E-FABP, ENA-78, and CTA in diagnosing CA stenosis severity were 0.828, 0.855, and 0.901, respectively. The areas under the curve for their combined use was 0.986. The diagnostic accuracies of CTA, E-FABP, and ENA-78 were 90.63%, 83.75%, and 83.23%, respectively, while the combined approach achieved a diagnostic accuracy of 93.13%. Conclusion Serum levels of E-FABP and ENA-78 are significantly elevated in CHD patients with moderate-to-severe CA stenosis. The combination of CTA with E-FABP and ENA-78 can improve the accuracy of assessing the severity of CA stenosis.

BACKGROUND: Pre-transplant exposure to immune checkpoint inhibitors (ICIs) significantly increases the risk of allograft rejection after liver transplantation (LT); however, whether ICI-related rejection leads to increased graft loss remains controversial. Therefore, this study aimed to investigate the association between ICI-related allograft rejection and perioperative graft loss. METHODS: This was a retrospective analysis of adult liver transplant recipients with early biopsy-proven T-cell-mediated rejection (TCMR) at Liver Transplantation Center of Sun Yat-sen Memorial Hospital from June 2019 to September 2024. The pathological features, clinical characteristics, and perioperative graft survival were analyzed. RESULTS: Twenty-eight patients who underwent early TCMR between June 2019 and September 2024 were included. Based on pre-LT ICI exposure, recipients were categorized into ICI-related TCMR (irTCMR, n = 12) and conventional TCMR (cTCMR, n = 16) groups. Recipients with irTCMR had a higher median Banff rejection activity index (RAI) (6 vs . 5, P = 0.012) and more aggressive tissue damage and inflammation. Recipients with irTCMR showed higher proportion of treatment resistance, achieving a complete resolution rate of only 8/12 compared to 16/16 for cTCMR. Graft loss occurred in 5/12 of irTCMR recipients within 90 days after LT, with no graft loss in cTCMRs recipients. Cox analysis demonstrated that irTCMR with an ICI washout period of <30 days was an independent risk factor for perioperative graft loss (hazard ratio [HR], 6.540; 95% confidence interval [CI], 1.067-40.067, P = 0.042). CONCLUSION IrTCMR is associated with severe pathological features, increased resistance to treatment, and higher graft loss in adult liver transplant recipients.
Humans ; Liver Transplantation/adverse effects* ; Male ; Female ; Middle Aged ; Retrospective Studies ; Graft Rejection/immunology* ; Immune Checkpoint Inhibitors/therapeutic use* ; Adult ; T-Lymphocytes/drug effects* ; Graft Survival/immunology* ; Aged

Various therapeuti modailities have been engineered for lung cancer treatment, but their clinic application is severely impeded by the poor therapy efficiency and immunosuppressive microenvironment. Herein, we fabricated a library of small molecule redox-labile nanoparticles (NPs) (i.e., diPTX-2C NPs, diPTX-2S NPs, and diPTX-2Se NPs) by the self-assembly of dimer paclitaxel (PTX) prodrug, and then utilized these NPs with the traditional Chinese medicine (TCM) Qi-Yu-San-Long-Fang (Q) for effective chemoimmunotherapy on Lewis lung carcinoma (LLC)-bearing mice models. Under the high concentration of glutathione (GSH) and H₂O₂, diPTX-2Se NPs could specifically release PTX in cancer cells and exert a higher selectivity and toxicity than normal cells. In LLC tumor-bearing mice, oral administration of Q not only effectively downregulated programmed death ligand-1 (PD-L1) expression, but also remodeled the immunosuppressive tumor immune microenvironment via the increase of CD4⁺ T and CD8⁺ T cell proportion and the repolarization of M2 into M1 macrophages in tumor tissues, collectively achieving superior synergistic treatment outcomes in combination with intravenous PTX prodrug NPs. Besides, we found that the combination regimen also demonstrated excellent chemoimmunotherapeutic performances on low-dose small established tumor and high-dose large established tumor models. This study may shed light on the potent utilization of Chinese and Western-integrative strategy for efficient tumor chemoimmunotherapy.

Bronchiectasis is one of the most common and refractory lower respiratory tract diseases in clinic practice.Pseudomonas aeruginosa is the most common frequently isolated pathogen in adults with bronchiectasis complicated by infection.The complex relationship among inflammation,immunity,infection and structural damage in the airway of patients has been described as a"vicious circle"model,but the specific mechanism of different pathological links in this model and their intricate interactions are still not fully understood.The theory of"Strengthening fire eating qi"first appeared in Su Wen·Yin Yang Ying Xiang Da Lun,and provides simply explain the"qi"damage to"shape"damage of patients'airway from the perspective of"fire"and"qi"in traditional Chinese medicine,and provide new ideas for explaining the pathological mechanism connotation of bronchiectasis combined with Pseudomonas aeruginosa infection.The exploration of pathological mechanism is the fundamental source of understanding disease progression and discovering new treatment ideas.At present,the clinical treatment of Western medicine for patients with bronchiectasis mainly focuses on anti-infection and symptomatic treatment.Although etiological targeted therapies and targeted drugs are constantly explored and developed,they are still rarely applied in clinical practice.As a treasure of Chinese culture,traditional Chinese medicine has the advantage of taking both specimens into consideration,and its clinical efficacy and pharmacological value are worthy of further study.Based on the classical theory of"Strengthening fire eating qi",this review aims to understand and summarize the modern pathological mechanism of bronchiectasis combined with Pseudomonas aeruginosa infection and highlights current research hotspots in both Chinese and Western medicine treatment,in order to provide clinical thinking.

The incidence of tumors among the elderly is notably high, presenting significant challenges in terms of harm, complexity, and treatment.The processes of diagnosis and treatment often lack a precise clinical foundation and robust experimental evidence, resulting in numerous difficulties and dilemmas.A collaborative approach that integrates traditional Chinese and Western medicine, leveraging the strengths of both, can substantially alleviate these challenges and ensure that elderly cancer patients can undergo systematic, comprehensive, and intensive cancer treatments.Traditional Chinese medicine can play a vital role throughout the entire continuum of diagnosis and treatment for elderly cancer patients, whether by leading, assisting, or complementing other treatment modalities.This article employs the concepts of ′righteousness′and ′evil′from traditional Chinese medicine, where ′righteousness′signifies the ′state of a person′and ′evil ′denotes the ′state of a tumor′.We systematically explore collaborative diagnosis and treatment strategies that integrate traditional Chinese and Western medicine for tumor management in the elderly, categorizing the approaches into four conditions: strong righteousness with strong evil, strong righteousness with weak evil, weak righteousness with strong evil, and weak righteousness with weak evil.In cases where both righteousness and evil are strong, the treatment strategy is primarily dominated by Western medicine, with support from traditional Chinese medicine.Conversely, when righteousness is strong and evil is weak, the strategy entails a combination of both Chinese and Western medicine.In situations characterized by weak righteousness and strong evil, the treatment approach is largely guided by traditional Chinese medicine, while also considering equal attention to both modalities.Finally, when both righteousness and evil are weak, the coordinated diagnosis and treatment strategy is primarily based on Chinese medicine, with Western medicine adapting to the circumstances and intervening appropriately throughout the process.By accurately assessing the concepts of ′righteousness′and ′evil′and implementing collaborative diagnostic and treatment strategies that integrate both traditional Chinese and Western medicine, we can significantly enhance the physical condition of elderly cancer patients.This comprehensive approach not only boosts immunity and improves organ function but also increases tolerance to tumor treatments, alleviates complications, reduces adverse reactions, and ensures that elderly cancer patients can undergo systemic cancer treatment to its fullest extent.Ultimately, this strategy aims to improve prognosis, enhance quality of life, and extend the effective survival period.

Objective:To compare the diagnostic value of semi-quantitative parameters of fluorine 18-labelled prostate-specific membrane antigen( 18F-PSMA)positron emission tomography /computed tomography(PET/CT)and the Prostate-specific Membrane Antigen Reporting and Data System(PSMA-RADS)score for identifying benign and malignant oligo-PSMA-avid bone lesions(1-5 lesions)in elderly patients with prostate cancer. Methods:A retrospective analysis was conducted on 157 prostate cancer patients who underwent 18F-PSMA PET/CT examinations at Beijing Hospital from October 2022 to August 2024.According to the inclusion and exclusion criteria, a total of 63 patients were selected.All patients underwent 18F-PSMA PET/CT examination for the purpose of initial staging or detecting lesions with biochemical recurrence.PSMA-avid bone lesions were evaluated using the PSMA-RADS version 2.0 scoring system and the semi-quantitative parameters were measured on PSMA PET/CT images.According to the comprehensive diagnostic criteria, PSMA-avid bone lesions were divided into metastatic group and non-metastatic group.The differences in PSMA-RADS scores, semi-quantitative parameters, bone density abnormalities, and lesion distribution were compared between the two groups.Multivariate logistic regression analysis was performed to determine the factors related to the bone metastasis in prostate cancer.By plotting the receiver operating characteristic(ROC)curves and calculating the area under the curve(AUC), factors with better diagnostic performance were evaluated and screened, and the optimal diagnostic threshold for each factor in diagnosing bone metastasis was determined. Results:There were a total of 129 PSMA-avid bone lesions for 63 patients(aged 60-84 years, median age 69 years), including 35 lesions(27.1%)in the metastatic group and 94 lesions(72.9%)in the non-metastatic group.The differences between metastatic group and non-metastatic group in PSMA-RADS scores[5(4, 5) vs.3(3, 3)], maximum standardized uptake value(SUV max)[12.6(7.0, 18.4) vs.4.7(3.5, 5.9)], lesion SUV max/mediastinal blood pool SUV max ratio(lesion-to-blood pool ratio, LBR)[5.4(3.0, 8.3) vs.1.7(1.4, 2.2)], lesion SUV max/liver SUV max ratio(lesion-to-liver ratio, LLR)[2.6(1.6, 4.1) vs.0.8(0.7, 1.1)], PSMA receptor expressing tumor volume(PSMA-TV)[0.6(0.3, 1.0) vs.1.0(0.7, 1.5)], total lesion of PSMA(TL-PSMA)[4.4(2.4, 7.0) vs.2.4(1.7, 3.9)], proportion of changes in osteogenic bone density[77.1%(27/35) vs.2.1%(2/94)], proportion of lesions located in the ribs[14.3%(5/35) vs.46.8%(44/94)], and proportion of lesions located in the pelvis[54.3%(19/35) vs.20.2%(19/94)]were all statistically significant(all P<0.05). Multivariate logistic regression analysis indicated that none of the variables with statistically significant differences between groups above were independent risk factors for osseous metastasis in prostate cancer(all P>0.05). Among them, The PSMA-RADS score, LLR, LBR, and SUV max all had good diagnostic efficacy for osseous metastasis, with 0.995(95% CI: 0.987-1.000), 0.923(95% CI: 0.869-0.977), 0.898(95% CI: 0.828-0.967), and 0.890(95% CI: 0.820-0.961), respectively.The cut-off values for diagnosing osseous metastasis were 4 score for PSMA-RADS score, 0.934 for LLR, 1.990 for LBR, and 5.47 for SUV max, respectively.According to Delong's test, there were statistically significant differences in AUC between PSMA-RADS score and 18F-PSMA PET/CT semi-quantitative parameters(LLR, LBR, and SUV max)( Z-values were 2.677, 2.776, and 2.929, respectively, and P-values were 0.007, 0.006, and 0.003, respectively). Conclusions:The PSMA-RADS score(Version 2.0)and 18F-PSMA PET/CT semi-quantitative parameters(LLR, LBR, and SUV max)both have good diagnostic value in differentiating benign and malignant PSMA-avid bone lesions in elderly patients with prostate cancer, among which the PSMA-RADS score has the best diagnostic efficacy.

The intervertebral disc is a complex structure composed of the central nucleus pulposus, the peripheral annulus fibrosus, and the cartilaginous endplates located at the top and bottom. This unique arrangement effectively isolates the nucleus pulposus from the host’s immune system. Additionally, specific substances within the intervertebral disc exhibit inhibitory effects on the infiltration of immune cells and cytokines, which has led to the recognition of the intervertebral disc as an immune-privileged tissue. However, during intervertebral disc degeneration (IDD), the physical barriers that maintain this immune privilege are compromised. As a result, the nucleus pulposus may be perceived as a foreign antigen by the immune system. Simultaneously, inflammatory cytokines released by the degenerating disc attract a significant influx of immune cells, disrupting the delicate immunological balance within the nucleus pulposus and exacerbating the progression of IDD. Recent studies have confirmed the infiltration of immune cells such as macrophages and mast cells into the degenerative intervertebral disc, and the phenotypic characteristics and quantitative changes of these immune cells are closely related to the process of IDD. In terms of treatment strategies, biological agents such as mesenchymal stem cell therapy, gene therapy and growth factors that regulate the immune microenvironment of degenerative intervertebral discs have entered the stage of animal experiments. At the same time, small molecule drugs have shown unique regulatory potential in restoring the immune-privileged status of intervertebral discs.

Objective To evaluate the quality of Uncaria Hook(UH)in the market.Methods Twenty-nine batches of UH were tested by legal standards(character,identification,inspection,and extract detection).The TLC method was used to explore the identification of the control herbs,pilocarcinine,dehydropilocarcinine,pilocarcinine and isocarcinine.The HPLC method was used to establish the characteristic spectrum of UH.Then cluster analysis,PCA-X,and OPLS-DA analysis methods were used to perform statistical analysis on the common peak area of unguttine,and determine the contents of heicoside,iso-dehydrounguttine,iso-unguttine,iso-unguttine,and unguttine,to screen out the key quality control components of UH and evaluate their quality.Results Among the 29 batches of samples,23 batches were qualified,and the qualified rate was 79.31％.The results of the TLC analysis showed that the chemical constituents of different base sources were very different.No pilocarcinine was detected in Uncaria macrophylla no hydropilocarcinine was detected in Uncaria sinensis,and four components were not detected in Uncaria hirsuta.Only the samples with the base source of the plant showed corresponding spots in the chromatographic position with the control drug and the control substance.The results of HPLC showed that the chemical composition and content of different base sources of UH were very different.No hydrouncinine and pilocarcinine were detected in Uncaria macrophylla.No iso-dehydrouncinine,dehydrouncinine,and dehydropilocarcinine were detected in Uncaria sinensis.And only heicoside was detected in Uncaria sinensis,and the content of heicoside was low.Based on statistical analysis,there were differences among different batches of UH,and three key quality control ingredients,iso-dehydrounguocarcinoma,dehydrounguocarcinoma,and iso-unguocarcinoma that may lead to quality differences of unguocarcinoma were found.Conclusions Overall,the UH is of poor quality,the current processing standards and testing standards can not ensure the quality of the product,affecting the safety and effectiveness of clinic use.The chemical composition categories and contents of different base sources of UH are very different,which increases the difficulty of formulating a unified quality standard.

Objective: To construct a scientific and perfect evaluation index system of infectious disease prevention and control ability in colleges and universities, so as to provide reference tools for colleges and universities to effectively respond to infectious disease. Methods: The initial framework of the evaluation index system of infectious disease prevention and control ability in colleges and universities was constructed by using literature analysis method. Experts familiar with infectious disease prevention and control or school health work were selected to conduct two rounds( n =16，18) of Delphi expert consultation for determining the evaluation index system. Analytical hierarchy process was used to calculate the index weights and combined weights. About 198 prevention and control personnel were conveniently selected from 3 universities in Inner Mongolia Autonomous Region to comprehensively evaluate the evaluation indicators by using fuzzy comprehensive evaluation method. Results: After two rounds of Delphi consultation questionnaire, the effective recovery rates were 80.0% and 90.0%, the expert authority levels were 0.89 and 0.86, the expert harmony coefficients for Kendall W were 0.166 and 0.310, and the variation coefficient of each index was <0.25. Finally, the evaluation index system of infectious disease prevention and control ability of colleges and universities included 4 first level indicators, 14 second level indicators and 75 third level indicators. The weights of prevention and monitoring and early warning, organizational system guarantee, emergency management, rehabilitation and summary were 0.176, 0.476, 0.268 and 0.080, respectively. The top 3 weights of the secondary indexes were 0.623 for infectious disease surveillance and early warning, 0.595 for loss assessment and 0.370 for emergency response. The score of fuzzy comprehensive evaluation of the index system of infectious disease prevention and control ability in colleges and universities was 79.148, suggesting a high level. Conclusion The established evaluation index system of infectious disease prevention and control ability in colleges and universities is scientific and reasonable, which is conducive to provide tool reference for the evaluation of infectious disease prevention and control ability in colleges and universities.

Emerging evidences have indicated the role of ferroptosis in the progression of metabolic-associated fatty liver disease (MAFLD); thus, inhibiting ferroptosis is a promising strategy for the development of MAFLD therapeutics. Recent studies have demonstrated the antioxidative effect of the gut commensal bacterium Akkermansia muciniphila (A. muc); however, whether it can alleviate ferroptosis remains unclear. The current study indicates A. muc intervention efficiently reversed high-fat high-fructose diet (HFHFD)-induced lipid peroxidation and ferroptosis in the liver. These beneficial effects were mediated by activation of the hepatic AMPK/SIRT1/PGC-1α axis, as evidenced by the finding that AMPK deficiency abrogated the amelioration of lipid peroxidation in vitro and in vivo. Furthermore, the short-chain fatty acids (SCFAs) were enriched upon A. muc treatment, and acetate was identified as a key activator of hepatic AMPK signalling. Mechanistically, microbiota-derived acetate was transported to the liver and metabolized to adenosine monophosphate (AMP), which triggered AMPK activation. Furthermore, a colonization assay in germ-free mice confirmed that A. muc mediated antiferroptotic effects in the absence of other microbes. These data indicated that A. muc exerts antiferroptotic effects against MAFLD, at least partially by producing acetate, which activates the hepatic AMPK/SIRT1/PGC-1α axis to alleviate ferroptosis via the inhibition of polyunsaturated fatty acid (PUFA) synthesis.