Ischemia-reperfusion (I/R) injury following skin flap transplantation is a critical factor leading to flap necrosis and transplant failure. Antagonizing inflammatory responses and oxidative stress are regarded as crucial targets for mitigating reperfusion injury and enhancing flap survival. In this study, caffeic acid-vanadium metal polyphenol nanoparticles (CA-V NPs) were prepared for the treatment of skin flap ischemia and reperfusion. This study was conducted using a one-step method to prepare new types of CA-V NPs with uniform sizes and stable structures. In vitro, the CA-V NPs exhibited CAT-like and SOD-like activities and could effectively scavenge ROS, generate oxygen, and alleviate oxidative stress. In the H₂O₂-induced cellular oxidative stress model, CA-V NPs effectively reduced ROS levels and inhibited apoptosis through the XIAP/Caspase-3 pathway. In the cellular inflammation model induced by LPS combined with IFN-γ, CA-V NPs reprogrammed macrophage polarization toward the M2 phenotype and reduced inflammatory responses by reducing the expression of the chemokines CCL4 and CXCL2. In addition, animal experiments have shown that CA-V NPs can alleviate oxidative stress in skin flap tissues, inhibit apoptosis, promote angiogenesis, and ultimately improve the survival rate of skin flaps. CA-V NPs provide a new target and strategy for the treatment of flap I/R injury.

BACKGROUND:In the initial stage of growth plate injury inflammation,platelet-derived growth factor BB promotes the repair of growth plate injury by promoting mesenchymal progenitor cell infiltration,chondrogenesis,osteogenic response,and regulating bone remodeling. OBJECTIVE:To elucidate the action mechanism of platelet-derived growth factor BB after growth plate injury. METHODS:PubMed,VIP,WanFang,and CNKI databases were used as the literature sources.The search terms were"growth plate injury,bone bridge,platelet-derived growth factor BB,repair"in English and Chinese.Finally,66 articles were screened for this review. RESULTS AND CONCLUSION:Growth plate injury experienced early inflammation,vascular reconstruction,fibroossification,structural remodeling and other pathological processes,accompanied by the crosstalk of chondrocytes,vascular endothelial cells,stem cells,osteoblasts,osteoclasts and other cells.Platelet-derived growth factor BB,as an important factor in the early inflammatory response of injury,regulates the injury repair process by mediating a variety of cellular inflammatory responses.Targeting the inflammatory stimulation mediated by platelet-derived growth factor BB may delay the bone bridge formation process by improving the functional activities of osteoclasts,osteoblasts,and chondrocytes,so as to achieve the injury repair of growth plate.Platelet-derived growth factor BB plays an important role in angiogenesis and bone repair tissue formation at the injured site of growth plate and intrachondral bone lengthening function of uninjured growth plate.Inhibition of the coupling effect between angiogenesis initiated by platelet-derived growth factor BB and intrachondral bone formation may achieve the repair of growth plate injury.

With the rapid advancement of artificial intelligence(AI)technology,its applications in the medical field have been expanding significantly.In the realm of hematopathological diagnosis,the advent of whole slide imaging(WSI)technology has paved the way for AI-based automatic slide reading,which is gradually transforming traditional diagnostic approaches.By establishing and training sophisticated algorithm models,AI,particularly deep learning and machine learning,can accurately and swiftly identify and analyze abnormal cells or tissues,as well as correctly inter-pret immunohistochemical staining results.This not only alleviates the workload of hematopathologists but also shortens the reporting cycle.As a result,it holds substantial application value in the fields of bone marrow pathology and bone marrow cell morphology diagnosis.Moreover,AI also demonstrates broad potential in the analysis of results from flow cytometry,chromosome karyotyping,and next-generation sequencing.Overall,the integration of AI technology is of great significance in propelling the development of intelligent diagnosis in hematopathology.This article aims to provide a comprehensive review of the application of AI in hematopathological diagnosis,and to explore its current status and future prospects.

Immune checkpoint inhibitor-related pneumonitis(CIP)is a relatively common immune-related adverse event.The current treatment for CIP mainly relies on glucocorticoids,with 70％～80％of patients being controlled by conventional glucocorticoid therapy.However,steroid-unresponsive CIP is often se-vere and can be life-threatening.There is no standard treatment protocol for steroid-unresponsive CIP,highlighting a significant unmet clinical need.This paper reviews the diagnosis,treatment progress,and exploratory research of steroid-unresponsive CIP to provide evidence-based guidelines and directions for clinical and translational research.

With the rapid advancement of artificial intelligence(AI)technology,its applications in the medical field have been expanding significantly.In the realm of hematopathological diagnosis,the advent of whole slide imaging(WSI)technology has paved the way for AI-based automatic slide reading,which is gradually transforming traditional diagnostic approaches.By establishing and training sophisticated algorithm models,AI,particularly deep learning and machine learning,can accurately and swiftly identify and analyze abnormal cells or tissues,as well as correctly inter-pret immunohistochemical staining results.This not only alleviates the workload of hematopathologists but also shortens the reporting cycle.As a result,it holds substantial application value in the fields of bone marrow pathology and bone marrow cell morphology diagnosis.Moreover,AI also demonstrates broad potential in the analysis of results from flow cytometry,chromosome karyotyping,and next-generation sequencing.Overall,the integration of AI technology is of great significance in propelling the development of intelligent diagnosis in hematopathology.This article aims to provide a comprehensive review of the application of AI in hematopathological diagnosis,and to explore its current status and future prospects.

Immune checkpoint inhibitor-related pneumonitis(CIP)is a relatively common immune-related adverse event.The current treatment for CIP mainly relies on glucocorticoids,with 70％～80％of patients being controlled by conventional glucocorticoid therapy.However,steroid-unresponsive CIP is often se-vere and can be life-threatening.There is no standard treatment protocol for steroid-unresponsive CIP,highlighting a significant unmet clinical need.This paper reviews the diagnosis,treatment progress,and exploratory research of steroid-unresponsive CIP to provide evidence-based guidelines and directions for clinical and translational research.

Bone marrow biopsy is one of the important means of hematopathological diagnosis, which has decisive diagnostic significance for various benign and malignant lymphohematopoietic system diseases. Its diagnostic value includes morphological observation, immunohistochemistry, genetics, and molecular biology testing. Owing to the unique nature of bone marrow biopsy, decalcification is an essential step in the pre-treatment process. Its purpose is to remove calcium from bone tissue, preserve intact collagen fiber components, facilitate tissue sectioning, and prevent tissue detachment during staining. If bone marrow biopsy lacks sufficient decalcification, preparing a section is difficult. Conversely, if decalcification is excessive, it can seriously disrupt tissue antigen activity. Therefore, a decalcification method with high decalcification efficiency and mild antigen damage is essential for bone marrow biopsy. This article introduces a bone marrow biopsy tissue decalcification method with high efficiency and less antigen loss: decalcification is performed at room temperature with 12% formic acid and 8% hydrochloric acid decalcification solution on a shaker.

Objective:To evaluate the efficacy and safety of apatinib in combination with chemoradiotherapy for head and neck squamous cell carcinoma (HNSCC).Methods:37 patients orally received apatinib at 250 mg/d during concurrent chemoradiotherapy until completion of radiotherapy, complete remission assessed by imaging examination, the onset of unacceptable toxicity or death. Baseline characteristics, objective response rates (ORR) and adverse events were assessed in all enrolled patients with complete baseline and safety data. Progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier method. Prognostic factors were statistically identified using Cox regression models.Results:The ORR was 85%(95% CI: 72%-98%). The median PFS was 17.9 months and the 2-year OS rate was 62%(95% CI: 48%-80%). Ineffective short-term efficacy ( HR=0.035, 995% CI: 0.02-0.652, P=0.025) was an independent risk factor for poor OS. In addition, ineffective short-term efficacy ( HR=0.104, 95% CI: 0.017-0.633, P=0.014) and lymphocytopenia ( HR=17.539, 95% CI: 2.040-150.779, P=0.009) were independent risk factors for poor PFS. Common adverse events (>60%) included lymphocytopenia (76%), leukopenia (68%) and irradiation-induced mucosal injury (65%). The most common treatment-associated grade 3 adverse event was lymphopenia (49%). Conclusions:Apatinib combined with chemoradiotherapy yield significant anti-tumor activity for HNSCC with controllable toxicity. For patients with advanced HNSCC, short-term efficacy and lymphocytopenia may be potential predictors for clinical efficacy of apatinib combined with chemoradiotherapy.

Objective To translate and revise the form of rheumatoid arthritis (RA) self-efficacy scale (RASE),and evaluate the revised scale.Methods Totally 101 patients with RA in one hospital were selected for investigation.Through the translation-back to the source scale and the cultural adjustment,the Chinese version of RASE (C-RASE) was formed.Exploratory factor analysis was conducted to acquire the construct validity while the Pearson correlation analysis was used to obtain the test-retest reliability.Results Factor analysis was carried out on 28 items,and the loading was 0.496,0.490,0.482 and 0.493 of item 5,and item 15 on two factors respectively.Exploratory factor analysis was conducted secondarily after deleting items of 5,15,and 17,considering the item contents,and 9 factors were extracted,respectively named for exercise,comprehensive treatment,relaxation,activity,sleep,social relationship,fatigue,cognition and active planning,which could explain 68.36％ of total variation;aud the correlation coefficient between each dimension and total table ranged 0.344 to 0.679 (P＜0.01);The Cronbach's alpha coefficient of the C-RASE was 0.751,and the retest reliability was 0.731.After deleting their own items,the Cronbach's alpha value range was 0.730 to 0.756.Conclusion C-RASE has sound reliability and validity and could provides a measurement of the self-efficacy among rheumatoid arthritis patients.

Objective To understand the status and influencing factors of thyroid disease in breast cancer patients, and to identify the high-risk people with thyroid disease. Methods Breast cancer patients were continually collected from Jan 2016 to Mar 2016 in Shanxi Cancer Hospital. Age, surgery time, the state of thyroid disease, medical record, the general condition, immunohistochemistry and pathological findings, thyroid B-mode ultrasonography were investigated respectively. All cases were divided into two groups according to whether to suffer from thyroid disease or not. The influencing factors for thyroid disease in patients with breast cancer were screened. Logistic regression was used for univariate and multivariate analysis. Results A total of 293 cases (69.3 %) suffered from thyroid disease in 423 breast cancer patients. The univariate analysis showed that prevalence rate of thyroid disease had statistical differences in age [<50 years old:49.5%(145/293) vs. 76.1%(99/130); ≥50 years old:50.5%(148/293) vs. 23.9%(31/130);χ2=24.297, P<0.001], body mass index [18.5-23.9 kg/m2:41.0%(120/293) vs. 52.3%(68/130);24.0-27.9 kg/m2:45.4%(133/293) vs. 40.8 % (53/130); ≥28.0 kg/m2: 13.7 % (40/293) vs. 6.9 % (9/130); χ2= 6.395, P=0.041], menopausal state [not: 59.7%(175/293) vs. 77.7%(101/130); yes: 40.3%(118/293) vs. 22.3%(29/130);χ2=12.443, P<0.001], estrogen receptor (ER) [ER--ER+: 44.0%(129/293) vs. 56.9%(74/130);ER++ - ER+++: 56.0 % (164/293) vs. 43.1 % (56/130); χ2 = 5.951, P= 0.015]. There were no significant differences in the times of pregnancy and production, history of abortion, progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), triple negative breast cancer, T stage, N stage, histological grade and TNM stage (P> 0.05). Multivariate analysis showed that the risk factors were age (OR= 3.928, 95 %CI=1.819-8.482, P<0.001) and ER++-ER+++(OR= 1.696, 95 %CI= 1.094-2.628, P= 0.018). Conclusion Age≥50 and ER++-ER+++are the major influencing factors of thyroid disease for patients with breast cancer.