The theory of blood stasis originated from"The Yellow Emperor's Inner Canon(huang Di Nei Jing)",and the drugs used for promoting blood stasis originated from"Shennong's Classic of Materia Medica(Shen Nong Ben Cao Jing)".Finally,the medical sage Zhang Zhong-jing first put forward the name of"blood stasis"in"Synopsis of the Golden Chamber(Jin Gui Yao Lue)",and used the method of promoting blood stasis to treat various diseases,which provided ideas for the future study on the mechanism and treatment of blood stasis syndrome.Therefore,Zhang Zhong-jing was the founder of the theory of blood stasis.Moreover,the principles,methods,prescriptions and medicines which he put forward were still appropriate effectively in the clinic.On the basis of comprehensively combing the research achievements of Zhongjing's blood stasis theory,with combination with the current research hotspots,the review gives a novel understanding of the theory,method,prescription and medicine of Zhongjing's blood stasis theory from new aspects,including etiology,pathogenesis,treatment of blood stasis theory,and the active ingredients of anti-blood stasis Chinese medicines.We intend to promote the research progress of the scientific connotation of blood stasis theory,and improve the diagnosis and treatment level of clinicians in preventing and treating difficult diseases related to blood stasis syndrome through integrated summary and novel interpretation.

The theory of blood stasis originated from"The Yellow Emperor's Inner Canon(huang Di Nei Jing)",and the drugs used for promoting blood stasis originated from"Shennong's Classic of Materia Medica(Shen Nong Ben Cao Jing)".Finally,the medical sage Zhang Zhong-jing first put forward the name of"blood stasis"in"Synopsis of the Golden Chamber(Jin Gui Yao Lue)",and used the method of promoting blood stasis to treat various diseases,which provided ideas for the future study on the mechanism and treatment of blood stasis syndrome.Therefore,Zhang Zhong-jing was the founder of the theory of blood stasis.Moreover,the principles,methods,prescriptions and medicines which he put forward were still appropriate effectively in the clinic.On the basis of comprehensively combing the research achievements of Zhongjing's blood stasis theory,with combination with the current research hotspots,the review gives a novel understanding of the theory,method,prescription and medicine of Zhongjing's blood stasis theory from new aspects,including etiology,pathogenesis,treatment of blood stasis theory,and the active ingredients of anti-blood stasis Chinese medicines.We intend to promote the research progress of the scientific connotation of blood stasis theory,and improve the diagnosis and treatment level of clinicians in preventing and treating difficult diseases related to blood stasis syndrome through integrated summary and novel interpretation.

Objective:To investigate the clinical characteristics and survival prognosis of patients with triple/quad-class exposed relapsed or refractory multiple myeloma(RRMM).Methods:The clinical data of patients with triple/quad-class exposed RRMM from eight centers in Shanxi Province between May 2017 and May 2024 were retrospectively analyzed.Overall survival(OS)and progression-free survival(PFS)were analyzed using the Kaplan-Meier method,and factors affecting survival were examined by the Cox proportional hazards model and Log-rank test.Results:Among the 112 patients with triple-class exposure,16 were quadruple-class exposed.The detection rates of high-risk cytogenetic abnormalities and extramedullary lesions in patients with triple-class exposure were 57.1%and 36.6%,respectively,while those in patients with quadruple-class exposure were 87.5%and 62.5%,respectively.The median PFS and OS of patients with triple-class expos-ure were 5.6 months and 12.2 months,respectively,while those of patients with quadruple-class exposure were 9.4 months and 16.9 months,respectively.Cox model analysis showed that extramedullary lesions and multi-line treatment(≥3 lines)were independent risk factors for the survival of patients with triple-class exposed RRMM(P<0.05).Previous autologous stem cell transplantation,subsequent con-ventional drug treatment,and B-cell maturation antigen(BCMA)chimeric antigen receptor T-cell(CAR-T)treatment were protective factors(P<0.05).After triple-class drug resistance,the Log-rank test verified that BCMA CAR-T treatment significantly prolonged the median PFS of patients compared to conventional drug treatment(9.4 months vs.5.2 months,P=0.026 9),whereas the difference in OS was not statistic-ally significant(16.9 months vs.7.9 months,P=0.263 4).Conclusions:Patients with triple/quad-class exposed RRMM have a poor prognosis,and BCMA CAR-T cell therapy can improve survival in patients with triple-class drug-resistant RRMM.

Objective:To investigate the clinical characteristics and prognosis of patients with newly diagnosed multiple myeloma(NDMM)with thrombocytopenia.Methods:Clinical data of 529 patients with NDMM admitted to The Second Hospital of Shanxi Medical University between January 2012 and December 2021 were retrospectively analyzed.The patients were categorized into thrombocytopenia and nor-mal platelet count groups based on their platelet count levels.Results:A total of 529 patients with NDMM were included in this study,with 108(20.42%)patients in the thrombocytopenia group.The median progression-free survival(mPFS)was 30.64 months(95%confidence in-terval[CI]:23.43-37.85)in the thrombocytopenia group,which was shorter than that in the normal platelet count group(41.39 months[95%CI:37.37-45.39],P=0.002).The median overall survival(mOS)was 40.59 months(95%CI:30.61-50.57)in the thrombocytopenia group,which was shorter than that in the normal platelet count group(60.92 months[95%CI:54.54-67.29],P<0.001).Multivariate Cox regression analysis identified thrombocytopenia as a risk factor for OS in patients with NDMM(HR=1.238[95%CI:1.16-1.952],P=0.03).Conclusions:The prognosis of patients with NDMM with thrombocytopenia was worse than that of patients with NDMM who had normal platelet levels.Thrombocytopenia may serve as a poor prognostic indicator for NDMM.

Objective To investigate the effects of Gli2 on the proliferation,growth,migration,and invasion of oral cancer cells(Tca8113)at the cellular level,and to clarify the molecular mechanism of how Gli2 regulation affects the migration and invasion of oral cancer cells.Methods Small interfering(si)RNA was used to inhibit Gli2 expression in Tca8113 cells.The effects of Gli2 on the proliferation,growth,migration,and invasion of Tca8113 cells were examined by CCK-8,platb cloning,and transwell chamber assay.Further qRT-PCR and Western blot assays were used to explore the mechanism of how Gli2 regulation effects the malignant proliferation and metastasis of Tca8113 cells.Results The mRNA and protein expression of Gli2 in oral cancer cells(Tca8113)increased.Interference of Gli2 expression inhibited the proliferation,growth,migration,and invasion of Tca8113 cells.Further experiments showed that interfering with Gli2 expression inhibited the mRNA and protein expression of key factors in the Hedgehog(Hh)pathway.In addition,interference of Gli2 expression significantly affected the mRNA and protein expression of key factors in epithelial mesenchymal transformation(EMT)pathways.Conclusions Gli2 is abnormally activated during oral cancer,and interference of Gli2 expression significantly inhibits the proliferation,growth,migration,and invasion of oral cancer cells.Gli2 influences the migration and invasion of oral cancer cells by regulating the Hh and EMT pathways.This study has provided a new way to elucidate the pathogenesis of oral cancer and new perspectives on the clinical treatment of oral cancer.

Mantle cell lymphoma (MCL) is a rare B cell lymphoma, and its incidence rate is increasing year by year. MCL has the common characteristics of both inert lymphoma and aggressive lymphoma: rapid progress and poor prognosis. The latest research believes that the pathogenesis of MCL is a continuum, and many factors such as cell cycle disorder, SOX11 overexpression, epigenetic aberration play a role in different stages of the disease. This paper mainly reviews the pathogenesis of MCL and new findings of different subtypes from the perspective of molecular genetics,and further analyzes the clinical diversity of MCL. At the same time, the understanding of the pathogenesis of MCL aims to provide potential targets for future treatment of MCL.

Objective:To investigate the clinical characteristics and survival prognosis of patients with triple/quad-class exposed relapsed or refractory multiple myeloma(RRMM).Methods:The clinical data of patients with triple/quad-class exposed RRMM from eight centers in Shanxi Province between May 2017 and May 2024 were retrospectively analyzed.Overall survival(OS)and progression-free survival(PFS)were analyzed using the Kaplan-Meier method,and factors affecting survival were examined by the Cox proportional hazards model and Log-rank test.Results:Among the 112 patients with triple-class exposure,16 were quadruple-class exposed.The detection rates of high-risk cytogenetic abnormalities and extramedullary lesions in patients with triple-class exposure were 57.1%and 36.6%,respectively,while those in patients with quadruple-class exposure were 87.5%and 62.5%,respectively.The median PFS and OS of patients with triple-class expos-ure were 5.6 months and 12.2 months,respectively,while those of patients with quadruple-class exposure were 9.4 months and 16.9 months,respectively.Cox model analysis showed that extramedullary lesions and multi-line treatment(≥3 lines)were independent risk factors for the survival of patients with triple-class exposed RRMM(P<0.05).Previous autologous stem cell transplantation,subsequent con-ventional drug treatment,and B-cell maturation antigen(BCMA)chimeric antigen receptor T-cell(CAR-T)treatment were protective factors(P<0.05).After triple-class drug resistance,the Log-rank test verified that BCMA CAR-T treatment significantly prolonged the median PFS of patients compared to conventional drug treatment(9.4 months vs.5.2 months,P=0.026 9),whereas the difference in OS was not statistic-ally significant(16.9 months vs.7.9 months,P=0.263 4).Conclusions:Patients with triple/quad-class exposed RRMM have a poor prognosis,and BCMA CAR-T cell therapy can improve survival in patients with triple-class drug-resistant RRMM.

There is still a lack of effective strategies for the prevention and treatment of liver cancer, and a deep understanding of its pathogenesis may help to develop new treatment methods. Due to the abnormal changes of lipid metabolism in the development and progression of liver cancer, such process is closely associated with the "phlegm-turbidity" theory in traditional Chinese medicine (TCM). Starting from the changes of lipid metabolism in hepatocellular carcinoma microenvironment, this article discusses the association of the abnormal changes of lipid metabolism in tumor cells and immune cells with the "phlegm-turbidity" theory and the clinical efficacy of phlegm-eliminating therapies in clinical practice. Since the "phlegm-turbidity" theory in TCM plays an important role in the pathogenesis and pathological changes of liver cancer, the analysis of its theoretical connotation helps to clarify pathological mechanism, thereby providing a theoretical basis for the role of TCM in the prevention and treatment of liver cancer.

Objective:To analyze the efficacy of second-line regimens and prognostic factors in patients with first-relapsed multiple myeloma (MM) treated with bortezomib, cyclophosphamide, and dexamethasone (BCD).Methods:A retrospective cohort study. Clinical data were collected in first-relapsed MM patients after BCD treatment from three tertiary hospitals in north China from July 2009 to October 2022. Patients were classified according to the second-line regimen into the immunotherapy group, single novel agent group [either proteasome inhibitor (PI) or immunomodulatory drug (IMiD)], combination treatment group (both PI+IMiD), and traditional treatment group. Responses to second-line regimens and survival data were analyzed. The Kaplan-Meier method was used for survival analysis and the Cox proportional risk model was used for univariate and multivariate analyses.Results:A total of 217 patients were enrolled including 8.8% (19/217) in the immunotherapy group, 48.4% (105/217) in the PI/IMiD group, 29.9% (65/217) in the PI+IMiD group, and 12.9% (28/217) in the traditional treatment group. The median age was 62 years (range 31-83 years) and 56.2% (122/217) were males. The overall response rates (ORRs) in the four groups were 94.7% (18/19) vs. 56.2% (59/105) vs. 73.8% (48/65) vs. 32.1% (9/28) ( χ2=24.55; P<0.001), respectively. The progression-free survival (PFS) of the second-line regimens (2ndPFS) was 17.7 vs. 9.0 vs. 9.2 vs. 4.6 months ( χ2=22.74; P<0.001), respectively, among which patients in the PI/IMiD and PI+IMiD groups had comparable 2ndPFS ( χ2=1.76; P=0.923). Patients with high-risk cytogenetic abnormalities (HRCAs) achieved the longest 2ndPFS of 22.0 months in the immunotherapy group ( χ2=15.03; P=0.002). Multivariate analysis suggested that immunotherapy ( HR=0.11, 95% CI 0.05-0.27), achievement of efficacy of partial response or better ( HR=0.47, 95% CI 0.34-0.66), and non-aggressive relapse ( HR=0.25, 95% CI 0.17-0.37) were independent prognostic factors of 2ndPFS. Conclusion:In this real-world study, immunotherapy was associated with a more favorable efficacy and PFS for first-relapsed MM patients after BCD treatment, with similar outcomes in patients with HRCAs.

To obtain chicken CD40L protein, the cDNA was prepared from chicken splenic cells and used as a template to clone and amplify CD40L by PCR. The target gene was cloned into pFastBac vector to construct a pFastBac-chCD40L donor plasmid. Recombinant plasmid was transformed into DH10Bac and recombinant Bacmid-chCD40L was obtained. The Bacmid-chCD40L plasmid was transfected into sf9 insect cells to obtain His-chCD40L protein. In addition, the target gene was cloned into pQM01 vector to construct a pQM01-chCD40L plasmid, recombinant plasmid was transfected into HEK 293T cells to obtain Strep-chCD40L protein. The chCD40L protein was purified by affinity chromatography, and the concentration of purified chCD40L protein was determined to be 0.01 mg/mL. Primary cells were isolated from the bursal tissue of 3-week old SPF chickens, and the chCD40L protein was added to the culture medium to stimulate cells. The chCD40L could bind to CD40 on B cells as examined by Western blotting, indirect immunofluorescence assay and flow cytometry, suggesting that chCD40L protein is biologically active. We successfully obtained chicken CD40L protein of biological activity, which laid the foundation in the in vitro culture of primary B lymphocytes for the isolation and diagnosis of virulent IBDV.
Animals ; Baculoviridae/genetics* ; CD40 Ligand/genetics* ; Chickens ; Cloning, Molecular ; Genetic Vectors/genetics* ; Recombinant Proteins/genetics*