Autoimmune diseases of the nervous system are a category of conditions in which a malfunction of the body's immune system leads to damage of nerve tissues, with B cells playing a critical role in their pathogenesis. Currently, the therapeutic approaches used in clinical practice (such as monoclonal antibodies targeting B cells) can effectively control the progression of these diseases, but fail to achieve a radical cure. Chimeric antigen receptor (CAR)-T cell therapy uses genetic engineering to modify T cells derived from either patients or donors, enabling them to specifically target and durably eliminate peripheral B cells, which might remit or even functionally cure these diseases. Currently, multiple clinical studies on efficacy and safety of CAR-T cell therapy in neurological autoimmune diseases have been carried out successively, and initial results have been achieved. This article reviews the clinical research progress in this field, discusses its application prospects and challenges, aiming to provide some references for in-depth research in this area.

Objective To explore the predictive value of MRI parameters of carotid artery plaque combined with low density lipoprotein cholesterol/high density lipoprotein cholesterol(LDL-C/HDL-C)ratio for predicting ischemic stroke in young patients with carotid atherosclerosis.Methods Totally 125 young patients with carotid atherosclerosis were prospectively included and divided into stroke group and non-stroke group based on whether ischemic stroke occurred within 3 months.Clinical data,laboratory indicators and carotid plaque-related MRI parameters were compared between groups.Based on carotid plaque-related MRI parameters being statistically different between groups,combined model 1 was constructed using multivariable logistic regression analysis,while combined model 2 was constructed combined with LDL-C/HDL-C ratio.The efficacy of each parameter and model for predicting ischemic stroke in young adults was analyzed.Results There were 48 cases in stroke group and 77 cases in non-stroke group.The levels of glycosylated hemoglobin,LDL-C,LDL-C/HDL-C ratio,carotid artery stenosis rate,plaque eccentricity index and plaque enhancement rate in stroke group were all higher than those in non-stroke group(all P＜0.05).The area under the curve(AUC)of LDL-C/HDL-C ratio,carotid artery stenosis rate,plaque eccentricity index,plaque enhancement rate,combined model 1 and 2 for predicting ischemic stroke in young adults was 0.816,0.757,0.768,0.805,0.883 and 0.936,respectively,of combined model 1 was higher than those of single parameter(all P＜0.05),while of combined model 2 was higher than that of combined model 1(Z=2.336,P=0.020).Conclusion MRI parameters of carotid artery plaque combined with LDL-C/HDL-C ratio could effectively predict ischemic stroke in young patients with carotid atherosclerosis.

Objective To establish a risk factor model for intracranial artery stenosis in young patients with acute ischemic stroke(AIS)based on high-resolution magnetic resonance vascular wall imaging(HR-VWI).Methods Young patients with AIS(n=290)treated at Hengshui People's Hospital between January 2021 and January 2023 were retrospectively analyzed and randomly divided into a modeling set(203 cases)and a validation set(n=87)at a ratio of 7∶3.Patients in the modeling set were divided into the stenosis and non-ste-nosis groups according to whether they had intracranial artery stenosis.Multivariate logistic regression was used to analyze the clinical data and HR-VWI characteristics of the patients in the modeling set to screen for factors influencing intracranial artery stenosis in young patients with AIS.R software was used to construct and verify the risk factor model.Results Among the 290 patients,88 had intracranial artery stenosis(30.34％).The proportions of low-density lipoprotein cholesterol(LDL-C),plaque load,smoking history,hypertension,and eccentric plaques were higher in the stenosis group than in the non-stenosis group(P＜0.05),and the minimum lumen area and remode-ling index were lower in the stenosis group than in the non-stenosis group(P＜0.05).Multivariate logistic regression analysis showed that smoking history,hypertension,LDL-C level,plaque load,plaque morphology,and remodeling index were all factors influencing intracra-nial artery stenosis in young patients with AIS(P＜0.05).Based on the above risk factors,R was used to build a nomogram early warning model.The ROC results showed that the AUC of the nomogram model for predicting intracranial artery stenosis in the modelling and vali-dation sets were 0.872(95％CI:0.815-0.902)and 0.850(95％CI:0.789-0.891),respectively.The Hosmer-Lemeshow test results of the modeling and validation sets were x2=0.589,P=0.571 and x2=0.602,P=0.558,respectively.The calibration curves of the two groups were consistent with the standard curves.Conclusion The risk factor model for intracranial artery stenosis in young patients built in this study based on HR-VWI features exhibits good predictive efficacy,providing a new method for clinical prevention and treatment.

Objective To explore the predictive value of MRI parameters of carotid artery plaque combined with low density lipoprotein cholesterol/high density lipoprotein cholesterol(LDL-C/HDL-C)ratio for predicting ischemic stroke in young patients with carotid atherosclerosis.Methods Totally 125 young patients with carotid atherosclerosis were prospectively included and divided into stroke group and non-stroke group based on whether ischemic stroke occurred within 3 months.Clinical data,laboratory indicators and carotid plaque-related MRI parameters were compared between groups.Based on carotid plaque-related MRI parameters being statistically different between groups,combined model 1 was constructed using multivariable logistic regression analysis,while combined model 2 was constructed combined with LDL-C/HDL-C ratio.The efficacy of each parameter and model for predicting ischemic stroke in young adults was analyzed.Results There were 48 cases in stroke group and 77 cases in non-stroke group.The levels of glycosylated hemoglobin,LDL-C,LDL-C/HDL-C ratio,carotid artery stenosis rate,plaque eccentricity index and plaque enhancement rate in stroke group were all higher than those in non-stroke group(all P＜0.05).The area under the curve(AUC)of LDL-C/HDL-C ratio,carotid artery stenosis rate,plaque eccentricity index,plaque enhancement rate,combined model 1 and 2 for predicting ischemic stroke in young adults was 0.816,0.757,0.768,0.805,0.883 and 0.936,respectively,of combined model 1 was higher than those of single parameter(all P＜0.05),while of combined model 2 was higher than that of combined model 1(Z=2.336,P=0.020).Conclusion MRI parameters of carotid artery plaque combined with LDL-C/HDL-C ratio could effectively predict ischemic stroke in young patients with carotid atherosclerosis.

Objective To establish a risk factor model for intracranial artery stenosis in young patients with acute ischemic stroke(AIS)based on high-resolution magnetic resonance vascular wall imaging(HR-VWI).Methods Young patients with AIS(n=290)treated at Hengshui People's Hospital between January 2021 and January 2023 were retrospectively analyzed and randomly divided into a modeling set(203 cases)and a validation set(n=87)at a ratio of 7∶3.Patients in the modeling set were divided into the stenosis and non-ste-nosis groups according to whether they had intracranial artery stenosis.Multivariate logistic regression was used to analyze the clinical data and HR-VWI characteristics of the patients in the modeling set to screen for factors influencing intracranial artery stenosis in young patients with AIS.R software was used to construct and verify the risk factor model.Results Among the 290 patients,88 had intracranial artery stenosis(30.34％).The proportions of low-density lipoprotein cholesterol(LDL-C),plaque load,smoking history,hypertension,and eccentric plaques were higher in the stenosis group than in the non-stenosis group(P＜0.05),and the minimum lumen area and remode-ling index were lower in the stenosis group than in the non-stenosis group(P＜0.05).Multivariate logistic regression analysis showed that smoking history,hypertension,LDL-C level,plaque load,plaque morphology,and remodeling index were all factors influencing intracra-nial artery stenosis in young patients with AIS(P＜0.05).Based on the above risk factors,R was used to build a nomogram early warning model.The ROC results showed that the AUC of the nomogram model for predicting intracranial artery stenosis in the modelling and vali-dation sets were 0.872(95％CI:0.815-0.902)and 0.850(95％CI:0.789-0.891),respectively.The Hosmer-Lemeshow test results of the modeling and validation sets were x2=0.589,P=0.571 and x2=0.602,P=0.558,respectively.The calibration curves of the two groups were consistent with the standard curves.Conclusion The risk factor model for intracranial artery stenosis in young patients built in this study based on HR-VWI features exhibits good predictive efficacy,providing a new method for clinical prevention and treatment.

Autoimmune diseases of the nervous system are a category of conditions in which a malfunction of the body's immune system leads to damage of nerve tissues, with B cells playing a critical role in their pathogenesis. Currently, the therapeutic approaches used in clinical practice (such as monoclonal antibodies targeting B cells) can effectively control the progression of these diseases, but fail to achieve a radical cure. Chimeric antigen receptor (CAR)-T cell therapy uses genetic engineering to modify T cells derived from either patients or donors, enabling them to specifically target and durably eliminate peripheral B cells, which might remit or even functionally cure these diseases. Currently, multiple clinical studies on efficacy and safety of CAR-T cell therapy in neurological autoimmune diseases have been carried out successively, and initial results have been achieved. This article reviews the clinical research progress in this field, discusses its application prospects and challenges, aiming to provide some references for in-depth research in this area.

Objective To evaluate the differences in chemical composition and pharmacological effects between Angelica-Astragalus medicine pair decoction(DGD)and traditional decotion,and to provide a reference for the rational clinical application of Danggui Buxue decoction.Methods With the two comparison methods of unified and non-uniform raw material source batches,we set up different sample groups,established characteristic maps by HPLC,and evaluated the chemical components based on the similarity of characteristic maps,component types,index component content,common peak area,and other factors.The efficacy of the drug was evaluated in the hemorrhagic blood deficiency model mice.Results ①The similarity of the feature map between the DGD and TD was high(similarity was greater than 0.87).②The number of chromatographic peaks was inconsistent.Traditional decoction from self-purchased decoction pieces,or traditional decoction-Factory A decoction pieces had a total of 12 chromatographic peaks each.The DGD of Factory A had a total of 15 chromatographic peaks.There were 10 chromatographic peaks in the DGD of Factory B.③The contents of ferulic acid and calycosin 7-O-glucoside(CG)in DGD of Factory A were higher than those in traditional decoction(P<0.05,n=3).There was no significant difference between DGD and TD ferulic acid content in Factory B,but the content of CG was lower than that in traditional decoction(P<0.05).④The total area of common peaks in DGD was different from that in TD.The relative total ratios of the contents of the components in the self-purchased traditional decoction pieces,the traditional decoction pieces of Factory A,the formula granules of Factory A,and the formula granules of Factory B were 1.00,0.96,2.14,0.60,respectively.⑤Both DGD and traditional decoction could significantly promote the recovery of hemoglobin and red blood cells in hemorrhagic anemia model mice(P<0.01);Compared with the model control group,there was a significantly difference(P<0.05)except for the DGD group of Plant B.There was no significant difference between DGD and TD of Plant A,but there was a very significant difference between DGD and TD of Plant B(P<0.01).Conclusion Whether the raw material source batch is consistent or not,DGD and TD have certain differences in chemical composition.In terms of pharmacological effect,DGD,prepared from a unified batch of decoction pieces,has similar efficacy to traditional decoction in alleviating hemorrhagic anemia.There are certain differences in the pharmacological effects between DGD prepared from different batches of decoction pieces and traditional decoctions.The differences caused by the different preparation processes of the same source batch of prepared slices were compared,and the quality differences of the formula granules from different manufacturers were caused by the different source batches of prepared slices and different preparation processes,indicating the necessity and urgency of the country to formulate a unified quality standard for formula granules and related process specifications.

Objective:To explore the key copy number variation (CNV) regions, abortion candidate genes and signaling pathways associated with recurrent spontaneous abortion (RSA).Methods:A retrospective cohort study was conducted based on the data of 1 870 miscarriage cases of RSA patients who received CNV analysis by high-throughput sequencing technology in the Laboratory Medicine Department of the Third Affiliated Hospital of Zhengzhou University from January 2016 to September 2022. These cases were divided into different groups based on the age of miscarriage and gestational age of the pregnant women. Chi-square test or Fisher's exact test was used to analyze the distribution of chromosome abnormalities and CNV. Gene functions and signaling pathways in RSA-related CNV were identified by gene enrichment analysis.Results:Among the 1 870 tissues, 1 001 (53.53%) cases were detected with chromosomal abnormalities. A total of 140 CNVs were detected in 93 tissues (9.29%), including 34 submicroscopic CNVs (segment<10 Mb) and 106 large CNVs with segment≥10 Mb. Submicroscopic pathogenicity CNVs with statistical differences were involved 1p36.33p36.23, 2q37.3, 4p16.3, 22q11.21 (χ 2=6.99, P=0.008) in early RSA embryos (≤12 weeks). 16p11.2 and Xp11.23p11.22 microdeletion were firstly reported in abortion cases. Significantly recurrent large CNVs were mainly involved 18q22q23 (del/dup), 4p16p15, 9p24p22, 8p23p22, and Xp22.3 regions, and the candidate genes mainly concentrated on PI3K-Akt and JAK-STAT signaling pathway. Conclusion:Rare submicroscopic CNVs and recurrent large CNVs were associated with RSA in early pregnancy. GO and KEGG database analysis revealed potential abortion candidate genes and signaling pathways, providing new information for the genetic etiology of RSA.

Objective:To explore the key copy number variation (CNV) regions, abortion candidate genes and signaling pathways associated with recurrent spontaneous abortion (RSA).Methods:A retrospective cohort study was conducted based on the data of 1 870 miscarriage cases of RSA patients who received CNV analysis by high-throughput sequencing technology in the Laboratory Medicine Department of the Third Affiliated Hospital of Zhengzhou University from January 2016 to September 2022. These cases were divided into different groups based on the age of miscarriage and gestational age of the pregnant women. Chi-square test or Fisher's exact test was used to analyze the distribution of chromosome abnormalities and CNV. Gene functions and signaling pathways in RSA-related CNV were identified by gene enrichment analysis.Results:Among the 1 870 tissues, 1 001 (53.53%) cases were detected with chromosomal abnormalities. A total of 140 CNVs were detected in 93 tissues (9.29%), including 34 submicroscopic CNVs (segment<10 Mb) and 106 large CNVs with segment≥10 Mb. Submicroscopic pathogenicity CNVs with statistical differences were involved 1p36.33p36.23, 2q37.3, 4p16.3, 22q11.21 (χ 2=6.99, P=0.008) in early RSA embryos (≤12 weeks). 16p11.2 and Xp11.23p11.22 microdeletion were firstly reported in abortion cases. Significantly recurrent large CNVs were mainly involved 18q22q23 (del/dup), 4p16p15, 9p24p22, 8p23p22, and Xp22.3 regions, and the candidate genes mainly concentrated on PI3K-Akt and JAK-STAT signaling pathway. Conclusion:Rare submicroscopic CNVs and recurrent large CNVs were associated with RSA in early pregnancy. GO and KEGG database analysis revealed potential abortion candidate genes and signaling pathways, providing new information for the genetic etiology of RSA.

ObjectiveTo investigate the feasibility of applying electronic nose technology to rapidly identify Bletillae Rhizoma and its approximate decoction pieces. MethodA total of 134 batches of Bletillae Rhizoma and its approximate decoction pieces， including 45 batches of Bletillae Rhizoma， 30 batches of Gastrodiae Rhizoma， 30 batches of Polygonati Odorati Rhizoma and 29 batches of Bletillae Ochraceae Rhizoma， were collected as test samples. The olfactory sensory data of the samples were collected by PEN3 electronic nose as the independent variable（X）. Based on the identification results of the 2020 edition of Chinese Pharmacopoeia and local standards， as well as the high performance liquid chromatography（HPLC） fingerprint and original purchase information of 134 batches of the decoction pieces， the benchmark data Y of the identification model were obtained， and four chemometric methods of principal component analysis-discriminant analysis（PCA-DA）， partial least squares-discriminant analysis（PLS-DA）， least square-support vector machine（LS-SVM） and K-nearest neighbor（KNN） were used to establish the binary identification model for 45 batches of Bletillae Rhizoma and 89 batches of non-Bletillae Rhizoma and the quadratic identification model of the four kinds of decoction pieces， that is， Y=F（X）. ResultAfter leave-one-out cross validation， the positive discrimination rates of the above four models were 97.01%， 97.01%， 98.51% and 97.01% in the binary identification， and 97.76%， 89.55%， 98.51% and 97.01% in the quadratic identification， respectively. The highest positive discrimination rate could reach 98.51% for the binary and quadratic identification models， and LS-SVM algorithm is both the optimal one， the most suitable kernel functions were chosen as radial basis function and linear kernel function， respectively. The optimal models discriminated well with no unclassified samples. ConclusionElectronic nose technology can accurately and rapidly identify Bletillae Rhizoma and its approximate decoction pieces， which can provide new ideas and methods for rapid quality evaluation of other decoction pieces.