A 42-year-old male with chest tightness and dyspnea was admitted to the hospital. Chest CT indicated diffuse interstitial lung infiltration. Despite receiving anti-infective therapy, glucocorticoid therapy, and immunosuppressive agents, the patient developed refractory hypoxaemia. Endotracheal intubation and invasive mechanical ventilation failed to improve oxygenation. Therefore the patient was diagnosed with rapidly progressive interstitial lung disease (RP-ILD) accompanied by type Ⅰ respiratory failure. Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) was initiated, and oxygenation improved in this patient. The patient subsequently underwent bilateral lung transplantation with veno-arterio-venous (VAV) ECMO support. ECMO machine was withdrawn on day 1, and extubation was achieved on day 9 after surgery. Histopathology revealed fibrotic nonspecific interstitial pneumonia (NSIP) with hyaline membrane formation. The patient developed ICU-acquired myasthenia and received early rehabilitation, with gradual recovery of muscle strength. During follow-up, graft lung function remained stable. This case demonstrates that ECMO can serve as a bridge to lung transplantation in RP-ILD patients.

Adriamycin is a widely used anti-tumor drug.Targeting mitochondrial fusion proteins/mitofusion 1/2(MFN1/2)and nuclear factor-erythroid 2-related factor 2(NRF2)can up-regulate the expression of mitochondrial fusion protein through PKCε/Stat3/MFN2,SIRT1/MFN2,AMPK/NRF2 and other signaling pathways,promote mitochondrial fusion,maintain kinetic balance and protect mitochondrial function,reduce myocardial cell apoptosis and reduce cardiac toxicity.Understanding the regulatory role and mechanism of mitochondrial fusion in doxorubicin-induced cardio toxicity will provide new strategies for the prevention and treatment of diseases.

[Objective]To explore Professor PENG Yu's experience in treating urinary incontinence after radical prostatectomy for prostate cancer with couplet and triplet medicines.[Methods]It elaborates Professor PENG Yu's experience in treating the said disease from three aspects:etiology and pathogenesis,treatment principles and commonly used compatibility,and provides a typical medical case to substantiate the arguments.[Results]Professor PENG Yu believes that the core pathogenesis of urinary incontinence after radical prostatectomy for prostate cancer lies in the deficiency of kidney Qi and the bladder loss of control,which is closely related to spleen deficiency and the accumulation of dampness and stasis.In treatment,he adheres to the principles of balancing support and elimination,warming the kidney and strengthening the spleen simultaneously,combining tonification and uplifting,and coordinating astringency and relaxation.He has formed a series of couplet and triplet medicine combinations,including Aconiti Lateralis Preparata Radix,Trigonellae Semen and Psoraleae Fructus for warming the spleen and kidney,Codonopsis Radix and Astragali Radix for tonifying Qi and strengthening the spleen,Cimicifugae Rhizoma and Bupleuri Radix for uplifting Yang and lifting the fallen,and Paeoniae Alba Radix and Chaenomelis Fructus for relaxing the sinews and activating the collaterals.These combinations have shown significant effects in relieving urinary leakage and enhancing the quality of life.In the presented medical case,the patient was identified as a pattern of deficiency of spleen and kidney with the bladder loss of control.The therapeutic strategy prioritized warming the kidney,fortifying the spleen,supplementing Qi and reinforcing containment,employing modified Buzhong Yiqi Decoction,demonstrating good effects.[Conclusion]Professor PENG Yu emphasizes the importance of supporting the body's vital energy and eliminating pathogenic factors in the treatment of urinary incontinence after radical prostatectomy for prostate cancer.He skillfully utilizes the antagonistic and synergistic effects of the combinations,with a sophisticated approach,concise medication and mild properties,providing valuable insights for the clinical treatment of this condition,embodying the value of traditional Chinese medicine in managing postoperative complications.

Getah virus(GETV)is an arbovirus capable of infecting humans and vertebrates such as horses and pigs via blood-sucking mosquitoes,which is extremely harmful to the livestock indus-try.Current monitoring methods are time-consuming,costly,and dependent on specialized instru-ments.These characteristics hinder rapid detection in clinical samples.Therefore,the development of a simple,rapid,specific,and sensitive method for detecting GETV antigen is crucial for the pre-vention and control of GETV.In this study,a GETV E1 monoclonal antibody strain SD17/09-E1-mAb was prepared by a prokaryotic expression system for GETV E1 protein expression,and a col-loidal gold double-antibody sandwich assay encapsulating two strains of GETV E1 monoclonal an-tibody wasestablished.The results showed that the prepared colloidal gold test strips had good sen-sitivity and did not cross-react with other common porcine virus-positive tissue samples;the test strips had a high compliance rate with the IFA assay for GETV,and could be stored at 37 ℃ for one month and at room temperature for at least three months.In this study,a colloidal gold anti-surveillance test strip for rapid detection of GETV was successfully prepared,which provides a powerful tool for GETV detection.

Getah virus(GETV)is an arbovirus capable of infecting humans and vertebrates such as horses and pigs via blood-sucking mosquitoes,which is extremely harmful to the livestock indus-try.Current monitoring methods are time-consuming,costly,and dependent on specialized instru-ments.These characteristics hinder rapid detection in clinical samples.Therefore,the development of a simple,rapid,specific,and sensitive method for detecting GETV antigen is crucial for the pre-vention and control of GETV.In this study,a GETV E1 monoclonal antibody strain SD17/09-E1-mAb was prepared by a prokaryotic expression system for GETV E1 protein expression,and a col-loidal gold double-antibody sandwich assay encapsulating two strains of GETV E1 monoclonal an-tibody wasestablished.The results showed that the prepared colloidal gold test strips had good sen-sitivity and did not cross-react with other common porcine virus-positive tissue samples;the test strips had a high compliance rate with the IFA assay for GETV,and could be stored at 37 ℃ for one month and at room temperature for at least three months.In this study,a colloidal gold anti-surveillance test strip for rapid detection of GETV was successfully prepared,which provides a powerful tool for GETV detection.

Objective To establish radioresistant human non-small cell lung cancer NCI-H460R model cells and evaluate the sensitivity of these radioresistant cells to a ferroptosis inducer. Methods Radioresistant cell lines, designated as NCI-H460 R20Gy and NCI-H460 R116Gy, were generated by subjecting parental NCI-H460 cells to fractionated irradiation with varying cumulative doses. Both parental cells and the established radioresistant cell lines were each randomly divided into four groups and exposed to irradiation at 0, 2, 4, and 6 Gy, respectively. Successful establishment of the radioresistant cell lines was confirmed by colony formation assay. Subsequently, cells were treated with increasing concentrations of the ferroptosis inducer RSL-3 to assess differential sensitivity between parental and radioresistant cells to ferroptosis. Results In comparison to the parental NCI-H460 cells (D_0WT=1.2), both NCI-H460 R116Gy and NCI-H460 R20Gy cells exhibited radioresistance, with NCI-H460 R116Gy demonstrating a stronger radioresistance (D_0R116Gy=1.5) than NCI-H460 R20Gy (D_0R20Gy=1.4). Furthermore, NCI-H460 R116Gy cells exhibited increased sensitivity to RSL-3 relative to the parental cells (P < 0.001), while NCI-H460 R20Gy cells did not display a significant difference in sensitivity to RSL-3. Conclusion Human non-small cell lung cancer cells with radioresistance induced by a high cumulative irradiation dose exhibit increased sensitivity to the glutathione peroxidase 4-specific ferroptosis inducer RSL-3. This finding provides an experimental basis for optimizing combined treatment regimens involving radiotherapy and RSL-3 for non-small cell lung cancer patients with radiotherapy resistance.

Objective:To investigate the changes in sympathetic nerve activity after lower limb immobilization and the role of sympathetic nerve in regulating disuse atrophy of skeletal muscles.Methods:The experiment was divided into the following 3 parts: ① Twelve 8-week-old male C57 mice were randomly divided into a blank control group and a hind limb fixation group ( n=6). The blank control group received no intervention while the hind limb fixation group received splint fixation of the hind limbs for 2 weeks before the musculoskeletal multi-dimensional characterization was completed at the behavioral, pathological and molecular levels. ② Thirty-six 8-week-old male C57 mice were selected and randomly divided into a control group and 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) ( n=6). The control group was fed normally until 14 days without any intervention while the 5 hind limb fixation groups were sampled after fixation for 1, 3, 5, 7 and 14 days, respectively. The level of norepinephrine in the serum and the expression level of tyrosine hydroxylase (TH), a marker of sympathetic nerve activity in the paraventricular nucleus of hypothalamus (PVN), were detected to observe the plasticity of sympathetic nerve activity. ③ Eighteen 8-week-old male C57 mice were selected and randomly divided into a blank control group, a hind limb fixation group and a hind limb fixation plus medication group ( n=6). The blank control group received no intervention while the 2 fixation groups were injected with phosphate buffer (PBS) and propranolol hydrochloride solution for 2 consecutive weeks, respectively. The parameters related to the skeletal muscles were compared between the 3 groups. Results:① Compared with the control group, the mass and function of skeletal muscles in the hind limb fixation group were statistically significantly decreased ( P<0.05). ② The levels of serum norepinephrine [(3.27±1.03) ng/mL, (9.21±1.05) ng/mL, (6.36±0.88) ng/mL, (3.84±1.00) ng/mL, and (3.91±0.75) ng/mL] and the PVN TH levels (42.00%±5.38%, 61.67%±5.57%, 55.82%±3.11%, 50.90%±2.53%, and 39.17%±9.07%) in the 5 hind limb fixation groups (for 1, 3, 5, 7 and 14 days) were significantly higher than those in the control group [(1.81±0.72)] ng/mL and 23.33%±5.50%] ( P<0.05). ③ The wet weight of the gastrocnemius muscle [(93.50±4.32) mg] and the cross-section area of the tibial anterior muscle [(1,180.00±95.09) μm 2] in the hind limb fixation plus medication group were increased significantly compared with those in the hind limb fixation group [(80.83±9.99) mg and (907.80±121.00) μm 2] ( P<0.05). Conclusions:Overactivation of the sympathetic nervous system occurs in the mice model of skeletal muscle disuse atrophy after hind limb fixation. Inhibition of sympathetic nerve activity may reduce the severity of skeletal muscle atrophy at the lower limbs.

[Objective]To explore Professor PENG Yu's experience in treating urinary incontinence after radical prostatectomy for prostate cancer with couplet and triplet medicines.[Methods]It elaborates Professor PENG Yu's experience in treating the said disease from three aspects:etiology and pathogenesis,treatment principles and commonly used compatibility,and provides a typical medical case to substantiate the arguments.[Results]Professor PENG Yu believes that the core pathogenesis of urinary incontinence after radical prostatectomy for prostate cancer lies in the deficiency of kidney Qi and the bladder loss of control,which is closely related to spleen deficiency and the accumulation of dampness and stasis.In treatment,he adheres to the principles of balancing support and elimination,warming the kidney and strengthening the spleen simultaneously,combining tonification and uplifting,and coordinating astringency and relaxation.He has formed a series of couplet and triplet medicine combinations,including Aconiti Lateralis Preparata Radix,Trigonellae Semen and Psoraleae Fructus for warming the spleen and kidney,Codonopsis Radix and Astragali Radix for tonifying Qi and strengthening the spleen,Cimicifugae Rhizoma and Bupleuri Radix for uplifting Yang and lifting the fallen,and Paeoniae Alba Radix and Chaenomelis Fructus for relaxing the sinews and activating the collaterals.These combinations have shown significant effects in relieving urinary leakage and enhancing the quality of life.In the presented medical case,the patient was identified as a pattern of deficiency of spleen and kidney with the bladder loss of control.The therapeutic strategy prioritized warming the kidney,fortifying the spleen,supplementing Qi and reinforcing containment,employing modified Buzhong Yiqi Decoction,demonstrating good effects.[Conclusion]Professor PENG Yu emphasizes the importance of supporting the body's vital energy and eliminating pathogenic factors in the treatment of urinary incontinence after radical prostatectomy for prostate cancer.He skillfully utilizes the antagonistic and synergistic effects of the combinations,with a sophisticated approach,concise medication and mild properties,providing valuable insights for the clinical treatment of this condition,embodying the value of traditional Chinese medicine in managing postoperative complications.

Objective To observe the expressions of nucleotide-binding oligomerization domain receptor 1(NOD1)and its mediated RIP2/NF-κB signaling pathway-related proteins and autophagy-related proteins in cerebral cortex of rats with cerebral ischemia-reperfusion injury(CIRI);To explore the possible mechanism of eye acupuncture alleviating CIRI.Methods SPF-grade male Wistar rats were randomly divided into blank control group(12 rats),sham-operation group(12 rats)and modeling group(36 rats).A CIRI model was established by improved suture method.The rats in the modeling group were randomly divided into the model group,eyeacupuncture group,outside the acupoint area group,with 12 rats in each group.Neurological deficits in rats were evaluated by Longa score,TTC staining was used to observe the cerebral infarction,HE staining was used to observe the morphology of ischemic brain tissue,electron microscopy was used to observe the formation of autophagosome in ischemic brain tissue,RT-qPCR was used to detect the mRNA expressions of NOD1,receptor interacting protein 2(RIP2),nuclear factor-κB(NF-κB)p65 in ischemic cerebral cortex,Western blot was used to detect the expressions of NOD1,RIP2,NF-κB p65 and autophagy related proteins in ischemic cerebral cortex.Results Compared with the sham-operation group,the neurological deficit score of rats in the model group significantly increased(P<0.01),the infarct volume significantly increased(P<0.01),the typical cribriform infarct foci and multiple autophagosomes appeared in the ischemic brain tissue,the mRNA expressions of NOD1,RIP2 and NF-κB p65 in ischemic cerebral cortex significantly increased(P<0.01),the protein expressions of NOD1,RIP2,p-NF-κB p65,Beclin1,LC3Ⅱ/LC3Ⅰ and ATG5 significantly increased(P<0.01),and the protein expression of p62 significantly decreased(P<0.01).Compared with the model group,the neurological deficit score in eye acupuncture group significantly decreased(P<0.01),the cerebral infarction volume significantly decreased(P<0.01),the area of cribriform reticular infarct and the number of autophagosomes in ischemic brain tissue significantly decreased,the mRNA expressions of NOD1,RIP2 and NF-κB p65 in ischemic cerebral cortex significantly decreased(P<0.01),the protein expressions of NOD1,RIP2,p-NF-κB p65,Beclin1,LC3Ⅱ/LC3Ⅰ and ATG5 significantly decreased(P<0.01),and the protein expression of p62 significantly increased(P<0.01).There was no statistical significance compared with outside the acupoint area group.Conclusion Eye acupuncture can attenuat the injury of neurons in CIRI rats,and its mechanism may be related to inhibiting the activation of RIP2/NF-κB signaling pathway mediated by NOD1,thereby reducing autophagy of neurons.

Objective:To compare the efficacy of robot system-assisted versus freehand screw revision for ankylosing spondylitis (AS) with lower cervical fractures.Methods:A multicenter retrospective cohort study was conducted to analyze the clinical data of 57 patients with AS combined with lower cervical fractures admitted to Honghui Hospital Affiliated to Xi'an Jiaotong University School of Medicine, Henan Provincial People's Hospital, Zhengzhou Orthopedic Hospital, and Qilu Hospital of Shandong University, including 46 males and 11 females, aged 38-77 years [(65.4±9.5)years]. Injury segments involved C 3 in 7 patients, C 4 in 13, C 5 in 25, C 6 in 10, and C 7 in 2. All the patients underwent revision surgery, among whom, 22 patients were treated with robot system-assisted cervical pedicle screw placement (robot nailing group, with 190 screws), and 35 with freehand cervical pedicle screw placement (freehand nailing group, with 300 screws). The operative duration, intraoperative bleeding volume, frequency of intraoperative fluoroscopy, incision length, and length of hospital stay of the two groups were compared; the time of single nscrew insertion, the number of single nail revisions, the distance between screws and the anterior cortex, the accuracy of screw placement of grade 0 and grade 0+1 were recorded in the two groups. The visual analogue scale (VAS), Japanese Orthopedic Society (JOA) score, neck dysfunction index (NDI), American Spine Injury Association (ASIA) classification before operation, at 3 days, 3 months after operation and at the last follow-up were compared between the two groups. The complication rate was also noted. Results:All the patients were followed up for 12-16 months [(14.3±2.1)months]. The operative duration, intraoperative bleeding volume, and frequency of intraoperative fluoroscopy were (186.4±12.9)minutes, (486.1±68.6)ml, and (3.4±1.3)times in the robot nailing group, which were shorter or less than (206.7±14.4)minutes, (660.3±45.2)ml, and (13.5±3.6)times in the freehand nailing group ( P<0.01). The incision length was (9.4±2.4)cm in the robot nailing group, longer than (5.6±1.2)cm in the freehand nailing group ( P<0.01), and the length of hospital stay was (3.7±0.4)days, shorter than (4.4±1.4)days in the freehand nailing group ( P<0.01). The length of single nail insertion, the number of single nail revision, and the distance between the screws and the front cortex were (6.5±0.4)minutes, (1.1±0.1)times, and (3.5±1.3)mm in the robot nailing group, which were shorter or less than (11.6±0.2)minutes, (1.5±0.2)times, and (12.4±4.7)mm in the freehand nailing group ( P<0.01). The accuracy of the screw placement in the robot nailing group was 90.0% (171/190) and 95.8% (182/190) with level 0 and 0+1 screws, better than 80.0% (240/300) and 89.0% (267/300) in the freehand nailing group ( P<0.05). There was no significant difference in VAS, JOA score, NDI, or ASIA grading between the two groups before operation ( P>0.05). The VAS, JOA, and NDI scores at 3 days after operation were (3.1±0.6)points, (12.1±1.2)points, and (15.6±2.9)points, respectively in the robot nailing group, which were better than (5.0±1.4)points, (11.3±1.1)points and (22.5±3.7)points, respectively in the freehand nailing group ( P<0.05). No statistically significant difference was observed in the ASIA grade between the two groups at 3 days after operation ( P>0.05). There were no significant differences in VAS, JOA, NDI scores, or ASIA grading between the two groups at 3 months after operation and at the last follow-up ( P>0.05). Compared with those before operation, the VAS, JOA, NDI scores, and ASIA grading were significantly improved at 3 days, 3 months after operation and at the last follow-up in the two groups, which were further improved with the passage of time. Two patients in the robot nailing group had pneumonia, with a complication rate of 9% (2/22), while 2 patients in the freehand nailing group had dural sac rupture and cerebrospinal fluid leakage and 3 had lung infection after operation, with a complication rate of 14% (5/35) ( P<0.05). Conclusion:Compared with freehand nailing, the robot system-assisted nailing revision for AS with lower cervical fracture has more advantages in terms of the operative duration, length of hospital stay, intraoperative bleeding volume, frequency of intraoperative fluoroscopy nailing speed and accuracy, screw holding force, early pain relief, function restoration, and complication rate, despite longer surgical incision.