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 ECMO machine was withdrawn on day 1, and extubation was achieved on day 9 after surgery.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.

Most cancers are currently incurable, partly due to abnormal post-translational modifications (PTMs). In this study, we initially used multiple myeloma (MM) as a working model and found that SUMOylation activating enzyme subunit 1 (SAE1) promotes the malignancy of MM. Through proteome microarray analysis, SAE1 was identified as a potential target for bioactive colcemid or its derivative colchicine. Elevated levels of SAE1 were associated with poor clinical survival and increased MM proliferation in vitro and in vivo. Additionally, SAE1 directly SUMOylated and upregulated the total protein expression of p27, leading to LLPS-mediated nuclear export of p27. Our study also demonstrated the involvement of SAE1 in other types of cancer cells, and provided the first monomer crystal structure of SAE1 and its key binding model with colchicine. Colchicine also showed promising results in the Patient-Derived Tumor Xenograft (PDX) model. Furthermore, a controlled clinical trial with 56 MM patients demonstrated the clinical efficacy of colchicine. Our findings reveal a novel mechanism by which tumor cells evade p27-induced cellular growth arrest through p27 SUMOylation-mediated nuclear export. SAE1 may serve as a promising therapeutic target, and colchicine may be a potential treatment option for multiple types of cancer in clinical settings.

Objective:To investigate the effects of berberine on the proliferation,apoptosis,inflammation,and osteogenic differen-tiation of human periodontal ligament stem cells(hPDLSCs)induced by lipopolysaccharide through regulating the NF-κB/NLRP3 signaling pathway.Methods:HPDLSCs with good growth status were separated into a blank group(without any treatment),a lipopolysaccharide group(1 μg/mL lipopolysaccharide,A group),a low concentration berberine(berberine-L)group(1 μg/mL lipopolysaccharide+25 μmol/L berberine,B group),a medium concentration berberine(berberine-M)group(1 μg/mL lipopolysac-charide+50 μmol/L berberine,C group),a high concentration berberine(berberine-H)group(1 μg/mL+100 μmol/L berberine,D group),and a berberine-H+Prostratin group(1 μg/mL lipopolysaccharide+100 μmol/L berberine+1 μmol/L Prostratin,E group).Subsequently,the cell proliferation,levels of interleukin-1β(IL-1β),IL-6,and tumor necrosis factor-α(TNF-α)in the supernatant,cell apoptosis,osteogenic differentiation ability,expression of osteogenic differentiation related genes[RUNX family transcription fac-tor 2(Runx2),osteopontin(OPN),osteocalcin(OCN)],and expression levels of NF-κB and NLRP3 mRNA were detected.Results:The number of mineralized nodules,cell proliferation rate,ALP content,OPN,OCN,and Runx2 protein expression in the lipopolysac-charide group were greatly reduced compared to the blank group,however,the levels of IL-1 β,IL-6,and TNF-α,apoptosis rate,NF-κB,and NLRP3 mRNA expression in the supernatant were greatly increased(P＜0.05).After treating cells with different doses of berberine,the number of mineralized nodules,proliferation rate,ALP content,OPN,OCN,and Runx2 protein expression were greatly increased,the levels of IL-1β,IL-6,and TNF-α,apoptosis rate,NF-κB,and NLRP3 mRNA expression in the supernatant were greatly reduced,and the berberine-H group was the most great(P＜0.05).After treatment with berberine-H combined with Prostratin,the number of mineralized nodules,proliferation rate,ALP content,OPN,OCN and Runx2 protein expression were greatly reduced compared to single berberine-H treatment,the levels of IL-1β,IL-6 and TNF-α,apoptosis rate,NF-κB,and NLRP3 mRNA expression in the supernatant were greatly increased(P＜0.05).Conclusion:Berberine enhances lipopolysaccharide induced proliferation of hPDLSCs,inhibits apoptosis and inflammation,and promotes osteogenic differentiation by inhibiting the NF-κB/NLRP3 signaling pathway.

Based on CT scan data,a bionic model of lumbar spine injuries with high biofidelity is developed and validated through cadaver experiments.Decoupling the constraint system that affects occupants during collisions due to inertial forces and the subsequent pressure exerted by the seat upon returning to position,a simulated fall experiment is designed.The simulated outcomes are trained and predicted using deep learning algorithms,and the accuracy of the trained neural network prediction model is verified.Key parameters are analyzed for correlation using principal component analysis and cross-reverse methods.The results shows that the predicted lumbar spine injury model obtained from training has high reliability(R2>0.9).Comprehensive analysis reveals that after experiencing axial impact,the L4 vertebral body bears the highest impact load and can be used as a representative measure of lumbar spine injury.Among the environmental variables,the axial force on the L4 lumbar spine is mainly affected by torso mass and fall height,both of which have positive correlations.Torso mass,fall height,and posture angle all have positive effects on internal energy.Conversely,torso mass and fall height have negative correlations with stress.These research findings provide a scientific basis for further elucidating lumbar spine injury mechanisms in intelligent cockpit environments,devising corresponding safety protection measures,and evaluating occupant safety in automobiles.

Based on CT scan data,a bionic model of lumbar spine injuries with high biofidelity is developed and validated through cadaver experiments.Decoupling the constraint system that affects occupants during collisions due to inertial forces and the subsequent pressure exerted by the seat upon returning to position,a simulated fall experiment is designed.The simulated outcomes are trained and predicted using deep learning algorithms,and the accuracy of the trained neural network prediction model is verified.Key parameters are analyzed for correlation using principal component analysis and cross-reverse methods.The results shows that the predicted lumbar spine injury model obtained from training has high reliability(R2>0.9).Comprehensive analysis reveals that after experiencing axial impact,the L4 vertebral body bears the highest impact load and can be used as a representative measure of lumbar spine injury.Among the environmental variables,the axial force on the L4 lumbar spine is mainly affected by torso mass and fall height,both of which have positive correlations.Torso mass,fall height,and posture angle all have positive effects on internal energy.Conversely,torso mass and fall height have negative correlations with stress.These research findings provide a scientific basis for further elucidating lumbar spine injury mechanisms in intelligent cockpit environments,devising corresponding safety protection measures,and evaluating occupant safety in automobiles.

Objective:To investigate the effects of berberine on the proliferation,apoptosis,inflammation,and osteogenic differen-tiation of human periodontal ligament stem cells(hPDLSCs)induced by lipopolysaccharide through regulating the NF-κB/NLRP3 signaling pathway.Methods:HPDLSCs with good growth status were separated into a blank group(without any treatment),a lipopolysaccharide group(1 μg/mL lipopolysaccharide,A group),a low concentration berberine(berberine-L)group(1 μg/mL lipopolysaccharide+25 μmol/L berberine,B group),a medium concentration berberine(berberine-M)group(1 μg/mL lipopolysac-charide+50 μmol/L berberine,C group),a high concentration berberine(berberine-H)group(1 μg/mL+100 μmol/L berberine,D group),and a berberine-H+Prostratin group(1 μg/mL lipopolysaccharide+100 μmol/L berberine+1 μmol/L Prostratin,E group).Subsequently,the cell proliferation,levels of interleukin-1β(IL-1β),IL-6,and tumor necrosis factor-α(TNF-α)in the supernatant,cell apoptosis,osteogenic differentiation ability,expression of osteogenic differentiation related genes[RUNX family transcription fac-tor 2(Runx2),osteopontin(OPN),osteocalcin(OCN)],and expression levels of NF-κB and NLRP3 mRNA were detected.Results:The number of mineralized nodules,cell proliferation rate,ALP content,OPN,OCN,and Runx2 protein expression in the lipopolysac-charide group were greatly reduced compared to the blank group,however,the levels of IL-1 β,IL-6,and TNF-α,apoptosis rate,NF-κB,and NLRP3 mRNA expression in the supernatant were greatly increased(P＜0.05).After treating cells with different doses of berberine,the number of mineralized nodules,proliferation rate,ALP content,OPN,OCN,and Runx2 protein expression were greatly increased,the levels of IL-1β,IL-6,and TNF-α,apoptosis rate,NF-κB,and NLRP3 mRNA expression in the supernatant were greatly reduced,and the berberine-H group was the most great(P＜0.05).After treatment with berberine-H combined with Prostratin,the number of mineralized nodules,proliferation rate,ALP content,OPN,OCN and Runx2 protein expression were greatly reduced compared to single berberine-H treatment,the levels of IL-1β,IL-6 and TNF-α,apoptosis rate,NF-κB,and NLRP3 mRNA expression in the supernatant were greatly increased(P＜0.05).Conclusion:Berberine enhances lipopolysaccharide induced proliferation of hPDLSCs,inhibits apoptosis and inflammation,and promotes osteogenic differentiation by inhibiting the NF-κB/NLRP3 signaling pathway.

Objective To compare the effect of three-dimensional visual (3DV) model, three-dimensional printing (3DP) model and computer-aided design (CAD) modified 3DP model in video-assisted thoracoscopic surgery (VATS) sublobular resection. Methods The clinical data of patients who underwent VATS sublobular resection in the Affiliated Hospital of Hebei University from November 2021 to August 2022 were retrospectively analyzed. The patients were divided into 3 groups including a 3DV group, a 3DP group and a CAD-3DP group according to the tools used. The perioperative indexes and subjective evaluation of operators, patients and their families were compared. Results A total of 22 patients were included. There were 5 males and 17 females aged 32-77 (56.95±12.50) years. There were 9 patients in the 3DV group, 6 patients in the 3DP group, and 7 patients in the CAD-3DP group. There was no statistical difference in the operation time, intraoperative blood loss, drainage volume, hospital stay time or postoperative complications among the groups (P>0.05). Based on the subjective evaluations of 4 surgeons, the CAD-3DP group was better than the 3DV group in the preoperative planning efficiency (P=0.025), intuitiveness (P=0.045) and doctor-patient communication difficulty (P=0.034); the CAD-3DP group was also better than the 3DP group in the overall satisfaction (P=0.023), preoperative planning difficulty (P=0.046) and efficiency (P=0.014). Based on the subjective evaluations of patients and their families, the CAD-3DP group was better than the 3DP group in helping understand the vessel around the tumor (P=0.016), surgical procedure (P=0.020), procedure selection (P=0.029), and overall satisfaction (P=0.048); the CAD-3DP group was better than the 3DV group in helping understand the tumor size (P=0.038). Conclusion CAD-modified 3DP model has certain advantages in pre-planning, intraoperative navigation and doctor-patient communication in the VATS sublobectomy.

Myocardial fibrosis （MF） is a common pathological manifestation of various heart diseases. Due to the non-renewable nature of myocardial cells， the occurrence of MF represents irreversible damage to the myocardium. Previous studies have suggested that fibroblast-mediated collagen deposition is the main mechanism of MF. Recent studies have found that there is an immune regulation mechanism in the heart itself， and macrophage activation/polarization plays an important role in MF. With the deepening of traditional Chinese medicine research， scholars have found that traditional Chinese medicine can interfere with MF by regulating the renin-angiotensin-aldosterone system （RAAS） system and the inflammatory process， repairing the extracellular matrix， managing oxidative stress， and maintaining the balance of autophagy. This process is closely related to the activation and M1/M2 polarization of macrophages. Throughout the MF process， macrophage activation is beneficial， but excessive activation will be harmful. In the early stage of MF， appropriate M1 macrophage polarization is conducive to activating immunity and removing harmful substances. In the middle and late stages of MF， appropriate M2 macrophage polarization is conducive to remodeling the damaged myocardium. If macrophage activation is excessive/insufficient， or the balance of M1/M2 macrophage polarization is broken， the effect changes from improvement to destruction. Traditional Chinese medicines that regulate the activation/polarization of macrophages have the effects of replenishing Qi and nourishing Yin， as well as regulating Qi and activating blood， but there are also some heat-clearing， dampness-drying， and detoxification products. Therefore， the occurrence of MF may be caused by Qi and Yin deficiency， damp heat accumulation， and Qi stagnation and blood stasis. By summarizing the biological processes involved in macrophage activation/polarization in MF， this paper expounded on the research progress of traditional Chinese medicine in regulating macrophage activation and M1/M2 polarization from different angles to improve MF， so as to provide a reference for the treatment of MF with traditional Chinese medicine.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Background/Aims: Metabolic syndrome is common in patients with acute pancreatitis and its components have been reported to be associated with infectious complications. In this post hoc analysis, we aimed to evaluate whether metabolic abnormalities impact the effect of immuneenhancing thymosin alpha-1 (Tα1) therapy in acute necrotizing pancreatitis (ANP) patients. Methods: All data were obtained from the database for a multicenter randomized clinical trial that evaluated the efficacy of Tα1 in ANP patients. Patients who discontinued the Tα1 treatment prematurely were excluded. The primary outcome was 90-day infected pancreatic necrosis (IPN) after randomization. Three post hoc subgroups were defined based on the presence of hyperglycemia, hypertriglyceridemia, or both at the time of randomization. In each subgroup, the correlation between Tα1 and 90-day IPN was assessed using the Cox proportional-hazards regression model. Multivariable propensity-score methods were used to control potential bias. Results: Overall, 502 participants were included in this post hoc analysis (248 received Tα1 treatment and 254 received matching placebo treatment). Among them, 271 (54.0%) had hyperglycemia, 371 (73.9%) had hypertriglyceridemia and 229 (45.6%) had both. Tα1 therapy was associated with reduced incidence of IPN among patients with hyperglycemia (18.8% vs 29.7%: hazard ratio, 0.80; 95% confidence interval, 0.37 to 0.97; p=0.03), but not in the other subgroups. Additional multivariate regression models using three propensity-score methods yielded similar results. Conclusions Among ANP patients with hyperglycemia, immune-enhancing Tα1 treatment was associated with a reduced risk of IPN (ClinicalTrials.gov, Registry number: NCT02473406).