BACKGROUND:Currently,the treatment methods for colorectal cancer include surgical resection and chemotherapy.However,the subsequent quality of life of patients cannot be improved due to the multiple surgical complications and drug resistance in the later stage of chemotherapy.OBJECTIVE:To review the mechanism of action,latest progress and existing problems of exosomes derived from mesenchymal stem cells in the treatment of colorectal cancer.METHODS:PubMed,CNKI and WanFang databases were searched for relevant literature using the search terms of"mesenchymal stem cells exosomes,colorectal cancer,chemotherapy,treatment"in Chinese and English,respectively.Finally,96 articles were included for analysis.RESULTS AND CONCLUSION:(1)Mesenchymal stem cell-derived exosomes play different roles in the treatment of colorectal cancer mainly through the microRNAs and long-chain non-coding RNAs carried by themselves to mediate different signaling pathways.(2)Mesenchymal stem cell-derived exosomes are highly stable and biocompatible,which makes them excellent carriers of therapeutic drugs.(3)Mesenchymal stem cell-derived exosomes have different effects on resistance to different types of chemotherapeutic agents.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective:To explore the impact of the stimulator of interferon genes(STING)-interferon regulatory factor 3(IRF3)pathway on the senescence of rapid pacing HL-1 myocytes.Methods:HL-1 cells were divided into five groups: the control group(HL-1 cells without any treatment), pacing group(HL-1 cells paced for 48 hours), STING siRNA group(HL-1 cells paced for 48 hours and transfected with STING siRNA), NC siRNA group(HL-1 cells paced for 48 hours and transfected with NC siRNA), and H151 inhibitor group(HL-1 cells paced for 48 hours with the addition of 1 μmol/L STING inhibitor H151). Mitochondrial membrane potential was assessed in control and pacing group cells, and mitochondrial MitoTracker and TFAM co-localization staining was performed on these cells.Cellular senescence was evaluated using β-galactosidase staining in each group, and the positive rate of cellular senescence was observed and calculated.Western blotting was employed to detect the expression levels of STING, IRF3, P-IRF3, P16, P21, and P53 proteins in all groups.Immunofluorescence was utilized to examine the expression distribution of STING and P21 across the various groups.ELISA was performed to measure the concentrations of interleukin(IL)-1β, IL-6, and IL-8 in the cell supernatants from each group as part of the senescence-associated secretory phenotype(SASP).Results:Compared with the control group, the ratio of mitochondrial JC-1 multimer to monomer was significantly decreased in the pacing group( t=16.42, P<0.05), the co-localization of mitochondrial MitoTracker and TFAM in the cells was significantly weakened, the proportion of cells with positive cellular senescence-associated β-galactosidase staining significantly increased in the pacing group, the expression levels of STING, P-IRF3/IRF3, P16, P21, and P53 proteins were significantly elevated in the pacing group, and the concentrations of IL-1β, IL-6, and IL-8 in the cell supernatants were markedly increased.Compared with the pacing group, the proportion of cells with positive cellular senescence-associated β-galactosidase staining decreased in the STING siRNA group and H151 inhibitor group ( F= 18.13, P<0.05), the expression levels of STING, P-IRF3/IRF3, P16, P21, and P53 were reduced in the STING siRNA group and H151 inhibitor group ( F=16.84, 26.56, 74.70, 31.80, 31.23, all P<0.05), and the concentrations of IL-1β, IL-6, and IL-8 in the cell supernatants decreased( F=197.80、1 339.00、1 308.00, all P<0.001). Conclusions:Rapid pacing of HL-1 cells can promote mtDNA release into the cytoplasm, activate the STING-IRF3 pathway, accelerate cellular senescence, and enhance the secretion of SASP.Inhibiting the expression of STING can delay the senescence induced by the rapid pacing of HL-1 cells and reduce SASP secretion.

BACKGROUND:Early treatment methods for colorectal cancer include endoscopy and surgical resection,but there are many postoperative complications.Chemotherapy is the most common treatment for late-stage colorectal cancer,but chemotherapy can cause gastrointestinal dysfunction,bone marrow suppression,liver and kidney function damage,and other adverse reactions.As a result,most patients are not proactive and do not cooperate with treatment.OBJECTIVE:To review the mechanism of action,latest treatment progress,and current problems of mesenchymal stem cells in the treatment of colorectal cancer,and provide a basis for future clinical application.METHODS:PubMed,CNKI,and WanFang databases were searched for relevant literature using the keywords of"mesenchymal stem cells,colorectal cancer,cancer stem cell,tumor microenvironment"in Chinese and English,respectively.Finally,119 articles were included for analysis.RESULTS AND CONCLUSION:(1)Mesenchymal stem cells have both promoting and inhibiting effects on colorectal cancer.(2)The tumor homing characteristics of mesenchymal stem cells enable them to migrate accurately to the tumor site and release drugs,which increases the safety and effectiveness of the treatment of colorectal cancer.(3)Exosomes derived from mesenchymal stem cells can serve as good carriers and shows a good application prospect in the targeted therapy of colorectal cancer.(4)Using viral vectors,non-viral vectors,or other transfection tools,drugs with mature anti-tumor effects can be loaded into mesenchymal stem cells for the treatment of colorectal cancer.(5)The combined use of mesenchymal stem cells and chemotherapy drugs can improve the efficacy of chemotherapy drugs and reduce the adverse reactions of chemotherapy drugs.(6)The mechanism by which mesenchymal stem cells promote the development of colorectal cancer is mainly related to the expression status of signal transduction and chemotactic factors in colorectal cancer cells and the transformation of mesenchymal stem cells into cancer-related fibroblasts.(7)Mesenchymal stem cells may have the characteristics of driving cancer stem cells,promoting tumor initiation and increasing tumor invasion.(8)There are still some unavoidable problems in the treatment of colorectal cancer with mesenchymal stem cells:lack of standardized treatment plans and efficacy evaluation,high treatment costs,preservation and transportation of mesenchymal stem cells,and the proportion of combined use of mesenchymal stem cells and chemotherapy drugs.

BACKGROUND:Currently,the treatment methods for colorectal cancer include surgical resection and chemotherapy.However,the subsequent quality of life of patients cannot be improved due to the multiple surgical complications and drug resistance in the later stage of chemotherapy.OBJECTIVE:To review the mechanism of action,latest progress and existing problems of exosomes derived from mesenchymal stem cells in the treatment of colorectal cancer.METHODS:PubMed,CNKI and WanFang databases were searched for relevant literature using the search terms of"mesenchymal stem cells exosomes,colorectal cancer,chemotherapy,treatment"in Chinese and English,respectively.Finally,96 articles were included for analysis.RESULTS AND CONCLUSION:(1)Mesenchymal stem cell-derived exosomes play different roles in the treatment of colorectal cancer mainly through the microRNAs and long-chain non-coding RNAs carried by themselves to mediate different signaling pathways.(2)Mesenchymal stem cell-derived exosomes are highly stable and biocompatible,which makes them excellent carriers of therapeutic drugs.(3)Mesenchymal stem cell-derived exosomes have different effects on resistance to different types of chemotherapeutic agents.

BACKGROUND:Early treatment methods for colorectal cancer include endoscopy and surgical resection,but there are many postoperative complications.Chemotherapy is the most common treatment for late-stage colorectal cancer,but chemotherapy can cause gastrointestinal dysfunction,bone marrow suppression,liver and kidney function damage,and other adverse reactions.As a result,most patients are not proactive and do not cooperate with treatment.OBJECTIVE:To review the mechanism of action,latest treatment progress,and current problems of mesenchymal stem cells in the treatment of colorectal cancer,and provide a basis for future clinical application.METHODS:PubMed,CNKI,and WanFang databases were searched for relevant literature using the keywords of"mesenchymal stem cells,colorectal cancer,cancer stem cell,tumor microenvironment"in Chinese and English,respectively.Finally,119 articles were included for analysis.RESULTS AND CONCLUSION:(1)Mesenchymal stem cells have both promoting and inhibiting effects on colorectal cancer.(2)The tumor homing characteristics of mesenchymal stem cells enable them to migrate accurately to the tumor site and release drugs,which increases the safety and effectiveness of the treatment of colorectal cancer.(3)Exosomes derived from mesenchymal stem cells can serve as good carriers and shows a good application prospect in the targeted therapy of colorectal cancer.(4)Using viral vectors,non-viral vectors,or other transfection tools,drugs with mature anti-tumor effects can be loaded into mesenchymal stem cells for the treatment of colorectal cancer.(5)The combined use of mesenchymal stem cells and chemotherapy drugs can improve the efficacy of chemotherapy drugs and reduce the adverse reactions of chemotherapy drugs.(6)The mechanism by which mesenchymal stem cells promote the development of colorectal cancer is mainly related to the expression status of signal transduction and chemotactic factors in colorectal cancer cells and the transformation of mesenchymal stem cells into cancer-related fibroblasts.(7)Mesenchymal stem cells may have the characteristics of driving cancer stem cells,promoting tumor initiation and increasing tumor invasion.(8)There are still some unavoidable problems in the treatment of colorectal cancer with mesenchymal stem cells:lack of standardized treatment plans and efficacy evaluation,high treatment costs,preservation and transportation of mesenchymal stem cells,and the proportion of combined use of mesenchymal stem cells and chemotherapy drugs.

Acute symptomatic osteoporotic thoracolumbar compression fracture (ASOTLF) can lead to chronic low back pain, kyphosis deformity, pulmonary dysfunction, loss of mobility, and even life-threatening complications. Vertebral augmentation is currently the mainstream treatment method for this condition. In 2019, the Editorial Board of Chinese Journal of Trauma and the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association collaboratively led the development of Clinical guideline for vertebral augmentation for acute symptomatic osteoporotic thoracolumbar compression fractures. Six years later, with advances in clinical diagnosis and treatment techniques as well as accumulating evidence in related fields, the 2019 guideline requires updating. To this end, the Spinal Trauma Group of Orthopedic Surgeons Branch of Chinese Medical Doctor Association, the Spinal Health Professional Committee of China Human Health Science and Technology Promotion Association, and the Minimally Invasive Orthopedics Professional Committee of Shaanxi Medical Doctor Association have organized experts in the field to develop the Clinical guideline for vertebral augmentation of acute symptomatic osteoporotic thoracolumbar compression fractures ( version 2025) , based on the latest evidence-based medical researches. This guideline incorporates 3 recommendations retained from the 2019 version with updated strength of evidence, along with 12 new recommendations. It provides recommendations from six aspects of diagnosis, pain management, treatment option selection, prevention of postoperative complications, anti-osteoporosis therapy, and postoperative rehabilitation, aiming to provide a reference for standard treatment of vertebral augmentation for ASOTLF in hospitals at all levels.

Objective:To explore the impact of the stimulator of interferon genes(STING)-interferon regulatory factor 3(IRF3)pathway on the senescence of rapid pacing HL-1 myocytes.Methods:HL-1 cells were divided into five groups: the control group(HL-1 cells without any treatment), pacing group(HL-1 cells paced for 48 hours), STING siRNA group(HL-1 cells paced for 48 hours and transfected with STING siRNA), NC siRNA group(HL-1 cells paced for 48 hours and transfected with NC siRNA), and H151 inhibitor group(HL-1 cells paced for 48 hours with the addition of 1 μmol/L STING inhibitor H151). Mitochondrial membrane potential was assessed in control and pacing group cells, and mitochondrial MitoTracker and TFAM co-localization staining was performed on these cells.Cellular senescence was evaluated using β-galactosidase staining in each group, and the positive rate of cellular senescence was observed and calculated.Western blotting was employed to detect the expression levels of STING, IRF3, P-IRF3, P16, P21, and P53 proteins in all groups.Immunofluorescence was utilized to examine the expression distribution of STING and P21 across the various groups.ELISA was performed to measure the concentrations of interleukin(IL)-1β, IL-6, and IL-8 in the cell supernatants from each group as part of the senescence-associated secretory phenotype(SASP).Results:Compared with the control group, the ratio of mitochondrial JC-1 multimer to monomer was significantly decreased in the pacing group( t=16.42, P<0.05), the co-localization of mitochondrial MitoTracker and TFAM in the cells was significantly weakened, the proportion of cells with positive cellular senescence-associated β-galactosidase staining significantly increased in the pacing group, the expression levels of STING, P-IRF3/IRF3, P16, P21, and P53 proteins were significantly elevated in the pacing group, and the concentrations of IL-1β, IL-6, and IL-8 in the cell supernatants were markedly increased.Compared with the pacing group, the proportion of cells with positive cellular senescence-associated β-galactosidase staining decreased in the STING siRNA group and H151 inhibitor group ( F= 18.13, P<0.05), the expression levels of STING, P-IRF3/IRF3, P16, P21, and P53 were reduced in the STING siRNA group and H151 inhibitor group ( F=16.84, 26.56, 74.70, 31.80, 31.23, all P<0.05), and the concentrations of IL-1β, IL-6, and IL-8 in the cell supernatants decreased( F=197.80、1 339.00、1 308.00, all P<0.001). Conclusions:Rapid pacing of HL-1 cells can promote mtDNA release into the cytoplasm, activate the STING-IRF3 pathway, accelerate cellular senescence, and enhance the secretion of SASP.Inhibiting the expression of STING can delay the senescence induced by the rapid pacing of HL-1 cells and reduce SASP secretion.

Objective:Trigeminal neuralgia(TN)is a common neuropathic pain.Voltage-gated potassium channel(Kv)has been confirmed to be involved in the occurrence and development of TN,but the specific mechanism is still unclear.MicroRNA may be involved in neuropathic pain by regulating the expression of Kv channels and neuronal excitability in trigeminal ganglion(TG).This study aims to explore the relationship between Kv1.1 and miR-21-5p in TG with a TN model,evaluate whether miR-21-5p has a regulatory effect on Kv1.1,and to provide a new target and experimental basis for the treatment of TN. Methods:A total of 48 SD rats were randomly divided into 6 groups:1)a sham group(n= 12),the rats were only sutured at the surgical incision without nerve ligation;2)a sham+ agomir NC group(n=6),the sham rats were microinjected with agomir NC through stereotactic brain injection in the surgical side of TG;3)a sham+miR-21-5p agomir group(n=6),the sham rats were microinjected with miR-21-5p agomir via stereotactic brain injection in the surgical side of TG;4)a TN group(n=12),a TN rat model was constructed using the chronic constriction injury of the distal infraorbital nerve(dIoN-CCI)method with chromium intestinal thread;5)a TN+antagonist NC group(n=6),TN rats were microinjected with antagonist NC through stereotactic brain injection method in the surgical side of TG;6)a TN+miR-21-5p antagonist group(n=6),TN rats were microinjected with miR-21-5p antagonist through stereotactic brain injection in the surgical side of TG.The change of mechanical pain threshold in rats of each group after surgery was detected.The expressions of Kv1.1 and miR-21-5p in the operative TG of rats were detected by Western blotting and real-time reverse transcription polymerase chain reaction.Dual luciferase reporter genes were used to determine whether there was a target relationship between Kv1.1 and miR-21-5p and whether miR-21-5p directly affected the 3'-UTR terminal of KCNA1.The effect of brain stereotaxic injection was evaluated by immunofluorescence assay,and then the analogue of miR-21-5p(agomir)and agomir NC were injected into the TG of rats in the sham group by brain stereotaxic apparatus to overexpress miR-21-5p.The miR-21-5p inhibitor(antagomir)and antagomir NC were injected into TG of rats in the TN group to inhibit the expression of miR-21-5p.The behavioral changes of rats before and after administration were observed,and the expression changes of miR-21-5p and Kv1.1 in TG of rats after intervention were detected. Results:Compared with the baseline pain threshold,the facial mechanical pain threshold of rats in the TN group was significantly decreased from the 5th to 15th day after the surgery(P<0.05),and the facial mechanical pain threshold of rats in the sham group was stable at the normal level,which proved that the dIoN-CCI model was successfully constructed.Compared with the sham group,the expression of Kv1.1 mRNA and protein in TG of the TN group was down-regulated(both P<0.05),and the expression of miR-21-5p was up-regulated(P<0.05).The results of dual luciferase report showed that the luciferase activity of rno-miR-21-5p mimics and KCNA1 WT transfected with 6 nmol/L or 20 nmol/L were significantly decreased compared with those transfected with mimic NC and wild-type KCNA1 WT,respectively(P<0.001).Compared with low dose rno-miR-21-5p mimics(6 nmol/L)co-transfection group,the relative activity of luciferase in the high dose rno-miR-21-5p mimics(20 nmol/L)cotransfection group was significantly decreased(P<0.001).The results of immunofluorescence showed that drugs were accurately injected into TG through stereotaxic brain.After the expression of miR-21-5p in the TN group,the mechanical pain threshold and the expression of Kv1.1 mRNA and protein in TG were increased.After overexpression of miR-21-5p in the sham group,the mechanical pain threshold and the expression of Kv1.1 mRNA and protein in TG were decreased. Conclusion:Both Kv1.1 and miR-21-5p are involved in TN and miR-21-5p can regulate Kv1.1 expression by binding to the 3'-UTR of KCNA1.

Communication with the family members of donors is an integral part of the organ donation and transplantation, and the core of it lies in building trust through interpersonal communication. Every word and deed from the communicator will directly affect the overall impression of family members of potential donors towards organ donation. Regardless of whether or not granted the donation ultimately, family members may share their personal experiences and feelings with friends and relatives around them, which develops a secondary dissemination. Therefore, "the choice of best candidate for communication with family members of organ donation" has been an issue that organ donation practitioners have been working on in clinical practice. Taking into consideration of the experiences from different countries or regions, various advices and practices on this issue have been proposed due to differences in social systems, cultural background, organizational structure, clinical practice, etc. In this paper, we had a discussion on this topic, summarize the difficulties currently encountered in communication with family members and propose corresponding strategies.