Copper is an essential trace element in the human body, extensively involved in key physiological and biochemical processes such as antioxidant defense, energy metabolism, neural signaling, and immune regulation. In recent years, increasing research has focused on the potential role of copper dyshomeostasis in the development of chronic diseases. Studies indicate that abnormal copper levels, particularly elevated free copper, may increase the risk of cardiovascular disease, neurodegenerative disorders, diabetes, and cancer by inducing oxidative stress, impairing mitochondrial function, and disrupting immune regulation. Concurrently, copper homeostasis abnormalities have been demonstrated to be closely associated with increased all-cause mortality and accelerated aging. This systematic review comprehensively examined physiological functions, metabolic pathways, and environmental exposure characteristics of copper. It emphasized the epidemiological and mechanistic links between copper metabolism disorders and multiple chronic diseases, while exploring the potential applications of copper ion transporters and chelating agents in disease intervention. This work provides scientific evidence for the prevention, control, and precision treatment of copper-related chronic diseases.

ObjectiveTo investigate the application of the novel inflammatory factor adsorption column CA280 combined with low-dose plasma exchange （LPE） in patients with acute-on-chronic liver failure （ACLF）. MethodsA prospective cohort study was designed， and a total of 93 ACLF patients who were admitted to The Ninth Hospital of Nanchang from June 2023 to January 2025 were enrolled and randomly divided into DPMAS+LPE group with 50 patients and CA280+LPE group with 43 patients. In addition to comprehensive medical treatment， the patients in the DPMAS+LPE group received DPMAS and LPE treatment， and those in the CA280+LPE group received CA280 and LPE treatment. The two groups were observed in terms of routine blood test results， liver function parameters， renal function markers， electrolytes， coagulation function parameters， cytokines， adverse events， and 28-day prognosis before surgery （baseline）， during surgery （DPMAS or CA280）， and after surgery （after sequential LPE treatment）. The paired t-test was used for comparison of normally distributed continuous data before and after treatment within each group， and the independent-samples t test was used for comparison between groups； the Wilcoxon signed-rank test was used for comparison of non-normally distributed continuous data before and after treatment within each group， and the Mann-Whitney U test was used for comparison between groups. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups， and the Spearman test was used for correlation analysis. ResultsAfter CA280 treatment， the ACLF patients had significant reductions in the levels of cytokines （IL-6， IL-8， IL-10， TNF-α， and IFN-γ）， liver function parameters （ALT， AST， ALP， TBil， DBil， Alb， and glutathione reductase）， and the renal function marker urea nitrogen （all P<0.05）， and in terms of coagulation function parameters， there were significant increases in prothrombin time， activated partial thromboplastin time （APTT）， thrombin time， and international normalized ratio （INR） and significant reductions in prothrombin activity （PTA） and fibrinogen （FIB） （all P<0.05）. Compared with the DPMAS+LPE group， the CA280+LPE group showed better improvements in the serum cytokines IL-8 （Z=-2.63， P=0.009）， IL-10 （Z=-3.94， P<0.001）， and TNF-α （Z=-1.53， P=0.023）， and the two artificial liver support systems had a similar effect in improving liver function （ALT， AST， GGT， GR， TBil， and DBil） （all P >0.05）， but the CA280+LPE group showed a significantly greater reduction in Alb （Z=-2.08， P=0.037）. CA280+LPE was more effective in reducing uric acid （Z=-2.97， P=0.003）. Compared with DPMAS+LPE， CA280+LPE treatment resulted in a significant reduction in INR （Z=-4.01， P<0.001）， a significant increase in APTT （Z=-2.53， P=0.011）， and significant greater increases in PTA （Z=-6.28， P<0.001） and FIB （Z=-3.93， P<0.001）. There were no significant differences in the incidence rates of adverse reactions and the rate of improvement at discharge between the two groups （all P>0.05）. The Spearman correlation analysis showed that IL-6 was significantly correlated with WBC （r=0.22， P=0.042）， TBil （r=0.29， P=0.005）， and FIB （r=-0.33， P=0.003）； IL-8 was positively correlated with APTT （r=0.37， P<0.001） and INR （r=0.25， P=0.013）； TNF-α was significantly correlated with WBC （r=0.40， P<0.001） and TBil （r=0.34， P<0.001）. ConclusionCompared with DPMAS， CA280 combined with LPE can effectively clear proinflammatory cytokines and improve liver function in ACLF patients， but it has a certain impact on Alb and coagulation function. This regimen provides a new option for the individualized treatment of ACLF and can improve the short-term prognosis of patients， but further studies are needed to verify its long-term efficacy.

Objective:To construct a sizeable naive human Fab phage display antibody library to screen high-affinity specific antibodies in vitro. Methods:Total RNA was extracted from peripheral blood mononuclear cells (PBMCs) of 126 healthy individuals, subsequently reverse-transcribed into cDNA, and used as a template. PCR amplification was performed to obtain the V H from IgG, IgM and light chain κ, λ, separately, with the initial PCR products serving as templates for a second round of PCR. Overlap extension PCR was employed to generate fragments of the κ and λ light chains. These fragments were ligated with the phage vector pNC3, which harbors the variable region 1 of the heavy chain, to construct a recombinant phage plasmid. This plasmid was then electroporated into competent Escherichia Coli TG1 cells to establish a naive human Fab phage display antibody library. One hundred clones were randomly selected for identification and sequencing, and antibody gene polymorphisms were analyzed using the IMGT database and MAFFT software. Recombinant α-hemolysin from Staphylococcus aureus was utilized to screen Fab antibody fragments through biopanning of the antibody library, followed by random selection of phage ELISA-identified clones. The positive clones (antigen A450∶blank control A450≥2.1) were sequenced. Results:Two large naive Fab phage display antibody libraries were successfully constructed, in which the capacity of κ and λ chain antibody libraries were 1.25×10 11 and 1.54×10 11, respectively. The titers for two antibody libraries were 6.04×10 13 CFU/ml and 3.50×10 13 CFU/ml. The positive transformation insertion rates for κ and λ chain antibody libraries were 96% (96/100) and 100% (100/100), respectively. Sequence analysis revealed that all antibody sequences were unique. The amino acid sequences in the skeletal region were relatively conserved. In contrast, significant variations in the length of the complementarity determining region (CDR) were found, and the diversity of amino acid sequence of the complementary determining region was high, especially the CDR3. Analysis using the IMGT database indicated that the sequences exhibited a broad distribution across variable-diversity-joining gene families. After six rounds of panning, specific phage antibodies enrichment targeting α-hemolysin were achieved. A total of 142 monoclonal antibodies were sequenced, yielding 8 distinct Fab antibody sequences. Conclusion:This study successfully constructed two naive human Fab phage display antibody libraries with large capacity and good diversity, which can be used for screening human antibodies for serum epidemiology.

Lower extremity arteriosclerosis obliterans(LEASO) is a disease in which systemic atherosclerosis affects the blood-supplying arteries of the lower extremities, resulting in chronic ischemia of the lower extremities. Angiopoietin-like protein 2(Angptl2) is a newly discovered pro-inflammatory protein that promotes the development of atherosclerosis by inducing vascular inflammatory responses. It is closely associated with certain risk factors for LEASO, such as advanced age, obesity, and type 2 diabetes. In addition, the high expression of Angptl2 in LEASO correlates with the continued progression of LEASO and may reflect the severity of the disease, suggesting that Angptl2 may be an important serologic biomarker for LEASO. In this article, we review the progress of research on the correlation between Angptl2 and LEASO, and analyze the value of Angptl2 as a biomarker for LEASO.

Objective To explore the application value of dynamic airway computed tomography(DACT)based on retrospective ECG-gating technology in the diagnosis of cardiovascular-related airway stenosis.Methods A retrospective analysis was performed on the bronchoscopy and DACT data of 48 children clinically suspected of having congenital heart disease(CHD)or cardiovascular-related airway stenosis.The image quality of DACT was assessed,and the accuracy differences in diagnosing airway abnormalities between bronchoscopy and DACT were compared.The correlation between DACT and bronchoscopy in diagnosing the degree of airway steno-sis was also evaluated.Results The DACT image quality met diagnostic requirements for all children.There was no significant statistical difference in the diagnosis of airway abnormalities between DACT based on retrospective ECG-gating technology and bronchoscopy.A good correlation was observed between DACT and bronchoscopy in the grading of tracheal stenosis.Conclusion DACT based on retrospective ECG-gating technology can effectively address the issue of motion artifacts in CT scans among infants and young children.It has certain value in clarifying the diagnosis of cardiovascular-related airway stenosis,guiding treatment,and assessing prognosis.

Objective To explore the application value of dynamic airway computed tomography(DACT)based on retrospective ECG-gating technology in the diagnosis of cardiovascular-related airway stenosis.Methods A retrospective analysis was performed on the bronchoscopy and DACT data of 48 children clinically suspected of having congenital heart disease(CHD)or cardiovascular-related airway stenosis.The image quality of DACT was assessed,and the accuracy differences in diagnosing airway abnormalities between bronchoscopy and DACT were compared.The correlation between DACT and bronchoscopy in diagnosing the degree of airway steno-sis was also evaluated.Results The DACT image quality met diagnostic requirements for all children.There was no significant statistical difference in the diagnosis of airway abnormalities between DACT based on retrospective ECG-gating technology and bronchoscopy.A good correlation was observed between DACT and bronchoscopy in the grading of tracheal stenosis.Conclusion DACT based on retrospective ECG-gating technology can effectively address the issue of motion artifacts in CT scans among infants and young children.It has certain value in clarifying the diagnosis of cardiovascular-related airway stenosis,guiding treatment,and assessing prognosis.

Under the background of deepening the reform of medical and health system,the reform of public hos-pital salary system reform faces the dual challenges of realizing the value of knowledge and maintaining public wel-fare.Based on the public value theory,it constructs a synergistic analytical framework of"knowledge value and pub-lic welfare"to reveal the internal logic and realization path of public hospital pay system reform.Through the mecha-nisms of policy design reconstruction,assessment system innovation,remuneration structure optimization and multi-dimensional collaborative governance,the current systemic obstacles such as incentive alienation,misalign-ment of assessment,and insufficient financial compensation can be effectively solved.It is necessary to build a pub-lic value target,construct a synergistic system of"constraints and incentives",and activate the main motivation of medical staff to form a closed loop of"target-setting-mechanism-driven-practice-feedback"value cycle.It pro-vides a theoretical innovation path for the reform of public hospital remuneration system,and has important reference value for balancing the efficiency and fairness of medical services.

Objective:To construct a sizeable naive human Fab phage display antibody library to screen high-affinity specific antibodies in vitro. Methods:Total RNA was extracted from peripheral blood mononuclear cells (PBMCs) of 126 healthy individuals, subsequently reverse-transcribed into cDNA, and used as a template. PCR amplification was performed to obtain the V H from IgG, IgM and light chain κ, λ, separately, with the initial PCR products serving as templates for a second round of PCR. Overlap extension PCR was employed to generate fragments of the κ and λ light chains. These fragments were ligated with the phage vector pNC3, which harbors the variable region 1 of the heavy chain, to construct a recombinant phage plasmid. This plasmid was then electroporated into competent Escherichia Coli TG1 cells to establish a naive human Fab phage display antibody library. One hundred clones were randomly selected for identification and sequencing, and antibody gene polymorphisms were analyzed using the IMGT database and MAFFT software. Recombinant α-hemolysin from Staphylococcus aureus was utilized to screen Fab antibody fragments through biopanning of the antibody library, followed by random selection of phage ELISA-identified clones. The positive clones (antigen A450∶blank control A450≥2.1) were sequenced. Results:Two large naive Fab phage display antibody libraries were successfully constructed, in which the capacity of κ and λ chain antibody libraries were 1.25×10 11 and 1.54×10 11, respectively. The titers for two antibody libraries were 6.04×10 13 CFU/ml and 3.50×10 13 CFU/ml. The positive transformation insertion rates for κ and λ chain antibody libraries were 96% (96/100) and 100% (100/100), respectively. Sequence analysis revealed that all antibody sequences were unique. The amino acid sequences in the skeletal region were relatively conserved. In contrast, significant variations in the length of the complementarity determining region (CDR) were found, and the diversity of amino acid sequence of the complementary determining region was high, especially the CDR3. Analysis using the IMGT database indicated that the sequences exhibited a broad distribution across variable-diversity-joining gene families. After six rounds of panning, specific phage antibodies enrichment targeting α-hemolysin were achieved. A total of 142 monoclonal antibodies were sequenced, yielding 8 distinct Fab antibody sequences. Conclusion:This study successfully constructed two naive human Fab phage display antibody libraries with large capacity and good diversity, which can be used for screening human antibodies for serum epidemiology.

Under the background of deepening the reform of medical and health system,the reform of public hos-pital salary system reform faces the dual challenges of realizing the value of knowledge and maintaining public wel-fare.Based on the public value theory,it constructs a synergistic analytical framework of"knowledge value and pub-lic welfare"to reveal the internal logic and realization path of public hospital pay system reform.Through the mecha-nisms of policy design reconstruction,assessment system innovation,remuneration structure optimization and multi-dimensional collaborative governance,the current systemic obstacles such as incentive alienation,misalign-ment of assessment,and insufficient financial compensation can be effectively solved.It is necessary to build a pub-lic value target,construct a synergistic system of"constraints and incentives",and activate the main motivation of medical staff to form a closed loop of"target-setting-mechanism-driven-practice-feedback"value cycle.It pro-vides a theoretical innovation path for the reform of public hospital remuneration system,and has important reference value for balancing the efficiency and fairness of medical services.

The design of the salary structure in public hospitals is an important part of the salary system reform.The salary structure is in a dynamic evolutionary process as the reform deepens,and at this stage,it is gradually shifting towards a development direction that emphasizes incentive-based salary performance.Continuous optimization of the salary structure is key to exploring the accurate measurement of doctors' value and the sustainable development of the hospital's public welfare attributes.Through literature research and comparative analysis,it presented a tabular presentation of the four incentive compensation models formed so far in the dynamic optimization of China's public hospitals after the new healthcare reform,and to conduct a comparative analysis of their respective advantages and disadvantages,in order to provide reference and information for the continuous optimization of the pay structure of public hospitals.