Systemic lupus erythematosus(SLE)is a diffuse,systemic autoimmune disorder that can impact multiple organs and systems,with patients exhibiting abnormal levels of various autoantibodies and immune markers in their serum.It is currently understood that dysregulation of B cells activation plays a pivotal role in the pathogenesis of SLE,as aberrantly activated B cells produce autoantibodies that inflict damage on multiple organs through complement activation and antibody-dependent cell-mediated cyto-toxicity.Traditional therapies for SLE may prove ineffective for certain patients or lead to adverse reactions.In most instances,conventional treatment merely alleviates symptoms and necessitates lifelong immuno-therapy.A limited number of clinical cases have explored chimeric antigen receptor T cells(CAR-T)therapy as a potential treatment for autoimmune diseases such as SLE.Research indicates that CAR-T can specifically target CD 19 expressed on the surface of B cells and plasma cells,achieving profound de-pletion while minimizing drug-related side effects.This report details a female patient diagnosed with SLE and lupus nephritis who was successfully treated using dual-targeting B cells maturation antigen CAR-T by our research team;following treatment,she ceased steroid and immunomodulator use,attaining sustained remission without these medications.The patient was a 23-year-old female.Multiple examinations in other hospitals and in our hospital showed positive anti-double-stranded DNA(dsDNA)antibody and low complement C3.Renal biopsy in our hospital showed lupus nephritis Ⅳ-G(A/C),and National Institu-tes of Health(NIH)activity index(AI)score=4.She was diagnosed with"SLE,lupus nephritis(LN)".She was treated with hormones,immunosuppressants and Chinese medicine,but the effect was not good.After the CAR-T treatment,She stopped using hormones and immune agents and achieved con-tinuous remission with zero hormones and zero immune agents.She became pregnant six months after CAR-T infusion,and gave birth to a healthy full-term,full-weight baby successfully.She is the first pa-tient in China who successfully discontinued hormone,immune preparations and gave birth after CAR-T therapy.During the follow-up of the patient,we found that the immune indexes had basically returned to normal,and the safety was good.It indicates that CAR-T therapy may represent a promising and innova-tive therapeutic approach for the management of SLE.This offers hope and establishes a precedent for SLE women of childbearing age.

tomography angiography ( CTA) and T12-S1 vertebral computed tomography three-dimensional reconstruction were selected .The operative win-dows of L1 ~L2 OLIF were observed:the vascular window ,bare window ,psoas major window ,ideal operative window and actual operative win-dow.The operative windows ’ percentage accounted for ideal operative window were calculated ,the actual operative window based on an actual operative window of <1 cm,≥1 cm were statistically analyzed ,and the positions of the left renal artery and renal vein in front of operative window of L1 ~L2 OLIF were observed.Results The actual operative window was <1 cm in 2 cases (3.3%) and ≥1 cm in 58 cases (96.7%).In 58 cases,the difference was significant(P=0.008) in gender and men were more than women.The vascular window,bare win-dow and psoas major window accounted for the ideal operative window by 45%,43%and 12%,respectively ,and the actual operative window accounted for the ideal operative window by 55%.The left renal artery and renal vein's walking planes were at between the middle 1/3 of L1 to up 1/3 of L2 .There were 31 cases (51.7%) of the left renal artery being behind the left renal vein .Conclusion The regional anatomy of the operative window of L1 ~L2 OLIF has its own peculiarities,and not all L1 ~L2 levels are suitable for OLIF.The left renal vessels’ walk-ing planes were in front of L 1 ~L2 .Before L1 ~L2 OLIF surgery,surgeons should analyze the imaging anatomimy through imaging .