Erectile Dysfunction(ED)is a relatively common clinical condition characterized by male sexual dysfunction.Macrophages,as key components of the immune and inflammatory response systems,play crucial roles in immune surveillance,tissue repair,and the maintenance of tissue homeostasis in processes related to erectile function.Immune inflammation is recognized as one of the pathological factors contributing to ED,and inflammatory markers—including macrophages—are widely believed to be closely associated with the onset of the disorder.This review summarizes the multifaceted roles of macrophages in vascular injury,neural repair,hormonal balance,and immune microenvironment remodeling in the context of erection.It aims to provide a theoretical foundation for further investigation into the involvement of macrophages in ED and discusses the potential of macrophage-targeted therapies for treating ED.

Erectile Dysfunction(ED)is a relatively common clinical condition characterized by male sexual dysfunction.Macrophages,as key components of the immune and inflammatory response systems,play crucial roles in immune surveillance,tissue repair,and the maintenance of tissue homeostasis in processes related to erectile function.Immune inflammation is recognized as one of the pathological factors contributing to ED,and inflammatory markers—including macrophages—are widely believed to be closely associated with the onset of the disorder.This review summarizes the multifaceted roles of macrophages in vascular injury,neural repair,hormonal balance,and immune microenvironment remodeling in the context of erection.It aims to provide a theoretical foundation for further investigation into the involvement of macrophages in ED and discusses the potential of macrophage-targeted therapies for treating ED.

Objective:To express NY-ESO-1 epitopes using circular RNA (circRNA) and construct circRNA cancer vaccines using a novel lipid-like material C1, and to evaluate the transfection efficiency and T cell activation potential at cellular level.Methods:In vitro transcription was used to synthesize mRNA and circRNA expressing EGFP and NY-ESO-1 epitopes. Then, they were transfected into COS7 cells and the expression of target proteins were detected in vitro. Lipid-like material C1 and commercial transfection agent TransIT-mRNA were used as delivery systems for mRNA NY-ESO-1 and circRNA NY-ESO-1, and their delivery efficiency was compared. Results:The expression of EGFP was observed under fluorescence microscopy after transfection of mRNA EGFP and circRNA EGFP into COS7 cells for 24 h. The secretion of IFN-γ by T cell receptor-engineered T (TCR-T) cells targeting NY-ESO-1/HLA-A2 was stimulated by COS7-A*02: 01 cells transfected with mRNA NY-ESO-1 and circRNA NY-ESO-1. Compared with mRNA NY-ESO-1, circRNA NY-ESO-1 was able to express the target antigen and stimulate the target cells to release IFN-γ more persistently. The delivery efficiency of C1 material was better than that of commercial transfection reagents when COS7 cells were transfected in vitro. Conclusions:Compared with the linear mRNA, transfection of COS7-A*02: 01 cells with circRNA can lead to more efficient and durable activation of T cells, suggesting that it could be a more suitable candidate for clinical treatment of tumors in the future. The lipid-like material C1 can effectively deliver linear mRNA and circular RNA molecules. This study provides reference for further research on circRNA tumor vaccines.

Objectives:To analyze the disease burden and changing trends of non-rheumatic valvular heart disease(NRVHD)from 1990 to 2019 in China. Methods:Based on the Global Burden of Disease 2019 database,we collected data related to NRVHD in China from 1990 to 2019,analyzed the crude incidence rate,crude prevalence rate,crude disability-adjusted life year(DALY),and age-scaled rate of NRVHD during this period,and analyzed the corresponding trends.The grey prediction model GM(1,1)was used to predict the disease burden of NRVHD in China from 2020 to 2029. Results:The crude incidence,crude prevalence,and crude DALY rates of NRVHD increased in China from 7.87/100 000,123.21/100 000,and 9.83/100 000 in 1990 to 22.85/100 000,374.16/100 000,and 11.95/100 000 in 2019;the age-standardized incidence rate and the age-standardized prevalence rate increased from 9.22/100 000 and 169.04/100 000 in 1990 to 15.30/100000 and 262.85/100 000 in 2019 respectively,with females being higher than males;the age-standardized DALY rate declined from 13.43/100 000 in 1990 to 9.07/100 000 in 2019,with females being higher than males.Joinpoint regression model analysis showed an increasing trend in the age-standardized incidence rate and age-standardized prevalence rate,and a decreasing trend in the age-standardized DALY rate(annual average percentage change[AAPC]values of 1.86%,1.72%and-1.66%,respectively),trend of change was statistically significant(all P<0.05).The burden of disease for all age groups from 1990 to 2019 showed an overall increasing trend,and the crude incidence rate,crude prevalence rate and crude DALY rate all increased with age,and the elderly group over 60 years old was the main group of disease burden.The results of the grey prediction model showed that by 2029,the age-standardized incidence rate and age-standardized prevalence rate would increase to 18.51/100 000 and 303.26/100 000,respectively,and the age-standardized DALY rate would decrease to 7.42/100 000. Conclusions:From 1990 to 2019,the age-standardized incidence rate and age-standardized prevalence rate of NRVHD in China showed an increasing trend,and the age-standardized DALY rate all showed a decreasing trend.The disease burden of NRVHD in China remains high.Women and the senior population are the main target groups needing special attention in China,and more targeted prevention and treatment strategies are needed for high-risk population.

Objective To discuss the medication law of Professor Gu Shizhe in the treatment of insomnia based on various data mining techniques.Methods Clinical information of patients of Professor Gu was collected from the hospital management information system of outpatient clinic of Beijing University of Chinese Medicine(BUCM)and BUCM Famous Elderly TCM Inheritance Research Integrated Platform from January 2018 to October 2022.Professor Gu's books,such as Zhi Zhen Zhi Yao,and Gu Jisheng,Gu Shizhe Yi An Yi Hua Jing Cui,and the medical records from CNKI were screened.WPS Office 5.2.1 was used to build a database of medicine data for Professor Gu's TCM prescriptions,and R 4.2.1 was used for descriptive analysis and Apriori association rule analysis.SPSS Statistics 26.0 was used for clustering analysis,combined with theoretical analysis,to extract Professor Gu's medication law and characteristics in the treatment of insomnia.Results A total of 307 prescriptions were included,involving 250 kinds of Chinese materia medica,among which 30 were high-frequency drugs.The top 5 most frequently used were Glycyrrhizae Radix et Rhizoma Praeparata Cum Melle,Fossilizid,Poria,Bupleuri Radix,and Ziziphi Spinosae Semen.The meridians were mainly liver and lung meridian,and the properties were mainly warm and cold,and the tastes were mainly sweet and bitter.Five core drug groups were obtained by clustering analysis,including Xiaochaihu Decoction,Erchen Decoction,Huanglian Wendan Decoction,Suanzaoren Decoction,Xiaoyao Powder and other prescriptions.Conclusion The characteristics of Professor Gu's treatment of insomnia are to reconcile Shaoyang,clear the heart and soothe the mind;pay attention to yin and yang,regulate the liver;pay attention to the liver,gallbladder,spleen and stomach;the main idea of syndrome differentiation is to reconcile Shaoyang,run the Shaoyang cardinal,and at the same time regulate qi and benefit qi and nourishes yin.

Objective:To investigate the application value of modified closure of overlap anastomotic common opening in total laparoscopic radical gastrectomy.Methods:The retrospec-tive and descriptive study was conducted. The clinicopathological data of 39 patients with gastric cancer who underwent total laparoscopic radical gastrectomy in Shanxi Hospital of Cancer Hospital, Chinese Academy of Medical Sciences from January 2023 to January 2024 were collected. There were 27 males and 12 females, aged (61±9)years. All patients underwent total laparoscopic radical gastrectomy for gastric cancer, with gastrointestinal reconstruction using overlap anastomosis and a modified closure of overlap anastomotic common opening. Measurement data with normal distribution were represented as Mean± SD, and count data were expressed as absolute numbers. Results:(1) Intraoperative and postoperative conditions. All 39 patients underwent total laparoscopic radical gastrectomy for gastric cancer, with gastrointestinal reconstruction using overlap anastomosis and a modified closure of overlap anastomotic common opening successfully, without conversion to open surgery or thoracotomy. The operation time of 39 patient was (210±52)minutes, with the volume of intraoperative blood loss of (132±55)mL, number of lymph node dissected of 23±11. The time to postoperative first flatus of 39 patients was (3.3±0.3)days, with time to postoperative liquid food intake of (4.4±0.6)days, time to postoperative semi-liquid food intake of (5.2±0.4)days, and duration of postoperative hospital stay of (9.5±3.1)days. (2) Complications. Seven of the 39 patients experienced perioperative complications, including 5 cases with complication classified as Clavien-Dindo grade Ⅱ, and 2 cases with complication classified as Clavien-Dindo grade Ⅲ. After conservative treatment, all patients with complications improved and were discharged. (3) Follow-up. Results of upper gastrointestinal imaging of the 39 patients showed no anastomotic leakage, and all patients were followed up at 1, 3, and 6 months after surgery. There was no other complications, tumor recurrence and metastasis, or mortality during the follow-up period.Conclusion:The modified closure of overlap anastomotic common opening in total laparoscopic radical gastrectomy has good safety and short-term efficacy.

Objective:To investigate the application value of modified closure of overlap anastomotic common opening in total laparoscopic radical gastrectomy.Methods:The retrospec-tive and descriptive study was conducted. The clinicopathological data of 39 patients with gastric cancer who underwent total laparoscopic radical gastrectomy in Shanxi Hospital of Cancer Hospital, Chinese Academy of Medical Sciences from January 2023 to January 2024 were collected. There were 27 males and 12 females, aged (61±9)years. All patients underwent total laparoscopic radical gastrectomy for gastric cancer, with gastrointestinal reconstruction using overlap anastomosis and a modified closure of overlap anastomotic common opening. Measurement data with normal distribution were represented as Mean± SD, and count data were expressed as absolute numbers. Results:(1) Intraoperative and postoperative conditions. All 39 patients underwent total laparoscopic radical gastrectomy for gastric cancer, with gastrointestinal reconstruction using overlap anastomosis and a modified closure of overlap anastomotic common opening successfully, without conversion to open surgery or thoracotomy. The operation time of 39 patient was (210±52)minutes, with the volume of intraoperative blood loss of (132±55)mL, number of lymph node dissected of 23±11. The time to postoperative first flatus of 39 patients was (3.3±0.3)days, with time to postoperative liquid food intake of (4.4±0.6)days, time to postoperative semi-liquid food intake of (5.2±0.4)days, and duration of postoperative hospital stay of (9.5±3.1)days. (2) Complications. Seven of the 39 patients experienced perioperative complications, including 5 cases with complication classified as Clavien-Dindo grade Ⅱ, and 2 cases with complication classified as Clavien-Dindo grade Ⅲ. After conservative treatment, all patients with complications improved and were discharged. (3) Follow-up. Results of upper gastrointestinal imaging of the 39 patients showed no anastomotic leakage, and all patients were followed up at 1, 3, and 6 months after surgery. There was no other complications, tumor recurrence and metastasis, or mortality during the follow-up period.Conclusion:The modified closure of overlap anastomotic common opening in total laparoscopic radical gastrectomy has good safety and short-term efficacy.

AIM: To investigate the protective effect of "DuZhong-DangGui" (DZ-DG) on the knee tissue of rats with osteoarthritis (OA) and its regulation role on NLPR3 inflammasome. METHODS: Twenty-four SPF male SD rats, eighteen rats were randomly selected to establish OA model by anteri- or cruciate ligament amputation (ACLT) method, and rats were divided into control group, OA model group, DZ-DG group and positive drug group, 6 in each group, treatment for 8 weeks. The peripheral blood were collected, ELISA was used to detect the levels of IL-1β, IL-6, IL-18, and TNF-α; cartilage tissue of knee joint were collected, HE staining was used to observe pathology changes, OARSI staining was used to observe cartilage calcification and preform quantitative OARSI scoring; immunohistochemistry and TUNEL staining were used to detect the contents of Caspase1 and Collagen II and the number of apoptosis in the tissue, respectively, and western blot was used to detect the protein expressions of matrix metalloproteinase-13 (MMP-13), tissue inhibitor of metalloproteinase-1 (TIMP-1), p53, p21, NLPR3, apoptosis-associated speck-like protein containing a CARD (ASC) and Pro-Caspase-1. RESULTS: Compared to control group, OA model group rats serum levels of IL-1β, IL-6, IL-18, and TNF - α significantly increased (P<0.01), OARSI scores significantly increased (P<0.01), chondrocyte apoptosis was increased (P<0.01), Caspase-1 content and MMP-13, p53, p21, NLPR3, ASC, Pro-Caspase-1 protein expressions significantly increased (P <0.01), while Collagen II content and TIMP-1 protein expression significantly decreased (P<0.01). Compared with the OA model group, DZ-DG group and positive drug group rats serum levels of IL-1β, IL-6, IL -18 and TNF - α significantly decreased (P< 0.05), chondrocyte apoptosis were significantly decreased (P<0.01), Caspase1 content, MMP-13, p53, NLPR3, Pro-Caspase-1 significantly decreased (P< 0.05), Collagen Ⅱ content and TIMP- 1 protein expression (P<0.01); DZ-DG group rats protein expression of p21 and ASC were decreased (P<0.01). CONCLUSION: The DZ-DG have protection role on cartilage of OA rats, its effect may related to mediation of NLPR3/ASC/Pro-Caspase-1 pathway, to decrease of IL-1β, and inhibition of cell apoptosis.

Objective:To investigate the influencing of inferior mediastinum and esophageal hiatus lymph node metastasis by submucosal different venous divisions of esophagogastric junction (EGJ) invaded in Siewert type Ⅱ adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective case-control study was conducted. The clinicopathological data of 547 patients with Siewert type Ⅱ AEG who were admitted to Shanxi Cancer Hospital from January 2018 to December 2021 were collected. There were 461 males and 86 females, aged 61 (range, 33?75)years. Observa-tion indicators: (1) lymph node metastasis rate in different groups; (2) influencing factors of inferior mediastinum lymph node metastasis in Siewert type Ⅱ AEG; (3) influencing factors of esophageal hiatus lymph node metastasis in Siewert type Ⅱ AEG. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M(range) or M( Q1, Q3), and com-parison between groups was conducted using the Mann-Whitney U test. Count data were described as percentages or absolute numbers, and comparison between groups was conducted using the chi-square test. The univariate analysis was conducted using the corresponding statistical methods based on data type. The Logistic regression model was used for multivariate analysis. Results:(1) Lymph node metastasis rate in different groups. The lymph node metastasis rate in No. 1, 2, 3, 4sa, 4sb, 7, 8a, 9, 11,20, 108, 110 of the 547 patients was 17.37%(95/547), 6.76%(37/547), 46.44%(254/547), 1.65%(9/547), 1.10%(6/547), 23.22%(127/547), 4.39%(24/547), 3.11%(17/547), 3.47%(19/547), 3.66%(20/547), 0.55%(3/547), 4.20%(23/547), respectively. Of the 547 patients, there were 456 cases with proximal of AEG invading submucosal palisade venous of EGJ including 4 cases with inferior mediastinum lymph node metastasis and no case with media mediastinum or up media-stinum lymph node metastasis. There were 91 cases with proximal of AEG invading submucosal perforator venous of EGJ including 18 cases with inferior mediastinum lymph node metastasis, 3 cases with media mediastinum lymph node metastasis and no case with up mediastinum lymph node metastasis. (2) Influencing factors of inferior mediastinum lymph node metastasis in Siewert type Ⅱ AEG. Results of multivariate analysis showed that age, tumor invading submucosal perforator venous of EGJ and histological classification were independent influencing factors for inferior media-stinum lymph node metastasis of Siewert type Ⅱ AEG ( odds ratio=0.93, 23.33, 0.31, 95% confidence interval as 0.87?0.99, 4.18?130.28, 0.12?0.78, P<0.05). (3) Influencing factors of esophageal hiatus lymph node metastasis in Siewert type Ⅱ AEG. Tumor invading submucosal perforator venous of EGJ was an independent influencing factor for esophageal hiatus lymph node metastasis of Siewert type Ⅱ AEG ( odds ratio=14.95, 95% confidence interval as 2.46?90.76, P<0.05). Conclusion:Age, tumor invading submucosal perforator venous of EGJ and histological classification are independent influencing factors for inferior mediastinum lymph node metastasis of Siewert type Ⅱ AEG, and tumor invading submucosal perforator venous of EGJ is an independent influencing factor for esophageal hiatus lymph node metastasis.

Klebsiella pneumoniae is one of the common pathogens causing hospital-acquired infection. With the wide use of carbapenem in recent years, carbapenem-resistant Klebsiella pneumoniae (CRKP) has emerged around the world. Carbapenemase production is the main cause of resistance to carbapenem antibiotics in Klebsiella pneumoniae. More than 70% of Klebsiella pneumoniae strains produce carbapenemase. Ceftazidime/avibactam (CAZ/AVI) can effectively treat CRKP infection, especially those caused by CRKP that can produce Klebsiella pneumoniae carbapenemase (KPC) or oxaclillinase (OXA)-48. However, it has been reported that CAZ/AVI-resistant CRKP strains have emerged. In this paper, the epidemiology, risk factors, resistance mechanism and treatment of CAZ/AVI-resistant CRKP were summarized to provide reference for clinical treatment.