[摘 要] 目的：探讨异位表达血红蛋白亚基（HBA/HBB）对缺氧条件下嵌合抗原受体T细胞（CAR-T细胞）功能障碍的改善作用及其对肿瘤细胞的杀伤效应。方法：全基因合成技术合成靶向HER2的CAR序列，构建共表达HBA或HBB的CAR慢病毒载体，包装慢病毒后感染人原代T淋巴细胞，制备异位表达HBA/HBB的CAR-T细胞，命名为HBA CAR-T和HBB CAR-T。采用缺氧探针检测小鼠实体瘤缺氧状态。通过流式细胞术检测瘤内CAR-T细胞占比、异位表达血红蛋白亚基的CAR-T细胞阳性率及CAR-T细胞的活性氧、凋亡水平。WB法检测HBA CAR-T和HBB CAR-T内相关血红蛋白亚基表达情况，采用细胞计数板计数检测细胞增殖水平，通过萤光素酶报告基因法检测CAR-T细胞对肿瘤细胞的杀伤能力，qPCR检测CAR-T细胞中缺氧诱导因子-1α（HIF-1α）表达水平，利用MitoXpress Intra试剂盒检测CAR-T细胞内氧气含量。结果：不同细胞构建的实体瘤模型均存在明显缺氧情况，且CAR-T细胞浸润水平与缺氧程度呈显著负相关（P < 0.000 1）。HBA CAR-T与HBB CAR-T构建成功（阳性率 > 60%），相应血红蛋白亚基可稳定表达。缺氧环境下HBA CAR-T和HBB CAR-T的ROS水平、凋亡水平显著下降，增殖、对肿瘤细胞的体外杀伤能力显著强于传统CAR-T细胞（均P < 0.05）。HBA CAR-T与HBB CAR-T内HIF-1α表达降低（均P < 0.001），且缺氧程度显著降低（均P < 0.001）。结论：异位表达血红蛋白亚基可改善缺氧条件下CAR-T细胞功能障碍并增强其对肿瘤细胞的体外杀伤作用。

Diabetic Nephropathy (DN) is the leading cause of end-stage renal disease (ESRD) globally, representing a major global health burden with limited disease-modifying therapies. Podocyte injury serves as the core pathological hallmark of DN, and conventional treatments targeting metabolic disorders or hemodynamic abnormalities fail to reverse the progressive decline of renal function. Accumulating evidence over the past decade has established that high glucose-induced podocyte pyroptosis—a pro-inflammatory form of programmed cell death—is a key driving force in DN progression. Its core molecular mechanism hinges on the activation of the TXNIP-NLRP3 inflammasome axis. Under sustained hyperglycemic conditions, excessive reactive oxygen species (ROS) are generated via pathways including the polyol pathway, advanced glycation end products (AGEs) accumulation, and mitochondrial dysfunction. Concurrently, methylglyoxal (a glucose metabolite) mediates post-translational modification of thioredoxin-interacting protein (TXNIP). These events collectively trigger the dissociation of TXNIP from thioredoxin (TRX), a redox-regulating protein. The free TXNIP then translocates to the mitochondria, where it binds to The NACHT, LRR, and PYD domain-containing protein 3 (NLRP3) and promotes inflammasome assembly. This assembly activates cysteine-aspartic acid protease 1 (caspase-1), which cleaves Gasdermin D (GSDMD) to generate its N-terminal fragment (GSDMD-NT). GSDMD-NT oligomerizes to form membrane pores, leading to podocyte swelling, rupture, and the release of pro-inflammatory cytokines interleukin-1β (IL-1β) and interleukin-18 (IL-18). These cytokines amplify local inflammatory responses, induce mesangial cell proliferation, and accelerate extracellular matrix deposition, ultimately exacerbating glomerulosclerosis. MCC950, a highly selective NLRP3 inhibitor, exerts its therapeutic effects through a multi-layered mechanism: it binds to the NACHT domain (NAIP, CIITA, HET-E and TP1 domain) of NLRP3 with nanomolar affinity, forming hydrogen bonds with key residues (Lys-42 and Asp-166) within the ATP-hydrolysis pocket to block ATP hydrolysis, thereby locking NLRP3 in an inactive conformational state. Additionally, MCC950 interferes with the protein-protein interaction between TXNIP and NLRP3 and regulates mitochondrial homeostasis to reduce ROS production. Preclinical studies have demonstrated that MCC950 dose-dependently reduces proteinuria, restores the expression of podocyte-specific markers (nephrin and Wilms tumor 1 protein, WT1), and alleviates podocyte foot process fusion and glomerulosclerosis in both streptozotocin (STZ)-induced type 1 diabetic models (characterized by absolute insulin deficiency) and db/db type 2 diabetic models (driven by insulin resistance). However, discrepancies in therapeutic outcomes exist across different models—some studies report exacerbated renal inflammation and fibrosis in STZ-induced models—which may stem from differences in disease pathogenesis, intervention timing (early vs. mid-stage disease), and dosing duration. Despite its promising preclinical efficacy, MCC950 faces significant translational challenges, including low oral bioavailability, insufficient podocyte targeting, potential hepatotoxicity, and drug-drug interactions with statins (commonly prescribed to diabetic patients for cardiovascular risk management). Furthermore, off-target effects such as the inhibition of carbonic anhydrase 2 have been identified, raising concerns about its safety profile. Nevertheless, its unique mechanism of action—directly blocking podocyte pyroptosis by targeting the TXNIP-NLRP3 axis—endows it with substantial translational value. In the future, strategies to overcome these barriers are expected to advance its clinical application: targeted delivery via nanocarriers (e.g., PLGA-PEG nanoparticles or nephrin antibody-conjugated systems) to enhance renal accumulation and podocyte specificity; precise patient stratification based on biomarkers such as serum IL-18 and renal TXNIP/NLRP3 expression to identify “inflammatory-phenotype” DN patients most likely to benefit; and combination therapy with sodium-glucose cotransporter 2 (SGLT2) inhibitors—whose metabolic benefits synergize with MCC950’s anti-inflammatory effects. These approaches hold great potential to break through clinical translation bottlenecks, offering a novel, precise anti-inflammatory treatment option for DN and addressing an unmet clinical need for therapies targeting the inflammatory underpinnings of the disease.

Diabetic Nephropathy (DN) is the leading cause of end-stage renal disease (ESRD) globally, representing a major global health burden with limited disease-modifying therapies. Podocyte injury serves as the core pathological hallmark of DN, and conventional treatments targeting metabolic disorders or hemodynamic abnormalities fail to reverse the progressive decline of renal function. Accumulating evidence over the past decade has established that high glucose-induced podocyte pyroptosis—a pro-inflammatory form of programmed cell death—is a key driving force in DN progression. Its core molecular mechanism hinges on the activation of the TXNIP-NLRP3 inflammasome axis. Under sustained hyperglycemic conditions, excessive reactive oxygen species (ROS) are generated via pathways including the polyol pathway, advanced glycation end products (AGEs) accumulation, and mitochondrial dysfunction. Concurrently, methylglyoxal (a glucose metabolite) mediates post-translational modification of thioredoxin-interacting protein (TXNIP). These events collectively trigger the dissociation of TXNIP from thioredoxin (TRX), a redox-regulating protein. The free TXNIP then translocates to the mitochondria, where it binds to The NACHT, LRR, and PYD domain-containing protein 3 (NLRP3) and promotes inflammasome assembly. This assembly activates cysteine-aspartic acid protease 1 (caspase-1), which cleaves Gasdermin D (GSDMD) to generate its N-terminal fragment (GSDMD-NT). GSDMD-NT oligomerizes to form membrane pores, leading to podocyte swelling, rupture, and the release of pro-inflammatory cytokines interleukin-1β (IL-1β) and interleukin-18 (IL-18). These cytokines amplify local inflammatory responses, induce mesangial cell proliferation, and accelerate extracellular matrix deposition, ultimately exacerbating glomerulosclerosis. MCC950, a highly selective NLRP3 inhibitor, exerts its therapeutic effects through a multi-layered mechanism: it binds to the NACHT domain (NAIP, CIITA, HET-E and TP1 domain) of NLRP3 with nanomolar affinity, forming hydrogen bonds with key residues (Lys-42 and Asp-166) within the ATP-hydrolysis pocket to block ATP hydrolysis, thereby locking NLRP3 in an inactive conformational state. Additionally, MCC950 interferes with the protein-protein interaction between TXNIP and NLRP3 and regulates mitochondrial homeostasis to reduce ROS production. Preclinical studies have demonstrated that MCC950 dose-dependently reduces proteinuria, restores the expression of podocyte-specific markers (nephrin and Wilms tumor 1 protein, WT1), and alleviates podocyte foot process fusion and glomerulosclerosis in both streptozotocin (STZ)-induced type 1 diabetic models (characterized by absolute insulin deficiency) and db/db type 2 diabetic models (driven by insulin resistance). However, discrepancies in therapeutic outcomes exist across different models—some studies report exacerbated renal inflammation and fibrosis in STZ-induced models—which may stem from differences in disease pathogenesis, intervention timing (early vs. mid-stage disease), and dosing duration. Despite its promising preclinical efficacy, MCC950 faces significant translational challenges, including low oral bioavailability, insufficient podocyte targeting, potential hepatotoxicity, and drug-drug interactions with statins (commonly prescribed to diabetic patients for cardiovascular risk management). Furthermore, off-target effects such as the inhibition of carbonic anhydrase 2 have been identified, raising concerns about its safety profile. Nevertheless, its unique mechanism of action—directly blocking podocyte pyroptosis by targeting the TXNIP-NLRP3 axis—endows it with substantial translational value. In the future, strategies to overcome these barriers are expected to advance its clinical application: targeted delivery via nanocarriers (e.g., PLGA-PEG nanoparticles or nephrin antibody-conjugated systems) to enhance renal accumulation and podocyte specificity; precise patient stratification based on biomarkers such as serum IL-18 and renal TXNIP/NLRP3 expression to identify “inflammatory-phenotype” DN patients most likely to benefit; and combination therapy with sodium-glucose cotransporter 2 (SGLT2) inhibitors—whose metabolic benefits synergize with MCC950’s anti-inflammatory effects. These approaches hold great potential to break through clinical translation bottlenecks, offering a novel, precise anti-inflammatory treatment option for DN and addressing an unmet clinical need for therapies targeting the inflammatory underpinnings of the disease.

Based on LI Gao's Academic Thought， focusing on the process of qi transformation and taking the regulation and restoration of metabolism and immunity as the entry point， a "source-pivot-convergence" diagnostic and therapeutic model for malignant tumors is constructed. In this model， spleen and stomach internal injury is the source of malignant tumor occurrence， while the disorder of ascending and descending is the pivot of the disease development， and the generation of yin fire is the convergence of malignant tumor progression. Based on this， the three major therapeutic methods of clearing the source， harmonizing the pivot， and resolving the convergence are established. To fortify spleen and boost qi， consolidate the root and clear the source， modified Buzhong Yiqi Decoction（补中益气汤）can be used. To raise the clear and direct the turbid downward， regulate qi and harmonize the pivot， modified Shengyang Yiwei Decoction （升阳益胃汤） is suggested. To restore balance and promote circulation， disperse accumulation and resolve convergence， modified Shengyang Sanhuo Decoction （升阳散火汤） is selected. In clinical practice， these formulas can be used in combination according to the complexity of the pathogenesis， and further adapted with prescriptions for promoting dispersion and penetrating pathogenic factors， resolving phlegm and promoting circulation， activating blood and eliminating concretions， which can provide a reference for the prevention and treatment of tumor diseases.

Based on LI Gao's Academic Thought， focusing on the process of qi transformation and taking the regulation and restoration of metabolism and immunity as the entry point， a "source-pivot-convergence" diagnostic and therapeutic model for malignant tumors is constructed. In this model， spleen and stomach internal injury is the source of malignant tumor occurrence， while the disorder of ascending and descending is the pivot of the disease development， and the generation of yin fire is the convergence of malignant tumor progression. Based on this， the three major therapeutic methods of clearing the source， harmonizing the pivot， and resolving the convergence are established. To fortify spleen and boost qi， consolidate the root and clear the source， modified Buzhong Yiqi Decoction（补中益气汤）can be used. To raise the clear and direct the turbid downward， regulate qi and harmonize the pivot， modified Shengyang Yiwei Decoction （升阳益胃汤） is suggested. To restore balance and promote circulation， disperse accumulation and resolve convergence， modified Shengyang Sanhuo Decoction （升阳散火汤） is selected. In clinical practice， these formulas can be used in combination according to the complexity of the pathogenesis， and further adapted with prescriptions for promoting dispersion and penetrating pathogenic factors， resolving phlegm and promoting circulation， activating blood and eliminating concretions， which can provide a reference for the prevention and treatment of tumor diseases.

Objective: To investigate the influence of sinus morphology on the safety of hydraulic sinus floor elevation surgery and provide a biomechanical basis for clinical treatment. Methods: After approval by the Medical Ethics Committee of the institution, cone beam computed tomography imaging data from nine patients were collected. The sinus morphologies were classified into slope, flat and concave types. Three-dimensional finite element models of maxillary sinuses with the aforementioned morphologies were constructed using Mimics, Geomagic, Solidworks, and ANSYS software, followed by a simulation of the hydraulic elevation process. The sinus membrane elevation height was set at 1-6 mm. The pressure required for elevation and the equivalent, compressive, tensile, and shear stresses generated on the sinus membrane were recorded and analyzed. The equivalent stress distribution on the sinus membrane was visualized using contour plots. Results: The elevation pressure and the equivalent, compressive, tensile, and shear stresses generated on the sinus membrane increased along with the elevation height. When the sinus membrane was lifted to 6 mm, the elevation pressure was (301.17 ± 98.1) kPa, (151.85 ± 3.7) kPa, and (149.36 ± 10.31) kPa in the slope, flat and concave finite element analysis models, respectively. The equivalent stress was (1 023.86 ± 201.99) kPa in the slope sinuses, comparing with (687.91 ± 69.08) kPa and (698.27 ± 96.09) kPa in the flat and concave sinuses. Higher elevation pressure and the equivalent stress, compressive stress and shear stress values were found in the slope sinus than in the flat and concave sinuses under the same elevation height (P < 0.05). Stress distribution analysis revealed that stress was uniformly distributed in the flat sinuses, followed by concave sinuses, but asymmetrically distributed in the slope sinuses Conclusions The slope sinuses demonstrated inferior safety and efficiency compared with the flat and concave sinuses when performing hydraulic sinus floor elevation surgery.

Objective To modify YC-1,an inhibitor of hypoxia-inducible factor-1α(HIF-1α)into nanoparticles and explore its effect on reversing chemoresistance of colorectal cancer cells.Methods Nano-inhibitor mPEG350-YC-1(MYC-1)was prepared by the carboxyl condensation reaction of the active functional group hydroxyl(-OH)in the YC-1 molecule with methoxy polyethylene glycol carboxylic acid,and was verified by 1H nuclear magnetic resonance(1H-NMR).Its morphology was analyzed by transmission electron microscope(TEM),and its particle size distribution was analyzed by dynamic light scattering(DLS).By interacting FITC-labeled MYC-1(FYC-1)with HCT15 cells,the uptake ability of FYC-1 by the cells was observed using laser confocal microscopy.The cytotoxicity of MYC-1 was measured with CCK-8 assay.The sensitization effect of MYC-1 on the chemotherapy drug 5-Fu was detected through toxicity tests of resistant HCT15 cells(resistant HCT15,R-HCT15)and live/dead cell staining.The mechanism of MYC-1 reversing drug resistance was determined with immunofluorescence staining of HIF-1α and western blotting.Finally,a subcutaneous transplanted tumor model of R-HCT15 cells was constructed.The tumor bearing mice were randomly divided into PBS,5-Fu,MYC-1,and MYF groups,with 3 mice in each group.The tumor volume and weight were observed after treatment in each group to evaluate the ability of MYC-1 to reverse 5-Fu resistance in colorectal cancer.Results The nano-inhibitor MYC-1 was successfully prepared.TEM and DLS showed that MYC-1 could self-assemble into nanoparticles with a diameter of approximately 19.96±2.97 nm in aqueous solution.FYC-1 was also successfully prepared.When FYC-1 was interacted with HCT15 cells,FYC-1 could be better taken up by the cells,indicating that the amphiphilic MYC-1 could be better endocytosed into the cells to exert its function.When MYC-1 and 5-Fu acted in combination in colon cancer R-HCT15 cells,the resistance index(RI)was decreased from 7.99 to 1.55,and the relative reversal rate(RRR)of RI was 80.6%.Live(green)/dead(red)cell staining revealed that MYC-1 increased the toxicity of 5-Fu to R-HCT15 cells.Immunofluorescence staining(P<0.01)and Western blotting indicated that MYC-1 effectively inhibited the intracellular expression of HIF-1α.The combined action of MYC-1 and 5-Fu on mice with R-HCT15 subcutaneous transplanted tumors had the best therapeutic effect when compared with PBS(P<0.001),5-Fu(P<0.01),and MYC-1(P<0.01).Immunofluorescence staining of HIF-1α in tumor tissues displayed that the expression of HIF-1α was decreased in the MYC-1 and MYF groups.HE staining showed that there was no obvious damage to the important organs in each treatment group.Conclusion Nano-inhibitor MYC-1 can reverse the drug resistance of colorectal cancer to 5-Fu chemotherapy by reducing the expression of HIF-1α protein in colorectal cancer cells,thereby effectively improving the therapeutic effect of 5-Fu.

Objective:To retrospectively analyze and compare the clinical effects of rigid neuroendoscopic hematoma removal and drilling irrigation drainage in the treatment of chronic subdural hematomas with mixed density on head CT, and explore the appropriate surgical methods for chronic subdural hematomas with mixed density.Methods:A retrospective case-control study was conducted to analyze the clinical data of 80 patients with CSDH with mixed density CT findings admitted to the Department of Neurosurgery of Guizhou Medical University Affiliated Hospital from January 2021 to November 2023. There were 57 males and 23 females. According to the surgical method, patients were divided into endoscopic group ( n=36) and drilling group ( n=44). Patients in the endoscopic group underwent hard neuroendoscopic hematoma removal surgery, while patients in the drilling group underwent drilling flushing and drainage surgery. Compared the surgical time, drainage time, hematoma clearance rate, length of hospital stay, markwalder neurological function grading, and activities of daily living (ADL) score between two groups 30 days after surgery. Followed up for 3 months to record the recurrence situation.Measurement data with a normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for inter-group comparison. Measurement data with a non-normal distribution were expressed as M( Q1, Q3), and rank sum test was used for inter-group comparison. Chi-square test or Fisher′s exact test was used for inter-group comparison of count data. Rank sum test was used for inter-group comparison of ordinal data. Results:The operation time, postoperative drainage time, 24-hour hematoma clearance rate, midline deviation distance and hospital stay in the endoscopic group respectively were (77.50±8.15) min, 1.00(1.00, 2, 00) d, (95.00±2.66)%, 1.00(0.00, 2.00) mm, (9.47±2.52) d. The drilling group were (44.77±6.56) min, 3.00(2.25, 3.00) d, (87.86±3.43)%, 3.00(2.00, 3.00) mm, (11.84±3.28) d, the difference was statistically significant between the two groups ( P<0.05). Comparison of long-term efficacy in the endoscopic group, the hematoma clearance rate at 30 days after operation, the ADL score at 30 days after operation, and the number of recurrence cases at 3 months after operation respectively were 99.00(97.25, 100.00)%, (88.06±7.86) points, and 1 case. The drilling group were 93.50(91.25, 95.75)%, (83.29±9.58) points and 10 cases, with statistical difference between the two groups( P<0.05). 30 day postoperative Markwalder neurological functional grading, there were 27 cases grades 0, 9 cases of grade I, and 0 cases of grade II in endoscopic surgery. In the drilling group, there were 24 cases, 15 cases, and 5 cases, respectively. The difference between the two groups was statistically significant ( P<0.05). Conclusions:Compared with drilling and drainage irrigation surgery, neuroendoscopic treatment of mixed density chronic subdural hematoma takes a relatively long time, but the hematoma clearance rate is higher, the hospitalization time is shorter, the postoperative recovery is faster and the recurrence rate is lower. Neuroendoscopic therapy has unique advantages and may be more suitable for the treatment of mixed density CSDH.

Acupuncture treatment of chronic pain combined with depression (CPDC) is the result of a multi-target, multi-pathway approach. Acupuncture can treat CPDC by inhibiting the activation of glial cells, regulating the release of inflammatory mediators, regulating the expressions of neurotransmitters, changing the plasticity of neural synapses, regulating related epigenetic effects, regulating the microbiota-brain-gut axis, inhibiting nerve cell apoptosis, and antagonizing oxidative stress. The mechanism of its effect mainly involves anti-inflammatory related signaling pathways, regulation of neural synapse-related signaling pathways, and exerts its therapeutic effect through hippocampus, cerebral cortex, and amygdala.

Objective : To investigate the effects of astragalus mongholicus extract ( AME) on lung injury and the myeloid differentiation factor 88 ( MyD88 ) / Toll-like receptor 4 ( TLR4 ) / nuclear factor kappa B ( NF-κB) p65 pathway in rheumatoid arthritis induced interstitial lung disease (RA-ILD) rats． Methods : SD rats were randomly divided into a control group，RA-ILD group，low-dose AME group (5 g / L) ，high-dose AME group ( 10 g / L) ，and high-dose AME + lipopolysaccharide (LPS) group ( 10 g / L AME + 1 mg / L TLR4 activator LPS) ．Except for the control group，rats in all other groups were injected with bovine type Ⅱ collagen，Freund ’s complete adjuvant， and bleomycin to establish the RA-ILD model．The arthritis index and lung tissue wet-dry weight ratio of rats were tested．ELISA was applied to detect the levels of inflammatory factors interleukin (IL) -1 β , IL-6 and tumor necrosis factor-α ( TNF-α) in bronchoalveolar lavage fluid． Hematoxylin eosin staining was used to observe pathological changes of rat knee joint tissue and lung tissue．Western blot was applied to detect the expression of autophagy fac- tors Beclin 1，microtubule-associated protein 1A /1B-light chain 3 (LC3) Ⅱ / Ⅰ , and MyD88 /TLR4 /NF-κB p65 pathway related proteins in lung tissue． Results : Compared with control group，knee joint tissue and lung tissue of rats in RA-ILD group were damaged，the arthritis index，lung tissue wet-dry weight ratio，levels of IL-1 β , IL-6， and TNF-α , the expression levels of MyD88 and TLR4 proteins ，and p-NF-κB p65 /NF-κB p65 ratio increased (P＜0. 01) ，the expression of Beclin 1 and LC3 Ⅱ / Ⅰ proteins decreased (P＜0. 01) ．Compared with RA-ILD group，the low-dose and high-dose AME groups showed reduced tissue damage in rats，the arthritis index，lung tis- sue wet-dry weight ratio，levels of IL-1 β , IL-6，and TNF-α , the expression levels of MyD88 and TLR4 proteins， and p-NF-κB p65 /NF-κB p65 ratio showed a dose-dependent decrease (P＜0. 05 or P＜0. 01) ，the expression of Beclin 1 and LC3 Ⅱ / Ⅰ proteins showed a dose-dependent increase (P＜0. 05 or P＜0. 01) ．Compared with high- dose AME group，the tissue damage of rats in the high-dose AME + LPS group was worsened，the arthritis index， lung tissue wet-dry weight ratio，levels of IL-1 β , IL-6，and TNF-α , the expression levels of MyD88 and TLR4 pro- teins，and p-NF-κB p65 /NF-κB p65 ratio were higher (P＜0. 01) ，the expression of Beclin 1 and LC3 Ⅱ / Ⅰ pro- teins was lower (P ＜0. 01 ) ． Conclusion AME inhibits the MyD88 /TLR4 /NF-κB p65 pathway and alleviates lung injury in RA-ILD rats．