Demyelination of the central nervous system often occurs in neurodegenerative diseases， such as multiple sclerosis （MS）. The myelin sheath， a layer of myelin membrane wrapping the axon， plays a role in the rapid conduction and metabolic coupling of impulses for neurons. The exposure of the axon will lead to axonal degeneratio， and further neuronal degeneration， which is the main cause of dysfunction and even disability in patients with demyelinating neurodegenerative diseases. In addition to the demyelination of mature myelin sheath， remyelination disorder is also one of the major reasons leading to the development of the diseases. The myelin sheath is composed of oligodendrocytes （OLs） derived from oligodendrocyte progenitor cells （OPCs） which are differentiated from neural stem cells （NSCs）. The process of myelin regeneration， i.e.， remyelination， is the differentiation of NSCs into OLs. Recent studies have shown that this process is regulated by a variety of genes. MicroRNAs， as important regulators of neurodegenerative diseases， form a complex regulatory network in the process of myelin regeneration. This review summarizes the main molecular pathways of myelin regeneration and microRNAs involved in this process and classifies the mechanisms and targets. This review is expected to provide a theoretical reference for the future research on the treatment of demyelinating diseases by targeting the regulation of microRNAs.

Purpose To explore the value of ultrasonography in distinguishing periductal mastitis(PDM)from granulomatous lobular mastitis(GLM)and summarize the sonographic features of non-puerperal mastitis(NPM).Materials and Methods The ultrasonographic findings of 134 NPM(84 PDM,50 GLM)patients treated in the Second Hospital of Lanzhou University from July 2016 to June 2021 were retrospectively analyzed.Comparing PDM and GLM sonograms,the difference of lesion number,lesion side,lesion orientation,distance from the nipple,long diameter,thick diameter,aspect ratio,boundary,edge,edge,shape,internal echo,peripheral high echo halo,rear echo,calcification,internal blood flow,ipsilateral axillary lymph node enlargement,and summarize the characteristics of NPM according to the lesion morphology and internal echo.Results There was no statistical difference between PDM and GLM(P＞0.05).But the probability of PDM combined with ipsilateral axillary lymph node enlargement was slightly higher than that of GLM(x2=4.209,P=0.040).The ultrasonography of 134 cases of NPM lesions was divided into 7 types according to the morphology and echo changes.The abscess type was more common in GLM than in PDM(x2=4.928,P=0.026).Conclusion There is no significant difference between PDM and GLM.In the case that PDM and GLM cannot be distinguished clinically and radiologically,it is recommended to perform puncture biopsy to determine the pathological type before treatment,which may be more conducive to obtaining the best prognosis for patients.In addition,the classification of NPM into 7 types is helpful for sonographers to grasp the ultrasonographic characteristics of NPM to diagnose NPM early.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Slow freezing is the most commonly used technique for the cryopreservation of spermatozoa in clinical practice. However, it has been shown to have a negative impact on sperm function and structure. Vitrification as a successful alternative method has been proved to have better protective effects on human embryos, but vitrification of spermatozoa is still subject to low recovery rates. In this study, a modified vitrification method for native spermatozoa was developed. A total of 28 semen samples were included; each sample was divided into three equal parts and assigned to fresh, slow freezing, and vitrification groups. Sperm vitality, motility, morphology, DNA integrity, and acrosome reaction were assessed for each of the groups. The results showed that vitrification achieves better results for several sperm protection parameters than slow freezing; vitrification achieves a higher recovery rate (P < 0.05), motility (P <0.05), morphology (P <0.05), and curve line velocity (P <0.05) than slow freezing. Furthermore, DNA fragmentation was decreased (P <0.05) and better acrosome protection (P <0.05) was exhibited in the spermatozoa after vitrification. Principal component analysis of all sperm parameters revealed that the vitrification cluster was closer to the fresh cluster, indicating that spermatozoa are better preserved through vitrification. In conclusion, while both slow freezing and vitrification have negative effects on sperm function and structure, the vitrification protocol described here had a relatively better recovery rate (65.8%) and showed improved preservation of several sperm quality parameters compared with slow freezing.

The species within the family Cunninghamellaceae are widely distributed and produce important metabolites. Morphological studies along with a molecular phylogeny based on the internal transcribed spacer (ITS) and large subunit (LSU) of ribosomal DNA revealed two new species in this family from soils in China, that is, Absidia ovalispora sp. nov. andCunninghamella globospora sp. nov. The former is phylogenetically closely related to Absidia koreana, but morphologically differs in sporangiospores, sporangia, sporangiophores, columellae, collars, and rhizoids. The latter is phylogenetically closely related to Cunninghamella intermedia, but morphologically differs in sporangiola and colonies. They were described and illustrated.

The species within the family Cunninghamellaceae are widely distributed and produce important metabolites. Morphological studies along with a molecular phylogeny based on the internal transcribed spacer (ITS) and large subunit (LSU) of ribosomal DNA revealed two new species in this family from soils in China, that is, Absidia ovalispora sp. nov. andCunninghamella globospora sp. nov. The former is phylogenetically closely related to Absidia koreana, but morphologically differs in sporangiospores, sporangia, sporangiophores, columellae, collars, and rhizoids. The latter is phylogenetically closely related to Cunninghamella intermedia, but morphologically differs in sporangiola and colonies. They were described and illustrated.

Objective To investigate the predictive and guiding significance of peripheral blood biomarkers on the therapeutic effects of PD-1/PD-L1 inhibitor treatment on lung cancer patients. Methods We collected the data of 200 lung cancer patients treated with PD-1/PD-L1 inhibitors treatment, including clinical indicators, peripheral blood indicators, efficacy indicators and survival indicators. Results The DCR of patients with non-hepatic metastasis, immune combined chemotherapy, NLR≤2.81 and LDH≤202.5 u/L was higher (P < 0.05). The AUC value of NLR combined with LDH predicting DCR was 0.698 (P < 0.05). Univariate analysis showed that non-hepatic metastasis, first-line immunotherapy, immunotherapy combined with chemotherapy and LDH≤202.5 u/L were related to PFS (P < 0.05). Multivariate analysis showed that the patients with non-hepatic metastasis and LDH≤202.5 u/L had longer PFS (P < 0.05). The significant decrease of NLR and LDH after two cycles of immunotherapy indicated the effectiveness of immunotherapy (P < 0.05). Conclusion NLR≤2.81, LDH≤202.5 u/L, non-hepatic metastasis and immunotherapy combined chemotherapy are positively correlated with immunotherapy efficacy. Non-hepatic metastasis and LDH≤202.5 u/L are independent prognostic factors of the patients treated with immunotherapy. The changes of peripheral blood NLR and LDH are related to the efficacy of PD-1/PD-L1 inhibitors treatment.

Objective: To explore the clinical features, the serotype distribution and drug resistance of the isolates in patient with invasive pneumococcal disease (IPD). Methods: By retrieving the laboratory information system in 18 children′s hospitals from 2012 to 2017, the children with IPD were enrolled. Streptococcus pneumoniae (Spn) must be isolated from the sterile sites (blood, cerebrospinal fluid, hydrothorax and joint effusion etc.). The clinical characteristics, serotype, drug resistance, treatment and prognosis were reviewed and analyzed. According to the telephone follow up results, the patients were divided into death group and recovered group. The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis. Results: There were 1 138 children with IPD, including 684 male and 454 female. The proportion of male to female was 1.5∶1. The age ranged from one day to 16 years. The median age was 1 year 3 month. The majority was under 5 years of age (89.3%, n= 1 016), especially under 2 years of age (61.9%, n=704). In all cases, 88.2% (n=1 004) were community acquired infection. The infections included meningitis (n=446, 39.2%), pneumonia with bacteremia (n=339, 29.8%), and bacteremia without focus (n=232, 20.4%). Underlying diseases were found in 242 cases (21.3%). Co-infections were determined in 62 cases (5.4%) with mycoplasma, 27 cases (2.4%) with adenovirus and 34 cases with influenza virus (3.0%). The penicillin insensitivity (PNSP) rates in meningitis and non-meningitis isolates were 69.5% (276/397) and 35.9% (221/615), respectively. There were 81 strains serotyped, in which 93.8% (76/81) were covered by 13-valent protein-polysaccharide conjugate vaccine (PCV13). In the 965 patients who were followed up by phone call, 156 cases (16.2%) were confirmed dead. The independent risk factors for the death were under 2 years of age (OR=2.143, 95%CI 1.284-3.577, P=0.004), meningitis (OR=3.066, 95%CI 1.852-5.074, P<0.01), underlying disease (OR=4.801, 95%CI 2.953-7.804, P<0.01), septic shock(OR=3.542, 95%CI 1.829-6.859, P<0.01), disseminated intravascular coagulation (DIC) (OR=4.150, 95%CI 1.468-11.733, P=0.007), multiple organ failure (OR=12.693, 95%CI 6.623-24.325, P<0.01) and complications of central nervous system (OR=1.975, 95%CI 1.144-3.410, P=0.015). Conclusions Most children with IPD were under 5 years of age, having underlying diseases and acquired the infection in community. The independent risk factors for death were under two years old, meningitis, underlying diseases and multiple organ failure. The problem of drug resistance was severe. The universal immunization of PCV13 would be effective to prevent IPD in Chinese children.

Objective To observe the positional variation of the ciliary body in eyes with acute primary angle-closure glaucoma (APACG) by ultrasound biomicroscopy (UBM),and to analyze the association between anterior chamber angle width and location parameters of the ciliary body in patients with APACG.Methods The subjects were divided into APACG group and normal control group and examined by UBM,and the clearer images were collected for quantitative analysis,followed by measurement of parameters including angle open distance 500 (AOD500),trabecular meshwork-ciliary process distance (TCPD),iris-ciliary process distance (ICPD),sclera-ciliary process angle (SCPA) and ciliary body length 500 (CBL500).Results Totally 89 patients (89 eyes) were enrolled in this study,including 57 patients with APACG (APACG group)and 32 normal controls (normal control group).According to the age-sex paired t test,the average of 23 pairs of measured data showed that the AOD500,TCPD,ICPD,SCPA,and CBL500 were (0.050 4 ± 0.031 0) mm,(0.499 6 ± 0.192 4) mm,(0.112 6 ± 0.089 2)mm,(35.317 0 ±4.575 2)° and (1.060 4 ±0.290 2)mm in the APACG group,and (0.242 6 ±0.078 5)mm,(0.741 7 ±0.240 4) mm,(0.272 6 ±0.218 8) mm,(44.913 0 ±10.089 2) ° and (0.633 0 ± 0.405 4)mm in the normal control group,respectively;and APACG group presented smaller AOD500,TCPD,ICPD and SCPA but larger CBL500 than normal control group,with significant differences (all P ＜ 0.01).Correlation analysis showed that TCPD,ICPD,SCPA and CBL500 were significantly correlated with AOD500 in APACG group.Conclusion Ciliary bodies are more anteriorly rotated in eyes with APACG,and anterior chamber angle width is associated with location parameters of ciliary body.

OBJECTIVETo observe the effect of S100A4 gene silencing mediated by small interfering RNA (siRNA) on the proliferation of bladder cancer stem cells (CSCs) and their capacity of xenograft tumor formation.

METHODSMB49 bladder cancer stem cells (MCSCs) were isolated and identified. The differentially expressed protein S100A4 was identified in MCSCs using isobaric tags for relative and absolute quantitation technology (iTRAQ). A siRNA targeting S100A4 was constructed and transfected into MCSCs, and its inhibitory effects on S100A4 expression in MCSCs were assessed with Western blotting and qPCR. The effects of siRNA-mediated S100A4 silencing on the proliferation and xenograft tumor formation ability of MCSCs were observed.

RESULTSAmong the 65 differentially expressed proteins identified by iTRAQ combined with LC/MS/MS, S100A4 protein showed the most distinct differential expression in MCSCs. Transfection of MCSCs with S100A siRNA significantly inhibited the expressions of S100A4 at both mRNA and protein levels, caused obvious suppression of the cell proliferation, and attenuated the xenograft tumor formation ability of the cells in nude mice.

CONCLUSIONS100A4 in MCSCs is associated with the recurrence and metastasis of bladder cancer. S100A4 may serve as a potential therapeutic target for eliminating bladder CSCs.