Objective To explore the therapeutic mechanism of maggot for psoriasis-like lesions in mice from the perspective of immune stress and complement activation regulation.Methods Thirty-six male C57BL/6 mice were randomly divided into control group,model group,maggot(1.25%,2.5%,and 5%)groups,and Benvitimod(1%)group.Psoriasis-like lesions were induced by application of imiquimod cream,and the severity of skin lesions was assessed using the modified Psoriasis Area and Severity Index(MPASI)score.Auricular swelling of the mice was observed,and histopathological changes of the skin lesions were examined with HE staining.Scratching behavior of the mice was observed and the spleen index was calculated.Toluidine blue staining was used to detect mast cells in the skin lesions,and serum levels of IgG,IgM,the complements CH50,C1s,C3,C3a,C5 and C5a,and the inflammatory factors IL-23,IL-17A and TNF-α were determined with ELISA.Results In mice with imiquimod-induced psoriasis-like skin lesions,treatment with the maggot at the 3 doses significantly decreased MPASI score,alleviated auricular swelling and pathologies in the skin lesions,reduced scratching behaviors,spleen index,and the number of mast cells in the lesions.Treatment with high-dose maggot significantly lowered serum levels of IgG,C1s,C3a,C5a,IL-23,IL-17A and TNF-α and the levels of C1s,C3,C3a,C5 and C5a in the lesion tissue,and increased serum levels of CH50,C3,and C5.The therapeutic effect of maggot showed a dose-effect dependence.Conclusion Maggot can alleviate psoriasis-like skin lesions in mice by inhibiting immune stress and complement activation.

Objective To retrospectively analyze the periprocedural and postprocedural antithrombotic therapy regimens for patients undergoing percutaneous left atrial appendage closure(PLAAC)at Nanjing Drum Tower Hospital(hereinafter referred to as"the hospital")and their association with prognosis,and to provide a basis for antithrombotic therapy in clinical practice for such patients.Methods We systematically collected medical records of non-valvular atrial fibrillation patients underwent PLAAC treatment from January 2018 to January 2022 at our hospital.We recorded basic patient information,preoperative left atrial appendage(LAA)thrombus screening,and antithrombotic regimens,and analyzed the incidence of bleeding and thrombotic events during the periprocedural period and up to 12 months postprocedure.Results A total of 96 patients underwent PLAAC,with 86 included in the final analysis.Eight patients had LAA thrombus detected by transesophageal echocardiography before the procedure,and all thrombi resolved after one month of extended antithrombotic therapy.There was one bleeding event in the continuous anticoagulation group during the periprocedural period,while no bleeding events occurred in the interrupted anticoagulation group.Within one year postprocedure,11 patients(18.0%)in the continuous anticoagulation group and 4 patients(16.0%)in the interrupted anticoagulation group experienced bleeding events.All patients adhered to anticoagulant therapy as prescribed for the first three months postprocedure;between three to six months postprocedure,33.7%of patients received dual antiplatelet therapy(DAPT),and 29.1%discontinued therapy;between six to twelve months,47.7%of patients received single antiplatelet therapy(SAPT)and 48.8%discontinued therapy.During the one-year follow-up,there was one case each of device-related thrombus,ischemic stroke,and cerebral hemorrhage,indicating a low overall incidence of adverse events.Conclusion In the real-world setting,the individualized antithrombotic regimens provided by physicians at the hospital,both periprocedurally and postprocedurally,were reasonable and consistent with guidelines.However,poor medication adherence was a significant issue among patients.It is recommended that clinical pharmacists actively engage in pharmacotherapy monitoring and enhance medication education to improve medication adherence.

Objective To explore the therapeutic mechanism of maggot for psoriasis-like lesions in mice from the perspective of immune stress and complement activation regulation.Methods Thirty-six male C57BL/6 mice were randomly divided into control group,model group,maggot(1.25%,2.5%,and 5%)groups,and Benvitimod(1%)group.Psoriasis-like lesions were induced by application of imiquimod cream,and the severity of skin lesions was assessed using the modified Psoriasis Area and Severity Index(MPASI)score.Auricular swelling of the mice was observed,and histopathological changes of the skin lesions were examined with HE staining.Scratching behavior of the mice was observed and the spleen index was calculated.Toluidine blue staining was used to detect mast cells in the skin lesions,and serum levels of IgG,IgM,the complements CH50,C1s,C3,C3a,C5 and C5a,and the inflammatory factors IL-23,IL-17A and TNF-α were determined with ELISA.Results In mice with imiquimod-induced psoriasis-like skin lesions,treatment with the maggot at the 3 doses significantly decreased MPASI score,alleviated auricular swelling and pathologies in the skin lesions,reduced scratching behaviors,spleen index,and the number of mast cells in the lesions.Treatment with high-dose maggot significantly lowered serum levels of IgG,C1s,C3a,C5a,IL-23,IL-17A and TNF-α and the levels of C1s,C3,C3a,C5 and C5a in the lesion tissue,and increased serum levels of CH50,C3,and C5.The therapeutic effect of maggot showed a dose-effect dependence.Conclusion Maggot can alleviate psoriasis-like skin lesions in mice by inhibiting immune stress and complement activation.

Objective:To construct an estimating equation to accurately reflect the aging phenomenon of the glomerular filtration rate(GFR).Methods:Healthy subjects receiving physical examinations at the First Affiliated Hospital of Nanjing Medical University between January 2017 and April 2018 were included in the study, and the aging phenomenon of renal function indicators such as serum creatinine(Scr)was used as the reference standard to evaluate the accuracy of four Scr-based GFR equations during GFR aging, including the full age spectrum(FAS)equation, the Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI)equation, the Osaka equation and the Xiangya equation.Results:Of 37 636 individuals receiving physical examinations, 6 534 met the criteria specified in this study.Scr, serum urea nitrogen, serum uric acid, and serum albumin showed a significant aging phenomenon( H=191.640, 196.693, 83.271, 414.585, P<0.001 for all).The GFR estimated by the four equations all decreased with aging, but the starting point and rate of decline were significantly different.The GFR aging phenomenon estimated by the FAS equation was closer to the trend of renal function indicators. Conclusions:The FAS equation may be more applicable to healthy people to understand the aging phenomenon of GFR.

At present, the teaching objects of clinical pharmacists have gradually changed from merely university students to complex and diverse groups including clinical pharmacist interns and others. However, the traditional teaching model cannot be tailored to different groups. In addition, it increases the burden of clinical pharmacists while not ensuring teaching quality. This study aims to classify teaching objects according to their characteristics, so as to provide individualized knowledge and service. Compared with the traditional way of teaching, this new method may make teaching more relevant and reduces the teaching load of teachers, which is of great significance to the training of clinical pharmacy personnel.

Objective:To analyze the research progress, hot spots and future trends of standardized residency training of Traditional Chinese Medicine from 1998 to now by using CiteSpace knowledge map software.Methods:The related literature on standardized residency training of Traditional Chinese Medicine were retrieved on CNKI. And after Refworks format conversion, using CiteSpace 5.6 R3 software for the construction of knowledge map, the author cooperation, institutional cooperation, keyword co-occurrence, and time-sharing research hot spots views of related literature on standardized residency training of Traditional Chinese Medicine were drawn respectively.Results:A total of 259 papers were obtained, with 253 authors. Ren Xianqing and Cui Jin published the most articles (each with 4 papers), and Beijing University of Chinese Medicine published the most articles (with 23 papers). There were 259 keywords in total, and 16 keywords with frequency greater than 5 and centrality greater than 0.1. There were 14 keyword cluster tags, and 15 burst terms were detected in total, and the trend discussion was carried out accordingly.Conclusion:The research trend of the standardized residency training of Traditional Chinese Medicine mainly follows the relevant policies issued by the functional departments of the government, and the research hot spots depend on the obstacles and difficulties encountered in the practical application of each training base.

Animals ; SARS-CoV-2 ; Antibodies, Neutralizing ; Macaca mulatta ; COVID-19/prevention & control* ; Antibodies, Viral ; Vaccines

Chimeric antigen receptor T cell (CAR-T) is a kind of adoptive cell immunotherapy, in which T cells are genetically modified to exert targeted killing effect on tumors. CAR-T cell therapy has shown remarkable antitumor efficacy for the treatment of tumors, especially for hematological malignancies, but is less effective in solid tumors. Single-target CAR-T is prone to off-target effect during application, and there is a risk of relapse or more refractory treatment. The development of double-target or multi-target CAR-T is expected to extend the antigen coverage of target cells, effectively avoids antigen escape and prevents tumor recurrence, and prolongs the survival time of patients. This article reviews the advances of multi-target chimeric antigen receptor T cell, and discusses the prospect of its development.

Objective:To evaluate the influence of sex on age-related changes in the glomerular filtration rate(GFR)in healthy individuals.Methods:A retrospective survey was performed.A total of 36 911 healthy subjects, of whom 43.61%(16 096 cases)were men, were enrolled and divided into six age groups: 18-29, 30-39, 40-49, 50-59, 60-69, and ≥70 years old.The estimated glomerular filtration rate(eGFR)was evaluated by the full age spectrum(FAS)equation.General linear regression analysis was used to calculate the annual decline rate of eGFR, and differences between the sexes in the same age group were evaluated using analysis of covariance.The chi-square test was used to compare the proportions of subjects with different eGFR levels between the sexes.Results:Regardless of sex, body mass index(BMI), systolic blood pressure(SBP)and fasting blood glucose(FBG)all increased gradually with age, while diastolic blood pressure(DBP)increased initially and then turned downward.The means of above results in men were generally higher than those in women of the same age.Before the age of 40, the levels of eGFR in men and women were relatively stable, with the mean eGFR in women higher than that in men[(121.98±16.77)ml·min -1·1.73 m -2vs.(111.01±13.36)ml·min -1·1.73 m -2, t=-53.793, P=0.000]; After the age of 40, eGFR decreased with age in both sexes, and the decline rate of eGFR in women was faster than that in men before the age of 70.Men had generally higher mean serum creatinine(Scr), blood urea nitrogen(BUN)and serum uric acid(UA)than women.With the increase of age, BUN levels increased gradually in men and women, but Scr levels started to increase after the age of 40 only in women and did not show a clear increase in men. Conclusions:There are sex-related differences with aging, as measured with many parameters.Young and middle-aged women have significantly higher eGFR than men of the same age, but eGFR declines faster with aging in women.

Objective:To investigate the distribution of blood concentration of cyclosporine (CsA) in patients with autoimmune disease in China, and analyze the effect of genetic polymorphisms of CsA-metabolizing enzymes, transporters and target enzymes on CsA levels.Methods:Steady-state trough blood concentrations (CsA C 0) of 193 patients' were detected by enzyme multiplied immunoassay technique. The genotype of the following sites in the included patients were sequenced by reverse transcription-polymerase chain reaction (RT-PCR): cytochrome P450 (CYP) 3A420230C>T, CYP3A56986A>G, ATP binding cassette subfamily B member 1 (ABCB1)1236C>T, ABCB12677G>T/A, ABCB13435C>T, cytochrome P450 oxidoreductase (POR) 1508 C>T and formyl peptide receptor 1 (FPR1) C>G were sequenced by RT-PCR. The influence of the gene polymorphism of the above-mentioned sites on the blood concentration of CsA was analyzed by using One-way analysis of variance (ANOVA), LSD- t test, Chi-square test. Results:One hundred and ninety-three patients included took CsA. The doses ranged from 75-200 mg/d and the patients' blood concentration distribution span was wide (33.0-313.8 ng/ml). The daily dose ( χ2=21.908, P=0.001) and age( F=4.262, P=0.006) had significant effect on the plasma concentration of CsA. ABCB12677G>T/A (rs2032582) gene polymorphism impacted on the unit dose of CsA C 0 (CsA C 0/d), CsA C 0/d [(0.81±0.42) ng·ml -1·mg -1] in wild type (GG) was higher than heterozygous mutant [GT/GA, (0.65±0.30) ng·ml -1·mg -1, P=0.023) and homozygous mutant (TT/AA/TA, (0.66±0.34) ng·ml -1·mg -1, P=0.039). Conclusion:The blood concentration of patients varies greatly among individuals. The Cold of CsA in wild type patients with ABCB12677G>T/A gene is signifficantly higher than that in mutant patients.