Objective Observing the feasibility of acute endovascular treatment for patients with symptomatic anterior intracranial atherosclerotic severe stenosis.Method From Jun 2019 to Jun 2023,30 symptomatic anterior intracranial atherosclerotic severe stenosis cases were retrospectively collected in the Guangdong Hospital of Traditional Chinese Medicine to evaluate the risk stratification score and explore the safety and effectiveness of acute(≤72.0h)endovascular treatment.Endovascular treatment includes balloon dilation+self-expanding stent placement,balloon-mounted stent placement,and balloon dilation.From the clinical experience,the risk stratification score was based on the ABCD3-I score for transient ischemic attacks(TIA)and additional evaluation of cerebral watershed infarction to identify the risk of stroke progression or recurrence in acute stage of symptomatic intracranial artery stenosis.The score of 0-3 was defined as low-risk,4-7 as medium risk,and 8-13 as high-risk.The successful revascularization of blood flow is determined based on the residual stenosis≤50％and the extended thrombolysis in cerebral infarction(eTICI)＞2c.The information of patient receiving endovascular treatment was recorded,including age,sex,risk factors of cerebrovascular disease(hypertension,diabetes,hyperlipidemia,hyperhomocysteinemia,drinking history,smoking history),onset data(time from onset to endovascular treatment,symptoms,progression),diseased vessels,risk stratification score,National Institutes of Health Stroke Scale(NIHSS)score before and 90 days after surgery,modified Rankin scale(mRS)score 90 days after surgery,intraoperative cerebrovascular events(intracranial hemorrhage,occlusion of responsible vessels),and postoperative cerebrovascular events 90 days after surgery(intracranial hemorrhage,cerebral infarction,TIA and in-stent restenosis)and deaths.Results Among 30 patients with symptomatic anterior intracranial atherosclerotic severe stenosis,3 patients were excluded from the time interval between onset and endovascular treatment＞72.0 hours,1 patient needed long-term anticoagulant drugs due to other diseases,1 patient lost follow-up,3 patients coexisted with other cardiogenic cerebral embolism diseases,4 patients with non-atherosclerotic arterial stenosis,and 7 patients refused emergency endovascular treatment.11 patients were finally included.(1)All 11 patients were successfully treated with endovascular treatment,and 7 were males;age ranged from 52 to 76 years old,with a median age of 64 years old;there were 9 cases with hypertension,3 cases diabetes,7 cases hyperlipidemia,2 cases hyperhomocysteinemia(only 9cases performed the examination),2cases smoking history,1 case drinking history;time from onset to endovascular treatment is 4.0-72.0 h,with a median time of 12.0 h;there were 3 and 8 cases of infarction in the left and right hemispheres,respectively,with 4,3,and 2 cases accompanied with anterior-posterior watershed,medial watershed,and anlerior-medial-posterior watershed infarctions,and 1 case accompanied by posterior-medial,anterior-medial watershed infarctions.(2)Among the 1 1 patients,the risk stratification score was 10-13 points,with a median score of 11 points;preoperative NIHSS score ranged 0-11 points,with a median score of 7 points.(3)Among the 1 1 patients,10 lesions located in the middle cerebral artery and 1 in the C7 segment of the internal carotid artery;the preoperative stenosis rate was 70％to 99％,with a median stenosis rate of 86％;preoperative eTICI grading was 2a in 7 cases and 2b50 in 4 cases(with slow distal blood flow);9 cases received balloon dilation and self-expanding stent placement,1 case received balloon-mounted stent placement,and 1 case received balloon dilation treatment;the postoperative stenosis rate is 10％to 20％,with a median stenosis rate of 15％;there were 3 cases with postoperative eTICI grade 2c and 8 cases with grade 3.(4)Among the 11 patients,one experienced intracranial hemorrhage on the first day after surgery and one had a new cerebral infarction on the third day after surgery.Eight patients were followed up by imaging 90days after surgery,demonstrating 2 cases of in-stent restenosis;90 days post-surgery,NIHSS score was 0-20 points,with a median score of 2 points;after 90 days of surgery,the mRS score was 0-4 points,with a median score of 1 point.There were 8 patients with mRS score ≤ 2 and no death events occurred.Conclusions Preliminary analysis shows that acute endovascular treatment for symptomatic anterior intracranial atherosclerotic severe stenosis has certain effectiveness,but the safety needs to be further validated.The screening of high-risk patients using risk stratification scores still requires further exploration through large sample and multicenter studies.

Objective To Investigate the effect of copper ions on the radiosensitivity of nasopharyngeal carcinoma(NPC)and identify potential targets to improve the efficacy of NPC radiation therapy.Methods The content of copper ions in normal nasopharyngeal epithelial cell line NP69 and a variety of NPC cell lines was detected by a copper microplate assay.After adding 0,5,10,20,50,100,200 μmol/L copper ion solution and 0,0.05,0.1,0.2,0.5,1.0,2.0 mmol/L TEPA solution,CCK-8 assay was used to determine the effect of intracellular copper ion content on the survival rate of NPC cells before and after irradiation.And determine the drug concentration to be used in subsequent experiments.CCK-8 assay was used to determine the effect of intracellular copper ion content on the survival rate of NPC cells before and after irradiation,and to determine the drug concentration used in the copper ion group and TEPA group in the subsequent experiments.CCK-8 assay and clone formation assay were used to detect the changes in radiosensitivity of NPC cells after drug treatment.The DNA damage and MAPK-ERK signaling pathway-related protein expression of NPC cells in each group before and after irradiation were detected by Western blot.Results The content of copper ions in NPC cells was significantly higher than that in normal naso-pharyngeal epithelial cells(P＜0.05).When the concentration of copper ion solution was lower than 50 μmol/L,the radiation resistance of CNE1 cells was improved,and the radiation sensitivity of SUNE1 cells was increased by 0.1～0.2 mmol/L TEPA(P＜0.05).Compared with the control group,the NPC cell radiotherapy resistance of copper ion group was enhanced,and the NPC cell radiotherapy sensitivity of copper ion group was enhanced(P＜0.05).Compared with the control group,the activation degree of MAPK-ERK pathway in copper ion group was up-regulated(P＜0.05).MAPK-ERK pathway inhibitor SCH772984 effectively reversed copper-mediated NPC radiotherapy resistance(P＜0.05).Conclusion The increased copper ion content in NPC cells promoted the radiotherapy resistance of NPC cells by activating the MAPK-ERK signaling pathway.

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.

Objective To investigate the intervention effect and mechanism of LUO's Neiyi Prescription on the proliferation and angiogenesis of eutopic endometrium in rats with endometriosis(EMs)based on hypoxia-inducible factor 1A(HIF1A)/enhancer of zeste homolog 2(EZH2)/anthrax toxin receptor 2(ANTXR2)signaling pathway.Methods SD rats were randomly divided into sham operation group,model group,Danazol group(4.2 g·kg-1),low-dose LUO's Neiyi Prescription group and high-dose LUO's Neiyi Prescription group(15.74,31.48 g·kg-1),eight rats in each group.The rat model of EMs with qi stagnation and blood stasis syndrome was constructed by autologous endometrial transplantation combined with multi-factor intervention.Intragastric administration was given once a day for 28 consecutive days.The pathological changes of endometrial tissue were observed by HE staining.The expression levels of proliferating cell protein 67(Ki67)and platelet endothelial cell adhesion molecule 1(CD31)in endometrial tissue were detected by immunohistochemistry.The mRNA and protein expression levels of HIF1A,EZH2 and ANTXR2 in endometrial tissues were detected by qRT-PCR and Western Blot.The expression levels of YAP1,CD44 and β-catenin in endometrial tissues were detected by Western Blot.Results Compared with the sham operation group,the epithelial cells of the eutopic endometrium of the model group were thickened,the interstitial cells were arranged disorderly,and the inflammatory cells increased.The expression levels of Ki67 and CD31 in endometrial tissues were significantly increased(P＜0.01),the mRNA and protein expression levels of HIF1A and ANTXR2 were significantly increased(P＜0.01),while the mRNA and protein expression levels of EZH2 were significantly decreased(P＜0.01),and the protein expression levels of YAP1,CD44 and β-catenin were significantly increased(P＜0.01).Compared with the model group,the epithelial layer of the eutopic endometrial tissue of the rats in each administration group became thinner,the interstitial disorder and inflammatory infiltration were improved,and the levels of Ki67 and CD31 in the eutopic endometrial tissue were significantly decreased(P＜0.01).The mRNA and protein expression levels of HIF1A and ANTXR2 in the endometrium of rats in the Danazol group and the high-dose LUO's Neiyi Prescription group were significantly decreased(P＜0.05,P＜0.01),and the mRNA and protein expression levels of EZH2 were significantly increased(P＜0.05,P＜0.01).The protein expression levels of YAP1,CD44 and β-catenin in endometrial tissue of rats in each administration group were significantly decreased(P＜0.05,P＜0.01).Conclusion LUO's Neiyi Prescription can play a role in the treatment of EMs by inhibiting the proliferation and angiogenesis of eutopic endometrial cells,and its mechanism may be related to the inhibition of HIF1A/EZH2/ANTXR2 signaling pathway.

Microfluidic liver and kidney chips have become preferred model carriers in recent years for new drug development， pharmacological and toxicological research， mechanism exploration， and disease model construction. In the context of the USA. Food and Drug Administration allowing the use of in vitro model data as a substitute for animal model data in new drug applications when animal disease models are difficult to construct， microfluidic chips have received widespread attention due to their high throughput， ability to highly mimic biological characteristics of living organisms， convenient evaluation of drug toxicity in normal or pathological states with repeated dosing， real-time induction and monitoring of culture processes， and real-time data acquisition and analysis. In toxicology research， liver and kidney chips can construct in vitro models suitable for the pharmacological and toxicological detection of different substances by combining 2D monocultures and co-cultures from different species sources， 3D cultures， spheroids/organoid cells， precision-cut liver and kidney slices， immortalized cell lines， or sandwich-cultured cell lines. This model maximally simulates or retains the organ function and in vivo microenvironment of the liver and kidney， including specific physiological tissue structures， multicellular interactions/crosstalk， and multi-organ coordination/feedback， to obtain results similar to or the same as in vivo experimental data， reducing interspecies differences. At the same time， it greatly reduces the use of experimental animals and lowers costs. Microfluidic technology provides necessary shear force microenvironments for the cultivation of contents and solves problems encountered in the cultivation process of liver and kidney chips， such as insufficient tissue oxygen supply， nutrient deficiencies， and accumulation of metabolites， leading to cell apoptosis and even tissue necrosis fibrosis， which make it difficult to maintain long-term structure and function. This article reviewed the application of microfluidic technology combined with liver and kidney chips in Chinese medicine toxicology research. By summarizing the development of microfluidic technology， liver chips， kidney chips， and providing application examples of microfluidic liver and kidney chips in Chinese medicine toxicology research， combined with the characteristics of Chinese medicine administration， the article explored the advantages and future development directions of their application in the field of Chinese medicine toxicology research.

Objective:To observe the intrinsic association between cognitive function in patients with Parkinson′s disease (PD) and retinal structural changes in retina nerve fiber layer thickness, macular volume and macular thickness.Methods:A total of 36 patients with PD and 12 normal controls matched with age and sex were selected randomly. Examinations of Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Unified Parkinson′s Disease Rating Scale Ⅲ (UPDRS-Ⅲ), Hoehn-Yahr stage were performed in all subjects. The PD patients were divided into three groups according to the score of MoCA: PD without cognitive impairment (PD-NCI; n=12), PD with mild cognitive dysfunction (PD-MCI; n=13) and PD dementia (PDD; n=11). The retinal nerve fiber layer thickness, macular volume and thickness which were corrected with body mass index (BMI) were determined and analyzed by optical coherence tomography imaging. Results:The total RNFL thickness (μm/BMI) of the PD with cognitive impairment group (PD-MCI group: 3.55±0.12 ( t=2.552, P=0.014), PDD group: 3.07±0.18 ( t=4.122, P=0.000)) was thinner than that of the normal control group (4.05±0.16). The RNFL thickness in each quadrant of the PD with cognitive impairment group (PD-MCI group and PDD group) was thinner than those of the normal control group. The RNFL thickness gradually became thinner with the cognitive impairment increasing ( r=0.558 3, P<0.001). The macular volume (mm 3/BMI) of PD group (PD-NCI group: 0.274±0.010 ( t=2.523, P=0.015), PD-MCI group: 0.268±0.010 ( t=2.848, P=0.007), PDD group: 0.266±0.010 ( t=2.604, P=0.013)) was smaller than that in the normal control group (0.316±0.010), and the macular volume gradually decreased with the severity of cognitive impairment ( r=0.234 1, P=0.024). The macula thickness in each subgroup of PD was thinner than that of the normal control group. The macula thickness gradually became thinner with the cognitive impairment increasing ( r=0.283 9, P<0.001). The macular thickness (normal controls: (10.67±0.12) μm/BMI, PD group: (9.51±0.07) μm/BMI, t=8.312, P<0.001) and volume (normal controls: (0.316±0.010) mm 3/BMI, PD group: (0.270±0.010) mm 3/BMI, t=3.570, P<0.001) became thinner and smaller in patients with PD. Conclusions:In patients with PD, the thickness of the retina nerve fiber layer, the volume and thickness of the macula become thinner/smaller with the severity of cognitive impairments increasing. Macular thickness and volume in patients with PD appear thinner/smaller, which can be used as a valuable biological marker in the early stage of PD. The retina nerve fiber layer thickness in patients with PD becomes thinner, which may be accompanied by cognitive impairment.

AIM: To investigate the role of miR-29a/HMGB1 signaling pathway in fibrosis H9C2 cells induced by HGHL. METHODS: DMEM medium containing glucose (33 mmol/L) and palmitate (500 μmol/L) was used to intervene in H9C2 cells for 24 h for subsequent experiments. There were 8 experimental groups, namely NC group, HGHL group, miR-NC group, mimics group, inhibitor group, pc-HMGB1 group, si-HMGB1 group, and miR-29a mimics+pc-HMGB1 group. Flow cytometry was used to detect the apoptosis rate of H9C2 cells in each group. The Western blot experiment detected the expression of TGF-β1, CTGF, MMP-9, PPARγ, and HMGB1 in H9C2 cells of each group. RT-qPCR detected the expression levels of miR-29a, TGF-β1, CTGF, MMP-9, PPARγ, HMGB1 mRNA in each group of cells. The scratch test was used to detect the migration ability of H9C2 cells in each group. RESULTS: After HGHL intervention, the apoptosis rate of H9C2 cells was significantly increased (P< 0.05), and the cell migration ability was significantly enhanced (P< 0.05). The expression level of TGF-β1, CTGF, and MMP-9 mRNA in cells increased significantly (P< 0.05), but the expression level of PPARγ mRNA decreased significantly (P< 0.05), and the expression of corresponding proteins also changed with the changes in mRNA (P< 0.05). Besides, the expression level of miR-29a in H9C2 cells was also significantly reduced (P< 0.05). After the transfection of miR-29a mimics, the increase in apoptosis rate of H9C2 cells caused by HGHL intervention was significantly inhibited (P< 0.05), and the cell migration ability was also significantly inhibited (P< 0.05). Compared with the HGHL group, TGF-β1, CTGF, and MMP-9 protein expression and mRNA expression levels in H9C2 cells were significantly lower (P< 0.05), and PPARγ protein expression and mRNA expression levels were significantly increased (P< 0.05). Transfection of miR-29a inhibitor promoted the fibrosis process of H9C2 cells induced by HGHL. miR-29a negatively regulated the expression of HMGB1 protein and its mRNA in H9C2 cells. The results of dual-luciferase reporter gene experiments showed that HMGB1 was a downstream target gene of miR-29a. Transfection of si-HMGB1 and miR-29a mimics had similar effects on H9C2 cell fibrosis induced by HGHL. Simultaneous transfection of miR-29a mimics and pc-HMGB1 had no significant effect on H9C2 cardiomyocyte fibrosis induced by HGHL. CONCLUSION: HGHL intervention can significantly increase the apoptosis rate of H9C2 cells, enhance their migration ability, and the process of fibrosis. At the same time, HGHL intervention can significantly down-regulate the expression level of miR-29a in cells, miR-29a negatively regulates the expression of HMGB1 in cells and then affects HGHL-induced H9C2 cell fibrosis.

Objective To understand the cognition ,attitudes and needs of the science and technology achievement trans-formation policies among the medical personnel of 21 tertiary hospitals in Shanghai .Methods Convenient sampling method was used .The self-designed questionnaires were used to survey 420 personals in 21 tertiary hospitals in Shanghai ,and 411 valid questionnaires were responded with a valid rate of 97 .86％ .Results The cognition of science and technology achievement transformation policies of the respondents was low ,and the degree of cognition was related to the professional titles ( P<0 .05) .While the recognition degree of some policies was high ;40 .47％ agreed that enterprises could be the decision-maker during the transformation process ;85 .99％ agreed that it is OK to hire the Technology intermediary service agencies to evalu-ate the achievements value ,confirmed that need such agencies to provide the services of information collection and screening . Conclusions More Policy publicity should be enhanced among the medical personnel ,communications about their needs and suggestions on the science and technology achievement transformation should be carried out to further update related policies , as well as improve the transformation of science and technology achievements in health system .

Objective To explore the treatment of children with EB virus infection accompanied by facial paralysis. Method The clinical data of a child with EB virus infection accompanied by facial paralysis was analyzed retrospectively, and the related literature were reviewed. Results A 2-year-old boy was admitted to hospital due to fever and mouth askew for 4 days. After admission, he was confirmed to have EB virus infection and viremia by serology and polymerase chain reaction, and then treated with acyclovir. The symptoms of facial paralysis and EB viremia disappeared completely 14 days after antiviral treatment. There was no recurrence in the short-term follow-up. Interestingly, the literature analysis shows that there is still limited evidence for the antiviral treatment by acyclovir in children with acute infection of EB virus associated with facial paralysis. Conclusion Antiviral treatment may be beneficial to EB viremia with facial paralysis.

Objective:To discuss the problems that exist in the operation mechanism of the third -party media-tion mode of medical disputes in China and put forward suggestions for improvement , through comparative study of the third-party mediation mode of domestic and foreign medical disputes .Results:People's mediation mechanism of medical disputes in our country still hadsome problems .For example , mediation talents were insufficient;propa-ganda was inadequate;mediation results were difficult to implement;mediation support funds couldn ' t be guaran-teed, and so on.Conclusion:It is recommended to improve the remuneration of employees and standardize the staff selection system;increase propaganda and raise public awareness;improve the judicial confirmation system and en-hance the guarantee of agreement;save regulation cost and increase multi -financing channels .