Objective:To summarize the use of Castor stent graft in aortic diseases and to analyze their efficacy.Methods:The clinical data of patients with aortic diseases treated with Castor stent graft from November 2017 to August 2022 in Fujian Provincial Hospital were collected and divided into branched stent group and branched stent co-operative group according to the operation method, and the clinical data of both groups were summarized.Results:A total of 75 cases of aortic disease were treated with Castor stents, and finally 53 cases were classified as branched stent group and 22 cases as branched stent co-operative group. The operations in both groups were successful. The median operative time in the branched stent group was 120(100, 160)min, and the median postoperative hospital stay was 7.0(5.5, 10.5)days.There was no postoperative ischemic stroke, no spinal cord ischemia. One case of new aortic dissection occurred. During follow-up, there was one lost case and two deaths, and the rest did not have endoleak, branch stent stenosis, ischemic stroke or re-intervention. In the branched stent co-operative group, there was one postoperative ischemic stroke, one case of slight stenosis of the left subclavian artery stent during follow-up, the remaining cases had satisfactory postoperative outcomes.Conclusion:Castor stent graft is a safe and effective procedure in the treatment of aortic diseases. And Castor stent graft can be used in combination with other endovascular repair techniques in the treatment of complex aortic diseases, with safe and reliable postoperative outcomes.

【Objective】 To observe the changes of coagulation factor activity and protein content of the thawed fresh frozen plasma (FFP) and fresh liquid plasma (FLP) during storage at 2-6℃, and to provide reference for exploring the appropriate storage time of FFP at 2-6℃ after thawing. 【Methods】 The small-thaw group and the large-thaw group were respectively detected for the activity of coagulation factor FⅤ (FⅤ∶C) and FⅧ(FⅧ∶C), and the levels of fibrinogen (Fib), total protein (TP) and albumin (Alb) in TTP at 1, 2, 3, 4, 5, 6 and 7 days after thawing. And the FLP was detected for FⅤ∶C, FⅧ∶C, Fib, TP and Alb at 1, 2, 3, 4, 5, 6, 7 days and 1, 6, 11, 16, 21, 26 and 31 days after preparation, respectively. 【Results】 In FFP group, FⅧ∶C decreased gradually with the prolongation of storage time after melting (P<0.05), and decreased by 37.4% and 47.6% respectively in the two groups on the 7th day. There was no statistical difference in FⅤ∶C, Fib, TP and Alb (P>0.05). In FLP group, FⅧ∶C decreased gradually with the prolongation of storage time after melting (P<0.05). There was no statistical difference in FⅤ∶C in 7-day storage group (P>0.05), but it decreased gradually in 31-day storage group (P<0.05). There was no statistical difference in Fib, TP and Alb (P>0.05). 【Conclusion】 Although FⅧ∶C is decreased in thawed FFP stored at 2-6℃ for 7 days, it is still about 52.4%, which should be able to play a normal role in clinical practice.

Colorectal cancer is a common malignant tumor in the digestive system， ranking third in incidence and second in the cause of death worldwide. In recent years， the incidence of colorectal cancer is on the rise， and the age of patients with colorectal cancer tends to be younger， with a heavy cancer burden. It is of great significance to prevent the occurrence， development， recurrence， and metastasis of colorectal cancer to reduce the incidence and mortality of colorectal cancer. Patriniae Herba has the effects of clearing heat， removing toxins， eliminating carbuncle， and discharging pus and shows good therapeutic efficacy on inflammatory bowel disease， digestive tract tumors， pelvic inflammation， gynecological tumor， and so on. Patriniae Herba is often used in the clinical treatment of colorectal cancer， but its mechanism of action is not clear. Modern studies have found that Patriniae Herba contains triterpenoids， saponins， iridoids， flavonoids， and other chemical components， with antioxidant， anti-tumor， anti-bacterial， and other pharmacological effects. The main anti-tumor components of Patriniae Herba are flavonoids. The analysis of network pharmacology and the spectrum-effect relationship has suggested that quercetin， luteolin， apigenin， isoorientin， and isovitexin play a major role in inhibiting the occurrence and development of colorectal cancer. In vivo and in vitro studies have shown that flavonoids in Patriniae Herba can play an anti-tumor role in various ways， such as preventing precancerous lesions of colorectal cancer， inhibiting the growth and proliferation of cancer cells， blocking cancer cell cycle， promoting cancer cell apoptosis， and reversing drug resistance of colorectal cancer. The oral availability of flavonoids is low. The gut is the main metabolic site of flavonoids in the body， its metabolic pathway is closely related to gut microbiota. This paper reviewed the anti-tumor mechanism of flavonoids and their influence on gut microbiota to provide a reference for further research on the mechanism of Patriniae Herba against colorectal cancer and its clinical application.

Hepatectomy is the most effective method for the treatment of liver cancer. Asso-ciating liver partition and portal vein ligation for staged hepatectomy (ALPPS) provides resectable opportunities for patients with unresectable or borderline resectable liver cancer. Traditional ALPPS procedures involve a short interval between two stages of the surgery, leading to a higher incidence of perioperative complications and mortality. The authors present a case of two-stage hepatectomy. Initially, laparoscopic ligation of the right hepatic artery and portal vein was performed. To prevent tumor progression after the first stage of surgery, combined immunotherapy and targeted therapy were administered. Three months later, a successful right hemihepatectomy was performed. Postoperative histopathological examination revealed hepatocellular carcinoma with extensive tumor necrosis. A 15-month follow-up showed no tumor recurrence. This indicated that two-stage hepatectomy including simultaneous ligation of the hepatic artery and portal vein, combined with two-stage hepatectomy plus immunotherapy and targeted therapy, showed considerable promise for borderline resectable liver cancer.

A retrospective analysis of the clinical data of seven acute B-lymphoblastic leukemia (B-ALL) patients with TCF3-HLF fusion gene-positive admitted to the First Affiliated Hospital of Soochow University from June 2017 to August 2022 was conducted to summarize their clinical features and prognoses. The seven B-ALL patients comprised four males and three females, with a median age of 18 (11-33) years. Five patients tested positive for CD33 expression, and four patients had a normal karyotype. Two patients had hypercalcemia at the initial diagnosis, and one patient developed hypercalcemia at relapse. Six patients presented with coagulation dysfunction at diagnosis. After induction chemotherapy, five out of seven patients achieved complete remission, of which four subsequently relapsed. Two patients did not achieve remission even after two rounds of induction chemotherapy, with one achieving complete remission after treatment with blinatumomab immunotherapy. Three patients underwent chimeric antigen receptor T cell therapy, whereas three patients subsequently underwent hematopoietic stem cell transplantation. Five patients died, while two patients survived with sustained complete remission. TCF3-HLF-positive B-ALL is rare and has a high relapse rate and poor prognosis.

Objective:To analyze the clinical features and genetic etiology of 17 Chinese pedigrees affected with X-linked intellectual disability (XLID).Methods:Seventeen pedigrees affected with unexplained intellectual disability which had presented at Henan Provincial People′s Hospital from May 2021 to May 2023 were selected as the study subjects. Clinical data of the probands and their pedigree members were collected. Trio-whole exome sequencing (Trio-WES), Sanger sequencing and X chromosome inactivation (XCI) analysis were carried out. Pathogenicity of candidate variants was predicted based on the guidelines from the American College of Medical Genetics and Genomics and co-segregation analysis.Results:The 17 probands, including 9 males and 8 females with an age ranging from 0.6 to 8 years old, had all shown mental retardation and developmental delay. Fourteen variants were detected by genetic testing, which included 4 pathogenic variants ( MECP2: c. 502C>T, MECP2: c. 916C>T/c.806delG, IQSEC2: c.1417G>T), 4 likely pathogenic variants ( MECP2: c. 1157_1197del/c.925C>T, KDM5C: c. 2128A>T, SLC6A8: c. 1631C>T) and 6 variants of uncertain significance ( KLHL15: c. 26G>C, PAK3: c. 970A>G/c.1520G>A, GRIA3: c. 2153C>G, TAF1: c. 2233T>G, HUWE1: c. 10301T>A). The PAK3: c.970A>G, GRIA3: c. 2153C>G and TAF1: c. 2233T>G variants were considered as the genetic etiology for pedigrees 12, 14 and 15 by co-segregation analysis, respectively. The proband of pedigree 13 was found to have non-random XCI (81: 19). Therefore, the PAK3: c. 1520G>A variant may underlie its pathogenesis. Conclusion:Trio-WES has attained genetic diagnosis for the 17 XLID pedigrees. Sanger sequencing and XCI assay can provide auxiliary tests for the diagnosis of XLID.

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 activation level of NLRP3 inflammasome in immune thrombocytopenia ( ITP) and the effect of inhibiting NLRP3 mediated inflammasome activation on polarization and immune function of M1 macrophages. Methods : The expression of NLRP3 mRNA in peripheral blood mononuclear cells (PBMC) and CD14 + monocytes of ITP patients (ITP group) and Control group (Control group) was detected by RT⁃qPCR. The levels of IL⁃1β and IL⁃18 in serum of the two groups were determined by ELISA. M0 macrophages (MDMs) from ITP group were divided into 4 groups : IgG control group ( IgG group) , MCC950 treatment group ( MCC950 group) , LPS , IFN⁃γ and IgG treatment group (LPS + IFN⁃γ + IgG group) and LPS , IFN⁃γ and MCC950 treatment group (LPS + IFN⁃γ + MCC950 group) ; mRNA and protein levels of M1 macrophage markers CD86 , iNOS and MCP⁃ 1 were detected by RT⁃qPCR and Western blot. Western blot was used to detect the expression of NLRP3 inflammasome associated protein , ASC , Cleaved caspase⁃1 and IL⁃ β . Flow cytometry was used to detect the phagocytosis of MDMs on platelets in each group , and CFSE was used to detect the proliferation of CD4 + T and CD8 + T. Results: Compared with the control group , the expression of NLRP3 mRNA in PBMC and CD14 + monocytes , and the concentration of IL⁃1β and IL⁃18 in serum of ITP group increased significantly ( P < 0. 05 ) . Platelet counts were negative correlated with NLRP3 mRNA expression in CD14 + monocyte and the concentration of IL⁃1β , IL⁃18 in serum in patients with ITP ( P < 0. 05) . Compared with IgG group , the mRNA and protein expressions of M1 macrophage markers CD86 , iNOS , MCP⁃1 , and the protein expression level of NLRP3 , ASC , cleaved caspase⁃1 and IL⁃ β , the platelet phagocytosis and the proliferation promoting ability of CD4 + T and CD8 + T cells significantly increased in LPS + IFN⁃γ + IgG group and LPS + IFN⁃γ + MCC950 group ( all P < 0. 05) . Compared with LPS + IFN⁃γ + IgG group , the above indexes significantly decreased in LPS + IFN⁃γ + MCC950 group (P < 0. 05) . Conclusion The activation level of NLRP3 inflammasome in ITP is abnormally elevated , which was related to the excessive M1 polarization of MDMs. Inhibiting NLRP3 mediated inflammasome activation could attenuate the M1 polarization and immune function of macrophages.

Femoral acetabular impingement (FAI) is a condition characterized by abnormal anatomical structures of the femoral head and/or acetabulum, leading to impingement between the proximal femur and the rim of the acetabulum during hip movement. This impingement causes damage to the acetabular cartilage, labrum, chronic hip pain, and limited range of motion. The diagnosis of this condition requires evaluation based on symptoms, physical signs, and imaging examinations. Among these, imaging plays a crucial role in assessing the pathology of FAI. In recent years, imaging techniques have contributed to a deeper understanding of the mechanisms underlying FAI and the development of hip-preserving surgeries. The purpose of this paper is to provide a reference for the imaging-related diagnosis and measurement of FAI. X-ray films include pelvic anteroposterior view, false-profile view and 45°Dunn view. Doctors can understand the anatomical morphology of the femur and acetabulum by measuring relevant indicators in the X-ray films. For example, the α Angle of the femur >50°-60 ° in the pelvic anteroposterior view can indicate CAM-type FAI. However, the crisscross sign, posterior wall sign and LCE Angle >40° suggest Pincer type FAI. The ACE Angle, which reflects the anterior coverage of the acetabulum, was mainly measured on the false-profile view. The ACE Angle <20° is considered as insufficient anterior acetabular coverage, and acetabular dysplasia may be present.If it >40° is the anterior acetabular overcoverage, suggesting pincer-type FAI. The 45°Dunn view is mainly used to show the femoral head and neck deformity at 3 o'clock, where the femoroacetabular impingement is obvious. This position has a good indication effect for CAM-type FAI. CT can show the shape of the hip joint more intuitively by three-dimensional reconstruction of the patient's hip joint, which is convenient for surgical planning and postoperative evaluation. In addition, CT can also be used for the differential diagnosis of external hip impingement, such as ischiofemoral impingement, anterior inferior iliac spine impingement and greatertrochanteric impingement. MR Has excellent soft tissue imaging ability and can show other lesions that are difficult to be found by X-ray and CT, such as acetabular labrum and cartilage injury. It is essential for preoperative evaluation. Appropriate imaging examination plays a key role in the diagnosis and treatment of FAI.

ObjectiveTo establish the specific chromatogram and thin layer chromatography（TLC） of Qingxin Lianziyin（QXLZY） benchmark samples， in order to clarify the key quality attributes and provide a reference for the quality evaluation of QXLZY. MethodHigh performance liquid chromatography（HPLC） specific chromatogram of QXLZY benchmark samples was developed by using a YMC Hydrosphere C₁₈ column（4.6 mm×250 mm， 5 μm） with the mobile phase of acetonitrile（A）-0.2% formic acid aqueous solution（B） for gradient elution（0-10 min， 5%-20%A； 10-20 min， 20%A； 20-25 min， 20%-24%A； 25-40 min， 24%-30%A； 40-55 min， 30%-50%A； 55-65 min， 50%-100%A； 65-75 min， 100%A； 75-75.1 min， 100%-5%A； 75.1-90 min， 5%A）， and the detection wavelength was 360 nm. Ultra-high performance liquid chromatography-linear ion trap/orbitrap mass spectrometry（UHPLC-LTQ-Orbitrap MS） with electrospray ionization（ESI） was used to identify the components of QXLZY benchmark samples by accurate relative molecular weight and multilevel MS fragment ion information， the detection conditions were positive and negative ion modes and data dependency scanning mode. TLC identification methods for Ophiopogonis Radix， Lycii Cortex， Nelumbinis Semen， Poria， Astragali Radix and Ginseng Radix et Rhizoma in QXLZY were established. ResultA total of 15 characteristic peaks were identified from Glycyrrhizae Radix et Rhizoma， Plantaginis Semen and Scutellariae Radix， and the relative standard deviations of the retention times of 15 characteristic peaks in 15 batches of QXLZY benchmark samples were≤3% with peak 8（baicalin） as the reference peak. A total of 100 compounds， including flavonoids， organic acids， saponins， amino acids and others， were identified in the benchmark samples by UHPLC-LTQ-Orbitrap MS. The established TLC had good separation and was suitable for the identification of Ophiopogonis Radix， Lycii Cortex， Nelumbinis Semen， Poria， Astragali Radix and Ginseng Radix et Rhizoma in QXLZY. ConclusionThe material basis of QXLZY benchmark samples is basically determined by MS designation and source attribution. The established specific chromatogram and TLC of QXLZY are simple， stable and reproducible， which can provide a reference for the development and quality control of QXLZY.