Objective To investigate the relationship between serum levels of thrombospondin-1(TSP-1)and thioredoxin 1(Trx1)and cognitive impairment after cerebral infarction.Methods A total of 155 patients with cerebral infarction(study group)admitted to a hospital from June 2021 to December 2022 were selected as the study objects,and were divided into normal cognitive function group(97 cases)and cognitive impair-ment group(58 cases)according to the scores of the montreal cognitive assessment scale(MoCA)after the pa-tients'condition stabilized.Another 150 healthy subjects in the same period were selected as the control group.Serum TSP-1 and Trx1 levels were detected by enzyme-linked immunosorbent assay(ELISA).Spearman analysis was used to analyze the correlation between serum TSP-1 and Trx1 levels and national in-stitutes of health stroke scale(NIHSS)score and MoCA score in patients with cerebral infarction.The predic-tive value of serum TSP-1 and Trx1 levels in cognitive impairment after cerebral infarction was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the levels of serum TSP-1 and Trx1 in the study group were significantly higher,and the differences were statistically significant(P＜0.05).Compared with the normal cognitive function group,the levels of serum TSP-1 and Trx1 in the cognitive impairment group were significantly higher,and the difference was statistically significant(P＜0.05).Compared with the normal cognitive function group,the NIHSS score of the cognitive impairment group was significantly higher,and the MoCA score was significantly lower,with statistical significance(P＜0.05).Spearman correlation analysis showed that serum TSP-1 and Trx1 levels were positively correlated with NIHSS score(P＜0.05),and negatively correlated with MoCA score(P＜0.05)in patients with cerebral infarction.ROC curve analysis showed that the area under the curve(AUC)of serum TSP-1 to predict cogni-tive impairment after cerebral infarction was 0.834,and the sensitivity and specificity were 72.41％and 86.60％,respectively.Serum Trx1 level alone predicted the AUC of cognitive impairment after cerebral infarc-tion was 0.851,and its sensitivity and specificity were 70.69％and 85.57％,respectively.The AUC of the combined prediction of cognitive impairment after cerebral infarction was 0.926,which was significantly greater than that of serum TSP-1 alone(Z=3.050,P=0.002)and Trx1 alone(Z=2.846,P=0.004).Conclusion Serum TSP-1 and Trx1 levels are elevated in patients with cerebral infarction,and their levels have certain predictive value for cognitive impairment after cerebral infarction.

Chimeric antigen receptor (CAR)-T cell therapy has achieved remarkable success in the treatment of hematological malignancies. Based on the immunomodulatory capability of CAR-T cells, efforts have turned toward exploring their potential in treating autoimmune diseases. Bibliometric analysis of 210 records from 128 academic journals published by 372 institutions in 40 countries/regions indicates a growing number of publications on CAR-T therapy for autoimmune diseases, covering a range of subtypes such as systemic lupus erythematosus, multiple sclerosis, among others. CAR-T therapy holds promise in mitigating several shortcomings, including the indiscriminate suppression of the immune system by traditional immunosuppressants, and non-sustaining therapeutic levels of monoclonal antibodies due to inherent pharmacokinetic constraints. By persisting and proliferating in vivo, CAR-T cells can offer a tailored and precise therapeutics. This paper reviewed preclinical experiments and clinical trials involving CAR-T and CAR-related therapies in various autoimmune diseases, incorporating innovations well-studied in the field of hematological tumors, aiming to explore a safe and effective therapeutic option for relapsed/refractory autoimmune diseases.

Objective:To explore the predictive value of complement and coagulation indicators in sepsis related acute kidney injury (AKI).Methods:Clinical data of 217 patients with sepsis admitted to the Department of Internal Medicine and Intensive Care Unit of Affiliated Hospital of Jiangnan University from January 2018 to June 2019 were retrospectively analyzed. All patients were divided into sepsis with AKI group and without AKI group. Laboratory indicators of all patients were collected, including complement C 3, complement C 4, activated partial thrombin time (APTT), prothrombin time (PT), international normalized ratio (INR), D-dimer, procalcitonin(PCT), etc. logistic regression analysis was used to explore the risk factors of sepsis related AKI. Receiver operating characteristic curve (ROC) was used to evaluate the predictive value of independent risk factors. Results:Among 217 patients, 120 patients developed sepsis related AKI and 97 patients didn′t. PCT, lactic acid, PT, APTT, INR and D-dimer in AKI patients were significantly higher than those without AKI ( P<0.01). Complement C 3 and complement C 4 were significantly lower in AKI group ( P<0.01). Multivariate logistic regression analysis suggested that blood pressure<90/60 mmHg (1 mmHg=0.133 kPa)( OR=3.705, 95% CI 1.536-8.934, P=0.004), increased lactic acid ( OR=1.479, 95% CI 1.089-2.008, P=0.012), decreased complement C 3 ( OR=0.027, 95% CI 0.005-0.152, P<0.001) and prolonged APTT ( OR=1.090, 95% CI 1.047-1.137, P<0.001)were independent risk factors predicting AKI. The area under the ROC curve (AUC) of these multivariates were 0.741 (95% CI 0.675-0.807), 0.798 (95% CI 0.732-0.864), 0.712 (95% CI 0.643-0.781) and 0.716 (95% CI 0.648-0.783) respectively. The relevant sensitivity was 57.5%, 80.8%, 87.5%, 59.2%, and the specificity was 90.7%, 75.3%, 51.5%, 77.3%, respectively. The AUC of the combined four indicators was 0.880 (95 %CI 0.835-0.926) with the sensitivity 75.0% and the specificity 90.7%. Conclusion:The low level of complement C 3 and prolonged APTT predict sepsis related AKI, and the predictive value can be enhanced if hypotension and hyperlactacidemia are added.