The incidence of intrahepatic cholangiocarcinoma (ICC) continues to rise, and there are no effective drugs to treat it. The immune microenvironment plays an important role in the development of ICC and is currently a research hotspot. Icaritin (ICA) is an innovative traditional Chinese medicine for the treatment of advanced hepatocellular carcinoma. It is considered to have potential immunoregulatory and anti-tumor effects, which is potentially consistent with the understanding of "Fuzheng" in the treatment of tumor in traditional Chinese medicine. However, whether ICA can be used to treat ICC has not been reported. Therefore, in this study, sgp19/kRas, an in situ ICC mouse model with intact immune system, was selected to evaluate the efficacy of ICA in the treatment of ICC in vivo for the first time, and the effects of ICA on the tumor immune microenvironment of ICC mice were analyzed by flow cytometry. This experiment was approved by the Experimental Animal Ethics Committee of Capital Medical University (approval number: AEEI-2023-138). In this study, sgp19/kRas ICC mouse model was treated with oral gavage of 100 mg·kg^-1 ICA. We found that ICA significantly inhibited tumor growth and tumor cell proliferation in the sgp19/kRas ICC mouse model after 3 weeks of treatment. Flow cytometry analysis indicated that ICA treatment markedly reduced the proportion of M2 macrophages and increased the number of CD3⁺CD4⁺ T cells. In vitro experiments demonstrated that ICA promoted macrophage polarization towards the M1 phenotype while inhibiting polarization towards the M2 phenotype. Furthermore, transcriptomic analysis suggested that ICA enhanced Toll-like receptor 9 (TLR9) expression, influencing macrophage nitric oxide metabolism synthesis pathways and receptor-related activities, thereby regulating macrophage polarization. In summary, this study demonstrates that ICA treatment significantly delays tumor progression in sgp19/kRas ICC mouse models. Mechanistically, ICA may achieve its anti-ICC effects by upregulating TLR9 receptor expression levels, promoting macrophage polarization towards the M1 phenotype, and altering the tumor immune microenvironment.

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 compare short-term clinical outcomes and patient satisfaction between robotic-assisted total knee arthroplasty(TKA)and conventional TKA.Methods A retrospective analysis was conducted on data of 93 patients who underwent primary unilateral TKA for knee osteoarthritis from June 2022 to April 2023.Among them,46 patients underwent Mako robot-assisted TKA(robot group)and 47 patients underwent traditional manual TKA(traditional group).There was no statistical difference in general data between the two groups(P＞0.05).Follow-up data were collected to compare the differences in surgical indicators,postoperative pain,range of motion(ROM),Hospital for Special Surgery(HSS)score,and Forgotten Joint Score(FJS)between the two groups.Results The operation time of the robotic group was longer than that of the traditional group[(105.8±26.7)min vs.(77.0±14.9)min,P＜0.001].There were no significant differences in total blood loss,hip-knee-ankle(HKA)angle deviation value and deviation rate(HKA angle＞3°)between the two groups at 3 days after surgery(P＞0.05).The robotic group had lower Visual Analogue Scale(VAS)scores for pain than the traditional group at 3 days,2 weeks,and 6 months after surgery(P＜0.001,P＜0.001,P=0.021),and had better knee joint ROM at 3 days,2 weeks,and 3 months after surgery(P＜0.001,P=0.011,P＜0.001).The HSS score(P=0.001)and FJS score(P＜0.001)of the robotic group were better than those of the traditional group at 6 months after surgery.Conclusion Compared with conventional TKA,robot assisted TKA has milder early pain,better mobility,and higher overall postoperative satisfaction.

Objective:To explore the configuration conditions and type-selections of positron emission tomography/computed tomography(PET/CT)and positron emission tomography/magnetic resonance(PET/MR)system under the national new policies during the 14th Five-Year Plan period,so as to provide references for configuration and type-selection of PET/CT and PET/MR equipment of medical institutions.Methods:According to the management polices of relevant configurations of PET/CT and PET/MR,which included configuration licensing,use management and configuration plan,and which were issued by China 14th Five-Year Plan,as well as the development trend and characteristics of PET/CT and PET/MR new techniques,the configuration conditions and type-selection plan of PET/CT and PET/MR equipment were analyzed.Results:Under the new polices during national 14th Five-Year Plan,medical institutions should configure PET/CT and PET/MR depended on the condition of institutions,personnel condition,work basis,the supporting facilities and other conditions,and should select the type of PET/CT and PET/MR which can meet the requirements of medical institutions depended on the technique parameters and performance indicators of PET/CT and PET/MR.Conclusions:Since the 14th Five-Year Plan,there were significant changes in the new policies related to the configurations of PET/CT and PET/MR compared to previous policies.The medical institutions should apply configurations and use PET/CT and PET/MR as new requirement,and configure the PET/CT and PET/MR equipment and conduct type-selection of them as various requirements of each institution.

Electronic tongue is one kind of bionic detection technologies, which can objectively reflect the taste of drugs based on electrochemical principle. In this paper, the development histories of electronic tongue both of potential type and voltammetry type were introduced, including their detection principles and key innovation technologies. In order to comprehensively improve the understanding of electronic tongue, its technological progresses, such as the study of dedicated sensors or biosensors for specific tastes, and the development of miniaturized or hybrid devices, were also discussed in detail. And the challenges and countermeasures in the application of electronic tongue were analyzed to provide some suggestions for its further technology promotion.

Objective:To compare short-term clinical outcomes and patient satisfaction between robotic-assisted total hip arthroplasty (THA) and conventional THA.Methods:Patient data of unilateral primary THA with the same prosthesis by the same operator due to osteoarthritis, osteonecrosis of the femoral head, and other diseases in Peking University Third Hospital from September 2019 to February 2022 was retrospectively analyzed. Patients were divided into robot-assisted THA group and conventional THA group according to surgical methods. The preoperative general data, operation time, intraoperative complications and other intraoperative data were collected. Anteroposterior X-ray of pelvis and cross-table X-ray of hip were taken. Main outcome measures consisted of total blood loss, blood transfusion rate, hospitalization stay, postoperative complications, and the inclination and anteversion angle of the acetabular cup, while the dislocation rate outside the Lewinnek and Callanan safe zone was also analyzed. Other outcomes measures included visual analogue scale, Harris score, quality of life score (QOL) and satisfaction score.Results:There was no significant difference in gender, age, height, weight, body mass index (BMI), operation side, preoperative blood volume and Harris score between the two groups ( P>0.05); Loosening of positioning screws occurred in 2 patients due to osteoporosis in robot-assisted THA group, so conventional THA was performed. Therefore, 84 cases in robot-assisted THA group and 87 cases in conventional THA group were enrolled in this study at last. There was no significant difference in follow-up time between conventional THA group and robot-assisted THA group (19.7±6.8 months vs. 18.6±5.4 months, t=1.16, P=0.249); The operation time of robot-assisted THA group was longer than that of conventional THA group (106.99±31.91 min vs. 73.79±29.48 min, t=7.07, P<0.001), but there was no significant difference in hospitalization stay between conventional THA group and robot-assisted THA group (6.40±2.40 d vs. 6.49±1.95 d, t=0.26, P=0.796). There was also no significant difference in total blood loss and blood transfusion rate between the two groups ( P>0.05). There was no significant difference in inclination angle (38.79°±6.93° vs. 39.41°±3.01°, t=0.58, P=0.449) and anteversion angle (14.81°±6.49° vs. 13.33°±4.32°, t=3.06, P=0.082) between conventional THA group and robot-assisted THA group, while the percentage in Lewinnek safe zone (96.4% vs. 73.6%, χ 2=15.60, P<0.001) and Callanan safe zone (92.9% vs. 65.5%, χ 2=17.61, P<0.001) was significantly higher in conventional THA than that of robot-assisted THA. There were no significant differences in postoperative VAS, Harris score and QOL score between the two groups ( P>0.05), but the excellent and good rate of Harris score of conventional THA group was lower than that of robot-assisted THA group (83.91% vs. 95.24%, χ 2=5.83, P=0.016); The overall satisfaction of patients in robot-assisted THA group was better than that in conventional THA group ( Z=-3.47, P=0.001), and 95.2% (80/84) of patients in robot-assisted THA group were very satisfied, which was higher than that in conventional THA group (75.86%, 66/87). The satisfaction of patients in robot-assisted THA group on pain relief ( Z=-2.44, P=0.015) and improvement of leisure activity ( Z=-2.12, P=0.034) was better than that in conventional THA group, but there was no significant difference in the satisfaction of ability of doing house work between the two groups ( Z=-0.49, P=0.626). Conclusion:Compared with conventional THA, robot-assisted THA has longer operation time but better short-term clinical outcomes and higher patient satisfaction after surgery.

OBJECTIVES: To study the clinical effect and adverse drug reactions of different doses of glucocorticoid (GC) in the treatment of children with recurrence of steroid-sensitive nephrotic syndrome (SSNS). METHODS: A total of 67 children who were hospitalized and diagnosed with SSNS recurrence in the Department of Nephrology, Children's Hospital, Capital Institute of Pediatrics, from November 2017 to December 2019 were enrolled. They were randomly divided into a moderate-dose GC group (32 children) and a full-dose GC group (35 children). The two groups were compared in terms of urinary protein clearance, recurrence rate within 6 months, and incidence rate of GC-associated adverse reactions. RESULTS: There was no significant difference in the urinary protein clearance rate between the moderate-dose GC and full-dose GC groups (91% vs 94%, P>0.05). There was also no significant difference in the recurrence rate within 6 months between the two groups (41% vs 36%, P>0.05). At 6 months of follow-up, compared with the full-dose GC group, the moderate-dose GC group had a significantly lower cumulative dose of prednisone [(87±18) mg/kg vs (98±16) mg/kg, P=0.039] and a significantly lower proportion of children with an abnormal increase in body weight (6% vs 33%, P=0.045). The logistic regression analysis showed that prednisone dose ≥10 mg/alternate day at enrollment was a risk factor for recurrence within 6 months in children with SSNS (P=0.018). CONCLUSIONS For children with SSNS recurrence, moderate-dose GC has similar effects to full-dose GC in the remission induction rate and the recurrence rate within 6 months, with a lower cumulative dose and fewer GC-associated adverse reactions within 6 months than full-dose GC.
Child ; Glucocorticoids/therapeutic use* ; Humans ; Nephrotic Syndrome/drug therapy* ; Prednisone/adverse effects* ; Prospective Studies ; Remission Induction

Aim To investigate the hub genes associated with response to valproate treatment in patients with epilepsy by using weighted gene co-expression network analysis.Methods We downloaded data from the GEO database and constructed the gene co-expression network.Pearson correlation test was used to calculate the correlation between module genes and clinical traits, to screen gene modules significantly associated with response to valproate treatment, and to screen hub genes according to the connectivity within modules.GO functional enrichment analysis and KEGG pathway analysis were used to annotate the functions of the modules.Results A total of 12 gene co-expression modules were constructed from the correlations of gene expression, in which the yellow module was significantly correlated with the drug treatment(r=0.57, P<0.000 1)and the blue module was significantly correlated with the response to valproate(r=-0.53, P<0.000 1).We found that S1PR5, SARM1 and MAGED1, FBXO31 were in the hub of the co-expression network.The biological annotation function revealed that the genes in both modules were mainly enriched in immune response and MPAK pathways.Conclusions Our work delivers preliminary data that valproate treatment causes the changes of immune and metabolic pathways in patients, and the response to epilepsy may be related to the expression of MAGED1, FBXO31.

Antibodies, Monoclonal, Humanized/therapeutic use* ; Atypical Hemolytic Uremic Syndrome/drug therapy* ; Humans

Objective:To study the effect of Gegen Qinliantang （GQT） on the structure of intestinal flora in dysbacterial diarrhea rats by 16S rRNA sequencing. Method:Sixty healthy SD rats were randomly and equally divided into a control group， a model group， high-， medium-， and low-dose GQT groups， and a Bifidobiogen group. The rat model was induced in the five groups except the control group by administration of mixed antibiotics （178.6 mg·kg^-1 cefradine and 31.25 mg·kg^-1 gentamicin sulfate） according to the dose. Drug intervention was carried out in each group （7.02， 3.51， and 1.755 g·kg^-1 GQT for the high-， medium-， and low-dose GQT groups， 0.125 g·kg^-1 bifidobacterium capsules for the Bifidobiogen group， and sterile distilled water for the control and model groups） with a volume of 10 mL·kg^-1 for seven days. Colon contents of rats were obtained under anesthesia. The extracted fecal DNA underwent 16S rRNA high-throughput sequencing and the results were analyzed. Result:GQT was proved capable of adjusting the species number and Alpha and Beta diversity， improving the biological richness and diversity of the flora， and positively regulating three differential phyla （Firmicutes， Proteobacteria， and Bacteroidetes） and 14 differential genera （Bacteroides， Parabacteroides， Blautia， etc.） in rat model of dysbacterial diarrhea. Conclusion:The present study confirmed the regulatory effect of GQT on intestinal flora of dysbacterial diarrhea rats， and revealed the physiological and pathological mechanism between intestinal flora and dysbacterial diarrhea.