Abstract:Objective To fabricate a mannitol-calcium alginate dressing loaded with L-shikonin by integrating digital design and three-dimensional printing(3DP)technology,and to evaluate its in vitro drug release and antibacterial properties.Methods L-shikonin at gradient concentrations of 50,100,200,400,800,and 1 600 mg/L was used as the drug loading group,and 100 μg penicillin group was used as the control group,which were respectively loaded into 40 g/L mannitol-sodium alginate.A shikonin-mannitol-calcium alginate grid hydrogel(15 mm × 15 mm × 3 mm)was prepared using 3DP technology.The cross-sectional three-dimensional porous structure of the material was observed using scanning electron microscopy(SEM).The drug release profile was assessed using the dynamic diffusion method,and the antibacterial properties were evaluated using colony-forming unit counting and crystal violet staining.Results The printed appearance showed a precision of±0.15 mm compared to the computer-aided design model,with clear geometric contours at the edges.SEM revealed a well-structured porous drug-loading matrix.The in vitro drug release standard curve demonstrated a typical sustained-release profile,with no burst release or plateau phase.The antibacterial performance was significant:the dilution plating method confirmed that the 200 mg/L dressing group achieved complete inhibition(inhibition rate＞99.9％)against Staphylococcus aureus and Escherichia coli at 24 h.Crystal violet staining indicated that the drug-loaded dressing exhibited an effective inhibition rate against 48-hour mature biofilms that surpassed the antibacterial efficacy of conventional drugs for combat trauma(P＜0.01).Conclusion Digital design combined with 3DP technology enables the construction of hydrogels with specific shapes loaded with various drugs,achieving targeted drug release and high-efficiency antibacterial functions.This approach holds promise as a novel strategy for the healing of maxillofacial combat trauma.

Abstract:Objective To analyze the risk factors for pathological upgrading to endometrial carcinoma(EC)in patients diagnosed with atypical endometrial hyperplasia(AEH)by hysteroscopy after total hysterectomy.Methods A retrospective analysis was performed on patients who underwent total hysterectomy for AEH diagnosed by hysteroscopy in Xijing Hospital,Air Force Medical University from January 2021 to December 2023.The clinical and pathological data were collected,and univariate and multivariate logistic regression analyses were used to analyze the risk factors of AEH complicated with EC and the pathological and The Cancer Genome Atlas molecular subtyping of AEH complicated with EC.Results A total of 62 patients were included,26 of whom were pathologically upgraded to EC after total hysterectomy.Univariate logistic regression analysis showed that BMI,endometrial thickness under ultrasound,triglyceride and CA125 were the influencing factors of AEH complicated with EC.Multivariate logistic regression analysis showed that elevated triglyceride was an independent risk factor for AEH complicated with EC.The pathological type of AEH complicated with EC was endometrioid adenocarcinoma,76.92％ were highly differentiated,and 71.43％ had no specific molecular profile.Conclusion Hypertriglyceridemia is an independent risk factor for AEH complicated with EC.

Abstract:Objective To analyze the current status of research on hepatocellular carcinoma in the elderly,and to explore the development trends and research hotspots in this field.Methods Based on the Web of Science Core Collection database of studies on hepatocellular carcinoma in the elderly from 1980 to 2022,the bibliometric and visualization analyses of annual distribution,source journals,countries,research institutions,authors,co-citations,and keywords were performed by CiteSpace and VOSviewer.Results A total of 10 471 papers were included,and the number of published papers showed an increasing trend year by year,with Japan being the most prolific country,followed by the United States and China.Hepato-Gastroenterology had the highest number of published papers,and Hepatology had the highest citation frequency.Institutions with high publication volume were mainly concentrated in the United States,France,and China,with the University of California System having the largest number of published papers and its centrality ranking second.Most of the active authors were from Japan and Taiwan,China,LU S N published the most articles,and LLOVET J M was the most frequently co-cited author.References were clustered into nine categories,and those with high citation frequencies were published in high-quality journals such as Hepatology and Lancet.Keyword analysis showed"sorafenib","transarterial chemoembolization","double-blind","hepatocellular carcinoma",and"multichannel"were the research hotspots in this field.Conclusion This study provides a comprehensive overview of hepatocellular carcinoma in the elderly using bibliometric analysis to provide clues for disease diagnosis and therapeutic approaches in this field,revealing the combination of immunotherapy and anti-angiogenic drugs as a new strategy for treatment.

Abstract:Intracranial hemorrhage(ICH)is a kind of serious neurosurgical disease.Minimally invasive neurosurgery has gradually become the primary treatment for ICH due to its advantages of less surgical trauma,short hospital stay,and low risk of postoperative complications.In recent years,with the continuous progress of endoscopy technology and the popularity of minimally invasive treatment,a series of innovative devices and technologies have emerged,including but not limited to the upgrading of high-resolution endoscopy,the optimization of supporting equipment,the introduction of three-dimensional visualization technology,and the fusion application of neurosurgical robot-assisted technology,which have greatly enriched the strategic selection of neuroendoscopic treatment of ICH.The purpose of this paper is to review the working principle,clinical application effect and potential value of these new technologies in the treatment of ICH,and also to discuss the future development trend of neuroendoscopy technology.The comprehensive application of these technologies provides more accurate and personalized treatment plans for ICH patients,and is expected to further enhance the treatment effect and improve the quality of life of patients in the future.

Abstract:Objective To systematically detect and analyze the phenotypic characteristics and functional alterations of natural killer(NK)cells in subcutaneous tumor-bearing mice with colon cancer,with a focus on exploring the correlation between the expression levels of CD226 and TIGIT on NK cells.Methods Ten C57BL/6 mice were randomly divided into the subcutaneous tumor-bearing group of colon cancer(MC38 group)and the control group(WT group).The MC38 group was injected with MC38 cells,and the WT group was injected with sterile phosphate buffered saline.After modeling,flow cytometry was used to detect the overall proportion of NK cells,the proportion of each subgroup of NK cells,and the expression levels of cytotoxic molecules(perforin,granzyme B,and TNF-α)in peripheral blood,spleen,lungs,and liver.Furthermore,the expression levels of CD226 and TIGIT on NK cells were detected,and their correlation was further analyzed.Results Compared with the WT group,the MC38 group exhibited significantly reduced NK cell proportions in peripheral blood,spleen,lungs,and liver(P＜0.05),accompanied by a decrease in the proportion of cytotoxic NK cells(P＜0.01)and downregulated expression of cytotoxic molecules(performn,granzyme B,and TNF-α)(P＜0.05).Furthermore,NK cells in the MC38 group showed reduced CD226 expression(P＜0.01)and increased TIGIT expression(P＜0.01),with a negative correlation observed between the two molecules(P＜0.05).Conclusion Subcutaneous tumor-bearing mice with colon cancer exhibit altered NK cell phenotypes and impaired cytotoxic function.

Abstract:In recent years,the prevalence of myopia has been increasing globally,and myopia has become a global public health problem that cannot be ignored.Studies have shown that the age of onset of myopia is negatively correlated with the likelihood of developing high myopia in the future.Nowadays,people frequently use electronic devices due to the fast pace of life and the pressure of study and work.Therefore,the prevention and control of myopia requires the concerted efforts of many parties to effectively reduce the incidence of myopia.In order to explore optical means of delaying myopia progression and to provide a research basis for mechanistic studies of myopia prevention and control,this paper provides a review of the mechanisms of the onset based on the defocus theory and its application in the prevention and control of myopia development.

Abstract:Objective To analyze the rules of acupoint selection in the treatment of inflammatory bowel disease(IBD)in the past 10 years based on data mining method.Methods In this study,relevant clinical research literature on IBD in acupuncture treatment was retrieved in PubMed,Embase,Cochrane Library,Web of Science,SinoMed and CNKI.The selected acupoints in the literature were extracted to form prescriptions and a database of acupoints was established.SPSS 26.0 software was used to analyze the frequency of acupoints,the distribution of meridians and the application of specific acupoints.Results Finally,59 literatures were included,and 52 acupuncture prescriptions were extracted,involving 34 acupoints,with a total frequency of 302.The most frequently used acupoint was Tianshu(14.90％),followed by Zusanli(11.59％)and Zhongwan(10.26％).According to the data analysis,specific acupoints such as Front-mu points and Xiahe points were selected in the clinical treatment of IBD,and the main acupoints were selected in the foot-yangming stomach meridian and the conception vessel.The results of association rules showed that the correlation between Tianshu and Zusanli was the highest.Conclusion In clinical acupuncture treatment of IBD,it is customary to choose stomach meridian and conception vessel as the dominant meridians,and Front-mu points and Xiahe points as the main acupoints,supplemented by Tianshu,Zusanli and other core compatibility,in order to achieve therapeutic effect by regulating the spleen and stomach and regulating qi stagnation.

Abstract:Blast traumatic brain injury(bTBI)is a specific type of craniocerebral injury caused by explosive shock waves.Its injury mechanism differs from that of conventional traumatic brain injury,exhibiting more complex pathophysiological characteristics.Posttraumatic stress disorder(PTSD)represents the most common psychological stress reaction following bTBI and seriously affects the prognosis of bTBI.Therefore,early prevention and treatment of PTSD after bTBI are of great importance.Incorporating the clinical experience of dozens of domestic experts in neurosurgery,psychiatry,and psychology,along with relevant domestic and international literature,this consensus systematically explores issues related to PTSD after bTBI,aiming to provide guidance for the clinical prevention and treatment of PTSD following bTBI.

Abstract:Hypertension is a major chronic disease affecting adult health worldwide,and its prevalence continues to increase.At the same time,with the change of lifestyle,the incidence of sleep disorders continues to climb.Studies have confirmed that sleep deprivation and its quality decline are closely related to the incidence of hypertension.This article aims to comprehensively summarize and analyze the characteristics of sleep duration,sleep quality,and sleep structure in patients with hypertension from macro to micro and from subjective to objective,and to explore how various sleep conditions affect the risk of hypertension,so as to provide new ideas and perspectives for the prevention and treatment of hypertension.

Abstract:Objective To analyze perioperative complications following surgery for posterior fossa tumors in children and to identify associated risk factors.Methods The clinical data of children who underwent surgical resection of posterior cranial fossa tumors in Department of Neurosurgery,Tangdu Hospital,Air Force Medical University from January 2017 to August 2023 were retrospectively analyzed.The data collected included age,clinical manifestations,tumor location,preoperative secondary hydrocephalus,operation timing,surgical approach,surgical team,surgical resection degree,perioperative complications and histopathological diagnosis,and statistical analysis of the correlation between the data obtained and perioperative complications.Results A total of 144 children were included.Perioperative complications occurred in 48 patients,the complication rate was 33.3％,of which 14 cases required intervention,and 1 case died during perioperative period,with a mortality rate of 0.7％.In univariate analysis,tumor volume and location,suboccipital posterior median approach,and combined approach were statistically associated with increased complication rates(P＜0.05).There was no significant correlation between the pathological type of tumor tissue,the scope of resection and whether there was secondary hydrocephalus before operation and perioperative complications.Multivariate analysis showed that midline tumor,and tumor volume＞113 cm3(diameter＞3 cm)and surgery by a non-pediatric neurosurgeon were independent risk factors(P＜0.05).Conclusion Posterior fossa tumor resection in children has a higher risk of complications during the perioperative period.The identification of relevant risk factors is helpful to develop more accurate surgical plans,improve perioperative treatment plans,and reduce the incidence of complications.

Abstract:Objective To investigate the impact of closed reduction and proximal femoral nail antirotation(PFNA)on the stability and torsional resistance of intertrochanteric femoral fractures.Methods A total of 90 patients with intertrochanteric femoral fractures admitted to Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Zhejiang Chinese Medical University from September 2021 to February 2023 were selected as the study objects.They were divided into two groups according to random number table method.The control group was given dynamic hip screw fixation,and the observation group was given closed reduction and PFNA fixation.The study compared the surgical outcomes of the two groups,including fracture alignment,hip joint mobility,and postoperative complication rates six months after surgery;pain levels at 1,3,and 7 d after surgery[Numerical Rating Scale(NRS)];and motor function and activities of daily living before and 6 months after surgery[hip joint function(Harris Hip Score),Hospital for Special Surgery Knee Score(HSS),and activities of daily living(Barthel Index)].Additionally,three-dimensional finite element analysis was employed to measure displacement under vertical loads of 200,400,and 600 N,and torque resistance at 1 °,3 °,and 5 ° of torsion six months after surgery.Results The observation group demonstrated reduced hospital stay,operative duration,and time to fracture consolidation compared to the control group,with less intraoperative blood loss(P＜0.01).NRS scores of the observation group were lower than those of the control group at 1,3,and 7 d after surgery at rest and during exercise(P＜0.05).No significant difference in fracture alignment was observed between the two groups at six months after surgery(P＞0.05).Both groups experienced an increase in hip joint mobility,with the observation group demonstrating a more significant enhancement compared to the control group at six months after surgery(P＜0.05).Harris Hip Score,HSS and Barthel Index in both groups were increased,and the observation group achieved higher scores than the control group(P＜0.05).The observation group exhibited less displacement under vertical loads of 200,400 and 600 N and greater torque resistance at 1°,3°,and 5° of torsion compared to the control group(P＜0.05).The total incidence of complications,including implant loosening,displacement,and rotational instability,was lower in the observation group at six months after surgery(P＜0.05).Conclusion Closed reduction and PFNA fixation is an effective treatment for intertrochanteric femoral fractures,which can promote postoperative recovery,improve joint function,enhance stability and torsional resistance,and reduce incidence of postoperative complications.

Abstract:Objective To investigate the clinical efficacy of immediate intraoperative enrichment of stem cells combined with calcium sulfate-calcium phosphate composite artificial bone in the treatment of bone defects in children.Methods A retrospective analysis was conducted on 11 pediatric patients with bone defects admitted to the Department of Orthopaedics,Tangdu Hospital,Air Force Medical University from July 2015 to July 2024.The feasibility and advantages of integrating autologous bone marrow mesenchymal stem cells(BMSCs)into calcium sulfate-calcium phosphate composite artificial bone during surgery were analyzed.This was achieved through a screen-enrich-combine circulating system implemented intraoperatively.The immediate enrichment effect of BMSCs in calcium sulfate-calcium phosphate composite artificial bone particles and its repair effect on bone defects in children were analyzed.Bone healing was assessed utilizing Samantha X-ray scoring system.Additionally,the adjacent joint function and quality of life before and after surgery were evaluated by Paley score and SF-36 score.Results In vitro experiments demonstrated favorable biocompatibility of the artificial bone,with optimal cell viability after coculture with human BMSCs for an extended period.Autologous BMSCs exhibited high enrichment efficiency on the surface of calcium sulfate-calcium phosphate artificial bone particles,indicating its efficacy in the treatment of bone defects in children.A total of 11 pediatric patients were enrolled in this study,with a follow-up duration of(16.3±5.8)weeks.Postoperative observations revealed no complications such as infection,bleeding,repair failure,intractable pain,and fracture.The repair outcome of bone defects was deemed satisfactory.Conclusion Immediate intraoperative enrichment of autologous BMSCs into calcium sulfate-calcium phosphate composite artificial bone represents a mature clinical approach,which stands as a satisfactory and feasible method for bone defect repair in children.

Abstract:Objective To explore the mechanism of lactylation in the occurrence of PANoptosis in brain microvascular endothelial cells induced by hypoxia.Methods A total of 20 male C57BL/6 mice aged 8 weeks were selected to establish an animal model simulating a hypoxic environment at an altitude of 6 000 m for 28 d.The 20 mice were randomly divided into normoxic group and hypoxic group(10 mice in each group).An in vitro model of bEnd.3 cell line exposure to normoxia(210 mL/L O2)and hypoxia(10 mL/L O2)for 24 h was constructed.Immunofluorescence labeling of CD31 and GSDMD was performed on the hippocampal tissue of the mice.Transmission electron microscopy was used to observe the ultrastructural changes of brain microvascular endothelial cells in the hippocampal tissue.qRT-PCR was utilized to detect the expression of PANoptosis-related molecules such as ZBP1,NLRP3,NLRP12,ASC,CASP4,and GSDMD in hippocampal tissue and bEnd.3 cells.Western blotting was used to detect the expression of GSDMD,Pan-Kla,and H3K18 lactylation(H3K18la)in hippocampal tissue and bEnd.3 cells.A lactate assay kit was used to measure the L-lactic acid(L-LA)content in hippocampal tissue and bEnd.3 cells,and a lactate dehydrogenase(LDH)assay kit was used to determine the release of LDH in peripheral blood and bEnd.3 cells.Further,sodium oxamate(OXA)was used to inhibit lactate metabolism in bEnd.3 cells,followed by detection of L-LA,LDH,and the expression levels of the aforementioned PANoptosis molecules.Results Immunofluorescence staining results indicated that the number of CD31+GSDMD+cells in the hippocampal tissue of the hypoxic group was increased compared to the normoxic group.Transmission electron microscopy revealed characteristic pyroptotic endothelial cells in the hippocampal microvessels of the hypoxic group.The levels of lactate(P＜0.01)and LDH(P＜0.01)in the peripheral blood and hippocampal tissue of the hypoxic group were higher than those in the normoxic group.qRT-PCR results showed that the expression of ZBP1(P＜0.01),NLRP3(P＜0.01),NLRP12(P＜0.01),ASC(P＜0.01),CASP4(P＜0.01),and GSDMD(P＜0.01)in the hippocampal tissue of the hypoxic group was significantly higher than that in the normoxic group.Western blotting showed that the levels of Pan-Kla(P＜0.01)and H3K18la(P＜0.01)in the hippocampus of the hypoxic group were higher than those of the normoxic group.Compared to the normoxic group,the expression of GSDMD protein in bEnd.3 cells in hypoxic group for 24 h increased,and the levels of Pan-Kla(P＜0.01)and H3K18la(P＜0.01)were elevated.The content of lactate(P＜0.01)and LDH(P＜0.01)was higher than that of the normoxic group.Compared to bEnd.3 cells in the hypoxic group,the lactate content(P＜0.05)and LDH release(P＜0.05)were reduced,and the damage was relatively alleviated in the hypoxia+OXA group,with corresponding decrease in the expression of PANoptosis molecules(P＜0.05).Conclusion Hypoxic exposure can induce the occurrence of PANoptosis in brain microvascular endothelial cells,and H3K18la may serve as an important target involved in hypoxia-induced PANoptosis of brain microvascular endothelial cells.

Abstract:Objective To understand the current situation of nutrition knowledge,attitude,and practice(KAP)among military academy cadets and analyze the existing problems,in order to provide a basis for enhancing nutritional literacy of cadets and improving their dietary nutritional status.Methods A random cluster sampling method was used to select 202 cadets from a military academy,and their height,body mass,and percent body fat(PBF)were measured.At the same time,a questionnaire survey was conducted on their nutrition KAP to analyze their nutritional status and nutrition KAP level.Results The average body mass index(BMI)of male students was(22.56±2.63)kg/m2,and the average PBF was(16.77±5.63)％.The average BMI of female students was(21.13±2.40)kg/m2,and the average PBF was(28.96±5.09)％.In terms of nutrition knowledge,the excellent rate for male students was 86.36％,with a qualified rate of 100％,and the excellent rate for female students was 97.10％,with a qualified rate of 100％.In terms of nutrition attitude,the excellent rate of male students was 27.27％,with a qualified rate of 68.18％,and the excellent rate of female students was 20.90％,with a qualified rate of 80.68％.In terms of dietary behavior,the excellent rate of male students was 9.09％,with a qualified rate of 29.55％,and the excellent rate of female students was 4.48％,with a qualified rate of 25.37％.Conclusion The surveyed students have rich nutrition knowledge and a positive attitude towards nutrition.Some students have some unhealthy dietary behaviors,which are correlated with PBF.When conducting nutrition promotion and health education among military cadets,in addition to spreading scientific nutrition knowledge,it should also be combined with practical life,focusing on helping them establish correct dietary concepts,correct unhealthy dietary behaviors,improve their nutritional status and health level,and enhance the combat effectiveness of the army.

Abstract:Objective To investigate the therapeutic effect of specnuezhenide(SPE)on seawater inhalation-induced acute lung injury(SW-ALI).Methods A total of 24 SPF-grade 8-week-old male C57BL/6J mice were randomly divided into four groups:blank control group(Con group),seawater group(SW group),low-dose SPE-treated group(LD group),and high-dose SPE-treated group(HD group),with 6 mice in each group.LD group and HD group were fed with 50 mg/(kg·d)and 100 mg/(kg·d)SPE by intragastric administration,respectively,while SW group was fed with equal volume of normal saline by intragastric administration.The drug and normal saline were administered once a day for 3 d.The SW-ALI model was established 2 h after the last administration of the drug and normal saline.The mice were executed 24 h after modeling,and the pathological changes of lung tissue were observed by HE staining.The wet-to-dry weight ratio(W/D)of the lungs and the protein content of bronchoalveolar lavage fluid(BALF)of the mice in each group were detected.The levels of IL-6,IL-1β and TNF-α in BALF were detected by ELISA,and qRT-PCR and Western blotting were used to detect NF-κB and NLRP3 mRNA and protein expression levels in lung tissues.Results Compared with Con group,mice in the SW group showed obvious lung injury and increased inflammatory cell infiltration in lung tissues and alveoli.The W/D of the lungs,the protein and IL-6,IL-1β and TNF-α contents in BALF,and the mRNA and protein levels of NF-κB and NLRP3 in lung tissues were all significantly increased(P＜0.05).Compared with SW group,the pathological state of lung tissue in LD group and HD group was significantly alleviated,and the W/D of the lungs,the protein and IL-6,IL-1β and TNF-α contents in BALF,and the mRNA and protein levels of NF-κB and NLRP3 in lung tissues were all significantly reduced(P＜0.05).Conclusion SPE alleviates SW-ALI in mice by inhibiting NF-κB/NLRP3 inflammatory signaling pathway.

Abstract:Objective To analyze the risk factors of mild cognitive impairment(MCI)in patients with chronic obstructive pulmonary disease(COPD)and the effect of pulmonary rehabilitation training on improving patients' cognition.Methods A total of 122 COPD patients admitted to the Department of Respiratory and Critical Care Medicine,Affiliated Jinhua Hospital,Zhejiang University School of Medicine,Jinhua Municipal Central Hospital from April 2022 to April 2024 were divided into MCI group(n=58)and non-MCI group(n=64)according to whether they were complicated with MCI.The risk factors of COPD patients with MCI were analyzed by univariate analysis and multivariate logistic regression analysis.Patients were included in the experimental group(n=61)and the control group(n=61)by random number table method.The control group received conventional symptomatic treatment,and the experimental group was combined with pulmonary rehabilitation training on the basis of conventional symptomatic treatment.Both groups were treated for 12 weeks.The risk factors of COPD patients with MCI were analyzed by univariate and multivariate logistic analysis.Cardiopulmonary exercise function,blood gas analysis,cognition,disease progression and quality of life,and auditory event-related potential P300 test results were compared between the two groups before treatment and 12 weeks after treatment.Results Compared with the non-MCI group,the age of the MCI group ≥ 60 years old,the education level of junior high school or below,COPD course ≥5 years,family income per capita＜5 000 yuan,combined with hypertension,COPD disease classification grade Ⅲ,combined with negative emotions,and the number of acute attacks≥1 time/year in the past 2 years accounted for a higher proportion,and the difference was statistically significant(P＜0.05).Multivariate logistic analysis showed that age≥60 years,COPD course ≥ 5 years,COPD disease classification grade Ⅲ,combined with negative emotions,and the number of acute attacks ≥ 1 time/year in the past 2 years were risk factors for MCI in COPD patients(OR=2.140,2.264,2.083,1.902,2.149,P＜0.05).Compared with before treatment,after 12 weeks of treatment,6-min walking distance,maximum minute ventilation,peak oxygen uptake,arterial oxygen saturation,arterial oxygen partial pressure and Montreal Cognitive Assessment scores in both groups improved(P＜0.05),and the experimental group was higher(P＜0.01).Compared with before treatment,after 12 weeks of treatment,the scores of carbon dioxide ventilation equivalent,COPD Assessment Test and St.George's Respiratory Questionnaire decreased in both groups(P＜0.05),and the experimental group was lower(P＜0.01).Compared with before treatment,after 12 weeks of treatment,the amplitude of Pz in control group was increased(P＜0.05),the latency of Fz,Cz and Pz in experimental group was shortened,and the amplitude was increased(P＜0.05).The latency of Fz,Cz and Pz in experimental group was shorter than that in control group(P＜0.05).Conclusion There were many risk factors for MCI in COPD patients,and pulmonary rehabilitation training can improve auditory event-related potential P300 test results,cognitive function,cardiopulmonary exercise function,and blood gas analysis,control disease progression,and finally improve the quality of life of patients.

Abstract:Objective To investigate the characteristics and clinical countermeasures of adverse transfusion reactions in patients with different blood components.Methods Clinical data of patients admitted to a Grade-A tertiary hospital from 2016 to 2023 were collected to analyze the incidence and types of adverse transfusion reactions,types of transfused blood preparations,distribution of departments where adverse transfusion reactions occurred,and treatment measures.Results A total of 96 patients in the hospital had adverse transfusion reactions from 2016 to 2023,with an incidence of 0.18‰,mainly febrile non-hemolytic transfusion reactions(0.04‰)and allergic transfusion reactions(0.14‰).The probability of adverse transfusion reactions caused by suspended red blood cells and common frozen plasma in blood preparations was relatively high.The departments with the most adverse transfusion reactions were gastroenterology(15.63％),neurosurgery(14.58％),gynecology(14.58％),oncology(12.50％)and orthopedics(12.50％).The patients with allergic reactions were treated with dexamethasone(25 cases),promethazine hydrochloride(3 cases),dexamethasone combined with promethazine hydrochloride(10 cases)and dexamethasone combined with loratadine(2 cases)after stopping blood transfusion.Patients with febrile non-hemolytic transfusion reactions were treated with dexamethasone(6 cases)and dexamethasone combined with promethazine hydrochloride(1 case)after stopping blood transfusion.Conclusion Allergic reactions and febrile non-hemolytic transfusion reactions are the main types of common adverse transfusion reactions in clinical practice.In the process of clinical blood transfusion,targeted prevention should be carried out for different types of blood preparations and clinical blood departments,and the awareness of medical personnel to identify and report adverse reactions of blood transfusion should be continuously improved to ensure the safety and effectiveness of the transfusion treatment process.

Abstract:At present,tumor immunotherapy has become a powerful weapon in clinical tumor treatment.However,immune escape is a bottleneck that restricts the efficacy of tumor immunotherapy,and CD8+T cell exhaustion is one of the crucial causes in tumor immune escape.Researches have shown that CD8+T cells undergo epigenetic reprogramming under the influence of various immunosuppressive factors in the tumor microenvironment,which leads to CD8+T cell exhaustion.How to effectively target and regulate epigenetic reprogramming mechanisms to inhibit CD8+T cell exhaustion is currently a key and difficult problem that needs to be solved urgently.This paper reviews the characteristics of CD8+T cell exhaustion in the tumor microenvironment and epigenetic reprogramming mechanisms in tumor immune escape.It also elucidates the strategies for improving CD8+T cell exhaustion through targeted regulation of epigenetic mechanisms,and aims to provide new ideas and open up new pathways for tumor immunotherapy.

Abstract:Inflammatory arthritis(IA)is a series of diseases including gout arthritis,rheumatoid arthritis,psoriatic arthritis,ankylosing spondylitis,and juvenile idiopathic arthritis.Nod-like receptors(NLRs)are innate immune pattern recognition receptors,and some NLRs family molecules can promote inflammation through the formation of inflammasomes.More and more studies have demonstrated the important role of NLRs in IA.This review systematically summarizes the main causes of IA,the mechanisms of NLRs contributing to IA,and the use of related inhibitors as potential treatments for IA,which provides a new framework for developing NLRs-related inhibitors and is expected to improve efficacy and specificity against chronic diseases such as IA.

Abstract:Objective To investigate the value of high-frequency musculoskeletal ultrasound imaging in the diagnosis of lateral collateral ligament injuries of the ankle joint.Methods A total of 79 patients with lateral collateral ligament injuries of the ankle joint admitted to the General Hospital of Northern Theater Command of PLA from July 2020 to July 2024 were enrolled.Using MRI and surgical results as the gold standard,musculoskeletal ultrasound imaging was performed before surgery to evaluate the accuracy and compare the diagnostic efficacy.Results The accuracy rate of high-frequency musculoskeletal ultrasound imaging in diagnosing lateral collateral ligament injuries of the ankle joint was 97.47％.The sensitivity for type Ⅲ ligament injuries was 90.9％,which was higher than that for type Ⅰ and type Ⅱ injuries.The diagnostic rates of high-frequency musculoskeletal ultrasound imaging for injuries in different sites(calcaneofibular ligament,anterior talofibular ligament,and posterior talofibular ligament)were 90％,100％,and 100％,respectively,with no statistically significant differences among them(P＞0.05).There were no significant differences in accuracy,sensitivity,and missed diagnosis rate between high-frequency musculoskeletal ultrasound imaging and magnetic resonance examination or surgical exploration(P＞0.05).Conclusion High-frequency musculoskeletal ultrasound imaging can dynamically observe the lateral collateral ligament of the ankle joint,clearly display the type and degree of ligament injury,and reflect the differences in various diagnostic efficacy indicators among different ligament types.It provides an effective basis for early targeted clinical treatment and the prompt recovery of patients.