Diarrhea-predominant irritable bowel syndrome （IBS-D） is a common digestive system disease with high prevalence and recurrence rates for years， high treatment costs， and serious impacts on patients' quality of life and economic burden. Therefore， it is important to explore new and safe treatment methods. The pathogenesis of IBS-D is complex， in which the gut-brain axis is a key factor. The gut-brain axis， a bidirectional signaling pathway connecting the gastrointestinal tract and the central nervous system， regulates gastrointestinal motility， secretion， and immune responses， playing a key role in the occurrence and development of IBS-D. Up to now， antidiarrheal agents， probiotics， and neurotransmitter modulators are the main methods for the clinical treatment of IBS-D. Although they can partially curb the progression of this disease， the therapeutic effects remain to be improved. Studies have confirmed that traditional Chinese medicine （TCM） has significant advantages in the treatment of IBS-D since it can regulate the gut-brain axis via multiple pathways and targets to improve the gastrointestinal motility and strengthen immune defenses. However， there is a lack of systematic reviews on the regulation of the gut-brain axis by TCM in the treatment of IBS-D. Based on the review of IBS-D-related articles published in recent years， this paper systematically summarized the relationship between the gut-brain axis and IBS-D and the role of TCM in the treatment， providing new ideas for the treatment of IBS-D.

BACKGROUND:The micro/nanostructured gradient biomimetic surface of implant materials can simulate the structure of the extracellular environment in human bone tissue,thereby achieving perfect bone integration function.However,further research is needed on the mechanisms by which the surface microstructure of bone implant materials regulates cell function and promotes osteogenesis. OBJECTIVE:To analyze the effect of titanium sheet microstructure surface on osteogenic differentiation of MC3T3-E1 osteoblasts. METHODS:(1)At a constant voltage of 5 V or 20 V,nanotube arrays of different diameters were prepared on the surface of titanium sheets by acid etching and anodic oxidation techniques,and were recorded as group R5 and group R20,respectively.The surface morphology,roughness,and hydrophilicity of pure titanium sheet(without acid etching or anodizing treatment)were measured in group R5 and group R20.(2)MC3T3-E1 osteoblasts of logarithmic growth stage were inoculated on the surface of pure titanium sheets,R5 group and R20 group respectively.After 24 hours of osteogenic induction culture,the expression of mechanical sensitive channel protein 1 was analyzed by RT-PCR and immunofluorescence staining.Osteoblast inducible base with or without the mechanosensitive channel protein 1 activator Yada1 was added,and alkaline phosphatase staining was performed after 7 days of culture.Alizarin red staining was performed after 14 days of culture. RESULTS AND CONCLUSION:(1)The surface of pure titanium sheets was smooth under scanning electron microscope.Relatively uniform and orderly nanotube arrays with average diameters of about 30 nm and 100 nm were observed on the surface of titanium sheets of groups R5 and R20,respectively.The results of scanning electron microscope were further verified by atomic force microscopy.The surface roughness of titanium sheet of group R5 was higher than that of pure titanium(P<0.05),and the water contact angle was lower than that of pure titanium(P<0.05).The surface roughness of titanium sheet in group R20 was higher than that in group R5(P<0.05),and the water contact angle was lower than that in group R5(P<0.05).(2)RT-PCR and immunofluorescence staining showed that the expression of mechanosensitive channel protein 1 in group R5 was higher than that in pure titanium group(P<0.05),and the expression of mechanosensitive channel protein 1 in group R20 was higher than that in group R5(P<0.05).Under the osteogenic induction,compared with the condition without Yada1,there were no significant changes in the activity of alkaline phosphatase and the deposition of calcified nodules in pure titanium group after Yada1 addition,while the activity of alkaline phosphatase and the deposition of calcified nodules in groups R5 and R20 after Yada1 addition were significantly increased(P<0.05).With or without Yada1,the alkaline phosphatase activity and calcified nodule deposition in group R5 were higher than those in pure titanium group(P<0.05),and the alkaline phosphatase activity and calcified nodule deposition in group R20 were higher than those in group R5(P<0.05).(3)The results show that the surface microstructure of titanium sheet can promote the osteogenic differentiation of osteoblast MC3T3-E1 by activating mechanosensitive channel protein 1.

Objective:To compare the differences in postoperative healing rates, hearing improvement, and complication rates between endoscopic butterfly inlay cartilage tympanoplasty and underlay cartilage tympanoplasty in Small-to-Medium-Sized Tympanic Membrane Perforations, and to provide clinical basis for indication of the butterfly inlay cartilage tympanoplasty. Methods:This study enrolled patients with chronic suppurative otitis media or traumatic tympanic membrane perforations who were treated at the Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Chongqing Medical University, between January 2022 and May 2023. Inclusion criteria comprised a dry ear period exceeding 3 months, absence of middle ear or mastoid pathology confirmed by temporal bone CT, and an air-bone gap of less than 40 dB. All surgeries were performed by the same surgeon using tympanoplasty techniques. Based on the surgical approach and perforation size, patients were categorized into four groups: Group A（butterfly cartilage tympanoplasty, perforation ≤3 mm）: 23 cases. Group B（butterfly cartilage tympanoplasty, perforation 3-5 mm）: 17 cases. Group C（full-thickness cartilage underlay tympanoplasty, perforation ≤3 mm）: 12 cases. Group D（full-thickness cartilage underlay tympanoplasty, perforation 3-5 mm）: 22 cases. Data collected included perforation duration, preoperative Eustachian Tube Score（ETS）, pure-tone audiometry, otoscopic findings, and postoperative follow-up data on pure-tone thresholds, otoscopic outcomes, and complications such as graft infection and otorrhea. Results: The mean postoperative follow-up period was 4 months （range: 3-12 months）. A total of 74 patients were enrolled, including 40 undergoing butterfly cartilage tympanoplasty and 34 receiving full-thickness cartilage inlay tympanoplasty. In the <3 mm perforation subgroup, the patients receiving butterfly technique （23 cases） exhibited a postoperative air-bone gap （ABG） improvement of （2.33±8.21） dB, and those receiving the inlay technique （12 cases） showed an ABG improvement of （2.49±7.9） dB, with no statistically significant difference between the two groups （P>0.05）. In the 3-5 mm perforation subgroup, the patients receiving butterfly technique （17 cases） demonstrated an ABG improvement of （8.16±5.69） dB, and those receiving the inlay technique （22 cases） achieved an ABG improvement of （8.08±10.42） dB, which were not significantly different （P>0.05）. Tympanic membrane healing rates across the four subgroups were 95.65%, 94.12%, 100%, and 95.45%, respectively, with no statistically significant differences （P>0.05）. Conclusion:In patients with tympanic membrane perforations ≤3 mm and 3-5 mm, butterfly cartilage tympanoplasty achieves comparable audiological outcomes to full-thickness cartilage underlay tympanoplasty. Compared with the underlay technique, the butterfly method is less invasive, preserves the normal anatomical structure of the tympanic membrane, requires a shorter dry ear period, and yields higher patient satisfaction. Therefore, it can be safely recommended for perforations ≤5 mm that do not require tympanotomy exploration.
Humans ; Tympanic Membrane Perforation/surgery* ; Tympanoplasty/methods* ; Treatment Outcome ; Endoscopy ; Cartilage/transplantation* ; Male ; Female ; Adult ; Middle Aged ; Myringoplasty/methods* ; Otitis Media, Suppurative/surgery* ; Aged

ObjectiveTo determine the association between solid fuel exposure and cancer risk among middle-aged and elderly adults in China, to investigate the underlying biological pathways through selected serological markers, and to examine whether adequate physical activity can mitigate this risk by modulating these pathways. MethodsBased on baseline characteristics, health status indicators and hematological data from the China Health and Retirement Longitudinal Study (CHARLS, 2011‒2018), multivariate logistic regression analyses were conducted to assess the association between solid fuel use and cancer risk, with stratified analyses conducted by physical activity levels. In addition, mediation analyses were performed to evaluate the role of serological markers including hemoglobin concentration and hematocrit in the association between solid fuel use and cancer incidence. ResultsSolid fuel use was significantly associated with an increased cancer risk (OR=1.344, 95%CI: 1.113‒1.615). This association remained significant among individuals with low levels of physical activity ( OR=1.344, 95%CI: 1.067‒1.673 ), but not statistically significant among those with adequate physical activity. Hemoglobin concentration and hematocrit showed a negative mediating effect between solid fuel use and cancer incidence, and this effect was stronger among those with low levels of physical activity. ConclusionIndoor solid fuel use represents an important environmental risk factor for cancer incidence in China’s middle-aged and elderly population, while regular physical activity may reduce carcinogenic risk through modulation of inflammatory levels and hematological indicators such as hemoglobin and hematocrit. Public health strategies should integrate clean energy promotion with exercise interventions to mitigate the cancer burden associated with solid fuel pollution.

Objective:To evaluate the effect of combined cognitive and physical intervention on mild cogni-tive impairment(MCI)using meta-analysis.Methods:Five databases including CNKI,PubMed,Web of Science,Cochrane and Embase were retrieved.Randomized Control Trials containing the combined cognitive and physical therapies on MCI were included.Statistical analysis,including the evaluation of the effects on global cognition,memory and executive function or attention,as well as the subgroup analysis were conducted using Stata 15.0.Results:A total of 28 articles was eventually included,with 2 796 participants.Results showed that the effec-tiveness of combined intervention on global cognitive function(SMD=0.68,95％CI:0.39-0.97),memory(SMD=0.35,95％CI:0.01-0.68)as well as executive function or attention(SMD=-0.28,95％CI:-0.51--0.05)were significantly better than the control group.Subgroup analysis indicated that the effects of combined intervention on the above domains of cognitive function among the participants were affected by the intervention mode,control type,whether there were other interventions and intervention frequency.Conclusion:Combined cogni-tive and physical intervention could effectively improve mild cognitive impairment.

Gallbladder cancer constitutes the most prevalent malignant tumor of the biliary tract. It exhibits clinical characteristics such as challenging diagnosis in early stages, aggressive invasiveness, and poor prognosis. Studies have discovered that the occurrence, development, and metastasis of malignant tumors are closely associated with the inflammatory response, and the level of systemic inflammation within the body can be reflected by peripheral blood inflammatory indicators. This review delineates the research progress on the correlation between peripheral blood inflammatory markers and the prognosis of gallbladder cancer, with the intention of providing references for the diagnosis, treatment, and prognosis evaluation of gallbladder cancer.

Objective:To investigate the clinical value of multiparameteric quantitative ultrasound combined with a non-invasive prediction model for assessing high-risk steatohepatitis.Methods:One hundred and ninety-four cases with metabolic-associated fatty liver disease (MAFLD) who underwent liver biopsy in Huashan Hospital, Fudan University, from June 2021 to September 2022 were selected. Shear wave elastography (SWE), shear wave dispersion (SWD) imaging, and attenuation imaging (ATI) examinations were conducted in all patients before biopsy. High-risk steatohepatitis was defined as a total activity score of ≥4 in patients with steatohepatitis, hepatocellular ballooning, and liver lobular inflammation based on pathological hepatic steatosis, inflammatory activity, and fibrosis scoring system (SAF), and fibrosis stage≥F2. Binary logistic regression analysis was used to identify the factors influencing high-risk steatohepatitis. A predictive model for diagnosing high-risk steatohepatitis was constructed using R language. The DeLong test was used to compare the area under the curve between groups. Measurement data was compared between groups using the t-test or rank-sum test, and count data were compared between groups using the χ2 test. Results:There were 46 cases (23.7%) with high-risk steatohepatitis. The quantitative ultrasound parameters included elastic modulus ( OR=2.958, 95% CI: 1.889-4.883, P<0.001), dispersion coefficient ( OR=1.786, 95% CI: 1.424-2.292, P<0.001) and attenuation coefficient ( OR=42.642, 95% CI: 3.463-640.451, P=0.004). Serological indexes of fasting blood glucose ( OR=1.196, 95% CI: 1.048-1.392, P=0.011), alanine aminotransferase ( OR=1.012, 95% CI: 1.006-1.019, P<0.001), aspartate aminotransferase ( OR=1.027, 95% CI: 1.014-1.042, P<0.001), γ-glutamyl transferase ( OR=1.008, 95% CI: 1.001-1.017, P=0.041) and HDL cholesterol ( OR=0.087, 95% CI: 0.016-0.404, P=0.003) were the factors influencing its progression. The AUCs of elastic modulus, dispersion coefficient, attenuation coefficient, multiparametric ultrasound model, serological index model, and ultrasound combined with serology model for the diagnosis of high-risk steatohepatitis were 0.764, 0.758, 0.634, 0.786, 0.773 and 0.825, respectively. The results of the DeLong test showed that the ultrasound combined with the serological model was significantly better than the serological index model and the elastic modulus, dispersion coefficient, and attenuation coefficient alone ( P=0.024, 0.027, 0.038 and <0.001). Conclusion:The combination of multiparametric quantitative ultrasound is helpful for the non-invasive diagnosis of high-risk steatohepatitis and possesses great clinical significance.

Sarcopenia and physical deconditioning are common complications in patients with liver cancer,which are frequently caused by insufficient physical activity and poor nutritional status,resulting in physical frailty and a significant impact on the patient's physical fitness.Notably,sarcopenia,frailty,and poor cardiopulmonary endurance have all been linked to higher mortality rates among patients with liver cancer.Exercise intervention significantly improves various health parameters in liver cancer patients,including metabolic syndrome,muscle wasting,cardiorespiratory endurance,health-related quality of life,and reduction in hepatic venous pressure gradient.However,the link between physical exercise and liver cancer is commonly overlooked.In this article,we will examine the impact of exercise on liver cancer and present the most recent evidence on the best types of exercise for various stages of liver cancer.This article also summarizes and discusses the molecular mechanisms that control metabolism and systemic immune function in tumors.In brief,physical exercise should be considered an important intervention in the prevention and treatment of liver cancer and its complications.

Objective:To discuss the effect of inhibiting microRNA(miR)-193a-5p expression on pulmonary fibrosis in the rats with acute respiratory distress syndrome(ARDS),and to clarify the related mechanism.Methods:A total of 60 male SD rats were divided into sham operation group,model group,miR-193a-5p antagonist group(Antagomir group),and negative control group(Antagomir-NC group),and there were 15 rats in each group.The ARDS animal model was induced by administering 10 mg·kg-1 lipopolysaccharide(LPS)via tracheal instillation,while the rats in sham operation group received an equal volume of saline.After successful modeling,the rats in Antagomir group and Antagomir-NC group were treated with miR-193a-5p Antagomir or Antagomir-NC via tail vein injection.The arterial partial pressure of oxygen(PaO2)and oxygenation index(OI)of the rats in various groups were measured;HE staining and Masson staining were used to observe the pathology and collagen fiber deposition in lung tissue of the rats;kit was used to detect the level of hydroxyproline(Hyp)in lung tissue of the rats in various groups;enzyme-linked immunosorbent assay(ELISA)method was used to detect the levels of inflammatory factors tumor necrosis factor α(TNF-α),interleukin(IL)-1β,and IL-6 in bronchoalveolar lavage fluid(BALF)of the rats in various groups;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of miR-193a-5p in lung tissue of the rats in various groups;Western blotting method was used to detect the expression levels of β-catenin,Snail family transcriptional repressor 1(Snail1),and α-smooth muscle actin(α-SMA)proteins in lung tissue of the rats in various groups.Results:Compared with sham operation group,the PaO2 and OI of the rats in model group were significantly decreased(P<0.05);compared with model group,the PaO2 and OI of the rats in Antagomir group were significantly increased(P<0.05).The HE staining results showed that the lung tissue structure of the rats in sham operation group was normal,and there were no obvious inflammatory changes;compared with sham operation group,mild abnormalities in lung tissue structure,alveolar atrophy,and collapse were observed in the rats in model group and Antagomir-NC group,with a large number of lymphocytes and a small number of neutrophils infiltrating in the alveolar cavities,and widened alveolar spaces;compared with model group,the rats in Antagomir group showed a significant reduction in lymphocytes and neutrophil infiltration in the alveolar cavities and there were no obvious hyperplasia.The Masson staining results showed no obvious blue collagen fiber deposition in lung tissue of the rats in sham operation group;compared with sham operation group,significant blue collagen fiber deposition was observed in lung tissue of the rats in model group and Antagomir-NC group,with severe damage of the alveolar structure,indicating obvious pulmonary fibrosis;compared with model group,the deposition of blue-stained collagen fibers in lung tissue of the rats in Antagomir group was significantly reduced.Compared with sham operation group,the level of Hyp in lung tissue of the rats in model group was significantly increased(P<0.05);compared with model group,the level of Hyp of the rats in Antagomir group was significantly decreased(P<0.05).The ELISA results showed that compared with sham operation group,the levels of TNF-α,IL-1β,and IL-6 in BALF of the rats in model group were significantly increased(P<0.05);compared with model group,the levels of TNF-α,IL-1β,and IL-6 of the rats in Antagomir group were significantly decreased(P<0.05).The RT-qPCR results showed that compared with sham operation group,the expression level of miR-193a-5p in lung tissue of the rats in model group was significantly increased(P<0.05);compared with model group,the expression level of miR-193a-5p of the rats in Antagomir group was significantly decreased(P<0.05).The Western blotting results showed that compared with sham operation group,the expression levels of β-catenin,Snail1,and α-SMA proteins in lung tissue of the rats in model group were significantly increased(P<0.05);compared with model group,the expression levels of β-catenin,Snail1,and α-SMA proteins in lung tissue of the rats in Antagomir group were significantly decreased(P<0.05).Conclusion:Inhibition of miR-193a-5p expression can improve the lung function and alleviate the pulmonary fibrosis in the ARDS rats by reducing the inflammatory responses and downregulating the expressions of β-catenin,Snail1,and α-SMA proteins.

Objective:To construct and verify a prognosis model of nomogram for the patients with locally advanced oral squamous cell carcinoma(OSCC).Methods:7 118 clinical cases with locally advanced OSCC from 2010 to 2015 in SEER database were in-cluded and randomly divided into training set(TS)and validation set(VS)by a 7:3 ratio.In TS,univariate and multivariate Cox proportional risk models were used to screen and determine the prognostic factors of locally advanced OSCC,and a nomogram predic-tion model was constructed to predict the cancer specific survival rate(CSS)of patients in 3 and 5 years.In TS and VS,the consis-tency index(C-index)and ROC curves were used to evaluate the differentiation of the model,the calibration curves were used to eval-uate the prediction accuracy of the model,and the decision curve analysis(DC A)method was used to evaluate the clinical applicabil-ity of the model.Results:4 984 and 2 134 cases were respectively included in TS and VS.No statistical difference of the analysis in-dexes was found between the 2 sets(P＞0.05).10 risk factors affecting the prognosis of the patients with locally advanced OSCC were identified in TS,including age,sex,race,marital status,location of onset,degree of histological differentiation,T stage,N stage,with or without operation and radiotherapy(P＜0.05).In the TS and VS,the C-index of the nomogram was 0.702 and 0.704 respectively,and the AUC of the 3-year and 5-year CSS was between 0.727 and 0.736.The calibra-tion curves showed that the 3-and 5-year CSS predicted by the nomogram model was in good agreement with the actual CSS.The DCA curves showed that the clinical benefit of the nomogram was better than that of the 7th e-dition of the AJCC TNM staging system.Conclusion:The nomogram constructed in this study can accurately predict the survival rate of OSCC patients with locally advanced tumor.