OBJECTIVE To investigate ameliorative effects and mechanisms of two probiotics （Bacillus subtilis， Lactobacillus acidophilus） combined with Aurantii Fructus Immaturus （AFI） on functional dyspepsia （FD） in rats. METHODS Rats were randomly divided into blank group， model group， positive control group （domperidone group， 2.7 mg/kg）， AFI group （9 g/kg）， L. acidophilus group （5×107 cfu/kg）， B. subtilis group （5×107 cfu/kg）， L. acidophilus+ AFI group （L. acidophilus 5×107 cfu/kg+ AFI 9 g/kg）， and B. subtilis+AFI group （B. subtilis 5×107 cfu/kg+AFI 9 g/kg）， with 8 rats in each group. Except for the blank group， FD model was established by tail-clamping stimulation+hunger and satiety disorder+swimming exhaustion in other groups. After modeling， each group was given the corresponding drug/probiotic suspensions/physiological saline intragastrically， once a day， for 14 consecutive days. After the last medication， gastric emptying rate and the rate of propulsion of the small intestine in rats were measured； the levels of brain-gut peptide-related indicators [gastrin （GAS）， substance P （SP）， vasoactive intestinal peptide （VIP）， somatostatin （SS） and cholecystokinin （CCK）] in the serum of rats were measured. The pathological morphology of the gastric antrum tissue and duodenal tissue was observed. Cecal contents from the rats were collected for gut microbiota sequencing analysis. The protein expression levels of tyrosine kinase receptor c-Kit and stem cell factor （SCF） in the gastric antrum tissue， as well as Toll-like receptor 4 （TLR4）， myeloid differentiation factor 88 （MyD88）， and nuclear factor κB （NF-κB） in the duodenal tissue of the rats were detected. RESULTS Compared with the blank group， model group showed significantly lower gastric emptying rate， small intestinal propulsion rate， serum levels of GAS and SP， relative abundance of Firmicutes， Ace， Chao and Sobs indexes of the gut microbiota， and protein levels of SCF and c-Kit in gastric antrum （P＜0.05）， while serum levels of VIP， SS and CCK， relative abundance of Bacteroidetes， as well as protein expressions of TLR4， MyD88， and NF-κB， were significantly higher （P＜0.05）. The histological structure JZYC23S53） of the gastric antrum tissue appeared basically normal； however， abnormalities were observed in the duodenal structure， with a significant infiltration of inflammatory cells visible. Compared with the model group， all treatment groups significantly modulated most of the above indexes （P＜0.05）. The histological structure of the gastric antrum tissue was normal. Except for the B. subtilis group and the B. subtilis+AFI group， the pathological states of the duodenum in the remaining rats gradually recovered. Compared with each single drug group， most of above indexes in rats from each combination group showed further improvement （P＜0.05）. CONCLUSIONS The combination of AFI with two probiotics can improve gastrointestinal motility in FD rats， and the effect is superior to that of using the drugs alone. The specific underlying mechanisms may be related to the activation of the SCF/c-Kit signaling pathway and the inhibition of the TLR4/MyD88/NF-κB signaling pathway.

Objective:To compare the efficacy of gasless robotic surgery via transaxillary approach and combined axillary-retroauricular approach for unilateral N1b PTC, and to explore the safety and effectiveness of gasless robotic surgery via transaxillary approach for unilateral N1b PTC. Methods:Unilateral N1b PTC patients who underwent surgery in the Department of Otolaryngology, Sun Yat Sen Memorial Hospital, Sun Yat sen University between July 2016 and December 2024 were included and analyzed. According to the inclusion and exclusion criteria and the differences of surgical approaches, the patients were divided into the transaxillary approach（TA） group and the combined axillary-retroauricular approach（TARA） group. The demographic data, operation time, intraoperative blood loss, postoperative drainage volume, postoperative complications, shoulder function evaluation, postoperative visual analogue scale（VAS） of neck aesthetics and recurrence of the two groups were statistically analyzed. Results:A total of 88 patients undergoing gasless robotic surgery were included in this study, including 23 cases in the TA group and 65 cases in the TARA group. The proportion of males in the TA group was significantly higher than that in the TARA group（56.5% vs 21.5%, χ²=9.776, P=0.002）. The total operation time in the TA group was significantly lower than that in the TARA Group（180.00[155.00, 220.00]min vs 220.00[177.50, 272.50]min, z=-2.775, P=0.006）, and the postoperative blood loss in the TA group was significantly lower than that in the TARA Group（30.00[20.00, 50.00]ml vs 50.00[30.00, 60.00]ml, Z=-2.127, P=0.033）. The proportion of area Ⅱ-Ⅴ in the TA group and the TARA group was 87.0% and 70.8%, respectively, and there was no significant difference between the two groups（P>0.05）. There was no significant difference in lateral cervical lymph node dissection and central lymph node dissection between the two groups（P>0.05）. During the follow-up period, no recurrence was found in the two groups, and there was no significant difference in the incidence of complications between the two groups（P>0.05）. According to the stratification of dynamic recurrence risk assessment, it can be seen that the proportion of curative effect satisfaction in the TA group was as high as 95.7%, and that in the TARA group was as high as 81.5%, with no significant difference between the two groups. There was no significant difference in VAS score of neck, Constant Shoulder Score and NDⅡ scale between the two groups（P>0.05）. Conclusion:Gasless robotic surgery via transaxillary approach for unilateral N1b PTC is safe and feasible, and the amount postoperative lymph node acquisition is equivalent to that of combined axillary-retroauricular approach, which can provide a new choice for the treatment of unilateral N1b PTC patients.
Humans ; Robotic Surgical Procedures/methods* ; Axilla/surgery* ; Male ; Female ; Operative Time ; Middle Aged ; Adult ; Treatment Outcome ; Postoperative Complications

The Janus kinase/signal transducers and activators of transcription (JAK-STAT) control natural killer (NK) cells development and cytotoxic functions, however, whether long non-coding RNAs (lncRNAs) are involved in this pathway remains unknown. We found that miR155HG was elevated in activated NK cells and promoted their proliferation and effector functions in both NK92 and induced-pluripotent stem cells (iPSCs)-derived NK (iPSC-NK) cells, without reliance on its derived miR-155 and micropeptide P155. Mechanistically, miR155HG bound to miR-6756 and relieved its repression of JAK3 expression, thereby promoting the JAK-STAT pathway and enhancing NK cell proliferation and function. Further investigations disclosed that upon cytokine stimulation, STAT3 directly interacts with miR155HG promoter and induces miR155HG transcription. Collectively, we identify a miR155HG-mediated positive feedback loop of the JAK-STAT signaling. Our study will also provide a power target regarding miR155HG for improving NK cell generation and effector function in the field of NK cell adoptive transfer therapy against cancer, especially iPSC-derived NK cells.

Objective:To evaluate the application value of extended latissimusdorsi musculocutaneous flap combined with breast precision hand in stage Ⅰ breast reconstruction.Methods:Twelve cases of extended latissimusdorsi musculocutaneous flap combined with stage Ⅰ breast reconstruction for breast cancer precision surgery were collected from January 2022 to February 2023 in our department, the postoperative complications of surgical techniques were analyzed, and the cosmetic effects of breast reconstruction were evaluated according to Harris standards.Results:All 12 cases underwent breast reconstruction with extended latissimusdorsi musculocutaneous flap, and the survival rate of the flap was 100%. There was local cutaneous margin necrosis in 1 case of back incision, partial ischemic necrosis of the nipple in 1 case, and effusion in the donor area of the back in 5 cases. Harris evaluation of cosmetic effect of breast reconstruction was excellent in 3 cases, good in 6 cases, and fair in 3 cases. Follow-up time was 4-16 months (median was 12 months), and no local recurrence or distant metastasis was observed during follow-up.Conclusions:The extended latissimusdorsi musculocutaneous flap combined with precision mastectomy stage Ⅰ reconstruction is a safe and feasible treatment method for breast cancer.

BACKGROUND: Vaccination has been shown effective in controlling the global coronavirus disease 2019 (COVID-19) pandemic and reducing severe cases. This study was to assess the flare and change in disease activity after COVID-19 vaccination in patients with stable rheumatoid arthritis (RA). METHODS: A prospective cohort of RA patients in remission or with low disease activity was divided into a vaccination group and a non-vaccination group based on their COVID-19 vaccination status. Each of them was examined every 3 to 6 months. In the vaccination group, disease activity was compared before and after vaccination. The rates of flare defined as disease activity scores based on 28-joint count (DAS28) >3.2 with ΔDAS28 ≥0.6 were compared between vaccination and non-vaccination groups. RESULTS: A total of 202 eligible RA patients were enrolled. Of these, 98 patients received no vaccine shot (non-vaccination group), and 104 patients received two doses of vaccine (vaccination group). The median time interval from pre-vaccination visit to the first immunization and from the second dose of vaccine to post-vaccination visit was 67 days and 83 days, respectively. The disease activity scores at pre-vaccination and post-vaccination visits in the vaccination group patients were similar. At enrollment, gender, RA disease course, seropositivity, and disease activity were comparable across the two groups. Flare was observed in five (4.8%) of the vaccination group patients and nine (9.2%) of the non-vaccination group patients at post-vaccination assessment ( P  = 0.221). In terms of safety, 29 (27.9%) patients experienced adverse events (AEs) after vaccination. No serious AEs occurred. CONCLUSIONS COVID-19 vaccinations had no significant effect on disease activity or risk of flare in RA patients in remission or with low disease activity. Patients with stable RA should be encouraged to receive the COVID-19 vaccination.
Humans ; Arthritis, Rheumatoid ; Cohort Studies ; COVID-19/prevention & control* ; COVID-19 Vaccines/adverse effects* ; East Asian People ; Prospective Studies ; Vaccination/adverse effects*

Objective: To investigate the nutritional status and associated factors of vitamin D among children aged 0 to 12 years old in Chongqing. Methods: From January 2019 to December 2021, 1 877 children aged 0-6 years who received regular child health care were randomly selected from Chongqing maternal and child health hospital, and 707 school age children were also selected from three primary school in Chongqing for investigation. The serum sample were collected for detecting serum 25 (OH) D level by chemiluminescence method, and the possible influencing factors of vitamin D deficiency (VDD) were analyzed. Results: The average serum 25 (OH) D concentration of children was (39.9±9.1) ng/mL with the positive rate of VDD was 14.59%. There were significant differences of VDD positive rate in different age, visiting time, visiting season, body shape, outdoor activity time and vitamin D supplementation (0-3 years old vs 4-6 years old vs 7-12 years old: 14.73% vs 22.19% vs 10.47%; visiting season: spring vs summer vs autumn vs winter: 12.97% vs 10.65% vs 14.86% vs 21.33%; pre COVID 19 epidemic vs post COVID-19 epidemic: 11.18% vs 17.08%; underweight or normal vs overweight or obesity: 12.34% vs 26.13%; adequate outdoor activity time vs inadequate:11.84% vs 16.27%; regular vitamin D supplementation vs irregular vitamin D supplementation: 11.71% vs 15.62% )( χ 2=26.17, 17.59, 30.98, 53.74, 9.60, 6.17, P <0.05). Underweight or normal body weight, sufficient outdoor activities and regular vitamin D supplementation were associated with less vitamin D deficiency with OR(OR95%CI ) at 0.68(0.55-0.84), 0.57 (0.25-0.77) and 0.62(0.44-0.85)( P <0.05). Conclusion The prevalence of VDD among preschool and school age children is high in Chongqing. Integrated prevention and control strategies incluing overweight or obesity control, increasing outdoor activities and oral vitamin D supplements should be taken.

Natural extracellular vesicles (EVs) play important roles in many life processes such as in the intermolecular transfer of substances and genetic information exchanges. Investigating the origins and working mechanisms of natural EVs may provide an understanding of life activities, especially regarding the occurrence and development of diseases. Additionally, due to their vesicular structure, EVs (in small molecules, nucleic acids, proteins, etc.) could act as efficient drug-delivery carriers. Herein, we describe the sources and biological functions of various EVs, summarize the roles of EVs in disease diagnosis and treatment, and review the application of EVs as drug-delivery carriers. We also assess the challenges and perspectives of EVs in biomedical applications.

Objective:To explore the current status and influencing factors of the physiological function of patients with chronic heart failure.Methods:From January to September 2020, convenience sampling was used to select 330 patients with chronic heart failure in Fuwai Central China Cardiovascular Hospital and Henan Provincial People's Hospital as the research object. The General Information Questionnaire, Patient-Reported Outcomes Instrument for Chronic Heart Failure (CHF-PRO) , and Self-Management Scale of Heart Failure Patients were used to conduct a cross-sectional survey.Results:A total of 330 questionnaires were distributed and 315 valid questionnaires were returned. The standardized score of self-reported physiological function of patients with chronic heart failure was (54.24±16.56) . The results of multiple linear regression analysis showed that the patient's age, occupational type, drinking history, heart function classification, number of complications, heart failure diagnosis time and self-management were the influencing factors of the physiological function of patients with chronic heart failure with a statistical difference ( P<0.05) , explaining 39.6% of the total variation. Conclusions:Patients with chronic heart failure based on the patient-reported outcomes have low levels of physiological function.Clinical nursing staff should give personalized intervention guidance based on the patient's demographic and disease characteristics, so as to improve the patient's physiological function and long-term prognosis.

Objective:To explore the path of standardized training and quality supervision for geriatric nursing assistants basing on the three-way linkage of "hospital, government and market".Methods:From January 2019 to December 2020, we conducted standardized training and management for geriatric nursing assistants in 24 nursing institutions for the aged in Mianyang, Sichuan Province in batches. Through the three-way linkage of "hospital, government and market", the whole-process management mode of "standardized training of geriatric nursing assistants, one-to-many tracking service for three months after the training, and service quality supervision of nursing institutions for the aged" has been established. The theoretical and operational achievements of nursing staff before and after training, the service quality of nursing home and the incidence of adverse events before and after the implementation of the project were observed and compared.Results:From 2019 to 2020, a total of 224 geriatric nursing assistants were trained in five sessions. There were statistical differences in the theoretical and operational scores before and after the training ( t=-72.494, -26.150; P<0.01) . 13 nursing institutions participating in the training in 2019 were selected to compare the service quality before and after the project implementation, the difference was statistically significant ( t=-14.575, P<0.01) , and the incidence of nursing adverse events decreased (χ 2=-7.913, P<0.01) . Conclusions:The mode of geriatric nursing assistants training and quality supervision based on the three-way linkage of "hospital, government, market" is conducive to giving full play to the administrative function of the government and the professional function of the hospital, effectively integrating resources and improving the quality of geriatric nursing service in the region.

Objective:To carry out online free medical consultation of the internet hospital to fight the COVID-19 so as to provide a necessary prevention guidance for patients, and reduce the consultation stress in Outpatient and Emergency Department and risk of crowed cross infection.Methods:Mianyang Central Hospital of Sichuan Province quickly responded since then COVID-19 had outbroken in January 2020. Our hospital established the internet free medical consultation project team which set up online specialized clinic based on actual state and demand analysis, provided targeted training for consultation experts, optimized intelligent hospitalization guidance in patient port, simplified process and was online urgently by the internet hospital.Results:Free medical consultation team of internet hospital was online on January 26th, 2020. Free medical consultation team completed 4 120 person-time online consultation within 7 days up to February 1st, 2020, of which, 2 489 (60.4%) person-time consulting respiratory symptoms, such as cough, expectoration and fever, 598 person-time consulting COVID-19 related knowledge and 425 consulting psychological problems, such as anxiety and fear. The online consultation screened out 622 patients with fever or epidemiologic history of COVID-19, including 5 cases with fever and epidemiologic history.Conclusions:The internet hospital helped patients distinguish the common cold and COVID-19, eliminated the suspected patients, provided psychological intervention and reduced social panic which built an anti-epidemic defense line before hospital treatment.