The sodium taurocholate co-transporting polypeptide(NTCP),a bile acids transporter,has been identi-fied as a new therapeutic target for the treatment of liver disease.This paper thoroughly investigates the function of NTCP for regulating bile acid regulation,its correlation with hepatitis B and D infections,and its association with various liver diseases.Additionally,in this review we examine recent breakthroughs in creating NTCP inhibitors and their prospective applications in liver disease treatment.While this review emphasizes the promising potential of targeting NTCP,it concurrently underscores the need for broader and more detailed research to fully understand the long-term implications and potential side effects associated with NTCP inhibition.

This paper analyzes a patient's clinical and laboratory characteristics with lumbar disc herniation invaded by Brucella in the bloodstream, causing brucellar spondylitis with paravertebral and psoas abscesses in Hebei Province in 2022. A 50-year-old male patient presented with lower back pain two months after physical exertion, and the symptoms were alleviated after bed rest but recurred intermittently. A Lumbar CT scan indicated disc protrusion, and the patient experienced multiple episodes of fever during this period. Twelve days before admission, the patient developed unexplained swelling pain and numbness in the right lower limb, which persisted despite bed rest. On October 21, 2022, tissue and abscess specimens were directly cultured and Gram-stained, along with blood culture, Brucella antibody testing, and CT imaging. Gram staining of the pus sample revealed tiny, sand-like bacterial bodies, suspected to be Brucella species. Paravertebral abscess samples and positive blood cultures were cultured on blood agar plates, yielding Brucella melitensis. Brucella antibody tests were positive. CT scanning of the lumbar vertebrae revealed bone destruction from L3 to L5, with swelling of the paravertebral soft tissues and left psoas muscle. The patient was diagnosed with brucellar spondylitis, with the accompanying paravertebral and psoas abscesses being a rare complication of brucellar spondylitis. Conservative treatment was ineffective, so surgery was performed to relieve nerve compression symptoms, along with the administration of anti-Brucella medication. The patient was discharged 15 days and continued anti-Brucella treatment post-discharge. One year follow-up showed the patient was cured with no recurrence. Brucellosis is characterized by sporadic outbreaks, with atypical clinical symptoms that can easily result in missed or incorrect diagnoses. Timely blood cultures are crucial for early diagnosis and effective anti-Brucella treatment to prevent disease progression and dissemination through the bloodstream, which could lead to multiple organ involvement, exacerbating the condition and hindering recovery.

Objective　This study conducted a series of biochemical and genetic analyses on three strains of Comamonas kerstersii isolated, aiming to enhance understanding of the bacterium and provide a reference for preventing and controlling infections and diseases associated with it. Methods　The fecal samples of patients from three patients from September to October 2023 in Sanya People's Hospital were inoculated on Columbia blood agar plates, and after sufficient incubation, the target strains were isolated and purified using oxidase reagent. Subsequently, the target colonies were subjected to biochemical identification and antibiotic susceptibility testing using the VITEK2-Compact analysis system, while the VITEK MS mass spectrometer was used to identify the bacterial genus. Meanwhile, bacterial DNA was extracted for 16S rRNA sequencing and bacterial genome framework sequencing, with sequencing analysis performed using various bioinformatics analysis tools. Results　Three strains of oxidase-positive single colonies were cultured, and the mass spectrometer could not identify the specific strain. The drug susceptibility test showed that all three strains were sensitive to most drugs, but some were resistant to ciprofloxacin and Compound Sulfamethoxazole. 16S rRNA sequencing identified the bacteria to Comamonas genus, and bacterial genome framework sequencing analysis indicated that all bacteria were Comamonas kerstersii. Bioinformatics analysis showed that all three bacterial strains contained virulence factors related to oxidase-positive enteric pathogenic bacteria, including the flmH gene of Aeromonas, vctC gene and rmlB gene of Vibrio, and the flgG gene and flhC gene of Yersinia. Pathogen-host interaction (PHI) analysis results suggested pathogenic genes in the target bacterial genomes that may cause intestinal infection. Conclusions　Comamonas kerstersii cannot be identified by conventional mass spectrometer and requires sequencing for analysis. This bacterium is sensitive to most antibiotics, but individual strains are resistant to ciprofloxacin and Compound Sulfamethoxazole. Comamonas kerstersii is associated with infections, especially gastrointestinal infections, though its pathogenesis remains to be further studied.

Abstract: To report a case of Aspergillus salwaensis-induced spinal infection and its laboratory detection. The inflammatory granulation and necrotic tissue samples of a patient with spinal infection were collected from, the Affiliated Hospital of Chengde Medical College on June 17, 2020 for direct smear microscopy and culture, and the isolated strain was identified by microscopy by smear staining, matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF-MS), molecular identification and in vitro antifungal susceptibility test. The patient was 62 years old female and presented with recurrent chest and back pain with no obvious cause. The initial diagnosis was spinal infection, after 7 days of treatment with levofloxacin, the effect was not good. Surgery was then performed remove the lesion via posterior thoracic debridement, and fungal hypha was observed under microscope in tissue specimens. The isolated strains had no typical structure, MALDI-TOF-MS was used for identification for many times, but there was no identification result. After 7 days of fluconazole treatment, the patient's condition improved, and her chest and back pain were alleviated compared to before surgery. The patient was discharged and followed up in the outpatient department, the fungus was later identified as Aspergillus salwaensis by sequence analysis of the internal transcribed spacer (ITS) gene sequencing, and the patient's antifungal medication was changed to voriconazole after with the attending physician. The patient consciously recovered well with no pain in the operative area and normal spinal activity at 1 year follow-up. The possibility of spinal fungal infection should be considered in patients with back pain without a clear cause and poor response to routine antibiotic treatment. Direct smear report of microscopic results are very important for guiding clinical antibiotic selection for rare filament fungi with atypical colony and microscopic morphology and unsuccessful MALDI-TOF-MS identification, molecular biological methods such as ITS sequence analysis can be helpful for early identification of the fungal species, improving identification speed.

Objective:To establish the normal values of water-perfused high resolution esophageal manometry (HREM)(GAP-36A) at resting period, water swallowing, semisolid swallowing and solid swallowing in Chinese population.Methods:From September 1, 2019 to June 30, 2020, 91 healthy volunteers receiving water-perfused HREM (GAP-36A) at resting period, water swallowing, semisolid swallowing and solid swallowing were selected from 9 hospitals (Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; the First Affiliated Hospital of Dalian Medical University; the Second Hospital of Hebei Medical University; the Second Affiliated Hospital, Naval Medical University; the First Affiliated Hospital, Sun Yat-sen University; the First Affiliated Hospital, University of Science and Technology of China; Aviation General Hospital of China Medical University; the Affiliated Hospital of Medical School of Nanjing University and the First People′s Hospital of Yichang). Parameters included the position of the upper and lower edges of the upper esophageal sphincter (UES) and lower esophageal sphincter (LES), the length of the LES and UES, the position of the pressure inversion point (PIP), the resting pressure of UES and LES and swallow-related parameters such as the distal contraction integral (DCI), 4 s integrated relaxation pressure (IRP), distal latency (DL) and UES residual pressure. One-way analysis of variance, post-hoc test and sum rank test were used for statistical analysis.Results:A total of 87 healthy volunteers were enrolled, including 40 males and 47 females, aged (38.5±14.2) years old (ranged from 19 to 65 years old). The position of the upper and lower edges of the LES was (42.7±2.8) and (45.6±2.8) cm, respectively, the length of the LES was (2.9±0.4) cm, and the position of PIP was (43.3±2.8) cm. The position of the upper and lower edges of the UES was (18.1±3.0) and (22.6±2.0) cm, respectively, and the length of the UES was (4.8±1.0) cm. The resting pressure of LES and UES was (17.4±10.7) and (84.1±61.1) mmHg (1 mmHg=0.133 kPa), respectively. The DCI value at solid swallowing was higher than those at water swallowing and semisolid swallowing ((2 512.4±1 448.0) mmHg·s·cm vs. (2 183.2±1 441.2) and (2 150.8±1 244.8) mmHg·s·cm), and the differences were statistically significant ( t=-4.30 and -3.74, both P<0.001). The values of 4 s IRP at semisolid swallowing and solid swallowing were lower than that at water swallowing ((4.6±4.1) and (4.9±3.9) mmHg vs. (5.4±3.9) mmHg), and the differences were statistically significant ( t=3.38 and 2.09, P=0.001 and 0.037). The DL at water swallowing was shorter than those at semisolid swallowing and solid swallowing ((8.5±1.8) s vs. (9.8±2.2) and (10.6±2.8) s), and the DL at semisolid swallowing was shorter than that at solid swallowing, and the differences were statistically significant ( t=-10.21, -13.91 and -4.68, all P<0.001). The UES residual pressure at water swallowing was higher than those at semisolid swallowing and solid swallowing (9.5 mmHg, 6.5 to 12.3 mmHg vs. 8.0 mmHg, 4.5 to 11.7 mmHg and 5.5 mmHg, 2.0 to 9.3 mmHg), and the UES residual pressure at semisolid swallowing was higher than that at solid swallowing, and the differences were statistically significant ( t=3.48, 10.30 and 6.35, all P<0.001). Conclusions:The normal values of water-perfused HREM (GAP-36A) in Chinese population at resting period, water swallowing, semisolid swallowing and solid swallowing can provide a reference basis for clinical diagnosis and treatment for patients receiving water-perfused HREM examination.

Objective:To analyze the genomic epidemiological subtyping of carbapenem resistant Klebsiella pneumoniae (CRKP) isolated from a Third-class A hospital in Zhengzhou. Methods:From December 4, 2019 to January 10, 2020, 67 strains of CRKP were isolated from the samples submitted by the clinical departments of a Third-class A teaching hospital in Zhengzhou for microbiological testing. Multi-locus sequence typing (MLST) and carbapenem resistance genes were identified by whole genome sequencing and sequence analysis. Based on the whole genome SNP, the phylogenetic tree was constructed, and 67 CRKP strains were divided into clonal groups. The isolation ward and date of each clone group were analyzed.Results:Sixty-seven CRKP strains were classified into four MLST types (STs), of which 64 were ST11. There were 62 ST11 strains carrying blaKPC-2 gene. Based on genome-wide SNP phylogenetic tree, 64 ST11 strains were divided into four clone groups, two of which were dominant clone groups, including 33 and 27 strains respectively; the other two clone groups only contained 2 strains respectively. There was no aggregation of the dominant clones in the isolation department and date. Conclusion:Multiple clonal groups of ST11 strain carrying blaKPC-2 gene are differentiated during spreading, and they can spread in parallel and independently in the same hospital.

Objective:To analyze the genomic epidemiological subtyping of carbapenem resistant Klebsiella pneumoniae (CRKP) isolated from a Third-class A hospital in Zhengzhou. Methods:From December 4, 2019 to January 10, 2020, 67 strains of CRKP were isolated from the samples submitted by the clinical departments of a Third-class A teaching hospital in Zhengzhou for microbiological testing. Multi-locus sequence typing (MLST) and carbapenem resistance genes were identified by whole genome sequencing and sequence analysis. Based on the whole genome SNP, the phylogenetic tree was constructed, and 67 CRKP strains were divided into clonal groups. The isolation ward and date of each clone group were analyzed.Results:Sixty-seven CRKP strains were classified into four MLST types (STs), of which 64 were ST11. There were 62 ST11 strains carrying blaKPC-2 gene. Based on genome-wide SNP phylogenetic tree, 64 ST11 strains were divided into four clone groups, two of which were dominant clone groups, including 33 and 27 strains respectively; the other two clone groups only contained 2 strains respectively. There was no aggregation of the dominant clones in the isolation department and date. Conclusion:Multiple clonal groups of ST11 strain carrying blaKPC-2 gene are differentiated during spreading, and they can spread in parallel and independently in the same hospital.

OBJECTIVE： To evaluate therapeutic efficacy of reteplase versus alteplase in the treatment of acute myocardial infarction in China， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from Cochrane library， PubMed， Embase， Medline， CJFD， CSJD， Wanfang database by computor， etc.， also by manual search， RCTs about therapeutic efficacy （recanalization rate of thrombolysis） of reteplase （trial group） versus alteplase （control group） in the treatment of acute myocardial infarction in China were collected from Jan. 1995 to Sept. 2018. After data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was performed for recanalization rate of thrombolysis by using Rev Man 5.3 software. RESULTS： A total of 23 RCTs were included， involving 1 742 patients. Results of Meta-analysis showed that recanalization rate of thrombolysis in trial group was significantly higher than control group， with statistical significance [OR＝0.61，95％CI（0.50，0.73），P＜0.001]. Sub-group Meta-analysis was performed according to the successful time of thrombolysis. Results of Meta-analysis showed that recanalization rate of thrombolysis in trial group 1 h [OR＝0.38，95％CI（0.25，0.58），P＜0.001]， 1.5 h [OR＝0.44，95％CI（0.25，0.79），P＝0.006] and 2 h [OR＝0.62，95％CI（0.42，0.92），P＝0.02] after thrombolysis were significantly higher than control group， with statistical significance. CONCLUSIONS： The recanalization rate of thrombolysis by reteplase in Chinese patients with acute myocardial infarction in better than by alteplase.