Objective:To investigate the effects of electroacupuncture on duodenal inflammation and intestinal mucosal barrier function in functional dyspepsia(FD)rats based on the Toll-like receptors 4(TLR4)/myeloid differentiation factor 88(Myd88)pathway.Methods:Sixty male Sprague-Dawley rats were randomly divided into a blank group(n=10)and a modeling group(n=50).The FD model was induced in the modeling group using a multi-factor comprehensive intervention.Forty successful model rats were randomly allocated into a model(FD)group,an electroacupuncture(EA)group,a TLR4 inhibitor(TAK242)group,and an EA+TAK242 group,with 10 rats in each group.In the EA group,following acupuncture at Zusanli(ST36)and Taichong(LR3),a filiform needle was perpendicularly inserted 3 mm into the lateral side of Zusanli(ST36)bilaterally,positioned between the Stomach Meridian and the Gallbladder Meridian at the lateral edge of the tibia,serving as an auxiliary electrode.An EA instrument was then connected to Zusanli(ST36)and the auxiliary electrode on the same side for intervention.The TAK242 group received tail vein injections of TLR4 inhibitor TAK242[0.5 mg/(kg·bw)],while the EA+TAK242 group received both TAK242 injections and EA intervention.Intragastric residual rate and small intestinal propulsion rate were observed in each group.Immunohistochemistry was used to detect tryptase expression in the duodenum;enzyme-linked immunosorbent assay was used to measure serum concentrations of 5-hydroxytryptamine(5-HT)and 5-hydroxyindole acetic acid(5-HIAA);Western blotting was used to analyze TLR4,MyD88,zonula occludens-1(ZO-1),and junctional adhesion molecule A(JAM-A)protein expression in the duodenal tissue.Results:In the FD group,the intragastric residual rate increased,small intestinal propulsion rate decreased,ZO-1 and JAM-A protein expression decreased,duodenal tryptase mean optical density increased,serum 5-HT and 5-HIAA levels increased significantly,and TLR4 and MyD88 protein expression increased significantly compared to the blank group(P<0.01).Compared to the FD group,the EA,TAK242,and EA+TAK242 groups showed a decreased gastric residual rate,increased small intestinal propulsion rate,increased ZO-1 and JAM-A protein expression,decreased optical density of duodenal tryptase,and significantly reduced serum 5-HT and 5-HIAA,as well as decreased TLR4 and MyD88 protein levels(P<0.01).Compared to the EA group,the TAK242 group had a higher intragastric residual rate and lower small intestinal propulsion rate(P<0.05),decreased TLR4 protein expression(P<0.05),no significant change in MyD88 protein expression(P>0.05),increased optical density of duodenal tryptase(P<0.05),increased serum 5-HT and 5-HIAA levels(P<0.05),and decreased ZO-1 and JAM-A protein expression(P<0.05).In the EA+TAK242 group,the intragastric residual rate was significantly lower,small intestinal propulsion rate was significantly higher,TLR4 and MyD88 protein expression was significantly lower,optical density of duodenal tryptase was significantly lower,and ZO-1 and JAM-A protein expression levels were significantly higher compared to the EA and TAK242 groups(P<0.01).Conclusion:EA promotes gastrointestinal motility,restores intestinal mucosal barrier function,and reduces inflammatory responses in FD rats,potentially through the down-regulation of the TLR4/Myd88 pathway.

The paper reports a 32-year-old female acute myeloid leukemia patient who developed graft-versus-host disease after paternal hematopoietic stem cell transplantation, which subsequently led to renal thrombotic microangiopathy. She subsequently required a kidney transplant from the same donor 5 years later due to renal failure. Considering that both the bone marrow and kidney were from the same donor and the recovery of renal function was favorable, immunosuppressive therapy was discontinued after a short course of anti-rejection treatment, with maintained stable kidney function. This case suggests that under the condition of high chimerism, allogeneic hematopoietic stem cell transplantation and kidney transplantation from the same donor can achieve immune tolerance, potentially improving solid organ transplantation success rate. The findings provide a novel therapeutic approach for solid organ transplantation following allogeneic hematopoietic stem cell transplantation.

Objective:To investigate the relationship between different types of tea intake and COVID-19 infection.Methods:Data were retrieved from a genome-wide association study(GWAS),involving 447 485,and 64 949 people for single nucleotide polymorphisms(SNPs).Two-sample Mendelian randomization(MR)analysis was used to investigate the relationship of different types of tea intake with four subgroups of COVID-19 infected population,including COVID-19 infected population versus general population,COVID-19 hospitalized population versus general population,COVID-19 hospitalized population versus non-hospitalized population,and very severe respiratory confirmed population versus general population.Inverse-variance weighted(IVW)method was used as the main method of causal analysis.MR Egger intercept was used for pleiotropy test,and Cochran's Q-statistic was used for heterogeneity test.Results:Compared to the general population,tea intake decreased the incidence of COVID-19 in the infection population(IVW method,OR=0.806,95%CI:0.651-0.999),and the hospitalized population(IVW method,OR=0.533,95%CI:0.369-0.770).Additionally,the underlying pleiotropy was not found following the MR-Egger regression intercept(MR intercept=-0.002,P=0.667),and the Cochran's Q-statistic showed no heterogeneity(Q-statistic=52.712,P=0.057).Compared to the general population,the underlying pleiotropy in the hospitalized patients was not found by MR-Egger regression intercept(MR intercept=-0.001,P=0.909),and the Cochran's Q-statistic showed no heterogeneity(Q-statistic=25.214,P=0.945).However,green tea and herbal tea had no effect on COVID-19 infection.Conclusions:Overall tea intake reduces the risk of COVID-19 infection in the general population compared to COVID-19 infected and hospitalized populations,while green tea and herbal tea have no protective effect against COVID-19 infection.

Objective:To study the effect and mechanism of ganoderma lucidum polysaccharide peptide(GLPP)on renal anti oxidative stress and immune inflammation in diabetes nephropathy mice.Methods:The C57 male mice model of diabetes nephropathy was established by streptozotocin combined with high glucose and high-fat diet.Sixty diabetes nephropathy mice were divided into model group,losartan group,GLPP group(low,medium and high dose groups),GLPP high-dose+losartan group,with 10 mice in each group,10 mice fed with normal diet as the blank group.The losartan group was given 10 mg/kg losartan by gavage,and GLPP low,medium and high dose groups was given 50,100,and 200 mg/kg GLPP by gavage,while the GLPP high-dose+losartan group were given 200 mg/kg GLPP+10 mg/kg losartan by gavage.The blank group and model group were given physiological saline by gavage.After gastric lavage,observe the diet,water intake,renal pathology,structure,and apoptosis of renal tubular epithelial cells in mice,and analyze the levels of blood biochemical indicators,immune inflammation,oxidative stress indicators,and expression of apoptosis/cycle regulatory proteins in mice.Results:Compared with the blank group,the model group showed an increase in blood biochemical indicators such as Scr,BUN,TC,TG and GSP(P<0.05),as well as inflammation indicators such as level of IL-6 and TNF-α、MCP-1 were decreased(P<0.05),the oxidative stress indicator MDA was increased,T-AOC,GSH-PX,SOD were decreased(P<0.05),the apoptosis rate of renal tubular epithelial cells were increased(P<0.05),the expression levels of Bax,Caspase-3,P53,P21 were all increased,and the expression levels of Bcl-2 and Cyclin D1 were decreased(P<0.05).Compared with the model group,the losartan group,GLPP dose groups,GLPP high-dose+losartan group Scr,BUN,TC,TG,GSP,IL-6,TNF-α,MCP-1,MDA levels,apoptosis rate of renal tubular epithelial cells,Bax,Caspase-3,P53,P21 expression levels were all reduced,while T-AOC,SOD,GSH-PX levels,Bcl-2,and Cyclin D1 expression levels were all increased.Renal pathological changes were improved,and mitochondrial swelling was reduced.The GLPP high-dose+losartan group showed the most significant improvement(P<0.05).Conclusion:GLPP can reverse the renal injury in diabetes nephropathy mice,which may be related to the inhibition of apoptosis of renal tubular epithelial cells by alleviating renal oxidative stress and immune inflammatory damage.

Objective:To investigate the relationship between different types of tea intake and COVID-19 infection.Methods:Data were retrieved from a genome-wide association study(GWAS),involving 447 485,and 64 949 people for single nucleotide polymorphisms(SNPs).Two-sample Mendelian randomization(MR)analysis was used to investigate the relationship of different types of tea intake with four subgroups of COVID-19 infected population,including COVID-19 infected population versus general population,COVID-19 hospitalized population versus general population,COVID-19 hospitalized population versus non-hospitalized population,and very severe respiratory confirmed population versus general population.Inverse-variance weighted(IVW)method was used as the main method of causal analysis.MR Egger intercept was used for pleiotropy test,and Cochran's Q-statistic was used for heterogeneity test.Results:Compared to the general population,tea intake decreased the incidence of COVID-19 in the infection population(IVW method,OR=0.806,95%CI:0.651-0.999),and the hospitalized population(IVW method,OR=0.533,95%CI:0.369-0.770).Additionally,the underlying pleiotropy was not found following the MR-Egger regression intercept(MR intercept=-0.002,P=0.667),and the Cochran's Q-statistic showed no heterogeneity(Q-statistic=52.712,P=0.057).Compared to the general population,the underlying pleiotropy in the hospitalized patients was not found by MR-Egger regression intercept(MR intercept=-0.001,P=0.909),and the Cochran's Q-statistic showed no heterogeneity(Q-statistic=25.214,P=0.945).However,green tea and herbal tea had no effect on COVID-19 infection.Conclusions:Overall tea intake reduces the risk of COVID-19 infection in the general population compared to COVID-19 infected and hospitalized populations,while green tea and herbal tea have no protective effect against COVID-19 infection.

Objective:To study the effect and mechanism of ganoderma lucidum polysaccharide peptide(GLPP)on renal anti oxidative stress and immune inflammation in diabetes nephropathy mice.Methods:The C57 male mice model of diabetes nephropathy was established by streptozotocin combined with high glucose and high-fat diet.Sixty diabetes nephropathy mice were divided into model group,losartan group,GLPP group(low,medium and high dose groups),GLPP high-dose+losartan group,with 10 mice in each group,10 mice fed with normal diet as the blank group.The losartan group was given 10 mg/kg losartan by gavage,and GLPP low,medium and high dose groups was given 50,100,and 200 mg/kg GLPP by gavage,while the GLPP high-dose+losartan group were given 200 mg/kg GLPP+10 mg/kg losartan by gavage.The blank group and model group were given physiological saline by gavage.After gastric lavage,observe the diet,water intake,renal pathology,structure,and apoptosis of renal tubular epithelial cells in mice,and analyze the levels of blood biochemical indicators,immune inflammation,oxidative stress indicators,and expression of apoptosis/cycle regulatory proteins in mice.Results:Compared with the blank group,the model group showed an increase in blood biochemical indicators such as Scr,BUN,TC,TG and GSP(P<0.05),as well as inflammation indicators such as level of IL-6 and TNF-α、MCP-1 were decreased(P<0.05),the oxidative stress indicator MDA was increased,T-AOC,GSH-PX,SOD were decreased(P<0.05),the apoptosis rate of renal tubular epithelial cells were increased(P<0.05),the expression levels of Bax,Caspase-3,P53,P21 were all increased,and the expression levels of Bcl-2 and Cyclin D1 were decreased(P<0.05).Compared with the model group,the losartan group,GLPP dose groups,GLPP high-dose+losartan group Scr,BUN,TC,TG,GSP,IL-6,TNF-α,MCP-1,MDA levels,apoptosis rate of renal tubular epithelial cells,Bax,Caspase-3,P53,P21 expression levels were all reduced,while T-AOC,SOD,GSH-PX levels,Bcl-2,and Cyclin D1 expression levels were all increased.Renal pathological changes were improved,and mitochondrial swelling was reduced.The GLPP high-dose+losartan group showed the most significant improvement(P<0.05).Conclusion:GLPP can reverse the renal injury in diabetes nephropathy mice,which may be related to the inhibition of apoptosis of renal tubular epithelial cells by alleviating renal oxidative stress and immune inflammatory damage.

Objective:To investigate the effects of electroacupuncture on duodenal inflammation and intestinal mucosal barrier function in functional dyspepsia(FD)rats based on the Toll-like receptors 4(TLR4)/myeloid differentiation factor 88(Myd88)pathway.Methods:Sixty male Sprague-Dawley rats were randomly divided into a blank group(n=10)and a modeling group(n=50).The FD model was induced in the modeling group using a multi-factor comprehensive intervention.Forty successful model rats were randomly allocated into a model(FD)group,an electroacupuncture(EA)group,a TLR4 inhibitor(TAK242)group,and an EA+TAK242 group,with 10 rats in each group.In the EA group,following acupuncture at Zusanli(ST36)and Taichong(LR3),a filiform needle was perpendicularly inserted 3 mm into the lateral side of Zusanli(ST36)bilaterally,positioned between the Stomach Meridian and the Gallbladder Meridian at the lateral edge of the tibia,serving as an auxiliary electrode.An EA instrument was then connected to Zusanli(ST36)and the auxiliary electrode on the same side for intervention.The TAK242 group received tail vein injections of TLR4 inhibitor TAK242[0.5 mg/(kg·bw)],while the EA+TAK242 group received both TAK242 injections and EA intervention.Intragastric residual rate and small intestinal propulsion rate were observed in each group.Immunohistochemistry was used to detect tryptase expression in the duodenum;enzyme-linked immunosorbent assay was used to measure serum concentrations of 5-hydroxytryptamine(5-HT)and 5-hydroxyindole acetic acid(5-HIAA);Western blotting was used to analyze TLR4,MyD88,zonula occludens-1(ZO-1),and junctional adhesion molecule A(JAM-A)protein expression in the duodenal tissue.Results:In the FD group,the intragastric residual rate increased,small intestinal propulsion rate decreased,ZO-1 and JAM-A protein expression decreased,duodenal tryptase mean optical density increased,serum 5-HT and 5-HIAA levels increased significantly,and TLR4 and MyD88 protein expression increased significantly compared to the blank group(P<0.01).Compared to the FD group,the EA,TAK242,and EA+TAK242 groups showed a decreased gastric residual rate,increased small intestinal propulsion rate,increased ZO-1 and JAM-A protein expression,decreased optical density of duodenal tryptase,and significantly reduced serum 5-HT and 5-HIAA,as well as decreased TLR4 and MyD88 protein levels(P<0.01).Compared to the EA group,the TAK242 group had a higher intragastric residual rate and lower small intestinal propulsion rate(P<0.05),decreased TLR4 protein expression(P<0.05),no significant change in MyD88 protein expression(P>0.05),increased optical density of duodenal tryptase(P<0.05),increased serum 5-HT and 5-HIAA levels(P<0.05),and decreased ZO-1 and JAM-A protein expression(P<0.05).In the EA+TAK242 group,the intragastric residual rate was significantly lower,small intestinal propulsion rate was significantly higher,TLR4 and MyD88 protein expression was significantly lower,optical density of duodenal tryptase was significantly lower,and ZO-1 and JAM-A protein expression levels were significantly higher compared to the EA and TAK242 groups(P<0.01).Conclusion:EA promotes gastrointestinal motility,restores intestinal mucosal barrier function,and reduces inflammatory responses in FD rats,potentially through the down-regulation of the TLR4/Myd88 pathway.

The paper reports a 32-year-old female acute myeloid leukemia patient who developed graft-versus-host disease after paternal hematopoietic stem cell transplantation, which subsequently led to renal thrombotic microangiopathy. She subsequently required a kidney transplant from the same donor 5 years later due to renal failure. Considering that both the bone marrow and kidney were from the same donor and the recovery of renal function was favorable, immunosuppressive therapy was discontinued after a short course of anti-rejection treatment, with maintained stable kidney function. This case suggests that under the condition of high chimerism, allogeneic hematopoietic stem cell transplantation and kidney transplantation from the same donor can achieve immune tolerance, potentially improving solid organ transplantation success rate. The findings provide a novel therapeutic approach for solid organ transplantation following allogeneic hematopoietic stem cell transplantation.

Coronary artery bypass grafting (CABG) is one of the most effective revascularization treatments for coronary heart disease. Secondary prevention strategies, which rely on antiplatelet and lipid-lowering drugs, are crucial after CABG to ensure the durability of revascularization treatment effects and prevent adverse cardiovascular and cerebrovascular events in the medium to long term. Previous research conducted by Professor Zhao Qiang's team from Ruijin Hospital of Shanghai Jiao Tong University, known as the DACAB study, indicated that dual antiplatelet therapy (DAPT, specifically ticagrelor+aspirin) after CABG can enhance venous graft patency. However, it remains uncertain whether DAPT can further improve the medium to long-term clinical outcomes of CABG patients. Recently, the team reported the medium to long-term follow-up results of the DACAB study, termed the DACAB-FE study, finding that DAPT administered after CABG can reduce the incidence of major cardiovascular events over five years and improve patients' medium to long-term clinical outcomes. This article will interpret the methodological highlights and significant clinical implications of the DACAB-FE study.

Objective:To investigate the relationship between the visceral adiposity index(VAI) and cognitive decline.Methods:A cross-sectional study was conducted.Between October 2020 and March 2023, 483 elderly residents living in communities in Hefei were recruited and divided into four groups based on VAI scores, Q1(VAI ≤ 1.14), Q2(VAI>1.15 and ≤1.85), Q3(VAI>1.86 and ≤2.81) and Q4(VAI>2.82).General cognitive function was assessed by(MMSE)and(MoCA).Attention and working memory were tested by forward and backward digit span tasks.Logistic regression was utilized to analyze the relationship between different VAI scores and insulin resistance.The correlation between different VAI scores and cognitive function domains was analyzed by partial correlation.Results:The values of BMI, fasting plasma glucose, fasting insulin, HbA1c, high-sensitivity C-reactive protein, HOMA-IR and HOMA-β increased with increasing VAI scores(all P<0.01).VAI was significantly correlated with insulin sensitivity after adjusting for confounding factors including sex.The risk of insulin resistance in Q4 was 7.40 times that in Q1( OR=7.40, 95% CI: 4.30-12.74, P<0.05).In addition, the correlation coefficients between VAI and forward digital span and between VAI and backward digital span were -0.116 and -0.105, respectively(both P<0.05), but there was no correlation between VAI and MMSE or MoCA. Conclusions:VAI is closely related to insulin resistance and also associated with early cognitive decline in elderly people with visceral obesity.