This article reports the first case of percutaneous closure of patent foramen ovale(PFO)using a biodegradable occluder under echocardiography guidance.The patient is a 43-year-old female diagnosed with PFO-related stroke.The procedure was successfully completed under echocardiography guidance without complications.During the 48-month follow-up period,the patient experienced no recurrent strokes,and the occluder was fully degraded.

Objective To establish the content determination method of Zhihuoding granules(ZHDG)by the anti-inflammatory active ingredients and fingerprint.Methods The inflammatory model of BEAS-2B cells was established by LPS(10 μg·mL-1)stimulation for 24 h,and the level of TNF-α in the supernatant was detected by enzyme-linked immunosorbent assay(ELISA).Using the reverse high-performance liquid chromatography(RP-HPLC)of 7 batch ZHDG fingerprint;HPLC was used to determine the content of geniposide and baicalin in granules.Results Compared with LPS Group,ZHDG,prim-O-glucosylcimifugin,5-O-methylvisammioside,baicalin,geniposide,and total polysaccharide extract all significantly decreased TNF-αlevels in BEAS-2B cells induced by LPS(P＜0.05).Fingerprint spectra of 7 batches of ZHDG were established,with a similarity of 1.000 to the reference.A total of 15 peaks were calibrated,and 7 chromatographic peaks were identified.Gardenin and baicalin were selected as the index components of ZHDG for evaluation.The established method was rapid and accurate.Conclusion The method for the determination of baicalin and geniposide in ZHDG are exclusive,accurate,and effective,providing reference for the quality control and clinical application of ZHDG.

This article reports the first case of percutaneous closure of patent foramen ovale(PFO)using a biodegradable occluder under echocardiography guidance.The patient is a 43-year-old female diagnosed with PFO-related stroke.The procedure was successfully completed under echocardiography guidance without complications.During the 48-month follow-up period,the patient experienced no recurrent strokes,and the occluder was fully degraded.

Objective To establish the content determination method of Zhihuoding granules(ZHDG)by the anti-inflammatory active ingredients and fingerprint.Methods The inflammatory model of BEAS-2B cells was established by LPS(10 μg·mL-1)stimulation for 24 h,and the level of TNF-α in the supernatant was detected by enzyme-linked immunosorbent assay(ELISA).Using the reverse high-performance liquid chromatography(RP-HPLC)of 7 batch ZHDG fingerprint;HPLC was used to determine the content of geniposide and baicalin in granules.Results Compared with LPS Group,ZHDG,prim-O-glucosylcimifugin,5-O-methylvisammioside,baicalin,geniposide,and total polysaccharide extract all significantly decreased TNF-αlevels in BEAS-2B cells induced by LPS(P＜0.05).Fingerprint spectra of 7 batches of ZHDG were established,with a similarity of 1.000 to the reference.A total of 15 peaks were calibrated,and 7 chromatographic peaks were identified.Gardenin and baicalin were selected as the index components of ZHDG for evaluation.The established method was rapid and accurate.Conclusion The method for the determination of baicalin and geniposide in ZHDG are exclusive,accurate,and effective,providing reference for the quality control and clinical application of ZHDG.

Objective To investigate the effects of Huanglian Jiedu Decoction Aqueous Extract(HJDAE)on the gut microbiota structure and colon metabolites of rats using 16S rRNA technology and non targeted metabolomics technology.Methods SD rats were continuously gavaged with HJDAE for 7 days and then Euthanized under anesthesia to extract the colon contents of the rats,,the contents of the rats'colon were taken,and 16S rRNA high-throughput sequencing was performed on the gut microbiota of the rats'colon segments using the Illumina Miseq platform.The differential microbiota,differential metabolites,and related pathways were analyzed in combination with the fecal non targeted metabonomics method.Results The results showed that HJDAE could affect the structure of gut microbiota in rats while maintaining a relatively stable proportion of various phyla of gut microbiota,and had significant promoting and inhibitory effects on multiple bacterial genera.Among them,it had the strongest inhibitory effect on Lactobacillus and Limosilactobacillus,and the most obvious promoting effect on Clostridium.Analyzing the data from two sets of experimental results,76 differential metabolites and 70 potential biomarkers were found.Among them,the top ten differential metabolites and their differences were xylose,acetic acid,propionic acid,and dimethylglycine with reduced production,while the production of palmitoleic acid,proline,and T-α-MCA,T-β-MCA,3-DHCA,HCA increased.The eight strongest metabolic pathways involved are Propanoate Metabolism,Butanoate Metabolism,TCA cycle,Alanine-Aspartate-Glutamate Metabolism,D-Glutamine and D-Glutamate Metabolism,Primary Bile Acid Biosynthesis,Nitrogen Metabolism,Valine-Leucine-Isoleucine Biosythesis,all of which are closely related to bile acid production.Conclusion The HJDAE promotes the production of primary bile acids by promoting the metabolism of sugars,amino acids,and fatty acids in rats.At the same time,the HJDAE causes a large number of Clostridium species to proliferate,and multiple Clostridium species metabolize primary bile acids into secondary bile acids,jointly leading to positive regulation of bile acid metabolism.

ObjectiveTo explore the impact of Gegen Qinliantang（GQT） on the fecal short-chain fatty acids（SCFAs） metabolism in antibiotic-associated diarrhea（AAD） through targeted metabolomics. MethodA total of 240 SD rats were randomly divided into six groups（n=40， half male and half female）， including blank group， model group， bifidobiogen group（0.15 g·kg^-1）， and GQT high-， medium-， and low-dose groups（10.08， 5.04， 2.52 g·kg^-1）， except for the blank group， clindamycin（250 mg·kg^-1） was given to all groups by gavage for modeling every day for 7 d. After successful modeling， each administered group was gavaged with the corresponding dose of the drug， and the blank and model groups were gavaged with an equal volume of normal saline solution， 1 time/d， for 14 d. At 0， 3， 7， 14 d after the drug intervention， eight rats were randomly selected from each group， respectively. Gas chromatography-time-of-flight mass spectrometry（GC-TOF-MS） was used to perform targeted metabolomic analysis of SCFAs in the feces of rats， and partial least squares-discriminant analysis（PLS-DA） was applied to compare the differences in metabolic profiles between groups at different treatment times， and to compare the changes in the contents of SCFAs in rat feces between groups. ResultPLS-DA results showed that the blank group could be clearly distinguishable from the model group， with GQT exhibiting a closer proximity to the blank group after 7 d of treatment. After further analyzing the composition of SCFAs， it was found that the proportion of acetic acid increased and the proportions of butyric acid， valeric acid， hexanoic acid and isovaleric acid decreased in the model group compared with the blank group. After the treatment with GQT， the proportions of butyric acid， isobutyric acid， valeric acid， and isovaleric acid increased， and the proportions of acetic acid， propionic acid and caproic acid decreased. Subsequent differential analysis revealed that GQT could significantly improve the content of butyric acid， and had a certain retrogressive effect on the contents of valeric acid and hexanoic acid. ConclusionThe medium dose group of GQT can improve the contents of SCFAs in AAD feces after 7 days of treatment， which may be related to the improvement of the composition ratio of SCFAs and the contents of butyric acid， valeric acid and caproic acid.

Objective To investigate the effects of Huanglian Jiedu Decoction Aqueous Extract(HJDAE)on the gut microbiota structure and colon metabolites of rats using 16S rRNA technology and non targeted metabolomics technology.Methods SD rats were continuously gavaged with HJDAE for 7 days and then Euthanized under anesthesia to extract the colon contents of the rats,,the contents of the rats'colon were taken,and 16S rRNA high-throughput sequencing was performed on the gut microbiota of the rats'colon segments using the Illumina Miseq platform.The differential microbiota,differential metabolites,and related pathways were analyzed in combination with the fecal non targeted metabonomics method.Results The results showed that HJDAE could affect the structure of gut microbiota in rats while maintaining a relatively stable proportion of various phyla of gut microbiota,and had significant promoting and inhibitory effects on multiple bacterial genera.Among them,it had the strongest inhibitory effect on Lactobacillus and Limosilactobacillus,and the most obvious promoting effect on Clostridium.Analyzing the data from two sets of experimental results,76 differential metabolites and 70 potential biomarkers were found.Among them,the top ten differential metabolites and their differences were xylose,acetic acid,propionic acid,and dimethylglycine with reduced production,while the production of palmitoleic acid,proline,and T-α-MCA,T-β-MCA,3-DHCA,HCA increased.The eight strongest metabolic pathways involved are Propanoate Metabolism,Butanoate Metabolism,TCA cycle,Alanine-Aspartate-Glutamate Metabolism,D-Glutamine and D-Glutamate Metabolism,Primary Bile Acid Biosynthesis,Nitrogen Metabolism,Valine-Leucine-Isoleucine Biosythesis,all of which are closely related to bile acid production.Conclusion The HJDAE promotes the production of primary bile acids by promoting the metabolism of sugars,amino acids,and fatty acids in rats.At the same time,the HJDAE causes a large number of Clostridium species to proliferate,and multiple Clostridium species metabolize primary bile acids into secondary bile acids,jointly leading to positive regulation of bile acid metabolism.

ObjectiveTo investigate the mechanism of Gegen Qinliantang（GQT） on the intestinal flora of antibiotic-associated diarrhea（AAD） by 16S rRNA sequencing and network pharmacology. MethodSixty SD rats were randomly divided into six groups（n=10）， including blank group， model group， GQT high-， medium- and low-dose groups（10.08， 5.04， 2.52 g·kg^-1） as well as Lizhu Changle group（0.15 g·kg^-1）， except for the blank group， each group was given clindamycin（250 mg·kg^-1） by gavage once a day for 7 consecutive days. After successful modeling， the blank group and the model group were given equal volumes of normal saline by gavage. The other groups were given corresponding doses of drugs by gavage for 14 days. Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform（TCMSP） was used to screen the active components and targets of GQT， GeneCards， Online Mendelian Inheritance in Man（OMIM） database， Pharmacogenetics and Pharmacogenomics Knowledge Base（PharmGKB）， DrugBank and DisGeNET were used to search for AAD disease targets. The drug-disease common targets were obtained by R software. STRING was applied to analyze the target protein-protein interaction， and Kyoto Encyclopedia of Genes and Genomes（KEGG） pathway enrichment analysis was performed. Then hematoxylin-eosin（HE） staining was used to observe the pathological changes of the colon， and 16S rRNA sequencing of AAD colon content flora structure further verified the results of network pharmacology. ResultThrough network pharmacology， it was found that 238 active components were screened from GQT and acted on 276 component targets， among which quercetin， puerarin， wogonin and apigenin were the main core components of GQT， 1 097 AAD disease targets and 127 drug-disease intersection targets. The protein-protein interaction network mainly included core targets such as protein kinase B1（Akt1）， interleukin（IL）-6 and IL-1β， which were mainly enriched in the IL-17 signaling pathway. It was verified through animal experiments that compared with the blank group， the colon structure of the model group was seriously abnormal， the intestinal epithelial columnar cells were damaged， the goblet cells were reduced， and a large number of inflammatory cells were infiltrated. Compared with the model group， the colon structure of the GQT high-dose group improved， but there were still abnormalities， the colon structure of GQT medium- and low- dose groups and Lizhu Changle group improved significantly and reached the normal level. GQT could improve the structural diversity of AAD intestinal flora. At the phylum level， the abundance of Firmicutes was increased and the abundance of Bacteroidetes was decreased. At the genus level， the abundance of Lactobacillus was increased， and the abundances of Prevotella and Bacteroides were decreased. Among them， Lactococcus could be used as a biomarker for AAD treatment with GQT， and the prediction of functional metabolism of intestinal flora revealed that GQT could promote acetate and lactate metabolic pathways in the intestine. ConclusionGQT may activate IL-17 signaling pathway by acting on the targets of Akt1 and IL-6 through key components such as quercetin and wogonin， and improve the abundance of Lactococcus in the intestinal tract as well as acetate and lactate metabolic pathways， so as to play a role in repairing the intestinal barrier for the treatment of AAD.

Objective To explore the epidemic characteristics,clinical features and treatment outcome of brucellosis in the Dali area of Yunnan province.Methods The clinical data of 43 cases with brucellosis from Janurany 2012 to September 2015 were retrospectively analyzed.Results Among 43 cases,there were 35 males,8 females, 37 farmers,5 veterinary,and 1 teacher.42 patients had a clear history of contact with cattle and sheep,1 case of no clear history of exposure to cattle and sheep,mainly fever,accompanied by chills,headache,joint pain,low back pain, weight loss,hepatosplenomegaly etc.Laboratory routine examination showed no specificity,SAT was detected in 30 cases,positive rate was 100.0%,blood culture in 28 cases,23 cases were positive,the positive rate was 82.1%. 41 cases of adult patients with rifampicin and tetracycline or doxycycline + levofloxacin and cefotaxime drugs combined therapy,treatment for 6 weeks,2 cases of children took rifampicin and SMZ -TMP treatment for 6 weeks, improvement rate was 100%,there was no recurrence and death cases.Conclusion Dali area is popular in brucellosis, the clinical manifestations and the infection way diversification,need the attention of the clinicians.

Objective To investigate the correlation between opportunistic infections in patients with HIV /AIDS in Dali of Yunnan Province and CD +4 lymphocyte count,discover the incidence trend of opportunistic infections in patients with HIV /AIDS in Dali and instruct early diagnosis and treatment.Methods Choosing 454 cases of opportunistic infections in patients with HIV /AIDS in Infectious Disease Dali Prefectural Hospital were chosen,ana-lyze various opportunistic infections,examining CD +4 lymphocyte count and analyze the differences of opportunistic infections on CD +4 lymphocyte count.Results 454 cases opportunistic infections with HIV /AIDS,48.24% were HCV infections,38.72% of various tuberculosis consumption phthisis,28.41% of bacterial pneumonia and 25.77%of oral condida monilia infections,high rate of opportunistic infections when CD +4 lymphocyte count <200 /μL;when CD +4 <50 /μL,53.33% of the patients with more than three pathogen infections,thus higher than those CD +4 >350 /μL of 5.56%(χ2 =34.88,P <0.01);The high rate of opportunistic infections found on patients without the treatment of HAART(40.83%,U =9.05,P <0.01),comparing to 18.79% of those with the treatment.Conclusion The com-mon opportunistic infections in our area are HCV,various tuberculosis consumption phthisis,bacterial pneumonia and oral condida monilia infections;high rate of opportunistic infections happens when CD +4 lymphocyte count are low and lower rate on those with the treatment of HAART,offering an effective method on controlling opportunistic infections.