Gut microbial communities are likely remodeled in tandem with accumulated physiological decline during aging, yet there is limited understanding of gut microbiome variation in advanced age. Here, we performed a metagenomics-based enterotype analysis in a geographically homogeneous cohort of 367 enrolled Chinese individuals between the ages of 60 and 94 years, with the goal of characterizing the gut microbiome of elderly individuals and identifying factors linked to enterotype variations. In addition to two adult-like enterotypes dominated by Bacteroides (ET-Bacteroides) and Prevotella (ET-Prevotella), we identified a novel enterotype dominated by Escherichia (ET-Escherichia), whose prevalence increased in advanced age. Our data demonstrated that age explained more of the variance in the gut microbiome than previously identified factors such as type 2 diabetes mellitus (T2DM) or diet. We characterized the distinct taxonomic and functional profiles of ET-Escherichia, and found the strongest cohesion and highest robustness of the microbial co-occurrence network in this enterotype, as well as the lowest species diversity. In addition, we carried out a series of correlation analyses and co-abundance network analyses, which showed that several factors were likely linked to the overabundance of Escherichia members, including advanced age, vegetable intake, and fruit intake. Overall, our data revealed an enterotype variation characterized by Escherichia enrichment in the elderly population. Considering the different age distribution of each enterotype, these findings provide new insights into the changes that occur in the gut microbiome with age and highlight the importance of microbiome-based stratification of elderly individuals.
Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Bacteroides ; China ; Diabetes Mellitus, Type 2/microbiology* ; Escherichia coli/classification* ; Gastrointestinal Microbiome/genetics* ; Metagenomics ; East Asian People

Objective: To explore the efficacy of focal radiofrequency ablation (RFA) in the treatment of low-to-intermediate risk localized prostate cancer and its impact on postoperative urinary control and sexual function recovery，in order to explore the feasibility of minimally invasive methods for the treatment of localized prostate cancer. Methods: Clinical data of 28 patients with low-to-intermediate risk localized prostate cancer who underwent RFA in Nanjing Drum Tower Hospital，Affiliated Hospital of Medical School during Jun.2017 and Feb.2021 were retrospectively analyzed.The 5-year failure-free survival (FFS) rate，surgery related complications，postoperative urinary control and sexual function were collected.The differences between the survival curves of patients in the low-risk and intermediate-risk subgroups were assessed with log-rank test and Breslow test. Results: All surgeries were successfully completed under local anesthesia.During the median follow-up of 43 (40-49) months，the 5-year FFS rate predicted by Kaplan-Meier method was 78.57%; 25 patients (89.29%) did not experience surgery-related complications; 27 patients (96.43%) were able to control urination; 1 patient developed new-onset sexual dysfunction.There was no significant difference in the survival curves between patients in the low-risk and intermediate-risk groups (P>0.05). Conclusion: RFA for patients with low-to-intermediate risk localized prostate cancer has good clinical efficacy，little impact on urinary control and sexual function recovery，and few postoperative complications，which can be used as one of the treatment options for these patients.

Cataract is the world's leading cause of blindness, and surgery is the most effective treatment for cataract. With the development of femtosecond laser technology and ophthalmic surgical equipment, the application of femtosecond laser systems in cataract surgery is becoming increasingly widespread. It can be used in cataract surgery for corneal incisions, anterior capsulotomy, lens fragmentation, arcuate incisions and other key operations. Compared to traditional surgery, femtosecond laser assisted cataract surgery(FLACS)offers significant advantages in precision, safety and postoperative visual outcomes. Its clinical benefits have garnered growing recognition among ophthalmologists. However, the key technologies and high-precision equipment for FLACS remain predominantly controlled by Western countries. In China, the research in this field began later. This article reviews the technological advancements in FLACS, with a focus on femtosecond laser technology, optical coherence tomography(OCT), artificial intelligence, and clinical application progress. The objective is to provide theoretical foundations and practical insights for the development of ophthalmic medical technology in China.

OBJECTIVE To investigate the induction of apoptosis in hepatocellular carcinoma cells by polyphyllin 9 （PP9） through the regulation of the Fas/Fas ligand （FasL） signaling pathway， and its inhibitory effect on the growth of transplanted tumor in nude mice. METHODS Based on the screening of cell lines and intervention conditions， HepG2 cells were selected as the experimental subject to investigate the effects of 2 μmol/L and 4 μmol/L PP9 treatment on cell colony formation activity， apoptosis rate， as well as the protein expressions of Fas， FasL， cleaved caspase-8 and cleaved caspase-3. Additionally， Fas inhibitor KR- 33493 was introduced to investigate the underlying mechanism of PP9’s anti-hepatocellular carcinoma activity. Using HepG2 cell tumor-bearing nude mice model as the object， and 5-fluorouracil （20 mg/kg） as the positive control， the effects of 10 mg/kg PP9 on tumor volume， tumor mass， and the protein expressions of the nuclear proliferation-associated antigen Ki-67 and cleaved caspase-3 in tumor-bearing nude mice were investigated. RESULTS Compared with the control group， 2， 4 μmol/L PP9 significantly decreased the number of clones and the clone formation rate of cells， but significantly increased the apoptosis rate， the protein expressions of Fas， FasL， cleaved caspase-8 and cleaved caspase-3 （P＜0.05 or P＜0.01）. However， the combination of Fas inhibitor KR-33493 could significantly reverse the effect of PP9 on the up-regulation of proteins related to the Fas/FasL signaling pathway （P＜0.01）. Compared with the control group， the tumor volume （on day 27）， mass and protein expression of Ki- 67 in nude mice of the PP9 group were significantly decreased， while the protein expression of cleaved caspase-3 was significantly increased （P＜0.01）. CONCLUSIONS PP9 can induce apoptosis of HepG2 cells by activating the Fas/FasL signaling pathway. Meanwhile， PP9 can also effectively inhibit the growth of transplanted tumors in nude mice.

Objective: To analyze the association of participation in non-sports extracurricular tutoring classes with the prevalence of screening myopia, axial length (AL) and axial length to corneal radius ratio (AL/CR) among primary school students, so as to provide evidences for formulating myopia prevention and control policies. Methods: In December 2024, combination of convenience and cluster sampling method was used to select 2 273 students from two primary schools in Hefei City, Anhui Province. Ophthalmic examinations and questionnaire surveys were conducted to obtain information on myopia, AL, AL/CR and participation in various types of extracurricular tutoring. A binary Logistic regression model was used to analyze the association between non-sports tutoring and screening myopia, and multiple linear regression models were used to examine the associations between non-sports tutoring and AL and AL/CR. Results: Among the surveyed students, the participation rate in non-sports extracurricular tutoring classes was 64.9% , and the overall prevalence of screening myopia was 39.1%. The average AL and AL/CR were (23.60± 1.01 ) mm and (3.00±0.12), respectively. Univariate analysis showed that students who attended non-sports, music, or academic tutoring classes for ≥2 h per week had higher risks of screening myopia and greater AL/CR values than non-participants (screening myopia: OR =1.38, 1.82, 1.55; AL/CR: β =0.01, 0.03, 0.03; all P <0.05). After adjusting for sex, grade, and participation in sports tutoring, multivariate analysis indicated that participation in non-sports and musical instrument tutoring classes for ≥2 h per week remained significantly associated with higher risks of screening myopia ( OR =1.26, 1.49, both P <0.05). Multiple linear regression showed that participation in musical instrument tutoring for ≥2 h per week was positively correlated with AL ( β=0.14, P < 0.05). Conclusions Participation in non-sports extracurricular tutoring is common among primary school students. Attending non-sports tutoring classes for ≥2 h per week increases the risk of screening myopia.

OBJECTIVE T o explore the values of body temperature,white blood cells(WBC),neutrophils(NEUT),platelets(PLT),red blood cell distribution width(RDW),procalcitonin(PCT)and C-reactive procal-citonin(PCT)in early diagnosis of postoperative nosocomial infections in the intensive care unit(ICU)patients undergoing surgical procedures.METHODS The clinical data that were collected from the surgery patients who were hospitalized in ICU of Affiliated Hospital of Nantong University from Mar.2021 to May 2022 were retro-spectively analyzed,and the enrolled patients were divided into the infection group with 45 cases and the non-infection group with 130 case according to the status of nosocomial infections.The highest body temperature and the levels of WBC,NEUT,PLT,RDW,PCT and CRP were observed and compared between the infection group within 48 hours before diagnosis with nosocomial infections and the non-infection group after ICU stay for 48 hours.The values of the single and joint detection of the indexes in prediction of postoperative nosocomial infec-tions in the ICU patients were analyzed.RESULTS The body temperature,WBC,NEUT,RDW,PCT and CRP of the infection group were 38.30(37.80,38.80)℃,14.10(10.90,17.30)× 109/L,12.22(9.32,15.12)×109/L,14.10(12.70,15.50)％,1.20(0.10,2.30)ng/ml and 55.00(40.00,70.00)mg/L,respectively,high er than those of the non-infection group(P＜0.05).CRP,body temperature,PCT,NEUT and WBC showed remarkable diag-nostic effects;the area under the curves(AUCs)of the above indexes were 0.968,0.952,0.939,0.896 and 0.886,respectively.The sensitivity of the joint detection of PCT and CRP was 0.978,with the specificity 0.985 and AUC 0.980;the sensitivity of the joint detection of body temperature,PCT and CRP was 0.978,with the specificity 0.992,AUC 0.991.CONCLUSIONS The ICU patients with postoperative nosocomial infections show high levels of body temperature,WBC,NEUT,PCT and CRP.The body temperature,PCT and CRP have high sensitivity and specificity,showing certain values in prediction of postoperative nosocomial infection in the ICU pa-tients;the joint detection of the indexes has higher diagnostic efficiency.

Objective:To explore the therapeutic efficacy, adverse reactions, and factors influencing recurrence of botulinum toxin type A (BTX-A) in patients with trigeminal neuralgia (TN), and to provide clinical reference for the application of BTX-A in the treatment of TN.Methods:Clinical data and pre- and post-treatment Visual Analogue Scale (VAS) scores were collected from 198 patients with TN treated with BTX-A at the First Affiliated Hospital of Zhengzhou University from June 2020 to December 2022. Correlation analysis, univariate and multivariate Logistic regression were used to analyze factors influencing treatment efficacy, adverse reactions, and recurrence in patients. The predictive value of these factors for adverse reactions and recurrence was assessed using receiver operating characteristic curves.Results:Following BTX-A treatment, there were significant correlations between the frequency of TN attacks, time to peak efficacy, duration of efficacy, and VAS scores difference before and after treatment ( B=0.141, P=0.043; B=-0.134, P=0.023; B=-0.405, P0.001), as well as percentage difference in VAS score ( B=0.015, P=0.033; B=-0.011, P=0.034; B=-0.056, P0.001). Multiple branch involvement of the trigeminal nerve was an independent risk factor for the occurrence of TN adverse reactions ( OR=2.899, 95% CI 1.280-6.566, P=0.011). The area under the curve (AUC) for multiple branch involvement of the trigeminal nerve was 0.615 (95% CI 0.600-0.732). Multiple branch involvement of the trigeminal nerve ( OR=4.103, 95% CI 1.610-9.600, P=0.002) and peak onset time ( OR=0.950, 95% CI 0.922-0.978, P=0.001) were independent risk factors for TN recurrence and the combined AUC for these two factors was 0.713 (95% CI 0.600-0.827). Conclusions:The frequency of TN episodes, time to peak efficacy and maintenance duration of efficacy after BTX-A treatment were correlated with the difference in VAS scores and the percentage of difference. And the involvement of multiple branches of the trigeminal nerve was an independent risk factor affecting the occurrence of adverse reactions and TN recurrence.

AIM:This study aims to investigate the mechanism by which Qingfei-Jiedu-Huatan Formula(QJHF)regulates autophagy in alveolar macrophages through mTOR in the treatment of severe pneumonia(SP)in rats.METHODS:Sixty SPF-grade male rats were randomly assigned to six groups:control,model,QJHF,moxifloxacin(MOX),rapamycin(RAPA),and QJHF+RAPA,with ten rats in each group.An SP rat model was established using Klebsiella pneumoniae.After seven days of treatment,changes in IL-33 and IFN-γ levels in bronchoalveolar lavage fluid(BALF)were measured using ELISA.Histopathological alterations in lung tissue were assessed via HE staining,and the autophagy of alveolar macrophages was detected using immunofluorescence co-localization methods.The expression levels of mTOR,beclin-1,and LC3 mRNA in lung tissue were analyzed using qPCR,while Western blot was employed to assess the protein levels of p-mTOR/mTOR,beclin-1,and LC3-II/LC3-I.RESULTS:Compared to the control group,the model group exhibited a deteriorated condition,characterized by alveolar wall rupture and thickening,significant inflammatory cell infiltration in the alveolar cavity,and extensive lung tissue damage(P<0.01).Elevated levels of IL-33 and IFN-γ in BALF were also observed(P<0.01),along with increased colocalization of CD68 and LC3 in immunofluorescence analy-sis.The mTOR mRNA expression in lung tissue decreased(P<0.01),while LC3 and beclin-1 mRNA expressions in-creased(P<0.01).Additionally,the protein expression ratio of p-mTOR/mTOR decreased(P<0.01),whereas LC3-II/LC3-I and beclin-1 protein levels increased(P<0.01).In comparison to the model group,significant improvements were noted after treatment with QJHF and MOX(P<0.01),while RAPA treatment led to a worsening of these indicators(P<0.05).A slight improvement was observed with the QJHF combined with RAPA intervention,though this was not statisti-cally significant.No significant differences were found between the MOX and QJHF groups.However,the QJHF+RAPA group displayed notable improvements in various indicators compared to the RAPA group(P<0.05).CONCLUSION:The QJHF can mitigate the inflammatory response associated with severe pneumonia,potentially by activating mTOR phos-phorylation activity,which in turn inhibits excessive autophagy in alveolar macrophages.

Objective:This study aims to explore the optimization needs of the cognitive training tool "Fun Brain" from a professional perspective, providing insights for its enhancement and application.Methods:In April 2024, a qualitative research approach was employed, involving group interviews with 61 elderly health professionals organized into 9 groups. The interviews primarily focused on the user experience and optimization suggestions related to the "Fun Brain" app. Thematic analysis was conducted, with NVivo 14 software utilized for data management and processing. Data analysis followed Braun and Clarke′s six-phase procedure to ensure the scientific and systematic extraction of themes. Furthermore, high-frequency word analysis was performed, offering crucial clues for subsequent thematic analysis.Results:The study identified 12 initial themes and 6 optimization themes, with a primary focus on age-appropriate interfaces, personalized modules, and feedback mechanisms. These themes were refined into three core themes, including adaptation of training content, optimization of interaction design, and enhancement of participant motivation.Conclusion:Optimizing cognitive training tools for elderly users requires careful consideration of their specific needs, particularly regarding functional adaptation, interface design, and interactive experience. Implementing these optimizations can improve user engagement and training effectiveness, offering both scientific and practical guidance for the design and promotion of cognitive training tools.

[Objective]To propose syndrome differentiation and treatment approach of acupuncture for migraine based on the relationship between"spleen and stomach disorders"and the etiology and pathogenesis of migraine,providing theoretical and practical references for the clinical management.[Methods]The connotation of"spleen and stomach disorders"and its association with migraine were systematically reviewed.Based on this perspective,treatment strategies and acupuncture prescriptions for migraine were formulated,and supported by a representative clinical case study.[Results]"Spleen and stomach disorders"serves as a critical pathological foundation for migraine.Its pathogenesis can be summarized into four patterns"impaired spleen transport leading to malnourishment of the brain""phlegm-dampness obstructing the orifices and impairing mental clarity""spleen-stomach disharmony causing Qi stagnation"and"spleen deficiency with blood stasis resulting in orifice obstruction".Acupuncture treatment should prioritize regulating spleen-stomach function,supplemented by dredging local meridians and harmonizing Qi and blood.Key acupoints include Zhongwan(CV12),Xiawan(CV10),Qihai(CV6),and Guanyuan(CV4)for reinforcing primordial Qi,consolidating the foundation,and harmonizing Qi and blood;Zusanli(ST36),Shangjuxu(ST37)and Xiajuxu(ST39)for regulating Qi movement and balancing Yin and Yang;Sizhukong(TE23)and Fengchi(GB20)for clearing the head,improving vision,and relieving pain.In the presented case,the patient was diagnosed as dual deficiency of Qi and blood,acupuncture therapy focusing on replenishing Qi,nourishing blood and unblocking collaterals achieved significant clinical efficacy.[Conclusion]"Spleen and stomach disorders"is a pivotal mechanism underlying recurrent migraine.Acupuncture treatment for migraine should emphasize restoring spleen-stomach function,prioritizing the reinforcement of primordial Qi and harmonization of Qi and blood,thereby addressing the root cause to reduce migraine recurrence.