OBJECTIVE: To investigate the effects of acupuncture on the neurotransmitter levels and gut microbiota in a mouse model of Tourette syndrome (TS). METHODS: Thirty-six male C57/BL6 mice were randomly divided into 4 groups using a random number table method: 3,3'-iminodipropionitrile (IDPN) group, control group, acupuncture group, and tiapride group, with 9 mice in each group. In the IDPN group, acupuncture group, and tiapride group, mice received daily intraperitoneal injections of IDPN (300 mg/kg body weight) for 7 consecutive days to induce stereotyped behaviors. Subsequently, in the acupuncture intervention group, standardized acupuncture treatment was administered for 14 consecutive days to IDPN-induced TS model mice. The selected acupoints included Baihui (DU 20), Yintang (DU 29), Waiguan (SJ 5), and Zulinqi (GB 41). In the tiapride group, mice were administered tiapride (50 mg/kg body weight) via oral gavage daily for 14 consecutive days. The control group, IDPN group, and acupuncture group received the same volume of saline orally for 14 consecutive days. Stereotypic behaviors were quantified through behavioral assessments. Neurotransmitter levels, including dopamine (DA), glutamate (Glu), and aspartate (ASP) in striatal tissue were measured using enzyme-linked immunosorbent assay. Dopamine transporter (DAT) expression levels were additionally quantified through quantitative polymerase chain reaction (qPCR). Gut microbial composition was analyzed through 16S ribosomal RNA gene sequencing, while metabolic profiling was conducted using liquid chromatography-mass spectrometry (LC-MS). RESULTS: Acupuncture administration significantly attenuated stereotypic behaviors, concurrently reducing striatal levels of DA, Glu and ASP concentrations while upregulating DAT expression compared with untreated TS controls (P<0.05 or P<0.01). Comparative analysis identified significant differences in Muribaculaceae (P=0.001), Oscillospiraceae (P=0.049), Desulfovibrionaceae (P=0.001), and Marinifilaceae (P=0.014) following acupuncture intervention. Metabolomic profiling revealed alterations in 7 metabolites and 18 metabolic pathways when compared to the TS mice, which involved various amino acid metabolisms associated with DA, Glu, and ASP. CONCLUSIONS Acupuncture demonstrates significant modulatory effects on both central neurotransmitter systems and gut microbial ecology, thereby highlighting its dual therapeutic potential for TS management through gut-brain axis regulation.
Animals ; Tourette Syndrome/metabolism* ; Gastrointestinal Microbiome ; Neurotransmitter Agents/metabolism* ; Acupuncture Therapy ; Male ; Mice, Inbred C57BL ; Mice

OBJECTIVES: To investigate the underlying causes and clinical manifestations in infants undergoing colonoscopy, and to analyze changes in disease spectrum. METHODS: Clinical data from 180 infants who underwent a total of 184 colonoscopies at the Department of Gastroenterology, Children's Hospital Affiliated to Shandong University from January 2015 to December 2024 were retrospectively analyzed. Patients were grouped by age: ≤6 months (n=41) and >6-12 months (n=139); and by examination period: 2015-2019 (n=83) and 2020-2024 (n=97). Primary causes for performing colonoscopy, final diagnoses, and disease spectrum evolution were assessed. RESULTS: Among 184 colonoscopies, the leading causes prompting examination were hematochezia (37.8%, 68/180), diarrhea (36.7%, 66/180), and co-occurring hematochezia and diarrhea (21.1%, 38/180). Causes for performing colonoscopy differed significantly by age group (P<0.05). Colonic polyps were only detected in the >6-12 months group (P<0.05). Compared to the 2015-2019 group, the 2020-2024 group had fewer food allergy-related gastrointestinal diseases (P<0.05) but more colitis (P<0.05). CONCLUSIONS Colonoscopy is essential for diagnosing infantile digestive disorders, with disease spectra varying by age and time period.
Humans ; Infant ; Colonoscopy ; Male ; Female ; Retrospective Studies ; Infant, Newborn ; Diarrhea/etiology* ; Gastrointestinal Hemorrhage/etiology*

Small intestinal bacterial overgrowth（SIBO）is a clinically common but poorly recognized disease with clinical symptoms that overlap with those of functional gastrointestinal disorders（FGID）. FGID is a common risk factor for the occurrence of SIBO，and its SIBO incidence rate is significantly higher than that of healthy people，and has a certain correlation. Intestinal microbiota dysbiosis（including SIBO）plays an important role in the pathophysiology of FGID. At present，the diagnosis and treatment of SIBO still face challenges，and the treatment plan of FGID is gradually introduced into the treatment of SIBO. SIBO and FGID are closely related in clinical manifestations，incidence rate，pathophysiology，treatment and other aspects，but there is little research on the relationship between them. Prospective and large-scale clinical research is still needed to improve understanding and diagnostic accuracy.This article reviews the research progress on the relationship between SIBO and FGID.

Objective:To evaluate the relevant factors to optimize the learning curve and the impact of the basic skills of endoscopic technology on the learning curve of gasless transaxillary posterior endoscopic thyroidectomy.Methods:A retrospective analysis was performed to evaluate the clinical outcomes of 50 patients who underwent Glandular Ultrasound-Assisted (GUA) thyroid surgery by a surgeon with a background in endoscopic thyroid surgery via the thoracic-areolar approach, and 50 patients operated on by a surgeon without such experience at the Thyroid Surgery Department of Jilin University China-Japan Union Hospital from Apr. to Dec. 2023. The patients were divided into two groups: the Endoscopic Experience Group and the Non-Endoscopic Experience Group. The Cumulative Sum Control Chart (CUSUM) was applied to construct learning curves for both groups, dividing the technical exploration period from the mastery period. The analysis compared the surgical time, postoperative first-day drainage volume, number of central lymph nodes dissected rates, and postoperative complications between the two groups and across the two phases.Results:The analysis of the learning curve revealed that the inflection point of the Endoscopic Experience Group was 15, while of the Non-Endoscopic Experience Group was 18. The learning curve was divided into the technical exploration stage and the proficient mastery stage. The operative time of technical exploration stagde was significantly longer than of proficient mastery stage of both group (183.46±36.13min vs.144.40±26.14min, P<0.001; 186.89±48.91min vs.131.59±22.90min; P<0.001) . The operative time in the proficient mastery stage of the Endoscopic Experience Group was longer than that of the Non-Endoscopic Experience Group (144.40±26.15min vs. 131.59±22.90min, P<0.05) . The postoperative drainage volume in the Endoscopic Experience Group was lower than that in Non-Endoscopic Experience Group in both stages (65.40±32.48mL vs.93.22±30.67mL, 57.40±15.35mL vs.78.50±28.30mL, P<0.05) , and the postoperative drainage volume in the proficient mastery stage of the Non-Endoscopic Experience Group was significantly lower than in the technical exploration stage (93.22±30.67mL vs.78.50±28.30mL, P<0.05) .No significant differences in central lymph node dissection numbers or postoperative complications were observed between the groups at both stages. Conclusions:There is a specific learning curve in the early stage of gasless transaxillary posterior endoscopic thyroidectomy. After crossing the learning curve, the operation time is obviously shortened with the improvement of the operator's surgical technique.Having a basic understanding of endoscopic technology in the early stage can reduce the occurrence of postoperative drainage, but has a minimal impact on the learning curve.

Objective To investigate the expression levels of serum tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein β(14-3-3β)and clara's cell secretory protein 16(CC16)in patients with chronic obstructive pulmonary disease(COPD)complicated by respiratory failure,and their relationship with prognosis.Methods A total of 232 patients with COPD complicated with respiratory failure admitted to Yantian Hospital of Southern University of Science and Technology from April 2020 to October 2023 were enrolled in the COPD complicated with respiratory failure group.According to the severity of the disease,they were divided into mild group(n=67),moderate group(n=73)and severe group(n=92).According to the 28-day prognosis,they were divided into death group(n=73)and survival group(n=159).In addition,80 patients with simple COPD(COPD group)and 80 healthy subjects(control group)were selected at the same time.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression of serum 14-3-3β and CC16.Multivariate Logistic regression analysis was used to analyze the factors of death in patients with COPD complicated with respiratory failure.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum 14-3-3β and CC16 expression on the death of patients with COPD complicated with respiratory failure.Results The expression of serum 14-3-3β in COPD complicated with respiratory failure group was higher than that in COPD group and control group(U=3.894,11.417),the expression of CC16 was lower than that in COPD group and control group(t=5.845,14.306),and the differences were statistically significant(all P<0.05),respectively.The expression of serum 14-3-3β in severe group was higher than that in moderate group and mild group(U=5.179,8.234),the expression of CC16 was lower than that of moderate group and mild group(t=4.090,9.281),and the differences were statistically significant(all P<0.05),respectively.The 28-day mortality rate of 232 COPD patients with respiratory failure was 31.47%(73/232).The expression of serum 14-3-3β in the death group was higher than that in the survival group,and the expression of CC16 was lower than that in the survival group,the differences were statistically significant(U/t=6.790,8.265,all P<0.05).The age of the death group was older than that of the survival group,the degree of airflow limitation and the number of acute exacerbations within 1 year were higher than those of the survival group,and the differences were statistically significant(t/χ2/U=3.895,7.202,3.360,all P<0.05).Age,severe airflow limitation,extremely severe airflow limitation,and the number of acute exacerbations within 1 year,elevated 14-3-3β were independent risk factors for death in patients with COPD complicated with respiratory failure(Wald χ2=3.914～22.668,all P<0.05),and elevated CC16 was an independent protective factor(Wald χ2=23.675,P<0.05).The area under the curve(AUC)of serum 14-3-3β combined and CC16 expression in predicting the death of patients with COPD complicated with respiratory failure which was greater than that of serum 14-3-3β and CC16 expression alone,the differences were statistically significant(Z=3.995,3.813,all P<0.01).Conclusion The increase of serum 14-3-3β expression and the decrease of CC16 expression in patients with COPD complicated by respiratory failure are closely related to the aggravation of the disease and poor prognosis.The combination of serum 14-3-3β and CC16 expression is of high value in predicting the death of patients with COPD complicated with respiratory failure.

Objective:To evaluate the relevant factors to optimize the learning curve and the impact of the basic skills of endoscopic technology on the learning curve of gasless transaxillary posterior endoscopic thyroidectomy.Methods:A retrospective analysis was performed to evaluate the clinical outcomes of 50 patients who underwent Glandular Ultrasound-Assisted (GUA) thyroid surgery by a surgeon with a background in endoscopic thyroid surgery via the thoracic-areolar approach, and 50 patients operated on by a surgeon without such experience at the Thyroid Surgery Department of Jilin University China-Japan Union Hospital from Apr. to Dec. 2023. The patients were divided into two groups: the Endoscopic Experience Group and the Non-Endoscopic Experience Group. The Cumulative Sum Control Chart (CUSUM) was applied to construct learning curves for both groups, dividing the technical exploration period from the mastery period. The analysis compared the surgical time, postoperative first-day drainage volume, number of central lymph nodes dissected rates, and postoperative complications between the two groups and across the two phases.Results:The analysis of the learning curve revealed that the inflection point of the Endoscopic Experience Group was 15, while of the Non-Endoscopic Experience Group was 18. The learning curve was divided into the technical exploration stage and the proficient mastery stage. The operative time of technical exploration stagde was significantly longer than of proficient mastery stage of both group (183.46±36.13min vs.144.40±26.14min, P<0.001; 186.89±48.91min vs.131.59±22.90min; P<0.001) . The operative time in the proficient mastery stage of the Endoscopic Experience Group was longer than that of the Non-Endoscopic Experience Group (144.40±26.15min vs. 131.59±22.90min, P<0.05) . The postoperative drainage volume in the Endoscopic Experience Group was lower than that in Non-Endoscopic Experience Group in both stages (65.40±32.48mL vs.93.22±30.67mL, 57.40±15.35mL vs.78.50±28.30mL, P<0.05) , and the postoperative drainage volume in the proficient mastery stage of the Non-Endoscopic Experience Group was significantly lower than in the technical exploration stage (93.22±30.67mL vs.78.50±28.30mL, P<0.05) .No significant differences in central lymph node dissection numbers or postoperative complications were observed between the groups at both stages. Conclusions:There is a specific learning curve in the early stage of gasless transaxillary posterior endoscopic thyroidectomy. After crossing the learning curve, the operation time is obviously shortened with the improvement of the operator's surgical technique.Having a basic understanding of endoscopic technology in the early stage can reduce the occurrence of postoperative drainage, but has a minimal impact on the learning curve.

Objective To investigate the expression levels of serum tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein β(14-3-3β)and clara's cell secretory protein 16(CC16)in patients with chronic obstructive pulmonary disease(COPD)complicated by respiratory failure,and their relationship with prognosis.Methods A total of 232 patients with COPD complicated with respiratory failure admitted to Yantian Hospital of Southern University of Science and Technology from April 2020 to October 2023 were enrolled in the COPD complicated with respiratory failure group.According to the severity of the disease,they were divided into mild group(n=67),moderate group(n=73)and severe group(n=92).According to the 28-day prognosis,they were divided into death group(n=73)and survival group(n=159).In addition,80 patients with simple COPD(COPD group)and 80 healthy subjects(control group)were selected at the same time.Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression of serum 14-3-3β and CC16.Multivariate Logistic regression analysis was used to analyze the factors of death in patients with COPD complicated with respiratory failure.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum 14-3-3β and CC16 expression on the death of patients with COPD complicated with respiratory failure.Results The expression of serum 14-3-3β in COPD complicated with respiratory failure group was higher than that in COPD group and control group(U=3.894,11.417),the expression of CC16 was lower than that in COPD group and control group(t=5.845,14.306),and the differences were statistically significant(all P<0.05),respectively.The expression of serum 14-3-3β in severe group was higher than that in moderate group and mild group(U=5.179,8.234),the expression of CC16 was lower than that of moderate group and mild group(t=4.090,9.281),and the differences were statistically significant(all P<0.05),respectively.The 28-day mortality rate of 232 COPD patients with respiratory failure was 31.47%(73/232).The expression of serum 14-3-3β in the death group was higher than that in the survival group,and the expression of CC16 was lower than that in the survival group,the differences were statistically significant(U/t=6.790,8.265,all P<0.05).The age of the death group was older than that of the survival group,the degree of airflow limitation and the number of acute exacerbations within 1 year were higher than those of the survival group,and the differences were statistically significant(t/χ2/U=3.895,7.202,3.360,all P<0.05).Age,severe airflow limitation,extremely severe airflow limitation,and the number of acute exacerbations within 1 year,elevated 14-3-3β were independent risk factors for death in patients with COPD complicated with respiratory failure(Wald χ2=3.914～22.668,all P<0.05),and elevated CC16 was an independent protective factor(Wald χ2=23.675,P<0.05).The area under the curve(AUC)of serum 14-3-3β combined and CC16 expression in predicting the death of patients with COPD complicated with respiratory failure which was greater than that of serum 14-3-3β and CC16 expression alone,the differences were statistically significant(Z=3.995,3.813,all P<0.01).Conclusion The increase of serum 14-3-3β expression and the decrease of CC16 expression in patients with COPD complicated by respiratory failure are closely related to the aggravation of the disease and poor prognosis.The combination of serum 14-3-3β and CC16 expression is of high value in predicting the death of patients with COPD complicated with respiratory failure.

With the aging and changes in living conditions,the incidence rate and mortality of tumors have been rising rapidly,which has become a hot topic in the medical field.At present,the treatment methods or tumors are also improving day by day,mainly relying on surgical resection.However,the characteristics of fast tumor metastasis and spread,as well as complex growth locations,make the surgical resection method limited.More and more people choose drug targeted therapy for tumors in order to reduce surgical side effects,among which cyclic guanosine monophosphate synthase interferon gene stimulatory factor(cGAS-STING signaling pathway)plays an important role in the occurrence,proliferation,and survival of tumor cells.At present,there are many types of drugs used to treat tumors,but most of them have limited control over tumor spread.In order to study the role of traditional Chinese medicine in tumor treatment and leverage its multi-component,multi target,and multi pathway characteristics,this article comprehensively analyzes and summarizes the treatment of tumors using traditional Chinese medicine based on the cGAS-STING signaling pathway in recent years,in order to further study the mechanism of action of traditional Chinese medicine and its active ingredients in the cGAS-STING signaling pathway,it also provides ideas for clinical research on new drugs.

ObjectiveTo investigate the role and possible mechanism of action of rhubarb decoction （RD） retention enema in improving inflammatory damage of brain tissue in a rat model of mild hepatic encephalopathy （MHE）. MethodsA total of 60 male Sprague-Dawley rats were divided into blank group （CON group with 6 rats） and chronic liver cirrhosis modeling group with 54 rats using the complete randomization method. After 12 weeks， 40 rats with successful modeling which were confirmed to meet the requirements for MHE model by the Morris water maze test were randomly divided into model group （MOD group）， lactulose group （LT group）， low-dose RD group （RD1 group）， middle-dose RD group （RD2 group）， and high-dose RD group （RD3 group）， with 8 rats in each group. The rats in the CON group and the MOD group were given retention enema with 2 mL of normal saline once a day； the rats in the LT group were given retention enema with 2 mL of lactulose at a dose of 22.5% once a day； the rats in the RD1， RD2， and RD3 groups were given retention enema with 2 mL RD at a dose of 2.5， 5.0， and 7.5 g/kg， respectively， once a day. After 10 days of treatment， the Morris water maze test was performed to analyze the spatial learning and memory abilities of rats. The rats were analyzed from the following aspects： behavioral status； the serum levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） and the level of blood ammonia； pathological changes of liver tissue and brain tissue； the mRNA and protein expression levels of phosphatidylinositol 3-kinase （PI3K）， protein kinase B （AKT）， and mammalian target of rapamycin （mTOR） in brain tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the MOD group， the RD1， RD2， and RD3 groups had a significantly shorter escape latency （all P<0.01）， significant reductions in the levels of ALT， AST， IL-1β， IL-6， TNF-α， and blood ammonia （all P<0.05）， significant alleviation of the degeneration， necrosis， and inflammation of hepatocytes and brain cells， and significant reductions in the mRNA and protein expression levels of PI3K， AKT， and mTOR in brain tissue （all P<0.05）， and the RD3 group had a better treatment outcome than the RD1 and RD2 groups. ConclusionRetention enema with RD can improve cognitive function and inflammatory damage of brain tissue in MHE rats， possibly by regulating the PI3K/AKT/mTOR signaling pathway.