This paper systematically reviews the core concepts and lines of theoretical inheritance of major spleen-stomach theories in traditional Chinese medicine （TCM）， including spleen deficiency theory， spleen-stomach damp-heat theory， and liver-spleen disharmony theory. It is found that these theories have all undergone a developmental trajectory characterized by classical foundation， refinement of therapeutic methods， systematization of pathogenesis， and modern innovation. The evolution of spleen-stomach theory has achieved a shift from a singular focus on tonifying the spleen to regulating dynamic middle-jiao （焦） balance， and from localized spleen-stomach regulation to the circular movement of qi involving all five zang organs. In terms of modern disease-syndrome integrative research， spleen deficiency syndrome is shown to be closely associated with impairment of the gastrointestinal mucosal barrier， metabolic disorders， and gene polymorphisms related to Helicobacter pylori-associated gastric diseases. Spleen-stomach damp-heat syndrome is closely linked to hyperactive energy metabolism， inflammatory cytokines， and abnormal expression of aquaporins. Liver-spleen disharmony syndrome is mainly associated with dysregulation of the brain-gut axis and microbiota-related metabolic disorders. It is proposed that future research on spleen-stomach diseases and syndromes should further elucidate their potential multidimensional differential biological characteristics， thereby promoting the modernization of the TCM discipline of spleen-stomach studies.

OBJECTIVE: To explore and quantify the association of hot night exposure during the sperm development period (0-90 lag days) with semen quality. METHODS: A total of 6,640 male sperm donors from 6 human sperm banks in China during 2014-2020 were recruited in this multicenter study. Two indices (i.e., hot night excess [HNE] and hot night duration [HND]) were used to estimate the heat intensity and duration during nighttime. Linear mixed models were used to examine the association between hot nights and semen quality parameters. RESULTS: The exposure-response relationship revealed that HNE and HND during 0-90 days before semen collection had a significantly inverse association with sperm motility. Specifically, a 1 °C increase in HNE was associated with decreased sperm progressive motility of 0.0090 (95% confidence interval [ CI]: -0.0147, -0.0033) and decreased total motility of 0.0094 (95% CI: -0.0160, -0.0029). HND was significantly associated with reduced sperm progressive motility and total motility of 0.0021 (95% CI: -0.0040, -0.0003) and 0.0023 (95% CI: -0.0043, -0.0002), respectively. Consistent results were observed at different temperature thresholds on hot nights. CONCLUSION Our findings highlight the need to mitigate nocturnal heat exposure during spermatogenesis to maintain optimal semen quality.
Humans ; Male ; Semen Analysis ; Adult ; Sperm Motility ; Hot Temperature/adverse effects* ; China ; Middle Aged ; Spermatozoa/physiology* ; Young Adult

OBJECTIVE: CRISPR-Cas protects bacteria from exogenous DNA invasion and is associated with bacterial biofilm formation and pathogenicity. METHODS: We analyzed the type I-F CRISPR-Cas system of Legionella pneumophila WX48, including Cas1, Cas2-Cas3, Csy1, Csy2, Csy3, and Cas6f, along with downstream CRISPR arrays. We explored the effects of the CRISPR-Cas system on the in vitro growth, biofilm-forming ability, and pathogenicity of L. pneumophila through constructing gene deletion mutants. RESULTS: The type I-F CRISPR-Cas system did not affect the in vitro growth of wild-type or mutant strains. The biofilm formation and intracellular proliferation of the mutant strains were weaker than those of the wild type owing to the regulation of type IV pili and Dot/Icm type IV secretion systems. In particular, Cas6f deletion strongly inhibited these processes. CONCLUSION The type I-F CRISPR-Cas system may reduce biofilm formation and intracellular proliferation in L. pneumophila.
Legionella pneumophila/pathogenicity* ; CRISPR-Cas Systems ; Biofilms/growth & development* ; Phenotype ; Bacterial Proteins/metabolism* ; Gene Deletion

Objective To investigate the efficacy of surface electromyography biofeedback combined with respiratory training on post-stroke dysphagia and its impacts on serum neuron specific enolase(NSE)and insulin-like growth factor 1(IGF-1)in patients.Methods Totally 120 patients with post-stroke dysphagia in our hospital were stochastically assigned into the control group and the combined group,with 60 patients in each group.Both groups were given conventional treatment first,while the control group received respiratory training treatment.The combined group received surface electromyography biofeedback treatment on the top of the control group.The efficacy,serum NSE,central nervous system specific protein(S100β),IGF-1,functional oral intake scale(FOIS)score,standard swallowing function assessment scale(SSA)score,respiratory function,pharyngeal contraction rate and duration of pharyngeal contraction were compared between the two groups.Results After treatment,the total effective rate was higher in the combined group(x2=4.876,P＜0.05).Compared with before treatment,NSE,S100β,SSA score and pharyngeal contraction rate decreased after treatment in both groups,and those were even lower in the combined group(t=5.193,9.000,8.976,10.614,P＜0.05).Compared with before treatment,IGF-1,FOIS score,force vital capacity(FVC),forced expiratory volume in one second(FEV1),peak expiratory flow rate(PEF)and duration of pharyngeal contraction increased after treatment in both groups,with even higher levels in the combined group(t=4.212,6.220,3.765,6.935,5.020,4.249,P＜0.05).Conclusion Surface electromyography biofeedback combined with respiratory training can improve neuronal damage in patients with dysphagia,enhance swallowing efficiency,reduce serum NSE,S100β levels and pharyngeal retention time,with significant curative effect.

Objective:To analyze the incidence of pregnancy complications and maternal-neonatal outcomes in women with a history of preconception metabolic and bariatric surgery (MBS).Methods:This study was a retrospective cohort study. Pregnant women with singleton pregnancy who delivered in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, from September 2019 to December 2024 were selected as the observation subjects. After propensity score matching, 42 women in the MBS group and 157 women in the control group were finally included. The general clinical characteristics, pregnancy status and maternal-neonatal outcomes of the two groups were compared and analyzed.Results:(1) There were no statistically significant differences in the age, proportion of preconception obesity, chronic hypertension, preconception diabetes and primipara between the MBS group and the control group (all P>0.05). The median interval between surgery and pregnancy of pregnant women in the MBS group was 14.0 months (6.0, 27.5 months). Twenty-nine pregnant women (69%, 29/42) were pregnant after 1 year of surgery, and 13 pregnant women (31%, 13/42) were pregnant within 1 year. (2) The levels of hemoglobin, serum iron and triglyceride in the MBS group were significantly lower than those in the control group in the second and third trimester (all P<0.05), but there were no statistically significant differences in the levels of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total cholesterol and albumin between the two groups (all P>0.05). (3) Compared with the control group, the incidence of gestational diabetes mellitus in MBS group [21.7% (34/157) vs 7.1% (3/42)] and the proportion of large for gestational age [23.6% (37/157) vs 2.4% (1/42)] were lower; the incidence of anemia [6.4% (10/157) vs 33.3% (14/42)], fetal growth restriction [7.0% (11/157) vs 23.8% (10/42)] and small for gestational age [3.8% (6/157) vs 19.0% (8/42)] were higher; the differences were statistically significant (all P<0.05). There were no significant differences in the cesarean section rate, premature rupture of membranes rate, postpartum hemorrhage ≥1 000 ml rate, gestational age at delivery and preterm birth rate between the two groups (all P>0.05). The neonatal birth weight of the MBS group was significantly lower than that of the control group [(3 044±523) vs (3 256±491) g, P=0.016], but the proportion of neonates with 1-minute Apgar score<7 and the rate of neonatal intensive care unit admission were not statistically significant (all P>0.05). Conclusions:Women who got pregnant after MBS had lower neonatal weight, decreased incidence of gestational diabetes mellitus and large for gestational age, but higher incidence of small for gestational age and anemia in late pregnancy. It is necessary to focus on the nutritional management of pregnant women with MBS before pregnancy, improve anemia, and strengthen the ultrasound follow-up of fetal growth to optimize the perinatal outcome.

Esophageal cancer is one of the most prevalent malignant tumors globally.Its clinical management is challenged by difficulties in early diagnosis,significant inter-individual variability in therapeutic efficacy,and high rates of tumor residuals and recurrence.Circulating tumor DNA(ctDNA),a novel liquid biopsy biomarker,reflects tumor burden and genetic characteristics.It offers advantages such as non-invasiveness,repeatability,and real-time dynamic monitoring,pro-viding a promising approach for precision diagnosis and treatment of esophageal cancer.In recent years,ctDNA has shown remarkable progress in the early detection,efficacy prediction,prognos-tic assessment,and monitoring of tumor residuals and recurrence in esophageal cancer,emerging as an essential tool in the clinical management of the disease.This review summarizes the latest advancements in ctDNA research in esophageal cancer,providing valuable insights and inspiration for future studies and clinical applications.

Eleutherococcus trifoliatus (Araliaceae) is called Baile or Lecai in China. E. trifoliatus is a medicinal and edible plant widely used in folk traditions. As a TCM, the dried herb of this species can remove damp heat and detoxicity, cure rheumatism, remove blood stasis, relieve pain, and alleviate cough and asthma symptoms. Many chemical compounds have been reported including diterpenoids, triterpenoids, phenylpropanoids, flavonoids, lignans, caffeoyl quinic acids, steroids, essential oils, etc., in which flavonoids, saponins, and caffeoyl quinic acids are the most bioactive components. In vitro and in vivo pharmacological experiments demonstrated that E. trifoliatus has anti-inflammatory, hypoglycemic, anticancer, antioxidant, antibacterial, anti-hyperalgesic, anti-fatigue, analgesic, and hemostatic effects. Here we reviewed E. trifoliatus in phytochemistry, analysis methods, and pharmacology.

Objective To investigate the fatigue and workload status among medical students,and to explore the latent profiles of fatigue and workload and their effects on sleep and emotion.Methods A cross-sectional study design with convenience sampling was employed to distribute a comprehensive survey via mixed online and offline modes,and medical college students were enrolled as the subjects for this investigation.The general demographic data,depression,anxiety and stress scale,Pittsburgh sleep quality index,Epworth sleepiness scale,insomnia severity index,National Aeronautics and Space Administration task load index(NASA-TLX)and fatigue scale-14(FS-14)were used to investigate the basic information of the medical students,their emotions(depression,anxiety and stress),sleep(sleep quality,sleepiness and insomnia),workload and fatigue status.Based on latent profile analysis,the types of workload-fatigue profiles and differences in sleep and emotion were analyzed.Results A total of 485 medical students were enrolled,with an average age of(22.07±2.42)years.The total score of the NASA-TLX was 64.44±12.50,and the total score of the FS-14 was 7.90±3.63.Latent profile analysis identified 3 distinct workload-fatigue profiles:low workload-medium fatigue group(12.8％),medium workload-low fatigue group(32.8％),and high workload-high fatigue group(54.4％).Among these,the medium workload-low fatigue group exhibited the highest performance level(all P＜0.05),while the low workload-medium fatigue group showed the lowest effort level and performance level(all P＜0.05).The high workload-high fatigue group showed the highest task-related demand and frustration level(all P＜0.05).Regarding sleep and emotional status,the medium workload-low fatigue group had significantly better outcomes compared to the high workload-high fatigue group and the low workload-medium fatigue group(all P＜0.05).Conclusion Medical students experience a heavy workload and subjective fatigue.It is essential to appropriately adjust their workload,prioritize sleep and emotional well-being,and alleviate fatigue levels,so as to sustain personal physical and mental health.

OBJECTIVE: To explore the expression and function of microRNA-144 (miR-144) in β-thalassemia (β-thal). METHODS: The expression of miR-144 during the differentiation of murine erythroleukemia (MEL) cells and mouse embryonic liver-derived erythroid precursor cells was analyzed by real-time fluorescence quantitative PCR (qRT-PCR); The expression levels of miR-144 in peripheral blood and day-14.5 embryonic hepatocytes of wild-type (WT) and β-thal mice, as well as the expression levels of miR-144 in peripheral blood of β-thal patients, was also measured by qRT-PCR. The proportion of Ter119 and CD71 double positive cells in peripheral blood of mild and severe β-thal mice was analyzed by flow cytometry, and the expression levels of miR-144 in the peripheral blood of mild and severe β-thal mice and patients were compared; Bone marrow nucleated erythrocytes from WT mice and β-thal mice were sorted and the expression levels of miR-144 potential target genes were analyzed by gene chip. RESULTS: The expression levels of miR-144 were gradually increased during the directed differentiation of mouse MEL cells and embryonic hepatocytes to the erythroid lineage (r _MEL=0.97, r _{embryonic hepatocytes}=0.86); Compared with WT mice, the expression levels of miR-144 in peripheral blood and 14.5-day embryonic hepatocytes of β-thal mice were significantly increased (P < 0.05); Compared with healthy controls, the patients with β-thal showed an increased expression levels of miR-144 in peripheral blood (P < 0.05). Compared with mice and humans with mild β-thal, the expression levels of miR-144 in peripheral blood of those with severe β-thal were significantly increased (P < 0.05). The expressions of potential target genes of miR-144 in nucleated erythroid cells of the β-thal mice were significantly reduced compared to the WT group. CONCLUSION The expression level of miR-144 gradually increases in erythroid development, and compared with mild β-thal patients, the expression level of miR-144 in the peripheral blood is higher in severe β-thal patients. MiR-144 is expected to be an auxiliary diagnostic indicator for β-thal in clinical practice.
MicroRNAs/metabolism* ; beta-Thalassemia/genetics* ; Animals ; Mice ; Humans ; Cell Differentiation ; Hepatocytes