OBJECTIVE: To review the research progress of pathological changes of glenohumeral capsule in patients with recurrent shoulder anterior dislocation (RSAD). METHODS: The literature on shoulder capsules, both domestic and international, was reviewed. The anatomy, histology, and molecular biology characteristics of the glenohumeral capsule in RSAD patients were summarized. RESULTS: Anatomically, the glenohumeral capsule is composed of four distinct parts: the upper, lower, anterior, and posterior sections. The thickness of these sections is uneven, and the stability of the capsule is further enhanced by the presence of the glenohumeral and coracohumeral ligaments. Histologically, the capsule tissue undergoes adaptive changes following RSAD, which improve its ability to withstand stretching and deformation. In the realm of molecular biology, genes associated with the regulation of structure formation, function, and extracellular matrix homeostasis of the shoulder capsule's collagen fibers exhibit varying degrees of expression changes. Specifically, the up-regulation of transforming growth factor β ₁ (TGF-β ₁), TGF-β receptor 1, lysyl oxidase, and procollagen-lysine, 2-oxoglutarate 5-dioxygenase 1 facilitates the repair of the joint capsule, thereby contributing to the maintenance of shoulder joint stability. Conversely, the up-regulation of collagen type Ⅰ alpha 1 (COL1A1), COL3A1, and COL5A1 is linked to the recurrence of shoulder anterior dislocation, as these changes reflect the joint capsule's response to dislocation. Additionally, the expressions of tenascin C and fibronectin 1 may play a role in the pathological processes occurring during the early stages of RSAD. CONCLUSION Glenohumeral capsular laxity is both a consequence of RSAD and a significant factor contributing to its recurrence. While numerous studies have documented alterations in the shoulder capsule following RSAD, further research is necessary to confirm the specific pathological anatomy, histological, and molecular biological changes involved.
Humans ; Joint Capsule/metabolism* ; Shoulder Dislocation/metabolism* ; Recurrence ; Shoulder Joint/metabolism* ; Tenascin/metabolism* ; Transforming Growth Factor beta1/genetics* ; Collagen Type I/genetics* ; Extracellular Matrix/metabolism*

Objective: To elucidate the potential mechanisms by which Chinese herbal medicine (CHM) regulates gut microbiota (GM) to influence the development of primary open-angle glaucoma (POAG). Methods: Data mining, network pharmacology, and Mendelian randomization (MR) analyses (two-sample design) were conducted in integration to systematically explore the CHM-GM-POAG axis. Literature-based data mining method was applied to identify frequently used herbs and herb pairs for POAG, and the properties and meridian tropism of the herbs were analyzed as well. Target prediction and pathway enrichment analyses were performed to identify shared molecular pathways among CHM components, GM, and POAG. MR analysis was performed to assess the genetically predicted causal associations between specific microbial taxa and POAG risk. Results: Our data mining work indicated that commonly used CHMs were mainly bitter and sweet in flavors and cold in property, with meridian tropism toward the liver, lung, and kidney. The predominant therapeutic effects of the CHMs included soothing the liver and regulating Qi, promoting blood circulation, and reducing fluid retention. Representative herb pairs were Shudihuang (Rehmanniae Radix Praeparata)-Gouqi (Lycii Fructus) with Zexie (Alismatis Rhizoma), Gouqi (Lycii Fructus)-Fuling (Poria) with Shudihuang (Rehmanniae Radix), and Juhua (Chrysanthemi Flos)-Gouqi (Lycii Fructus) with Zexie (Alismatis Rhizoma). Network pharmacology revealed overlapping targets involving antioxidative, anti-inflammatory, and metabolic regulation pathways. MR analysis demonstrated that higher abundances of Ruminiclostridium 6 [odds ratio (OR) = 0.73, 95% confidence interval (CI): 0.58 – 0.92, P = 0.007], Ruminococcaceae UCG-002 (OR = 0.77, 95% CI: 0.63 – 0.96, P = 0.018), Ruminococcus torques group (OR = 0.71, 95% CI: 0.57 – 0.90, P = 0.004), and Victivallis (OR = 0.82, 95% CI: 0.70 – 0.96, P = 0.016) were causally associated with reduced POAG risk, whereas Actinomyces (OR = 1.34, 95% CI: 1.06 – 1.68, P = 0.013) and Blautia (OR = 1.39, 95% CI: 1.01 – 1.90, P = 0.042) showed positive associations. Conclusion This study revealed potential causal links between GM and POAG and provided integrative evidence that CHM may modulate the microbiota to exert neuroprotective effects. These findings offer new integrative insights into the gut-eye axis and a theoretical basis for developing microbiota-targeted CHM strategies in glaucoma management.

At present,mechanical thrombectomy(MT)is the most effective means of achieving vascular recanalization in treating acute ischemic stroke(AIS)caused by large vessel occlusion.However,the monitoring and management of the patient's complications after MT has become a thorny clinical problem and it has attracted wide attention.Being of its non-invasive,flexible and quick diagnosis,and other advantages,the neurosonography has already established a perfect system in the evaluation and monitoring field of cerebral hemodynamic and structural pathology.With the innovation in technology and equipment,the guiding mode for non-invasive monitoring of intracranial pressure,autoregulation of cerebral blood flow,monitoring of intracranial hemorrhage and detection of other space-occupying lesions has been used for AIS patients,which has gradually become an important tool for the postoperative management of MT.This paper aims to make a comprehensive review about the application of neurosonography monitoring technology in AIS patients after MT,so as to provide a basis for the clinical implementation of prospective interventions,to enable AIS patients to obtain the maximum benefits from the postoperative management of MT,and to reduce the mortality of AIS patients.

ObjectiveTo assess the clinical efficacy and regulation of skin microbiota in children with atopic dermatitis and damp-heat accumulation syndrome treated by Zhaqu Xiaofeng Powder （楂曲消风散， ZXP）. MethodsNinety children were randomized into a treatment group and a control group， each with 45 children. The treatment group received ZXP orally， while the control group received levocetirizine hydrochloride syrup， both for 4 weeks. The atopic dermatitis severity index （SCORAD）score， visual analog scale （VAS）score for itching， children dermatology life quality index （CDLQI）score， and traditional Chinese medicine syndrome score were assessed before and after 2- and 4-week treatment. Simultaneously， adhering to the principles of sample size in microbial sequencing， 25 children were randomly selected from each group （total 50 children）； skin samples were collected before and after treatment， and skin specimen DNA was extracted for 16S rRNA gene amplifier sequencing； the skin microbiota levels were detected， and the distribution of bacteria， diversity of flora， and differences between groups were compared. ResultsThere were five drop-outs in each group， and 40 cases in each group were included in final analysis. After 2- and 4-week treatment， both groups showed a significant reduction in SCORAD scores， VAS scores， and CDLQI scores， and more reductions were shown after 4-week treatment than 2-week treatment （P＜0.01）. The SCORAD score， VAS score， and CDLQI score of the treatment group were significantly lower than those in the control group after 4-week treatment （P＜0.01）. The scores of upset， thirsty， poor appetite， short red urine， and dry stool were reduced in the treatment group （P＜0.05）， while the scores of thirsty， poor appetite， short and red urine decreased after treatment （P＜0.05）. After 4 weeks of treatment， among the differential genera with abundances ＞0.5% in the treatment group， The cumulative relative abundances of Staphylococcus aureus， Streptococcus_mitis， Escherichia coli and Gemella_haemolysans in the treatment group were downregulated after treatment； in the control group， there was a relative cumulative decrease in the abundance of Streptococcus_mitis. The control group had reduced relative abundance of Streptococcus_mitis， Escherichia coli， Staphylococcus aureus and Gemella_haemolysans， after treatment （P＜0.05）. Alpha diversity analysis revealed an increase in both Chaol index and Shannon index after treatment （P＜0.05）， while there was no significant difference in Chaol index and Shannon index in the control group before and after treatment （P＞0.05）. Higher Chaol index and Shannon index were found in the treatment group （P＜0.05）. Beta diversity analysis showed that there were significant differences in the microbial community structure at the lesion site between the treatment group and the control group before treatment. The microbial community structure in the treatment group was similar after treatment， while there was no significant change in the microbial community structure in the control group before and after treatment. There were significant structure differences of key bacteria genus in both groups before and after treatment. ConclusionZXP used in the treatment of pediatric atopic dermatitis （AD）with the syndrome of damp-heat accumulation， has shown efficacy in reducing the severity of skin lesions， alleviating itching， and enhancing the quality of life in children. This modulation aims to decrease the abundance of pathogenic bacteria while promoting the colonization of beneficial bacteria， thereby altering the skin microbiota and contributing to the treatment of pediatric AD.

OBJECTIVE: To screen the serum biomarkers in workers occupationally exposed to titanium dioxide nanoparticles(TiO_2 NPs) using metabolomics technology. METHODS: Using a typical sampling method, 56 workers who have occupationally exposed to TiO_(2 )in a TiO_2 NPs manufacturer were selected as the exposure group and 44 employees without occupational exposure to TiO_2 were selected as the control group. The high performance liquid chromatography-mass spectrometry technology was used to perform non-targeted metabolomics detection. The difference in serum metabolite profiles of the TiO_2 NPs exposure group and the control group were analyzed. Key differential metabolites and potential biomarkers were screened. The sensitivity and specificity of biomarkers were assessed through receiver operating characteristic(ROC) curve.RESULTS: We detected a total of 1 492 mass spectrum peaks in serum samples by serum metabolomics analysis, and 413 well-matched metabolites were obtained after annotation and identification. The results of principal component analysis and orthogonal partial least squares discriminant analysis showed that a total of 296 differentially expressed metabolites were found in the serum of individuals of the exposure group compared with the control group(all P<0.01). Among them the relative expression of metabolites increased in 265 species and decreased in 31 species. The ROC analysis results showed that the area under the ROC curve of five metabolites exceeded 0.900, and these metabolites included tanacetol A,(5 E)-2-hydroxy-4-oxobenzopenta-5-en-1-ylacetic acid, triterpene saponins organic compounds, 9,10,13-trihydroxystearic acid, and liquoric acid. The multiple linear regression analysis showed that the relative expression of all the five metabolites were positively correlated with occupational exposure to TiO_2 NPs after adjusting for the influence of confounding factors such as gender, age, body mass index, smoking and drinking(all P<0.01). CONCLUSION: Occupational exposure to TiO_2 NPs could induce changes in serum metabolite profiles. The metabolites represented by tanacetol A in serum can be used as potential biomarkers for indicating occupational exposure to TiO_2 NPs.

Objective: To understand cognitive flexibility among college students with childhood neglected experience, and to provide a thoretical basis and data reference for the study of cognitive characteristics of neglected people and its intervention. Methods: A total of 719 college students were surveyed using the Childhood Neglect Scale, and were screened through Childhood Neglect Scale. Wisconsin Card Sorting Test (WCST) and Verbal Fluency Test(VFT)were adminstered among those with childhood neglect to understand the responding flexibility and spontaneous flexibility. Results: The proportion of subjects with neglect experience was 43.74%. Boys,non-only children,students in rural areas neglect experience were higher(P<0.05). The neglect experience of childhood affects the individual’s response flexibility(t=2.22, P<0.05), as well as spontaneous flexibility(t=-2.17, P<0.05). Conclusion Childhood neglect experience has a negative impact on cognitive flexibility.

BACKGROUND: Catheter ablation is effective in restoring sinus rhythm and left atrial appendage closure (LAAC) is increasingly used for stroke prevention in patients with atrial fibrillation (AF). We aimed to observe the feasibility and safety of performing AF ablation and LAAC in a single (one-stop) procedure. METHODS: Consecutive AF patients who underwent the combined procedure of AF ablation and LAAC with WATCHMAN device between March 2017 and September 2018 were prospectively enrolled. Baseline and intra-procedural parameters were evaluated. Three-month and subsequent 1-year follow-up were performed in all and earlier-enrolled subjects, respectively. RESULTS: A total of 178 AF patients (94 males, 68.9 ± 8.1 years) underwent the one-stop procedure with CHA2DS2-VASc score 3.3 ± 1.5 and HAS-BLED score 1.6 ± 1.0, respectively. Pulmonary vein isolation was achieved in all patients while additional linear ablation was applied if the operator deemed necessary, yielding immediate ablation success rate of 98.9% (176/178). In the subsequent LAAC, satisfactory seal (residual leak <5 mm) was achieved in all patients. One stroke and four cardiac perforations occurred peri-operatively. At 3-month follow-up, sinus rhythm and satisfactory seal were maintained in 153/178 (86.0%) and 178/178 (100%) patients, respectively. One stroke and one delayed cardiac tamponade occurred, while no device-related thrombus or device migration was observed. During the 1-year follow-up for the earlier enrolled subjects, 52/72 (72.2%) of the patients maintained sinus rhythm. There was no stroke or systemic embolism observed. CONCLUSION Combining catheter ablation and LAAC in a single procedure can be successfully and safely performed in non-valvular AF patients of Chinese population.

Objective:To investigate the protective effect of Wutou Chishizhi Wan on myocardial ischemia reperfusion injury （MIRI） in rats， and observe its effect on such mechanisms as coagulation function， vascular endothelial cells and oxidative stress in rats. Method:A total of 40 SD rats were randomly divided into normal group， model group， positive drug group （Urokinase group） and Wutou Chishizhi Wan group， with 10 rats in each group. Except for the normal group， rat myocardial ischemia-reperfusion injury models were established. The changes of heart rate （HR） at 10 min before ischemia， 30 min after ischemia and 30， 60， 120 min （T₀，T₁，T₂，T₃，T₄）， and the change of electrocardiogram （ECG） J point after modeling in rats were observed. The pathological changes of rat myocardial tissue were observed by hematoxylin-eosin （HE） staining. The changes of four indexes of coagulation ［prothrombin time （PT）， activated partial thromboplastin time （APTT）， thrombin time （TT）， fibrinogen content decreased significantly （FIB）］ in rats were observed. The contents of endothelin-1 （ET-1）， thromboxane A₂ （TXA₂） and prostacyclin （PGI₂） in serum and myocardium levels of superoxide dismutase （SOD）， malondialdehyde （MDA） and glutathione peroxidase （GSH-Px） of MIRI rats were observed. Western blot assay was used for the detection of oxidative stress protein Keap1 and transcription factor-E2-related factor （Nrf2） expression levels in rat myocardial tissue. Result:Compared with the normal group， the ECG of MIRI rats showed significant myocardial ischemic injury-like changes， ST segment was significantly elevated， J point was significantly increased， and the incidences of HR in T₁， T₂， T₃ and T₄ were significantly reduced （P<0.05， P<0.01）. Compared with the model group， Wutou Chishizhi Wan significantly reduced ECG J-point changes in MIRI rats， while increased the incidence of HR in T₁， T₂， T₃ and T₄ （P<0.05， P<0.01）. Compared with the normal group， PT， APTT and TT in the model group were significantly shortened （P<0.01）， FIB content was significantly increased （P<0.01）， and the serum PGI₂ level decreased and TXA₂ and ET-1 levels increased significantly in the model group （P<0.01）. SOD content and GSH-Px activities of myocardial tissue in the model group were significantly reduced （P<0.01）， whereas the MDA content was increased （P<0.01）. Compared with the model group， PT of the Wutou Chishizhi Wan group was prolonged （P<0.05） and APTT slightly prolonged， TT significantly prolonged （P<0.01）， FIB content decreased （P<0.05）， serum PGI₂ increased （P<0.05）， TXA₂ and ET-1 decreased significantly in the Wutou Chishizhi Wan group （P<0.01）， myocardial MDA content decreased， and SOD content and GSP-Px activity increased significantly （P<0.01）. Meanwhile， the Wutou Chishizhi Wan group was able to activate the Keap1/Nrf2 signaling pathway， which significantly increased Nrf2 expression and significantly decreased Keap1 expression （P<0.01）. Conclusion:Wutou Chishizhi Wan group can protect myocardial injury in MIRI rats. The specific mechanism is to protect MIRI by regulating vascular endothelial cell homeostasis and oxidative stress levels and activating Keap1/Nrf2 signaling pathway.