ObjectiveTo explore the relationship between acne vulgaris and gut microbiota. MethodsA total of 29 clinical cases diagnosed with moderate-to-severe acne vulgaris and 26 healthy individuals as control subjects were recruited. Fecal specimens were collected from all participants， and further analysis of gut microbial communities was performed by leveraging high-throughput sequencing techniques that target the hypervariable regions of 16S rRNA genes. ResultsAssociations between acne vulgaris and alterations in gut microbiota were identified. At the phylum level， the relative abundance of Bacteroidota exhibited a statistically significant elevation in the acne vulgaris cohort when compared with the healthy control group （P<0.01）， while Cyanobacteria was significantly lower in the acne group （P<0.01）. At the genus level， the top five different bacterial taxa in both groups were Bacteroides， Escherichia⁃Shigella， Klebsiella， Roseburia， and Parabacteroides. Among them， Bacteroides， Roseburia， and Parabacteroides were more abundant in acne patients. Linear discriminant analysis identified five biomarkers all belonging to the Bacteroidota phylum in the acne and control groups. These biomarkers belong to the phylum Bacteroidetes. ConclusionThere are significant differences in the composition of intestinal microbiota between acne patients and healthy people. Changes in the richness of specific bacterial genera may become new targets for the diagnosis and treatment of acne.

Objective: To explore the correlation of balance ability with short term memory and executive function among college students, so as to provide a theoretical basis for balance training and cognitive enhancement in college students. Methods: In November 2024, 80 college students were recruited from Chongqing Normal University. The dynamic and static balance abilities were measured using the Y-balance test(YBT) and PhysioSensing equipment. Short term memory and executive function were assessed through the digital span test, trail making test(TMT) and Stroop colour-word task. Pearson or Spearman analysis was used to explore the correlation between balance ability and cognitive function among college students. Results: The comprehensive scores of the balance YBT for college students were as follows: left side (95.14±5.93)% and right side (95.17±5.24)%.The average sway velocity of static balance under the conditions of stable surface with eyes open, stable surface with eyes closed, unstable surface with eyes open and unstable surface with eyes closed were 27.58(20.45, 37.64), 23.56(17.57, 34.77), 61.15(40.73, 78.05), 55.88 (40.84, 66.65)mm/s. The comprehensive scores of the YBT for both lower limbs in college students were negatively correlated with the time taken for TMT Part A (TMT-A), TMT Part B (TMT-B), and the difference in time spent between TMT-A and TMT-B (TMT-D) ( r =-0.55 to -0.24，all P <0.05). The average sway velocity under the four conditions was positively correlated with TMT-A, TMT-B, TMT-D, consistent reaction time, conflict reaction time and reaction time difference ( r =0.26-0.69，all P < 0.05). Under conditions of normal vestibular sensation with proprioception interference, the visual contribution in college students was negatively correlated with TMT-A, TMT-B, conflict reaction time and reaction time difference ( r =-0.28 to -0.22,all P < 0.05 ). Under conditions of normal vision and vestibular sensation, the proprioception contribution in college students was positively correlated with TMT-A, TMT-B, consistent reaction time, conflict reaction time and reaction time difference( r =0.26-0.39,all P < 0.05). Under conditions of normal vestibular sensation with visual interference, the proprioception contribution in college students was positively correlated with consistent reaction time and conflict reaction time ( r =0.24, 0.25,both P <0.05). Conclusions There is a correlation between balance ability and executive function in college students. When maintaining static balance, if the visual or proprioceptive system is interfered with, college students with poorer executive function rely more on other systems for compensation.

Objective To construct large medical model named by "Huaxi HongYi"and explore its application effectiveness in assisting medical record generation. Methods By the way of a full-chain medical large model construction paradigm of "data annotation - model training - scenario incubation", through strategies such as multimodal data fusion, domain adaptation training, and localization of hardware adaptation, "Huaxi HongYi" with 72 billion parameters was constructed. Combined with technologies such as speech recognition, knowledge graphs, and reinforcement learning, an application system for assisting in the generation of medical records was developed. Results Taking the assisted generation of discharge records as an example, in the pilot department, after using the application system, the average completion times of writing a medical records shortened (21 min vs. 5 min) with efficiency increased by 3.2 time, the accuracy rate of the model output reached 92.4%. Conclusion It is feasible for medical institutions to build independently controllable medical large models and incubate various applications based on these models, providing a reference pathway for artificial intelligence development in similar institutions.

Objective To design and synthesize derivatives of oleanolic acid and ursolic acid, and investigate their anti-hepatitis C virus （HCV） activity along with that of common triterpenoid acids. To explore the structure-activity relationship and provide a reference for the research of anti-HCV drugs derived from natural products through obtaining compounds with higher activity. Methods Oleanolic acid and ursolic acid were directly reacted with corresponding amines using PyBOP as a condensing agent in the presence of DIEA. Alternatively, the target compounds were prepared through PCC oxidation followed by the Baeyer-Villiger reaction catalyzed by m-CPBA. In vitro anti-HCV activity was tested using the HCVcc infection model. Molecular docking was performed by Autodock software to investigate the interaction between the active compounds and HCV NS5B. Results Oleanolic acid, glycyrrhetinic acid, ursolic acid, and asiatic acid all exhibited certain anti-HCV effects. Specifically, oleanolic acid derivatives OA2-OA4, OA6, and OA7, as well as ursolic acid derivatives UA1 and UA2, demonstrated superior anti-HCV activity compared to their parent compounds. Preliminary structure-activity relationship analysis revealed that introducing a bulky group to 28-COOH of oleanolic acid and ursolic acid enhanced their activity. Molecular docking results demonstrated that the active compounds could stably bind to HCV NS5B, thereby exhibiting antiviral activity. Conclusion Pentacyclic triterpenoids possessed anti-HCV effects, and their derivatives coud be synthesized to obtain more active compounds. The anti-HCV mechanism of these compounds may be associated with their inhibition of NS5B.

Enhanced recovery after surgery (ERAS) is a series of perioperative optimization measures based on evidence-based medicine aimed at achieving rapid recovery. Existing studies have shown that ERAS can effectively reduce surgical stress, decrease the incidence of complications, shorten hospital stays, save medical costs, and improve patient satisfaction. Although lung transplantation techniques have become increasingly mature, lung transplant recipients still have a high incidence of complications during perioperative period. To further improve the perioperative survival rate of lung transplant recipients, introducing ERAS concept into the perioperative management strategy of lung transplantation is of great significance for reducing incidence of perioperative complications, promoting rapid recovery and long-term survival of lung transplant recipients. This article discusses the advances in application of ERAS concept in the perioperative management of lung transplantation, aiming to provide references for optimizing the perioperative management of lung transplant recipients and reducing perioperative complications.

Objective To investigate the effects of γ-glutamyl hydrolase(GGH)rs11545078 C＞T polymorphisms on serum concentrations,chemotherapy toxicities of methotrexate(MTX),and prognosis in children with intracranial tumors.Methods Peripheral blood samples were obtained from children with intracranial tumors to extract genome DNA.Matrix-assisted laser desorption/ionization-time of flight mass spectrometry was used to detect the genotypes of GGH rs11545078 C＞T polymorphisms.Fluorescence polarization immunoassay was employed to determine the serum concentrations of MTX.The incidences of toxicities,relapse,and metastasis were recorded after chemotherapy with MTX.The associations of GGH rs11545078 C＞T polymorphisms with concentration-to-dose ratios(C/D ratios),chemotherapy toxicities of MTX,relapse,and metastasis of tumors were analyzed.Results A total of 75 children were included in the present study.The frequencies of rs11545078 CC and CT genotypes were 82.67％and 17.33％,respectively.The frequencies of C and T alleles were 91.33％and 8.67％,respectively.There were no statistically significant differences for these frequencies among the children with intracranial tumors,the children with acute lymphoblastic leukemia,and the health population in Beijing.Children with the CC genotype had higher median C/D ratios of MTX in 24 and 42 h(25.19 and 0.14 μmol·L-1 per g·m-2,respectively),higher metastasis rates(46.77％),and lower relapse rates(17.74％)than those in CT genotype carriers(22.01 and 0.11 μmol·L-1 per g·m-2,38.46％,and 30.77％,respectively),and the differences were no statistically significant(all P＞0.05).The incidences of gastrointestinal disorders(76.92％)in children with the CT genotype were significantly higher than those in CC genotype carriers(45.16％,P＜0.05).There were no statistically significant differences in the incidences of other adverse events between patients with the CC genotype and patients with the CT genotype(all P＞0.05).Conclusion GGH rs11545078 CT might be a risk factor for gastrointestinal disorders in children with intracranial tumors treated with MTX.

Objective:To explore the factors influencing employment among spinal cord injury(SCI)patients in the com-munity and construct an employment prediction model to provide scientific evidence for policymakers,health-care professionals,and social service agencies,aiming to improve the employment status and quality of life of SCI patients.Method:Using a multi-stage stratified cluster random sampling method,we recruited 809 eligible SCI patients in community rehabilitation from 18 hospitals in Jiangsu Province and 10 hospitals in Sichuan Province.We used the Least Absolute Shrinkage and Selection Operator(LASSO)model to screen factors and constructed a logistic regression model to analyze the factors influencing employment rates among individuals with SCI patients in community rehabilitation.We then performed internal validation.Result:Age(OR=0.96,95%CI:0.94-0.97),mental health score(OR=1.27,95%CI:1.10-1.47),self-perceived health score(OR=1.45,95%CI:1.14-1.87),and the number of environmental barriers(OR=0.74,95%CI:0.68-0.80)significantly influenced employment among SCI patients in community rehabilitation.The predictive perfor-mance of the logistic regression model was good,with an area under the receiver operating characteristic curve(AUC)of 0.864,a sensitivity of 72.39%,and a specificity of 88.53%.The nomogram drawn can facilitate the employment probability assessment for SCI patients in the community.Conclusion:The employment rate of SCI patients in community rehabilitation is relatively low.Influencing fac-tors such as age,years of education,family income,mental health scores,self-perceived health scores,and the number of environmental barriers can effectively predict the employment probability of SCI patients in com-munity rehabilitation.

Epilepsy is a chronic neurological disorder caused by an imbalance between excitation and inhibition in the central nervous system.Recently,the role of the orexin system in the pathogenesis of epilepsy has garnered significant attention.Orex-in primarily regulates arousal states and enhances neuronal excit-ability through activation of OX1-R/OX2-R receptors.Studies have shown that elevated orexin levels lower the seizure thresh-old,while orexin receptor antagonists(ORAs)exhibit potential antiepileptic effects.ORAs suppress epileptiform discharges by reducing glutamate release,enhancing GABAergic inhibitory effects,and modulating the thalamocortical circuit.Animal ex-periments and preliminary clinical studies demonstrate that OX1R antagonists decrease excitatory synaptic transmission,whereas OX2 R antagonists primarily strengthen GABA-mediated inhibition.With the widespread application of ORAs in sleep disorders,exploring their clinical value as antiepileptic drugs will become a key focus for future research.This review summa-rizes the role of the orexin system in epileptogenesis and discus-ses the research progress and future directions of ORAs as poten-tial antiepileptic agents.

Objective:To explore the factors influencing employment among spinal cord injury(SCI)patients in the com-munity and construct an employment prediction model to provide scientific evidence for policymakers,health-care professionals,and social service agencies,aiming to improve the employment status and quality of life of SCI patients.Method:Using a multi-stage stratified cluster random sampling method,we recruited 809 eligible SCI patients in community rehabilitation from 18 hospitals in Jiangsu Province and 10 hospitals in Sichuan Province.We used the Least Absolute Shrinkage and Selection Operator(LASSO)model to screen factors and constructed a logistic regression model to analyze the factors influencing employment rates among individuals with SCI patients in community rehabilitation.We then performed internal validation.Result:Age(OR=0.96,95%CI:0.94-0.97),mental health score(OR=1.27,95%CI:1.10-1.47),self-perceived health score(OR=1.45,95%CI:1.14-1.87),and the number of environmental barriers(OR=0.74,95%CI:0.68-0.80)significantly influenced employment among SCI patients in community rehabilitation.The predictive perfor-mance of the logistic regression model was good,with an area under the receiver operating characteristic curve(AUC)of 0.864,a sensitivity of 72.39%,and a specificity of 88.53%.The nomogram drawn can facilitate the employment probability assessment for SCI patients in the community.Conclusion:The employment rate of SCI patients in community rehabilitation is relatively low.Influencing fac-tors such as age,years of education,family income,mental health scores,self-perceived health scores,and the number of environmental barriers can effectively predict the employment probability of SCI patients in com-munity rehabilitation.

Objective To investigate the feasibility and safety of transoral transgastric natural orifice transluminal endoscopic surgery(TG-NOTES)cholecystectomy in miniature pigs.Methods A total of 11 miniature pigs were selected as the experimental subjects and underwent TG-NOTES cholecystectomy.These pigs were divided into the Group A and Group B according to the surgical procedures.Among them,7 miniature pigs in the Group A underwent endoscopic cholecystectomy without dissecting the gallbladder triangle,while 4 miniature pigs in the Group B underwent endoscopic cholecystectomy after dissecting the gallbladder triangle.The success rate of surgery,the time of each stage of surgery,the incidence of complications,the success rate of cholecystectomy and the survival rate of miniature pigs in the two groups were counted.One miniature pig in the Group A and 4 miniature pigs in the Group B were selected for survival experiments.After surviving for 1 week,they were killed and dissected to observe the healing of incision and incidence of complications.Results The surgical survival rate of experimental animals was 100%,and the success rate of cholecystectomy was 100%.There was no significant difference in the surgical time,time of cut the stomach into the abdomen,time of gallbladder exploration or time of gallbladder removal of miniature pigs between the two groups(P>0.05).The time of ligating gallbladder artery of miniature pigs in the Group B was longer than that in the Group A,and the time of isdating gallbladder was shorter than that in the Group A,with statistically significant differences(P<0.05).There was no significant difference in the average number of complications of miniature pigs between the two groups(P>0.05).The dissection of animals after survival experiments revealed that the incisions healed well without serious complications.Conclusion This study successfully establishes the surgical model of TG-NOTES cholecystectomy,and confirms the safety and feasibility of TG-NOTES cholecystectomy.