Objective To explore the anti-inflammatory mechanism of Tong-Xie-Yao-Fang's intervention on irritable bowel syndrome with diarrhea(IBS-D),the effects of Tong-Xie-Yao-Fang on farnesol receptor(FXR),nuclear factor-κB(NF-κB)and inflammatory factors in IBS-D model rats were observed.Methods Healthy SD rats were randomly divided into blank group(Control group),model group(Model group),low-dose group of Tong-Xie-Yao-Fang(TXYF-L group,4.977 g/kg),middle-dose group of Tong-Xie-Yao-Fang(TXYF-M group,9.954 g/kg),and high-dose group of Tong-Xie-Yao-Fang(TXYF-H group,19.908 g/kg),Pivium bromide group(PWXA group,0.018 g/kg),with 10 rats in each group.Except for the blank group,the IBS-D rat models of liver depression and spleen deficiency were established by chronic restraint stress and senna intragastric administration.After the model was successfully established,the intervention was continued for 14 days according to the corresponding group treatment method.The general situation,diarrhea rate,fecal moisture content,water injection when abdominal wall retraction reflex reaches 3 scores,sugar water preference rate and serum D-xylose level were observed.The morphological and structural changes of rat colon were observed by HE staining.The expression of FXR gene in colon tissue was detected by real-time fluorescence quantitative PCR,the expression of FXR protein and NF-κB protein in colon tissue was detected by protein Western blot,and the levels of serum IL-6,IL-8 and TNF-α were detected by ELISA.Results After the treatment of Tong-Xie-Yao-Fang,the weight of each dosage group of Tong-Xie-Yao-Fang increased,the fecal water content decreased,the sugar water preference rate increased,the water injection volume increased when the rats reached the third grade of abdominal retraction reflex score,the serum D-xylose content increased and the food intake increased.HE staining showed that villous or finger-like structures appeared in the mucosal epithelium of model group,and inflammatory cells infiltrated in the upper mucosa.After treatment,the mucosal epithelium in TXYF-M group was smooth,villous or finger-like structures disappeared,and the infiltration degree of inflammatory cells decreased.Compared with the model group,the expression of FXR mRNA and FXR protein in the colon tissue of rats in the high-dose group of Tong-Xie-Yao-Fang increased significantly,while the concentration of IL-6,IL-8 and TNF-α in serum and the expression of NF-κB protein in the colon tissue of rats in the high-dose group of Tong-Xie-Yao-Fang decreased.Conclusion The mechanism of Tong-Xie-Yao-Fang in treating low-grade inflammation of IBS-D intestinal mucosa may be related to activating the expression of FXR in colon,inhibiting the expression of NF-κB in colon tissue,and then reducing the concentration of pro-inflammatory factors IL-6,IL-8 and TNF-α in serum.

Summary of nursing experience was conducted in a case of emergency liver transplantation during the second trimester of pregnancy complicated by acute liver failure.The key nursing points are as follows:preoperative participation in multidisciplinary discussions and emergency plan desktop exercises;preparation of preoperative equipment and supplies.Intraoperative fetal protection at critical stages,prevention and management of hyperkalemia,correction of coagulation function,maintenance of circulatory stability,implementing anticipatory surgical coordination to curtail operative duration,and prevention of perioperative hypothermia under a proactive nursing model.Through multidisciplinary team collaboration and meticulous nursing care,the patient recovered well 8 days postoperatively and successfully delivered a female infant via cesarean section.The patient was transferred back to the general ward 8 days after the cesarean section and was discharged 47 days postoperatively.Follow-up for over 2 months showed good recovery for both the patient and the infant.

Objective:To analyze the etiological characteristics, serotype distribution, drug resistance and molecular typing characteristics based on data collected by active surveillance of foodborne diseases in Shanxi Province from 2021 to 2022.Methods:Fecal and anal swabs for foodborne disease tests were collected from 17 sentinel hospitals in Shanxi Province from 2021 to 2022. The pathogens included Shigella, Salmonella, Vibrio parahaemolyticus and 5 types of diarrheagenic Escherichia coli ( E. coli). The positive strains were identified by mass spectrometry or systematic biochemistry. Salmonella and Shigella were serotyped by slide agglutination, and diarrheagenic E. coli was typed by multiplex fluorescence PCR. Vibrio parahaemolyticus was tested for tlh/ tdh/ trh virulence genes by multiplex fluorescent PCR. All strains were also tested for drug resistance by the microbroth dilution method. Molecular typing was performed by pulsed-field gel electrophoresis (PFGE). Results:A total of 4 481 samples were collected from patients with diarrhea, and 555 target strains were detected, with a detection rate of 12.39%(555/4 481). Among them, there were 365 strains of Salmonella, 175 strains of diarrheagenic E. coli, 15 strains of Vibrio parahaemolyticus, and no Shigella. There were 32 serotypes of Salmonella, and the dominant serotypes were 158 strains of Salmonella senteritidis and 124 strains of Salmonella typhimurium. diarrheagenic E. coli classification: 79 strains of enteroaggregative E. coli, 72 strains of enteropathogenic E. coli, 23 strains of enterotoxic E. coli, 1 strain of enterohemorrhagic E. coli, and none of enteroinvasive E. coli. For Vibrio parahaemolyticus virulence gene carriage, all strains carried tlh; 11 strains (73.33%, 11/15) carried tdh only; 2 strains (13.33%, 2/15) carried trh; 1 strain (6.67%, 1/15) carried both tdh and trh genes; 1 strain (6.67%, 1/15) did not carry these two virulence genes. Antimicrobial resistance tests presented that Salmonella had the highest resistance rate to ampicillin (85.21%, 311/365), followed by naphridic acid (66.58%, 243/365), and multi-drug resistance (78.63%, 287/365), resulting in 135 drug resistance spectrums. The resistance rate of diarrheagenic E. coli to ampicillin was the highest (81.71%, 143/175), followed by tetracycline (67.43%, 118/175), and multi-drug resistance (72.57%, 127/175), resulting in 81 drug resistance spectrums. Vibrio parahaemolyticus had the highest resistance rate to cefazolin (93.33%, 14/15), followed by tetracycline (26.67%, 4/15) and multi-drug resistance (20.00%, 3/15), resulting in 3 drug resistance spectrums. A total of 158 strains of Salmonella enteritidi, 124 strains of Salmonella typhimurium, 13 strains of Salmonella london and 175 strains of DEC were typed by PFGE. Among 470 strains of PFGE typing, 6 strains of DEC were degraded by DNA, while the remaining strains obtained effective PFGE band. Salmonella enteritidi were divided into 64 PFGE band types, Salmonella typhimurium were divided into 115 PFGE band types, Salmonella london were divided into 13 PFGE band types and diarrheagenic E. coli were divided into 165 PFGE band types. Conclusions:Shigella is not detected in the active surveillance, and Salmonella is detected most frequently. Salmonella and diarrheagenic E. coli have the highest resistance rates to ampicillin, and Vibrio parahaemolyticus has the highest resistance rates to cefazolin. The PFGE classification is polymorphic, and the dominant band type is not obvious. The evidence of multi-drug resistance suggests further strengthening monitoring and management of drug resistance.

AIM: To explore the efficacy of bilateral lateral rectus recession in the treatment of basic intermittent exotropia. METHODS: A prospective study was conducted on 104 patients with basic intermittent strabismus admitted to our hospital from October 2022 to October 2023, patients were randomly divided into a study group of 52 cases and a control group of 52 cases using a random number ranking method. The control group received unilateral recess-resect, while the study group received bilateral lateral rectus recession, the differences in surgical success rate, postoperative strabismus, and postoperative exotropia drift were compared between two groups.RESULTS: There was no statistically significant difference between the two groups at 1 d, 1, 3, and 6 mo after surgery(all P>0.05). The strabismus in the 6 m and 33 cm eye positions at 1, 3, and 6 mo after surgery were lower than those at 1 d after surgery(all P<0.05). However, there was no statistically significant difference in the strabismus in the 6 m and 33 cm eye positions between the two groups at 1 d, 1, 3, and 6 mo after surgery(all P>0.05), and there was statistical significant difference between the two groups in exotropia drift at different postoperative time points(all P<0.05). The exotropia drift of both groups increased at 3 and 6 mo after surgery compared to 1 mo after surgery, and the exotropia drift at 6 mo after surgery was greater than that at 3 mo after surgery(all P<0.05). However, the exotropia drift of the study group at 3 and 6 mo after surgery was lower than that of the control group(all P<0.001). CONCLUSION: Bilateral lateral rectus recession for the treatment of basic-type intermittent exotropia effectively reduces the amount of postoperative exotropia drift, and it has better long-term stability.

Objective:To investigate the effects and mechanism of very long chain acyl-CoA dehydrogenase(VLCAD)on prolifera-tion,invasion and metastasis of oral squamous cell carcinoma cells.Methods:The expression levels of VLCAD and glucose trans-porter 1(GLUT1)in human normal oral epithelial cell line(HOEC cells)and human oral squamous cell carcinoma line(SCC25 cells)were determined by Western blot,and the expression levels of VLCAD and GLUT1 in oral squamous cell carcinoma patients and their correlation with pathological stages and prognosis were analyzed in the TCGA database.SCC25 cell lines with VLCAD over-expression and knockdown were constructed and the expression level of VLCAD and GLUT1,cell proliferation,migration,invasion ability,lactate dehydrogenase content and lactate production level were detected respectively.Results:The expression level of VL-CAD in SCC25 cells was significantly lower than that in HOEC cells.The expression level of GLUT1 in SCC25 cells was significantly higher than that in HOEC cells.There was a significant negative correlation between the two expression levels(P＜0.05).VLCAD overexpression significantly inhibited GLUT1 expression and aerobic glycolysis in SCC25 cells,and also inhibited cell proliferation,migration and invasion.VLCAD knockdown effectively reversed the antitumor effects of overexpression mediated by VLCAD(P＜0.05).Conclusion:VLCAD inhibits proliferation,invasion,and metastasis of oral squamous cell carcinoma SCC25 cells by down-regulating GLUT1 and inhibiting its mediated aerobic glycolysis.

Objective:To investigate the effects and mechanism of very long chain acyl-CoA dehydrogenase(VLCAD)on prolifera-tion,invasion and metastasis of oral squamous cell carcinoma cells.Methods:The expression levels of VLCAD and glucose trans-porter 1(GLUT1)in human normal oral epithelial cell line(HOEC cells)and human oral squamous cell carcinoma line(SCC25 cells)were determined by Western blot,and the expression levels of VLCAD and GLUT1 in oral squamous cell carcinoma patients and their correlation with pathological stages and prognosis were analyzed in the TCGA database.SCC25 cell lines with VLCAD over-expression and knockdown were constructed and the expression level of VLCAD and GLUT1,cell proliferation,migration,invasion ability,lactate dehydrogenase content and lactate production level were detected respectively.Results:The expression level of VL-CAD in SCC25 cells was significantly lower than that in HOEC cells.The expression level of GLUT1 in SCC25 cells was significantly higher than that in HOEC cells.There was a significant negative correlation between the two expression levels(P＜0.05).VLCAD overexpression significantly inhibited GLUT1 expression and aerobic glycolysis in SCC25 cells,and also inhibited cell proliferation,migration and invasion.VLCAD knockdown effectively reversed the antitumor effects of overexpression mediated by VLCAD(P＜0.05).Conclusion:VLCAD inhibits proliferation,invasion,and metastasis of oral squamous cell carcinoma SCC25 cells by down-regulating GLUT1 and inhibiting its mediated aerobic glycolysis.

Objective To explore the anti-inflammatory mechanism of Tong-Xie-Yao-Fang's intervention on irritable bowel syndrome with diarrhea(IBS-D),the effects of Tong-Xie-Yao-Fang on farnesol receptor(FXR),nuclear factor-κB(NF-κB)and inflammatory factors in IBS-D model rats were observed.Methods Healthy SD rats were randomly divided into blank group(Control group),model group(Model group),low-dose group of Tong-Xie-Yao-Fang(TXYF-L group,4.977 g/kg),middle-dose group of Tong-Xie-Yao-Fang(TXYF-M group,9.954 g/kg),and high-dose group of Tong-Xie-Yao-Fang(TXYF-H group,19.908 g/kg),Pivium bromide group(PWXA group,0.018 g/kg),with 10 rats in each group.Except for the blank group,the IBS-D rat models of liver depression and spleen deficiency were established by chronic restraint stress and senna intragastric administration.After the model was successfully established,the intervention was continued for 14 days according to the corresponding group treatment method.The general situation,diarrhea rate,fecal moisture content,water injection when abdominal wall retraction reflex reaches 3 scores,sugar water preference rate and serum D-xylose level were observed.The morphological and structural changes of rat colon were observed by HE staining.The expression of FXR gene in colon tissue was detected by real-time fluorescence quantitative PCR,the expression of FXR protein and NF-κB protein in colon tissue was detected by protein Western blot,and the levels of serum IL-6,IL-8 and TNF-α were detected by ELISA.Results After the treatment of Tong-Xie-Yao-Fang,the weight of each dosage group of Tong-Xie-Yao-Fang increased,the fecal water content decreased,the sugar water preference rate increased,the water injection volume increased when the rats reached the third grade of abdominal retraction reflex score,the serum D-xylose content increased and the food intake increased.HE staining showed that villous or finger-like structures appeared in the mucosal epithelium of model group,and inflammatory cells infiltrated in the upper mucosa.After treatment,the mucosal epithelium in TXYF-M group was smooth,villous or finger-like structures disappeared,and the infiltration degree of inflammatory cells decreased.Compared with the model group,the expression of FXR mRNA and FXR protein in the colon tissue of rats in the high-dose group of Tong-Xie-Yao-Fang increased significantly,while the concentration of IL-6,IL-8 and TNF-α in serum and the expression of NF-κB protein in the colon tissue of rats in the high-dose group of Tong-Xie-Yao-Fang decreased.Conclusion The mechanism of Tong-Xie-Yao-Fang in treating low-grade inflammation of IBS-D intestinal mucosa may be related to activating the expression of FXR in colon,inhibiting the expression of NF-κB in colon tissue,and then reducing the concentration of pro-inflammatory factors IL-6,IL-8 and TNF-α in serum.

Summary of nursing experience was conducted in a case of emergency liver transplantation during the second trimester of pregnancy complicated by acute liver failure.The key nursing points are as follows:preoperative participation in multidisciplinary discussions and emergency plan desktop exercises;preparation of preoperative equipment and supplies.Intraoperative fetal protection at critical stages,prevention and management of hyperkalemia,correction of coagulation function,maintenance of circulatory stability,implementing anticipatory surgical coordination to curtail operative duration,and prevention of perioperative hypothermia under a proactive nursing model.Through multidisciplinary team collaboration and meticulous nursing care,the patient recovered well 8 days postoperatively and successfully delivered a female infant via cesarean section.The patient was transferred back to the general ward 8 days after the cesarean section and was discharged 47 days postoperatively.Follow-up for over 2 months showed good recovery for both the patient and the infant.

Objective:To analyze the etiological characteristics, serotype distribution, drug resistance and molecular typing characteristics based on data collected by active surveillance of foodborne diseases in Shanxi Province from 2021 to 2022.Methods:Fecal and anal swabs for foodborne disease tests were collected from 17 sentinel hospitals in Shanxi Province from 2021 to 2022. The pathogens included Shigella, Salmonella, Vibrio parahaemolyticus and 5 types of diarrheagenic Escherichia coli ( E. coli). The positive strains were identified by mass spectrometry or systematic biochemistry. Salmonella and Shigella were serotyped by slide agglutination, and diarrheagenic E. coli was typed by multiplex fluorescence PCR. Vibrio parahaemolyticus was tested for tlh/ tdh/ trh virulence genes by multiplex fluorescent PCR. All strains were also tested for drug resistance by the microbroth dilution method. Molecular typing was performed by pulsed-field gel electrophoresis (PFGE). Results:A total of 4 481 samples were collected from patients with diarrhea, and 555 target strains were detected, with a detection rate of 12.39%(555/4 481). Among them, there were 365 strains of Salmonella, 175 strains of diarrheagenic E. coli, 15 strains of Vibrio parahaemolyticus, and no Shigella. There were 32 serotypes of Salmonella, and the dominant serotypes were 158 strains of Salmonella senteritidis and 124 strains of Salmonella typhimurium. diarrheagenic E. coli classification: 79 strains of enteroaggregative E. coli, 72 strains of enteropathogenic E. coli, 23 strains of enterotoxic E. coli, 1 strain of enterohemorrhagic E. coli, and none of enteroinvasive E. coli. For Vibrio parahaemolyticus virulence gene carriage, all strains carried tlh; 11 strains (73.33%, 11/15) carried tdh only; 2 strains (13.33%, 2/15) carried trh; 1 strain (6.67%, 1/15) carried both tdh and trh genes; 1 strain (6.67%, 1/15) did not carry these two virulence genes. Antimicrobial resistance tests presented that Salmonella had the highest resistance rate to ampicillin (85.21%, 311/365), followed by naphridic acid (66.58%, 243/365), and multi-drug resistance (78.63%, 287/365), resulting in 135 drug resistance spectrums. The resistance rate of diarrheagenic E. coli to ampicillin was the highest (81.71%, 143/175), followed by tetracycline (67.43%, 118/175), and multi-drug resistance (72.57%, 127/175), resulting in 81 drug resistance spectrums. Vibrio parahaemolyticus had the highest resistance rate to cefazolin (93.33%, 14/15), followed by tetracycline (26.67%, 4/15) and multi-drug resistance (20.00%, 3/15), resulting in 3 drug resistance spectrums. A total of 158 strains of Salmonella enteritidi, 124 strains of Salmonella typhimurium, 13 strains of Salmonella london and 175 strains of DEC were typed by PFGE. Among 470 strains of PFGE typing, 6 strains of DEC were degraded by DNA, while the remaining strains obtained effective PFGE band. Salmonella enteritidi were divided into 64 PFGE band types, Salmonella typhimurium were divided into 115 PFGE band types, Salmonella london were divided into 13 PFGE band types and diarrheagenic E. coli were divided into 165 PFGE band types. Conclusions:Shigella is not detected in the active surveillance, and Salmonella is detected most frequently. Salmonella and diarrheagenic E. coli have the highest resistance rates to ampicillin, and Vibrio parahaemolyticus has the highest resistance rates to cefazolin. The PFGE classification is polymorphic, and the dominant band type is not obvious. The evidence of multi-drug resistance suggests further strengthening monitoring and management of drug resistance.

Objective To address the challenges of poor performance and lack of interpretability in existing models,the SHAP algorithm is used to develop an interpretable machine learning model that offers a novel approach to wound age estimation,Methods Based on the previous discovery of the expression of 35 wound age healing-related genes in contused skeletal muscle,the woun age estimaton model was constructed using four algorithms,namly,Multilayer Perceptron(MLP),Random Forest(RF),LightGBM(LGBM),and Support Vector Machine(SVM).The SHAP(Shapley Additive Explanation)algorithm was used to rank the importance of genetic features,eliminate redundant attributes,and optimize the model for accurate wound age estimation.the genetic features of the optimal model were analyzed using SHAP's local interpretation capabilities.Results The best results were obtained using model of MLP(area under the curve(AUC)=0.99)The wound ages were classified into four categories:4～12 h,16～24 h,28～36 h,and 40～48 h,using only 15 gene features.According to SHAP analysis,Fam210a was identified as the most relevant gene.Local analysis revealed that high expression of Fam210a contributed to an increase in the predicted probability of 4 h～12 h,while high expression of Rae1 contributed to an increase in the predicted probability of 16 h～24 h.Additionally,low expression of Tbx18 contributed to an increase in the predicted probability of 28 h～36 h,whereas high expression of Tbx18 contributed to an increase in the predicted probability of 40 h～48 h.Conclusions The combined MLP and SHAP model can be used to predict wound age.Using the SHAP interpreter can better understand the degree of contribution of feature genes to the model prediction,and lay the foundation for further in-depth study of wound age estimation.