The brain-gut interaction theory is a multidimensional integrative concept based on the brain-gut axis， involving neural， endocrine， and immune regulatory networks as well as the gut microbiota. Zang-fu organs （脏腑） theory in traditional Chinese medicine （TCM） shows a high degree of consistency with the brain-gut interaction theory， and the core functions such as the spleen and stomach governing the ascending of the clear and descending of the turbid， the liver governing the free flow of qi， and the heart governing mental and emotional activities are closely associated with the multi-level regulatory mechanisms of the brain-gut axis. TCM therapy can modulate brain-gut interactions through multiple pathways in the treatment of spleen and stomach diseases， including the regulation of gastrointestinal hormone secretion， neurotransmitter levels， the hypothalamic-pituitary-adrenal （HPA） axis， immune homeostasis and inflammatory responses， as well as the gut microecology. However， current basic research on the brain-gut interaction theory in TCM for spleen and stomach diseases still faces several challenges， such as difficulties in integrating TCM spleen-stomach theory with modern pathophysiology， lack of innovation in research concepts， and limitations in research methodologies. It is therefore proposed that multidisciplinary collaboration， multi-omics technologies， and targeted research approaches should be adopted to provide more comprehensive methods for basic research on TCM spleen and stomach diseases， thereby promoting the in-depth development of brain-gut interaction theory.

BACKGROUND:Macrophage migration inhibitory factor(MIF)is a pleiotropic cytokine,which is secreted in different types of stem cells and can regulate the proliferation,differentiation and migration of various types of stem cells.Our previous research has confirmed that human embryonic stem cells secrete MIF and that its concentration in the culture medium is relatively stable.However,whether MIF is involved in the survival,proliferation and differentiation of human embryonic stem cells remains unclear. OBJECTIVE:To investigate the effects of MIF on survival,proliferation,and differentiation of human embryonic stem cells. METHODS:(1)Human embryonic stem cells H9 were cultured.The growth curve of cells was detected and plotted by CCK-8 assay.Enzyme-linked immunosorbent assay was used to determine the level of MIF in the medium.(2)To determine the effects of exogenous MIF on the survival and proliferation of human embryonic stem cells,different groups were established:the control group,which was cultured in stem cell medium without any modifications;the exogenous MIF group,which was treated with different concentrations(30,100,300 ng/mL)of MIF in the stem cell medium;the MIF inhibitor ISO-1 group,which was treated with different concentrations(2,7,21 μmol/L)of ISO-1 in the stem cell medium;and the MIF+ISO-1 group,which was treated with different concentrations of ISO-1 along with 100 ng/mL of MIF.Cell viability was assessed using the CCK-8 assay.(3)To further elucidate the effect of MIF gene on survival and proliferation of human embryonic stem cell,the MIF knockout H9 cell line was constructed by CRISPR-Cas 9 technology to observe the lineage establishment.(4)To determine the effect of high concentrations of MIF on human embryonic stem cell differentiation,100 ng/mL MIF and 100 ng/mL of CXCR4 neutralizing antibody were separately added to the normal stem cell culture medium.The expression levels of self-renewal factors(KLF4,c-MYC,NANOG,OCT4,and SOX2)and differentiation transcription factors(FOXA2,OTX2)were measured using real-time quantitative polymerase chain reaction,immunofluorescence staining,and western blot analysis. RESULTS AND CONCLUSION:(1)The logarithmic growth phase of H9 cells was between 3-6 days.Under normal growth conditions,human embryonic stem cells secreted MIF at a concentration of approximately 20 ng/mL,independent of cell quantity.(2)Compared to the control group,the addition of different concentrations of MIF had no effect on the proliferation of human embryonic stem cells(P>0.05).ISO-1 significantly inhibited the proliferation of human embryonic stem cells,with a stronger inhibition observed at higher concentrations of ISO-1(P<0.05).The addition of MIF in the presence of ISO-1 reduced the inhibitory effect of ISO-1(P<0.05).(3)Real-time quantitative polymerase chain reaction showed that knocking out 50%of the MIF gene resulted in a significant decrease in the growth vitality of human embryonic stem cells and failure to establish cell lines.(4)Adding 100 ng/mL exogenous MIF to the culture medium resulted in a decrease in the mRNA,protein,and fluorescence expression levels of the self-renewal transcription factor KLF4,while the mRNA,protein,and fluorescence expression levels of the differentiation factor FOXA2 increased.(5)When 100 ng/mL CXCR4 neutralizing antibody was added to the culture medium,the mRNA and protein expression levels of KLF4 increased,while the mRNA and protein expression levels of FOXA2 decreased,contrary to the expression trend observed in the MIF group.In conclusion,the endogenous secretion of MIF by human embryonic stem cells is essential for their survival.The addition of MIF to the culture medium does not promote the proliferation of human embryonic stem cells.However,it can lead to a decrease in the expression of the self-renewal factor KLF4 and an increase in the expression of the transcription factor FOXA2.This provides a clue for further investigation into the effects and mechanisms of MIF on the differentiation of human embryonic stem cells.The MIF-CXCR4 axis plays a regulatory role in this process.

Objective:To systematically evaluate the psychological experiences of adolescent patients with inflammatory bowel disease.Methods:A computer-based search was conducted in PubMed, CINAHL, APA PsycNet, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative studies on the psychological experiences of adolescent patients with inflammatory bowel disease. The search covered publications from the inception of the databases to August 2024. The quality of the studies was assessed using the qualitative research quality standards from the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia. Meta-synthesis methods were used to synthesize and analyze the results.Results:A total of 12 articles were included, and similar findings were grouped into eight new categories. Three integrated results were derived: persistent physical and mental distress, diminished social participation, and multiple coping strategies with dual hopes.Conclusions:This Meta-synthesis study provides an in-depth interpretation of the psychological experiences of adolescent patients with inflammatory bowel disease. The findings suggest the need to alleviate gastrointestinal symptoms, reduce disease-related stigma, increase social participation, enhance family-school-social support, and establish multidisciplinary teams for effective disease management.

Objective:To understand the status of bone health literacy in middle-aged and older female breast cancer patients undergoing chemotherapy and analyze its influencing factors using structural equation modeling.Methods:A convenience sampling method was used to select 250 middle-aged and older breast cancer patients undergoing chemotherapy in two tertiary hospitals in Xi'an from May to October 2024. Patients were surveyed using a general information questionnaire, the Bone Health Literacy Scale for Middle-Aged and Older Women, the Perceived Social Support Scale, and the General Self-Efficacy Scale. Pearson correlation analysis was used to examine the correlations among bone health literacy, perceived social support, and self-efficacy.Results:A total of 250 questionnaires were distributed, and 239 valid questionnaires were recovered, yielding an effective response rate of 95.6% (239/250). The mean score of the Bone Health Literacy Scale among the 239 patients was (39.71±8.16). Bone health literacy was positively correlated with perceived social support and self-efficacy ( P<0.01). Perceived social support directly affected bone health literacy and could also indirectly influence it through general self-efficacy, with an indirect effect value of 0.367, accounting for 45.2% of the total effect (0.367/0.812) . Conclusions:Healthcare professionals should implement effective interventions to enhance patients' perceived social support and strengthen their self-efficacy, thereby improving bone health literacy.

Objective:To establish a solvent elution-liquid chromatography method for the determination of trichloroaniline concentration in the air of the workplace.Methods:From December 2023 to January 2024, 2, 4, 5-trichloroaniline, 2, 4, 6-trichloroaniline, and 3, 4, 5-trichloroaniline in the air were collected using glass fiber filter membranes. After elution with acetonitrile and filtration with a 0.22 μm mixed cellulose filter membrane, isometric elution with acetonitrile and water (volume ratio 55∶45) was performed using a C8 column (250 mm×4.6 mm×5 μm) , and detection was carried out using a photo-diode array (PDA) detector. The detection limit, precision and other indicators of the method were analyzed.Results:The separation and determination of trichloroaniline isomers were completed within 9 minutes by the solvent elution-liquid chromatography method. The linear range was 0.1-30 μg/ml, the detection limit of the method was 0.005 μg/ml, the recoveries were 88%-98%, and the relative standard deviation was 0.3%-3.2%.Conclusion:The solvent elution-liquid chromatography method for the determination of trichloroaniline is simple and efficient. Both the recovery and precision meet the standard requirements for the determination of toxic substances in the workplace, and it is suitable for the detection of trichloroaniline in the workplace.

Objective:To explore the clinical and genetic characteristics of X-linked intellectual disability associated with HUWE1 gene variants.Methods:A cases series study retrospectively analyzed the clinical data of 6 children with HUWE1 gene variants. The children were identified from the Third Affiliated Hospital of Zhengzhou University, the First Affiliated Hospital of Zhengzhou University, the First Affiliated Hospital of Henan University of Chinese Medicine, and Guangzhou Women and Children′s Medical Center of Guangzhou Medical University between April 2021 and July 2023.The data included sex, age, dysmorphic features, intellectual and motor development, seizure history, neuroimaging findings, family history, and genetic results was analyzed.Results:A total of 6 children, including 5 boys and 1 girl. The age of onset ranged from 1 day to 3 years. All children presented with varying degrees of intellectual disability, with or without motor developmental delay. Dysmorphic features were observed in 4 children, including microcephaly in 3 children. Short stature were observed in 3 children. One child was diagnosed with autism spectrum disorders and 1 child had seizures. Two boys had relevant maternal family histories of febrile seizures and mild intellectual disability, respectively. Abnormal neuroimaging findings were presented in 4 children, including cerebral dysplasia (1 child), prominent supratentorial ventricles (1 child), and mild white matter demyelination (2 children). Whole-exome sequencing identified 5 missense variants and 1 in-frame deletion variant. Five variants were novel and previously unreported (c.12290C>T, c.12701T>C, c.9875C>T, c.9641A>T and c.10313_10315del). The variants in 4 boys were maternally inherited, while the remaining 2 children had de novo variants. The child with the in-frame deletion variant (c.10313_10315del) presented with the most severe phenotype, exhibiting symptoms from 1 day of age, absent cognitive development, feeding difficulties, and congenital laryngeal chondrodysplasia. He was lost to follow-up at 3 months of age after treatment was withdrawn. The age at the last follow-up for the remaining 5 children ranged from 2 years and 10 months to 17 years. A boy with seizures died at 2 years and 10 months of age. The remaining 4 children were able to walk independently at the last follow-up, although their developmental progress was slow. Conclusions:HUWE1 gene related X-linked intellectual disability is characterized by varying degrees of developmental delay and intellectual disability, frequently accompanied by microcephaly, short stature, and occasionally by seizures and autism spectrum disorders. Missense variants are more common and the in-frame deletion variant appears to be associated with a particularly severe phenotypic presentation.

Objective To analyze the mediating effect of psychosocial adaptation on the relationship between loneliness and fatigue in young patients with cerebral infarction.Methods A total of 186 patients(aged 18 to 45 years)with cerebral infarction in Hengshui People's Hospital from Febru-ary,2023 to May,2024 were selected.They were investigated with Fatigue Severity Scale(FSS),Univesity of California at Los Angels Loneliness Scale(UCLA)and Psychosocial Adaptation to Illness Scale-self-report ver-sion(PAIS-SR)three months after discharging.The FSS scores were compared among patients with different characteristics.The correlation between the scores of FSS,UCLA and PAIS-SR was analyzed with Pearson's co-efficient.Structural equation modeling was used to analyze the mediating effect of PAIS-SR score on the relation-ship between scores of FSS and UCLA.Results A total of 183 valid questionnaires were returned.The FSS score was(36.78±7.23),the UCLA score was(42.26±9.18),and the PAIS-SR score was(56.62±13.89).There were significant differences in FSS scores among pa-tients with different National Institutes of Health Stroke Scale scores,modified Rankin Scale scores and depres-sion status(F>3.557,P<0.001).The FSS score was positively correlated with the UCLA score(r=0.740,P<0.001)and the PAIS-SR score(r=0.731,P<0.001),while the UCLA score was positively correlated with the PAIS-SR score(r=0.761,P<0.001).The main effect of UCLA score was significant on FSS score(effect size of 0.348),and the mediating effect of PAIS-SR score between UCLA score and FSS score was significant(effect size of 0.154).Conclusion Psychosocial adaptation plays a partial mediating role in the relationship between loneliness and fatigue for young patients with cerebral infarction.Improving psychosocial adaptation may relieve the influence of loneli-ness on fatigue.

Objective:To systematically evaluate the psychological experiences of adolescent patients with inflammatory bowel disease.Methods:A computer-based search was conducted in PubMed, CINAHL, APA PsycNet, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative studies on the psychological experiences of adolescent patients with inflammatory bowel disease. The search covered publications from the inception of the databases to August 2024. The quality of the studies was assessed using the qualitative research quality standards from the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center in Australia. Meta-synthesis methods were used to synthesize and analyze the results.Results:A total of 12 articles were included, and similar findings were grouped into eight new categories. Three integrated results were derived: persistent physical and mental distress, diminished social participation, and multiple coping strategies with dual hopes.Conclusions:This Meta-synthesis study provides an in-depth interpretation of the psychological experiences of adolescent patients with inflammatory bowel disease. The findings suggest the need to alleviate gastrointestinal symptoms, reduce disease-related stigma, increase social participation, enhance family-school-social support, and establish multidisciplinary teams for effective disease management.

Objective:To understand the status of bone health literacy in middle-aged and older female breast cancer patients undergoing chemotherapy and analyze its influencing factors using structural equation modeling.Methods:A convenience sampling method was used to select 250 middle-aged and older breast cancer patients undergoing chemotherapy in two tertiary hospitals in Xi'an from May to October 2024. Patients were surveyed using a general information questionnaire, the Bone Health Literacy Scale for Middle-Aged and Older Women, the Perceived Social Support Scale, and the General Self-Efficacy Scale. Pearson correlation analysis was used to examine the correlations among bone health literacy, perceived social support, and self-efficacy.Results:A total of 250 questionnaires were distributed, and 239 valid questionnaires were recovered, yielding an effective response rate of 95.6% (239/250). The mean score of the Bone Health Literacy Scale among the 239 patients was (39.71±8.16). Bone health literacy was positively correlated with perceived social support and self-efficacy ( P<0.01). Perceived social support directly affected bone health literacy and could also indirectly influence it through general self-efficacy, with an indirect effect value of 0.367, accounting for 45.2% of the total effect (0.367/0.812) . Conclusions:Healthcare professionals should implement effective interventions to enhance patients' perceived social support and strengthen their self-efficacy, thereby improving bone health literacy.

Objective:To research on the teaching effect of constructing and applying the test bank of Medical Immunology.Methods:A total of 475 students from Hainan Medical College in 2019 were set as the experimental group,the test bank was used in the teaching process,and 463 students from 2018 were set as the control group.The correlation between the test bank and final test scores of students of the two grades were analyzed and compared.Results:The final paper scores of grade 2019 students were not higher than those of grade 2018(P>0.05),the score distribution,average score,minimum score and pass rate of the 2019 grade were better than those of the 2018 grade(P<0.05).The experimental group had a significantly better learning effect on Medical Immunology than the control group(P<0.05).Conclusion:The construction and application of Medical Immunology test bank can improve students'learning effect.