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.

ObjectiveTo investigate the mechanism of Xiezhuo Jiedu prescription in the treatment of ulcerative colitis （UC） by inhibiting ferroptosis and alleviating intestinal mucosal injury based on the nuclear factor E₂ related factor 2/solute carrier family 7 member/glutathione peroxidase 4 （Nrf2/SLC7A11/GPX4） signaling pathway. MethodsA total of 60 male SD rats were divided into a normal group， a model group， high- and low-dose Xiezhuo Jiedu prescription groups （26.64 and 13.32 g·kg^-1， respectively）， a ferroptosis inhibitor group （Ferrostatin-1， 0.005 g·kg^-1）， and a mesalazine group （0.27 g·kg^-1）， with 10 rats in each group. A UC rat model was established by intrarectal administration of trinitrobenzene sulfonic acid （TNBS）-ethanol. The normal group and the model group were intragastrically administered normal saline. The other groups were given intragastric administration according to the corresponding dosage for 7 d. The general condition， disease activity index （DAI） score， colon length， and mucosal injury index （CDMI） score were observed in each group. The pathological changes of colon tissue in each group were observed by hematoxylin-eosin （HE） staining. The intestinal mucosa and mitochondrial morphology in each group were observed by transmission electron microscopy. The expression levels of Occludin， Claudin-1， mucin 2 （MUC2）， and E-cadherin in intestinal tissue were detected by immunofluorescence （IF）. Enzyme-linked immunosorbent assay （ELISA） was used to detect the expression levels of serum tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， and interleukin-10 （IL-10） in each group， and a lactic acid assay kit or ELISA was employed to detect the expression levels of reactive oxygen species （ROS）， ferrous ions （Fe²⁺）， glutathione （GSH）， malondialdehyde （MDA）， 4-hydroxynonenal （4-HNE）， diamine oxidase （DAO）， and D-lactate （D-LA）. Real-time quantitative polymerase chain reaction （Real-time PCR） was applied to detect the mRNA expression levels of Nrf2， SLC7A11， GPX4， Occludin， Claudin-1， MUC2， and E-cadherin in each group， and Western blot was adopted to detect the protein expression levels of Nrf2， p-Nrf2， SLC7A11， and GPX4 in each group. ResultsCompared with the normal group， rats in the model group exhibited listlessness， sluggish response， and mucopurulent and bloody stools. The model group also showed significantly increased DAI score， colon length， CDMI score， and expression levels of TNF-α， IL-6， ROS， Fe²⁺， MDA， 4-HNE， DAO， and D-LA （P<0.01）. In addition， it presented significantly decreased IF values of Occludin， Claudin-1， MUC2， and E-cadherin and mRNA and protein expression levels of IL-10， GSH， Nrf2， p-Nrf2， SLC7A11， and GPX4 （P<0.01）. There were different degrees of improvement in each administration group after treatment， and the improvement was the most significant in the high-dose Xiezhuo Jiedu prescription group （P<0.01）. ConclusionXiezhuo Jiedu prescription may alleviate intestinal mucosal injury by inhibiting ferroptosis of intestinal epithelial cells via regulating the Nrf2/SLC7A11/GPX4 signaling pathway， thereby exhibiting efficacy in the treatment of UC.

Objective To analyze the clinical characteristics and regularity of aristolochic acid nephropathy (AAN) induced by drugs containing aristolochic acid. Methods The clinical data of 111 patients with AAN induced by aristolochic acid were reviewed. The clinical features, medication and treatment of AAN were analyzed. Results Among 111 patients, there were more females than males (2.58∶1), 101 cases (90.99%) were over 50 years old； the mean age was (63.70±11.67) years old;the average duration of medication was (8.08±6.94) years. The drugs involved were Guanxinsuhe pill and Longdanxiegan pill in 106 cases (95.50%). Serum creatinine increased in 108 cases, urea nitrogen increased in 106 cases and hemoglobin decreased in 103 cases, most of which were hypogravity urine, mild to moderate proteinuria and occult blood. Ultrasonic examination revealed that the kidneys were damaged to varying degrees. Pathological biopsy of kidney showed renal tubular damage. Most patients had an insidious onset and varying degrees of progression, which were not proportional to the age and the duration of taking the medicine. In clinical, the renal function was progressively damaged, most of which were irreversible and with a poor prognosis. Conclusion Patients with renal impairment differed greatly individually, and the renal damage was not paralleled with the medication duration and dose of drugs containing aristolochic acid.AAN progressed rapidly, and the disease still progressed even after stopping taking drugs containing aristolochic acid. Strengthening pharmacovigilance, implementing early diagnosis and effective intervention could help to reduce the occurrence of AAN and attenuate its development.

Objective To analyze the structural changes in medical resources allocation and service utilization based on Chinese hospital categorization,offering data-backed references for understanding the current states of China's medical service system and exploring the strategic allocation of resources.Methods Utilizing data obtained from publicly available sources on the healthcare industry development in China from 2013 to 2022,indicators such as the number of institutions,healthcare techni-cians,practicing(assistant)physicians,registered nurses,management personnel,outpatient service visits,and hospital admis-sions were selected.The structural change analysis method was applied to describe and analyze the current changes in the alloca-tion of medical resources and service utilization structure in hospitals in China.Results The study observed a consistent annual increase in the absolute number of medical and health service resources,with general hospitals and specialized hospitals ranked as the first two contributors to structural changes.General hospitals presented a negative trend,for the number of institutions,healthcare technicians,practicing(assistant)physicians,registered nurses,management personnel,outpatient service visits,and hospital admissions were all negative during the study period,while specialized hospitals showed a positive trend.Notably,general hospitals experienced a shift from negative to positive in the number of management personnel during 2020 and 2021,while specialized hospitals experienced a shift from positive to negative.Traditional Chinese medicine hospitals,integrated tradi-tional Chinese and Western medicine hospitals,ethnic hospitals,and nursing homes contributed little to the changes in all the in-dicators.Conclusion General hospitals show a negative trend in medical resources and service utilization,while specialized hos-pitals exhibit a positive trend.The trends suggest progresses in China in building a high-quality and efficient integrated medical and health service model on the basis of effectively promoting the increase in the total amount of high-quality resources.However,there is a need to refine the system for selecting,training,and developing management personnel.Traditional Chinese medicine,integrated traditional Chinese and Western medicine hospitals,ethnic hospitals,and nursing homes require enhanced strategic planning and coordination.

Objective To analyze the research hotspots in the training of specialized hospitals in the China National Knowledge Infrastructure(CNKI)database,and through quantitative analysis of literature data,help evaluate the influence and quality of academic research in the field of specialized hospital training,and discover the trends in academic research in this field.Methods Using"specialized hospital training"as the search term,literature from the China National Knowledge Infra-structure(CNKI)database for the past decade from 2014 to 2023 was retrieved.The BICOMB 2.0 bibliographic analysis system was used for quantitative analysis,and statistical analysis software SPSS 26.0 was used for cluster analysis.Results A total of 199 articles were included,and there were two important turning points in the past decade.The top ten journals had more than 4 articles(including 4),with a cumulative percentage of 28.64％.Using the BICOMB 2.0 bibliographic analysis system,15 high-frequency keywords were extracted,accounting for a cumulative percentage of 27.52％of the total frequency.Four research hotspots were identified through systematic clustering analysis using SPSS 26.0 software,including the needs for on-the-job train-ing of nursing staff,pre-employment training needs,training effectiveness in specialized hospitals,and physician training.Con-clusion Specialized hospital training should play a supportive role in national policies and strategies,continuously expanding and improving research ideas in the fields of nursing staff and resident physician training,and further refining research in specialized hospital management personnel and disciplinary fields.With the continuous optimization of resource allocation in specialized hos-pitals and the improvement of professional discipline system construction in our country,there is still great potential and possibili-ty for the research direction and content of training in specialized hospitals.

Objective To sort out and summarize the researches of source,structures and identification technologies of glucosamine drugs,and provide a reference for the development and research of this kind of drugs.Methods The sources of glucosamine drugs was identified by stable isotope ratio test,and the crystal structures of glucosamine drugs was identified by X-ray powder diffraction.Results When the carbon isotope ratio was between-11‰ and-13‰,the source of glucosamine was from microbial fermentation.When the carbon isotope ratio was between-17‰ and-24‰,the source of glucosamine was from microbial animals.The 2θ angles of the strongest diffraction peak of hydrochloric glucosamine were 16.525°,12.360° and 17.330°,the 2θ angles of the strongest diffraction peak of sodium sulfate were 32.124° and 19.035,the 2θ angle of the strongest diffraction peak of the glucosamine sulfate potassium chloride/sodium was 27.036°,and the 2θ angle of the strongest diffraction peak of the physical mixture of glucosamine hydrochloride and chloride/sodium sulfate(2∶1)was 12.391°.Through X-ray powder diffraction technology,the glucosamine sulfate potassium chloride/sodium eutectic complex salt and the physical mixture of glucosamine hydrochloride and chloride/sodium sulfate.can be distinguished.Conclusion The research can effectively identify the sources and structures of glucosamine drugs,which is simple,accurate and reliable,and provides technical support for the supervision and management of glucosamine drugs.

Periodontitis is a chronic inflammatory disease marked by a dysregulated immune microenvironment, posing formidable challenges for effective treatment. The disease is characterized by an altered glucose metabolism in macrophages, specifically an increase in aerobic glycolysis, which is linked to heightened inflammatory responses. This suggests that targeting macrophage metabolism could offer a new therapeutic avenue. In this study, we developed an immunometabolic intervention using quercetin (Q) encapsulated in bioadhesive mesoporous polydopamine (Q@MPDA) to treat periodontitis. Our results demonstrated that Q@MPDA could reprogram inflammatory macrophages to an anti-inflammatory phenotype (i.e., from-M1-to-M2 repolarization). In a murine periodontitis model, locally administered Q@MPDA reduced the presence of inflammatory macrophages, and decreased the levels of inflammatory cytokines (IL-1β and TNF-α) and reactive oxygen species (ROS) in the periodontium. Consequently, it alleviated periodontitis symptoms, reduced alveolar bone loss, and promoted tissue repair. Furthermore, our study revealed that Q@MPDA could inhibit the glycolysis of inflammatory macrophages while enhancing oxidative phosphorylation (OXPHOS), facilitating the shift from M1 to M2 macrophage subtype. Our findings suggest that Q@MPDA is a promising treatment for periodontitis via immunometabolic rewiring.

Objective To investigate the effect of hydrogen sulfide(H2S)on olfactory function in mice and the recovery of olfactory function after H2S poisoning test.Methods Thirty-six clean grade BALB/c mice were randomly divided into control group,0.05 mg/L H2S exposure group,and 5.00 mg/L H2S exposure group according to the random number table method,with 12 mice in each group.The recovery of olfactory function was observed after H2S exposure cycle.The behavior and foraging time of the mice were recorded.Results Before the exposure test,there was no significant difference in olfaction time among the groups(P>0.05).On the 10th,20th and 30th day of the exposure test,the foraging time of 5.00 mg/L H2S exposure group was gradually prolonged,which was significantly different from that of the control group and 0.05 mg/L H2S exposure group(P<0.05).On the 5th,10th and 15th day after exposure test,the foraging time of 5.00 mg/L H2S exposure group gradually shortened,which was significantly longer than that of the control group and 0.05 mg/L H2S exposure group(P<0.05).Conclusion The short-term toxicity test of 5.00 mg/L H2S can cause olfactory dysfunction in mice,manifested by differences in foraging time.This olfactory dysfunction can be recovered to some extent within 15 days after leaving the exposed environment.

Background Occupational stress has been shown to be an important factor affecting the mental health of workers. The role of affective commitment to the organization and overcommitment to work cannot be ignored. However, there is a lack of research on this topic in China. Objective To explore a potential mediating effect of affective commitment on how occupational stress affects the mental health of medical staff and a potential moderating effect of overcommitment on the mediating effect of affective commitment. Methods A total of 1372 health care workers in a tertiary Grade A hospital in Lanzhou City were selected as study subjects for a cross-sectional survey. The occupational stress, emotional commitment, and psychological distress of the subjects were evaluated by the Effort-Reward Imbalance Scale, Affective Commitment Scale, and Kessler 10 Scale. SPSS 26.0 was used for correlation analysis, mediation analysis, and moderated mediation analysis. Common method bias wasevaluated by Harman one-factor test. Results A total of 1372 questionnaires were distributed, of which 1277 valid questionnaires were returned, with a valid recovery rate of 93.08%. The mean occupational stress score was 1.14±0.23, the mean overcommitment score was 20.26±3.21, the mean affective commitment score was 20.25±3.34, and the mean psychological distress score was 26.26±7.90. The Spearman correlation analysis results showed that occupational stress among medical staff was positively correlated with overcommitment and psychological distress (r=0.153, 0.410, P＜0.01) and negatively correlated with affective commitment (r=−0.341, P＜0.01); overcommitment was negatively related to affective commitment and positively related to psychological distress (r=−0.107, 0.312, P＜0.01); affective commitment was negatively related to psychological distress (r=−0.464, P＜0.01). The positive effect of occupational stress on psychological distress of medical staff was significant (b=0.41, t=15.42, P<0.001); affective commitment presented a partial mediating effect on the relationship between occupational stress and psychological distress (effect value=0.13), accounting for 31.71% of the total effect; overcommitment moderated the process of occupational stress-affective commitment-psychological distress (P＜0.01). Conclusion Affective commitment of medical staff has a partial mediating effect on the relationship between occupational stress and psychological distress, and overcommitment plays a significant role in moderating the process of occupational stress-affective commitment-psychological distress.

Objective:To investigate the efficacy and adverse reactions of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) combined with chemotherapy in the treatment of superior mediastinal lymph node metastasis after esophageal cancer surgery.Methods:The clinical data of 72 patients with concurrent chemoradiotherapy for superior mediastinal lymph node metastasis after esophageal cancer surgery in Tai'an Cancer Prevention and Treatment Hospital from January 2019 to May 2021 were retrospectively analyzed, and they were divided into intensity-modulated radiotherapy (IMRT) group (36 cases) and SIB-IMRT group (36 cases) according to different radiotherapy methods. The short-term efficacy, long-term survival rate and adverse reactions of the two groups were compared.Results:The response rate in the IMRT group was 66.7% (24/36), the response rate in the SIB-IMRT group was 86.1% (31/36), and the difference between the two groups was statistically significant ( χ2 = 3.77, P = 0.047). The 1-, 2- and 3-year overall survival rates in the IMRT group were 75.0%, 44.4% and 27.8%, and the 1-, 2- and 3-year overall survival rates in the SIB-IMRT group were 83.3%, 52.8% and 33.3%; the difference in the overall survival between the two groups was not statistically significant ( χ2 = 0.70, P = 0.401). There were statistical differences in the incidence of leukopenia, radiation esophagitis and radiation pleural gastritis between the two groups (all P < 0.05). There were no statistical differences in the incidence of radiation pneumonia and gastrointestinal reactions between the two groups (both P > 0.05). Conclusions:SIB-IMRT combined with chemotherapy in patients with superior mediastinal lymph node metastasis after esophageal cancer surgery has good local control rate and mild adverse reactions.