Objective: To investigate the objective characteristics of tongue manifestation in different stages of damp-heat syndrome in diabetic kidney disease (DKD). Methods: A cross-sectional study enrolled 134 patients with DKD G3-5 stages who met the diagnostic criteria for damp-heat syndrome in DKD. The patients were treated at Dongzhimen Hospital, Beijing University of Chinese Medicine, from May 2023 to January 2024. The patients were divided into three groups: DKD G3, DKD G4, and DKD G5 stage, with 53, 33, and 48 patients in each group, respectively. Clinical general data (gender, age, and body mass index) and damp-heat syndrome scores were collected from the patients. The YZAI-02 traditional Chinese medicine (TCM) AI Tongue Image Acquisition Device was used to capture tongue images from these patients. The accompanying AI Open Platform for TCM Tongue Diagnosis of the device was used to analyze and extract tongue manifestation features, including objective data on tongue color, tongue quality, coating color, and coating texture. Clinical data and objective tongue manifestation characteristics were compared among patients with DKD G3-5 based on their DKD damp-heat syndrome status. Results: No statistically significant difference in gender or body mass index was observed among the three patient groups. The DKD G3 stage group had the highest age (P<0.05). The DKD G3 stage group had a lower score for symptoms of poor appetite and anorexia(P<0.05) than the DKD G5 group. No statistically significant difference was observed in damp-heat syndrome scores among the three groups. Compared with the DKD G5 stage group, the DKD G3 stage group showed a decreased proportion of pale color at the tip and edges of the tongue (P<0.05). The DKD G4 stage group exhibited an increased proportion of crimson at the root of the tongue, a decreased proportion of thick white tongue coating at the root, a decreased proportion of pale color at the tip and edges of the tongue, an increased hue value (indicating color tone) of the tongue color in the middle, an increased brightness value (indicating color lightness) of the tongue coating color in the middle, and an increased thickness of the tongue coating (P<0.05). No statistically significant difference was observed in other tongue color proportions, color chroma values, body characteristics, coating color proportions, coating color chroma values, and coating texture characteristics among the three groups. Conclusion Tongue features differ in different stages of DKD damp-heat syndrome in multiple dimensions, enabling the inference that during the DKD G5 stage, the degree of qi and blood deficiency in the kidneys, heart, lungs, liver, gallbladder, spleen, and stomach is prominent. Dampness is more likely to accumulate in the lower jiao, particularly in the kidneys, whereas heat evil in the spleen and stomach is the most severe. These insights provide novel ideas for the clinical treatment of DKD.

Objective: To investigate the role of butyric acid-producing bacteria in long bone homeostasis in mice with periodontitis under a high-fat/high-sugar diet and to provide new insights for the prevention and treatment of periodontitis and related bone metabolic diseases. Methods: This study has been approved by the Animal Welfare and Ethics Committee of the Experimental Animal Center. Initially, 14 mice were randomly divided into the CON group (the control group) and the LIG group (the periodontitis group). Mice in the LIG group had experimental periodontitis induced by ligating the second maxillary molars bilaterally and were fed a high-fat and high-sugar diet. After 8 weeks, samples were collected. Micro-computed tomography (Micro-CT) was used to analyze alveolar bone resorption and various parameters of the proximal tibia trabecular bone, including bone mineral density (BMD), bone volume per tissue volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp). After decalcification, hematoxylin and eosin (HE) staining was performed on maxillary bone sections to assess periodontal tissue inflammation and connective tissue destruction. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect related genes in the distal femur and proximal tibia bone tissues, including osteocalcin (OCN), osteogenic transcription factor (Osterix), osteoprotegerin (OPG), tartrate resistant acid phosphatase (TRAP), osteoclast-associated receptor (OSCAR), receptor activator of nuclear factor kappa-B (RANK), and receptor activator of nuclear factor kappa-B ligand (RANK-L). Subsequently, the other 28 mice were randomly divided into the CON group (the control group), LIG group (the periodontitis group), CON + butyric acid-producing bacteria (BP) group, and LIG + BP group. The breeding, sampling, and sample detection methods remained the same. Finally, the other 28 mice were randomly divided into the CON group (the control group), LIG group (the periodontitis group), CON + sodium butyrate (SB) group, and LIG + SB group. The breeding, sampling, and sample detection methods remained the same. Results: ①Periodontitis modeling was successful. Compared with the CON group, the LIG group exhibited significant alveolar bone resorption of the maxillary second molar, aggravated periodontal tissue inflammation, and connective tissue destruction. ②Periodontitis exacerbated long bone resorption in mice fed a high-fat high-sugar diet. Compared with the CON group, the LIG group had significantly lower BMD, BV/TV, Tb.N, and Tb.Th (P<0.05), and significantly higher Tb.Sp (P<0.05). HE staining of the proximal tibia showed that the trabeculae in the LIG group were sparse and disordered, with some areas showing fractures or dissolution. The expression of osteoblast markers (OCN, Osterix, OPG) was significantly lower in the LIG group (P<0.05), while the expression of the osteoclast marker TRAP showed an increasing trend (P>0.05). The ratio of RANK-L/OPG was significantly higher in the LIG group compared with the CON group (P<0.05). ③ Supplementation with butyric acid-producing bacteria alleviates periodontitis-induced disruption of long bone homeostasis in mice fed a high-fat/high-sugar diet. Compared with the LIG group, BMD and Tb.Th were significantly higher in the LIG + BP group. HE staining of the proximal tibia showed that bone resorption was mitigated in the LIG + BP group compared with the LIG group. The expression of OCN and Osterix was significantly higher in the LIG + BP group, while the expression of osteoclast-specific genes (OSCAR, RANK, RANK-L) was significantly lower (P<0.05). ④ Supplementation with butyrate alleviates periodontitis-induced disruption of long bone homeostasis in mice fed a high-fat/high-sugar diet. Compared with the LIG group, BV/TV and Tb.N were significantly higher in the LIG + SB group, and Tb.Sp was significantly lower (P<0.05). HE staining of the proximal tibia showed that bone resorption was mitigated in the LIG + SB group compared with the LIG group. The expression of Osterix, OPG, OSCAR, TRAP, and RANK was significantly lower in the LIG + SB group compared with the LIG group (P<0.05). Conclusion Periodontitis disrupts the long bone homeostasis of mice fed a high-fat high-sugar diet, aggravating long bone resorption. Supplementation with butyric acid-producing bacteria or butyrate can effectively alleviate the disruption of long bone homeostasis caused by periodontitis.

To investigate the genetic relatedness between carbapenem-resistant Klebsiella pneumoniae(CRKP) strains isolated from intestinal colonization and subsequent bloodstream infections.

Liver regeneration following injury aids the restoration of liver mass and the recovery of liver function. In the present study we investigated the contribution of megakaryocytic leukemia 1 (MKL1), a transcriptional modulator, to liver regeneration. We report that both MKL1 expression and its nuclear translocation correlated with hepatocyte proliferation in cell and animal models of liver regeneration and in liver failure patients. Mice with MKL1 deletion exhibited defective regenerative response in the liver. Transcriptomic analysis revealed that MKL1 interacted with E2F1 to program pro-regenerative transcription. MAPKAPK2 mediated phosphorylation primed MKL1 for its interaction with E2F1. Of interest, phospholipase d2 promoted MKL1 nuclear accumulation and liver regeneration by catalyzing production of phosphatidic acid (PA). PA administration stimulated hepatocyte proliferation and enhanced survival in a MKL1-dependent manner in a pre-clinical model of liver failure. Finally, PA levels was detected to be positively correlated with expression of pro-regenerative genes and inversely correlated with liver injury in liver failure patients. In conclusion, our data reveal a novel mechanism whereby MKL1 contributes to liver regeneration. Screening for small-molecule compounds boosting MKL1 activity may be considered as a reasonable approach to treat acute liver failure.

Objective:To analyze the dental phenotypes of patients with EDA genovariation related selective tooth agenesis.Meth-ods:We summarized the selective tooth agenesis patients with EDA genovariation,based on literature published before April 2023.The literature search was conducted using PubMed and multiple Chinese databases.The total number and the percentages of missing teeth were analyzed.The dental phenotype between male and female patients were compared.Results:EDA related selective tooth a-genesis mainly affects mandibular incisors(47.7％),mandibular and maxillary lateral incisors(41.6％and 40.1％respectively),while molars are seldom affected.Additionally,male patients were more affected than female and have more missing teeth.Conclusion:Dental phenotype analysis of EDA variants might contribute to precise prediction of causative genes from phenotype of missing teeth and guide for genetic counseling.

The prevalence of periodontal disease in Chinese population is more than 90％.The present treatment techniques can only control the development of the disease,inducement of bone tissue regeneration is a promising strategy and a challenge for the treatment.Exosomes are multivesicle structures derived from endosomes.More and more studies have been conducted on their application in perio-dontal regeneration.This paper reviews the application of exosome in periodontal regeneration in recent years,which is expected to pro-vide new idea for periodontal regeneration therapy.

ObjectiveTo understand the current drug resistance status and bacterial multilocus sequence typing （MLST） of human and avian Campylobacter jejuni in Jinshan District， Shanghai. MethodsFecal samples were collected from diarrhea patients in the annuity mountainous area from 2021 to 2022， and poultry and related samples were collected from 2 poultry farms in the Jinshan area for detection of C. jejuni. Minimal inhibitory concentration （MIC） drug sensitivity test was performed on the detected C. jejuni， and some strains were selected for whole genome sequencing and MLST analysis. ResultsA total of 823 samples of diarrhea disease were collected， and 32 strains of C. jejuni were detected， with a detection rate of 3.89%. Out of 600 poultry related samples， 62 strains of C. jejuni were detected， with a detection rate of 10.33%. Human multidrug resistance reached 93.75% （30/32）， while avian multidrug resistance reached 100.00%（62/62）. The top four drug resistance rates of human and avian C. jejuni were azithromycin （100.00% from humans and 100.00% from birds）， naphthoic acid （93.75% from humans and 87.10% from birds）， ciprofloxacin （90.63% from humans and 98.39% from birds）， and tetracycline （84.38% from humans and 98.39% from birds）. The relatively low resistance strains of human derived C. were erythromycin， chloramphenicol， and thalithromycin. The relatively low resistance strains of avian C. jejuni were erythromycin， clindamycin， and flufenicol. MLST analysis showed that the selected 16 strains of bacteria were divided into 9 ST types， among which the evolutionary relationship of avian C. jejuni was relatively concentrated， while human C. jejuni was relatively dispersed. It was found that one strain of avian C. jejuni was closely related to two strains of human C. jejuni. ConclusionsC. jejuni infection is severe in patients with diarrhea in this region， with a detection rate second only to salmonella and Vibrio parahaemolyticus. C. jejuni infection in poultry is relatively common， and both are highly resistant. Therefore， monitoring and control should be strengthened. MLST analysis shows new ST types in both avian and human sources of C. jejuni， indicating the emergence of new mutations that require continuous monitoring to avoid the epidemics caused by new strains. The isolated strains with close genetic relationships between avian and human sources reveal the evidence of the spread of C. jejuni from poultry to humans. Therefore it is necessary to strengthen the monitoring of C. jejuni in relevant samples from breeding farms.

ObjectiveTo evaluate the efficacy and safety of various oral Chinese patent medicines in the adjuvant treatment of chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS） based on network Meta-analysis. MethodRandomized controlled trials （RCTs） of oral Chinese patent medicine in the adjuvant treatment of CP/CPPS were retrieved from the databases of China National Knowledge Infrastructure （CNKI）， Wanfang， VIP， SinoMed， PubMed， Cochrane Library， EMbase， and Web of Science from database inception to November， 2022. The quality of the included literature was evaluated according to the Cochrane risk-of-bias tool， and the data were analyzed by RevMan 5.4 and Stata 16 software. ResultA total of 63 RCTs were included， with 13 kinds of oral Chinese patent medicines involved， including Qianlie Shutong capsules， Ningmitai capsules， Qianlie Beixi capsules， Sanjin tablets， etc. The results of the network Meta-analysis showed that in terms of clinical effective rate， the intervention measure ranked first was Qianlie Beixi capsules combined with conventional western medicine. In terms of reducing pain， the intervention measure ranked first was Sanjin tablets combined with conventional western medicine. In terms of reducing urination disorder， the intervention measure ranked first was Relinqing granules combined with conventional western medicine. In terms of improving quality of life， the intervention measure ranked first was Qianlie Beixi capsules combined with conventional western medicine. In terms of reducing the total National Institutes of Health Chronic Prostatitis Symptom Index （NIH-CPSI） score， the intervention measure ranked first was Yinhua Miyanling tablets combined with conventional western medicine. In terms of reducing leukocyte count in prostatic secretions， the intervention measure ranked first was Qianlie Jiedu capsules combined with conventional western medicine. In terms of safety， the intervention measure with the least adverse reactions was Qianlie Shutong capsules combined with conventional western medicine. The cluster analysis results showed that Qianlie Shutong capsules combined with conventional western medicine had outstanding efficacy and high safety. ConclusionOral Chinese patent medicine in the adjuvant treatment of CP/CPPS can improve the comprehensive efficacy， reduce the NIH-CPSI score and leukocyte count in prostatic secretions， and improve the quality of life of patients. For clinical treatment， the preferred choice is Qianlie Beixi capsules or Qianlie Shutong capsules combined with conventional western medicine. Limited by the quantity and quality of literature included in this study， the results need to be verified by high-quality studies with a larger sample size.

Objective The aim of this study was to explore the influencing factors of orthostatic intolerance in adolescent idiopathic scoliosis patients after surgery for the first time out of bed movement.Methods A retrospective analysis was conducted on the clinical data of 226 adolescent idiopathic scoliosis patients admitted to Nanjing Drum Tower Hospital from June 2021 to June 2023.Based on whether upright intolerance occurred during the first postoperative ambulation,patients with upright intolerance were included in the upright intolerance group,and patients without upright intolerance were included in the non upright intolerance group.Collect general data of two groups of patients,as well as their blood pressure at different positions during their first postoperative out of bed activity.Conduct univariate and multivariate logistic regression analysis on the influencing factors of upright intoler-ance during their first postoperative out of bed activity in adolescent idiopathic scoliosis patients.Results Out of 226 patients who underwent their first postoperative ambulation,102 experienced orthostatic intolerance,accounting for 45.13%(102/226)of the cases.The systolic and diastolic blood pressure in both sitting and standing positions were lower in the orthostatic intolerance group than in the non orthostatic intolerance group(P＜0.05).Through univariate analysis,it can be seen that the postoperative bed rest time,sitting pain score,standing pain score,postoperative hospitalization time,and proportion of posture adaptation training in the orthostatic intolerance group were significantly different from those in the non orthostatic intolerance group(P＜0.05).Through multiple logistic regression analysis,it can be seen that long postoperative bed rest time,degree of sitting pain,degree of standing pain,and lack of posture adaptation training are risk factors for upright intolerance(P＜0.05).Conclusion of bed activity.

Objective To analyze the hotspots and frontiers of researches related to pain in Parkinson's disease. Methods The literatures on pain in Parkinson's disease were retrieved from CNKI,VIP,Wanfang data,CBM and Web of Science Core Collection from inception to November,2023,and were analyzed with CiteSpace 6.1.R6. Results A total of 926 literatures were included with 293 in Chinese and 633 in English,respectively.Chinese high-fre-quency keywords were quality of life,sleep disorders and depression,while English high-frequency keywords were nonmotor symptom,quality of life and levodopa.The latest bursting word in Chinese was pathogenesis,while the latest bursting words in English were exercise and management. Conclusion Number of researches related to pain in Parkinson's disease is gradually rising,and the characteristics,patho-genesis,quality of life,rehabilitation interventions and clinical efficacy have become research hotspots.The mechanism of pain in Parkinson's disease and rehabilitation management program will be the main research top-ics in the future.