ObjectiveTo evaluate the effects of drinking chlorinated water on the intestinal flora of rats and mice and to explore differences in the intestinal microecological responses of model animals to chlorine stimulation in chlorinated drinking water systems. MethodsSix 8-week-old male SD rats and six 8-week-old male C57BL/6J mice were acclimated for 5 days. Subsequently, the drinking water for both rats and mice was changed from pure water to water containing free chlorine at a concentration of 25.4–32.4 nmol/L. The intervention lasted for 8 weeks, during which all animals were fed the same diet. Fecal samples were collected before the intervention (week 0, as the control group) and on the last day of week 3 and week 8 (as the chlorinated water group), and microbial composition was analyzed by 16S rRNA sequencing, including α diversity (Chao1 and Shannon indices), β diversity [principal component analysis (PCA)], and linear discriminant analysis effect size (LEfSe) analysis. ResultsAfter 3 weeks of intervention, α diversity of the intestinal flora in both rats and mice in the chlorinated water group was significantly lower than that in the control group (P < 0.01). After 8 weeks of intervention, no significant difference in α diversity was observed between rats in the chlorinated water group and those in the control group, whereas α diversity in mice remained significantly lower than that in the control group (P < 0.01). β diversity analysis showed significant alterations in microbial structure in the chlorinated water group. LEfSe analysis indicated that, compared with the control group, the abundances of Bacteroides and Ruminococcus were significantly reduced in the chlorinated water group, and microbial disturbance was more pronounced in mice [linear discriminant analysis (LDA) > 4.0], with a greater decrease in microbial diversity and a larger number of differentially abundant genera. ConclusionConsumption of chlorinated water can alter the diversity and structure of the intestinal flora in both rats and mice, with mice being more sensitive to this exposure. These findings suggest that the potential effects of chlorine on gut microecology should be considered in drinking water management and model selection for animal experiments.

AIM: To investigate the relationship between microvascular density in macular area and anti-vascular endothelial growth factor(VEGF)response in patients with diabetic macular edema(DME). METHODS: Retrospective case-control study. Clinical data of DME patients who received anti-VEGF treatment in the hospital from January 2021 to August 2025 were collected. All patients received intravitreal anti-VEGF treatment once a month for a total of 3 times. The patients were divided into the good response group and the poor response group based on the anti-VEGF treatment response. The vascular density of superficial capillary plexus(SCP)and deep capillary plexus(DCP)were compared between the two groups before treatment. Multivariate logistic regression models were used to analyze the factors affecting the anti-VEGF treatment response in DME patients. The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of SCP and DCP vascular density for anti-VEGF treatment response in DME patients. RESULTS: The study included a total of 315 DME patients 315 eyes, including 172 males and 143 females with the mean age of 62.06±7.38 y. After completing three treatments, there were 211 cases 211 eyes in the good response group, including 114 males and 97 females with the mean age of 61.92±7.52 y. There were 104 cases in the poor response group, including 58 males and 46 females with the mean age of 62.35±7.10 y. The course of diabetes in the poor response group was longer than that in the good response group, the central retinal thickness before treatment was greater than that in the good response group, the level of glycosylated hemoglobin(HbA1c)before treatment was higher than that in the good response group, and the proportion of patients with serous retinal detachment was higher than that in the good response group. Before treatment, the vascular density of SCP and DCP in the poor response group was lower than that in the good response group(all P<0.01). Multivariate Logistic regression analysis showed that SCP and DCP vascular density were both influencing factors of anti-VEGF treatment response in DME patients(both P<0.05). ROC curves showed that the area under the curve(AUC)of the pre-treatment SCP vascular density, pre-treatment DCP vascular density alone, and their combined model for predicting poor response to anti-VEGF therapy in DME patients were 0.812, 0.797 and 0.901, respectively, indicating high predictive value.CONCLUSION: The microvascular density in the macular area is closely related to the anti-VEGF treatment response in DME patients. The vascular density of SCP and DCP before treatment can be used as important indicators to predict treatment response, and targeted preventive and therapeutic interventions can be adopted in clinical practice.

Radiochemotherapy-induced oral mucositis (OM) is a common oral complication in patients with tumors following head and neck radiotherapy or chemotherapy. Erosion and ulcers are the main features of OM that seriously affect the quality of life of patients and even the progress of tumor treatment. To date, differences in clinical prevention and treatment plans for OM have been noted among doctors of various specialties, which has increased the uncertainty of treatment effects. On the basis of current research evidence, this expert consensus outlines risk factors, clinical manifestations, clinical grading, ancillary examinations, diagnostic basis, prevention and treatment strategies and efficacy indicators for OM. In addition to strategies such as basic oral care, anti-inflammatory and analgesic agents, anti-infective agents, pro-healing agents, and photobiotherapy recommended in previous guidelines, we also emphasize the role of traditional Chinese medicine in OM prevention and treatment. This expert consensus aims to provide references and guidance for dental physicians and oncologists in formulating strategies for OM prevention, diagnosis, and treatment, standardizing clinical practice, reducing OM occurrence, promoting healing, and improving the quality of life of patients.
Humans ; Chemoradiotherapy/adverse effects* ; Consensus ; Risk Factors ; Stomatitis/etiology*

Objective: To explore the relationship between visual acuity and physical fitness of university freshmen, so as to provide reference for myopia prevention and control for freshmen. Methods: From October to November 2022, 2 160 college freshman without majoring in public safety administration, selected from Guangxi Police College in 2022 by using the stratified cluster random sampling method, were reviewed for the results of visual acuity test and physical fitness scores. The physical fitness indices were evaluated by using the Z scores of physical fitness test scores, and the strength of association between the level of physical fitness index and myopia was analyzed by using Logistic regression model. Results: Among 2 160 college freshman without majoring in public safety administration, 917 (42.5%) students were diagnosed screening myopia, including 66 (3.1%) cases of high myopia, 383 (17.7%) cases of moderate myopia and 468 (21.7%) cases of mild myopia. The differences in the distribution of visual acuity tests among students with different physical fitness indices, body mass index, and gender were statistically significant ( Z/H=54.50, 49.53, 15.51, P <0.01). Low level and low middle level physical fitness indices were associated with screening myopia among freshmen[ OR (95% CI )=2.81(1.93-4.08),1.87(1.38-2.54)], and low level physical fitness indexes were associated with high myopia [ OR (95% CI )=7.22(2.33-22.32)] ( P <0.01). Conclusions Screening myopia among college freshman without majoring in public safety administration is related to physical fitness, and low level and low middle level physical fitness index are risk factors for myopia. Improving the level of physical fitness might be effective in preventing myopia.

Objective To utilize single-cell and peripheral blood transcriptomic data from 3D brain organoids,combined with machine learning,to analyze the role of mitochondrial autophagy genes in schizophrenia(SCZ).Methods By integrating two machine learning algorithms,we identified differentially expressed mitochondrial autophagy-related genes between schizophrenia patients and healthy controls using peripheral blood RNA sequencing data.The relationship between mitophagy gene,immune cells and inflammatory factors was further explored.Comprehensive single-cell analysis was used to explore the signaling pathways and specific transcription factors based on mitophagy genes.Results Using machine learning,seven key mitophagy genes expressed in schizophrenia patients were identified.Based on Mitoscore analysis,at the single-cell level,neurons with high mitochondrial autophagy activity(Mitohigh_Neuron)formed new interactions with endothelial cells via the SPP1 signaling pathway.Conclusion This study identified two subtypes of mitophagy and seven key mitophagy genes in schizophrenia,providing new insights into the pathogenesis of the disease.

Objective: To investigate whether zerumbone ( ZER) has the effect of preventing cisplatin ( Cis) -induced acute kidney injury (Cis-AKI) . Methods: The MTT method was used to detect the effect of different concentrations of ZER on the cell viability of Cis-AKI. The in vivo and in vitro models of Cis-AKI mice were estab- lished by dividing into control group , separate administration group , model group , and dose group. Western blot and immunofluorescence experiments were used to detect the expression changes of kidney injury marker-1 ( KIM- 1) , phosphorylated NF-κB p65 ( P-p65 ) , Cleaved casepase3 , receptor interacting protein kinase 1 ( RIPK1) , RIPK3 , and tumor necrosis factor-α (TNF-α) . Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the mRNA expression of KIM-1 , TNF-α , interleukin-6 ( IL-6) , and monocyte chemoattractant protein-1(MCP-1) . Periodic acid-Schiff (PAS) staining confirmed the therapeutic effect of ZER on Cis-AKI. RNA-seq and cell thermal shift (CETSA) were used to explore possible target proteins. Results : MTT results showed that ZER could alleviate the decrease in cell viability of Cis-AKI ; in vivo and in vitro studies showed that compared with the model group , after treatment with ZER , its KIM-1 , P-p65 , Cleaved casepased3 , RIPK1 , RIPK3 , TNF -α expres- sion decreased significantly , and the mRNA expression of KIM-1 , TNF-α , IL-6 mRNA , and MCP-1 decreased. PAS staining showed that ZER had a therapeutic effect on Cis-AKI. RNA-seq and CETSA analysis showed that ZER might prevent and treat Cis-AKI by targeting the PIM1 protein. Conclusion ZER may alleviate Cis-AKI and im- prove inflammatory response and necroptosis by regulating PIM1 protein. ZER is expected to be a potential drug for the prevention and treatment of Cis-AKI.

Objective To investigate the possible mechanisms of Shouwu Wan on effects of ferroptosis inhibitory protein 1(FSP1),ferritin(Ferritin),nuclear factor E2 related factor 2(Nrf2),solute carrier family7A11(SLC7A11),glutathione peroxidase 4(GPX4)and mitochondrial ferritin(MtFt)in premature ovarian failure(POF)rats.Methods Sixty mature SD female rats were randomly divided into blank group,model group,Shouwu Wan-4 weeks group,Shouwu Wan-6 weeks group,Shouwu Wan prevention group,and Progynova group.Except for the rats in blank group,POF rats model were established in other groups by the intraperitoneal injection of VCD(160 mg·kg-1)for 15 days consecutively.After intragastric administration of Shouwu Wan,the serum sex hormone levels of rats were measured by ELISA;Ultrastructural changes of ovarian granulosa cells(GCs)were observed by electron microscopy.The content of active iron and malondialdehyde(MDA)were detected;Real time fluorescence quantitative PCR and Western blot were used to detect mRNA and protein expression levels of the related factors.Results Compared with blank group,the serum sex hormone levels in model group rats were severely disturbed,and the ultrastructure of ovarian granulosa cells(GCs)was impaired.The number of mitochondria were decreased,and the structure of mitochondrial were abnormal,and vacuolization and autophagosomes could be observed.The concentration of MDA and active iron in rat ovarian tissue significantly increased(P<0.01);The mRNA expression of Ferritin,SLC7A11,GPX4,and FSP1 were significantly decreased(P<0.01),and the protein expression of Nrf2,SLC7A11,GPX4,and FSP1 were significantly decreased(P<0.01).The mRNA and protein expression of MtFt were significantly increased(P<0.01).Compared with the model group,the above changes were significantly improved in each Shouwu Wan intervention group,and the effect of Shouwu Wan prevention group were more significant.Conclusion The mechanism of Shouwu Wan in preventing and treating POF may be related to regulate Nrf2/SLC7A11/GPX4 signal pathway and the expression of FSP1 and MtFt to inhibit ferroptosis.

Objective:To investigate the relationship between the duration of the second stage of labor and the amount of postpartum hemorrhage within 2 hours in primiparas using epidural analgesia.Methods:A retrospective study was conducted on the clinical data of pregnant women who delivered vaginally in the obstetrics department of the Affiliated Hospital of Jining Medical University from January 1, 2020, to December 31, 2020. The data included maternal age, pre-pregnancy body mass index (BMI), gravidity, gestational age at delivery, weight gain during pregnancy, common pregnancy complications (such as gestational hypertension, gestational diabetes, hypothyroidism, and pregnancy-related anemia), types of uterotonics, duration of each stage of labor, delivery outcomes, perineal conditions, postpartum hemorrhage within 2 hours, and neonatal birth length and weight. The exposure variable was the duration of the second stage of labor, and the outcome was the amount of postpartum hemorrhage within 2 hours. Potential risk factors were analyzed using univariate analysis. After adjusting for potential confounding factors, a generalized additive model was used for linear regression analysis, smooth curve fitting, and threshold effect analysis to observe the relationship between the duration of the second stage of labor and postpartum hemorrhage within 2 hours.Results:A total of 2 067 primiparas were included in the study. The mean age of the participants was 26.5±3.6 years, the median duration of the second stage of labor was 54 min (range: 35-81 min), and the median amount of postpartum hemorrhage within 2 hours was 230 ml (range: 200-300 ml). After adjusting for factors such as maternal age, pre-pregnancy BMI, gestational age at delivery, vaginal delivery, duration of the first and third stages of labor, perineal conditions, types of uterotonics used within 2 hours postpartum, and neonatal birth length and weight, a positive relationship was found between the duration of the second stage of labor and the amount of postpartum hemorrhage within 2 hours ( ?=0.20, 95% CI: 0.00-0.30, P<0.05). The smooth curve fitting results showed a non-linear relationship between the duration of the second stage of labor and postpartum hemorrhage within 2 hours. Threshold effect analysis indicated that the two-segment regression model (Model Ⅱ) was more suitable for fitting the correlation compared to the univariate linear regression model (Model Ⅰ), with a log-likelihood ratio test P-value of 0.001, and the inflection point was 115 min for the second stage of labor (95% CI: 99-125 min). Conclusions:In primiparas using epidural analgesia, there is a non-linear relationship and threshold effect between the duration of the second stage of labor and the amount of postpartum hemorrhage within 2 hours. When the second stage of labor exceeds 115 min, the extension of the second stage may increase the amount of postpartum hemorrhage within 2 hours.

Objective To investigate the possible mechanisms of Shouwu Wan on effects of ferroptosis inhibitory protein 1(FSP1),ferritin(Ferritin),nuclear factor E2 related factor 2(Nrf2),solute carrier family7A11(SLC7A11),glutathione peroxidase 4(GPX4)and mitochondrial ferritin(MtFt)in premature ovarian failure(POF)rats.Methods Sixty mature SD female rats were randomly divided into blank group,model group,Shouwu Wan-4 weeks group,Shouwu Wan-6 weeks group,Shouwu Wan prevention group,and Progynova group.Except for the rats in blank group,POF rats model were established in other groups by the intraperitoneal injection of VCD(160 mg·kg-1)for 15 days consecutively.After intragastric administration of Shouwu Wan,the serum sex hormone levels of rats were measured by ELISA;Ultrastructural changes of ovarian granulosa cells(GCs)were observed by electron microscopy.The content of active iron and malondialdehyde(MDA)were detected;Real time fluorescence quantitative PCR and Western blot were used to detect mRNA and protein expression levels of the related factors.Results Compared with blank group,the serum sex hormone levels in model group rats were severely disturbed,and the ultrastructure of ovarian granulosa cells(GCs)was impaired.The number of mitochondria were decreased,and the structure of mitochondrial were abnormal,and vacuolization and autophagosomes could be observed.The concentration of MDA and active iron in rat ovarian tissue significantly increased(P<0.01);The mRNA expression of Ferritin,SLC7A11,GPX4,and FSP1 were significantly decreased(P<0.01),and the protein expression of Nrf2,SLC7A11,GPX4,and FSP1 were significantly decreased(P<0.01).The mRNA and protein expression of MtFt were significantly increased(P<0.01).Compared with the model group,the above changes were significantly improved in each Shouwu Wan intervention group,and the effect of Shouwu Wan prevention group were more significant.Conclusion The mechanism of Shouwu Wan in preventing and treating POF may be related to regulate Nrf2/SLC7A11/GPX4 signal pathway and the expression of FSP1 and MtFt to inhibit ferroptosis.

Abstract: Objectives　To sequence the whole genome of Vibrio cholerae strains isolated from Fuzhou between 2018 and 2023, predict virulence genes, antimicrobial resistance genes, and sequence loci information, analyze the genetic relationships among different strains, and provide evidence for cholera prevention and control. Methods　Whole genome sequencing was performed on 60 strains of Vibrio cholerae, and bioinformatics software was used for quality control, gene assembly, and prediction of the sequencing data. PubMLST, ResFinder, and VFDB databases were used to predict the multilocus sequence typing, antimicrobial resistance genes, and virulence genes of different strains. Combined with the NCBI database, the phylogenetic tree was constructed by the maximum likelihood method through the core cgSNP phylogenetic analysis and de-recombination analysis. Results Based on the typing of 7 housekeeping genes, 60 Vibrio cholerae strains can be categorized into 16 known STs and 38 newly assigned STs. The clinical isolate H339 of serogroup O1 was identified as ST75. Serogroup O1 food isolates H13, H363, and H381 were all ST175. H263 and H357, the NOVC isolates, were both ST1218. H293 and H306 were ST1700. H311, H314, and H316 were all ST1699, with the remaining isolates displaying diversity. A total of 29 antimicrobial resistance genes were predicted, including aminoglycosides, β-lactams, quinolones, and folate pathway antagonists, with the majority of the strains carrying quinolones antimicrobial resistance genes. According to the VFDB prediction, all isolates had the virulence factors rtx and hlyA, 96.7% (58/60) of the strains carried the tlh genes, all serogroup O1 isolates carried tcp, zot, and ace genes, and all serogroup O1 clinical isolates carried ctxA genes. Phylogenetic tree analysis of the whole genome divided all strains into 20 branches, indicating high genomic divergence. Conclusions　Thirty-eight new STs were identified. Genetic correlations were found among serogroup O1 food isolates, whereas serogroup O1 clinical isolates and serogroup O1 food isolates, as well as between serogroup O1 and NOVC strains, show distant phylogenetic relationships. There was diversity among the isolates. This study provides data support for the traceability of foodborne diseases.