Objective To characterize neurological alterations associated with structural bowel damage in patients with Crohn's disease(CD)through radiomics-assisted neurophenotyping,utilizing multiparametric brain MRI.Methods This prospective study enrolled patients with CD who underwent brain MRI,MR enterography,and ileocolonoscopy within one week.The Lémann Index was used to quantitatively assess cumulative structural bowel damage.CD patients were stratified into two groups based on a cutoff value of 4.8:those with bowel damage(LI>4.8)and those without bowel damage(LI≤4.8).A neurophenotype model was developed to characterize the neural changes associated with bowel damage in CD.Key features were selected from first-order features extracted from multiparametric brain MRI in the training cohort and validated in an independent test cohort.Results The final study population comprised 109 patients,including 51 individuals with bowel damage and 58 without bowel damage.The neurophenotype model scores were 0.785(95%CI:0.506～0.945)in the bowel damage group and 0.155(95%CI:0.093～0.394)in the non-bowel damage group,showing a statistically significant difference between the two groups(P<0.001).The developed model exhibited strong discriminative performance,with area under the receiver operating characteristic curve(AUC)values ranging from 0.824 to 0.918 across the training,vali-dation,and test cohorts(all P<0.05).Conclusion Our radiomics-assisted neurophenotype analysis reveals neural alterations in CD patients with bowel damage,which may indicate extraintestinal manifestations associated with cumulative intestinal injury.

Background and aims:Metabolic dysfunction-associated fatty liver disease(MAFLD)is a common chronic condition that can lead to cancer due to its complex pathogenesis.Therapeutic agents targeting AMP-activated protein kinase(AMPK)activation have been suggested as potential treatments for metabolic disorders such as metabolic dysfunction-associated steatohepatitis(MASH).Rhizoma Atractylodis Mac-rocephalae(RAM)has been clinically used to treat obesity-related health problems,but its therapeutic effects on MAFLD and the underlying mechanism remain unclear.Therefore,this study was conducted to evaluate the function and underlying mechanism of RAM in the treatment of MAFLD.Methods:The effect of RAM decoction on MAFLD was evaluated using a high-fat diet(HFD)-induced MAFLD mouse model.In vitro studies were conducted using a palmitic acid/oleic acid-induced lipid accumulation model in the alpha mouse liver 12 cells and RAM-containing serum.The underlying mechanisms were elucidated through a combination of network pharmacology analysis,immunohis-tochemistry,western blotting,and polymerase chain reaction analysis.Results:Administration of RAM decoction significantly reduced body weight gain in MAFLD mice without changing food intake.The weights of the liver and inguinal adipose tissues were also reduced after RAM treatment.Additionally,RAM administration decreased serum levels of alanine aminotrans-ferase,aspartate transaminase,total cholesterol,triglyceride,low-density lipoprotein cholesterol,and glucose,while reducing lipid droplet accumulation in the liver tissues of MAFLD mice.The underlying mechanisms included the activation of the phosphorylation of AMPK and acetyl-CoA carboxylase(ACC),and inhibition of the expression of sterol regulatory element binding protein 1(SREBP1).However,RAM did not alter the protein expression levels of peroxisome proliferator-activated receptor α and carnitine palmitoyltransferase-1α.Furthermore,the RAM-induced upregulation of phosphorylated AMPK,phos-phorylated ACC,and SREBP1 expression,as well as the downregulation of fatty acid synthase expression,were reversed by using an AMPK inhibitor.Conclusions:Through a combination of network pharmacology and experimental validation,we demonstrated that RAM may exert therapeutic effects on MAFLD by inhibiting lipid synthesis and activating phosphorylated AMPK pathways.

Objective To characterize neurological alterations associated with structural bowel damage in patients with Crohn's disease(CD)through radiomics-assisted neurophenotyping,utilizing multiparametric brain MRI.Methods This prospective study enrolled patients with CD who underwent brain MRI,MR enterography,and ileocolonoscopy within one week.The Lémann Index was used to quantitatively assess cumulative structural bowel damage.CD patients were stratified into two groups based on a cutoff value of 4.8:those with bowel damage(LI>4.8)and those without bowel damage(LI≤4.8).A neurophenotype model was developed to characterize the neural changes associated with bowel damage in CD.Key features were selected from first-order features extracted from multiparametric brain MRI in the training cohort and validated in an independent test cohort.Results The final study population comprised 109 patients,including 51 individuals with bowel damage and 58 without bowel damage.The neurophenotype model scores were 0.785(95%CI:0.506～0.945)in the bowel damage group and 0.155(95%CI:0.093～0.394)in the non-bowel damage group,showing a statistically significant difference between the two groups(P<0.001).The developed model exhibited strong discriminative performance,with area under the receiver operating characteristic curve(AUC)values ranging from 0.824 to 0.918 across the training,vali-dation,and test cohorts(all P<0.05).Conclusion Our radiomics-assisted neurophenotype analysis reveals neural alterations in CD patients with bowel damage,which may indicate extraintestinal manifestations associated with cumulative intestinal injury.

Objective:To explore the current status and correlation of occupational stress and burnout among pediatric nurses.Methods:From April 2023 to January 2024, convenience sampling was used to select 150 pediatric nurses from Taizhou Hospital of Zhejiang Province, East Campus of Taizhou Hospital of Zhejiang Province, and Taizhou Enze Medical Center as research subjects. The survey was conducted using the General Information Questionnaire, Chinese version of the Maslach Burnout Inventory General Survey, and Nurse Job Stressors Scale.Results:A total of 150 nurses were surveyed, and 149 valid questionnaires were collected, with a valid response rate of 99.33%. Pediatric nurses had high scores in emotional exhaustion and depersonalization dimensions in occupational burnout. The job stressors for pediatric nurses were ranked in order of their scores in each dimension, including workload and time management, work environment and resources, nursing profession and work, management and interpersonal relationships, and patient nursing. There were correlations between occupational burnout and occupational stress among pediatric nurses in multiple dimensions (all P<0.05) . Conclusions:Pediatric nurses have a relatively high level of occupational burnout and often face significant occupational stress. In the development of the healthcare system, attention should be paid to the occupational burnout and stress of pediatric nurses. The physical and mental health of pediatric nursing staff can be promoted and work efficiency can be improved by reducing the overloaded work of pediatric nurses, optimizing personnel allocation, and improving social support.

ObjectiveTo explore the interaction among root fungi of Stellaria dichotoma var. lanceolata， soil factors， and main components of medicinal materials in lithosol habitats. MethodHigh-throughput sequencing technology was employed to determine the fungal community of the root system of S. dichotoma var. lanceolata at different levels （bulk soil， rhizosphere soil， rhizoplane soil， and root interior） and the soil properties of the root system （bulk and rhizosphere）， and the relationship among the fungal community， soil properties， and the main components of medicinal materials was analyzed. ResultThe total phosphorus， available phosphorus， alkaline nitrogen， dissolved organic carbon， and soil water content in the rhizosphere soil of S. dichotoma var. lanceolata were slightly higher than those in the rhizosphere， but the difference was not significant. Ascomycota is the dominant phylum of root fungi in S. dichotoma var. lanceolata. In the progressive level of bulk-rhizosphere-rhizoplane-root interior system， although the fungal diversity gradually decreased， the abundance of Hypocreales， a new phylum （unclassified_ k_ Fungi）， Helotiales， and Natipusilales gradually increased， among which Hypocreales is the most important fungal group in the root system of S. dichotoma var. lanceolata. The structural equation model （SEM） shows that the physicochemical factors of the root-soil play an important regulatory role in the fungal community and the main components of medicinal herbs， with soil total nitrogen， alkaline nitrogen， soil water content， and pH being the main regulatory factors. Soil nitrogen content is the key to promoting the main components of the medicinal herbs， and Penicillium fungi are the key fungal group to regulate the main components of the medicinal herbs. ConclusionIt highlights that the physicochemical properties of the soil of S. dichotoma var. lanceolata play a crucial role in the fungal community and the components of medicinal materials. Hypocreales fungi in the root of S. dichotoma var. lanceolata were an important group， and Penicillium fungi had a certain role in mediating the components of medicinal materials.

Objective:To explore the changes in serum neuron-specific enolase（NSE）in patients with moderately severe to profound idiopathic sudden sensorineural hearing loss（ISSHL）and the effect of hyperbaric oxygen（HBO）therapy on NSE，and to analyze the relationship between hearing recovery and serum NSE levels.Methods:Using convenient sampling，a total of 90 inpatients with unilateral moderately severe to profound ISSHL were selected as the research subjects，and they were divided into observation group and control group according to the random number table method，with 45 cases in each group. The control group received hormones，Ginkgo biloba injection，and neurotropic drugs，and the observation group was treated with HBO based on the treatment of the control group. Pure tone audiometry was performed before and after treatment to test hearing levels，and serum NSE was determined by ELISA. After 20 days of treatment，the effective rates and the changes of NSE of the two groups were compared，and the relation between NSE level and hearing change were analyzed.Results:The serum NSE levels of ISSHL patients in both groups were significantly higher than those of the control group，and it was correlated with the severity of hearing loss（ P<0.01）. The serum NSE levels of profound ISSHL patients were significantly higher than those of moderately severe and severe ISSHL patients（ P<0.01）. After treatment，the clinical effective rate of the observation group（82.2%）was significantly higher than that of the control group（60.0%）（ P<0.05）；the hearings of the patients in both groups were significantly improved compared with those before treatment；the pure tone average of the observation group was lower than that of the control group（ P<0.05）；and the hearing threshold gain of the observation group was significantly higher than that of the control group（ P<0.01）. After treatment，the NSE levels of the patients in the two groups decreased after treatment；the NSE level of the observation group was significantly lower than that of the control group（ P<0.05）；and the decrease of NSE level in the observation group was significantly greater than that of the control group（ P<0.01）. The decreases of serum NSE in the two groups were positively correlated with the gains of the auditory domain（ r=0.686， P<0.01 in the observation group； r=0.418， P<0.01 in the control group）. Conclusion:The serum NSE level of patients with moderately severe to profound ISSHL is increased，which is related to the severity of hearing loss. Additionally adopting HBO therapy could improve the hearing of patients，increase the effective rate，and reduce the NSE level of ISSHL patients.

Objective To investigate the effect of naringenin on the killing rate of natural killer (NK) cells and related mechanism by amplification of human peripheral blood mononuclear cells into NK cells in vitro and co-culture with hepatocellular carcinoma (HCC) CLC5 cells at a ratio of 1∶ 1. Methods A lymphocyte separation medium was used to isolate human peripheral blood mononuclear cells, which were induced with recombinant human interleukin-2 in vitro to culture NK cells. CCK-8 assay was used to measure the proliferation of HCC cells after human HCC cells were treated with naringenin (0, 3.125, 6.25, 12.5, 25, and 50 μmol/L) for 0, 24, and 48 hours, and after human NK cells were treated with different concentrations of naringenin for 24 hours, CCK-8 assay was used to measure the proliferation of NK cells. CellTiter-LumiTM was used to measure the killing rate of NK cells after the NK-HCC cell co-culture system at the ratio of 1∶ 1 was treated with naringenin for 24 hours. Quantitative real-time PCR was used to measure the gene expression of the activating receptor NKG2D in NK cells and NKG2D ligands in HCC cells. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results After being induced and cultured by recombinant human interleukin-2, NK cells were amplified to 82.33%±0.70% of human peripheral blood mononuclear cells. After naringenin treatment for 24 hours, there was no significant difference in the proliferation rate of HCC CLC5 cells between all mass concentration groups (all P > 0.05), and in the 25 and 50 μmol/L mass concentration groups, naringenin significantly promoted the proliferation of NK cells (both P < 0.000 1). After the NK-HCC cell co-culture system at the ratio of 1∶ 1 was treated with naringenin for 24 hours, there was a significant increase in the killing rate of NK cells in the 25 and 50 μmol/L mass concentration groups (both P < 0.000 1). After the co-culture system was treated with naringenin for 24 hours, naringenin had no effect on the expression of NKG2D in NK cells in the 25 and 50 μmol/L mass concentration groups, and it also had no effect on the expression of MICB and ULBP2 in HCC cells (all P > 0.05); it significantly upregulated the expression of the NKG2D ligands such as ULBP1 and ULBP3 in HCC cells (all P < 0.001). Conclusion Naringenin may increase the killing activity of NK cells by upregulating the expression of NKG2D ligands in HCC cells.

Objective:To explore the changes in serum neuron-specific enolase（NSE）in patients with moderately severe to profound idiopathic sudden sensorineural hearing loss（ISSHL）and the effect of hyperbaric oxygen（HBO）therapy on NSE，and to analyze the relationship between hearing recovery and serum NSE levels.Methods:Using convenient sampling，a total of 90 inpatients with unilateral moderately severe to profound ISSHL were selected as the research subjects，and they were divided into observation group and control group according to the random number table method，with 45 cases in each group. The control group received hormones，Ginkgo biloba injection，and neurotropic drugs，and the observation group was treated with HBO based on the treatment of the control group. Pure tone audiometry was performed before and after treatment to test hearing levels，and serum NSE was determined by ELISA. After 20 days of treatment，the effective rates and the changes of NSE of the two groups were compared，and the relation between NSE level and hearing change were analyzed.Results:The serum NSE levels of ISSHL patients in both groups were significantly higher than those of the control group，and it was correlated with the severity of hearing loss（ P<0.01）. The serum NSE levels of profound ISSHL patients were significantly higher than those of moderately severe and severe ISSHL patients（ P<0.01）. After treatment，the clinical effective rate of the observation group（82.2%）was significantly higher than that of the control group（60.0%）（ P<0.05）；the hearings of the patients in both groups were significantly improved compared with those before treatment；the pure tone average of the observation group was lower than that of the control group（ P<0.05）；and the hearing threshold gain of the observation group was significantly higher than that of the control group（ P<0.01）. After treatment，the NSE levels of the patients in the two groups decreased after treatment；the NSE level of the observation group was significantly lower than that of the control group（ P<0.05）；and the decrease of NSE level in the observation group was significantly greater than that of the control group（ P<0.01）. The decreases of serum NSE in the two groups were positively correlated with the gains of the auditory domain（ r=0.686， P<0.01 in the observation group； r=0.418， P<0.01 in the control group）. Conclusion:The serum NSE level of patients with moderately severe to profound ISSHL is increased，which is related to the severity of hearing loss. Additionally adopting HBO therapy could improve the hearing of patients，increase the effective rate，and reduce the NSE level of ISSHL patients.

Objective:To explore the clinical characteristics and risk factors of the severe delayed encephalopathy after acute carbon monoxide poisoning (s-DEACMP).Methods:A retrospective analysis of 170 acute carbon monoxide poisoning (ACMP) patients treated in the Hyperbaric Oxygen (HBO) Department of Beijing Chao-yang Hospital, Capital Medical University from January 1st, 2017 to December 31st, 2020 was conducted. According to the occurrence of delayed encephalopathy, the ACMP patients were divided into DEACMP group and non-DEACMP (n-DEACMP) group. The DEACMP patients were stratified by the activities of daily living scale when they were most severely ill. The patients with total score≤60 were classified as s-DEACMP and the patients with total score >60 were classified as mild to moderate DEACMP (m-DEACMP). Their clinical characteristics were compared and the risk factors of s-DEACMP were analyzed.Results:There were 70 s-DEACMP patients, 49 m-DEACMP patients, and 51 n-DEACMP patients. Compared with the n-DEACMP group, the s-DEACMP group was older (average age: 59.0 vs. 49.0, P=0.005), had a higher proportion of patients over 40 years old (97.1% vs. 66.7%, P<0.001), lower Glasgow coma scale scores [(4.0±3.0) vs.(6.0±5.0), P=0.024] on admission to the hospital, longer consciousness disturbance [(32.0±31.8) h vs.(20.5±26.4) h, P=0.017], a higher proportion of patients with consciousness disturbance over 48 hours (24.3% vs. 9.8%, P=0.041), a lower proportion of patients receiving HBO therapy (70.0% vs. 86.3%, P=0.036), a higher proportion of patients with hypertension (38.6% vs. 17.6%, P=0.013), a higher proportion of patients with hyperhomocysteinemia (40.0% vs. 19.6%, P=0.017), and a higher proportion of patients with smoking index over 400 (24.3% vs. 9.8%, P=0.041). Compared with the m-DEACMP group, the s-DEACMP group had a higher proportion of patients with hyperhomocysteinemia (40.0% vs. 20.4%, P=0.024). Multivariate Logistic regression showed that age over 40 years old, consciousness disturbance over 48 hours, hypertension, and hyperhomocysteinemia were independent risk factors of s-DEACMP( P<0.05). Conclusion:The clinical characteristics of s-DEACMP patients are that the patients are older, have a deeper and longer consciousness disturbance, a lower proportion of early HBO intervention, a higher proportion of hypertension, hyperhomocysteinemia, and smoking index over 400. Among them, the age over 40 years old, disturbance consciousness over 48 hours, and hypertension were the independent risk factors of the occurrence of s-DEACMP.In additon hyperhomocysteinemia was also an idependent risk factor for s-DEAMP, which special worth attention.