ObjectiveTo investigate the therapeutic effect of Astragali Radix-mediated changes in gut microbiota on treating type 2 diabetes （T2DM）. MethodsA 12-week randomized， placebo-controlled clinical trial enrolled eighty patients with newly diagnosed type 2 diabetes and poor glycemic control in the Qi deficiency type. All patients received insulin therapy. The observation group （40 cases） was administered with Astragali Radix Granules， while the control group （40 cases） received a placebo. Both treamtents were taken orally twice daily. Changes in gut microbiota were assessed by 16s rDNA sequencing. Serum glucagon-like peptide-1 （GLP-1） levels were measured using enzyme-linked immunosorbent assay （ELISA）. Glucose metabolism indicators including fasting blood glucose （FPG）， 2-hour postprandial blood glucose （2 h PG），glycated albumin（GA）， and glycated hemoglobin （HbA1c） were evaluated. Pancreatic function was evaluated using fasting C-peptide （FCP）， 2-hour postprandial C-peptide （2 h CP）， and C-peptide area under the curve （AUC_cp）. Traditional Chinese medicine （TCM） syndrome scores， clinical efficacy， and safety indicators were also observed. ResultsIn terms of glucose metabolism indicators， compared with the baseline， both groups exhibited significantly lower FPG， 2 h PG， GA and HbA1C （P<0.01），while FCP， 2 h CP and AUC_cp were significantly higher （P<0.01）. Compared with the control group after the treatment， the observation group showed significantly lower FPG， 2 h PG， GA and HbA1C（P<0.05， P<0.01），and significantly higher FCP， 2 h CP and AUC_cp （P<0.05， P<0.01）， indicating that Astragali Radix can improve glucose metabolism. In terms of the diversity of gut microbiota， no significant differences were detected in the Chao1， Shannon and Simpson indexes of the two groups compared with their respective baselines. However， compared with the post-treatment control group， the observation group demonstrated significant increases in the Chao1， Shannon and Simpson indexes （P<0.05， P<0.01）. The β-diversity analysis showed significant separation in gut microbiota composition before and after treatment in both groups， indicating that Astragali Radix can significantly alter the structure and improve the diversity of gut microbiota. At the phylum level， compared with the baseline， both groups showed a significant increase in the relative abundance of Bacteroidota（P<0.01）. The relative abundance of the potentially harmful phylum Proteobacteria was significantly lower in the observation Group after treatment （P<0.01）. Compared with the post-treatment control group， the observation group had a significantly higher relative abundance of Bacteroidota（P<0.01）. No significant difference was found in Firmicutes/Bacteroidota （F/B） ratio between the two groups after treatment， and other phyla showed no significant differences. At the genus level， compared with the baseline， the observation group exhibited a significant increase in Bacteroides （P<0.01） and a significant decrease in Escherichia-Shigella （P<0.01）， whereas no significant difference was seen in the control group . Compared with the control group after treatment， the observation group after treatment had a significantly higher relative abundance of Bacteroides （P<0.01）. No significant differences were seen in other genera. Linear discriminant analysis （LDA） identified potential characteristics taxa： in the observation group， Bacteroidota at the phylum level and Bacteroides and Dubosiella at the genus level， in the control group， Proteobacteria at the phylum level as well as Barnesiella and Staphylococcus at the genus level. Correlation analysis based on a heatmap revealed that GLP-1 levels were positively correlated with Firmicutes， F/B ratio and Fusobacterium， and negatively correlated with Bacteroidota， Proteobacteria， Bacteroides and Escherichia-Shigella. In terms of clinical efficacy， compared with the control group， the total effective rate of the observation group was significantly higher （P<0.05）. Compared with the baseline， the scores for shortness of breath， fatigue， weakness， spontaneous sweating and reluctance to speak significantly decreased in both groups （P<0.01）. Compared with the control group after treatment， the score for weakness was significantly lower in the observation group （P<0.01），indicating that Astragali Radix could improve clinical symptoms and alleviate weakness symptoms. In terms of safety， compared with the baseline， alanine aminotransferase （ALT） levels significantly decreased in both groups （P<0.05，P<0.01），indicating that Astragali Radix did not induce any significant abnormalities in liver and kidney functions. ConclusionAstragali Radix demonstrates the potential to significantly improve the gut microbiota environment in patients of newly diagnosed type 2 diabetes with Qi deficiency. The therapeutic effect may contribute to glycemic control， possibly mediated by an elevation in GLP-1 level. These findings may support its further clinical investigations and potential applications.

AIM: To investigate the changes in serum levels of trefoil factor 1(Tff1)and bone morphogenetic protein 4(BMP4)in patients with diabetic retinopathy, and to evaluate their diagnostic value for diabetic retinopathy.METHODS: From January 2022 to January 2024, 186 patients with type 2 diabetes were selected as the study group and divided into a retinopathy subgroup(52 cases)and a non-retinopathy subgroup(134 cases)based on the presence of retinopathy. Another 186 healthy volunteers who underwent physical examinations during the same period were chosen as the control group. Serum Tff1 and BMP4 levels were measured using the enzyme-linked immunosorbent assay(ELISA). Pearson analysis was used to assess the correlation between serum Tff1, BMP4 levels, and clinical data. Multivariate Logistic regression analysis was performed to identify factors influencing the development of retinopathy in type 2 diabetic patients. Receiver operating characteristic(ROC)curve analysis was conducted to evaluate the diagnostic value of serum Tff1 and BMP4 levels for retinopathy in type 2 diabetic patients.RESULTS: Compared to the control group, serum Tff1 levels were lower and BMP4 levels were higher in both retinopathy and non-retinopathy subgroups(all P<0.05). Specifically, serum Tff1 levels were lower and BMP4 levels were higher in the retinopathy subgroup than in the non-retinopathy subgroup(all P<0.05). Pearson analysis revealed that Tff1 levels in type 2 diabetes patients were negatively correlated with disease duration, glycated hemoglobin levels, and triglyceride levels, while BMP4 levels were positively correlated(all P<0.05). Multivariate Logistic regression analysis identified type 2 diabetes duration, glycated hemoglobin, triglycerides, Tff1, and BMP4 as influencing factors for retinopathy development in type 2 diabetes patients(all P<0.05). ROC curve analysis showed that the combined diagnosis of serum Tff1 and BMP4 had an area under the curve(AUC)of 0.901, which was significantly higher than that of Tff1 alone(Z=2.069, P=0.039)and BMP4 alone(Z=2.072, P=0.038).CONCLUSION: Serum Tff1 levels are decreased and BMP4 levels are increased in patients with diabetic retinopathy, and the combined detection of these two markers offers high diagnostic value for diabetic retinopathy.

Maxillofacial fractures are common and frequently occurring diseases in Oral and Maxillofacial Surgery.The traditional clinical diagnosis and treatment process is easily affected by complex maxillofacial anatomy and differences in doctors' experience in reading X-rays and making diagnoses.In recent years,artificial intelligence technology has provided new solutions for the accurate diag-nosis and treatment planning of maxillofacial fractures.Automating image analysis through computer vision methods improves diagnostic accuracy and efficiency and assists in formulating treatment plans,showing broad application prospects and value.This article reviews and summarizes the research on the application of artificial intelligence in the auxiliary diagnosis and treatment of maxillofacial fractures at home and abroad,analyzes its advantages and disadvantages,and looks forward to future research trends.

Maxillofacial fractures are common and frequently occurring diseases in Oral and Maxillofacial Surgery.The traditional clinical diagnosis and treatment process is easily affected by complex maxillofacial anatomy and differences in doctors' experience in reading X-rays and making diagnoses.In recent years,artificial intelligence technology has provided new solutions for the accurate diag-nosis and treatment planning of maxillofacial fractures.Automating image analysis through computer vision methods improves diagnostic accuracy and efficiency and assists in formulating treatment plans,showing broad application prospects and value.This article reviews and summarizes the research on the application of artificial intelligence in the auxiliary diagnosis and treatment of maxillofacial fractures at home and abroad,analyzes its advantages and disadvantages,and looks forward to future research trends.

Objective To investigate the influence factors of re-occlusion after intravenous thrombolysis of alteplase in patients with cerebral infarction and the therapeutic effect of tirofiban. Methods A total of 100 patients with cerebral infarction were selected as the study objects. The patients were divided into occlusion group (n=42) and non-occlusion group (n=58) according to whether re-occlusion after intravenous thrombolysis with alteplase. The occlusion group was given tirofiban treatment. General data were compared between two groups. Logistic regression model was used to analyze the influencing factors of re-occlusion after alteplase intravenous thrombolysis in patients with cerebral infarction. The total effective rate, recombinant human tissue plasminogen activator (rPA), plasminogen activator inhibitor-1 (PAI-1) levels and the score of National Institutes of Health Stroke Scale (NIHSS) and Simple Mental State Scale (MMSE) in the occlusion group were observed. Results There were statistically significant differences in type 2 diabetes mellitus, blood glucose, systolic blood pressure, NIHSS score and onset-thrombolysis time between the two groups (P < 0.05). Logistic regression analysis showed that type 2 diabetes mellitus, blood glucose, systolic blood pressure, NIHSS score, and onset- thrombolytic time were the influential factors of re-occlusion after intravenous thrombolytic alteplase in cerebral infarction patients (P < 0.05). The total effective rate was 88.10% (37/42) in 42 patients with re-occlusion after thrombolytic therapy. After 3 and 7 days of treatment, rPA was significantly higher than before treatment, PAI-1 was significantly lower than before treatment (P < 0.05); after 1 week, 2 and 4 weeks of treatment, MMSE score was significantly higher than before treatment, NIHSS score was significantly lower than before treatment (P < 0.05). Conclusion Type 2 diabetes mellitus, blood glucose, systolic blood pressure, NIHSS score, and time of onset and thrombolytic therapy may affect the re-occlusion of patients with cerebral infarction after alteplase intravenous thrombolytic therapy. The effect of tirofiban after re-occlusion is better, which is beneficial to improve the neurological function, rPA and PAI-1 levels of patients.

Objective:To investigate the clinicopathological characteristics of spiradenocarcinoma, cylindrocarcinoma, and spiradenocylindrocarcinoma, and to understand the correlations between their morphological patterns and clinical behaviors.Methods:Seven cases of spiradenocarcinoma, cylindrocarcinoma, and spiradenocylindrocarcinoma diagnosed at Fudan University Shanghai Cancer Center, Shanghai, China from 2015 to 2021 were collected. The clinicopathological characteristics and follow-up data were retrospectively analyzed. Histopathologic evaluation and immunohistochemical studies were carried out.Results:There were four men and three women in the cohort, with ages ranging from 46 to 75 years (mean, 61 years). The tumors were located on the head and neck (four cases), extremities (two cases), and trunk (one case). Histologically, the residuum of a benign neoplasm was present in all cases. One case presented salivary gland-type basal cell adenocarcinoma-like pattern, low-grade (BCAC-LG). Another case showed salivary gland-type basal cell adenocarcinoma-like pattern, high-grade (BCAC-HG). The remaining five cases were invasive adenocarcinoma, not otherwise specified (IAC-NOS). One of IAC-NOS contained a mucinous adenocarcinoma component. Immunohistochemically, BCAC-LG and BCAC-HG predominantly expressed basal cell markers such as p63 and p40, whereas IAC-NOS primarily exhibited positivity for CK7, a glandular epithelial marker. Follow-up was available for six patients, ranging from 1 to 9 years (mean, 4.5 years). Among the four patients of IAC-NOS with follow-up, three showed recurrences, two had regional lymph node metastases, and one died.Conclusions:The malignant components of spiradenocarcinomas, cylindrocarcinomas, and spiradenocylindrocarcinomas in this cohort contain BCAC-LG, BCAC-HG and IAC-NOS. This study also shows the presence of mucinous adenocarcinoma components in IAC-NOS. The tumors with IAC-NOS have a relatively poorer prognosis than those without.

Rosacea is a chronic recurrent inflammatory skin disease, and correct assessment of clinical symptoms and severity may facilitate treatment options. This review summarizes a range of subjective, semi-subjective and objective methods currently used in the assessment of rosacea severity, in order to provide useful tools for clinical assessment of rosacea severity and give guidance on treatment modification according to the therapeutic effect.

ObjectiveTo explore the effect of Ganoderma leucocontextum ethanol extract (GLE) on silicosis and its potential molecular mechanism using network pharmacology, molecular docking technology and animal experiments. Methods i) The components of GLE were analyzed using ultra-performance liquid chromatography-Q Exactive-mass spectrometry (UPLC-QE-MS) method. The active components, potential molecular pathways and targets of GLE in the intervention of inflammation process of silicosis was explored using network pharmacology and molecular docking technology. ii) Specific pathogen free male C57BL6/J mice were divided into four groups with 10 mice in each group. The mice in the silicosis model group and GLE intervention group were given a dose of 80 μL silica suspension with a mass concentration of 50 g/L once by non-exposed tracheal instillation, and the mice in the blank control group and GLE control group were given an equal volume of sterile 0.9% sodium chloride solution. From the second day after modeling, GLE control group and GLE intervention group were given GLE at a dose of 200 mg/(kg•d) by gavage, while blank control group and silicosis model group were given the same volume of 0.9% sodium chloride solution by gavage, once per day for 35 days. After that, the histopathological changes of lung tissues of mice were observed, the lung mass coefficient, inflammation score and the ratio of collagen deposition area were calculated, and the levels of tumor necrosis factor (TNF) -α, interleukin (IL) -1β and IL-6 in the lung tissues of mice were detected by enzyme-linked immunosorbent assay. Results i) A total of 76 active components of GLE were detected by UPLC-QE-MS. Among them, 36 ingredients met the screening criteria of the five principles of drug-like components. A total of 67 potential targets of the 36 GLE active ingredients to improve the inflammatory response of silicosis were screened based on the network pharmacology theory. The result of Kyoto Encyclopedia of Genes and Genomes enrichment analysis and Gene Ontology functional analysis showed that IL signaling and cytokine signaling of immune cells played a key role in the process of anti-silicosis of GLE. The results of molecular docking showed that the top 10 targets based on the 67 intersection targets were TNF, IL6, B-cell lymphoma 2, cellular tumor antigen p53, Caspase-3 subunit p12, JUN, epidermal growth factor receptor, IL1B, 67 kDa matrix metalloproteinase-9 and prostaglandin G/H synthase 2. The result of protein-protein interaction analysis showed that glycyrrhetinic acid had the strongest affinity with the key targets TNF-α, IL-1β and IL-6, followed by ganoderma acid DM, alismatol C, ganoderma acid β and red sapogenin. ii) The results of histopathological examination showed that the inflammatory response and collagen deposition were alleviated in the lungs of mice with silicosis. The lung mass coefficient, inflammation score, ratio of collagen deposition area and IL-6 expression in lung were lower in mice of the GLE intervention group (all P<0.05), compared with the silicosis model group. However, there was no significant difference in the levels of TNF-α and IL-1β in lung tissues between the two groups (all P>0.05). Conclusion GLE may reduce silica-induced lung inflammation and fibrosis by inhibiting the IL-6 level in lung tissues of mice. Its mechanism is associated with the synergistic action of multi-components, multi-targets and multi-pathways.

Objective This study aims to compare the accuracy of self-developed universal implant guide(SDG),3D printed digital guide(DG),and free hand(FH)simulated implantation in the posterior tooth area of dental models.Methods Ten junior dentists were selected to place three implants in the 35,37,and 46 tooth sites of the mandibular models(35,36,37,and 46 missing teeth)by using SDG,DG,and FH,and the process was repeated again to take the av-erage value.Cone beam computed tomography(CBCT)was used to evaluate the global coronal deviation,global apical deviation,depth deviation,and angular deviation between the actual position and preoperative planned position.Re-sults The coronal deviation and apical deviation of the three implant sites in the SDG group were not significantly dif-ferent from those in the two other groups(P>0.05).The depth deviation and angular deviation in the SDG group were smaller than those in the DG group(P<0.05)and FH group(P<0.05),respectively.All deviations at site 37 in the SDG group were not different from those at site 35(P>0.05),while the depth and angular deviation at site 37 in the DG group were higher than those at site 35(P<0.05).Conclusion The precision of the self-developed universal dental im-plant guide can meet the requirements of clinical posteri-or implantation.

Humans ; Skin ; Rosacea ; Patients