Objective To investigate the protective effect of β-glucan(BG)against intestinal ischemia reperfusion(II/R)injury by regulating the secretion of glucagon-like peptide-1(GLP-1).Methods Male C57BL/6 mice(6～8 weeks old)were subjected,and finally,the experiments had sham group,II/R group,II/R+BG group(0.1 mg/mL BG in drinking water for 2 weeks before modeling),II/R+liraglutide(LLT,GLP-1 analogue)group(0.2 μg/g LLT injected every 12 hours for 3 consecutive days before modeling),and II/R+BG+Ex9-39(GLP-1 R antagonist)group(intraperitoneal injection of 2 μg/g Ex9-39 1 h before modeling).After modeling,HE staining was used to observe intestinal morphological changes,and RT-qPCR and Western blotting were employed to evaluate the molecules(Occludin,ZO-1 and Claudin-1)related to intestinal barrier damage.The effect of 0.1 mg/mL BG treatment on the GLP-1 level in the serum and intestinal tissues of normal mice was determined with ELISA and immunofluorescence assay,respectively,and RT-PCR for the molecules related to GLP-1 expression(Gcg,Pcsk1/2,GIP and Foxa2).The effects of LLT and Ex9-39 pretreatment on intestinal morphology and intestinal barrier damage were also determined by morphological observation and expression levels of related molecules.Results II/R induced significant decreases in the mRNA levels of Occludin,ZO-1 and Claudin-1 and increase in Chiu's score when compared with sham control mice(P＜0.05).While,the mRNA levels of the 3 molecules were obviously higher and the Chiu's score was lower in the II/R+BG group than the II/R group(P＜0.05).BG pretreatment induced notably enhanced secretion of GLP-1 in the serum and intestinal tract of normal mice,and improved the mRNA expression of GLP-1-related molecules(P＜0.05).The intervention of GLP-1 analogue LLT could attenuate the II/R damage and decreased Chiu's score,with statistical difference in comparison with the II/R group(P＜0.05).GLP-1 receptor antagonist Ex9-39 reversed the protective effects of BG pretreatment against II/R damage,with notably differences in the expression of Occludin,ZO-1 and Claudin-1 and Chiu's score(P＜0.05).Conclusion BG can attenuate intestinal mucosal and functional injury after II/R by promoting intestinal GLP-1 secretion.

Objective To analyze the diversity and composition changes of gut fungal communities between patients with chronic kidney disease(CKD)and healthy controls.Methods A total of 8 CKD patients admitted in Department of Nephrology of our hospital,and another 5 age-and gender-matched healthy individuals were recruited in this study.Fresh fecal samples were collected from the CKD patients and healthy controls.ITS DNA sequencing was employed to determine the composition of intestinal fungi,and then bioinformatics analysis was applied to compare the differences in fungal community diversity,structure,and function between the 2 groups.Results There were no statistical differences between the 2 groups in terms of age,gender composition,BMI,and so forth.The results of Alpha diversity assessment showed statistical differences were observed in Simpson index and Shannon index in the intestinal fungi between the 2 groups(P＜0.01).So was in the Beta diversity between them(P＜0.01).The relative abundance of Candida was increased significantly(P＜0.01),while those of Cladosporium and Penicillium were decreased in the CKD group(P＜0.05).LEfSe analysis revealed that Candida was significantly enriched in CKD patients,whereas Cladosporium and Penicillium were significantly lower in abundance when compared to the healthy control group.Conclusion The composition of intestinal fungi in CKD patients is different from that in healthy individuals,exhibiting characteristic changes.Dysfunction of gut fungal flora may promote the progression of CKD.Regulating gut fungi and restoring gut microbiota homeostasis may become a new strategy for CKD treatment.

Objective:To assess iodine nutritional status and the prevalence of thyroid dysfunction in Kunming, Yunnan Province, along with correlation and risk factors between thyroid dysfunction and urinary iodine levels.Methods:This cross-sectional study was conducted from January 2014 to July 2016 using a multi-stage, stratified cluster sampling method. A total of 2 650 residents of Kunming, Yunnan Province, who met the inclusion criteria were selected. Data on participants′ demographics, physical measurements, and laboratory tests were collected through questionnaire and clinical assessments which led to 1 463 subjects in the final analysis considering missing data. Statistical analysis were performed using SPSS 26.0, while R Studio was used to model the nonlinear relationship between urinary iodine levels and the risk of thyroid dysfunction.Results:(1) Among 2 650 subjects, 755(28.5%) were diagnosed with thyroid dysfunction, with incidence rates of clinical hyperthyroidism(0.83%), subclinical hyperthyroidism(0.38%), clinical hypothyroidism(1.36%), subclinical hypothyroidism(17.66%), and isolated thyroid antibody positive(13.85%). The median urinary iodine concentration was 177.49(123.59, 251.85) μg/L, indicating adequate iodine nutritional. (2)Among the 1 463 subjects analyzed, significant differences in urinary iodine were found between healthy individual group and abnormal TSH group or abnormal TSH group and thyroid antibody positive group( H=-83.437, P=0.003; H=107.489, P=0.003). Logistic regression revealed that rural residents had a lower risk of thyroid dysfunction than urban residents( OR=0.429, 95% CI 0.256-0.717, P=0.001). Risk of thyroid disease increased with age, and TSH, thyroid peroxidase antibody(TPOAb), thyroglobulin antibody(TgAb), and urinary iodine levels were identified as significant risk factors, with a U-shaped relationship between urinary iodine levels and thyroid dysfunction. Conclusions:The prevalence of thyroid dysfunction in Kunming is comparable to the national average. The relationship between urinary iodine concentration and thyroid dysfunction follows a U-shaped curve. Factors including region, age, TSH, TPOAb, TgAb, and urinary iodine concentration are associated with thyroid dysfunction.

Objective To explore the indication, surgical technique, and clinical efficacy of the cross bar based on the Nuss procedure in pectus excavatum. Methods The clinical data of patients who underwent cross bar based on the Nuss procedure from August 2023 to August 2024 in Guangdong Provincial People's Hospital were retrospectively analyzed. Results A total of 88 patients including 85 males and 3 females with a mean age of (17.56±5.20) years were enrolled. All operations were performed successfully without intraoperative cardiac injury, pericardial injury or diaphragmatic injury. The mean operation time was (147.65±47.75) min. The mean blood loss was (13.30±9.06) mL. The mean postoperative hospitalization stay was (4.81±1.55) days, without perioperative death. Six (6.82%) patients developed early postoperative complications, including 3 patients of pleural effusion, 1 patient of subcutaneous hematoma, 1 patient of suffocation and 1 patient of bar rotation. The postoperative outcomes were excellent in 71 (80.68%) patients, good in 16 (18.18%) patients and moderate in 1 (1.13%) patient. The excellent and good rate was 98.86%. Conclusion The cross bar technique is safe and convenient, with satisfactory results. It is worth promoting in clinical application.

Objective:To assess iodine nutritional status and the prevalence of thyroid dysfunction in Kunming, Yunnan Province, along with correlation and risk factors between thyroid dysfunction and urinary iodine levels.Methods:This cross-sectional study was conducted from January 2014 to July 2016 using a multi-stage, stratified cluster sampling method. A total of 2 650 residents of Kunming, Yunnan Province, who met the inclusion criteria were selected. Data on participants′ demographics, physical measurements, and laboratory tests were collected through questionnaire and clinical assessments which led to 1 463 subjects in the final analysis considering missing data. Statistical analysis were performed using SPSS 26.0, while R Studio was used to model the nonlinear relationship between urinary iodine levels and the risk of thyroid dysfunction.Results:(1) Among 2 650 subjects, 755(28.5%) were diagnosed with thyroid dysfunction, with incidence rates of clinical hyperthyroidism(0.83%), subclinical hyperthyroidism(0.38%), clinical hypothyroidism(1.36%), subclinical hypothyroidism(17.66%), and isolated thyroid antibody positive(13.85%). The median urinary iodine concentration was 177.49(123.59, 251.85) μg/L, indicating adequate iodine nutritional. (2)Among the 1 463 subjects analyzed, significant differences in urinary iodine were found between healthy individual group and abnormal TSH group or abnormal TSH group and thyroid antibody positive group( H=-83.437, P=0.003; H=107.489, P=0.003). Logistic regression revealed that rural residents had a lower risk of thyroid dysfunction than urban residents( OR=0.429, 95% CI 0.256-0.717, P=0.001). Risk of thyroid disease increased with age, and TSH, thyroid peroxidase antibody(TPOAb), thyroglobulin antibody(TgAb), and urinary iodine levels were identified as significant risk factors, with a U-shaped relationship between urinary iodine levels and thyroid dysfunction. Conclusions:The prevalence of thyroid dysfunction in Kunming is comparable to the national average. The relationship between urinary iodine concentration and thyroid dysfunction follows a U-shaped curve. Factors including region, age, TSH, TPOAb, TgAb, and urinary iodine concentration are associated with thyroid dysfunction.

Malignancies are a difficult to treat disease in clinical practice.At present,there are many cases of differentiation and treatment based on qi and yin deficiency,the coagulation of phlegm,blood stasis and cancer toxin,there are few theories on the treatment of yang deficiency and yin excessiveness,as well as the coagulation of cold and dampness.On the basis of inheriting the cancer toxin theory of Chinese medicine master ZHOU Zhongying,combined with the theory of promoting yang and our own practice,we believe that malignancy is caused by yang deficiency as the foundation,cold dampness,phlegm-turbidity stagnation and toxin transformation as the manifestation,and the key pathogenesis can be summarized as yang deficiency and yin binding.Based on this,it is proposed to differentiate and treat malignancies from promoting yang and eliminating yin.The method of promoting yang and eliminating yin is people-oriented,with harmony as the value,based on the whole,with a focus on adjusting harmony,constantly promoting yang and timely eliminating yin.The specific differentiation and treatment strategies are as follows:in the early stages of malignancy,it is important to seize the opportunity to warm and dredge,or eliminate yin;malignancy is already present,balancing deficiency and excess,supplementing,eliminating,and harmonizing appropriately;after malignancy surgery,it is important to strengthen the foundation and regulate the spleen and kidney,and strengthen both congenital and acquired constitution;treating the zang-fu organs accordingly,elevating and lowering,and conforming to the physiology of the organs.Unlike simple malignancy treatment and detoxification,promoting yang and eliminating yin is a method of examining symptoms and identifying etiology and pathogenesis.It involves macroscopic regulation of yin and yang,dynamic management of medication,and orderly treatment,which can significantly improve the quality of life of patients and increase long-term survival rates.Exploring the theory and strategy of promoting yang and eliminating yin in the differentiation and treatment of malignancy can provide new ideas and references for the clinical differentiation and treatment of malignancies.

Objective To analyze the diversity and composition changes of gut fungal communities between mouse model of total parental nutrition(TPN)and normal control mice.Methods After mouse model of TPN was constructed,fresh feces were collected from TPN mice(n=5)and normal control mice(n=5).Internal transcribed spacer(ITS)DNA sequencing was applied to determine intestinal fungi,and then bioinformatics analysis was conducted to identify the differences in fungal diversity,structure,and functional properties between the 2 groups of mice.Results There were significant differences in Alpha diversity(P＜0.05)and Beta diversity(P＜0.01)of intestinal fungi between the 2 groups.In the TPN model group,the relative abundances of Candida,Penicillium,Aspergillus and Talaromyces were obviously reduced(all P＜0.01).LEfSe analysis indicated that the above 4 strains were notably enriched in the normal control mice.Conclusion TPN mice exhibit characteristic changes in the composition of gut fungal flora compared to normal control mice.Dysfunction of gut fungal community may promote the occurrence of TPN related complications,and regulating the balance of gut fungal community may become a new strategy for preventing TPN related complications.

Objective To campare biomechanical effects of different postural compression techniques on three-dimensional model of lumbar disc herniation(LDH)by finite element analysis.Methods Lumbar CT image of a 48-year-old female patient with LDH(heighted 163 cm,weighted 53 kg)was collected.Mimics 20.0,Geomagic Studio,Solidwords and other software were used to establish three-dimensional finite element model of LDH on L4,5 segments.Compression techniques under horizon-tal position,30° forward bending and 10° backward extension were simulated respectively.After applying the pressure,the ef-fects of compression techniques under different positions on stress,strain and displacement of various tissues of intervertebral disc and nerve root were observed.Results L4,5 segment finite element model was successfully established,and the model was validated.When compression manipulation was performed on the horizontal position,30° flexion and 10° extension,the annular stress were 0.732,5.929,1.286 MPa,the nucleus pulposus stress were 0.190,1.527,0.295 MPa,and the annular strain were 0.097,0.922 and 0.424,the strain sizes of nucleus pulposus were 0.153,1.222 and 0.282,respectively.The overall displace-ment distance of intervertebral disc on Y direction were-3.707,-18.990,-4.171 mm,and displacement distance of nerve root on Y direction were+7.836,+5.341,+3.859 mm,respectively.The relative displacement distances of nerve root and interverte-bral disc on Y direction were 11.543,24.331 and 8.030 mm,respectively.Conclusion Compression manipulation could make herniated intervertebral disc produce contraction and retraction trend,by increasing the distance between herniated interverte-bral disc and nerve root,to reduce symptoms of nerve compression,to achieve purpose of treatment for patients with LDH,in which the compression manipulation is more effective when the forward flexion is 30°.

Objective This study aimed to explore the diagnostic concordance of fractional flow reserve(FFR)and quantitative flow ratio(QFR)and the characteristics affecting this concordance.Methods Patients with non-acute myocardial infarction admitted to the Department of Cardiology,Peking University Third Hospital between January 2019 and December 2021 were enrolled.The patients were divided into four groups:FFR+/QFR+and FFR-/QFR-,FFR+/QFR-and FFR-/QFR+with FFR or QFR≤0.80 as positive and＞0.80 as negative.Using FFR as the gold standard,the diagnostic value of QFR was analyzed,and differences in clinical features and pathological characteristics among the groups were compared.Results A total of 236 patients were included.The mean age was(64.48±9.63)years,and 67.8％were male.All patients had 30％-70％coronary stenosis.The consistency rate of QFR and FFR was 78.0％(n=184),and the Person correlation coefficient was 0.557(P＜0.001).Among FFR+patients,the minimum lumen diameter was larger[(1.56±0.34)mm vs.(1.39±0.31)mm,P=0.019],lesion length was shorter[(21.37±11.73)mm vs.(36.86±18.09)mm,P＜0.001],and coronary angiography-based index of microcirculartory resistance(AMR)was higher[(277.50±28.87)mmHg·s/m vs.(178.02±49.13)mmHg·s/m,P＜0.001]in the disconcordance group.Multivariate regression analysis suggested that AMR[OR 0.93,95％CI 0.88-0.99,P=0.030]and lesion length[OR 1.27,95％CI 1.01-1.60,P=0.045]were independent predictors of disconcordance.In the FFR-group,the lesion length was longer[(33.08±16.05)mm vs.(21.40±13.36)mm,P=0.020],and AMR[(169.66±24.01)mmHg·s/m vs.(265.95±44.78)mmHg·s/m,P＜0.001]and low-density lipoprotein-C[1.57(1.10,1.97)mmol/L vs.2.15(1.79,2.74)mmol/L,P=0.031]were lower in the disconcordance group.No statistically significant variables were identified by multivariate regression.Conclusions QFR had high diagnostic value compared with FFR.In the FFR+group,AMR and lesion length may have affected the diagnostic consistency of QFR and FFR.The study provided more evidence for the clinical application of QFR.

Objective:To evaluate efficacy of safflower polysaccharide in treatment of thymic atrophy induced by estradiol in mice.Methods:A total of 75 female ICR mice were divided into 5 groups:control group,model group,ubenimex group,SPS high dose group,SPS low dose group.Except for control group,each group was given intraperitoneal injection of estradiol benzoate every other day for 6 times.Treatment group began administration 24 h after the last parenteral administration,once a day for 10 days.Mice were sacrificed 24 hours after the last administration,and body weight,immune organ index,MDA and GST levels in plasma,periph-eral blood cells and T cells changes were observed,thymus tissue was stained by HE staining and TUNEL cell apoptosis staining,and thymus output capacity was detected.Results:Both high and low doses of safflower polysaccharide significantly improved thymus index(P<0.05)in mice,increased leukocytes level in peripheral blood(P<0.05),proportions of CD3+CD4+T,CD3+CD8+T cells(P<0.05)and CD4+T/CD8+T,improved thymus tissue damage.High dose of safflower polysaccharide could significantly reduce apoptosis in thymus tissue and enhance thymus output.Conclusion:Safflower polysaccharide has a certain therapeutic effect on estradiol-induced thymus atrophy in mice.