Objective: To explore the early effects of birth weight at different gestational ages on blood pressure trajectory among primary school students, so as to provide evidence for incorporating gestational age birth weight into individualized early warning and intervention strategies for childhood hypertension. Methods: From May to November 2023, a purposeful sampling method was used to recruit 1 676 students in grade 1-3 from three primary schools in a certain urban district of Chongqing. Follow up assessments were conducted in May 2024(T1), November 2024(T2), and May 2025(T3). General demographic and birth related information were collected via self administered questionnaires, while height, weight and blood pressure were obtained through physical examinations. Linear mixed effects model was used to analyze the associations between birth weight at different gestational ages and blood pressure trajectories. Results: During the T1-T3 period, the systolic blood pressure of boys were 98.5 (93.0, 104.5 ),98.5 (93.5, 105.0), and 97.5 (92.5, 103.5)mmHg, respectively, while the diastolic blood pressure were 60.5 (56.5, 65.0), 61.5 ( 57.0 , 65.5), and 60.0 (56.0, 64.0)mmHg, respectively. For girls, the systolic blood pressure were 95.5 (90.0, 102.0),95.5 (90.5, 101.5), and 96.0 (90.5, 101.5)mmHg, respectively, and the diastolic blood pressure were 60.5 (56.0, 64.5 ),61.5 (57.5, 65.5), and 59.5 (56.0, 63.0)mmHg, respectively. Through Friedman test within both boys and girls, diostolic blood pressure were statistically significant across three measurements( χ 2=48.85，81.54，both P <0.01). The proportion of normal blood pressure increased , and the proportion of prehypertension and hypertension decreased with time( χ 2=39.72，25.62，both P < 0.01 ). Linear mixed effects model analysis revealed that after adjusting for age, sex, household income monthly, parental education, family history of hypertension and maternal pregnancy complications, large for gestational age had significantly higher trajectories of systolic ( β = 1.50) and diastolic( β =0.94) blood pressure compared to appropriate for gestational age(both P <0.01). Conclusion Large for gestational age is associated with elevated blood pressure trajectories during school age, and it may be considered as an early indicator for individualized screening and intervention for childhood hypertension.

ObjectiveSpinal cord injury (SCI) directly impairs the regulatory function of the autonomic nervous system, induces intestinal dysfunction, and significantly reduces patients’ quality of life. Preclinical studies have shown that electroacupuncture (EA) therapy can regulate the brain-gut axis and is used to treat central nervous system diseases such as major depressive disorder, Alzheimer’s disease and Parkinson’s disease. Recent research has established that fecal microbiota transplantation (FMT) from EA-treated SCI rats restored intestinal motility and colonic morphology. However, it remains unclear whether the regulation of gut microbiota by EA therapy directly contributes to neural repair after SCI. This study aims to explore whether gut microbiota mediates the neuroprotective effect of EA in the treatment of SCI and its possible mechanism. MethodsThe study employed RNA transcriptome analysis of spinal cord tissue to characterize gene expression profiles and to identify key signaling pathways following EA treatment for SCI. Hematoxylin-Eosin (HE) staining and Nissl staining were used to observe the morphological changes in spinal cord tissue. Western blot (WB) and enzyme-linked immunosorbent assay (ELISA) were applied to detect the effects of EA on the expression of proteins related to nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 (NLRP3) -dependent pyroptosis. Using 16S rDNA sequencing, the study observed alterations in gut microbiota diversity and community composition in SCI rats. Prior to establishing SCI models, rats were pretreated with an antibiotic cocktail to induce gut dysbiosis, and the effects on intestinal function and spinal cord neural repair were evaluated. FMT was performed to investigate the regulatory effects of post-EA FMT on motor function, general status, liver and spleen indices, and NLRP3-mediated pyroptosis in SCI rats. ResultsEA improved motor function and reduced regulated neuronal cell death in SCI rats. Transcriptomic analysis demonstrated the activation of immune- and inflammation-related pathways post-SCI, including NOD-like receptors, nuclear factor-kappa B(NF-κB), and Toll-like receptor (TLR) pathways. EA primarily influenced intestinal inflammation and autoimmune functions. 16S rDNA sequencing illustrated that EA did not alter the diversity of gut microbiota. However, EA altered the gut microbiota composition in SCI rats, increasing Lactobacillus and Akkermansia genera while rebalancing the Firmicutes/Bacteroidetes ratio. Furthermore, depletion of gut microbiota by antibiotics disrupted the intestinal barrier, reduced the expression of intestinal barrier proteins Zonula Occludens-1 (ZO-1) and Occludin, elevated serum lipopolysaccharide-binding protein (LBP) levels, exacerbated spinal cord tissue damage, and hindered motor function recovery in SCI rats. FMT from donors treated with EA reduced LBP levels in the intestine, blood, and spinal cord of rats, inhibited the TLR4 myeloid differentiation primary response protein 88 (MyD88)-NF‑κB pathway and NLRP3-dependent pyroptosis, and improved motor function. On the other hand, FMT treatment resulted in decreased body weight and food intake, whereas FMT using EA-treated donors effectively alleviated these alterations. ConclusionEA effectively alleviated neuroinflammatory responses in rats with SCI, primarily through regulating the gut microbiota and suppressing the NLRP3-dependent pyroptosis signaling pathway.

ObjectiveSpinal cord injury (SCI) directly impairs the regulatory function of the autonomic nervous system, induces intestinal dysfunction, and significantly reduces patients’ quality of life. Preclinical studies have shown that electroacupuncture (EA) therapy can regulate the brain-gut axis and is used to treat central nervous system diseases such as major depressive disorder, Alzheimer’s disease and Parkinson’s disease. Recent research has established that fecal microbiota transplantation (FMT) from EA-treated SCI rats restored intestinal motility and colonic morphology. However, it remains unclear whether the regulation of gut microbiota by EA therapy directly contributes to neural repair after SCI. This study aims to explore whether gut microbiota mediates the neuroprotective effect of EA in the treatment of SCI and its possible mechanism. MethodsThe study employed RNA transcriptome analysis of spinal cord tissue to characterize gene expression profiles and to identify key signaling pathways following EA treatment for SCI. Hematoxylin-Eosin (HE) staining and Nissl staining were used to observe the morphological changes in spinal cord tissue. Western blot (WB) and enzyme-linked immunosorbent assay (ELISA) were applied to detect the effects of EA on the expression of proteins related to nucleotide-binding domain leucine-rich repeat and pyrin domain-containing receptor 3 (NLRP3) -dependent pyroptosis. Using 16S rDNA sequencing, the study observed alterations in gut microbiota diversity and community composition in SCI rats. Prior to establishing SCI models, rats were pretreated with an antibiotic cocktail to induce gut dysbiosis, and the effects on intestinal function and spinal cord neural repair were evaluated. FMT was performed to investigate the regulatory effects of post-EA FMT on motor function, general status, liver and spleen indices, and NLRP3-mediated pyroptosis in SCI rats. ResultsEA improved motor function and reduced regulated neuronal cell death in SCI rats. Transcriptomic analysis demonstrated the activation of immune- and inflammation-related pathways post-SCI, including NOD-like receptors, nuclear factor-kappa B(NF-κB), and Toll-like receptor (TLR) pathways. EA primarily influenced intestinal inflammation and autoimmune functions. 16S rDNA sequencing illustrated that EA did not alter the diversity of gut microbiota. However, EA altered the gut microbiota composition in SCI rats, increasing Lactobacillus and Akkermansia genera while rebalancing the Firmicutes/Bacteroidetes ratio. Furthermore, depletion of gut microbiota by antibiotics disrupted the intestinal barrier, reduced the expression of intestinal barrier proteins Zonula Occludens-1 (ZO-1) and Occludin, elevated serum lipopolysaccharide-binding protein (LBP) levels, exacerbated spinal cord tissue damage, and hindered motor function recovery in SCI rats. FMT from donors treated with EA reduced LBP levels in the intestine, blood, and spinal cord of rats, inhibited the TLR4 myeloid differentiation primary response protein 88 (MyD88)-NF‑κB pathway and NLRP3-dependent pyroptosis, and improved motor function. On the other hand, FMT treatment resulted in decreased body weight and food intake, whereas FMT using EA-treated donors effectively alleviated these alterations. ConclusionEA effectively alleviated neuroinflammatory responses in rats with SCI, primarily through regulating the gut microbiota and suppressing the NLRP3-dependent pyroptosis signaling pathway.

Objective To investigate the protective effects and mechanism of Shuilian Fengkui Formula(SFF)of Yao medicine on sequelae pelvic inflammatory disease(SPID)in rats.Methods The SPID rat model was established by mechanical injury coupled with bacterial infection,and then the rats were randomly divided into:the SPID group,the positive drug(Fukeqianjin tablets)group,SFF groups at low,medium and high doses,and the sham-operation group,with 8 rats in each group;SPID group,SFF groups,TLR4 agonist CRX-527(CRX-527)group,SFF plus CRX-527 group,with 8 rats in each group.Corresponding drug intervention was given for 21 consecutive days.The indexes of uterus,spleen,thymus and other organs were calculated.The histopathological changes in rat uterus were observed by HE staining.The levels of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),immunoglobulin G(IgG),immunoglobulin M(IgM)in serum were detected by ELISA;The protein expression levels of Toll receptor 4(TLR4),myeloid differentiation factor(MyD88),nuclear factor kappa B p65(NF-κB p65),and phosphorylated nuclear factor kappa B p65(p-NF-κB p65)in rat uterine tissues were detected by Western blot.Results Compared with the sham operation group,the uterine index of SPID group significantly increased(P<0.01),the spleen index and thymus index significantly decreased(P<0.01),the pathological damage of uterine tissue was serious,the contents of IL-1β,IL-6,TNF-α in serum significantly increased(P<0.01),the contents of IgG and IgM significantly decreased(P<0.01),the TLR4,MyD88 protein and the ratio of p-NF-κB p65/NF-κB p65 protein in uterine tissue significantly increased(P<0.01).Compared with the SPID group,the uterine index of the positive drug group and the SFF groups significantly decreased(P<0.05),the spleen index and thymus index significantly increased(P<0.05),the pathological damage of uterine tissue significantly improved,the contents of IL-1β,IL-6 and TNF-α in serum were significantly lowered(P<0.05),the contents of IgG and IgM significantly increased(P<0.05),and the TLR4,MyD88 protein and the ratio of p-NF-κB p65/NF-κB p65 protein in uterine tissue significantly downregulated(P<0.01).However,CRX-527 significantly reversed the effects of SFF on SPID in rats.Conclusion SFF could improve SPID in rats by impeding the inflammatory response,and its mechanism might be attributed to inhibition of TLR4/MyD88/NF-κB signaling pathway.

Objective To investigate the protective effects and mechanism of Shuilian Fengkui Formula(SFF)of Yao medicine on sequelae pelvic inflammatory disease(SPID)in rats.Methods The SPID rat model was established by mechanical injury coupled with bacterial infection,and then the rats were randomly divided into:the SPID group,the positive drug(Fukeqianjin tablets)group,SFF groups at low,medium and high doses,and the sham-operation group,with 8 rats in each group;SPID group,SFF groups,TLR4 agonist CRX-527(CRX-527)group,SFF plus CRX-527 group,with 8 rats in each group.Corresponding drug intervention was given for 21 consecutive days.The indexes of uterus,spleen,thymus and other organs were calculated.The histopathological changes in rat uterus were observed by HE staining.The levels of interleukin-1β(IL-1β),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),immunoglobulin G(IgG),immunoglobulin M(IgM)in serum were detected by ELISA;The protein expression levels of Toll receptor 4(TLR4),myeloid differentiation factor(MyD88),nuclear factor kappa B p65(NF-κB p65),and phosphorylated nuclear factor kappa B p65(p-NF-κB p65)in rat uterine tissues were detected by Western blot.Results Compared with the sham operation group,the uterine index of SPID group significantly increased(P<0.01),the spleen index and thymus index significantly decreased(P<0.01),the pathological damage of uterine tissue was serious,the contents of IL-1β,IL-6,TNF-α in serum significantly increased(P<0.01),the contents of IgG and IgM significantly decreased(P<0.01),the TLR4,MyD88 protein and the ratio of p-NF-κB p65/NF-κB p65 protein in uterine tissue significantly increased(P<0.01).Compared with the SPID group,the uterine index of the positive drug group and the SFF groups significantly decreased(P<0.05),the spleen index and thymus index significantly increased(P<0.05),the pathological damage of uterine tissue significantly improved,the contents of IL-1β,IL-6 and TNF-α in serum were significantly lowered(P<0.05),the contents of IgG and IgM significantly increased(P<0.05),and the TLR4,MyD88 protein and the ratio of p-NF-κB p65/NF-κB p65 protein in uterine tissue significantly downregulated(P<0.01).However,CRX-527 significantly reversed the effects of SFF on SPID in rats.Conclusion SFF could improve SPID in rats by impeding the inflammatory response,and its mechanism might be attributed to inhibition of TLR4/MyD88/NF-κB signaling pathway.

Objective To explore the medication patterns of famous traditional Chinese medicine practitioners in treating challenging aspects of idiopathic membranous nephropathy(IMN)based on data mining.Methods Medical cases meeting the inclusion and exclusion criteria were collected.Statistical analysis of syndrome patterns,herb frequency,association rules,and cluster analysis were conducted for key challenges,including disease duration ≥ 1 year,renal function impairment,hypoalbuminemia,and hypertriglyceridemia.Results A total of 128 medical cases were included.Spleen-kidney deficiency syndrome was identified as the most common pattern.Based on herb frequency and association rule analysis,Huangqi,Baizhu,Fuling,Danggui,Danshen were the most frequently used in prescription.Cluster analysis revealed core herbal groupings primarily based on classical formulas such as Zhenwu decoction,Shenling Baizhu powder,and Shuilu Erxian dan.Conclusion In the medical cases addressing treatment challenges,the syndrome patterns were predominantly characterized by spleen-kidney deficiency.Core medications included Huangqi,Baizhu,Fuling,Danggui and Danshen.The treatment emphasizes strengthening invigorating spleen and kidney,with variations in medication patterns based on disease duration and complications.

AIM To investigate the effects of Yiqi Juanbi Formula on chondrocyte pyroptosis in rat models of collagen-induced arthritis(CIA).METHODS Fifty rats were subcutaneously injected at the tail base with an emulsion containing equal volumes of bovine type Ⅱ collagen and incomplete Freund's adjuvant(IFA)to establish the CIA models.These rats were then randomly assigned to the model group,the methotrexate group(0.35 mg/kg),and the low-dose,medium-dose,and high-dose Yiqi Juanbi Formula groups(9.4,18.7,37.4 g/kg),in contrast to the ten intact rats serving in the normal control group.Following four weeks of intragastric administration,the rats had their general conditions observed;their joint swelling and arthritis indices measured;their ankle joint pathology assessed by HE staining;their serum levels of IL-1β,IL-18 and TNF-ɑ detected by ELISA;their mRNA expressions of NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ in ankle cartilage quantified by RT-qPCR;their protein expressions of NF-κB,NLRP3 and Caspase-1 in ankle cartilage analyzed by Western blot;and their NLRP3 and GSDMD positive expressions in ankle cartilage examined by immunohistochemistry.RESULTS Compared to the control group,the model group showed significantly increased joint swelling and arthritis indices(P＜0.01);elevated serum levels of IL-1 β,IL-18 and TNF-ɑ(P＜0.01);pathological changes including cartilage surface defects,reduced cell count,altered cellular morphology,irregular cell arrangement,and significant inflammatory cell infiltration in synovial tissue;upregulated mRNA expressions of NF-κB,NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ(P＜0.01)and increased protein expressions of NF-κB,NLRP3 and Caspase-1(P＜0.01)in ankle cartilage;enhanced positive expressions of NLRP3 and GSDMD in ankle cartilage(P＜0.01).Compared to the model group,the groups intervened with methotrexate or medium-or high-dose Yiqi Juanbi Formula exhibited reduced joint swelling and arthritis indices(P＜0.01);alleviated pathological damage in ankle joints;decreased serum levels of IL-1β,IL-18 and TNF-ɑ(P＜0.01);downregulated mRNA expressions of NF-κB,NLRP3,Caspase-1,GSDMD,IL-1β,IL-18 and TNF-ɑ(P＜0.05,P＜0.01),and reduced protein expressions of NF-κB,NLRP3 and Caspase-1(P＜0.05,P＜0.01)in ankle cartilage;and diminished positive expressions of NLRP3 and GSDMD in ankle cartilage(P＜0.01).CONCLUSION Yiqi Juanbi Formula alleviates inflammation in CIA rats,potentially by inhibiting the activation of the NF-κB/NLRP3/Caspase-1 signaling pathway,thereby suppressing chondrocyte pyroptosis.

Objective:To compare postoperative anal function recovery between laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis and laparoscopic total colectomy with ileorectal anastomosis for slow transit constipation.Methods:This multicenter retrospective cohort study enrolled patients meeting the following criteria: (1) severe constipation symptoms (<2 bowel movements/week), absent or insignificant defecation urge, abdominal distension, requiring laxatives to maintain bowel movements or laxatives being ineffective; (2) constipation symptoms for over 5 years, ineffective after >2 years of medical treatment, with strong desire for surgery; (3) significantly prolonged colon transit time (>72 hours) without significant gastric or small intestinal transit dysfunction; (4) no organic colonic lesions confirmed by colonoscopy and abdominal CT. Exclusion criteria: (1) patients undergoing open surgery; (2) exclusion of outlet obstruction constipation (e.g., rectocele, rectal prolapse, puborectalis spasm) by functional defecation MRI; (3) comorbid psychiatric disorders; (4) missing clinical data or loss to follow-up (postoperative follow-up <24 months). Based on these criteria, clinical and follow-up data were collected from 220 patients who underwent either laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis (LSC group, n = 115) or laparoscopic total colectomy with ileorectal anastomosis (LTC group, n = 105) for slow transit constipation between January 2013 and December 2022. Subjective anal function (Constipation Severity Score and Wexner Fecal Incontinence Score) and objective anal function (positive rate of rectoanal inhibitory reflex [RAIR] and anorectal manometry) were observed preoperatively and at 6, 12, and 24 months postoperatively. Results:No significant differences were found in baseline characteristics between the two groups (all P >0.05). All surgeries were completed successfully without major significant complications. Subjective anal function assessment: At 24 months postoperatively, Constipation Severity Scores decreased significantly compared to preoperative scores in both groups [LSC group: (25.2±2.8) vs. (2.9±1.8), P <0.001; LTC group: (25.8±2.9) vs. (2.8±1.9), P<0.001]. No significant differences were found between the groups at 6, 12, and 24 months postoperatively (all P>0.05). Wexner Fecal Incontinence Scores at 24 months were significantly lower than those at 6 months in both groups [LSC group: (12.9±1.8) vs. (3.9±2.5), P<0.001; LTC group: (12.6±1.8) vs. (5.4±2.4), P<0.001]. Although no significant difference was found at 6 months ( P = 0.190), the LSC group had significantly lower Wexner scores than the LTC group at 12 and 24 months postoperatively (both P < 0.001). Objective anal function assessment: (1) Positive RAIR rate: Preoperative positive RAIR rates were 33.0% (38/115) in the LSC group and 25.7% (27/105) in the LTC group ( P > 0.05). At 24 months, positive rates increased significantly in both groups [LSC: 66.1% (76/115); LTC: 63.8% (67/105)] compared to preoperative rates (both P<0.001), but no significant differences were found between groups at 6, 12, and 24 months (all P>0.05). (2) Resting pressure (RP) and squeeze pressure (SP): No significant differences were found in preoperative RP and SP between groups (all P>0.05). The LSC group had significantly higher RP and SP than the LTC group at 6 and 12 months postoperatively (all P<0.05), but no significant differences were found at 24 months ( P>0.05). Conclusion:Both laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis and laparoscopic total colectomy with ileorectal anastomosis are safe for patients with slow transit constipation. However, laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis offers superior postoperative anal function recovery.

Objective:To construct an early rehabilitation exercise program for patients with agoraphobia after total knee arthroplasty (TKA) to provide guidance for orthopedic rehabilitation nursing practice.Methods:The first draft of an early rehabilitation exercise program for patients with agoraphobia after TKA was developed through literature search, semi-structured interviews, and group discussions. From November to December 2023, 20 experts from nine provinces and centrally administered municipalities were selected for two rounds of expert consultation using the Delphi method to form the final draft of the early rehabilitation exercise program for patients with agoraphobia after TKA.Results:In two rounds of consultation, the questionnaire recovery rates were 91.30% (21/23) and 95.24% (20/21), with authority coefficients of 0.92 and 0.96, and Kendall's coordination coefficients of 0.28 and 0.34, respectively ( P<0.05). After the second round of consultation, the mean importance assignment scores for all levels of indicators ranged from 3.90 to 5.00, with coefficients of variation ranging from 0 to 0.20. The finalized early rehabilitation exercise program for patients with agoraphobia after TKA contained two parts, including the preface and the main text, and the main text consisted of five first-level items, 21 second-level items, and 35 third-level items. Conclusions:The content of the early rehabilitation exercise program for patients with agoraphobia after TKA is scientific, reasonable, comprehensive, practical and targeted, which can provide a basis for clinical medical and nursing personnel to guide the early rehabilitation exercise for patients with agoraphobia after TKA.