Objective:To investigate the effects of electroacupuncture on duodenal inflammation and intestinal mucosal barrier function in functional dyspepsia(FD)rats based on the Toll-like receptors 4(TLR4)/myeloid differentiation factor 88(Myd88)pathway.Methods:Sixty male Sprague-Dawley rats were randomly divided into a blank group(n=10)and a modeling group(n=50).The FD model was induced in the modeling group using a multi-factor comprehensive intervention.Forty successful model rats were randomly allocated into a model(FD)group,an electroacupuncture(EA)group,a TLR4 inhibitor(TAK242)group,and an EA+TAK242 group,with 10 rats in each group.In the EA group,following acupuncture at Zusanli(ST36)and Taichong(LR3),a filiform needle was perpendicularly inserted 3 mm into the lateral side of Zusanli(ST36)bilaterally,positioned between the Stomach Meridian and the Gallbladder Meridian at the lateral edge of the tibia,serving as an auxiliary electrode.An EA instrument was then connected to Zusanli(ST36)and the auxiliary electrode on the same side for intervention.The TAK242 group received tail vein injections of TLR4 inhibitor TAK242[0.5 mg/(kg·bw)],while the EA+TAK242 group received both TAK242 injections and EA intervention.Intragastric residual rate and small intestinal propulsion rate were observed in each group.Immunohistochemistry was used to detect tryptase expression in the duodenum;enzyme-linked immunosorbent assay was used to measure serum concentrations of 5-hydroxytryptamine(5-HT)and 5-hydroxyindole acetic acid(5-HIAA);Western blotting was used to analyze TLR4,MyD88,zonula occludens-1(ZO-1),and junctional adhesion molecule A(JAM-A)protein expression in the duodenal tissue.Results:In the FD group,the intragastric residual rate increased,small intestinal propulsion rate decreased,ZO-1 and JAM-A protein expression decreased,duodenal tryptase mean optical density increased,serum 5-HT and 5-HIAA levels increased significantly,and TLR4 and MyD88 protein expression increased significantly compared to the blank group(P<0.01).Compared to the FD group,the EA,TAK242,and EA+TAK242 groups showed a decreased gastric residual rate,increased small intestinal propulsion rate,increased ZO-1 and JAM-A protein expression,decreased optical density of duodenal tryptase,and significantly reduced serum 5-HT and 5-HIAA,as well as decreased TLR4 and MyD88 protein levels(P<0.01).Compared to the EA group,the TAK242 group had a higher intragastric residual rate and lower small intestinal propulsion rate(P<0.05),decreased TLR4 protein expression(P<0.05),no significant change in MyD88 protein expression(P>0.05),increased optical density of duodenal tryptase(P<0.05),increased serum 5-HT and 5-HIAA levels(P<0.05),and decreased ZO-1 and JAM-A protein expression(P<0.05).In the EA+TAK242 group,the intragastric residual rate was significantly lower,small intestinal propulsion rate was significantly higher,TLR4 and MyD88 protein expression was significantly lower,optical density of duodenal tryptase was significantly lower,and ZO-1 and JAM-A protein expression levels were significantly higher compared to the EA and TAK242 groups(P<0.01).Conclusion:EA promotes gastrointestinal motility,restores intestinal mucosal barrier function,and reduces inflammatory responses in FD rats,potentially through the down-regulation of the TLR4/Myd88 pathway.

Objective:To study the effect and mechanism of ganoderma lucidum polysaccharide peptide(GLPP)on renal anti oxidative stress and immune inflammation in diabetes nephropathy mice.Methods:The C57 male mice model of diabetes nephropathy was established by streptozotocin combined with high glucose and high-fat diet.Sixty diabetes nephropathy mice were divided into model group,losartan group,GLPP group(low,medium and high dose groups),GLPP high-dose+losartan group,with 10 mice in each group,10 mice fed with normal diet as the blank group.The losartan group was given 10 mg/kg losartan by gavage,and GLPP low,medium and high dose groups was given 50,100,and 200 mg/kg GLPP by gavage,while the GLPP high-dose+losartan group were given 200 mg/kg GLPP+10 mg/kg losartan by gavage.The blank group and model group were given physiological saline by gavage.After gastric lavage,observe the diet,water intake,renal pathology,structure,and apoptosis of renal tubular epithelial cells in mice,and analyze the levels of blood biochemical indicators,immune inflammation,oxidative stress indicators,and expression of apoptosis/cycle regulatory proteins in mice.Results:Compared with the blank group,the model group showed an increase in blood biochemical indicators such as Scr,BUN,TC,TG and GSP(P<0.05),as well as inflammation indicators such as level of IL-6 and TNF-α、MCP-1 were decreased(P<0.05),the oxidative stress indicator MDA was increased,T-AOC,GSH-PX,SOD were decreased(P<0.05),the apoptosis rate of renal tubular epithelial cells were increased(P<0.05),the expression levels of Bax,Caspase-3,P53,P21 were all increased,and the expression levels of Bcl-2 and Cyclin D1 were decreased(P<0.05).Compared with the model group,the losartan group,GLPP dose groups,GLPP high-dose+losartan group Scr,BUN,TC,TG,GSP,IL-6,TNF-α,MCP-1,MDA levels,apoptosis rate of renal tubular epithelial cells,Bax,Caspase-3,P53,P21 expression levels were all reduced,while T-AOC,SOD,GSH-PX levels,Bcl-2,and Cyclin D1 expression levels were all increased.Renal pathological changes were improved,and mitochondrial swelling was reduced.The GLPP high-dose+losartan group showed the most significant improvement(P<0.05).Conclusion:GLPP can reverse the renal injury in diabetes nephropathy mice,which may be related to the inhibition of apoptosis of renal tubular epithelial cells by alleviating renal oxidative stress and immune inflammatory damage.

Objective:To investigate the relationship between different types of tea intake and COVID-19 infection.Methods:Data were retrieved from a genome-wide association study(GWAS),involving 447 485,and 64 949 people for single nucleotide polymorphisms(SNPs).Two-sample Mendelian randomization(MR)analysis was used to investigate the relationship of different types of tea intake with four subgroups of COVID-19 infected population,including COVID-19 infected population versus general population,COVID-19 hospitalized population versus general population,COVID-19 hospitalized population versus non-hospitalized population,and very severe respiratory confirmed population versus general population.Inverse-variance weighted(IVW)method was used as the main method of causal analysis.MR Egger intercept was used for pleiotropy test,and Cochran's Q-statistic was used for heterogeneity test.Results:Compared to the general population,tea intake decreased the incidence of COVID-19 in the infection population(IVW method,OR=0.806,95%CI:0.651-0.999),and the hospitalized population(IVW method,OR=0.533,95%CI:0.369-0.770).Additionally,the underlying pleiotropy was not found following the MR-Egger regression intercept(MR intercept=-0.002,P=0.667),and the Cochran's Q-statistic showed no heterogeneity(Q-statistic=52.712,P=0.057).Compared to the general population,the underlying pleiotropy in the hospitalized patients was not found by MR-Egger regression intercept(MR intercept=-0.001,P=0.909),and the Cochran's Q-statistic showed no heterogeneity(Q-statistic=25.214,P=0.945).However,green tea and herbal tea had no effect on COVID-19 infection.Conclusions:Overall tea intake reduces the risk of COVID-19 infection in the general population compared to COVID-19 infected and hospitalized populations,while green tea and herbal tea have no protective effect against COVID-19 infection.

Objective:To investigate the relationship between different types of tea intake and COVID-19 infection.Methods:Data were retrieved from a genome-wide association study(GWAS),involving 447 485,and 64 949 people for single nucleotide polymorphisms(SNPs).Two-sample Mendelian randomization(MR)analysis was used to investigate the relationship of different types of tea intake with four subgroups of COVID-19 infected population,including COVID-19 infected population versus general population,COVID-19 hospitalized population versus general population,COVID-19 hospitalized population versus non-hospitalized population,and very severe respiratory confirmed population versus general population.Inverse-variance weighted(IVW)method was used as the main method of causal analysis.MR Egger intercept was used for pleiotropy test,and Cochran's Q-statistic was used for heterogeneity test.Results:Compared to the general population,tea intake decreased the incidence of COVID-19 in the infection population(IVW method,OR=0.806,95%CI:0.651-0.999),and the hospitalized population(IVW method,OR=0.533,95%CI:0.369-0.770).Additionally,the underlying pleiotropy was not found following the MR-Egger regression intercept(MR intercept=-0.002,P=0.667),and the Cochran's Q-statistic showed no heterogeneity(Q-statistic=52.712,P=0.057).Compared to the general population,the underlying pleiotropy in the hospitalized patients was not found by MR-Egger regression intercept(MR intercept=-0.001,P=0.909),and the Cochran's Q-statistic showed no heterogeneity(Q-statistic=25.214,P=0.945).However,green tea and herbal tea had no effect on COVID-19 infection.Conclusions:Overall tea intake reduces the risk of COVID-19 infection in the general population compared to COVID-19 infected and hospitalized populations,while green tea and herbal tea have no protective effect against COVID-19 infection.

The paper reports a 32-year-old female acute myeloid leukemia patient who developed graft-versus-host disease after paternal hematopoietic stem cell transplantation, which subsequently led to renal thrombotic microangiopathy. She subsequently required a kidney transplant from the same donor 5 years later due to renal failure. Considering that both the bone marrow and kidney were from the same donor and the recovery of renal function was favorable, immunosuppressive therapy was discontinued after a short course of anti-rejection treatment, with maintained stable kidney function. This case suggests that under the condition of high chimerism, allogeneic hematopoietic stem cell transplantation and kidney transplantation from the same donor can achieve immune tolerance, potentially improving solid organ transplantation success rate. The findings provide a novel therapeutic approach for solid organ transplantation following allogeneic hematopoietic stem cell transplantation.

Objective:To investigate the effects of electroacupuncture on duodenal inflammation and intestinal mucosal barrier function in functional dyspepsia(FD)rats based on the Toll-like receptors 4(TLR4)/myeloid differentiation factor 88(Myd88)pathway.Methods:Sixty male Sprague-Dawley rats were randomly divided into a blank group(n=10)and a modeling group(n=50).The FD model was induced in the modeling group using a multi-factor comprehensive intervention.Forty successful model rats were randomly allocated into a model(FD)group,an electroacupuncture(EA)group,a TLR4 inhibitor(TAK242)group,and an EA+TAK242 group,with 10 rats in each group.In the EA group,following acupuncture at Zusanli(ST36)and Taichong(LR3),a filiform needle was perpendicularly inserted 3 mm into the lateral side of Zusanli(ST36)bilaterally,positioned between the Stomach Meridian and the Gallbladder Meridian at the lateral edge of the tibia,serving as an auxiliary electrode.An EA instrument was then connected to Zusanli(ST36)and the auxiliary electrode on the same side for intervention.The TAK242 group received tail vein injections of TLR4 inhibitor TAK242[0.5 mg/(kg·bw)],while the EA+TAK242 group received both TAK242 injections and EA intervention.Intragastric residual rate and small intestinal propulsion rate were observed in each group.Immunohistochemistry was used to detect tryptase expression in the duodenum;enzyme-linked immunosorbent assay was used to measure serum concentrations of 5-hydroxytryptamine(5-HT)and 5-hydroxyindole acetic acid(5-HIAA);Western blotting was used to analyze TLR4,MyD88,zonula occludens-1(ZO-1),and junctional adhesion molecule A(JAM-A)protein expression in the duodenal tissue.Results:In the FD group,the intragastric residual rate increased,small intestinal propulsion rate decreased,ZO-1 and JAM-A protein expression decreased,duodenal tryptase mean optical density increased,serum 5-HT and 5-HIAA levels increased significantly,and TLR4 and MyD88 protein expression increased significantly compared to the blank group(P<0.01).Compared to the FD group,the EA,TAK242,and EA+TAK242 groups showed a decreased gastric residual rate,increased small intestinal propulsion rate,increased ZO-1 and JAM-A protein expression,decreased optical density of duodenal tryptase,and significantly reduced serum 5-HT and 5-HIAA,as well as decreased TLR4 and MyD88 protein levels(P<0.01).Compared to the EA group,the TAK242 group had a higher intragastric residual rate and lower small intestinal propulsion rate(P<0.05),decreased TLR4 protein expression(P<0.05),no significant change in MyD88 protein expression(P>0.05),increased optical density of duodenal tryptase(P<0.05),increased serum 5-HT and 5-HIAA levels(P<0.05),and decreased ZO-1 and JAM-A protein expression(P<0.05).In the EA+TAK242 group,the intragastric residual rate was significantly lower,small intestinal propulsion rate was significantly higher,TLR4 and MyD88 protein expression was significantly lower,optical density of duodenal tryptase was significantly lower,and ZO-1 and JAM-A protein expression levels were significantly higher compared to the EA and TAK242 groups(P<0.01).Conclusion:EA promotes gastrointestinal motility,restores intestinal mucosal barrier function,and reduces inflammatory responses in FD rats,potentially through the down-regulation of the TLR4/Myd88 pathway.

The paper reports a 32-year-old female acute myeloid leukemia patient who developed graft-versus-host disease after paternal hematopoietic stem cell transplantation, which subsequently led to renal thrombotic microangiopathy. She subsequently required a kidney transplant from the same donor 5 years later due to renal failure. Considering that both the bone marrow and kidney were from the same donor and the recovery of renal function was favorable, immunosuppressive therapy was discontinued after a short course of anti-rejection treatment, with maintained stable kidney function. This case suggests that under the condition of high chimerism, allogeneic hematopoietic stem cell transplantation and kidney transplantation from the same donor can achieve immune tolerance, potentially improving solid organ transplantation success rate. The findings provide a novel therapeutic approach for solid organ transplantation following allogeneic hematopoietic stem cell transplantation.

Objective:To study the effect and mechanism of ganoderma lucidum polysaccharide peptide(GLPP)on renal anti oxidative stress and immune inflammation in diabetes nephropathy mice.Methods:The C57 male mice model of diabetes nephropathy was established by streptozotocin combined with high glucose and high-fat diet.Sixty diabetes nephropathy mice were divided into model group,losartan group,GLPP group(low,medium and high dose groups),GLPP high-dose+losartan group,with 10 mice in each group,10 mice fed with normal diet as the blank group.The losartan group was given 10 mg/kg losartan by gavage,and GLPP low,medium and high dose groups was given 50,100,and 200 mg/kg GLPP by gavage,while the GLPP high-dose+losartan group were given 200 mg/kg GLPP+10 mg/kg losartan by gavage.The blank group and model group were given physiological saline by gavage.After gastric lavage,observe the diet,water intake,renal pathology,structure,and apoptosis of renal tubular epithelial cells in mice,and analyze the levels of blood biochemical indicators,immune inflammation,oxidative stress indicators,and expression of apoptosis/cycle regulatory proteins in mice.Results:Compared with the blank group,the model group showed an increase in blood biochemical indicators such as Scr,BUN,TC,TG and GSP(P<0.05),as well as inflammation indicators such as level of IL-6 and TNF-α、MCP-1 were decreased(P<0.05),the oxidative stress indicator MDA was increased,T-AOC,GSH-PX,SOD were decreased(P<0.05),the apoptosis rate of renal tubular epithelial cells were increased(P<0.05),the expression levels of Bax,Caspase-3,P53,P21 were all increased,and the expression levels of Bcl-2 and Cyclin D1 were decreased(P<0.05).Compared with the model group,the losartan group,GLPP dose groups,GLPP high-dose+losartan group Scr,BUN,TC,TG,GSP,IL-6,TNF-α,MCP-1,MDA levels,apoptosis rate of renal tubular epithelial cells,Bax,Caspase-3,P53,P21 expression levels were all reduced,while T-AOC,SOD,GSH-PX levels,Bcl-2,and Cyclin D1 expression levels were all increased.Renal pathological changes were improved,and mitochondrial swelling was reduced.The GLPP high-dose+losartan group showed the most significant improvement(P<0.05).Conclusion:GLPP can reverse the renal injury in diabetes nephropathy mice,which may be related to the inhibition of apoptosis of renal tubular epithelial cells by alleviating renal oxidative stress and immune inflammatory damage.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

Coronary artery bypass grafting (CABG) is one of the most effective revascularization treatments for coronary heart disease. Secondary prevention strategies, which rely on antiplatelet and lipid-lowering drugs, are crucial after CABG to ensure the durability of revascularization treatment effects and prevent adverse cardiovascular and cerebrovascular events in the medium to long term. Previous research conducted by Professor Zhao Qiang's team from Ruijin Hospital of Shanghai Jiao Tong University, known as the DACAB study, indicated that dual antiplatelet therapy (DAPT, specifically ticagrelor+aspirin) after CABG can enhance venous graft patency. However, it remains uncertain whether DAPT can further improve the medium to long-term clinical outcomes of CABG patients. Recently, the team reported the medium to long-term follow-up results of the DACAB study, termed the DACAB-FE study, finding that DAPT administered after CABG can reduce the incidence of major cardiovascular events over five years and improve patients' medium to long-term clinical outcomes. This article will interpret the methodological highlights and significant clinical implications of the DACAB-FE study.