Tuberculosis (TB), a chronic infectious disease caused by Mycobacterium tuberculosis, is primarily airborne and remains a global health problem, especially in resource-limited countries and regions. The emergence of drug resistance in M. tuberculosis has rendered the existing means ineffective in the treatment of TB. Therefore, research in new therapeutic directions has become imperative. In this review, we outline functional peptides in terms of the mechanisms of action, anti-TB attempts, advantages and disadvantages, and latest advances, aiming to analyze the research progress in anti-TB peptides. Furthermore, we investigate the potential applications of bioactive compounds found in traditional Chinese Medicine within the context of peptides.

Bone marrow suppression is one of the common adverse reactions to radiotherapy and chemotherapy. Anticancer treatments such as radiotherapy and chemotherapy first directly damage the patient′s peripheral blood cells, impairing qi and blood; further, they damage the actively proliferating cell populations in the bone marrow, impairing yin and blood; and then they interfere with hematopoietic stem cells, impairing essence and blood. This process is rapid and intense, consistent with the characteristics of " acute deficiency syndrome" , marked by sudden onset, rapid changes, critical condition, complexity and variability, multiple complications, and poor prognosis. Given this, its diagnosis and treatment should differ from those of general deficiency syndromes. This paper advocates the principles and ideas of diagnosis and treatment such as " preventing first and treating early to prevent changes; supplementing for deficiency and strengthening vital qi to eliminate pathogenic factor; urgent rescue for critical conditions, no time to lose; and comprehensive supplementing throughout the process, with severe cases requiring singular action" . This approach is intended to provide theoretical reference and practical guidance for bone marrow suppression after radiotherapy and chemotherapy.

Objective: To investigate the association between dietary behaviors and overweight and obesity among middle school students, so as to provide the evidence for developing dietary intervention strategies for them. Methods: From October to December 2023, a total of 7 063 middle school students from six counties (districts) in Ma'anshan City, Anhui Province were selected through stratified cluster random sampling method. Demographic information, physical activity, sleep, and dietary behaviors over the past year were collected through questionnaire surveys. Height and weight were measured to calculate body mass index (BMI), with overweight and obesity determined based on gender- and age-specific BMI cut-off points. The association between dietary behaviors and overweight and obesity was analyzed using a multivariable logistic regression model. Results: Totally 7 063 questionnaires were allocated, and 7 045 valid questionnaires were recovered, with an effective recovery rate of 99.75%. There were 3 925 males (55.71%) and 3 120 females (44.29%). A total of 2 326 students were overweight and obesity, with the prevalence of 33.02%. There were significant differences in the prevalence of overweight and obesity among middle school students with different genders, whether they were the only child or not, different intake frequency of sugar-sweetened beverages, and different intake frequency of beans and soy products (all P<0.05). After adjusting for factors such as gender, education stage, whether the only child, whether living on school, physical activity and sleep, multivariable logistic regression analysis showed that the frequency of snack consumption (1-2 times/week, OR=0.803, 95%CI: 0.669-0.963; 3-6 times/week, OR=0.759, 95%CI: 0.623-0.926; daily, OR=0.758, 95%CI: 0.595-0.964), sugar-sweetened beverages consumption (1-2 times/week, OR=1.166, 95%CI: 1.012-1.343; daily, OR=1.891, 95%CI: 1.302-2.746) and beans and soy products consumption (1-2 times/week, OR=0.787, 95%CI: 0.628-0.987) were the influencing factors of overweight and obesity among middle school students. Conclusions The frequencies of snack, beans and soy products and sugar-sweetened beverage consumption are associated with overweight and obesity among middle school students. Targeted interventions should be strengthened to reduce the risk of overweight and obesity.

OBJECTIVE: To observe the clinical efficacy of acupuncture on mild cognitive impairment (MCI) and its effect on gut microbiota. METHODS: A total of 62 MCI patients were randomly divided into an experimental group (31 cases, 2 cases dropped out) and a control group (31 cases). Both groups received exercise and cognitive training. In addition, the experimental group underwent acupuncture treatment at acupoints including Baihui (GV20), Sishencong (EX-HN1), and bilateral Fengchi (GB20), Xuanzhong (GB39), Zusanli (ST36), Yanglao (SI6), Xinshu (BL15), and etc., once every other day, three times per week, for a total of 12 weeks. Before and after treatment, the Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) scores were evaluated in the two groups, changes in gut microbiota were detected using 16S rDNA sequencing technology. The clinical efficacy was assessed after treatment. RESULTS: Compared before treatment, MoCA and MMSE scores were increased in both groups after treatment (P<0.001), with higher scores in the experimental group than those in the control group (P<0.001, P<0.05). After treatment, the relative abundance of Faecalibacterium, Clostridia, and Ruminococcaceae was increased in the experimental group compared with that before treatment (P<0.05). Moreover, the relative abundance of Faecalibacterium in the experimental group was higher than that in the control group (P<0.05). The total effective rate was 82.8% (24/29) in the experimental group, which was higher than 61.3% (19/31) in the control group (P<0.05). CONCLUSION Acupuncture could improve cognitive dysfunction in patients with MCI, and its mechanism may be related to increasing the relative abundance of butyrate-producing bacteria such as Faecalibacterium, Clostridia, and Ruminococcaceae, maintaining the intestinal barrier, and inhibiting related inflammatory responses.
Humans ; Acupuncture Therapy ; Gastrointestinal Microbiome ; Cognitive Dysfunction/psychology* ; Male ; Female ; Aged ; Middle Aged ; Acupuncture Points ; Treatment Outcome ; Aged, 80 and over ; Cognition

Objective: To determine the clinical efficacy of platelet-rich plasma (PRP) injection combined with warm acupuncture and moxibustion for treating patients with knee osteoarthritis and cold dampness obstruction syndrome. Methods: One hundred and twenty-eight patients with knee osteoarthritis and cold dampness obstruction syndrome who visited the Rehabilitation Department and Orthopedics Department of the Second Affiliated Hospital of Anhui University of Chinese Medicine from January 2023 to March 2024 and who met the inclusion and exclusion criteria were randomly divided into an experimental (n=64) and control group (n=64) using the random number table method. The experimental group was treated with PRP injection combined with warm acupuncture and moxibustion, whereas the control group was treated with normal saline injection combined with warm acupuncture and moxibustion treatment. PRP and normal saline injections were administered once every two weeks, a total of four times. Patients were treated with warm acupuncture and moxibustion once a day, six times a week, for four consecutive weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Traditional Chinese Medicine (TCM) syndrome, visual analog scale (VAS), and Lysholm scores were determined before treatment, at week 4 and week 8 of treatment, and week 16 of follow-up. Serum interleukin-6 (IL-6), matrix metalloproteinase-3 (MMP-3), tumor necrosis factor-α (TNF-α), osteoprotegerin (OPG), bone gla protein(BGP), and cartilage oligomeric matrix protein (COMP) levels were compared between the two groups before and after 8 weeks of treatment. The clinical efficacy and safety indicators between the two groups were also compared. Results: There was no statistical difference in baseline data such as gender, age, disease duration, and body mass index between the two groups of patients. Compared with before treatment, both groups showed decreased WOMAC total and subscale, TCM syndrome total score and symptom scores, and VAS scores, and an increase in Lysholm scores at 4, 8, and 16 weeks after treatment. After treatment, serum IL-6, MMP-3, TNF-α, and COMP levels decreased, whereas serum OPG and BGP levels increased (P<0.05). Compared with the control group, patients in the experimental group showed decreased WOMAC total and subscale, TCM syndrome total score and symptom scores, and VAS scores, and an increase in Lysholm score at 4, 8, and 16 weeks after treatment. Compared with the control group, patients in the experimental group showed decreased serum IL-6, MMP-3, TNF-α, and COMP levels and an increase in serum OPG and BPG levels after treatment (P<0.05). The total effective rate of the experimental group was 91.94%, higher than that of the control group (81.97%; P<0.05). Conclusion PRP injection combined with warm acupuncture and moxibustion can improve various TCM symptoms, improve knee joint function and bone metabolism, and reduce inflammation in patients with knee osteoarthritis and cold dampness obstruction syndrome.

AIM: To analyze the clinical features and multimodal imaging features of peripapillary hyper-reflective ovoid mass-like structure(PHOMS).METHODS: Retrospective observation study. Totally 35 patients(56 eyes)with PHOMS that diagnosed in the Affiliated Eye Hospital of Nanjing Medical University from January 2020 to March 2024 were included in the study. All patients underwent fundus photography, fundus fluorescein angiography, fundus autofluorescence, optical coherence tomography, and B-ultrasound.RESULTS:PHOMS occurred across diverse age groups, with an insidious onset often detected incidentally during routine ophthalmic examinations. More patients came to hospital for refractive errors due to blurred vision The boundary of the optic disc is blurred on fundus photography, and the nasal eminence is more significant, showing a “C” shaped halo. No obvious abnormal fluorescence was observed on fundus autofluorescence and fundus fluorescein angiography during different periods. An elevated appearance in vary degrees with more prominent in the nasal parts was showed on different OCT scans. Vertical scanning on the nasal side of the optic disc showed the best PHOMS structure, which could be seen under the retinal nerve fiber layer and on the Bruch membrane, with sharply marginated hyper-reflective ovoid mass-like structures, and no shielding effect on the choroid. The higher the elevation, the larger the volume. Ocular B-mode ultrasound showed a pre-optic disc bulge on the posterior wall of the eyeball, and there was no strong signal echo in it.CONCLUSION:PHOMS can be found frequently in myopic patients and often asymptomatic. Transient vision loss and floaters may occur in symptomatic cases. The most typical OCT feature is a nasally located hyper-reflective ovoid structure with distinct margins.

OBJECTIVE: To explore the displacement and pressure distribution of American Chiropractic in a model of third lumbar syndrome based on finite element analysis. METHODS: On March 2021, CT and MRI images of a 23-year-old male patient with right third lumbar syndrome were selected. A 3D stl model was established using Mimics and CATIA, and the data was imported into Hypermesh, Abaqus & ANSYS. The elastic modulus and Poisson's ratio of the affected side material were adjusted to establish its finite element model. Based on the comparison of the operating positions and routines of the American Chiropractic and the lumbar spine oblique pull method, but with differences in the focus and direction of force, the experimental group simulated the American Chiropractic with the healthy side (left side) lying position of the model. The upper endplate of L₃ and the lower part below L₃ twisted accordingly with the body position, we applied a vertical forward thrust of 246 N to the plane formed by the L₄, L₅ spinous processes and L₄ upper articular processes;The control group simulates the oblique pull method of the lumbar spine, requiring the model to lie on the healthy side (left side), fix the upper endplate of L₄, and perform a horizontal rotation along the longitudinal axis of L₃ vertebral body. At this time, the contact force in the upward direction is also set to 246 N. Compare the displacement and stress differences between the L₁-L₅ intervertebral bodies, intervertebral discs, articular processes, and transverse process muscles in two intervention models. RESULTS: ① Under safe load conditions, a test force of 246 N was applied to the model, and the maximum vertebral displacement occurred on the right side of the L₃ vertebral body (1.197 mm) after manual intervention in the control group. The vertebral displacement between L₁-L₅ induced by manual intervention in the experimental group was smaller than that of the control group's manual intervention (P<0.05). ② The maximum vertebral body stress occurred on the right side of the L₃ vertebral body after manual intervention in the control group (98.425 MPa). The stress on each vertebral body formed by the experimental group's manual intervention was lower than that of the control group's manual intervention (P<0.05). ③The maximum intervertebral disc stress occurred on the right side of the L_2,3 intervertebral disc (6.282 MPa) after manual intervention in the control group. ④ The maximum joint process stress occurred on the right side of the L₄ upper joint process after manual intervention in the experimental group (1.587 MPa). The joint process stress on the left side below L₁ and the left side above and below L₂ induced by manual intervention in the experimental group was lower than that of the control group (P<0.05). ⑤The maximum stress on the intertransverse process muscle was observed at the right lateral L₃ process end (31.960 MPa) of L_3,4 in the control group after manual intervention. The stress on the L_2,3 and L_4,5 segments of the intertransverse process muscle induced by manual intervention in the experimental group was lower than that of the control group's manual intervention (P<0.05). CONCLUSION The mechanical feedback of the L₁-L₅ vertebral body, the lower left side of the articular process L₁, the upper and lower left side of the articular process L₂, and the L_2,3 and L_4,5 segments of the transverse process muscle in the model indicates that performing American Chiropractic for the treatment of third lumbar transverse process syndrome can accurately hit the target pain point and allow the patient's tissue to form a low stress and low tension state after manual operation, thereby reducing the possibility of tissue damage caused by hypertonia after intervertebral joint movement, making it relatively safe. The application of American Chiropractic will be a new supplement to the traditional treatment plan for third lumbar transverse process syndrome.
Humans ; Finite Element Analysis ; Male ; Lumbar Vertebrae/physiopathology* ; Biomechanical Phenomena ; Young Adult ; Manipulation, Chiropractic ; Adult ; Tomography, X-Ray Computed ; Magnetic Resonance Imaging

Objective·To analyze the molecular epidemiological characteristics of Klebsiella pneumoniae isolated from children,including the distribution of serotypes,resistance genes,and virulence genes,to provide a scientific basis for the prevention and treatment strategies of Klebsiella pneumoniae infections in children.Methods·A total of 133 non-duplicate strains of Klebsiella pneumoniae clinically isolated from Shanghai Children's Hospital,Shanghai Jiao Tong University School of Medicine,from April 2023 to April 2024,were collected.Antimicrobial susceptibility testing was performed by using the Vitek-2 Compact system.Capsular polysaccharide K antigen serotypes(K types)were determined by wzy-dependent initiator(wzi)gene sequencing.Resistance genes were detected by the colloidal gold method.Virulence genes and lipopolysaccharide O antigen serotypes(O types)were identified by PCR method.Results·Among the 133 strains of Klebsiella pneumoniae,a total of 50 strains of carbapenem-resistant Klebsiella pneumoniae(CRKP)were detected,mainly distributed in the neonatal ward and intensive care unit(ICU).CRKP exhibited high resistance to most antimicrobial agents,and the main type of carbapenemase gene was blaNDM(34/50,68.00%),followed by co-carriage of blaNDM+blaOXA-48(10/50,20.00%)and blaKPC(6/50,12.00%).Serotype analysis revealed that the 50 CRKP strains could be divided into 8 K types and 6 O types.The most common K type was KL17(30/50,60.00%),followed by KL105(10/50,20.00%)and KL47(5/50,10.00%).The most common O type was O4(30/50,60.00%),followed by O3b(7/50,14.00%,),O3/O3a(6/50,12.00%),and OL101(5/50,10.00%).Significant correlations were identified between KL47 and OL101 serotypes(KL47:OL101),between KL17 and O4 serotypes(KL17:O4),and between KL1/KL2 and O1 serotypes(KL1/KL2:O1).Conclusion·The CRKP strains infecting children primarily carry blaNDM-type carbapenemase genes,showing a significant difference compared to CRKP-infected adults.The detection rate of CRKP in the neonatal ward is significantly higher than those in other departments,suggesting that infection prevention and control measures in this ward need to be strengthened.

Objective:Acute kidney injury(AKI) is a common complication after cardiac surgery, and associated with increased risk of development of chronic kidney disease and mortality in the long term. Neutrophil percentage-to-albumin ratio(NPAR) is a new inflammatory marker that has been used to predict the poor prognosis of patients with cardiovascular disease or shock. However, the relationship between NPAR and AKI in patients with cardiac surgery has not been established. The aim was to evaluate the relationship between NPAR and AKI after cardiac surgery.Methods:Data of all adult patients underwent cardiac surgery with cardiopulmonary bypass from January 1, 2006 to December 31, 2018 were extracted from electronic medical record system of the Guangdong Provincial People's Hospital and retrospectively analyzed. The outcome of interest was AKI diagnosed by using the criteria of Kidney Disease Improving Global Outcomes. Logistic regression was used to assess the relationship between NPAR and postoperative AKI while adjust for potential confounders. In addition, restricted cubic spline(RCS) was utilized to provide a flexible description of the association of the preoperative NPAR and AKI. Results:Totally, 24 178 patients were analyzed. The incidence of AKI was 30.1%. Compared with patients without AKI, those with AKI were older and had higher rates of males, left ventricular ejection fraction(LVEF) less than or equal to 0.60, estimated glomerular filtration rate less than 90 ml·min -1·1.73 m -2, hypertension, diabetes, emergency surgery, preoperative critical illness, and reoperation. The baseline serum creatinine, serum uric acid, cardiopulmonary bypass time and postoperative mechanical ventilation time were higher or longer in AKI patients than those in none AKI patients. Then, patients were divided into four groups based on NPAR quartiles. After adjusting for confounding factors using logisitc regression, compared with patients with NPAR in group 3(1.551.97), respectively. The RCS showed a U-shaped nonlinear relationship( P for nonlinear less than 0.001) between NPAR and AKI after adjusting for potential confounding factors. RCS indicated the NPAR of 1.77 was the lowest risk for AKI. When NPAR less than 1.77, per 1-standard deviation(SD) increase in NPAR, the risk of AKI decreased by 23.2%( OR=0.768, 95% CI: 0.687, 0.859). Conversely, when NPAR above 1.77, per one SD increase in NPAR, the risk of AKI increased by 25.9%( OR=1.259, 95% CI: 1.166, 1.36). Conclusion:A U-shaped relationship between NPAR and AKI after cardiac surgery was shown. The appropriate value for NPAR might be 1.77. The risk of AKI might be increased, when less or above this value. NPAR might be used as an effective and economical tool to identify AKI risk among individuals with cardiac surgery, as well as to formulate individualized prevention and intervention strategy.