Compared with traditional therapies for chronic liver disease （CLD）， Bifidobacterium has the characteristics of multi-target intervention， high biosafety， and good host compatibility and provides new strategies for intervention of CLD progression in terms of microecological regulation. Various studies have shown that Bifidobacterium regulates liver homeostasis and exerts a therapeutic effect on CLD by regulating intestinal flora， maintaining antioxidation， promoting energy consumption， alleviating inflammation， improving glycolipid metabolism， and exerting an antitumor effect. This article systematically reviews the studies on Bifidobacterium in the treatment of CLD in China and globally， explores their different mechanisms， and elaborates on the interaction between related signaling pathways （such as the nuclear factor erythroid 2-related factor 2 signaling pathway and the adenosine monophosphate-activated protein kinase signaling pathway） and the liver， in order to provide a basis for probiotic intervention in liver pathology， as well as new ideas for the comprehensive treatment of CLD.

Objective To explore the application value of computed tomography (CT) three-dimensional reconstruction in total knee arthroplasty (TKA). Methods A total of 102 patients who underwent TKA in our hospital between April 2022 and April 2025 were enrolled and divided using a random number table into a traditional group (51 cases, routine preoperative evaluation) and a study group (51 cases, CT three-dimensional reconstruction-assisted surgery). The therapeutic efficacy at 3 months postoperatively and perioperative indicators were compared between the two groups. The hip-knee-ankle (HKA) angle was measured preoperatively and at 3 months postoperatively. The Hospital for Special Surgery (HSS) knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were recorded preoperatively and at 3 and 6 months postoperatively. Complications were documented. Results The excellent/good rate in the study group (92.16%) was higher than that in the traditional group (74.51%) (P<0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were (69.52 ± 7.11) min, (102.69 ± 8.54) mL, (167.33 ± 12.35) mL, and (10.93 ± 2.37) days, respectively, which were shorter than those in the traditional group [(78.45 ± 5.98) min, (108.36 ± 10.02) mL, (175.96 ± 14.93) mL, and (12.04 ± 1.95) days] (P<0.05). At 3 months postoperatively, the HKA angle was 178.02° ± 1.05° in the study group and 177.45° ± 1.34° in the traditional group, both were significantly improved compared with those before operation, with the study group showing better improvement (P<0.05). The HSS knee and WOMAC scores in both groups at 3 and 6 months postoperatively were improved compared with preoperative scores (P<0.05). At 3 and 6 months postoperatively, the study group showed higher HSS knee score and lower WOMAC score than the traditional group (P<0.05). The incidence of complications in the study group (3.92%) was lower than that in the traditional group (17.65%) (P<0.05). Conclusion TKA guided by CT three-dimensional reconstruction improved the excellent/good rate, optimized HKA angle and knee function, shortened operation time and hospital stay, reduced intraoperative blood loss and postoperative drainage volume, and decreased the incidence of complications.

Objective To explore the application value of computed tomography (CT) three-dimensional reconstruction in total knee arthroplasty (TKA). Methods A total of 102 patients who underwent TKA in our hospital between April 2022 and April 2025 were enrolled and divided using a random number table into a traditional group (51 cases, routine preoperative evaluation) and a study group (51 cases, CT three-dimensional reconstruction-assisted surgery). The therapeutic efficacy at 3 months postoperatively and perioperative indicators were compared between the two groups. The hip-knee-ankle (HKA) angle was measured preoperatively and at 3 months postoperatively. The Hospital for Special Surgery (HSS) knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were recorded preoperatively and at 3 and 6 months postoperatively. Complications were documented. Results The excellent/good rate in the study group (92.16%) was higher than that in the traditional group (74.51%) (P<0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were (69.52 ± 7.11) min, (102.69 ± 8.54) mL, (167.33 ± 12.35) mL, and (10.93 ± 2.37) days, respectively, which were shorter than those in the traditional group [(78.45 ± 5.98) min, (108.36 ± 10.02) mL, (175.96 ± 14.93) mL, and (12.04 ± 1.95) days] (P<0.05). At 3 months postoperatively, the HKA angle was 178.02° ± 1.05° in the study group and 177.45° ± 1.34° in the traditional group, both were significantly improved compared with those before operation, with the study group showing better improvement (P<0.05). The HSS knee and WOMAC scores in both groups at 3 and 6 months postoperatively were improved compared with preoperative scores (P<0.05). At 3 and 6 months postoperatively, the study group showed higher HSS knee score and lower WOMAC score than the traditional group (P<0.05). The incidence of complications in the study group (3.92%) was lower than that in the traditional group (17.65%) (P<0.05). Conclusion TKA guided by CT three-dimensional reconstruction improved the excellent/good rate, optimized HKA angle and knee function, shortened operation time and hospital stay, reduced intraoperative blood loss and postoperative drainage volume, and decreased the incidence of complications.

Objective To explore the application value of computed tomography (CT) three-dimensional reconstruction in total knee arthroplasty (TKA). Methods A total of 102 patients who underwent TKA in our hospital between April 2022 and April 2025 were enrolled and divided using a random number table into a traditional group (51 cases, routine preoperative evaluation) and a study group (51 cases, CT three-dimensional reconstruction-assisted surgery). The therapeutic efficacy at 3 months postoperatively and perioperative indicators were compared between the two groups. The hip-knee-ankle (HKA) angle was measured preoperatively and at 3 months postoperatively. The Hospital for Special Surgery (HSS) knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were recorded preoperatively and at 3 and 6 months postoperatively. Complications were documented. Results The excellent/good rate in the study group (92.16%) was higher than that in the traditional group (74.51%) (P<0.05). The operation time, intraoperative blood loss, postoperative drainage volume, and hospital stay in the study group were (69.52 ± 7.11) min, (102.69 ± 8.54) mL, (167.33 ± 12.35) mL, and (10.93 ± 2.37) days, respectively, which were shorter than those in the traditional group [(78.45 ± 5.98) min, (108.36 ± 10.02) mL, (175.96 ± 14.93) mL, and (12.04 ± 1.95) days] (P<0.05). At 3 months postoperatively, the HKA angle was 178.02° ± 1.05° in the study group and 177.45° ± 1.34° in the traditional group, both were significantly improved compared with those before operation, with the study group showing better improvement (P<0.05). The HSS knee and WOMAC scores in both groups at 3 and 6 months postoperatively were improved compared with preoperative scores (P<0.05). At 3 and 6 months postoperatively, the study group showed higher HSS knee score and lower WOMAC score than the traditional group (P<0.05). The incidence of complications in the study group (3.92%) was lower than that in the traditional group (17.65%) (P<0.05). Conclusion TKA guided by CT three-dimensional reconstruction improved the excellent/good rate, optimized HKA angle and knee function, shortened operation time and hospital stay, reduced intraoperative blood loss and postoperative drainage volume, and decreased the incidence of complications.

[Objective] : To explore the clinical characteristics and methods for syndrome differentiation prediction, as well as to construct a predictive model for Qi deficiency and blood stasis syndrome in patients with acute ischemic stroke (AIS). [Methods] : This study employed a retrospective case-control design to analyze patients with AIS who received inpatient treatment at the Neurology Department of The First Hospital of Hunan University of Chinese Medicine from January 1, 2013 to December 31, 2022. AIS patients meeting the diagnostic criteria for Qi deficiency and blood stasis syndrome were stratified into case group, while those without Qi deficiency and blood stasis syndrome were stratified into control group. The demographic characteristics (age and gender), clinical parameters [time from onset to admission, National Institutes of Health Stroke Scale (NIHSS) score, and blood pressure], past medical history, traditional Chinese medicine (TCM) diagnostic characteristics (tongue and pulse), neurological symptoms and signs, imaging findings [magnetic resonance imaging-diffusion weighted imaging (MRI-DWI)], and biochemical indicators of the two groups were collected and compared. The indicators with statistical difference (P < 0.05) in univariate analysis were included in multivariate logistic regression analysis to evaluate their predictive value for the diagnosis of Qi deficiency and blood stasis syndrome, and the predictive model was constructed by receiver operating characteristic (ROC) curve analysis. [Results] : The study included 1 035 AIS patients, with 404 cases in case group and 631 cases in control group. Compared with control group, patients in case group were significantly older, had extended onset-to-admission time, lower diastolic blood pressure, and lower NIHSS scores (P < 0.05). Case group showed lower incidence of hypertension history (P < 0.05). Regarding tongue and pulse characteristics, pale and dark tongue colors, white tongue coating, fine pulse, astringent pulse, and sinking pulse were more common in case group. Imaging examinations demonstrated higher proportions of centrum semiovale infarction, cerebral atrophy, and vertebral artery stenosis in case group (P < 0.05). Among biochemical indicators, case group showed higher proportions of elevated fasting blood glucose and glycated hemoglobin (HbA1c), while lower proportions of elevated white blood cell count, reduced hemoglobin, and reduced high-density lipoprotein cholesterol (HDL-C) (P < 0.05). Multivariate logistic regression analysis identified significant predictors for Qi deficiency and blood stasis syndrome including: fine pulse [odds ratio (OR) = 4.38], astringent pulse (OR = 3.67), superficial sensory abnormalities (OR = 1.86), centrum semiovale infarction (OR = 1.57), cerebral atrophy (OR = 1.55), vertebral artery stenosis (OR = 1.62), and elevated HbA1c (OR = 3.52). The ROC curve analysis of the comprehensive prediction model yielded an area under the curve (AUC) of 0.878 [95% confidence interval (CI) = 0.855 – 0.900]. [Conclusion] This study finds out that Qi deficiency and blood stasis syndrome represents one of the primary types of AIS. Fine pulse, astringent pulse, superficial sensory abnormalities, centrum semiovale infarction, cerebral atrophy, vertebral artery stenosis, elevated blood glucose, elevated HbA1c, pale and dark tongue colors, and white tongue coating are key objective diagnostic indicators for the syndrome differentiation of AIS with Qi deficiency and blood stasis syndrome. Based on these indicators, a syndrome differentiation prediction model has been developed, offering a more objective basis for clinical diagnosis, and help to rapidly identify this syndrome in clinical practice and reduce misdiagnosis and missed diagnosis.

Subarachnoid hemorrhage (SAH) is a serious intracranial hemorrhage characterized by acute bleeding into the subarachnoid space. The effects of shikonin, a natural compound from the roots of Lithospermum erythrorhizon, on oxidative stress and blood–brain barrier (BBB) injury in SAH was evaluated in this study. A rat model of SAH was established by endovascular perforation to mimic the rupture of intracranial aneurysms. Rats were then administered 25 mg/kg of shikonin or dimethylsulfoxide after surgery. Brain edema, SAH grade, and neurobehavioral scores were measured after 24 h of SAH to evaluate neurological impairment. Concentrations of the oxidative stress markers superoxide dismutase (SOD), glutathione (GSH), and malondialdehyde (MDA) in the brain cortex were determined using the corresponding commercially available assay kits. Evans blue staining was used to determine BBB permeability. Western blotting was used to quantify protein levels of tight junction proteins zonula occludens-1, Occludin, and Claudin-5. After modeling, the brain water content increased significantly whereas the neurobehavioral scores of rats with SAH decreased prominently. MDA levels increased and the levels of the antioxidant enzymes GSH and SOD decreased after SAH. These changes were reversed after shikonin administration. Shikonin treatment also inhibited Evans blue extravasation after SAH. Furthermore, reduction in the levels of tight junction proteins after SAH modeling was rescued after shikonin treatment. In conclusion, shikonin exerts a neuroprotective effect after SAH by mitigating BBB injury and inhibiting oxidative stress in the cerebral cortex.

Objective To investigate the efficacy and safety of compound cantharidis capsule combined with pemetrexed and platinum-based drugs in the treatment of elderly patients with advanced lungadenocarcinoma.Methods A total of 80 patients with advanced lung adenocarcinoma were retro-spectively selected as the study subjects.According to the treatment regimen,they were divided into chemotherapy group(treated with pemetrexed and platinum-based drugs)and traditional Chinese med-icine combined with chemotherapy group(treated with compound cantharidis capsule combined with-pemetrexed and platinum-based drugs),with 40 cases in each group.The short-term efficacy,serum tumor marker[carcinoembryonic antigen(CEA),carbohydrate antigen 72-4(CA72-4),carbohydrate antigen 125(CA125)]levels,and the incidence of adverse reactions were observed and compared between the two groups.The patients were followed up,and the progression-free survival(PFS)and overall survival(OS)of the two groups were recorded.Results The objective response rate(ORR)and disease control rate(DCR)in the traditional Chinese medicine combined with chemotherapy group were higher than those in the chemotherapy group,with statistically significant differences(P＜0.05).After treatment,the serum CEA,CA72-4 and CA125 levels in both groups were lower than those before treatment,and the levels in the traditional Chinese medicine combined with chemotherapy group were lower than those in the chemotherapy group,with statistically significant differences(P＜0.05).There was no statistically significant difference in the incidence of grade 3 to 4 adverse reac-tions between the two groups(P＞0.05).The progression-free survival rate and overall survival rate in the traditional Chinese medicine combined with chemotherapy group were higher than those in the chemotherapy group,with statistically significant differences(P＜0.05).Conclusion Compound cantharidis capsule combined with pemetrexed and platinum-based drugs can significantly improve the ORR and DCR,reduce serum tumor marker levels,prolong the survival of patients with ad-vanced lung adenocarcinoma,and has good safety.

Subarachnoid hemorrhage (SAH) is a serious intracranial hemorrhage characterized by acute bleeding into the subarachnoid space. The effects of shikonin, a natural compound from the roots of Lithospermum erythrorhizon, on oxidative stress and blood–brain barrier (BBB) injury in SAH was evaluated in this study. A rat model of SAH was established by endovascular perforation to mimic the rupture of intracranial aneurysms. Rats were then administered 25 mg/kg of shikonin or dimethylsulfoxide after surgery. Brain edema, SAH grade, and neurobehavioral scores were measured after 24 h of SAH to evaluate neurological impairment. Concentrations of the oxidative stress markers superoxide dismutase (SOD), glutathione (GSH), and malondialdehyde (MDA) in the brain cortex were determined using the corresponding commercially available assay kits. Evans blue staining was used to determine BBB permeability. Western blotting was used to quantify protein levels of tight junction proteins zonula occludens-1, Occludin, and Claudin-5. After modeling, the brain water content increased significantly whereas the neurobehavioral scores of rats with SAH decreased prominently. MDA levels increased and the levels of the antioxidant enzymes GSH and SOD decreased after SAH. These changes were reversed after shikonin administration. Shikonin treatment also inhibited Evans blue extravasation after SAH. Furthermore, reduction in the levels of tight junction proteins after SAH modeling was rescued after shikonin treatment. In conclusion, shikonin exerts a neuroprotective effect after SAH by mitigating BBB injury and inhibiting oxidative stress in the cerebral cortex.

Aim To study the correlation between es-trogen metabolism function of intestinal flora and liver fibrosis disease phenotype and differential intestinal bacteria by fecal microbiota transplantation(FMT).Methods C57BL/6J male mice were divided into normal group(Control-M),liver fibrosis Model group(Model),FMT-1 group(normal mice fecal microbiota transplantation from liver fibrosis mice),and FMT-2 group(liver fibrosis mice fecal microbiota transplanta-tion from female mice).The model group was induced by high fat and high glucose combined with low dose of CCl4 for 16 weeks.In the FMT group,the bacteria were destroyed by mixed antibacterial solution and then the corresponding fecal microbiota solution was given.The model group was established in the FMT-2 group and the model group at the same time.Liver function(ALT,AST)was detected by biochemical methods;liver inflammation(IL-1α,IL-6)was detected by ELISA;liver pathology was detected by HE and Mas-son methods;the expressions of α-SMA,collagen Ⅰ,estrogen receptor ERα,ERβ and GPER were detected by Western blot;estrogen metabolic enzymes β-glucu-ronidase and β-glucosidase in intestinal flora were de-tected by double antibody sandwich assay;gut microbi-ota was detected by 16S rDNA method;the correlation between estrogen metabolic enzymes,estrogen receptors and disease phenotypes and disease-related differential bacteria was analyzed by Pearson correlation analysis.Results Liver function,inflammation and fibrosis in-dices were significantly higher in the model group than those in the control-M group and significantly lower in the FMT-2 group than in the model group;estrogen metabolic enzymes of the intestinal flora significantly increased in the model group compared to the control-M group and significantly decreased in the FMT-2 group compared to the model group;the model group showed a significant increase in ERβ and GPER and a significant decrease in ERα compared to the control-M group,while the FMT-2 group showed a significant de-crease in ERβ and GPER and a significant increase in ERα compared to the model group;the FMT-2 group increased the enterobacterial abundance and diversity reduced by modelling;estrogen metabolic enzymes,es-trogen receptor ERβ and GPER were all positively cor-related with the disease phenotype,while the opposite was true for ERα;estrogen metabolic enzymes were positively correlated with Allobaculum,Ruminococcus and Alistipes,and negatively correlated with Akkerman-sia,Lactobacillus and Prevotella.Conclusions Fecal microbiota transplantation in female mice can alleviate liver fibrosis in male mice,which is related to the im-provement of estrogen metabolism of intestinal flora.

BACKGROUND:Microplastics are a common environmental pollutant that can cause damage to the gastrointestinal tract,liver and kidney,and reproductive system.However,little is known about the effects of microplastics on the prostate.OBJECTIVE:To investigate the effects of different charge-modified polystyrene microplastics on prostate tissues of male mice and its mechanism.METHODS:A total of 48 male BALB/c mice were randomly divided into a control group,an unmodified microplastic group,a negatively charged microplastic group,and a positively charged microplastic group using a random number table,with 12 mice in each group.The mice in the control group were given ddH2O by gavage;the mice in the unmodified microplastic group were given unmodified polystyrene microplastics by gavage,and the mice in the negatively charged microplastic group and the positively charged microplastic group were given negatively charged polystyrene microplastics and positively charged polystyrene microplastics by gavage,respectively,once a day for 4 consecutive weeks.The body weight,drinking water,and food intake of the mice were detected every week.After gavage,the prostate mass,prostate coefficient,prostate histopathological morphology,inflammatory factor expression,microplastic accumulation in the prostate tissue of the mice,and the mRNA and protein expressions of hypoxia-inducible factor 1α and vascular endothelial growth factor were compared among the groups of mice.RESULTS AND CONCLUSION:(1)With the prolongation of microplastic exposure time,the body weight of mice in the unmodified microplastics group and the positively charged microplastics exposure group was significantly suppressed.(2)After exposure to microplastics,they could enter the urinary system of mice,including prostate and bladder tissue.Among the mice in the positively charged microplastic group,the prostate mass and prostate coefficient increased most significantly.(3)Compared with the control group,the mass concentration and mRNA expression of interleukin 6,interleukin 1β,and tumor necrosis factorα were increased in the prostate tissue of the other three groups of mice(P＜0.05).Among them,the positively charged microplastic group exhibited most obvious increase.(4)Hematoxylin-eosin staining showed that the prostate tissue of mice in the unmodified microplastic group,negatively charged microplastic group,and positively charged microplastic group showed obvious proliferation of prostate epithelial cells and matrix,a significant increase in acini,and infiltration of a large number of inflammatory cells.Masson and Sirius red staining showed that compared with the control group,the prostate tissue of mice in the other three groups had obvious fibrosis.Immunohistochemical staining showed that compared with the control group,angiogenesis in the prostate tissue of mice increased in the other three groups(P＜0.05).(5)Compared with the control group,the mRNA and protein expressions of hypoxia-inducible factor 1αand vascular endothelial growth factor were increased in the prostate tissue of the other three groups of mice(P＜0.05),among which the negatively charged microplastic group and the positively charged microplastic group exhibited more significant increase.(6)The results show that polystyrene microplastics can enhance the release of inflammatory factors in mouse prostate tissue,promote angiogenesis in prostate tissue by activating the hypoxia-inducible factor 1α/vascular endothelial growth factor signaling pathway,and provide nutrition support for prostate hyperplasia and fibrosis.