Objective:To explore the effects of Jianpi Mixture on the glucose receptor/glucagon like peptide-1 (GLP-1)/5-hydroxytryptamine (5-HT) signaling pathway and the mechanism of Jianpi Mixture in improving visceral hypersensitivity in diarrhea-predominant irritable bowel syndrome (IBS-D) rats.Methods:Totally 40 healthy male SPF rats were divided into blank group, model group, Jianpi Mixture low- and high-dosage groups according to the random number table method, with 10 rats in each group. Except for the blank group, the rest of the rats were prepared by the "senna gavage combined with restraint stress" method to replicate the IBS-D spleen deficiency model. The aqueous extract of Jianpi Mixture was 2.52 and 7.56 g/kg in the low- and high-dosage groups, and the same volume of normal saline was given to the blank group and the model group, once a day, for 14 days. On the 1st, 7th and 14th days of administration, the body weight of rats was recorded, the fecal traits of the rats were scored with Bristol score, the visceral sensitivity of IBS-D rats was evaluated by the abdominal wall retraction reflex score (AWR) under rectal dilation, the morphology of colonic mucosal tissues was observed by HE staining, and the protein expressions of T1R2, SLGT1, GLUT2, GLP-1 and 5-HT in colon tissues were detected by immunohistochemical staining.Results:On the 1st, 7th and 14th days of administration, compared with the model group, the weight of the rats in the Jianpi Mixture high-dosage group increased ( P<0.05); on the 14th day of administration, the fecal Bristol score decreased significantly ( P<0.05) and the AWR score increased ( P<0.05); HE staining showed that the mucosal epithelium of colon tissue in the model group was slightly damaged, and local edema was visible. The pathological condition of colonic mucosa in the Jianpi Mixture low- and high-dosage groups was effectively improved; compared with the model group, the expressions of T1R2 and GLP-1 in the Jianpi Mixture low- and high-dosage groups increased ( P<0.05), and the expression of 5-HT decreased ( P<0.05); the protein expressions of GLUT2 and SGLT1 in the Jianpi Mixture high-dosage group increased ( P<0.05). Conclusion:Jianpi Mixture can treat spleen-deficiency IBS-D by restoring the normal expression of intestinal glucose receptors, regulating the secretion of GLP-1/5-HT, improving intestinal motility and alleviating visceral hypersensitivity.

Objective:To explore the correlation between water-soluble vitamin levels and clinical indicators and provide a theoretical basis for precise nutrition treatment of chronic kidney disease (CKD) .Methods:Clinical data of CKD patients who underwent water-soluble vitamin (B1, B2, B6, B9, B12, C) level tests at the First Affiliated Hospital, Army Medical University from Jan. 2016 to Dec. 2023 were collected and analyzed to investigate the relationship between water-soluble vitamin levels and clinical indicators.Results:The median values of B1 and B2 were 47.52 (range 41.65-135.36) and 184.52 (range 178.52-192.53), which were below the normal range. The results showed that age, serum creatinine, and fasting blood glucose in the low-level group for all vitamins were higher than those in the high-level group ( P<0.05). However, hemoglobin and estimated glomerular filtration rate were lower in the low-level group than those in the high-level group ( P<0.05). In the low-level group of B1, the percentage of neutrophils (NEUT%) was higher than that in the high-level group ( P<0.05). In CKD stage 5, the levels of all vitamins were lower than those of CKD stage 1 ( P<0.05). Spearman correlation analysis showed that the levels of all vitamins were negatively correlated with CKD stage, with correlation coefficients of -0.329, -0.357, -0.345, -0.373, -0.386 and-0.351, respectively ( P<0.01) . Conclusions:Metabolic abnormalities of watersoluble vitamins are common in CKD, which are closely related to the progression of CKD, inflammation and anemia. Timely evaluation and intervention may be beneficial to prevent the progression of CKD and provide a new treatment strategy for precise nutrition intervention in CKD.

Objective:To explore the correlation between water-soluble vitamin levels and clinical indicators and provide a theoretical basis for precise nutrition treatment of chronic kidney disease (CKD) .Methods:Clinical data of CKD patients who underwent water-soluble vitamin (B1, B2, B6, B9, B12, C) level tests at the First Affiliated Hospital, Army Medical University from Jan. 2016 to Dec. 2023 were collected and analyzed to investigate the relationship between water-soluble vitamin levels and clinical indicators.Results:The median values of B1 and B2 were 47.52 (range 41.65-135.36) and 184.52 (range 178.52-192.53), which were below the normal range. The results showed that age, serum creatinine, and fasting blood glucose in the low-level group for all vitamins were higher than those in the high-level group ( P<0.05). However, hemoglobin and estimated glomerular filtration rate were lower in the low-level group than those in the high-level group ( P<0.05). In the low-level group of B1, the percentage of neutrophils (NEUT%) was higher than that in the high-level group ( P<0.05). In CKD stage 5, the levels of all vitamins were lower than those of CKD stage 1 ( P<0.05). Spearman correlation analysis showed that the levels of all vitamins were negatively correlated with CKD stage, with correlation coefficients of -0.329, -0.357, -0.345, -0.373, -0.386 and-0.351, respectively ( P<0.01) . Conclusions:Metabolic abnormalities of watersoluble vitamins are common in CKD, which are closely related to the progression of CKD, inflammation and anemia. Timely evaluation and intervention may be beneficial to prevent the progression of CKD and provide a new treatment strategy for precise nutrition intervention in CKD.

Objective To develop a knowledge-attitude-practice assessment scale for home prevention and man-agement of parastostomy hernia in ostomy patients,and to test its reliability and validity,to provide a reliable tool for evaluating the knowledge and practice level of home prevention and management of parastostomy hernia in pa-tients with ostomy.Methods Based on the theory of knowledge,attitude and practice,the initial scale was generat-ed through literature review,semi-structured interviews,expert correspondence,research group discussion and pre-sur-vey.From May to December 2023,685 patients with ostomy from the ostomy clinic of a tertiary hospital in Tianjin were investigated by purpose sampling method,and the reliability and validity were tested.Results A total of 673 valid questionnaires were collected,the results showed that the knowledge-attitude-practice assessment scale for pre-venting and managing parastomal hernia of ostomy patients at home included 3 dimensions of knowledge,attitude and practice,with a total of 27 items.The response rates of 2 rounds of the questionnaire were both 100％;the au-thority coefficients were all 0.915;the Kendall's coefficients of concordance were 0.279 and 0.301,respectively.The content validity index of each item was 0.875～1.000;the content validity index of the average scale level was 0.988;after 2 exploratory factor analysis,the cumulative variance contribution rate was 65.920％.The results of con-firmatory factor analysis showed that the model had a good fit,with a chi-square degree of freedom ratio(/df)of 1.945,the fitting goodness index(GFI)of 0.851,the comparative goodness of fit index(CFI)of 0.919,the root means square error of approximation(RMSEA)of 0.060.The Cronbach's alpha coefficient result of the scale is 0.957,with a test-retest reliability of 0.826 and a half reliability of 0.934.Conclusion The knowledge-attitude-practice assessment scale has good reliability and validity,and can be used as an assessment tool for home prevention and management of parastostomy hernia in ostomy patients.

Objective To develop a knowledge-attitude-practice assessment scale for home prevention and man-agement of parastostomy hernia in ostomy patients,and to test its reliability and validity,to provide a reliable tool for evaluating the knowledge and practice level of home prevention and management of parastostomy hernia in pa-tients with ostomy.Methods Based on the theory of knowledge,attitude and practice,the initial scale was generat-ed through literature review,semi-structured interviews,expert correspondence,research group discussion and pre-sur-vey.From May to December 2023,685 patients with ostomy from the ostomy clinic of a tertiary hospital in Tianjin were investigated by purpose sampling method,and the reliability and validity were tested.Results A total of 673 valid questionnaires were collected,the results showed that the knowledge-attitude-practice assessment scale for pre-venting and managing parastomal hernia of ostomy patients at home included 3 dimensions of knowledge,attitude and practice,with a total of 27 items.The response rates of 2 rounds of the questionnaire were both 100％;the au-thority coefficients were all 0.915;the Kendall's coefficients of concordance were 0.279 and 0.301,respectively.The content validity index of each item was 0.875～1.000;the content validity index of the average scale level was 0.988;after 2 exploratory factor analysis,the cumulative variance contribution rate was 65.920％.The results of con-firmatory factor analysis showed that the model had a good fit,with a chi-square degree of freedom ratio(/df)of 1.945,the fitting goodness index(GFI)of 0.851,the comparative goodness of fit index(CFI)of 0.919,the root means square error of approximation(RMSEA)of 0.060.The Cronbach's alpha coefficient result of the scale is 0.957,with a test-retest reliability of 0.826 and a half reliability of 0.934.Conclusion The knowledge-attitude-practice assessment scale has good reliability and validity,and can be used as an assessment tool for home prevention and management of parastostomy hernia in ostomy patients.

The intestinal flora and gut barrier function are of great significance for gut function and human health. When the intestinal flora is disrupted and the gut barrier structure is disrupted, it can lead to bacterial translocation, endotoxin influx into the bloodstream, and the production of pro-inflammatory factors, leading to various tissue damage in the body. Tongfu method in TCM can affect the intestinal environment by regulating intestinal permeability and immune response, restoring normal intestinal movement, and regulating the structure and metabolites of intestinal flora, thereby maintaining intestinal homeostasis and body health. The research on regulating intestinal flora and improving intestinal barrier function by Tongfu method can provide reference for further research on the relationship between TCM and intestinal microecology, and provide ideas for clinical treatment.

Objective: To investigate the subclinical eating disorders among college students and to analyze associated factors, so as to provide a basis for the prevention and treatment of eating disorders among adolescents. Methods: From November to December 2023, a total of 5 201 college students were selected by stratified random cluster sampling from one undergraduate college and one specialized college in Yangzhou City, Jiangsu Province. Data on general information, subclinical eating disorders, body image perception, depressive symptoms, anxiety symptoms, and mental health literacy were collected using questionnaires. The Chisquare test was used to compare the detection rates of subclinical eating disorders between groups, and binary Logistic regression was employed to analyze associated factors. Results: The detection rate of subclinical eating disorders among college students was 16.0%. Binary Logistic regression analysis showed that the prevalence of subclinical eating disorders among college students was higher in the following categories:being in a relationship (OR=1.22, 95%CI=1.04-1.44), being overweight and obese (OR=2.75, 3.82, 95%CI=2.24-3.38, 2.89-5.06), overestimation of body shape (OR=2.04, 95%CI=1.68-2.49), being in a depressive state (OR=2.53, 95%CI=1.99-3.21), experiencing anxiety (OR=2.63, 95%CI=2.16-3.20), and having substandard mental health literacy (OR=1.37, 95%CI=1.11-1.70). Conversely, low body weight (OR=0.15, 95%CI=0.10-0.22) and underestimation of body shape (OR=0.37, 95%CI=0.27-0.51) were associated with a lower risk (P<0.05). Conclusions The detection rate of subclinical eating disorders among college students is high, and it is associated with relationship status, body mass index classification, body shape perception, depressive and anxiety symptoms, and mental health literacy. Comprehensive interventions should be implemented to improve the subclinical eating disorders and promote the physical and mental health of college students.

OBJECTIVE: To explore the clinical characteristics and genetic etiology of a child with multiple pterygium syndrome (MPS). METHODS: A child with MPS who was treated at the Orthopedics Department of Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University on August 19, 2020 was selected as the study subject. Clinical data of the child was collected. Peripheral blood samples of the child and her parents were also collected. Whole exome sequencing (WES) was carried out for the child. Candidate variant was validated by Sanger sequencing of her parents and bioinformatic analysis. RESULTS: The child, an 11-year-old female, had a complain of "scoliosis found 8 years before and aggravated with unequal shoulder height for 1 year". WES results revealed that she has carried a homozygous c.55+1G>C splice variant of the CHRNG gene, for which both of her parents were heterozygous carriers. By bioinformatic analysis, the c.55+1G>C variant has not been recorded by the CNKI, Wanfang data knowledge service platform and HGMG databases. Analysis with Multain online software suggested that the amino acid encoded by this site is highly conserved among various species. As predicted with the CRYP-SKIP online software, the probability of activation and skipping of the potential splice site in exon 1 caused by this variant is 0.30 and 0.70, respectively. The child was diagnosed with MPS. CONCLUSION The CHRNG gene c.55+1G>C variant probably underlay the MPS in this patient.
Humans ; Child ; Female ; Abnormalities, Multiple/genetics* ; Malignant Hyperthermia/genetics* ; Skin Abnormalities/genetics* ; Heterozygote ; Mutation ; Receptors, Nicotinic/genetics*

Objective:To understand the cognition and attitude of medical staff towards medical ethics review, analyze possible influencing factors, to put forward relevant suggestions for strengthening ethical management in the future.Methods:From November 2021 to May 2022, a self-designed questionnaire and general data questionnaire on the cognition and attitude of medical staff to ethical issues in clinical research were used to investigate 408 medical staff from two first-class ternary hospitals in Hunan Province, data was analyzed to explore the respondents′ cognition and attitude, as well as related influence factors.Results:The average cognitive score of medical staff was 65.41, and the average attitude score was 91.83. Many possible influence actors regarding the cognition were identified, including degree, technical title, professional field, number of clinical research projects engaged as investigators, number of clinical research projects conducted as principle investigators, whether the hospital has established an ethics committee, and research ethics training experiences. While the influence factors of attitude were experiences of conducting and engaging in clinical research, the construction of hospital ethics committee and research ethics trainings.Conclusions:Medical staffs have the willingness to explore more research ethics knowledge, while their cognition of research ethics should be improved. Root-cause analysis should be conducted to identify influencing factors for improvement. The research management department should strengthen the publicity and training of clinical research ethics of medical staff, to improve their clinical research ethics knowledge literacy, and ensure the well-functioning of clinical research ethics review.

Ischemic stroke is a severe disorder resulting from acute cerebral thrombosis. Here we demonstrated that post-ischemic treatment with ciclopirox olamine (CPX), a potent antifungal clinical drug, alleviated brain infarction, neurological deficits and brain edema in a classic rat model of ischemic stroke. Single dose post-ischemic administration of CPX provided a long-lasting neuroprotective effect, which can be further enhanced by multiple doses administration of CPX. CPX also effectively reversed ischemia-induced neuronal loss, glial activation as well as blood-brain barrier (BBB) damage. Employing quantitative phosphoproteomic analysis, 130 phosphosites in 122 proteins were identified to be significantly regulated by CPX treatment in oxygen glucose deprivation (OGD)-exposed SH-SY5Y cells, which revealed that phosphokinases and cell cycle-related phosphoproteins were largely influenced. Subsequently, we demonstrated that CPX markedly enhanced the AKT (protein kinase B, PKB/AKT) and GSK3 (glycogen synthase kinase 3) phosphorylation in OGD-exposed SH-SY5Y cells, and regulated the cell cycle progression and nitric oxide (NO) release in lipopolysaccharide (LPS)-induced BV-2 cells, which may contribute to its ameliorative effects against ischemia-associated neuronal death and microglial inflammation. Our study suggests that CPX could be a promising compound to reduce multiple ischemic injuries; however, further studies will be needed to clarify the molecular mechanisms involved.