Disruption of the intestinal mucosal barrier caused by gut dysbiosis and metabolic imbalance is the underlying pathology of inflammatory bowel disease (IBD). Traditional Chinese medicine Wuji Wan (WJW) is commonly used to treat digestive system disorders and showed therapeutic potential for IBD. In this interdisciplinary study, we aim to investigate the pharmacological effects of WJW against experimental colitis by combining functional metabolomics and gut-microbiota sequencing techniques. Treatment with WJW altered the profile of the intestinal microbiota and notably increased the abundance of Lactobacillus, thereby facilitating the conversion of tryptophan into indole-3-acetic acid (IAA) and indoleacrylic acid (IA). These indole derivatives activated the aryl hydrocarbon receptor (AhR) pathway, which reduced colonic inflammation and restored the expression of intestinal barrier proteins. Interestingly, the beneficial effects of WJW on gut barrier function improvement and tryptophan metabolism were disappeared in the absence of gut microbiota. Finally, pre-treatment with the AhR antagonist CH-223191 confirmed the essential role of IAA-mediated AhR activation in the therapeutic effects of WJW. Overall, WJW enhanced intestinal barrier function and reduced colonic inflammation in a murine colitis model by modulating Lactobacillus-IAA-AhR signaling pathway. This study provides novel insights into colitis pathogenesis and presents an effective therapeutic and preventive approach against IBD.

Objective To explore the significance of immunotherapy for patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF)using plasma exchange(PE)followed by double plasma molecular adsorption system(DPMAS),as well as its impact on prognosis.Methods Patients who were admitted to the Third People's Hospital of Kunming from June 2019 to June 2023 and met the early and mid-stage diagnostic criteria for HBV-ACLF were selected as the research subjects,with a total of 120 cases.After admission,the patients were divided into the PE+DPMAS group(PD group,63 cases)and the PE group(57 cases)based on different treatment plans.The changes in liver function,coagulation function,cytokines,and model for end-stage liver disease(MELD)scores after treatment,as well as the clinical improvement rates,were observed in both groups.Results ① After treatment,the levels of serum total bilirubin(TBil)in the PD group were significantly lower than those in the PE group(μmol/L:163.4±53.3 vs.226.1±72.5,P<0.05),and the prothrombin activity(PTA)was significantly increased[(51.5±9.2)%vs.(41.1±7.7)%,P<0.05].②After treatment,the levels of interleukins(IL-2,IL-6,IL-8)and tumor necrosis factor-α(TNF-α)in both groups decreased compared to before treatment at 1,2,and 4 weeks,reaching the lowest levels at 4 weeks,the levels of IL-2,IL-6,IL-8,and TNF-α in the PD group were lower than those in the PE group[IL-2(ng/L):1.83(1.75)vs.2.04(1.85),IL-6(ng/L):11.31(5.07)vs.18.18(9.05),IL-8(ng/L):21.14(8.35)vs.29.09(12.41),TNF-α(ng/L):9.16(5.10)vs.14.12(7.27)].The levels of IL-10 decreased at 1 week and 2 weeks after treatment.In the PD group,IL-10 increased at 4 weeks after treatment.The differences compared to the baseline levels before treatment were statistically significant(P<0.05).At 4 weeks after treatment,the level of IL-10 in the PD group was significantly higher than that in the PE group[ng/L:24.72(11.56)vs.19.03(10.04),P<0.05].③ The clinical improvement rates in the PD group were significantly higher than those in the PE group at 2 weeks and 4 weeks after treatment[2 weeks after treatment:65.08%(41/63)vs.40.35%(23/57);4 weeks after treatment:84.13%(53/63)vs.54.39%(31/57),both P<0.05].④After 4 weeks of treatment,the MELD scores in both groups decreased significantly.Compared with the PE group,the MELD score in the PD group was significantly lower(14.87±3.45 vs.19.68±4.63,P<0.05).Conclusion Compared with PE alone,PE+DPMAS treatment for early and mid-stage ACLF patients can more effectively clear the large amount of inflammatory mediators released in the body,better regulate the balance between pro-inflammatory and anti-inflammatory cytokines in the patient's serum,thereby preventing or delaying the formation of systemic inflammatory response syndrome(SIRS)and multiple organ dysfunction syndrome(MODS).The clinical therapeutic effect is better,with a higher improvement rate,achieving the goal of reducing liver damage,improving patient survival rate,and thus improving prognosis.

OBJECTIVE: To observe the clinical efficacy of acupoint thread-embedding therapy of regulating governor vessel, dispersing lung, and suppressing reflux for gastroesophageal reflux cough (GERC). METHODS: A total of 120 GERC patients were randomly assigned to an observation group (60 cases, 1 case dropped out) and a control group (60 cases, 1 case was eliminated). The observation group received acupoint thread-embedding treatment at positive response points of governor vessel. If no such points were detected, the following acupoints were used: Dazhui (GV14), Fenghu (Extra), Shendao (GV11), Lingtai (GV10), and Zhiyang (GV9). Treatment was administered once every two weeks. The control group received oral rabeprazole enteric capsules at 20 mg twice daily. All the treatment was given for 6 weeks. Clinical outcomes were assessed using cough symptom score, reflux disease questionnaire (RDQ) score, and Leicester cough questionnaire (LCQ) score before and after treatment in the two groups. Clinical efficacy was also compared between the two groups. RESULTS: After treatment, both groups showed decreased cough symptom scores and the each item scores and total scores of RDQ (P<0.001), and increased LCQ scores (P<0.001) compare with those before treatment. The observation group exhibited lower cough symptom score and chest pain, reflux and total score of RDQ, and higher LCQ score compared to those in the control group (P<0.05). The total effective rate in the observation group was 94.9% (56/59), which was higher than 84.7% (50/59) in the control group (P<0.05). CONCLUSION Acupoint thread-embedding therapy of regulating governor vessel, dispersing lung, and suppressing reflux could effectively alleviate cough and reflux symptoms in patients with GERC and improve their quality of life.
Humans ; Acupuncture Points ; Gastroesophageal Reflux/physiopathology* ; Male ; Female ; Cough/physiopathology* ; Middle Aged ; Aged ; Acupuncture Therapy ; Adult ; Treatment Outcome ; Lung/physiopathology* ; Meridians

Objective:To investigate and validate the performance of a dosiomics model that utilized 3D dose distribution to forecast radiation-induced temporal lobe injury (RTLI) in nasopharyngeal carcinoma (NPC) patients following intensity-modulated radiotherapy (IMRT).Methods:Clinical data of 3578 patients diagnosed with NPC admitted to Jiangsu Cancer Hospital from January 2011 to December 2021 were retrospectively analyzed. According to the inclusion and exclusion criteria, 97 NPC patients who developed RTLI were assigned into the case group. A 1:1 propensity score matching (PSM) method was used to match 97 NPC patients without RTLI as the control group. Patients were assigned into the training cohort ( n=135) and the validation cohort ( n=59) at a 7:3 ratio by simple random method. Dosiomics features were extracted from the patients' three-dimensional dose distribution maps. Spearman rho and the least absolute shrinkage and selection operator regression were used to select dosiomics features. Clinical features were collected and screened by univariate and multivariate analyses. Eight machine learning classifiers were then trained to build dosiomics models and clinical models, respectively. The area under the ROC curve (AUC), sensitivity, and specificity were calculated to compare the predictive performance of the dosiomics and clinical models. Multivariate analysis was conducted using logistic regression to assess the influencing factors, while comparisons of the ROC curves between two different models were performed using the DeLong test. Results:A total of 1130 dosiomics features were extracted from the three-dimensional dose distribution maps, and 14 features were retained for model building after feature selection. The model based on the support vector machine (SVM) classifier achieved the highest AUC value of 0.977 (95% CI: 0.949-1.000) in the validation cohort, with an AUC of 1.000 (95% CI: 1.000-1.000) in the training cohort. By conducting univariate and multivariate analyses of the patients' clinical features, 2 clinical features were retained to build the clinical model. The model based on the SVM classifier achieved the optimal AUC value of 0.667 (95% CI: 0.523-0.810) in the validation cohort, with an AUC of 0.804 (95% CI: 0.730-0.878) in the training cohort. DeLong test showed that the difference between the dosiomics and clinical models was statistically significant ( P<0.05). Conclusion:The dosiomics model based on 3D dose distribution yields high predictive performance for RTLI in NPC patients after IMRT, which surpasses the clinical feature model, providing a new approach for early clinical prediction of RTLI.

Objective To explore the significance of immunotherapy for patients with hepatitis B virus-related acute-on-chronic liver failure(HBV-ACLF)using plasma exchange(PE)followed by double plasma molecular adsorption system(DPMAS),as well as its impact on prognosis.Methods Patients who were admitted to the Third People's Hospital of Kunming from June 2019 to June 2023 and met the early and mid-stage diagnostic criteria for HBV-ACLF were selected as the research subjects,with a total of 120 cases.After admission,the patients were divided into the PE+DPMAS group(PD group,63 cases)and the PE group(57 cases)based on different treatment plans.The changes in liver function,coagulation function,cytokines,and model for end-stage liver disease(MELD)scores after treatment,as well as the clinical improvement rates,were observed in both groups.Results ① After treatment,the levels of serum total bilirubin(TBil)in the PD group were significantly lower than those in the PE group(μmol/L:163.4±53.3 vs.226.1±72.5,P<0.05),and the prothrombin activity(PTA)was significantly increased[(51.5±9.2)%vs.(41.1±7.7)%,P<0.05].②After treatment,the levels of interleukins(IL-2,IL-6,IL-8)and tumor necrosis factor-α(TNF-α)in both groups decreased compared to before treatment at 1,2,and 4 weeks,reaching the lowest levels at 4 weeks,the levels of IL-2,IL-6,IL-8,and TNF-α in the PD group were lower than those in the PE group[IL-2(ng/L):1.83(1.75)vs.2.04(1.85),IL-6(ng/L):11.31(5.07)vs.18.18(9.05),IL-8(ng/L):21.14(8.35)vs.29.09(12.41),TNF-α(ng/L):9.16(5.10)vs.14.12(7.27)].The levels of IL-10 decreased at 1 week and 2 weeks after treatment.In the PD group,IL-10 increased at 4 weeks after treatment.The differences compared to the baseline levels before treatment were statistically significant(P<0.05).At 4 weeks after treatment,the level of IL-10 in the PD group was significantly higher than that in the PE group[ng/L:24.72(11.56)vs.19.03(10.04),P<0.05].③ The clinical improvement rates in the PD group were significantly higher than those in the PE group at 2 weeks and 4 weeks after treatment[2 weeks after treatment:65.08%(41/63)vs.40.35%(23/57);4 weeks after treatment:84.13%(53/63)vs.54.39%(31/57),both P<0.05].④After 4 weeks of treatment,the MELD scores in both groups decreased significantly.Compared with the PE group,the MELD score in the PD group was significantly lower(14.87±3.45 vs.19.68±4.63,P<0.05).Conclusion Compared with PE alone,PE+DPMAS treatment for early and mid-stage ACLF patients can more effectively clear the large amount of inflammatory mediators released in the body,better regulate the balance between pro-inflammatory and anti-inflammatory cytokines in the patient's serum,thereby preventing or delaying the formation of systemic inflammatory response syndrome(SIRS)and multiple organ dysfunction syndrome(MODS).The clinical therapeutic effect is better,with a higher improvement rate,achieving the goal of reducing liver damage,improving patient survival rate,and thus improving prognosis.

Objective:To investigate and validate the performance of a dosiomics model that utilized 3D dose distribution to forecast radiation-induced temporal lobe injury (RTLI) in nasopharyngeal carcinoma (NPC) patients following intensity-modulated radiotherapy (IMRT).Methods:Clinical data of 3578 patients diagnosed with NPC admitted to Jiangsu Cancer Hospital from January 2011 to December 2021 were retrospectively analyzed. According to the inclusion and exclusion criteria, 97 NPC patients who developed RTLI were assigned into the case group. A 1:1 propensity score matching (PSM) method was used to match 97 NPC patients without RTLI as the control group. Patients were assigned into the training cohort ( n=135) and the validation cohort ( n=59) at a 7:3 ratio by simple random method. Dosiomics features were extracted from the patients' three-dimensional dose distribution maps. Spearman rho and the least absolute shrinkage and selection operator regression were used to select dosiomics features. Clinical features were collected and screened by univariate and multivariate analyses. Eight machine learning classifiers were then trained to build dosiomics models and clinical models, respectively. The area under the ROC curve (AUC), sensitivity, and specificity were calculated to compare the predictive performance of the dosiomics and clinical models. Multivariate analysis was conducted using logistic regression to assess the influencing factors, while comparisons of the ROC curves between two different models were performed using the DeLong test. Results:A total of 1130 dosiomics features were extracted from the three-dimensional dose distribution maps, and 14 features were retained for model building after feature selection. The model based on the support vector machine (SVM) classifier achieved the highest AUC value of 0.977 (95% CI: 0.949-1.000) in the validation cohort, with an AUC of 1.000 (95% CI: 1.000-1.000) in the training cohort. By conducting univariate and multivariate analyses of the patients' clinical features, 2 clinical features were retained to build the clinical model. The model based on the SVM classifier achieved the optimal AUC value of 0.667 (95% CI: 0.523-0.810) in the validation cohort, with an AUC of 0.804 (95% CI: 0.730-0.878) in the training cohort. DeLong test showed that the difference between the dosiomics and clinical models was statistically significant ( P<0.05). Conclusion:The dosiomics model based on 3D dose distribution yields high predictive performance for RTLI in NPC patients after IMRT, which surpasses the clinical feature model, providing a new approach for early clinical prediction of RTLI.

This study was designed to study the effect and mechanism of dehydroepiandrosterone(DHEA)on diabetic wound healing in mice.High-fat feed combined with streptozotocin was utilized to induce diabetes and full-thickness incisional wounds were made on the back.The mice were randomly divided into normal wound group(NW),diabetic wound group(DW)and DHEA intervention group(DHEA).The wounds were photographed and the wound healing rates were calculated;RT-PCR was used to detect the expression of inflammatory factors in wound tissues and wound macrophages,and the expression of Dicer1 and pentose phosphate pathway(PPP)related factors in wound macrophages.Furthermore,wound macrophages phagocytosis of apoptotic Jurkat cells were measured by flow cytometry.Data showed that the wound healing rate,the expression of inflammatory factors and the phagocytosis rate were similar between the DHEA group and the NW group(P＞0.05);compared with the DW group,the wound healing rate in the DHEA group was accelerated,the expression of TNF-α,IL-6 and IL-1β were decreased,the expression of IL-10 and TGF-β were increased,and the phagocytosis rate was increased(P＜0.01);the expression of Dicer1 in wound macrophages of the DW group was lower than that in the NW group,and the expression of PPP-related factors G6pdx,Taldo1,Pfkl,H6pd,Pgd,Aldoc1 and Tkt were increased(P＜0.01);the expression of Dicer1 between DW group and DHEA group was similar(P＞0.05),and the expression of PPP-related factors G6pdx,Taldo1,Pfkl,H6pd,Pgd,Aldoc1 and Tkt were lower in the DHEA group(P＜0.01).In conclusion,DHEA promotes diabetic wound healing by inhibiting macrophage pentose phosphate pathway activity.

Objective To observe the correlation between apparent diffusion coefficient(ADC)of sacroiliac joint and spondyloarthritis research consortium of Canada(SPARCC)score in ankylosing spondylitis(AS)patients with different grade sacroiliac joint inflammation.Methods MR examinations of sacroiliac joint were prospectively performed in 35 AS patients(AS group)and 30 healthy controls(HC group).The grade of sacroiliac joint inflammation and SPARCC score in AS group were evaluated according to MRI findings,and the patients were then further divided into bone marrow oedema(BMO)subgroup(n=19)and non-BMO subgroup(n=16)according to whether BMO presented under articular surface or not,and ADC of sacroiliac joint(ADCsacroiliac)were measured.Receiver operating characteristic curve was drawn,the area under the curve(AUC)was calculated to evaluate the efficacy of ADCsacroiliac for assessing AS sacroiliac joint inflammation grade.Pearson correlation analysis was performed to analyze the correlation between ADCsacroiliac and SPARCC score in AS patients with different grade sacroiliac joint inflammation.Results ADCsacroiliac in BMO subgroup and non-BMO subgroup was(4.85±1.44)×10-4 and(4.30±0.64)×10-4 mm2/s,respectively,being not significantly different(P＞0.05)but both higher than that in HC group([3.32±1.36]×10-4 mm2/s,both P＜0.05).The sensitivity of ADCsacroiliac for assessing grade of sacroiliac joint inflammation in AS patients was 49.44％,51.94％,73.06％and 60.50％,with specificity of 75.00％,78.92％,83.33％and 66.67％,respectively,and AUC of 0.613,0.712,0.837 and 0.645,respectively.ADCsacroiliac was moderately-highly positively correlated with SPARCC score of AS patients with Ⅱ and Ⅲgrade sacroiliac joint inflammation(r=0.580,0.933,both P＜0.05),but no obvious correlation was detected between ADCsacroiliac and SPARCC score of AS patients with Ⅰ or Ⅳ grade sacroiliac joint inflammation(both P＞0.05).Conclusion ADCsacroiliac was positively correlated with SPARCC scores of AS patients with Ⅱ and Ⅲ grade sacroiliac joint inflammation,which could be regarded as a reliable quantitative parameter for monitoring sacroiliac joint BMO.

Robotic surgery is known as the"third technological revolution"in the field of surgery,and is an important milestone in the development of modern surgery.However,our country's innovative surgical robot industry is still in its early stages,and it is only being utilized in certain surgical fields.To explore the effectiveness of the application of do-mestic surgical robot in oral and maxillofacial surgery,the author successfully completed a case of benign parotid tumor resection with the assistance of a domestic autonomous robot.The operation was successful,facial nerve function was preserved,and postoperative wound healing was good.

This study was designed to study the effect and mechanism of dehydroepiandrosterone(DHEA)on diabetic wound healing in mice.High-fat feed combined with streptozotocin was utilized to induce diabetes and full-thickness incisional wounds were made on the back.The mice were randomly divided into normal wound group(NW),diabetic wound group(DW)and DHEA intervention group(DHEA).The wounds were photographed and the wound healing rates were calculated;RT-PCR was used to detect the expression of inflammatory factors in wound tissues and wound macrophages,and the expression of Dicer1 and pentose phosphate pathway(PPP)related factors in wound macrophages.Furthermore,wound macrophages phagocytosis of apoptotic Jurkat cells were measured by flow cytometry.Data showed that the wound healing rate,the expression of inflammatory factors and the phagocytosis rate were similar between the DHEA group and the NW group(P＞0.05);compared with the DW group,the wound healing rate in the DHEA group was accelerated,the expression of TNF-α,IL-6 and IL-1β were decreased,the expression of IL-10 and TGF-β were increased,and the phagocytosis rate was increased(P＜0.01);the expression of Dicer1 in wound macrophages of the DW group was lower than that in the NW group,and the expression of PPP-related factors G6pdx,Taldo1,Pfkl,H6pd,Pgd,Aldoc1 and Tkt were increased(P＜0.01);the expression of Dicer1 between DW group and DHEA group was similar(P＞0.05),and the expression of PPP-related factors G6pdx,Taldo1,Pfkl,H6pd,Pgd,Aldoc1 and Tkt were lower in the DHEA group(P＜0.01).In conclusion,DHEA promotes diabetic wound healing by inhibiting macrophage pentose phosphate pathway activity.