OBJECTIVE: To observe the effect of moxibustion on small intestinal mucosal immune barrier in rats with diarrhea-predominant irritable bowel syndrome (IBS-D) and explore its underlying mechanisms. METHODS: Of 38 newborn rats from 4 healthy SPF pregnant rats, 12 neonatal rats were randomly selected in a normal group. IBS-D model was prepared by the combined measures for the rest rats, including neonatal maternal separation, acetic acid enema and chronic restraint stress. Twenty-four successfully-modeled rats were randomized into a model group and a moxibustion group, 12 rats in each one. In the moxibustion group, suspending moxibustion was delivered at bilateral "Tianshu" (ST25) and "Shangjuxu" (ST37), 20 min each time, once daily and for 7 consecutive days. Separately, before acetic acid enema (aged 35 days), after modeling (aged 45 days) and after intervention (aged 53 days), the body mass, loose stool rate (LSR) and and the minimum volume threshold when abdominal withdrawal reflex (AWR) scored 3 were observed in the rats of each group. After intervention (aged 53 days), using HE and PAS staining, the morphology of duodenum was observed, the length of villus and the depth of crypt were measured, the ratio of the length of villus to the depth of crypt was calculated; and the numbers of mucosal intraepithelial lymphocytes (IELs) and goblet cells were counted. With ELISA adopted, the contents of γ-interferon (IFN-γ), interleukin-4 (IL-4) and secretory immunoglobulin A (sIgA) in duodenal mucosa of rats were detected. The proportion of T cell subsets in duodenal mucosa was detected using flow cytometry. The microvilli and tight junctions of duodenal mucosal epithelial cells were observed by transmission electron microscopy, and the integrity of duodenal mucosa observed by scanning electron microscopy. RESULTS: Compared with the normal group, for the rats in the model group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the the ratio of the length of villus to the depth of crypt, as well as the proportion of CD₈⁺ T subset were all reduced (P<0.01, P<0.05), the counts of goblet cells in duodenal mucosa decreased (P<0.01); LRS, the proportion of CD₄⁺ T subset and CD₄⁺/CD₈⁺, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were all elevated (P<0.01); and the numbers of IELs rose (P<0.01). The morphology of duodenal mucosa was irregular, the villi got shorter, sparse and scattered, with uneven density. The morphology of epithelial cells was destroyed and the tight junctions damaged, with larger spaces. When compared with the model group, in the moxibustion group, the body mass, the minimum volume threshold when AWR scored 3, the length of duodenal villus and the ratio of the length of villus to the depth of crypt, as well as the counts of goblet cells in duodenal mucosa increased (P<0.01); LRS, the proportion of CD₄⁺ T subset, and CD₄⁺/CD₈⁺, as well as the contents of IFN-γ, IL-4 and sIgA in duodenal mucosa and IFN-γ/IL-4 were reduced (P<0.01); and the numbers of IELs was dropped (P<0.01). The morphology of duodenal mucosa was more regular, the villi were grew, got longer and arranged regularly, with even density. The morphology of epithelial cells was slightly destroyed, and the tight junctions partially damaged. CONCLUSION Moxibustion at "Tianshu" (ST25) and "Shangjuxu" (ST37) can reduce visceral hypersensitivity in IBS-D rats and relieve abdominal pain, diarrhea and other symptoms. Its effect mechanism may be related to the repair of small intestinal mucosal immune barrier and the improvement in the immune function in IBS-D.
Animals ; Irritable Bowel Syndrome/immunology* ; Rats ; Moxibustion ; Intestinal Mucosa/immunology* ; Female ; Diarrhea/therapy* ; Intestine, Small/immunology* ; Male ; Humans ; Rats, Sprague-Dawley ; Disease Models, Animal

Objective: To explore the therapeutic mechanism of puerarin in treating rheumatoid arthritis (RA) rats based on the serine/tyrosine protein kinase B (AKT)-phosphorylated forkhead box protein O1 (FOXO1)-interleukin-9 (AKT-FOXO1-IL-9) signaling pathway. Methods : 36 rats were randomly divided into a blank group , a model group , a positive control group , and low , medium , and high dose groups of puerarin. Except for the blank group , the other groups were induced with type Ⅱ collagen to establish a RA rat model. After successful modeling , different doses of puerarin and methotrexate were given to treat the rats. The body mass and toe thickness of the rats were measured , and biochemical indicators of rat blood rheology were detected. X-ray was used to observe changes in rat joint morphology. Safranin green staining were used to observe the pathology of rat joint tissue. ELISA was used to detect the levels of IL-9 and rheumatoid factors in rat serum , and Western blot was used to detect changes in levels of AKT and FOXO1 . 36 rats were randomly divided into a blank group , a model group , a positive control group , and low , medium , and high dose groups of puerarin. Except for the blank group , the other groups were induced with type Ⅱ collagen to establish a RA rat model. After successful modeling , different doses of puerarin and methotrexate were given to treat the rats. The body mass and toe thickness of the rats were measured , and biochemical indicators of rat blood rheology were detected. X-ray was used to observe changes in rat joint morphology. Safranin green staining were used to observe the pathology of rat joint tissue. ELISA was used to detect the levels of IL-9 and rheumatoid factors in rat serum , and Western blot was used to detect changes in levels of AKT and FOXO1 . Results: Compared with the blank group , the model group had the lowest toe thickness , and X-ray images showed more obvious segmental stenosis and more severe marginal bone invasion ; scaly like changes appeared at the edges of joints stained with safranin green , accompanied by the exudation of inflammatory cells and increased proliferation and secretion of chondrocytes ; the expression levels of inflammatory factors IL-9 and rheumatoid factors were the highest , and the expression levels of AKT and FOXO1 proteins were the highest (P < 0. 05) . Compared with the model group , the toe thickness of rats treated with different doses of puerarin decreased ; X-ray images showed that the puerarin treatment group of rats showed improvement in plantar joint stenosis and marginal bone invasion ; the results of safranin green staining showed that after treatment with different doses of puerarin , the infiltration of inflammatory cells decreased , and the expression levels of inflammatory factor IL-9 , rheumatoid factors , AKT , and FOXO1 proteins decreased significantly ( P < 0. 05 ) , with the high-dose puerarin group showing the most significant difference. Compared with the high-dose puerarin group , the positive control group showed a significant decrease in the above results and statistical differences (P < 0. 05) . Conclusion Puerarin has a good therapeutic effect on rats with RA by inhibiting the AKT-FOXO1-IL-9 pathway. The high-dose puerarin group (60 mg/kg) has the best therapeutic effect and the results show a dose-response relationship.

In October 2024， the 75th World Medical Association General Assembly adopted the tenth revised version of the Declaration of Helsinki. Using textual analysis， this paper systematically compared the changes between the 2024 version and the 2013 version of the Declaration of Helsinki. This study found that， while maintaining the original framework， the new version incorporated the common achievements of the values and civilizational development of human society in recent years， mainly presenting changes in three aspects. First， the core terms were updated， and new concepts such as vulnerability， structural inequality， and environmental sustainability were introduced to further emphasize human dignity， rights and interests， and autonomy in terms of values. Second， the contents of the provisions were refined， especially focusing on the vulnerability of research subjects， free and full informed consent， ethical principles in public health emergencies， and the responsibilities of the ethics committee， as well as the standardization of implementation continued to be improved in the research process. Third， mandatory expressions were strengthened， and the justice of value pursuit was further reinforced in terms of research responsibilities. The revised contents reflected the “human-oriented” fundamental principle in medical research ethics， indicating the direction for future ethical development in medical research. In the future， China should strengthen the construction of ethics committees， actively build a protection system for research participants， and continuously promote international cooperation in medical ethics， to contribute Chinese wisdom to global medical research.

[Objective] To investigate the non-pathological influencing factors of the unqualified alanine aminotransferase (ALT) in the initial screening of blood donors in Changchun and the laboratory re-examination, so as to provide evidence for reducing the deferral of blood donors and the discarding of blood due to ALT disqualification. [Methods] The unqualified results of ALT from the laboratory of our center from September 1, 2023 to October 31, 2024 were collected. The unqualified rates of ALT were statistically analyzed according to the blood collection sites and the initial screening detection equipment. The samples after ALT pre-donation screening were tested in the laborator, and the unqualified rates of ALT in the initial screening and the laboratory, the non-conformity rate of the results and the distribution range of ALT values were statistically analyzed according to the blood collection sites and the initial screening detection equipment. A questionnaire survey was conducted on the blood donors before blood collection to statistically analyze the influence of the blood donors' living habits and diet on ALT test results. [Results] The statistical analysis of the unqualified rate of ALT in the laboratory showed statistically significant differences in the ALT disqualification rates among different blood collection sites and different initial screening detection devices (P<0.05). Comparison of the ALT unqualified rate for the same type of equipment at different sites showed that for Equipment 1, there were differences between the combined blood collection house and the whole blood house, and between the combined blood collection house and the blood donation vehicle (P<0.05); for Equipment 2, there were differences between the combined blood collection house and the blood donation vehicle, and between the whole blood house and the blood donation vehicle (P<0.05); there were no significant differences among other groups with the same equipment. The initial screening and the laboratory test results for the same samples were compared, with unqualified rates of ALT of 16.29% and 13.01%, respectively. There were statistically significant differences in the unqualified rates of ALT among different blood collection sites (P<0.05), but no significant differences in the ALT test results among different detection equipment (P>0.05).. The non-conformity rate between the initial screening and the laboratory results was 5.26%, of which 81.15% (99/122) were unqualified in the initial screening but qualified in the laboratory. There were statistically significant differences in those unqualified in the initial screening but qualified in the laboratory among different blood collection sites and different detection equipment (P<0.05). The median ALT level in the initial screening was 29.0 U/L (with a 5%-95% range of 14-75 U/L), and the median ALT level in the laboratory was 19 U/L (with a 5%-95% range of 8-65 U/L). The results of the questionnaire survey showed that 33.3% (2/6) of those who consumed alcohol within 24 hours before blood donation had unqualified ALT, and 10% (1/10) of those who stayed up late the night before blood donation had unqualified ALT. [Conclusion] The unqualified rates of ALT in the initial screening before blood collection and the laboratory re-examination of blood donors in Changchun are closely related to the blood collection sites, detection equipment, detection environment, detection personnel, samples, ALT thresholds and detection time. Drinking alcohol and staying up late within 24 hours before blood donation increase the risk of unqualified ALT detection.

Objective To analyze the risk factors for moderate-to-severe coronary artery stenosis in the population of Tacheng,Xinjiang Uygur Autonomous Region,and to construct and verify a nomogram prediction model for the degree of coronary artery ste-nosis.Methods We retrospectively selected 629 patients who were hospitalized in the Cardiovascular Department of Tacheng Peo-ple's Hospital from January 2021 to June 2023.Using R language software,the sociodemographic data,disease-related data,and va-rious laboratory indicators of the 629 patients were included in the initial screening of risk factors for use in the LASSO regression analysis using a random number table method.The 629 patients were divided into a training group(n=440)and a validation group(n=189)in a 7:3 ratio.Data from the training group were used for model construction,with the degree of coronary artery stenosis as the dependent variable,and the variables selected by LASSO regression as independent variables in the logistic regression model.The validation group was used for model validation.Based on the results of the logistic regression analysis,a visual nomogram for predicting the degree of co-ronary artery stenosis was constructed using R language software.The discriminability,calibration,and clinical utility of the model were evaluated using the area under the receiver operating characteristic curve(AUC),a calibration curve,and decision curve analysis(DCA).Results Age,non-Han ethnicity,hypertension,hyperlipidemia,and a history of cerebrovascular disease were risk factors for mode-rate-to-severe coronary artery stenosis and were included in the risk prediction model.The AUC of the training group and the validation group were 0.905(95％CI:0.790-0.863)and 0.864(95％CI:0.744-0.861),respectively.The predicted values of the calibration curve were consistent with the actual values(Brier scores of the training and validation group:0.03 and 0.14,respectively).The predictive per-formance of the model was good,and the DC A results indicated that the model had net clinical benefits.Conclusion The risk prediction model for coronary artery stenosis in the population of the Tacheng area constructed in this study has good predictive performance and can provide a simple,feasible,economical,and easy-to-promote evaluation tool for medical personnel to screen patients with moderate-to-se-vere coronary artery stenosis.

Objective To investigate the impact of neutrophil percentage-to-albumin ratio(NPAR)on coronary lesion severity and short-term major adverse cardiovascular events(MACE)in patients with acute coronary syndrome(ACS).Methods The study included 345 newly diagnosed patients with ACS at the Second Hospital Affiliated to Shenyang Medical College from January 2020 to December 2023.NPAR was calculated,and the patients were divided into low,medium,and high NPAR groups using a tertile classification.Clinical data,including the coronary lesion Gensini score(GS),as well as the incidence of MACE during follow-up at various time points within one year,were compared among the three groups.Results The CS was significantly higher in the high NPAR group than in the low and medium groups.Spearman's analysis showed the strongest correlation between NPAR and GS(r=0.427,P＜0.001).Multiple linear regression analysis indicated that NPAR,body mass index,white blood cell count,and age were independent risk factors for increased GS.NPAR greater than 2.013 indicates a good predictive value for the incidence of MACE within 30 days,with the receiver operating cha-racteristic and area under the curve of 0.811.Conclusion The severity of coronary lesions in patients with ACS is positively correlated with NPAR,and a high NPAR can effectively predict the risk of MACE within 30 days.

Objective To investigate the impact of neutrophil percentage-to-albumin ratio(NPAR)on coronary lesion severity and short-term major adverse cardiovascular events(MACE)in patients with acute coronary syndrome(ACS).Methods The study included 345 newly diagnosed patients with ACS at the Second Hospital Affiliated to Shenyang Medical College from January 2020 to December 2023.NPAR was calculated,and the patients were divided into low,medium,and high NPAR groups using a tertile classification.Clinical data,including the coronary lesion Gensini score(GS),as well as the incidence of MACE during follow-up at various time points within one year,were compared among the three groups.Results The CS was significantly higher in the high NPAR group than in the low and medium groups.Spearman's analysis showed the strongest correlation between NPAR and GS(r=0.427,P＜0.001).Multiple linear regression analysis indicated that NPAR,body mass index,white blood cell count,and age were independent risk factors for increased GS.NPAR greater than 2.013 indicates a good predictive value for the incidence of MACE within 30 days,with the receiver operating cha-racteristic and area under the curve of 0.811.Conclusion The severity of coronary lesions in patients with ACS is positively correlated with NPAR,and a high NPAR can effectively predict the risk of MACE within 30 days.

Objective To analyze the risk factors for moderate-to-severe coronary artery stenosis in the population of Tacheng,Xinjiang Uygur Autonomous Region,and to construct and verify a nomogram prediction model for the degree of coronary artery ste-nosis.Methods We retrospectively selected 629 patients who were hospitalized in the Cardiovascular Department of Tacheng Peo-ple's Hospital from January 2021 to June 2023.Using R language software,the sociodemographic data,disease-related data,and va-rious laboratory indicators of the 629 patients were included in the initial screening of risk factors for use in the LASSO regression analysis using a random number table method.The 629 patients were divided into a training group(n=440)and a validation group(n=189)in a 7:3 ratio.Data from the training group were used for model construction,with the degree of coronary artery stenosis as the dependent variable,and the variables selected by LASSO regression as independent variables in the logistic regression model.The validation group was used for model validation.Based on the results of the logistic regression analysis,a visual nomogram for predicting the degree of co-ronary artery stenosis was constructed using R language software.The discriminability,calibration,and clinical utility of the model were evaluated using the area under the receiver operating characteristic curve(AUC),a calibration curve,and decision curve analysis(DCA).Results Age,non-Han ethnicity,hypertension,hyperlipidemia,and a history of cerebrovascular disease were risk factors for mode-rate-to-severe coronary artery stenosis and were included in the risk prediction model.The AUC of the training group and the validation group were 0.905(95％CI:0.790-0.863)and 0.864(95％CI:0.744-0.861),respectively.The predicted values of the calibration curve were consistent with the actual values(Brier scores of the training and validation group:0.03 and 0.14,respectively).The predictive per-formance of the model was good,and the DC A results indicated that the model had net clinical benefits.Conclusion The risk prediction model for coronary artery stenosis in the population of the Tacheng area constructed in this study has good predictive performance and can provide a simple,feasible,economical,and easy-to-promote evaluation tool for medical personnel to screen patients with moderate-to-se-vere coronary artery stenosis.

Objective To determine the role of cathepsin D(CTSD)in cardiovascular events after acute ST-segment elevation myocar-dial infarction(STEMI).Methods A total of 96 patients with STEMI admitted to the Department of Cardiovascular Medicine of Second Hospital Affiliated to Shenyang Medical College from November 2022 to July 2023 were selected as the STEMI group.In addition,20 patients with normal coronary angiography hospitalized during the same period were selected as the control group.Coronary blood was collected from both groups,and the relative expression levels of CTSD in the arterial blood were detected and compared using real-time quantitative polymerase chain reaction.The STEMI group was divided into low,medium,and high CTSD groups based on CTSD expression,and major adverse cardiovascular events(MACE)that occurred within 6 months following percutaneous coronary interven-tion(PCI)were monitored.Results Arterial blood CTSD expression(1.31[1.03-1.75])in the STEMI group was higher than that in the control group(1.02[0.67-1.48])(P＜0.05).Statistically significant differences in platelet count as well as troponin T,N-terminal pro-B natriuretic peptide,and high-density lipoprotein cholesterol levels were observed among the three groups(P＜0.05).The incidence of MACE was significantly higher in the low CTSD group(65％)than in the high CTSD group(10％,P＜0.05).Receiver operating cha-racteristic(ROC)curve analysis showed that the area under the ROC curve for predicting MACE within 6 months after PCI in patients with STEMI was 0.765(95％CI:0.658-0.872,P＜0.001).Conclusion Whole blood CTSD expression level is abnormal in STEMI patient.CTSD may be an indicator for predicting the prognosis of STEMI and,therefore,a drug target for preventing and treating STEMI.

Objective To analyze the risk factors of heart failure in patients with coronary heart disease(CHD),and to construct and verify a nomogram prediction model for the risk of heart failure in patients with CHD.Methods The clinical data of 453 patients with CHD who were hospitalized in the Second Affiliated Hospital of Shenyang Medical College from January to December 2022 were retrospectively analyzed,including 278 patients with CHD combined with heart failure and 175 patients without heart failure.The patients were divided into training group(318 cases)and validation group(135 cases)according to the ratio of 7:3.R software was applied to perform LASSO regression to screen the risk factors,and Logistic regression to establish a prediction model and construct a nomogram.The calibration curve and receiver operating characteristic(ROC)curve were used to evaluate the calibration and discrimination of the model.Results LASSO regression analysis ultimately screened five risk factors from 22 variables,and Logistic regression results showed that age,smoking,history of myocardial infarction,New York Heart Association(NYHA)cardiac function class Ⅳ,and left ventricular ejection fraction(LVEF)were all independent risk factors for heart failure in CHD patients(P＜0.05).The model formula was Z=-2.927+0.045 × age+0.886 × smoking+0.808 × history of myocardial infarction-2.829 × NYHA cardiac function class Ⅳ+0.037×LVFF.Internal validation of the model showed that area under the curve was 0.727(95％CI:0.588-0.752),the sensitivity was 40.4％,the specificity was 84.3％,and the Youden index was 0.247.According to the calibration curve,the predicted value of the calibration curve was highly consistent with the actual value,and the Brier score was 0.106.Conclusion The risk prediction model for heart failure in patients with CHD based on LASSO regression has good discrimination and prediction efficiency,which can be used as an evaluation tool for medical staff to predict the risk of patients.