Objective To investigate biomarkers for sepsis-induced lung injury based on results of proteomics combined with transcriptomics analyses.Methods A total of 70 patients with sepsis and 70 patients with sepsis-induced lung injury were included as research objects.These patients were di-vided into experimental group and validation group.The experimental group included 10 patients with sepsis and 10 patients with sepsis-induced lung injury.Proteomics was used to analyze differentially expressed proteins in plasma,and Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses were performed.The dataset GSE10474 of sepsis-induced lung injury was downloaded from the Gene Expression Omnibus(GEO),and GEO2R online database was used to analyze differential transcriptomics data for sepsis-induced lung injury.A Venn diagram was used online to analyze common differentially expressed genes related to sepsis-induced lung injury in pro-teomics and transcriptomics.The validation group included 60 patients with sepsis(sepsis group)and 60 patients with sepsis-induced lung injury(sepsis-induced lung injury group).Enzyme-linked immunosorbent assay(ELISA)was used to detect and compare the differences in protein expression level in peripheral blood between the sepsis group and the sepsis-induced lung injury group.Receiv-er operating characteristic(ROC)curve was used to analyze the clinical value of differential protein expression level in distinguishing sepsis and sepsis-induced lung injury.Results Proteomics results confirmed the presence of 239 significantly differentially expressed proteins in the plasma of patients with sepsis and sepsis-induced lung injury.Compared with patients with sepsis,there were 96 sig-nificantly upregulated proteins and 143 significantly downregulated proteins in patients with sepsis-induced lung injury.The results of GO enrichment analysis of differentially expressed proteins in-cluded cytoplasm,microtubule binding,adenosine triphosphate(ATP)binding,defense response to virus,and immune response.The results of KEGG enrichment analysis included metabolic path-ways,interleukin-17(IL-17)signaling pathway,and phosphatidylinositol-3-kinase-protein kinase B(PI3K-Akt)signaling pathway.In the GSE10474 dataset,compared with patients with sepsis,there were 77 significantly upregulated genes and 142 significantly downregulated genes in patients with sepsis-induced lung injury.The Venn diagram results showed that there were 6 common differential-ly expressed genes in proteomics and transcriptomics,namely BTNL8,FCGR2B,TAK1,KCNC1,TREM1,and SEC31A.Compared with the sepsis group,the levels of TAK1 and TREM1 proteins in the peripheral blood of the sepsis-induced lung injury group were significantly increased(P＜0.01).ROC curve showed that the areas under the curve(AUC)for the expression levels of TAK1 and TREM1 proteins in serum to distinguish sepsis and sepsis-induced lung injury were 0.925 and 0.785 respectively;when the cut-off value for TAK1 was 71.28 pg/mL,the sensitivity and specific-ity were 94.45％and 97.89％respectively;when the cut-off value for TREM1 was 58.22 mg/mL,the sensitivity and specificity were 83.43％and 82.19％respectively.Conclusion Proteomics and transcriptomics results confirm that the activation of TAK1,TREM1 and multiple inflammatory signa-ling pathways may play important roles in the progression of sepsis-induced lung injury.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Objective:To construct a temperature-sensitive hydrogel (PF-CA@AS-IV hydrogel) composed of Pluronic F-127 (PF-127)/calcium alginate (CA) loaded with astragaloside IV (AS-IV), and to explore its repair effect and potential mechanism on diabetic skin ulcers (DSU).Methods:The PF-CA@AS-IV hydrogel loaded with AS-IV and gelling at 37 ℃ was prepared. Its temperature sensitivity, rheological properties, and morphology were characterized. A rat model of DSU was established, and the rats were randomly divided into blank control group, model group, AS-IV spray group, PF-CA hydrogel group, and PF-CA@AS-IV hydrogel group ( n=5 each). After 21 days of intervention, the wound healing rate of each group was evaluated. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of granulation tissue, and immunohistochemistry was applied to detect the expression level of CD34, a marker of new blood vessels. Results:Rheological analysis showed that the storage modulus (G′) of PF-CA@AS-IV hydrogel began to exceed the loss modulus (G″) at 33 ℃, and a stable three-dimensional network structure was formed at 37 ℃. Scanning electron microscopy confirmed its loose and porous microstructure. Animal experiment results indicated that compared with the blank control group, the model group had a significantly lower wound healing rate, massive infiltration of inflammatory cells, and fewer new capillaries and CD34 expression (all P<0.05). Compared with the model group, each treatment group can promote wound healing, reduce inflammatory infiltration and increase the positive expression of CD34 to varying degrees (all P<0.05), and the curative effect of PF-CA@AS-IV hydrogel group is the most significant, which is better than that of AS-IV spray group and PF-CA hydrogel group (all P<0.05). Conclusions:PF-CA@AS-IV hydrogel can effectively regulate inflammatory response and promote angiogenesis through sustained release of AS-IV, thereby accelerating DSU healing, and has good translational potential in the field of chronic wound repair.

Thoracic anesthesia with spontaneous respiration represents a form of precision anesthesia meticulously customized to individual patients.Considering the more stringent requirements this anesthesia approach imposes on the regulation of respiratory function,the writing group of the"Consensus of Experts on the Management of Thoracic Anesthesia with Spontaneous Respiration"has formulated elaborate guidelines regarding indications and contraindications,preoperative evaluation,anesthesia implementation,common complications,and treatment strategies.This was accomplished by referencing relevant domestic and international literature and integrating it with actual clinical requirements.The objective is to standardize the rational application of this anesthesia method.

Objective:To construct a temperature-sensitive hydrogel (PF-CA@AS-IV hydrogel) composed of Pluronic F-127 (PF-127)/calcium alginate (CA) loaded with astragaloside IV (AS-IV), and to explore its repair effect and potential mechanism on diabetic skin ulcers (DSU).Methods:The PF-CA@AS-IV hydrogel loaded with AS-IV and gelling at 37 ℃ was prepared. Its temperature sensitivity, rheological properties, and morphology were characterized. A rat model of DSU was established, and the rats were randomly divided into blank control group, model group, AS-IV spray group, PF-CA hydrogel group, and PF-CA@AS-IV hydrogel group ( n=5 each). After 21 days of intervention, the wound healing rate of each group was evaluated. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of granulation tissue, and immunohistochemistry was applied to detect the expression level of CD34, a marker of new blood vessels. Results:Rheological analysis showed that the storage modulus (G′) of PF-CA@AS-IV hydrogel began to exceed the loss modulus (G″) at 33 ℃, and a stable three-dimensional network structure was formed at 37 ℃. Scanning electron microscopy confirmed its loose and porous microstructure. Animal experiment results indicated that compared with the blank control group, the model group had a significantly lower wound healing rate, massive infiltration of inflammatory cells, and fewer new capillaries and CD34 expression (all P<0.05). Compared with the model group, each treatment group can promote wound healing, reduce inflammatory infiltration and increase the positive expression of CD34 to varying degrees (all P<0.05), and the curative effect of PF-CA@AS-IV hydrogel group is the most significant, which is better than that of AS-IV spray group and PF-CA hydrogel group (all P<0.05). Conclusions:PF-CA@AS-IV hydrogel can effectively regulate inflammatory response and promote angiogenesis through sustained release of AS-IV, thereby accelerating DSU healing, and has good translational potential in the field of chronic wound repair.

The interaction of gut microbiota and its metabolites with the host not only plays an important role in maintaining gut homeostasis and host health, but also is a key link in responding to pathogen infections. A thorough understanding of the changes in gut microbiota and its metabolites during infection, as well as their role and mechanism in host defense against infection, is helpful to guide anti-infection treatment. This review focuses on the role of gut microbiota and their metabolites in host defense against bacterial, fungal, and viral infections, and reveals that they can exert anti-infection effects through resistance mechanisms (inducing antimicrobial substances, training immunity, inhibiting pathogen respiration, directly neutralizing pathogens, immune regulation) and tolerance mechanisms (altering energy metabolism patterns of microbiota, cell proliferation and tissue damage repair, maintaining physiological signal transduction in extraintestinal organs, inflammation regulation, maintaining the integrity of the intestinal barrier), and also summarizes measures to regulate gut microbiota against pathogen infections, in order to provide more ideas for novel anti-infection prevention and treatment strategies targeting gut microbiota and its metabolites.

ObjectiveTo explore new targets and herbal medicines of total ginsenosides in ameliorating alcoholic hepatitis （AH） by data mining and experimental validation and to provide new directions for the clinical treatment of AH. MethodGSE28619 was selected as the test set from the GEO database and GSE83148 and GSE103580 were selected as the validation sets. The limma package and weighted gene co-expression network analysis （WGCNA） were employed to identify the AH-related differentially expressed genes and modular genes， and Venny was used to extract the common genes. The protein-protein interaction （PPI） network was constructed and the enrichment analysis was carried out. The hub genes were further screened and evaluated for their diagnostic value. After validation with the datasets， new potential targets of AH and traditional Chinese medicine were predicted. Molecular docking between the targets and active ingredients of traditional Chinese medicine was performed， and the results were validated by experiments. Eight out of 48 SD rats were randomly selected into a blank group and received an equal amount of normal saline. The rest rats were subjected to modeling with ethanol by gavage and then randomized into low- （10 mg·kg^-1）， medium- （20 mg·kg^-1）， and high-dose （40 mg·kg^-1） total ginsenosides， model， and positive control （metadoxine， 117 mg·kg^-1） groups. After 3 weeks of gavage， serum samples were collected for the measurement of aspartate aminotransferase （AST） and alanine aminotransferase （ALT） levels， and liver samples were collected for hematoxylin-eosin （HE） staining. Western blot and Real-time PCR were employed to determine the protein and mRNA levels， respectively， of potential targets in the liver tissue. ResultData mining predicted the potential genes： Proto-oncogene FOS and collagen type Ⅰ alpha 2 （COL1A2）. Experimental validation showed that the liver injury was alleviated after drug administration compared with that after modeling. The serum AST and ALT levels were reduced after drug administration. The protein and mRNA levels of FOS were significantly up-regulated， while those of COL1A2 were down-regulated after drug administration. ConclusionTotal ginsenosides ameliorate HA via FOS and COL1A2.

Objective:To investigate the association of urinary cadmium level with body mass index (BMI) and body circumferences among the older adults over 65 years old in 9 longevity areas of China.Methods:Subjects were older adults over 65 years old from the Healthy Aging and Biomarkers Cohort Study (HABCS) between 2017 and 2018 conducted in 9 longevity areas in China. A total of 1 968 older adults were included in this study. Information including socio-demographic characteristics, lifestyles, diet intake, and health status was collected by using questionnaires and physical examinations. Urine samples were collected to detect urinary cadmium and creatinine levels. Body circumferences included waist circumference, hip circumference and calf circumference. Subjects were divided into three groups (low:<0.77 μg/g·creatinine, middle:0.77-1.69 μg/g·creatinine, high:≥1.69 μg/g·creatinine) by tertiles of creatinine-adjusted urinary cadmium concentration. Multiple linear regression models were used to analyze the association of creatinine-adjusted urinary cadmium level with BMI and body circumferences. The dose-response relationship of creatinine-adjusted urinary cadmium concentration with BMI and body circumferences was analyzed by using restrictive cubic splines fitting multiple linear regression model.Results:The mean age of subjects was (83.34±11.14) years old. The median (Q1, Q3) concentration of creatinine-adjusted urinary cadmium was 1.13 (0.63, 2.09) μg/g·creatinine, and the BMI was (22.70±3.82) kg/m 2. The mean values of waist circumference, hip circumference, and calf circumference were (85.42±10.68) cm, (92.67±8.90) cm, and (31.08±4.76) cm, respectively. After controlling confounding factors, the results of the multiple linear regression model showed that for each increment of 1 μg/g·creatinine in creatinine-adjusted urinary cadmium, the change of BMI, waist circumference, hip circumference, and calf circumference in the high-level group was -0.28 (-0.37, -0.19) kg/m 2, -0.74 (-0.96, -0.52) cm, -0.78 (-0.96, -0.61) cm, and -0.20 (-0.30, -0.11) cm, respectively. The restrictive cubic splines curve showed a negative nonlinear association of creatinine-adjusted urinary cadmium with BMI ( Pnonlinear<0.001) and negative linear associations of creatinine-adjusted urinary cadmium with waist circumference ( Plinear<0.001), hip circumference ( Plinear<0.001), and calf circumference ( Plinear<0.001). Conclusion:Urinary cadmium level is significantly associated with decreased BMI, waist circumference, hip circumference and calf circumference among older adults over 65 years old in 9 longevity areas of China.

Objective To explore the effect of the orthokeratology lenses on the control of different types of aniso-metropia in myopic children.Methods A total of 99 myopic children aged 8 to 16 years who got the orthokeratology len-ses at the Department of Ophthalmology,Heping Hospital Affiliated to Changzhi Medical College from September 2020 to November 2022 with complete data were included.These children were divided into the simple myopic anisometropia group(monocular myopia,binocular diopter difference ≥ 1.00 D,n=39)and the compound myopic anisometropia group(binoc-ular myopia,binocular diopter difference ≥ 1.00 D,n=60).The children with higher anisometropia(binocular diopter difference ≥ 2.50 D)in the two groups were set as the high anisometropia subgroup(n=18 and 29,respectively),and chil-dren with lower anisometropia(1.00 D≤ binocular diopter difference＜2.50 D)were set as the low anisometropia subgroup(n=21 and 31,respectively).In each group,eyes with a higher diopter were set as the high diopter eyes,and the contra-lateral eyes with a lower diopter were set as the low diopter eyes.Diopter,corneal topography,intraocular pressure,cor-neal endothelium and axial length of children in the two groups were examined and recorded.The changes in axial length before and after wearing orthokeratology lenses for 1 year were compared between the two groups,analyzing the correla-tion between the degree of anisometropia and changes in the binocular axial length.Results After wearing orthokeratolo-gy lenses for 1 year,children in both groups had an increase in the axial length with a lower increase in the axial length of the high diopter eyes compared to the low diopter eyes;before and 1 year after wearing orthokeratology lenses,the axial length of high diopter eyes was greater than that of the low diopter eyes in both groups,and the differences were statistical-ly significant(all P＜0.05).Both groups of children showed a decrease in the binocular axial length difference after wear-ing the orthokeratology lenses for 1 year;before and 1 year after wearing orthokeratology lenses,the binocular axial length difference of children in the simple myopic anisometropia group was greater than that in the compound myopic anisometro-pia group,and the differences were statistically significant(t=4.903 and 2.670;both P＜0.05).The changes in binocular axial length difference before and after wearing the orthokeratology lenses of children in the high anisometropia subgroup and low anisometropia subgroup of the simple myopic anisometropia group were greater than those in the high anisometro-pia subgroup and low anisometropia subgroup of the compound myopic anisometropia group,respectively,and the differ-ences were statistically significant(both P＜0.05).In the simple myopic anisometropia and compound myopic anisometro-pia groups,the degree of anisometropia was positively correlated with the binocular axial length changes before and 1 year after wearing the orthokeratology lenses(r=0.423 and 0.510,both P＜0.05).Conclusion Orthokeratology lenses can effectively reduce the difference in binocular axial length of children with myopic anisometropia,and their control effect on simple myopic anisometropia is better than that of compound myopic anisometropia.

Objective:To investigate the association of urinary cadmium level with body mass index (BMI) and body circumferences among the older adults over 65 years old in 9 longevity areas of China.Methods:Subjects were older adults over 65 years old from the Healthy Aging and Biomarkers Cohort Study (HABCS) between 2017 and 2018 conducted in 9 longevity areas in China. A total of 1 968 older adults were included in this study. Information including socio-demographic characteristics, lifestyles, diet intake, and health status was collected by using questionnaires and physical examinations. Urine samples were collected to detect urinary cadmium and creatinine levels. Body circumferences included waist circumference, hip circumference and calf circumference. Subjects were divided into three groups (low:<0.77 μg/g·creatinine, middle:0.77-1.69 μg/g·creatinine, high:≥1.69 μg/g·creatinine) by tertiles of creatinine-adjusted urinary cadmium concentration. Multiple linear regression models were used to analyze the association of creatinine-adjusted urinary cadmium level with BMI and body circumferences. The dose-response relationship of creatinine-adjusted urinary cadmium concentration with BMI and body circumferences was analyzed by using restrictive cubic splines fitting multiple linear regression model.Results:The mean age of subjects was (83.34±11.14) years old. The median (Q1, Q3) concentration of creatinine-adjusted urinary cadmium was 1.13 (0.63, 2.09) μg/g·creatinine, and the BMI was (22.70±3.82) kg/m 2. The mean values of waist circumference, hip circumference, and calf circumference were (85.42±10.68) cm, (92.67±8.90) cm, and (31.08±4.76) cm, respectively. After controlling confounding factors, the results of the multiple linear regression model showed that for each increment of 1 μg/g·creatinine in creatinine-adjusted urinary cadmium, the change of BMI, waist circumference, hip circumference, and calf circumference in the high-level group was -0.28 (-0.37, -0.19) kg/m 2, -0.74 (-0.96, -0.52) cm, -0.78 (-0.96, -0.61) cm, and -0.20 (-0.30, -0.11) cm, respectively. The restrictive cubic splines curve showed a negative nonlinear association of creatinine-adjusted urinary cadmium with BMI ( Pnonlinear<0.001) and negative linear associations of creatinine-adjusted urinary cadmium with waist circumference ( Plinear<0.001), hip circumference ( Plinear<0.001), and calf circumference ( Plinear<0.001). Conclusion:Urinary cadmium level is significantly associated with decreased BMI, waist circumference, hip circumference and calf circumference among older adults over 65 years old in 9 longevity areas of China.