ObjectiveTo investigate the metabolic alterations of serum short chain fatty acids （SCFAs） in pediatric patients with atopic dermatitis （AD） and their correlation with different clinical phenotypes using targeted metabolomics. MethodsThis study enrolled 87 AD patients and 67 healthy controls （HC）. Serum levels of eight SCFAs were quantified by ultra-high-performance liquid chromatography-mass spectrometry. The associations between SCFAs and AD were assessed using various statistical methods. ResultsCompared with the HC group， levels of acetic acid （AA）， propionic acid （PA）， and caproic acid （CA） （P=0.002，P=0.002，P=0.043） decreased in the AD group. Logistic regression analysis identified AA （OR=0.449， 95% CI： 0.289–0.698） and PA （OR = 0.487， 95% CI： 0.324–0.732） as protective factors against AD. The combination of AA and PA yielded an area under the curve （AUC） greater than 0.7， indicating good diagnostic efficacy. Age-stratified analysis revealed that AA reduction was predominant in childhood， whereas PA reduction was predominant in adolescence. Pathway enrichment analysis showed significant enrichment of fatty acid biosynthesis （FDR=0.341， P=0.003） and vitamin K metabolism （FDR=1， P=0.039） pathways. Furthermore， subgroup analyses based on disease severity， personal/family history of atopy， and sex revealed no significant differences in SCFAs levels among the groups. ConclusionDifferential serum SCFAs and their enriched metabolic pathways may be implicated in the pathogenesis of AD.

ObjectiveTo describe the characteristics of cardiorespiratory fitness levels in the baseline population of the South China Cohort， and to identify the potential contributing factors. MethodsFace-to-face surveys and physical examinations were conducted to collect information on demographic characteristics， medical histories， medications， lifestyles， and physical activity conditions. After excluding individuals with missing cardiorespiratory fitness-related data and covariates including physical activity and dietary information， a total of 77 024 participants aged 25 to 85 were included. Cardiorespiratory fitness levels were evaluated using a non-exercise algorithm， and low cardiorespiratory fitness level was defined as below the lower tertile of the population distribution. Logistic regression analysis was used to examine the distribution of low cardiorespiratory fitness level， and log-binomial regression and ordered logistic regression analyses were used to analyze the associations of cardiorespiratory fitness with demographic characteristics， socioeconomic factors， lifestyle factors （including alcohol consumption and dietary diversity）， and chronic diseases conditions （including diabetes， hypertension， pulmonary diseases， and cardiovascular diseases）. ResultsCardiorespiratory fitness levels showed a sufficiently normal distribution in both male and female group. We found that the proportion of low cardiorespiratory fitness level was higher among Han ethnicity， those with an educational level below 9th grade， households with an annual income of more than 100 000 Yuan， as well as those who drank alcohol at least one time per week and who exhibited low dietary diversity （all P＜0.001）. Ethnicity， socioeconomic status， lifestyle factors， and chronic diseases were found to be statistically associated with cardiorespiratory fitness levels in the South China population （all P＜0.001）. ConclusionCardiorespiratory fitness levels varied across different population groups in South China， with ethnicity， socioeconomic status， lifestyle factors， and chronic diseases serving as key determinants. Therefore， it is recommended that the public pay attention to cardiorespiratory fitness， as strengthening population-level monitoring and interventions for cardiorespiratory fitness carries significant public health implications.

Objective:To investigate alterations in the immune lineage of T-cell large granular lymphocytic leukemia (T-LGLL) at the single-cell transcriptome level and to elucidate its pathogenic mechanisms.Methods:Peripheral blood samples were collected from 5 T-LGLL patients before and after treatment (from June 2019 to December 2020) and 3 healthy controls at the Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC. Single-cell transcriptome sequencing libraries were prepared and sequenced using 10× Genomics technology. Differentially expressed genes in immune cells were compared between patients and healthy donors, followed by pathway enrichment analyses.Results:Profiling 67,237 immune cells revealed that, in T-LGLL: 1) Effector CD8+ T cells exhibited increased numbers, enhanced cytotoxicity, and greater proliferative capacity. Following effective immunosuppressive therapy, both the proliferative capacity and effector functions of these cells significantly decreased ( P<0.05). 2) The proportion of regulatory T (Treg) cells was reduced, accompanied by increased apoptosis. After effective immunosuppressive therapy leading to remission, Treg cell proportions increased, and apoptotic pathways were downregulated ( P<0.05). 3) Antigen-presenting cells (APCs) showed enhanced functionality. Monocytes and dendritic cells were enriched in antigen synthesis and presentation pathways, while B cells displayed increased antigen-binding capacity and were enriched in pathways related to T-cell activation ( P<0.05). 4) Natural killer (NK) cells exhibited attenuated cytotoxic function but demonstrated an enhanced regulatory capacity over T cells ( P<0.05) . Conclusions:T-LGLL patients present a characteristic immunological profile marked by an imbalance in immune homeostasis. This profile includes abnormal activation and expansion of effector CD8 + T cells, and a reduction in Treg cell numbers accompanied by functional impairment. Furthermore, APCs and NK cells were found to positively regulate T-lymphocyte activation, differentiation, and proliferation.

Objective:To investigate differences in serum lipid profiles between patients with dermatomyositis (DM) and healthy controls.Methods:A retrospective analysis was conducted on the clinical data and serum samples collected from 51 patients with DM who visited the First Affiliated Hospital, Anhui Medical University from September 2020 to January 2022. Serum samples were also collected from 66 healthy controls during the same period. Serum lipid profiles were analyzed using ultra-performance liquid chromatography-mass spectrometry in both groups. Differential lipids were screened using principal component analysis and orthogonal partial least squares-discriminant analysis. The predictive value of these differential lipids for DM was evaluated by receiver operating characteristic (ROC) curve analysis, and their correlations with clinical indicators were also evaluated.Results:A total of 51 patients with DM were enrolled, including 27 males and 24 females, with ages ( M[ Q1, Q3]) of 55.00 (47.00, 66.00) years and body mass index (BMI) values of 22.64 (19.79, 24.75) . The control group included 66 healthy individuals (33 males and 33 females) , with ages of 51.00 (43.75, 56.00) years and BMI values of 23.60 (21.18, 25.19) . No significant differences were observed between the two groups in terms of sex, age, or BMI (all P > 0.05) . A total of 341 lipid metabolites were identified, and 16 lipid metabolites such as ceramides (Cer) , sphingomyelins, phosphatidylcholines (PC) , phosphatidylethanolamines, lysophosphatidylcholines (LPC) , and triglycerides (TG) significantly differed between the DM group and the control group, of which 8 were upregulated and 8 were downregulated in the DM group. ROC curve analysis identified 7 differential lipids with area under the curve (AUC) values of > 0.9, of which 2 were Cer, 3 were TG, 1 was phosphatidylethanolamine, and 1 was LPC. In the DM patients, serum LPC (22∶1) levels were negatively correlated with creatine kinase isoenzyme MB levels ( r = -0.276, P < 0.05) , serum PC (15∶1/16∶0) levels were negatively correlated with aspartate aminotransferase levels ( r = -0.305, P < 0.05) , and serum Cer (d18∶1/18∶0) levels were positively correlated with C-reactive protein levels ( r = 0.283, P < 0.05) . Significant differences in serum lipid levels were observed between some DM subgroups (all P < 0.05) : sphingomyelin (d24∶0) levels significantly differed between anti-Sj?gren syndrome type A/Ro52 antibody-positive and -negative DM patients; LPC (17∶1) levels significantly differed between anti-PM-SCL75 antibody-positive and -negative DM patients; LPC (20∶0) and PC (32∶1p) levels significantly differed between anti-Mi-2 antibody-positive and -negative DM patients; LPC (22∶1) and TG (9∶0/9∶0/9∶0) levels significantly differed between anti-TIF1-γ antibody-positive and -negative DM patients; Cer (d18∶1/18∶0) levels significantly differed between DM patients with and without Heliotrope's sign. Conclusion:Lipid profiles were significantly altered in DM patients compared with healthy controls, and some lipids showed potential diagnostic value for DM.

Objective Previous studies have suggested that bilateral 5-Hz microcurrent stimulation has a hypnotic effect,but the lack of evidence on how the stimulation affects subjects'sleep limits the validation of this intervention.To address this gap,a crossover experimental design was employed,recruiting both insomnia and non-insomnia subjects.Methods 10 participants with insomnia and 10 healthy participants were selected to attend our study.In this crossover study,true(5 Hz)vs.sham stimulation was applied over the parietal temporal lobes.Impact of stimulation on subjective sleep experience,sleep efficiency,sleep structure and psychomotor vigilance task(PVT)was assessed.Results Subjects who received the true 5-Hz stimulation before bedtime had significantly enhanced sleep efficiency,sleep quality,and mental state compared to the night of sham stimulation.Additionally,subjects who received true stimulation exhibited higher sleep efficiency and a later appearance of dream sleep.These findings suggest that 5-Hz microcurrent stimulation before bedtime can enhance both objective and subjective sleep efficiency.Conclusion 5 Hz microcurrent stimulation before bedtime improved sleep efficiency of subjects and also enhanced their subjective perception of sleep.

Objective:To investigate differences in serum lipid profiles between patients with dermatomyositis (DM) and healthy controls.Methods:A retrospective analysis was conducted on the clinical data and serum samples collected from 51 patients with DM who visited the First Affiliated Hospital, Anhui Medical University from September 2020 to January 2022. Serum samples were also collected from 66 healthy controls during the same period. Serum lipid profiles were analyzed using ultra-performance liquid chromatography-mass spectrometry in both groups. Differential lipids were screened using principal component analysis and orthogonal partial least squares-discriminant analysis. The predictive value of these differential lipids for DM was evaluated by receiver operating characteristic (ROC) curve analysis, and their correlations with clinical indicators were also evaluated.Results:A total of 51 patients with DM were enrolled, including 27 males and 24 females, with ages ( M[ Q1, Q3]) of 55.00 (47.00, 66.00) years and body mass index (BMI) values of 22.64 (19.79, 24.75) . The control group included 66 healthy individuals (33 males and 33 females) , with ages of 51.00 (43.75, 56.00) years and BMI values of 23.60 (21.18, 25.19) . No significant differences were observed between the two groups in terms of sex, age, or BMI (all P > 0.05) . A total of 341 lipid metabolites were identified, and 16 lipid metabolites such as ceramides (Cer) , sphingomyelins, phosphatidylcholines (PC) , phosphatidylethanolamines, lysophosphatidylcholines (LPC) , and triglycerides (TG) significantly differed between the DM group and the control group, of which 8 were upregulated and 8 were downregulated in the DM group. ROC curve analysis identified 7 differential lipids with area under the curve (AUC) values of > 0.9, of which 2 were Cer, 3 were TG, 1 was phosphatidylethanolamine, and 1 was LPC. In the DM patients, serum LPC (22∶1) levels were negatively correlated with creatine kinase isoenzyme MB levels ( r = -0.276, P < 0.05) , serum PC (15∶1/16∶0) levels were negatively correlated with aspartate aminotransferase levels ( r = -0.305, P < 0.05) , and serum Cer (d18∶1/18∶0) levels were positively correlated with C-reactive protein levels ( r = 0.283, P < 0.05) . Significant differences in serum lipid levels were observed between some DM subgroups (all P < 0.05) : sphingomyelin (d24∶0) levels significantly differed between anti-Sj?gren syndrome type A/Ro52 antibody-positive and -negative DM patients; LPC (17∶1) levels significantly differed between anti-PM-SCL75 antibody-positive and -negative DM patients; LPC (20∶0) and PC (32∶1p) levels significantly differed between anti-Mi-2 antibody-positive and -negative DM patients; LPC (22∶1) and TG (9∶0/9∶0/9∶0) levels significantly differed between anti-TIF1-γ antibody-positive and -negative DM patients; Cer (d18∶1/18∶0) levels significantly differed between DM patients with and without Heliotrope's sign. Conclusion:Lipid profiles were significantly altered in DM patients compared with healthy controls, and some lipids showed potential diagnostic value for DM.

Objective : To explore whether chrysophanol(CHR) affects macrophage polarization by promoting mitochondrial biosynthesis through AMPK/PGC-1α pathway. Methods : The molecular docking and binding ability of CHR with AMPK and PGC-1α were predicted by Autodock vina software. Human monocytes(THP-1) were induced to M0 macrophages by phorbol myristate acetate(PMA), and to M1 macrophages by lipopolysaccharide(LPS) combined with interferon-γ(IFN-γ), which were set as Control group. M1 macrophages treated with CHR were set as CHR group. M1 macrophages treated with CHR combined with AMPK inhibitor(Compound C) were set as CHR+Compound C group. The mRNA expression levels of M1 macrophage markers(iNOS, CD86) and mitochondrial biosynthesis related genes(PGC-1α, NFR-1, TFAM) were detected by Quantitative real time polymerase chain reaction(qRT-PCR). The expression level of M1 macrophage marker iNOS was detected by immunofluorescence. The protein expression levels of AMPK, p-AMPK and PGC-1α were detected by Western blot. Results : The docking results showed that the binding energies of CHR with AMPK and PGC-1α were-8.4 kcal/mol and-7.4 kcal/mol, respectively. qRT-PCR results showed that the in vitro model of M1 macrophages was successfully established. Compared with the Control group, CHR treatment significantly increased the mRNA expression of mitochondrial biosynthesis-related genes PGC-1α, NFR-1, and TFAM(P<0.001). Compared with CHR treatment group, CHR combined with Compound C treatment significantly decreased the mRNA expression levels of mitochondrial biosynthesis-related genes PGC-1α, NFR-1, and TFAM(P<0.05). Immunofluorescence results showed that CHR treatment inhibited the protein expression of iNOS compared with the Control group(P<0.001). Compared with CHR treatment group,CHR combined with Compound C treatment reversed the inhibitory effect of CHR on i NOS protein expression(P<0.05). Western blot results showed that compared with the Control group,the CHR treatment group had significant increase in the protein expression levels of p-AMPK and PGC-1α(P<0.001).Compared with CHR treatment group,CHR combined with Compound C treatment significantly decreased the protein expression levels of p-AMPK and PGC-1α(P<0.05). Conclusion Chrysophanol may inhibit macrophage polarization to M1 by activating AMPK/PGC-1α signaling pathway to promote mitochondrial biosynthesis.

ObjectiveTo observe the clinical efficacy and safety of Zhuyuwan in the treatment of hyperlipidemia. MethodsIn this study， hyperlipidemia patients treated in the Hospital of Chengdu University of Traditional Chinese Medicine （TCM） from September 2022 to December 2023 were randomly assigned into a control group and an observation group. Finally， 162 valid cases were included， encompassing 74 cases in the control group and 88 cases in the observation group. The control group was treated with atorvastatin calcium tablets， and the observation group with atorvastatin calcium tablets + Zhuyuwan extract granules. Both groups were treated for 8 weeks. The efficacy in terms of blood lipid level recovery， blood lipid levels， TCM syndrome distribution， efficacy in terms of TCM syndrome， and TCM symptom scores were compared between the two groups as well as between before and after treatment. Liver and kidney functions were monitored for safety assessment. ResultsIn terms of blood lipid level recovery， the total response rate in the observation group was 86.36% （76/88） and that in the control group was 86.49% （64/74）， with no statistically significant difference between the two groups. After treatment， both groups showed declines in levels of triglyceride （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） （P<0.05） and elevations in the level of high-density lipoprotein cholesterol （HDL-C） （P<0.05）. Moreover， the observation group outperformed the control group in recovering the levels of TG， LDL-C， and HDL-C （P<0.05， P<0.01）. In terms of TCM syndrome， hyperlipidemia was mostly caused by phlegm turbidity and obstruction. The total response rate in terms of TCM syndrome in the observation group was 87.30% （55/63）， which was higher than that （63.46%， 33/52） in the control group （χ²=9.102， P<0.01）. After treatment， the scores of total TCM symptoms， primary symptoms， and secondary symptoms decreased in both groups （P<0.05）， and the observation group had lower scores than the control group （P<0.01）. The observation group was superior to the control group in alleviating obesity， chest tightness， and low food intake （P<0.05）. In terms of safety， the level of aminotransferase was slightly elevated in the control group， and no obvious adverse reaction was observed in the observation group， with no statistical significance in the incidence of adverse reactions. ConclusionZhuyuwan combined with atorvastatin can not only recover blood lipid levels and alleviate TCM symptoms but also reduce the occurrence of adverse reactions.

ObjectiveTo observe the clinical efficacy and safety of Zhuyuwan in the treatment of hyperlipidemia. MethodsIn this study， hyperlipidemia patients treated in the Hospital of Chengdu University of Traditional Chinese Medicine （TCM） from September 2022 to December 2023 were randomly assigned into a control group and an observation group. Finally， 162 valid cases were included， encompassing 74 cases in the control group and 88 cases in the observation group. The control group was treated with atorvastatin calcium tablets， and the observation group with atorvastatin calcium tablets + Zhuyuwan extract granules. Both groups were treated for 8 weeks. The efficacy in terms of blood lipid level recovery， blood lipid levels， TCM syndrome distribution， efficacy in terms of TCM syndrome， and TCM symptom scores were compared between the two groups as well as between before and after treatment. Liver and kidney functions were monitored for safety assessment. ResultsIn terms of blood lipid level recovery， the total response rate in the observation group was 86.36% （76/88） and that in the control group was 86.49% （64/74）， with no statistically significant difference between the two groups. After treatment， both groups showed declines in levels of triglyceride （TG）， total cholesterol （TC）， and low-density lipoprotein cholesterol （LDL-C） （P<0.05） and elevations in the level of high-density lipoprotein cholesterol （HDL-C） （P<0.05）. Moreover， the observation group outperformed the control group in recovering the levels of TG， LDL-C， and HDL-C （P<0.05， P<0.01）. In terms of TCM syndrome， hyperlipidemia was mostly caused by phlegm turbidity and obstruction. The total response rate in terms of TCM syndrome in the observation group was 87.30% （55/63）， which was higher than that （63.46%， 33/52） in the control group （χ²=9.102， P<0.01）. After treatment， the scores of total TCM symptoms， primary symptoms， and secondary symptoms decreased in both groups （P<0.05）， and the observation group had lower scores than the control group （P<0.01）. The observation group was superior to the control group in alleviating obesity， chest tightness， and low food intake （P<0.05）. In terms of safety， the level of aminotransferase was slightly elevated in the control group， and no obvious adverse reaction was observed in the observation group， with no statistical significance in the incidence of adverse reactions. ConclusionZhuyuwan combined with atorvastatin can not only recover blood lipid levels and alleviate TCM symptoms but also reduce the occurrence of adverse reactions.

OBJECTIVE: To evaluate the advantages and limitations of transcutaneous electrical acupoint stimulation (TEAS) in the treatment of patients with severe gastrointestinal function injury in intensive care unit (ICU) by analyzing dynamic changes of intestinal fatty acid binding protein (I-FABP), D-lactic acid and citrulline. METHODS: A prospective single-center randomized controlled trial was conducted. Patients with severe gastrointestinal function injury admitted to the ICU from February 2021 to January 2024 were enrolled [age > 18 years old, acute gastrointestinal injury (AGI) grade 2 to 3, stable hemodynamics]. Patients with different AGI grades were randomly assigned in a 1:1 ratio to the TEAS group and the control group using simple randomization. Both groups received conventional treatment and enteral nutrition (EN). In addition, the TEAS group underwent TEAS at the Neiguan and Zusanli points for 30 minutes per session, twice daily for 7 days. Baseline data, including age, gender, underlying diseases, and primary diagnoses, were recorded. Three intestinal biomarkers, such as I-FABP, D-lactic acid, and citrulline were measured before and after 7 days of treatment. EN tolerance indicators and 28 days survival status were documented. The differences in various indicators were compared between the two groups, subgroup analyses were conducted based on AGI grading, and interaction between AGI grade and TEAS were analyzed. The 28-day Kaplan-Meier survival curves were generated for both groups. RESULTS: Finally, 133 patients were included, with 68 in the TEAS group and 65 in the control group. Baseline characteristics were comparable between the two groups. A comparison of the dynamic changes in intestinal biomarkers revealed that the I-FABP level in both groups decreased after treatment compared to pre-treatment, with a more pronounced reduction in the TEAS group. The least square mean difference (LS Mean difference) for the corrected I-FABP level between the two groups during the observation period was -0.23 μg/L [95% confidence interval (95%CI) was -0.45 to -0.01], which was statistically significant (P = 0.041). Additionally, a significant interaction with AGI was observed (P = 0.004). Post-treatment, D-lactic acid level decreased in both groups compared to pre-treatment, with a more significant reduction in the TEAS group. The LS Mean difference for the corrected D-lactic acid level was -0.08 mmol/L (95%CI was -0.11 to -0.05), which was statistically significant (P < 0.001), and the interaction with AGI was also significant (P = 0.005). There was no significant change in citrulline levels between the two groups before and after treatment. The LS Mean difference for the corrected citrulline level was -0.17 μmol/L (95%CI was -1.87 to 1.53), which was not statistically significant (P = 0.845), and no significant interaction with AGI was observed (P = 0.913). Comparison of EN tolerance parameters between the two groups revealed that the TEAS group had a longer total EN time (hours: 72±31 vs. 60±28) and higher total EN calories (kJ: 11 469.23±7 237.34 vs. 6 638.76±5 098.37), as well as a higher 70% target caloric attainment rate (52.9% vs. 32.3%) compared to the control group (all P < 0.05). The incidence of abdominal distension after EN was lower in the TEAS group than that in the control group (23.5% vs. 43.1%, P < 0.05), while the incidence of diarrhea after EN was higher in the TEAS group (22.1% vs. 7.7%, P < 0.05). There were no significantly differences in AGI grade reduction rate, post-EN vomiting/gastric retention rate, incidence of feeding interruption, and 28-day survival rate between the two groups. Furthermore, there were no significantly interaction between these observation measures and AGI. Kaplan-Meier survival analysis showed that there was no significantly difference in 28-day cumulative survival rate between the TEAS group and the control group [Log-Rank test: P = 0.501, hazard ratio (HR) = 0.81, 95%CI was 0.43-1.51), and there was no significantly interaction with AGI (P = 0.702). CONCLUSIONS The advantage of TEAS in the treatment of ICU patients with severe gastrointestinal function injury lies in its ability to reverse intestinal cell necrosis and promote the reconstruction of intestinal barrier function. Additionally, gastrointestinal tolerance is significantly improved, and both the duration and total calories of EN are increased. However, the limitation of TEAS therapy is that it does not promote the recovery of intestinal cell absorption and synthesis function in the target patients. Moreover, it may lead to nutrient solution overload due to improved gastrointestinal tolerance. Furthermore, TEAS does not appear to improve 28-day cumulative survival rate in the target patients.
Humans ; Prospective Studies ; Intensive Care Units ; Acupuncture Points ; Fatty Acid-Binding Proteins/metabolism* ; Transcutaneous Electric Nerve Stimulation ; Male ; Female ; Citrulline/metabolism* ; Lactic Acid/metabolism* ; Gastrointestinal Diseases/therapy* ; Middle Aged ; Enteral Nutrition ; Adult