A targeted metabolomics study was conducted on the bile acid profiles in the liver and feces of rats induced by a high-fat diet and intervened by ginsenoside Rb_1, along with the detection of FXR pathway gene expression in the liver, to explore and clarify its mechanism of action. The content of biochemical indicators in the serum were detected using an automatic biochemical analyzer. Hematoxylin and eosin(HE) staining and oil red O staining were used to detect pathological changes and lipid deposition in the liver. RT-PCR was used to detect the mRNA expression of FXR, small heterodimer partner(SHP), cholesterol 7 alpha-hydroxylase(CYP7A1), and sterol regulatory element-binding protein-1c(SREBP-1c) in the liver. Targeted bile acid metabolomics technology was employed to analyze changes in bile acid profiles in liver tissue and feces, and a correlation analysis was performed between key genes such as FXR, SHP, CYP7A1, SREBP-1c and differential bile acid metabolites. The results showed that ginsenoside Rb_1 significantly reduced the levels of total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), and high-density lipoprotein cholesterol(HDL-C) in the serum, alleviated the large fat vacuoles and lipid deposition in the liver, increased the expression of FXR mRNA in the liver, and decreased the expression of SREBP-1c mRNA. The expression of CYP7A1 and SHP mRNA was increased, but the differences were not statistically significant. Targeted bile acid metabolomics showed that ginsenoside Rb_1 could restore the levels of 9 bile acids in the liver and 8 bile acids in the feces. Ginsenoside Rb_1 also increased the percentage of taurocholic acid(TCA) in the liver(56.78%) and the percentage of 12-ketolithocholic acid(12-KLCA) in the feces(26.10%). Pathway enrichment analysis revealed two pathways involved in bile acid metabolism: primary bile acid biosynthesis and taurine and hypotaurine metabolism. Correlation analysis showed that FXR, SHP, CYP7A1, and SREBP-1c were positively correlated with multiple differential bile acids. These results suggest that ginsenoside Rb_1 may intervene in lipid metabolism disorders induced by a high-fat diet by regulating the FXR pathway and modulating bile acid profiles in the liver and feces.
Animals ; Bile Acids and Salts/metabolism* ; Rats ; Ginsenosides/pharmacology* ; Male ; Receptors, Cytoplasmic and Nuclear/genetics* ; Liver/drug effects* ; Diet, High-Fat/adverse effects* ; Metabolomics ; Rats, Sprague-Dawley ; Feces/chemistry* ; Cholesterol 7-alpha-Hydroxylase/metabolism* ; Sterol Regulatory Element Binding Protein 1/genetics* ; Humans

ObjectiveTo explore the potential mechanisms by which spleen deficiency affects lipid metabolism in hyperlipidemia， from the perspective of gut microbiota and fecal endogenous metabolites. MethodsEighteen Sprague-Dawley （SD） rats were randomly divided into control group， hyperlipidemia group， and spleen-deficiency with hyperlipidemia group， with 6 rats in each group. The control group was fed with standard diet； the hyperlipi-demia group was given high-fat diet to induce hyperlipidemia model； and the spleen-deficiency with hyperlipidemia group received combination of high-fat diet， irregular feeding， and exercise restriction to induce the model. After 12 weeks of modeling， serum lipid levels including total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） were measured. 16S rRNA gene sequencing was used to analyze gut microbiota composition in fecal samples， and fecal metabolites were analyzed using high-performance liquid chromatography-mass spectrometry （HPLC-MS）. Differential metabolites and microbial taxa were screened for pathway enrichment and functional prediction analysis， followed by correlation analysis. ResultsCompared with the control group， rats in the hyperlipidemia and spleen-deficiency with hyperlipidemia groups showed significantly increased serum TG， TC， and LDL-C levels， and decreased HDL-C levels （P＜0.01）. Compared with the hyperlipidemia group， the spleen-deficiency with hyperlipidemia group showed further increases in TG， TC， and LDL-C and further decrease in HDL-C （P＜0.05 or P＜0.01）. Gut microbiota analysis revealed 3,066 unique species in the control group， 2,637 in the hyperlipidemia group， and 1,581 in the spleen-deficiency group. Chao1， Simpson， and Shannon indices were significantly reduced in the spleen-deficiency group compared with the hyperli-pidemia group， with an increased Firmicutes/Bacteroidetes ratio. Differentially abundant genera such as Romboutsia， Lactobacillus， Clostridium， Allobaculum， and Xylanibacter were significantly upregulated （P＜0.05 or P＜0.01）. Metabolomics identified 25 differential metabolites in feces of spleen-deficient rats， with 18 downregulated and 7 upregulated. Key enriched pathways included serotonergic synapse， nucleotide metabolism， vascular smooth muscle contraction， and arachidonic acid metabolism. Spearman correlation analysis showed significant positive correlations between Romboutsia and Desulfovibrio and metabolites such as digalactosyldiacylglycerol （48∶5）， dehydrated artemetin， lysophosphatidylcholine （26∶4）， and glucuronosyldiacylglycerol （46∶5）； Clostridium was positively correlated with cyclopassifloric acid E1， digalactosyldiacylglycerol （48∶5）， and lysophosphatidylcholine （26∶4）； Xylanibacter was positively correlated with digalactosyldiacylglycerol （48∶5）， dehydrated artemetin， and lysophosphatidylcholine （26∶4）. ConclusionSpleen deficiency can further alter gut microbiota composition in hyperlipi-demia model rats， leading to microbial dysbiosis and metabolic disturbances that aggravate lipid metabolism disorders. This mechanism may be associated with changes in pathways such as serotonergic synapse， nucleotide metabolism， vascular smooth muscle contraction， and arachidonic acid metabolism.

Objective: To analyze the characteristics of first-visit cases of herpes zoster in Zhoushan City, Zhejiang Province from 2021 to 2023, so as to provide the reference for improving herpes zoster prevention and control measures. Methods: Data on the incidence and vaccination of first-visit herpes zoster cases at all levels of public medical institutions in Zhoushan City from 2021 to 2023 were collected through the Zhoushan Comprehensive Health Information Platform and Zhoushan Immunization Program Information Management System. The incidence and outpatient proportion were calculated. The population distribution, seasonal distribution, and clinical consultation status of first-visit herpes zoster cases were described. Results: From 2021 to 2023, a total of 15 156 first-visit herpes zoster cases were reported in Zhoushan City, with an average annual incidence of 5.36‰. The incidences for each year were 5.78‰, 5.29‰ and 5.02‰, respectively, and the outpatient proportions were 0.15%, 0.14% and 0.11%, respectively, showed decreasing trends (both P<0.05). The number of doses of recombinant herpes zoster vaccine or live attenuated herpes zoster vaccine administered were 130, 312, and 633, respectively. The main consultation department was dermatology, with 11 004 cases (72.60%). The primary clinical diagnosis was visceral herpes zoster, with 5 901 cases (38.94%). A total of 1 936 cases (12.77%) had at least one underlying medical condition. The mean age of onset was (56.08±16.23) years, and the incidence showed an upward trend with increasing age (P<0.05). There were 7 386 male cases and 7 770 female cases, with a male-to-female ratio of 0.95∶1. The incidence among males aged ≥50 years was lower than that among females (6.53‰ vs. 8.69‰, P<0.05). The onset of the disease exhibited a significant seasonal pattern, with a peak period from June 21st to August 21st, covering 75% of the cases Conclusions From 2021 to 2023, the incidence and outpatient proportion of herpes zoster in Zhoushan City decreased. Summer was the peak season for onset, and women and the elderly were the key populations. It is necessary to strengthen the collaborative diagnostic and treatment capabilities of key departments such as dermatology and enhance the enthusiasm for vaccination among key populations.

Objective:To analyze the temporal trends and projections in disease burden attributable to preterm birth and low birth weight (PBLBW) in China from 1990 to 2021, providing evidence for prevention strategies.Methods:Using Global Burden of Disease (GBD) 2021 data, deaths, disability-adjusted life years (DALYs), and age-standardized rates (ASR) related to PBLBW were calculated. Joinpoint regression analyzed temporal trends, disease-specific impacts, sex/age disparities, and comparisons with socio-demographic index (SDI) regions. An autoregressive integrated moving average (ARIMA) model projected future trends.Results:In 2021, age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) for PBLBW were 3.89/100 000 and 413.24 years/100 000, respectively, which demonstrated a significant decline from 1990 levels (21.80/100 000 and 2 027.96 years/100 000), with average annual percentage changes (AAPC) of－5.39 and－5.03. Male burden exceeded female in 2021 (ASMR: 4.35/100 000 vs. 3.36/100 000; ASDR: 459.48 years/100 000 vs. 359.55 years/100 000). Preterm birth dominated PBLBW-related mortality and DALYs in 2021 (ASMR: 2.65/100 000; ASDR: 301.50 years/100 000). ASMR and ASDR of China in 2021 were lower than that of low-, low-middle-, and middle-SDI regions and global levels, with greater declines during 1990-2021 than that of global levels and all SDI regions. Projections indicate continued decline to 2030 (ASMR: 1.63/100 000; ASDR: 212.62 years/100 000). Conclusion:China achieved substantial reductions in PBLBW-related disease burden, although persistent gender disparities and methodological limitations in data collection necessitate further strengthening of the perinatal healthcare system.

Objective To investigate the effect of modified dorsal palmar artery flap in repairing skin defect of hand.Methods A prospective study was conducted on 78 patients with hand skin defects in our hospital from May 2018 to May 2023,who were randomly divided into a control group(n=39)and a study group(n=39)using a random number table method.The control group was given conventional flap repair,while the study group was given modified dorsal metacarpal artery flap repair.The surgical conditions,flap blood supply,motor function of the affected finger,sensory function,postoperative complications and appearance satisfaction of the two groups were compared.Results The operation time,hospital stay and wound healing time of the research group were(110.28±17.65)minutes,(8.94±1.76)d and(14.39±3.82)d,respectively.Which were shorter than the control group[(121.43±15.94)min,(10.13±1.88)d,and(16.51±4.07)d,respectively].The intraoperative blood loss in the research group was(38.12±7.81)ml,which was lower than that of the control group[(42.59±7.43)ml].The elasticity scores of the study group at 1 month,3 months,and 6 months after surgery were(1.31±0.28),(2.34±0.31),and(2.81±0.08),respectively,which were higher than those of the control group[(1.12±0.25),(2.05±0.28),and(2.59±0.17),respectively].The capillary filling time scores were(1.24±0.26),(2.42±0.27),and(2.75±0.12),respectively,which were higher than those of the control group(1.06±0.23),(2.13±0.25),and(2.43±0.27),respectively;the excellent and good rate of motor function of the affected fingers in the study group was 97.44％,which was higher than that of the control group(79.49％),the incidence of complications was 5.13％,which was lower than that of the control group(23.08％),the appearance satisfaction rate was 89.74％,which was higher than that of the control group(71.79％)(P＜0.05).Conclusion The modified dorsal palmar artery flap for the treatment of hand skin defects can optimize the operation process,improve the local blood flow of the flap,promote the recovery of finger motor function and sensory function,enhance the appearance effect and reduce the risk of complications.

Objective:To investigate the efficacy of laparoscopic salpingectomy in the treatment of ectopic pregnancy in patients and its effects on serum human chorionic gonadotropin levels.Methods:This study used a case-control design. A retrospective analysis was conducted on 70 patients with ectopic pregnancy who received treatment at Jiande Maternal and Child Health Care Hospital from January 2021 to December 2023. The patients were divided into a control group and an observation group ( n =35/group) according to the surgical methods used. The control group underwent open surgery, while the observation group received laparoscopic salpingectomy. Clinical indicators, postoperative recovery metrics, complications, and the time taken for symptom resolution were compared between the two groups. Serum human chorionic gonadotropin levels were measured and compared between the two groups both before surgery and 1 week after surgery. Results:The operation time in the observation group was longer than that in the control group [(45.87 ± 7.28) minutes vs. (36.52 ± 5.61) minutes, t = 6.02, P<0.001]. The intraoperative blood loss in the observation group was significantly less than that in the control group [(45.39 ± 8.84) mL vs. (93.42 ± 14.36) mL, t = -16.85, P<0.001]. The time to first passage of flatus, time to ambulation, and length of hospital stay in the observation group were (13.43 ± 3.61) hours, (6.98 ± 1.43) hours, and (4.01 ± 1.23) days, respectively, which were significantly shorter than those in the control group [(21.29 ± 4.57) hours, (11.29 ± 2.75) hours, (6.72 ± 1.84) days, t = -7.98, -8.23, -7.24, all P<0.001]. The incidence of complications in the observation group was significantly lower than that in the control group [8.57% (1/35) vs. 31.43% (8/35), χ2 = 4.59, P = 0.017]. The time to pain resolution, time to disappearance of vaginal bleeding, and the time for menstrual recovery in the observation group were (3.56 ± 0.75) days, (7.68 ± 1.37) days, and (30.04 ± 8.73) days, respectively, which were significantly shorter than those in the control group [(4.90 ± 1.34) days, (9.74 ± 1.52) days, (46.58 ± 12.31) days, t = -5.16, -5.96, -7.24, all P<0.001]. At 1 week after surgery, serum human chorionic gonadotropin levels in the observation group were significantly lower than those in the control group [(315.24 ± 39.48) IU/L vs. (559.71 ± 45.62) IU/L, t = -23.97, P<0.001]. Conclusions:Laparoscopic salpingectomy is highly effective for treating ectopic pregnancy. It can accelerate postoperative recovery and reduce serum human chorionic gonadotropin levels.

Objective To investigate the effect of modified dorsal palmar artery flap in repairing skin defect of hand.Methods A prospective study was conducted on 78 patients with hand skin defects in our hospital from May 2018 to May 2023,who were randomly divided into a control group(n=39)and a study group(n=39)using a random number table method.The control group was given conventional flap repair,while the study group was given modified dorsal metacarpal artery flap repair.The surgical conditions,flap blood supply,motor function of the affected finger,sensory function,postoperative complications and appearance satisfaction of the two groups were compared.Results The operation time,hospital stay and wound healing time of the research group were(110.28±17.65)minutes,(8.94±1.76)d and(14.39±3.82)d,respectively.Which were shorter than the control group[(121.43±15.94)min,(10.13±1.88)d,and(16.51±4.07)d,respectively].The intraoperative blood loss in the research group was(38.12±7.81)ml,which was lower than that of the control group[(42.59±7.43)ml].The elasticity scores of the study group at 1 month,3 months,and 6 months after surgery were(1.31±0.28),(2.34±0.31),and(2.81±0.08),respectively,which were higher than those of the control group[(1.12±0.25),(2.05±0.28),and(2.59±0.17),respectively].The capillary filling time scores were(1.24±0.26),(2.42±0.27),and(2.75±0.12),respectively,which were higher than those of the control group(1.06±0.23),(2.13±0.25),and(2.43±0.27),respectively;the excellent and good rate of motor function of the affected fingers in the study group was 97.44％,which was higher than that of the control group(79.49％),the incidence of complications was 5.13％,which was lower than that of the control group(23.08％),the appearance satisfaction rate was 89.74％,which was higher than that of the control group(71.79％)(P＜0.05).Conclusion The modified dorsal palmar artery flap for the treatment of hand skin defects can optimize the operation process,improve the local blood flow of the flap,promote the recovery of finger motor function and sensory function,enhance the appearance effect and reduce the risk of complications.

Objective:To investigate the efficacy of laparoscopic salpingectomy in the treatment of ectopic pregnancy in patients and its effects on serum human chorionic gonadotropin levels.Methods:This study used a case-control design. A retrospective analysis was conducted on 70 patients with ectopic pregnancy who received treatment at Jiande Maternal and Child Health Care Hospital from January 2021 to December 2023. The patients were divided into a control group and an observation group ( n =35/group) according to the surgical methods used. The control group underwent open surgery, while the observation group received laparoscopic salpingectomy. Clinical indicators, postoperative recovery metrics, complications, and the time taken for symptom resolution were compared between the two groups. Serum human chorionic gonadotropin levels were measured and compared between the two groups both before surgery and 1 week after surgery. Results:The operation time in the observation group was longer than that in the control group [(45.87 ± 7.28) minutes vs. (36.52 ± 5.61) minutes, t = 6.02, P<0.001]. The intraoperative blood loss in the observation group was significantly less than that in the control group [(45.39 ± 8.84) mL vs. (93.42 ± 14.36) mL, t = -16.85, P<0.001]. The time to first passage of flatus, time to ambulation, and length of hospital stay in the observation group were (13.43 ± 3.61) hours, (6.98 ± 1.43) hours, and (4.01 ± 1.23) days, respectively, which were significantly shorter than those in the control group [(21.29 ± 4.57) hours, (11.29 ± 2.75) hours, (6.72 ± 1.84) days, t = -7.98, -8.23, -7.24, all P<0.001]. The incidence of complications in the observation group was significantly lower than that in the control group [8.57% (1/35) vs. 31.43% (8/35), χ2 = 4.59, P = 0.017]. The time to pain resolution, time to disappearance of vaginal bleeding, and the time for menstrual recovery in the observation group were (3.56 ± 0.75) days, (7.68 ± 1.37) days, and (30.04 ± 8.73) days, respectively, which were significantly shorter than those in the control group [(4.90 ± 1.34) days, (9.74 ± 1.52) days, (46.58 ± 12.31) days, t = -5.16, -5.96, -7.24, all P<0.001]. At 1 week after surgery, serum human chorionic gonadotropin levels in the observation group were significantly lower than those in the control group [(315.24 ± 39.48) IU/L vs. (559.71 ± 45.62) IU/L, t = -23.97, P<0.001]. Conclusions:Laparoscopic salpingectomy is highly effective for treating ectopic pregnancy. It can accelerate postoperative recovery and reduce serum human chorionic gonadotropin levels.

Objective:To analyze the temporal trends and projections in disease burden attributable to preterm birth and low birth weight (PBLBW) in China from 1990 to 2021, providing evidence for prevention strategies.Methods:Using Global Burden of Disease (GBD) 2021 data, deaths, disability-adjusted life years (DALYs), and age-standardized rates (ASR) related to PBLBW were calculated. Joinpoint regression analyzed temporal trends, disease-specific impacts, sex/age disparities, and comparisons with socio-demographic index (SDI) regions. An autoregressive integrated moving average (ARIMA) model projected future trends.Results:In 2021, age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) for PBLBW were 3.89/100 000 and 413.24 years/100 000, respectively, which demonstrated a significant decline from 1990 levels (21.80/100 000 and 2 027.96 years/100 000), with average annual percentage changes (AAPC) of－5.39 and－5.03. Male burden exceeded female in 2021 (ASMR: 4.35/100 000 vs. 3.36/100 000; ASDR: 459.48 years/100 000 vs. 359.55 years/100 000). Preterm birth dominated PBLBW-related mortality and DALYs in 2021 (ASMR: 2.65/100 000; ASDR: 301.50 years/100 000). ASMR and ASDR of China in 2021 were lower than that of low-, low-middle-, and middle-SDI regions and global levels, with greater declines during 1990-2021 than that of global levels and all SDI regions. Projections indicate continued decline to 2030 (ASMR: 1.63/100 000; ASDR: 212.62 years/100 000). Conclusion:China achieved substantial reductions in PBLBW-related disease burden, although persistent gender disparities and methodological limitations in data collection necessitate further strengthening of the perinatal healthcare system.

Objective:To analyze the association between sleep status and ambulatory blood pressure monitoring indicators in community-dwelling hypertensive patients.Methods:It was a cross sentional study. Hypertensive patients who underwent 24-hour ambulatory blood pressure monitoring from May 2021 to April 2023 in Shanghai Xinzhuang Town were enrolled. The demographic information and sleep status of patients were obtained from the questionnaire. A TM-2430 blood pressure monitor was used to measure 24-hour ambulatory blood pressure, and the relevant indicators, including blood pressure level and blood pressure coefficient of variation were documented. The association between sleep status and blood pressure indicators was analyzed with multivariate linear regression model.Results:A total 1 135 patients aged (65.07±12.61) years were enrolled, and 473 (41.67%) of whom were males. The sleep time was<7 hours in 76 cases, 7- 8 hours in 219 cases and >8 hours in 840 cases; the bedtime was earlier than 22∶00 in 415 cases, between 22∶00 and 23∶00 in 474 cases and later than 23∶00 in 246 cases; the wake-up time was before 6∶00 in 230 cases, between 6∶00 and 7∶00 in 521 cases and after 7∶00 in 384 cases. Multivariate linear regression analysis showed that after controlling for gender and age, the sleep time was negatively associated with diurnal, noctumal and 24-hour diastolic blood pressure levels (all P<0.05), and positively associated with diurnal and noctumal systolic blood pressure coefficient of variation, noctumal diastolic blood pressure coefficient of variation, and 24-hour systolic blood pressure coefficient of variation (all P<0.05).The bedtime was positively associated with diurnal, noctumal and 24-hour diastolic blood pressure (all P<0.05), diastolic blood pressure (all P<0.05); and negatively associated with diurnal systolic blood pressure coefficient of variation, diurnal diastolic blood pressure coefficient of variation, noctumal systolic blood pressure coefficient of variation, 24-hour systolic blood pressure coefficient of variation, and 24-hour diastolic blood pressure coefficient of variation (all P<0.05). The wake-up time was positively associated with diurnal systolic blood pressure, diurnal, noctumal and 24-hour diastolic blood pressure (all P<0.05), and positively associated with diurmal systolic blood pressure and diastolic blood pressure (both P<0.05). Conclusion:Sleep status is closely associated with ambulatory blood pressure monitoring indicators in community-dwelling hypertensive patients.