The brain-gut interaction theory is a multidimensional integrative concept based on the brain-gut axis， involving neural， endocrine， and immune regulatory networks as well as the gut microbiota. Zang-fu organs （脏腑） theory in traditional Chinese medicine （TCM） shows a high degree of consistency with the brain-gut interaction theory， and the core functions such as the spleen and stomach governing the ascending of the clear and descending of the turbid， the liver governing the free flow of qi， and the heart governing mental and emotional activities are closely associated with the multi-level regulatory mechanisms of the brain-gut axis. TCM therapy can modulate brain-gut interactions through multiple pathways in the treatment of spleen and stomach diseases， including the regulation of gastrointestinal hormone secretion， neurotransmitter levels， the hypothalamic-pituitary-adrenal （HPA） axis， immune homeostasis and inflammatory responses， as well as the gut microecology. However， current basic research on the brain-gut interaction theory in TCM for spleen and stomach diseases still faces several challenges， such as difficulties in integrating TCM spleen-stomach theory with modern pathophysiology， lack of innovation in research concepts， and limitations in research methodologies. It is therefore proposed that multidisciplinary collaboration， multi-omics technologies， and targeted research approaches should be adopted to provide more comprehensive methods for basic research on TCM spleen and stomach diseases， thereby promoting the in-depth development of brain-gut interaction theory.

Background: and Purpose Vertebrobasilar fusiform aneurysms (VBFAs) carry substantial morbidity and mortality, but optimal management for unruptured VBFAs remains unclear. We compared the safety and efficacy of conservative management (CM), stent-assisted coiling (SAC), and flow diverters (FDs) in patients with unruptured VBFAs, focusing on long-term prognosis. Methods: This study included data from a nationwide Chinese cohort of patients with vertebrobasilar dissecting aneurysms. Inverse probability of treatment weighting (IPTW) balanced confounders across groups. The primary outcome was poor prognosis (modified Rankin Scale score >2). Secondary outcomes included aneurysm rupture, ischemic stroke, compression symptoms, and VBFA-related deaths. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were performed. Results: Among 1,115 patients with unruptured VBFAs, 838 (median age, 54 years; 655 men) were included. After IPTW, baseline characteristics were balanced. Median follow-up was 54 months. FD was associated with a lower risk of poor prognosis than CM (OR, 0.48 [95% CI, 0.30 to 0.77]; p=0.002), with no difference between CM and SAC. FD also reduced aneurysm rupture (OR, 0.20 [95% CI, 0.07 to 0.60]; p=0.004) and compression symptoms (OR, 0.30 [95% CI, 0.13 to 0.68]; p=0.004) versus CM. Time-to-event analyses further revealed significant differences in vertebral artery lesions and Type I–II VBFAs, whereas no significant differences were observed in basilar or vertebrobasilar junction lesions or in Type III–IV VBFAs. Conclusions Compared with CM, FD was associated with improved long-term outcomes in unruptured VBFAs, particularly in vertebral artery lesions and Type I–II VBFAs, although residual confounding cannot be excluded.

ObjectiveTo investigate the therapeutic effects of modified Baoyuantang combined with Linggui Zhugantang on post-myocardial infarction heart failure in rats and its influence on NOD-like receptor pyrin domain-containing protein 3 （NLRP3）/gasdermin D （GSDMD）-mediated pyroptosis. MethodsSixty male SD rats were randomized into sham， model， low-， medium-， and high-dose （2.52， 5.04， 10.08 g·kg^-1， respectively） modified Baoyuantang combined with Linggui Zhugantang， and sacubitril/valsartan sodium （0.021 g·kg^-1） groups， with 10 rats in each group. Except the sham group， the other groups underwent left anterior descending coronary artery ligation for the modeling of myocardial infarction. The treatment groups were administrated with corresponding drugs by gavage， and the sham and model groups received an equal volume of normal saline. Administration began on the first day after successful modeling， once daily， for 4 weeks. Echocardiography was used to measure left ventricular ejection fraction （LVEF）， left ventricular fractional shortening （LVFS）， left ventricular end-diastolic and end-systolic diameters （LVIDd and LVIDs）， left ventricular posterior wall thicknesses at end-diastole and end-systole （LVPWd， LVPWs）， and left ventricular volumes at end-diastole and end-systole （LV Vold and LV Vols）. Cardiac mass index and heart weight-to-tibia length ratio were calculated. Hematoxylin-eosin （HE） staining and Sirius Red staining were performed to observe myocardial morphology and collagen deposition. Immunohistochemistry was employed to detect the expression of type I collagen （Collagen Ⅰ）， NLRP3， GSDMD， and interleukin-1β （IL-1β）. Transmission electron microscopy was used to observe the mitochondrial ultrastructure. Tetramethylrhodamine methyl ester （TMRM） staining was conducted to assess mitochondrial membrane potential （MMP） in cardiomyocytes. Real-time PCR was used to quantify the mRNA levels of NLRP3， cysteinyl aspartate-specific proteinase-1 （Caspase-1）， IL-1β， GSDMD， and interleukin-18 （IL-18） in the myocardial tissue. Western blotting was employed to determine the protein levels of NLRP3， Caspase-1， GSDMD， IL-1β， IL-18， nuclear factor kappa-B （NF-κB） p50， and NF-κB p65 in the myocardial tissue. Enzyme-linked immunosorbent assay （ELISA） was adopted to measure the serum levels of tumor necrosis factor-α （TNF-α）， IL-1β， and IL-6. ResultsCompared with the sham group， the model group showed increased LVIDd， LVIDs， LV Vold， LV Vols， cardiac mass index， and heart weight-to-tibia length ratio （P<0.05）， decreased LVPWs， LVEF， LVFS， and MMP （P<0.05）， evident myocardial inflammation， fibrosis， and mitochondrial damage， upregulated expression of NLRP3， Caspase-1， GSDMD， IL-1β， IL-18， NF-κB p50， and NF-κB p65， and elevated serum levels of TNF-α， IL-1β， and IL-6 （P<0.05）. Compared with the model group， modified Baoyuantang combined with Linggui Zhugantang reduced the LVIDd， LVIDs， LV Vols， cardiac mass index， and heart weight-to-tibia length ratio （P<0.05）， increased the LVPWs， LVEF， LVFS， and MMP （P<0.05）， alleviated myocardial inflammation and fibrosis， improved the mitochondrial structure and function， downregulated the expression of NLRP3， Caspase-1， GSDMD， IL-1β， IL-18， NF-κB p50， and NF-κB p65 （P<0.05）， and reduced the serum levels of TNF-α， IL-1β， and IL-6 （P<0.05）. ConclusionModified Baoyuantang combined with Linggui Zhugantang can ameliorate post-myocardial infarction ventricular remodeling and improve the cardiac function by reducing mitochondrial damage and inhibiting NLRP3/GSDMD-mediated pyroptosis.

ObjectiveTo investigate the effect of Semaphorin 3A （Sema3A） on the progression of pathological cardiac hypertrophy. MethodsWild-type C57BL 6J mice， Sema3A global overexpressing （Sema3A/Cre-ER^TM） mice， and their littermate controls （Cre-ER^TM） were used， with 6 mice per group. A pressure-overload induced cardiac hypertrophy model was established via transverse aortic constriction （TAC）， with a sham-operated group （Sham） as the control. Cardiac hypertrophy was assessed by gross morphology， heart weight/body weight ratio （HW/BW）， heart weight/tibia length ratio （HW/HL）， and heart weight/lung weight ratio （HW/PW）. Cardiac function was evaluated by measuring ejection fraction （EF） and fractional shortening （FS） via echocardiography. In heart tissues， the mRNA level of atrial natriuretic peptide （ANP） and Sema3A were detected by RT-qPCR， Sema3A protein level was detected by western blot， morphological structure was detected by hematoxylin and eosin （HE） staining， level of fibrosis was detected by Masson’s trichrome staining， and angiogenesis was detected by immunohistochemical detection of CD31. For in vitro experiments， rat H9C2 cardiomyocytes were treated with angiotensin Ⅱ （Ang Ⅱ） to induce hypertrophy， with PBS-treated cells as the control. After 48 hours， the mRNA expression of ANP， B-type natriuretic peptide （BNP） and Sema3A were measured by RT-qPCR， and Sema3A protein level was assessed by western blot. ResultsAt the animal level， compared with the sham group， mice subjected to TAC showed significantly increased mRNA levels of ANP in cardiac tissue， as well as markedly elevated mRNA and protein levels of Sema3A （all P<0.05）. Compared with the Cre-ER^TM + TAC group， the Sema3A/Cre-ER^TM + TAC group exhibited more pronounced cardiac hypertrophy， greater ventricular wall thickening， higher HW/BW， HW/HL， and HW/PW ratios， more significant reductions in EF and FS， more severe cardiac fibrosis， and a significant decrease in cardiac CD31 expression levels （all P<0.05）. At the cellular level， compared with the control group， H9C2 cells treated with Ang Ⅱ displayed significantly increased mRNA levels of ANP and BNP， along with markedly elevated mRNA and protein levels of Sema3A （all P<0.05）. ConclusionSema3A promotes the progression of pressure overload-induced cardiac hypertrophy by inhibiting angiogenesis.

N-acetyl-p-aminophenol （APAP） is an antipyretic analgesic commonly used in clinical practice， and APAP overdose can cause severe liver injury and even death. In recent years， the incidence rate of APAP-induced liver injury （AILI） tends to increase， and it has become the second most common cause of liver transplantation worldwide. Autophagy is a highly conserved catabolic process that removes unwanted cytosolic proteins and organelles through lysosomal degradation to achieve the metabolic needs of cells themselves and the renewal of organelles. A large number of studies have shown that autophagy plays a key role in the pathophysiology of AILI， involving the mechanisms such as APAP protein conjugates， oxidative stress， JNK activation， mitochondrial dysfunction， inflammatory response and apoptosis. This article elaborates on the biological mechanism of autophagy in AILI， in order to provide a theoretical basis for the treatment of AILI and the development of autophagy regulators.

BACKGROUND:Cardiac dysfunction due to spinal cord injury is an important factor of death in patients with spinal cord injury;however,the specific mechanism is still not clear.Therefore,revealing the mechanism of cardiac dysfunction in spinal cord injury patients is of great significance to improve their quality of life and survival rate. OBJECTIVE:To investigate the mechanism of luteolin in improving serum-induced myocardial cell death in spinal cord injury rats. METHODS:Allen's impact instrument was used to damage the spine T9-T11 of male SD rats to establish a spinal cord injury model meanwhile a sham operation group was set as the control group.The serum of rats of each group was collected.H9c2 cells were divided into a blank control group,a sham operated rat serum group,a spinal cord injury rat serum group and a luteolin pretreatment group.The cells in blank control group were only cultured with ordinary culture medium.The cells in the sham operated rat serum group were treated with medium containing 10%serum from sham operated rat.The cells in the spinal cord injury rat serum group were treated with medium containing 10%serum from spinal cord injury rat.The cells in the luteolin pretreatment group were precultured with a final concentration of 20 μmol/L luteolin for 4 hours and then changed to a medium containing 10%rat serum from spinal cord injury rat.After 24 hours of culture,the survival rate of each group of H9c2 cells was measured by CCK-8 assay.Western blot assay was used to detect the expression of autophagy related protein LC3 and p62 in H9c2 cells in each group. RESULTS AND CONCLUSION:Compared with the blank control group,there was no significant change in cell survival rate in the sham operated rat serum group(P>0.05).Compared with the sham operated rat serum group,the cell survival rate(P<0.01)and the expression of LC3 protein(P<0.05)in spinal cord injury rat serum group was significantly reduced,and the expression of p62 protein was significantly increased(P<0.05).Compared with the spinal cord injury rat serum group,the survival rate of cells in the luteolin pretreatment group significantly increased(P<0.000 1);the expression of LC3 protein significantly increased(P<0.05),and the expression of p62 protein significantly decreased(P<0.05).The results indicate that luteolin may improve myocardial cell death induced by serum from rats with spinal cord injury by promoting autophagy.

Objective:To explore the clinical efficacy of endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic nasobiliary drainage (ENBD) in the treatment of acute obstructive suppurative cholangitis (AOSC).Methods:A total of 72 patients with AOSC admitted to Anqing Municipal Hospital from September 2021 to July 2023 were selected prospectively, and they were divided into two groups according to random number table method, each with 36 patients. The endoscopic group underwent ERCP+ENBD, while the surgical group underwent laparoscopic common bile duct exploration (LCBDE). The treatment effectiveness, clinical symptom improvement time, liver function indicators, inflammatory factors and complications between the two groups were compared.Results:The total effective rate in the endoscopic group was higher than that in the surgical group: 97.22% (35/36) vs. 77.78% (28/36), there was statistical difference ( χ2 = 4.57, P<0.05). The disappearance time of abdominal pain, recovery time of gastrointestinal function, and hospitalization time in the endoscopic group were shorter than those in the surgical group: (2.76 ± 0.65) d vs. (3.35 ± 0.72) d, (3.08 ± 0.83) d vs. (5.13 ± 1.07) d, (8.45 ± 1.26) d vs. (10.69 ± 1.48) d, there were statistical differences ( P<0.05). The levels of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), glutamyltranspeptidase (GGT), procalcitonin (PCT), C-reactive protein (CRP) in the two groups befor surgery had no statistical differences ( P>0.05). The levels of ALT, AST, GGT, PCT and CRP were decreased at 24 and 48 h after surgery in both groups, and the above indexes in the endoscopic group were lower than those in the surgical group: at 24 h after surgery: (42.18 ± 5.12) U/L vs. (48.53 ± 6.06) U/L, (60.25 ± 8.57) U/L vs. (69.13 ± 10.13) U/L, (155.74 ± 24.61) U/L vs. (171.45 ± 20.85) U/L, (2.67 ± 0.40) μg/L vs. (3.09 ± 0.52) μg/L, (38.72 ± 5.21) mg/L vs. (44.16 ± 7.83) mg/L; at 48 h after surgery: (34.22 ± 4.74) U/L vs. (39.17 ± 5.83) U/L, (34.10 ± 5.18) U/L vs. (38.52 ± 6.06) U/L, (124.57 ± 20.53) U/L vs. (147.82 ± 16.81) U/L, (1.13 ± 0.27) μg/L vs. (1.46 ± 0.33) μg/L, (20.14 ± 3.75) mg/L vs. (27.39 ± 5.28) mg/L, there were statistical differences ( P<0.05). The complications between the two groups had no statistical difference ( P>0.05). Conclusions:ERCP + ENBD in the treatment of AOSC patients can significantly improve the clinical efficacy, alleviate inflammatory reactions, improve liver function, promote disease recovery, and have high safety.

Objective:To evaluate corrective effect of cone beam computed tomography(CBCT)in children with malocclusion during mixed dentition period.Methods:A total of 90 children with malocclusion during mixed dentition period who admitted to 3201th hospital between January and December 2023 were enrolled,and all of them underwent routine orthodontics.Before and after treatment,CBCT scan was performed to obtain oral and maxillofacial imaging data.According to measurement and analysis for imaging data,the corrective effect,the relation indicators between sagittal and vertical directions of jawbone,which included the constructed angle among the center point of sella turcica-nasion-superior alveolar seat(SNA),the constructed angle among the center point of sella turcica-nasion-inferior alveolar seat(SNB),the constructed angle among superior alveolar seat-nasion-inferior alveolar seat(ANB),the constructed angle between occlusal plane and sella-nasion plane(OP-SN),the angle between mandibular plane and extended line of occlusal plane(SN-MP),were assessed.In addition,the other related mandibular indicators included the angle(Y axis angle)between Y axis and orbitoauricular plane,the angle of nasion A point line-orbitale-pterygomaxillary fissure line(NA-Apo),gonion-pogonion length(Go-Pg),the distance values(Wits)between anterior nasal crest and orbitomeatal plane,and between posterior nasal crest and orbitomeatal plane also were assessed.Third,the soft tissue-related indicators,which included the distance(UL-EP)between upper lip protrusion point,nasal protrusion point and soft tissue line,and the distance(LL-EP)between lower lip protrusion point,nasal protrusion point and soft tissue line,and the nasal labial angle(NLA),the lower intersection angle between the line connecting the nasal columella point and the infranasal point,and the lower intersection angle between the line connecting the nasal columella point and upper lip protrusion point,and the angle(H)between H line and soft tissue surface angle,were assessed.Finally,the dentally relative indicators,which included incisor mandibular plane angle(IMPA angle),upper central incisor-sella nasion plane angle(U1-SN),upper central incisor-nasion appoint angle(U1-NA),lower central incisor-nasion B point angle(L1-NB),overbite and coverage,were also assessed.Results:In the 90 children with malocclusion during mixed dentition period after treatment,25 cases(27.78%)were cured,and 56 cases obtained effective treatment(62.22%)and 9 cases(10.00%)did not obtain effective treatment,and effective rate of correction was 90.00%.There was not significant change in SNB angle between before and after treatment,and the difference was not statistically significant(P>0.05).Compared with the indicators before treatment,OP-SN was decreased,while SN-MP,SNA and ANB were all increased after treatment,and the differences were statistically significant(t=6.402,6.135,3.753,50.965,P<0.05).There were not significant changes in Y-axis angle,Wits value,S-Go/N-Me and L1-NB angle between before and after treatment,and the differences were not statistically significant(P>0.05).Compared with the indicators before treatment,the NA-Apo and Go-Pg were increased after treatment,and the differences were statistically significant(t=46.885,7.575,P<0.05).Compared with the indicators before treatment,the NLA,H angle and UL-EP were increased,while LL-EP was decreased after treatment,and the differences were statistically significant(t=2.707,4.163,28.622,3.276,P<0.05).There was not significant change in L1-NB between before and after treatment,and the difference was not statistically significant(P>0.05).Compared with the indicators before treatment,the coverage,U1-SN and U1-NA were increased,while overbite and IMPA were decreased,and the differences were statistically significant(t=16.154,4.723,6.432,4.802,4.106,P<0.05).Conclusion:CBCT can clearly and accurately display three-dimensional morphology and changes of maxillofacial structure of oral cavity,which can provides comprehensive and reliable basis for the assessment for correction effect.Moreover,orthodontic treatment has positive significance in improving dentition occlusion relationship,guiding normal development of jawbone,and optimizing morphology of facial soft tissues,which can provide important reference for the formulation and optimization of the treatment scheme of clinical orthodontics.

Objective To retrieve,evaluate and summarize the best evidence for blood glucose monitoring and management in patients with diabetes of the exocrine pancreas(DEP),and to provide evidence-based basis for clinical practice.Methods According to the"6S"evidence model,relevant evidence on blood glucose management in patients with DEP was searched from computer decision support systems,guideline networks,professional association websites and databases from top to bottom,covering clinical decision-making,clinical practice guidelines,evidence summaries,systematic reviews,expert consensuses,and randomized controlled trials.The search scope was from the establishment of the databases to June 30,2024.Totally 2 researchers independently evaluated the quality of the included literature,and extracted data and summarized evidence that met the criteria.Results A total of 10 articles were included,including 3 guidelines,1 expert consensus,2 systematic reviews,l clinical decision,1 RCT,and 2 cohort studies.Finally,26 pieces of best evidence were formed from 5 aspects,including blood glucose management team construction and goals,blood glucose monitoring methods,glucose control medication management,lifestyle health education and treatment of hypoglycemia.Conclusion This study summarizes the best evidence for blood glucose monitoring and management in DEP patients,which can provide resource preparation for clinical translation and a basis for medical staff to carry out blood glucose management in DEP patients.