Objective To investigate the efficacy of Lactobacillus plantarum ZG03(L.plantarum ZG03)for ameliorating oxidative stress in zebrafish.Methods We evaluated the growth pattern of L.plantarum ZG03,observed its morphology using field emission scanning electron microscopy,and assessed its safety and potential efficacy with whole-genome sequencing for genetic analysis.FITC-labeled ZG03 was used to observe its intestinal colonization in zebrafish.In a zebrafish model of 2%glucose-induced oxidative stress,the effect of ZG03 was evaluated by assessing the changes in neutrophils in the caudal hematopoietic tissue(CHT),superoxide dismutase(SOD)activity,reactive oxygen species(ROS)levels,and malondialdehyde(MDA)content.Liquid chromatography-mass spectrometry-based targeted metabolomics was used for analyzing short-chain fatty acids(SCFAs)in the zebrafish,and the antioxidant effects of the key metabolites(acetate,propionate,and caproate)were tested.Results On MRS agar,L.plantarum ZG03 formed circular,smooth,moist,and milky-white colonies with a rod-shaped cell morphology.Genomic analysis revealed abundant sugar metabolism gene clusters.After inoculation of FITC-labeled L.plantarum ZG03 in zebrafish,green fluorescence was clearly observed in the intestinal bulb,mid-intestine,and hind intestine.In zebrafish with glucose-induced oxidative stress,L.plantarum ZG03 significantly reduced ROS levels and the number of neutrophils in the CHT with increased SOD activity.L.plantarum ZG03 significantly increased the content of SCFAs including acetic acid,propionic acid,and caproic acid in zebrafish metabolites.In addition,sodium acetate,sodium propionate,and sodium caproate in the SCFAs significantly increased SOD activity in the zebrafish models.Conclusion L.plantarum ZG03 ameliorates oxidative stress in a glucose-induced zebrafish model through its metabolites,particularly the SCFAs including acetic acid,propionic acid and caproic acid.

OBJECTIVES: To investigate the efficacy of Lactobacillus plantarum ZG03 (L. plantarum ZG03) for ameliorating oxidative stress in zebrafish. METHODS: We evaluated the growth pattern of L. plantarum ZG03, observed its morphology using field emission scanning electron microscopy, and assessed its safety and potential efficacy with whole-genome sequencing for genetic analysis. FITC-labeled ZG03 was used to observe its intestinal colonization in zebrafish. In a zebrafish model of 2% glucose-induced oxidative stress, the effect of ZG03 was evaluated by assessing the changes in neutrophils in the caudal hematopoietic tissue (CHT), superoxide dismutase (SOD) activity, reactive oxygen species (ROS) levels, and malondialdehyde (MDA) content. Liquid chromatography-mass spectrometry-based targeted metabolomics was used for analyzing short-chain fatty acids (SCFAs) in the zebrafish, and the antioxidant effects of the key metabolites (acetate, propionate, and caproate) were tested. RESULTS: On MRS agar, L. plantarum ZG03 formed circular, smooth, moist, and milky-white colonies with a rod-shaped cell morphology. Genomic analysis revealed abundant sugar metabolism gene clusters. After inoculation of FITC-labeled L. plantarum ZG03 in zebrafish, green fluorescence was clearly observed in the intestinal bulb, mid-intestine, and hind intestine. In zebrafish with glucose-induced oxidative stress, L. plantarum ZG03 significantly reduced ROS levels and the number of neutrophils in the CHT with increased SOD activity. L.plantarum ZG03 significantly increased the content of SCFAs including acetic acid, propionic acid, and caproic acid in zebrafish metabolites. In addition, sodium acetate, sodium propionate, and sodium caproate in the SCFAs significantly increased SOD activity in the zebrafish models. CONCLUSIONS L. plantarum ZG03 ameliorates oxidative stress in a glucose-induced zebrafish model through its metabolites, particularly the SCFAs including acetic acid, propionic acid and caproic acid.
Animals ; Zebrafish/metabolism* ; Oxidative Stress ; Lactobacillus plantarum/metabolism* ; Fatty Acids, Volatile/metabolism* ; Probiotics ; Reactive Oxygen Species/metabolism* ; Superoxide Dismutase/metabolism*

Objective To perform an economic evaluation of ilaprazole in the treatment of patients with peptic ulcer bleeding and low-risk stigmata,and to provide a reference for drug selection.Methods From a societal perspective,we used decision analysis to evaluate the cost and effectiveness of ilaprazole and omeprazole in treating peptic ulcer bleeding patients dur-ing hospital stays.The probabilities of model nodes were taken from phase Ⅲ clinical trial research results,while cost data came from national medical insurance prices,published literature,and hospital databases.Sensitivity analysis and scenario analysis were performed to test the stability of the results.Results A cost minimization analysis was performed.Under the basic setting,the cost of the ilaprazole group was 4 038.99 yuan,and that of the omeprazole group was 3 837.61 yuan,which means that the cost of the ilaprazole group was 201.38 yuan higher.Sensitivity analysis showed that the results were stable.Scenario analysis showed that ilaprazole was more cost-effective than the innovator drug of omeprazole.Conclusion Ilaprazole was less economical than ome-prazole in the treatment of peptic ulcer bleeding patients with low-risk stigmata.

Objective To perform an economic evaluation of ilaprazole in the treatment of patients with peptic ulcer bleeding and low-risk stigmata,and to provide a reference for drug selection.Methods From a societal perspective,we used decision analysis to evaluate the cost and effectiveness of ilaprazole and omeprazole in treating peptic ulcer bleeding patients dur-ing hospital stays.The probabilities of model nodes were taken from phase Ⅲ clinical trial research results,while cost data came from national medical insurance prices,published literature,and hospital databases.Sensitivity analysis and scenario analysis were performed to test the stability of the results.Results A cost minimization analysis was performed.Under the basic setting,the cost of the ilaprazole group was 4 038.99 yuan,and that of the omeprazole group was 3 837.61 yuan,which means that the cost of the ilaprazole group was 201.38 yuan higher.Sensitivity analysis showed that the results were stable.Scenario analysis showed that ilaprazole was more cost-effective than the innovator drug of omeprazole.Conclusion Ilaprazole was less economical than ome-prazole in the treatment of peptic ulcer bleeding patients with low-risk stigmata.

Objective:To develop a network-structured clinical pathway grouping rule based on the principles and methods of China healthcare security diagnosis related groups(CHS-DRG), for references for optimizing clinical pathway management.Methods:From August to November 2024, this study constructed a network-structured clinical pathway management framework, followed the grouping principles of CHS-DRG, and developed a network-structured clinical pathway grouping rule through literature analysis and expert discussions. 54 clinical specialists from the sample hospital were organized and grouped according to the rule for the normal magnification cases(139 218 cases) of DRG medical insurance settlement in the hospital in 2023. Using a stratified random sampling method, 205 physicians from 54 clinical specialties in the hospital were selected to quantitatively evaluate the rationality, homogeneity, and clarity of the grouping results. The Likert 5-level scoring method was wsed to assign scores.Results:The network-structured clinical pathway grouping rule and nomenclature was established. A total of 341 main pathways and 35 sub-pathways covering 169 adjacent diagnosis related groups were formed. The quantitative assessment scores for rationality, homogeneity, and clarity were 4.90, 4.87 and 4.87 points, respectively.Conclusions:The network-structured clinical pathway grouping rule based on CHS-DRG had good, feasibility and standardization, and could meet the practical needs of clinical applications.

Objective To translate the Health Behavior Scale for Cancer Patients(HBSCP)into Chinese and conduct reliability and validity tests.The measurement invariance of the Chinese version of the scale among differ-ent cancer patients was measured to form a health behavior scale suitable for assessing cancer patients in China.Methods The original scale was translated and translated back according to the Brislin translation model.The Chinese version of the HBSCP was formed through cross-cultural adaptation and pre-test.A questionnaire survey was conducted on 600 cancer patients from 2 tertiary A hospitals in Tianjin and Nanchang from February to July 2024 by convenience sampling method to test the reliability,validity,and measurement invariance of the Chinese version of the HBSCP.Results 567 valid questionnaires were collected.The Chinese version of the HBSCP in-cludes 9 items with 2 factors.Confirmatory factor analysis supported the 2-factor model,and all indexes meet the ideal fitting standard.The factor load of each item on the scale ranged from 0.697 to 0.815.The composite relia-bility of the 2 dimensions was 0.815 and 0.874.Average variance extracted was 0.656 and 0.526.The Chinese version of the HBSCP was positively correlated with Health Promoting Lifestyle Profile-Ⅱ(r=0.760,P＜0.001).The con-tent validity index of items ranges of the scales from 0.930 to 1.000,and the content validity index/average of the scales was 0.993.The total Cronbach's alpha coefficient of the scale was 0.900,and the two-factor Cronbach's alpha coefficient was 0.849 and 0.873,respectively.The scale has measurement invariance in the equivalence test for 3 clusters of lung,gastrointestinal,and gynecologic cancers.Conclusion The Chinese version of the HBSCP has good reliability and validity and measurement invariance across cancer types,and can be used to measure the health behavior level of cancer patients.

Objective To translate the Health Behavior Scale for Cancer Patients(HBSCP)into Chinese and conduct reliability and validity tests.The measurement invariance of the Chinese version of the scale among differ-ent cancer patients was measured to form a health behavior scale suitable for assessing cancer patients in China.Methods The original scale was translated and translated back according to the Brislin translation model.The Chinese version of the HBSCP was formed through cross-cultural adaptation and pre-test.A questionnaire survey was conducted on 600 cancer patients from 2 tertiary A hospitals in Tianjin and Nanchang from February to July 2024 by convenience sampling method to test the reliability,validity,and measurement invariance of the Chinese version of the HBSCP.Results 567 valid questionnaires were collected.The Chinese version of the HBSCP in-cludes 9 items with 2 factors.Confirmatory factor analysis supported the 2-factor model,and all indexes meet the ideal fitting standard.The factor load of each item on the scale ranged from 0.697 to 0.815.The composite relia-bility of the 2 dimensions was 0.815 and 0.874.Average variance extracted was 0.656 and 0.526.The Chinese version of the HBSCP was positively correlated with Health Promoting Lifestyle Profile-Ⅱ(r=0.760,P＜0.001).The con-tent validity index of items ranges of the scales from 0.930 to 1.000,and the content validity index/average of the scales was 0.993.The total Cronbach's alpha coefficient of the scale was 0.900,and the two-factor Cronbach's alpha coefficient was 0.849 and 0.873,respectively.The scale has measurement invariance in the equivalence test for 3 clusters of lung,gastrointestinal,and gynecologic cancers.Conclusion The Chinese version of the HBSCP has good reliability and validity and measurement invariance across cancer types,and can be used to measure the health behavior level of cancer patients.

Objective:To develop a network-structured clinical pathway grouping rule based on the principles and methods of China healthcare security diagnosis related groups(CHS-DRG), for references for optimizing clinical pathway management.Methods:From August to November 2024, this study constructed a network-structured clinical pathway management framework, followed the grouping principles of CHS-DRG, and developed a network-structured clinical pathway grouping rule through literature analysis and expert discussions. 54 clinical specialists from the sample hospital were organized and grouped according to the rule for the normal magnification cases(139 218 cases) of DRG medical insurance settlement in the hospital in 2023. Using a stratified random sampling method, 205 physicians from 54 clinical specialties in the hospital were selected to quantitatively evaluate the rationality, homogeneity, and clarity of the grouping results. The Likert 5-level scoring method was wsed to assign scores.Results:The network-structured clinical pathway grouping rule and nomenclature was established. A total of 341 main pathways and 35 sub-pathways covering 169 adjacent diagnosis related groups were formed. The quantitative assessment scores for rationality, homogeneity, and clarity were 4.90, 4.87 and 4.87 points, respectively.Conclusions:The network-structured clinical pathway grouping rule based on CHS-DRG had good, feasibility and standardization, and could meet the practical needs of clinical applications.

Objective To explore the effect of intestinal nitrates on the growth of Klebsiella pneumoniae and its regulatory mechanisms. Methods K. pneumoniae strains with nitrate reductase narG and narZ single or double gene knockout or with NarXL gene knockout were constructed and observed for both aerobic and anaerobic growth in the presence of KNO3 using an automated bacterial growth analyzer and a spectrophotometer, respectively. The mRNA expressions of narG and narZ in K. pneumoniae in anaerobic cultures in the presence of KNO3 and the effect of the binary regulatory system NarXL on their expresisons were detected using qRT-PCR. Electrophoretic mobility shift assays (EMSA) and MST analysis were performed to explore the specific regulatory mechanisms of NarXL in sensing and utilizing nitrates. Competitive experiments were conducted to examine anaerobic growth advantages of narG and narZ gene knockout strains of K. pneumoniae in the presence of KNO3. Results The presence of KNO3 in anaerobic conditions, but not in aerobic conditions, promoted bacterial growth more effectively in the wild-type K. pneumoniae strain than in the narXL gene knockout strain. In anaerobic conditions, the narXL gene knockout strain showed significantly lowered mRNA expressions of narG and narZ (P<0.0001). EMSA and MST experiments demonstrated that the NarXL regulator could directly bind to narG and narZ promoter regions. The wild-type K. pneumoniae strain in anaerobic cultures showed significantly increased expressions of narG and narZ mRNAs in the presence of KNO3 (P<0.01), and narG gene knockout resulted in significantly attenuated anaerobic growth and competitive growth abilities of K. pneumoniae in the presence of KNO3 (P<0.01). Conclusion The binary regulatory system NarXL of K. pneumoniae can sense changes in intestinal nitrate concentration and directly regulate the expression of nitrate reductase genes narG and narZ to promote bacterial growth.

Objective To explore the effect of intestinal nitrates on the growth of Klebsiella pneumoniae and its regulatory mechanisms. Methods K. pneumoniae strains with nitrate reductase narG and narZ single or double gene knockout or with NarXL gene knockout were constructed and observed for both aerobic and anaerobic growth in the presence of KNO3 using an automated bacterial growth analyzer and a spectrophotometer, respectively. The mRNA expressions of narG and narZ in K. pneumoniae in anaerobic cultures in the presence of KNO3 and the effect of the binary regulatory system NarXL on their expresisons were detected using qRT-PCR. Electrophoretic mobility shift assays (EMSA) and MST analysis were performed to explore the specific regulatory mechanisms of NarXL in sensing and utilizing nitrates. Competitive experiments were conducted to examine anaerobic growth advantages of narG and narZ gene knockout strains of K. pneumoniae in the presence of KNO3. Results The presence of KNO3 in anaerobic conditions, but not in aerobic conditions, promoted bacterial growth more effectively in the wild-type K. pneumoniae strain than in the narXL gene knockout strain. In anaerobic conditions, the narXL gene knockout strain showed significantly lowered mRNA expressions of narG and narZ (P<0.0001). EMSA and MST experiments demonstrated that the NarXL regulator could directly bind to narG and narZ promoter regions. The wild-type K. pneumoniae strain in anaerobic cultures showed significantly increased expressions of narG and narZ mRNAs in the presence of KNO3 (P<0.01), and narG gene knockout resulted in significantly attenuated anaerobic growth and competitive growth abilities of K. pneumoniae in the presence of KNO3 (P<0.01). Conclusion The binary regulatory system NarXL of K. pneumoniae can sense changes in intestinal nitrate concentration and directly regulate the expression of nitrate reductase genes narG and narZ to promote bacterial growth.