Objective To analyze the types and distribution of microbiome in intestinal and lung tissues of children with asthma, and to explore the correlation between microbiota changes and asthma. Methods From 2021 to 2023, a total of 28,939 children with asthma who visited Ezhou Central Hospital, Maternal and Child Health Hospital or Ezhou Egang Hospital were selected as the study subjects, and 2,000 healthy children who underwent outpatient physical examinations at these three hospitals during the same period were selected as the control group. The distribution and characteristics of intestinal and pulmonary microbiome in the two groups were analyzed by 16SrDNA sequencing. Logistic regression analysis model was used to analyze the correlation between microbiota distribution and asthma occurrence. Results In the intestinal tissues of children with asthma compared to healthy children, the abundance of Bacteroidetes at the phylum level decreased, while the abundance of Firmicutes and Proteobacteria increased significantly (P<0.05), and the abundance of Prevotalle and Clostridium at the genus level increased significantly. In lung tissues of asthmatic children compared to health children, the abundance of Firmicutes at the phylum level decreased while the abundance of Proteobacteria increased significantly (P<0.05), and the abundance of Neisseria, Prevotella and Actinomyces at the genus level increased significantly. Binary logistic regression results showed that the abundances of Lactobacillus (OR=0.842, 95% CI: 0.533-0.947), Bacteroides fragilis (OR=0.649, 95%CI: 0.377-0.890), Bifidobacterium (OR=0.901, 95% CI: 0.633-0.994), and Parabacteroides distasonis (OR=0.547, 95% CI: 0.192-0.708) in the intestinal tissues were all protective factors for the asthma in children. In the lung tissue, the abundance of Neisseria (OR=2.140, 95% CI: 1.749-3.305) was a risk factor for the asthma in children, and Prevotella (OR=0.691, 95% CI: 0.491-0.926) was a protective factor for the asthma in children (P<0.05). Conclusion The dysbiosis of intestinal and pulmonary microbiome is closely related to the occurrence of asthma in children, and the detection of microbiota is of great significance for the diagnosis of childhood asthma.

ObjectiveTo investigate the mechanism of Xuefu Zhuyu capsules against atherosclerosis via regulating polarization of macrophages based on Notch1/jagged canonical Notch ligand 1（Jagged1）/Hes family BHLH transcription factor 1（Hes1） signaling pathway. MethodThe mouse models with atherosclerosis were prepared by feeding the mice with an ApoE^-/- high-fat diet for four weeks， and they were randomly divided into the model group， Xuefu Zhuyu capsule group， and atorvastatin group. C57BL/6 mice were fed as a normal group. The Xuefu Zhuyu capsule group was intragastrically given Xuefu Zhuyu capsules （0.728 g·kg^-1·d^-1）， and the atorvastatin group was intragastrically given atorvastatin tablet （6.07 mg·kg^-1·d^-1）. The normal group and the model group were given equal volume of the deionized water by intragastric administration， and the intervention lasted for 12 weeks. Aortic plaque morphology was observed by hematoxylin-eosin （HE） staining， and aortic plaque area and lipid deposition were observed by oil red O staining. The positive expression levels of CD86 and CD206 in aortic tissue were detected by immunohistochemistry， and serum levels of tumor necrosis factor （TNF）-α， interleukin（IL）-1β， transforming growth factor （TGF）-β₁， and IL-10 were detected by enzyme-linked immunosorbent assay （ELISA）. The relative mRNA expressions of inducible nitric oxide synthase （iNOS）， arginase-1 （Arg-1）， Notch1， Jagged1， and Hes1 in aortic tissue were detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. The relative protein expression of iNOS， Arg-1， Notch1， Jagged1， and Hes1 in aortic tissue was detected by Western blot. ResultCompared with the normal group， the model group had significant aortic plaque and lipid deposition， and the expression levels of pro-inflammatory cytokines TNF-α and IL-1β were increased （P<0.01）. The expression level of anti-inflammatory cytokine TGF-β₁ showed a downward trend， but the difference was not statistically significant. The mRNA and protein expressions of iNOS were increased （P<0.01）. The protein expression of Arg-1 was decreased （P<0.01）， and the mRNA expression of related pathway molecule Jagged1， as well as the protein expressions of Notch1， Jagged1， and Hes1 were increased in the model group （P<0.05， P<0.01）. Compared with those in the model group， the plaque area and lipid deposition had a decreasing trend in the Xuefu Zhuyu capsule group， and the expressions of TNF-α and IL-1β showed a downward trend. The expression of TGF-β₁ was increased （P<0.05）， and the expression of macrophage marker CD86 was decreased. The mRNA and protein expressions of iNOS were decreased （P<0.01）. The mRNA and protein expressions of Arg-1 were increased （P<0.05， P<0.01）. Furthermore， the mRNA and protein expressions of Notch1， Jagged1， and Hes1 were decreased （P<0.01）. ConclusionXuefu Zhuyu capsules can reduce aortic plaque area and lipid deposition in mice with atherosclerosis， alleviate inflammation， inhibit M1 macrophages， and promote the expression of M2 macrophages， and the mechanism may be related to the regulation of Notch1/Jagged1/Hes1 signaling pathway.

Objective To investigate the relationship between the expression levels of thyroid transcription factor-1(TTF-1)and Galectin-3 in differentiated thyroid carcinoma(DTC)tissues and clinical manifestations and prognosis of patients.Methods A total of 76 DTC patients admitted to the hospital from January 1,2017 to May 30,2020 were selected as the study objects.Cancer tissue specimens obtained during surgery were in-cluded in the DTC group(n=76),and corresponding paracancer tissue specimens were included in the para-cancer group(n=76).The expressions of TTF-1 and Galectin-3 in DTC group and paracancer group were de-tected by immunohistochemistry,and the relationship between the expression levels of TTF-1 and Galectin-3 and the clinicopathological characteristics of DTC patients was analyzed.Multivariate Cox regression analysis was used to investigate the prognostic factors of DTC patients.Results The positive expression rates of TTF-1 and Galectin-3 in DTC group were higher than those in paracancer group,and the difference was statistically significant(P＜0.05).The TTF-1 positive expression rate and Galectin-3 positive expression rate in DTC pa-tients with TNM stage Ⅲ to Ⅳ,low differentiation,tissue type of papillary thyroid carcinoma and lymph node metastasis were higher than those in DTC patients with TNM stage Ⅰ to Ⅱ,medium/high differentiation,tis-sue type of thyroid follicular carcinoma and no lymph node metastasis.The difference was statistically signifi-cant(P＜0.05).The 3-year overall survival rate of TTF-1 negative and Galectin-3 negative DTC patients was higher than that of TTF-1 positive and Galectin-3 positive DTC patients,and the difference was statistically significant(P＜0.05).Multivariate Cox regression analysis showed that lymph node metastasis,positive TTF-1 and positive Galectin-3 were prognostic factors in DTC patients(P＜0.05).Conclusion TTF-1 and Galectin-3 are related to TNM stage,differentiation degree,tissue type,lymph node metastasis and 3-year sur-vival rate of DTC patients,and have important reference value for the diagnosis and prognosis evaluation of DTC patients.

Objective To investigate the role of H9c2-derived exosomes in regulating angiogenesis in rat cardiomyocytes under hypoxia.Methods The hypoxia model of H9c2 cells was prepared by mixed gas method(the hypoxia model group),and the normal cultured cells were used as the control group.The exosomes secreted by the two groups of cells were extracted respectively.The concentration and particle size of exosomes were detected by nanoparticle tracking analysis.The morphology and size of exosomes were detected by transmission electron microscopy.Western blot assay was used to verify the exosome marker proteins.The hypoxia model of human umbilical vein endothelial cells(HUVEC)was established.HUVECs were incubated with H9c2 exosomes and divided into the normoxia group,the hypoxia group,the hypoxia+normal H9c2 exosomes(EXO-C)group and the hypoxia+hypoxia H9c2 exosomes(EXO-M)group.The proliferation,migration and tube formation of HUVECs were detected by CCK-8 method,cell scratch test and Matrigel in vitro three-dimensional forming test.Results The results of exosome identification showed that the particle concentration of H9c2 exosome samples was 1×107-1×1012 particles/mL and the particle size was 40-160 nm in the normoxia group and the hypoxia group.The morphological characteristics were spherical or saucer-like structure,uniform in size and complete in shape.Exosome marker proteins TSG101,CD63 and CD9 were expressed,and there was no expression of negative protein Calnexin.Compared with the normoxic group,the proliferation ability,migration area and migration rate of HUVEC were significantly decreased in the hypoxic group,and the length of tube,the number of branches and the number of nodes were decreased(P＜0.01).Compared with the hypoxia group,the proliferation ability of HUVEC cells was decreased,the migration area was decreased,the migration rate was decreased and the length and number of branches involved in tube formation were further decreased in the EXO-M group(P＜0.05).Compared with the EXO-C group,the proliferation ability of the EXO-M group decreased,the cell migration area decreased and the migration rate decreased(P＜0.01).Conclusion Exosomes derived from hypoxic H9c2 can inhibit the proliferation,migration and tube formation of HUVEC.

Objective:To retrieve, evaluate, and summarize evidence on the assessment and management of diarrhea in hematopoietic stem cell transplantation (HSCT) patients both domestically and internationally, providing evidence-based support for clinical practice.Methods:According to the "6S" model, guidelines, clinical decisions, recommended practices, evidence summaries, systematic reviews, and expert consensus related to the assessment and management of diarrhea in HSCT patients were systematically retrieved from relevant databases and websites both domestically and internationally. The search period was from January 1, 2013 to November 30, 2023. Seven researchers conducted literature screening, quality evaluation, evidence extraction, and summarization.Results:A total of 15 articles were included, including four guidelines, three clinical decisions, two recommended practices, one evidence summary, two systematic reviews, and three expert consensus. Thirty-one pieces of evidence were summarized from seven aspects of multidisciplinary management, risk factor management, assessment and monitoring, medication intervention, diet and nutrition management, health education, and daily management.Conclusions:The best evidence for HSCT patient assessment and management summarized can provide reference for clinical practice, and nursing staff should carefully apply evidence based on the actual situation of patients.

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. Fat accumulation "sensitizes" the liver to insult and leads to nonalcoholic steatohepatitis (NASH). G protein-coupled receptor 35 (GPR35) is involved in metabolic stresses, but its role in NAFLD is unknown. We report that hepatocyte GPR35 mitigates NASH by regulating hepatic cholesterol homeostasis. Specifically, we found that GPR35 overexpression in hepatocytes protected against high-fat/cholesterol/fructose (HFCF) diet-induced steatohepatitis, whereas loss of GPR35 had the opposite effect. Administration of the GPR35 agonist kynurenic acid (Kyna) suppressed HFCF diet-induced steatohepatitis in mice. Kyna/GPR35 induced expression of StAR-related lipid transfer protein 4 (STARD4) through the ERK1/2 signaling pathway, ultimately resulting in hepatic cholesterol esterification and bile acid synthesis (BAS). The overexpression of STARD4 increased the expression of the BAS rate-limiting enzymes cytochrome P450 family 7 subfamily A member 1 (CYP7A1) and CYP8B1, promoting the conversion of cholesterol to bile acid. The protective effect induced by GPR35 overexpression in hepatocytes disappeared in hepatocyte STARD4-knockdown mice. STARD4 overexpression in hepatocytes reversed the aggravation of HFCF diet-induced steatohepatitis caused by the loss of GPR35 expression in hepatocytes in mice. Our findings indicate that the GPR35-STARD4 axis is a promising therapeutic target for NAFLD.

【Objective】 To investigate the situation of whole blood collection in Tianjin after COVID-19 prevention and control measures were fully lifted. 【Methods】 The relevant data on whole blood collection of voluntary blood donors in Tianjin 15 days before Spring Festival (2023.01.07-2023.01.21, when China has managed COVID-19 with measures against Class B infectious disease instead of Class A infectious diseases) and 15 days before Spring Festival in 2018 (2018.02.01- 2018.02.15) and 2019 (2019.01.21-2019.02.04) before the breakout of COVID-19 were retrospectively collected and compared. 【Results】 The comparison between the above period in 2023, 2018 and 2019 was as follows: the number of blood donors was 6 124 vs 3 940 vs 4 069; blood collection volume (U) was 9 623 vs 7 378 vs 7 808; the proportion of first-time blood donors, local blood donors and group blood donors was 69.17% (4 236/6 124) vs 65.86% (2 595/3 940) vs 62.05% (2 525/4 069), 59.31% (3 632/6 124) vs 23.27% (9170) vs 18.19% (740/4 069) and 43.42% (2 659/6 124) vs 8.05% (317/2 595) vs 0.15% (6/4 069) (all P<0.05). 【Conclusion】 The adjustment of COVID-19 prevention and control policy has a significant impact on voluntary blood donation, and the corresponding adjustment of blood donor recruitment strategy in blood centers should be conducted to increase the whole blood collection.

Objective To develop the Quality of Life Scale for Patients with Aplastic Anemia(QLS-AA)and to test its reliability and validity.Methods According to the concept category and the four-dimensional model of quality of life,the scale item pool was initially constructed through literature review and qualitative interview.The draft of the QLS-AA was formed through expert inquiry,cognitive interviews and expert consultation.A questionnaire survey was conducted on 429 patients with aplastic anemia from the hematology departments of a tertiary general hospital in Zhejiang Province and a tertiary hematology hospital in Tianjin with the convenient sampling method from December 2021 to November 2022,and the item analysis and reliability,validity test of the pre-test scale were carried out.Results 422 valid questionnaires were collected,and the effective questionnaire recovery rate was 98.37％.3 common factors were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 66.113％.The scale level consensus content validity index was 0.821,the scale level average content validity index was 0.970,the item level content validity index was 0.833～1.000,and the correlation coefficient with SF-36 was 0.719.The Cronbach's α was 0.944,and the split half reliability was 0.882,and retest reliability was 0.931.The final QLS-AA includes 3 dimensions with 39 items.Conclusion The process of developing QLS-AA in this study is scientifically standardized,and the scale has good reliability and validity,which can effectively evaluate the quality of life for patients with aplastic anemia.

Objective: To investigate the effects of Helicobacter pylori (HP) radical treatment on diagnosis of early gastric cancer using conventional white light endoscopy (WLE), chromoendoscopy of indigo carmine dye added to acetic acid, and magnifying endoscopy with narrow band imaging (ME-NBI). Methods: Between January 2013 and March 2018, patients without HP (successful cured before six months) or with HP (no radical treatment for HP in recent 6 months), who underwent endoscopy examinations in the Department of Gastroenterology of Ezhou Hospital, People′s Hospital of Wuhan University or the Department of Gastroenterology of Union Hospital, Tongji Medical College Huazhong University of Science and Technology were enrolled in the study. Endoscopy examinations were performed according to the order of conventional WLE, chromoendoscopy using indigo carmine dye added to acetic acid, and ME-NBI. Among the patients finally diagnosed as early gastric cancer by histopathology, 120 patients without HP and 120 patients with HP were continuously collected, and included in the radical treatment group and the non-radical treatment group, respectively. Diagnostic reliabilities of WLE, chromoendoscopy, and ME-NBI for early gastric cancer between the two groups were statistically analyzed. Results: There were no statistical differences between the two groups in terms of hospital source (χ²=2.637, P=0.104), gender composition (χ²=0.074, P=0.785), mean age (t=0.582, P=0.561), and lesion morphology (χ²=0.179, P=0.914). The detection rates of early gastric cancer in the radical treatment group using WLE [75.0% (80/120) VS 81.7% (98/120), χ²=7.046, P=0.008], chromoendoscopy [57.5% (69/120) VS 93.3% (112/120), χ²=41.554, P<0.001], and ME-NBI [90.0% (108/120) VS 98.3% (118/120), χ²=7.585, P=0.006] were significantly lower than those in the non-radical treatment group. In the radical treatment group, chromoendoscopy had the lowest detection rate of early gastric cancer, followed by WLE (χ²=2.142, P=0.143) and ME-NBI (χ²=32.736, P<0.001), while ME-NBI had the highest detection rate of early gastric cancer, which higher than that of WLE (χ²= 19.247, P<0.001). Conclusion The diagnosis of early gastric cancer by WLE, chromoendoscopy using the indigo carmine dye added to acetic acid and ME-NBI becomes more difficult after radical treatment of HP. Among the above three endoscopic methods, ME-NBI has the highest diagnostic efficacy, and becomes the first choice for the clinical diagnosis of early gastric cancer after radical treatment of HP.

We hereby reported the clinical manifestations and genetic diagnosis of a rare case of congenital adrenal hyperplasia (CAH) caused by cytochrome P450 oxidoreductase ( POR ) gene mutation. The case was an 11-year-old girl presented with craniofacial and skeletal malformation such as a depressed nasal bridge, radiohumeral synostosis and camptodactyly in feet. Moreover, she was diagnosed with ambiguous genitalia, and her mother had obvious masculine features during pregnancy. Laboratory tests showed that the levels of peripheral blood progesterone, 17-hydroxyprogesterone and adrenocorticotrophic hormone (ACTH) had increased significantly, which were consistent with the symptom of CAH. Genetic testing revealed a complex heterozygous mutation in POR gene of maternally inherited c.744C>G (p.Tyr248Ter) and paternal inherited c.1370G>A (p.Arg457His). Therefore, she was diagnosed with cytochrome P450 oxidoreductase deficiency (PORD), which is a rare type of CAH. The patient received oral glucocorticoid therapy and underwent knee arthroplasty.