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.

OBJECTIVE To investigate the clinical characteristics of drug-induced liver injury （DILI） induced by glucagon- like peptide-1 receptor agonists （GLP-1RAs）， and to provide a reference for safe clinical medication. METHODS Using search terms such as “GLP-1”“GLP-1RAs”“semaglutide” “drug-induced liver injury”， relevant studies from PubMed， Embase， the Cochrane Library， CNKI， Wanfang Data and VIP were retrieved. Descriptive analysis was performed on cases of DILI induced by GLP-1RAs. RESULTS A total of 11 studies， comprising 11 patients， were included. Among them， 4 were male （36.4%） and 7 were female （63.6%）. Patient ages ranged from 17 to 64 years； 5 patients （45.5%） were between 50 and 65 years old. Six patients were treated for diabetes， and five for weight loss. Ten patients had underlying diseases. The shortest time to the onset of DILI was 5 days after medication， while the longest was approximately 180 days. The DILIs induced by GLP-1RAs were mainly hepatocellular injury type （6 cases）； severity levels included severe （3 cases）， moderate （6 cases）， and mild （2 cases）. Gastrointestinal symptoms and jaundice were the most common clinical manifestations. The association between DILI and GLP- 1RAs was assessed as “probable” in 10 cases and “possible” in 1 case. All 11 patients improved after drug discontinuation and （or） corresponding treatment. CONCLUSIONS DILI induced by GLP-1RAs is relatively concentrated in patients aged 50-65， with a higher incidence in females. The risk may be further increased in patients with underlying diseases. Clinical use of these agents should enhance pharmaceutical care， including identification of high-risk populations and patient education （especially symptom recognition）. When relevant symptoms appear， the drug should be discontinued immediately， with liver-protective therapy initiated when necessary， to ensure patient safety of drug use.

With the rapid development and widespread application of microwave technology,people's lives and work have been made more convenient.However,the health of those who are constantly exposed to complex microwave environments is also threatened.In recent years,many studies have found that long-term exposure to micro waves can cause damage to cognitive function.However,the damage mechanism has not been fully understood.This article reviews the research progress of microwave radiation on cognitive function in recent years,the damage mechanism,and the related drugs for protection and treatment,in order to provide references for research in this field.

Objective:To construct an exosome (EXO)-based nanosystem co-loaded with bovine serum albumin and isoquercitrin (BSA@ISO), and to investigate its protective mechanism against high glucose-induced damage in human retinal pigment epithelial cells (ARPE-19).Methods:EXO was extracted from ARPE-19 cells via ultracentrifugation, and the structure was observed using transmission electron microscopy (TEM). EXO markers were detected by Western blot.BSA@ISO nanoparticles were prepared using the oscillating synthesis method.A ROS-responsive EXO-based nanosystem co-loaded with BSA@ISO (BSA@ISO@EXO) was constructed using a membrane extruder.The particle size and zeta potential of BSA@ISO@EXO were measured and its morphology was observed by TEM.Chemical structure was analyzed using a spectrophotometer and infrared spectroscopy.Encapsulation efficiency and drug loading capacity were calculated using the differential method.Cells were divided into control group, model group, low-dose ISO nanosystem group (5 μmol/L ISO), medium-dose ISO nanosystem group (10 μmol/L ISO), high-dose ISO nanosystem group (20 μmol/L ISO), and pure ISO group.Cell viability at different time points was assessed using the CCK-8 assay.Apoptosis rate after 48 hours of culture was measured by flow cytometry.Levels of inflammatory factors tumor necrosis factor (TNF)-α and interleukin (IL)-1β in the cell supernatant were determined by ELISA, while activities of antioxidant enzymes glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) and the level of oxidative stress marker malondialdehyde (MDA) in the supernatant were measured using biochemical kits.Results:The BSA@ISO@EXO nanosystem exhibited a uniform spherical shape with an average particle size of approximately 39.6 nm.UV-visible and IR spectra showed characteristic absorption peaks of BSA, ISO and EXO.The encapsulation efficiency of the nanosystem was (76.6±5.0)%, the drug loading capacity was (10.3±0.6)%, and the 24-hour drug release rate reached 75.1%.CCK-8 assay showed that cell viability in all ISO nanosystem groups after 48-hour culture was significantly higher than that in the pure ISO group (all P<0.05). The ROS level was significantly lower in the medium-dose ISO group than in the pure ISO group ( P<0.01). The levels of TNF-α, IL-1β, and MDA were significantly lower and GSH-PX and SOD activities were significantly higher in the medium-dose ISO nanosystem group than those in the model and high-dose ISO nanosystem groups (all P<0.05). Conclusions:A stable BSA@ISO@EXO nanosystem was successfully constructed.This system enhances the antioxidant and anti-inflammatory effects by improving the bioavailability of ISO, offering a new strategy for the treatment of diabetic retinopathy.

Ulcerative colitis (UC) is a chronic inflammatory disease of unknown etiology, primarily involving the colon and rectum. Characterized by recurrent episodes and prolonged disease course, UC requires dynamic monitoring and evaluation. Current commonly used methods for disease monitoring and assessment include C-reactive protein (CRP), fecal calprotectin (FC), and colonoscopy. However, CRP lacks specificity, FC fails to effectively differentiate UC from Crohn's disease, while colonoscopy involves complex bowel preparation, is invasive, and suffers from poor patient compliance. Therefore, there is an urgent clinical need to identify non-invasive biological markers with high sensitivity and specificity for the diagnosis and evaluation of UC. Recent studies have demonstrated that anti-integrin αvβ6 autoantibodies hold significant value in the diagnosis, differential diagnosis, and disease assessment of UC, potentially emerging as an important clinical biomarker. This article reviews the research progress of anti-integrin αvβ6 autoantibodies in UC for reference.

Objective:To explore differences in the radiation-induced intestinal injury in mice exposed to ultra-high dose rate (FLASH) and conventional-dose-rate (CONV) pulsed X-ray irradiation in order to provide evidence for the application of ultra-high dose rate pulsed X-rays in gastrointestinal radiotherapy.Methods:Using the random number table method, 32 C57BL/6J mice were randomly divided into four groups: a sham irradiation group (SHAM), two conventional dose rate groups (CONV0.067 and CONV0.1), and an ultra-high dose rate group (F215), with each group containing eight mice. All groups, except SHAM, received a single 12 Gy abdominal X-ray irradiation at dose rates of 0.067, 0.1, and 215 Gy/s, respectively. At 3 d post-irradiation, histopathological (hematoxylin-eosin staining, HE staining), immunohistochemical, and Western blot analysis were performed to assess the histopathological markers and oxidative stress indicators of intestinal tissues, as well as relevant proteins involved in signaling pathways.Results:At 3 d post-irradiation, mice in all irradiation groups suffered from varying degrees of intestinal tissue degeneration and necrosis, epithelial cell shedding, villus shortening, and crypt loss ( t = 5.75, 8.79, 5.71, P < 0.05). Regarding oxidative stress, at 3 d post-irradiation, mice in the CONV0.067 and CONV0.1 groups showed significantly lower levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX), glutathione (GSH), and total antioxidant capacity (T-AOC) compared to those in the F215 group ( t = 7.06-10.64, P < 0.01). In contrast, their malondialdehyde (MDA) levels were significantly elevated ( t = 11.06, 8.31, P < 0.01), with no statistical significance observed between them and mice in the F215 group ( P > 0.05). Immunohistochemical and Western blot analyses indicated that at 3 d post-irradiation, mice in the three irradiation groups exhibited an upward trend in the Nrf2 and HO-1 protein levels and a downward trend in the Keap1 protein level compared to those in the SHAM group. Notably, statistical significance was observed between the F215 group and the two conventional dose rate groups ( t = 4.89-20.95, P < 0.05). These result were consistent with the prior changes in antioxidant markers. Conclusions:Ultra-high-dose-rate X-ray irradiation reduces acute RIII by alleviating oxidative stress and modulating the expression of the Keap1-Nrf2-HO-1 signaling pathway.

Objective:To explore the value of ultrasound imaging characteristics combined with clinical indicators in assessing the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC).Methods:A retrospective analysis was conducted for patients who underwent pancreatic contrast-enhanced ultrasound (CEUS) from September 2017 to October 2023 at Peking Union Medical College Hospital and were diagnosed with PDAC based on pathological findings. Various parameters were recorded, including CA19-9 levels, tumor size, location, morphologic features, echogenicity, presence of internal cystic components, dilatation of the main pancreatic duct, peripheral vascular invasion, CEUS characteristics, presence or absence of liver metastasis, and treatment methods. In April 2024, patient survival information was obtained through telephone follow-up or review of medical records. Based on the results of the cox regression model analysis, a nomogram model of the risk of death was developed. The receiver operating characteristic (ROC) curves were applied to evaluate the predictive efficacy of the model. The calibration curves were plotted to evaluate the accuracy of the model, and clinical decision curves were used to evaluate the clinical benefit of the model.Results:This study included a total of 207 patients with PDAC. As of April 2024, 71 patients were alive and 136 died, with a median survival time of 14 months (95% CI: 12 -17). Multivariate analysis confirmed that the elevated CA19-9 ( HR=1.689, 95% CI: 1.102-2.588), tumor size >4 cm ( HR=1.641, 95% CI: 1.159-2.322), taller-than-wide shapes ( HR=1.450, 95% CI: 1.019-2.065), incomplete hypo-enhancement ( HR=1.618, 95% CI: 1.100-2.380), and liver metastasis ( HR=1.687, 95% CI: 1.175-2.423) were independent risk factors for survival in patients with PDAC. A nomogram model was further constructed for 6-month, 12-month and 3-year survival of patients with PDAC. The areas under the ROC curve were 0.679, 0.705 and 0.815, respectively. The calibration curves suggested that the model was more accurate, and the clinical decision curves showed that the model had a better clinical benefit. Conclusion:The combined use of ultrasound imaging characteristics and clinical indicators could effectively predict the prognosis of PDAC patients. Specifically, tumor size >4 cm, taller-than-wide shapes, incomplete hypo-enhancement, elevated CA19-9, and the presence of liver metastasis are correlated with poorer survival outcomes. The nomogram model constructed on the basis of these factors can be used to assess the survival of patients with PDAC.

Objective:To observe the correlation between the level of advanced glycosylation end products (AGE) in skin and diabetic retinopathy (DR), and establish and preliminatively verify the nomogramolumbaric model for predicting the risk of DR.Methods:A clinical case-control study. A total of 346 patients with type 2 diabetes mellitus (T2DM) who were admitted to the Department of Endocrinology and Ophthalmology of the First Affiliated Hospital of Zhengzhou University from January 2023 to June 2024 were included in the study. Among them, 198 were males and 148 were females. The mean age was (54.77±10.92). According to whether the patients were accompanied by DR, the patients were divided into the non-DR group (NDR group) and the DR group (DR group), 174 and 172 cases, respectively. All patients underwent skin AGE detection using a noninvasive diabetes detector. Diabetes duration, hemoglobin A1c (HbA1c), fasting plasma glucose, Urea, creatinine (Crea), uric acid, total cholesterol, triglyceride, estimated glomerular filtration rate (eGFR), urinary albumin concentration (UALB), and body mass index (BMI) were collected in detail. Univariate analysis and multivariate logistic regression analysis were used to determine the independent risk factors for T2DM concurrent DR, and to construct a nomogram prediction model for DR risk. Receiver operating characteristic curve (ROC curve), calibration curve and decision curve (DCA) were used to evaluate the model.Results:Hypertension prevalence rate ( χ2=3.892), Diabetes duration ( Z=?7.708), BMI ( Z=?2.627), HbA1c ( Z=?4.484), Urea ( Z=?4.620), Crea ( Z=?3.526), UALB ( Z=?6.999), AGE ( Z=?8.097) in DR group were significantly higher than those in NDR group, with statistical significance ( P<0.05); eGFR was lower than that in NDR group, the difference was statistically significant ( Z=?6.061, P<0.05). Logistic regression analysis showed that AGE, diabetes duration, HbA1c, UALB and eGFR were independent risk factors for DR ( P<0.05). Based on the results of multi-factor regression analysis, a nomogram prediction model was constructed. The area under ROC curve of the model was 0.843, 95% confidence interval was 0.802-0.884, sensitivity and specificity were 79.1% and 75.9%, respectively. The calibration curve was basically consistent with the ideal curve. The results of DCA analysis showed that when the model predicted the risk threshold of patients with DR between 0.17 and 0.99, the clinical net benefit provided by the nomogram model was> 0. Conclusions:Skin AGE level is an independent risk factor for DR. The nomogram prediction model based on AGE, diabetes duration, HbA1c, eGFR and UALB can accurately predict the risk of DR, and has good clinical practicability.

Objective:To construct an exosome (EXO)-based nanosystem co-loaded with bovine serum albumin and isoquercitrin (BSA@ISO), and to investigate its protective mechanism against high glucose-induced damage in human retinal pigment epithelial cells (ARPE-19).Methods:EXO was extracted from ARPE-19 cells via ultracentrifugation, and the structure was observed using transmission electron microscopy (TEM). EXO markers were detected by Western blot.BSA@ISO nanoparticles were prepared using the oscillating synthesis method.A ROS-responsive EXO-based nanosystem co-loaded with BSA@ISO (BSA@ISO@EXO) was constructed using a membrane extruder.The particle size and zeta potential of BSA@ISO@EXO were measured and its morphology was observed by TEM.Chemical structure was analyzed using a spectrophotometer and infrared spectroscopy.Encapsulation efficiency and drug loading capacity were calculated using the differential method.Cells were divided into control group, model group, low-dose ISO nanosystem group (5 μmol/L ISO), medium-dose ISO nanosystem group (10 μmol/L ISO), high-dose ISO nanosystem group (20 μmol/L ISO), and pure ISO group.Cell viability at different time points was assessed using the CCK-8 assay.Apoptosis rate after 48 hours of culture was measured by flow cytometry.Levels of inflammatory factors tumor necrosis factor (TNF)-α and interleukin (IL)-1β in the cell supernatant were determined by ELISA, while activities of antioxidant enzymes glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD) and the level of oxidative stress marker malondialdehyde (MDA) in the supernatant were measured using biochemical kits.Results:The BSA@ISO@EXO nanosystem exhibited a uniform spherical shape with an average particle size of approximately 39.6 nm.UV-visible and IR spectra showed characteristic absorption peaks of BSA, ISO and EXO.The encapsulation efficiency of the nanosystem was (76.6±5.0)%, the drug loading capacity was (10.3±0.6)%, and the 24-hour drug release rate reached 75.1%.CCK-8 assay showed that cell viability in all ISO nanosystem groups after 48-hour culture was significantly higher than that in the pure ISO group (all P<0.05). The ROS level was significantly lower in the medium-dose ISO group than in the pure ISO group ( P<0.01). The levels of TNF-α, IL-1β, and MDA were significantly lower and GSH-PX and SOD activities were significantly higher in the medium-dose ISO nanosystem group than those in the model and high-dose ISO nanosystem groups (all P<0.05). Conclusions:A stable BSA@ISO@EXO nanosystem was successfully constructed.This system enhances the antioxidant and anti-inflammatory effects by improving the bioavailability of ISO, offering a new strategy for the treatment of diabetic retinopathy.

Ulcerative colitis (UC) is a chronic inflammatory disease of unknown etiology, primarily involving the colon and rectum. Characterized by recurrent episodes and prolonged disease course, UC requires dynamic monitoring and evaluation. Current commonly used methods for disease monitoring and assessment include C-reactive protein (CRP), fecal calprotectin (FC), and colonoscopy. However, CRP lacks specificity, FC fails to effectively differentiate UC from Crohn's disease, while colonoscopy involves complex bowel preparation, is invasive, and suffers from poor patient compliance. Therefore, there is an urgent clinical need to identify non-invasive biological markers with high sensitivity and specificity for the diagnosis and evaluation of UC. Recent studies have demonstrated that anti-integrin αvβ6 autoantibodies hold significant value in the diagnosis, differential diagnosis, and disease assessment of UC, potentially emerging as an important clinical biomarker. This article reviews the research progress of anti-integrin αvβ6 autoantibodies in UC for reference.