ObjectiveTo investigate the microbiological characteristics of bile in patients with common bile duct stones alone or comorbid with juxtapapillary duodenal diverticula （JPDD）. MethodsA prospective study was conducted among 30 patients with common bile duct stones who were admitted to Department of Gastroenterology， Hebei General Hospital， from January to May 2024， and according to the presence or absence of JPDD， they were divided into JPDD group and simple common bile duct stones group （CBD group）， with 15 patients in each group. Bile samples were collected during endoscopic retrograde cholangiopancreatography， and 16S rRNA microbial sequencing was performed to compare the differences in microbial composition， diversity， and metabolic pathways between the two groups. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. Pearson correlation analysis or Spearman correlation analysis was used to analyze the correlation between clinical indicators and microbial species abundance. ResultsClinical data showed that compared with the CBD group， the JPDD group had significantly greater maximum diameter of stones （10.87±3.42 mm vs 6.80±2.08 mm， t=3.94， P0.01） and common bile duct diameter （14.73±3.95 mm vs 9.67±2.64 mm， t=4.13， P0.01）. The microbiological analysis of the bile showed that Proteobacteria， Bacteroidetes， Firmicutes， and Actinobacteria were the most common phyla in both groups， and Proteobacteria was the dominate phylum in the JPDD group. At the genus and species levels， the JPDD group had higher relative abundances of Escherichia-Shigella， Enterococcus， and Escherichia coli. Alpha diversity was similar between the two groups， and there was a significant difference in beta diversity between the two groups （Adonis test， P0.05）. The LEfSe analysis identified 25 differentially expressed species （LDA2） between the two groups， and the JPDD group had enrichment of 7 flora such as Enterobacter， Enterococcaceae， and Klebsiella， while the CBD group had significant enrichment of 18 flora such as Peptococcaceae， Roseburia， and Alistipes （P0.05）. The correlation analysis showed that Enterococcaceae and Enterococcus significantly enriched in the JPDD group were positively correlated with the diameter of the common bile duct and the maximum diameter of stones （P0.01）， whereas Peptococcaceae， Acinetobacter， and Alistipes with reductions in expression were negatively correlated with the diameter of the common bile duct and the maximum diameter of stones （P0.05）. The enrichment analysis of biliary microbial metabolic pathways showed that there were significant differences between the two groups in 10 metabolic pathways such as cell growth and death， transportation and decomposition， nervous system， biosynthesis of valine， leucine， and isoleucine， and histidine metabolism （P0.05）. ConclusionThe presence of JPDD may lead to alterations in bile microbiota， such as an increase in Enterococcus and a reduction in Roseburia， and specific flora and metabolism can promote the formation of common bile duct stones.

Diabetic cataract, a prevalent ocular complication of diabetes mellitus, arises from a complex interplay of pathological mechanisms, with oxidative stress and glycation stress playing central roles. Autophagy, a critical cellular self-protection mechanism, sustains intracellular homeostasis by selectively degrading damaged organelles and misfolded proteins, thereby counteracting the detrimental effects of oxidative and glycation stress under hyperglycemic conditions. Emerging evidence indicates a synergistic interaction between glycation stress and oxidative stress, which may exacerbate autophagic dysfunction and accelerate the onset and progression of diabetic cataract. However, the precise molecular mechanisms underlying this relationship remain incompletely understood. This review systematically examines the regulatory role of autophagy inthe pathogenesis of diabetic cataract, with a particular focus on how autophagic impairment influences disease progression under the combined effects of glycation and oxidative stress. By elucidating these mechanisms, the paper aims to provide novel insights into molecular diagnostic approaches and targeted therapeutic strategies for diabetic cataract.

Objective To analyze the efficacy of hepatic arterial infusion chemotherapy(HAIC)sequential drug-eluting beads transcatheter arterial chemoembolization(DEB-TACE)in the treatment of liver metastases from colorectal cancer.Methods 86 patients with colorectal cancer liver metastasis admitted to multiple centers from September 2022 to September 2023 were selected and divided into a control group(43 cases)and an experimental group(43 cases)according to the random number table method.The control group was treated with HAIC,and the experimental group was treated with HAIC sequential DEB-TACE.The clinical data and the changes of tumor markers and liver function indexes before and after treatment were compared between the two groups,and the short-term and long-term efficacy was evaluated,and the adverse reactions were recorded.Results After treatment,the levels of carcinoembryonic antigen,carbohydrate antigen 125,carbohydrate antigen 199,carbohydrate antigen 242,aspartate aminotransferase,alanine aminotransferase,alkaline phosphatase and γ-glutamyl transpeptidase in the two groups decreased(P<0.05),and those in the experimental group were lower than the control group(P<0.05).The proportion of repeated treatment in the experimental group was lower than that in the control group(P<0.05).The objective remission rate and disease control rate in the experimental group were 60.00%and 82.50%respectively,which were higher than 30.95%and 61.90%in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the control group and the experimental group(P>0.05).The results of Kaplan-Meier survival curve showed that the overall survival rate and progression-free survival rate of the experimental group were higher than those of the control group(P<0.05).Conclusions HAIC sequential DEB-TACE can effectively remove tumor cells and improve liver function in patients with colorectal can-cer liver metastasis,and it has good clinical efficacy and can prolong the survival time of patients.

Objective:To study the relationship between human leukocyte antigen (HLA) Ⅱ and nuclear factor κB (NF-κB) gene polymorphisms and susceptibility to community-acquired pneumonia in children and the therapeutic effect of amoxicillin clavulanate potassium.Methods:A total of 120 children with community-acquired pneumonia admitted to the Baoding Second Central Hospital from February 2018 to January 2021 were selected as the study objects (observation group). According to the effect of amoxicillin and clavulanate potassium treatment, they were divided into effective group and ineffective group, and 120 healthy children in the same period were selected as the control group. The polymorphisms of HLAⅡ and NF-κB gene were compared between the two groups, and the correlation between the polymorphisms of HLAⅡ and NF-κB gene and the susceptibility of children to community-acquired pneumonia and the therapeutic effect of amoxicillin clavulanate potassium was analyzed.Results:The gene frequency of HLA-DQA1*0201 [86(71.67%) vs 40(33.33%)], HLA-DQA1*0301 [72(60.00%) vs 20(16.67%)] of the observation group was significantly higher than that of the control group, the gene frequency of HLA-DQA1*0401 [30(25.00%) vs 96(80.00%)] was significantly lower than that of control group (all P<0.05). The gene frequency of HLA-DRB1*07 [92(76.67%) vs 48(40.00%)], HLA-DRB1*15 [72(60.00%) vs 40(33.33%)], HLA-DRB1*16 [96(80.00%) vs 76(63.33%)] of the observation group was significantly higher than that of the control group, and the gene frequency of HLA-DRB1*11 [36(30.00%) vs 104(86.67%)] was significantly lower than that of control group (all P<0.05). The expression of 94ins/delATTG*II in the observation group was significantly higher than that in the control group [40(33.33%) vs 24(20.00%), P<0.05]. The gene frequency of HLA-DQA1*0201 [12(38.71%) vs 74(83.15%)], HLA-DQA1*0301 [9(29.03%) vs 63(70.79%)] in the ineffective group was significantly lower than that of the effective group, the gene frequency of HLA-DQA1*0401 [18(58.06%) vs 12(13.48%)] was significantly higher than that of the effective group (all P<0.05). The gene frequency of HLA-DRB1*07 [29(93.55%) vs 63(70.79%)], HLA-DRB1*15 [29(93.55%) vs 43(48.31%)], HLA-DRB1*16 [29(93.55%) vs 67(75.28%)] of the ineffective group was significantly higher than that of the effective group, and the gene frequency of HLA-DRB1*11 [17(54.84%) vs 19(21.35%)] was significantly higher than that of the effective group (all P<0.05). The expression of 94ins/delATTG*II gene in the ineffective group was significantly higher than that in the effective group [15(48.39%) vs 25(28.09%), P<0.05]. Conclusions:Polymorphisms of HLAⅡ and NF-κB genes are associated with susceptibility to community-acquired pneumonia and efficacy of amoxicillin and clavulanate potassium in children.

Objective:To study the relationship between human leukocyte antigen (HLA) Ⅱ and nuclear factor κB (NF-κB) gene polymorphisms and susceptibility to community-acquired pneumonia in children and the therapeutic effect of amoxicillin clavulanate potassium.Methods:A total of 120 children with community-acquired pneumonia admitted to the Baoding Second Central Hospital from February 2018 to January 2021 were selected as the study objects (observation group). According to the effect of amoxicillin and clavulanate potassium treatment, they were divided into effective group and ineffective group, and 120 healthy children in the same period were selected as the control group. The polymorphisms of HLAⅡ and NF-κB gene were compared between the two groups, and the correlation between the polymorphisms of HLAⅡ and NF-κB gene and the susceptibility of children to community-acquired pneumonia and the therapeutic effect of amoxicillin clavulanate potassium was analyzed.Results:The gene frequency of HLA-DQA1*0201 [86(71.67%) vs 40(33.33%)], HLA-DQA1*0301 [72(60.00%) vs 20(16.67%)] of the observation group was significantly higher than that of the control group, the gene frequency of HLA-DQA1*0401 [30(25.00%) vs 96(80.00%)] was significantly lower than that of control group (all P<0.05). The gene frequency of HLA-DRB1*07 [92(76.67%) vs 48(40.00%)], HLA-DRB1*15 [72(60.00%) vs 40(33.33%)], HLA-DRB1*16 [96(80.00%) vs 76(63.33%)] of the observation group was significantly higher than that of the control group, and the gene frequency of HLA-DRB1*11 [36(30.00%) vs 104(86.67%)] was significantly lower than that of control group (all P<0.05). The expression of 94ins/delATTG*II in the observation group was significantly higher than that in the control group [40(33.33%) vs 24(20.00%), P<0.05]. The gene frequency of HLA-DQA1*0201 [12(38.71%) vs 74(83.15%)], HLA-DQA1*0301 [9(29.03%) vs 63(70.79%)] in the ineffective group was significantly lower than that of the effective group, the gene frequency of HLA-DQA1*0401 [18(58.06%) vs 12(13.48%)] was significantly higher than that of the effective group (all P<0.05). The gene frequency of HLA-DRB1*07 [29(93.55%) vs 63(70.79%)], HLA-DRB1*15 [29(93.55%) vs 43(48.31%)], HLA-DRB1*16 [29(93.55%) vs 67(75.28%)] of the ineffective group was significantly higher than that of the effective group, and the gene frequency of HLA-DRB1*11 [17(54.84%) vs 19(21.35%)] was significantly higher than that of the effective group (all P<0.05). The expression of 94ins/delATTG*II gene in the ineffective group was significantly higher than that in the effective group [15(48.39%) vs 25(28.09%), P<0.05]. Conclusions:Polymorphisms of HLAⅡ and NF-κB genes are associated with susceptibility to community-acquired pneumonia and efficacy of amoxicillin and clavulanate potassium in children.

Objective To analyze the efficacy of hepatic arterial infusion chemotherapy(HAIC)sequential drug-eluting beads transcatheter arterial chemoembolization(DEB-TACE)in the treatment of liver metastases from colorectal cancer.Methods 86 patients with colorectal cancer liver metastasis admitted to multiple centers from September 2022 to September 2023 were selected and divided into a control group(43 cases)and an experimental group(43 cases)according to the random number table method.The control group was treated with HAIC,and the experimental group was treated with HAIC sequential DEB-TACE.The clinical data and the changes of tumor markers and liver function indexes before and after treatment were compared between the two groups,and the short-term and long-term efficacy was evaluated,and the adverse reactions were recorded.Results After treatment,the levels of carcinoembryonic antigen,carbohydrate antigen 125,carbohydrate antigen 199,carbohydrate antigen 242,aspartate aminotransferase,alanine aminotransferase,alkaline phosphatase and γ-glutamyl transpeptidase in the two groups decreased(P<0.05),and those in the experimental group were lower than the control group(P<0.05).The proportion of repeated treatment in the experimental group was lower than that in the control group(P<0.05).The objective remission rate and disease control rate in the experimental group were 60.00%and 82.50%respectively,which were higher than 30.95%and 61.90%in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the control group and the experimental group(P>0.05).The results of Kaplan-Meier survival curve showed that the overall survival rate and progression-free survival rate of the experimental group were higher than those of the control group(P<0.05).Conclusions HAIC sequential DEB-TACE can effectively remove tumor cells and improve liver function in patients with colorectal can-cer liver metastasis,and it has good clinical efficacy and can prolong the survival time of patients.

Neurodegenerative diseases are a group of diseases caused by degeneration and dysfunction of the cells and tissues of the central nervous system， mainly including Alzheimer's disease （AD）， Parkinson's disease （PD）， and epilepsy. A common clinical manifestation of these diseases is cognitive decline. Neurodegenerative diseases are more common in the elderly. As population aging is aggravating， neurodegenerative diseases have aroused increasing concern since they seriously affect human health and quality of life. The pathogenesis of neurodegenerative diseases is complex， mainly related to mitochondrial dysfunction， apoptosis， neurotoxin， neurotransmitter abnormalities， oxidative stress， and inflammation. Although western drugs on the market can attenuate the symptoms of neurodegenerative diseases， they may induce severe adverse reactions and are thus not conducive to long-term use by the patients. The Chinese herbal medicine Angelicae Sinensis Radix was first recorded in the Shennong's Classic of Materia Medica （Shen Nong Ben Cao Jing）. It has the functions of activating blood， tonifying blood， modulating the immune system， regulating menstruation， and relieving pain. This paper summarizes the research progress in the effects of Angelicae Sinensis Radix and the prescriptions containing this medicine on neurodegenerative diseases in recent 10 years， aiming to provide a reference for the future application and research of Angelicae Sinensis Radix in the treatment of neurodegenerative diseases.

Objective To provide pharmaceutical care for patients with hepatitis B cirrhosis by using the medication therapy management(MTM)model combined with Pharmaceutical Care Network Europe(PCNE),and to analyze the effectiveness of pharmaceutical care from clinical efficacy,safety,humanistic effect and drug-related problems(DRPs).Methods Patients with hepatitis B cirrhosis were randomly divided into the pharmaceutical care group and the control group who received only conventional treatment.Clinical pharmacists used MTM combined with PCNE to provide pharmaceutical care in the pharmaceutical care group.Economic effects,clinical indicators,safety,medication compliance and quality of life were compared between the two groups during the treatment and follow-up period.DRPs were analyzed in the pharmaceutical care group.Results The cost-utility ratio and clinical indicators in the pharmaceutical care group were better than those in the control group,and the adverse drug reactions of the former were statistically significant compared with the latter at the three months follow-up,and medication compliance and quality of life were statistically significant after intervention and during follow-up(P＜0.05).There were 52 DRPs in the pharmaceutical care group,mainly in the category of poor treatment outcome.The main reasons were poor drug selection and excessive usage and dosage.There were 46 DRPs accepted by intervention,and 45 DRPs were completely and partially solved.Conclusion The pharmaceutical care model of MTM combined with PCNE classification system for patients with hepatitis B cirrhosis played a positive role in the treatment and follow-up period.

As the guiding theory for the diagnosis and treatment of encephalopathy in traditional Chinese medicine （TCM）， The marrow sea theory has important theoretical connotation and clinical value. This paper summarized the clinical research literature on the differentiation and treatment of common encephalopathy based on the marrow sea theory published in recent years， analyzed the treatment method and effects from eight aspects in terms of stroke， dizziness， insomnia， headache， constraint syndrome， dementia， tremor syndrome， and atrophy syndrome， and discussed the possible mechanism based on the relevant basic research. It is believed that marrow sea depletion is the common pathogenesis of encephalopathy in TCM. Guided by the method of supplementing essence and boosting marrow， the corresponding formulas and medicinals are recommended in accordance with differentiated syndromes， which can effectively improve the symptoms of the disease， delay the progression， increase the daily life ability of the patients， and improve the quality of life. Based on the marrow sea theory， the method of supplementing essence and boosting marrow， rectifying healthy qi and dispelling pathogen can be used to highlight the advantages of TCM and provide ideas for the diagnosis and treatment of encephalopathy in TCM.

Objective:To clarify peripheral Th17 level in SSc patients and its correlation with disease.Methods:Chinese databases CNKI, CBM, Wanfang and VIP, and English databases PubMed, EMBASE, Web of Science, Cochrane Library and Science Direct were searched to collect a case-control study on the content of Th17 cells in peripheral blood of patients with SSc. The papers published when the database was first developed in 25 February 2021. Meta-analysis was conducted using Stata 12.0 software, and I2 and Egger tests were used to evaluate the heterogeneity and publication bias between studies. Results:A total of 26 case-controls were included in the study, including 1 160 patients with SSc and 778 healthy controls. Overall, the percentage of Th17 cells in SSc patients was higher than in healthy controls [SMD(95% CI)=1.85 (1.33, 2.38), P<0.001], which was most significant in IL-17 +Th17 concentration [SMD(95% CI)=1.88 (1.28, 2.48), P<0.001]. As for disease activity, the proportion of Th17 cells in active SSc patients was much higher than those of patients in remission [SMD(95% CI)=1.92 (1.12, 2.71), P<0.001]. SSc patients had a reduced Th17 level after receiving DMARDs treatment [SMD(95% CI)=-0.74 (-1.05, -0.42), P=0.029]. Conclusion:The number of Th17 cells increase significantly in the peripheral blood of patients with SSc, and is related to disease activity. DMARDs can be used to treat this disease by downregulating Th17 levels.