Objective To explore the dynamic changes of gut microbiota metabolites in septic patients following admission, as well as the correlations between these metabolites, the gut microbiota, and the prognosis of septic patients. Methods A total of 119 fecal samples were collected from 23 septic patients, 16 non-septic patients admitted to the Emergency Intensive Care Unit (ICU), and 20 healthy controls at Zhongshan Hospital, Fudan University, from January to August 2019. The 16S rRNA gene sequencing technology was applied to analyze the microbiome, while ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) was used for metabolomics research. The R software was used to analyze the gut microbiota and metabolite data. Based on 180-day survival status after admission, the sepsis group was divided into the survival group (n＝15) and the death group (n＝8) to analyze differential metabolites between the two groups. Spearman correlation coefficients were used to assess correlations between gut microbiota and metabolites. Results In the first week of ICU stay, gut microbiota metabolites such as nicotinic acid, methylsuccinic acid, and glutaric acid were significantly lower in septic patients than in healthy controls (P＜0.05), whereas tryptophan, histidine, valine, and pyroglutamic acid were higher in septic patients (P＜0.05). The methylsuccinic acid and phenylacetic acid levels in the first week were lower in the death group than those in the survival group (P＜0.05), and the levels of methylsuccinic acid, phenylacetic acid, and glutaric acid were lower in the third week (P＜0.05). Further analysis indicated that methylsuccinic acid was closely associated with sepsis prognosis. These differential metabolites involved in metabolic pathways such as phenylalanine metabolism and β-alanine metabolism. Most differential amino acids were positively correlated with opportunistic pathogens but negatively correlated with normal gut microbiota. Conversely, metabolites such as nicotinic acid, phenylacetic acid, methylsuccinic acid, and glutaric acid were negatively correlated with opportunistic pathogens and positively correlated with normal gut microbiota. Conclusions Significant dynamic changes occur in gut microbiota metabolites in septic patients, with methylsuccinic acid, phenylacetic acid, and glutaric acid potentially playing important roles in determining patient prognosis.

Non-small cell lung cancer(NSCLC) is the most common type of lung cancer worldwide, accounting for approximately 80%-85% of all lung cancer cases. Despite the clinical benefits of traditional treatments such as surgery, chemotherapy, and radiotherapy, challenges such as the high rate of postoperative recurrence and resistance of some patients to chemotherapy and targeted therapies limit their effectiveness, necessitating the exploration of more effective treatment options. In recent years, immunotherapy, especially immune checkpoint inhibitors(ICIs), has revolutionized NSCLC treatment and significantly improved the survival prognosis of some patients. However, the efficacy of immunotherapy is limited by tumor immune escape, drug resistance, and immune-related adverse events(irAEs), which have not been effectively addressed. Traditional Chinese medicine(TCM), as a traditional therapeutic approach, has shown unique advantages in NSCLC treatment, with studies indicating its ability to enhance immune responses, regulate immune checkpoints, and improve the tumor microenvironment(TME), thus boosting the efficacy of immunotherapy. Additionally, the multi-target and multi-pathway effects of TCM help mitigate the side effects of immunotherapy, further improving efficacy and safety. This review summarizes the latest research progress of TCM in NSCLC immunotherapy, focusing on the research results of TCM in enhancing the effect of immunotherapy by regulating immune cells, optimizing the immune microenvironment, and being applied with ICIs, etc. The latest research progress of TCM in alleviating irAEs is also elucidated. The aim is to provide theoretical support for the clinical application of TCM in the prevention and treatment of NSCLC and the research and development of new drugs and promote the optimization and development of combined immunotherapy and TCM treatment models.
Humans ; Carcinoma, Non-Small-Cell Lung/therapy* ; Lung Neoplasms/therapy* ; Immunotherapy/methods* ; Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional ; Animals ; Tumor Microenvironment/drug effects*

Objective:To evaluate the impact of sutureless approach to the dorsal venous complex(DVC)combined with ro-botic-assisted laparoscopic prostatectomy on sexual function of patients with prostatic cancer.Methods:This study included 114 prostate cancer patients who underwent robot-assisted laparoscopic radical prostatectomy at our hospital from January 2021 to January 2024.The patients were randomly divided into a control group(n=57)and an observation group(n=57).The control group re-ceived conventional"figure-of-eight"suture ligation of the dorsal venous complex(DVC),while the observation group underwent di-rect DVC transection using monopolar electrocautery scissors after increasing pneumoperitoneum pressure.Surgical duration,intraopera-tive blood loss,positive surgical margin rates,and positive apical margin rates were recorded.The continence rates and rates of morn-ing erections at 1,3 and 6 months after the operation were compared between groups.Sexual function was assessed pre-operatively and at 6 months post-operation by using the IIEF-5 and PEDT.Results:The operative time in the observation group was significantly lon-ger than that in the control group([115.71±19.42]min vs[103.42±12.78]min,P＜0.05).While no significant differences were observed in intraoperative blood loss,positive surgical margin rate,or positive apical margin rate between the two groups(P＞0.05).At 3 and 6 months after the operation,the observation group exhibited higher urinary continence rates and morning erection re-covery rates compared to the control group(P＜0.05).Furthermore,at 6 months postoperatively,the observation group demonstrated significantly higher IIEF-5 scores and lower PEDT scores than those of control group(P＜0.05).Conclusion:The use of a suture-less DVC technique in robotic-assisted laparoscopic radical prostatectomy protects the post-operative sexual function in patients.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Parathyroid hormone (PTH) is a polypeptide molecule synthesized and secreted by parathyroid principal cells. It is an important hormone to maintain the balance of calcium and phosphorus metabolism in the body. It has the dual function of promoting bone formation and bone resorption. In clinic, it promotes osteogenesis by intermittent low-dose subcutaneous injection. In order to avoid the problems of subcutaneous injection, such as poor patient compliance, low utilization of target organs and pain at the injection site, the local application of PTH has attracted much attention in recent years. However, how to realize the local application of PTH and the effect of the local application need to be confirmed by more experiments. This article reviews the local application of PTH and the promotion of jaw regeneration in recent years, in order to provide reference for the local application and research of PTH.

Artificial intelligence(AI) empowers the development of the medical industry, providing precise and intelligent assistance for clinical diagnosis, treatment, and rehabilitation.AI has the potential to facilitate shared decision making (SDM), but AI interventions used for SDM are currently in their infancy, presenting both challenges and opportunities. This paper aims to describe the application of AI in SDM, explore the problems and challenges of AI-based decision aid used for SDM, and propose possible solutions, aiming to provide a guide for the development and implementation of AI-based decision aid.

OBJECTIVES: To develop the birth weight curves of the Chinese Han (26-41 weeks of gestation) and Zhuang (28-41 weeks of gestation) singleton neonates in 11 cities of China, as well as the birth weight means of full-term neonates of 14 Chinese ethnic groups. METHODS: The live singleton neonates who were born in 11 maternal and child health care hospitals from 11 cities of China between January 2017 and December 2020 were classified according to the mother's ethnic group. Birth weight means were calculated for the full-term neonates of each ethnic group. For the Han and Zhuang singleton neonates with a large sample size, the Lambda-Mu-Sigma (LMS) method was used to establish the birth weight percentile curves of the Han and Zhuang singleton neonates with different gestational ages. RESULTS: A total of 105 365 live singleton neonates were included, among whom the Han neonates had the highest number of 84 851 (26-41 weeks of gestation), followed by the Zhuang neonates (12 803 neonates with a gestational age of 28-41 weeks). The neonates of the other Chinese ethnic groups enrolled were live full-term singleton neonates, with a sample size of more than 100 neonates for each ethnic group. The 3rd-97th percentile curves of birth weight were established for the Han singleton neonates with a gestational age of 26-41 weeks and the Zhuang singleton neonates with a gestational age of 28-41 weeks. The birth weight curves of the Han singleton neonates at each gestational age were higher than those of the Zhuang singleton neonates. Birth weight means (3 199-3 499 g) and standard deviations were determined for 14 Chinese ethnic groups, i.e., Li, Mulao, Zhuang, Yao, Dong, Miao, Han, Buyi, Mongolian, Tujia, Yi, Hui, Man, and Korean ethnic groups. The Li ethnic group had the lowest birth weight, followed by the Mulao, Zhuang, Yao, Dong, Miao, Han, Buyi, Mongolian, Tujia, Yi, Hui, Man, and Korean ethnic groups. CONCLUSIONS The 3rd-97th percentile curves of birth weight are developed for the Han (26-41 weeks of gestation) and Zhuang (28-41 weeks of gestation) singleton neonates in 11 cities of China, and birth weight means are determined for the full-term neonates of 14 Chinese ethnic groups in 11 cities of China, which provides a reference for evaluating the intrauterine growth of neonates in these ethnic groups.
Infant, Newborn ; Male ; Child ; Humans ; Infant ; Birth Weight ; Ethnicity ; Cities ; Gestational Age ; China

Cells are in complicated mechanical and physical microenvironment in vivo. The former mainly includes flow shear, tension, compression or torsion, and the latter covers stiffness and topography of extracellular matrix, spatial location, volume constraint or osmotic pressure, featured with various types, patterns, and parameters of mechanical or physical loading. Cell biomechanics mainly focuses on the alteration of mechanical properties of cells and the mechanical remodeling of subcellular components, the cell development, growth, proliferation, differentiation, and apoptosis under distinct mechanical stimuli, and the cellular sensation, transmission, transduction, and responses to external forces. This review summarized the major progresses in cell biomechanics in 2021, including studies on cardiomyocytes, endothelial cells, osteoblasts, immune cells, cancer cells and stem cells, as well as the related new techniques.

For a long time, the cultivation of medical students’ scientific research and innovation abilitymainly depends on scattered extracurricular scientific research activities. With limited students, unsystematic teaching and inadequate administrative guarantee, it often results in obvious weakness andinefficiency. Since 2002, the Biochemistry and Molecular Biology teaching team in Shantou UniversityMedical College has been working on a “3+X” model to nurture the scientific research and innovationability of medical students. Guided by the concepts of complementary development of science andeducation, student-centeredness, and Problem-based Learning, a model is established based on the‘HEART” professionalism courses and the academy culture specific to Shantou University. We also takefull advantage of the first-tier disciplines of biology, basic medicine and clinical medicine in ShantouUniversity and collaborate with other professional teaching teams. It is conceptualized in a framework thatembraces the comprehensive connotation of scientific research and innovation ability and adopts a corecurriculum system that runs through the 5-year medical undergraduate education. In this model, " 3" means " whole-person training", " whole-process training" and " omni-directional training" for medicalstudents; " X" refers to several confirmatory dimensions of the operational effectiveness of the " 3+X" model, including organizing medical students to participate in various forms of national college students’ innovative experimental research competitions, international college students’ academic seminars, writingand publishing academic papers by medical undergraduates as the first author, etc. The model proves tobe effective in cultivating the scientific research and innovation ability of medical students, hence settinga good example to solve the current problems in the cultivation of medical students’ scientific researchand innovation ability.