Simultaneous management of intestinal mucosal barrier dysfunction and gut microbiota dysregulation represents a significant challenge in the treatment of inflammatory bowel disease (IBD). Herein, we report a novel system that integrates multi-enzyme mimicking cerium single-atom nanocatalysts (CeSACs) with Lactobacillus reuteri probiotics (LR@CeSACs) for multipronged management of IBD. In this system, CeSACs demonstrate robust multi-enzyme activities across a broad pH range, effectively scavenging elevated reactive oxygen species, downregulating pro-inflammatory cytokines, and suppressing the expression of fibrosis-related genes. Moreover, probiotics promote the targeting and retention of the CeSACs for sustained catalytic antioxidant therapy. In turn, the inflammation relief enabled by CeSACs promotes bacterial viability, allowing for the rapid reshaping of intestinal barrier function and the restoration of gut microbiota. Therefore, LR@CeSACs exhibit excellent catalytic anti-inflammatory and anti-fibrotic therapeutic effects, as well as a certain prophylactic effect, as demonstrated in several murine models.

Objective To compare the efficacy and safety of different cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) combined with endocrine therapy (ET) for the treatment of hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2−) advanced or metastatic breast cancer. Methods Randomized controlled trials (RCTs) on CDK4/6i for the treatment of HR+/HER2− metastatic or advanced breast cancer were retrieved from databases including PubMed, EMbase, Web of Science, The Cochrane Library, CNKI, Wanfang, VIP, and SinoMed, with the search period ranging from database inception to August 2023. Bayesian network meta-analysis was conducted using R 4.2.0 software. Results A total of 18 RCTs from 25 articles, involving 8 031 patients and 11 treatment regimens, were included. There was no significant difference in progression-free survival (PFS) or overall survival (OS) among different CDK4/6i+ET combinations. The highest cumulative probability for PFS was observed with dalpiciclib (DAL)+fulvestrant (FUL), while ribociclib (RIB)+FUL ranked first for OS. In terms of efficacy, abemaciclib (ABE)+aromatase inhibitors (AI) and ABE+FUL ranked first in objective response rate and clinical benefit rate, respectively. Regarding safety, statistically significant difference in grade 3-4 adverse events was observed among certain types of CDK4/6i (P<0.05). Conclusion Current evidence suggests that CDK4/6i+ET is superior to ET alone for the treatment of HR+/HER2− advanced/metastatic breast cancer. Different CDK4/6i+ET combinations demonstrate comparable or similar efficacy; however, the incidence of adverse reactions is higher with combination therapy. Treatment regimens should be selected based on individual conditions.

To analyze the distribution of serotypes and antimicrobial resistance of clinical Salmonella isolates from multiple centers across China.

Objective:To construct an information management system based on the back-end framework of React componentization and front-end framework of Uni scalable enterprise,so as to explore its application effect in management for operation room.Methods:React was used as the backend framework to construct JavaScript program code library of user interface,and all front-end applications that adopted Uni as the development system of frontend framework were used to construct informatization management system based on React and Uni framework,so as to manage operation room of hospital.A total of 100 surgical equipment that were used in the operation room of Guizhou Provincial People's Hospital from January 2023 to December 2023 were selected.According to different management methods,the conventional management method was adopted to manage equipment during January and June 2023,while the management method of informatization management system(informatization management)based on React and Uni frameworks was adopted to manage these equipment during July and December 2023.The frequency of leaving operation room of nursing personnel due to non-nursing events,the timeliness rate of transporting surgical patients and incidence of adverse events of nursing,as well as implementation rates of"five confirmations"included confirmed equipment,confirmed staff,confirmed time,confirmed quality and confirmed quantity,between two kinds of management methods were compared.Results:In the 200 surgeries of adopting informatization management method,the frequency of leaving operation room of nursing personnel due to non-nursing events was 2.5%,which was lower than 7.5%of conventional management method,and the difference was statistically significant(x2=5.213,P<0.05).The implementation rate of the"five confirmations"for equipment was 100%,which was higher than that of conventional management methods,and the difference was statistically significant(x2=15.232,P<0.05).The timeliness rate of transporting surgical patients was 100%in 100 surgeries,which was higher than 85%of conventional management method,and the difference was significant(x2=15.136,P<0.05).The incidence of various kinds of adverse events of nursing in the operating room was 0 in 100 surgeries,which was lower than that of conventional management method,and the difference was statistically significant(x2=0.226,P<0.05).Conclusion:The informatization management system based on React and Uni framework can significantly reduce the frequency of leaving operation room of nursing personnel due to non-nursing events in operation room,and improve the work efficiency in operation room,and reduce the incidences of work errors and adverse events in management for surgery.

Objective:To investigate lipid metabolism gene mutations and pathogenicity of hypertriglyceridemia acute pancreatitis (HTG-AP) patients.Methods:Clinical data of 495 HTG-AP patients admitted from June 2018 to June 2020 in the center for severe acute pancreatitis of Eastern Theater General Hospital were retrospectively analyzed. Whole-exome sequencing and mutation verification were performed by next-generation sequencing technology and Sanger sequencing. The pathogenicity of gene mutation was analyzed by population mutation ratio, pathogenicity prediction software, conservation scoring software, protein structure prediction, and in vitro experiments. Results:The mutation ratio of lipid metabolism-related genes, namely LPL, APOA5, LMF1, GPIHBP1, and APOC2, were 14.81%, 55.78%, 43.61%, 1.62%, and 0.61%, respectively. Among them, 44 heterozygous mutations in LPL gene were detected including 36 missense mutations, 5 nonsense mutations and 3 frameshift mutations, which were all rarely carried in single patient. Six HTG-AP patients carried the LPL gene heterozygous mutation c.835C>G (p.Leu279Val). The mean level of serum triglyceride at the onset of HTG-AP was 27.4 mmol/L. All of them had a history of recurrent HTG-AP, and most of them had severe acute pancreatitis. The serum LPL concentration and activity were lower than the normal level. The pathogenicity analysis results suggested that the LPL p.Leu279Val was a rare, highly possible pathogenic and highly conserved gene mutation. The in vitro results showed that the LPL p.Leu279Val could significantly reduce the synthesis and secretion ability of LPL as well as its enzymatic activity. Conclusions:The mutation ratio of lipid metabolism-related genes, including LPL, APOA5, LMF1, GPIHBP1, and APOC2, are relatively high in the HTG-AP patients. The LPL p.Leu279Val is a rare and highly possible pathogenic gene mutation, which may lead to recurrent episodes of HTG-AP.

Objective:To investigate lipid metabolism gene mutations and pathogenicity of hypertriglyceridemia acute pancreatitis (HTG-AP) patients.Methods:Clinical data of 495 HTG-AP patients admitted from June 2018 to June 2020 in the center for severe acute pancreatitis of Eastern Theater General Hospital were retrospectively analyzed. Whole-exome sequencing and mutation verification were performed by next-generation sequencing technology and Sanger sequencing. The pathogenicity of gene mutation was analyzed by population mutation ratio, pathogenicity prediction software, conservation scoring software, protein structure prediction, and in vitro experiments. Results:The mutation ratio of lipid metabolism-related genes, namely LPL, APOA5, LMF1, GPIHBP1, and APOC2, were 14.81%, 55.78%, 43.61%, 1.62%, and 0.61%, respectively. Among them, 44 heterozygous mutations in LPL gene were detected including 36 missense mutations, 5 nonsense mutations and 3 frameshift mutations, which were all rarely carried in single patient. Six HTG-AP patients carried the LPL gene heterozygous mutation c.835C>G (p.Leu279Val). The mean level of serum triglyceride at the onset of HTG-AP was 27.4 mmol/L. All of them had a history of recurrent HTG-AP, and most of them had severe acute pancreatitis. The serum LPL concentration and activity were lower than the normal level. The pathogenicity analysis results suggested that the LPL p.Leu279Val was a rare, highly possible pathogenic and highly conserved gene mutation. The in vitro results showed that the LPL p.Leu279Val could significantly reduce the synthesis and secretion ability of LPL as well as its enzymatic activity. Conclusions:The mutation ratio of lipid metabolism-related genes, including LPL, APOA5, LMF1, GPIHBP1, and APOC2, are relatively high in the HTG-AP patients. The LPL p.Leu279Val is a rare and highly possible pathogenic gene mutation, which may lead to recurrent episodes of HTG-AP.

Objective:To construct an information management system based on the back-end framework of React componentization and front-end framework of Uni scalable enterprise,so as to explore its application effect in management for operation room.Methods:React was used as the backend framework to construct JavaScript program code library of user interface,and all front-end applications that adopted Uni as the development system of frontend framework were used to construct informatization management system based on React and Uni framework,so as to manage operation room of hospital.A total of 100 surgical equipment that were used in the operation room of Guizhou Provincial People's Hospital from January 2023 to December 2023 were selected.According to different management methods,the conventional management method was adopted to manage equipment during January and June 2023,while the management method of informatization management system(informatization management)based on React and Uni frameworks was adopted to manage these equipment during July and December 2023.The frequency of leaving operation room of nursing personnel due to non-nursing events,the timeliness rate of transporting surgical patients and incidence of adverse events of nursing,as well as implementation rates of"five confirmations"included confirmed equipment,confirmed staff,confirmed time,confirmed quality and confirmed quantity,between two kinds of management methods were compared.Results:In the 200 surgeries of adopting informatization management method,the frequency of leaving operation room of nursing personnel due to non-nursing events was 2.5%,which was lower than 7.5%of conventional management method,and the difference was statistically significant(x2=5.213,P<0.05).The implementation rate of the"five confirmations"for equipment was 100%,which was higher than that of conventional management methods,and the difference was statistically significant(x2=15.232,P<0.05).The timeliness rate of transporting surgical patients was 100%in 100 surgeries,which was higher than 85%of conventional management method,and the difference was significant(x2=15.136,P<0.05).The incidence of various kinds of adverse events of nursing in the operating room was 0 in 100 surgeries,which was lower than that of conventional management method,and the difference was statistically significant(x2=0.226,P<0.05).Conclusion:The informatization management system based on React and Uni framework can significantly reduce the frequency of leaving operation room of nursing personnel due to non-nursing events in operation room,and improve the work efficiency in operation room,and reduce the incidences of work errors and adverse events in management for surgery.

Objective To investigate clinical features and risk factors of obstructive sleep apnea(OSA)complicated with metabolic associated fatty liver disease(MAFLD),and to construct a prediction model,so as to provide reference for clinical diagnosis and treat-ment.Methods A total of 228 OSA patients admitted to Xiangyang No.1 People's Hospital Affiliate to Hubei University of Medicine from January 2020 to December 2022 were selected.According to whether complicated with MAFLD,the patients were divided into OSA+MAFLD group(n=94)and OSA group(n=134).According to the liver/spleen CT values,OSA+MAFLD group was further di-vided into OSA+mild MAFLD group(n=56)and OSA+moderate-severe MAFLD group(n=38).General clinical data,polysomnog-raphy(PSG),serological examination and other related indicators and parameters of all patients were collected for statistical analysis.Results Univariate analysis showed that there were significant differences between the OSA group and the OSA+MAFLD group in age,hypertension,diabetes,hyperlipidemia,body mass index(BMI),apnea hypopnea index(AHI),oxygen reduction index(ODI),lon-gest apnea time(LAT),snore frequency,lowest saturation oxygen(LSpO2),mean oxygen saturation(MSpO2),CT90％,fasting plasma glucose(FPG),alanine aminotransferase(ALT),aspartate aminotransferase(AST),γ-glutamyltransferase(GGT)(P＜0.05);and there were significant differences between the OSA+mild MAFLD group and the OSA+moderate-severe MAFLD group in age,hyperlip-idemia,BMI,AHI,ODI,LAT,snore frequency,LSpO2,MSpO2,CT90％and ALT(P＜0.05).Multivariate Logistic regression analy-sis showed that age,BMI,AHI,snore frequency were independent risk factors for OSA and MAFLD(P＜0.05);Age,BMI,AHI and ALT were independent risk factors for OSA with moderate-severe MAFLD(P＜0.05).The Logistic regression model was established:Y1=-13.183+0.083age+0.205BMI+0.039AHI+0.002snore frequency,the area under the receiver operating characteristic curve was 0.915,and the sensitivity and specificity of the regression model were 87.2％and 82.8％.Y2=-44.956+0.146age+0.510BMI+0.056AHI+0.022ALT,the area under the receiver operating characteristic curve was 0.924,and the sensitivity and specificity of the regression model were 78.9％and 91.1％.Conclusion In clinical work,the occurrence of MAFLD should be considered for OSA pa-tients with older age,higher BMI,higher AHI,and more snoring frequency.OSA patients with MAFLD with older age,higher BMI,higher AHI,and higher ALT are more serious.Moreover,the combined prediction model constructed in this study has better diagnostic value,and can provide reference for early diagnosis of OSA complicated with MAFLD.

Objective To analyze the efficacy and safety of double-ring sandwich procedure in the treatment of acute A-type aortic dissection root.Methods The clinical data of 103 patients with acute A-type aortic dissection treated by double-ring sandwich procedure in our center from October 2020 to May 2023 were retrospectively analyzed to investigate the surgical effect,short-term cardiac structural changes and short-term postoperative complications.Results Needle hemostasis was applied in 11.65％of all patients.The amount of red blood cell transfusion during the perioperative period was(2.95±1.97)U,plasma was(543.68±208.48)ml,and blood platelet was(0.08±0.30)U.The residual aortic regurgitation,cardiac function and pericardial effusion were significantly improved at 2 weeks after operation(P＜0.05).The proportion of residual false lumen in the aortic root was significantly reduced after operation(P＜0.05).The length of hospital stay,duration of intubation,and drainage within 24 hours after surgery were less.The incidence of postoperative short-term complications such as secondary thoracotomy,cerebral infarction,cerebral hemorrhage,hemofiltration,tracheal incision and death was low.Conclusions Double-ring sandwich procedure in the treatment of acute A-type aortic dissection can effectively block the false lumen of aortic root dissection,reduce the risk of aortic intimal avulsion,and the operation is safe and effective.

Objective To investigate the effect and potential mechanism of Desmodium renifolium(Linn.)Schindl on ovariectomized osteoporosis rat model.Methods Sixty 3-month-old female SD rats were randomly divided into Sham group,model group,Xianlin Gubao group(0.24 g·kg-1),Desmodium renifolium low-dose group(1.35 g·kg-1,medium-dose group(2.7 g·kg-1)and high-dose group(5.4 g·kg-1).Osteoporosis was induced by performing double ovariectomy in rats.After 14 weeks treatment,the contents of osteocalcin(BGP),osteoprotectin(OPG)and alkaline phosphatase(ALP)in serum were determined.Hematoxylin-eosin(HE)staining was used to observe the changes of bone trabeculae.The osteoclast progenitor-cell line RAW264.7 was divided into negative control group,Receptor activator of nuclear factor-κB ligand(RANKL)group,Xianlin Gubao group,Desmodium renifolium low-dose,medium-dose and high-dose drug groups.The RANKL group and drug groups were induced with 50 ng·mL-1 RANKL.Meanwhile,Xianlin Gubao group and different concentrations of drug-containing serum of Desmodium renifolium,were added for intervention.Tartrate-resistant acid phosphatase(TRAP)staining was performed 10 days after intervention to observe the differentiation of osteoclasts,and quantitative real-time PCR(qPCR)was used to determine the mRNA expression.Results Compared with Sham group,the contents of OPG in serum of model group were significantly decreased(P<0.01),while ALP and BGP were significantly increased(P<0.01),bone trabeculae were significantly reduced,broken,sparsely arranged,and the space between bone trabeculae was large,the OPG mRNA expression in model group were significantly decreased(P<0.01),and the mRNA expression of receptor activator of nuclear factor-κB ligand(RANKL),TNF receptor associated factor 6(TRAF6),nuclear factor of activated t-cells,cytoplasmic 1(NFATC1),cathepsin K(CTK)and calcitonin receptor(CALCR)in model group were significantly increased(P<0.01),all these aspects showed remarkable improvement after Desmodium renifolium intervention.After 10 days of RAW264.7 culture,no osteoclasts were found in the Control group.Compared with the negative control group,osteoclasts in RANKL group were significantly increased,treatment with Desmodium renifolium markedly decreased osteoclast number,the result of RANKL/RANK/OPG signaling mRNA expression were consistent with the animal experiments.Conclusion Desmodium renifolium exerts effects on osteoporosis in ovariectomized rats,its mechanism might be realized by inhibiting osteoclast proliferation and differentiation,and regulating OPG/RANKL/RANK signaling pathway.