OBJECTIVE: To investigate the effects of acupuncture on the neurotransmitter levels and gut microbiota in a mouse model of Tourette syndrome (TS). METHODS: Thirty-six male C57/BL6 mice were randomly divided into 4 groups using a random number table method: 3,3'-iminodipropionitrile (IDPN) group, control group, acupuncture group, and tiapride group, with 9 mice in each group. In the IDPN group, acupuncture group, and tiapride group, mice received daily intraperitoneal injections of IDPN (300 mg/kg body weight) for 7 consecutive days to induce stereotyped behaviors. Subsequently, in the acupuncture intervention group, standardized acupuncture treatment was administered for 14 consecutive days to IDPN-induced TS model mice. The selected acupoints included Baihui (DU 20), Yintang (DU 29), Waiguan (SJ 5), and Zulinqi (GB 41). In the tiapride group, mice were administered tiapride (50 mg/kg body weight) via oral gavage daily for 14 consecutive days. The control group, IDPN group, and acupuncture group received the same volume of saline orally for 14 consecutive days. Stereotypic behaviors were quantified through behavioral assessments. Neurotransmitter levels, including dopamine (DA), glutamate (Glu), and aspartate (ASP) in striatal tissue were measured using enzyme-linked immunosorbent assay. Dopamine transporter (DAT) expression levels were additionally quantified through quantitative polymerase chain reaction (qPCR). Gut microbial composition was analyzed through 16S ribosomal RNA gene sequencing, while metabolic profiling was conducted using liquid chromatography-mass spectrometry (LC-MS). RESULTS: Acupuncture administration significantly attenuated stereotypic behaviors, concurrently reducing striatal levels of DA, Glu and ASP concentrations while upregulating DAT expression compared with untreated TS controls (P<0.05 or P<0.01). Comparative analysis identified significant differences in Muribaculaceae (P=0.001), Oscillospiraceae (P=0.049), Desulfovibrionaceae (P=0.001), and Marinifilaceae (P=0.014) following acupuncture intervention. Metabolomic profiling revealed alterations in 7 metabolites and 18 metabolic pathways when compared to the TS mice, which involved various amino acid metabolisms associated with DA, Glu, and ASP. CONCLUSIONS Acupuncture demonstrates significant modulatory effects on both central neurotransmitter systems and gut microbial ecology, thereby highlighting its dual therapeutic potential for TS management through gut-brain axis regulation.
Animals ; Tourette Syndrome/metabolism* ; Gastrointestinal Microbiome ; Neurotransmitter Agents/metabolism* ; Acupuncture Therapy ; Male ; Mice, Inbred C57BL ; Mice

Objective:To outline and analyze the core elements of the coordinated development and governance of China's tripartite system,and to provide policy optimization recommendations to promote its coordinated development and governance.Method:Using grounded theory research methodology,this study constructs a path model for the coordinated development and governance of the tripartite system based on interview records from 28 participants.The process involves three levels of coding:open coding,axial coding,and selective coding.Results:The path of the coordinated development and governance of the tripartite system was summarized into 20 initial categories,8 main categories and 3 core categories(departmental coordination mechanism,construction of a service-oriented government,publicity and guidance),and then a theoretical model was formed with the long-term development of the coordinated development and governance of the tripartite system as the result and the protection of people's health as the ultimate goal.Conclusions:It is suggested to enhance the awareness of departmental coordination,consolidate the foundation of coordinated development and governance;try to change the thinking angle,and constantly improve the service awareness;strengthen public publicity and education,and attach importance to public opinion early warning and response.

BACKGROUND:Understanding the characteristics and influencing factors of the gut microbiota in athletes can help determine the optimal gut microbial composition for relevant sport events.Further investigation in this area could provide important insights for improving athletic performance and recovery as well as developing personalized nutrition prescriptions.OBJECTIVE:To summarize the characteristics of gut microbiota in athletes,and to elucidate the important factors influencing the gut microbiota characteristics of athletes from the perspectives of exercise training and dietary intake.METHODS:A literature search was conducted using the PubMed,ScienceDirect,CNKI,WanFang and VIP databases for publications from 2004 to 2024.The search terms included"microbiota,microbiome,athlete,exercise,training,diet,nutrition,dietary fiber,protein,ketogenic,fat"in English and Chinese.After excluding studies of poor quality and irrelevant content,a total of 65 articles were included for review and analysis.RESULTS AND CONCLUSION:(1)The gut microbiota of elite athletes differs from that of the general population,characterized by increased α-diversity,elevated Firmicutes/Bacteroidetes ratio,increased abundance of beneficial bacteria,and enrichment of functional pathways contributing to athletic performance.(2)The type of sport and training load are closely related to the species structure and functional expression of the gut microbiota in athletes.(3)The bidirectional communication between the host and gut microbiota mediated by metabolites is an important mechanism by which exercise influences the gut microbiota.(4)Phase training typically induces adaptive changes in the gut microbiota,and alterations in the structure or function of the microbiota have lasting effects.(5)The type,quantity,and combination of macronutrients intake can significantly influence the structure and function of the gut microbiota,and interact synergistically or antagonistically with exercise training.(6)In the future,it is important to continue the exploration of the gut microbiota in athletes,clarify causal relationships,and establish new targets for exercise training interventions.

Objective To analyze the clinical characteristics of co-infection of Talaromyces marneffei(TM)and non-tuberculous Mycobacterium(NTM)in human immunodeficiency virus(HIV)-negative patients.Methods Clinical data of 8 HIV-negative patients with co-infection of TM and NTM in a hospital from 2019 to 2022 were co-llected.Clinical manifestations,auxiliary examination,treatment and prognosis were retrospectively analyzed.Results Among the 8 patients,5 were females and 3 were males,with an average age of(52.25±12.31)years old.All patients presented TM and NTM disseminated infection.The major involved organs were lung(100％),lymph nodes(87.5％),and skin(75.0％).Clinical symptoms mainly included cough and expectoration(87.5％),fatigue(62.5％),joint and lumbosacral pains(62.5％),fever(50.0％),as well as skin and soft tissue abscess(50.0％),etc.Anti-interferon-γ(INF-γ)autoantibodies were detected in 4 patients and the results were positive.All 8 patients(100％)had pulmonary lesions,with chest CT mainly showing spots,patches,and striped shadows in both lungs.Among them,7 cases(87.5％)had increased and enlarged mediastinal lymph nodes,4 cases(50.0％)had pleural thickening and pleural effusion,2 cases each(25.0％for each)were accompanied by pulmonary mass shadows,bronchial stenosis,as well as increased and enlarged hilar lymph nodes.One case each(12.5％for each)had pulmonary cavity formation,bronchiectasis,and pericardial effusion.Conclusion The co-infection of TM and NTM in non-HIV patients presents disseminated infection,with multiple clinical symptoms.Chest imaging shows a wide variety of pulmonary lesions.It is prone to miss diagnosis in clinic,and the effect is not ideal after treatment for single pathogen infection.

Background As one of the key populations in the prevention and treatment of iodine deficiency disorders, it is important to continuously monitor the iodine nutritional level of school-age children. The current reference interval for thyroid volume in China is based on age only, without taking into account differences in individual developmental levels, and the distribution of thyroid volume may vary regionally due to economic, demographic, and environmental factors. The current reference cut-off points for thyroid volume proposed by the World Health Organization are not based on the Chinese population. Objective To understand the iodine nutritional status and distribution of thyroid volume (Tvol) among children aged 8-10 years in Huangpu District, Shanghai, China, to identify impact factors of Tvol, and to propose a reference range upper limit for local thyroid health surveillance, so as to provide a basis for goiter control and prevention. Methods Six hundred children aged 8-10 years in Huangpu District were recruited in 2017, 2020, and 2023, and body height, weight, thyroid volume, urinary iodine, and iodine content of household edible salt were determined. A multilevel model was constructed using population density and area as regional variables, and age, body surface area (BSA), and body mass index (BMI) as potential impact factors for at the individual level, to assess their effects on thyroid volume. Quantile regression of thyroid volume was performed, and the 98th percentile (P₉₈) of thyroid volume was predicted based on age and BSA. Results The iodized salt coverage in the households of surveyed children in 2017, 2020, and 2023 was 72.0%, 57.0%, and 48.0%, respectively, and the iodized salt coverage decreased by year (χ²=24.31, P<0.001). The urinary iodine level of children in 2017 was higher than that in 2020 and 2023 (χ²=18.77, P<0.001). The Tvol medians of children in 2017, 2020, and 2023 were 2.29, 2.49, and 2.97 mL, respectively, and the Tvol increased by year (χ²=60.04, P<0.001). The proportion of goiter was higher in children in 2023 than in 2017 and 2020 (χ²=6.57, P<0.05). Sex differences were not statistically significant for urinary iodine levels, thyroid volume, and goiter. The median Tvol was 2.26, 2.58, and 2.76 mL in children of 8, 9, and 10 years old respectively, and the Tvol increased with age (χ²=49.02, P <0.001). Tvol was positively correlated with age, BSA, and BMI with correlation coefficients of 0.2846, 0.3723, and 0.2950, respectively. The final quantile regression model showed that the strongest effect of BSA was associated with the 98th percentile of Tvol. Multilevel models considering population density or area as regional variables failed to achieve convergence. Conclusion To establish the upper limit of the reference interval for thyroid volume of healthy children in Huangpu District, the effects of age and BSA should be considered at the individual level, and the upper limit of the normal interval for goiter screening is suggested to be the 98th percentile value of BSA at the same age. In addition, the adaptability of population density and regional area as indicators of regional aggregation of thyroid volume distribution still needs to be further explored.

Forensic medicine has been designated as a first-level discipline,presenting new opportunities and challenges for the development of forensic medicine.Since the 1980s,the establishment of foren-sic medicine discipline and the cultivation of high-level forensic talents have become hot topics in the development of forensic medicine in China.Since the 13th Five-Year Plan,the forensic team of Shanxi Medical University has been aiming at the forefront,proposing the development goals of"Five First-class"and the discipline development path"Six Major Achievements".It has selected benchmark disci-plines,identified gaps in disciplinary development,unified thoughts,formulated completion timelines,concentrated superior resources,assigned tasks to individuals,and created an"Organized Fill-in-the-Blank Format"forensic medicine discipline construction model with the characteristics of the new era.The construction model of forensic medicine has achieved good results in the goals,discipline frame-work,scientific research,talent cultivation,discipline team and platform construction,forming a rela-tively complete discipline construction and management system,and accumulating valuable experience for the construction of first-level discipline and high-level talent cultivation of forensic medicine.

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective:To observe the clinical effect of urokinase along the pipeline under offline status to dissolve dialyzer microthrombus in patients undergoing continuous renal replacement therapy (CRRT).Methods:A prospective research method was adopted. A total of 248 CRRT patients with dialyzer microthrombus in Sinopharm-Gezhouba Central Hospital from January 2017 to December 2021 were selected. The patients were divided into experimental group (continued CRRT treatment after urokinase along the pipeline under offline status to dissolve dialyzer microthrombus) and control group (continued CRRT treatment after dialyzer replacement) by random number table method with 124 cases in each group. The baseline data were recorded, including gender, age, primary disease, hemoglobin, platelet count, hematocrit, plasma albumin, D-dimer, fibrinogen, anticoagulant method and symptoms associated with dialyzer microthrombus. The blood indexes were detected before and after treatment of microthrombus, and the symptom scores were performed. The blood indexes included creatinine, urea nitrogen, β 2 microglobulin (β 2-MG), international normalized ratio (INR), hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α); and the symptom scores included acute physiology and chronic health status score Ⅱ (APACHE Ⅱ) and (APACHE Ⅱ) and sequential organ failure score. The initial transmembrane pressure, transmembrane pressure before disembarkation, CRRT treatment extension time and coagulation classification were recorded. In experimental group, the blood coagulation function indexes before and after treatment were detected, including prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT) and fibrinogen (Fib). The adverse reactions were recorded, including black stools, arrhythmias and wound bleeding. Results:There were no statistical differences in baseline data, initial transmembrane pressure, transmembrane pressure before disembarkation, CRRT treatment extension time and coagulation classification between two groups ( P>0.05). There were no statistical differences in creatinine, urea nitrogen, β 2-MG, INR, hs-CRP, IL-6, TNF-α, APACHE Ⅱ and SOFA before treatment between two groups ( P>0.05); after treatment, the indexes in both groups were significantly lower than before treatment, and the indexes in experimental group were significantly lower than those in control group: (179.1 ± 41.2) μmol/L vs. (187.1 ± 53.9) μmol/L, (7.3 ± 2.8) mmol/L vs. (9.3 ± 2.5) mmol/L, (2.5 ± 0.6) mg/L vs. (4.2 ± 0.7) mg/L, 1.0 ± 0.3 vs. 1.8 ± 0.5, (8.7 ± 1.1) mg/L vs. (10.6 ± 2.4) mg/L, (21.5 ± 12.7) ng/L vs. (29.5 ± 10.3) ng/L, (20.2 ± 6.1) ng/L vs. (26.6 ± 7.2) ng/L, (12.1 ± 6.9) scores vs. (17.2 ± 5.2) scores and (5.9 ± 1.8) scores vs. (6.8 ± 1.9) scores, and there were statistical differences ( P<0.05). In experimental group, there were no statistical differences in PT, APTT, TT and Fib between before treatment and after treatment ( P>0.05). The incidence of adverse reactions in experimental group was significantly lower than that in control group: 4.03%(5/124) vs. 12.90%(16/124), and there was statistical difference ( χ2 = 6.30, P<0.05). Conclusions:The urokinase along the pipeline under offline status to dissolve dialyzer microthrombus in patients undergoing CRRT is safer, cheaper and more efficient. It can improve the biocompatibility of tissue with dialyzer and pipe, prolong the use time of the dialyzer, and complete renal replacement therapy.

Objective:To summarize the clinical characteristics of elderly patients with stage Ⅰ diffuse large B-cell lymphoma (DLBCL) and analyze the factors associated with prognosis.Methods:A case series study was conducted by retrospectively collecting clinical data from patients aged over 60 years with newly diagnosed stage Ⅰ DLBCL across 20 medical centers in Jiangsu Province, China, between June 2010 and April 2023. The involved site, classification and treatment plan were summarized. The primary endpoints were progression-free survival (PFS) and overall survival (OS). Statistical analyses were performed using the Kaplan-Meier method, and Cox regression model.Results:The study included 255 patients with a median age of 69 years, of whom 130 (51.0%) were male, 66 (25.9%) were aged ≥75 years and 26 (10.1%) had a high Charlson Comorbidity Index (CCI) score of ≥2. Extranodal involvement was observed in 163 (63.9%) patients, with the stomach (37.4%, 61/163), intestine (19.0%, 31/163), testes (11.0%, 18/163), and breast (7.4%, 12/163) being the most frequently affected sites. The non-germinal center B-cell (non-GCB) subtype was prevalent in 63.7% of patients (142/223), with no significant difference between the nodal and extranodal groups ( P=0.681). Furthermore, 73.9% (184/249) and 11.7% (29/249) of patients received the R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) and R-miniCHOP regimen, respectively. The overall 3-year PFS rate was 81.5%, and the 3-year OS rate was 85.6%. Patients aged ≥75 years ( HR=2.910, 95% CI 1.565-5.408, P=0.001) and/or with a CCI score ≥2 ( HR=2.324, 95% CI 1.141-4.732, P=0.020) had a significantly poorer PFS. Incorporating age ≥75 years and CCI score ≥2 into the stage-modified international prognostic index (sm-IPI) can better stratify the prognosis of elderly patients with stage Ⅰ DLBCL. The 3-year PFS rate was 48.7% in the high-risk group versus 85.7% in the low-risk group ( P<0.001). Conclusions:Our findings show that the elderly patients with stage Ⅰ DLBCL were predominantly characterized by extranodal involvement (particularly in the stomach and intestinal tract) and non-GCB subtype. Age ≥75 years and CCI ≥2 were identified as independent prognostic factors. The newly established sm-IPI-75-CCI incorporating these factors demonstrated superior prognostic discrimination compared to conventional risk assessment systems.