Objective:To analyze the clinical and endoscopic features of elderly patients with early gastric neuroendocrine neoplasms(g-NEN)to provide insights for clinical diagnosis and treatment.Methods:Seven cases of early-stage g-NEN in elderly patients admitted to Beijing Hospital from May 2020 to October 2024 were reported.Information including patient demographics, medical history, laboratory findings, endoscopic features, and pathological results was summarized an analyzed.Meanwhile, a literature review was conducted on g-NEN cases reported domestically and internationally from the establishment of databases to April 2025, with a comparative analysis of baseline characteristics, background mucosal conditions, and pathological diagnoses.Results:A total of 7 elderly patients with early g-NEN were included, including 3 males and 4 females, with an average age of 67 years at diagnosis.Endoscopic and pathological features: endoscopic lesions were mainly located on the greater curvature of the stomach, mostly slightly elevated, with 4/7(57.1%)being single lesions and the others accompanied by multiple polyps.The size of gastric neuroendocrine tumor(g-NET) lesions ranged from 1 mm to 19 mm, with a median Kyoto gastritis score of 3.In terms of pathological grading, there were 6 cases of G1 and 1 case of gastric neuroendocrine carcinoma(g-NEC). All 7 patients underwent endoscopic submucosal dissection(ESD). The follow-up period after surgery ranged from 3 months to 4 years, and no tumor was found at the vertical and horizontal margins of all lesions on pathology.A literature review of 32 reported cases showed that 40.6%(13/32)of cases exhibited background mucosal atrophy or intestinal metaplasia, with positive rates of chromogranin A(CgA) and synapsin(Syn)reaching 95.8%(23/24) and 100.0%(25/25), respectively.Notably, elderly patients with g-NEC demonstrated aggressive invasiveness, with a metastasis rate of 62.5%(5/8).Conclusions:Elderly patients with g-NEN exhibit high heterogeneity and significant differences in invasiveness, necessitating heightened clinical vigilance.Precise management should integrate background mucosal status, Kyoto gastritis score, pathological biomarkers, and imaging techniques.Blue laser imaging with magnifying endoscopy(BLI-ME)and endoscopic ultrasonography(EUS)can further analyze the characteristics of these tumors, and endoscopic submucosal dissection(ESD)remains the primary treatment modality for early-stage g-NEN.

Objective To observe the effects of Yitangkang on brown fat thermogenesis and mitochondrial biogenesis of PGC1α-NRF1/2-TFAM pathway in db/db mice;To explore its mechanism of regulating glucose and lipid metabolism.Methods Totally 27 six-week-old db/db mice were randomly divided into model group,Yitangkang group(30 g/kg)and liraglutide group(200 μg/kg),another 9 db/m mice of the same age were set as normal group.All groups received intervention with drugs or saline for 6 weeks.The body mass and FBG were measured weekly.After intervention,oral glucose tolerance test(OGTT)was carried out,the contents of serum TC,TG,LDL-C and HDL-C were detected by biochemical analyzer,HE staining was used to observe the morphology of brown adipose tissue(BAT)in scapular region,RT-qPCR and Western blot were used to detect the expressions of UCP1,PRDM16,PGC1α related to BAT thermogenesis and NRF1,Nrf2,TFAM related to mitochondrial biogenesis.Results Compared with the normal group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C content of model group significantly increased(P<0.01),the content of HDL-C significantly decreased(P<0.01);the diameter of BAT cells in scapular region was larger,white vacuoles appeared,lipid droplets increased,and the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT decreased significantly(P<0.01).Compared with the model group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C contents of Yitangkang group and liraglutide group significantly decreased(P<0.01),the content of HDL-C increased(P<0.01);BAT cells were smaller in diameter,more closely arranged,more regular in shape,and more abundant in capillary,the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT increased significantly(P<0.01).Conclusion Yitangkang can regulate mitochondrial biogenesis through PGC1α-NRF1/2-TFAM pathway to activate brown fat in db/db mice and improve glucose and lipid metabolism in db/db mice.

Objective To investigate the perioperative use of antimicrobial agents in class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City,and provide a basis for the rational use of antimicrobial agents in such surgeries.Methods Perioperative antimicrobial prophylaxis(PAP)in patients undergoing class Ⅰ incisional ophthalmic surgery reported by secondary first-class and above hospitals in Shanghai City from 2017 to 2022 was collected retrospectively.The prophylactic use rate,types,rationality of selection,and timing of use of antimicrobial agents were analyzed comprehensively.Results From 2017 to 2022,a total of 54 868 cases of class Ⅰ incisional ophthalmic surgeries were reported from secondary first-class and above hospitals in Shanghai City.The PAP rates in tertiary comprehensive hospitals,tertiary specialty hospitals,tertiary traditional Chinese medicine hospitals,and secondary comprehensive hospitals were 4.72％,1.79％,3.22％,and 6.63％,re-spectively.The overall PAP rate showed a yearly decreasing trend,from 6.39％in 2017 to 2.31％in 2021.Among different types of hospitals,the PAP rate in secondary comprehensive hospitals decreased most significantly,from 12.72％in 2017 to 0.53％in 2022.The main types of prophylactic antimicrobial use were first-,second-and third-generation cephalosporins,and quinolones.The rational selection rates of antimicrobial agents were highest in ter-tiary comprehensive hospitals(17.13％)and lowest in tertiary specialty hospitals(1.08％).The PAP rates in sys-temic veins 0.5-1 hour before surgery were highest in tertiary specialty hospitals(88.17％)and lowest in tertiary comprehensive hospitals(71.53％).The withdrawal rates of antimicrobial agents within 24 hours after surgery were highest in tertiary traditional Chinese medicine hospitals(80.87％)and lowest in tertiary specialty hospitals(13.26％).Conclusion The PAP for class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City still presents certain irrational phenomena in terms of antimicrobial types and administration routes.The administration rate 0.5-1 hour before surgery and withdrawal rate of antimicrobial agents within 24 hours after surgery need to be further improved.Enhanced management is necessary to promote more rational use of antimicrobial agents.

Objective:To learn about the clinical characteristics of patients with neurobrucellosis (NB) and provide references for clinical diagnosis and treatment of NB.Methods:The clinical data of 22 NB patients diagnosed and treated at Beidahuang Industry Group General Hospital from January 2018 to November 2024 and 178 healthy individuals undergoing physical examinations during the same period were retrospectively collected. The epidemiological characteristics, clinical manifestations, laboratory tests, treatment and prognosis of NB patients were analyzed.Results:Among the 22 NB patients, 12 were males (54.55%) and 10 were females (45.45%). The age was (51.77 ± 12.75) years old, ranging from 27 to 80 years old. Most of the patients were farmers (95.45%, 21/22), and 16 cases (72.73%) had contacted with cattle/sheep. The onset seasons were mainly in summer (40.91%, 9/22) and spring (31.82%, 7/22). Among all NB patients, there were 10 cases of encephalitis/meningoencephalitis, 9 cases of myelitis, and 3 cases of meningitis. The general symptoms were mainly fever (68.18%, 15/22), the neurological symptoms were mainly nausea and vomiting (36.36%, 8/22), and the physical signs were mainly muscle weakness (50.00%, 11/22) and pathological signs (45.45%, 10/22). The laboratory test results showed that the levels of hemoglobin, hematocrit, C-reactive protein, total protein, albumin, γ-glutamyl transpeptidase, α-hydroxybutyric acid dehydrogenase, lactate dehydrogenase, and glutathione reductase in NB patients were significantly different from those in healthy individuals ( P < 0.001). Brain magnetic resonance imaging revealed ischemic changes in 5 cases (22.73%), abnormal brain signals in 2 cases (9.09%), and demyelinating lesions in white matter in 1 case (4.55%). After treatment, 18 NB patients were followed up and showed good prognosis, with only 2 cases exhibiting varying degrees of sequelae (walking disorders or memory impairment). Conclusions:The clinical manifestations of NB patients are diverse. A comprehensive judgment should be made by combining epidemiological characteristics, clinical manifestations, laboratory tests and imaging examinations.

Objective To investigate the perioperative use of antimicrobial agents in class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City,and provide a basis for the rational use of antimicrobial agents in such surgeries.Methods Perioperative antimicrobial prophylaxis(PAP)in patients undergoing class Ⅰ incisional ophthalmic surgery reported by secondary first-class and above hospitals in Shanghai City from 2017 to 2022 was collected retrospectively.The prophylactic use rate,types,rationality of selection,and timing of use of antimicrobial agents were analyzed comprehensively.Results From 2017 to 2022,a total of 54 868 cases of class Ⅰ incisional ophthalmic surgeries were reported from secondary first-class and above hospitals in Shanghai City.The PAP rates in tertiary comprehensive hospitals,tertiary specialty hospitals,tertiary traditional Chinese medicine hospitals,and secondary comprehensive hospitals were 4.72％,1.79％,3.22％,and 6.63％,re-spectively.The overall PAP rate showed a yearly decreasing trend,from 6.39％in 2017 to 2.31％in 2021.Among different types of hospitals,the PAP rate in secondary comprehensive hospitals decreased most significantly,from 12.72％in 2017 to 0.53％in 2022.The main types of prophylactic antimicrobial use were first-,second-and third-generation cephalosporins,and quinolones.The rational selection rates of antimicrobial agents were highest in ter-tiary comprehensive hospitals(17.13％)and lowest in tertiary specialty hospitals(1.08％).The PAP rates in sys-temic veins 0.5-1 hour before surgery were highest in tertiary specialty hospitals(88.17％)and lowest in tertiary comprehensive hospitals(71.53％).The withdrawal rates of antimicrobial agents within 24 hours after surgery were highest in tertiary traditional Chinese medicine hospitals(80.87％)and lowest in tertiary specialty hospitals(13.26％).Conclusion The PAP for class Ⅰ incisional ophthalmic surgeries in secondary first-class and above medical institutions in Shanghai City still presents certain irrational phenomena in terms of antimicrobial types and administration routes.The administration rate 0.5-1 hour before surgery and withdrawal rate of antimicrobial agents within 24 hours after surgery need to be further improved.Enhanced management is necessary to promote more rational use of antimicrobial agents.

Objective To observe the effects of Yitangkang on brown fat thermogenesis and mitochondrial biogenesis of PGC1α-NRF1/2-TFAM pathway in db/db mice;To explore its mechanism of regulating glucose and lipid metabolism.Methods Totally 27 six-week-old db/db mice were randomly divided into model group,Yitangkang group(30 g/kg)and liraglutide group(200 μg/kg),another 9 db/m mice of the same age were set as normal group.All groups received intervention with drugs or saline for 6 weeks.The body mass and FBG were measured weekly.After intervention,oral glucose tolerance test(OGTT)was carried out,the contents of serum TC,TG,LDL-C and HDL-C were detected by biochemical analyzer,HE staining was used to observe the morphology of brown adipose tissue(BAT)in scapular region,RT-qPCR and Western blot were used to detect the expressions of UCP1,PRDM16,PGC1α related to BAT thermogenesis and NRF1,Nrf2,TFAM related to mitochondrial biogenesis.Results Compared with the normal group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C content of model group significantly increased(P<0.01),the content of HDL-C significantly decreased(P<0.01);the diameter of BAT cells in scapular region was larger,white vacuoles appeared,lipid droplets increased,and the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT decreased significantly(P<0.01).Compared with the model group,the body mass,FBG,area under the curve of OGTT and serum TG,TC,LDL-C contents of Yitangkang group and liraglutide group significantly decreased(P<0.01),the content of HDL-C increased(P<0.01);BAT cells were smaller in diameter,more closely arranged,more regular in shape,and more abundant in capillary,the mRNA and protein expressions of UCP1,PRDM16,PGC-1α,NRF1,NRF2 and TFAM in BAT increased significantly(P<0.01).Conclusion Yitangkang can regulate mitochondrial biogenesis through PGC1α-NRF1/2-TFAM pathway to activate brown fat in db/db mice and improve glucose and lipid metabolism in db/db mice.

Objective:To learn about the clinical characteristics of patients with neurobrucellosis (NB) and provide references for clinical diagnosis and treatment of NB.Methods:The clinical data of 22 NB patients diagnosed and treated at Beidahuang Industry Group General Hospital from January 2018 to November 2024 and 178 healthy individuals undergoing physical examinations during the same period were retrospectively collected. The epidemiological characteristics, clinical manifestations, laboratory tests, treatment and prognosis of NB patients were analyzed.Results:Among the 22 NB patients, 12 were males (54.55%) and 10 were females (45.45%). The age was (51.77 ± 12.75) years old, ranging from 27 to 80 years old. Most of the patients were farmers (95.45%, 21/22), and 16 cases (72.73%) had contacted with cattle/sheep. The onset seasons were mainly in summer (40.91%, 9/22) and spring (31.82%, 7/22). Among all NB patients, there were 10 cases of encephalitis/meningoencephalitis, 9 cases of myelitis, and 3 cases of meningitis. The general symptoms were mainly fever (68.18%, 15/22), the neurological symptoms were mainly nausea and vomiting (36.36%, 8/22), and the physical signs were mainly muscle weakness (50.00%, 11/22) and pathological signs (45.45%, 10/22). The laboratory test results showed that the levels of hemoglobin, hematocrit, C-reactive protein, total protein, albumin, γ-glutamyl transpeptidase, α-hydroxybutyric acid dehydrogenase, lactate dehydrogenase, and glutathione reductase in NB patients were significantly different from those in healthy individuals ( P < 0.001). Brain magnetic resonance imaging revealed ischemic changes in 5 cases (22.73%), abnormal brain signals in 2 cases (9.09%), and demyelinating lesions in white matter in 1 case (4.55%). After treatment, 18 NB patients were followed up and showed good prognosis, with only 2 cases exhibiting varying degrees of sequelae (walking disorders or memory impairment). Conclusions:The clinical manifestations of NB patients are diverse. A comprehensive judgment should be made by combining epidemiological characteristics, clinical manifestations, laboratory tests and imaging examinations.

Objective:To analyze the clinical and endoscopic features of elderly patients with early gastric neuroendocrine neoplasms(g-NEN)to provide insights for clinical diagnosis and treatment.Methods:Seven cases of early-stage g-NEN in elderly patients admitted to Beijing Hospital from May 2020 to October 2024 were reported.Information including patient demographics, medical history, laboratory findings, endoscopic features, and pathological results was summarized an analyzed.Meanwhile, a literature review was conducted on g-NEN cases reported domestically and internationally from the establishment of databases to April 2025, with a comparative analysis of baseline characteristics, background mucosal conditions, and pathological diagnoses.Results:A total of 7 elderly patients with early g-NEN were included, including 3 males and 4 females, with an average age of 67 years at diagnosis.Endoscopic and pathological features: endoscopic lesions were mainly located on the greater curvature of the stomach, mostly slightly elevated, with 4/7(57.1%)being single lesions and the others accompanied by multiple polyps.The size of gastric neuroendocrine tumor(g-NET) lesions ranged from 1 mm to 19 mm, with a median Kyoto gastritis score of 3.In terms of pathological grading, there were 6 cases of G1 and 1 case of gastric neuroendocrine carcinoma(g-NEC). All 7 patients underwent endoscopic submucosal dissection(ESD). The follow-up period after surgery ranged from 3 months to 4 years, and no tumor was found at the vertical and horizontal margins of all lesions on pathology.A literature review of 32 reported cases showed that 40.6%(13/32)of cases exhibited background mucosal atrophy or intestinal metaplasia, with positive rates of chromogranin A(CgA) and synapsin(Syn)reaching 95.8%(23/24) and 100.0%(25/25), respectively.Notably, elderly patients with g-NEC demonstrated aggressive invasiveness, with a metastasis rate of 62.5%(5/8).Conclusions:Elderly patients with g-NEN exhibit high heterogeneity and significant differences in invasiveness, necessitating heightened clinical vigilance.Precise management should integrate background mucosal status, Kyoto gastritis score, pathological biomarkers, and imaging techniques.Blue laser imaging with magnifying endoscopy(BLI-ME)and endoscopic ultrasonography(EUS)can further analyze the characteristics of these tumors, and endoscopic submucosal dissection(ESD)remains the primary treatment modality for early-stage g-NEN.

Objective To investigate the effects of Yitangkang on browning of white adipose and PINK1/Parkin pathway of mitophagy in adipose tissue of db/db mice.Methods Totally 30 six-week db/db mice were randomly divided into model group,Yitangkang Group(30 g/kg)and liraglutide group(200 μg/kg),and another 10 C57BL/6 mice of the same age were set as normal group.All groups were treated with corresponding drugs or normal saline for 5 weeks.During the period of administration,the body mass and fasting blood glucose(FBG)of mice in each group were detected regularly,the samples of liver,white and brown adipose of mice were weighed,the contents of serum triglyceride cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)were detected by biochemical analyzer,HE staining was used to observe the pathological changes of inguinal white adipose tissue(iWAT),immunohistochemical staining was used to detect the expression of browning marker protein uncoupling protein-1(UCP1)in iWAT,Western blot was used to detect the expressions of browning-related proteins UCP1,PRDM16,PGC-1α and mitophagy-related proteins PINK1,Parkin,Beclin-1,p62 in iWAT.Results Compared with the normal group,the body mass,liver,white adipose and brown adipose mass of the model group significantly increased(P<0.01),the FBG and serum TG,TC and LDL-C contents significantly increased(P<0.01),and the content of HDL-C significantly decreased(P<0.01);large vacuoles in iWAT adipocytes,the diameter of adipocytes increased obviously,some adipocytes were extruded and deformed,and the edge of adipocytes was not clear,the expressions of iWAT UCP1,PRDM16,PGC-1α and p62 proteins decreased(P<0.01),while the expressions of PINK1,Parkin and Beclin-1 proteins increased(P<0.01).Compared with the model group,the body mass,liver and white adipose mass significantly decreased in Yitangkang group and the liraglutide group(P<0.01),FBG and serum contents of TC,TG and LDL-C were significantly decreased(P<0.05,P<0.01),while HDL-C content significantly increased(P<0.01);the diameter of iWAT adipocytes decreased,the number increased,and the morphology was regular,the expressions of iWAT UCP1,PRDM16,PGC-1α and p62 proteins increased(P<0.01),while the expressions of PINK1,Parkin and Beclin-1 proteins decreased(P<0.05,P<0.01).Conclusion Yitangkang can improve glucose and lipid metabolism and promote browning of white adipose in db/db mice,which may be related to mitophagy mediated by PINK1/Parkin pathway.

Objective:To learn about the epidemiological and clinical characteristics of children with brucellosis, in order to provide reference for clinical diagnosis and treatment of brucellosis in children.Methods:Clinical data of children with brucellosis (aged ≤14 years) who visited the Department of Infectious Diseases at Beidahuang Industry Group General Hospital from December 2020 to December 2022 were retrospectively collected, and their epidemiological characteristics, clinical characteristics, laboratory tests, treatment and outcome were summarized and analyzed.Results:A total of 34 children with brucellosis were included, including 25 males (73.53%) and 9 females (26.47%), with a gender ratio of 2.78 ∶ 1.00. The median age was 8 years and 1 month, mainly in the age group of 6 to 14 years (19 cases, 55.88%). Epidemiological investigation showed that most of the affected children were rural residents (25 cases, 73.53%), with more contact with cattle/sheep (26 cases, 76.47%). The onset time was mainly concentrated in summer (15 cases, 44.12%) and spring (13 cases, 38.24%). The clinical symptoms were mainly fever (97.06%, 33/34) and arthralgia (64.71%, 22/34). In the laboratory tests, 25 cases (73.53%) had positive blood cultures, and the white blood cell count (WBC) of 30 cases (88.24%) was (4 - 10) × 10 9/L. Among the abnormalities of liver function, aspartate aminotransferase (AST) increased in 19 cases (55.88%), alanine aminotransferase (ALT) increased in 14 cases (41.18%) and γ-glutamyl transpeptidase (GGT) increased in 6 cases (17.65%). Among the myocardial enzymatic abnormalities, α-hydroxybutyrate dehydrogenase (HBDH) increased in 29 cases (85.29%), lactate dehydrogenase (LDH) increased in 27 cases (79.41%), and creatine kinase isoenzyme (CK-MB) increased in 8 cases (23.53%). After treatment, 25 children with positive blood culture turned negative. Conclusions:Children with brucellosis are mainly male, older and rural residents. The clinical manifestations are mainly fever and arthralgia. Doctors in relevant departments should conduct detailed epidemiological investigations and laboratory tests for such children in clinical work, in order to achieve early detection, diagnosis and treatment of pediatric brucellosis.