The disturbance of the human microbiota influences the occurrence and progression of many diseases. Live therapeutic bacteria, with their genetic manipulability, anaerobic tendencies, and immunomodulatory properties, are emerging as promising therapeutic agents. However, their clinical applications face challenges in maintaining activity and achieving precise spatiotemporal release, particularly in the harsh gastrointestinal environment. This review highlights the innovative bacterial functionalized encapsulation strategies developed through advances in physicochemical and biological techniques. We comprehensively review how bacterial encapsulation strategies can be used to provide physical barriers and enhanced adhesion properties to live microorganisms, while introducing superior material properties to live bacteria. In addition, this review outlines how bacterial surface coating can facilitate targeted delivery and precise spatiotemporal release of live bacteria. Furthermore, it elucidates their potential applications for treating different diseases, along with critical perspectives on challenges in clinical translation. This review comprehensively analyzes the connection between functionalized bacterial encapsulation and innovative biomedical applications, providing a theoretical reference for the development of next-generation bacterial therapies.

Objective To investigate the association between birth weight and dementia risk and the mediating roles of chronic diseases,and to assess potential biological pathways underlying the birth weight-associated dementia risk based on large-scale proteomics.Methods We used data from 279 743 participants aged 40 to 69 years enrolled in the UK Biobank.Birth weight was categorized into low birth weight(≤2 500 g),normal birth weight(2 500-3 999 g),and macrosomia(≥4 000 g).Multivariable Cox proportional hazards regression models were used to assess the associations between birth weight categories and all-cause dementia and its subtypes(Alzheimer's disease and vascular dementia).Proteomics analyses were conducted to identify proteins and the potential pathways involved.Results Low birth weight was associated with higher risks for all-cause dementia and its subtypes.The hazard ratios were 1.18(95%CI,1.08-1.30)for all-cause dementia,1.14(95%CI,1.00-1.31)for Alzheimer's disease,and 1.22(95%CI,1.01-1.48)for vascular dementia.A non-linear relationship was observed between birth weight and dementia risk(P for nonlinearity<0.001).Certain cardiometabolic diseases in middle-aged adults,such as diabetes,stroke,hypertension,and dyslipidemia,played a significant mediating role in the relationship between low birth weight and dementia risk,with the mediation proportion being 6.3%to 15.8%.Proteomic analyses identified 21 proteins linked to both low birth weight and all-cause dementia risk,which were significantly enriched in the pathways for viral protein interaction with cytokines and cytokine receptors,adipocytokine signaling,and cytokine-cytokine receptor interaction.Conclusion Low birth weight is positively associated with dementia risk.Cardiometabolic diseases in middle-aged adults may mediate the relationship between low birth weight and dementia risk.A number of proteins and the associated pathways underscore the relationship between low birth weight and dementia risk.

Background and purpose:Accurately locating pulmonary nodules is the key to the success of thoracoscopic surgery.This study aimed to investigate the strategy and evaluate the feasibility,safety,and clinical value of thoracoscopic surgical treatment for pulmonary nodules located beneath the interlobar pleura and close to the pulmonary hilum.Methods:The patients who underwent pulmonary nodule surgery at Liaocheng Tumor Hospital from May 2023 to November 2024 were enrolled,and the patients who did not meet the inclusion criteria were excluded.This study was approved by the Ethics Committee of Liaocheng Tumor Hospital(EC-20240112-1020)and informed consent was obtained from the patients.The research was designed as a prospective single-arm study.The patients were treated with wedge resection,which was performed following CT-guided localization,where the location needle was inserted through the interlobar pleura.The feasibility of the procedure was evaluated by analyzing the success rate of preoperative localization and perioperative complications.Results:A total of 28 patients who met the inclusion criteria were included in this study.There were 5 male and 23 female patients with an average age of(56.0±8.5)years(range 38-69 years).In all,28 patients with 28 nodules underwent thoracoscopic wedge resection,and the preoperative CT-guided localization was successfully performed in all patients,without urgent complications.The mean operation time of thoracoscopic surgery was(15.6±4.0)min,intraoperative bleeding was(20.9±14.3)mL,and postoperative drainage was(214.3±62.2)mL.No cases of postoperative air leaks or conversion to thoracotomy were observed.The average length of hospital stay was(5.4±0.9)days.The postoperative histological diagnosis revealed 3 benign lesions(pulmonary fibrosis in 2 cases,atypical adenomatous hyperplasia in 1 case)and 25 malignant lesions(adenocarcinoma in situ in 5 cases,minimally invasive adenocarcinoma in 16 cases,and invasive adenocarcinoma in 4 cases).Conclusion:Thoracoscopic wedge resection following CT-guided nodule localization through the interlobar pleura is a feasible approach for nodules located beneath the interlobar pleura and close to the pulmonary hilum.The method ensures precise tumor localization,adequate margin,and minimal loss of normal lung tissue,with a low incidence of postoperative complication,which has important guiding significance for the surgical treatment of pulmonary nodules in such special locations.

Background and purpose:Accurately locating pulmonary nodules is the key to the success of thoracoscopic surgery.This study aimed to investigate the strategy and evaluate the feasibility,safety,and clinical value of thoracoscopic surgical treatment for pulmonary nodules located beneath the interlobar pleura and close to the pulmonary hilum.Methods:The patients who underwent pulmonary nodule surgery at Liaocheng Tumor Hospital from May 2023 to November 2024 were enrolled,and the patients who did not meet the inclusion criteria were excluded.This study was approved by the Ethics Committee of Liaocheng Tumor Hospital(EC-20240112-1020)and informed consent was obtained from the patients.The research was designed as a prospective single-arm study.The patients were treated with wedge resection,which was performed following CT-guided localization,where the location needle was inserted through the interlobar pleura.The feasibility of the procedure was evaluated by analyzing the success rate of preoperative localization and perioperative complications.Results:A total of 28 patients who met the inclusion criteria were included in this study.There were 5 male and 23 female patients with an average age of(56.0±8.5)years(range 38-69 years).In all,28 patients with 28 nodules underwent thoracoscopic wedge resection,and the preoperative CT-guided localization was successfully performed in all patients,without urgent complications.The mean operation time of thoracoscopic surgery was(15.6±4.0)min,intraoperative bleeding was(20.9±14.3)mL,and postoperative drainage was(214.3±62.2)mL.No cases of postoperative air leaks or conversion to thoracotomy were observed.The average length of hospital stay was(5.4±0.9)days.The postoperative histological diagnosis revealed 3 benign lesions(pulmonary fibrosis in 2 cases,atypical adenomatous hyperplasia in 1 case)and 25 malignant lesions(adenocarcinoma in situ in 5 cases,minimally invasive adenocarcinoma in 16 cases,and invasive adenocarcinoma in 4 cases).Conclusion:Thoracoscopic wedge resection following CT-guided nodule localization through the interlobar pleura is a feasible approach for nodules located beneath the interlobar pleura and close to the pulmonary hilum.The method ensures precise tumor localization,adequate margin,and minimal loss of normal lung tissue,with a low incidence of postoperative complication,which has important guiding significance for the surgical treatment of pulmonary nodules in such special locations.

Objective To explore the relationship between baseline urinary protein levels and the onset of chronic obstructive pulmonary disease (COPD). Methods A questionnaire survey, blood and urine sample collection, physical examination, and pulmonary function test were conducted among permanent residents over 40 years old in Pudong New Area, Shanghai. The subjects were divided into four groups based on the baseline urine albumin-to-creatinine ratio (ACR) quartiles (0~1.65 mg/g, 1.65~4.89 mg/g, 4.89~10.78 mg/g, and ≥10.78 mg/g). Cox regression analysis was used to explore the relationship between ACR levels and the incidence of COPD in middle-aged and elderly people. Results Among the 3 105 subjects, the median follow-up time was 3.212 years (P25~P75：3.102~3.473). 116 new cases of COPD were observed, with an incidence density of 10.423 per 1000 person-years. The incidence densities for COPD at four ACR levels were 7.922 per 1 000 person-years, 8.300 per 1 000 person-years , 11.419 per 1 000 person-years, and 13.843 per 1 000 person-years, respectively. Cox regression analysis revealed that as the ACR level increased, there was a rising trend in the incidence rate of COPD (χ²=4.396, P=0.036). After adjusting for gender, age, education level, occupational exposure to dust, history of childhood pneumonia, smoking, family history of COPD, central obesity, and hypertension, the risk of developing COPD was 2.499 times higher (95% CI: 1.460~4.276) for ACR levels ≥10.78 mg/g compared to the reference group with a baseline ACR level of 0~1.65 mg/g. Conclusion Elevated ACR levels in middle-aged and elderly population may increase the risk of COPD, and early monitoring of urine protein levels is beneficial for COPD prevention.

By integrating the concept of narrative medicine and relevant models and tools into the Doctor-patient Communication course， this paper expounds the connotation of narrative medicine under the context of “new medicine” and “big health” and the practical significance of the shift to narrative in Doctor-patient Communication course in three aspects： academic frontier， social needs and practical needs. This paper analyzes the four dimensions of innovation that narrative medicine， as the frontier of the discipline， historical accumulation， educational philosophy and professional skills， provides for the Doctor-patient Communication course， and explores the effective path to realize the narrative transformation of the course. It is expected to achieve the purpose of forging students’ humanistic medical skills and literacy through teaching innovation， realizing the coordination of medical education and competency orientation， adapting to the psychological and social increase， the change of people and health， and promoting the reform of the supply side of medical talents.

Objective:To learn about the fasting blood glucose (FBG) level of adults in different water iodine areas in Shanxi Province, and to study the relationship between high iodine intake in drinking water and blood glucose.Methods:The urinary iodine content and FBG of 18-65 years old residents in the high-water iodine area of Gaoche Village, Wenshui County, Shanxi Province in 2016 (iodine content in drinking water > 100 μg/L) and the low-water iodine area of Maxi Village (iodine content in drinking water < 10 μg/L) were retrospectively analyzed, and the urinary iodine content, FBG level and its abnormal rate of adults in different water iodine areas were compared.Results:A total of 598 subjects were included, including 276 in Gaoche Village and 322 in Maxi Village. The difference of median urinary iodine (422.8, 126.5 μg/L) between Gaoche Village and Maxi Village was statistically significant ( Z = 7.81, P < 0.001). The FBG levels of adults in Gaoche Village and Maxi Village [(6.70 ± 1.87), (6.04 ± 1.23) mmol/L] were significantly different ( t = 5.18, P < 0.001). The difference of FBG level in males [(6.82 ± 1.82), (5.99 ± 1.11) mmol/L] between the two regions was statistically significant ( t = 4.45, P < 0.001), the difference of FBG level in females [(6.59 ± 1.91), (6.07 ± 1.30) mmol/L] was statistically significant ( t = 2.96, P = 0.003). In Gaoche Village and Maxi Village, there was no statistically significant difference in FBG level between males and females ( t = 1.04, 0.52, P = 0.308, 0.564). Comparison of FBG levels in 18-< 45 years old group [(6.31 ± 1.57), (5.79 ± 0.89) mmol/L] and 45-65 years old group [(7.00 ± 2.02), (6.18 ± 1.36) mmol/L] between the two regions, the differences were statistically significant ( t = 3.10, 4.60, P = 0.002, P < 0.001). Moreover, in Gaoche Village and Maxi Village, the FBG level of the 45-65 years old group was higher than that of the 18-< 45 years old group in the same area, and the difference was statistically significant ( t = 3.07, 2.74, P = 0.003, 0.006). The abnormal rate of FBG in adults in Gaoche Village and Maxi Village [28.3% (78/276) and 15.5% (50/322)] was statistically significantly different (χ 2 = 14.32, P < 0.001). Conclusion:Long-term intake of high iodine in drinking water may cause abnormal glucose metabolism.

Objective: To analyze the consistency between self-reported oral health and proposed standard in evaluating children oral health status, and to test whether self-reported oral health can be used in children population. Methods: The clinical examination data and questionnaire data were 2 158 children aged 12-year-old in Beijing, China. Child oral health status was measured by self-reported oral health and proposed standard from World Health Organization (WHO), and was classified into "good, general, poor" based on each method. Kappa test was used to evaluate the consistency of two measurements. Using multivariate nonordinal logistic regression to identify the influencing factors of self-reported oral health, and to explore the possible reasons for the consistency differences of two measurements. Results: According to the WHO standard, 25.5%, 65.3% and 9.2% children oral health were rated as good, general and poor, respectively. The proportion was 50.6%, 37.7% and 11.8% respectively based on self-report method. Kappa value for two measurements was 0.04, indicating poor agreement between two methods. Results from regression model show that both the untreated caries (OR=2.47, P<0.01) and toothache (OR=3.54, P<0.01) were associated with self-reported oral health, while not observed in periodontal health (OR=1.34, P=0.18) and oral hygiene status(OR=0.95, P=0.75). Conclusion Self-reported oral health results can reflect caries status to some extents among children, but it failed to reflect other aspects, such as periodontal health status and oral hygiene. Self-reported oral health among children should be considered based on the requirements of assessment content and accuracy in the future work.

Objective To evaluate the role of miR-146a in bone marrow mesenchymal stem cells ( BMSCs)-induced reduction of acute lung injury ( ALI ) in rats. Methods A total of 105 clean-grade healthy male Wistar rats, weighing 170-190 g, were divided into 5 groups ( n=21 each) using a random number table method: control group (group C), phosphate buffer solution group (group P), group ALI, BMSC group ( group B) and BMSC plus miR-146a inhibitor group ( group BM) . ALI was induced by intra-peritoneally injecting 5 mg∕kg lipopolysaccharide ( LPS) 0. 5 ml in anesthetized rats. Phosphate buffer solu-tion 0. 5 ml was injected via the tail vein in group P. In group B, 1×104 cells∕ml BMSC 0. 5 ml was injected via the tail vein after establishing the model. In group BM, miR-146a inhibitor 50 mg∕kg was injected via the tail vein after establishing the model, and 2 h later 1×104 cells∕ml BMSC 0. 5 ml was injected via the tail vein. Group C received no treatment. Blood samples were obtained from the abdominal aorta for blood gas a-nalysis at 6, 24 and 48 h after injection of BMSC ( T1-3 ) , the chest was immediately opened, and the lung tissues were obtained for microscopic examination of pathologic changes and for determination of the wet∕dry lung weight ratio ( W∕D ratio) , expression of IRAK-1, nuclear factor kappa B ( NF-κB) and interleukin-6 ( IL-6) ( by Western blot) and expression of miR-146a and IRAK-1 mRNA ( by quantitative real-time poly-merase chain reaction). Results Compared with group C, the pH value and PO2 were significantly de-creased, PCO2 and W∕D ratio were increased, and the expression of IRAK-1, NF-κB, IL-6 and miR-146a was up-regulated at each time point ( P<0. 05) , and the pathological changes of lung tissues were aggrava-ted in ALI, B and BM groups. Compared with group P, the pH value and PO2 were significantly decreased, PCO2 and W∕D ratio were increased, and the expression of IRAK-1, NF-κB, IL-6 and miR-146a was up-regulated at each time point (P<0. 05), and the pathological changes of lung tissues were aggravated in ALI, B and BM groups. Compared with group ALI, the pH value and PO2 were significantly increased, PCO2 and W∕D ratio were decreased, and the expression of IRAK-1, NF-κB, IL-6 and miR-146a was down-regulated at each time point ( P<0. 05 ) , and the pathological changes of lung tissues were attenuated in group B. Compared with group B, the pH value and PO2 were significantly decreased, PCO2 and W∕D ratio were increased, and the expression of IRAK-1, NF-κB, IL-6 and miR-146a was up-regulated at each time point ( P<0. 05) , and the pathological changes of lung tissues were aggravated in group BM. Conclusion miR-146a is involved in BMSCs-induced reduction of ALI in rats.

A 34-year-old female patient presented with itchy nodules on the left posterior ear for 7 years.Skin examination showed clustered light-red or brown-black nodules measuring about 4 cm × 5 cm in size on the left posterior auricle,as well as from the posterior sulcus of the auricle to the anterior border of the hair line on the posterior auricle.Histopathological examination of the skin lesion revealed epidermal hyperkeratosis,proliferation of a lot of small blood vessels in the dermis,swelling vascular endothelial cells with enlarged nuclei and eosinophilic cytoplasm bulging into vascular cavity,and perivascular infiltration of lymphocytes and many eosinophils.The patient was diagnosed with angiolymphoid hyperplasia with eosinophilia.After extended surgical resection,a skin graft from the left lower abdomen was used to repair the defect.After the surgery,the flap survived well,and the appearance of the auricle was improved.No recurrence was observed during 1 year of follow-up.