Objective To observe the effects of complex small molecule peptides on postoperative nutritional status and immune function of elderly patients with lower limb fractures.Methods A total of 160 elderly patients with unilateral hip fractures or unilateral femoral neck fractures who were hospitalized in Wuxi People's Hospital from April 2020 to September 2023 were selected and randomly assigned to experimental group or control group,with 80 cases in each group.The nutritional status of the patients was evaluated by using the mini nutritional assessment short-form(MNA-SF).From 3 days before surgery to 7 days after surgery,the patients in both groups were given standard nutritional intervention,including dietary guidance and volume-based diets.Additionally,the experimental group was orally administered complex small molecule peptides at a dose of 20 g/d.The blood biochemical and immunological indicators,as well as body composition were tested before and after nutritional intervention.Results All the 160 elderly patients with lower extremity fractures successfully completed the study.The liver and kidney functions of the patients were normal.Serum levels of prealbumin,albumin,total protein and hemoglobin(Hb)were decreased after the operation,and the serum protein level in the experimental group after the operation was significantly higher than that in the control group.Lymphocytes,immunoglobulin G,IgA and IgM were increased after the operation,and these parameters in the experimental group were higher than those in the control group(P<0.05).There was no significant difference in the C-reactive protein between the two groups before the operation.However,after the operation,CRP was increased in both groups,and CRP in the experimental group was lower than that in the control group(P<0.05).The incidence of postoperative malnutrition in the experimental group was significantly lower than that in the control group(17.5%vs.33.75%,χ2=5.542,P=0.019).The waist circumference,skeletal muscle mass index,mineral content,upper arm circumference and skeletal muscle were decreased after surgery,and these indicators in the experimental group were better than those in the control group(P<0.05).The postoperative hospital stay and wound healing time in the experimental group were significantly shorter than those in the control group(P<0.05).The incidence of postoperative infection in the experimental group was significantly lower than that in the control group(8.75%vs.20%,χ2=4.113,P=0.043).Conclusion Complex small molecule peptide can significantly increase the serum protein level of elderly patients with lower extremity fractures,improve their nutritional status and immune function,reduce inflammatory response and postoperative infection,promote wound healing,shorten hospital stay,improve prognosis and clinical outcomes,and is worthy of clinical application.

Inflammatory bowel disease (IBD) is a group of digestive tract diseases characterized by chronic intestinal inflammation, including ulcerative colitis and Crohn′s disease. The over-sustained immune response driven by imbalance of intestinal microbiota plays a key role in the initiation and progression of IBD. Studies have identified that intestinal microbiome possesses more than a hundred trillion types, including bacteria and fungi, which collectively participates in energy metabolism, intestinal barrier function and immune balance. There exists a stable relationship between fungi and bacteria in the intestine, involving cooperation, antagonism, and mutualism. Fungus-bacterium homeostasis plays an important role in maintaining intestinal homeostasis. Based on intestinal fungus changes in IBD patients, this article reviews the research progress in intestinal immunomodulation and therapeutic strategies derived from fungus-bacterial homeostasis.

Inflammatory bowel disease(IBD)is a group of non-specific chronic gastrointestinal inflammatory diseases whose etiology is not completely clear.In recent years,the problem of IBD complicated with psychological disorders has been widely concerned,which affects the quality of life of patients,and increases the recurrence of IBD and poor prognosis.The gut-brain axis is involved in the occurrence of IBD complicated with neuropsychiatric disorders.The gut regulates brain function through the nervous system,hypothalamic-pituitary-adrenal(HPA)axis and immune system.This article reviews the relationship between intestinal immunity,intestinal microecology and psychological disorders in IBD patients,as well as the treatment of psychological disorders based on intestinal immunity and microecology,so as to provide new ideas for the diagnosis and treatment of psychological disorders in IBD.

Inflammatory bowel disease (IBD) is a group of digestive tract diseases characterized by chronic intestinal inflammation, including ulcerative colitis and Crohn′s disease. The over-sustained immune response driven by imbalance of intestinal microbiota plays a key role in the initiation and progression of IBD. Studies have identified that intestinal microbiome possesses more than a hundred trillion types, including bacteria and fungi, which collectively participates in energy metabolism, intestinal barrier function and immune balance. There exists a stable relationship between fungi and bacteria in the intestine, involving cooperation, antagonism, and mutualism. Fungus-bacterium homeostasis plays an important role in maintaining intestinal homeostasis. Based on intestinal fungus changes in IBD patients, this article reviews the research progress in intestinal immunomodulation and therapeutic strategies derived from fungus-bacterial homeostasis.

Inflammatory bowel disease(IBD)is a group of non-specific chronic gastrointestinal inflammatory diseases whose etiology is not completely clear.In recent years,the problem of IBD complicated with psychological disorders has been widely concerned,which affects the quality of life of patients,and increases the recurrence of IBD and poor prognosis.The gut-brain axis is involved in the occurrence of IBD complicated with neuropsychiatric disorders.The gut regulates brain function through the nervous system,hypothalamic-pituitary-adrenal(HPA)axis and immune system.This article reviews the relationship between intestinal immunity,intestinal microecology and psychological disorders in IBD patients,as well as the treatment of psychological disorders based on intestinal immunity and microecology,so as to provide new ideas for the diagnosis and treatment of psychological disorders in IBD.

Objective:To investigate the correlation between the level of anti Mullerian hormone (AMH) in serum and ovarian interstitial blood flow in patients with polycystic ovary syndrome (PCOS).Methods:The clinical data of 88 patients with PCOS (PCOS group) admitted to Jiangshan Hospital of Traditional Chinese Medicine from June 2019 to June 2022 and 50 women of the same age who underwent physical examination during the same period (normal control group) were collected retrospectively. The patients in the PCOS group were divided into two subgroups according to the homeostatic model assessment for insulin resistance index (HOMA-IR) evaluated by the steady-state model. Among them, patients with HOMA-IR ≥ 2.69 were divided into the insulin resistance subgroup (PCOS-IR subgroup, 50 cases), and patients with HOMA-IR<2.69 were divided into the non-insulin resistance subgroup (PCOS-NIR subgroup, 38 cases). The level of AMH were measured by electrochemiluminescence, and ovarian interstitial blood flow indicators, including peak blood flow velocity (PSV), pulsation index (PI), and resistance index (RI) were monitored. Pearson correlation test was used to analyze the correlation between serum AMH and insulin resistance and ovarian interstitial blood flow. Meanwhile, Logistic linear regression model was used to analyze the influencing factors of ovarian interstitial blood flow in patients with PCOS.Results:The levels of AMH, HOMA-IR and PSV in the PCOS group were higher than those in the normal control group: (2.13 ± 0.84) μg/L vs. (0.84 ± 0.29) μg/L, 4.6(2.0, 8.4) vs. 1.8(0.5, 3.9), (10.05 ± 1.52) cm/s vs.(6.78 ± 0.89) cm/s; the PI and RI in the PCOS group were lower than those in the control group: (1.14 ± 0.26)% vs. (2.01 ± 0.53)%, (0.37 ± 0.18)% vs. (0.85 ± 0.33)%, there were statistical differences ( P<0.05). The levels of AMH, HOMA-IR and PSV in the PCOS-IR subgroup were higher than those in the PCOS-NIR subgroup: (2.68 ± 0.81) μg/L vs. (1.59 ± 0.43) μg/L, (10.74 ± 2.32) cm/s vs. (7.93 ± 1.90) cm/s, 7.2(3.1, 15.8) vs. 2.1(0.6, 5.3); the PI and RI in the PCOS-IR subgroup were lower than those in the PCOS-NIR subgroup: (0.88 ± 0.35)% vs. (1.52 ± 0.50)%, (0.29 ± 0.04)% vs. (0.51 ± 0.05)%, there were statistical differences ( P<0.05). Pearson correlation analysis showed that the level of AMH were positively correlated with PSV and HOMA-IR ( r = 0.694 and 0.540, P<0.05), but negatively correlated with PI and RI( r = - 0.687 and - 0.692, P<0.05). Logistic linear regression model analysis showed that AMH and HOMA-IR were risk factors for ovarian interstitial blood flow in patients with PCOS( P<0.05). Conclusions:The serum AMH level in patients with PCOS is abnormally high and increases with insulin resistance. At the same time, the imbalance of AMH expression plays an important role in the increase of abnormal ovarian interstitial blood flow.

Objective To investigate the relationship between occupational noise exposure and glycated hemoglobin (HbA1c) levels, as well as prediabetes diagnosed by HbA1c. Methods A total of 1 181 workers from a cigarette factory were selected as the research subjects using a judgment sampling method. Workers were divided into control, low-level noise exposure and high-level noise exposure groups, consisting of 236, 359, and 586 individuals, respectively. The blood sample was collected for HbA1c test and occupation noise exposure intensity in workplace was detected by an area-sampling method. Results There were no statistical significant differences in HbA1c levels and prediabetes prevalence among the three groups of workers (all P>0.05). After adjusting for potential confounding factors such as years of service, gender, smoking, pack-years of smoking, alcohol consumption, and body mass index, multiple linear regression analysis showed that the high-level noise exposure group had higher HbA1c level than the control group (P<0.05). Multivariable logistic regression analysis results showed that the high-level noise exposure group had higher risk of prediabetes compared with the control group (P<0.05). Conclusion Occupational noise exposure could be a risk factor for the increased HbA1c levels and prediabetes incidence among the occupational population. More attention should be paid to the effects of occupational noise exposure on the HbA1c level in occupational health surveillance.

Ulcerative colitis (UC) is a non-specific, chronic and relapsing intestinal inflammatory disease with unknown etiology. Biological agents had been used to treat UC, and efficacy was superior to traditional therapeutic drugs, however, many problems followed. This article reviewed the application of biological agents in the treatment of moderate-to-severe UC, therapeutic drug monitoring, special conditions occurred during the use of biological agents and their management.

Inflammatory bowel disease (IBD) is a chronic non-specific inflammatory digestive tract disease with unknown etiology. Patients with IBD are recommended to take life-long follow-up and treatment due to the long disease course and repeated recurrence of disease. With the development of ultrasound technology, trans-abdominal bowel ultrasound has been brought into focus in recent years because of its high sensitivity, specificity, free of radiation, convenience and economy. This article reviewed the characteristics of ultrasound of IBD and the application and value of trans-abdominal bowel ultrasound in IBD.

Objective:To investigate the effect of hysteroscopic cold knife technique on the treatment effect and postoperative inflammatory response in patients with intrauterine adhesion by regulating the expression of microRNA (miR)-29b.Methods:The clinical data of 166 patients with intrauterine adhesion in Zhejiang Medical and Health Group Hangzhou Hospital from January to December 2018 were retrospectively analyzed. Among them, 83 cases were treated by hysteroscopic cold knife technique (cold knife group) and 83 cases were treated by hysteroscopic electrosurgical operation (electrosurgical group). The operation time and hospitalization time were compared between 2 groups. The patients were followed up 3 months after operation, and the change of menstrual volume were observed; at the same time, the patient underwent hysteroscopy, and the changes of intrauterine morphology were observed in order to evaluate the efficacy; the interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, C-reactive protein (CRP) and miR-29b relative expression in endometrial tissue were detected.Results:The operation time and hospitalization time in cold knife group were significantly shorter than those in electrosurgical group: (20.01 ± 1.93) min vs. (26.46 ± 2.25) min and (3.84 ± 1.43) d vs. (5.01 ± 1.18) d, and there were statistical differences ( t= 12.134 and 4.051, P<0.05). The menstrual volume and intrauterine morphology efficacy in cold knife group were significantly better than those in electrosurgical group, and there were statistical differences ( P<0.05). The IL-4 and miR-29b 3 months after operation in cold knife group were significantly higher than those in electrosurgical group: (33.54 ± 5.61) mmol/L vs. (21.34 ± 3.62) mmol/L and 1.59 ± 0.42 vs. 1.16 ± 0.31, the IL-8, TNF-ɑ and CRP were significantly lower than those in electrosurgical group: (18.23 ± 3.67) mmol/L vs. (31.59 ± 7.20) mmol/L, (9.41 ± 1.41) mmol/L vs. (12.64 ± 2.24) mmol/L and (7.58 ± 1.59) mg/L vs. (11.06 ± 2.15) mg/L, and there were statistical differences ( P<0.01). Pearson correlation analysis result that IL-4 was positively correlated with miR-29b ( r=0.438, P<0.01), and the IL-8 and TNF-ɑ were negatively correlated with miR-29b ( r=-0.295 and -0.377, P<0.01). Conclusions:Hysteroscopy cold knife technique can shorten the operation time and hospitalization time of the patients with intrauterine adhesion, and significantly improve the curative effect by promoting the expression of miR-29b and anti-inflammatory factors.