Despite of the widespread use of hydrogen and methane breath test, the variability in testing protocols, gas measurement techniques, and interpretation criteria continues to challenge the reproducibility and comparability across centers, especially in the Asia-Pacific region. The Asian Neurogastroenterology and Motility Association hence presents the first Asian monograph guiding application and interpretation of breath test. The monograph was formulated according to the framework of indications, preparatory process, performance, and interpretation of results, as well as future direction for research.

Objective To explore the supportive care needs of heart transplant patients at different stages.Methods Purposive sampling method was used to select 15 heart transplant patients who were hospitalized in a tertiary A hospital in Guangdong Province from July 2023 to February 2024 as research subjects.According to the"Timing It Right"theory,5 semi-structured interviews were conducted with patients.Interpretive phenomenology was used to sort out and analyze the data.Results A total of 5 themes and 18 subthemes were extracted,including urgent desire for transplant information and psychological support during diagnosis,strong physiological and emotional needs during hospitalization,significant demand for health education in the preparation period for discharge,expectation of family support during the adjustment period,increasing demand for social support during the adaptation period.Conclusion The supportive care needs of heart transplant patients at different stages are dynamic.Medical staff should adopt the concept of dynamic and continuous care,and provide personalized care in stages,plans and continuance,in order to improve the quality of life of heart transplant patients.

Aim To verify the therapeutic effect of the Qushi Huoxue decoction(QSHXF)on a mouse model of non-alcoholic fatty liver disease(NAFLD)using network pharmacology and experimental approaches,to examine the changes in the PI3K-AKT-lipid metabo-lism signaling pathway,and to elucidate its molecular mechanisms.Methods The potential active ingredi-ents and targets of the QSHXF were identified using the TCMSP platform.NAFLD-related genes were sourced from the GeneCards,PharmGkb,TTD,and OMIM data-bases.The intersection of drug targets and NAFLD treatment targets was analyzed to identify the key tar-gets of the QSHXF in treating NAFLD.The STRING database and Cytoscape 3.9.1 software were utilized to construct networks linking traditional Chinese medicine active ingredients to disease targets and PPI networks,allowing for the screening of key active ingredients and core targets.GO and KEGG enrichment analyses of the intersecting targets were conducted using R version 4.2.2.The NAFLD model was established by feeding mice a methionine-choline deficient diet for a duration of five weeks.Following successful modeling,low,me-dium,and high doses of the QSHXF were administered for intervention over a period of six weeks.The efficacy was verified and the underlying mechanisms were ex-plored using methods such as HE staining,Oil Red O staining,and Western blot analysis.Results The net-work pharmacology prediction indicated that QSHXF might effectively treat NAFLD through key components such as quercetin and kaempferol,as well as core tar-gets including STAT3,AKT1,and HIF1A.KEGG en-richment analysis further suggested that QSHXF might exert its therapeutic effects on NAFLD via signaling pathways such as AGE-RAGE and PI3K-AKT.Verifi-cation through animal experiments demonstrated that QSHXF could significantly reduce hepatic steatosis and lipid droplet accumulation in NAFLD mice.Specifical-ly,it markedly decreased serum levels of TC,TG,ALT,AST,and LDL,while increasing HDL levels.Addition-ally,the treatment significantly reduced the protein ex-pression levels of p-PI3K,p-AKT,SREBP-1c,FASN,and ACC1 in the liver.Conclusions QSHXF can sig-nificantly enhance liver function,improve blood lipid levels,and alleviate hepatic steatosis in NAFLD mice,with its mechanism potentially linked to the inhibition of the PI3K-AKT-lipid metabolism signaling pathway.

Purpose To investigate the clinical significance of Gasdermin B(GSDMB)in ovarian cancer and its relationship with immune infiltration,aiming to explore novel biomarkers for immunotherapy.Methods Gene expres-sion matrix,somatic mutations,somatic copy number alterations(SCNA),and clinical data were obtained from the The Cancer Genome Atlas(TCGA)database.Copy number variation(CNV)analysis was performed using the GISTIC algorithm,and the CIBERSORT algorithm was applied to quantify the relative abundance of 22 immune cell types in the tumor microenvironment.Protein-protein interaction(PPI)network analysis was conducted to identify GSDMB-associ-ated interacting proteins.Additionally,multiplex immunofluorescence was used to verify the spatial distribution differ-ences of GSDMB protein in clinical ovarian cancer samples with different immune phenotypes and its interaction with immune cells.Results The expression level of the GSDMB gene was significantly higher in adjacent non-cancerous tissues than in tumor tissues(P＜0.001).Patients with high GSDMB expression exhibited elevated levels of immune chemokines(such as CXCL9 and CXCL10,P＜0.01)and tumor-killing lymphocytes(the proportion of CD8+T cell was significantly higher in the high-expression group than in the low-expression group,P＜0.001).CNV analysis re-vealed that GSDMB copy number alterations significantly influenced immune cell infiltration:patients with GSDMB cop-y number amplification had decreased infiltration levels of CD4+T cells and dendritic cells(P＜0.05),while those with deep deletion of GSDMB had significantly reduced infiltration levels of CD8+T cells and neutrophils(P＜0.01).PPI network analysis indicated that GSDMB might interact with key immune molecules,including IL-37,IL-18BP,IL-33,and IL-2(Pearson correlation coefficient r＞0.6,P＜0.001).Multiplex immunofluorescence analysis demonstra-ted that tumors with high GSDMB expression were more likely to exhibit an immune-inflamed phenotype(52.6％),while tumors in the low-expression group were predominantly immune-desert type(47.3％).Immunotherapy cohort a-nalysis suggested that GSDMB could serve as a potential predictive biomarker for immunotherapy responsiveness,with high predictive efficacy in multiple immune checkpoint inhibitor therapy cohorts targeting PD-1,PD-L1,and CTLA4(AUC＞0.8).Conclusion GSDMB plays a crucial role in reshaping the tumor microenvironment in ovarian cancer and may serve as a novel sensitizing target for immunotherapy.

Purpose To investigate the clinical significance of Gasdermin B(GSDMB)in ovarian cancer and its relationship with immune infiltration,aiming to explore novel biomarkers for immunotherapy.Methods Gene expres-sion matrix,somatic mutations,somatic copy number alterations(SCNA),and clinical data were obtained from the The Cancer Genome Atlas(TCGA)database.Copy number variation(CNV)analysis was performed using the GISTIC algorithm,and the CIBERSORT algorithm was applied to quantify the relative abundance of 22 immune cell types in the tumor microenvironment.Protein-protein interaction(PPI)network analysis was conducted to identify GSDMB-associ-ated interacting proteins.Additionally,multiplex immunofluorescence was used to verify the spatial distribution differ-ences of GSDMB protein in clinical ovarian cancer samples with different immune phenotypes and its interaction with immune cells.Results The expression level of the GSDMB gene was significantly higher in adjacent non-cancerous tissues than in tumor tissues(P＜0.001).Patients with high GSDMB expression exhibited elevated levels of immune chemokines(such as CXCL9 and CXCL10,P＜0.01)and tumor-killing lymphocytes(the proportion of CD8+T cell was significantly higher in the high-expression group than in the low-expression group,P＜0.001).CNV analysis re-vealed that GSDMB copy number alterations significantly influenced immune cell infiltration:patients with GSDMB cop-y number amplification had decreased infiltration levels of CD4+T cells and dendritic cells(P＜0.05),while those with deep deletion of GSDMB had significantly reduced infiltration levels of CD8+T cells and neutrophils(P＜0.01).PPI network analysis indicated that GSDMB might interact with key immune molecules,including IL-37,IL-18BP,IL-33,and IL-2(Pearson correlation coefficient r＞0.6,P＜0.001).Multiplex immunofluorescence analysis demonstra-ted that tumors with high GSDMB expression were more likely to exhibit an immune-inflamed phenotype(52.6％),while tumors in the low-expression group were predominantly immune-desert type(47.3％).Immunotherapy cohort a-nalysis suggested that GSDMB could serve as a potential predictive biomarker for immunotherapy responsiveness,with high predictive efficacy in multiple immune checkpoint inhibitor therapy cohorts targeting PD-1,PD-L1,and CTLA4(AUC＞0.8).Conclusion GSDMB plays a crucial role in reshaping the tumor microenvironment in ovarian cancer and may serve as a novel sensitizing target for immunotherapy.

Aim To verify the therapeutic effect of the Qushi Huoxue decoction(QSHXF)on a mouse model of non-alcoholic fatty liver disease(NAFLD)using network pharmacology and experimental approaches,to examine the changes in the PI3K-AKT-lipid metabo-lism signaling pathway,and to elucidate its molecular mechanisms.Methods The potential active ingredi-ents and targets of the QSHXF were identified using the TCMSP platform.NAFLD-related genes were sourced from the GeneCards,PharmGkb,TTD,and OMIM data-bases.The intersection of drug targets and NAFLD treatment targets was analyzed to identify the key tar-gets of the QSHXF in treating NAFLD.The STRING database and Cytoscape 3.9.1 software were utilized to construct networks linking traditional Chinese medicine active ingredients to disease targets and PPI networks,allowing for the screening of key active ingredients and core targets.GO and KEGG enrichment analyses of the intersecting targets were conducted using R version 4.2.2.The NAFLD model was established by feeding mice a methionine-choline deficient diet for a duration of five weeks.Following successful modeling,low,me-dium,and high doses of the QSHXF were administered for intervention over a period of six weeks.The efficacy was verified and the underlying mechanisms were ex-plored using methods such as HE staining,Oil Red O staining,and Western blot analysis.Results The net-work pharmacology prediction indicated that QSHXF might effectively treat NAFLD through key components such as quercetin and kaempferol,as well as core tar-gets including STAT3,AKT1,and HIF1A.KEGG en-richment analysis further suggested that QSHXF might exert its therapeutic effects on NAFLD via signaling pathways such as AGE-RAGE and PI3K-AKT.Verifi-cation through animal experiments demonstrated that QSHXF could significantly reduce hepatic steatosis and lipid droplet accumulation in NAFLD mice.Specifical-ly,it markedly decreased serum levels of TC,TG,ALT,AST,and LDL,while increasing HDL levels.Addition-ally,the treatment significantly reduced the protein ex-pression levels of p-PI3K,p-AKT,SREBP-1c,FASN,and ACC1 in the liver.Conclusions QSHXF can sig-nificantly enhance liver function,improve blood lipid levels,and alleviate hepatic steatosis in NAFLD mice,with its mechanism potentially linked to the inhibition of the PI3K-AKT-lipid metabolism signaling pathway.

Objective To explore the supportive care needs of heart transplant patients at different stages.Methods Purposive sampling method was used to select 15 heart transplant patients who were hospitalized in a tertiary A hospital in Guangdong Province from July 2023 to February 2024 as research subjects.According to the"Timing It Right"theory,5 semi-structured interviews were conducted with patients.Interpretive phenomenology was used to sort out and analyze the data.Results A total of 5 themes and 18 subthemes were extracted,including urgent desire for transplant information and psychological support during diagnosis,strong physiological and emotional needs during hospitalization,significant demand for health education in the preparation period for discharge,expectation of family support during the adjustment period,increasing demand for social support during the adaptation period.Conclusion The supportive care needs of heart transplant patients at different stages are dynamic.Medical staff should adopt the concept of dynamic and continuous care,and provide personalized care in stages,plans and continuance,in order to improve the quality of life of heart transplant patients.

Objective To monitor rodent species in the southern Fujian ports of China and investigate the natural pathogens they carry. Methods Rodents were captured using night-trapping and cage method across 17 port areas in southern Fujian in 2023. Morphological identification was performed to classify the captured specimens. Tissues from the liver, spleen, lungs, kidneys, and bladder were harvested for nucleic acid extraction. Nested and conventional PCR method were used to detect seven pathogens: Yersinia pestis, Hantavirus, pathogenic Leptospira, Borrelia burgdorferi, Bartonella, Orientia tsutsugamushi, and Anaplasma phagocytophilum. The Chi-square test was used to analyze the distribution of rodents and the status of natural pathogen infections across the study sites. Results A total of 161 rodents across five species belonging to two orders, two families, and three genera were captured. Suncus murinus was the dominant species(72.67 %), followed by Rattus tanezumi(13.04 %). Six pathogens were detected, with an overall positivity rate of 18.01%. Bartonella had the highest positivity rate(11.18%), followed by pathogenic Leptospira(4.97%), Borrelia burgdorferi(2.48%), Orientia tsutsugamushi(1.86%), Seoul virus(1.24%), and Anaplasma phagocytophilum(0.62%). Co-infections were noted in five rodents, representing 17.24% of those that tested positive, and one rodent was infected with four pathogens. No Y. pestis or Hantaan virus was detected in the captured rodents. Conclusions The rodents in the southern Fujian ports are naturally infected with multiple pathogens, including Bartonella, pathogenic Leptospira, and Seoul virus. Enhanced monitoring of rodent populations and the implementation of preventive and control measures for rodent-borne diseases are essential.

AIM To explore the mechanism of Dabugan Decoction's action on a rat model of generalized anxiety disorder(GAD).METHODS The rat models established by 21 days exposure to chronic unpredictable mild stress(CUMS)were then randomly divided into the model group,the paroxetine group(1.8 mg/kg)and the high-dose,medium-dose and low-dose Dabugan Decoction groups(13.2,6.6 and 3.3 g/kg),in contrast to the other normal rats assigned into the blank group,for the following 28 days administration of the corresponding drugs by gavage.After the intervention,the rats had their anxiety intensity analyzed by behavioral tests;their hippocampal pathological changes and Nissl's body differences observed by HE staining and Nissl staining;their cerebral ROS activity detected by immunofluorescence;their hippocampal activities of SOD and CAT,and levels of MDA and GSH detected by kit;and their hippocampal mRNA and protein expressions of Nrf2,Keap1,HO-1,NQO1,BDNF,5-HT1A,caspase-3 and GSH detected by RT-qPCR and Western blot.RESULTS Compared with the model group,the Dabugan Decoction groups displayed improved anxiety responses;increased movement distance at the open arm end and total distance as well,more entries and duration at the open box,more time and entries at the open field center in elevated plus maze(P＜0.05,P＜0.01);increased number of hippocampal neurons,ameliorated cell body damage,increased Nissl bodies in cells,decreased hippocampal ROS activity and MDA level(P＜0.05,P＜0.01);increased activities of SOD and CAT,and GSH level(P＜0.05,P＜0.01);increased hippocampal mRNA and protein expressions of Nrf2,HO-1,NQO1,BDNF and 5-HT1A(P＜0.05,P＜0.01),and decreased mRNA and protein expressions of p62,Keap1 and caspase-3(P＜0.05,P＜0.01).CONCLUSION Dabugan Decoction can effectively improve the anxiety of GAD rats,and its mechanism may be related to the recovery of oxidative stress-induced injury in hippocampal neurons via ROS/Nrf2/HO-1 signaling pathway.

ObjectiveTo investigate the value of baseline red cell distribution width （RDW） and alkaline phosphatase （ALP） level after ursodeoxycholic acid （UDCA） treatment for one month in predicting the response to UDCA treatment in patients with primary biliary cholangitis （PBC）. MethodsA retrospective analysis was performed for the data of 127 patients with PBC who were diagnosed in Department of Hepatology， The Third People’s Hospital of Jiangsu University， from January 2015 to July 2022， with data collected at baseline， after one month of treatment， and after one year of follow-up. Based on the Paris-I criteria， the patients were divided into good response group and poor response group， and the two groups were analyzed in terms of clinical and laboratory features and their association with response to UDCA. The Logistic regression method was used to investigate the independent risk factors for response to UDCA treatment. The area under the ROC curve （AUC） was used to determine the optimal cut-off values of related indicators； the patients were divided into two groups based on such values， and the two groups were compared in terms of baseline indicators and response. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. ResultsCompared with the good response group， the poor response group had significantly higher levels of total bilirubin， aspartate aminotransferase/alanine aminotransferase， ALP， RDW， and RDW-CV at baseline and a significantly higher level of ALP after one month of UDCA treatment （Z=-4.792， -3.697， -2.399， -4.102， -3.220， and -4.236， all P<0.05）. Compared with the good response group， the poor response group had significantly lower levels of albumin， hemoglobin， lymphocytes， hematocrit， and body mass index at baseline （Z=-3.592， -3.603， -2.602， -3.829， -2.432， all P<0.05）， as well as significantly lower levels of prealbumin， albumin/globulin ratio， apolipoprotein A， and free triiodothyronine at baseline （t=4.530， 3.402， 3.485， and 3.639， all P<0.001）. Compared with the poor response group， the good response group had a significantly lower proportion of patients with liver cirrhosis， gallstones/cholecystitis， or anemia （χ²=20.815， 3.892， and 12.283， all P<0.05）. Baseline RDW （odds ratio ［OR］=1.157， 95% confidence interval ［CI］： 1.028‍ — ‍1.301， P=0.015） and ALP level after one month of treatment （OR=1.012， 95%CI： 1.005‍ — ‍1.020， P=0.002） were independent risk factors for response to UDCA， with an AUC of 0.713 and 0.720， respectively. The patients with baseline RDW≥upper limit of normal （ULN） and ALP≥2.2×ULN after one month of UDCA treatment had a lower UDCA response rate （42.6% vs 8.2%， χ²=20.813， P<0.001）. ConclusionPatients with baseline RDW≥ULN and ALP≥2.2×ULN after one month of UDCA treatment tend to have a low biochemical response rate to UDCA.