Objective: To investigate the role of butyric acid-producing bacteria in long bone homeostasis in mice with periodontitis under a high-fat/high-sugar diet and to provide new insights for the prevention and treatment of periodontitis and related bone metabolic diseases. Methods: This study has been approved by the Animal Welfare and Ethics Committee of the Experimental Animal Center. Initially, 14 mice were randomly divided into the CON group (the control group) and the LIG group (the periodontitis group). Mice in the LIG group had experimental periodontitis induced by ligating the second maxillary molars bilaterally and were fed a high-fat and high-sugar diet. After 8 weeks, samples were collected. Micro-computed tomography (Micro-CT) was used to analyze alveolar bone resorption and various parameters of the proximal tibia trabecular bone, including bone mineral density (BMD), bone volume per tissue volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), and trabecular separation (Tb.Sp). After decalcification, hematoxylin and eosin (HE) staining was performed on maxillary bone sections to assess periodontal tissue inflammation and connective tissue destruction. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect related genes in the distal femur and proximal tibia bone tissues, including osteocalcin (OCN), osteogenic transcription factor (Osterix), osteoprotegerin (OPG), tartrate resistant acid phosphatase (TRAP), osteoclast-associated receptor (OSCAR), receptor activator of nuclear factor kappa-B (RANK), and receptor activator of nuclear factor kappa-B ligand (RANK-L). Subsequently, the other 28 mice were randomly divided into the CON group (the control group), LIG group (the periodontitis group), CON + butyric acid-producing bacteria (BP) group, and LIG + BP group. The breeding, sampling, and sample detection methods remained the same. Finally, the other 28 mice were randomly divided into the CON group (the control group), LIG group (the periodontitis group), CON + sodium butyrate (SB) group, and LIG + SB group. The breeding, sampling, and sample detection methods remained the same. Results: ①Periodontitis modeling was successful. Compared with the CON group, the LIG group exhibited significant alveolar bone resorption of the maxillary second molar, aggravated periodontal tissue inflammation, and connective tissue destruction. ②Periodontitis exacerbated long bone resorption in mice fed a high-fat high-sugar diet. Compared with the CON group, the LIG group had significantly lower BMD, BV/TV, Tb.N, and Tb.Th (P<0.05), and significantly higher Tb.Sp (P<0.05). HE staining of the proximal tibia showed that the trabeculae in the LIG group were sparse and disordered, with some areas showing fractures or dissolution. The expression of osteoblast markers (OCN, Osterix, OPG) was significantly lower in the LIG group (P<0.05), while the expression of the osteoclast marker TRAP showed an increasing trend (P>0.05). The ratio of RANK-L/OPG was significantly higher in the LIG group compared with the CON group (P<0.05). ③ Supplementation with butyric acid-producing bacteria alleviates periodontitis-induced disruption of long bone homeostasis in mice fed a high-fat/high-sugar diet. Compared with the LIG group, BMD and Tb.Th were significantly higher in the LIG + BP group. HE staining of the proximal tibia showed that bone resorption was mitigated in the LIG + BP group compared with the LIG group. The expression of OCN and Osterix was significantly higher in the LIG + BP group, while the expression of osteoclast-specific genes (OSCAR, RANK, RANK-L) was significantly lower (P<0.05). ④ Supplementation with butyrate alleviates periodontitis-induced disruption of long bone homeostasis in mice fed a high-fat/high-sugar diet. Compared with the LIG group, BV/TV and Tb.N were significantly higher in the LIG + SB group, and Tb.Sp was significantly lower (P<0.05). HE staining of the proximal tibia showed that bone resorption was mitigated in the LIG + SB group compared with the LIG group. The expression of Osterix, OPG, OSCAR, TRAP, and RANK was significantly lower in the LIG + SB group compared with the LIG group (P<0.05). Conclusion Periodontitis disrupts the long bone homeostasis of mice fed a high-fat high-sugar diet, aggravating long bone resorption. Supplementation with butyric acid-producing bacteria or butyrate can effectively alleviate the disruption of long bone homeostasis caused by periodontitis.

Objective To investigate the clinical characteristics,diagnosis and treatment of ileal injury secondary to percutaneous nephrolithotomy percutaneous nephrolithotomy(PCNL).Methods The diagnosis and treatment of a patient were reviewed,and relevant literature were retrieved.Results The patient was a 41-year-old male,who underwent stage PCNL(initial percutaneous nephrostomy,followed by secondary PCNL)due to right ureteral calculi with severe hydronephrosis.On postoperative day 1,he developed abdominal distension and pain.Abdominal X-ray revealed subdiaphragmatic free gas,and CT showed pelvic and abdominal fluid and gas accumulation,suggesting peritonitis due to intestinal perforation.Emergency exploratory laparotomy identified a 3 mm×3 mm ileal perforation approximately 30 cm from the ileocecal valve,which was repaired surgically.The patient recovered well and was discharged after one week,with no discomfort reported during a 6-month follow-up.Conclusion The clinical features of ileal injury secondary to PCNL include early postoperative abdominal distension,pain and peritonitis.Diagnosis relies on clinical manifestations,abdominal X-ray and CT,with surgical exploration if necessary.Conservative management under vigilant observation can be cautiously adopted for localized injuries,while surgical repair is required for peritonitis or failed conservative therapy.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

To screen potential drugs for the treatment of acute Liver Injury(ALI)through network pharmacology and mitochondrial dynamics,and to investigate their actions and mechanisms.Based on the commonly utilized Liver Pure Tablets and Liver-Protecting Capsules in the market,a com-ponent library of liver disease drugs was screened and established.Pharmacological anchoring anal-ysis was carried out.Potential liver disease therapeutic drugs were screened out through molecular docking,and feedback verification was performed using animal experiments.Acute liver injury mouse models were established through excessive induction with acetaminophen(APAP),and the histopathological changes of liver tissues were examined.The protective effect of the drug on ALI was evaluated by detecting alanine aminotransferase(ALT),aspartate aminotransferase(AST),superoxide dismutase(SOD),catalase(CAT),glutathione(GSH),and malondialdehyde(MDA)using enzyme-linked immunosorbent assay(ELISA).qRT-PCR was employed to detect peroxi-some proliferator-activated receptor gamma coactivator 1-alpha(PPARG1A),mitofusin 1(MFN1),mitofusin 2(MFN2),dynamin-related protein 1(DRP1),optic atrophy 1 protein(OP A1),Steroid receptor coactivator(SRC),and advanced glycosylation end-product specific re-ceptor(AGER)to explore the protective mechanism of the drug on ALI.The result showed that Network pharmacology identified a total of 662 intersection targets of three types of prescription drugs and ALI.Eventually,72 core targets were screened out.Pathway enrichment analysis indi-cates that the potential mechanism might be associated with the lipid and atherosclerosis signaling pathways.The results of the relevant molecular docking indicate that the most likely optimal drug might be emodin(EMO).EMO ameliorated the pathological damage in mice with acute liver inju-ry,significantly decreased the contents of transferase factors ALT and AST,simultaneously in-creased the contents of antioxidant enzymes CAT,GSH and SOD,and reduced the content of oxi-dative metabolic end product MDA.It also upregulated the mRNA expression levels of MFN1、MFN2,OPA1,DRP1,SRC and PPARGC1A proteins in liver tissue,and inhibited the mRNA ex-pression level of AGER protein.The drug EMO,jointly screened out by network pharmacology through anchoring and molecular docking,might promote mitochondrial fusion metabolism,allevi-ate liver oxidative stress,and improve liver injury in ALI mice via the Lipid and atherosclerosis pathway.

To screen potential drugs for the treatment of acute Liver Injury(ALI)through network pharmacology and mitochondrial dynamics,and to investigate their actions and mechanisms.Based on the commonly utilized Liver Pure Tablets and Liver-Protecting Capsules in the market,a com-ponent library of liver disease drugs was screened and established.Pharmacological anchoring anal-ysis was carried out.Potential liver disease therapeutic drugs were screened out through molecular docking,and feedback verification was performed using animal experiments.Acute liver injury mouse models were established through excessive induction with acetaminophen(APAP),and the histopathological changes of liver tissues were examined.The protective effect of the drug on ALI was evaluated by detecting alanine aminotransferase(ALT),aspartate aminotransferase(AST),superoxide dismutase(SOD),catalase(CAT),glutathione(GSH),and malondialdehyde(MDA)using enzyme-linked immunosorbent assay(ELISA).qRT-PCR was employed to detect peroxi-some proliferator-activated receptor gamma coactivator 1-alpha(PPARG1A),mitofusin 1(MFN1),mitofusin 2(MFN2),dynamin-related protein 1(DRP1),optic atrophy 1 protein(OP A1),Steroid receptor coactivator(SRC),and advanced glycosylation end-product specific re-ceptor(AGER)to explore the protective mechanism of the drug on ALI.The result showed that Network pharmacology identified a total of 662 intersection targets of three types of prescription drugs and ALI.Eventually,72 core targets were screened out.Pathway enrichment analysis indi-cates that the potential mechanism might be associated with the lipid and atherosclerosis signaling pathways.The results of the relevant molecular docking indicate that the most likely optimal drug might be emodin(EMO).EMO ameliorated the pathological damage in mice with acute liver inju-ry,significantly decreased the contents of transferase factors ALT and AST,simultaneously in-creased the contents of antioxidant enzymes CAT,GSH and SOD,and reduced the content of oxi-dative metabolic end product MDA.It also upregulated the mRNA expression levels of MFN1、MFN2,OPA1,DRP1,SRC and PPARGC1A proteins in liver tissue,and inhibited the mRNA ex-pression level of AGER protein.The drug EMO,jointly screened out by network pharmacology through anchoring and molecular docking,might promote mitochondrial fusion metabolism,allevi-ate liver oxidative stress,and improve liver injury in ALI mice via the Lipid and atherosclerosis pathway.

Objective To investigate the clinical characteristics,diagnosis and treatment of ileal injury secondary to percutaneous nephrolithotomy percutaneous nephrolithotomy(PCNL).Methods The diagnosis and treatment of a patient were reviewed,and relevant literature were retrieved.Results The patient was a 41-year-old male,who underwent stage PCNL(initial percutaneous nephrostomy,followed by secondary PCNL)due to right ureteral calculi with severe hydronephrosis.On postoperative day 1,he developed abdominal distension and pain.Abdominal X-ray revealed subdiaphragmatic free gas,and CT showed pelvic and abdominal fluid and gas accumulation,suggesting peritonitis due to intestinal perforation.Emergency exploratory laparotomy identified a 3 mm×3 mm ileal perforation approximately 30 cm from the ileocecal valve,which was repaired surgically.The patient recovered well and was discharged after one week,with no discomfort reported during a 6-month follow-up.Conclusion The clinical features of ileal injury secondary to PCNL include early postoperative abdominal distension,pain and peritonitis.Diagnosis relies on clinical manifestations,abdominal X-ray and CT,with surgical exploration if necessary.Conservative management under vigilant observation can be cautiously adopted for localized injuries,while surgical repair is required for peritonitis or failed conservative therapy.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Irritable bowel syndrome(IBS)is accompanied by impaired intestinal mucosal barrier,and there is currently no ideal drug therapy.Acupuncture has obvious advantages in protecting intestinal mucosal barrier of IBS,but the molecular biological mechanism needs to be further studied.Based on the overall intestinal homeostasis in the"flora-intestinal epithelial dialogue"study to repair damaged intestinal mucosal barrier has become a hot research in this field.Therefore,based on the frontier basis,this paper discusses the feasibility mechanism of acupuncture in repairing IBS intestinal mucosal barrier injury from the perspective of intestinal flora-short-chain fatty acid-intestinal PPAR γ pathway-mediated intestinal epithelial cell metabolic reprogramming,in order to interpret the scientific connotation of acupuncture in repairing intestinal mucosal barrier injury,and provide a scientific basis for acupuncture therapy to play a greater role in public health care and for the modernization of traditional Chinese medicine.

Objective To observe the effect of moxibustion of"Zusanli"and"Ganshu"on the intestinal flora of colorectal cancer cells liver metastasis in nude mice and its possible mechanism was explored.Methods HCT116-GFP colon cancer cells were inoculated by spleen injection,sixty SPF BALB/c male nude mice were divided into model control group,Pre-Mox group,Post-Mox group,Pre-Post-Mox group.Bilateral"Ganshu(BL18)"and"Zusanli(ST36)"acupoints were selected for moxibustion intervention for once a day for 10 minutes each time.the tumor formation rate,liver metastasis rate and the number of tumor of each group were calculated.Furthermore,16S rRNA analysis was used to assess their microbial diversity.Results Moxibustion intervention can significantly reduce the rate of liver metastasis,reduce the number of metastatic foci.Compared with the model control group,Lactobacillus_reuteri and Robinsoniella_peoriensis were significantly lower in Pre-Mox group(P<0.05).Lactobacillus_gasseri decreased significantly,Clostridium_cocleatum and Erysipelatoclostrdum_ramosum multiplex increased significantly in the Post-Mox group(P<0.01).Pre-Post-Mox mice had significantly decreased levels of Lactobacillus_gasseri,and Clostridium_cocleatum,Akkermansia_muciniphila and Clostridium_cocleatum were significantly increased(P<0.05).LEfSe Difference analysis showed that the Pre-Mox group was mainly changed by Coprobacillus;the Post-Mox group was marked by Muribaculaceae and erysipelas;the Pre-Post-Mox group took Verrucomicrobia,Akkermansia_muciniphila and erysipelas as signs.Conclusion Moxibustion could exert an inhibitory effect on CRC liver metastasis,especially the 5-week Pre-PostMox treatment showed the best inhibitory.The potential mechanism might rely on the alteration of microbiota diversity and composition.

Irritable bowel syndrome(IBS)is accompanied by impaired intestinal mucosal barrier,and there is currently no ideal drug therapy.Acupuncture has obvious advantages in protecting intestinal mucosal barrier of IBS,but the molecular biological mechanism needs to be further studied.Based on the overall intestinal homeostasis in the"flora-intestinal epithelial dialogue"study to repair damaged intestinal mucosal barrier has become a hot research in this field.Therefore,based on the frontier basis,this paper discusses the feasibility mechanism of acupuncture in repairing IBS intestinal mucosal barrier injury from the perspective of intestinal flora-short-chain fatty acid-intestinal PPAR γ pathway-mediated intestinal epithelial cell metabolic reprogramming,in order to interpret the scientific connotation of acupuncture in repairing intestinal mucosal barrier injury,and provide a scientific basis for acupuncture therapy to play a greater role in public health care and for the modernization of traditional Chinese medicine.