OBJECTIVES: To explore the mechanism of Lacticaseibacillus paracasei E6 for improving vinorelbine-induced immunosuppression in zebrafish. METHODS: The intestinal colonization of L. paracasei E6 labeled by fluorescein isothiocyanate (FITC) in zebrafish was observed under fluorescence microscope. In a zebrafish model of vinorelbine-induced immunosuppression, the immunomodulatory activity of L. paracasei E6 was assessed by analyzing macrophage and neutrophil counts in the caudal hematopoietic tissue (CHT), the number of T-lymphocyte, and the expressions of interleukin-12 (IL-12) and interferon-γ (IFN-γ). The contents of short-chain fatty acids (SCFAs) in L. paracasei E6 fermentation supernatant and the metabolites of L. paracasei E6 in zebrafish were detected by LC-MS/MS-based targeted metabolomics. The immunomodulatory effects of the SCFAs including sodium acetate, sodium propionate and sodium butyrate were evaluated in the zebrafish model of immunosuppression. RESULTS: After inoculation, green fluorescence of FITC-labeled L. paracasei E6 was clearly observed in the intestinal ball, midgut and posterior gut regions of zebrafish. In the immunocompromised zebrafish model, L. paracasei E6 significantly alleviated the reduction of macrophage and neutrophil counts in the CHT, increased the fluorescence intensity of T-lymphocytes, and promoted the expressions of IL-12 and IFN-γ. Compared with MRS medium, L. paracasei E6 fermentation supernatant showed significantly higher levels of acetic acid, propionic acid and butyric acid, which were also detected in immunocompromised zebrafish following treatment with L. paracasei E6. Treatment of the zebrafish model with sodium acetate and sodium propionate significantly increased macrophage and neutrophil counts in the CHT and effectively inhibited vinorelbine-induced reduction of thymus T cells. CONCLUSIONS L. paracasei E6 can improve vinorelbine-induced immunosuppression in zebrafish through its SCFA metabolites acetic acid and propionic acid.
Animals ; Zebrafish/immunology* ; Acetic Acid/metabolism* ; Propionates/metabolism* ; Fatty Acids, Volatile/metabolism*

Objective To explore the mechanism of Lacticaseibacillus paracasei E6 for improving vinorelbine-induced immunosuppression in zebrafish.Methods The intestinal colonization of L.paracasei E6 labeled by fluorescein isothiocyanate(FITC)in zebrafish was observed under fluorescence microscope.In a zebrafish model of vinorelbine-induced immunosuppression,the immunomodulatory activity of L.paracasei E6 was assessed by analyzing macrophage and neutrophil counts in the caudal hematopoietic tissue(CHT),the number of T-lymphocyte,and the expressions of interleukin-12(IL-12)and interferon-γ(IFN-γ).The contents of short-chain fatty acids(SCFAs)in L.paracasei E6 fermentation supernatant and the metabolites of L.paracasei E6 in zebrafish were detected by LC-MS/MS-based targeted metabolomics.The immunomodulatory effects of the SCFAs including sodium acetate,sodium propionate and sodium butyrate were evaluated in the zebrafish model of immunosuppression.Results After inoculation,green fluorescence of FITC-labeled L.paracasei E6 was clearly observed in the intestinal ball,midgut and posterior gut regions of zebrafish.In the immunocompromised zebrafish model,L.paracasei E6 significantly alleviated the reduction of macrophage and neutrophil counts in the CHT,increased the fluorescence intensity of T-lymphocytes,and promoted the expressions of IL-12 and IFN-γ.Compared with MRS medium,L.paracasei E6 fermentation supernatant showed significantly higher levels of acetic acid,propionic acid and butyric acid,which were also detected in immunocompromised zebrafish following treatment with L.paracasei E6.Treatment of the zebrafish model with sodium acetate and sodium propionate significantly increased macrophage and neutrophil counts in the CHT and effectively inhibited vinorelbine-induced reduction of thymus T cells.Conclusion L.paracasei E6 can improve vinorelbine-induced immunosuppression in zebrafish through its SCFA metabolites acetic acid and propionic acid.

Objective:To explore the clinical and salivary metabolic component characteristics of patients with OSA combined with LPRD, and to investigate the potential co-morbid mechanisms of LPRD and OSA.Methods:A total of 98 adult patients with OSA (81 males and 17 females) who visited the Department of Otolaryngology of Peking University Third Hospital from March 2024 to May 2024 were consecutively included. The age ranged from 19 to 68 years (mean±standard deviation: 39.44±11.39 years). The severity of OSA was grouped according to the apnea-hypopnea index (AHI) [mild group (29 cases), moderate group (26 cases), and severe group (43 cases)]. Patients with a reflux symptom index score (RSI)>13 points and/or a reflux sign score (RFS)>7 points were considered LPRD positive. Among the 98 OSA patients, 48 had LPRD and 50 did not. All patients were diagnosed with OSA through out of center sleep testing(OCST) or polysomnography (PSG), and general information, laryngoscopic examination images, and RSI scales were collected. The RFS was evaluated based on the laryngoscopic examination results. Saliva samples were collected from both groups for metabolomics analysis. Chi-square test was used for categorical variable comparison, and independent sample t-test or one-way ANOVA analysis of variance was used for continuous variable comparison.Results:Stratified analysis showed that the proportion of male patients in the mild OSA group was significantly lower than that in the moderate or severe OSA groups (58.6%, 92.3%, 93.0%, χ2=16.43, P<0.001), and the BMI was significantly lower in the mild OSA group [(25.80±4.41)kg/m 2, (27.53±3.88)kg/m 2, (28.99±3.65)kg/m 2, F=6.91, P=0.002]. There was no statistically significant difference in the prevalence of LPRD among patients with different severity of OSA. The BMI of OSA patients with LPRD was higher than that of patients with OSA alone [(28.65±4.75)kg/m 2, (26.94±3.16)kg/m 2, t=-2.07, P=0.041], but there were no statistically significant differences in gender composition, age, AHI, and minimum blood oxygen saturation between the two groups. The metabolomics results of saliva samples from both groups showed significant differences in the levels of tryptophan pathway metabolites. The salivary serotonin metabolite level in patients with LPRD combined with OSA was significantly lower than that in patients with OSA alone (relative abundance 0.12±0.019 vs 0.22±0.046, t=2.04, P=0.045). Conclusion:Patients with OSA combined with LPRD have a greater BMI and significantly lower serotonin, a tryptophan metabolite component of saliva, which may be a potential co-morbidity mechanism between OSA and LPRD.

Objective To investigate and analyze the various reasons that affect the accuracy of ICD-9-CM-3 classifica-tion coding,identify key factors,and propose improvement strategies to enhance the accuracy and standardization level of surgical operation coding.Methods Using case analysis method,various factors affecting the accurate coding of ICD-9-CM-3 were sys-tematically listed and analyzed in detail.Through specific examples,this article analyzes the non-standard behavior of clinical physicians in writing surgical operation names,as well as the problems of coders relying on doctors to write,ignoring coding rules,and not fully reading medical records and surgical records during the coding process.It further explores how these factors lead to surgical classification errors.Results The main reasons affecting the accuracy of ICD-9-CM-3 coding include:lack of standardization in writing surgical operation names by clinical physicians,and failure to provide detailed descriptions of key ele-ments of the surgery;The coder overly relied on the doctor's written content during the coding process,failed to strictly follow the coding rules,and did not fully and deeply read and analyze medical records and surgical records,resulting in errors and devia-tions in surgical classification.Conclusion Each component of the surgical procedure name is an important factor affecting the accuracy of coding.Ensuring the completeness and accuracy of surgical operation names is crucial for improving the precision of ICD-9-CM-3 coding.In order to improve the quality of coding,clinical physicians need to enhance writing standards,while cod-ers need to strengthen their professional knowledge learning,strictly abide by coding rules,and comprehensively and meticulously review medical records and surgical records to achieve precise classification and coding of surgical operations.

Objective:To retrieve, evaluate, and summarize evidence on the nonpharmacological management of chemotherapy-induced peripheral neuropathy (CIPN) to provide an evidence-based basis for the clinical nursing of patients undergoing cancer chemotherapy.Methods:In accordance with the "6S" model of evidence-based search resources, guidelines, evidence summaries, clinical decisions, expert consensus, and systematic reviews on the nonpharmacological management of CIPN were systematically searched on domestic and international websites or databases. The search period was from January 1, 2019 to December 31, 2023.Results:A total of 19 papers were included, including one evidence summary, one guideline, six expert consensus, and 11 systematic reviews. Forty pieces of best evidence in five aspects of assessment/screening, prevention, intervention, clinical management, and health education were summarized.Conclusions:The 40 best evidence for nonpharmacological management of CIPN summarized can be used to prevent or reduce CIPN in cancer patients. Clinical medical and nursing staff should select evidence entries as appropriate for different clinical situations, taking into account the patient's own condition and the feasibility and appropriateness of evidence implementation.

Objective To investigate and analyze the various reasons that affect the accuracy of ICD-9-CM-3 classifica-tion coding,identify key factors,and propose improvement strategies to enhance the accuracy and standardization level of surgical operation coding.Methods Using case analysis method,various factors affecting the accurate coding of ICD-9-CM-3 were sys-tematically listed and analyzed in detail.Through specific examples,this article analyzes the non-standard behavior of clinical physicians in writing surgical operation names,as well as the problems of coders relying on doctors to write,ignoring coding rules,and not fully reading medical records and surgical records during the coding process.It further explores how these factors lead to surgical classification errors.Results The main reasons affecting the accuracy of ICD-9-CM-3 coding include:lack of standardization in writing surgical operation names by clinical physicians,and failure to provide detailed descriptions of key ele-ments of the surgery;The coder overly relied on the doctor's written content during the coding process,failed to strictly follow the coding rules,and did not fully and deeply read and analyze medical records and surgical records,resulting in errors and devia-tions in surgical classification.Conclusion Each component of the surgical procedure name is an important factor affecting the accuracy of coding.Ensuring the completeness and accuracy of surgical operation names is crucial for improving the precision of ICD-9-CM-3 coding.In order to improve the quality of coding,clinical physicians need to enhance writing standards,while cod-ers need to strengthen their professional knowledge learning,strictly abide by coding rules,and comprehensively and meticulously review medical records and surgical records to achieve precise classification and coding of surgical operations.

Objective:To retrieve, evaluate, and summarize evidence on the nonpharmacological management of chemotherapy-induced peripheral neuropathy (CIPN) to provide an evidence-based basis for the clinical nursing of patients undergoing cancer chemotherapy.Methods:In accordance with the "6S" model of evidence-based search resources, guidelines, evidence summaries, clinical decisions, expert consensus, and systematic reviews on the nonpharmacological management of CIPN were systematically searched on domestic and international websites or databases. The search period was from January 1, 2019 to December 31, 2023.Results:A total of 19 papers were included, including one evidence summary, one guideline, six expert consensus, and 11 systematic reviews. Forty pieces of best evidence in five aspects of assessment/screening, prevention, intervention, clinical management, and health education were summarized.Conclusions:The 40 best evidence for nonpharmacological management of CIPN summarized can be used to prevent or reduce CIPN in cancer patients. Clinical medical and nursing staff should select evidence entries as appropriate for different clinical situations, taking into account the patient's own condition and the feasibility and appropriateness of evidence implementation.

Objective:To explore the clinical and salivary metabolic component characteristics of patients with OSA combined with LPRD, and to investigate the potential co-morbid mechanisms of LPRD and OSA.Methods:A total of 98 adult patients with OSA (81 males and 17 females) who visited the Department of Otolaryngology of Peking University Third Hospital from March 2024 to May 2024 were consecutively included. The age ranged from 19 to 68 years (mean±standard deviation: 39.44±11.39 years). The severity of OSA was grouped according to the apnea-hypopnea index (AHI) [mild group (29 cases), moderate group (26 cases), and severe group (43 cases)]. Patients with a reflux symptom index score (RSI)>13 points and/or a reflux sign score (RFS)>7 points were considered LPRD positive. Among the 98 OSA patients, 48 had LPRD and 50 did not. All patients were diagnosed with OSA through out of center sleep testing(OCST) or polysomnography (PSG), and general information, laryngoscopic examination images, and RSI scales were collected. The RFS was evaluated based on the laryngoscopic examination results. Saliva samples were collected from both groups for metabolomics analysis. Chi-square test was used for categorical variable comparison, and independent sample t-test or one-way ANOVA analysis of variance was used for continuous variable comparison.Results:Stratified analysis showed that the proportion of male patients in the mild OSA group was significantly lower than that in the moderate or severe OSA groups (58.6%, 92.3%, 93.0%, χ2=16.43, P<0.001), and the BMI was significantly lower in the mild OSA group [(25.80±4.41)kg/m 2, (27.53±3.88)kg/m 2, (28.99±3.65)kg/m 2, F=6.91, P=0.002]. There was no statistically significant difference in the prevalence of LPRD among patients with different severity of OSA. The BMI of OSA patients with LPRD was higher than that of patients with OSA alone [(28.65±4.75)kg/m 2, (26.94±3.16)kg/m 2, t=-2.07, P=0.041], but there were no statistically significant differences in gender composition, age, AHI, and minimum blood oxygen saturation between the two groups. The metabolomics results of saliva samples from both groups showed significant differences in the levels of tryptophan pathway metabolites. The salivary serotonin metabolite level in patients with LPRD combined with OSA was significantly lower than that in patients with OSA alone (relative abundance 0.12±0.019 vs 0.22±0.046, t=2.04, P=0.045). Conclusion:Patients with OSA combined with LPRD have a greater BMI and significantly lower serotonin, a tryptophan metabolite component of saliva, which may be a potential co-morbidity mechanism between OSA and LPRD.

To promote the development of extracellular vesicles of herbal medicine especially the establishment of standardization, led by the National Expert Committee on Research and Application of Chinese Herbal Vesicles, research experts in the field of herbal medicine and extracellular vesicles were invited nationwide with the support of the Expert Committee on Research and Application of Chinese Herbal Vesicles, Professional Committee on Extracellular Vesicle Research and Application, Chinese Society of Research Hospitals and the Guangdong Engineering Research Center of Chinese Herbal Vesicles. Based on the collation of relevant literature, we have adopted the Delphi method, the consensus meeting method combined with the nominal group method to form a discussion draft of "Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles (2023)". The first draft was discussed in online and offline meetings on October 12, 14, November 2, 2022 and April and May 2023 on the current status of research, nomenclature, isolation methods, quality standards and research applications of extracellular vesicles of Chinese herbal medicines, and 13 consensus opinions were finally formed. At the Third Academic Conference on Research and Application of Chinese Herbal Vesicles, held on May 26, 2023, Kewei Zhao, convenor of the consensus, presented and read the consensus to the experts of the Expert Committee on Research and Application of Chinese Herbal Vesicles. The consensus highlights the characteristics and advantages of Chinese medicine, inherits the essence, and keeps the righteousness and innovation, aiming to provide a reference for colleagues engaged in research and application of Chinese herbal vesicles at home and abroad, decode the mystery behind Chinese herbal vesicles together, establish a safe, effective and controllable accurate Chinese herbal vesicle prevention and treatment system, and build a bridge for Chinese medicine to the world.

Objective:Exploring the effect of radiofrequency ablation treatment to restore sinus rhythm on the improvement of functional mitral regurgitation (FMR) and cardiac structure in patients with atrial fibrillation combined with moderate or severe FMR, compared with drug therapy alone.Methods:This retrospective cohort study consecutively enrolled patients diagnosed with persistent atrial fibrillation and moderate or severe FMR who were admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2019 to December 2021. Forty-eight patients who were treated with radiofrequency ablation and maintained sinus rhythm were enrolled in the ablation group, and 63 patients who were treated with medication alone during the same period were in the medicine group. Patients in the ablation group and medicine group were matched in a 1∶1 ratio using a propensity score, and 41 patients were finally included in each of the 2 groups. All patients reexamined echocardiography after 3-month of treatment. The proportion of patients with FMR improvement and the differences in changes of cardiac structural and functional parameters were compared between groups.Results:After propensity score matching, the ablation group was aged (69.3±7.1) years with 21 males (51.2%) and the medicine group was aged (71.3±9.4) years with 21 males (51.2%). The echocardiography after 3-month of treatment showed the rate of FMR improvement was significantly higher in the ablation group than in the medicine group (19 (46.3%) vs. 33 (80.5%), P<0.001), and patients in the ablation group showed a significant decrease in FMR extent (Δmitral regurgitation area: (-1.30±2.64) cm 2 vs. (-3.55±2.50) cm 2, P<0.001), left atrial size (Δleft atrial diameter: (-0.17±3.78) mm vs. (-2.46±4.01) mm, P=0.009) and E/e′ (ΔE/e′:-2.54±7.34 vs.-6.34±7.08, P=0.021) compared with the medicine group. There was also a significant decrease in left ventricular size (Δleft ventricular end diastolic diameter: (-3.12±6.62) mm vs. (-0.73±3.62) mm, P=0.046) and significant increase in left ventricular ejection fraction (Δleft ventricular ejection fraction: (2.73±9.69) % vs. (-0.93±5.41) %, P=0.038) in ablation group. Conclusion:Performing radiofrequency ablation to restore sinus rhythm can effectively reduce the severity of mitral regurgitation and improve left atrial and left ventricular remodeling and cardiac function in patients with atrial fibrillation and FMR.