Objective:To examine the long-term efficacy and complications of fecal microbiota transplantation (FMT) for the treatment of diseases related to intestinal dysbiosis.Methods:This was a retrospective descriptive study. Relevant data were collected from the records of 15 000 patients who had undergone FMT and been followed up for more than 3 months during the period from May 2017 to September 2024. The patient cohort comprised 3746 male and 11 254 female patients aged (45.3±12.2) years. The inclusion criterion was meeting the indications for FMT. Application of this criterion yielded 8258 patients with constipation, 684 with Clostridium difficile infection, 1730 with chronic diarrhea, 510 with inflammatory bowel disease, 432 with radiation enteritis, 1940 with irritable bowel syndrome, 365 with autism, 870 with postoperative gastrointestinal dysfunction, and 211 with neurodegenerative diseases. The three routes of delivering FMT comprised infusion of an enterobacterial solution through a nasoenteric tube into the jejunum for 6 consecutive days (upper gastrointestinal FMT group, 11 125 patients), oral intake of enterobacterial capsules for 6 consecutive days (oral capsule FMT, 3597 patients), and a single injection of a bacterial solution into the colon via colonoscopy (lower gastrointestinal FMT group, 278 patients). Other treatments were discontinued during the treatment and follow-up period and administration of other medications was not recommended unless absolutely necessary. The primary outcomes were the efficacy of FMT after 3, 12 and 36 months of treatment, and improvement in chronic constipation, C. difficile infection, chronic diarrhea, inflammatory bowel disease, radiation enteritis, irritable bowel syndrome, post-surgery gastrointestinal dysfunction, and autism. Other outcomes included the occurrence of short-term (within 2 weeks after treatment) and long-term (within 36 months after treatment) adverse reactions.Results:At 3, 12 and 36 months after treatment, the overall rates of effectiveness of treatment were 71.8% (10 763/15 000), 64.4% (7600/11 808) and 58.8% (3659/6218), respectively. Specifically, the rates of clinical improvement were 70.3% (5805/8258), 62.6% (3970/6345), and 56.5% (1894/3352), respectively, for constipation; 85.8% (587/684), 72.3% (408/564), and 67.3% (218/324), respectively, for C.difficile infection; 81.0% (1401/1730), 78.1% (1198/1534), and 72.3% (633/876), respectively, for chronic diarrhea; 64.3% (328/510), 52.3% (249/476), and 46.6 % (97/208), respectively, for inflammatory bowel disease; 77.3% (334/432), 65.4% (212/324), and 53.6% (82/153), respectively, for radiculitis; 70.6% (1370/1940), 64.5% (939/1456), and 60.4% (475/786), respectively, for irritable bowel syndrome; 75.3% (275/365), 70.0% (201/287), and 63.6% (112/176), respectively, for autism; 65.3% (568/870), 54.3% (355/654), and 46.5% (114/245), respectively, for post-surgical gastrointestinal dysfunction; and 45.0% (95/211), 40.5% (68/168), and 34.7% (34/98), respectively, for neurodegenerative diseases. At 3, 12, and 36 months post-treatment, clinical improvement rates were 77.1% (8580/11 125), 67.1% (6437/9595), and 62.1% (3196/5145), respectively, in the upper gastrointestinal route group; and 57.3% (2062/3597), 53.6% (1115/2081), and 45.0% (453/1006), respectively, in the oral capsule group; and 43.5% (121/278) , 36.4% (48/132) and 14.9% (10/67), respectively, in the lower gastrointestinal route group. No serious adverse reactions occurred during treatment or follow-up. The most common adverse reactions in the upper gastrointestinal route group, oral capsule group, and lower gastrointestinal route group were respiratory discomfort (20.4%, 2269/11 125), nausea and vomiting on swallowing the capsule (7.6%, 273/3597), and diarrhea (47.5%, 132/278), respectively; these symptoms resolved at the end of treatment. At 36 months of follow-up, 19 patients reported exacerbation of symptoms of pre-existing diseases and there had been 16 deaths that were not directly related to FMT. Additionally, no systemic diseases had developed after FMT.Conclusion:FMT for the treatment of intestinal dysfunction associated with disorders of the intestinal flora and related extraintestinal diseases is effective and not associated with serious adverse events.

Objective:To examine the long-term efficacy and complications of fecal microbiota transplantation (FMT) for the treatment of diseases related to intestinal dysbiosis.Methods:This was a retrospective descriptive study. Relevant data were collected from the records of 15 000 patients who had undergone FMT and been followed up for more than 3 months during the period from May 2017 to September 2024. The patient cohort comprised 3746 male and 11 254 female patients aged (45.3±12.2) years. The inclusion criterion was meeting the indications for FMT. Application of this criterion yielded 8258 patients with constipation, 684 with Clostridium difficile infection, 1730 with chronic diarrhea, 510 with inflammatory bowel disease, 432 with radiation enteritis, 1940 with irritable bowel syndrome, 365 with autism, 870 with postoperative gastrointestinal dysfunction, and 211 with neurodegenerative diseases. The three routes of delivering FMT comprised infusion of an enterobacterial solution through a nasoenteric tube into the jejunum for 6 consecutive days (upper gastrointestinal FMT group, 11 125 patients), oral intake of enterobacterial capsules for 6 consecutive days (oral capsule FMT, 3597 patients), and a single injection of a bacterial solution into the colon via colonoscopy (lower gastrointestinal FMT group, 278 patients). Other treatments were discontinued during the treatment and follow-up period and administration of other medications was not recommended unless absolutely necessary. The primary outcomes were the efficacy of FMT after 3, 12 and 36 months of treatment, and improvement in chronic constipation, C. difficile infection, chronic diarrhea, inflammatory bowel disease, radiation enteritis, irritable bowel syndrome, post-surgery gastrointestinal dysfunction, and autism. Other outcomes included the occurrence of short-term (within 2 weeks after treatment) and long-term (within 36 months after treatment) adverse reactions.Results:At 3, 12 and 36 months after treatment, the overall rates of effectiveness of treatment were 71.8% (10 763/15 000), 64.4% (7600/11 808) and 58.8% (3659/6218), respectively. Specifically, the rates of clinical improvement were 70.3% (5805/8258), 62.6% (3970/6345), and 56.5% (1894/3352), respectively, for constipation; 85.8% (587/684), 72.3% (408/564), and 67.3% (218/324), respectively, for C.difficile infection; 81.0% (1401/1730), 78.1% (1198/1534), and 72.3% (633/876), respectively, for chronic diarrhea; 64.3% (328/510), 52.3% (249/476), and 46.6 % (97/208), respectively, for inflammatory bowel disease; 77.3% (334/432), 65.4% (212/324), and 53.6% (82/153), respectively, for radiculitis; 70.6% (1370/1940), 64.5% (939/1456), and 60.4% (475/786), respectively, for irritable bowel syndrome; 75.3% (275/365), 70.0% (201/287), and 63.6% (112/176), respectively, for autism; 65.3% (568/870), 54.3% (355/654), and 46.5% (114/245), respectively, for post-surgical gastrointestinal dysfunction; and 45.0% (95/211), 40.5% (68/168), and 34.7% (34/98), respectively, for neurodegenerative diseases. At 3, 12, and 36 months post-treatment, clinical improvement rates were 77.1% (8580/11 125), 67.1% (6437/9595), and 62.1% (3196/5145), respectively, in the upper gastrointestinal route group; and 57.3% (2062/3597), 53.6% (1115/2081), and 45.0% (453/1006), respectively, in the oral capsule group; and 43.5% (121/278) , 36.4% (48/132) and 14.9% (10/67), respectively, in the lower gastrointestinal route group. No serious adverse reactions occurred during treatment or follow-up. The most common adverse reactions in the upper gastrointestinal route group, oral capsule group, and lower gastrointestinal route group were respiratory discomfort (20.4%, 2269/11 125), nausea and vomiting on swallowing the capsule (7.6%, 273/3597), and diarrhea (47.5%, 132/278), respectively; these symptoms resolved at the end of treatment. At 36 months of follow-up, 19 patients reported exacerbation of symptoms of pre-existing diseases and there had been 16 deaths that were not directly related to FMT. Additionally, no systemic diseases had developed after FMT.Conclusion:FMT for the treatment of intestinal dysfunction associated with disorders of the intestinal flora and related extraintestinal diseases is effective and not associated with serious adverse events.

Objective To explore the optimal duration of long-term mild hypothermia(MHT)for traumatic brain injury(TBI)in rats,and observe its effect on intracranial pressure(ICP)and neurological function.Methods Forty-eight healthy adult male SD rats were divided into the normal temperature treatment(NT)group,the MHT4 h group,the MHT24 h group and the MHT48 h group by random number table method,with twelve rats in each group.The TBI model of rats was prepared by electronic controllable cortical injury device,and ICP monitoring probe was implanted.After modeling,the NT group was treated with normal temperature(37℃),and the other groups were treated with low temperature(33.0±1.0)℃for 4 h,24 h and 48 h,respectively.ICP was monitored and brain water content(BWC)was calculated after MHT treatment in each group.Blood-brain barrier permeability was determined by Evansland(EB)staining.The expression of 5-bromodeoxyuracil nucleoside(BrdU),neuronal nuclear antigen antibody(NeuN)and leukocyte differentiation antigen 86(CD86)positive cells were detected by immunofluorescence staining.The expressions of B-cell lymphoma-2(Bcl-2),Bcl-2 associated X protein(Bax),inducable nitric oxide synthase(iNOS),interleukin(IL)-10 and arginase 1(Arg-1)were detected by Western blot assay.Results Compared with the NT group,levels of BWC,ICP,EB,and CD86 positive cells,Bax and iNOS expression levels were decreased in the MHT4 h group,the MHT24 h group and the MHT48 h group,and the number of BrdU positive cells and BrdU/NeuN double-labeled positive cells were increased in hippocampus.The expression levels of Bcl-2,IL-10 and Arg-1 were increased(P＜0.01).Compared with the MHT24 h group,levels of BWC,ICP and EB,and CD86 positive cells,Bax and iNOS expression were decreased,and the number of BrdU positive cells and BrdU/NeuN double-labeled positive cells were increased in the MHT48 h group,while levels of Bcl-2,IL-10 and Arg-1 expression were increased(P＜0.01).Conclusion Long-term MHT can promote the proliferation and differentiation of neurons,inhibit apoptosis and reduce inflammation by suppressing ICP rebound,further promoting neuroprotection after TBI.

Objective To investigate the neurobehavioral effects of long-term mild hypothermia(MHT)combined with compound porcine cerebroside and ganglioside injection(CPCGI)after traumatic brain injury(TBI)in rats and its mechanism.Methods 36 healthy adult male SD rats were randomly divided into model group,MHT group,CPCGI group and MHT+CPCGI group.The TBI model was prepared using an electronically controlled cortical in-jury device.The rats in model group received an intraperitoneal injection of an equal amount of normal saline(NS,2 ml/kg)and were treated at room temperature(37℃)for 48 hours.The rats in MHT group received an intraper-itoneal injection of an equal amount of NS and were treated at a slightly low temperature(33.0±1.0)℃for 48 hours.The rats in CPCGI group received an intraperitoneal injection of an equal amount of CPCGI(0.6 ml/kg)and were treated at room temperature for 48 hours.The rats in MHT+CPCGI group received an intraperitoneal in-jection of an equal amount of CPCGI and were treated at a slightly low temperature for 48 hours.The sensorimotor function of rats was evaluated by modified Neurological Severity Score(mNSS).The motor and spatial memory a-bilities of rats were detected by Morris water maze test,and the motor function of rats was evaluated by beam walk-ing test(BWT)and inclined-grid climbing test.The number of neurons in hippocampus was observed by Nissl stai-ning and immunofluorescence was used to detect the expression of doublecortin(DCX)and neuronal nuclear anti-gen antibody(NeuN).Western blot was used to observe the protein expression of B-cell lymphoma-2(Bcl-2),Bcl-2 associated X protein(Bax)and cysteine proteinase-3(Caspase-3).Results Compared with MHT group and CPCGI group,MHT+CPCGI group had a lower mNNS score,shorter escape latency,higher times across the platform and the percentage of time in the target quadrant,higher BWT score and larger climbing angle,increased numbers of neurons,DCX and NeuN positive cells,increased Bcl-2 expression and decreased expression of Bax and Caspase-3.(P<0.05).Conclusion Long-term mild hypothermia combined with CPCGI can effectively im-prove the neurological deficits of TBI rats by promoting nerve regeneration and inhibiting cell apoptosis,and provide potential strategies and basis for the clinical treatment of TBI.

Objective To investigate the protective effect of target temperature management based different durations with delayed hypothermia for traumatic brain injury(TBI)in rats.Methods 36 healthy adult male SD rats were randomly divided into NT group,HT4h group,HT24h group and HT48h group.The TBI model of rats was prepared with an electronic controllable cortical injury device.NT group was treated with normal temperature(37℃)4 h after TBI,and the experimental groups were treated with low temperature(33.0±1.0℃)4 h after TBI for 4 h,24 h,and 48 h.Three days after TBI,the motor function of the rats in each group was evaluated by beam walking test and inclined-grid climbing test,EB staining was used to measure the blood-brain barrier perme-ability,the change of hippocampal neurons was observed by Nissl staining,the expression of DCX and GFAP was detected by immunofluorescence,and the expression of Bcl-2 and Bax was measured by Western blot and immuno-histochemistry.Results Compared with NT group,the experimental groups could significantly improve the motor function of TBI rats,reduce the permeability of blood-brain barrier,protect hippocampal neurons,promote DCX expression,inhibit GFAP expression,up-regulate the expression of Bcl-2 protein,and down-regulate the expres-sion of Bax protein.However,the protective effect was more apparent in HT48h group than other experimental groups(P<0.05).Conclusion Long-term delayed target temperature management has a significant brain protective effect.

Objective To explore the effects of delayed mild hypothermia (MHT) in different time windows on the expressions of Bcl-2, Bax and Caspase-3 in brain tissue of model rats with traumatic brain injury (TBI). Methods Thirty-six clean adult male SD rats were randomly divided into NT group (normal temperature), MHT 15 min group, MHT 2 h group and MHT 4 h group. TBI rat model was established by electronical controlled cortical injury device. The rats in the NT group were treated with normothermia (37℃) and the rats in the three hypothermia groups were implemented with low temperature (33.0±1.0)℃at 15 min, 2 h and 4 h for 6 h respectively after establishment of TBI model. The modified neurological senerity scores (mNSS), morphological changes in hippocampal CA1 areas, immunohistochemical staining and Western blot assay for Bcl-2, Bax and Caspase-3 were compared 3 days after TBI between the four groups. Results The neurological behavioral deficits were found in each group. Compared with the NT group, the mNSS were decreased in the three hypothermia groups (P<0.01). The results of HE staining showed that the structure of neurons was regular and arranged neatly, and the number of neurons decreased with alleviated nuclear fragmentation and dissolution in hypothermia groups. Compared with the NT group, the expression of Bcl-2 was upregulated, and the expressions of Bax and Caspase-3 were downregulated in three hypothermia groups (P<0.05). The above experimental results were superior in MHT15 min group to MHT 2 h group, and the therapeutic effect in MHT 2 h group was similar to MHT 4 h group. Conclusion The proper delayed mild hypothermia treatment could inhibit neuronal apoptosis and alleviate brain damage.

Objective To analyse the efficacy of microvascular decompression for hemifacial spasm (HFS) caused by vertebral basilar artery compression. Methods A total of 141 patients with HFS treated by microvascular decompression in our hospital were collected in this study. The improvement of the symptoms after operation was compared between patients with HFS caused by vertebral basilar artery compression (28 cases) and patients with HFS caused by non-vertebral basilar artery compression (113 cases). Results There was no significant difference in the effective rate between the two groups of HFS (96.43%vs. 98.23%,P=0.49) with mean following-up 13.81 ± 1.57 months. And there was no significant difference in the delayed cure rate after surgery between two groups (37.04%vs. 20.72%,χ2=1.38, P>0.05). Conclusion Microvascular decompression is a safe and effective method for the treatment of HFS caused by compressed vertebral basilar artery.

Objective:To evaluate the effect of interferon-αon the expression and activity of transcription factor specificity pro-tein 1(Sp1) in hepatocarcinoma cells .Methods :The effect of interferon-αon the expression and phosphorylation level of Sp1 in hepatocarcinoma cell line M HCC97H were detected by Western blotting .The effect of interferon-α on the activity of Sp1 was analyzed by electrophoretic mobility shift assay (EMSA) .Results :Interferon-α significantly reduced the expression and phos-phorylation level of Sp1 ,and the reducement on phosphorylation was more distinct .Interferon-α also inhibited the activity of Sp1 significantly .Conclusions :Interferon-αinhibits the activity of Sp1 by down regulating the expression and phosphorylation level of Sp1 .Sp1 may be an optional predictor of clinical efficacy of interferon-αon hepatocarcinoma .