AIM:To investigate the mechanism of reduced tear secretion in depression-related dry eye rats based on 5-HT/TRPV4/AQP5.METHODS:Healthy SD male rats were established with chronic unpredictable mild stress(CUMS)method to establish a depression-induced dry eye model(n=8), and the control group was blank rats(n=8). The ELISA method was used to compare the 5-hydroxytryptamine(5-HT)in serum and hippocampal tissue of the two groups, and the HE sections of lacrimal gland and AQP5 immunohistochemistry were observed. Western blot and RT-PCR were used to detect the expression of 5-HT3R, TRPV4 and AQP5 in the lacrimal gland tissue of the two groups of rats.RESULTS:The tear secretion in the depression-induced group was significantly reduced(P=0.001), the serum and hippocampal 5-HT levels were significantly reduced(all P<0.05), the expression of AQP5 antibody in the lacrimal gland immunohistochemistry was significantly lower than that in the control group(P<0.001), the expression of 5-HT3R, TRPV4 and AQP5 in the lacrimal gland was significantly reduced(all P<0.05), and no obvious inflammatory cells were found in the lacrimal gland tissue sections.CONCLUSION:Depression-related dry eye may occur through a non-inflammatory 5-HT/TRPV4/AQP5 mechanism.

AIM:To investigate the mechanism of reduced tear secretion in depression-related dry eye rats based on 5-HT/TRPV4/AQP5.METHODS:Healthy SD male rats were established with chronic unpredictable mild stress(CUMS)method to establish a depression-induced dry eye model(n=8), and the control group was blank rats(n=8). The ELISA method was used to compare the 5-hydroxytryptamine(5-HT)in serum and hippocampal tissue of the two groups, and the HE sections of lacrimal gland and AQP5 immunohistochemistry were observed. Western blot and RT-PCR were used to detect the expression of 5-HT3R, TRPV4 and AQP5 in the lacrimal gland tissue of the two groups of rats.RESULTS:The tear secretion in the depression-induced group was significantly reduced(P=0.001), the serum and hippocampal 5-HT levels were significantly reduced(all P<0.05), the expression of AQP5 antibody in the lacrimal gland immunohistochemistry was significantly lower than that in the control group(P<0.001), the expression of 5-HT3R, TRPV4 and AQP5 in the lacrimal gland was significantly reduced(all P<0.05), and no obvious inflammatory cells were found in the lacrimal gland tissue sections.CONCLUSION:Depression-related dry eye may occur through a non-inflammatory 5-HT/TRPV4/AQP5 mechanism.

Liver fibrosis is a vital cause of morbidity in patients with liver diseases and developing novel anti-fibrotic drugs is imperative.Isovalerylspiramycin Ⅰ(ISP Ⅰ)as a major component of carrimycin applied to upper respiratory infections,was first found to possess anti-fibrotic potential.The present study aims to evaluate the functions and mechanisms of ISP Ⅰ in protecting against liver fibrosis.According to our results,ISP Ⅰ not only reduced the expressions of fibrogenic markers in LX-2 cells but also appeared great protective effects on liver injury and liver fibrosis in bile duct ligation(BDL)rats and carbon tetrachloride(CCl4)mice.We proved that nucleotide-binding protein 2(NUBP2)was the direct target of ISP Ⅰ.ISP Ⅰ through targeting NUBP2,increased the amount of vascular non-inflammatory molecule-1(VNN1)on the cell membrane,which will inhibit oxidative stress and fibrosis.Simultaneously,the original carri-mycin's protective effect on liver damage and fibrosis was verified.Therefore,our study provides po-tential agents for patients with liver fibrosis-related diseases,and the clear mechanism supports wide application in the clinic.

Objective:To explore the gaze characteristics towards emotional portraits in children with attention deficit hyperactivity disorder(ADHD),in order to reveal their potential unique patterns of emotional cognition.Methods:A case-control design was employed,including 81 children diagnosed with the DSM-5 ADHD and 57 normal control(NC)children.Emotional images from the Chinese Children's Emotional Image Library were used as stimuli.The Tobii Pro X3-120 eye-tracking device was utilized to record fixation count(FC)and fixation duration percentage(FDP)under a free-viewing paradigm.Mixed-effects ANOVA was applied to explore the effects of group,gaze region(eyes and mouth),and emotional attributes on gaze characteristics,controlling for gen-der and age.Results:The FC and FDP of ADHD children were lower than those of NC children,particularly in the eye region of non-negative emotional images(P＜0.05).However,no significant differences were observed be-tween the two groups when viewing negative emotional images(sadness and anger)(P＞0.05).NC children ex-hibited a significant emotional bias effect in their gaze behavior towards emotional portraits(P＜0.05),whereas ADHD group showed only slight differences between non-negative emotional images(adjusted P＜0.05),indica-ting a weaker overall emotional attention bias.Conclusion:Children with ADHD display reduced attention to non-negative emotional expressions and a diminished emotional attention bias,suggesting potential deficits in emotional processing during face perception.

Objective To examine the serological and molecular prevalence as well as genotype characteristics of human Parvovirus B19 blood donors in Lanzhou,and to provide evidence for developing a screening strategy to reduce the risk of blood transfusion transmission.Methods A total of 5 722 blood samples collected from Lanzhou blood donors from April 2023 to October 2023 were tested for B19 DNA using real-time quantitative PCR(qRT-PCR).Additionally,383 samples were screened for anti-B19 IgG and anti-B19 IgM using synchronous enzyme-linked immunoassay(ELISA).Viral load and VP1 sequencing were conducted on the B19 DNA-positive samples and the Neighbor-Joining(N-J)method was used to construct an evolutionary tree for the sequenced samples.Results The prevalence of human Parvovirus B19 DNA,IgG antibody and IgM antibody was 0.47%(27/5 722),25.59%(98/383)and 0.26%(1/383),respectively,and the samples positive for B19 DNA,IgG antibody and IgM antibody were 0.26%(1/383).The co-positivity rate for B19 DNA and IgG antibody was 6.27%(24/383),while the positivity rates for B19 DNA or IgG antibody alone were 0.52%(2/383)and 19.06%(73/383),respectively.Viral loads ranged from 4.24 IU/ml to 5.67×102 IU/ml,all below 104 IU/ml.There was no statistical significance in the positive rate of B19 DNA in gender(χ2=0.86,P=0.35),but there was statistical significance in the positive rate of B19 DNA among all age groups(χ2=8.00,P=0.02).The highest positive rate of B19 DNA was 0.65%in the 18～30 age group.There was statistical significance in the positive rate of B19 IgG antibody in gender(χ2=5.03,P=0.02),but there was no statistical significance in the positive rate of B19 IgG antibody among all age groups(χ2=0.51,P=0.77).The highest positive rate of B19 IgG antibody was 29.09%in the age group of 41 to 60.There was no significant difference in the positive rate of B19 IgM antibody in gender(χ2=2.84,P=0.09).The highest positive rate of B19 IgM was 3.85%in the age group of 18～30 years old.Based on the VP1 sequence,the phylogenetic tree revealed that B19 strains in Lanzhou formed a distinct cladistic lineage within genotype 1,predominantly represented by genotype 1b.Conclusion The prevalence of B19 DNA and IgM antibodies among blood donors in the Lanzhou area is low,and so is the viral load.Therefore the risk of transmitting B19 through blood transfusion is relatively small.Since the prevalence of B19 IgG antibody is high,it is suggested to closely monitor the transmission situation in the area,regularly monitor the prevalence of B19 among blood donors,and track the situation of B19 DNA-positive blood donors to recipients to ensure the safety of clinical blood transfusion.

Objective:To explore the impact of National Metabolic Management Center (MMC) mode on the metabolic indexes in different age patients with type 2 diabetic mellitus (T2DM).Methods:A prospective study method was used. A total of 798 T2DM patients underwent the MMC mode management in Shanghai Punan Hospital of Pudong New District from May 2021 to August 2024 were selected. The patients followed the MMC one-stop diagnosis and treatment management service standards to enter the registration, treatment, examination and follow-up processes. The average follow-up time was 12.0 months. The glucose and lipid metabolism indexes, blood pressure and body mass index (BMI) before intervention and after receiving the intervention by MMC were measured. The glucose and lipid metabolism indexes included triacylglycerol, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose, 2 h postprandial blood glucose and glycated hemoglobin. The control rates of blood glucose, blood lipid, blood pressure and BMI were calculated after intervention.Results:The triacylglycerol, total cholesterol, LDL-C, fasting blood glucose, 2 h postprandial blood glucose and glycated hemoglobin after intervention in patients with T2DM were significantly lower than those before intervention: (1.75 ± 1.63) mmol/L vs. (2.08 ± 1.74) mmol/L, (4.37 ± 1.11) mmol/L vs. (4.88 ± 1.24) mmol/L, (2.47 ± 0.92) mmol/L vs. (2.92 ± 0.98) mmol/L, (6.54 ± 1.71) mmol/L vs. (8.12 ± 3.05) mmol/L, (9.04 ± 3.49) mmol/L vs. (12.10 ± 5.28) mmol/L and (6.89 ± 1.23)% vs. (8.85 ± 2.31)%, the HDL-C after intervention was significantly higher than that before intervention: (1.21 ± 0.31) mmol/L vs. (1.13 ± 0.29) mmol/L, and there were statistical differences ( P<0.01). The control rates of blood lipid and blood glucose after intervention in patients with T2DM were significantly higher than those before intervention: 54.6% (436/798) vs. 37.3% (298/798) and 62.0% (495/798) vs. 26.1% (208/798), and there were statistical differences ( P<0.01); there were no statistical differences in the control rates of BMI and blood pressure before intervention and after intervention ( P>0.05). In T2DM patients with age <50 years and from 50 to 59 years, the triacylglycerol, total cholesterol, LDL-C, fasting blood glucose, 2 h postprandial blood glucose and glycated hemoglobin after intervention were significantly lower than those before intervention, the HDL-C after intervention was significantly higher than that before intervention, and there were statistical differences ( P<0.05 or <0.01); the control rates of blood lipid and blood glucose after intervention were significantly higher than those before intervention, the patients with <50 years: 44.5% (114/256) vs. 27.7% (71/256) and 76.6% (196/256) vs. 28.9% (74/256), the patients with 50 to 59 years: 54.8% (86/157) vs. 28.0% (44/157) and 66.9% (105/157) vs. 24.8% (39/157), and there were statistical differences ( P<0.01); there were no statistical differences in the control rates of BMI and blood pressure between before intervention and after intervention ( P>0.05). In T2DM patients with age from 60 to 69 years, the triacylglycerol, total cholesterol, LDL-C, fasting blood glucose, 2 h postprandial blood glucose and glycated hemoglobin after intervention were significantly lower than those before intervention, and there were statistical differences ( P<0.05 or <0.01); there was no statistical differences in HDL-C before intervention and after intervention ( P>0.05); the control rates of blood lipid and blood glucose after intervention were significantly higher than those before intervention: 59.0% (177/300) vs. 47.3% (142/300) and 53.3% (160/300) vs. 25.7% (77/300), and there were statistical differences ( P<0.01); there were no statistical differences in the control rates of BMI and blood pressure before intervention and after intervention ( P>0.05). In T2DM patients with aged ≥70 years, the total cholesterol, LDL-C, 2 h postprandial blood glucose and glycated hemoglobin after intervention were significantly lower than those before intervention, and there were statistical differences ( P<0.05 or <0.01); there were no statistical difference in triacylglycerol, HDL-C and fasting blood glucose between before intervention and after intervention ( P>0.05); the control rate of blood glucose after intervention was significantly higher than that before intervention: 48.2% (41/85) vs. 22.4% (19/85), and there was statistical difference ( P<0.01); there were no statistical differences in the control rates of BMI, blood pressure and blood lipid between before intervention and after intervention ( P>0.05). Conclusions:The intervention based on MMC mode management could effectively improve the glucose and lipid metabolism in patients with T2DM, especially for patients with aged <70 years. However, additional health guidance is needed for patients with aged ≥ 70 years to further enhance their health benefits.

Objective : To investigate the diagnostic value of linear array endoscopic ultrasonography ( EUS) for common bile duct microlithiasis． Methods : Data of patients who attended in the hospital and diagnosed as common bile duct microlithiasis and biliary sludge by EUS were selected．A total of 85 patients with magnetic resonance cholangiopancreatography ( MRCP) examination and ERCP treatment during hospitalization were enrolled．The results of endoscopic retrograde cholangiopancreatography / endoscopic sphincterotomy ( ERCP / EST) were the gold standard for diagnosis．The results of EUS，MRCP，and diagnostic ERCP were compared with the gold standard， and the sensitivity，specificity，positive predictive value，negative predictive value，and diagnostic accuracy of the three methods were calculated，respectively．The chi-square test was used for comparison of the above indices． Results : Of all 85 patients，63 had positive EUS results，among whom 5 had false positive results; 22 had negative EUS results，among whom 1 had false negative results．Of all 85 patients，49 had positive MRCP results，among whom 4 had false positive results; 36 had negative MRCP results，among whom 14 had false negative results．Of all 85 patients，59 had positive diagnostic ERCP results，among whom 10 had false positive results; 26 had negative diagnostic ERCP results，among whom 10 had false negative results．The sensitivity，specificity，positive predictive value( PPV) ，negative predictive value ( NPV) ，and accuracy of EUS in diagnosing common bile duct microlithia- sis were 98. 3% ，80. 8% ，92. 1% ，95. 4% and 92. 9% ，respectively． For MRCP，these values were 76. 3% ， 84. 6% ，91. 8% ，61. 1% and 78. 8% ，respectively．For diagnostic ERCP，these values were 83. 1% ，61. 5% ， 83. 1% ，61. 5% and 76. 5% ，respectively．The EUS group had a significantly higher accuracy than the MRCP group ( χ2 = 6. 986，P ＜0. 05) and diagnostic ERCP group ( χ2 = 8. 900，P ＜0. 05) ．The areas under the ROC curves ( AUC) and 95% CI of EUS group，MRCP group and diagnostic ERCP were 0. 895 ( 95% CI: 0. 802 - 0. 988，P＜0. 001) ，0. 804 ( 95% CI: 0. 702 －0. 907，P ＜0. 001) and 0. 723 ( 95% CI: 0. 598 －0. 848，P = 0. 001) ，respectively． Conclusion EUS has a high diagnostic value in the diagnosis of common bile duct microli- thiasis and thus can be used as the preferred examination before therapeutic ERCP．

Objective To analyze the serum levels of angiopoietin-like protein 4(ANGPTL4)and fibro-blast growth factor-21(FGF-21)in patients with acute cerebral infarction complicated with type 2 diabetes,and explore their relationships with disease condition and carotid plaque stability.Methods A total of 224 pa-tients with acute cerebral infarction complicated with type 2 diabetes admitted to this hospital from June 2019 to June 2022 were selected as the study group,and 224 healthy volunteers undergoing physical examinations in the hospital during the same period were selected as the control group.Serum ANGPTL4 and FGF-21 levels were detected by ELISA.The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the severity of the disease.Patients were divided into the mild group(n=84,NIHSS score<4 points),the moder-ate group(n=100,NIHSS score 4-15 points),and the severe group(n=40,NIHSS score>15 points).Ca-rotid plaque stability was assessed by color Doppler ultrasound,and patients were divided into the no-plaque group(n=44),the stable plaque group(n=71),and the unstable plaque group(n=109).Pearson correlation analysis was used to analyze the correlation between serum ANGPTL4 level and FGF-21 level.Spearman cor-relation analysis was used to analyze the correlations between serum ANGPTL4/FGF-21 levels and disease se-verity or carotid plaque stability.Logistic regression analysis was performed to analyze the influencing factors of acute cerebral infarction complicated with type 2 diabetes.Results The serum ANGPTL4 level in the study group was significantly lower than that in the control group(P<0.05),while the FGF-21 level was signifi-cantly higher(P<0.05).Serum ANGPTL4 levels decreased progressively in the mild,moderate,and severe groups(P<0.05),while FGF-21 levels increased progressively(P<0.05).Serum ANGPTL4 levels also de-creased progressively in the no-plaque,stable plaque,and unstable plaque groups(P<0.05),while FGF-21 levels increased progressively(P<0.05).Pearson correlation analysis showed a negative correlation between serum ANGPTL4 and FGF-21 levels(r=-0.576,P<0.05).Spearman correlation analysis showed that ser-um ANGPTL4 level were negatively correlated with disease severity and carotid plaque stability(r=-0.561,-0.529;P<0.05),while serum FGF-21 levels were positively correlated with disease severity and carotid plaque stability(r=0.592,0.610;P<0.05).Logistic regression analysis showed that low ANGPTL4 expres-sion and high FGF-21 expression were risk factors for acute cerebral infarction complicated with type 2 diabe-tes(P<0.05).Conclusion In patients with acute cerebral infarction complicated with type 2 diabetes,serum ANGPTL4 level is significantly decreased,while FGF-21 is significantly increased compared with healthy indi-viduals.Both factors are closely associated with disease severity and carotid plaque stability.

Intestinal stem cells(ISCs),locating at the base of intestinal crypts and pivotal in orchestrating the homeostasis and damage repair of the intestinal epithelium,are characterized by their self-renewal and multipotential differentiation capabilities.With the continuous discoveries of new ISCs and related markers,the ISC migration and regeneration model has been further improved,greatly promoting the research in related fields.Diet can regulate ISC glycolipid and energy metabolism through influencing the stem cell niche,subsequently modulating overall metabolism.This paper summarizes the biological features of both classical and newly discovered ISCs,and analyzes the effects of common nutrients and different dietary patterns on ISCs,hoping to provide insights for the precise nutrition prevention and treatment of chronic intestinal diseases.

Objective:To explore the predictive factors for testicular atrophy in children with testicular torsion following orchiopexy.Methods:The clinical data of 82 patients with testicular torsion and orchiopexy admitted to Beijing Children’s Hospital Affiliated to Capital Medical University between October 2015 and September 2021 were retrospectively analyzed. The age was 147（110，162）months. Among these patients，62 presented with scrotal pain as the initial symptom，while 20 exhibited atypical symptoms. Regarding referral history，36 cases had no referrals，39 cases had one referral，and 7 cases had two or more referrals. Preoperative testicular ultrasonography revealed homogeneous echotexture in 24 cases and heterogeneous echotexture in 58 cases. Testicular blood flow was normal in 3 cases，reduced in 17 cases，and absent in 62 cases. Testicular torsion was considered at first diagnosis，testicular exploration was performed，and testicular fixation was performed if the testicle was viable. If bilateral testicular ultrasound examination was performed over 3 months after the operation，and the results showed that the difference in volume（TVL）between the affected testicle and the unaffected testicle was >50% or the blood flow in the affected testicle was absent，it was defined as testicular atrophy. If no ultrasound examination was performed over 3 months after the operation，but the ultrasound examination within 3 months after the operation indicated the absence of blood flow in the affected testicle，it was also defined as testicular atrophy. Univariate analysis was used to compare the clinical data between the two groups according to whether there was testicular atrophy or not. Multivariate logistic regression was used to analyze the independent risk factors associated with postoperative testicular atrophy. The predictive value of each factor was analyzed by receiver operating characteristic（ROC）curve.Results:Of the 82 patients，32（39.0%）had testicular atrophy after surgery.Patients presenting with atypical initial symptoms exhibited a significantly higher incidence of testicular atrophy compared to those with scrotal pain［75.0%（15/20）vs. 27.4%（17/62）， P<0.001］. Additionally，patients who underwent ≥2 referrals demonstrated a markedly elevated rate of testicular atrophy relative to those with 0 or 1 referral［100.0%（7/7）vs. 33.3%（12/36）vs. 33.3%（13/39）， P=0.002］. The incidence of testicular atrophy varied significantly depending on the level of the hospital where the patient was initially diagnosed：primary hospitals（100.0%，5/5），secondary general hospitals（50.0%，6/12），tertiary general hospitals（34.8%，8/23），and tertiary women and children’s hospitals（31.0%，13/42），with statistical significance（ P=0.020）. Furthermore，patients with uneven testicular echogenicity preoperatively were more likely to develop testicular atrophy than those with uniform echogenicity［55.2%（32/58）vs. 0， P<0.001］. Preoperative testicular ultrasonography revealed a significant difference in the rate of testicular atrophy among patients with absent blood flow，reduced blood flow，and normal blood flow［50.0%（31/62）vs. 5.9%（1/17）vs. 0， P=0.001］. Patients experiencing testicular atrophy had a longer preoperative preparation time compared to those without atrophy［median 4.0（3.4，5.1）h vs. 3.5（3.0，4.2）h， P=0.017］. Moreover，the duration of symptoms was significantly longer in patients with testicular atrophy than in those without［25.5（13.0，49.5）h vs. 8.0（6.3，11.8）h， P<0.001］. Finally，contralateral testicular fixation was associated with a higher incidence of testicular atrophy，with a statistically significant difference observed between groups［50.0%（23/46）vs. 25.0%（9/36）， P=0.038］. Multivariate logistic regression analysis revealed that preoperative testicular ultrasound blood flow loss（ OR = 1.22， P = 0.034），uneven testicular ultrasound echo（ OR = 1.33， P = 0.007），and not performing contralateral testicular fixation（ OR = 0.77， P = 0.003）were independent predictors of postoperative testicular atrophy. The area under the curve（AUC）for predicting postoperative testicular atrophy was 0.68，0.74，and 0.63，respectively. Conclusions:Lack of preoperative testicular ultrasound blood flow and uneven preoperative testicular ultrasound echo have good predictive value for testicular atrophy after testicular torsion testicular fixation in children，and the best predictor is uneven preoperative testicular ultrasound echo. The correlation between contralateral testicular fixation and postoperative testicular atrophy needs further study.