Background/Aims: Data from Asia regarding the short-term and long-term outcomes for acute severe ulcerative colitis (ASUC) are limited. We assessed the outcomes of ASUC, identified the risk factors for colectomy, and compared colectomy rates between the pre-biologics and post-biologics eras in Taiwan. Methods: The patients with an ASUC diagnosis between January 2013 and March 2022 at 5 tertiary medical centers were retrospectively analyzed. Results: In total, 98 patients were enrolled, with 68.4% diagnosed in the post-biologics era. In 78.6% of the ASUC patients initially received intravenous steroid therapy, for which the success rate was 74.1%. As for rescue therapy, 15 patients (93.8%) received biologics and 1 (6.3%) received cyclosporin. Biologics rescue therapy had a 93.3% success rate. One (1%) mortality due to septic shock occurred. The colectomy rate for index ASUC admission was 11.2%. Patients receiving colectomy were predominantly male (P= 0.012) and at older age (P= 0.016). Higher C-reactive protein (P= 0.035), lower albumin (P= 0.017), and hemoglobin (P= 0.023) levels were associated with colectomy risk. During a median follow-up of 24 months, 13 patients (15.1%) had recurrent ASUC and 23.1% of patients received colectomy. The accumulated colectomy rate at 3 years did not differ between the pre- and post-biologics eras (16.1% vs. 13.4%, P= 0.270). Conclusions This is the first Asian study on ASUC to compare colectomy rates between the prebiologics and post-biologics eras, revealing no significant difference. The recurrent ASUC had a higher colectomy rate than the index ASUC.

ObjectiveMagnetoencephalography (MEG), a non-invasive neuroimaging technique, meticulously captures the magnetic fields emanating from brain electrical activity. Compared with MEG based on superconducting quantum interference devices (SQUID), MEG based on optically pump magnetometer (OPM) has the advantages of higher sensitivity, better spatial resolution and lower cost. However, most of the current studies are clinical studies, and there is a lack of animal studies on MEG based on OPM technology. Pain, a multifaceted sensory and emotional phenomenon, induces intricate alterations in brain activity, exhibiting notable sex differences. Despite clinical revelations of pain-related neuronal activity through MEG, specific properties remain elusive, and comprehensive laboratory studies on pain-associated brain activity alterations are lacking. The aim of this study was to investigate the effects of inflammatory pain (induced by Complete Freund’s Adjuvant (CFA)) on brain activity in a rat model using the MEG technique, to analysis changes in brain activity during pain perception, and to explore sex differences in pain-related MEG signaling. MethodsThis study utilized adult male and female Sprague-Dawley rats. Inflammatory pain was induced via intraplantar injection of CFA (100 μl, 50% in saline) in the left hind paw, with control groups receiving saline. Pain behavior was assessed using von Frey filaments at baseline and 1 h post-injection. For MEG recording, anesthetized rats had an OPM positioned on their head within a magnetic shield, undergoing two 15-minute sessions: a 5-minute baseline followed by a 10-minute mechanical stimulation phase. Data analysis included artifact removal and time-frequency analysis of spontaneous brain activity using accumulated spectrograms, generating spectrograms focused on the 4-30 Hz frequency range. ResultsMEG recordings in anesthetized rats during resting states and hind paw mechanical stimulation were compared, before and after saline/CFA injections. Mechanical stimulation elevated alpha activity in both male and female rats pre- and post-saline/CFA injections. Saline/CFA injections augmented average power in both sexes compared to pre-injection states. Remarkably, female rats exhibited higher average spectral power 1 h after CFA injection than after saline injection during resting states. Furthermore, despite comparable pain thresholds measured by classical pain behavioral tests post-CFA treatment, female rats displayed higher average power than males in the resting state after CFA injection. ConclusionThese results imply an enhanced perception of inflammatory pain in female rats compared to their male counterparts. Our study exhibits sex differences in alpha activities following CFA injection, highlighting heightened brain alpha activity in female rats during acute inflammatory pain in the resting state. Our study provides a method for OPM-based MEG recordings to be used to study brain activity in anaesthetized animals. In addition, the findings of this study contribute to a deeper understanding of pain-related neural activity and pain sex differences.

Purpose: This study assessed the performance of the ultrasound-guided attenuation parameter (UGAP) in diagnosing and grading hepatic steatosis in patients with metabolic dysfunctionassociated steatotic liver disease (MASLD). Magnetic resonance imaging proton density fat fraction (MRI-PDFF) served as the reference standard. Methods: Patients with hepatic steatosis were enrolled in this prospective study and underwent UGAP measurements. MRI-PDFF values of ≥5%, ≥15%, and ≥25% were used as references for the diagnosis of steatosis grades ≥S1, ≥S2, and S3, respectively. Spearman correlation coefficients and area under the receiver operating characteristic curves (AUCs) were calculated. Results: Between July 2023 and June 2024, the study included 88 patients (median age, 40 years; interquartile range [IQR], 36 to 46 years), of whom 54.5% (48/88) were men and 45.5% (40/88) were women. Steatosis grades exhibited the following distribution: 22.7% (20/88) had S0, 50.0% (44/88) had S1, 21.6% (19/88) had S2, and 5.7% (5/88) had S3. The success rate for UGAP measurements was 100%. The median UGAP value was 0.74 dB/cm/MHz (IQR, 0.65 to 0.82 dB/ cm/MHz), and UGAP values were positively correlated with MRI-PDFF (r=0.77, P<0.001). The AUCs of UGAP for the diagnoses of ≥S1, ≥S2, and S3 steatosis were 0.91, 0.90, and 0.88, respectively. In the subgroup analysis, 98.4% (60/61) of patients had valid controlled attenuation parameter (CAP) values. UGAP measurements were positively correlated with CAP values (r=0.65, P<0.001). Conclusion Using MRI-PDFF as the reference standard, UGAP demonstrates good diagnostic performance in the detection and grading of hepatic steatosis in patients with MASLD.

Methods: Seventy-five patients with atlas fracture were included from January 2015 to December 2020. Based on the anatomy of the fracture line, atlas fractures were divided into three types. Each type was divided into two subtypes according to the fracture displacement. Unweighted Cohen kappa coefficients were applied to evaluate the reliability and reproducibility. Results: According to the new classification, 17 cases of type A1, 12 of type A2, seven of type B1, 13 of type B2, 12 of type C1, and 14 of type C2 were identified. The K-values of the interobserver and intraobserver reliability were 0.846 and 0.912, respectively, for the new classification. The K-values of interobserver reliability for types A, B, and C were 0.843, 0.799, and 0.898, respectively. The K-values of intraobserver reliability for types A, B, and C were 0.888, 0.910, and 0.935, respectively. The mean K-values of the interobserver and intraobserver reliability for subtypes were 0.687 and 0.829, respectively. Conclusions The new classification of atlas fractures can cover nearly all atlas fractures. This system is the first to evaluate the severity of fractures based on the C1 articular facet and fracture displacement and strengthen the anatomy ring of the atlas. It is concise, easy to remember, reliable, and reproducible.

Objective To examine the changing prevalence and antimicrobial resistance profiles of Burkholderia cepacia in 52 hospitals across China from 2015 to 2021.Methods A total of 9 261 strains of B.cepacia were collected from 52 hospitals between January 1,2015 and December 31,2021.Antimicrobial susceptibility of the strains was tested using Kirby-Bauer method or automated antimicrobial susceptibility testing systems according to a unified protocol.The results were interpreted according to the breakpoints released in the Clinical & Laboratory Standards Institute(CLSI)guidelines(2023 edition).Results A total of 9 261 strains of B.cepacia were isolated from all age groups,especially elderly patients.The proportion was 11.1％(1 032 strains)in children,significantly lower than the proportion in adults.About half(46.5％,4 310/9 261)of the strains were isolated from patients at least 60 years old and 42.3％(3 919/9 261)of the strains were isolated from young adults.Most isolates(71.1％)were isolated from sputum and respiratory secretions,followed by urine(10.7％)and blood samples(8.1％).B.cepacia isolates were highly susceptible to the five antimicrobial agents recommended in the CLSI M100 document(33rd edition,2023).B.cepacia isolates showed relatively higher resistance rates to meropenem and levofloxacin.However,the resistance rates to ceftazidime,trimethoprim-sulfamethoxazole,and minocycline remained below 8.1％.The percentage of B.cepacia strains resistant to levofloxacin was the highest compared to other antibiotics in any of the three age groups(from 12.4％in the patients＜18 years old to 20.6％in the patients aged 60 years or older).Conclusions B.cepacia is one of the clinically important non-fermenting gram-negative bacteria.Accurate and timely reporting of antimicrobial susceptibility test results and ongoing antimicrobial resistance surveillance are helpful for rational prescription of antimicrobial agents and proper prevention and control of nosocomial infections.

Objective To propose a multiple regression-variational auto-encoders(MR-VAE)model to realize precise and non-invasive prediction of intra-abdominal pressure(IAP)in critically ill patients.Methods At first,a dataset was constructed by retrospectively analysing baseline characteristics and clinical indicators of 100 critically ill patients admitted to the Intensive Care Unit of Daping Hospital of Army Medical University between 30 August 2019 and 30 March 2021.Then,a MR-VAE prediction model was developed by integrating a feedforward neural network for supervised regression onto a variational autoencoder(VAE)framework and incorporating multiple regression strategies to mitigate feature interference.Finally,the MR-VAE model had its performance evaluated by its comparison with five classical models including support vector machines(SVM),convolutional neural networks(CNN),Scikit-learn integrated model(SIM),multi-layer perceptron(MLP)and K-nearest neighbors(KNN),and its prediction accuracy verified by testing the data of 10 randomly selected patients.Results The MR-VAE model behaved the best when compared with the five classical models,with a mean squared error(MSE)of 0.207,a root mean square error(RMSE)of 0.454,a mean absolute error(MAE)of 0.361,a median absolute deviation(MAD)of 0.243,an explained variance score(EVS)of 0.814 and a R2of 0.823,which also outperformed the five models in fitting performance,convergence and final loss.In random sample testing,the MR-VAE model exhibited high consistency between predicted and actual values.Conclusion The MR-VAE model proposed can accurately predict IAP,which has great potential in reducing the repeated measurements of IAP in critically ill patients and providing new ideas for the early diagnosis and treatment of IAH.

OBJECTIVE To prepare the volatile oil cyclodextrin inclusion compound of Wenjing Decoction to improve its stability and characterize its formation;to compare the inclusion behavior of cinnamaldehyde,paeonol and ligustilide in volatile oil of Wenjing Decoction with different cyclodextrins;and to study the effect of different cyclodextrins on the inclusion of multiple components in the volatile oil of Wenjing Decoction.METHODS The inclusion compounds of volatile oil β-CD and its 5 derivatives in Wenjing Decoc-tion were prepared by ultrasonic method,and the inclusion rate of each component was determined by HPLC.TGA and FT-IR were used to characterize the formation of the inclusion complex.The inclusion behavior and influencing factors were studied by phase solu-bility test and molecular docking.RESULTS The inclusion compounds of volatile oil β-CD and its derivatives in Wenjing Decoction were successfully prepared.TGA results showed that the thermal stability of volatile oil in Wenjing Decoction was improved after inclu-sion by cyclodextrin.FT-IR results showed that some components of the volatile oil were bonded to cyclodextrin through non-covalent bonds such as hydrogen bonds.The results of phase solubility test showed that the three main components in the volatile oil of Wenjing Decoction were combined with β-CD in the molar ratio of 1∶n(n≥1),and with β-CD derivatives in the molar ratio of 1∶1.The re-sults of molecular docking showed that the benzene rings of cinnamaldehyde and paeonol,and lactone rings of ligustilide penetrated into the cyclodextrin cavity to form clathrates.The inclusion rates of β-CD and its derivatives for each component in the volatile oil of Wen-jing Decoction were DM-β-CD>HP-β-CD>β-CD>HE-β-CD>SBE-β-CD>CM-β-CD,which were consistent with the af-finity of phase solubility test and molecular docking.The inclusion rates of the three components with β-CD and its derivatives were cinnamaldehyde>paeonol>ligustilide,which was consistent with the concentration of each component in the volatile oil,but the affin-ity order was opposite to that obtained by phase solubility test and molecular docking.CONCLUSION β-CD and its derivatives can successfully incorporate the volatile oil of the decoction.The components of the volatile oil and cyclodextrin are combined to form the inclusion compound by hydrogen bonding and other non-covalent bonding forces,which increases the stability of the volatile oil.The inclusion rate of volatile oil with different cyclodextrins is related to the affinity between volatile components and cyclodextrins and the concentration of volatile components,which provides a way to ensure the consistency between the main component of volatile oil inclu-sion compound in Wenjing Decoction and the reference sample.

OBJECTIVE To prepare the volatile oil cyclodextrin inclusion compound of Wenjing Decoction to improve its stability and characterize its formation;to compare the inclusion behavior of cinnamaldehyde,paeonol and ligustilide in volatile oil of Wenjing Decoction with different cyclodextrins;and to study the effect of different cyclodextrins on the inclusion of multiple components in the volatile oil of Wenjing Decoction.METHODS The inclusion compounds of volatile oil β-CD and its 5 derivatives in Wenjing Decoc-tion were prepared by ultrasonic method,and the inclusion rate of each component was determined by HPLC.TGA and FT-IR were used to characterize the formation of the inclusion complex.The inclusion behavior and influencing factors were studied by phase solu-bility test and molecular docking.RESULTS The inclusion compounds of volatile oil β-CD and its derivatives in Wenjing Decoction were successfully prepared.TGA results showed that the thermal stability of volatile oil in Wenjing Decoction was improved after inclu-sion by cyclodextrin.FT-IR results showed that some components of the volatile oil were bonded to cyclodextrin through non-covalent bonds such as hydrogen bonds.The results of phase solubility test showed that the three main components in the volatile oil of Wenjing Decoction were combined with β-CD in the molar ratio of 1∶n(n≥1),and with β-CD derivatives in the molar ratio of 1∶1.The re-sults of molecular docking showed that the benzene rings of cinnamaldehyde and paeonol,and lactone rings of ligustilide penetrated into the cyclodextrin cavity to form clathrates.The inclusion rates of β-CD and its derivatives for each component in the volatile oil of Wen-jing Decoction were DM-β-CD>HP-β-CD>β-CD>HE-β-CD>SBE-β-CD>CM-β-CD,which were consistent with the af-finity of phase solubility test and molecular docking.The inclusion rates of the three components with β-CD and its derivatives were cinnamaldehyde>paeonol>ligustilide,which was consistent with the concentration of each component in the volatile oil,but the affin-ity order was opposite to that obtained by phase solubility test and molecular docking.CONCLUSION β-CD and its derivatives can successfully incorporate the volatile oil of the decoction.The components of the volatile oil and cyclodextrin are combined to form the inclusion compound by hydrogen bonding and other non-covalent bonding forces,which increases the stability of the volatile oil.The inclusion rate of volatile oil with different cyclodextrins is related to the affinity between volatile components and cyclodextrins and the concentration of volatile components,which provides a way to ensure the consistency between the main component of volatile oil inclu-sion compound in Wenjing Decoction and the reference sample.

AIM To establish the quantitative models for gallic acid,mononucleoside,loganin,resveratrol,and rhein in Yishen Xiezhuo Mixture.METHODS HPLC was adopted in the content determination of various effective components,after which the near-infrared spectroscopy(NIRS)data were collected in 128 batches of samples and pretreatment was conducted,competitive adaptive reweighting sampling(CARS)algorithm was used for screening wavelength,partial least square method(PLS)regression analysis was performed.RESULTS There were no significant differences between the predicted values obtained by PLS models and measured values obtained by HPLC for various effective components(P＞0.05).CONCLUSION The quantitative models established by NIRS combined with chemometrics display good predictive performance,which can be used for the rapid determination of effective components in Yishen Xiezhuo Mixture,and provide a reference for the rapid monitoring of other traditional Chinese medicine preparations in production processes.