Ulcerative colitis （UC）， a chronic relapsing inflammatory bowel disease， involves multifaceted pathological mechanisms such as intestinal barrier dysfunction， immune dysregulation， and oxidative stress. Current therapeutic strategies remain limited in efficacy and safety. In recent years， the adenosine monophosphate-activated protein kinase （AMPK） signaling pathway has emerged as a pivotal therapeutic target for UC due to its central role in energy metabolism， inflammatory regulation， and intestinal homeostasis. This article systematically reviewed the mechanisms by which traditional Chinese medicine （TCM） prevented and treated UC through the regulation of the AMPK signaling pathway， with a focus on elucidating AMPK's multidimensional regulatory network in inflammatory signaling crosstalk， alleviating oxidative stress， restoring intestinal immune balance， repairing the intestinal barrier， and modulating gut microbiota. Leveraging its unique advantages of multi-target engagement and low toxicity， TCM demonstrates promising potential in UC treatment and has become a focal area of research. By systematically summarizing and synthesizing the existing literature on TCM-mediated AMPK pathway modulation in UC， this review aims to provide a theoretical foundation for advancing mechanistic research and clinical interventions in UC.

Objective To explore the difference in the mid-term efficacy of arthroscopic treatment for small-and medium-size(≤3 cm)rotator cuff tears combined with or without shoulder joint adhesion.Methods A retrospective analysis was conducted on the clinical data of 254 cases of small-and medium-size rotator cuff tears treated by arthroscopy in our department from January 2018 to January 2023 and followed up for more than one year.Among them,86 cases were combined with shoulder joint adhesion,and 168 cases were not combined with shoulder joint adhesion.A total of 81 pairs of data were obtained through propensity score matching(PSM).The shoulder joint pain and functional scores at the last follow-up of the two groups were compared,including the Visual Analogue Scale(VAS)for pain,the American Shoulder and Elbow Surgeons(ASES)score,Constant-Murley score,and shoulder joint score of the University of California at Los Angeles(UCLA).The rotator cuff healing and retearing rate were evaluated by using the range of motion of the shoulder joint and the Sugaya classification of MR.Results The follow-up time of the shoulder joint adhesion group and the non-shoulder joint adhesion group was(42.2±13.0)months and(44.7±14.2)months,respectively(P=0.248).The preoperative VAS score,ASES score,Constant-Murley score and UCLA score in the shoulder joint adhesion group were all worse than those in the non-shoulder joint adhesion group(P<0.01).At the last follow-up,the VAS scores,ASES scores,Constant-Murley scores and UCLA scores of both groups were significantly improved compared with those before the operation(P<0.001),and there was no significant difference between the two groups(P>0.05).The angles of anterior flexion,abduction,lateral internal rotation and lateral external rotation of the shoulder joint in the shoulder joint adhesion group before the operation were all smaller than those in the non-shoulder joint adhesion group(P<0.001).At the last follow-up,the four ranges of motion of the shoulder joint in both groups were significantly larger than those before the operation(P<0.01),and the shoulder joint adhesion group was still worse than the non-shoulder joint adhesion group(P<0.05).There was no rotator cuff retear(Sugaya type Ⅳ and typeⅤ)in both groups.The proportion of Sugaya type Ⅰ in the shoulder joint adhesion group at the last follow-up was lower than that in the non-shoulder joint adhesion group[21.0%(17/81)vs.60.5%(49/81),P<0.001].Conclusions Arthroscopic rotator cuff repair and joint capsule release surgery for patients with small-and medium-size rotator cuff tears combined with shoulder joint adhesion can relieve shoulder joint pain.The shoulder joint function score at the mid-term follow-up is similar to that of those without shoulder joint adhesion.Although the range of motion of the shoulder joint is significantly improved compared with that before the operation,it still could not reach the level of those without shoulder joint adhesion.

Cardiovascular disease and pneumonia are the leading causes of death in the world,and often co-exist in severely ill patients,resulting in high mortality and severe sequelae.Community-acquired pneumonia and severe viral pneumonia(such as COVID-19)can cause new or worsen heart failure,arrhythmia,myocardial infarction,myocarditis,thromboembolism and other cardiovascular events(CVE).In turn,cardiac injury can also exacerbate lung disease,leading to multiple organ failure and even death.In this paper,we reviewed the correlation the advancements in pathophysiological mechanisms,high-risk factors,and clinical risk prediction models between pneumonia and CVE.

Objective:To evaluate the clinical efficacy and safety of polymyxin B sulfate in the treatment of carbapenem-resistant Gram-negative bacilli (CR-GNB) infections in pediatric liver transplant recipients.Method:This retrospective study included 13 children under 3 years of age who developed CR-GNB infections after liver transplantation and received polymyxin B sulfate-based combination therapy in the Surgical Intensive Care Unit (ICU) of Tianjin First Central Hospital between June 2020 and June 2023. Clinical data-including recipient characteristics, microbiological culture and susceptibility results, antibiotic regimens and duration, and laboratory parameters before and after polymyxin B sulfate treatment-were collected to assess bacterial clearance, clinical efficacy, and drug-related adverse events.Result:The median age was 7.5 months. Infection sites included intra-abdominal, bloodstream, and combined intra-abdominal plus bloodstream infections. A total of 13 CR-GNB strains were isolated: Klebsiella pneumoniae (6 cases), Escherichia coli (3 cases), Acinetobacter baumannii (3 cases), and Enterobacter cloacae (1 case). The median duration of polymyxin B sulfate therapy was 14 days. Clinical improvement was achieved in 11 recipients, bacterial eradication in 10 recipients, while 2 recipients died due to clinical failure. The incidence of adverse reactions was low.Conclusion:Polymyxin B sulfate appears to be a feasible and relatively safe therapeutic option for CR-GNB infections in pediatric liver transplant recipients.

Peri-implantitis is a pathologic condition associated with dental plaque that occurs in the implant tissue and is characterized by inflammation of the mucous membrane surrounding the implant, followed by the progressive loss of supporting bone. In this study, a case of guided bone regeneration therapy based on plaque control of peri-implant inflammation was reported. Four years after surgery for the left second premolar implant, the patient presented with "left lower posterior tooth swelling and discomfort for more than 2 years". The X-ray periapical film showed a decrease in distal bone mineral density of implant, and the clinical diagnosis was peri-implantitis of the left second premolar. Implants underwent guided bone regeneration and regular periodontal maintenance treatment. Re-examination at 3.5 months, 11 months, 18 months, and 7 years showed that the alveolar bone height and bone mineral density were stable, and the periodontal depth became shallow. However, the gingival recession was mild. In the present case, follow-up at 7 years demonstrated that the clinical periodontal indexes could be remarkably improved after complete periodontal treatment for peri-implantitis, and the alveolar bone could be well restored and regenerated.
Humans ; Peri-Implantitis/etiology* ; Follow-Up Studies ; Bone Regeneration ; Guided Tissue Regeneration, Periodontal/methods* ; Dental Plaque/prevention & control* ; Male ; Female ; Dental Implants/adverse effects*

Objective:To evaluate the clinical efficacy and safety of polymyxin B sulfate in the treatment of carbapenem-resistant Gram-negative bacilli (CR-GNB) infections in pediatric liver transplant recipients.Method:This retrospective study included 13 children under 3 years of age who developed CR-GNB infections after liver transplantation and received polymyxin B sulfate-based combination therapy in the Surgical Intensive Care Unit (ICU) of Tianjin First Central Hospital between June 2020 and June 2023. Clinical data-including recipient characteristics, microbiological culture and susceptibility results, antibiotic regimens and duration, and laboratory parameters before and after polymyxin B sulfate treatment-were collected to assess bacterial clearance, clinical efficacy, and drug-related adverse events.Result:The median age was 7.5 months. Infection sites included intra-abdominal, bloodstream, and combined intra-abdominal plus bloodstream infections. A total of 13 CR-GNB strains were isolated: Klebsiella pneumoniae (6 cases), Escherichia coli (3 cases), Acinetobacter baumannii (3 cases), and Enterobacter cloacae (1 case). The median duration of polymyxin B sulfate therapy was 14 days. Clinical improvement was achieved in 11 recipients, bacterial eradication in 10 recipients, while 2 recipients died due to clinical failure. The incidence of adverse reactions was low.Conclusion:Polymyxin B sulfate appears to be a feasible and relatively safe therapeutic option for CR-GNB infections in pediatric liver transplant recipients.

Objective:To provide preimplantation genetic testing (PGT) for a patient with Incontinentia pigmenti (IP) due to IKBKG gene variant but without family samples through construction of single nucleotide polymorphism (SNP)-based haplotype by Long-read sequencing (LRS) technology. Methods:A female IP patient with a heterozygous IKBKG c. 1167dup variant but without family genetic data who sought genetic counseling at Women and Children′s Hospital of Ningbo University in November 2021 was selected as the study subject. The IKBKG gene has a highly homologous pseudogene IKBKGP1. Genomic DNA was extracted from peripheral blood samples from the couple, and LRS was used to obtain informative SNP loci flanking the variant locus, enabling the construction of SNP haplotype with a long segment spanning from the non-homologous region of IKBKG to the variant site. Trophoblast cells were biopsied from blastocysts fertilized through intracytoplasmic sperm injection, and next-generation sequencing (NGS) was used to determine the SNP information of the embryos. Linkage analysis with the parental SNP haplotypes was conducted to detect the carrier status of the embryos and exclude chromosomal aneuploidies. Sanger sequencing was carried out to validate the result. A euploid embryo without the pathogenic variant was selected for transfer. Prenatal diagnosis was carried out by amniocentesis at mid-trimester to verify the result of PGT, and follow-up was conducted after the baby was born. This study has been approved by the Ethics Committee of the Women and Children′s Hospital of Ningbo University (Ethics No. EC2023-094). Results:In total seven blastocysts were tested, and PGT results indicated that two embryos were euploid and did not carry the pathogenic variant. One euploid embryo was transferred, which resulted in a singleton pregnancy. Amniocentesis at 24 weeks of gestation confirmed that the status of fetal IKBKG gene, and its chromosomal status was consistent with the PGT results. A healthy male infant was born at 38 + 6 weeks of gestation. Conclusion:For IP patients with de novo mutation or without family samples, PGT with LRS can directly construct the SNP-based haplotype while avoiding interference from pseudogenes, providing an effective strategy for PGT.

The National Essential Medicines System could protect public health and ensure access to essential medications.Although the current selection methods for China's National Essential Medicines Lists(NEMLs)are becoming more scientific and standardized,there are still problems such as much emphasis on expert experience and the lack of transparency of decision-making basis.To address these issues,it proposes an evidence-based decision-making pathway for NEMLs selection guided by clinical value.This approach ensures a strong integration of evidence and decision-making,offering valuable insights for improving the adjustment procedures and selection criteria of the NEMLs in China.

Objective To explore the difference in the mid-term efficacy of arthroscopic treatment for small-and medium-size(≤3 cm)rotator cuff tears combined with or without shoulder joint adhesion.Methods A retrospective analysis was conducted on the clinical data of 254 cases of small-and medium-size rotator cuff tears treated by arthroscopy in our department from January 2018 to January 2023 and followed up for more than one year.Among them,86 cases were combined with shoulder joint adhesion,and 168 cases were not combined with shoulder joint adhesion.A total of 81 pairs of data were obtained through propensity score matching(PSM).The shoulder joint pain and functional scores at the last follow-up of the two groups were compared,including the Visual Analogue Scale(VAS)for pain,the American Shoulder and Elbow Surgeons(ASES)score,Constant-Murley score,and shoulder joint score of the University of California at Los Angeles(UCLA).The rotator cuff healing and retearing rate were evaluated by using the range of motion of the shoulder joint and the Sugaya classification of MR.Results The follow-up time of the shoulder joint adhesion group and the non-shoulder joint adhesion group was(42.2±13.0)months and(44.7±14.2)months,respectively(P=0.248).The preoperative VAS score,ASES score,Constant-Murley score and UCLA score in the shoulder joint adhesion group were all worse than those in the non-shoulder joint adhesion group(P<0.01).At the last follow-up,the VAS scores,ASES scores,Constant-Murley scores and UCLA scores of both groups were significantly improved compared with those before the operation(P<0.001),and there was no significant difference between the two groups(P>0.05).The angles of anterior flexion,abduction,lateral internal rotation and lateral external rotation of the shoulder joint in the shoulder joint adhesion group before the operation were all smaller than those in the non-shoulder joint adhesion group(P<0.001).At the last follow-up,the four ranges of motion of the shoulder joint in both groups were significantly larger than those before the operation(P<0.01),and the shoulder joint adhesion group was still worse than the non-shoulder joint adhesion group(P<0.05).There was no rotator cuff retear(Sugaya type Ⅳ and typeⅤ)in both groups.The proportion of Sugaya type Ⅰ in the shoulder joint adhesion group at the last follow-up was lower than that in the non-shoulder joint adhesion group[21.0%(17/81)vs.60.5%(49/81),P<0.001].Conclusions Arthroscopic rotator cuff repair and joint capsule release surgery for patients with small-and medium-size rotator cuff tears combined with shoulder joint adhesion can relieve shoulder joint pain.The shoulder joint function score at the mid-term follow-up is similar to that of those without shoulder joint adhesion.Although the range of motion of the shoulder joint is significantly improved compared with that before the operation,it still could not reach the level of those without shoulder joint adhesion.

Objective:To explore the influence of initial high-risk cytogenetic abnormalities on the outcomes of children with acute myeloid leukemia (AML) after post-transplant Cyclophosphamide (PTCy)-based allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:A retrospective cohort study.AML children who underwent PTCy-based allo-HSCT after the first complete remission at Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science and Technology between April 2017 and April 2024 were enrolled.Patients were divided into intermediate-risk and high-risk groups based on their initial cytogenetic features.These patients were further divided into complex karyotype, 11q23 rearrangement, and other karyotype groups.Clinical characteristics and survival outcomes were compared among these groups.Measurement and count data were analyzed using Wilcoxon rank-sum/Kruskal-Wallis and χ2 tests, respectively.Survival and risk factor analyses were performed using Kaplan-Meier and Cox proportional hazards methods, respectively. Results:A total of 51 AML children who underwent allo-HSCT were included in this study.The median age at transplantation was 3.2 years and the median follow-up time was 4.6 years.There were 26 cases in the intermediate-risk group and 25 cases in the high-risk group; 8 cases in the complex karyotype group, 14 cases in the 11q23 rearrangement group, and 29 cases in the other karyotype groups.By the end of the follow-up on November 30, 2024, 11 patients relapsed, 8 patients died, and 13 patients developed grades Ⅱ-Ⅳ acute graft-versus-host disease (GVHD).The 3-year overall survival (OS), relapse-free survival (RFS), and grades Ⅱ-Ⅳ acute GVHD-free and relapse-free survival (GRFS) were 84.0% (95% CI: 74.4%-94.8%), 74.5% (95% CI: 63.4%-87.5%), and 58.8% (95% CI: 46.7%-74.0%), respectively.The 3-year OS of the high-risk group was significantly lower than that of the intermediate-risk group (71.8% vs.96.2%, P=0.022), while differences in 3-year RFS and GRFS between the 2 groups were not statistically significant (68.0% vs.80.8%, P=0.400; 52.0% vs.65.4%, P=0.420).The 3-year OS, RFS and GRFS of the complex karyotype group were significantly lower than those of 11q23 rearrangement and other karyotype groups (50.0% vs.85.7%, 93.1%, P=0.009; 37.5% vs.85.7%, 79.3%, P=0.022; 25.0% vs.64.3%, 65.5%, P=0.049).Multivariate analysis showed that a complex karyotype was an independent prognostic factor affecting 3-year OS and GRFS [OS: HR=6.79 (95% CI: 1.13-43.80), P=0.044; GRFS: HR=3.72(95% CI: 1.13-12.20), P=0.030]. Conclusions:High-risk cytogenetic features are significant predictors of survival outcomes in pediatric AML patients undergoing PTCy-based allo-HSCT.