The gut microbiota is regarded as the "eighth organ" of the human body and plays a critical regulatory role in the occurrence and progression of various diseases. Ulcerative colitis （UC） is a chronic inflammatory bowel disease with a complex etiology and a tendency toward recurrent episodes. In recent years， studies have shown that gut microbiota dysbiosis plays a key role in its pathological processes. Meanwhile， an increasing number of studies have demonstrated that imbalances in the gut microbiota and abnormalities in its metabolites are closely associated with the development of atrial fibrillation （AF）. Although UC and AF belong to diseases of the digestive system and cardiovascular system， respectively， both exhibit systemic inflammatory characteristics and are often accompanied by gut microbiota dysregulation and abnormal metabolic products. However， systematic investigations into the mechanisms by which gut microbiota-derived metabolites act in these two diseases remain limited. Based on this， the present study adopts literature review and theoretical analysis methods， taking the "gut microbiota-gut-heart" axis as the entry point， to systematically summarize the signaling networks of three key classes of metabolites， i.e.， short-chain fatty acids （SCFAs）， bile acids （BAs）， and trimethylamine N-oxide （TMAO）， in the comorbidity mechanism of UC and AF. The findings indicate that these metabolites may activate key inflammatory pathways， such as NF-κB and NLRP3， thereby synergistically mediating intestinal barrier dysfunction and systemic inflammation and constructing a potential comorbidity network. On this basis， potential intervention strategies for the treatment of UC-AF comorbidity， including probiotic intervention and fecal microbiota transplantation， are further discussed. This study aims to provide new theoretical evidence and research perspectives for prevention and treatment strategies of cross-system diseases.

Objective To investigate the correlation between serum amyloid A(SAA)level and disease se-verity in children infected with severe acute respiratory syndrome coronavirus 2(COVID-19).Methods A to-tal of 116 children infected with COVID-19 admitted to the Department of Pediatrics of the hospital from De-cember 2022 to April 2023 were included and divided into asymptomatic/mild group and moderate/severe group according to the severity of the disease.In addition,65 healthy children who received health examination during the same period were selected as the control group.Serum SAA levels in children in acute stage and convalescent stage were detected by enzyme-linked immunosorbent assay.Results Compared with the control group,the serum SAA level in the children infected with COVID-19 was significantly increased in the acute stage(P＜0.05).The area under the receiver operating characteristic(ROC)curve(AUC)of SAA levels in the acute stage for diagnosing children with COVID-19 infection was 0.926(95％CI:0.886-0.966).In SARS-CoV-2 infected children,the SAA levels in the acute stage in the asymptomatic/mild group and the moderate/severe group were 2.71(1.29-10.86)mg/L and 37.78(18.58-92.62)mg/L,the differences were statistically significant between the two groups(Z=5.782,P＜0.001).In addition,serum SAA was pos-itively correlated with severity of SARS-CoV-2 by Spearman analysis(r=0.657,P＜0.001).Serum SAA lev-els were also significantly positively correlated with C-reactive protein(CRP),immunoglobulin(Ig)M,IgG,IgA and neutralizing antibody(NAb)in acute stage(P＜0.05).The AUC of serum SAA level in acute stage for diagnosing the moderate/severe children with SARS-CoV-2 was 0.889(95％CI:0.842-0.955),which was higher than that of CRP(P＜0.05).Compared with serum antibodies(IgM,IgG,IgA and NAb),the rate of serum SAA positive(≥5.55 mg/L)in children in acute stage was significantly higher(P＜0.05).The positive rate of serum SAA in convalescent children was significantly lower than that of serum antibody(P＜0.05).Conclusion Elevated serum SAA in acute phase is associated with increased risk of SARS-CoV-2 infec-tion and disease severity in children.Serum SAA is promising as a good biomarker for monitoring SARS-CoV-2 infection and severity in children.

Objective To evaluate the effects of the method of blood-cooling and blood stasis-resolving on heart function and prognosis in patients with sepsis-induced myocardial dysfunction(SIMD).Methods Sixty patients with SIMD admitted to the department of critical care medicine of Affiliated Hospital of Nanjing University of Chinese Medicine from June 2022 to October 2024 were enrolled as study subjects.The patients were divided into treatment group and control group according to random number table,with 30 patients in each group.All patients received conventional treatments,the patients in the treatment group were given Taohe Chengqi decoction(Persicae Semen 12 g,Chinese rhubarb 12 g,Cinnamon twig 6 g,Licorice root 6 g and Sodium Sulfate 6 g),the decoction was concentrated to 200 mL and taken in 2 divided doses in the morning and evening,one dose daily;and the patients in the control group were given the same amount of warm water.The total course of treatment lasts for 7 days.The differences in indicators of cardiac function[brain natriuretic peptide(BNP),cardiac troponin I(cTnI),MB isoenzyme of creatine kinase(CK-MB),aspartate aminotransferase(AST)]and echocardiographic parameters[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),mitral orifice early/late diastolic blood flow velocity ratio(E/A ratio),E/mitral and tricuspid valve ostia and the peak early diastolic velocity(E/e')]at admission,at 1st and 7th day after treatment,and prognosis indexes[mechanical ventilation time,intensive care unit(ICU)length of stay,total hospital stay,28-day survival rate]were compared between two groups.Draw the Kaplan-Meier survival curve and compare the difference in the 28-day cumulative survival rate between the two groups of patients.Results After 7 days therapy,LVEF of the treatment group was significantly higher than that the control(0.524±0.132 vs.0.458±0.118,P<0.05)and E/e'ratio of the treatment group was significantly lower than the control group[11.17(9.57,12.04)vs.11.82(11.28,13.72),P<0.05].There were no significant differences in the 28-day mortality and total hospital stay time between the two groups,but mechanical ventilation time[days:7.00(0.00,11.00)vs.12.50(3.50,21.75),P<0.05]and stay time of ICU[days:14.50(7.75,25.00)vs.21.00(14.25,31.50),P<0.05]in the treatment group were shorter than those in the control group.The Kaplan-Meier survival showed that the cumulative 28-day survival rate was similar between two groups(Log-Rank:χ2=1.448,P=0.229).Conclusion The method of blood-cooling and blood stasis-resolving could decrease mechanical ventilation time and length of stay in ICU of SIMD patients and could increase LVEF in the treatment group.

Objective:To analyze the functional outcomes of arthrodesis for the first metatarsophalangeal joint.Methods:A retrospective study was conducted to analyze the 21 patients who had undergone arthrodesis for the first metatarsophalangeal joint at Department of Foot and Ankle Surgery, Beijing Jishuitan Hospital from August 2013 to October 2019. The cohort included 6 males and 15 females. One patient underwent bilateral surgery, 10 cases the left side surgery and 10 cases the right side surgery. Their ages averaged (63.1±9.2) years. There were 12 cases of simple hallux valgus, 5 cases of rheumatoid arthritis combined with hallux valgus, and 4 cases of gout combined with hallux valgus. The visual analog scale (VAS) pain score, American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score, foot function index (FFI) score, hallux valgus angle (HVA), and intermetatarsal angle (IMA) were compared between preoperation and the last follow-up. The proximal phalangeal inclination angle (PPIA) was measured postoperatively. Postoperative satisfaction was evaluated using the Coughlin rating scale. Complications were documented.Results:All patients were followed up for 71.0 (69.8, 75.0) months. In all patients at the last follow-up, VAS [1(0, 3) points], FFI [4.8 (1.6, 8.6) points], HVA [23.4° (14.3°, 28.5°)], and IMA (9.6°±3.2°) were significantly lower than the preoperative values [4 (3, 7) points, 30.4 (16.7, 46.8) points, 43.5° (31.5°, 48.2°), and 13.0°±4.5°], and the AOFAS forefoot score [80.0 (70.8, 90.0) points] was significantly higher than the preoperative one [46.0 (32.8, 55.3) points] ( P<0.05). The postoperative PPIA was 7.7°±10.1°. According to the Coughlin rating scale, 12 cases were rated as excellent, 5 as good, 2 as fair, and 3 as poor. All patients reported relief from painful plantar calluses, most ones experienced complete resolution of plantar calluses, and some ones had stiffness of the metatarsophalangeal joint after fusion. Conclusion:Arthrodesis for the first metatarsophalangeal joint is a reliable treatment for degenerative changes in the metatarsophalangeal joint, because it can well restore the postoperative foot function, significantly relieve pain, and lead to high patient satisfaction.

Objective:To investigate the impact of preoperative sarcopenia on chronic postsurgical pain(CPSP)after cardiac surgery in elderly patients.Methods:Elderly patients undergoing elective open-chest cardiac surgery at the Affiliated Hospital of Xuzhou Medical University from September 2022 to May 2024 were collected.According to the updated diagnostic criteria and revised by the Asian Working Group for Sarcopenia(AWGS2019)in 2019, patients were classified into sarcopenia and non-sarcopenia groups Elderly patients were divided into two groups based on the occurrence of chronic pain at 3 months postoperatively: CPSP group and non-CPSP group.Indicators with statistically significant differences in univariate regression analysis were included in multifactorial regression to analyze the influencing factors of chronic pain after cardiac surgery in elderly patients.The receiver operating characteristic(ROC)curve was plotted and the area under the curve(AUC)was calculated to compare the predictive efficacy of sarcopenia, commonly used clinical pain assessment tools(gender+ acute postoperative pain), and(gender+ acute postoperative pain+ sarcopenia)in predicting CPSP after cardiac surgery in elderly patients.Results:The study ultimately included 379 patients, consisting of 238 males(62.8%), with an average age of(66.6 ± 5.3)years.Among them, 83 patients had sarcopenia, and 119 patients developed CPSP.Univariate regression analysis showed that gender, history of atrial fibrillation, acute postoperative pain, American Society of Anesthesiologists(ASA)Physical Status Classification System, New York Heart Association(NYHA)Classification of Cardia Function, sarcopenia, and duration of extracorporeal circulation were associated with the occurrence of CPSP after cardiac surgery in elderly patients.However, after adjusting for all possible confounders, multifactorial regression analysis showed that gender, acute postoperative pain, and sarcopenia were independent risk factors for CPSP after cardiac surgery in elderly patients(all P<0.05), with sarcopenia patients having a 2.913-fold risk of developing CPSP compared with non-sarcopenia patients.The AUCs of the ROC curves for commonly used clinical perioperative pain assessment tools and those with the addition of sarcopenia determination were 0.731 and 0.802, respectively. Conclusions:Preoperative sarcopenia is an independent risk factor for the development of chronic pain after cardiac surgery in elderly patients, and the inclusion of sarcopenia determination in commonly used clinical pain assessment tools can significantly improve the predictive efficacy for chronic pain.

BACKGROUND:Mammary stem cells are vital for the development and homeostasis of mammary gland tissue.The occurrence of breast cancer has a close relationship with the mammary stem cells.Recent studies have shown that Hopx,as an important transcriptional regulator of morphogenesis and cell differentiation,has been confirmed to be expressed in a variety of adult stem cells such as nerves,intestines,hair follicles and lungs.However,its role in mammary stem cells has not been reported so far.OBJECTIVE:To investigate whether Hopx expression marks mammary stem cells.METHODS:(1) Female Hopx-LacZ transgenic mice aged 8 weeks were selected to detect the background expression of Hopx in breast tissue by β-galactosidase staining.(2) Female wild-type mice at 4,6,and 8 weeks of age and 14.5 days of gestation were selected for whole-tissue magenta staining and K14 and K8 immunofluorescence staining,respectively.(3) Female Hopx-CreERT2;Rosa26LacZ transgenic mice aged 8 weeks and 17.5 days of gestation were selected and stained with breast β-galactosidase.(4) The 4-week-old female Hopx-CreERT2;Rosa26LacZ transgenic mice were selected.The Cre/loxp system was activated by intraperitoneal injection of tamoxifen (once every other day,three times),and breast β-galactosidase staining was performed 4 weeks after injection.The 8-week-old female Hopx-CreERT2;Rosa26LacZ transgenic mice were selected.The Cre/loxp system was activated by intraperitoneal injection of tamoxifen (once every other day,three times),and breast β-galactosidase staining was performed 4 and 10 weeks after the last injection.(5) Female Hopx-CreERT2;Rosa26LacZ transgenic mice aged 8 weeks were selected.The Cre/loxp system was activated by intraperitoneal injection of tamoxifen (once every other day,three times).Hopx-CreERT2;Rosa26LacZ transgenic mice were pregnant 2 weeks after injection.The mammary tissue of mice at 17.5 days of the first pregnancy and 17.5 days of the third pregnancy was stained with β-galactosidase.RESULTS AND CONCLUSION:(1) The results of β-galactosidase staining showed that the mammary ducts of Hopx-LacZ transgenic mice at 8 weeks of age did contain Hopx-positive cells and were located in the basal epithelia,with a small number.(2) Whole-mount staining of mammary glands and immunofluorescence staining results exhibited that the mammary glands of mice had different characteristics with corresponding developmental stages such as puberty,maturity,and pregnancy,and underwent a series of complex epithelial remodeling processes.(3) The results of β-galactosylase staining showed that Hopx-labeled positive cells in the mammary duct of Hopx-CreERT2;Rosa26LacZ transgenic mice at 17.5 days of gestation increased compared with female Hopx-CreERT2;Rosa26LacZ transgenic mice at 8 weeks of age.(4) The results of β-galactosylase staining showed that the Hopx-labeled positive cells in the mammary glands of 4-and 8-week-old female Hopx-CreERT2;Rosa26LacZ transgenic mice after tamoxifen injection were located in the basal epithelium with a small number.(5) The results of β-galactosidase staining showed that Hopx-labeled positive cells in the mammary glands of mice at 17.5 days of the first and third gestation were located in the basal epithelia around the alveoli,and the number of Hopx-labeled positive cells at 17.5 days of the third gestation was more.(6) In conclusion,Hopx reporter-marked basal epithelial cells belong to dormant mammary stem cells,which are responsible for the growth of the mammary glands during pregnancy and contribute to acinar formation.

Eosinophilic gastroenteritis(EG)is a rare disease characterized by abnormal infiltration of eosinophils(Eos)in gastrointestinal tissues.Due to the unclear pathogenesis of EG and the lack of effective therapeutic drugs,research on its novel mechanisms,targets and drugs is critical.This article starts by outlining the research progress in the pathogenesis of EG,involving IgE mediated typeⅠimmediate allergic reactions and T helper 2 cell(Th2)mediated delayed allergic reactions.Then,the related targets of EG are summarized,including Th2 cytokines and factors regulating Eos function,but there has been no breakthrough in the treatment of these targets.Finally,the therapeutic drugs for EG are reviewed,such as glucocorticoids,antiallergic drugs and biologics.The advantages and disadvantages of various drugs are also described.However,these drugs cannot meet the current demands of clinical treatment and there is an urgent need to develop novel therapeutic drugs.It is believed that multi-target therapy is an ideal treatment for EG,and that traditional Chinese medicine and natural products should be the priorities of research and development for EG therapeutic drugs in the future.This review is expected to provide new ideas for the clinical treatment strategies and drug development of EG.

Objective:To explore the relationship between 23S rRNA domain V locus mutations in mycoplasma pneumoniae (MP) and the clinical characteristics plus macrolide resistance in pediatric MP pneumonia.Methods:A retrospective analysis was conducted on 220 children with MP pneumonia admitted to the Xi′an Central Hospital from January 2021 to June 2024. Patients were divided into a mutation group and a non-mutation group according to the presence or absence of point mutations at positions 2063, 2064, 2067 and 2617 within the 23S rRNA domain V. General data, clinical features [disease course, fever duration, length of hospital stay, time to resolution of chest X-ray infiltrates, pleural effusion, pulmonary parenchymal lesions, white blood cell count (WBC), lactate dehydrogenase (LDH), MP-DNA load] and macrolide resistance were compared between the two groups.Results:Among the 220 enrolled patients, 114 were assigned to the mutation group and 106 to the non-mutation group. Mutations detected in the 23S rRNA domain V were A2063 ( n=107), C2617 ( n=2), A2064 ( n=2) and A2067 ( n=0); three patients had combined A2063+ A2064 mutations. The proportion of severe pneumonia was higher in the mutation group ( P<0.05). Compared with the non-mutation group, the mutation group exhibited longer disease course, fever duration, hospital stay and time to resolution of chest X-ray infiltrates; higher rates of pleural effusion; and higher LDH levels and MP-DNA loads (all P<0.05). Both groups showed the highest resistance to first-generation macrolides (erythromycin, erythromycin ethylsuccinate, erythromycin stearate) and the highest sensitivity to third-generation macrolides (telithromycin, josamycin). Resistance rates to first-and second-generation macrolides were significantly higher in the mutation group (all P<0.05). Conclusions:Mutations in the 23S rRNA domain V of MP are closely associated with clinical severity in pediatric MP pneumonia, and patients harboring these mutations display higher rates of macrolide resistance.

OBJECTIVE To investigate the effect of salvianolic acid A(SAA)on functions of neutro-phils after activation in vitro.METHODS Rat neutrophils were extracted and activated by lipopolysac-charide(LPS)at 0.3,1,3 mg·L-1,and the number of adherent neutrophils and myeloperoxidase(MPO)activity were detected to determine the concentration of LPS.Neutrophils were divided into the control,model,model+4-aminobenzohydrazide(ABH)20 μmol·L-1,and model+SAA 1,3 and 10 μmol·L-1 groups.LPS was stimulated with 3 mg·L-1 for 30 min,and the neutrophil adhesion rate was detected by immunofluorescence after 1 h of drug incubation.After 2 h of drug incubation,phagocytosis of neutro-phils was detected by immunofluorescence and fluorescein isothiocyanate-immunoglobulin G.After 3 h of drug incubation,the neutrophil adhesion rate to endothelial cells was detected by colorimetric assay.Intracellular MPO activity and hypochlorous acid(HOCl)production were investigated by colorimetric assay in response to the degranulation function.Intracellular reactive oxygen species(ROS)levels were detected by probe assay,and mitochondrial membrane potential by JC-1 assay.The levels of malondialdehyde(MDA),superoxide dismutase(SOD),glutathione(GSH)and total antioxidant capacity(T-AOC)were measured to reflect oxidation function of neutrophils.RESULTS LPS increased the number of adherent cells and MPO activity in a concentration-dependent manner,with 3 mg·L-1 of LPS showing the most significant effect,which was used for subsequent experiments.Compared with the control group,LPS-activated neutrophil adhesion and phagocytosis were significantly enhanced.MPO activity and HOCl production significantly increased.The levels of ROS and MDA in LPS-activated neutrophils were significantly increased while the mitochondrial membrane potential and the levels of SOD,GSH,T-AOC were significantly decreased,indicating that the oxidative stress ability was enhanced.Compared with the model group,SAA dose-dependently inhibited LPS-induced adhesion,phagocytosis,degranu-lation,and ROS generation of neutrophils,with significant effects at medium and high doses.CONCLU-SION SAA can inhibit different functions of neutrophils after activation,which may be a potential drug for targeting neutrophil function regulation.