Objective:To systematically review and evaluate prediction models for aspiration risk in enteral nutrition patients, providing a reference for the development and application of future models.Methods:Literature related to prediction models for aspiration risk in enteral nutrition patients was searched in China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, Web of Science, Cochrane Library, Embase, and PubMed, with the search period covering from the inception of the databases to August 30, 2024. Two researchers independently conducted literature screening and data extraction, and the PROBAST tool was used to assess the risk of bias and applicability of the included studies.Results:A total of 18 studies were included, involving 24 prediction models, with sample sizes ranging from 103 to 512 and an event rate of 9.46% to 49.87%. The top six predictive variables reported most frequently were baseline age, history of aspiration, length of nasogastric tube insertion, nutritional risk, impaired consciousness, and Acute Physiology and Chronic Health Evaluation-Ⅱscore. The area under the receiver operating characteristic curve of the models ranged from 0.756 to 0.992. Twelve studies reported model calibration, six studies conducted internal validation only, one study conducted external validation only, and four studies performed both internal and external validation. The overall applicability of the 18 studies was good, but the risk of bias was high, mainly due to improper handling of continuous variables and missing data.Conclusions:The aspiration risk prediction models developed in various studies for enteral nutrition patients show good applicability but carry a high risk of bias. Future efforts should focus on further optimizing the model construction process, internal and external validation, and result analysis to provide more reliable and scientific tools for clinical aspiration risk assessment.

BACKGROUND:In recent years,numerous studies have shown that autophagy and mitophagy play an important role in the regulation of bone metabolism.Under non-physiological conditions,mitophagy breaks the balance of bone metabolism and triggers metabolism disorders,which affect osteoblasts,osteoclasts,osteocytes,chondrocytes,bone marrow mesenchymal stem cells,etc. OBJECTIVE:To summarize the mechanism of mitophagy in regulating bone metabolic diseases and its application in clinical treatment. METHODS:PubMed,Web of Science,CNKI,WanFang and VIP databases were searched by computer using the keywords of"mitophagy,bone metabolism,osteoblasts,osteoclasts,osteocytes,chondrocytes,bone marrow mesenchymal stem cells"in English and Chinese.The search time was from 2008 to 2023.According to the inclusion criteria,90 articles were finally included for review and analysis. RESULTS AND CONCLUSION:Mitophagy promotes the generation of osteoblasts through SIRT1,PINK1/Parkin,FOXO3 and PI3K signaling pathways,while inhibiting osteoclast function through PINK1/Parkin and SIRT1 signaling pathways.Mitophagy leads to bone loss by increasing calcium phosphate particles and tissue protein kinase K in bone tissue.Mitophagy improves the function of chondrocytes through PINK1/Parkin,PI3K/AKT/mTOR and AMPK signaling pathways.Modulation of mitophagy shows great potential in the treatment of bone diseases,but there are still some issues to be further explored,such as different stages of drug-activated mitophagy,and the regulatory mechanisms of different signaling pathways.

Objective:To systematically review and evaluate prediction models for aspiration risk in enteral nutrition patients, providing a reference for the development and application of future models.Methods:Literature related to prediction models for aspiration risk in enteral nutrition patients was searched in China National Knowledge Infrastructure, Wanfang Data, China Biology Medicine disc, Web of Science, Cochrane Library, Embase, and PubMed, with the search period covering from the inception of the databases to August 30, 2024. Two researchers independently conducted literature screening and data extraction, and the PROBAST tool was used to assess the risk of bias and applicability of the included studies.Results:A total of 18 studies were included, involving 24 prediction models, with sample sizes ranging from 103 to 512 and an event rate of 9.46% to 49.87%. The top six predictive variables reported most frequently were baseline age, history of aspiration, length of nasogastric tube insertion, nutritional risk, impaired consciousness, and Acute Physiology and Chronic Health Evaluation-Ⅱscore. The area under the receiver operating characteristic curve of the models ranged from 0.756 to 0.992. Twelve studies reported model calibration, six studies conducted internal validation only, one study conducted external validation only, and four studies performed both internal and external validation. The overall applicability of the 18 studies was good, but the risk of bias was high, mainly due to improper handling of continuous variables and missing data.Conclusions:The aspiration risk prediction models developed in various studies for enteral nutrition patients show good applicability but carry a high risk of bias. Future efforts should focus on further optimizing the model construction process, internal and external validation, and result analysis to provide more reliable and scientific tools for clinical aspiration risk assessment.

The theory of"qi cycle in round"originates from HUANG Yuanyu's Sisheng Xinyuan,which takes qi monism as the philosophical foundation,and constructs a qi circulation system with the spleen and stomach as the hub,linking the liver,heart,lung,and kidney on the basis of the gasification theory of Huangdi Neijing.Based on theory of"qi cycle in round,"the pathogenesis of Hashimoto thyroiditis begins with liver depression,leading to liver and spleen imbalance,which in turn develops into spleen and kidney deficiency.In the treatment,guided by the principle of"treating same disease with different methods,"combined with objective indicators such as the thyroid function,autoantibody,and ultrasound imaging characteristics,Hashimoto thyroiditis was treated in three stages:early,middle,and late stages.In the early stage,characterized by liver depression and qi stagnation,therapy focuses on regulating wood qi to facilitate the pivot;in the middle stage,marked by liver depression and spleen deficiency,and the method of pungent opening and bitter descending should be adopted to restore the ascending and descending of the spleen and stomach;in the late stage,characterized by spleen and kidney yang deficiency,treatment aims to warm the kidney and tonify the spleen,which helps"qi cycle in round"and restores the normal state of qi transformation of zang-fu viscera.Stage-specific differentiation and treatment aims to restore the qi transformation of zang-fu viscera,promote"qi cycle in round,"improve thyroid function,and delay the progression of Hashimoto thyroiditis,thereby providing insights and methods for clinical differentiation and treatment of this disease.

The theory of"qi cycle in round"originates from HUANG Yuanyu's Sisheng Xinyuan,which takes qi monism as the philosophical foundation,and constructs a qi circulation system with the spleen and stomach as the hub,linking the liver,heart,lung,and kidney on the basis of the gasification theory of Huangdi Neijing.Based on theory of"qi cycle in round,"the pathogenesis of Hashimoto thyroiditis begins with liver depression,leading to liver and spleen imbalance,which in turn develops into spleen and kidney deficiency.In the treatment,guided by the principle of"treating same disease with different methods,"combined with objective indicators such as the thyroid function,autoantibody,and ultrasound imaging characteristics,Hashimoto thyroiditis was treated in three stages:early,middle,and late stages.In the early stage,characterized by liver depression and qi stagnation,therapy focuses on regulating wood qi to facilitate the pivot;in the middle stage,marked by liver depression and spleen deficiency,and the method of pungent opening and bitter descending should be adopted to restore the ascending and descending of the spleen and stomach;in the late stage,characterized by spleen and kidney yang deficiency,treatment aims to warm the kidney and tonify the spleen,which helps"qi cycle in round"and restores the normal state of qi transformation of zang-fu viscera.Stage-specific differentiation and treatment aims to restore the qi transformation of zang-fu viscera,promote"qi cycle in round,"improve thyroid function,and delay the progression of Hashimoto thyroiditis,thereby providing insights and methods for clinical differentiation and treatment of this disease.

Background Imidacloprid is a neonicotinoid insecticide that is widely used in agricultural production, with a high detection rate in human biological samples. Previous studies have shown a high correlation between imidacloprid exposure and liver injury, but the specific mechanism is still unknown. Objective To observe potential toxic effects of HepG2 cells and its perturbation of non-targeted metabolic profile after imidacloprid exposure, and to explore possible molecular mechanisms of hepatotoxicity of imidacloprid by analyzing invovlved biological processes and signaling pathways. Methods HepG2 cell suspension was prepared and seeded in a 96-well plate, which was divided into blank control group, dimethyl sulfoxide (DMSO) solvent control group and imidacloprid exposure groups with multiple concentrations. Each group was set with 5 parallel samples. The viability of HepG2 cells viability were determined after 8 h of exposure to different concentrationsof imidacloprid (1, 2.5, 5, 7.5, 10 mmol·L⁻¹), and the dose-effect relationship was analyzed. A proper concentration (3 mmol·L⁻¹ with 80% viability) was chosen for imidacloprid exposure, non-targeted metabolomic analysis was applied to the cultivated HepG2 cells using UHPLC-Q-TOF/MS technology, the differential metabolites between groups were screened, and the bioprocess and related signaling pathways of their enrichment were annotated using the Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Results Compared to the other two groups, the survival rates of HepG2 cells in the imidacloprid exposure groups decreased. A survival rate of about 86% of HepG2 cells was found in HepG2 cells exposed to 2.5 mmol·L⁻¹ imidacloprid exposure. The non-targeted metabolomics studies showed that 61 metabolites were significantly affected in HepG2 cells after 3 mmol·L⁻¹ imidacloprid exposure, including creatine (variable importance in projection VIP=1.11, P<0.001), arginine (VIP=1.47, P=0.048), taurine (VIP=4.28, P=0.001), and α-D-glucose (VIP=1.90, P=0.006). The differential metabolites enriched in bioprocess and related signaling pathways were mainly directed to mTOR signaling pathways (P<0.001), arginine and proline metabolism (P=0.002), and galactose metabolism (P=0.015). Conclusion Imidacloprid exposure can significantly inhibit the survival rate of HepG2 cells, and interfere with the mTOR signaling pathway, arginine and proline metabolism, galactose metabolism, and so on.

Depression is a mental disorder with high morbidity, disability and relapse rates. Ginkgo biloba extract (GBE), a traditional Chinese medicine, has a long history of clinical application in the treatment of cerebral and mental disorders, but the key mechanism remains incompletely understood. Here we showed that GEB exerted anti-depressant effect in mice through regulating gut microbial metabolism. GBE protected against unpredictable mild stress (UMS)-induced despair, anxiety-like and social avoidance behavior in mice without sufficient brain distribution. Fecal microbiome transplantation transmitted, while antibiotic cocktail abrogated the protective effect of GBE. Spatiotemporal bacterial profiling and metabolomics assay revealed a potential involvement of Parasutterella excrementihominis and the bile acid metabolite ursodeoxycholic acid (UDCA) in the effect of GBE. UDCA administration induced depression-like behavior in mice. Together, these findings suggest that GBE acts on gut microbiome-modulated bile acid metabolism to alleviate stress-induced depression.
Humans ; Mice ; Animals ; Depression/drug therapy* ; Gastrointestinal Microbiome ; Plant Extracts ; Ginkgo biloba

Objective To analyze the clinical efficacy of thalidomide combined with anti tuberculosis drugs in the treatment of pulmonary tuberculosis,in order to evaluate its application value and safety. Methods Seventy-two pulmonary tuberculosis patients in the Qianshan Hospital of Anshan from Jan. 2012 to Aug. 2014 were selected as the subject. Patients were randomly divided into control group and observation group with 36 cases in each group. Patients in the control group were only received anti-tuberculosis drug treatment,while in the treatment group were given thalidomide combined with anti tuberculosis drug treatment. Efficacy rate of thalidomide treatment after two weeks was evaluated by X-ray examination. Incidence of sputum smear negative conversion rate and adverse reaction were recorded. Results There were 10 cases with obvious tuberculosis absorption,19 cases with lesions absorption,7 cases with no absorption in observation group. In control group, there were 5 cases with obvious tuberculosis absorption,12 cases with lesions absorption,17 cases with no absorption and the lesion increased in 2 cases. The focus absorption in observation group was superior to the control group( Z =11. 854,P ﹤0. 001 ). There were 6 cases with void closure,4 cases with decreased void closure,1 cases with unchanged and 1 cases with new cavity in observation group. There were 1 cases with void closure,3 cases with decreased void closure,6 cases with unchanged and 3 cases with new cavity in control group,and there was significant difference(Z=15. 536,P﹤0. 001). Sputum smear negative rate in observation group after treatment was 85. 0%(17/20),significantly higher than that in control group(50. 0%(11/22),χ2=5. 775,P=0. 016). Cases of adverse reactions in observation group was 8(22. 2%),lower than that in control group(17 cases,(47. 2%);χ2 =4. 963,P=0. 026). There were 2 cases with abnormal liver function without changing the original treatment symptomatic liver after treatment,in observation group. Of 8 cases with abnormal liver function in control group,5 cases change treatment schedule including 3 cases of modified pyrazinamide for streptomycin,2 cases converted to rifampicin for Levofloxacin. The syndromes including eukopenia,skin rash, anorexia and lethargy were disappeared after treatment. Conclusion The effect of Thalidomide combined with anti tuberculosis drugs in the treatment of pulmonary tuberculosis is significant and safety,which can be used as a routine drug treatment of tuberculosis in clinical trials.

Objective To evaluate the osteogenesis of alveolar bone graft (ABG) in patients with alveolar cleft by cone beam CT (CBCT).Methods ABG surgery was performed in 20 patients with unilateral complete alveolar cleft.The patients were followed up for 3 and 6 months after surgery and the osteogenesis of the bone graft was evaluated by CBCT.The bone density and the height of labial and palatal bone graft area were analyzed.Results There was no significant difference in the bone density between 3 months [(403.79 ± 64.70) HU] and 6 months[(411.45 ±42.62) HU] (P =0.329).However,there was significant difference in bone height in the labial and palatal side between 3 months and 6 months (labial P =0.020,palatal P =0.008).Conclusions The osteogenesis was the best 3 months after bone graft.The following treatment can start in this stage.

Extracellular matrix (ECM)is not only one of current hot-points in medical cell biology,but also one tricky part for undergraduates to learn. This article compared chapters of ECM in medical cell biology courses and spotlighted that ECM chapter was often neglected in some domes-tic universities. Then it analyzed the possible causes,such as variable arrangement of ECM section in current textbooks. Lastly,the article recommended several suggestions,including giving a timely re-vision of the old ECM knowledge,designing an appropriate strategy for teaching,enumerating certain representative diseases to improve the ECM education. It appealed our teachers to pay more attention to how to make the module of ECM master well in near future.