This study aimed to investigate the mechanism of compound Agrimonia pilosula enteritis capsules (CAPEC) on ulcerative colitis (UC) in mice with dampness-heat syndrome. The mice were randomly divided into five groups: the control group, the model group, the positive drug (5-aminosalicylic acid, 5-ASA) group, the low-dose CAPEC (CAPEC-L) group and the high-dose CAPEC (CAPEC-H) group. The mice models were established by using high-fat high-sucrose diet, feeding with distilled spirit and dextran sulfate sodium (DSS). The effects of CAPEC on bile acids (BAs) metabolic profiles in bile and the FXR-SREBP-1 signaling pathway were investigated in the model of UC in mice with dampness-heat syndrome by ELISA, qRT-PCR, UHPLC-QQQ/MS, and histopathological analysis. The results showed that, compared with the model group, the CAPEC-L group and the CAPEC-H group significantly reduced the disease activity index (DAI), and proinflammatory cytokine levels (including IL-6, IL-1β, and TNF-α) in both serum and colon tissues. Additionally, CAPEC markedly ameliorated intestinal inflammation, hepatic lipid accumulation, and pathological alterations in tongue tissue. The CAPEC-H group significantly attenuated the abnormal elevation of BAs profiles in bile, and up-regulated hepatic mRNA levels of Cyp7a1, Cyp7b1, Cyp27a1, Bsep, Fxr, and Shp, while down-regulating Srebp-1 and Cyp8b1 expression. The experimental results suggest that CAPEC alleviates UC with dampness-heat syndrome by ameliorating BAs metabolic disorders, hepatic lipid accumulation, and intestinal inflammation. These findings provide mechanistic insights into CAPEC’s traditional effects of clearing heat and drying dampness, and strengthening the spleen to relieve diarrhea.

Objective To investigate the predictive value of Mayo adhesion probability(MAP)score for intraoperative bleeding during microchannel percutaneous nephrolithotomy(PCNL), so as to provide reference for optimizing surgical decisions.Methods A retrospective analysis was conducted on the clinical data of 86 patients who underwent microchannel PCNL at our hospital during Jan.2018 and Jul. 2025.Patients were divided into two groups based on preoperative CT-derived MAP scores:MAP score＜3 group(n=45)and MAP score≥3 group(n=41).Baseline characteristics, surgical parameters and outcome measures were compared between the two groups.Univariate and multivariate logistic regression analyses were performed to identify risk factors for intraoperative bleeding(defined as a postoperative hemoglobin decrease of ≥20 g/L). Results The incidence of intraoperative bleeding was significantly higher in the MAP score≥3 group than in the MAP score＜3 group(43.9% vs.20.0%, P=0.017).Multivariate analysis identified MAP score ≥3(OR=3.045, 95%CI:1.125-9.547, P=0.019), use of anticoagulant medication(OR=3.016, 95%CI:1.251-9.257, P=0.020), establishment of multiple tracts(OR=5.445, 95%CI:1.798-17.578, P=0.003), and operation time ≥90 minutes(OR=5.697, 95%CI:1.890-13.632, P=0.001)as risk factors for intraoperative bleeding.The area under the curve for the MAP score in predicting intraoperative bleeding was 0.704.Conclusion The MAP score is an independent risk factor for intraoperative bleeding during microchannel PCNL.Preoperative assessment can help identify high-risk patients and provide a basis for optimizing surgical decision-making.

Objective To analyze the genomic characteristics of Legionella pneumophila (L. pneumophila) isolated from industrial circulating cooling water in workplace. Methods A total of 20 L. pneumophila strains isolated from industrial circulating cooling water collected from eight chemical enterprises were selected as the research subjects. Whole-genome sequencing was performed on the strains, followed by multilocus sequence typing (MLST), whole-genome single nucleotide polymorphism analysis, virulence factor profiling, and antibiotic resistance gene detection. Results The dominant MLST typing among the 20 L. pneumophila strains was ST2. Serogroup 1 (Lp1) strains exhibited high genetic diversity. Strains from different enterprises showed substantial genomic diversity, suggesting possible inter-enterprise dissemination. Each isolate harbored 175-295 virulence genes; among them, virulence genes were identified, and 139 genes were detected in all the 20 strains. These genes primarily included those related to the Dot/Icm type Ⅳ bacterial secretion system, flagellar synthesis and motility, and type Ⅳ pili. The number of virulence genes carried by L. pneumophila strains of different ST types differed (P<0.01), with unidentified sequence types harboring more virulence genes than other STs (P<0.01). A total of four resistance genes were predicted, including aminoglycoside phosphotransferase-encoding gene APH(9)-Ia, carbapenemase-encoding gene OXA-29, and efflux pump genes-encoding genes LpeA and LpeB, with detection rates of 100.00%, 100.00%, 10.00%, and 10.00%, respectively. These genes may confer resistance to cephalosporins, penicillins, and aminoglycosides, and all strains were multidrug resistance. Conclusion L. pneumophila isolated from industrial recirculating cooling water exhibits high genetic diversity, strong pathogenicity, and significant multidrug resistance potential.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Saponins associated with Panax notoginseng (P. notoginseng) demonstrate significant therapeutic efficacy across multiple diseases. However, certain high-yield saponins face limited clinical applications due to their reduced pharmacological efficacy. This study synthesized and evaluated 36 saponin-1,2,3-triazole derivatives of ginsenosides Rg1/Rb1 and notoginsenoside R1 for anti-adipogenesis activity in vitro. The research revealed that the ginsenosides Rg1-1,2,3-triazole derivative a17 demonstrates superior adipogenesis inhibitory effects. Structure-activity relationships (SARs) analysis indicates that incorporating an amidyl-substituted 1,2,3-triazole into the saponin side chain via Click reaction enhances anti-adipogenesis activity. Additionally, several other derivatives exhibit general adipogenesis inhibition. Compound a17 demonstrated enhanced potency compared to the parent ginsenoside Rg1. Mechanistic investigations revealed that a17 exhibits dose-dependent inhibition of adipogenesis in vitro, accompanied by decreased expression of preadipocytes. Peroxisome proliferator-activated receptor γ (PPARγ), fatty acid synthase (FAS), and fatty acid binding protein 4 (FABP4) adipogenesis regulators. These findings establish the ginsenoside Rg1-1,2,3-triazole derivative a17 as a promising adipocyte differentiation inhibitor and potential therapeutic agent for obesity and associated metabolic disorders. This research provides a foundation for developing effective therapeutic approaches for various metabolic syndromes.
Adipogenesis/drug effects* ; Triazoles/chemical synthesis* ; Ginsenosides/chemical synthesis* ; Saponins/chemical synthesis* ; Animals ; Mice ; Structure-Activity Relationship ; PPAR gamma/genetics* ; 3T3-L1 Cells ; Adipocytes/metabolism* ; Panax notoginseng/chemistry* ; Drug Design ; Molecular Structure ; Humans ; Cell Differentiation/drug effects* ; Fatty Acid-Binding Proteins/genetics*

ObjectiveTo evaluate the effectiveness and safety of Sufei Pingchuan Formula （肃肺平喘方） in the treatment of bronchiectasis with airflow limitation， phlegm-heat obstructing the lung， and lung-spleen qi deficiency syndrome. MethodsA randomized， double-blind， placebo-controlled trial was conducted. A total of 72 patients with stable bronchiectasis with airflow limitation of phlegm-heat obstructing the lung and lung-spleen qi deficiency syndrome were randomly divided into treatment group and control group， with 36 cases in each group. On the basis of regular inhalation of tiotropium bromide inhalation spray， the treatment group was given Sufei Pingchuan Formula granules， and the control group was given Sufei Pingchuan Formula granule simulant. The course of treatment in both groups was 12 weeks. The pulmonary function of both groups before and after treatment was observed， specifically focusing on forced expiratory volume in one second （FEV1）； the modified British Medical Research Council （mMRC） dyspnea scale， 24-hour sputum volume， COPD assessment test （CAT）， and traditional Chinese medicine （TCM） syndrome scores were assessed before treatment and after 4， 8， and 12 weeks of treatment； acute exacerbations were recorded at weeks 4， 8， and 12； additionally， changes in routine blood tests， urinalysis， liver and kidney function， and adverse events were monitored before and after treatment. ResultsAfter treatment， 4 patients in the treatment group and 6 in the control group dropped out. After 12 weeks of treatment， FEV1 increased in both groups compared to pre-treatment levels （P＜0.05）， but the difference between groups was not statistically significant （P＞0.05）. Compared to before treatment， the treatment group showed a reduction in mMRC scores after 12 weeks （P＜0.05） and a decrease in 24-hour sputum volume， CAT scores， and TCM syndrome scores at weeks 4， 8， and 12 （P＜0.05）. In the control group， 24-hour sputum volume decreased after 12 weeks （P＜0.05）， and TCM syndrome scores decreased at weeks 8 and 12 （P＜0.05）. Compared to the control group， the treatment group showed a greater reduction in mMRC scores at week 12 （P＜0.05）， a decrease in 24-hour sputum volume and TCM syndrome scores at weeks 4， 8， and 12 （P＜0.05）， and lower CAT scores at weeks 8 and 12 （P＜0.05）. The frequency and number of acute exacerbations in the treatment group were significantly lower than those in the control group at week 12 （P＜0.05）. No severe adverse events occurred in either group. ConclusionSufei Pingchuan Formula can improve the pulmonary function FEV1， the severity of dyspnea， reduce 24-hour sputum volume and frequent acute exacerbations， and improve the quality of life in patients with bronchiectasis and airflow limitation， with good safety.

Objective To investigate the serum levels of miR-488 and miR-654 in patients with diabetes nephropathy(DN)and their relationship with the severity and prognosis of the disease.Methods 92 DN patients who received treatment at Ya'an People's Hospital from January 2022 to January 2024(DN group)and 60 healthy controls(healthy group)were selected.The correlation between serum miR-488 and miR-654 was analyzed with pearson.The chi-square test was used to analyze the relationship between serum miR-488 and miR-654 expression levels,clinical pathological features,and degree of renal injury.ROC was used to predict the prognosis of DN patients Results Compared with healthy individuals,the expression level of serum miR-488(1.71±0.40 vs 1.08±0.15)was increased in DN patients,while the expression level of miR-654(0.66±0.19 vs 0.94±0.22)was reduced,and the differences were statistically significant(t=11.666,8.340,all P<0.05).In DN patients with diabetes≥10 years,24h urinary protein≥3 g/L,serum creatinine(Scr)≥150 μmol/L,glomerular filtration rate<60 ml/min/1.73m2,and blood urea nitrogen(BUN)≥7.5 mmol/L,the proportions of high expression of serum miR-488 and low expression of miR-654 were higher than the proportions of low expression of serum miR-488 and high expression of miR-654,and the differences were statistically significant(χ2=5.283～25.234;4.356～8.587,all P<0.05).Pearson analyze the correlation between serum miR-488 and miR-654 in the DN group were negatively correlated(r=-0.405),serum miR-488 was positively correlated with 24h urinary protein,Scr and BUN(r=0.376,0.435,0.406)and negatively correlated with glomerular filtration rate(r=-0.382).Serum miR-654 was negatively correlated with 24-hour urine protein,Scr and BUN(r=-0.418,-0.367,-0.425)and positively correlated with glomerular filtration rate(r=0.374).The proportions of high expression of miR-488 and low expression of miR-654 in DN patients with glomerular grade IV,2 points of interstitial inflammation,and 3 points of interstitial fibrosis and tubular atrophy(IFTA)were higher than proportions of low expression of miR-488 and high expression of miR-654,and the differences was statistically significant(χ2=7.916～20.669,8.432～13.258,all P<0.05).Compared with the poor prognosis group,the serum miR-488 expression level in the good prognosis group was obviously reduced(1.57±0.29 vs 1.89±0.17),while the miR-654 expression level was obviously increased(0.78±0.21 vs 0.51±0.19),and the differences were statisticolly significant(t=6.202,6.369,all P<0.05).The sensitivity of serum miR-488,miR-654 and their combination for prog-nosis of DN patients were 87.50%,80.00%and 90.00%,respectively.The specificity were 84.62%,86.54%and 82.69%,respec-tively.The AUC(95%CI)were 0.838(0.748～0.927),0.824(0.731～0.916)and 0.906(0.846～0.966),respectively,the joint prediction of the two was better than their individual predictions(Z=2.225,2.033,P=0.026,0.042).Conclusion The lower the degree of renal injury in DN patients,the lower the serum miR-488,and the higher the serum miR-654,serum miR-488 and miR-654 can be used to predict the condition and prognosis of DN patients,and combined prediction is better than individual predic-tion.

OBJECTIVE T o explore the prevention and control measures for the hospital-acquired pulmonary mu-cormycosis caused by Cunninghamella bertholletiae.METHODS One case of patient with pulmonary mucormyco-sis caused by Cunninghamella bertholletiae who was treated in pediatric intensive care unit(PICU)of a three-A general hospital was enrolled in the study,the process of clinical diagnosis and treatment was summarized.A ret-rospective survey regarding four aspects including people,machine,materials and environment was conducted.The related factors leading to the hospital-acquired infections in the patient were analyzed.RESULTS The child was diagnosed with severe aplastic anemia and underwent hematopoietic stem cell transplantation,the child was treated with various invasive procedures during the treatment period and was infected with pulmona-ry mucormycosis caused by the rare Cunninghamella bertholletiae.The occurrence of the pulmonary mucormyco-sis was associated with the poor management of medical textile,insufficient environmental cleaning and disinfec-tion and nonstandard invasive procedures.CONCLUSIONS The Cunninghamella bertholletiae infection is less com-mon,but the risk of death is high.It is necessary for the medical institutions to complete the prevention and con-trol measures and intensify the health care workers'capabilities in identification of the pathogenic fungus so as to reduce the incidence of pulmonary mucormycosis caused by the pathogen.

Objective To investigate the serum levels of miR-488 and miR-654 in patients with diabetes nephropathy(DN)and their relationship with the severity and prognosis of the disease.Methods 92 DN patients who received treatment at Ya'an People's Hospital from January 2022 to January 2024(DN group)and 60 healthy controls(healthy group)were selected.The correlation between serum miR-488 and miR-654 was analyzed with pearson.The chi-square test was used to analyze the relationship between serum miR-488 and miR-654 expression levels,clinical pathological features,and degree of renal injury.ROC was used to predict the prognosis of DN patients Results Compared with healthy individuals,the expression level of serum miR-488(1.71±0.40 vs 1.08±0.15)was increased in DN patients,while the expression level of miR-654(0.66±0.19 vs 0.94±0.22)was reduced,and the differences were statistically significant(t=11.666,8.340,all P<0.05).In DN patients with diabetes≥10 years,24h urinary protein≥3 g/L,serum creatinine(Scr)≥150 μmol/L,glomerular filtration rate<60 ml/min/1.73m2,and blood urea nitrogen(BUN)≥7.5 mmol/L,the proportions of high expression of serum miR-488 and low expression of miR-654 were higher than the proportions of low expression of serum miR-488 and high expression of miR-654,and the differences were statistically significant(χ2=5.283～25.234;4.356～8.587,all P<0.05).Pearson analyze the correlation between serum miR-488 and miR-654 in the DN group were negatively correlated(r=-0.405),serum miR-488 was positively correlated with 24h urinary protein,Scr and BUN(r=0.376,0.435,0.406)and negatively correlated with glomerular filtration rate(r=-0.382).Serum miR-654 was negatively correlated with 24-hour urine protein,Scr and BUN(r=-0.418,-0.367,-0.425)and positively correlated with glomerular filtration rate(r=0.374).The proportions of high expression of miR-488 and low expression of miR-654 in DN patients with glomerular grade IV,2 points of interstitial inflammation,and 3 points of interstitial fibrosis and tubular atrophy(IFTA)were higher than proportions of low expression of miR-488 and high expression of miR-654,and the differences was statistically significant(χ2=7.916～20.669,8.432～13.258,all P<0.05).Compared with the poor prognosis group,the serum miR-488 expression level in the good prognosis group was obviously reduced(1.57±0.29 vs 1.89±0.17),while the miR-654 expression level was obviously increased(0.78±0.21 vs 0.51±0.19),and the differences were statisticolly significant(t=6.202,6.369,all P<0.05).The sensitivity of serum miR-488,miR-654 and their combination for prog-nosis of DN patients were 87.50%,80.00%and 90.00%,respectively.The specificity were 84.62%,86.54%and 82.69%,respec-tively.The AUC(95%CI)were 0.838(0.748～0.927),0.824(0.731～0.916)and 0.906(0.846～0.966),respectively,the joint prediction of the two was better than their individual predictions(Z=2.225,2.033,P=0.026,0.042).Conclusion The lower the degree of renal injury in DN patients,the lower the serum miR-488,and the higher the serum miR-654,serum miR-488 and miR-654 can be used to predict the condition and prognosis of DN patients,and combined prediction is better than individual predic-tion.

AIM:To investigate the role of NLR family CARD domain containing 3(NLRC3)in endothelial cells and evaluate its diagnostic value in coronary artery disease.METHODS:Twenty male ApoE-/-C57BL/6 mice,aged eight weeks,were randomly assigned into two groups:an experimental group and a control group,with each group com-prising ten mice.The experimental group was subjected to a high-fat diet for 8 weeks to induce atherosclerosis(AS),whereas the control group was maintained on a standard diet.The expression of NLRC3 in the aorta was evaluated using RT-qPCR and immunofluorescence techniques.Additionally,human umbilical vein endothelial cells(HUVECs)were ex-posed to interleukin-1β(IL-1β)to investigate the expression levels of NLRC3.Lentiviral vectors or plasmid vectors were employed to either overexpress or knock down NLRC3 in endothelial cells,and subsequently subjected to inflammation in-duced by IL-1β.The RT-qPCR and ELISA were employed to assess the impact of NLRC3 on inflammation in endothelial cells.Western blot and immunofluorescence techniques were utilized to investigate the modulation of the NF-κB signaling pathway in endothelial cells by NLRC3.Plasma NLRC3 levels in coronary artery disease patients and healthy controls were measured using ELISA,and its diagnostic potential was assessed through ROC curve analysis.RESULTS:In AS mice,distinct plaque lesions were observed in the aorta,accompanied by a significantly reduced expression of NLRC3 in the aortic arch relative to the control group.Expression of NLRC3 exhibited a significant down-regulation in IL-1β-stimu-lated HUVECs,demonstrating both time-dependent and dose-dependent effects(P<0.01).Overexpression of NLRC3 markedly suppressed the levels of IL-6,IL-8,monocyte chemoatbactant protein-1(MCP-1),p-p65,and p-IκBα in endo-thelial cells stimulated with IL-1β(P<0.01).Conversely,knockdown of NLRC3 resulted in elevated levels of IL-6,IL-8,MCP-1,p-p65 and p-IκBα in endothelial cells(P<0.01).Coronary artery disease patients had significantly lower plasma NLRC3 levels than controls,with an AUC of 0.851(95%CI:0.785～0.918,P<0.01).A diagnostic threshold of 1.605 μg/L yielded a sensitivity of 93.8%and a specificity of 71.3%.CONCLUSION:The NLRC3 may modulate endothelial inflammation and suppress AS progression through inhibition of the NF-κB signaling pathway,and it holds potential as a diagnostic biomarker for coronary artery disease.