Objective　To explore and analyze the epidemiological characteristics of scarlet fever caused by group A Streptococcus (GAS) in Minhang District, Shanghai from 2023 to 2024, providing relevant information for clinical treatment and infection control. Methods Throat swab specimens were collected from children clinically diagnosed with scarlet fever at a sentinel hospital in Shanghai from May 2023 to June 2024. GAS strains were isolated and cultured using blood agar plates, and mass spectrometry performed species identification. The polymerase chain reaction (PCR) method was used to assess emm gene typing and 11 superantigens, while the broth microdilution method was used to determine the resistance of the strains to 14 antibiotics. Whole genome sequencing was performed on 68 GAS strains. The chi-square test and Fisher's exact probability method were conducted for intergroup comparisons. Results A total of 178 GAS strains were isolated from 305 throat swab specimens of scarlet fever cases in children. All GAS strains were sensitive to penicillin, cefotaxime, linezolid, vancomycin, meropenem, chloramphenicol, levofloxacin, teicoplanin, and cefepime, while the resistance rates to erythromycin, clarithromycin, and tetracycline were 99.44%, 99.44%, and 94.94%, respectively. There are two types of emm genes, with emm12 being the main type (89.33%, 159/178), followed by emm1 10.7% (19/178). There were 26 types of superantigen gene spectrums. The speA gene carrying rate of emm1 type GAS (94.74%, 18/19) was significantly higher than emm12(12.00%,32/159) (&chi;2=46.77, P<0.001). The simultaneous carrying rate of speH and speI genes in emm12 type GAS (59.75%, 95/159) was higher than in emm1 type (0) (&chi;2=24.35, P<0.001). Whole-genome sequencing revealed that all 68 GAS strains carried the drug resistance gene ermB, with 98.52% (67/68) carrying tetM. Conclusions In Minhang District of Shanghai, non-invasive scarlet fever in children is predominantly caused by emm12 GAS, which shows high resistance to erythromycin, clindamycin, and tetracycline, with higher carriage rates of speH and speI in emm12 types compared to other strains.

Objective To investigate changes in the intestinal flora and function in rats with antibiotic-associated diarrhea(A AD)treated with GeGen QinLian Decoction(GQD).Methods Sixty male or female SPF-grade SD rats were fed for 7 days and then divided randomly into Control(Con)and modeling groups(1∶5 ratio).Rats in the modeling group received clindamycin 250 mg/kg by gavage once a day for 7 consecutive days.After successful modeling,the rats were divided randomly into model(Mod),high-dose GQD(GQD-H,10.08 g/kg),medium-dose GQD(GQD-M,5.04 g/kg),low-dose GQD(GQD-L,2.52 g/kg),and live Bifidobacterium power(LBP,0.15 g/kg)groups(n=10 rats per group).GQD and LBP were administered by gavage,and the Con and Mod groups were given an equal volume of saline by gavage once a day.Feces were collected after 7 consecutive days of administration for macrogenomics sequencing analysis.Results α diversity and β diversity suggested that intestinal microbial diversity differed between the Mod and GQD-treated groups.GQD increased the abundance of thick-walled bacteria and decreased the abundance of Aspergillus at the phylum level,and increased the relative abundances of the intestinal mucus bacteria Blautia,Bacteroides,Thomasclavelia,and Mediterraneibacter,and decreased the relative abundances of Adlercreutzia,Muribaculum,and Escherichia at the genus level.GQD also up-regulated the amino acid,carbohydrate,and immune disease pathways.Conclusions GQD improves the abundance ratio of beneficial and pathogenic intestinal bacteria in rats with antibiotic-associated diarrhea,which in turn reduces the intestinal inflammatory response and repairs the intestinal immune system.

Objective To investigate changes in the intestinal flora and function in rats with antibiotic-associated diarrhea(A AD)treated with GeGen QinLian Decoction(GQD).Methods Sixty male or female SPF-grade SD rats were fed for 7 days and then divided randomly into Control(Con)and modeling groups(1∶5 ratio).Rats in the modeling group received clindamycin 250 mg/kg by gavage once a day for 7 consecutive days.After successful modeling,the rats were divided randomly into model(Mod),high-dose GQD(GQD-H,10.08 g/kg),medium-dose GQD(GQD-M,5.04 g/kg),low-dose GQD(GQD-L,2.52 g/kg),and live Bifidobacterium power(LBP,0.15 g/kg)groups(n=10 rats per group).GQD and LBP were administered by gavage,and the Con and Mod groups were given an equal volume of saline by gavage once a day.Feces were collected after 7 consecutive days of administration for macrogenomics sequencing analysis.Results α diversity and β diversity suggested that intestinal microbial diversity differed between the Mod and GQD-treated groups.GQD increased the abundance of thick-walled bacteria and decreased the abundance of Aspergillus at the phylum level,and increased the relative abundances of the intestinal mucus bacteria Blautia,Bacteroides,Thomasclavelia,and Mediterraneibacter,and decreased the relative abundances of Adlercreutzia,Muribaculum,and Escherichia at the genus level.GQD also up-regulated the amino acid,carbohydrate,and immune disease pathways.Conclusions GQD improves the abundance ratio of beneficial and pathogenic intestinal bacteria in rats with antibiotic-associated diarrhea,which in turn reduces the intestinal inflammatory response and repairs the intestinal immune system.

OBJECTIVE To explore the the reg ulation of intestinal flora and effects of Qingjie huagong decoction on intestinal mucosal barrier in severe acute pancreatitis （SAP）mode rats . METHODS SAP rat model was induced by intraperitoneal injection of caerulein and lipopolysaccharide.The survival state of rats in each group were observed.The levels of serum amylase ，interleukin 10（IL-10），IL-18 and IL- 1β in serum were all detected. The pathological changes of pancreatic and small intestinal tissue were observed. The expressions of Occludin，ZO-1 and HMGB1 were detected in small intestinal tissue of rats. The structure and relative abundance of intestinal microflora in rats were detected by 16S rRNA high throughput sequencing. RESULTS After the intervention of Qingjie huagong decoction ，abdominal distension symptoms of SAP model rats were significantly relieved ，and their mental state recovered better ；the levels of serum amylase and IL- 18 in serum were decreased significantly （P＜0.05），while the level of IL- 10 was increased significantly （P＜0.05）. The necrotic area of pancreatic tissue and the infiltration of inflammatory cells were reduced ， the degree of intestinal epithelial cell structural disorder was alleviated ，and the shedding of intestinal mucosal epithelium was reduced.The protein expression of HMGB 1 in small intestinal tissue was decreased significantly （P＜0.05），and the protein expression of Occludin and ZO- 1 were increased significantly . Results of 16S rRNA high throughput sequencing showed that Qingjie huagong decoction could increased the relative abundance of probiotics such as Bacteroidea and Lactobacillus in rat intestine ，reduced the colonization of harmful bacteria such as Firmicutes. CONCLUSIONS Qingjie huagong decoction can improve the intestinal barrier by up-regulating the expression of Occludin and ZO- 1 in small intestinal tissue and down-regulating the protein expression of HMGB 1. It can also adjust the relative abundances of different flora to protect the intestinal tract.

Objective:To explore the data of patients with inoperable stage Ⅲ non-small cell lung cancer (NSCLC) after radiotherapy from the Surveillance, Epidemiology, and End Results (SEER) database, and to evaluate the effect of age on prognosis.Methods:The data of patients with inoperable stage Ⅲ A and Ⅲ B NSCLC according to the 7th edition of the American Joint Committee on Cancer (AJCC) staging standard who had been treated with radiotherapy from 2010 to 2016 were collected in the SEER database. A total of 17 117 cases were included in the analysis. According to the maximally selected test, the best cut-off value of age was 72 years old. According to the best cut-off value of age, patients were divided into the young group (< 72 years old, 11 008 cases) and the elderly group (≥ 72 years old, 6 109 cases). The basic clinical characteristics were compared between the two groups. Kaplan-Meier method was used to analyze the overall survival (OS) and log-rank test was performed. The multivariate Cox proportional hazards regression model was used to analyze the influencing factors for OS. The cumulative incidence function (CIF) was used to calculate the lung cancer-specific death rate and death rate from other causes in the different age groups, and the difference between the two groups was compared by Fine-Gray competing risk model, and the influencing factors of lung cancer-specific death were analyzed. Results:The proportion of squamous cell carcinoma in the elderly group was higher than that in the young group [51.1% (3 123/6 109) vs. 46.8% (5 154/11 008), P < 0.01], and the proportion of stage Ⅲ A was also higher than that in the young group [67.4% (4 120/6 109) vs. 60.1% (6 615/11 008), P < 0.01]; the proportion of patients receiving chemotherapy in the elderly group was lower than that in the young group [69.2% (4 226/6 109) vs. 88.6% (9 748/11 008), P < 0.01]. The 2-year and 5-year OS rates of the young group were 39.2% and 18.0%, and the elderly group were 32.4% and 12.5% (both P < 0.01). The multivariate Cox regression analysis showed that age, gender, race, year of diagnosis, pathological type, T stage, N stage, reason for non-operation and chemotherapy were independent influencing factors for patients' OS after radiotherapy, and among them, HR of age (≥ 72 years old vs. < 72 years old) was 1.13 (95% CI 1.09-1.18) ( P <0.01). The 2-year and 5-year cumulative incidence rate of lung cancer-specific death in the elderly group were 60.3% and 75.7%, which were higher than the corresponding values of 55.9% and 74.0% in the young group, and the difference of cumulative incidence rate of lung cancer-specific death between the two groups was statistically significant ( P < 0.01). The 2-year and 5-year cumulative incidence rate of death from other causes in the elderly group were 7.3% and 11.8%, which were higher than the corresponding values of 4.9% and 8.0% in the young group, and the difference of death from other causes between the two groups was statistically significant ( P < 0.01). The competing risk model analysis showed that age, gender, race, year of diagnosis, pathological type, T stage, N stage, and with or without chemotherapy were independent influencing factors for lung cancer-specific death in patients with inoperable stage Ⅲ NSCLC after radiotherapy, and among them, HR of age (≥ 72 years old vs. < 72 years old) was 1.07 (95% CI 1.02-1.12) ( P =0.002). Conclusions:Age is an independent prognostic factor for patients with inoperable stage Ⅲ NSCLC after radiotherapy. The prognosis of elderly patients is poor, and they have high risks of lung cancer-specific death and death from other causes.

Objective:To analyze the inflammatory mechanism and potential intervention drugs related to angiotensin converting enzyme 2 (ACE2) inhibitory mutations in order to provide reference for the treatment of corona virus disease 2019 (COVID-19).Methods:The data of lung adenocarcinoma with ACE2 mutations were screened from the cancer genome atlas (TCGA) database. The data were analyzed by R program language edgeR package and cluster Profiler package, gene ontology (GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Using String online analysis website for protein-protein interaction (PPI) network analysis, screening out the core genes, and finally using the Epigenomic Precision Medicine Prediction Platform (EpiMed) for multi-group association analysis of key genes, and drug candidates prediction.Results:A total of 1 005 differential genes were obtained, of which 91 were up-regulated and 914 down-regulated. A total of 71 GO were enriched, including 45 items related to biological processes, 16 items related to cell components, and 10 items related to molecular function. A total of 13 KEGG pathways were enriched, mainly in inflammatory pathways, various viral infectious diseases, transcriptional regulation, drug metabolism and protein digestion and absorption pathways. The differentially expressed genes were introduced into String online analysis website for PPI network analysis, a total of 252 proteins were obtained, and 10 core genes were H2A clustered histone 16(HIST1H2AL), H3 clustered histone 2 (HIST1H3B), H3 clustered histone 7 (HIST1H3F), H3 clustered histone 11 (HIST1H3I), H3 clustered histone 3 (HIST1H3C), H2B clustered histone 3 (HIST1H2BB), H2B clustered histone 6 (HIST1H2BI), H4 clustered histone 2 (HIST1H4B), H1-4 linker histone (HIST1H1E), H2A clustered histone 4 (HIST1H2AB). Interferon-α, resveratrol, celecoxib, heartleaf houttuynia herb, weeping forsythia capsule, dexamethasone, Chinese pulsatilla root, tumor necrosis factor-α inhibitors, liquorice root and famciclovir might be drugs for the treatment of ACE2 mutation-related inflammation.Conclusions:Inflammation associated with ACE2 inhibitory mutations is similar to the pathogenesis of COVID-19, which could lead to disease by promoting the activation of inflammatory pathways such as mitogen-activated protein kinase (MAPK), the Janus kinase signal transducer and activator of transcription (JAK/STAT), mammalian target of rapamycin (mTOR). Celecoxib, interferon and resveratrol may have the potential therapeutic effects on COVID-19.

Objective:To investigate the omics mechanism of SARS-related immune injury and predict targeted therapeutic drugs through clinical bioinformatics analysis of the transcriptome data of SARS virus in order to provide reference for clinical treatment of COVID-19.Methods:The transcriptome data of SARA virus were collected from the Gene Expression Oibus (GEO) and used to screen differential genes. Enrichment analysis and protein interaction analysis were performed to investigate the mechanism of immune damage associated with SARS. A platform of epigenetics in precision medicine (EpiMed) was established to predict potential therapeutic drugs.Results:The mechanism of SARS-related immune injury was complex, involving affecting the function of immune cells through signaling pathways such as Toll-like receptors, increasing cytokines in plasma through Th17 signaling pathway and inducing autoimmune responses after autoantibodies were generated by molecules such as IL-6, NF-κB, and TNF. Drugs such as Chuanqiong and Etanercept might have therapeutic effects on SARS-related immune damage.Conclusions:SARS virus could cause abnormal expression of many immune-related molecules and signaling pathways. Drugs such as Chuanqiong and Etanercept might have therapeutic effects on SARS-related immune damage. This study might provide reference for clinical treatment of COVID-19.

Objective:To analyze the mechanism and potential intervention drugs of acute lung injury caused by severe acute respiratory syndrome coronavirus (SARS-CoV) infection in order to provide reference for the treatment of COVID-19.Methods:Gene Expression Omnibus (GEO) announcement database was used to screen coronavirus transcriptome data, and R language package was used for differential expression analysis and Kyoto Gene and Genome Encyclopedia (KEGG) and Gene Ontology (GO) enrichment analysis. A protein-protein interaction (PPI) network analysis was carried out by using STRING online analysis website, and the key genes were screened. Then the Epigenomic Precision Medicine Prediction Platform (EpiMed) was used to analyze the association of key genes and predict potential therapeutic drugs.Results:Based on the whole genome expression profile data of SARS-CoV, a total of 3 606 differential genes were screened, including 2 148 up-regulated and 1 458 down-regulated. GO enrichment is mainly related to viral infection, leukocyte migration and adhesion, acute inflammation and collagen secretion. KEGG enrichment is mainly related to signal transduction, acute inflammation, immune response and so on. Ten key genes related to lung injury, such as PTPRC, TIMP1, ICAM1 and IL1B, were screened by protein interaction network analysis. EpiMed platform predicted that pulsatilla chinensis, polygonum cuspidatum, tumor necrosis factor-α inhibitors, famciclovir, fluvastatin and other drugs have potential therapeutic effects.Conclusions:SARS-CoV infection can cause lung injury by activating a series of inflammation-related molecules. Drugs that may be effective in the treatment of coronavirus infections, including pulsatilla chinensis, polygonum cuspidatum, tumor necrosis factor-α inhibitors, famciclovir and fluvastatin.

BACKGROUND/AIMS: There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus. METHODS: Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method. RESULTS: Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy. CONCLUSIONS: Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.
Anti-Bacterial Agents ; Asia ; Asian Continental Ancestry Group ; Consensus ; Constipation ; Diagnosis ; Diarrhea ; Diet ; Epidemiology ; Gastrointestinal Diseases ; Humans ; Intestines ; Irritable Bowel Syndrome ; Life Style ; Methods ; Probiotics

Objective To establish rat models of extrahepatic biliary atresia,and to observe the characteristics of 99Tcm-MIBI hepatobiliary scintigraphy and evaluate its association with the expression Pglycoprotein (P-gp) in intestinal tissues.Methods A total of 12 SD rats were randomly divided into the normal control group (3 rats) and the group of common bile duct ligation (CBDL;9 rats).CBDL was used to establish the rat model of extrahepatic biliary atresia.99Tcm-MIBI hepatobiliary scintigraphy was performed at 2,3 and 4 weeks after ligation in the CBDL group and normal control group with continuous dynamic acquisition (3 min/frame) for 30 min and then delaying imaging at 30 min,1,2 and 3 h.After that,all rats were sacrificed,and the blood samples were taken out for the determination of serum ALT,AST,TBIL,DBIL,IBIL,ALP,γ-GT and TBA,and the tissues of duodenum,jejunum,ileum,colon and cecum were taken out for analyzing the expression level of P-gp by immunohistochemistry.Two-sample t test and one-way analysis of variance were used.Results Compared with the normal control group,the serum levels of ALT,AST,TBIL,DBIL,IBIL,ALP,γ-GT and TBA were significantly increasing at 2,3,4 weeks after ligation in CBDL group (t:-3.04 to-44.54,all P＜0.05).99Tcm-MIBI hepatobiliary imaging showed that there was radioactive accumulation in colon or cecum area,excluding the duodenum,jejunum and ileum area,at 3 h after intravenous injection of 99Tcm-MIBI in CBDL group.The results of immunohistochemistry showed that with the obstruction time prolonged,the expression levels of P-gp in duodenum,jejunum and ileum segments were gradually decreased (F=5.17,9.07,23.52;all P＜0.05),while the expression levels in the colon and cecum segments were not changed obviously (F=2.00,3.17;both P＞0.05).Conclusion 99Tcm-MIBI can be excreted through intestinal mucosa,and this process may be associated with P-gp expression.