ObjectiveTo explore the effect of modified Ditan Decoction （涤痰汤） on chronic intermittent hypoxia cognitive function and the potential function mechanism. MethodsTwenty-four Sprague-Dawley （SD） rats were randomly divided into a normal group， a model group， and a modified Ditan Decoction group， with eight rats in each group. Rats in the modified Ditan Decoction group were administered the decoction by gavage at 14.8 ml/（kg·d）， while the normal group and the model group received the same dose of normal saline. Thirty minutes after daily gavage， the rats in all three groups were placed in an intermittent hypoxia chamber. The oxygen concentration for the model group and the modified Ditan Decoction group was adjusted daily for 8 hours using a computer program to establish the model， while the normal group was exposed to the same airflow rate of ambient air. The intervention was continued for 12 weeks to establish a chronic intermittent hypoxia rat model. The Y-maze test was used to evaluate spatial working memory in the rats. Resting-state functional magnetic resonance imaging （rs-fMRI） was performed to detect whole-brain regional homogeneity （ReHo） and seed-based functional connectivity （FC）. Brain regions showing significant differences in rs-fMRI were selected for further analysis. Immunofluorescence was used to detect β-amyloid （Aβ） deposition and the number of ionized calcium-binding adapter molecule 1 （IBA1）-positive microglial cells. Immunohistochemistry was employed to assess the expression of synaptophysin （SYP）， the excitatory synapse marker vesicular glutamate transporter 1 （Vglut1）， and the inhibitory synapse marker vesicular γ-aminobutyric acid transporter （VGAT）. ResultsCompared with the normal group， the model group showed a reduced spontaneous alternation rate in the Y-maze test. The smoothed Z-score standardized regional homogeneity （SzReHo） value in the left entorhinal cortex significantly increased， and the FC value from this seed point to the left basal forebrain significantly reduced. Additionally， the model group exhibited significantly higher Aβ fluorescence intensity and Iba1 positivity in the left entorhinal cortex， decreased expression of SYP， Vglut1， and VGAT， along with an increased Vglut1/VGAT ratio （P＜0.05 or P＜0.01）. Compared to the model group， the modified Ditan Decoction group demonstrated an increased spontaneous alternation rate， a significantly reduced SzReHo value in the left entorhinal cortex， and a significantly increased FC value from this region to the left basal forebrain. Furthermore， this group showed significantly lower Aβ fluorescence intensity and Iba1 positivity in the left entorhinal cortex， increased levels of SYP， Vglut1， and VGAT， and a decreased Vglut1/VGAT ratio （P＜0.05 or P＜0.01）. ConclusionModified Ditan Decoction can reconstruct the projection from the left basal forebrain to the entorhinal cortex in chronic intermittent hypoxia， thereby reducing Aβ aggregation and excessive microglial activation in the left entorhinal cortex. This process improves the excitation/inhibition imbalance caused by synaptic remodeling， ultimately enhancing cognitive function in rats of chronic intermittent hypoxia.

Objective:To evaluate preliminary application effects of a provincial-county-township-village four-level network framework which aims at promoting oral health of the elderly, and to conduct preliminary evaluations of the application of this model in the prevention and treatment of oral diseases among the elderly in economically accelerated areas.Methods:Based on the population survey in June 2022, the study focuses on the elderly (≥85 years old) veterans who fought in the Korean War and currently resided in Wuyi County, an old revolutionary base area in Zhejiang Province with accelerated economic development. A four-level network medical service model matrix was constructed, spanning from the provincial level to the county, township, and village. Digital oral health records were established, and in-home dental treatment was provided for elderly individuals who met the inclusion and exclusion criteria. Pre-treatment and 3-months follow-up visits were conducted, and the impact of oral health was recorded using a scale, along with a survey of denture satisfaction.Results:A total of 54 elderly individuals received the geriatric oral healthcare services. After a 3-months follow-up, the mean total score of the oral health impact profile-14 questionnaires was (3.27±3.00), which was significantly lower than the score (32.82±7.15) in pre-treatment ones ( Z=-2.94, P=0.003). Scores in dimensions such as physical pain, functional limitations, psychological discomfort, psychological disorders, and physical disorders were all significantly lower than the pre-treatment scores ( P<0.05). The visual analogue score for denture satisfaction was 48.64±1.21, indicating a satisfaction rate of 100% (11/11). Conclusions:These findings confirm the favorable preliminary application effects of the four-level network framework in improving the prevention and treatment of oral diseases among the elderly in economically accelerated areas.

Objective A high sodium(HS)diet is believed to affect bone metabolism processes.Clarifying its impact on osseointegration of titanium(Ti)implants holds significant implications for postoperative dietary management of implanted patients. Methods This investigation probed the impact of sodium ions(Na+)on neovascularization and osteogenesis around Ti implants in vivo,utilizing micro-computed tomography,hematoxylin and eosin staining,and immunohistochemical analyses.Concurrently,in vitro experiments assessed the effects of varied Na+concentrations and exposure durations on human umbilical vein endothelial cells(HUVECs)and MC3T3-E1 cells. Results In vivo,increased dietary sodium(0.8%-6.0%)led to a substantial decline in CD34 positive HUVECs and new bone formation around Ti implants,alongside an increase in inflammatory cells.In vitro,an increase in Na+concentration(140-150 mmol/L)adversely affected the proliferation,angiogenesis,and migration of HUVECs,especially with prolonged exposure.While MC3T3-E1 cells initially exhibited less susceptibility to high Na+concentrations compared to HUVECs during short-term exposure,prolonged exposure to a HS environment progressively diminished their proliferation,differentiation,and osteogenic capabilities. Conclusion These findings suggest that HS diet had a negative effect on the early osseointegration of Ti implants by interfering with the process of postoperative vascularized bone regeneration.

Inflammatory bowel disease(IBD)is a chronic and relapsing inflammatory disorder of the gastrointestinal tract that poses a significant threat to human health.The pathogenesis of IBD remains unclear and is believed to involve various factors,including genetics,immune dysregulation,and environmental triggers.Recent evidence has highlighted the role of mitochondrial damage and dysfunction in the development of IBD.This article provides a comprehensive review and overview of studies related to the role of mitochondrial damage in IBD,focusing on the effects of mitochondrial oxidative stress damage,autophagy dysfunction,kinetic disturbances,and respiratory defects.The aim is to identify potential therapeutic targets and provide new insights for the scientific prevention and treatment of IBD.

Objective　To analyze the epidemiological characteristics, trends, risk factors, and pathogenic spectrum of adult diarrheal diseases in Xuhui District, Shanghai from 2017 to 2023, so as to provide scientific reference for pathogen monitoring and disease prevention and control of diarrheal diseases. Methods Samples of adult patients with diarrhea in sentinel hospitals of Xuhui District from 2017 to 2023 were collected, and nucleic acid detection of intestinal pathogens was conducted using real-time quantitative PCR. Thirty specimens were subjected to shotgun metagenomic next-generation sequencing (mNGS), with species identified as metagenomic positive pathogens at the level of genus or species by a threshold that at least one read per million of total reads identified by METAMIC. Pathogenic spectrum detected by qPCR and mNGS was listed and compared. Results A total of 1 265 adult diarrheal specimens were collected, showing a significant upward trend in pathogen positivity rates (χ2=23.493, P<0.05), peaking in 2023 at 64.9% (100/154). A higher incidence was found among males (52.9%, 669/1 265), with the primary affected age group being 26-45 years (51.8%, 655/1 265), and summer and autumn being peak seasons for infection (67.7%, 857/1 265). Most patients (72.3%, 914/1 265) sought medical attention within one day of onset. Before onset, 67.8% (858/1 265) of patients had eaten suspicious meat, eggs, dairy, or seafood products. qPCR results revealed the top three dominant pathogens as Norovirus GII (22.6%, 132/584), Campylobacter jejuni (20.0%, 117/584 ), and enterotoxigenic Escherichia coli (13.0%, 76/584). There were significant differences in pathogenic spectrum across different years (χ2=79.578, P<0.05), with enteroaggregative E. coli, Campylobacter jejuni, and Norovirus GII showing the most variation in prevalence. The difference in pathogenic spectrum detected by mNGS and qPCR was also significant (P<0.05), with the top three most abundant pathogens being Rotavirus (93.3%, 28/30), Vesiculovirus (83.3%, 25/30), and Herpesvirus (80.0%, 24/30). Factor analysis indicated that age, suspicious food, and fever were statistically significant related factors to the detection rates (P<0.05). Conclusions From 2017 to 2023, the overall positive rate of adults with diarrhea in Xuhui District exhibited an increasing trend. Summer and autumn were the peak infection seasons, with viruses predominantly detected in summer and bacteria in both summer and autumn. In addition, mNGS could be used as a complementary technology for conventional detection techniques to provide a scientific basis for the effective prevention and control of diarrhea.

OBJECTIVES: The aim of this study was to evaluate the disease burden of prostate cancer (PC) and assess key influencing factors associated with the disease expenditures of PC in the United States. METHODS: The total deaths, incidence, prevalence, and disability-adjusted life-years of PC were obtained from the Global Burden of Disease Study 2019. The Medical Expenditure Panel Survey was used to estimate healthcare expenditures and productivity loss and to investigate patterns of payment and use of healthcare resources in the United States. A multivariable logistic regression model was conducted to identify key factors influencing expenditures. RESULTS: For patients aged 50 and older, the burden for all age groups showed a modest increase over the 6-year period. Annual medical expenditures were estimated to range from US$24.8 billion to US$39.2 billion from 2014 to 2019. The annual loss in productivity for patients was approximately US$1,200. The top 3 major components of medical costs were hospital inpatient stays, prescription medicines, and office-based visits. Medicare was the largest source of payments for survivors. In terms of drug consumption, genitourinary tract agents (57.0%) and antineoplastics (18.6%) were the main therapeutic drugs. High medical expenditures were positively associated with age (p=0.005), having private health insurance (p=0.016), more comorbidities, not currently smoking (p=0.001), and patient self-perception of fair/poor health status (p<0.001). CONCLUSIONS From 2014 to 2019, the national real-world data of PC revealed that the disease burden in the United States continued to increase, which was partly related to patient characteristics.

Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.

As the first marketed epidermal growth factor receptor tyrosine kinase inhibitor, gefitinib plays an important role in the targeted therapy of malignant tumors such as non-small cell lung cancer, but this drug can cause serious adverse effects such as liver toxicity. If the reaction occurs, the drug must be stopped for liver protection treatment, which greatly affects the treatment process of cancer. However, the mechanism of gefitinib-induced hepatotoxicity is still unclear, and clinical treatment measures are very limited. This article aims to review the molecular mechanism of gefitinib-induced hepatotoxicity and the commonly used clinical therapeutic drugs, so as to provide scientific basis for clinical prevention and rational drug use.

Objective:To study the correlation between third lumbar skeletal muscle index(LSMI) and inflammatory factors and other factors in peripheral blood in gastric cancer patients.Methods:From October 2017 to December 2019, patients with gastric cancer admitted to West China Hospital Sichuan University were included. The LSMI of patients was obtained by dividing the area of skeletal muscle at the third lumbar vertebra level by the square of the height based on preoperative abdominal imaging data. The correlation between preoperative LSMI and inflammatory factors and other factors in peripheral blood were analyzed by person correlation analysis.Results:This study included 132 patients with gastric cancer. Among them, 39 were classified as stage Ⅰ, 36 were stage Ⅱ, and 57 were stage Ⅲ, respectively. Pearson correlation analysis suggested that the LSMI of gastric cancer patients was positively correlated with peripheral red blood cell count( P<0.01), hemoglobin( P<0.01), and prealbumin( P<0.01), and negatively correlated with interleukin-6(IL-6, P=0.027) and C-reactive protein(CRP, P= 0.014). Conclusion:Our study suggested that LSMI can be used as a nutritional index in gastric cancer patients and IL-6 and CRP played an important in the occurrence and development of sarcopenia in gastric cancer patients.

COVID-19 ; Coronavirus Nucleocapsid Proteins ; Humans ; Nucleocapsid Proteins ; Phosphoproteins ; SARS-CoV-2