Objective:To compare clinical features, esophageal motility, and reflux characteristics in elderly patients with gastroesophageal reflux disease(GERD)with and without extraesophageal symptoms.Methods:This study was conducted as a cross-sectional analysis involving 75 patients aged 60 years and older, who visited the outpatient department of gastroenterology at China-Japan Friendship Hospital between January and December 2023.Among these, 43 patients exhibited extraesophageal symptoms [23 males, 20 females; median age 69(66, 75)], while 32 patients did not present with such symptoms [12 males, 20 females; median age 69(66, 73.75)].We collected data regarding the patients' demographic characteristics, lifestyle habits, and comorbidities via a questionnaire, and analyzed the range of extraesophageal symptoms.The presence of reflux esophagitis was assessed according to the Los Angeles classification, and the status of the gastroesophageal valve was evaluated through gastroscopy.Additionally, we measured esophageal motility and reflux characteristics using high-resolution manometry and 24-hour pH-impedance monitoring.Results:The smoking rate was significantly higher in patients with extraesophageal symptoms compared to those without extraesophageal symptoms[39.53%(17/43) vs.15.63%(5/32), P=0.039].Conversely, the prevalence of hypertension was significantly higher in patients without extraesophageal symptoms compared to those with extraesophageal symptoms[41.86%(18/43) vs.65.63%(21/32), χ2=4.151, P=0.042].Among patients with extraesophageal symptoms, the proportion experiencing pharyngeal symptoms was the highest at 83.72% (36/43), followed by oral symptoms at 32.56%(14/43), while the lowest proportion was for respiratory symptoms at 16.28%(7/43).The esophageal body peristaltic contraction rate was significantly higher in patients without extraesophageal symptoms compared to those with extraesophageal symptoms[100%(100%, 100%) vs.100%(80%, 100%), Z=-2.671, P=0.008].The number of non-acid reflux episodes was significantly higher in patients with extraesophageal symptoms compared to those without[5.00(1.00, 5.00) vs.1.00(1.00, 2.00), Z=-3.842, P<0.001].Additionally, the proportion of proximal reflux was significantly higher in patients with extraesophageal symptoms compared to those without[83.8%(65.6%, 95.4%) vs.68.5%(59.8%, 77.35%), Z=-2.037, P=0.042]. Conclusions:Patients with GERD and extraesophageal symptoms exhibit a higher prevalence of smoking, diminished peristaltic function in the esophageal body, an increased incidence of proximal esophageal reflux, and a greater number of non-acid reflux episodes.

Mesenchymal stem cells (MSCs) have been widely used in the treatment of various autoimmune and inflammation-related diseases due to their potent immunomodulatory properties. Several studies have demonstrated that MSC-mediated immunomodulation is complex and bidirectional, with the in vivo microenvironment influencing the direction of this modulation. Indoleamine-2,3-dioxygenase (IDO), an immunosuppressive factor, has been identified as a key "switch" in the immunomodulatory role of MSCs. In this review, we explore how IDO functions as a critical regulator of MSC immunoregulatory plasticity. We delve into the mechanisms by which changes in IDO expression affect the function of various immune cells, summarize relevant research and clinical advances regarding the role of IDO expression in MSC-based therapies for various diseases, and discuss potential therapeutic strategies that target IDO to enhance the stability of MSC therapeutic effects. This provides a theoretical foundation for optimizing MSCs as safer and more effective clinical therapeutic agents.

Objective To establish a mouse model of H1N1 influenza wind-heat syndrome by combining climate intervention with influenza virus nasal drops.Methods Seventy-two BALB/c mice were divided randomly into nine groups:a Control group,wind-heat(FR)groups(FR-3Day,FR-5Day),and Model groups(1LD-3Day,2LD-3Day,3LD-3Day,1LD-5Day,2LD-5Day,2LD-5Day,3LD-5Day)(n=8 mice per group).Mice in the Control group were housed in a normal environment,while mice in the FR and Model groups were kept in wind-heat conditions for 7 d.Mice in the Model groups received nasal PR8 influenza virus infection on the 8th day,and mice in the Control and FR heat groups received equal amounts of physiological saline nasal drops.After virus challenge,each group was housed in a normal environment and samples were taken on days 3 and 5.The appearance of the mice was observed and recorded and the lung index,routine blood parameters,lung tissue pathology,serum interleukin(IL)-6 levels,and virus titers were detected in each group based on their behavioral status,stools,and body temperature.Results After 7 d of wind-heat intervention,mice in the FR groups showed no significant abnormalities in terms of appearance,stools,body temperature,routine blood parameters,or lung tissue pathology compared with the Control group.The appearance,lung index,red blood cell count,hemoglobin,hematocrit,pathological result,and body temperature in the Model groups worsened progressively with increasing time and toxin dosage,while the neutrophil percentage,lymphocyte percentage,virus titer,and serum IL-6 levels peaked on day 3 after viral attack,for the same viral dose,and then decreased slightly on day 5.Conclusions PR8 nasal drops and 7 d of wind-heat climate intervention can be used to establish a mouse model of influenza wind-heat syndrome.

Objective To establish a mouse model of H1N1 influenza wind-heat syndrome by combining climate intervention with influenza virus nasal drops.Methods Seventy-two BALB/c mice were divided randomly into nine groups:a Control group,wind-heat(FR)groups(FR-3Day,FR-5Day),and Model groups(1LD-3Day,2LD-3Day,3LD-3Day,1LD-5Day,2LD-5Day,2LD-5Day,3LD-5Day)(n=8 mice per group).Mice in the Control group were housed in a normal environment,while mice in the FR and Model groups were kept in wind-heat conditions for 7 d.Mice in the Model groups received nasal PR8 influenza virus infection on the 8th day,and mice in the Control and FR heat groups received equal amounts of physiological saline nasal drops.After virus challenge,each group was housed in a normal environment and samples were taken on days 3 and 5.The appearance of the mice was observed and recorded and the lung index,routine blood parameters,lung tissue pathology,serum interleukin(IL)-6 levels,and virus titers were detected in each group based on their behavioral status,stools,and body temperature.Results After 7 d of wind-heat intervention,mice in the FR groups showed no significant abnormalities in terms of appearance,stools,body temperature,routine blood parameters,or lung tissue pathology compared with the Control group.The appearance,lung index,red blood cell count,hemoglobin,hematocrit,pathological result,and body temperature in the Model groups worsened progressively with increasing time and toxin dosage,while the neutrophil percentage,lymphocyte percentage,virus titer,and serum IL-6 levels peaked on day 3 after viral attack,for the same viral dose,and then decreased slightly on day 5.Conclusions PR8 nasal drops and 7 d of wind-heat climate intervention can be used to establish a mouse model of influenza wind-heat syndrome.

Objective:To compare clinical features, esophageal motility, and reflux characteristics in elderly patients with gastroesophageal reflux disease(GERD)with and without extraesophageal symptoms.Methods:This study was conducted as a cross-sectional analysis involving 75 patients aged 60 years and older, who visited the outpatient department of gastroenterology at China-Japan Friendship Hospital between January and December 2023.Among these, 43 patients exhibited extraesophageal symptoms [23 males, 20 females; median age 69(66, 75)], while 32 patients did not present with such symptoms [12 males, 20 females; median age 69(66, 73.75)].We collected data regarding the patients' demographic characteristics, lifestyle habits, and comorbidities via a questionnaire, and analyzed the range of extraesophageal symptoms.The presence of reflux esophagitis was assessed according to the Los Angeles classification, and the status of the gastroesophageal valve was evaluated through gastroscopy.Additionally, we measured esophageal motility and reflux characteristics using high-resolution manometry and 24-hour pH-impedance monitoring.Results:The smoking rate was significantly higher in patients with extraesophageal symptoms compared to those without extraesophageal symptoms[39.53%(17/43) vs.15.63%(5/32), P=0.039].Conversely, the prevalence of hypertension was significantly higher in patients without extraesophageal symptoms compared to those with extraesophageal symptoms[41.86%(18/43) vs.65.63%(21/32), χ2=4.151, P=0.042].Among patients with extraesophageal symptoms, the proportion experiencing pharyngeal symptoms was the highest at 83.72% (36/43), followed by oral symptoms at 32.56%(14/43), while the lowest proportion was for respiratory symptoms at 16.28%(7/43).The esophageal body peristaltic contraction rate was significantly higher in patients without extraesophageal symptoms compared to those with extraesophageal symptoms[100%(100%, 100%) vs.100%(80%, 100%), Z=-2.671, P=0.008].The number of non-acid reflux episodes was significantly higher in patients with extraesophageal symptoms compared to those without[5.00(1.00, 5.00) vs.1.00(1.00, 2.00), Z=-3.842, P<0.001].Additionally, the proportion of proximal reflux was significantly higher in patients with extraesophageal symptoms compared to those without[83.8%(65.6%, 95.4%) vs.68.5%(59.8%, 77.35%), Z=-2.037, P=0.042]. Conclusions:Patients with GERD and extraesophageal symptoms exhibit a higher prevalence of smoking, diminished peristaltic function in the esophageal body, an increased incidence of proximal esophageal reflux, and a greater number of non-acid reflux episodes.

Objective To analyze the epidemiological patterns and pathogens of clusters of diarrhea in Xicheng Distract , Beijing during 2017-2022 , in order to update the policy of prevention. Mehods Between January 2017 and December 2022, stool samples of patients and partly cooks in clusters of diarrhea were collected and tested by Real-time PCR for Rotavirus, Norovirus, Adenovirus, Sapovirus and Astrovirus. Part of ORF1/ORF2 from Norovirus positive samples were amplified using RT-PCR. PCR products were sequenced and the genetypes were determined. Results Four hundreds and one clusters of diarrheas were reported. Among them , 369 were reported in kindergartens, primary schools and secondary schools. The morbidities were 4.14, 2.13 and 0.69 per thousand, respectively. Seventy four cooks in 15 clusters of diarrhea were Norovirus positive. The rate was 8.67%. Among these pathogens, Norovirus had the largest proportion , but the trend was declining. At least three kinds of genetype of GⅡ Norovirus were detected every year. Conclusion Clusters of diarrhea mainly occurred in kindergartens, primary schools and secondary schools. Result from the increasing proportions of unknown-cause clusters of diarrhea, the testing methods and scopes of pathogens should be extended. Diverse genetypes of Norovirus coexist and alternate in Beijing. So appearance of new genetypes and recombination of existed ones of Norovirus should be closely concerned.

Attention deficit hyperactivity disorder （ADHD）， also known as hyperactivity disorder in children， is a behavioral disorder commonly found in children， particularly preschool-aged children. This disorder can lead to cognitive impairment， learning difficulties， conduct disorders， and other mental health issues， severely impacting the quality of life for affected children. Moreover， the global prevalence of ADHD continues to rise. Establishing an animal model that closely aligns with clinical symptoms and the pathogenesis of the disease is crucial for advancing research on the prevention and treatment of ADHD. In recent years， research on animal models of ADHD has rapidly developed. Researchers have developed nearly 20 animal models from genetic and environmental perspectives. However， most of these models are still in the exploratory stage， and there is insufficient research to thoroughly investigate their pathogenesis， core characteristics， and drug effects. The spontaneously hypertensive rat （SHR） is currently the most commonly used animal model for ADHD because of its excellent face validity and developmental stage that better corresponds to childhood. In addition， dopamine transporter （DAT） knockout mice， LPHN3 knockout rats， and neonatal rat hypoxia models have also shown good face validity. Some researchers have injected SHRs with daily doses of levothyroxine sodium， which not only induces typical ADHD symptoms in the rats but also exhibits signs of Yin deficiency and Yang hyperactivity， which successfully simulates the Yin deficiency and Yang hyperactivity syndrome type of ADHD， providing a new approach for constructing and evaluating ADHD animal models that combine both traditional Chinese and western medicine. This article reviewed ADHD animal models reported in China and abroad over the past decade， summarized rodent models of ADHD into three major categories： genetic models， chemically induced models， and environmentally induced models， and analyzed each category to provide a reference for selecting and exploring appropriate models for experimental ADHD research.

Objective:To investigate the clinical and gene variant characteristics of PCDH19 gene related epilepsy, and improve the ability of clinicians in early disease identification. Methods:The clinical data of 3 PCDH19 gene related epilepsy patients admitted to Children′s Hospital Affiliated to Zhengzhou University from October 2018 to August 2023 diagnosed by gene detection were reviewed and analyzed. Results:All the patients are female, and the onset age of seizure ranged in their infancy. Seizures in clusters and fever sensitivity were observed in all patients, and were very hard to control by single-drug treatment. Proband 1 was seizure-free after 2 kinds of anti-epileptic drug treatment, but with mild degree of intellectual disability. Proband 2 had refractory epilepsy with severe degree of intellectual disability. Proband 3 was seizure-free after 2 kinds of anti-epileptic drug treatment and without intellectual disability. In the first family, the proband carried heterozygous c.369C>G variant in the PCDH19 gene which was identified as de novo after parental validation. In the second family, the proband carried c.1652T>A variant inherited from her mother. In the third family, the proband carried c.278G>A variant inherited from her father. The 3 mutations had not been reported in the Human Gene Mutation Database. Conclusions:PCDH19 gene related epilepsy is one special kind of X-linked inherited epilepsy syndrome characterized by seizures in clusters and sensitivity to fever. And gene detection can help with early diagnosis and make rational clinical strategies in time. The variants c.369C>G, c.1652T>A and c.278G>A have enriched the gene variant spectrum of PCDH19.

Attention deficit hyperactivity disorder(ADHD),also known as childhood hyperactivity disorder,is a very common clinical disorder in children,which seriously affects their physical and mental health.Animal models conforming to the clinical diseases of Chinese and Western medicine are the basis for in-depth research on the pathogenesis and prevention and treatment of ADHD.Taking"Attention Deficit Hyperactivity Disorder"as the theme,this paper summarizes the modeling methods and model features of ADHD animal models in CNKI,Wanfang,Wipu,and pubmed databases in the past 20 years,evaluates their strengths and weaknesses,and analyzes the extent to which the models are in agreement with the clinical diseases of Chinese and Western medicine.The results show that there are many existing animal models of ADHD,which can be mainly divided into three kinds:spontaneous model,induced model and gene model,among which the SHR rat model has become a popular and ideal animal model because of its good surface validity,moderate price and other advantages.Currently,animal models of ADHD are dominated by disease models of Western medicine,and models that meet the characteristics of Chinese medicine clinical conditions are rare,with insufficient reflection of Chinese medicine evidence.Therefore,it is suggested that the subsequent construction of animal models of ADHD should consider adding the relevant pathogenic factors and indexes of different certificates of Chinese medicine,such as the animal's tongue,mental state,water intake and heart rate,etc.,with the aim of constructing an animal model that is more close to the clinic.

Attention deficit hyperactivity disorder(ADHD),also known as childhood hyperactivity disorder,is a very common clinical disorder in children,which seriously affects their physical and mental health.Animal models conforming to the clinical diseases of Chinese and Western medicine are the basis for in-depth research on the pathogenesis and prevention and treatment of ADHD.Taking"Attention Deficit Hyperactivity Disorder"as the theme,this paper summarizes the modeling methods and model features of ADHD animal models in CNKI,Wanfang,Wipu,and pubmed databases in the past 20 years,evaluates their strengths and weaknesses,and analyzes the extent to which the models are in agreement with the clinical diseases of Chinese and Western medicine.The results show that there are many existing animal models of ADHD,which can be mainly divided into three kinds:spontaneous model,induced model and gene model,among which the SHR rat model has become a popular and ideal animal model because of its good surface validity,moderate price and other advantages.Currently,animal models of ADHD are dominated by disease models of Western medicine,and models that meet the characteristics of Chinese medicine clinical conditions are rare,with insufficient reflection of Chinese medicine evidence.Therefore,it is suggested that the subsequent construction of animal models of ADHD should consider adding the relevant pathogenic factors and indexes of different certificates of Chinese medicine,such as the animal's tongue,mental state,water intake and heart rate,etc.,with the aim of constructing an animal model that is more close to the clinic.