ObjectiveThis paper aims to explore the risk factors for chronic atrophic gastritis （CAG） with turbidity toxin accumulation syndrome and establish a prediction model. MethodsClinical data of 180 patients with CAG who participated in the "clinical study of Xianglian Huazhuo Particles blocking CAG cancer transformation" of Hebei Sheng Zhong Yi Yuan from July 2021 to March 2022 were collected. After confounding factors were controlled by propensity score matching， patients were divided into a training set （namely dev） and a validation set （namely vad） in a seven to three ratio. The risk factors for CAG with turbidity toxin accumulation syndrome in the training set were investigated by using univariate Logistic regression analysis and least absolute shrinkage and selection operator （namely Lasso） regression algorithms. Subsequently， a model， named model 1se， was developed by using the training set data to predict the risk factors for CAG with turbidity toxin accumulation syndrome. The accuracy of the prediction model was assessed by using various methods， including the receiver operating characteristic （ROC） curve， Hosmer-Lemeshow test （H-L）， calibration plot， and decision curve analysis （DCA）. ResultsAge， body mass index （BMI）， family history of cancer， job and life satisfaction， yellow and greasy fur with slippery pulse， and heavy body sensation were independent risk factors of the model. The prediction model showed excellent predictive value for both the training and validation sets. ConclusionThe established prediction model for CAG with turbidity toxin accumulation syndrome has high discrimination and excellent calibration， which could provide an excellent clinical basis for disease diagnosis and individualized treatment of patients.

ObjectiveThis paper aims to explore the risk factors for chronic atrophic gastritis （CAG） with turbidity toxin accumulation syndrome and establish a prediction model. MethodsClinical data of 180 patients with CAG who participated in the "clinical study of Xianglian Huazhuo Particles blocking CAG cancer transformation" of Hebei Sheng Zhong Yi Yuan from July 2021 to March 2022 were collected. After confounding factors were controlled by propensity score matching， patients were divided into a training set （namely dev） and a validation set （namely vad） in a seven to three ratio. The risk factors for CAG with turbidity toxin accumulation syndrome in the training set were investigated by using univariate Logistic regression analysis and least absolute shrinkage and selection operator （namely Lasso） regression algorithms. Subsequently， a model， named model 1se， was developed by using the training set data to predict the risk factors for CAG with turbidity toxin accumulation syndrome. The accuracy of the prediction model was assessed by using various methods， including the receiver operating characteristic （ROC） curve， Hosmer-Lemeshow test （H-L）， calibration plot， and decision curve analysis （DCA）. ResultsAge， body mass index （BMI）， family history of cancer， job and life satisfaction， yellow and greasy fur with slippery pulse， and heavy body sensation were independent risk factors of the model. The prediction model showed excellent predictive value for both the training and validation sets. ConclusionThe established prediction model for CAG with turbidity toxin accumulation syndrome has high discrimination and excellent calibration， which could provide an excellent clinical basis for disease diagnosis and individualized treatment of patients.

Sleep disorders are a serious global health problem influenced by neuropsychiatric disorders, diseases, environment, diet, and other factors. Recent studies have revealed that gut microbes (GM) are closely associated with sleep. Their metabolites regulate circadian rhythms, neurotransmitter systems, and other physiological processes through the gut-brain axis, influencing brain homeostasis and contributing to the pathogenesis of insomnia. Suanzaoren decoction (SZRD) is a classic and well-known traditional Chinese medicine (TCM) prescription for the treatment of insomnia. Modern pharmacological research indicates that SZRD can maintain intestinal microbial homeostasis, regulate microbial metabolites, and safeguard the intestinal immune barrier. This review elucidates the pathophysiological interplay between sleep disorders and GM and summarizes the progress of research on SZRD in treating insomnia via the “microbes-gut-brain axis” by regulating intestinal microecology. It is expected to broaden the clinical application of TCM in insomnia treatment and provide a theoretical foundation for pharmacological innovation of classic TCM prescriptions.

ObjectiveTo investigate the mechanism by which Xianglian Huazhuo prescription （XLHZ） ameliorates chronic atrophic gastritis （CAG） through regulating glycolysis via the microRNA-34b-5p （miR-34b-5p）/6-phosphofructo-2-kinase/fructose-2，6-bisphosphatase 1 （PFKFB1） signaling pathway. MethodsBioinformatic screening was performed to identify the target genes of miR-34b-5p. In the animal experiments， a mouse model of CAG was established through a combination of N-methyl-N′-nitro-N-nitrosoguanidine （MNNG）， ranitidine， and irregular feeding. The mice were randomized into the following groups： normal， model， Morodan group （2 g·kg^-1）， and high-， medium-， and low-dose XLHZ groups（7.2，3.8，1.9 g·kg^-1）. In the cell experiments， GES-1 cells were treated with MNNG for the modeling of CAG and grouped as follows： GES-1， MNNG+GES-1， MNNG+GES-1+XLHZ（10%）， MNNG+GES-1+miR-34b-5p mimics， MNNG+GES-1+miR-34b-5p inhibitor， MNNG+GES-1+PFKFB1 inhibitor， and MNNG+GES-1+PFKFB1 mimics+XLHZ（10%）. The general conditions of mice were observed. Real-time PCR was adopted to measure the expression levels of miRNA-34b-5p and PFKFB1 mRNA in the gastric mucosa of mice in each group. Dual luciferase reporter gene was used to verify the targeting interaction between miR-34b-5p and PFKFB1 in GES-1 cells exposed to MNNG. The cell-counting kit-8 （CCK-8） was used to screen the drug-containing serum concentration. Real-time PCR was employed to verify the transfection efficiency. Fluorescent probes were used to detect the expression and nuclear translocation of hypoxia-inducible factor-1α （HIF-1α） in each group of cells. The protein levels of HIF-1α， hexokinase 2 （HK2）， PFKFB1， phosphofructokinase 1 （PFK1）， and lactate dehydrogenase （LDHA） in the gastric mucosa of mice were determined by Western blot. The levels of glucose consumption and lactate in the serum and cells were measured by biochemical methods. Enzyme-linked immunosorbent assay （ELISA） was adopted to measure the content of adenosine triphosphate （ATP） in the gastric mucosa tissue and cells. ResultsThe animal experiments showed that compared with the normal group， the model group exhibited symptoms including mental fatigue， lethargy， sparse and dull fur， a tendency to curl up， sluggish responses， reduced food and water intake， and slow body weight gain. In addition， the model group showed decreased expression of miRNA-34b-5p （P<0.01）， increased mRNA level of PFKFB1 （P<0.01）， upregulated protein levels of HIF-1α， HK2， PFKFB1， PFK1， and LDHA （P<0.01）， and increased glucose consumption， lactate content， and ATP content （P<0.01）. Compared with the model group， the XLHZ group and Morodan group showed improved mental state， gradually improved fur， increased activity， food and water intake， and body weight. HE showed that each treatment group exhibited well arranged and increased gastric mucosal glands， reduced inflammatory cells， and recovered gastric pits. Transmission electron microscopy showed that the size of mitochondria in each treatment group returned to normal， with no obvious irregular shape， complete and clear cristae， and uniform matrix. Furthermore， each treatment group showed increased expression of miRNA-34b-5p （P<0.05）， reduced mRNA level of PFKFB1 （P<0.05）， downregulated protein levels of HIF-1α， HK2， PFKFB1， PFK1， and LDHA （P<0.05）， and decreased glucose consumption， lactic acid， and ATP （P<0.05）. The cell experiments showed that the expression and nuclear translocation of HIF-1α were reduced in all groups after treatment （P<0.05）. The cell transfection efficiency was satisfactory （P<0.05）. miR-34b-5p exhibited an effect comparable to that of XLHZ， effectively inhibiting glycolysis， whereas PFKFB1 promoted glycolysis and reversed the protective effect of XLHZ in CAG mice （P<0.05）. ConclusionXLHZ could regulate the miR-34b-5p/PFKFB1 axis to inhibit glycolysis， thereby ameliorating MNNG-induced gastric mucosal atrophy.

ObjectiveTo investigate the mechanism by which Xianglian Huazhuo prescription （XLHZ） ameliorates chronic atrophic gastritis （CAG） through regulating glycolysis via the microRNA-34b-5p （miR-34b-5p）/6-phosphofructo-2-kinase/fructose-2，6-bisphosphatase 1 （PFKFB1） signaling pathway. MethodsBioinformatic screening was performed to identify the target genes of miR-34b-5p. In the animal experiments， a mouse model of CAG was established through a combination of N-methyl-N′-nitro-N-nitrosoguanidine （MNNG）， ranitidine， and irregular feeding. The mice were randomized into the following groups： normal， model， Morodan group （2 g·kg^-1）， and high-， medium-， and low-dose XLHZ groups（7.2，3.8，1.9 g·kg^-1）. In the cell experiments， GES-1 cells were treated with MNNG for the modeling of CAG and grouped as follows： GES-1， MNNG+GES-1， MNNG+GES-1+XLHZ（10%）， MNNG+GES-1+miR-34b-5p mimics， MNNG+GES-1+miR-34b-5p inhibitor， MNNG+GES-1+PFKFB1 inhibitor， and MNNG+GES-1+PFKFB1 mimics+XLHZ（10%）. The general conditions of mice were observed. Real-time PCR was adopted to measure the expression levels of miRNA-34b-5p and PFKFB1 mRNA in the gastric mucosa of mice in each group. Dual luciferase reporter gene was used to verify the targeting interaction between miR-34b-5p and PFKFB1 in GES-1 cells exposed to MNNG. The cell-counting kit-8 （CCK-8） was used to screen the drug-containing serum concentration. Real-time PCR was employed to verify the transfection efficiency. Fluorescent probes were used to detect the expression and nuclear translocation of hypoxia-inducible factor-1α （HIF-1α） in each group of cells. The protein levels of HIF-1α， hexokinase 2 （HK2）， PFKFB1， phosphofructokinase 1 （PFK1）， and lactate dehydrogenase （LDHA） in the gastric mucosa of mice were determined by Western blot. The levels of glucose consumption and lactate in the serum and cells were measured by biochemical methods. Enzyme-linked immunosorbent assay （ELISA） was adopted to measure the content of adenosine triphosphate （ATP） in the gastric mucosa tissue and cells. ResultsThe animal experiments showed that compared with the normal group， the model group exhibited symptoms including mental fatigue， lethargy， sparse and dull fur， a tendency to curl up， sluggish responses， reduced food and water intake， and slow body weight gain. In addition， the model group showed decreased expression of miRNA-34b-5p （P<0.01）， increased mRNA level of PFKFB1 （P<0.01）， upregulated protein levels of HIF-1α， HK2， PFKFB1， PFK1， and LDHA （P<0.01）， and increased glucose consumption， lactate content， and ATP content （P<0.01）. Compared with the model group， the XLHZ group and Morodan group showed improved mental state， gradually improved fur， increased activity， food and water intake， and body weight. HE showed that each treatment group exhibited well arranged and increased gastric mucosal glands， reduced inflammatory cells， and recovered gastric pits. Transmission electron microscopy showed that the size of mitochondria in each treatment group returned to normal， with no obvious irregular shape， complete and clear cristae， and uniform matrix. Furthermore， each treatment group showed increased expression of miRNA-34b-5p （P<0.05）， reduced mRNA level of PFKFB1 （P<0.05）， downregulated protein levels of HIF-1α， HK2， PFKFB1， PFK1， and LDHA （P<0.05）， and decreased glucose consumption， lactic acid， and ATP （P<0.05）. The cell experiments showed that the expression and nuclear translocation of HIF-1α were reduced in all groups after treatment （P<0.05）. The cell transfection efficiency was satisfactory （P<0.05）. miR-34b-5p exhibited an effect comparable to that of XLHZ， effectively inhibiting glycolysis， whereas PFKFB1 promoted glycolysis and reversed the protective effect of XLHZ in CAG mice （P<0.05）. ConclusionXLHZ could regulate the miR-34b-5p/PFKFB1 axis to inhibit glycolysis， thereby ameliorating MNNG-induced gastric mucosal atrophy.

Objective:To investigate the efficacy of low-methoxyl pectin (LMP) combined with early enteral nutrition (EEN) in patients with severe acute pancreatitis (SAP) complicated by acute kidney injury (AKI).Methods:A prospective study was conducted, enrolling 85 patients with SAP complicated by AKI admitted to the First Hospital of Qinhuangdao from January 2022 to December 2023. These patients were randomized into an LMP group ( n=42) and a control group ( n=43) using a random number table. The control group received traditional EEN, while the LMP group received traditional EEN combined with LMP. Nutritional indicators [total protein (TP), albumin (Alb), and prealbumin (PA)], inflammatory markers [C-reactive protein (CRP), interleukin (IL)-1, IL-6, IL-8, and tumor necrosis factor-α (TNF-α)], renal function indicators [creatinine (Cr), estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), uric acid (UA)], AKI stage, and fecal intestinal flora were compared between these two groups before and 7 days after intervention. Results:After 7 days of intervention, the TP, Alb, and PA levels significantly increased in both groups (all P<0.05); the increases in TP and PA were more significant in the LMP group (both P<0.05), whereas the increase in Alb did not differ significantly between groups ( P>0.05). The levels of CRP, IL-1, IL-6, IL-8, and TNF-α decreased significantly in both groups (all P<0.05),with more significant reductions in the LMP group (all P<0.001). The levels of Cr, eGFR, BUN, and UA improved significantly in both groups (all P<0.05),with more significant improvements in the LMP group (all P<0.05). The incidence of a higher AKI stage in the LMP group was significantly lower than that in the control group( P<0.05), and the incidence of a lower AKI stage was significantly higher than that in the control group ( P<0.001). The fecal counts of Bifidobacterium and Lactobacillus increased significantly while the fecal counts of Enterococcus and Enterobacter decreased significantly in both group (all P<0.001); notably, these changes in bacterial counts were significantly more pronounced in the LMP group ( P<0.001). Conclusions:EEN combined with LMP can significantly enhance nutritional status, reduce inflammatory response, and improve renal function in patients with SAP complicated by AKI.

Objective To analyze the reverse mechano-electric effect of the layered structure of articular cartilage and its influencing factors.Methods The cartilage samples were classified according to their physiological thickness(approximately 0.4 mm for the upper layer,1 mm for the middle layer,and 0.6 mm for the lower layer).Through a non-contact external electric field testing method,how different influencing factors affected the reverse mechano-electric effect of articular cartilage was analyzed.Results When the electric field spacing decreased,water content increased,and in vitro time decreased,the displacement of normal layered cartilage in a non-contact electric field increased by 18,10,15 μm,respectively.In the case of simulated arthritis defects,as the defect depth and radius increased,the overall deviation deflection of articular cartilage gradually decreased by about 7 μm.Conclusions The three-layer cartilage differed in their reverse mechano-electricity effects,showing the greatest deflection in the middle layer at 90％water content,under 7 mm electric field spacing,and after 12 hours ex vivo.

Objective:To investigate the efficacy of low-methoxyl pectin (LMP) combined with early enteral nutrition (EEN) in patients with severe acute pancreatitis (SAP) complicated by acute kidney injury (AKI).Methods:A prospective study was conducted, enrolling 85 patients with SAP complicated by AKI admitted to the First Hospital of Qinhuangdao from January 2022 to December 2023. These patients were randomized into an LMP group ( n=42) and a control group ( n=43) using a random number table. The control group received traditional EEN, while the LMP group received traditional EEN combined with LMP. Nutritional indicators [total protein (TP), albumin (Alb), and prealbumin (PA)], inflammatory markers [C-reactive protein (CRP), interleukin (IL)-1, IL-6, IL-8, and tumor necrosis factor-α (TNF-α)], renal function indicators [creatinine (Cr), estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), uric acid (UA)], AKI stage, and fecal intestinal flora were compared between these two groups before and 7 days after intervention. Results:After 7 days of intervention, the TP, Alb, and PA levels significantly increased in both groups (all P<0.05); the increases in TP and PA were more significant in the LMP group (both P<0.05), whereas the increase in Alb did not differ significantly between groups ( P>0.05). The levels of CRP, IL-1, IL-6, IL-8, and TNF-α decreased significantly in both groups (all P<0.05),with more significant reductions in the LMP group (all P<0.001). The levels of Cr, eGFR, BUN, and UA improved significantly in both groups (all P<0.05),with more significant improvements in the LMP group (all P<0.05). The incidence of a higher AKI stage in the LMP group was significantly lower than that in the control group( P<0.05), and the incidence of a lower AKI stage was significantly higher than that in the control group ( P<0.001). The fecal counts of Bifidobacterium and Lactobacillus increased significantly while the fecal counts of Enterococcus and Enterobacter decreased significantly in both group (all P<0.001); notably, these changes in bacterial counts were significantly more pronounced in the LMP group ( P<0.001). Conclusions:EEN combined with LMP can significantly enhance nutritional status, reduce inflammatory response, and improve renal function in patients with SAP complicated by AKI.

Objective To analyze the reverse mechano-electric effect of the layered structure of articular cartilage and its influencing factors.Methods The cartilage samples were classified according to their physiological thickness(approximately 0.4 mm for the upper layer,1 mm for the middle layer,and 0.6 mm for the lower layer).Through a non-contact external electric field testing method,how different influencing factors affected the reverse mechano-electric effect of articular cartilage was analyzed.Results When the electric field spacing decreased,water content increased,and in vitro time decreased,the displacement of normal layered cartilage in a non-contact electric field increased by 18,10,15 μm,respectively.In the case of simulated arthritis defects,as the defect depth and radius increased,the overall deviation deflection of articular cartilage gradually decreased by about 7 μm.Conclusions The three-layer cartilage differed in their reverse mechano-electricity effects,showing the greatest deflection in the middle layer at 90％water content,under 7 mm electric field spacing,and after 12 hours ex vivo.

OBJECTIVE To investigate the distribution,drug resistance and molecular characteristics of the Staph-ylococcus aureus strains isolated from intensive care unit(ICU)environment in some hospitals of Shanghai Pudong New Area so as to provide bases for prevention and control of infections.METHODS The specimens were collected from ICU environment of 8 medical institutions in Pudong District in 2019 and 2023,the S.aureus strains were i-solated and identified.The drug susceptibility testing was performed by microbroth dilution method.The drug re-sistance genes and virulence genes were predicted based on virulence factors of bacterial pathogens,the compre-hensive antibiotic resistance database(mcmaster.ca)and PubMLST,multilocus sequence typing(MLST)and phylogenetic analysis were performed.RESULTS Totally 3408 samples were collected,and the isolated S.aureus strains accounted for 1.29％(44/3408);the isolated strains form both the shared articles and the articles that health care workers directly contact accounted for 20.45％.The drug resistance rate to penicillin was highest(72.73％,32/44);the strains were completely susceptible to vancomycin,rifampicin,sulfamethoxazole-trime-thoprim,daptomycin and nitrofurantoin.The methicillin-resistant Staphylococcus aureus(MRSA)strains accoun-ted for 25.00％.The multi-drug resistance rate was 40.91％.The strains carried 26 types of drug resistance genes in total,covering 9 categories;the carrying rate of fluroquinolones resistance gene nor A was 100.00％.The strains carried 12 types of enterotoxin genes,the carrying rate of sea gene was highest(50.00％,22/44),some of the strains carried lukS-PV,lukF-PV and tsst gene.There were 14 types of sequence type(ST),dominated by ST7(13/44,29.55％),and novel ST type ST9342 was discovered.The phylogenetic analysis showed that all of the strains were divided into 2 major branches,and the strains with the same ST type were phylogenetically close on the evolutionary tree.CONCLUSIONS The S.aureus strains are prevalent in ICU environment and are highly re-sistant to antibiotics.The strains exhibit various ST types,which,to a certain degree,is associated with the path-ogenicity.