Portal vein thrombosis (PVT) is one of the most common complications of liver cirrhosis. The formation of PVT can increase the mortality rate of cirrhotic patients and adversely affect the successful implementation and prognosis of liver transplantation. A hypercoagulable state is a unique mechanism underlying PVT formation in cirrhotic patients. In recent years, the pathogenesis of PVT has gradually been elucidated, with specific mechanisms including the following aspects: systemic and local inflammatory responses lead to vascular endothelial cell dysfunction, thereby promoting the activation of the coagulation system; abnormal activation of the monocyte-macrophage system exacerbates local inflammation, enhancing platelet adhesion and aggregation, and facilitating thrombus formation; an imbalance between the coagulation and fibrinolytic systems results in a sustained hypercoagulable state; and intestinal microbiota dysbiosis induces inflammation and metabolic disturbances, thereby increasing the risk of PVT. This article summarizes the latest research progress on these key mechanisms and their interactions, providing new insights into the molecular and cellular mechanisms of PVT. It also offers directions for the early diagnosis of PVT and the exploration of novel intervention strategies in the future.

Objective:To investigate the correlation between long-term statin use and Helicobacter pylori( Hp)infection in the elderly, and to compare the effects of rosuvastatin combined with bismuth-containing quadruple therapy for Hp eradication on lipid levels in elderly patients with mixed hyperlipidemia. Methods:A retrospective analysis was conducted on 1 181 elderly patients with hyperlipidemia, cardiovascular and cerebrovascular diseases, and peripheral arterial disease who were treated at the First Hospital of Lanzhou University between March 2019 and December 2023.According to the results of carbon 14 urea breath test(C 14-UBT), the subjects were divided into the Hp infection group and the non- Hp infection group.Multivariate logistic regression methods were used to analyze the correlation between Hp infection and statin use.A prospective case-control analysis was conducted on 109 patients with mixed hyperlipidemia and Hp infection treated during the same period, they were treated with rosuvastatin combined with bismuth-containing quadruple therapy for Hp eradication.The successful eradication people were selected as the eradication group (n=95). Patients with hyperlipidemia and Hp infection unwilling eradication was selected as the control group (n=109), and treated with rosuvastatin.Changes in lipid levels were compared over a consecutive 6-month period. Results:The overall Hp infection rate was 53.94%(637/1 181). Univariate analysis showed that the infection rate in women was higher than in men.Body mass index(BMI), low-density lipoprotein cholesterol(LDL-C), fasting blood glucose(FBG)levels in the Hp(+ )group were higher than in the Hp(-)group.Long-term low-dose aspirin users had a higher infection rate than non-users.The infection rate was lower in statin users than in non-users[42.65%(374/877) vs.55.59%(169/304), χ2=15.234, P<0.001]. Multivariate analysis showed that women had a higher infection risk than men ( OR=1.441, 95% CI: 1.102-1.729, P=0.011). Higher FBG and LDL-C levels increased the risk of Hp infection ( OR=1.406, 95% CI: 1.271-2.286, P<0.001, OR=1.118, 95% CI: 1.017-1.387, P=0.010). Aspirin use increased the risk of Hp infection( OR=1.162, 95% CI: 1.034-1.294, P=0.021), while statin use reduced the risk of Hp infection ( OR=0.177, 95% CI: 0.018-0.311, P<0.001). The Hp eradication rate was 87.16%(95/109). At 1-and 2-months post-eradication, statistically significant differences were observed between the eradication and control groups in LDL-C, total cholesterol(TC), changes from baseline, and target achievement rates(all P<0.05). At 1-month post-eradication, a statistically significant difference was observed in high-density lipoprotein cholesterol(HDL-C) levels between the two groups.Additionally, at both 1-and 2-months post-eradication, significant differences were found in the changes in HDL-C levels from baseline between the eradication group and the control group(all P<0.05). Conclusions:Long-term statin use in the elderly may reduce the risk of Hp infection.Rosuvastatin combined with a standard quadruple therapy does not improve the Hp eradication rates in elderly patients with mixed hyperlipidemia, but it facilitates short-term achievement of cholesterol targets.

Objective To investigate the clinical efficacy of pan-immune inflammatory value(PIV)in pre-dicting the prognosis of elderly patients with severe pneumonia(SP).Methods A total of 160 elderly patients with SP admitted to this hospital from January to June 2023 were selected as the study group,and 100 elderly patients with common pneumonia in the hospital in the same period were selected as the control group.Ac-cording to the prognosis at discharge,the patients were divided into good prognosis group(128 cases)and poor prognosis group(32 cases).Neutrophil count,platelet count,monocyte count and lymphocyte count were detected by automatic blood cell analyzer,and PIV was finally calculated.Receiver operating characteristic(ROC)curve was used to analyze the prognostic value of PIV in elderly patients with SP.Multivariate Logis-tic regression was used to analyze the prognostic factors in elderly patients with SP.Results The counts of neutrophil,monocyte and PIV in control group were lower than those in study group,and the counts of lym-phocytes,platelet in control group were higher than those in study group,the difference was statistically sig-nificant(P＜0.05).Neutrophil,monocyte count and PIV in the good prognosis group were significantly lower than those in the poor prognosis group,and platelet count and lymphocyte count in the good prognosis group were higher than those in the poor prognosis group,with statistical significance(P＜0.05).ROC curve analy-sis showed that the area under the curve of PIV in predicting poor prognosis in elderly SP patients was 0.941,which was larger than that of neutrophil,monocyte,platelet count and lymphocyte count(P＜0.001).The proportion of mechanical ventilation,C rection protein(CRP)and procalcitonin(PCT)levels in poor progno-sis group were higher than those in good prognosis group(P＜0.05).Multivariate Logistic regression analysis showed that mechanical ventilation,CRP,PCT and PIV were independent risk factors for the prognosis of eld-erly SP patients(P＜0.05).Conclusion PIV is an independent risk factor for predicting the prognosis of eld-erly patients with SP.PIV is an important prognostic factor for elderly patients with SP.

Objective:To investigate the correlation between long-term statin use and Helicobacter pylori( Hp)infection in the elderly, and to compare the effects of rosuvastatin combined with bismuth-containing quadruple therapy for Hp eradication on lipid levels in elderly patients with mixed hyperlipidemia. Methods:A retrospective analysis was conducted on 1 181 elderly patients with hyperlipidemia, cardiovascular and cerebrovascular diseases, and peripheral arterial disease who were treated at the First Hospital of Lanzhou University between March 2019 and December 2023.According to the results of carbon 14 urea breath test(C 14-UBT), the subjects were divided into the Hp infection group and the non- Hp infection group.Multivariate logistic regression methods were used to analyze the correlation between Hp infection and statin use.A prospective case-control analysis was conducted on 109 patients with mixed hyperlipidemia and Hp infection treated during the same period, they were treated with rosuvastatin combined with bismuth-containing quadruple therapy for Hp eradication.The successful eradication people were selected as the eradication group (n=95). Patients with hyperlipidemia and Hp infection unwilling eradication was selected as the control group (n=109), and treated with rosuvastatin.Changes in lipid levels were compared over a consecutive 6-month period. Results:The overall Hp infection rate was 53.94%(637/1 181). Univariate analysis showed that the infection rate in women was higher than in men.Body mass index(BMI), low-density lipoprotein cholesterol(LDL-C), fasting blood glucose(FBG)levels in the Hp(+ )group were higher than in the Hp(-)group.Long-term low-dose aspirin users had a higher infection rate than non-users.The infection rate was lower in statin users than in non-users[42.65%(374/877) vs.55.59%(169/304), χ2=15.234, P<0.001]. Multivariate analysis showed that women had a higher infection risk than men ( OR=1.441, 95% CI: 1.102-1.729, P=0.011). Higher FBG and LDL-C levels increased the risk of Hp infection ( OR=1.406, 95% CI: 1.271-2.286, P<0.001, OR=1.118, 95% CI: 1.017-1.387, P=0.010). Aspirin use increased the risk of Hp infection( OR=1.162, 95% CI: 1.034-1.294, P=0.021), while statin use reduced the risk of Hp infection ( OR=0.177, 95% CI: 0.018-0.311, P<0.001). The Hp eradication rate was 87.16%(95/109). At 1-and 2-months post-eradication, statistically significant differences were observed between the eradication and control groups in LDL-C, total cholesterol(TC), changes from baseline, and target achievement rates(all P<0.05). At 1-month post-eradication, a statistically significant difference was observed in high-density lipoprotein cholesterol(HDL-C) levels between the two groups.Additionally, at both 1-and 2-months post-eradication, significant differences were found in the changes in HDL-C levels from baseline between the eradication group and the control group(all P<0.05). Conclusions:Long-term statin use in the elderly may reduce the risk of Hp infection.Rosuvastatin combined with a standard quadruple therapy does not improve the Hp eradication rates in elderly patients with mixed hyperlipidemia, but it facilitates short-term achievement of cholesterol targets.

Atherosclerosis(As)is a chronic inflammatory disease associated with lipid deposition.Copper is con-sidered to be an important trace element and is closely related to the occurrence and development of As.Excessive accu-mulation of copper ions in cells can induce cell death,a new type of cell death named"cuproptosis".Under normal con-ditions,the body's copper metabolism can control the copper level in a stable range.When the disease occurs,copper ho-meostasis is destroyed,intracellular copper overload produces cytotoxicity,induces oxidative stress,inflammation,cell py-roptosis and cuproptosis,and promotes the occurrence and development of As.This article summarizes the relationship between copper levels and As,and discusses the mechanism of cuproptosis and the pathological mechanism of copper over-load promoting As from the perspective of the body's copper regulation,and reviews the relevant drug intervention,expec-ting to provide a new therapeutic target for As.

Gut microbiota dysbiosis is an avenue for the promotion of atherosclerosis (AS) and this effect is mediated partly via the circulating microbial metabolites. More microbial metabolites related to AS vascular inflammation, and the mechanisms involved need to be clarified urgently. Paeonol (Pae) is an active compound isolated from Paeonia suffruticoas Andr. with anti-AS inflammation effect. However, considering the low oral bioavailability of Pae, it is worth exploring the mechanism by which Pae reduces the harmful metabolites of the gut microbiota to alleviate AS. In this study, ApoE^-/- mice were fed a high-fat diet (HFD) to establish an AS model. AS mice were administrated with Pae (200 or 400 mg·kg^-1) by oral gavage and fecal microbiota transplantation (FMT) was conducted. 16S rDNA sequencing was performed to investigate the composition of the gut microbiota, while metabolomics analysis was used to identify the metabolites in serum and cecal contents. The results indicated that Pae significantly improved AS by regulating gut microbiota composition and microbiota metabolic profile in AS mice. We also identified α-hydroxyisobutyric acid (HIBA) as a harmful microbial metabolite reduced by Pae. HIBA supplementation in drinking water promoted AS inflammation in AS mice. Furthermore, vascular endothelial cells (VECs) were cultured and stimulated by HIBA. We verified that HIBA stimulation increased intracellular ROS levels, thereby inducing VEC inflammation via the TXNIP/NLRP3 pathway. In sum, Pae reduces the production of the microbial metabolite HIBA, thus alleviating the ROS/TXNIP/NLRP3 pathway-mediated endothelial inflammation in AS. Our study innovatively confirms the mechanism by which Pae reduces the harmful metabolites of gut microbiota to alleviate AS and proposes HIBA as a potential biomarker for AS clinical judgment.
Animals ; Mice ; Atherosclerosis/drug therapy* ; Diet, High-Fat ; Endothelial Cells ; Inflammation/drug therapy* ; Mice, Inbred C57BL ; NLR Family, Pyrin Domain-Containing 3 Protein/genetics* ; Reactive Oxygen Species

Objective:To investigate the changes in adaptive phenotypes of Yersinia pestis ( Yp) during successive passages in macrophages. Methods:A Yp strain of 201-MI was induced by 50 successive passages of Yp 201 strain in Raw264.7 cells. Phenotypic characteristics of 201 and 201-MI strains were compared by analyzing their survival rates in macrophages, growth curves, biofilm formation abilities, acid and hydrogen peroxide-stress tolerance, and virulence to mammal cells (Raw264.7 and HeLa cells) and mice. Results:Comparing with 201 strain, 201-MI strain showed various phenotypic changes, including higher survival rate in Raw264.7 cells, faster growth in iron-deficient medium, higher tolerance to acid and hydrogen peroxide, decreased biofilm formation ability, and less damages to Raw264.7 and HeLa cells. More-over, 201-MI strain showed decreased virulence to mice in both subcutaneous and intraperitoneal challenges. Preliminary comparative genomics analysis revealed some indel and nonsense mutations in 201-MI strain, which might account for its phenotype changes.Conclusions:After successive passages in macrophages, Yp showed some phenotypic changes, which might reflect its adaptive evolution under the pressure of macrophages. Detailed multi-omics analysis would be of great help to understand the underlying genetic mechanisms of these changes, and the related Yp-macrophage interaction processes as well.

Objective:To explore the clinical significance of anti-Crohn′s disease antibody binding polypeptide (anti-CABP) in the diagnosis of inflammatory bowel disease (IBD) .Methods:Clinical data of 190 IBD patients diagnosed in the First Affiliated Hospital of Anhui Medical University from June 2017 to December 2019 were analyzed prospectively, including 103 patients with Crohn’s disease (CD) and 87 patients with ulcerative colitis (UC) . And 107 patients with gastrointestinal polyposis were set as control group. The serum level of anti-CABP, anti- Saccharomyces cerevisiae antibodies (ASCA) and perinuclear anti-neutrophil cytoplasmic antibodies (pANCA) were detected in CD, UC and control groups by using ELISA. The differences in the serum level and positive rates of anti-CABP, ASCA and pANCA among the three groups were analyzed statistically. The diagnostic value of anti-CABP was evaluated by using receiver operating characteristic (ROC) analysis. The correlation between anti-CABP and clinical characteristics of IBD was analyzed. Results:The levels of anti-CABP IgA[14.46 (7.77, 34.71) U/ml vs. 10.22 (5.71, 14.98) U/ml and 6.60 (5.04, 8.38) U/ml, both P<0.01], anti-CABP IgG [11.12 (4.48, 42.31) U/ml vs. 5.26 (3.28, 10.02) U/ml and 2.85 (2.41, 3.52) U/ml, both P<0.01] and ASCA IgG[5.59 (2.68, 11.36) U/ml vs. 2.63 (1.42, 6.40) U/ml and 2.19 (1.20, 4.03) U/ml, both P<0.01] of CD patients were significantly higher than those of UC patients and control group. The pANCA level in UC patients was significantly higher than that of CD and control groups [8.55 (4.06, 19.98) U/ml vs. 2.91 (2.09, 3.99) U/ml and 1.65 (1.24, 2.23) U/ml, both P<0.01]. The positive rate of anti-CABP was 45.63% in CD patients, which was obviously higher than 4.60% in UC patients ( P<0.01) . Anti-CABP could effectively distinguish CD from non-CD patients (AUC 0.840) , and the diagnostic efficacy of anti-CABP was better than that of ASCA (AUC 0.708) . The combined use of three antibodies (anti-CABP, ASCA and pANCA) significantly improved the diagnostic value and the AUC was 0.892. The positive rate of anti-CABP IgA was not related with the clinical characteristics of IBD (all P>0.05) , while the positive rate of anti-CABP IgG was significantly different in the disease locations of CD patients ( P = 0.016) . Conclusion:The positive rate of anti-CABP in CD patients is significantly higher than that in UC patients, which suggests that the anti-CABP can be used as a serological marker to assist diagnosis and differential diagnosis of CD.

Objective:To explore the clinical significance of anti-Crohn′s disease antibody binding polypeptide (anti-CABP) in the diagnosis of inflammatory bowel disease (IBD) .Methods:Clinical data of 190 IBD patients diagnosed in the First Affiliated Hospital of Anhui Medical University from June 2017 to December 2019 were analyzed prospectively, including 103 patients with Crohn’s disease (CD) and 87 patients with ulcerative colitis (UC) . And 107 patients with gastrointestinal polyposis were set as control group. The serum level of anti-CABP, anti- Saccharomyces cerevisiae antibodies (ASCA) and perinuclear anti-neutrophil cytoplasmic antibodies (pANCA) were detected in CD, UC and control groups by using ELISA. The differences in the serum level and positive rates of anti-CABP, ASCA and pANCA among the three groups were analyzed statistically. The diagnostic value of anti-CABP was evaluated by using receiver operating characteristic (ROC) analysis. The correlation between anti-CABP and clinical characteristics of IBD was analyzed. Results:The levels of anti-CABP IgA[14.46 (7.77, 34.71) U/ml vs. 10.22 (5.71, 14.98) U/ml and 6.60 (5.04, 8.38) U/ml, both P<0.01], anti-CABP IgG [11.12 (4.48, 42.31) U/ml vs. 5.26 (3.28, 10.02) U/ml and 2.85 (2.41, 3.52) U/ml, both P<0.01] and ASCA IgG[5.59 (2.68, 11.36) U/ml vs. 2.63 (1.42, 6.40) U/ml and 2.19 (1.20, 4.03) U/ml, both P<0.01] of CD patients were significantly higher than those of UC patients and control group. The pANCA level in UC patients was significantly higher than that of CD and control groups [8.55 (4.06, 19.98) U/ml vs. 2.91 (2.09, 3.99) U/ml and 1.65 (1.24, 2.23) U/ml, both P<0.01]. The positive rate of anti-CABP was 45.63% in CD patients, which was obviously higher than 4.60% in UC patients ( P<0.01) . Anti-CABP could effectively distinguish CD from non-CD patients (AUC 0.840) , and the diagnostic efficacy of anti-CABP was better than that of ASCA (AUC 0.708) . The combined use of three antibodies (anti-CABP, ASCA and pANCA) significantly improved the diagnostic value and the AUC was 0.892. The positive rate of anti-CABP IgA was not related with the clinical characteristics of IBD (all P>0.05) , while the positive rate of anti-CABP IgG was significantly different in the disease locations of CD patients ( P = 0.016) . Conclusion:The positive rate of anti-CABP in CD patients is significantly higher than that in UC patients, which suggests that the anti-CABP can be used as a serological marker to assist diagnosis and differential diagnosis of CD.