Irritable bowel syndrome （IBS） is a functional bowel disorder characterized primarily by abdominal pain and altered defecation habits. In recent years， traditional Chinese medicine （TCM） has made progress in multiple aspects of IBS research and treatment， including syndrome distribution， development of TCM formulas， clinical efficacy evaluation， external therapies， and psychosocial regulation. However， it still faces challenges such as over-reliance on symptomatic manifestations rather than biomarkers for diagnostic criteria， and the lack of high-quality evidence-based data supporting the efficacy of TCM formulas in treating IBS. This paper proposed that TCM diagnosis and treatment of IBS should adhere to the strategy of integrating the holistic concept with syndrome differentiation and treatment， combining TCM external therapies such as acupuncture， moxibustion and acupoint application）， and emphasizing individualized diagnosis and treatment for psychosomatic abnormalities. Future research should integrate multi-omics technologies， artificial intelligence and other methods to deepen the understanding of the pathogenesis of IBS and the mechanisms of TCM formulas， so as to promote the standardization and internationalization of TCM in the diagnosis and treatment of IBS.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective:To identify the trajectories of dietary choline intake in middle-aged and older population, and to analyze its longitudinal association with cognitive function.Methods:Subjects aged 55 to 79 years with at least two rounds of completed population economics, lifestyle, disease history, cognitive function, dietary assessments and physical measurements in 1997-2018 and those with at least three rounds of dietary measures in 1991-2015 were selected from the China Health and Nutrition Survey. Dietary survey was conducted using three consecutive 24-hour dietary recalls combined with a weighing inventory at the household level. Cognitive assessment was performed using part of the Telephone Interview for Cognitive Status Scale. Group-based univariate trajectory modeling was used to identify trajectory of choline intake, and three-level linear mixed-effects models or three-level logistic mixed-effects models was employed to analyze the relationship between trajectory groups and cognitive function. Subgroup analyses were conducted by gender and age at baseline.Results:Four trajectories of dietary choline intake were identified in the whole population, named as low-intake-stable group (61.0%), medium-intake-stable group (23.9%), medium-intake-slowly-declined group (11.2%), and high-intake-stable group (3.9%). Three trajectories were identified for each subgroup. Low-intake-stable group accounted for more than 60% in total population as well as each subgroup, especially in women and 55-59 years group. After adjusting for covariates, global cognitive scores were 0.54 (95% CI: 0.26-0.82), 0.77 (95% CI: 0.36-1.18), and 0.85 (95% CI: 0.21-1.48) points higher in medium-intake-stable, medium-intake- slowly-declined and high-intake-stable groups in the whole population, respectively, compared with the low-intake-stable group. The likelihoods of cognitive decline were 18.4% ( OR=0.816,95% CI: 0.709-0.939), 17.6% ( OR=0.824, 95% CI: 0.680-0.998), 24.4% ( OR=0.756, 95% CI: 0.589-0.970) and 22.4% ( OR=0.776,95% CI: 0.623-0.968) lower in medium-intake-stable group of dietary choline in the whole population, medium-intake-stable group in males, medium-intake-slightly-increased group in females and medium-intake-slowly-increased group in 55-59 years at baseline than in low-intake-stable group, respectively. Conclusions:Dietary choline intake is generally lower in the Chinese population aged 55-79 years. Long-term lower choline intake has a negative impact on cognitive function in middle-aged and older adults and may increase the risk of cognitive decline. The increment in the consumption of choline-enriched foods should be recommended.

Objective:To identify the trajectories of dietary choline intake in middle-aged and older population, and to analyze its longitudinal association with cognitive function.Methods:Subjects aged 55 to 79 years with at least two rounds of completed population economics, lifestyle, disease history, cognitive function, dietary assessments and physical measurements in 1997-2018 and those with at least three rounds of dietary measures in 1991-2015 were selected from the China Health and Nutrition Survey. Dietary survey was conducted using three consecutive 24-hour dietary recalls combined with a weighing inventory at the household level. Cognitive assessment was performed using part of the Telephone Interview for Cognitive Status Scale. Group-based univariate trajectory modeling was used to identify trajectory of choline intake, and three-level linear mixed-effects models or three-level logistic mixed-effects models was employed to analyze the relationship between trajectory groups and cognitive function. Subgroup analyses were conducted by gender and age at baseline.Results:Four trajectories of dietary choline intake were identified in the whole population, named as low-intake-stable group (61.0%), medium-intake-stable group (23.9%), medium-intake-slowly-declined group (11.2%), and high-intake-stable group (3.9%). Three trajectories were identified for each subgroup. Low-intake-stable group accounted for more than 60% in total population as well as each subgroup, especially in women and 55-59 years group. After adjusting for covariates, global cognitive scores were 0.54 (95% CI: 0.26-0.82), 0.77 (95% CI: 0.36-1.18), and 0.85 (95% CI: 0.21-1.48) points higher in medium-intake-stable, medium-intake- slowly-declined and high-intake-stable groups in the whole population, respectively, compared with the low-intake-stable group. The likelihoods of cognitive decline were 18.4% ( OR=0.816,95% CI: 0.709-0.939), 17.6% ( OR=0.824, 95% CI: 0.680-0.998), 24.4% ( OR=0.756, 95% CI: 0.589-0.970) and 22.4% ( OR=0.776,95% CI: 0.623-0.968) lower in medium-intake-stable group of dietary choline in the whole population, medium-intake-stable group in males, medium-intake-slightly-increased group in females and medium-intake-slowly-increased group in 55-59 years at baseline than in low-intake-stable group, respectively. Conclusions:Dietary choline intake is generally lower in the Chinese population aged 55-79 years. Long-term lower choline intake has a negative impact on cognitive function in middle-aged and older adults and may increase the risk of cognitive decline. The increment in the consumption of choline-enriched foods should be recommended.

Colorectal cancer(CRC)is one of the most common malignant tumors worldwide,metastasizing most commonly to the liver and lung.Local treatment of pulmonary oligometastases from CRC has an important position in the therapeutic course of the disease,sometimes local therapy is the key to achieve a disease-free state.Surgery is the preferred treatment for pulmonary oligometastases from CRC,but some patients are unable to undergo surgery due to physical conditions or lesion's anatomical location limitations.Because of its minimally-invasive manipulation,repeatable adoption,maximum preservation of lung parenchyma and lung function,and the potential to cure new or recurrent lung metastases,percutaneous ablation therapy has emerged as an important surgical alternative,and its clinical application has been increasing in recent years.Percutaneous ablation techniques mainly include radiofrequency ablation(RFA),microwave ablation(MWA),and cryoablation(CA).RFA produces thermal effect through high-frequency electrical current,and it is easy to operate and applicable for a wide range of treatments.MW A uses efficient microwave heating technique and its energy distribution is uniform,suitable for larger lesions.Through repeated freeze-thaw cycles CA destroys tumor tissues,which is particularly suitable for the lesions near important structures.Besides,percutaneous ablation combined with surgery,medication,etc.can be used for the treatment of pulmonary oligometastases from CRC,this kind of combination therapy has synergistic effect to enhance the curative efficacy.This paper aims to make a comprehensive review about the importance of treating pulmonary oligometastases from CRC,the efficacy,prognosis,and influencing factors of various percutaneous ablation techniques,and the application progress of ablation combined with other therapies.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To analyze the relationships between pulmonary ground-glass nodules(GGN)and bronchi and blood vessels and their diagnostic values for infiltrative lesions based on high-resolution computed tomography(HRCT)target scanning technology.Methods Patients with GGN detected by HRCT target scanning and complete pathological results were retrospectively selected as the research subjects.The relationships between GGN and bronchi and blood vessels in patients with different pathological types were analyzed,and the relationships for detecting infiltrative lesions were further analyzed,using pathological results as the gold standard.Results Three hundred patients were divided into 237 cases of pre-invasive lesions and 63 cases of infiltrative lesions according to pathological results.There were statistically significant differences in lesion properties and lesion morphology in patients with different types of GGN(P＜0.05).There were statistically significant differences in the relationships between GGN and bronchi and blood vessels in the pre-invasive lesions and the infiltrative lesions(P＜0.05).Based on the pathological results as the gold standard,the sensitivity of HRCT bronchial classification,vascular classification,and their combined detection of infiltrative lesions were 84.13％(53/63),95.24％(60/63),and 95.24％(60/63);specificity were 83.12％(197/237),87.34％(207/237),and 87.34％(207/237);accuracy were 83.33％(250/300),89.00％(267/300),and 89.00％(267/300).Conclusion Evaluating the classification of pulmonary GGN and bronchi and blood vessels by HRCT target scanning technology has good value in identifying infiltrative lesions.The combined diagnosis of the two signs can further improve the accuracy of detection.

Transcatheter aortic valve implantation (TAVI) has become the main treatment for elderly patients with middle and high risk aortic stenosis. However, coronary artery occlusion (CAO) related to TAVI is a very serious complication, which often leads to poor prognosis. Therefore, active preoperative prevention is particularly important. Preoperative computed tomography evaluation, bioprosthetic or native aortic scallop intentional laceration and chimney stent implantation technology can prevent TAVI-related coronary orifice obstruction. Ensuring commissural alignment during operation can reduce the occurrence of coronary occlusion, but its long-term prognosis needs further study. In addition, percutaneous coronary intervention is the main treatment, but there are problems such as difficult coronary access after TAVI. This article summarized the research progress in the mechanism, prevention and treatment of CAO related to TAVI.

Objective To investigate the CT features of early infection stage of thoracic and pulmonary paragonimiasis. Methods Medical records of 56 patients with thoracic and pulmonary paragonimiasis from January 2010 to June 2017 were collected, and the patients were diagnosed and treated at Yongjia County People's Hospital, and the results of laboratory examination and CT imaging features were analyzed retrospectively. Results The absolute value of eosinophils in peripheral blood of 56 patients was (5.61 ± 3.18) × 109/L, and the percentage of eosinophils was (35.90 ± 19.16)％, all of which increased to varying degrees. Forty-two patients had different degrees of pleural effusion and 52 cases with lung lesions. Lung lesions demonstrated one or several kinds of foci at the same time, randomly distributed in the lung field, mostly located in the sub-pleural lung tissue. There were 12 cases with pulmonary ground glass shadow, 4 cases with peribronchitis, 31 cases with pulmonary invasive lesions and 28 cases with pulmonary nodular/strip shadow. The size of most nodules were 0.5 - 1.0 cm, accompanied with halo sign. Conclusions The CT features of early infection stage of thoracic and pulmonary paragonimiasis are diverse. The size of 0.5 - 1.0 cm lung nodules with halo sign has certain characteristics in the diagnosis of paragonimiasis. Peribronchitis, infiltrative lesions, pleural effusion and increased peripheral blood eosinophil percentage can suggest diagnosis.

We constructed a phage-displayed random mutation library of Tat38-61(51N/55N), for studying the molecular evolution screening of HIV-1 Tat38-61 epitope. We used primers containing the random nucleotide sequences, and introduced the random mutations at the sites of 51 and 55 amino acids coding sequences into full-length Tat sequences by overlapping PCR. With the randomly mutated full-length Tat as template, the Tat38-61(51N/55N) mutants which contained recognition sequences for the Xba I in both ends were amplified by PCR using the designed primers. The mutants were cloned into Xba I site in the phagemid vector pCANTAB5S, then the recombinants were transformed into E. coli TG1, a phage-displayed the random mutation library of Tat38-61(51N/55N) was constructed by the rescue of help virus M13KO7. The results showed that the library consisted of about 5.0 x 10(6) colonies and the phage library titer was 2.65 x 10(12) TU/mL. More than 56.50% colonies in the library were positive for insertion. Sequence analysis showed that the nucleotides encoding amino acids at the sites of 51 and 55 distributed randomly. The constructed mutation library could meet the requirements for the following molecular evolution screening, and might prepare the Tat mutants for the further study of new Tat vaccine candidates.
AIDS Vaccines ; immunology ; Escherichia coli ; genetics ; metabolism ; HIV-1 ; genetics ; Humans ; Mutation ; Peptide Fragments ; biosynthesis ; genetics ; immunology ; Peptide Library ; Recombinant Proteins ; biosynthesis ; genetics ; immunology ; tat Gene Products, Human Immunodeficiency Virus ; biosynthesis ; genetics ; immunology