Objective To explore the effect of compound centella asiatica on diabetic kidney disease(DKD)by regulating intestinal microflora metabolism.Methods Sixty DKD patients who visited Hangzhou Ninth People's Hospital from January to December 2022 were randomly divided into experimental group and control group,with 30 patients in each group.Patients in control group received basic treatment guided by lifestyle and diet,while patients in experimental group received treatment with compound centella asiatica on the basis of control group.Both groups of patients were followed up for 6 months to measure gut microbiota metabolite levels,urinary protein,and other indicators.Results After treatment,the levels of short-chain fatty acid(SCFA)in experimental group increased,while the levels of trimethylamine oxide(TMAO),indophenol sulfate(IS),microalbuminuria/creatinine(ACR),and 24-hour urinary protein quantification(24hPro)decreased;24hPro and ACR of experimental group patients were lower than those of control group.ACR in DKD patients is positively correlated with TMAO and negatively correlated with SCFA(P＜0.05).Conclusion ACR in DKD patients is positively correlated with TMAO and negatively correlated with SCFA;Compound centella asiatica can increase the levels of SCFA in DKD patients,reduce the levels of TMAO,IS,and ACR,indicating that compound centella asiatica can regulate the metabolic levels of gut microbiota in DKD patients and reduce proteinuria.

Objective:To investigate the safety and efficacy of flow diverter (FD) in the treatment of middle cerebral artery (MCA) dissection aneurysms.Methods:Patients with MCA dissection aneurysm received FD treatment at the Department of Neurosurgery, Jinjiang Hospital and the Cerebrovascular Disease Center of the First Affiliated Hospital of Naval Medical University from January 2021 to December 2023 were included retrospectively. The success rate of procedure, incidence of complications, occlusion rate of aneurysms, and clinical outcome were evaluated.Results:A total of 23 patients were included, with a success rate of 100% for FD implantation and a periprocedural complication rate of 8.7%. Nineteen patients (82.6%) completed angiography follow-up within an average of 7.2 months, of which the aneurysms of 16 patients (84.2%) were completely occluded, 3 (15.8%) were partial occluded, and 2 (10.5%) experienced in-stent restenosis; 14 (73.7%) showed stenosis of covered branch openings, of which 2 (10.5%) had branch occlusions, with no relevant clinical symptoms. The median clinical follow-up time was 23.2 months, with 95.7% of patients achieving good outcome (modified Rankin scale score ≤2).Conclusion:FD is safe and effective in the treatment of MCA dissection aneurysms, and precise device selection and release is the key to improving procedural safety.

Objective:To investigate the pathogen distribution characteristics and related risk factors for postoperative infection in liver transplant recipients.Method:A retrospective analysis was conducted on the clinical data of 153 recipients who underwent liver transplantation and received postoperative treatment in the intensive care unit (ICU) of China-Japan Friendship Hospital from January 2019 to December 2023. According to whether postoperative infection occurred, the recipients were divided into the infection group (33 cases) and the non-infection group (120 cases). Pathogen-related data were collected from multiple postoperative body fluid sites of liver transplant recipients. Univariate analysis and multivariate logistic regression analysis were performed to identify independent risk factors.Result:Among the 153 recipients, 105 were male and 48 were female, with a mean age of (52.2 ± 9.5) years. During the ICU stay after liver transplantation, 33 recipients developed infections, including 15 cases of single-pathogen infection and 18 cases of mixed-pathogen infection. The most common site of infection was the lung, accounting for 22 cases (66.67%). Eleven recipients (33.33%) in the infection group died, with septic shock being the leading cause of death (7 cases, 63.63%), and the median survival time was 14 days. Infected recipients had Gram-negative bacteria (171 strains), mainly Stenotrophomonas maltophilia[54 strains (31.57%)] and Pseudomonas aeruginosa[52 strains (30.41%)]. Gram-positive bacteria (47 strains) were dominated by Enterococcus faecalis[25 strains (53.19%)]. Multivariate regression analysis showed that postoperative mechanical ventilation for more than 48 hours was an independent risk factor for infection in liver transplant recipients ( OR=10.878, 95% CI: 3.632-32.580, P<0.001). Conclusion:It is necessary to prevent ventilator-associated pneumonia in liver transplant recipients. Early removal of the tracheal tube and strengthening hospital infection prevention and control are of great significance in reducing the risk of postoperative infection in liver transplant recipients.

Objective To explore the effect of compound centella asiatica on diabetic kidney disease(DKD)by regulating intestinal microflora metabolism.Methods Sixty DKD patients who visited Hangzhou Ninth People's Hospital from January to December 2022 were randomly divided into experimental group and control group,with 30 patients in each group.Patients in control group received basic treatment guided by lifestyle and diet,while patients in experimental group received treatment with compound centella asiatica on the basis of control group.Both groups of patients were followed up for 6 months to measure gut microbiota metabolite levels,urinary protein,and other indicators.Results After treatment,the levels of short-chain fatty acid(SCFA)in experimental group increased,while the levels of trimethylamine oxide(TMAO),indophenol sulfate(IS),microalbuminuria/creatinine(ACR),and 24-hour urinary protein quantification(24hPro)decreased;24hPro and ACR of experimental group patients were lower than those of control group.ACR in DKD patients is positively correlated with TMAO and negatively correlated with SCFA(P＜0.05).Conclusion ACR in DKD patients is positively correlated with TMAO and negatively correlated with SCFA;Compound centella asiatica can increase the levels of SCFA in DKD patients,reduce the levels of TMAO,IS,and ACR,indicating that compound centella asiatica can regulate the metabolic levels of gut microbiota in DKD patients and reduce proteinuria.

Objective:To investigate the pathogen distribution characteristics and related risk factors for postoperative infection in liver transplant recipients.Method:A retrospective analysis was conducted on the clinical data of 153 recipients who underwent liver transplantation and received postoperative treatment in the intensive care unit (ICU) of China-Japan Friendship Hospital from January 2019 to December 2023. According to whether postoperative infection occurred, the recipients were divided into the infection group (33 cases) and the non-infection group (120 cases). Pathogen-related data were collected from multiple postoperative body fluid sites of liver transplant recipients. Univariate analysis and multivariate logistic regression analysis were performed to identify independent risk factors.Result:Among the 153 recipients, 105 were male and 48 were female, with a mean age of (52.2 ± 9.5) years. During the ICU stay after liver transplantation, 33 recipients developed infections, including 15 cases of single-pathogen infection and 18 cases of mixed-pathogen infection. The most common site of infection was the lung, accounting for 22 cases (66.67%). Eleven recipients (33.33%) in the infection group died, with septic shock being the leading cause of death (7 cases, 63.63%), and the median survival time was 14 days. Infected recipients had Gram-negative bacteria (171 strains), mainly Stenotrophomonas maltophilia[54 strains (31.57%)] and Pseudomonas aeruginosa[52 strains (30.41%)]. Gram-positive bacteria (47 strains) were dominated by Enterococcus faecalis[25 strains (53.19%)]. Multivariate regression analysis showed that postoperative mechanical ventilation for more than 48 hours was an independent risk factor for infection in liver transplant recipients ( OR=10.878, 95% CI: 3.632-32.580, P<0.001). Conclusion:It is necessary to prevent ventilator-associated pneumonia in liver transplant recipients. Early removal of the tracheal tube and strengthening hospital infection prevention and control are of great significance in reducing the risk of postoperative infection in liver transplant recipients.

Post-stroke depression is a common complication after a stroke. Based on the theory of ＂deficiency of heart qi leading to sadness＂recorded in Huangdi Neijing, our team proposes that deficiency of heart qi is the basic pathogenesis of post-stroke depression, with sadness being its main manifestation. Therefore, we advocate treating post-stroke depression from the perspective of the heart, and clinically, it can be divided into four stages: heart-liver stage, heart-lung stage, heart-spleen stage, and heart-kidney stage. Treating post-stroke depression with the principle of regulating qi and nourishing the heart, patients in the heart-liver and heart-lung stages are mainly middle-aged and young adults, with a pathological nature of qi stagnation and mild deficiency of heart qi, and therefore, the method of promoting the flow of meridians and regulating qi should be adopted. In contrast, patients in the heart-spleen and heart-kidney stages are mainly middle-aged and elderly, with a pathological nature of qi deficiency and severe deficiency of heart qi, and therefore, nourishment and tonification should be prioritized. In response to the above four stages, our team has achieved good clinical efficacy by administering Xiaoyao Powder, Baihe Dihuang Decoction, Ganmai Dazao Decoction and Jingui Shenqi Pill respectively. This study discusses the approach to treating post-stroke depression from the perspective of a "deficiency of heart qi leading to sadness" by examining three aspects: the theoretical basis of Chinese and Western medicine to treat post-stroke depression from the heart, the basic pathogenesis and staging of post-stroke depression, and the treatment principle of regulating qi and nourishing the heart. The study also briefly analyzes the clinical experience of the medications used for this condition to provide a reference for the treatment of post-stroke depression.

Early distinction of bipolar disorder (BD) from major depressive disorder (MDD) is difficult since no tools are available to estimate the risk of BD. In this study, we aimed to develop and validate a model of oxidative stress injury for predicting BD. Data were collected from 1252 BD and 1359 MDD patients, including 64 MDD patients identified as converting to BD from 2009 through 2018. 30 variables from a randomly-selected subsample of 1827 (70%) patients were used to develop the model, including age, sex, oxidative stress markers (uric acid, bilirubin, albumin, and prealbumin), sex hormones, cytokines, thyroid and liver function, and glycolipid metabolism. Univariate analyses and the Least Absolute Shrinkage and Selection Operator were applied for data dimension reduction and variable selection. Multivariable logistic regression was used to construct a model for predicting bipolar disorder by oxidative stress biomarkers (BIOS) on a nomogram. Internal validation was assessed in the remaining 784 patients (30%), and independent external validation was done with data from 3797 matched patients from five other hospitals in China. 10 predictors, mainly oxidative stress markers, were shown on the nomogram. The BIOS model showed good discrimination in the training sample, with an AUC of 75.1% (95% CI: 72.9%-77.3%), sensitivity of 0.66, and specificity of 0.73. The discrimination was good both in internal validation (AUC 72.1%, 68.6%-75.6%) and external validation (AUC 65.7%, 63.9%-67.5%). In this study, we developed a nomogram centered on oxidative stress injury, which could help in the individualized prediction of BD. For better real-world practice, a set of measurements, especially on oxidative stress markers, should be emphasized using big data in psychiatry.
Biomarkers/metabolism* ; Bipolar Disorder/metabolism* ; Depressive Disorder, Major/diagnosis* ; Early Diagnosis ; Humans ; Oxidative Stress

Objective:To investigate the effect of hyperbaric oxygen（HBO）therapy on cerebral infraction in elderly patients and its influence on hemodynamic and hemorheological parameters.Methods:A total of 152 elderly patients with cerebral infarction admitted to the First Affiliated Hospital of Naval Medical University from January 2020 to June 2021 were selected as the research subjects and randomly divided into HBO group and control group，with 76 cases in each group. The changes of neurologic function scores and ultrasonic hemodynamic and hemorheological parameters before and after treatment were compared between the two groups.Results:After treatment，the NIHSS scores of the patients in the HBO treatment group were lower than those of the control group（ P<0.05），while the MoCA（Chinese version）score and Barthel Index in the HBO group were higher than those of the control group（ P<0.05）. The total effective rate，hemodynamic and hemorheological parameters of the patients in the HBO group were superior to those in the control group，with statistically significant differences（ P<0.001）. Conclusion:Compared with conventional treatment，HBO treatment has a more significant effect on cerebral infarction in elderly patients. It can positively promote the recovery of elderly patients’ cognitive function and activities of daily living，improve blood circulation and hemodynamic parameters.

Objective:To explore the risk factors of abortion and their interactions in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). Methods:A total of 3556 pregnant women who underwent IVF/ICSI-ET in Jiangxi Maternal and Child Health Hospital from January 2014 to June 2019 were analyzed, among which 889 women were diagnosed with PCOS (PCOS group) and 2667 women were diagnosed with infertility due to simple tube factors (control group). The clinical outcomes after pregnancy were compared between the two groups. Single and multiple logistic regression were used to find the influencing factors of abortion. Finally, subgroup analysis was conducted according to single/twin pregnancy and body mass index (BMI).Results:The abortion rate [11.81% (105/889)] and the late abortion rate [5.29% (47/889)] in PCOS group were significantly higher than those in control group [9.19% (245/2667), P=0.023; 3.64% (97/2667), P=0.031]. Univariate logistic regression showed that PCOS, twin pregnancy, high BMI, long duration of infertility were the risk factors of abortion. Multivariate logistics regression showed that the main risk factors affecting abortion rate were twin pregnancy, PCOS, and the interaction between the two factors. Subgroup analysis found that there were no differences in the early and late abortion rates between the two groups when women were singleton pregnancy. When women were twin pregnancy, the rate of early abortion was similar between the two groups, while the late abortion rate [8.58% (29/338)] in PCOS group was significantly higher than that in control group [3.11% (37/1188), P<0.001]. Conclusion:The rate of abortion is similar for PCOS women and simple tube factor infertility women when they were singleton pregnancy after IVF/ICSI-ET treatment. PCOS women have a similar rate of early abortion and higher rate of late abortion than simple tube factor infertility women when they were twin pregnancy.

Objective:To explore the risk factors of abortion and their interactions in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET). Methods:A total of 3556 pregnant women who underwent IVF/ICSI-ET in Jiangxi Maternal and Child Health Hospital from January 2014 to June 2019 were analyzed, among which 889 women were diagnosed with PCOS (PCOS group) and 2667 women were diagnosed with infertility due to simple tube factors (control group). The clinical outcomes after pregnancy were compared between the two groups. Single and multiple logistic regression were used to find the influencing factors of abortion. Finally, subgroup analysis was conducted according to single/twin pregnancy and body mass index (BMI).Results:The abortion rate [11.81% (105/889)] and the late abortion rate [5.29% (47/889)] in PCOS group were significantly higher than those in control group [9.19% (245/2667), P=0.023; 3.64% (97/2667), P=0.031]. Univariate logistic regression showed that PCOS, twin pregnancy, high BMI, long duration of infertility were the risk factors of abortion. Multivariate logistics regression showed that the main risk factors affecting abortion rate were twin pregnancy, PCOS, and the interaction between the two factors. Subgroup analysis found that there were no differences in the early and late abortion rates between the two groups when women were singleton pregnancy. When women were twin pregnancy, the rate of early abortion was similar between the two groups, while the late abortion rate [8.58% (29/338)] in PCOS group was significantly higher than that in control group [3.11% (37/1188), P<0.001]. Conclusion:The rate of abortion is similar for PCOS women and simple tube factor infertility women when they were singleton pregnancy after IVF/ICSI-ET treatment. PCOS women have a similar rate of early abortion and higher rate of late abortion than simple tube factor infertility women when they were twin pregnancy.