Acute pancreatitis (AP) is a life-threatening gastrointestinal disorder for which no effective pharmacological treatments are currently available. One of the pharmacological targets that merits further research is the neurokinin 1 receptor (NK1R), which is found on pancreatic acinar cells and responds to the neuropeptide substance P (SP) that participates in AP. Although a few studies have stated the involvement of SP/NK1R in neurogenic inflammation in AP development, the regulatory mechanism remains unclear. In this study, we found that following activation of NK1R by SP, β-arrestin1, a scaffold protein of NK1R, down-regulated transcription of Adss, Adsl, and Ampd in the purine nucleotide cycle, thereby inhibiting mitochondrial function through fumarate depletion. Interestingly, we identified magnolol as a new and natural NK1R inhibitor with a non-nitrogenous biphenyl core structure. It exhibited a beneficial effect on AP by restoring purine nucleotide cycle metabolic enzymes and fumarate levels. Our study not only provides new therapeutic strategies, leading compounds, and drug translation possibilities for AP, but also provides important clues for the study of downstream mechanisms driven by SP in other diseases.

Micro/nanoplastics (MNPs), recognized as emerging environmental pollutants, are widely distributed in natural environments. Due to their small particle size and significant migratory capacity, MNPs can infiltrate diverse environmental matrices, then invade and accumulate in the organism via the skin, respiration, and digestion. Recently, concerns have grown over the detrimental effects and potential toxicity of MNPs on reproductive health. This review summarized published epidemiological and toxicological studies related to MNPs exposure and their effects on reproductive health. Firstly, this review critically examined the current landscape of epidemiological evidence and found that MNPs (e.g., polystyrene, polypropylene, polyvinyl chloride, polyethylene, etc.) are present in various biological specimens from both males and females, and their presence may be associated with an increased risk of reproductive disorders. Secondly, extensive toxicological studies revealed that MNPs exposure induces reproductive health damage through mechanisms such as disrupting the microstructure of reproductive organs and altering molecular-level expressions. Oxidative stress, inflammatory responses, and apoptosis are identified as potential links between MNPs exposure and reproductive damage. Finally, this review addressed the prevalent shortcomings in existing studies and proposed future directions to tackle the challenges posed by MNPs-induced reproductive harm. These insights aim to inform strategies for safeguarding public reproductive health and ecological security, providing a scientific foundation for mitigating risks associated with MNPs pollution.

Objective To observe the effects of applying incremental positive end expiratory pressure(PEEP)lung recruitment method in lung protective ventilation strategy during anesthesia for laparoscopic colorectal cancer surgery on the respiratory mechanics and postoperative pulmonary complications.Methods The patients who underwent laparoscopic colorectal cancer surgery from June to December 2023 were randomly divided into two groups with 30 cases each group:the incremental PEEP lung recruitment combined with lung protective ventilation method group(RM group)and the lung protective ventilation method group(control group,C group).Both groups underwent lung protective ventilation.The RM group underwent the first lung recruitment immediately after the placement of Trendlenburg position,and then the lung recruitment was performed with the incremental PEEP method hourly thereafter.In the C group,no lung recruitment was performed throughout the procedure.The data of respiratory mechanics and oxygenation were recorded at 5 min before tracheal intubation(T0),immediately after tracheal intubation(T1),after the first pulmonary recruitment(after positioning in the C group)(T2),after the second pulmonary recruitment(60 min after positioning in the C group)(T3),after stopping the pneumoperitoneum(T4),and 30 min after extubation(T5),respectively.Postoperative pulmonary complications(PCC)were compared between the two groups.Results In terms of respiratory mechanics:the differences in peak airway pressure(Ppeak),airway plateau pressure(Pplat),driving pressure(△P),and pulmonary dynamic compliance(Cdyn)at the time point of T1 between the two groups were not significant(P＞0.05);the Ppeak,Pplat,and △P at the time points of T2 and T3 in the RM group were smaller than those in the C group(P＜0.05),and the Cdyn was larger than that in the C group(P＜0.05);the Ppeak at the time point of T4 in the RM group was smaller than that in the C group(P＜0.05),while the Pplat,△P,and Cdyn were not significant(P＞0.05).In terms of oxygenation:the differences in arterial partial pressure of oxygen(PaO2)and partial pressure of CO2(PaCO2)at the time point of T0 in the two groups were not significant(P＞0.05);the PaO2 at the time points of T3,T4,and T5 in the RM group was higher than that in the C group(P＜0.05),and the PaCO2 at the time points of T4 and T5 was lower than that in the C group(P＜0.05).In terms of postoperative pulmonary complications,the incidences of pulmonary atelectasis(5 cases vs.12 cases,P=0.045)and PPC(9 cases vs.18 cases,P=0.020)were lower in the RM group than those in the C group,while the difference of incidence of pulmonary infection and pleural effusion between the two groups was not significant(P＞0.05).There was no occurrence of respiratory failure in both groups.Conclusion Application of incremental PEEP lung recruitment in lung protective ventilation strategy can improve lung respiratory mechanics and reduce incidence of postoperative pulmonary complications in patients undergoing laparoscopic colorectal cancer surgery.

Objective To observe the effects of applying incremental positive end expiratory pressure(PEEP)lung recruitment method in lung protective ventilation strategy during anesthesia for laparoscopic colorectal cancer surgery on the respiratory mechanics and postoperative pulmonary complications.Methods The patients who underwent laparoscopic colorectal cancer surgery from June to December 2023 were randomly divided into two groups with 30 cases each group:the incremental PEEP lung recruitment combined with lung protective ventilation method group(RM group)and the lung protective ventilation method group(control group,C group).Both groups underwent lung protective ventilation.The RM group underwent the first lung recruitment immediately after the placement of Trendlenburg position,and then the lung recruitment was performed with the incremental PEEP method hourly thereafter.In the C group,no lung recruitment was performed throughout the procedure.The data of respiratory mechanics and oxygenation were recorded at 5 min before tracheal intubation(T0),immediately after tracheal intubation(T1),after the first pulmonary recruitment(after positioning in the C group)(T2),after the second pulmonary recruitment(60 min after positioning in the C group)(T3),after stopping the pneumoperitoneum(T4),and 30 min after extubation(T5),respectively.Postoperative pulmonary complications(PCC)were compared between the two groups.Results In terms of respiratory mechanics:the differences in peak airway pressure(Ppeak),airway plateau pressure(Pplat),driving pressure(△P),and pulmonary dynamic compliance(Cdyn)at the time point of T1 between the two groups were not significant(P＞0.05);the Ppeak,Pplat,and △P at the time points of T2 and T3 in the RM group were smaller than those in the C group(P＜0.05),and the Cdyn was larger than that in the C group(P＜0.05);the Ppeak at the time point of T4 in the RM group was smaller than that in the C group(P＜0.05),while the Pplat,△P,and Cdyn were not significant(P＞0.05).In terms of oxygenation:the differences in arterial partial pressure of oxygen(PaO2)and partial pressure of CO2(PaCO2)at the time point of T0 in the two groups were not significant(P＞0.05);the PaO2 at the time points of T3,T4,and T5 in the RM group was higher than that in the C group(P＜0.05),and the PaCO2 at the time points of T4 and T5 was lower than that in the C group(P＜0.05).In terms of postoperative pulmonary complications,the incidences of pulmonary atelectasis(5 cases vs.12 cases,P=0.045)and PPC(9 cases vs.18 cases,P=0.020)were lower in the RM group than those in the C group,while the difference of incidence of pulmonary infection and pleural effusion between the two groups was not significant(P＞0.05).There was no occurrence of respiratory failure in both groups.Conclusion Application of incremental PEEP lung recruitment in lung protective ventilation strategy can improve lung respiratory mechanics and reduce incidence of postoperative pulmonary complications in patients undergoing laparoscopic colorectal cancer surgery.

Objective To explore the characteristics of TCM syndromes in patients with coronary heart disease complicated with hypertension and diabetes based on latent structure model.Methods A multi-center cross-sectional study was used to collect the four diagnostic information of patients with coronary heart disease by using the Four Diagnostic Collection Scales of TCM developed by our research group,and a clinical database was established.Combined with frequency analysis and expert opinions,the four diagnostic information was screened to construct a latent structure model.Results Totally 702 patients with coronary heart disease complicated with hypertension and diabetes were collected.A total of 40 high-frequency four-diagnosis symptoms were screened,and 18 latent variables were obtained by latent structure model analysis.The model BIC score was-17 604.38.The latent variables in the model were comprehensively clustered,and it was found that the syndrome elements of disease location in patients with coronary heart disease complicated with hypertension and diabetes were mainly heart,liver,kidney,etc.,and the syndrome elements of disease nature were mainly qi deficiency,yin deficiency,qi stagnation,phlegm turbidity,blood stasis,etc.The syndrome types were mainly phlegm and blood stasis syndrome,spleen and kidney yang deficiency syndrome,liver depression and qi stagnation syndrome,liver and kidney yin deficiency syndrome,damp-heat intrinsic syndrome,and the mutual information and information coverage between each syndrome type and the four diagnostic information were suggested.Conclusion Latent structure model analysis can provide a qualitative and quantitative basis for the syndrome classification of patients with coronary heart disease complicated with hypertension and diabetes.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.

Objective:To explore the association between weight change from age 20 to middle age and diabetes risk.Methods:A total of 10 104 residents over 40 years old were recruited in Guangzhou. The final analysis data set is a cohort of 6 272 patients from the REACTION study. Quartile of weight changes from age 20 to middle-age was used as an independent variable to explore its association with newly diagnosed diabetes. Simple and multivariable logistic regression analysis were used to calculate OR and 95% CI. Results:The prevalence of newly diagnosed diabetes in study cohort was 15.7%. Weight changes from age 20 to middle-age was significantly higher in diabetes group( P<0.001). Logistic regression analysis found in general population and overweight people [24.0≤body mass index(BMI)<28.0 kg/m 2], after adjusting for gender, age, educational level, family history of diabetes, drinking, SBP, waist circumference, cholesterol, high-density lipoprotein-cholesterol(HDL-C), TG, ALT, AST, the risk of diabetes increased in line with the magnitude of weight change( P=0.081). While in group of lean, normal and obese adult, no significant association has been found. Conclusion:The risk of diabetes increased with weight change in general population and overweight people, indicating that weight change in adults after age of 20 was positively associated with diabetes. It is suggested the importance of weight management in the prevention of dialetes.

OBJECTIVE To study the spectru m-toxicity relationship of in vitro hepatotoxicity of aqueous extract from Euodia rutaecarpa. METHODS The aqueous extract from 16 batches of E. rutaecarpa from different habitats were prepared. The fingerprints of aqueous extract from E. rutaecarpa were established by ultra high performance liquid chromatography （UPLC） method and Similarity Evaluation System of TCM Fingerprint （2012A edition ），and common peaks were identified and the similarity was evaluated. Using normal human hepatocytes L 02 as subject ，inhibitory effect of aqueous extract from 16 batches of E. rutaecarpa to them were investigated. The spectrum-toxicity relationship of UPLC fingerprint of aqueous extract from E. rutaecarpa with the hepatotoxicity of hepatocytes L 02 was analyzed by grey relational analysis （GRA）and partial least squares regression analysis （PLSR）. The corresponding compound of the chromatographic peak with the greatest correlation with the in vitro hepatotoxicity of E. rutaecarpa were isolated ，prepared and identified. RESULTS There were 27 common peaks in UPLC fingerprints of aqueous extract from 16 batches of E. rutaecarpa ，with similarity of 0.375-0.995. Totally 9 peaks were confirmed ，i.e. neochlorogenic acid （peak 5），chlorogenic acid （peak 9），cryptochlorogenic acid （peak 10），caffeic acid （peak 12），rutin （peak 16），hyperin（peak 17），dehydroevotarine（peak 19），evotarine（peak 24），rutecarpine（peak 25）. The aqueous extract from 16 batches of E. rutaecarpa showed significant inhibitory effect on the growth of L 02 cells（P＜0.05 or P＜0.01），and the inhibitory rate ranged from 6.68％ to 67.95％. GRA showed that there were 18 common peaks with correlation degree greater than 0.8，which were peak 8＞peak 3＞peak 23＞peak 7＞peak 4＞peak 9＞peak 12＞peak 2＞peak 19＞peak 6＞ 4928381。E-mail：799247687@qq.com peak 15＞peak 5＞peak 1＞peak 17＞peak 21＞peak 26＞ peak 20＞peak 14 in descending order of correlation degree. PLSR showed that there were 14 peaks with regression coefficient＞0 and variable importance projection value ＞1，and the order of regression coefficient was peak 8＞peak 3＞peak 23＞ peak 2＞peak 7＞peak 4＞peak 12＞peak 9＞peak 19＞peak 5＞peak 17＞peak 26＞peak 10＞peak 15. Peak 8 had the greatest correlation with in vitro hepatotoxicity，and the corresponding compound of this peak was identified as 6-O-trans caffeoyl gluconic acid. CONCLUSIONS The in vitro hepatotoxicity of aqueous extract from E. rutaecarpa is the result of multiple component interaction，among which 6-O-trans caffeoyl gluconic acid shows closest relation with in vitro hepatotoxicity.

Objective:To explore the characteristics of intestinal flora in children with asthma from the theory of "lung and large intestine being interior-exterior" , and to provide an experimental basis for the study of "lung and intestine axis" .Methods:Based on 16S rDNA high-throughput sequencing technology, stool samples from children with 30 asthma and 28 healthy children were enrolloed and sequenced. All patients are from january 2018 to April 2018, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University Medical College and Oriental Hospital Affiliated to Tongji University. Statistical methods such as Principal component analysis (PCA), LEfSe analysis, linear discriminant analysis (LDA), and non-metric multidimensional scale analysis (NMDS) were used to analyze intestinal flora characteristics of asthma children.Results:The number of Intestinal flora operating taxon unit (OTU) in asthmatic group (141.96 ± 27.42 vs. 164.54 ± 50.58, P=0.048), Shannon index (2.49 ± 0.51 vs. 2.80 ± 0.56, P=0.044) were significantly lower than those of healthy children group, and Simpson index (0.18 ± 0.06 vs. 0.13 ± 0.07, P=0.010) was significantly higher than that of healthy children. There was no significant difference in intestinal flora abundance between asthmatic children and healthy children ( P>0.05), but there was a decreasing trend. Further differential intestinal flora analysis showed that there were differences in bacterial abundance between children with asthma and healthy children. Conclusion:Children with asthma showed high related with intestinal flora disorders, referring that asthma maybe treated when intestinal flora is treated, which provides a reference for the study of the relationship between lung and intestine from the perspective of intestinal flora.