OBJECTIVE To investigate the mechanism of the inhibitory effect of total flavonoids from Taraxacum mongolicum on high-fat diet-induced obesity in mice through modulation of intestinal flora. METHODS Twenty-four C57BL/6J mice were randomly divided into blank group， model group and T. mongolicum total flavonoid group， with 8 mice in each group. Except for the blank group， the other 2 groups were given a high-fat diet， while T. mongolicum total flavonoid group was given T. mongolicum total flavonoid [400 mg/（kg·d）] intragastrically， once a day， for 8 consecutive weeks. During the experiment， the food intake of each group of mice was recorded. After the last medication， the body mass， fat weight， blood lipid level and pathological changes of liver and epididymal fat in mice were evaluated to observe the effect of T. mongolicum total flavonoid on the treatment of obesity in mice. The changes in abundance and structure of intestinal flora in mice were detected by amplicon sequencing； the effects of T. mongolicum total flavonoids on fat metabolism related genes were analyzed by qPCR. RESULTS Compared with model group， the body weight of mice in T. mongolicum total flavonoids group was decreased significantly （P＜0.05）； the levels of total lipid cholesterol， triglycerides， and LDL cholesterol were all decreased significantly （P＜0.01）， and the level of HDL cholesterol was increased significantly （P＜0.01）； the fat indexes of inguinal white adipose tissue and epididymal white wind_lz@hactcm.edu.cn adipose tissue were significantly reduced （P＜0.05）； significant improvement in hepatocellular steatosis and adipose cytopathy were significantly improved； mRNA expressions of COX7A1 and COX8B were significantly upregulated （P＜0.05）. The results of bacterial colony detection showed that compared with the model group， there was a rising trend in the diversity of the bacterial colony in T. mongolicum total flavonoids group， and the Sobs index characterization and β diversity were increased significantly （P＜0.05）. Relative abundances of Blautia， norank_f_Ruminococcaceae， Bilophila， Alistipes， classified_f_Ruminococcaceae， Parabacteroides， norank_f_Desulfovibrionaceae， Anaerotruncus were significantly up-regulated（P＜0.05）， while those of Faecalibaculum， Erysipelatoclostridium， GCA-900066575， Tuzzerella， Lactobacillus， norank_f_norank_o_RF39， achnospiraceae_FCS020_group were significantly down-regulated （P＜0.05）. CONCLUSIONS T. mongolicum total flavonoids can reduce body mass， fat weight and blood lipid levels， and repair the pathological damage to liver and epididymal fat in obese mice， which is related to improving intestinal flora disorders caused by high-fat diet.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective A typical case survey and elemental analysis of the implementation of Antimicrobial Steward-ship(AMS)in a medical institution in Shanghai,summarize the excellent experience of AMS in practice,and pro-vide a reference for the further promotion and implementation of AMS in the future.Methods Through purposive sam-pling,7 typical hospitals in Shanghai were selected as sampling hospitals,and key informed persons of AMS were invited to conduct semi-structured interviews.Based on the core elements of AMS theory,it conducted subject analysis to summarize the implementation and excellent practical experience of AMS in hospitals.Results The sample hospitals are excellent in the AMS elements of leadership and accountability,but need to be further strengthened in training,tracking and reporting.On the basis of routine bundle of interventions,some hospitals actively explored and expanded AMS actions according to their own disciplinary advantages.Combined with a series of internal and ex-ternal control measures,AMS strategy with the characteristics of hospitals has been formed,and the related indica-tors of antibiotics in hospitals have been improved.Conclusion In the follow-up process of AMS,hospitals can draw on excellent experience,carry out the appropriate AMS strategy on the basis of consolidating their own governance structure and routine interventions.Besides,relevant departments should increase investment in AMS information systems and human resources in hospitals to ensure the implementation of AMS.

Objective To analyze the causal relationship between Sjogren's syndrome(SS)and primary biliary cholangitis(PBC)and abnormal liver function by two-sample Mendelian randomization.Methods From the ge-nome-wide association study,single nucleotide polymorphisms of SS,PBC,alkaline phosphatase,alanine amin-otransferase,aspartate aminotransferase,γ-glutamyltransferase,direct bilirubin and total bilirubin levels were extrac-ted as instrumental variables.Inverse-variance weighted(IVW)analysis was used as the main analysis,supplemen-ted by weighted median,MR-Egger,weighted mode,and simple mode.And a series of sensitivity analyses were car-ried out to verify the robustness of the results.Results The IVW analysis results of PBC on SS were as follows:P=8.57E-11,OR=1.185 9,95％CI=1.126 4-1.248 5;IVW analysis of PBC on SS(P＞0.05).IVW analysis results of SS on alkaline phosphatase were as follows:P=0.041 5,Beta=-0.007 2,95％CI=-0.014 0--0.000 3;IVW analysis results of SS on alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,direct bilirubin,total bilirubin levels showed no statistically significant difference.Conclusion PBC can significantly increase the risk of SS,but SS cannot be proved to have a causal effect on the occurrence of PBC.SS has a potential effect on re-ducing alkaline phosphatase levels,but it is not proved that SS has causal relationship with alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,direct bilirubin,total bilirubin levels.