Objective To explore the anesthetic effects of remimazolam combined with nalbuphine on patients undergoing painless gastroscopy.Methods A total of 120 patients who underwent painless gastroscopy in Handan Central Hospital from August 2019 to May 2021 were selected and randomly divided into the observation group(60 cases)and the control group(60 cases).Patients in the observation group anesthetized with remimazolam and nalbuphine,while patients in the control group anesthetized with propofol and alfentanil.The vital signs,sedative effect,recovery quality,cognitive function,and adverse reactions of patients were compared between the two groups.Results The heart rate(HR),respiratory rate(RR),and the level of pulse oxygen saturation(SpO2)of patients in the observation group were significantly higher than those in the control group(P<0.05).Five minutes after the examination,the Narcotrend score of patients in the observation group was significantly lower than that in the control group(P<0.05).The time from the last administration to awakening,the time from gastroscopy removal to awakening,and the time of leaving the anesthesia recovery room of patients in the observation group were significantly shorter than those in the control group(P<0.05).Five minutes after the examination,the score of the mini-mental state examination(MMSE)of patients in the observation group was significantly higher than that in the control group(P<0.05),while the incidence of adverse reactions was significantly lower than that in the control group(P<0.05).Conclusion The application of remimazolam combined with nalbuphine anesthesia in painless gastroscopy has a relatively ideal effect,which can effectively reduce the adverse reactions of patients and promote rapid postoperative recovery.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

The effect of Huanglian Jiedu Decoction on the intestinal flora of type 2 diabetes mellitus(T2DM) was investigated using 16S rRNA sequencing technology. Sixty rats were randomly divided into a normal group(10 rats) and a modeling group(50 rats). After one week of adaptive feeding, a high-fat diet + streptozotocin was given for modeling, and fasting blood glucose >16.7 mmol·L~(-1) was considered a sign of successful modeling. The modeling group was randomly divided into the model group, high-, medium-, and low-dose groups of Huanglian Jiedu Decoction, and metformin group. After seven days of intragastric treatment, the feces, colon, and pancreatic tissue of each group of rats were collected, and the pathological changes of the colon and pancreatic tissue of each group were observed by hematoxylin-eosin staining. The changes in the intestinal flora structure of each group were observed by the 16S rRNA sequencing method. The results showed that compared with the model group, the high-, medium-, and low-dose of Huanglian Jiedu Decoction reduced fasting blood glucose levels to different degrees and showed no significant changes in body weight. The number of islet cells increased, and intestinal mucosal damage attenuated. Alpha diversity analysis revealed that Huanglian Jiedu Decoction reduced the abundance and diversity of intestinal flora in rats with T2DM; at the phylum level, low-and mediam-dose of Huanglian Jiedu Decoction reduced the abundance of Bacteroidota, Proteobacteria, and Desulfobacterota and increased the abundance of Firmicute and Bacteroidota/Firmicutes, while the high-dose of Huanglian Jiedu Decoction increased the relative abundance of Proteobacteria and Bacteroidota/Firmicutes ratio, and decreaseal the relative; abundance of Firmicute; at the genus level, Huanglian Jiedu Decoction increased the relative abundance of Allobaculum, Blautia, and Lactobacillus; LEfse analysis revealed that the biomarker of low-and medium-dose groups of Huanglian Jiedu Decoction was Lactobacillus, and the structure of the intestinal flora of the low-dose group of Huanglian Jiedu Decoction was highly similar to that of the metformin group. PICRUSt2 function prediction revealed that Huanglian Jiedu Decoction mainly affected carbohydrate and amino acid metabolic pathways. It suggested that Huanglian Jiedu Decoction could reduce fasting blood glucose and increase the number of islet cells in rats with T2DM, and its mechanism of action may be related to increasing the abundance of short-chain fatty acid-producing strains and Lactobacillus and affecting carbohydrate and amino acid metabolic pathways.
Animals ; Drugs, Chinese Herbal/administration & dosage* ; Diabetes Mellitus, Type 2/metabolism* ; Gastrointestinal Microbiome/drug effects* ; Rats ; Male ; Rats, Sprague-Dawley ; Humans ; Bacteria/drug effects* ; Blood Glucose/metabolism*

Objective To explore the anesthetic effects of remimazolam combined with nalbuphine on patients undergoing painless gastroscopy.Methods A total of 120 patients who underwent painless gastroscopy in Handan Central Hospital from August 2019 to May 2021 were selected and randomly divided into the observation group(60 cases)and the control group(60 cases).Patients in the observation group anesthetized with remimazolam and nalbuphine,while patients in the control group anesthetized with propofol and alfentanil.The vital signs,sedative effect,recovery quality,cognitive function,and adverse reactions of patients were compared between the two groups.Results The heart rate(HR),respiratory rate(RR),and the level of pulse oxygen saturation(SpO2)of patients in the observation group were significantly higher than those in the control group(P<0.05).Five minutes after the examination,the Narcotrend score of patients in the observation group was significantly lower than that in the control group(P<0.05).The time from the last administration to awakening,the time from gastroscopy removal to awakening,and the time of leaving the anesthesia recovery room of patients in the observation group were significantly shorter than those in the control group(P<0.05).Five minutes after the examination,the score of the mini-mental state examination(MMSE)of patients in the observation group was significantly higher than that in the control group(P<0.05),while the incidence of adverse reactions was significantly lower than that in the control group(P<0.05).Conclusion The application of remimazolam combined with nalbuphine anesthesia in painless gastroscopy has a relatively ideal effect,which can effectively reduce the adverse reactions of patients and promote rapid postoperative recovery.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

The study was aimed at identifying the diversity of tick species in selected areas of Qinghai,to analyze the genetic differentiation characteristics of tick-borne spotted fever group rickettsiae(SFGR),and to provide the theoretical basis for SFGR prevention and control in the region.The 16S rRNA gene was used for molecular biological identification of 446 collected tick samples,and the infection characteristics of SFGR in tick samples were determined according to the SFGR outer membrane protein A(ompA)gene.Haplotype analysis,phylogenetic tree construction,and estimation of differentiation times for SFGR were conducted in DNASP v6,IQ-tree v2.2.0,and BEAST v2.7.4 software.The obtained 446 tick samples belonged to three categories:(1)Haemaphy-salis spp.,including Haemaphysalis qinghaiensis(n=192)and H.danieli(n=37);(2)Dermacentor spp.,including Dermacentor ever-estianus(n=121),D.nuttalli(n=55),and D.silvarum(n=36);and(3)Hyalomma marginatum(n=5).Rickettsia raoultii was de-tected in D.everestianus,D.silvarum,D.nuttalli,H.qinghaiensis,and H.danieli,with infection rates of 95.9%,80.6%,69.1%,4.1%,and 2.7%,respectively.R.sibirica subsp.sibirica BJ-90 was found only in D.silvarum and D.nuttalli,with infection rates of 5.6%and 1.8%,respectively.The Candidatus R.gannanii F107 was found in H.danieli and H.qinghaiensis,with infection rates of 16.2%and 7.8%,respectively.Ca.R.hongyuanensis was detected only in H.qinghaiensis,with a prevalence of 16.3%.The prevalence of R.aeschlimannii was 20%and 2.7%in Hy.marginatum and H.danieli,respectively.Haplotype and nucleotide polymorphism analy-ses revealed 13 haplotypes in R.raoultii,with haplotype H13 as the dominant haplotype(42/192);seven haplotypes in Ca.R.ganna-nii F107,with haplotype H4 as the dominant haplotype(4/18);and three haplotypes in Ca.R.hongyuanensis,with haplotype H1 as the dominant haplotype(11/13).The phylogenetic tree indicated that the sequences of R.raoultii in selected areas of Qinghai and R.rhipicephali clustered into one branch;Ca.R.hongyuanensis and Ca.R.gannanii F107 clustered into one branch;and R.sibirica subsp.sibirica BJ-90 clustered into one branch with R.sibirica.Estimates of differentiation time revealed that the mean differentiation time for the six Rickettsia was approximately 2 000 Mya(95%CI:1 999.08-2 001.02 Mya).The tick species distributed in selected ar-eas of Qinghai are diverse,and this study provides the first report of Hy.marginatum in Qinghai Province.SFGR significantly varied in prevalence among tick species and showed high genetic diversity.

The study was aimed at identifying the diversity of tick species in selected areas of Qinghai,to analyze the genetic differentiation characteristics of tick-borne spotted fever group rickettsiae(SFGR),and to provide the theoretical basis for SFGR prevention and control in the region.The 16S rRNA gene was used for molecular biological identification of 446 collected tick samples,and the infection characteristics of SFGR in tick samples were determined according to the SFGR outer membrane protein A(ompA)gene.Haplotype analysis,phylogenetic tree construction,and estimation of differentiation times for SFGR were conducted in DNASP v6,IQ-tree v2.2.0,and BEAST v2.7.4 software.The obtained 446 tick samples belonged to three categories:(1)Haemaphy-salis spp.,including Haemaphysalis qinghaiensis(n=192)and H.danieli(n=37);(2)Dermacentor spp.,including Dermacentor ever-estianus(n=121),D.nuttalli(n=55),and D.silvarum(n=36);and(3)Hyalomma marginatum(n=5).Rickettsia raoultii was de-tected in D.everestianus,D.silvarum,D.nuttalli,H.qinghaiensis,and H.danieli,with infection rates of 95.9%,80.6%,69.1%,4.1%,and 2.7%,respectively.R.sibirica subsp.sibirica BJ-90 was found only in D.silvarum and D.nuttalli,with infection rates of 5.6%and 1.8%,respectively.The Candidatus R.gannanii F107 was found in H.danieli and H.qinghaiensis,with infection rates of 16.2%and 7.8%,respectively.Ca.R.hongyuanensis was detected only in H.qinghaiensis,with a prevalence of 16.3%.The prevalence of R.aeschlimannii was 20%and 2.7%in Hy.marginatum and H.danieli,respectively.Haplotype and nucleotide polymorphism analy-ses revealed 13 haplotypes in R.raoultii,with haplotype H13 as the dominant haplotype(42/192);seven haplotypes in Ca.R.ganna-nii F107,with haplotype H4 as the dominant haplotype(4/18);and three haplotypes in Ca.R.hongyuanensis,with haplotype H1 as the dominant haplotype(11/13).The phylogenetic tree indicated that the sequences of R.raoultii in selected areas of Qinghai and R.rhipicephali clustered into one branch;Ca.R.hongyuanensis and Ca.R.gannanii F107 clustered into one branch;and R.sibirica subsp.sibirica BJ-90 clustered into one branch with R.sibirica.Estimates of differentiation time revealed that the mean differentiation time for the six Rickettsia was approximately 2 000 Mya(95%CI:1 999.08-2 001.02 Mya).The tick species distributed in selected ar-eas of Qinghai are diverse,and this study provides the first report of Hy.marginatum in Qinghai Province.SFGR significantly varied in prevalence among tick species and showed high genetic diversity.

Objective This study aimed to investigate the potential relationship between urinary metals copper (Cu), arsenic (As), strontium (Sr), barium (Ba), iron (Fe), lead (Pb) and manganese (Mn) and grip strength. Methods We used linear regression models, quantile g-computation and Bayesian kernel machine regression (BKMR) to assess the relationship between metals and grip strength.Results In the multimetal linear regression, Cu (β=-2.119), As (β=-1.318), Sr (β=-2.480), Ba (β=0.781), Fe (β= 1.130) and Mn (β=-0.404) were significantly correlated with grip strength (P < 0.05). The results of the quantile g-computation showed that the risk of occurrence of grip strength reduction was -1.007 (95％ confidence interval:-1.362, -0.652; P < 0.001) when each quartile of the mixture of the seven metals was increased. Bayesian kernel function regression model analysis showed that mixtures of the seven metals had a negative overall effect on grip strength, with Cu, As and Sr being negatively associated with grip strength levels. In the total population, potential interactions were observed between As and Mn and between Cu and Mn (Pinteractions of 0.003 and 0.018, respectively).Conclusion In summary, this study suggests that combined exposure to metal mixtures is negatively associated with grip strength. Cu, Sr and As were negatively correlated with grip strength levels, and there were potential interactions between As and Mn and between Cu and Mn.

Objective To explore the influence of intravenous injection of cis-atracurium during anesthesia induction on QT interval(QTc),hemodynamics and oxidative stress level in patients undergoing hysteroscopic surgery.Methods Patients undergoing hysteroscopic surgery were classified into control group and treatment group.The treatment group was given intravenous injection of 2 mg·kg-1 of propofol emulsion injection+3 μg·kg-1 of fentanyl+0.15 mg·kg-1 of cis-atracurium besylate for injection,while the control group was given intravenous injection of 2 mg·kg-1 of propofol emulsion injection+3 μg·kg-1 of fentanyl+the same amount of 0.9％NaCl as treatment group.Laryngeal mask was placed in the two groups after 3 min,and laryngeal mask ventilation was given for general anesthesia.QTc value and hemodynamics[mean arterial pressure(MAP)]were detected before entering the room(T0),after 1 min of propofol+fentanyl intravenous injection(T1),after 1 min of cis-atracurium besylate for injection/0.9％NaCl(T2),immediately after laryngeal mask insertion(T3)and after 3 min of laryngeal mask insertion(T4).The anesthetic effect,postoperative dynamic pain visual analogue scale(VAS)score and sore throat were counted.The levels of serum oxidative stress indicators[superoxide dismutase(SOD),malondialdehyde(MDA)]at T0 and at the end of surgery(T5)were detected,and the safety was assessed.Results Fifty-two cases in treatment group and forty-four cases in control group were included.There was no statistical difference in QTc value between treatment group and control group at T0-T4(all P＞0.05).The MAP values in treatment group and control group at T3 were(84.22±5.96)and(86.78±6.11)mmHg,respectively,with a statistical difference(P＜0.05).The laryngeal mask insertion times in treatment group and control group were(17.02±2.47)and(19.52±2.34)s;the spontaneous breathing recovery times were(8.51±1.84)and(6.18±1.15)min;the eye opening time were(10.49±2.42)and(9.53±2.17)min;the laryngeal mask removal time were(11.16±2.16)and(10.21±2.34)min;the incidence rates of postoperative sore throat were 13.46％and 31.82％,and the differences were statistically significant(all P＜0.05).The levels of SOD in treatment group and control group at T5 were(36.63±4.17)and(33.26±4.86)nU·mL-1;the levels of MDA were(7.42±2.14)and(8.59±2.83)mmol·L-1(all P＜0.05).The adverse drug reactions in treatment group were mainly nausea and vomiting,respiratory depression and hypotension,and the adverse drug reactions in control group were mainly nausea and vomiting and respiratory depression.The incidence rates of adverse reactions in treatment group and control group were 13.46％and 11.36％,respectively(P＞0.05).Conclusion Cis-atracurium intravenous injection during anesthesia induction has no influence on QTc in patients undergoing hysteroscopic surgery,and has advantages in stabilizing intraoperative hemodynamics,reducing postoperative sore throat and improving serum oxidative stress indicators.

This study was aimed at creating an engineered strain of Bacillus subtilis for efficient expression of biologically active type 2 toxin B(TcdB2)derived from a highly virulent strain of Clostridium difficile.The TcdB2 gene was cloned from ST1/RT027 strain genome DNA,incorporated into the PHT01 vector,and then transformed into B.subtilis strain WB800N for prokaryotic expression.Cell toxicity assays revealed that the recombinant TcdB2 exhibited cytotoxic effects in various cells.The engineered B.subtilis strain effectively expressed biologically active TcdB2,thus providing a basis for further exploration of the pathogenic mechanisms of highly virulent strains of C.difficile and establishing a foundation for potential vaccine can-didate targets.