OBJECTIVE: To observe the effect of electroacupuncture (EA) on the intestinal flora in rats with chronic obstructive pulmonary disease (COPD) and explore its possible mechanism based on the gut-lung axis theory. METHODS: A total of 30 male SD rats of SPF grade were randomly divided into a normal control (NC) group, a model group and an EA group, 10 rats in each one. In the model group and the EA group, COPD model was established by intratracheal instillation of lipopolysaccharide combined with cigarette fumigation. In the EA group, EA was applied at bilateral "Feishu" (BL13) and "Zusanli" (ST36), with disperse-dense waves, in frequency of 4 Hz/20 Hz, current of 1-3 mA, 20 min a time, once a day for 14 days continuously. Before and after modeling, as well as after intervention, body weight was observed; after intervention, the lung function indexes (forced expiratory volume in 0.1 second [FEV_0.1], FEV_0.1/forced vital capacity [FVC]%, forced expiratory volume in 0.3 second [FEV_0.3] and FEV_0.3/FVC%) were measured, serum levels of inflammatory factors (tumor necrosis factor-α[TNF-α], interleukin-6[IL-6], interleukin-1β[IL-1β] and interleukin-10[IL-10]) were detected by ELISA, histopathology of lung and colon tissues was observed by HE staining, the intestinal flora were analyzed by 16S rRNA, and the correlations between lung function and intestinal flora were analyzed. RESULTS: Compared with the NC group, in the COPD group, the body weight and lung function indexes were reduced (P<0.01); the lung and colon tissues were damaged, the mean linear intercept (MLI) of alveolus and inflammatory cell numbers of 100 μm² in lung tissue were increased (P<0.01); the serum levels of TNF-α, IL-6 and IL-1β were increased (P<0.01, P<0.05), and the serum level of IL-10 was decreased (P<0.01); α-diversity indexes of intestinal flora were increased (P<0.01); the relative abundance of Bacteroidetes, Proteobacteria and Oscillospira, Bacteroides, Coprococcus was increased (P<0.01), the relative abundance of Firmicutes, Actinobacteria, Tenericutes, TM7 and Lactobacillus, Allobaculum, Bifidobacterium, YRC22 was decreased (P<0.01, P<0.05); 31 different expressed metabolic pathways were identified between the two groups. Compared with the COPD group, in the EA group, the body weight and lung function indexes were increased (P<0.01); the damage of lung and colon tissues was improved, the MLI of alveolus was decreased (P<0.05); the serum levels of TNF-α, IL-6 and IL-1β were decreased (P<0.05), and the serum level of IL-10 was increased (P<0.05); α-diversity indexes of intestinal flora were decreased (P<0.01); the relative abundance of Bacteroidetes, Proteobacteria and Oscillospira, Bacteroides, Coprococcus was decreased (P<0.01, P<0.05), the relative abundance of Firmicutes, Actinobacteria, Tenericutes, TM7 and Lactobacillus, Allobaculum, Bifidobacterium, YRC22 was increased (P<0.01); 35 different expressed metabolic pathways were identified between the two groups. The lung function was positive related with Actinobacteria, Tenericutes, TM7 and YRC22, and was negative related with Bacteroidetes, Proteobacteria and Oscillospira, Bacteroides, Coprococcus. CONCLUSION EA may ameliorate lung function and tissue injury of COPD by regulating intestinal flora dysbiosis and inflammatory response, suggesting an anti-inflammatory effect mediated via "gut-lung" axis.
Animals ; Pulmonary Disease, Chronic Obstructive/genetics* ; Male ; Electroacupuncture ; Rats ; Rats, Sprague-Dawley ; Lung/metabolism* ; Gastrointestinal Microbiome ; Humans ; Interleukin-6/immunology* ; Tumor Necrosis Factor-alpha/immunology* ; Intestines/microbiology* ; Interleukin-10/immunology*

This study aimed to investigate the effects of sweet potato leaf extract on production per-formance,systematic and mammary gland oxidative stress status and rumen microbiota of dairy goats fed high concentrate diets.Twenty Guanzhong dairy goats with same parity,similar lactation period(120±15)d and healthy body condition were selected and randomly divided into four groups:low-concentrate(LC),low-concentrate supplemented with 1％sweet potato leaf extract(LCS),high-concentrate(HC)and high-concentrate supplemented with 1％sweet potato leaf ex-tract(HCS).The experimental period was 35 days.The results showed that in the third week,milk yield in the HCS group was significantly higher than that in the LC and LCS groups(P＜0.05).The content of lipopolysaccharide in the rumen fluid of the HC group was significantly higher than that of the other three groups(P＜0.05),the content of malondialdehyde in the serum of the HC group was significantly higher than that of the LCS group(P＜0.05),the content of reactive oxygen species,protein carbonyl,8-hydroxydeoxyguanosine in the milk of the HC group was sig-nificantly higher than that of the LC and LCS groups(P＜0.05),GSH-Px in HCS group was sig-nificantly higher than that in the other three groups(P＜0.05).After the addition of sweet potato leaf extract,there was an increasing trend in the content of Anabaena phylum at the phylum level.In the joint analysis of genera,rumen fluid LPS showed highly significant negative correlation with Succiniclasticum(P＜0.01)and negative correlation with Prevotella(P＜0.05).Valeric acid was negatively correlated with Prevotella(P＜0.05).The pH value was negatively correlated with Treponema(P＜0.05).Butyric acid was positively correlated with Anaeroplasma(P＜0.05).In conclusion,the addition of sweet potato leaf extract to the diet can increase milk production and al-leviate the state of mammary gland oxidative stress,as well as improving rumen microbial diversi-ty of dairy goats.

Objective:To investigate the clinical efficacy of laparoscopic hiatal hernia repair (LHHR) combined with Nissen, Toupet, or Dor fundoplication.Methods:The retrospective cohort study was conducted. The clinical data of 102 hiatal hernia patients who were admitted to 4 hospitals including Gansu Provincial Central Hospital from January 2019 to December 2023 were collected. There were 46 males and 56 females, aged (54±4)years. Among the 102 patients, 37 cases who underwent LHHR combined with Nissen fundoplication were assigned to the Nissen group, 34 cases who underwent LHHR combined with Toupet fundoplication were assigned to the Toupet group, and 31 cases who underwent LHHR combined with Dor fundoplication were assigned to the Dor group. Observation indicators: (1) surgical conditions and postoperative recovery; (2) dysphagia before and after surgery; (3) gastroesophageal reflux disease questionnaire (GERD-Q) scores before and after surgery. One-way analysis of variance (ANOVA) was used for comparison of measurement data with normal distribution among groups. In ANOVA, if there were statistically significant differences among groups, the least significant difference (LSD) method was further used for pairwise compari-son. Repeated-measures ANOVA was applied for comparison of repeated measure-ment data. Comparison of count data among multiple groups was conducetd using the chi-square test or Fisher exact probability, and the Dunn-Bonferroni correction was used for further pairwise comparison. Comparison of ranked data between groups was conducted using the Kruskal-Wallis H test. Results:(1) Surgical conditions and postoperative recovery. There was no significant difference in operation time, volume of intraoperative blood loss, time to postoperative first flatus, length of hospital stay, or the incidence of postoperative in-hospital dysphagia, abdominal distension, abdominal pain, diarrhea among the three groups ( P>0.05). At 12 months after surgery, there was no hernia recurrence in the Nissen group, 1 case of recurrence in the Toupet group, and 1 case of recurrence in the Dor group, showing no significant difference among the three groups ( P>0.05). (2) Dysphagia before and after surgery. Before surgery, there was no significant difference in the incidence of dysphagia among the three groups ( P>0.05). At 1 month after surgery, the number of patients with dysphagia in the Nissen group, Toupet group, and Dor group was 20, 18, and 7, respectively, showing a significant difference among the three groups ( χ2=8.39, P<0.05). There was no significant difference between the Nissen group and Toupet group ( P>0.05). There was a significant difference between the Nissen group and Dor group, between the Toupet group and Dor group ( χ2=6.98, 6.32, P<0.05). However, at 6 and 12 months after surgery, there was no significant difference in the incidence of dysphagia among the three groups ( P>0.05). (3) GERD-Q scores before and after surgery. The GERD-Q scores before surgery, at 1 month and 6 months after surgery were 10.8±1.9, 8.5±2.1, 7.1±1.9 of the Nissen group, 11.0±1.6, 8.6±1.9, and 7.1±1.7 of the Toupet group, 10.7±1.6, 8.7±1.9, 7.2±1.8 of the Dor group, respectively. For the GERD-Q scores of the three groups before and after surgery, there was a significant difference in the time effect ( F=104.17, P<0.05), while no significant difference was found in the inter-group effect and interaction effect ( F=0.13, 0.16, P>0.05). Intra-group comparison of GERD-Q scores in the three groups before surgery, at 1 month and 6 months after surgery showed significant differences respectively ( F=38.37, 40.29, 27.20, P<0.05). Conclusions:LHHR combined with Nissen, Toupet, or Dor fundoplication is safe and effective in the treatment of hiatal hernia , which can achieve good anti-reflux effects. The Dor fundoplication is associated with a lower short-term incidence of postoperative dysphagia.

This study aimed to investigate the effects of sweet potato leaf extract on production per-formance,systematic and mammary gland oxidative stress status and rumen microbiota of dairy goats fed high concentrate diets.Twenty Guanzhong dairy goats with same parity,similar lactation period(120±15)d and healthy body condition were selected and randomly divided into four groups:low-concentrate(LC),low-concentrate supplemented with 1％sweet potato leaf extract(LCS),high-concentrate(HC)and high-concentrate supplemented with 1％sweet potato leaf ex-tract(HCS).The experimental period was 35 days.The results showed that in the third week,milk yield in the HCS group was significantly higher than that in the LC and LCS groups(P＜0.05).The content of lipopolysaccharide in the rumen fluid of the HC group was significantly higher than that of the other three groups(P＜0.05),the content of malondialdehyde in the serum of the HC group was significantly higher than that of the LCS group(P＜0.05),the content of reactive oxygen species,protein carbonyl,8-hydroxydeoxyguanosine in the milk of the HC group was sig-nificantly higher than that of the LC and LCS groups(P＜0.05),GSH-Px in HCS group was sig-nificantly higher than that in the other three groups(P＜0.05).After the addition of sweet potato leaf extract,there was an increasing trend in the content of Anabaena phylum at the phylum level.In the joint analysis of genera,rumen fluid LPS showed highly significant negative correlation with Succiniclasticum(P＜0.01)and negative correlation with Prevotella(P＜0.05).Valeric acid was negatively correlated with Prevotella(P＜0.05).The pH value was negatively correlated with Treponema(P＜0.05).Butyric acid was positively correlated with Anaeroplasma(P＜0.05).In conclusion,the addition of sweet potato leaf extract to the diet can increase milk production and al-leviate the state of mammary gland oxidative stress,as well as improving rumen microbial diversi-ty of dairy goats.

Objective:To investigate the clinical efficacy of laparoscopic hiatal hernia repair (LHHR) combined with Nissen, Toupet, or Dor fundoplication.Methods:The retrospective cohort study was conducted. The clinical data of 102 hiatal hernia patients who were admitted to 4 hospitals including Gansu Provincial Central Hospital from January 2019 to December 2023 were collected. There were 46 males and 56 females, aged (54±4)years. Among the 102 patients, 37 cases who underwent LHHR combined with Nissen fundoplication were assigned to the Nissen group, 34 cases who underwent LHHR combined with Toupet fundoplication were assigned to the Toupet group, and 31 cases who underwent LHHR combined with Dor fundoplication were assigned to the Dor group. Observation indicators: (1) surgical conditions and postoperative recovery; (2) dysphagia before and after surgery; (3) gastroesophageal reflux disease questionnaire (GERD-Q) scores before and after surgery. One-way analysis of variance (ANOVA) was used for comparison of measurement data with normal distribution among groups. In ANOVA, if there were statistically significant differences among groups, the least significant difference (LSD) method was further used for pairwise compari-son. Repeated-measures ANOVA was applied for comparison of repeated measure-ment data. Comparison of count data among multiple groups was conducetd using the chi-square test or Fisher exact probability, and the Dunn-Bonferroni correction was used for further pairwise comparison. Comparison of ranked data between groups was conducted using the Kruskal-Wallis H test. Results:(1) Surgical conditions and postoperative recovery. There was no significant difference in operation time, volume of intraoperative blood loss, time to postoperative first flatus, length of hospital stay, or the incidence of postoperative in-hospital dysphagia, abdominal distension, abdominal pain, diarrhea among the three groups ( P>0.05). At 12 months after surgery, there was no hernia recurrence in the Nissen group, 1 case of recurrence in the Toupet group, and 1 case of recurrence in the Dor group, showing no significant difference among the three groups ( P>0.05). (2) Dysphagia before and after surgery. Before surgery, there was no significant difference in the incidence of dysphagia among the three groups ( P>0.05). At 1 month after surgery, the number of patients with dysphagia in the Nissen group, Toupet group, and Dor group was 20, 18, and 7, respectively, showing a significant difference among the three groups ( χ2=8.39, P<0.05). There was no significant difference between the Nissen group and Toupet group ( P>0.05). There was a significant difference between the Nissen group and Dor group, between the Toupet group and Dor group ( χ2=6.98, 6.32, P<0.05). However, at 6 and 12 months after surgery, there was no significant difference in the incidence of dysphagia among the three groups ( P>0.05). (3) GERD-Q scores before and after surgery. The GERD-Q scores before surgery, at 1 month and 6 months after surgery were 10.8±1.9, 8.5±2.1, 7.1±1.9 of the Nissen group, 11.0±1.6, 8.6±1.9, and 7.1±1.7 of the Toupet group, 10.7±1.6, 8.7±1.9, 7.2±1.8 of the Dor group, respectively. For the GERD-Q scores of the three groups before and after surgery, there was a significant difference in the time effect ( F=104.17, P<0.05), while no significant difference was found in the inter-group effect and interaction effect ( F=0.13, 0.16, P>0.05). Intra-group comparison of GERD-Q scores in the three groups before surgery, at 1 month and 6 months after surgery showed significant differences respectively ( F=38.37, 40.29, 27.20, P<0.05). Conclusions:LHHR combined with Nissen, Toupet, or Dor fundoplication is safe and effective in the treatment of hiatal hernia , which can achieve good anti-reflux effects. The Dor fundoplication is associated with a lower short-term incidence of postoperative dysphagia.

Objective:To analyze potential risk factors of early postoperative pulmonary infection (≤28 days) after abdominal incisional hernia repair, and to propose the corresponding prevention and treatment measures.Methods:A retrospective case-control study was conducted to collect the clinical data of 103 patients who underwent abdominal incisional hernia repair in the First Hospital of Lanzhou University from May 2017 to April 2023. According to the occurrence of early postoperative pulmonary infection, the patients were divided into pulmonary infection group ( n=29) and non-pulmonary infection group ( n=74), univariate and multivariate Logistic regression analysis were used to analyze the related factors that may affect the early postoperative pulmonary infection after abdominal incisional hernia repair. Measurement data conforming to normal distribution were expressed as mean±standard deviation ( ± s) and analyzed by independent sample t-test. Non-normal measurement data were expressed as median and interquartile range M( Q1, Q3), and Mann-Whitney U test was used. The count data were expressed as cases (%), and the chi-square test or Fisher′s exact test was used for comparison between groups. Results:Univariate analysis showed that smoking history, American Society of Anesthesiologists score, history of chronic lung disease, preoperative prognostic nutritional index, preoperative aerosol inhalation, preoperative indwelling gastric tube, size of abdominal wall defect, operation duration, and multimodal analgesia were associated with early pulmonary infection after abdominal wall incisional hernia surgery, and the difference was statistically significant ( P<0.05). Multivariate Logistic regression analysis showed that history of smoking ( OR=9.304, 95% CI: 1.959-46.560), history of chronic lung disease ( OR=10.507, 95% CI: 1.630-67.734), preoperative indwelling gastric tube ( OR=9.208, 95% CI: 1.745-48.579) was an independent risk factor for early postoperative pulmonary infection ( P< 0.05), while multimodal analgesia ( OR=0.057, 95% CI: 0.011-0.307) was a protective factor for early postoperative pulmonary infection ( P<0.05). Conclusions:Pulmonary infection is prone to occur early after abdominal incisional hernia repair, which is related to smoking history, chronic lung disease history and preoperative indwelling gastric tube. Multimodal analgesia can reduce the occurrence of early pulmonary infection after abdominal incisional hernia repair.

Postoperative complications of colorectal cancer (CRC) are the main cause of postoperative death and seriously affect the quality of life and survival time of patients. The application of a clinical prediction model for postoperative complications of CRC can help promptly identify high-risk patients. Accordingly, reasonable intervention measures can be actively taken to reduce the incidence of postoperative complications of CRC. A scientific basis can also be provided to improve the prognosis of patients. In this work, literature on the risk-factor analysis and prediction-model construction of postoperative complications of CRC at home and abroad in recent years was collected and reviewed. The evaluation content and efficiency of the clinical prediction models in postoperative complications of CRC were summarized. Their advantages and disadvantages were also analyzed. The purpose of this study was to provide a reference for the subsequent optimization of such models and the development of a strong, clinically practical, and universal risk-screening tool for postoperative complications of CRC.

Objective:To clarify the elements of post competency of public health professionals and technical personnel, and construct a post competency index system of public health professionals and technical personnel.Methods:Referring to the Hay Group Competency Dictionary and literature review method, the post competency information elements of public health professional and technical personnel were constructed, and were revised through the expert consultation method. Unit-level stratified sampling was used, and 120 public health professionals were invited to evaluate the importance of the elements. SPSS 26.0 was used for data analysis, the continuous data were expressed in ( x ± s) mode, and Pearson was used to study the degree of correlation of each dimension. Finally, the post competency index system for public health positions was constructed by using the factor analysis method to extract the common factor as the first-level index. Results:The index system contained 7 first-level indicators (43 items), including public health practice skills, clinical practice skills, professional basic subject knowledge, personal professional accomplishment, public health authority and management ability, public health leadership, and public health methodology knowledge. Its weight coefficients (%) were 20.03, 17.48, 15.89, 15.68, 13.98, 12.82 and 4.11, respectively. The elements with the highest materiality scores were personal protection, responsibility and professionalism.Conclusion:Personal protection and other public health practical skills and personal professional qualities such as sense of responsibility and professionalism are the core elements of public health positions, and it is recommended to strengthen the training of public health professionals' public health practical skills in actual work, and pay attention to the cultivation of personal professional qualities, so as to establish a better team of public health talents.

The acute abdomen of hernia mainly refers to an incarcerated hernia, which is a common acute abdomen in clinic. CT plays an important role in the diagnosis of incarcerated hernia. If incarcerated hernia is not handled timely and correctly, it may further develop into strangulated hernia, leading to intestinal necrosis, perforation and even endangering the patient′s life. Manual reduction can be attempted for patients with low risk of reduction, and active surgery should be performed for patients with unsuccessful reduction or high risk of manipulative reduction. More and more evidence shows that laparoscopic minimally invasive treatment of acute incarcerated hernia has practical clinical efficacy and fewer postoperative complications. The use of mesh in incarcerated hernia surgery has also been shown to be safe and feasible, as long as it is properly selected, even in incarcerated hernia repair during enterectomy, mesh does not increase the risk of infection in the surgical area and greatly reduces the likelihood of postoperative recurrence. At the same time, the concept of accelerated rehabilitation surgery was used to strengthen perioperative management, reduce complications and promote rehabilitation of patients.

Objective:To compare the effectiveness and recurrence rate of different types of mesh or without mesh in laparoscopic hiatal hernia repair.Methods:From Jan 2016 to Mar 2022 at the three hospital 90 patients with hiatal hernia, including 26 cases without mesh, 29 cases using synthetic mesh, and 35 cases using biological mesh underwent laparoscopic hiatal hernia repair.Results:The surgical procedures was successful in all the 90 cases without conversion to open surgeny. There were no statistically significant differences in operative time, intraoperative blood loss and postoperative hospital stay among the three groups ( P>0.05), and there were statistically significant differences in hospital cost between the group without mesh and synthetic mesh and biological mesh ( P<0.05). Long-term follow-up was achieved in 87 patients, with a follow-up rate of 96.7% (87/90), and a median follow-up time of 44 months. There were no significant differences in the incidence of postoperative complications (diarrhea, dysphagia, abdominal distension, chest pain), recurrence rate of symptoms (acid reflux, heartburn) and patient satisfaction among the three groups ( P>0.05). Conclusion:In laparoscopic hiatal hernia repair, the mesh should be carefully selected according to the specific intraoperative situation for a satisfactory clinical efficacy.