Objective To explore the correlation between alterations in intestinal microbiota composition and abnormal cytokine expression in patients with gastric cancer. Methods Fecal and peripheral blood samples were collected from 81 patients with gastric cancer (gastric cancer group) and 85 healthy subjects (healthy control group). Fecal bacterial DNA was sequenced through 16S rRNA gene amplicon sequencing, and the serum levels of 17 cytokines were measured with the AimPlex multiplex assay technology: IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p70, IL-15, IL-17A, TNF-α, TNF-β, GM-CSF, G-CSF, IFN-γ, IP-10, MCP-1, and VEGF-A. Results In the gastric cancer group, the abundances of 11 butyrate-producing bacteria, including certain genera of the Lachnospiraceae family (such as Lachnospira and Roseburia) and Faecalibacterium, considerably decreased. By contrast, the abundances of nine bacterial taxa, including Escherichia–Shigella, Streptococcus, Veillonella, and Parabacteroides, significantly increased. Correlation analysis showed that the decrease in the abundance of butyrate-producing bacteria were significantly negatively correlated with the high expression levels of pro-angiogenic and immunosuppressive cytokines in the gastric cancer group, including IP-10, IL-10, MCP-1, IL-8, IL-6, and VEGF-A. However, the decrease was significantly positively correlated with the downregulation of antitumor immune-related cytokines, including IL-2, IL-17A, IL-1β, TNF-β, and GM-CSF. Conversely, the enriched bacterial taxa exhibited opposite correlation patterns with these cytokines. Conclusion A close correlation is observed between intestinal microbiota dysbiosis and abnormal cytokine expression in patients with gastric cancer. The findings suggest that restoring the intestinal microbiota through fecal microbiota transplantation is a promising strategy for regulating cytokines and is a potential research direction for the adjuvant therapy of gastric cancer.

Objective: To evaluate the clinical efficacy of a novel autologous blood recovery device during the weaning process from extracorporeal membrane oxygenation (ECMO). Methods: A total of 16 patients who received ECMO support and underwent blood recovery during the weaning process from January 2022 to September 2024 at our hospital were included in the experimental group. In contrast, 58 patients who did not receive blood recovery during the weaning process were assigned to the control group. Transfusion components, costs, and changes in routine blood tests and coagulation functions were compared between the two groups from the day of weaning until 48 hours post-weaning. Results: Significant differences were observed in the volumes of red blood cell transfusions, plasma transfusions, and transfusion costs between the two groups from the day of weaning to 48 hours post-weaning (P<0.05). Additionally, in the experimental group, significant differences were noted in hemoglobin (Hb), platelet (Plt), and activated partial thromboplastin time (APTT) results when comparing values before and after extubation (P<0.05). Conclusion: The application of a novel autologous blood recovery device during ECMO weaning reduces patient costs, minimizes wastage of autologous blood, decreases reliance on exogenous blood transfusions, and mitigates the risks associated with allogeneic blood transfusion. This approach merits further promotion for clinical use.

Phages, prokaryotic viruses widely present in the human, are a crucial component of the gut microbiome. They play a significant role in human health and the development of diseases. Emerging evidence indicates that phages can interact with bacteria to affect their abundance, metabolism, and antibiotic resistance, thereby influencing the balance of the gut microbiota. In addition, phages also contribute to the gut immune response, and can become dysregulated in a range of immune-related diseases. Gut phages also carry important roles in fecal microbiota transplantation (FMT) for disease treatment. Phages can target specific bacterial members and communities, thereby reduce the risk of bacterial infections or the presence of bacteria, and maintain the stability of the gut microbiome. However, gut phageome research is still in its infancy and additional basic and clinical researches are required to evaluate its species composition, mechanisms of pathogenicity or protection, as well as its efficacy and safety.

Phages, prokaryotic viruses widely present in the human, are a crucial component of the gut microbiome. They play a significant role in human health and the development of diseases. Emerging evidence indicates that phages can interact with bacteria to affect their abundance, metabolism, and antibiotic resistance, thereby influencing the balance of the gut microbiota. In addition, phages also contribute to the gut immune response, and can become dysregulated in a range of immune-related diseases. Gut phages also carry important roles in fecal microbiota transplantation (FMT) for disease treatment. Phages can target specific bacterial members and communities, thereby reduce the risk of bacterial infections or the presence of bacteria, and maintain the stability of the gut microbiome. However, gut phageome research is still in its infancy and additional basic and clinical researches are required to evaluate its species composition, mechanisms of pathogenicity or protection, as well as its efficacy and safety.

Objective:To analyze interobserver variability in endoscopic diagnostic accuracy of chronic atrophic gastritis (CAG) among endoscopists with varying levels of experience.Methods:Endoscopic examination data from 247 patients who underwent endoscopy from January 2021 to June 2024 at Department of Gastroenterology, the First Affiliated Hospital of Army Medical University ( n=154), Renmin Hospital of Wuhan University ( n=35) and Shanxi Provincial Coal Central Hospital ( n=58) were retrospectively collected. The collected images were reviewed by an expert panel of three individuals with the title of deputy chief physician or above. The final endoscopic Kimura-Takemoto classification diagnosis of the expert panel was regarded as the golden standard. Fourteen endoscopists from the above three centers provided their Kimura-Takemoto classification diagnosis. These endoscopists were divided into the junior group ( n=7, with experience of <2 000 procedures) and the senior group ( n=7, with experience of >10 000 procedures). The difference in the accuracy of endoscopic Kimura-Takemoto classification diagnosis between the groups were analyzed. Results:Diagnostic accuracy for Kimura-Takemoto classification ranged from 65.99% (163/247) to 86.64% (214/247) in the senior group with the overall accuracy of 77.27% (1 336/1 729). The junior group exhibited diagnostic accuracy ranging from 36.44% (90/247) to 72.47% (179/247) with the overall accuracy of 62.12% (1 074/1 729). The senior group demonstrated higher overall diagnostic accuracy than that of the junior group ( χ 2=93.27, P<0.001). The diagnostic accuracy of non-CAG in the senior group was higher than that in the junior group [83.73% (463/553) VS 72.33% (400/553), χ 2=20.27, P<0.001]. The diagnostic accuracy of C-type atrophy in the senior group was higher than that in the junior group [90.10% (801/889) VS 82.79% (736/889), χ 2=19.66, P<0.001] .The diagnostic accuracy of O-type atrophy in the senior group was higher than that in the junior group [83.97% (241/287) VS 68.29% (196/287), χ 2=18.56, P<0.001]. Conclusion:Interobserver variability is observed in the diagnostic accuracy of endoscopic Kimura-Takemoto classification for CAG among endoscopists with different experience levels. Experienced endoscopists exhibit higher diagnostic accuracy for CAG compared with their less experienced counterparts.

Objective:To explore the impact of different nutritional statuses on the prognosis of elderly patients with idiopathic pulmonary fibrosis(IPF), and to provide a basis for early intervention of the nutritional status of elderly IPF patients.Methods:A retrospective analysis was conducted on 237 elderly patients clinically diagnosed with IPF who were admitted to the First Hospital of Shanxi Medical University from January 2018 to May 2024.The GLIM criteria were applied to diagnose malnutrition and classify its severity.The patients were divided into two groups: those without nutritional risk(Group A)and those with nutritional risk(Group B). Group B was further subdivided into three subgroups: patients with only nutritional risk(Subgroup B1), those with moderate malnutrition(Subgroup B2), and those with severe malnutrition(Subgroup B3). The study observed the clinical characteristics of elderly IPF patients and the impact of nutritional factors on hospital admission frequency, activities of daily living(ADL), and all-cause mortality.Results:A total of 237 patients was included, with 129 patients(54.43%)in Group A and 108 patients(45.57%)in Group B. Among them, there were 34 patients(14.35%)in Subgroup B1, 57 patients(24.05%)in Subgroup B2, and 17 patients(7.17%)in Subgroup B3.The number of hospitalizations was significantly higher in both Group B and Subgroup B3 compared to Group A(both P < 0.05). However, no significant differences were found in the number of hospitalizations between Subgroup B1 or Subgroup B2 and Group A. There was no significant difference in the reduction of ADL between Group B(including all its subgroups)and Group A. The risk of mortality significantly increased with the increase in the severity of malnutrition(all P<0.05). After adjusting for factors such as gender, age, polypharmacy, home oxygen therapy, self-care ability, days of hospital stay, number of hospitalizations, pulmonary function, and inflammatory factors, nutritional risk and the degree of malnutrition remained independent risk factors for all-cause mortality in elderly IPF patients. Conclusions:A significant proportion of elderly IPF patients were found to have nutritional risk or malnutrition.The number of hospitalizations was significantly correlated with the nutritional status of these patients.After adjusting for multiple relevant factors, nutritional risk and the severity of malnutrition remained independent risk factors for mortality in elderly IPF patients.Therefore, greater emphasis should be placed on nutritional assessment and early nutritional intervention in the management of elderly IPF patients, so as to prevent and reduce the occurrence of nutrition-related adverse events.

Objective:To explore the impact of different nutritional statuses on the prognosis of elderly patients with idiopathic pulmonary fibrosis(IPF), and to provide a basis for early intervention of the nutritional status of elderly IPF patients.Methods:A retrospective analysis was conducted on 237 elderly patients clinically diagnosed with IPF who were admitted to the First Hospital of Shanxi Medical University from January 2018 to May 2024.The GLIM criteria were applied to diagnose malnutrition and classify its severity.The patients were divided into two groups: those without nutritional risk(Group A)and those with nutritional risk(Group B). Group B was further subdivided into three subgroups: patients with only nutritional risk(Subgroup B1), those with moderate malnutrition(Subgroup B2), and those with severe malnutrition(Subgroup B3). The study observed the clinical characteristics of elderly IPF patients and the impact of nutritional factors on hospital admission frequency, activities of daily living(ADL), and all-cause mortality.Results:A total of 237 patients was included, with 129 patients(54.43%)in Group A and 108 patients(45.57%)in Group B. Among them, there were 34 patients(14.35%)in Subgroup B1, 57 patients(24.05%)in Subgroup B2, and 17 patients(7.17%)in Subgroup B3.The number of hospitalizations was significantly higher in both Group B and Subgroup B3 compared to Group A(both P < 0.05). However, no significant differences were found in the number of hospitalizations between Subgroup B1 or Subgroup B2 and Group A. There was no significant difference in the reduction of ADL between Group B(including all its subgroups)and Group A. The risk of mortality significantly increased with the increase in the severity of malnutrition(all P<0.05). After adjusting for factors such as gender, age, polypharmacy, home oxygen therapy, self-care ability, days of hospital stay, number of hospitalizations, pulmonary function, and inflammatory factors, nutritional risk and the degree of malnutrition remained independent risk factors for all-cause mortality in elderly IPF patients. Conclusions:A significant proportion of elderly IPF patients were found to have nutritional risk or malnutrition.The number of hospitalizations was significantly correlated with the nutritional status of these patients.After adjusting for multiple relevant factors, nutritional risk and the severity of malnutrition remained independent risk factors for mortality in elderly IPF patients.Therefore, greater emphasis should be placed on nutritional assessment and early nutritional intervention in the management of elderly IPF patients, so as to prevent and reduce the occurrence of nutrition-related adverse events.

Objective:To analyze interobserver variability in endoscopic diagnostic accuracy of chronic atrophic gastritis (CAG) among endoscopists with varying levels of experience.Methods:Endoscopic examination data from 247 patients who underwent endoscopy from January 2021 to June 2024 at Department of Gastroenterology, the First Affiliated Hospital of Army Medical University ( n=154), Renmin Hospital of Wuhan University ( n=35) and Shanxi Provincial Coal Central Hospital ( n=58) were retrospectively collected. The collected images were reviewed by an expert panel of three individuals with the title of deputy chief physician or above. The final endoscopic Kimura-Takemoto classification diagnosis of the expert panel was regarded as the golden standard. Fourteen endoscopists from the above three centers provided their Kimura-Takemoto classification diagnosis. These endoscopists were divided into the junior group ( n=7, with experience of <2 000 procedures) and the senior group ( n=7, with experience of >10 000 procedures). The difference in the accuracy of endoscopic Kimura-Takemoto classification diagnosis between the groups were analyzed. Results:Diagnostic accuracy for Kimura-Takemoto classification ranged from 65.99% (163/247) to 86.64% (214/247) in the senior group with the overall accuracy of 77.27% (1 336/1 729). The junior group exhibited diagnostic accuracy ranging from 36.44% (90/247) to 72.47% (179/247) with the overall accuracy of 62.12% (1 074/1 729). The senior group demonstrated higher overall diagnostic accuracy than that of the junior group ( χ 2=93.27, P<0.001). The diagnostic accuracy of non-CAG in the senior group was higher than that in the junior group [83.73% (463/553) VS 72.33% (400/553), χ 2=20.27, P<0.001]. The diagnostic accuracy of C-type atrophy in the senior group was higher than that in the junior group [90.10% (801/889) VS 82.79% (736/889), χ 2=19.66, P<0.001] .The diagnostic accuracy of O-type atrophy in the senior group was higher than that in the junior group [83.97% (241/287) VS 68.29% (196/287), χ 2=18.56, P<0.001]. Conclusion:Interobserver variability is observed in the diagnostic accuracy of endoscopic Kimura-Takemoto classification for CAG among endoscopists with different experience levels. Experienced endoscopists exhibit higher diagnostic accuracy for CAG compared with their less experienced counterparts.

Objective　To analyze the current situation and influencing factors of health-care seeking delay among pulmonary tuberculosis patients in Qingpu District of Shanghai from 2011 to 2022, and to provide a scientific basis for tuberculosis prevention and control. Methods　The data of pulmonary tuberculosis patients in Qingpu District of Shanghai from 2011 to 2022 was collected through the China Tuberculosis Information Management System to describe the distribution and change trend of the delay in health-care seeking. Univariate analysiswas performed using the chi-square (χ²) test, and the time trend of rates was tested with the trend chi-square (trend χ²) test. Multivariate logistic regression model analyzed the influencing factors of the delay in health-care seeking. Results　From 2011 to 2022, there were 3 488 cases of pulmonary tuberculosis in Qingpu District, with 1 438 patients experiencing health-care seeking delay. The median (quartile) number of days of delay was M (P25, P75) = 10 (2, 24) days, and the rate of health-care seeking delay was 41.23%. The annual rate of health-care seeking delay fluctuated between 33.88% and 50.45% from 2011 to 2022, with statistically significant differences between different years (χ²=38.355, P<0.001), and an upward trend in the health-care seeking delay rate was observed from 2020 to 2022 (χtrend²=13.290, P<0.001). Multivariate logistic regression analysis showed that compared to male, those under 25 years old, with local household registration, and detected through health check-ups, females (OR=1.21, 95%CI:1.04-1.41), those aged 45 to <65 (OR=1.36, 95%CI:1.06-1.75), intra-city migrants (OR=1.35, 95%CI:1.09-1.68), inter-provincial/overseas migrants (OR=1.50, 95%CI:1.23-1.83), and patients who directly sought medical care (OR=3.52, 95%CI:2.27-5.47), transfer treatment (OR=2.07,95%CI：1.31-3.25), referral (OR=2.16, 95%CI:1.36-3.44), follow-up (OR=3.07, 95%CI:1.74-5.44) patients with pulmonary tuberculosis were more likely to delay health-care, and the differences were statistically significant (P<0.05). Compared to sputum-positive patients, those with sputum-negative tests (OR=0.76, 95%CI: 0.59-0.97) were less likely to experience delayed health-care, and the difference was statistically significant (P<0.05). Conclusions　Health-care seeking delay of pulmonary tuberculosis patients is relatively common in Qingpu District of Shanghai. Corresponding intervention measures should be adopted for risk factors and key populations to further improve the health-care seeking delay.

Objective:To investigate the role and mechanism of microRNA (miR)-4472 targeting PIN1 in regulating the nuclear factor kappa B (NF-κB)/signal transducer and activator of transcription 3 (STAT3) signaling pathway in a rat model of hypoxic-ischemic encephalopathy (HIE).Methods:Between January 2022 and January 2024, sixty Sprague-Dawley rats were randomly assigned to six groups at The Second Hospital of Jiaxing using a random number table method: a normal control group, an HIE model group, an inhibition control group, a miR-4472 inhibition group, a miR-4472 inhibition + interference control group, and a miR-4472 inhibition + PIN1 interference group, with ten rats in each group. There was no significant difference in body mass among the six groups (all P > 0.05). Rat models of HIE were established using the Rice-Vannucci method. Behavioral performance was assessed using the Morris water maze test, while neurological function was evaluated using the Longa scoring method. Apoptosis was detected using the TUNEL assay, and the expression of NF-κB and STAT3 protein was measured using Western blot analysis. Results:Compared with the HIE model group, the miR-4472 inhibition group and the miR-4472 inhibition + interference control group showed a shortened escape latency, while the miR-4472 inhibition + PIN1 interference group exhibited an extended escape latency (all P < 0.05). The number of platform crossings in the miR-4472 inhibition + PIN1 interference group [(2.13 ± 0.54) times] was significantly lower than that in the HIE model group [(3.56 ± 0.71) times], the inhibition control group [(3.61 ± 0.87) times], the miR-4472 inhibition group [(5.47 ± 1.29) times], and the miR-4472 inhibition + interference control group [(5.58 ± 1.32) times] ( t = 5.07, 4.57, 7.55, 7.65, all P < 0.05). The Longa score in the miR-4472 inhibition + PIN1 interference group [(3.03 ± 0.30) points] was significantly lower than that in the HIE model group [(2.45 ± 0.54) points], the inhibition control group [(2.38 ± 0.69) points], the miR-4472 inhibition group [(1.27 ± 0.46) points], and the miR-4472 inhibition + interference control group [(1.29 ± 0.51) points] ( t = 2.97, 2.73, 10.13, 9.30, all P < 0.05). The apoptosis rate of hippocampal neurons in the miR-4472 inhibition + PIN1 interference group [(25.34 ± 6.16)%] was significantly lower than that in the HIE model group [(18.42 ± 5.46)%], the inhibition control group [(17.95 ± 4.38)%], the miR-4472 inhibition group [(8.89 ± 2.10)%], and the miR-4472 inhibition + interference control group [(9.13 ± 2.57)%] ( t = 2.97, 2.73, 10.13, 9.30, all P < 0.05). Compared with the HIE model group, the miR-4472 inhibition group and the miR-4472 inhibition + interference control group exhibited decreased gray values of NF-κB and STAT3 protein, while the miR-4472 inhibition + PIN1 interference group showed increased gray values of NF-κB and STAT3 protein (all P < 0.05). Conclusion:miR-4472 targets and regulates PIN1, which contributes to HIE injury through the activation of the NF-κB/STAT3 signaling pathway.