The gut microbiota is an indispensable symbiotic entity within the human holobiont, serving as a critical regulator of host lipid metabolism homeostasis. Therefore, it has emerged as a central subject of research in the pathophysiology of metabolic disorders. This microbial consortium orchestrates key aspects of host lipid dynamics-including absorption, metabolism, and storage-through multifaceted mechanisms such as the enzymatic processing of dietary polysaccharides, the facilitation of long-chain fatty acid uptake by intestinal epithelial cells (IECs), and the bidirectional modulation of adipose tissue functionality. Mounting evidence underscores that gut microbiota-derived metabolites not only directly mediate canonical lipid metabolic pathways but also interface with host immune pathways, epigenetic machinery, and circadian regulatory systems, thereby establishing an intricate crosstalk that coordinates systemic metabolic outputs. Perturbations in microbial composition (dysbiosis) drive pathological disruptions to lipid homeostasis, serving as a pathogenic driver for conditions such as obesity, hyperlipidemia, and non-alcoholic fatty liver disease (NAFLD). This review systematically examines the emerging mechanistic insights into the gut microbiota-mediated regulation of intestinal lipid metabolism, while it elucidates its translational implications for understanding metabolic disease pathogenesis and developing targeted therapies.
Humans ; Gastrointestinal Microbiome/physiology* ; Lipid Metabolism ; Animals ; Intestinal Mucosa/metabolism* ; Homeostasis ; Dysbiosis ; Obesity/metabolism* ; Intestines/microbiology* ; Non-alcoholic Fatty Liver Disease/metabolism* ; Metabolic Diseases/metabolism*

Objective To observe the effects of the traditional Chinese medicine Qingfeihuayutongfu prescription on oxygenation index,respiratory mechanics,inflammatory markers,and immune function in mechanically ventilated patients with sepsis-associated acute respiratory distress syndrome(ARDS).Methods A prospective randomized controlled trial was conducted.Sixty-eight patients with sepsis-associated ARDS,who met the TCM syndrome pattern of lung-heat transferring to intestines syndrome,admitted to the department of intensive care unit(ICU)of the Affiliated Hospital of Nanjing University of Chinese Medicine between January 2023 and January 2024,were enrolled as study subjects.Patients were randomly divided into an experimental group and a control group using a random number table,with 34 patients in each group.Four patients dropped out from each group,resulting in 30 patients being analyzed in each group.Both groups received conventional Western medical treatment after admission.The experimental group additionally received Qingfeihuayutongfu prescription[composition:Scutellaria baicalensis 10 g,Mori Cortex 10 g,Descurainiae Semen 15 g,Trichosanthis Fructus 10 g,Lumbricus 10 g,Persicae Semen 10 g,Salviae Miltiorrhizae Radix 10 g,Curcumae Rhizoma 6 g,Rheum palmatum 3 g(decocted later),Aurantii Fructus Immaturus 10 g,Magnoliae Officinalis Cortex 10 g,Glycyrrhizae Radix praeparata 3 g].The decoction was concentrated to 100 mL per bag.One dose was administered daily,divided into 2 nasogastric feedings.The control group received an equivalent volume of warm water twice daily via nasogastric tube in addition to conventional Western treatment.Treatment continued for 7 days in both groups.Differences in oxygenation index,respiratory mechanics parameters,inflammatory cytokines,and immune cell levels before and after treatment were compared between the two groups.Results Prior to treatment,no statistically significant differences were observed between the two groups in oxygenation index,respiratory mechanics parameters,levels of inflammatory cytokines or immune cell counts.Following treatment,both groups exhibited a significant increase in oxygenation index and natural killer cell(NK cell),alongside significant decreases in plateau pressure(Pplat),driving pressure(ΔP),hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT),interleukins(IL-6,IL-8,IL-1β),tumour necrosis factor-α(TNF-α),and CD4+/CD8+ratio compared to baseline.Post-treatment comparison between groups revealed that the experimental group had a significantly higher oxygenation index and NK cell than the control group[oxygenation index(mmHg,1 mmHg≈0.133 kPa):331.32±90.89 vs.238.64±83.26,NK cell:0.20(0.12,0.25)vs.0.10(0.08,0.19),both P<0.05].Conversely,the experimental group demonstrated significantly lower values than the control group for Pplat,ΔP,hs-CRP,PCT,IL-6,IL-8,TNF-α,CD4+/CD8+[Pplat(cmH2O,1 cmH2O≈0.098 kPa):16(15,19)vs.22(19,24),ΔP(cmH2O):11±2 vs.14±3,hs-CRP(mg/L):21.32(11.63,31.84)vs.41.36(17.41,89.02),PCT(μg/L):0.13(0.08,0.21)vs.0.45(0.14,1.35),IL-6(ng/L):16.25(10.72,49.96)vs.66.70(25.82,195.64),IL-8(ng/L):5.48(0.84,12.60)vs.26.23(23.10,50.16),TNF-α(ng/L):0.77(0.72,1.20)vs.1.10(0.92,1.48),CD4+/CD8+:1.76(1.43,2.00)vs.2.12(1.77,4.03),all P<0.05].Conclusion The Qingfeihuayutongfu prescription can effectively improves the oxygenation index,reduces Pplat and ΔP,mitigates inflammation,and modulates immune function in mechanically ventilated patients with sepsis-associated ARDS.

Objective To satisfy the normalized disinfection in the orthopedic ward,an air sterilizer based on low-temperature plasma has been developed to investigate its sterilization results in a dynamic environment of hospitalization where patients,companions and medical workers are involved.Methods This study took an orthopedics ward in the Secondary Affiliated Hospital of Xi'an Jiaotong University,as the research object,where a home-made low-temperature plasma air sterilizer was utilized.A six-stage viable Andersen cascade impactor was used to sample the natural bacteria in the ward before and after machine operation for three hours.The species and quantity of bacteria in the ward were analyzed.Results The ozone concentration in the indoor dynamic environment decreased to below 5 ppbv.After three-hour disinfection,the elimination rate of natural bacteria reached 92.35％.The final colony forming unit decreased to～150 CFU/m3;the extinction rates of Staphylococcus hominis,Bacillus cereus,molds,and Micrococcus luteus were 90.48％,80.90％,87.50％,and 92.82％respectively.Even all Haemophilus massiliensis disappeared after two-hour treatment.Conclusion Intermittent disinfection of the dynamic environment in the ward using low-temperature plasma synergistic catalyst has enabled the indoor ozone concentration to reach the first-level national standard line,effectively suppressing secondary pollution caused by ozone leakage while efficiently killing suspended microorganisms in the air,which is close to the disinfection level Ⅰenvironment specified in Hygienic Standard for Disinfection in Hospitals(GB 15982-2012).The results also show that the plasma catalytic synergistic disinfection and sterilization has the technical advantages of efficient disinfection and human-machine coexistence,which can ensure indoor air quality safety,reduce the workload of nursing staff,and thus is an effective method to assist or even replace the existing physical and chemical means.

Objective To explore the clinical effect of applying an improved"outside-in"technique in hip arthroscopic surgery.Methods Totally 136 patients undergoing hip arthroscopic surgery between June 2021 and July 2023 were selected and studied retrospectively.According to their different surgi-cal approach,they were divided into a modified approach group(n=75,including 30 males and 45 fe-males,with an average age of 36±14)and a classic approach group(n=61,including 33 males and 28 females,with an average age of 31±11).Before as well as 4 weeks,3 months and 6 months after the surgery,both groups were evaluated using the visual analog scale(VAS)and Harris hip score,and observed their surgical complications.Moreover,the surgical outcomes and time of sur-gical approach establishment were compared between the two groups.Results There was no significant difference between the two groups in general information,preoperative VAS and Harris scores.More-over,no significant difference was found between the two groups in the Harris score after surgery.Compared with the classic approach group,the improved group had significantly less surgical time(49.0±16.9 min vs.66.0±13.3 min,P<0.05),without using the C-arm fluoroscopy during surgery.Moreover,in the modified approach group,the time for establishing the mid-anteriorapproach was sig-nificantly shortened(10.4±5.9 min vs.25.9±15.1 min,P<0.05),along with the traction time during surgery(66.0±13.3 min vs.49.0±16.9 min,P<0.05).Conclusion The modified"outside-in"hip ar-throscopy technique is a safe and effective surgical method,easier to operate,with shorter surgical time.

Objective To explore the clinical effect of applying an improved"outside-in"technique in hip arthroscopic surgery.Methods Totally 136 patients undergoing hip arthroscopic surgery between June 2021 and July 2023 were selected and studied retrospectively.According to their different surgi-cal approach,they were divided into a modified approach group(n=75,including 30 males and 45 fe-males,with an average age of 36±14)and a classic approach group(n=61,including 33 males and 28 females,with an average age of 31±11).Before as well as 4 weeks,3 months and 6 months after the surgery,both groups were evaluated using the visual analog scale(VAS)and Harris hip score,and observed their surgical complications.Moreover,the surgical outcomes and time of sur-gical approach establishment were compared between the two groups.Results There was no significant difference between the two groups in general information,preoperative VAS and Harris scores.More-over,no significant difference was found between the two groups in the Harris score after surgery.Compared with the classic approach group,the improved group had significantly less surgical time(49.0±16.9 min vs.66.0±13.3 min,P<0.05),without using the C-arm fluoroscopy during surgery.Moreover,in the modified approach group,the time for establishing the mid-anteriorapproach was sig-nificantly shortened(10.4±5.9 min vs.25.9±15.1 min,P<0.05),along with the traction time during surgery(66.0±13.3 min vs.49.0±16.9 min,P<0.05).Conclusion The modified"outside-in"hip ar-throscopy technique is a safe and effective surgical method,easier to operate,with shorter surgical time.

Objective To satisfy the normalized disinfection in the orthopedic ward,an air sterilizer based on low-temperature plasma has been developed to investigate its sterilization results in a dynamic environment of hospitalization where patients,companions and medical workers are involved.Methods This study took an orthopedics ward in the Secondary Affiliated Hospital of Xi'an Jiaotong University,as the research object,where a home-made low-temperature plasma air sterilizer was utilized.A six-stage viable Andersen cascade impactor was used to sample the natural bacteria in the ward before and after machine operation for three hours.The species and quantity of bacteria in the ward were analyzed.Results The ozone concentration in the indoor dynamic environment decreased to below 5 ppbv.After three-hour disinfection,the elimination rate of natural bacteria reached 92.35％.The final colony forming unit decreased to～150 CFU/m3;the extinction rates of Staphylococcus hominis,Bacillus cereus,molds,and Micrococcus luteus were 90.48％,80.90％,87.50％,and 92.82％respectively.Even all Haemophilus massiliensis disappeared after two-hour treatment.Conclusion Intermittent disinfection of the dynamic environment in the ward using low-temperature plasma synergistic catalyst has enabled the indoor ozone concentration to reach the first-level national standard line,effectively suppressing secondary pollution caused by ozone leakage while efficiently killing suspended microorganisms in the air,which is close to the disinfection level Ⅰenvironment specified in Hygienic Standard for Disinfection in Hospitals(GB 15982-2012).The results also show that the plasma catalytic synergistic disinfection and sterilization has the technical advantages of efficient disinfection and human-machine coexistence,which can ensure indoor air quality safety,reduce the workload of nursing staff,and thus is an effective method to assist or even replace the existing physical and chemical means.

Objective To observe the effects of the traditional Chinese medicine Qingfeihuayutongfu prescription on oxygenation index,respiratory mechanics,inflammatory markers,and immune function in mechanically ventilated patients with sepsis-associated acute respiratory distress syndrome(ARDS).Methods A prospective randomized controlled trial was conducted.Sixty-eight patients with sepsis-associated ARDS,who met the TCM syndrome pattern of lung-heat transferring to intestines syndrome,admitted to the department of intensive care unit(ICU)of the Affiliated Hospital of Nanjing University of Chinese Medicine between January 2023 and January 2024,were enrolled as study subjects.Patients were randomly divided into an experimental group and a control group using a random number table,with 34 patients in each group.Four patients dropped out from each group,resulting in 30 patients being analyzed in each group.Both groups received conventional Western medical treatment after admission.The experimental group additionally received Qingfeihuayutongfu prescription[composition:Scutellaria baicalensis 10 g,Mori Cortex 10 g,Descurainiae Semen 15 g,Trichosanthis Fructus 10 g,Lumbricus 10 g,Persicae Semen 10 g,Salviae Miltiorrhizae Radix 10 g,Curcumae Rhizoma 6 g,Rheum palmatum 3 g(decocted later),Aurantii Fructus Immaturus 10 g,Magnoliae Officinalis Cortex 10 g,Glycyrrhizae Radix praeparata 3 g].The decoction was concentrated to 100 mL per bag.One dose was administered daily,divided into 2 nasogastric feedings.The control group received an equivalent volume of warm water twice daily via nasogastric tube in addition to conventional Western treatment.Treatment continued for 7 days in both groups.Differences in oxygenation index,respiratory mechanics parameters,inflammatory cytokines,and immune cell levels before and after treatment were compared between the two groups.Results Prior to treatment,no statistically significant differences were observed between the two groups in oxygenation index,respiratory mechanics parameters,levels of inflammatory cytokines or immune cell counts.Following treatment,both groups exhibited a significant increase in oxygenation index and natural killer cell(NK cell),alongside significant decreases in plateau pressure(Pplat),driving pressure(ΔP),hypersensitive C-reactive protein(hs-CRP),procalcitonin(PCT),interleukins(IL-6,IL-8,IL-1β),tumour necrosis factor-α(TNF-α),and CD4+/CD8+ratio compared to baseline.Post-treatment comparison between groups revealed that the experimental group had a significantly higher oxygenation index and NK cell than the control group[oxygenation index(mmHg,1 mmHg≈0.133 kPa):331.32±90.89 vs.238.64±83.26,NK cell:0.20(0.12,0.25)vs.0.10(0.08,0.19),both P<0.05].Conversely,the experimental group demonstrated significantly lower values than the control group for Pplat,ΔP,hs-CRP,PCT,IL-6,IL-8,TNF-α,CD4+/CD8+[Pplat(cmH2O,1 cmH2O≈0.098 kPa):16(15,19)vs.22(19,24),ΔP(cmH2O):11±2 vs.14±3,hs-CRP(mg/L):21.32(11.63,31.84)vs.41.36(17.41,89.02),PCT(μg/L):0.13(0.08,0.21)vs.0.45(0.14,1.35),IL-6(ng/L):16.25(10.72,49.96)vs.66.70(25.82,195.64),IL-8(ng/L):5.48(0.84,12.60)vs.26.23(23.10,50.16),TNF-α(ng/L):0.77(0.72,1.20)vs.1.10(0.92,1.48),CD4+/CD8+:1.76(1.43,2.00)vs.2.12(1.77,4.03),all P<0.05].Conclusion The Qingfeihuayutongfu prescription can effectively improves the oxygenation index,reduces Pplat and ΔP,mitigates inflammation,and modulates immune function in mechanically ventilated patients with sepsis-associated ARDS.

Objective:To explore the causal relationship between thyroid dysfunction and sepsis based on the bidirectional two-sample Mendelian randomization (MR) method.Methods:The genome-wide association study (GWAS) dataset were selected to screen single nucleotide polymorphisms (SNP) associated with thyroid dysfunction as instrumental variable (IV) for genetic variation, using hypothyroidism and hyperthyroidism as exposure factor and sepsis as outcome factor. Potential causal relationship between thyroid dysfunction and sepsis was analyzed using a bidirectional two-sample MR method primary analysis method of inverse-variance weighted (IVW). Potential pleiotropic analysis of SNP was performed using the MR Egger regression intercept test. Sensitivity analysis was performed using the "leave one out" test. Reverse MR method was used to prove the causal relationship.Results:The GWAS data were screened based on the three main assumptions of MR, resulting in 101 SNP strongly associated with hypothyroidism and 10 SNP strongly associated with hyperthyroidism entering the MR analysis. The results of the MR using the IVW method showed that the risk of sepsis in individuals with hypothyroidism was 2.293 times higher than those without hypothyroidism [odds ratio ( OR) = 2.293, 95% confidence interval (95% CI) was 1.199-4.382, P = 0.012]. There was no significant difference in the risk of sepsis between hyperthyroid and non-hyperthyroid populations ( OR = 1.049, 95% CI was 0.999-1.100, P = 0.560). MR Egger regression intercept test showed that the included SNP did not have pleiotropy, and the MR-PRESSO test did not find outliers. Sensitivity analysis suggested that the results of MR were stable. The results of the reverse MR analysis showed that the reverse causal relationship between hyperthyroidism and sepsis was not proved ( OR = 0.996, 95% CI was 0.988-1.004, P = 0.338), which further confirmed the robust MR analysis result. Conclusion:The results of the bidirectional two-sample MR analysis show that hypothyroidism can increase the risk of sepsis onset, while there is no causal relationship between hyperthyroidism and sepsis.