ObjectiveTo investigate the therapeutic effect of Astragali Radix-mediated changes in gut microbiota on treating type 2 diabetes （T2DM）. MethodsA 12-week randomized， placebo-controlled clinical trial enrolled eighty patients with newly diagnosed type 2 diabetes and poor glycemic control in the Qi deficiency type. All patients received insulin therapy. The observation group （40 cases） was administered with Astragali Radix Granules， while the control group （40 cases） received a placebo. Both treamtents were taken orally twice daily. Changes in gut microbiota were assessed by 16s rDNA sequencing. Serum glucagon-like peptide-1 （GLP-1） levels were measured using enzyme-linked immunosorbent assay （ELISA）. Glucose metabolism indicators including fasting blood glucose （FPG）， 2-hour postprandial blood glucose （2 h PG），glycated albumin（GA）， and glycated hemoglobin （HbA1c） were evaluated. Pancreatic function was evaluated using fasting C-peptide （FCP）， 2-hour postprandial C-peptide （2 h CP）， and C-peptide area under the curve （AUC_cp）. Traditional Chinese medicine （TCM） syndrome scores， clinical efficacy， and safety indicators were also observed. ResultsIn terms of glucose metabolism indicators， compared with the baseline， both groups exhibited significantly lower FPG， 2 h PG， GA and HbA1C （P<0.01），while FCP， 2 h CP and AUC_cp were significantly higher （P<0.01）. Compared with the control group after the treatment， the observation group showed significantly lower FPG， 2 h PG， GA and HbA1C（P<0.05， P<0.01），and significantly higher FCP， 2 h CP and AUC_cp （P<0.05， P<0.01）， indicating that Astragali Radix can improve glucose metabolism. In terms of the diversity of gut microbiota， no significant differences were detected in the Chao1， Shannon and Simpson indexes of the two groups compared with their respective baselines. However， compared with the post-treatment control group， the observation group demonstrated significant increases in the Chao1， Shannon and Simpson indexes （P<0.05， P<0.01）. The β-diversity analysis showed significant separation in gut microbiota composition before and after treatment in both groups， indicating that Astragali Radix can significantly alter the structure and improve the diversity of gut microbiota. At the phylum level， compared with the baseline， both groups showed a significant increase in the relative abundance of Bacteroidota（P<0.01）. The relative abundance of the potentially harmful phylum Proteobacteria was significantly lower in the observation Group after treatment （P<0.01）. Compared with the post-treatment control group， the observation group had a significantly higher relative abundance of Bacteroidota（P<0.01）. No significant difference was found in Firmicutes/Bacteroidota （F/B） ratio between the two groups after treatment， and other phyla showed no significant differences. At the genus level， compared with the baseline， the observation group exhibited a significant increase in Bacteroides （P<0.01） and a significant decrease in Escherichia-Shigella （P<0.01）， whereas no significant difference was seen in the control group . Compared with the control group after treatment， the observation group after treatment had a significantly higher relative abundance of Bacteroides （P<0.01）. No significant differences were seen in other genera. Linear discriminant analysis （LDA） identified potential characteristics taxa： in the observation group， Bacteroidota at the phylum level and Bacteroides and Dubosiella at the genus level， in the control group， Proteobacteria at the phylum level as well as Barnesiella and Staphylococcus at the genus level. Correlation analysis based on a heatmap revealed that GLP-1 levels were positively correlated with Firmicutes， F/B ratio and Fusobacterium， and negatively correlated with Bacteroidota， Proteobacteria， Bacteroides and Escherichia-Shigella. In terms of clinical efficacy， compared with the control group， the total effective rate of the observation group was significantly higher （P<0.05）. Compared with the baseline， the scores for shortness of breath， fatigue， weakness， spontaneous sweating and reluctance to speak significantly decreased in both groups （P<0.01）. Compared with the control group after treatment， the score for weakness was significantly lower in the observation group （P<0.01），indicating that Astragali Radix could improve clinical symptoms and alleviate weakness symptoms. In terms of safety， compared with the baseline， alanine aminotransferase （ALT） levels significantly decreased in both groups （P<0.05，P<0.01），indicating that Astragali Radix did not induce any significant abnormalities in liver and kidney functions. ConclusionAstragali Radix demonstrates the potential to significantly improve the gut microbiota environment in patients of newly diagnosed type 2 diabetes with Qi deficiency. The therapeutic effect may contribute to glycemic control， possibly mediated by an elevation in GLP-1 level. These findings may support its further clinical investigations and potential applications.

Objective To preliminarily investigate the safety and efficacy of donor pancreas needle biopsy in simultaneous pancreas-kidney transplantation. Methods Clinical data of 7 cases undergoing donor pancreas biopsy were collected retrospectively. All cases underwent donor pancreas biopsy before or during simultaneous pancreas-kidney transplantation. Frozen section or paraffin sectioning techniques were used for tissue preparation, and hematoxylin-eosin and Masson staining were performed to histologically evaluate the donor pancreas. The quality of donor pancreas was comprehensively assessed by combining histological findings with the donor's clinical data. Postoperative follow-up data of 5 simultaneous pancreas-kidney transplant recipients were collected to summarize the safety of donor pancreas biopsy and the prognosis of transplant recipients. Results The 7 pancreas donors were aged 28 to 62 years, with a body mass index ranging from 20.76 to 27.68 kg/m². Liver ultrasound indicated fatty liver in 3 cases, while pancreatic ultrasound did not reveal any significant abnormalities. Among them, biopsy was performed on 2 donors after completion of pancreatic procurement and processing, and the frozen section histology showed moderate acute pancreatitis changes (edema of acinar cells, necrosis and inflammatory cell infiltration). Combined with a serum amylase level elevated more than 3 times the upper limit of normal value, these two donor pancreases were finally discarded. The remaining 5 cases underwent biopsy immediately after pancreatic vascular anastomosis during simultaneous pancreas-kidney transplantation, and histological evaluation was performed on paraffin-embedded sections. No biopsy-related complications (such as bleeding, pancreatic fistula, etc.) occurred after transplantation. One recipient died of severe infection 2 months after transplantation, while the other 4 recipients were followed up for more than 5 years, with well-functioning transplant kidneys and pancreases. Conclusions Donor pancreas biopsy is relatively safe, and the risk of biopsy-related complications after transplantation is controllable. Comprehensive assessment of donor pancreas quality by combining histological evaluation with the donor's clinical indicators is conducive to improving the accuracy of donor pancreas selection and organ utilization.

Objective To construct a nursing registry platform for percutaneous coronary intervention(PCI)to provide data support for subsequent real-world research on PCI nursing.Methods From April to December 2023,we established a variable list and data dictionary based on literature review and expert discussion,and constructed a web-based PCI nursing registry platform based on registry-related standards.Results A total of 191 variables were screened in this study,and a corresponding data dictionary was developed for each variable according to the variable name,variable code,variable definition,variable type,variable value range,data source and data collection node.Three levels of account privileges has been set up in the platform,which can realize different data management privileges,and the data can be saved only after filling in and reviewing at each level.The platform is also equipped with automatic data checking function,which reduces data filling errors and improves data quality.Conclusion The constructed PCI nursing registration platform has strong scientific and professional characteristics,and can provide data support for subsequent research,and the content and functions of the platform can be further optimized in the future.

BACKGROUND:Vital pulp therapy is one of the main treatments for common oral diseases such as deep caries.The antibacterial properties of pulp-capping materials are crucial to the efficacy of the treatment.Currently,commonly used pulp-capping material has weak antibacterial properties and may induce a certain degree of inflammatory response in the pulp tissue,leading to treatment failure.OBJECTIVE:To investigate the antibacterial effects of nanosilver-reduced graphene oxide/polydopamine/methacrylated gelatin@Gap19(AgNPs-rGO/PDA/GelMA@Gap19)hydrogel material.METHODS:Nanosilver-reduced graphene oxide was prepared.Human dental pulp stem cells were cultured in complete medium containing different mass concentrations of nanosilver-reduced graphene oxide.Cell proliferation was detected by CCK-8 assay.The inhibition zone assay was used to detect the inhibitory effect of different mass concentrations of nanosilver-reduced graphene oxide on Staphylococcus aureus.The nanosilver-reduced graphene oxide mass concentration with the most obvious cell proliferation and antibacterial effects was screened by the results of CCK-8 and inhibition zone assays,and loaded into hydrogels.Human dental pulp stem cells were cultured in complete medium containing different concentrations of Gap19(a specific inhibitor of connexin 43 hemichannels),and cell proliferation was detected by CCK-8 assay.The Gap19 concentration with the most obvious cell proliferation effect was screened and loaded into hydrogels.AgNPs-rGO/PDA/GelMA@Gap19 hydrogel was prepared,and the physicochemical properties of the hydrogel material were characterized.The suspension of Staphylococcus aureus(or Escherichia coli,Streptococcus mutans,Lactobacillus)was co-cultured with mineral trioxide aggregates,polydopamine/methacrylated gelatin hydrogel,nanosilver-reduced graphene oxide/polydopamine/methacrylated gelatin hydrogel and AgNPs-rGO/PDA/GelMA@Gap19 hydrogel.The bacterial suspension cultured alone was used as the blank control group to detect the antibacterial rate of each group of hydrogels.RESULTS AND CONCLUSION:(1)The optimal mass concentration of nanosilver-reduced graphene oxide was determined to be 12.5 μg/mL by CCK-8 assay and inhibition zone test results,and the optimal concentration of Gap19 was determined to be 20 μmol/L by CCK-8 assay.(2)Scanning electron microscopy showed that AgNPs-rGO/PDA/GelMA@Gap19 hydrogel was wrinkled and porous,and nanosilver was loaded on the surface and inside of the hydrogel.Energy spectrum analysis results showed that nanosilver-reduced graphene oxide and Gap19 were successfully loaded on the hydrogel.(3)The four hydrogels had obvious inhibitory effects on Staphylococcus aureus,Escherichia coli,Streptococcus mutans,and Lactobacillus,and the antibacterial effects of nanosilver-reduced graphene oxide/polydopamine/methacryloyl gelatin hydrogel and AgNPs-rGO/PDA/GelMA@Gap19 hydrogel were the most significant,indicating that AgNPs-rGO/PDA/GelMA@Gap19 hydrogel,as a new type of pulp capping material,has an obvious antibacterial effect.

Objective To analyze the research hotspots,frontiers,and trends in clinical randomized controlled trials(RCTs)on acupuncture-moxibustion for post-stroke shoulder-hand syndrome(SHS)over the past decade using bibliometric and knowledge mapping methods.Methods The clinical RCTs on acupuncture-moxibustion for post-stroke SHS from five Chinese and English databases were retrieved,including CNKI,Wanfang,VIP,PubMed,and Web of Science(WOS).CiteSpace and VOSviewer were employed for analysis,and visualized knowledge maps were generated.Results A total of 1 226 Chinese and 20 English articles were included,with both reaching publication peaks in 2021.The top three institutions in terms of output were Huguosi Traditional Chinese Medicine Hospital Affiliated to Beijing University of Chinese Medicine,The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,and Heilongjiang University of Chinese Medicine.The most prolific author was Song Fengjun,while Pei Jian had the highest centrality.The five most frequently used keywords were shoulder-hand syndrome,stroke,acupuncture-moxibustion,rehabilitation training,and joint mobility.Emerging research topics included activities of daily living,limb function,and range of motion.Conclusion Clinical research on acupuncture-moxibustion for post-stroke SHS holds significant developmental potential.Strengthening international collaboration to explore therapeutic mechanisms is recommended,and researchers should continue optimizing treatment protocols to enhance the quality of clinical evidence.

BACKGROUND:Titanium surface micro-nano structure modification is a hot research field in titanium implant surface treatment.The diabetic hyperglycemia environment will affect the stable bonding between titanium implant and bone tissue,so it is necessary to explore the surface micro-nano structure modification to improve the osteogenic activity of titanium implant in high glucose environment.OBJECTIVE:To investigate the effect of gold nanoparticle@mesoporous silica nanoparticles(AuNPs@MSNs)coating on osteogenic activity of osteoblasts under high glucose in vitro.METHODS:Gold nanoparticle suspension and mesoporous silica were prepared respectively,and the two were mixed in deionized water in a certain proportion to prepare gold nanoparticle@mesoporous silica suspension.Titanium sheets were taken and divided into three groups for treatment:the smooth group was treated with water sandpaper;the nanotube group was treated with water sandpaper and then anodized to prepare titanium dioxide nanotube coating,and the experimental group prepared titanium dioxide nanotube coating and then immersed in gold nanoparticle@mesoporous silica suspension to prepare gold nanoparticle@mesoporous silica nanoparticles coating.The microscopic morphology and hydrophilicity of the surface of the three groups of titanium sheets were characterized.Rat bone marrow mesenchymal stem cells were inoculated on the surface of the three groups of titanium sheets.Cell proliferation was detected by cell live/dead fluorescence staining and CCK-8 assay.Cell adhesion was detected by DAPI/phalloidin staining.Rat bone marrow mesenchymal stem cells were inoculated on the surface of the three groups of titanium sheets,and high-glucose osteogenic induction medium was added for culture.Osteogenic differentiation was detected by alkaline phosphatase and Alizarin Red S staining.RESULTS AND CONCLUSION:(1)Scanning electron microscopy showed that the surface of the titanium sheet in the smooth group was uniform and flat.The titanium dioxide nanotube arrays in the nanotube group were closely arranged on the surface,and the titanium sheet in the experimental group was loaded with gold nanoparticle@mesoporous silica on the surface and inside of the titanium dioxide nanotubes.The hydrophilicity of the titanium sheets in the nanotube group and the experimental group was better than that in the smooth group.(2)The results of cell live/dead fluorescence staining exhibited that the cell viability on the surface of the three groups of titanium sheets was higher than 90%.The results of CCK-8 assay show that the cell proliferation rate in the experimental group was higher than that in the smooth group and the nanotube group.The results of DAPI/phalloidin staining showed that the titanium dioxide nanotube coating and the gold nanoparticle@mesoporous silica nanoparticles coating were more conducive to cell adhesion.(3)The results of alkaline phosphatase and Alizarin Red S staining showed that the alkaline phosphatase activity and extracellular matrix mineralization of the cells on the titanium sheet surface in the experimental group were higher than those in the smooth group and the nanotube group.(4)The results show that the gold nanoparticle@mesoporous silica nanoparticles coating can enhance the biological activity of the titanium surface and promote osteogenic differentiation in a high glucose environment.

Brain imaging abnormalities are present in schizophrenia (SZ) and bipolar disorder (BD), demonstrating disease-specific changes, yet they also share similarities in certain brain regions or functional characteristics, with SZ potentially exhibiting more extensive brain damage compared to BD. Structural magnetic resonance imaging (MRI) studies demonstrated widespread gray matter reductions in SZ, particularly in the prefrontal and temporal lobes. In BD, gray matter thickening was observed in the prefrontal lobes during manic episodes, while a reduction in gray matter was noted in the amygdala and hippocampus during depressive episodes. Both SZ and BD exhibited increased ventricular volume and reduced overall brain volume. Functional MRI studies revealed reduced functional connectivity in the prefrontal and temporal lobes in SZ, with decreased global and local efficiency in brain regions such as the hippocampus and cingulate gyrus. BD showed enhanced connectivity in the anterior cingulate gyrus and the default mode network (DMN). Both SZ and BD demonstrated altered functional connectivity in areas such as the striatum, salience network, central executive network and DMN. Diffusion tensor imaging studies showed decreased fractional anisotropy (FA) in the corpus callosum of SZ, with a decrease in FA in the left fronto-occipital fasciculus in BD. Both SZ and BD exhibited reduced FA in the uncinate fasciculus and corpus callosum. Magnetic resonance spectroscopy revealed decreased concentrations of glutathione, N-acetylaspartate (NAA) and inositol in the anterior cingulate gyrus of SZ. In BD, glutathione and inositol concentrations were elevated in the anterior cingulate gyrus, while NAA levels decreased during depressive episodes and increased during remission. Both SZ and BD showed increased levels of glutamate and gamma-aminobutyric acid in the prefrontal cortex. This article provides a review of the current evidence on the differences and similarities in multimodal magnetic resonance brain imaging between SZ and BD, aiming to offer a reference for future exploration of neuroimaging biomarkers and the neurobiological mechanisms of SZ and BD.

Brain imaging abnormalities are present in schizophrenia (SZ) and bipolar disorder (BD), demonstrating disease-specific changes, yet they also share similarities in certain brain regions or functional characteristics, with SZ potentially exhibiting more extensive brain damage compared to BD. Structural magnetic resonance imaging (MRI) studies demonstrated widespread gray matter reductions in SZ, particularly in the prefrontal and temporal lobes. In BD, gray matter thickening was observed in the prefrontal lobes during manic episodes, while a reduction in gray matter was noted in the amygdala and hippocampus during depressive episodes. Both SZ and BD exhibited increased ventricular volume and reduced overall brain volume. Functional MRI studies revealed reduced functional connectivity in the prefrontal and temporal lobes in SZ, with decreased global and local efficiency in brain regions such as the hippocampus and cingulate gyrus. BD showed enhanced connectivity in the anterior cingulate gyrus and the default mode network (DMN). Both SZ and BD demonstrated altered functional connectivity in areas such as the striatum, salience network, central executive network and DMN. Diffusion tensor imaging studies showed decreased fractional anisotropy (FA) in the corpus callosum of SZ, with a decrease in FA in the left fronto-occipital fasciculus in BD. Both SZ and BD exhibited reduced FA in the uncinate fasciculus and corpus callosum. Magnetic resonance spectroscopy revealed decreased concentrations of glutathione, N-acetylaspartate (NAA) and inositol in the anterior cingulate gyrus of SZ. In BD, glutathione and inositol concentrations were elevated in the anterior cingulate gyrus, while NAA levels decreased during depressive episodes and increased during remission. Both SZ and BD showed increased levels of glutamate and gamma-aminobutyric acid in the prefrontal cortex. This article provides a review of the current evidence on the differences and similarities in multimodal magnetic resonance brain imaging between SZ and BD, aiming to offer a reference for future exploration of neuroimaging biomarkers and the neurobiological mechanisms of SZ and BD.

BACKGROUND:Vital pulp therapy is one of the main treatments for common oral diseases such as deep caries.The antibacterial properties of pulp-capping materials are crucial to the efficacy of the treatment.Currently,commonly used pulp-capping material has weak antibacterial properties and may induce a certain degree of inflammatory response in the pulp tissue,leading to treatment failure.OBJECTIVE:To investigate the antibacterial effects of nanosilver-reduced graphene oxide/polydopamine/methacrylated gelatin@Gap19(AgNPs-rGO/PDA/GelMA@Gap19)hydrogel material.METHODS:Nanosilver-reduced graphene oxide was prepared.Human dental pulp stem cells were cultured in complete medium containing different mass concentrations of nanosilver-reduced graphene oxide.Cell proliferation was detected by CCK-8 assay.The inhibition zone assay was used to detect the inhibitory effect of different mass concentrations of nanosilver-reduced graphene oxide on Staphylococcus aureus.The nanosilver-reduced graphene oxide mass concentration with the most obvious cell proliferation and antibacterial effects was screened by the results of CCK-8 and inhibition zone assays,and loaded into hydrogels.Human dental pulp stem cells were cultured in complete medium containing different concentrations of Gap19(a specific inhibitor of connexin 43 hemichannels),and cell proliferation was detected by CCK-8 assay.The Gap19 concentration with the most obvious cell proliferation effect was screened and loaded into hydrogels.AgNPs-rGO/PDA/GelMA@Gap19 hydrogel was prepared,and the physicochemical properties of the hydrogel material were characterized.The suspension of Staphylococcus aureus(or Escherichia coli,Streptococcus mutans,Lactobacillus)was co-cultured with mineral trioxide aggregates,polydopamine/methacrylated gelatin hydrogel,nanosilver-reduced graphene oxide/polydopamine/methacrylated gelatin hydrogel and AgNPs-rGO/PDA/GelMA@Gap19 hydrogel.The bacterial suspension cultured alone was used as the blank control group to detect the antibacterial rate of each group of hydrogels.RESULTS AND CONCLUSION:(1)The optimal mass concentration of nanosilver-reduced graphene oxide was determined to be 12.5 μg/mL by CCK-8 assay and inhibition zone test results,and the optimal concentration of Gap19 was determined to be 20 μmol/L by CCK-8 assay.(2)Scanning electron microscopy showed that AgNPs-rGO/PDA/GelMA@Gap19 hydrogel was wrinkled and porous,and nanosilver was loaded on the surface and inside of the hydrogel.Energy spectrum analysis results showed that nanosilver-reduced graphene oxide and Gap19 were successfully loaded on the hydrogel.(3)The four hydrogels had obvious inhibitory effects on Staphylococcus aureus,Escherichia coli,Streptococcus mutans,and Lactobacillus,and the antibacterial effects of nanosilver-reduced graphene oxide/polydopamine/methacryloyl gelatin hydrogel and AgNPs-rGO/PDA/GelMA@Gap19 hydrogel were the most significant,indicating that AgNPs-rGO/PDA/GelMA@Gap19 hydrogel,as a new type of pulp capping material,has an obvious antibacterial effect.

Objective:To design two kinds of intensity modulated radiotherapy (IMRT) plans with different radiation field distributions,and to compare the dose differences of that at the dose of target region and organs at risk (OAR) for middle and lower esophageal cancer,so as to provide a reference for the design of IMRT plan. Methods:The data of 17 patients with middle and lower esophageal cancer who received IMRT at Shangluo Central Hospital from November 2022 to May 2023 were retrospectively analyzed. IMRT plans with different radiation fields for Plan 1 and Plan 2 were designed for each patient. The angles of radiation field for Plan 1 were 0°,80°,120°,160° and 200°,and those for Plan 2 were 30°,130°,180°,230° and 330°,respectively. The prescribed dose to the planning target volume (PTV) was 60 Gy/30 F. The differences in dosimetric parameters between the two plans were compared. Results:There were no statistically significant differences in the dose parameters of 2％,98％,50％ target dose (D2％,D98％,D50％),homogeneity index (HI),conformity index (CI) and monitor unit between the two groups (P>0.05). There were no significant differences in V5 of dual lungs,the mean dose (Dmean) of heart,and the maximum dose (Dmax) of spinal-cord between two groups (P>0.05). The volume percentage (V10,V20,V30) of dual lungs received radiation doses of 10,20 and 30 Gy,and the mean dose (Vmean) of lung in the Plan1 group reduced respectively 7.44％,21.16％,10.09％ and 5.31％ than those in the Plan2 group,and the differences of them were statistically significant (t=-5.845,-7.729,-2.247,-3.960,P<0.05). Heart V10 and V20 in the Plan1 group decreased respectively by 7.23％ and 5.78％,with statistical significance (t=-4.376,-3.523,P<0.01),while V30 and V40 of Plan 1 increased respectively by 2.7％ and 4.92％,without statistical significance (P>0.05). There was no significant difference in heart Dmean between the Plan1 group and the Plan2 group (P>0.05). Conclusion:Both two methods of distribution field can meet the clinical requirements,and Plan1 has more advantages in protecting organs at risk under the premise of meeting the requirements of target region.