The disturbance of the human microbiota influences the occurrence and progression of many diseases. Live therapeutic bacteria, with their genetic manipulability, anaerobic tendencies, and immunomodulatory properties, are emerging as promising therapeutic agents. However, their clinical applications face challenges in maintaining activity and achieving precise spatiotemporal release, particularly in the harsh gastrointestinal environment. This review highlights the innovative bacterial functionalized encapsulation strategies developed through advances in physicochemical and biological techniques. We comprehensively review how bacterial encapsulation strategies can be used to provide physical barriers and enhanced adhesion properties to live microorganisms, while introducing superior material properties to live bacteria. In addition, this review outlines how bacterial surface coating can facilitate targeted delivery and precise spatiotemporal release of live bacteria. Furthermore, it elucidates their potential applications for treating different diseases, along with critical perspectives on challenges in clinical translation. This review comprehensively analyzes the connection between functionalized bacterial encapsulation and innovative biomedical applications, providing a theoretical reference for the development of next-generation bacterial therapies.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Objective:To compare the anterior long-segment fixation, posterior long-segment fixation, and combined anterior-posterior fixation in the treatment of ankylosing spondylitis with cervical fracture (ASCF).Methods:A retrospective study was conducted to analyze the 153 patients with ASCF who had been treated at Department of Orthopaedics, Peking University Third Hospital and Department of Orthopedics, Luoche Central Hospital between January 2014 and December 2023. The cohort included 86 males and 67 females, with an age of (41.6±11.5) years, a disease duration of (10.0±3.9) years, and an interval from injury to surgery of (3.3±1.4) d. By Frankel's classification for preoperative nerve injury, 57 cases were grade B, 51 grade C, and 45 grade D. Based on the surgical approaches, the patients were divided into 3 groups: an anterior group ( n=63) undergoing the anterior cervical long-segment fixation, a posterior group ( n=51) undergoing the posterior cervical long-segment fixation, and a combination group ( n=39) undergoing combined anterior-posterior cervical fixation. Surgical time, intraoperative blood loss, fracture healing, complications, and changes in Frankel grading for spinal cord injury were compared among the 3 groups. Results:There was no statistically significant difference in the preoperative general data among the 3 groups, indicating comparability ( P > 0.05). All patients were followed up for (33.5±12.0) months after surgery. In the anterior group, the surgical time [(103.0±16.8) min] was significantly shorter than that in the posterior group [(148.4±17.7) min] and that in the combination group [(228.5±23.9) min], the intraoperative blood loss [(92.8±27.8) mL] was significantly less than that in the posterior group [(477.5±109.5) mL] and that in the combination group [(769.5±136.9) mL], and the incidence of complications [9.5% (6/63)] was significantly lower than that in the posterior group [41.2% (21/51)] and that in the combination group [53.8% (21/39)] (all P<0.05). There was no statistically significant difference in the fracture healing time among the 3 groups ( P=0.111). At the last follow-up, X-ray and CT scans showed no loosening or breakage of internal fixation in all the 3 groups. The Frankel grading at the last follow-up: 12 cases of grade C, 15 cases of grade D, and 36 cases of grade E in the anterior group; 3 cases of grade B, 12 cases of grade C, 12 cases of grade D, and 24 cases of grade E in the posterior group; 6 cases of grade C, 12 cases of grade D, and 21 cases of grade E in the combination group. At the last follow-up, all patients showed a significant improvement compared to their Frankel grades before surgery ( P<0.001), but there was no statistically significant difference between the 3 groups ( H=2.238, P=0.327). Conclusions:In the treatment of ASCF, anterior long-segment fixation is advantageous over posterior long-segment fixation and combined anteri-or-posterior fixation due to its shorter surgical time, reduced intraoperative blood loss, and a lower complication incidence. All the 3 surgical approaches demonstrate comparable outcomes in terms of fracture healing time, radiographic stability, and final neurological recovery.

Polyethylene (PE) is widely used due to its excellent properties. However, the improper disposal of PE waste has led to serious environmental pollution. Microbial degradation of PE is a low-carbon, environmentally friendly, and highly efficient method of homogeneous recycling. The use of microbial degradation technology to treat polyethylene waste has become one of the current research hotspots. As a result, employing microbial degradation technology to address polyethylene waste has become a key focus of current research. A PE-degrading strain ETX1 was screened from waste plastics in a landfill by the enrichment culture method. The strain was identified as Lysinibacillus sp.. After incubating PE powder with the strain for 20 days, a weight loss of 29.41% was observed. Fourier transform infrared spectroscopy (FTIR) showed that special absorption peaks such as carbonyl and hydroxyl groups appeared, proving that ETX1 had the effect of degrading PE. The degradation effect of this strain was characterized by the weight loss of PE film, FTIR, scanning electron microscopy, and contact angle. The results showed that ETX1 reduced the PE film weight by up to 5.23% within 120 days. The film structure was damaged, with holes formed by erosion on the film surface, and the hydrophilicity was enhanced. Additionally, a stronger carbonyl absorption peak appeared. The discovery of the PE-degrading strain ETX1 not only enriches the resources of PE plastic-degrading strains but also lays a foundation for mining efficient PE-degrading elements, obtaining degrading enzymes, and deciphering related degradation pathways.
Polyethylene/chemistry* ; Biodegradation, Environmental ; Spectroscopy, Fourier Transform Infrared ; Bacillaceae/classification* ; Plastics/metabolism*

ObjectiveTo evaluate the clinical efficacy of Huayu Tongluo Formula （化瘀通络方， HTF） in patients with mid-stage diabetic kidney disease of blood stasis syndrome and explore its potential mechanisms. MethodsA multi-center， randomized， double-blind， placebo-controlled clinical trial was conducted. Ninety patients of mid-stage diabetic kidney disease of blood stasis syndrome were divided into a control group of 46 cases and a treatment group of 44 cases. Both groups received conventional western medicine treatment， the treatment group additionally taking HTF， while the control group taking a placebo of the formula. The treatment was administered once daily for 24 weeks. The primary outcomes included 24-hour urine total protein （24 h-UTP）， serum albumin （Alb）， glycated hemoglobin （HbA1c）， and serum creatinine （Scr）.The secondary outcomes included changes in levels of endothelin-1 （ET-1）， nitric oxide （NO）， vascular endothelial growth factor （VEGF）， and traditional Chinese medicine （TCM） syndrome scores before and after treatment. Clinical efficacy was evaluated based on TCM syndrome scores and overall disease outcomes. Adverse reactions and endpoint events were recorded. ResultsIn the treatment group after treatment， 24 h-UTP， ET-1， and VEGF levels significantly decreased （P＜0.05）， Alb and NO levels significantly increased （P＜0.05）； while the TCM syndrome scores for edema， lumbar pain， numbness of limbs， dark purple lips， dark purple tongue or purpura， and thin， rough pulse all significantly decreased （P＜0.05）. In the control group， no significant changes were observed in any of the indicators after treatment （P＞0.05）.Compared with the control group， the treatment group showed significant reductions in 24 h-UTP， ET-1， and VEGF levels， and increases in Alb and NO levels （P＜0.05）. The TCM syndrome scores for edema， lumbar pain， dark purple tongue or purpura， and thin， rough pulse were all lower in the treatment group than in the control group （P＜0.05）. The total effective rate of TCM syndrome in the treatment group was 59.09% （26/44）， and the overall clinical effective rate was 45.45% （20/44）. In the control group， these rates were 15.22% （7/46） and 8.7% （4/46）， respectively， with the treatment group showing significantly better outcomes （P＜0.05）. A total of 7 adverse events occurred across both groups， with no significant difference （P＞0.05）. No endpoint events occurred during the study. ConclusionOn the basis of conventional treatment of Western medicine， HTF can further reduce urinary protein levels and improve clinical symptoms in patients with mid-stage diabetic kidney disease of blood stasis syndrome. The mechanism may be related to its effects on endothelial function.

The incidence of adenocarcinoma of the esophagogastric junction (AEG) continues to rise globally, with surgical resection representing the primary curative approach. Due to the complex anatomy and heterogeneous metastatic pathways of AEG, lymphadenectomy has become a critical focus in modern surgical oncology. However, traditional TNM staging and Siewert classification exhibit limitations in precisely guiding the optimal extent of lymphadenectomy. Consequently, this review integrated emerging evidence from membrane anatomy theory - a field experiencing breakthrough advances - to systematically explore lymphadenectomy strategies for AEG. Specifically, we analyzed the application of membrane anatomy principles to delineate lymphadenectomy strategies, dissection scope, and key surgical techniques tailored to each Siewert subtype (I, II, III) and varying degrees of esophageal involvement. Based on membrane anatomy, the review proposed specific, anatomically guided lymph node dissection strategies. Furthermore, we evaluated the feasibility, standardization, and clinical significance of membrane anatomy-guided dissection strategies considering recent advances, while also addressing current challenges and future directions for development and validation. Membrane anatomy is anticipated to serve as a novel and essential anatomical foundation for optimizing surgical approaches. Its application thus may hold significant promise for optimizing surgical pathways, enhancing the quality and precision of lymph node dissection, and ultimately improving oncological outcomes.

Objective:To observe any effect of combining repeated transcranial magnetic stimulation (rTMS) with electro-acupuncture in treating post-stroke cognitive impairment (PISC).Methods:Three groups of PISC patients were formed through random selection: an rTMS group, an electro-acupuncture group, and a combined group. In addition to routine medication and conventional rehabilitation training, the rTMS and electro-acupuncture groups received rTMS and electro-acupuncture treatment, while the combined group underwent both for six weeks. Before the treatment, immediately afterward and 3, 6, and 12 months later, everyone′s cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA). The modified Barthel Index (MBI), the 17-item Hamilton Depression Rating Scale (HAMD-17), and the National Institutes of Health Stroke Scale (NIHSS) were also applied. Transcranial Doppler ultrasound (TCD) was employed to measure the mean cerebral blood flow velocity (Vm), pulsatility index (PI), and breath-holding index (BHI) in the subjects′ bilateral middle cerebral arteries (MCAs). The total effectiveness rates and the incidence of adverse reactions were compared among the three groups.Results:The MoCA scores, MBI scores, HAMD-17 scores, NIHSS scores, and Vm of the MCA had improved significantly in all three groups right after the treatment. There was further significant improvement in the average MoCA scores 12 months later. The combined group showed significantly higher MoCA scores than the other two groups at each time point after the treatment. That group also had superior MBI, HAMD-17 and NIHSS scores and a better BHI compared to the other 2 groups, on average. Its total effectiveness rate was significantly higher too. There was no significant difference in the incidence of adverse reactions among the groups.Conclusions:Combining rTMS with electro-acupuncture significantly improves cognition, ADL ability, depression and neurological functioning after a stroke. The combined treatment is worthy of wider clinical application.

Objective:To observe any effect of combining repeated transcranial magnetic stimulation (rTMS) with electro-acupuncture in treating post-stroke cognitive impairment (PISC).Methods:Three groups of PISC patients were formed through random selection: an rTMS group, an electro-acupuncture group, and a combined group. In addition to routine medication and conventional rehabilitation training, the rTMS and electro-acupuncture groups received rTMS and electro-acupuncture treatment, while the combined group underwent both for six weeks. Before the treatment, immediately afterward and 3, 6, and 12 months later, everyone′s cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA). The modified Barthel Index (MBI), the 17-item Hamilton Depression Rating Scale (HAMD-17), and the National Institutes of Health Stroke Scale (NIHSS) were also applied. Transcranial Doppler ultrasound (TCD) was employed to measure the mean cerebral blood flow velocity (Vm), pulsatility index (PI), and breath-holding index (BHI) in the subjects′ bilateral middle cerebral arteries (MCAs). The total effectiveness rates and the incidence of adverse reactions were compared among the three groups.Results:The MoCA scores, MBI scores, HAMD-17 scores, NIHSS scores, and Vm of the MCA had improved significantly in all three groups right after the treatment. There was further significant improvement in the average MoCA scores 12 months later. The combined group showed significantly higher MoCA scores than the other two groups at each time point after the treatment. That group also had superior MBI, HAMD-17 and NIHSS scores and a better BHI compared to the other 2 groups, on average. Its total effectiveness rate was significantly higher too. There was no significant difference in the incidence of adverse reactions among the groups.Conclusions:Combining rTMS with electro-acupuncture significantly improves cognition, ADL ability, depression and neurological functioning after a stroke. The combined treatment is worthy of wider clinical application.

The incidence of adenocarcinoma of the esophagogastric junction (AEG) continues to rise globally, with surgical resection representing the primary curative approach. Due to the complex anatomy and heterogeneous metastatic pathways of AEG, lymphadenectomy has become a critical focus in modern surgical oncology. However, traditional TNM staging and Siewert classification exhibit limitations in precisely guiding the optimal extent of lymphadenectomy. Consequently, this review integrated emerging evidence from membrane anatomy theory - a field experiencing breakthrough advances - to systematically explore lymphadenectomy strategies for AEG. Specifically, we analyzed the application of membrane anatomy principles to delineate lymphadenectomy strategies, dissection scope, and key surgical techniques tailored to each Siewert subtype (I, II, III) and varying degrees of esophageal involvement. Based on membrane anatomy, the review proposed specific, anatomically guided lymph node dissection strategies. Furthermore, we evaluated the feasibility, standardization, and clinical significance of membrane anatomy-guided dissection strategies considering recent advances, while also addressing current challenges and future directions for development and validation. Membrane anatomy is anticipated to serve as a novel and essential anatomical foundation for optimizing surgical approaches. Its application thus may hold significant promise for optimizing surgical pathways, enhancing the quality and precision of lymph node dissection, and ultimately improving oncological outcomes.

[Objective]To explore the relationship between self-assessed health and age-adjusted Charlson comorbidity index(AICC)in older adults,and to further analyze the differences in this relationship across gender groups.[Methods]Based on the China health and retirement longitudinal study(CHARLS)database,this study selected data on basic characteristics,chronic disease status,depressive symptoms,and self-assessed health of older adults aged≥60 years.Chi-square tests were used to perform a preliminary analysis of the association between these factors and AICC scores.A multifactorial ordered logistic regression model was constructed to assess the effects of each influencing factor on AICC,while multiple linear regression analysis was used to explore the linear relationship between self-rated health and AICC scores.Additionally.Stratified analysis by gender was performed to evaluate gender differences.[Results]A total of 10 911 participants were included,with a mean age of 67.40±5.94 years;6 249(57.3%)were male and 4 662(42.7%)were female.The distribution of AICC scores was categorized into low-risk,moderate-risk,higher-risk,and high-risk groups,accounting for 23.5%,50.2%,20.6%,and 5.7%,respectively.Multifactorial logistic regression analysis revealed that self-rated health was negatively associated with AICC in the total population and in the male geriatric group(OR=0.843,95%CI:0.776,0.917,P=0.001),(OR=0.886,95%CI:0.796,0.987,P=0.028),but did not reach statistical significance in the female geriatric group.Linear regression analysis further indicated a significant negative linear relationship between self-rated health and AICC(b=-0.485,95%CI:-0.516,-0.455,P＜0.001).This relationship was consistent in both male(b=-0.356,95%CI:-0.406,-0.305,P＜0.001)and female(b=-0.373,95%CI:-0.435,-0.310,P＜0.001)subgroups,with a stronger negative association in females.[Conclusion]Self-rated health is significantly negatively associated with AICC,and attention should be given to self-rated health in the female geriatric population.Self-rated health can serve as an important tool for identifying elderly group at high risk of comorbidities providing a valuable basis for precise intervention.