Gut microbial communities are likely remodeled in tandem with accumulated physiological decline during aging, yet there is limited understanding of gut microbiome variation in advanced age. Here, we performed a metagenomics-based enterotype analysis in a geographically homogeneous cohort of 367 enrolled Chinese individuals between the ages of 60 and 94 years, with the goal of characterizing the gut microbiome of elderly individuals and identifying factors linked to enterotype variations. In addition to two adult-like enterotypes dominated by Bacteroides (ET-Bacteroides) and Prevotella (ET-Prevotella), we identified a novel enterotype dominated by Escherichia (ET-Escherichia), whose prevalence increased in advanced age. Our data demonstrated that age explained more of the variance in the gut microbiome than previously identified factors such as type 2 diabetes mellitus (T2DM) or diet. We characterized the distinct taxonomic and functional profiles of ET-Escherichia, and found the strongest cohesion and highest robustness of the microbial co-occurrence network in this enterotype, as well as the lowest species diversity. In addition, we carried out a series of correlation analyses and co-abundance network analyses, which showed that several factors were likely linked to the overabundance of Escherichia members, including advanced age, vegetable intake, and fruit intake. Overall, our data revealed an enterotype variation characterized by Escherichia enrichment in the elderly population. Considering the different age distribution of each enterotype, these findings provide new insights into the changes that occur in the gut microbiome with age and highlight the importance of microbiome-based stratification of elderly individuals.
Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Bacteroides ; China ; Diabetes Mellitus, Type 2/microbiology* ; Escherichia coli/classification* ; Gastrointestinal Microbiome/genetics* ; Metagenomics ; East Asian People

Chloropicrin is a commonly used pesticide in agricultural production. The clinical manifestations of oral poisoning patients are complex, and the lesions involve multiple organs. At present, the specific pathogenic mechanism of such poisoning is not clear, and the treatment experience is insufficient, so there are certain difficulties in clinical diagnosis, treatment and treatment. In this paper, the data of a patient with oral chloropicrin poisoning treated in Yidu Central Hospital of Weifang City in April 2023 were summarized. The patient was admitted to our hospital for treatment in time, and his condition improved after Hemopurification, methylene blue reduction, organ support, infection prevention as well as other symptomatic support. Oral chlorophenol can cause lung damage, skin and mucous membrane damage, and may have certain effects on the nervous system and kidney. Early intervention, especially blood purification, is effective.

Chloropicrin is a commonly used pesticide in agricultural production. The clinical manifestations of oral poisoning patients are complex, and the lesions involve multiple organs. At present, the specific pathogenic mechanism of such poisoning is not clear, and the treatment experience is insufficient, so there are certain difficulties in clinical diagnosis, treatment and treatment. In this paper, the data of a patient with oral chloropicrin poisoning treated in Yidu Central Hospital of Weifang City in April 2023 were summarized. The patient was admitted to our hospital for treatment in time, and his condition improved after Hemopurification, methylene blue reduction, organ support, infection prevention as well as other symptomatic support. Oral chlorophenol can cause lung damage, skin and mucous membrane damage, and may have certain effects on the nervous system and kidney. Early intervention, especially blood purification, is effective.

The STAR tool was used to evaluate and analyze the science, transparency, and applicability of Chinese pathology guidelines and consensus published in medical journals in 2022. There were a total of 18 pathology guidelines and consensuses published in 2022, including 1 guideline and 17 consensuses. The results showed that the guideline score was 21.83 points, lower than the overall guideline average (43.4 points). Consensus ratings scored an average of 27.87 points, on par with the overall consensus level (28.3 points). Areas that scored above the overall level were "conflict of interest" and "working groups", while areas that scored below the overall level were "proposals", "funding", "evidence", "consensus approaches" and "accessibility". To sum up, the formulation of pathology guidelines and consensuses in 2022 is not standardized, and the evidence retrieval process, evidence evaluation methods and grading criteria for recommendations on clinical issues are not provided in the formulation process; the process and method for reaching consensus are not provided, the plan is lacking, and registration is not carried out. It is therefore suggested that guidelines/consensus makers in the field of pathology should attach importance to evidence-based medical evidence, strictly follow guideline formulation methods and processes, further improve the scientific, applicable and transparent guidelines/consensuses in the field, and better provide support for clinicians and patients.

Objective:To report the experience of the application of internal carotid artery stent in skull base surgery, and to clarify the important role of internal carotid artery stent in skull base surgery.Methods:A retrospective study of 22 cases with skull base neoplasms implanted with internal carotid artery stents in the Department of ENT Head and Neck Surgery at the Sixth People′s Hospital affiliated with Shanghai Jiao Tong University between July 2019 and January 2021 was conducted. Among them, 17 were male and 5 were female, aged between 33 and 75 years. There were 5 cases on the left, 16 cases on the right, and 1 case on both sides. Of these, there were 4 cases of jugular paraganglioma, 1 case of chondrosarcoma in the jugular foramen, 1 case of carotid body paraganglioma, and 16 cases of nasopharyngeal carcinoma after radiotherapy.Results:The degree of internal carotid artery erosion was assessed by computed tomography angiography (CTA), magnetic resonance imaging and digital subtraction angiography (DSA) images in 22 patients before surgery. It was found that the internal carotid artery was involved to varying degrees in all patients, so internal carotid artery stents were implanted before surgery. Tumor tissue was found to surround the internal carotid artery to varying degrees. Total or subtotal tumor resection was performed in all patients, and no intraoperative and postoperative complications occurred. The postoperative follow-up was 5 months to 2 years, and all patients had no complications such as spontaneous bleeding and pseudo aneurysm. There were no signs of stenosis or occlusion of the internal carotid artery stent segment in all cases.Conclusions:For patients with skull base tumors, preoperative imaging indicates the limited involvement of the internal carotid artery, and internal carotid artery stent implantation before surgery is a safe and effective treatment.

Objective:To realize the characteristics of postgraduate students applying for Peking University Third Hospital and to explore the strategies to improve the enrollment quality on the background of "Double first-class".Methods:Enrollment data from 2015 to 2019 of the Peking University Third Hospital was statistically analyzed by SPSS 17.0 software. For variables that did not conform to the normal distribution, median and quartile were utilized for description. Mann-Whitney U test was utilized for comparison between admission group and non-admission group. For the counting data, number of cases and proportion were utilized for description. The comparison between groups was performed by chi-square test or Fisher precision test. All tests were two-sided and had a significance level of 0.05. Results:The average enrollment ratio was 4.9∶1. The overall admission rate of first choice was 76.9% (450/585), which kept increased steadily, and the gap between national key clinical specialties and non-key specialties was narrowed. The geographical distribution of students was mainly in north China (30%, 175/585) and east China (28%, 164/585). The admission group had characteristics of high score of CET-6 (505 vs. 480, Z=-5.86, P<0.001) and young age (24 vs. 25, Z=-8.15, P<0.001). The proportion of "985", "211" or "Double first-class" universities, patents invention, conference speeches and high level awards in admission group was higher than that in non-admission group. Conclusion:Sustainable policies should be taken to constantly improve the quality of enrollment including establishing sound mechanism of discipline adjustment and optimization, increasing the publicity of enrollment nationwide, and strengthening the selection of the comprehensive ability of students centered on the construction of first-class disciplines.

Objective:To assess the association between blood pressure and the risks of diabetes mellitus.Methods:Screening and intervention were conducted from 2015 to 2019 for high-risk subjects of cardiovascular diseases in eight counties of Henan. Information on demographic characteristics, lifestyle behaviors, and anthropometric measurements were obtained via a questionnaire. Fasting blood samples were collected for blood glucose and serum lipids. The R 3.6.3 software was used to analyze the relationship between blood pressure and diabetes mellitus.Results:The detection rate of diabetes mellitus was 23.5% among 120 040 participants aged 35-75 years. The mean fasting blood glucose level was significantly different among normotensive, prehypertensive, and hypertensive patients. Compared to normotensive patients, prehypertension and hypertension had adjusted ORs of 34%( OR=1.34, 95 CI%: 1.30-1.37) and 85%( OR=1.85, 95 CI%: 1.81-1.89). The corresponding ORs were 1.81(1.77-1.85) in controlled and 2.17(2.06-2.28) in uncontrolled patients. A subgroup analysis showed the same trend, where the risk of diabetes increased with blood pressure ( P<0.05). Conclusions:People with elevated BP may increase their risk of diabetes, while the risk declines when BP is under control. Therefore, targeted measures should be taken to reduce the risk.

Objective:To explore the difficulties and measures of clinical medical postgraduates management during the national prevention of COVID-19 pandemic.Methods:This study mainly used the document review, interview and questionnaire survey methodologies, to investigate the clinical medical postgraduates school situation, online teaching, training, scientific research, psychological state during prevention of COVID-19 emergency.Results:Up to February 14, 2020, the return rate of professional degree postgraduates was 92.8% (256/276). The average score of postgraduates participating in epidemic prevention and control training was 86.59. The effect of online learning was basically the same as that of face-to-face classroom teaching. Up to March 6, 2020, the in-hospital submission rate of postgraduates’ thesis was 50.0% (65/130). Facing the pressures of COVID-19 emergency, 62.6% professional degree postgraduates (124/198) and 35.4% (70/198) academic postgraduates suffered some anxiety or depression, the difference was statistically significant ( P<0.05). Conclusions:During the COVID-19 prevention and control period, it is important to innovate work style, found the linkage system of education department-clinical department-tutor-postgraduates, pay attention to physical and mental health of postgraduates, ensure the quality of teaching, adopt various measures to do well in the education and management of clinical medical postgraduates.

Objective To analyze the infection rate of hepatitis B virus (HBV) in aggressive B-cell non-Hodgkin lymphoma (B-NHL), indolent B-NHL and multiple myeloma (MM) and its relationship with clinicopathological features. Methods The clinical data of 293 aggressive B-NHL, 181 indolent B-NHL and 261 MM patients in Tianjin Medical University Cancer Institute and Hospital from January 2009 to April 2017 were retrospectively analyzed. The difference of HBV infection was compared among three groups. Serum samples from all patients were tested for HBV markers, including hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B e antigen (HBeAg), hepatitis B e antibody (HBeAb) and hepatitis B core antibody (HBcAb) by using chemiluminescence immunoassay. Results The positive rate of HBsAg was 9.2% (27/293), 5.5% (10/181) and 3.8% (10/261), respectively in the aggressive B-NHL group, indolent B-NHL group and MM group. The positive rate of HBsAg in the aggressive B-NHL group was higher than that in the indolent B-NHL group and MM group (χ2＝6.987, P＝0.030), and there was no statistical difference of HBsAg positive rate between the indolent B-NHL group and MM group (P ＞ 0.05). The positive rate of HBsAg, HBeAg, HBcAb in the aggressive B-NHL group was higher than that in the indolent B-NHL group and MM group [4.1% (12/293), 0, 0.8% (2/261); χ2＝ 14.976, P＝ 0.001], and there was no significant difference in the positive rate of HBsAg, HBeAg and HBcAb between the indolent B-NHL group and MM group (P ＞ 0.05). Compared with HBsAg negative aggressive B-NHL patients, HBsAg positive aggressive B-NHL patients showed, higher ratio of stage Ⅲ-Ⅳ [70.4% (19/27) vs. 49.2% (131/266), χ 2 ＝ 4.377, P＝0.036], more frequent involvement of spleen [51.9% (14/27) vs. 23.7% (63/266), χ 2＝ 10.039, P＝ 0.002], more frequent of B symptom [55.6% (15/27) vs. 32.0% (85/266), χ 2 ＝ 6.073, P＝ 0.014], more frequent of elevated total bilirubin [29.6% (8/27) vs. 14.3% (38/266), χ 2 ＝ 4.360, P ＝ 0.037] and more frequent of reduced albumin [55.6% (15/27) vs. 35.7% (95/266), χ 2＝ 4.115, P＝ 0.042]. Conclusions The infection rate of HBV in aggressive B-NHL patients is higher than that in the indolent B-NHL and MM patients. HBsAg positive aggressive B-NHL patients are associated with adverse clinical characteristics.

Objective To explore the effect Tiaoli-Qixue decoction on bleeding and coagulation during perioperative period of total hip arthroplasty (THA).Methods A total of 180 THA patients who met the inclusion criteria were randomly divided into three groups with 60 cases in each group.All patients underwent routine anti-infection treatment after unilateral THA through lateral hip approach.The patients took the Tiaoli-Qixue decoction 3 days before THA in the treatment group.The patients in the Xuesaitong control group received intravenous Xuesaitong on the day of operation and rivaroxaban tablets were administered orally on the day of operation in the westem medicine control group.The continuous medication was administered until 7 days after operation in three groups.The amount of hemorrhage and drainage after operation were recorded and the total amount of dominant hemorrhage was calculated.The Degao M4 semi-automatic hemagglutination instrument was used to detect plasma D-dimer level and observe thrombosis.Harris scale was used before and after operation to calculate the excellent and good rates of Harris score.Results The total amount of dominant hemorrhage (376.67 ± 61.44 ml vs.400.08 ± 61.16 ml,413.33 ± 53.76 ml,F=5.963),intraoperative hemorrhage (165.50 ± 15.67 ml vs.174.75 ± 14.68 ml,175.42 ± 11.13 ml,F=9.452) and postoperative drainage (211.17 ± 58.12 ml vs.225.33 ± 56.93 ml,237.92 ± 54.28 ml,F=3.370) in the treatment group of traditional Chinese medicine were significanlty less than those in the Xuesaitong control group and the Western medicine control group (P＜0.01 or P＜0.05).On the 7th day after operation,there were 6 cases of thrombosis in the treatment group of traditional Chinese medicine,4 cases in the Xuesaitong control group and 4 cases in the Western medicine control group.There was no significant difference between the three groups (x2=0.667,P=0.881).Six months after operation,the excellent and good rate of that the treatment group of traditional Chinese medicine was 45.0％ (27/60),which of the the Xuesaitong control group was 11.7％ (7/60),and which of the the Western medicine control group was 13.3％ (8/60).There was significant difference among the three groups.Conclusions The Tiaoli-Qixue decoction bleeding and coagulation can reduce the amount of dominant bleeding during perioperative period in patients with THA,and effectively prevent and treat deep venous thrombosis of lower limbs after THA.