Objective To explore the mechanism of Bufei Jiedu Granules in the treatment of methicillin-resistant Staphylococcus aureus(MRSA)chronic infection using network pharmacology;To verify it through animal experiments.Methods Active components and potential targets in Bufei Jiedu Granules were screened through the TCMSP database,and genes related to MRSA infection were retrieved through GeneCards,OMIM,DisGeNET,TTD,DrugBank and PharmGKB databases.The STRING database was employed to construct a protein-protein interaction network on common targets,and GO and KEGG pathway enrichment analysis were conducted to identify key signaling pathways for Bufei Jiedu Granules treatment of MRSA infection.The effects of Bufei Jiedu Granules on bacterial load and pathological changes in the lung,liver and kidney of MRSA chronic infection mice models were evaluated through WT and T/B immune cell deficient Rag2-/-mouse animal experiments.The mRNA expressions of inflammatory factors(IFN-γ,IL-10)and immune checkpoints(PD1,TIM3)were detected.Results Totally 54 active components related to Bufei Jiedu Granules were selected,and 50 potential targets related to MRSA infection were identified.118 signaling pathways significantly associated with MRSA infection were identified through GO and KEGG pathway enrichment analysis,in which the JAK-STAT signaling pathway,Th17 cell differentiation,and PD-L1 expression and PD-1 checkpoint pathway were closely related to cell activation and T cell differentiation.Animal experimental results indicated that Bufei Jiedu Granules could effectively reduce the bacterial load in organs and ameliorate the pathological damage in the chronic MRSA infection mouse model,increase the mRNA expression of IFN-γ in the lung tissue,and decrease the mRNA expressions of IL-10,PD1 and TIM3.Conclusion Bufei Jiedu Granules has the characteristics of multi-component and multi-target in the treatment of MRSA infection,and may be involved in adaptive immune activation to effectively treat chronic MRSA infection.

The incidence of leukemia,a malignant cancer originating from the hematopoietic system,is increasing annually.Although traditional treatment method such as chemotherapy and hematopoietic stem cell transplantation have improved patient survival rates to some extent,serious side effects,drug tolerance,and high recurrence rates remain.In recent years,studies have shown that the gut microbiota and its metabolites play an important role in the occurrence,development,and complications of leukemia.Imbalance of the gut microbiota can lead to decreased immune function and an intensified inflammatory response,which is a key factor driving disease progression.Some metabolites,such as short-chain fatty acids,enhance immune function and improve patient prognosis through intestinal barrier repair,while others,such as hydrogen sulfide and bile acids,show potential anti-tumor effects exerted through regulation of tumor cell apoptosis and immune balance.Traditional Chinese medicine aimed at regulating the structure of the gut microbiota and its metabolites has shown great potential in alleviating the side effects of chemotherapy for leukemia.This review covers the role of the gut microbiota and its metabolites in the occurrence,development,and complications of leukemia,and explores treatment strategies for regulating the microbiota,including fecal microbiota transplantation,probiotics,and traditional Chinese medicine intervention.We anticipate that this review will serve as a reference for improving the treatment and prognosis of leukemia.

Objectives:To analyze the risk factors of atrial fibrillation in patients with non-obstructive hypertrophic cardiomyopathy(NOHCM)and explore the relationship between left ventricular/atrial volume and atrial fibrillation.Methods:Consecutive NOHCM patients admitted at Fuwai Hospital from January 2023 to January 2024 with complete clinical data,satisfactory echocardiography imaging data were included in this analysis,patients were divided into atrial fibrillation group(n=28)and non-atrial fibrillation group(n=57).Left-sided volumetric and functional parameters were measured by one-beat real-time full-volume three-dimensional echocardiography,including left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),left atrial volume(LAV).The left ventricular end-diastolic volume(LVEDVi)index,left ventricular end-systolic volume index(LVESVi)and left atrial volume index(LAVi)were calculated.Other echocardiographic parameters including interventricular septum(IVSmax)thickness,left ventricular posterior wall thickness(LVPW),and left atrial diameter(LAD)were routinely measured.Mitral valve forward flow spectrum,tissue Doppler,tricuspid regurgitation velocity,and left atrial size were used to evaluate the left ventricular diastolic function of patients,and diastolic dysfunction was classified into grade I,II,and III.Multivariate logistic regression was used to analyze the influencing factors of atrial fibrillation in patients with non-obstructive hypertrophic cardiomyopathy Results:Compared with the non-atrial fibrillation group,LVEDV([143.8±26.7]ml vs.[117.1±21.9]ml)and LVEDVi([79.4±11.9]ml/m2 vs.[64.2±10.6]ml/m2)were smaller in atrial fibrillation group(both P<0.001).Compared with the non-atrial fibrillation group,LAD([40.2±4.7]mm vs.[48.6±4.8]mm)and LAVi([37.3±8.9]ml/m2 vs.[64.4±17.1]ml/m2)were lager in atrial fibrillation group(both P<0.001).Compared with the non-atrial fibrillation group,the proportion of NYHA functional classification≥Ⅲ was higher(15.8%vs.50.0%,P<0.001),LVEF was lower([61.5±5.5]%vs.[57.6±5.0]%,P=0.002),and proportion of severe diastolic dysfunction was higher in atrial fibrillation group(P<0.001).Logistic regression analysis showed that the factors associated with atrial fibrillation in NOHCM patients were LVEDVi(OR=0.744,95%CI:0.575-0.962,P=0.024)and LAVi(OR=1.602,95%CI:1.032-2.486,P=0.036).Conclusions:LVEDVi and LAVi are related factors for atrial fibrillation in patients with non-obstructive hypertrophic cardiomyopathy.LVEDVi is negatively,while LAVi is positively associated with the occurrence of atrial fibrillation in NOHCM patients.

AIM:To investigate the impact of es-ketamine-mediated opioid-free anesthesia(OFA)on postoperative gastrointestinal function in patients undergoing laparoscopic distal gastrectomy for gas-tric cancer.METHODS:A total of 150 pa-tients,scheduled for elective laparoscopic distal gas-trectomy for gastric cancer and meeting the inclu-sion and exclusion criteria,were randomly assigned to either the OFA group or the opioid-based anes-thesia(OBA)group using a random number ta-ble,with 75 patients in each group.The OFA group was administered an anesthesia regimen pri-marily consisting of esketamine,while the OBA group received conventional opioid anesthesia,pri-marily consisting of sufentanil and remifentanil.The primary outcome measure was postoperative flatus time,defined as the interval from the end of sur-gery to the first passage of gas.RESULTS:The OFA group exhibited a shorter postoperative flatus time compared to the OBA group(P＜0.01).Intraopera-tive blood loss and norepinephrine consumption were significantly less in the OFA group compared to the OBA group(P＜0.05);the postoperative HADS-D score was better in the OFA group than in the OBA group,and both the OFA and OBA groups showed significantly lower postoperative HADS-A and HADS-D scores compared to their preoperative levels(P＜0.05);the incidence rate of abdominal distension was significantly lower in the OFA group compared to the OBA group(P＜0.05).CONCLUSION:The use of esketamine-mediated opioid-free anesthesia can expedite gastrointestinal function recovery,reduce hospital stay duration,and decrease postoperative adverse reactions in patients undergoing laparo-scopic distal gastrectomy for gastric cancer.

AIM:To investigate the impact of es-ketamine-mediated opioid-free anesthesia(OFA)on postoperative gastrointestinal function in patients undergoing laparoscopic distal gastrectomy for gas-tric cancer.METHODS:A total of 150 pa-tients,scheduled for elective laparoscopic distal gas-trectomy for gastric cancer and meeting the inclu-sion and exclusion criteria,were randomly assigned to either the OFA group or the opioid-based anes-thesia(OBA)group using a random number ta-ble,with 75 patients in each group.The OFA group was administered an anesthesia regimen pri-marily consisting of esketamine,while the OBA group received conventional opioid anesthesia,pri-marily consisting of sufentanil and remifentanil.The primary outcome measure was postoperative flatus time,defined as the interval from the end of sur-gery to the first passage of gas.RESULTS:The OFA group exhibited a shorter postoperative flatus time compared to the OBA group(P＜0.01).Intraopera-tive blood loss and norepinephrine consumption were significantly less in the OFA group compared to the OBA group(P＜0.05);the postoperative HADS-D score was better in the OFA group than in the OBA group,and both the OFA and OBA groups showed significantly lower postoperative HADS-A and HADS-D scores compared to their preoperative levels(P＜0.05);the incidence rate of abdominal distension was significantly lower in the OFA group compared to the OBA group(P＜0.05).CONCLUSION:The use of esketamine-mediated opioid-free anesthesia can expedite gastrointestinal function recovery,reduce hospital stay duration,and decrease postoperative adverse reactions in patients undergoing laparo-scopic distal gastrectomy for gastric cancer.

Objectives:To analyze the risk factors of atrial fibrillation in patients with non-obstructive hypertrophic cardiomyopathy(NOHCM)and explore the relationship between left ventricular/atrial volume and atrial fibrillation.Methods:Consecutive NOHCM patients admitted at Fuwai Hospital from January 2023 to January 2024 with complete clinical data,satisfactory echocardiography imaging data were included in this analysis,patients were divided into atrial fibrillation group(n=28)and non-atrial fibrillation group(n=57).Left-sided volumetric and functional parameters were measured by one-beat real-time full-volume three-dimensional echocardiography,including left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF),left atrial volume(LAV).The left ventricular end-diastolic volume(LVEDVi)index,left ventricular end-systolic volume index(LVESVi)and left atrial volume index(LAVi)were calculated.Other echocardiographic parameters including interventricular septum(IVSmax)thickness,left ventricular posterior wall thickness(LVPW),and left atrial diameter(LAD)were routinely measured.Mitral valve forward flow spectrum,tissue Doppler,tricuspid regurgitation velocity,and left atrial size were used to evaluate the left ventricular diastolic function of patients,and diastolic dysfunction was classified into grade I,II,and III.Multivariate logistic regression was used to analyze the influencing factors of atrial fibrillation in patients with non-obstructive hypertrophic cardiomyopathy Results:Compared with the non-atrial fibrillation group,LVEDV([143.8±26.7]ml vs.[117.1±21.9]ml)and LVEDVi([79.4±11.9]ml/m2 vs.[64.2±10.6]ml/m2)were smaller in atrial fibrillation group(both P<0.001).Compared with the non-atrial fibrillation group,LAD([40.2±4.7]mm vs.[48.6±4.8]mm)and LAVi([37.3±8.9]ml/m2 vs.[64.4±17.1]ml/m2)were lager in atrial fibrillation group(both P<0.001).Compared with the non-atrial fibrillation group,the proportion of NYHA functional classification≥Ⅲ was higher(15.8%vs.50.0%,P<0.001),LVEF was lower([61.5±5.5]%vs.[57.6±5.0]%,P=0.002),and proportion of severe diastolic dysfunction was higher in atrial fibrillation group(P<0.001).Logistic regression analysis showed that the factors associated with atrial fibrillation in NOHCM patients were LVEDVi(OR=0.744,95%CI:0.575-0.962,P=0.024)and LAVi(OR=1.602,95%CI:1.032-2.486,P=0.036).Conclusions:LVEDVi and LAVi are related factors for atrial fibrillation in patients with non-obstructive hypertrophic cardiomyopathy.LVEDVi is negatively,while LAVi is positively associated with the occurrence of atrial fibrillation in NOHCM patients.

The incidence of leukemia,a malignant cancer originating from the hematopoietic system,is increasing annually.Although traditional treatment method such as chemotherapy and hematopoietic stem cell transplantation have improved patient survival rates to some extent,serious side effects,drug tolerance,and high recurrence rates remain.In recent years,studies have shown that the gut microbiota and its metabolites play an important role in the occurrence,development,and complications of leukemia.Imbalance of the gut microbiota can lead to decreased immune function and an intensified inflammatory response,which is a key factor driving disease progression.Some metabolites,such as short-chain fatty acids,enhance immune function and improve patient prognosis through intestinal barrier repair,while others,such as hydrogen sulfide and bile acids,show potential anti-tumor effects exerted through regulation of tumor cell apoptosis and immune balance.Traditional Chinese medicine aimed at regulating the structure of the gut microbiota and its metabolites has shown great potential in alleviating the side effects of chemotherapy for leukemia.This review covers the role of the gut microbiota and its metabolites in the occurrence,development,and complications of leukemia,and explores treatment strategies for regulating the microbiota,including fecal microbiota transplantation,probiotics,and traditional Chinese medicine intervention.We anticipate that this review will serve as a reference for improving the treatment and prognosis of leukemia.

Objective To explore the mechanism of Bufei Jiedu Granules in the treatment of methicillin-resistant Staphylococcus aureus(MRSA)chronic infection using network pharmacology;To verify it through animal experiments.Methods Active components and potential targets in Bufei Jiedu Granules were screened through the TCMSP database,and genes related to MRSA infection were retrieved through GeneCards,OMIM,DisGeNET,TTD,DrugBank and PharmGKB databases.The STRING database was employed to construct a protein-protein interaction network on common targets,and GO and KEGG pathway enrichment analysis were conducted to identify key signaling pathways for Bufei Jiedu Granules treatment of MRSA infection.The effects of Bufei Jiedu Granules on bacterial load and pathological changes in the lung,liver and kidney of MRSA chronic infection mice models were evaluated through WT and T/B immune cell deficient Rag2-/-mouse animal experiments.The mRNA expressions of inflammatory factors(IFN-γ,IL-10)and immune checkpoints(PD1,TIM3)were detected.Results Totally 54 active components related to Bufei Jiedu Granules were selected,and 50 potential targets related to MRSA infection were identified.118 signaling pathways significantly associated with MRSA infection were identified through GO and KEGG pathway enrichment analysis,in which the JAK-STAT signaling pathway,Th17 cell differentiation,and PD-L1 expression and PD-1 checkpoint pathway were closely related to cell activation and T cell differentiation.Animal experimental results indicated that Bufei Jiedu Granules could effectively reduce the bacterial load in organs and ameliorate the pathological damage in the chronic MRSA infection mouse model,increase the mRNA expression of IFN-γ in the lung tissue,and decrease the mRNA expressions of IL-10,PD1 and TIM3.Conclusion Bufei Jiedu Granules has the characteristics of multi-component and multi-target in the treatment of MRSA infection,and may be involved in adaptive immune activation to effectively treat chronic MRSA infection.

AIM:This study investigates the apoptotic and autophagic effects of atractylodin on lung cancer cells,elucidating the underlying molecular mechanisms.METHODS:Non-small cell lung cancer(NSCLC)A549 and H460 cells,in addition to non-cancerous HBE cells,were cultured in vitro.The effects of atractylodin at various concen-trations on cell viability were assessed using CCK-8 assay.Apoptotic effects were evaluated through Hoechst staining and flow cytometry,while Western blot analysis was performed to detect changes in protein expressions associated with apopto-sis and autophagy,including P62,beclin-1,microtubule-associated protein 1 light chain 3(LC3),Kelch-like epichloro-hydrin(ECH)-associated protein-1(Keap-1),nuclear factor E2-related factor 2(Nrf2),heme oxygenase-1(HO-1),and NAD(P)H:quinone oxidoreductase 1(NQO1).Autophagic flux was further analyzed using acridine orange(AO)stain-ing,and immunofluorescence for LC3 and Nrf2.Additionally,autophagy inhibition experiments were conducted using chloroquine(CQ),followed by analyses of autophagy and apoptosis.Reactive oxygen species(ROS)levels were quanti-fied using DCFH-DA.RESULTS:Treatment with atractylodin significantly reduced the viability of A549 and H460 lung cancer cells,promoting apoptosis and inducing autophagy.This was evidenced by an increase in acidic autophagic vesi-cles,upregulation of LC3 and beclin-1,and downregulation of P62.Inhibition of autophagy by chloroquine reversed atrac-tylodin-induced apoptosis.Moreover,atractylodin heightened ROS production,inhibited Keap-1,and stimulated the ex-pression of Nrf2,HO-1 and NQO1.CONCLUSION:Atractylodin effectively inhibits the proliferation of lung cancer cells by inducing apoptosis and autophagy.These effects are mediated through the modulation of the ROS/Nrf2/HO-1 sig-naling pathway,underscoring its potential as a therapeutic agent in lung cancer treatment.

Objectives:To examine the feasibility of using foundation model in computer vision for echocardiographic left ventricular ejection fraction measurement. Methods:Based on the most extensive publicly accessible repository of echocardiographic loops,EchoNet-Dynamic,featuring 10024 recordings from individual patients,a foundation model in computer vision,VideoMAE V2,was fine-tuned,validated,tested using 7460,1288,and 1276 echocardiographic loops,respectively. Results:The mean absolute error between left ventricular ejection fraction measurements of VideoMAE V2 and expert's measurements was 3.94％ (95％CI:3.79％-4.11％).The Pearson's correlation coefficient was 0.91 (95％CI:0.89-0.92).Additionally,VideoMAE V2 demonstrated exceptional accuracy in identifying patients with a left ventricular ejection fraction below 50％,achieving an AUC of 0.96 (95％CI:0.95-0.97). Conclusions:This study validates the feasibility of using foundation model in computer vision for measuring left ventricular ejection fraction in echocardiographic loops and lays the foundation for the development of a generalized multimodal automated interpretation system for echocardiography.