OBJECTIVES: To evaluate the effectiveness of single-balloon and double-balloon enteroscopy in diagnosing pediatric small bowel diseases and assess the diagnostic efficacy of computed tomography enterography (CTE) for small bowel diseases using enteroscopy as the reference standard. METHODS: Clinical data from 576 children who underwent enteroscopy at Hunan Children's Hospital between January 2017 and December 2023 were retrospectively collected. The children were categorized based on enteroscopy type into the single-balloon enteroscopy (SBE) group (n=457) and double-balloon enteroscopy (DBE) group (n=119), and the clinical data were compared between the two groups. The sensitivity and specificity of CTE for diagnosing small bowel diseases were evaluated using enteroscopy results as the standard. RESULTS: Among the 576 children, small bowel lesions were detected by enteroscopy in 274 children (47.6%).There was no significant difference in lesion detection rates or complication rates between the SBE and DBE groups (P>0.05), but the DBE group had deeper insertion, longer procedure time, and higher complete small bowel examination rate (P<0.05). The complication rate during enteroscopy was 4.3% (25/576), with 18 cases (3.1%) of mild complications and 7 cases (1.2%) of severe complications, which improved with symptomatic treatment, surgical, or endoscopic intervention. Among the 412 children who underwent CTE, the sensitivity and specificity for diagnosing small bowel diseases were 44.4% and 71.3%, respectively. CONCLUSIONS SBE and DBE have similar diagnostic efficacy for pediatric small bowel diseases, but DBE is preferred for suspected deep small bowel lesions and comprehensive small bowel examination. Enteroscopy in children demonstrates relatively good overall safety. CTE demonstrates relatively low sensitivity but comparatively high specificity for diagnosing small bowel diseases.
Retrospective Studies ; Treatment Outcome ; Double-Balloon Enteroscopy/statistics & numerical data* ; Single-Balloon Enteroscopy/statistics & numerical data* ; Humans ; Male ; Female ; Child ; Operative Time ; Tomography, X-Ray Computed/statistics & numerical data* ; Sensitivity and Specificity ; Intestine, Small/surgery* ; Intestinal Diseases/surgery*

BACKGROUND: Non-invasive computed tomography angiography (CTA)-based fractional flow reserve (CT-FFR) could become a gatekeeper to invasive coronary angiography. Deep learning (DL)-based CT-FFR has shown promise when compared to invasive FFR. To evaluate the performance of a DL-based CT-FFR technique, DeepVessel FFR (DVFFR). METHODS: This retrospective study was designed for iScheMia Assessment based on a Retrospective, single-center Trial of CT-FFR (SMART). Patients suspected of stable coronary artery disease (CAD) and undergoing both CTA and invasive FFR examinations were consecutively selected from the Beijing Anzhen Hospital between January 1, 2016 to December 30, 2018. FFR obtained during invasive coronary angiography was used as the reference standard. DVFFR was calculated blindly using a DL-based CT-FFR approach that utilized the complete tree structure of the coronary arteries. RESULTS: Three hundred and thirty nine patients (60.5 ±10.0 years and 209 men) and 414 vessels with direct invasive FFR were included in the analysis. At per-vessel level, sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of DVFFR were 94.7%, 88.6%, 90.8%, 82.7%, and 96.7%, respectively. The area under the receiver operating characteristics curve (AUC) was 0.95 for DVFFR and 0.56 for CTA-based assessment with a significant difference (P < 0.0001). At patient level, sensitivity, specificity, accuracy, PPV and NPV of DVFFR were 93.8%, 88.0%, 90.3%, 83.0%, and 95.8%, respectively. The computation for DVFFR was fast with the average time of 22.5 ± 1.9 s. CONCLUSIONS The results demonstrate that DVFFR was able to evaluate lesion hemodynamic significance accurately and effectively with improved diagnostic performance over CTA alone. Coronary artery disease (CAD) is a critical disease in which coronary artery luminal narrowing may result in myocardial ischemia. Early and effective assessment of myocardial ischemia is essential for optimal treatment planning so as to improve the quality of life and reduce medical costs.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Investigating the species/biovars,distribution patterns,and genetic correlations of Brucella from sheep in north-west China is critical to reveal the population and epidemiological characteristics of the Brucella melitensis.In this study,con-ventional identification and AMOS-PCR were used to determine the species/biovars of Brucella isolated from 13 regions in northwest China.MLST and MLVA-16 genotyping methods were used to analyze the genetic characteristics of the strains.Con-ventional identification and AMOS-PCR detection revealed that 59 Brucella melitensis were isolated in this study,in-cluding 22 strains from Inner Mongolia,17 strains from Xin-jiang,13 strains from Gansu,and 7 strains from Qinghai,of which 58 strains were B.melitensis biovar 3,and one strain was B.melitensis biovar 1.MLST analysis indicated that 90％(53/59)of B.melitensis were of ST8 sequence type,the dominant epidemic population.The MLVA-11 survey demonstrated that 59 B.melitensis strains clustered into six MLVA-11 genotypes,and 87％of the strains were of MLVA-11 genotype 116.Therefore,the predominant strains in the northwest region were from the Eastern Mediterranean lineage.MLVA-16 divided 59 strains of B.melitensis into 40 gen-otypes,eight of which were shared genotypes.Each genotype was composed of two to seven strains from the same region,thereby indicating that the cases of each shared genotype were outbreaks from a common source of infection.All shared MLVA-16 genotypes comprised strains from the same province,thus indicating apparent regional clustering characteristics of strains in each province.In a genetic comparison between populations and isolated strains from the spleens of sheep,multiple identical MLVA-16 genotypes were found to be composed of strains from different hosts.These findings indicated a transmission path-way from sheep/goats to humans.B.melitensis biovar 3 was the main pathogen causing animal brucellosis in the northwest re-gion,and infected sheep were the main brucellosis infection source in the regional population.The ST8 strains were the domi-nant epidemic population,and the MLVA genotype of strains in each region showed clear regional clustering characteristics.

Objective To investigate the therapeutic effect of Neferine on acute lung injury in sepsis rats and its mechanism.Methods A rat sepsis model was prepared by cecal ligation and puncture(CLP)method.After successful modeling,the rats were divided into model group,neferine low-and high-dose groups,neferine high-dose+PMA[nuclear factor kappa B(NF-κB)activator phorbol ester]group,and sham operation group was set up,with 15 rats in each group.At 6 hours after operation,the corresponding intervention was given for 2 days.Hematoxylin-eosin(HE)staining was used to observe the morphological changes of lung tissue,and the pathological damage score was performed.The wet-dry mass ratio of lung tissue was detected;the levels of arterial partial pressure of oxygen(PaCO2)and arterial partial pressure of carbon dioxide(PaCO2)were detected by blood gas analyzer.The levels of tumor necrosis factor α(TNF-α),interleukin 1β(IL-1β)and interleukin 6(IL-6)in bronchoalveolar lavage fluid(BALF)were measured by enzyme-linked immunosorbent assay(ELISA).The protein expression levels of NF-κB p65,phosphorylated NF-κB(p-NF-κB)p65(Ser536)and cyclooxygenase-2(COX-2)in lung tissue were detected by Western Blot.Results Compared with the sham operation group,the pathological injury of lung tissue in the model group was severe,the pathological injury score and wet-dry mass ratio of lung tissue as well as PaCO2 level were significantly increased(P＜0.01),PaO2 level was significantly decreased(P＜0.01),the levels of TNF-α,IL-1β and IL-6 in BALF,the ratio of p-NF-κB p65/NF-κB p65 and the protein expression level of COX-2 in lung tissue were significantly increased(P＜0.01).Compared with the model group,the pathological damage of lung tissue in the low-dose and high-dose neferine groups was significantly improved,the pathological damage score and wet-dry mass ratio of lung tissue as well as PaCO2 level were significantly decreased(P＜0.05 or P＜0.01),PaO2 level was significantly increased(P＜0.05 or P＜0.01),the levels of TNF-α,IL-1β and IL-6 in BALF,the ratio of p-NF-κB p65/NF-κB p65 and the protein expression level of COX-2 in lung tissue were significantly decreased(P＜0.05 or P＜0.01).However,after PMA intervention,the improvement of neferine on lung tissue injury in septic rats was significantly reversed(P＜0.01).Conclusion Neferine can improve acute lung injury and lung function in rats with sepsis,which may be related to inhibiting the activation of NF-κB signaling pathway and thereby reducing the release of inflammatory factors in vivo.

Objective To investigate the outcomes of Jiawei Wendan Decoction participating in post-stroke depression treatment through inhibiting the hyperpolarization-activated cyclic nucleotide-gated channel(HCN).Methods A total of 300 patients with post-stroke depression of liver depression and phlegm obstruction type were randomly divided into the control group and the observation group,with 150 patients in each group.The two groups were treated with the conventional basic treatment for stroke,including anticoagulants and medicines for controlling blood glucose,lipids and blood pressure.In addition,the control group was given Deanxit orally and the observation group was given Deanxit combined with Jiawei Wendan Decoction orally.The course of treatment for the two groups covered four weeks.After treatment,the clinical efficacy of the patients in the two groups was evaluated.Before and after treatment,the two groups were observed in the changes of Hamilton Depression Scale(HAMD)scores,Self-Rating Depression Scale(SDS)scores,modified Barthel Index scores,and the serum levels of monoamine neurotransmitters of neuropeptide,brain-derived neurotrophic factor(BDNF),5-hydroxytryptamine,substance P,neuron-specific enolase(NSE),and retinol-binding protein 4(RBP4),and mRNA expression levels of HCN1 and HCN2 subtypes in peripheral blood.Moreover,the correlation between peripheral blood mRNA expression levels of HCN1 and HCN2 subtypes and HAMD scores and SDS scores were analyzed.Results(1)After four weeks of treatment,the total effective rate of the observation group was 92.00%(138/150),and that of the control group was 80.00%(120/150);the intergroup comparison showed that the total effective rate(tested by chi-square test)and the overall efficacy(tested by rank sum test)of the observation group were significantly superior to those of the control group(P＜0.01).(2)After treatment,the modified Barthel index scores in the two groups were significantly increased(P＜0.05)and the scores of HAMD and SDS were significantly decreased when compared with those before treatment(P＜0.05),the increase of modified Barthel Index scores as well as the decrease of scores of HAMD and SDS in the observation group was superior to that in the control group(P＜0.01).(3)After treatment,the serum levels of monoamine neurotransmitters of BDNF,neuropeptide,and 5-hydroxytryptamine in the two groups were significantly increased(P＜0.05),and the serum levels of NSE,substance P,and RBP4 were significantly decreased when compared with those before treatment(P＜0.05);the increase of serum levels of BDNF,neuropeptide,and 5-hydroxytryptamine as well as the decrease of the serum levels of NSE,substance P,and RBP4 in the observation group was superior to that in the control group(P＜0.05).(4)After treatment,the mRNA expression levels of HCN1 and HCN2 subtypes in the two groups were significantly decreased when compared with those before treatment(P＜0.01),and the decrease of the mRNA expression levels of HCN1 and HCN2 subtypes in the observation group was significantly superior to that of the control group(P＜0.05).(5)The correlation analysis showed that the mRNA expression levels of HCN1 and HCN2 subtypes in the peripheral blood were positively correlated with both SDS scores and HAMD scores(P＜0.001).Conclusion Jiawei Wendan Decoction combined with conventional western medicine has achieved satisfactory efficacy for the treatment of patients with post-stroke depression of liver depression and phlegm obstruction type,which can effectively reduce the degree of depression,improve the serum levels of monoamine neurotransmitters,and improve the activities of daily living,and its anti-depression mechanism may be related to the inhibition of HCN ion channels.

The aim of this study was to investigate the serogroups,ST types,virulence genes,and resistance characteris-tics of Listeria monocytogenes(Lm)isolates from fresh edible mushrooms in Fujian Province.The whole genomes of Lm isola-ted from fresh edible mushrooms in Fujian province were sequenced.BioNumeric7.6 software was used to assemble the sequen-cing data,and the serogroups,ST types,virulence genes,and drug resistance characteristics were further analyzed.Ten Lm strains were classified into three serogroups(six Ⅱb strains,three Ⅱa strains,and one Ⅱc strain),five ST types(four ST5 strains;three ST8 strains;and one strain each for ST87,ST9,and ST429).CC5 and CC8 were the dominant clone groups.All Lm carried six virulence genes(actA,hly,mpl,plcA,plcB,and prfA)on LIPI-1,as well as internal genes(inlA,inlB,inlC,inlE,inlF,inlH,inlJ,and inlK).Some strains carried inlD,inlG,and inlL.Neither strain carried the gene on LI-PI-3,and two strains carried some genes on LIPI-4.The resistance rate of Lm to cefoxitin was 100％,and the resistance rates to oxacillin and clindamycin were both 30％.Five strains were resistant to two or more antibiotics,one ST87 strain had a resistance spectrum of OXA-CLI-CIP-FOX,two ST8 strains had a resistance spectrum of CLI-FOX,and two ST5 strains had a re-sistance spectrum of OXA-FOX.Prediction of antibiotic resistance genes revealed that all ten Lm carried fosX,mprF,norB,sul,and Lmo0919 antibiotic resistance genes.According to cgMLST a-nalysis,strains of Lm clustered on five separate evolutionary branches,each containing one ST type.No allelic differences were identified among the three ST8 strains and the four ST5 strains of Lm,thus indicating that they belonged to the same clone and could sustainably exist in fresh edible mushrooms.Lm strains isolated from retail fresh edible mushrooms in Fujian Province pose a potential risk human infection,and the drug re-sistance status is concerning.In particular,a highly virulent multi-drug resistant strain found in flammulina velutipes may pose a potential threat to public health and should be alerted.

The aim of this study was to investigate the serogroups,ST types,virulence genes,and resistance characteris-tics of Listeria monocytogenes(Lm)isolates from fresh edible mushrooms in Fujian Province.The whole genomes of Lm isola-ted from fresh edible mushrooms in Fujian province were sequenced.BioNumeric7.6 software was used to assemble the sequen-cing data,and the serogroups,ST types,virulence genes,and drug resistance characteristics were further analyzed.Ten Lm strains were classified into three serogroups(six Ⅱb strains,three Ⅱa strains,and one Ⅱc strain),five ST types(four ST5 strains;three ST8 strains;and one strain each for ST87,ST9,and ST429).CC5 and CC8 were the dominant clone groups.All Lm carried six virulence genes(actA,hly,mpl,plcA,plcB,and prfA)on LIPI-1,as well as internal genes(inlA,inlB,inlC,inlE,inlF,inlH,inlJ,and inlK).Some strains carried inlD,inlG,and inlL.Neither strain carried the gene on LI-PI-3,and two strains carried some genes on LIPI-4.The resistance rate of Lm to cefoxitin was 100％,and the resistance rates to oxacillin and clindamycin were both 30％.Five strains were resistant to two or more antibiotics,one ST87 strain had a resistance spectrum of OXA-CLI-CIP-FOX,two ST8 strains had a resistance spectrum of CLI-FOX,and two ST5 strains had a re-sistance spectrum of OXA-FOX.Prediction of antibiotic resistance genes revealed that all ten Lm carried fosX,mprF,norB,sul,and Lmo0919 antibiotic resistance genes.According to cgMLST a-nalysis,strains of Lm clustered on five separate evolutionary branches,each containing one ST type.No allelic differences were identified among the three ST8 strains and the four ST5 strains of Lm,thus indicating that they belonged to the same clone and could sustainably exist in fresh edible mushrooms.Lm strains isolated from retail fresh edible mushrooms in Fujian Province pose a potential risk human infection,and the drug re-sistance status is concerning.In particular,a highly virulent multi-drug resistant strain found in flammulina velutipes may pose a potential threat to public health and should be alerted.

This study aims to provide evidence for clinical practice by systematically reviewing the efficacy and safety of Gusongbao preparation in the treatment of primary osteoporosis(POP). The relevant papers were retrieved from four Chinese academic journal databases and four English academic journal databases(from inception to May 31, 2022). The randomized controlled trial(RCT) of Gusongbao preparation in the treatment of POP was included after screening according to the inclusion and exclusion criteria. The quality of articles was evaluated using risk assessment tools, and the extracted data were subjected to Meta-analysis in RevMan 5.3. A total of 657 articles were retrieved, in which 15 articles were included in this study, which involved 16 RCTs. A total of 3 292 patients(1 071 in the observation group and 2 221 in the control group) were included in this study. In the treatment of POP, Gusongbao preparation+conventional treatment was superior to conventional treatment alone in terms of increasing lumbar spine(L2-L4) bone mineral density(MD=0.03, 95%CI[0.02, 0.04], P<0.000 01) and femoral neck bone mineral density, reducing low back pain(MD=-1.69, 95%CI[-2.46,-0.92], P<0.000 1) and improving clinical efficacy(RR=1.36, 95%CI[1.21, 1.53], P<0.000 01). Gusongbao preparation was comparable to similar Chinese patent medicines in terms of improving clinical efficacy(RR=0.95, 95%CI[0.86, 1.04], P=0.23). Gusongbao preparation was inferior to similar Chinese patent medicines in reducing traditional Chinese medicine syndrome scores(MD=1.08, 95%CI[0.44, 1.71], P=0.000 9) and improving Chinese medicine syndrome efficacy(RR=0.89, 95%CI[0.83, 0.95], P=0.000 4). The incidence of adverse reactions of Gusongbao preparation alone or combined with conventio-nal treatment was comparable to that of similar Chinese patent medicines(RR=0.98, 95%CI[0.57, 1.69], P=0.94) or conventio-nal treatment(RR=0.73, 95%CI[0.38, 1.42], P=0.35), and the adverse reactions were mainly gastrointestinal discomforts. According to the available data, Gusongbao preparation combined with conventional treatment is more effective than conventional treatment alone in increasing lumbar spine(L2-L4) bone mineral density and femoral neck bone mineral density, reducing low back pain, and improving clinical efficacy. The adverse reactions of Gusongbao preparation were mainly gastrointestinal discomforts, which were mild.
Humans ; Bone Density ; Low Back Pain ; Medicine, Chinese Traditional ; Osteoporosis/drug therapy*