OBJECTIVE To analyze the clinical distribution characteristics and drug resistance of Enterobacter cloa-cae in Gansu Province from 2019 to 2023,providing reference for the prevention and control of E.cloacae infec-tions in this region.METHODS Data on the distribution and drug resistance of E.cloacae from hospitals in mem-ber units of the Gansu Antimicrobial Surveillance Network between 2019 and 2023 were collected.In vitro drug susceptibility testing was performed by the Kirby-Bauer disk diffusion(K-B)method,minimum inhibitory con-centration method,and fully automated instrumentation,followed by analysis of the susceptibility results.RESULTS From 2019 to 2023,a total of 402 490 bacterial strains were isolated and cultured in Gansu Province,including 17 417 strains of E.cloacae,with a detection rate of 4.33％.The bacteria were primarily iso-lated from sputum specimens(62.81％),followed by urine(7.37％)and wound pus specimens(6.07％).The de-partmental distribution was dominated by internal medicine(44.96％)and surgery(28.50％).The highest detec-tion rate was observed in the adult group(15-65 years,45.79％).E.cloacae exhibited varying degrees of resist-ance to over 20 antibacterial drugs,but the overall drug resistance rate showed a declining trend(P＜0.05).The highest drug resistance rate was observed for cefazolin(96.40％-98.38％),while the lowest was for tigecycline(0.44％—2.92％).Carbapenem-resistant E.cloacae demonstrated an increasing trend in drug resistance rates,with imipenem resistance ranging from 2.79％to 3.71％(P=0.044)and meropenem resistance ranging from 1.29％to 3.41％(P＜0.05).CONCLUSIONS The isolation rate of E.cloacae in Gansu Province remains stable,with a declining trend in drug resistance to multiple antibacterial drugs.However,the increasing drug resistance to carbapenems warrants attention.

Health behavior motivation significantly affects the quality of life of patients with cardiovascular diseases.Assessing the level of health behavior motivation can measure the health behavior of individuals,help to promote the participation rate of cardiac rehabilitation,reduce the readmission rate of patients,and promote patients'healthy lifestyles.This article reviews the content,characteristics and application of assessment tools for health behavior motivation of patients with cardiovascular diseases at home and abroad,with the aim of providing references for the development and application of such tools in China,and offering a basis for scientifically assessing their health behavior motivation level and formulating effective strategies to promote health behavior motivation.

The number of patients with chronic diseases in China has been increasing year by year,followed by the increase of treatment burden.It is particularly important to effectively evaluate the treatment burden of patients with chronic diseases.This paper reviews the main contents,application scope,advantages and disadvantages of the assessment tools for the treatment burden of patients with chronic diseases at home and abroad,so as to provide references and basis for medical staff to reasonably select assessment tools and conduct relevant clinical research.

This article reports three cases of refractory ulcerative colitis in children treated with vedolizumab. Combined with domestic and foreign literature, the effectiveness and safety of the drug for children are discussed to provide a reference for the subsequent exploration of individualized treatment.

Inflammatory bowel disease (IBD), a chronic recurrent inflammatory bowel disease, is associated with depression and anxiety. Intestinal inflammation increases susceptibility to psychiatric disorders through a multidimensional network of immune-inflammatory, neuroendocrine, intestinal flora, and intestinal barrier abnormalities. Conversely, psychiatric stress exacerbates the pathology of IBD through immune regulation, intestinal barrier disruption, and microenvironmental alterations. Therefore, it is important to explore the mechanisms of comorbidity between IBD and depression and anxiety to optimise clinical management. This article reviews the comorbid mechanisms of IBD and depression and anxiety from the perspectives of immune-inflammatory axis, intestinal flora-metabolic pathway, intestinal barrier dysfunction, and neuroendocrine regulation in the context of rodent models, and explore potential intervention strategies, with the aim of providing new ideas and targets for therapeutic and transformation research in this field.

Objective To investigate the inhibitory effect of running combined with chitosan on high-fat diet(HFD)induced obesity in rats through the expression of fatty acid transporter 4(FATP4)and Toll like receptor 4(TLR4)and its mechanism.Methods 50 male Wistar rats were randomly divided into normal control(NC)group,HFD group,chitosan(Chi)group,running exercise(Run)and chitosan+running exercise(Chi+Run)group,with 10 rats in each group.The levels of serum total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),very low density lipoprotein cholesterol(VLDL-C),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)were detected.ELISA was used to detect serum TNF-α,IL-6,APN,Ghrelin,Leptin(LP),and Ins levels.Western blot was used to test the expression of FATP4 and TLR4 proteins in liver and adipose tissue,and HE staining was used to evaluate liver and adipose tissue pathology.Results Compared with the HFD group,the Chi,Run,and Chi+Run groups showed an increase in HDL-C,serum APN,and Ghrelin(P<0.05),as well as an decreased in body weight,fat mass,obesity index,TC,TG,LDL-C,VLDL-C,ALT,AST,TNF-α,IL-6,LP,Ins,FATP4 protein expression,TLR4 protein expression,adipocyte size and quantity in liver and adipose tissue(P<0.05).The HDL-C was higher in Chi+Run group than in Chi and Run groups(P<0.05),and the final weight,LDL-C,TG,AST,IL-6,the expression of FATP4 protein,TLR4 protein,and adipocyte size in the liver and adipose tissue were lower in Chi+Run group than in Chi and Run groups(P<0.05).Conclusions The inhibitory effect of running combined with Chi on HFD induced obesity was superior to that of running or Chi alone,and its mechanism may be related to the downregulation of FATP4 and TLR4.

AIM:To observe the effects of Huangqi-Danggui mixture(HQDG)on the pyroptosis of brain tis-sues in rats with middle cerebral artery occlusion/reperfusion(MCAO/R),and to explore the mechanism of neuroprotec-tion provided by HQDG.METHODS:Sixty-four SD rats were randomly divided into 4 groups:sham group,model group,HQDG group,and Xuesaitong(XST)group.The infarct volume of brain tissues was observed by 2,3,5-triphenyl-tetrazolium chloride staining,while hematoxylin-eosin staining was used to observe the pathological changes of brain tis-sues.Immunofluorescence was employed to assess the expression of nucleotide-binding oligomerization domain-like recep-tor protein 3(NLRP3),cleaved caspase-1 and gasdermin D(GSDMD)in the ischemic penumbra of brain tissues.The se-rum levels of interleukin-1β(IL-1β)and IL-18 were measured using ELISA.Western blot was used to detect NLRP3,cleaved caspase-1,apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC),IL-1β and IL-18 in brain tissues.RESULTS:Compared with sham group,the neurological deficit scores of the rats in model group were significantly increased(P<0.01),while those in HQDG and XST groups were significantly reduced compared with model group(P<0.01).The cerebral infarct volume ratio was significantly reduced in HQDG and XST groups compared with model group(P<0.01).The pathological damage of brain tissue in HQDG and XST groups was significantly reduced compared with model group.The positive rates of NLRP3,cleaved caspase-1 and GSDMD in the ischemic penumbra of brain tissues were significantly decreased in HQDG group compared with model group(P<0.01).The expression of pyrop-tosis-related proteins,NLRP3,cleaved caspase-1 and ASC,in the ischemic penumbra of brain tissues was significantly el-evated in model group compared with sham group(P<0.01),and significantly decreased in HQDG group compared with model group(P<0.01).The serum levels of IL-1β and IL-18 were significantly increased in model group compared with sham group(P<0.01),and significantly reduced in HQDG group compared with model group(P<0.01).CONCLU-SION:The HQDG effectively attenuates brain tissue injury in rats with MCAO/R,and its mechanism may be related to the inhibition of neural cell pyroptosis.

Objective:To investigate the role of inhibitor of differentiation 2(Id2)in inducing the generation of central memory T(Tcm)cells and enhancing the anti-tumor persistence of T cells.Methods:CD8+na?ve T cells were sorted with magnetic beads and then co-cultured with carcinoembryonic antigen(CEA)-loaded dendritic cells(DCs).These cells were induced into effector T(Teff)or Tcm cells by interleukin-2(IL-2)or IL-7/15/21/23,respectively.The mRNA and protein expression of Id2 and Id3 in T cells were detected using qPCR and WB,respectively.Id2 gene in T cells was knocked down using lentivirus,and the T cell memory phenotype was analyzed by flow cytometry.The expression of PI3K/AKT pathway-related proteins was examined by WB.The extracellular acidification rate(ECAR)and oxygen consumption rate(OCR)were assessed using a Seahorse extracellular flux analyzer.A zebrafish colorectal cancer HCT116 xenograft model was employed to analyze the anti-tumor differences between Teff and Tcm cells.The effect of Id2 gene knockdown in Tcm cells(Tcm-shId2)on the growth inhibition of secondary xenografts was also observed.Results:Tcm cells exhibited high expression of Id3 mRNA(P<0.05),whereas Teff cells showed high expression of Id2 mRNA(P<0.001).Tcm cells with Id2 knockdown(Tcm-shId2)were successfully constructed,showing significantly upregulated Id3 expression.Knockdown of Id2 promoted the formation of Tcm cell(P<0.05).Tcm-shId2 cells underwent metabolic reprogramming via the PI3K/AKT pathway,which effectively suppressed the growth of colorectal cancer xenografts in zebrafish and also produced significant inhibitory effects on secondary tumor growth(P<0.01).Conclusion:Id2 gene may regulate T cell metabolism through the PI3K/AKT signaling pathway,promoting the differentiation of CD8+T cells into Tcm cells and effectively inhibiting the growth of colorectal cancer xenografts.

Crohn′s disease (CD) is a chronic, nonspecific inflammatory bowel disease involving the whole digestive tract with unknown etiology.The international inflammatory bowel disease organization recently proposed that the long-term goals of CD treatment are endoscopic remission, mucosal healing, and return to normal quality of life.Therefore, how to monitor disease activity to achieve long-term treatment goals faces severe challenges.As a new method, endoscopic healing index is of great significance for monitoring the activity of CD.In this paper, the concept of endoscopic healing index, the efficacy of monitoring endoscopic motion, the application in disease diagnosis and treatment, the challenges and opportunities are reviewed.

ObjectiveNonalcoholic fatty liver disease （NAFLD） is a metabolic stress liver injury. Ferroptosis is involved in the occurrence and development of NAFLD. Exploring the efficacy and mechanism of schisandrin B in treating NAFLD facilitates the development of strategies for the prevention and treatment of NAFLD. MethodsThe molecular structure of schisandrin B was obtained by searching against PubChem， and the related targets were predicted by SwissTargetPrediction. The active ingredients and their targets were retrieved from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and the high-throughput experiment- and reference-guide database of traditional Chinese medicine （HERB）. GeneCards and FerrDb were searched for the targets of NAFLD and ferroptosis. The common targets were taken as the core targets， and the protein-protein interaction network of the core targets was established. DAVID was used for gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） analyses. Finally， molecular docking was performed between schisandrin B and core targets， and the binding energy was calculated. C57BL/6 mice were fed with a methionine and choline-deficiency （MCD） diet for the modeling of NAFLD. Mice were randomized into normal， model， positive drug （essentiale）， and low- and high-dose schisandrin B groups. The body mass and liver index of mice were measured after drug administration. The levels of alanine aminotransferase （ALT） and aspartate aminotransferase （AST） in the serum and those of total cholesterol （TC）， triglyceride （TG）， malondialdehyde （MDA）， glutathione （GSH）， and Fe²⁺ in the liver homogenate were measured by biochemical assay kits. The pathological changes of the liver tissue were observed by hematoxylin-eosin （HE） and red oil O staining. Enzyme-linked immunosorbent assay was employed to determine the levels of interleukin （IL）-6， IL-1β， tumor necrosis factor （TNF）-α， and 4-hydroxynonenal （4-HNE） in the serum. Western blotting and real-time PCR were employed to determine the protein and mRNA levels， respectively， of solute carrier family 7 member 11 （SLC7A11）， solute carrier family 3 member 2 （SLC3A2）， glutathione peroxidase 4 （GPX4）， transferrin， and ferritin heavy chain （FTH） in the liver tissue. ResultsA total of 2 370， 2 547， and 1 451 targets of schisandrin B， NAFLD， and ferroptosis were obtained， in which 90 common targets were shared by the three. Enrichment analyses predicted 505 GO terms and 92 KEGG pathways. Molecular docking suggested that schizandrin B had strong binding affinity with the key targets of ferropstosis （SLC7A11 and SLC3A2）. Animal experiments showed that schizandrin B significantly decreased the liver index， lowered the levels of ALT， AST， TC， TG， IL-6， IL-1β， and TNF-α， alleviated hepatocyte ballooning and inflammatory cell infiltration， and reduced lipid accumulation in the liver of NAFLD mice. In addition， schisandrin B significantly lowered the levels of MDA， 4-HNE， and Fe²⁺， elevated the level of GSH， up-regulated the protein and mRNA levels of SLC7A11， SLC3A2， and GPX4， and down-regulated the protein and mRNA levels of transferrin in the liver tissue. ConclusionSchisandrin B can alleviate NAFLD by inhibiting ferroptosis in hepatocytes.