Objective To investigate the genetic association between nonalcoholic fatty liver disease(NAFLD)and type 2 diabetes mellitus(T2DM)using bidirectional two-sample Mendelian randomization(MR),as well as the causal relationship between NAFLD and T2DM across different body mass index(BMI)categories.Methods The data were derived from genome-wide association studies conducted in European populations,with a sample size of 32 941 cases for NAFLD,312 646 cases for T2DM,and 681 275 cases for BMI.The univariate and multivariate MR methods were used to assess the bidirectional causal relationship between NAFLD and T2DM in the general population and across different BMI subtypes.The methods of inverse-variance weighting,MR-Egger regression,constrained maximum likelihood and model averaging,and weighted median were used to conduct the MR analysis,and MR-Pleiotropy Residual Sum and Outlier,radial MR,the MR-Egger intercept method,and the Cochrane Q test were used for sensitivity analysis.Results The univariate MR analysis revealed a bidirectional causal relationship between NAFLD and T2DM in the general population(forward analysis:odds ratio[OR]=9.75,95%confidence interval[CI]:2.57-37.00,P＜0.001;reverse analysis:OR=1.01,95%CI:1.00-1.01,P＜0.01).After adjustment for BMI,the multivariate MR analysis showed that the causal relationship between NAFLD and T2DM remained significant in the general population(OR=33.12,95%CI:7.57-144.95,P＜0.000 1).The subgroup analysis showed a causal relationship between NAFLD and T2DM across all BMI subtypes(lean subgroup:OR=12.19,95%CI:3.35-44.40,P＜0.001;overweight subgroup:OR=4.30,95%CI:1.69-10.92,P＜0.01;obese subgroup:OR=1.67,95%CI:1.14-2.44,P＜0.01).Conclusion This study reveals the causal relationship between NAFLD and T2DM in the general population of NAFLD and across different BMI subtypes from a genetic perspective.

Objective To explore the dyad coping experience of stress in pregnant women with undifferentiated connective tissue disease and their spouses,providing a basis for developing dyadic coping intervention measures.Methods By purposive sampling,15 pairs of pregnant women and their spouses who visited the outpatient clinic for pregnancy complicated with immune diseases in a matemity hospital in Jiangsu Province from April to August 2023 were selected as the research subjects for semi-structured interviews.Content analysis was conducted using the Colaizzi 7-step method,and an interview outline and integrated themes were developed based on the Developmental Contextual Coping Model.Results 3 themes(coexistence of positive and negative stress experiences;diverse approaches to dyadic coping with stress;growth and challenges following stress adaptation)and 11 subthemes were identified.Conclusion Healthcare professionals should attach importance to the stress coping issues of pregnant women with undifferentiated connective tissue disease and their spouses,take measures to regulate the negative emotions of couples,ensure multi-faceted support,help the couple adopt positive coping strategies,and promote good stress adaptation.

Spontaneous bacterial peritonitis (SBP) is the most common type of infection in end-stage liver disease, and the diagnosis and treatment of SBP are facing great difficulties and challenges. In recent years, great achievements have been made in molecular diagnostic techniques, but they have not been widely used in clinical practice. Based on the current status of the diagnosis of SBP, this article reviews the advances in molecular microbiological methods in the diagnosis of SBP. Bacterial qualitative analysis alone cannot clarify the association between bacterial DNA and clinical manifestations, and the combination of bacterial quantitative analysis and bacterial type can more accurately describe the biological characteristics of SBP, which may help with the diagnosis of SBP and its special types and the application of antimicrobial agents.

Objective:To investigate the effects of rifaximin treatment outcomes on complications and 24-week survival rate in cirrhotic patients with refractory type ascites.Methods:A retrospective cohort study was conducted on 62 cases with refractory ascites, and were divided into rifaximin treatment group (42 cases) and control group (20 cases) according to the actual treatment conditions. Rifaximin treatment group patients were administered oral rifaximin-α 200 mg four times daily for 24 consecutive weeks, and the other treatments were basically the same in both groups. Fasting body weight, ascites, complications and survival rate between the two groups were observed. Measurement data of the two groups using t-test, Mann-Whitney U test, and repeated measures analysis of variance were compared. χ2 test or Fisher's exact test were used to compare the enumeration data between the two groups. Kaplan-meier survival analysis was used to compare the survival rates. Results:At 24-week of rifaximin treatment, patients average body weight was reduced by 3.2 kg and the average ascites depth was reduced by 4.5 cm with B-ultrasound measurement, while in the control group at 24-week, the average body weight was reduced by 1.1 kg and the average ascites depth was reduced by 2.1 cm with B-ultrasound measurement, and the differences between the two groups were statistically significant ( F=4.972, P=0.035; F=5.288, P=0.027). Hepatic encephalopathy incidence of grade II or above, hospitalization rates due to exacerbation of ascites, and spontaneous bacterial peritonitis were significantly lower in the rifaximin treatment group than those in the control group (2.4% vs. 20.0%, χ2=5.295, P=0.021; 11.9% vs. 50.0%, χ2=10.221, P=0.001; 7.1% vs. 25.0%, χ2=3.844, P=0.050). The 24-week survival rate was 83.3% in the rifaximin treatment group and 60.0% in the control group, P=0.039. Conclusion:Rifaximin treatment can significantly improve ascites symptoms, reduce the incidence of cirrhosis complications and improve the 24-week survival rate in cirrhotic patients with refractory type ascites.

Objective To establish a postpartum depression animal model induced by pre-pregnancy stress,assess abnormal maternal depressive-like behavior,observe the expression of disrupted-in-schizophrenia 1 (DISC1) in the hippocampus,and detect serum estradiol and corticosterone.Methods A total of 32 female Balb/c were assigned to two groups using random number table:the control group and the pre-pregnancy stressed group(model group),and the model group was subjected to 3 weeks of chronic restraint stress. After the last stressor,the control group and the model group were housed with a male. About 4 weeks later,the mice gave birth to pups. Then at 3 weeks postpartum,open field test,tail suspension test,and sucrose preference test were carried out. The expressions of DISC1 mRNA and protein of hippocampus were detected by real-time quantitative polymerase chain reaction and Western blot,respectively. The serum levels of estradiol and corticosterone were detected with enzyme linked immunosorbent assay. Results After 3 weeks of postpartum,the model mice showed depression-like behaviors. In the open field test,there was no effect on the total distance moved or time spent in the center field (P>0.05). Immobility in tail suspension test was significantly increased (t=-4.950,P<0.001) and sucrose preference was significantly reduced in model group (t=2.475,P<0.05). There was significant statistical difference between control and model group on the expression of DISC1 mRNA (t=-8.915,P<0.001) and protein (t=-5.004,P<0.01) in hippocampus. There was no significant statistical difference on estradiol and corticosterone between two groups (P>0.05). Conclusion Chronic pre-pregnancy stress can induce dams into postpartum depression.The pathogenesis of postpartum depression may be related to the regulation of DISC1 in the hippocampus.

Major depression is a public health problem that seriously harms individuals and the society.But one of the major shortcomings of mainstream antidepressant is the delayed onset.Recent series of studies demonstrated that,from a variety of animal models and clinical studies,classic stagnation-removing formula Yue-Ju (Y J) pill has the advantage in rapid antidepressant efficacy,which is similar to the prototype drug ketamine.It has the mechanism of rapid and sustained enhancement of neural plasticity and individual difference in response to YJ pill.The evidence of Gardenia jasminoides (Zhi-Zi) as the monarch component of YJ pill's rapid antidepressant action has also been revealed.The further in-depth research on rapid antidepressant traditional Chinese medicine (TCM) is important for providing the scientific and reliable TCM strategies to treat depression.

Objective:To investigate the immune mechanism of Shengxian decoction in experimental autoimmune myasthenia gravis(EAMG) rats. Methods:Lewis rats were immunized with the rat sequence 97-116 of the AChRαsubunit(Rα97-116) in CFA, 25 of which were successful. They were randomly divided into 5 groups:EAMG model group,prednisone group(5. 4 mg/kg),Shengxian decoction low, medium, high dose groups ( dosage 2. 6 g/kg, 5. 2 g/kg, 10. 4 g/kg ) . Clinical symptoms, weight, and the decrement percentage of RNS(5 Hz) were evaluated,and ELISA were adopted to determine the titers of AChR Ab,TGF-β,IFN-γ,IL-2,IL-4 and IL-17 in serum. Results:After molding,the percentage of decrement of RNS in each group noticeably increased by more than 10% in comparison with that in the CFA control group ( P<0. 01 or P<0. 05 ) . At the same time, they were also subjected to progressive decreasing weight and typical myasthenia symptoms,showing the successful molding. With medication,the decrement percentage of RNS of rats in the groups with low,medium and high dose of Shengxian decoction were all on obvious decline with alleviated weight decrease (P<0. 01),testifying to the symptom improvement. Compared with the CFA control group,the groups with low,medium and high dose of Shengxian decoction were coupled with decreasing AChR Ab content(P<0. 05),rising TGF-βlevel and reducing IFN-γ,IL-2,IL-4 and IL-17 level(P<0. 01 or P<0. 05). Conclusion: Shengxian decoction can turn the decrement percentage of RNS around,improve the progressive weight decrease in EAMG rats and increase the weight gains. By up-regulating the TGF-βlevel,lowering IFN-γ,IL-2,IL-4 and IL-17 level,preventing B cells from producing AChR Ab and reducing the content of AChR Ab in serum,it will soothe the damage of NMJ to AChR and cure EAMG.

Aim To observe the rapid antidepressant effect of Yuejuganmaidazao Decoction on postpatum de-pression offspring , and analyze its influence on the Akt and mTOR expression .Methods After postpartum de-pression model was established , the offsprings were randomly divided into the following groups: control group(CTL-F1,n =8), vehicle group (Veh,n =8) and YG group ( YG, n =8 ) .Veh group was treated with vehicle , YG group was treated with Yueju gan-maidazao Decoction(8.3 g· kg -1 ).Forced swimming test(FST) was measured 24 hours after single adminis-tration.The phosphorylation and total level of Akt and m-TOR in the hippocampus was detected by Western blot.Results The immobility time in YG group was significantly shorter than that in Veh group ( P <0.01 ) , and the expression of p-Akt and p-mTOR in the hippocampus was significantly increased ( P <0.05 ) .Conclusion Yuejuganmaidazao Decoction may rapidly alleviate depression-like behaviors of PPD offsprings through upregulation of Akt and mTOR ex-pression .

Objective To study the effect of new type antiseptic gallium nitrate on the clearance of Staphylococcus aureus (S .aureus)biofilm,and explore new methods for suppressing bacterial biofilm formation.Methods Biofilm positive strains were screened among 14 clinically isolated S .aureus strains by crystal violet staining method,mini-mal inhibitory concentration (MIC)of gallium nitrate for biofilm positive strains and effect of gallium nitrate on the clearance of biofilm were measured.Results Of 14 S .aureus isolates,9 were biofilm positive strains;gallium ni-trate MICs for S .aureus ATCC 25923,biofilm-negative strain,and 9 biofilm positive strains were all 16 μg/mL;the clearance rate of gallium nitrate for early biofilm of S .aureus was significantly higher than mature biofilm ([86.53±0.96]% vs [62.54±1 .53]%,t=35.699,P <0.001 ).Conclusion Gallium nitrate can inhibit growth of S .aureus strains and clear biofilm,it can be applied in the prevention and control of S .aureus infection.

Abstact:Aim To identify whether the petroleum e-ther fraction of Yueju pill (YJ-PE)could exhibit a po-tent rapid antidepressant effect and to investigate the underlying biological mechanism involved.Methods Fourty-four male KM mice were randomly assigned to five groups:the control group (saline group),low dosage of YJ-PE,middle dosage of YJ-PE,high dos-age of YJ-PE and ketamine.After a single drug admin-istration,we used tail suspension test (TST)to test the rapid antidepressant effect of YJ-PE in KMmice at 30 min.Another twenty-four male KM mice were ass-inged to three groups:control group,screened effective low dosage of YJ-PE group and ketamine group.We usd TST to assess these mice at 24 h post a single ad-
ministration.Western blot was performed to examine the expression of BDNF and TrkB in hippocampus of KMmice at 30 min and 24 h post a single administra-tion.Results An acute administration of YJ-PE de-creased the immobility time of KMmice in TST and in-creased the expression of BDNF and TrkB as soon as 30min post a single administration and lasted at least for 24 hours.Conclusion YJ-PE (low dosage)ex-hibits a rapid antidepressant-like potent,and the po-tent rapid antidepressant effects of YJ-PE are associat-ed with the up-regulation of BDNF and TrkB.