Diarrhea-predominant irritable bowel syndrome(IBS-D)is a clinically common functional gastrointestinal disease,the"SCFAs-intestinal barrier"pathway plays an important role in the pathogenesis of IBS-D.Traditional Chinese medicine monomers/compounds or Chinese medicine compound can treat IBS-D by regulating the"SCFAs-intestinal barrier"through multiple pathways and multiple targets.This article takes the relationship between SCFAs and the four major intestinal barriers,as well as the mediating effect of IBS-D,as the starting point to systematically review and sort out the relevant literature on the targeted regulation of"SCFAs-intestinal barrier"in the treatment of IBS-D by Traditional Chinese medicine monomers/compounds and Chinese medicine compound;explores the theoretical basis of IBS-D caused by"SCFAs-intestinal barrier"from the perspective of"Large intes-tine dominating fluid",in order to provid ideas for Traditional Chinese medicine to establish a precision treatment system with Chinese medicine characteristics.

Objective To analyse the risk factors for postoperative infection in traumatic tibial plateau fractures and to construct a Nomogram prediction model.Methods One hundred and forty-eight patients with traumatic tibial plateau fractures who underwent surgery in our hospital from October 2019 to August 2021 were selected for the study,and were divided into an infected group(n=20)and an uninfected group(n=128)according to whether they developed infection after surgery.The general data of the two groups were compared;the predictive value of statistically significant continuous variables was analysed using the ROC experiment;the risk factors affecting postoperative infection in traumatic tibial plateau fractures were analysed using the logistic regression experiment;and the clinical efficacy of the Nomogram model was verified using internal data.Results In the comparison of general data such as age and gender between the two groups,the differences were not statistically significant(P＞0.05).Compared with the uninfected group,patients in the infected group had a higher percentage of diabetes mellitus,open fracture type,and osteofascial compartment syndrome,and longer operative time and hospital stay(P＜0.05);diabetes(yes),fracture type(open),osteofascial compartment syndrome(yes),and operative time(＞3 h)were risk factors affecting postoperative infection in traumatic tibial plateau fractures.The AUCs for operative time and hospital stay were not 0.792 and 0.651;the optimal stage values were not 3 h and 13 d(P＜0.05);the Nomogram model predicted a C-index of 0.744(0.651-0.807)for the risk of postoperative infection in traumatic tibial plateau fractures.The model predicted the risk of infection after traumatic tibial plateau fracture at a threshold of＞0.09.Conclusion Diabetes mellitus(yes),fracture type(open),osteofascial compartment syndrome(yes),and operative time(＞3 h)were risk factors affecting postoperative infection in traumatic tibial plateau fractures,and the Nomogram model constructed based on the above variables had good predictive value.

Objective:To investigate the changes of dynamic functional brain network connectivity in patients with Parkinson disease(PD) using Hidden Markov model(HMM), and to analyze the correlation between dynamic functional parameters and clinical parameters.Methods:Forty-eight PD patients(PD group) and thirty-three healthy controls(HC group) were included from 2019 to 2023. The cognitive function was assessed using the Montreal cognitive assessment (MoCA), and motor status was assessed using the unified Parkinson's disease rating scale Ⅲ(UPDRS-Ⅲ) in PD group.HMM technique was used to analyze the dynamic functional brain network connectivity, and the dynamic higher-order index fractional occupancy(FO), switching rate(SR), and mean dwell time(MDT) were obtained. Two independent samples t-test was used to calculate the differences between groups of functional connectivity matrices in different states, and Mann-Whitney U test was used to calculate the differences between groups of dynamic higher-order indicators in different states. Spearman correlation analysis was used to calculate the correlation between dynamic higher-order parameters and clinical parameters in the PD group. Results:The HMM was used to construct 6 spatial states for all subjects.MDT was significantly higher in PD group(24.93(19.73)) in state 1 sparse junctions than that in HC group(17.63(14.80)) ( Z=-2.030, P=0.042), but significantly lower MDT was showed in PD group(6.00(3.00)) in state 5 tight junctions than that in HC group(9.75(7.70)) ( Z=-2.210, P=0.027).FO in state 3 was negatively correlated with MoCA score in PD group( r=-0.331, P=0.022).FO in state 5 was positively correlated with UPDRS-Ⅲ score in PD patients( r=0.412, P=0.004), and MDT in state 5 was positively correlated with UPDRS-Ⅲ score( r=0.448, P=0.001). Conclusion:HMM can capture the transient changes of dynamic brain network, which can provide some value for the study of dynamic brain network in patients with Parkinson disease.

Objective:To investigate the safety and feasibility of the CHESS endoscpic ruler (CHESS ruler), and the consistency between the measured values and the interpretation values by endoscopic physician experience.Methods:From January 2021 to January 2022, a total of 105 liver cirrhosis patients with portal hypertension were prospectively enrolled from General Hospital, Xixia Branch Hospital, Ningnan Hospital of People′s Hospital of Ningxia Hui Autonomous Region (29 cases), and the First People′s Hospital of Yinchuan (25 cases), General Hospital of Ningxia Medical University (18 cases), Wuzhong People′s Hospital (10 cases), the Fifth People′s Hospital of Ningxia Hui Autonomous Region (10 cases), Shizuishan Second People′s Hospital (6 cases), Yinchuan Second People′s Hospital (5 cases), and Zhongwei People′s Hospital (2 cases) 8 hospitals. The clinical characteristics of all the patients, including gender, age, nationality, etiolog of liver cirrhosis, and Child-Pugh classification of liver function were recorded. A big gastroesophageal varices was defined as diameter of varices ≥5 mm. Endoscopist (associated chief physician) performed gastroscopy according to the routine gastroscopy procedures, and the diameter of the biggest esophageal varices was measured by experience and images were collected, and then objective measurement was with the CHESS ruler and images were collected. The diameter of esophageal varices of 10 randomly selected patients (random number table method) was determined by 6 endoscopists (attending physician or associated chief physician) with experience or measured by CHESS ruler. Kappa test was used to test the consistency in the diameter of esophageal varices between measured values by CHESS ruler and the interpretation values by endoscopic physician experience.Results:Among 105 liver cirrhosis patients with portal hypertension, male 65 cases and female 40 cases, aged (54.8±12.2) years old, Han nationality 82 cases, Hui nationality 21 cases and Mongolian nationality 2 cases. The etiology of liver cirrhosis included chronic hepatitis B (79 cases), alcoholic liver disease (7 cases), autoimmune hepatitis (7 cases), chronic hepatitis C (2 cases), and other etiology (10 cases). Liver function of 32 cases was Child-Pugh A, Child-Pugh B 57 cases, and Child-Pugh C 16 cases. All 105 liver cirrhosis patients with cirrhotic portal hypertension were successfully measured the diameter of gastroesophageal varices by CHESS ruler, and the success rate of application of CHESS ruler was 100.0% (105/105). The procedure time from the CHESS ruler into the body to the exit of the body after measurement was (3.50±2.55) min. No complications happened in all the patients during measurement. Among 105 liver cirrhosis patients with cirrhotic portal hypertension, 96 cases (91.4%) were recognized as big gastroesophageal varices by the endoscopists. Totally 93 cases (88.6%) were considered as big gastroesophageal varices by CHESS ruler. Eight cases were recognized as big gastroesophageal varices by the endoscopist, however not by the CHESS ruler; 5 cases were recognized as big gastroesophageal varices by the CHESS ruler, but not by the endoscopists; 4 cases were not recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler; 88 cases were recognized as big gastroesophageal varices both by the endoscopists and CHESS ruler. The missed diagnostic rate of big gastroesophageal varices by the endoscopists experience was 5.4% (5/93), and the Kappa value of consistency coefficient between the measurement by the CHESS ruler and the interpretation by endoscopists experience was 0.31 (95% confidence interval 0.03 to 0.60). The overall Kappa value of consistency coefficient by 6 endoscopists measured by CHESS ruler in big gastroesophageal varices diagnosis was 0.77 (95% confidence interval 0.61 to 0.93).Conclusion:As an objective measurement tool, CHESS ruler can make up for the deficiency of subjective judgment by endoscopists, accurately measure the diameter of gastroesophageal varices, and is highly feasible and safe.

Objective:To assess the feasibility of delayed-enhancement MRI in contouring the lumpectomy cavity (LC) for patients with invisible seroma or a low cavity visualization score (CVS≤2) in the excision cavity after breast-conserving surgery (BCS).Methods:Twenty-six patients with stage T 1-2N 0M 0 who underwent prone radiotherapy after BCS were recruited. The LC delineated on CT simulation images was denoted as LC CT. The LCs delineated on T 2WI, as well as on different delayed phases (2-, 5-and 10-minute) of delayed-enhancement T 1WI were defined as LC T2, LC 2T1, LC 5T1 and LC 10T1, respectively. Subsequently, the volumes and locations of the LCs were compared between CT simulation images and different sequences of MR simulation images using deformable image registration. Results:The volumes of LC T2, LC 2T1, LC 5T1 and LC 10T1 were all larger than that of LC CT. A statistical significance was found between the volume of LC CT and those of LC 2T1 or LC 5T1, respectively (both P<0.05). The conformal index (CI), degree of inclusion (DI), dice similarity coefficient (DSC) and the distance between the center of mass of the targets (COM) of LC CT-LC 10T1 were better than those of LC CT-LC T2, LC CT-LC 2T1 and LC CT-LC 5T1, however, there was no statistical difference among them (all P>0.05). Conclusions:It is feasible to delineate the LC based on prone delayed-enhancement MR simulation images in patients with low CVS after BCS. Meanwhile, the LCs derived from prone delayed-enhancement T 1WI of 10-minute are the most similar with those derived from prone CT simulation scans using titanium clips, regardless of the volumes and locations of LCs.

Objective To assess the effectiveness and safety of Azithromycin for preventing bronchopulmonary dysplasia(BPD) in preterm infants in order to provide reference for the clinical treatment of BPD.Methods The electronic retrieval were conducted to review randomized controlled trials (RCTs) from The Cochrane Library,PubMed,EM-Base,China Biological Medicine Database (CBM),Chinese Journals full-text Database (CNKI),Chinese Technological Journals Database(VIP) and Wan Fang Digital Journal Full-text Database by free texts and medical subject headings.The retrieval time was from inception to Dec.2012.Randomized or quasi-randomized studies were conducted by comparing Azithromycin therapy and no treatment or placebo management to prevent BPD among the preterm or low birth weight infants were included.The reference lists of relevant trials and conference proceedings were searched.Risk biases of the trials were assessed.Statistical analysis was performed by using Revman 5.1 offered by Cochrane.Results A total of 2 trials including 328 preterm infants were included.No significant difference was observed between the Azithromycin group and the control group in the incidence of BPD(RR =0.81,95％ CI 0.55-1.19).The risk ratio of death and post-natal steroid used in the Azithromycin group were lower,but there was no difference.The risk ratio of length of stay was not significantly different.The rate of BPD in preterm infants who had a positive respiratory culture of Ureaplasma between the preventative Azithromycin group and the placebo group showed that the incidence of BPD was significantly less in the Azithromycin group.Conclusions The available data are insufficient to make a recommendation regarding treatment with prophylactic Azithromycin to prevent BPD in preterm infants.More RCTs with large-scale and high-quality are required to provide more reliable evidence.

Multiple etiological factors are integrally involved in the development of hepatitis B virus (HBV)infection.Interleukin-10 (IL-10)is an essential cytokine of immune regulation,and IL-10 gene promoter polymorphism affects its mRNA transcription and serum level. IL-10 is related to the prognosis of HBV infection.This review briefly discusses the association of IL-10 gene polymorphism and its serum level with the prognosis of HBV infection,and summarizes the role of IL-10,as an anti-inflammatory cytokine,in host immune function, the prognosis and progression of HBV infection,and HBV-related complications.IL-10 gene polymorphism and its serum level are closely associated with inflammatory response after HBV infection,influence HBV clearance,and are related to the severity of HBV-related liver injury,liver cirrhosis,and hepatocellular carcinoma.The determination of IL-10 gene and serum levels may provide a predictive marker for the prognosis of HBV infection.

Hepatitis B virus (HBV) infection seriously threatens human health. Viral, environmental, and host factors can influence the progression, outcome, and prognosis of HBV infection. Accumulating evidence has shown that the host interleukin 28B gene polymorphism is, to a certain degree, associated with host immunity, anti-HBV efficacy of interferon, and HBV infection outcome. However, at present a consistent conclusion has not been reached yet. IL28B may influence the efficacy of interferon therapy and virus spontaneous clearance in patients with chronic hepatitis B (CHB) by affecting the host′s immune status. Examining the immune status for CHB patients before the experimental study may help researchers to draw a more consistent conclusion.

OBJECTIVETo establish a chronic obstructive pulmonary disease (COPD) model by passive cigarette smoking and (or) intratracheal instillation of lipopolysaccharide (LPS) in spontaneously hypertensive (SH) rats.

METHODSFifteen male SH rats were randomly divided into control group, cigarette smoking exposure (CS) group and CS+LPS (cigarette smoking exposure plus intratracheal instillation of LPS) group. After 8 weeks' treatment, the COPD model was validated by inspecting the general condition and examining lung function and pulmonary pathological changes. The expressions of surfactant-associated protein A (SP-A), NF-κB, histone, p-Iκ-Kα/β, Iκ-Kα/β, and IκB-α were determined with Western blotting, and the expression of TNF-α and IL-6 mRNA were measured using qRT-PCR.

RESULTSThe rats in both CS and CS+LPS groups were marantic with intermittent cough and tachypnea. Lung function test showed increased RI and lowered peak expiratory flow in CS group, which were more prominent in CS+LPS group (P<0.05). HE staining demonstrated typical chronic bronchitic inflammation and emphysema in the lungs of the two model groups with significantly decreased mean alveolar number and significantly increased mean lining intermittent and destruction index. The emphysema level was more serious in CS+LPS group than in CS group. Western blotting showed markedly decreased expressions of SP-A and IκB-α in CS group and CS+LPS , especially the latter group. The protein levels of NF-κB, Iκ-K phosphorylation and mRNA expressions of TNF-α and IL-6 increased obviously in the two model groups.

CONCLUSIONCOPD model can be established by passive smoking and (or) intratracheal instillation of LPS in SH rats, and the model induced by combined exposures is optimal.

Animals ; Disease Models, Animal ; Lipopolysaccharides ; adverse effects ; Male ; Pulmonary Disease, Chronic Obstructive ; etiology ; Rats ; Rats, Inbred SHR ; Tobacco Smoke Pollution ; adverse effects

Objective To establish a chronic obstructive pulmonary disease (COPD) model by passive cigarette smoking and (or) intratracheal instillation of lipopolysaccharide (LPS) in spontaneously hypertensive (SH) rats. Methods Fifteen male SH rats were randomly divided into control group, cigarette smoking exposure (CS) group and CS+LPS (cigarette smoking exposure plus intratracheal instillation of LPS) group. After 8 weeks' treatment, the COPD model was validated by inspecting the general condition and examining lung function and pulmonary pathological changes. The expressions of surfactant-associated protein A (SP-A), NF-κB, histone, p-Iκ-Kα/β, Iκ-Kα/β, and IκB-αwere determined with Western blotting, and the expression of TNF-αand IL-6 mRNA were measured using qRT-PCR. Results The rats in both CS and CS+LPS groups were marantic with intermittent cough and tachypnea. Lung function test showed increased RI and lowered peak expiratory flow in CS group, which were more prominent in CS+LPS group (P<0.05). HE staining demonstrated typical chronic bronchitic inflammation and emphysema in the lungs of the two model groups with significantly decreased mean alveolar number and significantly increased mean lining intermiment and destrction index. The emphysema level was more serious in CS+LPS group than in CS group. Western blotting showed markedly decreased expressions of SP-A and IκB-αin CS group and CS+LPS , especially the latter group. The protein levels of NF-κB, Iκ-K phosphorylation and mRNA expressions of TNF-α and IL-6 increased obviously in the two model groups. Conclusion COPD model can be established by passive smoking and (or) intratracheal instillation of LPS in SH rats, and the model induced by combined exposures is optimal.