MMP-9 responsive hydrogel promotes diabetic wound healing by suppressing ferroptosis of endothelial cells.

Ferroptosis plays a crucial role in the progression of diabetic wounds, suggesting potential therapeutic strategies to target ferroptosis. Transient receptor potential ankyrin 1 (TRPA1) is a non-selective calcium channel that acts as a receptor for a variety of physical or chemical stimuli. Cinnamaldehyde (CA) is a specific TRPA1 agonist. In in vitro experiments, we observed that high glucose (HG) treatment induced endothelial cell ferroptosis, impairing cell function. CA successfully inhibited endothelial cell ferroptosis, improving migration, proliferation, and tube formation. Further mechanistic studies showed that CA-activated TRPA1-induced Ca2+ influx promoted the phosphorylation of calmodulin-dependent protein kinase II (CaMKII) and nuclear factor-E 2-related factor 2 (Nrf2) translocation, which contributed to the elevation of glutathione peroxidase 4 (GPX4), leading to the inhibition of endothelial cell ferroptosis. In addition, CA was incorporated into an MMP-9-responsive injectable duplex hybrid hydrogel (CA@HA-Gel), allowing its efficient sustained release into diabetic wounds in an inflammation-responsive manner. The results showed that CA@HA-Gel inhibited wound endothelial cell ferroptosis and significantly promoted diabetic wound healing. In summary, the results presented in this study emphasize the potential therapeutic application of CA@HA-Gel in the treatment of diseases associated with ferroptosis.

Gene-Directed In Vitro Mining Uncovers the Insect-Repellent Constituent from Mugwort (Artemisia argyi).

Plants contain a vast array of natural products yet to be discovered, particularly those minor bioactive constituents. Identification of these constituents requires a significant amount of plant material, presenting considerable technical challenges. Mugwort (Artemisia argyi) is a widely recognized insect repellent herb, particularly renowned for its extensive usage during the Dragon Boat Festival in China, but the specific constituent responsible for its repellent activity remains unknown. Here, we employed a gene-directed in vitro mining approach to characterize mugwort terpene synthases (TPSs) systematically in a yeast expression system. Based on the establishment of "Terpene synthase-standard library", we have successfully identified 54 terpene products, including a novel compound designated as cyclosantalol. Through activity screening, we have identified that (+)-intermedeol, which presents in trace amount in plants, exhibits significant repellent activity against mosquitoes and ticks. After establishing its safety and efficacy, we then achieved its biosynthetic production in a yeast chassis, with an initial yield of 2.34 g/L. The methodology employed in this study not only identified a highly effective, safe, and commercially viable insect repellent derived from mugwort but also holds promise for uncovering and producing other valuable plant natural products in future research endeavors.

Outcomes of Post-Immunotherapy Durable Responders of Advanced Hepatocellular Carcinoma- with Emphasis on Locoregional Therapy for Oligoprogression.

Introduction: The progression patterns, dispositions, and outcomes of patients with advanced hepatocellular carcinoma (HCC) who achieved durable responses with immunotherapy remain poorly characterized. Methods: Patients with advanced HCC who received immune checkpoint inhibitor (ICI)-based immunotherapy and achieved durable responses were retrospectively included. A durable response was defined as partial response (PR) or stable disease (SD) per RECIST 1.1 for more than 8 months after initiation of immunotherapy. Oligoprogression and polyprogression were defined as progression at ≤3 and >3 lesions, respectively. Results: A total of 91 durable responders (63 PR and 28 SD) were identified. The majority had chronic viral hepatitis (n = 69, 75.8%). Forty-seven (51.6%) and 44 (48.4%) patients received the index immunotherapy as first-line and second- or beyond-line therapy, respectively. Fifty-four (59.3%) patients subsequently developed progression, with a predominant pattern of oligoprogression (66.7%). The median overall survival (OS) was 46.2 months (95% CI: 34.1-58.3). For patients with subsequent progression, employment of locoregional therapy (LRT) for progression was associated with prolonged OS (univariate analysis: hazard ratio [HR] 0.397, p = 0.009; multivariate analysis: HR 0.363, p = 0.050). Patients with oligoprogression who received LRT showed longer median OS than those who did not (48.4 vs. 20.5 months, p < 0.001). In contrast, the median OS of patients with polyprogression who received LRT was not different from those without LRT (27.7 vs. 25.5 months, p = 0.794). Conclusion: Approximately 60% of the post-immunotherapy durable responders of HCC subsequently develop progression. Proactive LRT may further rescue patients who develop subsequent oligoprogression. Prospective studies are mandatory to clarify the proper management of durable responders with subsequent progression.

Thrombolysis exacerbates cerebrovascular injury after ischemic stroke via a VEGF-B dependent effect on adipose lipolysis.

Cerebrovascular injuries leading to edema and hemorrhage after ischemic stroke are common. The mechanisms underlying these events and how they are connected to known risk factors for poor outcome, like obesity and diabetes, is relatively unknown. Herein we demonstrate that increased adipose tissue lipolysis is a dominating risk factor for the development of a compromised cerebrovasculature in ischemic stroke. Reducing adipose lipolysis by VEGF-B antagonism improved vascular integrity by reducing ectopic cerebrovascular lipid deposition. Thrombolytic therapy in ischemic stroke using tissue plasminogen activator (tPA) leads to increased risk of hemorrhagic complications, substantially limiting the use of thrombolytic therapy. We provide evidence that thrombolysis with tPA promotes adipose tissue lipolysis, leading to a rise in plasma fatty acids and lipid accumulation in the ischemic cerebrovasculature after stroke. VEGF-B blockade improved the efficacy and safety of thrombolysis suggesting the potential use of anti-VEGF-B therapy to extend the therapeutic window for stroke management.

Interfering Josephson diode effect in Ta2Pd3Te5 asymmetric edge interferometer.

Edge states in topological systems have attracted great interest due to their robustness and linear dispersions. Here a superconducting-proximitized edge interferometer is engineered on a topological insulator Ta2Pd3Te5 with asymmetric edges to realize the interfering Josephson diode effect (JDE), which hosts many advantages, such as the high efficiency as much as 73% at tiny applied magnetic fields with an ultra-low switching power around picowatt. As an important element to induce such JDE, the second-order harmonic in the current-phase relation is also experimentally confirmed by half-integer Shapiro steps. The interfering JDE is also accompanied by the antisymmetric second harmonic transport, which indicates the corresponding asymmetry in the interferometer, as well as the polarity of JDE. This edge interferometer offers an effective method to enhance the performance of JDE, and boosts great potential applications for future superconducting quantum devices.

Combined application of resveratrol and a ryegrass endophyte in PAH-contaminated soil remediation and its impact on soil microbial communities.

The unique capacity of certain plant endophytes to degrade organic pollutants has garnered considerable interest in recent years. However, it remains uncertain whether endophytes can maintain high degradation activity after in vitro culture and whether they can be used directly in the remediation of contaminated soils. This study reveals that resveratrol, a plant secondary metabolite, selectively boosts the degradation of polycyclic aromatic hydrocarbons (PAHs) by endophytic Methylobacterium extorquens C1 (C1) in vitro, while exerting negligible effects on the activity of indigenous soil bacteria. For the first time, a combined application of C1 and resveratrol was employed in the remediation of polycyclic aromatic hydrocarbon (PAH)-contaminated soil. The findings indicate that the sole use of resveratrol failed to promote the removal of PAHs by indigenous soil microorganisms, whereas sole application of C1 boosted Methylobacterium-related PAH-degrading bacterial abundance, enhancing PAH removal, yet concurrently reduced overall soil microbial diversity. The combination of resveratrol and C1 not only stimulated the PAH removal but also mitigated the impact of C1 on the soil microbial community structure when C1 was applied individually. Specifically, the optimal removal efficacy was achieved with a treatment combination of 5 mg kg-1 resveratrol and 1.2 × 107 CFU kg-1 of C1, leading to a 130% and 231% increase in the removal of phenanthrene and acenaphthene, respectively, over a 15 days period. This study proposes a novel approach for the bioremediation of organic-contaminated soil by using the specific biological response of plant endophytic bacteria to secondary metabolites.

Introducing palmfungi.org, an integrated fungal-host data platform.

Palm fungi are a diverse and unique group mostly found on Arecaceae hosts. They have been studied for approximately 200 years resulting in a large number of known fungal species representing over 700 genera. The timeline of palm fungal studies could be roughly divided into three phases, based on the methods and frequency of reports. They are the "Historical palm fungi era", "Classical palm fungi era" and "Molecular palm fungi era". In the first two periods, the identification of palm fungi was based on morphology, which resulted in a considerable number of morphological species scattered across the data in books, monographs and papers. With the advancement of molecular techniques, studies on palm fungi accelerated. A large number of new species were introduced in the molecular era, especially from Asia, including China and Thailand. However, there is a necessity to link these three generations of studies into a single platform combining data related to host factors, geography and utilisation. Herein, we introduce the palm fungi website: https://palmfungi.org, an integrated data platform for interactive retrieval, based on palm and fungal species. This website is not only a portal for the latest, comprehensive species information on palm fungi, but also provides a new platform for fungal researchers to explore the host-specificity of palm fungi. Additionally, this study uses palmfungi.org and related data to briefly discuss the current status of research on the distribution of palm fungi populations, showing how palmfungi.org links fungi with their palm hosts. Furthermore, the website will act as a platform for collaboration amongst taxonomists, plant pathologists, botanists, ecologists and those who are interested in palms and their relationship with ecological sustainability.

Speech-Processing Network Formation of Cochlear-Implanted Toddlers With Early Hearing Experiences.

To reveal the formation process of speech processing with early hearing experiences, we tracked the development of functional connectivity in the auditory and language-related cortical areas of 84 (36 female) congenitally deafened toddlers using repeated functional near-infrared spectroscopy for up to 36 months post cochlear implantation (CI). Upon hearing restoration, the CI children lacked the modular organization of the mature speech-processing network and demonstrated a higher degree of immaturity in temporo-parietal than temporo-frontal connections. The speech-processing network appeared to form rapidly with early CI experiences, with two-thirds of the developing connections following nonlinear trajectories reflecting possibly more than one synaptogenesis-pruning cycle. A few key features of the mature speech-processing network emerged within the first year of CI hearing, including left-hemispheric advantage, differentiation of the dorsal and ventral processing streams, and functional state (speech listening vs. resting) specific patterns of connectivity development. The developmental changes were predictable of future auditory and verbal communication skills of the CI children, with prominent contribution from temporo-parietal connections in the dorsal stream, suggesting a mediating role of speech-processing network formation with early hearing experiences in speech acquisition.

MiR-21-5p Modulates Cisplatin-Resistance of CD44+ Gastric Cancer Stem Cells Through Regulating the TGF-ß2/SMAD Signaling Pathway.

Background: Cisplatin (DDP) resistance in gastric cancer (GC) is likely to come from gastric cancer stem cells (GCSC). It is a new idea to study the mechanism of the DDP-resistance in GCSC from miRNA. Materials and Methods: CD44+ GCSCs and CD44- control cells were constructed based on the HGC27 gastric cancer cell line. DDP sensitivities in CD44+ and CD44- cells were detected via CCK-8 assay. The differential expression of miR-21-5p in these cell lines was detected by RT‒qPCR. The expression levels of downstream TGF-ß2, SMAD2 and SMAD3 were determined through RT‒PCR and Western blotting. A luciferase assay was used to detect the relationship between miR-21-5p and TGFB2, and the TCGA database, clinical data from our centre, and vivo experiment were used for validation. Finally, we knocked down miR-21-5p to detect changes in cisplatin resistance in GCSCs and to verify changes in the levels of downstream pathways in GCSCs. Results: CD44+ GCSCs induced cisplatin resistance compared with CD44- cells. miR-21-5p was highly expressed in GCSCs, and the TGF-ß2/SMAD pathway was also highly expressed. TGFB2 was proven to be a downstream target gene of miR-21-5p and had a positive relationship with it in phenotype. After knockdown of miR-21-5p, the TGF-ß2/SMAD pathway was also inhibited, and the resistance of GCSCs to cisplatin was specifically decreased. Conclusion: MiR-21-5p promotes cisplatin resistance in gastric cancer stem cells by regulating the TGF-ß2/SMAD signalling pathway.

TME-responsive nanoplatform for multimodal imaging-guided synergistic precision therapy of esophageal cancer via inhibiting HIF-1α signal pathway.

Esophageal cancer (EC) is the sixth leading cause of cancer-related deaths, and its treatment poses significant challenges. In recent years, photodynamic, photothermal, and chemodynamic therapies have emerged as alternative strategies for tumor intervention. However, limitations such as poor tumor targeting, insufficient microenvironment responsiveness, and unclear mechanisms hinder their application. In this study, we found that hypoxia-inducible factor 1 alpha (HIF-1α) was highly expressed in clinical EC samples, which contributed to tumor malignancy and metastasis. We developed a carbon dots (CDs)-based tumor microenvironment (TME)-responsive nanoplatform, CDs-MnO2-Au-Cet (CMAC), designed for multimodal imaging-guided precision therapy in EC. Both in vitro and in vivo experiments demonstrated that CMAC effectively targeted and imaged EC cells and tissues. CMAC significantly inhibited tumor growth by inducing apoptosis and reducing lung metastasis. Mechanistically, CMAC administration led to a substantial downregulation of HIF-1α and its downstream targets, GLUT1 and MMP9. In summary, we presented a novel nanoplatform for imaging-guided synergistic therapy in EC, which demonstrated excellent anti-tumor growth and metastasis capabilities, along with favorable biocompatibility. This study laid the groundwork for developing innovative theranostic strategies for EC.

Vertebral marrow fat fraction is associated with circulating RANKL in postmenopausal females.

Objective: To investigate the relationship between circulating receptor activator of nuclear factor-kappa B ligand (RANKL) levels and marrow adipose tissue in postmenopausal females. Methods: A total of 164 postmenopausal females were included in the study. Serum levels of osteoprotegerin (OPG) and RANKL were measured using ELISA kits. Body composition and bone mineral density (BMD) were assessed using dual-energy X-ray absorptiometry. Complex-based chemical shift imaging-based MRI was employed to evaluate the vertebral marrow proton density fat fraction (PDFF). A multivariate linear regression model was utilized to analyze the predictive effects of PDFF and BMD on circulating levels of OPG and RANKL. Results: Simple regression analysis showed significant associations among the marrow PDFF, BMD at either site, serum RANKL, and the RANKL/OPG ratio. In multivariate linear regression models, marrow PDFF was found to have a positive correlation (ß = 3.15, 95% CI 2.60 to 3.70) and BMD had negative correlations (ß = -0.200, 95% CI -0.348 to -0.051 for vertebral BMD; ß = -0.383, 95% CI -0.589 to -0.177 for total hip BMD; and ß =-0.393, 95% CI -0.598 to -0.188 for femoral neck BMD, all p < 0.01) with circulating soluble RANKL levels after adjusting for age, body mass index, physical activity, total fat mass, android/gynoid ratio, and lean mass. Similar results were observed for the RANKL/OPG ratio. Additionally, multivariate linear regression analyses revealed that marrow PDFF was a significant independent contributor of circulating soluble RANKL (ß = 1.34, 95% CI 1.10 to 1.58, p < 0.001) after further controlling for BMD. However, marrow PDFF or BMD had no associations with circulating levels of OPG after adjusting for all potential confounders mentioned above. Conclusions: Vertebral marrow fat fraction is independently associated with circulating soluble RANKL levels in postmenopausal females.

Effects of the types and ages of vegetation restoration on land surface roughness in the Eastern Hobq Desert, Northern China.

Vegetation restoration has an important remodelling effect on near-surface characteristics, and consequent changes in land surface roughness (LSR) are key influences on soil wind erosion processes. However, the effects of vegetation restoration types and ages on LSR and the underlying mechanisms are not fully understood. In this study, the sand-fixing vegetation restoration area of the Hobq Desert was examined in comparison to a bare sand control area. The LSR of four artificial vegetation types (Salix psammophila, Caragana korshinskii, Artemisia ordosica, and Populus simonii) with restoration age of 36 years, and Salix psammophila and Caragana korshinskii after different periods of restoration (20, 28, 36 and 45 years) were measured using Structure-from-Motion (SfM) photogrammetry. Near-surface characteristics that may affect LSR were also measured. The results showed that vegetation restoration was associated with a 230-409 % higher LSR compared to the control site (1.74 mm). LSR in the different vegetation restoration areas were ranked, from high to low, as follows: AO (8.85 mm) > CK (7.89 mm) > SP (6.70 mm) > PS (6.61 mm). LSR also increased with time since restoration, with the greatest rate of increase during the first 20 years. The change of LSR is mainly affected by the change of near-surface characteristics, with the direct effects of biological crust thickness (0.331), litter thickness (0.289), soil bulk density (-0.239), and clay content (0.171) being significant. Stem diameter, litter density, biological crust coverage, and soil organic matter affected LSR indirectly, mainly through acting on the above factors. Finally, LSR was effectively estimated based on biological crust thickness, litter thickness, and soil bulk density (R2 = 0.904). The research results will help to further deepen the understanding of the influence mechanism of vegetation restoration on LSR, and provide scientific basis and practical reference for vegetation ecological restoration in similar areas.

Proximity-dependent labeling identifies dendritic cells that drive the tumor-specific CD4+ T cell response.

Dendritic cells (DCs) are uniquely capable of transporting tumor antigens to tumor-draining lymph nodes (tdLNs) and interact with effector T cells in the tumor microenvironment (TME) itself, mediating both natural antitumor immunity and the response to checkpoint blockade immunotherapy. Using LIPSTIC (Labeling Immune Partnerships by SorTagging Intercellular Contacts)-based single-cell transcriptomics, we identified individual DCs capable of presenting antigen to CD4+ T cells in both the tdLN and TME. Our findings revealed that DCs with similar hyperactivated transcriptional phenotypes interact with helper T cells both in tumors and in the tdLN and that checkpoint blockade drugs enhance these interactions. These findings show that a relatively small fraction of DCs is responsible for most of the antigen presentation in the tdLN and TME to both CD4+ and CD8+ tumor-specific T cells and that classical checkpoint blockade enhances CD40-driven DC activation at both sites.

Evolutionary fingerprint in rodent PD1 confers weakened activity and enhanced tumor immunity compared to human PD1.

Mechanistic understanding of the immune checkpoint receptor PD1 is largely based on mouse models, but human and mouse PD1 orthologs exhibit only 59.6% identity in amino acid sequences. Here we show that human PD1 is more inhibitory than mouse PD1 due to stronger interactions with the ligands PDL1 and PDL2 and with the effector phosphatase Shp2. A novel motif highly conserved among PD1 orthologs in vertebrates except in rodents is primarily responsible for the differential Shp2 recruitment. Evolutionary analysis suggested that rodent PD1 orthologs uniquely underwent functional relaxation, particularly during the K-Pg boundary. Humanization of the PD1 intracellular domain disrupted the anti-tumor activity of mouse T cells while increasing the magnitude of anti-PD1 response. Together, our study uncovers species-specific features of the PD1 pathway, with implications to PD1 evolution and differential anti-PD(L)1 responses in mouse models and human patients.

Organic Dye Molecule Intercalated Prussian Blue for Simultaneously Enhancing Coloration Efficiency and Energy Storage Capacity in Electrochromic Battery.

The dual-functional device combining electrochromic properties and energy storage has gained numerous attentions in the field of energy-saving smart electronics. However, achieving simultaneous optimization of coloration efficiency and energy storage capacity of materials poses a significant challenge. This study presents a novel approach by incorporating methyl orange into Prussian blue channels (PB-MO films) to adjust the internal electronic structure of Prussian blue. This modification allows the active layer to simultaneously improve the electrochromic and energy storage performance. The introduction of methyl orange not only alters the ratio of Fe3+/Fe2+ within the framework through the coordination reaction of Fe3+ with methyl orange, but also improves the reaction kinetics after intercalating organic dye molecules, including charge transfer resistance, diffusion capability of ions and capacitive contribution. The PB-MO films demonstrate remarkable properties: high optical contrast (81.4% at 670 nm), excellent coloration efficiency (265 cm2 C-1), and significant specific capacity (84 mAh m-2 at 0.05 A m-2), outperforming pure PB films. The PB-MO films are ideally suited for applications in displays and intelligent energy storage fields, boasting both high coloration efficiency and substantial energy storage capacity, thus advancing promote the development of dual-functional electrochromic devices.

[Evaluation of Land Ecological Status and Diagnosis of Obstacle Factors in Jiangsu, China].

By constructing a land ecological evaluation index system at the village scale and using models such as spatial correlation analysis, hotspot analysis, and obstacle factor diagnosis, the basic characteristics, spatial differentiation, and obstacle factors of land ecological status in Jiangsu Province were studied. This study sought to clarify the foundation, structure, function, and benefit characteristics of land ecosystems and optimize land management and policy regulation. The results showed that： ① The spatial distribution of land ecological status in Jiangsu Province was high in the north and low in the south, with multiple high-value areas radiating outward and decreasing, with low value centers radiating outward and increasing. The distribution area of the highest and lower values was relatively small, whereas the area of the middle value area was the largest. The higher values were mainly distributed in the suburbs and edge areas of each county. ② The spatial autocorrelation of land ecological status in Jiangsu Province was significant, with hot spots mainly concentrated in northern Jiangsu and cold spots concentrated in southern Jiangsu, as well as some areas of Taizhou and Nantong. The spatial distribution of cold and hot spots showed a complementary pattern with the level of regional development. The comprehensive index value of land ecology in developed areas was lower, whereas the index value in underdeveloped areas was higher. ③ The natural background conditions of Class Ⅰ land ecological zone in Jiangsu Province were superior, with good ecological construction and benefits and a high level of ecological status. The obstacle factors mainly included the proportion of water bodies and the average annual degradation rate of forest land. The Class Ⅱ land ecological zone was mostly located in the Huainan region and mainly composed of plain landforms. The Class Ⅲ land ecological zone had the largest area, located in the riverside areas of southern Jiangsu. The obstacle factors mainly included the average annual degradation rate of arable land and the proportion of soil pollution area. By controlling land ecological risks, the early warning level of ecological crisis could be improved.

Promoting equality in utilization of basic public health services in China: The role of the family doctor contract service.

BACKGROUND: The Family Doctor Contract Service (FDCS) system is a service model for primary care reform launched in 2016 to offer families and individuals active and continuous health care by a team of family doctors within primary care institutions in China. OBJECTIVES: This study aimed to estimate socioeconomic-related inequalities in the utilization of basic public health services, and to identify the contribution of FDCS to promoting equality. METHODS: Data for the study were collected from a 2023 cross-sectional household health survey in western China, involving 39,456 participants. The concentration index (C) was employed for analyzing the extent of socioeconomic-related inequalities in the utilization of basic public health services and the coarsened exact matching technique was employed for sensitivity analysis in order to reduce selection bias. RESULTS: Our results indicated pro-poor inequalities in the utilization of health records (C = -0.046), free health check-ups (C = -0.009), and follow-ups for hypertension (C = -0.051). Additionally, a more equitable distribution across the economic spectrum was observed within the FDCS group (people who voluntarily contracted for services) compared to the non-FDCS group. The FDCS demonstrated more favorable positive impacts among individuals with higher (quintiles 60-80%) and the highest (top 20%) socioeconomic status. The FDCS contributed 83.94%, 59.24%, and 36.92% to pro-poor inequalities in the utilization of three basic public health services. These contributions reflected the positive impact of the FDCS on utilization. CONCLUSIONS: Government policy and service delivery models require a paradigm shift to promote a stronger primary healthcare approach to practice, as evidenced by the effectiveness of the FDCS in promoting equality.

Paquinimod attenuates retinal injuries by suppressing the S100A9/TLR4 signaling in an experimental model of diabetic retinopathy.

Diabetic retinopathy (DR), the most common ocular complication of diabetes mellitus (DM), has exhibited an increase in incidence over the past decade. S100 calcium-binding protein A9 (S100A9) plays a significant role in inflammation and cancer. Toll-like receptor 4 (TLR4), a transmembrane receptor, initiates signaling cascades upon ligand binding. S100A9 activates TLR4, and their involvement in various diseases is well-established. We found elevated S100A9/TLR4 pathway proteins in the vitreous of DR patients. Bioinformatics analysis revealed differential gene expression related to this pathway. These proteins were also detected in diabetic rat retinas and induced structural damage. Paquinimod, an S100A9 inhibitor, decreased pathway protein expression and reduced retinal damage. Our study validates the S100A9/TLR4 pathway in diabetic retinas and suggests its potential as a therapeutic target for DR. Targeting S100A9 could offer a novel approach to prevention and treatment.

Effect of clustered nursing on liver function indexes, nutrition, and emotional status of patients with severe liver failure.

Liver failure is a metabolic disorder caused by a variety of mixed factors. For such diseases, adopting cluster care can effectively improve the relevant symptoms of patients. To explore the nursing effect of nutritional nursing combined with clustered nursing for patients with severe liver failure. A total of 129 patients with severe liver failure were selected as retrospective study subjects. Nine cases were due to an end event, such as death. The other patients were divided into control group and observation group according to different nursing methods. Among them, the control group adopted nutrition nursing, and the observation group implemented cluster nursing on this basis. The differences of liver function, anxiety and depression score, gastrointestinal recovery, nutritional status, and sleep quality were compared between the 2 groups before and after nursing. After nursing, the total bilirubin, albumin, and aspartate aminotransferase of the observation group were significantly higher than those of the control group (P < .05). The nursing staff used Self-Rating Anxiety Scale and Self-Rating Depression Scale of the observation group, which were slightly lower than those of the control group. The difference was statistically significant after testing (P < .05). After nursing, the observation group's upper arm circumference, brachial tri-scalp fold thickness, and hemoglobin were better than those of the control group. Statistics showed that the difference was statistically significant (P < .05). The depth of sleep, time to fall asleep, number of awakenings, time to fall asleep after awakening, overall sleep quality, and intensive care unit environmental noise intensity in the Richards-Campbell Sleep Questionnaire sleep scale after nursing in the 2 groups were significantly higher than those before nursing, and the scores of the observation group were significantly lower than those in the observation group. In the control group, this difference was statistically significant (P < .05). Nutritional nursing combined with clustered nursing can effectively promote the recovery of gastrointestinal function in patients with severe liver failure.

[Clinical efficacy observation of electroacupuncture based on the "ascending lucidity and descending turbidity" theory： a study of gut microbiota in patients with diabetic gastrointestinal dysfunction]. / "å‡æ¸ é™æµŠ"æ³•ç”µé’ˆè°ƒèŠ‚è‚ é“èŒç¾¤æ”¹å–„ç³–å°¿ç— èƒƒè‚ åŠŸèƒ½éšœç¢çš„ä¸´åºŠç–—æ•ˆè§‚å¯Ÿ.

OBJECTIVES: To explore the efficacy of electroacupuncture (EA) based on the "ascending lucidity and descending turbidity" theory in patients with diabetic gastrointestinal dysfunction and its regulatory effect on gut microbiota. METHODS: A total of 48 patients with diabetic gastrointestinal dysfunction were randomly divided into the EA group (24 cases, 3 cases dropped-off) and the control group (24 cases, no dropped off). Both groups received blood glucose control and basic symptomatic treatment. EA (15 Hz/100 Hz) was applied to Zhongwan (CV12), Tianshu (ST25), Zhongfu (LU1), bilateral Zhangmen (LR13), bilateral Taibai (SP3), bilateral Taiyuan (LU9), bilateral Zusanli (ST36), and bilateral Shangjuxu (ST37) in the EA group. Sham EA was applied to corresponding non-acupoints without electric stimulation in the control group. Both groups received treatment for 30 min per time, once daily, for a total of 5 treatments followed by a 2-day break, over a consecutive period of 2 weeks. Symptoms were evaluated by gastrointestinal symptom rating scale (GSRS) and gastroparesis cardinal symptom index (GCSI) before and after treatment, and 4 weeks after treatment. During the treatment period, fasting blood glucose levels were monitored daily. Stool samples were collected before and after treatment for 16S rDNA sequencing analysis to examine changes in gut microbiota. RESULTS: Compared with the control group, GSRS and GCSI scores in the EA group were significantly decreased (P<0.001) after treatment and at follow-up at the same time point, and compared with those before treatment, GSRS and GCSI scores in the EA group were significantly decreased after treatment and at follow-up (P<0.001). After treatment, the 16S rDNA sequencing showed that at the phylum level, the ratio of Proteobacteria in the EA group was higher than that in the control group (FDR<0.05). At the genus level, a total of 18 different gut microbiota were identified between the two groups. Compared to the control group, patients in the EA group showed a significant decrease in the abundance of Pseudomonas and Alkalibacter (FDR<0.05), while the abundance of the remaining 16 gut microbiota was significantly increased (FDR<0.05). Compared to the baseline, the EA group showed a significant up-regulation of Olsenella (FDR<0.05) and a significant down-regulation of Pseudomonas (FDR<0.05) after treatment. CONCLUSIONS: EA based on the "ascending lucidity and descending turbidity" theory can effectively improve the symptoms of patients with diabetic gastrointestinal dysfunction. EA can also affect the distribution of gut microbiota by up-regulating the levels of certain beneficial bacteria and suppressing pathogenic bacteria .