Infection is a common complication and leading cause of death in liver cirrhosis patients. In recent years, people gradually recognize the vital impact of infection, especially spontaneous bacterial peritonitis, on the course and prognosis of liver cirrhosis patients. Timely and effective empiric antibiotic therapy is particularly critical for the treatment of liver cirrhosis patients with bacterial infection. However, due to the spread of multidrug resistant bacteria and extensively drug-resistant bacteria, infection in cirrhosis has also become a difficult problem. At the same time, we have a clearer understanding on the pathogenesis of infection in cirrhosis. Novel therapeutic methods, such as intestinal microecological intervention and immunoregulatory therapy, have also become research hotspots recently. Establishing an effective treatment plan for liver cirrhosis patients with bacterial infections is the key to improve the survival rate and quality of life of these patients.

Acute-on-chronic liver failure (ACLF) is an acute decompensated syndrome that occurs on the basis of chronic liver disease, with rapid disease progression and poor prognosis, thus being an important cause of death in patients with cirrhosis. Predisposing factors play an important role in the occurrence, progression and prognosis of ACLF, which are heterogeneous in different definitions and regions. With the development of medical and health services and changes in lifestyles, the composition of predisposing factors also changes. These factors cause damage to organ function in various ways, leading to different types of organ failure and prognosis. Early warning of the predisposing factors can prevent the occurrence of ACLF. Actively removing predisposing factors can improve the prognosis of ACLF. Reasonable management of precipitating factors is important for ACLF.

Liver cirrhosis is the end stage of chronic liver diseases with various complications, thereby imposing great burden to the patient's family and public health care. Abnormal nutritional status, mainly including malnutrition and overnutrition(overweight/obesity), are related to the occurrence of many chronic liver diseases, and have major impact on the progression and outcome of liver cirrhosis. Nutritional status of cirrhotic patients should be comprehensively assessed based on various factors, including underlying diseases, diet, clinical manifestations, and laboratory tests, etc. Cirrhotic patients with malnutrition should receive individualized nutritional support therapy in timely fashion, and those with overweight/obesity should undergo dietary intervention or physical activity to improve the quality of life and reduce the risk of death.

Portal vein thrombosis (PVT) is a common complication of liver cirrhosis. Decreased portal vein velocity is the most important risk factor for cirrhotic PVT, and the etiology and severity of liver cirrhosis, hemostasis status, and inflammatory and immune mechanisms may also be associated with the development of cirrhotic PVT. The natural history of cirrhotic PVT includes improvement, stabilization, progression, and recurrence. Non-occlusive PVT and improvement of liver function may be associated with spontaneous improvement of cirrhotic PVT. The impact of different occlusion degree of cirrhotic PVT on patients' prognosis is inconsistent. Non-occlusive PVT may not significantly affect patients' outcomes; occlusive PVT may increase the risk of death, and PVT involving the mesenteric veins may also lead to intestinal ischemia and infarction. Clinical management strategies for cirrhotic PVT include wait-and-see strategy (no intervention), anticoagulation, thrombolysis, and transjugular intrahepatic portosystemic shunt (TIPS). When the degree of PVT is less than 50% and the mesenteric veins are not involved, immediate intervention may not be required. Anticoagulation is the first-line choice for cirrhotic PVT requiring treatment. Thrombolysis and TIPS are mainly used for patients with contraindications of anticoagulation and those who do not respond to anticoagulation. This paper reviews the clinical assessment of cirrhotic PVT and its predictors, natural history, impact on prognosis, treatment, and prophylaxis.

Objective To investigate the effect of ROCK inhibitor fasudil (FS) on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice and its possible mechanisms. Methods Forty male C57BL/6 mice were randomly divided into four groups (n=10): control group, ALI group, FS group, and ALI+FS group. After administration of LPS or FS, lung histopathological changes, inflammatory cytokine levels, expression levels of Rho kinase (ROCK), and cell pyroptosis-related proteins, including NLRP3, ASC, caspase-1, cleaved caspase-1, GSDMD, cleaved GSDMD, and IL-1β, were assessed. In vitro, human umbilical vein endothelial cells (HUVECs) were cultured and the cell activity, LDH release rate, inflammatory factor levels, and the expression levels of cell pyroptosis-related proteins were measured after administration of LPS+ATP and FS. Results In vivo experiments on mice demonstrated that the alveolar hemorrhage, alveolar septum thickening, and lung tissue edema were more pronounced in ALI group compared to the control group, and FS pretreatment significantly reduced these histopathological changes. Compared with the control group, mice in ALI group showed increased lung wet/dry weight ratio, increased total cell count and total protein concentration in alveolar lavage fluid, increased levels of TNF-α, IL-6, IL-18, and IL-1β, and increased expression of ROCK1, ROCK2, and pyroptosis-related proteins including NLRP3, ASC, cleaved caspase 1, cleaved GSDMD, and IL-1β in pulmonary tissues (P<0.05); compared with mice in ALI group, mice in ALI+FS group had a lower lung wet/dry weight ratio, a lower total cell count and total protein concentration in alveolar lavage fluid, lower levels of inflammatory factors and lower expression levsls of ROCK1, ROCK2, and pyroptosis-related proteins in lung tissue (P<0.05). In vitro experiments on HUVECs cells confirmed that compared with the control group, ALI group showed a significant decrease in cell viability, an increase in LDH release rate, cell death rate, and inflammatory factor levels, and an upregulation of the expression of the pyroptosis-related proteins (P<0.05); compared with ALI group, ALI+FS group showed an increase in cell viability, a significant decrease in LDH release rate, cell death rate, and inflammatory factor levels, and downregulation of the expression of pyroptosis proteins (P<0.05). Conclusion FS may alleviate LPS-induced ALI by inhibiting endothelial cell pyroptosis.

Objective To investigate the effect and mechanism of Yes-associated protein (YAP) on rat cardiac fibroblasts(CFs) proliferation and transdifferentiation induced by high glucose. Methods The CFs cells were isolated and cultured of newborn SD rats aged 1-3 days, then treated with 40 mmol/L D-glucose for concentration of diabetes cardiomyopathy model(DCM), and the relative expression levels were detected with Western blotting of YAP, α-smooth muscle actin (α-SMA), collagenⅠ, collagen Ⅲ and connective tissue growth factor (CTGF), respectively, at the time points 24 hours. The CFs cells were divided into normal glucose (NG) control group (5.5 mmol/L D-glucose), high glucose (HG) group (40.0 mmol/L D-glucose), normal glucose +0.5 μmol/L verteporfin (NG+VP) group and high glucose + 0.5 μmol/L verteporfin (HG+VP) group. Verteporfin is an inhibitor of YAP, which blockades the interaction between YAP and TEAD. Immunofluorescence of vimentin was used to identify CFs. Immunofluorescence of Ki-67 was used to detect the proliferation activities of CFs in various groups. Western blotting was performed to detect the levels of α-SMA, collagen Ⅰ and collagen Ⅲ, YAP and CTGF proteins in CFs of various groups. Results The positive result of vimentin immunofluorescence prompted that the primary cultured cells were rat's CFs. Immunofluorescence of Ki-67 showed that, the positive rate (%) of Ki-67 in CFs was obviously higher in HG group than in NG group (67.33±5.14 vs. 22.94±4.88, P<0.05); After treatment with VP, the positive rate (%) of Ki-67 in CFs decreased markedly (46.83±3.86 vs. 67.33±5.14, P<0.05). Western blotting showed that, compared with NG group, the relative expression levels of α-SMA, collagenⅠ and collagen Ⅲ in CFs increased significantly in HG group (1.43±0.98 vs. 0.93±0.06, 1.80±0.09 vs. 1.08±0.09, 1.43±0.09 vs. 0.88±0.10, P<0.05), and the relative expression levels of VAP and CTGF protein also increased (1.93±0.15 vs. 1.17±0.09, 1.80±0.18 vs. 1.23±0.16, P<0.05). Compared with the HG group, the relative expression levels of α-SMA, collagen I, collagen Ⅲand CTGF proteins decreased significantly in HG+VP group (1.27±0.06 vs. 1.71±0.12, 2.05±0.23 vs. 3.03±0.17, 1.10±0.12 vs. 1.82±0.18, 1.31±0.16 vs. 1.57±0.03, P<0.05), while compared with NG group, the relative expression levels of α-SMA, collagen Ⅰ and CTGF proteins were higher in HG+VP group (P<0.05). Conclusion High glucose promotes the proliferation and activation of neonatal rats CFs and excessive synthesis of extracellular matrix proteins such as collagen by regulating the YAP/TEAD/CTGF signaling pathway.

Objective To explore the effect of miR-491-5p on the apoptosis of trophoblast cells induced by hypoxia and the process of preeclampsia. Methods Human trophoblast cells were divided into control group, hypoxia group, hypoxia+miR-491-5p mimic group and hypoxia+miR-491-5p inhibit group. Cell viability staining was used to detect hypoxia-induced trophoblast cell apoptosis. qRT-PCR was used to detect the expression of miR-491-5p in hypoxia-induced trophoblast cells; TargetScan database to predict miR-491-5p target; Detection of dual-luciferase reporter gene was used to confirm the targeting relationship between miR-149-5p and BCL2l2; miR-491-5p mimic and inhibitor single-stained embryonic trophoblast cells, qRT-PCR was used to detect the expression of miR-491-5p. Western blotting was used to detect changes of BCL2l2 expression in trophoblast after overexpression and inhibition of miR-491-5p; cell viability staining, Western blotting, and flow cytometry to detect trophoblast apoptosis. Results Compared with control group, the hypoxia group had significantly increased cell apoptosis and increased expression of miR-491-5p (2.784±0.214 vs. 1.000±0.000, P<0.01); bioinformatics detection and dual luciferase detection report experiments showed that miR-491-5p can targete and regulate BCL2l2 expression. Compared with control group, the miR-491-5p content in hypoxia+miR-491-5p mimic group was significantly increased (7659.300±191.300 vs. 5.467±0.503, P<0.05), while that in miR-491-5p inhibit group was the opposite (0.139±0.022 vs. 0.323±0.035, P<0.01). Compared with hypoxia group, the apoptosis rate of trophoblast cells was decreased (11.56%±0.452% vs. 16.67%±0.750%, P<0.01), the expressions of BCL2L2 (0.702±0.047 vs. 0.312±0.007, P<0.001) and Bcl-2 (0.752±0.055 vs. 0.415±0.005, P<0.01) were increased, and the expression of Bax (1.221±0.066 vs. 1.652±0.085, P<0.01) was decreased in hypoxia+miR-491-5p inhibit group; but in hypoxia+miR-491-5p mimic group, the apoptosis rate was increased (23.54%±1.233% vs. 16.67%±0.750%, P<0.001), the contents of BCL2L2 (0.211±0.013 vs. 0.312±0.007, P<0.01) and Bcl-2 (0.203±0.011 vs. 0.415±0.005, P<0.001) was decreased, and Bax (2.362±0.284 vs. 1.652±0.085, P<0.01) expression was increased. Conclusions miR-491-5p might negatively regulates the expression of BCL2L2, increases the apoptosis of trophoblast cells induced by hypoxia and accelerates the development of preeclampsia.

Objective To investigate the action mechanism of Xibining decoction on mitigation of pain of knee osteoarthritis (KOA) through regulation of redox homeostasis of synoviocytes by carnitine palmitoyl transferase 1 (CPT1) enzyme. Methods Fibroblast-like synovial cells (FLS) were extracted from rats' knee joint and the optimal concentration of the freeze-dried powder of Xibining decoction on FLS was selected by CCK-8. Subsequently, the cells were divided into control group, KOA group and Xibining group. The inflammatory environment of KOA was induced by 5 μg/ml lipopolysaccharide (LPS) in the last two groups, and in Xibining group, 100 μg/ml Xibining were added and cultured for 24 hours. The mRNA and protein expressions of CPT1 and carnitine/organic cation transporters 1 (OCTN1) were detected by Real-time PCR and Western blotting. The activities of CPT1 and superoxide dismutase (SOD) and malondialdehyde (MDA) content were detected by assay kits. Reactive oxygen species(ROS) level was detected by a 2',7'-dichlorofluorescein diacetate assay. The dorsal root ganglion (DRG) neurons were extracted from rats and identified by βⅢ-tubulin and glial fibrillary acidic protein (GFAP) immunofluorescence. The neurons were divided into control group, KOA group and Xibining group, the FLS supernatants of the three groups were added to the DRG for 24 hours. The mRNA and protein expression of transient receptor potential A1 ion channel (TRPA1) were detected by Real-time PCR and Western blotting. Ca²⁺ influx in DRG neurons after TRPA1 opening was observed by Real-time fluorescent calcium imaging. ELISA assay was used to detect the content of calcitonin gene related peptide (CGRP) and substance P (SP) in DRG supernatant. Results The ideal freeze-dried powder of Xibining decoction concentration was identified as 100 μg/ml. Real-time PCR and Western blotting results showed that the expression levels of mRNA and protein in CPT1 and OCTN1 of Xibining group were significantly higher than those in KOA group (P<0.05). Compared with control group, the average fluorescence intensity and MDA contents increased significantly in KOA group [(5.52±0.78) AU vs. (26.46±2.07) AU; (2.77±0.03) nmol/ml vs. (3.13±0.02) nmol/ml] (P<0.05); the activities of CPT1 and SOD were significantly downregulated [(11.50±0.21) nmol/min vs. (4.98±0.02) nmol/min; (17.6±0.07) U/ml vs. (11.38±0.05) U/ml] (P<0.05). Compared with KOA group, the fluorescence intensity and MDA contents significantly decreased in Xibining group [(14.07±1.41) AU and (2.87±0.01) nmol/ml] (P<0.05), the activities of CPT1 and SOD [(7.94±0.21) nmol/min and (13.81±0.07) U/ml] were significantly upregulated (P<0.05). Compared with KOA group, after treatment with FLS supernatant in Xibining group, the mRNA and protein expression of TRPA1, and Ca²⁺ influx after TRPA1 opening were inhibited in DRG (P<0.05). In addition, the expression of CGRP and SP were also reduced in Xibining group [(19.93±1.2) ng/L vs. (30.19±1.58) ng/L, P<0.05; (84.23±1.26) ng/L vs. (123.16±2.95) ng/L, P<0.05]. Conclusion Xibining can regulate the local redox homeostasis of FLS through CPT1 enzyme, which can further influence the Ca²⁺ influx on the TRPA1 ion channel of DRG and reduce the secretion of pain factor to alleviate KOA pain.

Objective To investigate the effect and mechanism of Paris saponins on iron death in triple negative breast cancer cells. Methods MDA-MB-231 cells were treated with 0, 10, 20, 30, 40 and 50 μmol/L of Paris saponins. Cell viability was detected by CCK-8 method. MDA-MB-231 cells at logarithmic growth stage were randomly divided into control group, Paris saponin group (treated with 30 μmol/L Paris saponin for 12 h), inhibitor group (treated with 2 μmol/L Ferrostatin for 12 h) and Paris saponin + inhibitor group (treated with 30 μmol/L Paris saponin for 12 h after treatment with 2 μmol/L Ferrostatin-1 for 12 h), cell viability was detected by CCK-8 method, cell apoptosis rate was detected by flow cytometry. The expressions of divalent metal ion transporter 1 (DMT1), transferrin receptor 1 (TFR1), glutathione peroxidase 4 (GPX4), p53 and p53/SLC7A11 were detected by qRT-PCR and Western blotting. Results CCK-8 assay showed that the survival rate of MDA-MB-231 cells was decreased with the increase of the concentration of Paris saponin in a dose-dependent manner (P<0.05). Compared with control group, the cell survival rate, the relative expression levels of CPX4, SLC7A11 mRNA and protein decreased, while of apoptosis rate, the relative, expression levels of TFR1, DMT1, p53 mRNA and protein increased in Paris saponin group, the relative expression levels of CPX4, SLC7A11 mRNA and protein increased in inhibitor group, the apoptosis rate and the relative expressions of TFR1, DMT1 and p53 mRNA and protein were decreased (P<0.05). Compared with inhibitor group, the cell survival rate and the mRNA and protein relative expressions of CPX4 and SLC7A11 decreased, while the apoptosis rate and the mRNA and protein relative expressions of TFR1, DMT1 and p53 increased in parisaponin + inhibitor group (P<0.05). Conclusion Paris saponin inhibits the proliferation of triple negative breast cancer cells and promotes iron death in cancer cells, possibly through the regulation of p53/SLC7A11 signal axis.

Objective To explore the alternative value of internal jugular vein collapsibility index (IJVCI) and subclavian vein collapsibility index (SCVCI) used to substitute for inferior vena cava collapsibility index (IVCCI) in volume evaluation under spontaneous breathing and mechanical ventilation. Methods A total of 100 patients were selected who underwent elective surgery in the Department of Anesthesiology, the First Affiliated Hospital of Chongqing Medical University from December 2020 to August 2021, the cyclic indicators of patients with different respiratory states were compared. According to the cut-off value of IVCCI, the patients were divided into hypovolemic group and non-hypovolemic group, and the cyclic indicators of the two groups were compared under different respiratory states. Pearson correlation analysis and Bland-Altman analysis were used to determine the relevance and consistency between IJVCI, SCVCI and IVCCI. ROC curve was used to analyze the efficiency of IJVCI and SCVCI in volume evaluation. Results Under mechanical ventilation condition, compared to spontaneous breathing condition, the SpO₂ of patients was obviously increased, and heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), IVCCI, IJVCI and SCVCI were significantly decreased (P<0.01). IJVCI and SCVCI in non-hypovolemic group were significantly lower than those in hypovolemic group under the condition of spontaneous respiration (P<0.001). Under the condition of mechanical ventilation, SBP in non-hypovolemic group was significantly increased than that in hypovolemic group (P<0.05), while IJVCI and SCVCI were significantly lower than those in hypovolemic group (P<0.001). Under the condition of spontaneous breathing and mechanical ventilation, there was a significant positive correlation and consistency between IJVCI and IVCCI (r=0.586, P<0.01; r=0.514, P<0.001), and that a significant positive correlation and consistency between SCVCI and IVCCI (r=0.385, P<0.01; r=0.521, P<0.01). The area under the ROC curve (AUC) of IJVCI and SCVCI for the diagnosis of hypovolemia was 0.828, 0.684, and the best cut-off value was 22.2%, 25.4% under the condition of spontaneous breathing. The AUC of hypovolemia diagnosed by IJVCI and SCVCI were 0.701, 0.773, and the best cut-off value was 19.8%, 13.2% under the condition of mechanical ventilation. Conclusion Both IJVCI and SCVCI can replace IVCCI for volume evaluation in different respiratory states, but the alternative value of IJVCI is higher in spontaneous breathing state while of SCVCI is higher in mechanical ventilation state for volume evaluation.

Objective To explore the application value of routine electrocardiogram in the diagnosis of left ventricular hypertrophy (LVH) in hypertensive patients using different configuration diagnostic criteria. Methods The clinical data were collected of 228 patients with essential hypertension treated in Qilu Hospital of Shandong University from September 2016 to March 2021, and the results of echocardiography and electrocardiogram were retrospectively analyzed. Ganau classification of left ventricle was done according to 2018 European Society of Cardiology (ESC)/European Society of Hypertension (ESH) criteria. The patients were divided into normal configuration (NG, n=58) group, concentric remodeling (CR, n=107) group, eccentric hypertrophy (EH, n=24) group and concentric hypertrophy (CH, n=39) group. The classification was done again according to the Echocardiographic Measurements in Normal Chinese Adults (EMINCA) criteria, patients were divided into NG group (n=105), CR group (n=27), EH group (n=81) and CH group (n=15). The consistency of the results of left ventricular configuration classification according to different criteria was compared, and the diagnostic value of ECG in different left ventricular configuration and the difference between groups were analyzed. Results The results of configuration classified according to the 2018 ESC/ESH criteria and EMINCA criteria had statistical difference (P<0.01), and the consistency was poor (Kappa=0.330, P<0.01). According to the 2018 ESC/ESH criteria, the positive rate of ECG in NG group, CR group, EH group and CH group were 5.2%, 7.5%, 29.2%, and 30.8%, respectively. The differences among groups were statistically significant (P<0.01). The positive rate of EH group or CH group was significantly higher than that in NG group or CR group (P<0.0083). The sensitivity and specificity of ECG in diagnosing LVH were 30.2% and 93.3%, respectively. According to the EMINCA criteria, the positive rate of ECG in diagnosing LVH in NG group, CR group, EH group and CH group were 1.9%, 3.7%, 25.9%, and 40.0% respectively. The differences among groups were statistically significant (P<0.01). The positive rate in EH and CH group was significantly higher than that in in NG group (P<0.0083). The sensitivity and specificity of ECG in diagnosing LVH were 28.1% and 97.7%, respectively. Conclusions 2018 ESC/ESH criteria and EMINCA criteria showed a significant difference in classification of left ventricular configuration. In the two different criteria, ECG has low sensitivity and high specificity in the diagnosis of LVH.

Objective To explore the risk factors of thrombotic events in trauma patients by using random forest algorithm. Methods The data of 255 trauma patients admitted to the intensive care unit from July 2016 to December 2021 were retrospectively analyzed. These patients were divided into thrombosis group and non-thrombosis group by propensity score matching and according to the occurrence of thrombosis after trauma. The risk factors of 24 clinical variables including age, gender, injury severity score (ISS), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), white blood cell count, red blood cell count, platelet count, hemoglobin, alanine aminotransferase, aspartate aminotransferase, total bilirubin, creatinine, total protein, prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, fibrin degradation products, D-dimer, antithrombin 3, coagulation reaction time (CRT), clot formation rate, clot formation kinetics and maximum clot strength (maximal amplitude, MA) within 2 hours after admission were analyzed by random forest algorithm. The predictive values of the variables were evaluated by receiver operating characteristic (ROC) curve and verified by bootstrap method. Results One hundred and ten trauma patients were divided into thrombosis group (n=22) and non-thrombosis group (n=88) by propensity score matching. The results of random forest algorithms showed that high MA level was an important risk factor for thrombotic events after trauma(P<0.05). The area under ROC curve (AUC) of using MA value to predict thrombotic events in trauma patients was 0.70 (95%CI 0.56-0.81, P<0.01), and the bootstrap method confirmed that the AUC of using MA value to predict thrombotic events in trauma patients was 0.70 (95%CI 0.57-0.80, P<0.01). When the cut-off value of MA was 63.3 mm, the sensitivity and specificity of the trauma patients suffering thrombotic events were 63.6% and 78.4%, respectively. Conclusion The high MA level is an important risk factor for thrombotic events in trauma patients.

Objective To summarize the clinical features, diagnosing and treating passes of a case of primary ciliary dyskinesia (PCD) in newborns, and by literature review to increase awareness of PCD. Methods The clinical data of an infant patient, admitted in Children's Hospital Affiliated to Chongqing Medical University and diagnosed as PCD, was collected and retrospectively analyzed. CNKI, Wanfang, PubMed, Cochrane Library and Online Mendelian Inheritance in Man (OMIM) were searched, eligible literature was analyzed. Results A term female infant aged 1 month and 13 days was admitted to the hospital with 1-month history of cyanosis and 3-week of cough and wheeze, which aggravated 3 days prior to admission. She developed cyanosis on postnatal day 1, then cough and wheeze gradually. Her symptoms deteriorated due to pneumonia, non-invasive ventilation was performed, and continued CO₂ retention existed. Hypercapnia and oxygen dependence were found throughout the hospital stay even after clinical improvement. Whole exon sequencing test revealed DNAH1 compound heterozygous mutation in this patient, which leaded to the diagnosis of PCD. A total of 9 papers of neonatal respiratory distress caused by PCD were retrieved. All 12 patients in those papers were term infants, presented with varying degree of respiratory distress, which mainly manifested as tachypnea, retractions, elevated work of breath, cyanosis, hypoxemia, oxygen dependence. Of the 12 patients, 8 (66.7%) had situs inversus viscerum, 6 (50.0%) had atelectasis, 6 (50.0%) needed non-invasive or invasive ventilation. A total of 3 papers of PCD caused by DNAH1 mutation with 9 patients were retrieved. Of these patients, 7 were diagnosed in childhood and 2 in adulthood. The main clinical manifestations were Kartagener syndrome (55.5%), bronchiectasis (33.3%), atelectasis (22.2%), post-infectious bronchiolitis obliterans (33.3%), neonatal respiratory distress (11.1%), and female infertility (11.1%). Conclusions The clinical features of PCD in neonates are mainly unexplained respiratory distress, higher incidence of situs inversus viscerum and atelectasis, and the demand for respiratory support is high. Raising awareness of the clinical features of PCD in infants is helpful for early diagnosis and intervention.

Objective By literature review to retrospectively study the clinical characteristics, diagnosis and treatment process, and prognosis of anti-melanoma differentiation associated gene 5 (MDA5) autoantibody-positive dermatomyositis-associated with interstitial lung disease (ILD) treated with tofacitinib (TOF), so as to improve the understanding of the disease. Methods Retrospectively analyze the clinical and laboratory characteristics, imaging findings and adverse reactions before and after TOF treatment in seven patients who admitted to the First Medical Center of Chinese PLA General Hospital from January 2018 to October 2021. Thirty-six cases were found by searching databases to summarize the efficacy and safety of TOF in treating patients with anti-MDA5 autoantibody-positive dermatomyositis-associated ILD. Results Of the 7 patients, 5 were female and 2 were male with mean age of 50(30-64) years, the mean disease duration was 3(1-36) months, and the mean follow-up time was 12(1-35) months. Of them, 4 received previously the other immunosuppressive therapy, and 3 were newly treated. One patient died, and the remaining 6 patients were in relatively stable condition and maintenance treatment. One patient experienced fungal infection in the 18th month after TOF treatment. A total of 36 cases of anti-MDA5 autoantibody-positive dermatomyositis have been reported in databases. Clinical symptoms, laboratory tests and imaging findings were all improved after TOF therapy. Opportunistic infection occurred in 9(25%) cases after application of TOF. Conclusion Application of TOF is an effective and safe regimen in treatment of anti-MDA5 autoantibody-positive dermatomyositis-associated ILD, while attention should be paid for monitoring the opportunistic infection during treatment.

Intestinal tract is the largest immune organ of human body where hundreds of millions of microorganisms are colonized which are called intestinal flora. Each intestinal flora checks and balances each other, depends on and complements each other, and forms a mutually beneficial symbiotic relationship with the host. Changes in quantity and type of intestinal flora will cause the imbalance of intestinal microecology, affect the systemic immune function through immune regulation, and then affect the progress of the disease. At present, it has been found that intestinal microecology is closely related to rheumatic immune diseases such as systemic lupus erythematosus, ankylosing spondylitis, gouty arthritis and rheumatoid arthritis. Taking intestinal flora as the starting point to explore the pathogenesis of gout has become a new research hotspot. Based on the current research, the relevant literature was consulted in present paper, and the intestinal microecological composition and function, the structural characteristics of intestinal flora in patients with gout, the mechanism of intestinal flora in the pathogenesis of gout, and the treatment of probiotics, traditional Chinese medicine and fecal microbial transplantation were reviewed, in order to provide new ideas and directions for prevention and treatment of gout in the future.

Malocclusion seriously affect oral health and general health of patients, and keep a high prevalence remaining for many years. Orthodontics is an effective treatment. It is reported that osteogenesis by drag reduction distraction of the periodontal ligament can safely and efficiently accelerate the movement of orthodontic tooth, so might be used to solve some difficult problems caused by traditional correcting methods which took a long treatment duration, increased the risk of dental caries, periodontitis and root resorption. However, periodontal ligament distraction (PDLD) has not been widely used in clinical practice due to large force, inconvenient exertion, and poor comfort of patients. With the rapid development of high-throughput sequencing technology, more mechanical force-sensitive genes, non-coding RNA and lncRNAs/circRNA-miRNAs-mRNAs regulatory network maps involved in regulation have been found. At the same time, the research and development of accurate measurement and control and automatic distraction devices have also made great progress, which can gradually overcome the technical defects of PDLD in the past. A variety of new automatic distraction devices such as motor system, hydraulic system, shape memory alloy and piezoelectric motor have been developed, which have achieved encouraging results in animal experiments and clinical trials. Therefore, PDLD has made rapid progress in minimally invasive and automated aspects. The previous studies addressing the development history, important technical parameters, molecular biological mechanism, histological characteristics, technical advantages and innovation of PDLD have been reviewed in present article, in order to make a comprehensive summary of the latest progress in research and provide reference for accelerating the technical innovation and clinical application of orthodontic tooth movement.

Vesicovaginal fistula (VVF) is an abnormal anatomical structure formed between the bladder and vagina, which usually occurs after gyneco-obstetric or pelvic surgery. VVF is one of the most common female genitourinary fistulas, causing serious distress to patients' physical and mental health and the quality of life. At present, the majority of VVF patients have poor outcomes in conservative therapy such as continuous bladder drainage and electrocoagulation, surgical repair is the main treatment option. The traditional surgical methods include transvaginal repair and transabdominal open repair. In recent years, with the development of minimally invasive techniques such as laparoscopic/robot-assisted laparoscopic surgery, the selection of VVF repair procedures has become more diverse, and the safety and efficacy of the operation have been continuously improved. However, there is no uniform standard for the timing and optimal surgical method for VVF repair. This article reviews the current progress in the treatment of VVF, and provides a reference for surgeons to formulate the optimal options for individual differences.