The colonization of the gut microbiota in adolescents is unstable and more diverse than adults. Studies have shown that the intestinal bacterial flora of depression patients is imbalanced, indicating that there is a certain connection between depression and the intestinal flora. Probiotics refers to active microorganisms that are beneficial to the human body, mainly including yeast, probiotic spores, Clostridium butyricum, Lactobacillus, Bifidobacterium, Actinomycetes, etc. Pharmacological studies have found that it has various pharmacological effects such as stabilizing gut microbiomes, promoting digestion and absorption, and improving immunity. Recent studies have shown that probiotics also has an anti-depressant effect, can improve mood through the microbiota-gut-brain axis and other ways, and has been confirmed by experiments in animals and humans. This article reviews recent studies on the characteristics of adolescent intestinal flora and the antidepressant mechanism of probiotics in adolescents.

Objective To investigate the diagnostic value of platelet parameters, fibrinogen (Fib) and D-dimer for deep venous thrombosis (DVT). Methods Six hundred and sixty-seven patients with DVT hospitalized in the Peripheral Vascular Disease Department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from June 2014 to June 2019 were selected as the observation group, and 200 outpatients without DVT were selected as the control group. The general data, platelet parameters [platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), platelet hematocrit (PCT)and platelet-large cell ratio (P-LCR)], FIB and D-dimer of the subjects were collected, and the differences in the above indexes were compared between the two groups. Logistic regression was used to analyze the risk factors of DVT, Pearson correlation was used to analyze the relation between PLT, MPV, PDW, PCT, P-LCR, Fib and D-dimer, and area under ROC curve (AUC) were used to analyze the diagnostic value of the above indexes for DVT. Results Compared with control group, the levels of MPV, PDW and P-LCR of DVT group decreased (P<0.05), the levels of Fib and D-dimer of DVT group increased, and the differences were statistically significant (P<0.05). Fib and D-dimer were not only risk factors of DVT (OR=1.493, 28.154, P<0.05), but also independent risk factors of DVT (OR=1.739, 4.837, P<0.01); P-LCR was the protective factor of DVT (OR=0.914, P<0.05). PLT was negatively correlated with MPV, PDW and P-LCR (r=–0.269, –0.233, –0.120, P<0.01), positively correlated with PCT (r=0.062, P<0.01); MPV was positively correlated with PDW and P-LCR (r=0.945, 0.597, P<0.01); PDW was positively correlated with P-LCR (r=0.582,P<0.01) and negatively correlated with D-dimer (r=–0.551, P<0.01). MPV, PDW, P-LCR and Fib had low diagnostic value for DVT(AUC was 0.588, 0.606, 0.588 and 0.699, P<0.01), and D-dimer had medium diagnostic value (AUC was 0.882, P<0.01); MPV, PDW and P-LCR combined with Fib could improve the sensitivity of Fib diagnosis alone (53.3%-54.7% vs. 49.6%), and combined with D-dimer could improve the specificity of D-dimer diagnosis alone (88.1%-89.0% vs. 81.4%). Conclusion Platelet parameters (MPV,PDW, P-LCR), Fib and D-dimer have certain reference value for clinical diagnosis and disease condition evaluation of DVT.

Hepatic encephalopathy (HE) is a common clinical end-stage liver disease complicated with a complex neuropsychiatric syndrome, the occurrence of HE often suggests a poor outcome in patients with liver disease. The pathological mechanism involved in HE is complex, and the exact mechanism remains unclear. In recent years, with the continuous in-depth studies on the intestinal flora of patients with cirrhosis, the correlation between intestinal flora changes and HE occurrence has become the focus of attention. At present, the treatment of HE by regulating intestinal flora imbalance has achieved certain efficacy.Therefore, the relationship between intestinal flora and HE, as well as the treatment measures for HE are reviewed, aiming to provide new ideas for further exploring the pathogenesis of HE and new theoretical basis for clinical treatment of HE.

Objective To compare the safety and curative effect of video-assisted thoracoscopic surgery (VATS) and traditional thoracotomy in treatment of traumatic hemothorax. Methods The clinical data of 91 patients with hemothorax (received VATS) and 131 patients (received thoracotomy) in the Second Affiliated Hospital of PLA Air Force Military Medical University from January 2012 to December 2018 were retrospectively case-control analyzed. The curative effects between the two groups were compared by propensity score matching (PSM) method, and the risk factors of complications were predicted with multivariate logistic analysis. Results The total incidence of complications in the 222 patients was 22.1%. One patient died in thoracotomy group, whereas no patient died in VATS group. Before PSM, the numbers of fractured ribs, proportions of ribs fixation surgery and blunt injuries were lower (P<0.001) with lower incidence of complications (P=0.008) and shorter hospital length of stay (LOS) (P<0.001) in VATS group than those in thoracotomy group. After 1:1 PSM, 120 patients (60 patients in each group) were selected for further statistical analysis, and no significant difference was then identified between the two groups in the rate of complications and the hospital LOS (P>0.05). Significant statistical differences existed between the two groups in postoperative volume of drainage (P=0.006), drainage time (P=0.008), as well as postoperative hospital LOS (P=0.022) and ICU length of stay (P=0.010). Multivariate logistic analysis showed that the operation mode was not the independent risk factor for postoperative complications of traumatic hemothorax operation (OR=0.848, P=0.755). Conclusions VATS is safe and effective for hemodynamically stable patients with traumatic hemothorax since it can avoid the huge trauma of traditional thoracotomy,accelerate postoperative recovery of patients and shorten their postoperative hospital stay.

Stress is a non-specific response of the body when suffering from internal or external factors. It is involved in the development and progression of many physical and mental diseases such as irritable bowel syndrome, functional gastrointestinal diseases, anxiety and depression. It is the main cause of non-combat attrition. Gut microbiota can regulate the body's metabolism,immune and nervous system development and functions through the gut microbiota-gut-brain axis and affect the health and behavior. The interaction between its composition and function and stress-related diseases is gradually being revealed. The intervention and regulation of gut microbiota may become a new solution to prevent and treat stress-related diseases and participate in influencing the reaction of military personnel to military stress. This review focuses on the research progress of stress-related mechanisms, gut microbiota characteristics and related intervention research, the study status of military stress-related and gut microbiota and the prospects of its application.

Heart failure is the end state of various cardiovascular diseases, accompanied by a seriesof energy metabolism changes including transformation of energy substrates, mitochondrial dysfunction, and depletion of high-energy phosphate compounds, etc. In normal heart, fatty acid is the main energy metabolism substrate. However, myocardial substrate metabolism is damaged during heart failure, and metabolic substrate conversion characterized by ketone body occurred. It is of great significance to better understand the metabolism substrate selection during heart failure, regulatory mechanism and its pathophysiological significance for developing novel therapeutics targeting heart failure. The research progress on the changes of myocardial energy metabolism substrates in heart failure, especially the latest progress of ketone body as the substrate in recent years were reviewed in present paper.

Objective To analyze the correlation of plasma fibrinogen (Fib) and blood lipid composition to the progression of non-culprit coronary lesions (NCCLs) in CHD patients after percutaneous coronary intervention (PCI). Methods The clinical data were collected and retrospectively analyzed of 210 patients admitted from January 2017 to December 2017 in the Department of Cardiovascular Medicine of the First Hospital of Lanzhou University, received the first PCI treatment, and repeated the coronary angiography (CAG) before December 31, 2020 (the interval between two operations should be at least 6 months). According to whether the NCCLs progressed, 210 patients were divided into progressive group (n=99) and non-progressive group (n=111), and then, according to the degree of NCCLs progression, patients in progressive group were further divided into three subgroups: mild(n=42), moderate (n=35) and severe (n=22) progressive subgroup. The baseline clinical data were compared between the patients in progressive group and in non-progressive group, and among the patients in mild, moderate and severe progression subgroups. The correlation of the plasma Fib and blood lipid composition to the progression of NCCLs, and the risk factors affecting the progression of NCCLs were analyzed. Results There were no statistical difference between progressive group and non-progressive group in gender, smoking history, drinking history, hypertension history, hyperlipidemia history, heart failure, and admission blood pressure(P>0.05), but the mean age was higher in progressive group than that in non-progressive group, and more patients with diabetes in progressive group than those in non-progressive group, and there existed statistically significant differences (P<0.05). The plasma levels of Fib, cholesterol (TC), low density lipoprotein cholesterol (LDL-C), and non-high density lipoprotein cholesterol (non-HDL-C) were higher in progressive group than those in non-progressive group with statistically significant differences (P<0.05).There existed no significant difference (P>0.05) between the two groups in the levels of triglyceride (TG) and HDL-C; with the increasing in the severity of NCCLs, plasma Fib, TG, LDL-C, and non-HDL-C increased gradually in the mildly, moderately, and severely advanced subgroups, while the plasma level of HDL-C decreased gradually, but no statistical difference existed among the subgroups (P>0.05); Fib, TC, LDL-C, non-HDL-C, and D-dimer were positively correlated with the NCCLs progression. And also,Fib was positively correlated with TC, LDL-C, and non-HDL-C. Gender, age, and diabetes history can be used as risk factors for the progression of NCCLs with OR values of 2.284, 1.052, and 0.293, respectively. Conclusion The plasma Fib and blood lipid composition are correlated with the progression of NCCLs, and Fib is also correlated with some lipid components, but is not a risk factor for NCCLs progression.

Objective To evaluate the safety and effectiveness of ultrasound-guided percutaneous thermal ablation in the treatment of low-risk unifocal papillary thyroid microcarcinoma (PTMC). Methods Patients with single-focal PTMC admitted to the 928th Hospital of the PLA Joint Logistic Support Force from June 2017 to June 2019 were selected, and ultrasound-guided percutaneous thermal ablation therapy was performed. The extent of ablation was assessed with contrast-enhanced ultrasound immediately after thermal ablation, and the ablation area, and thyroid function were measured for clinical evaluation at 1, 3, 6, 12,and 18 months, respectively. Clinical evaluation was performed at 1, 3, 6 and 12 months after thermal ablation. Results A total of 214 patients with PTMC were included, including 62 males (29.0%) and 152 females (71.0%), aged 17-77 (44.1±13.1) years old.The maximum diameter of the tumor was 0.2-1.0 (0.59±0.18) cm. The patients were followed up at 1, 3, 6, 12 and 18 months after thermal ablation, the follow-up time was 12-18 (15.14±3.01) months. After the initial thermal ablation, the maximum diameter of the ablated area was (1.372±0.440) cm, and gradually decreased to (1.108±0.438) cm, (0.753±0.440) cm, (0.483±0.324) cm,(0.162±0.205) cm, and (0.047±0.140) cm. After initial thermal ablation, the volume of ablated lesion was (1.083±1.819) cm³, and gradually decreased to (0.606±1.259) cm³, (0.273±0.784) cm³, (0.069±0.154) cm³, (0.006±0.156) cm³, and (0.001±0.004) cm³.The volume reduction ratio (VRR) at 1, 3, 6, 12 and 18 months after thermal ablation was 0.457±0.218, 0.837±0.150,0.943±0.090, 0.994±0.012, 0.999±0.002. There was a significant difference in VRR between every two follow-up visits (P<0.001).The thyroid function test results of patients before and 1 month after thermal ablation were normal, and there were no statistically significant differences (P>0.05). During the follow-up period, no tumor regrowth, local recurrence or distant metastasis was found.The most common complication was mild pain (31.8%, 68/214). Some patients developed toothache, sub-mandibular radiation pain and unilateral headache during ablation, and the pain symptoms were relieved immediately after ablation. All local pain symptoms were relieved 24-48 h after thermal ablation without treatment. Conclusions Ultrasound-guided percutaneous thermal ablation for the treatment of low-risk PTMC is safe and effective. It has less trauma and fewer complications, and can preserve the patient's thyroid function. This is a safe and effective alternative strategy for the treatment of low-risk PTMC, especially for patients who are not suitable for surgical treatment.

Objective To investigate the effect and potential mechanism of Boschniakia rossica polysaccharides (BRPS) on the invasion and migration of human liver cancer cells. Methods Different concentrations of BRPS (12.5, 25, 50, 100 and 200 μg/L)were screened on liver cancer HepG2 cells to identify the appropriate concentration. Based on culture conditions, the HepG2 cells were named control group (no treatment), hypoxia-inducible factor-1α (HIF-1α) group (transfected with LV-HIF-1α), HIF-1α-NC group (transfected with LV-HIF-1α-NC), BRPS group (add 50 μg/L BRPS), and BRPS+HIF-1α group (transfected with LV-HIF-1α,and add 50 μg/L BRPS). Hoechst33258 staining was used to evaluate cell apoptosis; flow cytometry was used to detect cell apoptosis rate; the scratch test was used to detect cells migration ability; Transwell test was used to detect cell invasion ability; Western blotting was used to detect HIF-1α and epithelial-mesenchymal transition (EMT) related factors E-cadherin and vimentin protein expressions in cells. Results The ideal BRPS concentration was identified as 50 μg/L. The results of Hoechst33258 staining showed that the blue fluorescence of hepatocarcinoma cells was weak in control group and HIF-1α-NC group, the blue fluorescence of HIF-1α group was dimer than control group; the blue fluorescence of BRPS group was brighter than control group; the blue fluorescence of BRPS+HIF-1α group was lower than that in BRPS group. In the control group, the apoptosis rate was 3.89%±1.25%; the cell healing rate was 63.35%±3.35%; the number of transwell cells was 122.60±3.29. Compared with control group, HIF-1α group showed a lower apoptosis rate (1.67%±0.86%, P<0.05), higher cell healing rate (87.48%±3.92%, P<0.05), and higher number of transwell cells(208.60±6.17, P<0.05). On the contrary, BRPS group showed a higher apoptotic rate (26.58%±1.63%, P<0.05), lower cell healing rate (14.82%±3.81%, P<0.05), and decreased number of transwell cells (68.80±4.25, P<0.05). Interestingly, in BRPS+HIF-1α group,the apoptosis rate was 12.14%±1.05%, higher than HIF-1α group but lower than BRPS group; the cell healing rate and the number of transmembrane cells were 32.59%±3.76% and (123.40±4.94) cells, respectively, both of which were lower than HIF-1α group but higher than that in BRPS group (P<0.05). Compared with control group, in HIF-1α group, the expression levels of HIF-1α and vimentin increased while E-cadherin decreased; however, in BRPS group, the expression levels of HIF-1α and vimentin decreased while E-cadherin increased (P<0.05). As expected, the expression levels of HIF-1α and vimentin in BRPS+HIF-1α group were lower than those in HIF-1α group but higher than those in BRPS group; the expression levels of E-cadherin was higher than that in HIF-1α group but lower than that in BRPS group (P<0.05). Conclusion BRPS can promote HepG2 cell apoptosis, inhibit cell migration and invasion. Its mechanism may be that it can suppress EMT by regulating HIF-1α.

Inguinal hernia is a common surgical disease, which is more and more common in the elderly and children. With the aging of the population and the opening of the second child, there are more and more patients with inguinal hernia surgery,and the difficulty and risk of anesthesia management are increasing. With the application of ultrasound visualization technology in anesthesia field, regional block anesthesia technology is guaranteed and developed. Regional block anesthesia is increasingly used in inguinal hernia surgery, especially in the elderly and children for anesthesia and analgesia. At present, regional anesthesia methods have emerged in endlessly. This article reviews the methods including paravertebral nerve block (PVNB), lumbar plexus nerve block(LPNB), quadratus lumborum block (QLB), ilioinguinal/iliohypogastric nerve block (IINB) and transversus abdominis plane block(TAPB) of regional block anesthesia for inguinal hernia surgery, and to explore the best.