Background: A high-calorie diet (HCD) is a significant pathogenic factor contributing to obesity and can induce dysbiosis in the intestinal flora. Fecal microbiota transplantation (FMT) has been recognized for potentially restoring intestinal microecology. However, precise mechanisms underlying its therapeutic effects remain largely elusive. This study aimed to investigate the impact of FMT on the gut microbiota-short-chain fatty acids (SCFAs)-G protein-coupled receptor 43 (GPR43)-interleukin-18 (IL-18) pathway in HCD-induced rats. The findings provide insights and evidence for preventing and treating pediatric diseases caused Methods: Forty specific pathogen-free (SPF)-grade Sprague-Dawley (SD) rats were randomly allocated into six groups: normal control 1 (NC1), normal control 2 (NC2), normal control 3 (NC3), high-calorie diets model (M), fecal microbe transplantation treatment (FMTT), and Medilac-Vita (MV) groups. Antibiotic intervention simulated the state of antibiotic-treated rats, and a specialized diet was used to replicate the HCD model. Based on group assignments, rats received a normal diet bacterial solution, normal saline enema, or MV. Clinical characteristics and colonic morphology were observed, while changes in gut microbiota, SCFAs, GPR43, and IL-18 were assessed using 16SrDNA, gas chromatography-mass spectrometry (GC-MS), hematoxylin-eosin (HE), immunohistochemistry (IHC), and enzyme-linked immunosorbent assay (ELISA), respectively. Results: FMT effectively restored the gut microbiota of antibiotic-induced rats. In the HCD-induced rats, FMTT significantly alleviated the pathological state and increased alpha indices and beta distances (p < 0.05). Furthermore, significant alterations in the relative abundances of gut bacterial genera associated with SCFAs production were observed. FMTT increased SCFA content in feces, especially acetic acid (p < 0.05). Notably, downstream pathways related to SCFAs, such as GPR43-IL-18, were modulated by FMT in HCD-induced rats (p < 0.05). Recognizing the crucial role of gut microbiota in SCFAs metabolism, a co-occurrence network among the Lactobacillaceae and SCFAs-GPR43-IL-18 was constructed. Conclusion: The Lactobacillaceae-acetic acid-GPR43-IL-18 pathway emerges as a potential biological basis for the pathological state of HCD-induced rats. FMT exhibits corrective properties by influencing this pathway.

Objective To investigate the effect of Yinlai Decoction (YD) on the microstructure of colon, and activity of D-lactic acid (DLA) and diamine oxidase (DAO) in serum of pneumonia mice model fed with high-calorie and high-protein diet (HCD). Methods Sixty male Kunming mice were randomly divided into 6 groups by the random number table method: normal control, pneumonia, HCD, HCD with pneumonia (HCD-P), YD (229.2 mg/mL), and dexamethasone (15.63 mg/mL) groups, with 10 in each group. HCD mice were fed with 52% milk solution by gavage. Pneumonia mice was modeled with lipopolysaccharide inhalation and was fed by gavage with either the corresponding therapeutic drugs or saline water, twice daily, for 3 days. After hematoxylin-eosin staining, the changes in the colon structure were observed under light microscopy and transmission electron microscope, respectively. Enzyme-linked immunosorbent assay was used to detect the protein levels of DLA and DAO in the serum of mice. Results The colonic mucosal structure and ultrastructure of mice in the normal control group were clear and intact. The colonic mucosal goblet cells in the pneumonia group tended to increase, and the size of the microvilli varied. In the HCD-P group, the mucosal goblet cells showed a marked increase in size with increased secretory activity. Loose mucosal epithelial connections were also observed, as shown by widened intercellular gaps with short sparse microvilli. These pathological changes of intestinal mucosa were significantly reduced in mouse models with YD treatment, while there was no significant improvement after dexamethasone treatment. The serum DLA level was significantly higher in the pneumonia, HCD, and HCD-P groups as compared with the normal control group ( P <0.05). Serum DLA was significantly lower in the YD group than HCD-P group ( P <0.05). Moreover, serum DLA level significantly increased in the dexamethasone group as compared with the YD group ( P <0.01). There was no statistical significance in the serum level of DAO among groups ( P >0.05). Conclusions YD can protect function of intestinal mucosa by improving the tissue morphology of intestinal mucosa and maintaining integrity of cell connections and microvilli structure, thereby reducing permeability of intestinal mucosa to regulate the serum levels of DLA in mice.

六维辨证观是北京中医药大学谷晓红教授基于理论教学与临床经验总结提出的辨证观念,强调从病因、病位、病期、病势、病理、病性6个不同维度对病证进行辨析,有利于中医临床思维的锻炼和形成.白虎汤证作为伤寒温病皆可见到的一种证态,目前对于其辨证及治疗仍需要深入探讨.文章从六维辨证角度出发,汇总了谷晓红、于河两代温病学教师在教学过程中对白虎汤证治的理解和思考,并结合伤寒温病学派的不同观点对其进行重新解读.将白虎汤证所处阶段概括为因感外邪入里所致肺胃脏腑功能失调的气分期,此期邪盛而正不衰,处于里热壅盛、津液耗灼状态,症状可见大热、大汗、口渴及符合里实热盛的脉象表现.同时提出白虎汤证之病位可扩展至肺胃,治以白虎汤而有防阳明太实,土克水,预护肾阴之效.通过六维辨证观对白虎汤证愈后转归的动态辨析可知,伤寒温病虽都可见到白虎汤证,但具体病期传变、病势转归、病理兼夹、治疗方药又有区别,由此衍生的一系列白虎汤类方不仅扩展了白虎汤的应用范围,丰富了其研究价值,对临床应用也具有重要意义.

目的 评价中医药干预代谢综合征系统评价的方法学质量及其结局指标的可靠程度.方法 电子检索Cochrane Library、Pubmed、Web of Science,中国知网、维普、万方、中国生物医学文献数据库有关中医药治疗代谢综合征的系统评价,筛选出符合纳入标准的系统评价,检索时间为建库日至2020年3月.采用AMSTAR 2量表评价纳入研究的方法学质量,运用GRADE系统对纳入研究的结局指标进行证据质量分级.结果 共纳入17个系统评价,其中进行meta分析15篇.AMSTAR 2评分均为极低质量.GRADE分级结果显示,2个结局指标的证据质量为高,8个结局指标的证据质量为中,19个结局指标的证据质量为低,60个结局指标的证据质量为极低.结论 按现行评价标准显示关于代谢综合征治疗的系统评价整体方法学质量较低,结局指标可靠程度受影响,因此,临床在参考系统评价的结论时需结合临床实际情况全面考虑适用性,期待未来开展高质量的研究,为代谢综合征的临床治疗提供指导.

深度访谈是最常用的一种质性研究资料收集方法,所获得的信息作为原始资料决定了质性研究的产出.掌握访谈过程中的实施要点能够提高访谈质量,丰富访谈资料,确保质性研究顺利开展;在访谈准备阶段,研究者要明确研究目的 ,开展预访谈,了解受访者背景资料,确定访谈时间地点,衣着妥当;访谈过程中,关注暖场、提问、追问、沟通环节的实施要点;访谈后及时整理资料,评估是否进行二次访谈或用其他资料补充.本研究结合名医传承研究实例,详解访谈过程中不同阶段的实施要点,为开展优质、高效的访谈提供思路,为进一步深入开展中医药质性研究提供参考.

目的 观察莱菔子对胃肠积热大鼠胃肠动力的影响,并探讨其作用机制.方法 选择60只SPF级雄性大鼠,随机分为正常组、胃肠积热组及莱菔子低、中、高、超高(0.015、0.03、0.06、0.12 g/mL)剂量组.正常组给予普通饲料喂养,胃肠积热组、莱菔子各剂量组给予高热量饲料喂养及52％牛奶溶液,莱菔子各剂量组给予莱菔子混悬液灌胃干预.观察各组大鼠体征,取大鼠胃及结肠组织做HE染色,行小肠推进实验,用ELISA法检测血清中胃饥饿素(Ghrelin)、胃泌素(GAS)、P物质(SP)、一氧化氮(NO)的含量.结果 胃肠积热组及莱菔子各剂量组大鼠体质量明显低于正常组(P＜0.05).胃肠积热组、莱菔子低剂量组、中剂量组小肠推进率明显低于正常组(P＜0.05),超高剂量组小肠推进率高于胃肠积热组(P＜0.05).胃肠积热组、莱菔子低剂量组、中剂量组血清中Ghrelin含量明显低于正常组及超高剂量组(P＜0.05).胃肠积热组血清中NO含量高于正常组、莱菔子高剂量组、超高剂量组(P＜0.05);胃肠积热组、莱菔子低剂量组血清SP含量明显低于正常组(P＜0.05),而超高剂量组血清NO含量则明显高于胃肠积热组(P＜0.05).各组大鼠血清中GAS含量未见明显差异(P＞0.05).结论 莱菔子可以升高胃肠积热大鼠血清中Ghrelin、SP含量,降低NO含量,增强小肠推进作用,从而促进胃肠积热大鼠的胃肠动力,但其作用与剂量有关,大剂量莱菔子的推动作用更加明显.

目的 研制儿童胃肠积热评价性量表.方法 由专业人员采集了453例研究对象的临床信息,共包括38个症状及体征.采用5种方法进行条目筛选,包括基于经典测量理论的离散趋势法、相关系数法、克朗巴赫系数法及因子分析法和项目反应理论.最终保留至少4种方法保留的条目,并结合专业知识形成量表.结果 最终形成量表共有25个条目,包括面赤、唇红、咽红肿、舌红、舌苔黄、手足心热、脉数、脉滑、恶热、口臭、口渴喜冷饮、食欲异常、腹痛、大便次数减少、大便干结、排便费力、大便臭、小便色黄、夜间汗出、夜卧不安、烦躁、鼻衄、鼻痂、易呼吸道感染和饮食不节则加重.其中10个条目为二分类变量,以有或无分级;15个条目为四分类变量,以频率或程度分级.结论 形成了以胃肠积热为核心的评价量表,为胃肠积热与相关疾病的研究奠定了基础.

目的 应用网络药理学方法探讨莱菔子对胃肠动力的影响及作用机制,指导莱菔子的临床应用.方法 对炒莱菔子水煎液进行超高效液相色谱-四极杆飞行时间质谱(UPLC/Q-TOF-MS)分析,推断其化学成分;利用ChemSpider数据库获取莱菔子化合物属性,通过SwissTargetPrediction平台获取莱菔子潜在靶点;利用GeneCard、HPO数据库及PALM-IST、PolySearch2文献挖掘服务器获取胃肠动力相关基因;利用String数据库构建药物靶基因-胃肠动力基因网络,使用Cytoscape软件使网络可视化并进行网络拓扑分析,通过Metascape平台进行核心基因的功能和通路富集分析.结果 筛选出与莱菔子相关的胃肠动力基因148个,与胃肠动力直接相关的莱菔子靶基因95个(含二者交集基因11个),基因功能和通路富集分析相关结果584条.结论 莱菔子对胃肠动力具有多靶点、多通路的作用特点,其有效成分与5-羟色胺等神经活性物质具有一定的结构相似性,可能通过激活以cAMP/cGMP为第二信使的G蛋白偶联受体信号通路、Ca2+信号通路及其他阳离子通道,从而影响胃肠道平滑肌的收缩与舒张.

Gastrointestinal heat retention syndrome (GHRS) refers to a condition that is associated with increased gastrointestinal heat caused by a metabolic block in energy. It is common in children and is closely related to the occurrence and development of recurrent respiratory tract infection, pneumonia, recurrent functional abdominal pain, etc. However, there are no standardized diagnostic criteria to differentiate the GHRS. Therefore, this study is aimed to establish a diagnostic model for children's GHRS and explore the possible biological basis by using systems biology to achieve. Furthermore, Delphi method and the clinical data of Lasso analysis were used to screen out the core symptoms. Nineteen core symptoms of GHRS in children were screened including digestive symptoms such as dry stool, poor appetite, vomiting, and some nervous system symptoms such as night restlessness and irritability. Based on the core symptoms, a GHRS diagnosis model was established using the eXtreme Gradient Boosting (XGBoost) method, and the accuracy of internal verification reached 93.03%. Relevant targets of the core symptoms in the Human Phenotype Ontology (HPO) were retrieved, and target interactions were linked through the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database, and core targets were selected after topological analysis using Cytoscape. Relevant biological processes and pathways were analyzed by applying the DAVID and KEGG databases. The enriched biological processes focused on the cell proliferation, differentiation, apoptosis, and mitochondrial metabolism, which were mainly associated with PI3K-AKT, MAPK network pathways, and the Wnt signaling pathway. In conclusion, we established a diagnosis model of GHRS in children based on the core symptoms and provided an objective standard for its clinical diagnosis. And, the Wnt signaling pathway and the estrogen receptor-activated PI3K-AKT and MAPK network pathways may play important roles in the GHRS processing.

以温热、湿热两大类温病为纲,通过分析吴鞠通在应用利小便法时的药物性味合化配伍,详细阐述了各类利小便法在《温病条辨》中的应用,以期指导临床逐邪从水道外出的思路和方法的具体应用.在湿热类温病中,淡渗通利小便以祛湿,通下利小便以逐邪;在温热类温病中,淡渗利小便以通热郁,甘苦益阴气以利小便,淡通活用变苦通.