Ulcerative colitis (UC) is a chronic inflammatory bowel disease primarily localized to the mucosa and submucosa of the colorectal region. It is clinically characterized by diarrhea, bloody mucopurulent stools, abdominal pain, alternating periods of flare-ups and remission. Although its pathogenesis remains incompletely understood, it is associated with multiple factors including environment, genetics, gut microbiota and immunity. Tryptophan, an essential amino acid in humans, undergoes catabolism via three major pathways: the kynurenine, indole and 5-hydroxytryptamine pathways. Diverse tryptophan metabolites modulate intestinal barrier integrity, immune responses, inflammatory processes and microbial homeostasis, thereby influencing UC progression. Investigating the interplay between tryptophan metabolic disturbances and UC may facilitate the development of novel adjuvant therapeutic strategies. This article reviews the research progress on the three pathways of tryptophan metabolism, the pathological mechanisms linking tryptophan metabolism disorders to UC, and the UC treatment strategies targeting tryptophan metabolism.

Acute respiratory distress syndrome (ARDS) is a severe, acute and diffuse inflammatory lung injury arising from multiple etiologies, characterized by alveolar-capillary barrier disruption, pulmonary edema and hypoxemia, with mortality rates ranging from 35% to 50% among critically ill patients. Current management primarily relies on mechanical ventilation and supportive pharmacotherapy; however, there remains a lack of specific therapies for irreversible alveolar-capillary barrier damage, underscoring an urgent need for novel therapeutic strategies. Cellular therapy has emerged as a key focus in ARDS research owing to its multi-targeted actions: in terms of immunomodulation, mesenchymal stem cells (MSCs) and induced pluripotent stem cells (iPSCs) secrete anti-inflammatory factors such as prostaglandin E2 (PGE2) and interleukin (IL)-10, which inhibit the nuclear factor-κB (NF-κB) pathway, reduce levels of pro-inflammatory cytokines including tumor necrosis factor-α (TNF-α) and IL-6, and regulate immune cell homeostasis to mitigate excessive inflammatory responses; for antioxidative stress, MSCs and their exosomes restore mitochondrial function by activating the Nrf2-ARE pathway, diminish reactive oxygen species production and alleviate oxidative damage; regarding tissue repair, MSCs promote the proliferation and migration of alveolar epithelial cells and vascular endothelial cells via the Wnt/β-catenin pathway, while endothelial progenitor cells home to the injury site to repair the vascular endothelium and reduce vascular permeability; in relation to antifibrotic and anti-apoptotic effects, MSCs secrete hepatocyte growth factor to inhibit the TGF-β/Smad pathway and reduce myofibroblast activation, and exosomes deliver miRNAs to suppress alveolar epithelial pyroptosis and delay the fibrotic process. Clinical studies on corona virus disease 2019 (COVID-19)-associated ARDS have confirmed that MSCs, exosomes and regulatory T cells can effectively modulate inflammation and improve oxygenation, while umbilical cord blood, immunity-and-matrix regulatory cells and other cellular products, when combined with standard treatments, have demonstrated synergistic therapeutic potential. Nevertheless, cellular therapy for ARDS faces multiple challenges: therapeutic outcomes are influenced by cell source, dosage, timing of administration and patients’ baseline conditions, with limited long-term prognostic data available; safety concerns include microembolism, the tumorigenicity of iPSCs and immunogenicity issues; and standards for cell expansion, cryopreservation and quality control remain unstandardized, while the core mechanisms underlying therapeutic effects await further clarification. This article systematically reviews the pathogenesis of ARDS and advances in basic and clinical research on cellular therapy, aiming to provide new insights for future treatment strategies.

To analyze the risk factors for incomplete immune reconstitution in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS), and to construct and validate a visual nomogram prediction model.

The clinical data of 302 patients with HIV/AIDS who were treated for the first time at Zhongnan Hospital of Wuhan University from January 1st, 2016 to November 30th, 2020 before the initiation of antiretroviral therapy (ART) were analyzed, retrospectively. The patients were divided into immunological response group (IRs group) (202 cases) and incomplete immune reconstitution group (INRs group) (100 cases) based on the CD4⁺ T lymphocyte count for four consecutive years after the initiation of ART. All participants were randomly assigned to the training set (212 cases) and the validation set (90 cases) with a ratio of 7∶3. Random forest, Lasso regression and multivariate Logistic regression analysis were used to screen the predictive factors and construct a nomogram prediction model. The performance of the model was evaluated by comparing the receiver operating characteristic (ROC) curves, calibration curves and clinical decision curves of the training set and the validation set.

Among the 212 cases in the training set, 72 cases had incomplete immune reconstitution, with an incidence rate of 33.96%; among the 90 cases in the validation set, 28 cases had incomplete immune reconstitution, with an incidence rate of 31.11%. In the training set, the baseline CD4⁺ T lymphocyte count, white blood cell (WBC), platelet (PLT), and hemoglobin (Hb) levels of INRs group were significantly lower than those of IRs group (all P<0.05); the proportion of patients with co-infection of hepatitis B virus (HBV), age at ART initiation, baseline HIV load, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels of INRs group were significantly higher than those of the IRs group (all P<0.05); the route of infection and WHO stage between the two groups were with significant differences (both P<0.05). However, there were no statistically significant differences in gender, hepatitis C virus (HCV) antibody, ART regimen, body mass index (BMI), ART initiation delay, serum creatinine (SCr), triglyceride (TG) and cholesterol (TC) between the two groups (all P>0.05). The immune reconstitution incomplete predictors selected by random forest were baseline CD4⁺ T lymphocyte count, ART initiation age and WBC; the immune reconstitution incomplete predictors selected by Lasso regression were baseline CD4⁺ T lymphocyte count, ART initiation age and HBV co-infection. The multivariate Logistic regression analysis of the above factors (baseline CD4⁺ T lymphocyte count, ART initiation age, WBC and HBV co-infection) showed that a higher baseline CD4⁺ T lymphocyte count (OR=0.986, 95%CI: 0.982-0.990, P<0.001) was a protective factor for incomplete immune reconstitution in patients with HIV/AIDS , while a later ART initiation age (OR=1.035, 95%CI: 1.009-1.061, P=0.008) and HBV co-infection (OR=8.326, 95%CI: 1.836-37.765, P=0.006) were all independent risk factors for incomplete immune reconstitution in HIV/AIDS patients. Based on the above three predictors (baseline CD4⁺ T lymphocyte count, ART initiation age and HBV co-infection), a risk prediction model for incomplete immune reconstitution was constructed. The area under the ROC curve (AUC) of the training set and validation set were 0.882 and 0.825, respectively. The mean absolute errors of the calibration curves of the training set and validation set were 0.038 and 0.030, respectively; and the Brier scores were 0.135 and 0.154, respectively. The clinical decision curve (DCA) analysis indicated that the prediction model had clinical practical value in both the training set and validation set within the threshold probability range of 10% to 70%.

The nomogram model constructed based on baseline CD4⁺ T lymphocyte count, age at ART initiation and HBV co-infection has high performance in predicting immune reconstitution failure, and is helpful for clinical risk assessment and clinical decision-making.

To analyze the consistency of gene Xpert Mycobacterium Tuberculosis (MTB)/Rifampicin resistance assay (Xpert-MTB/RIF) and targeted metagenomic sequencing (tNGS) in detection of MTB, and to analyze the influencing factors of consistency differences.

The clinical data of 95 patients with suspected tuberculosis (TB) admitted to Lu’an People’s Hospital from October 2023 to May 2025 were analyzed, retrospectively. The consistency analysis was performed on MTB detection results from Xpert MTB/RIF and tNGS technologies, and the efficacy of the two methods in assisting TB diagnosis were analyzed by receiver operating characteristic (ROC) curves. The influencing factors of the consistency of Xpert MTB/RIF and tNGS detection results were analyzed by Logistic regression analysis. Cluster analysis was used to divide the enrolled patients into high-risk group (35 cases) and low-risk group (60 cases) based on different uric acid (UA) levels, and the differences in distribution characteristics of influencing factors of MTB detection consistency using Xpert MTB/RIF and tNGS technologies between the two groups were compared.

According to the final clinical diagnostic criteria, there were 55 TB cases and 40 non-TB cases. ROC curve analysis showed that the area under the ROC curve (AUC) for Xpert MTB/RIF and tNGS in assisting TB diagnosis were 0.931 (0.834-0.983) and 0.941 (0.884-0.975), respectively. The sensitivity and specificity of Xpert MTB/RIF were 90.91% and 90.00%, while those of tNGS were 90.91% and 92.50%, respectively. Logistic regression analysis indicated that age≥54 years old (OR=1.154, 95%CI: 1.059-1.226, P=0.019), disease type was non-TB (OR=6.836, 95%CI: 1.813-25.776, P=0.005), specimen type was sputum (OR=7.215, 95%CI: 5.264-8.965, P=0.005), and UA≥435.52 µmol/L (OR=5.643, 95%CI: 2.565-8.643, P=0.005) were all independent risk factors affecting the diagnostic concordance between Xpert MTB/RIF and tNGS. The diagnostic concordance between the two methods was higher in TB patients than that of non-TB patients, and alveolar lavage fluid specimens showed higher diagnostic concordance than sputum specimens. In the high-risk group, the proportion of “fewer risk factors distribution” type was significantly lower than that in the low-risk group, with significant difference (χ²=10.887, P=0.023).

Xpert MTB/RIF and tNGS demonstrated good consistency in MTB detection, the consistency is significantly affected by age, disease type, sample type and uric acid level.

To investigate the influencing factors for nucleic acid negative conversion and cinical characteristic of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of children in different age groups during the Omicron epidemic.

The clinical data of 155 children infected with SARS-CoV-2 admitted to Beijing Ditan Hospital, Capital Medical University from January 28th, 2022 to June 20th, 2023 were analyzed, retrospectively. According to the differences in immune system development and epidemiological characteristics, children were divided into<7-year-old group (24 cases), 7-12-year-old group (36 cases) and>12-year-old group (95 cases). The clinical characteristics, laboratory test indicators and vaccination distribution of the three groups were compared, respectively; Inter-group comparisons were analyzed by Chi-square test, rank sum test or one-way ANOVA. The related factors for SARS-CoV-2 nucleic acid conversion to negative were screened by Spearman correlation analysis, and the independent influencing factors were identified by constructing multiple linear regression model.

The proportion of children<7-year-old with a clinical classification of common type was higher than that of 7-12-year-old group (20.83% vs. 0.00%: P=0.008) and>12-year-old group (20.83% vs. 2.11%: P=0.004), with significant differences. The hospital duration [9.00 (8.00, 14.00) days] and nucleic acid negative conversion time [7.00 (6.25, 7.00) days] of children in<7-year-old group were shorter than those of 7-12-year-old group [14.00 (9.25, 15.75) days, 9.00 (6.00, 12.00) days] and>12-year-old group [13.00 (10.00, 15.00) days, 10.00 (8.00, 12.00) days], with significant differences (all P<0.05). The distribution of cronavirus dsease 2019 (COVID-19) vaccine doses in<7-year-old group [0 dose: 62.50% (15/24), 1 dose: 12.50% (3/24), 2 doses: 25.00% (6/24), 3 doses: 0.00% (0/24)] were different from those of 7-12-year-old group [0 dose: 5.56% (2/36), 1 dose: 11.11% (4/36), 2 doses: 77.78% (28/36), 3 doses: 5.56% (2/36)] and>12-year-old group [0 dose: 4.21% (4/95), 1 dose: 3.16% (3/95), 2 doses: 90.53% (86/95), 3 doses: 2.11% (2/95)], with significant differences (Z=－5.810, P<0.001; Z=－7.251, P<0.001). The incidence of nasal congestion and runny nose of children in<7-year-old group [39.13% (9/23)] was higher than that of>12-year-old group [14.12% (12/85)], with significant difference (P=0.015). The incidence of pharyngeal discomfort of children in>12-year-old group [57.65% (49/85)] was higher than that of<7-year-old group [21.74% (5/23)], with significant difference (χ²=9.336, P=0.002). The incidence of convulsions, vomiting and diarrhea among<7-year-old group, 7-12-year-old group and>12-year-old group were with significant differences (χ²=6.029, P=0.026; χ²=6.614, P=0.027), but no statistically significant difference was found between any two groups after Bonferroni correction (all P>0.0167). The proportion of children with elevated interleukin (IL) 6 in>12-year-old group [47.37% (45/95)] were lower than those of<7-year-old group [75.00% (18/24)] and 7-12-year-old group [72.22% (26/36)], with significant differences (χ²=5.872, P=0.015; χ²=6.496, P=0.011). The levels of lactate dehydrogenase [182.15 (161.00, 215.00) U/L], D-dimer [0.25 (0.18, 0.49) μg/ml] and N gene Ct value [21.92 (17.98, 26.41)] of children in>12-year-old group were all lower than those of<7-year-old group [275.35 (215.45, 320.10) U/L, 0.49 (0.33, 0.76) μg/ml, 27.59 (22.53, 32.60)] and 7-12-year-old group [237.35 (205.57, 260.15) U/L, 0.36 (0.25, 0.87) μg/ml, 27.90 (21.33, 34.44)], with significant differences (all P<0.05). The ORF1ab gene Ct value [23.80 (20.56, 29.30)] of children in>12-year-old group was lower than that of 7-12-year-old group [30.07 (22.85, 36.46)], with significant difference (Z=3.083, P=0.002). The anti-SARS-CoV-2 IgG level [3.32 (1.57, 8.28) S/CO] of children in 7-12-year-old group was higher than those of<7-year-old group [0.81 (0.03, 14.58) S/CO] and>12-year-old group [1.36 (0.58, 4.18) S/CO], with significant differences (Z=－2.537, P=0.034; Z=2.421, P=0.046). Spearman correlation analysis showed that age (ρ=0.312, P<0.001), body mass index (ρ=0.250, P=0.002), having received more than two doses of vaccine (ρ=0.326, P<0.001), presence of symptoms (ρ=0.445, P<0.001), fever (ρ=0.334, P<0.001), pharyngeal discomfort (ρ=0.401, P<0.001), headache and dizziness (ρ=0.252, P=0.002), neutrophil-to-lymphocyte ratio (ρ=0.369, P<0.001), IL-6 (ρ=0.192, P=0.016), and creatinine (ρ=0.323, P<0.001) were positively correlated with the time of SARS-CoV-2 nucleic acid negative conversion, while aspartate aminotransferase (ρ=－0.278, P<0.001), lactate dehydrogenase (ρ=－0.175, P=0.029), activated partial thromboplastin time (ρ=－0.162, P=0.044), D-dimer (ρ=－0.331, P<0.001) and anti-SARS-CoV-2 IgG (ρ=－0.278, P<0.001) were negatively correlated with the time of SARS-CoV-2 nucleic acid negative conversion, all with significant differences. The multiple linear regression model showed that the model was significant as a whole (F=7.016, P<0.001), and this model could explain 43.4% of the variation in SARS-CoV-2 nucleic acid negative conversion (R²=0.434). Whether having symptoms (β=0.263, 95%CI: 0.873-6.513, P=0.011) and pharyngeal discomfort (β=0.153, 95%CI: 0.029-2.603, P=0.045) were independent risk factors for delayed SARS-CoV-2 nucleic acid negative conversion, and the level of anti-SARS-CoV-2 IgG (β=－0.209, 95%CI: －0.022-0.002, P=0.022) was an independent protective factor for shortened SARS-CoV-2 nucleic acid negative conversion time.

During the Omicron epidemic, the clinical manifestations of children infected with SARS-CoV-2 were mainly mild, and the clinical features were closely related to age. Presence of symptoms and sore throat could prolong the time of SARS-CoV-2 nucleic acid negativity, while high level of SARS-CoV-2 IgG antibody could help shorten the conversion time to negativity. Individualized management of children in different age groups should be emphasized, and the value of vaccination and antibody monitoring in prognosis assessment should be highlighted.

To evaluate the clinical efficacy and safety of stratified drainage in the treatment of suppurative intracranial infection.

The clinical data, treatment outcomes and follow-up of 82 patients diagnosed with suppurative intracranial infection in the Plastic Surgery Hospital of the Chinese Academy of Medical Sciences from October 1st, 2022 to October 1st, 2023 were analyzed, retrospectively. Categorical data such as gender, type of primary disease and type of infecting bacteria were described as cases (%). Quantitative data, including layered drainage time and infection control time were expressed as medians (interquartile range) [M (P₂₅, P₇₅)], comparisons between groups were performed by Mann-Whitney U test.

All the 82 patients were hospitalized for more than 30 days, and all exhibited multidrug-resistant (MDR) bacterial infection and were treated with stratified drainage for suppurative intracranial infection. The culture results of pus or cerebrospinal fluid were positive before operation, including 78 (95.1%) cases of Gram-negative bacilli infection and 11(13.4%) cases of Gram-positive cocci infection. The number of patients’ systemic drainage tubes was more than 2, up to 6. The incidence of ventricular empyema was 56.1% (46/82), including 38 cases (46.3%) with drainage from the temporal horn of the lateral ventricle, 12 cases (14.6%) with drainage from the fourth ventricle and 19 cases (23.2%) with drainage from the lumbar cistern. The 30 day infection control rate was 91.5% (75/82) and infection control period was [15 (10, 21)] days. After 6-month follow-up, 4 (4.9%) cases died, 1 (1.2%) case had developed a new infection; 57 (69.5%) cases had undergone ventriculoperitoneal shunt procedures.

Through the subdural, intraventricular and subcutaneous multi-catheter combined with layered drainage technology, and dynamic cerebrospinal fluid pressure regulation mechanism, this study verified the significant effect of layered drainage technology in the effective control of cross anatomical level infection and improvement of cerebrospinal fluid circulation disorder, and provided innovative solutions for the treatment of suppurative intracranial infection.

To construct and validate a prediction model of multidrug-resistant organism (MDRO) infection risk in severe burned patients based on machine learning algorithm.

Clinical data of 675 patients with severe burn treated in Beijing Chao-yang Hospital, Capital Medical University from May 2017 to June 2024 were collected. Patients were divided into non-MDRO infection group (535 cases) and MDRO infection group (140 cases) based on whether MDRO infection occurred. The variable factors for MDRO infection were screened by the least absolute shrinkage and selection operator (LASSO). All the sample sizes were randomly divided into the training set (473 cases) and verification set (202 cases) according to the ratio of 7∶3, and the extreme Gradient Boost tree (XGBoost), Logistic regression, support vector machine (SVM), K-nearest neighbor (KNN) and Gauss Naive Bayes classification (GNB) prediction model were constructed, respectively. The performance of each model was evaluated by area under the receiver operating characteristic (ROC) curve (AUC), decision curve analysis (DCA) and calibration curve. The influence of each variable factor on the prediction model was analyzed using Shapley additive interpretation (SHAP).

Among the 675 patients, 140 cases developed MDRO infection, with an incidence of 20.74% (140/675). The burn depth (χ²=32.244, P<0.001), burn area (χ²=9.438, P=0.002), hypoalbuminemia (χ²=4.713, P=0.030), usage of antibacterial drugs before intensive care unit (ICU) admission (χ²=11.073, P=0.001), mechanical ventilation (χ²=4.125, P=0.042), usage of≥3 antibacterial drugs (χ²=22.031, P<0.001), duration of antibiotic use≥7 days (χ²=10.377, P=0.001), indwelling catheter (χ²=13.519, P<0.001), deep vein catheterization (χ²=11.743, P<0.001), duration of ICU stay (Z=21.359, P<0.001) and duration of hospitalization (Z=11.271, P<0.001) between patients in non-MDRO infection group and MDRO infection group were all with significant differences. Five prediction models were constructed based on LASSO regression screening variable factors of MDRO infection, among which the GNB model had the best overall performance, with the AUC of 0.877 (95%CI: 0.837-0.917) for the training set and 0.872 (95%CI: 0.809-0.934) for the validation set, and the calibration curve showed that the model’s predicted probability was closest to the actual results, and the DCA curve showed that when the risk probability value was between 0.10-1.00, the clinical net benefit was high. SHAP analysis showed that the factors affecting the occurrence of MDRO infection in severe burned patients, ranked by importance, were as follows: duration of ICU stay, duration of hospitalization, depth of burn, duration of antibiotic use≥7 days, indwelling urinary catheter, deep vein catheterization and use of antibiotics before ICU admission.

The GNB model based on burn depth, duration of antibiotic use≥7 days, indentation catheter, deep vein catheterization, use of antibacterial drugs before admission to ICU, duration of stay in ICU and duration of hospitalization are the best prediction models for MDRO infection in patients with severe burns, which has some guiding significance for clinicians to develop effective prevention and control strategies.

To investigate the clinical characteristics of lung cancer patients with pulmonary tuberculosis after chemotherapy and to identify the influencing factors for adverse outcomes.

Clinical data of 58 lung cancer patients who developed pulmonary tuberculosis after chemotherapy admitted to Xiangtan Central Hospital from May 2017 to July 2025 were collected, retrospectively, including 18 patients treated with immunocheckpoint inhibitor (ICIs) (ICIs group), while the remaining 40 patients were included in non-ICIs group. Patients were categorized into adverse outcome group (27 cases) and favorable outcome group (31 cases) based on treatment outcomes. Univariate and multivariate Logistic regression analyses were performed to identify influencing factors for adverse treatment outcomes (non-tuberculous death, tuberculous death, treatment failure or loss to follow-up) of lung cancer patients after chemotherapy.

ALC level of patients in ICI group was significantly lower than that of non-ICI group [0.76 (0.62, 1.05)×10⁹/L vs. 1.18 (0.95, 1.52)×10⁹/L: U=168.4, P=0.004], while the levels of NLR [4.7 (3.2, 6.5) vs. 2.8 (2.0, 3.5): U=105.5, P<0.001] and C-reactive protein [32.5 (21.0, 54.8) mg/L vs. 13.5 (8.2, 21.5) mg/L: U=97.6, P=0.001] were significantly higher than those of non-ICI group. Additionally, the proportion of patients with old pulmonary tuberculosis (33.3% vs. 17.5%: χ²=5.010, P=0.028), positive acid-fast sputum smear rate (77.8% vs. 47.5%: χ²=5.660, P=0.017) and positive sputum MTB DNA rate (88.9% vs. 55.0%: χ²=5.100, P=0.024) were significantly higher of patients in ICI group compared with non-ICI group. The results of multivariate Logistic regression analysis showed that ICIs therapy (adjusted OR=8.85, 95%CI: 2.41-32.52, P=0.001) and prior tuberculosis (adjusted OR=4.14, 95%CI: 1.38-12.42, P=0.011) were independent risk factors for adverse outcomes of patients with lung cancer complicated with pulmonary tuberculosis. Although diffused miliary opacities was with significant difference (adjusted OR=7.76, P=0.023), its excessively wide 95%CI (1.32-45.65) and limited number of events (n=5) precluded its establishment as a stable independent risk factor.

ICIs therapy is the strongest independent risk factor for adverse outcomes inpatients with lung cancer and pulmonary tuberculosis, while prior tuberculosis history increases the risk by 4-fold. Patients with diffused miliary opacities on chest imaging should be vigilant for severe tuberculosis, however, the independent predictive value needs to be further verified by large sample study.