Complete response of gallbladder cancer treated with gemcitabine and cisplatin chemotherapy combined with durvalumab:A case report and review of literature

BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.

Are Socially Responsible Banks More Risk Averse and Dividends Providers?Empirical Evidence from a Developing Economy

Purpose:This study examines whether socially responsible firms are uninterested in risk-taking and whether socially responsible banks are more dividend providers than socially irresponsible ones.We conducted the analysis using the least-squares method for 290-panel data observations of 32 commercial banks operating in Bangladesh from 2008 to 2018.Methodology:We employed Ordinary Least Squares Regression for 290-panel data observations of 32 commercial banks operating in Bangladesh from 2008 to 2018 using EViews software version-8.Moreover,we conducted descriptive analysis and correlations using SPSS software.We considered CSRI and CSRPI as the indicators of corporate social responsibility,dividend per share and stock dividend as a proxy of dividend policy,LEV(leverage),and non-performing loan to total loan as the indicators of financial risk,and lastly,Z score as the indicator of financial stability.Findings:Studies have shown that banks prioritizing social responsibility tend to pay dividends to their shareholders more frequently and consistently than banks that do not.In particular,banks that invest heavily in corporate social responsibility(CSR)tend to maintain a stable dividend payout,which can help address agency problems that arise from overinvestment in the CSR sector.Additionally,we found that banks that make huge expenditures on CSR also seem to have a low eagerness for risk-taking.Again,we found that the financial stability of a socially responsible bank is high and stable enough,which will help efficiently handle the bank’s financial risks,reduce price fluctuations,and increase financial assets that generally influence a bank’s monetary stability.Implications:Banks implementing fruitful CSR strategies can produce substantial shareholder advantages through high dividend payout levels.An expansion in CSR-related expenditure does not prompt a cut-down or reduce the portion of income paid out as dividends to shareholders.Therefore,the Output of our study will help provide critical information and a thorough understanding of corporate social responsibility and its association with the dividend policy,risk,and financial stability in the banking sector.This will also be useful to the researcher,students,and corporate policymakers while making a critical decision about whether a firm should make expenditures on CSR purposes,how it impacts a firm’s dividend decision,and its connection with its overall risk and financial stability.According to the study,corporate social responsibility should be integrated into a firm’s mission and strategy rather than appearing to be a mere act of generosity.Originality/Value:This study uniquely considers CSR,dividend policy,risk,and financial stability simultaneously in a developing country.Besides,the three-dimensional measures of CSR used in the research focused on developing the economy are a precious contribution.

Controlled illumination and seismic acquisition geometry for target-oriented imaging

The conventional method of seismic data acquisition geometry design is based on the assumption of horizontal subsurface reflectors, which often is not suitable for complex structure. We start from a controlled illumination analysis and put forward a method of seismic survey geometry design for target-oriented imaging. The method needs a velocity model obtained by a preliminary seismic interpretation. The one-way Fourier finite-difference wave propagator is used to extrapolate plane wave sources on the target layer to the surface. By analyzing the wave energy distribution at the surface extrapolated from the target layer, the shot or receiver locations needed for target layer imaging can be determined. Numerical tests using the SEG-EAGE salt model suggest that this method is useful for confirming the special seismic acquisition geometry layout for target-oriented imaging.

Target-oriented Gaussian beam migration using a modif ied ray tracing scheme

For large-scale 3D seismic data,target-oriented reservoir imaging is more attractive than conventional full-volume migration,in terms of computation efficiency.Gaussian beam migration(GBM)is one of the most robust depth imaging method,which not only keeps the advantages of ray methods,such as high efficiency and flexibility,but also allows us to solve caustics and multipathing problems.But conventional Gaussian beam migration requires slant stack for prestack data,and ray tracing from beam center location to subsurface,which is not easy to be directly applied for target-oriented imaging.In this paper,we modify the conventional Gaussian beam migration scheme,by shooting rays from subsurface image points to receivers to implement wavefield back-propagation.This modification helps us to achieve a better subsurface illumination in complex structure and allows simple implementation for target reservoir imaging.Significantly,compared with the wavefi eld-based GBM,our method does not reconstruct the subsurface snapshots,which has higher efficiency.But the proposed method is not as efficient as the conventional Gaussian beam migration.Synthetic and field data examples demonstrate the validity and the target-oriented imaging capability of our method.

Target-oriented Q-compensated reverse-time migration by using optimized pure-mode wave equation in anisotropic media

Research on seismic anisotropy and attenuation plays a significant role in exploration geophysics. To enhance the imaging quality for complicated structures, we develop several effective improvements for anisotropic attenuation effects in reverse-time migration (Q-RTM) on surface and vertical seismic profiling (VSP) acquisition geometries. First, to suppress pseudo-shear wave artifact and numerical instability of the commonly used anisotropic pseudo-acoustic wave equations, an optimized pure P-wave dispersion relation is derived and the corresponding pure-mode wave equation is solved by combining the finite-difference and Possion methods. Second, a simplified anisotropic pure-mode visco-acoustic wave equation (PVAWE) based on standard linear solid model is established. Third, a time-dispersion correlation strategy is applied to improve the modeling accuracy. Fourth, we extend a target-oriented scheme to anisotropic attenuated modeling and imaging. Instead of the conventional wavefield modeling and RTM, the proposed approach can extract available wavefield information near the target regions and produce high imaging resolution for target structures. Last, both anisotropic surface and VSP Q-RTMs are executed by combining optimized PVAWE, time-dispersion correlation and target-oriented algorithm. Modeling examples demonstrate the advantages of our schemes. Moreover, our modified Q-compensated imaging workflow can be regarded as a supplement to the classical anisotropic RTM.

The Openness Degree Study of the Jiaoshiba Shale Gas, Sichuan Basin, China–Potential Factor Responsible for Reversed Isotope Series

Objective Reversed alkane δ;C and δ;H values in many prolific shale plays all over the world have aroused much attention in the study of the formation mechanism of reversed isotope series in alkanes in the past few years（Zou Caineng et al., 2016）. Although many researchers have put forward different hypotheses, the mechanism has not been well understood yet. The openness degree of oil and gas system

Is thalamocortical tract injury responsible for memory impairment in a patient with putaminal hemorrhage?

Prior to development of diffusion tensor imaging （DTI）, there were many difficulties in visualization and estimation of the Papez circuit in the live human brain （Papez, 1995）. Diffusion tensor tractography （DTT）, derived from DTI, allows for identification and visualization of neural tracts in the Papez circuit （Concha et al., 2005; Kwon et al., 2010; Granziera et al., 2011; Jang and Yeo, 2013; Jang et al., 2014a）. In the current study, using DTT, we report on a patient who showed injured thalamocortical tract between the anterior thalamic nuclei and the cingulate gyrus following a putaminal hemorrhage.

Application of Responsible Tourism in Development of Tourism Destinations——A Case Study of Shangqiu City

The development of responsible tourism is always a focus of foreign scholars' attention,but the method of developing responsible tourism implemented in China's Shangqiu area,is the first of its kind. From the perspective of interests of many parties of tourists,tourism developers,government,and related group of people,this article puts forth the ideas of developing the cultural heritage tourism resources based on the basic ideas and goals of responsible tourism development,and especially researches the feasibility of specific implementation program. Understanding this will be of practical significance to the development of similar tourism resources,the protection and management of cultural relics in China.

A theory for three-dimensional response of micropolar plates

Through combined applications of the transfer-matrix method and asymptotic expansion technique,we formulate a theory to predict the three-dimensional response of micropolar plates.No ad hoc assumptions regarding through-thickness assumptions of the field variables are made,and the governing equations are two-dimensional,with the displacements and microrotations of the mid-plane as the unknowns.Once the deformation of the mid-plane is solved,a three-dimensional micropolar elastic field within the plate is generated,which is exact up to the second order except in the boundary region close to the plate edge.As an illustrative example,the bending of a clamped infinitely long plate caused by a uniformly distributed transverse force is analyzed and discussed in detail.

Thermo-hydro-poro-mechanical responses of a reservoir-induced landslide tracked by high-resolution fiber optic sensing nerves

Thermo-poro-mechanical responses along sliding zone/surface have been extensively studied.However,it has not been recognized that the potential contribution of other crucial engineering geological interfaces beyond the slip surface to progressive failure.Here,we aim to investigate the subsurface multiphysics of reservoir landslides under two extreme hydrologic conditions(i.e.wet and dry),particularly within sliding masses.Based on ultra-weak fiber Bragg grating(UWFBG)technology,we employ specialpurpose fiber optic sensing cables that can be implanted into boreholes as“nerves of the Earth”to collect data on soil temperature,water content,pore water pressure,and strain.The Xinpu landslide in the middle reach of the Three Gorges Reservoir Area in China was selected as a case study to establish a paradigm for in situ thermo-hydro-poro-mechanical monitoring.These UWFBG-based sensing cables were vertically buried in a 31 m-deep borehole at the foot of the landslide,with a resolution of 1 m except for the pressure sensor.We reported field measurements covering the period 2021 and 2022 and produced the spatiotemporal profiles throughout the borehole.Results show that wet years are more likely to motivate landslide motions than dry years.The annual thermally active layer of the landslide has a critical depth of roughly 9 m and might move downward in warmer years.The dynamic groundwater table is located at depths of 9e15 m,where the peaked strain undergoes a periodical response of leap and withdrawal to annual hydrometeorological cycles.These interface behaviors may support the interpretation of the contribution of reservoir regulation to slope stability,allowing us to correlate them to local damage events and potential global destabilization.This paper also offers a natural framework for interpreting thermo-hydro-poro-mechanical signatures from creeping reservoir bank slopes,which may form the basis for a landslide monitoring and early warning system.

Computed tomography radiomic features and clinical factors predicting the response to first transarterial chemoembolization in intermediate-stage hepatocellular carcinoma

Background:According to clinical practice guidelines,transarterial chemoembolization(TACE)is the standard treatment modality for patients with intermediate-stage hepatocellular carcinoma(HCC).Early prediction of treatment response can help patients choose a reasonable treatment plan.This study aimed to investigate the value of the radiomic-clinical model in predicting the efficacy of the first TACE treatment for HCC to prolong patient survival.Methods:A total of 164 patients with HCC who underwent the first TACE from January 2017 to September 2021 were analyzed.The tumor response was assessed by modified response evaluation criteria in solid tumors(mRECIST),and the response of the first TACE to each session and its correlation with overall survival were evaluated.The radiomic signatures associated with the treatment response were identified by the least absolute shrinkage and selection operator(LASSO),and four machine learning models were built with different types of regions of interest(ROIs)(tumor and corresponding tissues)and the model with the best performance was selected.The predictive performance was assessed with receiver operating characteristic(ROC)curves and calibration curves.Results:Of all the models,the random forest(RF)model with peritumor(+10 mm)radiomic signatures had the best performance[area under ROC curve(AUC)=0.964 in the training cohort,AUC=0.949 in the validation cohort].The RF model was used to calculate the radiomic score(Rad-score),and the optimal cutoff value(0.34)was calculated according to the Youden’s index.Patients were then divided into a high-risk group(Rad-score>0.34)and a low-risk group(Rad-score≤0.34),and a nomogram model was successfully established to predict treatment response.The predicted treatment response also allowed for significant discrimination of Kaplan-Meier curves.Multivariate Cox regression identified six independent prognostic factors for overall survival,including male[hazard ratio(HR)=0.500,95%confidence interval(CI):0.260–0.962,P=0.038],alpha-fetoprotein(HR=1.003,95%CI:1.002–1.004,P<0.001),alanine aminotransferase(HR=1.003,95%CI:1.001–1.005,P=0.025),performance status(HR=2.400,95%CI:1.200–4.800,P=0.013),the number of TACE sessions(HR=0.870,95%CI:0.780–0.970,P=0.012)and Rad-score(HR=3.480,95%CI:1.416–8.552,P=0.007).Conclusions:The radiomic signatures and clinical factors can be well-used to predict the response of HCC patients to the first TACE and may help identify the patients most likely to benefit from TACE.

Prediction of treatment response to antipsychotic drugs for precision medicine approach to schizophrenia:randomized trials and multiomics analysis

Background:Choosing the appropriate antipsychotic drug(APD)treatment for patients with schizophrenia(SCZ)can be challenging,as the treatment response to APD is highly variable and difficult to predict due to the lack of effective biomarkers.Previous studies have indicated the association between treatment response and genetic and epigenetic factors,but no effective biomarkers have been identified.Hence,further research is imperative to enhance precision medicine in SCZ treatment.Methods:Participants with SCZ were recruited from two randomized trials.The discovery cohort was recruited from the CAPOC trial(n=2307)involved 6 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,Quetiapine,Aripiprazole,Ziprasidone,and Haloperidol/Perphenazine(subsequently equally assigned to one or the other)groups.The external validation cohort was recruited from the CAPEC trial(n=1379),which involved 8 weeks of treatment and equally randomized the participants to the Olanzapine,Risperidone,and Aripiprazole groups.Additionally,healthy controls(n=275)from the local community were utilized as a genetic/epigenetic reference.The genetic and epigenetic(DNA methylation)risks of SCZ were assessed using the polygenic risk score(PRS)and polymethylation score,respectively.The study also examined the genetic-epigenetic interactions with treatment response through differential methylation analysis,methylation quantitative trait loci,colocalization,and promoteranchored chromatin interaction.Machine learning was used to develop a prediction model for treatment response,which was evaluated for accuracy and clinical benefit using the area under curve(AUC)for classification,R^(2) for regression,and decision curve analysis.Results:Six risk genes for SCZ(LINC01795,DDHD2,SBNO1,KCNG2,SEMA7A,and RUFY1)involved in cortical morphology were identified as having a genetic-epigenetic interaction associated with treatment response.The developed and externally validated prediction model,which incorporated clinical information,PRS,genetic risk score(GRS),and proxy methylation level(proxyDNAm),demonstrated positive benefits for a wide range of patients receiving different APDs,regardless of sex[discovery cohort:AUC=0.874(95%CI 0.867-0.881),R^(2)=0.478;external validation cohort:AUC=0.851(95%CI 0.841-0.861),R^(2)=0.507].Conclusions:This study presents a promising precision medicine approach to evaluate treatment response,which has the potential to aid clinicians in making informed decisions about APD treatment for patients with SCZ.Trial registration Chinese Clinical Trial Registry(https://www.chictr.org.cn/),18 Aug 2009 retrospectively registered:CAPOC-ChiCTR-RNC-09000521(https://www.chictr.org.cn/showproj.aspx?proj=9014),CAPEC-ChiCTRRNC-09000522(https://www.chictr.org.cn/showproj.aspx?proj=9013).

Probiotics: Shaping the gut immunological responses

Probiotics are live microorganisms exerting beneficial effects on the host’s health when administered in adequate amounts.Among the most popular and adequately studied probiotics are bacteria from the families Lactobacillaceae,Bifidobacteriaceae and yeasts.Most of them have been shown,both in vitro and in vivo studies of intestinal inflammation models,to provide favorable results by means of improving the gut microbiota composition,promoting the wound healing process and shaping the immunological responses.Chronic intestinal conditions,such as inflammatory bowel diseases(IBD),are characterized by an imbalance in microbiota composition,with decreased diversity,and by relapsing and persisting inflammation,which may lead to mucosal damage.Although the results of the clinical studies investigating the effect of probiotics on patients with IBD are still controversial,it is without doubt that these microorganisms and their metabolites,now named postbiotics,have a positive influence on both the host’s microbiota and the immune system,and ultimately alter the topical tissue microenvironment.This influence is achieved through three axes:(1)By dis-placement of potential pathogens via competitive exclusion;(2)by offering protection to the host through the secretion of various defensive mediators;and(3)by supplying the host with essential nutrients.We will analyze and discuss almost all the in vitro and in vivo studies of the past 2 years dealing with the possible favorable effects of certain probiotic genus on gut immunological responses,highlighting which species are the most beneficial against intestinal inflammation.

Diphylleia Grayi-Inspired Intelligent Temperature-Responsive Transparent Nanofiber Membranes

Nanofiber membranes(NFMs) have become attractive candidates for next-generation flexible transparent materials due to their exceptional flexibility and breathability. However, improving the transmittance of NFMs is a great challenge due to the enormous reflection and incredibly poor transmission generated by the nanofiber-air interface. In this research, we report a general strategy for the preparation of flexible temperature-responsive transparent(TRT) membranes,which achieves a rapid transformation of NFMs from opaque to highly transparent under a narrow temperature window. In this process, the phase change material eicosane is coated on the surface of the polyurethane nanofibers by electrospray technology. When the temperature rises to 37 ℃, eicosane rapidly completes the phase transition and establishes the light transmission path between the nanofibers, preventing light loss from reflection at the nanofiber-air interface. The resulting TRT membrane exhibits high transmittance(> 90%), and fast response(5 s). This study achieves the first TRT transition of NFMs, offering a general strategy for building highly transparent nanofiber materials, shaping the future of next-generation intelligent temperature monitoring, anti-counterfeiting measures, and other high-performance devices.

Inflammation: Complexity and significance of cellular and molecular responses

Inflammation is a multifaceted cellular and molecular response triggered by injury,infection,or various pathological conditions.Serving as a protective defense mechanism,the inflammatory response involves clinical signs like redness,swelling,pain,and increased body temperature.Immune cells,notably neutrophils and macrophages,play key roles in orchestrating this response.The delicate balance between proinflammatory and anti-inflammatory mediators,including cytokines and chemokines,regulates the inflammatory cascade.While acute inflammation is crucial for tissue repair,chronic inflammation may indicate an imbalance,contributing to conditions like autoimmune diseases.Understanding these mechanisms is vital for developing therapeutic strategies and managing chronic diseases.

Strengthening Mechanisms to Promote Tourists' Environmental Responsible Behaviors in the Context of All-for-One Tourism

The overall promotion of all-for-one tourism requires tourists' civilized behaviors. This paper focused on tourists' environmental responsible behaviors in the context of all-for-one tourism. On the basis of clarifying the connotation, dimension and driving factors of tourists' environmental responsible behaviors, this paper firstly analyzed the relationship between all-for-one tourism and tourists' environmental responsible behaviors, and proposed that the development of all-for-one tourism was an important path to optimize and upgrade China's tourism industry and a new concept of sustainable development of tourism industry. The emergence of all-for-one tourism has formed a new tourism trend, which will drive tourists to behave more civilly. Tourists' environmental responsible behaviors are a "subject and share" concept, and from tourists' point of view, all-for-one tourism development is the most basic requirement. Secondly, based on the theory of "value-belief-norm", this paper focused on the strengthening mechanism of "interaction effect" between all-for-one tourism and tourists' environmental responsible behaviors, and put forward the idea of "double internalization strengthening" to guide tourists' environmental responsible behaviors from being passive to active, from individuals to groups. Finally, this paper discussed the promotion of environmental responsible behaviors of tourist's specific strategies from two aspects, "external drive" and "internal drive" to enhance the level of all-for-one tourism construction and strengthen the environment responsibility of tourists. "External drives" were as follows:(1) to make a scientific development plan to implement the "host and guest sharing" mechanism;(2) to optimize the landscape, the environment, services, enhance the local attachment of visitors;(3) to improve the infrastructure system, pay attention to the details of visitors' experience;(4) to strengthen environment education and publicity, deepening the quality of tourists' civilization construction, and strengthen the environmental responsible behaviors of tourists. "Internal drives" were as follows:(1) to strengthen the sense of environmental responsibility of tourists;(2) to establish a model of environmental responsible behaviors;(3) to strengthen the supervision of environmental responsible behaviors.

Effects of Rosa roxburghii&edible fungus fermentation broth on immune response and gut microbiota in immunosuppressed mice

With the rise of probiotics fermentation in food industry,fermented foods have attracted worldwide attention.In this study,protective effects of Rosa roxburghii&edible fungus fermentation broth(REFB)on immune function and gut health in Cyclophosphamide induced immunosuppressed mice were investigated.Results showed that REFB could improve the immune organ index,and promote the proliferation and differentiation of splenic T lymphocytes.In addition,it attenuated intestinal mucosal damage and improved intestinal cellular immunity.REFB administration also up-regulated the expression of IL-4,INF-γ,TNF-α,T-bet and GATA-3 mRNA in small intestine.Furthermore,administration of REFB modulated gut microbiota composition and increased the relative abundance of beneficial genus,such as Bacteroides.It also increased the production of fecal short-chain fatty acids.These indicate that REFB has the potential to improve immunity,alleviate intestinal injury and regulate gut microbiota in immunosuppressed mice.

Coral records of Mid-Holocene sea-level highstands and climate responses in the northern South China Sea

High-resolution sea-level data and high-precision dating of corals in the northern South China Sea(SCS)during the Holocene provide a reference and historical background for current and future sea-level changes and a basis for scientific assessment of the evolutionary trend of coral reefs in the SCS.Although sporadic studies have been performed around Hainan Island in the northern SCS,the reconstructed sea level presents different values or is controversial because the indicative meaning of the sea-level indicators were neither quantified nor uniform criteria.Here,we determined the quantitative relationship between modern living coral and sea level by measuring the top surfaces of 27 live Porites corals from the inner reef flat along the east coast of Hainan Island and assessed the accuracy of results obtained using coral as sea-level indicators.Additionally,three in situ fossil Porites corals were analyzed based on elevation measurements,digital X-ray radiography,and U-Th dating.The survey results showed that the indicative meanings for the modern live Porites corals is(146.09±8.35)cm below the mean tide level(MTL).It suggested that their upward growth limit is constrained by the sea level,and the lowest low water is the highest level of survival for the modern live Porites corals.Based on the newly defined indicative meanings,6 new sea-level index points(SLIPs)were obtained and 19 published SLIPs were recalculated.Those SLIPs indicated a relative sea level fluctuation between(227.7±9.8)cm to(154.88±9.8)cm MTL between(5393±25)cal a BP and(3390±12)cal a BP,providing evidences of the Mid-Holocene sea-level highstand in the northern SCS.Besides that,our analysis demonstrated that different sea-level histories may be produced based on different indicative meanings or criteria.The dataset of 276 coral U-Th ages indicates that coral reef development in the northern SCS comprised the initial development,boom growth,decline,and flourishing development again.A comparison with regional records indicated that synergistic effects of climatic and environmental factors were involved in the development of coral reefs in the northern SCS.Thus,the cessation of coral reef development during the Holocene in the northern SCS was probably associated with the dry and cold climate in South China,as reflected in the synchronous weakening of the ENSO and East Asian summer monsoon induced by the reduction of the 65°N summer insolation,which forced the migration of the Intertropical Convergence Zone.

Time-domain dynamic constitutive model suitable for mucky soil site seismic response

Soil nonlinear behavior displays noticeable effects on the site seismic response.This study proposes a new functional expression of the skeleton curve to replace the hyperbolic skeleton curve.By integrating shear modulus and combining the dynamic skeleton curve and the damping degradation coefficient,the constitutive equation of the logarithmic dynamic skeleton can be obtained,which considers the damping effect in a soil dynamics problem.Based on the finite difference method and the multi-transmitting boundary condition,a 1D site seismic response analysis program called Soilresp1D has been developed herein and used to analyze the time-domain seismic response in three types of sites.At the same time,this study also provides numerical simulation results based on the hyperbolic constitutive model and the equivalent linear method.The results verify the rationality of the new soil dynamic constitutive model.It can analyze the mucky soil site nonlinear seismic response,reflecting the deformation characteristics and damping effect of the silty soil.The hysteresis loop area is more extensive,and the residual strain is evident.

Correlation between the neuroendocrine axis,microbial species,inflammatory response,and gastrointestinal symptoms in irritable bowel syndrome

BACKGROUND This study examines the complex relationships among the neuroendocrine axis,gut microbiome,inflammatory responses,and gastrointestinal symptoms in patients with irritable bowel syndrome(IBS).The findings provide new insights into the pathophysiology of IBS and suggest potential therapeutic targets for improving patient outcomes.AIM To investigate the interactions between the neuroendocrine axis,gut microbiome,inflammation,and gastrointestinal symptoms in patients with IBS.METHODS Patients diagnosed with IBS between January 2022 and January 2023 were selected for the study.Healthy individuals undergoing routine check-ups during the same period served as the control group.Data were collected on neuroendocrine hormone levels,gut microbiome profiles,inflammatory biomarkers,and gastrointestinal symptomatology to analyze their interrelations and their potential roles in IBS pathogenesis.RESULTS IBS patients exhibited significant dysregulation of the neuroendocrine axis,with altered levels of cortisol,serotonin,and neuropeptides compared to healthy controls.The gut microbiome of IBS patients showed reduced diversity and specific alterations in bacterial genera,including Bifidobacterium,Lactobacillus,and Faecalibacterium,which were associated with neuroendocrine disturbances.Additionally,elevated levels of inflammatory markers,such as C-reactive protein,interleukin-6,and tumor necrosis factor-α,were observed and correlated with the severity of gastrointestinal symptoms like abdominal pain,bloating,and altered bowel habits.CONCLUSION The findings suggest that targeting the neuroendocrine axis,gut microbiome,and inflammatory pathways may offer novel therapeutic strategies to alleviate symptoms and improve the quality of life in IBS patients.