Physical Activity,Sedentary Behavior,and the Risk of Cardiovascular Disease in Type 2 Diabetes Mellitus Patients:The MIDiab Study

The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity(MVPA)time and sedentary(SED)time with a history of cardiovascular disease(CVD)and multifactorial(i.e.,blood pressure(BP),body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin A1c(HbA1c))control status among type 2 diabetes mellitus(T2DM)patients in China.A cross-sectional analysis of 9152 people with type 2 diabetes from the Multifactorial Intervention on Type 2 Diabetes(MIDiab)study was performed.Patients were grouped according to their self-reported MVPA time(low,<150 min·week−1;moderate,150 to<450 min·week−1;high,≥450 min·week−1)and SED time(low,<4 h·d–1;moderate,4 to<8 h·d–1;high,≥8 h·d–1).Participants who self-reported a history of CVD were identified as having a CVD risk.Odds ratios(ORs)and 95%confidence intervals(CIs)of CVD risk and multifactorial control status associated with MVPA time and SED time were estimated using mixed-effect logistic regression models,adjusting for China’s geographical region characteristics.The participants had a mean±standard deviation(SD)age of(60.87±8.44)years,44.5%were women,and 25.1%had CVD.After adjustment for potential confounding factors,an inverse association between high MVPA time and CVD risk that was independent of SED time was found,whereas this association was not observed in the moderate-MVPA group.A higher MVPA time was more likely to have a positive effect on the control of BMI.Compared with the reference group(i.e.,those with MVPA time≥450 min·week−1 and SED time<4 h·d–1),CVD risk was higher in the low-MVPA group:The OR associated with an SED time<4 h·d–1 was 1.270(95%CI,1.040–1.553)and that associated with an SED time≥8 h·d–1 was 1.499(95%CI,1.149–1.955).We found that a high MVPA time(i.e.,≥450 min·week−1)was associated with lower odds of CVD risk regardless of SED time among patients with T2DM.

Molecular hydrogen regulates the expression of miR-9,miR-21 and miR-199 in LPS-activated retinal microglia cells

·AIM: To explore the potential mechanism of molecular hydrogen in the regulation of miRNA expression and signal-modulating activities. ·METHODS: Retinal microglia cells were activated by Lipopolysaccharides (LPS) and then treated with hydrogen -saturated medium or normal medium without hydrogen. qRT -PCR was used to detect the expression difference in miR-9, miR-21 and miR-199 between these two groups. Moreover, the expression of LPS -induced signaling proteins, including Myd88, IKK -β, NF -kB, and PDCD4, were detected by Western blotting. ·RESULTS: The results demonstrated a marked downregulation of miR -9 and miR -21 and up -regulation of miR-199 by hydrogen treatment; the expression of Myd88 and IKK-β was decreased after hydrogen treatment, whereas PDCD4 was increased, and there was no significant change in NF-kB expression. · CONCLUSION: The results in the present study indicate that miR -9, miR -199 and miR -21 play an important role in the anti -inflammatory regulation of LPS -activated microglia cells by molecular hydrogen, which will help to explain the protective mechanism of molecular hydrogen against inflammatory injury.·

Real world effectiveness of PCSK-9 inhibitors combined with statins versus statins-based therapy among patients with very high risk of atherosclerotic cardiovascular disease in China(RWE-PCSK study)

BACKGROUND The efficacy and safety of proprotein convertase subtilisin/kexin type 9(PCSK-9) inhibitors were confirmed by several clinical trials, but its effectiveness in routine clinical practice in China has not been evaluated. This study aims to describe the real world effectiveness of PCSK-9 inhibitors combined with statins compared with statins-based therapy among patients with very high risk of atherosclerotic cardiovascular disease(ASCVD).METHODS This is a multi-center observational study, enrolled patients from 32 hospitals who underwent percutaneous coronary intervention(PCI) from January to June in 2019. There are 453 patients treated with PCSK-9 inhibitors combined with statins in PCSK-9 inhibitor group and 2,610 patients treated with statins-based lipid lowering therapies in statins-based group. The lipid control rate and incidence of major adverse cardiovascular events(MACE) over six months were compared between two groups.A propensity score-matched(PSM) analysis was used to balance two groups on confounding factors. Survival analysis using Kaplan-Meier methods was applied for MACE.RESULTS In a total of 3,063 patients, 89.91% of patients had received moderate or high-intensity statins-based therapy before PCI, but only 9.47% of patients had low-density lipoprotein cholesterol(LDL-C) levels below 1.4 mmol/L at baseline. In the PSM selected patients, LDL-C level was reduced by 42.57% in PCSK-9 inhibitor group and 30.81%(P < 0.001) in statins-based group after six months. The proportion of LDL-C ≤ 1.0 mmol/L increased from 5.29% to 29.26% in PCSK-9 inhibitor group and 0.23% to 6.11% in statins-based group, and the proportion of LDL-C ≤ 1.4 mmol/L increased from 10.36% to 47.69% in PCSK-9 inhibitor group and 2.99% to 18.43% in statins-based group(P < 0.001 for both). There was no significant difference between PCSK-9 inhibitor and statins-based treatment in reducing the risk of MACE(hazard ratio = 2.52, 95% CI: 0.49-12.97, P = 0.250).CONCLUSIONS In the real world, PCSK-9 inhibitors combined with statins could significantly reduce LDL-C levels among patients with very high risk of ASCVD in China. The long-term clinical benefits for patients received PCSK-9 inhibitor to reduce the risk of MACE is still unclear and requires further study.

Solid Pseudopapillary Tumor of the Pancreas:a Case Report

Case Report Solid pseudopapillary tumors(SPT)of the pancreas are considered to be a rare low-grade malignancy that mainly appears in young women.It accounts for less than 1%of all pancreatic neoplasms and is pathologically distinctive from other types of pancreatic cancers.Curative resection is the optimal choice for SPT and the 5-year survival rate of SPT is about 95%.Here we report a case of a young girl who presented with this rare pancreatic tumor.

Cryptotanshinone increases the sensitivity of liver cancer to sorafenib by inhibiting the STAT3/Snail/ epithelial mesenchymal transition pathway

Objective:Sorafenib resistance has been a major factor limiting its clinical use as a targeted drug in liver cancer.The present study aimed to investigate whether cryptotanshinone can enhance the sensitivity of liver cancer and reduce the resistance to sorafenib.Methods:Sorafenib-resistant cells were established based on HepG2 and Huh7 cell lines.And the anti-tumor effect of sorafenib combined with cryptotanshinone on the sorafenib-resistant cells was verified by MTT,colony formation,transwell assays and tumor growth xenograft model.Moreover,the effects of the combined treatment on the expression of phosphorylated(p)-STAT3,as well as epithelial mesenchymal transition(EMT)and apoptosis related proteins of cells were evaluated by western blot analysis.Results:It was identified that cryptotanshinone inhibited the viability of both HepG2 and Huh7 cells in a dose-and time-dependent manner,and decreased p-STAT3 expression rather than total STAT3 expression at a concentration of 40μmol/L.In the sorafenib-resistant cells,sorafenib in combination with cryptotanshinone markedly inhibited cell viability,invasion and migration compared with sorafenib alone.In contrast,increased p-STAT3 level by colivelin led to the inhibition of the synergistic effect of cryptotanshinone and sorafenib not only on cell viability,but also on EMT and apoptosis,suggesting that cryptotanshinone and sorafenib may act by downregulating STAT3 signaling.Further,the inhibition of carcinogenicity effect was also verified in xenografted tumor models.Conclusion:The present results indicated that cryptotanshinone could synergize with sorafenib to inhibit the proliferative,invasive,and migratory abilities of sorafenib-resistant cells by downregulating STAT3 signaling.

The Chinese Society of Clinical Oncology (CSCO): Clinical guidelines for the diagnosis and treatment of gastric cancer, 2023

The 2023 update of the Chinese Society of Clinical Oncology(CSCO)Clini-cal Guidelines for Gastric Cancer focuses on standardizing cancer diagnosis and treatment in China,reflecting the latest advancements in evidence-based medicine,healthcare resource availability,and precision medicine.These updates address the differences in epidemiological characteristics,clinicopatho-logical features,tumor biology,treatment patterns,and drug selections between Eastern and Western gastric cancer patients.Key revisions include a structured template for imaging diagnosis reports,updated standards for molecular marker testing in pathological diagnosis,and an elevated recommendation for neoadju-vant chemotherapy in stage III gastric cancer.For advanced metastatic gastric cancer,the guidelines introduce new recommendations for immunotherapy,anti-angiogenic therapy and targeted drugs,along with updated management strategies for human epidermal growth factor receptor 2(HER2)-positive and deficient DNA mismatch repair(dMMR)/microsatellite instability-high(MSI-H)patients.Additionally,the guidelines offer detailed screening recommendations for hereditary gastric cancer and an appendix listing drug treatment regimens for various stages of gastric cancer.The 2023 CSCO Clinical Guidelines for Gastric Cancer updates are based on both Chinese and international clinical research and expert consensus to enhance their applicability and relevance in clinical practice,particularly in the heterogeneous healthcare landscape of China,while maintaining a commitment to scientific rigor,impartiality,and timely revisions.

Mitochondrial dysfunction in type 2 diabetes:A neglected path to skeletal muscle atrophy

Over the course of several decades,robust research has firmly established the significance of mitochondrial pathology as a central contributor to the onset of skeletal muscle atrophy in individuals with diabetes.However,the specific intricacies governing this process remain elusive.Extensive evidence highlights that individuals with diabetes regularly confront the severe consequences of skeletal muscle degradation.Deciphering the sophisticated mechanisms at the core of this pathology requires a thorough and meticulous exploration into the nuanced factors intricately associated with mitochondrial dysfunction.

Changes of TXA_2 and PGI_2 during Postoperative Hypertensive Crisis in Patients with Hypertensive Intracerebral Hemorrhage

In order to explore the changes and the roles of TXA2 and PGI2 during postoperative hypertensive crisis in patients with hypertensive intracerebral hemorrhage, 31 cases subject to craniotomy were divided into three groups： group A, 9 patients with postoperative hypertensive crisis; group B, 13 patients without postoperative hypertensive crisis; and group C, 9 patients without history of hypertension and hypertensive intracerebral hemorrhage. TXA2, TXB2, 6-keto-PGF1α and PGI2 were measured after operation in the three groups respectively. The postoperative blood pressure in group A, including SBP and DBP, was elevated more obviously than that in the other two groups. TXA2 and PGI2 in group A were significantly higher than those in other two groups （P〈0.01）. Moreover, the ratio of TXB2 to 6-keto-PGF1α in group A was significantly higher than that in other two groups （P〈0.05）. The increase of TXA2 and the relative inadequacy of prostacyclin, especially 6-keto-PGF1α, may play roles in the postoperative hypertensive crisis. And the increased value of TXB2 to 6-keto-PGF1α could provide the basis for diagnosis of postoperative hypertensive crisis.

Soluble expression of recomb inant cMyc,Klf4,Oct4,and Sox2 proteins in bacteria and transduction into living cells

AIM：To develop a new method to produce recombinant reprogramming proteins,c Myc,Klf4,Oct4,and Sox2,in soluble format with low cost for the generation of induced pluripotent stem cells（i PSCs）.METHODS：A short polypeptide sequence derived from the HIV trans-activator of transcription protein（TAT） and the nucleus localization signal（NLS） polypeptide were fused to the N terminus of the reprogramming proteins and they were constructed into p Cold-SUMO vector which can extremely improve the solubility of recombinant proteins.Then these vector plasmids were transformed into E.coli BL21（DE3） Chaperone competent cells for amplification.The solubility of these recombinant proteins was determined by SDS-PAGE and Coomassie brilliant blue staining.The recombinant proteins were purified by NiNTA resin and identified by Western blot.The transduction of these proteins into HEK 293 T cells were evaluated by immunofluorescence staining.RESULTS：These four reprogramming proteins could be produced in soluble format in p Cold-SUMO expression vector system with the assistance of chaperone proteins in bacteria.The proteins were purified successfully with a purity of over 70% with a relative high transduction rate into 293 cells.CONCLUSION：The results in the present study indicate the four important reprogramming proteins,c Myc,Klf4,Oct4,and Sox2,can be produced in soluble format in bacteria with low cost.Our new method thus might be expected to greatly contribute to the future study of i PSCs.

Development and external validation of models to predict acute respiratory distress syndrome related to severe acute pancreatitis

BACKGROUND Acute respiratory distress syndrome(ARDS)is a major cause of death in patients with severe acute pancreatitis(SAP).Although a series of prediction models have been developed for early identification of such patients,the majority are complicated or lack validation.A simpler and more credible model is required for clinical practice.AIM To develop and validate a predictive model for SAP related ARDS.METHODS Patients diagnosed with AP from four hospitals located at different regions of China were retrospectively grouped into derivation and validation cohorts.Statistically significant variables were identified using the least absolute shrinkage and selection operator regression method.Predictive models with nomograms were further built using multiple logistic regression analysis with these picked predictors.The discriminatory power of new models was compared with some common models.The performance of calibration ability and clinical utility of the predictive models were evaluated.RESULTS Out of 597 patients with AP,139 were diagnosed with SAP(80 in derivation cohort and 59 in validation cohort)and 99 with ARDS(62 in derivation cohort and 37 in validation cohort).Four identical variables were identified as independent risk factors for both SAP and ARDS:heart rate[odds ratio(OR)=1.05;95%CI:1.04-1.07;P<0.001;OR=1.05,95%CI:1.03-1.07,P<0.001],respiratory rate(OR=1.08,95%CI:1.0-1.17,P=0.047;OR=1.10,95%CI:1.02-1.19,P=0.014),serum calcium concentration(OR=0.26,95%CI:0.09-0.73,P=0.011;OR=0.17,95%CI:0.06-0.48,P=0.001)and blood urea nitrogen(OR=1.15,95%CI:1.09-1.23,P<0.001;OR=1.12,95%CI:1.05-1.19,P<0.001).The area under receiver operating characteristic curve was 0.879(95%CI:0.830-0.928)and 0.898(95%CI:0.848-0.949)for SAP prediction in derivation and validation cohorts,respectively.This value was 0.892(95%CI:0.843-0.941)and 0.833(95%CI:0.754-0.912)for ARDS prediction,respectively.The discriminatory power of our models was improved compared with that of other widely used models and the calibration ability and clinical utility of the prediction models performed adequately.CONCLUSION The present study constructed and validated a simple and accurate predictive model for SAPrelated ARDS in patients with AP.

Effect of components in activated sludge liquor on membranefouling in a submerged membrane bioreactor

By a membrane bioreactor with a settle tank in long-term operation and batch experiments, the effects of floes, soluble microorganism products （SMPs） and metal ions in activated sludge liquor on membrane fouling were investigated. The results showed that foulants absorbed each other and formed a fouling layer as a ＂second membrane＂ influencing the permeability of the membrane. The ＂gel layer＂ caused by SMPs and ＂cake layer＂ by floes showed great differences in morphology by analysis of scanning electron microscope and atomic force microscope. The ＂gel layer＂ was more compact and of poor permeability. When the membrane flux was 40 L/（m^2·h）, the rate of membrane fouling caused by supernatant （0.011 MPa/h） was greater than that by sludgc liquor （0.0063 MPa/h）. SMPs played very important roles on membrane fouling. In the bulking sludge, with SMPs increasing, the rate of membrane fouling （0.0132 MPa/h） was faster. While after flocculation of the SMPs, the rate of fouling decreased to 0.0034 M Pa/h. Floes could keep holes in their overlaps. They could alleviate membrane fouling by preventing the SMPs directly attaching on membrane surface.

MiR-503 promotes wound healing of diabetic foot ulcer by targeting FBN1

Objective: To highlight the relationship between miR-503 and wound healing of diabetic foot ulcer(DFU). Methods: Microarray analysis was used to detect the dysregulated miRNAs between the DFU tissues and normal tissues. The expression of miR-503 in tissues and serum of patients with DFU was detected by qRT-PCR technique. Then, CCK-8 assay was applied to determine the cell proliferation. TUNEL assay was used for assessing the apoptosis of cells after treatment with miR-503. Possible correlation between miR-503 and fibillinl(FBN1)was predicted according to data accessed on RNA22 website online, and was detected for confirmation by luciferase reporter assay. Results: Microarray analysis showed that miR-503 was significantly decreased in the DFU tissues compared with normal tissues. While marked increase in the expression of miR-503 in tissues and scrum of patients with DFU was confirmed by qRT-PCR technique. Then, CCK-8 assay indicated that transfection of miR-503 mimic obviously accelerated the cell proliferation. However, TUNEL assays suggested that miR-503 mimic inhibited the apoptosis of cells to improve the survival of fibroblasts.Besides. miR-503 AMO played a role in fibroblasts of DFU tissues exactly countering to miR-503 mimic treatment. It was predicted that MiR-503 is a complementary to the FBN1 by RNA22. Besides, SiRNA-FBN1 promoted the proliferation, but brought down the apoptosis of fibroblasts. Conclusions: MiR-503 regulates the function of fibroblasts and wound healing of patients with DFU by targeting FBN I directly which provids a novel and critical target for diagnosis and treatment of DFU.

Formation of microchimerism in rat small bowel transplantation by spienocyte infusion

瞄准：为了调查施主脾细胞的效果，注入在老鼠的拒绝上与 cyclosporine A (CsA ) 结合了小肠移植(SBT ) 。方法：男 Sprague-Dawley (SD ) 老鼠和女 Wistar 老鼠称 230-270 g 在学习分别地被用作施主和接受者。异位的小肠移植被执行。老鼠被划分成三个组：组织收到紧密相联的移植( SD rarr Wistar )的，组织二收到紧密相联的移植( SD rarr Wistar )+施主脾细胞注入，组织三收到+施主脾细胞注入+ CsA 在移植以后每天由 CsA 10 mg/kg 跟随了的紧密相联的移植( SD rarr Wistar )，在哪个接受者 Wistar 老鼠与 2 x 10 被注射( 8 ) SD splenocytes 在移植前的 28 d ，并且在移植以后与 CsA 对待。最后，施主 Y 的特定的 DNA 碎片被 PCR 在接受者外设血和皮肤检测。在小肠移植以后的生存时间被观察。粗野、组织病理学说的考试被执行。结果：在小肠移植以后的生存时间是 7.1 +/- 在组 1 的 1.2 d， 18.4 +/- 在组 2 和 31.5 +/- 的 3.6 d 在组 3 的 3.1 d。生存时间更长是重要的(P 【 0.01 ) 在比在组的组 3 1 和 2。粗野、组织病理学说的考试证明在组 3 的拒绝度在组是比那低的 1 和 2。结论：与 CsA 相结合的施主脾细胞注入显著地减少拒绝并且在老鼠以后延长生存时间小肠移植。

Nutritional Therapy in Patients Undergoing Elective Colorectal Cancer Surgery

The high incidence of malnutrition in patients with colorectal cancer directly affects their clinical outcomes,and is associated with increased postoperative complications,prolonged hospital stays,and decreased tolerance of chemotherapy and radiotherapy.Therefore,the nutritional management of patients with colorectal cancer is important.The perioperative nutritional management of patients includes preoperative education,nutritional screening and evaluation,preoperative intestinal preparation,and postoperative nutritional management.This article summarizes the current status of perioperative nutritional therapy and bowel preparation for patients with colorectal cancer.

Castleman disease presenting with jaundice: A case report and review of literature

BACKGROUND Castleman disease(CD) is a rare lymphoproliferative disorder that presents with various symptoms. CD accompanied with jaundice is uncommon since there are only 11 cases reported in the literature.CASE SUMMARY Here we report a 62-year-old woman who was admitted to the hospital with signs and symptoms of intermittent jaundice. Biochemical tests showed higher serum levels of total and direct bilirubin, and normal serum levels of tumor markers and interleukin-6. Contrast-enhanced computed tomography detected a6 cm × 4 cm × 2.5 cm mass between the hepatoduodenal ligament and the inferior vena cava. The mass was successfully excised and the patient had a complete resolution of symptoms. A diagnosis of idiopathic unicentric CD was made based upon histological examination, which demonstrated the pathological features of CD of mixed type, including hyperplasia of follicular lymphoids with abundant plasma cells, degenerative germinal centers, interfollicular vascularity and hyaline degeneration. The diagnosis was corroborated by immunohistochemical analysis which detected multiple biomarkers.CONCLUSION This is the first study that describes the clinicopathological features of CD presenting with jaundice, which may deepen and extend our understanding of this disease.

Solitary hyoid plasmacytoma with unicentric Castleman disease:A case report and review of literature

BACKGROUND Solitary plasmacytoma and unicentric Castleman disease(UCD)are rare lymphoproliferative disorders characterized by monoclonal plasma cells and a single set of locally enlarged lymph nodes,respectively.CASE SUMMARY A 48-year-old Han Chinese man presented to our department with a neck mass and progressive foreign body sensation in his throat.18F-FDG positron emission tomography revealed focally increased radioactivity centered around the hyoid,and computed tomography(CT)revealed osteolytic lesions.Histopathology revealed Castleman-like features and CD138/CD38-positive mature plasma cells.Systemic work-up ruled out the possibility of POEMS syndrome,lymphoma,and multiple myeloma,leading to a final diagnosis of solitary hyoid plasmacytoma with UCD.The patient underwent partial hyoid resection and selective neck dissection,followed by intensity-modulated radiotherapy.99mTc-MDP singlephoton emission computed tomography/CT reevaluation showed neither local recurrence nor distant bone metastasis at the 40-mo follow-up.CONCLUSION The diagnostic process and differential diagnosis of this rare case provided valuable educational information to clinicians.

Standardization of critical care management of non-critically ill patients with COVID-19

The large global outbreak of coronavirus disease 2019(COVID-19)has seriously endangered the health care system in China and globally.The sudden surge of patients with severe acute respiratory syndrome coronavirus 2 infection has revealed the shortage of critical care medicine resources and intensivists.Currently,the management of non-critically ill patients with COVID-19 is performed mostly by non-intensive care unit(ICU)physicians,who lack the required professional knowledge,training,and practice in critical care medicine,especially in terms of continuous monitoring of the respiratory function,intervention,and feedback on treatment effects.This clinical problem needs an urgent solution.Therefore,here,we propose a series of clinical strategies for non-ICU physicians aimed at the standardization of the management of non-critically ill patients with COVID-19 from the perspective of critical care medicine.Isolation management is performed to facilitate the implementation of hierarchical monitoring and intervention to ensure the reasonable distribution of scarce critical care medical resources and intensivists,highlight the key patients,timely detection of disease progression,and early and appropriate intervention and organ function support,and thus improve the prognosis.Different management objectives are also set based on the high-risk factors and the severity of patients with COVID-19.The approaches suggested herein will facilitate the timely detection of disease progression,and thus ensure the provision of early and appropriate intervention and organ function support,which will eventually improve the prognosis.

Decision-tree analysis for cost-effective management of solitary pulmonary nodules in China

AIM: To analyze the cost-effectiveness of the diagnosis of solitary pulmonary nodule(SPN) in China. METHODS: Decision analysis models were constructed to assess the cost-effectiveness of four strategies for the management of SPN: computed tomography(CT) alone, CT plus CT-guided automated cutting needle biopsy(ACNB), CT plus positron emission tomography/computed tomography(PET/CT), CT plus diffusionweighted magnetic resonance imaging(DWI) plus PET/CT. RESULTS: The prevalence of lung cancer among SPN discovered in the clinical setting was approximately 50%. The CT plus ACNB strategy had higher diagnostic accuracies(87% vs 81%), with a cost saving of $1945 RMB per patient, and reducing unnecessary thoracotomy by 16.5%; this was associated with a 4.5% missed diagnosis rate. CT plus DWI plus PET/CT strategy also had higher accuracies(95% vs 81%), with a cost saving of $590 RMB per patient, and reducing unneces-sary thoracotomy by 13.5%; this was accompanied by 0.3% missed diagnosis rate. CT plus PET strategy is cost effective at a prevalence rate of 0-34%, but there was a larger prevalence range of lung cancer for CT plus ACNB strategy(from 0 to 0.6) and CT plus DWI plus PET/CT strategy(from 0 to 0.64). CONCLUSION: CT plus DWI plus PET/CT strategy was cost-effective, and had a higher accuracy accompanied by a lower missed diagnosis rate than CT plus ACNB strategy.

Characteristics of gut microbiota in anastomotic leakage patients in cold zones post-colorectal cancer surgery: A high-throughput sequencing and propensity-score matching study

Objective:The study aimed to explore the association between gut microbiota and anastomotic leakage(AL)after surgery in colorectal cancer(CRC)patients from a frigid zone,based on high-throughput sequencing.Methods:A total of 98 CRC patients admitted to the Second Affiliated Hospital of Harbin Medical University from July 2018 to February 2019,who met the inclusion criteria,were included.Among these,10 patients were diagnosed as AL.After propensity-score matching of baseline characteristics,10 patients from the anastomotic leakage group(AG)and 10 patients from the normal group(NG)were finally included in this study.Fecal samples were collected,and total DNA was extracted for high-throughput sequencing and bioinformatic analysis.Results:Alpha diversity analysis showed no significant difference between the two groups,while beta diversity analysis revealed significant differences in principal components.Differential microbiota were classified as Proteobacteria at the phylum level(P=0.021).At the genus level,the abundances of Streptococcus(P=0.045),Citrobacter(P=0.008)and Klebsiella(P=0.002)were significantly different between the two groups.LEfSe analysis indicated that these genera contributed most to the differences between the groups.Conclusion:The characteristics of the gut microbiota in the AG and NG were significantly different,and these differences might be associated with AL in CRC patients from frigid zones.