A biopsychosocial safeness model: New directions for psychotherapy research and practice.

Metabolomic profiling reveals intestinal toxicity in zebrafish upon single and combined exposure to polystyrene microplastics and azithromycin.

While bone functional adaptation has been previously documented in adults and adolescents, the developmental trajectory of trabecular bone during early postnatal life remains poorly characterized. We investigated whether trabecular bone development follows a biphasic pattern analogous to synaptic pruning in neural development: initial selective trabecular elimination ("trabecular pruning") followed by architectural refinement. We conducted a systematic review synthesizing data from 14 human studies and 11 animal studies examining trabecular bone ontogeny from birth through the early juvenile period across multiple skeletal sites. Following initial in-utero trabecular overproduction, available evidence suggests that altricial mammals (including humans) undergo trabecular pruning during the perinatal period, characterized by decreases in trabecular bone volume fraction (BV/TV, 10-65%) driven primarily by a reduction in trabecular number (Tb.N) rather than trabecular thinning. In long bones directly involved in locomotion, where evidence is clearest, Tb.N decreases from 3-4/mm to below 2/mm while trabecular thickness (Tb.Th) increases modestly from approximately 100µm to 150µm. Trabecular pruning timing coincides with independent locomotion onset, and concurrent increases in the degree of anisotropy suggest mechanically guided elimination of minimally loaded trabeculae. Evidence from precocial animals (horses, pigs) is currently limited, but is broadly consistent with the absence of a perinatal trabecular pruning phase, in line with their immediate weight-bearing requirements at birth. Trabecular pruning represents a specific manifestation of "developmental sculpting"-a suggested fundamental biological principle whereby systems achieve functional optimization through initial overproduction followed by activity-dependent elimination. Recognizing trabecular pruning as a distinct skeletal functional adaptation phase provides new insights into bone development within broader principles of biological organization.

ABSTRACT Background Sex-related differences in nontuberculous mycobacterial pulmonary disease (NTM-PD) may influence both clinical presentation and radiographic phenotypes; however, evidence from Chinese populations remains limited. Research design and methods This retrospective study included 218 patients with NTM-PD in China. Patients were stratified by sex. Clinical characteristics, comorbidities, laboratory parameters, and high-resolution computed tomography findings were compared. Logistic regression analyses were performed to evaluate the association between sex and specific radiographic manifestations. Results Females had lower body mass index and higher rates of bronchiectasis and gastroesophageal reflux disease. The nodular bronchiectatic phenotype predominated in females (85.85%), with middle lobe/lingula involvement (71.70%). Female sex was independently associated with tree‑in‑bud opacities (p = 0.031). Males had higher rates of smoking, previous tuberculosis, and chronic obstructive pulmonary disease (COPD), and more fibrocavitary disease (25.00%), but cavitation was linked to smoking, tuberculosis, and COPD rather than sex (p = 0.118). Conclusions Significant sex differences exist in the clinical and radiographic phenotypes of Chinese patients with NTM-PD. Limitations include the single-center retrospective design, relatively small sample size, lack of long-term follow-up data, and absence of sex hormone and environmental exposure assessments.

Scalp psoriasis is a recalcitrant phenotype that imposes a substantial burden on quality of life. While the therapeutic landscape has expanded, comprehensive comparative evidence for newer biologics and small molecules in this specific manifestation remains limited. To systematically compare the short-term efficacy, safety and tolerability of biologics and small molecules for scalp psoriasis. We conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs) identified from MEDLINE, EMBASE, CENTRAL and other databases from inception to October 2025. The primary efficacy endpoint was scalp clearance (defined as Scalp Physician's Global Assessment [scPGA] 0/1, scalp-specific Investigator's Global Assessment [ss-IGA] 0/1 or Psoriasis Scalp Severity Index [PSSI] 90/100) at Weeks 12-16. Safety outcomes included all-grade adverse events (AEs) and serious AEs (SAEs). Tolerability was defined as the discontinuation rate due to AEs. Data were synthesized using a frequentist random-effects model. Sixteen RCTs comprising 10,266 patients were included. All active agents demonstrated statistically significant improvements versus placebo. Ixekizumab every 2 weeks (Q2W) (odds ratio [OR] 54.02; 95% confidence interval [CI] 39.38-74.09) and brodalumab (OR 53.16; 95% CI 15.47-182.69) ranked highest for scalp clearance, followed by ixekizumab every 4 weeks (Q4W), guselkumab and bimekizumab. Regarding safety, secukinumab, tildrakizumab, apremilast, deucravacitinib and both ixekizumab regimens were associated with significantly higher incidences of all-grade AEs compared with placebo, whereas SAE risks were non-significant across interventions. Apremilast was the only agent associated with significantly higher discontinuation rates due to AEs (OR 1.62; 95% CI 1.09-2.42). Interleukin-17 inhibitors, particularly ixekizumab and brodalumab, demonstrated the most significant short-term scalp clearance. Guselkumab showed a favourable balance of efficacy, safety and tolerability. Serious adverse events were not significantly increased with any agent. Collectively, these findings provide up-to-date comparative evidence to inform the selection of systemic therapies for scalp psoriasis.

This study explored the culturally specific manifestations of interpersonal psychotherapy's (IPT's) four problem areas within the Chinese cultural context. Synthesizing qualitative feedback from IPT training and clinical supervision involving approximately 500 Chinese mental health professionals (2018-2025), the analysis aimed to highlight how traditional values-such as collectivism, filial piety (xiao), and face (mianzi, or social reputation and dignity)-profoundly shape interpersonal distress. The specific cultural nuances examined included how complicated grief is often masked by male stoicism or compounded by the shidu (loss of only child) stigma; how role transitions are intensified by rapid urbanization, affecting both migrants and left-behind elders; how role disputes are navigated through indirect communication; and how interpersonal deficits are linked to systemic pressures from exam-oriented education. The authors argue that successful implementation of IPT necessitates cultural contextualization rather than structural alteration. Therapists are encouraged to act as cultural navigators, cultivating sensitivity to these internal social norms. By validating somatic expressions and reconstructing culturally resonant support systems, IPT can achieve clinical efficacy and social relevance to foster interpersonal recovery in China.

Introduction: Presently, liver transplantation is becoming a more common treatment option for adults and children suffering from liver failure. Antibody-mediated rejection (AMR), a phenomenon that is exceedingly uncommon and inadequately comprehended, may induce graft dysfunction. The objective of the investigation was to evaluate the clinical and histopathological manifestations of AMR in pediatric patients. Material and methods: The retrospective study comprised sixty-two liver core biopsies from forty-two pediatric patients. In a total of 10 biopsies, 7 children were diagnosed with AMR, while 35 of them exhibited features of acute T-cell-mediated rejection (TCMR) in 52 biopsies. The C4d binding assay was conducted in all biopsies using the immunohistochemical (IHC) method. Bilirubinostasis, steatosis and acute and chronic rejection were re-assessed in all specimens. The 6-grade Ishak scale was employed to evaluate fibrosis. The TCMR activity was established using the Banff classification. AMR was assessed according to a novel histopathological grading system that was developed by the authors. Depending on the type of rejection, the relationship between histopathological grading, morphological characteristics, and laboratory parameters was established for each group. Standard methods were implemented to conduct statistical analysis. Results: At the time of biopsy, the median age of patients was 47.6 months (15.03–98.83) and the median time from transplantation was 0.9 months (0.3–7.6). The study’s findings provided evidence that histopathological lesions were the least specific manifestation, which supported the presence of AMR. A positive C4d staining statistically increases the likelihood of AMR diagnosis, whether or not there are associated morphological abnormalities. The type of rejection and laboratory tests did not exhibit any statistically significant correlation. Conclusions: The diagnosis of AMR in a transplanted liver is intricate and requires a multifaceted approach. However, the proposed histopathological grading may be a helpful method for selecting patients who should be assessed for donor-specific antibodies (DSAs) or in whom AMR should be suspected when DSAs cannot be determined.

Gallbladder cancer is one of the most aggressive malignancies in the biliary system, and there is currently no internationally recognized standardized treatment protocol. Reports on the management of rare pathological types of gallbladder cancer are particularly limited. We present 2 cases of gallbladder cancer with rare pathological subtypes and their diagnostic and therapeutic processes, aiming to further enhance clinicians' understanding of these uncommon entities. This report describes 2 cases of gallbladder cancer, both presenting with abdominal discomfort, raising concerns about the nature of the lesion and effective treatment strategies. Postoperative pathology confirmed one case as gallbladder sarcomatoid carcinoma and the other as gallbladder carcinosarcoma, both of which are clinically rare types. Both patients underwent laparoscopic cholecystectomy at our institution, with subsequent pathological and immunohistochemical examination. As of the end of follow-up (November 30, 2025), both patients recovered well postoperatively. Rare types of gallbladder cancer lack specific clinical manifestations, making early screening difficult. Most patients are diagnosed at an advanced stage. Surgical intervention should be performed as early as possible upon discovery.

Aslanger's and de Winter's patterns associated with acute left coronary artery disease: A case report of two patients.

Individuals with depressive symptoms often exhibit deficits in executive function. This is especially true in advanced cognitive control tasks such as conflict inhibition. Specific manifestations include insufficient allocation of attentional resources and delayed responses. This study aimed to explore whether an 8 week cognitively engaging exercise has a continuous effect on improving the conflict inhibition of college students with depressive symptoms. It also aimed to reveal the underlying cognitive neural processing mechanisms. The study used the BDI-II depression symptom self-rating scale to recruit and screen 40 college students with scores greater than 13. These subjects were randomly assigned to an exercise group and a routine control group in a 1:1 ratio. The exercise group received moderate intensity Taekwondo target kicking exercise 3 times a week for 30 min each time over a total of 8 weeks. This included 5 min of warm up, 20 min of Taekwondo target kicking, and 5 min of cool down. The control group engaged in time matched 30-min quiet reading sessions focusing on mental health manuals. Both groups maintained their habitual daily routines and abstained from additional regular exercise. The BDI-II scale was used to examine changes in depressive symptoms among college students before and after the exercise intervention. Simultaneously, the Stroop task and event related potential techniques were used. These methods investigated the synchronized changes in the behavioral performance of conflict inhibition and the amplitude and latency of N2 and P3 in the brain among college students with depressive symptoms before and after the intervention. Independent sample t-tests and paired sample t-tests were used for data analysis of the scale scores. For the behavioral task and event related potential results, MATLAB 2022b was used for data preprocessing. Repeated measures analysis of variance was then used to explore the main effects and interaction effects of different groups, time points, task conditions, and electrodes. The results showed that after 8 weeks, the BDI II scores of college students with depressive symptoms in the exercise group significantly decreased (p < 0.05). The remission rate of depressive symptoms reached 70%. The BDI-II scores of the routine control group did not show significant changes (p > 0.05), and no remission occurred. There was a significant difference in the BDI II scores between the exercise group and the routine control group at the post test stage (p < 0.05). The Stroop behavioral results showed that the task reaction time had significant interaction effects for time by group and time by condition by group (p < 0.05). The event-related potential results showed that the N2 amplitude had significant two-way interaction effects for time by group (p < 0.05) and time by condition (p < 0.05). The P3 amplitude had a significant three-way interaction effect for time by condition by group (p < 0.05). The N2 latency had a significant interaction effect for time by group. It also showed a significant three-way interaction effect for time by electrode by group (p < 0.05). The P3 latency had a significant three-way interaction effect for time by condition by electrode (p < 0.05). Cognitively engaging exercise can effectively improve the mood of college students with depressive symptoms. It also has a specific regulatory effect on conflict inhibition capabilities. The underlying cognitive neural processing mechanisms are mainly reflected in enhancing conflict monitoring and optimizing the allocation of attentional resources. They also involve improving the temporal processing efficiency of the prefrontal and central areas. By regulating the temporal and spatial activation patterns of brain regions related to cognitive control, the conflict inhibition function of college students with depressive symptoms is strengthened. Trial Registration: Chinese Clinical Trial Registry Number: ChiCTR2400087261.

Behcet's syndrome (BS) was first described in 1937 as a triad of oral aphthae, genital ulceration, and ocular involvement. It is now recognized as a multisystemic vasculitis that can affect central nervous, gastrointestinal, and cardiovascular systems. Despite extensive research, the etiology of BS remains unclear, and genetic, viral, and environmental factors are thought to contribute to its pathogenesis. This study aimed to investigate the role of interleukin-17 (IL-17) and IL-23 receptor (IL-23R) gene polymorphisms in the etiology of BS and to evaluate their associations with disease activity and clinical features. The IL-23/IL-17 axis was selected due to its pivotal role in T cell-mediated inflammation and vasculitis, which are key pathogenic mechanisms in BS. This study was conducted at the Ankara University Faculty of Medicine over a 1-year period. A total of 142 patients with BS aged ≥18 years and 140 healthy controls without known rheumatologic or immunological diseases were included. BS was diagnosed according to the International Study Group criteria for Behçet's disease. Disease activity was assessed using the BS Activity Scale, and patients were classified as having active or inactive disease. Genomic DNA was extracted from peripheral blood samples. IL-17 and IL-23R gene polymorphisms were analyzed using the polymerase chain reaction-restriction fragment length polymorphism method. The IL-17 rs2275913 and rs763780 polymorphisms and the IL-23R rs11209032 polymorphism were evaluated. The frequency of the homozygous AA genotype of the rs11209032 was significantly higher in the BS group than in healthy controls (85.9% vs. 17.4%, p < 0.001). Carriage of the A allele was associated with a markedly increased risk of BS; after adjustment for age and sex, carriers had approximately 16-fold higher odds of disease (adjusted odds ratios [OR] = 16.32, 95% confidence intervals [CI]: 9.76-27.12, p < 0.001). No significant differences were observed between BS patients and controls for the IL-17 polymorphisms. Gene polymorphisms were not associated with specific clinical manifestations. However, in the IL-17 rs763780 polymorphism, inactive patients had a higher frequency of the TT genotype compared with the TC genotype (p = 0.03), suggesting a potential role in disease activity rather than susceptibility. These findings suggest that IL-17 and IL-23R-related pathways may contribute to the pathogenesis of BS. While the IL-17 variant may be associated with disease activity, the IL-23R rs11209032 polymorphisms show a strong association with disease susceptibility. However, larger studies are needed to confirm these findings and clarify their clinical relevance.

Successful Treatment of Balamuthia Mandrillaris Amebic Encephalitis Diagnosed by MetaCAP in China: A Case Report and Review of 25 Survival Cases.

Traumatic intrusion of the mandibular condyle into the middle cranial fossa is an extremely rare and life-threatening condition. It often lacks specific clinical manifestations, particularly in patients with polytrauma, which typically leads to oversight or misdiagnosis. Although many individuals present without obvious neurological deficits, associated craniofacial injuries such as concussion, intracranial hemorrhage, cerebrospinal fluid leakage, otorrhagia, hearing impairment, and facial nerve dysfunction are commonly observed. Most published cases have involved condylar fractures; however, intracranial penetration by an intact condyle is extremely rare. While guidelines for condylar fractures suggest prompt condylar removal and skull base repair, the feasibility of skull base reconstruction depends on the complexity of the trauma. Treatment decisions, including the choice of surgical approach and reconstruction, were individualized for each case. In the present case, skull base repair was not performed because of a comminuted fracture during emergency surgery. Despite severe craniocerebral injuries, emergency surgery could not resolve the issue, and the patient refused secondary surgery and opted for conservative treatment, which ultimately resulted in a favorable outcome. This case highlights that conservative treatment can be a prudent choice when surgical conditions are limited. This report describes a rare case of intact intracranial penetration of the mandibular condyle, discusses its clinical and imaging characteristics, and reviews therapeutic strategies, providing insights into early diagnosis and personalized management.

Abstract: This article presents the results of an analysis of the state-political discourse surrounding the publicly expressed positions of the Western Balkan countries regarding their accession processes to the European Union. A selection of key rhetorical, media, and public statements by politicians and institutions from Albania, North Macedonia, Serbia, and Montenegro has been made, in which messages, communication strategies, and visions regarding their European integra-tion are presented. A selection of key European Union-level documents regarding decisions on the accession of countries to the European Union has been compiled. One hypothesis is that the state-political discourse, rhetoric, and public and media statements used by leaders of the four Western Balkan countries incorporate various communicative approaches and rhetorical techniques; it is characterized by heterogeneity, pathos, declarativeness, not always clearly formulated demands, and situational conditioning. The second hypothesis is that, from a rhetorical perspective, logos and argumentation predominate in the institutional reports and official statements of European Union institutions when presenting these reports, which are a specific manifestation of political discourse at the supranational level. The methodology includes a critical discourse analysis by Teun van Dijk, rhetori¬cal analysis, and political science analysis, given the interdisciplinary nature of the research subject. The aim is to identify messages and strategies used to present positions at the national and international institutional levels regarding the Euro¬pean integration of states, as well as the effects or shortcomings at the rhetorical and political levels. Keywords: state-political discourse, rhetoric, critical discourse analysis, rhetori¬cal analysis, Western Balkans, EU, European integration.

Objective: To explore the clinical and pathological characteristics and prognosis of retroperitoneal unicentric Castleman disease (UCD). Methods: This study employed a retrospective observational research design. The inclusion criteria were: (1) postoperative pathological confirmation of Castleman disease; (2) patients underwent surgical treatment; (3) preoperative imaging diagnosis of a retroperitoneal unicentric lesion; (4) complete clinicopath- ological data. Exclusion criteria: (1) received preoperative antitumor therapy; (2) had a history of other malignancies within the past 5 years. According to these criteria, clinicopathological and follow-up data of 38 patients with retroperitoneal UCD treated at Tianjin Medical University Cancer Hospital from January 2015 to August 2024 were collected. The clinicopathological characteristics and prognosis were analyzed. Results: Among the 38 patients with retroperitoneal UCD, there were 12 males and 26 females. The mean age was (42.8±15.4) years (range, 18-70 years), and the mean maximum tumor diameter was (5.8±2.3) cm. The disease had no specific clinical manifestations, and 28 cases (73.7%) were detected during physical examination. Of the 38 patients, 35 (92.1%) underwent radical resection, while 3 (7.9%) received intracapsular piecemeal resection due to large, invasive tumor growth. Postoperative pathology revealed that 32 cases (84.2%) were of the hyaline vascular type, and 3 cases (7.9%) each were of the plasma cell type and mixed type, respectively. The median follow-up duration was 32.4 months (range, 3-78 months). Eight patients were lost to follow-up, 6 died of other diseases, and the remaining 24 patients had no recurrence during postoperative follow-up (including 3 patients who underwent piecemeal resection, with no tumor progression). Competing risk model analysis showed that the 5-year tumor-specific survival rate of patients with retroperitoneal UCD after surgical treatment was 100%. In the sensitivity analysis, the 5-year survival rate under the worst-case scenario was 75.0%. Conclusions: Retroperitoneal unicentric Castleman disease has a low incidence and lacks specific clinical manifestations. Surgical treatment is the main therapeutic approach, and patients have a favorable prognosis.

As a core representative of Cuban-American literature, Cristina Garc&amp;iacute;a focuses her creations on the exile experiences of Cubans after the Cuban Revolution, and profoundly depicts the identity predicament and intergenerational transmission of trauma faced by the Cuban-American &amp;ldquo;one-and-a-half generation&amp;rdquo;. Taking her representative works Dreaming in Cuban (1992) and The Ag&amp;uuml;ero Sisters (1997) as the research objects, this paper systematically analyzes the specific manifestations and transmission mechanisms of generational trauma in the two novels, as well as its profound influence on the identity construction of the Cuban-American one-and-a-half generation from the interdisciplinary perspectives of postcolonial theory, feminist criticism and trauma studies. The study finds that Garc&amp;iacute;a adopts narrative strategies such as female lineage inheritance, memory politics and cross-cultural conflict to reveal how Cuban exile trauma transcends generational boundaries and shapes the &amp;ldquo;in-between identity&amp;rdquo; of the one-and-a-half generation who neither fully belong to Cuba nor integrate into the United States. It is further pointed out that the process of the one-and-a-half generation experiencing, negotiating and reconstructing generational trauma has become an important path for them to construct a unique hybrid cultural identity.

As the top segment of the higher education system, postgraduate education serves as the core carrier for cultivating high-level professional and innovative talents, undertaking the vital mission of providing high-quality intellectual resources for social development. With the continuous expansion of postgraduate enrollment in China, various contradictions in the training process have gradually emerged, among which the dual predicament of "disordered life and stagnant research" faced by some postgraduates has become a typical issue. In life, they are trapped by academic pressure, time imbalance and social isolation, losing the autonomous rhythm of life and the sense of emotional gain; in research, they are restricted by confusion in topic selection, insufficient motivation and lack of resources, falling into a vicious circle of research internal friction and hindered achievement output. Based on the core concept of "helping people to help themselves" in social work, with ecological system theory and social support theory as the theoretical framework, and combined with the actual situation of postgraduate training in universities, this paper analyzes the specific manifestations and formation mechanism of postgraduates' dual predicament of "life and research" through literature review and semi-structured interviews. It further explores the paths and practical strategies of professional social work intervention from the micro individual, meso campus and macro social levels, aiming to provide practical references for alleviating the development predicament of postgraduates, optimizing the postgraduate training system in universities and improving the quality of postgraduate training, so as to help postgraduates realize the coordinated development of academic research and daily life.

The popularization of intelligent generation technology has greatly lowered the threshold for short drama creation, increased industry output, and quickly become an important form of mass cultural consumption due to its adaptation to fragmented consumption. However, with the expansion of the industry, the problem of homogenization permeates the entire process from creation to operation. Not only are there themes of urban romance and rebellious literature, but there are also phenomena such as fixed narrative routines, repetitive visual materials, and single promotion paths, which directly restrict the industry's transformation from "scale expansion" to "quality improvement". This article combines the actual situation of the short drama industry, first sorting out the specific manifestations of homogenization, then analyzing the causes of technology template dependence, traffic orientation, and insufficient creator literacy, as well as the negative impact of homogenization on content competitiveness and industry vitality. Finally, strategies such as optimizing the application of intelligent technology, deepening the cultivation of diverse themes, and building an original ecology are proposed to provide practical reference for the short drama industry to break through the low-quality cycle and achieve sustainable development, and to help the industry play its cultural communication and entertainment service value.

Bartter syndrome (BS) represents a group of rare, autosomal recessive renal tubular disorders characterized by hypokalemic hypochloremic metabolic alkalosis, secondary hyperaldosteronism, and normal to low blood pressure. The underlying pathophysiology is primarily driven by defects in critical ion transport proteins or channels localized within the thick ascending limb of the loop of Henle, leading to impaired salt reabsorption. Recent advances in molecular genetics have refined the classification of Bartter syndrome. Current evidence supports SLC12A1, KCNJ1, CLCNKB, BSND, and MAGED2 as the core disease genes within the contemporary BS spectrum, with MAGED2 causing a distinct X-linked transient antenatal form. In contrast, gain-of-function CASR variants, historically labeled "type V Bartter syndrome", are now more appropriately described as CaSR-associated Bartter-like phenotypes within the broader spectrum of disorders of calcium homeostasis. Despite significant progress, two primary research limitations remain. First, fully elucidating genotype-phenotype correlations and overcoming diagnostic complexities continues to be highly challenging due to substantial phenotypic overlap and genetic heterogeneity. Compounding these diagnostic hurdles is the equally critical challenge of understanding mutation-driven pathogenic mechanisms to develop viable clinical interventions. This review systematically summarizes the current molecular genetic landscape of BS to address these gaps. We highlight the relationships between specific genetic variants and clinical manifestations, delve into molecular pathophysiology including protein misfolding and trafficking defects, and explore emerging therapeutic approaches such as molecular chaperones. By integrating genetic and clinical data, this work aims to provide a comprehensive framework to facilitate precise diagnosis and individualized treatment strategies, ultimately advancing precision medicine in the management of Bartter syndrome.

Acquired immunodeficiency syndrome (AIDS) is one of the most dangerous diseases threatening global public health. Antiretroviral therapy (ART) is currently the primary treatment for people living with HIV (PLWH). However, some patients are classified as immunological non-responders (INRs), defined by the failure to achieve adequate CD4+ T cells reconstitution despite continuous viral suppression, and are associated with inferior clinical outcomes. This behavior may be linked to the ongoing dysfunction of the intestinal microenvironment. Although PLWH exhibit similar clinical changes such as intestinal mucosal injury, barrier failure, and microbial community problems, intestinal microenvironment abnormalities in INRs are more severe. The specific manifestations include persistently low levels of intestinal CD4+ T cells with limited reconstitution, along with a significant reduction in the proportion of Th17 cells, leading to severe impairment of mucosal anti-infective capacity and immune regulatory function. Additionally, elevated levels of pro-inflammatory mediators drive chronic inflammation, thereby exacerbating tissue damage. Furthermore, microbial dysbiosis is more pronounced, characterized by a marked decrease in beneficial symbiotic bacteria and an expansion of opportunistic pathogens. In contrast, immunological responders showed some degree of recovery in these indicators. These pathological features are not only associated with a higher risk of disease progression and complications in INRs but also provide a theoretical basis for developing adjuvant treatment strategies targeting intestinal immune reconstitution. In addition, we summarize the current mainstream definitions of INRs and propose a more robust definition. This review systematically elaborates the pathogenic mechanisms and potential intervention strategies underlying intestinal microenvironment abnormalities in INRs and holds important clinical value for improving the long-term prognosis of patients and advancing individualized treatment.