Background: and Purpose This study aimed to investigate the association between residual inflammatory risk (RIR) and vulnerable plaques using high-resolution magnetic resonance imaging (HRMRI) in symptomatic intracranial atherosclerotic stenosis (ICAS). Methods: This retrospective study included 70%–99% symptomatic ICAS patients hospitalized from January 2016 to December 2022. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP ≥3 mg/L and LDL-C ≥2.6 mmol/L), RIR (hs-CRP ≥3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C ≥2.6 mmol/L), and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). Vulnerable plaque features on HRMRI included positive remodeling, diffuse distribution, intraplaque hemorrhage, and strong enhancement. Results: Among 336 included patients, 21, 60, 58, and 197 were assigned to the RCIR, RIR, RCR, and NRR groups, respectively. Patients with RCIR (adjusted odds ratio [aOR], 3.606; 95% confidence interval [CI], 1.346–9.662; P=0.011) and RIR (aOR, 3.361; 95% CI, 1.774–6.368, P<0.001) had higher risks of strong enhancement than those with NRR. Additionally, patients with RCIR (aOR, 2.965; 95% CI, 1.060–8.297; P=0.038) were more likely to have intraplaque hemorrhage compared with those with NRR. In the sensitivity analysis, RCR (aOR, 2.595; 95% CI, 1.201–5.608; P=0.015) exhibited an additional correlation with an increased risk of intraplaque hemorrhage. Conclusion In patients with symptomatic ICAS, RIR is associated with a higher risk of intraplaque hemorrhage and strong enhancement, indicating an increased vulnerability to atherosclerotic plaques.

Background: and Purpose This study aimed to investigate the association between residual inflammatory risk (RIR) and vulnerable plaques using high-resolution magnetic resonance imaging (HRMRI) in symptomatic intracranial atherosclerotic stenosis (ICAS). Methods: This retrospective study included 70%–99% symptomatic ICAS patients hospitalized from January 2016 to December 2022. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP ≥3 mg/L and LDL-C ≥2.6 mmol/L), RIR (hs-CRP ≥3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C ≥2.6 mmol/L), and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). Vulnerable plaque features on HRMRI included positive remodeling, diffuse distribution, intraplaque hemorrhage, and strong enhancement. Results: Among 336 included patients, 21, 60, 58, and 197 were assigned to the RCIR, RIR, RCR, and NRR groups, respectively. Patients with RCIR (adjusted odds ratio [aOR], 3.606; 95% confidence interval [CI], 1.346–9.662; P=0.011) and RIR (aOR, 3.361; 95% CI, 1.774–6.368, P<0.001) had higher risks of strong enhancement than those with NRR. Additionally, patients with RCIR (aOR, 2.965; 95% CI, 1.060–8.297; P=0.038) were more likely to have intraplaque hemorrhage compared with those with NRR. In the sensitivity analysis, RCR (aOR, 2.595; 95% CI, 1.201–5.608; P=0.015) exhibited an additional correlation with an increased risk of intraplaque hemorrhage. Conclusion In patients with symptomatic ICAS, RIR is associated with a higher risk of intraplaque hemorrhage and strong enhancement, indicating an increased vulnerability to atherosclerotic plaques.

Background: and Purpose This study aimed to investigate the association between residual inflammatory risk (RIR) and vulnerable plaques using high-resolution magnetic resonance imaging (HRMRI) in symptomatic intracranial atherosclerotic stenosis (ICAS). Methods: This retrospective study included 70%–99% symptomatic ICAS patients hospitalized from January 2016 to December 2022. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP ≥3 mg/L and LDL-C ≥2.6 mmol/L), RIR (hs-CRP ≥3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C ≥2.6 mmol/L), and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). Vulnerable plaque features on HRMRI included positive remodeling, diffuse distribution, intraplaque hemorrhage, and strong enhancement. Results: Among 336 included patients, 21, 60, 58, and 197 were assigned to the RCIR, RIR, RCR, and NRR groups, respectively. Patients with RCIR (adjusted odds ratio [aOR], 3.606; 95% confidence interval [CI], 1.346–9.662; P=0.011) and RIR (aOR, 3.361; 95% CI, 1.774–6.368, P<0.001) had higher risks of strong enhancement than those with NRR. Additionally, patients with RCIR (aOR, 2.965; 95% CI, 1.060–8.297; P=0.038) were more likely to have intraplaque hemorrhage compared with those with NRR. In the sensitivity analysis, RCR (aOR, 2.595; 95% CI, 1.201–5.608; P=0.015) exhibited an additional correlation with an increased risk of intraplaque hemorrhage. Conclusion In patients with symptomatic ICAS, RIR is associated with a higher risk of intraplaque hemorrhage and strong enhancement, indicating an increased vulnerability to atherosclerotic plaques.

Objective To evaluate the inhibitory activity of fluoxetine alone and in combination with fluconazole on Candida albicans.Methods This study used standard strains of Candida albicans,clinical isolates of Candida albicans,and drug-resistant strains of Candida albicans for experiments to prepare the planktonic and biofilm states of Candida albicans,respectively.The effect of fluoxetine on Candida albicans was detected by XTT reduction method.Pharmacodynamic properties of fluoxetine against Candida albicans biofilm were determined by improved time-kill test.The morphological changes of fluoxetine on Candida albicans biofilm were observed by scanning electron microscopy,and the synergistic effect of fluoxetine combined with fluconazole on Candida albicans biofilms was detec-ted by the checkerboard dilution method.Results Fluoxetine had inhibitory effects on three types of Candida albicans biofilms.The minimum drug concentration that inhibited 50%activity(SMIC50)of biofilms of standard strains of Candida albicans and drug-resistant strains was 32 μg/mL;the SMIC50 of clinical strains of Candida albicans biofilm was 64 μg/mL.Time-kill test displayed that the bio-film activity of three types of Candida albicans significantly decreased compared to the control group at the fluoxetine concentration of 1×SMIC50 and 2×SMIC50.Scanning electron microscopy observation showed that compared with the control group,the number of fungal hyphae in the biofilm of Candida albicans treated with fluoxetine decreased and their morphology wrinkled.The checkerboard microdilu-tion method showed that the combination of fluoxetine and fluconazole exhibited a synergistic effect on the standard strain of Candida al-bicans bioflim,while showing no or antagonistic effects on the other two strains.Conclusion Fluoxetine alone has inhibitory effects on biofilms of different types of Candida albicans and has a synergistic inhibitory effect on biofilms of standard strains of Candida albicans combined with fluconazole.

Objective To evaluate the effects of chloroquine alone and in combination with traditional antifungal agents on the Candi-da albicans biofilms and its drug resistance.Methods This study used standard strains of Candida albicans,and drug-resistant strains of Candida albicans.The inhibitory effects of chloroquine alone and in combination with antifungal drugs on biofilms of Candida albi-cans were detected by XTT reduction method and chessboard dilution method respectively.The morphological characteristics of biofilms were observed under scanning electron microscopy.Results Chloroquine at the concentration of 50 μmol/L or above showed a direct inhibitory effect and increased with concentration.Chloroquine combined with amphotericin B had a synergistic inhibitory effect.Results of the time-killing curve showed that the growth trends of biofilms treated with chloroquine alone and combined with amphotericin B var-ied in different time periods during the experimental culture.Morphological observation also revealed that chloroquine alone and in com-bination with amphotericin B could reduce the ability of Candida albicans to form hyphae and biofilms.Conclusion Chloroquine has an inhibitory effect on Candida albicans biofilms and can reduce its drug resistance.Furthermore,chloroquine shows a synergistic anti-fungal effect when combined with amphotericin B.

Objective To investigate the changes of coagulation,fibrinolysis and platelet indexes in ovarian cancer patients before and after neoadjuvant chemotherapy,and to analyze the risk relationship between relevant indexes before treatment and the effect of neoadjuvant chemotherapy(NACT).Methods Patients with ovarian cancer admitted to Xi'an Fengcheng Hospital,from March 2020 to March 2023 were included as the ovarian cancer group,and female patients who underwent physical examination in the same period were selected as the control group according to a 2∶1 ratio.Prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),fibrinogen(FIB),platelet distribution width(PDW),platelet hematocrit(PCT),platelet(PLT)and mean platelet volume(MPV)were compared between the two groups.The changes of these indexes were compared before and after NACT,at different clinical stages and before and after NACT with different efficacy effects.Moreover,they were divided into effective and ineffective groups according to their treatment efficacy.Logistic regression was used to explore the relationship between the parameters and NACT efficacy;receiver operating characteristic curve was drawn to predict the value of NACT efficacy.Results A total of 144 patients were included,with 96 cases in the ovarian cancer group and 48 in the control group.The FIB,PLT and MPV of patients in the ovarian cancer group were higher than those in the control group(P<0.05).The PT,TT,APTT,FIB and PLT of ovarian cancer patients after NACT were lower than those before NACT(P<0.05).FIB and PLT of stage Ⅱ patients were lower than those of stage Ⅲ before and after NACT,and the PT,TT,APTT,FIB and PLT of the effective group were lower than those of the ineffective group before and after NACT,and the PT,TT,APTT,FIB and PLT of the two groups after NACT were lower than those before NACT(P<0.05).Multivariate Logistic regression analysis indicated that high PT,TT,APTT,FIB and PLT before NACT were independent risk factors for NACT ineffectiveness(P<0.05).The area under the curve of PT,TT,APTT,FIB and PLT before NACT to predict the effect of NACT were 0.713(sensitivity of 80.95%,specificity of 69.33%),0.756(sensitivity of 71.43%,specificity of 82.67%)and 0.787(sensitivity of 76.19%,specificity of 70.67%),0.727(sensitivity of 71.43%,specificity of 84.00%),0.794(sensitivity of 80.95%,specificity of 76.00%),respectively.Conclusion Changes in coagulation and fibrinolytic function and platelet parameters in ovarian cancer patients after NACT are associated with clinical stages and NACT effect.High levels of PT,TT,APTT,FIB and PLT before NACT are important reasons affecting NACT effect.Constructing the risk prediction model of NACT efficacy in ovarian cancer patients based on the above five parameters can provide a reference for clinical practice.

AIM To study the secondary metabolites from the endophytic fungi Candida sp.of Berberis atrocarpa Schneid.METHODS The ethyl acetate fraction and petroleum ether fraction from the secondary metabolites of Candida sp.fermentation extract were separated and purified by silica gel,Sephadex LH-20 and preparative liquid chromatography,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Eighteen compounds were isolated and identified as 1-phenyl-1,2-ethanediol(1),4-hydroxyphenethyl alcohol(2),4-hydroxybenzoic acid(3),4-hydroxyphenylacetic acid(4),3-hydroxyphenylacetic acid(5),3-methylsulfinyl propionic acid(6),phenylacetic acid(7),(S)-N-nitroso-1-amino-p-hydroxy phenylethanol(8),2-phenylacetamide(9),p-hydroxybenzaldehyde(10),ethyl 2-(4-hydroxyphenyl)acetate(11),dibutyl phthalate(12),5,5'-dimethoxybiphenyl-2,2'-diol(13),3-indolealdehyde(14),N-acetyl-L-phenylalanine(15),9-hydroxy-10E,12Z-octadecadienoic acid(16),9-hydroxy-10E,12E-octadecadienoic acid(17),(6E)-5-methylene-6-tetradecenoic acid(18).CONCLUSION Compounds 1,3-8 and 10-18 are isolated from Candida sp for the first time.

The demographic characteristics, drug use, clinical symptoms and other data of the patients treated with Huoxiang Zhengqi Oral Liquid were collected. The latent class analysis(LCA) was performed to reveal the distribution of primary symptoms, and then the doubly robust estimation was employed to analyze the efficacy of different doses of Huoxiang Zhengqi Oral Liquid in different populations. A total of 11 273 patients were enrolled in this study, including 4 347 males and 6 926 females. A total of 15 primary symptoms were included, with the top 3 being dizziness(53.9%), head heaviness(39.6%), and nausea(39.4%). According to the LCA, the population was divided into 3 groups of spleen deficiency and dampness exuberance(5 604 cases, 49.71%), upward harassing of wind-phlegm(4 955 cases, 43.96%), and spleen Qi deficiency(714 cases, 6.33%). Double robust estimation showed that the time to recovery of the patients with spleen Qi deficiency had no significant difference regarding the daily dose. Compared with the daily dose of 20 mL, the daily doses of 40, and 60 mL shortened the time to recovery by 16.67(95%CI[5.23, 28.12]) and 15.94 h(95%C1[7.45, 24.43]) in the patients with upward harassingof wind-phlegm, the daily doses of 30, 40, and 60 mL shortened the time to recovery by 4.42(95%CI[1.06, 7.77]), 13.07(95%CI[1.61, 24.54]), 13.92 h(95%CI[5.14, 22.70]) in the patients with spleen deficiency and dampness exuberance, respectively. The patients with cold due to wind-cold and dampness stagnation had more primary syndromes, and the disease locations were mainly in the head, stomach, and spleen. In clinical practice, the daily dose of Huoxiang Zhengqi Oral Liquid can be increased according to the symptoms of patients, which can shorten the time to recovery.
Humans ; Male ; Female ; Drugs, Chinese Herbal/therapeutic use* ; Middle Aged ; Adult ; Young Adult ; Aged ; Adolescent ; Administration, Oral ; Wind ; Child ; Spleen/drug effects* ; Cold Temperature ; Aged, 80 and over

Objective:To evaluate the protective effect of foam dressing in preventing intraoperative acquired pressure injury (IAPI), and to provide reference basis for prevention and treatment of IAPI during clinical operation.Methods:The clinical data of 455 surgical patients admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University from October 2020 to January 2021 were retrospectively collected. According to whether foam dressing was used at the compression site during operation, the patients were divided into dressing group (101 cases) and control group (354 cases). The two groups were matched with age, body mass index, preoperative Braden and cerebrovascular disease as covariates, and were finally divided into 89 patients in the dressing group and 162 patients in the control group. Logistic regression analysis and stratified analysis were used to comprehensively evaluate the actual effect of foam dressing on the occurrence of IAPI in the surgical patients.Results:Among the 251 patients, there were 14 (15.7%) cases with IAPI in the dressing group and 13 (8.0%) cases in the control group, and the difference was not statistically significant ( χ2=3.41, P>0.05). Among the patients in the prone position, compared to the control group, the dressing group can effectively reduce the risk of IAPI in surgical patients by 77% ( OR=0.23, 95% CI 0.05-0.98, P<0.05). There was no interaction between foam dressing and intraoperative surgical characteristics ( P>0.05). Conclusions:Foam dressing plays a protective role in preventing the occurrence of IAPI in patients undergoing surgery in the prone position. There was no significant protective effect of intraoperative foam dressing in patients with other surgical characteristics.

Glioblastoma(GBM)is a lethal cancer with limited therapeutic options.Dendritic cell(DC)-based cancer vaccines provide a promising approach for GBM treatment.Clinical studies suggest that other immu-notherapeutic agents may be combined with DC vaccines to further enhance antitumor activity.Here,we report a GBM case with combination immunotherapy consisting of DC vaccines,anti-programmed death-1(anti-PD-1)and poly I:C as well as the chemotherapeutic agent cyclophosphamide that was integrated with standard chemoradiation therapy,and the patient remained disease-free for 69 months.The patient received DC vaccines loaded with multiple forms of tumor antigens,including mRNA-tumor associated antigens(TAA),mRNA-neoantigens,and hypochlorous acid(HOCl)-oxidized tumor lysates.Furthermore,mRNA-TAAAs were modified with a novel TriVac technology that fuses TAAs with a destabilization domain and inserts TAAs into full-length lysosomal associated membrane protein-1 to enhance major histo-compatibility complex(MHC)class Ⅰ and Ⅱ antigen presentation.The treatment consisted of 42 DC cancer vaccine infusions,26 anti-PD-1 antibody nivolumab administrations and 126 poly I:C injections for DC infusions.The patient also received 28 doses of cyclophosphamide for depletion of regulatory T cells.No immunotherapy-related adverse events were observed during the treatment.Robust antitumor CD4+and CD8+T-cell responses were detected.The patient remains free of disease progression.This is the first case report on the combination of the above three agents to treat glioblastoma patients.Our results suggest that integrated combination immunotherapy is safe and feasible for long-term treatment in this patient.A large-scale trial to validate these findings is warranted.