Objective To compare the efficacy and safety of linezolid and vancomycin in the treatment of hospitalized patients with Enterococcus bloodstream infection,to provide medication choices for clinical practice.Methods The clinical data of 99 inpatients with Enterococcus bloodstream infection in Yantai Yuhuangding Hospital from June 2019 to June 2023 were retrospectively collected,and the patients were divided into linezolid group and vancomycin group according to the drug used.confounding factors were controlled by propensity score matching method.The clinical efficacy,inflammatory factor levels,and adverse reactions of the two groups were compared.Results After using propensity score matching,25 patients were assigned to both linezolid group and vancomycin group.There was no significant difference in the effective rate,30-day mortality,incidence of adverse reactions and inflammatory factor levels between the two groups(P＞0.05).Conclusion In the treatment of patients with Enterococcus bloodstream infection,the efficacy and safety of linezolid and vancomycin are the same.Linezolid can be a prioritized medicine when vancomycin causes nephrotoxicity and concentration does not meet the standard or exceeds the standard.Due to limitation of sample size and information collection,more high-quality studies are required to verify above conclusions.

Objective To observe the clinical efficacy of Tongyuan acupuncture combined with Bushen Huoxue Prescription in the treatment of obese polycystic ovary syndrome(PCOS).Methods Sixty-eight patients with obese PCOS were randomly divided into the observation group and the control group,with 34 patients in each group.The control group was given conventional western medicine treatment,and the observation group was given Tongyuan acupuncture combined with Bushen Huoxue Prescription on the basis of the treatment of the control group for a total of 6 menstrual cycles.After 6 months of treatment,the clinical efficacy of the two groups was evaluated,and the menstrual flow and the number of menstrual cycles of the two groups were observed,and the changes in the traditional Chinese medicine(TCM)syndromes,as well as the changes in the serum levels of luteinising hormone(LH),testosterone(T),oestradiol(E2),and prolactin(PRL)were compared between the two groups before and after the treatment.Results(1)The total effective rate of the observation group was 97.06%(33/34),and that of the control group was 82.35%(28/34).The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the menstrual flow of the observation group was significantly greater than that of the control group,and the difference was statistically significant(P＜0.05).The number of menstrual periods in the observation group was not statistically significant compared with the control group(P＞0.05).(3)After treatment,the TCM syndrome scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving TCM syndrome scores,with statistically significant differences(P＜0.05).(4)After treatment,the LH,T,E2 and PRL levels of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving LH,T,E2 and PRL levels,and the difference was statistically significant(P＜0.05).Conclusion Tongyuan acupuncture combined with Bushen Huoxue Prescription for the treatment of obese PCOS can significantly improve the clinical symptoms of the patients,can effectively regulate the level of sex hormones of the patients,and the therapeutic efficacy is remarkable.

Objective To investigate the mechanism of Guizhi Fuling Pills in the treatment of polycystic ovary syndrome(PCOS)and endometriosis(EMT).Methods TCMSP was utilized to obtain the active ingredients and related targets of the constituent Chinese medicines of Guizhi Fuling Pills.GeneCards,PharmGKB,and TTD databases were used to screen PCOS and EMT disease targets,respectively.The Venn R diagram was drawn after obtaining the intersecting targets of drugs and diseases using the Venn R package in R software,the drug-active ingredient-potential target interactions network diagram was made in Cytoscape,the intersecting target protein-protein interactions(PPI)network diagram was drawn in the STRING platform,and Cytoscape was used to optimize the PPI network and screen the core targets.R language was applied for Gene Ontology(GO)enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis,and AutoDockTools was for molecular docking.Results A total of 85 active ingredients and 191 corresponding targets of Guizhi Fuling Pills were obtained,and 77 potential targets of Guizhi Fuling Pills for the treatment of PCOS and EMT.The core active ingredients of Guizhi Fuling Pills for PCOS and EMT were quercetin,β-sitosterol,kaempferol,hederagenin,baicalein,and the core targets were AKT1,EGFR,IL-6,TNF,and TP53.GO functional analysis yielded 2 020 biological process,34 cellular components,126 molecular functions,and KEGG enrichment analysis yielded 165 signaling pathways.Molecular docking showed that the core components in the formula docked well with the targets.Conclusion Guizhi Fuling Pills may regulate the signaling pathways of lipid and atherosclerosis,AGE-RAGE signaling pathway,fluid shear stress and atherosclerosis,and chemical carcinogenesis-receptor activation through quercetin,β-sitosterol,kaempferol,hederagenin,and baicalein,and act on AKT1,EGFR,IL-6,TNF,and TP53,thus treating PCOS and EMT with homotherapy for heteropathy.

Objective To construct the prediction model of perineural invasion(PNI)in gallbladder carcinoma(GBC)based on preoperative enhanced CT image features and evaluate its prediction efficiency.Methods The clinical,imaging and pathological data of 180 GBC patients undergoing radical operation were retrospectively analyzed.They were divided into positive and negative groups according to the presence or absence of PNI.Preoperative enhanced CT imaging features(including presence of gallstones,imaging hepatic invasion,vascular invasion,T-stage,and hilar or retroperitoneal lymph node metastases)were evaluated by two radiologists.Independent sample t-test,Mann Whitney U test,and X2 test were used to compare the correlation between CT signs and PNI.Logistics regression analysis was used to screen independent risk factors and establish the prediction model formula.ROC curve was used to evaluate the prediction efficiency of the prediction model and the corresponding area under the curve(AUC)was calculated.Hosmer-Lemeshow goodness of fit test was used to verify the prediction model.Results Unifactorial analysis showed that CA199,CA125,imaging hepatic invasion,vascular invasion(hepatic artery or portal vein),T-stage,and hilar or retroperitoneal lymph node metastasis were correlated with nerve invasion(P＜0.05).Logistics multi-factor analysis results showed that CA199,imaging vascular invasion(hepatic artery or portal vein),and imaging T stage were independent risk factors for PNI.Based on the above independent risk factors,a prediction model formula was established and ROC curve was drawn,with an AUC of 0.807(95％CI:0.734～0.879),sensitivity of 0.792,specificity of 0.697,and the chi-square value of Hosmer-Lemeshow goodness of fit test of 0.594(P=0.997),indicating that the predicted value of the model was close to the actual value.Conclusion Combining CA199,imaging vascular invasion,T-stage,and other preoperative clinically-enhanced CT features to establish a prediction model can effectively predict postoperative PNI of GBC.

Diabetic foot(DF)is a common chronic complication in patients with diabetes.Fibrosis and degeneration occurred in fasciae in long term hyperglycemia and inflammatory environment.Fibrosis in fasciae may aggravate the development of diabetic foot due to the special cellular and molecular structure,physiological and biomechanical effects.Thus,we aimed at reviewing the research progress of fascial fibrosis in diabetic foot.

Background/Aims: The performance of machine learning (ML) in predicting the outcomes of patients with hepatocellular carcinoma (HCC) remains uncertain. We aimed to develop risk scores using conventional methods and ML to categorize early-stage HCC patients into distinct prognostic groups. Methods: The study retrospectively enrolled 1,411 consecutive treatment-naïve patients with the Barcelona Clinic Liver Cancer (BCLC) stage 0 to A HCC from 2012 to 2021. The patients were randomly divided into a training cohort (n=988) and validation cohort (n=423). Two risk scores (CATS-IF and CATS-INF) were developed to predict overall survival (OS) in the training cohort using the conventional methods (Cox proportional hazards model) and ML-based methods (LASSO Cox regression), respectively. They were then validated and compared in the validation cohort. Results: In the training cohort, factors for the CATS-IF score were selected by the conventional method, including age, curative treatment, single large HCC, serum creatinine and alpha-fetoprotein levels, fibrosis-4 score, lymphocyte-tomonocyte ratio, and albumin-bilirubin grade. The CATS-INF score, determined by ML-based methods, included the above factors and two additional ones (aspartate aminotransferase and prognostic nutritional index). In the validation cohort, both CATS-IF score and CATS-INF score outperformed other modern prognostic scores in predicting OS, with the CATSINF score having the lowest Akaike information criterion value. A calibration plot exhibited good correlation between predicted and observed outcomes for both scores. Conclusions Both the conventional Cox-based CATS-IF score and ML-based CATS-INF score effectively stratified patients with early-stage HCC into distinct prognostic groups, with the CATS-INF score showing slightly superior performance.

The plants of Rutaceae, with wide distribution in China, have a long history of medicinal use. They contain a wide variety of alkaloids, which include isoquinolines, quinolines, acridones, carbazoles, and indoles. Pharmacological studies have shown that most of these alkaloids have antitumor, anti-inflammatory, antiviral, antidiabetic and other activities. This article summarized 378 alkaloids isolated from plants of Rutaceae and their pharmacological effects, aiming to lay a basis for future drug development and sustainable utilization of plant resources.
Alkaloids/chemistry* ; Humans ; Rutaceae/chemistry* ; Animals ; Drugs, Chinese Herbal/chemistry* ; Anti-Inflammatory Agents/chemistry*

The sequelae of pediatric burn seriously affect the physical function and quality of life of children with burns. Rehabilitation exercise training mainly based on aerobic and resistance exercise can effectively alleviate the negative effects. This article reviews the effects of rehabilitation exercise training on cardiopulmonary function, muscle function, and quality of life of children with burns, and introduces the latest rehabilitation exercise training prescription for children with burns based on type, mode, intensity, frequency, and time of exercise, so as to improve the level of rehabilitation treatment for children with burns.

Objective:To explore the effects of resistance training with elastic band at home on muscle function and walking ability of severely burned children.Methods:A prospective non-randomized controlled study was conducted. From January 2022 to April 2023, 40 children with severe burns who met the inclusion criteria were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital. According to the willingness of the children or their families, the children were assigned to conventional rehabilitation group and combined rehabilitation group. During the study, 8 children dropped out of the study, 17 children were finally included in the conventional rehabilitation group with 6 males and 11 females, aged (8.5±2.4) years, and 15 children were included in the combined rehabilitation group with 5 males and 10 females, aged (9.6±2.5) years. The children in the 2 groups received conventional burn rehabilitation treatment in the hospital, including active and passive activity training, scar massage, and pressure therapy. The children in combined rehabilitation group received resistance training with elastic band of 3 to 5 times per week after discharge, and the children in conventional rehabilitation group received daily activity ability training after discharge. Before home rehabilitation training (1 week before discharge) and 12 weeks after home rehabilitation training, the grip strength was measured using a handheld grip dynamometer, the muscle strengths of the upper and lower limbs were measured using a portable dynamometer for muscle strength, lean body mass was measured by bioelectrical impedance measuring instrument, and the 6-min walking distance was measured. Data were statistically analyzed with independent sample t test, paired sample t test, Mann-Whitney U test, or Fisher's exact probability test. Results:After 12 weeks of home rehabilitation training, the grip strengths of children in combined rehabilitation group and conventional rehabilitation group were (15±4) and (11±4) kg, respectively, which were significantly higher than (10±4) and (9±4) kg before home rehabilitation training (with t values of -9.99 and -11.89, respectively, P values all <0.05); the grip strength of children in combined rehabilitation group was significantly higher than that in conventional rehabilitation group ( t=3.24, P<0.05). After 12 weeks of home rehabilitation training, the muscle strengths of upper and lower limbs of children in combined rehabilitation group (with t values of -11.39 and -3.40, respectively, P<0.05) and the muscle strengths of upper and lower limbs of children in conventional rehabilitation group (with t values of -7.59 and -6.69, respectively, P<0.05) were significantly higher than those before home rehabilitation training, and the muscle strengths of upper and lower limbs of children in combined rehabilitation group were significantly higher than those in conventional rehabilitation group (with t values of 3.80 and 7.87, respectively, P<0.05). After 12 weeks of home rehabilitation training, the lean body mass of children in combined rehabilitation group was significantly higher than that before home rehabilitation training ( t=0.21, P<0.05). After 12 weeks of home rehabilitation training, the 6-min walking distances of children in conventional rehabilitation group and combined rehabilitation group were significantly longer than those before home rehabilitation training (with t values of -5.33 and -3.40, respectively, P<0.05), and the 6-min walking distance of children in combined rehabilitation group was significantly longer than that in conventional rehabilitation group ( t=3.81, P<0.05). Conclusions:Conventional burn rehabilitation treatment in hospital and home resistance training with elastic band for 12 weeks after discharge can significantly improve the muscle function and walking ability of severely burned children.

RNA therapeutics inhibit the expression of specific proteins/RNAs by targeting complementary sequences of corresponding genes or encode proteins for the synthesis desired genes to treat genetic diseases. RNA-based therapeutics are categorized as oligonucleotide drugs (antisense oligonucleotides, small interfering RNA, RNA aptamers), and mRNA drugs. The antisense oligonucleotides and small interfering RNA for treatment of genetic diseases have been approved by the FDA in the United States, while RNA aptamers and mRNA drugs are still in clinical trials. Chemical modifications can be applied to RNA drugs, such as pseudouridine modification of mRNA, to reduce immunogenicity and improve the efficacy. The secure and effective delivery systems such as lipid-based nanoparticles, extracellular vesicles, and virus-like particles are under development to address stability, specificity, and safety issues of RNA drugs. This article provides an overview of the specific molecular mechanisms of eleven RNA drugs currently used for treating genetic diseases, and discusses the research progress of chemical modifications and delivery systems of RNA drugs.
Aptamers, Nucleotide ; RNA, Small Interfering/therapeutic use* ; RNA, Messenger ; Oligonucleotides, Antisense/therapeutic use*