OBJECTIVE To investigate the role of clinical pharmacists in the individualized treatment of a rare case of diffuse pulmonary microabscesses caused by Streptococcus constellatus complicated with organizing pneumonia （OP） in a non-immunocompromised patient. METHODS For a middle-aged， non-immunocompromised patient with a one-year disease course， whose imaging findings showed the coexistence of diffuse microabscesses and OP caused by S. constellatus pulmonary abscess， the clinical pharmacist， based on pharmacokinetics/pharmacodynamics characteristics， assisted the physician in optimizing the previously ineffective anti-infective regimen to Ceftriaxone sodium for injection combined with Metronidazole and sodium chloride injection， so as to enhance coverage of mixed anaerobes and lesion penetration. After the patient’s hemoptysis ceased， the clinical pharmacist recommended timely initiation of low-dose Methylprednisolone sodium succinate for injection to manage OP. Upon discharge， sequential oral therapy with Linezolid tablets， Metronidazole tablets， Methylprednisolone tablets and Omeprazole enteric-coated tablets was prescribed. RESULTS After implementation of the individualized treatment regimen， the patient’s hemoptysis resolved， pulmonary lesions significantly regressed， and the patient was discharged in a stable condition. At the three-month follow-up， the patient remained stable. CONCLUSIONS For chronic persistent pulmonary infection complicated with OP in a non-immunocompromised host， clinical pharmacists assist clinicians in optimizing anti-infective regimens and recommend the timely initiation of anti-inflammatory therapy after infection control， thereby contributing to favorable clinical outcomes. Individualized treatment of such complex cases requires comprehensive consideration of pathogen coverage， pathological barriers， and the timing of anti-inflammatory intervention.

With the continuous progress of modern science and technology, the research of TCM inspection is gradually moving towards a new stage of objectification and intelligence. By systematically sorting out the key technologies involved in the objectification of inspection and diagnosis, and summarizing its clinical application progress in the three core areas of face diagnosis, tongue diagnosis and visual diagnosis, it is found that the inspection and diagnosis of TCM can not only significantly improve the efficiency and accuracy of clinical diagnosis with the help of modern technology, but also achieve more results in disease differentiation, constitution identification and efficacy evaluation. The key technologies include digital image processing, infrared thermal imaging, spectroscopy, photoelectric volume and artificial intelligence (AI) technology. In terms of clinical application, facial diagnosis focuses on image and infrared thermography feature analysis, tongue diagnosis involves image, spectral feature research and AI model construction, and eye diagnosis focuses on white eye collaterals extraction, fundus sign analysis and eye movement information research. However, there are still some problems, such as imperfect standardization system, bottleneck of multi-modal fusion and interpretation, insufficient clinical verification and practicability. In the future, the deep integration of TCM observation and modern science and technology should be promoted by means of technological integration and innovation and strengthening interdisciplinary cooperation, so as to help the modernization of TCM diagnosis.

Objective : To explore the effects of the antihypertensive drug Amlodipine on calcium influx and autoph- agy in human podocytes ( HPC) ． Methods : HPC cells were routinely cultured in vitro． HPC cells were treated with angiotensin Ⅱ ( Ang Ⅱ ) ，the L-type Ca2 + blocker Amlodipine alone or in combination．The Ca2 + imaging system was used to detect the transient changes in the intracellular Ca2 + flux of HPC cells in real time after drug treatment．Western blot was employed to detect the changes in the ratio of autophagy marker proteins LC3B-Ⅱ/ LC3B-Ⅰ , and the expression levels of Beclin-1，P62，as well as apoptosis-related proteins Bcl-2 and Bax．Flow cytometry was used to detect the number of Fluo-4AM positive cells at 488 nm to analyze the level of intracellular Ca2 + influx in HPC cells．Lyso-Tracker Green live cell staining was applied to analyze the fluorescence intensity of lysosomes．Flow cytometry was also used to detect the apoptosis rate of HPC cells． Results : Compared with the control group，in the Ang Ⅱ group，the transient Ca2 + flux and the number of Fluo-4AM positive cells increased significantly (P＜0. 001) ．The ratio of autophagy marker proteins LC3B-Ⅱ/ LC3B-Ⅰ (P＜0. 001) and the pro- tein expression of Beclin-1 (P＜0. 01) decreased significantly，while the expression of P62 increased (P＜0. 01) ． The fluorescence intensity of lysosomes weakened (P＜0. 05) ，the apoptosis rate increased (P＜0. 0001) ，the ex- pression of apoptosis-related protein Bcl-2 decreased (P ＜0. 01 ) ，and the protein level of Bax increased (P < 0. 001) ．Compared with the control group，in the Amlodipine group，the number of Fluo-4AM positive cells de- creased significantly (P＜0. 001) ，the ratio of LC3B-Ⅱ/ LC3B-Ⅰ (P＜0. 001) and the protein expression of Bec- lin-1 (P＜0. 001) increased，the protein expression of P62 decreased (P＜0. 05) ，the fluorescence intensity of ly- sosomes enhanced (P＜0. 01) ，the apoptosis rate decreased (P＜0. 01) ，the protein expression of Bcl-2 increased (P＜0. 001) ，and the protein level of Bax decreased (P＜0. 001) ．Compared with the Ang Ⅱ group，in the Ang Ⅱ + Amlodipine group，the number of Fluo-4AM positive cells decreased significantly (P＜0. 001) ，the ratio of LC3B-Ⅱ/ LC3B-Ⅰ (P＜0. 01) and the protein expression of Beclin-1 increased (P＜0. 05) ，the protein level of P62 decreased (P＜0. 01) ，the fluorescence intensity of lysosomes increased (P ＜0. 05) ，the apoptosis rate de- creased (P＜0. 001) ，the protein expression of Bcl-2 increased (P ＜0. 001 ) ，and the protein level of Bax de- creased (P＜0. 001) ． Conclusion Amlodipine inhibits calcium influx，promotes autophagy and inhibits apoptosis in human podocytes，which is useful in preventing the development of hypertensive nephropathy．

The study investigated the specific mechanism by which oxocrebanine, the anti-hepatic cancer active ingredient in Stephania hainanensis, inhibits the proliferation of hepatic cancer cells. Firstly, methyl thiazolyl tetrazolium(MTT) assay, 5-bromodeoxyuridine(BrdU) labeling, and colony formation assay were employed to investigate whether oxocrebanine inhibited the proliferation of HepG2 and Hep3B2.1-7 cells. Propidium iodide(PI) staining was used to observe the oxocrebanine-induced apoptosis of HepG2 and Hep3B2.1-7 cells. Western blot was employed to verify whether apoptotic effector proteins, such as cleaved cysteinyl aspartate-specific protease 3(c-caspase-3), poly(ADP-ribose) polymerase 1(PARP1), B-cell lymphoma-2(Bcl-2), Bcl-2-associated X protein(Bax), Bcl-2 homologous killer(Bak), and myeloid cell leukemia-1(Mcl-1) were involved in apoptosis. Secondly, HepG2 cells were simultaneously treated with oxocrebanine and the autophagy inhibitor 3-methyladenine(3-MA), and the changes in the autophagy marker LC3 and autophagy-related proteins [eukaryotic translation initiation factor 4E-binding protein 1(4EBP1), phosphorylated 4EBP1(p-4EBP1), 70-kDa ribosomal protein S6 kinase(P70S6K), and phosphorylated P70S6K(p-P70S6K)] were determined. The results of MTT assay, BrdU labeling, and colony formation assay showed that oxocrebanine inhibited the proliferation of HepG2 and Hep3B2.1-7 cells in a dose-dependent manner. The results of flow cytometry suggested that the apoptosis rate of HepG2 and Hep3B2.1-7 cells increased after treatment with oxocrebanine. Western blot results showed that the protein levels of c-caspase-3, Bax, and Bak were up-regulated and those of PARP1, Bcl-2, and Mcl-1 were down-regulated in the HepG2 cells treated with oxocrebanine. The results indicated that oxocrebanine induced apoptosis, thereby inhibiting the proliferation of hepatic cancer cells. The inhibition of HepG2 cell proliferation by oxocrebanine may be related to the induction of protective autophagy in hepatocellular carcinoma cells. Oxocrebanine still promoted the conversion of LC3-Ⅰ to LC3-Ⅱ, reduced the phosphorylation levels of 4EBP1 and P70S6K, which can be reversed by the autophagy inhibitor 3-MA. It is prompted that oxocrebanine can inhibit the proliferation of hepatic cancer cells by inducing autophagy. In conclusion, oxocrebanine inhibits the proliferation of hepatic cancer cells by inducing apoptosis and autophagy.
Humans ; Apoptosis/drug effects* ; Autophagy/drug effects* ; Cell Proliferation/drug effects* ; Hep G2 Cells ; Liver Neoplasms/genetics* ; Carcinoma, Hepatocellular/genetics* ; Caspase 3/genetics*

The processing mechanism of the human brain for speech information is a significant source of inspiration for the study of speech enhancement technology. Attention and lateral inhibition are key mechanisms in auditory information processing that can selectively enhance specific information. Building on this, the study introduces a dual-branch U-Net that integrates lateral inhibition and feedback-driven attention mechanisms. Noisy speech signals input into the first branch of the U-Net led to the selective feedback of time-frequency units with high confidence. The generated activation layer gradients, in conjunction with the lateral inhibition mechanism, were utilized to calculate attention maps. These maps were then concatenated to the second branch of the U-Net, directing the network's focus and achieving selective enhancement of auditory speech signals. The evaluation of the speech enhancement effect was conducted by utilising five metrics, including perceptual evaluation of speech quality. This method was compared horizontally with five other methods: Wiener, SEGAN, PHASEN, Demucs and GRN. The experimental results demonstrated that the proposed method improved speech signal enhancement capabilities in various noise scenarios by 18% to 21% compared to the baseline network across multiple performance metrics. This improvement was particularly notable in low signal-to-noise ratio conditions, where the proposed method exhibited a significant performance advantage over other methods. The speech enhancement technique based on lateral inhibition and feedback-driven attention mechanisms holds significant potential in auditory speech enhancement, making it suitable for clinical practices related to artificial cochleae and hearing aids.
Humans ; Attention/physiology* ; Speech Perception/physiology* ; Neural Networks, Computer ; Speech ; Noise ; Feedback

Objective: This study aimed to elucidate the hand function recovery capacity of degenerative cervical myelopathy (DCM) patients with different severities of hand dexterity impairment. Methods: Hand functional outcome measures such as the 10-second grip and release (10s-G&R) test, modified Japanese Orthopaedic Association (mJOA) upper extremity score and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) upper extremity function were collected before surgery and at the 1-year follow-up. A total of 102 DCM patients were categorized into mild, moderate and severe group based on the preoperative 10s-G&R test result. Hand functional parameters were compared across the 3 groups. Multivariate linear regression was conducted to explore predictive factors. Receiver operating characteristic curve analysis was performed to assess the predictive efficacy of the preoperative 10s-G&R test and establish the cutoff value for incomplete recovery of hand dexterity. Results: At the 1-year follow-up, significant improvements were observed in all hand functional parameters across all 3 groups. However, the incomplete recovery rates of the mild, moderate, severe groups were 26.67%, 46.88%, and 57.50%, respectively (p < 0.05). Multivariate regression revealed that preoperative 10s-G&R test result, age, Hoffmann sign, duration of symptom, and mJOA Upper score serve as significant predictors for postoperative 10s-G&R test outcomes. Patients with a preoperative 10s-G&R test < 15 cycles have a 1.9 times higher risk of incomplete recovery of hand function (p = 0.005). Conclusion Most patients, regardless of their preoperative hand function, exhibit potential for improvement in hand dexterity. However, worse initial hand dexterity correlates with poorer outcomes. Surgical treatment is recommended before the 10s-G&R test drops below 15 cycles.

Objective: This study aimed to elucidate the hand function recovery capacity of degenerative cervical myelopathy (DCM) patients with different severities of hand dexterity impairment. Methods: Hand functional outcome measures such as the 10-second grip and release (10s-G&R) test, modified Japanese Orthopaedic Association (mJOA) upper extremity score and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) upper extremity function were collected before surgery and at the 1-year follow-up. A total of 102 DCM patients were categorized into mild, moderate and severe group based on the preoperative 10s-G&R test result. Hand functional parameters were compared across the 3 groups. Multivariate linear regression was conducted to explore predictive factors. Receiver operating characteristic curve analysis was performed to assess the predictive efficacy of the preoperative 10s-G&R test and establish the cutoff value for incomplete recovery of hand dexterity. Results: At the 1-year follow-up, significant improvements were observed in all hand functional parameters across all 3 groups. However, the incomplete recovery rates of the mild, moderate, severe groups were 26.67%, 46.88%, and 57.50%, respectively (p < 0.05). Multivariate regression revealed that preoperative 10s-G&R test result, age, Hoffmann sign, duration of symptom, and mJOA Upper score serve as significant predictors for postoperative 10s-G&R test outcomes. Patients with a preoperative 10s-G&R test < 15 cycles have a 1.9 times higher risk of incomplete recovery of hand function (p = 0.005). Conclusion Most patients, regardless of their preoperative hand function, exhibit potential for improvement in hand dexterity. However, worse initial hand dexterity correlates with poorer outcomes. Surgical treatment is recommended before the 10s-G&R test drops below 15 cycles.

Objective: This study aimed to elucidate the hand function recovery capacity of degenerative cervical myelopathy (DCM) patients with different severities of hand dexterity impairment. Methods: Hand functional outcome measures such as the 10-second grip and release (10s-G&R) test, modified Japanese Orthopaedic Association (mJOA) upper extremity score and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) upper extremity function were collected before surgery and at the 1-year follow-up. A total of 102 DCM patients were categorized into mild, moderate and severe group based on the preoperative 10s-G&R test result. Hand functional parameters were compared across the 3 groups. Multivariate linear regression was conducted to explore predictive factors. Receiver operating characteristic curve analysis was performed to assess the predictive efficacy of the preoperative 10s-G&R test and establish the cutoff value for incomplete recovery of hand dexterity. Results: At the 1-year follow-up, significant improvements were observed in all hand functional parameters across all 3 groups. However, the incomplete recovery rates of the mild, moderate, severe groups were 26.67%, 46.88%, and 57.50%, respectively (p < 0.05). Multivariate regression revealed that preoperative 10s-G&R test result, age, Hoffmann sign, duration of symptom, and mJOA Upper score serve as significant predictors for postoperative 10s-G&R test outcomes. Patients with a preoperative 10s-G&R test < 15 cycles have a 1.9 times higher risk of incomplete recovery of hand function (p = 0.005). Conclusion Most patients, regardless of their preoperative hand function, exhibit potential for improvement in hand dexterity. However, worse initial hand dexterity correlates with poorer outcomes. Surgical treatment is recommended before the 10s-G&R test drops below 15 cycles.

Objective: This study aimed to elucidate the hand function recovery capacity of degenerative cervical myelopathy (DCM) patients with different severities of hand dexterity impairment. Methods: Hand functional outcome measures such as the 10-second grip and release (10s-G&R) test, modified Japanese Orthopaedic Association (mJOA) upper extremity score and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) upper extremity function were collected before surgery and at the 1-year follow-up. A total of 102 DCM patients were categorized into mild, moderate and severe group based on the preoperative 10s-G&R test result. Hand functional parameters were compared across the 3 groups. Multivariate linear regression was conducted to explore predictive factors. Receiver operating characteristic curve analysis was performed to assess the predictive efficacy of the preoperative 10s-G&R test and establish the cutoff value for incomplete recovery of hand dexterity. Results: At the 1-year follow-up, significant improvements were observed in all hand functional parameters across all 3 groups. However, the incomplete recovery rates of the mild, moderate, severe groups were 26.67%, 46.88%, and 57.50%, respectively (p < 0.05). Multivariate regression revealed that preoperative 10s-G&R test result, age, Hoffmann sign, duration of symptom, and mJOA Upper score serve as significant predictors for postoperative 10s-G&R test outcomes. Patients with a preoperative 10s-G&R test < 15 cycles have a 1.9 times higher risk of incomplete recovery of hand function (p = 0.005). Conclusion Most patients, regardless of their preoperative hand function, exhibit potential for improvement in hand dexterity. However, worse initial hand dexterity correlates with poorer outcomes. Surgical treatment is recommended before the 10s-G&R test drops below 15 cycles.

Objective: This study aimed to elucidate the hand function recovery capacity of degenerative cervical myelopathy (DCM) patients with different severities of hand dexterity impairment. Methods: Hand functional outcome measures such as the 10-second grip and release (10s-G&R) test, modified Japanese Orthopaedic Association (mJOA) upper extremity score and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) upper extremity function were collected before surgery and at the 1-year follow-up. A total of 102 DCM patients were categorized into mild, moderate and severe group based on the preoperative 10s-G&R test result. Hand functional parameters were compared across the 3 groups. Multivariate linear regression was conducted to explore predictive factors. Receiver operating characteristic curve analysis was performed to assess the predictive efficacy of the preoperative 10s-G&R test and establish the cutoff value for incomplete recovery of hand dexterity. Results: At the 1-year follow-up, significant improvements were observed in all hand functional parameters across all 3 groups. However, the incomplete recovery rates of the mild, moderate, severe groups were 26.67%, 46.88%, and 57.50%, respectively (p < 0.05). Multivariate regression revealed that preoperative 10s-G&R test result, age, Hoffmann sign, duration of symptom, and mJOA Upper score serve as significant predictors for postoperative 10s-G&R test outcomes. Patients with a preoperative 10s-G&R test < 15 cycles have a 1.9 times higher risk of incomplete recovery of hand function (p = 0.005). Conclusion Most patients, regardless of their preoperative hand function, exhibit potential for improvement in hand dexterity. However, worse initial hand dexterity correlates with poorer outcomes. Surgical treatment is recommended before the 10s-G&R test drops below 15 cycles.