Under the background of increasingly severe drug-resistant bacteria infections,protracted course of chronic wounds has become clinical difficulties disturbing both patients and doctors.With the unique advantages of broad antibacterial spectrum,low drug resistance rate and high safety,polyhexanide antibacterial agent has gradu-ally become a major approach for treatment and nursing of chronic wounds.The application of polyhexamethylene biguanide(PHMB)antimicrobial agents in treatment and nursing of chronic wounds was reviewed in the article,including the antibacterial properties,comparisons with other antimicrobial agents,actual clinical practice and potential side effects,aiming to guide the further application of PHMB antimicrobial agents in treatment of chronic wounds.

A 53-year-old female patient with type 2 diabetes mellitus,hypertension,and hyperlipidemia,on long-term therapy with metformin,gliclazide,dapagliflozin,sacubitril/valsartan,lercanidipine,and atorvastatin,was initiated on semaglutide due to obesity and suboptimal glycemic control.Patient using semaglutide 0.25 mg and 0.5 mg without adverse effects,and developed gastric discomfort after adjusting dose to 0.75 mg.She remained on this dose for 7 weeks.Upon further dose escalation to 1 mg,she experienced persistent nausea,vomiting,and diarrhea.Fifteen days later,she was admitted to the hospital with impaired consciousness.Laboratory findings revealed blood urea nitrogen of 35.4 mmol·L-1 and serum creatinine of 825 μmol·L-1.The patient was diagnosed with acute kidney injury(AKI),which was considered related to semaglutide,metformin,dapagliflozin,and sacubitril/valsartan.All medications were discontinued.Following symptomatic treatment including fluid resuscitation,volume expansion,and hemodialysis,the patient's renal function gradually recovered.The association between AKI and semaglutide,metformin,dapagliflozin,and sacubitril/valsartan was evaluated using the Naranjo's Assesment Scale,the results were all"probable".This case highlighted that clinical use of semaglutide requires careful consideration of concomitant medications and vigilance for renal impairment.In the event of AKI,prompt assessment,discontinuation of medications with potential renal impairment and symptomatic management were necessary to ensure safe medication administration.

Objective The study aimed to explore the mechanism of Mume Fructus and Rosa multiflora in the treatment of recurrent oral ulceration(ROU)through network pharmacology and animal experiments.Methods The chemical components of Mume Fructus and Rosa multiflora were filtrated by OB and DL,which were respectively searched from TCMSP and references.The targets were predicted by TCMSP and Swiss Target Prediction.The targets of ROU were searched from OMIM and GeneCards database.Cystoscape 3.2.1 software was used to construct the"components-targets"network and analysis gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway with Clue GO.The protein-protein interaction(PPI)network analysis was carried out on the common targets by String database and Cystoscape 3.2.1 software.Moreover,after constructing the rat model of ROU,the pathological changes of oral mucosa of rats were observed by HE staining,and the effects of Mume Fructus and Rosa multiflora on inflammatory factors and key targets were detected by ELISA and Western blot.Results 33 active ingredients were selected for treating ROU,among which quercetin,ursolic acid,β-sitosterol,stigmasterol,palmitic acid,apioline and kaempferol were the core components.Key targets such as STAT3,PIK3R1,PIK3CA,STAT1,JAK2 and IL-6 were screened.GO functional enrichment and KEGG enrichment analysis showed that the core targets mainly affected the process of response to organic substance,cellular response to chemical stimulus and cellular response to organic substance,involving NF-κB,JAK-STAT,IL-17 and other signaling pathways.Experimental results in rats showed that Mume Fructus and Rosa multiflora could significantly improve the pathological status of ulcer mucosal tissue,reduce the expression of IL-1β,IL-6,TNF-α and IFN-γ,and reduce the expression of JAK2 and STAT1 in oral mucosa.Conclusion The anti-ROU effect of Mume Fructus and Rosa multiflora may be achieved by regulating the JAK2-STAT1 signaling pathway,reducing the levels of IL-1β,IL-6,TNF-α and IFN-γ inflammatory factors.

A 53-year-old female patient with type 2 diabetes mellitus,hypertension,and hyperlipidemia,on long-term therapy with metformin,gliclazide,dapagliflozin,sacubitril/valsartan,lercanidipine,and atorvastatin,was initiated on semaglutide due to obesity and suboptimal glycemic control.Patient using semaglutide 0.25 mg and 0.5 mg without adverse effects,and developed gastric discomfort after adjusting dose to 0.75 mg.She remained on this dose for 7 weeks.Upon further dose escalation to 1 mg,she experienced persistent nausea,vomiting,and diarrhea.Fifteen days later,she was admitted to the hospital with impaired consciousness.Laboratory findings revealed blood urea nitrogen of 35.4 mmol·L-1 and serum creatinine of 825 μmol·L-1.The patient was diagnosed with acute kidney injury(AKI),which was considered related to semaglutide,metformin,dapagliflozin,and sacubitril/valsartan.All medications were discontinued.Following symptomatic treatment including fluid resuscitation,volume expansion,and hemodialysis,the patient's renal function gradually recovered.The association between AKI and semaglutide,metformin,dapagliflozin,and sacubitril/valsartan was evaluated using the Naranjo's Assesment Scale,the results were all"probable".This case highlighted that clinical use of semaglutide requires careful consideration of concomitant medications and vigilance for renal impairment.In the event of AKI,prompt assessment,discontinuation of medications with potential renal impairment and symptomatic management were necessary to ensure safe medication administration.

Objective The study aimed to explore the mechanism of Mume Fructus and Rosa multiflora in the treatment of recurrent oral ulceration(ROU)through network pharmacology and animal experiments.Methods The chemical components of Mume Fructus and Rosa multiflora were filtrated by OB and DL,which were respectively searched from TCMSP and references.The targets were predicted by TCMSP and Swiss Target Prediction.The targets of ROU were searched from OMIM and GeneCards database.Cystoscape 3.2.1 software was used to construct the"components-targets"network and analysis gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway with Clue GO.The protein-protein interaction(PPI)network analysis was carried out on the common targets by String database and Cystoscape 3.2.1 software.Moreover,after constructing the rat model of ROU,the pathological changes of oral mucosa of rats were observed by HE staining,and the effects of Mume Fructus and Rosa multiflora on inflammatory factors and key targets were detected by ELISA and Western blot.Results 33 active ingredients were selected for treating ROU,among which quercetin,ursolic acid,β-sitosterol,stigmasterol,palmitic acid,apioline and kaempferol were the core components.Key targets such as STAT3,PIK3R1,PIK3CA,STAT1,JAK2 and IL-6 were screened.GO functional enrichment and KEGG enrichment analysis showed that the core targets mainly affected the process of response to organic substance,cellular response to chemical stimulus and cellular response to organic substance,involving NF-κB,JAK-STAT,IL-17 and other signaling pathways.Experimental results in rats showed that Mume Fructus and Rosa multiflora could significantly improve the pathological status of ulcer mucosal tissue,reduce the expression of IL-1β,IL-6,TNF-α and IFN-γ,and reduce the expression of JAK2 and STAT1 in oral mucosa.Conclusion The anti-ROU effect of Mume Fructus and Rosa multiflora may be achieved by regulating the JAK2-STAT1 signaling pathway,reducing the levels of IL-1β,IL-6,TNF-α and IFN-γ inflammatory factors.

Under the background of increasingly severe drug-resistant bacteria infections,protracted course of chronic wounds has become clinical difficulties disturbing both patients and doctors.With the unique advantages of broad antibacterial spectrum,low drug resistance rate and high safety,polyhexanide antibacterial agent has gradu-ally become a major approach for treatment and nursing of chronic wounds.The application of polyhexamethylene biguanide(PHMB)antimicrobial agents in treatment and nursing of chronic wounds was reviewed in the article,including the antibacterial properties,comparisons with other antimicrobial agents,actual clinical practice and potential side effects,aiming to guide the further application of PHMB antimicrobial agents in treatment of chronic wounds.

OBJECTIVE To establish the quality standards of medicinal materials in light of related methods in the general principles of part four of Chinese Pharmacopoeia(2020 Edition), and to conduct systematic research on the Tibetan medicine "Yajima"(Chrysosplenium axillare). METHODS The powder characteristics of medicinal materials were described by microscopic identification method. Silica gel GF254 thin-layer plate was employed to establish a TLC identification method with 5-O-demethylapulein and oxyayanin A as reference substances. Loss on drying, total ash, acid-insoluble ash and ethanol-soluble extractives of 10 batches of Chrysosplenium axillare were determined according to the general principles of part four of Chinese Pharmacopoeia(2020 Edition). HPLC was used to establish the characteristic chromatogram of Chrysosplenium axillare, and the content determination method was established with chrysosplenoside I(CI) and chrysosplenoside A(CA) as the quality control index components of Chrysosplenium axillare. RESULTS The water content, total ash, acid-insoluble ash, ethanol-soluble extractive and the content of CI and CA of all samples varied in the ranges of 9.17%−12.52%, 14.11%−16.74%, 1.50%−4.72%, 32.77%−40.30%, 0.30%−0.99% and 0.28%−0.88%, respectively. CONCLUSION The identification and content determination methods of Yajima(Chrysosplenium axillare) are established for the first time. The methods are easy to operate and exclusive, which is of great significance to accurately evaluate the internal quality of medicinal materials and ensure the quality of drug used.

Objective:To analyze the risk factors which may lead to tracheostomy in patients receiving invasive mechanical ventilation (IMV) in emergency intensive care unit (EICU).Methods:A case-control study was adopted to retrospectively analyze the clinical data of patients hospitalized in EICU receiving IMV from August 2016 to August 2019. The clinical data of patients were extracted through the electronic medical record system of the hospital information database. Patients were divided into the tracheostomy group and successful extubation group according to whether they received tracheostomy during hospitalization. The different clinical characteristics of the two groups were compared, and logistic regression was used to analyze the independent risk factors of tracheostomy.Results:A total of 109 patients were included in this study, among which, 53 patients underwent tracheotomy and 56 patients were successfully extubated. Logistic regression showed that GCS score ≤ 8 ( OR=5.10, 95% CI: 1.68-15.42, P < 0.01), cervical spinal cord injury ( OR=10.32, 95% CI: 2.74-38.82, P < 0.01), and sepsis ( OR=3.45, 95% CI: 1.39-8.54, P<0.01) were independent risk factors of tracheostomy for patients receiving IMV in EICU. Conclusions:If patients receiving IMV have GCS score ≤ 8, cervical spinal cord injury, or sepsis, they should be given more attention, because they may need early tracheostomy to save lives and improve the prognosis.

Drug-associated reward memories are conducive to intense craving and often trigger relapse. Simvastatin has been shown to regulate lipids that are involved in memory formation but its influence on other cognitive processes is elusive. Here, we used a mass spectrometry-based lipidomic method to evaluate the impact of simvastatin on the mouse brain in a cocaine-induced reinstatement paradigm. We found that simvastatin blocked the reinstatement of cocaine-induced conditioned place preference (CPP) without affecting CPP acquisition. Specifically, only simvastatin administered during extinction prevented cocaine-primed reinstatement. Global lipidome analysis showed that the nucleus accumbens was the region with the greatest degree of change caused by simvastatin. The metabolism of fatty-acids, phospholipids, and triacylglycerol was profoundly affected. Simvastatin reversed most of the effects on phospholipids induced by cocaine. The correlation matrix showed that cocaine and simvastatin significantly reshaped the lipid metabolic pathways in specific brain regions. Furthermore, simvastatin almost reversed all changes in the fatty acyl profile and unsaturation caused by cocaine. In summary, pre-extinction treatment with simvastatin facilitates cocaine extinction and prevents cocaine relapse with brain lipidome remodeling.

Drug-associated reward memories are conducive to intense craving and often trigger relapse. Simvastatin has been shown to regulate lipids that are involved in memory formation but its influence on other cognitive processes is elusive. Here, we used a mass spectrometry-based lipidomic method to evaluate the impact of simvastatin on the mouse brain in a cocaine-induced reinstatement paradigm. We found that simvastatin blocked the reinstatement of cocaine-induced conditioned place preference (CPP) without affecting CPP acquisition. Specifically, only simvastatin administered during extinction prevented cocaine-primed reinstatement. Global lipidome analysis showed that the nucleus accumbens was the region with the greatest degree of change caused by simvastatin. The metabolism of fatty-acids, phospholipids, and triacylglycerol was profoundly affected. Simvastatin reversed most of the effects on phospholipids induced by cocaine. The correlation matrix showed that cocaine and simvastatin significantly reshaped the lipid metabolic pathways in specific brain regions. Furthermore, simvastatin almost reversed all changes in the fatty acyl profile and unsaturation caused by cocaine. In summary, pre-extinction treatment with simvastatin facilitates cocaine extinction and prevents cocaine relapse with brain lipidome remodeling.
Animals ; Brain ; Cocaine ; Conditioning, Operant ; Extinction, Psychological ; Lipidomics ; Male ; Mice ; Simvastatin/therapeutic use*