The blood-brain barrier （BBB） is a physical and biochemical barrier that precisely regulates brain homeostasis and plays a central role in controlling the transport of endogenous and exogenous drugs and related metabolites across the blood-brain interface. These functions of the BBB are mediated by its major components， including brain microvascular endothelial cells （BMECs）， tight junction protein complexes， and influx and efflux transporter proteins. One of the pathological features of ischemic stroke （IS） is BBB disruption， which plays an important role in the development of post-stroke brain injury and subsequent neurological dysfunction. Therefore， given the increasing incidence of IS， there is an urgent need to develop new therapeutic strategies to prevent BBB dysfunction and thereby protect injured brain tissue after IS. This study describes the pathological mechanisms by which BMEC injury after IS leads to BBB dysfunction and elucidates the association between BMECs and IS， including the regulation of apoptosis， autophagy， inflammatory responses， oxidative stress， neurotoxic effects， and cerebral edema. In addition， this article summarizes Chinese herbal medicines that may prevent and treat IS by targeting BMECs. These include monomeric compounds and single herbs such as flavonoids， glycosides， phenols， phthalides， terpenoids， and Styrax. Traditional Chinese medicine （TCM） compound formulas and preparations include oral formulations such as Buyang Huanwu decoction， Sailuotong， Naoxintong capsules， Dandeng Tongnao capsules， and Shexiang Tongxin dropping pills， as well as injectable preparations such as Tongluo Jiunao injection， Xingnaojing injection， Danshen polyphenolic acid for injection， Yiqi Fumai injection， and Shuxuetong injection. This study aims to explore the protective effects of TCM against IS through targeted regulation of BMEC function， providing new insights into the mechanisms of IS and endovascular therapeutic strategies.

BACKGROUND: Generalized pustular psoriasis (GPP), a rare and recurrent autoinflammatory disease, imposes a substantial burden on patients and society. Awareness of GPP in China remains limited. METHODS: This cross-sectional survey, conducted between September 2021 and May 2023 across 14 hospitals in China, included GPP patients of all ages and disease phases. Data collected encompassed demographics, clinical characteristics, economic impact, disease severity, quality of life, and treatment-related complications. Risk factors for GPP recurrence were analyzed. RESULTS: Among 127 patients (female/male ratio = 1.35:1), the mean age of disease onset was 25 years (1st quartile [Q1]-3rd quartile [Q3]: 11-44 years); 29.2% had experienced GPP for more than 10 years. Recurrence occurred in 75.6% of patients, and nearly half reported no identifiable triggers. Younger age at disease onset ( P  = 0.021) and transitioning to plaque psoriasis ( P  = 0.022) were associated with higher recurrence rates. The median diagnostic delay was 8 months (Q1-Q3: 2-41 months), and 32.3% of patients reported misdiagnoses. Comorbidities were present in 53.5% of patients, whereas 51.1% experienced systemic complications during treatment. Depression and anxiety affected 84.5% and 95.6% of patients, respectively. During GPP flares, the median Dermatology Life Quality Index score was 19.0 (Q1-Q3: 13.0-23.5). This score showed significant differences between patients with and without systemic symptoms; it demonstrated correlations with both depression and anxiety scores. Treatment costs caused financial hardship in 55.9% of patients, underscoring the burden associated with GPP. CONCLUSIONS The substantial disease and economic burdens among Chinese GPP patients warrant increased attention. Patients with early onset disease and those transitioning to plaque psoriasis require targeted interventions to mitigate the high recurrence risk.
Humans ; Male ; Female ; Psoriasis/pathology* ; Adult ; Cross-Sectional Studies ; Adolescent ; Child ; Young Adult ; Quality of Life ; Middle Aged ; China/epidemiology* ; Recurrence ; Risk Factors ; Surveys and Questionnaires ; East Asian People

Salmonellosis represents a global epidemic, and the emergence of extensively drug-resistant (XDR) Salmonella and its sustained transmission worldwide constitutes a significant public health concern. Flagellum-mediated motility serves as a crucial virulence trait of Salmonella that guides the pathogen toward the epithelial surface, enhancing gut colonization. Artemisia argyit essential oil, a traditional herb extract, demonstrates efficacy in treating inflammation-related symptoms and diseases; however, its effects on flagellum assembly and expression mechanisms in anti-Salmonella activity remain inadequately explored. This study aimed to elucidate the mechanism by which Artemisia argyit essential oil addresses Salmonella infections. Network pharmacological analysis revealed that Traditional Chinese Medicine (TCM) Artemisia argyit exhibited anti-Salmonella infection potential and inhibited flagellum-dependent motility. The application of Artemisia argyit essential oil induced notable motility defects through the downregulation of flagellar and fimbriae expression. Moreover, it significantly reduced Salmonella-infected cell damage by interfering with flagellum-mediated Salmonella colonization. In vivo studies demonstrated that Artemisia argyit essential oil administration effectively alleviated Salmonella infection symptoms by reducing bacterial loads, inhibiting interleukin-1 beta (IL-1β), IL-6, and tumor necrosis factor-alpha (TNF-α) production, and diminishing pathological injury. Gas chromatography-mass spectrometry (GC-MS) analysis identified forty-three compounds in Artemisia argyit essential oil, with their corresponding targets and active ingredients predicted. Investigation of an in vivo model of Salmonella infection using the active ingredient demonstrated that alpha-cedrene ameliorated Salmonella infection. These findings suggest the potential application of Artemisia argyit essential oil in controlling Salmonella, the predominant food-borne pathogen.
Artemisia/chemistry* ; Oils, Volatile/chemistry* ; Animals ; Flagella/drug effects* ; Salmonella Infections/microbiology* ; Humans ; Mice ; Anti-Bacterial Agents/pharmacology* ; Salmonella/pathogenicity*

Genetically modified (GM) crops, as a pivotal innovation in modern agriculture, exhibit significant advantages such as pest and disease resistance, herbicide tolerance, stress tolerance, and yield enhancement. However, their widespread adoption has been associated with potential ecological risks, including weediness of transgenic plants, gene flow, emergence of novel viral strains in virus-resistant crops, impacts on non-target organisms and soil ecosystems, and evolution of target pest resistance. This review focuses on the dual characteristics of GM crops, systematically examining their agronomic benefits and the underlying mechanisms of ecological risks. This review provides a theoretical foundation for optimizing the development of GM crops and ecological risk management, facilitating sustainable agricultural practices.
Plants, Genetically Modified/growth & development* ; Crops, Agricultural/growth & development* ; Ecosystem ; Ecology

Objective:To analyze the drug survival rate and safety of dupilumab in the treatment of atopic dermatitis (AD) in elderly patients.Methods:Clinical data were collected from patients diagnosed with AD and treated with dupilumab at the Hospital of Dermatology, Chinese Academy of Medical Sciences from May 2021 to May 2023, and were retrospectively analyzed. The patients aged ≥ 60 years were selected as a study group, and disease severity-matched patients aged <60 years served as a control group. Follow-up was conducted from the start of treatment until 24 weeks after the start of treatment. Drug survival rate and safety were analyzed and compared between the two groups. Drug survival rate was determined through Kaplan-Meier survival analysis; differences in drug survival rate between the two groups were analyzed using the log-rank test; chi-square test was used to compare the reasons for treatment discontinuation between the two groups.Results:The study group and the control group each included 45 patients with AD, and the disease severity of patients in the study group was matched with that in the control group. At 24 weeks after the start of treatment, there was a significant difference in the overall drug survival rate of dupilumab between the study group (37.8%, 17/45) and the control group (57.8%, 26/45; P = 0.030). Among the 45 elderly patients with AD in the study group, a significant difference was observed in the proportion of patients with nodular prurigo phenotype between the patients who completed the 24-week treatment (4/17) and those who did not complete (0, P = 0.007). Main reasons for dupilumab withdrawal in the 28 patients in the study group were poor response (8/28, 28.6%), followed by unaffordability (5/28, 17.9%) and persistent clinical remission (4/28, 14.3%), and the adverse reactions included conjunctivitis (2 cases) and suspected systemic anaphylaxis (3 cases) ; the main reasons for dupilumab discontinuation in 19 patients in the control group were poor response (7/19, 36.8%) and persistent clinical remission (6/19, 31.6%), and the adverse reaction was injection site reaction in 1 case; there was no significant difference in the composition of reasons for drug withdrawal between the two groups. Conclusion:Dupilumab generally exhibited good safety in elderly patients with AD, but its drug survival rate was lower than that in the younger patients.

Objective:To analyze clinical characteristics, treatment, and outcomes of 36 patients with pyoderma gangrenosum, and to compare and evaluate the applicability and consistency between the PARACELSUS score and Delphi criteria.Methods:From January 2000 to January 2022, clinical data were collected from 36 patients who were diagnosed with pyoderma gangrenosum in the Hospital of Dermatology, Chinese Academy of Medical Sciences. The PARACELSUS score and Delphi criteria were applied to their diagnosis, and the kappa test was used to evaluate the consistency between the two diagnostic criteria.Results:Among the 36 patients, 6 (16.67%) had definite precipitating factors before the onset, and 31 (86.11%) exhibited lesions with different degrees of pain. Ulcerative lesions predominatd in 31 (86.11%) patients, which mostly involved the lower extremities, while 16 (44.44%) presented with multiple lesions all over the body. Four (11.11%) patients were complicated by inflammatory bowel disease, and 3 (8.33%) with inflammatory arthritis. Glucocorticoids, Tripterygium wilfordii, and cyclosporin were the main systemic treatment options, and tumor necrosis factor-α antagonist was used in 8 (22.22%) patients. Twenty-two (64.71%) and 17 (50.00%) patients were diagnosed with pyoderma gangrenosum using the PARACELSUS score and Delphi criteria, respectively. The kappa test showed moderate agreement between the two diagnostic criteria (kappa value = 0.47, 95% CI: 0.19 - 0.76, P = 0.004) . Conclusions:Classic ulcerative subtype was the major subtype in the patients with pyoderma gangrenosum, who were usually complicated by inflammatory bowel disease and inflammatory arthritis. Glucocorticoids and immunosuppressants were the main therapeutic drugs. The PARACELSUS score and Delphi criteria focus on different aspects of pyoderma gangrenosum, and the PARACELSUS score is recommended in the context of absence of typical histopathological manifestations.

Objective:To observe the effect of methylprednisolone (MP) combined with cyclophosphamide (CTX) on inflammation and immune cell activity in bleomycin (BLM)-induced pulmonary fibrosis rat model.Methods:Forty healthy 6 to 8-week-old SD rats were randomly divided into blank control, BLM model, BLM+MP, and BLM+MP+CTX groups, with 10 rats in each group. The rat model of pulmonary fibrosis was prepared by intratracheal infusion of BLM (5 mg/kg, only once). From the 7th day of modeling, MP (3 mg/kg) was injected in rats in the BLM+MP group and MP (3 mg/kg)+CTX (8 mg/kg) was injected via tail vein in rats in the BLM+MP+CTX group, once daily for 21 days. The degree of lung inflammation and fibrosis in rats was detected using HE and Masson staining methods. The numbers of granu-locytes and neutrophils in bronchoalveolar lavage fluid (BALF) and blood T cell subsets in rats were detected using flow cytometry.Results:On the 7th day of modeling, the external morphology, HE and Masson staining results of rat lung tissue showed that BLM-induced pulmonary fibrosis model was successfully prepared. On the 28th day of modeling, the lung tissue structure of the BLM group was disordered with obvious collagen deposition, the number of granulocytes and neutrophils in BALF increased significantly, the proportion of blood T cells, CD4 + T cells, and regulatory T cells (Tregs) decreased, the proportion of CD8 + T cells, and the CD4 +/CD8 + T cells ratio decreased significantly (all P<0.05). Compared with the BLM group, the degree of pulmonary fibrosis in the BLM+MP+CTX group was improved significantly, the number of granulocytes and neutrophils in BALF decreased significantly, the proportion of blood T cells, CD4 + T cells and Tregs cells increased significantly, the proportion of CD8 + T cells decreased, and the ratio of CD4 +/CD8 + T cells increased significantly (all P<0.05). The improvement effect in rats of BLM+MP+CTX group was better than that of BLM+MP group, and the difference was statistically significant ( P<0.05). Conclusion:MP combined with CTX can reduce the degree of inflammatory reaction in rats with pulmonary fibrosis and improve T cell immune activity.

Objective:To observe the effect of methylprednisolone (MP) combined with cyclophosphamide (CTX) on inflammation and immune cell activity in bleomycin (BLM)-induced pulmonary fibrosis rat model.Methods:Forty healthy 6 to 8-week-old SD rats were randomly divided into blank control, BLM model, BLM+MP, and BLM+MP+CTX groups, with 10 rats in each group. The rat model of pulmonary fibrosis was prepared by intratracheal infusion of BLM (5 mg/kg, only once). From the 7th day of modeling, MP (3 mg/kg) was injected in rats in the BLM+MP group and MP (3 mg/kg)+CTX (8 mg/kg) was injected via tail vein in rats in the BLM+MP+CTX group, once daily for 21 days. The degree of lung inflammation and fibrosis in rats was detected using HE and Masson staining methods. The numbers of granu-locytes and neutrophils in bronchoalveolar lavage fluid (BALF) and blood T cell subsets in rats were detected using flow cytometry.Results:On the 7th day of modeling, the external morphology, HE and Masson staining results of rat lung tissue showed that BLM-induced pulmonary fibrosis model was successfully prepared. On the 28th day of modeling, the lung tissue structure of the BLM group was disordered with obvious collagen deposition, the number of granulocytes and neutrophils in BALF increased significantly, the proportion of blood T cells, CD4 + T cells, and regulatory T cells (Tregs) decreased, the proportion of CD8 + T cells, and the CD4 +/CD8 + T cells ratio decreased significantly (all P<0.05). Compared with the BLM group, the degree of pulmonary fibrosis in the BLM+MP+CTX group was improved significantly, the number of granulocytes and neutrophils in BALF decreased significantly, the proportion of blood T cells, CD4 + T cells and Tregs cells increased significantly, the proportion of CD8 + T cells decreased, and the ratio of CD4 +/CD8 + T cells increased significantly (all P<0.05). The improvement effect in rats of BLM+MP+CTX group was better than that of BLM+MP group, and the difference was statistically significant ( P<0.05). Conclusion:MP combined with CTX can reduce the degree of inflammatory reaction in rats with pulmonary fibrosis and improve T cell immune activity.

Methods:Two thousand standard sections images werre collected from 2 000 clinical retrospective pediatric hip ultrasound videos from January 2019 to January 2021. All standard sections were annotated by the annotation team through the self-designed software based on Python 3.6 environment for image cross-media data annotation and manual review standardization process with unified standards. Among them, 1 753 were randomly selected for training the deep learning system, and the remaining 247 were used for testing the system. Further, 200 standard sections were randomly selected from the test set, and 8 clinicians independently completed the film reading annotation. The 8 independent results were then compared with the AI results.Results:The testing set consists of 247 patients. Compared with the clinician's measurements, the area under the receiver operating characteristic curve (AUC) of diagnosing hip joint maturity was 0.865, the sensitivity was 76.19%, and the specificity was 96.9%. The AUC of AI system interpretation under Graf detailed typing was 0.575, the sensitivity was 25.90%, the specificity was 89.10%. The 95% LoA of α-angle determined by Bland-Altman method, of -4.7051° to 6.5948° ( Bias -0.94, P<0.001), compared with clinicians' measurements. The 95% LoA of β-angle, of -7.7191 to 6.8777 ( Bias -0.42, P=0.077). Compared with those from 8 clinicians, the results of AI system interpretation were more stable, and the β-angle effect was more prominent. Conclusion:The AI system can quickly and accurately measure the Graf correlation index of standard DDH ultrasonic standard diagnosis plane.

Objective:To evaluate the clinical efficacy and safety of omalizumab in the treatment of chronic spontaneous urticaria (CSU) .Methods:Clinical data were collected from 60 patients, who were diagnosed with CSU and received subcutaneous injections of omalizumab at a dose of 300 mg once every 4 weeks for 3 sessions in Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from March 2020 to September 2020, and retrospectively analyzed. At weeks 0, 2, 4, 6, 8, 10 and 12, urticaria activity score over 7 days (UAS7) and chronic urticaria quality of life (CU-Q2oL) score were used to evaluate clinical symptoms and quality of life of patients. Changes in the use of other drugs were evaluated before and after the treatment with omalizumab. Paired t test was used to compare UAS7 or CU-Q2oL score before and after treatment. Results:All the 60 CSU patients received 12 weeks of omalizumab treatment. The baseline UAS7 score was 22.37 ± 8.88 points; after one session of the treatment, the UAS7 score dropped to 2.01 ± 5.13 points, reaching the treatment plateau; at week 12, it dropped to 0.6 ± 2.63 points, and 0 point (complete control) in 93.3% of the patients, 1-6 points (favorable control) in 3.3%; the time required for UAS7 score to decrease to 0 point was 22.4 ± 3.2 days. The baseline CU-Q2oL score was 34.10 ± 15.01 points; after one session of the treatment, the CU-Q2oL score dropped to 2.41 ± 7.18 points, reaching the treatment plateau; at week 12, it was 0.56 ± 2.90 points; the time required for CU-Q2oL score to drop to 0 point was 21.15 ± 16.02 days. After the combination treatment with omalizumab, a gradual decrease in dosage or withdrawal of previous therapeutic drugs was realized. At week 12, 39 patients (65%) achieved complete control, and withdrew all therapeutic drugs except omalizumab. During the treatment and follow-up, omalizumab showed good safety, and no adverse reactions were observed.Conclusion:Omalizumab at a dose of 300 mg once every 4 weeks is markedly effective and safe for the treatment of CSU, providing a new treatment option for CSU patients with poor response to traditional therapy.