To investigate the risk factors for acute kidney injury (AKI) following the use of amphotericin B deoxycholate and to develop a predictive model to guide clinical monitoring and intervention.

Objective To evaluate the role and differences of Fuzheng Jiedu formula in preventing postoperative recurrence and metastasis in patients with lymph node metastatic colorectal cancer.Methods Patients were categorized into two cohorts based on whether they received systematic traditional Chinese medicine(TCM)treatment or not.The primary endpoint was re-lapse-free survival(RFS),while the secondary endpoint was the hazard ratio(HR).Results A total of 407 patients were includ-ed in the study.After propensity score matching,no significant difference was observed in baseline characteristics between the groups(P＞0.05).The Fuzheng Jiedu formula significantly reduced the risk of recurrence and metastasis[HR:0.46,P＜0.05,Full Analysis Set(FAS)analysis],which was consistent with Per-Protocol Set(PPS)analysis.In the FAS analysis,for patients with＜4 involved lymph nodes(N1),the risk of recurrence and metastasis in the TCM group was 0.548 times that of the non-TCM group(95％CI:0.365-0.823).For patients with ≥4 involved lymph nodes(N2),the risk of recurrence and metastasis in the TCM group was 0.260 times that of the non-TCM group(95％CI:0.138-0.490).The findings from the PPS analysis were consistent.Conclusion The Fuzheng Jiedu formula can effectively reduce the risk of recurrence and metastasis after surgery for lymph node metastatic colorectal cancer,particularly benefiting patients in stage N2.

Aim To explore the molecular mechanism of Tongluo Tangtai(TLTT)prescription in the preven-tion and treatment of diabetic peripheral neuropathy(DPN)based on network pharmacology and in vitro experimental verification.Methods The chemical composition information of Tongluo Tangtai was searched by TCMSP database and literature search,and the target of chemical composition was collected by PubChem and SwissTargetPrediction database.DPN targets were collected through GeneCards database.GO function and KEGG pathway enrichment of common target proteins were analyzed using DAVID database.The correlation network diagram was constructed using Cytoscape software,and the main active components and target genes were screened for molecular docking study.The in vitro model of DPN was constructed in Schwann cells induced by high glucose.The effect of TLTT on the survival rate of RSC96 cells was detected by CCK-8 method,and the gene expression of Wnt/β-catenin pathway related target molecules in RSC96 cells was detected by Real-time PCR.The expression levels of Wnt/β-catenin pathway-related proteins in RSC96 cells were detected by Western blot.Results The main active components such as stigmasterol,β-si-tosterol and quercetin were screened,which mainly ac-ted on EGFR,AKT1,MAPK3 and Wnt,PI3K-Akt and MAPK signaling pathways.The molecular docking re-sults showed that stigmasterol,β-sitosterol,quercetin and other components could dock well with EGFR,AKT1,MAPK3 and other targets.The results of cell experiment showed that 10％TLTT drug-containing ser-um could promote the viability of high-glucose Schwann cells,up-regulate the expression of β-catenin protein,and down-regulate the expression of GSK-3β and Wif-1 protein.Conclusions TLTT has the characteristics of multi-target-multi-pathway in the treatment of DPN.The possible mechanism is that TLTT activates the Wnt/β-catenin signaling pathway,improves the inhibi-tory effect of high glucose on the proliferation of Schwann cells,promotes the proliferation of Schwann cells,and thus improves the status of DPN.

To evaluate the immunogenicity and immunoprotective effects of a tRNA thiouridylase TgMnmA deletion strain of Toxoplasma gondii(T.gondii)on ICR mice,we constructed a mouse model immunized with RH△MnmA.Mice were immunized with 10 RH△MnmA tachyzoites by in-traperitoneal injection.After 30 d,indirect ELISA was used to detect the specific IgG antibody and its subtypes of immunized mice.Spleen lymphocyte suspension was prepared,and the splenic lym-phocyte subsets were analyzed by flow cytometry.Moreover,the relative expression level of cyto-kine mRNA was detected by real-time fluorescence quantitative PCR.After 30 d of immunization,mice were intraperitoneally inoculated with RH△ku80 tachyzoites.At 5 d post infection,the para-site load in the ascites,heart,liver and brain of mice was measured,and the survival of mice within 30 d after infection was observed and recorded.The results showed that compared with the control PBS group,RH△MnmA immunized group produced higher level of IgG and IgG2a antibodies,higher mRNA relative expression level of cytokines IL-2,IL-4,IL-6,IL-10,IL-12 and IFN-γ,and the number of CD4+and CD8a+in spleen lymphocytes also increased significantly.Mean-while,for the attack of RH△ku80 strain,the immune group can effectively reduce the parasite load in the ascites and some tissues,inhibit the reproduction of parasites In vivo,and significantly improve the survival rate of mice.The results of this study showed that the TgMnmA deletion strain of T.gondii can induce strong humoral and cellular immune responses in mice,and provide good immune protection against the infection of RHΔku80 strain,which has the potential to be-come a potentially promising live attenuated vaccine candidate against T.gondii.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To evaluate the role and differences of Fuzheng Jiedu formula in preventing postoperative recurrence and metastasis in patients with lymph node metastatic colorectal cancer.Methods Patients were categorized into two cohorts based on whether they received systematic traditional Chinese medicine(TCM)treatment or not.The primary endpoint was re-lapse-free survival(RFS),while the secondary endpoint was the hazard ratio(HR).Results A total of 407 patients were includ-ed in the study.After propensity score matching,no significant difference was observed in baseline characteristics between the groups(P＞0.05).The Fuzheng Jiedu formula significantly reduced the risk of recurrence and metastasis[HR:0.46,P＜0.05,Full Analysis Set(FAS)analysis],which was consistent with Per-Protocol Set(PPS)analysis.In the FAS analysis,for patients with＜4 involved lymph nodes(N1),the risk of recurrence and metastasis in the TCM group was 0.548 times that of the non-TCM group(95％CI:0.365-0.823).For patients with ≥4 involved lymph nodes(N2),the risk of recurrence and metastasis in the TCM group was 0.260 times that of the non-TCM group(95％CI:0.138-0.490).The findings from the PPS analysis were consistent.Conclusion The Fuzheng Jiedu formula can effectively reduce the risk of recurrence and metastasis after surgery for lymph node metastatic colorectal cancer,particularly benefiting patients in stage N2.

To evaluate the immunogenicity and immunoprotective effects of a tRNA thiouridylase TgMnmA deletion strain of Toxoplasma gondii(T.gondii)on ICR mice,we constructed a mouse model immunized with RH△MnmA.Mice were immunized with 10 RH△MnmA tachyzoites by in-traperitoneal injection.After 30 d,indirect ELISA was used to detect the specific IgG antibody and its subtypes of immunized mice.Spleen lymphocyte suspension was prepared,and the splenic lym-phocyte subsets were analyzed by flow cytometry.Moreover,the relative expression level of cyto-kine mRNA was detected by real-time fluorescence quantitative PCR.After 30 d of immunization,mice were intraperitoneally inoculated with RH△ku80 tachyzoites.At 5 d post infection,the para-site load in the ascites,heart,liver and brain of mice was measured,and the survival of mice within 30 d after infection was observed and recorded.The results showed that compared with the control PBS group,RH△MnmA immunized group produced higher level of IgG and IgG2a antibodies,higher mRNA relative expression level of cytokines IL-2,IL-4,IL-6,IL-10,IL-12 and IFN-γ,and the number of CD4+and CD8a+in spleen lymphocytes also increased significantly.Mean-while,for the attack of RH△ku80 strain,the immune group can effectively reduce the parasite load in the ascites and some tissues,inhibit the reproduction of parasites In vivo,and significantly improve the survival rate of mice.The results of this study showed that the TgMnmA deletion strain of T.gondii can induce strong humoral and cellular immune responses in mice,and provide good immune protection against the infection of RHΔku80 strain,which has the potential to be-come a potentially promising live attenuated vaccine candidate against T.gondii.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

A total of 300 1-day-old broilers were randomly divided into 5 groups with 5 replicates per group and 12 broilers per replicate.The control group was given free drinking water(CG),the astragalus polysaccharide control group(HPS)received 0.8 mL/L of astragalus polysaccharide o-ral liquid in drinking water,and the experimental groups(SBL,SBM,SBH)received 1.5,3.0,4.5 mL/,of Shenling Baizhu Oral Liquid in drinking water.The results showed as follows:com-pared to the CG group,SIgA content in HPS group,group SBM and group SBH was significantly increased(P＜0.05),IL-6 and IL-1β contents were significantly decreased(P＜0.05),Occludin,Mucin-2 and Bcl-2 contents were significantly increased(P＜0.05).The results of 16S rRNA test showed that the specific OUT number in groups HPS and SBM was significantly higher than that in group CG(P＜0.05),α diversity analysis showed that compared with group CG,Chao1 index and Simpson index of group HPS,group SBM and group SBH were significantly increased,and βdiversity analysis showed that there were significant differences in species composition between test group and blank control group(P＜0.05).The relative abundance analysis at the phylum level showed that the relative abundance of Firmicutes and Bacteroides in groups SBM and SBH was significantly higher than that in group CG(P＜0.05).The above results showed that Shenling Baizhu Oral Liquid could improve the intestinal health and enhance the resistance of broilers.

Objective This study investigated feasible cases and their significance in promoting the"generalized"development of inspection through digital-intelligent equipment.Methods A qualitative research approach was used,involving interviews conducted between February 2025 and March 2025 with experts in traditional Chinese medicine diagnostics,clinical research methodology,medical engineering integration,and related disciplines,using both online and offline methods.In accordance with the Consolidated Criteria for Reporting Qualitative Research,feasible cases involving the specific application of digital equipment in various parts of observation were collected through item enrichment.The significance of extending observation capabilities via these cases was analyzed,along with the overall implications of integrating digital technologies with traditional inspection method.Results Interviews were completed with 11 experts from domestic universities and research institutes in the fields of traditional Chinese medicine diagnosis,medical engineering integration,and related disciplines.A total of 78 feasible cases of digital-intelligent inspection were identified,along with 69 insights regarding the significance of enhancing the inspection capabilities.These insights were synthesized into two dimensions and 23 holistic meanings.The first dimension is to expand the scope of inspection,including obtaining internal environmental characteristics,observing external environmental characteristics,expanding thermodynamic characteristic data,and crossing time and space.The second dimension is to improve the quality of observation and diagnosis information collection and analysis,including 19 specific meanings,such as standardized collection environment,objective quantification,and refined observation.Conclusion Digital-intelligent equipment plays a significant role in expanding the scope of inspection content and achieving high-quality acquisition and analysis of extensive inspection information.These advancements extend and enrich the capabilities of traditional inspection method in traditional Chinese medicine.