OBJECTIVE To screen for bioactive compounds in Siwei granules against triple-negative breast cancer （TNBC）， and explore their anti-TNBC effects.METHODS Network pharmacology was applied to screen bioactive compounds of Siwei granules， corresponding targets and TNBC-related targets. A “component-target” interaction regulatory network was constructed， followed by Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analyses. Using MDA-MB-231 and 4T1 cells as subjects， bioactive compounds from Siwei granules against TNBC were screened. Using MDA-MB-231 cells as the subject， the effects of these bioactive compounds， either alone or in combination， on cell apoptosis， migration， cell cycle， reactive oxygen species （ROS） generation， and the expression of proteins related to enriched pathways were explored.RESULTS A total of 67 bioactive compounds were identified by network pharmacology， with 131 overlapping targets between the compound targets and TNBC targets. Six core key targets were identified， including the phosphatidylinositol-4，5-bisphosphate 3-kinase catalytic subunit alpha， etc. The overlapping targets were enriched in GO functions such as proliferation， phosphotransferase complexes， and protein tyrosine kinase activity， as well as in signaling pathways including phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） and ROS. A total of 4 bioactive compounds were identified by cell experiments. Among them， the half-maximal inhibitory concentration （IC 50 ） of ursolic acid for both cell lines was 25 μmol/L， while that of licochalcone A， luteolin， and aloe-emodin （for 4T1 cells only） was 50 μmol/L for both cell lines. When administered alone （all 20 μmol/L） or in combination （10 μmol/L each）， the four compounds significantly increased the apoptosis rate in MDA-MB-231 cells （only in the combination group only）， relative ROS levels （only in the combination group） and the proportion of cells in the G 2 phase （only in the luteolin group， licochalcone A group， and combination group）， while they significantly reduced the proportion of cells in the G 1 phase （only in the licochalcone A group and the combination group）， scratch healing rate， and the phosphorylation levels of PI3K （except in the aloe-emodin group）， Akt （except in the aloe-emodin group）， and the mammalian target of rapamycin （ P ＜0.05）.CONCLUSIONS The bioactive compounds in Siwei granules responsible for its anti-TNBC activity may be ursolic acid， licochalcone A， luteolin， and aloe-emodin； these compounds can， to varying degrees， inhibit TNBC cell proliferation and migration， promote apoptosis， arrest the cell cycle in the G 2 phase， induce ROS production， and inhibit the phosphorylation the related proteins of the PI3K/Akt signaling pathway.

INTRODUCTION: Adolescent depression is prevalent, and teen suicide rates are on the rise locally. A systemic review to understand associated risk and protective factors is important to strengthen measures for the prevention and early detection of adolescent depression and suicide in Singapore. This systematic review aims to identify the factors associated with adolescent depression in Singapore. METHODS: A systematic search on the following databases was performed on 21 May 2020: PubMed, EMBASE and PsycINFO. Full texts were reviewed for eligibility, and the included studies were appraised for quality using the Newcastle Ottawa Scale. Narrative synthesis of the finalised articles was performed through thematic analysis. RESULTS: In total, eight studies were included in this review. The four factors associated with adolescent depression identified were: (1) sociodemographic factors (gender, ethnicity); (2) psychological factors, including childhood maltreatment exposure and psychological constructs (hope, optimism); (3) coexisting chronic medical conditions (asthma); and (4) lifestyle factors (sleep inadequacy, excessive internet use and pathological gaming). CONCLUSION The identified factors were largely similar to those reported in the global literature, except for sleep inadequacy along with conspicuously absent factors such as academic stress and strict parenting, which should prompt further research in these areas. Further research should focus on current and prospective interventions to improve mental health literacy, targeting sleep duration, internet use and gaming, and mitigating the risk of depression in patients with chronic disease in the primary care and community setting.
Humans ; Singapore/epidemiology* ; Adolescent ; Risk Factors ; Depression/etiology* ; Protective Factors ; Male ; Female ; Life Style ; Suicide

INTRODUCTION: Antimicrobial resistance (AMR) poses a critical global health threat, with millions of deaths attributed to it annually. Antibiotic stewardship to combat AMR is the responsibility of all healthcare professionals. Despite evidence suggesting that it is unnecessary, dentists routinely prescribe prophylactic antibiotics following third molar (3M) surgeries. METHOD: This mixed-methods study examined the behavioural barriers influencing antibiotic prescribing practices within the Division of Oral and Maxillofacial Surgery at the National University Centre for Oral Health Singapore. This study used the capability, opportunity and motivation for behavioural change or COM-B framework to implement interventions targeting the behavioural barriers. RESULTS: Pre- and post-intervention data over 6 months showed a significant reduction in antibiotic prescriptions from 84.45% to 20.89%, following the implementation of COM-B strategies (P<0.001). Qualitative feedback from focus group discussions highlighted a positive shift in clinicians' attitudes towards antibiotic reduction, acknowledging the minimal infection risk associated with non-prescribing practices. Notably, complication rates remained stable throughout the study period, indicating no adverse effects from reduced antibiotic usage. CONCLUSION These findings demonstrated that the COM-B model can be successfully applied to modify deeply ingrained prescription habits, and underscored the effectiveness of a structured behavioural change intervention in enhancing compliance with antibiotic stewardship guidelines. The study advocates continuation of initiatives to sustain this positive trend and mitigate AMR in clinical practice.
Humans ; Molar, Third/surgery* ; Anti-Bacterial Agents/therapeutic use* ; Singapore ; Antimicrobial Stewardship/methods* ; Practice Patterns, Dentists'/statistics & numerical data* ; Antibiotic Prophylaxis ; Female ; Attitude of Health Personnel ; Male ; Tooth Extraction ; Adult ; Focus Groups ; Practice Patterns, Physicians'

Objective : To investigate the antagonistic activity of Lactococcus garvieae SHAMU-LG6 against Staphy- lococcus . Methods : VITEK 2 GP identification card , Microflex LT MALDI-TOF mass spectrometer and 16S rDNA amplification sequencing were used to identify the strain species . The antagonistic activity of L. garvieae SHAMU- LG6 against different Staphylococcus was detected by Oxford cup method for bacterial inhibition ; the antimicrobial active components were preliminarily isolated and purified by adsorption on XAD16 nonionic macroporous resin , gradient ethanol elution and rotary evaporation drying. Results : L. garvieae SHAMU-LG6 exhibited potent antago- nistic effect against methicillin-resistant Staphylococcus aureus , methicillin-susceptible S. aureus , S. epidermidis , S. saprophyticus , S. lugdunensis , S. hominis , S. capitis and S. warneri , with inhibitory indices of 3 . 3 , 3 . 0 , 4. 3 , 2. 0 , 4. 0 , 3 . 5 , 3 . 8 , and 3 . 5 , respectively. The antimicrobial active components produced by L. garvieae SHAMU-LG6 were mainly present in 70% and 80% ethanol eluates . Conclusion L. garvieae SHAMU-LG6 ex- hibits a potent antagonistic effect on Staphylococcus , and the antimicrobial active components produced by it are ex- pected to be a lead compound for the development of novel antimicrobial agents .

Objective: To investigate the hemolytic phenotypes of Staphylococcus aureus clinical isolates． Methods: The hemolytic phenotypes of 105 Staphylococcus aureus isolates were analyzed and summarized using the three-point inoculation method．Real-time fluorescence quantitative PCR was used to measure the mRNA expression levels of four hemolysin genes (hla，hlb，hlc，and hld) ; The VITEK 2 GP639 antimicrobial susceptibility card was used to detect resistance to commonly used antibiotics ; DNA gel electrophoresis was performed to determine the prevalence of the mecA，sea，tst，and pvl genes ; The microtiter plate crystal violet staining method was used to assess biofilm formation ability ; The CCK-8 assay was used to evaluate cytotoxicity against macrophages． Results: Seven hemo- lytic phenotypes were identified among the Staphylococcus aureus clinical isolates． Differences were found among Staphylococcus aureus clinical isolates with different hemolytic phenotypes in terms of mRNA expression levels of he- molysin genes，antibiotic resistance，virulence gene prevalence，biofilm formation ability，and cytotoxicity to mouse macrophages (P ＜0. 05 ) ． Conclusion Staphylococcus aureus clinical isolates exhibit diverse hemolytic pheno- types，which should be a focus across multiple dimensions，including microbiological testing，clinical treatment， and nosocomial infection prevention and control．

AIM To investigate the promotional effects of esculin combined with bone marrow mesenchymal stem cells(BM-MSCs)transplantation on the repair of spinal cord injury(SCI)in rats.METHODS The rats were randomly divided into the sham operation group,the model group,the esculin group for gavage of 20 mg/kg esculin,the BM-MSCs group for tail vein injection of 1 mL of 1×106/mL BM-MSCs,and the combinaiton treatment group.The SCI rat model was established using Allen's method,followed by the 14 days consecutive corresponding drug administration starting from the 2nd day after modeling.On days 3,7 and 14 of drug administration,the rats had their hind limbs motor function evaluated by the BBB scoring;and their footprint experiment conducted on the 14th day after modeling.After 14 days of administration,the rats had their morphological changes of spinal cord tissue observed with HE staining and Nissl staining;their activities of SOD and GSH,and level of MDA in spinal cord tissue detected by kits;their expressions of MAP2,GAP43 and GFAP in spinal cord tissue detected by immunofluorescence;and their expressions of NQO-1,Nrf-2,Bcl-2 and Bax proteins in spinal cord tissue detected by Western blot.RESULTS Compared with the model group,the groups interved with esculin,or BM-MSCs,or the combination treatment showed improvements in hind limb function and spinal cord tissue morphology(P＜0.05);decreased MDA levels(P＜0.05);increased SOD and GSH activities(P＜0.05);increased MAP2 and GAP43 fluorescence intensity(P＜0.05);decreased GFAP fluorescence intensity(P＜0.05);increased NQO-1,Nrf-2 and Bcl-2 protein expressions(P＜0.05);and decreased Bax protein expression(P＜0.05).And the combination treatment group was observed with an even better effects(P＜0.05).CONCLUSION The combination of esculin and BM-MSCs transplantation can effectively improve the spinal cord tissue damage and hind limb function in SCI rats.This effect may be achieved by activating the Nrf-2/NQO-1 signaling pathway to inhibit oxidative stress response,thereby reducing neuronal apoptosis,blocking glial scar formation,and promoting stem cell differentiation to rebuild neurons.

To evaluate long-term survival and clinical outcomes of patients with knee osteo-arthritis undergoing total knee arthroplasty (TKA) through long-term follow-up.

To analyze the occurrence of early complications after total hip arthroplasty (THA) in patients with systemic lupus erythematosus (SLE).

Objective:This article aims to investigate effect of information-knowledge-attitude-practice(IKAP)theory-based health management mode on rehabilitation effect and quality of life in patients with coronary heart disease(CHD).Methods:This randomized controlled study enrolled 160 CHD patients admitted in First Depart-ment of Cardiovascular Medicine,the First People's Hospital of Wuhu and first received,transradical artery percu-taneous coronary intervention between August 2022 and February 2023.They were divided into control group(n=80,routine health management)and intervention group(n=80,IKAP theory-based health management mode),and both groups were intervened for 1 month.Visual Analogue Scale(VAS)score,frequency of pain attack,scores of Hamilton Anxiety scale(HAMA),Hamilton Depression scale(HAMD),World Health Organization Quality of Life BREF(WHOQOL-BREF)and Activities of Daily Living(ADL),and incidence of complications were com-pared between two groups.Results:After intervention,compared with patients in control group,those in interven-tion group had significant lower VAS score[(2.15±0.34)points vs.(3.99±0.44)points],frequency of pain at-tack[(1.37±0.30)times/d vs.(2.31±0.33)times/d],scores of HAMA[(9.21±0.65)points vs.(12.87±0.63)points]and HAMD[(8.87±0.52)points vs.(13.57±0.92)points],and significant higher scores of ADL[(78.32±2.95)points vs.(68.54±2.86)points]and WHOQOL-BREF[(311.54±10.73)points vs.(251.38±10.30)points](P＜0.001 all).Incidence of complications in intervention group was significantly lower than that of control group(15.00％vs.31.25％,P=0.015).Conclusion:IKAP theory-based health management mode could effectively improve the psychological state and self-care ability of daily living,reduce frequency of pain attack and incidence of complications,and improve quality of life in CHD patients.

To summarize the nursing experience of a patient with Danon disease after heart transplantation.Nursing key points:closely monitor heart function,prevent right heart failure;phased analgesic and sedative measures were implemented to reduce the occurrence of related complications.Skeletal muscle function was evaluated and rehabilitation training was strengthened to promote the prognosis of patients.The patient was transferred to the general ward 5 days after operation,and was discharged 22 days after operation.