OBJECTIVE To quantitatively assess the compatibility risk of commonly used intravenous drugs in intensive care unit （ICU） patients with severe pneumonia， and provide a reference for reducing the incidence of adverse events caused by incompatibility. METHODS The PASS clinical pharmacy management system was used to retrospectively collect the data of patients diagnosed with “severe pneumonia” in the ICU of Hebei General Hospital from January 2023 to June 2025， and the commonly used intravenous drugs and medication frequency were extracted. Based on authoritative databases such as Micromedex and Stabilis as well as relevant literature， the compatibility data of commonly used intravenous drugs with 0.9% Sodium chloride injection and 5% Glucose injection were summarized. The theoretical and actual compatibility risk values were calculated using formulas， and high-risk drugs were screened and the compatibility query table was drawn. RESULTS A total of 158 ICU patients with severe pneumonia were treated with 89 intravenous drugs， and 24 drugs with high compatibility risk were identified. The drug with the highest theoretical compatibility risk value was Amphotericin B for injection （risk value 146）， and the drug with the highest actual compatibility risk value was Propofol medium and long chain fat emulsion injection （risk value 8 740）. Among the 24 high-risk drugs， six drugs， namely Esomeprazole sodium for injection， Ambroxol hydrochloride injection， Midazolam injection， Methylprednisolone sodium succinate for injection， Furosemide injection， and Cefoperazone sodium and sulbactam sodium for injection， simultaneously ranked among the top 15 in both theoretical and actual compatibility risk rankings. Among 650 pairwise compatibility combinations of the 24 drugs， 24.62% were compatible， 11.23% were incompatible， 6.77% had conflicting evidence， and 57.38% had missing evidence. CONCLUSIONS This study quantitatively analyzed the medication safety of commonly used intravenous drugs in ICU patients with severe pneumonia， identified 24 drugs with high compatibility risk， and established a compatibility query table for high-risk drugs， which helps reduce the risk of ICU compatibility adverse events.

IgA nephropathy (IgAN) is a glomerulonephritis characterized by diffuse deposition of immune complexes mainly composed of IgA in the mesangial area of the glomerulus. However, some patients show monotypic IgA deposits in the immunofluorescence examination, and its clinicopathological significance is not yet clear. The renal pathological changes of IgAN with monotypic IgA deposition are similar to those of proliferative glomerulonephritis with monoclonal IgA deposit (IgA-PGNMID), which has a risk of progressing to hematological malignancies and a worse clinical prognosis. It is necessary to differentiate them based on clinical pathological manifestations and hematological examinations. Based on previous literature reports and the research results of our research group, this review summarizes and analyzes the mechanism, clinical and pathological characteristics, and prognosis of IgAN with monotypic IgA deposition, and the relationship between IgAN with monotypic IgA deposition and IgA-PGNMID, to improve clinical doctors' understanding of IgAN with monotypic IgA deposition, reduce missed diagnosis and misdiagnosis, and improve patients' prognosis.

BACKGROUND: Senescent human skin primary fibroblast (FB) models have been established for studying aging-related, proliferative, and inflammatory skin diseases. The aim of this study was to compare the transcriptome characteristics of human primary dermal FBs from children and the elderly with four senescence models. METHODS: Human skin primary FBs were obtained from healthy children (FB-C) and elderly donors (FB-E). Senescence models were generated by ultraviolet B irradiation (FB-UVB), D-galactose stimulation (FB-D-gal), atazanavir treatment (FB-ATV), and replication exhaustion induction (FB-P30). Flow cytometry, immunofluorescence staining, real-time quantitative polymerase chain reaction, co-culturing with immune cells, and bulk RNA sequencing were used for systematic comparisons of the models. RESULTS: In comparison with FB-C, FB-E showed elevated expression of senescence-related genes related to the skin barrier and extracellular matrix, proinflammatory factors, chemokines, oxidative stress, and complement factors. In comparison with FB-E, FB-UVB and FB-ATV showed higher levels of senescence and expression of the genes related to the senescence-associated secretory phenotype (SASP), and their shaped immune microenvironment highly facilitated the activation of downstream immune cells, including T cells, macrophages, and natural killer cells. FB-P30 was most similar to FB-E in terms of general transcriptome features, such as FB migration and proliferation, and aging-related characteristics. FB-D-gal showed the lowest expression levels of senescence-related genes. In comparisons with the single-cell RNA sequencing results, FB-E showed almost complete simulation of the transcriptional spectrum of FBs in elderly patients with atopic dermatitis, followed by FB-P30 and FB-UVB. FB-E and FB-P30 showed higher similarity with the FBs in keloids. CONCLUSIONS Each senescent FB model exhibited different characteristics. In addition to showing upregulated expression of natural senescence features, FB-UVB and FB-ATV showed high expression levels of senescence-related genes, including those involved in the SASP, and FB-P30 showed the greatest similarity with FB-E. However, D-galactose-stimulated FBs did not clearly present aging characteristics.
Humans ; Fibroblasts/drug effects* ; Cellular Senescence/physiology* ; Skin/metabolism* ; Child ; Transcriptome/genetics* ; Aged ; Ultraviolet Rays ; Cells, Cultured ; Galactose/pharmacology*

Objective: To explore the impact of personalized early treatment appliances (ETA) on the relationship between dental and maxillofacial structures in patients with ClassⅡ malocclusion during the replacement phase, and to provide a basis for clinical treatment. Methods: This study was reviewed and approved by the Medical Ethics Committee, and informed consent was obtained from patients. From May 2023 to December 2023, 15 patients with Angle ClassⅡ malocclusion accompanied by mandibular retraction and anterior deep overjet during mixed dentition were enrolled in this study (8 males and 7 females; mean age 8.8 years). Each patient received a customized domestically manufactured ETA that was created based on dental arch dimensions, overjet severity, and occlusal relationships assessed from study models. Patients were instructed to wear the appliance for at least 2 hours during the day and throughout the night. The treatment duration was 6 months, at which time the changes in cephalometric data before treatment (T0) and after treatment (T1) were compared using Uceph software Results: The angle between sella, nasion and supramentale point B (SNB) of the patients increased significantly by (1.03 ± 1.74°) compared to before treatment (P = 0.039). The angle between subspinale point A and supramentale point B (ANB), the distance between point A and point B on the FH plane (wits value), the overjet, and the overbite decreased by (0.47 ± 0.61°), (2.48 ± 2.11) mm, (2.48 ± 3.42) mm, and (0.79 ± 1.40) mm, respectively, compared to before treatment, and the differences were statistically significant (P<0.05). The angle between sella, nasion and subspinale point A (SNA), the angle between the FH and MP planes (FMA), the angle between the long axis of the L1 and MP plane (IMPA), the angle between the MP plane and SN plane (MP-SN), the distance from S to Go divided by the distance from N to Me (S-Go/N-Me), and the distance of the FH plane perpendicular from G point to the Pog point (G Vert Pog) increased compared to before treatment, while the angle between the SGn and FH planes (Y-axis) and the angle between the long axis of the L1 and FH plane (FMIA) decreased compared to before treatment, but there was no statistical difference (P>0.05). Conclusion Personalized, customized ETA orthodontic appliances can effectively improve the sagittal and vertical relationships between the maxilla and mandible in patients with ClassⅡ malocclusion.

PURPOSE: Traumatic brain injury (TBI) is a significant public health issue that impacts individuals all over the world and is one of the main causes of mortality and morbidity. Decompressive craniectomy is the usual course of treatment. Basal cisternostomy has been shown to be highly effective as an alternative procedure to decompressive craniectomy. METHODS: We conducted a retrospective cohort of patients who received surgery for severe TBI between January 2019 and March 2023. Inclusion criterias were patients between the ages of 18 and 70 years who met the diagnostic criteria for severe TBI at first presentation and who underwent surgical intervention. The exclusion criteria were patients who have severe multiple injuries at the time of admission; preoperative intracranial pressure > 60 mmHg; cognitive impairment before the onset of the disease; hematologic disorders; or impaired functioning of the heart, liver, kidneys, or other visceral organs. Depending on the surgical approach, the patients were categorized into decompressive craniectomy group as well as basal cisternostomy group. General data and postoperative indicators, including Glasgow coma scale, intracranial pressure, etc., were recorded for both groups of patients. Among them, the Glasgow outcome scale extended assessment at 6 months served as the primary outcome. After that, the data were statistically analyzed using SPSS software. RESULTS: The trial enrolled 41 patients (32 men and 9 women) who met the inclusion criteria. Among them, 25 patients received decompressive decompressive craniectomy, and 16 patients received basal cisternostomy. Three days postoperative intracranial pressure levels were 10.07 ± 2.94 mmHg and 17.15 ± 14.65 mmHg (p = 0.013), respectively. The 6 months following discharge Glasgow outcome scale extended of patients was 4.73 ± 2.28 and 3.14 ± 2.15 (p = 0.027), respectively. CONCLUSION Our study reveals that basal cisternostomy in patients with surgically treated severe TBI has demonstrated significant efficacy in reducing intracranial pressure as well as patient prognosis follow-up and avoids removal of the bone flap. The efficacy of cisternostomy has to be studied in larger, multi-clinical center randomized trials.
Humans ; Brain Injuries, Traumatic/surgery* ; Retrospective Studies ; Male ; Female ; Adult ; Middle Aged ; Decompressive Craniectomy/methods* ; Aged ; Young Adult ; Adolescent ; Glasgow Coma Scale ; Treatment Outcome

IgA nephropathy (IgAN) is a glomerulonephritis characterized by diffuse deposition of immune complexes mainly composed of IgA in the mesangial area of the glomerulus. However, some patients show monotypic IgA deposits in the immunofluorescence examination, and its clinicopathological significance is not yet clear. The renal pathological changes of IgAN with monotypic IgA deposition are similar to those of proliferative glomerulonephritis with monoclonal IgA deposit (IgA-PGNMID), which has a risk of progressing to hematological malignancies and a worse clinical prognosis. It is necessary to differentiate them based on clinical pathological manifestations and hematological examinations. Based on previous literature reports and the research results of our research group, this review summarizes and analyzes the mechanism, clinical and pathological characteristics, and prognosis of IgAN with monotypic IgA deposition, and the relationship between IgAN with monotypic IgA deposition and IgA-PGNMID, to improve clinical doctors' understanding of IgAN with monotypic IgA deposition, reduce missed diagnosis and misdiagnosis, and improve patients' prognosis.

Objective To establish a high-throughput screening system to obtain key Staphylococcus aureus (S.aureus)secretory proteins which required for S.aureus survival in macrophages.Methods Based on our validated eukaryotic expression vector library of S.aureus secretory proteins,DNA transfection was used to obtain an RAW264.7 macrophage array expressing S.aureus secretory proteins.After the RAW264.7 cells were infected with S.aureus,the extracellular bacteria were removed to observe the intracellular surviving situation of S.aureus.Finally,the screening results were validated by the overexpression and knockout S.aureus of corresponding secretory proteins.Results The optimal transfection dose (1.0 μg/well)of plasmids for RAW264.7,multiplicity of infection (MOI,1 .0 ),and infection time (4 h after removing extracellular bacteria of S.aureus ) were established respectively.To validate the screening results,the corresponding overexpression and knockout strains were constructed.And hypothetical protein and Serine protease E were found to promote the survival of intracellular S.aureus.Conclusion We successfully construct a screening system for key secreted secretory proteins which required for S.aureus surviving in macrophages,which may advance the study of the intracellular surviving mechanism of S.aureus.

Objective To explore the mechanism which drives nimbolide(NIM)in treating acute pneumonia caused by Staphylococcus aureus(S.auteus).Methods A mouse model of acute pneumonia caused by S.auteus was constructed through endotracheal intubation.After NIM treatment,the survival rate was observed,the amount of bacteria in the lung was tested by plate culture,and the expression of inflammatory cytokines in the lung tissues was detected with ELISA.After primary cultured peritoneal macrophages(PM)were infected with S.auteus,the effect of NIM on the expression of inflammatory cytokines and activation of inflammatory pathway were studied with ELISA and Western blotting,respectively.The effect of RNF114 knockdown by lentiviral shRNA infection on inflammation responses in PM was explored with ELISA and Western blotting.Results Acute infection of S.auteus in the lung could cause acute death in the mice,while NIM treatment significantly improved the survival rate and down-regulated the levels of inflammatory cytokines in the lung.However,it had no effect on the lung colonization of S.auteus in the short term.The results of in vitro experiments indicated that NIM may regulate RNF114 function to down-regulate the phosphorylation level of ERK,inhibit the activation of MAPK pathway,and thus suppress the expression of inflammatory cytokines.Conclusion NIM may inhibit the activation of MAPK pathway by regulating the function of RNF114,and thus suppress the expression of inflammatory cytokines in the lung,and finally inhibit the death of mice with acute pulmonary hyperinflammation caused by S.auteus.

BACKGROUND:Patients with severe lumbar degenerative disease may have their bone mineral density incorrectly raised by dual-energy X-ray absorptiometry.While lumbar cancellous bone Hounsfield unit value can assist dual-energy X-ray absorptiometry in reducing osteoporosis misdiagnosis. OBJECTIVE:To identify osteoporosis in woman patients with lumbar degenerative diseases using lumbar CT scans. METHODS:Bone mineral density test results and lumbar CT data of 192 women patients who were treated at the Department of Spine Surgery,Sixth Affiliated Hospital of Xinjiang Medical University were retrospectively reviewed.All patients were divided into a degeneration group(n=107)and a control group(n=85)according to the criteria of severity of vertebral degeneration as assessed on CT of the lumbar spine.The CT value of axial cancellous bone of L1 vertebral body was measured in the two groups.The T score and bone mineral density of the hip and L2-L4 were recorded.According to previously published studies,osteoporosis was diagnosed at L1 vertebral CT values≤110.The prevalence of osteoporosis diagnosed by dual-energy X-ray absorptiometry and CT values was compared between the two groups. RESULTS AND CONCLUSION:(1)CT values were significantly and positively correlated with T scores and mean bone mineral density of the L2-L4 vertebrae in both groups(P<0.001),while the correlation was higher in the control group.(2)Lumbar T scores and bone mineral density values were significantly higher in the degeneration group than those in the control group(P<0.05)and CT values were significantly lower in the degeneration group than that in the control group(P = 0.001).Hip T scores and bone mineral density were not significantly different in the two groups.(3)The prevalence of osteoporosis diagnosed by CT thresholds was higher in all patients than that diagnosed by T values(51.0%and 42.7%).(4)The prevalence of osteoporosis diagnosed by CT values was as high as 23.6%in the 110 patients diagnosed with non-osteoporosis by dual energy X-ray absorptiometry in both groups,and was higher in the degeneration group than that in the control group(31.7%and 14.0%,respectively).(5)The prevalence of missed osteoporosis was as high as 38.6%(27/70)of non-osteoporosis patients diagnosed by dual-energy X-ray absorptiometry of the lumbar spine in the degeneration group compared to 19.6%(11/56)in the control group.(6)It is concluded that osteoporosis is common in female patients with lumbar degenerative diseases aged≥50 years.Measurement of lumbar cancellous bone CT values may be a useful complementary method for diagnosing osteoporosis in patients with lumbar degenerative diseases,especially in patients with severe degenerative lumbar degenerative diseases where more missed osteoporosis patients can be identified.

Sarcomatoid carcinoma of the renal pelvis accounts for a very low percentage of malignant tumors in the renal pelvis and has a poor prognosis. This article reported a patient with sarcomatoid carcinoma of the renal pelvis. The patient presented with macroscopic hematuria as the first symptom, and CT suggested left renal occupancy, unilateral nephrectomy was performed, and pathology suggested sarcomatoid carcinoma of the renal pelvis. Three weeks after surgery, a follow-up CT showed tumor recurrence. Programmed death 1(PD-1)inhibitor was given once every 3 weeks. Repeated CT examination after 24 weeks of continuous treatment suggested that the recurrent tumor disappeared. The patients was followed-up for 42 months without tumor recurrence or metastasis.