1.Colonization, drug resistance, and molecular epidemiological characteristics of methicillin-resistant Staphylococcus aureus among dairy farm workers in Xinjiang
Jiguo JIN ; Zhaojie WANG ; Yanggui CHEN ; Xixiao MA ; Wanting XU ; Xingyu WANG ; Xiangnan WEI ; Fan WU ; Xintao DANG ; Xueying XIANG ; Jianyong WU ; Fuye LI
Journal of Environmental and Occupational Medicine 2026;43(2):201-207
Background Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen for both human bloodstream infections and mastitis in cows. However, little attention has been paid to the cross-host transmission of MRSA from cows to high-risk groups in China. Objective To determine the MRSA colonization rates among dairy cows and dairy farm workers in Xinjiang, identify the antibiotic resistance profiles and molecular characteristics of the isolates, and provide scientific evidence for the formulation of targeted infection control strategies. Method A cross-sectional survey combined with laboratory pathogen analysis was conducted. From June to August 2024, large-scale dairy farms in Xinjiang region were selected as study sites. Nasal swabs (n=96) and skin swabs (n=39) were collected from workers, and bovine nasal swab samples (n=109) were collected simultaneously. All samples were subjected to MRSA isolation, cultivation, and identification, followed by antibiotic susceptibility testing to characterize resistance phenotypes. Staphylococcus aureus protein A (Spa) typing was performed to determine strain genotypes and elucidate MRSA colonization rates and molecular epidemiological patterns. Results A total of 35 MRSA strains was successfully isolated from 244 samples. The MRSA colonization rates among dairy farm workers and dairy cows were 20.83% (20/96) and 12.84% (14/109), respectively, with an overall isolation rate of 14.34% (35/244). Among the workers, the nasal colonization rate was 16.67% (16/96), and the skin colonization rate was 12.82% (5/39). One worker exhibited MRSA colonization at multiple body sites. All MRSA strains were resistant to cefoxitin (100%, 35/35). The resistance rates to erythromycin and clindamycin were 42.86% (15/35) and 34.29% (12/35), respectively. Thirteen strains showed a multidrug-resistant phenotype, whereas all strains were susceptible to vancomycin. The MRSA isolates exhibited high genetic diversity, with 13 Spa types identified, among which t441 was the most prevalent (8 strains). Both t441 and t034 types were detected in samples from both the dairy cows and their handlers. These two Spa types also carried and stably inherited specific resistance combinations, including erythromycin–clindamycin–cefoxitin and ciprofloxacin–erythromycin–clindamycin–gentamicin–cefoxitin–tetracycline, and a statistically significant association was also observed between the two resistance profiles and the bacterial types (P < 0.001). In addition, one novel Spa type strain was identified. Conclusion MRSA colonization rates among dairy cows and dairy farm workers in Xinjiang are relatively high, with evidence of multi-site colonization. The isolates exhibit high levels of multidrug resistance and genetic diversity, indicating a potential risk of cross-host transmission.
2.The efficacy and cost of ambulatory and hospitalized surgical resection in patients with lung tumors: A systematic review and meta-analysis
Shanshan JIANG ; Yue WANG ; Haiping MA
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(01):132-140
Objective To compare the cost and efficacy of ambulatory versus hospitalized surgery for lung tumor patients. Methods Two researchers independently conducted a computer search on February 14, 2025, in databases including CNKI, PubMed, Web of Science, Ovid Medline, Cochrane Library, and Wanfang Database, with the search period covering from the inception of these databases to February 2025. The outcome indicators were postoperative complication rate, length of hospital stay, hospitalization costs, et al. For the included randomized controlled trials and non-randomized controlled trials, we used the Cochrane risk of bias assessment tool and the Newcastle Ottawa Scale (NOS) respectively to evaluate the quality of the literature, and extracted data from the included studies for meta-analysis using RevMan 5.4 and Stata 18.0. Results A total of 12 researches were ultimately included, consisting of 2 randomized controlled trials, 2 prospective cohort studies, and 8 retrospective cohort studies, involving a total of 76 403 patients. All researches were evaluated as high-quality. Meta-analysis showed that the ambulatory surgery group had advantages over the hospitalized surgery group in terms of operation time [MD=−21.07, 95%CI (−30.55, −11.58), P<0.001], length of hospital stay [MD=−2.17, 95%CI (−3.25, −1.09), P<0.001], hospitalization costs [SMD=−1.22, 95%CI (−2.18, −0.26), P=0.01], and overall postoperative complications [OR=0.48, 95%CI (0.32, 0.74), P<0.001]. There was no statistically significant difference between the two groups in terms of postoperative hoarseness [OR=0.62, 95%CI (0.24, 1.61), P=0.33] and postoperative chylothorax [OR=0.27, 95%CI (0.07, 1.07), P=0.06]. Conclusion Compared to conventional hospitalized lung tumor resection, ambulatory lung tumor resection can significantly reduce the patient’s surgery and hospital stay time, decrease hospitalization costs, and reduce the incidence of postoperative complications. Ambulatory surgery can improve hospital efficiency while reducing the economic burden on patients. It is worthy of further promotion and application.
3.Comparative Study on Effect of Jingui Shenqiwan and Liuwei Dihuangwan on Reproductive Ability and Brain Function of Normal Mice
Hong SUN ; Fan LEI ; Chenggong LI ; Rui LUO ; Shixian HU ; Bin REN ; Juan HAO ; Yi DING ; Lijun DU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):1-14
ObjectiveTo explore the effects of Jingui Shenqiwan (JSW) and Liuwei Dihuangwan (LDW) on the reproductive ability and brain function of normal mice and compare the actions of the two medications. MethodsSeven groups of female and male mice were divided at a ratio of 2∶1. Except for the control group, the other six groups were as follows: a group of both males and females receiving JSW (3.0 g·kg-1), a group of both males and females receiving LDW (4.5 g·kg-1), a group of males receiving water and females receiving JSW, a group of males receiving water while females receiving LDW, a group of females receiving water while males receiving JSW, and a group of females receiving water while males receiving LDW. Each group was administered the drug for 14 days and then caged together at a 2∶1 (female∶male) ratio to detect the number of pregnant mice and calculate the pregnancy rate. Pregnant mice continued receiving the drug until they naturally gave birth, which was followed by the observation of newborn mice, calculation of their average number, and the measurement of the offspring's preference for sugar water and neonatal recognition index. At the end of the experiment, the weights of the thymus and spleen were measured to calculate the organ coefficients, and mRNA or protein expression was analyzed in the brain and testes or ovaries. A 1% sucrose solution was used to examine the euphoria of their brain reward systems, while novel object recognition test (NOR) was applied to assess their memory capabilities. mRNA expression was detected using real-time quantitative polymerase chain reaction (Real-time PCR) assay, and protein expression was analyzed with Western blot. ResultsCompared with the control group, oral administration of JSW to both male and female mice for 14 days significantly increased the pregnancy rate of female mice on day 2 after being caged together (P<0.05), while LDW showed a trend but no statistical significance. Additionally, compared with the control group, JSW could upregulate the gene expression of gonadotropin-releasing hormone (GnRH) in the thalamus, as well as reproductive stem cell factor (SCF) and tyrosine kinase receptor (c-Kit) in the testes and reproductive stem cell marker mouse vasa homologue (MVH) in the ovaries, upregulate the expression of proteins influencing neuronal functional activity, such as brain-derived neurotrophic factor (BDNF), in hippocampal neurons (P<0.05), and enhance sucrose preference in male mice (P<0.05). Compared with the control group, JSW significantly increased sucrose preference and novel object recognition index in offspring mice (P<0.05), which was related to the upregulation of hippocampal dopamine D1 receptor (D1R) and N-methyl-D-aspartate receptor (Nmdar) gene expression. Compared with the control group, both JSW and LDW could upregulate the protein expression of glucocorticoid receptor (GR), BDNF, and tyrosine kinase receptor B (TrkB) in the hippocampus of offspring mice (P<0.05). ConclusionJSW significantly enhances the reproductive ability of normal mice, which is not only related to the release of gonadotropin but also associated with its regulation of brain function. Additionally, JSW has a certain regulatory effect on the brain function of the offspring mice.
4.Study on the effects and mechanisms of Lycium ruthenicum Murr. in improving sleep
Ming QIAO ; Yao ZHAO ; Yi ZHU ; Yexia CAO ; Limei WEN ; Yuehong GONG ; Xiang LI ; Juanchen WANG ; Tao WANG ; Jianhua YANG ; Junping HU
China Pharmacy 2026;37(1):24-29
OBJECTIVE To investigate the effects and mechanisms of Lycium ruthenicum Murr. in improving sleep. METHODS Network pharmacology was employed to identify the active components of L. ruthenicum and their associated disease targets, followed by enrichment analysis. A caffeine‑induced zebrafish model of sleep deprivation was established , and the zebrafish were treated with L. ruthenicum Murr. extract (LRME) at concentrations of 0.1, 0.2 and 0.4 mg/mL, respectively; 24 h later, behavioral changes of zebrafish and pathological alterations in brain neurons were subsequently observed. The levels of inflammatory factors [interleukin-6 (IL-6), IL-1β, IL-10, tumor necrosis factor-α (TNF-α)], oxidative stress markers [superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), catalase (CAT)], and neurotransmitters [5- hydroxytryptamine (5-HT), γ-aminobutyric acid (GABA), glutamic acid (Glu), dopamine (DA), and norepinephrine (NE)] were measured. The protein expression levels of protein kinase B1 (AKT1), phosphorylated AKT1 (p-AKT1), epidermal growth factor receptor (EGFR), B-cell lymphoma 2 (Bcl-2), sarcoma proto-oncogene,non-receptor tyrosine kinase (SRC), and heat shock protein 90α family class A member 1 (HSP90AA1) in the zebrafish were also determined. RESULTS A total of 12 active components and 176 intersecting disease targets were identified through network pharmacology analysis. Among these, apigenin, naringenin and others were recognized as core active compounds, while AKT1, EGFR and others served as key targets; EGFR tyrosine kinase inhibitor resistance signaling pathway was identified as the critical pathway. The sleep improvement rates in zebrafish of LRME low-, medium-, and high-dose groups were 54.60%, 69.03% and 77.97%, 开发。E-mail:hjp_yft@163.com respectively, while the inhibition ratios of locomotor distance were 0.57, 0.83 and 0.95, respectively. Compared with the model group, the number of resting counts, resting time and resting distance were significantly increased/extended in LRME medium- and high-dose groups (P<0.05). Neuronal damage in the brain was alleviated. Additionally, the levels of IL-6, IL-1β, TNF-α, MDA, Glu, DA and NE, as well as the protein expression levels of AKT1, p-AKT1, EGFR, SRC and HSP90AA1, were markedly reduced (P<0.05), while the levels of IL-10, SOD, GSH-Px, CAT, 5-HT and GABA, as well as Bcl-2 protein expression, were significantly elevated (P<0.05). CONCLUSIONS L. ruthenicum Murr. demonstrates sleep-improving effects, and its specific mechanism may be related to the regulation of inflammatory responses, oxidative stress, neurotransmitter balance, and the EGFR tyrosine kinase inhibitor resistance signaling pathway.
5.Umbrella review analysis of the safety and efficacy of vonoprazan in the treatment of peptic ulcers and post-ESD ulcers
Qingmei ZHU ; Min SHI ; Dongliang YANG ; Haixia ZHAO
China Pharmacy 2026;37(3):389-394
OBJECTIVE To analyze the safety and efficacy of vonoprazan (VPZ) in the treatment of peptic ulcer (PU) and post-endoscopic submucosal dissection (ESD) ulcers, providing evidence-based pharmaceutical evidence for clinical practice and medical decision-making. METHODS Retrieved from CNKI, Wanfang, VIP, CBM, PubMed, Embase, Web of Science, and the Cochrane Library, meta-analyses/systematic reviews related to VPZ in the treatment of PU and post-ESD ulcers were collected. Two researchers independently performed literature screening, data extraction, quality assessment of included studies, and evaluation of literature overlap. By employing the umbrella review analysis, a fresh meta-analysis was conducted on all relevant raw research data when a high degree of overlap was identified among the included studies. RESULTS A total of 17 meta-analyses were included, with quality ranging from high to very low; all outcome measures involved showed a very high level of overlap in the included meta-analyses (corrected covered area: 22.22%-100%). In the treatment of post-ESD ulcers, compared to proton pump inhibitor (PPI), VPZ significantly improved the ulcer healing rate at 4 weeks post-ESD [RR=1.27, 95%CI (1.03, 1.56), Z=2.21, P= 0.027] and the ulcer contraction rate post-ESD [MD=0.08, 95%CI (0.00, 0.16), Z=2.09, P=0.037], while significantly reducing the ulcer recurrence rate in patients with a history of PU [RR=0.49, 95%CI (0.32, 0.73), Z=3.49, P=0.001]; the delayed bleeding rate in the VPZ group was significantly lower than that in the lansoprazole subgroup [RR=0.47, 95%CI (0.25, 0.90), Z=2.28, P=0.02]. In the treatment of PU, the incidence of adverse events with VPZ was significantly higher than that with PPI in the duodenal ulcer subgroup [RR=1.13, 95%CI (1.02, 1.26), Z=2.38, P=0.017]. CONCLUSIONS For post-ESD ulcers, VPZ demonstrates superior therapeutic efficacy compared to PPI and can reduce ulcer recurrence rates in patients with a history of PU. However, it does not offer advantages in terms of safety for duodenal ulcer treatment.
6.Diagnostic and prognostic value of differential expression of Cyclin D1 and p53 in eyelid tumors
Minli MA ; Jingjing ZHANG ; Ying LIU ; Hongyan SONG ; Fang LIN ; Qi MA
International Eye Science 2026;26(3):511-517
AIM: To investigate the diagnostic and prognostic value of differential expression of Cyclin D1 and p53 in eyelid tumors.METHODS: This retrospective study enrolled patients who underwent surgical resection for eyelid tumors at our hospital between March 2018 and March 2023. Participants were categorized into benign and malignant groups based on tumor characteristics. Clinical data were collected. Genetic data for eyelid tumors were obtained from the GEO database, and differential gene analysis, including volcano plot visualization and KEGG pathway enrichment analysis, was performed using the Sangerbox 3.0 platform. Immunohistochemistry was used to detect the expression levels of Cyclin D1, p53, and BAX in tissue samples. Correlations with clinical features were analyzed using Spearman analysis, and prognostic factors were identified via Logistic regression analysis.RESULTS: This study included 69 patients with eyelid tumors(78 eyes), categorized into a benign group(37 patients, 41 eyes)and a malignant group(32 patients, 37 eyes)based on tumor characteristics. There were significant differences between the two groups in histological subtype, TNM staging, vascular invasion, differentiation status, and local infiltration(all P<0.05). Among benign tumors: pigmented nevi in 11 eyes(27%), hemangiomas in 9 eyes(22%), squamous cell papillomas in 5 eyes(12%), epidermoid cysts in 5 eyes(12%), seborrheic keratoses in 4 eyes(10%), neurofibromas in 3 eyes(7%), and both calcifying epithelioma and xanthelasma in 2 eyes each(5%); among malignant tumors: basal cell carcinoma in 18 eyes(49%), meibomian gland carcinoma in 8 eyes(22%), squamous cell carcinoma in 5 eyes(14%), sebaceous gland carcinoma in 4 eyes(11%), lymphoma and malignant melanoma each in 1 eye(3%). At the follow-up cutoff date of March 2025, the 2-year survival rate in the benign group(95%)was significantly higher than that in the malignant group(78%; P<0.05). Bioinformatics analysis identified 4 103 differentially expressed genes, including Cyclin D1, p53, and BAX, which were predominantly involved in pathways such as the p53 signaling pathway and calcium-related signaling. Spearman analysis revealed that local invasion(rs=0.71, P<0.05)and TNM stage(rs=0.73, P<0.05)correlated with Cyclin D1 expression; local invasion(rs=0.76, P<0.05)and histological subtype(rs=0.65, P<0.05)correlated with p53 expression. Logistic regression results indicated that Cyclin D1, p53, TNM staging, and local invasion were prognostic risk factors. ROC curve analysis demonstrated that the combined detection of these four indicators had the highest predictive value for prognosis(AUC=0.83).CONCLUSION: High expression of cyclin D1 and p53 serves as molecular markers for distinguishing benign from malignant eyelid tumors and assessing prognosis. Combined detection of these markers with TNM staging and local invasion demonstrates high predictive value for prognosis.
7.The regulatory mechanism of TLR4 on the inflammatory response in mice with gastric ulcers through autophagy and oxidative stress
Jinxuan DU ; Feiluore DILIXIATI ; Qiuyun XUAN
Acta Universitatis Medicinalis Anhui 2026;61(1):30-37
ObjectiveTo investigate the effects of Toll-like receptor 4 (TLR4) inhibition on autophagy and oxidative stress, as well as its regulatory role and mechanism in the inflammatory response in a mouse model of gastric ulcer. MethodsSixty adult male Kunming mice were equally divided into five groups: control group, model group, model+TLR4-IN-C34 group, model+TLR4-IN-C34+3-MA group, and model+TLR4-IN-C34+H₂O₂ group. Except for the control group, all groups were administered 40 mg/kg indomethacin via gavage. Treatment groups received injections every three days, and all groups were treated for 30 days. Mice were euthanized by cervical dislocation, and gastric tissues were collected. Gastric ulcer scores were assessed, and pathological changes were evaluated via HE staining and scoring. Serum levels of interleukin-1β (IL-1β), IL-6, tumor necrosis factor-α (TNF-α), advanced oxidation protein products (AOPP), and prostaglandin E2 (PGE2), as well as gastric tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), and reduced glutathione (GSH), were measured using ELISA. Western blot analysis was performed to detect the expression of TLR4, microtubule-associated protein 1 light chain 3-Ⅰ (LC3-Ⅰ),LC3-Ⅱ, autophagy-related protein 5 (Atg5), Beclin-1, nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and NAD(P)H quinone dehydrogenase 1 (NQO1) in gastric tissues. Immunofluorescence staining was used to assess LC3-Ⅱ fluorescence intensity in gastric tissues. ResultsCompared with the control group, the model group exhibited upregulation of ulcer scores, HE staining scores, TLR4, IL-1β, IL-6, TNF-α, and AOPP levels, and downregulation of LC3-Ⅱ fluorescence intensity, PGE2 levels, Atg5, Beclin-1, nuclear Nrf2, HO-1, NQO1 levels, and the LC3-Ⅱ/Ⅰ ratio (all P < 0.05). Compared with the model group, the model+TLR4-IN-C34 group showed downregulation of ulcer scores, HE staining scores, TLR4, IL-1β, IL-6, TNF-α, and AOPP levels, and upregulation of LC3-Ⅱ fluorescence intensity, PGE2 levels, Atg5, Beclin-1, nuclear Nrf2, HO-1, NQO1 levels, and the LC3-Ⅱ/Ⅰ ratio (all P < 0.05). Compared with the model+TLR4-IN-C34 group, the model+TLR4-IN-C34+3-MA group exhibited upregulation of ulcer scores, HE staining scores, IL-1β, IL-6, TNF-α, and AOPP levels, and downregulation of LC3-Ⅱ fluorescence intensity, PGE2 levels, Atg5, Beclin-1, and the LC3-Ⅱ/Ⅰ ratio (all P < 0.05). Compared with the model+TLR4-IN-C34 group, the model+TLR4-IN-C34+H₂O₂ group showed upregulation of ulcer scores, HE staining scores, IL-1β, IL-6, TNF-α, and AOPP levels, and downregulation of PGE2 levels and nuclear Nrf2, HO-1, and NQO1 levels (all P < 0.05). ConclusionInhibition of TLR4 ameliorates gastric ulcer symptoms and suppresses the inflammatory response in mice by upregulating autophagy and reducing oxidative stress.
8.Analysis of follicular helper T cell percentage and expression levels of functionally related cytokines in a mouse model of incomplete embryo implantation disorders
Peng WANG ; Xiaoyun GONG ; Manli ZHANG ; Yunian ZHANG ; Xiaolin LA
Acta Universitatis Medicinalis Anhui 2026;61(1):38-44
ObjectiveTo detect the proportion of splenic follicular helper T (Tfh) cells and their functionally related cytokine expression levels in the incomplete embryo implantation disorder (EID) model mice, and to explore the immunological mechanism of Tfh in infertility caused by embryo implantation disorder. MethodsSixteen female Kunming mice were randomly divided into two groups, with eight mice in each group. On day 4 of pregnancy, an incomplete EID mouse model was established by oral gavage of mifepristone suspension, while an equal volume of saline was administered to the control group. On day 8 of pregnancy, the mice were euthanized. Flow cytometry was used to detect the levels of Tfh cells in the spleen lymphocytes of both incomplete EID mice and normal control mice. qRT-PCR was performed to measure the mRNA levels of B-cell lymphoma 6 (Bcl-6) and C-X-C chemokine receptor type 5 protein (CXCR5) in the spleen lymphocytes of both groups. Western blot was employed to assess the protein expression levels of Bcl-6 and CXCR5 in the spleen lymphocytes of both groups. Serum levels of interleukin-4 (IL-4), IL-6, and IL-21 were measured by ELISA. Immunohistochemistry (IHC) was used to observe the expression levels of progesterone receptor (PR), Bcl-6, and CXCR5 proteins in the uterine endometrial tissue of mice in both groups. ResultsIncomplete-type EID mice had a reduced number of embryo implantation points and reduced endometrial PR expression. Flow assay results showed that the proportion of CD4+CXCR5+Tfh cells in splenic lymphocytes of incomplete-type EID mice was significantly higher than that of normal controls (P<0.05). Compared with the normal control group, Bcl-6 and CXCR5 mRNA levels and protein levels were elevated in splenic lymphocytes of incomplete EID mice, with statistically significant differences (P<0.05); serum IL-4, IL-6, and IL-21 levels were elevated in incomplete EID mice, and Bcl-6 and CXCR5 proteins in the endometrium were significantly elevated (P<0.05). ConclusionThe increase of Tfh cells and their associated cytokines Bcl-6 and CXCR5 is associated with the development of incomplete EID, and may be involved in the development of female immune infertility.
9.Acacetin Ameliorates Hyperuricemia by Regulating Uric Acid Transporter and NF-κB/NLRP3 Signaling Pathway
Xuanxia WU ; Juan BU ; YELEDAN·MAHAN ; Shengnan ZHANG ; Xiaoling ZHANG ; Ling ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(1):191-198
ObjectiveTo investigate the uric acid-lowering effects and mechanisms of acacetin on hyperuricemia (HUA) in mice. MethodsOteracil potassium and adenine were used to establish the mouse model of HUA. Male Kunming mice (n=48) were randomized into six groups: control, model, low-dose (12.5 mg·kg-1) acacetin, medium-dose (25 mg·kg-1) acacetin, high-dose (50 mg·kg-1) acacetin, and allopurinol (10 mg·kg-1). Each group received continuous gavage administration for 21 days. An automatic biochemical analyzer was used to measure the levels of uric acid (UA), creatinine (Cr), urea nitrogen (BUN), alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Additionally, the activity of xanthine oxidase (XOD) in the liver and the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-18 in the serum were measured by enzyme-linked immunosorbent assay (ELISA). Pathological changes in the renal tissue were observed by hematoxylin-eosin (HE) staining. Western blot was employed to determine the levels of glucose transporter 9 (GLUT9), urate transporter 1 (URAT1), phospho-NF-κB p65 (p-NF-κB p65), and nucleotide-binding oligomerization domain-like receptor pyrin domain-containing 3 (NLRP3) in the renal tissue. ResultsCompared with the control group, the model group showed elevated levels of UA, Cr, BUN, ALT, and AST, increased activity of XOD in the liver(P<0.01), raised levels of TNF-α, IL-1β and IL-18 in the serum(P<0.01), and significantly up-regulated expression of GLUT9, URAT1, p-NF-κB p65, and NLRP3 in the renal tissue(P<0.01). Compared with the model group, acacetin reduced the UA level in a dose-dependent manner, significantly improved liver and kidney functions, decreased the XOD activity in the liver, ameliorated the pathological changes in the renal tissue, down-regulated the expression of GLUT9, URAT1, p-NF-κB p65 and NLRP3 in the renal tissue(P<0.01), and lowered the levels of TNF-α, IL-1β, and IL-18 in the serum(P<0.01). ConclusionAcacetin can ameliorate HUA by decreasing uric acid production, increasing uric acid excretion, and inhibiting the NF-κB/NLRP3 signaling pathway. Therefore, acacetin may be a potential drug for the treatment of HUA.
10.Efficacy and safety of omadacycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneu-monia in children
Qingmei ZHU ; Jing WANG ; Lili SHI ; Dongliang YANG ; Jiawei HE ; Jing SHEN ; Jianhua YANG
China Pharmacy 2026;37(4):480-485
OBJECTIVE To investigate the efficacy and safety of omadacycline in the treatment of macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) in children. METHODS A retrospective study was conducted on children aged 1-18 years old with MUMPP who were hospitalized in the Department of Pediatrics, the First Affiliated Hospital of Xinjiang Medical University from January 2022 to June 2025. According to the selection of secondary antibiotics after 72 h of initial treatment with macrolides, they were divided into the omadacycline group and the doxycycline group. Based on conventional treatment, children in the omadacycline group were given intravenous infusion of 2.4 mg/kg (once daily) of omadacycline tosylate, while children in the doxycycline group were given oral doxycycline hydrochloride tablets at 2 mg/kg (twice daily). The efficacy and safety were compared between the two groups of pediatric patients. Univariate analysis and multivariate Logistic regression analysis were performed on clinical efficacy, and subgroup analysis along with multiple sensitivity analyses were conducted to verify the robustness of the conclusions. RESULTS A total of 284 children with MUMPP were included in this study, with 142 in the omadacycline group and 142 in the doxycycline group. In terms of efficacy, although the hospitalization time of children in the omadacycline group was longer than that in the doxycycline group ( P <0.05), the lung lesion absorption rate and clinical efficacy were significantly higher or better than those in the doxycycline group ( P <0.05). The results of multivariate Logistic regression analysis showed that medication (OR=5.300, 95%CI: 2.526-11.123), length of hospital stay (OR=1.348, 95%CI: 1.167-1.556), and medication duration (OR=1.422, 95%CI: 1.169-1.729) were influencing factors of clinical efficacy ( P <0.05). The subgroup analysis results showed that the clinical efficacy of omadacycline was significantly better than that of doxycycline in all subgroups ( P <0.05). The results of multiple sensitivity analysis showed that the regression coefficients B of the four models (gradually adjust variables) before and after inverse probability of treatment weighting were significantly greater than 1 ( P <0.05). In terms of safety, there was no statistically significant difference in the inci dence of adverse drug reactions between the two groups of patients ( χ 2 =0.447, P =0.504). CONCLUSIONS In the case of hospitalization and prolonged medication, the efficacy of omadacycline in treating childhood MUMPP is superior to that of doxycycline, and its safety is good.

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