Identifying drug-drug interactions (DDIs) is essential to prevent adverse effects from polypharmacy. Although deep learning has advanced DDI identification, the gap between powerful models and their lack of clinical application and evaluation has hindered clinical benefits. Here, we developed a Multi-Dimensional Feature Fusion model named MDFF, which integrates one-dimensional simplified molecular input line entry system sequence features, two-dimensional molecular graph features, and three-dimensional geometric features to enhance drug representations for predicting DDIs. MDFF was trained and validated on two DDI datasets, evaluated across three distinct scenarios, and compared with advanced DDI prediction models using accuracy, precision, recall, area under the curve, and F1 score metrics. MDFF achieved state-of-the-art performance across all metrics. Ablation experiments showed that integrating multi-dimensional drug features yielded the best results. More importantly, we obtained adverse drug reaction reports uploaded by Xiangya Hospital of Central South University from 2021 to 2023 and used MDFF to identify potential adverse DDIs. Among 12 real-world adverse drug reaction reports, the predictions of 9 reports were supported by relevant evidence. Additionally, MDFF demonstrated the ability to explain adverse DDI mechanisms, providing insights into the mechanisms behind one specific report and highlighting its potential to assist practitioners in improving medical practice.

Objective Non-compliance of active treatments occurred in clinical trials is usually unavoidable,and improper use of standard approaches may lead to biased results,especially for non-inferiority trials.Thus,for three-arm non-inferiority clinical trials,we established a Bayes causal model to estimate causal effects in the presence of non-compliance.Methods Based on the framework of principal stratification,population was stratified according to types of compliance,and the issue was transformed into mixed-distribution identification.Bayes causal model was constructed and data augmentation(DA)algorithm were employed to calculate the posterior distribution of parameters of interest and complete statistical inference.Through simulation,we evaluated performances of our approach,compared with traditional methods including ITT,PP and AT.Results The method of ITT,PP,and AT all had a significant bias when the type of compliance associated with outcomes.The method proposed in this study both had a good performance whether the type of compliance associated with outcomes or not.Conclusion For non-inferiority trials with a high proportion of non-compliance,the method in this article has a better control of the bias.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Background Overweight/obesity in children are a global health issue. Preschool age is an important stage of children's growth and development and dietary behaviors, so it is crucial to explore dietary behavior characteristics and childhood overweight/obesity. Objective To explore the association between dietary behavior characteristics and overweight/obesity in preschool children in Shanghai, and the consistency of children's eating behavior characteristics with their parents'. Methods The children aged 3 to 6 years in 5 kindergartens in Shanghai in 2015 were selected by convenience sampling and surveyed. Their height and weight were measured. Children's and parents' dietary behavior characteristics were self-reported by their parents. According to the weight-for-height recommended by the World Health Organization, excess weight was calculated by the following formula: excess-weight%=[(measured weight - standard weight)/standard weight×100%]; obese is determined at excess-weight% > 20%, overweight: excess-weight% at 10%-20%, normal weight: excess-weight% at −10%-<10%. Chi-squared test and t test were used to compare the differences of demographic and dietary behavior characteristics between overweight/obese and normal weight children. Multiple logistic regression models were used to evaluate the association between dietary behaviors and overweight/obesity. The consistency of dietary behavior characteristics was tested between children and their parents. Results Among the 897 preschool children, 217 (24.2%) were overweight/obese and 680 (75.8%) were of normal weight. The birth weight [(3439±472) g vs. (3361±418) g] and proportion of monthly household income < 10000 yuan (17.1% vs. 10.7%) in the overweight/obese children were significantly higher than those in the normal weight children, and there were no statistical differences in sex, age, gestational age, time of adding complementary foods, outdoor activities after school every day, and parental BMI. After adjusting for potential confounders such as sex, age, household income, outdoor activities after school every day, and parental overweight/obesity, frequently having puffed food (OR=2.46, 95%CI: 1.20-4.95), western-style fast food (OR=3.52, 95%CI: 1.41-8.79), and carbonated drinks (OR=2.92, 95%CI: 1.37-6.13), often eating a lot (OR=1.51, 95%CI: 1.09-2.08) and having a good appetite (OR=2.60, 95%CI: 1.87-3.62), having regular meals (OR=1.48, 95%CI: 1.07-2.03), and fast eating (OR=3.37, 95%CI: 2.10-5.42) were positively associated with children's overweight/obesity (P<0.05). Children's partial/picky eating was inconsistent with fathers' behavior (P<0.05), while the other dietary behaviors were similar with both mothers' and fathers'. Conclusion Eating behavior characteristics of preschool children are associated with overweight/obesity, and affected by their parents. Early identifying dietary behavior problems and improving dietary habits of children might be an effective strategy in preventing and controlling the occurrence and development of obesity in childhood.

Background: Studies have shown that intestinal microbiota is closely related to the occurrence and development of depression, however, the regulatory mechanism of the classic antidepressant fluoxetine on intestinal microbiota is still unclear. Aims: To investigate the mechanism of fluoxetine in regulating intestinal microbiota structure and metabolic diversity in rats with depression. Methods: Thirty SD rats were randomly divided into blank group, model group and fluoxetine group. Depression rat model was established by chronic unpredictable mild stress (CUMS) combined with solitary care. Fluoxetine hydrochloride dispersible tablets 3.17 mg•kg

Objective To study the clinical distribution and drug resistance of Acinetobacter baumannii (AB) .Methods Clinical distribution and drug resistance of 1 190 strains of AB ,isolated in 2012 and 2013 ,were retrospectively analyzed .Results Most of AB strains were isolated from sputum ,and mainly from Intensive Care Unit ,Department of Neurosurgery and Department of Re‐spiratory .Resistance rates of AB to most antimicrobial agents were 60% -80% .Resistance rate to tobramycin ,piperacillin/tazobac‐tam and imipenem was increased significantly .Resistance rate to cefoperazone/sulbactam was decreased .Conclusion Drug resist‐ance of AB might be serious ,with increasing tendency .

Objective To study the effects of sleep inertia (SI) of different time course sleeps on sleep stages and cognitions in healthy men after 30 h sleep deprivation,and also to investigate the mechanism of cognitive functions impairment in sleep inertia stages and the influential factors of sleep inertia.Methods Ten healthy men (age,(20.8 ±2.1) years) participated in the program.The program was divided into 2 stages.First,participants attended a series of tests after 20 min nap(20 min nap group)after 30 h sleep deprivation.The testing series included 3 parts:the continuous performance task,the Stroop Tests,and the Addition Tests.The series of tests were done 3 times immediately after the volunteers were awoken and each lasted about 15 minutes with an interval of 10 minutes between each test.The polysomnogram (PSG) was recorded during the nap.The following 7 days was set as washing-out period to ensure a complete recovery.Participants repeated the similar processes with 2 h nap(2 h nap group) instead of 20 min nap.The cognitive performance of each group was compared with each other along with the best cognitive performance in awakening to estimate whether or not the cognitive abilities regained the normal condition.Results ( 1 ) Sleep latency became shortened in both groups after 30 h sleep deprivation.There were no slow wave sleep (SWS) and rapid eye movement sleep (REM) sleep stages in the 20 min naps,while the percentage of SWS was increased and percentage of REM declined in 2 h naps.(2)In the early of SI (5 min after awaking),cognitive tasks showed that the abilities of continuous attention,selected attention and addition ability were all impaired (continuous performance task:(371.8 ± 21.3 ) times/3 min vs (334.4 ± 22.4) times/3 min,( 373.2 ± 19.0) times/3 min vs ( 323.7 ± 23.8) times/3 min,t =10.443,7.774,both P＜0.01; Stroop tests:(20.3 ±1.5) points vs(17.3 ± 1.0) points,(21.5 ±0.8)points vs( 16.1 ± 1.4 ) points,t =8.478,4.934,both P ＜ 0.05 ; Addition Tests:( 222.2 ± 13.2 ) s vs ( 266.6 ±23.7 ) s,( 226.3 ± 10.9) s vs ( 267.6 ± 23.4 ) s,t =5.748,6.685,both P ＜ 0.01 ).The cognitive functions impairments of 2 h nap group were more severe at the initiation of sleep inertia,but regained the normal condition more quickly.Different cognitive tasks recovered at different speeds.The dispersion of SI needed 30 min.Conclusions ( 1 ) There are difference in the sleep construction and awaked sleep stage between 20 min nap and 2 h nap groups.(2) SI exerts negative influences on cognitive performances of continuous attention,selected attention and addition after sleep deprivation.Many factors may influence the dispersion of SI,including sleep debt,compensation of sleep debt and others.(3) Fragments of sleep are unfavorable to the recovery of body.

Objective To establish an animal model of rapid eye movement (REM) sleep deprivation (SD) and an animal model for perifornical nucleus microdialysis and investigate the change of cognition, hypocretinergic system and GABAergic system in rats' hypothalamus after various degrees of REM sleep deprivation and sleep revival and two GABAergic drugs intervention. Methods The modified multiple platform method (MMPM)was used to establish sleep deprivation model and the cognitive function was assessed by Morris' water maze. Immunofluorescence technique was used to analyze the number of Hypocretin (Hcrt) immunoreactive neurons, total Fos immunoreactive neurons, Hcrt and Fos colabeled neurons, and the integrated optical density ( IA ) of GABAA Rαl immunoreactive area in rats' hypothalamus.High performance liquid chromatograph (HPLC) was used to quantitatively analyze the level of GABA and Gluin in the rats' hypothalamus. Two GABAergic drugs, a selective GABAA R antagonist, SR-95531, and a selective blocker of type 1 GABA transporter (uptake blocker), NO-711, were used for perifornical nucleus microdialysis. Results There was no statistically significant difference in tests between CC and TC ( Define CC and TC). There was a significant decrease (P ＜ 0. 05 ) of cognitive function measured by Morris maze test in SD 3 d, SD 5 d and RS 6 h of SD groups compared with CC and TC groups. Number of Fos immunoreactive, F+ &H+ immunoreactive neuronsand IA of GABAA Rαl immunoreactive area were all significantly increased ( P ＜ 0. 05 ). Content of GABA measured by HPLC was also increased ( P ＜ 0. 05 ). However, all these changes were partly reversed by sleep revival SR-95531 and NO-711 had different effect on these changes. Conclusions Sleep deprivation, no matter mild or severe, has adverse effects on cognitive function. Activities of both GABAergic and Hcrtergic system are increased during REMSD. These two neurons system could be regulated by each other and the relationship between them is positive correlation. GABAergic system also had self-regulation during REMSD, but microdialysision of either SR-95531 or NO-711 acquired adverse effects on cognitive function of rats. So GABAergic system is not an optimal therapeutic target. Because GABAergic and Hcrtergic system has inhibitory effect on each other,suppressing activity of Hcrtergic system might be a promising therapeutic target.