The most common medications for the treatment of zoonotic toxoplasmosis are pyrimethamine and sulfadiazine, which may cause serious undesirable side effects. Thus, there is an urgent need to develop novel therapeutics. Baicalein (BAI, C₁₅H₁₀O₅) has been shown to perform well against protozoan parasites including Leishmania and Cryptosporidium. In this study, the inhibition efficacy of BAI on Toxoplasma gondii was evaluated using plaque, invasion, and intracellular proliferation assays. BAI effectively inhibited T. gondii (half-maximum inhibitory concentration (IC₅₀)=6.457×10^-5 mol/L), with a reduced invasion rate (33.56%) and intracellular proliferation, and exhibited low cytotoxicity (half-maximum toxicity concentration (TC₅₀)=5.929×10^-4 mol/L). Further investigation using a mouse model shed light on the inhibitory efficacy of BAI against T. gondii, as well as the potential mechanisms underlying its anti-parasitic effects. The survival time of T. gondii-infected ICR mice treated with BAI was remarkably extended, and their parasite burdens in the liver and spleen were greatly reduced compared with those of the negative control group. Histopathological examination of live sections revealed effective therapeutic outcomes in the treatment groups, with no notable pathological alterations observed. Furthermore, alterations in cytokine levels indicated that BAI not only effectively suppressed the growth of T. gondii but also prevented excessive inflammation in mice. Collectively, these findings underscore the significant inhibitory efficacy of BAI against T. gondii, positioning it as a promising alternative therapeutic agent for toxoplasmosis.
Animals ; Toxoplasma/drug effects* ; Flavanones/therapeutic use* ; Mice ; Antiparasitic Agents/therapeutic use* ; Mice, Inbred ICR ; Toxoplasmosis/drug therapy* ; Female

Background::Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.Methods::This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group ( n = 665) and fasting group ( n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle. Results::The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models. Conclusion::Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.Trail Registration::ClinicalTrials.gov, No. NCT03075280.

Objective To evaluate the effect of ultrasound-guided selective brachial plexus block on postoperative muscle strength in the block area of patients after wrist surgery.Methods Sixty patients who underwent wrist surgery,33 males and 27 females,aged 18-64 years,BMI 21-28 kg/m2,ASA physi-cal status Ⅰ or Ⅱ,were randomly divided into two groups by random number table method:ultrasound guided selective brachial plexus block in the middle of the forearm group(group A)and ultrasound guided axillary brachial plexus block group(group B),30 patients in each group.In group A,the ulnar nerve,and/or median nerve,and/or radial nerve were selectively blocked in the middle of the forearm according to the location of the surgical incision,and 0.4％ropivacaine was injected into each nerve with 5 ml.Patients in group B received conventional axillary brachial plexus block under ultrasound guidance and injected 30 ml of 0.4％ropivacaine.In the both two groups,dexmedetomidine 0.8 μg/kg was injected for 10 minutes be-fore nerve block,and was changed to 0.4 μg·kg-1·h-1 until the end of operation,and then patients were transferred to the recovery room for observation 30 minutes and then returned to the ward.Muscle strength 2,4,8,12,24,48 hours after operation and recovery time to grade 5 were recorded.VAS pain scores at rest and exercise 2,4,8,12,24,and 48 hours after surgery and tourniquet tolerance scores were recorded.Satisfaction score,nerve block operation time,anesthesia onset time,duration of analgesia,number of addi-tional postoperative analgesics,occurrence of postoperative remedial analgesia,and length of hospital stay were recorded.Complications such as hematoma,nerve injury and infection were recorded.Results Com-pared with group B,the muscle strength score of patients in group A 2,4,8 and 12 hours after surgery was significantly higher(P＜0.05),the time of muscle strength recovery to level 5 in group A was significantly shorter(P＜0.05).Compared with group B,the satisfaction score in group A was better(P＜0.05),the duration of nerve block operation and hospitalization in group A was shorter(P＜0.05),the intraoperative tourniquet tolerance score of in group A was worse(P＜0.05),and both groups were tolerated.There were no significant differences in VAS pain scores at rest and exercise,the onset time of anesthesia,duration of analgesia,number of postoperative analgesia remedies between the two groups.There were no complications such as hematoma,nerve injury and infection in the two groups.Conclusion Ultrasound-guided selective brachial plexus block has little effect on the motor function of upper arm and forearm,and muscle strength recovers quickly after operation,can be safely and effectively adopted in short wrist surgery.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Purpose To investigate and summarize the clinicopathological features,immunophenotype,diagnosis and differential diagnosis of anaplastic thyroid carcinoma(ATC).Methods The clinicopathological features and follow-up data of 15 patients with ATC were reviewed and retrospectively ana-lyzed,and the histological features,immunophenotypic,and molecular features were observed.Results There were 8 males and 7 females with a mean age of 63.5 years.The largest tumor diameter was 45.9 mm(range,20-73 mm).Macroscopically,the tumors appeared nodular or lobulated,mostly firm to hard,with a cut surface of gray-white or gray-yellow in color,and were accompanied by hemorrhage,necrosis,and cystic changes.Mi-croscopically,the tumor exhibited diverse structures and cellular morphology mainly composed of epithelioid,spindle,multinu-cleated giant cells,rarely rhabdoid morphology(2 cases)and heterologous osteosarcomtoid differentiation(1 case).Two cases showed squamous cell carcinoma morphology as well.Among them,there were pure ATC in 11 cases while three cases had mixed papillary thyroid carcinoma components and one case had coexisting high-grade differentiated thyroid carcinoma compo-nent.Cervical lymph node metastasis was present in 6 cases.CK(AE1/AE3)expression was observed in 80%of the cases while PAX8 expression was seen in53.3%.Varying degrees of BRAF(VE1)expression were found in 42.9%whereas weak focal TTF-1 expression occurred only in two cases;and all cases did not express TG.Overall,genetic testing was performed in 8 cases(53.3%).The TP53 gene was the most frequently muta-ted gene(5/8,62.5%),followed by the RAS(3/8,37.5%)and BRAF(3/8,37.5%)genes,while the TERT combined with PIK3CA gene was mutated in only one case.Moreover,multiple gene mutations occurred simultaneously in five cases.Of the total fourteen patients who underwent follow-up,the mean and median survival times were 13.9 and 5.0 months,respec-tively.The disease-specific mortality rate reached 78.6%.Conclusion ATC is extremely rare,displaying unique histolog-ical characteristics,often accompanied by various gene muta-tions.It has a poor prognosis;therefore,establishing a defini-tive pathological diagnosis provides valuable evidence for predic-ting patient outcomes and guiding clinical management.

This article provides a comprehensive overview of the concepts and types of comorbidities associated with cardiovascular diseases in the aged, summarizing their impacts on patients and potential intervention measures. The aim is to offer a reference for future research related to comorbidity management in aged cardiovascular disease patients in China.

Objective:To observe the efficacy and safety of teriprizumab combined with bevacizumab in above the second line treatment of high-level microsatellite instability (MSI-H) type metastatic colorectal cancer (mCRC) patients.Methods:From February 2019 to September 2019, 56 patients with MSI-H mCRC admitted to the Third Affiliated Hospital of Guangdong Medical University were selected and divided into control group and test group by random number table method, with 28 cases in each group. The control group was treated with bevacizumab, and the test group was treated with teriprizumab combined with bevacizumab. The objective response rate (ORR), disease control rate (DCR), progression-free survival, overall survival and incidence of adverse reactions were compared between the two groups.Results:The ORR and DCR of the test group were 60.71% (17/28) and 75.00% (21/28) respectively, higher than 28.57% (8/28) and 46.63% (13/28) of the control group, with statistically significant differences ( χ2=5.85, P=0.016; χ2=4.79, P=0.029). The median progression-free survival of patients in the control group and the test group were 3.5 months and 5.8 months respectively, with a statistically significant difference ( χ2=9.83, P=0.003). The median overall survival of patients in the control group and the test group were 12.1 months and 16.2 months respectively, with a statistically significant difference ( χ2=6.13, P=0.007). There were no significant diffe-rences in the incidences of hematological reaction (17.86% vs. 14.29%, χ2=0.13, P=0.716), cardiovascular injury (10.71% vs. 14.29%, χ2=0.16, P=0.686), liver and kidney function injury (25.00% vs. 21.43%, χ2=0.10, P=0.752), gastrointestinal reaction (28.57% vs. 35.71%, χ2=0.33, P=0.567), skin and mucosal injury (7.14% vs. 10.71%, χ2=0.35, P=0.553), nervous system disease (3.57% vs. 14.29%, χ2=2.25, P=0.134), endocrine reaction (3.57% vs. 10.71%, χ2=1.29, P=0.256), alopecia (14.29% vs. 17.86%, χ2=0.13, P=0.716) and fatigue (25.00% vs. 28.57%, χ2=0.27, P=0.605) between the control group and the test group. Conclusion:The combination of teriprizumab and bevacizumab can improve the short-term and medium-long-term efficacy of patients with MSI-H mCRC, which is safe and reliable.

Objective:To develop and validate a MRI-based radiomics nomogram combining with radiomics signature and clinical factors for the preoperative differentiation of benign parotid gland tumors (BPGT) and malignant parotid gland tumors (MPGT).Methods:From January 2015 to May 2020, 86 patients with parotid tumors confirmed by surgical pathology in the Affiliated Hospital of Qingdao University were enrolled as training sets, and 35 patients in the University of Hong Kong-Shenzhen Hospital from January 2013 to January 2020 were enrolled as independent external validation sets. The logistic regression was used to establish a clinical-factors model based on demographics and MRI findings. Radiomics features were extracted from preoperative T 1WI and fat-saturated T 2WI (fs-T 2WI), a radiomics signature model was constructed, and a radiomics score (Rad-Score) was calculated. A combined diagnostic model and nomogram combining with the Rad-score and independent clinical factors was constructed using multivariate logistic regression analysis. The receiver operating characteristic (ROC) analysis was used to evaluate the performance of each model and DeLong test was used for comparison of area under the ROC curve (AUC). Results:The logistic regression results showed that deep lobe involvement (OR=3.285, P=0.040) and surrounding tissue invasion (OR=15.919, P=0.013) were independent factors for MPGT and constructed the clinical-factors model. A total of 19 features were extracted from the joint T 1WI and fs-T 2WI to build the radiomics signature model. The combined diagnostic model and nomogram incorporating deep lobe involvement, surrounding tissue invasion and Rad-score were established. The AUCs of the clinical-factors model, radiomics signature model and combined diagnostic model for differentiating BPGT from MPGT for the training and validation sets were 0.758, 0.951, 0.953 and 0.752, 0.941 and 0.964 respectively. The AUCs of the radiomics signature model and the combined diagnostic model were significantly higher than those of the clinical-factors model for both training and validation sets (training set: Z=3.95, 4.31, both P<0.001; validation set: Z=2.16, 2.67, P=0.031, 0.008). There was no statistical difference in AUCs between the radiomics signature model and combined diagnostic model (training set: Z=0.39, P=0.697; validation set: Z=1.10, P=0.273). Conclusions:The MRI-based radiomics signature model and radiomics nomogram incorporating deep lobe involvement, surrounding tissue invasion, and Rad-score showed favorable predictive efficacy for differentiating BPGT from MPGT.

Few studies have described the key features and prognostic roles of lung microbiota in patients with severe community-acquired pneumonia (SCAP). We prospectively enrolled consecutive SCAP patients admitted to ICU. Bronchoscopy was performed at bedside within 48 h of ICU admission, and 16S rRNA gene sequencing was applied to the collected bronchoalveolar lavage fluid. The primary outcome was clinical improvements defined as a decrease of 2 categories and above on a 7-category ordinal scale within 14 days following bronchoscopy. Sixty-seven patients were included. Multivariable permutational multivariate analysis of variance found that positive bacteria lab test results had the strongest independent association with lung microbiota (R² = 0.033; P = 0.018), followed by acute kidney injury (AKI; R² = 0.032; P = 0.011) and plasma MIP-1β level (R² = 0.027; P = 0.044). Random forest identified that the families Prevotellaceae, Moraxellaceae, and Staphylococcaceae were the biomarkers related to the positive bacteria lab test results. Multivariable Cox regression showed that the increase in α-diversity and the abundance of the families Prevotellaceae and Actinomycetaceae were associated with clinical improvements. The positive bacteria lab test results, AKI, and plasma MIP-1β level were associated with patients' lung microbiota composition on ICU admission. The families Prevotellaceae and Actinomycetaceae on admission predicted clinical improvements.
Acute Kidney Injury/complications* ; Bacteria/classification* ; Chemokine CCL4/blood* ; Community-Acquired Infections/microbiology* ; Humans ; Lung ; Microbiota/genetics* ; Pneumonia, Bacterial/diagnosis* ; Prognosis ; RNA, Ribosomal, 16S/genetics*

ObjectiveTo investigate the effects of inoculation of potassium-solubilizing bacteria on the physiological characteristics of Paris polyphylla var. yunnanensis. MethodThe effects of different potassium-solubilizing bacteria on leaf area，photosynthetic pigment content， and active component indexes of P. polyphylla var. yunnanensis were investigated by pot planting at room temperature. ResultThe results showed that the inoculation of potassium-solubilizing bacteria could increase the leaf area of P. polyphylla var. yunnanensis. The largest average leaf area was observed in the S3 group，reaching 10.497 cm²，with a maximum increase of 11.0% compared with that of the CK group. The inoculation of potassium-solubilizing bacteria could increase the content of photosynthetic pigments in leaves. Among them，the increase in chlorophyll a content was significant （P<0.05），which was 80.6% higher than that of the CK group. The chlorophyll a/b values in all treatment groups were higher than that of the CK group. The activities of superoxide dismutase（SOD），catalase（CAT） and peroxidase（POD） in the leaves of P. polyphylla var. yunnanensis increased by 88.4%，33.8%， and 30.6%，respectively， as compared with that in the CK group. The inoculation of potassium-solubilizing bacteria could promote the accumulation of osmoregulation substances such as soluble sugar and soluble protein in leaf cells of P. polyphylla var. yunnanensis，with a maximum increase of 55.3% and 70.5% respectively compared with that of the CK group. Meanwhile，it also reduced the content of malondialdehyde（MDA），with a maximum decrease of 34.1% compared with that of the CK group. The results of correlation analysis showed that there were some correlations between different chemical components in P. polyphylla var. yunnanensis leaves. ConclusionThe inoculation of potassium-solubilizing bacteria can effectively promote the growth and development of P. polyphylla var. yunnanensis and improve its survival ability in adversity. It is of practical scientific significance and potential application value for improving the survival rate of P. polyphylla var. yunnanensis by artificial planting.