Objective To systematically review the efficacy and safety of azithromycin versus amoxicillin and clavulanate potassium in the treatment of otitis media in children.Methods PubMed,Embase,Cochrane Library,CNKI,WanFang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs)of azithromycin versus amoxicillin and clavulanate potassium in the treatment of otitis media in children from inception to February 28,2025.Two researchers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Meta-analysis was then performed using RevMan 5.3 software.Results A total of 21 RCTs involving 6,092 patients were included.The results of Meta-analysis showed that there was no statistically significant difference in the total effective rate after completion of treatment[RR=0.99,95％CI(0.96,1.03),P=0.72]and the total effective rate during follow-up period[RR=0.99,95％CI(0.94,1.04),P=0.10]between amoxicillin and clavulanate potassium group and azithromycin group.The results of subgroup analysis showed there was no statistically significant difference in the total effective rate between amoxicillin and clavulanate potassium group and azithromycin group in children under two years old or 2 years old and above(P＞0.05).The incidence of diarrhea[RR=0.41,95％CI(0.28,0.60),P＜0.001],vomiting[RR=0.49,95％CI(0.28,0.87),P=0.02],nausea[RR=0.46,95％CI(0.27,0.78),P=0.004],loose stools[RR=0.44,95％CI(0.24,0.79),P=0.006],rash[RR=0.62,95％CI(0.39,0.96),P=0.03],fungal dermatitis[RR=0.32,95％CI(0.18,0.57),P＜0.001],dermatitis[RR=0.31,95％CI(0.14,0.67),P=0.003]in the azithromycin group were all lower than those in the amoxicillin and clavulanate potassium group,and the difference was statistically significant.Conclusion The current evidence shows that azithromycin versus amoxicillin and clavulanate potassium are equally effective in treating otitis media in children,but azithromycin is considered safer.Due to the limited quality and quantity of included studies,more high-quality studies are required to verify the above conclusions.

BACKGROUND: Double-stranded RNA-specific adenosine deaminase 1 (ADAR1) binds to double-stranded RNA and catalyzes the deamination of adenosine (A) to inosine (I). The functional mechanism of ADAR1 in non-small cell lung cancer (NSCLC) remains incompletely understood. This study aimed to investigate the prognostic significance of ADAR1 in NSCLC and to elucidate its potential role in regulating tumor cell proliferation and migration. METHODS: Data from The Cancer Genome Atlas (TCGA) and cBioPortal were analyzed to assess the correlation between high ADAR1 expression and clinicopathological features as well as prognosis in lung cancer. We performed Western blot (WB), cell proliferation assays, Transwell invasion/migration assays, and nude mouse xenograft modeling to examine the phenotypic changes and molecular mechanisms induced by ADAR1 knockdown. Furthermore, the ADAR1 p150 overexpression model was utilized to validate the proposed mechanism. RESULTS: ADAR1 expression was significantly elevated in lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) tissues compared with adjacent non-tumor tissues (LUAD: P=3.70×10-15, LUSC: P=0.016). High ADAR1 expression was associated with poor prognosis (LUAD: P=2.03×10-2, LUSC: P=2.81×10-2) and distant metastasis (P=0.003). Gene Set Enrichment Analysis (GSEA) indicated that elevated ADAR1 was associated with mitogen-activated protein kinase/extracellular signal-regulated kinase (MAPK/ERK) pathway activation, matrix metalloproteinase-9 (MMP-9) expression, and cell adhesion. ADAR1 and MMP-9 levels showed a strongly positive correlation (P=6.45×10-34) in 10 lung cancer cell lines, highest in H1581. Knockdown of ADAR1 in H1581 cells induced a rounded cellular morphology with reduced pseudopodia. Concomitantly, it suppressed cell proliferation, invasion, migration, and in vivo tumorigenesis. It also suppressed ERK phosphorylation and downregulated cellular Finkel-Biskis-Jinkins murine osteosarcoma viral oncogene homolog (c-FOS), MMP-9, N-cadherin, and Vimentin. Conversely, ADAR1 p150 overexpression in PC9 cells enhanced ERK phosphorylation and increased c-FOS and MMP-9 expression. CONCLUSIONS High ADAR1 expression is closely associated with poor prognosis and distant metastasis in NSCLC patients. Mechanistically, ADAR1 may promote proliferation, invasion, migration, and tumorigenesis in lung cancer cells via the ERK/c-FOS/MMP-9 axis.
Humans ; Lung Neoplasms/physiopathology* ; Adenosine Deaminase/genetics* ; Matrix Metalloproteinase 9/genetics* ; Cell Proliferation ; Carcinoma, Non-Small-Cell Lung/physiopathology* ; Cell Movement ; Animals ; Mice ; RNA-Binding Proteins/genetics* ; Female ; Male ; Cell Line, Tumor ; Proto-Oncogene Proteins c-fos/genetics* ; Middle Aged ; MAP Kinase Signaling System ; Gene Expression Regulation, Neoplastic ; Mice, Nude ; Extracellular Signal-Regulated MAP Kinases/genetics*

Objective To systematically review the efficacy and safety of azithromycin versus amoxicillin and clavulanate potassium in the treatment of otitis media in children.Methods PubMed,Embase,Cochrane Library,CNKI,WanFang Data and VIP databases were electronically searched to collect randomized controlled trials(RCTs)of azithromycin versus amoxicillin and clavulanate potassium in the treatment of otitis media in children from inception to February 28,2025.Two researchers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Meta-analysis was then performed using RevMan 5.3 software.Results A total of 21 RCTs involving 6,092 patients were included.The results of Meta-analysis showed that there was no statistically significant difference in the total effective rate after completion of treatment[RR=0.99,95％CI(0.96,1.03),P=0.72]and the total effective rate during follow-up period[RR=0.99,95％CI(0.94,1.04),P=0.10]between amoxicillin and clavulanate potassium group and azithromycin group.The results of subgroup analysis showed there was no statistically significant difference in the total effective rate between amoxicillin and clavulanate potassium group and azithromycin group in children under two years old or 2 years old and above(P＞0.05).The incidence of diarrhea[RR=0.41,95％CI(0.28,0.60),P＜0.001],vomiting[RR=0.49,95％CI(0.28,0.87),P=0.02],nausea[RR=0.46,95％CI(0.27,0.78),P=0.004],loose stools[RR=0.44,95％CI(0.24,0.79),P=0.006],rash[RR=0.62,95％CI(0.39,0.96),P=0.03],fungal dermatitis[RR=0.32,95％CI(0.18,0.57),P＜0.001],dermatitis[RR=0.31,95％CI(0.14,0.67),P=0.003]in the azithromycin group were all lower than those in the amoxicillin and clavulanate potassium group,and the difference was statistically significant.Conclusion The current evidence shows that azithromycin versus amoxicillin and clavulanate potassium are equally effective in treating otitis media in children,but azithromycin is considered safer.Due to the limited quality and quantity of included studies,more high-quality studies are required to verify the above conclusions.

Skin modeling of transdermal drug delivery system refers to experimental models that mimic the structure and function of human skin to explore and evaluate absorption,penetration,and efficacy of medicines in transdermal drug delivery.It provides an alternative to traditional human skin experiments and reduces the use of human skin in medical research,which is convenient,controllable,and cost effective.For skin models of transdermal drug delivery systems,this article introduces commonly used animal skin models,artificial skin models,and recombinant human skin models from the perspective of the transdermal absorption pathway of medicines,and analyzes their advantages,disadvantages,and applications so provide references the research and development of transdermal formulations and topical therapies.

OBJECTIVE To investigate the expression and clinical significance of tissue inhibitor of matrix metalloproteinase-3(TIMP-3)and fibronectin 1(FN1)in nasopharyngeal carcinoma patients.METHODS A total of 102 nasopharyngeal cancer patients admitted to Taihe Hospital from May 2018 to May 2019 were selected as the observation subjects(case group),and another 102 patients with chronic nasopharyngitis were selected as the control group.Immunohistochemistry was applied to determine the expression of TIMP-3 and FN1 in both groups.The prognosis of the patient is followed up.Kaplan-Meier method was applied to analyze the relationship between the expression levels of TIMP-3 and FN1 in nasopharyngeal carcinoma tissue with the 3-year prognostic survival of patients.The influencing factors were analyzed using Cox risk regression method.RESULTS The positive rate of TIMP-3 protein in the case group(25.49%,26/102)was lower than that in the control group(82.35%,84/102),with a statistically significant difference(χ2=66.369,P<0.05);the positive rate of FN1 protein(71.57%,73/102)was higher than that in the control group(20.59%,21/102),with a statistically significant difference(χ2=53.348,P<0.05).The expression of TIMP-3 and FN1 was related to lymph node metastasis and TNM staging(P<0.05).During the 5-year follow-up period,64 of 102 nasopharyngeal cancer patients with disease-free survival were categorized into the survival group,and 38 nasopharyngeal cancer patients who experienced death were categorized into the death group.The 5-year survival rate(56.58%,43/76)of patients with TIMP-3 negative expression in nasopharyngeal carcinoma tissue was lower than that of patients with TIMP-3 positive expression(80.77%,21/26)(χ2=8.921,P<0.05).The 5-year survival rate(23/29,79.31%)of patients with FN1 negative expression in nasopharyngeal carcinoma tissue was higher than that of patients with FN1 positive expression(41/73,56.16%)(χ2=8.596,P<0.05).FN1 positive,TNM staging,and lymph node metastasis were independent risk factors for mortality in nasopharyngeal carcinoma patients,while TIMP-3 was a protective factor for mortality in nasopharyngeal carcinoma patients(P<0.05).CONCLUSION TIMP-3 expression decreases and FN1 expression increases in tissues of nasopharyngeal carcinoma patients.Both are closely related to the progression and prognosis of nasopharyngeal carcinoma,and may serve as potential prognostic markers for nasopharyngeal carcinoma.

Alzheimer's disease(AD)is a degenerative neurological disorder that can lead to cognitive decline,mental behavior abnormalities,and a reduced ability to undertake daily life activities.Tryptophan is an essential amino acid for the human body and is produced by three main metabolic pathways,namely kynurenine,5-hydroxytryptamine,and indole derivatives.Influencing the metabolites of tryptophan can ameliorate neuroinflammation in the brain and significantly improve cognitive ability,while the occurrence and development of AD are reduced.In this paper,we review the research literature on the use of tryptophan metabolism intervention in AD in the last 3 years from CNKI,PubMed,and other databases,and summarize its mechanism of action,with a view to providing a reference for further research on anti-AD drugs.

Alzheimer's disease(AD)is a degenerative neurological disorder that can lead to cognitive decline,mental behavior abnormalities,and a reduced ability to undertake daily life activities.Tryptophan is an essential amino acid for the human body and is produced by three main metabolic pathways,namely kynurenine,5-hydroxytryptamine,and indole derivatives.Influencing the metabolites of tryptophan can ameliorate neuroinflammation in the brain and significantly improve cognitive ability,while the occurrence and development of AD are reduced.In this paper,we review the research literature on the use of tryptophan metabolism intervention in AD in the last 3 years from CNKI,PubMed,and other databases,and summarize its mechanism of action,with a view to providing a reference for further research on anti-AD drugs.

OBJECTIVE To prepare spider fibroin membrane loaded with Periplaneta americana extract， and investigate its characterization， in vitro drug release property and cytotoxicity. METHODS Using natural spider silk collected from Chilobrachys guangxiensis as raw material， P. americana extract as model drug， the drug-loaded spider fibroin membrane （hereinafter referred to as drug-loaded membrane） was prepared by solvent casting method. The material matrix spider fibroin membrane without P. americana extract （hereinafter referred to as blank membrane） was prepared with same method. The membrane structure was characterized by static water contact angle， Fourier infrared chromatography， X-ray diffraction and scanning electron microscopy from different angles； drug release characteristics in artificial saliva were simulated in vitro to evaluate the drug sustained-release performance. MTT assay was adopted to validate the cytotoxicity of drug-loaded membrane. RESULTS The drug-loaded membrane was prepared， and the static water contact angle was less than 90°， which was less than that of blank membrane. The drug-loaded membrane showed the characteristic absorption peak to polypeptide of P. americana extract at 1 500-1 700 cm－1. X-ray diffraction and scanning electron microscopy also proved that the drug was successfully loaded into the pellicle. The release time of the pellicle in artificial saliva was more than 200 min. The MTT test results showed that the cell proliferation rates of blank membrane and drug-loaded membrane were 84.6% and 79.4% （both greater than 70%）， respectively， without significant potential cytotoxicity. CONCLUSIONS Drug-loaded membrane prepared with natural spider silk has a certain sustained-release effect in artificial saliva， which can be further developed as a drug sustained-release carrier with excellent biological characteristics and biocompatibility.

Objective:To investigate the expression of human epidermal growth factor receptor 2(HER2)and P53 and their relationship with microsatellite instability(MSI)in gastric cancer tissues.Methods:A total of 103 patients diagnosed with gastric cancer between January 2018 and October 2020 at Yueyang Hospital were enrolled in this study.HER2, P53 and mismatch repair proteins in gastric cancer tissues were detected with immunohistochemical(IHC)methods, and MSI screening was conducted at 7 sites with a new Idylla MSI(multiple fluorescent PCR)method.Results:Of 103 gastric cancer patients in this study, 77(74.8%)showed microsatellite stability(MSS)and 26(25.2%)showed MIS via IHC, and PCR also detected 77 MSS cases and 26 MSI cases.In MSI, there was more low HER2 expression than high HER2 expression, and the rate of low HER2 expression in MSI was higher than the rate of high HER2 expression in MSI( P<0.05).Also in MSI, there was more low P53 expression than high P53 expression, and the rate of low P53 expression in MSI was higher than the rate of high expression in MSI( P<0.05). Conclusions:MSS may exist in the process of gastric carcinogenesis and in gastric cancer it may be accompanied by low expression of HER2 and p53 in cancer tissues.There may be a mutually exclusive relationship between MSI and expressions of HER2 and p53, suggesting that carcinogenic mechanisms involving MSI may be very different from those involving HER2 and p53.MSI detection is very valuable in guiding treatment drug selection and prognosis assessment.

This study aimed at exploring a fast method to accurately identify the medicinal insect Vespa mandarinia Smith from its adulterants using DNA barcode and COI sequences.The extracted DNAs from V.mandarinia and its adulterants V.soror were amplified by polymerase chain reaction (PCR) and sequenced bilaterally based on COI barcode sequence investigation.The information of the COI sequences of V.mandarinia and V.soror were gathered from GenBank.All the sequences were compared and analyzed,and their intraspecific and interspecific genetic distances were calculated using MEGA 6.06.In addition,the phylogenetic tree was established with neighbor-joining (NJ) method.As a result,the COI sequences of V.mandarinia and V.soror were successfully amplified.The minimum interspecific distance between V.mandarinia and its adulterants was 0.152 ± 0.017,being considerably larger than the maximal intraspecific distance between V.mandarinia,0.009±0.004.The constructed phylogenetic tree showed an independent branch for each species.It was concluded that the DNA barcode based on COI sequence can efficiently identify V.mandarinia and its adulterants.This study provided an innovative tool for the quality control and market regulation of Chinese materia medica,securing the safe medication of V.mandarinia.