One of the most common diseases in the world is sinusitis, which is an inflammation of the membranes lining the paranasal sinuses. The bacteria involved are highly resistant to antibiotics, prompting scientists to explore green bioactives as potential biofilm inhibitors. The current study investigated the antioxidant potential, phytochemical screening, antibacterial and biofilm inhibition potential of polyherbal extracts prepared using distilled water, ethanol, hydroethanol and n-hexane solvents. However, no prior research has specifically addressed their use in treating sinusitis. Samples were prepared by maceration method followed by antioxidant and phytochemical analysis. Chemical fingerprinting was conducted using FTIR, GC-MS and LC-MS analysis. Antibacterial activity, Minimum inhibitory concentration (MIC) and biofilm inhibition was checked. Among the extracts, polyherbal ethanol extract showed the highest antioxidant activity, followed by n-hexane, distilled water and hydroethanol. The distilled water extract showed the highest flavonoid and phenolic content, followed by hydroethanol. Different functional groups were identified in all extracts. Bioactive compounds such as quercitrin and kaempferol derivatives were identified. Antibacterial profile showed that hydroethanol extract was the most effective against sinusitis isolates (Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Staphylococcus aureus and Enterococcus faecalis) with the lowest MIC against Proteus mirabilis. Biofilm inhibition assay revealed the highest inhibition by hydroethanol extract against E. faecalis followed by ethanol extract against E. coli. The findings suggest that polyherbal extracts, particularly in hydroethanol and ethanol, possess significant antioxidant, antibacterial and biofilm inhibiting properties and could serve as promising candidates for the effective management of sinusitis.

Paraquat (PQ) poisoning causes acute pulmonary injury via oxidative stress and epithelial-mesenchymal transition (EMT), with limited treatment options. This study investigated whether andrographolide (Andro) alleviates PQ-induced lung damage and the underlying mechanisms. PQ-induced pulmonary injury was established in C57BL/6J mice. Animals were assigned to Control, Andro, PQ and PQ +Andro groups. Lung pathology, oxidative stress markers (MPO, ROS, MDA, SOD, CAT), EMT markers (E-cadherin, α-SMA), and PI3K/Akt/PPARγ pathway proteins were assessed in vivo and in MLE-12 cells, with PI3K inhibition using LY294002. Andro significantly improved survival, reduced alveolar injury and collagen deposition, and suppressed oxidative stress by downregulating ROS/MDA/MPO and enhancing SOD/CAT. It suppressed EMT by upregulating E-cadherin and reducing α-SMA. Andro inhibited PI3K/Akt activation and increased PPARγ expression. LY294002 partially reproduced these effects, supporting pathway involvement. Andro mitigates PQ-induced lung damage by limiting oxidative stress and EMT via the PI3K/Akt/PPARγ pathway. These findings provide preclinical evidence for its further investigation as a candidate protective agent.

Edaravone can reduce damage to brain cells in a variety of ways. Rho/ROCK signaling is involved in Alzheimer's disease. This study uses AD cell models to explore edaravone's effect on AD nerve synapse damage. The ROCK2 promoter luciferase reporter gene was constructed, Aβ25-35 was used as a processing factor and transfected into PC12 cells to construct an AD cell model which was then treated with edaravone, followed by analysis of 95 antibody (PSD95), synapse-related mRNA synapsin 1 (SYN1) level to observe its effect on Rho/ROCK signaling. Edaravone can effectively inhibit the transcriptional activity of ROCK2 promoter in AD cell model, upregulate SYN1 and GAP43 protein and downregulate ROCK2. After ROCK2 overexpression, edaravone can affect SYN1 expression in AD cell model, while SYN1 expression did not change significantly after ROCK2 was silenced. Edaravone has a protective effect on AD nerve synapse damage and plays a role in repairing nerve synapse damage through ROCK2 signaling pathway.

Curcumin exhibits limited oral bioavailability owing to its poor solubility and rapid metabolism. To develop a novel curcumin nano-gel (CNG) and evaluate its pharmacokinetics following oral and rectal administration. A sensitive LC MS/MS method was established for the simultaneous quantification of curcumin and its major metabolite curcumin O glucuronide (COG) in plasma. The pharmacokinetics of CNG were compared with those of curcumin suspension (CS) to evaluate the improvement in oral and rectal absorption. CNG and curcumin suspension (CS) were administered orally (1000 mg/kg) and rectally (200 mg/kg) to mice or rats. Plasma samples were collected, and pharmacokinetic parameters were analyzed using WinNonlin. CNG formed well dispersed nanoparticles in water. Oral administration of CNG significantly enhanced curcumin absorption, yielding a 66.7 fold higher Cmax for curcumin and an 84.8 fold higher Cmax for COG compared with CS. The AUC of curcumin and COG increased by 9.2 fold and 24.4 fold, respectively. Rectal administration of CNG resulted in a 5.5 fold higher Cmax and a 3.5 fold higher AUC of curcumin relative to oral CS. CNG markedly improves the bioavailability of curcumin via both oral and rectal routes, demonstrating its potential as an effective delivery system for enhancing curcumin therapeutic application.

Post-herpetic neuralgia (PHN) is a common refractory complication of herpes zoster, characterized by persistent neuropathic pain that seriously impairs patients' quality of life. The study aimed to assess the clinical effects of gabapentin when administered in combination with Hegu-point catgut embedding in patients suffering from post-herpetic neuralgia (PHN). A randomized, assessor-blinded study was conducted, wherein a total of 210 PHN patients were equally divided into two groups: 1) the control group receiving only gabapentin and 2) the combination group that received combined therapy of gabapentin and Hegu-point catgut embedding weekly. After 4 weeks of treatment, pain intensity, sleep quality, serum biomarkers, clinical efficacy and adverse events were evaluated. After 4 weeks, both groups displayed a significant reduction in Visual Analogue Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) scores, with greater improvement reported in the combination group (P < 0.05). In addition, both groups showed a significant decrease in serum levels of substance P, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), while β-endorphin levels showed a significant increase. The changes were found to be more pronounced in the combination group (P < 0.05). Interestingly, the combination group demonstrated a higher overall response rate (92.38% vs 80.00%) and fewer adverse events (12.38% vs 26.67%, P < 0.05). Altogether, combination therapy provided superior short-term improvement in symptoms and biomarker modulation as compared to gabapentin alone. Since the present study only assessed peripheral serum markers, the underlying mechanistic pathways could not be deciphered. Additionally, longer-term outcomes of therapy were not assessed, serving as a major limitation of this study.

Studies have confirmed that the progression of sepsis is closely related to intestinal barrier dysfunction, including intestinal mucosa ischemia and hypoxia, flora imbalance and epithelial cell apoptosis. Therefore, protecting the intestinal barrier function has become a key link in the comprehensive treatment of sepsis. This study evaluated the impact of a novel β-lactamase inhibitor compound preparation (ceftazidime/avibactam) on intestinal barrier function in sepsis patients. The study included 108 sepsis patients (January 2022‒August 2025) and grouped them as an observation group (54 cases, ceftazidime/avibactam+dynamic nutritional support) and a control group (54 cases, Ceftazidime/Sulbactam+dynamic nutritional support). Of the outcome measures assessed, the 28-day all-cause mortality was primary, while ICU length of stay, mechanical ventilation time, antibiotic course, intestinal barrier function markers (DAO, LBP, Claudin-1) and inflammatory cytokines (IL-6, TNF-α) were secondary. The results indicated lower 28-day all-cause mortality in the observation group vs the control group, along with shorter ICU length of stay, mechanical ventilation time and time to negative blood culture conversion (P<0.05). Concerning post-treatment intestinal barrier function, DAO, LBP and FC were lower while claudin-1 was higher in the observation group compared to the control group (P<0.05). Analysis of inflammatory factors also showed greater reductions in IL-1β, IL-6 and TNF-α in the observation group post-treatment (P<0.05). Ceftazidime/Avibactam plus dynamic nutritional support is instrumental in improving the intestinal barrier function of sepsis patients and alleviating inflammatory reactions, thus enhancing life safety.

Congenital Adrenal Hyperplasia (CAH) is a group of disorders characterized by impaired adrenal steroid hormone synthesis, with a wide spectrum of clinical manifestations. The prognosis of CAH depends on factors, such as clinical phenotype, treatment and management. To analyze the factors influencing the quality of life in children with CAH. This retrospective study included 30 CAH patients divided into good prognosis (n=13) and poor prognosis (n=17) groups. Clinical characteristics, genetic mutations, treatment compliance, medication regimens and complications were analyzed by t-tests and logistic regression. The good prognosis group presented better compliance (92.31% vs. 47.06%, P=0.017) and hormonal control (84.62% vs. 35.29%, P=0.01). The prevalence of the salt-wasting (SW) type of CAH was higher in the poor prognosis group (70.59% vs. 23.08%, P=0.038), while the simple virilizing (SV) type was higher in the good prognosis group (53.85% vs. 17.65%). The poor prognosis group received a higher hydrocortisone dose (16±3mg/m2/day) compared to the good prognosis group (12±4mg/m2/day, P=0.025). Complications such as hypertension (P=0.017), hyperpigmentation (P=0.026) and urinary incontinence (P=0.017) were more prevalent in the poor prognosis group. In children with CAH, the quality of life is significantly affected by treatment compliance, hormonal control, and the presence of complications.

Patients with diabetes mellitus combined with hypertension and coronary artery disease (DM-HTN-CAD) are prone to QTc interval prolongation and ventricular arrhythmia. Although sodium glucose cotransporter-2 (SGLT2) inhibitors have hypoglycemic and cardioprotective effects, their regulatory effects on relevant indicators in such patients still need to be clarified. This study aimed to analyze the impact of SGLT2 inhibitor on QTc interval and ventricular arrhythmia in patients with DM-HTN-CAD. From January 2023 to January 2025, 150 patients with DM-HTN-CAD were selected in the Hospital. Patients were divided into conventional treatment and SGLT2 inhibitor groups depending on the treatment regimen. The SGLT2 inhibitors group received SGLT2 inhibitor treatment in addition to the conventional treatment group. Compression of the main indicators [including QTc interval, changes in echocardiographic parameters (left and right ventricular diameter, left and right atrial diameter and ejection fraction), blood pressure and glucose indicators] and secondary indicators (including quality of life score, incidence of complications and incidence of adverse reactions) before and after treatment was done among both groups. No differences were observed in the basic characteristics between the two groups (P>0.05). After treatment, all parameters between the two groups illustrated a remarkable discrepancy compared with pre-treatment (P<0.05). In addition, patients in the SGLT2 inhibitors group exhibited lower QTc intervals, left and right atrial diameters, left and right ventricular diameters, systolic blood pressure, diastolic blood pressure and fasting blood glucose levels as compared to the conventional therapy group; The left ventricular ejection fractions, quality of life scores and overall clinical response rates were higher (P<0.05). The complications and adverse reaction incidences were lower in the SGLT2 inhibitors group compared to the conventional treatment group (P<0.05). SGLT2 inhibitors effectively shorten QTc interval, reduce ventricular arrhythmia and cardiovascular risks in DM-HTN-CAD patients and show favorable safety for clinical reference.

The gene msrA is an efflux pump that encodes proteins causing macrolide resistance in different organisms. Macrolide resistance in Staphylococcus aureus is an emerging clinical challenge. The msrA efflux pump gene plays a significant role in mediating this resistance, making its local prevalence clinically relevant. To determine the frequency of the msrA gene among clinically isolated erythromycin-resistant Staphylococcus aureus strains. This was a cross-sectional study carried out at the Department of Microbiology, Dow Diagnostic Research and Reference Laboratory, Karachi, Pakistan from 1st January 2018 to 31st January 2019. The frequency of msrA gene was determined in clinically isolated erythromycin resistant Staphylococcus aureus (S. aureus) strains. The study was reviewed and approved by the Institutional Review Board (IRB) of Dow University of Health Sciences. A total of 40 (n=40) erythromycin resistant S. aureus strains were isolated from the clinical samples and were obtained according to standard procedures. Antibiotic sensitivity was done as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Resistant isolates were stored in Brain Heart Infusion Broth (BHI) and Polymerase Chain Reaction (PCR) were performed to detect the presence of msrA genes. The frequency of msrA was 70% in clinically isolated erythromycin-resistant S. aureus strains. Based on the results, it was concluded that msrA is a significant contributor to the macrolide resistance in locally isolated clinical strains. A major clinical implication of this finding could be the use of efflux pump inhibitors with the macrolides may increase the sensitivity of the bacteria to the drugs, with favorable clinical outcomes.

Psoriasis is one of the chronic inflammatory skin conditions, affecting about 2-3% of the world population. Steroidal treatment are only best choice of treatments, but it is often associated with side effects due to higher lipophilicity. In this work, a nanoparticle-loaded transdermal film was developed to maintain nanoparticle integrity in the skin. Fluticasone propionate loaded chitosan nanoparticles (NPs) were developed, and their particle size, zeta potential, drug loading, entrapment efficiency and scanning electron microscope (SEM) images were determined. The NPs-loaded film was further characterized for appearance, thickness and Fourier Transform Infrared (FTIR) spectra, and an in vitro and in vivo permeation study was conducted. The particle size of FSNPs was found to be 250nm with +32.4 ±1.5 mV zeta potential, great entrapment efficiency and spherical in shape. In vivo dermato-kinetic studies showed long-term, confined drug release from the NP-formulated film in the epidermal layers, compared with the film containing free drug. The study demonstrated that the FSNPs-loaded film showed higher skin permeation, which is effective for managing psoriasis and warrants further evaluation.