AP Treatment Research Articles

Association of antipsychotic drugs on type 2 diabetes mellitus risk in patients with schizophrenia: a population-based cohort and in vitro glucose homeostasis-related gene expression study

BackgroundType 2 diabetes mellitus (T2DM) and its related complications are associated with schizophrenia. However, the relationship between antipsychotic medications (APs) and T2DM risk remains unclear. In this population-based, retrospective cohort study across the country, we investigated schizophrenia and the effect of APs on the risk of T2DM, and glucose homeostasis-related gene expression.MethodsWe used information from the Longitudinal Health Insurance Database of Taiwan for individuals newly diagnosed with schizophrenia (N = 4,606) and a disease-free control cohort (N = 4,606). The differences in rates of development of T2DM between the two cohorts were assessed using a Cox proportional hazards regression model. The effects of APs on the expression of glucose homeostasis-related genes in liver and muscle cell lines were assessed using quantitative real-time PCR.ResultsAfter controlling potential associated confounding factors, the risk of T2DM was higher in the case group than that in the control group [adjusted hazard ratio (aHR), 1.80, p < 0.001]. Moreover, the likelihood of T2DM incidence in patients with schizophrenia without AP treatment (aHR, 2.83) was significantly higher than that in non-schizophrenia controls and those treated with APs (aHR ≤ 0.60). In an in vitro model, most APs did not affect the expression of hepatic gluconeogenesis genes but upregulated those beneficial for glucose homeostasis in muscle cells.ConclusionThis study demonstrates the impact of schizophrenia and APs and the risk of developing T2DM in Asian populations. Unmeasured confounding risk factors for T2DM may not have been included in the study. These findings may help psychiatric practitioners identify patients at risk of developing T2DM.

Design, synthesis, anti-trypsin and anti-inflammatory evaluation of new guanidinobenzoic acid ester derivatives

Herein, we designed a series of guanidinobenzoic acid ester derivatives on the basis of approved AP drugs, such as nafamostat, gabexate and camostat, and evaluated their inhibitory effects on trypsin and anti-inflammatory activity. Among them, five compounds (6a, 6c–6e, 7j) showed excellent inhibitory effects on trypsin with IC50 values of 0.0756 μM to 0.1227 μM, which are more potent than nafamostat and gabexate. Moreover, compounds 6a, 6b and 6c also showed significant inhibitory potency against the pro-inflammatory molecule NO with IC50 values of 1.618 μM, 2.276 μM, and 3.022 μM, respectively. Consequently, the potential lead compounds simultaneously with anti-trypsin and anti-inflammatory activities were identified, which would profit further structural optimization for the treatment of AP.

Engineered Bio‐Heterojunction with Robust ROS‐Scavenging and Anti‐Inflammation for Targeted Acute Pancreatitis Therapy

AbstractAcute pancreatitis (AP) is one of the most severe mortal inflammatory diseases worldwide, which is characterized by the over‐activation of reactive oxygen species (ROS)‐induced inflammation and pancreatic enzymes (PEs). As the PEs induced by ROS exacerbate the progression of AP, therefore, scavenging ROS within PEs is a prerequisite for AP treatment. To address the daunting issue, the engineered bio‐heterojunctions (bio‐HJs) consisting of Mo2C‐Au (MA), phospholipid, and protease inhibitors are devised. First, the decorated phospholipid and protease inhibitors facilitate the delivery of MA to the inflammatory pancreas as well as neutralization of PEs. Next, the MA exhibits outstanding antioxidant and ROS scavenging abilities, primarily benefiting from the increased empty orbitals on Mo attributed to electron transfer between the Mo2C and Au confirmed by theoretical calculation. The in vitro experiments demonstrate that the bio‐HJs exhibit splendid biocompatibility, excellent trypsin neutralization, and efficient ROS elimination properties. More encouragingly, the in vivo studies further reveal that the bio‐HJs prevent the infiltration of inflammatory cells and alleviate the severity of AP by suppressing the ROS‐induced activation of the TLR4‐ERK1/2 MAPK‐MLCK inflammatory signaling pathway. As envisioned, the engineered bio‐HJs represent a promising approach to the treatment and prevention of AP.

Drug-induced pancreatitis: Study of 38 patients

IntroductionAcute pancreatitis (AP) is an inflammatory disease with multiple etiologies, and the emergence of complications. Between 0.1%–5% of cases are attributed to drugs. The absence of specific characteristics complicates the diagnosis and treatment of drug-induced AP. Reviewing patients admitted with the diagnosis of drug-induced AP can provide information and improve its management. Patients and methodsThis is a descriptive, observational, and retrospective study. All patients admitted to the Hospital Universitari de Bellvitge (HUB) between June 2007 and March 2023 with suspected drug-induced AP were included. The data were obtained from the HUB pharmacovigilance program database. ResultsThirty-eight patients with suspected drug-induced AP were identified, representing 0.62% of all adverse drug reactions (ADRs) (n = 6085). Of these, 65.8% (n = 25) had a single suspected drug. The median latency period for the onset of ADRs was 160.5 days (IQR 18–582 days), and the median hospital stay was 5 days (IQR 3–7 days). Fifty-nine suspected drugs were identified, involving 26 active principles. Azathioprine and atorvastatin were the most frequent, with 9 cases each (15.2%), followed by enalapril with 8 cases (13.6%). Drug etiology was assessed in 23 cases (60.5%), and the suspected drug was discontinued in all cases. There was 1 fatal case documented (2.63%). ConclusionThis study can contribute to better understanding of drug-induced pancreatitis episodes. We propose the creation of a diagnostic algorithm that includes the assessment of the drug as a possible cause.

Seasonal and vertical patterns of water availability and variability determine plant reproductive phenology.

Changing precipitation regimes can influence terrestrial plants and ecosystems. However, plant phenological responses to changing precipitation temporal patterns and the underlying mechanisms are largely unclear. This study was conducted to explore the effects of seasonal precipitation redistribution on plant reproductive phenology in a temperate steppe. A field experiment with control (C), advanced (AP) and delayed (DP) growing-season precipitation peaks, and the combination of AP and DP (ADP) were employed. Seven dominant plant species were selected and divided into two functional groups (early- vs. middle-flowering species, shallow- vs. deep-rooted species) to monitor reproductive phenology including budding, flowering, and fruiting date, as well as reproductive duration for four growing seasons from 2015 to 2017, and 2022. The AP, but not DP treatment advanced the phenological (i.e., budding, flowering, and fruiting) dates and lengthened the reproductive duration across the 4 growing seasons and 7 monitored species. In addition, the phenological responses showed divergent patterns among different plant functional groups, which could be attributed to shifts in soil moisture and its variability in different months and soil depths. Moreover, species with lengthened reproductive duration increased phenological overlap with other species, which could have a negative impact on their dominance under the AP treatment. Our findings reveal that changing precipitation seasonality could have considerable impacts on plant phenology by affecting soil water availability and variability. Incorporating these two factors simultaneously in the phenology models will help us understand the response of plant phenology under intensified changing precipitation scenarios. In addition, the observations of decreased dominance for the species with lengthened reproductive duration suggest that changing reproductive phenology can have a potential to affect community composition in grasslands under global change.

Efficacy and safety of time-of-day infusion of pemetrexed plus platinum and paclitaxel plus platinum for patients with advanced non-small cell lung cancer: A retrospective study.

e20557 Background: Retrospective studies suggest that administering chemotherapy infusions in the morning can enhance treatment efficacy and mitigate side effects in non-small cell lung cancer (NSCLC) patients. However, the effectiveness of chronotherapy using pemetrexed plus platinum (AP) and paclitaxel plus platinum (TP) in advanced NSCLC chemotherapy remains unexplored. This study aims to evaluate the impact of AP and TP chrono-chemotherapy (CCT) on treatment response and adverse events in advanced NSCLC patients. Methods: We retrospectively analyzed 78 advanced NSCLC patients treated with AP (AP cohort) and 50 advanced NSCLC patients treated with TP (TP cohort) at Guangdong Second Provincial General Hospital from 2018 to 2021. Based on previous research, we classified patients who received chemotherapy infusions more than twice after 2:00 PM as the afternoon (PM) group, while the rest were categorized as the morning (AM) group. Treatment response was evaluated using the Response Evaluation Criteria in Solid Tumors Criteria V.1.1. The primary endpoint was progression-free survival (PFS). All adverse events were identified and graded according to the National Cancer Institute-Common Terminology Criteria for Adverse Events version 5.0. Results: In the AP cohort, the AM group exhibited a longer PFS compared to the PM group (AM vs. PM, n = 26 vs. n = 52, 43.0 vs. 13.0 months, p = 0.001). However, no significant difference was observed in PFS in the TP cohort (AM vs. PM, n = 23 vs. n = 27, 11.0 vs. 22.0 months, p = 0.501). Subsequent subgroup analysis in the AP cohort favored the AM group across all major subgroups for PFS treatment effect. In contrast, the TP cohort subgroups showed a PFS benefit only in the smoking patients of the PM group. Furthermore, the analysis of adverse reactions revealed similar incidences of any treatment emergent adverse events (TEAE) in both AP and TP cohorts (AM vs. PM, 92.3% vs. 86.5% in AP cohort and 95.7% vs. 100.0% in TP cohort), and grade 3 TEAEs (AM vs. PM, 34.6% vs. 21.2% in AP cohort and 39.1% vs. 29.63% in TP cohort). The most common adverse events were anemia (73.1%), leukopenia (57.7%), and elevated ALT (46.2%) in AP cohort and anemia (100%), leukopenia (65.2%), and hypoalbuminemia (47.8%) in TP cohort. Univariate and multivariate analyses indicated that afternoon infusion of AP chemotherapy (p = 0.009) was an independent prognostic factor for NSCLC. Conclusions: AP treatment administered in the morning may enhance PFS in advanced NSCLC, while TP remains unaffected. This suggests that CCT could potentially enhance the efficacy of individualized chemotherapy in advanced NSCLC.

Investigating the protective effects of Astragalus polysaccharides on cyclophosphamide-induced bone marrow suppression in mice and bone mesenchymal stem cells

BackgroundThis study determines the role and mechanism of APS in cyclophosphamide-induced myelosuppression in mice and bone mesenchymal stem cells (BMSCs) cell model. MethodsCy-induced myelosuppression mice and BMSCs cell model were established. Fifty C57BL/6 mice (weighing 20 ± 2 g) were randomly divided into five groups. Femur and tibia samples, bone marrow samples, and blood samples were collected 3 days after the last injection of Cy. Histopathology changes and cell apoptosis were detected. Cell viability, apoptosis, cycle distribution, reactive oxygen species activity, osteogenesis ability, and protein levels were detected. γ-H2AX and senescence-associated β-galactosidase activity expression was detected by immunofluorescence. Cy-induced senescence and Wnt/β-catenin related protein levels were detected using western blotting. ResultsThe results showed that APS effectively induced Cy-induced histological injury and cell apoptosis rate. After treated with APS, ROS and ALP levels were significantly increased. In BMSCs, cell viability, apoptosis, and cell cycle distribution were also influenced by APS treatment. Compared with the control group, cell viability was significantly increased, the cell apoptosis rate was decreased while the number of cells remained in the G0-G1 phase was increased. Meanwhile, ROS levels were significantly increased in APS group. Cell senescence and Wnt/β-catenin related protein (γ-H2AX, SA-β-gal, p21, p16, p-β-catenin/ β-catenin, c-Myc, and AXIN2) levels were also altered both in vivo and in vitro. Interestingly, the effects of APS were reversed by BML-284. ConclusionOur results indicate that APS protected Cy-induced myelosuppression through the Wnt/β-catenin pathway and APS is a potential therapeutic drug for Cy-induced myelosuppression.

In-vitro biofilm removal from TiUnite® implant surface with an air polishing and two different plasma devices

BackgroundWe investigated the efficacy of two different cold atmospheric pressure jet plasma devices (CAP09 and CAPmed) and an air polishing device with glycine powder (AP) either applied as monotherapies or combined therapies (AP + CAP09; AP + CAPmed), in microbial biofilm removal from discs with anodised titanium surface.MethodsDiscs covered with 7-day-old microbial biofilm were treated either with CAP09, CAPmed, AP, AP + CAP09 or AP + CAPmed and compared with negative and positive controls. Biofilm removal was assessed with flourescence and electron microscopy immediately after treatment and after 5 days of reincubation of the treated discs.ResultsTreatment with CAP09 or CAPmed did not lead to an effective biofilm removal, whereas treatment with AP detached the complete biofilm, which however regrew to baseline magnitude after 5 days of reincubation. Both combination therapies (AP + CAP09 and AP + CAPmed) achieved a complete biofilm removal immediately after cleaning. However, biofilm regrew after 5 days on 50% of the discs treated with the combination therapy.ConclusionAP treatment alone can remove gross biofilm immediately from anodised titanium surfaces. However, it did not impede regrowth after 5 days, because microorganisms were probably hidden in holes and troughs, from which they could regrow, and which were inaccessible to AP. The combination of AP and plasma treatment probably removed or inactivated microorganisms also from these hard to access spots. These results were independent of the choice of plasma device.

Patterns of antipsychotic prescription in inpatient and outpatient psychiatric settings: a real world study

IntroductionAntipsychotic (AP) are increasingly prescribed off-label and used as, but not limited to, anti-aggressive, anti-impulsive, and anti-suicidal medication. The use of second-generation AP (SGAs) has progressively increased compared to first-generation AP (FGAs). FGAs cause more extrapyramidal motor side effects and tardive dyskinesia than SGAs, whereas SGAs generally cause more weight gain and cardiometabolic adverse effects.ObjectivesAim of this observational study was to describe the socio-demographic and clinical features of the patients receiving new AP treatment and the features of the pharmacological treatment itself in “real world” context. Furthermore, we aimed to compare socio-demographic and clinical characteristics of the subjects who were prescribed either FGAs or SGAs.MethodsData were collected on the latest new AP prescriptions issued across different settings (two psychiatric wards; five outpatients clinics; and one rehabilitation community) belonging to ASST Fatebenefratelli Sacco (located in Milan) in reverse chronological order from May 2023. Socio-demographic and clinical variables of the subjects who received new AP treatment were collected through medical records. We compared age, age at onset, age at first pharmacological treatment, duration of illness, duration of untreated illness, treatment duration, number of hospitalization and admissions to Day Hospital services, involuntary commitments and suicidal attempts in patients who received either FGAs or SGAs. Chi-square was used for qualitative variables and t-test for quantitative variables. Data were collected anonymously and analyzed using SPSS v.27.ResultsThe sample included 155 new AP prescriptions, out of which 29.2% were formulated in the psychiatric wards, 66.9% in the outpatient clinics e 3.9% in the rehabilitative community. Mean age of the subjects was 41.1 ± 16.9 years, 53.2% were male.The most represented diagnoses were psychotic disorders (32.2%), personality disorders (24.8%), bipolar disorder (16.1%) and depressive disorder (12.8%).90.7% of new AP prescriptions were SGAs. The most prescribed were aripiprazole (30.5%), quetiapine (21.2%) and olanzapine (15.2%); while the most prescribed FGAs were haloperidol (5.3%), zuclopenthixol (2%) and chlorpromazine (1.3%). 26.2% of the prescriptions were in monotherapy and 83.8% were for oral administration.The reasons for introduction were partial or absent response to previous treatments (52.3%), disease onset (23.5%), non-compliance (8.3%), adverse effects to previous treatments (6.8%) or other (9.1%). Patients treated with FGA had a longer duration of untreated illness (p&lt;0,001) and a greater number of lifetime hospitalizations (p&lt;0,001) and involuntary commitments (p=0,002).ConclusionsPatients treated with SGAs have a shorter duration of untreated illness and also lower chance of lifetime hospitalization and involuntary commitment.Disclosure of InterestNone Declared

Gemination of maxillary incisors in decidous and permanent dentition – a case report

&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Introduction. &amp;lt;/strong&amp;gt;Shape variations of teeth can be present both in perma nent and in deciduous dentition. Gemination, fusion, concrescention, and ,,twin teeth&amp;amp;rdquo; are development anomalies. Aim of this article is to show different cases of simultaneous gemination in deciduous denti tion and supernumerary teeth in permanent dentition in upper incisors region.&amp;lt;/p&amp;gt; &amp;lt;p&amp;gt;&amp;lt;strong&amp;gt; Case report.&amp;lt;/strong&amp;gt; A nine-year-old girl, suffering from juvenile idiopathic arthritis, has been sent to the Dental Clinic of Vojvodina. The clinical examination and OPG (orthopantomography) analysis revealed the presence of supernumerary tooth in the region of tooth 51, and also supernumerary tooth in tooth region 11. There was the presence of a cyst in the region 23, which was corresponding to the follicular cyst. The treatment plan included extraction of tooth 51 and supernumer ary tooth, extraction of tooth 52, and control examination after three months with 3D radiography.&amp;lt;/p&amp;gt; &amp;lt;p&amp;gt;&amp;lt;strong&amp;gt; Conclusion. &amp;lt;/strong&amp;gt;Full cooperation between pediatric dentist, oral surgeon and orthodontics is required. Therapy should be focused on balanc ing the occlusion and gaining best aesthetic results. The significance of highlighting the importance of this case lies in its contribution to expanding our understanding of gemination anomalies in the dental f ield. By presenting a rare occurrence involving gemination of maxillary incisors in both deciduous and permanent dentition, this case report offers valuable insights into the clinical manifestations, diagnostic ap proaches and treatment strategies associated with this condition.&amp;lt;/p&amp;gt;

Aiouea padiformis extract exhibits anti-inflammatory effects by inhibiting the ATPase activity of NLRP3

Inflammation is implicated as a cause in many diseases. Most of the anti-inflammatory agents in use are synthetic and there is an unmet need for natural substance-derived anti-inflammatory agents with minimal side effects. Aiouea padiformis belongs to the Lauraceae family and is primarily found in tropical regions. While some members of the Aiouea genus are known to possess anti-inflammatory properties, the anti-inflammatory properties of Aiouea padiformis extract (AP) have not been investigated. In this study, we aimed to examine the anti-inflammatory function of AP through the NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome and elucidate the underlying mechanisms. Treatment with AP inhibited the secretion of interleukin-1 beta (IL-1β) mediated by NLRP3 inflammasome in J774A.1 and THP-1 cells without affecting the viability. In addition, AP treatment did not influence NF-κB signaling, potassium efflux, or intracellular reactive oxygen species (ROS) production—all of which are associated with NLRP3 inflammasome activation. However, intriguingly, AP treatment significantly reduced the ATPase activity of NLRP3, leading to the inhibition of ASC oligomerization and speck formation. Consistent with cellular experiments, the anti-inflammatory property of AP in vivo was also evaluated using an LPS-induced inflammation model in zebrafish, demonstrating that AP hinders NLRP3 inflammasome activation.

Prospects for the use of ozone therapy and low-intensity laser therapy in the treatment of atrophic pharyngitis

Improving the effectiveness of treatment of patients with atrophic pharyngitis through the use of ozone therapy and low-intensity laser therapy. A single-center experimental controlled randomized open-label study of 90 patients with AP aged 18 and over was conducted. All patients were randomly divided into three groups depending on the treatment performed: group I - traditional treatment method (rinsing the oropharynx with antiseptic solutions, the use of tablets for resorption), group II - treatment with ozone therapy (fine drip irrigation of the mucous membrane of the posterior pharyngeal wall with Ozonide oil), group III - treatment with ozone therapy and laser therapy. During the examination of patients, anamnesis collection, examination of ENT organs, cytological and microbiological examination of the mucous membrane of the posterior pharyngeal wall, contact endoscopy of the mucous membrane of the posterior pharyngeal wall were performed. 5-point visual analogue scales (VAS) were used to assess complaints and pharyngoscopic signs. Our results showed a statistically significant improvement in the quality of life of patients with AP (p=0.012), an improvement in the pharyngoscopic picture (p=0.003). The results obtained by us indicate an improvement in microcirculation under the influence of ozone therapy and low-intensity laser radiation. The technique using ozone therapy and low-intensity laser therapy is characterized by a bactericidal and fungicidal effect. There is a decrease in the total contamination of the posterior wall of the oropharynx with pathogenic and saprophytic microflora (there is a decrease in the contamination of the posterior wall of the pharynx with saprophytic and pathogenic microflora (p≤0.05), the differences are statistically significant). The technique using ozone therapy and low-intensity laser therapy has a pronounced anti-inflammatory effect, which was expressed in a decrease in the severity of dyskeratosis and hyperkeratosis. Thus, the use of ozone therapy in combination with laser therapy opens up new prospects for pathogenetically sound and effective treatment of AP.

Effects of preceding antiplatelet agents on severity of ischemic stroke in patients with a history of stroke

IntroductionAntiplatelet agents are effective for secondary prevention of ischemic stroke and can reduce the severity of first-ever ischemic stroke. However, it is uncertain if prophylactic antiplatelet therapy reduces the severity of recurrent ischemic stroke. The aim of this study was to determine the effect of preceding antiplatelet treatment on the severity of thrombotic stroke (TS) in patients with a prior history of stroke. MethodsFrom a prospective hospital registry of 1338 consecutive patients with acute ischemic stroke, we identified patients with a prior history of stroke who were admitted for cardioembolic stroke (CE); TS including large-artery atherosclerosis, small vessel occlusion, and branch atheromatous disease; or other cause or cryptogenic stroke (OCS). Cases in each subtype were categorized based on preceding medication: antiplatelet agents (AP) and none (N). Severity of stroke (National Institutes of Health Stroke Scale: NIHSS) on admission was compared between AP and N cases. ResultsThe total cohort of 252 patients included 83 with CE, 102 with TS, and 67 with OCS. After excluding those with prior anticoagulants, the median NIHSS on admission was lower in AP cases than in N cases (3 vs. 5, p = 0.002). In multivariate analysis, preceding AP treatment was independently associated with minor stroke (NIHSS ≤4) on admission in CE group (OR 8.48, 95% CI 1.71–62.9, p = 0.008) and TS group (OR 4.24, 95% CI 1.44–13.4, p = 0.009). ConclusionPreceding antiplatelet treatment in patients with a prior history of stroke may reduce the severity of subsequent thrombotic and cardiogenic stroke.

Central insulin dysregulation in antipsychotic-naïve first-episode psychosis: In silico exploration of gene expression signatures

Antipsychotic drug (AP)-naïve first-episode psychosis (FEP) patients display premorbid cognitive dysfunctions and dysglycemia. Brain insulin resistance may link metabolic and cognitive disorders in humans. This suggests that central insulin dysregulation represents a component of the pathophysiology of psychosis spectrum disorders (PSDs). Nonetheless, the links between central insulin dysregulation, dysglycemia, and cognitive deficits in PSDs are poorly understood. We investigated whether AP-naïve FEP patients share overlapping brain gene expression signatures with central insulin perturbation (CIP) in rodent models. We systematically compiled and meta-analyzed peripheral transcriptomic datasets of AP-naïve FEP patients along with hypothalamic and hippocampal datasets of CIP rodent models to identify common transcriptomic signatures. The common signatures were used for pathway analysis and to identify potential drug treatments with discordant (reverse) signatures. AP-naïve FEP and CIP (hypothalamus and hippocampus) shared 111 and 346 common signatures respectively, which were associated with pathways related to inflammation, endoplasmic reticulum stress, and neuroplasticity. Twenty-two potential drug treatments were identified, including antidiabetic agents. The pathobiology of PSDs may include central insulin dysregulation, which contribute to dysglycemia and cognitive dysfunction independently of AP treatment. The identified treatments may be tested in early psychosis patients to determine if dysglycemia and cognitive deficits can be mitigated.

Evidence quality assessment of sodium tanshinone IIA sulfonate injection intervention coronary heart disease angina pectoris: An overview of systematic reviews and meta-analyses.

Sodium tanshinone IIA sulfonate injection (STS) is widely used in the clinical treatment of coronary heart disease angina pectoris (CHDAP). This article systematically summarizes and evaluates the available evidence for STS in the treatment of AP, and assess its quality. Two researchers searched and extracted 8 databases for systematic reviews (SRs)/meta-analyses (MAs), and independently assessed the methodological quality, risk of bias, reporting quality, and quality of evidence of SRs/MAs included in randomized controlled trials (RCTs). Tools used included the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the risk of bias in systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This overview includes 11 SRs/MAs that use quantitative calculations to comprehensively evaluate various efficacies of STS in AP intervention. The methodological quality, reporting quality, risk of bias, and quality of evidence for outcome measures of SRs/MAs were all unsatisfactory. All SRs/MAs are of low quality according to the results of the AMSTAR-2 assessment, and only a small number of SRs/MAs were assessed as low risk of bias based on the results of the ROBIS assessment, and none of the SRs/MAs has been fully reported on the checklist. According to GRADE system, 33 outcomes were extracted from the included SRs/MAs for evaluation, of which 12 were rated as moderate-quality evidence, 7 as low-quality evidence, and 14 as very low-quality evidence. Limitations included the lack of essential items such as protocol registration, screening of duplicate studies, provision of a list of excluded studies and assessment of publication bias. Tanshinone IIA Sulfonate Sodium Injection may be an effective and safe treatment method. However, further standardized, comprehensive SRs/MAs and RCTs are needed to provide evidence-based medical support.

Study on the Mechanism of Dachaihu Decoction in the Treatment of Acute Pancreatitis Based on Artificial Intelligence Combined with in vivo Experiments.

To explore the possible mechanism of Dachaihu Decoction (DCHD) in the treatment of AP, and use in vivo experiments to verify. The targets and active ingredients of DCHD in the treatment of AP were obtained through network pharmacology, and the preliminary verification was carried out by molecular docking. Caerulein was used to develop the AP rat model. H&E staining was performed to observe variations in pancreatic tissue. Western blot and RT-qPCR were conducted to evaluate the associated proteins and mRNA. The network pharmacology and molecular docking results showed that the key targets (EGFR, TNF, SRC, VEGFA and CTNNB1) and key active components (beta-sitosterol, stigmasterol, baicalein, quercetin, and kaempferol) of DCHD in the treatment of AP had good binding. H&E staining revealed that rat pancreatic tissues considerably damaged post caerulein intervention, and it has also been suggested that DCHD ameliorates damage to pancreatic tissue. Simultaneously, EGFR, TNF, SRC, VEGFA protein, and mRNA expression levels were increased in the model group compared to the blank group (P < 0.01), whereas CTNNB1 expression was found to be decreased in the model group (P < 0.01). Compared with the model group, the protein expression levels of EGFR, TNF, SRC, and VEGFA in the treatment group were down-regulated (P < 0.01), and CTNNB1 was up-regulated (P < 0.05). DCHD protects pancreatic tissues and improves symptoms in AP rats by upregulating CTNNB1 protein and mRNA while inhibiting EGFR, TNF, SRC, and VEGFA protein and mRNA expression.

The Combination of β-Glucan and Astragalus Polysaccharide Effectively Resists Nocardia seriolae Infection in Largemouth Bass (Micropterus salmoides).

Effectively treating and preventing outbreaks is crucial for improving the economic benefits of aquaculture. Therefore, utilizing immunostimulants, either alone or in combination, is regarded as a promising strategy. In this study, β-glucan + APS (200 mg/kg + 200 mg/kg), β-glucan (200 mg/kg), APS (200 mg/kg), enrofloxacin (15 mg/kg), and sulfadiazine (15 mg/kg) were added to feed to assess the effects against Nocardia seriolae infection in largemouth bass (Micropterus salmoides) within 14 days. The survival rates did not differ between the enrofloxacin group and the β-glucan + APS group, but both were significantly higher than that of the control group. Additionally, the enrofloxacin group and the β-glucan + APS group exhibited the lowest bacterial loads and tissue damage. Importantly, the β-glucan + APS treatment significantly improved serum enzyme activities (total superoxide dismutase, lysozyme, total protein) and the expression of immune genes (IL-1β, TNF-α, IFN-γ, IgM) compared to the other treatment groups. The enrofloxacin group showed similar efficacy to the β-glucan + APS group in combating N. seriolae infection, but N. seriolae in the enrofloxacin group developed drug resistance. In summary, the combined use of β-glucan and APS is a promising strategy for treating bacterial diseases, thereby contributing to the promotion of sustainable aquaculture development.

Anti-cervical cancer mechanism of bioactive compounds from Alangium platanifolium based on the ‘compound-target-disease’ network

In this study, we analyzed the chemical compositions of Alangium platanifolium (Sieb. et Zucc.) Harms (AP) using ultraperformance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) non-targeted plant metabolomics integration MolNetEnhancer strategy. A total of 75 compounds, including flavonoids, alkaloids, terpenes, C21 steroids, among others, were identified by comparing accurate mass-to-charge ratios, MS2 cleavage fragments, retention times, and MolNetenhancer-integrated analytical data, and the cleavage rules of the characteristic compounds were analyzed. A total of 125 potential cervical cancer (CC) therapeutic targets were obtained through Gene Expression Omnibus (GEO) data mining, differential analysis, and database screening. Hub targets were obtained by constructing protein-protein interaction (PPI) networks and CytoNCA topology analysis, including SRC, STAT3, TP53, PIK3R1, MAPK3, and PIK3CA. According to Gene ontology (GO) analysis, AP was primarily against CC by influencing gland development, oxidative stress processes, serine/threonine kinase, and tyrosine kinase activity. Enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes (KEGG) indicated that the PI3K/AKT and MAPK signaling pathways play a crucial role in AP treatment for CC. The compound-target-pathway (C-T-P) network revealed that quercetin, methylprednisolone, and caudatin may play key roles in the treatment of CC. The results of molecular docking revealed that the core compound could bind significantly to the core target. In this study, the compounds in AP were systematically analyzed qualitatively, and the core components, core targets, and mechanisms of action of AP in the treatment of CC were screened through a combination of network pharmacology tools. Providing a scientific reference for the therapeutic material basis and quality control of AP.

Role of nutrition management in the treatment of acute pancreatitis – comprehensive review

Introduction and purpose&#x0D; The treatment of acute pancreatitis remains a clinically significant problem worldwide, as well as in Poland, where the incidence of the condition is nearly twice as high as in the global population. The aim of this study is to present the latest available guidelines regarding conservative management of patients diagnosed with acute pancreatitis, focusing on nutritional management and treatment methods.&#x0D; &#x0D; Materials and methods:&#x0D; The literature available in PubMed, Scopus, Google Scholar databases, and guidelines from the European Society for Clinical Nutrition and Metabolism (ESPEN) was reviewed using the following keywords: "acute pancreatitis," "AP treatment," "nutritional treatment of acute pancreatitis," "enteral nutrition," "parenteral nutrition."&#x0D; &#x0D; Description of the state of knowledge:&#x0D; The approach to conservative treatment for acute pancreatitis has evolved over the years. Previously, the preferred route of feeding was parenteral with limited lipid content, aimed at reducing the stress on the pancreas. Current guidelines emphasize the superiority of enteral nutrition using a complete nutritional composition.&#x0D; &#x0D; Conclusions:&#x0D; The latest guidelines highlight the advantage of enteral nutrition over parenteral nutrition, with implementation within 48 hours of diagnosis. This approach reduces mortality, the risk of complications, and the duration of hospital stay for patients. The appropriate caloric intake should be adjusted to the individual needs of the patient, considering the severity of the disease and coexisting conditions. Meeting the patient's energy requirements, along with the choice of administration method and precise composition of nutritional formulas, play a crucial role in therapy.

Surface microrelief induced by tillage management alters the pathway and composition of dissolved organic matter exports from soils to runoff during rainfall

Rainfall-runoff process mobilizes considerable dissolved organic matter (DOM) from soils to aquatic systems via surface and sub-surface flow pathways. Microrelief induced by tillage management can alter this flow partitioning and thus likely affect the associated pathway and composition of DOM exports during rainfall. This study conducted rainfall simulation experiments, combined with three-dimensional fluorescence spectra analysis and Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS) technology, to explore the effects of different surface microreliefs treatments on the quantity and composition of DOM exports at a plot scale. Four typical microrelief treatments (i.e., contour tillage (CP), longitudinal tillage (LP), artificial digging tillage (AP), and flat tillage (CK, as control)) were selected. Results showed that ratios of surface to sub-surface flow volume under four treatments were in order of LP (193:1)>CK (73:1)>AP (4.5:1)>CP (0.5:1). DOM concentrations in sub-surface flow (13.37∼33.50 mg L-1) were 7∼18 times of that in surface flow (0.03∼4.56 mg L-1). The total export fluxes of DOM were 134, 139, 563, and 1214 mg m-2 at LP, CK, AP, and CP treatments, respectively, with proportions of 8%, 17%, 82%, and 98% via sub-surface flow. Compared to surface flow, DOM molecular composition in sub-surface flow showed a significant feature of higher oxygen to carbon ratio, higher molecular weight, and lower hydrogen to carbon ratio. The findings indicated that microrelief with higher surface storage capacity tends to favor a large flux of DOM export, primarily via sub-surface flow, which might significantly affect the DOM cycling in the receiving aquatic ecosystems.