Xian Yang Central Hospital

Two compounds, including one new alkaloid, namely, aspergilloid A (1), together with one known compound (2), were isolated from the sponge-derived fungus Aspergillus sp. MF01. The structure of one undescribed compound was elucidated by NMR, HRESIMS, and electronic circular dichroism (ECD) diffraction spectroscopy. All the isolated compounds were evaluated for their antimicrobial activities. Compound 1 showed weak antibacterial activity against Gram-positive bacteria Staphylococcus aureus and Staphylococcus epidermidis at 1 mg/mL.

Acute lung injury (ALI), frequently triggered by sepsis, is characterized by severe respiratory distress and high mortality, particularly in critically ill or elderly individuals. Xuanqing Hefa formula (XQHF) has been clinically applied to alleviate ALI by reducing pulmonary inflammation; however, its underlying mechanisms remain poorly understood. This study aimed to evaluate the therapeutic effects of XQHF on sepsis-induced ALI using both in vitro and in vivo models, and to explore its potential mechanisms of action. Multiple active constituents of XQHF were identified using UPLC-MS/MS. To investigate the therapeutic potential of XQHF against sepsis-induced lung injury, a cecal ligation and puncture (CLP) model was established in mice, while an in vitro pyroptosis model was developed using lipopolysaccharide (LPS) and Nigericin (Nig) stimulation in Immortalized bone marrow-derived macrophages (iBMDMs). The protective effects of XQHF were evaluated through seven-day survival analysis, histopathological examination of lung tissue, pulmonary wet-to-dry weight ratio assessment (W/D), and quantification of total protein in bronchoalveolar lavage fluid (BALF). In addition, inflammatory responses and cellular injury were assessed via ELISA, oxidative stress assays, lactate dehydrogenase (LDH) release, and immunofluorescence staining. The anti-pyroptotic effects of XQHF were further elucidated using western blotting and flow cytometry. The results demonstrated that XQHF significantly preserved lung tissue architecture by attenuating both inflammatory responses and oxidative stress, thereby improving the survival rate of septic mice. At the molecular level, XQHF inhibited the expression of key pyroptosis-related proteins. Similar protective effects were observed in the LPS + Nigericin-induced pyroptosis model in iBMDMs, where XQHF also reduced apoptosis. Confocal microscopy further confirmed that XQHF markedly decreased the expression of pro-inflammatory cytokines, including IL-1β and IL-18. Our results suggest that the therapeutic effects of XQHF may be attributed to the synergistic actions of its multiple active constituents, which collectively suppress the inflammatory cascade and attenuate pyroptosis, thereby alleviating lung injury. Furthermore, both in vivo and in vitro experiments demonstrated that XQHF modulates sepsis-induced acute lung injury, at least in part, through the inhibition of the NLRP3/Caspase-1-dependent pyroptosis signaling pathway.

M1 macrophage exosomes (M1-Exos) have been shown to play a significant role in regulating Lung adenocarcinoma (LUAD) progression. Krüppel-Like Factor 6 (KLF6) is a widely expressed nuclear transcriptional regulator involving in various key cellular processes and functions as a tumor suppressor. Here, this study aimed to investigate the role of KLF6 in LUAD and whether M1-Exos function in LUAD by KLF6.Levels of mRNA and protein were detected using qRT-PCR and western blotting. Exosomes were isolated from M1 macrophages and co-cultured with LUAD cell lines for functional analysis. In vitro analyses were conducted using 5-ethynyl-2'-deoxyuridine assay, flow cytometry and transwell assay. The N6-methyladenosine (m6A) modification profile was analyzed using the methylated RNA immunoprecipitation assay and the interaction was determined by RNA Immunoprecipitation assay. The murine model was established for in vivo analysis.M1 macrophage exosomes suppressed LUAD cell proliferation, migration and invasion. Further analyses showed that KLF6 was packaged in M1 macrophage exosomes and could be transferred into LUAD cells. Functionally, the incubation of KLF6-decreased M1 macrophage exosomes led to the enhancement of LUAD cell proliferation, migration and invasion. Mechanistically, alkylation repair homolog protein 5 (ALKBH5), an RNA m6A demethylase, could reduce KLF6 m6A modification and then broke the stabilization of KLF6and decreased its expression in M1 macrophages and LUAD cells. Importantly, ALKBH5 reversed the anticancer effects of M1-Exo on LUAD cells. Moreover, the inhibition of LUAD tumor growth in vivo mediated by M1-Exo was also impeded by ALKBH5.In conclusion,M1 macrophage exosomes inhibited LUAD growth by reducing ALKBH5-mediated KLF6 demethylation.

This study aimed to investigate the distribution of pathogens, the usage of antimicrobial agents, and the sensitivity analysis of antimicrobial agents in patients with urinary tract infections (UTIs) in a certain hospital from 2021 to 2023, so as to provide clinical evidence for the selection of antimicrobial agents in clinical patients with UTIs. A retrospective review was conducted on medical records of patients diagnosed with UTI during 2021-2023. Demographic characteristics (gender, age), urine sample data, pathogen distribution, and antimicrobial prescription patterns were collected. Midstream urine specimens submitted to the microbiology laboratory were processed for bacterial culture, identification, and antibiotic susceptibility testing. Differences in resistance rates to various antimicrobials were compared among pathogens from different clinical categories. From 2021 to 2023, 623 cases of positive urine culture samples were detected. Gram-negative organisms predominated (489 isolates), particularly Escherichia coli (E. coli, 61.80%, 385 isolates). Gram-positive isolates were mainly Enterococcus faecalis (6.10%, 38 isolates) and Enterococcus faecium (E. faecalis, 4.01%, 25 isolates). Gender distribution revealed that E. coli was more frequent in females (69.87%), while other principal pathogens were more common in males. Age analysis showed higher prevalence in females at young and middle age, whereas elderly males predominated (68.60%). Susceptibility testing indicated marked interspecies differences: E. coli showed 81.56% resistance to ampicillin; Proteus mirabilis exhibited 72.73% resistance to levofloxacin; E. faecalis demonstrated 94.74% resistance to tetracycline. Conversely, cefotaxime/clavulanic acid and vancomycin retained good activity against most isolates. From 2021 to 2023, E. coli was the leading UTI pathogen. There were significant differences in the susceptibility of various pathogens to antimicrobial agents. It is necessary to regularly monitor the distribution of pathogens causing UTIs and their sensitivity to antimicrobial agents to provide a scientific reference for the rational use of antimicrobial agents during treatment.

Abstract Aim To develop and evaluate a questionnaire to measure the factors influencing the knowledge, attitudes and practices (KAP) of ICU nurses regarding protocolized weaning from invasive mechanical ventilation (IMV). Methods From July to October in 2023, an online survey was conducted among ICU nurses from 30 top-level hospitals in China. The questionnaire’s items were generated through relevant literature reviews, group discussion, Delphi expert consultation and small sample pre-test. The validity and reliability of the questionnaire were assessed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA). Results The questionnaire developed in this study consists of three dimensions: knowledge, attitude, and practice. The knowledge dimension contains 13 items, the attitude dimension has 15 items, and the practice dimension has 11 items. The Cronbach's α coefficient, split-half reliability coefficient, and test-retest reliability coefficient of each of the three dimensions are all greater than 0.7, indicating good internal consistency and stability. The CFA shows that the model fitting results are acceptable. Conclusion The questionnaire developed in this study can be used as an effective tool to investigate the knowledge, attitude and practice of adult intensive care unit nurses regarding the protocolized weaning process. Implications for Profession and/or Patient Care: A better understanding of the influencing factors of nurses' knowledge, attitude and practice regarding protocolized weaning can lay the foundation for formulating targeted intervention measures and provide a reference for optimizing the medical and nursing collaboration strategies for weaning. Impact: The questionnaire developed in this study has good reliability and validity, which was used to measure the factors influencing ICU nurses' knowledge, attitude and practice regarding the protocolized weaning process. By using this questionnaire for investigation, relevant intervention measures can formulate. This could optimize the collaboration strategy between doctors and nurses, promote the implementation of nurse-led protocolized weaning, and reduce the duration of mechanical ventilation for patients. Reporting Method : We followed the STROBE checklist in reporting this study. Patient or Public Contribution: No patient or public contribution.

Abstract Purpose: To investigate the impact of obstructive sleep apnea (OSA) on depression inacute ischemic stroke (AIS) patients within 14 days post-stroke, and to develop and validate a nomogram for predicting early post-stroke depression (PSD) risk. Methods: This retrospective cohort study enrolled AIS patients admitted to Hefei Second People's Hospital. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9; cutoff ≥5). Demographic, clinical vascular risk factors, insomnia, uric acid（UA）, and apnea-hypopnea index（AHI）were collected. Multivariable logistic regression identified independent predictors of early PSD. A nomogram incorporating significant predictors was developed and internally validated using bootstrap resampling (1,000 repetitions). Model performance was evaluated by C-statistic and calibration curves. Clinical utility was assessed via decision curve analysis. Results: Among 138 AIS patients (median AHI: 18.15 events/h [IQR:11.70–28.82]), moderate-to-severe OSA (AHI≥15) prevalence was 60.1% (83/138), and early PSD incidence was 50.7% (70/138). Regression analysis revealed: 1. Continuous AHI model: Insomnia (OR=6.507, 95% CI:2.931–14.447; P<0.001), uric acid（UA）(OR=1.006, 95% CI:1.001–1.011; P=0.027), and AHI (OR=1.039, 95% CI:1.007–1.072; P=0.016) independently predicted PSD. 2. Categorical AHI model: Moderate-to-severe OSA (OR=2.248, 95% CI:1.006–5.023; P=0.048), insomnia (OR=5.825, 95% CI:2.672–12.702; P<0.001), and uric acid (OR=1.006, 95% CI:1.001–1.011; P=0.013) were significant predictors. The nomogram demonstrated good discrimination (C-statistic=0.784, 95% CI:0.704–0.863) and calibration. Decision curve analysis confirmed clinical utility across threshold probabilities. Conclusion: Insomnia, UA, and AHI are independent risk factors for early depression in AIS patients, while moderate to severe OSA further increases this risk. The nomogram constructed based on the above factors shows good predictive efficacy for early depression in AIS patients.

Long-chain polyunsaturated fatty acids (LC-PUFAs) are vital for brain health, with cis9, trans11-conjugated linoleic acid (c9, t11-CLA) showing neuroprotective effects. This study investigated the impact of c9, t11-CLA on offspring cognitive development in an ω-3 PUFA deficiency model. c9, t11-CLA supplementation during gestation and lactation improved episodic-like memory and learning ability, as evidenced by a 63% increase in novel object recognition time and reduced Morris water maze latency. c9, t11-CLA altered brain lipid profiles and promoted myelination in the prefrontal cortex of pubescent offspring mice by upregulating the protein levels of myelin-associated glycoprotein (MAG) and platelet-derived growth factor receptor alpha (PDGFRα). In addition, although proteomic KEGG analysis and western blotting verified that c9, t11-CLA supplementation appears to modulate the PTEN/AKT signaling pathway in the hippocampus, its relationship with synaptic plasticity remains speculative. Western blot validation further revealed that c9, t11-CLA supplementation enhanced α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) activation and trafficking through increased phosphorylation of Ca/calmodulin-dependent protein kinase II alpha (CaMKIIα) at Thr286, ultimately strengthening synaptic plasticity as evidenced by significant upregulation of postsynaptic density protein 95 (PSD95), p-CaMKIIα/CaMKIIα, and glutamate ionotropic receptor AMPA type subunit 1 (GluA1). These findings highlight the potential of c9, t11-CLA as a nutritional intervention for neurodevelopment and provide preliminary insights into the mechanisms by which c9, t11-CLA supplementation may regulate cognitive function.