Urinary tract infections (UTIs) remain the most frequent clinical diagnosis and Vancomycin-resistant Enterococci (VRE) second-leading cause of UTIs. The aims of this study were to ascertain the patterns and prevalence of UTIs in Sindh and underlying resistance mechanisms for VRE. Bacterial colonies were identified traditionally from a total of 33272 urine samples. Enterococcus species were identified using Facklam and Collins scheme. Antibiotic susceptibility was determined by Kirby-Bauer method and minimum inhibitory concentration (MIC) by E-test. VRE phenotypes were checked using vancomycin and teicoplanin discs. UTIs prevalence during November-2022 to December-2023 is 22%. Reproductive-age women and elders affected most. Predominant Gram-negative pathogens were Escherichia coli (47.6%), Klebsiella spp. (15.7%), Pseudomonas aeruginosa (13.3%) and Morganella morganii (9.3%) while Enterococci were the leading Gram-positive pathogen (46%). E. faecium was the most prevalent (74.8%) followed by E. faecalis and motile Enterococci. VRE were noted 16.3%. All Enterococci were resistant to cefotaxime, ampicillin and co-amoxiclav and susceptible to linezolid. Each E. faecium was VanA phenotype while 20% E. faecalis were VanB phenotype. Vancomycin-resistance has increased by two-fold in Pakistan. The negligent-opportunistic M. morganii has emerged the fourth-leading cause of UTIs. We recommend focusing on VanRS system, a potential target of novel therapeutics for VRE.

Mesenchymal stem cells (MSCs) are applied to clinical practice. Nanometer titanium dioxide (Nano-TiO2) is a type of biological material with great biocompatibility. Herein, we aimed to explore Nano-TiO's effects on differentiation of bone marrow MSCs (BMSCs) after transfection with CXCR4. After transfection of CXCR4 to BMSCs, we cultured BMSCs in medium containing 70 nm and 100 nm Nano-TiO. At the same time, BMSCs without CXCR4 transfection were cultured using 100nm Nano-TiO medium and set as NC group. Then the cytotoxicity was detected by MTT assay, followed by ALP staining. Western blot and RT-qPCR were conducted to determine Runx2 and BGP expression. Application of TiO (70 nm and 100 nm) decreased the viability of BMSCs (P < 0.05) and ALP activity, while ALP activity of 70 nm group was markedly greater than that of 100 nm group. After BMSCs were cultured for 7 d and 14 d, lower expression of Runx2 and BGP was noticed in BMSCs of 100 nm group relative to 70 nm group (P < 0.05), accompanied with lower CXCR4 mRNA expression. In conclusion, Nano-TiO exhibited inhibitory effects on CXCR4-transfected BMSCs in a participle size-dependent manner. Increased size of nanoparticles was associated with decreased viability and greater cytotoxicity.

The predictiveness and diagnostic utility of thyroid antibodies-thyroid-stimulating hormone receptor antibody, anti-thyroglobulin antibody and anti-thyroid peroxidase antibody-were investigated in autoimmune thyroid disease. The charts of 85 patients with Hashimoto's thyroiditis or Graves' disease were retrospectively analyzed with causal inference techniques and machine learning algorithms to estimate adjusted associations and interactions among antibodies. The most robust estimated disease diagnosis association was with anti-thyroid peroxidase antibody (mean treatment effect = 0.731) which also gave the best predictive accuracy (area under the receiver operating characteristic curve = 0.875) especially in the middle-aged and older population. Predictive accuracy was enhanced by using several antibodies (area under the curve = 0.913) whereas, interaction effects were trivial. Thyroid-stimulating hormone receptor antibody positivity was highly predictive of the clinical decision to start Methimazole treatment in Graves' disease. The findings suggest that anti-thyroid peroxidase antibody preference for screening and thyroid antibody profile use in treatment planning can guide clinical decision-making, within the constraints of causal inference assumption employed.

The clinical and microbiological features of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia among intensive care unit (ICU) patients were assessed in this study, as well as the relationship between linezolid treatment and outcomes. Of 282 ICU patients (January 2019-March 2024), 176 survived and 106 passed away. Independent predictors of death were age >60 years, tracheal intubation, central venous catheterization, ≥3 comorbidities and elevated procalcitonin (PCT). Seventy-two sputum representative MRSA isolates were analyzed for resistance determinants (mecA, SCCmec) and prevalent virulence genes (sea, hla,tsst-1,icaA,pvl). Linezolid therapy was associated with improved survival, reduced PCT levels and reduced prevalence of sea, tsst-1 and icaA. pvl co-presence with other virulence genes was related to poor outcomes. Including use of linezolid in predictive models improved discrimination (ROC AUC 0.805) .Transfusion recipients frequently present with independent risk factors associated with mortality in ICU patients diagnosed with MRSA pneumonia. Prognosis for ICU MRSA pneumonia is based on clinical risk factors, virulence gene carriage and transfusion status. Limitations are the retrospective study design and that sputum samples were used, which may result in misclassification.

Older leukemia patients frequently endure cancer-related pain and fatigue, impairing their daily lives and reducing treatment adherence. Pharmacological intervention is a key approach to alleviating these symptoms. This study focuses on the efficacy and safety of analgesic and anti-fatigue drugs in elderly leukemia patients, aiming to optimize drug selection for precision treatment. From January 2022 to June 2024, Taixing People's Hospital enrolled 82 elderly leukemia patients with pain and fatigue, dividing them into a control group (no analgesics) and a celecoxib group. Clinical outcomes: Pain relief, fatigue reduction, depression improvement, quality of life and adverse reactions were compared at 1, 4, and 8 weeks. The celecoxib group showed significant improvements in pain, fatigue, anxiety, and depression, with better scores on the Numeric Rating Scale (NRS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Edmonton Symptom Assessment System-revised (ESAS-r), the Hospital Anxiety and Depression Scale-Anxiety (HADS-A) and the Hospital Anxiety and Depression Scale-Depression (HADS-D) scales at all-time points (P<0.05). Their Quality of Life Questionnaire Core 15 Palliative (QLQ-C15-PAL) scores also indicated enhanced functional and overall quality of life, with lower symptom scores compared to the control group (P<0.05). No serious adverse events occurred, confirming celecoxib's safety.

Endophytic fungi live inside healthy plant tissues and have become common plant partners. These fungi not only help plants grow and produce pigments, enzymes and bioactive compounds, but they can also harm plant tissues and produce toxins. They are found in various parts of plants, such as stem, shoot, root, leaves and bark. Sunflower (Helianthus annuus L.) is a universal host for many species of endophytic fungi, which possess unique medicinal properties. This study aimed to isolate, identify and analyze the biochemical characteristics of endophytic fungi from sunflower. Sunflower (Helianthus annuus L.) plant was collected and chopped into smaller pieces and put on potato dextrose agar (PDA) medium for fungal growth. Fungi were separated, cleaned and maintained in a continuous subculture. After morphological and molecular identification sample was subjected to biochemical profiling by FTIR. Results showed the presence of Rhizopus sp., Cladosporium sp., Penicillium sp. and Aspergillus sp. in sunflower and structural determination by FTIR showed a number of bands and peaks.

This study aimed to explore the effect of a targeted collaborative nursing scheme of antimicrobial agents combined with physical cooling on drug efficacy and patient comfort during the postoperative infection period of orthopedic patients. A total of 150 patients with postoperative infection in the Department of Orthopedics of Zhejiang Provincial Tongde Hospital from January 2023 to January 2024 were selected and randomly divided into a control group (75 cases) and an observation group (75 cases). The control group received conventional antimicrobial treatment and basic nursing care, while the observation group received a collaborative nursing program of antimicrobial treatment combined with physical cooling on the basis of the control group. Compared with the control group, the observation group showed significantly shorter onset time, infection control time and temperature recovery time of antimicrobial drugs (P<0.05); significantly higher General Comfort Questionnaire (GCQ) scores (P<0.05); significantly lower incidence of adverse reactions (P<0.05); and significantly higher blood concentration compliance rate of different antimicrobial drugs (P<0.05). This collaborative nursing can significantly improve the efficacy of antimicrobial drugs, accelerate infection control, enhance patient comfort and reduce the risk of adverse reactions, with important clinical promotion value from a pharmaceutical perspective.

Salvia przewalskii Maxim. is a traditional Chinese herbal medicine which has long been used for the treatment of cardiovascular diseases in China. The current study aimed to investigate the neuroprotective effect of Salvia przewalskii extract of total phenolic acids (SPE) in a rat model of acute spinal cord injury (ASCI). Quantitative analysis of the active constituents in SPE by HPLC showed that rosmarinic acid accounted for 34.32% and salvianolic acid B for 4.27%. The experiment with the ASCI rat model demonstrated that SPE did not have significant adverse effects on body mass on day 1 and 3 after drug administration. In addition, SPE treatment significantly enhanced the BBB scores, improved the inclined plane angles and increased the serum levels of oxidative stress markers SOD and GSH in ASCI rats. Concurrently, it reduced the serum levels of MDA and inflammatory cytokines TNF-α, IL-1β, IL-6, IL-17 and IL-18. SPE also mitigated neuronal damage within the spinal cord tissue by minimizing hemorrhage and preserving neuronal integrity. Mechanistically, SPE ameliorated neuronal damage in the spinal cord by attenuating oxidative stress and inflammatory responses, thereby facilitating the recovery of motor function in ASCI rats.

The current work aims to study the anti-hyperlipidemic effectiveness of the ethanolic extracts from various parts of Ziziphus spina-christi (Sidr) plant; seed (SSF), pulp (SPF) and leaf (SLF) against rosuvastatin (ROF), 10 mg/kg) in rats induced with hyperlipidemia via a (10-week) high-fat diet. Several biochemical, hematological and physiological parameters were determined. The SSF verified greater effectiveness, mainly enhancing liver and kidney functions in particular; it reduced alanine aminotransferase (ALT) levels to 29.16 U/L (vs. 35.89 in SLF and 29.14 in control) and considerably improved kidney functions by reducing urea and creatinine levels to 1.84 mmol/L and 119.83 µmol/L, respectively. Lipid profile with the SSF group was comparable to the rosuvastatin group. Additionally, SSF group ameliorated the hematological alterations and decreased hyperlipidemia-induced organ damage more than the other extracts. In conclusion, the seed extract was the most efficient part, as it established the most positive function biomarkers, such as ALT activity, urea and creatinine, sustaining its potential for more preclinical and clinical developments.

Two microglia phenotypes, M1 pro-inflammatory and M2 anti-inflammatory phenotypes, exert distinct functions post-intracerebral hemorrhage (post-IH). The M1-to-M2 switch is noted within 7 days, but precise timing remains undetermined. This research sought to examine the specific timing of the M1-to-M2 transition and examine the effect of Sheng-Di-Da-Huang Decoction (SDDHD) on M2 microglia post-IH. Rats were grouped into sham, IH and dose-varied SDDHD treatment cohorts. Rats of IH group had an intrastriatum injection of collagenase IV (0.2 U), while those of sham group were only injected with saline. All rats underwent neurological score assessment and magnetic resonance imaging (MRI) scans at different time points after procedure. The expression markers (iNOS for M1; Arg1, IL-4, and IL-10 for M2) were assessed across days. M1 markers (iNOS) peaked at day 3, whereas M2 markers (Arg1, IL-4 and IL-10) rose progressively, suggesting the M1-to-M2 switch around day 3. SDDHD decreased iNOS expression and elevated Arg1, IL-4 and IL-10 expression, improving neurological outcomes. SDDHD exhibits a bidirectional regulation of microglia, promoting M2 transformation while inhibiting M1, thereby enhancing neurological recovery post-IH.

Granulomatous mastitis (GM) is a chronic inflammatory breast disease with a high recurrence rate and low effectiveness of the traditional treatments. This randomized controlled trial compared the effectiveness of the combined use of Xihuang Capsules and low-power High-Intensity Focused Ultrasound (HIFU) and their impact on macrophage infiltration (CD68) and cell proliferation (Ki67). Sixty women with histologically proven GM were randomized to experimental (HIFU + Xihuang) or control (HIFU alone) groups (n=30 each group). Follow-up was for 12 weeks and recurrence at 6 months. Compared with controls, the combination group experienced more lesion reduction (3.50±0.79 cm to 0.92±0.42 cm vs. 3.42±0.88 cm to 1.85±0.60 cm, p<0.001), improved complete resolution (86.7% vs. 60.0%, p = 0.023), earlier resolution (6.2±1.4 vs. 9.1±1.8 weeks, p<0.001) and greater pain reduction (VAS: 7.2±1.1 to 1.3±0.6 vs. 7.0±1.3 to 2.8±0.9, p<0.001). Immunohistochemistry also demonstrated marked reductions in CD68+ macrophages and Ki67 index, both blindly graded. Recurrence at 6 months reduced with combination therapy (6.7% vs. 20.0%, p=0.098). Both treatments were well tolerated. These data indicate that Xihuang Capsules plus low-power HIFU produce faster regression of lesions, disappearance of symptoms and modulation of macrophage infiltration and cell proliferation in GM, with tendency of decreased recurrence.

Using a rat model of neuropathic pain, this study investigated the analgesic mechanism of massage therapy with an emphasis on the lncRNA H19/miR-342-3p/IER3 signaling pathway. Rats were split into control, model, sham, massage and lentiviral intervention groups using a spinal nerve ligation (SNL) paradigm. Molecular tests (qRT-PCR, Western blotting), behavioral evaluations (paw withdrawal thresholds and latencies) and ELISA were carried out. Massage reduced mechanical and thermal hyperalgesia by dramatically upregulating LncRNA H19 and IER3 expression and downregulating miR-342-3p and IL-17 levels. The effects of massage were replicated by intrathecal delivery of agolnc-H19a, thereby confirming H19's role in modulating the miR-342-3p/IER3 axis. By focusing on inflammatory signaling via the lncRNA H19/miR-342-3p/IER3 pathway, these results imply that massage alleviates neuropathic pain, providing new molecular understanding of the therapeutic benefits of massage.

Glomerulonephritis (GN) is a kidney disorder characterized by inflammation of the glomeruli. This study aims to explore the potential therapeutic mechanisms of C. officinalis in the treatment of GN through network pharmacology and molecular docking analysis. The active ingredients of the plant were obtained from the intersections of articles and databases. The GN targets were obtained from the GeneCards database. The STRING database was used to construct a PPI network obtained from the intersection of target and disease. Functional enrichment analysis was performed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) to examine the biological significance of disease and plant active ingredient targets. Quercetin, isorhamnetin and kaempferol were identified as key compounds, while TNF, AKT1 and SRC emerged as central targets in the PPI network. GO and KEGG analyses revealed that C. officinalis may exert its effects through processes on important signaling pathways including PI3K-Akt and EGFR tyrosine kinase inhibitor resistance. Molecular docking results provided important affinities between the main compounds and the core proteins. This study provides a preliminary scientific foundation for future investigations into the molecular mechanisms by which C. officinalis may contribute to the treatment of glomerulonephritis.

This study addresses the crucial problem of antibiotic-resistant Pseudomonas aeruginosa, a major pathogen in severe skin infections that is becoming increasingly resistant to antibiotics worldwide. The research was conducted in Iraq and aimed to isolate and identify P. aeruginosa from wound and burn patients, with a particular focus on identifying isolates that are resistant to ceftazidime. Between January and May 2022, a total of 283 samples were collected from five hospitals, leading to the identification of 117 P. aeruginosa isolates. Notably, 35.04% of these isolates were found to be resistant to ceftazidime. The study's crucial findings include the identification of the most common resistance genes, pel and bla, in the resistant isolates using conventional PCR and real-time PCR. Additionally, the researchers performed a detailed sequence analysis of the pel genes in SE36 isolates that showed a high prevalence of virulence genes. This analysis was conducted using bioinformatics tools. These insights are critical for understanding the resistance patterns of P. aeruginosa in Iraq and developing more effective treatment strategies against this increasingly resistant pathogen.

Polycystic ovary syndrome (PCOS) can lead to increased abortion rates. Quercetin treats PCOS, but its specific mechanism has not been fully clarified. PCOS was induced in mice by dehydroepiandrosterone, and decidualization was induced by corn oil. Mice were treated with quercetin, autophagy inhibitor 3-MA, autophagy inducer rapamycin, PI3K inhibitor LY294002, and PI3K inducer 740Y-P. Pathological damage in the ovary and uterus was observed by HE staining. The levels of sex hormones, metabolism, and inflammatory factors were detected using ELISA. The survival and decidualization of endometrial stromal cells were identified by immunohistochemistry, immunofluorescence, qRT-PCR, and Western blot. Autophagy and the PI3K/Akt/FoxO1 pathway-related protein levels were detected by Western blot. The theca cell layer and endometrium of PCOS mice were significantly thinner. The levels of sex hormone, pro-inflammatory factors, COX-2, integrin ανβ3, and autophagy-related proteins were obviously raised, while Vimentin, IGFBP-1, PRL, and PI3K/Akt/FoxO1 pathway expression were significantly decreased. The above indices were reversed considerably after quercetin treatment. 3-MA could reduce the level of autophagy, LY294002 could reduce the levels of PI3K/Akt/FoxO1 pathway, Vimentin, and PRL, and increase the level of autophagy. In conclusion, quercetin enhanced autophagy through the PI3K/Akt/FoxO1 pathway; thereby protecting endometrial stromal cells and improving decidualization disorders.

This study constructed a chain analysis model linking pharmaceutical attributes, physician preferences, clinical efficacy and pharmacoeconomic outcomes. Using multicenter prospective data, we analyzed the multi-level mechanisms influencing the key pharmaceutical attributes of emergency trauma hemostatics. A total of 1,500 patients from six hospitals in China were included. The pharmacological properties of tranexamic acid, ethamide and hemocoagulase were analyzed and their impact on physician preferences, efficacy and economic outcomes was assessed. Results showed that antifibrinolytic mechanism (weighted 38.2%), onset of action (29.7%) and thrombotic risk (24.1%) were the core attributes influencing physician preferences. Due to its advantageous pharmaceutical attributes, tranexamic acid had the shortest hemostatic time (14.5 ± 3.0 minutes), the lowest 24-hour blood transfusion volume (320 ± 70 ml) and the best cost-effectiveness (328.6 yuan/minute). This study provides evidence-based guidance for the precise selection of hemostatics based on pharmaceutical attributes.

After the occurrence of cerebral hemorrhage (CH), patients generally develop neurological disorders and dysphagia, requiring enteral nutrition support. In this study, the research team explored the impact of predictive management-assisted probiotic low-fat nutritional supplements on CH patients. A total of 114 CH patients admitted to our hospital from August 2022 to June 2024 were selected as the study subjects. They were divided into a control group (n=57) using low-fat nutritional supplements and an experimental group (n=57) using probiotic combined with low-fat nutritional supplements. After treatment, the NIHSS of the experimental group was found to be lower than that of the control group, while the ADL was higher than that of the control group (p<0.05). In addition, glutamate (Glu), aspartic acid (Asp), CD8+ and inflammatory factors were lower in the experimental group than in the control group after treatment, whereas glycine (Gly), gamma-aminobutyric acid (GABA), cluster of differentiation (CD)3+, CD4+, CD4+/CD8+ were higher than in the control group (P< 0.05). In conclusion, probiotic low-fat nutrition combined with predictive management significantly improves neurological function.

Gingivitis, affecting 50%-90% of the population, is characterized by red, swollen gums and bleeding. If untreated, it can progress to periodontitis. Azithromycin, a macrolide antibiotic, has anti-inflammatory properties by inhibiting the NF-κB pathway and reducing the release of inflammatory mediators such as IL-1β and TNF-α. This study investigates the effects of azithromycin-coated implants on gingival tissue healing in patients with gingivitis. Clinical indicators (gingival index, bleeding on probing, probing depth and mucosal redness and swelling) and cellular dynamics (Ki-67 positive cell rate, apoptosis rate and expression levels of Cyclin D1 and CDK4) were evaluated preoperatively and at 1 and 3 months postoperatively. The study found significant improvements in clinical indicators and cellular dynamics in the experimental group compared to the control group, indicating that azithromycin-coated implants effectively reduce inflammation and enhance cell proliferation and tissue healing.

Blood transfusion planning in traumatic brain injury (TBI) is ideal and pharmacotherapy such as tranexamic acid (TXA) may influence transfusion requirement. Within this retrospective, single-center case-control study, 259 TBI patients who were admitted from January 2022 to December 2024 were randomly allocated into training (70%) and validation (30%) datasets. Demographic, clinical, laboratory, surgical and pharmacologic variables-like TXA-were evaluated using univariable and multivariable logistic regression for independent predictors of transfusion. Surgery, tracheal intubation, longer hospital stay, lower hemoglobin and TXA administration were independent predictors of transfusion. The TXA nomogram had high discrimination (AUC 0.94 training; 0.93 validation), good calibration and clinical utility as demonstrated by decision curve analysis. Higher TXA use in transfused patients is likely due to confounding by indication, as patients were more ill and more likely to receive TXA. The inclusion of TXA in predictive models enhances personalized risk prediction of transfusion, but the model remains hypothesis-generating and requires external multicenter verification before being used clinically. This study is supportive of the development of pragmatic, pharmacology-driven tools for early risk stratification and precision transfusion planning in TBI.

To compare synthetic and natural-source pulmonary surfactants (PS) for treating neonatal respiratory distress syndrome (NRDS) in very low-birth-weight neonates. A total of 113 neonates with NRDS were retrospectively divided into the natural-source PS group (NSPS, 63 cases) and the synthetic PS group (SPS, 50 cases). Oxygenation, ventilation, complications, efficacy and mortality were compared. Binary logistic regression analysis was performed using Statistical Package for the Social Sciences (SPSS) 23.0 to analyze the impact of PS type on the treatment of NRDS in very low birth weight neonates (VLBWIs). Additionally, the receiver operating characteristic curve (ROC) and the area under the curve (AUC) were calculated and evaluated to assess the association and closeness between PS type and the treatment of NRDS in VLBWIs. After treatment, NSPS group had higher arterial partial pressure of oxygen (PaO), lower arterial partial pressure of carbon dioxide (PaCO) and oxygenation index (OI). It also had shorter ventilation and hospital stay, lower pneumothorax, total-complication and mortality rates and higher effective rate. PS type correlated with complications and efficacy; the closeness (AUC) order was: clinical efficacy > complications. Natural-source PS in treating NRDS in very low-birth-weight neonates improves efficacy, optimizes blood gas, shortens treatment and reduces complications and mortality.

Description Following a complaint and technical (editorial) investigation, the authors were requested to provide essential documentation to verify the reliability, validity, and ethical compliance of the study published. Despite repeated reminders, the required documentation was not provided. Specifically, the authors did not correspond or supply: • Raw Data: Original anonymized patient-level datasets; laboratory reports or case report forms supporting the statistical analysis. • Statistical Records: Detailed explanation of statistical methods, confirmation of reported p-values, and verification of results presented in Tables 1-5. • Ethics Approval: Copies of institutional ethics approval letters from all recruitment sites, and clarification on trial registration (as study was conducted at multiple sites). • Image Documentation and proof of originality: Original source files of Figures 1 and 2, with confirmation of their originality and linkage to the patient dataset. (Suspected Image plagiarism reported of fig 2. An ABC report: "Eight surgeries and still no cure in sight: How endometriosis is crippling women" (https://www.abc.net.au/news/2018-04-05/endometriosis-sufferers-seek-relief-as-doctors-chase-treatment/9595476). • Clarification of Methodology: Clear description of patient recruitment procedures across multiple hospitals, and additional supporting information for methodological transparency. The absence of these critical materials undermines confidence in the integrity and validity of the published findings. In accordance with the journal's ethical policies and guidance of Committee on Publication Ethics (COPE), this article is retracted to maintain the accuracy and transparency of the scientific record. The retracted article will remain accessible online, but it will be clearly marked as "Retracted" on each page.