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OBJECTIVE: In acupuncture therapy, the accurate location of acupoints is essential for its effectiveness. The advanced language understanding capabilities of large language models (LLMs) like Generative Pre-trained Transformers (GPTs) and Llama present a significant opportunity for extracting relations related to acupoint locations from textual knowledge sources. This study aims to explore the performance of LLMs in extracting acupoint-related location relations and assess the impact of fine-tuning on GPT's performance. MATERIALS AND METHODS: We utilized the World Health Organization Standard Acupuncture Point Locations in the Western Pacific Region (WHO Standard) as our corpus, which consists of descriptions of 361 acupoints. Five types of relations ("direction_of", "distance_of", "part_of", "near_acupoint", and "located_near") (n = 3174) between acupoints were annotated. Four models were compared: pre-trained GPT-3.5, fine-tuned GPT-3.5, pre-trained GPT-4, as well as pretrained Llama 3. Performance metrics included micro-average exact match precision, recall, and F1 scores. RESULTS: Our results demonstrate that fine-tuned GPT-3.5 consistently outperformed other models in F1 scores across all relation types. Overall, it achieved the highest micro-average F1 score of 0.92. DISCUSSION: The superior performance of the fine-tuned GPT-3.5 model, as shown by its F1 scores, underscores the importance of domain-specific fine-tuning in enhancing relation extraction capabilities for acupuncture-related tasks. In light of the findings from this study, it offers valuable insights into leveraging LLMs for developing clinical decision support and creating educational modules in acupuncture. CONCLUSION: This study underscores the effectiveness of LLMs like GPT and Llama in extracting relations related to acupoint locations, with implications for accurately modeling acupuncture knowledge and promoting standard implementation in acupuncture training and practice. The findings also contribute to advancing informatics applications in traditional and complementary medicine, showcasing the potential of LLMs in natural language processing.
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Pontos de Acupuntura , Processamento de Linguagem Natural , Humanos , Terapia por Acupuntura/métodosRESUMO
PURPOSE: The RECIST guidelines provide a standardized approach for evaluating the response of cancer to treatment, allowing for consistent comparison of treatment efficacy across different therapies and patients. However, collecting such information from electronic health records manually can be extremely labor-intensive and time-consuming because of the complexity and volume of clinical notes. The aim of this study is to apply natural language processing (NLP) techniques to automate this process, minimizing manual data collection efforts, and improving the consistency and reliability of the results. METHODS: We proposed a complex, hybrid NLP system that automates the process of extracting, linking, and summarizing anticancer therapy and associated RECIST-like responses from narrative clinical text. The system consists of multiple machine learning-/deep learning-based and rule-based modules for diverse NLP tasks such as named entity recognition, assertion classification, relation extraction, and text normalization, to address different challenges associated with anticancer therapy and response information extraction. We then evaluated the system performances on two independent test sets from different institutions to demonstrate its effectiveness and generalizability. RESULTS: The system used domain-specific language models, BioBERT and BioClinicalBERT, for high-performance therapy mentions identification and RECIST responses extraction and categorization. The best-performing model achieved a 0.66 score in linking therapy and RECIST response mentions, with end-to-end performance peaking at 0.74 after relation normalization, indicating substantial efficacy with room for improvement. CONCLUSION: We developed, implemented, and tested an information extraction system from clinical notes for cancer treatment and efficacy assessment information. We expect this system will support future cancer research, particularly oncologic studies that focus on efficiently assessing the effectiveness and reliability of cancer therapeutics.
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Registros Eletrônicos de Saúde , Processamento de Linguagem Natural , Neoplasias , Critérios de Avaliação de Resposta em Tumores Sólidos , Humanos , Neoplasias/terapia , Aprendizado de Máquina , Mineração de Dados/métodos , Algoritmos , Aprendizado ProfundoRESUMO
Acute myeloid leukemia (AML) is a heterogeneous hematological malignancy with historically high mortality rates. The treatment strategies for AML is still internationally based on anthracyclines and cytarabine, which remained unchanged for decades. With the rapid advance on sequencing technology, molecular targets of leukemogenesis and disease progression related to epigenetics are constantly being discovered, which are important for the prognosis and treatment of AML. Traditional Chinese medicine (TCM) is characterized by novel pharmacological mechanisms, low toxicity and limited side effects. Several biologically active ingredients of TCM are effective against AML. This review focuses on bioactive compounds in TCM targeting epigenetic mechanisms to address the complexities and heterogeneity of AML.
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Background: Chronic Obstructive Pulmonary Disease (COPD) progression in the elderly is notably influenced by nutritional, immune, and inflammatory status. This study aimed to investigate the impact of adequate energy supply on these indicators in COPD patients. Methods: COPD patients meeting specific criteria were recruited and categorized into energy-adequate and energy-deficient groups based on their energy supply. Comparable demographic factors such as age, gender, smoking and drinking history, COPD duration, inhaled drug classification, and home oxygen therapy application were observed. Notable differences were found in BMI and inhaled drug use between the two groups. Results: The energy-adequate group exhibited significant improvements in various health indicators, including lymphocyte count, hemoglobin, CRP, total cholesterol, prealbumin, albumin, PNI, SII, SIRI, CAR, and CONUT scores in the secondary auxiliary examination. These positive changes suggest a notable enhancement in nutritional, immune, and inflammatory status. Conclusion: This research highlights the substantial benefits of adequate energy supply in elderly COPD patients. The observed improvements in nutritional, immune, and inflammatory markers underscore the importance of addressing energy needs to positively influence disease-related outcomes in this population. These findings have implications for developing targeted interventions to optimize the well-being of elderly individuals with COPD.
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Mediadores da Inflamação , Inflamação , Estado Nutricional , Doença Pulmonar Obstrutiva Crônica , Humanos , Doença Pulmonar Obstrutiva Crônica/imunologia , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/terapia , Doença Pulmonar Obstrutiva Crônica/sangue , Masculino , Feminino , Idoso , Mediadores da Inflamação/sangue , Mediadores da Inflamação/metabolismo , Inflamação/imunologia , Inflamação/sangue , Biomarcadores/sangue , Metabolismo Energético , Ingestão de Energia , Fatores Etários , Pulmão/fisiopatologia , Pulmão/imunologia , Idoso de 80 Anos ou mais , Pessoa de Meia-IdadeRESUMO
Asthma is a chronic and heterogeneous disease affecting the lungs and respiratory tract. In particular, the neutrophil subtype of asthma was described as persistent, more severe, and corticosteroid-resistant. Growing evidence suggested that nontypeable Haemophilus influenzae (NTHi) infection contributes to the development of neutrophilic asthma, exacerbating clinical symptoms and increasing the associated medical burden. In this work, arginine-grafted chitosan (CS-Arg) was ionically cross-linked with tris(2-carboxyethyl) phosphine (TCEP), and a highly-efficient antimicrobial agent, poly-ε-L-Lysine (ε-PLL), was incorporated to prepare ε-PLL/CS-Arg/TCEP (ECAT) composite nanogels. The results showed that ECAT nanogels exhibited highly effective inhibition against the proliferation of NTHi, Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli). In addition, ECAT nanogels could effectively inhibit the formation of mucins aggregates in vitro, suggesting that the nanogel might have the potential to destroy mucin in respiratory disease. Furthermore, in the ovalbumin (OVA)/NTHi-induced Balb/c mice model of neutrophilic asthma, the number of neutrophils in the alveolar lavage fluid and the percentage of inflammatory cells in the blood were effectively reduced by exposure to tower nebulized administration of ECAT nanogels, and reversing airway hyperresponsiveness (AHR) and reducing inflammation in neutrophilic asthma mice. In conclusion, the construction of ECAT nanogels was a feasible anti-infective and anti-inflammatory therapeutic strategy, which demonstrated strong potential in the clinical treatment of neutrophilic asthma.
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Antibacterianos , Asma , Quitosana , Escherichia coli , Camundongos Endogâmicos BALB C , Neutrófilos , Staphylococcus aureus , Animais , Staphylococcus aureus/efeitos dos fármacos , Asma/tratamento farmacológico , Antibacterianos/administração & dosagem , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Neutrófilos/efeitos dos fármacos , Quitosana/administração & dosagem , Quitosana/química , Escherichia coli/efeitos dos fármacos , Feminino , Haemophilus influenzae/efeitos dos fármacos , Nanogéis/química , Ovalbumina/administração & dosagem , Mucinas , Polilisina/química , Polilisina/administração & dosagem , Infecções por Haemophilus/tratamento farmacológico , Camundongos , Polietilenoimina/química , Polietilenoimina/administração & dosagem , GéisRESUMO
We have previously shown that excessive activation of macrophage proinflammatory activity plays a key role in TCE-induced immune liver injury, but the mechanism of polarization is unclear. Recent studies have shown that TLR9 activation plays an important regulatory role in macrophage polarization. In the present study, we demonstrated that elevated levels of oxidative stress in hepatocytes mediate the release of mtDNA into the bloodstream, leading to the activation of TLR9 in macrophages to regulate macrophage polarization. In vivo experiments revealed that pretreatment with SS-31, a mitochondria-targeting antioxidant peptide, reduced the level of oxidative stress in hepatocytes, leading to a decrease in mtDNA release. Importantly, SS-31 pretreatment inhibited TLR9 activation in macrophages, suggesting that hepatocyte mtDNA may activate TLR9 in macrophages. Further studies revealed that pharmacological inhibition of TLR9 by ODN2088 partially blocked macrophage activation, suggesting that the level of macrophage activation is dependent on TLR9 activation. In vitro experiments involving the extraction of mtDNA from TCE-sensitized mice treated with RAW264.7 cells further confirmed that hepatocyte mtDNA can activate TLR9 in mouse peritoneal macrophages, leading to macrophage polarization. In summary, our study comprehensively confirmed that TLR9 activation in macrophages is dependent on mtDNA released by elevated levels of oxidative stress in hepatocytes and that TLR9 activation in macrophages plays a key role in regulating macrophage polarization. These findings reveal the mechanism of macrophage activation in TCE-induced immune liver injury and provide new perspectives and therapeutic targets for the treatment of OMDT-induced immune liver injury.
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DNA Mitocondrial , Hepatócitos , Estresse Oxidativo , Receptor Toll-Like 9 , Tricloroetileno , Animais , Camundongos , Hepatócitos/efeitos dos fármacos , Tricloroetileno/toxicidade , Receptor Toll-Like 9/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Células RAW 264.7 , Doença Hepática Induzida por Substâncias e Drogas , Ativação de Macrófagos/efeitos dos fármacos , Masculino , Camundongos Endogâmicos C57BLRESUMO
This bioequivalence study was conducted to evaluate two oral formulations of cotrimoxazole tablets in healthy Chinese subjects. All 26 subjects recruited to this study were randomly and evenly classified into two groups and received a single dose (sulfamethoxazole: 400 mg and trimethoprim: 80 mg) of test cotrimoxazole tablets (generic drug) or reference cotrimoxazole tablets (branded drug). After a 7-day washout period, these subjects received one dose of reference drug or test drug. Blood samples were collected from participants before and up to 48 h after dosing to assess the concentration of sulfamethoxazole (SMX) and trimethoprim (TMP) in plasma and a plasma concentration-time curve was drawn. Then, the pharmacokinetics parameters were calculated accordingly. Our data revealed that there were no significant differences observed in the maximum plasma concentration (Cmax), area under the curve from time 0 to the last measurable concentration (AUC0-t), and area under the curve from time 0 to infinity (AUC0-∞) between the two formulations. For SMX, the 90% confidence intervals (CI) of the geometric mean ratio for Cmax, AUC0-t, and AUC0-∞ were 104.03-113.92%, 100.46-103.70%, and 100.41-103.81%, respectively. Similarly, for Trimethoprim (TMP), the 90% CI ranged from 98.54 to 106.95% for Cmax, from 99.31 to 107.68% for AUC0-t, and from 99.49 to 107.55% for AUC0-∞. Importantly, all these 90% CI values fell within the range of 80.00-125.00%, indicating that the test drug is bioequivalent to the reference drug. Furthermore, throughout the entire trial, no suspected serious adverse events were reported, indicating the safety profile of the newly developed generic cotrimoxazole. In summary, our study demonstrates that the newly developed generic formulation of cotrimoxazole is bioequivalent to the branded formulation under fasting conditions.
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Jejum , Combinação Trimetoprima e Sulfametoxazol , Humanos , Área Sob a Curva , China , Estudos Cross-Over , Voluntários Saudáveis , Comprimidos , Equivalência TerapêuticaRESUMO
Alpha-tellurene (α-Te), a two-dimensional (2D) material that has been theoretically predicted and experimentally verified, has garnered significant attention due to its unique properties. In this study, we investigated the 2D trilayer MoS2/α-Te/WS2 van der Waals heterostructure with different stacking orders using first-principles calculations. Our results indicate that this heterotrilayer exhibits an intrinsic type-I band alignment and an indirect band gap similar to that of monolayer α-Te. Notably, the band edges of the heterostructure can be modulated by biaxial strain and an external electric field, enabling these edges to arise from different monolayers. This controlled manipulation facilitates the effective separation of photogenerated electron-hole pairs and prolongs the carrier lifetime. Moreover, the heterostructure can undergo a transition from an indirect to a direct band gap under biaxial compressive strain or a moderate negative electric field, and semiconductor-to-metal transition can also be achieved by intensifying the biaxial strain and external electric field. Overall, our research provides valuable theoretical insights into the potential applications of α-Te-based heterostructures, rendering them promising candidates for the next generation of nanodevices.
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IMPORTANCE: The study highlights the potential of large language models, specifically GPT-3.5 and GPT-4, in processing complex clinical data and extracting meaningful information with minimal training data. By developing and refining prompt-based strategies, we can significantly enhance the models' performance, making them viable tools for clinical NER tasks and possibly reducing the reliance on extensive annotated datasets. OBJECTIVES: This study quantifies the capabilities of GPT-3.5 and GPT-4 for clinical named entity recognition (NER) tasks and proposes task-specific prompts to improve their performance. MATERIALS AND METHODS: We evaluated these models on 2 clinical NER tasks: (1) to extract medical problems, treatments, and tests from clinical notes in the MTSamples corpus, following the 2010 i2b2 concept extraction shared task, and (2) to identify nervous system disorder-related adverse events from safety reports in the vaccine adverse event reporting system (VAERS). To improve the GPT models' performance, we developed a clinical task-specific prompt framework that includes (1) baseline prompts with task description and format specification, (2) annotation guideline-based prompts, (3) error analysis-based instructions, and (4) annotated samples for few-shot learning. We assessed each prompt's effectiveness and compared the models to BioClinicalBERT. RESULTS: Using baseline prompts, GPT-3.5 and GPT-4 achieved relaxed F1 scores of 0.634, 0.804 for MTSamples and 0.301, 0.593 for VAERS. Additional prompt components consistently improved model performance. When all 4 components were used, GPT-3.5 and GPT-4 achieved relaxed F1 socres of 0.794, 0.861 for MTSamples and 0.676, 0.736 for VAERS, demonstrating the effectiveness of our prompt framework. Although these results trail BioClinicalBERT (F1 of 0.901 for the MTSamples dataset and 0.802 for the VAERS), it is very promising considering few training samples are needed. DISCUSSION: The study's findings suggest a promising direction in leveraging LLMs for clinical NER tasks. However, while the performance of GPT models improved with task-specific prompts, there's a need for further development and refinement. LLMs like GPT-4 show potential in achieving close performance to state-of-the-art models like BioClinicalBERT, but they still require careful prompt engineering and understanding of task-specific knowledge. The study also underscores the importance of evaluation schemas that accurately reflect the capabilities and performance of LLMs in clinical settings. CONCLUSION: While direct application of GPT models to clinical NER tasks falls short of optimal performance, our task-specific prompt framework, incorporating medical knowledge and training samples, significantly enhances GPT models' feasibility for potential clinical applications.
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Registros Eletrônicos de Saúde , Processamento de Linguagem Natural , Humanos , Mineração de Dados/métodosRESUMO
Purpose: Inhaled corticosteroids, including budesonide (BUD), are widely employed for the treatment of asthma. However, the frequent use of corticosteroids is associated with numerous adverse effects and poses challenges to ongoing drug therapy and patient adherence. Budesonide liposomal nanoparticles (BUD-LNPs) were developed to improve the bioavailability of the drug and thereby improve the effectiveness of asthma treatment. Methods: BUD-LNPs were prepared via thin-film hydration, and the characterizations, stability, and in vitro release of BUD-LNPs were studied. In vitro cellular uptake was observed by laser-scanning confocal microscope (LSCM) and flow cytometry. And the in vitro anti-inflammatory activity of BUD-LNPs was evaluated by measuring the expression of pro-inflammatory cytokines in activated macrophages. Besides, the accumulation time in the lung of drugs delivered via liposomal carriers and free drugs was compared in vivo. And the in vivo therapeutic efficacy of BUD-LNPs was assessed in OVA-induced asthmatic mice. Finally, in vivo biosafety assessment was performed. Results: The particle size, PDI, and zeta potential of BUD-LNPs were 127.63±1.33 nm, 0.27±0.02, and 3.33±0.13 mV, respectively. BUD-LNPs exhibited excellent biosafety and anti-inflammatory activity in vitro. Furthermore, compared with the free drugs, the utilization of liposomal nano-vehicles for drugs delivery could effectively extend the duration of drugs accumulation in the pulmonary system. Additionally, treatment with BUD-LNPs alleviated airway hyperresponsiveness, reduced airway mucus secretion, and mitigated pulmonary inflammation in OVA-induced asthmatic mice. And the BUD-LNPs demonstrated superior therapeutic efficacy compared to free BUD. Conclusion: BUD-LNPs was successfully prepared with excellent stability and sustained release for 24 h in vitro. The data of anti-inflammatory activity, asthma therapeutic effects and safety studies indicated that drug delivery mediated by liposomal nano-vehicles was a feasible and desirable strategy for medical strategy and showed great promise in the clinical therapy of asthma.
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Asma , Budesonida , Camundongos , Humanos , Animais , Budesonida/farmacologia , Ovalbumina/farmacologia , Asma/induzido quimicamente , Asma/tratamento farmacológico , Pulmão , Anti-Inflamatórios/farmacologia , Corticosteroides/metabolismo , Corticosteroides/farmacologia , Corticosteroides/uso terapêutico , Lipossomos/farmacologiaRESUMO
OBJECTIVES: COVID-19, since its emergence in December 2019, has globally impacted research. Over 360 000 COVID-19-related manuscripts have been published on PubMed and preprint servers like medRxiv and bioRxiv, with preprints comprising about 15% of all manuscripts. Yet, the role and impact of preprints on COVID-19 research and evidence synthesis remain uncertain. MATERIALS AND METHODS: We propose a novel data-driven method for assigning weights to individual preprints in systematic reviews and meta-analyses. This weight termed the "confidence score" is obtained using the survival cure model, also known as the survival mixture model, which takes into account the time elapsed between posting and publication of a preprint, as well as metadata such as the number of first 2-week citations, sample size, and study type. RESULTS: Using 146 preprints on COVID-19 therapeutics posted from the beginning of the pandemic through April 30, 2021, we validated the confidence scores, showing an area under the curve of 0.95 (95% CI, 0.92-0.98). Through a use case on the effectiveness of hydroxychloroquine, we demonstrated how these scores can be incorporated practically into meta-analyses to properly weigh preprints. DISCUSSION: It is important to note that our method does not aim to replace existing measures of study quality but rather serves as a supplementary measure that overcomes some limitations of current approaches. CONCLUSION: Our proposed confidence score has the potential to improve systematic reviews of evidence related to COVID-19 and other clinical conditions by providing a data-driven approach to including unpublished manuscripts.
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COVID-19 , Humanos , Revisões Sistemáticas como Assunto , Projetos de Pesquisa , PubMed , PandemiasRESUMO
Magnetized edge states of nanoribbon systems open a new path for designing functional spintronic devices. Here, we introduce a general mechanism for electrically generating nonzero net magnetization in antiferromagnetic (AFM) semiconducting nanoribbons. In the proposed spin configuration, in which the empty and occupied edge states of one side close to the Fermi energy are in the same spin channel, the Zeeman-type spin splitting between the states of opposite edges arising from the electric field allow the system to be tuned from the AFM semiconducting phase to the ferromagnetic (FM) metallic phase, yielding nonzero net magnetization. Our ab initio calculations show that this strategy is realizable in the example of the FePSe3 nanoribbon, in which self-passivation-driven reconstruction at the Se termination edge gives rise to the key spin configuration. Moreover, we demonstrate that an electric field could trigger a series of electronic phase transitions among AFM semiconductor, AFM half-metal, and FM metal phases, based on which we were able to design an electronically controllable versatile spintronics device.
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Cells are the smallest units that make up living organisms, which constantly undergo the processes of proliferation, differentiation, senescence and death. Dead cells need to be removed in time to maintain the homeostasis of the organism and keep it healthy. This process is called efferocytosis. If the process fails, this may cause different types of diseases. More and more evidence suggests that a faulty efferocytosis process is closely related to the pathological processes of respiratory diseases. In this review, we will first introduce the process and the related mechanisms of efferocytosis of the macrophage. Secondly, we will propose some methods that can regulate the function of efferocytosis at different stages of the process. Next, we will discuss the role of efferocytosis in different lung diseases and the related treatment approaches. Finally, we will summarize the drugs that have been applied in clinical practice that can act upon efferocytosis, in order to provide new ideas for the treatment of lung diseases.
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Pneumopatias , Transtornos Respiratórios , Humanos , Apoptose/fisiologia , Fagocitose/fisiologia , Macrófagos , Fagócitos/fisiologiaRESUMO
Respiratory diseases, such as asthma and chronic obstructive pulmonary disease (COPD), are critical areas of medical research, as millions of people are affected worldwide. In fact, more than 9 million deaths worldwide were associated with respiratory diseases in 2016, equivalent to 15% of global deaths, and the prevalence is increasing every year as the population ages. Due to inadequate treatment options, the treatments for many respiratory diseases are limited to relieving symptoms rather than curing the disease. Therefore, new therapeutic strategies for respiratory diseases are urgently needed. Poly (lactic-co-glycolic acid) micro/nanoparticles (PLGA M/NPs) have good biocompatibility, biodegradability and unique physical and chemical properties, making them one of the most popular and effective drug delivery polymers. In this review, we summarized the synthesis and modification methods of PLGA M/NPs and their applications in the treatment of respiratory diseases (asthma, COPD, cystic fibrosis (CF), etc.) and also discussed the research progress and current research status of PLGA M/NPs in respiratory diseases. It was concluded that PLGA M/NPs are the promising drug delivery vehicles for the treatment of respiratory diseases due to their advantages of low toxicity, high bioavailability, high drug loading capacity, plasticity and modifiability. And at the end, we presented an outlook on future research directions, aiming to provide some new ideas for future research directions and hopefully to promote their widespread application in clinical treatment.
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Asma , Nanopartículas , Doença Pulmonar Obstrutiva Crônica , Transtornos Respiratórios , Doenças Respiratórias , Humanos , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Ácido Poliglicólico/química , Ácido Láctico/química , Nanopartículas/química , Portadores de Fármacos/químicaRESUMO
Influenza A virus (IAV) infection leads to severe inflammation, and while epithelial-driven inflammatory responses occur via activation of NF-κB, the factors that modulate inflammation, particularly the negative regulators are less well-defined. In this study we show that A20 is a crucial molecular switch that dampens IAV-induced inflammatory responses. Chronic exposure to low-dose LPS environment can restrict this excessive inflammation. The mechanisms that this environment provides to suppress inflammation remain elusive. Here, our evidences show that chronic exposure to low-dose LPS suppressed IAV infection or LPS stimulation-induced inflammation in vitro and in vivo. Chronic low-dose LPS environment increases A20 expression, which in turn positively regulates PPAR-α and -γ, thus dampens the NF-κB signaling pathway and NLRP3 inflammasome activation. Knockout of A20 abolished the inhibitory effect on inflammation. Thus, A20 and its induced PPAR-α and -γ play a key role in suppressing excessive inflammatory responses in the chronic low-dose LPS environment.
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Influenza Humana , NF-kappa B , Humanos , NF-kappa B/metabolismo , Lipopolissacarídeos/farmacologia , Receptores Ativados por Proliferador de Peroxissomo , Proteína 3 Induzida por Fator de Necrose Tumoral alfa/metabolismo , Inflamação/metabolismoRESUMO
Methotrexate is an anti-metabolite drug that is frequently used for rheumatoid arthritis treatment. This study is aimed at evaluating the bioequivalence of 2 methotrexate tablets (2.5 mg) under fasting and fed conditions in healthy Chinese volunteers. A single-center, randomized, open-label, two-drug, two-period, crossover, single-dose trial protocol was designed. Fifty-two healthy Chinese participants were enrolled and randomly classified into fasting (n = 26) and fed (n = 26) group. Fifty of them participated in the whole trial course. Blood samples for pharmacokinetic (PK) analysis were collected 1 h before and up to 24 h after drug administration. To evaluate the bioequivalence of test and reference tablets, PK parameters including maximum plasma drug concentration (Cmax), time to reach maximum concentration (Tmax), area under the plasma concentration-time curve from time 0 to the last measurable concentration (AUC0-t), and area under the plasma concentration-time curve from time 0 to infinity (AUC0-∞) were calculated. Our data revealed that 90% CIs of geometric mean ratio of the test or reference drugs for Cmax, AUC0-t, and AUC0-∞ fell within the acceptance range for bioequivalence (80-125%). Besides, it is worthwhile to mention that Cmax and Tmax in the fed group were lower than those in the fasting group. Interestingly, the absorption, measured by AUC, did not have significant difference in both groups. There were no suspected serious adverse reactions or serious adverse events over the entire trial. Our results demonstrated that the test and reference tablets were bioequivalent under fasting and fed conditions.
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População do Leste Asiático , Metotrexato , Humanos , Equivalência Terapêutica , Jejum , Comprimidos , Voluntários SaudáveisRESUMO
A one-step hydrothermal method for preparation of copper oxides with different valences using ascorbic acid as a reducing reagent was developed for environmental remediation. The results suggested that the notable degradation performance of CuO0 may be attributable to the abundant active sites, such as Cu or Cu-O, and was not significantly related to the Cu valence state. In contrast to direct degradation of pollutants by traditional superoxide radicals (O2â¢-), O2â¢- played an important role in the reduction of high-valence Cu ions (Cu(III)). In addition, a series of radical quenching, electron paramagnetic resonance (EPR), and electrochemical experiments validated the existence of direct electron transfer between methylene blue (MB) and PMS mediated by CuO0 and surface-bound radicals. The results suggested that the CuO0/PMS system may be less susceptible to diverse ions and natural organic matter other than dihydrogen phosphate anions. The mechanism of MB degradation under alkaline conditions was different from that under acidic conditions in that it was not reliant on radicals or charge transfer but direct oxidation by PMS. This study provides new insights into the heterogeneous processes involved in PMS activation by the copper oxides. Furthermore, this paper devotes to providing theoretical basis on pollutant removal via PMS activated by copper oxides and developing low-cost and high-efficiency catalysts.
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Cobre , Azul de Metileno , Cobre/química , Peróxidos/químicaRESUMO
The types of clinical notes in electronic health records (EHRs) are diverse and it would be great to standardize them to ensure unified data retrieval, exchange, and integration. The LOINC Document Ontology (DO) is a subset of LOINC that is created specifically for naming and describing clinical documents. Despite the efforts of promoting and improving this ontology, how to efficiently deploy it in real-world clinical settings has yet to be explored. In this study we evaluated the utility of LOINC DO by mapping clinical note titles collected from five institutions to the LOINC DO and classifying the mapping into three classes based on semantic similarity between note titles and LOINC DO codes. Additionally, we developed a standardization pipeline that automatically maps clinical note titles from multiple sites to suitable LOINC DO codes, without accessing the content of clinical notes. The pipeline can be initialized with different large language models, and we compared the performances between them. The results showed that our automated pipeline achieved an accuracy of 0.90. By comparing the manual and automated mapping results, we analyzed the coverage of LOINC DO in describing multi-site clinical note titles and summarized the potential scope for extension.
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Registros Eletrônicos de Saúde , Logical Observation Identifiers Names and Codes , Humanos , Armazenamento e Recuperação da Informação , SemânticaRESUMO
Asthma is a chronic airway inflammatory disease with complex mechanisms, and these patients often encounter difficulties in their treatment course due to the heterogeneity of the disease. Currently, clinical treatments for asthma are mainly based on glucocorticoid-based combination drug therapy; however, glucocorticoid resistance and multiple side effects, as well as the occurrence of poor drug delivery, require the development of more promising treatments. Nanotechnology is an emerging technology that has been extensively researched in the medical field. Several studies have shown that drug delivery systems could significantly improve the targeting, reduce toxicity and improve the bioavailability of drugs. The use of multiple nanoparticle delivery strategies could improve the therapeutic efficacy of drugs compared to traditional delivery methods. Herein, the authors presented the mechanisms of asthma development and current therapeutic methods. Furthermore, the design and synthesis of different types of nanomaterials and micromaterials for asthma therapy are reviewed, including polymetric nanomaterials, solid lipid nanomaterials, cell membranes-based nanomaterials, and metal nanomaterials. Finally, the challenges and future perspectives of these nanomaterials are discussed to provide guidance for further research directions and hopefully promote the clinical application of nanotherapeutics in asthma treatment.
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Asma , Nanoestruturas , Doença Pulmonar Obstrutiva Crônica , Humanos , Asma/tratamento farmacológico , Nanoestruturas/uso terapêuticoRESUMO
Advanced oxidation processes (AOPs) are efficient methods for water purification. However, there are few studies on using peroxymonosulfate (PMS) to remove pollutants directly. In this study, about 76% of methylene blue (MB) was removed by PMS directly within 180 min through a non-radical pathway, verified by scavenging tests, electron paramagnetic resonance and kinetic calculations. Additionally, the effects of PMS dosage, MB concentration, temperature, initial pH and competitive anions were determined. High PMS dosage, temperature and pH promoted MB degradation (from 76 to 98%) while MB concentration showed no effect on MB removal. Besides, MB degradation followed pseudo-first-order kinetic with rate constants of 0.0082 to 0.3912 min-1. The second-order rate constant for PMS reaction with MB was 0.08 M-1 s-1 at pH 3-6, but increased dramatically to 4.68 M-1 s-1 at pH 10.50. Chlorine could be catalysed by PMS at high concentration Cl- and degradation efficiency reached 98% within 90 min. High concentration of bicarbonate accelerated MB removal due to the high pH value while humic acid showed a marginal effect on MB degradation. Furthermore, TOC removal rate of MB in the presence of chloride reached 45%, whereas PMS alone caused almost no mineralisation. This study provides new insights into pollutant removal and an additional strategy for water purification.