The anti-hyperlipidemia effect of Atractylodes macrocephala Rhizome increased HDL via reverse cholesterol transfer.

Aim: Atractylodes macrocephala Rhizome (AM) has been used to treat hyperlipidemia for centuries, but its functional components and mechanisms are not clear. This research aimed to investigate the active components in AM and the mechanisms that underlie its anti-hyperlipidemia effect. Methods: SD rats were fed a high-sucrose high-fat diet in conjunction with alcohol (HSHFDAC) along with different AM extracts (AMW, AMO, AME, and AMP) for 4 weeks. AM's active components were analyzed using multiple databases, and their mechanisms were explored through network pharmacology. The relationship between AM's effect of enhancing serum HDL-c and regulating the expression of reverse cholesterol transport (RCT)-related proteins (Apo-A1, LCAT, and SR-BI) was further validated in the HSHFDAC-induced hyperlipidemic rats. The kidney and liver functions of the rats were measured to evaluate the safety of AM. Results: AMO, mainly comprised of volatile and liposoluble components, contributed the most significant anti-hyperlipidemia effect among the four extracts obtained from AM, significantly improving the blood lipid profile. Network pharmacology analysis also suggested that volatile and liposoluble components, comprise AM's main active components and they might act on signaling pathways associated with elevated HDL-c. Validation experiments found that AMO substantially and dose-dependently increased HDL-c levels, upregulated the expression of Apo-A1, SR-BI, and LCAT, improved the pathological changes in the kidney and liver, and significantly reduced the serum creatinine levels in rats with hyperlipidemia. Conclusion: The main anti-hyperlipidemia active components of AM are its volatile and liposoluble components, which may enhance serum HDL-c by increasing the expression of the RCT-related proteins Apo-A1, LCAT, and SR-BI.

AURKA knockdown inhibits esophageal squamous cell carcinoma progression through ferroptosis.

Aurora kinase A, as a pro-carcinogenic in gastric cancer and glioma kinase, is enhanced in several human tumors. However, it's regulatory mechanism in esophageal squamous cell carcinoma (ESCC) remains unclear. Thus, this study aimed to investigate the expression status, functional roles, and molecular mechanisms of AURKA in ESCC development. AURKA expression was analyzed by the screening of the GEO database and detected using an immunohistochemical method. The biological function of AURKA on ESCC was evaluated in vitro and in vivo. Western blot assay, malondialdehyde (MDA), iron, and glutathione (GSH) kits were utilized to assess changes in ferroptosis. Database analysis results showed that AURKA was a differential gene in ESCC and was highly expressed in human ESCC tissues. Functionally, AURKA knockdown decreased ESCC cell proliferation, invasion, and metastasis both in vitro and in vivo. Moreover, when AURKA was knockdown, cells were more correctly blocked in the G2/M phase, and the ferroptosis-related MDA and Fe increased, whereas the GSH reduced. Consistently, Glutathione peroxidase 4 (GPX4) and solute carrier family 7a member 11 (SLC7A11) expression were downregulated by AURKA knockdown. However, ferroptosis inhibitor partially restore ESCC cell proliferation, invasion, and metastasis caused by AURKA knockdown. AURKA knockdown enhances ferroptosis and acts against cancer progression in ESCC. AURKA acts as a tumor-promoting gene and may serve as potential target for ESCC treatment.

Efficacy and safety of tranexamic acid in the treatment of gastric cancer complicated with upper gastrointestinal bleeding.

OBJECTIVE: To investigate the efficacy and safety of tranexamic acid (TXA) in preventing upper gastrointestinal (GI) bleeding in patients with gastric cancer. METHODS: The clinical data of patients with gastric cancer complicated with acute non-operative GI bleeding treated in the Fourth Hospital of Hebei Medical University from 2020 to 2022 were collected and retrospectively analyzed. The survival status of the patients was followed up by telephone. The dataset of 168 patients was divided into a control group (n=85) and a TXA group (n=83), at a 1:1 ratio. The patients in the control group were treated with esomeprazole, and the patients in the TXA group received additional TXA. The hemostatic effect, rebleeding rate, and mortality of patients were compared between the two groups. The Cox proportional hazard model was used to evaluate the overall survival of patients as well as the related risk factors. RESULTS: The success rate of hemostasis and the normal blood coagulation rate in the TXA group were significantly higher than those in the control group (P=0.003 and P=0.016). The secondary bleeding rate, thrombus formation rate and digestive tract perforation rate in the TXA group were significantly lower than those in the control group (P=0.002, P=0.003 and P=0.035). The improvement of all indicators in the TXA group was better than that in the control group (all P<0.05). For patients with gastric cancer complicated with acute GI bleeding treated with TXA, the Cox proportional hazard model identified III~IV stage, time of TXA treatment, surgical treatment after hemorrhage, and an increase of D-dimer as independent risk factors for upper GI bleeding (all P<0.05). CONCLUSION: TXA can be an effective treatment for patients with gastric cancer complicated by GI bleeding.

Preoperative localization for pulmonary nodules: a meta-analysis of coil and liquid materials.

PURPOSE: This study was designed to conduct pooled comparisons of the relative clinical efficacy and safety of computed tomography (CT)-guided localization for pulmonary nodules (PNs) using either coil- or liquid material-based approaches. MATERIAL AND METHODS: Relevant articles published as of July 2023 were identified in the Web of Science, PubMed, and Wanfang databases, and pooled analyses of relevant endpoints were then conducted. RESULTS: Six articles that enrolled 287 patients (341 PNs) and 247 patients (301 PNs) that had respectively undergone CT-guided localization procedures using coil- and liquid material-based approaches prior to video-assisted thoracic surgery (VATS) were included in this meta-analysis. The liquid material group exhibited a significantly higher pooled successful localization rate as compared to the coil group (p = 0.01), together with significantly lower pooled total complication rates (p = 0.0008) and pneumothorax rates (p = 0.01). Both groups exhibited similar rates of pulmonary hemorrhage (p = 0.44) and successful wedge resection (p = 0.26). Liquid-based localization was also associated with significant reductions in pooled localization and VATS procedure durations (p = 0.004 and 0.007). CONCLUSIONS: These data are consistent with CT-guided localization procedures performed using liquid materials being safer and more efficacious than coil-based localization in patients with PNs prior to VATS resection.

Fundamental and Practical Feasibility of Electrocardiogram Reconstruction from Photoplethysmogram.

Electrocardiogram (ECG) reconstruction from contact photoplethysmogram (PPG) would be transformative for cardiac monitoring. We investigated the fundamental and practical feasibility of such reconstruction by first replicating pioneering work in the field, with the aim of assessing the methods and evaluation metrics used. We then expanded existing research by investigating different cycle segmentation methods and different evaluation scenarios to robustly verify both fundamental feasibility, as well as practical potential. We found that reconstruction using the discrete cosine transform (DCT) and a linear ridge regression model shows good results when PPG and ECG cycles are semantically aligned-the ECG R peak and PPG systolic peak are aligned-before training the model. Such reconstruction can be useful from a morphological perspective, but loses important physiological information (precise R peak location) due to cycle alignment. We also found better performance when personalization was used in training, while a general model in a leave-one-subject-out evaluation performed poorly, showing that a general mapping between PPG and ECG is difficult to derive. While such reconstruction is valuable, as the ECG contains more fine-grained information about the cardiac activity as well as offers a different modality (electrical signal) compared to the PPG (optical signal), our findings show that the usefulness of such reconstruction depends on the application, with a trade-off between morphological quality of QRS complexes and precise temporal placement of the R peak. Finally, we highlight future directions that may resolve existing problems and allow for reliable and robust cross-modal physiological monitoring using just PPG.

Meta-analysis indicates better climate adaptation and mitigation performance of hybrid engineering-natural coastal defence measures.

Traditional approaches to coastal defence often struggle to reduce the risks of accelerated climate change. Incorporating nature-based components into coastal defences may enhance adaptation to climate change with added benefits, but we need to compare their performance against conventional hard measures. We conduct a meta-analysis that compares the performances of hard, hybrid, soft and natural measures for coastal defence across different functions of risk reduction, climate change mitigation, and cost-effectiveness. Hybrid and soft measures offer higher risk reduction and climate change mitigation benefits than unvegetated natural systems, while performing on par with natural measures. Soft and hybrid measures are more cost-effective than hard measures, while hybrid measures provide the highest hazard reduction among all measures. All coastal defence measures have a positive economic return over a 20-year period. Mindful of risk context, our results provide strong an evidence-base for integrating and upscaling nature-based components into coastal defences in lower risk areas.

Strong Second-Harmonic Generation Induced by a Triphenylamine-Based Bismuth-Organic Framework for Photocatalytic Activity Enhancement.

Taking advantage of the well-defined geometry of metal centers and highly directional metal-ligand coordination bonds, metal-organic frameworks (MOFs) have emerged as promising candidates for nonlinear optical (NLO) materials. In this work, taking a photoresponsive carboxylate triphenylamine derivative as an organic ligand, a bismuth-based MOF, Bi-NBC, NBC = 4',4‴,4‴″-nitrilotris(([1,1'-biphenyl]-4-carboxylic acid)) is obtained. Structure determination reveals that it is a potential NLO material derived from its noncentrosymmetric structure, which is finally confirmed by its rarely strong second harmonic generation (SHG) effect. Theoretical calculations reveal that the potential difference around Bi atoms is large; therefore, it leads to a strong local built-in electric field, which greatly facilitates the charge separation and transfer and finally improves the photocatalytic performance. Our results provide a reference for the exploration of MOFs with NLO properties.

Ferroelectricity-Defects Synergistic Artificial Synapses for High Recognition Accuracy Neuromorphic Computing.

The ability of ferroelectric memristors to modulate conductance and offer multilevel storage has garnered significant attention in the realm of artificial synapses. On one hand, the resistance change of ferroelectric memristors mainly depends on the polarization reversal. On the other hand, the defects such as oxygen vacancies, which are inevitable presence during high-temperature processes, can undergo diffusion drift with the polarization reversal, thereby change the interface potential barrier. Thus, it is both desirable and necessary to investigate the synergistic effect of ferroelectricity and defects. Here, we prepare BaTiO3 ferroelectric memristor by pulse laser deposition and achieve resistance switching through the synergistic effect of ferroelectricity and oxygen vacancies. The memristor shows excellent switching characteristics with a large switching ratio (104) and good stability (103 s). It effectively emulates the features of artificial synapses and accomplishes decimal logical neural computing. In the neuromorphic system crafted with the memristor, the recognition accuracy of the 28 × 28 pixel image reaches 94.9%. These findings strongly support the research of ferroelectric memristors in neuromorphic devices.

Exosomal miR-1202 mediates Brodmann Area 44 functional connectivity changes in medication-free patients with major depressive disorder: An fMRI study.

Previous large-sample postmortem study revealed that the expression of miR-1202 in brain tissues from Brodmann area 44 (BA44) was dysregulated in patients with major depressive disorder (MDDs). However, the specific in vivo neuropathological mechanism of miR-1202 as well as its interplay with BA44 circuits in the depressed brain are still unclear. Here, we performed a case-control study with imaging-genetic approach based on resting-state functional magnetic resonance imaging (MRI) data and miR-1202 quantification from 110 medication-free MDDs and 102 healthy controls. Serum-derived circulating exosomes that readily cross the blood-brain barrier were isolated to quantify miR-1202. For validation, repeated MR scans were performed after a six-week follow-up of antidepressant treatment on a cohort of MDDs. Voxelwise factorial analysis revealed two brain areas (including the striatal-thalamic region) in which the effect of depression on the functional connectivity with BA44 was significantly dependent on the expression level of exosomal miR-1202. Moreover, longitudinal change of the BA44 connectivity with the striatal-thalamic region in MDDs after antidepressant treatment was found to be significantly related to the level of miR-1202 expression. These findings revealed that the in vivo neuropathological effect of miR-1202 dysregulation in depression is possibly exerted by mediating neural functional abnormalities in BA44-striatal-thalamic circuits.

Mixed diets can meet nutrient requirements with lower carbon footprints.

Achieving sustainable dietary change is essential for safeguarding human and environmental health. However, dietary recommendations based on broad food groups may not accurately reflect real-world realities because individuals select and consume dishes with multiple food items influenced by diverse context-specific factors. Therefore, here we explored the sustainability trade-offs of dietary choices at the dish level through an optimization modeling approach tested in Japan. We estimated the nutritional quality, price, and carbon footprint of major Japanese dishes and examined 16 dietary scenarios to identify options that meet the nutritional requirements and minimize carbon footprint. Overall, mixed diets contain more combinations of dishes that meet nutritional requirements with lower carbon footprints compared to more restrictive dietary scenarios. We argue that the approach developed here enables a better understanding of dietary trade-offs, complements existing methods, and helps identify sustainable diets by offering nuanced information at the national and sub-national levels.

SC912 inhibits AR-V7 activity in castration-resistant prostate cancer by targeting the androgen receptor N-terminal domain.

Androgen deprivation therapies (ADT) are the mainstay treatments for castration-resistant prostate cancer (CRPC). ADT suppresses the androgen receptor (AR) signaling by blocking androgen biosynthesis or inhibiting AR with antiandrogens that target AR's ligand-binding domain (LBD). However, the ADT's effect is short-lived, as the AR signaling inevitably arises again, which is frequently coupled with AR-V7 overexpression. AR-V7 is a truncated form of AR that lacks the LBD, thus being constitutively active in the absence of androgens and irresponsive to AR-LBD-targeting inhibitors. Though compelling evidence has tied AR-V7 to drug resistance in CRPC, pharmacological inhibition of AR-V7 is still an unmet need. Here, we discovered a small molecule, SC912, which binds to full-length AR as well as AR-V7 through AR N-terminal domain (AR-NTD). This pan-AR targeting relies on the amino acids 507-531 in the AR-NTD. SC912 also disrupted AR-V7 transcriptional activity, impaired AR-V7 nuclear localization and DNA binding. In the AR-V7 positive CRPC cells, SC912 suppressed proliferation, induced cell-cycle arrest, and apoptosis. In the AR-V7 expressing CRPC xenografts, SC912 attenuated tumor growth and antagonized intratumoral AR signaling. Together, these results suggested the therapeutic potential of SC912 for CRPC.

Effects of Various Nectar and Pollen Plants on the Survival, Reproduction, and Predation of Neoseiulus bicaudus.

Neoseiulus bicaudus is a predatory mite species that could potentially be used for the biological control of spider mites and thrips. Floral resources can provide excellent habitats and abundant nutrients for natural enemies. The objective of this experiment was to evaluate the effects of eight floral resources on the longevity, fecundity, and predation ability of N. bicaudus. Among the considered plants, Cnidium monnieri led to the highest longevity (24 days) and fecundity (13.8 eggs) of N. bicaudus, while Tagetes erecta resulted in the lowest longevity (7 days) and fecundity (0.1 eggs) observed in the predatory mites. By comparing the effects of three nectar and pollen plants on the predation of predatory mites, it was observed that N. bicaudus still exhibited a type II functional response to Tetranychus turkestani. In the presence of pollen, the predation efficacy (a/Th) of N. bicaudus exhibited a lower value, compared to that in the absence of pollen (Control: a/Th = 24.00). When pollen was supplied, the maximum consumption (1/Th) of predatory mites was higher than in its absence (Control: 1/Th = 9.90 d-1), with the highest value obtained in the presence of B. officinalis pollen (B. officinalis: 1/Th = 17.86 d-1). The influence coefficient of predation of N. bicaudus on T. turkestani in the presence of pollen was compared in the presence of three nectar and pollen plants: Cnidium monnieri, Centaurea cyanus, and Borago officinalis. At low prey densities, the influence coefficient of C. cyanus exceeded that of B. officinalis, and the overall influence coefficient values were negative (i.e., the presence of pollen reduced predatory mite feeding on T. turkestani). They exhibited similar values at high prey densities, and all of the influence coefficient values were close to 0 (i.e., the presence of pollen had no effect on predatory mite feeding on T. turkestani). The findings revealed that diverse plant species exert differential impacts on N. bicaudus, with some influencing its lifespan and others affecting its reproductive capabilities. Furthermore, the presence of nectar and pollen plants had a significant impact on predatory mite feeding on T. turkestani at low prey densities; however, this effect diminished as the prey density increased. Therefore, we recommend planting C. monnieri, C. cyanus, and B. officinalis in the field to ensure an ample population of predatory mites. The obtained results hold significant implications for the utilization of nectar and pollen plants in eco-friendly pest management strategies within agricultural contexts.

Decision Regret Following the Choice of Surgery or Active Surveillance for Small, Low-Risk Papillary Thyroid Cancer: A Prospective Cohort Study.

Background: It is important to understand cancer survivors' perceptions about their treatment decisions and quality of life. Methods: We performed a prospective observational cohort study of Canadian patients with small (<2 cm) low-risk papillary thyroid cancer (PTC) who were offered the choice of active surveillance (AS) or surgery (Clinicaltrials.gov NCT03271892). Participants completed a questionnaire one year after their treatment decision. The primary intention-to-treat analysis compared the mean decision regret scale total score between patients who chose AS or surgery. A secondary analysis examined one-year decision regret score according to treatment status. Secondary outcomes included quality of life, mood, fear of disease progression, and body image perception. We adjusted for age, sex, and follow-up duration in linear regression analyses. Results: The overall questionnaire response rate was 95.5% (191/200). The initial treatment choices of respondents were AS 79.1% (151/191) and surgery 20.9% (40/191). The mean age was 53 years (standard deviation [SD] 15 years) and 77% (147/191) were females. In the AS group, 7.3% (11/151) of patients crossed over to definitive treatment (two for disease progression) before the time of questionnaire completion. The mean level of decision regret did not differ significantly between patients who chose AS (mean 22.4, SD 13.9) or surgery (mean 20.9, SD 12.2) in crude (p = 0.730) or adjusted (p = 0.29) analyses. However, the adjusted level of decision regret was significantly higher in patients who initially chose AS and crossed over to surgery (beta coefficient 10.1 [confidence interval; CI 1.3-18.9], p = 0.02), compared with those remaining under AS. In secondary adjusted analyses, respondents who chose surgery reported that symptoms related to their cancer or its treatment interfered with life to a greater extent than those who chose AS (p = 0.02), but there were no significant group differences in the levels of depression, anxiety, fear of disease progression, or overall body image perception. Conclusions: In this study of patients with small, low-risk PTC, the mean level of decision regret pertaining to the initial disease management choice was relatively low after one year and it did not differ significantly for respondents who chose AS or surgery.

High glucose promotes atherosclerosis by regulating miRNA let7d-5p level.

BACKGROUND: MiRNA let7d-5p has been recently reported to be abnormally expressed in diabetes-associated atherosclerosis (AS). However, it still remains unknown how let7d-5p contributes to the process of atherosclerosis. METHODS: Twenty fresh tissues and a total of 28 wax block specimens from carotid endarterectomy procedures were obtained from the Luoyang Central Hospital affiliated to Zhengzhou University. The expression of let7d-5p was assessed using quantitative RT-PCR (qRT-PCR). A series of in vitro experiments was used to determine the roles of let7d-5p knockdown and overexpression in vascular smooth muscle cells (VSMCs). RESULTS: We discovered that the carotid plaques from diabetic patients had lower expression levels of miR let7d-5p. In VSMCs, the expression of miRNA let7d-5p was significantly lower in high glucose conditions compared with low glucose situations. The proliferation and migration of VSMCs were also inhibited by the overexpression of let7d-5p, whereas the opposite was true when let7d-5p was inhibited, according to gain and loss of function studies. Mechanically, let7d-5p might activate the GSK3ß/ß-catenin signaling pathway via binding to the high mobility group AT-Hook 2 (HMGA2) mRNA in VSMCs. Additionally, GLP-1RA liraglutide may prevent the migration and proliferation of VSMCs by raising let7d-5p levels. CONCLUSIONS: High glucose stimulated the proliferation and migration of VSMCs by regulating the let7d-5p/HMGA2/GSK3ß/ß-catenin pathway, and liraglutide may slow atherosclerosis by increasing the levels of miR let7d-5p.

Hydrogen sulfide signaling in plant response to temperature stress.

For the past 300 years, hydrogen sulfide (H2S) has been considered a toxic gas. Nowadays, it has been found to be a novel signaling molecule in plants involved in the regulation of cellular metabolism, seed germination, plant growth, development, and response to environmental stresses, including high temperature (HT) and low temperature (LT). As a signaling molecule, H2S can be actively synthesized and degraded in the cytosol, chloroplasts, and mitochondria of plant cells by enzymatic and non-enzymatic pathways to maintain homeostasis. To date, plant receptors for H2S have not been found. It usually exerts physiological functions through the persulfidation of target proteins. In the past 10 years, H2S signaling in plants has gained much attention. Therefore, in this review, based on that same attention, H2S homeostasis, protein persulfidation, and the signaling role of H2S in plant response to HT and LT stress were summarized. Also, the common mechanisms of H2S-induced HT and LT tolerance in plants were updated. These mechanisms involve restoration of biomembrane integrity, synthesis of stress proteins, enhancement of the antioxidant system and methylglyoxal (MG) detoxification system, improvement of the water homeostasis system, and reestablishment of Ca2+ homeostasis and acid-base balance. These updates lay the foundation for further understanding the physiological functions of H2S and acquiring temperature-stress-resistant crops to develop sustainable food and agriculture.

Preparation and Evaluation of Folate Modified PEG-PLLA Nanoparticles Loaded with Lycorine for Glioma Treatment.

Lycorine is a kind of natural active ingredient with a strong antitumor effect. In this study, folate ligand-conjugated polyethylene glycol-block-poly(l-lactide) (PEG-PLLA) nanoparticles (FA-PEG-PLLA NPs) were designed to deliver lycorine to enhance its anti-glioma activity. The successful preparation of the FA-PEG-PLLA polymer was confirmed by 1H-NMR, FT-IR, XRD, TGA, and DSC. The optimal formulation for LYC@FA-PEG-PLLA NPs was determined by response surface analysis as follows: sodium dodecyl sulfate (SDS) of 1%, carrier material of 0.03 g, organic phase volume of 3 mL, and ultrasonic power of 20%. The LYC@FA-PEG-PLLA NPs exhibited an encapsulation efficiency of 83.58% and a particle size of 49.71 nm, demonstrating good stability. Hemolysis experiments, MTT assays, and cell scratch assays revealed excellent biocompatibility of FA-PEG-PLLA and superior anti-glioma activity of LYC@FA-PEG-PLLA NPs compared to the raw drug. Additionally, cell apoptosis assays, ROS experiments, and western blot analysis demonstrated that LYC@FA-PEG-PLLA NPs contributed to cell apoptosis by inducing ROS generation and increasing the expression of NF-κB inhibitory protein IκBα. These results suggested that LYC@FA-PEG-PLLA NPs hold promise for glioma treatment.

The PPO family in Nicotiana tabacum is an important regulator to participate in pollination.

Polyphenol oxidases (PPOs) are type-3 copper enzymes and are involved in many biological processes. However, the potential functions of PPOs in pollination are not fully understood. In this work, we have screened 13 PPO members in Nicotiana. tabacum (named NtPPO1-13, NtPPOs) to explore their characteristics and functions in pollination. The results show that NtPPOs are closely related to PPOs in Solanaceae and share conserved domains except NtPPO4. Generally, NtPPOs are diversely expressed in different tissues and are distributed in pistil and male gametes. Specifically, NtPPO9 and NtPPO10 are highly expressed in the pistil and mature anther. In addition, the expression levels and enzyme activities of NtPPOs are increased after N. tabacum self-pollination. Knockdown of NtPPOs would affect pollen growth after pollination, and the purines and flavonoid compounds are accumulated in self-pollinated pistil. Altogether, our findings demonstrate that NtPPOs potentially play a role in the pollen tube growth after pollination through purines and flavonoid compounds, and will provide new insights into the role of PPOs in plant reproduction.

Carrimycin in the treatment of acute promyelocytic leukemia combined with pulmonary tuberculosis: A case report.

BACKGROUND: Pulmonary tuberculosis (PTB) is prevalent in immunocompromised populations, including patients with hematologic malignancies, human immunodeficiency virus infections, and chronic diseases. Effective treatment for acute promyelocytic leukemia (APL) combined with PTB is lacking. These patients show an extremely poor prognosis. Therefore, studies should establish efficient treatment options to improve patient survival and prognosis. CASE SUMMARY: A 60-year-old male with pain in the right side of his chest and a fever for 4 d visited the outpatient department of our hospital. Peripheral blood smear revealed 54% blasts. Following bone marrow examinations, variant APL with TNRC18-RARA fusion gene was diagnosed. Chest computed tomography scan showed bilateral pneumonitis with bilateral pleural effusions, partial atelectasis in the lower lobes of both lungs, and the bronchoalveolar lavage fluid gene X-Pert test was positive, indicative of PTB. Carrimycin, ethambutol (EMB), and isoniazid (INH) were administered since he could not receive chemotherapy as the WBC count decreased continuously. After one week of treatment with carrimycin, the patient recovered from fever and received chemotherapy. Chemotherapy was very effective and his white blood cells counts got back to normal. After being given five months with rifampin, EMB and INH and chemotherapy, the patient showed complete remission from pneumonia and APL. CONCLUSION: We report a case of PTB treated successfully with carrimycin with APL that requires chemotherapy.