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The intestinal epithelium provides an important barrier against bacterial endotoxin translocation, which can regulate the absorption of water and ions. The disruption of epithelial barrier function can result in water transport and tight junction damage, or further cause diarrhea. Therefore, reducing intestinal epithelial barrier injury plays an important role in diarrhea. Inflammatory response is an important cause of intestinal barrier defects. Daidzein improving the barrier integrity has been reported, but the effect on tight junction proteins and aquaporins is not well-described yet, and the underlying mechanism remains indistinct in the human intestinal epithelium. This study aimed to investigate the effects and mechanisms of daidzein on intestinal epithelial barrier injury induced by LPS, and a barrier injury model induced by LPS was established with human colorectal epithelial adenocarcinoma cell line Caco-2 cells. We found that daidzein protected the integrity of Caco-2 cell monolayers, reversed LPS-induced downregulation of ZO-1, occludin, claudin-1, and AQP3 expression, maintained intercellular junction of ZO-1, and suppressed NF-κB and the expression of inflammatory factors (TNF-α, IL-6). Furthermore, we found that daidzein suppressed the phosphorylation of the PI3K/AKT and P38 pathway-related proteins and the level of the related genes, and the PI3K/AKT and P38 pathway inhibitors increased ZO-1, occludin, claudin-1, and AQP3 expression. The study showed that daidzein could resist LPS-induced intestinal epithelial barrier injury, and the mechanism is related to suppressing the PI3K/AKT and P38 pathways. Therefore, daidzein could be a candidate as a dietary supplementation or drug to prevent or cure diarrhea.

With the continuous updating and progress of medical equipment, the overdue medical device has problems such as management difficulties, resource waste, and potential security risks. Therefore, this paper used the Kohonen network algorithm to quantitatively evaluate and analyze the surplus value of overdue medical devices. In this paper, the Kohonen network algorithm was used to build a quantitative model of the surplus value of the overdue medical device, and the self-organization characteristics and data-driven learning ability of the Kohonen network were used to predict the surplus value of the equipment more accurately. Support vector machine was used to quantitatively evaluate and predict the surplus value of overdue medical devices, and further optimize the model performance, to provide more accurate and reliable decision support for medical equipment management. The Kohonen network algorithm used in this paper evaluated the correlation between the service life and maintenance cost of eight types of overdue medical devices and quantitatively predicted the surplus value of overdue medical devices with the random forest algorithm. According to the comparison of prediction bias, the maximum deviation between the expected surplus value and the actual surplus value is only 1, and the deviation value by the random forest algorithm is as low as 6, the Kohonen network algorithm in this paper has better prediction performance than the random forest algorithm. In the experiment of comparative analysis and verification by introducing the decision tree algorithm, the average error rate of the Kohonen network algorithm in this paper was only 20.57%, which was far lower than 46.34% of the random forest algorithm and 65.31% of decision tree algorithm. The Kohonen network algorithm used in this paper can effectively quantitatively evaluate and predict the surplus value of overdue medical devices, thus improving the efficiency of medical equipment management, reducing costs, and ensuring patient safety.

With the increasing interest in the application of large language models (LLMs) in the medical field, the feasibility of its potential use as a standardized patient in medical assessment is rarely evaluated. Specifically, we delved into the potential of using ChatGPT, a representative LLM, in transforming medical education by serving as a cost-effective alternative to standardized patients, specifically for history-taking tasks. The study aims to explore ChatGPT's viability and performance as a standardized patient, using prompt engineering to refine its accuracy and use in medical assessments. A 2-phase experiment was conducted. The first phase assessed feasibility by simulating conversations about inflammatory bowel disease (IBD) across 3 quality groups (good, medium, and bad). Responses were categorized based on their relevance and accuracy. Each group consisted of 30 runs, with responses scored to determine whether they were related to the inquiries. For the second phase, we evaluated ChatGPT's performance against specific criteria, focusing on its anthropomorphism, clinical accuracy, and adaptability. Adjustments were made to prompts based on ChatGPT's response shortcomings, with a comparative analysis of ChatGPT's performance between original and revised prompts. A total of 300 runs were conducted and compared against standard reference scores. Finally, the generalizability of the revised prompt was tested using other scripts for another 60 runs, together with the exploration of the impact of the used language on the performance of the chatbot. The feasibility test confirmed ChatGPT's ability to simulate a standardized patient effectively, differentiating among poor, medium, and good medical inquiries with varying degrees of accuracy. Score differences between the poor (74.7, SD 5.44) and medium (82.67, SD 5.30) inquiry groups (P<.001), between the poor and good (85, SD 3.27) inquiry groups (P<.001) were significant at a significance level (α) of .05, while the score differences between the medium and good inquiry groups were not statistically significant (P=.16). The revised prompt significantly improved ChatGPT's realism, clinical accuracy, and adaptability, leading to a marked reduction in scoring discrepancies. The score accuracy of ChatGPT improved 4.926 times compared to unrevised prompts. The score difference percentage drops from 29.83% to 6.06%, with a drop in SD from 0.55 to 0.068. The performance of the chatbot on a separate script is acceptable with an average score difference percentage of 3.21%. Moreover, the performance differences between test groups using various language combinations were found to be insignificant. ChatGPT, as a representative LLM, is a viable tool for simulating standardized patients in medical assessments, with the potential to enhance medical training. By incorporating proper prompts, ChatGPT's scoring accuracy and response realism significantly improved, approaching the feasibility of actual clinical use. Also, the influence of the adopted language is nonsignificant on the outcome of the chatbot.

Emergency departments (EDs) face significant challenges due to overcrowding, prolonged waiting times, and staff shortages, leading to increased strain on health care systems. Efficient triage systems and accurate departmental guidance are critical for alleviating these pressures. Recent advancements in large language models (LLMs), such as ChatGPT, offer potential solutions for improving patient triage and outpatient department selection in emergency settings. The study aimed to assess the accuracy, consistency, and feasibility of GPT-4-based ChatGPT models (GPT-4o and GPT-4-Turbo) for patient triage using the Modified Early Warning Score (MEWS) and evaluate GPT-4o's ability to provide accurate outpatient department guidance based on simulated patient scenarios. A 2-phase experimental study was conducted. In the first phase, 2 ChatGPT models (GPT-4o and GPT-4-Turbo) were evaluated for MEWS-based patient triage accuracy using 1854 simulated patient scenarios. Accuracy and consistency were assessed before and after prompt engineering. In the second phase, GPT-4o was tested for outpatient department selection accuracy using 264 scenarios sourced from the Chinese Medical Case Repository. Each scenario was independently evaluated by GPT-4o thrice. Data analyses included Wilcoxon tests, Kendall correlation coefficients, and logistic regression analyses. In the first phase, ChatGPT's triage accuracy, based on MEWS, improved following prompt engineering. Interestingly, GPT-4-Turbo outperformed GPT-4o. GPT-4-Turbo achieved an accuracy of 100% compared to GPT-4o's accuracy of 96.2%, despite GPT-4o initially showing better performance prior to prompt engineering. This finding suggests that GPT-4-Turbo may be more adaptable to prompt optimization. In the second phase, GPT-4o, with superior performance on emotional responsiveness compared to GPT-4-Turbo, demonstrated an overall guidance accuracy of 92.63% (95% CI 90.34%-94.93%), with the highest accuracy in internal medicine (93.51%, 95% CI 90.85%-96.17%) and the lowest in general surgery (91.46%, 95% CI 86.50%-96.43%). ChatGPT demonstrated promising capability for supporting patient triage and outpatient guidance in EDs. GPT-4-Turbo showed greater adaptability to prompt engineering, whereas GPT-4o exhibited superior responsiveness and emotional interaction, which are essential for patient-facing tasks. Future studies should explore real-world implementation and address the identified limitations to enhance ChatGPT's clinical integration.

Allergic diseases, such as asthma and allergic rhinitis, are common. Therefore, the discovery of therapeutic drugs for these conditions is essential. Methyleugenol (ME) is a natural compound with antiallergic, antianaphylactic, antinociceptive, and anti-inflammatory effects. This study examined the antiallergic effect of ME on IgE-mediated inflammatory responses and its antiallergy mechanism in the mast cell line, RBL-2H3. We found that ME significantly inhibited the release of β-hexosaminidase, tumor necrosis factor- (TNF-) α, and interleukin- (IL-) 4, and was not cytotoxic at the tested concentrations (0–100 μM). Additionally, ME markedly reduced the production of the proinflammatory lipid mediators prostaglandin E2 (PGE2), prostaglandin D2 (PGD2), leukotriene B4 (LTB4), and leukotriene C4 (LTC4). We further evaluated the effect of ME on the early stages of the FcεRI cascade. ME significantly inhibited Syk phosphorylation and expression but had no effect on Lyn. Furthermore, it suppressed ERK1/2, p38, and JNK phosphorylation, which is implicated in proinflammatory cytokine expression. ME also decreased cytosolic phospholipase A2 (cPLA2) and 5-lipoxygenase (5-LO) phosphorylation and cyclooxygenase-2 (COX-2) expression. These results suggest that ME inhibits allergic response by suppressing the activation of Syk, ERK1/2, p38, JNK, cPLA2, and 5-LO. Furthermore, the strong inhibition of COX-2 expression may also contribute to the antiallergic action of ME. Our study provides further information about the biological functions of ME.

Allergic rhinitis (AR) is one of the most common allergic diseases, which adversely affect patients’ quality of life. Mahuang Fuzi Xixin decoction (MFXD) has been widely used to treat AR in clinics in Asian countries. This study investigated the effect and possible therapeutic mechanisms of MFXD in the treatment of AR. A Wistar rat model of ovalbumin- (OVA-) induced AR was established and then treated with three doses of MFXD; AR symptoms, serum total immunoglobulin E, histamine, histopathological features, and release and expression of factors related to type 1 helper T (Th1) and type 2 helper T (Th2) responses were analyzed. Our study demonstrated that MFXD has a good therapeutic effect on OVA-induced allergic inflammation in an AR rat model as manifested in reduced frequencies of sneezing and nasal scratching and in reduced serum levels of total IgE and HIS. In addition, MFXD regulates imbalance in Th1/Th2 cells caused by AR by simultaneously attenuating Th1 and Th2 responses, such as by reducing the serum levels of IFN-γ and IL-4 and mRNA expression levels of IFN-γ, IL-4, GATA-3, and STAT-6. This study provided valuable information on the immunoregulatory effect of MFXD for the treatment of AR in future clinical studies.

Nucleolar protein 12 (NOL12), one of the nucleolar proteins which are primarily expressed in the nucleolus and play key roles in RNA metabolism, cell proliferation, cell cycle, and cell survival, is widely expressed in various species and multiple organs. Although it has been reported that the mRNA of Drosophila NOL12 homolog viriato is expressed in the eyes of Drosophila , the protein expression of NOL12 in mammalian eyes remains to be elucidated. In this study, we showed through immunohistochemistry that NOL12 was present in the rat retina, with predominant distribution in the cytoplasm of the retinal neuronal cells. In the human retinoblastoma cell line WERI-Rb1, we found that altering NOL12 expression led to a change in WERI-Rb1 cell viability. Knocking down NOL12 expression decreased cell viability. In contrast, overexpressing NOL12 increased cell viability. Furthermore, increasing NOL12 expression inhibited ultraviolet (UV)-induced apoptosis. These findings demonstrated that NOL12 may play an important protective role in retinal cells. In the WERI-Rb1 cells exposed to UV irradiation, we detected that NOL12 was degraded, but this degradation could be attenuated by a pan-Caspase inhibitor. Notably, the inhibitory effect of NOL12 against UV-induced apoptosis could be restrained by increasing the expression of ATR serine/threonine kinase (ATR), a kinase that, when activated by severe DNA damage, can result in apoptosis. We also found that upregulating NOL12 inhibited the activation of ATR caused by UV irradiation. Additionally, inhibiting ATR activity reduced apoptosis resulting from both silencing NOL12 expression and UV exposure. Thus, NOL12 may protect against UV irradiation-induced retinal damage by inhibiting ATR activity.

To explore the effect of continuity of nursing (CON) service platform application under \"smart elderly care (SEC)\" on family nursing of elderly patients with chronic diseases (CDs) after discharge. 200 elderly patients with CDs treated in Medical Care Ward, Zhejiang Hospital were included and grouped into the control group (CG) and experimental group (EG) in line with the sequential order of admission (100 cases per group). After discharge, routine nursing and smart CON services were given, respectively. 36-Item Short Form Questionnaire (SF-36) score of quality of life (QOL), Barthel index (BI) score of activity of daily living (ADL), Self-rating Depression Scale (SDS) score of depression, Self-rating Anxiety Scale (SAS) score of anxiety, compliance, and nursing satisfaction were compared. Compared to CG, SF-36 score and BI score were highly increased in EG 0 months (mo) and 3 mo after discharge, while SDS and SAS scores were greatly decreased (all P < .001). The compliance rate was 70% in CG and 93% in EG during the follow-up period. The nursing satisfaction rate of CG reached 92%, while that of EG was 97%. Compared with CG, the compliance and nursing satisfaction rates of EG were notably higher (P < .001). It was illustrated that the smart CON service model could enhance the effect of discharged family nursing for elderly patients with CDs, improve patients' mental status and QOL, and raise nursing compliance. Therefore, it was conducive to the rehabilitation of patients. The findings of this study highlight the transformative potential of smart CON service models in enhancing the effectiveness of family nursing for elderly patients with CDs post-discharge. Embracing these innovative approaches has the potential to not only improve individual patient outcomes but also contribute to the advancement of patient-centered care practices and healthcare delivery systems on a broader scale.

► A S. Typhi anti-capsular human reference serum (IgG anti-Vi) established. ► An estimated protective level in μg/ml against typhoid fever proposed. ► The reference serum is available to regulatory agencies and global manufactures. ► The human reference serum can facilitate Vi conjugate vaccine development. Recent data showing the high incidence of typhoid fever in young children, the demonstration of safety and efficacy of a Vi conjugate for this age group, the safety and similar immunogenicity in infants when administrated concurrently with EPI vaccines, together with the interests of manufacturers and investigators in studying such conjugate vaccines prompted us to prepare a human IgG anti-Vi standard to facilitate this work. Volunteers were injected with an investigational Vi-recombinant Pseudomonas aeruginosa exoprotein A (Vi-rEPA) conjugate vaccine. Plasmas with the highest levels of IgG anti-Vi were pooled. The IgG anti-Vi content of this preparation, assayed by precipitin analysis with purified Vi, was 33μg/ml. Accordingly, the estimated IgG anti-Vi protective level of 3.5 ELISA unit/ml, derived from our efficacy trial of Vi-rEPA in 2–5 years old children, is equivalent to 4.3μg/ml. This reagent is suitable for comparison of immune response of Vi conjugate vaccines or for other purposes requiring anti-Vi measurement.

Abscisic acid (ABA) plays pivotal roles in plant biotic and abiotic stress responses, where calcium ions are important second messengers. Calcium/calmodulin-dependent protein kinase (CCaMK) is essential for nodulation in legumes, but whether it will perceive calcium signals from abiotic stresses is not clear, especially in non-legume plants. Here we report the isolation and characterization of the D-genome copy of wheat CCaMK gene TaCCaMK . TaCCaMK was predominantly expressed in root tissues of wheat seedlings, and its proteins were located both on the cytoplasm membrane and in the nucleus as shown in the onion epidermis cells. Quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR) assay showed that the expression of TaCCaMK was downregulated by ABA, as well as NaCl and PEG treatments in wheat seedling roots. A DNA fragment of 1,119 bp upstream of the start codon of the TaCCaMK gene (p TaCCaMK ) was isolated by thermal asymmetric interlaced PCR (TAIL-PCR), on which six ABA-responsive cis -elements were predicted. p TaCCaMK can drive GUS reporter gene expression in the root and stem stalk of the transgenic Arabidopsis plants which can be repressed by ABA treatments, consistent with the observation in the qRT-PCR assay in wheat. Overexpressing TaCCaMK in Arabidopsis plants reduced their sensitivity to ABA treatment during seed germination and root elongation. Under high-salt conditions, the transgenic plants also conferred enhanced seed germination rate and became hypersensitive with increased chlorosis. Therefore, our data suggest that TaCCaMK is a negative regulator for ABA signaling which may participate in abiotic stress responses in wheat.