Sepsis-induced acute lung injury (SALI) poses a significant threat with high incidence and mortality rates. Ginsenoside Rg1 (GRg1), derived from Ginseng in traditional Chinese medicine, has been found to reduce inflammation and protect lung epithelial cells against tissue damage. However, the specific roles and mechanisms by which GRg1 mitigates SALI have yet to be fully elucidated. In this context, we employed a relevant SALI mouse model, alongside network pharmacology, molecular docking, and molecular dynamics simulation to pinpoint GRg1's action targets, complemented by in vitro assays to explore the underlying mechanisms. Our research shows that GRg1 alleviates CLP-induced SALI, decreasing lung tissue damage and levels of serum proinflammatory factor IL-6, TNF-α, and IL-1β, also enhancing the survival rate of CLP mice. A total of 116 common targets between GRg1 and ALI, with specific core targets including AKT1, VEGFA, SRC, IGF1, ESR1, STAT3, and ALB. Further in vitro experiments assessed GRg1's intervention effects on MLE-12 cells exposed to LPS, with qRT-PCR analysis and molecular dynamics simulations confirming AKT1 as the key target with the favorable binding activity for GRg1. Western blot results indicated that GRg1 increased the Bcl-2/Bax protein expression ratio to reduce apoptosis and decreased the high expression of cleaved caspase-3 in LPS-induced MLE-12 cells. More results showed significant increases in the phosphorylation of PI3K and AKT1. Flow cytometric analysis using PI and Annexin-V assays further verified that GRg1 decreased the apoptosis rate in LPS-stimulated MLE-12 cells (from 14.85 to 6.54%, p < 0.05). The employment of the AKT1 inhibitor LY294002 confirmed these trends, indicating that AKT1’s inhibition negates GRg1’s protective effects on LPS-stimulated MLE-12 cells. In conclusion, our research highlights GRg1's potential as an effective adjunct therapy for SALI, primarily by inhibiting apoptosis in alveolar epithelial cells and reducing pro-inflammatory cytokine secretion, thus significantly enhancing the survival rates of CLP mice. These beneficial effects are mediated through targeting AKT1 and activating the PI3K-AKT pathway.

Background Triage is an essential part of Emergency Medicine, which may be assisted by AI models due to limited availability of medical staff. However, AI models for aiding triage have difficulty in identifying levels that are difficult or ambiguous for human clinicians to distinguish. This study aims to develop a more reliable triage model that improves the accuracy of classification, especially for cases with moderate acuity. Methods We developed a new triage model called KUTS, a foundational classification model for emergency triage, which leverages a knowledge prompt-tuning encoder and an uncertainty-based classifier. KUTS takes tabular data and chief complaints as input, and then assign different acuity levels to patients based on their condition acuity. We trained and tested the model on multiple real-world emergency department datasets. Results Here we show that on the most difficult level for human to distinguish (moderate acuity level), our KUTS substantially outperforms the previous shallow single-modal methods, deep single-modal methods and deep multi-modal methods on AUC score, by an average of 0.19, 0.35, and 0.13 (from 0.76, 0.60, 0.82 to 0.95), respectively. Besides, on all the triage levels, our KUTS also outperforms the previous shallow single-modal methods, deep single-modal methods and deep multi-modal methods on AUC score, by an average of 0.14, 0.20 and 0.06 (from 0.82, 0.76, 0.90 to 0.96), respectively. Conclusions KUTS provides a foundational framework and paradigm for the study of emergency triage, and facilitates the development of more efficient triage systems.

Sudden cardiac arrest (SCA) is one of the most common critical illnesses encountered in clinical practice. Shenfu injection (SFI) has received extensive attention as an alternative therapy that can effectively maintain the autonomic circulation function after cardiopulmonary resuscitation. However, the mechanism of SFI is not yet fully understood. In addition, there has been no systematic review or meta-analysis of SFI in the treatment of patients with return of spontaneous circulation after SCA. Herein, we describe the protocol of a proposed study based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines that aims to systematically evaluate the efficacy and safety of SFI in patients with return of spontaneous circulation after SCA. Two researchers will search 9 electronic databases (PubMed, Medline, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese VIP Information, Wanfang, and Chinese Biomedical Database) to identify all studies that meet the inclusion criteria and were published before July 2018. After information extraction and methodological quality evaluation, we will use Stata 13.0 software (STATA Corporation, College Station, TX, USA) to synthesize the data. The primary outcomes will be the survival rate and Glasgow Coma Scale. The data synthesis results will objectively illustrate the efficacy and safety of SFI in patients with return of spontaneous circulation after SCA. The findings will provide a reference for the use of SFI in the treatment of patients with return of spontaneous circulation after SCA. PROSPERO (registration number: CRD42018104230).

Purpose: This study aimed to analyze the current status, research hotspots, and frontiers of brucellosis from 2014 to 2023 using data from China National Knowledge Infrastructure (CNKI) and Web of Science (WoS) via CiteSpace, and to provide new insights for researchers in the field. Material and Methods: Articles related to brucellosis published from 2014 to 2023 were retrieved from CNKI and WoS databases. CiteSpace V.6.3.R3 was employed to generate network maps and perform bibliometric analysis. Results: A total of 467 references from CNKI and 3686 references from WoS were analyzed. In CNKI, the annual publication trend showed a decline, with Xu Liqing, Ma Li, and Yang Xuxin being the most prolific authors, and the Chinese Center for Disease Control and Prevention being the leading institution. The keyword cluster analysis identified 13 main clusters, while the keyword emergence map highlighted 15 keywords with the strongest emergence intensity. In contrast, WoS displayed an increasing trend in annual publications, with Heinrich Neubauer, Egyptian Knowledge Bank (EKB), and China as the top contributors in terms of authors, institutions, and countries, respectively. “Infection” was the most frequently occurring keyword. WoS analysis revealed 16 primary clusters and 25 keywords with high emergence intensity. Conclusion: Between 2014 and 2023, CNKI saw a slight dip in brucellosis studies, while WoS research on it gained growing attention. CNKI literature primarily focuses on epidemiology, clinical manifestations, complications, and diagnostic methods, while WoS literature emphasizes pathogenesis and public health management. Effective prevention and control of brucellosis require interdisciplinary, cross-sectoral, and transnational cooperation.

Infectious diseases caused by viruses or bacteria pose a serious threat to human life and health system, such as influenza, COVID‐19, and sepsis. They are characterized by obstacles of pathogen clearance, immune dysfunction, or microbial dysbiosis. Conventional therapies are facing tremendous challenges such as antibiotic resistance and viral rapid mutations. Chinese herbal medicine‐derived extracellular vesicles‐like particles (CHM‐EVLPs), a novel strategy, have exhibited great potential for infectious disease therapy. These natural CHM‐EVLPs possess unique advantages in clearing pathogens, orchestrating host immune homeostasis, repairing tissue barrier, and mitigating microbial dysbiosis. Besides, they can deliver some therapeutic drugs for targeted therapy as nano carriers. Good biocompatibility and organotropism also endowed them satisfactory security. These advantages might assist CHM‐EVLPs overcome the limitations of traditional therapeutics. Thus, this review first summarizes the basic information of CHM‐EVLPs regarding preparation methods and bioactive components. Then, the pathological mechanisms of infectious diseases and the protective effects of CHM‐EVLPs through interaction with these mechanisms will be comprehensively discussed. Finally, future perspectives of CHM‐EVLPs for infectious diseases treatment are proposed. Overall, as a bridge connecting traditional herbal medicine and nanotechnology, CHM‐EVLPs offer a high‐efficiency, sustainable, and multitarget approach to treat infectious diseases.