A previous study found that a biocontrol bacterium, Bacillus pumilus HR10, inhibited the Sphaeropsis shoot blight disease of pine, and the fermentation broth of HR10 strain contained protein antifungal substances. The optimal formulation of the fermentation medium for the antagonistic substance of B. pumilus HR10 was finally obtained by single-factor test, Packett-Burman test, steepest ascent test and Box-Behnken Design (BBD) response surface test, and the best formulation of the fermentation medium for the antagonistic substance of B. pumilus HR10 was 12 g/L corn meal, 15 g/L beef extract and 13 g/L magnesium sulfate, with a predicted bacterial inhibition rate of 89%. The fermentation filtrate of B. pumilus HR10 cultured with the optimized medium formulation was verified to have an inhibition rate of (87.04 ± 3.2) % on the growth of Sphaeropsis sapinea by three replicate tests. The antagonistic crude protein of B. pumilus HR10 were further isolated and identified using HiTrap Capto Q strong Ion-Exchange Chromatography and LC–MS-MS, and it was speculated that glycoside hydrolase (Ghy), beta-glucanase (Beta), arabinogalactan endonuclease β-1,4-galactanase (Arab), and immunosuppressant A (ImA) are proteins with antagonistic activity against S. sapinea in the B. pumilus HR10.

Background: Postoperative intensive care unit (ICU) admission affects 15% to 20% of surgical patients and represents a major source of morbidity and health care costs. Current anesthetic dosing relies on empirical guidelines rather than individualized risk assessment. We developed a counterfactual dose-response model to identify optimal fentanyl-propofol combinations. Objective: This study aimed to develop and evaluate a stratified, causal machine learning framework using electronic health record data to identify optimal fentanyl-propofol dose combinations and predict postoperative ICU admission risk, enabling precision anesthesia and individualized clinical decision support. Methods: We analyzed perioperative electronic health records of 67,134 surgical procedures from UC Irvine Medical Center (2017‐2022). A hierarchical learning framework was used to estimate causal effects while controlling for confounding variables. A total of 6 dose-sensitive subgroups were identified through stratified analysis. The primary end point was postoperative ICU admission. Results: High-risk combinations (fentanyl >5 mcg/kg with propofol <1 mg/kg) increased ICU admissions’ absolute risk difference by 36% (absolute risk increase; 95% CI 0.351-0.509; P <.001). A total of 6 patient subgroups demonstrated distinct dose-response patterns, with populations considered vulnerable (high glucose, elevated creatinine) showing elevated risk even at standard doses. The optimal dose range for decision-making was determined to be 1.25 to 4.25 mg/kg for propofol and 3.5 to 4.0 mcg/kg for fentanyl. Conclusions: Fentanyl-propofol combinations exhibit complex, nonlinear dose-response relationships with ICU admission risk. High-dose combinations markedly increase risk through synergistic effects, while specific patient subgroups require enhanced monitoring even at standard doses. These findings support the development of individualized dosing algorithms and risk assessment tools that could inform future decision support tools aimed at reducing postoperative ICU use, although their predictive performance and clinical impact would require external validation.

Background: There has been a surge in prescribing opioids for pain-related conditions and it has resulted in a prescription "opioid epidemic." It is critical for researchers and clinicians to explore nonpharmacological approaches to manage pain and mitigate the reliance on opioid analgesics. Acupuncture could be an effective therapy to modulate pain. This study examined the effects on regional pressure pain threshold (PPT) following needling of the Small Intestine 3 (SI3 -Houxi) acupoint in healthy participants.Methods: In a randomized, three-arm cross-over design study, 32 healthy participants enrolled between November 2018 and March 2019, received 3 different acupuncture interventions, in different sequences, to the right hand at SI3: (1) SI3 without manual manipulation (SI3m-); (2) SI3 with manual needle manipulation (SI3m+); and (3) sham laser, to assess changes in PPT following the interventions. The mean change in PPT was measured at 10 different regional acupoint sites using an algometer. All PPT scores were reported as a percentage change from the mean preintervention value, the mean of the 3 PPT measurements obtained prior to receiving the intervention.Results: The SI3m+ and SI3m- interventions for the 31 participants (drop out n=1), showed that the postintervention mean % PPT scores were significantly elevated compared to the control (sham laser; p < 0.001). The SI3m+ intervention significantly increased % PPT compared with the SI3m- intervention (p < 0.001).Conclusion: The needling intervention was an important contributor raising regional PPT in healthy participants.

Background: Restless Legs Syndrome (RLS) significantly impairs sleep and daily life. Conventional treatments often cause side effects leading patients to seek alternative treatments like Chinese Herbal Medicine (CHM). A systematic review and meta-analysis of studies which used CHM treatment for RLS will facilitate the evaluation of its efficacy and safety.Methods: Randomized controlled trials will be retrieved systematically from electronic databases including PubMed, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang and Chongqing Value-added Information Platform. Comparisons between the effects of CHM (as monotherapy or adjunct therapy), placebos, and conventional interventions will be made. Two reviewers will independently perform study selection, data extraction, and risk of bias assessments using the Cochrane RoB 2.0 tool. The primary outcomes will be RLS symptom severity (e.g., IRLSSG rating scale), quality of life, and adverse events. Data will be pooled using a random-effects meta-analysis, and the overall certainty of evidence will be assessed for quality of evidence and strength of recommendation using the Grading of Recommendations, Assessment, Development, and Evaluation system.Conclusion: This review aims to synthesize high-quality evidence to determine the effectiveness and safety of CHM treatment for RLS, provide valuable insights for clinicians, patients, and policymakers, and identify gaps for future research.

Background: The needling sensation known as deqi is theorized to be integral to acupuncture's effects, yet its correlation with clinical improvement requires further objective validation through controlled studies. Objectives: This human experimental study aimed to examine how pressure pain threshold (PPT) changes correlate with subjective deqi sensations following three standardized protocols, two needling interventions, and a sham laser (SL), in healthy volunteers. We hypothesized that the manual needle manipulation would enhance deqi more than non-manipulation needling or the SL. Materials and Methods: This randomized, three-intervention crossover trial evaluated 32 healthy participants who received three distinct SI3 acupoint interventions on the right hand in varying sequences: (1) non-manipulated needling (SI3m ⁻ ), (2) manually stimulated needling (SI3m ⁺ ), and (3) SL control. Outcomes included post-intervention changes in PPT and deqi visual analog scale (VAS) and the Massachusetts General Hospital Acupuncture Sensation Scale (MASS). The present research utilized a linear mixed-effects model (LMM) for data analysis. Results: Of 32 participants, 31 completed all interventions. Both SI3m ⁺ and SI3m ⁻ significantly increased PPT compared to SL, with SI3m ⁺ being most effective. Meanwhile, deqi , as measured by both MASS and VAS, differed between the two needling interventions and SL acupuncture, but its intensity did not correlate with the observed analgesic effect. Conclusion: SI3 needling was associated with statistically higher deqi scores than SL and did not show an association between deqi intensity and the observed PPT changes. VAS alone may serve as a practical tool for measuring deqi in experimental settings.