Data were expressed as mean ± standard deviation for continuous variables, and unpaired Student's t-test was performed to determine intergroup differences between mean values. Results ASP team recommended 184 interventions [overall acceptance rate of 82.6% (152/184)]. There was no significant difference in demographics, and age-adjusted Charlson co-morbidity index between the 2 groups. Accepted group had shorter duration of therapy by 1.67 days (4.99±2.50 days vs 6.66±2.34 days; p less then 0.01) . Though not statistically significant, patients in the accepted group had a shorter PLOS by 2 days (22.5±22.2 days vs 24.5±51.4 days; p=0.83). There were no significant differences in 14-day mortality and readmission rates between the 2 groups. Conclusion In neurological patients with no clinical evidence of bacterial infections, ASP interventions to discontinue empiric antibiotics were not associated with increased mortality and readmissions, but were associated with significant reduction in duration of therapy.Malathion is an organophosphate insecticide used in agriculture and for controlling vector-borne diseases such as Zika. Humans can be exposed to malathion by means of ingestion of contaminated food. The juvenile and peripubertal periods are a large window of vulnerability to the action of toxic agents. The aim of the present study was to evaluate the effects of low doses of malathion during the development of testes in the juvenile and peripubertal periods in rats. For this purpose, 45 male Wistar rats (postnatal day (PND) 25) were assigned to 3 experimental groups and treated for 40 days. The animals were exposed daily to malathion 10 mg/kg (M10 group) or 50 mg/kg (M50 group) diluted in 0.9 % saline via gavage. The control group received only the vehicle. On the 40th experimental day, the rats were anaesthetized and euthanized. The blood was collected for determination of testosterone concentration. The testes were removed and weighed. Spermatozoa from the vas deferens were used for sperm morphological analysis. The testes were used for evaluation of sperm count and oxidative stress status to determine the inflammatory profile and analysis of tissue constitution. The results showed that both malathion doses reduced the sperm count and increased the number of abnormal sperms. Furthermore, both doses altered the spermatogenetic process, delayed spermiogenesis, reduced the Leydig and Sertoli cell number and increased the thickness of tunica albuginea. The M10 group presented increased IL-10 levels and reduced GSH levels. These parameters did not change in the M50 group. However, the M50 group showed an increase in the number of abnormal seminiferous tubules, a decrease in plasma testosterone concentration and an increase in lipid peroxidation in the testes. In conclusion, the exposure to low doses of malathion during juvenile and peripubertal development resulted in testicular toxicity and compromised the testicular morphology and function.Tangeretin is a polymethoxyflavone concentrated in citrus peels and has several biological activities. This study examined whether tangeretin improved reproductive dysfunction in Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME)-induced hypertensive rats. Male Sprague-Dawley rats received L-NAME to induce hypertension and reproductive dysfunction for 5 w and were treated with tangeretin (15 or 30 mg/kg) or sildenafil citrate (10 mg/kg) for the final two weeks. Mean arterial pressure (MAP), intracavernosal pressure (ICP) response to cavernous nerve stimulation, endothelial nitric oxide synthase (eNOS), Angiotensin II receptor type 1 (AT1R) and gp91phox protein expressions and malondialdehyde (MDA) level in penile tissues were measured. Sperm concentrations and motility, seminiferous tubule morphology, serum testosterone, testicular eNOS and steroidogenic acute regulatory protein (StAR) expression were evaluated. Aortic superoxide generation, plasma and testicular MDA and plasma nitrate/nitrite levels were determined. Tangeretin reduced blood pressure and increased the maximum ICP/MAP associated with suppression of AT1R/gp91phox and upregulation of eNOS expression in hypertensive rats (P less then 0.05).  https://www.selleckchem.com/products/azd9291.html  Furthermore, improvement of sperm quality relevant to increased testicular eNOS and StAR expression was found in tangeretin treated rats (P less then 0.05). Changes in seminiferous tubule morphology in hypertensive rats were recovered by tangeretin (P less then 0.05). It increased testosterone levels and reduced oxidative stress biomarkers and raised plasma nitrate/nitrite levels in L-NAME rats (P less then 0.05). In conclusion, tangeretin improved maximum ICP/MAP and testicular dysfunction and morphology in rats treated with L-NAME. The molecular mechanisms are mediated by modulations of penile eNOS and AT1R/gp91phox expressions and testicular eNOS and StAR expression.Ethnopharmacological relevance Liver fibrosis is an outcome of many chronic liver diseases and often results in cirrhosis, liver failure, and even hepatocarcinoma. Xiaoyaosan decoction (XYS) as a classical Traditional Chinese Medicine (TCM) formula is used to liver fibrosis in clinical practice while its mechanism is unclear. Aim of the study The aim of this study was to investigate the anti-fibrosis effect of XYS and to explore the molecular mechanisms by combining network pharmacology and transcriptomic technologies. Materials and methods The carbon tetrachloride (CCl4)-induced liver fibrosis rat were treated with three doses of XYS. The liver fibrosis and function were evaluated by histopathological examination and serum biochemical detection. The fibrosis related protein a-SMA and collagen I were assessed by Western blot. Different expressed genes (DEGs) between XYS-treated group and model group were analysed. The herb-component-target network was constructed combined the network pharmacology. The predictct may occur via the TGFβ1/Smad and Akt/FoxO signaling pathways.Objectives Multiple high-flow arteriovenous malformations (AVMs) are the hallmark of Parkes-Weber syndrome (PWS). Surgical resection has historically shown poor outcomes with PWS. The aim of this study was to assess the management of PWS in the current era. Methods A retrospective review was performed from 2004 to 2017 on all patients presenting to a single institution for the management of PWS. Presentation, techniques, complications, and outcomes were reviewed. Results Fourteen patients (50% male) with PWS were seen at our institution and mean age was 19.9 years (range, 4.7-68.8). The lower extremity was affected in 12 (86%) and the upper extremity in 2 (14%) patients. All patients presented with pain and swelling in the affected limb. Seven (50%) patients presented with ulcers, of which 3 (43%) had extensive wounds. Five (36%) patients had echocardiographic evidence of high-output cardiac failure. All patients underwent angiography with the intention to treat. Three (21%) patients were found to have diffuse arteriovenous communication with no discrete AVM nidus and thus did not undergo intervention.