Objective:To explore the role of combined detection of cell free BMPR1A and PLAC8 gene methylation in plasma in predicting postoperative recurrence of hepatocellular carcinoma.Methods:Case series study. Patients with stage Ⅰ-Ⅳ hepatocellular carcinoma who were treated at the Third Affiliated Hospital of Sun-Yat-sen University from January 2022 to July 2023 were selected. All enrolled patients underwent alpha fetoprotein (AFP) and imaging assessments 1 month, 3 months, 6 months, 9 months, and 12 months after treatment. Simultaneously, peripheral blood of patients was extracted for plasma circulating tumor DNA (ctDNA) methylation detection, and the results of free BMPR1A and PLAC8 gene methylation detection in patients′ plasma after treatment were compared with the positive rate of traditional tumor marker AFP detection. Draw the receiver operating characteristic curve (ROC) of the subjects to demonstrate the effectiveness of this method in predicting the recurrence of hepatocellular carcinoma. Based on the results of cell free DNA methylation and whether AFP is more than 7 μg/L, hepatocellular carcinoma patients were divided into high-risk methylation group (12 cases), low-risk methylation group (21 cases), high-risk AFP group (15 cases), and Kaplan Meier survival analysis was performed on them.Results:The sensitivity and specificity of combined detection of free BMPR1A PLAC8 gene methylation in plasma for predicting liver cancer recurrence were 66.7% and 88.9%, respectively. The area under curve (AUC) of BMPR1A PLAC8 gene methylation detection for liver cancer recurrence were 0.770 and 0.778, and the AFP was 0.522 in ROC curve analysis. Compared to imaging examinations, cell free DNA methylation detection can detect the recurrence of hepatocellular carcinoma on average by 58.3 days in advance(53.8 days vs 112.1 days). The progression free survival rate of the high-risk group based on free DNA methylation prediction at 400 days was 22.2%, significantly lower than the low-risk group (76.2%, P<0.001). Conclusion:Compared to AFP, detecting the methylation of BMPR1A and PLAC8 genes can predict the recurrence of hepatocellular carcinoma more accurately, making it a practical method for monitoring liver cancer recurrence.

Objective:To validate the performance of a multi-omics combined test for early screening of high-risk liver cancer populations.Methods:173 high-risk patients with liver cancer were prospectively screened in a real-world setting, and 164 cases were finally enrolled. B-ultrasound, alpha-fetoprotein (AFP), and HCC screens were conducted in all patients. A multi-omics early screening test was performed for liver cancer in combination with multi-gene methylation, TP53/TERT/CTNNB1 mutations, AFP, and abnormal prothrombin (PIVKA-II). Differences in rates were compared using the chi-square test, adjusted chi-square test, or Fisher's exact probability method for count data. A non-parametric rank test (Mann-Whitney) was used to compare the differences between the two groups of data.Results:The HCCscreen detection had a sensitivity of 100% for liver cancer screening, 93.8% for liver cancer and precancerous diseases, 34.1% for positive predictive value, 99.2% for negative predictive value, and 0.89 for an area under the curve (AUC). Parallel detection of AFP, AFP+B-ultrasound, and methylation+mutation had a sensitivity/specificity and AUC of 31.3%/88.5% (AUC=0.78), 56.3%/88.2% (AUC=0.86), and 81.3%/82.4 % (AUC=0.84). At the same time, the disease severity range was significantly correlated with the methylation+mutation score, HCCscreen score, or positive detection rate (PDR). There was no significant correlation between AFP serum levels and methylation+mutation or HCCscreen scores, while there was a significant linear correlation between methylation+mutation scores and HCCscreen scores ( r ?=?0.73, P ?

Hepatitis E is a globally distributed infection that varies in seroprevalence between developed and developing regions.In the less developed regions of Asia and Africa,a high seropositivity rate has been reported for hepatitis E virus(HEV)antibodies.Although acute hepatitis E is often self-limited and has a favorable prognosis,some populations experience severe manifestations,which may progress to liver failure.Moreover,some immunocompromised patients are at risk of developing chronic HEV infection and cirrhosis.Proactive screening,reducing misdiagnosis,improving patient management,timely anti-viral therapy for severe and chronic cases,and vaccination of high-risk groups are important measures to reduce the morbidity of hepatitis E.This review focused on the clinical presentation,management,and prevention of hepatitis E.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective:To explore the feasibility and safety of integrating the geriatric intensive care unit (GICU) into the friendly management model of the elderly critically ill patients.Methods:A prospective controlled study was conducted. Patients with elderly critically ill admitted to the GICU and the general intensive care unit (ICU) of Jintan First People's Hospital of Changzhou from December 2021 to May 2023 were enrolled. Patients in the ICU group received the traditional intensive care and nursing mode. In addition to the ICU group basic medical care measures, the patients in the GICU group were treated with friendly management models such as flexible visitation, diagnosis and treatment environment optimization, caring diagnosis and treatment, and family participation in hospice care according to their condition assessment. The gender, age, main diagnosis, and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) at admission were recorded and compared between the two groups. During the treatment period, the incidence of nosocomial infection, unplanned extubation, falling out of bed/fall, unexpected readmission to ICU/GICU, and ICU/GICU mortality, the incidence of post-intensive care syndrome (PICS), the satisfaction rate of patients/families with medical care, and the satisfaction rate of patients/families with diagnosis and treatment environment were recorded and compared between the two groups.Results:According to the admission criteria for ICU and GICU, as well as the willingness of the patients and/or their families, a total of 59 patients were finally included in the ICU group, and 48 patients were enrolled in the GICU group. There were no significantly differences in gender, age, main diagnosis and APACHEⅡ score between the two groups, and there were comparability. There were no significantly differences in the incidence of adverse events such as nosocomial infection [13.6% (8/59) vs. 12.5% (6/48)], unplanned extubation [5.1% (3/59) vs. 6.2% (3/48)], falling out of bed/fall [3.4% (2/59) vs. 0% (0/48)], unexpected readmission to ICU/GICU [8.5% (5/59) vs. 10.4% (5/48)], and ICU/GICU mortality [6.8% (4/59) vs. 6.2 (3/48)] between the ICU group and GICU group (all P > 0.05). Compared with the ICU group, the incidence of PICS in GICU group was significantly lower [8.3% (4/48) vs. 25.4% (15/59), P < 0.05], the satisfaction rate of patients/families with medical care [89.6% (43/48) vs. 74.6% (44/59)] and satisfaction rate of patients/families with diagnosis and treatment environment [87.5% (42/48) vs. 67.8% (40/59)] were significantly increased (both P < 0.05). Conclusion:The use GICU as a friendly management model for elderly critically ill patients is feasible and safe, and it is worthy of further exploration and research.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To explore the reform path of clinical laboratory technical talents training in local universities under the background of "New Medicine".Methods:The present situation of medical laboratory technical personnel training under the background of "New Medicine" was analyzed, and the teaching mode, teaching platform and practical teaching were reformed according to the reality of Guizhou Medical University.Results:An open education system of "healthcare-education collaboration and academia-industry alliances" and the talent training mode of "three-oriented drive, four-sided integration" had been formed, which improved the training quality and provided a large number of qualified medical laboratory technical undergraduate talents to the grass-roots of Guizhou Medical System.Conclusion:The reform and practice of applied talent training in Guizhou Medical University can be used as a reference for local colleges and universities to educate applied medical laboratory technical talents.

Objective:To explore the distribution of airborne pollen in summer and autumn in Taiyuan, analyze the correlation between pollen characteristics, meteorological factors and allergic sensitization, and provide for the prevention and treatment of allergic diseases in this. Methods:The gravity sedimentation method was used to investigate the types, quantities and dispersion patterns of airborne pollen in Taiyuan City from July 21, 2022 to October 20, 2022. he meteorological and patient information was collected during the same period SPSS 26.0 software. Results:①A total of 17 118 pollen grains were collected, and identified as 14 families, 10 genera, and 4 species. The peak period for pollen dispersal in summer and autumn in Taiyuan City from late August to early September. airborne pollen Artemisia（66.62%）, Cannabis/Humulus（17.79%）, Sophora japonica（8.18%）, Chenopodiaceae/Amaranthaceae（2.83%）, Gramineae（2.11%）. ②The concentration of airborne pollen in Taiyuan City positively correlated with the average temperature（5-20℃） and maximum temperature（11-30℃） within a certain range（r=0.547, 0.315, P<0.05）. ③The content of airborne pollen in Taiyuan City positively correlated with the number of visits and allergen positive rate of patients with allergic rhinitis（AR） in our hospital（r=0.702, 0.747, P<0.05）. Conclusion:The peak period for airborne pollen dispersal during the summer and autumn seasons in Taiyuan City from late August to early September. The dominant pollen is Artemisia, Cannabis/Humulus, Sophora japonica, Chenopodiaceae/Amaranthaceae, Gramineae, and the absolute advantage pollen is Artemisia. Meteorological factors pollen content. Within a certain range, temperature the diffusion and transportation of pollen. The number of pollen grains the number of visits, which can serve as an environmental warning indicator for AR patients to take preventive, thereby reducing the risk of allergies.
Male ; Humans ; Seasons ; Pollen ; Rhinitis, Allergic ; Allergens ; Cities

Hepatitis B virus (HBV) infection is closely associated with the adverse events such as liver cirrhosis, liver cancer, and liver failure and remains a serious threat to human health. Pegylated interferon is an indispensable drug for the treatment of chronic hepatitis B (CHB), and interferon-stimulated genes are associated with a variety of viruses, but few studies have mentioned their association with hepatitis B and their predictive effect after the treatment of hepatitis B with interferon. This article introduces the predictive factors for interferon treatment of CHB and summarizes the association of interferon-stimulated genes with hepatitis B and their predictive effect, so as to provide a reference for clinical work and basic research.

The normal function of vascular endothelial cells is an important foundation for maintaining vascular permeability， restricting inflammatory activities of the vascular wall， and balancing the coagulation and fibrinolytic system. Endothelial dysfunction caused by persistent damage from pathological factors is considered as an early and prominent event of diabetic macroangiopathy. In traditional Chinese medicine， the classical theory of "restraining excessiveness to acquire harmony" was originally a condensed generalization of the rule of generation， restriction， replacement and evolution in the natural world， revealing the internal regulation mechanism of the stable operation of things. Then it gradually evolved into an important rule to explain the physiological phenomena and pathological mechanism of human body and guide the treatment. Corresponding to the nature， the body homeostasis also requires to achieve a state of strong viscera function and inexhaustible Qi and blood generation under the rule of restriction and generation. The pathogenesis of diabetic macroangiopathy is the process of "the predominant one failing to restrict and the hyperactive one becoming harmful". The loss of restriction and generation of the five organs leads to powerless Qi transformation and， as a result， the Qi， blood and body fluid cannot be dispersed. Therefore， the Qi， blood and body fluid turn into phlegm and blood stasis， such as glucose and lipid metabolism disorder， oxidative stress， inflammatory response and high blood viscosity， and finally block the veins. Excessive phlegm and blood stasis cannot be resolved， instead they become harmful and invade the blood vessel， causing endothelial dysfunction and further resulting in diabetic macroangiopathy. Under the guidance of the theory of "restraining excessiveness to acquire harmony"， the method of "harmonizing viscera， eliminating pathogen and removing turbidity" can effectively regulate the function of vascular endothelial cells， thus playing a positive role in preventing and treating diabetic macroangiopathy. The mechanism may be related to reducing oxidative stress， inhibiting inflammation， limiting vascular smooth muscle proliferation， and reducing platelet adhesion.