Objective:To explore the diagnostic value of transvaginal color Doppler sonography (TVCDS) combined with serum allograft inflammatory factor-1 (AIF-1) and pyruvate kinase M2 type (PKM2) in cervical cancer.Methods:From Jan. 2022 to Jun. 2024, 168 patients with early cervical cancer who visited Taizhou Central Hospital were regarded as the cervical cancer group, and 96 patients with cervical precancerous lesions were regarded as the precancerous lesion group. All patients underwent TVCDS examination to obtain parameters such as peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI). ELISA method was used to detect serum AIF-1 and PKM2 levels. Kappa test was used to analyze the consistency between different diagnostic methods and pathological results. ROC curve was used to analyze the diagnostic value of serum AIF-1 and PKM2 levels for cervical cancer.Results:The cervical cancer group had manifestly higher proportions of irregular morphology, unclear boundaries, low echo ratio, and levels of PSV, EDV, AIF-1, and PKM2 than precancerous lesion group, and manifestly lower RI than precancerous lesion group ( P<0.05). The consistency analysis between TVCDS diagnosis of cervical cancer and pathological results showed a Kappa value of 0.674 ( P<0.05). The serum levels of AIF-1 and PKM2 in cervical cancer patients with a maximum tumor diameter of ≥ 4 cm, low differentiation, and vaginal infiltration were manifestly higher than those in patients with a maximum tumor diameter of < 4 cm, medium/high differentiation, and non vaginal infiltration ( P<0.05). The AUC of AIF-1 and PKM2 in the diagnosis of cervical cancer was 0.824 and 0.816, respectively, with diagnostic thresholds of 81.21 ng/L and 29.26 ng/mL. The consistency analysis of TVCDS combined with serum AIF-1 and PKM2 in the diagnosis of cervical cancer and pathological results showed a Kappa value of 0.918 ( P<0.05). The negative predictive value, accuracy, and sensitivity of TVCDS combined with serum AIF-1 and PKM2 in the diagnosis of cervical cancer were higher than those of each indicator alone, and the positive predictive value and specificity were higher than those of AIF-1 alone ( P<0.05) . Conclusion:TVCDS combined with serum AIF-1 and PKM2 has high accuracy and sensitivity in the diagnosis of cervical cancer, and their combination can serve as a potential method for clinical diagnosis of cervical cancer.

Objective:To study the risk factors and the molecular epidemiology characteristics for Carbapenem-resistant Enterobacteriaceae(CRE) colonization in neonatal inpatients in Shenzhen region, China, which provide reference for the prevention and control of clinical CRE infection.Methods:This study is a prospective case-control study.Anal samples from inpatients between January 2023 and December 2023 at Longgang Maternity and Child Institute of Shantou University Medical College and Shenzhen Children's Hospital were collected for screening CRE strain. Drug susceptibility test, modified Carbapenem Inactivation Method (mCIM) test, drug resistance-related gene sequencing and multilocus sequence typing (MLST) were performed for isolated CRE strains.Meanwhile, the clinical data were collected for analyzing the risk factors of CRE intestinal colonization by multivariate regression analysis.Results:A total of 1 517 patients were screened, 26 CRE(1.7%, 26/1 517) were identified which including 14 Escherichia coli(53.8%, 14/26), 11 Klebsiella pneumoniae(42.3%, 11/26), 1 Enterobacter cloacae(3.9%, 1/26). The predominant carbapenemase gene was New Delhi Metallo(NDM) (92.4%, 24/26), followed by Imipenem (IMP) (3.8%, 1/26) and Guiana extended spectrum gene (GES) (3.8%, 1/26).Among the carried NDM resistance genes, New Delhi Metallo 5 (NDM5) was the main one, accounting for 84.6% (22/26).The MLST typing of Escherichia coli was mainly Sequence Type 48 (ST48) (6/14), while that of Klebsiella pneumoniae was mainly Sequence Type 35 (ST35) (10/11). All CRE isolates were resistant to penicillin, penicillinase inhibitors, cephalosporins, ertapenem and imipenem.The resistance rates of Escherichia coli to amikacin, levofloxacin was 1/14, 4/14, respectively. All isolates of Klebsiella pneumoniae were sensitive to amikacin, and the resistance rate to levofloxacin is 1/11. Risk factors for CRE colonization include the older age, length of hospital stay, tracheal intubation, invasive respiration, lumbar puncture, Apgar <7 score, and exposure to antibiotics.Conclusions:NDM5 is the predominant resistant gene in CRE isolated from neonatal patients feces in Shenzhen region.It is necessary to strengthen the screening of CRE colonization in neonate for prevention and control of CRE infection.

Objective To investigate the influencing factors and predictive efficacy of joint function recovery in patients with tibial plateau fracture with intercondylar spine.Methods Fifty-eight patients with tibial plateau fracture with intercondylar spine admitted to the hospital from May 2020 to July 2022 were selected,all of whom were treated by surgery.The patients were followed up for 12 months after surgery,at the last follow-up,the patients were divided into two groups:poor prognosis group and good prognosis group according to Hospital for Special Surgery(HSS)score,and the clinical data of the two groups were compared.R software was used to build a nomogram prediction model based on the risk factors affecting the poor prognosis of postoperative joint function.Goodness of fit test,receiver operating characteristic(ROC)curve to assess risk nomogram model calibration and differentiation.Results All 58 patients were followed up for 12 months after operation.The HSS score at the last follow-up was 40-95 points,of which 19 were＜59 points.The results of univariate analysis showed that BMI,osteoporosis,preoperative ASA grade,skin and soft tissue injury,intercondylar spine fracture block free,and postoperative functional training may be correlated with poor prognosis of postoperative joint function(P＜0.05).Multivariate logistic regression analysis showed that BMI ≥23 kg/m2,osteoporosis,preoperative ASA grade Ⅲ to Ⅳ,skin and soft tissue injury,intercondylar spine fracture mass free and non-adherence to postoperative functional training were independent risk factors for poor prognosis of postoperative joint function(P＜0.05),there was no interaction among the risk factors(deviation=1.02,Pearson x2=0.98,R2=0.34,P＞0.05).A nomogram model was constructed based on BMI,osteoporosis,preoperative ASA grading,skin and soft tissue injury,intercondylar spine fracture block free,and postoperative functional training.Calibration results showed that the measured values were basically consistent with the predicted values.The results of the Bootstrap internal validation method showed that the sensitivity,specificity,and area under the ROC curve of this nomogram model for predicting poor postoperative joint function recovery in patients with tibial plateau fractures with intercondylar spinous fractures were 86.50％,72.40％,and 0.885,respectively.Conclusion BMI ≥ 23 kg/m2,osteoporosis,preoperative ASA grade,skin and soft tissue injury,intercondylar spine fracture fragment free,and non-adherence to postoperative functional training are risk factors for poor prognosis of postoperative joint function in patients with tibial plateau fracture with intercondylar spine fracture.The nomogram model constructed based on this has good accuracy and discrimination.

Objective:To explore the diagnostic value of transvaginal color Doppler sonography (TVCDS) combined with serum allograft inflammatory factor-1 (AIF-1) and pyruvate kinase M2 type (PKM2) in cervical cancer.Methods:From Jan. 2022 to Jun. 2024, 168 patients with early cervical cancer who visited Taizhou Central Hospital were regarded as the cervical cancer group, and 96 patients with cervical precancerous lesions were regarded as the precancerous lesion group. All patients underwent TVCDS examination to obtain parameters such as peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI). ELISA method was used to detect serum AIF-1 and PKM2 levels. Kappa test was used to analyze the consistency between different diagnostic methods and pathological results. ROC curve was used to analyze the diagnostic value of serum AIF-1 and PKM2 levels for cervical cancer.Results:The cervical cancer group had manifestly higher proportions of irregular morphology, unclear boundaries, low echo ratio, and levels of PSV, EDV, AIF-1, and PKM2 than precancerous lesion group, and manifestly lower RI than precancerous lesion group ( P<0.05). The consistency analysis between TVCDS diagnosis of cervical cancer and pathological results showed a Kappa value of 0.674 ( P<0.05). The serum levels of AIF-1 and PKM2 in cervical cancer patients with a maximum tumor diameter of ≥ 4 cm, low differentiation, and vaginal infiltration were manifestly higher than those in patients with a maximum tumor diameter of < 4 cm, medium/high differentiation, and non vaginal infiltration ( P<0.05). The AUC of AIF-1 and PKM2 in the diagnosis of cervical cancer was 0.824 and 0.816, respectively, with diagnostic thresholds of 81.21 ng/L and 29.26 ng/mL. The consistency analysis of TVCDS combined with serum AIF-1 and PKM2 in the diagnosis of cervical cancer and pathological results showed a Kappa value of 0.918 ( P<0.05). The negative predictive value, accuracy, and sensitivity of TVCDS combined with serum AIF-1 and PKM2 in the diagnosis of cervical cancer were higher than those of each indicator alone, and the positive predictive value and specificity were higher than those of AIF-1 alone ( P<0.05) . Conclusion:TVCDS combined with serum AIF-1 and PKM2 has high accuracy and sensitivity in the diagnosis of cervical cancer, and their combination can serve as a potential method for clinical diagnosis of cervical cancer.

Objective To investigate the influencing factors and predictive efficacy of joint function recovery in patients with tibial plateau fracture with intercondylar spine.Methods Fifty-eight patients with tibial plateau fracture with intercondylar spine admitted to the hospital from May 2020 to July 2022 were selected,all of whom were treated by surgery.The patients were followed up for 12 months after surgery,at the last follow-up,the patients were divided into two groups:poor prognosis group and good prognosis group according to Hospital for Special Surgery(HSS)score,and the clinical data of the two groups were compared.R software was used to build a nomogram prediction model based on the risk factors affecting the poor prognosis of postoperative joint function.Goodness of fit test,receiver operating characteristic(ROC)curve to assess risk nomogram model calibration and differentiation.Results All 58 patients were followed up for 12 months after operation.The HSS score at the last follow-up was 40-95 points,of which 19 were＜59 points.The results of univariate analysis showed that BMI,osteoporosis,preoperative ASA grade,skin and soft tissue injury,intercondylar spine fracture block free,and postoperative functional training may be correlated with poor prognosis of postoperative joint function(P＜0.05).Multivariate logistic regression analysis showed that BMI ≥23 kg/m2,osteoporosis,preoperative ASA grade Ⅲ to Ⅳ,skin and soft tissue injury,intercondylar spine fracture mass free and non-adherence to postoperative functional training were independent risk factors for poor prognosis of postoperative joint function(P＜0.05),there was no interaction among the risk factors(deviation=1.02,Pearson x2=0.98,R2=0.34,P＞0.05).A nomogram model was constructed based on BMI,osteoporosis,preoperative ASA grading,skin and soft tissue injury,intercondylar spine fracture block free,and postoperative functional training.Calibration results showed that the measured values were basically consistent with the predicted values.The results of the Bootstrap internal validation method showed that the sensitivity,specificity,and area under the ROC curve of this nomogram model for predicting poor postoperative joint function recovery in patients with tibial plateau fractures with intercondylar spinous fractures were 86.50％,72.40％,and 0.885,respectively.Conclusion BMI ≥ 23 kg/m2,osteoporosis,preoperative ASA grade,skin and soft tissue injury,intercondylar spine fracture fragment free,and non-adherence to postoperative functional training are risk factors for poor prognosis of postoperative joint function in patients with tibial plateau fracture with intercondylar spine fracture.The nomogram model constructed based on this has good accuracy and discrimination.

Exosomes are small vesicles commonly found in bodily fluids such as blood, urine, ascites, and breast milk. As essential mediators of intercellular communication, exosomes play pivotal roles in physiological and pathological processes including material transport, signal transduction, homeostasis regulation, immune response, and angiogenesis. They are promising biomarkers for disease diagnosis and key carriers for therapeutic drug delivery. Longitudinal tracking of exosome biodistribution, elucidating their migratory routes and homing effects, determining optimal delivery routes and therapeutic dosages, and evaluating implantation in target tissues are crucial for better understanding their mechanisms of action and guiding clinical applications. Magnetic resonance imaging (MRI), as a non-invasive and repeatable imaging technique, offers an ideal approach for exosome tracking. By labeling exosomes with specific contrast agents or tracers and detecting them via MRI, researchers can trace exosomes in vivo. This facilitates advancements in exosome-based nanomedicine and accelerates the clinical translation of exosome diagnostics and therapeutics.
Exosomes/metabolism* ; Humans ; Magnetic Resonance Imaging/methods* ; Contrast Media ; Animals ; Tissue Distribution

Objective:To study the risk factors and the molecular epidemiology characteristics for Carbapenem-resistant Enterobacteriaceae(CRE) colonization in neonatal inpatients in Shenzhen region, China, which provide reference for the prevention and control of clinical CRE infection.Methods:This study is a prospective case-control study.Anal samples from inpatients between January 2023 and December 2023 at Longgang Maternity and Child Institute of Shantou University Medical College and Shenzhen Children's Hospital were collected for screening CRE strain. Drug susceptibility test, modified Carbapenem Inactivation Method (mCIM) test, drug resistance-related gene sequencing and multilocus sequence typing (MLST) were performed for isolated CRE strains.Meanwhile, the clinical data were collected for analyzing the risk factors of CRE intestinal colonization by multivariate regression analysis.Results:A total of 1 517 patients were screened, 26 CRE(1.7%, 26/1 517) were identified which including 14 Escherichia coli(53.8%, 14/26), 11 Klebsiella pneumoniae(42.3%, 11/26), 1 Enterobacter cloacae(3.9%, 1/26). The predominant carbapenemase gene was New Delhi Metallo(NDM) (92.4%, 24/26), followed by Imipenem (IMP) (3.8%, 1/26) and Guiana extended spectrum gene (GES) (3.8%, 1/26).Among the carried NDM resistance genes, New Delhi Metallo 5 (NDM5) was the main one, accounting for 84.6% (22/26).The MLST typing of Escherichia coli was mainly Sequence Type 48 (ST48) (6/14), while that of Klebsiella pneumoniae was mainly Sequence Type 35 (ST35) (10/11). All CRE isolates were resistant to penicillin, penicillinase inhibitors, cephalosporins, ertapenem and imipenem.The resistance rates of Escherichia coli to amikacin, levofloxacin was 1/14, 4/14, respectively. All isolates of Klebsiella pneumoniae were sensitive to amikacin, and the resistance rate to levofloxacin is 1/11. Risk factors for CRE colonization include the older age, length of hospital stay, tracheal intubation, invasive respiration, lumbar puncture, Apgar <7 score, and exposure to antibiotics.Conclusions:NDM5 is the predominant resistant gene in CRE isolated from neonatal patients feces in Shenzhen region.It is necessary to strengthen the screening of CRE colonization in neonate for prevention and control of CRE infection.

Objective:To establish and assess the quality control and improvement system for metabolic and bariatric surgery in Beijing.Methods:Based on relevant documents from the National Health Commission and the Beijing Municipal Health Commission,and referencing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) by the American Society for Metabolic and Bariatric Surgery,a quality control system was developed under the Beijing Quality Control and Improvement Center of Metabolic and Bariatric Surgery. The system incorporated on-site evaluations,data registration,and specialized training. From May to December 2023,on-site assessments were conducted at 21 hospitals in Beijing performing bariatric surgery,evaluating personnel qualifications,infrastructure,clinical workflows,and postoperative follow-up. A quality control database was created to collect real-time surgical data,and training was provided for data entry and professional skills. Assessment results were classified as excellent,qualified,or needing improvement,with rectification suggestions offered and follow-up visits conducted to track progress.Results:All 21 hospitals achieved a 100% compliance rate for surgical indications, 16 (76.2%) met standardized surgical operation criteria,and 14 (66.7%) had standardized postoperative management. However,only 5 (23.8%) achieved a 12-month postoperative follow-up rate of ≥60%,and 4 (19.1%) had established specialized databases. Key challenges included insufficient specialized staffing (19.1%), lack of multidisciplinary collaboration (47.6%), inadequate equipment (57.1%), and low follow-up rates (57.1%). The database collected data from over 2 000 patients across 111 fields. After rectification, specialized database coverage rose to 61.9% (13 hospitals). Multi-level training programs developed backbone physicians and specialized nurses,significantly addressing the shortage of specialized personnel.Conclusion:The quality control system established in this study,through the integration of on-site evaluation,data registration,and specialized training,effectively enhances the standardization of surgical practices and data management capabilities.

Objective:To establish and assess the quality control and improvement system for metabolic and bariatric surgery in Beijing.Methods:Based on relevant documents from the National Health Commission and the Beijing Municipal Health Commission,and referencing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) by the American Society for Metabolic and Bariatric Surgery,a quality control system was developed under the Beijing Quality Control and Improvement Center of Metabolic and Bariatric Surgery. The system incorporated on-site evaluations,data registration,and specialized training. From May to December 2023,on-site assessments were conducted at 21 hospitals in Beijing performing bariatric surgery,evaluating personnel qualifications,infrastructure,clinical workflows,and postoperative follow-up. A quality control database was created to collect real-time surgical data,and training was provided for data entry and professional skills. Assessment results were classified as excellent,qualified,or needing improvement,with rectification suggestions offered and follow-up visits conducted to track progress.Results:All 21 hospitals achieved a 100% compliance rate for surgical indications, 16 (76.2%) met standardized surgical operation criteria,and 14 (66.7%) had standardized postoperative management. However,only 5 (23.8%) achieved a 12-month postoperative follow-up rate of ≥60%,and 4 (19.1%) had established specialized databases. Key challenges included insufficient specialized staffing (19.1%), lack of multidisciplinary collaboration (47.6%), inadequate equipment (57.1%), and low follow-up rates (57.1%). The database collected data from over 2 000 patients across 111 fields. After rectification, specialized database coverage rose to 61.9% (13 hospitals). Multi-level training programs developed backbone physicians and specialized nurses,significantly addressing the shortage of specialized personnel.Conclusion:The quality control system established in this study,through the integration of on-site evaluation,data registration,and specialized training,effectively enhances the standardization of surgical practices and data management capabilities.

AIM: To investigate the influencing factors of corneal edema after phacoemulsification combined with intraocular lens(IOL)implantation in middle-aged and elderly patients with diabetic cataract, reducing postoperative complications of cataract in such patients.METHODS: A total of 198 middle-aged and elderly patients(226 eyes)with diabetic cataract who underwent phacoemulsification combined with IOL implantation in Zhongxian People's Hospital of Chongqing from August 2021 to June 2023 were retrospectively analyzed, and they were divided into corneal edema group(n=53)and non-corneal edema group(n=173)according to their postoperative corneal edema. Baseline data were collected and compared between the two groups, and the operation-related indexes such as preoperative corneal thickness, endothelial cell density, operation time and effective phaco time were recorded and compared between the two groups. The influencing factors of corneal edema were analyzed by multivariate Logistic model, and the risk nomogram was drawn.RESULTS: The age distribution of patients ≥60 years old in the corneal edema group was significantly higher than that in the non-corneal edema group, the duration of diabetes mellitus in the corneal edema group was significantly longer than that in the non-corneal edema group, and the lens nuclear hardness grade was significantly higher than that in the non-corneal edema group(all P<0.05). The changes in endothelial cell density in the corneal edema group were significantly higher than those in the non-corneal edema group(P<0.05); compared with the non-corneal edema group, the patients in the corneal edema group had a longer operation time and a longer effective phaco time(all P<0.05). Age, duration of diabetes mellitus, lens nuclear stiffness grade, operation time and effective phaco time were the risk factors for corneal edema after surgery(all P<0.05). When the total score of the patient risk nomogram is 150 points, the risk of corneal edema after surgery is about 65%.CONCLUSION: The factors influencing the occurrence of corneal edema after phacoemulsification combined with IOL implantation include age, duration of diabetes, lens nuclear stiffness, operation duration and effective phaco time.