Objective To compare the clinical characteristics of pneumococcal meningitis in different age groups, and to provide a basis for early diagnosis of pneumococcal meningitis. Methods Cerebrospinal fluid and/or serum samples were collected from 1742 suspected cases of meningitis in Baoji, Shaanxi Province from August 2013 to July 2019. Streptococcus pneumoniae was detected by isolation culture and real-time fluorescence quantitative polymerase chain reaction. Retrospective analysis of clinical manifestations, biochemical indicators and other information of laboratory confirmed cases was conducted by χ² test or Fisher's exact test. Results A total of 1742 samples of encephalitis or meningitis cases were detected, and 41 cases were confirmed as laboratory-confirmed Streptococcus pneumoniae infection. Among them, there were 12 cases (29.27%) in the infant group, 14 cases (34.15%) in the child group, and 15 cases (36.59%) in the adult group. The proportion of the adults with headache was significantly higher than that of the infants (χ²=11.408，P＜0.017). The proportion of the adults with consciousness disorder, elevated white blood cells and elevated neutrophils were significantly higher than those in the infant and the child groups（Fisher's exact test, P＜0.017；χ² =6.428，P＜0.017；χ² =10.898，P＜0.017；χ² =6.421，P＜0.017；χ² =9.758，P＜0.017；χ² =7.744，P＜0.017). The proportion of the infants with cerebrospinal fluid turbidity was significantly higher than that of the children (Fisher's exact test，P＜0.017). The proportion of the infants with decreased white blood cells and reduced glucose in cerebrospinal fluid was significantly higher than that of the children group and the adult group（Fisher's exact test, P＜0.001；Fisher's exact test, P＜0.001；Fisher's exact test, P＜0.017; Fisher's exact test, P＜0.017). Conclusion Most adult patients with pneumococcal meningitis have headache and consciousness disorders, with significantly increased proportion of white blood cells and neutrophils. Infant patients tend to have cloudy appearance of cerebrospinal fluid, leukopenia in blood, and decreased glucose in cerebrospinal fluid.

Guided by the theory of "the kidney storing essence, governing the bones, and producing marrow", this study explored the mechanism of icariin(ICA) in regulating the osteogenic differentiation of rat bone mesenchymal stem cells(BMSCs) through caveolin-1(Cav1) via in vitro and in vivo experiments, aiming to provide a theoretical basis for the prevention and treatment of postmenopausal osteoporosis with traditional Chinese medicine(TCM). Primary cells were obtained from 4-week-old female SD rats using the whole bone marrow adherent method. Flow cytometry was used to detect the expression of surface markers CD29, CD90, CD11b, and CD45. The potential for osteogenic and adipogenic differentiation was assessed. The effect of ICA on cell viability was determined using the CCK-8 assay, and the impact of ICA on the formation of mineralized nodules was verified by alizarin red staining. A stable Cav1-silenced cell line was constructed using lentivirus. The effect of Cav1 silencing on osteogenic differentiation was observed via alizarin red staining. Western blot analysis was conducted to detect the expression of Cav1, Hippo/TAZ, and osteogenic markers such as Runt-related transcription factor 2(RUNX2) and alkaline phosphatase(ALP). The results showed that primary cells were successfully obtained using the whole bone marrow adherent method, positively expressing surface markers of rat BMSCs and possessing the potential for both osteogenic and adipogenic differentiation. The CCK-8 assay and alizarin red staining results indicated that 1×10~(-7) mol·L~(-1) was the optimal concentration of ICA for intervention in this experiment(P<0.05). During osteogenic induction, ICA inhibited Cav1 expression(P<0.05) while promoting TAZ expression(P<0.05). Alizarin red staining demonstrated that Cav1 silencing significantly promoted the osteogenic differentiation of BMSCs. After ICA intervention, TAZ expression was activated, and the expression of osteogenic markers ALP and RUNX2 was increased. In conclusion, Cav1 silencing significantly promotes the osteogenic differentiation of BMSCs, and ICA promotes this differentiation by inhibiting Cav1 and regulating the Hippo/TAZ signaling pathway.
Animals ; Mesenchymal Stem Cells/metabolism* ; Caveolin 1/genetics* ; Osteogenesis/drug effects* ; Rats, Sprague-Dawley ; Rats ; Cell Differentiation/drug effects* ; Female ; Signal Transduction/drug effects* ; Flavonoids/administration & dosage* ; Protein Serine-Threonine Kinases/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Cells, Cultured ; Humans

AIM To establish an HPLC-MS/MS method for the simultaneous residue determination of 11 plant growth regulators(PGRs)in Renshen Guben preparations,and to conduct a risk assessment.METHODS The analysis was performed on a 40 ℃ thermostatic ACQUITY UPLC ? Waters HSS T3 column(2.1 mm×100 mm,1.8 μm),with the mobile phase of acetonitrile-0.1％formic acid(containing 5 mmol/L ammonium formate)flowing at 0.30 mL/min in a gradient elution manner,and electro spray ionization was employed in both positive and negative ion scanning,with multiple reaction monitoring mode.The chronic and acute exposure risk values of the detected PGRs were calculated and assessed based on residue levels,health guidance values,and exposure estimates.RESULTS Eleven PGRs exhibited good linear relationships within their own ranges(R2 ≥ 0.990),whose average recoveries were 70.0％-120.0％,with RSDs all below 12.0％.In both oral liquid and pill forms,mepiquat chloride showed the highest average residue levels,while sodium 5-nitroguaiacolate exhibited the highest acute risk value(0.765 7,0.908 1)and chronic risk value(0.023 1,0.027 0).CONCLUSION Although PGRs residues are detected in Renshen Guben preparations,all levels remained within safe limits.

AIM To establish a GC-MS/MS method for the analysis of volatile components in Yinhu Ganmao Powder,and to determine the contents of α-pinene,camphene,sabinene,β-pinene,α-terpinene,(+)-limonene,p-cymene,1,8-cineole,linalool,L-menthol,terpinen-4-ol,DL-menthol,α-terpineol,tridecane,pulegone,caryophyllene,humulene,n-hexadecane and patchouli alcohol.METHODS The analysis was performed on a DB-624 UI capillary column(30 m×0.25 mm×1.40 μm ),and electron ionization source was adopted with multiple reaction monitoring mode.RESULTS Fifty volatile components and twenty-five liposoluble components were identified in volatile oils and medicinal material powder,respectively.Nineteen constituents showed good linear relationships within their own ranges(r ≥ 0.999 0),whose average recoveries were 84.43％-113.31％with the RSDs of less than 9.15％.CONCLUSION This stable,accurate and reproducible method can provide a reference for the quality evaluation of Yinhu Ganmao Powder.

Objective:To explore the predictive value of preoperative CT angiography (CTA) for incomplete endothelialization of the occluder after left atrial appendage closure (LAAC) in patients with atrial fibrillation.Methods:The clinical data of 92 atrial fibrillation patients underwent LAAC in the Tangdu Hospital of Air Force Military Medical University from January 2022 to June 2024 were retrospectively analyzed. CTA examinations were performed both before operation and 3 months after operation. Before operation, the long diameter of left atrial appendage opening, short diameter of left atrial appendage opening, area of left atrial appendage opening, diameter of anchoring area and effective depth were measured. After operation, the condition of occluder endothelialization was evaluated, and the patients were divided into the completely endothelialization group and the incomplete endothelialization group. Multivariate Logistic regression analysis was used to analyze the independent risk factors of occluder incomplete endothelialization after LAAC in patients with atrial fibrillation. The predictive value of independent risk factors was evaluated by the receiver operating characteristic (ROC) curve.Results:Among the 92 patients, CTA 3 months after the operation showed that 58 cases had complete occluder endothelialization (complete endothelialization group), and 34 cases had occluder incomplete endothelialization (incomplete endothelialization group). Before operation, the long diameter of left atrial appendage opening, short diameter of left atrial appendage opening, area of left atrial appendage opening and diameter of anchoring area in incomplete endothelialization group were significantly larger than those in complete endothelialization group: (28.35 ± 1.77) mm vs. (26.21 ± 2.21) mm, (22.09 ± 2.01) mm vs. (20.86 ± 1.75) mm, (512.76 ± 63.35) mm 2 vs. (453.83 ± 75.39) mm 2 and (24.71 ± 2.50) mm vs. (23.12 ± 2.40) mm, and there were statistical differences ( P<0.01); there was no statistical difference in effective depth between the two groups ( P>0.05). Multivariate Logistic regression analysis result showed that the long diameter of left atrial appendage opening before operation was an independent risk factor for occluder incomplete endothelialization after LAAC in patients with atrial fibrillation ( OR = 2.141, 95% CI 1.217 to 3.768, P<0.01). ROC curve analysis result showed that the area under the curve of the long diameter of left atrial appendage opening before operation for predicting occluder incomplete endothelialization after LAAC in patients with atrial fibrillation was 0.768 (95% CI 0.674 to 0.862, P<0.01), the optimal cut-off value was 26.5 mm, the sensitivity was 88.2%, and the specificity was 55.2%. Conclusions:A larger long diameter of left atrial appendage opening before operation can lead to occluder incomplete endothelialization after LAAC in patients with atrial fibrillation.

OBJECTIVE To investigate the current status of prevalence of hand eczema(HE)among the health care workers,explore the influencing factors and analyze the association with hand hygiene.METHODS A questionnaire survey was conducted for the health care workers.The health care workers who had HE were followed up by the dermatology department and were completed the assessment of severity.Logistic regression analysis was per-formed for the influencing factors.RESULTS The questionnaires were distributed to the health care workers of Shanghai First Peoples Hospital in Jul.2024,and 659 valid questionnaires were recycled.The prevalence rate of HE by self-report was 37.03％in recent almost one year.The finger and dorsal hand were the predilection sites of skin damage,with the symptom dominated by itching;dryness,desquamation and vesicles were the primary man-ifestations of skin damage,most of which(64.81％)were moderate.Wearing gloves in work environment and contact with hand sanitizer and disinfectants could make the HE symptoms ever more severe.The use of hand san-itizer/frequent hand washing with soap lye and prolonged glove-wearing were the leading causes of HE.The nurses were dominant among the health care workers with HE(P=0.003),and the proportion of those with allergic his-tory was even higher(P＜0.001).As for the health care workers who washed hands for surgeries,high volume of daily surgical procedures(OR=1.325,95％CI:1.121 to 1.567)and glove-wearing duration more than 120 min(OR=3.177,95％CI:1.087 to 9.281)were the risk factors for HE.As for the common hand-washing health care workers,daily hand washing more than 15 times(OR=3.199,95％CI:1.014 to 10.137),glove-wearing dura-tion more than 120 min(OR=2.216,95％CI:1.117 to 4.391)and use of powdered latex glove(OR=1.591,95％CI:1.058 to 2.390)were the risk factors for HE.CONCLUSION The prevalence rate of HE is high among the health care workers.It is necessary to attach great importance to the hand skin health of the health care work-ers and take comprehensive intervention measures for prevention of HE such as optimization of hand hygiene pro-cedure,enhancement of barrier protection and stress on occupational health education so as to achieve the dual goals of infection control and skin health.

Objective:To explore the application effectiveness of the large language model DeepSeek in the cultivation of clinical thinking skills for medical laboratory technology students.Methods:A non-randomized controlled study was conducted. In the 2024-2025 academic year, two classes of second-year medical laboratory technology students from Hubei University of Chinese Medicine were selected and divided into a DeepSeek-assisted teaching group (Class A, n=53) and a traditional teaching control group (Class B, n=53), totaling 106 students. Both groups followed a 20-week problem-based learning (PBL) framework with identical teaching content, instructors, and class hours. Class A utilized DeepSeek via the"Learning Pass AI"platform for case diagnosis reasoning, prompt construction training, test plan formulation, and result analysis, while Class B received traditional PBL instruction. Paired t-tests were used to compare pre-and post-teaching scores in clinical thinking skills, AI interaction literacy, and prompt construction in Class A. Independent samples t-tests and chi-square ( χ2) tests were used to evaluate differences in case reasoning scores, etiology analysis accuracy, and teaching satisfaction between groups. Structured questionnaires supplemented the evaluation of model-assisted teaching processes. Results:The comparison of pre-and post-teaching scores in Class A showed that post-teaching scores significantly improved in clinical thinking skills[(4.02±0.45) points vs. (3.09±0.50) points, t=2.23)] and AI interaction literacy [(4.62±0.41) points vs. (3.27±0.54) points, t=2.18]. Compared to Class B, Class A demonstrated superior performance in case reasoning scores [(81.1±3.8) points vs.(74.3±4.2) points, t=8.97], etiology analysis accuracy [94.3% (50/53) vs. 81.1% (43/53), χ2=4.29], and teaching satisfaction [(95.6±3.2)points vs. (82.6±4.8) points, t=11.86] ( P<0.05). The results of questionnaires indicated that during model application, the prompt construction improved in logic [(2.85±0.58) points to (4.25±0.50) points, t=14.23, P<0.01] and innovation [(2.60±0.53) points to (4.05±0.46) points, t=11.57, P<0.05], but question clarity (77.4%, 41/53) and medical terminology accuracy (43.4%, 23/53) remained primary shortcomings. Conclusion:Integrating large language models into AI-teacher collaborative learning pathways can effectively promote students′ autonomous inquiry and clinical reasoning skills, thereby enhancing medical laboratory technology students′ clinical thinking skills.

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective To modify YC-1,an inhibitor of hypoxia-inducible factor-1α(HIF-1α)into nanoparticles and explore its effect on reversing chemoresistance of colorectal cancer cells.Methods Nano-inhibitor mPEG350-YC-1(MYC-1)was prepared by the carboxyl condensation reaction of the active functional group hydroxyl(-OH)in the YC-1 molecule with methoxy polyethylene glycol carboxylic acid,and was verified by 1H nuclear magnetic resonance(1H-NMR).Its morphology was analyzed by transmission electron microscope(TEM),and its particle size distribution was analyzed by dynamic light scattering(DLS).By interacting FITC-labeled MYC-1(FYC-1)with HCT15 cells,the uptake ability of FYC-1 by the cells was observed using laser confocal microscopy.The cytotoxicity of MYC-1 was measured with CCK-8 assay.The sensitization effect of MYC-1 on the chemotherapy drug 5-Fu was detected through toxicity tests of resistant HCT15 cells(resistant HCT15,R-HCT15)and live/dead cell staining.The mechanism of MYC-1 reversing drug resistance was determined with immunofluorescence staining of HIF-1α and western blotting.Finally,a subcutaneous transplanted tumor model of R-HCT15 cells was constructed.The tumor bearing mice were randomly divided into PBS,5-Fu,MYC-1,and MYF groups,with 3 mice in each group.The tumor volume and weight were observed after treatment in each group to evaluate the ability of MYC-1 to reverse 5-Fu resistance in colorectal cancer.Results The nano-inhibitor MYC-1 was successfully prepared.TEM and DLS showed that MYC-1 could self-assemble into nanoparticles with a diameter of approximately 19.96±2.97 nm in aqueous solution.FYC-1 was also successfully prepared.When FYC-1 was interacted with HCT15 cells,FYC-1 could be better taken up by the cells,indicating that the amphiphilic MYC-1 could be better endocytosed into the cells to exert its function.When MYC-1 and 5-Fu acted in combination in colon cancer R-HCT15 cells,the resistance index(RI)was decreased from 7.99 to 1.55,and the relative reversal rate(RRR)of RI was 80.6%.Live(green)/dead(red)cell staining revealed that MYC-1 increased the toxicity of 5-Fu to R-HCT15 cells.Immunofluorescence staining(P<0.01)and Western blotting indicated that MYC-1 effectively inhibited the intracellular expression of HIF-1α.The combined action of MYC-1 and 5-Fu on mice with R-HCT15 subcutaneous transplanted tumors had the best therapeutic effect when compared with PBS(P<0.001),5-Fu(P<0.01),and MYC-1(P<0.01).Immunofluorescence staining of HIF-1α in tumor tissues displayed that the expression of HIF-1α was decreased in the MYC-1 and MYF groups.HE staining showed that there was no obvious damage to the important organs in each treatment group.Conclusion Nano-inhibitor MYC-1 can reverse the drug resistance of colorectal cancer to 5-Fu chemotherapy by reducing the expression of HIF-1α protein in colorectal cancer cells,thereby effectively improving the therapeutic effect of 5-Fu.