OBJECTIVE To explore the distribution and drug resistance trends of the main pathogens causing blood-stream infections(BSI)in neonatal intensive care unit(NICU)of Henan Province from 2014 to 2023 so as to pro-vide bases for prevention and control of hospital-associated infections in the neonates and reasonable use of antibi-otics in the whole province.METHODS The data regarding to the pathogens causing BSI in the NICU neonates and drug resistance were retrospectively collected from Jan.2014 to Dec.2023,and the statistical analysis was per-formed by SPSS 26.0 and WHONET 5.6 software.RESULTS Totally 27,984 strains of pathogens were collected from 2014 to 2023,13,547(48.41％)of which were gram-negative bacteria,and 14,437(51.59％)were gram-pos-itive bacteria.Klebsiella pneumoniae(4221 strains,15.08％),Escherichia coli(3735 strains,13.35％),Acine-tobacter baumannii(1288 strains,4.60％),Enterobacter cloacae(847 strains,3.12％)and Pseudomonas aerugi-nosa(655 strain,2.34％)were the major species of gram-negative bacteria;Staphylococcus aureus(4545 strains,16.24％),Staphylococcus epidermidis(3306 strains,11.81％),Staphylococcus haemolyticus(2048 strains,7.32％),Staphylococcus hominis(1085 strains,3.88％)and Enterococcus faecalis(946 strains,3.38％)were the predominant species of gram-positive bacteria.The drug resistant analysis indicated that the drug resistance rate of the K.pneumoniae strains to imipenem showed an upward trend during the past six years,peaking at 44.23％,and it began to decline in 2021;though the drug resistance rate of the E.coli strains to imipenem showed some fluctuations,it gener-ally presented a downward trend,peaking at 7.00％.The drug resistance rates of the K.pneumoniae strains to the third generation of cephalosporins and carbapenems were higher than those of the E.coli,and there was significant differ-ence in the antimicrobial prevalence trend between the two species of Enterobacter during the ten years(P＜0.05).CONCLUSIONS K.pneumoniae and coagulase-negative Staphylococcus are dominant among the pathogens causing BSI in the ICU neonates of the whole province,and the isolation rates of drug-resistant strains are high.It is grossly necessary for the reasonable clinical use of antibiotics to carry out the bacterial drug resistance surveillance.

Elderly patients are a crucial population for medical treatment and referral.The establishment of standardized and efficient referral channels is essential for enhancing the referral process, improving treatment outcomes for the elderly, and optimizing the allocation of medical resources.Referral network analysis examines the integrity, structure, and dynamics of referrals to infer the characteristics of the network.This can offer insights for enhancing referral policies and elevating medical service standards.While existing research predominantly concentrates on referral networks within the general population, there is a noticeable gap in studies focusing on elderly patients.This review article assesses domestic and international research on networks formed between medical institutions or physicians through patient referrals, aiming to inform and enhance referral policies in our country.

Mitochondria are the convergence point of multiple pathways that trigger programmed cell death (PCD). Mitochondrial-associated PCD (mtPCD) is involved in the pathogenesis of several diseases. However, the role of mtPCD in the prognostic prediction of cancers including non-small-cell lung cancer (NSCLC) remains to be investigated. Here, 12 mtPCD patterns were analyzed in transcriptomics, genomics, and clinical data collected from 4 datasets containing 977 patients. A risk-score assessment system containing 18 genes was established. We found that NSCLC patients with a high-risk score had a poorer prognosis. A nomogram was constructed by incorporating the risk score with clinical features. The risk score was further associated with clinicopathological information, tumor-mutation frequency, and immunotherapy responses. NSCLC patients with a high risk score had more Treg cells infiltration. However, these patients had higher tumor-mutation burden scores and may be more sensitive to immunotherapy. Moreover, receptor-interacting serine/threonine protein kinase 2 (RIPK2) was selected from mtPCD gene model for validation. We found that RIPK2 exhibited oncogenic function, and its expression level was inversely associated with the overall survival of NSCLC. Taken together, our results indicated the accuracy and practicability of the mtPCD gene model and RIPK2 in predicting the prognosis of NSCLC.
Humans ; Carcinoma, Non-Small-Cell Lung/pathology* ; Lung Neoplasms/pathology* ; Prognosis ; Male ; Female ; Nomograms ; Middle Aged ; Mitochondria/metabolism* ; Apoptosis/genetics* ; Mutation ; Biomarkers, Tumor/genetics* ; Aged

OBJECTIVE To explore the distribution and drug resistance trends of the main pathogens causing blood-stream infections(BSI)in neonatal intensive care unit(NICU)of Henan Province from 2014 to 2023 so as to pro-vide bases for prevention and control of hospital-associated infections in the neonates and reasonable use of antibi-otics in the whole province.METHODS The data regarding to the pathogens causing BSI in the NICU neonates and drug resistance were retrospectively collected from Jan.2014 to Dec.2023,and the statistical analysis was per-formed by SPSS 26.0 and WHONET 5.6 software.RESULTS Totally 27,984 strains of pathogens were collected from 2014 to 2023,13,547(48.41％)of which were gram-negative bacteria,and 14,437(51.59％)were gram-pos-itive bacteria.Klebsiella pneumoniae(4221 strains,15.08％),Escherichia coli(3735 strains,13.35％),Acine-tobacter baumannii(1288 strains,4.60％),Enterobacter cloacae(847 strains,3.12％)and Pseudomonas aerugi-nosa(655 strain,2.34％)were the major species of gram-negative bacteria;Staphylococcus aureus(4545 strains,16.24％),Staphylococcus epidermidis(3306 strains,11.81％),Staphylococcus haemolyticus(2048 strains,7.32％),Staphylococcus hominis(1085 strains,3.88％)and Enterococcus faecalis(946 strains,3.38％)were the predominant species of gram-positive bacteria.The drug resistant analysis indicated that the drug resistance rate of the K.pneumoniae strains to imipenem showed an upward trend during the past six years,peaking at 44.23％,and it began to decline in 2021;though the drug resistance rate of the E.coli strains to imipenem showed some fluctuations,it gener-ally presented a downward trend,peaking at 7.00％.The drug resistance rates of the K.pneumoniae strains to the third generation of cephalosporins and carbapenems were higher than those of the E.coli,and there was significant differ-ence in the antimicrobial prevalence trend between the two species of Enterobacter during the ten years(P＜0.05).CONCLUSIONS K.pneumoniae and coagulase-negative Staphylococcus are dominant among the pathogens causing BSI in the ICU neonates of the whole province,and the isolation rates of drug-resistant strains are high.It is grossly necessary for the reasonable clinical use of antibiotics to carry out the bacterial drug resistance surveillance.

Elderly patients are a crucial population for medical treatment and referral.The establishment of standardized and efficient referral channels is essential for enhancing the referral process, improving treatment outcomes for the elderly, and optimizing the allocation of medical resources.Referral network analysis examines the integrity, structure, and dynamics of referrals to infer the characteristics of the network.This can offer insights for enhancing referral policies and elevating medical service standards.While existing research predominantly concentrates on referral networks within the general population, there is a noticeable gap in studies focusing on elderly patients.This review article assesses domestic and international research on networks formed between medical institutions or physicians through patient referrals, aiming to inform and enhance referral policies in our country.

OBJECTIVES: This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults. METHODS: We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag non-linear model. RESULTS: Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a non-linear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period. CONCLUSIONS The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.

OBJECTIVES: This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults. METHODS: We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag non-linear model. RESULTS: Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a non-linear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period. CONCLUSIONS The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.

OBJECTIVES: This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults. METHODS: We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag non-linear model. RESULTS: Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a non-linear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period. CONCLUSIONS The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.

OBJECTIVES: This study investigated the seasonal impact of diurnal temperature range (DTR) on hospitalization rates for intracerebral hemorrhage (ICH) in middle-aged and elderly adults. METHODS: We collected data on the DTR and hospitalization records of ≥45-year-old patients with ICH in 2019 in Hunan Province, central China. Time-series analyses were performed using a distributed lag non-linear model. RESULTS: Overall, 54,690 hospitalizations for ICH were recorded. DTR showed a non-linear relationship with ICH hospitalization in both middle-aged and elderly populations (45-59 and ≥60 years, respectively). During spring, a low DTR coupled with persistently low temperatures increased ICH risk in both age groups, while a high DTR was associated with an increased risk in the middle-aged group only (relative risk [RR], 1.24; 95% confidence interval [CI], 1.21 to 1.27). In the summer, a low DTR combined with persistently high temperatures was linked to a higher risk exclusively in the middle-aged group. A high DTR in the autumn was correlated with increased risk in both age groups. In winter, either a low DTR with a continuously low temperature or a high DTR elevated the risk solely in the elderly population (RR, 1.37; 95% CI, 1.00 to 1.69). In the elderly group, the impact of DTR on hospitalization risk manifested within a 5-day period. CONCLUSIONS The impact of DTR on ICH hospitalization risk differed significantly across seasons and between age groups. Elderly individuals demonstrated greater sensitivity to the impact of DTR. Weather forecasting services should emphasize DTR values, and interventions targeting sensitive populations are needed.

The passing of ethical review is a necessary conditions and prerequisite for the development of life science and medical research involving humans. At present, some medical and health institutions have no or insufficient ethical review capabilities. The lack of ethical review ability has become a bottleneck restricting the development of life science and medical research involving humans. According to documents such as Opinions on Deepening the Reform of the Review and Approval System and Encouraging the Innovation of Pharmaceutical and Medical Devices, Opinions on Strengthening the Ethical Governance of Science and Technology, institutions can entrust competent institutional ethics review committees or regional ethics review committees in writing to conduct ethical review. Entrustment ethical review provides a viable solution for institutions that need to carry out life science and medical research involving humans but do not have an ethics (review) committee or the ethics (review) committee is not competent to review. To conduct the entrustment ethical review, the entrustment between the principal and the trustee is required. According to The Measures for Ethical Review of Life Sciences and Medical Research Involving Humans, if medical and health institutions and their ethical review committees do not accept the formal entrustment to provide the ethical review opinions for other institutions, the local health authorities at or above the county level will impose administrative penalties and sanctions on the relevant institutions and personnel in accordance with the law. Signing the entrustment ethical review contract, implementing legal compliance entrusted ethical review to protect the rights and interests of the trustee and the principal, and protect the research participants.