Automotive antifreeze, being colorless and odorless, can easily cause acute poisoning if ingested. Acute poisoning can lead to damage to the central nervous system, digestive system, and kidney function, and may even result in death. This article analyzes the clinical data, diagnostic and therapeutic processes, and outcomes of two patients admitted to the Department of Poisoning and Occupational Diseases, Emergency Medicine of Qilu Hospital, Shandong University, who suffered acute poisoning due to ingesting antifreeze. The findings aim to provide a reference for clinicians in the diagnosis and treatment of antifreeze poisoning.

Objective:To explore the feasibility of selecting appropriate respiratory motion management strategies for patients undergoing stereotactic radiotherapy for liver cancer using chi-square feature testing and machine learning techniques.Methods:A retrospective analysis was conducted on 95 liver cancer patients who underwent respiratory motion evaluation at Xiangya Hospital of Central South University between March 2022 and August 2024. Chi-square testing was used to screen features related to respiratory motion evaluation in liver cancer patients. Based on these features, predictive models were constructed using 4 machine learning classification algorithms: support vector machine (SVM), random forest (RF), gradient boosting decision tree (GBDT), and adaptive boosting (AdaBoost). The predictive performance of these models was evaluated using accuracy, sensitivity, specificity, F1 value, and area under the curve (AUC).Results:The accuracy values for the SVM, RF, GBDT and AdaBoost models were 0.75, 0.75, 0.70, and 0.82, respectively. The sensitivity values were 0.82, 0.82, 0.64, and 0.82, respectively. The specificity values were 0.63, 0.63, 0.63, and 0.75, respectively. The F1 scores were 0.78, 0.78, 0.67, and 0.82, respectively. The AUC values were 0.85, 0.80, 0.76, and 0.85, respectively.Conclusions:The predictive models constructed by combining chi-square feature testing and machine learning methods can effectively predict the selection of respiratory motion management strategies. Among the models, the AdaBoost model demonstrated the best predictive performance for selecting respiratory motion management strategies.

Automotive antifreeze, being colorless and odorless, can easily cause acute poisoning if ingested. Acute poisoning can lead to damage to the central nervous system, digestive system, and kidney function, and may even result in death. This article analyzes the clinical data, diagnostic and therapeutic processes, and outcomes of two patients admitted to the Department of Poisoning and Occupational Diseases, Emergency Medicine of Qilu Hospital, Shandong University, who suffered acute poisoning due to ingesting antifreeze. The findings aim to provide a reference for clinicians in the diagnosis and treatment of antifreeze poisoning.

Cushing′s syndrome refers to a group of disorders caused by excessive secretion of adrenal glucocorticoid due to various underlying etiologies. Among these, ACTH-dependent Cushing′s syndrome, in which the source of ACTH-secretion remains unclear for extended periods, poses significant challenges in clinical management. This article presents a patient with ACTH-dependent Cushing′s syndrome where the ACTH-secreting source could not be definitively localized from our hospital. Additionally, the article reviews recent advancements in the diagnosis and treatment of such cases, both domestically and internationally, with the aim of enhancing clinicians′ understanding and improving the management of this condition.

Objective:To investigate lymph node metastasis(LNM)in the prostatic anterior fat pad(PAFP)of PCa patients after robot-assisted radical prostatectomy(RARP),and analyze the clinicopathological features and prognosis of LNM in the PAFP.Methods:We retrospectively analyzed the clinicopathological data on 1 003 cases of PCa treated by RARP in the Department of Urolo-gy of PLA General Hospital from January 2017 to December 2022.All the patients underwent routine removal of the PAFP during RARP and pathological examination,with the results of all the specimens examined and reported by pathologists.Based on the pres-ence and locations of LNM,we grouped the patients for statistical analysis,compared the clinicopathological features between different groups using the Student's t,Mann-Whitney U and Chi-square tests,and conducted survival analyses using the Kaplan-Meier and Log-rank methods and survival curves generated by Rstudio.Results:Lymph nodes were detected in 77(7.7％)of the 1 003 PAFP samples,and LNM in 11(14.3％)of the 77 cases,with a positive rate of 1.1％(11/1 003).Of the 11 positive cases,9 were found in the upgraded pathological N stage,and the other 2 complicated by pelvic LNM.The patients with postoperative pathological stage≥T3 constituted a significantly higher proportion in the PAFP LNM than in the non-PAFP LNM group(81.8％[9/11]vs 36.2％[359/992],P=0.005),and so did the cases with Gleason score ≥8(87.5％[7/8]vs 35.5％[279/786],P=0.009).No statisti-cally significant differences were observed in the clinicopathological features and biochemical recurrence-free survival between the pa-tients with PAFP LNM only and those with pelvic LNM only.Conclusion:The PAFP is a potential route to LNM,and patients with LNM in the PAFP are characterized by poor pathological features.There is no statistically significant difference in biochemical recur-rence-free survival between the patients with PAFP LNM only and those with pelvic LNM only.Routine removal of the PAFP and inde-pendent pathological examination of the specimen during RARP is of great clinical significance.

Cushing′s syndrome refers to a group of disorders caused by excessive secretion of adrenal glucocorticoid due to various underlying etiologies. Among these, ACTH-dependent Cushing′s syndrome, in which the source of ACTH-secretion remains unclear for extended periods, poses significant challenges in clinical management. This article presents a patient with ACTH-dependent Cushing′s syndrome where the ACTH-secreting source could not be definitively localized from our hospital. Additionally, the article reviews recent advancements in the diagnosis and treatment of such cases, both domestically and internationally, with the aim of enhancing clinicians′ understanding and improving the management of this condition.

Objective:To explore the feasibility of selecting appropriate respiratory motion management strategies for patients undergoing stereotactic radiotherapy for liver cancer using chi-square feature testing and machine learning techniques.Methods:A retrospective analysis was conducted on 95 liver cancer patients who underwent respiratory motion evaluation at Xiangya Hospital of Central South University between March 2022 and August 2024. Chi-square testing was used to screen features related to respiratory motion evaluation in liver cancer patients. Based on these features, predictive models were constructed using 4 machine learning classification algorithms: support vector machine (SVM), random forest (RF), gradient boosting decision tree (GBDT), and adaptive boosting (AdaBoost). The predictive performance of these models was evaluated using accuracy, sensitivity, specificity, F1 value, and area under the curve (AUC).Results:The accuracy values for the SVM, RF, GBDT and AdaBoost models were 0.75, 0.75, 0.70, and 0.82, respectively. The sensitivity values were 0.82, 0.82, 0.64, and 0.82, respectively. The specificity values were 0.63, 0.63, 0.63, and 0.75, respectively. The F1 scores were 0.78, 0.78, 0.67, and 0.82, respectively. The AUC values were 0.85, 0.80, 0.76, and 0.85, respectively.Conclusions:The predictive models constructed by combining chi-square feature testing and machine learning methods can effectively predict the selection of respiratory motion management strategies. Among the models, the AdaBoost model demonstrated the best predictive performance for selecting respiratory motion management strategies.

ObjectiveTo provide scientific support for the compilation of high-quality anti-nuclear， biological， and chemical （NBC） medical textbooks in China by retrieving books in the field of biological weapons defense in China， summarizing the publication time and distribution of publishing institutions， and categorizing content and key points of related books. MethodsRelevant subject terms in the field of biological weapons defense were searched through the official website of China National Digital Library and other websites， up until December 31， 2023， and were limited to books. Topic analysis was conducted on the introductions and contents of the books using the latent Dirichlet allocation （LDA） model. The number of topics was determined based on perplexity， and topics were identified according to the intertopic distance map， followed by a qualitative description of the core content of each topic. ResultsA total of 104 books were included in this study， among which four were identified as higher educational textbooks. The volume of publications increased during the periods 2002‒2004 and 2020‒2023. Research institutions accounted for the highest percentage of publishers （37.78%）， and 56.67% of the publishers were military institutions. The study identified six topics： "distribution， defense， and response to biological weapons"， "category， diagnosis， and treatment of biological warfare agents"， "response to biological public health emergencies"， "status of nuclear， biological， and chemical weapons internationally"， "biosafety risk management and prevention and control"， and "technologies and equipment related to biological hazard identification". ConclusionThere are few books in the field of biological weapons defense in China and the content is relatively outdated. In the future， the preparation of teaching materials should be aimed at practical emergency handling techniques for biological weapons， enhance the emphasis on biological weapons detection and biological warfare early warning， improve the fundamental theories at different training levels， and timely update the current research status in the field.

Objective To investigate the epidemiological characteristics of local visceral leishmaniasis in Beijing Municipality from 2021 to 2023, so as to provide insights into formulation of the visceral leishmaniasis control strategy. Methods Epidemiological data of visceral leishmaniasis cases reported in Beijing Municipality from 2021 to 2023 were collected from the National Health Informatization Disease Prevention and Control Information System, and the epidemiological characteristics of local visceral leishmaniasis cases were analyzed using a descriptive epidemiological method. In November 2021 and 2023, 50 to 100 permanent residents were voluntarily selected within a 100 meter radius of sites where patients lived or acquired Leishmania infections, and venous blood was sampled for anti-Leishmania antibody testing. Venous blood was sampled from dogs for anti-Leishmania antibody testing in natural villages where patients lived or acquired Leishmania infections, or in districts where Leishmania infected dogs were reported. In addition, sandflies were captured with CO₂ mosquito traps and fine mesh nets in natural villages where patients lived or acquired Leishmania infections from May to September, 2021 and 2023, for sandfly species identification. Results A total of 4 local visceral leishmaniasis cases were reported in Beijing Municipality from 2021 to 2023, with ages of 2 to 77 years, and acquiring Leishmania infections in Mentougou District (2 cases), Changping District (1 case), and Yanqing District (1 case). The anti-Leishmania antibody testing was all negative in 73 human blood samples and the sero-prevalence of anti-Leishmania antibody was 25.00% in 36 venous blood samples from domestic dogs in 2021, with a total of 4 520 Phlebotomus chinensis captured. The sero-prevalence of anti-Leishmania antibody was 0.51% in 198 human blood samples and 13.58% in 243 venous blood samples from domestic dogs in 2023, with 16.10%, 25.00%, 17.78% and 3.13% sero-prevalence in dogs sampled from Mentougou District, Changping District, Yanqing District and Haidian District, respectively (P = 0.011), while a total of 1 712 Ph. chinensis were captured, including 1 421 female sandflies (86.54%). Conclusions The prevalence of local visceral leishmaniasis was low in Beijing Municipality from 2021 to 2023; however, there is a risk of further spread in the epidemic foci. Intensified visceral leishmaniasis surveillance and control is recommended.

OBJECTIVE: Our study aimed to conduct genomic characterization of Salmonella strains carrying the bla _NDM-1 gene in the intestinal tract of healthy individuals. The objectives were to underscore the importance of genomic surveillance for drug resistance in both commensal and pathogenic bacteria among healthy populations, and to establish protocols for regulating drug resistance plasmids based on the completion of a comprehensive map of drug resistance plasmid genomes. METHODS: We performed antimicrobial susceptibility testing and employed second- and third-generation sequencing techniques to analyze Salmonella strains harboring the bla _NDM-1 gene, to surveil drug-resistant bacteria in the intestines of healthy subjects. Sequence comparison was conducted using both core- and pan-genome approaches. Concurrently, conjugation experiments were carried out to assess the efficiency of plasmid transfer. RESULTS: We isolated a carbapenem-resistant Salmonella enterica serovar Typhimurium strain from a healthy food worker in China. This strain harbored an IncHI2/IncHI2A plasmid carrying bla _NDM-1 along with multiple antibiotic resistance genes (ARGs). Our findings highlight the potential for asymptomatic carriers to facilitate the transmission of ARGs. Pan-genomic analysis revealed that bla _NDM-1-positive plasmids could traverse bacterial species barriers, facilitating cross-host transmission. CONCLUSION This study marks the first detection of bla _NDM-1 in Salmonella strains isolated from healthy individuals. We underscore the risk associated with the transmission of conjugative hybrid plasmids carrying bla _NDM-1, which have the potential to be harbored and transmitted among healthy individuals. Enhanced surveillance of drug-resistant pathogens and plasmids in the intestinal microbiota of healthy individuals could provide insights into the risk of ARG transmission and pathways for population-wide dissemination via ARG transfer factors.
beta-Lactamases/genetics* ; Plasmids/genetics* ; Humans ; Anti-Bacterial Agents/pharmacology* ; China ; Microbial Sensitivity Tests ; Salmonella typhimurium/isolation & purification* ; Salmonella/isolation & purification* ; Salmonella Infections/microbiology*