ObjectiveTo investigate the risk factors for acute kidney injury （AKI） after liver transplantation， and to establish and validate a risk prediction model， and to provide a basis for early identification of high-risk patients and intervention in clinical practice. MethodsA single-center retrospective study was conducted， and clinical data were collected from 162 patients who received liver transplantation in Liver Transplantation Center of The First Hospital of Shanxi Medical University from March 2020 to June 2025. The patients were divided into AKI group with 69 patients and non-AKI group with 93 patients according to the diagnostic criteria for AKI established by the Kidney Disease： Improving Global Outcomes organization and the presence or absence of AKI within 7 days after surgery. The independent-samples t test was used for comparison of normally distributed continuous data between groups， while the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The univariate differential analysis was used to obtain the factors associated with AKI after liver transplantation， and the multivariate logistic regression analysis was used to identify the independent risk factors and establish a nomogram model； the Bootstrap method with 1 000 repeated samples was used to perform internal validation of the model. The dataset was randomly divided into a training set and a validation set at a ratio of 7∶3， and the receiver operating characteristic （ROC） curve， the calibration curve， and decision curve analysis （DCA） were used to assess the discriminatory ability， calibration， and clinical applicability of the predictive model. ResultsBody mass index （BMI） （odds ratio ［OR］=1.281， 95% confidence interval ［CI］： 1.037　—　1.582， P=0.022）， serum creatinine （OR=1.097， 95%CI： 1.020　—　1.181， P=0.013）， intraoperative blood loss （OR=1.005， 95%CI： 1.002　—　1.009， P=0.004）， and cold ischemia time （OR=0.984， 95%CI： 0.976　—　0.991， P<0.001） were independent risk factors for the development of AKI after liver transplantation. The nomogram prediction model established based on the above factors had an area under the ROC curve （AUC） of 0.964 （95%CI： 0.931　—　0.997）， with an optimal cutoff value of 0.319， a sensitivity of 0.971， and a specificity of 0.903. In the training set （n=113）， the nomogram had an AUC of 0.969 （95% CI： 0.933　—　0.971）， while in the validation set （n=49）， the nomogram had an AUC of 0.941 （95%CI： 0.855　—　0.944）. The calibration curve showed good consistency between the predicted incidence rate and the actual incidence rate， and DCA showed that it had good net clinical benefit. ConclusionBMI， serum creatinine， cold ischemia time， and intraoperative blood loss are independent risk factors for the development of AKI after liver transplantation， and the nomogram prediction model established based on these factors performs well and has a good value in predicting the development of AKI after liver transplantation.

Objective:To compare the psychometric properties of the EQ-5D-Y and CHU-9D in assessing utility values among Chinese children with general health aged 7-9 years.Methods:A total of 458 children in 4 primary schools in Guangxi and Guizhou were investigated by a questionnaire based on validated Chinese versions of the EQ-5D-Y and CHU-9D.The differences in the measurement results of these two scales were analyzed.Results:The ceiling effect of the EQ-5D-Y scale was significantly higher than that of the CHU-9D scale,both of which demonstrated acceptable internal consistency.The ICC and Bland-Altman scatter plots indicated poor agreement between the EQ-5D-Y and CHU-9D utility value measurements.Both scales exhibited good known-group validity and discriminatory ability,but the CHU-9D was better at distinguishing the health status of children across different ages and genders.Conclusion:The CHU-9D outperforms the EQ-5D-Y in terms of ceiling effect,internal consistency,and known-group validity.The two scales are not interchangeable,and researchers should make informed choices based on the strengths and characteristics of each scale when conducting studies on health-related quality of life in children.

In recent years,with the advancement of microbial detection technologies,an increasing number of studies have revealed significant differences in the gut microbiota composition of kidney transplant recipients before and after surgery.These changes in the gut microbiota may influence graft function and the occurrence of post-transplant complications through a variety of factors.This article will review the research progress in the relationship between gut microbiota and kidney transplantation.It focuses on the changes in gut microbiota after kidney transplantation.The role of gut microbiota in immune regulation,drug metabolism,graft function protection,and post-transplant complications is also studied.At the same time,these effects may be of great significance in improving the short-term and long-term prognosis of kidney transplant recipients,thus providing a novel idea for further improving kidney transplant prognosis.

Objective To explore the clinical effect of applying an improved"outside-in"technique in hip arthroscopic surgery.Methods Totally 136 patients undergoing hip arthroscopic surgery between June 2021 and July 2023 were selected and studied retrospectively.According to their different surgi-cal approach,they were divided into a modified approach group(n=75,including 30 males and 45 fe-males,with an average age of 36±14)and a classic approach group(n=61,including 33 males and 28 females,with an average age of 31±11).Before as well as 4 weeks,3 months and 6 months after the surgery,both groups were evaluated using the visual analog scale(VAS)and Harris hip score,and observed their surgical complications.Moreover,the surgical outcomes and time of sur-gical approach establishment were compared between the two groups.Results There was no significant difference between the two groups in general information,preoperative VAS and Harris scores.More-over,no significant difference was found between the two groups in the Harris score after surgery.Compared with the classic approach group,the improved group had significantly less surgical time(49.0±16.9 min vs.66.0±13.3 min,P<0.05),without using the C-arm fluoroscopy during surgery.Moreover,in the modified approach group,the time for establishing the mid-anteriorapproach was sig-nificantly shortened(10.4±5.9 min vs.25.9±15.1 min,P<0.05),along with the traction time during surgery(66.0±13.3 min vs.49.0±16.9 min,P<0.05).Conclusion The modified"outside-in"hip ar-throscopy technique is a safe and effective surgical method,easier to operate,with shorter surgical time.

OBJECTIVE To analyze the characteristics of global surgical site infection(SSI)outbreaks and provide references for targeted prevention and control measures.METHODS SSI outbreak events from Jan.1,1990 to Dec.31,2023 were searched from Wanfang Med,CNKI,VIP and PubMed.Data on department distribution dur-ing the outbreak,duration,investigation methods,main causes,transmission modes,pathogen composition and outbreak outcomes were summarized for analysis.RESULTS A total of 111 SSI outbreaks in 20 countries were identi-fied,involving 1 382 patients and 24 deaths.The source of the outbreak was identified in 78 cases,mainly involving med-ical personnel in 27 cases(34.62％),hospital equipment in 19 cases(24.36％),environmental factors in 11 cases(14.10％),workflow factors in 10 cases(12.82％),hospital water factors in 7 cases(8.97％)and disinfectant fac-tors in 4 cases(5.13％).The duration of SSI outbreaks abroad was 5.00(1.50,12.00)months,longer than that in China[1.00(1.00,2.00)month](P＜0.05).In China,the outbreaks mainly occurred in neurosurgery,cardiac surger-y,orthopedics,obstetrics and general surgery,while at abroad,they mainly occurred in cardiac surgery,orthopedics,and involved multiple surgical departments.Environmental hygiene methods were adopted in up to 90.63％of cases in China.Compared with China,analytical epidemiological methods and molecular epidemiological methods were more com-monly used abroad.Targeted measures and strengthened basic measures were implemented for different outbreak sources to terminate the SSI outbreaks.Pulsed-field gel electrophoresis(34 times)was a widely used molecular typing method in outbreak investigations.CONCLUSIONS Based on the analysis of SSI outbreak characteristics and risk factors,it is neces-sary to strengthen medical personnel training and monitoring of special pathogens.At the same time,the epidemiologi-cal investigation capabilities of infection control professionals should be strengthened.

In recent years,with the advancement of microbial detection technologies,an increasing number of studies have revealed significant differences in the gut microbiota composition of kidney transplant recipients before and after surgery.These changes in the gut microbiota may influence graft function and the occurrence of post-transplant complications through a variety of factors.This article will review the research progress in the relationship between gut microbiota and kidney transplantation.It focuses on the changes in gut microbiota after kidney transplantation.The role of gut microbiota in immune regulation,drug metabolism,graft function protection,and post-transplant complications is also studied.At the same time,these effects may be of great significance in improving the short-term and long-term prognosis of kidney transplant recipients,thus providing a novel idea for further improving kidney transplant prognosis.

AIM:This study aims to investigate the role of ferroptosis in the myocardium of mice with lipopoly-saccharide(LPS)-induced sepsis and in the injury of H9c2 rat cardiomyocytes,and to explore the regulatory function of microRNA-351-5p(miR-351-5p)in this context.METHODS:An in vivo model of sepsis-induced cardiomyopathy was established in mice through intraperitoneal injection of LPS.Twenty-four mice were randomly divided into negative control(NC)group,LPS group,and LPS+ferroptosis inhibitor ferrostatin-1(Fer-1)group.Hematoxylin-eosin(HE)staining was conducted to assess cardiac injury,and plasma levels of creatine kinase(CK)and lactate dehydrogenase(LDH)were also measured.Additionally,the levels of Fe2+and malondialdehyde(MDA)in plasma were quantified,and the mRNA levels of acyl-CoA synthetase long chain family member 4(ACSL4)and prostaglandin-endperoxide synthase 2(PTGS2)were de-tected by RT-qPCR.In vitro,H9c2 cardiomyocytes were stimulated with LPS to create cellular models,followed by treat-ment with Fer-1,inhibitor NC,or miR-351-5p inhibitor.Cell viability was evaluated using CCK8 assay,intracellular re-active oxygen species(ROS)were measured by flow cytometry,intracellular Fe2+levels were assessed using a fluorescence probe,and the protein expression of glutathione peroxidase 4(GPX4)and ACSL4 was analyzed by Western blot.The MDA and reduced glutathione(GSH)levels were measured using commercial kits.MicroRNA(miRNA)sequencing was performed on the LPS-stimulated H9c2 cardiomyocyte models,with differential miRNAs identified and subsequently vali-dated using RT-qPCR.RESULTS:The mice in LPS group exhibited significant myocardial tissue dysregulation com-pared with NC group,with enlarged space,increased plasma CK and LDH levels(P<0.05),elevated Fe2+and MDA levels in myocardial tissues(P<0.05),and increased mRNA levels of ACSL4 and PTGS2(P<0.05).In contrast,the mice in LPS+Fer-1 group demonstrated improved myocardial tissue structure,reduced space,decreased plasma CK and LDH levels(P<0.05),and lower Fe2+and MDA levels in myocardial tissues(P<0.05),along with decreased mRNA level of PTGS2(P<0.05).In H9c2 cardiomyocytes,cell viability,intracellular GSH level,and GPX4 protein level were significantly reduced in LPS group compared with NC group(P<0.05),while ROS,MDA,Fe2+,and ACSL4 protein levels were elevated(P<0.05).The cells in LPS+Fer-1 group showed increased viability,intracellular GSH level,and GPX4 protein level compared with LPS group(P<0.05),alongside reduced ROS,MDA,Fe2+,and ACSL4 levels(P<0.05).miRNA sequencing revealed a significant decrease in several miRNAs,with miR-351-5p showing the most pro-nounced reduction.In LPS+miR-351 inhibitor group,H9c2 cell viability significantly declined(P<0.05),and the levels of GSH and GPX4 were notably lowered(P<0.05),while ROS,MDA,Fe2+and ACSL4 protein levels were significantly elevated(P<0.05).However,in LPS+miR-351 inhibitor+Fer-1 group,the cell viability increased(P<0.05),and the GSH level rose significantly(P<0.05),with corresponding decreases in intracellular ROS,Fe2+and ACSL4 protein levels(P<0.05).CONCLUSION:Inhibition of ferroptosis attenuated sepsis-induced myocardial injury,and inhibition of miR-351-5p promotes sepsis-induced ferroptosis of H9c2 cardiomyocytes.

Objective To investigate the neuroprotective effect of Tibetan medicine 70 Wei Pearl Pill(RNSP)on 6-hydroxydopamine(6-OHDA)induced Parkinson's disease model rats and its related mechanism.Methods Totally 48 male SD rats were randomly divided into control group,model group,model plus low-dose RNSP group(90 mg/kg),model plus medium-dose RNSP group(180 mg/kg),model plus high-dose RNSP group(360 mg/kg),and model plus madopar group(50 mg/kg),with 8 rats in per group.Except for the control group,the other rats were treated with 6-OHDA single injection into the striatum to establish the PD model.Each group was given intragastric administration after modeling and the control group and model group were given an equal volume of saline once a day for 4 weeks.The rats were subjected to apomorphine-induced rotation,experiments at the 2nd and 4th week after the completion of modeling,and the open field experiment was conducted the next day after the last rotation experiment to observe the animal behavior.After the behavioral experiment,the rats were stained with tyrosine hydroxylase(TH)in the substantia nigra pars compacta by immunohistochemical method and the positive neurons were counted.The protein levels of Bcl-2,BAX,Caspase-3 in substantia nigra and P38,P-P38,ERK,P-ERK,JNK,P-JNK in the striatum were detected by Western blotting.Results Compared with the control group,the rotation frequency and percentage of rotating rats in the model group increased significantly at the 2nd and 4th weeks after modeling;the open field active distance,average speed and times of crossing the grid were significantly decreased;and the rest time was significantly increased.While the number of TH positive neurons in the substantia nigra was significantly decreased,the BAX and Caspase-3 protein levels were increased significantly,Bcl-2 was decreased significantly,the ratios of P-P38/P38,P-JNK/JNK and P-ERK/ERK in the striatum were significantly increased in PD group.Compared with the model group,the rotation frequency and percentage of rotating rats in the low-,medium-and high-dose groups of RNSP had no significant changes after 2 weeks of administration,the rotation frequency in the high-dose group and percentage of rotating rats in the low-and medium-dose RNSP groups significantly decreased after 4 weeks of administration.The open field active distance,average speed,and times of crossing the grid were significantly increased;the rest time was significantly decreased.The number of TH positive neurons in the substantia nigra was significantly increased,the Bax and Caspase-3 protein levels were decreased significantly while the Bcl-2 was significantly increased.The ratios of P-P38/P38,P-JNK/JNK and P-ERK/ERK in the striatum were significantly decreased.Conclusion Tibetan medicine RNSP can improve the motor ability and reduce the loss of DA neurons in PD rats,and its mechanism may be related to inhibiting P38/JNK/ERK signaling pathway and reducing the apoptosis of midbrain neurons.

Acute kidney injury (AKI) is a common clinical acute and critical condition. There is a lack of clinical interventions or therapeutic drugs that can significantly improve AKI outcomes. Lipids, including fatty acids, triglycerides, sphingolipids, phospholipids and cholesterol play crucial roles in energy metabolism, cell membrane composition, cell signaling, and cell homeostasis and survival. Recent lipidomics studies have revealed significant alterations in the content and composition of renal lipids during AKI, highlighting their important roles in the onset, progression, and outcomes of the disease. A common feature of AKI across multiple etiologies is altered lipid metabolism, characterized by insufficient energy generation due to mitochondrial damage and deposition of excess lipids in the kidney. The article summarizes the characteristics of renal lipid metabolism in physiological state, alterations of renal lipid metabolism in AKI and molecular mechanisms related to lipid metabolism disorders that aggravate AKI through mitochondrial damage, oxidative stress, autophagy dysfunction, activation of inflammatory and immune responses and regulated cell death, to provide new ideas and therapeutic targets for the clinical treatment of AKI.

OBJECTIVE To analyze the characteristics of global surgical site infection(SSI)outbreaks and provide references for targeted prevention and control measures.METHODS SSI outbreak events from Jan.1,1990 to Dec.31,2023 were searched from Wanfang Med,CNKI,VIP and PubMed.Data on department distribution dur-ing the outbreak,duration,investigation methods,main causes,transmission modes,pathogen composition and outbreak outcomes were summarized for analysis.RESULTS A total of 111 SSI outbreaks in 20 countries were identi-fied,involving 1 382 patients and 24 deaths.The source of the outbreak was identified in 78 cases,mainly involving med-ical personnel in 27 cases(34.62％),hospital equipment in 19 cases(24.36％),environmental factors in 11 cases(14.10％),workflow factors in 10 cases(12.82％),hospital water factors in 7 cases(8.97％)and disinfectant fac-tors in 4 cases(5.13％).The duration of SSI outbreaks abroad was 5.00(1.50,12.00)months,longer than that in China[1.00(1.00,2.00)month](P＜0.05).In China,the outbreaks mainly occurred in neurosurgery,cardiac surger-y,orthopedics,obstetrics and general surgery,while at abroad,they mainly occurred in cardiac surgery,orthopedics,and involved multiple surgical departments.Environmental hygiene methods were adopted in up to 90.63％of cases in China.Compared with China,analytical epidemiological methods and molecular epidemiological methods were more com-monly used abroad.Targeted measures and strengthened basic measures were implemented for different outbreak sources to terminate the SSI outbreaks.Pulsed-field gel electrophoresis(34 times)was a widely used molecular typing method in outbreak investigations.CONCLUSIONS Based on the analysis of SSI outbreak characteristics and risk factors,it is neces-sary to strengthen medical personnel training and monitoring of special pathogens.At the same time,the epidemiologi-cal investigation capabilities of infection control professionals should be strengthened.