ObjectiveTo compare the differences between clinical and environmental sources of Acinetobacter baumannii （AB） at a tertiary hospital in Guangzhou in terms of molecular epidemiological characteristics， antimicrobial resistance， disinfectant tolerance， virulence and the distribution of related genes， as well as plasmid epidemiological characteristics； and to assess the association between environmental and clinical strains and the potential transmission risks associated with environmental contamination. MethodsA total of 118 clinical and 102 environmental AB isolates were collected from a tertiary hospital in Guangzhou between 2024 and 2025. Species identification was performed using mass spectrometry and 16S rRNA sequencing； minimum inhibitory concentrations （MICs） for eight antimicrobial agents were determined using the agar dilution method； biofilm formation capacity was assessed using the crystal violet staining method； A Galleria mellonella infection model was used to evaluate the virulence； whole-genome sequencing was employed for multilocus sequence typing （MLST）， phylogenetic analysis， and studies on the distribution of resistance， disinfectant resistance and virulence genes， and plasmid screening. ResultsA total of 38 known ST types were identified among the 220 AB strains， with ST2 and ST40 being the predominant lineages. Antimicrobial susceptibility testing revealed that the clinical infection group exhibited resistance to minocycline， imipenem and other antibiotics， as well as the tolerance levels to the disinfectants triclosan and benzalkonium bromide， were generally higher than those in the environmental group （P＜0.001）， and the detection rates of drug resistance genes such as bla_OXA-23 and adeB all exceeded 70.0%. Statistical analysis confirmed that the MIC values of TCS and BAB were significantly positively correlated with various antibiotic resistance phenotypes （P＜0.05）. In biofilm experiments， the proportion of strong biofilm-forming strains in the environmental group （64.7%） was significantly higher than that in the clinical infection group （11.9%；χ²=69.06， df=2， P＜0.000 1）， and the mortality rate of the strains increased with enhanced biofilm-forming ability. Furthermore， a total of 41 plasmid lineages and 219 insertion sequences were detected； ISs such as IS1006 and IS1007 were frequently co-occurring with resistance and virulence genes including bla_OXA-23 and katA. ConclusionsThe predominant lineages of AB in this tertiary hospital were ST2 and ST40. The clinical infection group generally exhibits higher levels of antibiotic resistance and tolerance to disinfectants compared to the environmental group， while biofilm-forming ability differs ： the environmental group dominates in strong biofilm formation， and the clinical group dominates in weak to moderate biofilm formation. Plasmids and ISs may be involved in the co-occurrence and dissemination control strategies and for the molecular epidemiological surveillance of multidrug-resistant bacteria.

The Janus kinase/signal transducers and activators of transcription (JAK-STAT) control natural killer (NK) cells development and cytotoxic functions, however, whether long non-coding RNAs (lncRNAs) are involved in this pathway remains unknown. We found that miR155HG was elevated in activated NK cells and promoted their proliferation and effector functions in both NK92 and induced-pluripotent stem cells (iPSCs)-derived NK (iPSC-NK) cells, without reliance on its derived miR-155 and micropeptide P155. Mechanistically, miR155HG bound to miR-6756 and relieved its repression of JAK3 expression, thereby promoting the JAK-STAT pathway and enhancing NK cell proliferation and function. Further investigations disclosed that upon cytokine stimulation, STAT3 directly interacts with miR155HG promoter and induces miR155HG transcription. Collectively, we identify a miR155HG-mediated positive feedback loop of the JAK-STAT signaling. Our study will also provide a power target regarding miR155HG for improving NK cell generation and effector function in the field of NK cell adoptive transfer therapy against cancer, especially iPSC-derived NK cells.

Objective This study aims to analyze the application and effect of a competency-based blended teaching model in obstetrics and gynecology education.Methods The study included 90 interns undergoing training in the Department of Obstetrics and Gynecology at Zhongshan Torch Development Zone People's Hospital from March 2023 to July 2024.The partici-pants were randomly divided into two groups using a random number table method.The control group received traditional teaching methods,while the observation group received a competency-based blended teaching model.The teaching effects were compared between the two groups.Results At the end of the rotation,both groups showed varying degrees of improvement in theoretical examination scores,practical skills scores,and CTDI-CV scores.The observation group showed significantly greater improvement compared to the control group(P＜0.05).At the end of the rotation,the scores of clinical basic competency,teamwork ability,and other dimensions of the Student Job Competency Evaluation Scale were significantly higher in the observation group compared to the control group(P＜0.05).The differences were statistically significant.Conclusion The application of a competency-based blended teaching model in obstetrics and gynecology education has significant effects,improving teaching quality and enab-ling medical students to achieve better assessment results.It also enhances critical thinking skills and job competency.This mod-el has high value for promotion and application.

Objective This study aims to analyze the application and effect of a competency-based blended teaching model in obstetrics and gynecology education.Methods The study included 90 interns undergoing training in the Department of Obstetrics and Gynecology at Zhongshan Torch Development Zone People's Hospital from March 2023 to July 2024.The partici-pants were randomly divided into two groups using a random number table method.The control group received traditional teaching methods,while the observation group received a competency-based blended teaching model.The teaching effects were compared between the two groups.Results At the end of the rotation,both groups showed varying degrees of improvement in theoretical examination scores,practical skills scores,and CTDI-CV scores.The observation group showed significantly greater improvement compared to the control group(P＜0.05).At the end of the rotation,the scores of clinical basic competency,teamwork ability,and other dimensions of the Student Job Competency Evaluation Scale were significantly higher in the observation group compared to the control group(P＜0.05).The differences were statistically significant.Conclusion The application of a competency-based blended teaching model in obstetrics and gynecology education has significant effects,improving teaching quality and enab-ling medical students to achieve better assessment results.It also enhances critical thinking skills and job competency.This mod-el has high value for promotion and application.

Objective To investigate the correlation between MEX3A and differentiation characteristics of gastric cancer and intestinal metaplasia,and its combination with caudal-related homeobox transcription factor 2(CDX2)and mucin 2(MUC2)and mucin 5AC(MUC5AC)to determine the role of carcinogenic intestinal metaplasia.Methods From January 2010 to December 2014,a total of 410 cases of gastric cancer and paracarcinoma paraffin-embedded tissue samples were selected from the Central Hospital Affiliated to Shenyang Medical College and the Second Hospital Affiliated to Shenyang Medical College.According to pathological diagnosis,they were divided into control group(mild superficial gastritis,79 cases),intestinal metaplasia group(149 cases)and gastric cancer group(182 cases).The expressions of MEX3A,CDX2,MUC2 and MUC5AC were detected by immunohistochemistry.Results MEX3A was highly expressed in gastric cancer group and intestinal metaplasia group,especially diffuse gastric cancer,poorly differentiated gastric cancer and type Ⅲ intestinal metaplasia(P<0.05).CDX2 and MUC2 were highly expressed in gastric cancer group and intestinal metaplasia group,especially intestinal type gastric cancer,highly and moderately differentiated gastric cancer,type Ⅰ and type Ⅱ intestinal metaplasia(P<0.05).The expression of MUC5AC was high in control group and low in gastric cancer group and intestinal metaplasia group,especially in intestinal type gastric cancer,type Ⅰ and type Ⅲ intestinal metaplasia(P<0.05).Gastric cancer and intestinal metaplasia differentiation were negatively correlated with MEX3A and MUC5AC expression,but positively correlated with CDX2 and MUC2 expression(P<0.05).MEX3A was negatively correlated with the expression of CDX2 and MUC2,and positively correlated with the expression of MUC5AC in gastric cancer(P<0.05).MEX3A was negatively correlated with the expression of CDX2 and MUC2 in intestinal metaplasia(P<0.05),while CDX2 was positively correlated with the expression of MUC2(P<0.05).Conclusion MEX3A is negatively correlated with gastric cancer and intestinal metaplasia differentiation.Gastric cancer is characterized by high MEX3A expression and low CDX2 and MUC2 expression.

Objective: To investigate the spatial clustering characteristics of varicella public health emergency events in Nanjing City from 2017 to 2022, so as to provide the evidence for the development of varicella prevention and control strategies. Methods: Data of varicella public health emergency events in Nanjing City from 2017 to 2022 were collected through Emergency Public Health Management Information System of Chinese Disease Prevention and Control Information System. The software ArcGIS 10.2 was employed for trend-surface analysis, spatial autocorrelation analysis and hotspot analysis to understand the spatial clustering characteristics of varicella public health emergency events. Results: A total of 84 varicella public health emergency events were reported in Nanjing City from 2017 to 2022, with an average attack rate of 2.53% (2 558 cases). Ⅳ-level events were predominant, accounting for 90.48% (76 events). The trend-surface analysis showed lower incidence of varicella public health emergency events in the west of Nanjing City and higher in the east, and lower in the north and higher in the south. The global spatial autocorrelation analysis showed that there was a positive spatial correlation in varicella public health emergency events in 2017 and 2019, indicating spatial clustering (P<0.05). The hot spots were Jiangning District, Gaochun District, Yuhuatai District and Jianye District. Conclusion The incidence of varicella public health emergency events in Nanjing City from 2017 to 2022 has spatial aggregation, with a concentration in suburban areas such as Jiangning District and Gaochun District.

Objective To evaluate the role of heat shock protein 70 (HSP70) in ozone preconditioning-induced reduction of hepatic ischemia-reperfusion (I/R) injury in rats.Methods Twenty-four pathogen-free healthy male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were divided into 4 groups (n=6 each) using a random number table:sham operation group (group S),group I/R,ozone preconditioning group (group OP) and HSP70 inhibitor quercetin group (group Q).Hepatic I/R injury was induced by clamping the branches of hepatic artery supplying left and middle lobes of the liver,portal vein and bile vessel for 45 min,followed by 2 h of reperfusion.In group OP,the mixture of ozone and oxygen was intraperitoneally injected at the concentration of ozone 50 μg/ml and bolus dose 1 mg/kg once a day for 5 consecutive days before operation.In group Q,quercetin 7 mg/kg was intraperitoneally injected at 1 h before injecting the mixture of ozone and oxygen.Blood samples from the abdominal aorta were collected at 2 h of reperfusion for determination of serum alanine transaminase (ALT) and aspartate transaminase (AST) activities and concentrations of interleukin-1beta (IL-1β),IL-6 and tumor necrosis factor-alpha (TNF-α) in serum (by enzyme-linked immunosorbent assay).The animals were sacrificed after blood sampling,and hepatic tissue specimens were collected for detection of activated caspase-3 expression (by Western blot) and cell apoptosis (by TUNEL).Apoptotic index (AI) was calculated.Results Compared with group S,the serum ALT and AST activities,concentrations of IL-1β,IL-6 and TNF-α in serum and AI were significantly increased,and the expression of activated caspase-3 was up-regulated in group I/R (P＜0.05 or 0.01).Compared with group I/R,the serum ALT and AST activities,concentrations of IL-1β,IL-6 and TNF-α in serum and AI were significantly decreased,and the expression of activated caspase-3 was downregulated in group OP (P＜0.05 or 0.01).Compared with group OP,the serum ALT and AST activities,concentrations of IL-1β,IL-6 and TNF-α in serum and AI were significantly increased,and the expression of activated caspase-3 was up-regulated in group Q (P＜0.05 or 0.01).Conclusion The mechanism by which ozone preconditioning reduces hepatic I/R injury is related to activating HSP70 and inhibiting inflammatory responses and cell apoptosis in rats.

Group B streptococcus ( GBS) is the most common cause of neonatal invasive infections in western countries , leading to severe pneumonia , sepsis and meningitis with high mortality and morbidity . Neonatal GBS infections are mainly transmitted from mother to baby .Since the end of 1990 s, prevention strategies of antenatal GBS screening and intrapartum antibiotic prophylaxis ( IAP) have been implemented by European and American area , decreasing the incidence of neonatal GBS disease significantly .The harm of GBS to neonates has been recognized and valued in recent years in China , but the authorized prevention measures are still lacking.Efficacy of IAP-based prevention depends on the accuracy of GBS screening results during pregnancy .Here, the GBS prevention guideline or consensus recommended by European and American CDC, including the screening strategies , detection methods, sample collection, storage and transportation were interpreted .

Objective To investigate the clinical characteristics,antibiotic susceptibilities and serotypes of Group B Streptococcus(GBS)isolated from neonatal meningitis to provide references for the prevention and treatment of neonatal GBS meningitis. Methods From June 2013 to June 2016,we surveyed the GBS strains iso-lated from purulent meningitis of < 90 days infants from Guangzhou Women and Children′s Medical Center. The GBS isolates were identified and the minimum inhibitory concentration of the antibiotics was determined by Vitek 2 Compact automatic bacterial identification system.GBS serotyping was performed using Strep-B-Latex?rapid latex agglutination test kit. Results A total of 46 cases of neonatal GBS meningitis,15 cases of early-onset infection and 31 cases of late-onset infection were diagnosed. 78.3% of GBS meningitis with varying degrees of complica-tions.Among 41 survivors with 3~24 months follow-up,50% of the early-onset and 44.8% of the late-onset GBS meningitis with varying degrees of neurological sequelae.Four capsular types were identified among the 46 isolates, serotype-Ⅲwas the most prevalent(73.9%),followed by Ib(19.6%),V(4.3%)and Ia(2.2%).All the isolates were susceptible to penicillins,cephalosporins,linezolid and vancomycin. Conclusion The highly pathogenic serotype-Ⅲ was the predominant serotype among neonatal GBS meningitis in Guangzhou,Therefore,it is neces-sary to strengthen the epidemiological surveillance of GBS invasive infection and the effective implementation of pre-ventive measures.

Chinese donation after citizen's death (CDCD) is an important way to solve the donor shortage problem,but if we can't effectively control warm ischemia time of CDCD donor,it's easy to cause grafts primary nonfunction,early grafts dysfunction and biliary complications.Nowadays,with the development of surgical techniques,the definition of warm ischemia continues has been continuously updated.The understanding on different definitions may lay the foundation for improving the survival rate of liver and kidney and effectively protect liver and kidney function after transplantation.This paper overviewed the significance of different definitions of warm ischemia and its effect on liver and renal function,which could provide a reference for further experimental study and clinical practice.