OBJECTIVE To investigate the current status of contamination with carbapenem-resistant gram-negative bacteria in environment of intensive care units(ICU)of tertiary hospitals in Shanghai and find out the potential contamination sources so as to provide bases for prevention and control of multidrug-resistant organisms infec-tions in the ICUs.METHODS The surroundings of the ICU patients detected with CRGNB and environmental ob-jects surfaces in public area were sampled by mSuperCARBA chromogenic media from Dec.2024 to Jan.2025,the strains were isolated,and the targeted strains were identified by matrix-assisted laser desorption/ionization time-of-flight(MALDI-TOF)mass spectrometer.RESULTS A total of 653 samples were collected in the survey,76 of which were positive for bacterial culture,60 were detected with CRGNB,and the isolation rate of CRGNB was 9.19％.The isolation rate of CRGNB was 53.40％in the water-source group,0.91％in the non-water-source group,and there was significant difference(x2=286.450,P＜0.001).The result of whole genome sequencing for 17 strains of CRKP showed that ST11 and ST15 were the two major types of multilocus typing(MT),respective-ly carrying 2-12 types of drug resistance genes.CONCLUSIONS The CRGNB strains are detected in some environ-mental sites of the ICUs of 15 tertiary hospitals in Shanghai,and the isolation rate of CRKP is highest among them.The colonization rate of CRGNB is relatively low on the highly frequent-contact object surfaces of the ICUs,however,sink drain holes poses a risk of hospital-acquired CRGNB infections transmissions.Additionally,the ba-sins and towels of the CRGNB patients are hard to be thoroughly cleaned,disinfected and dried,resulting in a high contamination rate.

Risk prediction models for postoperative pulmonary complications (PPCs) can assist healthcare professionals in assessing the likelihood of PPCs occurring after surgery, thereby supporting rapid decision-making. This study evaluated the merits, limitations, and challenges of these models, focusing on model types, construction methods, performance, and clinical applications. The findings indicate that current risk prediction models for PPCs following lung cancer surgery demonstrate a certain level of predictive effectiveness. However, there are notable deficiencies in study design, clinical implementation, and reporting transparency. Future research should prioritize large-scale, prospective, multi-center studies that utilize multiomics approaches to ensure robust data for accurate predictions, ultimately facilitating clinical translation, adoption, and promotion.

This report described a case of neonatal alloimmune thrombocytopenic purpura presenting with generalized petechiae. The infant was admitted at Nanfang Hospital, Southern Medical University on March 30, 2022, following detection of wide spread petechiae 30 minutes post-delivery. Blood tests revealed severe thrombocytopenia (platelet count 5×10 9/L) with leukopenia, decreased hemoglobin, and hepatomegaly, though coagulation function remained normal. Initial treatments—random donor platelet transfusion, and intravenous immunoglobulin—proved ineffective. Pretreatment blood samples showed strongly positive platelet antibodies (3+). Further typing confirmed human leukocyte antigen (HLA) antibodies in both infant and mother, establishing HLA-negative neonatal alloimmune thrombocytopenia. HLA-negative platelet transfusion resolved petechiae and normalized platelet counts, enabling discharge on postnatal day 14. Subdural hemorrhage was detected on MRI at day 29. Platelet levels remained normal at six-month follow-up, with age-appropriate development confirmed at 2.5 years.

OBJECTIVE To investigate the current status of contamination with carbapenem-resistant gram-negative bacteria in environment of intensive care units(ICU)of tertiary hospitals in Shanghai and find out the potential contamination sources so as to provide bases for prevention and control of multidrug-resistant organisms infec-tions in the ICUs.METHODS The surroundings of the ICU patients detected with CRGNB and environmental ob-jects surfaces in public area were sampled by mSuperCARBA chromogenic media from Dec.2024 to Jan.2025,the strains were isolated,and the targeted strains were identified by matrix-assisted laser desorption/ionization time-of-flight(MALDI-TOF)mass spectrometer.RESULTS A total of 653 samples were collected in the survey,76 of which were positive for bacterial culture,60 were detected with CRGNB,and the isolation rate of CRGNB was 9.19％.The isolation rate of CRGNB was 53.40％in the water-source group,0.91％in the non-water-source group,and there was significant difference(x2=286.450,P＜0.001).The result of whole genome sequencing for 17 strains of CRKP showed that ST11 and ST15 were the two major types of multilocus typing(MT),respective-ly carrying 2-12 types of drug resistance genes.CONCLUSIONS The CRGNB strains are detected in some environ-mental sites of the ICUs of 15 tertiary hospitals in Shanghai,and the isolation rate of CRKP is highest among them.The colonization rate of CRGNB is relatively low on the highly frequent-contact object surfaces of the ICUs,however,sink drain holes poses a risk of hospital-acquired CRGNB infections transmissions.Additionally,the ba-sins and towels of the CRGNB patients are hard to be thoroughly cleaned,disinfected and dried,resulting in a high contamination rate.

This report described a case of neonatal alloimmune thrombocytopenic purpura presenting with generalized petechiae. The infant was admitted at Nanfang Hospital, Southern Medical University on March 30, 2022, following detection of wide spread petechiae 30 minutes post-delivery. Blood tests revealed severe thrombocytopenia (platelet count 5×10 9/L) with leukopenia, decreased hemoglobin, and hepatomegaly, though coagulation function remained normal. Initial treatments—random donor platelet transfusion, and intravenous immunoglobulin—proved ineffective. Pretreatment blood samples showed strongly positive platelet antibodies (3+). Further typing confirmed human leukocyte antigen (HLA) antibodies in both infant and mother, establishing HLA-negative neonatal alloimmune thrombocytopenia. HLA-negative platelet transfusion resolved petechiae and normalized platelet counts, enabling discharge on postnatal day 14. Subdural hemorrhage was detected on MRI at day 29. Platelet levels remained normal at six-month follow-up, with age-appropriate development confirmed at 2.5 years.

Objective To investigate the reasons for the inconsistent results between the vertical auto profile(VAP)method and bio-chemical homogeneous phase(BHP)method in detecting plasma low-density lipoprotein cholesterol(LDL-C),and provide experimen-tal basis for the accurate and quantitative detection of plasma LDL-C levels.Methods A total of 360 plasma samples from diabetes mellitus patients combined with carotid plaque admitted to the Department of Endocrinology of Ningbo Yinzhou Hospital of Traditional Chinese Medicine during January,2022 and January,2023 were collected.The LDL-C levels of these samples were detected by the VAP method and BHP method,respectively.The VAP method uses software to automatically calculate the area under the LDL-C curve after centrifugation of the sample as the LDL-C level(LDL-CVAP)and the BHP method directly detects the LDL-C level(LDL-CBHP)by the special surfactant method.360 samples were divided into the consistent group(group A)and inconsistent group(group B)ac-cording to the relative deviation between the LDL-CBHP and LDL-CVAP methods.Group B was further divided into the LDL-CBHP on the high side group(Group B1)and LDL-CBHP on the low side group(Group B2).Groups B1 and B2 were divided into B1-1,B1-2,B1-3 and B2-1 groups based on the degree of relative deviation.The percentages of samples and levels of lipoprotein a cholesterol[Lp(a)-C],intermediate-density lipoprotein cholesterol(IDL-C),Lp(a)-C and IDL-C[Lp(a)-C+IDL-C],very low-density lipo-protein cholesterol(VLDL-C),total cholesterol(TC)and total triglyceride(TG)in each group were compared.Results The LDL-CBHP levels of 360 samples were significantly higher than that of LDL-CVAP(P＜0.01).The percentage of samples in group B was significantly higher than that in group A,and that of group B1 was significantly higher than that of group B2(P＜0.05).The levels of Lp(a)-C,IDL-C and Lp(a)-C+IDL-C in groups B1-1,B1-2,and B1-3 were significantly higher than those in group A(P＜0.01).The relative deviation between LDL-CBHP and LDL-CVAP in 360 samples was significantly positively correlated with the levels of Lp(a)-C,IDL-C,and Lp(a)-C+IDL-C(P＜0.01).The maximum correlation coefficient was found in Lp(a)-C+IDL-C.Conclusion The results of plasma LDL-C in diabetes mellitus patients combined with carotid plaque detected by the BHP method are significantly different from those detected by the VAP method,which mainly shows that the results of the BHP method are on the high side.The higher the level of plasma Lp(a)-C+IDL-C,the greater the relative deviation between the BHP method and VAP method.The reason for the high results of LDL-C detected by the BHP method may be related to the fact that LDL-CBHP contains irremovable Lp(a)-C and cholesterol carried by IDL-C.The VAP method can be used as an accurate method for detecting real LDL-C without Lp(a)-C and IDL-C.

Objective To research the procedure for creating an animal model of mitral regurgitation by implanting a device through the apical artificial chordae tendineae, and to assess the stability and dependability of the device. Methods Twelve large white swines were employed in the experiments. Through a tiny hole in the apex of the heart, the artificial chordae tendineae of the mitral valve was inserted under the guidance of transcardiac ultrasonography. Before, immediately after, and one and three months after surgery, cardiac ultrasonography signs were noted. Results All models were successfully established. During the operation and the follow-up, no swines died. Immediately after surgery, the mitral valve experienced moderate regurgitation. Compared with preoperation, there was a variable increase in the amount of regurgitation and the values of heart diameters at a 3-month follow-up (P<0.05). Conclusion In off-pump, the technique of pulling the mitral valve leaflets with chordae tendineae implanted transapically under ultrasound guidance can stably and consistently create an animal model of mitral regurgitation.

Objective:To establish a predictive model of acute physiological and chronic health status score (APACHEⅡ) and the British Thoracic Society modified pneumonia score (CURB-65) score on the prognosis of patients with emergency severe pneumonia complicated with acute respiratory distress syndrome (ARDS) and to evaluate the predictive effect.Methods:The relevant clinical data of patients with severe pneumonia combined with ARDS admitted to the Emergency Intensive Care Unit (EICU) of General Hospital of Ningxia Medical University from January 2017 to December 2021 were retrospectively collected, and different logistic regression models were established. On this basis, three prediction models (model 1: APACHE Ⅱ score, model 2: CURB-65 score, Model 3: APACHE Ⅱ score combined with CURB-65 score) were established and the accuracy of the prediction model was evaluated by repeating 50 times of 10-fold cross-validations. The efficacy of the prediction model was evaluated by C statistics, Kendall's tau-a rank correlation coefficient, R2, Brier score, calibration curve, net reclassification index (NRI), composite discriminant improvement index (IDI) and decision curve (DCA).Results:The study eventually included 108 patients, including 81 males and 27 females, with mean age (57.92 ± 16.56) years. Forty-eight patients survived and 60 patients died. The age of the death group was older, and APACHEⅡ score and CURB-65 score of the death group were all greater than those in the survival group, and the differences were statistically significant ( P<0.05). Different logistic regression models showed that the OR value of model 1 was 1.12 (95% CI: 1.06 -1.20), that of model 2 was 2.21 (95% CI: 1.43 - 3.40), and that of model 3 was 1.10 (95% CI: 1.03 - 1.18) and 1.95 (95% CI: 1.24 - 3.07). The average accuracy of model 1, model 2, and model 3 were 0.68±0.14, 0.66±0.11, and 0.72±0.13, respectively. The C statistic, Kendall's Tau-a rank correlation coefficient, R2 and Bril score of model 3 were better than those of model 1 and model 2, and the different models fit well ( P<0.05). The calibration curve results of 500 resampling showed that the calibration degree of model 2 was better than that of model 1 and model 3, and the predictive ability of model 3 was improved compared with model 1, and the IDI was increased by 0.08 ( P<0.01). Compared with model 2, the reclassification ability of cases and the comprehensive discrimination ability of model 3 were improved ( P<0.01). The decision curves of different models showed that the net benefit of model 3 was higher than that of single model 1 and model 2 when the prediction probability was about 25% to 55%, while the benefits of model 1, model 2 and model 3 in other probability prediction intervals were basically equal. Conclusions:Both APACHE Ⅱ score and CURB-65 score have certain predictive power for prognosis of patients with emergency severe pneumonia and ARDS, and their combination has the best prediction effect. CURB-65 score has fewer parameters, and its prognostic benefit in emergency patients with severe pneumonia complicated with ARDS is basically equivalent to APACHE Ⅱ score, which may be more suitable for the prognosis evaluation of emergency patients with severe pneumonia complicated with ARDS.

Objective:To observe the relationship between inducible carbon monoxide synthase (iNOS) and delayed encephalopathy after acute carbon monoxide poisoning (DEACMP), and explore its mechanism of action in DEACMP.Methods:This study was designed as prospective cohort study. Patients with acute carbon monoxide poisoning who met the diagnostic criteria and were admitted to Emergency Intensive Care Unit(EICU) of our hospital from June 2019 to June 2021 were selected as subjects. Patients were divided into the DEACMP group and non-DEACMP group according to the occurrence of DEACMP. Serum samples were collected on the first 24 h after admission and on day 7 and 14 after admission, and the serum nitric oxide (NO), neuronal nitric oxide synthase (nNOS), inducible carbon monoxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS) level were measured by enzyme-linked immunosorbent assay. The generalized estimating equation was used to estimate the difference of NO, nNOS, iNOS and eNOS between DEACMP and non-DEACMP patients.Results:A total of 78 patients with carbon monoxide poisoning were included in our study finally, including 49 (62.82%) males and 29 (37.18%) females, with an average age of (53.96±14.95) years, 20 (25.64%) patients with DEACMP, and 1 (1.28%) death. Univariate analysis showed that patients with DEACMP had an average increase of 3 h (95% CI: 1.00, 5.00) in carbon monoxide exposure time and a 5-point decrease in GCS score (95% CI: 1.00, 6.00) than the patients without DEACMP, and the proportion of patients with severe carbon monoxide poisoning in the DEACMP group was higher than that of the non-DEACMP group (90.00% vs. 32.76%). According to the analysis of generalized estimation equation, on day 7 and 14 after admission, Compared with non-DEACMP patients, neither by performing unadjusted nor adjusted analysis with the iNOS of DEACMP patients was significantly higher than that in non-DEACMP patients regardless of whether exposure time, GCS score, coma time or severity of carbon monoxide poisoning were adjusted or not ( P <0.01 or P <0.05). Except for the level of nNOS in the GEE model adjusted with carbon monoxide exposure time, the levels of NO, nNOS and eNOS showed no significant difference between DEACMP and non-DEACMP patients ( P >0.05). Conclusions:The expression of iNOS level is increased in DEACMP patients, and its continuous expression may be involved in the pathogenesis of DEACMP.

Objective:To evaluate the effect of social media based behavioral intervention on promoting joint testing of HIV and syphilis in young men who have sex with men (MSM).Methods:After the recruitment, the participants who met the inclusion criteria were randomly divided (1∶1) into two groups, i.e. social media intervention group and control group. The control group was given routine voluntary counseling and testing (VCT) services. The intervention group was also given VCT services, besides; the comprehensive strategies through social media, including regular health education message and testing information sending, were given to them to strengthen the behavioral intervention. Follow up was conducted for the participants for 12 months after the intervention. The number and the proportion of young MSM receiving HIV and syphilis testing, and the reported proportion of the young MSM with sexually transmitted diseases (STD) symptoms between the intervention group and the control group were compared to evaluate the effect of the intervention.Results:A total of 315 young MSM were recruited (158 in the intervention group and 157 in the control group), in whom 248 young MSM completed the follow up. The follow-up rate was 78.7%. There was no significant difference in baseline characteristics between the intervention group and the control group (all P>0.05). The proportion of young MSM receiving more than one joint testing in the intervention group was slightly higher than that in the control group (53.2% vs. 48.4%, rate difference (RD): 4.8%, 95% CI: -7.5%-17.0%, P=0.448) without significant difference. However, in the young MSM who used condoms in the last anal sex, the proportion of those receiving more than one joint testing in the intervention group was higher than that in the control group (63.8% vs. 46.1%, RD: 17.7%, 95% CI: 1.5%-32.6%, P=0.035). In addition, the reported proportion of young MSM with STD symptoms in the intervention group was significantly lower than that in the control group (6.3% vs. 18.0%,RD: -11.7%, 95% CI: -20.6%- -3.0%, P=0.005). Conclusion:Compared with routine VCT, social media based behavioral intervention might promote joint HIV and syphilis testing in the young MSM who used condom in the study. It could significantly reduce the reporting proportion of STD symptoms, suggesting that this method can promote the AIDS and STD prevention related behaviors in young MSM.