[Objective] To explore the clinical features of IgG4-related urinary diseases so as to provide reference for the diagnosis and treatment of such diseases. [Methods] The clinical data of 4 cases of IgG4-related urinary system diseases diagnosed and treated in Xijing Hospital of Air Force Medical University during Aug.2019 and Dec.2023 were retrospectively collected.Here, we report on the diagnosis and treatment of these patients, analysing their symptoms, serology, imaging and pathology as well as their treatment and outcomes. [Results] The patients included 2 male and 2 female.The lesions were involved with the retroperitoneum and urinary system.Three patients had symptoms of lumbar pain.The imaging manifestations were complex, including retroperitoneal mass involving urinary system organs in 2 cases, tabdense shadow of the right kidney in 1 case, and simple cystic mass of kidney in 1 case.Serum IgG4 value was not detected before surgery.All patients underwent radical surgical treatment.Postoperative pathology showed fibrous tissue hyperplasia with a large number of plasma cells, lymphocytes, a few neutrophil infiltrates, and lymphoid follicles and obliterated vasculitis in some specimens.The number of IgG4⁺ plasma cells was more than 10 in all tissues under high power microscope.After surgery, 3 patients had symptoms improved, and serum IgG4 value was within the normal range; 1 patient (patem 3) had elevated IgG4 value during follow-up, received subsequent hormone therapy, and the serum IgG 4 level remained stable. [Conclusion] The symptoms of IgG4-related diseases involving the urinary system are non-specific, and the imaging findings are various, easily confused with other diseases.Early detection of serum IgG4 and biopsy pathology can help clinicians make correct diagnosis in the early stage.

OBJECTIVE To construct a Seasonal Autoregressive Integrated Moving Average(SARIMA)model based on the incidences of hospital-acquired infections(HAIs),and provide a reference for the prevention and control of HAI in such hospitals.METHODS The incidences of HAIs in a tertiary psychiatric hospital from Jan.2016 to Aug.2024 were collected by the Weining Hospital Infection Information Management software and paper-based HAI reporting cards.The incidence rates from 2016 to 2023 were analyzed and a SARIMA model was established.The incidence rates from Jan.to Aug.2024 were predicted,and the accuracy of the SARIMA model was evaluated based on the actual measured values.RESULTS From 2016 to 2023,a total of 98,075 patients were admitted,including 936 patients who developed HAIs,with an incidence rate of 0.95％ranged from 0.79％to 1.23％.The time series plot from 2016 to 2023 did not meet the requirements for sequence stability.After differ-entiating the original data,analyzing the correlation plot(ACF)and partial autocorrelation plot(PACF),and con-ducting multiple assessments and verifications,it was finally determined that SARIMA(1,1,1)(1,1,1)12,SA-RIM A(1,1,1)(1,1,0)12,ARIMA(1,1,1)(0,1,0)12,and SARIMA(1,1,1)(0,1,1)12 were the alterna-tive models.The Ljung-Box Q test was used to retain the models with P＞0.05 that met the sequence with white noise and the minimum Bayesian Information Criterion(BIC)value was obtained,it was determined that SARIMA(1,1,1)(0,1,1)12 was the optimal model.When validated with Jan.to Aug.2024 HAI incidence data,the infection rates predicted by SARIMA(1,1,1)(0,1,1)12 model remained within the 95％confidence interval,indicating high prediction accuracy.CONCLUSION SARIMA model can effectively predict the monthly HAI incidences in a tertiary psychiatric hospital,and it plays an role in the decision-making of HAI prevention and control in psychiatric inpatients.

Objective To explore potential categories of post-stroke depression in acute-phase stroke patients and its correlation with the degree of neurological deficits,and to provide references for healthcare professionals in developing targeted interventions.Methods Using convenience sampling,patients with acute stroke who were hospitalized in neurological ward of 2 tertiary general hospitals in Henan Province from January to April 2024 were selected as the survey participants.The investigation was conducted using the General Information Questionnaire,the National Institute of Health Stroke Scale,and the Patient Health Questionnaire-9.The correlation between potential categories of post-stroke depression and the degree of neurological deficit was analysed using unordered multiclassified logistic regression.Results Post-stroke depression score was 10.22±3.61 in 193 acute-phase stroke patients,and post-stroke depression could be categorized into 3 potential categories,namely"low depressive symptoms"(44.6％),"melancholic depression"(15.0％),and"atypical depression"(40.4％).There was a significant difference in the degree of neurological deficits(H=38.074,P＜0.001).Compared with severe neurological deficits,patients with mild deficits were more likely to be categorized as"melancholic depression"(OR=0.016,P=0.001)and"atypical depression"(OR=0.040,P＜0.001),and patients with moderate deficits were more likely to be classified as"atypical depression"(OR=0.085,P=0.001).Conclusion Post-stroke depression in acute-phase stroke patients has obvious categorization characteristics,and it is recommended that healthcare professionals should pay more attention to patients with different degrees of neurological deficits and adopt targeted interventions according to the different categories of post-stroke depression in order to alleviate their depressive symptoms.

Objective To understand the changing profiles of antimicrobial susceptibility of the bacterial strains isolated from patients at Liuzhou Workers'Hospital in Guangxi from 2020 to 2022.Methods The bacteria were isolated,identified,and underwent antimicrobial susceptibility testing using VITEK 2 Compact,disk diffusion method,or E-test.The results were interpreted according to the breakpoints recommended by CLSI M100 32nd Edition in 2022.The data were analyzed using WHONET 5.6 software.Results A total of 26 254 nonduplicate strains were collected from 2020 to 2022,including Gram-positive bacteria(27.9％)and gram-negative bacteria(72.1％).The prevalence of methicillin-resistant strains was 20.0％in SS.aureus(MRSA),and 72.2％in coagulase-negative Staphylococcus(MRCNS).Methicillin-resistant staphylococcal strains were more resistant to most antimicrobial agents than methicillin-susceptible strains(MSSA and MSCNS).None of the staphylococcal strains was resistant to vancomycin,linezolid or tigecycline.Enterococcus faecium strains showed higher resistance rates to most antimicrobial agents than Enterococcus faecalis.None of enterococcal strains was resistant to vancomycin.A few enterococcal strains were resistant to linezolid.Overall,691 strains of the non-meningitis Streptococcus pneumoniae were isolated from children and 123 strains were isolated from adults.The prevalence of penicillin-resistant SS.pneumoniae(PRSP)was 0.4％in the strains from children and 1.6％in the strains from adults.None of S.pneumoniae strains was intermediate to penicillin.The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn)was 1.2％,1.2％,and 13.8％in 2020,2021,and 2022,respectively.The prevalence of carbapenem-resistant P.aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 10.7％and 68.4％in 2020,17.5％and 75.2％in 2021,14.3％and 77.3％in 2022,respectively.About 84.6％of the 1 269 strains of Haemophilus influenzae were isolated from children and 15.4％isolated from adults.The prevalence of beta-lactamase-producing strains was 39.4％in the isolates from children and 46.8％in the isolates from adults.The β-lactamase-producing H.influenzae was resistant to ampicillin.Furthermore,some β-lactamase-nonproducing ampicillin-resistant(BLNAR)H.influenzae strains(27.0％)were also identified.Conclusions Antimicrobial resistance is still serious in this hospital,especially high prevalence of carbapenem-resistant organisms(CRO).Hospital infection prevention and control measures,antibiotic stewardship,and proactive CRO screening should be strengthened.More clinical specimens should be collected for suspected infections.Antimicrobial treatment should be prescribed empirically in time and adjusted when the results of antimicrobial susceptibility testing are available.

Objective:To evaluate the predictive value of the Controlling Nutritional Status (CONUT) score for severe acute pancreatitis (SAP).Methods:A total of 426 patients with acute pancreatitis (AP) admitted to the First Affiliated Hospital of Zhengzhou University between January and December 2024 were retrospectively reviewed. After applying exclusion criteria, 189 patients were included and classified into non-severe AP (NSAP) and SAP groups according to diagnostic criteria. Demographic characteristics (age, sex, underlying diseases), vital signs, CONUT score, Bedside Index for Severity in Acute Pancreatitis (BISAP) score, and laboratory parameters (including complete blood count, blood glucose, liver and kidney function, coagulation profile, amylase, and lipase) on admission were compared between the two groups. Binary logistic regression was used to identify independent risk factors associated with AP severity. Receiver operating characteristic (ROC) curves were generated to assess the predictive performance of each indicator by determining the area under the curve (AUC), sensitivity, specificity, and optimal cutoff values.Results:Compared with the NSAP group, the SAP group had significantly longer hospital stays, higher respiratory rates, and elevated levels of PCT, CRP, absolute neutrophil count, AST, GGT, PT, D-dimer, INR, fibrinogen, FDP, as well as higher CONUT, SIRS, and BISAP scores (all P < 0.05). In contrast, the NSAP group showed significantly higher red blood cell count, hemoglobin, absolute lymphocyte count, serum calcium, albumin, total cholesterol, prothrombin time activity, and PNI score (all P < 0.05). Binary logistic regression analysis identified CONUT score ( OR = 1.623, 95% CI: 1.048–2.512) and BISAP score ( OR = 19.608, 95% CI: 6.585–58.387) as independent risk factors for disease severity. The AUC values for predicting SAP using CONUT score, BISAP score, and their combination were 0.694, 0.815, and 0.864, respectively. Conclusions:The CONUT score is an early independent risk factor for SAP. Combining CONUT with BISAP scores provides better predictive performance for assessing the severity of acute pancreatitis.

Objective:To explore the prognostic value of monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) in assessing patients with heart failure with reduced ejection fraction (HFrEF).Methods:Patients with HFrEF (LVEF<40%) admitted to the TEDA International Cardiovascular Disease Hospital between 2 January 2019 and 15 January 2023 were selected. The MHR levels were recorded at admission in patients with HFrEF who were followed up regularly for 12 months. The major adverse cardiovascular events (cardiac death and readmission for heart failure) were defined as poor prognosis. Multivariate Cox regression was used to analyze factors associated with poor prognosis. The receiver operator characteristic (ROC) curves were used to assess the diagnostic value of MHR for poor prognosis. The DeLong test was used to analyze whether there was a difference in the effectiveness of MHR and BNP for detecting poor prognosis. The critical value grouping for poor prognosis was evaluated by MHR, and survival analyses were performed using Kaplan-Meier.Results:A total of 286 subjects were enrolled in the study, including 206 males and 80 females, with a median age ( Q1, Q3) of 67 (58, 74) years. Multivariate Cox regression showed that MHR ( HR=1.482, 95% CI:1.015-2.164) and BNP ( HR=1.001, 95% CI:1.000-1.001) were associated with poor prognosis in patients with HFrEF. The area under the ROC curve for the adjunctive diagnostic value of MHR, BNP and the combination of both for poor prognosis in patients with HFrEF was 0.709, 0.738 and 0.769, respectively. The critical values were 0.486, 1 090 pg/ml and 0.41, respectively. The DeLong test showed no differences in the validity of MHR, BNP and their combination for detecting poor prognosis. Kaplan Meier survival analysis of 12-month follow-up showed that the time for poor prognosis in HFrEF patients with MHR>0.486 group (8.645 months) was significantly shorter than that in MHR≤0.486 group (10.296 months, P<0.001), and the risk of poor prognosis in MHR>0.486 group was 2.843 times higher than that in MHR≤0.486 group ( HR=2.843, 95% CI:1.867-4.327). Conclusion:MHR can be an indicator of poor prognosis in patients with HFrEF.

Objectives:To investigate the effect of circular RNA (circRNA) hsa_circ_0019217 on the biological function of chorionic trophoblast cell line (HTR8/SVneo) and its mechanism in the occurrence of pre-eclampsia (PE).Methods:The circRNA expression database was used to analyze the differentially expressed circRNA in placental tissues of PE women. The expression levels of hsa_circ_0019217 and miR-526b-5p were detected by reverse transcription real-time fluorescent quantitative PCR (RT-qPCR), and the subcellular localization of hsa_circ_0019217 was detected by fluorescence in situ hybridization. The proliferation, migration and invasion of trophoblast cells were detected by cell counting kit-8 (CCK-8) assay and transwell assay. Western blot and enzyme-linked immunosorbent assay (ELISA) were used to verify the effects of hsa_circ_0019217, miR-526b-5p and decorin (DCN) on matrix metalloproteinase 2 (MMP2), tissue inhibitor of metalloproteinase 2 (TIMP2), placental growth factor (PlGF) and human chorionic gonadotropin (hCG) protein expression levels. Dual luciferase reporter gene assay and RNA immunoprecipitation (RIP) assay were used to verify the interaction between hsa_circ_0019217, miR-526-5p and DCN.Results:(1) The analysis of circRNA expression database showed that the expression level of hsa_circ_0019217 was significantly increased in the placental tissues of PE women (fold change=67, P<0.05), and it was mainly located in the cytoplasm. (2) Knockdown of hsa_circ_0019217 promoted the proliferation, migration and invasion of HTR8/SVneo cells, increased the expression levels of MMP2 and PlGF, and decreased the expression levels of TIMP2 and hCG in HTR8/SVneo cells. (3) Hsa_circ_0019217 targeted adsorption of miR-526b-5p, and inhibition of miR-526b-5p reduced the proliferation, migration and invasion of HTR8/SVneo cells. The expression levels of MMP2 and PlGF in HTR8/SVneo cells were increased, and the expression levels of TIMP2 and hCG were decreased. Hsa_circ_0019217 knockdown and inhibiting miR-526b-5p could reverse the effect of hsa_circ_0019217 knockdown on promoting the proliferation, migration and invasion of HTR8/SVneo cells, and reversed the effect of hsa_circ_0019217 knockdown on the protein expression levels of MMP2, PlGF, TIMP2 and hCG. (4) miR-526b-5p targeted DCN in HTR8/SVneo cells, hsa_circ_0019217 knockdown reduced the expression level of DCN, and inhibiting miR-526b-5p increased the expression level of DCN. When hsa_circ_0019217 and miR-526b-5p were inhibited simultaneously, there was no significant change in the protein expression level of DCN. (5) Overexpression of miR-526b-5p promoted the proliferation, migration and invasion of HTR8/SVneo cells, while overexpression of DCN inhibited the proliferation, migration and invasion of HTR8/SVneo cells. Simultaneous overexpression of miR-526b-5p and DCN reversed the effects of miR-526b-5p overexpression on cell proliferation, migration and invasion. Overexpression of miR-526b-5p increased the expression levels of MMP2 and PlGF and decreased the expression levels of TIMP2 and hCG in HTR8/SVneo cells. Overexpression of DCN reduced the expression levels of MMP2 and PlGF and increased the expression levels of TIMP2 and hCG. Overexpression of miR-526b-5p and DCN reversed the effects of miR-526b-5p on the expression of these proteins. Conclusion:Hsa_circ_0019217 regulates the expression of DCN by adsorption of miR-526b-5p, thereby affecting the proliferation, migration and invasion of trophoblast cells and regulating the protein expression levels of MMP2, TIMP2, PlGF and hCG, which might be used as a target for early prevention of PE.

Objective To understand the changing profiles of antimicrobial susceptibility of the bacterial strains isolated from patients at Liuzhou Workers'Hospital in Guangxi from 2020 to 2022.Methods The bacteria were isolated,identified,and underwent antimicrobial susceptibility testing using VITEK 2 Compact,disk diffusion method,or E-test.The results were interpreted according to the breakpoints recommended by CLSI M100 32nd Edition in 2022.The data were analyzed using WHONET 5.6 software.Results A total of 26 254 nonduplicate strains were collected from 2020 to 2022,including Gram-positive bacteria(27.9％)and gram-negative bacteria(72.1％).The prevalence of methicillin-resistant strains was 20.0％in SS.aureus(MRSA),and 72.2％in coagulase-negative Staphylococcus(MRCNS).Methicillin-resistant staphylococcal strains were more resistant to most antimicrobial agents than methicillin-susceptible strains(MSSA and MSCNS).None of the staphylococcal strains was resistant to vancomycin,linezolid or tigecycline.Enterococcus faecium strains showed higher resistance rates to most antimicrobial agents than Enterococcus faecalis.None of enterococcal strains was resistant to vancomycin.A few enterococcal strains were resistant to linezolid.Overall,691 strains of the non-meningitis Streptococcus pneumoniae were isolated from children and 123 strains were isolated from adults.The prevalence of penicillin-resistant SS.pneumoniae(PRSP)was 0.4％in the strains from children and 1.6％in the strains from adults.None of S.pneumoniae strains was intermediate to penicillin.The prevalence of carbapenem-resistant Klebsiella pneumoniae(CRKpn)was 1.2％,1.2％,and 13.8％in 2020,2021,and 2022,respectively.The prevalence of carbapenem-resistant P.aeruginosa(CRPae)and carbapenem-resistant Acinetobacter baumannii(CRAba)was 10.7％and 68.4％in 2020,17.5％and 75.2％in 2021,14.3％and 77.3％in 2022,respectively.About 84.6％of the 1 269 strains of Haemophilus influenzae were isolated from children and 15.4％isolated from adults.The prevalence of beta-lactamase-producing strains was 39.4％in the isolates from children and 46.8％in the isolates from adults.The β-lactamase-producing H.influenzae was resistant to ampicillin.Furthermore,some β-lactamase-nonproducing ampicillin-resistant(BLNAR)H.influenzae strains(27.0％)were also identified.Conclusions Antimicrobial resistance is still serious in this hospital,especially high prevalence of carbapenem-resistant organisms(CRO).Hospital infection prevention and control measures,antibiotic stewardship,and proactive CRO screening should be strengthened.More clinical specimens should be collected for suspected infections.Antimicrobial treatment should be prescribed empirically in time and adjusted when the results of antimicrobial susceptibility testing are available.

Emotional blunting leads to significant declines in cognitive function and activities of daily living in patients with Parkinson's disease, thereby impacting their quality of life and increasing the caregiver burden. Emotional blunting is a progressive condition, and early detection and intervention can slow its progression, making it necessary to assess emotional blunting in patients early. Currently, there are various tools for assessing emotional blunting, but there is a lack of evidence to guide tool selection. This review discusses the impact of emotional blunting on patients with Parkinson's disease and reviews existing assessment tools for emotional blunting, including their content, applications, advantages, and limitations. It also summarizes issues in the application of these tools and offers future directions, aiming to provide a basis for the identification and assessment of emotional blunting in Parkinson's disease patients.

Abstract To promote the development of sexuality education for Chinese adolescents, the study analyses Ireland s relationships and sexuality education (RSE) curriculum and concludes that it centers on student development in terms of curriculum philosophy and objectives, emphasizing its educational value. At the content level, it employs a staged teaching approach to achieve comprehensive coverage based on students physical and mental development characteristics. In terms of implementation, it adopts a spiral organization to ensure the scientific integrity of the curriculum. In addition, it utilizes diverse evaluation methods to strengthen the systematic nature of the curriculum. Based on these insights, China could collaborate with multiple stakeholders to advance the development of RSE, establish a scientific and systematic framework for RSE, and constructing a comprehensive implementation and teacher support system, thereby promoting the refinement and innovation of RSE programs.