Objective To analyze the clinical distribution and antimicrobial susceptibility of Ralstonia mannitolilytica strains isolated from clinical specimens at a tertiary hospital in Shanghai.The results could inform better clinical treatment of R.mannitolilytica.Methods A total of 47 R.mannitolilytica isolated from January 2022 to August 2024 were collected.The clinical data of patients from whom these strains were isolated were reviewed and analyzed.Results The 47 strains of R.mannitolilytica were mainly isolated from hematology department(85.1％,40/47)and intensive care unit(4.3％,2/47).In the 47 patients with R.mannitolilytica isolate,83.0％had hematological disease and 85.1％stayed in hospital for at least 28 days.Overall,63.8％of the 47 patients used antibiotics for at least 3 weeks and 76.6％of the patients used at least three types of antibiotics during hospital stay.All of the 47 R.mannitolilytica strains were resistant to aztreonam,while 84.6％,83.3％,70.4％,and 69.6％of the strains were resistant to meropenem,ticarcillin-clavulanate acid,ceftazidime,and piperacillin-tazobactam,respectively,58.7％,55.8％,52.2％,and 42.2％of the strains were resistant to amikacin,tobramycin,cefepime,and imipenem,respectively.In contrast,88.1％,83.3％,82.9％,67.4％and 60.5％of the strains were susceptible to minocycline,doxycycline,cotrimoxazole,ciprofloxacin,and levofloxacin,respectively.Conclusions Most of the R.mannitolilytica strains were multi-drug resistant.The bacteria is more prevalent in patients with hematological disorders and long-term treatment with multiple broad-spectrum antimicrobial agents.

IgA nephropathy（IgAN）is the most prevalent primary glomerulonephritis worldwide and exhibits a particularly high incidence in Asian populations.Despite advances in understanding its clinical and pathological features，the precise pathogenesis of IgAN remains incompletely elucidated.Emerging evidence highlights the complement lectin pathway as a critical contributor to IgAN progression，influencing both disease initiation and advancement.Key components of this pathway may serve as promising biomarkers for evaluating disease severity and prognosis，as well as potential therapeutic targets.This review focuses on the activation，regulation，and roles of diverse lectin pathway components in IgAN，aiming to deepen the understanding of the lectin pathway's contribution to IgAN pathogenesis and facilitating the identification of effective targeted therapies for this condition.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Background The association between occupational physical activity (OPA) and cardiometabolic risk factors remains controversial, potentially due to differences in the associations between OPA and various cardiometabolic indicators, as well as the lack of a clearly defined optimal OPA range for multiple-indicator synergistic benefits. Objective To investigate the relationship between OPA and cardiometabolic risk factors in individuals at high risk of cardiovascular disease (CVD) in Hubei Province, and to explore an optimal OPA range for multi-indicator improvements. Methods Data were derived from the Hubei Province dataset of the China Health Evaluation And Risk Reduction Through Nationwide Teamwork from 2015 to 2023, including 19028 high-risk CVD individuals. OPA (metabolic equivalent·h·d⁻¹, MET·h·d⁻¹) was assessed using the China Kadoorie Biobank physical activity questionnaire, anthropometric measurements (height, weight, waist circumference) and cardiometabolic indicators (blood pressure, fasting blood glucose, lipid profiles) were measured. Multivariate logistic regression was used to analyze the association between logOPA quartiles (Q1-Q4) and abnormal cardiometabolic indicators, while restricted cubic spline (RCS) models were employed to explore their dose-response relationships. Subgroup and interaction analyses were also conducted by gender. Results The median OPA of all participants was 12.86 MET·h·d⁻¹ (male: 14.40 MET·h·d⁻¹, female: 11.14 MET·h·d⁻¹). After adjusting for confounders, compared with the Q1 group, logOPA in the Q4 group was associated with 20% (OR=0.80, 95%CI: 0.72, 0.89), 14% (OR=0.86, 95%CI: 0.78, 0.96), and 13% (OR=0.87, 95%CI: 0.79, 0.95) reduction in the risk of abdominal obesity, low high-density lipoprotein cholesterol (HDL-C), and metabolic syndrome (MS), respectively, and 33% (OR=1.33, 95%CI: 1.18, 1.49), 33% (OR=1.33, 95%CI: 1.18, 1.50), and 38% (OR=1.38, 95%CI: 1.21, 1.57) increase in the risk of high total cholesterol (TC), high low-density lipoprotein cholesterol (LDL-C), and high non-HDL-C, respectively. Similar trends were observed in males and females, with significant positive associations of logOPA with high TC and high non-HDL-C in males (P_interaction<0.05). The risk of low HDL-C decreased rapidly when logOPA was more than 2.213 (OPA>9.14 MET·h·d⁻¹), showing an inverted L-shaped trend. The risk of high TC, high LDL-C, and high non-HDL-C increased beyond logOPA thresholds of 3.244, 2.476, and 3.377 (OPA >25.64, 11.89, and 29.28 MET·h·d⁻¹), respectively, showing a J-shaped trend. However, logOPA exhibited a U-shaped nonlinear dose-response relationship with blood pressure and fasting blood glucose abnormalities (P_non-linear<0.05) , with minimal risks at logOPA 2.969 and 2.372 (OPA of 19.47 and 10.72 MET·h·d⁻¹). Conclusion OPA exhibits heterogeneous dose-response patterns across cardiometabolic indicators. Integrating the inverted L-, J-, and U-shaped association patterns, we suggest an optimal OPA range of 9.14−25.64 MET·h·d⁻¹ for multiple cardiometabolic indicators in total individuals at high-risk of CVD, with ranges of 9.61−31.34 MET·h·d⁻¹ for males and 8.97−22.87 MET·h·d⁻¹ for females. These findings provide critical evidence for developing OPA interventions strategies targeting high-risk population for CVD.

Fabry disease (FD) is a rare X-linked inherited lysosomal storage disorder caused by variants in the GLA gene, which encodes α-galactosidase A (α-Gal A). These mutations lead to reduced or absent α-Gal A activity, resulting in the accumulation of its substrates in various organs and tissues. This accumulation causes multi-system damage and can be life-threatening. This article reviews the current landscape of various treatment strategies for FD, including specific therapies (such as enzyme replacement therapy, chaperone therapy, substrate reduction therapy, and gene therapy), symptomatic management, as well as dietary and exercise interventions, aiming to provide a reference for the clinical management of FD.

To investigate the therapeutic effect and related mechanisms of hordenine on ovalbumin (OVA)-induced allergic rhinitis (AR) in rats, HE and AB-PAS staining were used to detect the improvement of pathological damage to the nasal mucosa induced by hordenine. ELISA was employed to detect the effect of hordenine on OVA-sIgE in serum and IL-4 in the nasal mucosa supernatant of rats. IHC and Western blot experiments were undertaken to examine the effect of hordenine on Th1/Th2 cell balance. Bioinformatics analysis was performed to predict pathways, which were verified by in vivo and in vitro experiments. The experimental results showed that hordenine could alleviate the behavioral manifestations of OVA-induced AR rats, alleviate nasal mucosal pathological damage caused by AR, and reduce the secretion of OVA-sIgE and IL-4. In addition, hordenine could regulate the Th1/Th2 balance. Bioinformatics analysis results showed that the potential pathway of action of hordenine on AR was the phosphoinositide 3 kinase (PI3K)/protein kinase B (Akt) signaling pathway. The in vivo experimental results showed that the expression of PI3K and p-Akt proteins in the nasal mucosa of the model group rats was significantly increased (P < 0.01), and that the protein expression level was significantly decreased after the administration of hordenine, which was also confirmed by an in vitro experiment. This study suggests that hordenine may regulate Th1/Th2 cell balance through the PI3K/Akt signaling pathway, thereby exerting an alleviating effect on OVA-induced AR.

Pseudorabies (PR) is an infectious disease caused by the pseudorabies virus (PRV), affecting various domesticated and wild animals. Since pigs are the only natural hosts of PRV, PR poses a serious threat to the pig farming industry. Currently, PR is primarily prevented through vaccination with inactivated vaccines or genetically modified attenuated live vaccines. Developing safe and effective genetically engineered vaccines would facilitate the eradication and control of PR. In this study, the PRV vaccine strain Bartha-K61 was used as the reference strain. The gB protein was expressed via the baculovirus-insect cell expression system. Non-denaturing gel electrophoresis confirmed that the gB protein could form a trimeric structure. The purified gB protein was used to immunize mice, and the immune effect was evaluated by a challenge test. The results showed that the gB antigen induced a strong immune response in mice, with the serum-neutralizing antibody titer above 1:70. The lymphocyte stimulation index reached more than 1.29, and the level of (interferon gamma, IFN-γ) release was higher than 100 pg/mL. After immunization, mice were challenged with the virus at a dose of 10⁴ TCID₅₀/mL, 200 μL per mouse, and the clinical protection rate was 100%. Immunohistochemistry, histopathological section, and tissue viral load results showed that the pathological damage and viral load in the gB-immunized group were significantly lower than those in the PBS group. In summary, the gB protein obtained in this study induced strong humoral and cellular immune responses in mice, laying a foundation for developing a recombinant gB protein subunit vaccine.
Animals ; Mice ; Baculoviridae/metabolism* ; Viral Envelope Proteins/biosynthesis* ; Herpesvirus 1, Suid/genetics* ; Pseudorabies/immunology* ; Swine ; Pseudorabies Vaccines/genetics* ; Antibodies, Viral/blood* ; Insecta/cytology* ; Mice, Inbred BALB C ; Female ; Viral Vaccines/immunology*

Objective To analyze the clinical distribution and antimicrobial susceptibility of Ralstonia mannitolilytica strains isolated from clinical specimens at a tertiary hospital in Shanghai.The results could inform better clinical treatment of R.mannitolilytica.Methods A total of 47 R.mannitolilytica isolated from January 2022 to August 2024 were collected.The clinical data of patients from whom these strains were isolated were reviewed and analyzed.Results The 47 strains of R.mannitolilytica were mainly isolated from hematology department(85.1％,40/47)and intensive care unit(4.3％,2/47).In the 47 patients with R.mannitolilytica isolate,83.0％had hematological disease and 85.1％stayed in hospital for at least 28 days.Overall,63.8％of the 47 patients used antibiotics for at least 3 weeks and 76.6％of the patients used at least three types of antibiotics during hospital stay.All of the 47 R.mannitolilytica strains were resistant to aztreonam,while 84.6％,83.3％,70.4％,and 69.6％of the strains were resistant to meropenem,ticarcillin-clavulanate acid,ceftazidime,and piperacillin-tazobactam,respectively,58.7％,55.8％,52.2％,and 42.2％of the strains were resistant to amikacin,tobramycin,cefepime,and imipenem,respectively.In contrast,88.1％,83.3％,82.9％,67.4％and 60.5％of the strains were susceptible to minocycline,doxycycline,cotrimoxazole,ciprofloxacin,and levofloxacin,respectively.Conclusions Most of the R.mannitolilytica strains were multi-drug resistant.The bacteria is more prevalent in patients with hematological disorders and long-term treatment with multiple broad-spectrum antimicrobial agents.

With the rapid development of competitive sports, the incidence of anterior cruciate ligament (ACL) injury is on the rise. Such injuries may shorten athletes′ career and lead to other long-term adverse consequences. Although athletes generally recover well after ACL reconstruction, many still struggle to return to their pre-injury performance levels. Advances in the understanding of ACL anatomy and injury mechanisms, along with the evolution of surgical techniques and rehabilitation methods, have provided more individualized and tailored options for athletes following ACL injuries. However, there is currently no consensus in China regarding surgical and rehabilitation strategies for competitive athletes aiming to return to sports after ACL injuries. To this end, the Sports Medicine Committee of the Chinese Research Hospital Association and the Editorial Board of the Chinese Journal of Trauma jointly formulated the Expert consensus on surgical treatment and rehabilitation for competitive sports athletes returning to sports after anterior cruciate ligament injury ( version 2025), and presented 14 recommendations covering surgical indications, preoperative rehabilitation, surgical timing, surgical strategies and postoperative rehabilitation strategies, aiming to improve the surgical treatment and rehabilitation system for ACL injuries in competitive athletes and facilitate their return to high-level sports performance after injury.

Objective:To explore the care experience of caregivers of adolescents with first-episode depres-sion.Methods:Nine family caregivers of adolescent with first-episode depression were enrolled.A qualitative re-search was carried out,and semi-structured interviews were performed to investigate the caregivers'opinion of de-pressive disorder,emotional state,caring experiences and dilemma,coping strategy,and support requirements.The data were analyzed,summarized and distilled by using the Colaizzi phenomenological 7-step analysis.Results:Four kinds of first order themes of caring experiences(complex caring experience,heavy burden of care,yearn for sup-port,achieved post-traumatic growth)were extracted,including 10 kinds of second order themes,namely shock and disbelief,pessimism and helplessness,guilt and stigma,inefficient coping strategy,impaired physical and mental health,heavy economic burden,family relationship tension,changed personal role,lack of medical support,dying to be admitted by society.Conclusion:Family caregivers of adolescent with first-episode depression may have obvious negative emotions,which faced with caring dilemma such as impaired health status or heavy economic burden,and urgently need professional resources and social support.