"Clinical microbiology testing technology" is one of the core courses of medical laboratory science (MLS). Clinical microbiology testing enables quick and accurate identification of pathogens causing infectious diseases and provides guidance to the rational use of medications, thereby playing a key role in the diagnosis and treatment of infectious diseases. To address the evolving needs for intelligent testing and to nurture proficient microbiology technologists with self-learning abilities and advanced critical thinking skills, this course has undergone a series of reforms, focusing on content structure, method diversification, and the establishment of a skill-based assessment system. After three years of exploration and practice, an online-offline hybrid teaching mode aimed at improving students' thinking skills was developed. This teaching mode enhanced students' learning and logical thinking abilities and strengthened their professional training, serving as a reference for the reform of MLS courses.

Objective To analyze the composition characteristics and biological functions of tumor cell subpopulations in glioblastoma(GBM)through multi-transcriptomics sequencing technology,and explore the hypoxia characteristics and spatial localization features of the mesenchymal-like(MES-like)tumor cell subpopulation in GBM and the influence on malignant biological behaviors.Methods Multi-transcriptomics sequencing data,including single-cell RNA sequencing(scRNA-seq)data(18 patients),bulk RNA sequencing(bulk RNA-seq)and spatial transcriptomics(ST)data of GBM,were employed to define cell subpopulations in GBM,and Gene Ontology(GO)and Gene Set Enrichment Analysis(GSEA)were utilized to analyze their functions.The proportions and locations of cell subpopulations in bulk RNA-seq data were evaluated with BayesPrism deconvolution.Immunofluorescence assay was conducted for verification on 12 paraffin samples of GBM from patients who visited the neurosurgical department of our hospital from 2015 to 2023 and met the pathological diagnostic criteria for GBM(10 males and 2 females,at an average age of 53.50 years and a median age of 54.50 years).pySCENIC was applied to predict specific transcription factors of tumor cell subpopulations.Results Tumor cells in GBM were highly heterogeneous,and could be mainly divided into 4 subpopulations:astrocyte-like(AC-like),neural progenitor-like(NPC-like),oligodendrocyte progenitor-like(OPC-like)and MES-like.Differential gene analysis found that the MES-like tumor cells highly expressed vascular endothelial growth factor A(VEGFA),adrenomedullin(ADM),N-myc downstream regulated 1(NDRG1),insulin like growth factor binding protein 5(IGFBP5),and A-kinase anchoring protein 12(AKAP12)(P<0.001).pySCENIC transcription factor prediction found that the high-active transcription factors of the MES-like tumor cells were AT-rich interaction domain 3A(ARID3A),FOS like 2,AP-1 transcription factor subunit(FOSL2),endothelial PAS domain protein 1(EPAS1),CCAAT enhancer binding protein delta(CEBPD),and CCAAT enhancer binding protein beta(CEBPB)(P<0.05).GO and GSEA enrichment analyses found that the MES-like tumor cells were enriched in hypoxia-related pathways,especially the pathway of cell responses to hypoxia levels(NES=2.437,P<0.001).BayesPrism deconvolution showed that the MES-like tumor cells mainly existed in PAN(Pseudopalisading cells around necrosis)and perinecrotic zone.Immunofluorescence assay confirmed CD44+(CD44 antigen)MES-like tumor cells were mainly located in hypoxia areas with highly expression of hypoxia inducible factor 1 subunit alpha(HIF1α)(P<0.01).Multivariate Cox regression analysis indicated that the MES-like tumor cells were significantly correlated with the adverse prognosis of GBM patients(HR=1.71,95%CI:1.38～2.11,P<0.001).Conclusion Tumor cells in GBM are of highly heterogeneity.They could be mainly divided into 4 subpopulations:AC-like,NPC-like,OPC-like and MES-like.MES-like tumor cells,mainly locating in PAN and perinecrotic zone,are characterized by hypoxia,which can promote the malignant progression of GBM.

OBJECTIVE To analyze the correlation between styloid process related parameters and symptoms in patients with styloid process syndrome.METHODS A retrospective study was conducted on the 3D reconstruction CT results of the styloid process in 68 patients diagnosed with styloid process syndrome who visited the Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xi'an Jiaotong University from January 2010 to December 2024.The relationship between parameters such as styloid process length,angle,distance from styloid process tip to pharynx,and specific symptoms in patients with styloid process syndrome was analyzed.RESULTS Among 68 patients with styloid process syndrome,44 had unilateral symptoms and 24 had bilateral symptoms.The length of the styloid process on the symptomatic side of patients with unilateral symptoms(3.86±0.16)cm was significantly longer than that on the asymptomatic side(2.98±0.17)cm(Z=-2.191,P=0.028);The length of the styloid process on the side with severe symptoms in patients with bilateral symptoms(3.98±0.37)cm was also significantly longer than that in patients with mild symptoms(3.37±0.15)cm(t=2.448,P=0.024).Patients with styloid process syndrome mainly present with pharyngalgia(64.71%,44/68).There were no significant differences in the length,inclination angle,anteversion angle,and distance between the styloid process tip and the pharynx among those with unilateral pharyngalgia(n=29),bilateral pharyngalgia(n=15),and non pharyngalgia(n=24)(P>0.05).However,among the 68 patients with styloid syndrome,12 had calcification of the styloid hyoid ligament,while 56 did not.The incidence of unilateral pharyngalgia was significantly higher in patients with calcification of the styloid hyoid ligament than in patients without calcification(66.7%vs.35.7%,χ2=3.909,P=0.048).CONCLUSION The severity of symptoms in patients with styloid process syndrome is related to the length of the styloid process,and those with calcification of the styloid hyoid ligament are more likely to experience pharyngalgia.

Pfeiffer syndrome，an extremely rare autosomal dominant disorder in prenatal settings，is caused by pathogenic variants in Fibroblast Growth Factor Receptor 1（ FGFR1）or Fibroblast Growth Factor Receptor 2（ FGFR2）. In this article，a 33-year-old pregnant woman whose fetus was diagnosed with Pfeiffer syndrome type Ⅱ was reported. Initial ultrasound at 23 +1 weeks revealed temporal skull depression and spinal alignment abnormalities. By 29 +3 weeks，subsequent ultrasound identified additional findings：a cloverleaf-shaped skull，midface hypoplasia，elbow joint fusion，and broad thumb/toe deformities. Fetal MRI confirmed cranial deformities and sacral kyphosis. Postpartum，a CT 3D reconstruction demonstrated craniosynostosis and humeroulnar fusion. Whole exome sequencing（WES）identified an FGFR2 pathogenic variant. This case dynamically illustrates the phenotypic evolution of Pfeiffer syndrome type Ⅱ from subtle to classic triads during gestation，highlighting that multimodal imaging combined with WES enables precise diagnosis and facilitates genetic counseling.

Objective: To analyze the epidemiological characteristics of leptospirosis in Jinhua City, Zhejiang Province, from 2007 to 2024, so as to provide a basis for improving the prevention and control strategies of leptospirosis. Methods: Data pertaining to leptospirosis cases in Jinhua City from 2007 to 2024 were collected through the Monitoring and Reporting Management System of the Chinese Disease Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the distribution characteristics of leptospirosis in terms of time, region, population, interval from the onset of the disease to diagnosis and the outbreak of the epidemic. Results: A total of 81 cases of leptospirosis were reported in Jinhua City from 2007 to 2024, with an average annual reported incidence of 0.08/100 000. The peak incidence occurred from August to September, with 57 cases accounting for 70.37%. Leptospirosis cases were reported in 9 counties (cities, districts) in Jinhua City. Pan'an County reported the most cases, with 52 cases accounting for 64.20%. There were 54 male cases and 27 female cases, with a male-to-female ratio of 2∶1. The majority of cases were aged over 40 years, with 73 cases accounting for 90.12%. The average reported incidence of leptospirosis showed an upward trend with the increase of age (P<0.05), and the highest incidence of leptospirosis was at the 60-<80 age group (0.21/100 000). The majority of patients were farmers, with 77 cases accounting for 95.06%. The median interval from onset to diagnosis was 4.00 (interquartile range, 6.00) days. There were significant differences in the interval from onset to diagnosis among cases in Dongyang City compared with Pan'an County, Wuyi County, and Wucheng District, between Pan'an County and Jindong District, Wucheng District, and between Wuyi County and Wucheng District (all P<0.05). In 2007, one outbreak of leptospirosis was reported, which occurred in Jiuhe Township, Pan'an County, with 36 reported cases. Conclusions The reported incidence of leptospirosis in Jinhua City from 2007 to 2024 is generally low. The high-incidence period is from August to September, and Pan'an County is the high-incidence area. Males over 40 years and farmers are the key populations for prevention and control. It is recommended to strengthen epidemic surveillance and health education for high-risk populations.

"Clinical microbiology testing technology" is one of the core courses of medical laboratory science (MLS). Clinical microbiology testing enables quick and accurate identification of pathogens causing infectious diseases and provides guidance to the rational use of medications, thereby playing a key role in the diagnosis and treatment of infectious diseases. To address the evolving needs for intelligent testing and to nurture proficient microbiology technologists with self-learning abilities and advanced critical thinking skills, this course has undergone a series of reforms, focusing on content structure, method diversification, and the establishment of a skill-based assessment system. After three years of exploration and practice, an online-offline hybrid teaching mode aimed at improving students' thinking skills was developed. This teaching mode enhanced students' learning and logical thinking abilities and strengthened their professional training, serving as a reference for the reform of MLS courses.

Pfeiffer syndrome，an extremely rare autosomal dominant disorder in prenatal settings，is caused by pathogenic variants in Fibroblast Growth Factor Receptor 1（ FGFR1）or Fibroblast Growth Factor Receptor 2（ FGFR2）. In this article，a 33-year-old pregnant woman whose fetus was diagnosed with Pfeiffer syndrome type Ⅱ was reported. Initial ultrasound at 23 +1 weeks revealed temporal skull depression and spinal alignment abnormalities. By 29 +3 weeks，subsequent ultrasound identified additional findings：a cloverleaf-shaped skull，midface hypoplasia，elbow joint fusion，and broad thumb/toe deformities. Fetal MRI confirmed cranial deformities and sacral kyphosis. Postpartum，a CT 3D reconstruction demonstrated craniosynostosis and humeroulnar fusion. Whole exome sequencing（WES）identified an FGFR2 pathogenic variant. This case dynamically illustrates the phenotypic evolution of Pfeiffer syndrome type Ⅱ from subtle to classic triads during gestation，highlighting that multimodal imaging combined with WES enables precise diagnosis and facilitates genetic counseling.

Objective:To establish a method for the determination of triclocarban (TCC) and triclosan (TCS) in urine by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) after purification by QuEChERS.Methods:In May 2022, urine samples were extracted by acetonitrile, purified by QuEChERS, separated by Waters Acquity UPLC BEH C18 column (100 mm×2.1 mm, 1.7 μm), and eluated with water-acetonitrile as mobile phase gradient at a flow rate of 0.3 ml/min. The detection was conducted in negative ion mode (ESI -) and multiple reaction monitoring (MRM) scanning, it was quantified with a internal standard method, and the methodology was verified. Results:The linear ranges of TCC and TCS were 0.5-100.0 μg/L and 1.0-100.0 μg/L, and the correlation coefficients were 0.9997 and 0.9991, respectively. The limits of detection and quantitation of TCC and TCS were 0.17 and 0.33 μg/L, and 0.5 and 1.0 μg/L, respectively. The recoveries of TCC and TCS were 100.1%-102.8% and 96.7%-108.6%, and the relative standard deviations were 4.9%-6.7% and 4.1%-8.3%, respectively, at 2.0, 10.0 and 80.0 μg/L.Conclusion:QuEChERS-UPLC-MS/MS method is simple, rapid, sensitive and reproducible, and can be used for rapid and accurate simultaneous detection of TCC and TCS exposure levels in occupational population.

Objective To analyze the clinical features and magnetic resonance imaging(MRI)features of adult diffuse glioma,define the preoperative MRI enhancement grade(ET grade)of the disease,and explore the relationship of ET grade with isocitrate dehydrogenase(IDH)mutation and WHO grade.Methods The clinical data of 306 cases of adult diffuse glioma confirmed by surgery and pathology admitted in our hospital from January 2018 to December 2023 were collected and retrospectively analyzed.There were 169 cases of mutant IDH and 137 cases of wildtype IDH.The differences in gender,age,MRI signal uniformity,clear tumor margin,obvious edema,compression of adjacent ventricles and ET grade were analyzed between the 2 types of IDH patients.A logistic regression model was established to identify the independent influencing factors for IDH mutation,and the correlation of ET grade with IDH status and WHO grade was analyzed.Results There were significant differences in age,whether the MRI signal was uniform,whether the tumor margin was clear,whether the edema was obvious,the compression of the adjacent ventricle and the ET grade in patients with different IDH status.The independent variables were screened by Forward method and then included in the logistic regression model.ET grade,age and tumor margin were independent influencing factors of IDH mutation status and negatively correlated with IDH mutation.For every 1 year increase in age,the probability of mutant IDH in adult diffuse glioma was decreased by 0.93 times.The accuracy of the established regression model for predicting IDH status was 0.859,the sensitivity was 0.852,the specificity was 0.869,and the AUC value was 0.922(0.892～0.952).ET grade was significantly correlated with WHO grade.The most prominent proportion of glioma patients with WHO grade 2 was noET,that with WHO grade 3 was ET2,and that with WHO grade 4 was ET3.Conclusion For adult diffuse glioma,preoperative MRI ET grade is negatively correlated with IDH mutation status,and positively with WHO grade.ET grade is helpful for determination of of IDH mutation status and WHO grade.

OBJECTIVE To analyze the narrow-band imaging(NBI)endoscopic characteristics of recurrent early glottic carcinoma patients after undergoing CO2 laser surgery with a suspend laryngoscopy.METHODS A retrospective study was conducted on patients with early-stage glottic carcinoma(Ⅰ-Ⅱ stage)who received CO2 laser surgery under supportive laryngoscopy at the Department of Otolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Xi'an Jiao Tong University from January 2017 to December 2023.The medical history,treatment methods,laryngoscopy(including common white light endoscopy and NBI endoscopy),imaging examinations,and pathological results of patients with recurrent glottic carcinoma were collected at different time points including preoperation,postoperative 1 month,postoperative 3 months,and postoperative 6 months.The endoscopic characteristics of NBI in patients with recurrent glottic carcinoma were summarized.RESULTS First,among 18 patients with early-stage glottic cancer recurrence after CO2 laser,the diagnostic rate of NBI endoscopy for laryngeal cancer recurrence(88.89％,16/18)was significantly higher than that of common white light endoscopy(55.56％,10/18)(χ2=4.985,P=0.026).The intraepithelial papillary capillary loop(IPCL)was classified as a vertical vessel according to ELS in all relapsed patients.However,according to Ni classification,the IPCL of the 72.22％(13/18)were classified as type V,while the IPCL of 27.78％(5/18)showed suspicious abnormal neovascularization(punctate or dilated and curved).The proportion of patients with abnormal IPCL on the surgical surface at 1 month,3 months,and 6 months postoperatively was 0.00％,27.78％(5/18),and 61.11％(11/18),respectively,with statistically significant differences(χ2=16.164,P<0.001),which indicated that the longer the follow-up time for recurrent laryngeal cancer patients,the higher the proportion of patients with abnormal IPCL on the surface of the surgical area under NBI endoscopy.CONCLUSION For early glottic carcinoma after CO2 laser surgery with a suspend laryngoscopy,the appearance of suspicious new blood vessels with type Ⅴ IPCL and punctate or dilated curvature under NBI endoscopy may indicate early recurrence of laryngeal cancer.