Background Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen for both human bloodstream infections and mastitis in cows. However, little attention has been paid to the cross-host transmission of MRSA from cows to high-risk groups in China. Objective To determine the MRSA colonization rates among dairy cows and dairy farm workers in Xinjiang, identify the antibiotic resistance profiles and molecular characteristics of the isolates, and provide scientific evidence for the formulation of targeted infection control strategies. Method A cross-sectional survey combined with laboratory pathogen analysis was conducted. From June to August 2024, large-scale dairy farms in Xinjiang region were selected as study sites. Nasal swabs (n=96) and skin swabs (n=39) were collected from workers, and bovine nasal swab samples (n=109) were collected simultaneously. All samples were subjected to MRSA isolation, cultivation, and identification, followed by antibiotic susceptibility testing to characterize resistance phenotypes. Staphylococcus aureus protein A (Spa) typing was performed to determine strain genotypes and elucidate MRSA colonization rates and molecular epidemiological patterns. Results A total of 35 MRSA strains was successfully isolated from 244 samples. The MRSA colonization rates among dairy farm workers and dairy cows were 20.83% (20/96) and 12.84% (14/109), respectively, with an overall isolation rate of 14.34% (35/244). Among the workers, the nasal colonization rate was 16.67% (16/96), and the skin colonization rate was 12.82% (5/39). One worker exhibited MRSA colonization at multiple body sites. All MRSA strains were resistant to cefoxitin (100%, 35/35). The resistance rates to erythromycin and clindamycin were 42.86% (15/35) and 34.29% (12/35), respectively. Thirteen strains showed a multidrug-resistant phenotype, whereas all strains were susceptible to vancomycin. The MRSA isolates exhibited high genetic diversity, with 13 Spa types identified, among which t441 was the most prevalent (8 strains). Both t441 and t034 types were detected in samples from both the dairy cows and their handlers. These two Spa types also carried and stably inherited specific resistance combinations, including erythromycin–clindamycin–cefoxitin and ciprofloxacin–erythromycin–clindamycin–gentamicin–cefoxitin–tetracycline, and a statistically significant association was also observed between the two resistance profiles and the bacterial types (P < 0.001). In addition, one novel Spa type strain was identified. Conclusion MRSA colonization rates among dairy cows and dairy farm workers in Xinjiang are relatively high, with evidence of multi-site colonization. The isolates exhibit high levels of multidrug resistance and genetic diversity, indicating a potential risk of cross-host transmission.

Objective:To develop a skeleton structure for the flexible manipulator of a robotic system used in natural orifice transluminal endoscopic surgery (NOTES), meeting the performance requirements of surgical actuators.Methods:A flexible manipulator structure and a control strategy for the corresponding structure were designed based on metal braiding technology. Geometric relationship formulas were derived according to the mechanical structure characteristics of the flexible manipulator. A theoretical model was established using the chained beam-constraint-model (CBCM) and mechanical spring theory. The finite element model of the mechanical structure was established, and simulation analysis was performed to verify the accuracy of the theoretical model. The bending stiffness of the metal-braided structure was tested to verify the load capacity of the flexible manipulator.Results:A flexible manipulator structure and a control strategy for the corresponding structure were designed based on metal braiding technology. With proper constraints, the maximum strain of the metal ring as a single stressed unit was about 1.49% when subjected to an axial force of 0.5 N. At this time, the material was in the linear elastic phase and the maximum deformation was about 0.308 9 mm, which was 3.26% higher than the theoretical value. The maximum strain of the manipulator skeleton was about 0.21% in the linear elastic phase. The maximum total deformation was about 7.135 5 mm, which was 6.30% higher than the theoretical value. The flexural stiffness of the manipulator skeleton was calculated to be 3.19 N·mm 2, which was comparable to a flexible manipulator made of shape memory polymers (SMPs) of the same magnitude and size. Conclusions:A skeleton structure for application to NOTES robotic flexible manipulators is developed that meets the support stiffness requirements for performing NOTES surgical tasks.

Objective:To explore the clinical efficacy and safety of moderate-dose glucocorticoid treatment in patients with advanced thymoma.Methods:A retrospective analysis was conducted on clinical data of 56 patients with thymoma who received glucocorticoid treatment at Beijing Tongren Hospital, Capital Medical University, from January 2018 to March 2023. Among them, there were 33 males and 23 females; aged from 28 to 72 years old, with a median age of(43.8±11.2)years old. There were 16 cases of type B1 thymoma, 23 cases of type B2, and 17 cases of type B3. There were 17 cases with myasthenia gravis and 1 case with pure red blood cell aplasia. All patients had received radiotherapy or chemotherapy. Patients received moderate-dose glucocorticoid treatment(50 mg/day), and tumor response was evaluated by CT scan after 2 weeks of treatment. The tumor treatment effect and adverse reactions were recorded.Results:Among the patients, 22 cases achieved partial remission, and 3 cases achieved complete remission, resulting in an overall objective response rate (ORR) of 44.6%. Among them, 23 patients had type B2 thymoma, with 17 achieving partial remission and 3 achieving complete remission, resulting in an ORR of 87.0%. Among the 16 patients with type B1 thymoma, 5 achieved partial remission. No efficacy was observed in 17 patients with type B3 thymoma. The follow-up period ranged from 2 to 26 months, and 2 patients experienced thymoma recurrence.Conclusion:Moderate-dose glucocorticoid treatment demonstrates effective and safe outcomes in advanced or invasive thymoma, particularly for the treatment of type B2 thymoma.

Objective:Analyzed the clinicopathological features of thymoma with alopecia areata, and discussed the pathogenesis and treatment methods.Methods:The clinicopathologic data of patients with thymoma who underwent surgery from August 1, 2015 to July 31, 2020 in Beijing Tongren Hospital, Capital Medical University were reviewed. Transversally analyzed the patients of thymoma with alopecia areata and longitudinally compared with the patients of thymoma without alopecia areata after 1﹕10 matched by propensity score matching.Results:A total of 252 patients of thymoma were enrolled, including 6 patients with alopecia areata, accounting for 2.38%. The anti-AchR antibody, CD4 + /CD8 + T inversion in serum and myasthenia gravis were present in the all 6 thymoma patients with alopecia areata, which were significantly higher than those in the group of thymoma without alopecia areata. Besides myasthenia gravis, the proportion of complicated with other autoimmune diseases in thymoma patients with alopecia areata was significantly higher than that of thymoma patients without alopecia areata[83.33%(5/6) vs. 20.00%(12/60), P=0.003]. After operation, 5 patients’ alopecia areata were improved in 6 thymoma patients with alopecia areata(83.33%, 5/6). Conclusion:The thymoma patients with alopecia areata always complicated with myasthenia gravis and other autoimmune diseases. The pathogenesis may be associated with autoimmune CD8 + T lymphocytes produced by thymoma. At present, surgery is still the most effective way to improve thymoma-associated alopecia areata.

Objective To systematically evaluate and analyze the qualitative research on the experience of maintenance hemodialysis patients,so as to provide references for the implementation of exercise interventions in maintenance hemodialysis patients.Methods We searched databases including PubMed,Embase,Web of Science,Cochrane Library,PsycINFO,CINAHL,CBM,CNKI,WanFang Database and VIP from inception to September 30,2022,to collect qualitative studies about exercise experience of maintenance hemodialysis patients.The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia.The results were integrated by integrating methods.Results A total of 14 studies were included.47 completed findings were grouped according to their similarities to form 12 categories.These categories resulted in 4 synthesized findings.Integration results 1:recognizing the positive effects and potential risks of intradialytic exercise.Integration results 2:barriers and facilitators of intradialytic exercise.Integration results 3:needs of intradialytic exercise.Integration results 4:exercise experience on non-dialysis day.Conclusion The experience and needs of maintenance hemodialysis patients should be considered to ensure patient compliance and continuity when exercise programs were designed.

Objective:To explore the effect of group education intervention strategy based on harmonious nursing theory on understanding and application of pelvic floor knowledge and exercise skills in first gestation women, so as to promote the early recovery of pelvic floor function in postpartum women.Methods:This study was a quasi-experimental study. A total of 80 first gestation women in the pregnant women′s school of the First Hospital of Shanxi Medical University were selected as the research objects, 40 women from April to May 2023 were involved in the control group and 40 women from June to July 2023 were involved in the intervention group. The control group was given routine health education, while the intervention group was given group educational nursing intervention based on harmonious nursing theory. The Primary Prevention of Female Pelvic Floor Dysfunction-self-care Ability Scale was used to evaluate and compare the primary prevention self-care ability of pelvic floor dysfunction among pregnancy 1-4 weeks between the two groups before and after pregnancy intervention. Pelvic floor muscle strength was measured and pelvic floor function exercise compliance was evaluated during outpatient follow-up at 42-49 days postpartum (hereinafter referred to as postpartum 42 days) to evaluate and compare the rehabilitation effect of pelvic floor skills exercise between the two groups at 42 days postpartum.Results:Finally, the control group was (29.97 ± 3.68) years old involved 38 cases, and the intervention group was (29.79 ± 3.66) years old involved 38 cases. There was no significant difference in self-care ability score of primary prevention of pelvic floor dysfunction between the two groups before intervention ( P>0.05). After pregnancy intervention, the scores of self-care knowledge, self-care responsibility, self-care skills, self-regulation and total score of the intervention group were (58.13 ± 6.46), (11.73 ± 1.18), (10.16 ± 0.86), (29.21 ± 2.74) and (109.21 ± 8.92) points, respectively, which were higher than the control group (47.76 ± 4.25), (11.05 ± 1.09), (8.82 ± 1.78), (27.34 ± 2.18), (94.97 ± 6.46) points, and the differences between the two groups were statistically significant ( t values were - 8.26 - - 2.63, all P<0.05). In the intervention group, the maximum value of the fast muscle stage and the mean value of the slow muscle stage of the comparison of pelvic floor muscle strength between the two groups 42 days after delivery were 48.25(44.75, 53.45)μV and 31.00 (27.33, 34.23) μV, respectively, which were higher than the control group 36.80 (32.25, 44.28) μV and 22.40 (19.28, 25.88) μV, the differences between the two groups were statistically significant ( Z = - 4.98, - 5.37, both P<0.01). There was no significant difference in the average value of the pre-resting stage and the average value of the post-resting stage between the two groups ( P>0.05). Comparison of pelvic floor functional exercise compliance between the two groups showed that in the intervention group, the proportion of good compliance was 73.7% (28/38), and the proportion of general compliance was 26.3% (10/38), while in the control group, the proportion of general compliance was 86.8% (33/38) and the proportion of good compliance was 7.9% (3/38). The difference between the two groups was statistically significant ( χ2 = 34.46, P<0.01). Conclusions:Application of the theory of harmonious nursing group educational nursing intervention was carried out on the first gestation women, can effectively improve the first gestation women during pregnancy pelvic floor functional exercise primary prevention self-care ability level, strengthen puerperal women pelvic floor muscle, improve the puerperal pelvic floor functional exercise adherence, coordination and optimization of the first gestation women early for pelvic floor functional rehabilitation nursing process.

Objective To explore the effects of polyethylene glycol-2-methoxyestradiol(PEG-2ME2/2ME2)nanoparticles on cerebral vascular endothelial RBE4 cells after oxygen glucose deprivation/reperfusion(OGD/R).Methods To construct the PEG-2ME2/2ME2 nanoparticles by solvent evaporation method,and the characterization of nanoparticles was detected by transmission electron microscope(TEM)and laser particle size analyzer;the cellular cytotoxicity of PEG-2ME2/2ME2 nanoparticles was detected by CCK-8.Using OGD/R to simulate the process of ischemia-reperfusion in vitro,to detect the cell activity by CCK-8;Western blot and immu-nofluorescence were used to detect the expression of tight junction proteins,and the barrier function of cerebrovascular endothelial cells was comprehensively evaluated by establishing blood-brain barrier(BBB)model in vitro and measuring fluorescence probe leakage;re-active oxygen species(ROS)probe was used to detect the ROS level of RBE4 cells,and Western blot was used to detect superoxide dis-mutase to identify the redox status of RBE4 cells.Results The results of TEM showed that the spherical morphology of PEG-2ME2/2ME2 nanoparticles was stable,and the results of laser particle size analyzer showed that the size of PEG-2ME2/2ME2 nanoparticles was uniform;the results of CCK-8 assay showed that the PEG-2ME2/2ME2 nanoparticles had no significant cytotoxicity to RBE4 cells with-in 5μmol/L of 2ME2;the results of CCK-8 assay showed that PEG-2ME2/2ME2 nanoparticles rescued the cellular activity of RBE4 cells after OGD/R compared to the 2ME2 alone,inhibited the downregulation of tight junction protein expression,and effectively restored the barrier function of cerebral vascular endothelial cells;the detection results of ROS probe and Western blot showed that PEG-2ME2/2ME2 nanoparticles reduced intracellular ROS levels,restored the expression of superoxide dismutase compared to the 2ME2 alone.Conclusion PEG-2ME2/2ME2 nanoparticles have uniform size and stable morphology,which can protect RBE4 cells against OGD/R,effectively restore the integrity and barrier function of the blood-brain barrier.The PEG-2ME2/2ME2 nanoparticles are expected to be-come potential drugs for the treatment of cerebrovascular endothelial barrier injury after OGD/R.

Objective:To seek the effect of group education under the BOPPPS model(bridge-in, objective, pre-assessment, participatory learning, post-assessment, summary) on the breastfeeding competency of first gestation women, to improve the breastfeeding competency of first gestation women and promote the realization of postpartum breastfeeding.Methods:Eighty-one first gestation women were chosen from the gestation class of the First Affiliated Hospital of Shanxi Medical University, the quasi-experimental research method was adopted, 40 women from January to February 2022 were involved in the control group and 41 women from May to June 2022 were involved in the intervention group. The control group was assigned common education, while the intervention group was assigned group education based on BOPPPS model. Breastfeeding Competency Scale (BCS) and breastfeeding family support questionnaire were used to compare breastfeeding competency and family support level of the two groups before and after intervention, and the skin contact rate at 1 hour after delivery and the pure breastfeeding rate at 42 days after delivery were compared between the two groups.Results:Before intervention, there was no significant difference in breastfeeding competency and family support level between the two groups (all P>0.05). After 4 weeks of intervention, the scores of breastfeeding competency and family support were (147.59 ± 13.50), (3.16 ± 0.18) points in the intervention group, more than those in the control group (125.48 ± 16.87), (2.87 ± 0.22) points, the differences were statistically significant between the two groups ( t=-6.52, -6.30, both P<0.05). The skin contact rate at 1 hour after delivery and the pure breastfeeding rate at 42 days postpartum were 75.6%(31/41), 53.7%(22/41) in the intervention group, more than those in the control group 52.5%(21/40), 30.0%(12/40), the differences were statistically significant between the two groups ( χ 2=4.71, 4.65, both P<0.05). Conclusions:Group education based on BOPPPS model can improve the level of breastfeeding competency and family support of gestation women. It increases the skin contact rate, and plays a good role in promoting the increase of pure breastfeeding rate.

OBJECTIVE To investigate the effects and mechanism of luteolin on osteogenic repair of bone defects. METHODS The targets and potential pathways of luteolin in the treatment of bone defects were screened by network pharmacology method， and then the top 2 targets were selected by Hub gene screening for molecular docking verification， with binding energy as the evaluation standard. In vitro experiments were conducted on rat bone mesenchymal stem cells （BMSC） and rat umbilical vein endothelial cells （RUVEC）. Phenotypic validation was performed using alkaline phosphatase staining， alizarin red S staining， and in vitro angiogenesis experiments. Western blot assay was used to detect the protein expressions of phosphatidylinositol 3 kinase （PI3K） and protein kinase 1 （Akt1）， so as to validate the mechanism of luteolin on osteogenic differentiation of BMSC and angiogenesis of RUVEC in vitro. RESULTS The results of network pharmacology showed that the effects of luteolin on vascular formation and bone repair in bone defects were mainly related to Akt1， SRC， estrogen receptor 1， epidermal growth factor receptor， cyclooxygenase 2， matrix metalloproteinase 9 targets， and were closely related to PI3K-Akt signaling pathway. The results of molecular docking showed that luteolin binding to Akt1 and SRC proteins was stable. The results of in vitro experiments showed that luteolin could significantly improve the expressions and activities of alkaline phosphatase in BMSC， increased the number of calcium salt deposits and calcified nodules， and promoted calcification of BMSC. Compared with luteolin 0 μmol/L group， the angiogenesis ability of RUVEC was enhanced significantly in luteolin 1， 10 μmol/L groups， the length of blood vessels and the protein expressions of PI3K and Akt1 were significantly increased （P＜0.05 or P＜0.01）； the higherthe concentration， the better the effect. CONCLUSIONS Luteolin may play a role in promoting angiogenesis and bone repair at the fracture site by activating PI3K/Akt signaling pathway and promoting the protein expressions of PI3K and Akt1.