Objective: To explore the clinical features, treatment and prognosis of emphysematous pyelonephritis (EPN), so as to enhance the clinical awareness of this disease. Methods: A retrospective analysis was conducted on the clinical data of one EPN patient at The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, and a literature review was performed on articles published in the China National Knowledge Infrastructure and PubMed databases from Jan.1, 2015 to Dec.31, 2024. Results: The patient, a 62-year-old male with a 5 years' history of type 2 diabetes, was admitted due to left flank pain for 4 days, with a temperature of 39.4 ℃.Laboratory tests indicated significantly elevated inflammatory markers, decreased platelet count, and abnormal coagulation function.Preoperative blood and urine cultures showed positivity for Escherichia coli.Computed tomography (CT) revealed complete erosion of the left kidney, with gas in the left ureter and surrounding effusion, as well as multiple free gas in the abdominal cavity, bilateral ureteral stones, right renal lower calyx stones.After a multidisciplinary consultation, he underwent emergency phase Ⅰ left pyeloplasty and perirenal drainage with ureteral stenting.After discharge, the patient received maintenance hemodialysis once every two days in the outpatient clinic.One week after-discharge, the patient was readmitted due to polypnea.Following symptomatic management, vital signs stabilized.Approximately 2 months after the first-stage surgery, ureteroscopic stone extraction was successfully performed.One month after the stone extraction procedure, a follow-up CT showed normalization of the left kidney, renal pelvis and calyces, leading to phase Ⅱ laparoscopic left nephrectomy via the abdominal approach, with postoperative pathology indicating renal necrosis.Among 89 EPN patients reported in 35 articles, the median age was 58(24-92) years old；there were 59（66.3%） females and 30（33.7%） males；fever was the most common clinical symptom (60.7%)；73(82.0%) had diabetes, 12 (13.5%) had urinary tract obstruction；55 (61.8%) were infected with Escherichia coli, and 7 (7.9%) were infected with Klebsiella pneumoniae; 13 died due to ineffective treatmen. Conclusion: EPN presents acutely and progresses rapidly, often leading to misdiagnosis due to the lack of specific early symptoms.Abdominal CT is the preferred imaging modality for rapid diagnosis, and proactive interdisciplinary intervention can improve survival rates, reduce the need for nephrectomy, and enhance prognosis.

Objective:To explore the white matter structural characteristics in patients with bipolar disorder(BD)using diffusion tensor imaging(DTI)and investigate their relationship with cognitive function.Methods:A total of 15 patients with BD type Ⅰ and 26 patients with BD type Ⅱ who met the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)diagnostic criteria and 37 normal controls were included.Cognitive function was assessed with the Trail Making Test(TMT)and Repeatable Battery for the Assessment of Neuropsy-chological Status(RBANS).The tract-based spatial statistics(TBSS)method was used to explore the differences in fractional anisotropy(FA)and mean diffusivity(MD)among the three groups and perform correlation analyses with cognitive function.Results:Patients with BD Ⅰ and BD Ⅱ had lower scores in attention(P＜0.001),delayed memory(P＜0.01),and total scores(P＜0.001)on the RBANS compared to the normal control group.They also exhibited lower FA values in the corpus callosum and right superior corona radiata compared to the normal control group(P＜0.05).In the BD Ⅰ group,there was a positive correlation between FA values in the genu of corpus cal-losum and visuospatial/constructional scores(r=0.74,P＜0.05),while in the BD Ⅱ group,a positive correlation was found between FA values in the same region and language function scores(r=0.55,P＜0.05).Conclusion:It suggests that patients with bipolar disorder may have impaired white matter integrity in the corpus callosum and right superior corona radiata,which may be associated with cognitive impairment.

Alzheimer's disease (AD) is a central nervous system degenerative disease that is prone to occur in the pre-senile period and senile period . It is characterized by behavioral impairment and progressive cognitive impairment, with an insidious onset and progressive aggravation. It not only has cognitive decline, but also is accompanied by other neurological and psychiatric symptoms. Memory loss is the core symptom of the disease. Diabetes mellitus (DM) is a disease characterized by hyperglycemia. In recent years, with the increasing incidence of the two diseases, more and more studies have reported the correlation between AD and DM. This article reviews the correlation between AD and DM from the aspects of correlation research, pathological mechanism and drug treatment through the review of relevant literature, with a view to providing guidance for clinical practice.

Objective To analyze the clinical characteristics,drug resistance and risk factors for poor prognosis in children patients with carbapenem resistant Klebsiella pneumoniae(CRKP)infection.Methods The samples of CRKP isolated from the children inpatients in this hospital from August 5,2016 to December 31,2020 were collected.The clinical data and drug resistance of CRKP in the patients with CRKP positive were analyzed.The risk factors in the poor prognosis group and good prognosis group of children pa-tients with CRKP infection conducted the correlation analysis.Results A total of 106 strains of non-repeti-tive CRKP were collected,which were mainly isolated from the patients ≤ 1 year old.The department distri-bution was dominated by the neonatal ICU and comprehensive ICU.CRKP showed the high resistance to mul-tiple antibacterial drugs,and its resistance rates to amikacin,levofloxacin,gentamicin,ciprofloxacin,minocy-cline and chloramphenicol were less than 30％.The poor prognosis rate in the children patients with CRKP in-fection reached 27.4％.The logistic multivariate regression analysis results showed that the multiple organ dysfunction and anemia were the independent risk factors for poor prognosis in the children patients with CRKP infection(P＜0.05).Conclusion The children CRKP infection is mainly the infants ≤1 years old,and CRKP shows the high resistance to multiple antibacterial drugs,the independent risk factors of poor prognosis include the multiple organ dysfunction and anemia

Objective To explore the correlation between the incidence of foodborne diseases and meteorological factors in Jinan, and to provide targeted measures for the prevention and control of foodborne diseases. Methods Data from the reporting systems of two sentinel hospitals for active surveillance of foodborne diseases from 2013 to 2021 in Jinan were collected. The meteorological data in the same period in Jinan were also collected. The generalized additive model was used to explore the nonlinear relationship between meteorological factors and the incidence of foodborne diseases, and threshold function analysis was use to perform subsection regression. Results The incidence of foodborne diseases was positively correlated with daily average temperature (r_s=0.23), relative humidity (r_s=0.05), and daily average wind speed (r_s=0.01), and negatively correlated with daily average air pressure (r_s=-0.19). Based on the GAM results and segmented regression analysis of meteorological factors, it was found that when the daily average temperature was below or above the threshold of 24.63°C, for every 1°C increase in daily average temperature, the incidence of foodborne diseases correspondingly increased by 0.04% and 0.18%. When the daily average wind speed was above the threshold of 2.26 m/s, the incidence of foodborne diseases decreased by 0.36% for every 1 m/s increase in the daily average wind speed. Conclusion Nine years of observation and data analysis have shown that meteorological factors such as daily average temperature, relative humidity, air pressure, and wind speed are related to the incidence of foodborne diseases. These findings suggest that meteorological factors may be important factors leading to foodborne diseases, which provides an important scientific basis for formulating effective prevention and control measures.

ObjectiveTo explore the interaction among root fungi of Stellaria dichotoma var. lanceolata， soil factors， and main components of medicinal materials in lithosol habitats. MethodHigh-throughput sequencing technology was employed to determine the fungal community of the root system of S. dichotoma var. lanceolata at different levels （bulk soil， rhizosphere soil， rhizoplane soil， and root interior） and the soil properties of the root system （bulk and rhizosphere）， and the relationship among the fungal community， soil properties， and the main components of medicinal materials was analyzed. ResultThe total phosphorus， available phosphorus， alkaline nitrogen， dissolved organic carbon， and soil water content in the rhizosphere soil of S. dichotoma var. lanceolata were slightly higher than those in the rhizosphere， but the difference was not significant. Ascomycota is the dominant phylum of root fungi in S. dichotoma var. lanceolata. In the progressive level of bulk-rhizosphere-rhizoplane-root interior system， although the fungal diversity gradually decreased， the abundance of Hypocreales， a new phylum （unclassified_ k_ Fungi）， Helotiales， and Natipusilales gradually increased， among which Hypocreales is the most important fungal group in the root system of S. dichotoma var. lanceolata. The structural equation model （SEM） shows that the physicochemical factors of the root-soil play an important regulatory role in the fungal community and the main components of medicinal herbs， with soil total nitrogen， alkaline nitrogen， soil water content， and pH being the main regulatory factors. Soil nitrogen content is the key to promoting the main components of the medicinal herbs， and Penicillium fungi are the key fungal group to regulate the main components of the medicinal herbs. ConclusionIt highlights that the physicochemical properties of the soil of S. dichotoma var. lanceolata play a crucial role in the fungal community and the components of medicinal materials. Hypocreales fungi in the root of S. dichotoma var. lanceolata were an important group， and Penicillium fungi had a certain role in mediating the components of medicinal materials.

Objective:To systematically review the adverse events and relatedfactors ofmindfulness-based stress reduction therapy(MBSR)and mindfulness-based cognitive therapy(MBCT).Methods:By searching the randomized controlled trails of adverse events and adverse effects of MBSR and MBCT from PubMed,CINAHL,Embase,Web of Science,Scopus,Proquest,ScienceDirect,PsycINFO databases and unpublished studies and grey literature,and traces the references and related journals of the included studies.The databases were searched from inception to June 1,2022.Meta analysis was performed by using RevMan 5.4 softwareto calculate combined odds radio(OR)and 95％CI.Results:Fifteen literatures with a total of 2 841 subjects were included in the study.The results of meta-analysis showed that there were statistically significant differences in the incidence of adverse events or adverse reactions between theMBSR and MBCT group and the control group(OR=2.48,95％CI:1.09-1.61,P＜0.05).The mindfulness-based intervention methods(only MBSR,OR=9.04,95％CI:5.34-15.30),the un-derlying diseases of the participants(complicated with mental disorders,OR=1.49,95％CI:1.12-1.97;compli-cated with physical diseases,OR=8.65,95％CI:5.17-14.45),exercise intensity(once a week for 8 weeks,each time more than 2 hours,OR=1.43,95％CI:1.04-1.96)and the level of mindfulness therapists(did not underg-one standardized training,OR=1.96,95％CI:1.20-3.23)were factors that may affect the occurrence of adverse events or adverse reactions in the process of MBSR and MBCT.Conclusion:During the MBSR and MBCT thera-py,there may be occur adverse events or adverse effects.

Objective:To explore the impact of sleep duration, physical exercise, and their interactions on the risk of dyslipidemia in older adults aged ≥80 (the oldest old) in China.Methods:The study subjects were the oldest old from four rounds of Healthy Aging and Biomarkers Cohort Study (2008-2009, 2011-2012, 2014 and 2017-2018). The information about their demographic characteristics, lifestyles, physical examination results and others were collected, and fasting venous blood samples were collected from them for blood lipid testing. Competing risk model was used to analyze the causal associations of sleep duration and physical exercise with the risk for dyslipidemia. Restricted cubic spline (RCS) function was used to explore the dose-response relationship between sleep duration and the risk for dyslipidemia. Additive and multiplicative interaction model were used to explore the interaction of sleep duration and physical exercise on the risk for dyslipidemia.Results:The average age of 1 809 subjects was (93.1±7.7) years, 65.1% of them were women. The average sleep duration of the subjects was (8.0±2.5) hours/day, 28.1% of them had sleep duration for less than 7 hours/day, and 27.2% had sleep for duration more than 9 hours/day at baseline survey. During the 9-year cumulative follow-up of 6 150.6 person years (follow-up of average 3.4 years for one person), there were 304 new cases of dyslipidemia, with an incidence density of 4 942.6/100 000 person years. The results of competitive risk model analysis showed that compared with those who slept for 7-9 hours/day, the risk for dyslipidemia in oldest old with sleep duration >9 hours/day increased by 22% ( HR=1.22, 95% CI: 1.07-1.39). Compared with the oldest old having no physical exercise, the risk for dyslipidemia in the oldest old having physical exercise decreased by 33% ( HR=0.67, 95% CI: 0.57-0.78). The RCS function showed a linear positive dose-response relationship between sleep duration and the risk for hyperlipidemia. The interaction analysis showed that physical exercise and sleep duration had an antagonistic effect on the risk for hyperlipidemia. Conclusion:Physical exercise could reduce the adverse effects of prolonged sleep on blood lipids in the oldest old.

Objective:To analyze the incidence and progression of overactive bladder(OAB)symp-toms following radical prostatectomy for prostate cancer patients and to identify related risk factors.Methods:A retrospective study was conducted on 263 local stage prostate cancer patients who underwent radical prostatectomy at Peking University Third Hospital from January 2013 to May 2017.Clinical base-line information,comprehensive imaging features,perioperative parameters,preoperative urinary control status,pathological diagnosis,and the incidence of OAB within one year postoperatively were collected and analyzed.In the imaging features,two parameters were defined:Bladder wall thickness(BWT)and bladder mucosal smoothness(BMS),which were used to predict the occurrence of OAB.Patients were evaluated based on their clinical baseline characteristics,including age,body mass index(BMI),co-morbidities,and prostate-specific antigen(PSA)levels.The imaging characteristics were assessed using preoperative MRI,focusing on BWT and BMS.Perioperative parameters included operative time,blood loss,and length of hospital stay.The OAB symptoms were assessed using the overactive bladder symptom score(OABSS)and the international prostate symptom score(IPSS).These scores were correlated with the postoperative incidence of OAB.Results:Among the 263 patients who underwent radical prostatecto-my,52(19.8％)exhibited OAB within one year postoperatively.Of the 40 patients with preoperative OAB symptoms,17(42.5％)showed remission postoperatively,while 23(57.5％)had persistent symptoms.Additionally,29 patients developed new-onset OAB,accounting for 55.77％of all postopera-tive OAB cases.Univariate analysis indicated that BWT,BMS,OABSS,and IPSS score were all associ-ated with the occurrence of postoperative OAB.Further multivariate analysis identified BMS as an inde-pendent risk factor for long-term OAB(P＜0.001).Conclusion:Long-term postoperative overactive bladder is a common complication following radical prostatectomy.The findings suggest that preoperative MRI measurements of bladder wall thickness and bladder mucosal smoothness during bladder filling phase can predict the risk of OAB occurrence postoperatively.Identifying these risk factors preoperatively can help in counseling patients about potential complications and in developing strategies to mitigate the risk of developing OAB after surgery.Early detection and management of these parameters might improve the quality of life for patients undergoing radical prostatectomy.

Objective:To develop the nursing staff's perception scale of patients′ suicide risk and test its reliability and validity, so as to provide basis for managers to formulate training strategies for nurses' suicide gatekeepers.Methods:This was a cross-sectional study. Based on cognitive-experiential self-theory, and on the basis of literature review and semi-structured interviews at home and abroad, a scale item pool was formed, and an initial scale was formed through expert inquiry and pre-investigation. In September, 2022, a cross-sectional survey was conducted among 459 nurses from three tertiary general hospitals and oncology hospitals by convenience sampling method in Jinan and Dezhou, Shandong Province. SPSS25.0 and AMOS23.0 software were used to analyze the items and test the reliability and validity of the scale.Results:The formal scale included three dimensions, namely, cognitive judgment, emotional evaluation, and concern, with 15 items in total. Exploratory factor analysis extracted three common factors, and the cumulative variance contribution rate was 67.845%. The results of confirmatory factor analysis showed that each test quantity of the fitness of the formal scale model is within the acceptable range and loads of 15 items in the corresponding factors were all >0.45; the content validity index S-CVI of the scale was 0.972, Cronbach′s α coefficient of the total scale was 0.907, and the half reliability was 0.814. Conclusion:The scale of nurses′ perception of patients′ suicide risk has good reliability and validity, and it can be used to evaluate nurses′ perceptions of patients′ suicide risk.