Objective To construct a prediction model for the risk of peripherally inserted central venous catheter(PICC)-related bloodstream infection(CRBSI)in preterm infants,and evaluate the effect of the model.Methods 1 295 preterm infants admitted to the neonatal intensive care unit(NICU)in a hospital and received PICC intrave-nous infusion from January 2019 to October 2023 were selected as the study subjects,including 1 080 preterm in-fants from January 2019 to December 2022 in the modeling set and 215 premature infants from January to October 2023 in the validation set.Risk factors of cases were analyzed based on 24 clinical characteristics,optimized charac-teristics was selected by LASSO regression,independent risk factors for CRBSI of preterm infants during PICC in-dwelling period were identified by multiple logistic regression analysis,and nomogram model was constructed with R software.Discrimination and fitting of the model were evaluated by the area under the curve(AUC)of the receiver operating characteristic(ROC)as well as Hosmer-Lemeshow test and calibration curve,and clinical practicality of the model was evaluated by decision curve analysis(DCA).Results Multivariate logistic analysis showed that birth weight ≥1 500 g,sterile protection during catheter maintenance,and sterile cloth wrapped joints were protective factors for CRBSI during PICC indwelling period in preterm infants(OR=0.172,0.187,0.063,respectively,all P＜0.05),while puncture frequency＞2 times,catheter indwelling period＞14 days,and use of tees were inde-pendent risk factors for CRBSI during PICC indwelling period in premature infants(OR=2.533,14.128,13.256,respectively,all P＜0.05).The AUC of ROC of the modeling set was 0.953(95％CI:0.936-0.969),and that of the validation set was 0.930(95％CI:0.885-0.974),indicating good discriminability of the model.The calibra-tion curve and Hosmer-Lemeshow goodness of fit test showed that the model had good accuracy and consistency,with high net profit value,indicating that the predictive value of the model was high and with good clinical practica-lity.The statistical test result in the rationality analysis of the model was P＜0.001.Conclusion The nomogram model based on the general clinical characteristics of preterm infants as well as the basic prevention and control measures of the catheter can provide a visual and simple evaluation tool for early identification of high risk factors for CRBSI in preterm infants.

Five meroterpenoids, rhodonoids K-M (1-2), daurichromene E (3), and grifolins A-B (4-5), together with seven known compounds (6-12), were isolated from Rhododendron anthopogonoides. The chemical structures of these compounds were elucidated through comprehensive analysis of high-resolution electrospray ionization mass spectrometry (HR-ESI-MS), ultraviolet (UV), infrared spectroscopy (IR), and nuclear magnetic resonance (NMR) data. Their absolute configurations were determined by comparing experimental electronic circular dichroism (ECD) spectra with computed values. Notably, compounds 1 and 3 demonstrated significant inhibitory effects on lipopolysaccharide (LPS)-induced inflammation in RAW264.7 cells. These compounds markedly suppressed the mRNA expressions of inflammatory factors, including interleukin (IL)-1β, IL-6, and tumor necrosis factor-α (TNF-α) while also down-regulating the protein expressions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2).
Mice ; Rhododendron/chemistry* ; Animals ; Anti-Inflammatory Agents/isolation & purification* ; RAW 264.7 Cells ; Terpenes/isolation & purification* ; Molecular Structure ; Tumor Necrosis Factor-alpha/immunology* ; Cyclooxygenase 2/immunology* ; Nitric Oxide Synthase Type II/immunology* ; Macrophages/immunology* ; Interleukin-6/immunology* ; Lipopolysaccharides ; Interleukin-1beta/immunology*

Objective:To investigate the relationship between lean lipid accumulation product (LAP) and metabolic associated fatty liver disease (MAFLD).Methods:This cross-sectional study consecutively enrolled 1 990 adult subjects who underwent health examinations at the Second Affiliated Hospital of Xi′an Jiaotong University between June 2021 and May 2023. All recruited participants had a body mass index (BMI)<23 kg/m2. Data collection included general information, physical examination, serum biochemical parameter measurements, and liver ultrasonography. Participants were divided into four groups (Q1-Q4) according to quartiles value of LAP from low to high. The differences of biochemical parameters and the prevalence of lean MAFLD were compared among the groups. Logistic regression, restricted cubic spline (RCS) and receiver operating characteristic (ROC) curve analysis were used to explore the relationship between LAP and lean MAFLD and assess the diagnostic predictive value of LAP for lean MAFLD.Results:A total of 1990 participants were selected, and the detection rate of lean MAFLD was 4.97% (99 cases). The detection rate of lean MAFLD showed a significant increasing trend from Q1 to Q4 groups ( P<0.001) and respectively was 0.40%, 0.81%, 4.01% and 14.70%. The average age, male proportion, BMI and waist circumference significantly increased in a dose-response manner from Q1 to Q4 (all P<0.001). Indirect bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-glutamyltranspeptidase, alkaline phosphatase, total cholesterol, triglycerides, low-density lipoprotein, serum uric acid, fasting blood glucose, fatty liver index, fibrosis-4 index and every metabolic syndrome component in groups Q2 to Q4 were significantly higher than in the Q1 group, while high-density lipoprotein levels gradually decreased (all P<0.05). RCS showed that the risk of lean MAFLD rose significantly with the increase of LAP ( P<0.005), presenting a nonlinear relationship between them ( P for nonlinear<0.001). Logistic regression analysis revealed that after adjusting other confounding factors, the risk of lean MAFLD in the Q4 group remained 4.75 times higher than that in the Q1 group (95% CI: 11.22-31.69, P<0.05). ROC curve demonstrated that LAP had a better predictive value for lean MAFLD than BMI and waist circumference, with area under the curve of 0.839, critical value of 19.59, diagnostic sensitivity of 82.8% and specificity of 75.1%. Conclusions:Elevated LAP is independently and positively correlated with the risk of lean MAFLD, and its predictive efficacy is significant superior to traditional obesity indicators.

Cognitive decline is one of the most common adverse symptoms following acute high-altitude exposure(AHAE).MRI can reveal the structural and functional changes in brain caused by AHAE,thereby deeply understanding the specific mechanism of its cognitive decline,which is of great significance for early prevention and intervention.Research progresses on MRI assessment of cognitive function after AHAE and related intervention methods were reviewed in this article.

Objective:To investigate the correlation between the expression of the immunohistochemical marker cytokeratin (CK)-19 and the clinical characteristics and prognosis of dual-phenotype hepatocellular carcinoma (DPHCC).Methods:The data of patients diagnosed with hepatocellular carcinoma (HCC) who underwent surgical resection were collected. DPHCC cases were screened by immunohistochemistry, followed up, and grouped. The correlation between the expression of the immunohistochemical marker CK-19 and the clinical pathological characteristics and prognosis of DPHCC was analyzed by statistical methods. The enumeration data were compared using the χ2 test or Fisher's exact probability method between groups. Results:The expression of CK19 was significantly correlated with factors such as the tumor size, histological grade, liver tissue cirrhosis surroundings, microvascular invasion (MVI), and serum carbohydrate antigen 199 (CA-199) levels in DPHCC, and the differences were statistically significant ( P<0.05). There was no significant correlation between the expression of CK19 and the gender, age, tumor necrosis, multiple lesions, liver capsule invasion, serum alpha-fetoprotein (AFP), and immunohistochemical CK7 and mucin 1 (MUC-1) in DPHCC patients, and the differences were not statistically significant ( P>0.05). The results of univariate analysis showed that immunohistochemical CK19 expression, MVI, number of lesions, tumor necrosis, tumor differentiation degree, serum AFP, and carbohydrate antigen 199 levels were related factors affecting the prognosis in DPHCC patients ( P<0.05); while gender, age, capsule invasion, tumor size, and expression of immunohistochemical markers (vascular endothelial growth factor, CK7, MUC-1) were not significantly correlated with the prognosis in DPHCC patients ( P>0.05). The results of multivariate analysis showed that tumor necrosis ( P=0.042, 95% CI: 1.031-5.501) and serum AFP levels were independent risk factors affecting the prognosis in DPHCC patients ( P<0.001, 95% CI: 2.581-24.075). Conclusions:The expression of CK19 is closely related to the prognosis of patients with DPHCC. Patients with high CK19 expression have faster disease progression than those with low CK19 expression. Furthermore, the overall survival rate of patients with high CK19 expression is significantly lower than that of patients with low CK19 expression, which is a risk factor for poor prognosis in patients with DPHCC.

Objective:To investigate the current status and influencing factors of barriers to going out among elderly patients with chronic obstructive pulmonary disease (COPD), and to provide a reference for implementing targeted preventive measures.Methods:Elderly COPD patients from the People's Hospital of Xinjiang Uygur Autonomous Region were selected between January and May 2024 by convenience sampling. A cross-sectional survey was conducted using a general information questionnaire, Scale on Barriers to Going Out for the Elderly, Perceived Isolation Scale and COPD Assessment Test (CAT).Results:A total of 270 questionnaires were distributed, with 250 valid responses, the effective response rate was 92.6%. Among the 250 elderly COPD patients, there were 124 males and 126 females, with age distributions: 116 patients aged 60-69 years, 94 aged 70-79 years, and 40 aged ≥80 years. The total score for Scale on Barriers to Going Out for the Elderly was (20.01 ± 4.09). The score on barriers to going out in elderly COPD patients were positively correlated with the Perceived Isolation Scale and CAT scores ( r = 0.456 and 0.625, both P <0.05). Multiple linear regression analysis revealed that age, oxygen therapy, exercise habits,Perceived Isolation Scale, and CAT score classification were the main influencing factors for barriers to going out ( t values were -2.85 to 8.93, all P<0.05), explaining 63.0% of the total variance. Conclusions:The level of barriers to going out in elderly COPD patients is moderate-to-high level. Healthcare professionals should emphasize the assessment of barriers to going out, closely monitor high-risk groups, and develop and implement interventions to prevent such barriers.

Objective:To strengthen the management of low-value consumables in public hospitals by introducing the Supply Processing Distribution(SPD)management model,and to explore refined operational management strategies and path optimization for low-value consumables.Methods:The SPD management model was introduced,and the entire process of hospital consumables was refinedly managed using third-party supply chain information management platforms,visualized tertiary department warehouses,Radio Frequency Identification(RFID)technology and intelligent cabinet systems,Unique Device Identification(UDI)coding,"four-code integration"and other supporting technologies.Results:Based on the analysis of the current situation in the target Hospital,specific measures related to the management of low-value consumables were introduced after the introduction of the SPD model.Conclusion:It provides a reference and guidance for the hospital's medical consumables management department to promote refined management of medical consumables under the SPD model.

ObjectiveTo analyze the diversity and structural characteristics of microbial communities in the rhizosphere soil of healthy and diseased Andrographis paniculata and to explore the interactions of soil， plants， and microorganisms during the occurrence of diseases. MethodsThe physicochemical properties of the rhizosphere soil of healthy and diseased A.paniculata were determined， and the composition and diversity of bacterial and fungal communities in the rhizosphere soil were analyzed by Illumina high-throughput sequencing. Furthermore， the correlations between physicochemical properties and microorganisms of the rhizosphere soil were explored. ResultsThe content of total nitrogen， total potassium， and available potassium in the rhizosphere soil of diseased A. paniculata was significantly higher than that of healthy A. paniculata. The alpha diversity and richness （operational taxonomic units） of bacterial and fungal communities in the rhizosphere soil of diseased plants decreased compared with those of healthy plants. The microbial communities in the rhizosphere soil of healthy and diseased A. paniculata showed similar composition but different relative abundance. At the phylum level， the relative abundance of Proteobacteria and Chytridiomycota significantly increased， while that of Bacteroidota significantly decreased in the rhizosphere soil of diseased plants. At the genus level， the relative abundance of Sphingomonas， Pseudomonas， and Bryobacter significantly increased， while that of RB41 showed a significant decrease in the rhizosphere soil of diseased plants. The correlation analysis showed different correlations of microbial phyla with physicochemical properties of the rhizosphere soil between healthy and diseased plants. Organic matter， alkaline nitrogen， available phosphorus， and total potassium were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of healthy plants， while available nitrogen and total phosphorus were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of diseased plants. ConclusionThere are differences in the diversity and richness of microbial communities in the rhizosphere soil of healthy and diseased A. paniculata. The physicochemical properties of soil may have an impact on the rhizosphere microorganisms of A. paniculata， leading to the development of diseases. The results provide a scientific basis for the prevention and ecological management of A. paniculata diseases.

ObjectiveTo analyze the diversity and structural characteristics of microbial communities in the rhizosphere soil of healthy and diseased Andrographis paniculata and to explore the interactions of soil， plants， and microorganisms during the occurrence of diseases. MethodsThe physicochemical properties of the rhizosphere soil of healthy and diseased A.paniculata were determined， and the composition and diversity of bacterial and fungal communities in the rhizosphere soil were analyzed by Illumina high-throughput sequencing. Furthermore， the correlations between physicochemical properties and microorganisms of the rhizosphere soil were explored. ResultsThe content of total nitrogen， total potassium， and available potassium in the rhizosphere soil of diseased A. paniculata was significantly higher than that of healthy A. paniculata. The alpha diversity and richness （operational taxonomic units） of bacterial and fungal communities in the rhizosphere soil of diseased plants decreased compared with those of healthy plants. The microbial communities in the rhizosphere soil of healthy and diseased A. paniculata showed similar composition but different relative abundance. At the phylum level， the relative abundance of Proteobacteria and Chytridiomycota significantly increased， while that of Bacteroidota significantly decreased in the rhizosphere soil of diseased plants. At the genus level， the relative abundance of Sphingomonas， Pseudomonas， and Bryobacter significantly increased， while that of RB41 showed a significant decrease in the rhizosphere soil of diseased plants. The correlation analysis showed different correlations of microbial phyla with physicochemical properties of the rhizosphere soil between healthy and diseased plants. Organic matter， alkaline nitrogen， available phosphorus， and total potassium were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of healthy plants， while available nitrogen and total phosphorus were correlated with the relative abundance of some dominant bacterial and fungal phyla in the rhizosphere soil of diseased plants. ConclusionThere are differences in the diversity and richness of microbial communities in the rhizosphere soil of healthy and diseased A. paniculata. The physicochemical properties of soil may have an impact on the rhizosphere microorganisms of A. paniculata， leading to the development of diseases. The results provide a scientific basis for the prevention and ecological management of A. paniculata diseases.

Objective:To investigate the relationship between lean lipid accumulation product (LAP) and metabolic associated fatty liver disease (MAFLD).Methods:This cross-sectional study consecutively enrolled 1 990 adult subjects who underwent health examinations at the Second Affiliated Hospital of Xi′an Jiaotong University between June 2021 and May 2023. All recruited participants had a body mass index (BMI)<23 kg/m2. Data collection included general information, physical examination, serum biochemical parameter measurements, and liver ultrasonography. Participants were divided into four groups (Q1-Q4) according to quartiles value of LAP from low to high. The differences of biochemical parameters and the prevalence of lean MAFLD were compared among the groups. Logistic regression, restricted cubic spline (RCS) and receiver operating characteristic (ROC) curve analysis were used to explore the relationship between LAP and lean MAFLD and assess the diagnostic predictive value of LAP for lean MAFLD.Results:A total of 1990 participants were selected, and the detection rate of lean MAFLD was 4.97% (99 cases). The detection rate of lean MAFLD showed a significant increasing trend from Q1 to Q4 groups ( P<0.001) and respectively was 0.40%, 0.81%, 4.01% and 14.70%. The average age, male proportion, BMI and waist circumference significantly increased in a dose-response manner from Q1 to Q4 (all P<0.001). Indirect bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-glutamyltranspeptidase, alkaline phosphatase, total cholesterol, triglycerides, low-density lipoprotein, serum uric acid, fasting blood glucose, fatty liver index, fibrosis-4 index and every metabolic syndrome component in groups Q2 to Q4 were significantly higher than in the Q1 group, while high-density lipoprotein levels gradually decreased (all P<0.05). RCS showed that the risk of lean MAFLD rose significantly with the increase of LAP ( P<0.005), presenting a nonlinear relationship between them ( P for nonlinear<0.001). Logistic regression analysis revealed that after adjusting other confounding factors, the risk of lean MAFLD in the Q4 group remained 4.75 times higher than that in the Q1 group (95% CI: 11.22-31.69, P<0.05). ROC curve demonstrated that LAP had a better predictive value for lean MAFLD than BMI and waist circumference, with area under the curve of 0.839, critical value of 19.59, diagnostic sensitivity of 82.8% and specificity of 75.1%. Conclusions:Elevated LAP is independently and positively correlated with the risk of lean MAFLD, and its predictive efficacy is significant superior to traditional obesity indicators.