OBJECTIVE To explore the clinical distribution and drug resistance of common species of pathogens iso-lated from a three-A hospital of Guangzhou from Jan.2017 to 2023 Dec.so as to provide bases for clinical diagno-sis and reasonable use of antibiotics.METHODS A total of 10,086 strains of aerobic bacteria were clinically isola-ted from the patients who were hospitalized in a three-A hospital of Guangzhou from 2017 to 2023.The constituent ratios of the common species of pathogens,specimen sources,distribution of departments and drug resistance rates to commonly used antibiotics were retrospectively analyzed.RESULTS Totally 10,086 strains of pathogens were isolated from the specimens of the hospitalized patients from 2017 to 2023.Klebsiella pneumoniae,Pseudo-monas aeruginosa,Escherichia coli,Acinetobacter baumannii and Staphylococcus aureus ranked the top 5 species of pathogens.The sputum,midstream urine and whole blood were the major specimen sources.The hospital-asso-ciated infection was highly prevalent in critical care medicine department,neurology department,geriatrics depart-ment,neurosurgery department and urology department.The result of drug resistance showed that the drug re-sistance rates of the K.pneumoniae and P.aeruginosa strains to various types of antibiotics showed upward trends(P＜0.05);the drug resistance rate of the A.baumannii strains to imipenem was decreased,while the drug resist-ance rates to most of the antibiotics were more than 45％.No gram-positive cocci strains that were resistant to vancomycin,teicoplanin or linezolid were found.CONCLUSIONS The common clinical isolates of pathogens are generally resistant to antibiotics.It is necessary for clinicians to attach great importance to the culture of pathogens and drug susceptibility testing and reasonably use antibiotics based on the result of drug susceptibility testing so as to reduce the occurrence and spread of drug-resistant strains.The hospital should strengthen the surveillance of drug resistance of bacteria so as to boost the clinical curative effect,standardize the management and use of antibi-otics and take effective measures to control of the hospital-associated infection.

Objective To explore the effects of robot assisted training (RAT) combined with neural mobi-lization (NM) training on the recovery of upper limb functions in stroke patients. Methods A total of 110 stroke patients who met the inclusion criteria were selected as the subjects and randomly divided into a control group (n=28),RAT group (n=27),NM group (n=28),and combination group (n=27). All patients underwent routine upper limb occupational therapy. Additionally,the patients in the RAT group were treated with upper limb rehabilitation robots,those in the NM group underwent neural mobilization for treatment,those in the combination group were managed with robot-assisted training for upper limb rehabilitation and neural mobilization. Before treat-ment and 4 weeks after treatment,the modified Ashworth scale (MAS),Fugl-Meyer assessment upper extremity (FMA-UE),functional test for the hemiplegic upper extremity Hong Kong version (FTHUE-HK),and modified Barthel index (MBI) were used to assess the effects. The surface electromyographic signals of the biceps and triceps at the maximum isometric voluntary contraction (MIVC) position during elbow flexion and extension were measured,the integrated electromyographic values (iEMG) were recorded and the synergistic contraction rate (CR) was calculated. Results There was no statistically significant difference (P>0.05) between the four groups in the general information and pre-treatment assessments of MAS,FMA-UE,FTHUE-HK,MBI,iEMG,and CR. After 4 weeks,significant improvements were observed in all indicators compared to the pre-treatment assessments (P<0.05),with the exception of the triceps brachii CR,biceps brachii CR,and elbow extension MIVC biceps brachii iEMG in the control group.Among the group comparisons,all indicators showed statistically significant differences in mean or distribution (P<0.05),except for MAS and triceps brachii CR. The RAT group,NM group,and combination group all demonstrated significant improvements compared to the control group (P<0.05). Nota-bly,the combination group exhibited a greater degree of improvement than the RAT and NM groups. Conclusion RATcombined with NM can reduce upper limb muscle tone in stroke patients. This approacheffectively promotes the establishment of normal movement patterns,improve upper limb motor function,and enhance activities of daily living. This combination is effective and worthy of further clinical promotion and application.

Objective To analysa the correlation between the mRNA expression of potassium voltage-gated channel subfamily F member 1(KCNF1)in lung cancer tissue and clinical pathological features and prognosis.Methods 102 patients with lung cancer in Shexian People's Hospital and the First Affiliated Hospital of Bengbu Medical University from December 2019 to December 2021 were selected as the research object.All patients were divided into metastasis group(n=34)and non metastasis group(n=68)according to whether the patients had lung cancer metastasis.Compared the expression of KCNF1 protein and mRNA in lung cancer tissues and adjacent normal tissues.The influencing factors of metastasis of lung cancer were analyzed by univariate analysis.Spearman correlation was used to analyze the relationship between KCNF1mRNA expression and metastasis related factors.Analyzed the independent correlation between the expression of KCNF1 mRNA and the metastasis of lung cancer.Used survival curve analysis to investigate the relationship between KCNF1 protein levels and 3-year survival of lung cancer.Results The high expression rate of KCNF1 protein in lung cancer tissues was 38.24%(39/102),which was significantly higher than 7.84%(8/102)in adjacent normal tissues(χ2=26.568,P<0.001).The relative expression levels of KCNF1 mRNA in lung cancer tissues were significantly higher than those in adjacent normal tissues,the difference was statistically significant(t=23.127,P<0.001).Compared with the non metastatic group,the proportion of high and moderate differentiation in the metastatic group was higher,the proportion of TNM stages III to IV,KCNF1,Epidermal Growth Factor Receptor(EGFR),C-erbB-2,the mRNA expression levels of chemokine receptor 2(CXCR2),matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF)and HIF-l α were significantly increased,the differences were statistically significant(χ2/t=3.036～19.555,all P<0.05).The expression of KCNF1mRNA in lung cancer tissues was independently correlated with the metastasis of lung cancer.The expression of KCNF1mRNA and the transfer related factor EGFR,C-erbB-2,CXCR2,MMP-9,the expression of VEGF and HIF-l α was positively correlated(r=0.633～0.803,all P<0.05).The 3-year survival rate of patients with high expression of KCNF1 protein was significantly shorter than that of patients with low expression(HR=1.85,95%CI:1.04～3.27,P=0.032).Conclusion KCNF1mRNA and protein are highly expressed in lung cancer tissues,and its expression level is closely related to the metastasis and prognosis of patients with lung cancer,which is a risk factor for predicting the metastasis of lung cancer.

Objective To investigate the diagnostic accuracy and clinical applicability of the Linknet-VGG16 deep learning algorithm for measuring the effective optical zone(EOZ)after corneal refractive surgery.Methods This single-center retrospective cohort study included 69 patients(69 eyes)who underwent femtosecond laser-assisted in situ kerato-mileusis(FS-LASIK)(34 eyes)or small incision lenticule extraction(SMILE)(35 eyes)at the Refractive Surgery Center of Affiliated Zhengzhou Aier Eye Hospital of Henan University from June 2023 to June 2024.Data from the right eyes of all patients were selected for statistical analysis.During the surgery,patients in the FS-LASIK group adopted the VisuMax fem-tosecond laser system combined with the Amaris 750S excimer laser system,while those in the SMILE group only used the VisuMax femtosecond laser system.A total of 276 Pentacam images were re-examined postoperatively.A Linknet segmenta-tion model based on the VGG16 encoder was constructed,and image normalization techniques were applied to accelerate model convergence.Model performance was assessed using accuracy,intersection over union(IoU),and the Dice coeffi-cient.The traditional EOZ measurement method based on corneal tangential curvature served as the reference standard.Bland-Altman analysis was conducted to evaluate consistency across all images and within each group,and the time effi-ciency of both methods was compared.Results Six representative medical image segmentation architectures(U-Net,U-Net++,DeepLabv3-ResNet50,DeepLabv3+-ResNet50,Unet-Densenet169,and Linknet-VGG16)were systematically evaluated.The Linknet-VGG16 model demonstrated superior performance over the other 5 models in pixel-level accuracy,IoU and Dice coefficient,which were 99.83％,99.48％and 99.74％,respectively.Although there was no significant differ-ence in accuracy and Dice coefficient between Linknet-VGG16 and U-Net models(whose accuracy was 99.82％and Dice coefficient was 99.72％),the inference speed of the U-Net model(62.46 ms)was 31.76％slower than that of the Linknet-VGG16 model(42.62 ms).The evaluation results of a clinically applicable comprehensive scoring model(weights:accura-cy 20％,IoU 20％,Dice coefficient 20％,speed 25％,model size 15％)showed that the Linknet-VGG16 model achieved a score of 88.01,surpassing other architectures(U-Net:86.29;DeepLabv3+-ResNet50:80.41;DeepLabv3-ResNet50:73.82;U-Net++:73.22;Unet-Densenet169:66.66).Bland-Altman analysis revealed that the mean difference of the 136 images in the FS-LASIK group was 0.01 mm[95％limits of agreement(LoA):-0.36 to 0.35 mm],with 96.3％of data points falling within the LoA.The mean difference of the 140 images in the SMILE group was-0.01 mm(95％LoA:-0.36 to 0.33 mum),with 95.7％of data points falling within the LoA.The mean difference of all 276 images was 0.00 mm(95％LoA:-0.36 to 0.34 mm),with 96.4％of data points falling within the LoA.These results indicated excellent consistency.The average measurement time per image using the traditional EOZ measurement method was 13.00 minutes,whereas the deep learning model required only 3.22 seconds.Conclusion The traditional EOZ measurement method based on corne-al tangential curvature exhibits good consistency with the fully automatic EOZ measurement method based on deep learning algorithms,achieving high image recognition accuracy.Additionally,the deep learning algorithm significantly reduces measurement time,compared with the traditional method based on corneal tangential curvature.

Objective To investigate the effect of long-chain non-coding ribonucleic acid maternal expression 3(MEG3)on high glucose-induced pancreatic islet β-cell injury through the transforming growth factor-β-Smad 2/3 signaling pathway.Methods INS-1 rat insulinoma cells were divided into normal control(Con)group,HG group,negative control(si-NC)group,HG+si-NC group,siRNA targeting MEG3(si-MEG3)group,HG+si-MEG3 group,HG+si-MEG3+TGF-β-Smad2/3 signaling pathway inhibitor(HG+si-MEG3+LY2109761)group.Cell viability was detected by cell counting kit-8(CCK-8).The mRNA expression of MEG3 and pyroptosis-associated markers was detected by qRT-PCR.Autophagic vesicles were tested by transmission electron microscopy,and expression of autophagy-associated proteins and pyroptosis-associated proteins was detected by Western blot and immunofluorescence.TGF-β-Smad2/3 protein expression was detected by Western blot.Results Glucose downregulated MEG3 mRNA expression in a dose-dependent manner.Compared with si-NC group,p-Smad2,TGF-β1,Beclin1,LC3-II/LC3-I,NLRP3,GSDMD-N,IL-1β,ASC,and c-Caspase1 protein expression was elevated(P<0.05),and cell viability was decreased in HG+si-NC group(P<0.05).Compared with the HG+si-NC group,TGF-β1,NLRP3,GSDMD-N,IL-1β,ASC,c-Caspase1 protein expression was elevated(P<0.05),and p-Smad2,cell viability,Beclin1,and LC3-II/LC3-I were decreased in the HG+si-MEG3 group(P<0.05).Compared with HG+si-MEG3 group,NLRP3,GSDMD-N,IL-1β,ASC,and c-Caspase1 protein expression was elevated(P<0.05),and cell viability,p-Smad2,TGF-β1,Beclin1,and LC3-II/LC3-I protein expression was decreased in HG+si-MEG3+LY2109761 group(P<0.05).Conclusions MEG3 regulates autophagy and pyroptosis in pancreatic β-cells through the TGF-β-Smad2/3 signaling pathway.

To investigate the awareness of cognitive impairment disorders among residents of the Xizang Autonomous Region and its influencing factors, thereby providing a basis for targeted prevention and treatment efforts.

Objective To investigate the effect of long-chain non-coding ribonucleic acid maternal expression 3(MEG3)on high glucose-induced pancreatic islet β-cell injury through the transforming growth factor-β-Smad 2/3 signaling pathway.Methods INS-1 rat insulinoma cells were divided into normal control(Con)group,HG group,negative control(si-NC)group,HG+si-NC group,siRNA targeting MEG3(si-MEG3)group,HG+si-MEG3 group,HG+si-MEG3+TGF-β-Smad2/3 signaling pathway inhibitor(HG+si-MEG3+LY2109761)group.Cell viability was detected by cell counting kit-8(CCK-8).The mRNA expression of MEG3 and pyroptosis-associated markers was detected by qRT-PCR.Autophagic vesicles were tested by transmission electron microscopy,and expression of autophagy-associated proteins and pyroptosis-associated proteins was detected by Western blot and immunofluorescence.TGF-β-Smad2/3 protein expression was detected by Western blot.Results Glucose downregulated MEG3 mRNA expression in a dose-dependent manner.Compared with si-NC group,p-Smad2,TGF-β1,Beclin1,LC3-II/LC3-I,NLRP3,GSDMD-N,IL-1β,ASC,and c-Caspase1 protein expression was elevated(P<0.05),and cell viability was decreased in HG+si-NC group(P<0.05).Compared with the HG+si-NC group,TGF-β1,NLRP3,GSDMD-N,IL-1β,ASC,c-Caspase1 protein expression was elevated(P<0.05),and p-Smad2,cell viability,Beclin1,and LC3-II/LC3-I were decreased in the HG+si-MEG3 group(P<0.05).Compared with HG+si-MEG3 group,NLRP3,GSDMD-N,IL-1β,ASC,and c-Caspase1 protein expression was elevated(P<0.05),and cell viability,p-Smad2,TGF-β1,Beclin1,and LC3-II/LC3-I protein expression was decreased in HG+si-MEG3+LY2109761 group(P<0.05).Conclusions MEG3 regulates autophagy and pyroptosis in pancreatic β-cells through the TGF-β-Smad2/3 signaling pathway.

Objective To explore the effects of robot assisted training (RAT) combined with neural mobi-lization (NM) training on the recovery of upper limb functions in stroke patients. Methods A total of 110 stroke patients who met the inclusion criteria were selected as the subjects and randomly divided into a control group (n=28),RAT group (n=27),NM group (n=28),and combination group (n=27). All patients underwent routine upper limb occupational therapy. Additionally,the patients in the RAT group were treated with upper limb rehabilitation robots,those in the NM group underwent neural mobilization for treatment,those in the combination group were managed with robot-assisted training for upper limb rehabilitation and neural mobilization. Before treat-ment and 4 weeks after treatment,the modified Ashworth scale (MAS),Fugl-Meyer assessment upper extremity (FMA-UE),functional test for the hemiplegic upper extremity Hong Kong version (FTHUE-HK),and modified Barthel index (MBI) were used to assess the effects. The surface electromyographic signals of the biceps and triceps at the maximum isometric voluntary contraction (MIVC) position during elbow flexion and extension were measured,the integrated electromyographic values (iEMG) were recorded and the synergistic contraction rate (CR) was calculated. Results There was no statistically significant difference (P>0.05) between the four groups in the general information and pre-treatment assessments of MAS,FMA-UE,FTHUE-HK,MBI,iEMG,and CR. After 4 weeks,significant improvements were observed in all indicators compared to the pre-treatment assessments (P<0.05),with the exception of the triceps brachii CR,biceps brachii CR,and elbow extension MIVC biceps brachii iEMG in the control group.Among the group comparisons,all indicators showed statistically significant differences in mean or distribution (P<0.05),except for MAS and triceps brachii CR. The RAT group,NM group,and combination group all demonstrated significant improvements compared to the control group (P<0.05). Nota-bly,the combination group exhibited a greater degree of improvement than the RAT and NM groups. Conclusion RATcombined with NM can reduce upper limb muscle tone in stroke patients. This approacheffectively promotes the establishment of normal movement patterns,improve upper limb motor function,and enhance activities of daily living. This combination is effective and worthy of further clinical promotion and application.

Objective To analysa the correlation between the mRNA expression of potassium voltage-gated channel subfamily F member 1(KCNF1)in lung cancer tissue and clinical pathological features and prognosis.Methods 102 patients with lung cancer in Shexian People's Hospital and the First Affiliated Hospital of Bengbu Medical University from December 2019 to December 2021 were selected as the research object.All patients were divided into metastasis group(n=34)and non metastasis group(n=68)according to whether the patients had lung cancer metastasis.Compared the expression of KCNF1 protein and mRNA in lung cancer tissues and adjacent normal tissues.The influencing factors of metastasis of lung cancer were analyzed by univariate analysis.Spearman correlation was used to analyze the relationship between KCNF1mRNA expression and metastasis related factors.Analyzed the independent correlation between the expression of KCNF1 mRNA and the metastasis of lung cancer.Used survival curve analysis to investigate the relationship between KCNF1 protein levels and 3-year survival of lung cancer.Results The high expression rate of KCNF1 protein in lung cancer tissues was 38.24%(39/102),which was significantly higher than 7.84%(8/102)in adjacent normal tissues(χ2=26.568,P<0.001).The relative expression levels of KCNF1 mRNA in lung cancer tissues were significantly higher than those in adjacent normal tissues,the difference was statistically significant(t=23.127,P<0.001).Compared with the non metastatic group,the proportion of high and moderate differentiation in the metastatic group was higher,the proportion of TNM stages III to IV,KCNF1,Epidermal Growth Factor Receptor(EGFR),C-erbB-2,the mRNA expression levels of chemokine receptor 2(CXCR2),matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF)and HIF-l α were significantly increased,the differences were statistically significant(χ2/t=3.036～19.555,all P<0.05).The expression of KCNF1mRNA in lung cancer tissues was independently correlated with the metastasis of lung cancer.The expression of KCNF1mRNA and the transfer related factor EGFR,C-erbB-2,CXCR2,MMP-9,the expression of VEGF and HIF-l α was positively correlated(r=0.633～0.803,all P<0.05).The 3-year survival rate of patients with high expression of KCNF1 protein was significantly shorter than that of patients with low expression(HR=1.85,95%CI:1.04～3.27,P=0.032).Conclusion KCNF1mRNA and protein are highly expressed in lung cancer tissues,and its expression level is closely related to the metastasis and prognosis of patients with lung cancer,which is a risk factor for predicting the metastasis of lung cancer.

OBJECTIVE To explore the clinical distribution and drug resistance of common species of pathogens iso-lated from a three-A hospital of Guangzhou from Jan.2017 to 2023 Dec.so as to provide bases for clinical diagno-sis and reasonable use of antibiotics.METHODS A total of 10,086 strains of aerobic bacteria were clinically isola-ted from the patients who were hospitalized in a three-A hospital of Guangzhou from 2017 to 2023.The constituent ratios of the common species of pathogens,specimen sources,distribution of departments and drug resistance rates to commonly used antibiotics were retrospectively analyzed.RESULTS Totally 10,086 strains of pathogens were isolated from the specimens of the hospitalized patients from 2017 to 2023.Klebsiella pneumoniae,Pseudo-monas aeruginosa,Escherichia coli,Acinetobacter baumannii and Staphylococcus aureus ranked the top 5 species of pathogens.The sputum,midstream urine and whole blood were the major specimen sources.The hospital-asso-ciated infection was highly prevalent in critical care medicine department,neurology department,geriatrics depart-ment,neurosurgery department and urology department.The result of drug resistance showed that the drug re-sistance rates of the K.pneumoniae and P.aeruginosa strains to various types of antibiotics showed upward trends(P＜0.05);the drug resistance rate of the A.baumannii strains to imipenem was decreased,while the drug resist-ance rates to most of the antibiotics were more than 45％.No gram-positive cocci strains that were resistant to vancomycin,teicoplanin or linezolid were found.CONCLUSIONS The common clinical isolates of pathogens are generally resistant to antibiotics.It is necessary for clinicians to attach great importance to the culture of pathogens and drug susceptibility testing and reasonably use antibiotics based on the result of drug susceptibility testing so as to reduce the occurrence and spread of drug-resistant strains.The hospital should strengthen the surveillance of drug resistance of bacteria so as to boost the clinical curative effect,standardize the management and use of antibi-otics and take effective measures to control of the hospital-associated infection.