Objective: To analyze the association between alcohol consumption and lumbar disc herniation (LDH), so as to provide a reference for the development of prevention and treatment strategies for LDH. Methods: From May to July 2022, permanent residents aged ≥18 years from eight counties (cities/districts) in Gansu Province were selected using a multistage stratified random sampling method. Data on basic characteristics, alcohol consumption in the past 30 days, hypertension, and diabetes mellitus were collected through questionnaire surveys. LDH was determined based on imaging findings, combined with disease history or clinical symptoms. Multivariable logistic regression model was used to analyze the association between alcohol consumption and LDH, with subgroup analyses conducted by gender, age, ethnicity, and altitude of residence. Propensity score matching (PSM) was utilized for sensitivity analysis. Results: A total of 4 545 individuals were surveyed. There were 2 026 (44.58%) males and 2 519 (55.42%) females. The mean age was (44.82±15.33) years. The study participants were predominantly of Han ethnicity, with 2 598 persons accounting for 57.17%. The altitude of residence was mainly above 3 500 m, with 1 941 persons accounting for 42.71%. There were 574 alcohol drinkers, accounting for 12.63%. LDH was detected in 1 035 cases, with a detection rate of 22.77%. Multivariable logistic regression analysis showed that after adjusting for gender, age, physical activity, and hypertension, compared to non-drinking residents, alcohol-consuming residents exhibited a 27.6% reduction in the risk of LDH (OR=0.724, 95%CI: 0.544-0.963). No significant interaction effects on LDH risk were observed between alcohol consumption and gender, age, ethnicity, or altitude of residence (all Pfor interaction >0.05). The results of the sensitivity analysis indicated that compared to non-drinking residents, alcohol-consuming residents exhibited a 38.8% reduction in the risk of LDH (OR=0.612, 95%CI: 0.382-0.976). Conclusion Alcohol consumption was statistically associated with a lower risk of LDH.

Vaccination is a crucial strategy for the prevention and control of infectious diseases. Virus-like particles (VLPs), composed of structural proteins, have garnered significant attention as a novel type of vaccine due to their excellent safety and immunogenicity. However, similar to most vaccine antigens, VLPs exhibit insufficient thermal stability, which not only restricts the widespread application of vaccines but also increases the risk of vaccine inactivation. This study aims to enhance the stability and shelf life of VLPs derived from type A foot-and-mouth disease virus (FMDV) by employing vacuum freeze-drying technology. The optimal lyoprotectant formulation was determined through single-factor and combinatorial screening. Subsequently, the correlation between the immunogenicity of the freeze-dried vaccine and the content of FMDV VLPs was evaluated via a mouse model. The stability of FMDV VLPs before and after freeze-drying was further assessed by storing them at 4, 25, and 37 ℃ for varying time periods. Results indicated that the lyoprotectant formulation No.1, composed of 7.5% trehalose, 0.1% Tween 80, 50 mmol/L glycine, 1% sodium glutamate, and 3% polyvinylpyrrolidone (PVP), effectively preserved the content of FMDV VLPs during the vacuum freeze-drying process. The immunization trial in mice revealed that the levels of specific antibodies, immunoglobulin G1 (IgG1), interleukin-4 (IL-4), and neutralizing antibodies induced by freeze-dried FMDV VLPs were comparable to those induced by non-freeze-dried FMDV VLPs. The heat treatment results showed that the storage periods of freeze-dried FMDV VLPs at 4, 25, and 37 ℃ were significantly longer than those of non-freeze-dried FMDV VLPs. In conclusion, the selected lyoprotectant formulation effectively improved the stability of FMDV VLPs vaccines. This study provides valuable insights for enhancing the stability of novel subunit vaccines.
Freeze Drying/methods* ; Animals ; Foot-and-Mouth Disease Virus/immunology* ; Mice ; Vaccines, Virus-Like Particle/chemistry* ; Foot-and-Mouth Disease/immunology* ; Vacuum ; Drug Stability ; Mice, Inbred BALB C ; Viral Vaccines/immunology*

Since the concept of GIST was proposed in 1983, the diagnosis and treatment of GIST in China have continuously progress. Over the two decades from 1990 to 2010, the diagnosis and treatment of GIST had achieved a foundation of development through the collective efforts of GIST scholars, from the first pathological review to the first expert consensus. The period from 2010 to 2020 marked rapid development. Besides the updates of expert consensus, other relevant expert consensus was published regarding pathology, surgery, targeted therapy, therapeutic drug monitoring, and patient' management. Based on the above development, China's first GIST guideline, the "CSCO Gastrointestinal Stromal Tumor Diagnosis and Treatment Guidelines (2020 Edition)", was published. This guideline considers regional development disparities, accessibility of treatments and diagnostic methods, and the social value of cancer care, maintaining its scientific rigor, fairness, and timeliness. Over the past 30 years, the diagnosis and treatment of GIST in China significantly development. However, we should recognize that further development must require more original Chinese research, which would better benefit the Chinese population.

Objective:To investigate the prognosis and the factors that influence it in patients with non-gastric gastrointestinal stromal tumors (GISTs) who are at low risk of recurrence.Methods:This was a retrospective cohort study. Clinicopathologic and prognostic data from patients with non-gastric GISTs and at low risk of recurrence (i.e., very low-risk or low-risk according to the 2008 version of the Modified NIH Risk Classification), who attended 18 medical centers in China between January 2000 and June 2023, were collected. We excluded patients with a history of prior malignancy, concurrent primary malignancy, multiple GISTs, and those who had received preoperative imatinib. The study cohort comprised 1,571 patients with GISTs, 370 (23.6%) of whom were at very low-risk and 1,201 (76.4%) at low-risk of recurrence. The cohort included 799 (50.9%) men and 772 (49.1%) women of median age 57 (16–93) years. Patients were followed up to July 2024. The prognosis and its influencing factors were analyzed. Receiver operating characteristic curves for tumor diameter and Ki67 were established, and the sensitivity, specificity, area under the curve (AUC) and optimal cut-off value with 95% confidence intervals were calculated. Propensity score matching was implemented using the 1:1 nearest neighbor matching method with a matching tolerance of 0.02.Results:With a median follow-up of 63 (12–267) months, the 5- and 10-year overall survival (OS) rates of the 1,571 patients were 99.5% and 98.0%, respectively, and the 5- and 10-year disease-free survival (DFS) rates were 96.3% and 94.4%, respectively. During postoperative follow-up, 3.8% (60/1,571) patients had disease recurrence or metastasis, comprising 0.8% (3/370) in the very low-risk group and 4.7% (57/1,201) in the low-risk group. In the low-risk group, recurrence or metastasis occurred in 5.5% (25/457) of patients with duodenal GISTs, 3.9% (25/645) of those with small intestinal GISTs, 9.2% (6/65) of those with rectal GISTs, and 10.0% (1/10) of those with colonic GISTs. Among the 60 patients with metastases, 56.7% (34/60) of the metastases were located in the abdominal cavity, 53.3% (32/60) in the liver, and 3.3% (2/60) in bone. During the follow-up period, 13 patients (0.8%) died of disease. Receiver operating characteristic curves were plotted for tumor diameter and Ki67 and assessed using the Jordon index. This showed that the difference in DFS between the two groups was statistically significant when the cutoff value for tumor diameter was 3.5 cm (AUC 0.731, 95% CI: 0.670–0.793, sensitivity 77.7%, specificity 64.1%). Furthermore, the difference in DFS between the two groups was statistically significant when the cutoff value for Ki67 was 5% (AUC 0.693, 95% CI: 0.624–0.762, sensitivity 60.7%, specificity 65.3%). Multifactorial analysis revealed that tumor diameter ≥3.5 cm, Ki67 ≥5%, and R1 resection were independent risk factors for DFS in patients with non-gastric GISTs at low risk of recurrence (all P<0.05). Furthermore, age >57 years, Ki67 ≥5%, and R1 resection were also independent risk factors for OS in patients with non-gastric GISTs at low risk of recurrence (all P<0.05). We also grouped the patients according to whether they had received postoperative adjuvant treatment with imatinib for 1 or 3 years. This yielded 137 patients in the less than 1-year group, 139 in the 1-year plus group; and 44 in both the less than 3 years and 3-years plus group. After propensity score matching for age, tumor diameter, Ki67, and resection status, the differences in survival between the two groups were not statistically significant (all P>0.05). The 10-year DFS and OS were 87.5% and 95.5%, respectively, in the group treated with imatinib for less than 1 year and 88.5% and 97.8%, respectively, in the group treated for more than 1 year. The 10-year DFS and OS were 89.6% and 92.6%, respectively, in the group treated with imatinib for less than 3 years and 88.0% and 100.0%, respectively, in the group treated with imatinib for more than 3 years. Conclusion:The overall prognosis of primary, non-gastric, low recurrence risk GISTs is relatively favorable; however, recurrences and metastases do occur. Age, tumor diameter, Ki67, and R1 resection may affect the prognosis. For some patients with low risk GISTs, administration of adjuvant therapy with imatinib for an appropriate duration may help prevent recurrence and improve survival.

Objective To explore the relationship between basic motor skills and social interaction ability in school-age children with moderate autism,and the mediating role of executive function and the realization path.Methods A cross-sectional design was used to investigate 117 school-age children with autism from Sep.to Dec.2020.The level of basic motor skills was assessed by the test of gross motor development(TGMD),the impairment of executive function was assessed by the behavior rating inventory of executive function(BRIEF),and the social disorder was assessed by the social responsive scale-second edition(SRS-2).Pearson correlation analysis was used to explore the interrelationship,and structural equation modeling was applied to explore the path relationship.Results There was a significant negative correlation between the level of basic motor skills and SRS-2 scores(r=-0.312,P＜0.001).There were significant negative correlations between the level of basic motor skills and the BRIEF scores of inhibition(r=-0.336,P＜0.001),switching(r=-0.325,P＜0.001),affective control(r=-0.338,P＜0.001),task initiation(r=-0.240,P=0.009),working memory(r=-0.278,P=0.002),and planning(r=-0.224,P=0.015).The SRS-2 score was positively correlated with the BRIEF scores of inhibition(r=0.378,P＜0.001),switching(r=0.299,P=0.001),affective control(r=0.417,P＜0.001),task initiation(r=0.246,P=0.007),working memory(r=0.409,P＜0.001),and monitoring(r=0.258,P=0.005).Executive function played a complete intermediary role between basic motor skills and social interaction ability(B=-1.912,95％confidence interval:-3.116 to-1.069).Conclusion In school-age children with moderate autism,executive function and social interaction ability change positively with the level of basic motor skills.Basic motor skills can affect social interaction ability through the mediating role of executive function,and inhibition and affective control are important pathways to achieve this.

Objective:To investigate the spectrum and antimicrobial resistance of major pathogens causing nosocomial infections in China during 2020-2021.Methods:A total of 1 311 non-duplicated nosocomial pathogens causing bloodstream infections (BSI, n=670), hospital-acquired pneumonia (HAP, n=394) and intra-abdominal infections (IAI, n=297) were collected from 10 teaching hospitals across China. The minimum inhibitory concentrations (MICs) of clinical common strains were determined using agar dilution or broth microdilution method. Interpretation of reults followed the CLSI M100-Ed33 criteria, with data analysis conducted using WHONET-5.6 software. The Chi-square test was used to compare rates. Results:The most prevalent pathogens causing BSI were Escherichia coli (21.2%, 142/670), Klebsiella pneumoniae (14.9%, 100/670) and Staphylococcus aureus (11.5%, 77/670); the most prevalent pathogens causing HAP were K. pneumoniae (27.7%, 109/394), Acinetobacter baumanii (22.1%, 87/394) and Pseudomonas aeruginosa (18.3%, 72/394). IN IAI, E. coli (24.3%, 60/247), Enterococcus faecium and K. pneumoniae (both 14.6%, 36/247) were dominated. All S. aureus strains were susceptible to tigecycline, linezolid, daptomycin and glycopeptides. Rates of methicillin-resistant S. aureus (MRSA) and coagulase-negative Staphylococcus (MRCNS) were 36.5% (42/115) and 74.5% (38/51), respectively. The rate of vancomycin-resistant E. faecium and E. faecalis was 3.3% (3/90) and 1.9% (1/53), respectively. The prevalence of extended-spectrum β-lactamase (ESBL) was 23.7% (58/245) in K. pneumonia and 60.5% (130/215) in E. coli.The rate of carbapenem-resistant K. pneumonia and E. coli was 29.8% (73/245) and 4.2% (9/215), respectively; the percentage of tigecycline-resistant K. pneumonia and E. coli was 1.6% (4/245) and 0, respectively; the rate of colistin-resistant K. pneumonia and E. coli was 1.6% (4/245) and 2.8% (6/215), respectively; the percentage of ceftazidime/avibactam-resistant K. pneumonia and E. coli was 2.0% (5/245) and 2.3% (5/215), respectively. The rate of carbapenem-resistant A. baumanii and P. aeruginosa was 76.7% (125/163) and 28.4% (33/116), respectively. A. baumanii showed low susceptibility to most antimicrobial agents except colistin (98.8%, 161/163) and tigecycline (89.6%, 146/163). Colistin, amikacin and ceftazidime/avibactam demonstrated high antibacterial activity against P. aeruginosa with susceptility rates of 99.1% (115/116), 94.0% (109/116) and 83.6% (97/116), respectively. Conclusions:The major pathogens of nosocomial infections were K. pneumonia, E. coli, A. baumanii, P. aeruginosa and S. aureus. Nosocomial Gram-negative pathogens exhibited high susceptibilities to tigecycline, colistin and ceftazidime/avibactam. Antimicrobial resistance in A. baumannii remains a significant challenge. The increasing prevalence of carbapenem-resistant Enterobacterales underscores the urgency of antibiotics rational applications and hospital infection controls.

Objective:To construct a metrological safety evaluation model for large medical equipment based on the perspective of metrological safety,and to explore its application value in the management of large medical equipment.Methods:According to the different safety risk sources,the diagnosis and treatment area of large medical equipment was divided into five types:light source,electricity,water,radiation and information.The metrological safety assessment indicators were empowered by combining subjective and objective methods,and engineering support strategies were developed according to the metrological safety levels and safety change trends.A total of 48 large medical equipment in clinical use in The 960th Hospital of PLA Joint Logistic Support Force from 2020 to 2023 were selected.The 42 sets of equipment used during 2020 to 2021 adopted the conventional fault maintenance support mode(referred to as the conventional support mode),and the 43 sets of equipment used from 2022-2023(including 37 in conventional mode and 6 newly added)adopted the metrology safety technical support mode(referred to as metrology safety support mode).The metrology safety management ability score,metrological inspection qualification levels and metrological safety management effects of large medical equipment were compared between the two management modes.Results:The evaluation scores of theoretical knowledge,safety awareness,practical operation and emergency level indicators of large medical equipment use management personnel of the metrology safety support model were(17.39±1.38)points,(17.87±1.08)points,(27.68±1.45)points and(27.96±1.24)points,respectively,which were higher than those of the conventional support mode,the difference was statistically significant(t=4.234,4.371,5.832,3.764,P＜0.05).The average metrological inspection qualified rates(％)of medical imaging equipment,life support equipment,clinical laboratory equipment,operating room equipment and other equipment using the metrology safety support mode were(95.19±2.56)％,(95.56±1.79)％,(94.64±2.42)％,(96.20±2.01)％and(93.46±2.22)％,respectively,which were higher than those of the conventional support mode,the difference was statistically significant(t=3.846,2.809,2.405,2.492,2.742,P＜0.05).The proportion of large medical equipment rated as high safety level and low safety level in the metrological safety support model were 67.44％(29/43)and 4.65％(2/43),respectively,the proportion of high safety level was higher than that in the conventional support mode,and the proportion of low safety level was lower than that in the conventional support mode,the difference was statistically significant(x2=4.261,7.085,P＜0.05).Conclusion:The large medical equipment metrological safety support mode based on the safety perspective can improve the safety management ability of personnel related to equipment use and management,improve the operation quality and performance level of equipment,increase the proportion of high-safety level metrology safety of large medical equipment,and reduce the proportion of low-safety level.

Small nucleolar RNAs (snoRNAs), a type of non-coding RNAs ubiquitous in eukaryotes, can be categorized into two types based on structural characteristics: box C/D snoRNAs and box H/ACA snoRNAs, which mediate the RNA modification of 2′-O-methylation and pseudouridylation, respectively. Recent studies have found that snoRNAs also affect the alternative splicing of mRNA precursors (pre-mRNA), mediate gene silencing by generating miRNA, and interact with proteins to regulate their functional activity. The process of DNA damage and repair always serves as a pivotal biological basis in research on the biological effects of ionizing radiation. Currently, there are rather limited studies on the role of snoRNAs in ionizing radiation-induced DNA damage. Thus, this paper reviews the biological functions of snoRNAs and their potential role in the regulatory repair of ionizing radiation-induced DNA damage, with a view to providing new ideas for exploring the function and mechanism of snoRNAs.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.