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.

Background Animal farming may affect the structure and diversity of gut microbiota of farm workers, but it needs more studies to provide solid evidence. Objective To analyze the diversity characteristics of gut microbiota in dairy farm workers, dairy cows, and the control population (non-animal contact occupational group), and to assess the impact of dairy farming on the gut microbiota of workers. Methods The 16S rRNA full-length amplicon sequencing technology was used to sequence 60 fecal samples from dairy farm workers, 89 from dairy cows, and 50 from the general population. The gut microbiota structure characteristics, including operational taxonomic units (OTUs), alpha diversity, beta diversity, and the composition of species at the phylum, family, and genus levels were analyzed. The differences in gut microbiota among the three groups of samples were compared to explore the impact of occupational exposure on the gut microbiota structure of dairy farm workers. Results A total of 50478 OTUs were identified in the gut microbiota of farm workers, dairy cows, and the general population, with 23613, 42723, and 16592 OTUs, respectively. The number of shared OTUs between the dairy cows and the general population was 12674 (27.17%), between the general population and the farm workers was 10099 (33.54%), and between the dairy cows and the farm workers was 17690 (36.36%). Compared with the general population, the farm workers and dairy cows showed more shared gut microbiota (P<0.01). The abundance of Firmicutes in the gut of the farm workers was higher than that of the general population (P<0.01), while Actinobacteriota and Proteobacteria were the opposite (P<0.01). The alpha diversity of gut microbiota in the farm workers was different from that of the general population. The ACE index of the farm workers was slightly lower than that of the general population and much lower than that of dairy cows (P<0.05), while their Shannon index was higher than that of the general population but lower than that of dairy cows (P<0.01). The linear discriminant analysis effect size (LefSe) showed that the abundances of Lachnospiraceae and Ruminococcaceae in the gut microbiota of the farm workers were significantly higher than those of the general population, while Streptococcaceae, Lactobacillaceae, Bifidobacteriaceae, Enterobacteriaceae, and Erysipelatoclostridiaceae were lower than those of the general population. Conclusion The dairy farm workers shares a certain proportion of common bacterial communities with dairy cows. Dairy farming operations can affect the structure and diversity of the gut microbiota of workers by increasing the abundances of Lachnospiraceae and Ruminococcaceae, while decreasing the abundances of Streptococcaceae, Lactobacillaceae, Bifidobacteriaceae, Enterobacteriaceae, and Erysipelatoclostridiaceae. The study results provide reference data for further exploring the cross-host transmission of pathogens related to occupational exposure in dairy farming.

Objective To explore the microsurgical treatment strategies for patients with carotid artery stenosis complicated by tortuosity.Methods A retrospective study was conducted on 9 patients with carotid artery stenosis and tortuosity who underwent microsurgical treatment in the Department of Neurosurgery,the Second People's Hospital of Liaocheng,from June 2019 to August 2023.Patient demographics and clinical data,including sex,age,initial admission diagnosis,clinical symptoms,risk factors for carotid artery stenosis(hypertension,diabetes,hyperlipidemia,smoking,drinking),pre-operative and contralateral vascular imaging were collected.According to the type of vascular tortuosity,three surgical methods were employed:(1)For"C"-shaped tortuosity of the internal carotid artery(ICA),the ICA was divided obliquely at the carotid bifurcation,and eversion carotid endarterectomy was performed.Then ICA was opened longitudinally along its medial side,the common carotid artery(CCA)was extended proximally along its lateral border.The ICA was end-to-side anastomosis anastomosed to the CCA.(2)For coiling of the ICA,the ICA was divided obliquely at the carotid bifurcation and eversion carotid endarterectomy was completed.The redundant segment of the ICA origin was resected,and an end-to-side anastomosis between the ICA and CCA was performed.(3)For cases of kinking of both the ICA and external carotid artery(ECA),or kinking of the CCA,the technique was performed by transection of the CCA,and then eversion carotid endarterectomy was performed,and part of the CCA was resected.After downward mobilization of the ICA and ECA,an end-to-end anastomosis of the CCA was carried out.Postoperatively,all patients underwent neck CT angiography(CTA)and duplex ultrasound examination within 1-3d to assess carotid patency,tortuosity improvement,and hemodynamic changes.Surgical success was defined as residual stenosis ≤30％,improved tortuosity,and no occurrence of stroke within 1-3d after surgery.Postoperative complications,including stroke,myocardial infarction,hoarseness,surgical site bleeding,swelling,and poor wound healing,were also observed.Follow-up carotid ultrasound was performed at 1,6,and 12 months to monitor for restenosis(peak systolic velocity＞220 cm/s or＞70％reduction in vessel diameter).Results Among the 9 patients,4 were males and 5 were females;the age ranged from 61 to 74 years,with an average of(67±4)years.3 cases had asymptomatic severe stenosis,3 cases had symptomatic moderate stenosis,and 3 cases had symptomatic severe stenosis.There were 9 cases of previous hypertension,5 cases of diabetes,6 cases of hyperlipidemia,4 cases of coronary heart disease,5 cases of smoking,and 4 cases of drinking.There were 5 cases of ICA"C"-shaped tortuosity,2 cases of coiling of the ICA,1 case of both ICA and ECA tortuosity,and 1 case CCA tortuosity.All 9 patients successfully underwent surgery.Postoperative neck CTA within 1-3 d demonstrated patency of the operated carotid artery and improvement in vascular tortuosity in all cases,with duplex ultrasound showing favorable hemodynamic status.No postoperative complications were observed.Follow-up at 1,6,and 12 months revealed no restenosis in any of the patients.Conclusions Microsurgical surgery is an effective method for treating carotid artery stenosis complicated by tortuosity.Detailed preoperative evaluation and selection of appropriate surgical techniques are essential.This study is a single-center study with a small sample size,and the findings require further validation through multi-center,large-scale research.

Objective To explore the microsurgical treatment strategies for patients with carotid artery stenosis complicated by tortuosity.Methods A retrospective study was conducted on 9 patients with carotid artery stenosis and tortuosity who underwent microsurgical treatment in the Department of Neurosurgery,the Second People's Hospital of Liaocheng,from June 2019 to August 2023.Patient demographics and clinical data,including sex,age,initial admission diagnosis,clinical symptoms,risk factors for carotid artery stenosis(hypertension,diabetes,hyperlipidemia,smoking,drinking),pre-operative and contralateral vascular imaging were collected.According to the type of vascular tortuosity,three surgical methods were employed:(1)For"C"-shaped tortuosity of the internal carotid artery(ICA),the ICA was divided obliquely at the carotid bifurcation,and eversion carotid endarterectomy was performed.Then ICA was opened longitudinally along its medial side,the common carotid artery(CCA)was extended proximally along its lateral border.The ICA was end-to-side anastomosis anastomosed to the CCA.(2)For coiling of the ICA,the ICA was divided obliquely at the carotid bifurcation and eversion carotid endarterectomy was completed.The redundant segment of the ICA origin was resected,and an end-to-side anastomosis between the ICA and CCA was performed.(3)For cases of kinking of both the ICA and external carotid artery(ECA),or kinking of the CCA,the technique was performed by transection of the CCA,and then eversion carotid endarterectomy was performed,and part of the CCA was resected.After downward mobilization of the ICA and ECA,an end-to-end anastomosis of the CCA was carried out.Postoperatively,all patients underwent neck CT angiography(CTA)and duplex ultrasound examination within 1-3d to assess carotid patency,tortuosity improvement,and hemodynamic changes.Surgical success was defined as residual stenosis ≤30％,improved tortuosity,and no occurrence of stroke within 1-3d after surgery.Postoperative complications,including stroke,myocardial infarction,hoarseness,surgical site bleeding,swelling,and poor wound healing,were also observed.Follow-up carotid ultrasound was performed at 1,6,and 12 months to monitor for restenosis(peak systolic velocity＞220 cm/s or＞70％reduction in vessel diameter).Results Among the 9 patients,4 were males and 5 were females;the age ranged from 61 to 74 years,with an average of(67±4)years.3 cases had asymptomatic severe stenosis,3 cases had symptomatic moderate stenosis,and 3 cases had symptomatic severe stenosis.There were 9 cases of previous hypertension,5 cases of diabetes,6 cases of hyperlipidemia,4 cases of coronary heart disease,5 cases of smoking,and 4 cases of drinking.There were 5 cases of ICA"C"-shaped tortuosity,2 cases of coiling of the ICA,1 case of both ICA and ECA tortuosity,and 1 case CCA tortuosity.All 9 patients successfully underwent surgery.Postoperative neck CTA within 1-3 d demonstrated patency of the operated carotid artery and improvement in vascular tortuosity in all cases,with duplex ultrasound showing favorable hemodynamic status.No postoperative complications were observed.Follow-up at 1,6,and 12 months revealed no restenosis in any of the patients.Conclusions Microsurgical surgery is an effective method for treating carotid artery stenosis complicated by tortuosity.Detailed preoperative evaluation and selection of appropriate surgical techniques are essential.This study is a single-center study with a small sample size,and the findings require further validation through multi-center,large-scale research.

Objective To evaluate the efficacy and safety of aripiprazole treatment for co-morbid attention defi?ciency hyperactivity disorder (ADHD) in children with Tourette syndrome (TS). Methods Forty four TS children with co-morbid ADHD were randomly divided into aripiprazole group and haloperidol group. The aripiprazole group and halo?peridol group received aripiprazole and haloperidol treatment for 12 weeks, respectively. Yale global tic severity scale (YGTSS) and Conners parent symptom questionnaire (PSQ) were used to assess the tic and ADHD symptoms before, 2, 4, 8 and 12 weeks after treatment. Side effects were recorded weekly. Results Repeated measure ANOVA indicated that the main effects of groups was not significant to the YGTSS scores (P>0.05), but significant to the PSQ scores (P<0.05). After 12-week treatment, the YGTSS scores between two groups were not significantly different (P>0.05). The PSQ scores of aripiprazole group were significantly lower than that of haloperidol group. The adverse reactions of aripiprazole group were milder compared with the haloperidol group (P<0.05). Conclusions The present study demonstrates that aripipra?zole has the same efficacy in the treatment of tics as haloperidol, improves co-morbid ADHD symptoms, and its adverse reactions are much less compared with haloperidol.