To evaluate the clinical value of nebulized indocyanine green(ICG) combined with near-infrared fluorescence imaging for intraoperative detection of air leaks during pulmonary resection.

Objective:To explore the changes in plasma lipoprotein associated phospholipase A2(Lp-PLA2)and silencing information regulatory protein 1(SIRT1)in patients with sepsis complicated with acute kidney injury(AKI)and their relationship with short-term prognosis.Methods:243 sepsis patients who received treatment in our hospital from May 2022 to May 2024 were prospective selected,including 80 sepsis patients with AKI(AKI group)and 163 sepsis patients without AKI(non AKI group),the plasma Lp-PLA2 and SIRT1 levels between the two groups were compared.They were divided into good prognosis group and poor prognosis group according to 28 d prognosis after admission in AKI group.The influencing factors of short-term prognosis in sepsis patients complicated with AKI were analyzed by multiple logistic regression model.The short-term prognostic value of plasma Lp-PLA2 and SIRT1 alone and in combination for sepsis complicated with AKI patients was analyzed using receiver operating characteristic(ROC)curve.Results:Compared with non AKI group,AKI group had higher Lp-PLA2 and lower SIRT1(P＜0.05).39 deaths within 28 d after admission in AKI group(poor prognosis group),41 cases survived(good prognosis group),with poor prognosis rate of 48.75％(39/80).Sequential organ failure assessment(SOFA)score,acutephysiology and chronic health evaluationⅡ(APACHEⅡ)score,creatinine(Scr),lactate dehydrogenase albumin ratio(LAR)in poor prognosis group were higher than those in good prognosis group,while procalcitonin(PCT)was lower than that in good prognosis group(P＜0.05).Compared with the good prognosis group,poor prognosis group had higher Lp-PLA2 and lower SIRT1 at admission(P＜0.05).Elevated SOFA score,elevated Scr,elevated APACHEⅡ score,and elevated plasma Lp-PLA2 were risk factors for poor prognosis in sepsis patients complicated with AKI(P＜0.05),while elevated plasma SIRT1 was a protective factor(P＜0.05).ROC curve analysis results showed that,the combined detection of plasma Lp-PLA2 and SIRT1 predicted a poor prognosis for sepsis patients with AKI with an area under the curve(AUC)of 0.935,which was better than the prediction of 0.813 and 0.858 for plasma Lp-PLA2 and SIRT1 alone.Conclusion:Sepsis complicated with AKI patients have elevated plasma Lp-PLA2 and decreased SIRT1,combined detection of the two can assist in predicting the risk of poor prognosis.

Objective To analyze the association between lifestyle and the risk of type 2 diabetes(T2D)among adult residents.Methods The data was sourced from the Shanghai Suburban Adult Cohort and Biobank.A total of 42 096 adult residents who had not developed T2D were recruited from four districts of Shanghai(Songjiang,Jiading,Minhang,and Xuhui)between 2016 and 2019.The follow-up ended on Feb 28,2023.A structured questionnaire was used to collect information on six lifestyle-related items,including smoking,alcohol consumption,BMI,waist circumference(WC),physical activity,and diet.The unhealthy lifestyle scores(UHLS)were calculated by counting the number of all the unhealthy lifestyle items,with a range of 0-6.New-onset T2D events diagnosed by physicians were obtained through the medical information system.Cox proportional hazards regression model and restricted cubic spline model were utilized to evaluate the association between unhealthy lifestyles and the risk of T2D incidence.Results About 28.1%of the participants led 4-6 unhealthy lifestyles.A total of 1 752 new T2D cases were identified during 218 513.4 person-years of follow-up.Analysis of single unhealthy lifestyle showed that abnormal WC(HR=1.5,95%CI:1.4-1.7)and abnormal BMI(HR=1.3,95%CI:1.2-1.5)were associated with an increased risk of T2D.Compared with individuals with a UHLS of 0-1,those with a UHLS of 3 and 4-6 had 30%(95%CI:1.1-1.6)and 50%(95%CI:1.2-1.8)higher risks of T2D,respectively.Each additional unhealthy lifestyle was associated with a 10%increase in T2D incidence risk(HR=1.1,95%CI:1.1-1.2).Conclusion The risk of T2D in adult residents increases with the cumulative number of unhealthy lifestyles.Adult residents with abnormal WC or BMI,or have three or more unhealthy lifestyles accumulated,will increase the risk of new-onset T2D.

Objective To investigate the clinicopathological parameters and risk factors of the patients with connective tissue disease-associated interstitial lung disease(CTD-ILD)complicated with Epstein-Barr virus(EBV)viraemia.Methods The CTD-ILD pa-tients admitted to Department of Respiratory and Critical Care Medicine,Nanjing Drum Tower Hospital from January 2023 to April 2024 were collected.Based on the detection results of EBV DNA,the patients were divided into the EBV DNA(+)group and EBV DNA(-)group.The clinicopathological parameters of the two groups were analyzed.Results Out of 162 CTD-ILD patients who underwent EBV DNA testing,a total of 28 were found to have EBV viraemia.The levels of serum albumin([32.7±4.1]g/L vs[34.8±3.8]g/L,t=2.559,P＜0.05),oxygenation index([268.5±94.0]mmHg vs[323.2±120.9]mmHg,t=2.062,P＜0.05),and percentages of predicted diffusing capacity for carbon monoxide([30.9±15.3]% vs[44.9±18.8]%,t=2.127,P＜0.05])in the EBV DNA(+)group were significantly lower than those in the EBV DNA(-)group,while the levels of lactate dehydrogenase(LDH,[369.1±206.2]U/L vs[298.8±128.7]U/L,t=2.335,P＜0.05)were significantly higher than that in the EBV DNA(-)group.The acute exacerbation of ILD in the EBV DNA(+)group was more common than that in the EBV DNA(-)group(P＜0.05).Multivariate Lo-gistic analysis showed that honeycombing and low oxygenation index were independent risk factors of CTD-ILD patients complicated with EBV viraemia.Conclusion The CTD-ILD patients complicated with EBV viraemia have poorer oxygenation and are more prone to suf-fer from acute exacerbation of ILD.Honeycombing in chest HRCT and low oxygenation index are independent risk factors of CTD-ILD patients complicated with EBV viraemia.

Objective:To explore the changes in plasma lipoprotein associated phospholipase A2(Lp-PLA2)and silencing information regulatory protein 1(SIRT1)in patients with sepsis complicated with acute kidney injury(AKI)and their relationship with short-term prognosis.Methods:243 sepsis patients who received treatment in our hospital from May 2022 to May 2024 were prospective selected,including 80 sepsis patients with AKI(AKI group)and 163 sepsis patients without AKI(non AKI group),the plasma Lp-PLA2 and SIRT1 levels between the two groups were compared.They were divided into good prognosis group and poor prognosis group according to 28 d prognosis after admission in AKI group.The influencing factors of short-term prognosis in sepsis patients complicated with AKI were analyzed by multiple logistic regression model.The short-term prognostic value of plasma Lp-PLA2 and SIRT1 alone and in combination for sepsis complicated with AKI patients was analyzed using receiver operating characteristic(ROC)curve.Results:Compared with non AKI group,AKI group had higher Lp-PLA2 and lower SIRT1(P＜0.05).39 deaths within 28 d after admission in AKI group(poor prognosis group),41 cases survived(good prognosis group),with poor prognosis rate of 48.75％(39/80).Sequential organ failure assessment(SOFA)score,acutephysiology and chronic health evaluationⅡ(APACHEⅡ)score,creatinine(Scr),lactate dehydrogenase albumin ratio(LAR)in poor prognosis group were higher than those in good prognosis group,while procalcitonin(PCT)was lower than that in good prognosis group(P＜0.05).Compared with the good prognosis group,poor prognosis group had higher Lp-PLA2 and lower SIRT1 at admission(P＜0.05).Elevated SOFA score,elevated Scr,elevated APACHEⅡ score,and elevated plasma Lp-PLA2 were risk factors for poor prognosis in sepsis patients complicated with AKI(P＜0.05),while elevated plasma SIRT1 was a protective factor(P＜0.05).ROC curve analysis results showed that,the combined detection of plasma Lp-PLA2 and SIRT1 predicted a poor prognosis for sepsis patients with AKI with an area under the curve(AUC)of 0.935,which was better than the prediction of 0.813 and 0.858 for plasma Lp-PLA2 and SIRT1 alone.Conclusion:Sepsis complicated with AKI patients have elevated plasma Lp-PLA2 and decreased SIRT1,combined detection of the two can assist in predicting the risk of poor prognosis.

Objective To investigate the clinicopathological parameters and risk factors of the patients with connective tissue disease-associated interstitial lung disease(CTD-ILD)complicated with Epstein-Barr virus(EBV)viraemia.Methods The CTD-ILD pa-tients admitted to Department of Respiratory and Critical Care Medicine,Nanjing Drum Tower Hospital from January 2023 to April 2024 were collected.Based on the detection results of EBV DNA,the patients were divided into the EBV DNA(+)group and EBV DNA(-)group.The clinicopathological parameters of the two groups were analyzed.Results Out of 162 CTD-ILD patients who underwent EBV DNA testing,a total of 28 were found to have EBV viraemia.The levels of serum albumin([32.7±4.1]g/L vs[34.8±3.8]g/L,t=2.559,P＜0.05),oxygenation index([268.5±94.0]mmHg vs[323.2±120.9]mmHg,t=2.062,P＜0.05),and percentages of predicted diffusing capacity for carbon monoxide([30.9±15.3]% vs[44.9±18.8]%,t=2.127,P＜0.05])in the EBV DNA(+)group were significantly lower than those in the EBV DNA(-)group,while the levels of lactate dehydrogenase(LDH,[369.1±206.2]U/L vs[298.8±128.7]U/L,t=2.335,P＜0.05)were significantly higher than that in the EBV DNA(-)group.The acute exacerbation of ILD in the EBV DNA(+)group was more common than that in the EBV DNA(-)group(P＜0.05).Multivariate Lo-gistic analysis showed that honeycombing and low oxygenation index were independent risk factors of CTD-ILD patients complicated with EBV viraemia.Conclusion The CTD-ILD patients complicated with EBV viraemia have poorer oxygenation and are more prone to suf-fer from acute exacerbation of ILD.Honeycombing in chest HRCT and low oxygenation index are independent risk factors of CTD-ILD patients complicated with EBV viraemia.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Objective To investigate the clinical efficacy and safety of facilitated percutaneous coronary intervention(PCI)with half-dose recombinant staphylokinase(r-SAK)in patients with ST-segment elevation myocardial infarction(STEMI)who are expected to undergo PCI within 120 minutes.Methods From October 2021 to August 2022,a total of 200 STEMI patients in eight centers were included and randomly assigned in a 1﹕1 ratio to either r-SAK group or control group.Patients received loading doses of aspirin and ticagrelor and intravenous heparin and were randomized to receive an intravenous bolus of either 5 mg r-SAK or normal saline prior to PCI.The outcomes were set as ST-segment resolution(STR)at 60-90 minutes after PCI,the proportion and transition of pathological Q waves on the 5th day after PCI,and the proportion of high-sensitivity cardiac troponin T(hs-cTnT)peaking within 12 hours of onset.The safety outcome was major bleeding events defined as Bleeding Academic Research Consortium(BARC)≥type 3 bleeding during hospitalization.Results Compared with the control group,the r-SAK group had a higher proportion of STR≥70%within 60-90 minutes after PCI(58.3%vs.40.3%,P=0.009);a lower proportion of pathological Q waves(59.1%vs.74.1%,P=0.040);a lower rate of Q wave progression(14.8%vs.43.2%,P＜0.001);a higher rate of Q wave disappearance(12.5%vs.3.7%,P=0.027);and a higher proportion of hs-cTnT peaking within 12 hours of symptom onset[31/40(77.5%)vs.17/33(51.5%),P=0.027].Regarding the safety outcome,no significant difference in BARC≥type 3 bleeding was found between the two groups during hospitalization(P＞0.05).Conclusions For STEMI patients who were expected to undergo primary PCI within 120 minutes of symptom onset,the facilitated PCI with half-dose r-SAK significantly increased the proportion of STR≥70%at 60-90 minutes after PCI,reduced the formation of pathological Q waves,and shortened the time to peak hs-cTnT,without increasing the risk of bleeding,which should be an alternative reperfusion strategy worthy of further study.

Nocardia is a Gram-positive pathogen responsible for causing dairy mastitis,which leads to purulent granulomatous lesions in mammary tissue and can significantly impact the dairy indus-try,resulting in substantial economic losses.To develop a rapid and accurate diagnostic method for detecting Nocardia of bovine origin,a conserved sequence of the 16S rRNA gene from Nocardia was selected from the NCBI database.Based on this sequence,a pair of primers and a TaqMan fluo-rescent quantitative probe were designed.The validation of the TaqMan fluorescence quantitative PCR(qPCR)method found in this study showed that the Ctvalue had a good linear relationship with recombinant plasmid concentrations ranging from 1×1010 to 1×102 copies/μL,with a regres-sion equation of y=-3.536x+43.78,a correlation coefficient(R2)of 0.997 5,a slope of-3.536,and an amplification efficiency(E)of 91％(where 90％＜E＜110％).The specificity was strong,with no cross-reactions with other pathogens.The standard curve had a high sensitivity with a low-er detection limit of 1 × 102 copies/μL,it was 100-fold higher than conventional PCR.The repeatability of the standard curve was also good.Both intra-and inter-group coefficients of varia-tion were below 2％.Using this method,234 milk samples and 80 environmental samples were tested using this method,respectively,with a positive detection rate of 27.07％,whereas conven-tional PCR had a positive detection rate of 19.43％,indicating that this method was more sensitive compared to conventional PCR.The fluorescent quantitative PCR detection method established in this study provides an effective means for the clinical detection of Nocardia in dairy cows.

Objective This study investigated feasible cases and their significance in promoting the"generalized"development of inspection through digital-intelligent equipment.Methods A qualitative research approach was used,involving interviews conducted between February 2025 and March 2025 with experts in traditional Chinese medicine diagnostics,clinical research methodology,medical engineering integration,and related disciplines,using both online and offline methods.In accordance with the Consolidated Criteria for Reporting Qualitative Research,feasible cases involving the specific application of digital equipment in various parts of observation were collected through item enrichment.The significance of extending observation capabilities via these cases was analyzed,along with the overall implications of integrating digital technologies with traditional inspection method.Results Interviews were completed with 11 experts from domestic universities and research institutes in the fields of traditional Chinese medicine diagnosis,medical engineering integration,and related disciplines.A total of 78 feasible cases of digital-intelligent inspection were identified,along with 69 insights regarding the significance of enhancing the inspection capabilities.These insights were synthesized into two dimensions and 23 holistic meanings.The first dimension is to expand the scope of inspection,including obtaining internal environmental characteristics,observing external environmental characteristics,expanding thermodynamic characteristic data,and crossing time and space.The second dimension is to improve the quality of observation and diagnosis information collection and analysis,including 19 specific meanings,such as standardized collection environment,objective quantification,and refined observation.Conclusion Digital-intelligent equipment plays a significant role in expanding the scope of inspection content and achieving high-quality acquisition and analysis of extensive inspection information.These advancements extend and enrich the capabilities of traditional inspection method in traditional Chinese medicine.