Background: Adrenocortical hormones, particularly 11-oxygenated androgens, are pivotal in female reproductive health and fertility. Standardized detection kits and population-specific reference intervals are lacking in China, hindering related clinical applications. Methods: A HPLC-tandem mass spectrometry (HPLC-MS/MS) pipeline was developed, rigorously validated, and applied to simultaneously quantify corticosterone, cortisone, cortisol, 18-OH cortisol, androstenedione (A4), 11β-hydroxyandrostenedione (11-OH A4), dehydroepiandrosterone, and dehydroepiandrosterone sulfate in serum samples from 455 reproductive-aged women (18–45 yrs) in Guangxi, China. Age-dependent concentration trends were analyzed, and reference intervals stratified by age (2.5th to 97.5th percentiles) were established. Correlations with body-composition metrics, ethnicity, and the menstrual cycle were investigated. Results: The HPLC-MS/MS method demonstrated high precision (intra- and inter-assay CVs < 15%), accuracy, and sensitivity. All eight hormones exhibited significant age-related declines (P < 0.001 for seven hormones; P = 0.001 for 11-OH A4). Notably, 11-OH A4 levels were significantly lower in the 35–45-yr (3.05 nmol/L) and 25–34-yr (3.09 nmol/L) age groups than in the 18–24-yr (3.57 nmol/L) age group, whereas no significant difference was observed between the 35–45-yr and 25–34-yr age groups. Weak negative correlations were observed between the body mass index and corticosterone and cortisone levels, whereas ethnicity and the menstrual cycle showed no significant associations with hormone levels. Conclusions We developed an HPLC-MS/MS-based method for simultaneously quantifying eight adrenocortical hormones, including 11-OH A4, and defined age-specific reference intervals for reproductive-aged Chinese women. These findings advance the clinical utility of adrenocortical hormones in diagnosing and managing reproductive disorders.

Objective To explore the echocardiographic features of critically ill patients with infection, and to evaluate the predictive value of echocardiographic parameters for 28-day mortality and myocardial injury. Methods Using a single-center prospective cohort design, 120 critically ill patients with infection admitted to the Intensive Care Unit, Jinshan Hospital of Fudan University from January 2024 to January 2025 were enrolled consecutively. According to the severity of infection, patients were divided into the sepsis group (n＝75) and the non-sepsis group (n＝45). Cox proportional hazards models and modified Poisson regression were used to analyze risk factors of 28-day all-cause mortality and myocardial injury. Kaplan-Meier survival curve and log-rank test were used to assess prognosis differences among patients with different ultrasound parameters. ROC curve and area under the curve (AUC) were applied to evaluate the predictive performance of ultrasound parameters, and restricted cubic spline (RCS) model was used to explore nonlinear relationships. Results The E/e′ ratio was significantly higher in the sepsis group than in the non-sepsis group (P＜0.001), while left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) were lower in the sepsis group (P＜0.05). The Cox proportional hazards model found no association between ultrasound parameters and 28-day all-cause mortality. Modified Poisson regression showed that, after adjusting for confounding factors, elevated E/e′ was an independent risk factor of myocardial injury (RR＝1.12, 95% CI 1.07–1.17, P＜0.001). Survival analysis demonstrated that patients with E/e′ ＞10.9 had lower 28-day survival rates (P＝0.02), and the AUC for E/e′ predicting myocardial injury was 0.835. RCS analysis suggested a nonlinear relationship between E/e′ and myocardial injury risk (P＜0.001). Conclusions E/e′, LVEF, and LVFS have no significant predictive value for 28-day mortality risk in critically ill patients with infections. Elevated E/e′ is an independent risk factor of myocardial injury in such patients, with a nonlinear relationship.

Objective To compare imaging quality and semi-quantitative parameters of 18F-FDG whole-body images obtained with domestic NeuWise and Philips Ingenuity TF PET/CT scanners.Methods Thirty-four patients who underwent 18F-FDG whole-body scanning using NeuWise and Philips Ingenuity TF PET/CT systems respectively on the same day were enrolled.The imaging quality and semi-quantitative parameters of 2 kind images,also the mean standard uptake value(SUVmean)of normal tissue,the maximum standard uptake value(SUVmax),peak standard uptake value(SUVpeak),SUVmean of lesions,total lesion glycolysis(TLG)and metabolic tumor volume(MTV)were compared.Results No significant difference of imaging quality nor semi-quantitative parameters of lesions(all P＞0.05),while significant differences of SUVmean of aortic arch,liver,lumbar vertebra and spinal cord were found between 2 kind images(all P＜0.05).Strong correlations of SUVmax,SUVmean,MTV and TLG of lesions(r,=0.734-0.890,P＜0.001),and high correlation of SUVpeak(rs=0.919,P＜0.001)were found between 2 kind images.The consistency of SUVmax,SUVpeak,SUVmean,TLG and MTV at the lesion site between 2 kind images were very good to extremely good(ICC=0.891-0.986,all P＜0.001),and the differences of all above semi-quantitative parameters were within 95％confidence interval.Conclusion Imaging quality of 18F-FDG whole-body images obtained with domestic NeuWise and Philips Ingenuity TF PET/CT scanners could meet the requirements of clinical diagnosis and treatment,and semi-quantitative parameters obtained based on both images had good consistencies.

Objective:To develop a scientific and practical questionnaire for general practice residents, and to conduct multidimensional and comprehensive evaluation of the quality of general practice teaching clinics.Methods:A preliminary draft of the questionnaire items was formulated based on a literature review and in-depth interviews. The Delphi method was employed to conduct two rounds of consultation with 14 experts. Following revisions, a convenience sampling method was used to invite general practice residents from three standardized residency training bases to test the reliability and validity of the questionnaire.Results:The questionnaire consisted of 23 items, covering the three dimensions of preparation, implementation process, and comprehensive evaluation of the teaching clinics. The response rates for the two rounds of the expert consultation were both 100.00%, with expert authority coefficients of 0.89 and 0.90, respectively. The overall Cronbach's α coefficient of the questionnaire was 0.93, and the correlation coefficients between each item score and the total score were all >0.30. Structural validity analysis revealed that three common factors were extracted from the questionnaire, with a cumulative variance contribution rate of 77.89%. Conclusions:The General Practice Teaching Clinic Quality Evaluation Questionnaire for Residents developed in this study demonstrates high reliability and validity. The questionnaire provides a scientific basis for the standardized assessment of teaching quality in general practice clinics. By incorporating resident feedback on the teaching process, the questionnaire promotes the development of a teaching clinic quality improvement mechanism focused on residents and plays a significant role in enhancing the teaching capabilities of supervising physicians in clinics.

Objective:To investigate the perception of supportive mentoring style among master's degree students in traditional Chinese medicine, as well as the current status of research autonomous motivation and self-efficacy, and to analyze the impact of such a style on these two factors.Methods:From April 14 to April 20, 2023, a questionnaire survey was conducted among master's degree students in traditional Chinese medicine from eight traditional Chinese medicine standardized training bases in Beijing using the Supportive Mentoring Style Scale, Research Autonomous Motivation Scale, and Research Self-Efficacy Scale. SPSS 20.0 was used for difference analysis, correlation analysis, and regression analysis on the collected data.Results:In the survey, 405 qualified samples were collected. The score of the Supportive Mentoring Style Scale was (6.00±1.25), the score of the Research Autonomous Motivation Scale was (5.12±1.51), and the score of the Research Self-Efficacy Scale was (4.67±1.55). There were no significant differences in the four demographic variables, students' sex, students' grade, supervisors' title, and supervisors' sex, for the three scales. The supportive mentoring style was positively correlated with both research autonomous motivation ( r=0.509, P<0.01) and research self-efficacy ( r=0.468, P<0.01). Research autonomous motivation was positively correlated with research self-efficacy ( r=0.826, P<0.01). The supportive mentoring style can positively predict research self-efficacy through the mediating effect of research autonomous motivation, with the mediating effect accounting for 86.32% of the total effect. Conclusions:The overall research self-efficacy of master's degree students in traditional Chinese medicine in Beijing is poor. The supportive mentoring style can enhance research autonomous motivation and self-efficacy, promote cultivation efficiency, and strengthen students' self-efficacy, which is beneficial for improving their research capacity training.

Background and Aims:Acute pancreatitis(AP)is a common acute abdominal disease,with some patients progressing to moderately severe(MSAP)or severe acute pancreatitis(SAP).Secondary infection is a major determinant of prognosis.Carbapenem-resistant Acinetobacter baumannii(CRAB)has emerged as an important pathogen in AP,characterized by high drug resistance and mortality.This study aimed to comprehensively analyze the clinical characteristics,mortality risk factors,and antimicrobial resistance patterns of CRAB infection in MSAP/SAP patients,and to develop a predictive model.Methods:A retrospective cohort of 108 MSAP/SAP patients with CRAB infection admitted to Xiangya Hospital,Central South University,between January 2012 and August 2022 was analyzed.Clinical data,laboratory parameters,and antimicrobial susceptibility results were collected.Cox regression was performed to identify independent mortality risk factors,and a nomogram prediction model was constructed and validated.Results:The cohort comprised 108 patients(mean age 48 years,71.3%male).The leading etiologies were hypertriglyceridemia(61.1%)and biliary causes(33.3%).The most common infection sites were the pancreas/peripancreatic region(44.4%)and the lungs(43.5%).Overall mortality was 42.6%(46/108).Compared with survivors,deceased patients were older,more frequently had biliary etiology,ICU admission,mechanical ventilation,hemorrhage,and septic shock(all P<0.05).Multivariate Cox regression identified age>60 years(HR=6.694),hemorrhage(HR=4.466),septic shock(HR=4.495),and hemoglobin<80 g/L(HR=2.343)as independent predictors of death.Among 175 CRAB isolates,resistance rates exceeded 60%for most antibiotics,while tigecycline showed the lowest resistance(<40%).The nomogram model demonstrated excellent discrimination(C-index=0.897)and calibration,with an AUC of 0.897 for 90-day survival prediction.Conclusion:CRAB infection significantly worsens clinical outcomes in MSAP/SAP patients,with advanced age,hemorrhage,septic shock,and severe anemia as key mortality risk factors.The nomogram provides an effective tool for early identification of high-risk patients.Tailored therapeutic strategies,rational antibiotic use,and prevention of complications are essential to improving prognosis in this population.

Objective To compare imaging quality and semi-quantitative parameters of 18F-FDG whole-body images obtained with domestic NeuWise and Philips Ingenuity TF PET/CT scanners.Methods Thirty-four patients who underwent 18F-FDG whole-body scanning using NeuWise and Philips Ingenuity TF PET/CT systems respectively on the same day were enrolled.The imaging quality and semi-quantitative parameters of 2 kind images,also the mean standard uptake value(SUVmean)of normal tissue,the maximum standard uptake value(SUVmax),peak standard uptake value(SUVpeak),SUVmean of lesions,total lesion glycolysis(TLG)and metabolic tumor volume(MTV)were compared.Results No significant difference of imaging quality nor semi-quantitative parameters of lesions(all P＞0.05),while significant differences of SUVmean of aortic arch,liver,lumbar vertebra and spinal cord were found between 2 kind images(all P＜0.05).Strong correlations of SUVmax,SUVmean,MTV and TLG of lesions(r,=0.734-0.890,P＜0.001),and high correlation of SUVpeak(rs=0.919,P＜0.001)were found between 2 kind images.The consistency of SUVmax,SUVpeak,SUVmean,TLG and MTV at the lesion site between 2 kind images were very good to extremely good(ICC=0.891-0.986,all P＜0.001),and the differences of all above semi-quantitative parameters were within 95％confidence interval.Conclusion Imaging quality of 18F-FDG whole-body images obtained with domestic NeuWise and Philips Ingenuity TF PET/CT scanners could meet the requirements of clinical diagnosis and treatment,and semi-quantitative parameters obtained based on both images had good consistencies.

Objective:To compare the therapeutic efficacy and safety of local anesthesia and spinal anesthesia for the patients with varicocele(VC)who underwent microsurgical varicocelectomy(MV).Methods:We retrospectively analyzed the data of VC patients who underwent MV treatment at the Andrology Department of the Affiliated Ruikang Hospital of Guangxi University of Chinese Medicine from May 2020 to March 2023.Cases with complete clinical data and follow-up evaluation were selected and divided into a control group(spinal anesthesia)and an observation group(local anesthesia)according to different anesthesia methods.The surgical time(including anesthesia time),visual analogue scale(VAS)score for pain,hospital stay,treatment cost,sperm concentration,for-ward motile sperm rate,and normal sperm morphology rate after three months of surgery,as well as postoperative complications and re-currence rate were compared between the two groups.Results:A total of 107 eligible cases were included,with 56 cases in the con-trol group and 51 cases in the observation group.There was no significant difference in the VAS score for pain during and after four hours of surgery,as well as postoperative complications,and recurrence rate between the two groups(P＞0.05).There was an signif-icant increase in sperm concentration,forward motile sperm rate,and normal sperm morphology rate in both of two groups after three months of surgery(P＜0.05).However,there was no significant difference between the two groups three months after surgery(P＞0.05).The surgical time and hospital stay were shorter than those of the control group(P＜0.05).And the treatment cost in observa-tion group was lower than that of the control group(P＜0.05).Conclusion:Both local anesthesia and lumbar anesthesia for MV treatment of VC have good efficacy and safety.However,patients treated with MV under local anesthesia for VC have obvious advanta-ges in terms of operation time(including anesthesia time),hospital stay,and treatment cost,which is worthy of clinical promotion and application.

Objective:To analyze the epidemiological characteristics of imported malaria in Shaoxing City and provide scientific basis for formulating prevention and control measures against imported malaria.Methods:A retrospective analysis was conducted. Data on imported malaria cases reported in Shaoxing City from 2012 to 2024 were collected from the infectious disease reporting information system of China Center for Disease Control and Prevention, and the parasitic disease control information management system, including general information, epidemiological investigation reports and diagnosis/treatment status, to analyze their epidemiological characteristics.Results:From 2012 to 2024, there were 110 imported malaria cases in Shaoxing City, including 105 males and 5 females, with a sex ratio of 21 ∶ 1. The youngest patient was 21 years old and the oldest was 73 years old, with 72 cases (65.45%) in the 30-50 age group. The 110 malaria cases included 69 cases of falciparum malaria, 22 cases of vivax malaria, 15 cases of ovale malaria, 3 cases of quartan malaria, and 1 case of mixed infection. The infection sources were Africa (84.55%, 93/110) and Asia (15.45%, 17/110). Among all patients, there were 19 foreign nationals and 91 Chinese citizens. The main purposes of travel for Chinese citizens were labor work (67.03%, 61/91) and business (29.67%, 27/91). Areas with more reported cases were Zhuji City (32 cases), Keqiao District (27 cases), Xinchang County (19 cases) and Yuecheng District (19 cases). The peak months of onset were January, July and September, with 12, 12 and 18 cases respectively. The first medical visits were mainly at county-level hospitals, center for disease control and prevention at all levels and municipal hospitals, with diagnosis rates of 86.67% (52/60), 100% (21/21) and 12/15 respectively. Compared with cases without malaria history, cases with malaria history had shorter time from onset to diagnosis (median, 5.00 d vs. 2.00 d, Z =-2.40, P = 0.004). Conclusions:From 2012 to 2024, imported malaria in Shaoxing City was mainly falciparum malaria, with Africa being the main infection source. The peak incidence occurred in summer. Male young adult overseas workers were the high-risk population. The prevention and control of imported malaria in Shaoxing City should focus on preventing relapse after importation and cure.

Objective:To analyze the epidemiological characteristics of imported malaria in Shaoxing City and provide scientific basis for formulating prevention and control measures against imported malaria.Methods:A retrospective analysis was conducted. Data on imported malaria cases reported in Shaoxing City from 2012 to 2024 were collected from the infectious disease reporting information system of China Center for Disease Control and Prevention, and the parasitic disease control information management system, including general information, epidemiological investigation reports and diagnosis/treatment status, to analyze their epidemiological characteristics.Results:From 2012 to 2024, there were 110 imported malaria cases in Shaoxing City, including 105 males and 5 females, with a sex ratio of 21 ∶ 1. The youngest patient was 21 years old and the oldest was 73 years old, with 72 cases (65.45%) in the 30-50 age group. The 110 malaria cases included 69 cases of falciparum malaria, 22 cases of vivax malaria, 15 cases of ovale malaria, 3 cases of quartan malaria, and 1 case of mixed infection. The infection sources were Africa (84.55%, 93/110) and Asia (15.45%, 17/110). Among all patients, there were 19 foreign nationals and 91 Chinese citizens. The main purposes of travel for Chinese citizens were labor work (67.03%, 61/91) and business (29.67%, 27/91). Areas with more reported cases were Zhuji City (32 cases), Keqiao District (27 cases), Xinchang County (19 cases) and Yuecheng District (19 cases). The peak months of onset were January, July and September, with 12, 12 and 18 cases respectively. The first medical visits were mainly at county-level hospitals, center for disease control and prevention at all levels and municipal hospitals, with diagnosis rates of 86.67% (52/60), 100% (21/21) and 12/15 respectively. Compared with cases without malaria history, cases with malaria history had shorter time from onset to diagnosis (median, 5.00 d vs. 2.00 d, Z =-2.40, P = 0.004). Conclusions:From 2012 to 2024, imported malaria in Shaoxing City was mainly falciparum malaria, with Africa being the main infection source. The peak incidence occurred in summer. Male young adult overseas workers were the high-risk population. The prevention and control of imported malaria in Shaoxing City should focus on preventing relapse after importation and cure.