Objective To analyze drug resistance and clustering of environmental and clinical isolates of Acinetobacter baumannii (A. baumannii) in ICU of a medical institution in Shanghai. Methods The isolates of A. baumannii from ICU environments and clinic were used to analyze the contamination and distribution in 2021-2024. Antimicrobial susceptibility testing was carried out with microbroth dilution method. Whole genome sequencing was performed out of strains for MLST typing and SNP clustering. Results The detection rate of contamination in ICU environment was 7.67%, and the most serious contamination was found in pillows, bedding, hospital gowns and other items that patients directly contacted. Clinical isolates were predominantly from sputum specimens. The environmental and clinical isolates had a high level of resistance to third generation cephalosporins, third generation quinolones and carbapenems (more than 85%). Environmental isolates had a low level of resistance to polymyxin B, but none of the clinical isolates were resistant. MLST typing showed that ST2 was the dominant clone (66.67%), and SNP clustering found that isolates from different sources but with the same ST type were clustered together. Conclusion ST2 is the dominant clone of A. baumannii isolates in this medical institution, and there is cross-contamination between different samples. Monitoring of drug resistance and disinfection should be further strengthened to prevent the emergence and spread of pan-resistant or even fully resistant strains.

Objective:To explore the factors influencing adherence to voice therapy among patients with voice disorders in China. Methods:Patients with voice disorders who visited the Voice Therapy Center at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, from February to May 2022 were enrolled in the study. Adherence was assessed using the URICA-Voice scale, while influencing factors were assessed through the Voice Handicap Index（VHI） scale and a general information questionnaire. Correlation analysis was conducted using univariate and multivariate logistic regression analysis. Results:A total of 247 patients were included in the study, comprising 57 males（23.08%） and 190 females（76.92%）. The results revealed that: ①Female patients demonstrated higher likelihood of being in the contemplation stage（OR=0.22） compared to males. ②Patients with a monthly family income per capita>6 000 yuan were more likely to be in the contemplation stage than those with<3 000 yuan with an OR = 13.94. ③High vocal-demand occupations increased contemplation stage probability（OR=7.70） compared to moderate-demand occupations. ④Residence within 30-minute commute predicted action/maintenance stages（OR=7.14） versus≥60-minute commute. ⑤Patients whose occupations had high voice demands were more likely to be in the action and maintenance stages than those with average voice demands, with an OR of 16.20. Conclusion:Gender, monthly family income per capita, occupational voice demands, and distance to the hospital significantly impact the URICA-Voice compliance stages of patients. Patients who are female, have higher family income, have occupations with high voice demands, and live closer to the hospital exhibit higher compliance with voice training.
Humans ; Male ; Female ; Voice Disorders/therapy* ; Patient Compliance ; Voice Training ; Surveys and Questionnaires ; China ; Middle Aged ; Adult ; Voice Quality ; Logistic Models ; Aged

Objective:To analyze the etiology, diagnosis, treatment of cholesteatoma of temporal bone complicated with brain abscess. Methods:A total of 27 patients with cholesteatoma complicated with brain abscess admitted to the Peoples Hospital of Xinjiang Uygur Autonomous Region from January 2008 to January 2024 were collected, and their clinical characteristics and treatment methods were summarized. Results:Tow patients underwent modify radical mastoidectomy and eliminate abscess by pricking. The other patients underwent ear surgery after neurosurgical treatment of brain abscess. Among them, 19 cases underwent open craniotomy for brain abscess and 5 cases with small abscess were transferred to otorhinolaryngology for radical mastoidectomy after transcranial drainage. Only one patient died, the other patients had a good prognosis without recurrence. Conclusion:OBA is the most serious complication of temporal cholesteatoma with a high mortality rate, and MRI can assist in early diagnosis. Early treatment and multidisciplinary collaboration can improve the cure rate of the disease.
Humans ; Brain Abscess/therapy* ; Temporal Bone ; Cholesteatoma/therapy* ; Male ; Female ; Mastoidectomy ; Adult ; Middle Aged ; Magnetic Resonance Imaging ; Craniotomy

In order to study the effects of prostaglandin D2(PGD2)on cow bone marrow-derived macrophages induced by E.coli,cultured cow bone marrow-derived macrophages were taken as the research object.The effects of endogenous and exogenous PGD2 on the secretion and phagocytosis of E.coli induced proinflammatory cytokines(IL-1β,IL-6 and TNF-α)in macrophages were ana-lyzed.The results showed that the synthesis of PGD2 in macrophages induced by E.coli is depend-ent on the natural pattern recognition receptors TLR2,TLR4 and NLRP3.Inhibition of endogenous PGD2can down-regulate the secretion of pro-inflammatory cytokines(IL-1β,IL-6 and TNF-α)in E.coli induced macrophages(P＜0.001),and inhibition of endogenous PGD2 can enhance the kill-ing function of macrophages to a certain extent(P＜0.01).In addition,exogenous PGD2 could up-regulate the secretion of pro-inflammatory cytokines(IL-1β,IL-6 and TNF-α)in macrophages af-ter E.coli stimulation(P＜0.01),and exogenous PGD2 could weaken the killing function of mac-rophages within a certain concentration range(P＜0.01).Results indicated that PGD2 had certain effects on the secretion of cytokines and phagocytosis and killing function of macrophages induced by E.coli.

ObjectiveTo assess the current status of medical waste management in Jinshan District of Shanghai, China, to identify existing issues, and to provide a scientific basis for formulating targeted strategies. MethodsData were collected from the routine supervision and inspection records of the Jinshan District Health Commission Supervision Institute from 2017 to 2021, covering all aspects of medical waste management, including collection, classification, transportation, storage, and administrative penalties. ResultsThe compliance rates for the establishment of institutional frameworks, staffing, internal handover, and registration in medical and healthcare institutions all exceeded 95.00%. However, only 2.31% of the medical and healthcare institutions met the 48-hour storage limit requirement for medical waste. Private institutions had significantly lower compliance rates (P<0.05) in aspects such as proper classification and collection, maintaining records for three years, adhering to the 48-hour storage limit, refraining from commercial transactions, timely disinfection and cleaning, and implementing emergency measures for waste loss. Compliance rates also varied among different types of institutions regarding the establishment of temporary storage facilities and the implementation of the transfer manifest system, with community healthcare institutions exhibiting relatively lower compliance rates (P<0.05). Over the past five years, private medical and healthcare institutions accounted for 63.33% of administrative penalty cases. ConclusionWhile medical waste management in Jinshan District, Shanghai, has gradually become more standardized, challenges remain. To address the issue of medical waste being stored for over 48 hours, medical waste transfer stations should be established to improve transfer efficiency and ensure complete waste collection. Additionally, for private and community healthcare institutions, weak links in management should be addressed by establishing medical waste quality control teams, enhancing supervision through digital tools, and optimizing management processes to comprehensively elevate medical waste management.

Objective To investigate the effect of Lactobacillus plantarum LB12 on kidney calcium oxalate stones in rats.Methods A total of 24 male SD rats aged 6～8 weeks were randomly divided into four groups:control group,model group,LB12 group,and LB12 intervention group,with 6 rats in each group.The control group and LB12 group had free access to water,and were gavaged with 2 mL of normal saline in the morning.In the evening,the control group received 2 mL of normal saline,while the LB12 group received 2 mL of Lactobacillus plantarum LB12 suspension.The model group and LB12 intervention group were given 1%ethylene glycol in drink-ing water and 2 mL of 2%ammonium chloride solution via gavage in the morning.In the evening,both groups received 2 mL of normal saline and 2 mL of Lactobacillus plantarum LB12 suspension,respectively.After the experiment,the body weight change trend of the rats was recorded,and the levels of urinary calcium,urinary oxalate,serum creatinine,blood urea nitrogen,renal SOD,and MDA were measured.Additionally,H&E staining,VK staining,immunohistochemistry,ROS fluorescence analysis,and Western blot(WB)were performed on kidney tissues.Results Lactobacillus plantarum LB12 demonstrated a 12.34%oxalate degradation rate in vitro.Further animal experiments indicated that Lactobacillus plantarum LB12 alleviated the weight loss trend in the model rats and reduced the levels of urinary calcium,urinary oxalate,serum creatinine,urea nitrogen,and MDA,while increasing SOD levels(P<0.05).Histopathological analysis revealed that the LB12 intervention group had signifi-cantly fewer renal crystals compared to the model group,with lower expressions of IL-6 and ROS(P<0.01).Western blot analysis demonstrated that Lactobacillus plantarum LB12 inhibited the expression of TLR4,NF-κB,and OPN proteins(P<0.01).Conclusions Lactobacillus plantarum LB12 can effectively alleviate the oxidative stress damage caused by calcium oxalate stones to the kidneys and reduce kidney crystal formation in rats.Further-more,it inhibits the expression of TLR4/NF-κB and OPN,making it a potential therapeutic approach for the prevention and treatment of kidney calcium oxalate stones.

Objective:To screen the risk factors for non-complete procedural success of transvenous lead extraction(TLE),and to establish a prediction model based on the results and evaluate its predictive efficacy.Methods:A total of 1 029 patients who underwent TLE in Peking University People's Hospital from January 2014 to December 2020 were enrolled and divided into training set(n=720)and validation set(n=309)using the random number method.There were no statistically significant differences among the variables in the training set and the validation set.The training set was divided into the complete procedural success(CPS)group(n=664)and the non-CPS group(n=56).Univariate analysis was employed to screen the relevant indicators of non-CPS,followed by binary logistic regression analysis to identify the independent risk factors of non-CPS.Subsequently,a predictive model and nomogram were constructed.The receiver operating characteristic(ROC)curve analysis was applied to evaluate the ability of the model to distinguish non-CPS from TLE patients in the training set and validation set.The Hosmer-Lemeshow goodness-of-fit test was used to assess the consistency between the predicted risk and the actual risk of the model.Results:Univariate analysis showed that the relevant variables with P<0.1 including the age at the first implantation of the lead,the number of leads extracted,the oldest dwell time of lead extracted,the presence of abandoned leads,non-manual traction for lead extracted,the number of extracted leads>3,bilateral lead implantation,and the indications for TLE.The binary logistic regression analysis revealed that the presence of abandoned leads(OR=2.252,95%CI:1.111-4.564,P=0.024),the oldest dwell time of the extracted leads(OR=1.009,95%CI:1.005-1.012,P<0.001),and the number of extracted leads>3(OR=3.177,95%CI:1.306-7.733,P=0.011)were independent risk factors for non-CPS of TLE.ROC curve analysis revealed that the area under the ROC curve(AUC)of the training set was 0.80(95%CI:0.75-0.85,P<0.001).The AUC of the validation set was 0.81(95%CI:0.72-0.90,P<0.001).The Hosmer-Lemeshow goodness-of-fit test indicated that the P values of both the training set(P=0.089)and the validation set(P=0.136)were greater than 0.05.Conclusions:The presence of abandoned leads,the oldest dwell time of lead extracted,and the number of extracted leads>3 are independent risk factors for non-CPS in patients undergoing TLE.The nomogram model based on the above factors has satisfactory predictive ability.

Escherichia coli(E.coli)is a key pathogenic bacterium responsible for postpartum endo-metritis,with its colonization in the reproductive tract closely associated with endometrial damage and disruption of the ovarian cycle.This ultimately leads to infertility,causing significant economic losses to the dairy industry.Macrophages play a pivotal role in the inflammatory response.This study aims to investigate the mRNA expression profile of bovine bone marrow-derived macropha-ges following E.coli infection using RNA sequencing(RNA-seq)technology.Additionally,it seeks to identify the biological functions and signaling pathways of differentially expressed genes(DEGs)through Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses.The results demonstrated that E.coli infection induced differential expression of 4 522 genes,with 2 141 upregulated and 2 381 downregulated.These genes were primarily asso-ciated with inflammatory responses,where TLR2,TLR4,NLRP3,and PTGS2 played pivotal roles.PGD2 synthesis was mediated by TLR2,TLR4,and NLRP3.Transcriptome sequencing of bovine bone marrow-derived macrophages infected with E.coli and treated with a PGD2 inhibitor revealed a marked downregulation of TLR2 and TLR4 gene expression.qPCR validation results were highly consistent with the RNA-seq findings.This study elucidates the interactive regulatory roles of TLR2,TLR4,and NLRP3 in conjunction with PGD2,which collectively modulate bovine endome-tritis.These findings offer significant molecular insights that enhance our understanding of the pathological mechanisms underlying bovine endometritis,thereby informing its prevention and treatment strategies.

Escherichia coli(E.coli)is a key pathogenic bacterium responsible for postpartum endo-metritis,with its colonization in the reproductive tract closely associated with endometrial damage and disruption of the ovarian cycle.This ultimately leads to infertility,causing significant economic losses to the dairy industry.Macrophages play a pivotal role in the inflammatory response.This study aims to investigate the mRNA expression profile of bovine bone marrow-derived macropha-ges following E.coli infection using RNA sequencing(RNA-seq)technology.Additionally,it seeks to identify the biological functions and signaling pathways of differentially expressed genes(DEGs)through Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analyses.The results demonstrated that E.coli infection induced differential expression of 4 522 genes,with 2 141 upregulated and 2 381 downregulated.These genes were primarily asso-ciated with inflammatory responses,where TLR2,TLR4,NLRP3,and PTGS2 played pivotal roles.PGD2 synthesis was mediated by TLR2,TLR4,and NLRP3.Transcriptome sequencing of bovine bone marrow-derived macrophages infected with E.coli and treated with a PGD2 inhibitor revealed a marked downregulation of TLR2 and TLR4 gene expression.qPCR validation results were highly consistent with the RNA-seq findings.This study elucidates the interactive regulatory roles of TLR2,TLR4,and NLRP3 in conjunction with PGD2,which collectively modulate bovine endome-tritis.These findings offer significant molecular insights that enhance our understanding of the pathological mechanisms underlying bovine endometritis,thereby informing its prevention and treatment strategies.

In order to study the effects of prostaglandin D2(PGD2)on cow bone marrow-derived macrophages induced by E.coli,cultured cow bone marrow-derived macrophages were taken as the research object.The effects of endogenous and exogenous PGD2 on the secretion and phagocytosis of E.coli induced proinflammatory cytokines(IL-1β,IL-6 and TNF-α)in macrophages were ana-lyzed.The results showed that the synthesis of PGD2 in macrophages induced by E.coli is depend-ent on the natural pattern recognition receptors TLR2,TLR4 and NLRP3.Inhibition of endogenous PGD2can down-regulate the secretion of pro-inflammatory cytokines(IL-1β,IL-6 and TNF-α)in E.coli induced macrophages(P＜0.001),and inhibition of endogenous PGD2 can enhance the kill-ing function of macrophages to a certain extent(P＜0.01).In addition,exogenous PGD2 could up-regulate the secretion of pro-inflammatory cytokines(IL-1β,IL-6 and TNF-α)in macrophages af-ter E.coli stimulation(P＜0.01),and exogenous PGD2 could weaken the killing function of mac-rophages within a certain concentration range(P＜0.01).Results indicated that PGD2 had certain effects on the secretion of cytokines and phagocytosis and killing function of macrophages induced by E.coli.