Objective To explore the clinical factors influencing complete response in patients with locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (nCRT). Methods Clinical data of LARC patients treated in the Department of Radiation Oncology at Beijing Shijitan Hospital between January 2013 and December 2024 were retrospectively collected. All patients received nCRT, after which surgery or a watch-and-wait approach was adopted based on treatment response. Univariable and multivariable logistic regression analyses were performed to identify prognostic factors influencing complete response. A clinical prediction model was constructed based on the multivariable analysis results, and its predictive performance was evaluated using the receiver operating characteristic curve. Results A total of 113 eligible patients were included. After nCRT, 19 patients (16.8%) achieved complete response, including 3 with clinical complete response and 16 with pathological complete response. Univariable analysis indicated that pretreatment clinical N stage, extramural venous invasion, carcinoembryonic antigen level, and neoadjuvant treatment regimen were associated with complete response after nCRT (P<0.05). Multivariable logistic regression analysis identified pretreatment extramural venous invasion, carcinoembryonic antigen level, and neoadjuvant treatment regimen as independent influencing factors for complete response (P<0.05). A prediction model incorporating these independent factors yielded an area under the receiver operating characteristic curve of 0.813 (95% confidence interval: 0.713-0.913), with a sensitivity of 89.5% and a specificity of 60.6%, demonstrating good predictive performance. Conclusion Pretreatment extramural venous invasion, carcinoembryonic antigen level, and neoadjuvant treatment regimen are independent factors influencing complete response after nCRT in LARC patients. The prediction model combining these factors may assist in evaluating treatment efficacy following nCRT in LARC patients.

ObjectiveTo investigate and manage an imported dengue fever (DF) outbreak in Shanghai in 2024, to summarize the experience and lessons learned from the on-site management, and to provide a reference basis for future prevention and control of DF. MethodsEpidemiological investigation and case search were carried out for an imported DF outbreak in Shanghai, 2024. Real-time fluorescence polymerase chain reaction (RT-PCR) was used to detect dengue virus nucleic acid in the serum samples from cases. Meanwhile, emergency vector surveillance and mosquito control measures were carried out in the affected areas, and the effectiveness of the management was evaluated. ResultsAccording to the epidemiological investigation, it was confirmed that this epidemic was a family cluster of imported DF, with both cases infected in Thailand and developed symptoms successively after returning to Shanghai. Laboratory testing identified the pathogens as dengue virus serotype-3 (DENV-3). In the core and precautionary area, ultra-low-volume space spraying and residual spraying were combined to kill adult mosquitoes, and at the same time, comprehensive cleaning and elimination of mosquito breeding sites was carried out. After 2 weeks, the Breteau Index (BI) in the core area decreased from 20 to 5, and the mosquito net trap index decreased from 2 mosquitoes (net·hour)^-1 to 0.67 mosquitoes (net·hour)^-1. Continuous implementation of mosquito control measures kept the BI and net trap index below the safety thresholds [BI<5 and mosquito net trap index <2 mosquitoes (net·hour)^-1] both in the core and precautionary area. ConclusionEarly diagnosis and isolation of patients, combined with rapid suppression of the density of vector Aedes mosquitoes, are the key measures to prevent the transmission of imported DF cases.

Objective To investigate the value of ¹⁸F-FDG PET/CT metabolic parameters in the prognostic assessment of nasopharyngeal cancer patients. Methods The clinical data and PET/CT metabolic parameters of 185 nasopharyngeal cancer patients were retrospectively analyzed. The collected parameters were SUV_max, MTV, TLG, total metabolic tumor volume (TMTV) and whole-body total lesion glycolysis (WTLG). The ROC curve was used to determine the optimal cut-off values of PET/CT metabolic parameters. Univariate and multivariate Cox regression models were used to screen the independent prognostic factors. Kaplan–Meier curves were used to analyze the survival differences. Results The results of univariate Cox regression analysis showed that age, pathologic type, WTLG, TMTV, MTV, and TLG were closely associated with OS and PFS; and SUV_max was associated with PFS (P<0.05). Multivariate Cox regression analysis results showed that age, TMTV, and WTLG were the independent prognostic factors for OS and PFS (P<0.05). The combination of WTLG with T/N staging (AUC=0.781 and 0.781) and TMTV with T/N staging (AUC=0.800 and 0.790) yielded greater predictive accuracy than that of WTLG and TMTV alone (AUC=0.724 and 0.719) or T/N staging (AUC=0.593 and 0.575). Conclusion TMTV and WTLG are important prognostic predictors of nasopharyngeal carcinoma. TLG and MTV of primary lesions are prognostic factors for patients’ PFS and OS. SUV_max has limited prognostic value. Systemic metabolic indexes (TMTV and WTLG), when combined with T/N staging, can optimize prognostic stratification.

Objective To investigate the distribution and antimicrobial resistance profiles of common pathogens isolated from cerebrospinal fluid(CSF)in CHINET program from 2015 to 2021.Methods The bacterial strains isolated from CSF were identified in accordance with clinical microbiology practice standards.Antimicrobial susceptibility test was conducted using Kirby-Bauer method and automated systems per the unified CHINET protocol.Results A total of 14 014 bacterial strains were isolated from CSF samples from 2015 to 2021,including the strains isolated from inpatients(95.3％)and from outpatient and emergency care patients(4.7％).Overall,19.6％of the isolates were from children and 80.4％were from adults.Gram-positive and Gram-negative bacteria accounted for 68.0％and 32.0％,respectively.Coagulase negative Staphylococcus accounted for 73.0％of the total Gram-positive bacterial isolates.The prevalence of MRSA was 38.2％in children and 45.6％in adults.The prevalence of MRCNS was 67.6％in adults and 69.5％in children.A small number of vancomycin-resistant Enterococcus faecium(2.2％)and linezolid-resistant Enterococcus faecalis(3.1％)were isolated from adult patients.The resistance rates of Escherichia coli and Klebsiella pneumoniae to ceftriaxone were 52.2％and 76.4％in children,70.5％and 63.5％in adults.The prevalence of carbapenem-resistant E.coli and K.pneumoniae(CRKP)was 1.3％and 47.7％in children,6.4％and 47.9％in adults.The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)and Pseudomonas aeruginosa(CRPA)was 74.0％and 37.1％in children,81.7％and 39.9％in adults.Conclusions The data derived from antimicrobial resistance surveillance are crucial for clinicians to make evidence-based decisions regarding antibiotic therapy.Attention should be paid to the Gram-negative bacteria,especially CRKP and CRAB in central nervous system(CNS)infections.Ongoing antimicrobial resistance surveillance is helpful for optimizing antibiotic use in CNS infections.

Objective To investigate the antimicrobial resistance of clinical isolates from elderly patients(≥65 years)in major medical institutions across China.Methods Bacterial strains were isolated from elderly patients in 52 hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 to 2021.Antimicrobial susceptibility test was carried out by disk diffusion method and automated systems according to the same CHINET protocol.The data were interpreted in accordance with the breakpoints recommended by the Clinical and Laboratory Standards Institute(CLSI)in 2021.Results A total of 514 715 nonduplicate clinical isolates were collected from elderly patients in 52 hospitals from January 1,2015 to December 31,2021.The number of isolates accounted for 34.3％of the total number of clinical isolates from all patients.Overall,21.8％of the 514 715 strains were gram-positive bacteria,and 78.2％were gram-negative bacteria.Majority(90.9％)of the strains were isolated from inpatients.About 42.9％of the strains were isolated from respiratory specimens,and 22.9％were isolated from urine.More than half(60.7％)of the strains were isolated from male patients,and 39.3％isolated from females.About 51.1％of the strains were isolated from patients aged 65-＜75 years.The prevalence of methicillin-resistant strains(MRSA)was 38.8％in 32 190 strains of Staphylococcus aureus.No vancomycin-or linezolid-resistant strains were found.The resistance rate of E.faecalis to most antibiotics was significantly lower than that of Enterococcus faecium,but a few vancomycin-resistant strains(0.2％,1.5％)and linezolid-resistant strains(3.4％,0.3％)were found in E.faecalis and E.faecium.The prevalence of penicillin-susceptible S.pneumoniae(PSSP),penicillin-intermediate S.pneumoniae(PISP),and penicillin-resistant S.pneumoniae(PRSP)was 94.3％,4.0％,and 1.7％in nonmeningitis S.pneumoniae isolates.The resistance rates of Klebsiella spp.(Klebsiella pneumoniae 93.2％)to imipenem and meropenem were 20.9％and 22.3％,respectively.Other Enterobacterales species were highly sensitive to carbapenem antibiotics.Only 1.7％-7.8％of other Enterobacterales strains were resistant to carbapenems.The resistance rates of Acinetobacter spp.(Acinetobacter baumannii 90.6％)to imipenem and meropenem were 68.4％and 70.6％respectively,while 28.5％and 24.3％of P.aeruginosa strains were resistant to imipenem and meropenem,respectively.Conclusions The number of clinical isolates from elderly patients is increasing year by year,especially in the 65-＜75 age group.Respiratory tract isolates were more prevalent in male elderly patients,and urinary tract isolates were more prevalent in female elderly patients.Klebsiella isolates were increasingly resistant to multiple antimicrobial agents,especially carbapenems.Antimicrobial resistance surveillance is helpful for accurate empirical antimicrobial therapy in elderly patients.

Objective To investigate the expressions of long non-coding ribonucleic acid OPA-interacting protein 5 antisense transcript 1(lncRNA OIP5-AS1)and microribonucleic acid 22-3p(miR-22-3p)in gastric cancer tissue and their relationships with clinicopathological features and prognosis.Methods A total of 106 patients diagnosed with gastric cancer in Zhuji Central Hospital from June 2017 to November 2020 were retrospectively enrolled as the study subjects.Cancer tissue and adjacent tissue(＞5cm from the lesion)were collected during surgery and assigned into the gastric cancer group and adjacent group,respectively.Quantitative reverse transcription polymerase chain reaction(qRT-PCR)was applied to detect the levels of lncRNA OIP5-AS1 and miR-22-3p in various tissues.The prognoses were poor(death)in 40 patients(poor prognosis group)and good in 66 patients(good prognosis group).Pearson method was applied to analyze the relationship between lncRNA OIP5-AS1 and miR-22-3p levels in cancer tissues.Kaplan-Meier method was applied to analyze the relationships of the expression levels of lncRNA OIP5-AS1 and miR-22-3p with prognosis.COX re-gression analysis was performed to analyze the factors influencing the prognosis.Results Compared with the adjacent group,the gastric cancer group had significantly increased lncRNA OIP5-AS1 level and significantly reduced miR-22-3p level(all P＜0.05).Lucifer-ase assay showed that lncRNA OIP5-AS1had a targeting relationship with miR-22-3p.The expression level of lncRNA OIP5-AS1 was negatively correlated with that of miR-22-3p in cancer tissues(rp=-0.426,P＜0.001).The expression levels of lncRNA OIP5-AS1 and miR-22-3p were closely related to tumor staging and differentiation(all P＜0.05).Compared with the good prognosis group,the poor prognosis group had significantly increased lncRNA OIP5-AS1 level and significantly reduced miR-22-3p level in cancer tissues(all P＜0.05).Kaplan-Meier method reveled that the 3-year survival rate was significantly lower in the high lncRNA OIP5-AS1 expression group than in the low lncRNA OIP5-AS1 expression group(x2=27.667,P＜0.001)but was significantly higher in the high miR-22-3p expression group than in the low miR-22-3p expression group(x2=19.876,P＜0.001).COX regression showed that the expressions of lncRNA OIP5-AS1(HR=3.652)and miR-22-3p(HR=0.748)were the prognostic factors for gas-tric cancer patients(all P＜0.05).Conclusion LncRNA OIP5-AS1 is highly expressed in gstric cancer tissues,while miR-22-3p is lowly expressed.The two are negatively correlated,and both of them are closely related to the clinicopathological features and prognosis of gastric cancer.

Aim To predict and verify the potential mechanism of the compatibility of"ginseng-astragalus-pueraria"in protecting islet morphology and improving insulin resistance by using network pharmacology.Methods The active ingredients and targets of the horn medicine were obtained from three platforms:TC-MSP,TCMIP,and BATMAN.The targets of type 2 dia-betes mellitus(T2DM)were obtained from three plat-forms:TTD,OMIM,and disgeNET.The PPI network was constructed by using the STRING database and Cy-toscape 3.9.1;GO and KEGG analysis were per-formed;POCASA 1.1 was used to predict protein binding sites,and AutoDock Vina1.1.2 was used for docking and experimental verification.Results"Gin-seng-astragalus-pueraria"screened out 2 021 targets,of which 152 were closely related to T2DM,and 10 key genes and the AGE-RAGE signaling pathway were i-dentified.Molecular docking showed that quercetin had good binding to RAGE,INS,and PI3K.Experi-ments showed that the horn drug increased insulin binding rate and secretion index and reduced serum in-sulin level and insulin resistance index.These data benefited from"ginseng-astragalus-pueraria"reducing the expression of AGE-RAGE,activating PI3K-Akt,in-hibiting NF-κB,and reducing the expression of IL-6,IL-1β and TNF-α.Conclusion The study suggests that"ginseng-astragalus-pueraria"regulates the AGE-RAGE/PI3K-Akt/NF-κB signaling pathway,repairs damaged islet morphology,and improves insulin resist-ance.

Objective To explore limb coordination patterns and energy flow strategies during the sit-to-stand(STS)transition in individuals with patellofemoral pain(PFP),so as to provide a theoretical evidence for the pathogenesis of PFP and subsequent formulation of treatment and rehabilitation strategies for PFP patients.Methods A totoal of 36 participants was recruited for the STS test.They were divided into the unilateral PFP group(unilateral group),bilateral PFP group(bilateral group),and control group,based on the number of limbs affected by PFP.An infrared motion capture system and a three-dimensioanl force plate were used for motion capture.Visual 3D and Matlab software were used to calculate the trunk and pelvis angles,angular velocities,linear velocities,and proximal and distal joint forces.Additionally,the angles,torques,and joint forces of the hip,knee,and ankle joints,along with the angular and linear velocities of the thigh and shank,were computed.Coupling angles was used to represent coordination patterns via vector coding;the segmental net energy integration method was used to calculate energy flow within segments at each stage.Results For the coordination pattern at frontal plane,the proximal coordination mode frequency of the pelvis-hip coordination in the flexion momentum phase(FMP)was higher in unilateral group than that in bilateral group(P=0.024).In the momentum transfer phase(MTP),the frequency of in-phase coordination in the trunk-pelvis coordination was higher in unilateral group than that in bilateral group(P=0.023),while the frequency of distal coordination was higher in control group than in that in unilateral group(P=0.032).For the knee-ankle coordination pattern,the frequency of distal coordination in control group was lower than that in unilateral and bilateral groups(P=0.025,P=0.005).In segmental energy flow,during the FMP,the energy output from the pelvis during extension phase(MP)was higher in bilateral group than that in control group(P=0.021).Conclusions PFP affects energy flow patterns and coordination patterns at frontal plane during the STS transition.Individuals in unilateral group may engage in lateral pelvic and ankle movements as a dynamic compensation for patellofemoral joint pressure,whereas individuals in bilateral group appear to increase pelvic region energy output and employ a more complex whole-body coordination pattern to compensate for functional deficits in the knee caused by PFP.

Objective"Red butterfly sore","yin-yang toxin"and"Bi disease"are different Chinese medicine diagnoses of systemic lupus erythematosus(SLE).It is not clear whether there are biological differences between these three types of Chinese medicine diagnoses.The aim of this study was to compare the different TCM diagnoses of SLE patients from the perspective of lymphocyte subsets and cytokines.Methods Patients diagnosed with SLE in our hospital from June 1,2021 to December 1,2023 were retrospectively collected,and the differences of T cell subsets,NK cells,B lymphocytes and Th1,Th2 and Th17 cytokines among different groups were compared by one-way ANOVA or nonparametric test.As well as differences in laboratory test indicators such as erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),immunoglobulin,and complement,receiver operating characteristic curve(ROC curve)was used to analyze the value of these indexes in the differential diagnosis of different types of SLE.Results From June 1,2021 to December 1,2023,291 patients diagnosed with SLE in our hospital for the first time were collected,and 104 cases meeting the exclusion criteria of this study were included,including 31 cases of red butterfly sores,30 cases of yin-yang toxin and 43 cases of BI disease.The absolute number and percentage of CD8+T cells,interleukin-10(IL-10)content and tumor necrosis factor α(TNF-α)content were different among the three groups of SLE patients diagnosed by different Chinese medicine,and the absolute number of CD8+T cells in the red butterfly sore group was significantly higher than that in the yin-yang toxicities group(P=0.039)and the disease group(P=0.008).CD8+T cell percentage in red butterfly sore group was significantly higher than that in yin-yang toxin group(P=0.014)and disease group(P=0.004),IL-10 and TNF-α levels in red butterfly sore group were significantly lower than those in disease group(P=0.015,P=0.036),and ROC curve analysis showed that,the absolute number and percentage of CD8+T cells can effectively distinguish red butterfly sores from yin-yang toxins(AUC=0.65,AUC=0.61,P<0.05),and the absolute number and percentage of CD8+T cells,IL-10 and TNF-α can effectively distinguish red butterfly sores from diseases(AUC=0.68,AUC=0.66,P<0.01,AUC=0.67,AUC=0.64,P<0.05).Conclusion Immune lymphocyte subtypes,cytokines,especially the absolute number and percentage of CD8+T cells,IL-10 and TNF-α may play an important role in the identification of different TCM diagnosis of SLE.

Purpose To analyse the expression of aldo-keto reductase AKR1C3 in the tumour tissues of oral squa-mous carcinoma(OSCC)and the correlation of clinical prognosis of patients.Methods Immunohistochemical(IHC)staining was performed to analyze the expression characteristics of AKR1C3 in 86 cases of OSCC tumor tissues and paired paratumor normal tissue.The correlation between AKR1C3 expression and clinical prognosis was evaluated.Ka-plan-Meier survival analysis was conducted to assess the survival outcomes of OSCC patients.Univariate and multivari-ate Cox regression analyses were employed to identify prognostic factors.The findings were further validated by compar-ison with the Cancer Genome Atlas(TCGA)database.Results The expression of AKR1C3 was significantly higher in OSCC tumor tissues than in paratumor normal tissue,with higher expression observed at the invasive front relative to the tumor centers.Immunohistochemical analysis revealed high expression in both tumor cells and tumor-associated fibro-blasts,while no expression was detected in tumor-infiltrating immunocytes.The x2 test was used to compare the rela-tionship between different expression levels of AKR1C3 and clinicopathological features in OSCC,the results showed that high expression of AKR1C3 was strongly associated with higher tumour stage(P=0.001),lymph node metastasis(P=0.023),differentiation(P=0.018),worst pattern of invasion(P=0.024)and depth of invasion(P=0.012).Kaplan-Meier survival curve analysis showed high expression of AKR1C3 was associated with overall survival(P=0.004),disease-free survival(P=0.019),and metastasis-free survival(P=0.05)in OSCC patients.Cox re-gression model was performed for prognostic analysis.Univariate analysis showed that high expression of AKR1C3 in tumour cells was a high-risk factor for patients' tumour stage(P＜0.001),lymph node metastasis(P＜0.001),dif-ferentiation(P＜0.001),worst pattern of invasion(P＜0.001),depth of invasion(P＜0.001).Multivariate analy-sis further showed that high expression of AKR1C3 in tumour cells was an independent prognostic factor in OSCC pa-tients(P=0.025).Conclusion The AKR1C3 expression is closely related to the prognosis of OSCC patients,and patients with high AKR1C3 expression have a poor prognosis,suggesting that AKR1C3 plays an important role in the occurrence and development of OSCC.