Objective:To investigate the application of Galectin-9 and Pentraxin3 in cardiotoxicity assessment during anthracycline chemotherapy in breast cancer patients.Methods:A total of 143 breast cancer patients who received anthracycline chemotherapy in Department of Breast, Shanxi Provincial People’s Hospital from Oct. 2021 to Oct. 2023 were separated into cardiotoxic group ( n=47) and non-cardiotoxic group ( n=96) according to whether cardiotoxicity occurred. Clinical data of patients were collected and the risk factors of cardiotoxicity were analyzed by univariate and multivariate Logistic regression. The predictive efficacy of serum Galectin-9 and Pentraxin3 levels on cardiotoxicity was evaluated by receiver operating characteristic curve (ROC) . Results:There was no statistically significant difference in age, body mass index, total cholesterol, triglycerides, low density lipoprotein, high density lipoprotein, smoking history, drinking history, underlying disease (hypertension, diabetes, hyperlipidemia) , tumor stage, pathological type, tumor size, anthracycline type, or dose between the two groups ( t=1.07, 1.22, 0.96, 0.43, 1.07, 0.50; χ 2=0.12, 1.20, 0.14, 0.01, 0.47, 0.14, 3.32, 3.83, 1.91, 3.18, P > 0.05) ; The levels of troponin and B-type brain natriuretic peptide in cardiotoxicity group were higher than those in non-cardiotoxicity group ( t=13.48, 10.28, P < 0.05) , and serum Galectin-9 and Pentraxin3 levels were also higher ( t=22.53, 17.92, P < 0.05) . Multivariate Logistic regression analysis showed that high levels of troponin, B-type brain natriuretic peptide, Galectin-9 and Pentraxin3 were all influential factors in the occurrence of cardiotoxicity ( OR=2.221, 2.050, 1.925, 1.976, P < 0.05) . ROC curve analysis showed that the area under curve of serum Galectin-9 for predicting cardiotoxicity was 0.722, the predictive sensitivity was 68.09%, and the specificity was 77.08%; The area under the curve of miR-135 for predicting cardiotoxicity was 0.636, the predictive sensitivity was 44.68%, and the specificity was 82.29%. Conclusion:Serum Galectin-9 and Pentraxin3 have high expression levels in breast cancer patients treated with anthracyclines, which are influential factors for the occurrence of cardiotoxicity after chemotherapy, and have high predictive value for the occurrence of cardiotoxicity in patients.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective:To explore the barriers to nurses applying the best evidence for non-pharmacologic prophylactic management of venous thromboembolism (VTE) in patients with multiple myeloma (MM), and to provide a basis for the development of clinical responses.Methods:A parallel mixed-methods study was conducted in January 2024 to facilitate the selection of nurses from the hematology department of Affiliated Hospital of Jiangsu University to conduct semi-structured in-depth interviews. Concurrently, convenience sampling was employed to select nursing staff from the same departineat for a quantitative questionnaire survey. The interview outlines based on the theoretical domains framework and the questionnaires based on the Barriers to the Application of the Evidence and Facilitators Scale. The questionnaire was developed based on the Barriers and Facilitators to Evidence Application Scale and combined with qualitative and quantitative analyses to derive barriers to nurses' implementation of best evidence.Results:The qualitative study conducted interviews with 9 female nurses in the hematology department, aged 25-49. The quantitative study surveyed 17 female nurses in the hematology department with an average age of (33.18 ± 9.09) years. Nurses scored high overall in evidence application (156.65 ± 20.09) points, with high scores on the organizational form dimension (34.47 ± 1.48) points, the evidence application leader dimension (44.24 ± 1.30) points, the nurses' team dimension (42.53 ± 1.41) points, and the implementation scenario dimension (11.18 ± 0.61) points, which suggests that nurses were process was well supported overall. Low scores on the evidence dimension (11.94 ± 0.91) points and patient dimension (12.41 ± 1.03) points indicated that nurses had barriers in knowledge acquisition and practical application. The results of qualitative interviews further revealed that nurses encourter multiple challenges when applying best evidence, including insufficient knowledge base, low professional identity within societym, absence of standardized departmental protocols, negative outcome expectations, and inadequate motivation coupled with ulcear objectives.Conclusions:There are multiple clinical factors affecting nurses' application of best evidence, and departments should propose targeted coping strategies based on the barrier factors to ensure the successful implementation of evidence-based practice changes, and thus advance the clinical application of best evidence for non-pharmacological prevention of VTE in MM patients.

Creutzfeldt-Jakob disease(CJD)is a rapidly progressive and fatal neurodegenerative disorder caused by prions,with certain infectivity and iatrogenic transmission risks.With the rapid progress and application of new dia-gnostic biomarkers and detection methods,as well as the construction and improvement of surveillance and reporting systems,the detection of CJD in patients domestically and internationally has shown an increasing trend year by year.Due to its long incubation period and heterogeneity of early symptoms,early identification and diagnosis of the disease is difficult,increasing the risk of transmission within medical institutions.Currently,there is a lack of con-sensus on the infection prevention and control of CJD.In order to timely identify and diagnose CJD as well as effec-tively block its transmission in medical institutions,this consensus summarizes 15 clinical concerns and formulates 24 specific recommendations based on the latest domestic and international research findings and clinical evidence,as well as combines with clinical practice,aiming to standardize healthcare-associated infection prevention and control measures for CJD and reduce its transmission risk in medical institutions.

Objective To understand the implementation of WS/T 508-2016 and the status of washing and disin-fection of medical textiles in China,and provide basis for the revision of the standard.Methods A questionnaire survey was conducted on the management of medical institutions and washing and disinfection workplace,building layout,personnel protection,equipment and supplies,washing and disinfection principles,and hygiene quality mo-nitoring of medical textiles in 323 medical institutions and 31 washing institutions in China.Meanwhile,microbio-logical index sampling was conducted on 234 pieces of medical textiles in 9 medical institutions and 8 washing insti-tutions in Hubei,Shanxi,Shanghai,and Sichuan Provinces before and after washing and disinfection.Results The awareness rates of WS/T 508-2016 among medical institutions and washing institutions were 96.90％and 96.77％,respectively,and the implementation rates were 94.12％and 96.77％,respectively.47.99％medical in-stitutions use purchasing services for washing and disinfecting medical textiles,and the higher the level of the medi-cal institution was,the higher the proportion of purchasing services was(x2=15.312,P＜0.001).85.16％medi-cal institutions have conducted risk assessments on service providers,and 52.99％were responsible for or participa-ted in pre-job training by the medical institution.Washing institutions were higher than medical institutions in terms of system soundness rate,pre-job training rate,proportion of quality management leaders and full-time(part-time)quality inspectors,setting rate of hand-washing facilities in zones,passages,isolation barriers,dressing(buffer)room,and toilets,configuration rate of hygiene isolation washing equipment,tunnel washing unit,washing equip-ment with heating functions,drying equipment and mechanical ventilation facilities,and specialty machine washing rate.Among 234 medical textiles specimens,11.97％were detected fungi,and the total fungal colonies in 5 clean textiles exceeded 100 CFU/100 cm2.Conclusion WS/T 508-2016 can further standardize the washing and disin-fection of medical textiles in China through strengthening institutional management,improving the supervision level of service providers,perfecting hardware facilities and layout,introducing new technologies,and increasing the mo-nitoring on fungi in clean textiles.

Objective:To explore the influence of cardiac rehabilitation therapy on the postoperative quality of life, cardiac function and prognosis of patients undergoing transcatheter aortic value replacement (TAVR).Methods:A total of 182 patients with aortic valve stenosis who underwent TAVR in the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2021 to May 2023 were selected as the research subjects. The patients were divided into the observation group and the control group by the random number table method, with 91 cases in each group. The control group was given conventional drug treatment after the operation, while the observation group was given conventional drug treatment + cardiac rehabilitation treatment after the operation. The baseline clinical data, quality of life before and after intervention (Minnesota Quality of Life Scale score), cardiac function [6-minute walking distance (6MWT), B-type brain natriuretic peptide (BNP)] of the two groups of patients were compared. The left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and the incidence of adverse events one year after TAVR were evaluated using the Cox regression model to assess the effect of cardiac rehabilitation therapy on the occurrence of adverse events one year after TAVR. Kaplan-Meier survival analysis was used to compare the cumulative rate of no adverse events one year after TAVR in the two groups of patients.Results:After the intervention in both groups, the Minnesota Quality of Life Scale score, 6MWT, BNP, and LVEF were significantly improved compared with those before the intervention (all P<0.05), and the Minnesota Quality of Life Scale score, 6MWT, BNP, and LVEF in the observation group after the intervention were better than those in the control group (all P<0.05). The incidences of stroke and heart failure in the observation group one year after TAVR were significantly lower than those in the control group (all P<0.05). Cox regression analysis showed that cardiac rehabilitation significantly reduced the risk of adverse events one year after TAVR in patients ( HR: 0.72; 95% CI: 0.46-0.97; P=0.035). Kaplan-Meier survival analysis showed that the cumulative rate of no adverse events at 3, 6, and 12 months after TAVR in the observation group was significantly higher than that in the control group (94.3%, 89.5%, 76.8% vs 83.4%, 74.6%, 57.8%, all P<0.05). Conclusions:Cardiac rehabilitation therapy can significantly improve the postoperative quality of life and cardiac function of patients with TAVR, bringing obvious survival benefits to such patients.

Objective:To analyze the distribution and epidemiological characteristics of common non-bacterial pathogens in hospitalized children with acute respiratory tract infections(ARTI)from a multi-center study covering 4 regions in Fujian Province in 2023.Methods:A retrospective cohort study was conducted using medical record analysis.A total of 22 769 hospitalized children with ARTI were enrolled from January to December 2023 across seven regional pediatric medical centers in Fujian Province (covering four major geographical divisions of Fuzhou, Nanping, Sanming and Longyan; all selected hospitals were regional children′s medical centers).Using single-tube multiplex PCR with fragment analysis on a Sanger sequencing platform, the nucleic acids of 11 common non-bacterial respiratory pathogens were tested in nasopharyngeal swabs collected from 22 769 children. These pathogens included influenza A virus(FluA), influenza B virus(FluB), parainfluenza virus(PIV), respiratory syncytial virus (RSV), adenovirus (ADV), human rhinovirus (HRV), human bocavirus (HBoV), human coronavirus (HCoV), human metapneumovirus(HMPV), Mycoplasma pneumoniae(MP), and Chlamydia (Ch). Count data were described as [ n(%)], and the chi-square test/Fisher′s exact test was used to compare the differences in rates between groups. Epidemiological features, including positive detection rates, pathogen profiles, and correlations with region, sex, age and month, were analyzed. Results:Among 22 769 children with ARTI, pathogens were detected in 16 213 cases (71.21%), including 13 340 single infections (58.59%).The detection rates of single pathogens in descending order were human rhinovirus (HRV, 12.95%), Mycoplasma pneumoniae(MP, 12.27%), respiratory syncytial virus(RSV, 11.12%), influenza A virus (Flu-A, 7.98%), parainfluenza virus(PIV, 4.66%), human metapneumovirus(HMPV, 4.60%), adenovirus(ADV, 2.70%), human bocavirus(HBoV, 0.84%), human coronavirus(HCoV, 0.82%), influenza B virus(Flu-B, 0.47%) and Chlamydia(Ch, 0.18%).Mixed infections occurred in 2 873 cases(12.62%), primarily dual infections(2 679 cases).Regional analysis revealed significant disparities:Luoyuan County Hospital (Fuzhou) exhibited the highest total detection rate(86.59%, 1 414/1 633)and mixed infection rate(23.27%, 380/1 633)(both P<0.001), with notably elevated MP (26.39%, 431/1 633);Jian′ou City Hospital(Nanping) ranked second for Flu-A(14.21%, 409/2 879), RSV(13.20%, 380/2 879) and mixed infections(17.12%, 493/2 879);Lianjiang County Hospital(Fuzhou) showed distinct prevalence of Flu-A(10.68%, 130/1 217), PIV(6.00%, 73/1 217), and HBoV(1.73%, 21/1 217); Yong′an City Hospital (Sanming) reported high MP (26.07%, 238/913) and RSV(12.38%, 113/913);Shaowu City Hospital(Nanping) was dominated by MP (18.60%, 407/2 188) and HRV(13.39%, 293/2 188); Tingzhou Hospital(Longyan) had the highest HRV (17.88%, 407/2 276) and Flu-B (0.75%, 17/2 276); and Fuzhou Children′s Hospital showed elevated ADV(3.38%, 394/11 663) and HCoV(1.08%, 126/11 663). Except for Flu-B(0.47%, 108/22 769; P=0.054) and Ch(0.18%, 40/22769; P=0.900), all pathogens and mixed infections exhibited significant regional variations ( P<0.05).Gender analysis indicated higher detection rates of HRV, RSV, Flu-A, ADV, PIV, HBoV and mixed infections in males, while MP, HMPV, Flu-B, HCoV, and Ch were more prevalent in females, with statistically significant differences for HRV and MP (both P<0.001). Age stratification showed the highest overall detection rate in the 3-<6 years group (75.48%; P<0.001): RSV and Ch peaked in infants (<1 year), HRV, PIV, ADV and HBoV in toddlers (1-<3 years), HMPV, HCoV, and mixed infections in preschool children (3-<6 years), and MP, Flu-A and Flu-B in older children (6-<18 years).Analyzing the prevalent months, the monthly prevalence trends of pathogens in various regions are similar.Seasonal trends demonstrated year-round HRV activity (peaking in spring/autumn), MP prevalence in autumn/winter, RSV surges in spring-summer (April-June) and late summer-autumn (August-October), and Flu-A predominanced in winter-spring. Conclusion:Multiplex PCR with fragment analysis demonstrated high diagnostic efficacy. The top 4 non-bacterial pathogens in Fujian Province′s ARTI-hospitalized children in 2023 were HRV, MP, RSV and Flu-A. Pathogen distribution exhibited significant regional, age and seasonal variations, emphasizing the need for targeted prevention strategies.

Objective:To investigate the application of Galectin-9 and Pentraxin3 in cardiotoxicity assessment during anthracycline chemotherapy in breast cancer patients.Methods:A total of 143 breast cancer patients who received anthracycline chemotherapy in Department of Breast, Shanxi Provincial People’s Hospital from Oct. 2021 to Oct. 2023 were separated into cardiotoxic group ( n=47) and non-cardiotoxic group ( n=96) according to whether cardiotoxicity occurred. Clinical data of patients were collected and the risk factors of cardiotoxicity were analyzed by univariate and multivariate Logistic regression. The predictive efficacy of serum Galectin-9 and Pentraxin3 levels on cardiotoxicity was evaluated by receiver operating characteristic curve (ROC) . Results:There was no statistically significant difference in age, body mass index, total cholesterol, triglycerides, low density lipoprotein, high density lipoprotein, smoking history, drinking history, underlying disease (hypertension, diabetes, hyperlipidemia) , tumor stage, pathological type, tumor size, anthracycline type, or dose between the two groups ( t=1.07, 1.22, 0.96, 0.43, 1.07, 0.50; χ 2=0.12, 1.20, 0.14, 0.01, 0.47, 0.14, 3.32, 3.83, 1.91, 3.18, P > 0.05) ; The levels of troponin and B-type brain natriuretic peptide in cardiotoxicity group were higher than those in non-cardiotoxicity group ( t=13.48, 10.28, P < 0.05) , and serum Galectin-9 and Pentraxin3 levels were also higher ( t=22.53, 17.92, P < 0.05) . Multivariate Logistic regression analysis showed that high levels of troponin, B-type brain natriuretic peptide, Galectin-9 and Pentraxin3 were all influential factors in the occurrence of cardiotoxicity ( OR=2.221, 2.050, 1.925, 1.976, P < 0.05) . ROC curve analysis showed that the area under curve of serum Galectin-9 for predicting cardiotoxicity was 0.722, the predictive sensitivity was 68.09%, and the specificity was 77.08%; The area under the curve of miR-135 for predicting cardiotoxicity was 0.636, the predictive sensitivity was 44.68%, and the specificity was 82.29%. Conclusion:Serum Galectin-9 and Pentraxin3 have high expression levels in breast cancer patients treated with anthracyclines, which are influential factors for the occurrence of cardiotoxicity after chemotherapy, and have high predictive value for the occurrence of cardiotoxicity in patients.

Schizophrenia is a common, severe, and complex psychiatric disorder worldwide. Genetic factors account for around 80% of the etiology of schizophrenia, yet objective diagnostic biomarkers remain lacking. This article reports two cases of female monozygotic twins diagnosed with schizophrenia, exhibiting a balanced translocation between 22q11.2 and 4p15.3. Reviewing the literature, we analyze and discuss the correlation between chromosomal balanced translocation regions and the pathogenesis of mental disorders. This aims to encourage psychiatrists to consider new perspectives on the diagnosis of schizophrenia.

B and T lymphocyte attenuator (BTLA) is an inhibitory immune checkpoint, which typically interacts with herpesvirus entry mediator (HVEM) and plays a crucial role in regulating immune balance. BTLA interacts with its ligand HVEM in a cis manner on the surface of the same immune cell to maintain immune tolerance, while trans interactions on the surface of different immune cells mediate immunosuppressive effects. Dysregulation of the BTLA/HVEM axis can impair the functions of immune cells, particularly T lymphocytes, promoting immune escape of tumor cells and ultimately leading to tumor progression. Researchers have found that BTLA and HVEM are abnormally expressed in various tumors and are associated with prognosis, suggesting that they may be potential targets for tumor immunotherapy. This review summarizes the molecular structures of BTLA and HVEM, immunomodulatory mechanisms, recent advances in hematologic malignancies, potential inhibitors of BTLA/HVEM interaction, and their applications in immunotherapy for hematologic malignancies.
Humans ; Receptors, Tumor Necrosis Factor, Member 14/chemistry* ; Receptors, Immunologic/immunology* ; Hematologic Neoplasms/genetics* ; Immunotherapy/methods* ; Animals