This study was aimed at identifying the pathogenic bacteria responsible for the death of a young tiger at the Fujian Meihua Mountain South China Tiger Breeding Research Institute.Tissue samples from the lungs,liver,and intestines of the deceased tiger were collected,and the bacteria were cultured inasterile environment.The bacterial strains were characterized according to their morphological and molecular biological properties,including assessment of virulence genes and antibiotic resistance genes,mouse lethality tests,and antibiotic susceptibility evaluations.A predominant bacterial strain isolated from the liver of the deceased tiger was identified as enterotoxigenic Escherichia coli(ETEC)strain Tiger22513F.Phylogenetic analysis of the 16S rRNA gene revealed that the Tiger22513F strain exhibited close genetic similarity to the reference strain ETEC(MF919609.1),with 99.9%nucleotide similarity,and resided on the same evolutionary branch.The Tiger22513F strain contained 11 antibiotic resistance genes(tetA,sul1,sul3,cmlA,floR,blaTEM,blaSHV,blaCMY-2,qnrA,qnrS,and qnrD)along with five virulence genes(VT1,fyuA,tsh,iucD,and ST).Mouse lethality tests indicated significant pathogenicity toward mice,affecting primarily the lungs,liver,and intestines.Antibiotic susceptibility testing demonstrated that this strain exhibited resistance to various classes of beta-lactam antibiotics,as well as quinolones and aminoglycosides.This investigation successfully isolated a multi-drug resistant enterotoxigenic Escherichia coli strain with pronounced pathogenicity from the liver of a deceased tiger;thus providing valuable scientific insights for clinical diagnosis,as well as prevention and control measures,against ETEC infections in South China tigers.

At present,the laboratory medicine industry in China has developed rapidly,with various new technologies and methods emerge one after another. However,the current training process of laboratory medicine technology professionals still follows a training model that emphasizes theyory over practice,and the quality of training personnel is far from the requirments of the current development of the laboratory medicine industry in China. In order to effectively alleviate the current situation of the shortage of practical high-quality laboratory medicine talents,it is urgent to reform the teaching of laboratory medicine. The author of this paper puts forward the "Four-in-one" personnel training mode which is suitable for the development of laboratory medicine in China. It is proposed to explore a new teaching mode on the basis of the existing one,giving full play to the students' initiative and innovation,and providing new ideas for training high-quality laboratory medicine professionals.

Objective To study the clinical characteristics,imaging findings,pathological features,treatment methods,and prognosis of nasopharyngeal carcinoma in children.Methods The clinical data of 6 children(<18 years)with nasopharyngeal carcinoma admitted to the Department of Pediatrics,Beijing Tongren Hospital from March 2021 to February 2025 were retrospectively reviewed,and outcomes were followed up.Results All 6 patients were male.Age at onset ranged from 11 to 15 years,with a median of 12.5 years.The interval from onset to diagnosis was 1-6 months.The main clinical symptoms were cervical mass(4 cases,67%)and headache(3 cases,50%);some patients also had nasal congestion and rhinorrhea,epistaxis,or limited mouth opening.TNM staging was stage III in 4 cases and stage IVa in 2 cases.All patients had non-keratinizing undifferentiated nasopharyngeal carcinoma on pathology.Treatments included radiotherapy,chemotherapy,surgery,targeted therapy,and immunotherapy.By July 1,2025,after comprehensive treatment,5 patients(83%)achieved complete remission,and 1 patient(17%)experienced recurrence and progression and died.Conclusions Comprehensive treatment based on combined radiotherapy and chemotherapy is the mainstay for childhood nasopharyngeal carcinoma,overall prognosis is favorable,and long-term follow-up is required.Molecular targeted therapy and immunotherapy are expected to improve the prognosis of advanced nasopharyngeal carcinoma and require further research for validation.

Chemotherapy-induced peripheral neuropathy(CIPN)refers to some symptoms and signs of peripheral nerve dysfunc-tion caused by using anti-tumor drugs,which is related to the dose of chemotherapy drugs.The pathogenesis of CIPN has not been fully defined,and the efficacy of existing therapeutic drugs and methods is limited.Therefore,it is of great scientific value and social significance to explore the pathogenesis of CIPN,de-velop new therapeutic drugs and methods,and solve the unmet clinical needs.This paper will elaborate on the pathogenesis of CIPN from the molecular and cellular levels,and review the treatment progress of CIPN,so as to provide reference for clinical treatment and direction for future research.

Objective To investigate the effectiveness of new-generation snapshot freeze(NG SSF)technology for improving image quality of coronary CT angiography(CCTA)in patients with different heart rate(HR).Methods CCTA data of 164 patients obtained with a 256-row CT scanner and voltages of 80,100 and 120 kV,respectively,in one cardiac cycle were retrospectively analyzed.Smart electrocardiogram(ECG)gating technology was used to calculate patient's HR and choose automatic exposure phase.For these with HR≤65 beats/min(low HR group),the exposure time window was set between 70%—80%R-R interval,for 65 beats/min＜HR≤85 beats/min(medium HR group)was set between 40%—80%R-R interval,while for those HR＞85 beats/min(high HR group)was set between 40%—60%R-R interval.Standard reconstruction(STD),the first-generation snapshot freeze(SSF1)and NG SSF were performed to reconstruct CCTA images,respectively.Subjective scoring of each segment of right coronary artery(RCA),left anterior descending(LAD)and left circumflex artery(LCX)shown on CCTA were performed based on Likert scale.Results In low HR group,the scores of middle and distal segments of LAD and all segments of RCA and LCX on NG SSF CCTA were significantly higher than on STD,and of middle segment of RCA and distal segment of LAD were both higher than on SSF1(all P＜0.05).In medium HR group,the scores of all branches on NG SSF CCTA were significantly higher than on STD or SSF1 CCTA(all P＜0.05).In high HR group,the scores of coronary branches showed on NG SSF CCTA were all significantly higher than on STD CCTA,while of the proximal and distal segments of RCA,middle and distal segments of LAD and all segments of LCX were significantly higher than on SSF1 CCTA(all P＜0.05).Conclusion NG SSF could effectively enhance image quality of prospective ECG-gated CCTA in patients with varying HR.

Objective:To investigate the clinical value of laparoscopic evaluation of anato-mical position of inferior mesenteric artery (IMA), inferior mesenteric vein (IMV) and left colic artery (LCA).Methods:The prospective one-arm study was conducted. The clinical data of 229 pati-ents who underwent laparoscopic left hemicolectomy for left colon or laparoscopic radical resection of rectal cancer in The Second Affiliated Hospital of Air Force Medical University from December 2022 to December 2023 were selected. The distance between the origin point of IMA and the origin point of the first branch (L1) as well as the distance from the origin point of LCA root to the junction of LCA and IMV (L2) were measured during the operation. IMA classification, the location relation-ship of LCA and IMV junction were recorded. Observation indicators: (1) situations of enrolled patients; (2) difference analysis between L1, L2 and clinical features; (3) distribution characteristics of the location relationship between LCA and IMV in different types of IMA. Mann-Whitney U test was used for comparison of measurement data with skewed distribution between groups, Kruskal-Wallis H test was used for comparison between multiple groups, and Dunn-Bonferroni test was used for pairwise comparison. Comparison of count data between groups was performed by chi-square test. Pearson or Spearman correlation analysis was conducted for correlation of continuous variables. Results:(1) Situations of enrolled patients. A total of 229 eligible patients were screened out, including 146 males and 83 females, aged 64(range, 55-71)years. The height of 229 patients was 168(range, 160-172)cm, the weight was 65.0(55.5,71.5)kg, the body surface area was (1.68±0.17)m 2, the tumor maximum diameter was 3.0(2.5,4.0)cm. The total number of lymph nodes dissected was 19(17,21), and the number of No.253 lymph node dissected was 4(3,5). The L1 was 3.50(1.20,8.00)cm, and the L2 was 2.20(0.50,7.30)cm. There were 58, 31, 32, 71, 22, 90, 26 and 212 patients with smoking, alcohol drinking, diabetes, hypertension, coronary heart disease, neoadjuvant chemo-therapy, neoadjuvant radiotherapy and preservation of the LCA, respectively. Among 229 patients, cases with BMI <18.5 kg/m 2, 18.5-23.9 kg/m 2 and >23.9 kg/m 2 were 11, 133 and 85, respectively. There were 153 cases in pathological stage Ⅰ-Ⅱ and 76 cases in stage Ⅲ. There were 168 cases of Dixon operation, 6 cases of Miles operation and 55 cases of sigmoid colon resection. There were 135 cases of IMA type 1, 44 cases of IMA type 2, 23 cases of IMA type 3, 2 cases of IMA type 4, and 25 cases of IMA type unable to judge. (2) Difference analysis between L1, L2 and clinical features.Correlation analysis showed negative correlation between the height, body surface area and L1 ( r=-0.17, -0.15, P<0.05). The L1 was 3.20(2.68,4.00)cm for male patients and 3.60(3.00,4.20)cm for female patients, respectively, showing a significant difference between the two groups ( Z=-2.37, P<0.05). The L1 of patients with IMA type 1, 2, and 3 was 3.20(2.80,4.00)cm, 3.85(3.00,4.48)cm, and 3.20(2.50,4.30)cm, respectively, showing a significant difference among them ( H=7.54, P<0.05). Further pairwise com-parison showed that there was a significant difference in L1 between patients with IMA type 2 and those with IMA type 1 ( P<0.05). The L2 of smokers and non-smokers were 2.50(1.95,3.20)cm and 2.20(1.60,2.80)cm, respectively, showing a significant difference between the two groups ( Z=-2.24, P<0.05). (3)Distribution characteristics of the location relationship between LCA and IMV in different types of IMA. There was no significant difference in LCA distribution between the anterior and posterior positions of IMV among the three IMA types (type 1, 2, 3) ( χ2=1.63, P>0.05). Conclusions:Patients with greater height have larger body surface area and shorter L1. L1 is significantly longer in female patients than in male patients. L1 is significantly longer in patients with IMA type 2 than in those with type 1. L2 is significantly longer in smokers than in non-smokers. There was no significant difference in the distribution location between LCA and IMV among patients of IMA type 1, 2 and 3.

Objective:To compare the outcomes between the arthroscopic en masse repair and the modified separate repair for type Ⅰ delaminated rotator cuff tears.Methods:This retrospective study analyzed the clinical data of 46 patients who had been treated for delaminated rotator cuff tears at Department of Sports Medicine, The Second People's Hospital of Fujian Province from January 2021 to January 2023. This cohort consisted of 15 males and 31 females, with an age of (58.2±9.0) years. Their delaminated rotator cuff tears were all classified as typeⅠ according to Choo et al. According to different surgical methods, they were divided into 2 groups: group A (22 cases) was treated by arthroscopic en masse repair while group B (24 cases) by arthroscopic modified separate repair. The 2 groups were compared in terms of forward flexion, external rotation, internal rotation, visual analogue scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, and Constant-Murley score at preoperation and the last follow-up. MRI was used to evaluate the healing status of rotator cuff at the last follow-up.Results:There was no significant difference in the baseline data between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for 26.0 (24.0, 28.0) months. At the last follow-up, the external rotation (57.3°±15.7°), ASES score [(97.5±3.6) points] and Constant-Murley score [(93.7±3.0) points] in group B were significantly better than those in group A [40.9°±17.7°, (85.5±18.3) points, and (78.6±22.7) points] ( P<0.05), but the differences in forward flexion, internal rotation or VAS pain score were not significantly different between the 2 groups ( P>0.05). In both groups A and B, significant improvements were achieved at the last follow-up in forward flexion, external rotation, internal rotation, VAS pain score, ASES score, and Constant-Murley score compared with the preoperative period ( P<0.05). At the last follow-up, in group A and group B respectively, the rotator cuff was completely healed in 9 and 18 cases, partially healed in 10 and 6 cases, and re-torn in 3 and 0 cases, showing significant differences in the healing status between the 2 groups ( P<0.05). Conclusion:In the treatment of type Ⅰ delaminated rotator cuff tears, the modified separate repair can obtain significantly better external rotation, ASES score, Constant-Murley score, and healing status of rotator cuff than the arthroscopic en masse repair.

Objective To find and select stable and specific identification indexes in chest CT images,to establish mathematical models and provide a systematic and scientific identification method.Methods Medical imaging analysis and processing technology were applied to compare the image indexes such as lung apical shadow,double lung texture,trachea,sternum,thoracic morphology,liver,spleen,interlobular fissure morphology,first rib,aorta and thoracic vertebrae morphology of 600 serial chest CT scans of of the same adults at different periods and 600 scans of different adults.Consistency test(Kappa analysis)was applied to determine the consistency of different identification indexes,and to screen out the image identification indexes that were not easily affected by subjective factors and had high consistency;the cumulative exclusion probability method was applied to calculate the combined identification ability of the observation indexes,and select optimal indexes to establish the identification index system.Results Five indexes-left lung texture,right lung texture,interlobular fissure of the liver,first rib on the left side,and first rib on the right side demonstrated high consistency across age groups and minimal subjective interference.A combination of any three indexes achieved＞99.99％discrimination probability for homologous versus non-homologous sources identification.Conclusion The independent or combined use of the indexes of left lung texture,right lung texture,interlobular fissure of the liver,first rib on the left side,and first rib on the right side enables individual identification in adult chest CT under different imaging conditions.

Chaihu and Longgu Muli Decoction has demonstrated significant efficacy in the treatment of tachyarrhythmia accompanied by anxiety and depression. However, there is a lack of standardized guidelines for its clinical application. In this study, the Chaihu and Longgu Muli Decoction was investigated through extensive research on ancient and modern literature, as well as a collection of clinical medical records. The basic information, medication details, and diagnostic information from medical records, personal experience literature, and clinical cases in the treatment of tachyarrhythmia accompanied by anxiety were extracted and analyzed to preliminarily identify the prescription characteristics and syndrome patterns. Subsequently, the Delphi method was employed to construct an item pool based on the data obtained in the first step. An expert questionnaire was prepared to collect scores and revision opinions from experts regarding these items. After statistical analysis and group discussions, a second round of questionnaires was formed by screening out certain items. This process was repeated until a final item set for the treatment of tachyarrhythmia accompanied by anxiety with Chaihu and Longgu Muli Decoction was determined. These findings provided guidance for clinical prescription practices. By extracting 71 syndromes and signs, as well as 33 tongue and pulse characteristics, the main syndrome features included palpitations, chest tightness, irritability, etc., which were basically consistent with the ancient syndromes. Through frequency analysis and group discussions, 71 items were screened out. After screening, modification, and primary and secondary division, 11 main diagnostic items and 10 secondary diagnostic items were determined. On this basis, the research team believes that Chaihu and Longgu Muli Decoction is mainly indicated for the following syndromes in the treatment of tachyarrhythmia accompanied by anxiety(palpitations, poor sleep, bitter taste, dry mouth, irritability/easily angered/anxiety/fearfulness/easily startled, red tongue with greasy yellow coating, rapid pulse, high work/life pressure, tachyarrhythmia on electrocardiogram/Holter monitor, and positive results on anxiety scale). Secondary syndromes include chest tightness, shortness of breath, feeling heavy and weak in the body, sweating, poor appetite, constipation, greasy white tongue coating, wiry pulse, slippery pulse, or knotted and intermittent pulse.
Drugs, Chinese Herbal/therapeutic use* ; Humans ; Delphi Technique ; Anxiety/complications* ; Tachycardia/psychology* ; Female ; Male ; Middle Aged ; Adult ; Aged

This study aims to explore the protective effect of Chaihu Jia Longgu Muli Decoction on rats with heart failure after myocardial infarction, and to clarify its possible mechanisms, providing a new basis for basic research on the mechanism of classic Chinese medicinal formula-mediated inflammatory response in preventing and treating heart failure induced by apoptosis after myocardial infarction. A heart failure model after myocardial infarction was established in rats by coronary artery ligation. The rats were divided into sham group, model group, and low, medium, and high-dose groups of Chaihu Jia Longgu Muli Decoction, with 10 rats in each group. The low-dose, medium-dose, and high-dose groups of Chaihu Jia Longgu Muli Decoction were given 6.3, 12.6, and 25.2 g·kg~(-1) doses by gavage, respectively. The sham group and model group were given an equal volume of distilled water by gavage once daily for four consecutive weeks. Cardiac function was assessed using color Doppler echocardiography. Myocardial pathology was detected by hematoxylin-eosin(HE) staining, apoptosis was measured by TUNEL assay, and mitophagy was observed by transmission electron microscopy. The levels of tumor necrosis factor-α(TNF-α), interleukin(IL)-1β, and N-terminal pro-B-type natriuretic peptide(NT-proBNP) in serum were detected by enzyme-linked immunosorbent assay(ELISA). The expression of apoptosis-related proteins B-cell lymphoma 2(Bcl-2), Bcl-2-associated X protein(Bax), and cleaved caspase-3 was detected by Western blot. Additionally, the expression of phosphorylated nuclear transcription factor-κB(NF-κB) p65(p-NF-κB p65)(upstream) and nuclear factor kappa B inhibitor alpha(IκBα)(downstream) in the NF-κB signaling pathway was assessed by Western blot. The results showed that compared with the sham group, left ventricular ejection fraction(LVEF) and left ventricular short axis shortening(LVFS) in the model group were significantly reduced, while left ventricular end diastolic diameter(LVEDD) and left ventricular end systolic diameter(LVESD) increased significantly. Myocardial tissue damage was severe, with widened intercellular spaces and disorganized cell arrangement. The apoptosis rate was increased, and mitochondria were enlarged with increased vacuoles. Levels of TNF-α, IL-1β, and NT-proBNP were elevated, indicating an obvious inflammatory response. The expression of pro-apoptotic factors Bax and cleaved caspase-3 increased, while the anti-apoptotic factor Bcl-2 decreased. The expression of p-NF-κB p65 was upregulated, and the expression of IκBα was downregulated. In contrast, the Chaihu Jia Longgu Muli Decoction groups showed significantly improved of LVEF, LVFS and decreased LVEDD, LVESD compared to the model group. Myocardial tissue damage was alleviated, and intercellular spaces were reduced. The apoptosis rate decreased, mitochondrial volume decreased, and the levels of TNF-α, IL-1β, and NT-proBNP were lower. The expression of pro-apoptotic factors Bax and cleaved caspase-3 decreased, while the expression of the anti-apoptotic factor Bcl-2 increased. Additionally, the expression of p-NF-κB p65 decreased, while IκBα expression increased. In summary, this experimental study shows that Chaihu Jia Longgu Muli Decoction can reduce the inflammatory response and apoptosis rate in rats with heart failure after myocardial infarction, which may be related to the regulation of the IκBα/NF-κB signaling pathway.
Animals ; Apoptosis/drug effects* ; Drugs, Chinese Herbal/administration & dosage* ; Rats ; Myocardial Infarction/physiopathology* ; Male ; NF-kappa B/genetics* ; Heart Failure/etiology* ; Rats, Sprague-Dawley ; Signal Transduction/drug effects* ; NF-KappaB Inhibitor alpha/genetics* ; Humans ; Tumor Necrosis Factor-alpha/genetics*