Objective To investigate changes of serum peroxiredoxin 4 level in patients with gestational diabetes mellitus(GDM)at the early stage and its diagnostic value for GDM.Methods A total of 372 early pregnant women who visited our hospital from March 2021 to May 2024 were selected as the study subjects.The diagnosis of GDM was determined based on the results of the oral glucose tolerance test(OGTT).Pregnant women were divided into the GDM group(n=89)and the control group(n=283).Clinical data,laboratory indicators and levels of peroxiredoxin 4 were compared between two groups of patients.The correlation between serum peroxiredoxin 4 levels and laboratory indicators was analyzed.Risk factors for the occurrence of GDM and its diagnostic efficacy for GDM were also analyzed.Results The proportion of family history of diabetes,insulin resistance index(HOMA-IR),fasting plasma glucose(FPG),postprandial 1 h glucose(1 hPG),postprandial 2 h glucose(2 hPG),C-peptide and serum peroxidase reductase 4 were higher in the GDM group than those in the control group(P＜0.05),while the pancreatic β-cell function index(HOMA-β)was lower in the GDM group than those in the control group(P＜0.05).The level of serum peroxidase reductase 4 was positively correlated with HOMA-IR,FPG,1 hPG,2 hPG and C-peptide in the GDM group,and which was negatively correlated with HOMA-β(P＜0.05).Multifactorial Logistic regression analysis showed that elevated HOMA-IR,FPG,1 hPG,2 hPG,C-peptide and peroxidase reductase 4 were risk factors for the occurrence of GDM,while elevated HOMA-β was the protective factor for the occurrence of GDM(P＜0.05).The area under the curve(AUC)for peroxidase reductase 4 in diagnosing GDM was 0.912(95%CI:0.871-0.953),with a sensitivity of 79.79%and specificity of 89.36%when the optimal cutoff value was 0.93 U/L.Conclusion The serum level of peroxiredoxin 4 in GDM patients is significantly elevated,showing good diagnostic efficacy for GDM.

Objective:To observe any therapeutic effect of kinesio taping the orbicularis oris and cervical swallowing muscle groups on drooling among children with cerebral palsy (CP).Methods:Fifty-two children with CP salivating excessively were divided at random into a control group and an experimental group, each of 26. Both groups received routine oral and facial exercise training and sensory stimulation, but the experimental group was additionally provided with kinesio taping of the orbicularis oris muscle and related neck muscle groups. The taping was applied twice a week for 12 hours each time, continuing for 6 months. Before and after the treatment, both groups′ drooling and language use were evaluated using the teacher drooling grading method (TDS) and a language developmental delay assessment (S-S), respectively. Kendall rank correlation coefficients were computed to compare the treatment efficacy for children with the same TDS grading, cerebral palsy classification, and S-S segmentation.Results:After the treatment the average TDS scores of both groups had decreased significantly. The average TDS score of the experimental group was then significantly lower than that of the control group. The total effectiveness rate for those in the experimental group with TDS grades II or V was significantly higher than those controls with the same TDS grades, the effectiveness rate for those with spastic and mixed type or language function in stage 4-2 and stage 5-2 in the experiment group was also significantly higher than for those of the control group. According to the correlation analysis, the language function of both groups was significantly correlated with the therapeutic effect.Conclusions:Supplementing routine rehabilitation training with kinesio taping of the orbicularis oris muscle and the cervical swallowing muscle group can significantly relieve CP children′s excessive salivation. Their language use is significantly positively correlated with the effectiveness of such combined treatment.

Objective:To observe any therapeutic effect of kinesio taping the orbicularis oris and cervical swallowing muscle groups on drooling among children with cerebral palsy (CP).Methods:Fifty-two children with CP salivating excessively were divided at random into a control group and an experimental group, each of 26. Both groups received routine oral and facial exercise training and sensory stimulation, but the experimental group was additionally provided with kinesio taping of the orbicularis oris muscle and related neck muscle groups. The taping was applied twice a week for 12 hours each time, continuing for 6 months. Before and after the treatment, both groups′ drooling and language use were evaluated using the teacher drooling grading method (TDS) and a language developmental delay assessment (S-S), respectively. Kendall rank correlation coefficients were computed to compare the treatment efficacy for children with the same TDS grading, cerebral palsy classification, and S-S segmentation.Results:After the treatment the average TDS scores of both groups had decreased significantly. The average TDS score of the experimental group was then significantly lower than that of the control group. The total effectiveness rate for those in the experimental group with TDS grades II or V was significantly higher than those controls with the same TDS grades, the effectiveness rate for those with spastic and mixed type or language function in stage 4-2 and stage 5-2 in the experiment group was also significantly higher than for those of the control group. According to the correlation analysis, the language function of both groups was significantly correlated with the therapeutic effect.Conclusions:Supplementing routine rehabilitation training with kinesio taping of the orbicularis oris muscle and the cervical swallowing muscle group can significantly relieve CP children′s excessive salivation. Their language use is significantly positively correlated with the effectiveness of such combined treatment.

Objective To investigate changes of serum peroxiredoxin 4 level in patients with gestational diabetes mellitus(GDM)at the early stage and its diagnostic value for GDM.Methods A total of 372 early pregnant women who visited our hospital from March 2021 to May 2024 were selected as the study subjects.The diagnosis of GDM was determined based on the results of the oral glucose tolerance test(OGTT).Pregnant women were divided into the GDM group(n=89)and the control group(n=283).Clinical data,laboratory indicators and levels of peroxiredoxin 4 were compared between two groups of patients.The correlation between serum peroxiredoxin 4 levels and laboratory indicators was analyzed.Risk factors for the occurrence of GDM and its diagnostic efficacy for GDM were also analyzed.Results The proportion of family history of diabetes,insulin resistance index(HOMA-IR),fasting plasma glucose(FPG),postprandial 1 h glucose(1 hPG),postprandial 2 h glucose(2 hPG),C-peptide and serum peroxidase reductase 4 were higher in the GDM group than those in the control group(P＜0.05),while the pancreatic β-cell function index(HOMA-β)was lower in the GDM group than those in the control group(P＜0.05).The level of serum peroxidase reductase 4 was positively correlated with HOMA-IR,FPG,1 hPG,2 hPG and C-peptide in the GDM group,and which was negatively correlated with HOMA-β(P＜0.05).Multifactorial Logistic regression analysis showed that elevated HOMA-IR,FPG,1 hPG,2 hPG,C-peptide and peroxidase reductase 4 were risk factors for the occurrence of GDM,while elevated HOMA-β was the protective factor for the occurrence of GDM(P＜0.05).The area under the curve(AUC)for peroxidase reductase 4 in diagnosing GDM was 0.912(95%CI:0.871-0.953),with a sensitivity of 79.79%and specificity of 89.36%when the optimal cutoff value was 0.93 U/L.Conclusion The serum level of peroxiredoxin 4 in GDM patients is significantly elevated,showing good diagnostic efficacy for GDM.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Functional gastrointestinal disorders(FGIDs)are common digestive system diseases in children,which can severely affect the growth and development of infants and toddlers.Probiotics therapy,as a relatively safe treatment method,have attracted the attention of researchers.However,their effectiveness in treating FGIDs in infants and toddlers is still unclear.This article reviews the mechanisms of probiotics in treating FGIDs in infants and toddlers,explores the reasons for the inconsistency in various research results,and aims to provide assistance for the clinical treatment of FGIDs in infants and toddlers and future research.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective: We aimed to investigate whether 2-[ 18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (2-[ 18F]FDG PET/CT) can aid in evaluating the risk of malignancy in ampullary tumors detected by endoscopy. Materials and Methods: This single-center retrospective cohort study analyzed 155 patients (79 male, 76 female; mean age, 65.7 ± 12.7 years) receiving 2-[ 18F]FDG PET/CT for endoscopy-detected ampullary tumors 5–87 days (median, 7 days) after the diagnostic endoscopy between June 2007 and December 2020. The final diagnosis was made based on histopathological findings. The PET imaging parameters were compared with clinical data and endoscopic features. A model to predict the risk of malignancy, based on PET, endoscopy, and clinical findings, was generated and validated using multivariable logistic regression analysis and an additional bootstrapping method. The final model was compared with standard endoscopy for the diagnosis of ampullary cancer using the DeLong test. Results: The mean tumor size was 17.1 ± 7.7 mm. Sixty-four (41.3%) tumors were benign, and 91 (58.7%) were malignant. Univariable analysis found that ampullary neoplasms with a blood-pool corrected peak standardized uptake value in earlyphase scan (SUVe) ≥ 1.7 were more likely to be malignant (odds ratio [OR], 16.06; 95% confidence interval [CI], 7.13–36.18;P < 0.001). Multivariable analysis identified the presence of jaundice (adjusted OR [aOR], 4.89; 95% CI, 1.80–13.33; P = 0.002), malignant traits in endoscopy (aOR, 6.80; 95% CI, 2.41–19.20; P < 0.001), SUVe ≥ 1.7 in PET (aOR, 5.43; 95% CI, 2.00–14.72; P < 0.001), and PET-detected nodal disease (aOR, 5.03; 95% CI, 1.16–21.86; P = 0.041) as independent predictors of malignancy. The model combining these four factors predicted ampullary cancers better than endoscopic diagnosis alone (area under the curve [AUC] and 95% CI: 0.925 [0.874–0.956] vs. 0.815 [0.732–0.873], P < 0.001). The model demonstrated an AUC of 0.921 (95% CI, 0.816–0.967) in candidates for endoscopic papillectomy. Conclusion Adding 2-[ 18F]FDG PET/CT to endoscopy can improve the diagnosis of ampullary cancer and may help refine therapeutic decision-making, particularly when contemplating endoscopic papillectomy.

Synaptic dysfunction plays an important role in the early stage of frontotemporal dementia (FTD), and there are differences in the pattern of synaptic damage in different genotypes. GRN gene mutations are rare in the Chinese population, and there are no reports of synaptic damage patterns in GRN mutations or semantic variant primary progressive aphasia (svPPA). The synaptic injury characteristics of a patient with svPPA harboring GRN gene mutations, which was characterized by decreased synaptic density in the left frontal, temporal, parietal lobe and contralateral cerebellum were reported in this article. The underlying mechanism of synaptic dysfunction involved in the disease process, and potential targets for future clinical interventions were indicated.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in healthcare facilities in major regions of China in 2023.Methods Clinical isolates collected from 73 hospitals across China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2023 Clinical & Laboratory Standards Institute (CLSI) breakpoints.Results A total of 445199 clinical isolates were collected in 2023,of which 29.0％ were gram-positive and 71.0％ were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species (excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi) (MRSA,MRSE and MRCNS) was 29.6％,81.9％ and 78.5％,respectively.Methicillin-resistant strains showed significantly higher resistance rates to most antimicrobial agents than methicillin-susceptible strains (MSSA,MSSE and MSCNS).Overall,92.9％ of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 91.4％ of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis had significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 93.1％ in the isolates from children and and 95.9％ in the isolates from adults.The resistance rate to carbapenems was lower than 15.0％ for most Enterobacterales species except for Klebsiella,22.5％ and 23.6％ of which were resistant to imipenem and meropenem,respectively .Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.6％ to 10.0％.The resistance rate to imipenem and meropenem was 21.9％ and 17.4％ for Pseudomonas aeruginosa,respectively,and 67.5％ and 68.1％ for Acinetobacter baumannii,respectively.Conclusions Increasing resistance to the commonly used antimicrobial agents is still observed in clinical bacterial isolates.However,the prevalence of important crabapenem-resistant organisms such as crabapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a slightly decreasing trend.This finding suggests that strengthening bacterial resistance surveillance and multidisciplinary linkage are important for preventing the occurrence and development of bacterial resistance.