Objective:To analyze the seroepidemiological characteristics of common respiratory pathogens in patients screened at a tertiary hospital in Zhangjiakou from 2018 to 2024.Methods:This single-center cross-sectional study utilized data from the laboratory information management system (LIS) of The First Affiliated Hospital of Hebei North University. We collected clinical data and serum-specific IgM antibody test results for 11 common respiratory pathogens ( influenza A virus, influenza B virus, respiratory syncytial virus, parainfluenza virus, mycoplasma pneumoniae, chlamydia pneumoniae, legionella pneumophila, coxsackie A virus, coxsackie B virus, echovirus and adenovirus), excluding SARS-CoV-2, from January 1, 2018, to December 31, 2024. Comparative analyses were conducted across three periods: 2018-2019, 2020-2022, and 2023-2024. Statistical analyses were performed using SPSS 26.0, with categorical data presented as percentages and compared using χ2 tests. Results:From 2018 to 2024, a total of 35 665 patients with respiratory tract infection were screened, of which 10 531 were positive for at least one pathogen, with a total positive rate of 29.53% (10 531/35 665). Age-adjusted positive rates were highest in 2023-2024 compared to 2018-2019 and 2020-2022 ( χ2=690.789, P<0.001). The specific data are as follows: 21.35% (2 476/11 598) in 2018-2019, 24.35% (2 942/12 081) in 2020-2022, and 35.73% (4 283/11 986) in 2023-2024. Among the 11 pathogens, mycoplasma pneumoniae had the highest overall positivity rate (11.99%, 4 278/35 665), followed by influenza B virus (10.83%, 3 861/35 665), the other nine pathogens showed lower rates (0.88%-4.97%). At different time stages, the positive rates of serum IgM antibodies of various pathogens showed different changing characteristics: in 2023-2024, the positive rates of serum specific IgM antibodies against mycoplasma pneumoniae, influenza B/A virus and adenovirus increased significantly compared with those in 2020-2022, from 10.35%, 11.91%, 3.68%, 0.43% to 12.11%, 14.97%, 5.37%, 4.43% respectively ( χ2=59.150, P<0.001; χ2=579.484, P<0.001; χ2=116.263, P<0.001; χ2=654.125, P<0.001). The positive rates of serum IgM antibody in patients of different age groups also showed different changing trends. In 2023-2024, the proportion of people in 18 to 60 and ≥60 age groups increased compared with that in 2018-2019 ( χ2=325.069, P<0.001; χ2=593.612, P<0.001), while the 0 to 3, 3 to 6, and 6 to 12 age groups showed declines ( χ2=382.067, P<0.001; χ2=252.835, P<0.001; χ2=285.888, P<0.001). Regarding the composition of serum IgM antibodies in different infection patterns, the proportion of single-pathogen infections decreased in 2023-2024 compared with that in 2018-2019 ( χ2=130.19, P<0.001), while the proportion of two and three pathogen co-positive increased ( χ2=65.533, P<0.001; χ2=46.836, P<0.001).The most common single-pathogen infections were mycoplasma pneumoniae, influenza B/A virus and legionella pneumophila; the predominant dual-pathogen combinations were influenza A+B viruses, influenza B virus+ mycoplasma pneumoniae, and mycoplasma pneumoniae+ legionella pneumophila. Conclusion:From 2018 to 2024, the seroepidemiological characteristics of common respiratory pathogens changed significantly with different time stages. The positive rate of serum-specific IgM antibodies were influenced by the social environment and public health intervention measures. Serological testing is an important means for the monitoring of respiratory pathogens and the prevention and control of infections in this region.

Objective To analyze the risk factors associated with intraoperative parathyroid injury during thyroid cancer surgery and develop a predictive model to evaluate its predictive efficacy.Methods A retrospective study was conducted involving 76 patients who experienced intraoperative parathyroid injury during thyroid cancer surgery between May 2021 and February 2024.These patients were included in the parathyroid injury group.For the control group,76 patients who underwent thyroid cancer surgery without intraoperative parathyroid injury during the same period were selected.Clinical data,complete blood count parameters,and other relevant variables were collected.Univariate analysis was performed to screen for potential risk factors,and Logistic regression analysis was used to identify independent risk factors.A regression predictive model was established,and the model's goodness-of-fit and predictive power were evaluated.Results Among the 76 patients,75 had temporary parathyroid function impairment and 1 had permanent parathyroid function impairment.Univariate and multivariate Logistic regression analyses showed that bilateral lymph node dissection,bilateral total lobectomy,capsule invasion,and combined hashimoto's thyroiditis were independent risk factors(P＜0.05).A predictive regression model was developed based on these factors.The Hosmer-Lemeshow test showed a x2=2.064,P=0.356,indicating good model fit.The receiver operating characteristic(ROC)curve revealed that the model had an area under the curve(AUC)of 0.713,with a 95％confidence interval(CI)of 0.639 to 0.787,suggesting good predictive efficacy.Conclusion Hashimoto's thyroiditis,capsular invasion,bilateral lymph node dissection,and bilateral total lobectomy are significant risk factors for intraoperative parathyroid injury during thyroid cancer surgery.The predictive model constructed based on these factors has good predictive efficacy.

Objective:To analyze the seroepidemiological characteristics of common respiratory pathogens in patients screened at a tertiary hospital in Zhangjiakou from 2018 to 2024.Methods:This single-center cross-sectional study utilized data from the laboratory information management system (LIS) of The First Affiliated Hospital of Hebei North University. We collected clinical data and serum-specific IgM antibody test results for 11 common respiratory pathogens ( influenza A virus, influenza B virus, respiratory syncytial virus, parainfluenza virus, mycoplasma pneumoniae, chlamydia pneumoniae, legionella pneumophila, coxsackie A virus, coxsackie B virus, echovirus and adenovirus), excluding SARS-CoV-2, from January 1, 2018, to December 31, 2024. Comparative analyses were conducted across three periods: 2018-2019, 2020-2022, and 2023-2024. Statistical analyses were performed using SPSS 26.0, with categorical data presented as percentages and compared using χ2 tests. Results:From 2018 to 2024, a total of 35 665 patients with respiratory tract infection were screened, of which 10 531 were positive for at least one pathogen, with a total positive rate of 29.53% (10 531/35 665). Age-adjusted positive rates were highest in 2023-2024 compared to 2018-2019 and 2020-2022 ( χ2=690.789, P<0.001). The specific data are as follows: 21.35% (2 476/11 598) in 2018-2019, 24.35% (2 942/12 081) in 2020-2022, and 35.73% (4 283/11 986) in 2023-2024. Among the 11 pathogens, mycoplasma pneumoniae had the highest overall positivity rate (11.99%, 4 278/35 665), followed by influenza B virus (10.83%, 3 861/35 665), the other nine pathogens showed lower rates (0.88%-4.97%). At different time stages, the positive rates of serum IgM antibodies of various pathogens showed different changing characteristics: in 2023-2024, the positive rates of serum specific IgM antibodies against mycoplasma pneumoniae, influenza B/A virus and adenovirus increased significantly compared with those in 2020-2022, from 10.35%, 11.91%, 3.68%, 0.43% to 12.11%, 14.97%, 5.37%, 4.43% respectively ( χ2=59.150, P<0.001; χ2=579.484, P<0.001; χ2=116.263, P<0.001; χ2=654.125, P<0.001). The positive rates of serum IgM antibody in patients of different age groups also showed different changing trends. In 2023-2024, the proportion of people in 18 to 60 and ≥60 age groups increased compared with that in 2018-2019 ( χ2=325.069, P<0.001; χ2=593.612, P<0.001), while the 0 to 3, 3 to 6, and 6 to 12 age groups showed declines ( χ2=382.067, P<0.001; χ2=252.835, P<0.001; χ2=285.888, P<0.001). Regarding the composition of serum IgM antibodies in different infection patterns, the proportion of single-pathogen infections decreased in 2023-2024 compared with that in 2018-2019 ( χ2=130.19, P<0.001), while the proportion of two and three pathogen co-positive increased ( χ2=65.533, P<0.001; χ2=46.836, P<0.001).The most common single-pathogen infections were mycoplasma pneumoniae, influenza B/A virus and legionella pneumophila; the predominant dual-pathogen combinations were influenza A+B viruses, influenza B virus+ mycoplasma pneumoniae, and mycoplasma pneumoniae+ legionella pneumophila. Conclusion:From 2018 to 2024, the seroepidemiological characteristics of common respiratory pathogens changed significantly with different time stages. The positive rate of serum-specific IgM antibodies were influenced by the social environment and public health intervention measures. Serological testing is an important means for the monitoring of respiratory pathogens and the prevention and control of infections in this region.

Objective To analyze the risk factors associated with intraoperative parathyroid injury during thyroid cancer surgery and develop a predictive model to evaluate its predictive efficacy.Methods A retrospective study was conducted involving 76 patients who experienced intraoperative parathyroid injury during thyroid cancer surgery between May 2021 and February 2024.These patients were included in the parathyroid injury group.For the control group,76 patients who underwent thyroid cancer surgery without intraoperative parathyroid injury during the same period were selected.Clinical data,complete blood count parameters,and other relevant variables were collected.Univariate analysis was performed to screen for potential risk factors,and Logistic regression analysis was used to identify independent risk factors.A regression predictive model was established,and the model's goodness-of-fit and predictive power were evaluated.Results Among the 76 patients,75 had temporary parathyroid function impairment and 1 had permanent parathyroid function impairment.Univariate and multivariate Logistic regression analyses showed that bilateral lymph node dissection,bilateral total lobectomy,capsule invasion,and combined hashimoto's thyroiditis were independent risk factors(P＜0.05).A predictive regression model was developed based on these factors.The Hosmer-Lemeshow test showed a x2=2.064,P=0.356,indicating good model fit.The receiver operating characteristic(ROC)curve revealed that the model had an area under the curve(AUC)of 0.713,with a 95％confidence interval(CI)of 0.639 to 0.787,suggesting good predictive efficacy.Conclusion Hashimoto's thyroiditis,capsular invasion,bilateral lymph node dissection,and bilateral total lobectomy are significant risk factors for intraoperative parathyroid injury during thyroid cancer surgery.The predictive model constructed based on these factors has good predictive efficacy.

Objective:To explored the clinical characteristics and risk factors of acute kidney injury (AKI) caused by vancomycin combined with piperacillin sodium and tazobactam sodium (VPT) in adult patients with severe infections.Methods:Clinical data of adult patients with VPT-related AKI (AKI group) hospitalized at the Affiliated Hospital of Gansu Medical College and People′s Hospital of Hengshui from January 2022 to August 2023 due to severe infections were collected. The occurrence time, severity, and prognosis of AKI in the AKI group were descriptive statistically analyzed. According to the ratio of 1∶1, patients in the control group were randomly selected from those who did not develop AKI after using VPT in the same period. The general information, disease status, baseline laboratory tests results, and the application of VPT and combined drugs, etc. in patients of the 2 groups were collected. The influencing factors of AKI caused by VPT were analyzed by univariate and multivariate logistic regression.Results:A total of 1 547 adult patients with severe infections were treated with VPT, of which 175 (11.3%) developed AKI. Among the 175 patients, 81 (46.3%) were male and 94 (53.7%) were female, with an age of (55±22) years; the time from VPT treatment to the occurrence of AKI was (4±1) days, and the severity of AKI was staged as grade 1, 2 and 3 in 97 (55.4%), 54 (30.9%), and 24 (13.7%) patients, respectively. After drug withdrawal, the renal function gradually recovered in 169 (96.6%) of the 175 patients with AKI, and 6 (3.4%) patients needed continuous renal replacement therapy. Multivariate logistic regression analysis showed that the trough concentration of vancomycin >20 mg/L [odds ratio ( OR)=2.105, 95% confidence interval ( CI): 1.427-3.105, P=0.022], the duration of vancomycin treatment ≥11 days ( OR=1.518, 95% CI: 1.232-1.871, P=0.014), the duration of piperacillin sodium and tazobactam sodium treatment ≥14 days ( OR=1.826, 95% CI: 1.152-2.894, P=0.029) and longer duration of combined vasoactive drugs ( OR=3.315, 95% CI: 1.428-7.695, P=0.005) were independent risk factors for VPT-related AKI. Conclusions:VPT-related AKI in adult patients with severe infections mostly occurs within one week of combination therapy, and the severity was mostly stage 1 and 2. The trough concentration of vancomycin >20 mg/L, longer course of VPT treatment, and longer time of combined vasoactive drugs can increase the risk of VPT-related AKI.

Objective:To explored the clinical characteristics and risk factors of acute kidney injury (AKI) caused by vancomycin combined with piperacillin sodium and tazobactam sodium (VPT) in adult patients with severe infections.Methods:Clinical data of adult patients with VPT-related AKI (AKI group) hospitalized at the Affiliated Hospital of Gansu Medical College and People′s Hospital of Hengshui from January 2022 to August 2023 due to severe infections were collected. The occurrence time, severity, and prognosis of AKI in the AKI group were descriptive statistically analyzed. According to the ratio of 1∶1, patients in the control group were randomly selected from those who did not develop AKI after using VPT in the same period. The general information, disease status, baseline laboratory tests results, and the application of VPT and combined drugs, etc. in patients of the 2 groups were collected. The influencing factors of AKI caused by VPT were analyzed by univariate and multivariate logistic regression.Results:A total of 1 547 adult patients with severe infections were treated with VPT, of which 175 (11.3%) developed AKI. Among the 175 patients, 81 (46.3%) were male and 94 (53.7%) were female, with an age of (55±22) years; the time from VPT treatment to the occurrence of AKI was (4±1) days, and the severity of AKI was staged as grade 1, 2 and 3 in 97 (55.4%), 54 (30.9%), and 24 (13.7%) patients, respectively. After drug withdrawal, the renal function gradually recovered in 169 (96.6%) of the 175 patients with AKI, and 6 (3.4%) patients needed continuous renal replacement therapy. Multivariate logistic regression analysis showed that the trough concentration of vancomycin >20 mg/L [odds ratio ( OR)=2.105, 95% confidence interval ( CI): 1.427-3.105, P=0.022], the duration of vancomycin treatment ≥11 days ( OR=1.518, 95% CI: 1.232-1.871, P=0.014), the duration of piperacillin sodium and tazobactam sodium treatment ≥14 days ( OR=1.826, 95% CI: 1.152-2.894, P=0.029) and longer duration of combined vasoactive drugs ( OR=3.315, 95% CI: 1.428-7.695, P=0.005) were independent risk factors for VPT-related AKI. Conclusions:VPT-related AKI in adult patients with severe infections mostly occurs within one week of combination therapy, and the severity was mostly stage 1 and 2. The trough concentration of vancomycin >20 mg/L, longer course of VPT treatment, and longer time of combined vasoactive drugs can increase the risk of VPT-related AKI.

Background: Antibiotic resistance is a significant public health concern around the globe.Antimicrobial peptides exhibit broad-spectrum and efficient antibacterial activity with an added advantage of low drug resistance. The higher water content and 3D network structure of the hydrogels are beneficial for maintaining antimicrobial peptide activity and help to prevent degradation. The antimicrobial peptide released from hydrogels also hasten the local wound healing by promoting epithelial tissue regeneration and granulation tissue formation. Objective: This study aimed at developing sodium alginate based hydrogel loaded with a novel antimicrobial peptide Chol-37(F34-R) and to investigate the characteristics in vitro and in vivo as an alternative antibacterial wound dressing to treat infectious wounds. Methods: Hydrogels were developed and optimized by varying the concentrations of crosslinkers and subjected to various characterization tests like cross-sectional morphology, swelling index, percent water contents, water retention ratio, drug release and antibacterial activity in vitro, and Pseudomonas aeruginosa infected wound mice model in vivo. Results: The results indicated that the hydrogel C proved superior in terms of cross-sectional morphology having uniformly sized interconnected pores, a good swelling index, with the capacity to retain a higher quantity of water. Furthermore, the optimized hydrogel has been found to exert a significant antimicrobial activity against bacteria and was also found to prevent bacterial infiltration into the wound site due to forming an impermeable barrier between the wound bed and external environment. The optimized hydrogel was found to significantly hasten skin regeneration in animal models when compared to other treatments in addition to strong inhibitory effect on the release of pro-inflammatory cytokines (interleukin-1β and tumor necrosis factor-α). Conclusions Our results suggest that sodium alginate -based hydrogels loaded with Chol-37(F34-R) hold the potential to be used as an alternative to conventional antibiotics in treating infectious skin wounds.

Objective:To investigate the effects of breast milk to total milk intake ratio during hospitalization on the duration of antibiotic therapy in preterm infants less than 34 weeks of gestation.Methods:Clinical data of preterm infants ( n=1 792) less than 34 gestational weeks were retrospectively collected in 16 hospitals of Jiangsu Province Neonatal-Perinatal Cooperation Network from January 1, 2019, to December 31, 2021. The days of therapy (DOT) were used to evaluate the duration of antibiotic administration. The median DOT was 15.0 d (7.0-27.0 d). The patients were divided into four groups based on the quartiles of DOT: Q 1 (DOT≤7.0 d), Q 2 (7.0 d27.0 d) groups. According to the breast milk intake ratio (breast milk intake to total milk intake during hospitalization×100%), they were also divided into four groups: very-low-ratio breastfeeding group (breast milk intake ratio≤25%), low-ratio breastfeeding group (25%75%). Univariate analysis ( Chi-square test and Kruskal-Wallis rank-sum test) was used to analyze the factors influencing DOT. Spearman correlation analysis and trend Chi-square test were used to explore the relationship between breast milk intake ratio and DOT. After using multiple imputations to address missing data, two models were constructed after adjusting for different factors, and multinomial logistic regression model was applied to evaluate the effects of the breast milk intake ratio on DOT. Finally, sensitivity analysis was conducted to assess the stability of the models. Results:(1) Of the 1 792 preterm infants, there were 507 (28.3%) in the Q 1 group, 422 (23.5%) in the Q 2 group, 438 (24.4%) in the Q 3 group and 425 (23.7%) in the Q 4 group. (2) The median values of DOT in the very-low-ratio, low-ratio, medium-ratio and high-ratio breastfeeding groups were 20.0 d (11.0-31.0 d), 20.0 d (11.0-32.0 d), 13.0 d (6.0-25.8 d) and 10.0 d (4.0-21.0 d), respectively. Compared with the very-low-ratio and low-ratio breastfeeding groups, the medium-ratio and high-ratio breastfeeding groups had shorter DOT (all P<0.05). (3) After adjusting for factors with P<0.1 (prenatal glucocorticoid exposure, antimicrobial use within 24 h before delivery, gestational age at delivery, birth weight, Apgar score≤7 at 1 min, neonatal respiratory distress syndrome, infectious pneumonia and early-onset neonatal sepsis) between the DOT quartile groups, it showed that medium-ratio and high-ratio breastfeeding were protective factors in contrast to very-low-ratio breastfeeding in the Q 2, Q 3 and Q 4 groups as compared with the Q 1 group [Q 2 group: OR=0.50 (95% CI: 0.30-0.85) and OR=0.36 (95% CI: 0.26-0.51); Q 3 group: OR=0.31 (95% CI: 0.18-0.55) and OR=0.20 (95% CI: 0.14-0.29); Q 4 group: OR=0.22 (95% CI: 0.12-0.42) and OR=0.17 (95% CI: 0.12-0.26)]. Conclusion:Breast milk intake accounting for over 50% of total milk intake has a positive impact on reducing DOT in premature infants requiring antibiotics, which suggests that breastfeeding should be actively encouraged.

OBJECTIVETo evaluate the short-term efficacy and safety of neoadjuvant synchronous chemoradiotherapy (paclitaxel plus carboplatin regimen) in stage III adenocarcinoma of esophagogastric junction (AEG).

METHODSForty cases clinically diagnosed as stage III AEG were prospectively enrolled at the Department of Gastrointestinal Oncology Surgery, the First Affiliated Hospital of Hebei North University from December 2014 to November 2017 and then were randomly divided into paclitaxel plus carboplatin combined with synchronous radiotherapy group(neoadjuvant group) and direct operation group. Inclusion criteria was as follows:(1) AEG was diagnosed by gastroscopic biopsy and III stage was confirmed by ultrasound endoscopy and spiral CT;(2) physical strength score ≥70, and age ≤75 years old; (3) no contraindications of chemoradiotherapy and operation. Exclusion criteria was as follows:(1) patients voluntarily withdrew or refused the treatment;(2) occurrence of severe anaphylaxis; (3) uncontrollable events happened during treatment and treatment was unable to continue;(4) tumor developed obviously during treatment. Preoperative neoadjuvant synchronous chemoradiotherapy used TP regimen: paclitaxel 80 mg/m², drug concentration-time area under curve of carboplatin= 1.5 mg×ml⁻¹×min⁻¹, once per week for 9 weeks; radiotherapy began at the second week, 40 Gy/20 F, completed within 4 weeks. Operative procedure of both groups was radical resection of cardiac cancer(D2). Postoperative chemotherapy regimen was oral Tegafur(Gimeracil and Oteracil potassium). The side effects, diet situation, change of gastroscopic image after treatment in patients of neoadjuvant group were observed and efficacy evaluation of chemotherapy was performed according to solid tumor efficacy evaluation criteria of US National Cancer Institute. Operation-associated parameters, including R0 resection rate, lymph node metastasis, operative mortality and postoperative complications, were compared between two groups.

RESULTSThere were no significant differences in baseline information between the two group (all P>0.05). One case in neoadjuvant group was excluded because of perforation at lesion site 7 weeks after chemotherapy. The side effects of 19 cases in neoadjuvant group were mainly alopecia (100%) and marrow inhibition (68.4%), while 3-4 degree side effects were alopecia(8/19,42.1%), leukopenia (3/19, 15.8%) and neutropenia(3/19, 15.8%). Complete remission was observed in 4 cases; partial remission was observed in 13 cases and stable disease in 2 cases, with an objective response rate of 89.5% and a disease control rate of 100%. Before neoadjuvant chemotherapy, 16 cases were difficult to take liquid diet and 3 cases received liquid diet only, while after 12 weeks of neoadjuvant chemotherapy, all the 19 cases received normal diet. Besides, after neoadjuvant chemotherapy, gastroscopic examination showed close healing of cardiac ulcer, disappearance of swelling, and renewal of normal mucosa. Compared to direct operation group, neoadjuvant group had less number of positive lymph node (4.9±3.6 vs. 8.8±2.8, P<0.05) and higher R0 resection rate (94.7% vs. 50.0%, P<0.05). Total number of harvested lymph node was not significantly different between two groups (19.1±2.5 vs. 18.6±7.0, t=0.326, P=0.746). There was no surgical death in either group. One case in direct operation group developed postoperative inflammatory obstruction. No associated complication was found in neoadjuvant group.

CONCLUSIONPaclitaxel plus carboplatin combined with synchronous radiotherapy can elevate the R0 resection rate of patients with stage III esophagogastric junction adenocarcinoma, without increasing operative mortality and postoperative complications.

Adenocarcinoma ; drug therapy ; therapy ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carboplatin ; administration & dosage ; Chemoradiotherapy ; Esophageal Neoplasms ; therapy ; Esophagogastric Junction ; Humans ; Neoadjuvant Therapy ; Neoplasm Staging ; Paclitaxel ; administration & dosage ; Stomach Neoplasms ; therapy ; Survival Rate

Objective:To investigate the expression of PIK3CA and PTEN in PI3K/Akt/Mtor signaling pathway and its correlation with clinicopathological parameters in invasive B-cell lymphoma.Methods:A total of 235 invasive B-cell lymphoma cases enrolled in First Affliated Hospital of Xinjiang Medical University from January 2008 to December 2012,without any pre-operative treatment,were collected;those included 205 cases of diffuse large B-cell lymphoma(DLBCL),27 cases of Burkitt lymphoma(BL),and the remaining three cases were somewhere between DLBCL and BL,but could not be classified clearly.The expression of PIK3CA and PTEN genes was detected by fluo-rescence in situ hybridization.The relationship between PIK3CA and PTEN genes was analyzed statistically and extended to clinicopathological parameters and prognosis.Results:The positive rate of PIK3CA amplification in invasive B-cell lymphoma was 12.3%(29/235),and the positive rate of clinical stageⅠ-Ⅱ(8.6%,12/139)was much lower than that ofⅢ-Ⅳ(17.7%,17/96),with the difference being statistically significant (P=0.038).The deletion rate of PTEN in invasive B cell lymphoma was 13.6%(32/235),which was not correlated with other clinicopathological features.PIK3CA amplification was negatively correlated with PTEN deletion(P=0.046),and neither was found to be significantly associated with survival.Conclusions:PIK3CA amplification and PTEN deletion play a role in the development of invasive B-cell lymphoma,and the former is associated with late stage of the disease.