Liver transplantation is a key treatment for end-stage liver disease and primary liver cancer, yet acute rejection remains a major factor affecting the prognosis of recipients. At present, the diagnosis of acute rejection mainly relies on liver biopsy, but it is traumatic and has diagnostic errors. Non-invasive detection methods such as ultrasound elastography and cytokine assays can assist in the diagnosis of acute rejection, but a single method cannot completely replace liver biopsy. Combining multiple non-invasive methods to predict and diagnose rejection after liver transplantation is likely the direction of future research. Therefore, this article reviews non-invasive approaches for acute rejection after liver transplantation, including imaging evaluation and various biomarkers, in order to achieve personalized immunosuppressive management and improve the prognosis of liver transplant recipients.

This paper summarized the experience of Chinese medical master Han Mingxiang in treating pathogenic-damp caused diseases by the method of dispelling dampness.Han Mingxiang believes that refractory diseases are usually caused by pathogenic cold and dampness,and complicated diseases are usually caused by phlegm and stagnation.Predominant dampness causes the inactivation of yang,and warming therapy is not the only one choice for activating yang.In clinical practice,he emphasizes the principles for dispelling dampness mainly by simultaneous treatment of phlegm and qi,lifting lucid yang and lowering turbid yin,nourishing spleen and resolving dampness,expelling and resolving pathogens by elevation and dispersion,relieving exterior and activating yang,which is summed up as"warming,resolving,dispersing and activating,regulating qimovement".For the treatment of the diseases caused by pathogenic-damp,the warm-natured medicines are usually used frequently,and the warm-natured medicines are not limited to the pungent-warm medicine.For dispelling dampness,the method of relieving exterior and promoting qi movement,percolating and draining dampness with aromatics,and relieving fluid retention with pungent-sweet medicine can be chosen flexibly based on syndrome differentiation,thus to reach the goal of activating yang and resolving stagnation and to obtain satisfactory efficacy.

ObjectiveTo provide technical support for the molecular surveillance of pathogenic bacteria strains carrying mobile colistin resistance-1 （mcr⁃1） gene isolate from inlet of wastewater treatment plants （WWTP）. MethodsThe Enterobacteriaceae strains carrying mcr⁃1 resistance gene isolate from inlet of WWTP during April 1 to June 30， 2023 in Shanghai were cultured on blood-rich and SS culture medium and were identified using a mass spectrometry analyzer. The mcr⁃1 gene and copy number were detected by real-time fluorescence quantitative PCR. Drug susceptibility test was performed by microbroth dilution method. The copy numbers of Escherichia coli carrying mcr⁃1 gene isolated from wastewater and human fecel were statistically analyzed by SPSS 25.0. ResultsA total of 14 strains carrying the mcr⁃1 gene were isolated from 49 WWTP samples， and the positive isolation rate was 28.6%， including 12 non-diarrheal E. coli strains and 2 Klebsiella pneumoniae strains. The drug susceptibility results showed that all 14 strains were multi-drug resistant bacteria. They were all sensitive to imipenem and tigecycline， but were ampicillin- and cefazolin-resistant. There was no significant difference in the copy number between human-sourced diarrheal E. coli and wastewater-sourced non-diarrheal E. coli （t=0.647， P>0.05）. ConclusionThe isolation and identification of strains carrying the mcr⁃1 gene from inlet of WWTP samples were firstly established in Shanghai. The multi-drug resistance among the isolated strains is severe. To effectively prevent and control the spread of colistin-resistant bacteria， more attention should be paid to the surveillance of mcr⁃1 gene.

Objective:To investigate the current situation of pregnancy distress and related factors in the third trimester of pregnancy,and explore its association with self-compassion and emotional inhibition.Methods:A total of 214 women in the third trimester of pregnancy were selected and measured the pregnancy pain,self-compassion and emotional depression levels of pregnant women in the third trimester with the Tilburg Pregnancy Pain Scale(TPDS),Self-Compassion Scale(SCS),and Emotional Suppression Scale(EIS).Results:The average score of pregnancy distress of 214 pregnant women in the third trimester was(26.7±4.9),with a medium level of pregnan-cy distress.Multiple linear regression analysis showed that the total scores of pregnancy distress in the third trimes-ter of pregnancy were negatively associated with the accompanying situation of the lover(β=-0.15,P＜0.05),the number of accompanying prenatal examinations(β=-0.24,P＜0.05)and the total scores of self-compassion(β=-0.12,P＜0.05),while positively correlated with gestational age(β=0.14,P＜0.05),complications(β=0.15,P＜0.05),and the total score of emotional suppression(β=0.17,P＜0.05).Conclusion:Pregnancy distress is common in pregnant women in the third trimester,which may be related to gestational age and complications,companionship of loved ones,number of accompanying prenatal examinations,self-compassion level and emotional inhibition.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.

Objective　To understand the contamination status and distribution of Escherichia coli in frozen raw poultry meat in Hongkou District, Shanghai,from February to November 2023, as well as the genetic characterization of colistin resistance gene mcr-1. Methods　A total of 100 samples of different kinds of raw poultry meat, such as chicken, duck, and pigeon, were randomly collected from four types of venues including farmers' markets, stores, restaurants, and online stores in Hongkou District of Shanghai from February to November 2023. These samples were used for the isolation and culture of diarrheagenic Escherichia coli. Micro broth dilution method was used to conduct the drug susceptibility experiments, and real-time fluorescence quantitative PCR was adopted to detect mcr-1 resistance genes. Whole-genome sequencing was carried out to explore the resistance genes, plasmid type, and multilocus sequence typing (MLST) of mcr-1 positive strains. Phylogenetic trees of the core genome of the strain and MCR-1 protein were constructed based on single-copy genes and the maximum likelihood method, respectively. The data was analyzed by IBM SPSS Statistics 25.0 software. Results　Among 100 raw poultry meat samples, diarrheagenic Escherichia coli was detected in 29 samples, and all of them were identified as enteroaggregative Escherichia coli (EAEC), with an overall detection rate of 29.0% (29/100). The highest detection rate was observed in restaurants (53.3%, 8/15). Among them, two strains (6.9%, 2/29) of chicken-origin EAEC carried mcr-1 resistance genes, both of which were multidrug-resistant strains producing extended-spectrum beta-lactamases (ESBLs), with 100.0% resistance to ciprofloxacin, nalidixic acid, ampicillin, cefotaxime, cefazolin, tetracycline, gentamicin, and polymyxin. Additionally, they carried various resistance genes including blaCTX-M-55, blaCTX-M-14, blaTEM-1, qnrS1, tet(A), tet(M), sul1, sul2, fosA3, aadA2, aac(3)-IVa, aac(3)-IId, aph(4)-Ia, mph(A) and mrx. MLST analysis showed that the ST types of two positive strains belonged to ST69 and ST156, respectively, with plasmids carrying mcr-1 of InCHI2 type. Core group genome analysis of the two avian-derived E.coli strains found high similarity to human-derived E.coli_042 (GCA_000027125) and E.coli_SE11 (GCA_000010385). The MCR-1 protein showed high phylogenetic similarity to avian-origin MCR-1 proteins reported from other countries. Conclusions　The contamination of raw poultry meat with EAEC in Hongkou District is serious, with most of the isolated strains exhibiting multidrug resistance. The molecular surveillance of antibiotic resistance genes with public health significance such as mcr-1 should be continuously carried out in frozen raw poultry to control the development of resistance.

【Objective】 To establish and verify the vacuum decay method for the tightness inspection of blood products. 【Methods】 The method for inspecting the tightness of blood product was established, and the detection limit, linearity, range, accuracy, precision and durability were verified according to the requirements of methodological verification.The validated method was used to check the tightness of blood product packaging. 【Results】 The detection limit of this method was 2.5 μm, linear correlation coefficient was r=1, the differential pressure of positive sample was within the allowable range of accuracy, and the durability met the requirements.The RSD of results of 6 repeatability tests and 12 intermediate precision tests were both less than 10%, and all validation items met the verification standards. 【Conclusion】 Vacuum decay method can be used to check the tightness of blood products.

【Objective】 To establish gas chromatography for the determination of tributyl phosphate(TBP) residues in human prothrombin complex and then verify it. 【Methods】 Acid modified polyethylene glycol(PEG)(20M) capillary column was used with n-hexane as solvent. The chromatographic parameters were as follows: gasification chamber temperature at 220 ℃, column temperature at 155 ℃, detector temperature at 220 ℃, column flow rate at 2.0 mL/min, carrier gas as N2, detector as FID, and collection time for 10min. The accuracy, repeatability, linearity, specificity, intermediate precision, detection limit, quantitative limit, range and durability were verified. 【Results】 The verification results showed that the method had good specificity. The linear regression correlation coefficient of standard curve was 0.999 90. The recovery rate were 98.4%, 97.5% and 95.7% when the concentration at 50%, 100%(30μg/mL) and 150%, respectively, with an average recovery of 97.2% and a relative deviation of 2.15%. When the concentration was 100%, the repeatability was 2.08%, and the relative deviation of intermediate precision was 1.63%. The detection limit was 0.255 μg/mL, and the quantitative limit was 0.511 μg/mL. After changing capillary chromatographic columns with different batch numbers but the same types and manufacturer, the applicability test of the system met the requirements, and the method had good durability. 【Conclusion】 This method can be used for the determination of TBP residues of human prothrombin complex in laboratory.

Genomic studies of cancer cell alterations,such as mutations,copy number variations(CNVs),and translocations,greatly promote our understanding of the genesis and development of cancers.However,the 3D genome architecture of cancers remains less studied due to the complexity of cancer genomes and technical difficulties.To explore the 3D genome structure in clin-ical lung cancer,we performed Hi-C experiments using paired normal and tumor cells harvested from patients with lung cancer,combining with RNA sequenceing analysis.We demonstrated the feasibility of studying 3D genome of clinical lung cancer samples with a small number of cells(1×104),compared the genome architecture between clinical samples and cell lines of lung cancer,and identified conserved and changed spatial chromatin structures between normal and cancer sam-ples.We also showed that Hi-C data can be used to infer CNVs and point mutations in cancer.By integrating those different types of cancer alterations,we showed significant associations between CNVs,3D genome,and gene expression.We propose that 3D genome mediates the effects of cancer genomic alterations on gene expression through altering regulatory chromatin structures.Our study highlights the importance of analyzing 3D genomes of clinical cancer samples in addition to cancer cell lines and provides an integrative genomic analysis pipeline for future larger-scale studies in lung cancer and other cancers.

Objective: To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks. Methods: Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman’s rank correlation coefficient was used to test bivariate associations. Results: Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods (P < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline F < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), P = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), P = 0.466. In patients with baseline F < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29). Conclusion Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.