Objective:To compare the cardiac size，morphology，and function between anemic and normal fetuses using a hybrid artificial intelligence（AI）model，and to evaluate the utility of AI in quantitatively assessing fetal cardiac function in cases of anemia.Methods:A retrospective study was conducted by collecting data from 2018 to 2024 at the Seventh Affiliated Hospital of Sun Yat-sen University，including 15 cases of anemic fetuses（anemia group）diagnosed through umbilical venous puncture and 32 cases of normal fetuses（control group）. Four-chamber fetal cardiac ultrasound videos and left/right ventricular segments were included，with 44 videos and 1 056 segments in the anemia group，and 46 videos and 1 104 segments in the control group. Based on dynamic four-chamber heart images，the hybrid AI model was employed to extract heart measurement parameters，including basal-apical length（BAL），transverse width（TW），global sphericity index（GSI），end-diastolic area（EDA），24-segment left and right ventricular end-diastolic diameter（LVEDD，RVEDD），segmental sphericity index（LVSI，RVSI），global longitudinal strain（LVGLS，RVGLS），fractional area change（LVFAC，RVFAC），segmental fractional shortening（LVFS，RVFS），along with their corresponding Z-scores. The differences in cardiac size，morphology，and function parameters between the two groups were compared. Pearson correlation analysis was performed for the parameters of the control group（BAL，TW，EDA，GLS，LVGLS，RVGLS，LVFAC，and RVFAC）against gestational age. The measurement consistencies of AI technology and fetal HQ technology in normal and anemia groups were evaluated.Results:No significant differences were found in BAL，TW，EDA，or GSI between groups（all P>0.05）. RVEDD in segments 3-24 was significantly larger in the anemia group（all P<0.05），with significantly higher Z-score abnormality rates for LVEDD and RVEDD across 24 segments（both P<0.001）. LVSI in segments 7-10，12，14-15 and RVSI in segments 1-23 were lower in the anemia group（all P<0.05），with significantly higher Z-score abnormality rates for LVSI and RVSI across 24 segments（both P<0.001）. The absolute values of LVGLS and LVFAC were significantly reduced in the anemia group（both P<0.05），while the absolute values of RVGLS and RVFAC showed no significant differences（both P>0.05）. Segmental LVFS values were significantly lower in the anemia group for segments 2，5-8，11-13（all P<0.05）. In the control group，BAL，TW，and EDA positively correlated with gestational age（ r=0.913，0.947，0.907；all P<0.001），while GSI，LVGLS，RVGLS，LVFAC and RVFAC showed no or weak correlations（ r=-0.221，0.353，0.515，-0.409，-0.425）. The intraclass correlation coefficient（ICC）between AI-based and conventional fetal HQ evaluations were 0.788 for the control group and 0.837 for the anemia group，indicating good consistency. Conclusions:AI offers a reliable approach for quantitatively evaluating fetal cardiac size，shape，and systolic function. Fetal anemia primarily affects right ventricular morphology and left ventricular systolic performance，characterized by spherical remodeling of the right ventricle and reductions in LVGLS，LVFAC，and segmental LVFS. The hybrid AI model holds potential value in fetal cardiac function assessment.

Objective:To investigate the long-term efficacy and influencing factors of transcatheter adrenal ablation in patients with primary aldosteronism (PA).Methods:This cohort study retrospectively enrolled PA patients who underwent transcatheter adrenal ablation at Daping Hospital, Army Medical University between January 2021 and December 2024. According to PASO criteria, patients were categorized into groups based on clinical outcomes (complete, partial, or no remission), biochemical outcomes (complete, partial, or no remission), and composite outcomes (complete or incomplete remission). All participants underwent 1-year follow-up, with intergroup comparisons of clinical characteristics and surgical approaches. Multivariate logistic regression models were used to identify factors influencing long-term efficacy post-transcatheter adrenal ablation in PA patients.Results:A total of 122 PA patients were enrolled, aged (47.7±11.1) years, including 55 males (45.1%). Baseline aldosterone-to-renin ratio was 0.43(0.19,0.86)(pmol·L -1)/(μU·L -1). Bilateral adrenal lesions were present in 33 cases (27.1%), while 70 (57.4%) had nodules or adenomas. Adrenal venous sampling confirmed lateralized hypersecretion in 107 patients (87.7%, left or right dominance). According to PASO criteria, 93.4% (114/122) and 95.1% (116/122) of patients achieved complete or partial remission in biochemical and clinical parameters at 1-year post-ablation, respectively. For biochemical outcomes: 40 complete, 74 partial, and 8 no remission. Patients in the partial-remission group were older than those in the no-remission group ((49.4±11.2) vs. (39.6±9.8) years), while complete-remission group had higher bilateral non-lateralized secretion rates than partial remission group (27.5% vs. 4.1%, both P<0.05). For clinical outcomes: 26 complete, 90 partial, 6 no remission. Compared to complete-remission group, partial-remission group had higher male proportion (51.1% vs. 26.9%), longer hypertension duration (4.0 (0.7, 10.0) years vs. 1.5 (0.1, 5.0) years), but lower office diastolic blood pressure ((88±11) mmHg vs. (94±12 mmHg), 1 mmHg=0.133 kPa, all P<0.05). For composite outcomes: 56 complete and 66 incomplete remission. Compared with incomplete remission group, complete remission group had lower prevalence of diabetes (8.9% vs. 22.7%) and higher proportion of bilateral non-lateralized secretion (21.4% vs. 4.6%, both P<0.05). Multivariate logistic regression identified diabetes ( OR=3.635, 95% CI 1.029-12.834, P=0.045) and lateralized secretion ( OR=9.056, 95% CI 2.039-40.212, P=0.004) as independent risk factors for poor composite outcomes after transcatheter adrenal ablation in PA patients, whereas higher office diastolic blood pressure acts as a protective factor ( OR=0.957, 95% CI 0.925-0.992, P=0.015). Conclusion:One year after transcatheter adrenal ablation, the majority of patients achieved complete or partial remission in biochemical and clinical parameters.Patients with non-lateralized adrenal hypersecretion demonstrated a higher likelihood of sustained biochemical remission and superior composite outcomes compared to those with lateralized hypersecretion.

OBJECTIVE: Recombination events are common and serve as the primary driving force of diverse human adenovirus (HAdV), particularly in children with acute respiratory tract infections (ARIs). Therefore, continual monitoring of these events is essential for effective viral surveillance and control. METHODS: Respiratory specimens were collected from children with ARIs between January 2022 and December 2023. The penton base, hexon, and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type. In cases with inconsistent typing results, genes were cloned into the pGEM-T vector to detect recombination events. Metagenomic next-generation sequencing (mNGS) was performed to characterize the recombinant HAdV genomes. RESULTS: Among 6,771 specimens, 277 (4.09%, 277/6,771) were positvie for HAdV, of which 157 (56.68%, 157/277) were successfully typed, with HAdV-B3 being the dominant type (91.08%, 143/157), and 14 (5.05%, 14/277) exhibited inconsistent typing results, six of which belonged to species B. The penton base genes of these six specimens were classified as HAdV-B7, whereas their hexon and fiber genes were classified as HAdV-B3, resulting in a recombinant genotype designated P7H3F3, which closely resembled HAdV-B114. Additionally, a partial gene encoding L1 52/55 kD was identified, which originated from HAdV-B16. CONCLUSION A novel recombinant, P7H3F3, was identified, containing sequences derived from HAdV-B3 and HAdV-B7, which is similar to HAdV-B114, along with additional sequences from HAdV-B16.
Humans ; Adenoviruses, Human/isolation & purification* ; Respiratory Tract Infections/epidemiology* ; Child, Preschool ; Child ; Recombination, Genetic ; Male ; Beijing/epidemiology* ; Infant ; Female ; Phylogeny ; Adenovirus Infections, Human/epidemiology* ; Acute Disease ; Genome, Viral

OBJECTIVE: This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. METHODS: A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. RESULTS: Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m ²) presented an increase in all-cause mortality (adjusted hazards ratio [ aHR] = 2.00, 95% confidence interval [ CI]: 1.66-2.41), while overweight (≥ 24.0 to < 28.0 kg/m ²) and obesity (≥ 28.0 kg/m ²) presented a decrease with an aHR of 0.61 (95% CI: 0.52-0.73) and 0.51 (95% CI: 0.37-0.70), respectively. Overweight ( aHR = 0.76, 95% CI: 0.67-0.86) and mild obesity ( aHR = 0.72, 95% CI: 0.59-0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m ² ( aHR = 0.95, 95% CI: 0.92-0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. CONCLUSION This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.
Humans ; Body Mass Index ; China/epidemiology* ; Male ; Female ; Middle Aged ; Prospective Studies ; Rural Population/statistics & numerical data* ; Aged ; Follow-Up Studies ; Adult ; Mortality ; Cause of Death ; Obesity/mortality* ; Overweight/mortality*

In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Objective To construct a quality evaluation index system for non-medical technical services in public hospitals,aiming to provide a more scientific and feasible basis for evaluating patient service quality.Methods Based on literature research,the SERVQUAL theory was used to preliminarily formulate a comprehensive and full-cycle evaluation index for patient service quality.The final evaluation index system was determined through expert consultation,and the Analytic Hierarchy Process was used to determine the weights of the evaluation indices.Results The questionnaire response rates for the two rounds of expert consultation were both 100％.The authority coefficients of the experts were 0.82 and 0.80,respectively,indicating a high level of expert authority.The Kendall's W coefficient increased from 0.088 to 0.107 between the two rounds,and the difference was statistically significant (P<0.001),indicating good consistency of expert opinions.The consistency results of each judgment matrix were less than 0.1,passing the consistency test.The final evaluation index system consisted of six primary indicators (tangibility,reliability,responsiveness,assurance,empathy,and continuity) and 33 secondary indicators.Conclusion The selection of evaluation indicators revolves around the core service processes of outpatient,inpatient,and other hospital services,focusing on key elements at various critical junctures that influence patient experience.The evaluation indicators aim to guide hospitals to improve not only essential needs but also desired improvements in service quality,thus promoting the continuous enhancement of hospital services.

Objective To construct a quality evaluation index system for non-medical technical services in public hospitals,aiming to provide a more scientific and feasible basis for evaluating patient service quality.Methods Based on literature research,the SERVQUAL theory was used to preliminarily formulate a comprehensive and full-cycle evaluation index for patient service quality.The final evaluation index system was determined through expert consultation,and the Analytic Hierarchy Process was used to determine the weights of the evaluation indices.Results The questionnaire response rates for the two rounds of expert consultation were both 100％.The authority coefficients of the experts were 0.82 and 0.80,respectively,indicating a high level of expert authority.The Kendall's W coefficient increased from 0.088 to 0.107 between the two rounds,and the difference was statistically significant (P<0.001),indicating good consistency of expert opinions.The consistency results of each judgment matrix were less than 0.1,passing the consistency test.The final evaluation index system consisted of six primary indicators (tangibility,reliability,responsiveness,assurance,empathy,and continuity) and 33 secondary indicators.Conclusion The selection of evaluation indicators revolves around the core service processes of outpatient,inpatient,and other hospital services,focusing on key elements at various critical junctures that influence patient experience.The evaluation indicators aim to guide hospitals to improve not only essential needs but also desired improvements in service quality,thus promoting the continuous enhancement of hospital services.

Objective:To compare the cardiac size，morphology，and function between anemic and normal fetuses using a hybrid artificial intelligence（AI）model，and to evaluate the utility of AI in quantitatively assessing fetal cardiac function in cases of anemia.Methods:A retrospective study was conducted by collecting data from 2018 to 2024 at the Seventh Affiliated Hospital of Sun Yat-sen University，including 15 cases of anemic fetuses（anemia group）diagnosed through umbilical venous puncture and 32 cases of normal fetuses（control group）. Four-chamber fetal cardiac ultrasound videos and left/right ventricular segments were included，with 44 videos and 1 056 segments in the anemia group，and 46 videos and 1 104 segments in the control group. Based on dynamic four-chamber heart images，the hybrid AI model was employed to extract heart measurement parameters，including basal-apical length（BAL），transverse width（TW），global sphericity index（GSI），end-diastolic area（EDA），24-segment left and right ventricular end-diastolic diameter（LVEDD，RVEDD），segmental sphericity index（LVSI，RVSI），global longitudinal strain（LVGLS，RVGLS），fractional area change（LVFAC，RVFAC），segmental fractional shortening（LVFS，RVFS），along with their corresponding Z-scores. The differences in cardiac size，morphology，and function parameters between the two groups were compared. Pearson correlation analysis was performed for the parameters of the control group（BAL，TW，EDA，GLS，LVGLS，RVGLS，LVFAC，and RVFAC）against gestational age. The measurement consistencies of AI technology and fetal HQ technology in normal and anemia groups were evaluated.Results:No significant differences were found in BAL，TW，EDA，or GSI between groups（all P>0.05）. RVEDD in segments 3-24 was significantly larger in the anemia group（all P<0.05），with significantly higher Z-score abnormality rates for LVEDD and RVEDD across 24 segments（both P<0.001）. LVSI in segments 7-10，12，14-15 and RVSI in segments 1-23 were lower in the anemia group（all P<0.05），with significantly higher Z-score abnormality rates for LVSI and RVSI across 24 segments（both P<0.001）. The absolute values of LVGLS and LVFAC were significantly reduced in the anemia group（both P<0.05），while the absolute values of RVGLS and RVFAC showed no significant differences（both P>0.05）. Segmental LVFS values were significantly lower in the anemia group for segments 2，5-8，11-13（all P<0.05）. In the control group，BAL，TW，and EDA positively correlated with gestational age（ r=0.913，0.947，0.907；all P<0.001），while GSI，LVGLS，RVGLS，LVFAC and RVFAC showed no or weak correlations（ r=-0.221，0.353，0.515，-0.409，-0.425）. The intraclass correlation coefficient（ICC）between AI-based and conventional fetal HQ evaluations were 0.788 for the control group and 0.837 for the anemia group，indicating good consistency. Conclusions:AI offers a reliable approach for quantitatively evaluating fetal cardiac size，shape，and systolic function. Fetal anemia primarily affects right ventricular morphology and left ventricular systolic performance，characterized by spherical remodeling of the right ventricle and reductions in LVGLS，LVFAC，and segmental LVFS. The hybrid AI model holds potential value in fetal cardiac function assessment.

Objective:To investigate the long-term efficacy and influencing factors of transcatheter adrenal ablation in patients with primary aldosteronism (PA).Methods:This cohort study retrospectively enrolled PA patients who underwent transcatheter adrenal ablation at Daping Hospital, Army Medical University between January 2021 and December 2024. According to PASO criteria, patients were categorized into groups based on clinical outcomes (complete, partial, or no remission), biochemical outcomes (complete, partial, or no remission), and composite outcomes (complete or incomplete remission). All participants underwent 1-year follow-up, with intergroup comparisons of clinical characteristics and surgical approaches. Multivariate logistic regression models were used to identify factors influencing long-term efficacy post-transcatheter adrenal ablation in PA patients.Results:A total of 122 PA patients were enrolled, aged (47.7±11.1) years, including 55 males (45.1%). Baseline aldosterone-to-renin ratio was 0.43(0.19,0.86)(pmol·L -1)/(μU·L -1). Bilateral adrenal lesions were present in 33 cases (27.1%), while 70 (57.4%) had nodules or adenomas. Adrenal venous sampling confirmed lateralized hypersecretion in 107 patients (87.7%, left or right dominance). According to PASO criteria, 93.4% (114/122) and 95.1% (116/122) of patients achieved complete or partial remission in biochemical and clinical parameters at 1-year post-ablation, respectively. For biochemical outcomes: 40 complete, 74 partial, and 8 no remission. Patients in the partial-remission group were older than those in the no-remission group ((49.4±11.2) vs. (39.6±9.8) years), while complete-remission group had higher bilateral non-lateralized secretion rates than partial remission group (27.5% vs. 4.1%, both P<0.05). For clinical outcomes: 26 complete, 90 partial, 6 no remission. Compared to complete-remission group, partial-remission group had higher male proportion (51.1% vs. 26.9%), longer hypertension duration (4.0 (0.7, 10.0) years vs. 1.5 (0.1, 5.0) years), but lower office diastolic blood pressure ((88±11) mmHg vs. (94±12 mmHg), 1 mmHg=0.133 kPa, all P<0.05). For composite outcomes: 56 complete and 66 incomplete remission. Compared with incomplete remission group, complete remission group had lower prevalence of diabetes (8.9% vs. 22.7%) and higher proportion of bilateral non-lateralized secretion (21.4% vs. 4.6%, both P<0.05). Multivariate logistic regression identified diabetes ( OR=3.635, 95% CI 1.029-12.834, P=0.045) and lateralized secretion ( OR=9.056, 95% CI 2.039-40.212, P=0.004) as independent risk factors for poor composite outcomes after transcatheter adrenal ablation in PA patients, whereas higher office diastolic blood pressure acts as a protective factor ( OR=0.957, 95% CI 0.925-0.992, P=0.015). Conclusion:One year after transcatheter adrenal ablation, the majority of patients achieved complete or partial remission in biochemical and clinical parameters.Patients with non-lateralized adrenal hypersecretion demonstrated a higher likelihood of sustained biochemical remission and superior composite outcomes compared to those with lateralized hypersecretion.

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.