Objective To analyze the structural and phylogenetic characteristics of the mitochondrial genome from Bulinus globosus, so as to provide a theoretical basis for classification and identification of species within the Bulinus genus, and to provide insights into understanding of Bulinus-schistosomes interactions and the mechanisms of parasite transmission. Methods B. globosus samples were collected from the Ruya River basin in Zimbabwe. Mitochondrial DNA was extracted from B. globosus samples and the corresponding libraries were constructed for high-throughput sequencing on the Illumina NovaSeq 6000 platform. After raw sequencing data were subjected to quality control using the fastp software, genome assembly was performed using the A5-miseq and SPAdes tools, and genome annotation was conducted using the MITOS online server. Circular maps and sequence plots of the mitochondrial genome were generated using the CGView and OGDRAW software, and the protein conservation motifs and structures were analyzed using the TBtools software. Base composition and codon usage bias were analyzed and visualized using the software MEGA X and the ggplot2 package in the R software. In addition, a phylogenetic tree was created in the software MEGA X after sequence alignment with the software MAFFT 7, and visualized using the software iTOL. Results The mitochondrial genome of B. globosus was a 13 730 bp double-stranded circular molecule, containing 2 ribosomal RNA (rRNA) genes, 22 transfer RNA (tRNA) genes, and 13 protein-coding genes, with a marked AT preference. The mitochondrial genome composition of B. globosus was similar to that of other species within the Bulinus genus. Phylogenetic analysis revealed that the complete mitochondrial genome sequence of B. globosus was clustered with B. truncatus, B. nasutus, and B. ugandae into the same evolutionary clade, and gene superfamily analysis showed that the metabolism-related proteins of B. globosus were highly conserved, notably the cytochrome c oxidase family, which showed a significant consistency. Conclusions This is the first whole mitochondrial genome sequencing to decode the compositional features of the mitochondrial genome of B. globosus from Zimbabwe and its evolutionary relationship within the Bulinus genus, which provides important insights for further understanding of the phylogeny and mitochondrial genome characteristics of the Bulinus genus.

As the intricate interplay between microbiota and the host garners increasing research attention, a significant parallel surge has emerged in the investigation of intestinal bacterial extracellular vesicles (BEVs). Most intestinal bacteria secrete BEVs, which harbor specific cargo molecules and exhibit diverse functions, encompassing interactions among bacteria themselves and between bacteria and the host. These interactions can either bolster host health or contribute to various pathologies. By integrating the characteristics of BEVs, we summarized the current research landscape, delving into the intricate interplay between BEVs and different diseases. Furthermore, we offer a succinct overview of the challenges faced in BEVs-based research, encompassing separation, detection, engineering for drug purposes, clinical diagnostics, safety, and future study. In essence, these summaries may serve as invaluable guides for BEVs as communication tools between the gut microbiome and host, ultimately propelling the discovery of novel studies and drug discovery.

Objective:The aim of this study was to investigate whether the Model for end-stage liver disease-excluding international normalised ratio ( MELD-XI) score whether it can predict the prognosis of patients on veno-arterial extracorporeal membrane oxygenation support.Methods:This study was a retrospective cohort study, which retrospectively included clinical data data of patients using ECMO from January 2015 to December 2023 in Fuwai Huazhong Cardiovascular Disease Hospital. Inclusion criteria: 1. clinical patients using VA-ECMO, excluding VAV-ECMO and VV-ECMO; 2. available laboratory values of blood creatinine and total bilirubin within the first 24 hours of on-boarding; 3. complete basic information of the patients; and 4. age greater than 18 years. Exclusion criteria: 1. patients whose family members abandoned the treatment due to economic reasons; 2. on-boarding time less than 24 hours; 3. patients with incomplete clinical information or patients who did not have a detailed record of general information on VA-ECMO. Using X-tile software, they were divided into MELD-XI score ≤13.9 and MELD-XI score >13.9 groups, and variables with P < 0.05 were included in the binary logistic regression model after using univariate analysis. Results:: Univariate analysis of 940 patients revealed that the MELD-XI score ≤13.9 group compared with the MELD-XI score >13.9 group had a significant difference in the success of machine withdrawal ( χ2=31.812, P<0.001), death while the machine was in operation ( χ2=52.453, P<0.001), death after machine withdrawal ( χ2=4.210, P=0.040), cerebral thrombotic complications ( χ2=4.319, P=0.038), lower extremity thrombotic complications ( χ2=8.789, P=0.003), and CRRT use ( χ2=15.648, P<0.001), length of boarding (Z=-17.786, P<0.001), length of hospital stay (Z=-17.503, P<0.001), and length of ICU stay ( Z=-18.790, P<0.001) were significantly different. Multifactorial binary logistic regression showed that successful machine withdrawal ( OR=2.078, 95% CI:1.158-3.731, P=0.014), death while the machine was running ( OR=0.271, 95% CI:0.144-0.512, P<0.001), CRRT use ( OR=3.227, 95% CI:1.659-6.474, P=0.001), length of hospital stay ( OR=1.138, 95% CI:1.107-1.171, P<0.001), length of boarding ( OR=1.035, 95% CI:1.027-1.043, P<0.001), ICU stay ( OR=1.365, 95% CI:1.278-1.458, P < 0.001) are independent influencing factor for VA-ECMO support patients. Kaplan-Meier curve analysis showed that both in-hospital mortality ( HR=2.167, 95% CI:1.508-3.114, P<0.001) and withdrawal success ( HR=5.353, 95% CI:4.023-7.121, P<0.001) were significantly lower in the MELD-XI score ≤13.9 group than in the MELD-XI score >13.9 group. Conclusions:The MELD-XI score can predict the prognosis of VA-ECMO-supported patients and help clinician doctors to make complex clinical decisions.

Objective To investigate the feasibility of developing a grading diagnostic model for schistosomiasis-induced liver fibrosis based on B-mode ultrasonographic images and clinical laboratory indicators. Methods Ultrasound images and clinical laboratory testing data were captured from schistosomiasis patients admitted to the Second People’s Hospital of Duchang County, Jiangxi Province from 2018 to 2022. Patients with grade I schistosomiasis-induced liver fibrosis were enrolled in Group 1, and patients with grade II and III schistosomiasis-induced liver fibrosis were enrolled in Group 2. The machine learning binary classification tasks were created based on patients’radiomics and clinical laboratory data from 2018 to 2021 as the training set, and patients’radiomics and clinical laboratory data in 2022 as the validation set. The features of ultrasonographic images were labeled with the ITK-SNAP software, and the features of ultrasonographic images were extracted using the Python 3.7 package and PyRadiomics toolkit. The difference in the features of ultrasonographic images was compared between groups with t test or Mann-Whitney U test, and the key imaging features were selected with the least absolute shrinkage and selection operator (LASSO) regression algorithm. Four machine learning models were created using the Scikit-learn repository, including the support vector machine (SVM), random forest (RF), linear regression (LR) and extreme gradient boosting (XGBoost). The optimal machine learning model was screened with the receiver operating characteristic curve (ROC), and features with the greatest contributions to the differentiation features of ultrasound images in machine learning models with the SHapley Additive exPlanations (SHAP) method. Results The ultrasonographic imaging data and clinical laboratory testing data from 491 schistosomiasis patients from 2019 to 2022 were included in the study, and a total of 851 radiomics features and 54 clinical laboratory indicators were captured. Following statistical tests (t = −5.98 to 4.80, U = 6 550 to 20 994, all P values < 0.05) and screening of key features with LASSO regression, 44 features or indicators were included for the subsequent modeling. The areas under ROC curve (AUCs) were 0.763 and 0.611 for the training and validation sets of the SVM model based on clinical laboratory indicators, 0.951 and 0.892 for the training and validation sets of the SVM model based on radiomics, and 0.960 and 0.913 for the training and validation sets of the multimodal SVM model. The 10 greatest contributing features or indicators in machine learning models included 2 clinical laboratory indicators and 8 radiomics features. Conclusions The multimodal machine learning models created based on ultrasound-based radiomics and clinical laboratory indicators are feasible for intelligent identification of schistosomiasis-induced liver fibrosis, and are effective to improve the classification effect of one-class data models.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.

In order to promote the development of grassroots hospitals through targeted assistance,ZhuJiang Hospital of Southern Medical University took the lead in responding in Guangdong Province and established a tight-ly-knit specialty alliance belonging to Zhujiang.It introduces the construction content,principles and measures of Zhujiang Tightly-Knit Specialty Alliance,and proposes a dual-promotion management model for the tightly-knit Spe-cialty Alliance.A comprehensive comparison of the changes in specialized technical capabilities and medical quality of Guangning County People's Hospital before and after aid shows that the close specialist alliance has achieved initial results in effectively promoting the sinking of resources and improving the medical technology capabilities and quality of member units.It is of great practical significance for further promoting the development of specialist alliances and filling the shortcomings of primary medical institutions.