Objective To analyze the characteristics of postoperative hospital-acquired infections and drug sensitivity in lung transplant recipients over the past 5 years in a single center. Methods A total of 724 lung transplant recipients at Wuxi People's Hospital from January 2019 to December 2023 were selected. Based on the principles of hospital-acquired infection diagnosis, a retrospective analysis was conducted on the hospital infection situation and infection sites of lung transplant recipients, and an analysis of the distribution of hospital-acquired infection pathogens and their antimicrobial susceptibility test status was performed. Results Among the 724 lung transplant recipients, 275 cases of hospital-acquired infection occurred, with an infection rate of 38.0%. The case-time infection rate decreased from 54.2% in 2019 to 22.8% in 2023, showing a downward trend year by year (Z=30.98, P<0.001). The main infection site was the lower respiratory tract, accounting for 73.6%. The pathogens were mainly Gram-negative bacteria, with the top four being Acinetobacter baumannii (37.1%), Pseudomonas aeruginosa (17.3%), Klebsiella pneumoniae (13.7%), and Stenotrophomonas maltophilia (13.4%), with imipenem resistance rates of 89%, 53%, 58% and 100%, respectively. Gram-positive bacteria were mainly Staphylococcus aureus (3.6%), with a methicillin resistance rate of 67%. Conclusions Over the past 5 years, the hospital-acquired infections in lung transplant recipients have shown a downward trend, mainly involving lower respiratory tract infections, with the main pathogens being Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae, all of which have high resistance rates to imipenem.

Objective:We study the prognostic value of TNM stage and L3-skeletal muscle mass index in overall survival(OS)in elderly patients with colorectal cancer after surgery.Furthermore, investigate the prognostic value of combined scoring system(TNM-SMI score)in patients with colorectal cancer.Methods:From January 1, 2018 to January 31, 2019, the clinical data of elderly patients who were diagnosed with colorectal cancer for the first time in Longyan First Hospital, Fujian Medical University were retrospectively analyzed.The baseline data were compared in patients with different TNM stage and L3SMI.The relevant factors that might affect the prognosis of the patients were analyzed to determine the independent risk factors in cox regression analyses.Survival curves were plotted by using the Kaplan-Meier method, and Log-rank test was used to compare Overall Survival.Predictive efficacy was compared by plotting (ROC)curve and calculating the area under the curve(AUC).Results:A total of 128 eligible patients aged 65-88(73.96±6.20)years were enrolled.Among them, 82 were male.Univariate and multifactorial cox regression analyses showed that TNM stage( HR=3.944, 95% CI: 1.519-10.237, P<0.05)and L3SMI( HR=3.194, 95% CI: 1.222-8.349, P<0.05)were the independent risk factors for OS in elderly colorectal cancer patients; Survival curves plotted by Kaplan-Meier method showed that the 5-year survival rate(OS rate)of patients in TNM(Ⅲ and Ⅳ)group was lower than in TNM(Ⅰ and Ⅱ)group(58.8% vs.88.9%, P<0.001), and the 5-year survival rate(OS rate)of patients in low L3SMI group was lower than in high L3SMI group(51.0% vs.88.3%, P<0.001); Elderly colorectal patients were risk stratified by TNM-SMI score, the patients with higher score had worse 5-year OS rate; The AUC of L3SMI, TNM stage, and TNM-SMI score are 0.729, 0.695, and 0.800. Conclusions:The TNM stage and L3SMI are independent risk factors of OS after colorectal cancer surgery; TNM-SMI score, which combines TNM stage and L3SMI, can predict prognosis more efficiency compare to single-factor.The higher TNM-SMI score had the worse prognosis; TNM stage in combination with L3SMI improves the efficiency prediction of OS after colorectal cancer surgery.

Objective To explore the risk factors for healthcare-associated infection(HAI)in lung transplant re-cipients(LTRs),and construct a predictive nomogram model.Methods Clinical data of patients who underwent lung transplant in Wuxi People's Hospital from January 2019 to December 2023 were analyzed retrospectively.The patients were divided into a training set(n=506)and a validation set(n=218).Independent risk factors were screened through LASSO regression,and multivariate logistic regression was included to construct a nomogram pre-diction model.The discrimination,calibration,and clinical applicability of the model were evaluated using receiver operating characteristic(ROC)curves,Hosmer-Lemeshow goodness-of-fit,and decision curves.Results Among the 506 LTRs,201 developed HAIs,with an incidence of 39.72％.The major infection site was lower respiratory tract,and the major pathogen were Gram-negative bacilli(Acinetobacter baumannii).Older age,use of extracorpo-real membrane oxygenation(ECMO),double-lung transplant,surgery duration＞3 hours,long duration of contin-uous fever,frequent abnormal blood routine examination,and long duration of combined use of antimicrobial agents were identified as independent risk factors for HAI after lung transplant.The ROC curve analysis results showed that the areas under the curve(AUCs)of the training set and the validation set were 0.74(95％CI:0.70-0.78)and 0.71(95％CI:0.64-0.78),respectively.The Hosmer-Lemeshow test results showed that there was no sta-tistically significant difference between the predictive and actual probability of HAI(P＞0.05).The clinical decision curve results indicated that the model had clinical benefits at a threshold probability value of 7％-71％.Conclusion The nomogram prediction model constructed in this study can effectively evaluate the risk of postoperative infection in LTRs.The model is stable and has high clinical application value,providing scientific reference for postoperative infection prevention and control.

Objective:To investigate the characteristics of semantic and orthographic processing in school-age children with different reading abilities using event-related potential (ERP).Methods:Children aged 7-11 years old were recruited from the Learning Difficulties Clinic of Changzhou Children's Hospital Affiliated to Nantong University and local elementary schools from September 2022 to December 2024. All the participants were divided into three groups: developmental dyslexia (DD) group ( n=28), DD-risk group ( n=21), and normal control (NC) group ( n=30). All subjects completed ERP tasks including Chinese character semantic priming and pseudo-character judgment tasks. The P200 and N400 amplitudes as well as behavioral indicators were recorded. Data were analyzed using repeated-measures ANOVA by SPSS 27.0 software. Results:(1) P200 amplitude comparison: a significant interaction effect of task condition × electrode location × group was observed ( F(4, 152)=3.243, P=0.014, ηp2=0.079). Specifically, during the pseudo-character judgment task, the amplitude in the left frontal-central brain region was significantly higher than that in the right frontal-central brain region in the NC group ( P=0.003). In the semantic-related and semantic-unrelated tasks, the amplitudes of the DD group and DD-risk group were significantly higher than those of the NC group (all P<0.05). In the left frontal-central brain region, no significant difference in amplitude was found among the three groups in the pseudo-character task. In the right frontal-central brain region, the amplitude of the DD group and DD-risk group were still significantly higher than that of the NC group in the pseudo-character task (both P<0.05). (2) N400 amplitude comparison: the interaction effect of task condition × electrode location × group( F(4, 152)=2.237, P=0.068, ηp2=0.056), task condition × group( F(4, 152)=0.778, P=0.541, ηp2=0.020), electrode location × group( F(2, 76)=2.178, P=0.120, ηp2=0.054), task condition × electrode location( F(2, 152)=2.751, P=0.067, ηp2=0.035)were not significant.The main effect of group was significant ( F(2, 76)=10.346, P<0.001, ηp2=0.214). The amplitudes in the DD group and DD-risk group were significantly lower than that in the NC group ( P<0.05). The main effect of task condition was also significant ( F(2, 152)=53.710, P<0.01, ηp2=0.414). The amplitudes followed the order: pseudo-character judgment > semantically unrelated > semantically related (all P<0.05). The main effect of electrode location was significant ( F(1, 76)=4.511, P=0.037, ηp2=0.056). The amplitudes in the left frontal-central brain region((-2.54±0.33)μV) were significantly higher than those in the right frontal-central brain region((-1.94±0.30)μV) across all three groups( P<0.05). (3) Accuracy comparison: a significant interaction effect of task condition × group was observed ( F(4, 152)=10.260, P<0.01, ηp2=0.213). Specifically, for semantically related and unrelated tasks, accuracies in the DD group and DD-risk group were significantly lower than those in the NC group (all P<0.05), with no significant difference between the DD group and DD-risk group ( P>0.05). During the pseudo-character judgment task, no significant difference in accuracy was found among the three groups ( P>0.05). (4)Reaction time comparison: the interaction effect of task condition × group was not significant( F(2, 76)=2.896, P=0.063, ηp2=0.083). The main effect of group was significant ( F(2, 76)=11.181, P<0.01, ηp2=0.259). The reaction time in the DD-risk group was significantly longer than those in the DD group and NC group (both P<0.05). Conclusion:Chinese children with DD exhibit deficits in both semantic and orthographic processing: enhanced P200 amplitudes (reflecting insufficient attentional allocation and/or inefficient orthographic processing), preserved yet diminished N400 effects (indicating impaired semantic integration while automatic semantic priming remains intact). Children at risk for DD show similar neural profiles, suggesting that semantic and orthographic processing abnormalities may represent stable neurobiological markers of reading disorder development.

Objective To evaluate the effect of multi-disciplinary team(MDT)management mode on the preven-tion and control of carbapenem-resistant Enterobacterales(CRE)infection after lung transplant surgery,and explore the influencing factors for CRE infection after lung transplant.Methods A total of 654 lung transplant recipients from Lung Transplant Center of Wuxi People's Hospital from January 2014 to July 2023 were selected as the re-search subjects.According to the time nodes of the implementation of MDT management mode,lung transplant re-cipients from January 2014 to December 2019 were assigned to the control group without implementation of MDT management mode.Lung transplant recipients from January 2020 to July 2023 were in the intervention group with MDT management mode implementation.Kaplan-Meier method was used to calculate the risk of CRE infection in lung transplant recipients 90 days after surgery.Cox regression model was used to adjust variables such as length of hospital stay,surgical duration,and catheterization days of three catheters,and the effect of implementing MDT management mode on the risk of CRE infection was analyzed.Results Among 654 lung transplant recipients,215 had healthcare-associated infection(HAI),including 158 cases from the control group and 57 from the intervention group,with HAI rates of 38.54％and 23.36％,respectively.The incidence of HAI in lung transplant recipients in the intervention group was lower than that in the control group(x2=15.965,P＜0.001).A total of 74 cases of CRE infection were confirmed,and CRE infection rate in the intervention group was lower than that in the control group(7.79％[19/244]vs 13.41％[55/410];x2=4.828,P=0.028).By the end of the 90-day follow-up period,the cumulative infection risks of the control group and intervention group were 14.67％and 8.26％,respectively,with a statistically significant difference between the two groups(P＜0.05).The implementation of MDT manage-ment mode was a protective factor for post-operative CRE infection in lung transplant recipients,while duration of surgery,duration of ventilator use,and duration of urinary catheterization were risk factors for CRE infection(all P＜0.05).Conclusion Implementing MDT management mode in lung transplant recipients can effectively reduce the risk of post-operative CRE infection.Continuously standardizing and implementing MDT management of multidrug-resistant organisms in hospitals is an important mean of preventing CRE infection and controlling transmission.

Objective:To investigate the characteristics of semantic and orthographic processing in school-age children with different reading abilities using event-related potential (ERP).Methods:Children aged 7-11 years old were recruited from the Learning Difficulties Clinic of Changzhou Children's Hospital Affiliated to Nantong University and local elementary schools from September 2022 to December 2024. All the participants were divided into three groups: developmental dyslexia (DD) group ( n=28), DD-risk group ( n=21), and normal control (NC) group ( n=30). All subjects completed ERP tasks including Chinese character semantic priming and pseudo-character judgment tasks. The P200 and N400 amplitudes as well as behavioral indicators were recorded. Data were analyzed using repeated-measures ANOVA by SPSS 27.0 software. Results:(1) P200 amplitude comparison: a significant interaction effect of task condition × electrode location × group was observed ( F(4, 152)=3.243, P=0.014, ηp2=0.079). Specifically, during the pseudo-character judgment task, the amplitude in the left frontal-central brain region was significantly higher than that in the right frontal-central brain region in the NC group ( P=0.003). In the semantic-related and semantic-unrelated tasks, the amplitudes of the DD group and DD-risk group were significantly higher than those of the NC group (all P<0.05). In the left frontal-central brain region, no significant difference in amplitude was found among the three groups in the pseudo-character task. In the right frontal-central brain region, the amplitude of the DD group and DD-risk group were still significantly higher than that of the NC group in the pseudo-character task (both P<0.05). (2) N400 amplitude comparison: the interaction effect of task condition × electrode location × group( F(4, 152)=2.237, P=0.068, ηp2=0.056), task condition × group( F(4, 152)=0.778, P=0.541, ηp2=0.020), electrode location × group( F(2, 76)=2.178, P=0.120, ηp2=0.054), task condition × electrode location( F(2, 152)=2.751, P=0.067, ηp2=0.035)were not significant.The main effect of group was significant ( F(2, 76)=10.346, P<0.001, ηp2=0.214). The amplitudes in the DD group and DD-risk group were significantly lower than that in the NC group ( P<0.05). The main effect of task condition was also significant ( F(2, 152)=53.710, P<0.01, ηp2=0.414). The amplitudes followed the order: pseudo-character judgment > semantically unrelated > semantically related (all P<0.05). The main effect of electrode location was significant ( F(1, 76)=4.511, P=0.037, ηp2=0.056). The amplitudes in the left frontal-central brain region((-2.54±0.33)μV) were significantly higher than those in the right frontal-central brain region((-1.94±0.30)μV) across all three groups( P<0.05). (3) Accuracy comparison: a significant interaction effect of task condition × group was observed ( F(4, 152)=10.260, P<0.01, ηp2=0.213). Specifically, for semantically related and unrelated tasks, accuracies in the DD group and DD-risk group were significantly lower than those in the NC group (all P<0.05), with no significant difference between the DD group and DD-risk group ( P>0.05). During the pseudo-character judgment task, no significant difference in accuracy was found among the three groups ( P>0.05). (4)Reaction time comparison: the interaction effect of task condition × group was not significant( F(2, 76)=2.896, P=0.063, ηp2=0.083). The main effect of group was significant ( F(2, 76)=11.181, P<0.01, ηp2=0.259). The reaction time in the DD-risk group was significantly longer than those in the DD group and NC group (both P<0.05). Conclusion:Chinese children with DD exhibit deficits in both semantic and orthographic processing: enhanced P200 amplitudes (reflecting insufficient attentional allocation and/or inefficient orthographic processing), preserved yet diminished N400 effects (indicating impaired semantic integration while automatic semantic priming remains intact). Children at risk for DD show similar neural profiles, suggesting that semantic and orthographic processing abnormalities may represent stable neurobiological markers of reading disorder development.

Objective To explore the risk factors for healthcare-associated infection(HAI)in lung transplant re-cipients(LTRs),and construct a predictive nomogram model.Methods Clinical data of patients who underwent lung transplant in Wuxi People's Hospital from January 2019 to December 2023 were analyzed retrospectively.The patients were divided into a training set(n=506)and a validation set(n=218).Independent risk factors were screened through LASSO regression,and multivariate logistic regression was included to construct a nomogram pre-diction model.The discrimination,calibration,and clinical applicability of the model were evaluated using receiver operating characteristic(ROC)curves,Hosmer-Lemeshow goodness-of-fit,and decision curves.Results Among the 506 LTRs,201 developed HAIs,with an incidence of 39.72％.The major infection site was lower respiratory tract,and the major pathogen were Gram-negative bacilli(Acinetobacter baumannii).Older age,use of extracorpo-real membrane oxygenation(ECMO),double-lung transplant,surgery duration＞3 hours,long duration of contin-uous fever,frequent abnormal blood routine examination,and long duration of combined use of antimicrobial agents were identified as independent risk factors for HAI after lung transplant.The ROC curve analysis results showed that the areas under the curve(AUCs)of the training set and the validation set were 0.74(95％CI:0.70-0.78)and 0.71(95％CI:0.64-0.78),respectively.The Hosmer-Lemeshow test results showed that there was no sta-tistically significant difference between the predictive and actual probability of HAI(P＞0.05).The clinical decision curve results indicated that the model had clinical benefits at a threshold probability value of 7％-71％.Conclusion The nomogram prediction model constructed in this study can effectively evaluate the risk of postoperative infection in LTRs.The model is stable and has high clinical application value,providing scientific reference for postoperative infection prevention and control.

Objective To evaluate the effect of multi-disciplinary team(MDT)management mode on the preven-tion and control of carbapenem-resistant Enterobacterales(CRE)infection after lung transplant surgery,and explore the influencing factors for CRE infection after lung transplant.Methods A total of 654 lung transplant recipients from Lung Transplant Center of Wuxi People's Hospital from January 2014 to July 2023 were selected as the re-search subjects.According to the time nodes of the implementation of MDT management mode,lung transplant re-cipients from January 2014 to December 2019 were assigned to the control group without implementation of MDT management mode.Lung transplant recipients from January 2020 to July 2023 were in the intervention group with MDT management mode implementation.Kaplan-Meier method was used to calculate the risk of CRE infection in lung transplant recipients 90 days after surgery.Cox regression model was used to adjust variables such as length of hospital stay,surgical duration,and catheterization days of three catheters,and the effect of implementing MDT management mode on the risk of CRE infection was analyzed.Results Among 654 lung transplant recipients,215 had healthcare-associated infection(HAI),including 158 cases from the control group and 57 from the intervention group,with HAI rates of 38.54％and 23.36％,respectively.The incidence of HAI in lung transplant recipients in the intervention group was lower than that in the control group(x2=15.965,P＜0.001).A total of 74 cases of CRE infection were confirmed,and CRE infection rate in the intervention group was lower than that in the control group(7.79％[19/244]vs 13.41％[55/410];x2=4.828,P=0.028).By the end of the 90-day follow-up period,the cumulative infection risks of the control group and intervention group were 14.67％and 8.26％,respectively,with a statistically significant difference between the two groups(P＜0.05).The implementation of MDT manage-ment mode was a protective factor for post-operative CRE infection in lung transplant recipients,while duration of surgery,duration of ventilator use,and duration of urinary catheterization were risk factors for CRE infection(all P＜0.05).Conclusion Implementing MDT management mode in lung transplant recipients can effectively reduce the risk of post-operative CRE infection.Continuously standardizing and implementing MDT management of multidrug-resistant organisms in hospitals is an important mean of preventing CRE infection and controlling transmission.

Objective:We study the prognostic value of TNM stage and L3-skeletal muscle mass index in overall survival(OS)in elderly patients with colorectal cancer after surgery.Furthermore, investigate the prognostic value of combined scoring system(TNM-SMI score)in patients with colorectal cancer.Methods:From January 1, 2018 to January 31, 2019, the clinical data of elderly patients who were diagnosed with colorectal cancer for the first time in Longyan First Hospital, Fujian Medical University were retrospectively analyzed.The baseline data were compared in patients with different TNM stage and L3SMI.The relevant factors that might affect the prognosis of the patients were analyzed to determine the independent risk factors in cox regression analyses.Survival curves were plotted by using the Kaplan-Meier method, and Log-rank test was used to compare Overall Survival.Predictive efficacy was compared by plotting (ROC)curve and calculating the area under the curve(AUC).Results:A total of 128 eligible patients aged 65-88(73.96±6.20)years were enrolled.Among them, 82 were male.Univariate and multifactorial cox regression analyses showed that TNM stage( HR=3.944, 95% CI: 1.519-10.237, P<0.05)and L3SMI( HR=3.194, 95% CI: 1.222-8.349, P<0.05)were the independent risk factors for OS in elderly colorectal cancer patients; Survival curves plotted by Kaplan-Meier method showed that the 5-year survival rate(OS rate)of patients in TNM(Ⅲ and Ⅳ)group was lower than in TNM(Ⅰ and Ⅱ)group(58.8% vs.88.9%, P<0.001), and the 5-year survival rate(OS rate)of patients in low L3SMI group was lower than in high L3SMI group(51.0% vs.88.3%, P<0.001); Elderly colorectal patients were risk stratified by TNM-SMI score, the patients with higher score had worse 5-year OS rate; The AUC of L3SMI, TNM stage, and TNM-SMI score are 0.729, 0.695, and 0.800. Conclusions:The TNM stage and L3SMI are independent risk factors of OS after colorectal cancer surgery; TNM-SMI score, which combines TNM stage and L3SMI, can predict prognosis more efficiency compare to single-factor.The higher TNM-SMI score had the worse prognosis; TNM stage in combination with L3SMI improves the efficiency prediction of OS after colorectal cancer surgery.

Objective To evaluate the effectiveness of multi-disciplinary team (MDT) mode in the prevention and control of multidrug resistant organism (MDRO) infection in lung transplant recipients. Methods Lung transplant recipients admitted to the hospital from 2019 to 2022 were enrolled. MDT expert group was established in January, 2020. A series of prevention and control measures were conducted. The implementation rate of MDRO prevention and control measures and the detection rate of MDRO on the environmental surface from 2020 to 2022, and the detection rate of MDRO in lung transplant recipients from 2019 to 2022 were analyzed. Results The overall implementation rate of MDRO prevention and control measures for medical staff was increased from 64.9% in 2020 to 91.6% in 2022, showing an increasing trend year by year (P<0.05). The detection rate of MDRO on the environmental surface was decreased from 28% in 2020 to 9% in 2022, showing a downward trend year by year (P<0.05). The detection rate of MDRO in lung transplant recipients was decreased from 66.7% in 2019 to 44.3% in 2022, showing a decreasing trend year by year (P<0.001). Conclusions MDT mode management may enhance the implementation of MDRO prevention and control measures for medical staff, effectively reduce the infection rate of MDRO in lung transplant recipients and the detection rate of MDRO on the environmental surface, which is worthy of widespread application.