Objective:To explore the feasibility of transvaginal core needle biopsy for pelvic masses under finger guidance during a vagino-recto-abdominal examination.Methods:The clinicopathological data and follow-up information of 29 patients with pelvic masses who underwent transvaginal core needle biopsy under finger guidance during a vagino-recto-abdominal examination at Affiliated Hospital of Southwest Medical University from January 2020 to July 2024 were collected, and the safety and diagnostic accuracy of the procedure were retrospectively analyzed.Results:(1) A total of 29 patients with pelvic masses were enrolled in this study, with a median age of 50 years (range: 29-73 years), and a median tumor diameter of 3.9 cm (range: 2.7-13.3 cm). Among these patients, 7 were newly diagnosed, and 22 were follow-up. The pre-procedure disease types included 21 patients (72%, 21/29) cervical cancer, 6 patients (21%, 6/29) epithelial ovarian cancer, and 2 patients (7%, 2/29) other suspected gynecologic tumors. (2) Among 29 patients with pelvic masses, 8 cases (28%, 8/29) were diagnosed with benign diseases according to core needle biopsy pathological findings, and 1 case suggested possible residual cervical cancer in the parametrial region by contrast-enhanced magnetic resonance imaging after radical chemoradiotherapy 3 months, while the result of core needle biopsy for this patient was negative, with follow-up after 1 year revealed progression of the lesion in the right parametrial area. Another patient underwent fine-needle aspiration cytology, which suggested gastrointestinal stromal tumor, requiring differentiation from endometriosis, and core needle biopsy pathology confirmed endometriosis, with follow-up at 6 months revealed no evidence of malignancy in this patient. The remaining 6 patients with benign diagnoses had follow-up periods exceeding 1 year without imaging or clinical evidence of local lesion progression or malignancy. Among the 21 patients (72%, 21/29) diagnosed with malignant tumors by core needle biopsy, 14 cases were suspected cases of residual or recurrent cervical cancer, 6 cases had advanced ovarian cancer, and 1 case had rectal cancer metastasis, with all biopsy diagnoses being consistent with preoperative clinical findings and imaging results. The overall diagnostic accuracy of the core needle biopsy was 97% (28/29). Among the 7 newly diagnosed patients, the diagnostic accuracy was 7/7, while it was 95% (21/22) for the 22 follow-up patients, with no statistically significant difference observed between the two groups ( P=1.000). (3) All 29 patients with pelvic masses successfully underwent transvaginal core needle biopsy guided by vagino-recto-abdominal examination. Among them, 28 cases (97%, 28/29) reported tolerable pain during the procedure, while 1 case (3%, 1/29) experienced transient syncope at the end of the procedure due to pain, which resolved within seconds. Vaginal bleeding exceeding 50 ml occurred in 3 patients (10%, 3/29) during paracervical tissue sampling, with the maximum blood loss being 150 ml, and hemorrhage was successfully controlled using vaginal tamponade. The overall incidence of adverse events during the core needle biopsy procedure was 14% (4/29). Conclusion:Transvaginal core needle biopsy for pelvic masses guided by vagino-recto-abdominal examination is a simple, safe, and accurate diagnostic method, suitable for patients with gynecologic malignancies, non-gynecologic malignancies suspected of pelvic mass metastasis, and other benign pelvic lesions.

Objective:To explore the feasibility of transvaginal core needle biopsy for pelvic masses under finger guidance during a vagino-recto-abdominal examination.Methods:The clinicopathological data and follow-up information of 29 patients with pelvic masses who underwent transvaginal core needle biopsy under finger guidance during a vagino-recto-abdominal examination at Affiliated Hospital of Southwest Medical University from January 2020 to July 2024 were collected, and the safety and diagnostic accuracy of the procedure were retrospectively analyzed.Results:(1) A total of 29 patients with pelvic masses were enrolled in this study, with a median age of 50 years (range: 29-73 years), and a median tumor diameter of 3.9 cm (range: 2.7-13.3 cm). Among these patients, 7 were newly diagnosed, and 22 were follow-up. The pre-procedure disease types included 21 patients (72%, 21/29) cervical cancer, 6 patients (21%, 6/29) epithelial ovarian cancer, and 2 patients (7%, 2/29) other suspected gynecologic tumors. (2) Among 29 patients with pelvic masses, 8 cases (28%, 8/29) were diagnosed with benign diseases according to core needle biopsy pathological findings, and 1 case suggested possible residual cervical cancer in the parametrial region by contrast-enhanced magnetic resonance imaging after radical chemoradiotherapy 3 months, while the result of core needle biopsy for this patient was negative, with follow-up after 1 year revealed progression of the lesion in the right parametrial area. Another patient underwent fine-needle aspiration cytology, which suggested gastrointestinal stromal tumor, requiring differentiation from endometriosis, and core needle biopsy pathology confirmed endometriosis, with follow-up at 6 months revealed no evidence of malignancy in this patient. The remaining 6 patients with benign diagnoses had follow-up periods exceeding 1 year without imaging or clinical evidence of local lesion progression or malignancy. Among the 21 patients (72%, 21/29) diagnosed with malignant tumors by core needle biopsy, 14 cases were suspected cases of residual or recurrent cervical cancer, 6 cases had advanced ovarian cancer, and 1 case had rectal cancer metastasis, with all biopsy diagnoses being consistent with preoperative clinical findings and imaging results. The overall diagnostic accuracy of the core needle biopsy was 97% (28/29). Among the 7 newly diagnosed patients, the diagnostic accuracy was 7/7, while it was 95% (21/22) for the 22 follow-up patients, with no statistically significant difference observed between the two groups ( P=1.000). (3) All 29 patients with pelvic masses successfully underwent transvaginal core needle biopsy guided by vagino-recto-abdominal examination. Among them, 28 cases (97%, 28/29) reported tolerable pain during the procedure, while 1 case (3%, 1/29) experienced transient syncope at the end of the procedure due to pain, which resolved within seconds. Vaginal bleeding exceeding 50 ml occurred in 3 patients (10%, 3/29) during paracervical tissue sampling, with the maximum blood loss being 150 ml, and hemorrhage was successfully controlled using vaginal tamponade. The overall incidence of adverse events during the core needle biopsy procedure was 14% (4/29). Conclusion:Transvaginal core needle biopsy for pelvic masses guided by vagino-recto-abdominal examination is a simple, safe, and accurate diagnostic method, suitable for patients with gynecologic malignancies, non-gynecologic malignancies suspected of pelvic mass metastasis, and other benign pelvic lesions.

Objective:To explore the categories and characteristics of health behaviors of community residents in Dongfang City, Hainan Province, and to analyze the influencing factors of different categories.Methods:From March to May 2023, 795 community residents of Dongfang City were selected for the study using a simple random sampling method. General Information Questionnaire, Chinese version Short of Health Promotion Lifestyle Profile-Ⅱ, Health Conception Scale, and Self-rated Abilities for Health Practice Scale were used to conduct the survey. Cluster analysis was used to explore the health behavior categories of community residents, and a decision tree model was applied to analyze the influencing factors of different categories.Results:A total of 830 questionnaires were distributed, and 795 valid questionnaires were recovered, with a valid recovery rate of 95.78%. The health behaviors of 795 community residents in Dongfang City were divided into four categories of comprehensive behavior group (26.04%, 207/795), healthy behavior group (37.23%, 296/795), risky behavior group (18.99%, 151/795), and poor health behavior group (17.74%, 141/795). The decision tree model showed that exercise efficacy, gender, ethnicity, and clinical health concepts were the factors influencing different health behavior categories of community residents in Dongfang City ( P<0.05), with exercise efficacy being the core factor. Conclusions:There is heterogeneity in the health behavior of community residents in Dongfang City. Community healthcare workers can implement targeted health promotion measures according to the behavioral characteristics of the population.

Objective:To explore the categories and characteristics of health behaviors of community residents in Dongfang City, Hainan Province, and to analyze the influencing factors of different categories.Methods:From March to May 2023, 795 community residents of Dongfang City were selected for the study using a simple random sampling method. General Information Questionnaire, Chinese version Short of Health Promotion Lifestyle Profile-Ⅱ, Health Conception Scale, and Self-rated Abilities for Health Practice Scale were used to conduct the survey. Cluster analysis was used to explore the health behavior categories of community residents, and a decision tree model was applied to analyze the influencing factors of different categories.Results:A total of 830 questionnaires were distributed, and 795 valid questionnaires were recovered, with a valid recovery rate of 95.78%. The health behaviors of 795 community residents in Dongfang City were divided into four categories of comprehensive behavior group (26.04%, 207/795), healthy behavior group (37.23%, 296/795), risky behavior group (18.99%, 151/795), and poor health behavior group (17.74%, 141/795). The decision tree model showed that exercise efficacy, gender, ethnicity, and clinical health concepts were the factors influencing different health behavior categories of community residents in Dongfang City ( P<0.05), with exercise efficacy being the core factor. Conclusions:There is heterogeneity in the health behavior of community residents in Dongfang City. Community healthcare workers can implement targeted health promotion measures according to the behavioral characteristics of the population.

The clinical diagnosis of tubulointerstitial nephritis and uveitis (TINU) syndrome combined with Fanconi syndrome is relatively rare. The paper reports a 47-year-old female patient of TINU syndrome with hypokalemia, hypophosphatemia, hypouricemia and renal impairment as initial symptoms followed by uveitis. Serological tests showed that the patient also met the diagnostic criteria of Fanconi syndrome. Renal tissue pathology confirmed tubular interstitial injury, manifested as interstitial nephritis with acute tubular injury. Ophthalmic examination confirmed iritis in the right eye. After excluding other primary diseases, the patient was diagnosed as TINU syndrome with Fanconi syndrome. After glucocorticoid therapy, ocular symptoms, renal impairment and electrolyte disturbance were significantly improved.

Objective:To investigate the application value of metagenomics next-generation sequencing（mNGS）in the detection of pathogens and antimicrobial resistance genes in bronchoalveolar lavage fluid（BALF）of patients with severe pneumonia.Methods:Clinical data of 93 patients with severe pneumonia who underwent both BALF traditional microbial culture and mNGS testing from May 2020 to September 2021 in the intensive care unit of the Second Affiliated Hospital of Shandong First Medical University were retrospectively collected. Using traditional cultivation methods as the gold standard，analyze the sensitivity，specificity，bacterial resistance phenotype，and resistance genes of mNGS in detecting bacteria and fungi. SPSS 22.0 software was used to analyze the data.Results:The positive rate of mNGS was 84.9%（79/93），and the positive rate of traditional culture was 49.5%（46/93），and the difference was statistically significant（ χ2=26.56， P<0.01）. mNGS mixed infection detection rate was 60.2%（56/93），which was significantly higher than that of traditional culture 16.1%（15/93）（ χ2=38.29， P<0.01）. Using traditional cultivation methods as the gold standard，the sensitivity of mNGS for detecting bacteria and fungi was 97.8%（45/46），specificity was 31.0%（13/42），positive predictive value was 60.8%（45/74），and negative predictive value was 92.9%（13/14）. The consistency of the detection results between the two methods was 65.9%（58/88）. mNGS detected a total of 26 cases（28.0%）harboring resistance genes based on the mNGS results，the treatment regimen was adjusted in 50（53.8%）patients. Conclusion:The mNGS can improve the detection rate of pathogens in BALF of patients with severe pneumonia and can obtain antimicrobial drug resistance genes，which can provide the basis for clinical realization of precise antimicrobial drug-targeted therapy.

Objective:To investigate the application value of metagenomics next-generation sequencing（mNGS）in the detection of pathogens and antimicrobial resistance genes in bronchoalveolar lavage fluid（BALF）of patients with severe pneumonia.Methods:Clinical data of 93 patients with severe pneumonia who underwent both BALF traditional microbial culture and mNGS testing from May 2020 to September 2021 in the intensive care unit of the Second Affiliated Hospital of Shandong First Medical University were retrospectively collected. Using traditional cultivation methods as the gold standard，analyze the sensitivity，specificity，bacterial resistance phenotype，and resistance genes of mNGS in detecting bacteria and fungi. SPSS 22.0 software was used to analyze the data.Results:The positive rate of mNGS was 84.9%（79/93），and the positive rate of traditional culture was 49.5%（46/93），and the difference was statistically significant（ χ2=26.56， P<0.01）. mNGS mixed infection detection rate was 60.2%（56/93），which was significantly higher than that of traditional culture 16.1%（15/93）（ χ2=38.29， P<0.01）. Using traditional cultivation methods as the gold standard，the sensitivity of mNGS for detecting bacteria and fungi was 97.8%（45/46），specificity was 31.0%（13/42），positive predictive value was 60.8%（45/74），and negative predictive value was 92.9%（13/14）. The consistency of the detection results between the two methods was 65.9%（58/88）. mNGS detected a total of 26 cases（28.0%）harboring resistance genes based on the mNGS results，the treatment regimen was adjusted in 50（53.8%）patients. Conclusion:The mNGS can improve the detection rate of pathogens in BALF of patients with severe pneumonia and can obtain antimicrobial drug resistance genes，which can provide the basis for clinical realization of precise antimicrobial drug-targeted therapy.

Objective:To retrospect the blood transfusion status of patients with extensive burns in multiple centers and analyze its influencing factors.Methods:A retrospective case series study was conducted. Clinical data of 455 patients with extensive burns who met the inclusion criteria and were admitted to the burn centers of 3 hospitals from January 2016 to June 2022 were collected, including 202 patients from the First Affiliated Hospital of Nanchang University, 179 patients from the Second Affiliated Hospital of Zhejiang University School of Medicine, and 74 patients from the First Affiliated Hospital of Anhui Medical University. The following data were collected from patients during their hospitalization, including infusion of red blood cells, plasma, and platelets during hospitalization; age, gender, body mass index, combined underlying diseases, cause of injury, time of admission after injury, type of admission, total burn area, full-thickness burn area, combination of inhalation injury, combination of other trauma, and combination of pulmonary edema; the blood lactic acid, serum creatinine, total bilirubin, and albumin values within 24 h of admission; combination of bloodstream, wound, lung, and urinary tract infection, and combination of sepsis; the number of escharectomy or tangential excision and skin grafting surgery (hereinafter referred to as surgery) and total surgical blood loss volume; occurrence of hemoglobin<70 g/L, admission to intensive care unit (ICU), conduction of mechanical ventilation and continuous renal replacement therapy (CRRT), length of hospital stay, and prognosis were recorded. In 602 surgeries of patients within 14 days after injury, data including area of escharectomy or tangential excision and skin graft harvesting, duration of operation, and surgical blood loss volume per surgery, operation site, and use of tourniquet and wound graft were collected. Data were statistically analyzed with Mann-Whitney U test, Kruskal-Wallis H test, and Spearman correlation analysis. Combined with the results of single factor analysis and clinical significance, multiple linear regression analysis was performed to screen the independent influencing factors of red blood cell infusion volume and plasma infusion volume, as well as blood loss volume per surgery. Results:During the whole hospitalization period, 437 (96.0%) patients received blood transfusion therapy, including 435 (95.6%) patients, 410 (90.1%) patients, and 73 (16.0%) patients who received transfusion of plasma, red blood cells, and platelets, respectively. The patients were mainly male, aged 18 to 92 years. There were statistically significant differences in the plasma infusion volume among patients with different combination of underlying disease, combination of inhalation injury, combination of other trauma, combination of pulmonary edema, combination of bloodstream infection, combination of wound infection, combination of lung infection, combination of urinary tract infection, combination of sepsis, occurrence of hemoglobin value <70 g/L, admission to ICU, conduction of mechanical ventilation, and conduction of CRRT (with Z values of -2.06, -4.67, -2.11, -6.13, -9.56, -4.93, -8.08, -4.78, -9.12, -6.55, -9.37, -11.46, and -7.17, respectively, P<0.05). The total burn area, full-thickness burn area, blood lactic acid value within 24 h of admission, serum creatinine value within 24 h of admission, albumin value within 24 h of admission, number of surgeries, and total surgical blood loss volume were correlated with the plasma infusion volume of patients (with r values of 0.39, 0.51, 0.14, 0.28, -0.13, 0.47, and 0.56, respectively, P<0.05).There were statistically significant differences in the red blood cell infusion volume among patients with different gender, combination of inhalation injury, combination of other trauma, combination of pulmonary edema, combination of bloodstream infection, combination of wound infection, combination of lung infection, combination of urinary tract infection, combination of sepsis, occurrence of hemoglobin value <70 g/L, admission to ICU, conduction of mechanical ventilation, and conduction of CRRT (with Z values of -2.00, -4.34, -3.10, -4.22, -8.24, -7.66, -8.62, -4.75, -7.42, -9.36, -6.12, and -8.31, -6.64, respectively, P<0.05). The age, total burn area, full-thickness burn area, blood lactic acid value within 24 h of admission, serum creatinine value within 24 h of admission, total bilirubin value within 24 h of admission, number of surgeries, and total surgical blood loss volume were correlated with the red blood cell infusion volume of patients (with r values of 0.12, 0.22, 0.49, 0.09, 0.18, 0.13, -0.15, 0.69, and 0.77, respectively, P<0.05). Combined underlying diseases, full-thickness burn area, combined pulmonary edema, serum creatinine value within 24 h of admission, combined sepsis, conduction of CRRT, number of surgeries, and total surgical blood loss volume were the independent influencing factors for plasma infusion volume during hospitalization in patients with extensive burns (with standardized regression coefficients of 0.09, 0.16, 0.12, 0.07, 0.11, 0.15, 0.31, and 0.26, respectively, P<0.05). Female, full-thickness burn area, serum creatinine value within 24 h of admission, combined sepsis, occurrence of hemoglobin value <70 g/L, conduction of CRRT, and total surgical blood loss volume were the independent influencing factors for red blood cell infusion volume during hospitalization in patients with extensive burns (with standardized regression coefficients of 0.10, 0.12, 0.10, 0.11, 0.05, 0.19, and 0.54, respectively, P<0.05). There were statistically significant differences in blood loss volume per surgery of patients with different surgical site and wound graft (with Z values of -2.54 and -2.27, respectively, P<0.05). The area of escharectomy or tangential excision and skin graft harvesting and duration of operation were correlated with the blood loss volume per surgery of patients (with r values of 0.40 and 0.21, respectively, P<0.05). The area of escharectomy or tangential excision and skin graft harvesting, duration of operation, and active wound grafts were the independent influencing factors for blood loss volume per surgery of patients with extensive burns (with standardized regression coefficients of 0.41, 0.16, and 0.12, respectively, P<0.05). Conclusions:The major factors influencing blood transfusion status in patients with extensive burns are female, combined underlying diseases, full-thickness burn area, serum creatinine value within 24 h of admission, combined pulmonary edema, occurrence of hemoglobin value <70 g/L, combined sepsis, conduction of CRRT, number of surgery, and total surgical blood loss volume. In addition, the area of escharectomy or tangential excision and skin graft harvesting, duration of operation, and active wound grafts indirectly affect the patient's blood transfusion status by affecting the blood loss volume per surgery.

Objective To prepare rabbit polyclonal antibody specifically against human lactate dehydrogenase C4 (LDHC4). Methods Site-directed mutation was performed by PCR to generate the mutated LDHC gene, and the mutated gene was ligated into the pET-28a vector to form the pET-28a-LDHC recombinant expression vector. The recombinant vector was introduced into E. coli BL21 (DE3), and LDHC4 protein was obtained by induced expression. The recombinant protein was used as an antigen to immunize New Zealand rabbits, and the antiserum was obtained after three boosted immunizations. The titer of the antiserum against LDHC4 were detected by ELISA. Western blot was used to detect the specificity of the antiserum, and immunohistochemistry was used to detect the expression of LDHC4 in human triple-negative breast cancer tissue. Results A specific rabbit anti-human LDHC4 polyclonal antibody was obtained with an antibody titer of 1:51 200. The antibody can be used for Western blot and immunohistochemistry. Conclusion The specific rabbit anti-human LDHC4 polyclonal antibody is successfully prepared.
Humans ; Rabbits ; Animals ; Escherichia coli/genetics* ; Antibodies ; Enzyme-Linked Immunosorbent Assay ; L-Lactate Dehydrogenase/metabolism* ; Blotting, Western ; Antibody Specificity

Objective:To investigate the pathogen spectrum of acquired immunodeficiency syndrome (AIDS) patients with pulmonary opportunistic infections in the local area, and to evaluate the clinical application of metagenomic next-generation sequencing (mNGS) in these patients.Methods:From January to December 2021, AIDS patients with pulmonary infections admitted to Zhongnan Hospital of Wuhan University were enrolled. Their bronchoalveolar lavage fluid (BALF) was subjected to mNGS and coventional pathogen detection.Routine pathogen detection methods included smear, culture, polymerase chain reaction (PCR), and immunochromatographic colloidal gold. Fisher′s exact probability method was used for statistical analysis.Results:A total of 69 patients were included, and all of them were tested positive for mNGS. Among them, 53 cases (76.8%) were positive for fungi and viruses, 40 cases (58.0%) were positive for bacteria (excluding Mycobacterium tuberculosis (MTB) and nontuberculous mycobacteria (NTM)), six cases were positive for MTB, 11 cases were positive for NTM, and seven cases were positive for other pathogens. Mixed infections with two or more pathogens were found in 89.9%(62/69) of the patients. Among the conventional pathogen detections of BALF, 79.7%(55/69) of the patients were positive for pathogens, including 42 cases positive for Pneumocystis jirovecii PCR, 16 cases positive for BALF culture, nine cases positive for MTB PCR, and five cases positive for Cryptococcus antigen. The total detection rate of mNGS was 100.0%(69/69), which was higher than that of the conventional pathogen detection rate of 79.7%(55/69), and the difference was statistically significant (Fisher′s exact probability method, P<0.001). The specificity of mNGS detection was 88.4%. Combining clinical and two detection methods, the top five pathogens were Pneumocystis jirovecii (62.3%(43/69)), Candida (29.0%(20/69)), MTB (20.3%(14/69)), NTM and Talaromyces marneffei (15.9%(11/69), each). Fifty-three patients (76.8%) had co-infection with virus. Conclusions:The main cause of pulmonary infection in AIDS patients in this area is mixed infection, and Pneumocystis jirovecii is the most common pathogen. mNGS could significantly improve the pathogen detection rate in AIDS patients with pulmonary infections.