Objective:To analyze the predictive value of the prognostic nutritional index combined with inflammatory indicators for clinical outcomes in patients with ischemic stroke, providing a basis for targeted therapeutic interventions and nursing care for patients at potential risk of poor outcomes.Methods:This retrospective cohort study recruited 424 ischemic stroke patients admitted to the Stroke Center of the First Hospital of Jilin University from June 2021 to May 2024 by the convenience sampling method. Collect the general demographic data, routine laboratory examination results within 24 hours of admission, as well as the National Institutes of Health Stroke Scale (NIHSS) scores at admission and discharge of the patients. Based on 3-month functional outcomes, patients were divided into a favorable prognosis group and a poor prognosis group. Univariate analysis, least absolute shrinkage and selection operator regression, and binary Logistic regression were employed to screen predictive variables and develop a nomogram model. Internal validation was performed using the Bootstrap method. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve were drew to evaluate the predictive performance of the model.Results:The favorable prognosis group comprised 256 patients, including 57 females and 199 males, with an age of 61(54, 68) years. The poor prognosis group included 168 patients, with 55 females and 113 males, and an age of 66(58, 72) years. Binary Logistic regression identified age, sex, hyperlipidemia, NIHSS score at discharge, prognostic nutritional index, systemic inflammatory response index, and systemic immune-inflammation index as independent predictors of prognosis in ischemic stroke patients ( χ2 values were 4.52-56.18, all P<0.05). The prediction model demonstrated the area under the curve of ROC of 0.806 (95% CI 0.764-0.849), with an optimal cutoff value of 0.406, achieving specificity of 78% and sensitivity of 68%. The Hosmer-Lemeshow test yielded a non-significant P>0.05, and the calibration curve showed good agreement between predicted and observed outcomes, with a mean absolute error of 0.012. Decision curve analysis confirmed the clinical utility of the model across a wide range of threshold probabilities. Conclusions:The integrated prognostic model combining the prognostic nutritional index and inflammatory indicators demonstrated favorable discriminative ability, robust calibration, and substantial clinical utility. This risk stratification tool shows high applicability for predicting ischemic stroke outcomes, facilitating early identification of high-risk patients with poor prognosis and guiding personalized intervention strategies.

Objective To investigate the distribution of Streptococcus,sensitivity to commonly used antibiotics,and prognosis of the patients with bloodstream infections,and provide evidence for early diagnosis and selection of antibiotics.Methods The Streptococci i-solated from the blood samples of the First Affiliated Hospital of Nanjing Medical University from 2017 to 2022 were collected and di-vided into α-and β-hemolytic Streptococci according to the type of hemolysis.Their sensitivity to commonly used antibiotics was ana-lyzed.The differences in clinical data and prognosis between the two groups were also compared.Results A total of 314 strains of Streptococcus were isolated from 305 patients,including 270 strains of α-hemolytic Streptococcus and 44 β-hemolytic Streptococcus.The results of the drug sensitivity test showed that the proportion of Streptococcus strains with a diameter of 17-19 mm in the inhibition zone of vancomycin increased year by year.The positive alarm time of blood culture for β-hemolytic Streptococcus was significantly shorter than that for α-hemolytic Streptococcus(P＜0.001).Using 10.5 hours as the diagnostic threshold could assist in distinguishing blood-stream infections caused by α-and β-hemolytic Streptococcus.The overall mortality rate of patients with streptococcal bloodstream infec-tion was 15.1％,and there was no statistically significant difference in the mortality rate between the two groups(P=0.813).Conclu-sion The main Streptococcus causing bloodstream infections in our hospital is α-hemolytic Streptococcus.There are differences in the antimicrobial sensitivity and clinical characteristics among patients with different streptococcal bloodstream infections.The positive a-larm time of blood culture can assist in distinguishing the type of streptococcal bloodstream infections.In addition,the diameter of the inhibition zone of vancomycin against Streptococcus has drifted towards the breakpoint of drug resistance.

Objective:To analyze the predictive value of the prognostic nutritional index combined with inflammatory indicators for clinical outcomes in patients with ischemic stroke, providing a basis for targeted therapeutic interventions and nursing care for patients at potential risk of poor outcomes.Methods:This retrospective cohort study recruited 424 ischemic stroke patients admitted to the Stroke Center of the First Hospital of Jilin University from June 2021 to May 2024 by the convenience sampling method. Collect the general demographic data, routine laboratory examination results within 24 hours of admission, as well as the National Institutes of Health Stroke Scale (NIHSS) scores at admission and discharge of the patients. Based on 3-month functional outcomes, patients were divided into a favorable prognosis group and a poor prognosis group. Univariate analysis, least absolute shrinkage and selection operator regression, and binary Logistic regression were employed to screen predictive variables and develop a nomogram model. Internal validation was performed using the Bootstrap method. The receiver operating characteristic (ROC) curve, calibration curve, and decision curve were drew to evaluate the predictive performance of the model.Results:The favorable prognosis group comprised 256 patients, including 57 females and 199 males, with an age of 61(54, 68) years. The poor prognosis group included 168 patients, with 55 females and 113 males, and an age of 66(58, 72) years. Binary Logistic regression identified age, sex, hyperlipidemia, NIHSS score at discharge, prognostic nutritional index, systemic inflammatory response index, and systemic immune-inflammation index as independent predictors of prognosis in ischemic stroke patients ( χ2 values were 4.52-56.18, all P<0.05). The prediction model demonstrated the area under the curve of ROC of 0.806 (95% CI 0.764-0.849), with an optimal cutoff value of 0.406, achieving specificity of 78% and sensitivity of 68%. The Hosmer-Lemeshow test yielded a non-significant P>0.05, and the calibration curve showed good agreement between predicted and observed outcomes, with a mean absolute error of 0.012. Decision curve analysis confirmed the clinical utility of the model across a wide range of threshold probabilities. Conclusions:The integrated prognostic model combining the prognostic nutritional index and inflammatory indicators demonstrated favorable discriminative ability, robust calibration, and substantial clinical utility. This risk stratification tool shows high applicability for predicting ischemic stroke outcomes, facilitating early identification of high-risk patients with poor prognosis and guiding personalized intervention strategies.

Objective To investigate the distribution of Streptococcus,sensitivity to commonly used antibiotics,and prognosis of the patients with bloodstream infections,and provide evidence for early diagnosis and selection of antibiotics.Methods The Streptococci i-solated from the blood samples of the First Affiliated Hospital of Nanjing Medical University from 2017 to 2022 were collected and di-vided into α-and β-hemolytic Streptococci according to the type of hemolysis.Their sensitivity to commonly used antibiotics was ana-lyzed.The differences in clinical data and prognosis between the two groups were also compared.Results A total of 314 strains of Streptococcus were isolated from 305 patients,including 270 strains of α-hemolytic Streptococcus and 44 β-hemolytic Streptococcus.The results of the drug sensitivity test showed that the proportion of Streptococcus strains with a diameter of 17-19 mm in the inhibition zone of vancomycin increased year by year.The positive alarm time of blood culture for β-hemolytic Streptococcus was significantly shorter than that for α-hemolytic Streptococcus(P＜0.001).Using 10.5 hours as the diagnostic threshold could assist in distinguishing blood-stream infections caused by α-and β-hemolytic Streptococcus.The overall mortality rate of patients with streptococcal bloodstream infec-tion was 15.1％,and there was no statistically significant difference in the mortality rate between the two groups(P=0.813).Conclu-sion The main Streptococcus causing bloodstream infections in our hospital is α-hemolytic Streptococcus.There are differences in the antimicrobial sensitivity and clinical characteristics among patients with different streptococcal bloodstream infections.The positive a-larm time of blood culture can assist in distinguishing the type of streptococcal bloodstream infections.In addition,the diameter of the inhibition zone of vancomycin against Streptococcus has drifted towards the breakpoint of drug resistance.

Objective:To analyze the clinical characteristics and predictive factors of SSc associated heart disease.Methods:The clinical data of patients with SSc from January 2016 to December 2021 in Ningbo Medical Center Lihuili Hospital were collected. Aight healthy controls come from the medicial examination center. They were divided into a positive group and a negative group based on whether heart involvement was present or not. The clinical manifestations of the two groups were compared by t test, Wilcoxon signed rank test and χ2 test and Logistic regression or ROC curve was used to analyze the prognostic risk of SSc associated heart disease. Then the transcriptome sequencing was used to analyze the differential gene expression. Results:①A total of 75 SSc patients were treated in our hospital, of which 6 patients with overlap syndrome and 1 patient with congenital heart disease were excluded. The clinical data of 68 patients were analyzed including 16 patients in the positive group and 52 patients in the negative group. Among the 16 patients with cardiac involvement, 12 patients (75.0%) had abnormal electrocardiogram, 9 patients (56.2%) with heart valve disease, 8 patients (50.0%) with abnormal cardiac structure and 8 patients (50.0%) with pericardial effusion. The biomarkers were elevated in 10 cases (83.3%). ②Univariate analysis showed that the positive group had a longer course of disease [120(11.2, 132) months vs 48(24, 90)months, Z=-2.08, P=0.037], and the rate of pulmonary arterial hypertension (50.0% vs 11.5%, χ2=11.07, P<0.001) and renal insufficiency(50.0% vs 3.8%, χ2=20.78, P<0.001) in the positive group were significantly higher than those in the negative group. Further Logistic regression analysis revealed that long course of disease [ OR (95% CI) =1.011 (1.001, 1.021), P=0.031], pulmonary arterial hypertension [ OR (95% CI) =5.431, 95% CI (1.065, 27.710), P=0.042] and renal insufficiency [ OR (95% CI) =30.444 (4.139, 223.938), P<0.001] were risk factors for SSc associated heart disease. ③Nail-fold videocapillaroscopy (NVC) was checked in 63 patients. The difference of abnormal NVC changes between the two groups was statistically significant (93.3% vs 58.3%, χ2=5.87, P=0.013). The total number of capillaries in the positive group was significantly less than that in the negative group [3.5(2, 4.8) vs 6 (5, 7), Z=-2.97, P=0.003]. Further ROC curve analysis showed that the total number of capillaries less than 4.5 predicted the occurrence of cardiac involvement (sensitivity was 80.0%, specificity was 83.8%), and the area under the ROC curve (95% CI) was 0.805 (0.061, 1.000, P=0.003).④The transcriptome of a total of 11 SSc patients (including 6 in the positive group and 5 in the negative group) and 8 healthy controls were analyzed to obtain the synchronously down regulated gene TNFRSF13B. The differences between the three groups were statistically significant ( χ2=11.88, P=0.003), especially in the positive group and the healthy controls( χ2=11.19, P=0.004). Conclusion:SSc patients with long course of disease accompanied by PAH and renal insufficiency are prone to have heart involvement. Early capillary endoscopy is also helpful to predict the risk of heart involvement. Moreover, TNFRSF13B genetic testing is helpful but further study is needed.

Objective To investigate the undergraduates′cognition ,attitude and behavior about low‐carbon life and then to provide a relatively scientifically strategy .and provide scientific basis to formulate countermeasures about undergraduates′low‐car‐bon lifestyle .Methods By multistage sampling ,382 students′knowledge ,attitude and practice about low‐carbon life in Wuhan Uni‐versity of science and technology were analyzed .Results The students′cognition about low‐carbon life was good ,the awareness rate of girl was higher than that of boy ;Their attitude was positive ,grade and knowledge awareness were the two influence factors ;the behavior situation was unsatisfactory ,the origin of students and attitude enthusiasm were the elements affect rationality of be‐havior .Conclusion Undergraduates should strengthen the cognition of low‐carbon life ,improve attitude enthusiasm ,and form a good behavioral habit of low‐carbon life .

Objective To detect the levels of eosinophil and eotaxin in the children with virus associated wheezing diseases,and explore the role of both in virus correlation breathing occurrence and development.Methods Sixty-eight cases of children with virus associated wheezing diseases were selected as observation group,and the other 42 cases of healthy children were selected as control group.The peripheral eosinophil count and serum eotaxin level were detected and compared in observation group and control group on the acute stage and recovery stage.Results The eosinophil count in observation group on the acute stage was (1.12 ± 0.62) × 1099/L,the recovery stage was (0.34 ± 0.13) × 109/L,control group was (0.16 ± 0.07) ×109/L,the eosinophil count in observation group on the acute stage was higher than that on the recovery stage and control group,the eosinophil count in observation group on the recovery stage was higher than that in control group,there were statistically significant differences (P ＜ 0.05).The eotaxin level in observation group on the acute stage was (437.2 ±87.6) ng/L,the recovery stage was (182.4 ±56.2) ng/L,control group was (84.1 ± 39.7) ng/L,the eotaxin level in observation group on the acute stage was higher than that on the recovery stage and control group,the eotaxin level in observation group on the recovery stage was higher than that in control group,there were statistically significant differences (P ＜0.05).There were positively correlated between the eosinophil count and the eotaxin level in observation group on the acute stage,recovery stage and control group (r =0.579,0.593,0.581,P＜ 0.05).Conclusions The eosinophils and eotaxin may be involved in the children with virus associated wheezing diseases pathophysiological process,the levels of the eosinophils and eotaxin can monitor the course change,and be helpful for clinical diagnosis and treatment.

Objective To investigate the association of urinary albumin-to-creatinine ratio (UACR) and the diameter of retinal vessel in population with essential hypertension in Fujian coastal area.Methods Central retinal artery and vein equivalents (CRAE and CRVE) were measured from the avoiding mydriatic digitized photographs and semi-automatic fundus analysis software,as well as albumin and urine creatinine.Results There were significant differences in CRAE levels among the normal control group,normoalbuminuria with essential hypertension group and microalbuminuria with essential hypertension group [(135.68 ± 10.10) μm,(129.79 ± 10.48) μm,(125.29 ± 11.17) μm,all P values ＜0.01].The CRAE levels were significantly negative correlated with UACR (r =-0.29,P ＜ 0.01).Linear regression analysis showed CRAE was associated with UACR in the patients with hypertension(β =-5.0,P ＜ 0.01).Logistic regression analysis showed,systolic blood pressure (β =1.08,P =0.02) was risk factor for CRAE abnormality.The CRAE abnormality was increased in turn in the normal control group,normoalbuminuria with the essential hypertension group and microalbuminuria with essential hypertension group (P ＜ 0.01).Conclusion The reduction of central retinal artery diameter are associated with the hypertensive renal damage.UACR and CRAE could be used to evaluate the microvascular lesions and be used as an indicator to assess the target organs damage in essential hypertension patients.

Objective To investigate the expression of serum vascular endothelial growth factor (VEGF) in children with Wilms tumor,and clarify the effect of VEGF in the invasion and progression of Wilms tumor.Methods Thirty children with Wilms tumor who underwent surgical treatment were retrospectively analyzed as Wilms tumor group,the control group was 30 children who underwent treatment by cold and fever symptoms.The serum VEGF levels of 2 groups were detected by enzyme-linked immunosorbent assay.Results The serum VEGF level of Wilms tumor group was significantly higher than that of control group [(567.90 ± 189.30) ng/L vs.(55.46 ± 18.49) ng/L,t =14.757,P ＜0.05].The expression of serum VEGF was closely related to NWTS stage,prognosis tissue type and lymph node metastasis (P ＜ 0.01).The expressions of serum VEGF in the NWTS Ⅲ-Ⅳ stage,lymph node metastasis and poor prognosis tissue type Wilms tumor were significantly higher than those of NWTS Ⅰ-Ⅱ stage,without lymph node metastasis,good prognosis tissue type Wilms tumor (P＜ 0.01).Conclusions The expression of serum VEGF is high in children with Wilms tumor,the serum VEGF level is closely related to NWTS stage,prognosis tissue type and lymph node metastasis.The high expression of serum VEGF shows the invasion,progression and poor prognosis in children with Wilms tumor.

Objective To analyze the serumα1-antitrypsin (α1-AT) and α1-glycoprotein (α 1-AGP) in children with Wilms tumor,and to explore the clinical application value.Methods Thirtyeight children with Wilms tumor who received treatment from January 2007 to December 2010 were designed as observation group,38 healthy children were designed as control group.Fluorescence quantitative PCR was performed to analyze α 1-AT andα 1-AGP mRNA transcription levels of two groups,and ELISA was used to measure the serum concentration of α 1-AT and α 1-AGP.Results The mRNA levels of α 1-AT and α 1-AGP in observation group were 3.50 ± 0.37 and 2.10 ± 0.41,which were significantly higher than those in control group (0.90 ± 0.45,0.50 ± 0.24) (P =0.000,0.002).The levels of α 1-AT and α 1-AGP in observation group were (4516.8 ± 102.4),(1316.0 ± 27.3) g/L,which were significantly higher than those in control group [(2467.4 ± 23.8),(728.6 ± 9.4) g/L] (P =0.015,0.008).Conclusion To detect the levels of α 1-AT and α 1-AGP have the potential value for the diagnosis of Wilms tumor,which can be applied to early screening.