Objective: To delineate the epidemiologic profile of rifampicin resistant pulmonary tuberculosis (RR-PTB) among students in Chongqing, so as to provide evidence for effectively controlling RR-PTB outbreaks in schools. Methods: Individual level surveillance records of 395 student RR-PTB cases reported from 2015 to 2024 were extracted from the China Information System for Disease Control and Prevention. The Joinpoint regression analysis was employed to quantify temporal trends in the registration rate of student RR-PTB cases, and the comparison of RR-PTB registration rates with different demographic characteristics and different regions was performed using Chi-square test. Results: From 2015 to 2024, a total of 395 student RR-PTB cases were identified, with the registration rate ranged from 0.07 per 100 000 to 1.47 per 100 000, showed a fluctuating upward trend ( AAPC= 35.22%, t =4.13, P <0.01). A turning point was detected in 2017, rates rose during 2015-2017 (APC=295.23%， t =4.62， P < 0.01 ) and plateaued thereafter (APC=-0.47%， t =-0.12， P =0.91). The proportion of RR-PTB cases occurring among students increased both among all RR-PTB cases (1.54% in 2015, 7.48% in 2024) and all student pulmonary tuberculosis cases (0.20% in 2015, 7.17% in 2024), with significant linear trends ( χ 2 trend =33.55,159.98, both P <0.01). The majority of cases were enrolled in senior high school (50.38%), classified as retreatment (53.92%), of Han ethnicity (75.95%), and diagnosed with multidrug resistant tuberculosis(53.16%). There were significant differences in the composition of different ethnicity, registration category and resistance pattern between different years( χ 2=23.47, 17.23, 59.64，all P <0.05). The South-Eastern Wuling Mountainous Region exhibited the highest notification rate (3.96 per 100 000), whereas the western region had the lowest rate ( 0.47 per 100 000). County level jurisdictions reported higher rates than district level ones (2.16 per 100 000 vs 0.63 per 100 000 ). Statistically significant differences were observed in the RR-PTB reported rates among students across different districts and counties( χ 2=418.05,167.05,both P <0.01). Conclusions From 2015 to 2024, the registration rate of detected student RR-PTB cases in Chongqing showed an increasing trend. Students have become one of the key populations for drug resistant TB prevention and control. Intensified health education and active case finding should be implemented to enhance proactive surveillance capabilities.

Objective To study the relationship between irisin and the risk of sarcopenia in elderly patients with hyperhomocysteine-mia of different genders.Methods A retrospective study was conducted on 180 elderly patients with hyperhomocysteinemia who were ad-mitted to the Geriatrics Department of the First Hospital of Lanzhou University between January 2021 and January 2023.The study partici-pants were categorized into the male sarcopenia group(n=43)and the male non-sarcopenia group(n=57),the female sarcopenia group(n=44),and the female non-sarcopenia group(n=36)according to the《2019 Consensus Update on the Diagnosis and Treat-ment of Sarcopenia》.Serum irisin levels were measured by enzyme-linked immunosorbent assay,and the clinical data of patients in sar-copenia and non-sarcopenia groups were compared under different genders.Serum irisin concentrations were grouped into quartiles,and the differences in the indicators related to sarcopenia[appendicular skeletal muscle mass index(ASMI),grip strength,and step speed]were statistically assessed among the four groups using analysis of ANOVA or the Kruskal-Wallis test.Multifactorial Logistic regression a-nalysis was used to evaluate the influencing factors of sarcopenia in elderly patients with hyperhomocysteinemia of different genders.Results Among elderly male patients,there were statistically significant differences in age,irisin,hemoglobin,total protein,albumin,triglycerides,High-density lipoprotein cholesterol,ASMI and percent body fat between the sarcopenia group and the non-sarcopenia group(P＜0.05).Among elderly female patients,there were statistically significant differences in irisin,C-reactive protein,platelets count,uric acid,ASMI and percent body fat between the sarcopenia group and the non-sarcopenia group(P＜0.05).After statistical a-nalysis,it was found that the ASMI was significantly different between the irisin quartile groups of elderly male patients with hyperhomo-cysteinemia(P＜0.001);grip strength and step speed were significantly different between the irisin quartile groups of elderly female pa-tients with hyperhomocysteinemia(P=0.016,0.020).Multiple Logistic regression analysis showed that serum irisin(OR=0.951,95％CI:0.905-0.999)and percent body fat(OR=0.741,95％CI:0.641-0.857)were independent influences on the development of sarcopenia in elderly male patients with hyperhomocysteinemia(P＜0.05).Serum irisin(OR=0.942,95％CI:0.892-0.994),per-cent body fat(OR=0.698,95％CI:0.576-0.846),and platelet count(OR=1.013,95％CI:1.002-1.024)were independent influencing factors for sarcopenia in the elderly female patients with hyperhomocysteinemia(P＜0.05).Conclusion Elevated serum iri-sin and body fat percentage are independent protective factors against sarcopenia in elderly male and female patients with hyperhomocys-teinemia;elevated platelet count is an independent risk factor for sarcopenia in elderly female patients with hyperhomocysteinemia.

Objective To study the relationship between irisin and the risk of sarcopenia in elderly patients with hyperhomocysteine-mia of different genders.Methods A retrospective study was conducted on 180 elderly patients with hyperhomocysteinemia who were ad-mitted to the Geriatrics Department of the First Hospital of Lanzhou University between January 2021 and January 2023.The study partici-pants were categorized into the male sarcopenia group(n=43)and the male non-sarcopenia group(n=57),the female sarcopenia group(n=44),and the female non-sarcopenia group(n=36)according to the《2019 Consensus Update on the Diagnosis and Treat-ment of Sarcopenia》.Serum irisin levels were measured by enzyme-linked immunosorbent assay,and the clinical data of patients in sar-copenia and non-sarcopenia groups were compared under different genders.Serum irisin concentrations were grouped into quartiles,and the differences in the indicators related to sarcopenia[appendicular skeletal muscle mass index(ASMI),grip strength,and step speed]were statistically assessed among the four groups using analysis of ANOVA or the Kruskal-Wallis test.Multifactorial Logistic regression a-nalysis was used to evaluate the influencing factors of sarcopenia in elderly patients with hyperhomocysteinemia of different genders.Results Among elderly male patients,there were statistically significant differences in age,irisin,hemoglobin,total protein,albumin,triglycerides,High-density lipoprotein cholesterol,ASMI and percent body fat between the sarcopenia group and the non-sarcopenia group(P＜0.05).Among elderly female patients,there were statistically significant differences in irisin,C-reactive protein,platelets count,uric acid,ASMI and percent body fat between the sarcopenia group and the non-sarcopenia group(P＜0.05).After statistical a-nalysis,it was found that the ASMI was significantly different between the irisin quartile groups of elderly male patients with hyperhomo-cysteinemia(P＜0.001);grip strength and step speed were significantly different between the irisin quartile groups of elderly female pa-tients with hyperhomocysteinemia(P=0.016,0.020).Multiple Logistic regression analysis showed that serum irisin(OR=0.951,95％CI:0.905-0.999)and percent body fat(OR=0.741,95％CI:0.641-0.857)were independent influences on the development of sarcopenia in elderly male patients with hyperhomocysteinemia(P＜0.05).Serum irisin(OR=0.942,95％CI:0.892-0.994),per-cent body fat(OR=0.698,95％CI:0.576-0.846),and platelet count(OR=1.013,95％CI:1.002-1.024)were independent influencing factors for sarcopenia in the elderly female patients with hyperhomocysteinemia(P＜0.05).Conclusion Elevated serum iri-sin and body fat percentage are independent protective factors against sarcopenia in elderly male and female patients with hyperhomocys-teinemia;elevated platelet count is an independent risk factor for sarcopenia in elderly female patients with hyperhomocysteinemia.

Objective:To explore the diagnostic value of ultrasound combined with tumor markers carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) for peritoneal metastasis of gastrointestinal adenocarcinoma.Methods:A retrospective case series study was conducted. A total of 140 patients with gastrointestinal adenocarcinoma who were admitted to Shanxi Province Cancer Hospital from August 2021 to January 2023 were collected. Preoperative diagnosis of peritoneal metastasis was performed using tumor markers CEA and CA199 (tumor marker method) and ultrasound combined with CEA and CA199 (combined method). Using postoperative pathological results as the gold standard, the detection rate and diagnostic efficacy of the two methods for peritoneal metastasis in patients were compared.Results:Among 140 patients, there were 78 males and 62 females; the age was (59±5) years old; there were 40 cases of gastric cancer and 100 cases of colorectal cancer; pathological staging: 4 cases in stage Ⅰ, 36 cases in stage Ⅱ, 52 cases in stage Ⅲ, and 48 cases in stage Ⅳ. All patients underwent radical resection surgery, and postoperative pathological results showed that 32 cases (22.86%) had peritoneal metastasis. The detection rate of combined method for peritoneal metastasis of gastrointestinal adenocarcinoma was higher than that of tumor marker method [96.88% (31/32) vs. 78.13% (25/32)], but the difference was not statistically significant ( χ2 = 5.14, P = 0.059). The sensitivity of tumor marker method for diagnosing peritoneal metastasis of gastrointestinal adenocarcinoma was 64.00%, the specificity was 86.09%, the positive predictive value was 50.00%, the negative predictive value was 91.67%, the Kappa value was 0.379, and the area under the curve (AUC) was 0.793. The sensitivity of combined method for diagnosing peritoneal metastasis of gastrointestinal adenocarcinoma was 77.42%, the specificity was 92.66%, the positive predictive value was 75.00%, the negative predictive value was 93.52%, the Kappa value was 0.905, and the AUC was 0.985. The sensitivity and positive predictive value of combined method for diagnosing peritoneal metastasis of gastrointestinal adenocarcinoma were higher than those of tumor marker method, and the differences were statistically significant ( χ2 values were 4.06 and 13.33, both P < 0.05). Conclusions:Ultrasound combined with serum tumor markers CEA and CA199 has high diagnostic value for peritoneal metastasis of gastrointestinal adenocarcinoma.

Objective To determine the infectiousness of the respiratory syncytial virus(RSV)18537 strain of subtype B in different host cell lines and evaluate its pathogenicity and pathological damage in various animal models.Methods The cytopathic features,viral plaque morphology,viral protein expression,and in vitro proliferation efficiency were assessed to determine the basic biological characteristics of such infections.Nasal drops were used to infect 10-month-old BALB/c mice and 6-week-old cotton mice.The viral load in lung tissue after infection was detected,and the pathological injury was analyzed to assess the pathogenicity.Results The RSV 18537 strain of subtype B strain induced polynuclear fusion in Hep-2 cells,and typical viral plaques were formed in BHK-21 cells.In addition,viral proteins could be detected in Hep-2 and A549 cells.In BALB/c and cotton mice infected with nasal drops,viral nucleic acids were detectable in lung tissue on day 5 post-infection.This dose caused mild thickening of alveolar walls with scattered lymphocytes and neutrophil infiltration.Conclusion The RSV 18537 strain of subtype B can be effectively proliferated in Hep-2 and A549 cells while infecting BALB/c mice and cotton mice,resulting in pathological injury to lung tissue.The 18537 strain of RSV subtype B is less contagious than the A2 strain of subtype A both in cells and animals.

As the state vigorously promotes the high-quality development of hospitals and improves people's medical ex-perience,the patient-centered hospital should make full use of technological resources such as the Internet,5 G and artificial in-telligence,vigorously develop mobile medical services and artificial intelligence services,transform and optimize the diagnosis and treatment process,and streamline all links before,during and after diagnosis so as to provide better data services to the pa-tient to ensure that they can get things done with greater ease.The patients'medical experience and hospital management effi-ciency can be greatly improved.In this study,specific measures to create a new diagnosis and treatment model through the con-struction of smart hospital platform were expounded in order to provide references for related research and policy formulation of other Chinese medical institutions.

Objective:To compare the prognostic values of different classification by using transpulmonary pressure gradient (TPG), diastolic pressure gradient (DPG) and pulmonary vascular resistance (PVR) in patients with pulmonary hypertension due to left heart disease (PH-LHD), and investigated hemodynamic and clinical factors associated with mortality in patients with PH-LHD.Methods:This was a single-center prospective cohort study. In-hospital patients diagnosed with PH-LHD via right heart catheterization at the Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, from September 2013 to December 2019 were enrolled. Patients were divided according to TPG (cutoff value 12 mmHg; 1 mmHg=0.133 kPa), DPG (cutoff value 7 mmHg), PVR (cutoff value 3 Wood Units), and the combination of TPG and PVR. Baseline characteristic was recorded. All patients were followed up until the occurrence of endpoint event, defined as all-cause death that occurred during the follow-up period, or until April 18, 2022. Receiver operating characteristic curves were used to compare the predictive value of 3 classification methods for all-cause death in PH-LHD patients. The optimal cutoff values were calculated using Jorden index. Survival analysis was performed using Kaplan-Meier analysis, and log-rank test was used to compare the predictive efficacy of classification methods based on optimal cutoff values or guidance-recommended thresholds for the survival of PH-LHD patients. Variables showing statistical significance in the univariate analysis were incorporated into multivariate Cox regression model to analyze the independent risk factors for all-cause mortality.Results:A total of 243 patients were enrolled, aged (54.9±12.7) years old, including 169 (69.5%) males. During a median follow-up of 57 months, there were 101 (41.6%) deaths occurred. Grouping results were as follows: (1) TPG: TPG≤12 mmHg group 115 patients, TPG>12 mmHg group 128 patients; (2) DPG: DPG<7 mmHg group 193 patients, DPG≥7 mmHg group 50 patients; (3) PVR: PVR≤3 Wood Units group 108 patients, PVR>3 Wood Units group 135 patients; (4) TPG and PVR: TPG≤12 mmHg and PVR≤3 Wood Units group 89 patients, TPG>12 mmHg and PVR>3 Wood Units group 109 patients. PVR ( AUC=0. 698,95% CI:0.631-0.766) had better predictive value for all-cause mortality than TPG ( AUC=0.596, 95% CI: 0.523-0.669) and DPG ( AUC=0.526, 95% CI: 0.452-0.601) (all P<0.05). The optimal cutoff values for TPG, DPG, and PVR were13.9 mmHg, 2.8 mmHg, and 3.8 Wood Units, respectively. Kaplan-Meier analysis based on the optimal cutoff values or guidance-recommended thresholds showed that PVR and TPG were the predictors of survival ( P<0.05), while DPG did not showed significance ( P>0.05). Multivariate Cox regression analysis showed that age, PVR and log 2N-terminal pro-B-type natriuretic peptide were independent risk factors for all-cause mortality in PH-LHD patients (all P<0.05). Conclusion:Classification according to PVR was most valuable in predicting all-cause death in PH-LHD patients, while TPG showed moderate predictive ability and DPG had no predictive value.

Objective:To explore the diagnostic value of ultrasound combined with tumor markers carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) for peritoneal metastasis of gastrointestinal adenocarcinoma.Methods:A retrospective case series study was conducted. A total of 140 patients with gastrointestinal adenocarcinoma who were admitted to Shanxi Province Cancer Hospital from August 2021 to January 2023 were collected. Preoperative diagnosis of peritoneal metastasis was performed using tumor markers CEA and CA199 (tumor marker method) and ultrasound combined with CEA and CA199 (combined method). Using postoperative pathological results as the gold standard, the detection rate and diagnostic efficacy of the two methods for peritoneal metastasis in patients were compared.Results:Among 140 patients, there were 78 males and 62 females; the age was (59±5) years old; there were 40 cases of gastric cancer and 100 cases of colorectal cancer; pathological staging: 4 cases in stage Ⅰ, 36 cases in stage Ⅱ, 52 cases in stage Ⅲ, and 48 cases in stage Ⅳ. All patients underwent radical resection surgery, and postoperative pathological results showed that 32 cases (22.86%) had peritoneal metastasis. The detection rate of combined method for peritoneal metastasis of gastrointestinal adenocarcinoma was higher than that of tumor marker method [96.88% (31/32) vs. 78.13% (25/32)], but the difference was not statistically significant ( χ2 = 5.14, P = 0.059). The sensitivity of tumor marker method for diagnosing peritoneal metastasis of gastrointestinal adenocarcinoma was 64.00%, the specificity was 86.09%, the positive predictive value was 50.00%, the negative predictive value was 91.67%, the Kappa value was 0.379, and the area under the curve (AUC) was 0.793. The sensitivity of combined method for diagnosing peritoneal metastasis of gastrointestinal adenocarcinoma was 77.42%, the specificity was 92.66%, the positive predictive value was 75.00%, the negative predictive value was 93.52%, the Kappa value was 0.905, and the AUC was 0.985. The sensitivity and positive predictive value of combined method for diagnosing peritoneal metastasis of gastrointestinal adenocarcinoma were higher than those of tumor marker method, and the differences were statistically significant ( χ2 values were 4.06 and 13.33, both P < 0.05). Conclusions:Ultrasound combined with serum tumor markers CEA and CA199 has high diagnostic value for peritoneal metastasis of gastrointestinal adenocarcinoma.

ObjectiveTo explore the effects of different intensity of wearable lower limb rehabilitation robot-assisted training on walking function, lower limb motor function, balance function and functional independence of stroke patients. MethodsFrom November, 2021 to December, 2022, 60 stroke patients hospitalized in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), observation group 1 (n = 20) and observation group 2 (n = 20). All the groups received routine rehabilitation, while the control group received routine walking training 30 minutes a day, the observation group 1 received wearable lower limb rehabilitation robot-assisted training 30 minutes a day, and the observation group 2 received wearable lower limb rehabilitation robot-assisted training 60 minutes a day, for four weeks. They were assessed with Functional Ambulation Category scale (FAC), Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Berg Balance Scale (BBS) and Rivermead Mobility Index (RMI) before and after treatment. ResultsOne case in the observation group 1 and three cases in the observation group 2 dropped down. The FAC, FMA-LE, BBS and RMI scores improved in all the three groups after treatment (|Z| > 3.448, |t| > 8.102, P < 0.001), and there was no significant difference in all the indexes among the three groups (|H| < 4.643, F = 1.454, P > 0.05); however, the improvement of BBS score was more in the observation group 1 than in the control group (P < 0.05), and the improvement of all the indexes was more in the observation group 2 than in the control group (P < 0.05). ConclusionThe wearable lower limb rehabilitation robot-assisted training may promote the recovery of walking function, lower limb motor function, balance function and functional independence of stroke patients, and high-intensity training seems to be more effective.

Objective: To investigate the effect of berberine (BBR) on the proliferation and autophagy of mesangial cells in high glucose (HG) environment and the specific molecular mechanism． Methods: Mesangium cells at exponential growth stage were divided into the following groups : normal group，high glucose group，high glucose + BBR treatment group (30，60 and 90 μmol / L) ，high glucose + BBR (90 μmol / L) + AMPK inhibitor Compound C group ( CC group) ; the number of mesangial cells was calculated by high content cell imager．The expressions of type Ⅳ collagen ( Col-Ⅳ) ，fibronectin (FN) and microtubule-associated protein 1 light chain 3B (LC3B) in mesangial cells were detected by immunofluorescence assay．The protein expression levels of LC3B，Beclin-1， p62，Col-Ⅳ , FN and silencing regulatory factor 1 (SIRT1) / adenylate activated protein kinase (AMPK) signaling pathway were detected by Western blot. Results: Compared with the normal group ，high content cell imaging showed abnormal proliferation of mesangial cells in the hyperglycemic group．The results of immunofluorescence and Western blot showed that the expression levels of Col-Ⅳ and FN deposited in mesangial extracellular matrix increased in the high glucose group．The results of Western blot showed that the protein expressions of SIRT1，p- AMPK，LC3B and Beclin-1 decreased，while the protein expressions of p-p65 and p62 increased．BBR inhibited the abnormal proliferation of mesangial cells induced by high glucose．BBR could reduce the expression levels of Col-Ⅳ and FN deposited in mesangial extracellular matrix． BBR could increase the expressions of SIRT1 ，p- AMPK，LC3B and Beclin-1 proteins in mesangial cells，while decrease the expressions of p-p65 and p62 proteins. CC group weakened the inhibition of mesangial cell proliferation and autophagy by high dose BBR. Conclusion Berberine can effectively inhibit the proliferation of mesangial cells induced by high glucose and increase the level of autophagy，which may be related to SIRT1 / AMPK signaling pathway.