This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.

Objective To observe the effects of asiaticoside on renal fibrosis in diabetic nephropathy(DN)rats by regulating the Hippo-yes-associated protein(YAP)/transcriptional co-activator with PDZ-binding motif(TAZ)signaling pathway.Methods A DN rat model was established by feeding a high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin(STZ).The successfully modeled rats were randomly divided into model group,low-and high-dose asiaticoside groups,and high-dose asiaticoside+XMU-MP-1(Hippo-YAP/TAZ pathway activator)group,with a normal group set as control.After group intervention,blood urea nitrogen(BUN),serum creatinine(SCr),fasting blood glucose(FBG),and 24-hour urinary protein levels were measured.Hematoxylin-eosin(HE)staining was used to observe renal histopathological changes,Masson staining was used to assess renal fibrosis,and Western Blot was used to detect the protein expressions of YAP and TAZ in renal tissue.Results Compared with the normal group,the model group showed disordered renal tissue structure,enlarged and irregular cystic cavities,enlarged renal tubules with thickened basement membranes,inflammatory cell infiltration,and significant collagen deposition in the glomeruli,renal tubules,and vascular walls.The levels of FBG,BUN,SCr,24-hour urinary protein,and the protein expressions of YAP and TAZ in renal tissue were significantly increased(P＜0.05).Compared with the model group,the low-and high-dose asiaticoside groups showed significant improvement in renal tissue damage and fibrosis,with reduced levels of FBG,BUN,SCr,24-hour urinary protein,and decreased protein expressions of YAP and TAZ in renal tissue(P＜0.05).Compared with the high-dose asiaticoside group,the high-dose asiaticoside+XMU-MP-1 group showed a reversal in all the above indicators.Conclusion Asiaticoside may alleviate renal fibrosis and improve renal injury in DN rats by inhibiting the Hippo-YAP/TAZ pathway.

This study aims to analyze the screening results and epidemiological characteristics of prostate cancer (PCa) among elderly males in the rural areas of Songjiang, Shanghai City, through the implementation of a preliminary prostate-specific antigen (PSA) screening based on a community-linkage model, and to explore an effective screening approach. A retrospective observational study design was employed to collect data from residents who underwent PSA screening at Songjiang Hospital affiliated to Shanghai Jiao Tong University School of Medicine, in collaboration with multiple community health service centers in Songjiang District, Shanghai City, between June 2022 and June 2024, through free clinics and annual health examinations. Prostate biopsy was recommended for individuals with total PSA (tPSA) levels >10 ng/ml and those with 4 ng/ml≤tPSA≤10 ng/ml and abnormal free-to-total PSA (f/tPSA) ratios. Clinical characteristics of detected PCa patients were analyzed. Follow-up was conducted through phone calls and home visits by family doctors, coupled with enhanced health education. The results indicated that a total of 17 198 residents participated in the screening, among which 2 234 (12.99%) had tPSA levels between 4 ng/ml and 10 ng/ml, and 257 (1.49%) had tPSA levels >10 ng/ml. Ultimately, 417 residents underwent prostate biopsy, with 171 being diagnosed with PCa, yielding a positive biopsy rate of 41.00% and a PCa detection rate of 0.99%. The predominant pathological subtype among PCa patients was adenocarcinoma (168 cases, 98.24%). Of the 146 PCa patients who received treatment, the majority were classified as intermediate or high-risk (124 cases, 84.93%). Furthermore, with the optimization of the screening model, there was a significant increase in the proportion of subsequent outpatient visits. In conclusion, the community-linkage-based PSA screening model demonstrated high effectiveness in screening for PCa among elderly males in the rural areas of Songjiang, Shanghai City. Epidemiological findings revealed that PCa patients in this region are primarily composed of intermediate and high-risk groups, highlighting the need for intensified early screening and health education.

OBJECTIVE To investigate the impact of the methionine synthase reductase （MTRR） rs10380 C＞T gene polymorphism on methotrexate （MTX） plasma concentration， adverse drug reaction， and prognosis in children with intracranial tumors. METHODS Peripheral blood was collected from children with intracranial tumors， and genomic DNA was extracted. The MTRR rs10380 C＞T genotype was analyzed using matrix-assisted laser desorption/ionization-time of flight-mass spectrometry. The association of the MTRR rs10380 C＞T gene polymorphism with the ratio of MTX plasma concentration to dose （C/D ratio）， adverse drug reaction， tumor recurrence， and metastasis was analyzed. Bioinformatics analysis was used to explore the association of the rs10380 genotype and MTRR gene expression and its possible mechanisms. RESULTS A total of 75 children were included in the study. The distribution frequencies of the wild-type CC genotype and C allele of rs10380 were 62.67% and 81.33%， respectively， while the distribution frequencies of the variant CT genotype and T allele were 37.33% and 18.67%， respectively， which were in accordance with Hardy-Weinberg equilibrium（P＞0.05）. The incidence of electrolyte disorders （51.06%） and tumor metastasis rate （57.45%） in children with the CC genotype were significantly higher than those with the CT genotype （P＜0.05）. No significant differences were observed in the 24-hour and 42-hour C/D ratios and recurrence rates between the two genotypes of children （P＞0.05）. Bioinformatics analysis showed that MTRR protein mainly works in conjunction with 10 proteins， including MMAA， and was involved in various biological processes such as sulfur amino acid biosynthesis. CONCLUSIONS The MTRR rs10380 CC genotype may be a risk factor for electrolyte disorders and tumor metastasis in children with intracranial tumors after MTX chemotherapy.

Objective To investigate the current status of infection management quality control centers in county-level hospitals in Guangdong Province,providing reference for the development of quality control management programs for county-level infection control centers by provincial infection control centers,and exploring corresponding management strategies.Methods A survey was conducted using the QuestionStar questionnaire platform to investigate county-level quality control centers established in Guangdong Province before December 31,2023.The survey covered the establishment time,personnel structure,level of in-formatization,management,quality control,and training of hospital infection management professional quality control centers.Results There are 68 county-level infection control centers in Guangdong Province,with a coverage rate of 50.37%,and 95.59%of them have been established within the past five years.Experts mainly come from clinical and nursing backgrounds(accounting for23.75%and62.97%respectively),and the majority have a bachelor's degree(71.06%).Only 13%have operational funding.Among them,39 have established hospital infection informatization monitoring,23 have not been equipped,and 6 are under construction.Twenty centers have conducted quality control supervision and issued quality control reports,ac-counting for 29.41%,while 41 have organized training,accounting for 60.29%.Conclusion The coverage rate of county-level infection management quality control centers in Guangdong Province is steadily increasing,but not all counties and districts are covered.There is a lack of policy and funding support,insufficient personnel allocation,and inadequate professional coverage.The health administrative departments and county-level infection control centers need to unify monitoring standards,quality con-trol specifications,and evaluation programs,improve infection control capabilities,and enhance the"four-level"management and training system to effectively promote the quality and safety management level of primary healthcare institutions.

A 32-year-old woman,previously diagnosed with schizophrenia and undergoing long-term treatment with clozapine,experienced the onset of symptoms such as shallow coma,persistent high fever,and increased muscle tone one day after transitioning from clozapine to amisulpride.Combining with elevated creatine kinase levels and other examination findings,the patient was diagnosed with amisulpride-related neuroleptic malignant syndrome(NMS).Amisulpride treatment was promptly discontinued,and the patient was treated with bromocriptine,but it failed to relieve the symptoms.On the same day,intravenous administration of dantrolene sodium was conducted,then her body temperature decreased,convulsions and tremors improved,and other symptoms gradually relieved.After 5 days,her consciousness improved,and she was discharged after 10 days.Amisulpride-related NMS are relatively rare,and dantrolene sodium can be used as a potential option when conventional treatments prove ineffective.

OBJECTIVE To compare the safety of high-dose methotrexate （HD-MTX） via peripherally inserted central catheter （PICC） and totally implantable venous access port （TIVAP） in pediatric patients with malignant brain tumors. METHODS Patients with malignant brain tumors who received HD-MTX via PICCs or TIVAPs in our hospital from July 2018 to April 2022 were retrospectively analyzed. Clinical data were collected to compare differences in blood concentration of methotrexate （MTX），the incidence of adverse events （including adverse drug reactions and catheter-related complications） and length of stay in hospital. Multivariate linear regression was applied to analyze the factors that influenced the blood concentration of MTX. RESULTS A total of 107 patients were included in the study，with 65 patients in the PICC group and 42 patients in the TIVAP group. Blood concentration of MTX at 24 h （C24 h） in TIVAP group was significantly higher than PICC group （[ 126.87±61.99） μmol/L vs. （102.45±48.77） μmol/L，P＜0.05）. There was no significant difference in blood concentration of MTX at 42 h （C42 h），compared with PICC group （P＞0.05）. Results of multivariate linear regression analysis showed that TIVAP was associated with the increase of C24 h（P＜0.05）. No significant differences were observed in the incidence of adverse events and the length of stay in the hospital between 2 groups （P＞0.05）. CONCLUSIONS Risk of adverse events is not increased，although the MTX C24 h level is elevated after administration of TIVAP. TIVAP is a safe choice for HD-MTX therapy with implementing therapeutic drug monitoring.

Objective To analyze the risk factors and pathogen drug resistance of senile stroke-associated pneumonia (SAP), and to provide references for early clinical intervention. Methods A total of 859 elderly patients with cerebral stroke admitted to our hospital from June 2018 to June 2020 were selected and divided into the study group (SAP, n=375) and the control group (no SAP, n=484) according to the occurrence of stroke associated pneumonia. Clinical data of age, gender, and other complications of the two groups were analyzed. The sputum culture and drug sensitivity test of senile SAP patients were analyzed. Results A total of 313 pathogens were detected in 375 SAP patients, including 211 strains of gram-negative bacteria (67.41%), mainly consisting of 92 Acinetobacter baumannii (29.39%), 54 Pseudomonas aeruginosa (17.25%), and 42 Klebsiella pneumoniae (13.42%), and 73 strains (23.32%) of gram-positive bacteria, mainly 62 strains of Staphylococcus aureus (19.81%). In addition, there were 29 strains of fungi (9.27%). Pseudomonas aeruginosa was highly sensitive to piperacillin/tazobactam and ceftazidime. Acinetobacter baumannii and Klebsiella pneumoniae were highly sensitive to imipenem, meropenem, and cefoperazone sodium and sulbactam sodium. Staphylococcus aureus and Enterococcus were highly sensitive to teicolanin, linezolid and vancomycin. The proportion of patients aged ≥80 years old, mechanical ventilation, bed rest and use of prophylactic antibiotics in the experimental group was significantly higher than that in the control group (P<0.05). Logistic regression analysis showed that age ≥80 years, mechanical ventilation, hypoproteinemia and use of prophylactic antibiotics were independent risk factors for SAP (P<0.05). Conclusion The main pathogens of stroke-associated pneumonia in the elderly are Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baumannii. It is necessary to rationally choose antibiotics according to the results of drug sensitivity. The risk factors are patients' age ≥ 80 years old, mechanical ventilation, and bed rest. Clinicians should attach great importance to the prevention of stroke-related pneumonia in the elderly.

【Objective】 To analyze the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) in Xi’an so as to investigate the relationship between the dynamic changes of lymphocytes and the disease progression. 【Methods】 We retrospectively analyzed the clinical data of 15 patients with COVID-19 in The First Affiliated Hospital of Xi’an Jiaotong University from January 22 to February 16, 2020. 【Results】 Among the 15 patients with COVID-19, 8 were males and 7 were females, aged from 22 to 89 years. There were 12 ordinary cases (80%), 1 severe case (6.67%), and 2 critical cases(13.33%). There were 6 groups of family clusters.Most of the patients (14/15, 93.3%) had fever of different degrees. The average time from illness onset to admission was 2.80±1.66 days, and the average time from illness onset to diagnosis was 2.83±2.29 days. The main accompanying symptoms were dry cough (8/15, 53.33%) and shortness of breath (4/15, 26.67%). Nine patients (60%) who had low lymphocyte counts at admission, including of all of the critically ill patients (1 severe case and 2 critical cases) and 6 (6/12, 50%) ordinary patients. Lymphocyte counts in the ordinary cases increased gradually, but fluctuated in the severely ill patients. They were always at low level, or even decreased overall in critical cases. 【Conclusion】 In Xi’an City, COVID-19 mostly occurred in family clusters. Lymphocyte counts were reduced in most patients, especially in critically ill (severe and critical) ones. The lymphocyte count at admission and its kinetics during therapy may be an important predictor for the severity and prognosis of the disease.

Objective:To explore the application effect of online teaching supervision in nursing teaching quality of undergraduate nursing students.Methods:Using the convenient sampling method, the 2017 (September 2019 to January 2020) and 2018 (March to July 2020) undergraduate nursing students from the School of Nursing of Harbin Medical University were selected as the research objects. The 2018 undergraduate nursing students were included in the online live teaching group ( n=80) , and the 2017 undergraduate nursing students were included in the offline teaching group ( n=76) . A total of 10 supervisors were selected to evaluate the teaching quality of teachers' online and offline classes through the Multiple Comprehensive Evaluation Tables. The results of the final examination of nursing students in the two groups were used to evaluate the effect of the online live teaching form. The teaching satisfaction with the online live teaching method of nursing students in the two groups was compared. Results:The online teaching scored (95.05±2.14) on the Multiple Comprehensive Evaluation Tables, which was higher than that of the offline teaching (90.05±0.96) , and the difference was statistically significant ( t=6.745, P<0.01) . There were no statistically significant differences in the final exam scores of nursing students in the two groups and their satisfaction with online live teaching methods ( P>0.05) . Conclusions:The practice form of online classroom teaching supervision can effectively ensure the teaching quality and teaching effect of teachers and ensure the teaching satisfaction of nursing students with online live teaching.