The widespread prevalence of multidrug-resistant organisms in clinical settings poses significant challen-ges to the prevention and control of hospital-associatal infections.Novel gene sequencing techniques,such as whole-genome sequencing(WGS)and metagenomic next-generation sequencing(mNGS),have emerged as revo-lutionary tools for precisely tracing to the source of hospital-associatal infection outbreak and the prevention and control through high-resolution genomic analysis.The technical principles and advantages of WGS and mNGS were systematically reviewed in the article.The pivotal roles of the techniques in confirmation of outbreak,identification of infection source,transmission chain rebuilding,study on transmission dynamics and evaluation of effect on in-fection prevention and control were elaborated through analysis of typical cases in China and abroad so as to pro-vide theoretical bases and technical support for precise identification of prevention and control of nosocomial infec-tion.

Objective To investigate the role of matrix GLA protein(MGP)in the pathogenesis of idiopathic calcium oxalate kidney stones(ICOS),and to find potential biomarkers for early diagnosis and disease evaluation.Methods A total of 120 patients admitted to our hospital from September 2021 to September 2023 were prospectively included,of which 60 patients with ICOS were in the calculus group and 60 patients without calculus were in the control group.Serum biochemical indexes and immunohistochemical scores of the two groups were detected,urinary MGP levels were determined by ELISA,and MGP mRNA and protein expression in renal papilla tissues were detected by qPCR and Western blot.The independent risk factors of ICOS were screened by Logistic regression analysis,and the prediction model was drawn by nomogram.Results Compared with control group,urinary MGP content in calculus group was decreased[(1 805.91±244.44)pg/ml vs.(2 014.79±252.14)pg/mnl,P＜0.05).Expression of MGP mRNA and MGP protein in renal papillae decreased(0.89±0.15 vs.1.00±0.00,P=0.001)and decreased(0.87±0.18 vs.1.00±0.00,P＜0.05).MGP immunohistochemical scores of renal tissue were decreased[4(2-6)scores vs.6(4-8)scores,P＜0.001].Multivariate analysis showed that urinary calcium(OR=1.370),urinary MGP(OR=1.127),renal papilla MGP relative expression level(OR=27.532)and renal tissue MGP immunohistochemical score(OR=1.359)were independent risk factors for ICOS.Area under ROC curve of the nomogram prediction model built based on the above factors is 0.839,indicating that the model has good differentiation ability in risk prediction.Conclusion MGP is closely related to the pathogenesis of ICOS.Urinary and renal tissue MGP levels may be potential biomarkers for early diagnosis and disease assessment of ICOS.

The development of surgery brings about the transformation of surgeons′ con-cepts, and in turn, each renewal of surgical concepts propels progress of surgical techniques. These two aspects complement each other. The treatment of hepatocellular carcinoma is a comprehensive therapy centered on surgery. With the deepening understanding of liver anatomy, the surgical methods have evolved from initial local resection to anatomical liver resection, and then to resection of the tumor-bearing portal vein territory. In recent years, with the emergence of hepatic membrane anatomy, portal plate theory, and three-dimensional visualization, the theoretical and technical systems of laparoscopic anatomical liver resection has become more and more mature. Based on own experience and literature reports, the authors systematically elaborate on the construction of theoretical and technological systems of laparoscopic anatomic liver resection for hepatocellular carcinoma, for reference by colleagues.

Objective To investigate the role of matrix GLA protein(MGP)in the pathogenesis of idiopathic calcium oxalate kidney stones(ICOS),and to find potential biomarkers for early diagnosis and disease evaluation.Methods A total of 120 patients admitted to our hospital from September 2021 to September 2023 were prospectively included,of which 60 patients with ICOS were in the calculus group and 60 patients without calculus were in the control group.Serum biochemical indexes and immunohistochemical scores of the two groups were detected,urinary MGP levels were determined by ELISA,and MGP mRNA and protein expression in renal papilla tissues were detected by qPCR and Western blot.The independent risk factors of ICOS were screened by Logistic regression analysis,and the prediction model was drawn by nomogram.Results Compared with control group,urinary MGP content in calculus group was decreased[(1 805.91±244.44)pg/ml vs.(2 014.79±252.14)pg/mnl,P＜0.05).Expression of MGP mRNA and MGP protein in renal papillae decreased(0.89±0.15 vs.1.00±0.00,P=0.001)and decreased(0.87±0.18 vs.1.00±0.00,P＜0.05).MGP immunohistochemical scores of renal tissue were decreased[4(2-6)scores vs.6(4-8)scores,P＜0.001].Multivariate analysis showed that urinary calcium(OR=1.370),urinary MGP(OR=1.127),renal papilla MGP relative expression level(OR=27.532)and renal tissue MGP immunohistochemical score(OR=1.359)were independent risk factors for ICOS.Area under ROC curve of the nomogram prediction model built based on the above factors is 0.839,indicating that the model has good differentiation ability in risk prediction.Conclusion MGP is closely related to the pathogenesis of ICOS.Urinary and renal tissue MGP levels may be potential biomarkers for early diagnosis and disease assessment of ICOS.

The development of surgery brings about the transformation of surgeons′ con-cepts, and in turn, each renewal of surgical concepts propels progress of surgical techniques. These two aspects complement each other. The treatment of hepatocellular carcinoma is a comprehensive therapy centered on surgery. With the deepening understanding of liver anatomy, the surgical methods have evolved from initial local resection to anatomical liver resection, and then to resection of the tumor-bearing portal vein territory. In recent years, with the emergence of hepatic membrane anatomy, portal plate theory, and three-dimensional visualization, the theoretical and technical systems of laparoscopic anatomical liver resection has become more and more mature. Based on own experience and literature reports, the authors systematically elaborate on the construction of theoretical and technological systems of laparoscopic anatomic liver resection for hepatocellular carcinoma, for reference by colleagues.

The widespread prevalence of multidrug-resistant organisms in clinical settings poses significant challen-ges to the prevention and control of hospital-associatal infections.Novel gene sequencing techniques,such as whole-genome sequencing(WGS)and metagenomic next-generation sequencing(mNGS),have emerged as revo-lutionary tools for precisely tracing to the source of hospital-associatal infection outbreak and the prevention and control through high-resolution genomic analysis.The technical principles and advantages of WGS and mNGS were systematically reviewed in the article.The pivotal roles of the techniques in confirmation of outbreak,identification of infection source,transmission chain rebuilding,study on transmission dynamics and evaluation of effect on in-fection prevention and control were elaborated through analysis of typical cases in China and abroad so as to pro-vide theoretical bases and technical support for precise identification of prevention and control of nosocomial infec-tion.

Objective:To compare the characteristics of background mucosa, lesion features, and the efficiency of endoscopic submucosal dissection(ESD)between elderly and non-elderly patients with early gastric cancer(EGC).Methods:This study retrospectively collected data on patients with EGC who underwent ESD treatment at Beijing Hospital from April 2020 to December 2022.The clinical characteristics, background mucosa, lesion features, ESD outcomes, and pathological results of the patients were analyzed to compare the differences between elderly and non-elderly patients.Results:A total of 100 patients with EGC were selected, comprising 57 patients in the elderly group and 43 patients in the non-elderly group, with a total of 111 lesions identified(64 lesions in the elderly group and 47 lesions in the non-elderly group).The proportion of patients with a history of chronic atrophic gastritis was significantly higher in the elderly group(89.5%、51/57)compared to the non-elderly group(74.4%、32/43), with a statistically significant difference( P=0.047).Additionally, the difference in the extent of atrophy between elderly patients with EGC and their non-elderly counterparts was statistically significant( P=0.022).Among these patients, the proportion of those classified as Kimura-Takemoto C0 to C1 in the elderly group(15.6%、10/64)was lower than that in the non-elderly group(40.4%、19/47).In contrast, the proportion of patients classified as C2 to C3 in the elderly group(65.6%、42/64)was higher than that in the non-elderly group(51.1%、24/47), and the proportion of those classified as O1 to O3 in elderly patients(12.5%、8/64)was also higher than in the non-elderly group(4.3%、2/47).Furthermore, the difference in the extent of intestinal metaplasia between elderly and non-elderly patients with early gastric cancer was statistically significant( P=0.007).The overall proportion of total intestinal metaplasia in elderly patients(85.9%、55/64)was significantly higher than that in non-elderly patients(61.7%、29/47).Notably, the proportion of patients exhibiting extensive intestinal metaplasia(intestinal metaplasia present in both the gastric antrum and gastric body)was greater in the elderly group(43.8%、28/64)compared to the non-elderly group(23.4%、11/47).The Kyoto gastric cancer risk endoscopic score for elderly patients with EGC was(2.43±1.28)points, significantly higher than that of the non-elderly group(1.72±1.41)points, with a statistically significant difference observed( t=2.778, P=0.006).No statistically significant differences were observed in the proportions of total resection rates, R0 resections, curative resections, or postoperative complications following ESD when comparing elderly patients with EGC to their non-elderly counterparts. Conclusions:The proportion of extensive atrophy and intestinal metaplasia was higher in the background mucosa of elderly patients with EGC, and correspondingly, the Kyoto endoscopic gastric cancer risk score was elevated.Therefore, endoscopic examinations for elderly patients with chronic atrophic gastritis should be conducted with greater care and comprehensiveness.

The density and composition of lymphocytes infiltrating colon tumors serve as predictive factors for the clinical outcome of colon cancer.Our previous studies highlighted the potent anti-cancer properties of the principal compounds found in Garcinia yunnanensis(YTE-17),attributing these effects to the regu-lation of multiple signaling pathways.However,knowledge regarding the mechanism and effect of YTE-17 in the prevention of colorectal cancer is limited.In this study,we conducted isobaric tags for relative and absolute quantification(iTRAQ)analysis on intestinal epithelial cells(IECs)exposed YTE-17,both in vitro and in vivo,revealing a significant inhibition of the Wnt family member 5a(Wnt5a)/c-Jun N-terminal kinase(JNK)signaling pathway.Subsequently,we elucidated the influence and mechanism of YTE-17 on the tumor microenvironment(TME),specifically focusing on macrophage-mediated T helper 17(Th17)cell induction in a colitis-associated cancer(CAC)model with Wnt5a deletion.Additionally,we performed the single-cell RNA sequencing(scRNA-seq)on the colonic tissue from the Wnt5a-deleted CAC model to characterize the composition,lineage,and functional status of immune mesenchymal cells during different stages of colorectal cancer(CRC)progression.Remarkably,our findings demon-strate a significant reduction in M2 macrophage polarization and Th17 cell phenotype upon treatment with YTE-17,leading to the restoration of regulatory T(Treg)/Th17 cell balance in azoxymethane(AOM)/dextran sodium sulfate(DSS)model.Furthermore,we also confirmed that YTE-17 effectively inhibited the glycolysis of Th17 cells in both direct and indirect co-culture systems with M2 macrophages.Notably,our study shed light on potential mechanisms linking the non-canonical Wnt5a/JNK signaling pathway and well-established canonical β-catenin oncogenic pathway in vivo.Specifically,we proposed that Wnt5a/JNK signaling activity in IECs promotes the development of cancer stem cells with β-catenin activity within the TME,involving macrophages and T cells.In summary,our study undergoes the po-tential of YTE-17 as a preventive strategy against CRC development by addressing the imbalance with the immune microenvironment,thereby mitigating the risk of malignancies.

Objective:Based on latent profile analysis, the category characteristics of decisional dilemma of participating in thrombolysis decision-making agents of patients with acute myocardial infarction (AMI) are analyzed to reduce the decision-making difficulties of decision-making agents in AMI patients.Method:The 292 cases of decision-making agents of patients with AMI and treated by intravenous thrombolysis in emergency department of Xinjiang Uygur Autonomous Region People's Hospital were selected as respondents From January 2022 to June 2023.A cross-sectional survey was conducted using General Information Questionnaire, Perceived Social Support Scale, State-Trait Anxiety Inventory, Control Preference Scale, Wake Forest Physician Trust Scale and Decisional Conflict Scale.Selected Mplus 8.3 software to conduct potential profile analysis on the survey data.Results:The 281 valid questionnaires were ultimately collected, with 146 males and 135 females aged 35-72(55.61 ± 9.05) among 281 AMI patients; 135 acting decision-makers from the south, 146 females, aged 30-72(55.52 ± 6.74).The score of decisional dilemma of participating in thrombolysis of decision-making agents of patients with AMI was 45(41, 46). LPA analysis showed that decisional dilemma of participating in thrombolysis of decision-making agents can be divided into 4 latent profiles which were low-level decisional dilemma profile accounts for 16.01% (45/281), high-level decisional dilemma profile accounts for 16.38% (46/281), extra high-level decisional dilemma profile with social support restricting accounts for 35.23% (99/281) and extra high-level decisional dilemma profile with information restricting accounts for 32.28% (91/281). Multiple logistic regression analysis showed represented patients with AMI history, decision-making agent ′s age, gender, educational level, decision-making role, decision-making participation type were significant influencing factors of decisional dilemma of participating in thrombolysis of high-level decisional dilemma profile (all P<0.05);represented patients with AMI history, decision-making agent ′s age, gender, education level, decision-making role, assuming patient ′s treatment payment role, assuming patient ′s care role, perceived social support level, state anxiety level, decision-making participation type and trust doctors level were significant influencing factors of decisional dilemma of participating in thrombolysis of extra high-level decisional dilemma profile with social support restricting and extra high-level decisional dilemma profile with information restricting(all P<0.05). Conclusions:The level decisional dilemma of participating in thrombolysis of decision-making agents for intravenous thrombolysis treatment of AMI patients were high, and their decisional dilemma can be divided into low-level decisional dilemma profile, high-level decisional dilemma profile, extra high-level decisional dilemma profile with social support restricting and extra high-level decisional dilemma profile with information restricting.They should be purposively intervened based on their corresponding decisional dilemma profile.

Objective To explore the protein expression levels of serum neurite outgrowth inhibitor-A(Nogo-A),energy balance related protein(Adropin),zonula occludens-1(ZO-1)and angiopoietin-like protein 4(ANGPTL4)in patients with acute cerebral hemorrhage and their predictive efficacy for prognosis.Methods A total of 148 patients with acute cerebral hemorrhage treated in the hospital from April 2020 to May 2022 were selected as the study group,and another 150 healthy people who came to the hospital for gen-eral physical examination during the same period were selected as the control group,and a retrospective analy-sis was conducted.The protein expression levels of Nogo-A,Adropin,ZO-1 and ANGPTL4 in serum of the two groups were detected by enzyme-linked immunosorbent assay(ELISA)and compared.Spearman correla-tion coefficient was used to analyze the correlation between serum Nogo-A,Adropin,ZO-1,ANGPTL4 protein expression levels and the occurrence of acute cerebral hemorrhage.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of the combined detection of the above four indicators for a-cute cerebral hemorrhage.In addition,patients in the study group were followed up for 6 months,and were di-vided into good group(91 cases)and poor group(57 cases)according to the prognosis.Serum protein expres-sion levels of Nogo-A,Adropin,ZO-1 and ANGPTL4 were compared between the two groups.ROC curve was used to verify the predictive efficacy of the combined detection for the prognosis of these patients.Results Compared with the control group,the protein expression levels of Nogo-A,ZO-1 and ANGPTL4 in the study group were significantly increased,while the protein expression level of Adropin was significantly decreased(all P<0.05).Spearman correlation coefficient analysis showed that serum Nogo-A,ZO-1,ANGPTL4 pro-tein expression levels were positively correlated with the incidence rate of acute cerebral hemorrhage,while Adropin protein expression level was negatively correlated with the incidence rate of acute cerebral hemor-rhage(all P<0.05).ROC curve verification showed that the combined detection of Nogo-A,Adropin,ZO-1 and ANGPTL4 protein expression levels had high diagnostic efficacy in the evaluation of acute cerebral hemor-rhage,with the sensitivity and the specificity of 92.57%and 90.67%,respectively.Compared with good group,the protein expression levels of Nogo-A,ZO-1 and ANGPTL4 in poor group were significantly higher,while the protein expression level of Adropin was significantly decreased(all P<0.05).ROC curve showed that compared to single detections,the area under the curve of the combined detection of protein expression levels of Nogo-A,Adropin,ZO-1 and ANGPTL4 was larger(P<0.05),with the sensitivity of 84.21%and the specificity of 89.01%.Conclusion The protein expression levels of Nogo-A,Adropin,ZO-1 and AN-GPTL4 are abnormal in patients with acute cerebral hemorrhage,and the protein expression levels of Nogo-A,Adropin,ZO-1 and ANGPTL4 are closely related to the development of acute cerebral hemorrhage.The com-bined detection of the four indicators could not only assist clinical accurate judgment of acute cerebral hemor-rhage,but also have important clinical value in predicting the prognosis of patients.