ObjectiveTo explore the microbiological characteristics of Staphylococcus epidermidis with hemolytic phenotype （SEHP）. MethodsHemolytic phenotype was detected using the three-point inoculation method， involving a total of 5 strains of SEHP and 5 strains of Staphylococcus epidermidis with non-hemolytic phenotype （SENHP） . Bacterial species were identified using the Microflex LT MALDI-TOF mass spectrometer， and a phylogenetic tree was constructed through 16S rRNA sequence alignment. Growth curves were monitored through the microcultivation assay. Biofilm formation ability was assessed by microplate crystal violet staining. Red blood cell toxicity was detected using the microplate method. Antimicrobial susceptibility testing of SEHP and SENHP against commonly used antibiotics was performed using a VITEK 2 GP639 test kit. Antagonistic effects of SEHP and SENHP against Staphylococcus aureus and Corynebacterium striatum were evaluated by the Oxford cup inhibition assay. ResultsCompared with SENHP， SEHP exhibited a marked decrease in growth rate during the late logarithmic phase， accompanied by significant hemolytic toxicity. Additionally， it showed lower resistance rates to levofloxacin and moxifloxacin， and could antagonize Staphylococcus aureus and Corynebacterium striatum. ConclusionThe microbiological characteristics of SEHP differ from those of SENHP in that SEHP demonstrates antagonistic effects against S. aureus and C. striatum.

Flap transplantation is a critical surgical strategy for the reconstruction of tissue defects caused by trauma, tumor resection, and congenital malformations, and its survival rate directly determines surgical efficacy and patient prognosis. Following transplantation, flaps inevitably undergo ischemia-reperfusion (I/R) injury, during which oxidative stress, inflammatory responses, and metabolic disturbances are intricately intertwined, ultimately leading to cellular injury and tissue necrosis. Recent studies have demonstrated that multiple forms of programmed cell death—including apoptosis, pyroptosis, ferroptosis, necroptosis, and PANoptosis—play central roles in flap I/R injury. The extensive crosstalk and molecular interactions among these pathways form a highly complex cell death network. Specifically, apoptosis is mediated by the imbalance of Bcl-2 family proteins and the activation of cysteine-dependent aspartate-specific protease (caspase) cascades; pyroptosis is driven by the NLRP3-caspase-1-GSDMD axis, resulting in membrane pore formation and the release of pro-inflammatory cytokines; ferroptosis is characterized by iron-dependent lipid peroxidation and dysfunction of glutathione peroxidase 4 (GPX4); necroptosis is triggered by the receptor-interacting serine/threonine-protein kinase 1 (RIPK1)-RIPK3-MLKL signaling complex, leading to membrane rupture; and PANoptosis represents an integrated form of inflammatory cell death that coordinates multiple death pathways. Importantly, these forms of programmed cell death are not independent but are interconnected through extensive signaling crosstalk. Key regulatory molecules, including caspase-8, reactive oxygen species (ROS), nuclear factor-κB (NF-κB), and nuclear factor erythroid 2-related factor 2 (Nrf2), collectively modulate the dynamic balance among these pathways. Therefore, the multidimensional interplay and spatiotemporal dynamics of programmed cell death constitute a fundamental pathological basis of flap I/R injury. This review systematically summarizes the latest advances in the mechanisms and interactions of various programmed cell death pathways in flap I/R injury, aiming to elucidate the underlying regulatory network. These insights may provide novel theoretical foundations for optimizing flap protection strategies, improving flap survival, and promoting tissue repair.

Aim To elucidate the mechanism of ma-trine(MT)-induced liver damage.Methods After ex-posure of L02 cells and BALB/c mice to MT,mouse hepatic function,histopathological examinations of the liver,cell viability of L02 cells,reactive oxygen spe-cies(ROS)levels,mitochondrial function,apoptosis,and cystathionine β-synthase(CBS)/H2S/ATP syn-thase F1 subunit alpha(ATP5 A)pathway activity were detected.Results MT treatment decreased L02 cell viabilities in a dose-dependent manner.MT also decreased the levels of CBS and ATP5A S-sulfhydra-tion,increased ROS levels,depolarized the mitochon-drial membrane potential,decreased the biosynthesis of H2S and ATP,ultimately activated the caspase-3 activ-ity and apoptosis(P＜0.05).In vivo experiments showed that MT induced severe liver injury in BALB/c mice,along with a decline in CBS,SH-ATP5A,H2S,and ATP levels,and caspase-3 activation(P＜0.05).However,either NaHS treatment or methionine treat-ment reversed MT-induced apoptosis and hepatotoxicity by increasing the intracellular H2S levels in vivo and in vitro(P＜0.05).Conclusions MT induces ROS ac-cumulation,mitochondrial dysfunction,caspase-3 acti-vation and apoptosis by inhibiting the CBS/H2S/ATP5A pathway.The upregulation of intracellular H2S levels partially reverses MT-induced hepatotoxicity via ATP5A S-sulfhydration.

Objective:To investigate the impact of postoperative complications on adverse outcomes following curative-intent resection for gallbladder cancer (GBC).Methods:The multi-center real-world study was conducted. The clinicopathological data of 629 patients with GBC, who were admitted to 14 medical centers including The First Affiliated Hospital of Army Medical University from the national multicenter database of Biliary Surgery Group of Elite Group of Chinese Journal of Digestive Surgery, from April 2020 to April 2024 were collected. There were 225 males and 404 females, aged (64±10)years. Patients underwent open curative-intent resection for GBC. Observation indicators: (1)surgery, postoperative complica-tions and adverse outcomes; (2) analysis of risk factors affecting postoperative adverse outcomes in patients and population attributable fraction (PAF). Missing data in predictor variables were addressed using multiple imputation with chained equations, while cases with missing outcome variables were addressed using the "multiple imputation then deletion (MID)" strategy. The severity of multicollinearity among independent variables was assessed using the variance inflation factor (VIF) test. Multivariable possion regression models with log link and robust error variance were construc-ted incorporating restricted cubic splines (3 knots) to address nonlinear relationships in continuous variables, calculating adjusted relative risk ( RR) with corresponding 95% confidence interval ( CI). Adjusted PAF was calculated for each imputed dataset using the AF package of R software, with subsequent pooling performed according to Rubin's rules. Results:(1) Surgery, postoperative complications and adverse outcomes. All 629 patients underwent curative-intent resection for GBC, of which 143 cases had postoperative complications, including 68 cases of intra-abdominal ascites, 39 cases of pulmonary infection, 21 cases of bile leakage, 12 cases of intra-abdominal hemorrhage, 11 cases of liver failure, 10 cases of pan-creatic fistula, 10 cases of wound infection, 10 cases of gastroparesis, 7 cases of cholangitis, 7 cases of sepsis. The same patient could have more than one kind of complication. Of 629 patients, there were 19 cases of postoperative 90-day death and 11 cases of missing data, 42 cases with post-operative 90-day reoperation and 7 cases with missing data, 44 cases with postoperative 90-day readmission and 3 cases with missing data, 155 cases with prolonged postoperative hospital stay and 3 cases with missing data. (2) Analysis of risk factors affecting the postoperative adverse outcomes in patients and PAF. Results of multivariate analysis showed that pulmonary infection and liver failure were independent risk factors for postoperative 90-day mortality ( RR=3.74, 12.15, 95% CI as 1.18-11.83, 1.98-74.48, P<0.05). Pulmonary infection demons-trated the highest PAF as 4.61% (95% CI as 3.94%-5.28%, P<0.05). Intra-abdominal ascites, pulmonary infection, bile leakage, and intra-abdominal hemorrhage were independent risk factors for post-operative 90-day reoperation ( RR=4.80, 3.62, 3.46, 4.99, 95% CI as 2.49-9.26, 1.42-9.21, 1.34-8.92, 1.55-16.06, P<0.05). Intra-abdominal ascites demonstrated the highest PAF as 8.65% (95% CI as 8.22%-9.08%, P<0.05). Intra-abdominal ascites, bile leakage, and liver failure were independent risk factors for postoperative 90-day readmission ( RR=6.20, 3.33, 14.33, 95% CI as 3.21-11.95, 1.33-8.35, 3.72-55.28, P<0.05). Intra-abdominal ascites demonstrated the highest PAF as 9.11% (95% CI as 8.85%-9.37%, P<0.05). Intra-abdominal ascites, pulmonary infection, bile leakage, liver failure, and wound infection were independent risk factors for prolonged postoperative hospital stay ( RR=2.29, 2.21, 2.26, 2.14, 3.35, 95% CI as 1.63-3.23, 1.41-3.46, 1.32-3.86, 1.11-4.13, 1.70-6.60, P<0.05). Intra-abdominal ascites demonstrated the highest PAF as 6.03% (95% CI as 5.71%-6.35%, P<0.05). Conclusion:Pulmonary infection is the most significant risk factor for postoperative 90-day mortality after curative-intent resection for GBC, while intra-abdominal ascites is the most significant risk factor for postoperative 90-day reoperation, postoperative 90-day readmission, and prolonged postoperative hospital stay.

Objective To explore the antimicrobial activity of the bacteriocin(tentatively named garvicin LG6)se-creted by Lactococcus garvieae(L.garvieae)SHAMU-LG6 against Staphylococcus aureus(S.aureus)of different hemolytic phenotypes.Methods S.aureus isolated from clinical patients in a hospital of Anhui from 2021 to 2023 were collected.The hemolytic phenotypes of S.aureus were detected by three-point inoculation method.S.aureus of different hemolytic phenotypes were further categorized into methicillin-sensitive S.aureus(MSSA)and methi-cillin-resistant S.aureus(MRSA)according to antimicrobial susceptibility testing results.The antagonistic activity of L.garvieae SHAMU-LG6 against S.aureus of different hemolytic phenotypes was assayed by Oxford cup me-thod.The whole-genome sequencing of L.garvieae SHAMU-LG6 was performed.Biosynthetic gene cluster of gar-vicin LG6 was searched by online databases antiSMASH 7.0 and BAGEL4.Through macroporous resin adsorption,ethanol gradient elution,rotary evaporation,and dried material reconstitution,antimicrobial activity of garvicin LG6 crude extract against S.aureus was detected by the inhibitory testing of Oxford cup method.Results L.garvieae SHAMU-LG6 could significantly antagonize MSSA and MRSA of different hemolytic phenotypes.Biosynthetic gene cluster of garvicin LG6 was present on the chromosomal genome of L.garvieae SHAMU-LG6.The antimicrobial activity of garvicin LG6 secreted by a single colony or 6 mL fermentation fluid of L.garvieae SHAMU-LG6 were at least equal to that of antibiotic disc of 30 pg cefoxitin.Conclusion Garvicin LG6 can efficiently kill MSSA and MR-SA of different hemolytic phenotypes,and has the potential to be developed into a novel antimicrobial agent,which has great prospects for clinical application.

In-depth study of the components of polymyxins is the key to controlling the quality of this class of antibiotics.Similarities and variations of components present significant analytical challenges.A two-dimensional(2D)liquid chromatography-mass spectrometry(LC-MS)method was established for screening and comprehensive profiling of compositions of the antibiotic colistimethate sodium(CMS).A high concentration of phosphate buffer mobile phase was used in the first-dimensional LC system to get the components well separated.For efficient and high-accuracy screening of CMS,a targeted method based on a self-constructed high resolution(HR)mass spectrum database of CMS components was established.The database was built based on the commercial MassHunter Personal Compound Database and Library(PCDL)software and its accuracy of the compound matching result was verified with six known components before being applied to genuine sample screening.On this basis,the unknown peaks in the CMS chromatograms were deduced and assigned.The molecular formula,group composition,and origins of a total of 99 compounds,of which the combined area percentage accounted for more than 95％of CMS components,were deduced by this 2D-LC-MS method combined with the MassHunter PCDL.This profiling method was highly efficient and could distinguish hundreds of components within 3 h,providing reliable results for quality control of this kind of complex drugs.

Objective To explore the value of dual-energy CT Bone Marrow Edema in quantitatively evaluating the timing of rib fracture evolution.Methods Sixty patients with thoracic trauma were scanned by dual-energy CT.Using CT Bone Marrow Edema technique,bone marrow CT values were standardized and quantified in both the Bone Marrow Edema area at the rib fracture site and in normal areas 1 cm on both sides of the fracture.The increments of standardized CT values for Bone Marrow Edema and VNCa were obtained for three stages of healing.The numerical variables were statistically described,and both the standardized CT value increments and VNCa standardized CT value increments were compared between the three stages and between each pair of stages.Diagnostic efficacy for stages with significant differences was evaluated using the area under the receiver operating characteristic(ROC)curve(AUC),and Cut-offvalues were calculated.Results There were significant differences in standardized CT value increments and VNCa standardized CT value increments across the three stages of Bone Marrow Edema(H=10.788,p=0.005;F=115.787,p=0.000).The standardized CT value increment of Bone Marrow Edema showed significant differences between the cartilaginous callus stage(fibrous callus stage)and the bony callus-remodeling stage(H=54.958,p=0.003),while the other pairwise comparisons showed no statistical significance(H=-25.603,p=0.183;H=29.354,p=0.113,respectively).However,the VNCa standardized CT value increments showed statistical significance across all three pairwise comparisons(all p=0.000).The ROC curve for differentiating the cartilaginous callus stage(fibrous callus stage)from the bony callus-remodeling stage using Bone Marrow Edema standardized CT value increment had an AUC of 0.652,with a Cut-offvalue of 81.575 Hu.The ROC curve for distinguishing the hematoma inflammation stage from the cartilaginous callus stage(fibrous callus stage)using VNCa standardized CT value increment had an AUC of 0.668,with a Cut-offvalue of 55.700 Hu.The ROC curve for differentiating the cartilaginous callus stage(fibrous callus stage)from the bony callus-remodeling stage using VNCa standardized CT value increment had an AUC of 0.905,with a Cut-offvalue of 37.625 Hu.Conclusion Dual-energy CT Bone Marrow Edema can quantitatively evaluate the timing of rib fracture evolution,and the differences in standardized CT value increments at different stages can provide a theoretical basis for forensic identification of fractures at different time periods.The Cut-offvalues of standardized CT value increments can,to some extent,predict the time stage of a fracture,providing quantitative evidence for forensic experts in the identification of rib fractures.

Objective To investigate the ameliorative effects and mechanisms of six types of tea(green tea,cyan tea,red tea,white tea,black tea and yellow tea)on metabolic disorders in obesity mice induced by high-fat diet(HFD).Methods Four-week-old male C57BL/6J mice were randomly divided into 8 groups with 7 mice per group.An HFD-induced obese mouse model was established,and the mice in control group maintained on standard diet followed by intragastric administration of different teas for 5 weeks.The body weight,liver weight ratio,fasting blood glucose,and lipid profile of the mice were measured to assess glucose and lipid metabolism.Serum inflammatory factors including IL-6,tumor necrosis factor-alpha(TNF-α)and oxidative stress markers[malondialdehyde(MDA)and superoxide dismutase(SOD)were measured.Additionally,liver histopathology and the expression of key glycolipid metabolism-related genes,adenosine monophosphate-activated protein kinase(AMPK)and carnitine palmitoyltransferase 1(CPT-1),were analyzed to explore underlying mechanisms.Results Cyan tea significantly suppressed weight gain,demonstrating superior weight control.White tea markedly reduced fasting blood glucose levels and decreased the area under the curve of oral glucose tolerance test(OGTT)and insulin tolerance test(ITT),indicating synergistic improvements in glucose metabolism and insulin sensitivity.Yellow tea exhibited exceptional anti-inflammatory and antioxidant effects,reducing hepatic IL-6 and MDA while enhancing SOD activity.Green tea activated the lipid oxidation pathway by upregulating AMPK/CPT-1 expression.All kinds of tea significantly attenuated hepatic lipid droplet accumulation.Conclusion All six types of tea alleviated metabolic disorders by reducing hepatic fat content in obesity mice.However,different types of tea exert their unique effects on improving metabolic disorders through differential mechanisms such as glucose metabolism regulation,lipid oxidation,and anti-inflammatory and antioxidant actions.

Objective:To investigate the impact of postoperative complications on adverse outcomes following curative-intent resection for gallbladder cancer (GBC).Methods:The multi-center real-world study was conducted. The clinicopathological data of 629 patients with GBC, who were admitted to 14 medical centers including The First Affiliated Hospital of Army Medical University from the national multicenter database of Biliary Surgery Group of Elite Group of Chinese Journal of Digestive Surgery, from April 2020 to April 2024 were collected. There were 225 males and 404 females, aged (64±10)years. Patients underwent open curative-intent resection for GBC. Observation indicators: (1)surgery, postoperative complica-tions and adverse outcomes; (2) analysis of risk factors affecting postoperative adverse outcomes in patients and population attributable fraction (PAF). Missing data in predictor variables were addressed using multiple imputation with chained equations, while cases with missing outcome variables were addressed using the "multiple imputation then deletion (MID)" strategy. The severity of multicollinearity among independent variables was assessed using the variance inflation factor (VIF) test. Multivariable possion regression models with log link and robust error variance were construc-ted incorporating restricted cubic splines (3 knots) to address nonlinear relationships in continuous variables, calculating adjusted relative risk ( RR) with corresponding 95% confidence interval ( CI). Adjusted PAF was calculated for each imputed dataset using the AF package of R software, with subsequent pooling performed according to Rubin's rules. Results:(1) Surgery, postoperative complications and adverse outcomes. All 629 patients underwent curative-intent resection for GBC, of which 143 cases had postoperative complications, including 68 cases of intra-abdominal ascites, 39 cases of pulmonary infection, 21 cases of bile leakage, 12 cases of intra-abdominal hemorrhage, 11 cases of liver failure, 10 cases of pan-creatic fistula, 10 cases of wound infection, 10 cases of gastroparesis, 7 cases of cholangitis, 7 cases of sepsis. The same patient could have more than one kind of complication. Of 629 patients, there were 19 cases of postoperative 90-day death and 11 cases of missing data, 42 cases with post-operative 90-day reoperation and 7 cases with missing data, 44 cases with postoperative 90-day readmission and 3 cases with missing data, 155 cases with prolonged postoperative hospital stay and 3 cases with missing data. (2) Analysis of risk factors affecting the postoperative adverse outcomes in patients and PAF. Results of multivariate analysis showed that pulmonary infection and liver failure were independent risk factors for postoperative 90-day mortality ( RR=3.74, 12.15, 95% CI as 1.18-11.83, 1.98-74.48, P<0.05). Pulmonary infection demons-trated the highest PAF as 4.61% (95% CI as 3.94%-5.28%, P<0.05). Intra-abdominal ascites, pulmonary infection, bile leakage, and intra-abdominal hemorrhage were independent risk factors for post-operative 90-day reoperation ( RR=4.80, 3.62, 3.46, 4.99, 95% CI as 2.49-9.26, 1.42-9.21, 1.34-8.92, 1.55-16.06, P<0.05). Intra-abdominal ascites demonstrated the highest PAF as 8.65% (95% CI as 8.22%-9.08%, P<0.05). Intra-abdominal ascites, bile leakage, and liver failure were independent risk factors for postoperative 90-day readmission ( RR=6.20, 3.33, 14.33, 95% CI as 3.21-11.95, 1.33-8.35, 3.72-55.28, P<0.05). Intra-abdominal ascites demonstrated the highest PAF as 9.11% (95% CI as 8.85%-9.37%, P<0.05). Intra-abdominal ascites, pulmonary infection, bile leakage, liver failure, and wound infection were independent risk factors for prolonged postoperative hospital stay ( RR=2.29, 2.21, 2.26, 2.14, 3.35, 95% CI as 1.63-3.23, 1.41-3.46, 1.32-3.86, 1.11-4.13, 1.70-6.60, P<0.05). Intra-abdominal ascites demonstrated the highest PAF as 6.03% (95% CI as 5.71%-6.35%, P<0.05). Conclusion:Pulmonary infection is the most significant risk factor for postoperative 90-day mortality after curative-intent resection for GBC, while intra-abdominal ascites is the most significant risk factor for postoperative 90-day reoperation, postoperative 90-day readmission, and prolonged postoperative hospital stay.

Objective To explore the value of dual-energy CT Bone Marrow Edema in quantitatively evaluating the timing of rib fracture evolution.Methods Sixty patients with thoracic trauma were scanned by dual-energy CT.Using CT Bone Marrow Edema technique,bone marrow CT values were standardized and quantified in both the Bone Marrow Edema area at the rib fracture site and in normal areas 1 cm on both sides of the fracture.The increments of standardized CT values for Bone Marrow Edema and VNCa were obtained for three stages of healing.The numerical variables were statistically described,and both the standardized CT value increments and VNCa standardized CT value increments were compared between the three stages and between each pair of stages.Diagnostic efficacy for stages with significant differences was evaluated using the area under the receiver operating characteristic(ROC)curve(AUC),and Cut-offvalues were calculated.Results There were significant differences in standardized CT value increments and VNCa standardized CT value increments across the three stages of Bone Marrow Edema(H=10.788,p=0.005;F=115.787,p=0.000).The standardized CT value increment of Bone Marrow Edema showed significant differences between the cartilaginous callus stage(fibrous callus stage)and the bony callus-remodeling stage(H=54.958,p=0.003),while the other pairwise comparisons showed no statistical significance(H=-25.603,p=0.183;H=29.354,p=0.113,respectively).However,the VNCa standardized CT value increments showed statistical significance across all three pairwise comparisons(all p=0.000).The ROC curve for differentiating the cartilaginous callus stage(fibrous callus stage)from the bony callus-remodeling stage using Bone Marrow Edema standardized CT value increment had an AUC of 0.652,with a Cut-offvalue of 81.575 Hu.The ROC curve for distinguishing the hematoma inflammation stage from the cartilaginous callus stage(fibrous callus stage)using VNCa standardized CT value increment had an AUC of 0.668,with a Cut-offvalue of 55.700 Hu.The ROC curve for differentiating the cartilaginous callus stage(fibrous callus stage)from the bony callus-remodeling stage using VNCa standardized CT value increment had an AUC of 0.905,with a Cut-offvalue of 37.625 Hu.Conclusion Dual-energy CT Bone Marrow Edema can quantitatively evaluate the timing of rib fracture evolution,and the differences in standardized CT value increments at different stages can provide a theoretical basis for forensic identification of fractures at different time periods.The Cut-offvalues of standardized CT value increments can,to some extent,predict the time stage of a fracture,providing quantitative evidence for forensic experts in the identification of rib fractures.