ObjectiveTo construct an Enterococcus faecium （Ef）-based recombinant Ef-PA0057 vaccine of Pseudomonas aeruginosa（Pa）and to study its protective immune mechanism in mice. MethodsThe PA0057 gene was cloned from the genomic DNA of PA01 strain ATCC9027 by PCR and inserted into pGEX-1λT to construct pGEX-PA0057. The recombinant plasmid was electroporated into TX0016 strain to construct rEf-PA0057 vaccine. The plasmid was extracted from rEf for PCR. The rEf vaccine was expressed through IPTG induction， and the expression of protein was analyzed by SDS-PAGE and Western blot. BALB/c mice were immunized intragastrically with 5×10⁸ CFU rEf-PA0057 vaccine 3 times per week for 3 weeks. 4 weeks after the first immunization， mice were challenged intranasally with 5×10⁷ CFU of PA01 strain. 2 weeks after challenge， mice were sacrificed， and their lungs were separated. Bacteria in lungs were incubated and colonies were counted. Sera were collected at 0， 4， and 6 weeks after the first immunization. The IgG and its subclasses， and IgE were detected by ELISA. ResultsThe 900 bp PA0057 gene was successfully cloned by PCR. PCR showed that PA0057 gene was amplified when the extracted plasmid from rEf as template； the relative molecular mass （Mr） of the expressed PA0057-GST fusion protein was approximately 58 ku， detected by SDS-PAGE. The amount of the expressed protein was 18% of the total bacterial proteins. Western blot showed that the target protein could be recognized by Pa sera. The colony numbers of lung tissue in rEf-PA0057 vaccine group， blank vector group and Ef control group were （0.297±0.011）×10⁸ CFU， （7.576±0.206）×10⁸ CFU and （7.551±0.185）×10⁸ CFU， respectively， the difference was statistically significant （P0.01）. The levels of IgG， IgG1， IgG2b， IgG3 and IgE increased. At the same time point， there was a significant difference compared with the two control groups （P0.01）. ConclusionThe rEf-PA0057 vaccine is successfully constructed. It may induce mice to produce humoral response against challenge with PA01.

Objective To explore the current situation and experience of the development of multi-hospital areas in foreign medical institutions,and to analyze its enlightenment to the construction of"one hospital with multiple campuses"in public hospitals in China.Methods Through the combing of relevant literature,it systematically analyzes the development status of multi-hospital construction of medical institutions in typical countries such as the United States,the United Kingdom,and Germany,summarizes the relevant experience of different countries,and analyzes the current situation of the construction of"one hospital with multiple campuses"in China's public hospitals.Results At present,the orderly development of multiple hospitals of foreign medical institutions mainly depends on the homogenization of medical care,the scientific management of human resources and the improvement of information construction.China can learn from its experience and technical means to build a development pattern of"one hospital with multiple campuses"suitable for China's national conditions.Conclusion In the future,the construction of"one hospital with multiple campuses"in China's public hospitals should focus on"rationalization of human resource allocation,homogenization of medical service quality,and intelligent information system construction",improve"human resource allocation",establish and improve"information sharing mechanism",differentiate the layout of"hospital functions",and strengthen"quality supervision and patient feedback",aiming to improve the construction effect of"one hospital with multiple campuses"in China's public hospitals.

Objective:To investigate the prognostic value of 18F-FDG PET/CT-based habitat radiomics combined with stacking ensemble learning model in overall survival (OS) of patients with hepatocellular carcinoma (HCC). Methods:A total of 136 HCC patients (114 males, 22 females, age (55.3±10.4) years) who underwent 18F-FDG PET/CT before treatment between January 2018 and January 2023 were retrospectively analyzed. Eighty-five cases from Tianjin First Central Hospital and 51 cases from Tianjin Medical University Cancer Institute and Hospital were used as a training cohort and an external validation cohort, respectively. The tumor volume of interest (VOI) was delineated on PET and CT images, and a total of 4 habitats were segmented by using the Otsu algorithm, including PET high ∩ CT low, PET low ∩ CT low, PET high ∩ CT high, and PET low ∩ CT high. After the feature selection, a total of 36 stacking ensemble learning models were established, and the optimal model was selected based on the calculated concordance index (C-index). Moreover, a combined model was developed by integrating the optimal model with clinical information. The predictive efficacy of those models was assessed by time-dependent ROC curves. Results:The model based on PET high ∩ CT high habitat radiomics features with multilayer perceptron (MLP) classifier had the highest C-index (0.770) in the external validation cohort, and it was regarded as the optimal radiomics model. The combined model incorporating this model with clinical information achieved an improved C-index of 0.815 in the external validation cohort. The combined model outperformed the other models for OS prediction, with a time-dependent AUC of 0.919, 0.900, and 0.862 in predicting the 1-year, 2-year, and 3-year OS, respectively. Conclusions:18F-FDG PET/CT-based habitat analysis outperforms traditional radiomics in OS prediction for HCC patients. By integrating the optimal habitat model with the clinical model, the combined model is able to improve the predictive efficacy.

Proteus mirabilis is a significant foodborne pathogen that frequently causes diseases in humans and animals.Understanding the cytokine profile alterations following gastrointestinal in-fection with P.mirabilis is crucial for developing effective treatment strategies.This study em-ployed an intragastric infection model in mice to observe clinical symptoms and pathological chan-ges.Blood samples were collected at various time points post-infection,and the concentrations of 21 cytokines in the serum of both infected and control mice were quantitatively analyzed using the Bio-Plex suspension array system.The results of the infection experiment indicated that gastroin-testinal infection with P.mirabilis in mice led to splenic hemorrhage and significant splenomegaly.A notable difference in spleen index between the infected and control groups was observed at 24 hours post-infection(P=0.001 688),with the greatest difference occurring at 96 hours post-infec-tion(P=0.000 074).Cytokine analysis revealed significant elevations in IL-2,IL-17A,KC,Eotax-in,MCP-1,RANTES,MIP-1α,MIP-1β,IFN-γ,G-CSF,and IL-10 levels in the infected group.A-mong these,the pro-inflammatory cytokines IL-17A and G-CSF exhibited the most substantial changes,positively correlating with the splenomegaly,and peaking at 96 hours post-infection,with concentrations of(104.74±3.91)and(5 184.08±280.22)ng/L,respectively,which were 26.79 and 36.25 times higher than those in the control group.These findings indicate that IL-17A and G-CSF play significant roles in the pro-inflammatory response following gastrointestinal infection with P.mirabilis.

Objective To observe the value of PET/CT radiomics for predicting Ki-67 expression level of non-small cell lung carcinoma(NSCLC).Methods 18F-FDG PET/CT data of 139 NSCLC patients were retrospectively analyzed.The patients were divided into high-expression group(≥40%,n=75)and low-expression group(＜40%,n=64)according to Ki-67 expression level of NSCLC.CT,PET and PET/CT data were divided into training set and test set at a ratio of 7∶3 and make the distribution of Ki-67 expression levels balanced between sets,respectively.CT,PET and PET/CT radiomics features of NSCLC were extracted,and the optimal radiomics features were screened,then random forest(RF),categorical boosting(CatBoost)and extreme gradient boosting(XGBoost)algorithms were used to construct models,respectively.Receiver operating characteristic curve was plotted,and the area under the curve(AUC)was calculated to screen the radiomics model with the highest efficacy for predicting Ki-67 expression level of NSCLC.Results RF models had the highest performance among radiomics models constructed based on CT,PET and PET/CT.The efficacy of RFCT,RFPET and RFPET/CT models for predicting Ki-67 expression level of NSCLC in test set increased sequentially,with AUC of 0.830,0.870 and 0.940,respectively(all P＜0.05),and RFPET/CT was the best radiomics model.Conclusion PET/CT radiomics could be used to effectively predict Ki-67 expression level of NSCLC,and RFPET/CT model had the best performance.

Objective To observe the value of PET/CT radiomics for predicting Ki-67 expression level of non-small cell lung carcinoma(NSCLC).Methods 18F-FDG PET/CT data of 139 NSCLC patients were retrospectively analyzed.The patients were divided into high-expression group(≥40%,n=75)and low-expression group(＜40%,n=64)according to Ki-67 expression level of NSCLC.CT,PET and PET/CT data were divided into training set and test set at a ratio of 7∶3 and make the distribution of Ki-67 expression levels balanced between sets,respectively.CT,PET and PET/CT radiomics features of NSCLC were extracted,and the optimal radiomics features were screened,then random forest(RF),categorical boosting(CatBoost)and extreme gradient boosting(XGBoost)algorithms were used to construct models,respectively.Receiver operating characteristic curve was plotted,and the area under the curve(AUC)was calculated to screen the radiomics model with the highest efficacy for predicting Ki-67 expression level of NSCLC.Results RF models had the highest performance among radiomics models constructed based on CT,PET and PET/CT.The efficacy of RFCT,RFPET and RFPET/CT models for predicting Ki-67 expression level of NSCLC in test set increased sequentially,with AUC of 0.830,0.870 and 0.940,respectively(all P＜0.05),and RFPET/CT was the best radiomics model.Conclusion PET/CT radiomics could be used to effectively predict Ki-67 expression level of NSCLC,and RFPET/CT model had the best performance.

Objective To explore the current situation and experience of the development of multi-hospital areas in foreign medical institutions,and to analyze its enlightenment to the construction of"one hospital with multiple campuses"in public hospitals in China.Methods Through the combing of relevant literature,it systematically analyzes the development status of multi-hospital construction of medical institutions in typical countries such as the United States,the United Kingdom,and Germany,summarizes the relevant experience of different countries,and analyzes the current situation of the construction of"one hospital with multiple campuses"in China's public hospitals.Results At present,the orderly development of multiple hospitals of foreign medical institutions mainly depends on the homogenization of medical care,the scientific management of human resources and the improvement of information construction.China can learn from its experience and technical means to build a development pattern of"one hospital with multiple campuses"suitable for China's national conditions.Conclusion In the future,the construction of"one hospital with multiple campuses"in China's public hospitals should focus on"rationalization of human resource allocation,homogenization of medical service quality,and intelligent information system construction",improve"human resource allocation",establish and improve"information sharing mechanism",differentiate the layout of"hospital functions",and strengthen"quality supervision and patient feedback",aiming to improve the construction effect of"one hospital with multiple campuses"in China's public hospitals.

Proteus mirabilis is a significant foodborne pathogen that frequently causes diseases in humans and animals.Understanding the cytokine profile alterations following gastrointestinal in-fection with P.mirabilis is crucial for developing effective treatment strategies.This study em-ployed an intragastric infection model in mice to observe clinical symptoms and pathological chan-ges.Blood samples were collected at various time points post-infection,and the concentrations of 21 cytokines in the serum of both infected and control mice were quantitatively analyzed using the Bio-Plex suspension array system.The results of the infection experiment indicated that gastroin-testinal infection with P.mirabilis in mice led to splenic hemorrhage and significant splenomegaly.A notable difference in spleen index between the infected and control groups was observed at 24 hours post-infection(P=0.001 688),with the greatest difference occurring at 96 hours post-infec-tion(P=0.000 074).Cytokine analysis revealed significant elevations in IL-2,IL-17A,KC,Eotax-in,MCP-1,RANTES,MIP-1α,MIP-1β,IFN-γ,G-CSF,and IL-10 levels in the infected group.A-mong these,the pro-inflammatory cytokines IL-17A and G-CSF exhibited the most substantial changes,positively correlating with the splenomegaly,and peaking at 96 hours post-infection,with concentrations of(104.74±3.91)and(5 184.08±280.22)ng/L,respectively,which were 26.79 and 36.25 times higher than those in the control group.These findings indicate that IL-17A and G-CSF play significant roles in the pro-inflammatory response following gastrointestinal infection with P.mirabilis.

Objective:To investigate the prognostic value of 18F-FDG PET/CT-based habitat radiomics combined with stacking ensemble learning model in overall survival (OS) of patients with hepatocellular carcinoma (HCC). Methods:A total of 136 HCC patients (114 males, 22 females, age (55.3±10.4) years) who underwent 18F-FDG PET/CT before treatment between January 2018 and January 2023 were retrospectively analyzed. Eighty-five cases from Tianjin First Central Hospital and 51 cases from Tianjin Medical University Cancer Institute and Hospital were used as a training cohort and an external validation cohort, respectively. The tumor volume of interest (VOI) was delineated on PET and CT images, and a total of 4 habitats were segmented by using the Otsu algorithm, including PET high ∩ CT low, PET low ∩ CT low, PET high ∩ CT high, and PET low ∩ CT high. After the feature selection, a total of 36 stacking ensemble learning models were established, and the optimal model was selected based on the calculated concordance index (C-index). Moreover, a combined model was developed by integrating the optimal model with clinical information. The predictive efficacy of those models was assessed by time-dependent ROC curves. Results:The model based on PET high ∩ CT high habitat radiomics features with multilayer perceptron (MLP) classifier had the highest C-index (0.770) in the external validation cohort, and it was regarded as the optimal radiomics model. The combined model incorporating this model with clinical information achieved an improved C-index of 0.815 in the external validation cohort. The combined model outperformed the other models for OS prediction, with a time-dependent AUC of 0.919, 0.900, and 0.862 in predicting the 1-year, 2-year, and 3-year OS, respectively. Conclusions:18F-FDG PET/CT-based habitat analysis outperforms traditional radiomics in OS prediction for HCC patients. By integrating the optimal habitat model with the clinical model, the combined model is able to improve the predictive efficacy.

Objective:To analyze and evaluate the equity of children's health in countries along the"the Belt and Road",promote further attention to children's health in countries along the route,and promote cooperation and exchanges on children's health between China and countries along the"the Belt and Road".Methods:Using concentration index and concentration curve to measure overall equity,and using the Thiel index for intraregional and interregional euqity measurement.Results:The under-five mortality concentration index is 0.349 7,the concentration curve is below the absolute fair line.The Thiel index shows that inequality in low-income countries,lower-middle-income countries,upper-middle-income countries and high-income countries is the leading cause of child health inequities in the"the Belt and Road"countries.Conclusion:There is inequity in the health of children in countries along"the Belt and Road Initiative",countries along the"the Belt and Road"should take comprehensive measures to reduce the under-five mortality rate,at the same time strengthen international cooperation to further promote equity in children's health in"Belt and Road"countries.