Objective:To investigate the immunohistochemical expression pattern of phosphatase and tensin homolog deleted on chromosome ten(PTEN)protein with chromosome 10 deletion in endometrioid carcinoma(EEC)and its relationship with DNA mismatch repair(MMR)protein.Methods:A total of 121 patients diagnosed with EEC,endometrial atypical hyperplasia/endometrial intraepithelial neoplasia(EAH/EIN),and normal endome-trium due to uterine fibroid resection at Hubei Cancer Hospital Affiliated to Tongji Medical College of Huazhong U-niversity of Science and Technology from May 14,2019 to June 7,2023 were selected as the study subjects,inclu-ding 84 patients in the EEC group,17 patients in the EAH/EIN group,and 20 patients in the control group.Immu-nohistochemical was used to detect the expression patterns and differences of PTEN and MMR in endometrial tis-sues of three groups,and the differences in abnormal expression of PTEN protein in EEC between MMR protein deficient(MMRd)group and non-deficient(MMRp)group were compared.Results:①The expression of PTEN protein in 121 endometrial glandular epithelial cells includes four patterns:normal expression,negativeexpression,reduced expression,and heterogeneous expression.②The abnormal expression rates of PTEN protein in the EEC and EAH/EIN groups(84.5％and 94.1％)were higher than those in the control group(10.0％);The ex-pression rates of MMRd protein in the EEC group and EAH/EIN group(35.7％and 35.3％)were higher than those in the control group(0％),and the above differences were statistically significant(P＜0.05).③The abnor-mal expression rate of PTEN in the MMRd group was 96.7％,which was higher than that in the MMRp group(96.7％vs.77.8％,P=0.048).④In the EEC group,with normal and abnormal expression of PTEN protein,there was no statistically significant difference in the comparison of different pathological grades,muscle infiltration depth,lymph node metastasis,and lymphatic vessel invasion between the MMRd group and the MMRp group(P＞0.05).Conclusions:Identifying the abnormal expression pattern of PTEN protein and combining it with MMR protein detection can help identify endometrial dysplasia,and there may be a correlation between PTEN and MMR protein expression in EEC.The abnormal expression of PTEN may not have a clear impact on the biological behavior of MMRd expressing EEC.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective:To analyze the human immunodeficiency virus (HIV) screening status and the resulting residual risk (RR) among blood donors across 17 provincial blood centers in China.Methods:This study used a cross-sectional study. Data on HIV infection markers per 100 000 first-time donors (FD) and repeat donors (RD) from January 2015 to December 2024 were extracted from the National Blood Establishment Performance Comparison Information Management System. Questionnaires were used to collect each center′s HIV screening strategy, algorithm, serological test (ST) kit manufacturers, gray-zone setting for ST, and nucleic acid test (NAT) modality, method, and platform. The incidence-window-period model was used to calculate the residual risk for first-time donors (RR FD), repeat donors (RR RD), and total donors (RR TD) at each center. Horizontal and vertical analysis of RR FD, RR RD, and RR TD across centers and years were performed. Results:All 17 centers applied the same HIV screening strategy which was two rounds of ST followed by one round of NAT. Eight of them operated a single screening algorithm, six employed two algorithms and three used three. Eleven centers used both imported and domestic ST kits, five relied on domestic ST kits only, and one used imported ST kits only, while four centers never set a grey zone for ST throughout the decade. For NAT modalities, eight centers adopted both individual nucleic acid test (ID-NAT) and minipool nucleic acid test (MP-NAT), eight used MP-NAT only and one used ID-NAT only. Seven centers combined transcription mediated amplification (TMA) and polymerase chain reaction (PCR), nine used PCR only and one used TMA only, and fourteen centers ran both imported and domestic NAT systems, two used imported systems only and one used a domestic system only. Over the ten-year period, the mean RR FD across the centers ranged from 2.22 to 12.33 per 10 6 person-years, RR RD from 0.83 to 3.29 per 10 6 person-years and RR TD from 1.59 to 9.29 per 10 6 person-years, with center Z4 consistently showing the lowest values for all three metrics and center U4 recording the highest RR FD and RR TD, while center D2 had the highest RR RD. In 2024 compared with 2015, eleven centers achieved a lower RR FD and ten centers achieved lower RR RD and RR TD. The RR FD and RR TD of centers W2 and U4 displayed pronounced fluctuations and an upward trend in recent years. Conclusions:The 17 provincial blood centers maintain consistent HIV screening strategies, while demonstrating variations in screening algorithm, ST kit manufacturers, NAT modalities, methods, and platform. And the RR FD, RR RD, and RR TD differ across centers. Although most centers show declining trend in RR over the ten-year period, some centers exhibite data fluctuations with a rising trend, suggesting potential for further optimization of HIV screening protocols.

Objective To explore the value of phase contrast(PC)MRI intracranial hemodynamic parameters for predicting acute mountain sickness(AMS).Methods Totally 72 healthy young volunteers were prospectively recruited.Intracranial hemodynamic parameters of internal carotid artery(ICA)and internal jugular vein(IJV)were measured using PC MRI under normal breathing,as well as mild,moderate and severe Valsalva maneuvers(VM)in plain area.The subjects were divided into AMS group(n=9)and non-AMS group(n=63)according to results of Lake Louise score(LLS)10 h after a rapid ascent to plateau area with altitude of 4 411 m.Univariate and multivariate logistic regression analyses were performed to screen independent predictors of AMS under different states and then construct single and combined VM states prediction models.Receiver operating characteristic curves were plotted,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of each model.Results ICA pulsatility index(PIICA)under mild VM,IJV cross-sectional area(SIJV)under moderate VM and IJV resistance index(RIIJV)under severe VM were all independent predictors of AMS(all P＜0.05).The efficacy of combined VM states model(AUC=0.869)for predicting AMS was higher than each single VM state model(AUC=0.698-0.738).Conclusion The model constructed based on PIICA under mild VM,SIJV under moderate VM and RIIJV under severe VM could be used to effectively predict AMS.

Objective To explore the value of phase contrast(PC)MRI intracranial hemodynamic parameters for predicting acute mountain sickness(AMS).Methods Totally 72 healthy young volunteers were prospectively recruited.Intracranial hemodynamic parameters of internal carotid artery(ICA)and internal jugular vein(IJV)were measured using PC MRI under normal breathing,as well as mild,moderate and severe Valsalva maneuvers(VM)in plain area.The subjects were divided into AMS group(n=9)and non-AMS group(n=63)according to results of Lake Louise score(LLS)10 h after a rapid ascent to plateau area with altitude of 4 411 m.Univariate and multivariate logistic regression analyses were performed to screen independent predictors of AMS under different states and then construct single and combined VM states prediction models.Receiver operating characteristic curves were plotted,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of each model.Results ICA pulsatility index(PIICA)under mild VM,IJV cross-sectional area(SIJV)under moderate VM and IJV resistance index(RIIJV)under severe VM were all independent predictors of AMS(all P＜0.05).The efficacy of combined VM states model(AUC=0.869)for predicting AMS was higher than each single VM state model(AUC=0.698-0.738).Conclusion The model constructed based on PIICA under mild VM,SIJV under moderate VM and RIIJV under severe VM could be used to effectively predict AMS.

Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2％)and gram-negative organisms(60.8％).The top three organisms were S.aureus(13.6％,1 453/10 688),A.baumannii(10.0％,1 067/10 688),and coagulase-negative Staphylococcus(9.9％,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1％,19.4％,8.8％,30.9％,67.4％,and 28.8％,respectively.Overall,more than 50％of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25％of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80％of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3％in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.

Objective To explore the correlation of MET status in patients with advanced prostatic acinar adenocarcinoma with the clinical pathological parameters and prognosis. Methods The specimen from 135 patients with advanced prostatic acinar adenocarcinoma was included. The expression of c-MET protein was detected via immunohistochemistry, and MET gene amplification was assessed by fluorescence in situ hybridization. The relationships of c-MET expression and gene amplification with clinicopathological features and prognosis were analyzed. Results The positive expression rate of c-MET was 52.60% (71/135). Compared with the c-MET expression in adjacent tissues, that in tumor tissues showed lower heterogeneous expression. Among the cases, 1.71% (2/117) exhibited MET gene polyploidy, but no gene amplification was detected. Positive c-MET expression was significantly correlated with high Gleason scores and grade groups (P=0.0073). However, no significant relationship was found between c-MET expression and progression-free survival or post-treatment t-PSA levels. Conclusion c-MET protein is expressed at a relatively low level in advanced prostatic acinar adenocarcinoma, suggesting that c-MET may not be a viable target for ADC drug development in prostatic acinar adenocarcinoma.

Objective:To investigate the immunohistochemical expression pattern of phosphatase and tensin homolog deleted on chromosome ten(PTEN)protein with chromosome 10 deletion in endometrioid carcinoma(EEC)and its relationship with DNA mismatch repair(MMR)protein.Methods:A total of 121 patients diagnosed with EEC,endometrial atypical hyperplasia/endometrial intraepithelial neoplasia(EAH/EIN),and normal endome-trium due to uterine fibroid resection at Hubei Cancer Hospital Affiliated to Tongji Medical College of Huazhong U-niversity of Science and Technology from May 14,2019 to June 7,2023 were selected as the study subjects,inclu-ding 84 patients in the EEC group,17 patients in the EAH/EIN group,and 20 patients in the control group.Immu-nohistochemical was used to detect the expression patterns and differences of PTEN and MMR in endometrial tis-sues of three groups,and the differences in abnormal expression of PTEN protein in EEC between MMR protein deficient(MMRd)group and non-deficient(MMRp)group were compared.Results:①The expression of PTEN protein in 121 endometrial glandular epithelial cells includes four patterns:normal expression,negativeexpression,reduced expression,and heterogeneous expression.②The abnormal expression rates of PTEN protein in the EEC and EAH/EIN groups(84.5％and 94.1％)were higher than those in the control group(10.0％);The ex-pression rates of MMRd protein in the EEC group and EAH/EIN group(35.7％and 35.3％)were higher than those in the control group(0％),and the above differences were statistically significant(P＜0.05).③The abnor-mal expression rate of PTEN in the MMRd group was 96.7％,which was higher than that in the MMRp group(96.7％vs.77.8％,P=0.048).④In the EEC group,with normal and abnormal expression of PTEN protein,there was no statistically significant difference in the comparison of different pathological grades,muscle infiltration depth,lymph node metastasis,and lymphatic vessel invasion between the MMRd group and the MMRp group(P＞0.05).Conclusions:Identifying the abnormal expression pattern of PTEN protein and combining it with MMR protein detection can help identify endometrial dysplasia,and there may be a correlation between PTEN and MMR protein expression in EEC.The abnormal expression of PTEN may not have a clear impact on the biological behavior of MMRd expressing EEC.

Objective:To analyze the human immunodeficiency virus (HIV) screening status and the resulting residual risk (RR) among blood donors across 17 provincial blood centers in China.Methods:This study used a cross-sectional study. Data on HIV infection markers per 100 000 first-time donors (FD) and repeat donors (RD) from January 2015 to December 2024 were extracted from the National Blood Establishment Performance Comparison Information Management System. Questionnaires were used to collect each center′s HIV screening strategy, algorithm, serological test (ST) kit manufacturers, gray-zone setting for ST, and nucleic acid test (NAT) modality, method, and platform. The incidence-window-period model was used to calculate the residual risk for first-time donors (RR FD), repeat donors (RR RD), and total donors (RR TD) at each center. Horizontal and vertical analysis of RR FD, RR RD, and RR TD across centers and years were performed. Results:All 17 centers applied the same HIV screening strategy which was two rounds of ST followed by one round of NAT. Eight of them operated a single screening algorithm, six employed two algorithms and three used three. Eleven centers used both imported and domestic ST kits, five relied on domestic ST kits only, and one used imported ST kits only, while four centers never set a grey zone for ST throughout the decade. For NAT modalities, eight centers adopted both individual nucleic acid test (ID-NAT) and minipool nucleic acid test (MP-NAT), eight used MP-NAT only and one used ID-NAT only. Seven centers combined transcription mediated amplification (TMA) and polymerase chain reaction (PCR), nine used PCR only and one used TMA only, and fourteen centers ran both imported and domestic NAT systems, two used imported systems only and one used a domestic system only. Over the ten-year period, the mean RR FD across the centers ranged from 2.22 to 12.33 per 10 6 person-years, RR RD from 0.83 to 3.29 per 10 6 person-years and RR TD from 1.59 to 9.29 per 10 6 person-years, with center Z4 consistently showing the lowest values for all three metrics and center U4 recording the highest RR FD and RR TD, while center D2 had the highest RR RD. In 2024 compared with 2015, eleven centers achieved a lower RR FD and ten centers achieved lower RR RD and RR TD. The RR FD and RR TD of centers W2 and U4 displayed pronounced fluctuations and an upward trend in recent years. Conclusions:The 17 provincial blood centers maintain consistent HIV screening strategies, while demonstrating variations in screening algorithm, ST kit manufacturers, NAT modalities, methods, and platform. And the RR FD, RR RD, and RR TD differ across centers. Although most centers show declining trend in RR over the ten-year period, some centers exhibite data fluctuations with a rising trend, suggesting potential for further optimization of HIV screening protocols.

ObjectiveTo present the exploration and application of a prospective follow-up research method for acute infectious disease surveillance based on natural community populations， using COVID-19 infection as an example， and to provide a reference for improving the infectious disease surveillance and early warning system. MethodsA multi-stage probability proportional sampling method was employed to sample residents from all communities of 16 administrative districts in Shanghai， with households as the units. A cohort for acute infectious diseases based on natural community populations was established. The baseline survey was conducted for all cohort subjects， and COVID-19 antigen test kits were distributed. From December 21， 2022 to September 30， 2023， prospective follow-up monitoring of COVID-19 antigen and nucleic acid was carried out on the study subjects on a weekly basis. The baseline characteristics and follow-up information of the cohort subjects were described. ResultsThe cohort for acute infectious diseases included a total of 12 881 subjects， comprising 6 098 males （47.3%） and 6 783 females （52.7%）. The baseline survey revealed that 35.2% （4 540/12 881） of the subjects had a history of COVID-19 infection. During the follow-up period from December 21， 2022 to September 30， 2023， the average incidence density in the cohort was 0.61/person-year， with a higher incidence density in females （0.63/person-year） compared to males （0.59/person-year）. Individuals aged 60 and above （0.64/person-year） and those with underlying health conditions （0.67/person-year） had a higher incidence density. Healthcare workers showed a notably higher incidence density （0.84/person-year） than that in other occupational groups. As of September 30， 2023， a total of 340 subjects in the cohort experienced secondary infections， with a median interval of 170 days between the first and second infections. ConclusionThis study applies cohort study method to acute infectious disease surveillance， providing crucial data support for estimating infection rates and forecasting alerts for acute infectious diseases in the community. This method can be promoted and applied as a new approach for acute infectious disease surveillance.