Objective To explore the relationship between new obesity indicators and the risk of diabetic kidney disease (DKD) in elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 105 elderly patients with T2DM and DKD admitted from November 2021 to November 2025 were selected as the study group, and 255 elderly patients with simple T2DM were included in the control group. The new obesity indicators and renal function indicators were measured in the two groups, and the relationship between the above indicators and the risk of DKD was analyzed. Results Compared with the control group, patients in the study group exhibited higher body roundness index (BRI), lipid accumulation product (LAP), visceral adiposity index (VAI), triglyceride-glucose index (TyG), and TyG-body mass index (TyG-BMI), lower estimated glomerular filtration rate (eGFR), and higher serum creatinine (Scr) and blood uric acid (UA) (all P<0.05). Pearson analysis revealed that BRI, LAP, VAI, TyG index, and TyG-BMI were negatively correlated with eGFR (all P<0.05) and positively correlated with Scr and UA (all P<0.05). Multivariate logistic regression analysis suggested that disease duration, BRI, TyG index, TyG-BMI, and UA were all related factors for the occurrence of DKD in T2DM (all P<0.05). Conclusion New obesity indicators (BRI, LAP, VAI, TyG index, and TyG-BMI) are closely related to renal function in elderly T2DM patients. BRI, TyG index, and TyG-BMI are associated factors for the development of DKD in T2DM patients and may indicate the risk of DKD.

This report presents a rare case of viral encephalitis resulting from co-infection with human herpesvirus 7(HHV-7)and Epstein-Barr virus(EBV)in a 16-year-old patient with Crohn's disease following adalimumab therapy.The patient was treated with adalimumab,with an initial subcutaneous dose of 160 mg,followed by 80 mg at week 2,and maintenance doses of 40 mg every two weeks,three months after initiating treatment,the patient developed symptoms including headache,diplopia,and signs of intracranial hypertension.Metagenomic sequencing of the cerebrospinal fluid identified HHV-7 and EBV as the causative pathogens,with cranial magnetic resonance imaging supporting the diagnosis of viral encephalitis.Targeted antiviral therapy and supportive care led to significant resolution of neurological symptoms.Using the Naranjo's Assessment Scale,the association between adalimumab and viral encephalitis was evaluated,yielding a score of 5,indicating a"probable"causal link.This case underscores the importance of vigilant monitoring for rare central nervous system viral infections in patients with Crohn's disease receiving tumor necrosis factor inhibitors.

Objective:To compare enrichment and nucleic acid detection method for hepatitis E virus (HEV) in simulated cola samples.Methods:Cola samples experimentally contaminated with HEV were enriched using positively charged filter membrane-direct lysis (Method 1), tangential flow ultrafiltration membrane-direct lysis (Method 2), and Method 3 and 4 (with the addition of a PCR inhibitor removal step on the basis of Method 1 and 2, respectively), and were assayed by real-time fluorescence quantitative RT-PCR(RT-qPCR), and the recoveries and inhibition rates were compared. Digital RT-PCR(RT-dPCR) and RT-qPCR were applied to detect the recovery of HEV in different medium and low concentrations of experimentally contaminated cola samples; and the inhibition rate and sensitivity of HEV RNA detection in different matrices.Methods 3 was selected for virus enrichment of 8 commercially available cola specimens, RT-qPCR and RT-dPCR for HEV RNA detection.Results:The HEV recoveries of method 3 and 4 (10.44% and 10.16%) were higher than those of method 1 and 2 (4.89% and 0.32%), and the differences were statistically significant ( P<0.05). The inhibition rates of method 3 and 4 were smaller than the inhibition rates of method 1 and 2. The recoveries of HEV in medium concentration artificially contaminated cola samples by RT-qPCR and RT-dPCR were 17.04% and 16.28%, respectively, and for low concentration artificially contaminated cola samples were 6.91% and 4.65%, respectively, and the differences in recoveries between the two assays at the same concentration were not statistically significant ( P=0.260, P=0.107 ); Cola matrix inhibits the detection of both RT-qPCR and RT-dPCR assays. Eight commercially available cola specimens were negative for HEV. Conclusions:Detection of HEV in cola beverages can be done by positively charged filter membrane-direct lysis + inhibitor removal (method 3) or tangential flow ultrafiltration membrane-direct lysis + inhibitor removal (method 4) enrichment, followed by RT-dPCR or RT-qPCR, with a high recovery of virus detection.

Objective:To construct a volume management program for peritoneal dialysis patients in the peridialysis period.Methods:The intervention map was used as a guiding framework to build a first draft of a volume management program for peritoneal dialysis patients during the peridialysis period based on semi-structured interviews and a literature review in conjunction with a health belief model. Between December 2023 and February 2024, the first draft of the volume management program was revised by two rounds of expert consultation to produce a final program.Results:A total of 15 peritoneal dialysis medical and nursing experts were invited to complete two rounds of Delphi expert consultation. In the two rounds of expert consultation, 15 questionnaires were issued, and 15 valid questionnaires were recovered; the effective recovery rate was 100.00%, and the expert authority coefficient was both 0.903. The final constructed volume management program for peritoneal dialysis patients during the peridialysis period consisted of four first-level items (knowledge training, volume management plan development, behavioral assessment, and belief support), 10 second-level items, and 30 third-level items.Conclusions:The volume management program for peritoneal dialysis patients in the peridialysis period constructed in this study is scientific and can provide a reference for healthcare professionals.

Objective:To compare enrichment and nucleic acid detection method for hepatitis E virus (HEV) in simulated cola samples.Methods:Cola samples experimentally contaminated with HEV were enriched using positively charged filter membrane-direct lysis (Method 1), tangential flow ultrafiltration membrane-direct lysis (Method 2), and Method 3 and 4 (with the addition of a PCR inhibitor removal step on the basis of Method 1 and 2, respectively), and were assayed by real-time fluorescence quantitative RT-PCR(RT-qPCR), and the recoveries and inhibition rates were compared. Digital RT-PCR(RT-dPCR) and RT-qPCR were applied to detect the recovery of HEV in different medium and low concentrations of experimentally contaminated cola samples; and the inhibition rate and sensitivity of HEV RNA detection in different matrices.Methods 3 was selected for virus enrichment of 8 commercially available cola specimens, RT-qPCR and RT-dPCR for HEV RNA detection.Results:The HEV recoveries of method 3 and 4 (10.44% and 10.16%) were higher than those of method 1 and 2 (4.89% and 0.32%), and the differences were statistically significant ( P<0.05). The inhibition rates of method 3 and 4 were smaller than the inhibition rates of method 1 and 2. The recoveries of HEV in medium concentration artificially contaminated cola samples by RT-qPCR and RT-dPCR were 17.04% and 16.28%, respectively, and for low concentration artificially contaminated cola samples were 6.91% and 4.65%, respectively, and the differences in recoveries between the two assays at the same concentration were not statistically significant ( P=0.260, P=0.107 ); Cola matrix inhibits the detection of both RT-qPCR and RT-dPCR assays. Eight commercially available cola specimens were negative for HEV. Conclusions:Detection of HEV in cola beverages can be done by positively charged filter membrane-direct lysis + inhibitor removal (method 3) or tangential flow ultrafiltration membrane-direct lysis + inhibitor removal (method 4) enrichment, followed by RT-dPCR or RT-qPCR, with a high recovery of virus detection.

This report presents a rare case of viral encephalitis resulting from co-infection with human herpesvirus 7(HHV-7)and Epstein-Barr virus(EBV)in a 16-year-old patient with Crohn's disease following adalimumab therapy.The patient was treated with adalimumab,with an initial subcutaneous dose of 160 mg,followed by 80 mg at week 2,and maintenance doses of 40 mg every two weeks,three months after initiating treatment,the patient developed symptoms including headache,diplopia,and signs of intracranial hypertension.Metagenomic sequencing of the cerebrospinal fluid identified HHV-7 and EBV as the causative pathogens,with cranial magnetic resonance imaging supporting the diagnosis of viral encephalitis.Targeted antiviral therapy and supportive care led to significant resolution of neurological symptoms.Using the Naranjo's Assessment Scale,the association between adalimumab and viral encephalitis was evaluated,yielding a score of 5,indicating a"probable"causal link.This case underscores the importance of vigilant monitoring for rare central nervous system viral infections in patients with Crohn's disease receiving tumor necrosis factor inhibitors.

Objective:To construct a volume management program for peritoneal dialysis patients in the peridialysis period.Methods:The intervention map was used as a guiding framework to build a first draft of a volume management program for peritoneal dialysis patients during the peridialysis period based on semi-structured interviews and a literature review in conjunction with a health belief model. Between December 2023 and February 2024, the first draft of the volume management program was revised by two rounds of expert consultation to produce a final program.Results:A total of 15 peritoneal dialysis medical and nursing experts were invited to complete two rounds of Delphi expert consultation. In the two rounds of expert consultation, 15 questionnaires were issued, and 15 valid questionnaires were recovered; the effective recovery rate was 100.00%, and the expert authority coefficient was both 0.903. The final constructed volume management program for peritoneal dialysis patients during the peridialysis period consisted of four first-level items (knowledge training, volume management plan development, behavioral assessment, and belief support), 10 second-level items, and 30 third-level items.Conclusions:The volume management program for peritoneal dialysis patients in the peridialysis period constructed in this study is scientific and can provide a reference for healthcare professionals.

Objective:To establish a digital reverse transcription polymerase chain reaction（dRT-PCR）detection method for hepatitis E virus（HEV）using nanoplates，and to provide technical reference for HEV monitoring in shellfish by combining virus enrichment pretreatment methods.Methods:The annealing temperature，primer and probe concentrations of HEV dRT-PCR were optimized，and the specificity of the method was evaluated；the sensitivity of this method for detecting HEV in water samples and oyster extracts was compared. The inhibition rate and recovery rate of HEV detection in artificially contaminated oyster samples were calculated，commercially available oyster samples were tested，and compare them with real-time fluorescence quantitative RT-PCR（qRT-PCR）method.Results:The optimized annealing temperature for HEV dRT-PCR was determined to be 60 ℃，and the final concentrations of primers and probes were 0.4 μmol/L，0.4 μmol/L，and 0.2 μmol/L，respectively，indicating good specificity. The sensitivity of both methods for detecting HEV RNA in water samples was higher than that in oyster extracts. The recovery rates of HEV in oyster specimens contaminated with HEV fecal suspension by dRT-PCR and qRT-PCR were 18.76% and 18.36%，respectively，with no statistically significant difference（ P>0.05）；the inhibition rates were 17.26% and 9.58%，respectively，with statistically significant differences（ P<0.05）；55 commercially available oyster samples were tested，and both methods detected HEV RNA positivity in the same sample. Conclusion:The dRT-PCR method established in this study，combined with “proteinase K digestion，PEG/NaCl precipitation，and chloroform/n-butanol extraction” pretreatment，has a good recovery effect on HEV in shellfish food containing a large amount of PCR inhibitors，and can achieve absolute quantification. It has certain application value in monitoring and risk assessment of HEV in shellfish food.

Objective:To establish a digital reverse transcription polymerase chain reaction（dRT-PCR）detection method for hepatitis E virus（HEV）using nanoplates，and to provide technical reference for HEV monitoring in shellfish by combining virus enrichment pretreatment methods.Methods:The annealing temperature，primer and probe concentrations of HEV dRT-PCR were optimized，and the specificity of the method was evaluated；the sensitivity of this method for detecting HEV in water samples and oyster extracts was compared. The inhibition rate and recovery rate of HEV detection in artificially contaminated oyster samples were calculated，commercially available oyster samples were tested，and compare them with real-time fluorescence quantitative RT-PCR（qRT-PCR）method.Results:The optimized annealing temperature for HEV dRT-PCR was determined to be 60 ℃，and the final concentrations of primers and probes were 0.4 μmol/L，0.4 μmol/L，and 0.2 μmol/L，respectively，indicating good specificity. The sensitivity of both methods for detecting HEV RNA in water samples was higher than that in oyster extracts. The recovery rates of HEV in oyster specimens contaminated with HEV fecal suspension by dRT-PCR and qRT-PCR were 18.76% and 18.36%，respectively，with no statistically significant difference（ P>0.05）；the inhibition rates were 17.26% and 9.58%，respectively，with statistically significant differences（ P<0.05）；55 commercially available oyster samples were tested，and both methods detected HEV RNA positivity in the same sample. Conclusion:The dRT-PCR method established in this study，combined with “proteinase K digestion，PEG/NaCl precipitation，and chloroform/n-butanol extraction” pretreatment，has a good recovery effect on HEV in shellfish food containing a large amount of PCR inhibitors，and can achieve absolute quantification. It has certain application value in monitoring and risk assessment of HEV in shellfish food.

Objective:To further study the causes of acute occupational poisoning accidents, and to provide scientific basis and decision support for the prevention of accidents in advance.Methods:From September 2022 to May 2023, the literature was searched and 232 cases of acute occupational poisoning cases occurred from 2013 to 2022 were collected. The causal nodes of the accident were determined according to the expert score, and the interpretative structural model (ISM) was used to construct the correlation model between the causal nodes to obtain the hierarchical relationship between the factors. The influence of each causal node on the occurrence of acute occupational poisoning accidents was studied by using Bayesian network (BN), and the relationship and influence among the causal nodes were analyzed by Netica 5.18 software to establish the pre-prevention model of acute occupational poisoning accidents and identify the key causal factors.Results:A total of 23, 203, and 6 cases of significant, large, and medium acute occupational poisoning accidents were included, of which 179, 29, and 24 cases were asphyxiating gas, irritating gas, and mixed gas, respectively. ISM of acute occupational poisoning accidents divided the causal factors into a 7-layer and 3-level hierarchical structure model. Among them, operation conditions, protective measures, ventilation equipment, hidden trouble investigation, emergency management, illegal operation, equipment and facilities, and blind rescue were the direct causes of the occurrence and expansion of accidents. Warning devices, inspection situation, safety education situation, safety operation procedures, and technology in the production process were indirect influences that lead to the occurrence and expansion of accidents. Safety production responsibility system, enterprise supervision and management and government supervision were the deep-rooted influences. BN reasoning showed that the maximum probability causal chain of acute occupational poisoning accidents was as follows: safety production responsibility system→enterprise supervision and management→safety education and training→protective measures→accident occurrence. The key factors leading to the occurrence of acute occupational poisoning accidents were inadequate protective measures, equipment and facility failures, operational errors, ventilation equipment not being used properly and improper emergency management.Conclusion:In the prevention of acute occupational poisoning accidents, it is necessary to correctly use protective measures, test equipment and facilities before operation, operate according to regulations, ensure the normal use of ventilation equipment, and strengthen emergency management, so as to reduce the incidence of acute occupational poisoning accidents.