Background: The tight junction protein claudin18.2 (CLDN18.2) has been implicated in poor prognosis and suboptimal immunotherapy response in gastric cancer (GC). This study investigates the clinicopathological relevance of CLDN18.2 expression and its association with molecular subtypes in GC patients from a high-incidence region, combining transcriptomic and proteomic approaches to explore how CLDN18.2 contributes to progression and metastasis. Methods: A retrospective cohort of 494 GC patients (2019–2024) underwent immunohistochemical analysis for CLDN18.2, Epstein-Barr virus (Epstein–Barr virus–encoded RNA), p53, human epidermal growth factor receptor 2 (HER2), and mismatch repair proteins (MLH1, MSH2, PMS2, and MSH6). CLDN18.2 positivity was defined as moderate to strong (2+/3+) membranous staining in ≥75% of tumor cells. Clinicopathological correlations, biomarker associations, and survival outcomes were evaluated. Transcriptomic and proteomic sequencing was performed to explore molecular mechanisms. Results: CLDN18.2 positivity was observed in 26.9% (133/494) of gastric adenocarcinomas. CLDN18.2-positive tumors correlated with TNM stage (p = .003) and shorter overall survival (p = .018). No associations were identified with age, sex, HER2 status, microsatellite instability, or Epstein-Barr virus infection. Transcriptomic profiling revealed CLDN18.2-high tumors enriched in pathways involving cell junction disruption, signaling regulation, and immune modulation. Proteomic profiling showed that tumors with high CLDN18.2 were enriched in multiple mechanism-related pathways such as integrated metabolic reprogramming, cytoskeletal recombination, immune microenvironment dysregulation, and pro-survival signaling. These mechanisms may collectively contribute to tumor progression and metastasis. Conclusions CLDN18.2 overexpression is associated with poor prognosis in GC patients. Transcriptomic and proteomic analyses demonstrate that CLDN18.2 promotes tumor progression and metastasis, underscoring its potential as an independent prognostic factor in regions with a high incidence of GC.

Bacterial infection is a major threat to global public health, and can cause serious diseases such as bacterial skin infection and foodborne diseases. It is essential to develop a new method to rapidly diagnose clinical multiple bacterial infections and monitor food microbial contamination in production sites in real-time. In this work, we developed a 4-mercaptophenylboronic acid gold nanoparticles (4-MPBA-AuNPs)-functionalized hydrogel microneedle (MPBA-H-MN) for bacteria detection in skin interstitial fluid. MPBA-H-MN could conveniently capture and enrich a variety of bacteria within 5 min. Surface enhanced Raman spectroscopy (SERS) detection was then performed and combined with machine learning technology to distinguish and identify a variety of bacteria. Overall, the capture efficiency of this method exceeded 50%. In the concentration range of 1 × 10⁷ to 1 × 10¹⁰ colony-forming units/mL (CFU/mL), the corresponding SERS intensity showed a certain linear relationship with the bacterial concentration. Using random forest (RF)-based machine learning, bacteria were effectively distinguished with an accuracy of 97.87%. In addition, the harmless disposal of used MNs by photothermal ablation was convenient, environmentally friendly, and inexpensive. This technique provided a potential method for rapid and real-time diagnosis of multiple clinical bacterial infections and for monitoring microbial contamination of food in production sites.

Objective To investigate the current status of construction and monitoring of healthcare-associated in-fection(HAI)system in maternal and child health care institutions in Guangxi Zhuang Autonomous Region,and provide reference for improving the quality of HAI management.Methods After discussed by members of expert group of HAI Prevention and Control Professional Committee of Guangxi Maternal and Child Health Care Associa-tion,the"Questionnaire on the construction and monitoring of HAI system in maternal and child health care institu-tions in Guangxi Zhuang Autonomous Region"was designed.The questionnaires were distributed to all maternal and child health care institutions in the region via"Questionnaire Star",and a WeChat group was established to ad-dress any questions in questionnaires.Results A total of 104 maternal and child health care institutions were in-cluded in the study,including 6 primary,74 secondary,and 24 tertiary level institutions.All maternal and child health care institutions have established HAI management departments,95.19％(n=99)of institutions held HAI management committee meeting at least once every six months.Among 201 HAI management professionals,most were female(90.55％),with nursing specialty(72.64％),with a bachelor's degree(66.17％),and aged 31-50 years old(73.13％).Only 30.77％of the maternal and child health care institutions had HAI monitoring system.Seventy institutions(67.30％)have carried out the special action of improving the pathogen detection rate before antimicrobial therapy for hospitalized patients,out of which 55(78.57％)were led by the HAI management depart-ment.Ninety-seven(92.27％)maternal and child health care institutions conducted surgery-related monitoring,with 50.96％of institutions relying on manual monitoring;only 30.77％of institutions have carried out the special action of"Strengthening perioperative infection prevention and control to ensure surgical quality and safety".Conclusion HAI management system in maternal and child health care institutions in Guangxi has been basically es-tablished and can carry out monitoring work,but personnel compostion is limited and talent reserve is insufficient.The information construction of HAI monitoring is underdeveloped,with a lagged implement of special action.Ad-ministrative support is needed to enhance infection prevention and control at the grassroots level.All levels of ma-ternal and child health care institutions should communicate and exchange work experience.Hospitals should in-crease their support for the construction of HAI information technology,improve level of HAI monitoring as well as prevention and control capabilities.

Objective To analyze the distribution and drug resistance patterns of pathogenic bacteria in bile and blood cultures obtained from patients with biliary stones accompanied by acute biliary tract infection,to evaluate the clinical appropriate-ness of antibiotic use based on drug sensitivity results,and to provide evidence for empirical antibiotic treatment in such patients.Methods The clinical data of 161 patients with biliary calculi complicated by acute biliary tract infection who were admitted to the First People's Hospital of Neijiang from 2017 to 2023 were retrospectively analyzed.The results of microbial culture,drug sensitivity analysis,and patient characteristics were assessed to evaluate the appropriateness of clinical antimicrobial therapy.Results Among the 161 patients with positive cultures,212 strains of pathogenic bacteria were detected.The predominant patho-gens were Escherichia coli,Klebsiella pneumoniae subspecies,and Enterococcus faecium.Age and underlying diseases significantly affected the distribution of Escherichia coli and Klebsiella pneumoniae subspecies.Within the gram-negative bacterial group,Esche-richia coli and Klebsiella pneumoniae subspecies exhibited higher drug resistance to commonly used broad-spectrum penicillin,third-generation cephalosporin and quinolones but lower resistance rates to piperacillin and tazobactam;furthermore,elderly indi-viduals aged ≥65 years showed higher resistance rates to ceftriaxone than those under age 65 while people with drug exposure history had higher ceftazidime resistance rates that were statistically significant.In contrast to Enterococcus faecalis which displayed low antimicrobial resistance rates for most drugs tested in this study,Enterococcus faecium demonstrated high levels of antibiotic resistance;however,both Enterococcus faecalis and Enterococcus faecium exhibited zero-resistance rates against vancomycin and tigecycline although this may be attributed to their small sample size in our study cohort.Finally,we found that empirical anti-in-fective drugs,as well as target anti-infective drugs,were not prescribed rationally among these patients due mainly to inappropriate combinations of antibiotics or incorrect dosages.Conclusions The predominant pathogens in patients with acute biliary tract infection are gram-negative bacteria,Gram-positive bacteria,and fungi;however,the potential involvement of anaerobic bacteria should not be overlooked.Vancomycin exhibits sensitivity against gram-positive bacteria,yet the overall rationality of antibiotic usage remains suboptimal.Enhanced clinical testing for pathogenic microorganisms is imperative in the management of biliary stones accompanied by acute biliary tract infection.In contrast,clinical pharmacists should provide comprehensive training on anti-infective drugs to clinicians to facilitate their judicious selection of antibiotics based on drug sensitivity results and prevent the e-mergence of multidrug-resistant bacteria.

Bacterial infection is a major threat to global public health,and can cause serious diseases such as bacterial skin infection and foodborne diseases.It is essential to develop a new method to rapidly di-agnose clinical multiple bacterial infections and monitor food microbial contamination in production sites in real-time.In this work,we developed a 4-mercaptophenylboronic acid gold nanoparticles(4-MPBA-AuNPs)-functionalized hydrogel microneedle(MPBA-H-MN)for bacteria detection in skin inter-stitial fluid.MPBA-H-MN could conveniently capture and enrich a variety of bacteria within 5 min.Surface enhanced Raman spectroscopy(SERS)detection was then performed and combined with ma-chine learning technology to distinguish and identify a variety of bacteria.Overall,the capture efficiency of this method exceeded 50％.In the concentration range of 1 × 10 7 to 1 × 10 10 colony-forming units/mL(CFU/mL),the corresponding SERS intensity showed a certain linear relationship with the bacterial concentration.Using random forest(RF)-based machine learning,bacteria were effectively distinguished with an accuracy of 97.87％.In addition,the harmless disposal of used MNs by photothermal ablation was convenient,environmentally friendly,and inexpensive.This technique provided a potential method for rapid and real-time diagnosis of multiple clinical bacterial infections and for monitoring microbial contamination of food in production sites.

Objective To analyze the causes and intervention measure efficacy of an outbreak of neonatal Pseudo-monas aeruginosa(P.aeruginosa)infection in a medical institution.Methods The epidemiological investigation was conducted on 5 neonates who had P.aeruginosa infection in the neonatal intensive care unit(NICU)of this medical institution from May 26 to June 10,2024.Specimens were taken from potentially contaminated environ-ments to infer the cause of P.aeruginosa transmission in the NICU,infection control measures were also taken,and the efficacy of the control measures was continuously monitored.Results Among the 5 infected neonates,3 had lower respiratory tract infection and 2 had lower respiratory tract combined with bloodstream infection.Seven strains of P.aeruginosa were detected with a consistent antimicrobial resistance spectrum.Infected neonates were in the same ward and had spatial and temporal clustering.Through environmental hygiene monitoring,P.aerugi-nosa with consistent antimicrobial resistance spectrum of neonatal infection was isolated from the NICU handwashing sink and water-related environment(suction connection pipe,bedside isolation gowns).Infection was controlled af-ter improving sink disinfection methods and enhancing contact isolation measures,and no further P.aeruginosa was detected in the environment.Conclusion The outbreak of neonatal HAI in the NICU is inferred to be caused by contamination of ward handwashing sink by P.aeruginosa,then further contaminated the suction connection tube,thereby leading to the transmission of neonatal infection through suction procedures.Healthcare-associated infection surveillance and control professionals need to fully understand the characteristics of outbreak pathogens and take tar-geted measures to curb the transmission of neonatal infection.

Objective To analyze the distribution and drug resistance patterns of pathogenic bacteria in bile and blood cultures obtained from patients with biliary stones accompanied by acute biliary tract infection,to evaluate the clinical appropriate-ness of antibiotic use based on drug sensitivity results,and to provide evidence for empirical antibiotic treatment in such patients.Methods The clinical data of 161 patients with biliary calculi complicated by acute biliary tract infection who were admitted to the First People's Hospital of Neijiang from 2017 to 2023 were retrospectively analyzed.The results of microbial culture,drug sensitivity analysis,and patient characteristics were assessed to evaluate the appropriateness of clinical antimicrobial therapy.Results Among the 161 patients with positive cultures,212 strains of pathogenic bacteria were detected.The predominant patho-gens were Escherichia coli,Klebsiella pneumoniae subspecies,and Enterococcus faecium.Age and underlying diseases significantly affected the distribution of Escherichia coli and Klebsiella pneumoniae subspecies.Within the gram-negative bacterial group,Esche-richia coli and Klebsiella pneumoniae subspecies exhibited higher drug resistance to commonly used broad-spectrum penicillin,third-generation cephalosporin and quinolones but lower resistance rates to piperacillin and tazobactam;furthermore,elderly indi-viduals aged ≥65 years showed higher resistance rates to ceftriaxone than those under age 65 while people with drug exposure history had higher ceftazidime resistance rates that were statistically significant.In contrast to Enterococcus faecalis which displayed low antimicrobial resistance rates for most drugs tested in this study,Enterococcus faecium demonstrated high levels of antibiotic resistance;however,both Enterococcus faecalis and Enterococcus faecium exhibited zero-resistance rates against vancomycin and tigecycline although this may be attributed to their small sample size in our study cohort.Finally,we found that empirical anti-in-fective drugs,as well as target anti-infective drugs,were not prescribed rationally among these patients due mainly to inappropriate combinations of antibiotics or incorrect dosages.Conclusions The predominant pathogens in patients with acute biliary tract infection are gram-negative bacteria,Gram-positive bacteria,and fungi;however,the potential involvement of anaerobic bacteria should not be overlooked.Vancomycin exhibits sensitivity against gram-positive bacteria,yet the overall rationality of antibiotic usage remains suboptimal.Enhanced clinical testing for pathogenic microorganisms is imperative in the management of biliary stones accompanied by acute biliary tract infection.In contrast,clinical pharmacists should provide comprehensive training on anti-infective drugs to clinicians to facilitate their judicious selection of antibiotics based on drug sensitivity results and prevent the e-mergence of multidrug-resistant bacteria.

Objective To analyze the causes and intervention measure efficacy of an outbreak of neonatal Pseudo-monas aeruginosa(P.aeruginosa)infection in a medical institution.Methods The epidemiological investigation was conducted on 5 neonates who had P.aeruginosa infection in the neonatal intensive care unit(NICU)of this medical institution from May 26 to June 10,2024.Specimens were taken from potentially contaminated environ-ments to infer the cause of P.aeruginosa transmission in the NICU,infection control measures were also taken,and the efficacy of the control measures was continuously monitored.Results Among the 5 infected neonates,3 had lower respiratory tract infection and 2 had lower respiratory tract combined with bloodstream infection.Seven strains of P.aeruginosa were detected with a consistent antimicrobial resistance spectrum.Infected neonates were in the same ward and had spatial and temporal clustering.Through environmental hygiene monitoring,P.aerugi-nosa with consistent antimicrobial resistance spectrum of neonatal infection was isolated from the NICU handwashing sink and water-related environment(suction connection pipe,bedside isolation gowns).Infection was controlled af-ter improving sink disinfection methods and enhancing contact isolation measures,and no further P.aeruginosa was detected in the environment.Conclusion The outbreak of neonatal HAI in the NICU is inferred to be caused by contamination of ward handwashing sink by P.aeruginosa,then further contaminated the suction connection tube,thereby leading to the transmission of neonatal infection through suction procedures.Healthcare-associated infection surveillance and control professionals need to fully understand the characteristics of outbreak pathogens and take tar-geted measures to curb the transmission of neonatal infection.

Objective To investigate the current status of construction and monitoring of healthcare-associated in-fection(HAI)system in maternal and child health care institutions in Guangxi Zhuang Autonomous Region,and provide reference for improving the quality of HAI management.Methods After discussed by members of expert group of HAI Prevention and Control Professional Committee of Guangxi Maternal and Child Health Care Associa-tion,the"Questionnaire on the construction and monitoring of HAI system in maternal and child health care institu-tions in Guangxi Zhuang Autonomous Region"was designed.The questionnaires were distributed to all maternal and child health care institutions in the region via"Questionnaire Star",and a WeChat group was established to ad-dress any questions in questionnaires.Results A total of 104 maternal and child health care institutions were in-cluded in the study,including 6 primary,74 secondary,and 24 tertiary level institutions.All maternal and child health care institutions have established HAI management departments,95.19％(n=99)of institutions held HAI management committee meeting at least once every six months.Among 201 HAI management professionals,most were female(90.55％),with nursing specialty(72.64％),with a bachelor's degree(66.17％),and aged 31-50 years old(73.13％).Only 30.77％of the maternal and child health care institutions had HAI monitoring system.Seventy institutions(67.30％)have carried out the special action of improving the pathogen detection rate before antimicrobial therapy for hospitalized patients,out of which 55(78.57％)were led by the HAI management depart-ment.Ninety-seven(92.27％)maternal and child health care institutions conducted surgery-related monitoring,with 50.96％of institutions relying on manual monitoring;only 30.77％of institutions have carried out the special action of"Strengthening perioperative infection prevention and control to ensure surgical quality and safety".Conclusion HAI management system in maternal and child health care institutions in Guangxi has been basically es-tablished and can carry out monitoring work,but personnel compostion is limited and talent reserve is insufficient.The information construction of HAI monitoring is underdeveloped,with a lagged implement of special action.Ad-ministrative support is needed to enhance infection prevention and control at the grassroots level.All levels of ma-ternal and child health care institutions should communicate and exchange work experience.Hospitals should in-crease their support for the construction of HAI information technology,improve level of HAI monitoring as well as prevention and control capabilities.

Branch atheromatous disease (BAD) is a common type of acute ischemic stroke, accounting for 10% to 15% of all ischemic stroke etiologies. Clinically, it often presents as early neurological deterioration (END) primarily characterized by progressive motor deficits, leading to poor clinical outcomes. The mechanism of END in BAD patients has not been fully elucidated, and there is a lack of effective risk prediction markers and treatment strategies. With the application of high-resolution and high-field magnetic resonance imaging technologies to evaluate the vessel wall of parent artery and the morphology of penetrating artery, the pathogenesis and progression mechanisms of BAD have been further revealed. Some studies have shown that the effectiveness and safety of using enhanced antiplatelet agents such as tirofiban or combining antiplatelet therapy with anticoagulant treatment such as argatroban are gradually emerging. This article will focus on the research progresses in imaging evaluation and treatment of BAD, aiming to enhance clinicians′ understanding of BAD to take early measures to prevent END, reduce recurrence, and improve patient prognosis.