Objective To establish a rat model of venous thrombosis in a plateau hypobaric hypoxic environment and to investigate the effect of this environment on venous thrombosis.Methods A total of 144 healthy male SD rats were assigned randomly to four groups(n=36 rats per group):a plains sham operation(A)group,plains operation(B)group,plateau altitude 6000 m+sham operation(C)group,and plateau altitude 6000 m+surgery(D)group.Rats in A and B groups were maintained in a plains normoxic environment,while rats in C and D groups C and D were subjected to a plateau environment.Rats in the surgical groups underwent quantitative constriction to incompletely obstruct the inferior vena cava blood flow.Each group was further divided into subgroups based on time:1,3,5,7,14,and 21 d(n=6 rats per group).Regular vascular ultrasound monitoring was conducted,and blood samples were taken for whole blood viscosity testing and the assessment of inflammatory indicators,including endothelin-1(ET-1),interleukin-6(IL-6)and tissue factor(TF).Coagulation function was evaluated through the activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)and D-dimer.After the observation period,the experimental animals were sacrificed and the limbs were removed.Thrombus samples were stained with hematoxylin/eosin(HE),and the thrombus wet mass was measured.Results The thrombosis incidence was significantly higher in the plateau D group than in B group,accompanied by a marked increase in blood viscosity and hematocrit(P＜0.01).Additionally,levels of ET-1,IL-6,and TF were significantly elevated(P＜0.05),indicating a coagulation disorder.Conclusions A plateau hypoxic environment model can be successfully simulated by quantitative coarctation of the inferior vena cava,combined with a specialized environmental chamber.The findings of this study suggest that a plateau hypoxic environment promotes venous thrombosis.

Objective To analyze the interspecies differences in virulence of different carbapenem-resistant Enterobacterales(CREb)strains and provide a theoretical basis for understanding the pathogenic mechanisms of CREb and for guiding individualized treatment strategies.Methods A total of nine CREb clinical isolates collected between 2013 and 2022 were included,representing five species:Enterobacter cloacae(E.cloacae),Enterobacter hormaechei(E.hormaechei),Enterobacter kobei(E.kobei),Enterobacter asburiae(E.asburiae),and Enterobacter chuandaensis(E.chuandaensis).Whole-genome sequencing was performed to characterize virulence gene profiles.Phenotypic assays included growth curve analysis,biofilm formation assessment,serum bactericidal assays,and Galleria mellonella infection models to evaluate virulence-related traits.Results Virulence gene analysis revealed that motility-related factors were the most abundant(16 to 20 per strain),followed by nutrition/metabolism-related factors(10 to 12 per strain),while invasion-related genes were rare,with the ibeB gene detected in only two E.asburiae strains.The strains of the same species shared similar viru-lence gene profiles,and E.chuandaensis harbored the fewest virulence genes.In vitro growth assays showed that E.hormaechei and E.cloacae had the fastest growth rates,while E.chuandaensis and E.kobei exhibited slower growth,and E.asburiae displayed the slo-west growth.Biofilm assays indicated that E.hormaechei and E.cloacae had the strongest biofilm-forming capacity,while E.kobei had the weakest.In serum bactericidal assays,E.hormaechei and E.cloacae showed high survival rates(＞70%),whereas the survival rate of E.chuandaensis was less than 1%.In the Galleria mellonella model,E.asburiae and E.cloacae exhibited marked dose-dependent virulence,whereas the remaining strains showed reduced virulence.Conclusion Different CREb species exhibit significant variation in virulence gene content and phenotypic traits.The pathogenic potential of CREb may provide fundamental data to inform strategies for prevention and treatment of CREb infection.

Objective To compare the value of ultrashort echo time(UTE)and T1W sequences for detecting bone erosions of gouty arthritis.Methods Forty-four gouty patients were prospectively enrolled,including 32 cases with affected feet and 12 cases with affected knee.MR UTE and T1W sequence scanning of the affected area were performed,and subjectively scoring of imaging quality of 2 kinds of MRI were evaluated,respectively.Then total number and total score of bone erosions of each case were calculated according to all affected bones.Taken DECT as reference standard,the efficacy of UTE and T1WI for detecting bone erosions was assessed through comparing with DECT using Kappa coefficient.Results The imaging quality score of T1WI was lower than that of DECT(all P＜0.05),while no significant difference was found between UTE and DECT(all P＞0.05).There was high agreement between UTE and DECT for detecting bone erosions(κ=0.949),while the agreement between T1WI and DECT ranged from good to high(κ=0.718 to 0.805).The total number and total score of bone erosions based on T1WI were significantly lower than those based on DECT(all P＜0.05),while no significant difference was found between UTE and DECT(all P＞0.05).Conclusion UTE was better than T1WI for detecting bone erosions of gouty arthritis.

Objective:To investigate the relationship between SET domain bifurcated 1(SETDB1)expression and trefoil factor 1(TFF1)gene methylation,along with its clinical significance.Methods:Fifty-five lung adenocarcinoma samples and normal tissues of distant cancer were collected from the Affiliated Hospital of Chengde Medical College Hebei Province.TFF1 gene methylation levels were measured by pyrosequencing,relative TFF1 mRNA expression was assessed using quantitative real-time polymerase chain reaction(qRT-PCR),and TFF1 and SETDB1 protein expression were quantified via immunohistochemistry.The clinical significance and correlation between TFF1 methyla-tion levels and SETDB1 protein expression were analyzed statistically.In vitro,SETDB1 siRNA or negative control siRNA was transfected into A549 cells.Following transfection,SETDB1 mRNA expression was analyzed using qRT-PCR,and SETDB1 protein expression was evaluated via Western blot.TFF1 methylation was reassessed via pyrosequencing.Results:In lung adenocarcinoma and normal tissues of distant cancer,TFF1 gene methylation rates were(70.16±6.32)%and(12.46±2.22)%,respectively.TFF1 mRNA relative expression levels were 0.56±0.17 for cancer tissues and 1.56±0.22 for the normal tissues of distant cancer.All detected differences were statistically significant(all P<0.05).TFF1 protein expression rates were 29.09%(16/55)for cancer tissues and 65.45%(36/55)for the normal tissues of distant cancer.Additionally,relative positivity rates for SETDB1 protein expression were 74.55%(41/55)and 23.64%(13/55),respectively,and all differences were stat-istically significant(all P<0.05).Western blot analysis showed that SETDB1 protein expression was significantly higher in cancer tissues(72.89±5.27)%,compared to normal tissues of distant cancer(24.27±2.37)%.In contrast,TFF1 protein expressed was markedly lower in can-cer tissues(15.38±2.33)%than in normal tissues of distant cancer(72.72±4.48)%.All differences were statistically significant(all P<0.05).TFF1 methylation and SETDB1 expression were associated with lung adenocarcinoma(r=0.486,P<0.05).Both TFF1 methylation and SETDB1 expression were closely associated with tumor TNM stage,tissue differentiation,and lymph node metastasis(P<0.05).Furthermore,TFF1 methylation increased following SETDB1 downregulation(P<0.05).Conclusions:During lung adenocarcinoma progression,SETDB1 expres-sion correlates with TFF1 methylation,and the highly expressed SETDB1 may play a role in catalyzing TFF1 methylation.

Objective:To analyze the short-term hospital-based transmission characteristics and gene variation of Carbapenem-Resistant Klebsiella pneumoniae (CRKP) by genome-wide technique to provide evidence for transmission control. Methods:The experimental strain was derived from all the CRKP isolated in Affiliated Hospital of North China University of Science and Technology from October 2022 to December 2023. Strain identification and drug susceptibility were tested with VITEK 2-Compact automatic bacterial identification drug susceptibility analyzer or disk method, and the results were interpreted through whole genome sequencing. The ST type, carbapenem resistance gene, virulence factor, and O serotype of the collected strains were analyzed.Results:Among the 115 strains of CRKP, 94 strains were isolated from the intensive care unit (ICU), accounting for 81.7%, and 21 strains were isolated from the non-intensive care unit (NICU), accounting for 18.3%. The 115 strains of CRKP can be divided into 11 ST types, of which ST11 type was the most (54.8%, 63/115), followed by ST15 type (22.6%, 26/115) and ST5492 type (15.7%, 18/115). Type ST5492 was a new clonal group in the region. The 115 strains of CRKP could be divided into 7 O serotypes, most of which were O2a type(32.2%,37/115), followed by O5 type(30.4%,35/115) and O1 type(27.8%,32/115). The resistance genes of carbapenem antibiotics showed that there were 107 strains carrying the blaKPC-2 gene, one strain with the blaNDM-1 gene, and one strain with both the blaKPC-2 and blaNDM-13 genes. Virulence genes were detected in 55 CRKP strains (47.8%, 55/115), among which six strains detected peg-344, iucA, iroB, rmpA, and rmpA2 virulence genes (5.2%, 6/115). Four virulence genes ( peg-344, iucA, rmpA, and rmpA2) were detected in 34 strains (29.6%, 34/115). Three virulence genes ( iucA, iroB and rmpA) were detected in two strains (1.7%, 2/115). Three virulence genes ( peg-344, iucA and rmpA) were detected in one strain (0.8%, 1/115). IucA and rmpA virulence genes were detected in 12 strains (10.4%, 12/115). KPC-2_ST11_O2a, KPC-2_ST15_O1 and KPC-2_ST5492_O5 were dominant clones, and their distribution was mainly in the intensive care unit. The whole genome sequence analysis showed that there were three dominant clones, among which ST11 clones were subdivided into three dominant O serotypes, all of which were mainly in the intensive care unit. Conclusion:The popular strain in the hospital of CRKP is a KPC-2_ST11 clone group carrying iucA, rmpA/rmpA2, with cross-department transmission and mutation. ST5492 is a newly-launched clone type. The intensive care unit of hvKP carrying five virulence genes, including peg-344, should be alert to the epidemic risk of CR-hvKP outbreak.

Objective:To analyze the incidence of surgical site infection (SSI) in patients undergoing colorectal cancer (CRC) surgery and to identify risk factors associated with SSI in an attempt to provide a reference for clinical prevention strategies.Methods:A retrospective cohort study was conducted. Clinical data were retrospectively collected from a total of 2,248 patients who underwent surgery for pathologically confirmed CRC between 2017 and 2022 at two centers: Huangshan Shoukang Hospital ( n=649) and Northern Jiangsu People's Hospital ( n=1 599). Inclusion criteria consisted of the following: (1) age >18 years; (2) pathologically confirmed CRC treated with curative resection, including extended resections (e.g. pelvic exenteration); (3) no surgical incisions other than abdominal or perineal; and (4) no use of prosthetic implants. The incidence of SSI was analyzed, and multivariate logistic regression was used to identify independent its risk factors. Results:A total of 121 patients (5.4%) developed SSI. Among them, 68 cases (56.2%) were organ/space infections, 35 cases (28.9%) were deep incisional infections, and 18 cases (14.9%) were superficial incisional infections. The median postoperative hospital stay was significantly longer in patients with SSI compared to those without (21.0 days vs. 13.0 days, U=65,754, P<0.001). The median hospitalization cost was also significantly higher in the SSI group (56,550 yuan vs. 43,645 yuan, U=72,008, P<0.001). Multivariate logistic regression analysis identified body mass index (BMI) ≤ 20 kg/m 2 (OR=4.25, 95%CI: 3.38-5.34, P<0.001), diabetes mellitus (OR=3.44, 95%CI: 1.89-6.24, P<0.001), open surgery (OR=4.23, 95%CI: 2.37-7.56, P<0.001), and colostomy or ileostomy (OR=1.67, 95% CI: 1.04-2.69, P=0.034) as independent risk factors for SSI. Conclusion:To prevent SSI following CRC surgery, attention should be given to optimizing body weight and glycemic control, promoting minimally invasive surgical approaches when feasible, and cautiously considering the necessity of colostomy or ileostomy.

Objective To constructed a predictive model of gastric adenocarcinoma prognosis-related proteins by using TCPA and UCSC Xena databases to obtain sample information.And its application value was tested in order to provide reference for clinical treatment and related mechanism research.Methods Using R project,univariate Cox analysis and LASSO-Cox regression analysis were used to select the proteins related to the prognosis of gastric adenocarcinoma,and the risk scores were calculated.According to the risk scores,the patients were divided into high risk group and low risk group for survival analysis.At the same time,draw the ROC curve of the risk score and the protein heat map to evaluate the predictive ability of these proteins.Then,risk scores were combined with other clinical phenotype data of the patients,in order to establish a prognostic model through multivariate regression analysis,and draw a nomogram.The accuracy of the prognostic model was evaluated by C-index,ROC curve and decision curve.GO enrichment analysis and KEGG enrichment analysis were carried out to explore the proteins involved in biological processes.Results Fifteen differential proteins(CKIT,CHK1,CLAUDIN7,COLLAGENVI,DVL3,EGFR_pY1173,ERALPHA_pS11,NFKBP65_pS536,SYK,ETS1,MYOSINIIA_pS1943,P21,P90RSK,RAPTOR,XBP1)were selected by univariate Cox analysis and LASSO-Cox analysis,for calculating the protein risk scores.Through multivariate regression analysis,five factors including age,gender,M stage,N stage and risk score were selected to construct a prognostic model.The results of survival analysis showed that there were significant differences in overall survival between high and low risk groups(P＜0.0001).The nomogram can be used to predict 3-year and 5-year survival rate of patients,and it is considered to have good predictive value(C-index=0.7257).The ROC curve showed that the model exhibited stable sensitivity and specificity in prediction(AUC=0.79 and 0.88).Conclusion The prognostic model of gastric adenocarcinoma prognosis-related proteins can be used to predict the clinical prognosis of patients,and the research results will help to further guide clinical treatment,which could provide a reference for personalized treatment and management.

Objective To explore the differences in the radiological features,clinical,and laboratory indicators of frequent versus infrequent gout flares in the feet and ankles using dual-energy computed tomography(DECT).Methods A retrospective selection was made on 385 gout patients,who were divided into the frequent flare group(≥2 gout attacks per year,219 cases)and the infre-quent flare group(<2 gout attacks per year,166 cases).Clinical data,laboratory indicators,and DECT imaging findings were col-lected for statistical analysis.Binary logistic regression was used to analyze the independent risk factors for frequent gout flares and receiver operating characteristic(ROC)curve was plotted.Results Statistically significant differences were found between the fre-quent flare group and the infrequent flare group in terms of disease duration,body mass index(BMI),blood pressure,triglyceride(TG),serum uric acid(SUA),monosodium urate(MSU)crystal deposition,total volume of MSU crystals,maximum diameter of individ-ual tophi,number of affected joints,bone erosion,maximum depth of bone erosion,soft tissue swelling,bone proliferation and sclero-sis,and joint space narrowing(P<0.05).SUA levels,MSU crystal deposition,total volume of MSU crystals,and maximum depth of bone erosion were identified as independent risk factors for frequent gout(P<0.05).Both the combination of four factors model and the maximum depth of bone erosion model had better diagnostic efficacy.Conclusion Gout patients with high SUA levels,MSU crystal deposition,larger total volume of MSU crystals,and greater maximum depth of bone erosion are more likely to experience frequent gout attacks.Patients with bone erosion depth>3.200 mm are more likely identified early as having frequent gout.

Objective To constructed a predictive model of gastric adenocarcinoma prognosis-related proteins by using TCPA and UCSC Xena databases to obtain sample information.And its application value was tested in order to provide reference for clinical treatment and related mechanism research.Methods Using R project,univariate Cox analysis and LASSO-Cox regression analysis were used to select the proteins related to the prognosis of gastric adenocarcinoma,and the risk scores were calculated.According to the risk scores,the patients were divided into high risk group and low risk group for survival analysis.At the same time,draw the ROC curve of the risk score and the protein heat map to evaluate the predictive ability of these proteins.Then,risk scores were combined with other clinical phenotype data of the patients,in order to establish a prognostic model through multivariate regression analysis,and draw a nomogram.The accuracy of the prognostic model was evaluated by C-index,ROC curve and decision curve.GO enrichment analysis and KEGG enrichment analysis were carried out to explore the proteins involved in biological processes.Results Fifteen differential proteins(CKIT,CHK1,CLAUDIN7,COLLAGENVI,DVL3,EGFR_pY1173,ERALPHA_pS11,NFKBP65_pS536,SYK,ETS1,MYOSINIIA_pS1943,P21,P90RSK,RAPTOR,XBP1)were selected by univariate Cox analysis and LASSO-Cox analysis,for calculating the protein risk scores.Through multivariate regression analysis,five factors including age,gender,M stage,N stage and risk score were selected to construct a prognostic model.The results of survival analysis showed that there were significant differences in overall survival between high and low risk groups(P＜0.0001).The nomogram can be used to predict 3-year and 5-year survival rate of patients,and it is considered to have good predictive value(C-index=0.7257).The ROC curve showed that the model exhibited stable sensitivity and specificity in prediction(AUC=0.79 and 0.88).Conclusion The prognostic model of gastric adenocarcinoma prognosis-related proteins can be used to predict the clinical prognosis of patients,and the research results will help to further guide clinical treatment,which could provide a reference for personalized treatment and management.