Objective To analyze the clinical and therapeutic characteristics of Epstein-Barr virus (EBV)-negative posttransplant lymphoproliferative disease (PTLD) with diffuse large B-cell lymphoma (DLBCL) in the context of specific cases and literature. Methods A case of EBV-negative DLBCL (GCB type) after kidney transplantation is reported. The patient was a 45-year-old male who underwent living-related kidney transplantation in 2016 and has been receiving triple immunosuppressive therapy with tacrolimus, mycophenolate mofetil and methylprednisolone since then. In 2024, the patient presented with intermittent fever, night sweats and gastrointestinal symptoms. The diagnosis was confirmed by endoscopic pathology, immunohistochemical staining and positron emission tomography/computed tomography. The R-CDOP regimen (rituximab + cyclophosphamide + liposomal doxorubicin + vincristine + dexamethasone) was used for treatment. Results The patient was diagnosed with EBV-negative DLBCL (GCB type, Ann Arbor stage Ⅳ B). After 4 cycles of R-CDOP chemotherapy, the efficacy assessment was partial remission, and the transplant kidney function remained stable. Conclusions For EBV-negative PTLD after kidney transplantation, it is necessary to break through the "virus-dependent" diagnostic thinking. In clinical practice, the focus should be on protecting the transplant kidney, and individualized treatment plans should be developed for patients.

To evaluate the application value of the Peyton four-step teaching method in the standardized training of intestinal ultrasound and compare it with traditional teaching methods, so as to provide an optimized approach for clinical ultrasound training.

OBJECTIVE To systematically evaluate the influential factors for all-cause mortality in patients with carbapenem-resistant Gram-negative bacteria （CR-GNB） treated with polymyxin B. METHODS PubMed， Embase， the Cochrane Library， Web of Science， Wanfang Data， VIP， CBM and CNKI were searched to collect clinical studies on all-cause death within 30 days or 28 days after treatment with polymyxin B in patients with CR-GNB infection from database establishment to July 2025. After literature screening， data extraction and evaluation of literature quality， meta-analysis was performed using RevMan 5.4 software. RESULTS A total of 12 studies were included， involving 1 326 patients， among whom 529 patients died， with a mortality rate of 39.89%. Meta-analysis results showed that combined with cardiovascular disease [OR＝2.06， 95%CI （1.37， 3.09）， P ＝0.005 ] ， increased Sequential Organ Failure Assessment （SOFA） score [OR＝1.20， 95%CI （1.07， 1.35）， P ＝0.003 ] ， mechanical ventilation [OR＝2.35， 95%CI （1.65， 3.34）， P ＜0.001 ] ， continuous renal replacement therapy （CRRT） [OR＝2.58， 95%CI （1.67， 3.97）， P ＜0.001 ] ， bloodstream infection [OR＝3.24， 95%CI （2.19， 4.78）， P ＜0.001 ] ， multiple-site infection [OR＝1.51， 95%CI （1.03， 2.20）， P ＝0.03 ] ， septic shock [OR＝3.19， 95%CI （1.94， 5.24）， P ＜0.001 ] ， use of vasoactive drugs [OR＝2.90， 95%CI （1.97， 4.27）， P ＜0.001 ] ， and the occurrence of acute kidney injury （AKI） [OR＝2.17， 95%CI （1.41， 3.36）， P ＜0.001 ] were risk factors for all-cause mortality in patients with CR-GNB infection treated with polymyxin B. Conversely， an extended duration of polymy xin B treatment [OR＝0.92， 95%CI （0.86， 0.99）， P ＝0.03 ] and early administration after CR-GNB infection [OR＝0.47， 95%CI （0.25， 0.85）， P ＝0.01 ] were protective factors. CONCLUSIONS Patients with cardiovascular disease， receiving mechanical ventilation or CRRT， having bloodstream infection， multiple-site infection or septic shock， combining with vasoactive drugs， with AKI and increased SOFA scores have a higher risk of all-cause mortality. Conversely， extending the duration of polymyxin B treatment （beyond 7 days） and early administration within 48 hours after confirmed CR-GNB infection can significantly reduce the risk of all-cause mortality.

Diabetic kidney disease （DKD） is a microvascular complication of diabetes， with a complex pathogenesis， in which mitochondrial dysfunction is considered to be the core of DKD development. Taking mitochondria as a target to regulate mitochondrial energy metabolism， mitochondrial oxidative stress， mitophagy， and mitochondrial dynamic function represents a promising strategy for the DKD prevention and treatment， with good prospects in clinical application. Traditional Chinese medicine （TCM） has great potential to mediate mitochondrial dysfunction in the DKD prevention and treatment. This article deeply explores the intrinsic relationship between various forms of mitochondrial dysfunction and DKD， and summarizes the current research status of various Chinese herbal compounds and Chinese herbal formulas in targeting mitochondrial dysfunction for the DKD prevention and treatment. This article aims to provide new targets and strategies for the DKD prevention and treatment， and the research and development of TCM.

Objective To explore the feasibility of magnetic compression technique (MCR) in the treatment of severe single mid-ureteral stricture in a rabbit model. Methods After 10 female New Zealand rabbits were selected, the distal end of the right ureter was ligated with silk thread. Two weeks after the operation, when the right ureter was dilated, the mid-ureter was ligated again with silk thread to create a severe single mid-ureteral stricture animal model. Longitudinal incisions were made at the upper and lower ends of the ligation site, and cylindrical NdFeB magnets with central holes (sub-magnets and main magnets) were placed to anastomose and recanalize the mid-ureteral stricture. The magnets were adjusted to the appropriate position to automatically align and attract each other. The longitudinal incision sites of the ureter were sutured with 6-0 Prolene thread, and the abdominal cavity was closed layer by layer. The operation time was recorded. X-ray films were taken every two days to confirm the position of the magnets and record the time of magnet detachment. Three weeks after the operation, the anastomotic specimens were obtained, and the formation of the anastomosis was evaluated with gross observation and histological staining. Results Two weeks after ligation, all experimental rabbits showed obvious dilation of the right ureter. The mid-ureteral ligation and placement of the male and female magnets were successfully completed in all 10 experimental rabbits, with an operation time of (24.00±5.15)minutes. The male and female magnets attracted each other well. X-ray examination showed that the magnets detached and entered the distal ureter (14.0±1.9) days after magnetic compression. The recanalization of the severe single mid-ureteral stricture was successfully achieved. The gross specimens and histological examination of the anastomosis showed that the anastomosis remained patent and the mucosal healing was good. All experimental rabbits survived well after the operation without serious complications. Conclusion MCT provides a new idea and novel method for the treatment of mid-ureteral stricture. This study confirmed the feasibility of this technique in treating severe single mid-ureteral stricture in a rabbit model. The operation is relatively simple and has potential for clinical application.

Objective To investigate the influencing factors for frailty in elderly patients with mild ischemic stroke(MIS),construct a risk prediction model based on random forest algorithm and evaluate its application performance.Methods A total of 322 elderly MIS patients subjected by cluster sampling in the Neurodiagnosis and Treatment Center of our hospital during January and June 2022 were enrolled and divided into non-frailty group(n=261)and frailty group(n=61)according to the results of frailty screening scale.The general clinical data,and the scores of Daily Living Ability Scale,Simplified Geriatric Depression Scale,Social Support Rating Scale,36-Item Concise Health Questionnaire,and Simplified Intelligent State Examination Scale were compared between two groups.Random forest algorithm was used to construct a risk prediction model for frailty in the elderly MIS patients,and ROC curve was plotted to analyze the predictive value of the model.Results The incidence of frailty in elderly MIS patients was 18.94％.There were sta-tistical differences in age,marital status,monthly income,medical expense payment,sleep condi-tion and comorbidities in the frail group(P＜0.01).The frail group had significantly lower scores of support utilization,concise health status,physiological function,body pain,general health,social function,and emotional function,and higher scores of Activities of Daily Living Scale and the Simplified Geriatric Depression Scale than the non-frail group(P＜0.05).The random forest model obtained an accuracy of 88.28％,a sensitivity of 88.24％,a specificity of 88.89％,an F1 score of 0.933,and an AUC value of 0.816.Random forest algorithm ranked the important varia-bles influencing frailty in elderly MIS patients through variable importance scores,and the top five predictors were types of basic diseases(≥2 types),sleep condition,quality of life score,self-care ability score,and personal monthly income(＜2000 Yuan).Conclusion A risk prediction model for frailty in elderly MIS patients is constructed by using random forest algorithm.The model is helpful to identify key factors of frailty as early as possible,provide empirical evidence for clinical medical staff to implement early intervention,improve the health and quality of elderly MIS patients,and prevent or delay the occurrence of frailty.

Objective To compare and find an optimal model for predicting the risk of DKD occurrence in patients with type 2 diabetes mellitus(T2DM).Methods A total of 2005 patients with T2DM were enrolled in this study from The Second Hospital of Shijiazhuang City during December 2017 to December 2022.All the subjects were divided into a training set(n=1403)and a validation set(n=602)according to the ratio of 3∶1 by simple random sampling.With the occurrence of DKD as the outcome variablein the training set,important feature variables were screened by LASSO regression.Six different machine learning models were established according to the feature variables,thenthe optimal model was determined by comparison,and anonlinerisk predictor for DKD occurrence was constructed in patients with T2DM.Results Taking the occurrence of DKD as the outcome variable in the training set,the results of LASSO regression analysis showed that the optimal value of the model was 10-fold cross validation lambda.1se=0.01662473,and 15 characteristic variables with nonzero coefficient were screened out to be related to the occurrence of DKD.The data included sex,age,family history of DM,DM duration,LDL-C,HbA1c,WBC,PDW,Scr,urine α1-microglobulin,urine β2-microglobulin,urine microalbumin,hypertension,hypokalemia,and DR.In the training set and validation set,the prediction performance of XGBoost model was better than that of other models(AUC=0.872,0.893,95%CI 0.853～0.891,0.865～0.921),the sensitivity was 0.779,0.863,and the specificity was 0.721,0.758,respectively.The F1 scores were 0.774 and 0.787.DCA analysis showed that the XGBoost model had a greater net benefit and threshold probability.According to the XGBoost model,the online predictor of DKD risk in T2DM patients was laid out,and two patients were selected for application,the results showed that the predictive value of the model was 0.185 in non-DKD patients,and the predictive value was 0.510 in DKD patients.Conclusions The XGBoost model is the best model for predicting the occurrence of DKD in T2DM patients,and an online predictor was successfully built.

Irritability is defined as a decreased setback threshold associated with increased anger outburst,which could be both a normal emotion in an individual's developmental stage as well as a cross diagnostic psycho-pathological symptom with functional impairment.The article provides a review of the definition,related factors,neurobiological mechanisms,evaluation strategies,and treatment measures of irritability,aiming to help better under-standing of irritability in normal psychological development and in clinical psychiatry.

Objective To evaluate the implementation effect of specail treatment for dental implant medical services charges and comsumable prices in public stomatological hospital.Methods The cost information of outpatient patients,various medical services,and financial statement data were collected to compare changes of patient costs,success rates,and income and expenditure after the implementation of specail treatment for dental implant medical services charges and comsumable prices in the sample hospital.Results After the implementation of specail treatment,the full process cost of a single conventional dental im-plants restoration in the sample hospital was lower than the regulation target.Patients'average costs and average costs was de-creased significantly,and the success rate didn't change significantly.The average cost composition ratio changed.The number of patients,medical revenue and expenditure were increased,and the hospital income composition composition ratio didn't change significantly.Conclusion The specail treatment for dental implant medical services charges and consumables prices have achieved preliminary results.The cost of patients is significantly reduced,the cost composition is more reasonable,and the medi-cal quality has not changed.Hospitals should strengthen internal management to promote sustainable development.

Objective To evaluate the implementation effect of specail treatment for dental implant medical services charges and comsumable prices in public stomatological hospital.Methods The cost information of outpatient patients,various medical services,and financial statement data were collected to compare changes of patient costs,success rates,and income and expenditure after the implementation of specail treatment for dental implant medical services charges and comsumable prices in the sample hospital.Results After the implementation of specail treatment,the full process cost of a single conventional dental im-plants restoration in the sample hospital was lower than the regulation target.Patients'average costs and average costs was de-creased significantly,and the success rate didn't change significantly.The average cost composition ratio changed.The number of patients,medical revenue and expenditure were increased,and the hospital income composition composition ratio didn't change significantly.Conclusion The specail treatment for dental implant medical services charges and consumables prices have achieved preliminary results.The cost of patients is significantly reduced,the cost composition is more reasonable,and the medi-cal quality has not changed.Hospitals should strengthen internal management to promote sustainable development.