Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10 /L vs preoperative 3.07×10 /L, P<0.001), with significant upregulation of CD11b (7.30×10 /L vs preoperative 3.05×10 /L, P<0.001) and CD54 (7.15×10 /L vs preoperative 2.99×10 /L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10 /L vs preoperative 1.12×10 /L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10 /L vs preoperative 1.12×10 /L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.

Objective To analyze the risk of bias during the experimental process and the shortcomings of the research report by evaluating the methodological and reporting quality of animal experimental studies on the prevention and treatment of precancerous lesions of gastric cancer(PLGC)using TCM compounds.To provide reference for improving the quality of animal experimental research on the prevention and treatment of PLGC with TCM compounds.Methods Experimental literature about the prevention and treatment of PLGC with TCM compounds was retrieved from CNKI,Wanfang Data,VIP,CBM,PubMed,Cochrane Library,Web of science and Embase from January 1,2014 to February 23,2024.SYRCLE assessment tool and ARRIVE 2.0 guideline were used to score the included literature and calculate the"low-risk"compliance rate for each item.Results Totally 213 articles were finally included,including 189 Chinese articles and 24 English articles.The SYRCLE tool score was(12.86±1.29)points,and the"low risk"compliance rate was 32.79％.The score of the necessary items of the ARRIVE 2.0 guideline was(24.15±2.80)points,and the"low risk"compliance rate was 49.08％;the score of the recommended items was(11.28±3.40)points,and the"low risk"compliance rate was 30.27％.In the SYRCLE tool evaluation,144(67.61％)studies did not elaborate on the method of generating the allocation sequence.All studies did not describe the adequacy of allocation concealment and the blinding method in the implementation of bias.Only 51 studies(23.94％)explicitly proposed the success criteria for PLGC modeling,only 66 studies(30.96％)provided detailed information on the statistical methods used,29 studies(13.62％)provided complete ethical statements,and 22 studies(10.33％)reported conflicts of interest.Conclusion There are many problems in the methodological quality and reporting quality of animal experimental literature on the prevention and treatment of PLGC with TCM compounds published from 2014 to 2024,especially the implementation of the random blinding strategy during the experimental process,the calculation details of the sample size,and the reporting of inclusion and exclusion criteria,etc.There are many deficiencies in this aspect.It is recommended to refer to the SYRCLE evaluation tool and the ARRIVE 2.0 guideline list to design and report the research plan,thereby improving the credibility and standardization of the PLGC animal experimental research results.

Metastatic Crohn's disease (MCD) represents one of the rare cutaneous extraintestinal manifestations in patients with Crohn's disease. The genital area, particularly the vulva in females, is the most commonly affected site in MCD. However, clinical cases of metastatic vulval Crohn's disease (MVCD) are relatively scarce, and the symptoms often lack specificity, making differential diagnosis challenging. This article aims to summarize the clinical characteristics, diagnostic approaches, and treatment modalities of MVCD, thereby providing a reference for the clinical management of this condition.

To explore the value of general information and rapid laboratory tests obtained from the emergency department in the early diagnosis and prevention of young patients with acute myocardial infarction and acute myocarditis, in order to prevent the disease from progressing to a critical stage. This study employs a retrospective observational study, compiling clinical data from young patients diagnosed with acute myocardial infarction or acute myocarditis who were admitted to the Department of Cardiology or Emergency Department of the Second Affiliated Hospital of Soochow University from January 2015 to September 2024. Demographic information and laboratory test results from both the outpatient and emergency departments were retrieved. The acute myocardial infarction group comprised 267 patients (257 males, 10 females) aged 23-44 ys, while the acute myocarditis group included 134 patients (93 males, 41 females) aged 18-44 ys. A comparative analysis of the clinical data between the two groups was conducted, encompassing variables such as age, gender, comorbidities, high-risk factors, emergency blood routine tests, high-sensitivity C-reactive protein levels, coagulation profiles, renal function tests, NT-proBNP levels, myocardial injury markers, electrocardiogram readings, blood pressure, and heart rate. The results showed that:Compared with the young myocarditis group, the myocardial infarction group was older (ys)[38(35, 42) vs 30(25, 37), U=7 893, P<0.001], more male [257(96.3%) vs 93(69.4%), χ2=57.95, P<0.001], more smoking [211(79.0%) vs 38(28.4%), χ2=97.32, P<0.001], drinking history [125(46.8%) vs 22(16.4%), χ2=35.51, P<0.001], family history of coronary heart disease [45(16.9%) vs 3(2.2%), χ2=18.09, P<0.001], hypertension [100(37.5%) vs 12(9.0%), χ2=36, P<0.001] and diabetes [42(15.7%) vs 4(3.0%), χ2=14.27, P<0.001]. Systolic blood pressure (mmHg)[126(114, 144) vs 119(101, 126), U=11 389.50, P<0.001], diastolic blood pressure (mmHg)[80(70, 93) vs 72(62, 81), U=12 220.50, P<0.001], total white blood cell count (10 9/L)[11.3(9.2, 14.1) vs 8.5(6.6, 11.2), U=10 825.50, P<0.001], hemoglobin (g/L)[157(147, 166) vs 143(129, 154), U=9 404.50, P<0.001], platelet count (10 9/L)[244(206, 297) vs 207(173, 253), U=11 680, P<0.001], uric acid (μmol/L)[380(315, 446) vs 347(265, 412), U=14 805.50, P=0.005], ST segment elevation [204(76.4%) vs 57(42.5%), χ2=73.03, P<0.001] and Q wave formation [76(28.5%) vs 17(12.7%), χ2=12.47, P<0.001] in ECG were higher than those in myocarditis group. The duration of onset (hs) [6(3, 25) vs 48(24, 73), U=27911, P<0.001], heart rate (beats/min)[82(74, 92) vs 92(78, 103), U=22 347, P<0.001], D-dimer (μg/ml)[0.23(0.17, 0.51) vs 0.61(0.30, 1.38), U=25 806, P<0.001], High-sensitivity troponin T/99th percentile upper reference limit [5(1, 36) vs 16(8, 39), U=22 577, P<0.001], NT-proBNP (pg/ml) [204(64, 644) vs 824(189, 4 043), U=25 134, P<0.001], C-reactive protein (mg/L)[6(3, 9) vs 24(6, 55), U=26 349.50, P<0.001] and body temperature (℃) [36.50(36.30, 36.60) vs 37.35(36.50, 38.50), U=26 961, P<0.001] were significantly lower than those in myocarditis group, the symptoms of chest pain in myocardial infarction group was significantly higher than those in myocarditis group [262(98.1%) vs 83(61.9%), χ2=97.24, P<0.001], and the history of prodromal infection [12(4.5%) vs 112(83.6%), χ2=261.26, P<0.001], syncope [11(4.1%) vs 18(13.4%), χ2=11.53, P<0.001] and shock [6(2.2%) vs 22(16.4%), χ2=27.59, P<0.001] in myocardial infarction group were significantly lower than those in myocarditis group. With acute myocardial infarction as the target outcome, 8 influencing factors selected by LASSO regression, and 5 independent influencing factors were found after multiple Logistic regression, those were age ( OR=1.21, 95% CI: 1.12-1.31; P<0.001), pre-infection ( OR=0.02, 95% CI: 0.01-0.06; P<0.001), body temperature ( OR=0.37, 95% CI: 0.18-0.77; P=0.008), chest pain ( OR=26.75, 95% CI: 5.87-121.81; P<0.001) and white blood cell count ( OR=1.27, 95% CI: 1.12-1.44; P<0.001). Younger age, high body temperature and pre-infection are independent predictors for acute myocarditis, while chest pain and elevated white blood cell count are independent predictors for acute myocardial infarction. The five influencing factors selected by multivariate logistic regression and their combined diagnostic model were subjected to ROC analysis. The AUC reached 0.969, sensitivity reached 0.940 and specificity reached 0.925. Calibration curve and decision curve analysis(DCA) demonstrate that the model possesses excellent clinical application value. In conclusion, age, chest pain, pre-infection, body temperature and white blood cell count were independent factors in distinguishing acute myocardial infarction and acute myocarditis in young people. The clinical differential diagnosis model based on 5 independent factors may has high efficiency and good clinical practicability.

Liquid chip technology is based on liquid carrier. Comparing to the traditional detection methods, it has unique characteristics such as multiple detection ability, high throughput, high sensitivity, good repeatability, less sample and fast analysis. It can analyse proteins, nucleic acids and other biological molecules in liquid. At present, it has been widely used in the laboratory diagnosis of tumors, autoimmune diseases, allergic diseases, cytokines related diseases, as well as infectious diseases. This article discussed the principles, detection performances, clinical applications and future prospects of liquid chip technology.

Objective:To analyze the carriage status, subtype distribution and flanking gene sequence characteristics of oxacillinases (OXA enzyme) in 241 clinical strains of Pseudomonas aeruginosa, and assess their roles in the drug resistance of Pseudomonas aeruginosa and ability to horizontally transfer across species. Methods:Clinical P. aeruginosa isolates were collected from four hospitals in Sanya, Tangshan, Zhangjiakou, and Beijing. The prevalence of oxacillinases and their flanking gene sequences was analyzed by whole-genome sequencing (NGS) and bioinformatic approaches. Results:A total of 241 isolates of P. aeruginosa were gathered, and 35 blaOXA subtypes were identified through screening of 252 blaOXA genes. These genes were classified into three subfamilies: blaOXA-50-like (241, 95.6%), blaOXA-1-like (9, 3.6%) and blaOXA-10-like (2, 0.8%). Among these, 11 subtypes (11, 31.4%) were novel blaOXA subtypes. Nine of these belonged to the blaOXA-50-like subfamily and were designated as blaOXA-1244, blaOXA-1245, blaOXA-1246, blaOXA-1250, blaOXA-1252, blaOXA-1253, blaOXA-1254, blaOXA-1255, and blaOXA-1256. The remaining two belonged to the blaOXA-10-like subfamily and were named blaOXA-1247 and blaOXA-1248. Compared to the amino acid sequence of OXA-10, the newly identified subtype OXA-1247 exhibited a mutation at position 117, where a valine was replaced by a leucine. This change was thought to improve the enzyme′s ability to hydrolyze carbapenems. In the analysis of the flanking sequences of the blaOXA genes, Class I integrons were identified in four bacterial strains. The variable regions of these integrons carried three distinct patterns of resistance gene cassettes: aac( 6′) -Ib-blaOXA-1247-ant( 3′′) -Ia, aac( 6′) -Ib-blaOXA-1248 and aac( 6′) -Ib- blaIMP-45-blaOXA-1-catB3. Among these, the strain BJ2326 carried a class I integron that was connected to the downstream IS CR1 element to form a composite class I integron structure, additionally carrying the resistance gene blaPER-1. Out of the 223 non-wild-type P. aeruginosa strains, 127 strains exhibited non-wild-type profiles to the four beta-lactam antibiotics MEM, CAZ, FEP, and TZP, with the combination of MEM+CAZ+FEP being the most prevalent, representing 57.0% of the total. Conclusions:The blaOXA genes in 241 clinical P. aeruginosa strains showed diversity. Some blaOXA genes had a co-transfer risk with the metallo-β-lactamase resistance gene blaIMP-45. Among the 11 newly discovered blaOXA subtypes, the new subtype OXA-1247 may have carbapenemase activity and potential for horizontal transfer.

Objective:To develop a deep learning model based on super-resolution endorectal ultrasound（ERUS）images for the preoperative prediction of perineural invasion（PNI）in patients with rectal cancer，thereby providing a reference for risk stratification and individualized treatment planning.Methods:A retrospective analysis was conducted on 382 patients with rectal cancer who underwent total mesorectal excision at Fujian Medical University Union Hospital between June 2019 and February 2024. Patients were randomly divided into a training set（ n=305）and a test set（ n=77）at a ratio of 8∶2，and further grouped into PNI-negative group and PNI-positive group subgroups based on pathological results. Super-resolution ultrasound images were generated from original ERUS images using a generative adversarial network（GAN）. Deep convolutional neural networks were developed based on features from intratumoral and peritumoral regions to identify the optimal region of interest（ROI）. The dSR5_ResNet18 and dSR5_ResNet50 models were constructed using the super-resolution images with a 5-pixel peritumoral extension. Representative clinical features were selected for subgroup analysis based on sample size and intergroup statistical differences between PNI-positive and PNI-negative patients. Forest plots were used to evaluate model applicability and robustness across subgroups. Results:The dSR5_ResNet18 model，built using super-resolution images of the tumor combined with a 5-pixel peritumoral region，achieved the best predictive performance，with an AUC of 0.867（95% CI=0.782 - 0.952）in the test set. Decision curve analysis demonstrated that the dSR5_ResNet18 model provided the greatest net clinical benefit. Forest plot analysis indicated strong generalizability of the models across subgroups such as pathological N stage，maximum lesion length，and lymph node enlargement，though relatively weaker performance was observed in the carcinoembryonic antigen（CEA）subgroup. Among all models，dSR5_ResNet18 exhibited the most consistent performance across subgroups，with the narrowest confidence intervals and highest robustness. Conclusions:The deep learning model incorporating ERUS-based super-resolution reconstruction demonstrated excellent performance in the preoperative prediction of PNI in rectal cancer. It offers significant advantages in image quality and generalizability，and may serve as a valuable tool to assist clinicians in formulating personalized treatment strategies.

Objective To elucidate the mechanism of Polygonatum kingianum water extract(PW)on the proliferation and colonization of Lactobacillus reuteri 1.2838,the differential expression of genes associated with proliferation,the quorum sensing signal molecule autoinducer-2(AI-2),and stress resistance were detected.Method L.reuteri 1.2838 was anaerobically cultured at 37℃in MRS medium supplemented with 0.0126 g·mL-1 PW,and the growth curve was subsequently plotted.The quantification of AI-2 production was conducted using the bioluminescence assay with Vibrio harveyi BB170.Transcriptome sequencing was executed using Illumina HiSeq technology,followed by the identification of differentially expressed genes.The expression profiles of these genes were analyzed,and real-time quantitative PCR was employed for validation.Results Incubation with PW resulted in increased proliferation and AI-2 production capacity of L.reuteri 1.2838.Transcriptome sequencing revealed 425 genes with significant differential expression,comprising 253 upregulated and 172 downregulated genes.Post GO and KEGG annotation analysis,genes related to L.reuteri 1.2838 proliferation,including pdhA,pshB,dlat,dld,genes pertinent to AI-2 production such as luxS,sec,and genes linked to the strain's stress resistance,groEL,groES,gltC,exhibited an upregulated expression pattern.Conclusion PW facilitates the proliferation and colonization of L.reuteri 1.2838 by influencing the tricarboxylic acid cycle,quorum sensing,and the strain's stress resistance,thus offering theoretical support for the development of both Polygonatum kingianum and Lactobacillus reuteri.

Objective To investigate the effects of long non coding RNA(lncRNA)metastasis associated lung adenocarcinoma transcript 1(MALAT1)on the proliferation and osteogenic differentiation of human periodontal ligament stem cells(PDLSCs)by regulating the miR-150-5p/X-box binding protein 1(XBP1)axis.Methods Quantitative real-time PCR(qRT-PCR)was used to detect the expression of lncRNA MALAT1,miR-150-5p and XBP1 mRNA in undifferentiated and differentiated PDLSCs.The third generation PDLSCs were divided into control group,pcDNA group,pcDNA-lncRNA MALAT1 group,anti-miR-NC group,anti-miR-150-5p group,pcDNA-lncRNA MALAT1+mimic NC group and pcDNA-lncRNA MALAT1+miR-150-5p mimic group.The expression of lncRNA MALAT1,miR-150-5p and XBP1 mRNA of PDLSCs were detected by qRT-PCR.CCK-8 and the clone formation assay were used to detect the proliferation of PDLSCs.P-nitrophenolphosphate substrate method was used to detect alkaline phosphatase(ALP)activity.Alizarin red staining was applied to detect the formation rate of mineralized nodules.Western blot was used to detect XBP1,Cyclin D1,osteocalcin(OCN),Runt related transcription factor 2(RUNX2)and osteopontin(OPN)proteins.Dual luciferase assay was used to verify the targeting relationship between lncRNA MALAT1 and miR-150-5p,and between miR-150-5p and XBP1 was validated.Results Compared with the undifferentiated group,the expression of lncRNA MALAT1(1.95±0.14 vs 1.00±0.00)and XBP1 mRNA expression(1.63±0.12 vs 1.00±0.00)increased in the differentiated PDLSCs,the expression of miR-150-5p decreased(0.26±0.01 vs 1.00±0.00)in differentiated group,with the differences were statistical significance(t=16.622,12.860,181.262,all P<0.001).Overexpression of lncRNA MALAT1 or down-regulation of miR-150-5p could promote the proliferation and osteogenic differentiation of human PDLSCs(t=13.693～45.518),miR-150-5p mimic reversed the effects of overexpression of lncRNA MALAT1 on proliferation and osteogenic differentiation of PDLSCs(t=9.229～27.854),and the differences were statistically significant(all P<0.05),respectively.Dual luciferase assay confirmed that overexpression of miR-150-5P reduced the luciferase activity in transfected lncRNA MALAT1-WT and XBP1-WT cells(t=56.546,89.826,all P<0.001).Conclusion Overexpression of lncRNA MALAT1 may promote XBP1 expression by downregulating miR-150-5p,thereby promoting proliferation and osteogenic differentiation of human PDLSCs.

To analyze the in vitro antibacterial effects of colistin (COL) or tigecycline (TGC) in combination with imipenem (IPM), amikacin (AMK), and cefoperazone-sulbactam (CSL) against carbapenem-resistant Acinetobacter baumannii(CRAB), so as to provide evidence for screening effective combination regimens for clinical microbial infections.