Objective To evaluate the effect of donor gender on short-term survival rate of lung transplant recipients. Methods A retrospective analysis was conducted on the data of 1 066 lung transplant recipients. The log-rank test was used to evaluate the differences in short-term fatality among different donor gender groups and donor-recipient gender combination groups. Multivariate Cox regression, propensity score (PS) regression, and propensity score matching (PSM) were employed to control for confounding factors and further assess the differences in fatality. Subgroup analyses were also performed based on donor gender. Results Multivariate Cox regression analysis showed no statistically significant differences in fatality at 30 days, 1 year, 2 years and 3 years postoperatively between male and female donor groups (all P>0.05). After PS regression and PSM, univariate Cox regression analysis indicated that recipients from female donors had a higher fatality at 2 years postoperatively compared to those from male donors, with hazard ratios (95% confidence intervals) of 1.29 (1.01-1.65) and 1.36 (1.03-1.80) respectively. Multivariate Cox regression analysis also revealed no statistically significant differences in fatality at various follow-up time points among different donor-recipient gender combination groups (all P>0.05). Subgroup analyses based on donor sex showed no statistically significant differences in fatality among recipients of different gender within either male or female donor groups (all P>0.05). Conclusions Female donors may reduce the short-term postoperative survival rate of lung transplant recipients, but this negative impact is not sustainable in the long term. At present, there is no evidence to support the inclusion of sex as a factor in lung allocation rules.

Objective To analyze the relational factors influencing the formation of cauda equina redundant nerve roots(RNRs)of the lumbar spinal stenosis.Methods Clinical data of 116 patients with lumbar spinal stenosis treated from January 2016 to June 2019 were retrospectively analyzed.The patients were divided into redundant nerve roots(RNRs)group and non-RNRs group based on the presence or absence of RNRs on sagittal T2-weighted MRI.In the non-RNRs group,there were 74 patients,including 38 males and 36 females with an average age of(62.00±10.41)years old,the body mass index(BMI)was(23.09±2.22)kg.m-2;the maximum stenosis segment was L2-L3 in 12 cases,L3-L4 in 38,L4-L5 in 20,and L5S1 in 4,respec-tively.In the RNRs group,there were 42 patients,including 18 males and 24 females with an average age of(63.36±8.73)years old,the BMI was(22.63±2.60)kg·m-2;the maximum stenosis segment was L2-L3 in 3 cases,L3-L4 in 9,L4-L5 in 27 and L5S1 in 3,respectively.MRI was performed in the supine position to observe the conshape and morphology of the redundant nerve in the sagittal position.The preoperative low back and leg pain visual analogue scale(VAS),and preoperative Oswestry disability index(ODI)were analyzed,and the rate of spondylolisthesis and ligamentum flavum hypertrophy were compared.Si-multaneously,the inter-vertebral height,intervertebral foramen height,inter-vertebral height+vertebral height,median sagittal diameter at the inter-vertebral space level(DIW-MSD),median sagittal diameter at the pedicel level(DV-MSD),range of mo-tion(ROM)of the stenotic segment were measured and analyzed.Results Among the 116 patients with lumbar spinal stenosis,42 patients developed RNRs,with an incidence of 36.2％.There were no significant differences in gender,age,BMI,preopera-tive VAS for lumbar and leg pain and ODI between two groups(P＞0.05).There were statistically significant differences regard to the duration of symptoms and the rate of spondylolisthesis and ligamentum flavum hypertrophy(P＜0.05);the inter-vertebral height,intervertebral foramen height,inter-vertebral height+vertebral height,DIW-MSD,ROM of the stenotic segment were al-so significantly different between two groups(P＜0.05).However,there was no significant difference in DV-MSD between two groups(P＞0.05).Conclusion The inter-vertebral height,inter-vertebral foramen height,inter-vertebral height+vertebral height,DIW-MSD and ROM of the stenotic segment were the crucial factors related to RNRs in lumbar spinal stenosis.

For the past 30 years,percutaneous balloon mitral valve dilatation has been performed under the guidance of X-rays and bedside ultrasound.However,there are still some cases of mitral valve stenosis in the large atrium where balloon dilation failed.Intraperitoneal ultrasound-guided percutaneous balloon mitral valve plasty is accurate and feasible,which can reduce the occurrence of complications and improve the success rate of such elderly complex cases.Two patients with severe mitral stenosis underwent percutaneous balloon mitral valve plasty guided by intracardiac ultrasound.The operations were successful without any complications,which can provide reference for clinical treatment of mitral stenosis.

Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

This study was aimed at studying the phenotypic and molecular characteristics of a Salmonella Grumpensis isolate from a patient with diarrhea in Shanghai,to provide evi-dence for the prevention of salmonellosis.Biochemical identifi-cation,serum agglutination testing,antimicrobial susceptibility testing,and whole genome sequencing(WGS)were performed on isolate 2023JD76.Global Salmonella Grumpensis genome sequences were searched and downloaded for serotyping predic-tion,multilocus sequence typing(MLST),prediction of anti-microbia resistance genes and virulence genes,and phylogenetic analysis of 2023JD76.The 2023JD76 strain was identified as Salmonella Grumpensis(13,23:d:1,7)with ST2060,and was susceptible to 20 antimicrobial agents.Strain 2023JD76 carried the aminoglycoside resistance gene aac(6')-Iaa and five types of virulence genes:the adhesion genes csg and rat;the secretion and transport genes sip and inv;the typhoid toxin genes cdt and plt;the invasive gene nutrient metabolism factor mgt;and the antimicrobial peptide resistance factor mig.Global S.Grumpensis strains harbored ten types of antimicrobial resistance genes whose prevalence ranged from 58.33％to 100％.The global genome sequences of S.Grumpensis were divided into two lineages.Lineage I was dominated by ST751(88.89％,16/18),and lineage Ⅱ was dominated by ST2060(89.47％,17/19).The genome sequence of strain 2023JD76 belonged to lineage Ⅱ,and was closely related to the genome sequences from human fecal and human cerebrospinal fluid.This study provides the first report of a S.Grumpensis isolate from the stool of a patient with diarrhea in China.Considerable variability in antimicrobial resistance genes was observed among genome sequences from different sources,and the strains harbored a substantial number of virulence genes.Enhanced surveillance should be emphasized to prevent a potential risk of global dissemination.

Objective:To investigate the efficacy and influencing factors of initial 131I therapy in serum thyroglobulin (Tg) antibody (TgAb)-positive patients with papillary thyroid cancer (PTC). Methods:A retrospective analysis was performed on the clinical data of 1 624 patients with PTC who underwent 131I therapy in Henan Provincial People′s Hospital between January 2017 and January 2023. The patients were divided into TgAb-positive group (246 cases (36 males, 210 females), age: 43.5(31.0, 52.0) years) and TgAb-negative group (1 378 cases (439 males, 939 females), age: 44.0(34.0, 53.0) years). The efficacy was evaluated 6-12 months post 131I therapy based on serological tests (TgAb, Tg) and imaging results (ultrasonography, CT, 131I-whole body scan (WBS), SPECT/CT imaging), and the patients were divided into disease persistence/recurrence and non-persistence/recurrence groups. The χ2 test was used to analyze the difference in efficacy between the TgAb-positive group and the TgAb-negative group. Among TgAb-positive patients, the clinical characteristics of disease persistence/recurrence group were compared with those of non-persistence/recurrence ones by χ2 test or Mann-Whitney U test, and the independent risk factors affecting the efficacy of 131I therapy were analyzed by binary logistic regression. Results:The disease persistence/recurrence were found in 38 cases (15.4%, 38/246) of the TgAb-positive group and 143 cases (10.4%, 143/1 378) of the TgAb-negative group, with a statistically significant difference between the two groups ( χ2=5.42, P=0.020). Among the TgAb-positive patients, statistically significant differences were found in lymph node metastasis (35 vs 23 cases), the interval between surgery and 131I therapy (2.0(1.5, 3.0) vs 2.3(2.0, 3.0) months), stimulated Tg(sTg) level before the initial 131I therapy (0.18(0.04, 5.78) vs 0.04(0.04, 0.46) μg/L), and TgAb level before the initial 131I therapy (40.15(19.13, 156.15) vs 22.25(7.53, 76.20) kU/L) between disease persistence/recurrence group and non-persistence/recurrence group ( χ2=117.13, z values: -2.29, -2.41, -2.80, all P<0.05). Lymph node metastasis was an independent risk factor (odds ratio( OR)=89.326, 95% CI: 25.005-319.106, P<0.001) for the efficacy of 131I therapy in patients with TgAb-positive PTC. Conclusion:The overall efficacy of 131I therapy in patients with TgAb-positive PTC is relatively poor, and lymph node metastasis is an independent risk factor for the efficacy of 131I therapy, while the level of TgAb is not an independent risk factor for the efficacy of 131I therapy in these patients.

Objective:To investigate the effects of Xiongcan Yishen Formula(XYF)on ferroptosis in mouse TM3 Leydig cells after oxidative stress injury(OSI)induced by H2O2.Methods:An oxidative stress injury model was established in mouse TM3 Leydig cells using H2O2 induction.The modeled TM3 cells were randomly divided into OSI group,XYF group,the ferroptosis inhibitor Ferrostatin-1(F-1)group,and F-1+XYF group,which were respectively intervened with blank serum,20%drug-containing serum,2μmol/L F-1,and2μmol/L F-1+20%drug-containing serum.A control group(normal TM3 cells+blank serum)was also set up.The morphology of cells in each group was observed,and the levels of testosterone,superoxide dismutase(SOD),reactive oxygen spe-cies(ROS),malondialdehyde(MDA),ferritin heavy chain 1(FTH1),solute carrier family 7 member 11(SLC7A11),glutathione(GSH),glutathione peroxidase 4(GPX4),fatty acid CoA ligase 4(FACL4),total iron ions,and ferrous ions were detected.Re-sults:Compared with the model group,the control group showed significantly decreased expression of ROS,MDA,FACL4,total iron,and ferrous ions(P<0.05),and significantly increased levels of testosterone,SOD,GSH,FTH1,SLC7A11,and GPX4(P<0.05).The male silkworm kidney-tonifying formula group significantly promoted testosterone secretion by TM3 cells and upregulated the expression of FTH1,SLC7A11,GPX4,GSH,and SOD in TM3 cells(P<0.05),while significantly downregulating ROS,MDA,FACL4,total iron ions,and ferrous ions(P<0.05).Conclusion:Following H2O2 exposure,oxidative stress can induce ferroptosis in mouse TM3 Leydig cells.XYF can antagonize OSI and ferroptosis in TM3 cells by activating the SLC7A11/GSH/GPX4 axis,which may underlie the mechanism of XYF in the treatment of male late-onset hypogonadism.

Objective:To determine the differential expressions of long non-coding RNA(lncRNA)and messenger RNA(mRNA)in normal and asthenospermia(AS)men and analyze their biological significance in AS.Methods:We isolated and ex-tracted total RNAs from 9 normal and 9 AS sperm samples,determined the expressions of RNAs in the sperm using the DNBSEQ se-quencing platform,and analyzed their relevant functions by gene ontology enrichment(GO)and Kyoto encyclopedia of genes and ge-nomes pathway(KEGG)analyses.Results:An average of 10.64G data was generated per group,with 282 185 RNAs detected,in-cluding 107 009 lncRNAs.Among the total number of lncRNAs,15 157 were differentially expressed,2 190 upregulated and 12 967 downregulated;and among the 19 514 mRNAs,13 736 were differentially expressed,4 995 upregulated and 8 741 downregulated.Differentially expressed genes were enriched mainly in the sperm cell membrane and the pathways related to the ion channel functions,sperm development and fertilization.Conclusion:Differentially expressed lncRNAs and mRNAs can be identified by sequencing a-nalysis of AS and normal sperm.Regulation of sperm function through membrane ion channels may contribute to the development of AS,which provides a molecular basis for further research on AS.

Objective To compare the properties of hip joint implants with plasma sprayed and sintered porous coating.Methods The biological fixation femoral stems by plasma spraying and sintered porous titanium coating were observed in terms of the microstructure,tensile properties and abrasion resistance of the coating materials by a fully automatic metallur-gical microscope,a material testing machine and an abrasion meter,and the two coating processes were evaluated by observing the stems'stereological structure and the bonding performance between the coatings and the substrates.Results Plasma spraying titanium coating made the stem having refined and uniform microstructure,a tensile strength of(1 065±21)MPa and an elongation of(15±2)％,which had a loose and porous structure,with an average thickness of 521 μm,an average percentage of pore volume of 37％,and an average pore-intercept of 135 μm,a shear strength with the substrate of(39±4)MPa,a tensile strength of(47±5)MPa and a mass loss after 100 wear cycles of 48 mg;sintered porous titanium coating made the stem having coarse grains in its microstructure,a tensile strength of(879±23)MPa and an elongation of(7±2)％,which had gently sloping surface and uniform distribution of pores,with an average thickness of 1 167 μm,an average percentage of pore volume of 41％,and an average pore-intercept of 240 μm,a shear strength with the substrate of(44±5)MPa,a tensile strength of(62±7)MPa and a mass loss after 100 wear cycles of 15 mg.Conclusion The hip implants with the two coating processes both have their own advantages and disadvantages and meet the requirements of relevant industry standards,which can be expected to obtain excellent in vivo performance.[Chinese Medical Equipment Journal,2024,45(2):41-45]

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]