Background Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen for both human bloodstream infections and mastitis in cows. However, little attention has been paid to the cross-host transmission of MRSA from cows to high-risk groups in China. Objective To determine the MRSA colonization rates among dairy cows and dairy farm workers in Xinjiang, identify the antibiotic resistance profiles and molecular characteristics of the isolates, and provide scientific evidence for the formulation of targeted infection control strategies. Method A cross-sectional survey combined with laboratory pathogen analysis was conducted. From June to August 2024, large-scale dairy farms in Xinjiang region were selected as study sites. Nasal swabs (n=96) and skin swabs (n=39) were collected from workers, and bovine nasal swab samples (n=109) were collected simultaneously. All samples were subjected to MRSA isolation, cultivation, and identification, followed by antibiotic susceptibility testing to characterize resistance phenotypes. Staphylococcus aureus protein A (Spa) typing was performed to determine strain genotypes and elucidate MRSA colonization rates and molecular epidemiological patterns. Results A total of 35 MRSA strains was successfully isolated from 244 samples. The MRSA colonization rates among dairy farm workers and dairy cows were 20.83% (20/96) and 12.84% (14/109), respectively, with an overall isolation rate of 14.34% (35/244). Among the workers, the nasal colonization rate was 16.67% (16/96), and the skin colonization rate was 12.82% (5/39). One worker exhibited MRSA colonization at multiple body sites. All MRSA strains were resistant to cefoxitin (100%, 35/35). The resistance rates to erythromycin and clindamycin were 42.86% (15/35) and 34.29% (12/35), respectively. Thirteen strains showed a multidrug-resistant phenotype, whereas all strains were susceptible to vancomycin. The MRSA isolates exhibited high genetic diversity, with 13 Spa types identified, among which t441 was the most prevalent (8 strains). Both t441 and t034 types were detected in samples from both the dairy cows and their handlers. These two Spa types also carried and stably inherited specific resistance combinations, including erythromycin–clindamycin–cefoxitin and ciprofloxacin–erythromycin–clindamycin–gentamicin–cefoxitin–tetracycline, and a statistically significant association was also observed between the two resistance profiles and the bacterial types (P < 0.001). In addition, one novel Spa type strain was identified. Conclusion MRSA colonization rates among dairy cows and dairy farm workers in Xinjiang are relatively high, with evidence of multi-site colonization. The isolates exhibit high levels of multidrug resistance and genetic diversity, indicating a potential risk of cross-host transmission.

ObjectiveThis paper aims to observe the syndrome improvement and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome）. MethodsThrough a multi-center randomized controlled methodology design，confirmed influenza cases were collected from October 2022 to April 2023 in the pediatrics department of eight hospitals，such as Dongfang Hospital of Beijing University of Chinese Medicine. A total of 180 children with influenza and heat accumulation in the lung and stomach syndrome conforming to the standard were recruited through the clinic. The sick children meeting the inclusion criteria were randomly divided into groups by a block-randomized method. The children in the experimental group were treated with Qingxuan Daozhi formula for five days，and those in the control group were treated with Oseltamivir Phosphate Granules for five days. The primary efficacy indicator was the negative conversion rate of influenza antigen detection. Secondary efficacy indicators were the Canadian acute respiratory illness and flu scale （CARIFS） and the incidence of complications，severe cases， and critical cases. Follow-up observation was conducted on the day of enrollment，48 hours after medication，72 hours after medication， and （6+1） d after medication. ResultsOne hundred and eighty participants were randomly assigned to the experimental group （90 cases） or the control group （90 cases）. All participants were followed up during the study. Comparison of influenza antigen detection results in the primary efficacy indicators showed that the average time of negative influenza antigen conversion in the experimental group was （5.29±1.25） d，and that in the control group was （5.40±1.68） d，without a statistically significant difference. After five days of intervention，52 cases in the experimental group and 51 cases in the control group converted to negative，without a statistically significant difference. CARIFS score results in the secondary efficacy indicators showed that during 72 hours after intervention，there were statistically significant differences between the experimental group and the control group in three dimensions， including headache，muscle soreness， and the need for extra care （P<0.05）. On the （6+1） days after the intervention，the differences in both the experimental group and the control group were statistically significant in 10 dimensions， including sore throat，bad sleep，uncomfortable feeling，poor spirit and fatigue，crying more than usual，the need for extra care，symptom，function，influence on parents，and total score （P<0.05）. The comparison results within the group in the dimensional scores of symptom， function， and influence on parents，as well as the CARIFS total score showed that with the delay of follow-up time，scores of both groups decreased significantly，with a statistically significant difference （P<0.01）. Inter-group comparison results showed that the mean score of the experimental group was higher than that of the control group at the time of enrollment. With the progress of intervention，the score of the experimental group was significantly decreased compared with that of the control group. At the end of follow-up，the mean score of the experimental group was lower than that of the control group，with no statistically significant difference. In terms of the incidence of complications，severe cases， and critical cases， there were no complications，severe cases， and critical cases in the two groups，without a statistically significant difference. ConclusionThe symptom improvement effect and negative antigen conversion rate of Qingxuan Daozhi formula in the treatment of influenza in children （heat accumulation in the lung and stomach syndrome） are not inferior to Oseltamivir Phosphate granules， and children's acceptance is better. It can be more widely used in clinical treatment of influenza in children （heat accumulation in the lung and stomach syndrome）.

AIM:To investigate the prevalence of ocular fundus lesions among active-duty military personnel with high myopia and to analyze the associated influencing factors.

METHODS: A cross-sectional study. Subjects included military personnel with high myopia(≤-6.00 D)and elongated axial length(≥26 mm). A systematic evaluation protocol was implemented, consisting of standardized questionnaires, general physical health examinations, and comprehensive ophthalmic assessments. Optical coherence tomography(OCT)was used to screen for fundus lesions in highly myopic subjects, and the prevalence of related lesions was calculated. Axial length, refractive error, best-corrected visual acuity(BCVA), and macular ganglion cell complex(GCC)thickness were measured. Univariate analysis was performed to compare differences in the above parameters between highly myopic subjects with and without concomitant fundus lesions. Multivariate Logistic regression analysis was further applied to identify risk factors for fundus lesions.

RESULTS:A total of 134 male patients(268 eyes)were enrolled, with the mean age of 24.5±3.2 y. Of the 268 eyes, 123 eyes(45.9%)showed positive signs of fundus lesions. Among these, parapapillary blood flow density reduction was found in 84 eyes(31.3%), GCC thinning in 46 eyes(17.2%), drusen in 8 eyes(3.0%), optic disc edema in 7 eyes(2.6%), retinoschisis in 6 eyes(2.2%), and choroidal excavation in 3 eyes(1.1%). BCVA was significantly lower in highly myopic patients with retinoschisis than in those without retinoschisis(P<0.05).Univariate analysis showed that refractive error, axial length, and posterior scleral expansion were associated with the occurrence of fundus lesions(P<0.05). Multivariate Logistic regression analysis revealed that axial length(OR=2.52, 95%CI: 1.67-3.80, P<0.001)and posterior scleral expansion(OR=3.12, 95%CI: 1.65-5.92, P<0.01)were significant risk factors for fundus lesions in highly myopic military personnel.

CONCLUSION: The prevalence of fundus lesions is relatively high among active-duty military personnel with high myopia. Peripapillary flow density reduction and GCC thinning are the most common manifestations in this population. Increased axial length and posterior scleral ectasia are significant contributing factors. It is recommended that OCT be incorporated into routine ophthalmic examinations for these military personnel, thereby providing a basis for the early detection and intervention of fundus lesions.

Objective To report cases of checkpoint inhibitor pneumonitis （CIP） in patients with advanced biliary tract cancer, aiming to provide additional approaches for the assessment, treatment, and monitoring of this condition. Methods Three patients developed oxygen desaturation and interstitial lung lesions during chemotherapy combined with immunotherapy, and were diagnosed with CIP in collaboration with the respiratory department. Antitumor therapy was discontinued in the acute phase, and glucocorticoids were administered, with regular monitoring of disease progression. During follow-up, case 1 developed lung metastasis; case 2 showed improvement; case 3 had concurrent infection and tumor progression. Results Glucocorticoids improved lung lesions and hypoxic symptoms in patients with CIP, but attention should be paid to the potential for concurrent infections and tumor progression. Conclusions Comprehensive assessment and early identification of CIP are crucial for patients with advanced biliary tract cancer. For those with recurrent symptoms after glucocorticoid therapy, timely and accurate adjustment of the treatment regimen is essential.

Genomic imprinting refers to the phenomenon of differential expression of two alleles due to their different parental origins. Genes that produce genomic imprinting are usually called imprinted genes. The genetic effect caused by the presence of imprinted genes is called parent-of-origin effect. Parent-of-origin effect and genomic imprinting play important roles in the pathophysiological mechanism and occurrence and development of cardio-metabolic diseases. In-depth exploration of the law and potential roles of imprinted genes and parent-of-origin effects will help to better understand the mechanism of cardio-metabolic diseases, and also provide important theoretical basis for the precise treatment of diseases related to imprinted genes.

Objective To analyze the law of acupoint selection and compatibility of acupuncture and moxibustion and the application law of acupuncture and moxibustion in the treatment of lactational mastitis using complex network technology.Methods The clinical research literature about acupuncture and moxibustion treatment of lactational mastitis was retrieved from CNKI,CBM,Wanfang Data,VIP and PubMed from the establishment of the databases to March 15,2025.The literature was screened according to the standards to build a prescription database of acupuncture and moxibustion treatment of lactational mastitis.SPSS Modeler 18.0 software was used to analyze association rules,and Gephi 0.9 software was used for complex network analysis.Results A total of 108 articles were included.141 acupuncture and moxibustion prescriptions were extracted,involving 74 acupoints,with a total use frequency of 677 times.The high-frequency acupoints were Jianjing,Danzhong,Rugen,Zusanli,Neiguan,etc.Specific acupoints were mainly composed of Wushu acupoints(169 times,21.10%);the acupoints were mainly distributed in the limbs(36);the most frequently used meridian was stomach meridian(168 times,24.82%).The combination of acupoints with the highest correlation was Jianjing-Neiguan-Rugen.Complex network analysis identified 22 core acupoints,with the most commonly used acupuncture method being filiform needle acupuncture(79 times).Conclusion Acupuncture and moxibustion treatment of lactational mastitis pays special attention to the selection of stomach meridian.The compatibility mode is mainly from top to bottom,and the corresponding acupoints are selected according to syndrome differentiation.

Objective To investigate the thalamus and thalamic subnucleus volume changes in patients with trigeminal neuralgia(TN)and to preliminarily investigate whether there is a pain processing lateralization advantage in the thalamus.Methods The three-dimensional T1WI images of 56 TN patients and 56 matched healthy controls(HC)were collected,and thalamus and thalamic subnucleus volumes were extracted by automated segmentation via a region of interest(ROI)-based morphological analysis method.Results There was no significant difference in the whole thalamus volume between TN and HC groups.Compared with HC,the bilateral ventral lateral(VL)of the thalamus were significantly smaller in patients with right-sided trigeminal neuralgia(RTN),and no significant thalamic subnucleus volume changes were found in patients with left-sided trigeminal neuralgia(LTN).After mirror-flipping the whole-brain images of the LTN,it was found that the volume of ipsilateral thalamic VL of TN group was significantly reduced than that of HC group.The volume of ipsilateral mediodorsal lateral parvocellular(MD1)of TN group was significantly smaller than that of HC group.There was no significant difference in the volume of ipsilateral and contralateral thalamic subnucleus.Conclusion The thalamic subnucleus are exclusively reduced in volume in patients with TN,and there is no significant change in whole thalamus volume,suggesting no lateralization advantage for pain processing.

Objective:To evaluate the characteristics of neutrophil extracellular traps (NET) in children with inflammatory bowel disease (IBD) and its role in diagnosis and disease activity monitoring.Methods:A total of 66 IBD children admitted to Beijing Children′s Hospital from December 2017 to August 2024 were enrolled in this cross-sectional study, another 20 age-matched children who underwent gastrointestinal endoscopy during the same period in the same hospital and showed no abnormalities were selected as the controls. Clinical data of IBD and control group were collected. Children with IBD were divided into active group and remission group according to clinical score and endoscopic score. The peripheral blood of IBD and control group were collected, and the levels of NET markers, including neutrophil elastase (NE) and myeloperoxidase (MPO)-DNA were detected by enzyme-linked immunosorbent assay. The levels of NET markers in control group and different IBD groups were compared. Independent sample t-test or Mann-Whitney U test was used for group comparisons. Kruskal-Wallis H test was used for multiple group comparisons. Spearman correlation analysis was used to analyze the correlation between NET markers and IBD activity. The efficacy of laboratory indicators in diagnosing IBD and control group was evaluated using receiver operating characteristic (ROC) curve. Results:There were 66 children with IBD, including 36 in Crohn′s disease group with the age of (11.0±3.7) years, and 30 in ulcerative colitis (UC) group with the age of (8.3±5.0) years. The control group consisted of 20 children with the age of (10.1±3.5) years. Compared with control group, the levels of NE (958 (771, 1 328) vs. 303 (196, 501) μg/L) and MPO-DNA (0.11 (0.09, 0.18) vs. 0.09 (0.06, 0.12)) in peripheral blood of IBD group were significantly higher (both P<0.05). However, there was no significant difference in the levels of NE (1 008 (863, 1 301) vs. 807 (567, 1 535) μg/L) and MPO-DNA (0.11 (0.09, 0.21) vs. 0.12 (0.09, 0.14)) between Crohn′s disease and UC groups (both P>0.05). The NE levels in the endoscopic active group and remission group of Crohn's disease were higher than those in the control group (both P<0.05). The MPO-DNA level in the endoscopic active group of Crohn's disease was higher than that in the control group ( P<0.05), while the MPO-DNA level in the endoscopic remission group of Crohn's disease was lower than that in the control group ( P>0.05). The NE levels in the endoscopic activity group and remission group of UC were higher than those in control group (both P<0.05). NET markers were not correlated with the clinical activity and endoscopic activity of IBD (all P>0.05). ROC curve analysis showed that the area under the curve of NE combined with MPO-DNA for distinguishing IBD from controls was 0.95, with a sensitivity was 90.0% and a specificity was 89.4%. Conclusion:The combination of NE and MPO-DNA demonstrated high sensitivity and specificity for distinguishing pediatric IBD patients from healthy children, suggesting its potential as a diagnostic biomarker panel of IBD.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Atherosclerosis is recognized as an inflammatory disease,and its development is regulated by multiple fac-tors,particularly dyslipidemia.Peroxisome proliferator-activated receptor(PPAR)regulate the expression of genes that are involved in lipid metabolism and inflammation;and they have three subfamily members including PPARα,PPARβ,and PPARγ.However,synthetic PPAR agonists exhibit ambiguous effects in atherosclerotic therapy and induce various side effects.Notably,recent studies demonstrate that traditional Chinese medicine(TCM)alleviate atherosclerotic cardiovascular diseases via suppressing hyperlipidemia and inflammation through regulation of PPAR signaling pathway.This article pri-marily reviews the regulatory effects of TCM on PPAR and their therapeutic effects on atherosclerosis,provides valuable in-formation for pharmacologists that are interested in searching for effective herbal prescriptions for atherosclerosis therapy and for clinicians that are interested in prevention and treatment of atherosclerotic cardiovascular diseases using TCM.