Objective To understand the distribution characteristics of fungi on object surface in hospital environ-ment,and provide reference for the scientific and precise formulation of environment control strategies based on fun-gal in clinic.Methods From December 7 to 23,2023,a total of 60 environmental specimens of 19 categories in 6 departments of a large tertiary first-class hospital were collected and divided into water-related environmental speci-men group,complete facade environmental specimen group,and sanitary ware environmental specimen group.18S rRNA sequencing was performed on specimens with fungi detected.Results Fungal detection rate of environmental specimens was 20.00％(12/60).Sink in the department of endocrinology had the highest fungal colony count(15 CFU/cm2),followed by the air outlet of air disinfection device in the department of thoracic surgery and the in-ternal part of a faucet in the department of endocrinology(both 10 CFU/cm2).The water-related environmental specimen group detected most diverse fungal genera(14 species),with high relative abundances of Aspergillus(100％),Meyerozyma(99.06％),Ophiocordyceps genus(95.63％),and Kodamaea(87.86％).The air outlet of air disinfection device was detected with a high abundance of Chaetomium(44.08％)and Corollospora(39.71％).There was no statistically significant difference in the α-diversity(Shannon and Simpson indices,P values of 0.661 and 0.568,respectively)and β-diversity(P=0.712)among the three environmental specimens.Conclusion Under the routine implementation of basic environmental cleaning and disinfection in medical institutions,fungi are in a low prevalence in the environment.However,moist surfaces and air disinfection device are prone to fungal colonization,and it is necessary to strengthen daily monitoring and take corresponding intervention measures to reduce the risk of infection.

Infectious diseases of the respiratory system are very common in clinical practice,among which pneumonia caused by in-fluenza virus infection is characterized by high morbidity and mortality.Current clinical treatments for respiratory viral infections still face challenges such as drug resistance and poor efficacy.Necroptosis,a form of programmed cell death,is closely associated with the progression of respiratory viral infections.Traditional Chinese medicine modulating necroptosis has demonstrated beneficial therapeu-tic effects in these diseases.This paper introduces the concept and mechanisms of necroptosis,reviews recent research on the relation-ship between necroptosis and respiratory virus infections diseases,and summarizes the therapeutic effects of traditional Chinese medi-cine in regulating necroptosis to intervene in these diseases,aiming to provide insights for the development and clinical application of therapeutic agents for respiratory viral infections.

Objective:To explore the latent-classes of HIV high risk behaviors among college students, and the association between experiences of intimate partner violence (IPV) and HIV high risk behaviors, to provide evidence for reducing the HIV high risk behaviors among them.Methods:A cross-sectional study was conducted from October to December 2019 among university students from six higher education institutions in Zhuhai City, using a multi-stage cluster sampling method, with an estimated sample size of 1 318. The study included participants who self-reported being in a romantic relationship and having sexual experience within the past year. Data on sociodemographic characteristics, IPV experiences, and HIV high risk behaviors were collected. Latent-class analysis was performed on HIV high risk behaviors, and chi-squared tests and multivariable logistic regression were used to analyze the associations between IPV experiences and different latent classes of HIV high risk behaviors.Results:The effective response rate for the survey was 95.4% (12 235/12 821). 1 382 college students from Zhuhai were included as participants in the study, with 19.4% (268/1 382) self-reporting having experienced IPV. Latent-class analysis of HIV high risk behaviors classified the participants into three latent groups: low-risk group (78.1%, 1 079/1 382), multiple sexual partners/alcohol use before sex group (15.8%, 219/1 382), and high-risk group (6.1%, 84/1 382). Multivariable logistic regression analysis showed that students who had experienced psychological violence were more likely to be in the group that had multiple sexual partners/alcohol use before sex (a OR=2.51, 95% CI:1.48-4.27). Those who had experienced IPV (a OR=5.74, 95% CI:3.45-9.55), physical violence (a OR=9.26, 95% CI: 5.24-16.35), sexual violence (a OR=8.46, 95% CI:4.93-14.52), or psychological violence (a OR=15.99, 95% CI:8.64-29.57) were more likely to be in the high-risk group. Students who experienced two (a OR=9.37, 95% CI:3.55-24.71) or three types of IPV (a OR=50.09, 95% CI: 21.06-119.14) were more likely to be in the high-risk group compared to those with no IPV experiences. Conclusions:HIV high risk behaviors among college students in Zhuhai exhibited heterogeneity across different latent groups, and these groups have different associations with IPV experiences. Universities should tailor targeted HIV/AIDS education and prevention strategies based on the characteristics of each latent group to reduce HIV high risk behaviors among college students.

Human naïve pluripotent stem cells (PSCs) hold great promise for embryonic development studies. Existing induction and culture strategies for these cells, heavily dependent on MEK inhibitors, lead to widespread DNA hypomethylation, aberrant imprinting loss, and genomic instability during extended culture. Here, employing high-content analysis alongside a bifluorescence reporter system indicative of human naïve pluripotency, we screened over 1,600 chemicals and identified seven promising candidates. From these, we developed four optimized media-LAY, LADY, LUDY, and LKPY-that effectively induce and sustain PSCs in the naïve state. Notably, cells reset or cultured in these media, especially in the LAY system, demonstrate improved genome-wide DNA methylation status closely resembling that of pre-implantation counterparts, with partially restored imprinting and significantly enhanced genomic stability. Overall, our study contributes advancements to naïve pluripotency induction and long-term maintenance, providing insights for further applications of naïve PSCs.
Humans ; DNA Methylation/drug effects* ; Genomic Instability ; Pluripotent Stem Cells/metabolism* ; Cell Culture Techniques/methods* ; Cells, Cultured

INTRODUCTION: Outcomes after SARS-CoV-2 Omicron infection in patients with heart failure (HF) and ischaemic heart disease (IHD) remain poorly defined. METHOD: In a highly vaccinated cohort of adult Singapore citizens and permanent residents, we used Cox proportional hazards models (adjusted for sociodemographic variables and comorbidities) to compare the risks of Omicron infection, COVID-19- related hospitalisation, and severe COVID-19 between indivi-duals with HF or IHD and matched controls without these conditions. RESULTS: From national databases, we identified 15,426 HF patients matched 1:∼3 to 41,221 controls, and 110,442 IHD patients matched 1:∼2 to 223,843 controls. Over 80% of HF and IHD patients had received at least 3 vaccine doses. During the Omicron-predominant period, both HF and IHD cohorts demonstrated higher adjusted risks of COVID-19 hospitalisation compared with matched controls (HF: adjusted hazard ratio [aHR] 1.77, 95% confidence interval [CI] 1.65-1.90; IHD: aHR 1.21, 95% CI 1.17-1.26). Among those with at least 1 HF-or IHD-related admission in the prior year, hospitalisation risk was further elevated (HF: aHR 1.27, 95% CI 1.13-1.42; IHD: aHR 1.11, 95% CI 1.01-1.23). Receipt of ≥3 vaccine doses was associated with substantially lower risk of severe COVID-19 versus only 2 doses (HF: aHR 0.35, 95% CI 0.28-0.43; IHD: aHR 0.27, 95% CI 0.23-0.32). A fourth dose conferred additional reductions in infection and adverse outcomes, though CIs for infection overlapped with those for 3 doses. CONCLUSION During Omicron predominance, HF and IHD patients experienced greater risk of COVID-19 hospitalisation and severe COVID-19 versus matched controls. Booster vaccinations attenuated these risks. Individuals with recent HF/IHD admissions should be prioritised for receipt of booster vaccine doses.
Humans ; COVID-19/complications* ; Male ; Heart Failure/complications* ; Myocardial Ischemia/complications* ; Female ; Middle Aged ; Hospitalization/statistics & numerical data* ; Aged ; COVID-19 Vaccines/administration & dosage* ; Singapore/epidemiology* ; SARS-CoV-2 ; Proportional Hazards Models ; Adult ; Case-Control Studies ; Vaccination/statistics & numerical data*

Aim To investigate the intestinal protection and possible mechanism of magnolol(MG)in newborn rats with necrotizing enterocolitis(NEC).Methods The rats were randomly divided into control group(Ctrl group),model group(NEC group)and treatment group(MG group).The NEC model was induced by hypoxia,cold stimulation,deep formula milk and LPS intragastric administration in 7-day-old rats for four days.They were killed after five days of treatment with MG(20 mg·kg-1).HE staining was used to observe the intestinal pathological injury.Western blot was used to detect the expressions of IL-1 β,TNF-α,NL-RP3,ASC,caspase-1 and tight junction protein in the distal ileum of rats.Colon contents were collected for 16S rDNA sequencing to understand the gut microbio-ta.Results MG improved the body mass and intesti-nal injury of NEC neonatal rats.The expressions of in-testinal IL-1β,TNF-α,NLRP3,ASC and caspase-1 proteins were down-regulated,and the expressions of Claudin,Occludin and ZO-1 proteins were up-regula-ted.16S rDNA showed that MG increased the diversity of intestinal flora,and at the phylum level,MG in-creased the abundance of firmicutes and bacteroides in NEC model,and decreased the abundance of pro-teobacteria.At the genus level,MG treatment in-creased the abundance of Lactobacillus,unclassified_Muribaculaceae,Racteroides,but decreased the abun-dance of Escherichia_Shigella,Rodentibacter and Fuso-bacterium.Conclusion MG intervention can protect the intestinal tract of NEC rats by potentially improving barrier function,and regulating the intestinal microbiota through the NLRP3/ASC/caspase-1 signaling pathway.

Postoperative infection of internal fixation of closed fractures the lower limbs in adults represents a devastating complication, characterized by diagnostic challenges, prolonged treatment duration and high disability rates. Current management of these infections faces multiple challenges, such as difficulties in early accurate diagnosis, and various controversies about the treatment plan, leading to poor overall diagnosis and treatment results. To address these issues, based on evidence-based medicine and principles with emphasis on scientific rigor, clinical applicability and innovation, the Trauma Branch of the Chinese Medical Association, Orthopedic Branch of the Chinese Medical Doctor Association, Orthopedics Branch of the Chinese Medical Association, and Trauma Orthopedics and Polytrauma Group of the Resuscitation and Emergency Committee of the Chinese Medical Doctor Association have collaboratively organized a panel of relevant experts to develop the Guideline for diagnosis and treatment of infection after internal fixation of closed lower limb fractures in adults ( version 2025). The guideline proposed 10 recommendations, aiming to provide a foundation for standardized diagnosis and treatment of postoperative infection in adults with closed lower limb fractures.

Objective:To investigate the changes in and correlations between melanin-concentrating hormone (MCH) and androgen levels in the serum of patients with polycystic ovary syndrome (PCOS), aiming to provide a novel research perspective for its diagnosis.Methods:A cross-sectional study. A total of 307 subjects were enrolled from the physical examination center and endocrinology clinic of the Affiliated Hospital of Zunyi Medical University from June 2023 to June 2024. The cohort comprised 114 healthy controls and 193 patients with PCOS, diagnosed according to the Rotterdam criteria. The patients were grouped into four phenotypes: Phenotype A (hyperandrogenemia [HA]+ovulatory dysfunction [OA]+polycystic ovarian morphology [PCOM], n=44), Phenotype B (HA+OA, n=50), Phenotype C (HA+PCOM, n=46), and Phenotype D (OA+PCOM, n=53). Clinical data were collected for all subjects. Serum MCH levels were determined by enzyme-linked immunosorbent assay. The relationship between MCH and androgen-related risk factors for PCOS was analyzed using Spearman partial correlation analysis and stepwise multiple linear hierarchical regression. Binary logistic regression was used to analyze factors influencing PCOS onset. The diagnostic value of MCH for PCOS was evaluated using a receiver operating characteristic (ROC) curve. Results:There were no significant differences in age and height between the healthy control group and the PCOS phenotypic groups (both P>0.05). MCH levels [17.63 (12.69, 22.00), 17.31 (11.05, 20.09), 17.82 (11.47, 19.40), 16.50 (11.14, 19.41) μg/L vs. 12.14 (9.78, 15.05) μg/L], homeostatic model assessment of insulin resistance, fasting plasma glucose, fasting serum lisulin, body mass index, and weight were significantly higher across all four PCOS phenotypes (A, B, C, and D) than in healthy controls (all P<0.05), whereas sex hormone-binding globulin (SHBG) contents were significantly lower ( P<0.05). Free androgen index (FAI), total testosterone (TES) and dehydroepiandrosterone (DHEA) levels were significantly higher in PCOS phenotypes A, B, and C than in the control group and PCOS phenotype D (all P<0.05). Spearman partial correlation analysis revealed no significant correlation between MCH and TES, DHEA, or FAI in healthy controls and patients with non-HA PCOS (all P>0.05). However, in PCOS patients with HA, MCH showed a significant positive correlation with TES and DHEA ( r=0.227 and 0.196, respectively; both P<0.05), but not FAI ( P>0.05). Stepwise multiple linear hierarchical regression analysis showed that MCH was positively correlated with TES, DHEA and luteinizing hormone and negatively correlated with SHBG (all P<0.05). Binary logistic regression indicated that an increase in MCH may be a potential risk factor for PCOS occurrence ( OR=1.113, 95% CI 1.012-1.224, P=0.028). ROC analysis showed that MCH has diagnostic value for PCOS ( P<0.05), with an area under the curve of 0.713. Conclusion:Serum MCH is closely related to FAI, TES, and DHEA levels in PCOS patients and may play an important role in the etiology and progression of the syndrome.

Objective To investigate the predictive value of dual-energy computed tomography(DECT)quantitative parameters in the diagnosis and pathological aggressiveness of lung adenocarcinoma.Methods A total of 174 patients with lung cancer were pro-spectively selected.All patients underwent DECT examination,and the types of lung cancer were determined according to the patho-logical tissue.According to the pathological classification,they were divided into lung adenocarcinoma group(n=99),lung squamous cell carcinoma group(n=47)and small cell lung cancer group(n=28).According to whether the lung adenocarcinoma patients had pathological aggressiveness,they were divided into invasive group(n=34)and non-invasive group(n=65).Receiver operating char-acteristic(ROC)curve was used to diagnose the predictive value of DECT quantitative parameters in the diagnosis and pathological aggressiveness of lung adenocarcinoma.Results The normalized iodine concentration(NIC)and k in venous phase of lung adenocar-cinoma group were higher than those in lung squamous cell carcinoma group and small cell lung cancer group(P<0.05).ROC curve analysis showed that the combined diagnosis value of NIC and k in venous phase was higher(P<0.05).The lobular proportion,vac-uolar proportion,pleural indentation proportion,vascular cluster proportion,effective atomic number(Eff-Z),NIC and k in arterial phase,and NIC and k in venous phase in invasion group were higher than those in non-invasion group(P<0.05).Logistic regression analysis showed that pleural indentation,NIC in arterial phase and NIC in venous phase were risk factors for pathological aggerssive-ness in lung adenocarcinoma patients(P<0.05).ROC curve analysis showed that the combination of NIC in arterial phase and NIC in venous phase had higher value in predicting the pathological aggressiveness of lung adenocarcinoma(P<0.05).Conclusion The combination of NIC and k in venous phase is effective in the diagnosis of lung adenocarcinoma,while NIC in arterial phase and NIC in venous phase have high predictive values for the aggressiveness of lung adenocarcinoma.

In recent years, the study of single-cell transcriptome sequencing technology in the heterogeneity of astrocytes (astrocytes) after spinal cord injury (SCI) has provided new perspectives on post-traumatic nerve regeneration and repair. To provide a review on the research progress of single-cell sequencing technology in astrocytes after spinal cord injury (SCI), and to more comprehensively and deeply elaborate the application of single-cell sequencing technology in the field of astrocytes after SCI. Single-cell sequencing technology can analyse the transcriptomes of individual cells in a high-throughput manner, thus revealing fine differences in cell types and states. By using single-cell sequencing technology, the heterogeneity of astrocytes after SCI and their association with nerve regeneration and repair were revealed. In conclusion, the application of single-cell sequencing technology provides an important tool to reveal the heterogeneity of astrocytes after SCI, to further explore the mechanisms of astrocytes in SCI, and to develop intervention strategies targeting their regulatory mechanisms in order to improve the therapeutic efficacy of SCI. The discovery of changes in astrocyte transcriptome dynamics has improved researchers' understanding of spinal cord injury lesion progression and provided new insights into the treatment of spinal cord injury at different time points. To date, all of these findings need to be validated by more basic research and sufficient clinical trials. In the future, single-cell sequencing technology, through interdisciplinary collaboration with bioinformatics, computer science, tissue engineering, and clinical medicine, is expected to open a new window for the treatment of spinal cord injury.
Spinal Cord Injuries/metabolism* ; Astrocytes/cytology* ; Single-Cell Analysis/methods* ; Humans ; Animals ; Transcriptome ; Nerve Regeneration