Abstract On September 26, 2024, a municipal hospital in Jiaxing City reported a maternal case of Listeria monocytogenes infection. In order to clarify the source of infection, the Jiaxing Center for Disease Control and Prevention immediately conducted the epidemiological investigation, laboratory testing and related disposal work. The case presented with fever (37.9 ℃), gradually intensifying paroxysmal abdominal pain without obvious cause, and went to hospital on the day of onset. Due to fetal intrauterine distress, a male infant was delivered by cesarean section on the same day. The epidemiological investigation identified that the case usually consumed fruits, often store fruits such as watermelon and grapes in the refrigerator alongside raw meat, and the refrigerator had never been cleaned or disinfected, posing a risk of cross contamination. Laboratory tests on amniotic fluid sample from the pregnant woman, infant blood sample showed positive results for Listeria monocytogenes infection. One strain of Listeria monocytogenes was detected in a smear sample from the inner wall of the refrigerator, and all the strains were ST2 type. Consuming fruits contaminated with Listeria monocytogenes may be the main source of infection. Food safety education for pregnant women and their family members should be strengthened to reduce the risk of infection.

Objective:To study the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with fine needle aspiration biopsy (FNA) for thyroid imaging reporting and data system (TI-RADS) 4 type thyroid micro-nodules (TN).Methods:A total of 121 TI-RADS 4 TN patients admitted to Zhanjiang Central People's Hospital from June 2020 to June 2023 were selected as the research subjects. All patients underwent examinations such as CEUS, FNA, and pathology (as the gold standard). The CEUS manifestations of TI-RADS 4 benign and malignant nodules were observed. The diagnostic accuracy, sensitivity, and specificity of CEUS and FNA alone and in combination for TI-RADS 4 type TN benign and malignant nodules were calculated and compared.Results:Among the 121 patients, there were 109 females and 12 males, with an age of (48.27 ± 7.76) years. Pathological diagnosis showed 74 cases of malignancy and 47 cases of benign. CEUS diagnosed 64 cases of malignancy and 57 cases of benign, with a diagnostic accuracy of 86.49% (64/74); the CEUS manifestations of benign and malignant nodules were compared in terms of enhancement mode, enhancement level, uniformity, peripheral ring shape, and post enhancement boundary, and the differences were statistically significant ( P < 0.001). FNA diagnosed 62 cases of malignancy and 59 cases of benign, with a diagnostic accuracy of 83.78% (62/74). CEUS combined with FNA diagnosed 72 cases of malignancy and 49 cases of benign, with a diagnostic accuracy rate of 97.30% (72/74). The accuracy of CEUS combined with FNA in diagnosing malignant nodules was higher than that of CEUS and FNA alone ( P < 0.05). The sensitivity and specificity of CEUS combined with FNA in diagnosing malignant nodules were higher than those of CEUS and FNA alone ( P < 0.05). Conclusion:The combination of CEUS and FNA has good diagnostic value for TI-RADS 4 type TN, which can improve the accuracy and diagnostic efficiency of malignant nodule diagnosis.

Objective:To study the diagnostic value of contrast-enhanced ultrasound (CEUS) combined with fine needle aspiration biopsy (FNA) for thyroid imaging reporting and data system (TI-RADS) 4 type thyroid micro-nodules (TN).Methods:A total of 121 TI-RADS 4 TN patients admitted to Zhanjiang Central People's Hospital from June 2020 to June 2023 were selected as the research subjects. All patients underwent examinations such as CEUS, FNA, and pathology (as the gold standard). The CEUS manifestations of TI-RADS 4 benign and malignant nodules were observed. The diagnostic accuracy, sensitivity, and specificity of CEUS and FNA alone and in combination for TI-RADS 4 type TN benign and malignant nodules were calculated and compared.Results:Among the 121 patients, there were 109 females and 12 males, with an age of (48.27 ± 7.76) years. Pathological diagnosis showed 74 cases of malignancy and 47 cases of benign. CEUS diagnosed 64 cases of malignancy and 57 cases of benign, with a diagnostic accuracy of 86.49% (64/74); the CEUS manifestations of benign and malignant nodules were compared in terms of enhancement mode, enhancement level, uniformity, peripheral ring shape, and post enhancement boundary, and the differences were statistically significant ( P < 0.001). FNA diagnosed 62 cases of malignancy and 59 cases of benign, with a diagnostic accuracy of 83.78% (62/74). CEUS combined with FNA diagnosed 72 cases of malignancy and 49 cases of benign, with a diagnostic accuracy rate of 97.30% (72/74). The accuracy of CEUS combined with FNA in diagnosing malignant nodules was higher than that of CEUS and FNA alone ( P < 0.05). The sensitivity and specificity of CEUS combined with FNA in diagnosing malignant nodules were higher than those of CEUS and FNA alone ( P < 0.05). Conclusion:The combination of CEUS and FNA has good diagnostic value for TI-RADS 4 type TN, which can improve the accuracy and diagnostic efficiency of malignant nodule diagnosis.

Objective:To investigate the diagnostic value of lung ultrasound in hospitalized children with community-acquired pneumonia (CAP).Methods:In the cross-sectional study, a total of 422 children with CAP who were hospitalized in the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University, from February 2021 to August 2022 and completed lung ultrasound examination within 48 hours after admission were enrolled. The clinical characteristics, lung ultrasound and chest CT were collected. The patients were divided into two groups according to the signs of pneumonia indicated by chest CT, and the signs of lung ultrasound with diagnostic value were screened according to the signs of pneumonia indicated by chest CT by least absolute shrinkage and selection operator (Lasso) regression. According to severity of the disease, the children were divided into the severe group and the mild group, and the differences of lung ultrasound signs between the two groups were compared. Kruskal-Wallis test, Fisher′s exact test was selected for comparison between groups. Random forest classifier wes used to evaluate the value of lung ultrasound in the diagnosis of CAP and prediction of severe pneumonia in children. The receiver operating characteristic curve was used to evaluate the prediction effect. Use DeLong test to compare the area under the curve.Results:Among the 422 cases of CAP, there were 258 males and 164 females, and the age of onset was 2.8 (1.3, 4.3) years. The confluent B-line, consolidation and pleural effusion detected by lung ultrasound were 309 cases (73.2%), 232 cases (55.0%) and 16 cases (3.8%), respectively, and the size of consolidation was 3.0 (0, 11.0) mm. One hundred and ten children (26.1%) with CAP completed chest CT. There were 90 cases with signs of pneumonia in chest CT and 20 cases without signs of pneumonia. Lasso was used for feature selection.Lung consolidation ( OR=2.46), bilateral lung consolidation ( OR=1.16) and confluent B-line ( OR=1.34) were the main index. With random forest classifier, the accuracy of models using full variables and Lasso-selected variables were 0.79 (95% CI 0.70-0.86) and 0.79 (95% CI 0.70-0.86), the sensitivity were 0.81 and 0.81, and the specificity were 0.75 and 0.70, and the area under curve were 0.87 (95% CI 0.81-0.94, P<0.001) and 0.84 (95% CI 0.76-0.91, P<0.001), respectively. There were 97 cases in severe group and 325 cases in mild group. Compared with the mild group, the detection rate of consolidation, multiple consolidation, the size of consolidation and the size of consolidation was adjusted by body surface area (consolidation size/body surface area) in severe group were higher (66 cases (68.0%) vs. 166 cases (51.1%), 42 cases (43.3%) vs. 93 cases (28.6%), 8.0 (0, 17.0) vs. 1.0 (0, 9.0) mm, 12.5 (0, 24.6) vs. 2.1 (0, 17.6), χ2=8.59, 9.98, Z=14.40, 12.79, all P<0.05). Using lung ultrasound lung consolidation size and consolidation size/body surface area to predict the severe CAP, the optimal cut-off value were 6.7 mm and 10.2, the accuracy was 0.80 (95% CI 0.75-0.83) and 0.89 (95% CI 0.86-0.92), the sensitivity was 0.99 and 0.99, the specificity was 0.14 and 0.56, respectively, and the area under the curve was 0.66 (95% CI 0.60-0.72, P<0.001) and 0.76 (95% CI 0.70-0.83, P<0.001), respectively. The area under the curve of consolidation size/body surface area was higher than that of consolidation size ( Z=5.50, P<0.001). Conclusions:Consolidation and confluent B-line, are important index for lung ultrasound diagnosis of CAP in children. The actual consolidation size adjusted by body surface area is superior to the size of consolidation in predicting severe CAP.

AIM:To investigate the effects of γ-synuclein on autophagy and apoptosis of colon cancer cells in-duced by endoplasmic reticulum stress,as well as the protective effect on the cells.METHODS:Gene expression profile chip analysis was performed to compare the cDNA expression profiles between human colon cancer HCT116 cells with γ-synu-clein knockdown and HCT116 cells with control siRNA,and to identify potential molecules related to autophagy and apop-tosis.In colon cancer cell lines,the functional effects of γ-synuclein on autophagy and apoptosis induced by thapsigargin(TG),an endoplasmic reticulum stress-inducing agent,were systematically explored by conducting immunofluorescence staining,Western blot,CCK-8 assay,flow cytometry,and transmission electron microscopy.Western blot was used to de-tect the expression of γ-synuclein protein,autophagy-related proteins[microtubule-associated protein 1 light chain 3(LC3),beclin-1,autophagy-related protein 5(ATG5)and ATG7],and apoptosis-related proteins[poly(ADP-ribose)polymerase(PARP),pro-caspase-3,and pro-caspase-9].To further analyze the mechanism of γ-synuclein in regulating autophagy and apoptosis,extracellular signal-regulated kinase(ERK)inhibitor PD98059,ERK inhibitor SP600125 and c-Jun N-terminal kinase(JNK)activator anisomycin were applied separately to test HCT116 cells transfected with γ-synu-clein siRNA.Subsequently,autophagy proteins,apoptosis proteins,and ERK and JNK pathway-related proteins were de-tected by Western blot.RESULTS:The TG-induced autophagy of colon cancer cells mainly occurred at the early stage(0～24 h),and apoptosis mainly occurred at the late stage(36～48 h).Endoplasmic reticulum stress up-regulated the ex-pression of γ-synuclein in colon cancer cells,which was associated with enhanced autophagy.γ-Synuclein promoted au-tophagy by activating ERK and JNK pathways at the early stage(0～24 h),and inhibited apoptosis by blocking JNK path-ways at the late stage(24～48 h)to protect HCT116 cells.In our model,γ-synuclein was observed to play a critical role in the transition from endoplasmic reticulum stress-induced autophagy to apoptosis.CONCLUSION:In the context of endo-plasmic reticulum stress,γ-synuclein promotes autophagy and inhibits apoptosis by regulating ERK and JNK signaling pathways,thus protecting colon cancer cells.This provides a potential idea for anti-tumor therapy.

Interferon regulatory factor -4 binding protein ( IBP ) , served as a novel type of microtubule binding protein ,is proven to play an important role in the immune system .New evidence suggests that the protein is associated with the occurrence and development of some malignant tumors through the effects of cytoskeletal re -modeling and cell conduction mechanism .Therefore researchers believe that IBP may become a new target for cancer molecular therapy .Based on the existing experimental data ,this study aims to investigate the structure of IBP,as well as its multiple oncology effects .Furthermore,we provide the theoretical basis for IBP targeted therapy in the treatment of malignant tumors .

Objective:To investigate the understanding of cancer pain by medical doctors and its therapeutic status in Shanghai. Methods:We recruited 1 982 medical physicians from 106 secondary and tertiary hospitals in Shanghai city from January to March in 2007. The understanding and the therapeutic status of cancer pain were investigated by conducting a questionnaire survey and the results were statistically analyzed.Rusults:There were 52.3% physicians who believed that they understand the treatment protocol of the Three-step Analgesic Ladder regimen. The rate increased by 21.6 percentage point compared with the results in 1999. The understanding degree of oncologists was significantly better than non-oncologists. There were 16.8% physicians giving the correct answers on the three main principles of the dosage titration in analgesic management. The correct rate of oncologists was significantly higher than that of non-oncologists. Opium with strong analgesic effect had become the first choice for severe cancer pain, and the use of pethidine (Dolantin) for severe cancer pain decreased significantly.The pain was significantly relieved in 74.8% patients. The pain-relieving rate increased by 25.4 percentage point compared with the results in 1999. There were 81.1% medical doctors confirming the effect of pain treatment and among them oncologists were more optimistic to therapeutic outcome than others. There were 93.3% physicians who agreed that it was necessary to carry out the standardized training of cancer pain treatment and the requirement of non-oncologists were much emergent. The over-strict controls by the hospitals and the regulations were the main obstacles for using analgesic drugs.Conclusion:The understanding of medical doctors and the diagnostic and therapeutic levels of cancer pain were improved significantly compared with those in 1999. But more training of cancer pain treatment are still required to publicize the standardized therapy and overcome the obstacles of using analgesic drug.