BACKGROUND: Mild cognitive impairment (MCI) is common in atrial fibrillation (AF) patients and may develop earlier in those with multiple cardiovascular comorbidities, potentially impairing self-management and treatment adherence. This study aimed to characterize the prevalence and profile of MCI in AF patients, examine its associations with cardiovascular comorbidities, and assess how these comorbidities influence specific cognitive domains. METHODS: This cross-sectional study analyzed data from AF patients who underwent cognitive assessment between 2017 and 2021. Cognitive status was categorized as MCI or non-MCI based on the Montreal Cognitive Assessment. Associations between comorbidities and MCI were assessed by logistic regression, and cognitive domains were compared using the Mann-Whitney U test. RESULTS: Of 4136 AF patients (mean age: 64.7 ± 9.4 years, 64.7% male), 33.5% of patients had MCI. Among the AF patients, 31.2% of patients had coronary artery disease, 20.1% of patients had heart failure, and 18.1% of patients had hypertension. 88.7% of patients had left atrial enlargement, and 11.0% of patients had reduced left ventricular ejection fraction. Independent factors associated with higher MCI prevalence included older age (OR = 1.04, 95% CI: 1.03-1.05, P < 0.001), lower education level (OR = 1.51, 95% CI: 1.31-1.73, P < 0.001), hypertension (OR = 1.28, 95% CI: 1.07-1.52, P = 0.001), heart failure (OR = 1.24, 95% CI: 1.04-1.48, P = 0.020), and lower left ventricular ejection fraction (OR = 1.43, 95% CI: 1.04-1.98, P = 0.028). A higher CHA₂DS₂-VASc score (OR = 1.27, 95% CI: 1.22-1.33, P < 0.001; ≥ 2 points vs. < 2 points), and greater atherosclerotic cardiovascular disease burden (OR = 1.45, 95% CI: 1.02-2.08, P = 0.040; 2 types vs. 0 type) were linked to increased MCI risk. These above factors influenced various cognitive domains. CONCLUSIONS MCI is common in AF and closely associated with cardiovascular multimorbidity. Patients with multiple comorbidities are at higher risk, highlighting the importance of routine cognitive assessment to support self-management and integrated care.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.

AIM:This study aims to investigate the effect of Agaricus blazei extract FA-2-b-β on ferroptosis of Burkitt lymphoma cells and its mechanism.METHODS:Burkitt lymphoma cell lines Raji and CA46 were treated with FA-2-b-β alone and in combination with ferrostatin-1,a ferroptosis inhibitor,or Stattic,a signal transducer and activator of transcription 3(STAT3)inhibitor.Cell viability was assessed using the CCK-8 method,and the half-maximal inhibitory concentration(IC50)of FA-2-b-β was calculated.Flow cytometry was used to detect apoptosis,cell cycle,mitochondrial membrane potential,and reactive oxygen species(ROS).Additionally,malondialdehyde(MDA)and glutathione(GSH)levels were measured using kits.The mRNA and protein expression levels of ferroptosis-related molecules were determined by RT-qPCR and Western blot.RESULTS:The extract FA-2-b-β at different concentrations significantly inhibited the proliferation of Raji and CA46 cells(P＜0.05),promoted their death,regulated cell arrest in G0/G1 phase,and decreased the mitochondrial membrane potential.(2)ROS and MDA levels were significantly increased with different concentrations of the extract FA-2-b-β(P＜0.05),while the GSH content was significantly decreased(P＜0.05).(3)The protein and mRNA levels of signal transducer and activator of transcription 3(STAT3),p-STAT3,and glutathione peroxidase 4(GPX4)were down-regulated at different concentrations of the extract FA-2-b-β.In addition,prostaglandin-endoperoxide synthase 2(PTSG2)and transferrin receptor protein 1(TfR1)protein and mRNA were up-regulated(P＜0.05),while the protein and mRNA levels of solute carrier family 7 member 11(SLC7A11)were not significantly changed.CONCLU-SION:The extract FA-2-b-β can induce ferroptosis in burkitt lymphoma,and the mechanism may be related to the inhibi-tion of STAT3/GPX4 signaling pathway.

Objective To investigate the temporal predictive value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1),procalcitonin(PCT),and myeloid-related protein 8/14(MRP8/14)for secondary acute respiratory distress syndrome(ARDS)in patients with severe pulmonary tuberculosis.Methods A retro-spective cohort study was conducted among patients with severe pulmonary tuberculosis admitted between January 2021 and December 2024.Patients were randomly assigned in an 8∶2 ratio to a training set(n=148)and a valida-tion set(n=37).Serum sTREM-1,PCT,and MRP8/14 were extracted from the electronic medical record at three time points:on admission(day 0),day 3,and day 7.Multivariable logistic regression was used to identify risk factors,and predictive performance was evaluated using receiver operating characteristic(ROC)curves.Results A total of 185 patients were included.In the training set(n=148),27 developed ARDS and 121 did not;in the validation set(n=37),7 developed ARDS and 30 did not.In the training set,serum sTREM-1,PCT,and MRP8/14 levels showed significant temporal changes(P<0.05).At admission,day 3,and day 7,levels of sTREM-1,PCT,and MRP8/14 were higher in the ARDS group than in the non-ARDS group(all P<0.05).At each time point,sTREM-1,PCT,and MRP8/14 were independently associated with the development of ARDS(P<0.05).In the training set,the combination of sTREM-1,PCT,and MRP8/14 at admission yielded the largest area under the ROC curve[AUC=0.976;95%confidence interval(CI),0.952～1.000],with a sensitivity of 88.9%and a specificity of 98.3%.In the validation set,the same combination achieved an AUC of 0.957(95%CI,0.895～1.000),with a sensitivity of 100.0%and a specificity of 86.7%.Conclusion Dynamic changes in sTREM-1,PCT,and MRP8/14 provide temporal predictive value for ARDS in patients with severe pulmonary tuberculosis,and the combined assessment improves early warning accuracy.

Objective To investigate the association between nutritional status and serum hepcidin and pentraxin 3(PTX3)levels in patients undergoing maintenance hemodialysis(MHD).Methods A total of 76 patients with MHD who met the inclusion criteria were recruited from the hemodialysis center at the Affiliated Hospital of Chengde Medical University.Nutritional status was assessed using the Subjective Global Assessment(SGA),which categorizes patients into three grades:SGA-A,SGA-B,and SGA-C.Serum levels of PTX3 and hepcidin were mea-sured by enzyme-linked immunosorbent assay(ELISA).Statistical analyses were conducted using SPSS software.One-way analysis of variance(ANOVA)was applied to compare differences across the three SGA groups.Logistic regression analysis was performed to identify influencing factors,and receiver operating characteristic(ROC)curve analysis was used to evaluate diagnostic value.Among the participants,45 patients were classified as malnourished based on SGA-B and SGA-C scores,while those with SGA-A constituted the well-nourished control group.Results Among the 76 MHD patients,59.2%were malnourished.We then compared clinical characteristics across the three groups.The results showed that the malnourished group was older and exhibited significantly higher levels of hs-CRP,PTX3,and hepcidin(P<0.05),while serum albumin,creatinine,and phosphorus levels were significantly lower(P<0.05).Pearson correlation analysis revealed positive correlations between SGA grades and hs-CRP,PTX3,and hepcidin levels(all P<0.05).Logistic regression analysis with"malnutrition"as the dependent variable indicated that elevated hs-CRP,PTX3,and hepcidin levels,along with age and male gender,were associated with increased risk of malnutrition in MHD patients,whereas higher serum phosphorus and creatinine levels were protec-tive factors.Further multivariate logistic regression analysis demonstrated that serum PTX3 level was an independent risk factor for malnutrition(P=0.032),while higher creatinine level was an independent protective factor(P=0.047).ROC curve analysis showed that the combination of serum PTX3 and creatinine levels had a high diagnostic value for identifying malnutrition in MHD patients,yielding an AUC of 0.789(P<0.001),a Youden index of 0.448,sensitivity of 77.8%,and specificity of 71.0%.Conclusions Elevated levels of PTX3 and hepcidin,along with reduced serum creatinine levels,are associated with an increased risk of malnutrition in patients undergoing MHD.Notably,elevated serum PTX3 and decreased serum creatinine independently predict malnutrition in this population and demonstrate high predictive value.

Objective To investigate the distribution and antimicrobial resistance profiles of clinically isolated Haemophilus influenzae and Moraxella catarrhalis in hospitals across China from 2015 to 2021,and provide evidence for rational use of antimicrobial agents.Methods Data of H.influenzae and M.catarrhalis strains isolated from 2015 to 2021 in CHINET program were collected for analysis,and antimicrobial susceptibility testing was performed by disc diffusion method or automated systems according to the uniform protocol of CHINET.The results were interpreted according to the CLSI breakpoints in 2022.Beta-lactamases was detected by using nitrocefin disk.Results From 2015 to 2021,a total of 43 642 strains of Haemophilus species were isolated,accounting for 2.91％of the total clinical isolates and 4.07％of Gram-negative bacteria in CHINET program.Among the 40 437 strains of H.influenzae,66.89％were isolated from children and 33.11％were isolated from adults.More than 90％of the H.influenzae strains were isolated from respiratory tract specimens.The prevalence of β-lactamase was 53.79％in H.influenzae strains.The H.influenzae strains isolated from children showed higher resistance rate than the strains isolated from adults.Overall,779 strains of H.influenzae did not produce β-lactamase but were resistant to ampicillin(BLNAR).Beta-lactamase-producing strains showed significantly higher resistance rates to these antimicrobial agents than the β-lactamase-nonproducing strains.Of the 16 191 M.catarrhalis strains,80.06％were isolated from children and 19.94％isolated from adults.M.catarrhalis strains were mostly susceptible to both amoxicillin-clavulanic acid and cefuroxime,evidenced by resistance rate lower than 2.0％.Conclusions The emergence of antibiotic-resistant H.influenzae due to β-lactamase production poses a challenge for clinical anti-infective treatment.Therefore,it is very important to implement antibiotic resistance surveillance for H.influenzae and guide rational antibiotic use.All local clinical microbiology laboratories should actively improve antibiotic susceptibility testing and strengthen antibiotic resistance surveillance for H.influenzae.

Objective To investigate the association between nutritional status and serum hepcidin and pentraxin 3(PTX3)levels in patients undergoing maintenance hemodialysis(MHD).Methods A total of 76 patients with MHD who met the inclusion criteria were recruited from the hemodialysis center at the Affiliated Hospital of Chengde Medical University.Nutritional status was assessed using the Subjective Global Assessment(SGA),which categorizes patients into three grades:SGA-A,SGA-B,and SGA-C.Serum levels of PTX3 and hepcidin were mea-sured by enzyme-linked immunosorbent assay(ELISA).Statistical analyses were conducted using SPSS software.One-way analysis of variance(ANOVA)was applied to compare differences across the three SGA groups.Logistic regression analysis was performed to identify influencing factors,and receiver operating characteristic(ROC)curve analysis was used to evaluate diagnostic value.Among the participants,45 patients were classified as malnourished based on SGA-B and SGA-C scores,while those with SGA-A constituted the well-nourished control group.Results Among the 76 MHD patients,59.2%were malnourished.We then compared clinical characteristics across the three groups.The results showed that the malnourished group was older and exhibited significantly higher levels of hs-CRP,PTX3,and hepcidin(P<0.05),while serum albumin,creatinine,and phosphorus levels were significantly lower(P<0.05).Pearson correlation analysis revealed positive correlations between SGA grades and hs-CRP,PTX3,and hepcidin levels(all P<0.05).Logistic regression analysis with"malnutrition"as the dependent variable indicated that elevated hs-CRP,PTX3,and hepcidin levels,along with age and male gender,were associated with increased risk of malnutrition in MHD patients,whereas higher serum phosphorus and creatinine levels were protec-tive factors.Further multivariate logistic regression analysis demonstrated that serum PTX3 level was an independent risk factor for malnutrition(P=0.032),while higher creatinine level was an independent protective factor(P=0.047).ROC curve analysis showed that the combination of serum PTX3 and creatinine levels had a high diagnostic value for identifying malnutrition in MHD patients,yielding an AUC of 0.789(P<0.001),a Youden index of 0.448,sensitivity of 77.8%,and specificity of 71.0%.Conclusions Elevated levels of PTX3 and hepcidin,along with reduced serum creatinine levels,are associated with an increased risk of malnutrition in patients undergoing MHD.Notably,elevated serum PTX3 and decreased serum creatinine independently predict malnutrition in this population and demonstrate high predictive value.

AIM:This study aims to investigate the effect of Agaricus blazei extract FA-2-b-β on ferroptosis of Burkitt lymphoma cells and its mechanism.METHODS:Burkitt lymphoma cell lines Raji and CA46 were treated with FA-2-b-β alone and in combination with ferrostatin-1,a ferroptosis inhibitor,or Stattic,a signal transducer and activator of transcription 3(STAT3)inhibitor.Cell viability was assessed using the CCK-8 method,and the half-maximal inhibitory concentration(IC50)of FA-2-b-β was calculated.Flow cytometry was used to detect apoptosis,cell cycle,mitochondrial membrane potential,and reactive oxygen species(ROS).Additionally,malondialdehyde(MDA)and glutathione(GSH)levels were measured using kits.The mRNA and protein expression levels of ferroptosis-related molecules were determined by RT-qPCR and Western blot.RESULTS:The extract FA-2-b-β at different concentrations significantly inhibited the proliferation of Raji and CA46 cells(P＜0.05),promoted their death,regulated cell arrest in G0/G1 phase,and decreased the mitochondrial membrane potential.(2)ROS and MDA levels were significantly increased with different concentrations of the extract FA-2-b-β(P＜0.05),while the GSH content was significantly decreased(P＜0.05).(3)The protein and mRNA levels of signal transducer and activator of transcription 3(STAT3),p-STAT3,and glutathione peroxidase 4(GPX4)were down-regulated at different concentrations of the extract FA-2-b-β.In addition,prostaglandin-endoperoxide synthase 2(PTSG2)and transferrin receptor protein 1(TfR1)protein and mRNA were up-regulated(P＜0.05),while the protein and mRNA levels of solute carrier family 7 member 11(SLC7A11)were not significantly changed.CONCLU-SION:The extract FA-2-b-β can induce ferroptosis in burkitt lymphoma,and the mechanism may be related to the inhibi-tion of STAT3/GPX4 signaling pathway.

Objective To investigate the temporal predictive value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1),procalcitonin(PCT),and myeloid-related protein 8/14(MRP8/14)for secondary acute respiratory distress syndrome(ARDS)in patients with severe pulmonary tuberculosis.Methods A retro-spective cohort study was conducted among patients with severe pulmonary tuberculosis admitted between January 2021 and December 2024.Patients were randomly assigned in an 8∶2 ratio to a training set(n=148)and a valida-tion set(n=37).Serum sTREM-1,PCT,and MRP8/14 were extracted from the electronic medical record at three time points:on admission(day 0),day 3,and day 7.Multivariable logistic regression was used to identify risk factors,and predictive performance was evaluated using receiver operating characteristic(ROC)curves.Results A total of 185 patients were included.In the training set(n=148),27 developed ARDS and 121 did not;in the validation set(n=37),7 developed ARDS and 30 did not.In the training set,serum sTREM-1,PCT,and MRP8/14 levels showed significant temporal changes(P<0.05).At admission,day 3,and day 7,levels of sTREM-1,PCT,and MRP8/14 were higher in the ARDS group than in the non-ARDS group(all P<0.05).At each time point,sTREM-1,PCT,and MRP8/14 were independently associated with the development of ARDS(P<0.05).In the training set,the combination of sTREM-1,PCT,and MRP8/14 at admission yielded the largest area under the ROC curve[AUC=0.976;95%confidence interval(CI),0.952～1.000],with a sensitivity of 88.9%and a specificity of 98.3%.In the validation set,the same combination achieved an AUC of 0.957(95%CI,0.895～1.000),with a sensitivity of 100.0%and a specificity of 86.7%.Conclusion Dynamic changes in sTREM-1,PCT,and MRP8/14 provide temporal predictive value for ARDS in patients with severe pulmonary tuberculosis,and the combined assessment improves early warning accuracy.

BACKGROUND: Periodontitis is a severe chronic inflammatory disease, whose traditional systemic antimicrobial therapy faces great limitations. In-situ gels provide an effective solution as an emerging local drug delivery system. METHODS: In this study, the novel thermosensitive poloxamer/carbopol in-situ gels loaded with 20 lmol/L quercetin for the treatment of periodontitis were prepared by cold method. Thirteen batches of in-situ gels based on two independent factors (X1 : poloxamer 407 and X2 : carbopol 934P) were designed and optimized by the statistical method of central composite design (CCD). The transparency, pH, injectability, viscosity, gelation temperature, gelation time, elasticity modulus, degradation rate and in-vitro drug release studies of the batches were evaluated, and the percentage of drug release in the first hour, the time required for 90% drug release, gelation temperature, and gelation time were selected as dependent variables. RESULTS: These two independent factors significantly affected the four dependent variables (p < 0.05). The optimization result displayed that the optimized concentration of poloxamer 407 was 20.84% (w/v), and carbopol 934P was 0.5% (w/v). The optimized formulation showed a clear appearance (++), acceptable injectability (Pass), viscosity(151,798 mPa s), gelation temperature (36 °C), gelation time (213 s), preferable cell viability and cell proliferation, conformed to first-order release kinetics, and had a significant antibacterial effect. CONCLUSIONS The article demonstrates the great potential of the quercetin in-situ gel as an effective treatment for periodontitis.