Objectives: . This study aimed to explore the role of the Pcdh15 gene in hearing maintenance and to examine the effects of its deficiency on cochlear structure, cochlear function, and hearing loss in mice. Methods: . CRISPR/Cas9 technology was used to generate Pcdh15 knockout (KO) mice. Auditory function was evaluated using hearing tests, while histological approaches were employed to assess morphological changes in cochlear hair cells and spiral ganglion neurons (SGNs). RNA sequencing (RNA-seq) was performed on cochlear tissue from postnatal day 18 (P18) wild-type (WT) and Pcdh15 KO mice to identify differentially expressed genes (DEGs). These DEGs were subjected to functional annotation and pathway analysis, with particular emphasis on oxidative phosphorylation (OXPHOS). Reactive oxygen species (ROS) levels were quantified using flow cytometry and DCFH-DA assays. Results: . Pcdh15 KO mice exhibited progressive sensorineural hearing loss, which worsened to profound deafness by P18. Notably, cochlear hair cells and SGNs showed substantial loss and pronounced morphological abnormalities, particularly within the basal high-frequency region. RNA-seq analysis identified 1,359 DEGs, including 1,024 downregulated and 335 upregulated genes. Pathway analysis indicated that Pcdh15 deficiency was associated with inhibition of the OXPHOS pathway, potentially disrupting mitochondrial respiratory chain complexes I, III, IV, and V and thereby impairing energy production and ATP metabolism. In addition, early-stage cochleae from KO mice demonstrated elevated ROS levels and increased oxidative stress, suggesting that redox imbalance may contribute to hearing damage. Conclusion . Pcdh15 plays a critical role in hearing maintenance. Its deficiency is associated with severe hearing loss and marked cochlear abnormalities, which are linked to inhibition of OXPHOS, disruption of energy metabolism, and exacerbation of oxidative stress. Together, these findings provide new insights into the mechanisms underlying hearing loss and suggest potential targets for therapeutic intervention.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective To investigate the changes of brain deep gray matter nucleus volume and iron content in patients with type 2 dia-betes mellitus(T2DM)based on quantitative MR technology,and their correlation and mediating effect with cognitive impairment.Methods A total of 60 T2DM patients(T2DM group)and 61 healthy controls(HC)(HC group)were prospectively selected.The volume of brain deep gray matter nucleus of 3D-T1 sequence map was measured by artificial intelligence(AI)automatic segmentation technique,the corresponding region of interest(ROI)was manually drawn and quantitative susceptibility mapping(QSM)value was measured on QSM,the cognitive score,QSM value and volume of nucleus were compared by independent sample t test and rank sum test,and the correlation analysis of imaging indexes with differences between the two groups was made.The mediating effect between fasting blood glucose(FBG)and Montreal cognitive assessment(MoCA)score was analyzed.Results The MoCA and mini-mental state examination(MMSE)scores in the T2DM group were lower than those in the HC group(P＜0.05),the volumes of bilateral caudate nucleus,putamen,globus pallidus,thalamus,and right hippocampus in the T2DM group were lower than those in the HC group(P＜0.05),and the QSM values of left caudate nucleus,thalamus and bilateral globus pallidus in the T2DM group were higher than those in the HC group(P＜0.05).In the T2DM group,the volumes of bilateral thalamus and right hippocampus were positively correlated with MoCA score(left thalamus:r=0.326,P=0.012;right thalamus:r=0.373,P=0.004;right hippocampus:r=0.509,P＜0.001),and the QSM value of left thalamus was negatively correlated with MoCA score(r=-0.263,P=0.044).The mediating effect of right hippocampus volume and left thalamus QSM value was significant(P＜0.05),and the direct effect of FBG on cog-nitive score was significant(P＜0.05).Conclusion Brain deep gray matter nucleus atrophy and brain iron deposition are closely related to T2DM and cognitive impairment,and there is a mediating effect.Brain iron deposition will increase the risk of cognitive impairment in T2DM.

Objective To investigate the changes of brain deep gray matter nucleus volume and iron content in patients with type 2 dia-betes mellitus(T2DM)based on quantitative MR technology,and their correlation and mediating effect with cognitive impairment.Methods A total of 60 T2DM patients(T2DM group)and 61 healthy controls(HC)(HC group)were prospectively selected.The volume of brain deep gray matter nucleus of 3D-T1 sequence map was measured by artificial intelligence(AI)automatic segmentation technique,the corresponding region of interest(ROI)was manually drawn and quantitative susceptibility mapping(QSM)value was measured on QSM,the cognitive score,QSM value and volume of nucleus were compared by independent sample t test and rank sum test,and the correlation analysis of imaging indexes with differences between the two groups was made.The mediating effect between fasting blood glucose(FBG)and Montreal cognitive assessment(MoCA)score was analyzed.Results The MoCA and mini-mental state examination(MMSE)scores in the T2DM group were lower than those in the HC group(P＜0.05),the volumes of bilateral caudate nucleus,putamen,globus pallidus,thalamus,and right hippocampus in the T2DM group were lower than those in the HC group(P＜0.05),and the QSM values of left caudate nucleus,thalamus and bilateral globus pallidus in the T2DM group were higher than those in the HC group(P＜0.05).In the T2DM group,the volumes of bilateral thalamus and right hippocampus were positively correlated with MoCA score(left thalamus:r=0.326,P=0.012;right thalamus:r=0.373,P=0.004;right hippocampus:r=0.509,P＜0.001),and the QSM value of left thalamus was negatively correlated with MoCA score(r=-0.263,P=0.044).The mediating effect of right hippocampus volume and left thalamus QSM value was significant(P＜0.05),and the direct effect of FBG on cog-nitive score was significant(P＜0.05).Conclusion Brain deep gray matter nucleus atrophy and brain iron deposition are closely related to T2DM and cognitive impairment,and there is a mediating effect.Brain iron deposition will increase the risk of cognitive impairment in T2DM.

To develop a novel immunocastration vaccine for animals,researchers designed and syn-thesized the recombinant plasmid pET-30a-SF which could express the recombinant protein SF.This protein was then conjugated in vitro with the synthetic peptide STGP to prepare the SF-STGP nanoparticle vaccine,and its immunocastration effect on mice was studied.The Spy Catcher and ferritin amino acid sequences were connected via GGGGS,and after codon optimization for E.coli,the recombinant plasmid pET-30a-SF was constructed and transformed into E.coli for in-duced expression.The recombinant protein SF was purified using Ni-column affinity chromatogra-phy and characterized.The peptide STGP,composed of Spy Tag,GnRH,and PADRE connected by GGGS,was conjugated with the recombinant protein SF in vitro.The self-assembled nanoparticles were observed using transmission electron microscopy(TEM)and dynamic light scattering(DLS).The prepared SF-STGP nanoparticles were mixed with MONTANIDE ISA 206 VG at a 1∶1 ratio to form the vaccine,which was then subcutaneously injected into male BALB/c mice for immunocastration evaluation.The recombinant protein SF showed the highest soluble expression when induced at 18 ℃ with 0.25 mmol/L IPTG for 14 h,and the maximum conjugation efficiency with STGP was achieved at a 1∶8 molar ratio.TEM and DLS analyses revealed that both the re-combinant protein SF and SF-STGP could self-assemble into nanoparticles with average diameters of 16.2 nm and 17.8 nm,respectively.Mouse immunization results demonstrated that the SF-STGP nanoparticle vaccine generated specific GnRH antibodies after the first immunization,with the spe-cific antibody D45o reaching its peak at the 10 th week.The SF-STGP+ISA 206 immunization group showed a peak D450 value of 2.8,and the specific antibody levels in all immunization groups were significantly higher than those in the control group(P＜0.05).Additionally,the SF-STGP nanoparticle vaccine effectively reduced serum testosterone levels in mice,with the testosterone concentration in the immunization groups being significantly lower than that in the control group(P＜0.05).Compared to the control group,the immunization group exhibits testicular atrophy.The constructed SF-STGP nanoparticle vaccine proves to be a highly effective immunogen,capable of inducing testicular atrophy and reducing gonadal hormone concentrations,demonstrating excellent castration effects.This study provides new insights into immunocastration vaccines for mammals.

Objective To understand the current situation of healthcare-associated infection(HAI)in China,pro-vide data support and decision-making basis for formulating scientific and effective strategies for HAI prevention and control.Methods A nationwide cross-sectional survey on HAI was conducted among various types and levels of medical institutions in China according to a unified protocol of bedside surveys and case investigations.Results In 2024,a total of 5 736 medical institutions and 2 751 765 patients were surveyed.Among them,34 889 HAI cases were identified,with a prevalence rate of 1.27％.The number of HAI episodes was 38 032,and case prevalence rate was 1.38％.The prevalence rate of HAI in medical institutions in different regions of China ranged from 0.66％to 2.35％.Among medical institutions of different scales,those with a bed capacity of ≥900 had the high-est incidence of HAI,reaching 1.65％.The most common infection site was the lower respiratory tract(44.66％),followed by the urinary tract(12.94％),surgical site(9.32％),upper respiratory tract(7.02％),and bloodstream infection(5.78％).The top 3 departments with the highest HAI rates were the general intensive care unit(10.02％),department of neurosurgery(5.51％),and department(group)of hematology(5.34％).A total of 23 238 strains of HAI pathogens were detected,with 10 714 strains(46.10％)from lower respiratory tract speci-mens.The top 5 detected strains were Klebsiella pneumoniae(14.76％),Pseudomonas aeruginosa(13.33％),Escherichia coli(12.79％),Acinetobacter baumannii(9.23％),and Staphylococcus aureus(7.88％).231 944 pa-tients underwent class Ⅰ incision surgery were monitored,with 1 647 cases experienced surgical site infection,and the prevalence rate of surgical site infection was 0.71％.The number of patients who should undergo pathogen de-tection(patients receiving therapeutic and therapeutic combined prophylactic antimicrobial agents)was 715 179,while the actual number was 480 492,with a pathogen detection rate of 67.18％.425 225 patients received patho-genic detection before treatment,with a detection rate of 59.46％.Conclusion The overall HAI prevalence in Chi-na is lower,showing disparities among medical institutions of different regions and scales.Therefore,precise imple-mentation of measures is necessary for HAI prevention and control,with a focus on high-risk institutions and high-risk departments,key areas,and critical procedures.All levels of medical institutions should continuously reduce the incidence of HAI by strengthening monitoring,standardizing the use of antimicrobial agents,and reinforcing basic HAI prevention and control measures.

Objective:To explore the application effect of fine skin care in patients with psoriasis, and provide evidence-based theoretical basis for the development of skin care in patients with psoriasis.Methods:A randomized controlled trial was conducted. Patients with psoriasis admitted to the People′s Hospital of Wenshan Zhuang and Miao Autonomous Prefecture, Yunnan Province from December 2022 to March 2024 were selected as the research subjects by the convenience sampling method and divided into the control group and the experimental group by the random number table method. The control group was given routine care. The experimental group was given fine skin care on the basis of control group. Before and after the intervention, the itching symptoms, skin lesions, comfort and quality of life were evaluated using 12-item Pruritus Severity Scale (12-PSS), Psoriasis Area and Severity Index (PASI), General Comfort Questionnaire (GCQ), 36-item Short Form (SF-36) and compared between the two groups. The incidence of complications and recurrence rate in the two groups were counted 3 months after intervention.Results:Finally, 96 patients were included in the study, including 48 patients in the experimental group, 28 males and 20 females, aged (59.31 ± 17.31) years old; 48 cases in the control group, 29 males and 19 females, aged (61.54 ± 18.11) years old. Before the intervention, there were no statistically significant differences in the scores of 12-PSS, PASI, GCQ and SF-36 between the two groups (all P>0.05). After the intervention, the scores of 12-PSS and PASI in the experimental group were (3.65 ± 2.96), (5.08 ± 1.15) points respectively, which were lower than (8.29 ± 2.00), (7.37 ± 1.34) points in the control group, the differences were statistically significant ( t=9.00, 8.99, both P<0.05). The scores of GCQ and SF-36 in the experimental group were (41.42 ± 4.01), (95.08 ± 4.47) points respectively, which were higher than (33.94 ± 5.74) and (84.19 ± 8.52) points in the control group, the differences were statistically significant ( t=7.40, 7.84, both P<0.05). The total incidence of complications and recurrence rate in the experimental group were 4.17% (2/48), 2.08% (1/48) respectively, which were lower than 18.75% (9/48), 14.58% (7/48) in the control group, the differences were statistically significant ( χ2=5.03, 4.91, both P<0.05). Conclusions:Fine skin care can improve the itching symptoms of patients with psoriasis and reduce the severity of skin lesions. It can also improve the comfort and quality of life of patients and reduce the incidence of complications and recurrence rate, and the clinical application effect is good.

To develop a novel immunocastration vaccine for animals,researchers designed and syn-thesized the recombinant plasmid pET-30a-SF which could express the recombinant protein SF.This protein was then conjugated in vitro with the synthetic peptide STGP to prepare the SF-STGP nanoparticle vaccine,and its immunocastration effect on mice was studied.The Spy Catcher and ferritin amino acid sequences were connected via GGGGS,and after codon optimization for E.coli,the recombinant plasmid pET-30a-SF was constructed and transformed into E.coli for in-duced expression.The recombinant protein SF was purified using Ni-column affinity chromatogra-phy and characterized.The peptide STGP,composed of Spy Tag,GnRH,and PADRE connected by GGGS,was conjugated with the recombinant protein SF in vitro.The self-assembled nanoparticles were observed using transmission electron microscopy(TEM)and dynamic light scattering(DLS).The prepared SF-STGP nanoparticles were mixed with MONTANIDE ISA 206 VG at a 1∶1 ratio to form the vaccine,which was then subcutaneously injected into male BALB/c mice for immunocastration evaluation.The recombinant protein SF showed the highest soluble expression when induced at 18 ℃ with 0.25 mmol/L IPTG for 14 h,and the maximum conjugation efficiency with STGP was achieved at a 1∶8 molar ratio.TEM and DLS analyses revealed that both the re-combinant protein SF and SF-STGP could self-assemble into nanoparticles with average diameters of 16.2 nm and 17.8 nm,respectively.Mouse immunization results demonstrated that the SF-STGP nanoparticle vaccine generated specific GnRH antibodies after the first immunization,with the spe-cific antibody D45o reaching its peak at the 10 th week.The SF-STGP+ISA 206 immunization group showed a peak D450 value of 2.8,and the specific antibody levels in all immunization groups were significantly higher than those in the control group(P＜0.05).Additionally,the SF-STGP nanoparticle vaccine effectively reduced serum testosterone levels in mice,with the testosterone concentration in the immunization groups being significantly lower than that in the control group(P＜0.05).Compared to the control group,the immunization group exhibits testicular atrophy.The constructed SF-STGP nanoparticle vaccine proves to be a highly effective immunogen,capable of inducing testicular atrophy and reducing gonadal hormone concentrations,demonstrating excellent castration effects.This study provides new insights into immunocastration vaccines for mammals.

Under the background of the Healthy China Strategy, public hospitals urgently need to break through the limitations of the traditional medical mode, build a precise and continuous medical service system to meet the growing personalized health needs of the people. In 2022, a tertiary public hospital launched a multidisciplinary whole course management service practice. By integrating multidisciplinary medical and health resources, clarifying service targets and contents, forming a whole course management service team, constructing a supporting information platform, linking full process services, creating standardized service processes, and providing patients with comprehensive, full process, professional, and accurate full cycle intervention management and care. The hospital covered diseases in stages, ensuring continuous medical for patients after leaving the hospital, improving their medical experience, and supporting the high-quality development of the hospital. As of June 2024, the hospital′s multidisciplinary whole course management services had covered 25 departments and 41 disease, and 43 management teams have been established. A total of 7 453 patients signed up for the whole course service. This practice achieved good results, could provide references for the implementation of whole course management services led by public hospitals.

Based on the theories of "pathogenesis caused by constraint emotions" and "visceral orifices"， it is believed that the pathogenesis of tinnitus caused by constraint syndrome follows the evolution pattern of "qi constraint （liver qi constraint） → fire disturbance （liver constraint transforming into fire） → deficiency impairment （liver constraint with spleen deficiency） → blood stasis （liver constraint leading to blood stasis）". The treatment is guided by the principle of integrated internal and external therapy with harmonization of both body and mind. Internally， the treatment focuses on rectifying zang-fu imbalances， primarily using the Xiaoyao Powder （逍遥散）， with modifications based on syndrome differentiation. External therapies aim to unblock the meridians and orifices， commonly using auricular acupressure and Chinese herbal hot compresses. Additionally， traditional Chinese five-tone music therapy is applied to regulate emotional and mental disturbances. By integrating these three approaches， a comprehensive treatment strategy is formed that harmonizes both body and mind for managing tinnitus associated with constraint syndrome.