Objective To analyze the rates of drug resistance of carbapenem-resistant Klebsiella pneumoniae (CRKP) and extended-spectrum β-lactamase-producing Escherichia coli (ESBL-E.coli) in bronchoalveolar lavage fluid (BALF) of critically ill patients with severe pneumonia and artificial airway and risk factors of CRKP. Methods Patients with severe pneumonia and artificial airway treated in the Center of Emergency and Intensive Care Unit, Jinshan Hospital, Fudan University from May 2022 to May 2025 were selected. Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E.coli) isolated and cultured from BALF of these patients were analyzed. The drug resistance rates of the two bacteria were compared. The multivariate logistic regression was used to analyze related risk factors for CRKP infection. Results A total of 384 patients were included, and 384 strains were cultured, including 330 strains (85.9%) of K. pneumoniae and 54 strains (14.1%) of E.coli. The infection rate of K. pneumoniae was higher. Compared with E.coli, the drug-resistant gene expression rate of K. pneumoniae was lower (37.3% vs 57.4%, P＜0.01). The resistance rates of CRKP to cefotaxime, cefepime, aztreonam, and imipenem were higher than those of ESBL-E.coli (P＜0.003). Both CRKP and ESBL-E.coli had high sensitivity to polymyxin and tigecycline. Multivariate logistic regression showed duration of mechanical ventilation ≥ 7 days, and combination of ≥ 2 antibiotics for over 7 days were independent risk factors for CRKP infection (P＜0.01). Conclusions For patients with severe pneumonia and artificial airway in ICU, K. pneumoniae is the main bacterial infection. CRKP and ESBL-E.coli in BALF exhibit different degrees of drug resistance to various antibacterial agents, both have the characteristic of multidrug resistance, and are sensitive to polymyxin and tigecycline. Prevention and control of risk factors related to CRKP should be formulated particularly.

Objective: To analyze the implementation status and challenges of sex education in special education schools, so as to provide a scientific basis for formulating effective promotion strategies. Methods: From November 2023 to January 2024, a census survey was conducted among 120 in service teachers from 7 special education schools in Luzhou. The questionnaire covered the current status of sex education in schools, teachers attitudes and knowledge toward sex education, and their coping methods for students inappropriate sexual behaviors. Results: About 77.5% of teachers reported having provided sex education to students, but 93.2% indicated a lack of specialized sex education textbooks for special children, 90.4% reported no full time teachers for sex education, and the methods of sex education were relatively limited (50.0% mainly based on lecture method). Nearly 95.8% of teachers held a positive attitude toward sex education, with 98.3% supporting its implementation. Only 26.7% of teachers demonstrated a good grasp of sex education knowledge, with the best understood topic being "recognition and protection of private parts" (21.6%). When dealing with students inappropriate sexual behaviors, the active response rate of teachers was 23.9%, with the highest active response rate observed for "intentionally hugging or kissing the opposite sex" (39.7%). Conclusions The special education schools in Luzhou lack comprehensive sex education curricula, teaching materials and full time teachers, sufficient knowledge among teachers, and adequate proactive responses to students inappropriate sexual behaviors. Greater emphasis should be placed on sex education for special children, including the training of dedicated teachers, to provide comprehensive and high quality sex education services for special children.

The cellular and molecular components of the tumor immune microenvironment (TIME) and their information exchange processes significantly influence the trends of anti-tumor immunity. In recent years, numerous studies have begun to evaluate TIME in the context of previous cancer treatment strategies. This review will systematically summarize the compositional characteristics of TIME and, based on this foundation, explore the impact of current cancer therapies on the remodeling of TIME, aiming to provide new insights for the development of innovative immune combination therapies that can convert TIME into an anti-tumor profile.
Tumor Microenvironment/immunology* ; Humans ; Neoplasms/therapy* ; Immunotherapy/methods* ; Animals

Lung cancer is still one of the most common malignant tumors in the world. With the increase of its incidence and the development of medical technology, the overall survival of lung cancer patients has significantly extended compared to before. The incidence of brain and meningeal metastases from lung cancer has also been rising year by year, but patients with brain and meningeal metastases from lung cancer have a poor prognosis and a very high mortality rate, and the diagnosis is mainly based on computed tomography (CT), magnetic resonance imaging (MRI) and other imaging examinations. However, the imaging features are diverse and the specificity is low, which makes it easy to be misdiagnosed and missed. Therefore, accurately identifying brain and meningeal metastases and timely targeted treatment is crucial for improving patient prognosis. This paper analyzed the diagnosis and treatment of a case of lung cancer with no obvious recurrence and metastasis in nearly 7-year long-term follow-up after radical lung cancer surgery, but the patient with abnormal behavior, impaired consciousness and epilepsy in the past 5 months, and multiple punctate calcifications in the brain found by head CT and MRI. This paper consider that the patient's mental and behavioral symptoms were caused by brain and meningeal metastasis of lung cancer after excluding infectious disease and ineffective treatment of autoimmune encephalitis, and further pathological biopsy and genetic detection confirmed the diagnosis of metastatic lung adenocarcinoma with epidermal growth factor receptor (EGFR) L858R gene mutation, and the patient's symptoms were significantly improved after targeted therapy by Osimertinib. This paper also searched the relevant literatures of brain calcifications in databases such as China National Knowledge Infrastructure (CNKI), Wanfang, UpToDate, PubMed, etc., and found that intracerebral calcifications exist in a variety of diseases, including infectious, genetic and neurodegenerative diseases, vascular diseases, metabolic diseases and tumors. However, brain calcification in brain and meningeal metastases are often underestimated, and the consequent risk is misdiagnosis and delayed treatment. Therefore, brain and meningeal metastases manifested as brain calcification should not be ignored in patients with a history of previous tumors.
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Humans ; Lung Neoplasms/pathology* ; Brain Neoplasms/diagnostic imaging* ; Meningeal Neoplasms/diagnostic imaging* ; Calcinosis/diagnostic imaging* ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Magnetic Resonance Imaging

Objective To establish an ultra-high-performance liquid chromatography-triple quadrupole tandem mass spectrometry method for the determination of N-(1,3-dimethylbutyl)-N′-phenyl-p-phenylenediamine quinone (6PPDQ) in human plasma and urine. Methods Plasma and urine samples (0.3 mL each) were mixed with 0.9 mL acetonitrile and dichloromethane, vortexed, and subjected to ultrasonic treatment to facilitate extraction. After centrifugation, the extract was collected, evaporated to dry powder under nitrogen, and reconstituted. Separation was performed on a C18 column, and detection was carried out using ultra-high-performance liquid chromatography-triple quadrupole tandem mass spectrometry with external standard quantification. Results 6PPDQ showed good linearity in the range of 0.01-25.00 μg/L in both human plasma and urine, with correlation coefficients of 0.999 5 and 0.999 7, respectively. The detection limits for plasma and urine were 8 and 6 ng/L, and the lower limits of quantification were 27 and 19 ng/L, respectively. The average recovery rates were 97.00%-100.00% for plasma and 90.00%-96.50% for urine. The within-run relative standard deviations (RSDs) were 4.35%-10.00% for plasma and 2.34%-11.11% for urine, while the between-run RSDs were 6.80%-8.46% and 2.60%-10.00%, respectively. Samples can be stored for seven days at 4 ℃ or -20 ℃. respectively. Samples can be stored for seven days at 4 ℃ or -20 ℃. Matrix effects ranged from 87.12%-99.27% for plasma and 91.00%-97.56% for urine. Conclusion The proposed method is simple, highly sensitive, and reproducible, and is suitable for the determination of 6PPDQ in human plasma and urine samples.

Objective:To apply patent metrics to analyze the distribution, development trends, and characteristics of patents related to orthokeratology lenses for assisted wearing, providing a reference for the research and development of such patents.Methods:Patents related to orthokeratology lenses for assisted wearing were retrieved by computer from the China National Intellectual Property Administration database, incopat, Derwent Innovations Index, Free Patents Online, Organisation Africaine de la Propriété Intellectuelle, and IP Australia. The search timeframe was from the establishing of these databases until March 8, 2024. Patent metrics methods, word frequency analysis, and high-frequency word co-occurrence analysis were used for data analysis.Results:A total of 60 relevant patents were selected. The development of orthokeratology lens-assisted wearing patents began relatively late but has shown a strong growth trend, reaching a peak around 2015. Chinese patents accounted for the largest share (91.7%, 55/60) , with Zhejiang Province, Beijing City, Jiangsu Province, Guangdong Province, and Shanghai City having the highest number of patents. The majority of the applicants were enterprises. The research focus in this field is on mechanical assistance patents for lens wearing, with cutting-edge technologies focusing on monitoring the displacement of lenses relative to the pupil and providing timely feedback and guidance.Conclusions:This study, using patent metrics, word frequency analysis, and high-frequency word co-occurrence analysis, provides a reference for patent applications and product development in orthokeratology lens-assisted wearing in nursing.

Objective:To apply patent metrics to analyze the distribution, development trends, and characteristics of patents related to orthokeratology lenses for assisted wearing, providing a reference for the research and development of such patents.Methods:Patents related to orthokeratology lenses for assisted wearing were retrieved by computer from the China National Intellectual Property Administration database, incopat, Derwent Innovations Index, Free Patents Online, Organisation Africaine de la Propriété Intellectuelle, and IP Australia. The search timeframe was from the establishing of these databases until March 8, 2024. Patent metrics methods, word frequency analysis, and high-frequency word co-occurrence analysis were used for data analysis.Results:A total of 60 relevant patents were selected. The development of orthokeratology lens-assisted wearing patents began relatively late but has shown a strong growth trend, reaching a peak around 2015. Chinese patents accounted for the largest share (91.7%, 55/60) , with Zhejiang Province, Beijing City, Jiangsu Province, Guangdong Province, and Shanghai City having the highest number of patents. The majority of the applicants were enterprises. The research focus in this field is on mechanical assistance patents for lens wearing, with cutting-edge technologies focusing on monitoring the displacement of lenses relative to the pupil and providing timely feedback and guidance.Conclusions:This study, using patent metrics, word frequency analysis, and high-frequency word co-occurrence analysis, provides a reference for patent applications and product development in orthokeratology lens-assisted wearing in nursing.

Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.

As an important part of the enteric nervous system(ENS),enteric glial cells(EGCs)play an important role in regulating intestinal homeostasis and maintaining intestinal health in hu-mans and animals.This review focuses on the role of EGCs in maintaining intestinal barrier homeo-stasis,maintaining gastrointestinal transit and motor function,regulating the niche of intestinal cells,and the role in the occurrence and development of intestinal diseases,hoping to provide new ideas for further research on the function and mechanism of EGCs in the intestine and the occur-rence,development and treatment of related intestinal diseases.

Objective To investigate the value of CT calcification type of hepatic alveolar echinococcosis(HAE)for predicting its lymph node metastasis.Methods Totally 100 patients with HAE confirmed by surgical pathology were retrospectively collected,among them 50 with lymph node metastases were divided into metastasis group,while the other 50 with lymph node reactive hyperplasia into non-metastasis group.Patients'general data,as well as preoperative CT findings,including the number,location,the maximum diameter and calcification type of lesions were compared between groups.Multivariate logistic regression analysis was performed for clinical and CT features being significant different between groups to screen the independent predictors of HAE lymph node metastasis.Receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated to evaluate the predictive efficacy of CT calcification type alone and combining with other independent predictors for predicting node metastasis of HAE.Results A total of 62 groups of lymph node metastases were detected in 50 patients in metastasis group,including 39 cases with single group lymph node metastasis,10 cases with 2 groups lymph node metastasis and 1 case with 3 groups lymph node metastasis.There were significant differences of location,the maximum diameter and CT calcification type of HAE lesions within liver between groups(all P＜0.05),which were all independent predictors of HAE lymph node metastasis(all P＜0.05).The AUC of CT calcification type alone and combining with other independent predictors for predicting node metastasis of HAE was 0.757 and 0.859,respectively,which were significant different(P=0.002).Conclusion CT calcification type of HAE could effectively predict lymph node metastasis,and the predictive efficacy might be improved by combining location and maximum diameter of HAE lesions.