Radiogenomics, an extension of radiomics, explores the relationship between imaging features and underlying gene expression patterns. This field is instrumental in providing reliable imaging surrogates, thus potentially representing an alternative to genetic testing. The rapidly growing area of radiogenomics that utilizes ultrasound (US) imaging seeks to elucidate the connections between US image characteristics and genomic data. In this review, the authors outline the radiogenomics workflow and summarize the applications of US-based radiogenomics. These include the prediction of gene variations, molecular subtypes, and other biological characteristics, as well as the exploration of the relationships between US phenotypes and cancer gene profiles. Although the field faces various challenges, US-based radiogenomics offers promising prospects and avenues for future research.

OBJECTIVE T o analyze the current situation and characteristics of hospital-associated infection in a psy-chiatric hospital,providing references for formulation of control measures for hospital-associated infection.METHODS A retrospective analysis was conducted on hospital-associated infection data from Shanghai Mental Health Center between Jan.1,2019,and Oct.31,2024.The infection rates and infection sites across different years,patient populations,and departments were analyzed.RESULTS A total of 47 051 inpatients were investiga-ted,with 1 798 cases of hospital-associated infections,resulting in an infection rate of 3.82％.The highest inci-dence rate was observed in 2020(4.13％).The top three departments with the highest incidence rates were the in-fectious disease department(12.13％),geriatric psychiatry(7.67％),and the Traditional Chinese Medicine De-partment department(4.90％).The primary infection sites were the lower respiratory tract(57.06％),urinary tract(18.24％),skin and soft tissue(14.29％).The incidence rate was higher in males(5.32％)than in females(2.72％)(P＜0.001).Statistically significant differences were found in the incidence rates among different age groups(P＜0.001),with the highest rate observed in patients aged over 90 years(17.11％).The lowest infection rate was found in patients hospitalized for less than 60 days(0.69％),while the highest was in those hospitalized for more than 1 000 days(49.94％).CONCLUSIONS The patients in psychiatric hospitals are susceptible to infec-tions in the respiratory tract,urinary tract,skin and soft tissue.Targeted prevention and control measures can be implemented based on high-risk factors such as age,length of stay,and gender to reduce the occurrence of in-fections.

OBJECTIVE To explore the clinical value of metagenomic next generation sequencing(mNGS)in detec-tion of pathogens from the patients with pulmonary infection.METHODS The clinical data were collected from 103 patients with pulmonary infection who were treated in respiratory and critical care medicine department of Gansu Province People's Hospital from Jun.2021 to Jun.2023.The pathogens were detected from all of the patients with the use of mNGS for bronchoalveolar lavage fluid(BALF)and traditional cultures(including sputum culture and BALF culture).The positive rates,consistency,distribution,efficacy and curative effects were observed and sys-tematically compared between the two detection methods.RESULTS Totally 122 strains of bacteria,47 strains of fungi,94 strains of viruses,3 strains of Mycoplasma and 2 strains of Chlamydia were detected from the 103 pa-tients by mNGS,as compared with only 45 strains of bacteria and 20 strains of fungi that were detected by the tra-ditional culture method.The positive rate of detection of pathogens was 89.32％by mNGS,higher than 38.83％of the traditional culture method(P＜0.001).There was certain difference in the distribution of pathogens be-tween the two detection method,the two detection method showed the poor consistency of detection efficacy,and the effect of targeted drug therapy based on the mNGS-detected pathogens was higher than that of the mNGS-negative empirical therapy(P＜0.001).In addition,some of drug resistance genes could be detected by mNGS.CONCLUSIONS The mNGS shows remarkable higher efficacy in detection of the pathogens causing pul-monary infections than the traditional culture method and can detect various types of pathogens.The effect of the targeted drug therapy based on the pathogens detected by mNGS is remarkable.It plays an imorptant role in guid-ing the clinical diagnosis and treatment of the patients with pulmonary infections.

Objective To investigate the practical effects of pediatric rapid sequence intubation(RSI)nursing coordination training based on the LSPPDM(learn,see,practice,prove,do,maintain)framework in order to provide evidence for optimizing pediatric RSI nursing training programs.Methods Nurses from the intensive care unit(ICU)of Children's Hospital,Fudan University during Feb 2023 and Jan 2024 were divided into the experimental group(n=35)and the control group(n=35)by block randomization.The experimental group received LSPPDM framework-based training,while the control group underwent conventional training with theoretical lectures and procedural demonstrations.Outcomes included training satisfaction,theoretical knowledge and procedural skill assessment scores,team collaboration compliance and RSI procedure time were compared between the two groups.Results The experimental group demonstrated significantly higher training satisfaction(123.80±2.04 vs.117.26±9.82,P<0.05),superior post-training theoretical knowledge and procedural skills(P<0.05),enhanced team collaboration compliance(P<0.05),and shorter RSI completion time(P<0.05)compared with the control group.Conclusion Pediatric RSI nursing coordination training based on the LSPPDM framework can effectively increase training satisfaction,promote theoretical and procedural skills and reduce completion time in nurses.

In recent years,adoptive T cell immunotherapy has become a research hotspot in cancer treat-ment,in which the directional homing of T cells to tumor tissues is the core of the anti-tumor immune re-sponse,which is closely related to good clinical treatment outcomes.However,the infiltration of T cells into solid tumors remains challenging due to the complex tumor microenvironment,tumor vasculature bar-riers,and loss of chemotaxis signals.This review systematically outlines the migration pathways of T cell homing,including blood homing after intravenous infusion,transvascular endothelial migration,and its infiltration into targeted solid tumor tissues.On this basis,we also explore the regulatory mechanism of T cell homing,especially the synergistic relationship between the chemokine-receptor axis,and the effects of tumor vascular abnormalities,tumor microenvironment(TME)-shaped infiltration barriers,and tumor stromal barriers on T cell homing.In response to the above obstacles,three main strategies to enhance the homing efficiency of T cells are reviewed.First,chemokine receptors(e.g.,CXCR2,CXCR6)are modified to match tumor chemotaxis signals,or immune checkpoint molecules(PD-1,LAG-3,SHP-1)are knocked out to reverse T cell exhaustion by CRISPR gene editing or lentiviral transduction technolo-gy.Second,targeting the VEGF/VEGFR axis combined with ATCT can promote vascular normalization and improve T cell infiltration.Third,the combination of local therapy(radiotherapy,oncolytic virus)or systemic drugs(chemotherapy,immune checkpoint inhibitors,etc.)can improve the homing of T cells by remodeling tumor TME.These strategies will provide a theoretical basis and research direction for a-doptive T cell immunotherapy in the treatment of solid tumors.

In recent years,adoptive T cell immunotherapy has become a research hotspot in cancer treat-ment,in which the directional homing of T cells to tumor tissues is the core of the anti-tumor immune re-sponse,which is closely related to good clinical treatment outcomes.However,the infiltration of T cells into solid tumors remains challenging due to the complex tumor microenvironment,tumor vasculature bar-riers,and loss of chemotaxis signals.This review systematically outlines the migration pathways of T cell homing,including blood homing after intravenous infusion,transvascular endothelial migration,and its infiltration into targeted solid tumor tissues.On this basis,we also explore the regulatory mechanism of T cell homing,especially the synergistic relationship between the chemokine-receptor axis,and the effects of tumor vascular abnormalities,tumor microenvironment(TME)-shaped infiltration barriers,and tumor stromal barriers on T cell homing.In response to the above obstacles,three main strategies to enhance the homing efficiency of T cells are reviewed.First,chemokine receptors(e.g.,CXCR2,CXCR6)are modified to match tumor chemotaxis signals,or immune checkpoint molecules(PD-1,LAG-3,SHP-1)are knocked out to reverse T cell exhaustion by CRISPR gene editing or lentiviral transduction technolo-gy.Second,targeting the VEGF/VEGFR axis combined with ATCT can promote vascular normalization and improve T cell infiltration.Third,the combination of local therapy(radiotherapy,oncolytic virus)or systemic drugs(chemotherapy,immune checkpoint inhibitors,etc.)can improve the homing of T cells by remodeling tumor TME.These strategies will provide a theoretical basis and research direction for a-doptive T cell immunotherapy in the treatment of solid tumors.

Aim To explore the mechanism of the syn-ergistic effect of the ferroptosis inducer erastin com-bined with shikonin in promoting ferroptosis in human hypertrophic scar fibroblasts(HSFBs).Methods Hypertrophic scar tissues provided by the General Hos-pital of Ningxia Medical University were collected,and HSFBs were extracted.HSFBs were identified by HE staining and immunofluorescence.The inhibitory rates of Era and SHK on HSFBs at different concentrations were detected by CCK-8 assay,and the IC50 value was calculated.CompuSyn software was used to calculate the co-use index(CI).Control group,Erastin(Era)group,shikonin(SHK)group and Era+SHK group were set up,and the number and morphological chan-ges of cells were observed after 24 hours of interven-tion.The ability of cell migration and invasion was de-tected by scratch test and Transwell test.The changes of malondialdehyde(MDA),total iron ion and reactive oxygen species(ROS)were detected by corresponding biochemical kits.The expressions of collagen I,α-SMA and GOT1,SLC7A11,GPX4 and FTH1 were detected by Western blot.Results The IC50 value of Era and SHK of primary HSFBs was 2.22 μmol·L-1 and 3.94μmol·L-1 respectively,which was used as the single drug concentration for subsequent experiments.The CompuSyn software was employed to calculate the CI value when the two drugs were used in combination,and the concentrations corresponding to CI=0.39597(Era:1.2 μmol·L-1+SHK:1.5 μmol·L-1)were selected as subsequent combination concentrations(Because when CI was equal to 0.395 97,the concen-tration of each drug was lower than the concentration of single drug,and the inhibition rate of combined drug was greater than 50％).Compared with the monother-apy group,the number of HSFBs in the SHK+Era group was significantly reduced,cell membrane showed breakage and vesiculation,cell wrinkling became smal-ler,and cytoplasm was concentrated.The migration and invasion ability of HSFBs in the SHK+Era group were obviously weakened(P＜0.05),and the expres-sion of fibrosis-related proteins collagen Ⅰ and α-SMA was reduced(P＜0.05);the contents of MDA,total i-ron ions,and ROS in HSFBs of the SHK+Era group increased(P＜0.05),and the protein expression lev-els of SLC7A11,GOT1,GPX4,and FTH1 further de-creased(P＜0.05).Conclusions Erastin in combi-nation with shikonin can synergistically inhibit the pro-liferation,migration and fibrosis levels of HSFBs.The mechanism may be that erastin enhances the inhibition of shikotin on GOT1,increases the levels of cellular i-ron ions,ROS,and lipid peroxides,thereby promoting ferroptosis in HSFBs.

Radiogenomics, an extension of radiomics, explores the relationship between imaging features and underlying gene expression patterns. This field is instrumental in providing reliable imaging surrogates, thus potentially representing an alternative to genetic testing. The rapidly growing area of radiogenomics that utilizes ultrasound (US) imaging seeks to elucidate the connections between US image characteristics and genomic data. In this review, the authors outline the radiogenomics workflow and summarize the applications of US-based radiogenomics. These include the prediction of gene variations, molecular subtypes, and other biological characteristics, as well as the exploration of the relationships between US phenotypes and cancer gene profiles. Although the field faces various challenges, US-based radiogenomics offers promising prospects and avenues for future research.

Objective:To systematically identify and summarize the best available evidence on feeding management during the peridischarge period for very low birth weight infants (VLBWI) and extremely low birth weight infants (ELBWI), providing a reference for clinical nursing practice.Methods:Evidence on feeding management for VLBWI/ELBWI during the peridischarge period was retrieved from decision support systems, guideline repositories, major databases, and relevant professional organizations' websites. Sources included clinical decisions, guidelines, evidence summaries, systematic reviews, expert consensus documents and so on. The search spanned from database inception to April 2024. Guidelines were reviewed by four researchers, while other documents were screened and appraised by two researchers.Results:A total of 24 documents were included: six clinical decision tools, four guidelines, three systematic reviews, three evidence summaries, and eight expert consensus statements. A total of three primary themes, 10 secondary themes, and 49 best evidence items were synthesized. These covered: pre-discharge feeding management (establishing a peridischarge feeding team, parental feeding education, assessing feeding status of VLBWI/ELBWI, evaluating parental feeding competence, preparing feeding materials/environment and assessing community resources) ; discharge feeding management (providing feeding-related medical records and developing individualized feeding plans) ; post-discharge feeding management (setting growth and development goals, conducting follow-up and growth monitoring, and supplementing necessary nutrients) .Conclusions:The summarized best evidence provides a practical reference for healthcare professionals to effectively implement feeding management for VLBWI/ELBWI during the peridischarge period. Evidence-based strategies should be selectively applied in clinical practice based on individual conditions to ensure a successful transition to home feeding and support healthy growth and development of VLBWI/ELBWI.

OBJECTIVE: Hepatocellular carcinoma (HCC) is sensitive to ferroptosis, a new form of programmed cell death that occurs in most tumor types. However, the mechanism through which ferroptosis modulates HCC remains unclear. This study aimed to investigate the oncogenic role and prognostic value of FANCD2 and provide novel insights into the prognostic assessment and prediction of immunotherapy. METHODS: Using clinicopathological parameters and bioinformatic techniques, we comprehensively examined the expression of FANCD2 macroscopically and microcosmically. We conducted univariate and multivariate Cox regression analyses to identify the prognostic value of FANCD2 in HCC and elucidated the detailed molecular mechanisms underlying the involvement of FANCD2 in oncogenesis by promoting iron-related death. RESULTS: FANCD2 was significantly upregulated in digestive system cancers with abundant immune infiltration. As an independent risk factor for HCC, a high FANCD2 expression level was associated with poor clinical outcomes and response to immune checkpoint blockade. Gene set enrichment analysis revealed that FANCD2 was mainly involved in the cell cycle and CYP450 metabolism. CONCLUSION To the best of our knowledge, this is the first study to comprehensively elucidate the oncogenic role of FANCD2. FANCD2 has a tumor-promoting aspect in the digestive system and acts as an independent risk factor in HCC; hence, it has recognized value for predicting tumor aggressiveness and prognosis and may be a potential biomarker for poor responsiveness to immunotherapy.
Humans ; Carcinoma, Hepatocellular/diagnosis* ; Liver Neoplasms/diagnosis* ; Immunotherapy ; Fanconi Anemia Complementation Group D2 Protein/metabolism* ; Prognosis ; Male ; Female ; Middle Aged ; Biomarkers, Tumor/metabolism*