Objective: To establish a rapid, accurate, and decentralized workflow for bacterial whole-genome sequencing (WGS) and risk profiling within the shelf-life of platelet concentrates, and to characterize the species, virulence, antimicrobial resistance (AMR), and immune evasion mechanisms of co-existing bacteria in qualified platelet products, thereby providing a scientific basis for transfusion safety assessment. Methods: Three units of platelet concentrates, which tested negative by routine bacterial screening, were collected from the Chengdu Blood Center between May and June 2025. Samples were enriched at 37℃under six aerobic and nine anaerobic conditions for 7 days. Using a culturomics strategy, aliquots were plated for isolation on days 1, 3, 5, and 7 to obtain cultivable isolates, with negative culture controls included to exclude contamination. High-molecular-weight genomic DNA was extracted via mechanical grinding, purified, and size-selected. Sequencing libraries were constructed and sequenced on the G-seq500 single-molecule nanopore sequencing platform. Genomes were assembled using Flye and polished with NextPolish, with quality evaluated by BUSCO and CheckM. Taxonomic identification was performed using GTDB-Tk. Functional annotation and database comparisons were conducted to analyze virulence factors, AMR genes, and genes related to immune evasion and environmental adaptation. Results: Viable bacteria were successfully isolated from all three qualified platelet units within their shelf life. The isolates were identified as Bacillus albus, Niallia taxi, and Staphylococcus warneri. Nanopore sequencing generated 92 227-109 813 reads (totaling 680-758 Mb) with an N50 of 7 625-8 584 bp and Q20/Q30 scores of 97%/93%, respectively. All three genomes were assembled into complete circular chromosomes with 1-3 plasmids, achieving >93% completeness. Functional analysis revealed that B. albus carried multiple hemolysins, metalloproteases, and multidrug resistance genes, indicating the highest potential pathogenicity and AMR risk. S. warneri exhibited a typical multidrug resistance profile and regulatory network characteristic of coagulase-negative staphylococci, suggesting intermediate virulence. N. taxi harbored few canonical virulence factors and lacked functional AMR determinants, presenting a "low-virulence, low-resistance" profile. Notably, all three strains were enriched in genes encoding antimicrobial peptide resistance systems (e.g., dltABCD, mprF, GraRS, BceAB) and antioxidant enzymes, suggesting a strong capacity to withstand immune stress in the blood environment. Conclusion: Viable bacteria can be recovered from qualified platelet concentrates that test negative by routine screening. Nanopore WGS enables rapid strain-level identification and comprehensive risk profiling of virulence, resistance, and immune adaptation traits. The functional repertoires of these "co-existing" isolates range from environmental adaptation to potential pathogenicity, representing an underappreciated risk for transfusion-transmitted infections in susceptible recipients.

Objective: To compare the Reveos automated blood processing system with the current method, and to evaluate the feasibility and validity of using the Reveos system for blood component preparation. Methods: Forty units of 400 mL whole blood samples were divided into two groups: 2C group (for two-component preparation) and 3C group (for three-component preparation). Each group was further divided into a Reveos subgroup and a control subgroup. Blood components were prepared using the Reveos system and the current centrifugation method respectively. The 2C group yielded suspended red blood cells and plasma, while the 3C group yielded suspended red blood cells, plasma, and platelets. Key quality indicators for red blood cells, plasma, and platelets were measured before and after separation. Inter-group differences were analyzed using SPSS 25.0. Results: The trend of changes in the main performance indicators of red blood cells, plasma, and platelets before and after separation was generally consistent between the Reveos group and the control group, with no significant differences for most performance indicators. The Reveos system outperformed the current method in several aspects: in the 3C group, the hematocrit (Hct) was significantly higher in the Reveos group than in the control group [(62.82%±1.64%) vs (53.62%±3.04)%, P<0.001]; the white blood cell count in red blood cell suspensions was significantly lower than that in the control group [(3.37±1.42)×10 /L vs (8.42±2.30)×10 /L, P<0.001]; plasma yield was 27.5% higher than that in the control group [(183.90±17.37) mL vs (144.28±20.53) mL, P<0.001]; and the platelet activation rate was significantly lower than that in the control group [(21.97±14.25)% vs (34.73±11.92)%, P=0.044]. Conclusion: The Reveos system demonstrates good consistency with the current method in preparing blood components, and outperforms the current method in terms of leukocyte reduction and red blood cell concentration.

OBJECTIVE To screen characteristic peaks of hypervirulent Klebsiella pneumoniae(hvKP)using ma-trix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)combined with EX-Smartspec software and establish a rapid detection model for hvKP.METHODS Based on identification criteria of any positive peg-344,iroB,iucA,rmpA,prmpA2 genes or siderophore production＞30 μg/ml,89 hvKP and 72 classical Klebsiella pneumoniae(cKP)strains were initially collected and validated for virulence via Galleria mellonella assays.A diagnostic model distinguishing hvKP from cKP was constructed using EX-Smartspec soft-ware and a convolutional neural network algorithm,integrating characteristic peaks and cluster analysis to provide a rapid and accurate clinical diagnostic tool.RESULTS MALDI-TOF MS analysis identified a characteristic hvKP peak at(3 835±100)ppm.Receiver operating characteristic(ROC)curve analysis revealed optimal performance in distinguishing hvKP with an area under the curve(AUC)=0.741.When AUC ≥0.089,the model demonstra-ted high sensitivity(86.41％),specificity(69.90％),accuracy(78.16％),positive predictive value(74.17％),and negative predictive value(83.72％)in differentiating hvKP from cKP.Cluster analysis further validated the model's classification accuracy.Additionally,the typing classification model exhibited high accuracy(approxi-mately 0.95 and 0.90 in training and validation phases,respectively)and low loss values(-0.18 and 0.30).Val-idation of 6 randomly selected hvKP and 5 cKP strains showed a 100.00％pass rate.CONCLUSION The estab-lished diagnostic model for hvKP and cKP provides a rapid and accurate clinical tool for timely treatment of hvKP-related infections.

This study was aimed at comprehensively understanding the epidemic status of acute hemorrhagic conjunctivitis(AHC)and influencing factors related outbreak in Fujian Province,to provide valuable insights for AHC prevention and control in this region.We conducted a descriptive statistical analysis of epidemiological data for AHC cases.Additionally,clinical samples collected from a 2023 outbreak were subjected to pathogen detection,determination of full-length nucleotide sequences within the VP1 region,genotype identification,and comprehensive analysis.The peak incidence of AHC in 2023 was observed in September and accounted for a substantial proportion(86.39%,5 205/6 025)of the total cases throughout the year.The three areas with the highest incidence rates were Sanming(118.57/100 000),Longyan(53.83/100 000)and Zhangzhou(16.02/100 000).From 2011 to 2022,the inci-dence of AHC in Longyan City was the highest for consecutive 12 years.During the peak AHC outbreak period in Fujian Province in 2023,all 62 conjunctival swabs collected were identified as CVA24v,and 60 complete VP1 sequences were obtained through se-quencing.The nucleotide sequence identity among these 60 sequences ranged from 98.7%to 100%,whereas the amino acid identity ranged from 98.4%to 100%.The highest nucleotide sequence identity was observed for the 2023 strain isolated from Zhongshan,Guangdong Province(rang:99.0%～100%).The 2023 strains in Fujian Province belonged to the GIV genotype,and L16I represented a potential unique amino acid variation within the sequence.CVA24v was the causative agent responsible for this AHC epidemic,and its GIV genotype is currently the dominant type in China.Future efforts should prioritize AHC prevention and control measures cen-tered in key cities.Monitoring and early warning of AHC in the whole province should be strengthened before September each year,and the variation of pathogen nucleic should also be tracked in time.

This study was aimed at comprehensively understanding the epidemic status of acute hemorrhagic conjunctivitis(AHC)and influencing factors related outbreak in Fujian Province,to provide valuable insights for AHC prevention and control in this region.We conducted a descriptive statistical analysis of epidemiological data for AHC cases.Additionally,clinical samples collected from a 2023 outbreak were subjected to pathogen detection,determination of full-length nucleotide sequences within the VP1 region,genotype identification,and comprehensive analysis.The peak incidence of AHC in 2023 was observed in September and accounted for a substantial proportion(86.39%,5 205/6 025)of the total cases throughout the year.The three areas with the highest incidence rates were Sanming(118.57/100 000),Longyan(53.83/100 000)and Zhangzhou(16.02/100 000).From 2011 to 2022,the inci-dence of AHC in Longyan City was the highest for consecutive 12 years.During the peak AHC outbreak period in Fujian Province in 2023,all 62 conjunctival swabs collected were identified as CVA24v,and 60 complete VP1 sequences were obtained through se-quencing.The nucleotide sequence identity among these 60 sequences ranged from 98.7%to 100%,whereas the amino acid identity ranged from 98.4%to 100%.The highest nucleotide sequence identity was observed for the 2023 strain isolated from Zhongshan,Guangdong Province(rang:99.0%～100%).The 2023 strains in Fujian Province belonged to the GIV genotype,and L16I represented a potential unique amino acid variation within the sequence.CVA24v was the causative agent responsible for this AHC epidemic,and its GIV genotype is currently the dominant type in China.Future efforts should prioritize AHC prevention and control measures cen-tered in key cities.Monitoring and early warning of AHC in the whole province should be strengthened before September each year,and the variation of pathogen nucleic should also be tracked in time.

ObjectiveTo investigate the effects and potential mechanisms of morning and evening fasting on postprandial lipid responses, a post hoc analysis based on a crossover randomized controlled trial was conducted to assess the effects of different fasting strategies on postprandial lipid metabolism in community residents in Shanghai. MethodsA total of 23 participants took part in a randomized crossover trial involving two intervention days: morning fasting and evening fasting, with a washout period of 6 days between intervention days. Two-way analysis of variance was used to test the differences in total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and the relative expression of circadian clock genes before and after the next meal under fasting. Wilcoxon rank sum tests were used to analyze the different metabolites between the two groups. Principal component analysis and Orthogonal partial least squares-discriminant analysis were conducted to evaluate the ability of metabolites to differentiate between morning fasting and evening fasting and identify the important differential metabolites. After adjusting for age, sex, and BMI, a partial correlation analysis was performed to identify metabolites associated with plasma lipids. In addition, important metabolites associated with plasma lipids were computed by pathway enrichment analysis. ResultsAfter evening fasting intervention, fasting TG level [(0.37±0.29) vs (0.27±0.18)] mmol·L^-1, fasting and postprandial change values in TC [(2.74±0.47) vs (2.51±0.27)] mmol·L^-1 and LDL-C [(1.32±0.38) vs (0.99±0.27)] mmol·L^-1 were significantly lower than those after morning fasting (P<0.05). While, change values of fasting LDL-C [(0.89±0.37) vs (1.14±0.37)] mmol·L^-1 and TG [(1.14±0.19) vs (1.28±0.17)] mmol·L^-1 were significantly higher than those after morning fasting intervention (P<0.05). After fasting intervention, the relative expression of AMPK, CRY1, CLOCK, MTNR1B, AANAT, and ASMT was correlated with the amount of plasma lipid changes (P<0.05). Specifically, CLOCK and AANAT were upregulated following evening fasting and downregulated after morning fasting. Among the 217 important differential metabolites, 111 were correlated with plasma lipids, and which were primarily enriched in the cysteine and methionine metabolism pathways (P<0.05). ConclusionCompared to morning fasting, evening fasting was more effective in improving postprandial lipid responses, indicating that an evening fasting window during intermittent fasting could be conducive to cardiovascular disease prevention in adults. Meanwhile, it is suggested that morning and evening fasting may affect lipid responses through circadian rhythm oscillations and the cysteine and methionine metabolism pathways.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease(CKD), cardiovascular disease(CVD), diabetes, osteoarthritis(OA), and gastrointestinal disorders. This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO(population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus. The guideline presents 26 evidence-based recommendations addressing 7 clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage≥3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases. The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.

To summarize the emergency nursing experience of 1 patient with neck suicide complicated with airway obstruction and hemorrhagic shock.Nursing points:to ensure airway safety and establish artificial airway;to optimize airway management and implement early sedation and wake-up;to control injury bleeding and limited fluid resuscitation;to establish a micro blood station in the emergency department and start a high-dose blood transfusion procedure;to carry out the refined target body temperature management to reduce complications;to optimize speech communication strategies and implement early psychological care.After 7 days of careful treatment and nursing,the patient's condition improved and recovered.After 2 months of follow-up,the patient recovered well.

Background Per- and polyfluoroalkyl substances (PFAS), a group of persistent organic pollutants associated with adverse health effects including hepatotoxicity, immunosuppression, and carcinogenicity, have undergone risk assessments by multiple international organizations, with dietary exposure being the primary pathway. Objective To characterize the exposure to PFAS from food and drinking water sources of elderly residents in Songjiang District of Shanghai and to evaluate associated health risk and health effects. Methods A cross-sectional study was conducted from May to July 2024 in Songjiang District based on the Shanghai Suburban Adult Cohort and Biobank (SSACB) cohort. Dietary surveys were administered via face-to-face interviews among older adults aged 65 years and above, yielding 4 583 valid questionnaires. The estimated daily intake (EDI) of PFAS was calculated by integrating data from the Sixth National Dietary Survey and recent literature on PFAS concentrations in food and drinking water in Shanghai. Health risk assessment was performed using health-based guideline values (HBGV) proposed by various institutions and studies. Additionally, correlation analysis and linear regression modeling of EDI and biochemical indicators in the elderly were conducted to evaluate potential adverse health effects. Results The elderly population in Songjiang District exhibited dietary characteristics consistent with the Eastern Healthy Diet Pattern. Among PFAS compounds, PFOA showed the highest level of oral exposure [mean: 1.495 ng·(kg·d⁻¹)], followed by PFOS [mean: 0.637 ng·(kg·d⁻¹)], PFHxS [mean: 0.636 ng·(kg·d⁻¹)], and PFBS [mean: 0.273 ng·(kg·d⁻¹)]. Specifically, drinking water was the primary source of PFOA [1.415 ng·(kg·d⁻¹), accounting for 94.60%], while aquatic products were the major source of PFOS [0.278 ng·(kg·d⁻¹), accounting for 43.66%]. Using the HBGV derived by China's epidemiological studies, the mean hazard index (HI) for PFAS exposure was 1.39, indicating 54.35% of the population had potential health risks (HI>1). Following the 2024 standard established by the Food Safety Commission of Japan (FSCJ), the HI value dropped to 0.11, suggesting negligible risk. PFAS exposure was negatively associated with triglyceride levels and the indicators of liver and kidney function, but positively associated with low-density lipoprotein cholesterol (LDL-C) and lung cancer markers in the elderly residents. Conclusion PFAS exposure among the elderly residents in Songjiang District is predominantly attributed to PFOA, PFOS, PFHxS, and PFBS, with drinking water and aquatic products identified as primary exposure sources. Current exposure levels demonstrate significant associations with biomarkers of lipid metabolism and lung cancer markers, suggesting potential population health risks. These findings underscore the urgent need to establish HBGV for PFAS compounds based on Chinese population-specific metabolic characteristics.