Background Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen for both human bloodstream infections and mastitis in cows. However, little attention has been paid to the cross-host transmission of MRSA from cows to high-risk groups in China. Objective To determine the MRSA colonization rates among dairy cows and dairy farm workers in Xinjiang, identify the antibiotic resistance profiles and molecular characteristics of the isolates, and provide scientific evidence for the formulation of targeted infection control strategies. Method A cross-sectional survey combined with laboratory pathogen analysis was conducted. From June to August 2024, large-scale dairy farms in Xinjiang region were selected as study sites. Nasal swabs (n=96) and skin swabs (n=39) were collected from workers, and bovine nasal swab samples (n=109) were collected simultaneously. All samples were subjected to MRSA isolation, cultivation, and identification, followed by antibiotic susceptibility testing to characterize resistance phenotypes. Staphylococcus aureus protein A (Spa) typing was performed to determine strain genotypes and elucidate MRSA colonization rates and molecular epidemiological patterns. Results A total of 35 MRSA strains was successfully isolated from 244 samples. The MRSA colonization rates among dairy farm workers and dairy cows were 20.83% (20/96) and 12.84% (14/109), respectively, with an overall isolation rate of 14.34% (35/244). Among the workers, the nasal colonization rate was 16.67% (16/96), and the skin colonization rate was 12.82% (5/39). One worker exhibited MRSA colonization at multiple body sites. All MRSA strains were resistant to cefoxitin (100%, 35/35). The resistance rates to erythromycin and clindamycin were 42.86% (15/35) and 34.29% (12/35), respectively. Thirteen strains showed a multidrug-resistant phenotype, whereas all strains were susceptible to vancomycin. The MRSA isolates exhibited high genetic diversity, with 13 Spa types identified, among which t441 was the most prevalent (8 strains). Both t441 and t034 types were detected in samples from both the dairy cows and their handlers. These two Spa types also carried and stably inherited specific resistance combinations, including erythromycin–clindamycin–cefoxitin and ciprofloxacin–erythromycin–clindamycin–gentamicin–cefoxitin–tetracycline, and a statistically significant association was also observed between the two resistance profiles and the bacterial types (P < 0.001). In addition, one novel Spa type strain was identified. Conclusion MRSA colonization rates among dairy cows and dairy farm workers in Xinjiang are relatively high, with evidence of multi-site colonization. The isolates exhibit high levels of multidrug resistance and genetic diversity, indicating a potential risk of cross-host transmission.

Extracorporeal membrane oxygenation (ECMO) is primarily used in clinical practice to provide continuous extracorporeal respiratory and circulatory support for patients with severe heart and lung failure, thereby sustaining life. It is a key technology for managing severe heart failure and respiratory failure that are difficult to control. With the accumulation of clinical experience in ECMO for circulatory and/or respiratory support, as well as advancements in biomedical engineering technology, more portable and stable ECMO devices have been introduced into clinical use, benefiting an increasing number of critically ill patients. Although ECMO technology has become relatively mature, the timing of ECMO initiation, management of sudden complications, and monitoring and early warning of physiological indicators are critical factors that greatly affect the therapeutic outcomes of ECMO. This article reviews traditional methods and artificial intelligence techniques used in risk assessment related to ECMO, including the latest achievements and research hotspots. Additionally, it discusses future trends in ECMO risk management, focusing on six key areas: multi-center and prospective studies, external validation and standardization of model performance, long-term prognosis considerations, integration of innovative technologies, enhancing model interpretability, and economic cost-effectiveness analysis. This provides a reference for future researchers to build models and explore new research directions.
Extracorporeal Membrane Oxygenation ; Humans ; Artificial Intelligence ; Risk Assessment ; Respiratory Insufficiency/therapy* ; Heart Failure/therapy*

Objective To prepare CD318-specific monoclonal antibodies and evaluate their specificity, affinity, and application in immunological detection, laying the foundation for the development of CD318-targeted antibody drugs. MethodsCD318 protein was expressed and purified, and was used as an antigen to immunize mice, then mice with higher antiserum titers were screened. We prepared CD318-specific monoclonal antibodies through cell fusion and monoclonal screening, and the specificity, affinity, and application of the obtained monoclonal antibodies in immunological assays were evaluated. Then we constructed a CD318/CD3-targeting bispecific antibody and assessed its impact on T-cell cytotoxicity. Results Thirteen monoclonal antibodies were successfully generated, with the hybridoma clone 13-8-G2 exhibiting the highest titer, strongest specificity, and broadest applicability. The antibody was identified as an IgG1 isotype with a kappa light chain. The variable region of the light chain measured 318 bp, while the heavy chain variable region was 357 bp, yielding an affinity constant of approximately 7.68×10⁹. The specificity of CD318 was confirmed using flow cytometry and immunofluorescence assays. Additionally, a CD318/CD3-targeting bispecific antibody was constructed using the variable regions of this CD318 monoclonal antibody, which demonstrated enhanced T-cell cytotoxicity. Conclusion High-affinity and highly specific CD318 monoclonal antibodies were successfully prepared, laying a foundation for the development of therapeutic antibodies targeting CD318.
Animals ; Antibodies, Monoclonal/biosynthesis* ; Mice ; Antibodies, Bispecific/immunology* ; Humans ; Mice, Inbred BALB C ; Antibody Specificity/immunology* ; CD3 Complex/immunology* ; Antigens, CD/genetics* ; T-Lymphocytes/immunology* ; Hybridomas/immunology* ; Female

Background Personal protection is crucial for reducing the risk of zoonotic pathogen infection among livestock workers. Investigating the current status of its implementation and associated influencing factors can provide empirical evidence for developing more effective intervention measures. Objective To investigate the current status of personal protection implementation among livestock workers in Xinjiang, China and its influencing factors, providing a reference for formulating targeted intervention measures. Methods This study was conducted in Bayingolin Mongol Autonomous Prefecture, Kashgar region, and the First and Eighth Divisions of Xinjiang Production and Construction Corps. We selected large-scale cattle and sheep farms, cooperatives, individual livestock households, livestock trading markets, slaughterhouses, and retail markets. Using cluster sampling, we recruited all livestock workers (1074 participants) at sampled sites. During the period from April to July 2024, we conducted face-to-face surveys with a self-designed questionnaire among livestock workers, collecting general demographic information, occupational exposure history, and information related to the use of personal protective equipment, resulting in 939 valid questionnaires. EpiData 3.1 was used for data entry and SPSS 26.0 for statistical analysis. We employed logistic regression to compare the implementation of personal protection among workers by selected categories. Results Among the study subjects, there were 300 workers from large-scale farms (31.95%) and 583 self-employed livestock farmers (62.09%). The sample included 600 males (63.90%) and 339 females (36.10%). The majority of the study subjects was farmers, breeders, or aged 18-60 years (87.75%), auxiliary workers (87.97%) and had an education level of junior high school or below (81.36%). The proportion of workers who consistently and correctly implemented all five personal protective measures (washing hands after work, wearing gloves, wearing masks, wearing dedicated work clothes, and using rubber boots) was 35.14% (330/939). The implementation rates for these five protective measures were 93.61% (879/939), 58.68% (551/939), 57.93% (544/939), 46.01% (432/939), and 42.81% (402/939), respectively. There were statistically significant differences in the implementation rates of differen personal protective measures among the workers by occupation and education level (P<0.05). Among them, workers with lower education levels had lower implementation rates for various protective measures. The results of logistic regression indicated that, compared to male workers, female workers (OR=2.26, 95%CI: 1.68, 3.04) showed a higher rate of non-standard implementation of personal protection. Using the age group of 18 to less than 36 years as a reference, those aged 36 to less than 60 years (OR=1.82, 95%CI: 1.33, 2.50) and 60 years or older (OR=4.45, 95%CI: 2.56, 7.73) reported higher rates of non-standard implementation of personal protection. Compared to those with an education level of primary school or below, those with a junior high school education (OR=0.64, 95%CI: 0.47, 0.88) and a high school education or above (OR=0.13, 95%CI: 0.19, 0.29) showed lower rates of non-standard implementation of personal protection. Compared to farmers, veterinarians (OR=0.03, 95%CI: 0.02, 0.07) reported the lowest rate of non-standard implementation of personal protection, followed by auxiliary workers (OR=0.08, 95%CI: 0.05, 0.12), breeders (OR=0.10, 95%CI: 0.07, 0.15), and other occupational groups (OR=0.28, 95%CI: 0.15, 0.52). Using large-scale farms as a reference, self-employed farmers (OR=13.5, 95%CI: 9.65, 18.88) reported a higher rate of non-standard implementation of personal protection, followed by workers from other workplaces (OR=3.63, 95%CI: 2.01, 6.54). Conclusion The implementation of personal protective measures among livestock workers in Xinjiang is generally satisfactory. However, significant disparities in the execution of these measures exist among different types of workers, indicating the need to enhance occupational health promotion to reduce the risk of zoonotic pathogen infection among the workers.

ObjectiveTo investigate whether the effect of Taohong Siwutang on cerebral ischemia-reperfusion （CIRI） injury in rats is related to the regulation of astrocyte polarization and explore the related mechanism. MethodsEighty-four male SD rats were randomly assigned to the following groups： A sham operation group， a model group， Taohong Siwutang treatment groups （low dose， medium dose， and high dose）， ligustrazine phosphate tablet （LPT） group， and AG490 group. All groups， except for the sham operation group， underwent middle cerebral artery occlusion/reperfusion （MCAO/R） modeling and were treated for seven days. The neurological impairment was evaluated using the Longa score. The volume of cerebral infarction was assessed through 2，3，5-triphenyltetrazolium chloride （TTC） staining. Real-time fluorescent quantitative polymerase chain reaction （Real-time PCR） and Western blot analyses were performed to analyze the mRNA and protein expression levels of cortical complement 3 （C3）， S100 calcium-binding protein A10 （S100A10）， Janus kinase 2 （JAK2）， and signal transducer and activator of transcription 3 （STAT3）. Additionally， protein expression levels of vascular endothelial growth factor-A （VEGF-A） were assessed， and the mRNA expression levels of inflammatory factors， including interleukin-6 （IL-6）， interleukin-1β （IL-1β）， and tumor necrosis factor-α （TNF-α）， were evaluated. Glial fibrillary acidic protein （GFAP） and C3， S100A10 and Co-localization was detected via immunofluorescence double staining. Lastly， VEGF expression levels were measured using enzyme-linked immunosorbent assay （ELISA）. ResultsCompared with the sham operation group， the model group showed a significant increase in cerebral infarction volume and neurological impairment （P<0.01）. C3 protein levels were elevated， while S100A10 levels were decreased. Pathway-related markers were significantly upregulated （P<0.05， P<0.01）， and VEGF-A protein levels were significantly reduced （P<0.01）. The mRNA expression of inflammatory factors was significantly upregulated （P<0.01）. Co-localization analysis showed significantly increased GFAP and C3 fluorescence intensity （P<0.01） and greatly decreased GFAP and S100A10 fluorescence intensity （P<0.01）. Additionally， VEGF content was significantly elevated （P<0.01）. Compared with the model group， medium- and high-dose Taohong Siwutang and LPT groups exhibited a significant reduction in cerebral infarction volume and neurological impairment （P<0.01）. Groups treated with low， medium， and high doses of Taohong Siwutang and LPT group exhibited a decrease in C3 protein expression levels and an increase in S100A10 expression levels （P<0.01）. In the high-dose Taohong Siwutang and AG490 groups， both protein and mRNA expression of C3 and pathway-related markers were significantly downregulated （P<0.05， P<0.01）， while S100A10 expression and VEGF-A protein levels were significantly increased （P<0.01）. Additionally， the mRNA expression levels of inflammatory factors were significantly reduced （P<0.01）. The co-localization fluorescence intensity of GFAP and C3 significantly decreased （P<0.01）， while that of GFAP and S100A10 greatly increased （P<0.01）. Furthermore， VEGF content exhibited a marked elevation （P<0.01）. ConclusionTaohong Siwutang exerts a protective effect in rats with cerebral CIRI injury. The underlying mechanism is associated with the downregulation of the JAK2/STAT3 signaling pathway， promotion of A2-type astrocyte polarization， reduction of inflammatory factor release， and enhancement of VEGF production.

Objective To explore the influencing factors forcerebral small vessel disease(CSVD)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 160 patients with T2DM admitted to the Department of Endocrinology our hospital were enrolled in this study from January 2024 to March 2024,and divided into simple T2DM group(n=107)and T2DM combined with CSVD(CSVD,n=53)group according to the combination of CSVD.The general information and biochemical indicators were compared between the two groups.Logistic regression analysis was used to analyze the influencing factors for CSVD in patients with T2DM,and ROC curve was used to evaluate the diagnostic efficacy of CSVD markers.Results The CSVD group showed significantly higher values than the T2DM group(P<0.05)in the following parameters:DM duration,serum uric acid,cystatin C(CysC),neutrophils,monocytes,C-RP,monocyte-to-high-density lipoprotein cholesterol ratio(MHR),and PAC-1 levels.Conversely,the CSVD group had significantly lower levels of LDL-C,lymphocytes,and albumin-to-globulin ratio(A/G)compared to the T2DM group(P<0.05).Logistic regression analysis indicated that A/G,CysC,MHR,and DM duration were influencing factors for T2DM complicated with CSVD.Receiver operating characteristic(ROC)curveanalysis demonstrated that the combined prediction model incorporating A/G,CysC,MHR,and DM duration yielded an area under the curve of 0.88,indicating good predictive performance.Conclusions A/G,CysC,MHR,and duration are independent risk factors for CSVD in patients with T2DM.Early identification of these items may facilitate the prevention of CSVD in patients with T2DM.

Objective To analyze the relationship between 15 immunophenotypes of peripheral blood T cells and age and gender in healthy adults in the Dalian area. Methods A total of 277 healthy adults admitted to the physical examination center of the Second Affiliated Hospital of Dalian Medical University from October 2022 to June 2023 were selected as the research subjects,including 154 males and 123 females. They were divided into three groups according to age:young group(18～44 years,n=103),middle-aged group(45～60 years,n=114) and old age group(>60 years,n=60). Flow cytometry was used to determine immunophenotypes of T cells,including the absolute count and proportion of na?ve cells (N),central memory (CM),effector memory (EM),terminal effector memory (TEM),activation (HLA-DR+) and senescence (CD28-) CD4+and CD8+T cells,and the differences of them among age and gender were analyzed. Spearman correlation analysis was also used to evaluate the correlation between age and immunophenotypes of T cells. Results Compared with the young group,the absolute count and proportion of CD8+TEM,CD4+HLA-DR+,CD8+HLA-DR+and CD8+CD28-T lymphoaytes cells were increased in the middle-aged group and old age group (Z=2.009～6.607),while the absolute count and proportion of CD8+N T cells were decreased in the middle-aged group (Z=5.574～7.999) and old age group,and the differences were statistically significant (all P<0.05),respectively. Compared with the female group,the absolute count and proportion of CD8+CM,CD8+HLA-DR+and CD8+CD28-T cells were increased in the female group (Z=2.945～6.131),while the absolute count and proportion of CD3+,CD4+and CD8+N T cells were decreased in the male group (Z=2.075～4.225),and the differences were statistically significant(all P<0.05),respectively. Spearman correlation analysis showed that age was positively correlated with the absolute count and proportion of CD4+CM,CD4+HLA-DR+,CD4+CD28-,CD8+TEM,CD8+HLA-DR+and CD8+CD28-T lymphocytes cells (r=0.125～0.479,all P<0.05),while negatively correlated the absolute count and proportion of CD4+N and CD8+N T lymphocytes cells (r=-0.538～-0.148,all P<0.05). Conclusion The 15 immunophenotypes of peripheral blood T lymphocytes cells in healthy adults from Dalian area are affected by age and gender,so it is necessary to establish a suitable local reference interval to provide a more accurate reference for immune function assessment.

Objective:To evaluate the clinical efficacy of the operation treated of unilateral unstable sacral fracture with S 1 dysplasia by bi-perforative screws of the middle and posterior pelvic columns. Methods:A retrospective analysis was conducted on 18 patients with proximal S 1 dysplasia and unilateral unstable sacral fractures treated at Tianjin Hospital, from January 2018 to January 2023. The cohort included 10 males and 8 females, with an average age of 46.3±1.2 years (range, 18-56 years). The causes of injury were traffic accidents in 12 cases and falls in 6 cases. All patients had combined anterior pelvic ring injuries, including 14 cases of simple fractures and 4 cases of fractures combined with pubic symphysis injuries. Preoperative neuro-magnetic resonance imaging (MRI) confirmed that the lumbosacral nerves were not compressed by fracture fragments or displaced bone ends. According to the Dennis classification, there were 8 cases of type I and 10 cases of type II sacral fractures. Abnormalities in S 1 development included 9 cases of steep slopes, 6 cases of anterior rim depression, and 3 cases of both deformities simultaneously. There were 2 cases of nerve injury, both of which were Gibbons grade II. The average time from injury to surgery was 5.4±1.7 days (range, 4-14 days). All patients underwent combined anterior and posterior pelvic fixation in a single stage, with sacral fractures fixed using bi-perforative screws of posterior pelvic ring. The following parameters were recorded: screw placement time, intraoperative blood loss, fluoroscopy time, fracture healing time, accuracy of internal fixation placement, postoperative infection rate, and iatrogenic injury incidence. The Mears scoring system was used to evaluate the satisfaction rate of sacral fracture reduction, the Gibbons classification was used to assess neurological recovery, and the Majeed score was used to evaluate pelvic function. Results:The average screw placement time was 38.7±3.5 min for S 1 and 16.5±1.3 min for the posterior column. The average blood loss during screw placement was 30.53±1.61 ml, and the average fluoroscopy time was 11.3±3.2 s. No vascular or nerve injuries occurred in any case after the operation. All sacral fractures healed, with an average healing time of 7.6±2.2 months (range, 3-12 months). No cases of fracture re-displacement or internal fixation failure were observed. The Mears evaluation results showed anatomical reduction in 12 cases, satisfactory reduction in 4 cases, and unsatisfactory reduction in 2 cases. All internal fixations were accurately placed. All 18 patients were followed up with an average of 18.2±2.5 months (range, 12-36 months). At the last follow-up, the average Majeed score was 87.4±2.9, with 11 cases rated as excellent, 4 as good, and 3 as fair. The two patients with Gibbons grade II nerve injuries improved to grade I postoperatively. Conclusion:Bi-perforative screws fixation for the middle and posterior pelvic columns offers several advantages, including straightforward operation, precise minimally invasive placement, safety and efficacy, robust fixation, and low complication rates, resulting in satisfactory clinical outcomes.

Objective:To evaluate the value of intraoperative cone beam CT (CBCT) in robot-assisted iliosacral screw fixation for posterior pelvic ring injuries.Methods:The 70 patients' data with posterior pelvic ring injuries treated in Tianjin Hospital from March 2020 to October 2023 were retrospectively analyzed. According to the operation method and whether there was intraoperative CBCT verification, the patients were divided into the robot-assisted iliosacral screw fixation group verified by CBCT with 15 cases (robot+CT group), the simple robot-assisted iliosacral screw fixation group with 25 cases (robot group), the freehand iliosacral screw fixation group verified by CBCT with 10 cases (freehand+CT group), and the freehand iliosacral screw fixation group with 20 cases (freehand group). The operation time, the number of intraoperative fluoroscopies, the frequency of guide needle adjustment of each iliosacral screw, Majeed function score, Matta score, fracture healing time, Gras classification of screw position of the four groups were compared, and the iliosacral screw's perforation site were recorded.Results:All patients were followed up, and the follow-up time was 18.89±4.13 months (range, 12-30 months). There were no statistically significant differences in postoperative fracture Matta score, Majeed score and fracture healing time among the four groups ( P>0.05). Specifically, 26, 45, 15, and 32 iliacsacral screws were inserted in the robot+CT group, the robot group, the freehand+CT group, and the freehand group, respectively. The operation times for these groups were 20.19±1.24, 18.78±1.00, 38.13±2.32, and 37.56±1.80 min, respectively. The number of intraoperative fluoroscopies per screw were 20.50±1.37, 18.47±1.06, 39.80±3.56, and 39.34±1.93, respectively. The guide needle adjustment times were 0.54±0.15, 0.47±0.10, 9.33±1.34, and 8.56±0.86, respectively. Statistically significant differences were observed in the above three indicators among the four groups ( P<0.05). There was no statistically significant difference in Gras classification of screw positions among the four groups ( P>0.05). However, in the CBCT verification group (robot+CT group and freehand+CT group), the Gras classification results were 36 screws in Grade I, 4 in Grade II, 1 in Grade III, and 0 in Grade IV. In contrast, in the non-CBCT verification group (robot group and freehand group), there were 48 screws in Grade I, 17 in Grade II, 11 in Grade III, and 1 in Grade IV, with a statistically significant difference (χ 2=8.945, P=0.030). The screw perforation rate in the CBCT verification group was 2% (1/41), with no perforation observed in the robot+CT verification group, compared to 16% (12/77) in the non-CBCT verification group, showing a statistically significant difference (χ 2=4.716, P=0.030). Among the 13 perforating iliosacral screws, two were located in the anterior slope of the sacrum, while 11 were positioned in the posterior and inferior dangerous triangle area of the sacral vertebral body, and the screws were penetrated into the sacral nerve root channel. Conclusions:Robot-assisted iliosacral screw with short operation time, less fluoroscopies and less guide needle adjustments, the screws can be accurately placed according to the plan, with satisfactory clinical outcomes. The penetration sites of robot-assisted iliosacral screw based on two-dimensional X-ray planning were mostly located in the posterior and inferior of the vertebral body at the pedicle level. Intraoperative CBCT can significantly improve the accuracy of sacroiliac screw placement.

A case of traumatic complete lumbosacral spondylolisthesis combined with unstable pelvic fracture is reported. A 55-year-old male patient was admitted to the hospital 8 h after being hit by a heavy object on the lumbosacral region. Admission diagnosis: (1) traumatic hemorrhagic shock; (2) bilateral pulmonary contusion with pleural effusion, and dislocation of the right 12th costovertebral joint; (3) left renal contusion with subcapsular hematoma; (4) traumatic lumbosacral spondylolisthesis (Meyerding grade V), L 5 lamina fracture, L 2 and L 5 spinous process fractures, left L 3-L 5 transverse process fractures, right L 5 inferior articular process fracture, and L 1-L 3 and L 5 transverse process fractures; (5) lumbosacral Morel-Lavallée lesion; (6) pubic symphysis separation, left sacral wing fracture, and sacroiliac joint dislocation (Young-Burgess APC type III); (7) Multiple incomplete injuries of bilateral lumbosacral nerves, and cauda equina syndrome (Gibbons type Ⅳ). The patient underwent open reduction of pelvic fracture and pubic symphysis separation, closed reduction of sacroiliac joint dislocation and combined internal and external fixation, and open reduction and internal fixation of lumbosacral spondylolisthesis. At the 1-year follow-up after surgery, the pelvis achieved anatomical reduction with good fracture healing, the spinal anatomical alignment returned to normal, and lumbosacral bony fusion was observed, and weakness of both lower limbs and abnormal urodynamics caused by residual lumbosacral nerve injury were observed.