This study investigated the infectious status and pathogen characteristics of Leptospira in rodents and the environment in Fujian province to provide data for the prevention and control of leptospirosis.A total of 723 rodents and 31 water samples were col-lected from 19 regions in Fujian Province during 2020-2023.The prevalent rodent species was Rattus losea(35.82%,259/723),which was followed by Rattus norvegicus(20.06%,145/723),Rattus tanezumi(19.64%,142/723),and Niviventer fulvescens(13.97%,101/723).A total of 144 positive samples of Leptospira spp.were detected in rodent kidney samples,accounting for 19.92%(144/723).The positivity rate of Leptospira spp.in wild rodents was higher than that in domestic rodents(χ2=8.48,P<0.05),and the positivity rate in adult rodents was higher than that in juvenile rodents(χ2=14.19,P<0.05).The positivity rates varied among rodent species(χ2=46.11,P<0.05),and differences in the positivity rates of Leptospira spp.were observed among regions(χ2=32.113,P<0.05).Ten strains were isolated from 440 rodent samples,and the isolation rate was 2.27%(10/440).Genospecies identification indi-cated that Leptospira borgpetersenii accounted for seven of the ten isolates,and L.interrogans accounted for three.MLST typing divided 10 isolates into three ST types:ST1,ST16,and ST143.5 isolates were isolated from 31 water samples,with an isolation rate of 16.13%,all of which were nonpathogenic L.tsangambouensis.Although pathogenic Leptospira spp.were not isolated from the water samples,the rodents in Fujian Province were generally infected with pathogenic Leptospira spp.Surveillance of the environment and ro-dents infected with Leptospira spp.should be strengthened.

This study investigated the infectious status and pathogen characteristics of Leptospira in rodents and the environment in Fujian province to provide data for the prevention and control of leptospirosis.A total of 723 rodents and 31 water samples were col-lected from 19 regions in Fujian Province during 2020-2023.The prevalent rodent species was Rattus losea(35.82%,259/723),which was followed by Rattus norvegicus(20.06%,145/723),Rattus tanezumi(19.64%,142/723),and Niviventer fulvescens(13.97%,101/723).A total of 144 positive samples of Leptospira spp.were detected in rodent kidney samples,accounting for 19.92%(144/723).The positivity rate of Leptospira spp.in wild rodents was higher than that in domestic rodents(χ2=8.48,P<0.05),and the positivity rate in adult rodents was higher than that in juvenile rodents(χ2=14.19,P<0.05).The positivity rates varied among rodent species(χ2=46.11,P<0.05),and differences in the positivity rates of Leptospira spp.were observed among regions(χ2=32.113,P<0.05).Ten strains were isolated from 440 rodent samples,and the isolation rate was 2.27%(10/440).Genospecies identification indi-cated that Leptospira borgpetersenii accounted for seven of the ten isolates,and L.interrogans accounted for three.MLST typing divided 10 isolates into three ST types:ST1,ST16,and ST143.5 isolates were isolated from 31 water samples,with an isolation rate of 16.13%,all of which were nonpathogenic L.tsangambouensis.Although pathogenic Leptospira spp.were not isolated from the water samples,the rodents in Fujian Province were generally infected with pathogenic Leptospira spp.Surveillance of the environment and ro-dents infected with Leptospira spp.should be strengthened.

OBJECTIVES: The conventional Fr26 resectoscope is difficult to use in patients with benign prostatic hyperplasia (BPH) complicated by urethral stricture. This study aims to evaluate the safety and efficacy of transurethral plasmakinetic resection of the prostate (PKRP) using a small-caliber (Fr18.5) plasmakinetic resectoscope combined with urethral dilation in patients with BPH and mild urethral stricture. METHODS: A retrospective analysis was conducted on 37 patients with BPH and mild urethral stricture treated at the Department of Urology, Hunan Provincial People's Hospital from January 2023 to December 2023. All patients underwent PKRP with a small-caliber plasmakinetic resectoscope, followed by routine placement of a Fr20 three-way Foley catheter for continuous bladder irrigation. International Prostate Symptom Score (IPSS), maximum urinary flow rate (Q_max), post-voiding residual urine volume (PVR), and Quality of Life (QOL) scores were compared before and after surgery. Perioperative indicators (intraoperative bleeding, operative time, postoperative catheterization time, and postoperative hospital stay) and complications were recorded. RESULTS: The median age was 69 years, and the median duration of voiding difficulty was 36 months. Median total prostate specific antigen (T-PSA) was 2.095 ng/mL, free prostate specific antigen (F-PSA) 0.561 ng/mL, and F/T ratio 0.3. Median prostate diameter was 48 mm and volume 41 mL. All 37 surgeries were completed successfully: 11 had external meatal stricture, 19 had mild anterior urethral stricture, and 7 had mild posterior urethral stricture (1 patient with a 1 cm pseudo-blind tract near the membranous urethral). Operative time was (2.4±0.7) hours, blood loss was (40±29) mL, median catheterization duration was 7 days, and median hospital stay was 7 days. No cases of postoperative urinary incontinence, recurrent hematuria, or sepsis occurred, and patients were satisfied with the surgical outcome. At 3 to 6 months follow-up, IPSS, Q_max, PVR, and QOL scores significantly improved compared to preoperative levels (all P<0.01), with no cases of urethral stricture progression or new-onset stricture. CONCLUSIONS PKRP using a small-caliber plasmakinetic resectoscope is safe and effective for treating BPH with mild urethral stricture. It offers advantages such as minimal trauma, rapid postoperative recovery, and a lower risk recovery, and a lower risk of aggravating urethral injury.
Humans ; Male ; Prostatic Hyperplasia/complications* ; Urethral Stricture/complications* ; Retrospective Studies ; Aged ; Transurethral Resection of Prostate/instrumentation* ; Middle Aged ; Treatment Outcome ; Quality of Life ; Aged, 80 and over

OBJECTIVES: To evaluate the performance of different multi-modality fusion models for predicting radiation-induced oral mucositis (RIOM) following radiotherapy in patients with nasopharyngeal carcinoma (NPC). METHODS: We retrospectively collected the data from 198 patients with locally advanced NPC who experienced RIOM following radiotherapy at the Affiliated Tumor Hospital of Guangzhou Medical University from September, 2022 to February, 2023. Based on oral radiation dose-volume parameters and clinical features of NPC, basic classification models were developed using different combinations of feature selection algorithms and classifiers and integrated using a multi-criterion decision-making (MCDM)-based classifier fusion (MCF) strategy and its variant, the H-MCF model. The basic classification models, MCF model, the H-MCF model with a single modality or multiple modalities and other ensemble classifiers were compared for performances for predicting RIOM by assessing the area under the ROC curve (AUC), accuracy, sensitivity, and specificity. RESULTS: The H-MCF model, which integrated multi-modality features, achieved the highest accuracy for predicting severe RIOM with an AUC of 0.883, accuracy of 0.850, sensitivity of 0.933, and specificity of 0.800. CONCLUSIONS Compared with each of the individual classifiers, the multimodal multi-classifier fusion algorithm combining clinical and dosimetric modalities demonstrates superior performance in predicting the incidence of severe RIOM in NPC patients following radiotherapy.
Humans ; Nasopharyngeal Carcinoma/radiotherapy* ; Nasopharyngeal Neoplasms/radiotherapy* ; Retrospective Studies ; Stomatitis/diagnosis* ; Algorithms ; Radiation Injuries/diagnosis* ; Female ; Male ; ROC Curve

Objective To investigate the effects of long-term exposure to three new types of light emitting diode (LED) sources on the behavior, learning, and memory of rats. Methods A total of 160 specific pathogen-free SD rats were divided into eight groups as followed, trichromatic fluorescent lamps color temperature control group, violet-chip full-spectrum white LED group, blue-chip white LED group, and blue-chip full-spectrum white LED group based on the light sources types, with color temperature of 4 000 K and 6 500 K groups in each group using the 4×2 factorial design. There were 20 rats in each group, with half of the rats were males and half females. Rats were exposed to artificial lighting, and the illumination was set at 750 lx. The rats in each group were exposed to different lighting environments for 12 hours per day for 24 weeks. The open-field and step-down tests were conducted in rats after 24 weeks exposure, followed by sacrifice of rats and measurement of organ coefficients. Differences in body weight, organ coefficients, and neurobehavioral indexes of rats in different groups were compared. Results The spleen coefficient of female rats decreased in blue-chip white LED of 6 500 K color temperature group, and the liver coefficient of male rats decreased in the violet-chip full-spectrum white LED of 4 000 K color temperature, blue-chip full-spectrum white LED of 4 000 K color temperature, and blue-chip full-spectrum white LED of 6 500 K color temperature groups, compared with the same-sex rats in trichromatic fluorescent lamps with same-color temperature control group (all P<0.05). The result of different types of light sources compared in the open-field test showed that the index of total distance and movement speed of female rats in the blue-chip full-spectrum white LED group were lower than those in the other three groups, and the time cost to the central area was longer than that in the blue-chip white LED group and the violet-chip full-spectrum white LED group (all P<0.05). The total distance and movement speed of male rats in the blue-chip full-spectrum white LED group were longer or higher than those in the violet-chip full-spectrum white LED group (all P<0.05). Based on the comparison of color temperature, the time and total distance of male rats in 6 500 K color temperature group were lower than that in the 4 000 K color temperature group (both P<0.05). In the step-down test, both male and female rats in the blue-chip full-spectrum white LED group made more errors compared with other three groups with the same gender (all P<0.05). Conclusion Based on the experimental conditions of this study, the blue-chip full-spectrum white light LED affects behavior, learning and memory of the rats, and trichromatic fluorescent lamp has the lowest effect on neurobehavior. The color temperature also affects behavior of the rats, and high color temperature has higher risk.

Objective:To summarize the clinical treatment of complete left bundle branch block (CLBBB) after the transcatheter closure of ventricular septal defect (VSD).Methods:A case series study was conducted on the treatments and outcomes of 25 children with CLBBB after transcatheter VSD closure in Guangdong Provincial People′s Hospital from January 2010 to December 2023.Paired sample t test was used to evaluate the effect of occlude removal. Results:Among the 25 patients, 12 were males (48%), and 13 were females (52%).The age at surgery was 3.18 (2.51-3.86) years, the height before surgery was 95.0 (90.0-97.5) cm, and the weight before surgery was 13 (12-15) kg.Fourteen children were early-onset cases (≤ 1 month), while the other 11 were late-onset cases (> 1 month).The mean follow-up time was (6.63±3.93) years.Of the 14 early-onset cases, 6 children underwent occluder removal within 1 month and restored normal heart rhythm or incomplete right bundle branch block; 4 children underwent occluder removal after 1 month, of whom 2 recovered, 1 remained CLBBB, and 1 had complete atrioventricular block (CAVB); the other 4 children received drug treatment, of whom 2 had normal heart rhythm, 1 had left anterior fascicular block, and 1 died of cardiac shock and heart failure.All the 11 late-onset cases were first treated by drugs, of whom 3 recovered, and the other 8 remained CLBBB.One of the 8 cases received occluder removal at 8 months after surgery and recovered, 1 had CAVB, and the other 6 remained CLBBB.Conclusions:For patients with CLBBB after transcatheter closure of VSD, drug therapy is not always effective, and CLBBB is easy to recur.Therefore, occluder removal is recommended to be done immediately after CLBBB is discovered.Patients with persistent CLBBB should be followed up regularly, and pacemaker implantation may be performed if necessary.

Objective To investigate the mechanism of fisetin inhibiting the activation of microglia NOD-like receptor family protein 3(NLRP3)inflammasome in microglia and alleviating cognitive impairment after sepsis.Methods C57BL/6 mice were used to establish the sepsis model by cecal ligation and puncture.Mice were divided into four groups:the sham group,the sepsis group,the sepsis+caspase-1 knockout group(sepsis+Cas-1-/-group)and the sepsis+fisetin group.Evans blue was used to detect the permeability of blood-brain barrier(BBB).Morris water maze was used to evaluate the cognitive function of mice.Western blot assay and immunofluorescence double staining were used to detect the expression of NLRP3 inflammasome-related proteins including caspase-1,N-terminal fragment of the GSDMD(GSDMD-N),interleukin(IL)-1β,IL-18 and mitophagy-related proteins(Pink1,Parkin and LC3-Ⅱ)in brain tissue and microglia.Results Compared with the sham group,expression levels of caspase-1,GSDMD-N,IL-1β and IL-18 were significantly increased in the sepsis group(P＜0.05).Compared with the sepsis group,expression levels of caspase-1,GSDMD-N,IL-1β and IL-18 were significantly decreased in the sepsis+Cas-1-/-group(P＜0.05).The expression levels of Pink1,Parkin and LC3-Ⅱ were significantly higher in the sepsis+fisetin group than those of the sepsis group(P＜0.05),and expression levels of caspase-1,GSDMD-N,IL-1β and IL-18 were significantly lower(P＜0.05).After fisetin intervention,the permeability of BBB was decreased and the cognitive impairment(decreased escape latency and increased frequencies of crossing the platform)was alleviated in the sepsis+fisetin group compared with those of the sepsis group(P＜0.05).Conclusion Fisetin may alleviate central inflammation and cognitive impairment after sepsis by inhibiting the activation of microglial NLRP3 inflammasome through activating mitophagy.

Objective Developing a new type of full-face respiratory protective mask for nuclear facility sites to enhance the sound transmission function and improve the facial adaptability. Methods Combined with feedback from on-site practical needs, this study utilized finite element simulation and ergonomic design methods to investigate the voice transmission units of full-face masks and the facial features of workers at key nuclear facilities. Based on the research results, a new full-face respiratory protection mask structure was designed. Results The optimized structure of passive thin film voice transmission unit significantly enhanced voice transmission efficiency, reducing average voice transmission loss by approximately 70% compared to the control group using thin plate units of equivalent thickness. The existing facial feature test panels insufficiently cover and unevenly classify the facial features of workers at key nuclear facilities. In this study, a specialized test panel based on measurement data achieved a total coverage of 98.5% with high distribution uniformity within each class, providing effective guidance for redesigning full-face mask structural parameters. In comparison to foreign products currently utilized in nuclear facilities, the newly designed full-face mask structure exhibited excellent tightness and structural safety and reliability, and can be cleaned, decontaminated, and reused. Conclusion The results of this study provide significant guidance for improving and optimizing full-face respiratory protection mask used at nuclear facilities, as well as promoting domestic production of high-quality full-face respiratory protection masks.

Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation- related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.