Objective To analyze the characteristics of postoperative hospital-acquired infections and drug sensitivity in lung transplant recipients over the past 5 years in a single center. Methods A total of 724 lung transplant recipients at Wuxi People's Hospital from January 2019 to December 2023 were selected. Based on the principles of hospital-acquired infection diagnosis, a retrospective analysis was conducted on the hospital infection situation and infection sites of lung transplant recipients, and an analysis of the distribution of hospital-acquired infection pathogens and their antimicrobial susceptibility test status was performed. Results Among the 724 lung transplant recipients, 275 cases of hospital-acquired infection occurred, with an infection rate of 38.0%. The case-time infection rate decreased from 54.2% in 2019 to 22.8% in 2023, showing a downward trend year by year (Z=30.98, P<0.001). The main infection site was the lower respiratory tract, accounting for 73.6%. The pathogens were mainly Gram-negative bacteria, with the top four being Acinetobacter baumannii (37.1%), Pseudomonas aeruginosa (17.3%), Klebsiella pneumoniae (13.7%), and Stenotrophomonas maltophilia (13.4%), with imipenem resistance rates of 89%, 53%, 58% and 100%, respectively. Gram-positive bacteria were mainly Staphylococcus aureus (3.6%), with a methicillin resistance rate of 67%. Conclusions Over the past 5 years, the hospital-acquired infections in lung transplant recipients have shown a downward trend, mainly involving lower respiratory tract infections, with the main pathogens being Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae, all of which have high resistance rates to imipenem.

BACKGROUND:Due to the lack of mechanical stimulation generated by functional loading,alveolar bone atrophy and bone loss in the missing area prevents the effective embedding of dental implants.Therefore,it is necessary to implant bone meal during implantation to compensate for the lack of alveolar bone height on the stability of the implant. OBJECTIVE:To derive the optimal time point for second-stage restorations from a biomechanical perspective by means of finite element analysis,thereby providing a biomechanical basis for selecting the correct time point for second-stage restoration to shorten the clinical course of dental implantation. METHODS:Three-dimensional finite element models of the maxilla were developed for normal,16-deficient with conventional implant surgery(model B)and 16-deficient with internal maxillary sinus lift(model A).Model A was filled with hydroxyapatite bone powder between the mucosa and the maxillary sinus floor,and Model B and the normal maxillary bone model did not require bone grafting.The healing time of bone grafting was set at 3-9 months postoperatively,and a force of 200 N was applied to the adjacent teeth at 3-5 months postoperatively,and directly to the implant at 6-9 months,simulating the load applied to the implant in the second stage of restoration.Biomechanical analysis of the three models was performed with the aid of the implants and the surrounding hard and soft tissues. RESULTS AND CONCLUSION:The stress on Model A and Model B was around 103 MPa and 95 MPa respectively when the force was directly loaded onto the implant.Bone grafting increased the stress values on the implant,while not doing bone grafting reduced the stress on the implant and the whole system.As the strength of the bone powder increased,the stress values on the alveolar bone decreased.When the healing time was up to 6-9 months postoperatively,the stress values were ranked as follows:normal model

Objective:To investigate the clinical significance of tumor budding as an indicator of postoperative distant organ metastasis after radical gastrectomy in elderly patients diagnosed with gastric cancer.Methods:The clinical and pathological data of 124 elderly patients who experienced metastasis after undergoing radical gastrectomy were retrospectively analyzed.The analysis was conducted from March 2015 to June 2022, focusing on the clinicopathological factors that influenced the occurrence of postoperative distant metastasis in these patients.Tumor budding in gastric cancer tissues was assessed using hematoxylin-eosin staining, and its clinical significance was analyzed.Results:The tumor budding grade of gastric cancer tissues showed a significant correlation with vascular invasion( χ2=6.731, P=0.009), the number of lymph node metastases( rs=0.481, P<0.001), and the time of distant metastasis( rs=-0.450, P<0.001).In the univariate analysis, factors such as tumor budding grade, tumor size, vascular invasion, postoperative chemotherapy, cancerous nodule, preoperative serum carbohydrate antigen 125, and the number of lymph node metastases were found to influence distant metastasis-free survival after radical gastrectomy in elderly patients(all P<0.05).The multifactorial analysis also indicated that tumour outgrowth grade was an important independent prognostic factor for postoperative distant metastasis in elderly gastric cancer patients( HR=3.731, P<0.001). Conclusions:The findings of this study indicate that tumor budding may serve as a potential marker for predicting distant organ metastasis in elderly patients who have undergone radical gastrectomy.This discovery holds significant clinical implications.

Objective To investigate the impact of type 2 inflammation markers blood eosinophils(EOS)and fractional exhaled nitric oxide(FeNO)on bronchodilator responsiveness(BDR)in patients with chronic obstructive pulmonary disease(COPD).Methods This study was conducted among 389 patients with an established diagnosis of COPD in our hospital from October,2019 to October,2023,who all underwent bronchial dilation test(BDT)of the large and small airways.Based on smoking history,blood EOS,and FeNO,these patients were divided group A(blood EOS<300/μL+FeNO<35 ppb+smoking history<20 pack-years),group B(blood EOS<300/μL+FeNO<35 ppb+smoking history≥20 pack-years),group C(blood EOS≥300/μL or FeNO≥35 ppb+smoking history≥20 pack-years),and group D(blood EOS≥300/μL or FeNO≥35 ppb+smoking history<20 pack-years)for analyzing the relationship between clinical indexes and BDR.Results BDR evaluation based on forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),and maximum mid-expiratory flow(MMEF)yielded consistent results,all showing a younger mean age,higher FeNO levels,and higher blood EOS counts and percentages in patients positive for BDT(P<0.05).The improvement value and improvement rate of FEV1 were significantly lower in group A than in group D.The improvement value and improvement rate of FEV1 as well as the improvement rate of MMEF were significantly lower in group B than in group D.In the overall patients,age and FeNO were significantly correlated with the improvement value and improvement rate of FEV1 and the improvement rate of MMEF(P<0.05).Conclusion Type 2 inflammation markers have different effects on BDR in the large and small airways of COPD patients,and their clinical significance needs further investigation.

Objective The occurrence of chickenpox in rapidly developing areas poses substantial seasonal risk to children.However,certain factors influencing local chickenpox outbreaks have not been studied.Here,we examined the relationship between spatial clustering,heterogeneity of chickenpox outbreaks,and socioeconomic factors in Southern China. Methods We assessed chickenpox outbreak data from Southern China between 2006 and 2021,comprising both relatively fast-growing parts and slower sub-regions,and provides a representative sample of many developing regions.We analyzed the spatial clustering attributes associated with chickenpox outbreaks using Moran's I and local indicators of spatial association and quantified their socioeconomic determinants using Geodetector q statistics. Results There were significant spatial heterogeneity in the risk of chickenpox outbreaks,with strong correlations between chickenpox risk and various factors,particularly demographics and living environment.Furthermore,interactive effects among specific are factors,such as population density and per capita residential building area,percentage of households with toilets,percentage of rental housing,exhibited q statistics of 0.28,0.25,and 0.24,respectively. Conclusion This study provides valuable insights into the spatial dynamics of chickenpox outbreaks in rapidly developing regions,revealing the socioeconomic factors affecting disease transmission.These implications extend the formulation of effective public health strategies and interventions to prevent and control chickenpox outbreaks in similar global contexts.

Objective:To investigate the correlation between overweight or obesity defined by body mass index (BMI) and functional outcome in patients with hypertensive intracerebral hemorrhage (HICH).Methods:Patients with HICH admitted to the Department of Neurosurgery, the First People's Hospital of Lianyungang from October 2020 to February 2022 were included retrospectively. According to BMI, they were divided into underweight or normal group (<24 kg/m 2) and overweight or obese group (≥24 kg/m 2). At one year after onset, the functional outcome were evaluated using the modified Rankin Scale. 0-2 was defined as good outcome, while >2 were defined as poor outcome. Cox proportional hazards regression model was used to analyze the correlation between BMI and the outcome of patients. Results:A total of 394 patients with HICH were enrolled, including 263 males (66.8%), aged 60.2±12.0 years. At one year after onset, 145 patients (36.8%) had poor outcome and 54 (13.7%) died. Compared with the underweight or normal group, the overweight or obese group had a higher proportion of previous type 2 diabetes history, as well as higher baseline diastolic blood pressure, low-density lipoprotein cholesterol and liver enzyme levels, better early outcome after discharge, and lower mortality at 1 year (all P<0.05). Multivariate analysis showed that the overweight or obese group had significantly better functional outcome compared to the underweight or normal group (hazard ratio 0.598, 95% confidence interval 0.419-0.854; P=0.005), but there was no statistically significant difference in all-cause mortality risk (hazard ratio 1.201, 95% confidence interval, 0.462-3.126; P=0.707). Conclusion:The overweight or obese patients with HICH have significantly better functional outcome at one year after onset, indicating that the obesity paradox also exists in patients with HICH.

Head and neck tumor is a common malignant tumor with increasing incidence and mortality worldwide. Traditional diagnostic methods for head and neck tumor are limited by the lack of specific biomarkers and the limitation of invasive detection methods, as well as high time cost and a high rate of misdiagnosis. Therefore, research on head and neck tumor diagnosis based on new technologies is needed. Hyperspectral imaging (HSI) is a non-contact optical imaging technique that captures a series of images in multiple spectral bands to generate a hyperspectral image cube. HSI has shown its corresponding potential in the early diagnosis, tumor margin identification and clinical research of head and neck cancer.

Due to the significant anatomical location and physiological functions of the larynx, laryngeal lesions can severely impact patients' voice, quality of life, and even survival prognosis, making early diagnosis and treatment crucial. The electronic laryngoscope is the most important auxiliary tool for the early diagnosis and treatment of laryngeal cancer and precancerous lesions. In recent years, the rapid development of artificial intelligence technology has led to increasing applications and research in the field of laryngoscopy, demonstrating enormous potential and value in assisting diagnosis, quality control, and post-treatment evaluation of diseases. It is expected to become a powerful assistant for endoscopists in clinical decision-making and early diagnosis and treatment of laryngeal cancer in the future.

Gastric cancer is a malignant tumor originating from the epithelium of the gastric mucosa and it is one of the most common malignant tumors of the digestive tract. Patients with gastric cancer have high incidence, metastasis rate and mortality rate. Despite various treatments such as surgery, chemotherapy and immunotherapy, some patients still show recurrence, metastasis and poor prognosis due to its high heterogeneity, high recurrence rate and metastasis rate. Antibody-drug conjugates, a novel class of highly efficient anti-tumor drugs composed of monoclonal antibodies and small molecule cytotoxic payloads linked by a connector, provide a new treatment method for the treatment of gastric cancer due to the high targeting specificity and potent cytotoxic effects of small molecule chemotherapy drugs. Currently, they are being evaluated in multiple clinical trials targeting different sites. This article mainly reviews the latest research progress of antibody-drug conjugates in gastric cancer and adenocarcinoma of esophageal-gastric junction, as well as the challenges in the future development.

Objective To investigate the impact of type 2 inflammation markers blood eosinophils(EOS)and fractional exhaled nitric oxide(FeNO)on bronchodilator responsiveness(BDR)in patients with chronic obstructive pulmonary disease(COPD).Methods This study was conducted among 389 patients with an established diagnosis of COPD in our hospital from October,2019 to October,2023,who all underwent bronchial dilation test(BDT)of the large and small airways.Based on smoking history,blood EOS,and FeNO,these patients were divided group A(blood EOS<300/μL+FeNO<35 ppb+smoking history<20 pack-years),group B(blood EOS<300/μL+FeNO<35 ppb+smoking history≥20 pack-years),group C(blood EOS≥300/μL or FeNO≥35 ppb+smoking history≥20 pack-years),and group D(blood EOS≥300/μL or FeNO≥35 ppb+smoking history<20 pack-years)for analyzing the relationship between clinical indexes and BDR.Results BDR evaluation based on forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),and maximum mid-expiratory flow(MMEF)yielded consistent results,all showing a younger mean age,higher FeNO levels,and higher blood EOS counts and percentages in patients positive for BDT(P<0.05).The improvement value and improvement rate of FEV1 were significantly lower in group A than in group D.The improvement value and improvement rate of FEV1 as well as the improvement rate of MMEF were significantly lower in group B than in group D.In the overall patients,age and FeNO were significantly correlated with the improvement value and improvement rate of FEV1 and the improvement rate of MMEF(P<0.05).Conclusion Type 2 inflammation markers have different effects on BDR in the large and small airways of COPD patients,and their clinical significance needs further investigation.