Objective To explore the diagnostic value of exhaled volatile organic compounds (VOCs) for cystic fibrosis (CF). Methods A systematic search was conducted in PubMed, EMbase, Web of Science, Cochrane Library, CNKI, Wanfang, VIP, and SinoMed databases up to August 7, 2024. Studies that met the inclusion criteria were selected for data extraction and quality assessment. The quality of included studies was assessed by the Newcastle-Ottawa Scale (NOS), and the risk of bias and applicability of included prediction model studies were assessed by the prediction model risk of bias assessment tool (PROBAST). Results A total of 10 studies were included, among which 5 studies only identified specific exhaled VOCs in CF patients, and another 5 developed 7 CF risk prediction models based on the identification of VOCs in CF. The included studies reported a total of 75 exhaled VOCs, most of which belonged to the categories of acylcarnitines, aldehydes, acids, and esters. Most models (n=6, 85.7%) only included exhaled VOCs as predictive factors, and only one model included factors other than VOCs, including forced expiratory flow at 75% of forced vital capacity (FEF75) and modified Medical Research Council scale for the assessment of dyspnea (mMRC). The accuracy of the models ranged from 77% to 100%, and the area under the receiver operating characteristic curve ranged from 0.771 to 0.988. None of the included studies provided information on the calibration of the models. The results of the Prediction Model Risk of Bias Assessment Tool (PROBAST) showed that the overall bias risk of all predictive model studies was high, and the overall applicability was unclear. Conclusion The exhaled VOCs reported in the included studies showed significant heterogeneity, and more research is needed to explore specific compounds for CF. In addition, risk prediction models based on exhaled VOCs have certain value in the diagnosis of CF, but the overall bias risk is relatively high and needs further optimization from aspects such as model construction and validation.

Objective To investigate the virulence and drug resistance characteristics of diarrheagenic Escherichia coli isolated from patients with infectious diarrhea in our hospital.Methods The preliminary identification of microbes was carried out by the VITEK-MS microbial mass spectrometry detection system and virulence genes were detected by the multiplex real-time PCR.Five types of diarrhea-genic Escherichia coli(DEC)clinically isolated from patients with infectious diarrhea in our hospital were identified.The drug resist-ance characteristics of DEC strains were detected by the microbroth dilution and E-test.The drug-resistant molecular characteristics were analyzed by the next-generation sequencing and bioinformatics.The Fisher exact probability method was used for statistical analy-sis.Results The detection rate of DEC in our hospital was 11.9%,with enteroaggregative E.coli(EAEC)accounting for 37.5%,a-typical enteropathogenic Escherichia coli(EPEC)accounting for 34.38%,enterotoxigenic E.coli(ETEC)accounting for 25.0%,and enteroinvasive E.coli(EIEC)accounting for 3.12%.None of enterohemorrhagic E.coli(EHEC)strain was detected.The resistance rates of 32 DEC strains to ampicillin,tetracycline,and trimethoprim/sulfamethoxazole were 53.12%,43.75%,and 37.5%,respec-tively.ESBLs(+)strains accounted for 18.75%,and the detection rate of multidrug-resistant strains was 83.83%,significantly higher than that of ESBLs(-)strains(P=0.042).A total of 25 ST genotypes were obtained from 32 DEC strains.The dominant genotypes were ST10(4 strains,12.5%),followed by ST28(2 strains,6.25%),ST31(2 strains,6.25%),ST3153(2 strains,6.25%),and the other 21 genotypes(1 strain,3.13%).One carbapenem resistant strain carrying the blaNDM-1 gene was detected in EAEC.Conclu-sion Four virulence genes such as aggR,pic,astA,and eae,are more common in the DEC of patients with infectious diarrhea in our hospital,with EAEC and EPEC as the main subtypes.The genotypes are highly polymorphic,and multidrug-resistant strains have been detected.

A 50-year-old male patient diagnosed with extensive stage small cell lung cancer was treated with pamiparib in combination with temozolomide.Five days later,the patient developed fever with fatigue.After 10 days,the patient stopped taking the drug due to worsening symptoms and was diagnosed with chemotherapy-induced myelosuppression(grade 4).The clinicist evaluated the patient's condition and assessed the association of adverse reactions using the Naranjo's evaluation scale,and concluded that myelosuppression may be induced by the combination of pamiparib and temozolomide.After symptomatic treatment,the patient's myelosuppression recovered completely.This article discusses the correlation between myelosuppression and the combination of the two drugs,provides treatment measures for this situation,briefly describes the risk factors of myelosuppression,treatment and prevention,and guides medical personnel to adjust the treatment plan in time according to different individuals in the process of using similar programs,and strengthens the monitoring and education of adverse drug reactions,so as to provide references for safe drug use.

Objective To explore the clinical efficacy of human interferonα-2b(INF α-2b)combined with chlorquinaldol-promestriene(CP)in treating cervical intraepithelial neoplasia(CIN)following a loop electrosurgical excision procedure(LEEP).Methods Clinical data of CIN patients treated at the Shunyi District Maternal and Child Health Hospital in Beijing from September 2022 to September 2023 were retrospectively collected.Patients were divided into two groups based on their postoperative medication regimen:the interferon group(INF α-2b)and the combination group(INF α-2b combined with CP).Changes in inflammatory factors[C-reactive protein(CRP)and serum amyloid A(SAA)]and immune function factors[CD4+,CD8+,and CD4+/CD8+ratios]were compared before and after 3 months of the treatment.Clinical efficacy[treatment response rate,HPV clearance rate,and six-month recurrence rate]and complications were also assessed.Results A total of 106 CIN patients were included,with 68 in the interferon group and 38 in the combination group.Before treatment,there were no significant differences in serum CRP,SAA levels,blood CD4+lymphocyte ratio,CD8+lymphocyte ratio,and CD4+/CD8+ratio between the two groups(P＞0.05).After treatment,both groups showed significant decreases in serum CRP,SAA levels,and blood CD8+lymphocyte ratio(P＜0.05),and significant increases in blood CD4+lymphocyte ratio and CD4+/CD8+ratio(P＜0.05),compared with before treatment.In addition,the combination group had significantly lower serum CRP,SAA levels,and blood CD8+lymphocyte ratio,and significantly higher blood CD4+lymphocyte ratio and CD4+/CD8+ratio than the interferon group.The effective rate and HR-HPV clearance rate in the combination group were significantly higher than those in the interferon group.There was no significant difference in the six-month recurrence rate(P＜0.05)or the postoperative complication rate(P＞0.05).Conclusion INF α-2b combined with CP can improve inflammation levels,immune function,clinical efficacy,and HPV clearance rate in CIN patients after LEEP but not affect the six-month recurrence rate or complication rate.

Objective:To observe the effects of nutritional status on the surgical outcomes, nutritional indicators, and renal anemia of maintenance hemodialysis patients with secondary hyperparathyroidism undergoing parathyroidectomy.Methods:A retrospective study was conducted on 35 patients who underwent maintenance hemodialysis with secondary hyperparathyroidism at Huadu District People′s Hospital of Guangzhou from January 2016 to January 2021. All patients underwent total parathyroidectomy with autologous forearm transplantation due to ineffective drug treatment. Before surgery, patients were divided into three groups based on their nutritional status scores: no malnutrition group (0-1 points), mild malnutrition group (2-4 points), and moderate to severe malnutrition group (5-12 points). The changes in serum parathyroid hormone, blood calcium, blood phosphorus, blood albumin, and other indicators were observed at different time points before and after surgery in different groups of patients.Results:The serum parathyroid hormone, blood phosphorus, and calcium phosphorus product of maintenance hemodialysis patients with different nutritional status who underwent parathyroidectomy at 3, 6, and 12 months were significantly decreased compared with preoperative levels, and the differences were statistically significant (all P<0.05). There were no significant changes in albumin, lymphocyte count, and total cholesterol levels in patients without malnutrition at 3, 6, and 12 months after surgery compared with preoperative levels (all P>0.05); The lymphocyte count of patients with mild malnutrition increased significantly at 6 and 12 months after surgery compared to preoperative levels (all P<0.05). The levels of albumin and total cholesterol in patients with moderate to severe malnutrition increased significantly at 3, 6, and 12 months after surgery compared with preoperative levels (all P<0.05). The Hb levels of patients without malnutrition and those with mild malnutrition increased significantly at 6 and 12 months after surgery compared with preoperative levels (all P<0.05); The Hb levels of patients with moderate to severe malnutrition increased significantly at 3, 6, and 12 months after surgery compared with preoperative levels (all P<0.05). Conclusions:Nutritional status affects the long-term outcomes of parathyroidectomy in hemodialysis patients, and parathyroidectomy can significantly improve the nutritional and anemia status of hemodialysis patients with secondary hyperparathyroidism. This effect is more pronounced in patients with moderate to severe malnutrition before surgery.

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.

Objective:To explore the effect of "Internet +" combined with multidisciplinary out of hospital management in hospital-home transitional period management of patients after lumbar internal fixation.Methods:From October 2021 to September 2022, convenience sampling was used to select 176 patients who underwent lumbar internal fixation at the Department of Orthopedics of the First Affiliated Hospital of Zhengzhou University. According to the admission time, patients enrolled from October 2021 to March 2022 were included in the control group, and patients enrolled from April to September 2022 were included in the observation group, with 88 cases in each group. The control group implemented routine out of hospital follow-up management, while the observation group implemented "Internet +" combined with multidisciplinary out of hospital management. After three months of intervention, the recovery of lumbar and back function [Oswestry Disability Index (ODI) and Macnab score], surgical efficacy (NaKa grading), nursing satisfaction, and readmission rate were compared between the two groups.Results:After three months, the ODI score of the observation group was lower than that of the control group, and the Macnab score was higher than that of the control group, the NaKa grading was better than that of the control group, with statistically significant differences ( P<0.05). In the observation group and control group, the total effective rate of surgery, nursing satisfaction, and readmission rate were 88.64% (78/88) vs. 67.05% (59/88), 94.32% (83/88) vs. 78.41% (69/88), 4.55% (4/88) vs. 17.05% (15/88), respectively. The total effective rate and nursing satisfaction of the observation group were higher than those of the control group, and the readmission rate was lower than that of the control group, with statistical differences ( P<0.05) . Conclusions:"Internet +" combined with multidisciplinary out of hospital management can effectively improve the recovery of lumbar function in hospital-home transitional period management of patients after lumbar internal fixation, enhance the surgical efficacy and nursing satisfaction, and reduce the readmission rate.

Abstract： Objective　To analyze the epidemic situation and risk factors of schistosomiasis in Hubei Province from 2015 to 2022, and to provide a scientific basis for the goal of all schistosomiasis-endemic counties in the province reaching the elimination standard by 2030. Methods　According to the requirements of the National Schistosomiasis Surveillance Plan (2014 edition) and National Schistosomiasis Surveillance Plan (2020 edition), the snail situation and the risk of wild fecal transmission, along with regional distribution in schistosomiasis endemic areas in Hubei Province from 2015 to 2022 were analyzed and the risk was rated. Results　From 2015 to 2022, a total of 60 203 risk monitoring environments per time was carried out, with 10 223 460 frames of snails inspected, capturing 2 344 094 snails, among which 1 357 479 live snails, and an average density ranging from 0.07-0.29 snails/0.11 m2. In 2015 and 2017, 11 and 3 schistosomiasis-infected snails were detected respectively, corresponding to 3 and 2 positive snail environments. The proportion of wild feces distribution environment in the total monitoring environment showed a downward trend, with cow dung accounting for the highest proportion (69.27%). A total of 19 549 wild feces were collected, of which 78 were positive for schistosomiasis. Since 2018, only one positive cow dung was found in 2019, and none in other years. From 2015 to 2020, the density of live snails and the proportion of wild feces in the monitoring environment in each risk monitoring county (city, district) had significantly reduced, with areas of higher snail density such as Gongan County, Yangxin County with higher density of live snails decreasing to below 1 per 0.11 m2 from 2017. Among the 60 203 risk monitoring environments, 53 were identified as GradeⅠrisk (not detected since 2020), 1 999 as GradeⅡrisk, and 58 030 as GradeⅢrisk. Conclusions　From 2015 to 2022, the overall schistosomiasis epidemic in Hubei Province showed a downward trend. However, the risk of schistosomiasis transmission still exists in some areas. In the future, we should continue to strengthen the epidemic monitoring in key areas, improve the sensitivity and level of monitoring, and prevent the rebound of the epidemic.

Glioblastoma (GBM) is the most common and aggressive malignant brain tumor in adults and is poorly controlled. Previous studies have shown that both macrophages and angiogenesis play significant roles in GBM progression, and co-targeting of CSF1R and VEGFR is likely to be an effective strategy for GBM treatment. Therefore, this study developed a novel and selective inhibitor of CSF1R and VEGFR, SYHA1813, possessing potent antitumor activity against GBM. SYHA1813 inhibited VEGFR and CSF1R kinase activities with high potency and selectivity and thus blocked the cell viability of HUVECs and macrophages and exhibited anti-angiogenetic effects both in vitro and in vivo. SYHA1813 also displayed potent in vivo antitumor activity against GBM in immune-competent and immune-deficient mouse models, including temozolomide (TMZ) insensitive tumors. Notably, SYHA1813 could penetrate the blood-brain barrier (BBB) and prolong the survival time of mice bearing intracranial GBM xenografts. Moreover, SYHA1813 treatment resulted in a synergistic antitumor efficacy in combination with the PD-1 antibody. As a clinical proof of concept, SYHA1813 achieved confirmed responses in patients with recurrent GBM in an ongoing first-in-human phase I trial. The data of this study support the rationale for an ongoing phase I clinical study (ChiCTR2100045380).

Objective:To report a case of acute kidney injury caused by rhabdomyolysis and summarize its etiology, pathogenesis, and treatment strategy.Methods:The clinical data of a case of rhabdomyolysis complicated by acute kidney injury admitted to Affiliated Huadu Hospital of Southern Medical University on August 30, 2020, were collected, including clinical manifestation, auxiliary examination, and disease outcome. Referring to the previous literature reports of rhabdomyolysis complicated by acute kidney injury, this paper discusses its etiology, monitors and analyzes some indicators such as serum creatinine, blood urea nitrogen, creatine kinase, myoglobin, and 24-hour urine volume during the treatment, and summarizes the clinical diagnosis and treatment ideas of the disease.Results:This case developed an intestinal infection after an unclean diet, which induced rhabdomyolysis and acute kidney injury. Renal pathology after renal biopsy showed that renal biopsy result was consistent with an acute tubulointerstitial injury caused by myoglobin tubular nephropathy. The biochemical indexes such as creatine kinase and myoglobin decreased rapidly after ordinary hemodialysis, but the levels of serum creatinine and blood urea nitrogen did not decrease markedly, and there was continuous oliguria. After switching to hemodialysis filtration and continuous intensive dialysis treatment, the levels of serum creatinine and blood urea nitrogen decreased rapidly, the amount of urine increased gradually, and finally, the renal function recovered.Conclusion:For acute kidney injury caused by rhabdomyolysis, early sufficient blood purification can accelerate the clearance of myoglobin, promote the recovery of the injured kidney, and improve the prognosis of the disease.