Objective

To develop an evaluation index system of assessing data management for investigator-initiated trial (IIT), so as to provide an objective and operable basis for scientific evaluation.

Methods

Using the Delphi method, 23 experts were invited to conduct 2 rounds of correspondence to rate the importance of each proposed indicator in the evaluation system. The index system was assessed based on expert's response rate, authority coefficient and opinion coordination degree, with final modifications incorporating experts feedback.

Results

In the 2 rounds of consultation, the positive coefficient of experts were both 100%, the credibility ratio were 0.899 and 0.890 respectively, and the Kendall's W coefficient were 0.247 and 0.375, respectively. The finalized evaluation system comprises 3 first-level indicators, 14 secondlevel indicators and 52 third-level indicators.

Conclusion

The evaluation index system based on Delphi method in this study demonstrates good reliability and practicality for assessing IIT data management.

Objective

To analyze the global distribution， sequence types （ST）， and epidemiological characteristics of antibiotic-resistant genes among global Enterococcus faecium， providing insights for antimicrobial agent usage and nosocomial infection control.

Methods

A total of 3256 genomic sequences of Enterococcus faecium were obtained from the national center of biotechnology information（NCBI） website. Nucleotide sequences were extracted from GenBank files using Perl， and annotation was conducted using Prodigal. Quality filtering of each genome was performed with CheckM v1.1.3 and Quest 5.0.2 software， resulting in 2235 high-quality genomes for further analysis. A structured antibiotic-resistant genes （ARGs） database was constructed， and genomic sequences were aligned against it using blastn for detailed ARGs distribution analysis. 7 Enterococcus faecium housekeeping gene sequence and profile files were obtained from the pubMLST website and underwent blastn alignment to determine ST results. Strain information， including isolation time， country， host， and sample sourcewas extracted from GenBank files using Perl for comprehensive analysis.

Results

Multilocus sequence typing results revealed ST17 as the predominant global sequence type， with 104 strains detected （6.9%）. ARGs detection indicated that 99.7%of strains harbored aminoglycoside-resistant genes， and 94.0% carried macrolide/lincosamide/streptogramin B-resistant genes.

Conclusions

Global Enterococcus faecium ST is predominantly characterized by ST17，while in China， ST78 is predominant. The most prevalent ARG globally and in China is aac（6）-I， conferring resistance to aminoglycosides. Strengthening monitoring and research on ARGs carriage is imperative to standardize antimicrobial usage， enhance surveillance and control of Enterococcus faecium infections in healthcare settings， and prevent widespread occurrence.

Objective

To investigate the toxic effects of rotenone on dopaminergic neurons and the protective effects and mechanisms of MCC950 against rotenone-induced neuron damage.

Methods

The rotenone-induced SN4741 Parkinson's disease neuron cell model was constructed. The effects of rotenone on the viability of SN4741 cells were detected by cell counting kit-8 method and lactate dehydrogenase release test.Propidium iodide staining was used to detect the effect of rotenone on apoptosis of SN4741 cells. The effects of rotenone on the expression of NOD-like receptor pyrin domain containing 3 (NLRP3) and its downstream inflammatory factors in SN4741 cells were detected by Western blot and ELISA. The effect of NLRP3 inhibitor MCC950 on rotenone-induced SN4741 cell inflammation and cell apoptosis was investigated.

Results

With the increase of rotenone concentration, SN4741 cell viability decreased and apoptosis increased (P＜0.01).The expressions of NLRP3, IL-1β and IL-18 in rotenone treatment group were increased compared with those in control group (P＜0.01). Rotenone plus MCC950 treatment group alleviated the decreased cell viability, increased apoptosis and increased expression of NLRP3, IL-1β and IL-18 caused by rotenone treatment group.

Conclusion

Rotenone can induce neuronal apoptosis and cell death through activation of neuroinflammation, and MCC950 attenuates rotenone-induced neuroinflammation and cell apoptosis.

Objective

To establish a multidimensional evaluation framework for medical students' labor competency， aiming to enhance pedagogical effectiveness， improve healthcare workforce adaptability， and promote holistic development in medical education.

Methods

The Delphi method，analytic hierarchy process， and questionnaire methods were used to analyze the connotation of medical students' labor competency， determine the evaluation indicators and weights of medical students' labor competency， and conduct evaluation through statistical methods such as factor analysis and structural equation modeling.

Results

A medical student labor competency index system was determined， which consists of 3 primary domains， 12 subdomains and 31 measurable indicators. The 3 primary domains and their weights are professional values （0.448）， applied knowledge （0.249）， clinial-community skills （0.303）.

Conclusion

This rigorously validated labor competency evaluation system demonstrates excellent reliability and cross-institutional applicability， providing theoretical reference for improving labor education evaluation in medical universities.

Bladder cancer remains the most prevalent malignant tumor in the urinary system.Current treatment strategies are primarily determined by tumor invasiveness. Non-muscle-invasive bladder cancer (NMIBC) typically undergoes transurethral resection with adjuvant intravesical therapy, while muscle-invasive urothelial carcinoma (MIBC) requires radical cystectomy. However, both approaches face significant challenges with disease recurrence. Recent advances in cancer molecular biology, immunology, and genetics have revealed the therapeutic potential of oncolytic viruses, with promising efficacy demonstrated in preclinical bladder cancer models. This emerging modality offers novel treatment opportunities for bladder cancer management. This review comprehensively examines the current research status and recent progress in oncolytic virotherapy for bladder cancer, highlighting its potential to address the limitations of conventional treatments.

Objective

To identify shared key genes and pathways linking primary gouty arthritis(PGA) and hyperuricemia (HUA) through bioinformatics approaches.

Methods

Disease-associated gene targets of PGA and HUA were retrieved from GeneCards, OMIM and DisGeNET databases. After deduplication and filtration, the final gene targets for two groups of diseases were obtained. Then take the intersection and import the common gene targets into the STRING database to construct a protein-protein interaction (PPI) network diagram. Download the tsv format PPI network and import it into Cytoscape 3.8.0.Hub genes were prioritized using CytoHubba plugin with topological criteria: degree/closeness/betweenness centrality above median values, yielding top 27 hub genes. Perform GO enrichment analysis and KEGG enrichment analysis on common target genes of PGA and HUA using the DAVID database.

Results

389 genes from PGA and 802 genes from HUA were selected, 150 common target genes, according to the PPI network diagram, IL-6, RELA, APP, TNF, INS, IL-1β, CXCL8, MAPK1, and TLR4 are the common key target genes of PGA and HUA, GO enrichment showed that it was mainly related to inflammatory response, immune response, etc., KEGG signaling includes NOD-like receptor signaling, Toll-like receptor signaling, nuclear factor-kappa B signaling, HIF-1 signaling and tumor necrosis factor signaling.

Conclusion

The common key genes and signaling pathways involved in PGA and HUA provide a theoretical basis for understanding the correlation between the two diseases and subsequent related research.

Objective

To investigate the clinical infection status of ureaplasma urealyticum (UU),mycoplasma hominis (MH) and chlamydia trachomatis (CT) in the genital tract of female infertility patients in Guangzhou area.

Methods

505 cases of female infertility patients in outpatient clinics of Guangdong Women and Children Hospital were selected, including 215 cases of primary infertility patients (primary infertility group) and 290 cases of secondary infertility patients (secondary infertility group), and 60 cases of normal pregnancy and obstetrics examination in Guangdong Women and Children Hospital in the same period of time were taken as the control group, and all of the patients were tested for CT antigen and the cultivation of UU and MH, as well as drug sensitivity test.

Results

The positive rates of single infections of UU, MH and CT in patients in the infertility group were 46.1%, 8.5% and 6.5%, respectively, which were significantly higher than those in the control group (P＜0.05); the positive rate of single infections in patients in the infertility group was 61.2% (309/505), and that of mixed infections was 11.9% (60/505), and there was no statistical significance in the difference of positive rates of mixed infections when compared with those in the control group (P＞0.05). The positive rates of UU, MH and CT single infections and mixed infections were similar in the primary and secondary infertility groups, and there was no statistically significant difference in the positive rates of single infections and mixed infections between the two groups (P＞0.05); UU and UU+MH mixed infections were both more sensitive to doxycycline and cosyntropin; the difference in the positive rate of UU was statistically significant in patients of different ages (P＜0.05), with the highest UU positivity rate in women in the ≥41-year-old group, and the differences in MH and CT positivity rates were not statistically significant in all age groups (P＞0.05)

Conclusion

Positive rates of female genital tract UU, MH, and CT infections are positively correlated with the occurrence of infertility, and female patients with all types of infertility should be intensely screened for these pathogens.

Objective

To analyze the risk factors for adverse pregnancy outcomes in patients with preeclampsia （PE） and to develop and validate a predictive model.

Methods

This retrospective study included data from patients diagnosed with preeclampsia （PE） who delivered at the Third Affiliated Hospital of Zhengzhou University-Henan Provincial Maternal and Child Health Hospital from January 2021 to March 2024. Patients were categorized into adverse and non-adverse outcome groups based on the occurrence of adverse pregnancy outcomes. After screening， univariate and multivariate logistic regression analyses were used to evaluate clinical data. Independent risk factors identified were then utilized to develop a nomogram and construct a predictive model via R software 4.2.1. The receiver operating characteristic curve was calculated， and the model's discrimination， calibration， and clinical utility were assessed through the area under the curve （AUC） and Hosmer-Lemeshow （H-L） test. Internal validation of the predictive model was performed using the bootstrap resampling method and ten-fold cross-validation.

Results

A total of 472 PE patients were included in this study to construct the model， comprising 428 patients with adverse pregnancy outcomes and 44 without. Multivariate logistic regression analysis identified independent risk factors for adverse pregnancy outcomes in PE patients （P＜0.05）， including gestational age at onset ≤34 weeks， peak diastolic blood pressure during pregnancy ≥110 mmHg， abnormal umbilical artery blood flow， positive urine protein analysis， serum uric acid ＞369 μmol/L， and lactate dehydrogenase ＞246 U/L. Based on these independent risk factors， a clinical predictive model was constructed， yielding an AUC of 0.942 （95% CI：0.909～0.975）. The optimal cutoff value was 0.836， with a specificity of 84.1% and sensitivity of 92.1%. The H-L goodness-of-fit test indicated good calibration of the model （χ²=4.969， P=0.761）. Decision curve analysis shows that the model can achieve higher net benefits in clinical decision-making. The model validation shows that the model has good generalization ability and practical application value.

Conclusion

Based on clinical data， this study identified 6 independent risk factors to construct a predictive model for adverse pregnancy outcomes in preeclampsia patients. The model demonstrated strong predictive performance， with an AUC of 0.942 and good calibration （P=0.761）， indicating substantial potential for clinical application.

Objective

To investigate the association between CYP2C19 gene polymorphism and voriconazole valley concentration and adverse drug reactions, so as to provide evidence for clinical dose adjustment.

Methods

327 patients treated with voriconazole from January 2021 to July 2023 who were simultaneously monitored with voriconazole concentration and detected with CYP2C19 gene polymorphism at the First Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed, recorded their basic information, CYP2C19 genotype, dosage, duration of administration, blood concentration and abnormal liver function. Analysis of the relationship between CYP2C19 gene polymorphism and voriconazole steady-state plasma concentration and liver function abnormalities.

Results

CYP2C19 normal metabolizer and intermediate metabolizer accounted for 43.12%, and poor metabolizer accounted for 13.76%. There are statistical differences in serum voriconazole concentration among different CYP2C19 genotype carriers (P＜0.05). However, no statistically significant association was found between CYP2C19 gene polymorphisms and adverse drug reactions(P＞0.05).

Conclusion

CYP2C19 gene polymorphism affects voriconazole metabolism in vivo, but has no statistical correlation with adverse reactions after voriconazole use.

Objective

To investigate the correlation between the international normalized ratio（INR） and outcomes in patients with sepsis-associated acute kidney injury（SA-AKI）using data from the Medical Information Mart for Intensive Care-Ⅳ （MIMIC-Ⅳ）.

Methods

Using a retrospective queue design，information on adult SA-AKI patients with ICU admission records was extracted from the MIMIC-Ⅳ 2.0.Restricted cubic spline models and multivariable Cox proportional hazards regression were employed to evaluate the nonlinear relationship between INR levels and mortality. Patients were stratified by an ICU admission 24-hour INR cutoff for Kaplan-Meier survival analysis.

Results

Elevated INR was independently associated with increased mortality （adjusted HR=1.73， 95%CI： 1.59～1.88， P＜0.001）， and it shows a non-linear relationship with the prognosis of SA-AKI patients （P＜0.001）， with a cutoff value of 1.4.

Conclusion

High INR is an independent risk factor for predicting in-hospital mortality in SA-AKI patients. In the treatment process of SA-AKI patients， attention should be paid to the comprehensive evaluation of INR levels and other indicators.

Objective

The study aims to evaluate the potential clinical application of combined 15 bile acids （BAs） using liquid chromatography-tandem mass spectrometry （LC-MS/MS） and 17 trace elements using inductively coupled plasma mass spectrometry （ICP-MS） in the auxiliary predictive diagnosis of Alzheimer's disease （AD）.

Methods

A total of 72 patients diagnosed with AD in the Neurology and Cognitive Disorder Departments of the Third affiliated Hospital of Shenzhen University from 2021 to 2022 were enrolled in the AD group， and 70 healthy individuals undergoing physical examinations during the same period were included as the control group. Quantification of 15 BAs in serum was performed using LC-MS/MS， while 17 trace elements in whole blood were quantified using ICP-MS. The differences in BAs and trace element levels between AD patients and healthy controls were compared. Logistic regression models were constructed for combined diagnostic analysis， and receiver operating characteristic （ROC） curves were plotted to evaluate the diagnostic value of these biomarkers in AD.

Results

Methodological validation confirmed that the analytical performance of LC-MS/MS and ICP-MS met the stringent standards required by the assay kits. In the biomarker analysis comparing AD group and healthy controls， significantly lower levels of lithocholic acid （LCA）， ferrum （Fe）， and strontium （Sr）were observed in AD group （P＜0.05）. Conversely， levels of magnesium （Mg）， calcium （Ca）， manganese（Mn）， copper （Cu）， selenium （Se）， and lithium （Li） were significantly higher in AD patients （P＜0.05）.The combined diagnostic model of LCA with Fe and Sr demonstrated good predictive ability， with an area under the curve （AUC） of 0.82， sensitivity of 93.8%， and specificity of 56.1%. Another model combining Mg， Ca， Mn， Cu， and Se also exhibited good predictive performance， with an AUC of 0.80， sensitivity of 83.3%， and specificity of 68.3%.

Conclusion

This study reveals significant imbalances in BAs and trace elements in patients with AD， particularly the decreased levels of LCA， Fe， and Sr， and the increased levels of Mg， Ca， Mn， Cu， and Se. These changes have the potential to serve as predictive biomarkers for AD， providing new insights into the biological pathways involved in the disease and offering potential avenues for early diagnosis.

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Objective

To investigate the vitro antibacterial effects of platelet-rich plasma (PRP)and platelet-rich gel supernant (PGS), prepared using different methods against common burn wound pathogens: Staphylococcus epidermidis (SE), Staphylococcus aureus (SA) and Pseudomonas aeruginosa (PA).

Methods

Clinical isolates of SA, SE, and PA were collected, and PRP was collected from healthy volunteers by mechanical collection method and manual two-step centrifugation method, and part of PRP obtained by manual two-step centrifugation method was prepared into PGS. Oxford cup assay method was used to observe the inhibition zone of PRP, PGS and control group and determine its diameter.

Results

The PRP prepared by manual two-step centrifugation method demonstrated significant antibacterial activity against SA(2.164±0.354 mm inhibitory zone) and PA (3.544±0.507 mm inhibitory zone), but no obvious inhibitory zone was observed in SE group. Neither apheresis-prepared PRP nor manual PGS showed detectable inhibition zones against any tested pathogens.

Conclusions

This study demonstrated that PRP prepared by manual two-step centrifugation method has antibacterial effect on SA and PA, but has no antibacterial effect on SE. PRP prepared by mechanical collection method and PGS prepared by manual two-step centrifugation method lack measurable antimicrobial activity against these three common burn wound pathogens.

Objective

To establish and verify the reference intervals of neutrophil to lymphocyte ratio （NLR）， platelet to lymphocyte ratio （PLR） and lymphocyte to monocyter ratio （LMR） in the elderly over 60 years of age in Nanjing area.

Methods

A total of 851 healthy elderly people who underwent physical examination in Lanyuan Community Health Service Center of Xuanwu District in Nanjing from January to December 2021 were selected as the research subjects by complete randomization method. There were 378 males in the male group and 473 females in the female group， aged from 60 to 89 years old. NLR， PLR and LMR were calculated according to the parameters of blood cell analysis， and the reference intervals of NLR， PLR and LMR were established and the established reference intervals were verified.

Results

NLR showed the rule of male higher than female. PLR and LMR showed the rule of female higher than male， and the differences were statistically significant （P＜0.05）. Therefore， the reference intervals for peripheral blood NLR， PLR and LMR in apparently healthy elderly over 60 years old were established according to gender：For male NLR is 0.83～3.09， PLR is 53.08～162.67， LMR is 2.95～10.42； for female NLR is 0.75～2.91， PLR is 55.55～173.57， LMR is 3.54～11.64. After verification， the set reference interval is effective.

Conclusion

The reference intervals of NLR， PLR and LMR in peripheral blood of elderly people over 60 years old in Nanjing area were established and verified， which provided a reference for the clinical application of NLR， PLR and LMR in elderly people in Nanjing area.