Tuberculous meningitis (TBM) is a non-suppurative meningeal inflammation caused by Mycobacterium tuberculosis (Mtb) infection, characterized by insidious onset, poor specificity in clinical manifestations and poor prognosis, making it the type of extrapulmonary tuberculosis with the highest mortality rate. The pathogenesis of TBM is complex and diverse, primarily resulting from insufficient primary immune response or secondary immune deficiency of the body, leading to Mtb penetration through the blood-brain barrier and dissemination. Due to the atypical early clinical symptoms and conventional test results, as well as the low sensitivity of Mtb culture, early diagnosis of TBM is difficult. Recent advances in clinical testing and treatment have greatly improved, automated real-time nucleic acid amplification detection for Mtb and Rifampicin resistance and high-throughput sequencing technologies have been widely adopted, immunological and multi-omics detection techniques continue to advance, and novel anti-tuberculosis drugs along with comprehensive treatment regimens are now in clinical use. These integrated diagnostic and therapeutic approaches have significantly improved the clinical confirmation rate of TBM while reducing the complications and sequelae. This article reviews the current advances in diagnosis, treatment and research of TBM.

Gastric cancer is one of the most common malignant tumors worldwide, and its pathogenesis is complex, including genetic, environmental and dietary factors. In recent years, the relationship between gastric microbiota and gastric cancer has gradually become a hot research topic. More and more studies have shown that gastric microbiota plays an important role in the occurrence and development of gastric cancer. This review systematically expounds the relationship between the composition and changes of gastric microbiota and the occurrence and development of gastric cancer, including the association between microbial infections such as Helicobacter pylori, non-Helicobacter pylori bacteria, fungi and viruses and gastric cancer, as well as the influence and mechanism of microbial imbalance on gastric cancer. At the same time, the limitations of existing research and future research directions are also discussed, which provides new ideas and strategies for the prevention and treatment strategies of gastric cancer.

To investigate the methylation characteristics of the integrin αL (ITGAL) promoter region in peripheral blood mononuclear cells (PBMCs) and its diagnostic value in patients with colon cancer complicated with sepsis.

Total of 209 patients initially diagnosed with colon cancer in the Second People’s Hospital of Nantong from March 1st, 2022 to March 31st, 2023 were selected and divided into simple colon cancer group (117 cases) and colon cancer with sepsis group (92 cases) based on the presence of sepsis complications, while 50 healthy subjects were selected as control group. The methylation levels at seven sites of the ITGAL promoter region in peripheral blood were analyzed by methylation-specific polymerase chain reaction (MSP). The levels of procalcitonin (PCT), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) of patients in both groups were detected by Chemiluminescence method and compared by one-way ANOVA among multiple groups. The diagnostic value of various indicators for sepsis of patients with colon cancer were evaluated by receiver operating characteristic (ROC) curves. The associations of gender, age, pathological grade, TNM stage, treatment method, PCT, IL-6, neutrophil-to-lymphocyte ratio (NLR) and ITGAL levels with the risk of sepsis in patients with colon cancer were analyzed by multivariate Logistic regression models.

The methylation levels at ITGAL sites 40, 128 and 342 were significantly higher of patients in colon cancer with sepsis group compared with simple colon cancer group (t=3.69, 2.51, 4.76, P=0.017, 0.032, 0.010), but the methylation level at ITGAL-310 was significantly lower (t=5.19, P < 0.001), all with significant differences. The combined diagnosis of PCT, NLR, IL-6 and TNF-α showed the highest area under ROC curve (0.902), followed by PCT (0.857), ITGAL (0.842) and IL-6 (0.783). Multivariate Logistic regression analysis showed that age (OR=1.075, 95%CI: 1.022-1.060, P=0.041), TNM stage (OR=1.056, 95%CI: 1.009-9.894, P=0.047), treatment method (OR=3.933, 95%CI: 1.482-10.442, P=0.006), PCT (OR=1.353, 95%CI: 0.002-6.818, P=0.031) and ITGAL (OR=2.014, 95%CI: 0.000-5.726, P=0.014) were all influencing factors of the occurrence of sepsis in patients with colon cancer.

ITGAL and inflammatory factors are involved in the progression of sepsis in colon cancer and serve as sensitive biomarkers for the diagnosis of colon cancer-associated sepsis. PBMC-ITGAL methylation has discriminative diagnostic significance for colon cancer complicated with sepsis.

To analyze the clinical characteristics of patients with chronic hepatitis C (CHC) and influencing factors for progression to liver cirrhosis.

Total of 755 chronic hepatitis C (CHC) patients with positive hepatitis C virus (HCV) antibody, positive HCV RNA, and successful polymerase chain reaction (PCR) gene sequencing admitted to Qinghai Fourth People’s Hospital from January 2023 to December 2024 were collected, retrospectively. According to HCV genotype, the cases were divided into GT3 group (250 cases) and non-GT3 group (505 cases); according to whether progressed to liver cirrhosis after completing antiviral therapy, the cases were divided into liver cirrhosis group (575 cases) and non-liver cirrhosis group (180 cases). Gender, age, population classification, route of infection, treatment rate and liver inflammation indicators were compared between the two groups, respectively. The normally distributed and non-normally distributed measurement data were compared by independent samples t-test and non-parametric test, respectively; and the rates were compared by Pearson Chi-square test. The correlation between various baseline indicators of CHC patients and progression to liver cirrhosis were analyzed by Spearman rank correlation analysis. The independent influencing factors of progression to liver cirrhosis of CHC patients were analyzed by multiple factor Logistic regression model.

Among the 755 patients with CHC, the infection rate of HCV GT3 was 33.11% (250/755). Compared with patients of non-GT3 group, the GT3 group had a significantly higher proportion of males (197/250, 78.80%), cases aged 40-60 years old (224/250, 89.60%), unemployed individuals and farmers (219/250, 87.60%) and those with intravenous drug use as the route of infection (124/250, 49.60%), with significant differences (all P<0.001). The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alpha-fetoprotein (AFP), total bilirubin (TBil), liver stiffness measurement (LSM) and APRI score of patients in GT3 group were significantly higher than those in non-GT3 group, with significant differences (all P<0.001). The platelet (PLT) count and SVR12 rate of patients in GT3 group were significantly lower than those in non-GT3 group (Z=－6.424, P<0.001: χ²=6.370, P=0.012), and the incidence of liver cirrhosis was significantly higher among patients in GT3 group (39.60% vs. 16.04%; χ²=51.121, P<0.001). Among the 250 patients infected with HCV GT3 subtype, the proportion of GT3b subtype was 71.6% (179/250). Compared with those infected with GT3a subtype, patients infected with GT3b subtype had a significantly older average age [(53.52±5.34) years old vs. (51.37±8.32) years old] and significantly higher AFP level [6.85 (3.61, 13.67) ng/ml vs. 5.05 (3.56, 8.89) ng/ml], with significant differences (t=8.574, P=0.046; Z=－2.303, P=0.021). Spearman rank correlation analysis showed that the progression to liver cirrhosis in patients with CHC was positively correlated with age (r=0.125, P<0.001), HCV GT3 infection (r=0.262, P<0.001), ALT (r=0.104, P=0.004), AST (r=0.304, P<0.001), APRI (r=0.510, P<0.001), AFP (r=0.183, P<0.001), LSM (r=0.671, P<0.001) and TBil (r=0.276, P<0.001), while negatively correlated with platelet (PLT) count (r=－0.408, P<0.001) and albumin level (r=－0.103, P=0.005). Multivariate Logistic regression analysis showed that HCV GT3 infection (OR=1.842, 95%CI: 1.584-2.192, P<0.001), AST (OR=1.008, 95%CI: 1.000-1.016, P=0.041), PLT (OR=0.992, 95%CI: 0.985-0.994, P<0.001), AFP (OR=1.012, 95%CI: 1.002-1.022, P=0.014), albumin (ALB) (OR=0.870, 95%CI: 0.781-0.969, P=0.011), age (OR=1.028, 95%CI: 1.011-1.044, P<0.001) and LSM (OR=1.430, 95%CI: 1.329-1.539, P<0.001) were all influencing factors for the progression to liver cirrhosis in CHC patients after completing antiviral treatment.

HCV genotype 3 (especially subtype 3b) infection accounts for a significant proportion of CHC patients in Qinghai region, and is associated with a more aggressive clinical course and higher risk of liver cirrhosis. HCV genotype 3 infection, AST, PLT, AFP, ALB, age and LSM are all independent influencing factors for the progression to liver cirrhosis in patients with CHC.

To establish a prediction model for 28-day in-hospital mortality of patients with septic shock using machine learning (ML) and verify its effectiveness.

The clinical data of patients with septic shock admitted to Suzhou Ninth Hospital Affiliated to Soochow University from January 2019 to June 2024 were analyzed, retrospectively. Patients were divided into death group (104 cases) and survival group (161 cases) based on their prognosis at 28 days after admission. The key variables associated with 28-day in-hospital mortality were screened by the least absolute shrinkage and selection operator (LASSO) algorithm. The entire dataset was randomly divided into training set and test set with a ratio of 3∶1. By comparing eight different ML algorithms, the optimal algorithm was selected to construct the prediction model. The model performance were evaluated by area under the receiver operating characteristic (ROC) curve (AUC) and clinical decision curve analysis (DCA). The model was interpreted by Shapley additive exPlanations (SHAP) algorithm.

Total of 265 patients with septic shock were enrolled. Forty-seven variables were initially included based on clinical preliminary screening; nine key variables were selected by the LASSO model for subsequent model development. Among the eight models constructed, the radial basis function-support vector machine (RSVM) model demonstrated the best overall performance. After optimization by this algorithm, the AUCs were 0.85 for the training set and 0.77 for the test set; the accuracies were 78.8% and 71.6%, respectively; the recall rates were 75.6% and 69.2%, respectively; and the DCA curves indicated higher net benefits. SHAP value analysis revealed that septic shock complicated with multiple organ dysfunction syndrome (involving four or more organs) was the most important predictive variable, followed by the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and the sequential organ failure assessment (SOFA) score.

Machine learning could be used to build an accurate prediction model for the 28-day in-hospital mortality risk of patients with septic shock. This model could improve the risk stratification and may guide clinicians in implementing appropriate interventions.

To investigate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in late-pregnancy women on maternal and neonatal clinical outcomes during the Omicron variant pandemic.

A retrospective analysis was conducted on 70 pregnant women admitted to Beijing Ditan Hospital, Capital Medical University from November 1st, 2022 to April 30th, 2023. These patients were divided into infection group (35 cases) and control group (35 cases) based on whether they were infected with SARS-CoV-2 during the late pregnancy period. The clinical characteristics, laboratory parameters and the effects of SARS-CoV-2 infection on maternal and neonatal outcomes between the two groups were compared by Mann-Whitney U test, Kruskal-Wallis test and Chi-square test.

The Infection group had a significantly longer hospital stay than the control group [11 (10, 14) days vs. 7 (4, 10) days: Z=4.263, P<0.001]. The cesarean section rate between the Infection group and control group was without significant difference (48.57% vs. 48.57%: χ²=0.000, P=1.000). Among the indications for cesarean section, the Infection group had higher incidence of fetal distress (41.18% vs. 5.88%: χ²=4.087, P=0.043). Compared with control group, patients in Infection group had lower proportions of elevated white blood cell count (17.14% vs. 51.43%: χ²=9.130, P=0.003) and elevated neutrophil count (34.29% vs. 68.57%: χ²=8.235, P=0.004), but with higher proportions of decreased lymphocyte count (85.71% vs. 14.29%: χ²=35.714, P<0.001) and elevated fibrinogen degradation products (68.57% vs. 28.57%: χ²=11.209, P<0.001). In Infection group, women who received 3 doses of inactivated COVID-19 vaccine had higher serum anti-SARS-CoV-2 IgG levels than unvaccinated women [2.66 (1.25, 8.72) S/CO vs. 0.04 (0.02, 0.11) S/CO, Z=－4.044, P<0.001]. SARS-CoV-2 nucleic acid of all neonates born from infected women were negative, which indicated no vertical transmission. The Infection group had a lower incidence of pathological jaundice in neonates (14.2% vs. 37.14%: χ²=4.786, P=0.029), but higher proportions of neonatal decreased lymphocyte count (72.22% vs. 37.14%: χ²=5.853, P=0.016) and elevated C-reactive protein (83.33% vs. 20.00%: χ²=19.638, P<0.001). Neonates in the Infection group had lower anti-IgG levels than those in the control group [4.32 (0.74, 16.13) S/CO vs. 62.12 (3.76, 103.21) S/CO: Z=－3.610, P<0.001]. Among the 70 enrolled women, neonates born from those with hybrid immunity (natural infection + vaccination) had higher anti-SARS-CoV-2 IgG levels than those born from naturally infected mothers [46.34 (6.99, 96.20) S/CO vs. 0.20 (0.05, 2.16) S/CO: Z=4.267, P<0.001].

SARS-CoV-2 infection in late pregnancy may increase the risk of fetal distress and prolong maternal hospital stay, necessitating enhanced perinatal monitoring. Although no vertical transmission was observed, maternal inflammatory and immune status may affect neonatal inflammatory and immune parameters. Timely COVID-19 vaccination of mothers may enhance neonatal passive immunity.

To investigate the incidence and influencing factors of lesion regression after biopsy of cervical intraepithelial neoplasia grade 3 (CIN3) associated with human papillomavirus (HPV) infection.

A retrospective analysis was performed on the clinical data of 240 patients who underwent colposcopic biopsy, diagnosed as CIN3 and subsequent cold knife conization at Maternal and Children’s Healthcare Hospital of Beijing Dongcheng District from January 1st, 2016 to December 31st, 2024. Cone pathology ≤ CIN1 was defined as CIN3 lesion regression; patients were divided into regression group (63 cases) and non-regression group (177 cases) based on whether CIN3 lesions regressed. Age, gravidity and parity, number of cervical quadrants involved, number of biopsies obtained, biopsy-conization interval, menopausal status, contraceptive methods, educational level, medical comorbidities, cytology and HPV screening results, types of transformation zone and performance of endocervical curettage (ECC) between two groups were compared, respectively. The influencing factors of CIN3 lesion regression were analyzed by multivariate Logistic regression analysis.

The regression rate of CIN3 lesions after biopsy was 26.3% (63/240). Compared with non-regression group, patients in regression group had lower proportion of high-grade cytological lesions (χ²=12.671, P < 0.001), lower proportion of type 3 transformation zones (χ²=5.002, P=0.025), fewer involved quadrants (t=3.553, P=0.001) and longer biopsy-conization interval (t=－2.250, P=0.027), all with significant differences. Multivariate Logistic regression analysis showed that high-grade cytological lesions (OR=0.297, 95%CI: 0.130-0.679, P=0.004) and multi-quadrant involvement (OR=0.661, 95%CI: 0.455-0.962, P=0.030) were independent influencing factors for CIN3 lesion regression.

CIN3 patients with low-grade cytology (≤ low-grade squamous intraepithelial lesion) and localized lesions (≤ 2 quadrants) are more likely to experience lesion regression after biopsy.

To investigate the efficacy of Sulbactam-Durlobactam combined with Meropenem in treatment of extensively drug-resistant Acinetobacter baumannii (XDR-AB)-associated severe hospital-acquired pneumonia.

Retrospective analysis of a case with severe pneumonia caused by XDR-AB who was admitted to Beijing Anzhen Hospital, Capital Medical University on May 1st, 2025 and relevant literatures were reviewed.

A 76-year-old male was hospitalized due to “recurrent fever accompanied by cough and sputum for 2 days”. Chest CT revealed diffused ground-glass opacities in bilateral lower lobes. Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid identified human herpesvirus type 1 (102 reads) infection. Based on the clinical manifestations and laboratory tests, ganciclovir was administered for antiviral treatment, and meropenem combined with vancomycin were used for antibacterial treatment. Hospital-acquired severe pneumonia caused by XDR-AB infection and septic shock occurred during the treatment. XDR-AB was sensitive to Tigecycline, Cotrimoxazole, Eravacycline and Sulbactam-Durlobactam, and the highest body temperature of the patient reached 42 ℃, and levels of inflammatory indicators (count of white blood cells, levels of C-reactive protein and procalcitonin, etc.) increased significantly. After 5 days treatment with Sulbactam-Durlobactam (1.0 g/1.0 g per dose via intravenous drip, every 6 hours) and Meropenem (1.0 g per dose via intravenous drip, every 8 hours), the patient’s infection status improved significantly, and was discharged avoiding endotracheal intubation caused by type Ⅱ respiratory failure. Domestic and international studies had reported successful treatment of XDR-AB infections using Sulbactam-Durlobactam in combination with Imipenem. This case demonstrated that adjusting the treatment regimen based on the patient’s medical history, with the addition of Meropenem, could achieve both clinical cure and microbial eradication.

The combination of Sulbactam-Durlobactam and Meropenem could effectively treat hospital-acquired pneumonia caused by XDR-AB, and can significantly improve the patient’s symptoms and eliminate the pathogens.