According to the National Cancer Center’s 2024 National Cancer Report, liver cancer remains the second leading cause of cancer death in our country. A large number of studies have found that microbes are widely present in various types of cancer tissues such as colorectal cancer, pancreatic cancer and breast cancer. Their composition is different from that of normal tissues. In addition, some studies have found that intratumoral microbiome has an important effect on the occurrence, development of tumors. The immune microenvironment, metabolic pathways and epigenetic modification might be the main mechanisms. In this paper, the ways that the intratumoral microbiome of liver cancer affected tumour occurrence and development, and the role in clinical treatment and prevention were reviewed.

To investigate the risk factors for significant liver damage (SLD) in patients with chronic hepatitis B (CHB) during the immune-tolerant phase (IT-CHB) and establish a diagnostic model to guide clinical decisions on initiating antiviral therapy.

A retrospective analysis was conducted on the clinical data (including age, gender, examination and test results, etc.) of IT-CHB patients who were hospitalized and undergoing liver biopsy at the Fifth Medical Center of the PLA General Hospital from August 2018 to June 2022. Patients were stratified into SLD group [≥ G2 (inflammation) or S2 (fibrosis) according to Scheuer classification] and non-SLD group. Influencing factors were identified and diagnostic models were established by univariate and multivariate Logistic regression analysis, and the diagnostic performance was evaluated by receiver operating characteristic (ROC) curve and mosaic plots.

Among the 478 enrolled IT-CHB patients, the age was (32.9 ± 10.1) years old, with 62.1% males (297 cases), 21.1% cases (101/478) showed SLD (SLD group), 377 cases (78.9%) showed no SLD (non-SLD group). The results of the multivariate Logistic regression analysis showed that age (OR = 1.07, 95%CI: 1.04-1.11, P < 0.001), aspartate aminotransferase (AST) (OR = 1.09, 95%CI: 1.05-1.14, P < 0.001), platelet (PLT) (OR = 0.99, 95%CI: 0.98-0.99, P < 0.001), hepatitis B virus (HBV) DNA (OR = 0.51, 95%CI: 0.29-0.91, P = 0.017) and liver stiffness measurement (LSM) (OR = 2.25, 95%CI: 1.81-2.78, P < 0.001) were all independent influencing factors for SLD. The diagnostic model (IT-CHB-5) integrating these factors achieved an AUC of 0.89 (optimal cut-off: 23.8), with the sensitivity of 77.3%, the specificity of 89.2%, and the accuracy of 95.4% for SLD detection.

A substantial proportion of IT-CHB patients present SLD. The non-invasive IT-CHB-5 model provides an objective tool to timely initiation of antiviral therapy for IT-CHB patients who refuse liver biopsy.

To analyze the status and risk factors of nosocomial infection in patients with malignant tumors during chemotherapy, and to construct a nomogram model for predicting the risk of infection.

Total of 402 patients with malignant tumors who were hospitalized for chemotherapy in Suzhou Ninth Hospital Affiliated to Soochow University from January 2024 to October 2024 were selected. The patients showed no signs of infection upon admission. The patients were divided into infection group (47 cases) and non-infection group (355 cases) according to whether nosocomial infection occurred during hospitalization. The clinical data of the two groups were compared. The risk factors of nosocomial infection in cancer patients undergoing chemotherapy were analyzed by multivariate Logistic regression analysis, and nomogram model was constructed to predict the risk of infection. The predictive efficacy of Logistic regression model and nomogram model were analyzed by receiver operating characteristic (ROC) curve. The two models were compared by Delong test. The stability and clinical value of the dominant model were evaluated by K-fold cross-validation and decision curve.

The hospital infection rate for the first hospitalization chemotherapy of 402 patients with malignant tumors was 11.69% (47/402), the main infection site was respiratory system (27 cases, 57.45%). Among the 47 infected specimens, 30 strains (51.72%) of Gram-negative bacteria, 24 strains (41.38%) of Gram-positive bacteria, and 4 strains (6.90%) of fungi were isolated and cultured. The ages of patients in the infection group and the non-infection group [(63.96 ± 6.85) years old vs. (60.22 ± 5.94) years old: t=3.982, P < 0.001], complicated with diabetes [17 (36.17%) vs. 69 (19.44%): χ²=6.911, P=0.009], neutrophil count before chemotherapy [(2.39 ± 0.47) vs. (2.59 ± 0.54) × 10⁹/L]: t=2.038, P=0.042), neutrophil count to lymphocyte count ratio (NLR) before chemotherapy [(1.07 ± 0.26) vs. (0.79 ± 0.24): t=7.442, P < 0.001], nutritional risks before chemotherapy [15 (31.91%) vs. 62 (17.46%): χ²=5.597, P=0.018)] and invasive operations [39 (82.98%) vs. 225 (63.38%): χ²=7.072, P=0.008] were all with significant differences. Multivariate Logistic regression analysis showed that age (OR=2.775, 95%CI: 1.415-5.447, P=0.003), complicated with diabetes (OR=2.106, 95%CI: 1.157-3.834, P=0.015), NLR before chemotherapy (OR=3.557, 95%CI: 1.763-7.178, P < 0.001), nutritional risk before chemotherapy (OR=1.679, 95%CI: 1.059-2.662, P=0.028), invasive procedures (OR=2.391, 95%CI: 1.224-4.673, P=0.011) were risk factors for nosocomial infection of tumor patients undergoing chemotherapy in hospital. ROC curve analysis and Delong test showed that the area under the curve (AUC) of nomogram in predicting the risk of nosocomial infection in patients with tumor chemotherapy was significantly higher than that of Logistic regression model (0.884 vs. 0.798: Z=4.137, P=0.018). The 10-fold cross-validation of the nomogram model for 100 times showed that the model had good stability. The decision curve showed that the net benefit curve of the model is located above the two extreme curves of all measures and no measure, indicating that the model had clinical practical value in this range.

The risk of nosocomial infection in cancer patients undergoing chemotherapy is high. This study based on factors such as age, whether diabetes was present, NLR before chemotherapy, whether there was nutritional risk before chemotherapy and whether invasive procedures were performed, constructed a nomogram model which has a good predictive ability for the risk of hospital-acquired infections in cancer patients undergoing inpatient chemotherapy, can be used as risk assessment tool for medical staff to identify patients with nosocomial infection.

To evaluate and compare the experimental parameters and resultant differences of two magnetic bead-based nucleic acid extraction reagents in pathogen-targeted next-generation sequencing (ptNGS) for the detection of bronchoalveolar lavage fluid (BF) and peripheral blood (PB) samples, and to identify the more effective nucleic acid extraction reagent and assess its applicability in ptNGS detection, in order to offer guidance for the selection of appropriate nucleic acid extraction reagents tailored to various sample types.

Two representative magnetic bead-based nucleic acid extraction kits, designated as KitA and KitB were employed to conduct ptNGS detection on 12 BF samples and 8 PB samples, all of which had established culture or real-time fluorescence quantitative PCR (qPCR) results. An equal volume was utilized for each sample. The methodology encompassed several key stages, including nucleic acid extraction, library construction, sequencing and subsequent result analysis. The experimental parameters, including total nucleic acid extraction mass, absorbance (A) _260/280, library concentration and sample sequencing data quality index Q30; and pathogen detection copy numbers between KitA and KitB during the detection process of samples (BF and PB) were systematically compared by Wilcoxon signed-rank tests, and the magnetic bead extraction reagent which was more suitable for ptNGS detection of BF and PB samples were clarified. The suitability of the extraction kit was further evaluated by the accuracy, precision, detection limit and conventional anti-interference ability of ptNGS detection.

The total amount of nucleic acid extracted in BF by KitA was significantly higher than that of KitB (W=-66, P=0.001), but without significant difference in PB (W=19, P=0.063). However, the absorbance A_260/280 of KitB nucleic acid in BF and PB samples were significantly better than those of KitA (BF: W=54, P=0.014; PB: W=21, P=0.031). But the library concentration and fragment size of the libraries constructed by KitA and KitB nucleic acid were not significantly different; sequencing data quality metrics including Q30 scores, primer dimer percentage and percentage of Real aligne were not significantly different between the two extraction methods (all P > 0.05). The number and species of KitA and KitB detected in the pathogen were consistent. The pathogen copy number detected by KitA in BF was significantly higher than that of KitB (W=-301, P < 0.001), however, there was no statistically significant difference in pathogen copy number in PB between the two extraction methods (W=-3, P=0.844). Further, a more suitable nucleic acid extraction kit KitA was selected to evaluate its suitability for ptNGS detection in BF and PB. The positive concordance rate of ptNGS detected by KitA was 97.14%, the missed detection rate was 2.86%, and the overall concordance rate was 95%. Both intra-batch and inter-batch precision exhibited coefficients of variation below 10%. The limit of detection (LOD) was established at 100 copies/ml for bacterial and fungal targets, and 1 000 copies/ml for viral targets. Notably, non-target nucleic acids (including human-derived DNA/RNA) in the samples did not interfere with the qualitative results of ptNGS analysis.

For ptNGS detection in BF samples, Kit A demonstrated overall superior performance compared with Kit B across all evaluated parameters. In PB samples, both kits were consistent in overall experimental parameters, including total nucleic acid yield, library concentration and sequencing data quality indicators Q30. KitA meets the requirements of clinical testing in terms of accuracy, precision, detection limit and routine anti-interference capability in the performance evaluation of ptNGS detection

To explore the influencing factors of postoperative recurrence of chronic suppurative otitis media (CSOM), and to construct the relevant prediction model of postoperative recurrence based on procalcitonin (PCT), soluble interleukin-2 receptor (sIL-2R) and clinical characteristics.

The clinical data of 400 patients with CSOM who were treated by surgery and reached the cure standard in Chengdu Seventh People’s Hospital from June 2018 to June 2023 were collected, retrospectively. After following-up for one year, the patients were divided into recurrence group (31 cases) and non-recurrence group (369 cases) according to whether they had recurrence. The influencing factors of postoperative recurrence of CSOM were analyzed by univariate analysis and multivariate Logistic regression analysis models, and a risk prediction model for postoperative recurrence of CSOM based on PCT, sIL-2R and clinical characteristics was established, and the predictive efficacy of the risk prediction model was analyzed by receiver operating characteristic (ROC) curve.

Age (χ²=3.955, P=0.047), impatency of eustachian tube (χ²=3.955, P=0.047), repeated upper respiratory tract infection (χ²=5.679, P=0.017), fasting blood glucose (t=4.741, P < 0.001), postoperative PCT level (t=3.488, P=0.001) and sIL-2R level (t = 2.864, P=0.004) between patients in recurrence group and non-recurrence group were all significantly different. The results of the binary Logistic regression model showed that impatency of eustachian tube (OR=2.492, 95%CI: 1.062-5.852, P=0.036), recurrent upper respiratory tract infection (OR=3.830, 95%CI: 1.668-8.791, P=0.002), fasting blood glucose (OR=2.843, 95%CI: 1.643-4.919, P < 0.001), postoperative PCT level (OR=155.371, 95%CI: 3.650-6 613.023, P=0.008) and sIL-2R level (OR=1.007, 95%CI: 1.001-1.014, P=0.029) were all independent risk factors for CSOM recurrence after surgery. According to the results of Logistic regression analysis, the prediction model equation was obtained: G=Log (P)=0.923 × impatency of eustachian tube + 1.299 × repeated upper respiratory tract infection + 1.093 × fasting blood glucose + 5.367 × postoperative PCT + 0.007 × sIL-2R-14.803. ROC curve analysis of the predictive model showed that AUC of this predictive model was 0.819 (95%CI: 0.737-0.902), suggesting a good predictive value for postoperative recurrence of CSOM.

Eustachian tube obstruction, repeated upper respiratory tract infection, fasting blood glucose, postoperative PCT level and sIL-2R level are all risk factors for recurrence after CSOM surgery. The predictive model constructed based on these factors has certain predictive value.

To investigate the distribution characteristics and drug resistance of pathogenic bacteria in patients with chronic refractory wounds, and to guide the formulation of personalized antimicrobial treatment plans and promote rational use of antibacterial drug in clinical practice.

A retrospective study was conducted on the clinical data of 124 patients with chronic refractory wounds admitted to the Dermatology Outpatient Department, Dermatology Inpatient Unit and Vascular Surgery Inpatient Unit of the First Affiliated Hospital of Tsinghua University from January 2020 to January 2025. Wound secretions or necrotic tissues were collected by sterile swabs and sent to laboratory for bacterial culture. Species identification was performed by VITEK MS microbial identification system (bioMérieux, France) with VITEK-2 identification cards. In vitro antimicrobial susceptibility testing employed matching VITEK-2 susceptibility cards and the Kirby-Bauer disk diffusion method (Oxoid, UK). All experimental procedures and result interpretations were adhered to guidelines established by the Clinical and Laboratory Standards Institute (CLSI). The independent risk factors for positive pathogen culture in wound were analyzed by binary Logistic regression.

Total of 92 strains of pathogenic bacteria were isolated, with the isolation rate of 74.2%; Gram-positive cocci primarily included Staphylococcus aureus (27 strains, 29.3%) and coagulase-negative Staphylococci (23 strains, 25%); Gram-negative bacilli mainly comprised Pseudomonas aeruginosa (9 strains, 9.8%), Escherichia coli (4 strains, 4.3%) and Proteus mirabilis (4 strains, 4.3%). The top three etiological factors for chronic refractory wounds were lower extremity arterial vascular ulcers (43 cases, 34.7%), infectious ulcers (38 cases, 30.6%) and postoperative poor wound healing (15 cases, 12.1%). The detection rate of Staphylococcus aureus was significantly higher in patients with infectious ulcer group compared with patients of lower extremity arterial disease (χ²=6.618, P=0.014). Wound pathogen detection rates were significantly elevated in patients ≥ 60 years old compared with those < 60 years old (χ²=5.236, P=0.022). Logistic regression analysis showed that diabetes mellitus was an independent risk factor for positive wound pathogen culture (OR=2.620, 95%CI: 1.013-6.777, P=0.047). The detection rate of wound pathogen was significantly higher in patients with diabetes compared with patients without diabetes (χ²=7.079, P=0.008), the positive detection rate of other Gram-negative bacilli was also significantly higher in patients with diabetic (χ²=3.932, P=0.047). In patients with type 2 diabetes mellitus duration ≥ 15 years, detection rates of other Gram-negative bacilli were significantly higher than those with duration < 15 years (χ²=5.013, P=0.025), all with significant differences. The detection rate of Staphylococcus aureus in head and neck region was significantly higher than that in trunk (χ²=8.531, P=0.003) and limbs (χ²=11.738, P=0.001). Methicillin-resistant Staphylococcus aureus accounted for 5 strains (5.4%) and methicillin-resistant coagulase-negative Staphylococci accounted for 15 strains (16.3%), all were sensitive to vancomycin, tigecycline and linezolid. Pseudomonas aeruginosa (9 strains, 9.8%) demonstrated universal susceptibility to cefepime, meropenem, amikacin, levofloxacin, ciprofloxacin and colistin, while 1 strain (11.1%) exhibited resistance to imipenem. Among Escherichia coli isolates (4 strains, 4.3%), resistance was observed in 1 strain (25%) to amikacin, levofloxacin and sulfamethoxazole/trimethoprim, respectively. Proteus mirabilis (4 strains, 4.3%) showed resistance to tigecycline in 3 strains (75%) and 2 strains (50%) to cefuroxime and sulfamethoxazole/trimethoprim, respectively.

Infection is closely associated with the development of chronic refractory wounds, with diabetic and elderly patients being particularly high-risk populations. Wound bacteria exhibit diverse species and characteristic clinical distribution patterns. Rational individualized selection of antimicrobial agents can effectively control infection, promote wound healing, and prevent or delay the emergence and spread of antibiotic-resistant bacteria.

To investigate the relationship of serum 25-hydroxyvitamin D₃ [25-(OH) D₃], annexin A2 (ANXA2), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores with disease severity and prognosis of children with bronchopneumonia.

Total of 356 children with bronchopneumonia in the Children’s Diagnosis and Treatment Center of Xuzhou Central Hospital from January 2023 to January 2024 were selected. According to the severity of the disease, the patients were divided into mild group (175 cases), moderate group (101 cases) and severe group (80 cases). After treatment, patients were categorized into good prognosis group (292 cases) and poor prognosis group (64 cases). The serum 25-(OH) D₃, ANXA2 and APACHE Ⅱ scores of patients in different groups were compared, and the correlations between the above three indicators and the disease severity of children with bronchopneumonia were analyzed by Spearman correlation analysis. Whether the above three indicators were risk factors for poor prognosis in children with bronchopneumonia were determined by multivariate Logistic analysis. The predictive value of the three indicators alone and combination for poor prognosis in children with bronchopneumonia were analyzed by receiver operating characteristic (ROC) curve. The goodness of fit of the risk model were tested by Hosmer-Lemeshow method.

At admission, the serum 25-(OH) D₃ of children in the severe group [(33.25±12.35) nmol/L] was significantly lower than those of children in moderate group and mild group [(54.63±13.16) nmol/L, (68.98±15.27) nmol/L]; However, the ANXA2 and APACHE Ⅱ scores [(4.81±1.25) μmol/L, (18.25±6.98) scores] were significantly higher than those of moderate condition group [(4.07±0.89) μmol/L and (13.63±4.21) scores] and mild condition group [(3.22±0.64) μmol/L and (8.74±2.32) scores], with significant differences (all P<0.001). Spearman correlation analysis showed that serum 25-(OH) D₃ was negatively correlated with the severity of the disease (r_s =-0.626, P<0.001), while ANXA2 and APACHE Ⅱ score were positively correlated with the severity of the disease (r_s=0.434, 0.490, both P<0.001). The serum 25-(OH) D₃ of children in poor prognosis group [(62.45±12.78) nmol/L] was lower than that of good prognosis group [(93.16±18.93) nmol/L]. The ANXA2 and APACHE Ⅱ scores [(4.92±1.23) μmol/L and (12.36±3.84) scores] were significantly higher than those of good prognosis group [(3.11±0.87) μmol/L and (5.63±1.28) scores], with significant differences (all P<0.001). Logistic multivariate regression analysis showed that serum 25-(OH) D₃ (OR=0.955, 95%CI: 0.936-0.975, P<0.001), ANXA2 (OR=3.817, 95%CI: 2.535-5.748, P<0.001) and APACHE Ⅱ score (OR=2.079, 95%CI: 1.523-2.839, P<0.001) were all the main influencing factor for the prognosis of children with bronchopneumonia. ROC curve analysis showed that the AUC of the combined prediction of poor prognosis in children with bronchopneumonia by serum 25-(OH) D₃, ANXA2 and APACHE Ⅱ score was 0.895 (95%CI: 0.858-0.947), and the sensitivity and specificity were 85.90% and 80.80%, respectively. Meanwhile, the DeLong test revealed that the performance of the combined prediction model was superior to that of individual indicator of serum 25-(OH) D₃, ANXA2 or APACHE Ⅱ score (Z=5.275, P<0.001; Z=4.211, P<0.001; Z=2.505, P=0.033). Hosmer-Lemeshow result showed a relative high predictive efficacy (χ²=10.347, P=0.242).

Low serum 25-(OH) D₃, high ANXA2 and high APACHE Ⅱ scores are closely related to the severity and prognosis of children with bronchoponia. It is of certain guiding significance to pay attention to the changes of the above indicators in the treatment of children with bronchopneumonia.

To improve the clinical cognition of congenital tuberculosis in preterm infants with gestational age less than 32 weeks, and to improve the early diagnosis and treatment of the disease.

A retrospective analysis was conducted on the clinical data, diagnosis and treatment of a 27⁺² weeks of gestation of premature infant with congenital tuberculosis admitted to Dongguan Maternal and Child Health Care Hospital in October, 2023. A comprehensive search was conducted across Wanfang, CNKI and PubMed databases to identify relevant cases from January, 1976 to December, 2024 through the keyword "congenital tuberculosis", followed by a summary and analysis of all cases involving preterm infants with a gestational age of less than 32 weeks.

The male infant was born at 27⁺² weeks of gestation. At the 6th day after birth, the infant occurred recurrent respiratory apnoea and intermittent fever, which did not respond to multiple courses of antibiotic treatment. At the 30th day after birth, a diagnosis of congenital tuberculosis was identified and the infant was subsequently treated with isoniazid (15 mg·kg^-1·d^-1), rifampicin (15 mg·kg^-1·d^-1) and pyrazinamide (40 mg·kg^-1·d^-1), leading to recovery and discharge. The total course of anti-tuberculosis treatment was 6 months. Review of previous literatures and this case, a total of 23 cases of congenital tuberculosis in preterm infants with a gestational age of less than 32 weeks were identified. Among them, there were 12 male and 11 female infants; 82.6% (19/23) infants with congenital tuberculosis were in vitro fertilization, and 7 infants died, with a mortality rate of 30.4%. There were 15.8% (3/19) mothers of the children were infected with Mycobacterium tuberculosis (MTB) before delivery, 79% (15/19) mothers were not infected with MTB before delivery, but tuberculosis was diagnosed after delivery; and 5.3% (1/19) mothers were not infected with MTB before and after delivery. Children with congenital tuberculosis whose gestational age less than 32 weeks were mostly diagnosed about 1 month after birth. Common symptoms included respiratory distress (11/23, 47.8%), apnea (10/23, 43.5%), fever (9/23, 39.1%), poor response (3/23, 13%) and bradycardia (3/23, 13%).

Premature infants with gestational age less than 32 weeks have a high mortality rate of congenital tuberculosis, which is common in in vitro fertilization infants. The clinical symptoms are mostly respiratory distress, apnea, fever, poor response and bradycardia. If the mother was diagnosed with tuberculosis before or after childbirth and the child had the above symptoms, it is necessary to improve the pathogenic examination related to tuberculosis for early diagnosis and anti-tuberculosis treatment.