Jia Li

Background: Carbapenem-resistant Klebsiella pneumoniae bloodstream infection (CRKP BSI) is associated with substantial mortality and limited therapeutic options, yet institutional epidemiology and risk profiles vary. We evaluated antimicrobial susceptibility, non-blood-site detection, factors associated with carbapenem resistance, and in-hospital all-cause mortality among patients with K. pneumoniae BSI at a secondary-care hospital over seven years. Methods: We retrospectively analyzed 141 adults with K. pneumoniae BSI hospitalized at Shidong Hospital, Shanghai, China, from January 2019 through December 2025, including 49 patients with CRKP BSI and 92 with carbapenem-susceptible K. pneumoniae BSI (CSKP BSI). Clinical and microbiological data were analyzed using univariable comparisons and multivariable logistic regression. Results: Crude in-hospital mortality was higher among patients with CRKP BSI than among those with CSKP BSI (40.8% vs. 16.3%; p = 0.002). Among the tested CRKP isolates, high in vitro susceptibility to ceftazidime/avibactam and tigecycline was observed. In multivariable analysis, pulmonary disease (aOR, 9.441; 95% CI, 2.958–30.136; p < 0.001), urinary catheterization before BSI onset (aOR, 13.821; 95% CI, 3.987–47.904; p < 0.001), prior carbapenem exposure (aOR, 3.982; 95% CI, 1.274–12.448; p = 0.018), and prior cephalosporin exposure (aOR, 11.341; 95% CI, 3.411–37.713; p < 0.001) were associated with carbapenem resistance. Non-blood-site detection of K. pneumoniae was more frequent in CRKP BSI than in CSKP BSI (73.5% vs. 35.9%; p < 0.001). In the overall mortality model, sepsis or septic shock assessed at BSI onset or within 48 h thereafter was associated with higher odds of in-hospital mortality (aOR, 4.738; 95% CI, 1.916–11.720; p < 0.001), whereas the adjusted association of CRKP BSI status with mortality did not reach statistical significance. Conclusion: In multivariable analysis, pulmonary disease, urinary catheterization before BSI onset, prior carbapenem exposure, and prior cephalosporin exposure were associated with carbapenem resistance. Although crude mortality was higher among patients with CRKP BSI, sepsis or septic shock was associated with higher odds of mortality after adjustment for age and CRKP BSI status, whereas the adjusted association of CRKP BSI status with mortality did not reach statistical significance. These findings support targeted infection prevention, antimicrobial stewardship, appropriate urinary catheter use, and early recognition and management of sepsis.

Cancer remains a major global health challenge, underscoring the urgent need for early diagnostic strategies. Altered cancer metabolism can be captured through serum analysis by laser desorption/ionization mass spectrometry (LDI‐MS). Here, we report the design of gold nanoparticle‐modified manganese–cobalt oxide heterojunctions (Au/MCOHs) as a high‐performance LDI‐MS nano‐matrix. The Au/MCOHs combine strong ultraviolet absorption, enhanced charge separation, and favorable surface potential to achieve efficient laser energy conversion and ionization. Leveraging this platform, we performed serum metabolomic analysis on 698 participants, comprising healthy controls and patients with six different cancer types. Machine learning models distinguished cancer patients from healthy controls with area under the curve (AUC) values up to 0.955. Critically, early‐stage cancers were also detected, with AUCs ranging from 0.776 to 0.938. Thirteen cancer‐associated metabolites were identified, and a combined diagnostic panel achieved an AUC of 0.865. This study demonstrates how rationally engineered plasmonic heterojunction nanomatrices can bridge materials innovation and clinical translation, offering a robust, non‐invasive route for pan‐cancer metabolomic screening.

Airway epithelial cells (AECs) and mast cells (MCs) are pivotal initiators and amplifiers of airway inflammation, orchestrating a dynamic crosstalk that drives pathological hyperreactivity in respiratory diseases. AECs, as the frontline barrier, detect pathogens and allergens, releasing cytokines (e.g., IL-33, TSLP) and chemokines to activate neighboring MCs. Conversely, MC-derived proteases (tryptase, chymase) and mediators (histamine, leukotrienes) disrupt epithelial junctions (e.g., E-cadherin, occludin), exacerbating barrier dysfunction and perpetuating cycles of inflammation. This reciprocal interaction establishes a molecular hub for ‘hyperinflammation’ in asthma, chronic obstructive pulmonary disease (COPD), and viral infections, while also contributing to pathological processes such as airway remodeling, fibrosis, and epithelial-mesenchymal transition (EMT). Therefore, elucidating the synergistic mechanisms underlying AEC-MC crosstalk is critically important. This review synthesizes emerging insights into AEC-MC crosstalk, emphasizing context-specific mechanisms in viral, allergic, and chronic inflammatory settings, and provide suggestions for future research directions.

Preeclampsia (PE) affects 2–4% of pregnancies, and early detection and intervention can reduce its incidence. Dysregulation of the maternal immune response and red blood cells (RBCs) are key to its development, although early alterations remain unclear. This study analyzed data from 17,955 pregnant women across two centers to explore the relationships among inflammatory markers, RBC indices, and PE via multivariate logistic regression and restricted cubic splines (RCSs). Machine learning integrated inflammatory markers, RBC indices, and maternal risk factors to predict PE risk at 14 weeks, as validated by receiver operating characteristic (ROC) curve analysis. After adjusting for confounders, the lymphocyte (LYMPH) count (OR = 1.27, 95% CI: 1.05–1.53, P = 0.013), monocyte (MONO) count (OR = 2.57, 95% CI: 1.31–5.03, P = 0.006), systemic inflammatory response index (SIRI) (OR = 1.11, 95% CI: 1.01–1.21, P = 0.032), and systemic immune inflammatory index (SII) (OR = 1.01, 95% CI: 1.01–1.01, P = 0.002) were identified as significant risk factors for PE. Nonlinear associations between white blood cell (WBC) count, neutrophil (NEUT) count, platelet (PLT) count, RBC count, and hemoglobin (HGB) and PE were observed via RCS (nonlinear P < 0.05). Further analysis revealed threshold effects for WBC (P = 0.034), with an inflection point at 8.44. Below 8.44, no significant association was found (OR = 0.92, P = 0.307), but above 8.44, each unit increase was linked to a 0.14-fold rise in PE risk (OR = 1.14, P < 0.001). Similar threshold effects were found for the PLT, RBC, and HGB (P < 0.001). A prediction model based on inflammatory markers, RBC indices, and maternal risk factors achieved high performance (ROC = 0.82). LYMPH, MONO, SIRI, and SII were linearly associated with PE, whereas WBC, NEUT, PLT, RBC, and HGB showed nonlinear associations with threshold effects. Early prediction using these indicators is a cost-effective strategy for PE prevention.

Non-pharmaceutical interventions (NPIs) implemented during the COVID-19 pandemic had a significant impact on the epidemiology of respiratory pathogens. Following the relaxation of these measures, a notable increase in Mycoplasma pneumoniae (Mp) pneumonia incidence among children was observed. To comprehensively analyze the impact of NPIs on the patterns of Mp infections in children, we assessed changes in the epidemiology and clinical features of Mp infections in Songjiang District, Shanghai, before, during, and after the pandemic. A total of 6,050 hospitalized children with community-acquired pneumonia (CAP) from January 2017 to December 2024 were included. Annual Mp epidemiology was analyzed from 2017 to 2024. To assess NPI-specific effects, three comparative phases were defined: Before (June 2017–May 2019, pre-pandemic), During (June 2020–May 2022, active pandemic with NPIs), and After (June 2022–May 2024, post-NPIs). Epidemiological characteristics, clinical features, and laboratory findings were systematically compared across these phases. From 2017 to 2024, the number of hospitalized CAP cases significantly decreased from 2020 to 2022, with an overall Mp positivity rate of 43.16%. Annual Mp positivity rate peaked at 56.32% in 2022 versus 30.70% in 2020. Intergroup comparisons revealed that the After group exhibited the highest Mp positivity rate (56.03%), significantly exceeding both the Before (28.59%) and During (41.63%) groups. Notably, the After group exhibited significantly lower white blood cell count (WBC) and C-reactive protein (CRP), alongside elevated platelet count (PLT) and alanine aminotransferase (ALT). The proportion of patients with low Mp antibody titers (1:80) was significantly higher in the During group, whereas high-titer categories (1:320 and >1:640) predominated in the After group. NPIs during the COVID-19 pandemic significantly altered the epidemiology and clinical features of Mp infections in children in Songjiang District, Shanghai. IMPORTANCE: This study examines the effects of non-pharmaceutical interventions (NPIs) during the COVID-19 pandemic on the epidemiology of Mycoplasma pneumoniae (Mp) infections in children. By analyzing data from over 6,000 hospitalized children with community-acquired pneumonia, the research reveals a significant change in Mp infection patterns, with a marked increase in positivity rates after NPIs were relaxed. The findings indicate a shift in the affected demographic, with more school-age children presenting with Mp infections, as well as variations in clinical features such as different laboratory results. This research provides valuable insights for healthcare professionals in understanding the implications of NPIs on respiratory infections in children, guiding future treatment approaches and public health strategies. It represents a meaningful contribution to the ongoing evaluation of pediatric health in a post-pandemic context.

To analyze the positive rate and genotype distribution of human papillomavirus (HPV) infection in Yangpu District, Shanghai, and to provide a scientific basis for the prevention and treatment of cervical cancer and related diseases. A retrospective analysis was conducted on HPV genotyping data from 19,142 outpatients, inpatients, and health examinees at Shanghai Shidong Hospital from 2020 to 2024. Overall infection rate, genotype distribution, age-specific positivity, and annual trends were evaluated. Among 19,142 specimens, 4,421 tested positive for HPV, yielding a total positive rate of 23.10%. The top five prevalent genotypes were HPV-52 (21.72%), HPV-53 (11.94%), HPV-58 (10.19%), HPV-51 (8.02%), and HPV-39 (6.86%). Dominant genotypes varied across years. Age-specific infection rates followed an approximate U-shaped curve, with peaks in the ≤ 20-year group (57.69%) and the 61–70-year group (29.72%). Among mixed infections (28.70% of positives), single infections predominated (71.30%). The most common co-infection combinations were HPV-52 + HPV-53 and HPV-52 + HPV-58. High-risk age groups for HPV infection were 31–40, 51–60, and 61–70 years. The HPV infection rate in Yangpu District, Shanghai, was 23.10%, primarily driven by single-genotype infections. HPV-52, -53, and − 58 were the dominant genotypes, with significant age-specific variations. These findings underscore the need for enhanced HPV vaccination promotion and targeted preventive strategies.

To investigate the effectiveness of combining intrapartum ultrasound with free maternal positions in managing abnormal labor, specifically focusing on its impact on delivery outcomes. A retrospective cohort study was conducted on 176 cases of abnormal labor progression in women who attempted vaginal delivery at our hospital from June 2021 to May 2022. Among these, 88 cases were diagnosed with abnormal fetal positions using a combination of intrapartum ultrasound and vaginal examination, and these patients were guided to adopt free maternal positions (experimental group). The control group comprised 88 cases diagnosed with abnormal fetal positions through vaginal examination alone, without any intervention to correct positioning. Maternal and neonatal outcomes, including the duration of the first and second stages of labor, total labor time, cesarean section rates due to failed progression, postpartum hemorrhage, and length of hospital stay, were compared between the two groups. The experimental group demonstrated significantly reduced durations of the first and second stages of labor, as well as total labor time, compared to the control group. Furthermore, the rate of cesarean sections due to failed progression was significantly lower in the experimental group. Additionally, the experimental group experienced lower rates of postpartum hemorrhage and shorter hospital stays, with statistically significant differences observed. Combining intrapartum ultrasound with free maternal positions shows promise in improving delivery outcomes for women with abnormal fetal positions during labor. These findings highlight the potential benefits of this approach in enhancing the quality of delivery.

Objective: HCV infection is frequently asymptomatic, with current diagnosis relying mainly on costly and less accessible HCV RNA testing. While HCV-Ab and biochemical markers exhibit suboptimal diagnostic performance, whether machine learning can enhance their accuracy remains unclear. Methods: This study is a retrospective study, which included data from 179 patients whose HCV-Ab levels were greater than 1.00 S/CO to explore the relationship between HCV-Ab, biochemical indicators, and HCV infection. Univariate logistic regression and restricted cubic splines (RCS) were employed to explore these associations. Machine learning integrated HCV-Ab and biochemical indicators to predict early HCV infection (undiagnosed chronic cases), with validation conducted using receiver operating characteristic curve (ROC) analysis. The machine learning approach randomly divided study participants into training and test sets at a 5:5 ratio, with the training set being used for variable selection and model construction. Results: After full adjustment, TP showed no significant association with HCV infection. Restricted cubic spline (RCS) analysis revealed nonlinear relationships between HCV-Ab, ALT, AST, mAST, GGT, A/G and HCV infection. HCV-Ab exhibited an inflection point at 11.17 (below: OR = 1.04 per unit increase; above: no association). Similar threshold patterns were observed for ALT, AST, mAST and GGT. The integrated HCV-Ab and biochemical marker model achieved excellent predictive performance (AUC = 0.977). Conclusion: TP exhibited a linear association with HCV infection, whereas HCV-Ab, ALT, AST, mAST and GGT showed nonlinear associations with distinct threshold effects. Early prediction of HCV infection using these indicators represents a cost-effective strategy.

Elevated subcutaneous adipose tissue in obese men correlates strongly with a higher risk of aggressive prostate cancer and poor treatment outcomes, but the exact mechanism underlying the increased risk remains elusive. To address this question, we analyzed prostate cancer transcriptomic data from The Cancer Genome Atlas as well as single-cell RNA sequencing and tissue microarray data from prostate cancer cells. Subcutaneous adipose tissue-associated cysteine-rich protein 2 (CSRP2) was significantly downregulated in prostate cancer epithelial cells. Knockdown of CSRP2 promoted proliferation of prostate cancer cell lines DU145 and PC3, whereas the opposite effect was observed with CSRP2 overexpression. In vivo xenograft assays confirmed that CSRP2 overexpression inhibits the growth of prostate cancer cells. Importantly, co-immunoprecipitation and mass spectrometry assays confirmed that CSRP2 inhibits the deubiquitination of WD40 repeat protein 5 (WDR5) by ubiquitin-specific protease 44 (USP44). Overexpression of WDR5 reversed the growth inhibition of CSRP2 overexpression on prostate cancer cells. Altogether, our data indicate that CSRP2 suppresses prostate cancer cell proliferation via a CSRP2/WDR5/USP44 dependent pathway to control prostate cancer progression, suggesting a potential mechanism for prostate cancer treatment.