To investigate the molecular characteristics and biofilm-forming ability of 116 Enterococcus faecium (Efm) and 72 Enterococcus faecalis (Efs) isolates obtained from patients with bloodstream infections (BSI) at a Chinese hospital between July 2011 and March 2018. The presence of glycopeptide resistance genes and five virulence genes (esp, gelE, asa1, hyl, and cylA) was screened using two multiplex PCR. MLST was used to assess the clonality. Crystal violet staining was used to detect biofilms. Vancomycin resistance was detected in 30.1% of Efm and 2.8% of Efs isolates, respectively. All VRE strains carried the vanA gene. The esp, gelE, asa1, and cylA genes in 72 Efs strains were detected at 62.5%, 84.7%, 84.7%, and 69.4%, respectively. Among the 116 Efm isolates, 74.1% and 25.8% carried esp and hyl, respectively. The esp gene was significantly associated with vancomycin-resistant Efm (VREfm) compared to vancomycin-susceptible Efm (VSEfm). In total, 91.7% of Efs and 20.0% of Efm produced biofilms. Twenty-six STs were identified among the 72 Efs isolates, with ST4 (29.2%) being the predominant. In total, 116 Efm strains were grouped into 26 STs, with ST78 (46.6%) being the predominant. Both VREfm (41.7%) and VSEfm (48.8%) were dominant in ST78. There is no clear evidence suggesting that some STs are associated with vancomycin resistance or biofilm formation. Both Efm and Efs BSI isolates showed a polyclonal pattern with a dominant clone and many unique types, implying the coexistence of clonal dissemination and an influx of new clones. The horizontal transmission of resistance genes may play a more important role in VREfm prevalence than clonal expansion.

Although alpha-fetoprotein (AFP) is a widely used tumor marker in hepatocellular carcinoma (HCC), 40% of newly diagnosed patients do not have an elevated AFP level. Research has revealed that mutations in the HNF1A binding site of the AFP gene promoter cause significantly elevated serum AFP levels in patients with hereditary persistence of AFP. This study investigated the relationship between HNF1A genetic variants and serum AFP levels. We examined the association between the HNF1A-rs1169288 (A/C), rs2464196 (G/A), and rs1169310 (C/T) polymorphisms and AFP levels in a healthy Chinese population (n=1010) and HCC patients (n=185). Single nucleotide polymorphisms were genotyped by the amplification refractory mutation system combined with TaqMan probe in real-time PCR. The serum AFP concentrations were measured using the Architect i2000 immunochemistry analyzer. In healthy individuals, serum AFP levels were significantly lower with the rs2464196-AA and rs1169310-TT genotypes. Similar significant differences were observed in HCC patients. Moreover, in HCC patients, the distribution frequencies of rs2464196-AA+AG and rs1169310-TT+TC among those withAFP≤20ng/mlor ≤400 ng/ml were significantly lower than those in patients withAFP>20ng/mlor >400 ng/ml. Among all subjects, those carrying the HNF1A-rs2464196-A or rs1169310-T allele tended to have low levels of AFP. However, the HNF1A-rs1169288 polymorphism showed no significant association with the serum AFP level. These findings provide new insight into the genetic determinants of serum AFP level and can aid the differential diagnosis of HCC patients with low serum AFP.

Purpose: This meta-analysis aimed to evaluate the comparative diagnostic efficacy of Syndecan-2(SDC2) and Septin-9(SEPT9) in the early detection of colorectal cancer (CRC).Methods: We searched PubMed, Embase, Web of Science, and Cochrane Library databases to identify available publications up to October 2024. A direct head-to-head comparator analysis were performed using the random-effects model. Subgroup analyses and corresponding meta-regressions focusing on sample source, number of patients, region, study design, and methylated detection methods were conducted. Intra-group and inter-group heterogeneity were assessed by Cochrane Q and I² statistics.Results: Eleven articles involving 1,913 CRC patients and 2,851 healthy people were included in the meta-analysis. The sensitivity of SDC2 was similar compared to SEPT9 for CRC patients (0.67 vs. 0.71, p = 0.61), SDC2 has a similar specificity in comparison to SEPT9 for CRC patients (0.90 vs. 0.91, p = 0.86). In subgroup analysis, stool SDC2 was similar compared to stool SEPT9 for CRC patients (sensitivity of 0.81 vs. 0.80, p = 0.92; specificity of 0.93 vs. 0.91, p = 0.73), plasma SDC2 was similar compared to plasma SEPT9 for CRC patients (sensitivity of 0.57 vs. 0.72, p = 0.27; specificity of 0.90 vs. 0.89, p = 0.89). In the subgroup analysis of clinical staging for colorectal cancer (CRC), the results indicate that there is no significant difference in sensitivity between the two markers for both early (0.7 vs. 0.67, p = 0.64) and advanced (0.76 vs. 0.70, p = 0.23) stages of CRC.Conclusion: In our head-to-head comparison meta-analysis, it was found that SDC2 and SEPT9 have similar sensitivity and specificity in the diagnosis of colorectal cancer. However, this result may be influenced by high heterogeneity and further confirmation of this finding is needed through large-scale prospective studies.

Candida auris is a globally disseminated invasive ascomycetous yeast, that imposes a substantial burden on healthcare systems. It has been documented to have spread to over 40 countries across six continents, necessitating in-depth comprehension through advanced techniques like Whole-Genome Sequencing. This study entailed the isolation and Whole-Genome Sequencing of a fluconazole-resistant C. auris strain (CA01) obtained from a patient's blood in Beijing. Genome analysis was conducted to classify the strain, and molecular docking was performed to understand the impact of mutations on drug resistance. Genome analysis revealed that CA01 belongs to the South Asia Clade (I) and shares the closest genetic relationship with previously reported strains BJCA001 and BJCA002. Notably, unlike BJCA001, CA01 exhibits significant resistance to fluconazole primarily due to the A395T mutation in the ERG11 gene. Molecular docking studies demonstrated that this mutation leads to geometric changes in the active site where fluconazole binds, resulting in decreased binding affinity. Additionally, the present findings have identified several core virulence genes in C. auris, such as RBF1. The findings from this study expand the understanding of the genetic diversity and adaptive mechanisms of C. auris within the South Asia Clade (I). The observed fluconazole resistance driven by the ERG11 mutation A395T highlights the need for heightened awareness and adaptation in clinical treatment strategies in China. This study provides critical insights into drug resistance and virulence profiles at a genetic level, which could guide future therapeutic and management strategies for C. auris infections.

Objective: To investigate the associations between longitudinal body roundness index (BRI) trajectories and the risk of incident diabetes mellitus (DM) using data from the China Health and Retirement Longitudinal Study (CHARLS). Methods: Group-based trajectory modeling (GBTM) identified distinct BRI trajectories (Waves 1–3, 2011–2016). Their associations with DM incidence (Wave 4, 2017–2018) were assessed using multivariate Cox models. The predictive performance of a single baseline BRI was compared with body mass index (BMI) and waist circumference (WC) via receiver operating characteristic ( ROC ) analysis. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) evaluated the incremental value of adding BRI trajectories to a conventional risk model. Subgroup and sensitivity analyses, including a landmark approach, assessed robustness. Results: Among 4,150 participants, 103 developed DM. Three stable BRI trajectories were identified: low-stable (49.0%), moderate-stable (41.3%), and high-stable (9.7%). Compared with the low-stable group, the high-stable group had a significantly increased DM risk with a fully-adjusted hazard ratio ( HR ) of 2.63 (95% confidence interval [ CI ]: 1.41–4.91). A single baseline BRI showed comparable discrimination to BMI and WC (AUC ≈ 0.63). Longitudinal trajectories of BRI, BMI, and WC all identified high-stable subgroups with elevated risk ( HR s: BRI = 2.63, BMI = 2.16, WC = 2.31), with overlapping confidence intervals. However, adding BRI trajectories to a conventional model significantly improved risk reclassification (NRI = 10.76%, 95% CI : 2.40–19.47) and discrimination (IDI = 0.27%, 95% CI : 0.03–0.52). Results were consistent across subgroups and sensitivity analyses. Conclusions: Sustained high BRI exposure, captured by longitudinal trajectory modeling, is independently associated with increased DM risk. While BRI trajectories were not statistically superior to BMI or WC trajectories, the longitudinal framework itself adds value over single-time-point assessments by more robustly identifying individuals with persistent high adiposity-related risk, highlighting the utility of monitoring long-term body shape stability for early risk stratification.

This study aims to preliminarily explore the advantages and potential issues of artificial intelligence in the teaching of blood cell morphology to undergraduate medical students, so as to provide theoretical support and practical experience for promoting the intelligent transformation of medical education. Undergraduate students from the 2021 cohort of the Aerospace School of Clinical Medicine at Peking University were assigned as the experimental group, while students from the 2020 cohort served as the control group. The experimental group utilized the AI platform to study blood cell morphology, whereas the control group relied on conventional teaching methods. We compared the accuracy rates of cell identification between two groups of students. Additionally, we conducted supplementary research through questionnaires, post-class interviews, and classroom observations. The experimental group achieved a significantly higher average score in cell identification (87.82 ± 9.63) compared to the control group (74.83 ± 12.41) (P<0.0001). The correct identification rates of metamyelocytes, eosinophils, and monocytes in the experimental group were significantly increased by over 30%. AI holds considerable promise in medical education, particularly in the instruction of hematology cell morphology. Nevertheless, further research is required. Traditional microscope-based teaching should not be completely dismissed, as current digital platforms for blood cells do not yet capture all cellular nuances.