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To investigate: 1) the demographics and clinical characteristics, 2) the findings, and 3) the safety and effectiveness in a cohort of Chinese pediatric patients undergoing colonoscopy. The study participants were consecutive patients aged ≤14 years old that underwent their first colonoscopy in the endoscopy center at the First Affiliated Hospital, Sun Yat-sen University between Jan. 1, 2001 and Dec. 31, 2012. Demographic, clinical, endoscopic, and pathological findings were collected. The cohort consisted of 322 patients, including 218 boys (67.7%) and 104 girls (32.3%). The median age was 8.0 years old and ranged from 9 months to 14 years old. Hematochezia (48.8%) and abdominal pain/discomfort (41.3%) were the most common presentations preceding pediatric colonoscopy. The caecal intubation success rate was 96.3%. No serious complications occurred during the procedures. A total of 227 patients (70.5%) received a positive diagnosis under endoscopy, including 138 patients with polyps and 53 patients with inflammatory bowel disease (IBD). Among the patients with polyps, 71.0% were juvenile polyps. Comparisons between years 2001-2006 and 2007-2012 showed that the IBD detection rate increased significantly (4.6% vs. 22.4%, P<0.001), while the opposite occurred for the polyp detection rate (73.1% vs. 27.6%, P<0.001). Colonoscopy in pediatric patients is a safe and effective procedure. Polyps are the primary finding during colonoscopy. In South China there has been an increase in pediatric patients diagnosed with IBD over the past decade. However, a large epidemiological study is needed to confirm our findings.

Purpose The purpose of this study is to estimate the detection rates of adenomas and serrated polyps and to identify proximalization and associate risk factors in patients from Southern China. Methods Consecutive patients undergoing colonoscopy from 2004 to 2013 in Guangzhou were included. The proportions of proximal adenomas to advanced adenomas and serrated polyps were compared and potential predictors were evaluated. Results Colonoscopies ( n  = 62,560) were performed, and 11,427 patients were diagnosed with polyps. Detection rates for adenomas, hyperplastic polyps, and serrated adenomas were 12.0, 2.5, and 0.2 patients per 100 colonoscopies. When comparing the 1st (2004–2008) to the 2nd period (2009–2013), adenoma and serrated polyp detection in proximal and distal colon both increased significantly (proximal colon [adenoma 3.9 vs. 6.1 patients/100 colonoscopies, P  < 0.001; serrated polyp 0.4 vs. 1.1 patients/100 colonoscopies, P  < 0.001]; distal colon [adenoma 6.6 vs. 7.2 patients/100 colonoscopies, P  = 0.003; serrated polyp 1.2 vs. 2.4 patients/100 colonoscopies, P  < 0.001]). Advanced adenoma detection increased over these two periods only in proximal colon (1st vs. 2nd period: 1.5 vs. 2.4 patients/100 colonoscopies, P  < 0.001), not the distal colon ( P  = 0.114). Multivariate analyses showed that diagnostic period was an independent predictor for adenoma proximalization (OR = 1.36, 95% CI 1.25–1.48, P  < 0.001), but not for advanced adenomas ( P  = 0.117) or serrated polyps ( P  = 0.928). Conclusions Adenomas and serrated polyps were increasingly detected throughout the colon, whereas advanced adenomas were only in proximal colon. A proximal shift tendency detected by colonoscopy was observed for adenomas, but not advanced adenomas or serrated polyps, in Southern China. The screening for proximal polyps should be emphasized and colonoscopy might be a preferred initial screening tool.

Background To date, it is not clarified whether patients with gastric polyps without any alarming symptoms for colorectal neoplasia need colonoscopy screening. The objective of this study is to prospectively determine the association between gastric polyps and colorectal neoplasia. Methods A multicenter prospective cross-sectional study was performed from July 2012 to December 2014. We compared patients with and without gastric polyps for prevalence of colorectal adenomas. The odds ratios (OR) were computed by logistic regression analysis after multivariable adjustments. Results Totally 1546 patients were included, with 770 patients in the gastric polyp group and 776 in the age- and sex- matched control group. Patients with gastric polyps had greater odds of having any colorectal adenoma (adjusted OR=2.34, 95% confidence interval [CI]: 1.79 to 3.06, p< 0.001) and advanced colorectal adenomas (adjusted OR=2.71, 95% CI: 1.74 to 4.23, p< 0.001) than those without. The positive association between gastric polyps and colorectal adenomas remained significant in both women (OR=2.34, 95% CI: 1.66 to 3.29, p< 0.001) and men (OR=1.87, 95% CI: 1.31 to 2.66, p=0.001). Patients over the age of 40 with gastric polyps had a higher prevalence of colorectal adenomas than those without (40-49yr: OR=1.81, 95% CI=1.02-3.21, p=0.04; 50-59yr: OR=1.88, 95% CI=1.26-2.81, p< 0.001; 60-74yr: OR=2.62, 95% CI=1.73-3.98, p< 0.001). Conclusions The presence of gastric polyps is significantly associated with a higher prevalence of colorectal adenomas, especially advanced colorectal adenomas. Colonoscopy might be considered in patients with gastric polyps, of any gender, and over the age of 40.

The main challenge in designing broadband achromatic metalenses is to achieve the desired phase distribution at different wavelengths and positions. Finding the exact relationship between phase modulation and the size or shape of individual nanopillars is a critical but time-consuming step. This paper presents a novel joint design framework predictive neural networks and particle swarm optimization-genetic algorithms, which combines predictive neural network (PNN) and particle swarm optimization-genetic algorithm (PSO-GA). The proposed framework aims to accurately predict the phase response of nanopillars using PNN, increase the number of phase data points to establish a one-to-one correspondence between the phase and nanopillar parameters in the design of broadband achromatic metalenses, and optimize the parameters of an individual nanostructure of the metalens using PSO-GA. To validate the efficacy of the proposed method, a broadband achromatic metalens for line polarization light in the range of 260–350 nm is designed. Numerical simulations demonstrate that the designed metalens exhibits achromatic focusing. The method proposed in this paper may find wider application in the design of more complex metasurface devices.

Objective To analyse the antibiotic resistance, resistance genes and clonal relationship of Escherichia coli in bloodstream infections in Ningxia from 2022 to 2023. Methods We retrospectively analyzed the antibiotic susceptibilities of 257 isolates. PCR was used to detect bla TEM , bla SHV , bla CTX−M , qnrS , qnrA , qnrB , oqxA , qepA , gyrA , gyrB , parC , and parE , and the clonal relationship through multilocus sequence typing (MLST). Results One hundred and twenty-nine of 257 patients were male (50.2%). The 257 E. coli isolates were mainly obtained from the Emergency, Hepatobiliary Surgery, and Haematology Departments, accounting for 56.6%, 7.3%, and 6.2%, respectively. There is no significant difference in sex and genes between the two groups over and under 60 years old ( P  > 0.05), but there is a significant difference in ST between them( P <0.05). The antimicrobial susceptibility testing showed that the 257 isolates had the highest rates of resistance to ampicillin (82.8%), followed by cefazolin (71.6%), and all isolates were susceptible to tigecycline. Based on the antibiotic susceptibility results for ceftriaxone, we tested 126 isolates of E. coli for extended-spectrum beta-lactamase (ESBL) resistance genes. As a result, bla CTX−M was detected in 76 isolates (60.32%), bla SHV in 26 isolates (20.63%), and bla TEM in 38 isolates (30.16%). Based on the ciprofloxacin and levofloxacin antibiotic susceptibility results, we tested for quinolone resistance genes in 148 isolates, revealing 66 isolates of aac(6')-Ib-cr (44.60%), 3 isolates of oqxA (2.02%), 32 isolates of qnrS (21.62%), and 2 isolates of qepA (1.35%). We did not detect qnrA or qnrB . The detection rates of gyrA , gyrB , parC , and parE were 98%, 42.6%, 91.2%, and 87.8%, respectively and the main amino acid mutations were Ser83 to Leu, Asp87 to Asn(75.2%), Leu417 to Ser, Ser418 to Leu (6.3%), Ser80 to Ile (65.2%), and Ser458 to Ala (21.5%), respectively. MLST revealed that the most common sequence types (STs) were ST69 (12.5%), ST131 (8.2%), and ST1193 (7.8%). Conclusion In our hospital, E. coli was resistant to most commonly used antibiotics, and cefoperazone/sulbactam, cefotetan, amikacin, and tigecycline were empirically selected for the treatment of bloodstream infections. The predominant ESBL genotype in our hospital was bla CTX−M and the major quinolone resistance gene was aac(6')-Ib-cr . Clonal relationship analysis revealed genetic diversity among the isolates.

This study aimed to create a visualized extreme gradient boosting (XGBOOST) model to distinguish prostatic carcinoma (PCA) from non-PCA using noninvasive prebiopsy parameters before biopsy. This was a cross-sectional study of 310 Chinese men who underwent prostate biopsy and were divided into PCA ( n  = 126) and non-PCA ( n  = 184) groups. The non-PCA patients were diagnosed with benign prostatic hyperplasia (BPH) based on biopsy results. The XGBOOST model was used to analyze 15 noninvasive prebiopsy parameters. The model performance was assessed by the area under the receiver operating characteristic curve (AUC) and compared with four other machine learning models (decision tree learning, lasso, neural network (NNET), and support vector machine (SVM)) and a logistic model. The logistic model identified serum thymidine kinase 1 (STK1p), total prostate-specific antigen (TPSA), and age as key prognostic factors. In the Lasso procedure, free prostate-specific antigen (FPSA) and free-to-total prostate-specific antigen (FTPSA) were also added to machine learning models. The XGBOOST model achieved an AUC of 0.965, which was significantly greater than those of other models (AUC = 0.708–0.817) and the logistic model (AUC = 0.813) ( P  < 0.001). The 49 decision trees generated by the XGBOOST model were visualized to aid in decision making. This study successfully developed a visualized XGBOOST model with high accuracy in differentiating PCA from non-PCA using eight noninvasive predictors. This model could aid in the precise selection of high-risk PCA patients for biopsy, potentially minimizing unnecessary procedures and their associated costs.

Objectives The continuous evolution of NDM variants, some of which exhibit enhanced hydrolytic activity, poses a serious public health threat and necessitates ongoing surveillance. This study aimed to investigate the clinical and molecular characteristics of Escherichia coli strains producing NDM-9 and NDM-13 variants. Methods Six bla NDM-9 -carrying and two bla NDM-13- carrying E. coli strains were isolated from six hospitals in China. MALDI-TOF MS and Vitek-2 systems were used for identification and antimicrobial susceptibility testing (AST). Phenotypic detection of carbapenemases was conducted using a combined disc test. Multi-locus sequence typing (MLST) was used to assess clonal relatedness among the eight E. coli isolates. Whole genome sequencing (WGS) and bioinformatics analysis were used to characterize the bla NDM-9 and bla NDM-13 -carrying strains. Phylogenetic trees and core SNP comparisons were generated using isolates from this study and publicly available sequences from the GenBank database. Conjugation experiments were performed to evaluate the horizontal transferability of bla NDM genes. Plasmid stability was assessed by serial passage for 10 days without antibiotic selection. Results All E. coli isolates exhibited a multiple drug resistance phenotype, but remained susceptible to amikacin and tigecycline. The E. coli types were diverse by MLST, including ST1 ( n  = 2), ST19 ( n  = 2), ST2 ( n  = 1), ST664 ( n  = 2), and one novel ST type. WGS analysis identified 41 and 49 resistance genes and virulence factor genes. The bla NDM-9 genes were carried by IncHI2-type plasmids ( n  = 4) or IncK2-type plasmids ( n  = 2), while all bla NDM-13 genes were exclusively carried by IncX3-type plasmids ( n  = 2). Both variants were associated with Tn 125 -related transposons. Phylogenetic analysis of core SNPs revealed that 52 E. coli strains (including 44 genome sequences from GenBank) were divided into six clustering clades with SNP differences ranging from 2 to 10,625. Two bla NDM-13 -carrying isolates differed by only two SNPs. Conjugation experiments confirmed the successful transfer of bla NDM-9 and bla NDM-13 to E. coli C600, and plasmids remained stable after 10 days of passage. Conclusions The detailed clinical and molecular characteristics of NDM-9 and NDM-13 producing CR-EC enhance our understanding of the evolution and dissemination of NDM variants. These insights highlight the further comprehensive surveillance to evaluate the public-health risk of NDM variants producing strains.

Ovarian cancer is a global problem, and is typically diagnosed in the middle or late stages, with a mysterious abdominal mass or atypical abdominal metastases due to the lack of specific initial diagnostic methods. Dual-modal near-infrared II (NIR-II, 1,000–1,700 nm) fluorescence/photoacoustic imaging has great potential in early ovarian cancer diagnosis and image-guided surgery due to its high sensitivity and deep penetration. Herein, we report a novel organic NIR-II dye (H10) with excellent aggregation-induced-emission (AIE) characteristics ( I/I 0 > 1.6) utilizing a selenadiazolo-[3,4-f]benzo[c][1,2,5]thiadiazole (ST)-based building block. Then, water-soluble and biocompatible H10@follicle-stimulating hormone (H10@FSH) dots with superior optical/photoacoustic properties and a tenfold increase in ovarian-specific targeting ability were synthesized. Finally, for the first time, in vivo dual-mode NIR-II fluorescent/photoacoustic (PA) imaging and image-guided surgery of patient-derived tumor xenograft (PDTX) and micro-metastatic abdominal ovarian cancer lesions were investigated. This novel strategy will establish a new method for early detection of ovarian cancer and significantly improve the prognosis of ovarian cancer patients.

A single-stage anaerobic ammonium oxidation (ANAMMOX) process with an integrated biofilm–activated sludge system was carried out in a laboratory-scale flow-through reactor (volume = 57.6 L) to treat pharmaceutical wastewater containing chlortetracycline. Partial nitrification was successfully achieved after 48 days of treatment with a nitrite accumulation of 70%. The activity of ammonia oxidizing bacteria (AOB) decreased when the chemical oxygen demand (COD) concentration of the influent was 3000 mg/L. When switching to the single-stage ANAMMOX operation, (T = 32–34 °C, DO = 0.4–0.8 mg/L, pH = 8.0–8.5), the total nitrogen (TN) removal loading rate and efficiency were 1.0 kg/m3/d and 75.2%, respectively, when the ammonium concentration of the influent was 287 ± 146 mg/L for 73 days. The findings of this study imply that single-stage ANAMMOX can achieve high nitrogen removal rates and effectively treat pharmaceutical wastewater with high concentrations of COD (1000 mg/L) and ammonium.