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Background The comprehensive impact of human papillomavirus (HPV) infection on reproductive tract inflammation and adverse pregnancy outcomes among women of reproductive age has not been fully investigated. Methods A retrospective cohort study was conducted among women presenting to the gynecological departments of specialized women’s hospitals in Ningbo, China, between 2016 and 2020. A total of 6506 women, with an average age of 28.7 years, who had undergone HPV testing and genotyping were included in the study. Results Overall, the most prevalent HPV types were HPV 52 (25.8%), HPV 16 (17.9%), and HPV 58 (7.7%). Vaginitis and cervicitis were significantly more prevalent in women with high-risk HPV (HR-HPV) compared to those with low-risk HPV(LR-HPV) (9.0% vs. 4.7%; 10.8% vs.7.1%; P  < 0.05). Moreover, the incidence of cervicitis in patients with persistent HPV infection for more than two years was significantly higher than in those with HPV infection for one year (21.8% vs. 11.8%; P  < 0.05). Pregnant women with HR-HPV infection had a significantly increased risk of miscarriage (9.7% vs. 6.1%; P  < 0.05). Our cross-sectional analysis of potential risk factors for HPV infection during pregnancy revealed that higher pregnancy glucose levels (prevalence, 4.23%; OR, 1.10; 95% CI, 1.10–1.20; P  < 0.05) significantly increased the risk of HPV infection. Women with persistent HR-HPV infection had a significantly higher risk of reproductive tract inflammation and adverse pregnancy outcomes. The analysis revealed significant associations between HPV infection and several pregnancy outcomes, including an increased risk of miscarriage, reduced live birth rate, and a higher cesarean section rate. Conclusions This highlights the need to monitor gestational glucose levels, reproductive tract inflammation, and HPV infection to reduce the risk of adverse pregnancy outcomes among pregnant women.

Objective We aimed to evaluate the heterogeneity of gestational diabetes mellitus (GDM) patients diagnosed with various screening criteria. Methods We stratified pregnant women using consecutive fasting plasma glucose (FPG) and 2-hour postprandial plasma glucose (2hPPG) intervals of 0.2 mmol/L. The incidence of abnormal neonatal birthweight and birth-related adverse outcomes was compared with that of pregnant women without GDM. Results The study included 39,988 pregnant women (18–45 years, mean [SD], 31.5 [4.7] years) in Ningbo, China. The means (SDs) of FPG and 2hPPG within 24–28 weeks of gestation were 4.5 (0.5) and 6.8 (1.3) mmol/L, respectively. A total of 3025 (7.6%) women had 5.1–6.9 mmol/L FPG and 4560 (11.4%) had 8.5 – 11.0 mmol/L 2hPPG. The incidence of GDM according to the two combination criteria was 17.3% (6908 cases). The relative risk (RR) for < 10th percentile birthweight (< 10th WT) was 0.82 (95% CI, 0.74 – 0.91, p  < 0.001) by 5.1 mmol/L FPG criterion and 1.14 (95% CI, 1.06 – 1.23, p  < 0.001) by 8.5 mmol/L 2hPPG criterion, while the RRs for > 90th percentile birthweight (> 90th WT) were 1.48 (95% CI, 1.35 – 1.63, p  < 0.001) and 0.95 (95% CI, 0.86 – 1.04, p  = 0.29) according to the corresponding criteria. The FPG criterion was more strongly associated with maternal hypertension than the 2hPPG criterion. Both criteria did not show a distinct association with other composite adverse outcomes. Conclusion High FPG is significantly associated with high birth weight, whereas high 2hPPG is slightly associated with low birth weight. Our findings highlight the heterogeneity of patients with GDM diagnosed by different criteria.

Background Since long COVID has hindered people from normal life, it is essential to understand its full spectrum of manifestation. However, it was heterogeneous in the existing studies and few large-scale studies have been conducted on Asian populations. Here, we conducted a multi-centre questionnaire-based study among Chinese people to explore the long COVID based on the definition of WHO. Methods During March 20, 2023 and June 18, 2023, individuals with a history of confirmed or self-reported SARS-CoV-2 infection were recruited from three hospitals to fill out the questionnaire for long COVID. Each symptom was assigned with 0 to 3 points based on their severity. And the long COVID score was a sum of these points of each symptom. The reporting rate, time trend and risk factors of long COVID stratified by different systems were explored. Results 3,693 individuals were recruited for the study. The reporting rate of at least one persistent long COVID symptoms and symptoms impacting daily life was 30.2% (1,117) and 10.7% (394). Systemic symptoms (20.7%, 765) were most easily reported. The most common symptoms were fatigue (16.3%, 602), cough (6.3%, 234) and expectoration (5.5%, 203). The reporting rate of long COVID and long COVID score decreased over time during a 180-day follow-up period ( P  < 0.05). For long COVID, older age (OR: 1.63, 1.38–1.93), female (OR: 1.19, 1.03–1.38) and SARS-CoV-2 reinfection (OR: 3.56, 2.63–4.80) were risk factors; while number of COVID-19 vaccine doses (OR: 0.87, 0.81–0.94) was a protective factor. The use of traditional Chinese medicine (OR: 0.51, 0.37–0.71) was a protective factor for symptoms impacting daily life. Conclusions Early interventions should be taken to minimize the impact of long COVID, especially for the elderly, females and those with SARS-CoV-2 reinfection. COVID-19 booster vaccination might play a potential role in minimizing the impact of long COVID.

The overweight and obese population experiences a higher occurrence of both hyperuricemia and metabolic syndrome. The present study was to explore the relationship between serum uric acid and metabolic syndrome-related risk factors among 409 obese Chinese adults (254 women and 155 men) with >24 kg/m2 BMI. Based on sex-specific reference ranges, 233 (57%) patients showed elevated serum uric acid. A total of 15 attributes were selected to assess the associations between elevated serum uric acid and components of metabolic syndrome, including serum uric acid, total cholesterol, HDL-C, LDL-C, triglyceride, systolic blood pressure, fasting blood glucose, glycosylated hemoglobin, HOMA-IR, alanine aminotransferase, creatinine, urine microalbumin, muscle mass amount, BMI, and age. Among the participants stratified into three groups of grade I, grade II, and grade III obesity, as well as among the participants stratified into male and female groups, univariate correlation analysis identified a negative association (P<0.01) for age, positive associations (P<0.01) for BMI, muscle mass, alanine aminotransferase, and creatinine. The stepwise multivariate logistic regression proved similar associations for age, BMI, creatinine, and alanine aminotransferase. No significant associations were testified between serum uric acid levels and cholesterol, HDL-C, LDL-C, triglyceride, fasting blood glucose, glycosylated hemoglobin, HOMA-IR, and urine microalbumin. Factor analysis illustrated that 15 attributes could be grouped into two common factors and five individual factors. A common underlying factor was identified among uric acid, muscle mass, creatinine, alanine aminotransferase, and BMI. The results indicate that serum uric acid has no apparent association with metabolic syndromes that are commonly characterized by hypertension, dyslipidemia, and T2DM.

BackgroundThe viral persistence in patients with Coronavirus Disease 2019 (COVID-19) remains to be investigated.MethodsWe investigated the viral loads, therapies, clinical features, and immune responses in a 70-year patient tested positive for SARS-CoV-2 for 3 months.FindingsThe patient exhibited the highest prevalence of abnormal indices of clinical features and immune responses at the first admission, including fever (38.3 ℃), decreased lymphocytes (0.83 × 109/L) and serum potassium (3.1 mmol/L), as well as elevated serum creatinine (115 µmol/L), urea (8.6 mmol/L), and C-reactive protein (80 mg/L). By contrast, at the second and the third admission, these indices were all normal. Through three admissions, IL-2 increased from 0.14 pg/mL, 0.69 pg/mL, to 0.91 pg/mL, while IL-6 decreased from 11.78 pg/mL, 1.52 pg/mL, to 0.69 pg/mL, so did IL-10 from 5.13 pg/mL, 1.85 pg/mL, to 1.75 pg/mL. The steady declining trend was also found in TNF-α (1.49, 1.15, and 0.85 pg/mL) and IFN-γ (0.64, 0.42, and 0.27 pg/mL). The threshold cycle values of RT-PCR were 26.1, 30.5, and 23.5 for ORFlab gene, and 26.2, 30.6, and 22.7 for N gene, showing the patient had higher viral loads at the first and the third admission than during the middle term of the disease. The patient also showed substantially improved acute exudative lesions on the chest CT scanning images.ConclusionsThe patient displayed declining immune responses in spite of the viral shedding for 3 months. We inferred the declining immune responses might result from the segregation of the virus from the immune system.

Lateral flow assay (LFA) has demonstrated high sensitivity and specificity for diagnosing cryptococcosis. However, its role in predicting therapeutic efficacy for pulmonary cryptococcosis (PC) remains underexplored. We conducted a retrospective analysis of HIV-negative patients with PC to describe the clinical profile and identify potential predictors of radiological prognosis. All the 168 participants received antifungal therapy with a triazole agent. Of these, 84.5% experienced partial or complete absorption of pulmonary lesions. The results of the gamma test, chi-square trend test, and ordinal logistic regression all indicated that both baseline LFA and changes in LFA after treatment were significant predictors of imaging prognosis. The degree of radiological improvement was inversely associated with the baseline LFA positive grade(P for linear-by-linear association: 0.011, Spearman correlation coefficient = -0.17; γ= -0.368, P = 0.045). Patients with a decrease in LFA after therapy had significantly better radiological outcomes compared to those with equal or increased LFA(linear-by-linear association, P = 0.014, Spearman correlation coefficient = 0.188; γ = 0.371, P = 0.012). Additionally, favorable outcomes were more likely in patients with lesions confined to the right lung. LFA shows potential of monitoring radiological outcomes in pulmonary cryptococcosis.

Background Fluoroquinolone resistance and ESBL-production are concurrently found in a limited number of Salmonella serotypes. The present study was aimed to characterize fluoroquinolone-resistant and ESBL-producing Salmonella enteric serotype Derby ( S . Derby) isolates in terms of antimicrobial susceptibility, relevant genetic mechanisms, and PFGE. Results From 2013 to 2017 in Ningbo China, 52  S. Derby isolates were identified out of 826 non-typhoidal Salmonella isolates from patient feces, food, and environmental water samples. Three S. derby isolates were identified to be fluoroquinolone-resistant and ESBL-producing with cefotaxime MIC of 64 μg/mL and ciprofloxacin MIC of 4 μg/mL. The three isolates contained the same genetic structure of quinolone resistance, including a silent gyrA mutation S (TCC) 83S (TCT) and three PMQR genes qnrB , qnrS and aac(6′)-Ib-cr . As withβ-lactams resistance mechanisms, two isolates contained bla TEM , bla OXA , and bla CTX-M genes and one isolate contained bla OXA and bla CTX-M genes. Additionally, two isolates displayed more identical PFGE pattern than the third isolate, whereas three isolates showed the same plasmid profile of I1, W and P by PCR-based replicon typing . The conjugation experiment showed no dissemination of β-lactam resistance by direct contact among isolates; the transformation experiment failed to transfer plasmid conferring ampicillin resistance to E. coli DH5a. Conclusion The present study demonstrates the emerging fluoroquinolone-resistant and ESBL-producing S. Derby in both humans and the environment. Seeing that S. Derby has become one of the most common Salmonella serotypes, this situation gives rise to a new major risk of food-borne diseases.

Cryptococcosis is an invasive fungal disease with increased morbidity in China over the past two decades. Cryptococci can infect immunocompromised hosts as well as immunocompetent ones. In this study, we reviewed data of 71 inpatients with cryptococcosis at Ningbo First Hospital from May 2010 to May 2020 and compared the clinical profiles of pulmonary cryptococcosis (PC) and extrapulmonary cryptococcosis (EPC). Of 71 patients (38 males, 33 females), 70 were non-HIV. The annual inpatient population increased dramatically, especially in the PC group. PC was confirmed in 77.46% (55/71) of cases by pathology. The rest were EPC including intracranial infection (15.49%, 11/71) and cryptococcemia (7.04%, 5/71). Compared with PC, a larger proportion of EPC patients were found to have immunocompromised conditions judged by predisposing factors ( p  < 0.01), or detectable humoral or cellular immunodeficiency. Fever and headache were more common in EPC patients ( p  < 0.001). Patients with EPC had lower serum sodium level ( p  = 0.041), lower monocyte counts ( p  = 0.025) and higher C-reactive protein ( p  = 0.012). In our study, the sensitivity of cryptococcus antigen detection for EPC was 100% regardless of sample type, while serum lateral flow assay (LFA) tested negative in 25% (5/20) of PC. Immunocompromised hosts are more likely to suffer from EPC than PC.

In this study, we synthesized polyacrylic acid (PAA)-Ca (Eu) nanoclusters as a luminescence sensor of phosphate ion by a complex method, and we aimed to achieve the quantitative detection of PO43− based on the sensitivity of the charge transfer band of Eu3+ to anionic ligand. The resulting PAA-Ca(Eu) nanoclusters showed a well-dispersed and a dot-like morphology, with an ultra-small diameter (the average size of 2.17 nm) under high resolution transmission electron microscopy(HRTEM) observation. A dynamic light scattering particle size analyzer (DLS) showed a hydrodynamic size of 2.39 nm. The (PAA)-Ca (Eu) nanoclusters as a luminescence sensor showed a significantly higher sensitivity for PO43− than other anions (CO32−, SiO32−, SO42−, SO32−, Br−, Cl−, F−). The luminescence intensity displayed a linear increase (y = 19.32x + 74.75, R2 > 0.999) in a PO43 concentration range (0–10 mM) with the concentration of PO43− increase, and the limit of detection was 0.023 mM. The results showed good recovery rates and low relative standard deviations. These (PAA)-Ca (Eu) nanoclusters are hopeful to become a luminescence sensor for quantitatively detecting PO43−.

Cryptococcosis is the second most common invasive yeast infection in China. Pulmonary cryptococcosis (PC) is difficult to diagnose due to the lack of specific clinical features and the limitation of diagnostic techniques. Although lateral flow assay was very useful in diagnosing cryptococcal infection, quite a few patients with PC presented negative serum lateral flow assay (sLFA). We conducted a retrospective study of HIV-negative patients who were diagnosed with PC in our hospital over the past decade to explore the potential relationship between the clinical profiles and sLFA in PC. In total, 112 patients with sLFA tested were enrolled in this study, of which 58.93% were male. The positivity rate of sLFA for PC was 91.07%. The extent of pulmonary lesions was positively correlated with sLFA grade (Spearman  = 0.268,  < 0.01). Solitary nodule (SN) and pneumonia were the most common imaging findings in PC with negative and positive sLFA respectively. Among 65 symptomatic PC patients, 14 presented with fever and had higher hypersensitive C-reactive protein (hsCRP) level and more extensive pulmonary involvement (Mann-Whitney U test,  < 0.05) than those without fever. Symptomatic PC patients were more likely to have positive results of sLFA (Mann-Whitney U test,  = 0.05) compared against asymptomatic ones. In conclusion, negative sLFA cannot exclude PC in patients with a solitary nodule in lung. Positive sLFA is more reliable in diagnosing PC in symptomatic patients with diffused lesions in lung who generally experience a more severe systemic inflammatory reaction.