成功大学医院

Hepatitis B virus (HBV) infection can lead to hepatocellular carcinoma, and HBV integration into the host genome is regularly observed in the liver of chronic HBV carriers and is speculated to trigger carcinogenesis. To detect HBV integration, PCR-based methods are sensitive but may not be effective depending on the HBV integration site. High-throughput sequencing reveals not only HBV integration but also the site. However, it is still expensive for clinical applications. In situ hybridization is efficient and allows detection of DNA and RNA in single cells and has been applied to study HBV infection and dynamics. The technique, however, has not been applied to detect HBV integration. The task is challenging because of the small copy number of integrated HBV genomes, which results in a small signal-to-noise ratio. Here, we developed a fluorescence in situ hybridization approach for examining HBV integration in each liver cell. The obtained images of cells were analyzed using a deep learning model. Using several hepatoma cell lines with and without integrated HBV DNA, we showed that our trained neural network achieved an over 90% accuracy for majority of positive and negative control cells. This is the first proof-of-concept study showing that fluorescence imaging and deep learning are useful in detecting HBV integration at the single-cell level.

The superficial cerebral venous system demonstrates considerable anatomical variability. The inferior anastomotic vein, or vein of Labbé (VOL), is a key anastomotic channel between the superficial middle cerebral veins and the transverse sinus. However, the morphological characteristics of the VOL remain inadequately defined, particularly in East Asian populations. This study aimed to systematically analyze the angioarchitecture of the VOL. The VOL was evaluated using three-dimensional (3D) reconstructions derived from gadolinium-enhanced 3D T1-weighted turbo spin-echo sequences and validated against digital subtraction angiography (DSA). Key anatomical parameters – including number, diameter, lateralization, drainage entry points, and the relationship with the superior anastomotic vein – were assessed in 200 cerebral hemispheres from 100 healthy individuals (50 males, 50 females). In the validation cohort (n = 20 hemispheres), 3D MRA demonstrated high concordance with DSA in identifying VOL anatomy and diameter. Among all 200 hemispheres analyzed, VOL duplication was identified in 2

Background: Due to advances in arthroscopic rotator cuff repair, a knotless suture anchor is expected to hold more than two suture limbs. The objective of this study is to investigate whether when employing different fixation mechanisms, the suture-holding strength of knotless anchors are altered by the number of loaded sutures. Objectives: To evaluate the impact of different fixation mechanisms on the suture-holding strength of knotless anchors when varying the number of loaded sutures. Materials and Methods: Three types of knotless anchors (spiral core clamping, winged clamping, and spooling) were tested, with each anchor double-loaded or quadruple-loaded. Cyclic loading was applied, followed by a tensile load until failure. Clinical failure load was defined by 3 mm slippage. A two-way ANOVA was performed to examine the effects of suture anchors and suture number. Results: The two-way ANOVA revealed a significant interaction between the type of suture anchor and the number of sutures (P < 0.001). Specifically, increasing the number of sutures enhanced the suture-holding strength for the spiral core clamping anchor and the winged clamping anchor (P < 0.001 for both). Conversely, the spooling anchor did not show any improvement in suture-holding strength with an increased number of sutures. Conclusions: The suture-holding strength of knotless suture anchors is influenced by the number of loaded sutures, with quadruple-loaded spiral core and winged clamping anchors outperforming double-loaded ones, while the spooling anchor shows no improvement.

OBJECTIVES:To evaluate cefiderocol (FDC) activity against carbapenem-resistant Enterobacterales (CRE) globally, characterize the β-lactamase gene profiles of non-susceptible isolates by metallo-β-lactamase status, and assess alternative agents. METHODS:Cefiderocol minimum inhibitory concentrations for 1657 CRE isolates from the 2024 Antimicrobial Testing Leadership and Surveillance programme were determined by broth microdilution. Isolates underwent molecular screening for carbapenemase, extended-spectrum β-lactamase, and AmpC genes. Between-group differences were assessed using odds ratios (ORs) with Fisher's exact tests. RESULTS:Overall FDC susceptibility rate was 93.1% by Clinical and Laboratory Standards Institute and 80.7% by EUCAST criteria, respectively. Non-susceptibility varied substantially by genus: Escherichia spp. 25.3%, Providencia spp. 14.0%, Enterobacter spp. 12.5%, and Klebsiella spp. 3.5%. FDC non-susceptibility rates revealed further heterogeneity within genera; notably, Enterobacter cloacae (23.1%) and Enterobacter kobei (50.0%) had substantially higher non-susceptibility than Enterobacter hormaechei (7.2%), and Providencia rettgeri (22.2%) exceeded Providencia stuartii (8.0%). Asia had the highest unadjusted non-susceptibility rate (10.5%; OR 4.73, P = 0.002); however, in a multivariable logistic regression adjusting for genus, age, and specimen source, genus was the dominant independent predictor (Escherichia spp. adjusted OR 8.21, 95% confidence interval 4.75-14.17), and the Asia effect was attenuated to a non-significant trend (adjusted OR 3.99, 0.93-17.14, P = 0.063). Among 115 non-susceptible isolates, 51 (44.3%) were metallo-β-lactamase-positive, predominantly blaNDM (94.1%), with high extended-spectrum β-lactamase co-carriage (blaCTX-M 74.5%), while 50 (43.5%) harboured no identifiable carbapenemase gene. CONCLUSIONS:FDC remains active against most CRE globally, although non-susceptibility varies by genus, species and region. Notably, nearly half of non-susceptible isolates lacked detectable carbapenemase genes.