Stepwise Synthesis of Low-Symmetry Hexacationic Pyridinium Organic Cages.

An efficient approach was developed for the synthesis of the well-known BlueCage by pre-bridging two 2,4,6-tris(4-pyridyl)-1,3,5-triazine (TPT) panels with one linker followed by cage formation in a much improved yield and shortened reaction time. Such a stepwise methodology was further applied to synthesize three new pyridinium organic cages, C2, C3, and C4, where the low-symmetry cages C3 and C4 with angled panels demonstrated better recognition properties toward 1,1'-bi-2-naphthol (BINOL) than the high-symmetry analogue C2 featuring parallel platforms.

Characteristics of soil nitrogen and phosphorus fractions and microbial traits with increasing stand age in two-layered Cunninghumia lanceolata + Phoebe bournei plantations.

Soil nitrogen and phosphorus are two key elements limiting tree growth in subtropical areas. Understanding the regulation of soil microorganisms on nitrogen and phosphorus nutrition is beneficial to reveal maintenance mechanism of soil fertility in plantations. We analyzed the characteristics of soil nitrogen and phosphorus fractions, soil microbial community composition and function, and their relationship across three stands of two-layered Cunninghumia lanceolata + Phoebe bournei with different ages (4, 7 and 11 a) and the pure C. lanceolata plantation. The results showed that the contents of most soil phosphorus fractions increased with increasing two-layered stand age. The increase in active phosphorus fractions with increasing stand age was dominated by the inorganic phosphorus (9.9%-159.0%), while the stable phosphorus was dominated by the organic phosphorus (7.1%-328.4%). The content of soil inorganic and organic nitrogen also increased with increasing two-layered stand age, with NH4+-N and acid hydrolyzed ammonium N contents showing the strongest enhancement, by 152.9% and 80.2%, respectively. With the increase of stand age, the composition and functional groups of bacterial and fungal communities were significantly different, and the relative abundance of some dominant microbial genera (such as Acidothermus, Saitozyma and Mortierella) increased. The relative abundance of phosphorus solubilization and mineralization function genes, nitrogen nitrification function and aerobic ammonia oxidation function genes tended to increase. The functional taxa of fungi explained 48.9% variation of different phosphorus fractions. The conversion of pure plantations to two-layered mixed plantation affected soil phosphorus fractions transformation via changing the functional groups of saprophytes (litter saprophytes and soil saprophytes). Changes in fungal community composition explained 45.0% variation of different nitrogen fractions. Some key genera (e.g., Saitozyma and Mortierella) play a key role in promoting soil nitrogen transformation and accumulation. Therefore, the conversion of pure C. lanceolata plantation to two-layered C. lanceolata + P. bournei plantation was conducive to improving soil nitrogen and phosphorus availability. Bacteria and fungi played important roles in the transformation process of soil nitrogen and phosphorus forms, with greater contribution of soil fungi.

54 K Spin Transition Temperature Shift in a Fe6L4 Octahedral Cage Induced by Optimal Fitted Multiple Guests.

Spin-crossover (SCO) coordination cages are at the forefront of research for their potential in crafting next-generation molecular devices. However, due to the scarcity of SCO hosts and their own limited cavities, the interplay between the SCO host and the multiple guests binding has remained elusive. In this contribution, we present a family of pseudo-octahedral coordination cages (M6L4, M = ZnII, CoII, FeII, and NiII) assembled from a tritopic tridentate ligand L with metal ions. The utilization of FeII ion leads to the successful creation of the Fe6L4-type SCO cage. Host-guest studies of these M6L4 cages reveal their capacity to encapsulate four adamantine-based guests. Notably, the spin transition temperature T1/2 of Fe6L4 is dependent on the multiple guests encapsulated. The inclusion of adamantine yields an unprecedented T1/2 shift of 54 K, a record shift in guest-mediated SCO coordination cages to date. This drastic shift is ascribed to the synergistic effect of multiple guests coupled with their optimal fit within the host. Through a straightforward thermodynamic cycle, the binding affinities of the high-spin (HS) and low-spin (LS) states are separated from their apparent binding constant. This result indicates that the LS state has a stronger binding affinity for the multiple guests than the HS state. Exploring the SCO thermodynamics of host-guest complexes allows us to examine the optimal fit of multiple guests to the host cavity. This study reveals that the T1/2 of the SCO host can be manipulated by the encapsulation of multiple guests, and the SCO cage is an ideal candidate for determining the multiple guest fit.

The Effect of Dexmedetomidine as a Local Anesthetic Adjuvant for Iliac Fascia Compartment Block on Postoperative Delirium in Elderly Patients Undergoing Elective Hip Surgery.

INTRODUCTION: We analyzed the effect of dexmedetomidine (DEX) as a local anesthetic adjuvant on postoperative delirium (POD) in elderly patients undergoing elective hip surgery. METHODS: In this study, 120 patients undergoing hip surgery were enrolled and randomly assigned to two groups: fascia iliaca compartment block with DEX + ropivacaine (the Y group, n = 60) and fascia iliaca compartment block with ropivacaine (the R group, n = 60). The primary outcomes: presence of delirium during the postanesthesia care unit (PACU) period and on the first day (D1), the second day (D2), and the third day (D3) after surgery. The secondary outcomes: preoperative and postoperative C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), occurrence of insomnia on the preoperative day, day of operation, D1 and D2; HR values of patients in both groups before iliac fascia block (T1), 30 min after iliac fascia block (T2), at surgical incision (T3), 20 min after incision (T4), when they were transferred out of the operating room (T5) and after leaving the recovery room (T6) at each time point; VAS for T1, PACU, D1, D2; the number of patients requiring remedial analgesics within 24 h after blockade and related complications between the two groups. RESULTS: A total of 97 patients were included in the final analysis, with 11 and 12 patients withdrawing from the R and Y groups, respectively. The overall incidence of POD and its incidence in the PACU and ward were all lesser in the Y group than in the R group (p < 0.05). Additionally, fewer cases required remedial analgesia during the PACU period, and more vasoactive drugs were used for maintaining circulatory system stability in the Y group as compared to the R group (p < 0.05). At the same time, the incidence of intraoperative and postoperative bradycardia in the Y group was higher than that in the R group, accompanied by lower postoperative CRP and ESR (all p < 0.05). CONCLUSION: Ultrasound-guided high fascia iliaca compartment block with a combination of ropivacaine and DEX can reduce the incidence of POD, the use of intraoperative opioids and postoperative remedial analgesics, and postoperative inflammation in elderly patients who have undergone hip surgery, indicating that this method could be beneficial in the prevention and treatment of POD.

Two new megastigmane glycosides from the leaves of Nicotiana tabacum and their anti-inflammatory activities.

Two new megastigmane glycosides, (6 R,7E,9R)-3-oxo-α-ionyl-9-O-α-L-rhamnopyranosyl-(1''→4')-ß-D-glucopyranoside (1) and (6 R,7E,9R)-3-oxo-α-ionyl-9-O-ß-D-glucopyranosyl-(1''→6')-ß-D-glucopyranoside (2), together with six known analogues (3-8) were isolated from the leaves of Nicotiana tabacum. The structures of all metabolites were determined by comprehensive analysis of NMR and MS spectroscopic data as well as by comparison with those of previously reported. The in vitro anti-inflammatory activity of all isolates was evaluated using a lipopolysaccharide (LPS)-induced RAW264.7 cell inflammatory model, and the compounds 1, 3, 7, and 8 exhibited inhibition of LPS-induced NO production in RAW264.7 macrophage cells with IC50 values of 42.3-61.7 µM (positive control, dexamethasone, IC50 = 21.3 ± 1.2 µM).

Subtle adjustments for constructing multi-nuclear luminescent lanthanide organic polyhedra with triazole-based chelates.

Controlled self-assembly of predetermined multi-nuclear lanthanide organic polyhedra (LOPs) still presents a challenge, primarily due to the unpredictable coordination numbers and labile coordination geometries of lanthanide ions. In this study, through introducing triazole-based chelates to increase the chelating angle of C2-symmetric linear ligands and stabilize the coordination geometry of Eu(III) centers, M4L6-type (M = EuIII, L = ligand) tetrahedra were efficiently synthesized, especially a biphenyl-bridged ligand which is well known to form M2L3-type helicates. A series of LOPs were formed and characterized by high-resolution electrospray ionization time-of-flight mass spectroscopy (ESI-TOF-MS) and X-ray crystallography. Moreover, the europium complexes exhibit bright emission (luminescence quantum yield up to 42.4%) and circularly polarized luminescence properties (|glum| up to 4.5 × 10-2). This study provides a feasible strategy for constructing multi-nuclear luminescent LOPs towards potential applications.

Risk factors associated with postoperative delirium in elderly patients undergoing hip surgery.

Objective: We retrospectively analyzed the occurrence of postoperative delirium following hip surgery and the associated risk factors. The aim was to establish a clinical foundation for preventing postoperative delirium after hip surgery. Methods: We retrospectively selected elderly patients who had hip surgery at our hospital between January 2022 and August 2022. We included patients who experienced delirium in the observation group and those who did not encounter delirium in the control group. We then proceeded to compare various indicators among these two groups of patients. Results: We analyzed a total of 97 cases of hip surgery, and among them, 32 cases experienced postoperative delirium, resulting in an incidence rate of 32.9%. Various factors were found to be linked to the development of postoperative delirium, including age, height, gender (male), preoperative erythrocyte sedimentation rate (ESR), postoperative ESR, preoperative lactate levels, pain scores on the first day after surgery, type of surgical procedure, and the occurrence of delirium in the post-anesthesia care unit (PACU delirium). Additionally, it was observed that 75% of patients who had PACU delirium also experienced postoperative delirium. Conclusion: Postoperative delirium in patients who have hip surgery had an incidence rate of 32.9%. This phenomenon is linked to various factors that pose a risk, such as the patient age, height, gender, preoperative ESR levels, postoperative ESR levels, preoperative lactate levels, pain scores on the day following surgery, and the specific surgical procedure performed. The likelihood of experiencing delirium increases by 12% for every additional 10 years in patient age. Additionally, the occurrence of delirium in the PACU is a strong indicator of the likelihood of experiencing postoperative delirium.

Paeoniflorin, the Main Monomer Component of Paeonia lactiflora, Exhibits Anti-inflammatory Properties in Osteoarthritis Synovial Inflammation.

OBJECTIVE: To explore the mechanism of paeoniflorin (PF) on osteoarthritis (OA) synovial inflammation from network pharmacology to experimental pharmacology. METHODS: Targets of OA were constructed by detecting the database of network database platforms (Therapeutic Target database, DrugBank and GeneCards), and the targets of PF were constructed by PubChem and Herbal Ingredients' Targets database. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis of these co-targeted genes were conducted via Database for Annotation, Visualization, and Integrated Discovery (DAVID) database, and protein-protein interaction (PPI) networks were conducted via the search tool for the retrieval of interacting genes (STRING) database. Cell counting kit-8 (CCK-8) assay was performed to assess the potential toxicity of PF on human OA fibroblast-like synoviocytes (FLS), quantitative real-time polymerase chain reaction (qPCR), enzyme-linked immunosorbent assay (ELISA) and Western blot were used to verify the potential mechanism of PF in synovial inflammation. RESULTS: Twenty-six co-targeted genes were identified. GO enrichment results showed that these co-targeted genes were most likely localized in the cytoplasm, and the biological processes mainly involved 'cellular response to hypoxia' 'lipopolysaccharide (LPS)-mediated signaling pathway' and 'positive regulation of gene expression'. KEGG pathway analysis indicated that these co-targeted genes may function through pathways associated with 'hypoxia-inducible factor-1 (HIF-1) signaling pathway' and 'tumor-necrosis factor (TNF) signaling pathway'. The PPI network showed that the top 3 hub genes were TP53, TNF, and CASP3. Molecular docking results showed that PF was well docking with TNF. CCK-8 showed no potential toxicity of 10, 20 and 50 µmol/L PF on human OA FLS. And PF significantly decreased the expression levels of interleukin-1 ß, interleukin-6, TNF-α matrix metalloproteinase 13 (MMP13), and a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS5) and TNF-α in LPS-induced OA FLS. CONCLUSION: PF exhibited potent anti-inflammatory effect in OA synovial inflammation.

Excited-Multimer Mediated Supramolecular Upconversion on Multicomponent Lanthanide-Organic Assemblies.

Upconversion (UC) is a fascinating anti-Stokes-like optical process with promising applications in diverse fields. However, known UC mechanisms are mainly based on direct energy transfer between metal ions, which constrains the designability and tunability of the structures and properties. Here, we synthesize two types of Ln8L12-type (Ln for lanthanide ion; L for organic ligand L1 or L2R/S) lanthanide-organic complexes with assembly induced excited-multimer states. The Yb8(L2R/S)12 assembly exhibits upconverted multimer green fluorescence under 980 nm excitation through a cooperative sensitization process. Furthermore, upconverted red emission from Eu3+ on the heterometallic (Yb/Eu)8L12 assemblies is also realized via excited-multimer mediated energy relay. Our findings demonstrate a new strategy for designing UC materials, which is crucial for exploiting photofunctions of multicomponent lanthanide-organic complexes.

Acquired syphilis with flat condyloma in a 3 year-old girl: A case report.

The incidence of syphilis in young children is very low, with acquired syphilis exceptionally rare. A 3 year-old girl presented to our service with a reddish-brown rash on the external genitals and perianal area. The rash had been apparent for a period of 1 week. The girl was asymptomatic and had no history of sexual contact. Syphilis was suspected and the Treponema pallidum particle agglutination test (TPPA) was found to be positive, as well as the rapid plasma regin ring card test (RPR), with a titer of 1:64. The girl was diagnosed with toddler acquired secondary syphilis. The girl was cured after three treatments with penicillin. This report points out the need for clinicians to be aware of nonsexually transmitted syphilis, acquired in daily life by children without a history of sexual contact.

Counteranion-mediated efficient iodine capture in a hexacationic imidazolium organic cage enabled by multiple non-covalent interactions.

Developing efficient adsorbents to capture radioactive iodine produced from nuclear wastes is highly desired. Here we report the facial synthesis of a hexacationic imidazolium organic cage and its iodine adsorption properties. Crucial role of counteranions has been disclosed for iodine capture with this cage, where distinct iodine capture behaviors were observed when different counteranions were used. Mechanistic investigations, especially with the X-ray crystallographic analysis of the iodine-loaded sample, allowed the direct visualization of the iodine binding modes at the molecular level. A network of multiple non-covalent interactions including hydrogen bonds, halogen bonds, anion···π interactions, electrostatic interaction between polyiodides and the hexacationic skeleton of the cage are found responsible for the observed high iodine capture performance. Our results may provide an alternative strategy to design efficient iodine adsorbents.

Controlled Self-Assembly, Isomerism, and Guest Uptake/Release of Charge-Reversible Lanthanide-Organic Octahedral Cages.

Charge plays a crucial role in the function of molecular and supramolecular systems, but coordination hosts capable of orthogonal charge regulation remain elusive so far. In this study, we report the condition-dependent self-assembly of charge-reversible lanthanide-organic tetra-capped octahedral cages, i.e., [Ln6(H3L)4]6+ and [Ln6L4]6-, from a series of lanthanide ions (Ln3+; Ln = Lu, Yb, Eu) and a tritopic tetradentate acylhydrazone ligand (H6L) featuring multiple deprotonation states and propeller conformations. While direct self-assembly under basic conditions produced a mixture of various ΔxΛ6-x-[Ln6L4]6- (x = 0-6) stereoisomers, racemic Δ6- and Λ6-[Ln6L4]6- could be exclusively obtained from the first self-assembly of Δ6- and Λ6-[Ln6(H3L)4]6+ under neutral conditions followed by post-assembly deprotonation. Rich isomerism on the tetra-capped octahedral cages arising from the coupling between the metal-centered Δ/Λ chirality and the ligand conformations has been discussed based on X-ray single-crystal structures of the C3-symmetric Δ3Λ3-Ln6L4 and T-symmetric Δ6/Λ6-Ln6L4 complexes. Host-guest studies confirmed that positively charged rac-Δ6/Λ6-[Ln6(H3L)4]6+ could bind anionic sulfonates, and negatively charged rac-Δ6/Λ6-[Ln6L4]6- exhibited strong encapsulation ability toward ammonium guests, where acid/base-triggered guest uptake/release could be realized taking advantage of the charge reversibility of the cage. Moreover, photophysical studies revealed visible-light-sensitized and guest-encapsulation-enhanced NIR emissions on the rac-Δ6/Λ6-Yb6L4 cage. This work not only enriches the library of functional lanthanide-organic cages but also provides a promising candidate with charge reversibility for the development of smart supramolecular materials.

Self-Assembly of Triple-Stranded Lanthanide Molecular Quasi-Lantern Containing 2,2'-Bipyridine Receptor: Luminescence Sensing and Magnetic Property.

Ln2L3-type supramolecular architectures have received significant attention recently due to their unique magnetism and optical properties. Herein, we report the triple-stranded Ln2L3-type lanthanide molecular quasi-lanterns, which are fabricated by the deprotonation self-assembly of a linear ligand featuring a ß-diketone chelating claw and 2,2'-bipyridine (bpy) moiety with lanthanide ions (Ln = Eu3+ and Dy3+). The crystal structure analysis indicates that Eu3+ and Dy3+ ions are all coordinated by eight oxygen donors but in different coordination geometries. The eight oxygen donors in Eu2L3 and Dy2L3 are arranged in a square antiprism and triangular dodecahedron geometry, respectively. Taking into account the fact that the bpy moiety has a strong coordination affinity for transition metal ions, luminescence sensing toward Cu2+ ions has been demonstrated with Eu2L3, bearing a detection of limit as low as 2.84 ppb. The luminescence sensing behavior of Eu2L3 is ascribed to the formation host-guest complex between Eu2L3 and Cu2+ ions with a 1:2 binding ratio. Dynamic AC susceptibility measurements for Dy2L3 reveal the relaxation of magnetization in it. This work provides a potential way for design and fabrication of lanthanide-based molecular materials with functions endowed by the ligands.

Hierarchical subcomponent self-assembly of covalent triple-stranded complexes with 3d-4f vertices: luminescence and magnetic properties.

Well-defined 3d-4f heterometallic supramolecular architectures have attracted attention because of their applications in the field of luminescence and magnetism. However, covalent metallo-supramolecular discrete complexes, decorated with hetero-metallic vertices, have never been reported because of the difficulties in design and control. Herein, we report a series of covalent metallo-supramolecular discrete complexes with 3d-4f vertices synthesized by hierarchical subcomponent self-assembly of tris(2-aminoethyl)amine, 2,6-diformyl-p-cresol, and lanthanide ions (Ln) with different amines and transition metal ions. The programmable self-assembly process results in the formation of triple-stranded hetero-metallic covalent organic discrete complexes, namely 3a-3c-(Ln, Zn) (Ln = SmIII, EuIII, DyIII, YbIII and LuIII) and 3a'-(Dy, Co), which are characterized by nuclear magnetic resonance (NMR) analysis, electrospray ionization time-of-flight mass spectrometry (ESI-TOF-MS), and single-crystal X-ray analysis. Photophysical investigations disclose that the organic skeleton of 3a-(Ln, Zn) exhibits an excellent sensitizing ability toward SmIII, EuIII, and YbIII ions, displaying characteristic luminescence emission in both the visible and near-infrared (NIR) regions. AC susceptibility measurements of 3a'-(Dy, Co) reveal the frequency-independent performance under zero dc field, suggesting the absence of slow relaxation of magnetization. This work offers a new approach for the fabrication of discrete metallic covalent architectures with 3d-4f vertices.

A Pd4L2 cage containing Brønsted-base active sites for the one-pot photooxidation/Knoevenagel condensation reaction.

Brønsted-base active sites on a Pd4L2 cage facilitates enhanced catalytic efficiency, wide substrate scope and high turnover number (TON) for the one-pot photooxidation/Knoevenagel condensation reaction under mild conditions.

Dynamic Interconversion and Induced-Fit Guest Binding with Two Macrocycle-Based Coordination Cages.

We report the syntheses and host-guest chemistry of two interconvertible coordination cages, Pd2L2 and Pd1L1, from a dynamic macrocycle ligand (L) and a cis-blocking (tmen)Pd(NO3)2 (tmen = tetramethylethylenediamine) unit (Pd). The water-soluble macrocyclic L, which can bind various polycyclic aromatic hydrocarbon (PAH) guests in its cis-conformation, was constructed via four pyridinium bonds between two 2,4,6-tri(4-pyridyl)-1,3,5-triazine [TPT] panels and two p-xylene bridges. We selectively formed each cage either by changing the reaction concentration/solvent/temperature or through induced-fit guest encapsulation, while direct assembly of L and Pd resulted in a mixture of Pd2L2 and Pd1L1 in equilibrium. X-ray structures of the free ligand and the host-guest complexes confirmed the induce-fit adaptive changes in the ligand's conformation and the cage's cavity. This work demonstrates a useful strategy for designing multistimuli-responsive supramolecular hosts by coordination self-assembly with macrocyclic ligands featuring rich conformational freedom.

Combinatorial Coordination Self-Assembly for Organopalladium Cages with Fine-Tuned Structure and Function.

Discrete organopalladium coordination cages have shown great potential in applications ranging from molecular recognition and sensing, drug delivery to enzymatic catalysis. While many of the known organopalladium cages are homoleptic structures with regular polyhedral shapes and symmetric inner cavities, heteroleptic cages with complex architectures and new functions coming from their anisotropic cavities have received an increasing attention recently. In this concept article, we discuss a powerful combinatorial coordination self-assembly strategy toward the construction of a family of organopalladium cages, including both homoleptic and heteroleptic ones, from a given library of ligands. Within such a cage family, the heteroleptic cages often feature systematically fine-tuned structures and emergent properties, distinct from their parent homoleptic counterparts. We hope the concepts and examples provided in this article can offer some rational guidance for the design of new coordination cages toward advanced functions.

Embedding Lanthanide Organic Polyhedra into Mesoporous Silica Nanoparticles for the Photocatalytic Degradation of Organic Dyes.

Organic pollutants cause severe environmental problems because of their damage to human health and ecological systems. Photocatalytic degradation of persistent organic pollutants is of great importance to address these hazards. Herein, we report a lanthanide organic polyhedra-based hybrid material Gd8 L12 ⊂MSN with the capability of photocatalytic dye degradation. Gd8 L12 ⊂MSN was prepared by embedding the Gd8 L12 complex into mesoporous silica nanoparticles (MSNs) using a "ship-in-a-bottle" strategy. Photocurrent response tests revealed that this hybrid material is a potential semiconductor and could generate a rapid and steady photocurrent upon irradiation. Further dye degradation experiments indicated that it could photocatalyze the degradation of familiar organic dyes. Thereinto, compared with the critical Gd8 L12 complex, the hybrid material exhibited an acceleration of 2.4 times and realized reusability. This not only offers a potential advanced photocatalyst for degrading persistent organic pollutants, but also provides a strategy for the application of supramolecular materials in environmental science.

Study on the features of Clostridioides difficile infection among diarrhea patients in Kunming from 2018 to 2020 / 中华流行病学杂志

Objective: We analyze the characteristics of Clostridioides difficile (C. difficile) infection among diarrhea patients in Kunming from 2018 to 2020 and provide evidence for follow-up surveillance and prevention. Methods: A total of 388 fecal samples of diarrhea patients from four sentinel hospitals in Yunnan Province from 2018 to 2020 were collected. Real-time quantitative PCR was used to detect the fecal toxin genes of C. difficile. The positive fecal samples isolated the bacteria, and isolates were identified by mass spectrometry. The genomic DNA of the strains was extracted for multi-locus sequence typing (MLST). The fecal toxin, strain isolation, and clinical patient characteristics, including co-infection with other pathogens, were analyzed. Results: Among the 388 fecal samples, 47 samples with positive reference genes of C. difficile were positive, with a total positive rate of 12.11%. There were 4 (8.51%) non-toxigenic and 43 (91.49%) toxigenic ones. A total of 18 strains C. difficile were isolated from 47 positive specimens, and the isolation rate of positive specimens was 38.30%. Among them, 14 strains were positive for tcdA, tcdB, tcdC, tcdR, and tcdE. All 18 strains of C. difficile were negative for binary toxins. The MLST results showed 10 sequence types (ST), including 5 strains of ST37, accounting for 27.78%; 2 strains of ST129, ST3, ST54, and ST2, respectively; and 1 strain of ST35, ST532, ST48, ST27, and ST39, respectively. Fecal toxin gene positive (tcdB+) results were statistically associated with the patient's age group and with or without fever before the visit; positive isolates were only statistically associated with the patient's age group. In addition, some C. difficile patients have co-infection with other diarrhea-related viruses. Conclusions: The infection of C. difficile in diarrhea patients in Kunming is mostly toxigenic strains, and the high diversity of strains was identified using the MLST method. Therefore, the surveillance and prevention of C. difficile should be strengthened.