Objective To establish a three-dimensional digitized visible model to meet the clinical and research needs.Methods The head of the volunteer was scanned by a cone beam CT (CBCT).The bone tissue,the facial soft tissue and the teeth were extracted from the cone beam CT raw data according to the different Houns field values.The 3D digital craniofacial model was reconstructed from the three tissues extracted from the CBCT original data.The 3D dental model with high resolution was acquired by scanning the dental cast with the laser scanner.The 3D facial model with texture was acquired by scanning the volunteer's face directly by other laser scanner.With the regis tration algorithm in 3D graphics,the 3D facial model with texture and the 3D dental model with high resolution were transformed to the same coordinate which was of the 3D digital craniofacial model.Results We acquired a complicated 3D craniofacial digital model which combined the teeth model with high resolution,the bone model and the face model with texture.Conclusions The method is able to accurately establish the craniofacial digital model.

Objective To explore skeletal‐related events (SREs) clinical factors and analysis prognosis factors on patients with non‐small cell lung cancer(NSCLC) with bone metastases .Methods We collected clinical data of pathology confirmed 383 patients with non‐small cell lung cancer between April 2007 and January 2007 in the third affiliated hospital of the third military medical uni‐versity .It was used to screening for Emission Computed Tomography (ECT ) for bone metastases .And then it was need to con‐firmed for CT ,MRI or PET‐CT or pathology .Statistics in patients between clinical features and the SREs prediction factor with Univariate and Multivariate .And Kaplan‐Meier method analysis of survival in the non‐small cell lung cancer patients with bone me‐tastases .Results Out of 383 patients with bone metastases ,178 patients with SREs .The incidence was 46 .5% .Univariate analysis showed that women ,adenocarcinoma ,never smoking history ,single bone metastases ,bisphosphonate therapy ,targeted therapy in patients with bone metastases are less likely to have SREs ,it was considered statistically significant (P<0 .05) .Multivariate analy‐sis showed multiple bone metastases and no bisphosphonate therapy is independent risk factors for SREs .Median survival time was 14 .5 months in non‐small cell lung cancer patients with bone metastases ,1 year survival rate was 46 .5% ,2 years survival rate was 15 .9% .The survival analysis shows that more bisphosphonate treatment and bisphosphonate with EGFR‐TKI therapy on the prog‐nosis of patients with statistically significance (P<0 .05) .Conclusion It was likely to occur SREs in NSCLC patients with bone metastases .No bisphosphonate and multiple bone metastases are independent risk factors for SREs .Bisphosphonate treatment may prevent or reduce occur SREs for NSCLC patients with bone metastases ,and it may prolong survival ,it speculated that bisphospho‐nate may have resistant NSCLC cell activity .

OBJECTIVETo investigate the effect of IL-12 on IFN-gamma and IL-10 production of peripheral blood mononuclear cells (PBMC) in chronic hepatitis B virus infection patients during IFN-alpha treatment.

METHODSBefore and after IFN-alpha treatment of 3 months and 6 months, PBMC of 20 patients with chronic hepatitis B virus infection were collected and cultured in vitro in the culture fluid containing PHA (100 microg/ml), HBcAg (1 microg/ml), or HBeAg (1 microg/ml) for 48 h under the condition of the presence or absence of IL-12 (10 ng/ml). Then the levels of IFN-gamma and IL-10 were determined by ELISA.

RESULTSThere were 12 responders and 8 nonresponders to IFN-alpha treatment. In the responders, the enhancing effect of IL-12 on IFN-gamma production was significantly greater after IFN-alpha treatment than before the treatment. The production of IL-10 was suppressed in the presence of IL-12 after 3 months and 6 months of IFN-alpha treatment. In the same treatment time, the level of IFN-gamma in the presence of IL-12 was significantly higher than that in the absence of IL-12. To the nonresponders, the enhancing effect of IL-12 on IFN-gamma production was also significantly increased after IFN-alpha treatment. Moreover, in the same treatment time, the level of IFN-gamma in the presence of IL-12 was significantly higher than that in the absence of IL-12.

CONCLUSIONSThe enhancing effect of IL-12 on IFN-gamma production of PBMC in patients with chronic hepatitis B virus infection is increased during IFN-alpha treatment. IFN-alpha and IL-12 may enhance the efficacy for the treatment of chronic hepatitis B virus infection.

Adolescent ; Adult ; Antiviral Agents ; therapeutic use ; Enzyme-Linked Immunosorbent Assay ; Female ; Hepatitis B, Chronic ; blood ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Interferon-gamma ; metabolism ; Interleukin-10 ; metabolism ; Interleukin-12 ; pharmacology ; Leukocytes, Mononuclear ; cytology ; drug effects ; metabolism ; Male ; Middle Aged ; Time Factors

Objective:To investigate the predictive value of serumal retinol-binding protein 4(RBP4) level fro fetal macrosomia of non-diabetic pregnant women .Methods :The serumal levels of RBP4 of 500 non-diabetic pregnant women at 12 week ,20 week and 24 week of pregnancy were measured by immune projection turbidimetric method .Fetal macrosomia was defined as birth weight≥4000 g .The cut-off value ,sensitivity and specificity were calculated with receiver operating characteristic (ROC) curve .Results:Of the 500 non-diabetic pregnant women ,30 cases(6% ) got fetal macrosomia .The ROC curve showed that the predictive cut-off values of RBP4 at 12 week ,20 week and 24 week of pregnancy were 61 .0 mg/L ,50 .5 mg/L and 52 .5 mg/L , respectively ;the predictive sensitivity and specificity at 12 week ,20 week and 24 week of pregnancy were 42 .9% and 94 .5% , 70 .0% and 69 .5% ,76 .9% and 73 .2% ,respectively .The predictive cut-off value of RBP4 no later than 24 week of pregnancy was 51 .5 mg/L ;the predictive sensitivity and specificity were 61 .8% and 69 .5% .There was significant difference(P<0 .05) between the serumal level of RBP4 at 24 week of pregnancy in group fetal macrosomia and that in group nonfetal macrosomia . Conclusions :The predictive sensitivity of RBP4 increases in accordance with the increase of serumal level of RBP 4 .The serumal level of RBP4 of non-diabetic pregnant women at 24 week of pregnancy may have higher sensitivity and specificity in the predic-tion of fetal macrosomia .If the serumal level of RBP4 no later than 24 week of pregnancy is beyond 50 mg/L ,then the risk of fetal macrosomia will be higher .

Objective To analyze the distribution and antimicrobial resistance profile of clinical bacterial strains isolated from blood culture in China.Methods Clinical bacterial strains isolated from blood culture from participating hospitals of Blood Bacterial Resistance Investigation Collaborative System (BRICS) during January 2014 to December 2015 were collected.Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods as recommended by US Clinical and Laboratory Standards Institute(CLSI)2018.The data were analyzed with Whonet 5.6 software.Results During the study period,4 801 clinical bacterial isolates were collected from 26 hospitals,of which 1 798 (37.5％) were Gram-positive bacteria and 3 003 (62.5％) were gram-negative bacteria.The top 10 isolates were Escherichia coli (33.8％),coagulase-negative Staphylococcus (19.0％),Klebsiella pneumoniae (11.9％),Staphylococcus aureus (10.1％),Acinetobacter baumannii (4.0％),Pseudomonas aeruginosa (3.8％),Streptococcus (3.0％),Enterobacter sulcus (2.9％),Enterococcus faecium (2.8％) and Enterococcus faecalis (1.8％).Methicillin-resistant Staphylococcus aureus (MRSA) and methicillinresistant coagulase-negative Staphylococcus (MRCNS) accounted for 33.9％ (165/487) and 56.9％ (520/913) of Staphylococcus aureus and coagulase-negative Staphylococcus respectively.No vancomycinresistant Staphylococcus was detected.The resistance rate of Enterococcus faecium to vancomycin was 0.7％ (1/135),and no vancomycin-resistant Enterococcus faecaliss was detected.The positive rates of extendedspectrum β-1actamases(ESBLs)-producing Escherichia coli,Klebsiella pneumoniae and Proteus were 56.9％ (923/1 621),30.1％ (172/572) and 29.2％ (7/24),respectively.The positive rates of carbapenemresistant Escherichia coli,Klebsiella pneumoniae,Enterobacter,Salmonella and Citrobacter were 1.2％ (20/1 621),7.2％ (41/572),4.3％ (6/141),1.5％ (1/67) and 2.9％ (1/34),respectively.The resistance rates of Acinetobacter baumannii to polymyxin and tegacycline were 2.6％ (5/190) and 8.9％ (17/190)respectively,and that of Pseudomonas aeruginosa to polymyxin and fosfomycin were 1.1％ (2/183)and 0.6％ (1/183),respectively.Conclusions The surveillance results from 2014 to 2015 show that the main pathogens of blood stream infection in China are Gram-negative bacteria,while Escherichia coli is the most common pathogen,the detection rate of MRSA is lower than other surveillance data in the same period in China;carbapenem-resistant Klebsiella pneumoniae and Escherichia coli are at a low level as shown in this surveillance.

【Objective】 To analyze the efficacy of scrotum cold compress combined with antibiotics on necrospermia patients with seminal tract infection. 【Methods】 We made a retrospective analysis of the patients who were confirmed as necrospermia by more than 2 times of semen examination and positive by sperm bacteria culture at the Andrology Department of our center from January 2019 to September 2022. The experiment group patients who were cured by scrotum cold compress combined with sensitive antibiotics and L-carnitine were divided into experiment group A (1 time/day) and experiment group B (2 times/day) according to the daily times of scrotum cold compress. Meanwhile, only sensitive antibiotics and L-carnitine were administered in the control group patients. We recorded the improvement of sperm parameters and the number of negative sperm bacterial cultures in different groups at 4 weeks, 8 weeks, and 12 weeks of treatment. 【Results】 A total of 145 patients were enrolled in the study. According to the principle of randomization, 49 patients in group A, 49 patients in group B, and 47 patients in the control group were enrolled. After 4 weeks of treatment, there was no significant difference between the experiment group and the control group in terms of abstinence time, the number of negative sperm bacterial cultures, semen pH, sperm ratio of forward motility, or the sperm survival rate (all P>0.05). In terms of the sperm survival rate, group B (53.1±14.1) was superior to group A (46.2±16.4) (P<0.05). In the results of the treatment at 8 weeks, the number of negative sperm bacterial cultures was significantly higher in the experiment group (74/98) than in the control group (26/47) (χ²=5.14, P<0.05). Sperm ratio of forward motility was higher in the experiment group (26.5±11.9) than in the control group (22.8±12.6). The experimental group (53.1±14.6) also had a significantly higher sperm survival rate than the control group (47.6±13.4) (P<0.05). However, the number of negative sperm bacterial cultures, sperm ratio of forward motility, and the sperm survival rate were lower in experiment group A (35/49, 25.5±10.3, 51.1±15.0) than in experiment group B (39/49, 27.5±13.2, 55.1±14.2), but there was no statistical difference between the two groups (all P>0.05). After 12 weeks of treatment, the number of negative sperm bacterial cultures in the experimental group (67/98) was significantly higher than that in the control group (21/47) (χ²=6.11, P<0.05). Sperm ratio of forward motility in the experiment group (30.9±11.2) was higher than that in the control group (24.7±13.4) (P<0.05). The experiment group (56.3±13.0) had a significantly higher sperm survival rate than the control group (46.7±12.0, P<0.01). However, in terms of the number of negative sperm bacterial cultures, sperm ratio of forward motility, and the sperm survival rate, there were no statistical differences between group A (31/49, 28.8±10.0, 55.9±12.7) and group B (36/49, 32.8±12.1, 56.7±13.4) (all P>0.05). 【Conclusion】 Scrotum cold compress combined with antibiotics is superior to only antibiotic treatment on necrospermia patients with seminal tract infection, especially in the sperm ratio of forward motility and sperm survival rate, but it has little relationship with the times of cold compressions per day. Therefore, the method deserves application in this type of patients’ diagnosis and treatment.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2018 to December 2019. Antibiotic susceptibility tests were conducted with agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 14 778 bacterial strains were collected from 50 hospitals, of which 4 117 (27.9%) were Gram-positive bacteria and 10 661(72.1%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.2%), Klebsiella pneumoniae (17.0%), Staphylococcus aureus (9.7%), coagulase-negative Staphylococci (8.7%), Pseudomonas aeruginosa (3.7%), Enterococcus faecium (3.4%), Acinetobacter baumannii(3.4%), Enterobacter cloacae (2.9%), Streptococci(2.8%) and Enterococcus faecalis (2.3%). The the prevalence of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus were 27.4% (394/1 438) and 70.4% (905/1 285), respectively. No glycopeptide-resistant Staphylococcus was detected. More than 95% of S. aureus were sensitive to amikacin, rifampicin and SMZco. The resistance rate of E. faecium to vancomycin was 0.4% (2/504), and no vancomycin-resistant E. faecalis was detected. The ESBLs-producing rates in no carbapenem-resistance E. coli, carbapenem sensitive K. pneumoniae and Proteus were 50.4% (2 731/5 415), 24.6% (493/2001) and 35.2% (31/88), respectively. The prevalence of carbapenem-resistance in E. coli and K. pneumoniae were 1.5% (85/5 500), 20.6% (518/2 519), respectively. 8.3% (27/325) of carbapenem-resistance K. pneumoniae was resistant to ceftazidime/avibactam combination. The resistance rates of A. baumannii to polymyxin and tigecycline were 2.8% (14/501) and 3.4% (17/501) respectively, and that of P. aeruginosa to carbapenem were 18.9% (103/546). Conclusions:The surveillance results from 2018 to 2019 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while E. coli was the most common pathogen, and ESBLs-producing strains were in majority; the MRSA incidence is getting lower in China; carbapenem-resistant E. coli keeps at a low level, while carbapenem-resistant K. pneumoniae is on the rise obviously.

Objective:To investigate the distribution and antimicrobial resistance profile of clinical bacteria isolated from blood culture in China.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2016 to December 2017. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by US Clinical and Laboratory Standards Institute (CLSI) 2019. WHONET 5.6 was used to analyze data.Results:During the study period, 8 154 bacterial strains were collected from 33 hospitals, of which 2 325 (28.5%) were Gram-positive bacteria and 5 829 (71.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (34.7%), Klebsiella pneumoniae (15.8%), Staphylococcus aureus (11.3%), coagulase-negative Staphylococci (7.4%), Acinetobacter baumannii (4.6%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.8%), Streptococci (2.9%), Enterobacter cloacae (2.7%) and Enterococcus faecalis (2.5%). Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus (MRCNS) accounted for 34.2%(315/922) and 77.7%(470/605), respectively. No vancomycin-resistant Staphylococcus was detected. The resistance rate of Enterococcus faecium to vancomycin was 0.6%(2/312), and no vancomycin-resistant Enterococcus faecium was detected. The ESBLs-producing rates in Escherichia coli, Klebsiella pneumoniae and Proteus were 55.7%(1 576/2 831), 29.9%(386/1 289) and 38.5%(15/39), respectively. The incidences of carbapenem-resistance in Escherichia coli, Klebsiella pneumoniae were 1.2%(33/2 831), 17.5%(226/1 289), respectively. The resistance rates of Acinetobacter baumannii to polymyxin and tigecycline were 14.8%(55/372) and 5.9%(22/372) respectively, and those of Pseudomonas aeruginosa to polymyxin and carbapenem were 1.3%(4/315) and 18.7%(59/315), respectively. Conclusion:The surveillance results from 2016 to 2017 showed that the main pathogens of blood stream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen; the MRSA incidence was lower than other surveillance data in the same period in China; carbapenem-resistant Escherichia coli was at a low level during this surveillance, while carbapenem-resistant Klebsiella pneumoniae is on the rise.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.