Objective To analyze the antimicrobial resistance profile of clinical isolates in Shanghai Xinhua Hospital Chongming Branch affiliated to Shanghai Jiaotong University School of Medicine , a member of China Antimicrobial Resistance Surveillance System, during 2015, for the purpose to facilitate rational antimicrobial therapy. Methods Strain identification?and?susceptibility?testing?were?carried?out?for?the?clinical?isolates?using?MicroScan?WalkAway?96?Automated?Systems and Kirby-Bauer method. Results In 2015, a total of 1815 isolates were collected, including gram-negative bacteria (73.2 %) and gram-positive bacteria (26.8 %). The top three frequently isolated species were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. ESBL-producing strains were found in 36.3 % of the Escherichia coli isolates, 12.6 % of the Klebsiella (K. pneumoniae and K. oxytoca) isolates, and 28.0 % of the Proteus mirabilis isolates. The prevalence of carbapenem-resistant strains was 0.69 % in Enterobacteriaceae isolates. The prevalence of methicillin-resistant strain was 29.1 % in S. aureus, and 61.4 % in coagulase-negative Staphylococcus isolates. No more than 15 % of the Enterobacteriaceae isolates and no more than 20 % of the P. aeruginosa and Acinetobacter isolates were resistant to carbapenems. No vancomycin-or linezolid-resistant strains were found in Enterococcus or Staphylococcus. Conclusions Antibiotic-resistant clinical isolates are a serious threat for clinical antimicrobial treatment. We should pay more attention to such urgent situation and rational use of antibiotics.

Objective To investigate the effects of different culture media and pretreatment methods on the results of matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS) for the identification of Vibrio parahaemolyticus,and then provide the optimal conditions.Methods Forty strains of Vibrio parahaemolyticus were collected,and subcultured with the blood agar plate,thiosulfate citrate bile salts sucrose(TCBS) agar plate and double wash agar plate,respectively.The pretreatment methods before mass spectrometry included the smear method,extension method and extraction method.The effects of different culture media and pretreatment methods on the results of MALDI-TOF MS for the identification of Vibrio parahaemolyticus were analyzed by the logistics regression model and Chi-square test of SAS software.Results The detection rate of Vibrio parahaemolyticus was the highest in the combination of blood agar plate with the extraction method(genus level:100％;species level:67.5％),followed by the combination of double wash agar plate with the extraction method(genus level:70％;species level:37.5％).For the genus identification level of Vibrio parahaemolyticus,when the pretreatment method was the same,different culture media produced significantly different detection rates(P ＜ 0.01).However,when the culture medium was the same,there was no significant difference in detection rates for different pretreatment methods (P ＞ 0.05).The odd ratios (OR) of the smear method and extention method relative to the extraction method were 0.66 and 0.95,respectively,and there was no significant difference in detection rates for them(P ＞ 0.05),while the ORs of the TCBS agar plate and double wash agar plate relative to blood agar plate were 0.06 and 0.10,respectively,and there was significant difference in detection rates for them(P ＜0.05).The logistic regression equation was Y=2.95-0.41a-0.05b-2.83c-2.83d(a:smear method;b:extension method;c:TCBS agar plate;d:double wash agar plate).For the species identification level of Vibrio parahaemolyticus,when the extension method or the extraction method was used,different culture media produced significantly different detection rates(P ＜ 0.05).When the blood agar plate was used,different pretreatment methods also produced significantly different detection rates(P ＜ 0.01).The ORs of the smear method and extention method relative to the extraction method were 0.32 and 0.55,respectively,and there was significant difference in detection rates for them (P ＜ 0.05),while the ORs of the TCBS agar plate and double wash agar plate relative to blood agar plate were 0.18 and 0.49,respectively,and there was significant difference in detection rates for them(P ＜0.05).The logistic regression equation was Y =0.20-1.15a-0.61b-1.72c-1.72d(a:smear method;b:extension method;c:TCBS agar plate;d:double wash agar plate).Conclusion For improving the detection rate of Vibrio parahaemolyticus by MALDI-TOF MS,the selection of appropriate culture medium is more important than that of the pretreatment method.It is recommended that the extraction method may be as a conventional pretreatment method,and that the optimal medium is the blood agar plate,followed by the double wash agar plate and TCBS agar plate.

Objective To analyze the changes of mortality and potential years of life lost （PYLL） due to chronic obstructive pulmonary disease （COPD） among residents in Baoshan District， Shanghai from 2010 to 2019 and provide strategies and basis for COPD prevention and treatment in the future. Methods Based on the cause-of-death surveillance system in Baoshan District of Shanghai from 2010 to 2019， Microsoft Excel 2010， SPSS 22.0 and Joinpoint Trend Analysis Software were used to sort out and analyze the data over the years and calculate the crude mortality， standardized mortality， age-specific mortality， PYLL， annual percent change （APC）， etc. Results From 2010 to 2019， the average annual mortality of COPD was 48.08/100 000， and the standardized mortality rate was 39.95/100 000， accounting for 5.82% of the total deaths in the same period， and COPD ranked as the third leading cause of death in Baoshan District. During the 10 years， the crude and standardized mortality of male COPD patients were generally higher than those of female patients （ P <0.01）. However， the crude mortality and standardized mortality of COPD showed a decreasing trend with the increase of years （ P <0.001）， and an increasing trend with the increase of age， of which the proportion of patients aged 75 and above was the highest， accounting for 85.71% of all age groups. The PYLL caused by COPD deaths was 2 352.5 years， including 1 977.5 years for men and 375.0 years for women. The number of years of life lost per 10 000 people due to COPD in males （4.18 years） was much longer than that in females （0.82 years）. Conclusion From 2010 to 2019， the standardized mortality of chronic obstructive pulmonary disease among residents in Baoshan District， Shanghai has shown a significant decline. However， due to the heavy burden brought by COPD， which has an especially profound impact on the health of elderly and male residents， COPD should be regarded as one of the key diseases in the prevention and control of chronic diseases in public health services， and effective preventive measures should be taken.

Objective To propose a two-way fluid-structure interaction (FSI) method based on real patients with carotid artery stenosis, and analyze the hemodynamic parameters of carotid plaques with different types at the lesion as well as deformation and stress changes of the plaque itself. Methods Three-dimensional ( 3D) modeling was performed based on computed tomography angiography ( CTA) data of patients with moderate carotid artery stenosis. The carotid artery wall model and plaque model were separated, and transient fluid structure coupling calculation was performed. The situation from early stage of carotid atherosclerosis to formation of the plaque was simulated. The plaque types were divided into thickened plaques, lipid plaques, mixed plaques and calcified plaques, among which thickened plaques were regarded as non-plaque conditions for representing the thickening of vascular intima-media. The stenotic carotid arteries with different plaque types were compared and analyzed. Results The plaques with different types had little effect on the overall blood flow, but the wall shear stress of lipid plaques at the lesion was lower than that of other plaques. With thickened plaques as a control, concurrence of the plaque would inhibit artery expansion, and lipid plaques were the most obvious. Calcified plaques had the highest average plaque structure stress, while lipid plaques had the lowest average plaque structure stress. Conclusions The method proposed in this study can analyze fluid area and solid area at the same time. The results can contribute to better understanding the influence of different plaque types on carotid artery diseases.