Objective To investigate the predictive value of plasma lipoprotein associated phospholipase A 2 (Lp-PLA2 ) in cere-bral infarction(CI) after transient cerebral ischemia attack (TIA).Methods Plasma Lp-PLA2 level was detected in 112 TIA pa-tients ,and the incidence rate of CI was observed on 7 ,30 ,90 d after TIA.Then the grouping was performed according to the Lp-PLA2 level ,and the predictive value of Lp-PLA2 in the risk of CI occurrence after TIA was evaluated.Results Among 112 patients with TIA ,27 cases (24.1% ) developed CI within 90 d;there were 17 cases(63.0% ) of CI after TIA in the Lp-PLA2 >207 μg/L group ,which were significantly higher than that in the 175-207 μg/L group and <175 μg/L group (P<0.05);moreover the CI occurrence in TIA patients was mainly concentrated within 7 d after onset ;the patients of Lp-PLA2 ≥175μg/L were mainly distrib-uted in the moderate and high risk groups of ABCD2 score system ;in ROC curve of Lp-PLA2 for predicting CI after TIA ,with Lp-PLA2 ≥194 μg/L as the diagnostic critical point ,the sensitivity was 0.730 and specificity was 0.680.Conclusion Lp-PLA2 may be an effective risk predictive indicator of CI occurrence after TIA ,and can improve the adverse outcome of TIA patients.

BACKGROUND: The number of roots and morphology of the root canal system of permanent mandibular first molars vary greatly among different populations; therefore, it is important to be familiar with the variations in the root and root canal for the location and negotiation of the canals. OBJECTIVE: To investigate the variations in the roots and root canal of permanent mandibular first molars in the Han population of southwest Shandong Province by cone-beam CT. METHODS: 656 patients undegoing cone-beam CT examination at the Department of Stomatology, Affiliated Hospital of Jining Medical University, from September 2012 to October 2015 were recruited, and all patients had healthy, well-developed, and untreated bilateral permanent mandibular first molars with normal appearance. Subsequently, the three-dimensional reconstruction based on cone-beam CT data was performed using Planmeca Romexis software to observe the variations in the root and root canal system of permanent mandibular first molars in the Han population of southwest Shandong Province. RESULTS AND CONCLUSION: Among 1312 permanent mandibular first molars, the incidence of permanent mandibular first molars with three roots was 70.66% (927/1312); the majority of root canal variations involved two roots and three root canals, accounting for 48.09% (631/1312). The incidence of distal root was 35.37% (232/656), the incidence of distal root was 29.34% (385/1312) in total teeth, and the incidence of distal root bilaterally was 68.95% (153/232). There was a significantly increased incidence of distal root on the right side than on the left side (P < 0.05), and the incidence in the male was significantly higher than that in the female (P < 0.05). These results suggest that most of Han populations in southwest Shandong Province have permanent mandibular first molars with two roots, and the root canal variations mainly involve two roots and three root canals, with the high incidence of distal root. Moreover, cone-beam CT is available for detecting the variation in roots and root canal system, which can provide references for root canal treatment.

Objective:To establish an HPLC method for the determination of content and entrapment efficiency of HIV-1 virus in-fection factor Vif inhibitor VEC-5 liposomes. Methods:VEC-5 liposomes were prepared by a method of freeze-drying and reconstruc-tion. The separation of free drug from the liposomes was achieved by ultracentrifugation, and an HPLC method was used to determine the content and entrapment efficiency of VEC-5 liposomes. Results:The linear range of VEC-5 was 20-100 μg·ml-1(r=0. 999 0). The average recovery was 100. 25% and RSD was 0. 93%(n=9). The content of three batches of VEC-5 liposomes was 98. 63%, 100. 43% and 102. 65%, respectively within the range of 90%-110%, and the entrapment efficiency was 94. 89%, 93. 68% and 94. 56%, respectively, which was above 90%. Conclusion:The method is accurate and reliable, which can be used to determine the content and entrapment efficiency of VEC-5 liposomes.

Objective:To observe the effects of ultrasound intermediate frequency acupoint targeted drug guiding technology on the recovery of gastrointestinal function and serum gastrin levels in elderly patients after lumbar spine surgery under general anesthesia.Methods:This study used prospective research methods.A total of 90 elderly patients undergoing lumbar spine surgery after general anesthesia in the orthopaedic ward of Beijing Geriatrics Hospital from June 2019 to June 2021 were randomly divided into blank control group, drug control group, and drug-guided treatment group, with 30 cases each group. After the operation, no intervention was given to the blank control group, the drug control group received oral mosapride citrate tablets, the drug-guided treatment group used the D patch to guide the medicine at the two acupoints of Zusanli and Zhongwan with ultrasound medium frequency guided medicine instrument for 1 week each. The serum gastrin levels of the patients in each group were detected 1 d before operation, 3 d after operation, and 1 week after operation, and the time of first exhaust and first defecation after operation were recorded.Results:The results showed that the level of serum gastrin preoperativein the three groups was not significantly different ( P>0.05). On the third day after operation, the levelof serum gastrin in the drug guide treatment group, drug control group and blank control group were lower than those at 1 d before operation: (66.51 ± 5.34) ng/L vs. (69.36 ± 6.50) ng/L, (58.34 ± 5.71) ng/L vs. (68.75 ± 5.13) ng/L, (55.76 ± 6.23) ng/L vs. (70.20 ± 6.71) ng/L, the differences were statistically significant ( P<0.05), and showed a decreasing trend in turn. Among them, the level of serum gastrin in the drug guide treatment group was higher than that in the drug control group and blank control group, the difference was statistically significant ( P<0.05). One week after operation, the level of serum gastrin in the three groups increased compared with the third day after operation ( P<0.05), and the drug guiding treatment group was higher than the drug control group and the blank control group: (72.38 ± 6.78) ng/L vs. (67.15 ± 6.27) ng/L, (63.52 ± 5.38) ng/L, the differences were statistically significant ( P<0.05). The time of first exhaust and defecation after the operation of the three groups of patients, the drug-guided treatment group was significantly shorter than the drug control group and the blank control group: (15.25 ± 3.10) h vs. (20.38 ± 4.21) h and (28.52 ± 3.69) h, (24.14 ± 3.53) h vs. (36.15 ± 3.54) h and (49.51 ± 4.37) h, the differences were statistically significant ( P<0.05). Conclusions:Ultrasound intermediate frequency acupoint drug guiding technology can increase the patient′s serum gastrin level and promote the recovery of gastrointestinal function in elderly patients with lumbar spine surgery after general anesthesia.

Objective To explore the correlation between serum hepatitis C virus (HCV)-RNA level with cholinesterase (CHE), albumin (ALB) and prealbumin (PA) in patients with hepatitis C, and provide the references for the early diagnosis and the prognosis monitoring of hepatitis C. Methods Four hundred and fifty-five patients with hepatitis C were selected. The serum level of HCV-RNA was determined by quantitative real-time polymerase chain reaction (real-time PCR), and serum levels of CHE, ALB and PA were detected using the automatic biochemistry analyzer. The patients were divided into 6 group according to the result of HCV-RNA level:HCV-RNA<103 kU/L group (group A, 52 cases), 103 kU/L≤HCV-RNA<104 kU/L group (group B, 77 cases), 104 kU/L≤HCV-RNA<105 kU/L group (group C, 81 cases), 105 kU/L≤HCV-RNA<106 kU/L group (group D, 92 cases), 106 kU/L≤HCV-RNA<107 kU/L group (group E, 87 cases) and HCV-RNA≥107 kU/L group (group F, 66 cases). Moreover, the patients were divided into 3 groups according to the result of serum CHE: CHE normal group (> 5000 U/L, 321 cases), CHE mild abnormal group (4000- 5000 U/L, 56 cases) and CHE abnormal group (<4000 U/L, 78 cases). Results With the rising level of serum HCV-RNA from group A to group F, the serum levels of CHE, ALB and PA were all gradually decreased in hepatitis C patients, CHE: (7288 ± 2817), (6316 ± 2341), (6103 ± 2596), (5208 ± 2222), (4282 ± 2173) and (3905 ± 1378) U/L; ALB: (46.3 ± 9.9), (44.0 ± 8.4), (43.1 ± 7.6), (42.6 ± 7.1), (41.1 ± 5.4) and (39.3 ±5.1) g/L;PA:(212.1 ± 67.8), (179.9 ± 72.8), (163.4 ± 57.5), (137.4 ± 60.3), (120.6 ± 45.0) and (112.5 ± 42.0) mg/L, and there were statistical differences (F=21.08, 6.08 and 27.54;P<0.01). With the decreasing level of serum CHE, the serum levels of ALB and PA were all gradually decreased, ALB:(45.4 ± 10.1), (33.1 ± 4.2) and (31.5 ± 8.8) g/L;PA:(209.3 ± 56.4), (108.4 ± 44.1) and (81.5 ± 49.6) mg/L, and there were statistical differences (F = 70.23 and 152.57, P<0.01). The bivariate Spearman correlation analysis result showed that the serum HCV-RNA level was negatively correlated with serum CHE, ALB and PA (r =-0.357, -0.326 and-0.471; P<0.05), and the serum CHE was positively correlated with serum ALB and PA (r=0.726 and 0.807, P<0.05). Conclusions The serum HCV-RNA level is closely related to liver function indices. Performing simultaneous detection of serum HCV-RNA level and serum PA is helpful in the early diagnosis and treatment of Hepatitis C.

Objective:To investigate the bacterial composition and antimicrobial resistance profile of clinical isolates from bloodstream infections in China.Methods:The clinical bacterial strains isolated from blood culture were collected during January 2020 to December 2020 in member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS). Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute(CLSI, USA). WHONET 5.6 was used to analyze data.Results:During the study period, 10 043 bacterial strains were collected from 54 hospitals, of which 2 664 (26.5%) were Gram-positive bacteria and 7 379 (73.5%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (38.6%), Klebsiella pneumoniae (18.4%), Staphylococcus aureus (9.9%), coagulase-negative Staphylococci (7.5%), Pseudomonas aeruginosa (3.9%), Enterococcus faecium (3.3%), Enterobacter cloacae (2.8%), Enterococcus faecalis (2.6%), Acinetobacter baumannii (2.4%) and Klebsiella spp (1.8%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 27.6% and 74.4%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci were detected. More than 95% of Staphylococcus aureus were sensitive to rifampicin and SMZco. No vancomycin-resistant Enterococci strains were detected. Extended spectrum β-lactamase (ESBL) producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 48.4%, 23.6% and 36.1%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.3% and 16.1%, respectively; 9.6% of carbapenem-resistant Klebsiella pneumoniae strains were resistant to ceftazidime/avibactam combination. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii. The prevalence rate of carbapenem-resistance of Pseudomonas aeruginosa was 23.2%. Conclusions:The surveillance results in 2020 showed that the main pathogens of bloodstream infection in China were gram-negative bacteria, while Escherichia coli was the most common pathogen, and ESBL-producing strains declined while carbapenem-resistant Klebsiella pneumoniae kept on high level. The proportion and the prevalence of carbapenem-resistant Pseudomonas aeruginosa were on the rise slowly. On the other side, the MRSA incidence got lower in China, while the overall prevalence of vancomycin-resistant Enterococci was low.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical bacterial isolates from bloodstream infections in China in 2021.Methods:The clinical bacterial strains isolated from blood culture from member hospitals of Blood Bacterial Resistant Investigation Collaborative System (BRICS) were collected during January 2021 to December 2021. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical Laboratory Standards Institute (CLSI). WHONET 5.6 was used to analyze data.Results:During the study period, 11 013 bacterial strains were collected from 51 hospitals, of which 2 782 (25.3%) were Gram-positive bacteria and 8 231 (74.7%) were Gram-negative bacteria. The top 10 bacterial species were Escherichia coli (37.6%), Klebsiella pneumoniae (18.9%), Staphylococcus aureus (9.8%), coagulase-negative Staphylococci (6.3%), Pseudomonas aeruginosa (3.6%), Enterococcus faecium (3.6%), Acinetobacter baumannii (2.8%), Enterococcus faecalis (2.7%), Enterobacter cloacae (2.5%) and Klebsiella spp (2.1%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococcus aureus were 25.3% and 76.8%, respectively. No glycopeptide- and daptomycin-resistant Staphylococci was detected; more than 95.0% of Staphylococcus aureus were sensitive to ceftobiprole. No vancomycin-resistant Enterococci strains were detected. The rates of extended spectrum B-lactamase (ESBL)-producing isolated in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis were 49.6%, 25.5% and 39.0%, respectively. The prevalence rates of carbapenem-resistance in Escherichia coli and Klebsiella pneumoniae were 2.2% and 15.8%, respectively; 7.9% of carbapenem-resistant Klebsiella pneumoniae was resistant to ceftazidime/avibactam combination. Ceftobiprole demonstrated excellent activity against non-ESBL-producing Escherichia coli and Klebsiella pneumoniae. Aztreonam/avibactam was highly active against carbapenem-resistant Escherichia coli and Klebsiella pneumoniae. The prevalence rate of carbapenem-resistance in Acinetobacter baumannii was 60.0%, while polymyxin and tigecycline showed good activity against Acinetobacter baumannii (5.5% and 4.5%). The prevalence of carbapenem-resistance in Pseudomonas aeruginosa was 18.9%. Conclusions:The BRICS surveillance results in 2021 shows that the main pathogens of blood stream infection in China are gram-negative bacteria, in which Escherichia coli is the most common. The MRSA incidence shows a further decreasing trend in China and the overall prevalence of vancomycin-resistant Enterococci is low. The prevalence of Carbapenem-resistant Klebsiella pneumoniae is still on a high level, but the trend is downwards.

Objective:To report the results of national surveillance on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2022.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of national bloodstream infection Bacterial Resistant Investigation Collaborative System（BRICS）were collected during January 2022 to December 2022. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 software were used to analyze the data.Results:During the study period，9 035 strains of Gram-negative bacteria were collected from 51 hospitals，of which 7 895（87.4%）were Enterobacteriaceae and 1 140（12.6%）were non-fermenting bacteria. The top 5 bacterial species were Escherichia coli（ n=4 510，49.9%）， Klebsiella pneumoniae（ n=2 340，25.9%）， Pseudomonas aeruginosa（ n=534，5.9%）， Acinetobacter baumannii complex（ n=405，4.5%）and Enterobacter cloacae（ n=327，3.6%）. The ESBLs-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus spp. were 47.1%（2 095/4 452），21.0%（427/2 033）and 41.1%（58/141），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（58/4 510）and 13.1%（307/2 340）；62.1%（36/58）and 9.8%（30/307）of CREC and CRKP were resistant to ceftazidime/avibactam combination，respectively. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 59.5%（241/405），while less than 5% of Acinetobacter baumannii complex was resistant to tigecycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 18.4%（98/534）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of main Gram-negative bacteria resistance among different regions，with statistically significant differences in the prevalence of CRKP and CRPA（ χ2=20.489 and 20.252， P<0.001）. The prevalence of CREC，CRKP，CRPA，CRAB，ESBLs-producing Escherichia coli and Klebsiella pneumoniae were higher in provinicial hospitals than those in municipal hospitals（ χ2=11.953，81.183，10.404，5.915，12.415 and 6.459， P<0.01 or <0.05），while the prevalence of CRPA was higher in economically developed regions（per capita GDP ≥ 92 059 Yuan）than that in economically less-developed regions（per capita GDP <92 059 Yuan）（ χ2=6.240， P=0.012）. Conclusions:The proportion of Gram-negative bacteria in bloodstream infections shows an increasing trend，and Escherichia coli is ranked in the top，while the trend of CRKP decreases continuously with time. Decreasing trends are noted in ESBLs-producing Escherichia coli and Klebsiella pneumoniae. Low prevalence of carbapenem resistance in Escherichia coli and high prevalence in CRAB complex have been observed. The composition ratio and antibacterial spectrum of bloodstream infections in different regions of China are slightly different，and the proportion of main drug resistant bacteria in provincial hospitals is higher than those in municipal hospitals.