Objective To investigate the distribution and antimicrobial susceptibility of clinically isolated bacteria from intensive care units(ICUs)in hospitals of Hunan Province Antimicrobial Resistance Surveillance System from 2012 to 2021.Methods According to China Antimicrobial Resistance Surveillance System,data of clinically isolated bacterial strains and antimicrobial susceptibility testing results of bacteria from ICUs reported by all member units of Hunan Province Antimicrobial Resistance Surveillance System were analyzed with WHONET 2022 software.Results From 2012 to 2021,the total number of bacteria isolated from ICUs of member units of the Hunan Province Antimi-crobial Resistance Surveillance System was 5 777-22 369,with Gram-negative bacteria accounting for 76.1％-78.0％annually.Staphylococcus aureus ranked first among isolated Gram-positive bacteria each year.The top 5 bacteria among Gram-negative bacteria were Acinetobacter baumannii,Klebsiella pneumoniae,Escherichia coli,Pseudo-monas aeruginosa,and Stenotrophomonas maltophilia.Detection rate of methicillin-resistant Staphylococcus aureus showed a downward trend year by year.No Staphylococcus spp.were found to be resistant to vancomycin,teico-planin and linezolid.Detection rates of vancomycin-resistant Enterococcus faecalis and vancomycin-resistant Entero-coccus faecium were 0.6-1.1％and 0.6％-2.2％,respectively.Resistance rates of Escherichia coli and Kleb-siella pneumoniae to imipenem were 3.1％-5.7％and 7.7％-20.9％,respectively.Resistance rates of Pseudo-monasaeruginosa and Acinetobacter baumannii to imipenem were 24.6％-40.1％and 76.1％-80.9％,respective-ly.Detection rates of carbapenem-resistant Pseudomonas aeruginosa declined year by year.Acinetobacter baumannii maintained high susceptibility to polymyxin B,with resistance rate＜10％.Conclusion Antimicrobial resistance of bacteria from ICUs is serious.Carbapenem-resistant Enterobacteriales has an upward trend after 2019.It is nece-ssary to strengthen the surveillance of bacterial resistance and carry out multidisciplinary collaboration.

The purpose of this study was to identify the tick species native to Xindi Township,Yumin County,Xinjiang,China.Preliminary morphological identification of parasitic ticks collected from animals in the area was conducted with an ultra-depth of field three-dimensional VHX 600 digital stereo microscope.Total DNA of the ticks was extracted,amplified by PCR based on the COI and ITS2 gene loci,and the posi-tive PCR products were sequenced.The sequence were a-ligned with reference sequences from the NCBI database were aligned with the Basic Local Alignment Search Tool.A genet-ic phylogenetic tree was generated with the neighbor-joining method of MEGA 7.0 software to determine the evolutionary biological characteristics of ticks.Morphological identification showed that the ticks collected from Xindi Township of Yu-min County were consistent with the characteristics of Hya-lomma asiaticum.An evolutionary tree based on the COI and ITS2 gene sequences showed that the ticks collected in this study were clustered with known H.asiaticum sequences.The PCR products of COI and ITS2 were sequenced and compared,which confirmed that the collected tick species were H.asiaticum,in agreement with the morphological and molecular biological results.These findings help to clarify the distribution of ticks in Xindi Township of Xinjiang,and provide basic data for the analysis of tick genetic and evolutionary characteristics,as reference for surveillance and control of ticks in the Xinjiang Uygur Autonomous Region.

Pancreatic polypeptide(PP),a pancreatic hormone containing 36 amino acids,plays impor-tant roles in the diagnosis and evaluation of pancreatic function,injury and diseases.In this study,a phage nanobody library against PP was constructed to screen specific PP nanobodies,which would be used to evaluate whether they have binding activity with PP antigen.After PP antigen with high purity was prepared by prokaryotic expression system,it was used to immunize alpaca to construct the nanobody li-brary against PP with high storage capacity and high abundance,from which 8 strains of PP nanobodies were obtained by phage display.One of nanobody strain(PP-VHH)was selected to be expressed in a prokaryotic expression system,which was induced overnight by IPTG.After purification and identifica-tion,the antigen-antibody binding activity and PP level in serum were detected by indirect ELISA and Sandwich ELISA methods,respectively.The results showed that PP-VHH had binding activity with PP,which could be used to detect PP in chicken and human serum.The Sandwich ELISA methods with R2 of the fitting curve 0.9868 could be used to detect PP concentrations of 48-55 pg/mL in the serum of chick-ens,while the concentrations of PP in human serum varied significantly.In summary,PP-VHH screened from nanobody library against PP could detect PP in serum,which would supply the basis for evaluation of abnormal pancreatic function and diagnosis of relative disease.

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.

The biological clock(also known as the circadian rhythm)is the fundamental reliance for all organisms on Earth to adapt and survive in the Earth's rotation environment.Circadian rhythm is the most basic regulatory mechanism of life activities,and plays a key role in maintaining normal physiological and biochemical homeostasis,disease occurrence and treatment.Recent studies have shown that the biologi-cal clock plays an important role in the development of oral tissues and in the occurrence and treatment of oral diseases.Since there is cur-rently no guiding literature on the research methods of biological clock in stomatology,researchers mainly conduct research based on pub-lished references,which has led to controversy about the research methods of biological clock in stomatology,and there are many confusions about how to rationally apply the research methods of circadia rhythms.In view of this,this expert consensus summarizes the characteristics of the biological clock and analyzes the shortcomings of the current biological clock research in stomatology,and organizes relevant experts to summarize and recommend 10 principles as a reference for the rational implementation of the biological clock in stomatology research.

OBJECTIVE: To explore feasibility, clinical and imaging outcomes of percutaneous endoscopic interlaminar discectomy (PEID) for single level large lumbar disc herniation(LDH). METHODS: From October 2018 to March 2023, 31 patients with single level LDH treated with PEID were retrospectively analyzed. Among patients, including 18 males and 13 females, aged from 15 to 40 years old with an average of (28.5±7.4) years old;L_4,5 in 10 patients, L₅S₁ in 21 patients;14 patients on the left side, 17 patients on the right side;the courses of disease ranged from 3 to 19 months with an average of (6.8 ± 3.1) months. Operation time, blood loss, fluoroscopy times and hospital stay were observed. Visual analogue scale (VAS) was used to evaluate low back and leg pain, Oswestry disability index (ODI) was used to evaluate lumbar function, modified MacNab was used to evaluate clinical efficacy at the latest follow-up. Median sagittal diameter of spinal canal, effective sagittal diameter of spinal canal, spinal canal area, and dural sac area were used to evaluate spinal decompression. Anterior, middle, and posterior heights of intervertebral space were used to evaluate intervertebral space changes. RESULTS: All patients were performed spinal endoscopic surgery, operation time ranged from 30 to 71 min with an average of (48.7±14.2) min, blood loss ranged from 10 to 40 ml with an average of (21.1±7.0) ml, and intraoperative fluoroscopy times ranged from 4 to 7 with an average of (4.7±0.7). The hospital stay ranged from 3 to 8 days with an average of (5.1±1.3) days, and postoperative follow-up ranged from 12 to 34 months with an average of (16.9±4.1) months. VAS of low back pain before operation and 3, 6 months after operation, the latest follow-up were (6.2±1.8), (1.4±0.8), (1.9±0.7), (1.6±0.6), respectively;VAS of leg pain were (7.6±1.6), (1.8±0.9), (1.6±0.6), (1.4±0.7), respectively;ODI were (35.74±4.62), (6.68±1.78), (6.90±1.85), (7.10±1.94), respectively;postoperative lower back pain and leg pain VAS and ODI were significantly improved at all time points after operation (P<0.05). Postoperative VAS of low back pain at 6 months was higher than that of 3 months after operation (P<0.05). At the laest follow-up, 14 patients were excellent, 15 good, and 2 acceptable according to modified MacNab standard. Median diameters of spinal canal were (0.77±0.18) and (1.18±0.24) cm before operation and at the latest follow-up. The effective diameters of spinal canal were (0.48±0.17) and (0.89±0.23) cm, respectively. The vertebral canal areas were (0.90±0.22) and (1.68±0.43) cm², respectively. Dural sac areas were (0.41±0.10) and (0.81±0.24) cm², respectively. At the least follow-up, median diameter, effective diameter, area of spinal canal and dural sac were significantly increased compared with those before operation (P<0.05). Anterior vertebral space height before operation was (1.13±0.13) cm, and improved to (0.83±0.11) cm at the latest follow-up. Central height decreased from (0.81±0.20) cm before operation to (0.61±0.14) cm at the latest follow-up. The height of posterior margin decreased from (0.67±0.21) cm before operation to (0.46±0.15) cm at the latest follow-up (P<0.05). CONCLUSION PEID for giant LDH could effectively remove protruding giant nucleus pulposus tissue, and avoid injury to cauda equina nerve and nerve roots, which has good early clinical effect. However, the height of intervertebral space was obviously lost after operation.
Humans ; Male ; Female ; Adult ; Intervertebral Disc Displacement/surgery* ; Lumbar Vertebrae/surgery* ; Endoscopy/methods* ; Young Adult ; Adolescent ; Diskectomy, Percutaneous/methods* ; Retrospective Studies ; Nucleus Pulposus/surgery*

Objective To analyze the epidemiological characteristics of pulmonary tuberculosis in the elderly people in Wuhan during 2016-2020, and to provide a basis for formulating effective prevention and control strategies and measures. Methods Using the National Tuberculosis Information Management System, a descriptive statistical analysis was performed on the medical records of elderly (≥60 years old) pulmonary tuberculosis patients registered in Wuhan from 2016 to 2020. Results A total of 9 427 elderly pulmonary tuberculosis patients were registered in Wuhan during 2016-2020, accounting for 32.07% of the total number of registrations in the whole population. The reported incidence rate of tuberculosis in the elderly was significantly higher than that in the total population, and the reported incidence rates in both the elderly and the general population showed declining trends (whole population χ²_trend=216.97, P<0.05, elderly population χ²_trend=153.57, P<0.05). The time distribution showed that more cases occurred from April to November (70.90%). The top three districts with the largest number of registered cases were far urban areas, namely Huangpi District (13.81%), Xinzhou District (11.55%), and Jiangxia District (9.82%). The ratio of male to female with pulmonary tuberculosis in elderly patients was 2.85:1. Among the elderly pulmonary tuberculosis, the most registered cases were in the age group of 60 ~ years old, followed by 65 ~ years old. The proportion of smear-positive in elderly patients with pulmonary tuberculosis retreatment was 16.83%. Conclusion From 2016 to 2020, the epidemic situation of elderly pulmonary tuberculosis showed a downward trend in Wuhan. However, the elderly population with tuberculosis registrations still accounted for a relatively high proportion of the total population. According to the epidemiological characteristics of pulmonary tuberculosis among the elderly, the city should carry out tuberculosis prevention and control work in a timely, appropriate and focused manner.

The name"Lonicerae Japonicae Flos"was first published in Materia Medica from Steep Mountainsides of the Southern Song Dynasty.After the Song Dynasty,the name was gradually used by later generations and became the proper name of medicinal ma-terials.The origin of the varieties of LJF is complicated in ancient times.Since the 2005 edition of the Chinese Pharmacopoeia has stip-ulated that L.japonica Thunb.is the only source of LJF,and medicinal parts are buds or flowers with initial bloom.It is mostly used for raw products,and the processing accessories are mainly wine.Shandong and Henan are the genuine producing area,and the quality of flower buds harvested at the first crop is better.Based on current research results combined with modern research results and re-source cultivation situation,the application and development of the classic prescriptions containing LJF(Simiao Yong'an Soup,Wuwei Disinfectant Drink and Tuoli Disinfection San)in the Catalogue of Ancient Classic Recipes(The First Batch)is suggested to use raw ma-terials from Shandong,Henan,and other genuine producing areas with L.japonica Thunb.being the origin,and the buds harvested from the first crop during the second white to big white period were preferred for medicinal use.Based on the clinical application litera-ture of famous classical prescriptions and bibliometric methods,the common dosage and average dosage of LJF in the three prescriptions were obtained,which could be used as the reference dosage of LJF in the development and utilization of famous classical prescriptions.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.