The formation of Staphylococcus epidermidis biofilm on the surface of medical biomaterials may resist the antibiotics treatment and cause chronic infection,which has become a research focus in recent years.Multiple genes constitute complex regulatory network which affect the biofilm formation,and play different roles in the different stages of biofilm formation.Accessory gene regulator (agr) is one of the most important genes in the process of biofilm formation.The process of bacterial biofilm formation,research status of regulation mechanism of agr system and its related genes in the formation of biofilm are reviewed,to provide reference of using agr as a target for the treatment of staphylococcus epidermidis biofilm related infections.

Objective To explore the mechanisms of posterior pilon fractures and evaluate the curative effects of different types of fixation on the treatment of posterior pilon fractures.Methods We included in this retrospective study 20 patients with posterior pilon fracture who had been treated from January 2012 to January 2015 at our department.They were 10 men and 10 women,from 23 to 77 years of age (average,50.6 years).According to the classification by Yu Guangrong,5 cases belonged to type Ⅰ,3 to type Ⅱa,4 to type Ⅱb,and 7 to type Ⅲ.One was not indentified because of lacking CT examination.The mechanisms included ground level fall in 2 cases,motor vehicle accident in 7,fall off stairs in 5,sport injury in 2,fall from a bike in one and fall from a height in 3.More than 25％ of the articular surface was involved in 13 patients.Syndesmosis injury was identified in 6 patients by Cotton test during operation.Internal fixation varied accordingly.We recorded the mechanism,classification,proportion of the articular surface involved (more or less than 25％),and syndesmosis injury to figure out the characteristics of posterior pilon fractures.We used the Burwell-Charnley radiographic criteria to assess the postoperative reduction of the articular surface,and the Olerud-Molander scoring scale and visual analogue scale (VAS) to assess the ankle function.The curative effects of different types of fixation on the treatment of posterior pilon fractures were compared.Results Of the 20 patients,17 were available for follow-up for 6 to 36 months (average,17.8 months).Two patients received reoperation because of implant failure after cannulated screw fixation from anterior to posterior.The Burwell-Charnley radiographic evaluation revealed 12 anatoinical reducations and 8 fair reductions.The mean Olerud-Molander score for the 17 patients at the final follow-ups was 81.5 (range,from 35 to 100) and the mean walking VAS was 1 (from 0 to 3).Conclusions Posterior pilon fractures are mostly caused by medium to high energy violence,resulting from a combination of rotational and vertical forces.Since there is a high risk of implant failure,the cannulated screw fixation from anterior to posterior is not recommended.Good clinical outcomes are observed in the cannulated screw fixation from posterior to anterior and the plate/cannulated screw fixation for posterior pilon fractures.

Objective To evaluate the relationship between quartz's deposit and expression of NF-κB in non-small cell lung cancer (NSCLC) lung tissues in Xuanwei, Yunnan Province, and to clarify the role of quartz in Xuanwei NSCLC's carcinogenic mechanism. Methods As research objects, the lung tissues of NSCLC and lung benign lesions after surgical resection were collected from July 2009 to September 2015 at the Third Affiliated Hospital of Kunming Medical University. Firstly, the transmission electron microscopic (TEM) with energy dispersive X-ray analyzer (EDS) was used for observation of crystalline deposit and local pathological changes. Secondly, expression level of NF-κB had been analysed and a correlation analysis with particle size of SiO2 crystal in the same lung sample was made. Results The occurrence rates of quartz in Xuanwei NSCLC lung tissues were above non-Xuanwei NSCLC and benign lung tissues (P<0.01);the average particle size of SiO2 crystal was (226 ± 120) nm × (237 ± 163) nm in Xuanwei NSCLC group and it was smaller than the other two groups; In Xuanwei NSCLC group, the expression level of NF-κB was significantly higher than non-Xuanwei and benign lung tissues (P< 0.01), but there was no significant difference between cancer tissues and normal lung tissues in the group (P>0.05). The expression level of NF-κB was generally increasing when quartz 's size became smaller. Conclusion Quartz 's deposit may play a certain role in carcinogenic mechanism of lung cancer in Xuanwei, the smaller the particle size, the greater the cytotoxicity.

Dementia,with a poor outcome,is a syndrome characterized by persistent impairment in cognitive function or behavioral abnormalities as evidenced by deficits in memory,attention,language,and motor activity.Hip fractures represent a widespread morbidity among the geriatric population,and fall is the main cause of osteoporotic fracture.The mortality after hip fracture reaches from 20％ to 40％ within one year after operation.Co-occurrence of dementia and hip fracture is a common challenge for orthopedic surgeons and other clinicians involved in hip fracture care.Until recently,dementia in patients with hip fracture has been an issue that has received scant recognition compared with conditions considered to represent a more immediate threat to life,such as cardiopulmonary and thromboembolic diseases.This article reviews the current issues and available evidence concerning dementia in patients with hip fracture.

Abstract As a common public health problem in society, it can seriously affect sleep, and lead to sleep structure disorder, sleep pattern changes, and sleep disturbance. Poor sleep can adversely affect the normal development of physiological, psychological, cognitive, and behavioral functions, and reduce quality of life. On the basis of summarizing the definition, classification, and epidemic status of child abuse, this paper summarizes the sleep characteristics and influencing factors of childhood abuse victims. It aims to provide a scientific basis for developing prevention and intervention measures to address sleep problems among childhood abuse victims, so as to improve sleep quality, and promote their physical and mental health.

Objective:To sort out the current status and development of standardized nursing terminology in China, and reveal research hotspots and trends.Methods:The bibliometric and keyword cluster analysis and burstiness detection were performed using CiteSpace software on periodicals of standardized nursing terminology in China National Knowledge Infrastructure, WanFang Database and VIP Database from their establishment to December 31, 2021.Results:A total of 1 761 articles were included. The development process of standardized nursing terminology includes three stages: sprouting period, stagnant period and rapid growth period. Researches were clinically-oriented. Researches focus on clinical application. The main reference tools of the studies include Omaha system, North America Nursing Diagnosis Association-International (NANDA-I) , Nursing Outcome Classification (NOC) and Nursing Intervention Classification (NIC) . Research settings mostly involve the elderly population and specialties such as stroke, diabetes and chronic obstructive pulmonary disease. Research topics focus on transitional care, case management, home visiting and nursing educationbased on nursing process. The Delphi method is commonly used for quality evaluation.Conclusions:Standardized nursing terminology is paid more attention and the overall trend is positive, but the local construction of nursing terminology needs to be developed. It is suggested that future research aim at actual demand of domestic clinical applications, nursing informatics talents be developed and cultivated, and research consensus be gathered in order to promote the construction of a standardized nursing terminology system with Chinese characteristics.

Childhood household dysfunction(CHD)is a common adverse childhood experience,which brings the heavy physical and mental afflictions to children and adolescents.Trauma-focused cognitive behavioral therapy(TF-CBT)is an evidence-based psychotherapy that helps children and adolescents who have experienced childhood trauma with traumatic memories.It aims to enhance the coping abilities of CHD children and adolescents,thereby improving the negative effects caused by trauma and effectively reducing psychological burden.TF-CBT can effectively improve post-traumatic stress disorder,emotional and behavioral problems,and family function in children and adolescents with CHD.It is recommended to conduct high-quality original research in the future,develop targeted TF-CBT intervention plans based on potential predictive factors,adopt a combination of online and offline methods,and construct TF-CBT interventions suitable for the Chinese CHD population to meet the mental health service needs of CHD children and adolescents.

As a global public health problem, adverse childhood experiences (ACEs) is an important factor leading to serious psychological and behavioral problems in children and adolescents. Mental health service plan based on mental health service needs is the key to effectively improve the psychological problems of children and adolescents with ACEs. Emotional support, life skills training, mental health education, and individualized psychological intervention can effectively improve the mental health of children and adolescents with ACEs. Among them, emotional support is an important way to help individual reduce psychological and behavioral problems; secondly, life skills training can significantly improve the individual's psychosocial ability; and mental health education is a necessary way to promote the development of individual mental health. Individualized psychological intervention can promote individual to obtain more professional mental health service and improve their psychological symptoms, which is crucial for preventing the occurrence of mental health problems. Future research can develop targeted mental health interventions based on the specific mental health service needs.
Adolescent ; Adverse Childhood Experiences ; Child ; Humans ; Mental Health ; Mental Health Services

Objective To monitor the susceptibility of clinical isolates to antimicrobial agents in tertiary hospitals in major regions of China in 2022.Methods Clinical isolates from 58 hospitals in China were tested for antimicrobial susceptibility using a unified protocol based on disc diffusion method or automated testing systems.Results were interpreted using the 2022 Clinical &Laboratory Standards Institute(CLSI)breakpoints.Results A total of 318 013 clinical isolates were collected from January 1,2022 to December 31,2022,of which 29.5％were gram-positive and 70.5％were gram-negative.The prevalence of methicillin-resistant strains in Staphylococcus aureus,Staphylococcus epidermidis and other coagulase-negative Staphylococcus species(excluding Staphylococcus pseudintermedius and Staphylococcus schleiferi)was 28.3％,76.7％and 77.9％,respectively.Overall,94.0％of MRSA strains were susceptible to trimethoprim-sulfamethoxazole and 90.8％of MRSE strains were susceptible to rifampicin.No vancomycin-resistant strains were found.Enterococcus faecalis showed significantly lower resistance rates to most antimicrobial agents tested than Enterococcus faecium.A few vancomycin-resistant strains were identified in both E.faecalis and E.faecium.The prevalence of penicillin-susceptible Streptococcus pneumoniae was 94.2％in the isolates from children and 95.7％in the isolates from adults.The resistance rate to carbapenems was lower than 13.1％in most Enterobacterales species except for Klebsiella,21.7％-23.1％of which were resistant to carbapenems.Most Enterobacterales isolates were highly susceptible to tigecycline,colistin and polymyxin B,with resistance rates ranging from 0.1％to 13.3％.The prevalence of meropenem-resistant strains decreased from 23.5％in 2019 to 18.0％in 2022 in Pseudomonas aeruginosa,and decreased from 79.0％in 2019 to 72.5％in 2022 in Acinetobacter baumannii.Conclusions The resistance of clinical isolates to the commonly used antimicrobial agents is still increasing in tertiary hospitals.However,the prevalence of important carbapenem-resistant organisms such as carbapenem-resistant K.pneumoniae,P.aeruginosa,and A.baumannii showed a downward trend in recent years.This finding suggests that the strategy of combining antimicrobial resistance surveillance with multidisciplinary concerted action works well in curbing the spread of resistant bacteria.