Objective To evaluate the effect of ulinastatin on neuronal apoptosis in spinal cord af-ter peripheral nerve injury in mice. Methods A total of 225 healthy male SPF C57BL∕6J mice, aged 6-8 weeks, weighing 18-22 g, were divided into 3 groups ( n=75 each) using a random number table method:sham operation group ( group Sham), peripheral nerve injury group ( group PNI) and ulinastatin group ( group UTI) . The model of unilateral sciatic nerve transection was established in PNI and UTI groups. Uli-nastatin 10000 U∕kg was injected intraperitoneally once a day for 3 consecutive days in group UTI, while the equal volume of normal saline was given instead in Sham and PNI groups. The mice were sacrificed at 1, 3, 7, 14 and 28 days after administration ( T0-4 ) , and the L4-6 segments of the spinal cord were re-moved for examination of the pathological changes ( under the light microscope ) and for determination of neuronal apoptosis (by TUNEL) and expression of caspase-12, Bcl-2, Bax and activated caspase-3 (by Western blot) and expression of caspase-12 mRNA ( by real-time polymerase chain reaction) . Apoptosis in-dex ( AI) and Bcl-2∕Bax ratio were calculated. Results Compared with group Sham, AI was significantly increased, the expression of Bcl-2 was down-regulated, the expression of caspase-12, activated caspase-3 and Bax was up-regulated, and Bcl-2∕Bax ratio was decreased in PNI and UTI groups (P<0. 05). Com-pared with group PNI, AI was significantly decreased, the expression of Bcl-2 was up-regulated, the ex-pression of caspase-12, activated caspase-3 and Bax was down-regulated, and Bcl-2∕Bax ratio was in-creased in group UTI ( P<0. 05) . The pathological changes of the spinal cord were significantly attenuatedin group UTI than in group PNI. Conclusion Ulinastatin can inhibit neuronal apoptosis in the spinal cord after peripheral nerve injury in mice.

Mother-to-child transmission of hepatitis B virus (HBV) is one of major public health issues. Difference is found on effect of preventions of mother to child transmission of HBV such as Hepatitis B vaccine, Hepatitis B immunoglobulin and antiretroviral drugs. Based on the risks of hepatitis B virus on children, influencing factors and interventions of HBV mother-to-child transmission were explored to improve prevention mother-to-child transmission of hepatitis B and to search appropriate strategies reducing mother-to-child transmission of HBV.

Objective: To analyze serologic surveillance indicators during pregnancy among syphilis-infected women who delivered in 2013 in East China. Methods: Data were from national 'Information System of Prevention of Mother-to-child Transmission of HIV, syphilis and HBV Management’ and in total 5 206 syphilis-infected pregnant women who delivered in 2013 and in East China were involved in the analysis. Information on demographic characters, laboratory tests, and treatment regimens were collected. The maternal non-treponemal testing surveillance and titer distribution were described and compare the proportions between pregnant women receiving standard testing and non-standard testing, taking baseline testing and testing before delivery or at the third trimester. Multivariate logistic regression model was analyzed using maternal titer control as dependent variable, using prior history of syphilis infection, syphilis stages, titer, gestational weeks of treatment initiation and treatment regimens as independent variables in 3 940 pregnant women with both baseline testing results and testing results before delivery or at the third trimester. Results: The ages of the 5 206 syphilis infected pregnant women were (28.1±5.8) years old. The numbers of women received penicillin treatment, other treatment regimens and no treatment were 2 967 (57.0%), 281 (5.4%), and 1 958 (37.6%), respectively. The number of women with maternal seroconversion, 4-fold or greater titer decline, or titer increase were 349 (6.7%), 251 (4.8%) and 28 (0.5%). Multivariate analysis results showed that compared with pregnant women with prior history of syphilis, the OR(95%CI) for maternal titer control was 1.49 (1.18-1.88) among those with syphilis-infection history. Compared with pregnant women initiated treatment at 28 gestational weeks or before, the OR (95%CI) for maternal titer control was 4.09 (3.19-5.24) among those who initiated treatment after 28 gestational weeks. Compared with pregnant women initiated treatment at 28 gestational weeks or before, the OR (95%CI) for maternal titer control was 4.09 (3.19-5.24) among those who initiated treatment after 28 gestational weeks or received no treatment. Compared with pregnant women received penicillin treatment, the OR (95%CI) for maternal titer control among those received non-penicillin treatment and those received no treatment were 2.35 (1.46-3.76) and 1.55 (1.13-2.12), respectively. Conclusion In East China, the proportion of women achieved seroconversion or 4-fold or greater titer decline during pregnancy was very low. Pregnant women with no prior history of syphilis infection, early maternal initiation of treatment, and penicillin treatment were more likely to reach maternal titer control.

Objective To describe the changing demographic profile over time of pregnant women diagnosed with HIV infection, and trends in mode of delivery and pregnancy outcome. Methods An observational investigation was conducted based on a population of 1 128 HIV-positive pregnant women at eight sites in China in provinces with high prevalence of HIV among pregnant women and children between 2007 and 2013. The study area included Shangcai and Weishi counties in Henan province; Ruili and Longchuan counties and Linxiang prefecture in Yunnan province;Yining County in Xinjiang;and Lingshan county and Babu district in Guangxi province. Main outcome measures were maternal characteristics, mode of delivery, and related trends over time by Cochram-Mantel-Haenszel(CMH) χ2-test. Results A total hospital delivery rate of 96.4%was reported. For each year during the period 2007-2013, hospital delivery rates were 95.1%(253/266), 94.8%(188/198), 93.7%(164/175), 98.8%(159/161), 98.6%(141/143), 97.4%(114/117), and 100.0%(68/68), respectively (χ2CMH=7.68, P=0.006). The neonatal survival rate increased by 0.7% incrementally from 2007 to 2013, with 98.5% (262/266), 99.0% (196/198), 99.4% (174/175), 99.4%(160/161), 100.0% (143/143), 100.0% (117/117), and 100.0% (68/68), respectively (χ2CMH=4.58, P=0.030). The proportions of vaginal deliveries in those years were 62.2% (166/266), 54.8% (109/198), 59.9% (105/175), 61.7% (100/161), 66.7% (96/143), 58.8% (69/117), and 66.7% (46/68), respectively (χ2CMH=1.19, P=0.276). The average rate for midwives skilled in procedures such as artificial rupture of membranes and episiotomy was 37.8% (261/691), with proportions decreasing during the study period at 39.2% (65/166), 47.4% (52/109), 35.9% (38/105), 46.0% (46/100), 25.5% (25/96), 31.2% (22/69), and 28.3% (13/46), respectively (χ2CMH=6.76, P=0.009). Conclusion The annual rate of reported hospital delivery increased between 2007 and 2013, with a declining rate of skilled midwifery over the same period. Survival of neonates born to HIV-infected mothers in China has increased to nearly equivalent levels as those of developed countries.

Objective To describe the changing demographic profile over time of pregnant women diagnosed with HIV infection, and trends in mode of delivery and pregnancy outcome. Methods An observational investigation was conducted based on a population of 1 128 HIV-positive pregnant women at eight sites in China in provinces with high prevalence of HIV among pregnant women and children between 2007 and 2013. The study area included Shangcai and Weishi counties in Henan province; Ruili and Longchuan counties and Linxiang prefecture in Yunnan province;Yining County in Xinjiang;and Lingshan county and Babu district in Guangxi province. Main outcome measures were maternal characteristics, mode of delivery, and related trends over time by Cochram-Mantel-Haenszel(CMH) χ2-test. Results A total hospital delivery rate of 96.4%was reported. For each year during the period 2007-2013, hospital delivery rates were 95.1%(253/266), 94.8%(188/198), 93.7%(164/175), 98.8%(159/161), 98.6%(141/143), 97.4%(114/117), and 100.0%(68/68), respectively (χ2CMH=7.68, P=0.006). The neonatal survival rate increased by 0.7% incrementally from 2007 to 2013, with 98.5% (262/266), 99.0% (196/198), 99.4% (174/175), 99.4%(160/161), 100.0% (143/143), 100.0% (117/117), and 100.0% (68/68), respectively (χ2CMH=4.58, P=0.030). The proportions of vaginal deliveries in those years were 62.2% (166/266), 54.8% (109/198), 59.9% (105/175), 61.7% (100/161), 66.7% (96/143), 58.8% (69/117), and 66.7% (46/68), respectively (χ2CMH=1.19, P=0.276). The average rate for midwives skilled in procedures such as artificial rupture of membranes and episiotomy was 37.8% (261/691), with proportions decreasing during the study period at 39.2% (65/166), 47.4% (52/109), 35.9% (38/105), 46.0% (46/100), 25.5% (25/96), 31.2% (22/69), and 28.3% (13/46), respectively (χ2CMH=6.76, P=0.009). Conclusion The annual rate of reported hospital delivery increased between 2007 and 2013, with a declining rate of skilled midwifery over the same period. Survival of neonates born to HIV-infected mothers in China has increased to nearly equivalent levels as those of developed countries.

Objective To examine the changing antimicrobial resistance profile of Enterobacter spp.isolates in 53 hospitals across China from 2015 t0 2021.Methods The clinical isolates of Enterobacter spp.were collected from 53 hospitals across China during 2015-2021 and tested for antimicrobial susceptibility using Kirby-Bauer method or automated testing systems according to the CHINET unified protocol.The results were interpreted according to the breakpoints issued by the Clinical & Laboratory Standards Institute(CLSI)in 2021(M100 31st edition)and analyzed with WHONET 5.6 software.Results A total of 37 966 Enterobacter strains were isolated from 2015 to 2021.The proportion of Enterobacter isolates among all clinical isolates showed a fluctuating trend over the 7-year period,overall 2.5％in all clinical isolates amd 5.7％in Enterobacterale strains.The most frequently isolated Enterobacter species was Enterobacter cloacae,accounting for 93.7％(35 571/37 966).The strains were mainly isolated from respiratory specimens(44.4±4.6)％,followed by secretions/pus(16.4±2.3)％and urine(16.0±0.9)％.The strains from respiratory samples decreased slightly,while those from sterile body fluids increased over the 7-year period.The Enterobacter strains were mainly isolated from inpatients(92.9％),and only(7.1±0.8)％of the strains were isolated from outpatients and emergency patients.The patients in surgical wards contributed the highest number of isolates(24.4±2.9)％compared to the inpatients in any other departement.Overall,≤ 7.9％of the E.cloacae strains were resistant to amikacin,tigecycline,polymyxin B,imipenem or meropenem,while ≤5.6％of the Enterobacter asburiae strains were resistant to these antimicrobial agents.E.asburiae showed higher resistance rate to polymyxin B than E.cloacae(19.7％vs 3.9％).Overall,≤8.1％of the Enterobacter gergoviae strains were resistant to tigecycline,amikacin,meropenem,or imipenem,while 10.5％of these strains were resistant to polycolistin B.The overall prevalence of carbapenem-resistant Enterobacter was 10.0％over the 7-year period,but showing an upward trend.The resistance profiles of Enterobacter isolates varied with the department from which they were isolated and whether the patient is an adult or a child.The prevalence of carbapenem-resistant E.cloacae was the highest in the E.cloacae isolates from ICU patients.Conclusions The results of the CHINET Antimicrobial Resistance Surveillance Program indicate that the proportion of Enterobacter strains in all clinical isolates fluctuates slightly over the 7-year period from 2015 to 2021.The Enterobacter strains showed increasing resistance to multiple antimicrobial drugs,especially carbapenems over the 7-year period.