[Summary] The incidences of obesity and its associated diseases are increasing worldwide.Bariatric surgery leads to more sustainable weight loss and better glycemic control compared with conservative medical treatment. Potential mechanisms mediating the improvement in glycemic control after bariatric surgery include changes in the levels of food intake, gastrointestinal hormones, bile acids as well as intestinal bacterial flora.

Objective To analyze the resistance of Stenotrophomonas maltophilia to commonly used antibacterial drugs,and to investigate the existence status of 3 kinds of integron(Ⅰ,Ⅱand Ⅲ)and the carrying drug resistance gene cassettes so as to offer help for better preventing and controlling the infectious diseases caused by stenotrophomonas maltophilia in local place.Methods 51 strains of Stenotrophomonas maltophilia from clinical samples were collected and the minimum inhibitory concentration(MIC)of 17 kinds of antibacterial drugs to stenotrophomonas maltophilia was measured by the broth microdilution antifungal susceptibility test(Mi-AFST).3 kinds of integron(Ⅰ,Ⅱand Ⅲ)were amplified by PCR with primers designed according to registrated DNA se-quence in GenBank.The variable region products in the positive integron strains were amplified and performed the sequencing analy-sis.The homological comparison in the Genebank database was performed on the sequencing results for finding out what gene was included in variable domain of those integrons.Results (1)Among 51 strains of stenotrophomonas maltophilia,41 srains (80.39%) were collected from sputum samples,and the infected crowd was dominated by individuals aged over 60 years,38 strains accounted for 74.5%.In the department distribution,20 strains(39.22%)were collected from ICU,13 strains (25.49%)from the respiratory department and 6 strains(11 .76%)from the veteran cardres wards,which accounted for the larger proportion.(2)The drug suscep-tibility test demonstrated that stenotrophomonas maltophilia strains had the higher resistance to most of commonly used antibacteri-al drugs,some strains even showed the multi-drug resistance to over 9 kinds of antibacterial drugs.(3)The PCR gene amplification results showed that 7 strains (13.7%)were positive integronⅠ,while no strains containing integron Ⅱ or ⅢI were detected;the resistance genes carried in the variable region of integron I included the 5 kinds of aacA4,aadA1,catB8,dfrA17 and aphA15.Conclu-sion Stenotrophomonas maltophilias has relatively high resistance to majority of commonly used antibacterial drugs in clinic,and some strains show the muti-drug resitance.IntegronⅠis one of important factors for the multi-drug resistance of Stenotrophomonas maltophilias.

Objective:To identify the risk factors for postoperative complications in the patients with acute fatty liver during pregnancy.Methods:The medical records from patients with acute fatty liver during pregnancy admitted to the hospital from January 2016 to April 2023, including baseline characteristics, clinical symptoms, laboratory examinations, complications, etc. were collected.Patients were divided into postoperative complication group and non-postoperative complication group according to whether the patients developed postoperative complications, and logistic regression analysis was used to identify the risk factors for postoperative complications in the patients with acute fatty liver during pregnancy.Results:A total of 61 patients were included in this study, 26 patients developed postoperative complications, and the incidence was 43%. There were significant differences in the ratio of primigravida, ratio of jaundice, prothrombin time, activated partial thromboplastin time, alanine aminotransferase, total bilirubin, direct bilirubin, and serum creatinine concentrations between the two groups ( P<0.05). The results of logistic regression analysis showed that primigravida, prothrombin time and serum creatinine concentrations were risk factors for postoperative complications ( P<0.05). Conclusions:Primigravida, prothrombin time and serum creatinine concentrations are risk factors for postoperative complications in the patients with acute fatty liver during pregnancy.

Objective To explore the treatment effects and mechanism of Fangji Huangqi Xiaozhong Prescription in metabolic syndrome phenotype osteoarthritis(MS-OA)based on PPARγ/NF-κB signaling pathway.Methods SD rats were randomly divided into sham-operation group,OA group,MS-OA group,Western medicine group,and TCM high-and low-dasage groups.The modified Hulth method was used to make the OA model,and OA model was added with high-carbohydrate high-fat diet to make the MS-OA model.TCM high-and low-dosage groups were given 15.12,7.56 g/kg Fangji Huangqi Xiaozhong Prescription for gavage.The Western medicine group was given 16.2 mg/kg of losoprofen sodium by gavage,while the other groups were given physiological saline by gavage once a day for 6 consecutive weeks.Rat body mass was measured,biochemical detection of blood lipids and blood glucose was conducted,ELISA was used to detect the contents of serum TNF-α,IL-1β,IL-10 and leptin,morphological changes in cartilage tissue were observed using safranin O-fixed green and HE staining,immunohistochemical staining was used to detect expressions of Acan,ColⅩ,MMP13,TNF-α,IL-1β and PPARγ in cartilage tissue,Western blot was used to detected the expression of PPARγ,NF-κBp65 and p-NF-κBp65 protein in cartilage tissue.Results Compared with the sham-operation group,body mass and serum TC,TG,LDL-C,TNF-α,IL-1β and leptin of MS-OA group increased significantly(P<0.01),the contents of HDL-C and IL-10 decreased(P<0.01),cartilage tissue degeneration was significant,and the Mankin score increased(P<0.01),the expression of ColⅩ,MMP13,TNF-α,IL-1β,p-NF-κBp65 protein increased(P<0.05,P<0.01),and the expression of Acan and PPARγ protein decreased(P<0.01).Compared with the MS-OA group,the contents of serum TC,TG,LDL-C,TNF-α and leptin decreased in TCM high-dosage group(P<0.05,P<0.01),the content of IL-10 increased(P<0.05),the pathological damage of cartilage tissue improved,the Mankin score decreased(P<0.01),the expressions of ColⅩ,MMP13,TNF-α,IL-1β and p-NF-κBp65 protein in cartilage tissue decreased(P<0.05,P<0.01),and the protein expressions of Acan and PPARγ protein increased(P<0.01,P<0.05).Conclusion Fangji Huangqi Xiaozhong Prescription can improve lipid metabolism disorder,improve intra-articular inflammatory environment,balance cartilage metabolism,and delay cartilage degeneration in MS-OA rats.Its mechanism may be related to the regulation of PPARγ/NF-κB signaling pathway.

Objective:To explore the association between parental socioeconomic status (SES) and preschoolers’ consumption of sugar-sweetened beverages (SSB).Methods:In June 2018, all preschoolers from 15 kindergartens were selected from the jurisdiction of Education Commission in Dongcheng District of Beijing by using an equal-proportion stratified cluster sampling method in the study. A self-designed questionnaire was used to investigate the parents of preschoolers to obtain the basic information of preschoolers and parents, the consumption situation of preschoolers’ sugar-sweetened beverages and the perception of parents to SSB. A tatol of 3 217 preschoolers were finally included in the analysis. A generalized structural equation model was used to analyze the relationship between preschoolers' consumption of sugar-sweetened beverages and their parents' socioeconomic status and the mediating effect of their cognition of sugar-sweetened beverages. The size of mediating effect was estimated by using deviation correction non-parameter percentile Bootstrap method.Results:The age of 3 217 preschoolers was (4.23±0.67) years, of which 52.6% ( n=1 692) were boys, and 77.62% ( n=2 497) were SSB consumers. Among the parents of 3 217 preschoolers, fathers and mothers accounted for 24.90% ( n=801) and 75.10% ( n=2 416), and the M ( P25, P75) scores of SES were 66.7 (62.5, 69.5) and 69.5 (64.6, 71.4), respectively. The proportion of parents who took the initiative to learn about their children's consumption of SSB, lacked confidence in restricting preschooler's consumption of SSB and read nutrition labels before purchasing food was 74.08% ( n=2 383), 82.90% ( n=2 667) and 36.24% ( n=1 166), respectively. The generalized structural equation model showed that after adjusting for preschoolers’ gender, age, body mass index (BMI) of preschoolers and their parents, preschoolers’ consumption of SSB was negatively associated with their parents’ SES score [path coefficient (95% CI):-4.69×10 -2 (-6.56×10 -2,-2.69×10 -2) ]. The mediating effect of parents’ perception of SSB consumption could explain 48.71% of the total effect [path coefficient (95% CI):-2.28×10 -2 (-3.54×10 -2, -1.10×10 -2)]. Conclusion:The consumption of SSB in preschoolers is negatively associated with their parent’s SES, and this relationship is partially mediated by parent’s perception of SSB consumption.

Objective:To explore the association between parental socioeconomic status (SES) and preschoolers’ consumption of sugar-sweetened beverages (SSB).Methods:In June 2018, all preschoolers from 15 kindergartens were selected from the jurisdiction of Education Commission in Dongcheng District of Beijing by using an equal-proportion stratified cluster sampling method in the study. A self-designed questionnaire was used to investigate the parents of preschoolers to obtain the basic information of preschoolers and parents, the consumption situation of preschoolers’ sugar-sweetened beverages and the perception of parents to SSB. A tatol of 3 217 preschoolers were finally included in the analysis. A generalized structural equation model was used to analyze the relationship between preschoolers' consumption of sugar-sweetened beverages and their parents' socioeconomic status and the mediating effect of their cognition of sugar-sweetened beverages. The size of mediating effect was estimated by using deviation correction non-parameter percentile Bootstrap method.Results:The age of 3 217 preschoolers was (4.23±0.67) years, of which 52.6% ( n=1 692) were boys, and 77.62% ( n=2 497) were SSB consumers. Among the parents of 3 217 preschoolers, fathers and mothers accounted for 24.90% ( n=801) and 75.10% ( n=2 416), and the M ( P25, P75) scores of SES were 66.7 (62.5, 69.5) and 69.5 (64.6, 71.4), respectively. The proportion of parents who took the initiative to learn about their children's consumption of SSB, lacked confidence in restricting preschooler's consumption of SSB and read nutrition labels before purchasing food was 74.08% ( n=2 383), 82.90% ( n=2 667) and 36.24% ( n=1 166), respectively. The generalized structural equation model showed that after adjusting for preschoolers’ gender, age, body mass index (BMI) of preschoolers and their parents, preschoolers’ consumption of SSB was negatively associated with their parents’ SES score [path coefficient (95% CI):-4.69×10 -2 (-6.56×10 -2,-2.69×10 -2) ]. The mediating effect of parents’ perception of SSB consumption could explain 48.71% of the total effect [path coefficient (95% CI):-2.28×10 -2 (-3.54×10 -2, -1.10×10 -2)]. Conclusion:The consumption of SSB in preschoolers is negatively associated with their parent’s SES, and this relationship is partially mediated by parent’s perception of SSB consumption.

Objective: To investigate the relationship between the expression of RNA-binding protein 38 (RBM38) and distant metastasis and prognosis of breast cancer. Methods: A total of 161 cases of breast cancer tissues were selected, and the expression of RBM38 was detected by immunohistochemical SP method. The relationship between the expression of RBM38 and the distant metastasis and prognosis of breast cancer patients were analyzed. Cox regression model was applied to analyze the influence factors of distant metastasis of breast cancer. Results: Among the 161 breast cancer patients, high expression of RBM38 was observed in 85 cases and low expression was observed in 76 cases. Log rank test showed that the distant metastasis rate of RBM38 highly expressed group was significantly lower than that of RBM38 lowly expressed group (P=0.010), while the survival rate was significantly higher (P=0.009). Univariate Cox regression analysis showed that the pathological stage (P=0.001), axillary lymph node positive (P=0.001), and the expression of RBM38 (P=0.015) were dramatically related to the distant metastasis of breast cancer patients. Multivariate Cox regression analysis showed that positive axillary lymph node was an independent risk factor (RR=4.222, 95% CI: 1.235-14.432), and high expression of RBM38 was an independent protective factor (RR=0.328, 95% CI: 0.128-0.839) of distant metastasis of breast cancer patients. Conclusion High expression of RBM38 is positively related with low distant metastasis rate and good prognosis of breast cancer patients. Hence, high expression of RBM38 is an independent protective factor of distant metastasis.

ObjectiveTo assess the curative effects of Fangji Huangqi detumescence prescription （FHDP） on synovitis and polarization of synovial macrophages of knee osteoarthritis （KOA） model in rats induced by Hulth method. MethodThirty-six rats were randomly divided into sham operation group， model group， high-dose， medium-dose， and low-dose （29.16， 14.58， and 7.29 g·kg^-1） FHDP groups， and loxoprofen sodium （16.2 mg·kg^-1） group. KOA model in rats was induced by modified Hulth method. Six weeks after the operation， rats were given high， medium， and low concentrations of FHDP， normal saline （NS）， and loxoprofen sodium according to the group to intervene， and sacrificed after 2-week administration. Synovium and cartilage histopathological changes were observed after hematoxylin-eosin （HE） staining. Flow cytometry （FCM） and immunofluorescence （IF） test were used to evaluate the polarization of M1/M2 macrophages. Immunohistochemistry （IMC） and enzyme-linked immunosorbent assay （ELISA） were used to detect the related protein expression levels of macrophage polarization， such as interleukin-1β （IL-1β）， tumor necrosis factor-α （TNF-α）， interleukin-10 （IL-10）， and matrix metalloproteinase-13 （MMP-13） in joint tissues and serum. ResultCompared with the sham operation group， Krenn and Mankin scores in the model group were significantly increased （P<0.01）. Compared with the model group， Krenn score was decreased in all administration groups （P<0.05， P<0.01）， but there was no significant difference in Mankin score in any administration groups. Compared with the sham operation group， M1/mø （CD38⁺） ratio in the model group was significantly increased （P<0.01）， and M2/mø （CD206⁺） ratio in the model group was decreased （P<0.05）. Compared with the model group， M1/mø ratio in the high， medium， and low-dose FHDP groups was decreased （P<0.05， P<0.01）， but M2/mø ratio was increased in all administration groups （the difference had no statistical significance）. Compared with the sham operation group， M1/M2 ratio in the model group was significantly increased （P<0.01）. Compared with the model group， M1/M2 ratio in all FHDP groups was significantly decreased （P<0.01）， and M1/M2 ratio in the high and medium-dose FHDP groups was lower than that in the loxoprofen sodium group （P<0.05）. Compared with the sham operation group， the levels of TNF-α， IL-1β， and MMP-13 in synovium and cartilage of the model group were significantly increased （P<0.01）， the level of IL-10 was significantly decreased （P<0.01）. Compared with the model group， the levels of TNF-α and IL-1β in synovium were decreased in all administration groups （P<0.05）， but the difference of the levels of MMP-13 and IL-10 in synovium had no statistical significance. The level of inflammatory mediators in cartilage was not affected in all administration groups. Compared with the sham operation group， the levels of TNF-α and IL-β in serum of the model group were significantly increased （P<0.01）， the level of IL-10 was decreased （P<0.05）. Compared with the model group， the level of TNF-α in the high-dose FHDP group was decreased （P<0.05）， and the level of IL-10 was increased in all administration groups （P<0.05， P<0.01）. The difference of the level of IL-β in all administration groups had no statistical significance. ConclusionFHDP attenuated the synovitis of KOA rats. FHDP exert the effect on the releasing of proinflammatory cytokines and MMP by inhibiting the polarization of M1 macrophages in synovium， and had no significant effect on the polarization of M2 macrophages. Modulating the imbalanced polarization of synovial macrophages was a possible mechanism of FHDP on attenuating synovitis and treating KOA.