Objective To explore the postoperative recovery of the patients with glioma-related epilepsy and the possible risk factors for recurrence of epilepsy.Methods To collect clinical data of 89 patients with glioma-related epilepsy,we recorded Engle grade score of all patients underwent resection of tumor and seizure focus in a week,1,3 and 6 month after surgery Repeated measures ANOVA was used to analysis the difference within group.Kaplan-Meier method and Cox regression analysis were used to analysis seizure recurrence risk curve and the epileptic recurrence related factors,respectively.Results The postoperative recurrence rate was 26.97％ (24/89).Engle grade scores were 2.966±0.081.2.202±0.080,1.730±0.093 and 1.313±0.042 in a week,1,3 and 6 month after surgery.The difference was statistically significant (Ftime=96.076,P=0.000).Cox regression model showed that tumor accumulation site (RR =2.908,CI:1.083 ～7.806),postoperative edema formation (RR =4.769,CI:1.737 ～ 13.096),tumor relapse (RR=8.309,CI:3.379～20.432)were the important risk factors for recurrence epileptic seizures (all P＜ 0.05).Conclusions Surgical treatment can significantly reduce or even eliminate seizures postoperative and its long term efficacy is superior to short term efficacy.Appropriate measures should be taken to treat risk factors associated with recurrence epileptiform seizure to improve the prognosis of patients quality of life.

Objective To explore the down-regulation of advanced receptor for advanced glycation end products(RAGE)on expression of high mobility group protein B1(HMGB1)in glioma cells line and the volume change of transplanted tumor in nude mice. Methods HMGB1 expression in glioma LN229 cells line (divided into a control group and a study group) was observed by immunohistochemical assay and Western blot. The control group received normal saline,whereas the study group received RAGE receptor blocking agent FPS-ZM1. Expression of HMGB1 protein was detected by the same methods. The difference of the expression was examined by independent sample t test. 30 Nu/Nu nude mice were randomly divided into two groups;the above two kinds cell lines were injected into the same area of the left back of nude mice. Six weeks after injection ,the volume size was measured six times ,and the variance of repeated measurement data was used to analyze the difference of the volume change. Results HMGB1 protein was mainly expressed in the cytoplasm and nucleus. As compared with the control group,HMGB1 protein expression levels were decreased in the study group(P < 0.05),the growth rate of transplanted tumor in nude mice was significantly faster in the control group than in the study group ,the difference was statistically significant(P < 0.05). Conclusions The growth and invasion of HMGB1 protein may be involved in glioma by RAGE receptor. RAGE receptor blocker FPS-ZM1 can significantly reduce the expression of HMGB1 protein and inhibit the growth of transplanted tumor volume. It is expected to be used for the research on glioma cell apoptosis.

Objective To explore the expression of human sodium coupled neutral amino acid transporter 1 (SNAT1) in human glioma tissues and its relationship with clinical pathological parameters and prognosis. Methods Immu?nohistochemical and western blotting were used to detect SNAT1 expression in glioma tissue and tumor peripheral tissue from 89 cases of glioma patients including 55 cases of low grade gliomas (WHO I-II), and 34 cases of high grade gliomas (WHO grade III-IV).χ2 test and was used to analyze the relationship between expression and clinical pathological param?eters of SNAT1. Kaplan-Meier method was used to analyze the effect of different expression of SNAT1 on the prognosis of patients and to establish the Cox regression model. Results The expression of SNAT1 was significantly higher in gliomas than in tumor peripheral tissue (t=-9.803, P=0.001). The expression of SNAT1 was significantly higher in high pathologi?cal grade tissues than in low grade of glioma tissues (t=-6.682, P=0.003). SNAT1 expression was associated with tumor di?ameter and pathological grade (χ2=4.963, 8.527, P<0.05);Cox regression model showed that the tumor pathological grade and different SNAT1 protein expression were independent risk factors for the prognosis of patients with glioma. Conclu?sions The expression of SNAT1 protein is closely associated with the pathological grade of gliomas and the prognosis of the patients, which may be a new target to judge the biological characteristics and to evaluate the prognosis of gliomas.

Objective:To explore the risk factors of diabetic nephropathy(DN).Methods:From January 2016 to September 2019, the clinical data of 403 patients with type 2 diabetes in the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were analyzed retrospectively.Excluding other factors, they were divided into DM group (315 cases) and DN group(88 cases) according to whether or not they were complicated with DN.The age, course of disease, complications, monocyte to high-density lipoprotein cholesterol ratio(MHR) and other test data were included in the logistic regression model to analyze the independent risk factors of DN.Results:There were statistically significant differences in the course of ≥10 years[95 cases(30.16%) vs.37 cases(42.05%)], complicated with hypertension[141 cases(44.76%) vs.58 cases(65.91%)], insulin application[94 cases(29.84%) vs.39 cases(44.32%)], ACEI/ARB application[132 cases(41.90%) vs.62 cases(70.45%)], FBG[(7.38±2.45)mmol/L vs.(8.26±2.06)mmol/L], HbA1c≥7%[91 cases(28.89%) vs.36 cases(40.91%)], MHR[(10.30±4.38) vs.(17.10±7.18)] and HDL-C[(0.58±0.16)mmol/L vs.(0.52±0.17)mmol/L] between the two groups( t=4.41, 13.31, 6.52, 22.46, 3.08, 4.60, 11.02, 2.65, all P<0.05). Multivariate logistic regression analysis showed that hypertension( OR=2.06, 95% CI=1.36-2.76), HbA1c≥7%( OR=1.32, 95% CI=1.04-1.60), MHR≥11.78( OR=1.65, 95% CI=1.03-2.67) were independent risk factors for DN. Conclusion:Hypertension, HbA1c ≥7%, MHR ≥11.78 are independently correlated with DN, which provide a basis for clinical prognosis.

Objective:To explore the relationship between sex hormone binding globulin and glycolipid metabolism in patients with obese polycystic ovary syndrome.Methods:From April 2016 to April 2019, 114 patients with obese polycystic ovary syndrome in the Integrated Chinese and Western Medicine Hospital of Wenzhou were selected and divided into two groups according to the level of sex hormone binding globulin, including 66 cases in the low level group and 48 cases in the normal group.The blood glucose, blood lipid and sex hormone levels of the two groups were measured and the results were analyzed.Results:The levels of TC, TG, LDL-C and ApoB in the low level group[(2.32±0.97)mmol/L, (6.45±1.25)mmol/L, (3.57±1.01)mmol/L, (0.93±0.32)g/L] were significantly higher than those in the normal group[(1.87±0.89)mmol/L, (4.88±0.94)mmol/L, (3.12±0.88)mmol/L, (0.76±0.17)g/L]( t=2.477-7.322, all P<0.05). The level of ApoA in the low level group[(1.22±0.34)g/L] was significantly lower than that in the normal group[(1.58±0.47)g/L]( t=-4.748, P<0.05), while there was no statistically significant difference in HDL-C between the two groups[(1.45±0.31)mmol/L vs.(1.43±0.56)mmol/L, t=0.244, P>0.05]. The levels of FPG, HbA1C and FINS in the low level group[(5.53±1.45)mmol/L, (6.42±0.79)% and (18.71±5.46)mU/L] were significantly higher than those in the normal group[(5.09±0.76)mmol/L, (6.01±0.92)% and (15.49±4.98)mU/L]( t=2.136-3.225, all P<0.05), while there was no statistically significant difference in 2hPG between the two groups[(8.79±1.56)mmol/L vs.(8.32±1.84)mmol/L]( t=1.472, P>0.05). The incidence of insulin resistance in the low level group[54.55%(36/66)] was significantly higher than that in the normal group[35.42%(17/48)](χ 2=4.088, P<0.05). The level of T in the low level group[(61.45±21.44)ng/mL] was significantly higher than that in the normal group[(50.39±22.31)ng/mL]( t=2.673, P<0.05), while there were no statistically significant differences in FSH, LH, E 2 and PRL between the two groups( t=0.427-1.714, all P>0.05). Conclusion:The patients with low levels of sex hormone binding globulin are more likely to suffer from hyperglycemia and hyperlipidemia, and low levels of sex hormone binding globulin may be a risk factor for obese polycystic ovary syndrome.

Objective To understand the changing distribution and antimicrobial resistance profiles of Klebsiella strains in 52 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Antimicrobial susceptibility testing was carried out according to the unified CHINET protocol.The susceptibility results were interpreted according to the breakpoints in the Clinical & Laboratory Standards Institute(CLSI)M100 document.Results A total of 241,549 nonduplicate Klebsiella strains were isolated from 2015 to 2021,including Klebsiella pneumoniae(88.0％),Klebsiella aerogenes(5.8％),Klebsiella oxytoca(5.7％),and other Klebsiella species(0.6％).Klebsiella strains were mainly isolated from respiratory tract(48.49±5.32)％.Internal medicine(22.79±3.28)％,surgery(17.98±3.10)％,and ICU(14.03±1.39)％were the top 3 departments where Klebsiella strains were most frequently isolated.K.pneumoniae isolates showed higher resistance rate to most antimicrobial agents compared to other Klebsiella species.Klebsiella isolates maintained low resistance rates to tigecycline and polymyxin B.ESBLs-producing K.pneumoniae and K.oxytoca strains showed higher resistance rates to all the antimicrobial agents tested compared to the corresponding ESBLs-nonproducing strains.The K.pneumoniae and carbapenem-resistant K.pneumoniae(CRKP)strains isolated from ICU patients demonstrated higher resistance rates to majority of the antimicrobial agents tested than the strains isolated from non-ICU patients.The CRKP strains isolated from adult patients had higher resistance rates to most of the antimicrobial agents tested than the corresponding CRKP strains isolated from paediatric patients.Conclusions The prevalence of carbapenem-resistant strains in Klebsiella isolates increased greatly from 2015 to 2021.However,the Klebsiella isolates remained highly susceptible to tigecycline and polymyxin B.Antimicrobial resistance surveillance should still be strengthened for Klebsiella strains.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.

Objective To understand the distribution and changing resistance profiles of clinical isolates of Enterococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Enterococcus according to the unified protocol of CHINET program by automated systems,Kirby-Bauer method,or E-test strip.The results were interpreted according to the Clinical & Laboratory Standards Institute(CLSI)breakpoints in 2021.WHONET 5.6 software was used for statistical analysis.Results A total of 124 565 strains of Enterococcus were isolated during the 7-year period,mainly including Enterococcus faecalis(50.7％)and Enterococcus faecalis(41.5％).The strains were mainly isolated from urinary tract specimens(46.9％±2.6％),and primarily from the patients in the department of internal medicine,surgery and ICU.E.faecium and E.faecalis strains showed low level resistance rate to vancomycin,teicoplanin and linezolid(≤3.6％).The prevalence of vancomycin-resistant E.faecalis and E.faecium was 0.1％and 1.3％,respectively.The prevalence of linezolid-resistant E.faecalis increased from 0.7％in 2015 to 3.4％in 2021,while the prevalence of linezolid-resistant E.faecium was 0.3％.Conclusions The clinical isolates of Enterococcus were still highly susceptible to vancomycin,teicoplanin,and linezolid,evidenced by a low resistance rate.However,the prevalence of linezolid-resistant E.faecalis was increasing during the 7-year period.It is necessary to strengthen antimicrobial resistance surveillance to effectively identify the emergence of antibiotic-resistant bacteria and curb the spread of resistant pathogens.

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.

Objective To understand the changing distribution and antimicrobial resistance profiles of Proteus,Morganella and Providencia in hospitals across China from January 1,2015 to December 31,2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods Antimicrobial susceptibility testing was carried out following the unified CHINET protocol.The results were interpreted in accordance with the breakpoints in the 2021 Clinical & Laboratory Standards Institute(CLSI)M100(31 st Edition).Results A total of 32 433 Enterobacterales strains were isolated during the 7-year period,including 24 160 strains of Proteus,6 704 strains of Morganella,and 1 569 strains of Providencia.The overall number of these Enterobacterales isolates increased significantly over the 7-year period.The top 3 specimen source of these strains were urine,lower respiratory tract specimens,and wound secretions.Proteus,Morganella,and Providencia isolates showed lower resistance rates to amikacin,meropenem,cefoxitin,cefepime,cefoperazone-sulbactam,and piperacillin-tazobactam.For most of the antibiotics tested,less than 10％of the Proteus and Morganella strains were resistant,while less than 20％of the Providencia strains were resistant.The prevalence of carbapenem-resistant Enterobacterales(CRE)was 1.4％in Proteus isolates,1.9％in Morganella isolates,and 15.6％in Providencia isolates.Conclusions The overall number of clinical isolates of Proteus,Morganella and Providencia increased significantly in the 7-year period from 2015 to 2021.The prevalence of CRE strains also increased.More attention should be paid to antimicrobial resistance surveillance and rational antibiotic use so as to prevent the emergence and increase of antimicrobial resistance.