Objective? To?investigate?the?antimicrobial?resistance?and?beta-lactamase?production?profile?in?the?gram-negative?bacilli?isolated from urinary tract infections in the Second People's Hospital of Gansu Province during the period from 2014 to 2015. The results will provided to clinicians for better antimicrobial treatment. Methods? The?bacterial?isolates?were?identified?via?conventional?laboratory?tests?or?automatic?identification?systems?and?subjected?to?antimicrobial?susceptibility?testing?by?using?Kirby-Bauer?method.?Three-dimensional test was used to detect the enzymes conferring antimicrobial resistance. The susceptibility testing results were interpreted according to the CLSI breakpoints issued in 2012. Results A total of 987 gram-negative strains were isolated from urinary tract infections, including E. coli (51.6%, 509/987), Enterobacter (11.0%, 109/987), P. aeruginosa (10.5%, 104/987), K. pneumoniae (9.9%, 98/987), P. mirabilis (9.3%, 92/987), C. freundii (4.7%, 46/987), and other gram-negative bacilli (2.9%, 29/987). ESBLs were produced?in?494?(50.1?%)?of?the?987?strains?of?gram?negative?bacilli.?Preliminary?screening?test?identified?243?AmpC?beta-lactamases?producing?strains,?and?135?(13.7?%)?strains?were?confirmed?by?three-dimensional?test.?Both?ESBLs?and?Amps?beta-lactamases?were?produced in 16 (1.6%) strains. The prevalence of ESBLs-producing strains was 79.6% in E. coli, 34.6% in P. aeruginosa and 37.8% in K. pneumoniae?isolates.?Metallo-β-lactamase?or?KPC?beta-lactamase?was?not?identified.?The?antimicrobial?resistance?was?serious?in?gram-negative bacilli, which showed relatively low resistance rate to imipenem (0.02%), amikacin (10.6%), cefoperazone-sulbactam (23.8 %), and nitrofurantoin (25.2 %). E. coli prevalence of levofloxacin,?ciprofloxacin?resistance?respectively?were?89.8%,?91.8%. The gram-negative bacilli from urinary tract also showed various levels of resistance to cephalosporins. Conclusions The gram-negative bacilli isolated from urinary tract infections are mainly E. coli. The gram-negative isolates show high level antimicrobial resistance and high prevalence of beta-lactamases. Imipenem, amikacin, cefoperazone-sulbactam, and nitrofurantoin still have very high antibacterial activity against these isolates in vitro.

Objective:To observe the effects of electroacupuncture(EA)combined with Western medication on lower-limb motor function and blood circulation in patients with cerebral infarction-induced hemiplegia in the acute stage. Methods:One hundred eligible patients with acute ischemic stroke accompanied by lower-limb motor dysfunction were allocated to an observation group and a control group using the random number table method,with 50 cases in each group.The control group received routine Western medications for treatment,and the observation group received additional EA intervention.After 2-week and 4-week treatments,the improvement of lower-limb motor function was assessed using the Fugl-Meyer assessment scale for lower extremity(FMA-LE),and changes in the peak blood flow velocities of the posterior tibial(PT)and dorsalis pedis(DP)arteries on the affected side were detected using Doppler. Results:Three cases dropped out during the study,so there were 48 cases in the observation group and 49 in the control group collected for statistical analysis.The FMA-LE score and the peak blood flow velocities of PT and DP arteries increased after 2-week and 4-week treatments in both groups compared with the pre-treatment baseline(P<0.05).After 2-week treatments,the FMA-LE score and the peak blood flow velocities of PT and DP arteries showed no significant differences between the two groups(P>0.05).After 4-week treatments,compared with the control group,the FMA-LE score was higher(P<0.05),and the peak blood flow velocities of PT and DP arteries on the affected side were larger in the observation group(P<0.05). Conclusion:EA combined with Western medication can significantly improve the motor function and blood flow velocity of the affected lower limb in patients with acute cerebral infarction accompanied by hemiplegia.

Objective:To investigate the molecular mechanism of the disease based on the clinical characterization and genetic mutation analysis in a family with intellectual disability.Methods:The proband with intellectual disability was diagnosed at Luohe Central Hospital in December 2019. Peripheral blood samples were collected from four family members. Whole exome sequencing (WES) was used to screen the pathological mutations. Then the PCR and Sanger sequencing were used to verify the selected mutations and combine the relevant database to analyze variation loci.Results:We infer that the ARX c.1162 A>G was co-segregated with the phenotype of the family based on the results of WES. The results of sanger sequencing and WES are consistent. The mother of the proband is the carrier of the mutation. There is no mutation frequency reported in the healthy population. The mutation of the ARX c.1162A>G is harmful inferred by a variety of bioinformatics software. Combined with the phenotypic analysis of OMIM database, we infer the phenotype caused by the mutation is consistent with the patients in the family.Conclusion:The mutation of the ARX c.1162 A>G may be the cause of the intellectual disability in the family affected. And the variant has not been reported in China.

Objective:To explore the effect of nursing intervention based on leadership life cycle theory in patients with swallowing dysfunction after acoustic neuroma surgery.Methods:From February 2017 to March 2020, 100 patients with swallowing dysfunction after acoustic neuroma surgery in our hospital were selected as the research object. According to a random number table, a randomized controlled study was used to divide all patients into an observation group and a control group, 50 cases in each group. Patients in the control group received routine postoperative rehabilitation nursing, and the observation group adopted nursing intervention based on the leadership life cycle theory. After the intervention, the Water swallow test was used to evaluate the recovery of swallowing dysfunction in the two groups. A swallowing dysfunction rehabilitation training compliance questionnaire was used to evaluate rehabilitation compliance. The Swallowing Quality of Life scale (SWAL-QOL) was used to evaluate the quality of life of patients. At the same time the occurrence of aspiration pneumonia was recorded.Results:After the intervention, the result of drinking water test rating was better in the observation group compared the control group, the difference was statistically significant ( Uc=2.053, P <0.05). The participation in compliance, monitoring compliance and learning compliance scores were 16.94±2.46, 6.96±1.24, 5.66±2.11 in the observation group, significantly higher than in the control group (12.36±2.59, 4.80±1.20, 4.48±1.49), the difference was statistically significant ( t value was 9.058, 8.851, 3.236, P <0.05). After a one-month follow-up, the scores of psychological burden, eating time, appetite, swallowing symptom frequency, food choice, language communication, eating fear, mental health, social interaction, fatigue sleep were 8.06±1.39, 7.14±1.76, 10.92±1.79, 58.26±6.41, 6.38±1.81, 7.00±1.07, 15.82±2.41, 21.86±1.81, 16.80±1.81, 18.96±3.24, significantly higher than those of the control gorup (6.76±2.17, 4.80±1.83, 7.84±1.74, 37.30±5.07, 3.72±1.23, 4.98±1.33,12.06±2.97, 16.96±1.67, 11.00±1.76, 1.84±3.05), the differences were statistically significant ( t value was 6.945-18.142, P <0.05). The incidence of aspiration pneumonia in the observation group were 6.00% (3/50), lower than that in the control group 20.00% (10/50), the difference was statistically significant ( χ2 value was 4.332, P<0.05). Conclusions:Nursing intervention based on the leadership life cycle theory is beneficial to promote the recovery of swallowing dysfunction in patients with swallowing dysfunction after acoustic neuroma surgery, improve the compliance of rehabilitation training, improve the quality of life of patients, and reduce the occurrence of aspiration pneumonia.

Objective:To report a large family of epileptic seizures caused by DEPDC5 gene variation, and to conduct a clinical genetic analysis on a proband in this family with both DEPDC5 gene mutation and a de novo GABRA1 gene mutation. Methods:The medical records of a family suffering from epilepsy due to a newly identified DEPDC5 gene variant were compiled from cases admitted to Hebei General Hospital in January 2024. The relevant genetic detection was carried out by sampling the peripheral blood of the family members. The whole exome sequencing techniques were employed for the identification of pathogenic mutation sites in the proband. The next generation sequencing technology was utilized for other family members to identify disease-causing mutation sites associated with the clinical phenotype of patients, and these findings were confirmed using first-generation Sanger sequencing technology. Results:The proband, who experienced seizures in early childhood and harbored two gene mutation sites, exhibited an early onset age along with significant delays in both intellectual and motor development. The primary clinical manifestations included focal seizures, myoclonus, and tonic-clonic symptoms. When compared with other family members who had the onset of epilepsy during adolescence, carried only one mutation site, and had generalized epileptic seizures and mostly accompanied by attention deficit hyperactivity disorder, the proband showed obvious clinical heterogeneity. The results of whole exome sequencing indicated that the proband had both GABRA1 c.640C>T(p.Arg214Cys) and DEPDC5 c.4348A>T(p.Lys1450 *) mutations inherited from the father. The mutation inherited from the father was reported here for the first time and had not been reported before, with the paternal mutation traceable to the proband's grandfather, while the proband's mother and grandmother were found to be devoid of the mutation. In this family, 5 patients with similar seizure phenotype all had pathogenic mutations at the same locus of the DEPDC5 gene(c.4348A>T, p.Lys1450 *), and the remaining 3 patients with seizure symptoms were not tested. Conclusions:The DEPDC5 gene mutation is the cause of the disease in this family, and the c.4348A>T is the newly discovered mutation site. The proband carries the mutation sites of both GABRA1 gene and DEPDC5 gene. The clinical manifestations of proband are significantly heterogeneous compared with those of his family members.

Background: Long coronavirus disease 2019 (COVID-19) in recovered patients (RPs) is gradually recognized by more people. However, how long it will last and the underlining mechanism remains unclear. Methods: We conducted a prospective follow-up study to evaluate the long-term symptoms and clinical indices of RPs at one-year after discharge from Union Hospital, Wuhan, China between December 2020 to May 2021. We also performed the 16S rRNA sequencing of stool samples from RPs and healthy controls (HCs) and analyzed the correlation between the gut microbiota and long COVID-19. Results: In total, 187 RPs were enrolled, among them, 84 (44.9%) RPs reported long COVID-19 symptoms at one-year after discharge. The most common long-term symptoms were cardiopulmonary symptoms, including chest tightness after activity (39/187, 20.9%), palpitations on exercise (27/187, 14.4%), sputum (21/187, 11.2%), cough (15/187, 8.0%) and chest pain (13/187, 7.0%), followed by systemic symptoms including fatigue (34/187, 18.2%) and myalgia (20/187, 10.7%), and digestive symptoms including constipation (14/187, 7.5%), anorexia (13/187, 7.0%), and diarrhea (8/187, 4.3%). Sixty-six (35.9%) RPs presented either anxiety or depression (42/187 [22.8%] and 53/187 [28.8%] respectively), and the proportion of anxiety or depression in the long symptomatic group was significantly higher than that in the asymptomatic group (41/187 [50.6%] vs. 25/187 [24.3%]). Compared with the asymptomatic group, scores of all nine 36-Item Short Form General Health Survey domains were lower in the symptomatic group (all P < 0.05). One hundred thirty RPs and 32 HCs (non-severe acute respiratory syndrome coronavirus 2 infected subjects) performed fecal sample sequencing.Compared with HCs, symptomatic RPs had obvious gut microbiota dysbiosis including significantly reduced bacterial diversities and lower relative abundance of short-chain fatty acids (SCFAs)-producing salutary symbionts such as Eubacterium_hallii_group, Subdoligranulum, Ruminococcus, Dorea, Coprococcus, and Eubacterium_ventriosum_group. Meanwhile, the relative abundance of Eubacterium_hallii_group, Subdoligranulum, and Ruminococcus showed decreasing tendencies between HCs, the asymptomatic group, and the symptomatic group. Conclusion This study demonstrated the presence of long COVID-19 which correlates with gut microbiota dysbiosis in RPs at one-year after discharge, indicating gut microbiota may play an important role in long COVID-19.

Objective:To analyze the changes of fasting plasma glucose(FPG)level before and after menopause.Methods:Kailuan health checkup cohort was used to extract data of women aged≥18 years who participated in the first physical examination of Kailuan physical examination cohort and had menopausal age at the end of the seventh physical examination. A total of 3 749 women with 22 057 physical examination records were included in the analysis. Natural logarithmic transformation was applied to FPG, and a segmented linear mixed-effects model was used to analyze the changes in ln-transformed FPG before and after menopause. Additionally, an interaction analysis was performed to assess the multiplicative effect of baseline age and baseline body mass index(BMI)on ln-transformed FPG concerning pre- and post-menopausal periods.Results:The average age of the first physical examination for women in this study was (45.63±4.52)years, the median menopausal age was 51(50~53)years, and the median number of physical examinations was 6(5~7)times. The results of the piecewise linear mixed effect model showed that lnFPG increased from 1 year before menopause, with an average annual increase of 0.021 mmol/L, and continued to increase from menopause to 5 years after menopause, with an average annual increase of 0.007 mmol/L. LnFPG tended to be stable after 5 years of menopause. Baseline age could affect the changes of lnFPG before and after menopause, and there was a negative multiplicative interaction between baseline age ≥45 years and the time period from 6 years to 1 year before menopause( P=0.032). Women with baseline age ≥45 years had a higher average annual increase in lnFPG from 1 year before menopause to 5 years after menopause than women with baseline age <45 years( P<0.05). On lnFPG, there was a positive multiplicative interaction between baseline BMI and time segments around menopause. Compared to women with BMI <24.0 kg/m 2, obese women displayed more annual increase in lnFPG from 6 years to 1 year before menopause as well as from menopause to 5 years after menopause( P<0.05). Conclusions:Menopause has an adverse impact on FPG, with the most significant changes occurring within the period of one year before menopause and up to five years after menopause. Age and BMI significantly influence the changes in FPG before and after menopause.

Background: Most patients including health care workers (HCWs) survived the coronavirus disease 2019 (COVID-19), however, knowledge about the sequelae of COVID-19 after discharge remains limited. Methods: A prospectively observational 3-month follow-up study evaluated symptoms, dynamic changes of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) IgG and IgM, lung function, and high resolution computed tomography (HRCT) of survivors of COVID-19 after discharge at Wuhan Union Hospital, China. Results: Seventy-six survivors (55 females) with a mean age of 41.3 ± 13.8 years were enrolled, and 65 (86%) were HCWs. A total of 69 (91%) patients had returned to their original work at 3-months after discharge. Most of the survivors had symptoms including fever, sputum production, fatigue, diarrhea, dyspnea, cough, chest tightness on exertion and palpitations in the three months after discharge. The serum troponin-I levels during the acute illness showed high correlation with the symptom of fatigue after hospital discharge (r = 0.782; P = 0.008) and lymphopenia was correlated with the symptoms of chest tightness and palpitations on exertion of patients after hospital discharge (r = −0.285, P = 0.027; r = −0.363, P = 0.004, respectively). The mean values of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, total lung capacity and diffusion capacity were all normal (> 80% predicted) and lung HRCTs returned to normal in most of the patients (82%), however, 42% of survivors had mild pulmonary function abnormalities at 3-months after discharge. SARS-CoV-2 IgG turned negative in 11% (6 of 57 patients), 8% (4 of 52 patients) and 13% (7 of 55 patients), and SARS-CoV-2 IgM turned negative in 72% (41 of 57 patients), 85% (44 of 52 patients) and 87% (48 of 55 patients) at 1-month, 2-months and 3-months after discharge, respectively. Conclusion Infection by SARS-CoV-2 caused some mild impairments of survivors within the first three months of their discharge and the duration of SARS-CoV-2 antibody was limited, which indicates the necessity of long-term follow-up of survivors of COVID-19.

Objective To investigate whether autophagy can be induced by 1,4-benzoquinone (1,4BQ) in HL60 cells,as well as the role of reactive oxygen species (ROS)in induced autophagy.Methods In order to determine a suitable 1,4-BQ treatment concentration for autophagy detection in HL60 cells,the cell vitality were examined by CCK8 assay.Logarithmic-growth-phased cells were divided into control group,1,4-BQgroup(10μmol/L 1,4-BQ,24 h),NAC group (antioxidant n-acetyl cysteine,5mmol/L,24 h) and the 1,4-BQ+NAC group (5 mmol/L NAC were preincubated for 1h prior to the treatment with 10 μmol/L 1,4-BQ for 24 h).The autophagic acidic vesicle were inspected by acridine orange staining,LC3 were detected by immunofluorescence staining,and expressions of LC3 and Beclin1 were quantitatively detected by Western blot.Results The results from cell viability test indicated that 1,4-BQ exhibited a dose-dependent toxicity to HL60cells.Compared with control group.the cell viability in 20.0、40.0μmol/L concentration were decreased obviously,and the differences had statistical significance (P＜0.05).Compare with contrd group acidic vesicle,LC3II,LC3II/LC3I and Beclin1 protein expressions were increased in 1,4-BQ group,after both respectively 12.4％ and 27％,the differences had statistital significance.While 1,4-BQ+NAC group was observed that acidic vesicle,LC3 and Beclin1 protein level were markedly lower than 1,4-BQ group,after both decreased 12.6％ and 22.6％ respectively,both the difference were statistically significant (P＜0.05).Conclusion 1,4-BQ can induce autophagy in HL60 cells,the induction of autophagy is at least partly resulted from ROS.Antioxidant can effectively suppress the occurrence of induced autophagy.

Objective To investigate whether autophagy can be induced by 1,4-benzoquinone (1,4BQ) in HL60 cells,as well as the role of reactive oxygen species (ROS)in induced autophagy.Methods In order to determine a suitable 1,4-BQ treatment concentration for autophagy detection in HL60 cells,the cell vitality were examined by CCK8 assay.Logarithmic-growth-phased cells were divided into control group,1,4-BQgroup(10μmol/L 1,4-BQ,24 h),NAC group (antioxidant n-acetyl cysteine,5mmol/L,24 h) and the 1,4-BQ+NAC group (5 mmol/L NAC were preincubated for 1h prior to the treatment with 10 μmol/L 1,4-BQ for 24 h).The autophagic acidic vesicle were inspected by acridine orange staining,LC3 were detected by immunofluorescence staining,and expressions of LC3 and Beclin1 were quantitatively detected by Western blot.Results The results from cell viability test indicated that 1,4-BQ exhibited a dose-dependent toxicity to HL60cells.Compared with control group.the cell viability in 20.0、40.0μmol/L concentration were decreased obviously,and the differences had statistical significance (P＜0.05).Compare with contrd group acidic vesicle,LC3II,LC3II/LC3I and Beclin1 protein expressions were increased in 1,4-BQ group,after both respectively 12.4％ and 27％,the differences had statistital significance.While 1,4-BQ+NAC group was observed that acidic vesicle,LC3 and Beclin1 protein level were markedly lower than 1,4-BQ group,after both decreased 12.6％ and 22.6％ respectively,both the difference were statistically significant (P＜0.05).Conclusion 1,4-BQ can induce autophagy in HL60 cells,the induction of autophagy is at least partly resulted from ROS.Antioxidant can effectively suppress the occurrence of induced autophagy.