Child ; Humans ; Plasma Exchange ; Thrombotic Microangiopathies ; therapy

Objective·To investigate the changes and distribution of thyroid transcription factor-1 (TTF1) expression around the puberty and to explore the position relationship among gonadotropin-releasing hormone (GnRH), KiSS1 and TTF1 expression in the hypothalamus of female SD rats. Methods?·?Female SD rats were divided into three groups: juvenile (JUV), early puberty (EP), and adult (AD). Tissue immunofluorescence staining was used to detect the expression of TTF1, KiSS1 and GnRH immunoreactive cells in the hypothalamus and the relative position among them. Real-time PCR was used to measure the expression of KiSS1, GnRH, TTF1 on mRNA levels in the hypothalamus, anteroventral periventricular nucleus (AVPV), and arcuate nucleus (ARC) respectively. Western blotting was performed to detect the changes in protein level of KiSS1 and TTF1. Results?·?TTF1 was densely expressed in hypothalamus nucleus AVPV, ARC and median eminence (ME) of female rats. GnRH,KiSS1 and TTF1 were adjacently expressed in ARC and ME. The mRNA level of TTF1 in the hypothalamus showed an upward trend after a slight decrease, while in AVPV and ARC tended to be consistent and showed an upward trend. The GnRH mRNA expression levels were significantly increased and reached the peak at AD. The mRNA expression levels of KiSS1 showed a sharp rise which was prior to the peak expression of GnRH mRNA at EP and then sustained the high level until AD. The protein expression level of TTF1 reached the peak at AD and the KiSS1 expression showed a sustained growth. Both of them showed an upward trend and basically consistent with the mRNA expression trend. Conclusion?·?Neuronal nuclei protein TTF1 mainly expressed in the nuclei AVPV, ARC, and ME of female rat hypothalamus. It was prominent in cells of ARC and ME which were localized GnRH, KiSS1, TTF1 positive neural cells. During the development of puberty onset, KiSS1 mRNA preceded GnRH mRNA to reach the peak at EP. The expression of TTF1 mRNA increased and reached a peak at AD, which was consistent with the overall increase of KiSS1 and GnRH expression. Protein expression of KiSS1 showed a corresponding upward trend together with their mRNA expression. TTF1 protein expression increased and peaked in AD.

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.