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Objective This study was to understand the structure characteristics of prophages in the genome of Enterococcus hirae R17,and also to analyze their interaction relationships with the host bacterium.Methods The gene distribution and gene encoding characteristics of prophages in the genome of Enterococcus hirae R17 were identified using the PHAST software.The virulence gene,antimicrobial resistance genes,and environmental resistance genes in the prophages were also analyzed.Results Three prophages were found on the chromosome of Enterococcus hirae,including two incomplete prophage elements (Prophage-1 and Prophage-2) and one complete prophage (Prophage-3).Some function genes of bacteria were found in the sequence of three prophages,including nucleotide transportation and metabolism related genes.One incomplete prophage carrying erythromycin-and bacitracin-resistance genes was identified in the plasmid,which suggested that prophage induced gene horizontal transfer caused erythromycin-and bacitracin-resistance of Enterococcus hirae R17.Conclusion This study laid a solid foundation for the diversity analysis of prophages of Enterococcus hirae.Prophages played an important role in promotion of antimicrobial resistance of enterococci.Scientists should pay more attention to the spread of antimicrobial resistance and pathogenicity induced by prophages.

Enterococcus species are important opportunistic pathogens that are associated with nosocomial-and community-invasive infections. Currently, drug-resistant enterococcal isolates are challenging nosocomial Enterococci species with limited antimicrobial therapeutic options being available to treat these infections. Moreover, the ability of enterococci to act as reservoirs of antibiotic resistance genes within the food chain poses an important food safety risk. In this paper, we reviewed the new development of the pathogenicity and drug-resistance and its mechanism of Enterococcus species, and also drug-resistance of foodborne Enterococcus species spreading in human and livestock. And then, we proposed the ways to control and decrease the drug-resistance of foodborne Enterococcus species.

Objective:To understand the willingness of contracted residents to renew the family doctor contract service in Shandong Province, and to explore its influencing factors.Methods:From July to August 2020, 1 500 contracted residents in 3cities of Shandong Province were investigated by questionnaire survey.Descriptive statistical analysis, Mann-Whitney U test and binary logistic regression model were used to analyze the contracted residents′ cognition, utilization, satisfaction evaluation and renewal intention of family doctor contract service. Results:1 445 valid questionnaires were obtained, of which 682(47.2%)were willing to renew their contracts.The results of binary logistic regression analysis showed that marital status, educational level, time to see a doctor in contracted institutions, optimism about the development prospect of contracted service policy, whether the proportion of medical insurance reimbursement increased after signing the contract, whether follow-up work was carried out on time, satisfaction with family doctor service attitude and satisfaction with the effect of disease treatment were factors affecting the willingness of contracted residents to renew the contract.Conclusions:The contracted residents in Shandong Province have a high willingness to renew their contracts. On the basis of consolidating and improving the policy cognition and confidence of the contracted residents, we should actively optimize and improve the contracted service quality, ensure the sense of service access of contracted residents, and continuously and effectively realize the comprehensive promotion of the contracted services of family doctors.

Objective:To explore the current status of medical preventive integration at primary medical institutions, analyze the problems of medical prevention integration, and put forward optimization suggestions.Methods:From June to July 2020, 169 primary medical institutions in a city were selected as the survey objects to conduct a questionnaire survey on the basic information of institutions and the evaluation indicators of medical preventive integration. The evaluation index system of medical preventive integration was divided into a factual survey and a sensory survey. In addition, 32 relevant personnel were interviewed on the current situation of medical preventive integration at primary medical institutions. The reliability and validity of the data were tested and analyzed, while descriptive analysis and classification extraction analysis were carried out.Results:The reliability and validity analysis proved the data reliability. The factual survey extracted three common factors, namely organization management, performance appraisal distribution and information management. The sensory survey extracted two common factors, namely working mode and personnel training. In terms of organization, management and working methods, the degree of medical preventive integration was low. Among them, 53.8% of the institutions had formulated the medical preventive integration norms, and only 41.4% of them had shared residents′ health information in time.Conclusions:The degree of medical preventive integration of primary medical institutions in the city still need to be improved. In the future, we should strengthen the top-level design, establish the norms and cooperation mechanism of medical preventive integration, improve the awareness of medical preventive integration of medical personnel, improve the information level, and to build a new service model integrating disease prevention, medical treatment and health management.

Objective:To evaluate and analyze the patient experience of residents contracted with primary medical institutions, for providing a basis for improving quality of contracted family doctor services.Methods:Using the Chinese version of the primary care assessment tools(PCAT), a household survey was conducted on 1 400 contracted residents in 9 community health service centers and 9 township health centers in a city from May to June 2020, and their medical experience in primary medical institutions was statistically analyzed. At the same time, interviews were conducted with institutional managers and family doctors. Descriptive statistics and one-way ANOVA were used for data analysis.Results:1 333 valid questionnaires were collected, and the effective recovery rate was 95.2%.The total PCAT scoring was 25.17. Seven dimensions of first contact, continuous, coordination, comprehensiveness, patient and family centered, community-oriented and cultural competence scored in average 3.57, 3.68, 3.54, 3.40, 3.72, 3.67 and 3.59 respectively.372 people(47.1%) had not been referred by the contracted institution before going to the superior hospital or specialized hospital. There were significant differences in the scores of four core dimensions in different types of institutions, age, education level, occupation and income( P<0.001). Conclusions:Given the initial progress of contracted family doctor services in the city, there is still room for improvement. It is suggested to further improve the comprehensiveness, coordinationand accessibility of services, and promote the high-quality development of contracted family doctor services.

OBJECTIVE: To explore the mediating role of psychological capital in the sense of occupational mission and work engagement in preschool teachers.METHODS: A method of stratified cluster sampling was used to select 464 preschool teachers from 16 kindergartens in a city of Hubei Province. Occupational Mission Scale, Psychological Capital Questionnaire and Job Involvement Questionnaire were used to investigate their sense of occupational mission, psychological capital and job engagement. RESULTS: The total score of occupational mission was(48.6±6.9); the total score of psychological capital was(87.1±11.8); and the total score of work engagement was(79.8±11.4). Occupational mission was positively correlated with job engagement [correlation coefficient(r) was 0.607, P<0.01].The self-efficacy, hope, tenacity and optimism were positively correlated with job engagement(r were 0.526, 0.544, 0.573, 0.415, respectively, P<0.01). The mediating effect of psychological capital on occupational mission and work engagement was 0.15, accounting for 26.8% of the total effect. CONCLUSION: The sense of occupational mission can directly or indirectly promote job engagement. The psychological capital plays a mediating role between occupational mission and job engagement.

Objective: To monitor the antimicrobial resistance and drug-resistance genes of Yersinia enterocolitis, Y. intermedia and Y. frederiksenii recovered from retailed fresh poultry of 4 provinces of China. Methods: The susceptibility of 25 isolated Yersinia spp. to 14 classes and 25 kinds of antibiotics was determined by broth microdilution method according to CLSI (Clinical and Laboratory Standards Institute). The antibiotic resistance genes were predicted with antibiotic resistance genes database (ARDB) using whole genome sequences of Yersinia spp. Results: In all 22 Y. enterocolitis tested, 63.7% (14 isolates), 22.8% (5 isolates), 4.6% and 4.6% of 1 isolates exhibited the resistance to cefoxitin, ampicillin-sulbactam, nitrofurantoin and trimethoprim-sulfamethoxazole, respectively. All the 25 isolates were multi-drug resistant to more than 3 antibiotics, while 64.0% of isolates were resistant to more than 4 antibiotics. A few Y. enterocolitis isolates of this study were intermediate to ceftriaxone and ciprofloxacin. Most Yersinia spp. isolates contained antibiotic resistance genes mdtG, ksgA, bacA, blaA, rosAB and acrB, and 5 isolates recovered from fresh chicken also contained dfrA1, catB2 and ant3ia. Conclusion The multi-drug resistant Yersinia spp. isolated from retailed fresh poultry is very serious in the 4 provinces of China, and their contained many kinds of drug-resistance genes.

Objective: To obtain the serotype diversity and antimicrobial resistance of Salmonella isolates recovered from retail chicken carcasses for sale in six regions of China. Methods: From August 2010 to March 2012, each month 20 retail chicken carcasses including freshly slaughtered, chilled and frozen samples were collected from supermarkets and farmer's markets in 7 monitoring sites in Beijing, Jilin province, Inner Mongolia Autonomous, Shanxi province, Jiangsu province and Guangdong province, respectively. Samples were routinely collected for 12 months for each site. 1 680 chicken carcasses were collected in total and 2 629 Salmonella strains were isolated by PCR and biochemical method. Luminex xMAP method and classical slide agglutination method were carried out to determine isolates' serotypes. Minimal inhibitory concentrations (MICs) of 10 classes of antimicrobials including 14 agents were determined using broth micro-dilution method. Mocular methods were used to determine antimicrobial resistance genes of CIP-CTX-CT co-resistant isolates. Results: In all, 2 629 Salmonella isolates, there were 17 seorgroups and 58 serotypes, B and D1 were the dominant serogroups with rates of 34.7% (n=913) and 31.0% (n=815), Enteritidis (30.8%, n=810), Indiana (17.6%, n=463), Infantis (10.6%, n=278) were the top three serovars. We found 224 CIP-CTX co-resistant S. Indiana containing 3 colistin resistant strains, one of them carrying mcr-1 gene and being ESBLs positive, which demonstrated a nine multi drug resistance against 11 antimicrobials tested. Conclusion These data began to describe the complicated serovar diversity and heavy antimicrobial resistance of Salmonella isolates recovered from retail chicken carcasses in six regions of China. The findings highlight the emergence of ciprofloxacin and cefotaxime co-resistant S. Indiana and also a mcr-1 positive S. Indiana with heavy multi drug resistance.

ObjectiveTo study the pathway of cis-dichlorodiamineplatinum (DDP) inhibiting the synthesis of steroid hormones in mice, and to observe the intervention effect of dehydroepiandrosterone (DHEA).MethodsSixty adult ICR mice were randomly divided into three groups: control group, DDP modeling group, and DHEA group, with 10 male and 10 female mice in each group. The DDP modeling group mice were intraperitoneally injected with DDP solution at a dose of 2.5 mg·kg^-1·d^-1, once every 3 days, a total of 7 times. On the same day of modeling, the control group mice were injected with an equal amount of physiological saline intraperitoneally. The DEHA treatment group mice were treated with DDP and given a dose of 8.3 mg·kg^-1·d ^-1 of DHEA by gavage for 21 consecutive days. The changes of fatigue indexes of mice were observed by open field, grip and rod rotation tests. The morphology changes of adrenal gland, testicular and ovarian tissue were observed by pathological section and HE staining. The levels of serum steroid hormones were detected by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The mRNA and protein expression levels of the related genes of the hypothalamus, hypophysis, adrenal, testis and ovary were tested by real-time fluorescent quantitative PCR (RT-qPCR) and Western blotting.ResultsCompared with control group, both male and female mice in DDP modeling group were significantly losing weight (P＜0.05), their abilities in horizontal movement and vertical movement decreased (all P＜0.05), and the stay time and grip also significantly decreased (all P＜0.05) in female mice. Indexes of fatigue were improved after DHEA supplement (all P＜0.05). In the DDP modeling group, the arrangement of spermatogenic cells at all levels in the testicular tissue was disordered and the testicular interstitial edema was observed, and a large number of primordial follicles in the ovarian tissue were activated, the number of atresia follicles increased, and the number of granulosa cells in the follicles decreased; while in the DHEA group, the damaged phenotype of testicles and ovaries was significantly improved. Compared with control group, the levels of serum testosterone and dihydrotestosterone in both male and female DDP modeling mice significantly decreased (P＜0.01), the pregnenolone was down-regulated but corticosterone was up-regulated significantly (P＜0.05) in male mice, the corticosterone was down-regulated significantly (P＜0.05) in female mice. Compared with the DDP group, after DHEA supplement, the pregnenolone in male mice and the progesterone in female mice increased significantly (P＜0.05), but the pregnenolone in female mice and the progesterone in male mice decreased significantly (P＜0.05). Compared with control group, the expression levels of Cyp21a1 and Cyp11a1 genes in the adrenal gland and Gnrh gene in the hypothalamus of male and female mice in the DDP modeling group significantly decreased (all P＜0.05); the expression levels of Hsd3b2 gene in the adrenal gland, Star, Cyp11a1, and Lhr genes in the ovaries, Crh, Pomc, and Lhb genes in the hypothalamus, pituitary, and pituitary of female mice significantly decreased (all P＜0.05); the expression levels of Star gene and StAR protein in the testicles of male mice, as well as Fshb and Lhb genes in the pituitary gland, were significantly down-regulated (all P＜0.05). After DHEA supplement, compared with the DDP modeling group, the mRNA expression levels of Cyp17a1 in the adrenal gland of male mice and Cyp17a1, Lhr and Fshr genes in testis were down-regulated significantly (P＜0.05); the expression level of Cyp11a1 gene in the adrenal gland of female mice was also decreased (P＜0.05); while the expression levels of Hsd3b2 gene in the adrenal gland, Star, Cyp11a1, Hsd3b2 and Lhr gene in the ovary, and Lhb gene in the pituitary gland were all up-regulated ( P＜0.05).ConclusionThe function of hypothalamus-pituitary-adrenal/gonadal axis was inhibited by DDP intermittent injection, especially in female. Supplementation of DHEA can help regulate the homeostasis of steroid hormone levels.