Objective To monitor Staphylococcus infection in a hospital,and trace the source of Staphylococcus isolated from infectious wound-related hospital environment by molecular analysis. Methods By combination of fluorescence quanti-tative polymerase chain reaction (FQ-PCR)and culture method,environmental specimens related to 5 patients with wound infection were taken and performed multilocus sequence and MecA gene typing analysis. Results A total of 71 environmen-tal specimens were taken,Staphylococcus accounted for 36.62% (n= 26),88.46% (23/26 )of which were MecA+ methi-cillin-resistant strains. 77.78% (7/9)of Staphylococcus aureus (S. aureus)and 95.00% (19/20)of coagulase negative Staphylococcus (CNS)were methicillin-resistant strains. Multilocus sequence analysis revealed that ST239 (n= 6)was the most common sequence type in S. aureus;Staphylococcal cassette chromosome mec (SCCmec)analysis showed that the ma-jor type of S. aureus was typeⅢ,and CNS were typeⅢandⅣ. Conclusion Staphylococcus is common in healthcare-associated infection,and most Staphylococcus are multidrug-resistant,continuous monitor on drug-resistant Staph-ylococcus is necessary,and risk of Staphylococcus variant to medical institutes need to be paid attention.

Objective To investigate the clinical features,early diagnosis and individualized treatment of renal hypophosphatemia and osteomalacia induced by adefovir dipivoxil (ADV) in patients with chronic hepatitis B (CHB).Methods Thirty-nine CHB or hepatitis B virus (HBV)-related cirrhosis patients of renal hypophosphatemia and osteomalacia induced by ADV were consecutively collected.The clinical features were analyzed and treatment outcome was followed up.Results The mean age of the 39 patients was 54 (27-71) years old.There were 26 male and 13 female patients,and 19 patients with cirrhosis.The mean ADV treatment duration was 69 (range 18-116) months,and 31 patients were treated for 36-96 months.The mean serum phosphate was 0.68 (0.42-0.79) mmol/L.Twenty-six cases developed renal hypophosphatemic osteomaolacia,of which 14 had bone pain and 19 had abnormally elevated alkaline phosphatase (ALP).Three patients had increased serum creatinine and 24 patients had decreased estimated glomerular filtration rate (eGFR).After individualized treatment,patients gained normal serum phosphate in mean of 2.0 (range 0.5-6.0) months,and had bone pain remission in the mean of 0.8 (range 0.2-1.0) month and bone pain disappeared in the mean of 1.5 (range 0.5-5.0) months.Function indices of liver and kidney were improved gradually,and the bone mineral density examination improved slowly.Conclusions CHB and HBV-related cirrhosis patients treated with longterm ADV could develop renal hypophosphatemia and hypophosphatemic osteomalacia,which is partially reversible.Monitoring serum phosphate,creatinine and cystatin C is necessary during long-term ADV therapy.After confirmed diagnosis,withdrawal or dosage reduction of ADV,and switch to telbivudine or entecavir should be considered.Meanwhile,serum phosphate and HBV DNA level should be monitored.

Objective To investigate the anti-fatigue activity of fermented grain-containing blueberry anthocyanins ( LANHE,LH) in mice.Methods Experiments were conducted in two phases .In the first phase , forty mice were randomly divided into four groups:control group(distilled water,dw) and three LH administration groups (8.75,17.5 and 35.08 ml/kg body mass).In the second phase, mice were randomly divided into two groups:high-dose LH group (35.08 ml/kg body mass) and control group (dw 35.08 ml/kg body mass).After four weeks, a forced swimming test was performed and the biochemical parameters related to fatigue were examined .Results and Conclusion The administration groups showed a significant increase of swimming time to exhaustion compared with the control group , especially the high-dose group ( P<0.001).There was no significant change in the blood lactate between the two groups , but at 20 min after swimming, the lactic acid(LA) contents of the high-dose group were lower than in the control group (P>0.05).LH could significantly increase the liver glycogen contents and decrease the serum contents (P<0.05).These data indicate that LH has anti-fatigue activity and can elevate the exercise tolerance in mice .

Objective To evaluate individualized treatment of aseptic femoral nonunion after interlocking intramedullary nailing based on the morphology of each nonunion and nailing stability in each specific patient.Methods This study reviewed 108 patients who had been treated and followed up for more than one year for aseptic femoral nonunion following interlocking intramedullary nailing between February 2012 and February 2016.They were 89 men and 19 women,aged from 23 to 65 years (average,45.5 years).The classification and corresponding treatments were as follows:Type Ⅰ (15 cases),characterized by callus (+)/bone defect (-) and nailing stability (+),were treated by augmentation plating;Type Ⅱ (43 cases),characterized by callus (+)/bone defect (-) and nailing stability (-),were treated by exchange for larger nailing/larger nailing with poller screws;Type Ⅲ (23 cases),characterized by callus (-)/bone defect (+) and stability of nailing (+),were treated by augmentation plating with bone grafting;Type ⅣV (27 cases),characterized by callus (-)/bone defect (+) and stability of nailing(-),were treated by double plating and bone grafting.The healing of bone nonunion,complications and assessments for bone and function were followed up.Results All these patients received follow-up for 12 to 14 months (average,12.5 months).All the nonunions were healed with no postoperative complications.Bone healing was achieved after 4 to 8 months (average,5.5 months).The good to excellent rates for bone and function were 100％.Conclusion To achieve better surgical outcomes,the treatment of aseptic femoral nonunion after interlocking intramedullary nailing should be individualized according to the morphology of each nonunion and nailing stability in each specific patient.

Objective: To understand the knowledge of disinfection and its influencing factors among caregivers in childcare centers in Huangpu District, Shanghai, in order to provide a basis for the future development of targeted training programs and the work plan to enhance the professional level of disinfection practitioners in childcare centers. Methods: A total of 423 caregivers from 62 childcare centers (including nursery schools) in Huangpu District were selected for a questionnaire about disinfection knowledge, influencing factors, and training needs in March 2023. Differences in disinfection knowledge among subjects with different characteristics were compared using χ 2 tests, and influencing factors were analyzed using a multi factor binary Logistic regression model. Results: The overall knowledge rate of disinfection among caregivers was 50.12%, and those in public kindergartens, private ones, and nursery schools were 51.35%, 46.18%, and 42.57%, respectively, with statistically significant differences ( χ 2=14.25, P < 0.05 ). The caregivers in the highest level kindergartens ( OR =4.50, 95% CI =1.97-10.29), in first level ones ( OR =4.29, 95% CI = 1.98-9.33), in the institutions had clusters of outbreaks ( OR =1.87, 95% CI =1.14-3.07), in which the number of children to caregivers ratio being less than 10∶1 ( OR =21.81, 95% CI =2.55-186.59), with 6-14 years of working experience ( OR =3.51, 95% CI = 1.59 -7.75) had better knowledge of disinfection( P <0.05). Conclusions Knowledge of disinfection among caregivers of childcare institutions is low in Huangpu District, Shanghai. Training of caregivers disinfection knowledge should be strengthened for caregivers with fewer years of experience, in childcare institutions, to improve caregivers disinfection expertise and skills.

At present, the routine specialized training for primary pediatricians (focusing on theoretical learning of public subjects) cannot meet the needs of primary pediatricians. In order to promote the development of children's medical care at the grassroots level and improve the quality, medical and clinical research abilities of regional pediatric medical personnel, the Children's Hospital of Chongqing Medical University has designed and built a "hierarchical training model for improving the professional ability of pediatricians" from the aspects of training objectives, training contents, training methods, construction and evaluation of training programs, and quality control. In addition, the 8-month "Pediatric Professional Basic Training" and the 9-month "Pediatric Professional Ability Improvement Training" were respectively carried out in Xianyang Children's Hospital. In the "Professional Basic Training", 88 trainees were comprehensively evaluated after training, 53 of whom were qualified or above. In the "Ability Improvement Training", 26 of the 29 students actually participated in the evaluation and reached the qualified level or above. Learners provided feedbacks that they have effectively improved their own knowledge structure, expanded their clinical diagnosis and treatment thinking and clinical research ideas, and provided some guidance for clinical work.

Objective:To investigate the role of TcpC, a virulence factor of uropathogenic Escherichia coli (UPEC), in immune evasion, and analyze its related pathogenic mechanism. Methods:C57BL/6 mice were injected with 10 9 colony-forming unit of wild-type (CFT073 wt) or tcpc gene-knockout (CFT073 Δ tcpc) UPEC CFT073 strains from urethra into bladder to construct a mouse model of pyelonephritis. These mice were sacrificed 5 d after infection and their kidneys were taken to observe the gross pathological changes. Hematoxylin-eosin staining was used to observe histopathological changes in kidney tissues and immunohistochemistry was performed to locate TcpC in kidney tissues. The bacterial loads in urine samples of UPEC infected-mice were counted by ten-fold dilution method, and the presence of tcpc gene in the genomic DNA of bacteria from CFT073-infected mouse kidney or urine samples was measured by PCR. The expression of TcpC at mRNA level was detected by qRT-PCR after infecting dendritic cells with CFT073 wt strains. The influences of UPEC infection on the activation of NF-κB signaling pathway and the secretion of proinflammatory factors by dendritic cells were analyzed by Western blot and ELISA, respectively. The viability of UPEC strains in dendritic cells were observed by laser confocal microscope. Results:Compared with the CFT073 Δ tcpc group, the mice in the CFT073 wt group had obvious abscess in the kidneys as well as massive neutrophil infiltration and abundant TcpC in kidney tissues. The bacterial loads in the urine of CFT073 wt-infected mice were significantly higher than those in the urine of CFT073 Δ tcpc mice. PCR results showed that tcpc gene was successfully amplified from mouse kidney and urine samples. Increased expression of TcpC at both mRNA and protein levels was detected in CFT073 wt-infected dendritic cells. CFT073 wt infection inhibited the phosphorylation of NF-κB p50 and the production of proinflammatory factors in dendritic cells. TcpC promoted the survival of CFT073 wt in dendritic cells. Conclusions:TcpC expression increases significantly during CFT073 wt infection or in mice with CFT073 wt-induced pyelonephritis. It promotes the survival of CFT073 wt in dendritic cells by inhibiting the activation of NF-κB signaling pathway and reducing the secretion of pro-inflammatory cytokines. TcpC is involved in the pathogenesis of UPEC and immune evasion.

Alveolar ridge preservation (ARP) has developed rapidly as a method for preserving the alveolar socket's bone volume after tooth extraction. ARP can create conditions for implant restoration, and reduce operation difficulties by decreasing alveolar ridge absorption. There are certain difficulties of ARP applicationin patients with tooth extracted due to periodontitis. This paper mainly introduces the characteristics of ARP, compares the similarities and differences among ARP, guided tissue regeneration, guided bone regeneration and immediate implant, and then summarizes their advantages and disadvantages. The paper focuses on the specificity of ARP and the progress of ARP application in patients with tooth extracted due to periodontitis, in order to offer direction for clinical application and future research on ARP.

Abstract Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

Non-conventional yeasts such as Yarrowia lipolytica, Pichia pastoris, Kluyveromyces marxianus, Rhodosporidium toruloides and Hansenula polymorpha have proven to be efficient cell factories in producing a variety of natural products due to their wide substrate utilization spectrum, strong tolerance to environmental stresses and other merits. With the development of synthetic biology and gene editing technology, metabolic engineering tools and strategies for non-conventional yeasts are expanding. This review introduces the physiological characteristics, tool development and current application of several representative non-conventional yeasts, and summarizes the metabolic engineering strategies commonly used in the improvement of natural products biosynthesis. We also discuss the strengths and weaknesses of non-conventional yeasts as natural products cell factories at current stage, and prospects future research and development trends.
Yeasts/genetics* ; Yarrowia/metabolism* ; Gene Editing ; Metabolic Engineering