Objective To study the correlation between Periostin, interleukin-33 (IL-33), and chronic cough after thoracoscopic lobectomy in patients with coronary artery bypass grafting (CABG) combined with lung cancer. Methods A total of 102 lung cancer and coronary heart disease patients at Tianjin Chest Hospital from January 2022 to January 2024 were prospectively enrolled, and they were divided into a chronic cough group (n=42) and a non-chronic cough group (n=60) based on whether chronic cough occurred after surgery. Serum levels of Periostin and IL-33 were measured on the 1st, 7th, and 14th days post-lobectomy. The Pearson method was employed to analyze the correlation between Periostin and IL-33 levels and the severity of cough. Univariate and multivariate logistic regression analyses were conducted to identify factors influencing the occurrence of chronic cough. Additionally, receiver operating characteristic (ROC) curve analysis was utilized to assess the potential value of serum Periostin and IL-33 levels in predicting postoperative chronic cough. Results In patients with chronic cough, the peripheral blood Periostin and IL-33 levels measured on days 7 and 14 were significantly higher than those in patients with non-chronic cough, and the interactions between the two groups and at different time points were significant (P<0.001). The degree of cough was positively correlated with the levels of Periostin and IL-33 on days 7 and 14 (P<0.05), but had no significant correlation with the levels on day 1 (P>0.05). In patients with lung cancer, after thoracoscopic lobectomy, Periostin [OR=1.619, 95%CI (1.295, 2.025)] and IL-33 [OR=1.831, 95%CI (1.216, 2.758)] on day 7 and Periostin [OR=1.952, 95%CI (1.306, 2.918)] and IL-33 [OR=1.742, 95%CI (1.166, 2.603)] on day 14 were identified as risk factors for chronic cough. ROC curve analysis showed that the sensitivity of Periostin on day 7 was 69.05%, the specificity was 71.67%, and the area under the curve (AUC) was 0.756 [95%CI (0.616, 0.893)]. The sensitivity of Periostin on day 14 increased to 71.43% and the specificity was 76.67%, AUC was 0.762 [95%CI (0.633, 0.898)]. At the same time, the critical value of IL-33 on day 7 was 45.03 pg/mL, the sensitivity and specificity were both 83.33%, the AUC was 0.884 [95%CI (0.789, 0.980)], and the critical value of IL-33 on day 14 was 56.01 pg/mL, the sensitivity was 85.71%, the specificity was 80.00%, and the AUC was 0.899 [95%CI (0.799, 0.999)]. Joint logistic regression analysis of Periostin and IL-33 levels on days 7 and 14 showed showed that the sensitivity was 95.24%, the specificity was 95.00%, and the AUC reached 0.993 [95%CI (0.979, 1.000)]. Conclusion Periostin and IL-33 levels, measured at various time points, are abnormally elevated following thoracoscopic lobectomy in patients with combined CABG and lung cancer. These levels significantly correlate with cough severity. Given their predictive potential for chronic cough, these markers are deemed valuable biomarkers.

Objective: Fibromyalgia syndrome (FMS) is a chronic pain condition characterized by central sensitivity to pain, and it is universally acknowledged as a recalcitrant disease. A single-blind randomized controlled trial was conducted to assess the effectiveness and safety of the Roujin formula in treating FMS patients with liver depression and spleen deficiency syndrome, aiming to provide more scientific and effective treatment options. Methods: Forty-eight eligible participants were enrolled and randomly assigned to either the Roujin formula group (n = 24) or the placebo group (n = 24). The Roujin formula group received 150 mL of the Roujin formula twice daily, whereas the placebo group was given a tenth of the Roujin formula dosage, twice daily. The treatment lasted for 8 weeks, with a follow-up extending to 12 weeks. The primary outcome was the improvement in the pain Visual Analogue Scale (VAS) score, whereas secondary outcomes included enhancements in the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-II (BDI-II), Revised Fibromyalgia Impact Questionnaire (FIQR), and 36-item Short-Form Health Survey (SF-36) scores. These measures were assessed at baseline and after 4, 8, and 12 weeks. The Patients’ Global Impression of Change (PGIC) was collected at week 12. Safety assessments were based on routine blood tests, urine tests, and liver and kidney function evaluations. Results: The improvement in the pain VAS score was significantly greater in the Roujin formula group than that in the placebo group at the 4-, 8-, and 12-week follow-ups (p < 0.05). At the 8-week treatment and the 12-week follow-up, improvements in PSQI and FIQR scores were also superior in the Roujin formula group compared with the placebo group (p < 0.05). There were no differences between the 2 groups in the improvement of BDI-II scores, SF-36 physical component summary, and mental component summary scores at any observation time points. At the 12-week follow-up, PGIC ratings were significantly better in the Roujin formula group (p < 0.05). There were 4 adverse events, all of which occurred in the Roujin formula group, including 3 cases of diarrhea and 1 case of stomach pain; no serious adverse events were reported during the study. Conclusion: The Roujin formula can effectively enhance the overall condition of FMS patients, relieve pain, improve sleep quality, and elevate physical and mental well-being. Only mild gastrointestinal reactions were observed. The Roujin formula may be a viable candidate for clinical implementation.

Objective: Fibromyalgia syndrome (FMS) is a chronic pain condition characterized by central sensitivity to pain, and it is universally acknowledged as a recalcitrant disease. A single-blind randomized controlled trial was conducted to assess the effectiveness and safety of the Roujin formula in treating FMS patients with liver depression and spleen deficiency syndrome, aiming to provide more scientific and effective treatment options. Methods: Forty-eight eligible participants were enrolled and randomly assigned to either the Roujin formula group (n = 24) or the placebo group (n = 24). The Roujin formula group received 150 mL of the Roujin formula twice daily, whereas the placebo group was given a tenth of the Roujin formula dosage, twice daily. The treatment lasted for 8 weeks, with a follow-up extending to 12 weeks. The primary outcome was the improvement in the pain Visual Analogue Scale (VAS) score, whereas secondary outcomes included enhancements in the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-II (BDI-II), Revised Fibromyalgia Impact Questionnaire (FIQR), and 36-item Short-Form Health Survey (SF-36) scores. These measures were assessed at baseline and after 4, 8, and 12 weeks. The Patients’ Global Impression of Change (PGIC) was collected at week 12. Safety assessments were based on routine blood tests, urine tests, and liver and kidney function evaluations. Results: The improvement in the pain VAS score was significantly greater in the Roujin formula group than that in the placebo group at the 4-, 8-, and 12-week follow-ups (p < 0.05). At the 8-week treatment and the 12-week follow-up, improvements in PSQI and FIQR scores were also superior in the Roujin formula group compared with the placebo group (p < 0.05). There were no differences between the 2 groups in the improvement of BDI-II scores, SF-36 physical component summary, and mental component summary scores at any observation time points. At the 12-week follow-up, PGIC ratings were significantly better in the Roujin formula group (p < 0.05). There were 4 adverse events, all of which occurred in the Roujin formula group, including 3 cases of diarrhea and 1 case of stomach pain; no serious adverse events were reported during the study. Conclusion: The Roujin formula can effectively enhance the overall condition of FMS patients, relieve pain, improve sleep quality, and elevate physical and mental well-being. Only mild gastrointestinal reactions were observed. The Roujin formula may be a viable candidate for clinical implementation.

Objective: Fibromyalgia syndrome (FMS) is a chronic pain condition characterized by central sensitivity to pain, and it is universally acknowledged as a recalcitrant disease. A single-blind randomized controlled trial was conducted to assess the effectiveness and safety of the Roujin formula in treating FMS patients with liver depression and spleen deficiency syndrome, aiming to provide more scientific and effective treatment options. Methods: Forty-eight eligible participants were enrolled and randomly assigned to either the Roujin formula group (n = 24) or the placebo group (n = 24). The Roujin formula group received 150 mL of the Roujin formula twice daily, whereas the placebo group was given a tenth of the Roujin formula dosage, twice daily. The treatment lasted for 8 weeks, with a follow-up extending to 12 weeks. The primary outcome was the improvement in the pain Visual Analogue Scale (VAS) score, whereas secondary outcomes included enhancements in the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory-II (BDI-II), Revised Fibromyalgia Impact Questionnaire (FIQR), and 36-item Short-Form Health Survey (SF-36) scores. These measures were assessed at baseline and after 4, 8, and 12 weeks. The Patients’ Global Impression of Change (PGIC) was collected at week 12. Safety assessments were based on routine blood tests, urine tests, and liver and kidney function evaluations. Results: The improvement in the pain VAS score was significantly greater in the Roujin formula group than that in the placebo group at the 4-, 8-, and 12-week follow-ups (p < 0.05). At the 8-week treatment and the 12-week follow-up, improvements in PSQI and FIQR scores were also superior in the Roujin formula group compared with the placebo group (p < 0.05). There were no differences between the 2 groups in the improvement of BDI-II scores, SF-36 physical component summary, and mental component summary scores at any observation time points. At the 12-week follow-up, PGIC ratings were significantly better in the Roujin formula group (p < 0.05). There were 4 adverse events, all of which occurred in the Roujin formula group, including 3 cases of diarrhea and 1 case of stomach pain; no serious adverse events were reported during the study. Conclusion: The Roujin formula can effectively enhance the overall condition of FMS patients, relieve pain, improve sleep quality, and elevate physical and mental well-being. Only mild gastrointestinal reactions were observed. The Roujin formula may be a viable candidate for clinical implementation.

Objective To summarize the changing prevalence of carbapenem resistance in Enterobacterales based on the data of CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021 for improving antimicrobial treatment in clinical practice.Methods Antimicrobial susceptibility testing was performed using a commercial automated susceptibility testing system according to the unified CHINET protocol.The results were interpreted according to the breakpoints of the Clinical & Laboratory Standards Institute(CLSI)M100 31st ed in 2021.Results Over the seven-year period(2015-2021),the overall prevalence of carbapenem-resistant Enterobacterales(CRE)was 9.43％(62 342/661 235).The prevalence of CRE strains in Klebsiella pneumoniae,Citrobacter freundii,and Enterobacter cloacae was 22.38％,9.73％,and 8.47％,respectively.The prevalence of CRE strains in Escherichia coli was 1.99％.A few CRE strains were also identified in Salmonella and Shigella.The CRE strains were mainly isolated from respiratory specimens(44.23±2.80)％,followed by blood(20.88±3.40)％and urine(18.40±3.45)％.Intensive care units(ICUs)were the major source of the CRE strains(27.43±5.20)％.CRE strains were resistant to all the β-lactam antibiotics tested and most non-β-lactam antimicrobial agents.The CRE strains were relatively susceptible to tigecycline and polymyxins with low resistance rates.Conclusions The prevalence of CRE strains was increasing from 2015 to 2021.CRE strains were highly resistant to most of the antibacterial drugs used in clinical practice.Clinicians should prescribe antimicrobial agents rationally.Hospitals should strengthen antibiotic stewardship in key clinical settings such as ICUs,and take effective infection control measures to curb CRE outbreak and epidemic in hospitals.

Objective To characterize the changing species distribution and antibiotic resistance profiles of respiratory isolates in hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Methods Commercial automated antimicrobial susceptibility testing systems and disk diffusion method were used to test the susceptibility of respiratory bacterial isolates to antimicrobial agents following the standardized technical protocol established by the CHINET program.Results A total of 589 746 respiratory isolates were collected from 2015 to 2021.Overall,82.6％of the isolates were Gram-negative bacteria and 17.4％were Gram-positive bacteria.The bacterial isolates from outpatients and inpatients accounted for(6.0±0.9)％and(94.0±0.1)％,respectively.The top microorganisms were Klebsiella spp.,Acinetobacter spp.,Pseudomonas aeruginosa,Staphylococcus aureus,Haemophilus spp.,Stenotrophomonas maltophilia,Escherichia coli,and Streptococcus pneumoniae.Each microorganism was isolated from significantly more males than from females(P＜0.05).The overall prevalence of methicillin-resistant S.aureus(MRSA)was 39.9％.The prevalence of penicillin-resistant S.pneumoniae was 1.4％.The prevalence of extended-spectrum β-lactamase(ESBL)-producing E.coli and K.pneumoniae was 67.8％and 41.3％,respectively.The overall prevalence of carbapenem-resistant E.coli,K.pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,and Acinetobacter baumannii was 3.7％,20.8％,9.4％,29.8％,and 73.3％,respectively.The prevalence of β-lactamase was 96.1％in Moraxella catarrhalis and 60.0％in Haemophilus influenzae.The H.influenzae isolates from children(＜18 years)showed significantly higher resistance rates to β-lactam antibiotics than the isolates from adults(P＜0.05).Conclusions Gram-negative bacteria are still predominant in respiratory isolates associated with serious antibiotic resistance.Antimicrobial resistance surveillance should be strengthened in clinical practice to support accurate etiological diagnosis and appropriate antimicrobial therapy based on antimicrobial susceptibility testing results.

Objective To analyze the direct economic burden caused by surgical site infection(SSI)in orthopedics and joint surgery,and provide evidence-based support for intervention measures.Methods 3 348 hospitalized pa-tients in the department of orthopedics and joint surgery of a hospital from July 2021 to July 2023 were selected.They were divided into an infection group and a control group based on whether they had SSI.The propensity score matching(PSM)method was adopted to match the two groups of patients in a 1∶1 ratio.The length of hospital stay and various hospitalization expenses between patients with different types of SSI and control group were compared.Results Among 3 348 hospitalized patients,259 had SSI,with an incidence of 7.74％.Superficial incisional wound infection had the highest number of patients(n=177,68.34％),followed by deep incisional wound infection(n=65,25.10％),organ/space infection had the lowest number of patients(n=17,6.56％).After PSM matching,257 pairs were successfully matched,with a matching rate of 99.23％.Infection group extended length of hospital stay by 18 days compared with the control group(P＜0.001).The total hospitalization expenses and individual hos-pitalization expenses of infection group were all higher than those of the control group(all P＜0.001).Among the various expenses,difference in drug expense was the largest,with an increase of 5 067.83 Yuan in Western medi-cine(P＜0.001)and 957.30 Yuan in antimicrobial agents(P＜0.001).Patients with different types of SSI all had longer hospital stay compared with the control group.Patients with deep incisional wound infection,superficial inci-sional wound infection,and organ/space infection had an extended hospital stay of 26,18,and 13 days,respectively(all P＜0.05).The total hospitalization expenses,Western medicine expenses,and antimicrobial agent expenses of patients with different types of SSI were all higher than those of the control group(all P＜0.05).Conclusion The occurrence of postoperative SSI in patients in the department of orthopedics and joint surgery can prolong the length of hospital stay,resulting in huge economic losses for the patient and the hospital.Effective control of healthcare-associated infection is of great significance for optimizing medical resources,improving medical quality,and ensuring patient safety.

Immunometabolism studies focus on the relationships between immune cell functions and cellular energy metabolism pathways.Immunometabolism plays an important regulatory role in immune-related diseases.Mycobacterium tuberculosis(M.tb),an important intracellular pathogenic bacterium,enters alveolar macrophages after infection.The confrontation between M.tb and the host is a complex and dynamic process involving multiple aspects and mechanisms,such as the immune response,granuloma formation,and immune evasion.M.tb effector proteins play key roles in maintaining bacterial virulence and regulating host cell metabolism.This article reviews the reprogramming process of glucose metabolism,lipid metabolism,and immunometabolism,as well as changes in mi-tochondrial function in M.tb-infected host cells,thereby revealing the relationship between M.tb pathogenicity and host metabolic regu-lation,which is important for understanding tuberculosis.

Objective To investigate the distribution and antimicrobial resistance profiles of common pathogens isolated from cerebrospinal fluid(CSF)in CHINET program from 2015 to 2021.Methods The bacterial strains isolated from CSF were identified in accordance with clinical microbiology practice standards.Antimicrobial susceptibility test was conducted using Kirby-Bauer method and automated systems per the unified CHINET protocol.Results A total of 14 014 bacterial strains were isolated from CSF samples from 2015 to 2021,including the strains isolated from inpatients(95.3％)and from outpatient and emergency care patients(4.7％).Overall,19.6％of the isolates were from children and 80.4％were from adults.Gram-positive and Gram-negative bacteria accounted for 68.0％and 32.0％,respectively.Coagulase negative Staphylococcus accounted for 73.0％of the total Gram-positive bacterial isolates.The prevalence of MRSA was 38.2％in children and 45.6％in adults.The prevalence of MRCNS was 67.6％in adults and 69.5％in children.A small number of vancomycin-resistant Enterococcus faecium(2.2％)and linezolid-resistant Enterococcus faecalis(3.1％)were isolated from adult patients.The resistance rates of Escherichia coli and Klebsiella pneumoniae to ceftriaxone were 52.2％and 76.4％in children,70.5％and 63.5％in adults.The prevalence of carbapenem-resistant E.coli and K.pneumoniae(CRKP)was 1.3％and 47.7％in children,6.4％and 47.9％in adults.The prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)and Pseudomonas aeruginosa(CRPA)was 74.0％and 37.1％in children,81.7％and 39.9％in adults.Conclusions The data derived from antimicrobial resistance surveillance are crucial for clinicians to make evidence-based decisions regarding antibiotic therapy.Attention should be paid to the Gram-negative bacteria,especially CRKP and CRAB in central nervous system(CNS)infections.Ongoing antimicrobial resistance surveillance is helpful for optimizing antibiotic use in CNS infections.

Objective To investigate the antimicrobial resistance of clinical isolates from elderly patients(≥65 years)in major medical institutions across China.Methods Bacterial strains were isolated from elderly patients in 52 hospitals participating in the CHINET Antimicrobial Resistance Surveillance Program during the period from 2015 to 2021.Antimicrobial susceptibility test was carried out by disk diffusion method and automated systems according to the same CHINET protocol.The data were interpreted in accordance with the breakpoints recommended by the Clinical and Laboratory Standards Institute(CLSI)in 2021.Results A total of 514 715 nonduplicate clinical isolates were collected from elderly patients in 52 hospitals from January 1,2015 to December 31,2021.The number of isolates accounted for 34.3％of the total number of clinical isolates from all patients.Overall,21.8％of the 514 715 strains were gram-positive bacteria,and 78.2％were gram-negative bacteria.Majority(90.9％)of the strains were isolated from inpatients.About 42.9％of the strains were isolated from respiratory specimens,and 22.9％were isolated from urine.More than half(60.7％)of the strains were isolated from male patients,and 39.3％isolated from females.About 51.1％of the strains were isolated from patients aged 65-＜75 years.The prevalence of methicillin-resistant strains(MRSA)was 38.8％in 32 190 strains of Staphylococcus aureus.No vancomycin-or linezolid-resistant strains were found.The resistance rate of E.faecalis to most antibiotics was significantly lower than that of Enterococcus faecium,but a few vancomycin-resistant strains(0.2％,1.5％)and linezolid-resistant strains(3.4％,0.3％)were found in E.faecalis and E.faecium.The prevalence of penicillin-susceptible S.pneumoniae(PSSP),penicillin-intermediate S.pneumoniae(PISP),and penicillin-resistant S.pneumoniae(PRSP)was 94.3％,4.0％,and 1.7％in nonmeningitis S.pneumoniae isolates.The resistance rates of Klebsiella spp.(Klebsiella pneumoniae 93.2％)to imipenem and meropenem were 20.9％and 22.3％,respectively.Other Enterobacterales species were highly sensitive to carbapenem antibiotics.Only 1.7％-7.8％of other Enterobacterales strains were resistant to carbapenems.The resistance rates of Acinetobacter spp.(Acinetobacter baumannii 90.6％)to imipenem and meropenem were 68.4％and 70.6％respectively,while 28.5％and 24.3％of P.aeruginosa strains were resistant to imipenem and meropenem,respectively.Conclusions The number of clinical isolates from elderly patients is increasing year by year,especially in the 65-＜75 age group.Respiratory tract isolates were more prevalent in male elderly patients,and urinary tract isolates were more prevalent in female elderly patients.Klebsiella isolates were increasingly resistant to multiple antimicrobial agents,especially carbapenems.Antimicrobial resistance surveillance is helpful for accurate empirical antimicrobial therapy in elderly patients.